23A-253 (5) 193 NONOTUCK ST BP-2017-0901
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:23A-253 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Categorv: INSULATION BUILDING PERMIT
Permit# BP-2017-0901
Project JS-2017-001532
Est.Cost:$761.00
Fee: $65.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: JOHN PERRIER 105319
Lot Size(sa.ft.): 10672.20 Owner., RAVETT ABRAHAM&REBECCA I MUL
zoning: URB(100)/ Applicant: JOHN PERRIER
AT. 193 NONOTUCK ST
Applicant Address: Phone: Insurance:
18 BROADWAY POND RD (860) 930-7794 WC
STAFFORD SPRINGSCT06076 ISSUED ON.-112712017 0:00:00
TO PERFORM THE FOLLOWING WORKL-TO ADD R-48 CELLULOSE INSULATION IN
ATTIC
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:
Driveway Final:
Final: Final:
Rough Frame:
Gas: Fire Department Fireplace/Chimney:
Rough: Oil: Insulation:
Final: Smoke: Final:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occupancy Signature:
FeeTvpe: Date Paid: Amount:
Building 1/27/20170:00:00 565.00
212 Main Street, Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
Filed BP-2017-0901
APPLICANT/CONTACT PERSON JOHN PERRIER
ADDRESS/PHONE 18 BROADWAY POND RD STAFFORD SPRINGS (860)930-7794
PROPERTY LOCATION 193 NONOTUCK ST
MAP 23A PARCEL 253 001 ZONE URB(100)/
THIS SECTION FOR OFFICIAL USE ONLY
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid
TypeofConstructiow TO ADD -48 CgVULOSE INSULATION IN ATTIC
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 105319
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFO ION PRESENTED:
Approved_Additional permits required(see below)
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
gliti elay
Signatureof ITudding 011ficifil 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.
F;
The Commonwealth of Massachusetts
i' Board of Building Regulations and Standards FOR
Massachusetts State Building Code,780 CMR MUNICIPALITY
ti USE
Building Permit Application To Construct,Repair,Renovate Or Demolish a Revised Mar 1011
FOne-or Two-Family Dwelling
�(,_II This Section For Official Use Only
L_ gPermit NumIber: Date Applied:
Building Official(Print Name) Shama re Date
SECTION I:SITE INFORMATION
1.1p5�periy ddreas• 1.2 Assessors Ma &Parcel Numbers
I'1S �/l Y7L�/P/C- :r� P
L la Is thisms aceopted street?yes no Map Number Parrs)Number
13 Zoning Information; 1.4 Prape.y Dimensions:
Zoning District Proposed Use Lm Arra(sq 8) Frontage(R)
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.40,554) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public O Private D Zone: _ Outside Flood Zone? Municipal O On site disposal system O
Check if yesCI
SECTION 2: PROPERTY OWNERSHIP'
1 Owaer'of Record:� �cu rnr� n����l:a�r"�'/7r? i ;� o /Drz
�
A(Print)(�7/� i Cuy,,Staatte,ZZI
No and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK'(check all that apply)
New Construction❑ Existing Building❑ Owner-Occupied ❑ Repatrs(s) O Alteration(s) O Addition ❑
Demolition O Accessory Bldg. ❑ Number of Un its_ Other ❑ Specify:
Brief Description of Proposed Work :
To Add R-48 Cellulose Insulation in Attic for weatherization purposes
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
Labor and Materials
L Building S 1. Building Permit Fee:$ Indicate how fee is determined:
2.Electrical $ ❑Standard City/Town Application Fee
❑Total Project Cost'(Item 6)x multiplier_x
3.Plumbing $ 2. Other Fees: $
4.Mechanical (HVAC) S List:
5.Mechanical (Fire $
S ression Total All Fees:$
Check No._Check Amount:_Cash Amount:_
6.Total Project Cost: $ ' [I Paid in Pltll O Outstanding Balance Due:
NEGH
28 Spellman rd
Please Submit Stafford Springs,Ct
Permits to: 06076
SECTIONS; CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
John Perrier 105319 12-12-2017
License Number Exp4ation Dare
Name of CSL Holder
18 Badway Pond rd Lik CSL Type(see below)_I
Tat Deacripdon
No.and Street U Unrestricted(Buildings to 35,000 mi.ft.
R Restricted U2 Family Dwelling
City/rown,State,ZIp M Masonry
RC goofing Coverin
Stafford Spring,Ct 06076 WS Window and Sidin
SF Solid Fuel Burning Appliances
I lnsulatwn
860-930-7794_ jperrier06076f@yahoo.mrs
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC)
RIC Company Name or HIC Registrant Name 173021 8-27-2018
John Perrier HIC Re,estration Number Expiration D.
No.and Street
jperrier06076ddress .coat
St Bnd Sp Pond t. Email address
Stafford Springs,Cl 06076
CitytTown,State ZIP Telephone 860-930-7794
SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.132.}2SC(6))
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure in provide
this affidavit will result in the denial of the Issuance of the building permit.
Signed Affidavit Attached? Yes ..........I No...........O
SECTION 7r.OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
1,as Owner of the subject property,hereby authorize New England Green Homes to act on my behalf,in all matters
relative to work authorized by this building permit application.
John Perrier
01/?6/2017
Print Owner's Name jElectronic Signatmal Date
SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION
By entering my name below,I hereby attest under the pains and penalties ofpedury that all ofthe information
contained in this application is true and nccroste to the best of my knowledge and understanding.
Lynn Ford
oii /2oi7
Print Owner's or AuthorizedAgent's Name lecuamc Si acme 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 ar
www.mess.gov/oca Information on the Construction Supervisor License can be found a www.mass.gov/dos
2. When substantial work is planned,provide the information below:
Total floor ares(sq.ft.) (including garage,finished basement/attics,decks or porch)
Gross living area(sq.ft.) Habitable room cowl
Number of fireplaces Number of bedrooms
Number of bathrooms Number of half/bams
Type of heating system Number ofdecks/porches
Type of cooling system Enclosed Open
3. "Total Project Square Footage"may be substituted for"Total Project Cost"
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Ate: 26 SPELLMAN ROAD
C• STAFFORD SPRINGS CT 08076 Phone 4: e13-264-2003
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�Registmtion:
173021
^� Expiration: 8/21f2019 IndivlsiuiV.
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JOHN PERRIER
to 9RADWAY POND RA
STAFFORD SPRINGS
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JOHN A,PtRHICR
16 BROADWAY IK)NU ROAD -
S IAFFORO SPRINGS CI 06076
12/12/2017
New England Green Homes
Permit Authorization Form
n �p
I, C < r lw Owner of the property located at:
(Owner's Name, printed)
O 1042.
(Property Street Address) (City/Town)
herby authorize New England Green homes to act on my behalf and obtain a building permit to
perform insulation and/or weatherization work on my property.
`ers Signature)
(Date)