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17C-223 (28) BP 022-1302 76 MAPLE ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 17C-223-001 CITY OF NORTHAMPTON Permit: Alts Renovations Repair PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit# BP-2022-I302 PERMISSION IS HEREBY GRANT D TO: Project# 2022 PARSONS BLOCK RENO Contractor: License: Est. Cost: 50000 KEVIN NETTO 001317 Const.Class: Exp.Date: 10/02/2023 Use Group: Owner: LLC BLUE MOUNTAIN PROPERTIES, Lot Size (sq.ft.) Zoning: GB Applicant: KEVIN NETTO CONSTRUCTION INC Applicant Address Phone: Insurance: 90 Southampton Rd. (413)527-3168 WCC-500-5008057 WESTHAMPTON, MA 01027 ISSUED ON: 10/13/2022 • TO PERFORM THE FOLLOWING WORK: REPLACE WINDOWS ON 2ND FLOOR POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Service: Meter: Footings: Rough: Rough: House# Foundation: Final: Final: Final: Rough Frame: Gas: Fire Department Driveway Final: Fireplace/Chimney: Rough: Oil: Insulation: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIO ATION OF ANY OF ITS RULES AND REGULATIONS. Signature: I t Fees Paid: $350.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner Z—o File #BP-2022-1302 APPLICANT/CONTACT PERSON:KEVIN NETTO CONSTRUCTION INC 90 Southampton Rd.WESTHAMPTON, MA 01027(413)527-3168 PROPERTY LOCATION 76 MAPLE ST MAP:LOT 17C-223-001 ZONE THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Building Permit Filled out Fee Paid $350.00 Type of Construction: REPLACE WINDOWS ON 2ND FLOOR New Construction Non Structural Renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON IrRMATION PRESENTED: Approved Additional permits required (see below) PLANNING BOARD PERMIT REQUIRED UNDER:§ Intermediate Project: Site Plan AND/OR SpecialPennit With Site Plan Major Project: Site Plan AND/OR SpecialPennit With Site Plan ZONING BOARD PERMIT REQUIRED UNDER: Finding Special Permit Variance* Received&Recorded at Registry of Deeds Proof Enclosed Other Perm its Required: Curb Cut from DPW WaterAvailability Sewer Availability Septic ApprovalBoard of Health Well Water Potability Board of Health Permit from Conservation Commission Permit from CB Architecture Committee Permit from Elm Street Commission Permit DPW Storm Water Management Demolition Delay I c0/),3/?), Sign.`ure of Building Official Date Note: Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning requirements and obtain all required permits from Board of Health, Conservation Commission,Department of public works and other applicable permit granting authorities. *Variances are granted only to those applicants who meet the strict standards of MGL 40A.Contact Office or Planning&Development for more information. RECEIr1 ., I I 1 I i t.,t 1 , OCT 122022 1 The Commonwealth of Massachusetts Office of Public Safety and Inspections Massachusetts State Building Code(780 CMR) r .7 cy,run ui Application for any Building other than a One-or Two-Family!Dwelling w a _ , (ems Section For Official Use Only) Building Permit Number: d 1'12 0 2. Date Applied: Building Official: SECTION 1:LOCATION -IV)-ck‘o t•NecsV: , , R.M\IN ONoN \ tea No.and Street City/Town Zip Code Name of Building(if applicable) Assessors Map# Block#and/or Lot # SECTION 2:PROPOSED WORK 1 i Edition of MA State Code used If New Construction check here 0 or check all that apply in the twio rows below Existing Building 0 Repair 0 Alteration 0 Addition 0 Demolition 0 (Please fill out and submit Appendix 2) Change of Use 0 Change of Occupancy 0 Other 0 Specify:l. Li\ W& Are building plans and/or construction documents being supplied as part of this permit application? Yes 0 No Is an Independent Structural Engineering Peer Review required? Yes 0 No 0 Brief Description of Proposed Work: c i lC'. Ve-lcv0-4C. 0\1?!.W�`:fa..1J __.nIskla\\ N"Ne..\ I VX4e..0 'alZR VzA .