30A-042 (2) BP-2024-1150
13 LEXINGTON AVE COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
30A-042-001 CITY OF NORTHAMPTON
Permit: Addition
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
BUILDING PERMIT
Permit# BP-2024-1150 PERMISSION IS HEREBY GRANTED TO:
Project# 2 STORY ADDITION 2024 Contractor: License:
Est.Cost: 320000 Alexander Lane 117411
Const.Class: Exp.Date: 05/04/2026
PARKER, JEFFERY MOYCE ELIZABETH MARY
Use Group: Owner: GRAY
Lot Size (sq.ft.)
Zoning: URB Applicant: ALEXANDER LANE
Applicant Address Eh= Insurance:
57 Prospect Ave. 9174704122
NORTHAMPTON, MA 01060
ISSUED ON: 09/23/2024
TO PERFORM THE FOLLOWING WORK:
CONSTRUCT 2 STORY ADDITION
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector
l;nderground: Service: Meter: Footings:
Rough: Rough: House# Foundation:
I final: Final: Final: Rough Frame:
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: S2,400.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
rREcE1VLu , :..-IT -q-d
t
SEP — 5 2024
t
)FPT,,OszF nun DING INSPECTIONS Tl a Commonwealth of Massachusetts FOR
i
�A',tr?ON.MA01060 lard of I3uildlttg Regulations and Standards
MUNICIPALITY
•
Massachusetts State Building Code, 780 CMR USE
Building Permit Application To Construct.Repair.Renovate Or Demolish a Revised Mar 2011
(hm'-or Two-Family Dwelling
This Section For Official Use Only
Building Permit Number: 401C-"Ai— //g-T) Date Applied:
dvt1._5 , 17'17 __ 9. Z3-zQzy
Building Official(Print Name) Signature bate
SECTION 1:SITE INFORMATION
1.1 Property Address: 1.2 Assess(Lrs Map& Parcel Numbers
1 3 L€Attli i2N fie. — 30 A �.__�_. Li �..�_._
1.la Is this an accepted street? no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
A4 �IE ;J1-r.c, It t156 �20.0-7
Pr
oposed District Use Lot Area(sq fl) Frontage(11)
1.5 Building Setbacks(ft)
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
10 IC 1 5- I S a,0 3r,
1.6 Water Supply:(M.G.L c.40.154) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Zone: — Outside Flood Zone?
Public Er Private 0 Municipal B(-n site disposal system 0
Check iryes°
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record: .J'e1•42 11•1
T -Lr1.0c-F PAt:r�ca.f TAASX kc `t 14CAA o►OS)-
Name(Prim) f City.State.ZIP'
o. 1.6.11>��a�u. b.v31 -_!�1 cttg;, t4►r a g•.�,►;t.
and Street Telephone 3 Email Ado .
SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply)
New Construction 0 Existing Building l Owner-Occupied 0'1 Repairs(s) 0 Alteration(s)El Addition B—J
Demolition Pr Accessory Bldg.0 Number of Units I Other 0 Specify:
Brief Description of Proposed Work=. =. -_ . .___ „!.:, C sit.44t..,1 _
• • �- ..St • • .. i e . -
'x . '�tirilki'At .._ - . .. !. . errs .L�IC1�PL ' .
p,r' k.
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1. Building $ 130 u 0O0 1. Building Permit Fee:S Indicate how fee is detepnined:
0 Standard City/Town Application Fee
2.Electrical $ `'S t 0 00 0 Total Project Costa(Item 6)x multiplier______x__________
3. Plumbing $ a a )0 Oo 2. Other Fees: $___
4. Mechanical (HVAC) $ v 0 t0 O0 List:
5. Mechanical (Fire l
Suppression) $ — Total All F $ � D
Check No. bUAheck AnloLin j_` -Cash Amount:
6.Total Project Cost: S 3101000 0 Paid in Full 0 Outstanding Balance Due:
1
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor'License(CSL)
l kcn5e Nu ber . ivt�n Dale
Name of CSI_I older ((��
�n 4-DA.Ser f/CE list('SI.Type Ore below) U ._-
No.and Street _---------_._.---.__.._ Typo Ocurigion
(.1 to 35,000 cu.II.)
4A-'MRel•lptJ A OY0Q0_ It Restricted lea Family Dwellinyt
City/Town.State.ZIP ! M Masonry
RC 'Roofing Covering
WS Window and Siding
/� t�t.ta SF Solid Fuel Burning Appliances
t�A �)F At td4�G`�r�ov12 I Insulation
clephone E +I address creel I) Demolition
5.2 Registered Home Improvement Contractor(HIC) ,�����
t' -�� I lle Registration Number Ex iratan Date
I lIC Cc y Name or I C Registrant Name
Nand Street I n+..+I address t�
Ci 1-own,State,ZIP T Tele hone
SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152.§ 25C(6))
Workers Compensation Insuramm 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 APPLIESnn FOR BUILDING PERMIT
I,as Owner of the subject property,hereby authorize Pkoaw Yer t_ -
to act on my behalf,in all matters relative to work authorized by this building permit application.
