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24C-178 (2) 185 CRESCENT ST BP-2020-1039 GIS#: COMMONWEALTH OF MASSACHUSETTS MaQBlock:24C- 178 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: Bath reno BUILDING PERMIT Permit# BP-2020-1039 Project# JS-2020-001758 Est.Cost: $5840.00 Fee: $65.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: PAUL GASS 077256 Lot Size(sq. ft.): 11064.24 Owner: BETSY POWELL Zoning: URB(100)/ Applicant: PAUL GASS AT: 185 CRESCENT ST Applicant Address: Phone: Insurance: 58 SUMMER ST (413) 387-9105 GREENFIELDMA01301 ISSUED ON:3/27/2020 0:00:00 TO PERFORM THE FOLLOWING WORK:BATH RENO -ADD NEW WASHER/DRYER 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: FeeType: Date Paid: Amount: Building 3/27/2020 0:00:00 $65.00 212 Main Street, Phone(413)587-1240, Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner Department use only City®# Northarnpt®n Status of Permit: Building [)epartmDnt Curb Cut/Driveway Permit J/ 212 Main Stroot Sewer/Septic Availability ____ I � !(i N®®m 100 Water/Well Availability Northampton, Q1060 Two Sets of Structural Plans ----- ------ ph®nN 413.587ml240 ox 4RA87-1272 Plot/Site Plans__ _--- ----___-- Other Specify_ __- APPLICATION TO CONSTRUCT,AVE ,RE All, NOVATE OR DEINOLISH A ONE OR TWO FAMILY DWELLING ti 2020 SECTION 1 -SITE INFORMATION rvoRT i ieetien t0 completed by office 1,1 Property Addvs ?re : tiAr 44 o ori NS 60 S+• MaP YC Wt-- 7 C—Unit Zone Overlay District Elm St.District_- CB District. SECTION E=PROPERTY OWNERSHIPIAUTHORIEED AGENT 2.1 Own Nem@(Rrintfii Current Mailing Address- Teleph®n@ 13- 58S rEi nstt�r$ �. _ 5� S� �� s�• �t�;e(.1(I ,1Mf�-� Old Nem@(Plin Cufforit Meiling Address? 7 S:L4A Y 13-3g�-Rio §ign Tele hone (SECTION S_ESTIMATED CONSTRUCTION CO&M Item Eetimeted Cost(Dollars)t®be Oftiel Use Only m I@t@d by Permit applicant 1: Building (e)Building Permit Fee 2, Eleetlial (b)Estimated Total Cost of Construction fr®m 5 3. Plumbing Building Permit flee 4. Meehenilol(HVAC) g. Fire Protection g, Total = (1 + 2+ 3*4*E) Check Number This ection For Official Use nl Building Permit Number. Data Bignliture: Building Commissioner/Inspector o Buildings Date EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) Section 4. ZONING All Information Must®@ Cofnpl@t@dm P@rmit Can 6@ Dan*Duo To ln@ompl@t@ Information Existing PropoR@d R@quWd by Zoning Thi§wltmm to b@ fill@d in by l�uildin�lent Lot Sin ftofl K@th@@it6 From 816 I,: R: L: — '-- &K MOOS H@fight -_--:i Bldg:Scipooh@ % 0p@o 8p&@@ po@ (Lo 4M miat4 bids&Pnv@d #of Parking S &@@4 -- ation) X Has a Special ftrmit/VarianoWFinding Over been issued for/on this sit@4 NO 0 DON'T KNOW YES 0 IF YES, dat@ issued: IF YES: Was this p@rmit r@o@rd@d at th@ R@gistry of ®@@d8? NO ® DON'T KNOW 0 YES IF YEST @nt@r Book Page and/or pocum@nt# S� Dom th@ sit@ contain a brook, body of water or wetlands? NOV�lDON'T KNOW YES IF YES, has a p@rmit b@@n or n@@d to be obtained from the Gonsory@tion Commission' Needs to be obtained 0 Obtained 0 , pate Issued C, ®o any