`Ne e \%itexe. j1ts ` licvN. V,FacN-ac = o,a1 SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR CHANGE IN USE OR OCCUPANCY Check here if an Existing Building Investigation and Evaluation is enclosed(See 780 CMR 34) 0 Existing Use Group(s): Proposed Use Group(s): SECTION 4:BUILDING HEIGHT AND AREA Existing Proposed No.of Floors/Stories(include basement levels)&Area Per Floor(sq.ft) Total Area(sq.ft)and Total Height(ft) SECTION 5:USE GROUP(Check as applicable) A: Assembly A-1 0 A-2 0 Nightclub 0 A-3 0 A-4 0 A-5 0 B: Business 0 E: Educational 0 F: Factory F-1 0 F2 0 H: High Hazard H-1 0 H-2 0 H-3 0 H-4 4 H-5 0 I: Institutional I-1 0 I-2❑ I-3 0 I-4 0 M: Mercantile 0 R: Residential R-10 R-2 0 R+3 0 R-4 0 S: Storage S-1 0 S-2 0 U: Utility 0 Special Use 0 and please describe below: Special Use Description: SECTION 6:CONSTRUCTION TYPE(Check as applicable) IA 0 IB ❑ IIA ❑ IIB ❑ ILIA ❑ IIIB ❑ IV El VA El VB ❑ SECTION 7:SITE INFORMATION(refer to 780 CMR 105.3 for details on each item) i Water Supply: Flood Zone Information Sewage Disposal: Trench Permit: Debris Removal: lil Public® Check if outside Flood Zone 0 Indicate municipal A trench will not be Licensed Disposal Site required El or trench or specify: Private 0 or indentify Zone: or on site system 0 permit is enclosed 0 Railroad right-of-way: Hazards to Air Navigation: .• Not Applicable® Is Structure within airport approach area? Is their review completed? or Consent to Build enclosed 0 Yes 0 or No® Yes 0 No 0 SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY Edition of Code: Use Group(s): Type of Construction: Does the building contain an Sprinkler System?: Special Stipulations: Design Occupant Load per Floor and Assembly space: SECTION 9: PROPERTY OWNER AUTHORIZATION 1 Name and Address of Property Owner )Lre. tAra.n-kcun Pfcvitt\e a(©ce&AS Sig le,. A,c,9"6 Weal SFr i n cek\ )-'\k Name(Print) No.and Street City/Town Zip Property Owner Contact Information: J(AC,'‘ 1kec.1►6 - - `j -``i-►1-- C035 . c,rAL..ne ,.cic i .cam" Title Telephone No.(business) Telephone No. (cell) e-mail address If applicable,the property owner hereby authorizes: `-kr`tkt1 C.• IVJ qp i�&a Ncte. \ Nticks 1 t't1k OW al Name Street Address City/Town State Zip to apply for and act on the property owner's behalf,in all matters relative to work authorized by this building permit application. SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 1) , If a building is less than 35,000 cu.ft.of enclosed space and/or not under Construction Control then check here 0. Otherwise provide construction control forms(see section 107 in the code)as required. 10.1 Registered Professional Responsible for Construction Control(the professional coordinating document submittals) Name(Registrant) Telephone No. e-mail address Registration Number Street Address City/Town State Zip Discipline Expiration Date 10.2 General Contractor ‘TkeAA1,e.•NeN\o Czcea .�m:I . Company Name `c vctiC,•tve o oo\%\-t u. Name of Person Responsible for Construction License No. and Type if Applicable gO ,� t'szes- \9Je.��%\'NertA-14 -N MPN Q\Ol Street Address City/Town State Zip M5-`Val . \\D0 - -\o\'' C.. /t\,,•r+P... '06. 1;: \•u cN Telephone No.(business) Telephone No.(cell) e-mail address SECTION 11:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152.§25C(6)) A Workers'Compensation Insurance Affidavit from the MA Department of Industrial Accidents must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the build#rng permit. Is a signed Affidavit submitted with this application? Yes® No C SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE Item Estimated Costs:(Labor and Materials) Total Construction Cost(from Item 6)=$ ��4 - 1.Building $ �JO; Building Permit Fee=Total Construction Cost x nsert here 2.Electrical $ appropriate municipal factor)=$_ . 3.Plumbing $ 4.Mechanical (HVAC) $ Note:Minimum fee=$ (contact munici ality) 5.Mechanical (Other) $ Enclose check payable to 6.Total Cost $ ! O IZ ), (contact municipality)and write check number here b 14`f I SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information contaied� in this application is true and accurate to the best of my knowledge and understanding. N kh C.•h vt lnd st. t& C C -----. CUc\ C.