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32C-276 (30)
BP-2023-1798 80-82 WILLIAMS ST COMMONWEALTH OF MASSACHUSETTS UNIT 2C Map:Block:Lot: CITY OF NORTHAMPTON 32C-276-007 Permit: Exterior Res PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit# BP-2023-1798 PERMISSION IS HEREBY GRANTED TO: Project# 2023 WINDOWS Contractor: License: PHIL BEAULIEU & SONS HOME Est. Cost: 23850 IMPROVEMENT 62638 Const.Class: Exp.Date: 06/13/2024 Use Group: Owner: D. CONNELLY, HEATHER Lot Size (sq.ft.) Zoning: URC Applicant: PHIL BEAULIEU & SONS HOME IMPROVEMENT Applicant Address Phone: Insurance: 217 GRATTAN ST (413)592-1498 WMZ-800-6205 CHICOPEE,MA 01020 ISSUED ON: 01/02/2024 TO PERFORM THE FOLLOWING WORK: REPLACE 6 WINDOW UNITS 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: r 3)9T Fees Paid: $40.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Ruilding Commissioner o ..) The Commonwealth of Massachusetts FOR Board of Building Regulations and Standards -J Massachusetts State Building Code, 780 CMR MUNICIPALITY USE Buj ding Permit Application To Construct,Repair, Renovate Or Demolish a Revised Mar 2011 w One- or Two-Family Dwelling Res r-tei4 This Section For Official Use Only Building Permits umber: Date Applied: , --., • . %.2 , -�Building Official(Print Name) / Signature te SECTION 1: SITE INFORMATION Irak Address: 1.2 Assessors Map jaarcel Numbers 1.1a Is this an accepted street?yes . no Map Number Parcel Number 1.r Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq ft) , Frontage(11) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public 0 Private 0 Zone: — Outside Flood Zone? Municipal❑ On site disposal system ❑ Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2 Owner'of Rec d: .1/ea#tier Conn II Ai0(-1-11 acne#an Mfg- O 1Dto O Namey (Print) City.State.ZIP q b O a Iii an1S a . Unit 2C- 0413)391 - 733,4 hdConoe/1yZ ma, /. con, No.and Street Telephone Email Ad ess SECTION 3: DESCRIPTION OF PROPOSED WORK(check all that apply) New Construction 0 Existing Building C Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition ❑ Demolition ❑ Accessory Bldg. 0 Number of Units Other 0 Specify: Brief Description of Proposed Work2: /4 GL CO tO%ncioW un;i'S SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ 2 3 $5Q 00 1. Building Permit Fee: $ Indicate how fee is determined: ❑ Standard City/Town Application Fee 2.Electrical $ ❑Total Project Cost3 (Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ °° 4.Mechanical (HVAC) $ ----- List: 5.Mechanical (Fire $ Suppression) Total All Fees: $ e n ) Check NW1/672-Check Amount:iidD" Cash Amount: 6.Total Project Cost: $ 2 Si SO." 0 Paid in Full CI Outstanding Balance Due: City of Northampton f " Massachusetts ��? s►- '�� - DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building eti. ca Northampton, MA 01060 �s'i arpx. � 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: PcAan S Location of Facility: SSS Taj ) -I I c C7- The debris will be transported by: Us fl a L,t,(,n5 Is 0 Name of Hauler: Signature of Applicant: Date: / Z /?-4 /23 A! ® DATE(MMIDDP1 VV) � CERTIFICATE OF LIABILITY INSURANCE 2i15/2023 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 CONTNAME: ERIC ERIC MASON _ THE MASON AGENCY INC PHONE — - Iwc.No.Ext): (413)569-2307 FAX ,No (413)569-2308 504 College Hwy E-MAIL themasonagencyfamerican-nationalcom Southwick, MA 01077 INSURER(S)AFFORDINGCOVERAGE NAM(t _ INSURER A: Farm Family Casualty Insurance 13803 INSURED INSURER S: PHIL BEAULIEU &SONS INSURERC: HOME IMPROVEMENT, INC. INSURER D: 217 GRATTAN STREET INSURERE: Chicopee, MA 01020 MA 01020 INSURER F: COVERAGES CERTIFICATE NUMBER: 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. INTSRR TYPE OF INSURANCE �Sp yL yyp POLICY NUMBER POLICY EFF POLICY EXP LIMITS (MMIDD/YYYY) (IYIMIDD/YYYY) X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000DAMAGE TO RENTED CLAIMS-MADE X OCCUR PREMISES Ea occurrence) S 300,000 BUSINESS OWNER'S MED EXP(Any one person) S 25,000 A _ x x 2001X2810 2/25/2023 2/25/2024 PERSONAL 8 ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 3,000,000 X POLICY JET LOC PRODUCTS-COMP/OP AGG $ 3,000,000 OTHER: S AUTOMOBILE LIABILITY COMBINED I�INGLE LIMIT $ 1,000,000 ANY AUTO BODILY INJURY(Per person) S OWNED X OS SCHEDULED A AUTOS ONLY X 2001C7139 2/25/2023 2/25/2024 BODILY INJURY(Per accident) S XHIRED NON-OWNED PROPERTY DAMAGE S AUTOS ONLY X AUTOS ONLY (Peraccldent) $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE S 3,000,000 A EXCESS LIAB CLAIMS-MADE 2001E1738 2/25/2023 2/25/2024 AGGREGATE S 3,000,000 DED X RETENTIONS 10,000 S WORKERS COMPENSATION PER 0TH- AND EMPLOYERS'LIABILITY YIN I STATUTE ER _ ANY PROPRIETOR/PARTNERIEXECUTIVE I I E.L.EACH ACCIDENT $ OFFICER MEMBER EXCLUDED? N I A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-:POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS f VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CARPENTRY CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE EVIDENCE OF INSURANCE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENT IVE ©1 -2 CORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD i•� PHILBEA-01 NICOLES "etc—of-et, CERTIFICATE OF LIABILITY INSURANCE DATD/YYYY) 2/15/215/2023 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 NAMEACT Nicole Sarafin Phillips Insurance Agency,Inc. PHONE FAX 97 Center Street (ac,No,Ext):(413)594-5984 (Arc,No):(413)592-8499 Chicopee,MA 01013 ADDRESS:nicole@phillipsinsurance.