signs @hist on th@ property? YES0 NO IF YES, d@sorib@ sim, type and location: D, Am th@r@ any propos@d changes to or additions of signs intended for th@ prop@rty I YES ® NO IF YES, d@sorib@ six@, typ@ and iaEatian: E, WIII this construction activity disturb(o @ring,grading, @@v@tion,or filling)ov@r I @@r@ or is it part of @ common plan that will disturb ov@r 9 @@r@? YES C) N® iF YES,thsn a Northampton St©rm Wat@r wnag@rnent P@rmit from the DPW is r@quir@d. SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable) New Hogg@ Lj Addition Replacemennindows Alteration(o) Roofing Or Doors Accessory Bldg, ® Demolition ® Now Signs [®) Decks [q Siding [Q) Other[o) RI9@f®ascription of Proposed Work !3& '-e NOV14+' 0 I*iVyl N l�1 tk( tz l�c�ca tC u Alteration of @lasting bedroom Y@s No Adding new bedroom Yes '� No Attach@d N@rr@tiv@ renovating unfinished basement Y@—@ ✓No Plans Att@gh@d Roll -Sheet Ba If New house and or addition to existing housing, complete the following: a. Use of building °An@ Family— — Two f=amily - Other b� Nwmp@r of room§in @@ch family unit= _ Number of Bathrooms_ o, Is there @ gar@g@ @tta@h@dT d: Proposed€guar@ foot@g@ of new construction, Dimensions @: Number of§tori@§y f. M@thod of h@atingT Fimplacos or Woodstovos Numb@r of each g. Energy Don§@ry@tion Compliance, Mass@hook E=nergy Dompliano@ form att@ch@dT K Type of con§truotion i. Is oon0ruotion within 100%of w@fl@nd§T Yes No, Is con§truction within 100 yr. floodplain-- Yes No J, Depth of basement of c@IIaF floor b@low fini§h@d grade k. Will building conform to th@ Building and Zoning regulations? Yes No I. S@ptic flank City Saw Private w@II City water Supply SECTION To-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNED$AGENT OR CONTRACTOR APPLI€I FOR BUILDING PERMIT 1, '-BW , a§own@r of tho subject property homby authollim to act on my b@ha in all matt r-@ @tiv@ authorIz@d by this building permit a plication- �I n�t,r@ ®1Nn@F Date ,, � Ls Own@r/Authorized Ag@nt @r@ y @ @r@thotth@stot@m@nt@ and in ormat�th foregoing application ar@ tru@ and acourat@,to th@ b@st of my knowledge and b@li@f, Signed and @ p@in§and p@n@ltie f p@qury, PrintN @ 3 I 5 /�0 Si nstuii®f pwnpF/A t@ 1Do — i1=GTION 0-CONITRUCTION gFERVICEs 1.1_Licensed Construgfign fupervisor: d.� Not Applic@bl@ Name of License Halder: a-- 0,7n Li@@n@@ Number - S.� _ `3"(a3 1 Jnr Aid ExpIF@iiAn Date C4 ly 13--3q 1, gryatym Telephone 9. Registered ome Improvement Contractor, Not Applicobl@ 6 b M C�-j Name R@g!oV@Uon Numb@r Q s#- 0 3o ©6 0% 010M dr@si Expiration at@ T@I@phon@ GICTION 10-WBRK€R8'COMPPNISATION INiURANCB AFFIDAVIT(M.01,0, 153,135C(5)) Workers Comp@nsation InSUranc@ affidavit must be gompl@t@d and submitted with this application, Fail0r@ to provid@ this affidavit will r@sglt in the denial of the issuang@ of th@ building @rmiL signed Affidavit Att@gh@d Y@a.:::.:: No...... The Commonwealth of Massachusetts Department of IndustrialAccidents 1 Congress Street,Srdta 100 Boston,MA 02111-2017 Y wwmmass lovIdla Work@rs'Comp@nontion Insurasnc@ AMdasvitt Buiid@r@/Contrsctors/El@ctricians/Plumb@rs, TO RE FILED WITH THE PERMITTING AUTHORITY, Allplicant Information Clause Print Lyalhl N@ (Ilasin@ss/Argaa'<itttitt/Ittdlvidt�l), — �_ n( — Aa ss: Sj w s� City/State/Zip: Ccs r&'&jJ77fL0M . 