�C -r�-W01� Please print and sign name Title Telephone No. Date StSc:` x4 44:1cNIik. . VJ‘p..,•4kreitcci? N' O\CYa7 C.• Ntz .e.. od.cA Street Address City/Town State Zip "Email Address Municipal Inspector to fill out this section upon application approval: Cal ��ALJ - • +6 i 1 I d i 3/as Name �at _�°'\ The Commonwealth of Massachusetts 11,_*� I� Department of Industrial Accidents C _]� • �'_ s 1 Congress Street,Suite 100 , Boston, MA 02114-2017 _ www.mass.gov/dia • 11 in Lers'('ompensation Insurance. flidas it: Builderv'('ontractursiElectriciansJPlumhers. IO BE FILED V I111 111F:PERM(I i I\(. Al I IIOR111. .tpplicanl Information Please Print Lrrihl� Name(Business(_lrgantiatant IndntduaII.." Address: c�V. Erc��`�CJ'n�ooa CityrStatelZip: -N,;Cni.Q\oa, l'IUine t.: Are you an emplotrr:"('heck fhe appropriate hns: Ty pe of project(required): SZ1Iama employer wish ) emplu)ecs(lull anti urpart•turol.• 7_ 0 New construct!,m =0 I am a suk proprietor or purtnenArp and hate nu employe'.working tar me in 8. Remodeling any capaa:rt).(Nu wutkcn'coop.insurance maimed" LJ 30 I am a homeowner dung all work myself.!No worries c'comp.rmurne mammal!!' 9. ❑Demolition 10 o Building additio 4E1 1 am a h,neowrei and will be bring contractors to conduct all wurl on my property. I se ill moon that all contractors either hate winter'compensation uuurance or are wee 1 1a Electrical repai -or additions pruexaetun w uh no employees. 12.0 Plumbing repo or additions 510 I am a generat contractor and I hate hind the sub-contractors listed un the attached sheet 13.0Roof repairs Thew sub-cuntraetun hate eunployees and late workers'comp.unurarce. 6.0 We arc a caorpurmun and officers hat a ete�eised thou right ut oieniehun per AKiL c. 14.'�Other ' • ;�. 152.411(41.and we hate no employees.I No workers'comp.insurance required_) •Any applea.rt that checks but r1 muse ale till out the section below allow mg their workers compenssanor policy irfurmaliun. o I4nncvwnen who submit this at►rdatrt indicating they are doing all work and then hue outside cantracturs muss subnut a new athdat it unlit g such. :C'untsacton that check this but must atta bed an additional sheet show ing the name of the sir►cuniractun and slate whether or nut those cnh es hate employees. It the sub-curnractora lute empluyecs,they nest pros.idetheir workers'wrnp pulues number. I am an employer that is providing reorders'compensation insurance for my employees Below is the policy and job site information. Insurance Company Name. E\ M I `t`V.c' \ Policy#or Self-ins.Lic.#: `EGG°�Q"'SO�'�O`�� Expiration Date: -\-'a', Job Site Address: ZAD-fib ^lip. c�j�Ceec City/State+Ztp 3 . mQ1 Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152.*25A is a criminal violation punishable by a fine up to SI.500.00 and or one-year lmpnsonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to S250.00 a day against the s tolator.A copy of this statement may be forwarded to the Office of Investigations oldie DIA for insurance coverage verification. I do hereby certify under the pains and en allies of perjury that the information provided above i►true and correct Signature is__ 1).elc 1Z)- Phone Official use only. Do not write in this area.to he completed by city or town ofciaL ( its or Town: PrrmitfLicrnse It Issuing.%uthorits (circle one): I. Board of Ilealth 2.Building Department 3.('ityrlown Clerk 4.Electrical Inspector 5. Plumbing Inspector 6.Other ( ontact Person: _— — Phone#: City of Northampton �N M, oa a 'Oti �s...':'..,s, � is Massachusetts ��?S'` k- "*'Peso R s. DEPARTMENT OF BUILDING INSPECTIONS '. FPe !i 212 Main Street • Municipal Building yeti :C� ram Northampton, MA 01060 s4,, 10 CONSTRUCTION DEBRIS AFFIDAVIT (FOR ALL DEMOLITION AND RENOVATION PROJECTS) In accordance of the provisions of MGL c 40, S54, a condition of Building Permit Number is that all debris resulting from this work shall be disposed of in a properly licensed waste disposal facility, as defined by MGL c 111, S 150A. The debris will be disposed of in: Location of Facility: \\Q. `ec... \•I\, The debris will be transported by: Name of Hauler: NNT- \\- C. \\'e 0 e.o'wi 'U.e\-\, —hc.. Signature of Applicant: Date: O - : - - - ACC) CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 1 all/2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Gail Croake NAME: Borawski Insurance PHONE (413)586-5011 FAX (413)586-7973 (A/C,No,Ext): (A/C,No): 88 King Street,Suite B E-MAIL gcroake@borawskiinsurance.com ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC p Northampton MA 01060-3257 INSURER A: Safety Indemnity Insurance Co. 33618 INSURED INSURER B: Safety Property&Casualty 12808 Kevin C.Netto Construction Inc. INSURER C: Associated Employers Ins-Co. 90 Southampton Road INSURER D INSURER E: Westhampton MA 01027 INSURER F: COVERAGES CERTIFICATE NUMBER: Construction 22/23 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MMIDD/YYYY) (MM/DD/YYYY) LiMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR DAMAGE TO RENTED 100,000 PREMISES(Ea occurrence)i $ MED EXP(Any one person) $ 10,000 A BMA0029810 03/02/2022 03/02/2023 PERSONAL BADVINJURY • $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY I JECOT I LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) ANY AUTO BODILY INJURY(Per person) $ g OWNED X SCHEDULED 6234247 07/06/2022 07/06/2023 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED X NON-OWNED PROPERTY DAMAGE $ - AUTOS ONLY AUTOS ONLY (Per accident) $ UMBRELLA LIAB OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ 1 $ WORKERS COMPENSATION X STATUTE EORH AND EMPLOYERS'LIABILITY Y/N , C ANY PROPRIETOR/PARTNER/EXECUTIVE N NIA WCC5005008057 03/02/2022 03/02/2023 500'000 OFFICER/MEMBER EXCLUDED? E.L.EACH ACCIDENT $ (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIM T $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE: 76-96 Maple Street,Northampton,MA 01060 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN City of Northampton ACCORDANCE WITH THE POLICY PROVISIONS. 210 Main Street AUTHORIZED REPRESENTATIVE Northampton MA 01060 ItJfR .t4 7' ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Conanonarin or Mass at nuseus Division of Occupational Ucensure Board of Building Regulations and Standards ConstkizlittdA'Sre v -;k1 CS-0C1317 IStpirr.',.. 11:P022023 KE1194 C NET,0 90 SOUTHA9104001 INESTHANIFIV;101 MA 91027 4'.6/,1.vc1113) Commissioner --jittki rowitht., • • • • • Oct. 12 .2022 17 : 43 PAGE. 2/ 2 QUOTE NAME PROJECT NAME CUSTOMER PO# DATE REQUESTED NE-ITO BIRDS BLOCK FLORENCE u SALES REPRESENTATIVE TERMS SHIP VIA QUOTE NUMBER • blaisr@rkmiles.com 79a085 Lineltem# Description Net Price Quantity Extended Price J 2-1 $369.42 1 $369.42 Cumment/Room: Product: 8300 Series,Double Hung,Rpl RO:24"x 33.25" J f - TTT Overall Size:23.75"x 33" 'ITI'Unit Size:23.75"x 33" to Sash Split:Equal N Performance Level:Standard, •�:-::_ '- Glass Options:Double Glazed,LowE,Argon,Annealed,SS I 3/4"ICr Thickness,Clear Opening: 18.375"x 11.085",1.414Sq ft tY i Ratings:U-Factor=0.27, SHGC:=0.28, VT=0.53 f Vinyl Color: Tan I 1- --•-_—..,,�_ i Locks: Standard,Single .. �r4�� Hardware: Tan, z Screen: Half Screen,Extruded-Fiberglass,'Ian,Sash Options: Vent Stop, W.O.C.D.(Double), Interior Trim: No, Installation Options:Standard Sill Angle,Head Expander Lineltem# Description Net Price Quantity Extended Price 3•1 $445.08 55 $24{479.40 Comment/Room: 8300 Series,Double Hung,Rpl RO:31.5"x 69.25" 't'I-I'Overall Size:31.25"x 69" TTT Unit Size: 3125"x 69" Sash Split:Equal N I Performance Level:Standard, o� . - Glass Options:Double Glazed,LowE,Argon,Annealed,SS 0 3/4" IG Thickness,Clear Opening:25.875"x 29.085",5.226.Sq ft Ratings: U-Factor=027, SHGC:=0.28, VT=0.53 1 Vinyl Color: Tan Locks: Standard,Single • 3' 25" • • Hardware: Tan, • RO.31 5" • Screen: Half'Screen,Extruded-Fiberglass,Tan,Sash Options:Vent Stop, W.O.C.-(Double), Interior Trim:No, Installation Options:Standard Sill Angle,Head Expander Last Update: 9/14/2022 6:03:55 PM Page 2 Of 5 Printed: 9/14/2022 6:04:02 PM :40 I \ M 1� e 1 - lb l • �k. ! 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