Print Owner's Name(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.
Print Owner's or Authorized Agent's Name(Electronic Signature) Dyne
NOTES:
I. 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 Homt4lmprovement Contractor(HIC)Program),will not have access to the arbitration
program or guaranty fund under M.G.L.c. I42A.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.govidps
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.) a+0 ' Habitable room count
Number of fireplaces --_ Number of bedrooms
Number of bathrooms .� Number of halt7baths
Type of heating system '[•fi .; i' eyw:,e t+^f s Number of d ks!porches
Type of cooling system/;�:. Enclosed Open
3, "Total Project Square Footage"may be substituted for"Total Project Cost"
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL) 45 a icense111411
umber Ex iration Date
Name of CS Holder U
S� f 2 MO('
List CSL Type(see below)
•
No.and Street T U Description
�llAit� n Ac- O Unrestricted(Buildings up to 35,000 cu.ft.)
ll'own,State,ZIP Restricted l&2 Family Dwelling
Cit
y ) M Masonry
RC Roofing Covering
WS Window and Siding
(1 SF Solid Fuel Burning Appliances
(� `1'?oL( ''+- a� �Ay�1'�S���V� �o•rs�3�+t °�^• 1 Insulation
Telephone Emairaddress e— D Demolition
5.2 Registered Home Improvement Contractor(HIC)
tL 'ides...1)Eft 4'417 HIC Registration Number Expi ion Date
HIC Company Name or HIC Registrant Name `l n(�
a\elCaky. Sa 1s..4
No.and Street ` Emil address �a
rbvJl TA 0lc)(#0
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 .Er No 0
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 ' 15U A- CD^5 . Il�.�.3( 6J=-2
to act on my behalf,in all matters relative to work authorized this building permit applica on.
.* 7 Pi . Da ci iv /20)<c
Print Owner' Name(Electronic Signal(' Date
SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION
By entering my name below, I hereby attest u er tl e pains and penalties of perjury that all of the information
contained in this application is true d a to the best of my knowledge and understanding.
4t1ifr,,
Print Owner's or Authorized s Name(Electronic Signature) Date
NOTES:
I. 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. I 42A.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"
r
,-----.N ® CERTIFICATE OF LIABILITY INSURANCE [DATE(MM/DD/YYYY1
09/11/2024
T .ERTIFICATE 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,
ItIMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed.
IIf SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on
his certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER CONTACT
NAME:
FINCK&PERRAS INS AGCY PHONE FAX
6 CAMPUS LANE (NC,No,Ext): (A/C,No):
E-MAIL
EASTHAMPTON,MA 01027 ADDRESS:
2RNJK r
INSURER(S)AFFORDING COVERAGE NAIC#
INSURED INSURER A: A/ 1 AMI RI(AN INSURANCE COMPANY
SAGEBUILT CONSTRUCTION LLC INSURER B:
INSURER C:
INSURER D:
57 PROSPECT AVE
INSURER E:
NORTHAMPTON. MA 01060 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 5DDLSUBR POLICY EFF POLICY EXP
LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MMIDD\YYYY) (MMIDDIYYYY) LIMITS
COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $
-- CLAIMS MADE El OCCUR. DAMAGE TO RENTED $
- PREMISES(Ea occurrence)
MED EXP(Any one person) $ _
GEN'L AGGREGATE LIMIT APPLIES PER. PERSONAL&ADV INJURY $
GENERAL $
. AGGREGAT❑PROJECT ELOC E POLICY PRODUCTS-COMP/OP AGG $
$
AUTOMOBILE LIABILITY COMBINED SINGLE $
LIMIT(Ea accident)
- ANY AUTO '
■ OWNED SCHEDULE AU)OS BODILY INJURY $
AUTOS ONLY (Per person)
I '— NON-OWNED BODILY INJURY $
HIRED AUTOS ONLY
— (Per accident)
AUTOS ONLY PROPERTY DAMAGE $
(Per accident)
- EXCESS LIAR
UMBRELLA LIAB H OCCUR EACH OCCURRENCE CLAIMS-MADE AGGREGATE $
. DED uRETENTION $ $
WORKER'S COMPENSATION AND PER OTHER
EMPLOYER'S LIABILITY STATUTE
UB-1W142803-24 09/05/2024 09/05/2025
ANY PROPERITOR/PARTNERJEXECUTIVE Y/N E L.EACH ACCIDENT $ 100,000
OFFICER/MEMBER EXCLUDED/
(Mandatory in NH) n N/A E.L.DISEASE-EA EMPLOYEE S 100,000
H yes,descr,be under
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT IS 500,000
I
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
I I IIS RI PLACES ANY PRIOR C'ER'ITIICA I I:ISSUED TO'HIE C'I'.RTIPICA'I'E HOLDER AFFECTING WORKERS CI IMP('OVI[RAGIE.
CERTIFICATE HOLDER CANCELLATION
CITY OF NORTHAMPTON Y. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL B DELIV D
ATTN: BUILDING INSPECTOR IN ACCORDANCE WITH THE POLICY PROV
212 MAIN ST,SUITE 100 AUTHORIZED REPRESENTATIVE
NORTHAMPTON,MA 01060 )Or(
OR r� i TIONA'All tw,n
ACORD 25(2016/03)(Rev.09-18) The ACORD name and logo are registered marks of ACORD 1988-2015 ACOR C Pk sA g���s�reserved.
CITY OF NORTHAMPTON
SETBACK PLAN 5c.c.skSa 0.16-a
MAP: 30 A- LOT: ) 9-4t.
LOT SIZE:_AV,VSt?s'•
6
REAR LOT DIMENSION: �,G 1
REAR YARD 1".8 k°,
Y
oo�
SIDE YARD ,� sb Qt SIDE YARD S
IS �
t �
it k
I' I
t �
FRONT SETBACK 4O
FRONTAGE 10 .
•
.;;,. City of Northampton
Massachusetts L:, �<<
,1/4 111111111rt
�y DEPARTMENT OF BUILDING INSPECTIONS
'. Ili
212 Main Street • Municipal Building �O
, : )::\'
Northampton, Ma 01060 +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: •
Location of Facility: Atl A WO•At arR
The debris will be transported by:
t\ ,
Name of Hauler: 413 s.0 p/s#c.;' rt,e,o. (,reit„1.1x.m.1
J
Signature of Applicant: Date: +1,}4
DArI CERTIFICATE OF LIABILITY INSURANCE (MWOOrryrrl
osrosno2a
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 pollcy(les)must be endorsed. If SUBROGATIONIS WAIVED,
subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does
net confer rights to the certificate holder in lieu of such ondorsomont(s),
PRODUCER
FINCK&PERRAS INSURANCE AGCY INC CONTACT NAME.
080$1515 PHONE (413)527 3000 "FAX
6 CAMPUS LANE 1~C•No.Est) _ INC.No)
EASTHAMPTON MA 01027 EMAIL ADDRESS;
INSURERISI AFFORDING COVERAGE IMICa
INSURER A• Hanford Underwriters Insurance Company 30104
kYSURED INSURER B:
SAGEBUII T CONSTRUCTION l LC INSURER C
•
57 PROSPECT AVE
NORTHAMPTON MA 01060.1625 INSURER D:
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 NOTIMTHSTANOING 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 AFFORDEO BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE
TERMS EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOMI MAY HAVE BEEN REDUCED BY PAID CLAIMS
INSR TYPE OF INSURANCE ADOL SUM POLICY NUMBER POLICY EFF I POLICY EXP LIMITS
LTR INSR Sh/D IMWODYYYYI IMMIDD/Y YYY)
COMMERCMI GENERAL LIABILITY EACH OCCURRENCE S1 000.000
CAMAGE TO RENTED
(CLAIMS-MADETOCCuR PPEM ESI ascna+awel Si 000.000
X General Liability MED FAR Iers ore Persal, $10.000
A 08 SBN1 AV7BYU 01/10/2024 01/10/2025 PEPSO':AL aADM INJURY S1.000 000
GE NI.AGGREGATE LIMIT ARRAS PER GENERAL AGGREGATE S2,000.COO
POLICY I y PR6 1 Loc. P!tCOUCTS-COMPrOPAGG $2,000,000
OTHER ,• LL��
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
IEaacaaeM)
ANY AUTO BODILY INJURY(Per wad`,
.�ALL OWNED-SCHEDULED
AUTOS AUTOS BO`YLY INJURY Icier acabvl
^�Ha1EO NONCA'AD PROPERTY DAMAGE
AUTOS AUTOS !Per balder()
OCCUR LUB EACH OCCURRENCE
EXCESS UAB MAD
` S AGGREGATE
E
LIEU RETENTIONS
WORKERS COMPENSATION PER OTH
AND EMPLOYERS'LIABILITY STATUTE ER
ANY YIN E I EACH ACCIDENT
PROPRIETOR,PARTULR/EXECUTIVE
CrrICERMEMBEREXCLUDED' C N/A EL DSEASE-EAEMPLOYEE
(MafdatO5,In NH)
H yss.eescroe under E L DISEASE-POLICY LIMN
DEYR PT•D'4 Or OPERATIONS be,*
A Employment Practices Liability 08 SBM AV7BYU 01/10,2024 01/10./2025 Each Claim Lund $25.000
Annual Aggregate Limit 525.000
Insurance
DESCRIPTION OF OPERATIONS/LOCATIONSI VEHICLES 1ACORD 101.Aedrbooal Remarks Schedule.may be alIached if more space Is requr.dl
Those usual to the Insureds Operations
CERTIFICATE HOLDER __CANCELLATION__
For Informational Purposes SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
57 PROSPECT AVE BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED
NORTHAMPTON MA 01060-1625 IN ACCORDANCE WITH THE POLICY PROVISIONS.
• AUTHORIZED REPRESENTATIVE
(0 1988.2015 ACORD CORPORATION.All rights reserved.
ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD