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31B-077 (2)
BP-2024-1289 18 SUMMER ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 31B-077-001 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-I289 PERMISSION IS HEREBY GRANTED TO: Project# new ramp 2024 Contractor: License: Est. Cost: 18700 DAVID MILL 080477 Const.Class: Exp.Date:07/10/2025 Use Group: Owner: GANDARA MENTAL HEALTH CTR INC Lot Size (sq.ft.) Zoning: URC Applicant: DAVE MILL GENERAL CONTRACTOR LLC Applicant Address phone: insurance: 1003 CHURCH ST 413-283-1616 WCC 500 500 6566 PLAMER, MA 01069 ISSUED ON: 10/09/2024 TO PERFORM THE FOLLOWING WORK: REMOVE RAMP AND BUILD NEW LANDING 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 Drives%av Final: Fireplace/Chimney: Rough: Oil: Insulation: Final: Smoke: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: /Fr Fees Paid: S140.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner I 6--) ) h.; t I (2,1Cur F RECEIVED &, The Commonwealth of Massac nett IV Board of Building Regulations and tand rdsOc1 R 80 MR 3 - 2024 UNI IPALITY Massachusetts State Building Code, SE • Building Permit Application To Construct, Repair,Ren vise Mar 2011 One-or Two-Family Dwell NOPTHA'.t"TIC INSPEC NS on This Sectionti For Official Use Only ' Building Permit Number: 8p.„, Si— /o; A'/ Date Applied: 401.....i(14, 10.61.7-6ZY Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Pro ert Address: 1.2 Assessors Map&Parcel Numbers /W \)LIM etr Si ,3t Q, -0 7 - 021 1.1a Is this an accepted street?yes no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: u r RIti- 7 1 O$ 6 / Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Ni.(i- 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 it Private❑ Zone: _ Outside Flood Zone? MunicipalA On site disposal system 0 Check if ye411. SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: Name(Print) City,State,ZIP' 7 3 3 Ea.S}- (AN 4b(As �} v e.- W3-yd 6 -/0 5, /-c a r ittAl lib e Ha wie.vp re LA res.0'• No.and Street Telephone Email k Idress SECTION 3:DESCRIPTION OF PROPOSED WORK'(check all that apply) New Construction 0 Existing Building,lll, Owner-Occupied 0 Repairs(s) il21 Alteration(s) sz Addition ❑ Demolition rit Accessory Bldg. 0 Number of Units Other 0 Specify: Brief Description of Proposed Work2: 11 a .^ • ` Cc,,,,41.,.g . Sec i -t PAC p SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) I.Building $ i e 7, — I. Building Permit Fee:$ Indicate how fee is determined: 0 Standard City/Town Application Fee 2. Electrical $ 0 Total Project Cost3(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: __ 5.Mechanical (Fire $ Suppression) Total All Fe?es• / Check No.q g7Check Amount: � Cash Amount: 6.Total Project Cost: $< 7�j 0 Paid in Full 0 Outstanding Balance Due: — l A5C--O I1026-- l Ad PO 5i=k-)r LHntit. 10 Li SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) 1 CS �a0 Y77 740A ---n _ ; t License Number ! Expiration Date Name of CSL Holder tt List CSL Type(see below) fig _ /003_ C.Ae.tAr-Ciam_ Ty, Description No.and Street _, AO / _ Unrestricted(Buildings up to 35,000 cu.ft.) __ ___.►'` _�-. �Q� ._._..__....___ _ R Restricted I&2 Family Dwelling City 'own.State,ZIP —_ 1v1 _ j Masonry L� (' f RC Roofing Covering --l�3-=s��_... �19..._.._._ ..._..._ WS Window and Siding y SF Solid Fuel Burning Appliances y/-3 ' Y3: der u y,Le Grp rs/t.�.t 1-. r')ddl I insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) f Q 3 S Taus L m (- _..._._..._...... }IIC Registration Number Expiration vete ItIC Company Name or HIC Registrant Name - flay 41,v);I k. N and Street w Email a dress t _ 'fiak.*Aear_.-M- ►- 106/.__Ybs- t3-1611,.__ CkaNaretAJ 0 a.cwsM; leoAfYaGF .UM City/Town,State,ZIP Telephone SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152.§ 2SC(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 eR1No... .. . .. 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 .a. k _. TdaCtris ✓ (— to act on my behalf,in all matters relative to work authorized by this building permit application. b463.C4C_C .190P*,1 4&-11/01 owner's Signature Dale SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION _ I By entering my name below, i hereby attest under the pains and penalties of perjury that all of the information coma' in this application is true and accurate to the best of my knowledge and understanding. .