42-037 (4) 7 LADYSLIPPER LN BP-2019-0091
GIS u: COMMONWEALTH OF MASSACHUSETTS
May Btoek:42-037 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL 042A)
Category: INSULATION BUILDING PERMIT
Permit# BP-2019-0091
Project# JS-2019-000143
Est.Cost:$2500.00
Fee:$65.00 PERMISSIONIS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Grow JOHN PERRIER 105319
Lm Size(sa ft.): 46609.20 Owner: STEIN ROBERT A C/O CATHERINE L DIMMITT
zoning: Applicant JOHN PERRIER
AT: 7 LADYSLIPPER LN
Applicant Address: Phone: Insurance:
18 BROADWAY POND RD (860) 930-7794 WC
STAFFORD SPRINGSCT06076 ISSUED ON:7/2412018 0:00:00
TO PERFORM THE FOLLOWING WORKTO ADD/ACHIEVE R-49 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 N 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 Occuoancv signature:
FeeTvoe: Date Paid: Amount:
Building 7/24/20180:00:00 $65.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
�r)uc,la firrj,
The Commonwealth of Massachusetts
n c Board of Building Regulations and Standards FOR
ao Massachusetts State Building Code,780 CMR MUNICIPALITY
o _
USE
wilding Permit Application To Construct,Repair,Renovate Or Demolish a Revised Mar 1011
>a o One.or 7Wo-Family Dwelling
This Section For Official Use Only
°z° it Number. Dale Applied: /q
Building Official(Print Name3emre n,,SI
SECTION 1: TE RMATION
1.1 Prover dd as: 1.2 Aase;a9�Map&Parcel Numbers 7
I.Is is this an ae ep4dslree[7 yes 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.0,154) 1.7 Flood Zone Information LS Sewage Disposal System:
Public 13 Private CI Zone: _ Outside Flood Zone? Municipal On site disposal system 0
Check R yesI3
SECTION 2: PROPERTY OWNERSHIPI
Ow rt of eeord: �y
j j lan✓sm Ca�LcQ iu�hYbf 0✓D P a i (- /1 0 /GYPZ
N e(P nl � Ciry„Slate,ZIP
� r)
1 /I _A
N .end Street elephone Fmeil Address
SECTION 3:DESCRIPTION OF PROPOSED WORK'(check a6 that apply)
New Construction 0 Existing Building❑ Owner-Occupied ❑ Aepairs(s) 0 Alteretlon(s) 0 Addition 0
Demolition ❑ AccessoryBldg.❑ Number o[Unils_ Other 0 specay:
Brief Description of Proposed Work:
To AddiAchieve R49 Cellulose Insulation in Attic for weathertzation purposes
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Coss: Official Use Only
Labor and Materials
1.Building $ 1. Building Permit pea:$_Indicate how fee is determined:
2. Electrical $ 0 Standard CityPlbwn Application Fee
❑Total Project Cost'(Item 6)x multiplier x_
3. Plumbing S 2. Other Fees: S
4.Mechanical (HVAC) $ List:
5. Mechanical (Fire $ Total All Fees:
Suppression)
Check No. _Check Amount:_Cash Amount:_
6.Total Project Cost: Sa ❑Paid in Full ❑Outstanding Balance Due:
NEGH
28 Spellman rel
Please Submit Stafford Spring:,Ct
Permits to: 06076
SECTIONS: CONSTRUCTION SERVICES
5.1 Construction Supervisor IJcem(CSL)
Jahn Pettier 105319 12-124019
Unease Number Expiration Data
Name of CSL Holder
List CSL Type(see below)_I
18 Bradway Pond rd
Type Descrlptlon
No.and Street U Unrestricted(Building up to 35,000 cu.ft.
R Restrictcd 1&2 Family Dwelling
Cityrrown,Stat;ZIP M Meson
ry
RC Roofing Covering
Stafford Springs Ct 06076 WE Window and Siding
SF Solid Fuel Bunting Appliances
I Im le ion
413-2.44-2003_ jperrier06076®yahoo.com D DemolitionTele hone Email address
5.2 Registered Home Improvement Contractor(RIC)
RIC Company Name or HIC Registrant Name 173021 9-27-2018
BIC Registration Number Expiranan Date
John Perrier
No.and Street jperrier96076Qyahoornm
18 Bradway Pond rd Email address
Stafford Springs,CL 06076
Ci /Town,Sante ZIP Telephone 413-244.2003
SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152.125C(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..........I No...........❑
SECTION 7s: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 net on my behalf,in all matters
relative to work authorized by this building permit application.
01/)0/2018
Print Owner's Name fElectroni.Si azure Data
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 hue and accurate to the bear of my knowledge and understanding.
John Perrier
oiono>
Print Owner's or AuthorizedAgent's Name Electronic Signs=) Date
NOTES:
1, An Owner who obtains a building permit to do hw her own work,or an owner who hires an unregistered contractor
(not registered in the Home improvement Contractor(HIC)Program),will no 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 9
wwwmass.sov/ons Information on the Construction Supervisor License can be found at www rnass.aov/dos
2. When substantial work is planned,provide the information below:
Total floor area(sq,ft.) (including garage, firtished bamement/attics,decks or porch)
Gross living area(sq.ft.) Habitable room count
Number of fireplaces Number of bedrooms
Number of baduooms Number of half/baths
Type divesting system Number of decks/porches
Type ofecoling system Enclosed Open
3. "Total Project Square Footage'may be substituted for"Total Project Cost"
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