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10-023
BP-2024-0623 441 KENNEDY RD COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 10-023-001 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-2024-0623 PERMISSION IS HEREBY GRANTED TO: Project# ELEVATOR 2024 Contractor: License: Est. Cost: 125243 KEITER CORPORATION 102457 Const.Class: Exp.Date: 06/20/2024 Use Group: Owner: TRUSTEE SMITH DIANNA G Lot Size(sq.ft.) Zoning: WP/WSP ;Applicant: KEITER CORPORATION Applicant Address Phone:, insurance: 35 MAIN ST,2ND FLOOR (413)586-8600 MCC20020005382022 FLORENCE, MA 01062 ISSUED ON: 05/17/2024 TO PERFORM THE FOLLOWING WORK: ADDITION OF 3 STORY ELEVATOR 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: l/Z�!r % - Fees Paid: $814.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner File #BP-2024-0623 APPLICANT/CONTACT PERSON:KEITER CORPORATION .aN 35 MAIN ST,2ND FLOOR FLORENCE, MA 01062(413)586-8600 PROPERTY LOCATION 441 KENNEDY RD MAP:LOT 10-023-001 ZONE THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Building Permit Filled out Fee Paid S814.00 Type of Construction: ADDITION OF 3 STORY ELEVATOR New Construction Non Structural Renovations 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: t/ Approved Additional permits required(see below) For all projects that need additional reviews E ice;fi0 as checked below,please sec the Office of Planning& Sustainabilitv Permit page or scan here t ,, T� 1 . PLANNING BOARD PERMIT REQUIRED UNDER:§ Intermediate Project: Site Plan AND/OR Special Permit With Site Plan Major Project: Site Plan AND/OR Special Permit With Site Plan ZONING BOARD PERMIT REQUIRED UNDER: § Finding Special Permit Variance* Received&Recorded at Registry of Deeds Proof Enclosed Other Permits Required: Curb Cut from DPW Water Availability Sewer Availability Septic Approval Board 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 // 7 5-17- Z02 Signature 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 of Planning& Development for more information. to la n s A-14-- F. _ RECEIVED The Commonwealth of Massachusetts MAY 1 6 202' Board of Building Regulations and Standards Massachusetts State Building Code, 780 CMR MUNICIPALITY . -run DI . . •. .. USEs Building Permit Application To Construct, Repair, Renovate Or Demolish‘a Rei'ised Mar 2011 One-or Two-Family Dwelling This Section For Official Use Only Building Pe it Number: 4 p _5� 0-13 Date Applied: I itiii /5� //& 5 17 Zozq Building Official(Print Name) Signature Date SECTION 1: SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map& Parcel Num rs 441 Kennedy Road, Northampton,MA 01053 10 ID 10-023 901 1.1a Is this an accepted street?yes 0 no ❑ Map Number Parce mber 1.3 Zoning Information: 1.4 Property Dimensions: WSP 375,443 SF Zoning District Proposed Use Lot Area(sq f1) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 20 FT 340 FT 15 FT 125 FT/70 FT 20 FT 850 FT • 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Zone: _ Outside Flood Zone? Public El Private El Check if yes❑✓ Municipal ElOn site disposal system ❑✓ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: Howard&Dianna Smith Northampton, MA 01053 Name(Print) City,State,ZIP 441 Kennedy Road (914)714-0640 howard.a.smith@comcast.net No.and Street Telephone Email Address SECTION 3: DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction❑ Existing Building❑ Owner-Occupied❑ Repairs(s) ❑ Alteration(s)❑✓ Addition ❑✓ Demolition ❑ Accessory Bldg.