�: 4114 o cr's or Authorized Agent's 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. 142A.Other important infonnation on the HIC Program can be found at www.Avi: gSL1L ogit Information on the Construction Supervisor License can be found at w_.nta ,gov/0p j 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"'Dotal Project Cost" —^ ..r‘ The Commonwealth of MasacIg use/Is fTa ar,;;, Department of industrial Accidents 1 __,vf; k' r. Congress.Street, Suite 100 r•f Boston, MA 02114-2017 , ` wwts mass.gov/ilia Warners' Compensation Insurance Affidavit:Bulidera/C:untr•actrrrs/Elcctricias►s/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. cHIJ'itoil ______ ._._. __.___ - Please Print {>Gibk Name (Business/Orgattizationflndividnal): � - 1'!l.)iL G...e. ,L C Address: j063 G. S ________ -^Ci—ty/State/Zip: NG1\.+c41-- nr1/- o I Ob`� _ Phoiie.#: 9/ 02�3 /6/‘ ---- A'o you au employer?Check, appropriate hox: ---- Typo OF project(required): 1 1,01 am a employer with. .....___employees(fall anti/or part•timc).° 7. [�Nets coast action 2.0 i am a sole proprietor or partnership and have no employees writing for me in 8. ll Remodeling any capacity.[No workers'comp.insurance required.) i--, 3.0 I am a homeowner doing all work myself.j q'o workers'comp.insurance tequired.l' 9. ._..1Demolition 10t_"] Building addition 4.0 I am a homeowner and will be luring contractors to conduct all work on my property I will a ensure that all contractors either have workers'compensation insurance or are sole E i.,_,j Electrical repairs or additions proprietors with no employees. ., 1.�.0 Plumbing repairs or additions 5.0 I am a.general contractor and I have hired the subcontractors listed on the attached sheet These sub-contractors have employees and have workers'camp,insurance.t E3. Roof repairs 6.0 We arc a corporation and its officers have exercised their right of exemption per MC!.a 14. atlier-- 152,§1(4),and we have no employees.[No workers'comp.insurance required.i 'Any applicant that checks box N1 must also fill out the section below showing their workers'compensation policy information t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractars that cheek this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. if the Sub-canuactors have employees,they must provide their workers'comp.policy number. I mn an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:.-Pt �kPtc,:ir,,,Nk .5„_t isyl Gi._. .._.. 1►_veSr 4.42 _._.._...__. ._ PolicyG it or Self-ins. Lie. ii: ( Seib 5-1/0 .Z Expiration Tate: /j1 Job Site Address: L I 3t — _ _ City/State/in: nd —______ . Attach a copyof the workers' compensation policydeclaration page(showingthe policynun�aexpiration date ). Failure It secure coverage as required under NIGL c. 152,§25A is a criminal violation punishable by a fine up to S 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 S250.00 R day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. ... i._,i -. W. .... Tr+r_--c�. .. ,.-. �.._ _... ._.. ,. ice.n 1 do hereby cent under the pains and penalties of perjury that the information prouided above is true and correct. Suture: ( Al �r-_ Lam. Date_ 1.ada2. V • Phone it: VI.3 ,211 _6_1[? O,fficial use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2. Bnllding Department 3. City/Town Clerk 4. Electrical inspector 5.Plumbing inspector 6.Other Contact Person: Phone#: '� - 4 MASSAGHUSITTS DRIVER'S LICENSE , i hl�r Y� Zj ^ ti "S .44 NiO R ,' ' t o7/96,2022 r S8 t 5a•t 790 ExP r' �{ x r 'D7i 10'2027' 3 .q? Ct�y j g•. I t lSS RES' IND t D' NONE NI NONE 'a . 2DAM ERIC a)` r t, 1 ;. ;1003 CHURCH Si a e it ae PALMER,MA 01069,17Q3 i' tK ✓r/ / g IU EYES 8Ro Ir . l��",+J•',4.,./ /.G.� 155EY h} 76407 5'0": 'p t�, �)+,. 60D 071o&2o21 Rev 07722/7o76 !1* j" Commonw Mhusetts Division of Occupational assac Licensure Board of Building Re utxtrons and Standards Consioltf&A IS1l0e/fv1sor C S Q80477 " r. �ires:07110/2025 ?: DAVID E MIL a r I 1003 CHURCH ST PALMER MA',1069 { G. r �lft. Commissioner ACORO CERTIFICATE OF LIABILITY INSURANCE DATE(MM DD:YYYY) 10/1/2024 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 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 Laura Monsalve, Ext 122 NAME: Foley Insurance Group Inc. (ACNE Eau. (413)214-7474 �aC No): tu3)2ta--u 37 Elm Street EMAIL lmonsalve@foleyinsurancegroup.com ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC M West Springfield MA 01089-2703 INSURERA Atlantic Casualty ins. Co. INSURED INSURER B:Safety Property and Casualty 12808 Dave Mill General Contractor LLC INsuRERc:Associated Employers Insurance Co 1003 Church Street INSURER 0: INSURER E: Palmer MA 01069-1703 INSURERF: COVERAGES CERTIFICATE NUMBER:CL242818088 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 EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER (MMIDD/YYYY) (MM/DD/YYYY) X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 DAMAGE A CLAIMS-MADE X OCCUR PREMISES (Ea Eoccurrrrence) $ 100,000 L1850008754 2/4/2024 2/4/2025 MED EXP(Any one person) S 5,000 PERSONAL&ADV INJURY S 1,000,000 GENLAGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE S 3,000,000 POLICY X JECT PRO• I LOC PRODUCTS-COMP/OPAGG S 3,000,000 OTHER. S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S 1,000,000 (Ea accident) B ANY AUTO BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED 5905699 10/29/2023 10/29/2024 BODILY INJURY(Per accident) S AUTOS AUTOS NON-OWNED PROPERTY DAMAGE X HIRED AUTOS X AUTOS (Per acc4en1( _ UMBRELLA LIAB OCCUR EACH OCCURRENCE S _ EXCESS LIAR CLAIMS-MADE AGGREGATE S DEC RETENTION S S WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $ 500,000 C OFFICER/MEMBER EXCLUDED? Y - (Mandatory in NH) WCC5005006566-2023A 10/29/2023 10/29/2024 E.L.DISEASE•EA EMPLOYEE $ 500,000 if yes.describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE•POLICY LIMIT S 500,000_ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101.Additional Remarks Schedule,may be attached it more space is required) The certificate holder named below is included as an additional insured for General Liability coverage for ongoing operations if required by written contract, permit, or agreement executed prior to a loss. Proprietor/Partner/Executive Officer/Member exclusion applies on Workers Compensation. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Northampton THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN 212 Main St. , #100 ACCORDANCE WITH THE POLICY PROVISIONS. Northampton, MA 01060 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025 12:•a;. DAVE MILL'S GENERAL PROPOSAL CONTRACTING LLC 1003 Church St. Palmer MA. 01069 DATE 7/17/2024 413-283-1616 david.mill@comcast.net TO: RE Gandara Center 18 Summer Street, Northampton 933 E. East Colombus Ave Springfield MA 01 105 Revised 9/27/24 Description Remove and dispose of existing handicap ramp. Place 4-foot-deep Sono tube concrete footings. Construct a new ramp with the same configuration using pressure treated lumber to include post rails, framing, and decking in accordance with the CRM521 architectural access code. Provide all necessary licenses, insurance, permits, and inspections. Clean and dispose of all debris incurred. $15,200. Build a 48" by 42" landing and stairs with 2 4' deep sono tubes and a hand rail. Install a new storm door. $3,500. Amount: $18,700.00 Quotation prepared by: David Mill. This quotation is subject to the conditions noted below: To accept this quotation, sign here and return: _ Payment Terms: Net 21 days. 1.5% Per Month i t rest will be charged to all accounts over 30 days old. (18% per year). Material Deposits are due upon receipts. All merchandise remains the property of this company until paid in full. In the event of any default in payment, Customer (owner/buyer) agrees to pay all collection costs to include attorney's fees should this become necessary. Dave Mill General Contractor LLC may, at the option without process of law, take possession of any or all materials for nonpayment. Thank you for your business! Ci ( 3bf � y JJt - ( , I • - --- _. . .ss � Is` t II M I S --4---- -- -- -- ‘P•k- "61 ! v 30,,,i- e 13c' 1,7c, 24,6 t • 1 1 ! I 1 I i! i I •, 1 . --,•• 4 i 4 4 i 41 1 1) II 4 • ,---___, ;: 4 ti 4 i .• . 4 P . 4 4 .• 4 44 4 4 4 __ ___• _ .. _ 4 4 . kno.4A 4 i 44 4 4 • I- -----.,=--- t-- . ' - . 4 4 i •••„„, - --- I , .....6.4- 1 •.„--. 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