Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
17C-132 (2)
BP-2024-1247 103 HIGH ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 17C-132-001 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-2024-1247 PERMISSION IS HEREBY GRANTED TO: Project# RENOVATION 2024 Contractor: License: Est.Cost: 50000 JAMES O'SULLIVAN CS-066335 Const.Class: Exp.Date:08/21/2025 Use Group: Owner: MICHELE RUSCHHAUPT Lot Size (sq.ft.) Zoning: URB Applicant: MADISON CONSTRUCTION Applicant Address Phone: Insurance: 264 BUCK POND RD (413)532-1312 WESTFIELD, MA 01085 ISSUED ON: 10/02/2024 TO PERFORM THE FOLLOWING WORK: INTERIOR RENOVATION 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: //77. Fees Paid: S375.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Buildine Commissioner -sr e / err,a, ‘f- 1-110 i l /' �C,�%, - , sZ.. The Commonwealth of Massac I usetts�� oep ' V ..' Board of Building Regulations an' Stan lards 41 6 F R Massachusetts State Building C.' - 780- , r4 (9424 / USE IPALITY Building Permit Application To Construct,Repair,Ren•`�'' r. • h a r Rev' ed Mar 2011 One-or Two-FamilyDwelling ''•; 1„. - / a "ow, ns / This Section For Official Use Only Building Permit Number:11 —.). (-/— / a c./ 7 Date Applied: 4,t.nr...) 'N4,s // /O- 1-ZZZY Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers _fO/-1yA 56reef c4,,e-i-icc M•4 1.la Is this an accepted street?yes X- no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 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 Private 0 Zone: _ Cheeckkif yes❑Outside Flood Zone? Municipal On site disposal system CI SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: IL iG11etZ Rtis6-1-ika-t-c.pf- rl©r.e-stiCe MA 0/dt 2-- Name(Print) City,State,ZIP 4 2 6 Ci ss 5-E-reel" 512 -c./"-- - bt.2S i c.Je% / I e m e , c o'-t No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction❑ Existing Building* Owner-Occupied 0 Repairs(s) Alteration(s))4 Addition 0 Demolition 0 Accessory Bldg.0 Number of Units Other ❑ Specify: . Brief Description of Proposed Work2:©LdJ /_s 1L 1/O or 1 dA r oc,m , -c'-`x/---re.s -{lam ),5 Cir,/wc..Lg. g2' .\As -/aa;or- in CXftr;o.- e✓ueis /2Pmoie/ 2nd •//do, b, 4/.00/+7 necv -F;x -1-1..c,,e( -ri.,/nq ,-/.•1 wr--LJ R21 in3,.,/�-k,'o-r‘ i� �)<Fc/.ro.- we.._L/ C3i 7 er1,0et e l k•.Jc/,or J 'pi ew -I))(1-ecr^e5 tO Add let/ /11su/4,41:"•1 /a /5k •-f/oa.- eelrt" - €L O' SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ _136200 1. Building Permit Fee:$ Indicate how fee is determined: / , 0 Standard City/Town Application Fee 2.Electrical $ 7 5"` 0 Total Project Costa(Item 6)x multiplier x 3.Plumbing $ 7 So° 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire $ Suppression) Total All F Check No. t.UP Check Amour 3/6 6.Total Project Cost: $ 9/ 0 Do 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) 006a3s a, i Z .3 A.r S OS : i l\4-(J License Number Expiration ate Name of CSL Holder 26a4 B Tow b (2') ,` List CSL Type(see below) No.and Street UIv i�i{� T Description W SC`Tc i sb R' a idO S — ) Unrestricted(Buildings up to 35,000 cu.ft.) cJ K Restricted I&2 Family Dwelling City/Town,State,ZIP M Masonry (13 �5O 74� RC Roofing Covering `�f ! WS Window and Siding SF Solid Fuel Burning Appliances /4/1f 5J/1CJS7Q-L 77QA a ALf _ I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement� Contractor(HIC) P/5 v O 140/ 5 Yfr2 Ai (-U/1� '16e 4157241 G77& ) HIC Registration Number Expiration Date HIC Company Name or C Registrant Na e 2ce ei Bud - r)d�/i� i22 /yt,rjreNcONS72 AJZGG� No.and tr t Email address WESTVi MA—dim 3/413 0 7 Yz City/Town,State,ZIP Telephone ?