18C-132 (2) 92 BLACKBERRY LN BP-2019-1058
GIs n: COMMONWEALTH OF MASSACHUSETTS
Meo:Block: 18C- 132 CITY OF NORTHAMPTON
Lot: 01 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Buildlna DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL 042A)
Cateeorv:renovation BUILDING PERMIT
Permit a BP-2019-1058
Project u JS-2019-001724
Es(,Cost:SI05000.00
Fee: $683.00 PERMISSIONIS HEREBY GRANTED TO:
Const Class: Coni actor: License.,
Use Group: GARY J CHAGNON 060175
Lot Size(sa.ft.): 12675.96 Owner., MASON DANIEL.K
Zoning:URB(100y Applicant. GARY J CHAGNON
AT. 92 BLACKBERRY LN
Applicant Address: Phone: Insurance:
91 STOCKBRIDGE ST (413)259-6785 WC
HADLEYMA01035 ISSUED ON,51112019 0:00:00
TO PERFORM THE FOLLOWING WORKNEW SIDING, ROOF, WINDOWS, BASEMENT
EGRESS WINDOW, NEW DECK, PORCH ENTRY AND CONVERT REAR PORCH TO 4 SEASON
ROOM
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector
Underground: Semi": Meter:
Footings:
Rough: Rough: House Foundation:
Driveway Final:
Final: Final:
Rough Frame:
Gas: Firc Department Fireplace/Chimney:
Rough: Oil: Insu:atiou:
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 Sianature•
FeeType: Date Paid: Amount:
Building 5/1/20190:00:00 $683.00
212 Main Street,Phone(413)587-1240,Fax:(413)587.1272
Louis Hasbrouck—Building Commissioner
File#BP-2019.1058 0000 INFO jmj`k L
APPLICANT/CONTACT PERSON GARY 3 CHAGNON M�- z/ 6K-
ADDRESS/PHONE
K-
ADDRESS/PHONE 91 STOCKBRIDGE ST HADLEY (413)259-6785
PROPERTY LOCATION 92 BLACKBERRY LN
MAP 18C PARCEL 132 001 ZONE URB(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
CLOSED REQUIRED DATE
ZONING FORM FILLED OUT 9;2
Fee Paid
Buildine Permit Filled out
Fee Paid
TvoeofConstruc i= NEW SIDING ROOF WINDOWS,BASEMENT EGRESS WINDOW.NEW DECK.
PORCH ENTRY AND CONVERT REAR PORCH TO 4 SEASON ROOM
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure -
Building Plans Included:
Owner/Statement or License 060175
3 sets of Plans/Plot Plan
THE/#OLLOW ING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
RMATION 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: She 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
Demolition Delay
/ S-I- ZDl9
Signature o udding Official 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.
Department use only
R City of Northampton Stabs of Pelma:
Building Department Curt Cut/Dnveway Permit
212 Main Street Sewer/Septic Availabiliy
ROOM 100 Water/Weil Availability
Northampton, MA 01060 Two Sets of Structural Plans
_ phone 413-587-1240 Fax 413567-1272 Plot/Site Plans
-- Other Specify
APPLICATION TO CONSTRUCT,ALTER,REPAW,RENOVATE OR DEMOLISH A ONE OR TWO FAMAY DWELLING
FORMIITIM
SECTION 1 -SITE INL7lls
1.1 Property Address: This section to be completed by office
901 a14craO�y �n we M•P-J P= Lot /3- Una
'vo, A4'*4/j'cit ,/ t N A 0
/0
60 ZaN Overlay District
Ewa wmNx CB Dim
SECTION 2-PROPERTY OWNERSHIP/AUTHORED AGENT
2.1 Owner of Record:
JPA e% M ffxv�/ y�1 /3� env l rn t/o iM+ n,�'a
Name(Pant) Current lingm
— 7�l-13 ff�
Telephone
Slgnawre
2.2 Authorized Agent:
Name(Pti Cunent Mailing Address:
�r3—y�ss-y�y�
sgnewre Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cast(Dollars)to be Oficial Use Only
completed by permit applicant
1. Building /0(-O,
Q -O 6�co (a)Building Permit Fee
2. Electrical 500 (b)Estimated Total Cost of
O Construction from 6
3. Plumbing Building Permit Fee r
4. Mechanical(HVAC)
5.Fire Protection
6. Total=(1 +2+3+4+5) Check Number /
TMs Section For Official Use Only
Date
Building Permit Number. Issued'
Signature: ty5-1 2019
Bu ion,Commissiaiedlnspector of Buildings Date
GCR,46- 0V C cfyoAxp -JR. coli
EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR)
Section 4. ZONING All Information Must Be Completed. Permit Can Be Dented Due To Incomplete Information
Existing Proposed Required by Zoning
Tins column to b filkd in by
Building Department
Lot Size /6170 /r?708'
Fronto a /00 ,
Setbacks Front .39
Side L. R: �7 r L (6 R: 17r
Rear 1771 / /?Va
Building Height /cI l67
Bldg.Square Footage �9 1/0 A1,3_014 /F75 /f(, 75
Open Space Footage (( %
Ila aro mbl &pa
kin � 79 (//,�,.vte^t� 7C/•
�
p GfParking SPEI
Fill:
volume&I.acation
A. Has a Special Permit/Variance/Finding ever been issued fa/an the site?
NO O DONT KNOW (D' YES O
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO O DONT KNOW O� YES O
IF YES: enter Book Page and/or Document H
B. Does the site contain a brook, body of water or wetlands? NO (D� DONT KNOW O YES O
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained O Obtained O , Date Issued:
C. Do any signs exist on the property? YES O NO
IF YES, describe size,type and location:
D. Are there any proposed changes to or additions of signs intended for the property? YES O NO (a—
IF YES, describe size, type and location:
E. Will the construction activity disWrb(clearing,grading,excavation,m filing)over 1 ave or is it part of a common plan
that will disturb over t acre? VES O NO
IF YES,Nen a Northampton Storm Water Management Permit from the DPW is required.
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
New House ❑ Addition ❑ Replacement)Vo&ws AIteration(s) Roofing
Or Doom 0
Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks )2r Siding IdZ— Other[a
Brief Description of Proposed ,ces l
Work:/x3t A041 S.a" a F?co�r�t lath. / / r39�or'.J c'�n�A wiuba,,1,41'WAO-I&r/ro�.rc; e
Alteration of existing bedroom_Yes ✓ No Adding new betlroom Yes '--No
Attached Narrative Renovating unfinished basement _Yes /� No
Plans Attached Roll -Sheet
ea.If New house and or additiontoexisting housing, complete the following:
a. Use of building . One Family // Two Family Other
b. Number of rooms in each family unit: Number of Bathrooms
c. Is mere a garage attached?4e5 �/ y
d. Proposed Square footage of new construction. H Dimensions /RAI a�(5/ .Y/)r-X f Lo , `l�L
e. Number of stories?
C Method of healing?11 )114 CTAS Fire�l`s or Woodstoves L�ember of each
g. Energy Conservation Compliance. Masscheck Energy Compliance form attached?
h. Type of construction
i. Is construction within 100 h,of wetlands? Yes //''��/� No. Is construction within 100 yr. floodplain-Yes /�NO
J. Depth of basement or cellar floor below finished grade(&-n'/ /'JR�
k. Will building conform to the Building and Zoning regulations? / Ves No.
I. Septic Tank_ City Sewer // Private well City water Supply
SECTION Ta-OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I, as Owner of the subject
property
hereby authorize (7T1'Y JT�M�`�
to act on my behalf,In all mad m relative to work authorized by this building permit application.
Signatureof Osner Dale
I, GARt1 J ' -s!/RYA,�/v/ as Owner/Aulhonwd
Agent hemby decla that the statements and information on the foregoing application are true and accurate,to the best of my knowledge
and belief.
Signed under the pains and penalties of perjury.
r4pv T CM6L&1--
PnmNama� �.
l
Sfilfighm,of Oyfrer Bent Date
I
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
No..of License Holder: e;Ag UT^- �[/17Q1r'T/'� GJ-06Qr7f�
License Number
S�oc�Parfd �I • �� M old - Z� Loo
Address Expiration Date
r -as9-�7
gnalure Telephone
8.Registered Home Improvement Contractor. Not Applicable ❑
C1W, L, 6o,r k4 /ZaMa�e�uti GCC //a 75�
Com an Nam J Registration Number
d a �e( - 0103 Z//w/y
A ress ����//�� pp ESI IbonD to
Telephone 116- f-6;
SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.O.L.c.152,g 25C(6))
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this aKdavil will result
In the denial of the Issuance of the building permit.
Signed Affidavit Attached Yes....... No...... ❑
City of Northampton
w �
Massachusetts
�1. DEPAM� OF BUILDING INSPECTIONS a
313 Maio ruse 010• WNAC1Building
u
fd .et
6oxq,ton, Ma 01060
AFFIDAVIT
Home Improvement Contractor Law
Supplement to Permit Application
The Office of Consumer Affairs and Business Regulation("OCABR")regulates the registration of contractors and
subcontractors performing improvements or renovations on detached one to four family homes.Prior to
performing work on such homes,a contractor must be registered as a Home Improvement Contractor("HIC").
M.G.L.Chapter 142A requires that the"reconstruction,alteration,renovation,repair,modemization, conversion,
carie rd, removal,demo/d—, orconshuctlon of en add*-to any pre-existing owneroccupred buwhv containing
at least one but not more than four dwelling units....or to structures which are adjacent to such residence or building'be
done by registered contractors.
Note:If the homeowner has contracted with a corporation or LLC,that entity must be registered
Type of Work: ,, r� ' -Est. Cost:
Address of Work: ga �J41 /tJ�KP- 4*LY� /L.C1'XZ
Date of Permit Application: 3zz
I hereby certify that:
Registration is not required for the following reason(s):
_Work excluded by law(explain):
_Job under$1,000.00
_Owner obtaining own permit(explain):
_Building not owner-occupied
Other(specify):
OWNERS OBTAINING THEIR OWN PERMIT OR ENTERING INTO CONTRACTS WITH UNREGISTERED
CONTRACTORS OR SUBCONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK ARE NOT
ELIGIBLE FOR AND DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND
UNDER M.G.L.Chapter 142A.SUCH OWNERS ALSO ASSUME THE RESPONSIBILITES FOR ALL WORK
PERFORMED UNDER THE BUILDING PERMIT.SEE NEXT PAGE FOR MORE INFORMATION.
Signed under the penalties of perjury:
I hereby apply for a building permit as the agent of the owner:
-0,gll9
Date Contractor Natne HIC Registration No.
OR:
Notwithstanding the above notice,I hereby apply for a building permit as the owner of the above property:
Date Owner Name and Signature
City of Northampton
r
f
Massachusetts (i)
DBPABTY®.wT OP BDIDDINO INaPBCTIONB212 I41n Stho Bwiclpal au11d1nqNoclhampton, rat 01060
Debris Disposal Affidavit
In accordance of the provisions of MGL c 40, S54, I acknowledge that as a condition of the building
permit all debris resulting from the construction activity governed by this Building Permit shall be disposed
of In a property licensed solid waste disposal facility, as defined by MGL c 111, S 150A.
The debris from construction work being performed at:
9a /xnck3e��U 6!U'e
(Please print house number an street name)
Is to be disposed of at:
4l( e� ea��ari an�iionatoff
Or will be disposed of in a dumpster onsite rented or leased from:
ti/A
(Company Name and Address)
�� 3b/�
1ignature f emit Applicant or Owner Date
ermit Applicant or Owner Date
If, for any reason, the debris will not be disposed of as indicated, the Applicant or Owner shall notify the
Building Department as to the location where the debris will be disposed.
4\
-"' The Commonwmlth ojMnssachusetis
Department of Industrial Accidents
�. I Congress Street,Suite 100
-» - -
Iv, Boston,MA 01114-2017
wwucmassgov/dna
H urkers'Compenalion Insurance AfBdaHC Bofl&rstCoasracfordElecttic[Plumbers.
TO HE FILED WITH THE PERMITTING AUTHORITY.
Applicant Information //��,, 6 PleaaseP�rint LeObly
Name (Rusiness Organization/Individual): �f/K,J,7i11 tbLZ�/r
olsr i`�Q/L/_ tom`/
Address:9, / 5"&K ZL-144ZA Kr+ '
t'
City/State/Zip: Phone#:�/,1
Attention employer?Cheek the appropriate box: Type of project(required):
I.�lamaemployer wid�amployeea(bilaM/mpon-a:rc)• 7. ❑New construction
3.❑Iamesole proprietormpermdship end have no employers working formein g. remodeling
any capacity.[No workers'comp.initiative m,mont]
3.�1 are a homeowner doing of work myself.[No woderi comp.immuno"u nod.]t 9. ❑Demolition
4.[]l am a homeowner and will be hinng contractors to conduct all work on my property. 1 will 10 Building addition
err thisaN connections;either have wreakers'caepcmxianinsmmmceas a .rile 11.0 Electrical repairs or additions
propincons with no employees.
12.�Plumbing repa¢s or additions
5.[31 an a general contractor and 1 have hired she cub-commeemrs listed on me attached shod. t3.EJ<f repairs
new sub employees-contractors have eloyees and have waken amp.immance.
b.F We arc a corporation and its officers have emmiced their right of exemption per MGL a 14.❑Other
152,§114),and we have no employers.[No workers camp.to..
'Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
I lioneemonces,who submit Ibis eXdevi,indicating they are doing all work and then hire outside eminacmrs most submit a new amdevit indicating such,
it'unoxton,that chat Its box must arrechcad an additmmel shax showing son,manro ofde,subaxemser.a aM stun,whether ar nus those entities hire
empinyeev. If the sub<omracturs have empluyeee,they most provide their workeri comp.pahet nmwo
I am an employer that is providing workers'enmpensaBon insurance for my employees. Below is the policy andjob site
information. /' /
Insurance Company Name: /A✓'ae1 F/ir+/lat./ S(/19L1-•�
Policy#or Self-ins.Lic.#: t7w/^WJ7a aExpiration Date:
Job Site Address: Aa, City/State2ip:AAn v
Attach a copy of the workers'compensation policy declaration page(showing the policy number and eapintion date).
Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to$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$250.00 a
day against the violator. A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance
coverage verification.
Ido hereby certi/fy�ymder�JJhfpains and ties of perjury that the information provided above is true and correct.
5'enatme' / /✓t+4i// Date: 3/a�//9
Phone#' G yf3 J 5. 6-2
Official 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.Building Department 3.CByffewn Ckek 4.Electrical Inspector S.Plum"Ixispeetor
6.Other
Contact Person: Phone#:
HOME YPROVEYFM COMfRA0T011
qg TYPE LLC
'^r_Fpt BYE 001,22[=1¢
112151 0121P1019
Chagnon BLO*V A Remodelling LLC
GARYCNAGNON
81 Sbddbridge Rd
Hadley.MA 01035Undensemetery
Cormmnweaah of Massachusetts
D'nlson of Professional Lnensure
Board of Building Regulations and Standards
ConstryctiOn Supervisor
CS-060175 Efpires: 09/302020
GADIS MA 0
5 -
91 STOCKBRAME RD
f1ADLEY MA 0103/5 (p
Com mrssonrr V""
Cft el
Pa
Louis Hasbrouck <Ihasbrouck@northamptonma.gov>
92 Blackberry Lane
Louis Hasbrouck<Iasbrouck@northamptonma.gov> Thu,Apr 4,2019 at 11:44 AM
Draft To: Gary Chagnon<gchagnon@chagnon-br.cem>
Cc: Kevin Ross<kross@northamptonma.gov>
Gary,
We need a set of electronic plans for the project at 92 Blackberry Lane.
No details for work in basement are shown; an egress window is indicated but no other information.
There's no structural information for the new deck or the front porch.
There aren't any real sections for the sunroom/den renovations. I can't tell if the walls and roof insulation will meet code.
Since it's changing from unheated to heated space, it needs to meet current code requirements, including the ceiling. The
windows also need to meet current code.
Send the information so we can finish the review;on the electronic plans is OK.
Louis Hasbrouck
Building Commissioner
City of Northampton
Town of Williamsburg
(413)587-1240 office
(413)587-1272 fax
Inn Ownors,to tnelrt LL
Daniel Masun k$arm Wrdud
92 Blackberry lane
Northampton.MA 01060
F.nail(s):swrelzed(u)gnuil.Lom
ARTICLE 23
TERMINATION
23.0 If the Contractor shall:
(a)be adjudged bankrupt,
(b)persistently or repeatedly refuse or foil,except in rases where extension of time is provided,to
supply rnough properly skilled workmen or proper materials to perform the work,
(c)persistently disregard laws,ordinances,rules•regulations.conditions of any public authorities
hae'ingjurisdidion over the WORK.or
(d)he guilty of material violation of this Agreement. '
i
then the Owner shall be entitlod, seven(7)ds j
upon days prior notice.unless the Contractor shall Lure cosh i
violatimi during mid setrn(7)day period,to terminate this Agreement mid take prasession of the Site and all )
materials and equipment thereon and finish the WORK by whatever method(Tuner may deem expedient. 1
t
ARTICLE 24 9
GOVERNING LAW;EFFECT
This Contract shall be construed and enforced in accordance with the substantive law of the )
C.aara.wealth of Massachusetts without giving effm in the con0icis or choice of law provisions thereof,and shall
hoes the cf$ct of scaled instrument li
1
This Agreement esccuted an die day and year first corium shove.
C ontreclQ f
t'HAGNO ddUILD!r/�
&REMODELING LLC
Bo•.
Ilwt (xl
Contractorlrnoals l�� Ownerslnl0ah' OJ/1-1
Wr!�°)o L9,/npn'•nllX l:lyriryr&eMnla HmlttleY^B ILL ')
m /IWglce)eW.w 11
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