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17C-223 (29) BP-2023-1122 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-2023-1122 PERMISSION IS HEREBY GRANTED TO: Project# STAIRS/LAUNDRY 2023 Contractor: License: Est. Cost: 18000 CSL111802 Const.Class: Exp.Date: 06/12/2025 Use Group: Owner: LLC BLUE MOUNTAIN PROPERTIES, Lot Size (sq.ft.) Zoning: GB Applicant: LLC BLUE MOUNTAIN PROPERTIES, Applicant Address Phone: Insurance: 268 COLD SPRING AVENUE, SUITE B WEST SPRINGFIELD, MA 01089 ISSUED ON: 08/18/2023 TO PERFORM THE FOLLOWING WORK: REPLACE EXTERIOR STAIRS, ADD LAUDRY ROOM ON GROUND 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 VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: Fees Paid: $175.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner / R-- -76 -_ /ViY / The Commonwealth of Mas ch seP 7 T a,y c� „� Office of Public Safety and Insp tiara, swAY -- I`l i `- Massachusetts State Building Code( Op uko Building Permit Application for any Building other than a One-o Olt s %• ng (This Section For Official Use Only) or,go NS Building Permit Numberep Date Applied: Building Official: SECTION 1:LOCATION 76-96 Maple Street, Florence MA Parsons Block No.and Street City/Tow Zip Code Name of Building(if applicable) /7C —?)3 Assessors Map# Block#and/or Lot # SECTION 2 PROPOSED WORK Edition of MA State Code used If New Construction check here 0 or check all that apply in the two rows below Existing Building[E Repair IX Alteration 0 Addition 0 Demolition 0 (Please fill out and submit Appendix 2) Change of Use 0 Change of Occupancy 0 Other 0 Specify: Are building plans and/or construction documents being supplied as part of this permit application? Yes ® No 0 Is an Independent Structural Engineerine Peer Review required? Yes 0 No IEI Brief Description of Proposed Work:_A replacement of the existing exterior stairway on the west-side of the building evacuating the porches and south end units.And a new Laundry Room was added on the ground floor for the use of the tenants, as per discussions with the Plumbing Inspector, Smith. 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 0 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 0 IIA ❑ IIBO IIIA0 IIIB0 IV CI VA 0 VB ❑ SECTION 7:SITE INFORMATION(refer to 780 CMR 105.3 for details on each item) Water Supply: Flood Zone Information: Sewage Disposal: Trench Permit Debris Removal: A trench will not be Licensed Disposal Site 0 Public 0 Check if outside Flood Zone 0 Indicate municipal 0 required 0 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: MA Historic Commission Review Process: Not Applicable 0 Is Structure within airport approach area? Is their review completed? or Consent to Build enclosed 0 Yes 0 or No 0 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 Name and Address of Pro erty Owner Blue Mountain Prorties,268 Cold Spring Ave Ste B West Springfield MA 01089 Name(Print) No.and Street City/Town Zip Property Owner Contact Information: Jordan Healy 4137170635 - Jordan@patriotpmg.com Title Telephone No.(business) Telephone No. (cell) e-mail address If applicable,the property owner hereby authorizes: Patriot Property Management Group,268 Cold Spring Ave Ste B West Springfield MA 01089 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) Steve Drakulich and Associates _ Name(Registrant) Telephone No. e-mail address Registration Number 27 James St Greenfield MA 01301 _ Street Address City/Town State Zip Discipline Expiration Date 10.2 General Contractor Patriot Property Management Group Company Name Jordan Healy CS-111802, Unrestricted CSL Name of Person Responsible for Construction License No. and Type if Applicable 268 Cold Spring Ave Suite B West Springfield MA 01089 Street Address City/Town State Zip 413-7171)635 Jordan@patriotpmg.com 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 building permit. Is a signed Affidavit submitted with this application? Yes 0 No 0 SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE Item Estimated Costs:(Labor and Materials) Total Construction Cost(from Item 6)=$ 1.Building $ 13,000.00 Building Permit Fee=Total Construction Cost x (Insert here 2.Electrical $ 2,000.00 appropriate municipal factor)=$ 3.Plumbing $ 3,000.00 4.Mechanical (HVAC) $ Note:Minimum fee=$ (contact municipality) 5.Mechanical (Other) $ Enclose check payable to 6.Total Cost $ 18,000.00 (contact municipality)and write check number here 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 contained in this application_ is true and accurate to the best of my knowledge and understanding. - p #e4 Manager - - Please print and sign name Title Telephone No. Date 268 Cold Spring Ave Suite B West Springfield MA 01089 Street Address City/Town State Zip Email Address I Municipal Inspector to fill out this section upon application approval: V 'POP�j A . Z2b d Name D to City of Northampton Massachusetts ti �_ % * y .4 DEPARTMENT OF BUILDING INSPECTIONS 4 212 Main Street • Municipal Building � Northampton, MA 01060 3'4111/ Q,`\ 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:K&W Materials and Recycling, 138 Palmer Ave West Springfield MA 01089 The debris will be transported by: Name of Hauler: Joe Bruno,All State Disposal 7/24/2023 Signature of Applicant: /d... 4 4e Date: The Commonwealth of Alassachusetts — = 1=1•4 . = t,41111 Department of Industrial Accidents I Congress Street,Suite 100 Boston, MA02114-2017 sk '..isr •-'-' -0' www.mass.govidia VIOrkers'(Compensation Insurance Affidavit: Buiklers/(5ontractorsfElectriciansiPlumbers. III BE FILED%Still THE PERNIITITSG AL`THORITV. Applicant Information Please Print ieiiibh Name iausiness:Organizatiorvinclividual); Patriot Proper0!Management Group Address: 268 Cold Spring Ave Suite B West Springfield MA 01089 413-707-4434 City."StatelZip: Phone --• ,..... Ate...iriu an enipta?.rr?( heck the appraptbute hot: Type of project(required): ilE1 1-MI 4 VITTIIC,yIS'Alai ..,,,9_ _eingsloyeat(full andAw partgimet• 7. a Nevi,construction 2.C]1 am a auk promII:tux or mutrimalup and have nu employues working tot me its 8. )or Remodeling .. any mionciw.(No workers'comp.insurance in...gaited.] 9. 1:j Demolition 30 I an,a hornabroiner doing alt*ort nryieit ilk.10 wearkers-cirnip.ninnance nvnrcti 1. 10 El Building addition .1,0 1 ant a honseownry und will be hiring ountraours to...viaduct all work MI rity property. I will ...maim that all contractors either have workers"curvemahon insurance tw are sole 11 a Electrical repairs or additions proprietors w ith nu erripluYile%. 12.0 Plumbing repairs or additions 50 lam a general contractor and I he.c hired tau Alb-contractor,listed on the attatimat sheet 130 Roof repairs Theta:auh-contractura have matployek-,and have%Ain-kers"amp.insurance.7, i4.1:10thea tia Vo`a.arc a I:imputation and its utTccta !man ekati:844:i their night of eat trainman per 152,§i(41.and we}woe nu artplo.:,ves.[No workers'cearip.insurance requital] 'Any applwarit that cheeks but al mum also till uut the section below shov.inn their W1/1114,1:18 t:ontputuation pol icy infurinawn. 'niYALCI:00 ex-rs who submit this affidavit tridicating they art doing all work and then hire out..%iile contractors must submit a new affidak it uniimarlg such. :Contractors that cheyk titiN,but nails*attached an additional Awl show in the namc of the sub-cuntructors acid state IA 114.70113 Of MA LIILISI:01.iii.1e%11.11.1.11 litIrky CC', I rtiw .1,,,,,,,,,,,,,„,,,..,.tmarlo,cc..rho-must proi,idc their ,i.orker,"...•..mnp puttc 191:MIKA . . — .. 1 am an employer that is providing n'orAerN*compettstaiva ittNlirt f nee Pr My employee . Beloit i.1 the'Why and irob Nue information. insurance Company Name: Penn-American/Quaker Policy#or Self-ins.Lie. 4: PAC7236041 Expiration Date: 10/3/2023 76- 96 Maple St Florence MA Job Site Address: CityiStaterZip: 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 siolation punishable by a fine up to$1,500.00 and'or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine 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 fur insurance coverage..verificatieli I do hereby certify under the pains and penalties of perjury that the inforannion provided above il,true and correct Sii,mature: ii„.../....i, 4/4 i),,_ 7/24/2023 413-717-0635 ••• Official use only. At trot write in this area.to hi'l°nip/err-if/ii city or WWII afficial. .i 1. it or Town: IN:rmitiLicense# .............„._ '. Issuing Authority (circle one): • I. Board of Health 2.Building Department 3.City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6.Other I"oniact Person: Phone 4: .... Appendix 1 Construction Documents are required for structures that must comply with 780 CMR 107. The checklist below is a compilation of the documents that may be required. The applicant shall fill out the checklist and provide the contact information of the registered professionals responsible for the documents. This appendix is to be submitted with the building permit application. Checklist for Construction Documents* Mark"x"where applicable No. Item Submitted Incomplete Not Required 1 Architectural 2 Foundation 3 Structural 4 Fire Suppression 5 Fire Alarm(may require repeaters) 6 HVAC 7 Electrical 8 Plumbing(include local connections) 9 Gas(Natural,Propane,Medical or other) 10 Surveyed Site Plan(Utilities,Wetland,etc.) 11 Specifications 12 Structural Peer Review 13 Structural Tests&Inspections Program 14 Fire Protection Narrative Report 15 Existing Building Survey/Investigation 16 Energy Conservation Report 17 • Architectural Access Review(521 CMR) 18 Workers Compensation Insurance 19 Hazardous Material Mitigation Documentation 20 Other(Specify) 21 Other(Specify) 22 Other(Specify) *Areas of Design or Construction for which plans are not complete at the time of application submittal must be identified herein.Work so identified must not be commenced until this application has been amended and the proposed construction document amendment has been approved by the authority having jurisdiction. Registered Professional Contact Information Name(Registrant) Telephone No. e-mail address Registration Number Street Address City/Town State Zip Discipline Expiration Date Name(Registrant) Telephone No. e-mail address Registration Number Street Address City/Town State Zip Discipline Expiration Date Name(Registrant) Telephone No. e-mail address Registration Number Street Address City/Town State Zip Discipline Expiration Date Please follow this link for construction control forms to be used by Registered Design Professionals. g >o . � „ . , ,,:ensure p. , Board of Budding Re r and Standards * io 7:.::, t . :;o<-:! rvis * r CS- 111802 , ':!- ,, , i pires . i 611 21 0 JORDAN PA AL' 268 COLD SPRING SUITE B ` 4.444, WEST SPRINGPIELD le)i. , , C 0 i io er ...„. , , _,„. ..,,, 4_4_, (..... 04" ,S ",*-00---- Zµ A DATE(MM/DD/YYYY) CERTIFICATE OF PROPERTY INSURANCE 07/26/2023 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. PRODUCER CONTACT Cyndie Henderson CISR,CPIA NAME: Alera Group,Inc. talc No,Ext): (413)586-0111 FAX No): (413)586-6481 Webber&Grinnell Division E-MAIL chenderson@webberandgrinnell.com ADDRESS: 8 North King Street PRODUCER 00025071 CUSTOMER ID: Northampton MA 01060 INSURERS)AFFORDING COVERAGE NAIC# INSURED INSURER A: Union Mutual Fire Insurance Company 25860 Blue Mountain Properties,LLC INSURER B: Attn: Marc Murphy INSURER C: 268 Cold Spring Ave Ste B INSURER D: West Springfield MA 01089 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: Blue Mountain Exp 2024 REVISION NUMBER: LOCATION OF PREMISES I DESCRIPTION OF PROPERTY (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Loc#000,01 Bldg#00001:76-96 Maple Street Blue Mountain Properties Florence MA 01062 See Attached Overflow Pages 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 TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION COVERED PROPERTY -LIMITS LTR DATE(MM/DD/YYYY) DATE(MM/DD/YYYY) XI PROPERTY X BUILDING $ 4,297,000 CAUSES OF LOSS DEDUCTIBLES - PERSONAL PROPERTY $ BASIC BUILDING - BUSINESS INCOME 10,000 — BROAD CONTENTS - EXTRA EXPENSE $ X SPECIAL RENTAL VALUE $ - EARTHQUAKE BLANKET BUILDING B0P020612102 06/22/2023 06/22/2024 A $ WIND BLANKET PERS PROP $ FLOOD - BLANKET BLDG&PP $ IINLAND MARINE TYPE OF POLICY $ CAUSES OF LOSS NAMED PERILS POLICY NUMBER $ CRIME TYPE OF POLICY IBOILER&MACHINERY I $ EQUIPMENT BREAKDOWN A General Liability BOP020612102 06/22/2023 06/22/2024 -X Per Occurrence $ 2,000,000 X General Aggregate $ 4,000,000 SPECIAL CONDITIONS/OTHER COVERAGES (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 City of Northampton ACCORDANCE WITH THE POLICY PROVISIONS. 210 Main Street AUTHORIZED REPRESENTATIVE Northampton MA 01060 ©1995-2015 ACORD CORPORATION. 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