-26nAfcmc 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 nAPPLIES -FOR BUILDING PERMIT I,as Owner of the subject property,hereby authorize A fr 7a', rV & Ns /C.0 677O N to act on my behalf,in all matte4.s relative to work authorized by this building permit application. i6i ElL D5 h 1 - /0 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 conta ed in this application ' true and accurate to the best of my knowledge and understanding. , jell A -6tA k) iv 1 ii zy Print Owner's or Authorized 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" 1 1 s The Commonwealth of,Ilassachusettc —(0 Department of Industrial.4rcidents i Congress Street.Suite 100 t Boston. 411.4 02114-201 7 �� wtvw:massgob/dia /1orkers'Compensation insurance Affidavit:Builders/ContractorsiElectritcinre.<lPlumherr. re HE 11LU:U N 1111 1 Ilk Pk1011 ICING-it 11101.1 tl. .4milli.lint Information �/�/� C .vfli/ �Plea(se�Print Icihls Name t livatatcis'Zlkgaiuz tla4t lndi.LLlual r. ' . !147450/\V 06 Ai U I )C_ e/O' . Addra . 2 ,BuC ?O,Jb ife(, Citytstatc�Zip:(`VAST/u) fif}- (yaks Phone #: Zt/3 Z O - 3--1/Z :Rre),sr to maspbrrrr2 f bark tray appruprudr iron: Ty pe of project lreyuiredi I a Lim a rt>q,hty,s will, cmphtyet1 hull arid ue pot-that(:(_• 7. 0".e'. consiruvttort :tm a.tk pmpnetar or pnatnmt up and bannu cmpin"-nn.>.utksng Truax m S. ( Rtmerticling styi;a peaty.(flu uotkers'.uanp.utawancr tequirttat.J "�'�\\ 9. ©Demolition (.0 t am a 1ktnl.Xtwna ttutng all Hurt,nrsclf.(Ku t...tkut cunt.usrurnm>e rnttatcd.I" 4 a I am a tauram.sncr and.dl be ha t�. raonno to ccmd,nt all nark an nr!im party I Wilt i(1 Building addition auutr that all Contz*.iani either Itatr wusi.7s':entpcsuulrw luminance or air auk I I 0 Electrical repairs or album; pnrperetun with sin mtpk,yea+ 120 Plumbing repairs ur atkiittuns } Q 1 at»a gonad inner-Amur and t tm.Mini Mc subcrnttractrr it a ((stem.m s inat:ha tact l . thane sub�uuta►tuts tat(ia,pluwm and la,c*tatter.'won. mW,ru.�•c• I_ !tool aspires 4 6 0 Vsc are:a.atrpuratnm aud rr.utfn a a linty:.1atsac4 their nyht a.asnrio.n p..a%Ka c 1 Other 15::It it.and nt halo nn cumlinack (Nu watkrrs'came mstuun.:c moaned.' `Ant upphtanr that cfiok.bat it I tmnr also fill out the.actin(l.:lk.w LinWe,ng thur a trues't umpas nuns luts-y inturuu.wi, `litatncaue,ta:rs hits iulnud that.%Iranit in.hs*llti airy are Joan;all.ark and tram his ta,bi.k ctxduatta,n term aubnut a ucu alu,lauit uaitcatin rush 4:nnlraa.1lr►that check dns bole rmast attn:hni an ahttbnnnJ apart alum map the pain tri the abgroattm tan.and aatr alwha nt not timer.cntshr.hair aatipluyeci. ►fthc aub-c.,t:uacr.r.ha.:t'attdn4'ene,the meta, uiuktkrn- °...ukcr,'canny.policy nuuthcr l am at employer that is providing worker's•compensation insurance for may employer(. Below it. Me policy unit Joh sett information. insurance Company Name Policy#or Sclf•ius.Lie.1$: Expiration Dote: Jab Site Atktlt«,_ City'State:Zip- Attach a copy of the workers'compensation policy declaration page tabooing the policy number and capitation dstrk. Failure to secure coverage as requua d under MCiL c. (5 §2.5A is a criminal violation punvthable by a zinc up to S1 SUO.til1 antl4tr one-year unpn onmenL ws well as aril pmmics m the form of a STOP WORK ORDER and a line of up to S2i(1.(1U a day agam..t the violator-A copy coffins statement may he forwarded to the Office of Invthtigat►otts of the DIA fuc itlautance coverage verif ' 1. I du hereby certify cider the parrs and pcnaldes of perjury that the information provided above 1.true and correct/c Stgnsatune: ��,, 66 Date: /d `—2- 7 Phone 4/3 - Zso- 7 t 2-O • f)111rial use only, Da not write in this area.to he completed br city or town official City or fosse: Permitii.icensc Jt Issuing Authority (circle one): 1.Huard of Health 2.Building Department 3.C'it)irosn(leek 4.Electrical Inspector i.Plumbing Inspector (a.Other ( rrnit}ct Person: Phone tl: City of Northampton --;r; e.....'