0(3Z Phone #: Arf you afl employ@r)'O@fk tie approprinte hom `yyp@ of proj@ot(r@quir@d),. I,®1 Am it @mploy@r With— @mpipy@@s(full And/or part=tim@):* 9. [3 N@w oonstruction 2:S1 Am A sol@ prpprietor of pgrtn@rship gild hav@ no @mploy@@s working for m@ in a, Itcmod@ws Any c4pwily[No Work@FS'comp,insuFan@@ Mquirgd.] 1L J 1 Am a hpm@own@r doing all work mys@if[No work@rs'@omp:iflsurgn@@ r@puired.]' �, BuildiMmong a 4:r]1 Am A hom@pwn@r and will W hiring @9wra@tprs to @polo@t Rif work on my prpp@rty. I will 10®I�liidt �md�iti®#1 @"4w that all wntra@tpm WOW lav@ work@rs'@omp@nsation iflswww of W sol@ I I,®I;i@�tFi@a i r@p�ir9 or additions propri@tors with no @mplpy@@s: 12?®Plumbins r@pairs or additions 3,®1 grog g@n@rgl ppotrgctor and I have hired the sub=ppfltFgptpfs listed pn th@ gtWh@d sh@@I. l3,®Roof r@p airs Th@S@ sob ppptrgptors have employ@@$and bgve Wn&M,pomp.insprgflp@:t b,®W@ arc it porporation and ils offs@@m lgv@ @4@rgiwd th@ir right of @g@mphon p@F MUL p. I�:®AIi1@r lgZ,010),and w@ lav@ no @mplpy@@s:[No work@W romp.inswww roquimd] *Affy applWimi that gfiwks box#1 must also fill put the section below showing th@if woftfs,@ompensgtion pplipy informal ion. #1lAm@pwfl@rs who submit this affidavit indi@#Jing th@y are doing All Work gild then hire outside contractors must submit A new gt�ldAVit indipgting$urh: IC-omrAoPrs thgt ph@ck this box must# @h@d An Additional sh@@t showing tb@ nam@ otthe sub-contractors and stgt@ whether or not the$@ @ntiti@s hgv@ @mplpy@@s: If th@ sNi pontrgptoFs hgv@ @mploy@@s,th@Y most prttvid@ th@ir work@m'comp.policy number. tam an employer that is provldln#workem'compensation insurance for my employees. Below is the polley and job site ltlfilrmtlon, Iiififir&w Compamy Nam@I policy#or b@lf ins:W@:# l; piration batt@; Job Sit@ Addr@gs! city/Stat@/Zip; Attach it copy of th@ work@", comp@ngation policy dMalration png@(showing th@ policy numb@r @Rd @xpiragtion dot@). Pail=to g@@ur@ @ov@rad@#§r@quWd und@r M6f,c, 152, §25A[s a crlminal violation ptmishabl@ by a lin@ up to$1,500,00 and/or oto@=y@ar imprigonmm@nt,tts well as @ivil p@nalt[@s in ft form of a STOP WORK OVER and a fin@ of up to 5250:00 a day against th@ violator.A copy of this gtat@m@nt may b@ forwarded to th@ We@ of Invwigtttions of th@ AIA ibr insurm@@ QOV@Mo@ v@r 01ttion. 1 da hereby nn r the pa ns pot naltl�g�jperJnry that the information provided above A trNe and correct~ Date: IL Phan##: 0470101 NNO on(p, Aa not write in this area,to be contpletetl by city or town official. City or Towni P@rmlt/Lic@ns@# issuing Authority(circle on@)t 1.Board of II@alth 3,Building D@partm@nt 3.City/Town Cl@rk 4.Fi@etrlcnl lnop@ctor ;I,Plumbing Insp@@tor 6,®th@r Contact P@rgoni Phon@#t City of Northampton Massachusetts = •`I l nEP���' ®�' �� NG IN9�1�E,'���� 9�. 