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24D-016
BP-2023-0509 223 PROSPECT ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 24D-016-001 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-2023-0509 PERMISSION IS HEREBY GRANTED TO: Project# DECK/ELEC UPGRADES 2023 Contractor: License: INTEGRITY DEVELOPMENT & Est. Cost: 68601 CONSTRUCTION INC 090514 Const.Class: Exp.Date: 09/12/2024 Use Group: Owner: HOLDEN SMITH MEGHAN E &SEAN D Lot Size (sq.ft.) INTEGRITY DEVELOPMENT & CONSTRUCTION Zoning: URB Applicant: INC Applicant Address Phone: Insurance: 110 PULPIT HILL RD (413)549-7919 WMZ80080062242021 AMHERST, MA 01002 ISSUED ON: 04/27/2023 TO PERFORM THE FOLLOWING WORK: REPLACE PATIO WITH NEW DECK, WINDOWS ELECTRICAL UPGRADES 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 VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: ft u � Fees Paid: $446.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner —aK File #BP-2023-0509 APPLICANT/CONTACT PERSON:INTEGRITY DEVELOPMENT &CONSTRUCTION INC 110 PULPIT HILL RD AMHERST, MA 01002(413)549-7919 PROPERTY LOCATION 223 PROSPECT ST MAP:LOT 24D-016-001 ZONE THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Building Permit Filled out Fee Paid $446.00 Type of Construction: REPLACE PATIO WITH NEW DECK, WINDOWS ELECTRICAL UPGRADES New Construction Non StructuralRenovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 3 sets of Plans/Plot Plan Driveway Grade% THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION PRESENTED: XApproved Additional permits required(see below) PLANNING BOARD PERMIT REQUIRED UNDER:§ Intermediate Project: Site Plan AND/OR Spec' 1 Permit With Site Plan Major Project: Site Plan AND/OR Specia Permit With Site Plan ZONING BOARD PERMIT REQUIRED UNDER: § Finding Special Permit Variance* Received&Recorded at Registry of Deeds Proof Enclose4 Other Permits Required: Curb Cut from DPW Water Availability Sewer Availability Septic Approval Board of Health Well Water P tability Board of Health Permit from Conservation Commission Permit fro CB Architecture Committee Permit from Elm Street Commission Permit DP Storm Water Management Demolition Delay Lip 7/-?..3 Sign :ure of Building Official ate Note:Issuance of a Zoning permit does not relieve a applicant's burden t comply with all zoning requirements and obtain all required permits from Board of Health,Co servation Commission,Department of public works and other applicable permit granting authorities. *Variances are granted only to those applicants who meet the strict stands s of MGL 40A.Contact Office of Planning&Development for more information. 14 The Commonwealth of MassachusettA '4p, ,M Board of Building Regulations and Starx�iards '4 J „'OR s, ' Massachusetts State Building Code, 780 CMR CIPALITY ��y c,`� USE Building Permit Application To Construct,Repair,Renova't` C ":', Re sed Mar 2011 1l�i P One-or Two-Family Dwelling '44 oF�nroNs This Section For Official Use Only Building Permit Number: 6(2 L 3 —6-Of Date Applied: ') ,,,2 4.A.i . Building Official(Print Name) Sig nature I �Da[e SECTION 1:SITE INFORMATION 1.1 Prop¢t'ty Address: 1.2 Assessors Map&Parcel Numbers z2-3 Volt,.i- 4• 2.10 -016 — co 1 1.1 a Is this an accepted street?yes no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Sam S/yo1 6o. Zoning District Proposed Use Lof Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 2)0' (n0 cS�,.. ice(Iv(nv 16' 1.6 Water Supply: (M.G.L c.40,04) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public 0 Private 0 Zone: — Outside Flood Zone? Municipal❑ On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: he.q,G,., 4- su• N.a 1aei �G r .,,,}a,1, 11 A O I C{.C, Nat.*(Print) City,State,2IP 723 Pr-,5pe F , g o^t/1s 7Zo I Sean tole, @lilies . I.Cern No.and Str bt Telephone Email Addfess SECTION 3: DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building 12T Owner-Occupied 0 Repairs(s) ❑ Alteration(s) El' Addition ❑ Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify: Brief Description of Proposed Work2: �� f9a;;a %,.►I*' J <..K i t'. .t , t.y o ct; w►�� 5 '/1J 1ek 11 /k,t`i 5pv kS a's. ihr-41c .e er 4 cc.) yerv;Ge . 1 SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ 3? 36) 1. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical $ s SV 0 Standard City/Town Application Fee 0 Total Project Cost- (Item 6)x multiplier x 3. Plumbing $ 2. Other Fees: $ 4. Mechanical (HVAC) $ 2 S O g 0 List: / 5. Mechanical (Fire Suppression) $ Total All Fees // Check No.t� I Check Amount 14 `► Cash Amount: 6. Total Project Cost: $ b b 0 Paid in Full 0 Outstanding Balance Due: • SECTION 5: CONSTRUCTION SERVICES 5.1 Constructionu/ Supervisor License(CSL) CS— D90SIy 9I121 VI /�Fnni. l.00‘1- License Numb r Expiration Date Name of CSL Holder List CSL Type(see below) t\3 36nk)`� ��I1\5 Type Description No.and Street yP p } ,,�A U L nrestricted(Buildings up to 35,000 cu.ft.) AA- ' A 0'0 Z- R Restricted l&2 Family Dwelling City/Town,state,ZIP M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances 413--59' - 740 A^vc,e i„}tgqt/v;11, �,r, i insulation Telephone E�(iail address D Demolition 5.2 Registered Home Improvement Contractor(MC) I RO`1 (t a l2°Z� Lnk"�jjr" ty 0-Wt n., r 4(onfIric.};... Tic. HIu Registration Number Expiration Date HIC CothpanyNName or C Registrant Name Ito Mp i- 31� . A 'c c ' t,•+lti;.Ia.L.41 No.and S t mail address A-044ec 11 "A 0wb2 City/Town,State,ZIP Telephone SECTION 6: WORKERS' COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152.§ 25C(6)) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the Issuance of the building permit. Signed Affidavit Attached? Yes Et/ No . ❑ SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1,as Owner of the subject property,hereby authorize_ r. f 11.ie n,t.A e 64 fi)n,c 'o-, z‹ _ to act on my behalf,in all matters relative to work authorized bis building pe it application. knt Owner's Na (Electronic Signature) Date SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information contained in this application is true and accurate to the best of my knowledge and understanding.(L6 4/2ti/Z 2Print O 's or Authonzed Agent's Name(Electronic Signature) Date NOTES: 1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC)Program),will have access to the arbitration program or guaranty fund under M.G.L.c. 142A.Other important information on the HIC Program can be found at www.mass.gov/oca Information on the Construction Supervisor License canbe found at www.mass.gov/dps 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) (including garage,finished basement/attics,decks or porch) Gross living area(sq. ft.) Habitable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of half/baths Type of heating system Number of decks/porches Type of cooling system Enclosed_ Open 3. `Total Project Square Footage"may be substituted for"Total Project Cost" CITY OF NORTHAMPTON SETBACK PLAN MAP:2y O -GI(' LOT: V°\ LOT SIZE: S tAol REAR LOT DIMENSION: REAR YARD 1 `1 SIDE YARD l O SIDE YARD (b FRONT SETBACK FRONTAGE • City of Northampton " Massachusetts * to X it DEPARTMENT OF BUILDING INSPECTIONS 17 7k7 212 Main Street • Municipal Building � b �»-+ Northampton, MA 01060 CONSTRUCTION DEBRIS AFFIDAVIT (FOR ALL DEMOLITION AND RENOVATION PROJECTS) In accordance of the provisions of MGL c 40, 554, 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: S Qecict q Sl,o c(4-1 /21. P0, - WiAs,)r (.L7 The debris will be transported by: Name of Hauler: W CYAC S Signature of Applicant: OWL `�e� Date: (26g Pp ZH � • Lti:47..... \,.... The Commonwealth of Massachusetts ...Md. Department of Intlustrial.4ccidents Mi.....=, Wirt = mr. . mt. .:::r„ , I Congress Street,Suite 100 .. 1, t, Boston, MA 02114-2017 ,... , , -„,•,...-7,t, www,mass.govidia il otters'Compensation Insurance Affidavit:Builderslf:ontractors/Electricians/Plumbers. `14)111:1:11.,ED iNti'll Till:,PlEttMITTIrlil(;A t 1410RITIr. Applicant Information Please Print Ledildv Name li3 usuk"ss;Organtiationilndiviclual): -- -V ...t t° 4 )- .:t C.,,i 1-rk.c.4:4,, (:..T.-%c, , , . Address: City/S tateiZip:,Af„tk,!_elt*A4 ...C.),Ip c i',... Phone#: i(j 3-,5:1 el-7 q)9 Are,toi as einpioyer,Cheek the appropriate boa: Type of project(required): LEI!..im a chasloyer with .\,?- triapilOyee%if ail aratin part-ti iriet..* 7. ID New construction 20 I am a NJ.lopruprietoT or paeinepship and have no employees worktrq for rne Dia ki. gRemodeting any capacity_[No*often,'eomp.insurance rorptired.] 9.. up I ant a homeowner thins,all work iriatelf.[NO workerr'comp.insuraawv rogrdireal' D Demolition 10 C3 Building addition 4.0 1 aria a homoliwrier and will be hiring contractors to mariner all work on thy property. I will ensure that al0 eon's:a:tura eiElaer treat WockerS"CvfmkilitabOsi i:asLtrarkt'Or Art sole II a Electrical repairs or additions proprieteasos ids no employee', 12.0 Plumbing repairs or additions - irj 1 arse a general contractor and I have lined the lied*conttisek,r)LiSkti on the attached sheet 1 3C1 Roof repairs 1-beike sab-cUtitraCiOrs have cmployeta and IlaVe*utters`conga.insurance.; 6.E3 we are a corporation and eta officer%have exercised their right of t2ACT1101011 per AlKIL c. 14.ejOther 152..1144).and we have rso cyriployees.