07-064 (4) 331 NORTH FARMS RD BP-2016-1378
GIS#: COMMONWEALTH OF MASSACHUSETTS
MR.-Block: 07-064 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Buildinq DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: INSULATION BUILDING PERMIT
Permit# BP-2016-1378
Project# JS-2016-002370
Est. Cost: $6350.00
Fee: $65.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: JOSEPH GEORGE 99372
Lot Size(sq. ft.): 29795.04 Owner: HORWITZ MARK&JULIA F MOSS
Zoning: RR(100)/WSP(100)/WP(98)/ Applicant. JOSEPH GEORGE
AT. 331 NORTH FARMS RD
Applicant Address: Phone: Insurance:
6414AYWOOD ST (413) 774-3604 WC
GREENFIELDMA01301 ISSUED ON:5/23/2016 0:00:00
TO PERFORM THE FOLLOWING WORK.INSTALL ATTIC AND BASEMENT 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 Signature:
FeeType: Date Paid: Amount:
Building 5/23/2016 0:00:00 $65.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
File#BP-2016-1378
APPLICANT/CONTACT PERSON JOSEPH GEORGE
ADDRESS/PHONE 64 HAYWOOD ST GREENFIELD (413)774-3604
PROPERTY LOCATION 331 NORTH FARMS RD
MAP 07 PARCEL 064 001 ZONE RR(100)/WSP(100)/WP(98)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid 4Z 7?y5 LO
Building Permit Filled out
Fee Paid
Typeof Construction: INSTALL ATTIC AND BASEMENT INSULATION
New Construction
Non Structural interior renovations
Addition to Existing
Accesso Structure
Building Plans Included:
Owner/Statement or License 99372
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION PRESENTED:
_±<A'—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
Demolitio Delay
Z � - _;�Z�A�
Signature of Efuildinibf ficial 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.
t
j Department use only
City of No
_":2 Main Street Status of Permit:
3uilding Department Curb Cut/Driveway Permit
sewer/Septic Availability
p, ( room 700 �Nater/Well Availability
Northampton, MA 01060 }s
two Sets of Structural Plans
phone 413-587-1240 Fax 413-587-1272 Plot/Site Pians
Other Specify
APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION
This section to be completed by office
1.1 PCOPer!j Address: 3 I F[A rW U'l � f
D ` Map Lot Unit
r3rC w, /VA Zone Overlay District
C)(0 U)- Elm St.District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
LAI O �s5 3 {W� fi�c�s �z �Iorrqq,/A-A ai0
Name(Print} g Current Mailing Address: ( 463 t
Sj-P-Q, A�5{1<L��� Telephone 13 I
Signature
2.2 Authorized Agent:
3-oS 2 PN 64 ��+Y�►oo ��',
G�ee� `�et�INtA 01301
Name(Print v Current Mailing Address:
111-11131-77g- �
Signature Telephone
SECTION 3-ES (MATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Uae Only
com leted by permit applicant
1. Building 350,n' (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=(1 +2+3+4+5) ��,�a n Check Number 7 ^'
This Section For Official Use Only
Building Permit Number: Date
Issued:
Signature-
Building Commissionerlinspector or Buildings
Date
i
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all appli0able
lew House Addition Replacement Windows Alteration(s) 0 Roofing
]-OrDoors E3
Accessory Bldg. I'D
Demolition New Signs [[:31 Decks [E:] Siding[0] Other(50
o(,Proposed Brief Descriptio
Work:—TM A I[ 'VW01- 6K in Irl to ojemo�_ A, sleol %r- ONO -e IN t
Alteration of existing bedroom—Yes No Adding new bedroom—Yes No io 60ir
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll -Sheet
Ga.If New house and or addition to existing 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 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
9. Energy Conservation Compliance. Msscheck Energy Compliance form attached?
h. Type of construction I
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 Pdvate well City water Supply
SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED #HEN
P
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING MIT
1, as Owner of the subject
property
hereby authorize arise c7tom
to act on my behalf,in all matters relative Fo work authorized by this building permit application.
Yet r"L"p-lll V/010/6
Signature
Signature of Owner Date
1, 10 S e L�" as Owner/Authorized
Agent hereby declare 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.
u0sp 0,
Print Name 05 A0
signature of Own Alent Date
\J
SECTION 8-CONSTRUCTION SERVICES Not Applicable 0
F3.1 Licensed Construction Supervisor. CD) r4 ll 31
'dame of License Holder* 1—j0Jt6\ Ucense Number
010
Address Expiration Date
r (qIWTN-Ao�
Signature uTelephone
9.Registered Home improvement Contractor: Not Applicable 0
s. e- Gforq on, `iris, ISW(i
Company Name Registration Number
&ff-e4vl MIN 0130 7-2s
Address a Expiration Date
0�
TelephonAC)-77`1-3 6
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_
SignedAffidavit Attached Yes....... 9 No...... 0
Home Owner Exemption
The current exemption for"homeowners"was extended t include Owner-occupied Dwellings f one(1) or two(2)families
and to allow such homeowner to engage an individual for ire who does not possess a license,provided that the owner gets
Section
_10
supervisor.CMR 780. Sixth Edition Section 108133 -.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 neriod 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 binding 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.
Alsobe 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
.ty of Northampton .-
t Massacliuset is
DEPARTMENT OF BDItDING INSPECTIONS
J 212 Main Street • Municipal Building
Northampton, MA 01060
Property Address: 331 Fvf ms Qj, %ren c , o 10 4�
Contractor
Name: Jo$ep1 &eos�t fit , GeD!ne ot+ Sg'\, 1r\e.
.ddress: k)-l' grn�wooA S="!Rj
City, State: ,1� �fZ 2fri3t � 0130
Phone: `113)-774- 3LO4 t
1
,property Owner �� C
Name:
(�
r i
Address: 331 N, Fuirms W. I
City, State: P[)re'n ce '0 i
{
i, Jou e? kon g (contractor)attest and affirm that the building i intend to
osu►ate does not have any open air(knob and tubs)wiring in the spaces to be insulated and that l have
provided the property owner with a copy of this affidavit.
,ontractor signature ( „
I
Date 105/I�1�, 6
� I
r
I
ni
�
74? Conmfzornwealth ofMassackusetts �^-1ni:Form
�-
=-- ciasr.4 ccidetats
-_
tMassachuse'tts -Deparmeni ol uja+ ns --nu V�?4'�G E =,'
ill t1L iI1/1i Jiiitil�1�1)t 'jii�L(i11i� '
_. 'SSL-09372
�OSEPH P GEORVE
,4 HAYWOOD STREET" = I
GREENFIELD KA 01301
Commissioner
02%11/2017
+I
H
Office of Consumer Affairs&Business Regulation License or registration valid for individul use only
-= HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to:
--'�Registration: 156686 Type: Office of Consumer Affairs and Business Regulation
—_ Expiration: 7/25/2017 Private Corporation 10 Park Plaza-Suite 5170
Boston,VIA 02116
GEORGE&SON INC
JOSEPH GEORGE �, r� r f
54 HAYWOOD ST g `� J✓'�'L
GREENFIELD,MA 01301 ' --
Undersecretary No validhout signature
wit
y Permit Authorization ', '
masssav Form f� _
CoCruR
Site ID: S00002139463 Customer: JULIA MCS::
I. JULIA MOSS ,owner of the property located at:
(Owner's Name.orinte-'
331 N Farms Rd FLORENCE
;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 o perform insulation and/or
;)Eeatherization work on my propert
Owner's Signature: S
Date:
( . ., :;OCU OCi,.,^pp:, 7SCG ;D::...)U';COC.` ..::�'�,....._' .
FOR CSG OFFICE USE ONLY,
Conservation Services Group has assigned the following Mass Save Home Energy Services Participating
Contractor to the above referenced project: j
1
I
05110,o 16
Participating Contractor Date
r
RIM
For Offma U.s*On