212 main @t€o@t •i ft-$4l l" ftgt-►tet®n, NA otofo Debris Disposal Affidavit In accordance of the provisions of MOL c 40, 654, 1 acknowledge that as a condition of the building permit all debris resulting from the construction activity governed by this Quilding Permit shall be disposed of in a properly licensed solid waste disposal facility, as defined by MQL c 111, 6150X The debris from construction work being performed at; "D' 57 Ck—Sc,wi--� —4, (Please 0—t house numb@r and street name) Is to be disposed of at: (Pl@@@@ print name and location of aci qty)-- Or will be disposed of in a dumpster onsite rented or loosed from kb"S 'lItc o4 0 ®mpany Name and Address) ' iigna:tur@ of f r Ie or Owner Date if, for any reason, the debris will not be disposed of as indicated, the Applicant or Owner shall notify the ®gilding Department as to the location where the debris will be disposed. • - _ City of Northampton Massachusetts A: Pr $12 main @t€@@t • mmi@ip4l l" fid' @€ 01060 AFFIDAVIT Home Improvement Contractor Law Supplement to Kermit Application The Oftice of Consumer.Aftirs and Business Reguiation("OCABR")regulates the registration of contractors and subcontractors performing improvements or renovations on detached one to four f milt'homes, prior to performing work on such homes,a contractor most be reglstered as it Home Improvement Contractor("HIC"). VI,G& Chapter I42A requires that the"r@oonstnrotion, altomfi®n, renovation, repair, modomi0tion, oonvomicn, improv@m@nt, removal, demolition, OF oonatnrotion of an addition to any pm=existing aWrieFownp*d building containing at IMat®n@ but not m®f@ than loaf 0@11ing anita....of to 8tryotums which alb af#aoont to much rosid@n@@ OF building"he done by contractors. Nater If the honwowner has contracted with a corporation or LLC,that endity mast he registered Typo of Work: -— -- —Est,Cost, - Address of Work, Date of permit Application, I hereby cortin+that, registration is not required for the following rmson(s), _Work excluded by law(explain), _Job under$I,®®®,®® Owner obtaining own permit(@xplaln), Building not owner=occupied Other(specify)=. OWNERS OBTAINING THEIR OWN PERMIT OR ENTERING INTO CONTRACTS WITH UNREGISTERED CONTRACTORS OR SUBCONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORD ARE NOT ELIGIBLE FOR AND DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER M,G,L,Chapter I42A,SUCH OWNERS ALSO ASSUME THE RESPONSIRILITES FOR ALL WORD PERFORMED UNDER THE BUILDING PERMIT,SEE NEXT PAGE FOR MORE INFORMATION, Signed under the penalties of penury! I hereby apply for a building permit as the agent of the owner, Date Contractor blame HIC registration No, OR: Notwithstanding the above notice, I hereby apply for a building permit as the owner of the above property, Cato Owner Name and Signature ar.10 essa.0— afst�*.0--- b(dd a� 16, a-- pjig g g Tj; Ff iipppOpt. Bm I ga a 5Z go A mTZ fig A Aw X4 -k- .11 7L =IMF, View Valley - ore Impeovdmehti kic, M NO ,F6 f3&660i, MA M062 MAIN FLOOR PLAN PAHUMI A POWU