❑ Number of Units Other ❑ Specify: Brief Description of Proposed Work2:Addition of 3-story residential elevator. SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) I. Building $113,768 1. Building Permit Fee: $814.00 Indicate how fee is determined: 2. Electrical $ 9 975 ❑Standard City/Town Application Fee ❑✓ Total Project Costa(Item 6)x multiplier 125.24 x 6.5 3. Plumbing $ 1,500 2. Other Fees: $ 4. Mechanical (HVAC) $ 0 List: 5. Mechanical (Fire $ 0 Suppression) Total All Fees: $ Check No. Check Amount: $814.00 Cash Amount: 6. Total Project Cost: $125,243 ['Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) CS-102457 6/20/2024 Scott Keiter License Number Expiration Date Name of CSL Holder List CSL Type(see below) U 35 Main Street No.and Street Type Description Florence,MA 01062 U Unrestricted(Buildings up to 35,000 cu.ft.) R Restricted 1&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances 413-586-8600 skeiter@keiter.com I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) 175168 4/28/25 Keiter Corporation HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name 35 Main Street skeiter@keiter.com No.and Street Email address Florence, MA 01062 413-586-8600 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 ❑✓ No ❑ SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,as Owner of the subject property,hereby authorize Keiter Corporation to act on my behalf,in all matters relative to work authorized by this building permit application. Scott Keiter ! 05/15/2024 Print Owner's Name(Ele onic 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.ru Scott Keiter Fs 05/15/2024 Print Owner's or Authori 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 not 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 can be 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 Massachusetts .S' DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building Jti.. (sD� Northampton, MA 01060 f{ •i,;)(‘4 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: Valley Recycling Location of Facility: 234 Easthampton Road, Northampton, MA 01060 The debris will be transported by: USA Waste Name of Hauler: USA Waste Signature of Applicant: Date: 05/15/2024 L.,Lu:q,lII CH l:1I1JFi✓_ Ltd'4`41_4)-:dl V V CV-V Scar �.;t► �.r__ ', By St ott Keiter, Chief Executive Officer Date Date NOTICE THE 'SIGNATURES OF THE PARTIES ABOVE APPLY ONLY TO THE AGREEMENT OF THE. PARTIES TO ALTERNATIVE DISPUTE. SETTLEMENT IIIITIATED BY THE CONTRACTOR. THE. OWNER MAY INITIATE ALTERNATIVE DEPUTE.RESOLUTION EVEN WHERE THIS SECTION IS NOT SEP .RATELY SIGNED BY THE PARTIES. THE RIGHTTO INITIATE ALTERNATIVE DISPUTERESOLUTIC'N SHALL END SBOYEARSAFTER THE.DATE.OF THIS AGREEMENT. DISPUTE RESOLUTION AND ATT ORNE Y'S FEE S AI'tvcontioversy cir claim arising out of or related to 1 this Agreement invoking art amount less than$,5,000(or the muanu1m limit of tie Small Claims court) must be heard in tit S recall Claims Division of the Municipal Court in tit county where e f._,'.i I. I r i. located. Any± _ut- r the dollar limit rl • re _mtri,t]r s office � r=.z y 1 -1-I e r-;'e � _f tit Small Claims Court arising out C If this Agee shall}_le s113rrtitted to an experienced private construction arbitrator that shall be mutually se lecte d by the parties to conduct abin:hr arbitration in accordance with the arbitration laws of the State where the project is located. The aibitrator shall be either a licensed attorney or ie tired judge ,?,i'to is familiar with cC lrtstnlchon law. If the partie s cart not mutually agree ort an arbitrator within thirty( 0)days of written ck mand for arbitration, then either of the parties shall submit the dispute to bit.-112'U? c }=11tI'it1C41 before the American Arbitration A C�'lahCRl in cccu 'I i2'U'e with the t_�ort`sIniciic n Industry Rale: Of the uirrieric an Arbitration Association then in effect. Ju 'me Ilt upon the award mate}_e entered in any Court having juris3iction thtereof. The prevailing party; in any legal proceeding related to I this Agreement shall be e nulled to pa5ane nt ofreattnable attorney's fees, costs, and p_ot-judgment interest at the legal rate. ENTIRE AGREEMENT, SEW RABILITY,AND MODIFICATION This Agreement represents and contains the entire agreement and understanding n tit parties. Prior dix>usions or verbal DE,Re?.nti lions byContractor or Owner that are riot contained in this Agreement are not a part of this Agreement. In the event that anyprurtilon of th is A greemertt is at any time held bya Court to be invalid or unenforceable, tie parties ,agre.e that all other govisions of this Ag,reerne rd will remain in full force and effect. Anyfuture modiiicahon of this Agreement shouldbe made rn writing and exec uted by(Diner and Contractolr. MISCELLANEOUS C cQitr actor Owner CI,(v Sign Envelope ID:3 CD35 E 2 g-.4B CC?44 CD-a:115-849 r'E B ,Er_rQ This Agieeme ill is a IVIa ache etts contract, contains the entilN agreement bet;?e'en us, any representation or 17 ina Iles not expnfk3ly contained in it are not a pint of the Aerieement, and it is binding 1riJn our heirs, executor, succex,or and assigns. This Agreement maybe modified oral by an instnniient in 17riitingg signed b*,r tot h of us. This Agreement is s-ubjec t to and is intended to comply with the provisions of Charter 142A of the Maalachth.43tts C�f+neral LBi.;.S and it conesp:'nth rc regulations. YOU MAY CANCEL THIS AGREEMENT IF IT HAS BEEN SIGNED BY A PARTY THERETO BY FORWARDING YOUR INTENT TO CANCEL IN WRITING BY ORDINARY IvIAl .. POSTED, BY TELEGRAM SENT OR BY DELIVERY, NOT LATER- THAN MIDNIGHT OF THE. THIRD BUSINESS DAY FOLLOWING THE SIGNING OF THE AGREEMENT. Bvsig llrg this Agreement, oil acknowledge that yDuhave received a complete ard original cow of the entire Agreement and attached Addenda. Contractor may not start vvri,u til aile r this Agie ement has been signed. SIGN T CONTRACT IF �T++ 4 "!+ SPACES r T r r-! DO NOT S N THIS' C�,'NTRAC T THERE E ARE ANY 5L AAK SPACES THISIS A ( L 1 G AGREEMENT IF THERE ARE ANY PROVISIONS WI I 1':T YOU LU NOT UNDERSTAND, YOU SHOULD CONSULT 14ITH N ATTORNEY.BEFORE SIGN?'N Is"EIILR CORPORATION OWNER (C ORPORATI ON) __ I By Scott Keiter, Otief Executive Officer Date Date ADDENDA & EXHIBITS The following exhibits and adderda have bee n attached tio this Agreeriterlt arid as such aie inclined as part of this agreement: Exhibit•_lSMITH RES ELEVATOR 2024 SCOPE OF ri7k.DRK Ex hi it2 2 402 21-44 1 Kennedy RiiP ermit Set:1 Exhi}_it e Smith Elevator 4.15 J24 1 • 2 C oritractor - Owner The Commonwealth of Massachusetts Jr*War!m ft Department of Industrial Accidents ■s +�iar 1 Congress Street,Suite 100 =�J:1 Boston, MA 02114-2017 ntass.gov/dla 11'urkers Compensation Insurance .Affidavit: Builders/Contractors/Electricians/Plumbers. '1O BE FILEDWffll THE PERMll•CCIM(::ill"1'IIORI'1"1'. Applicant Information Pleace Print Leeihly Name(Plus;xss"Organiarntion.lndi%idual):Keiter Corporation Address: 35 Main Street City/State/Zip:Florence, MA 01062 Phone#:413-586-8600 Arc)ou an cnqpl.)re Cheek the appropriate box: Type of project (required): I ✓D I am 3 emptoytx with 90 _cmptoyces(t1iU snrl'or parttime).* 7. New construction 20 I am a soar proprietor or patina-ship and have no enwloVo working for me in 1{. Q Remodeling anycapme:ty (No workers'Coanp insurance regained) 9. Ei Demolition 30 I am a hoewoowtter doing all work myself.(No workers;comp.insurance required.)' 0 El Building addition 4 Q m I am a homeowner and will be hiring contractors to conduct all work on my property I will 1 ensure tha 311 contractors cittkr have workers'o+cnpdnaatioe insuran a or ax soie I I ❑ Electrical repairs or additions prUPrirton with no employer . 12.D Plumbing repairs or additions 50 1 am a seutial contrretor and 1 brie hind the sub.contr ctors listed on the atuciceRl sheet. These sub<ontr ctors lntY emp!o)ces ant hst'e workers'catnp insurance.: 13❑Root repairs 6 IDWe am a corpOralion and its officers hat c exercised their rigtl of exemption per ltfGl.c. 14.0 Other 152.i 1(4).and we haw no employers.[No wotke's'comp.insurartte required.) 'Any applicant ihti cheeks b.'s I moat alto fill out the section below showing their workers'compensation policy information. t Homeowners who submit this atlida%it indicating they ate Joins all work and then hire outside eontractears mtrrt submit a new affidavit it 1kafins such. Contractors tlrst cheek this bin must attached an additional sheet slowing the name of Ibc subcontractors and slate w1tcthcr oa riot those entities have employees. if the subcontractoes talc eircklyces.they must ptovid`their workers'comp.policy number. I am an employer that is providing workers'compenmtion insurance for my employees. Below is the policy and job site information. Insurance Company Name:MA Employers/AIM Policy#or Self-ins.Lie.#:MCC20020005382023A Expiration Da:e:6/11/2024 Job Site Address: 441 Kennedy Road CitytStafciZip:Northampton, MA 01053 Attach a copy of the corkers'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 S 1500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to S250.00 a day against the violator.A copy of this statement may be ffnward d to the Office of Investigations of the DIA for insurance coverage serifcation. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Siinanue: pze Date: 05/15/2024 Phone;.413-586-8600 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License ti Issuing Authority(circle one): 1. Board of Health 2. Building Department 3.Cityfrown Clerk 4.Electrical Inspector 5. Plumbing Inspector 6.Other / ,ACORCI`� CERTIFICATE OF LIABILITY INSURANCE DATE(MMlDDlYYYY) ‘4.........--.- 05/30/2023 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 Cyndie Henderson CISR,CPIA NAME: Alera Group,Inc. PHONE (413)586-0111 FAX (413)586-6481 (A/C,No,Ext): (A/C,No): Webber&Grinnell Division E-MAIL chenderson©webberandgrinnell.com ADDRESS: 8 North King Street INSURER(S)AFFORDING COVERAGE NAIC M Northampton MA 01060 INSURERA: Selective Ins Co of S Carolina 19259 INSURED INSURER B: MA Employers/A.I.M. 12886 Keiter Corporation INSURER C: Attn:Scott Keiter INSURER D: - 35 Main Street INSURER E: Florence MA 01062 INSURER F: COVERAGES CERTIFICATE NUMBER: Master Exp 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 LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DDIYYYY) (MM/DD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE s 1,000,000 IEU CLAIMS-MADE Xi OCCUR PDREM S SO(EaEoccu occurrence) S 500.000 MED EXP(Any one person) $ 15.000 A S2265567 06/0112023 06/01/2024 PERSONAL BADV INJURY S 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ Z,000,OOO POLICY n PEC n LOC PRODUCTS-COMP/OPAGG S 2'000'000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) X ANY AUTO BODILY INJURY(Per person) $ A ^� OWNED SCHEDULED A9105217 06/01/2023 06/01/2024 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED —� NON-OWNED PROPERTY DAMAGE $ _ AUTOS ONLY AUTOS ONLY (Per acodent) Medical payments $ 5.000 X UMBRELLA LIAR X OCCUR EACH OCCURRENCE S 10,000,000 A EXCESS UAB CLAIMS-MADE S2265567 06/01/2023 06/01/2024 AGGREGATE $ 10.000,000 DED X RETENTION $ 0 �/ S WORKERS COMPENSATION X STATUTE X ERH AND EMPLOYERS'LIABILITY Y/N 1.000 000 B ANY PROPRIETOR/PARTNER/EXECUTIVE N NIA MCC20020005382023A 06/11/2023 06/11/2024 E.L.EACH ACCIDENT $ , OFFICER/MEMBER EXCLUDED? 1.000,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE S If yes.describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101.AddNional Remarks Schedule,may be attached it more space is required) Waiver of Subrogation can be obtained should Insured win the bid for project. 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 I- r n 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD RELOCATE COMPRESSOR UNIT AND POWER SUPPLY r L I I I I r LA V I. PM h 1W 20.0H08 . 7 ..`....... 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