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23A-113 (2)
BP-2024-0209 51 MAPLE ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 23A-113-001 CITY OF NORTHAMPTON Permit: Alts Renovations Repair PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit# BP-2024-0209 PERMISSION IS HEREBY GRANTED TO: Project# INSULATION 2024 Contractor: License: Est.Cost: 1900 J P GEORGE AND SON INC 099372 Const.Class: Exp.Date: 02/11/2025 GIDEON FISCHER E &KATHERINE H Use Group: Owner: TODHUNTER Lot Size (sq.ft.) Zoning: URB Applicant: J P GEORGE AND SON INC Applicant Address Phone: Insurance: 64 HAYWOOD ST (413)774-3604 4220066477 GREENFIELD, MA 01301 ISSUED ON: 03/07/2024 TO PERFORM THE FOLLOWING WORK: INSULATION/WEATHERIZATION 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: Final: Final: Final: Rough Frame: Gas: Fire Department Driveway Final: Fireplace/Chimney: Rough: Oil: Insulation: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: Fees Paid: $65.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner 11 d--- A-i 7.Za tk I � 0i�r et) _ The Commonwealth of Massachusetts �_ FOR Board of Building Regulations and Standards MUNICIPAL)TY .' �-? - 1 Massachusetts State Building Code,780 CMR USE .i Building Permit Application To Construct,Repair,Renovate Or Demolish a Revised Mar 2011 s ` mco One-or Two-Family Dwelling 1;J ( This Section For Official Use Only . ' ry—' DilaNalr it Number: 1. • 20If Date.Applied: ' • , . s o,'. Keno J -,z • . I/ . '! 3. 7-20zy "•' ,Building Mc*(Print Name) • Stgnature" Leto c' ` SECTION 1 SITE INFORMATION 1.1 Property A4�aares • 1.2 Assessors Map&Parcel Numbers /53 /it -f , f.4vilma.>c�d i .111, 1.1 a Is this in street?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 -1-- Required Provided Required Provided Required Provided 1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public O Private 0 Zone: _._. outside Flood Zone?Check if}scsfl Municipal❑ On site disposal system 0 . • • SECTION 2: PROPERl Y"OWNERSHIP' 2.1,Q er'of Record: AjaihetY/?e, 70c./X,;c ra r e r A/or'T‘c-r►��fan, i .61,'1 -2 Name(Print) City,State,ZIP 5311 S/ 23 ODO 59 No.and S Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WOW(check.all that apply) • - - New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) ❑ Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg.0 Number of Units Other id Specify: Cl I0-7/c► Brie Description of posed Work2: r S .'' - as ') -/ SECTION 4i ESTIMATED CONSTRUCTION COSTS - Estimated Costs: Item OfficialUse:Only Labor and Materials) 1.Building $ / 9 00 1. Building Permit Fee:$ ,'Indicate how fee is determined: 2.Electrical $ .©Standard City/Town"Application Fee, .•C!•Total Project Costs(Item 6)x multiplier - x. 3.Plumbing $ 2. Other-Fees: $ 4.Mechanical (HVAC) $ List: •.. • 5.Mechanical (Fire $ Total All Fces: Suppression) V" • • Cost: $ p Cheek No.(xQV'Check Amount: Cash Amount: 6,Total Project f / G1 0 ❑Paid in Full.. ©Outstanding Balance Due: ;� SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) Mk 494 37a c3, 'ose._0, License Number Expiration Date Name of CSL Holder JJ t„ V,O0d �fr�� List CSL Type(see below) WS r� No.and Street l �'f(J�� Type Description Gcettn e-ld O (3o ) U Unrestricted(Buildings up to 35.000 cu.ft.) R Restricted 1&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding �( SF Solid Fuel Burning Appliances (413) 53( «76 �luAtd .000 utl_____ 1 I Insulation Telephone ��— Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) UT. Cs�e-o f j� n /S'(o�86 �'YSo , i HIC Registration Number Expiration Date HIC Co ipany me or HIC Re i tram ame tog No. d Street 4tie.1d, t30 % C4i ) 5311076 Email address City/Town, State,ZIP Telephone SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152.