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:A.I.M. Mutual Insurance Company 33758 INSURED INSURER B: Phil Beaulieu&Sons Home Improvement Inc. INSURER C: Phil Beaulieu 217 Grattan Street INSURER D: Chicopee,MA 01020 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 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 TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD (MM/DD/YYYYI (MM/DD/YYYYI COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE OCCUR DAMAGE TO RENTED PREMISES(Ea occurrence) $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY 7 LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILECOMBINED SINGLE LIMIT LIABILITY (Ea accident) $ _ ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED _ AUTOSRE� ONLY AUTOS BODILY� INJURYp (Per accident) $ AUTOS ONLY Al1TOS ONLY (Peer accident)AMAGE _ UMBRELLA LIAB _ OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ A WORKERS COMPENSATION X STATUTE OTH- ER AND EMPLOYERS'LIABILITY WMZ-800-6205-2023A 2/25/2023 2/25/2024 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE i N/A E.L.EACH ACCIDENT $ (Mandat oM�n NEH)EXCLUDED? f J 1,000 000 ((MMandatory m NH) E.L.DISEASE-EA EMPLOYEE $ It yes,describe under 1,000,000 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 Evidence of Insurance THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Commonwealth of Massachusetts ®, Division of Occupational Licensure Board of Building Regulations and Standards Constoitkig ISIkervisor CS-062638 z f#,pires:06/13/2025 • ALAIN M BEAULIEU 217 GRATTAN STREET CHICOPEE MS- 01020 Commissioner Q`Ma., THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs and Business Regulation 1000 Washington Street- Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration Type: Corporation PHIL BEAULIEU&SONS HOME IMPROVEMENT,INC. Registration: 100073 217 GRATTAN STREET Expiration: 06/07/2024 CHICOPEE,MA 01020 Update Address and Return Card. 1- THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs 8,Business Regulation Registration valid for individual use only before the HOME IMPROVEMENT CONTRACTOR expiration date. If found return to: TYPE:Corporation Office of Consumer Affairs and Business Regulation Registration Exuiratt.Qn 1000 Washington Street -Suite 710 100073 06/07/2024 Boston,MA 02118 'NIL BEAULIEU&SONS HOME IMPROVEMENT,INC. (LAIN M.BEAULIEU !17 GRATTAN ( ,e4„4 ; 01020 HICOPEE,MA 01020 Undersecretary Not valid without signature • 14 The Commonwealth of Massachusetts [' _- s- Department of Industrial Accidents .1A.��1 Office of Investigations 1 1. 600 Washington Street • iT, V Boston, MA 02111 s--y� w►vw.istass.gov/dia Workers' Compensation insurance Affidavit: Buil(lers/Contractors/Electricians/Plumhers Applicant Information Please Print Legibly Name(Business/0rgani7ation/Individual): Pbt 1`3e-a.1.4.i 15 SO-4 S I40 tt iteMix4d— Address: 21/ V roui -an S*eu* /'1 Cily/Stalel%ip:___ l j/l►CDp.pp M A Oiozo rho a t1:.(q43)61 —1 q-/r Are ou an employer?Check the appropriate box: Type of project(required): I. I am a employer with 2 `I• ❑ I am a general contractor mull employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction listed on the attached sheet. 7. 0 Remodeling 2.❑ 1 am a sole proprietor or partner- ship and have no tmploydcs These sub-contractors have 8. 0 Demolition working for me in any capacity. employees and have workers' comp. insurance.$ 9• El Building addition [No%micas'comp. insurance l required.] 5. ❑ We arc a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I I.❑ Plumbing repairs or additions myself [No workers'comp. right of exemption per MCL. Y 1 12 roof repairs insurance required.]t c. 152,§1(4),and we have no' /Ng() • employees. [No workers' 13. Other W _ . comp. insurance required.] 'Any applicant that checks box ill must also till out the section below showing their workers'compensation policy intimation. r Ilouteownen who submit this affidavit indicating they arc doing all wok and then hire outside contractors must submit a new affidavit indicating such. tContraetois Ihal check Ibis box must attached an additional sheet showing the name of the sub•contractos and slate whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I aim an employer that is providing workers'compensation lusarance far tut'employees. Below is the policy and fob site in/battalion. Insurance Company Name:_ A.I,M M tkiletCd In5uranc.e._ Company Policy I/or Sell-ins. Lie.II: wt4 Z-SOO - U20S - 2023 A Expiration Date: 2/2512 LiJob.Site Address: oF0 GO; /1'o S v (,& u'M C 2. City/State/Zip: M/14is rip fO/i M 6 Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). 0/06O Failure to secure coverage as required under Section 25A of MGL e. 152 cam lead to the imposition of criminal penalties of 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. Re advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. • I do hereby certify , I s any lollies of peduty that the informallon provided above is true and correct. Signature: Dane: /2 / 20 /2 3 Phone II: ( 13) 5 i 2 - l L1° ' _.— Official use only. Ao not write in this area,to be completed by city or town official. • City or Town: _ Permit/License II issuing Authority(circle one): . 1.Board of Health 2. Building Department 3. City/Town (Torte 4. Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: • Phone ii: