The URL can be used to link to this page

31A-272 (8) 23 DRYADS GREEN ST BP-2020-0688 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 31 A-272 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: INSULATION BUILDING PERMIT Permit# BP-2020-0688 Proiect# JS-2020-000163 Est.Cost: $4505.00 Fee: $4505.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: JOSEPH GEORGE 99372 Lot Size(sa.ft.): 33541.20 Owner. SULLIVAN VIRGINIA M zoning: URA(100)/ Applicant. JOSEPH GEORGE AT. 23 DRYADS GREEN ST Applicant Address: Phone: Insurance: 64 HAYWOOD ST (413) 774-3604 WC GREENFIELDMA01301 ISSUED ON.121612019 0:00:00 TO PERFORM THE FOLLOWING WORK.INSTALL 6" LAYER OF R-19 TO ATTIC FLOOR 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 12/6/2019 0:00:00 $ r 15 t� 212 Main Street, Phone(413)587-1240,Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner Deppol? City of Northbmp n s- Building D artr7entOee tJ 21 Roofn Str et SULATION Northampton, 1Y1 101 r� CiFAb"j7an, t phone 413-587-1240 Fax 41 ONLY APPLICATION FOR INSULATION FOR A ONE OR TWO FAMILY DWELLING ONLY SECTION 1 -SITE INFORMATION INSULATION PERMIT 1.1 Property Address: This section to be completed by office �3 ]]�� -y u ry u�1 (r�Pfn S t Map Lot ,-I oUnit N0rfKrAMpt0A,N1n Zone Overlay District OtObr) Elm St. District CS District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: V I(9m,A S�411'I10n �3 D�y�IJ (rctlr` �t Name(Print) 2. aa 1 Current Mailing Address: �Ce �1� ��eu Telephone �� " 1pit,11 . Signature 2.2 Authorized Agent: J'o� � G•ex e 6'{ kuw�d S�• GrPwfva, Name(Print) Current Mailing Addre s: (' 13)- 774 - 36911 Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building 4 0 S 4O (a) Building Permit Fee 2. Electrical (b) Estimated Total Cost of Construction from (6 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) 5. Fire Protection 6. Total = 0 +2 + 3+4+5) JOS, ra Check Number This Section For Official Use Only v„ ,�� Date Building Permit Number: 0 Issued: Signature: 13 A l9 Building Commissioner/Inspector of Buildings Date EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) City of Northampton i Massachusetts DEPARTMENT OF BUILDING INSPECTIONS �z 212 Main Street • Municipal Building b Northampton, 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, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner-occupied building 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 hay contracted with a corporation or LLC,that entity must be registered Type of Work: 111 f ion 4trast f o Est. Cost: Address of Work: 3 d f)(41 Date of Permit Application: 11(14 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: � �� -IA(. ��J�� s a 9 6d' Date Contractor Name 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 Massachusetts r i F.i C DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street •Municipal Building Northampton, MA 01060 vbs`' aCb 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 properly licensed solid waste disposal facility, as defined by MGL c 111, S 150A. The debris from construction work being performed at: a3 Dq4f &f% sf.. (Please print house number and street name) Is to be disposed of at: Br�1e' WD SCA�Vj{ q31 VtT0A (J' 9rc4le6ro '/(Please p i t d l ca ion o aci ity) Y T Or will be disposed of in a dumpster onsite rented or leased from: (Company Name and Address) *Prmi Signaturner 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. rheco rtjnonwe4*h°ofMasSaCkUsetts 3eptar iinent'of lnainsifr�W Accirfetzts p r EE�t . Offlee ofInv�sfiano7ts 1 Congtless Street;Sake 10# Bosco t, MA.02.114.-20-17 Workers' CanIpc>asation Insurance ww zass gr�vfdia iicalzt orruatiun fila ►it..i3;3ii iers/Contractors/Electric[ans/pIMM iers Name tl3usins/pr — /� Please Print L ,b guiliraEitrn/Inditi7duttl):.. ��. �'� �d Address. 64 �' z�.r �� 1 G-en 4 city/state/zip: Are You an em �to er? t713D(Phone g: `ql-3 P Y Cheek_the aPProP. ate box:. I I am a empioyer with [] I am a enc -Type of ro'ect re employees(fu�.i, I and/or part time_ 4 have hired the sub antraetod I 5• Ne;� (required): 2. T L3In a sole proprietor or partner- listed on the attached sheet construction Woo and for no employees These sub-contractors have Remodeling working for me in any capacity. employees and have-workers' [No workers':comp_insuranceg- ❑Demolition required.] �OmP-jnsurattce* g- ❑ Building addition ' 5• ❑ We are a corporation and its 10-0 Electrical repairs or additions • 3•� 7 am a(tomeowuer doing all�,orlt officers have exercised their myself[No workers' comp. right of exemption per MGL I I.❑Plumbing repairs or additions iE;sEirance squired.] C, 1a2, 51.(4),and ive have no 12❑ Roofrepairs employees.[No workers' 13.® Other i Yl-54J 4ct'�'l`O.y4 • comp. insurance required.] y applicant that chei ks box 0j must also til!out:fhe section below showing the' T Nmneovrncis atho submit this affidavit indioadng they, doing till wor3c and then hire outsidempensoto S [r workers'compensation policy information. 'Contctctars ihat.check this box musr attached an additional shu lshoWork the name oirthe employees. if the sub con tractormus�c m must submit a new affidavit indi caaltS cmpiayces,they must pt vide their workers'cam sub contiactn�c m"Istate whetheror not those such- I QTIT tUi--Mplvyer that is rnv' , P Policy number. erztit hale infnrnTQtion, p TdTrig IO©t kers eoutpeTTsativn insul`Qnce for my employeesHelotis flte v..lic ynd tInsurance'Company Fame: Obsie Policy'"or Self-ins.Lic.A1: Job Site Address: p`3 of Expiration Date.• rl�dr Gres,, Attach.a Copy of the workers'compensation pitiicydeclaratiatr Page CkY/State/Zip: �r}��Ytl rpn fi / 010(0 Failure to.secure coverage as re P g (shoving ttte.pd ieY number and expiration-date)- fine up to 57,500.00 and/or one yearn prsontnen asection well as c utic. 152 can lead to the.imposition of Of p to$290;40 a da o - penalties in the fotYu of a STOP crimiilaI penalties of a Inver • y a�atnst the violator- Be advised that a copy-of this statement may be forwarded to the Office of ttgations of the DTA for insurance coverage verification. ORIF ORDER and a fine I do hereb tuTder elle aims acrd e,Ta hies o e u .slim the infarmati©nroulded;abnve htrue andcorrect Si ature: — Phone:F: ! Date -- Y t?}Trirrl useonly. Dn not syriie ln. tris ares i'o be copleted by circ,-or ivtan Official . City or Town: Inning AutiZorrty{cerete PermWLieense.# T.Board of Neatth 2.Snilding Department 3.Ctty!'y"own'Clerk s! $.E}thet' .lE7ecti•ical�nspeetor 5.Plumbing,tnspactar Contact Person' Phone IT: Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:Corporation before the expiration date. If found return to: Registration Expiration Office of Consumer Affairs and Business Regulation 156686 07/24/2021 1000 Washington Street -Suite 710 JP GEORGE&SON INC Boston,MA 02118 JOSEPH GEORGE 64 HAYWOOD ST GREENFIELD,MA 01301 Not'valid itho .t signature Undersecretary Commonwealth of Massachusetts Division of Professional Licensure Board of Building Regulations and Standards ConstructiOO-s "- r Specialty CSSL-099372 ires: 02/11/2021 JOSEPH P GEORGE 64 HAYWOOD STREET GREENFIELD MA 01301 Commissioner DocuSign Envelope ID:CE206533-A332-46B8-8A53-CAF5D58CDA60 RISE ENGINEERING' OWNER AUTHORIZATION FORM 1, Virginia Sullivan (Owner's Name) owner of the property located at: 23 Dryads Green Street (Property Address) Northampton, MA 01060 (Property Address) hereby authorize a'P. sol),a . (Subcontractor) an authorized subcontractor for RISE Engineering, to act on my behalf to obtain a building permit and to perform work on my property. This form is only valid with a signed contract. DocuSigned by: la �14(14,WJA A„ ture 10/5/2019 14:52 AM EDT Date RISE Engineering, a Division of Thielsch Engineering, Inc. 60 Shawmut Road Unit 2 1 Canton, MA 02021 1339-502-6335 www.RISEengineering.com City of Northampton s Massachusetts - . DEPARTMENT OF BUILDING INSPECTIONS ; x, 212 Main Street a Municipal Building Northampton, MA 01060 MANDATORY FOR h►OUSES BUILT BEFORE 1945 Property Address: (Vi\ $� Contractor Name: 3,F- G((e�c�C W+ 501), u►t. Address: b�{ �-{g►r 4v�o a 5 t. City, State: �r(ticnfcG�1� q, t3Q' _ Phone: _ `[L3} -114-3604 Property Owner Name: �Jit �p�n Swl��l Address: rt(4 �rferti St City, State: �G>�t��rr�a 1r 01€60 )QSfek t (contractor) attest and affirm that the building I intend to insulate does not have any open air(knob and tube)wiring in the spaces to be insulated and that I have provided the property owner with a copy of this affidavit. Contractor signature- S, / ,t t Date W04 401