§ 25C(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 No 0 SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,as Owner of the subject property.hereby authorize 3ose_Q� to act on my behalf,in all matters relative to work authorized by this building permit applica ton. Print Owner's Name(Electronic Signature) Date 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 true and accurate to the best of my knowledge and understanding. i).1 E 2A be rclQ , )//(// y Print Own s or Authorized Ag9t's Name(Electronic Signature) 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 at www.mass.gov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dps 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) (including garage,finished basement/attics.decks or porch) Gross living area(sq.ft.) Habitable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of half/baths Type of heating system Number of decks/porches Type of cooling system Enclosed Open 3. "Total Project Square Footage"may be substituted for"Total Project Cost" The Commonwealth of Massachusetts .. Department of Industrial Accidents ,_--� �} Office of Investigations -=, ..... Lafayette City Center --M = 2 Avenue de Lafayette, Boston,MA 02111-1750 4 �'� � - www mass gov/dia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual):JP George& Son Inc Address:64 Haywood St City/State/Zip:Greenfield, MA 01301 Phone#:423-774-3604 Are you an employer? Check the appropriate box: Type of project(required): I.© T am a employer with 5 4. [] I am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. 0 Remodeling ship and have no employees These sub-contractors have S. 0 Demolition working for me in any capacity. employees and have workers' [No workers' comp. insurance comp. insurance.t 9• ❑Building addition required.] 5. 0 We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their MD Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs • insurance required.]t c. 152, §1(4),and we have no 13.1111 Other INSULATION employees. [No workers' comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their woticets'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:Arbella __.. Policy#or Self-ins. Lic.#:42200664477 Expiration Date:8-1-2025 Job Site Address:53 le (}! City/State/Zip:A)0/4'dt//??f1 A; Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of 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. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. Ido hereby certify under t epai and penalties ofperjuiy that the information provided above is true and correct. Signature:y ilifiDate: a//1 /, V Phone#: 413-774-3604 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(check one): 10Board of Health 20 Building Department 31:City/Town Clerk 4.0 Electrical Inspector 5E'lumbing Inspector 6.DOther Contact Person: Phone#: .. ._ ._,- 1. _ j fN O N N v. 0 4:1 74.38 i s.4.. 4,1::it,44.0&::it:07, .to.,Av gom Q , o c= Is .vlfgatikes Emmr. ar 8zo �' dt so 7:1).1 THE COMMONWEALTH OF MASSACHUSETTS co Office of Consumer Affairs and Business Regulation , 1 i 1000 Washingtgn Street - Suite 710 Boston,Massachusetts 02118 Home Improvement Contractor Registration t g [ ‘,--,--------. 1,-*rt Type: Corporation r• JP GEORGE&SON INC ' b ; Registration: 156686 y s > t 64 HAYWOOD ST 1 i X „-f•- Expiration: 07/24/2025 2 6 & w r1 GREENFIELD,MA 01301 ' "' 9.. +�•-«•-. ."'' M, �, 9 - 60 i. a 4 r u ,�m N �R'y I ,; ..a r02 j �a 47 rS� II `'` Update Address and Return Card. c.2 c a a v.v o iii N THE COMMONWEALTH OF MASSACHUSETTS v �? a = k 4.e. 1 Office of Consumer Affairs&Business Regulation Registration valid for individual use only before the a.S��'6. HOME IMPROVEMENT CONTRACTOR expiration date. If found return to: a s ,o z . i TYPE:Coi'Qq ion Office of Consumer Affairs and Business Regulation o-r-r pip Registration Expiration 1000 Washington Street -Suite 710 .- 'Fa' 156686 . 07/24/2025 Boston,MA 02118 re u.to I P GEORGE&SON INC r .-Z..? • f OSEPH P.GEORGE �" b' \ 0 \I\ • 4 HAYWOOD ST a./2 y,L- I. Pt-54• REENFIELD,MA 01301 Undersecretary , Not vak wit ut signature * 3• ; kits,. l COMMONWEALTH OF MASSACHUSETTS DEBRIS DISPOSAL AFFIDAVIT Town of Dam f r' Massachusetts/4 IN ACCORDANCE WITH THE PROVISIONS OF MGL Chapter 40, Section 54, A CONDITION OF BUILDING PERMIT NUMBER IS THAT THE DEBRIS RESULTING FROM THIS WORK SHALL BE DISPOSED OF IN A PROPERLY LICENSED SOLID WASTE DISPOSAL FACILITY AS DEFINED BY MGL Chapter 111, Section 150A. Brattleboro Salvage 437 Vernon St. Brattleboro, VT DISPOSAL/DUMPSTER FIRM 53 fl/ i .. it/op-iiiairri644, M4 CONSTRUCTION SITE ADDRESS eOrtifiLi 9,,,,.". S GNATURE OF kRailif APPLICANT ,,?///)/21/ DATE 44/0 /V Permit Authorization mass save Form Site ID: 5060855 Customer: KATHERINE TODHUNTER Katherine Todhunter , owner of the property located at: (Owner's Name,printed) 53 Maple St Northampton, MA 01062 (Property Street Address) (City) hereby authorize the Mass Save Home Energy Services Program assigned Participating Contractor listed below to act on my behalf and obtain a building permit to perform insulation and/or weatherization work on my property. Owner's Signature: K el7u2 rP��fUk/- Date: 01 /23 /2024 FOR OFFICE USE ONLY We have assigned the following Mass Save Home Energy Services Participating Contractor to the above referenced project: :Tr G� So w/?7 4/ Pafiticipating Contractor Date Name: CLEAResult Phone: 800-480-7472 Email: Page 1 of 1 For Office Use Only Document Ref:BGRNW-XSMMK-QNJPP-BDYPD Page 6 of 6 mass save 2023 weatherization barrier clearing Based on your Energy Specialist's recommendations,your home can benefit from program-eligible insulation and/or air sealing improvements.Before moving forward,please see the steps below to remediate your weatherization barrier(s). CUSTOMER INSTRUCTIONS 1. A qualified,licensed contractor will be assigned to evaluate your weatherization barriers)at no cost to you and will call to schedule. 2.The contractor will complete and submit a copy of this form.If the contractor is unable to clear the barrier,the contractor will provide you a quote for additional services and/or parts. It is recommended to get multiple quotes for work needed beyond the evaluation visit. You are not required to use the assigned contractor for remediation. CUSTOMER INFORM ATION a•b'.•C ”:- •'i b1 E eO e -,.v. .. , .:11 , '" n Owner Name! Katherine Todhunter Project ID(s): 5060854 Owner Occupied.D Number of Units:1 Phone Number: 413522597° Email: fischunter@comcast.net cite Address:53 Maple Street City:Northampton state, MA zip.01062 Wheresermels tobeperformed Owner Signature: K/t�rahtfi der 11 127/2023 Date: ,. TION KNOB' To deterrn.ne if there is any actve knob and tube(K&T)wiring,a MA licensed electrician will evaluate the following areas where eligible Mass Save weatherization recommendations have been made: Energy Specialist Evaluation:K&T evaluation is needed in the following areas Attic Floor Kneewall Area Live Live 0 Live CLive0 Live 0 Live Q Live Live 40 Not Live Not Live 0 Not Live ( Not Live 0 Not Live ONot Live C_,;Not Live Not Live Notes: Rear attic open and enclosed floor areas.Left side kneewall slope and gable areas. If you decide to have any lighting fixtures covered or made in contact with insulating materials,a MA licensed electrician must certify that all fixtures located in the areas indicated below are insulated contact(IC)rated Energy Specialist Evaluation:IC rated recessed light verification is needed in the following areas Open Attic Enclosed Floor Cavity Enclosed Interior Slope Ali Recessed Lights 0 Qty _ ''._:Qty. Qty 0 Qom•_... C.IC Rated C'IC Rated 0 IC Rated : `IC Rated • C:Not IC Rated -Not IC Rated Not IC Rated ' Not IC Rated t*, I have read and agree to the Terms and Conditions on the back of this form. Contractor Name: . ...._ _,Ca,..V]___LIu..�.,C?� Address:___Aa�__5 Lj ksci, . City: ae -Nhxr-dsr0 State: fJ1 ZIP 6 133 7 Company Name LJ �S�: si _ lerrr.r� $,Le' , License Number: 3 34 6 3 Contractor Signature: ___3i0+!+",- ti Date: I Z -15-213 Z 3