[No worker).cintsp.insinarice riNaired.] *Any applicant that elnia%but al roost also all uurr.),,,:action below showing.theirWort:al:cornitenzatiOn poheynd;arrnatiaart, Hinneowner%who submit ths%affidavit niiheating they are doling all si uric and then hire olutsride contractors minx lubmat a error attldsv it iniliting lrch. ;Contractor%that cheek this bores must attached an additional sheet showing the maim of Our inib-cointractors and state whether'LIT not those entities have employees. It Eh.Atb-curitracrozi hiaVe enclo!..c.i..›.Liki,, niusil provide their Worki:r4'iArAttp pukes mtrribcr — ... . , , , , „ . „.,,, „„• „„..„„.. , ..,,,,,. „ „ . I till an employer that is providing ovorAers compensation insurance for my employees. Below is the policy and job sire information. Insurance Company Name:A... ill , 11-/Vvrk k _ Policy#or Self-ins.Lie.#: \A)117-, go3 3o0 czzi 'zoz3A Expiration Date: LI 110 I Z. -1 Job Site Address: 2Z-, puve_c4- $4. , CitylState2ir. /143(44--,-,,,, /-6, fill a 0 6 0 Attack a copy of the workers'conspenution policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Nirit,c. 152,§25A is a criminal violation punishable by a tine up to$1,500.01) andIor one-year imprisonment,as well as civil penalties in the form°fa STOP WORK ORDER and a line of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coVe rage ve ri fi a ion. . .... --- ., .. I do hereby certifj under the pains and penalties of petjary that the inforntarian provided above is trite and correct. Sitpuiture: (1,16) - Date: Litaq/Zoe 7 phone#:1-417- 5-11 -7 AI 1 , ti Offi id use only. Do nor write in this area,to be completed by city or town ofilciaL -'. City or Town: Permit/license# hustling Authority(circle one): 1. Board of Health 2,Building Department 3.CitylEown Clerk 4.Electrical Inspector 5. Plumbing Inspector ;., 6.Other , k Contact Persori: Phone#: AO CERTIFICATE OF LIABILITY INSURANCE `C °ATE`MM,°°"YYY' V' 04/21/2023 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 Meghan Kelleher,CIC,CISR NAME: Alera Group,Inc. PHONE (413)586-0111 FAX (413)586-6481 (A/C,No,Ext): (A/C,No): Webber&Grinnell Division E-MAIL mkelleher@webberandgrinnell.com ADDRESS: 8 North King Street INSURER(S)AFFORDING COVERAGE NAIC# Northampton MA 01060 INSURERA: Arbella Protection 41360 INSURED INSURER B: A.I.M.Mutual/A.I.M. 33758 Integrity Development and Construction,Inc. INSURER C: Attn:Anna and Heidi INSURER D: 110 Pulpit Hill Road INSURER E: Amherst MA 01002 INSURER F: COVERAGES CERTIFICATE NUMBER: Exp 4/2024 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 TYPE OF INSURANCE LTR INSD MD POLICY NUMBER (MM/DDIYYYY) (MM/DD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTE CLAIMS-MADE X OCCUR PREMISES Ea occur ence) $ 100,000 MED EXP(Any one person) $ 5,000 A 8500065625 04/10/2023 04/10/2024 PERSONAL&ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY n PRO- n 2,000,000 JECT LOC PRODUCTS-COMP/OPAGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) ANY AUTO BODILY INJURY(Per person) $ A OWNED X SCHEDULED 1020051526 04/10/2023 04/10/2024 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ X AUTOS ONLY X AUTOS ONLY (Per accident) Underinsured motorist $ 100,000 UMBRELLA LIAB �,",,.."'Vu v"'y'v'E'' 4,000,000 X OCCUR EACH OCCURRENCE $ A EXCESS LIAB CLAIMS MADE 4620092974 04/10/2023 04/10/2024 AGGREGATE $ 4,000,000 DED X RETENTION$ 10,000 $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER Y/N 500,000 B F PROPRIETOR/PARTNER/EXECUTIVE EDXECUTIVE n N/A WMZ80080062242023A 04/10/2023 04/10/2024 E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Evidence of Insurance ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Commonwealth of Massachusetts Division of OccupatIonal Licerisure Board of Building Reagi,ations and Standards Oonst„ctittbnSlifOeivisor CS-090514 •.-;" -Apires: 0911212024 ANNA R COGX 113 JANUARY HILLS ROAD, AMHERST MA 01002 - • • Commissioner THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR TYPE:Corporation Registration Expiration 118041 01,19./2025 INTEGRITY DEVELOPMENT AND CONSTRIA,TICN, ANNA COOK 110 PULPIT HILt.RD • ..%:;.;•7 AMHERST,MA 01002 UIdersecretary •