. sic ++' Massachusetts ' r .. > ki ii 1 ( • p r! D :PARTMNT OF BUILDING INSPECTIONS VI A l n L' ". e i. '4 212 Main Street • Municipal Building sJti. ' Northampton, MA 01060 ffk4 % 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: -1-)c.c -p 51e The debris will be transported by: Name of Hauler: A A.ro s bu pS r5 Signature of Applicant: I� 7 Date: 9/2_ /2 ® CERTIFICATE OF LIABILITY INSURANCE DATE (M Dm^rY) 5/2024 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 NAME: Next First Insurance Agency,Inc. PHONE (855)222-5919 I FAX ,No): PO Box 60787 yuc.►D.Eat IAIC Palo Alto,CA 94306 AMAIL A : supportOnextinsurance.com INSURER(S)AFFORDING COVERAGE NAIC s MIBURERA: Next Insurance US Company 16285 INSURED ----- INSURER B: James O'Sullivan Madison Construction. INSURER C: 264 Buck Pond Rd EISURERD: Westfield,MA 01085 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:002242878 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. NOTVMTHSTANDING 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. t TR S POLICY EFF POLicy EXP TYPE OF INSURANCE rim POUCY NUMBER (WYYYY1 IMWDDryYYYI UNITS X COMMERCIAL GENERALLUWBIUTY EACH OCCURRENCE $1,000,000.00 DAMAGE TO l CLAIMS-MADE X OCCUR PREMISES(EaENTED occurrence) $100,000.00 MED EXP(My one person) $15,000.00 A X NXTFXUDZ3K-04-GL 07/01/2024 07/01/2025 PERSONAL&ADV(NJURY 31,000,000.00 GENL AGGREGATE LIMIT APPLES PER: GENERAL AGGREGATE S2,000,000.00 X POLICY PECOT- n LOC PRODUCTS-COMP/OP AGG S2,000,000.00 OTHER: S AUTOMOBLE UABIUTY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ OWNED ^ SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED PRRTY DAMAGE AUTOS ONLY _ AUTOS YY (PerOPEaccident) $ S UMBRELLA L,AB OCCUR EACH OCCURRENCE S EXCESS UPS CLAIMS-MADE AGGREGATE $ DED RETENTIONS $ WORKERS COMPENSATION PER AND EMPLOYERS'LIABIUTY Y/N STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE N/A E.L EACH ACCIDENT S OFFICE R/MEMBER EXCLUDED? (Mandatory in NH) E.L DISEASE-EA EMPLOYEE S I describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S Each Occurrence: $25,000.00 A Contractors Errors and Omissions X NXTFXUDZ3K-04-GL 07/01/2024 07/01/2025 Aggregate: $50,000.00 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) The Certificate Holder is Michelle Ruschhaupt.This Certificate Holder is an Additional Insured on the General Liability policy per the Additional Insured Automatic Status Endorsement.All Certificate Holder privileges apply only if required by written agreement between the Certificate Holder and the insured,and are subject to policy terms and conditions. CERTIFICATE HOLDER CANCELLATION Michelle Ruschhaupt LIVE CERTIFICATE 103 High St • SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Florence,MA 01062 ID SHOULD EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN j' rt ACCORDANCE WITH THE POLICY PROVISIONS. 1}Yi J AUTHORIZED REPRESENTATIVE a ,^, Click or;,an to viQti ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 103 High Street Layouts t- Floor Plan Scale: 1/4"= 1'-0" _':=_.', 0 1 E i I Kitchen I > II - Hallway/5 orage Entry Half Bath �' � , - �• T I -1 n 1 LI" ; , .i - 14 - at•X zi I 4 ii, LI v • t ---L----- a y., mot„_....,, &2----: V.0 , c---'' 1:, 1 --J- 0 ill t _ r [ .....„, �t! _ 1.-.......__ _ it , _ II! z Dining Room er ` Ilh I 1 5- X) O Ij sue, ----r1 _ 7 / .. 1 11 Iw1 ;Add ii1 ,n5„Oa-4,'or, I all I NM I Add IEMI R21 2 I n I fsu.1 A.4',Orn Q __ 0 The intent of these drawings/renderings are conceptual and ✓> for the convenience of reference.Plans are not to be considered final until all decisions have been made Q g. § Q' a c a Mod o g 41 W -- / 8. vex / er-- - —pi Sri—er-- -2/ T i �� N --j it Linen Cabinet } 4RTuylyYnver � f� 1 --, a J .. — ' 'fl go OMPMP 4. o tY A'fil tit iii J lA ii (www+a 91 hlu.A AV b r- b .��. gt .a �1— 1 1 P R Q I B 0 L,r it / 24sir , se,,r-- / 41rr - / S © L A N A JAMES 103 High Street Remodel I.hyour.111 •_mow M�GIIAY