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Massachusetts-Department of Public Safety Unrestricted-Buildings of any use group which
Board of Building Regulations and Standards contain less than 35,000 cubic feet(991m)of
Construction Supervisor enclosed Space
License: CS-083982
`-1:,c r. ,j,
Bryan G Hobbs
346 Conway Streef It Ag
Greenfield MA 0Y301
Failure to possess a current edition of the Massachusetts
"A State Building Code is cause for revocation of this license.
Expiration
Commissioner 0510212016 For OPS Licensing information visit: www.Mass.Goy/tips
t
�tal2cvwcc 0. �C?� LrrJlccc;
Office of Consumer Affairs and Business Regulation
J9
10 Park Plaza - Suite 5170
Boston, Massachusetts 02116
Home Improvement Contractor Registration
Registration: 139564
Type: DBA
Expiration: 7/23/2015 Tr# 243916
BRYAN G. HOBBS REMODELING
BRYAN HOBBS ---_-__^----------._.__-.---------____--
' 346.CONWAY ST --------- -_----------------___
GREENFIELD, MA 01301 --------.-.__---_-------_-._._.___-- ---_-_------___--
Update Address and return card.Mark reason for change.
2UM-05/11
SCA 7 co
(J Address [:j Renewal [—I Employment F] Lost Card
n%� �
L l((4p/IIG7/tI/t:flll�t����CL6:IJ/!C'JLIIJt!��J '
V Office of Consumer Affairs&Business Regulation License or registration valid for individul use only
OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to:
egistration: 139564 Type: Office of Consumer Affairs and Business Regulation
Expiration: 7/2312015 DBA 10 Park Plaza-Suite 5170
r Boston,MA 02116
BRYAN G.HOBBS REMODELING -
BRYAN HOBBS /
346 CONWAY ST d
GREENFIELD,MA 01301 A' r Undersccrctary without signature
The Commonwealth of Massachusetts
Department of IndustrialAccidents
Office of Investigations
1 Congress Street,Suite 100
Boston,MA 02114-2017
www.mass gov/dia
Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Auplicant Information Please Print Legibly
Name (Business/Organization/Individual): BQMn G.Hohhs Ramrutelinn
346 Conway St.
Address: Greenfield,MA 01301
City/State/Zip: Phone M " S DoLq
Are on an employer?Check the appropriate box: Type of project(required):
171 am a employer with(Q_ 4. 0 I am a general contractor and I 6. E]New construction
employees(full and/or part-time).* have hired the sub-contractors
2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling
ship and have no employees These sub-contractors have g, []Demolition
working for me in any capacity. employees and have workers' 9. E]Building addition
[No workers' comp.insurance comp.insurance':
required.] 5. We are a corporation and its 10.❑Electrical repairs or additions
3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions
myself. [No workers' comp. right of exemption per MGL
12.0 Roof repairs
insurance required.]t c. 152,§1(4),and we have no f ,
employees. [No workers' 13. Other I n� l -?f
comp.insurance required.] a
*My applicant that checks box#I 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.
$Contractors 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 workers'comp.policy number.
lam an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name:_ U� '�� � —
Policy#or Self-ins. Lic.#: JC_�� Expiration Date:
Job Site Address: (� / ' ' ( (� City/State/Zip:�� rEt
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.
I do hereby certify under the pains andpenahies ofperjury that the information provided above is true and correct
��' b, Date: _Ibi
Suture• 1�� ,
Phone#:
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.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone#:
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor. Not/Applicable ❑
Name of License Holder: l"_�— C) -2' �t5ryan C7.Hobbs Remodeling
346 Conway St. License Number
Greenfield,MA 01301
Address Expiration l ate
Signature Telephone
9.Realstered Home Improvement Contractor: Not Applicable ❑
«c1 S Co L)
Company Name Registration Number
Bryan G.Hobbs Remodeling ;1� � ��
346 Conway St.
Address Greenfield,MA 01301 Expiration Date
Y
Telephone
SECTION 10-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...... ❑
11. - Home Owner Exemption
The current exemption for"homeowners"was extended to include Owner-occupied Dwellings of one(1) or two(2)families
and to allow such homeowner to engage an individual for hire who does not possess a license,provided that the owner acts
as supervisor.CMR 780, Sixth Edition Section 108.3.5.1.
Definition of Homeowner:Person(s)who own a parcel of land on which he/she resides or intends to reside,on which there
is,or is intended to be,a one or two family dwelling,attached or detached structures accessory to such use and/or farm
structures.A person who constructs more than one home in a two-year period shall not be considered a homeowner.
Such"homeowner"shall submit to the Building Official,on a form acceptable to the Building Official.,that he/she shall be
responsible for all such work performed under the building permit.
As acting Construction Supervisor your presence on the job site will be required from time to time,during and upon
completion of the work for which this permit is issued.
Also be advised that with reference to Chapter 152(Workers'Compensation) and Chapter 153(Liability of Employers to
Employees for injuries not resulting in Death)of the Massachusetts General Laws Annotated,you may be liable for person(s)
you hire to perform work for you under this permit.
The undersigned"homeowner"certifies and assumes responsibility for compliance with the State Building Code,City of
Northampton Ordinances,State and Local Zoning Laws and State of Massachusetts General Laws Annotated.
Homeowner Signature
/Al
r
Section 4. ZONING All Information Must Be Completed.Permit Can Be Denied Due To Incomplete Information
Existing Proposed Required by Zoning
This column to be filled in by
Building Department
Lot Size
Frontage
Setbacks Front
Side L: R: L: R:
Rear
Building Height
Bldg.Square Footage %
Open Space Footage %
(Lot area minus bldg&paved
parking)
#of Parking Spaces
Fill:
volume&Location
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO O DONT KNOW (D YES
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO () DONT KNOW YES O
IF YES: enter Book Page and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO O DONT KNOW YES O
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained 0 Obtained O , Date Issued:
C. Do any signs exist on the property? YES 0 NO
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property? YES 0 NO
IF YES, describe size, type and location:
E. Will the construction activity disturb(clearing,grading,excavation,or filling)over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES O NO 0
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
SECTION 5-Dk,%RIPTION_OF PROPOSED WORK(check ill applicable)
New House ❑ Addition [, Replacement Windows Atteration(s) ❑ Roofing
Or Doors C3
Accessory Bldg. ❑ Demolition ❑ New Signs Decks (Q Siding[D) Other
Brief Descri ption of Proposed
Work o ter �y1 �"Clc1 e_ i nSvi(Yi�r�t1 -3 ; rk i fu CL li tlr� �tj�c--Fl our
Ko -poi CL ttl c .oar
Afteration of anti g bedroom Yes No Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement . Yes No
Plans Attached Roll -Sheet
6a.N New house and or addition to existing housino.complete the f60owina: (J
a. Use of building:One Family Two Family Other
b. Number of rooms in each family unit: Number of Bathrooms
a Is there a garage attached?
d. Proposed Square footage of new construction. Dimensions
e. Number of stories?
f. Method of heating? Fireplaces or Woodstoves Number of each
g. Energy Conservation Compliance. Masscheck Energy Compliance form attached?
h. Type of construction
L Is construction within 100 ft.of wetlands? Yes No. is construction within 100 yr. floodplain Yes No
j. Depth of basement or cellar floor below finished grade
k. Will building conform to the Building and Zoning regulations? Yes No.
1. 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
1, A m S 0'r h v ry L4 h ,as Owner of the subject
Jt7oan Q �\ }�
!y:be:e � ojl G • [ t r-��S lC..(t..r�111)C
a .ins m relative to work authorized by this building permit appli .
svhkture Z17
of Owner Date
I, rU i�,{1 ! ► V b�j as Owner/Authorized
Agent hereby dedarelthat 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.
tz,�r u ai) 4D b bs
Print Name 1
''
PIIA�aA 14-0 WO
�-t
Signawre of Owner/Abet Date
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
New House ❑ Addition Replacement Windows Alteration(s) Roofing
Or Doors ❑
Accessory Bldg. ❑ Demolition ❑ New Signs [p] Decks [Q Siding[Q] Other
Brief Description of Proposed
ky
Work: (a 1��A L
Alteration of wasting bedroom Yes No Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll -Sheet
6a.If New house and or addition to existing housing, complete the following: Vi/A"
a. Use of building:One Family Two Family Other
b. Number of rooms in each family unit: Number of Bathrooms
c. Is there a garage attached?
d. Proposed Square footage of new construction. Dimensions
e. Number of stories?
f. Method of heating? Fireplaces or Woodstoves Number of each
g. Energy Conservation Compliance. Masscheck Energy Compliance form attached?
h. Type of construction
i. Is construction within 100 ft.of wetlands? Yes No. Is construction within 100 yr. floodplain Yes No
j. Depth of basement or cellar floor below finished grade
k. Will building conform to the Building and Zoning regulations? Yes No.
1. Septic Tank City Sewer Private well City water Supply
SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
as Owner of the subject
property
hereby authorize
to act on my behalf,in all matte relative to work authorized by this building permit application.
Signature of Owner Date
I, i,,,i Yl { �. J r> ,as Owner/Authorized
Agent hereby declard 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.
Print Name
Signature of Owner/ t Date
Department use only
City of Northampton Status of Permit
Building Department Curb Cuwriveway Permit
212 Main Street Sewer/Septic Availability
Room 100 Water/Well Availability
Northampton, MA 01060 Two Sets of Structural Plans
phone 413-587-1240 Fax 413-587-1272 PIoVSite Plans
Other specify
APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1-SITE INFORMATION
1.1 Property Address: This section to be completed by office
„ wcklr FS—I & P ICLCQ- Map Lot Unit
PZone Overlay District
Earn St.District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Recce:
Zcar orouQjn I �ofr�t!A F!
Na ) Current Mading Address:
w
nature
2.2 Authorized Agent
b N Q0 Eli)10 b-5- 'n C-,retn{i2la ,�
Name(Prio Current Mailing Address:
eXMa 1 `bW
Signature Telephone
SECTION 3 ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by rmit applicant
1. Building t4 GU (a)Building Permit Fee
2. Electrical (b)Estimated Total Cost of
Construction from B
3. Plumbing Building Penult Fee
4. Mechanical(HVAC)
5.Fire Protection
6. Total=0 +2+3+4+5) v. d U Check Number
This Section For Official Use Only
Date
Building Permit Number. issued:
Signature:
Building Commissionerflnspector of Buildings Date
Department use only
City of Northampton Status of Permit:
Building Department Curb Cut/Driveway Permit
2 5 2014 212 Main Street Sewer/Septic Availability
Room 100 Water/Well Availability.
inspe°t1O1 rthampton, MA 01060 Two Sets of Structural Plans
h,. ,rt&I s 1:':60
Electri Nc`uran ` e 13-587-1240 Fax 413-587-1272 Plot/Site Plans
Other Specify
APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION
1.1 Property Address:
This section to be completed by office
L_r Map Lot Unit
Zone Overlay District
Elm St.District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
R
Name(Print) Current Mailing Address:
'.2 k-t+CL Telephone
�=--
Signature
2.2 Authorized Agent:
Name(Prinh Current Mailing Address:
Signature Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by ermit applicant
1. Building (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) { Cs U Check Number Q 6
This Section For Official Use Only
Date
Building Permit Number. Issued:
Signature:
Building Commissioner/Inspector of Buildings Date
File#BP-2015-0224
APPLICANT/CONTACT PERSON BRYAN HOBBS
ADDRESS/PHONE 346 CONWAY ST GREENFIELD (413)775-9006
PROPERTY LOCATION 11 WARFIELD PL
MAP 24D PARCEL 198 001 ZONE URC000)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid dtze
Buildin Permit Filled out
Fee Paid
Typeof Construction: INSTALL ATTIC&WALL IINSULATION
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included•
Owner/Statement or License 83982
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFOR N PRESENTED:
pproved Additional permits required(see below)
PLANNING BOARD PERMIT REQUIRED UNDER:§
Intermediate Project: Site Plan AND/OR Special Permit With Site Plan
Major Project: Site 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
n ay
e7o
Signature of Building fficial 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.
11 WARFIELD PL BP-2015-0224
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 24D- 198 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-2015-0224
Project# JS-2015-000421
Est. Cost: $1440.00
Fee: $55.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: BRYAN HOBBS 83982
Lot Size(sq. ft.): 4617.36 Owner: SCARBOROUGH ADAM&CECILIA SHINER
zoning:URC(100)/ Applicant. BRYAN HOBBS
AT. 11 WARFIELD PL
Applicant Address: Phone: Insurance:
346 CONWAY ST (413) 775-9006 WC
GREENFIELDMA01301 ISSUED ON.812712014 0:00:00
TO PERFORM THE FOLLOWING WORK.-INSTALL ATTIC &WALL INSULATION
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 Siznature:
FeeType• Date Paid: Amount:
Building 8/27/2014 0:00:00 $55.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner