22D-065 (2) 77 FLORENCE RD BP-2016-1499
GIS#: COMMONWEALTH OF MASSACHUSETTS
Man:Block:22D-065 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGLLcc.1144/2�A)
Category: INSULATION BUILDING PERMIT
Penult# BP-2016-1499
Project# JS-2016-002560
Est.Cost: $2815.00
Fee: $65.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: JOHN PERRIER 105319
Lot Size(sq. ft.): 21605.76 Owner: DIEMAND PETER.'&COLEEN K C/O SETH A CLAWSON
Zoning:URA(100)/WSP(100V Applicant: JOHN PERRIER
AT: 77 FLORENCE RD
Applicant Address: Phone: Insurance:
18 BROADWAY POND RD (860) 930-7794 WC
STAFFORD SPRINGSCT06076 ISSUED ON::6/16/2016 0:00:00
TO PERFORM THE FOLLOWING WORK:ADD INSULATION TO OPEN ATTIC
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 ft 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:
FeeTene: Date Paid: Amount:
Building 6/16/2016 0:00:00 $65.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
File#BP-2016-1499
APPLICANT/CONTACT PERSON JOHN PERRIER
ADDRESS/PHONE 18 BROADWAY POND RD STAFFORD SPRINGS (860)930-7794
PROPERTY LOCATION 77 FLORENCE RD
MAP 22D PARCEL 065 001 ZONE URA(100)/WSP(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT/
Fee Paid CCIC. "6330 `! (((—
Building Permit Filled out
Fee Paid
Typeof Construction: ADD INSULATION TO OPEN ATTIC
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 105319
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFO TION PRESENTED:
Approved 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
e 7/51//
Sit . ire of Burin_ fficiaff 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.
RECEIV
al _ 72016
The Commonwealth of Massachusetts i I
oen[o"'r`zlt.`t�immam Board of Building Regulations and Standards FOR
ALII Y
! yji -'; Massachusetts State Building Code, 780 CMR Mh'NICCIPIP
Building Permit Application To Construct, Repair, Renovate Or Demolish a I Revised Mar 20)I !I
One- or Two-Family Dwelling
__
_ This Section For Official Use Only _
l Building Permit Number: I Dote Applied:
Bolding O'Lnal (PnntName) Signore Date
, SECTION 1: SITE INFORMATION
' 1.1 Property Address: 7 1.2 Assessors Map& Parcel Numbers '
I I.la Is;hi➢an.accepted street?yes _ no I Map Number Parcel Number
1.3 toning Information: 1.4 Property Dimensions:
Jotting thstoot Proposed We L Lot Area(sq ft) Frontage(Po
1.5 Building Setbacks(ft) __
hFiord Yard i Side Yards Rear Yard
kcy ired Provided Required Provide Required ( Urns4d
PP - , — �
r 1.6 Waley Supply: (M.C._c.40, §54) i 1.7 Flood Zone In�'ormation: 1.8 Sewage Disposal System:
Publla❑ Private D Chet*IfyesZone. _ Outside t.yesD I Flood Zone'? Municipal D On site di.sposI system D
SECTION 2: PROP RTY OWNERSHIP'
- I Owne or Rc o d: C^ / o, ,, yn' )/ 1,4„ar ,t,� ,,, c ) ) 1c D I
Name(Print; AA h'7YL l. GUAXIV K/ (' Sta1, ZIP - / 11i't 4 lJ
7_1 edict - _ X11 i -7D-1 - 3y3/
No.and StreeI Telephone Email Address
SECTION 3: DESCRIPTION OF PROPOSED WORK'(check all that apply)
New Constriction O ! Existing Building I Owner-Occupied ID Repairs(s) ❑ I Alteration(s) 0 I Addition D�
I
LDemolition DDI Accessory Bldg. D jNumbernf Units Other D Specify: —__ l
I Brit Description of Proposed Work':
_ ___ To Add R-38 Insulation to open attic �
SECTION 4: ESTIMATED CONSTRUCTION COSTS __ I
I Ian Estimated Costs- Official Use Only
�iabor and Materials) I __ _ ——
Bd.lding I S I
I. Building Permit Fee S_ Indicate how tee is determined.
1 C Standard City/Town Application Fee
' 2. Elecudca S C ❑Total Project Cast' (Item 6)x multiplier__x_
13. Plumbing ) Si 1 2. Other Fees: $ _
4.Mechanical (HVAC) H$ I List —
I 5.Mecliar nal (Foe S I Total All Fees: S _
S�Pre son) ��tt !as-
, _
q Cheek No.Ib.l S.Uheck AIM/UM:: Cash Amount._
6.Total Project 0061 1 <�CD `S. D paid in Full ❑Outstanding Balance Due `
NEGH
28 Spellman rd
Please Submit Stafford Springs,Ct
Permits to: 06076
_1
SECTION5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License (CSL)
John Perrier 1 105319 12-12.2015
License Number Expiration Date
Name of CSI.Nokia
List CSL Type(see below) I
18 Bradwa).Pond rd -- _- -81
–
Type l Description
No and Street : U Unrestricted(Buikllnes up ic35000cu B
R Restricted I&2 Family D e tip 1
r
CayRo n,Siete ZIP , m 1 Masonry
RCRoofing Coverin :1
Stn(ford ipri' CI(1076 WS 1 Window and Siding _
SF j Solid Fuel Burning App' antes _
•
L I I Insulation _.
8-80-930-7194_ jperrierOb0764yahuncom
Telcpho .. [mall address D ( Demolition
.5.2 Registered Home Improvement Contractor(HIC) 77021 8-;;-2CIG
HIC Company Name or HIC Registrant Name 1113 Registration Number Lkairailor Date
John Perrier
and gado errier06076
IS Bredwa Pond rd ID ®Yasoo.cam
Y Email address
t.
C ite/ld o. ias. 06076—
Cl M1rl own.State, ZIP Telephone 860.930.779)
SECTION 6: WORKERS' COMPENSATION INSURANCE AFFIDAVIT(M.G.L. c. 152.§ 25C(6))
- H
: Workers Compensation Insurance affidavit must be completed and submined with this application. Failure to provide
r this affidavit will result in the denial of the issuance of the building permit.
Sipco Affidavit Attached? Yes.. II No _ ❑
F 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 New England Green Homes to act on my behalf, in all matters
relative to work authorized by this building permit application.
John Perrier
5/3( /2016
Fn.Owners 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
Lynn Ford
5/3j/2016
Print Owl Authorized Agent's Name(Electronic Signature) Dale
NOTES: yl
I. An Owner who obtains a building permit to do histher own work,or an owner who hires an unregistered contractor I
(not registered in the Home Improvement Coinractor(TIC)Program), will not have access to the arbitration
program or guaranty fund under M.G.L. c. 142A.Other important information on the -1[C Program can be found at
www mats eovPoca Information on the Construction Supervisor License can be found at Neww - o0t�'d
When substantial work is planned,provide the information below:
Total floor area(sq. F..) _ _(including garage. finished basement/attics, decks or porch)
Gross living area(sq. Il.)__ — Habitable room count ___
N umber of fireplaces __ Number of bedrooms
Number at bathrooms_ ___ Number of half/baths _ _
Type of boatinsystem _ Number of decks/porches
i
' Type of cooling system__ _ Enclosed Open_
7. "Total Project Square Footage"may be substituted for"Total Project Cost"
Installation Agreement Contract
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,.�.:{t1Cn, a„ ,
REENHOMEcommsgronJ
New England Green Homes
1(855)7EARTH7 Toll Free
413-244-2003
Info@negreenhomes.com
Customer Name: Sel-ry 0 Li.0 S:;T �. Dingjng 6�,�„tL
Address: '77 FlorenceI-}
. 4i loes,c 44ess
Home Phone: Cell: (q,2) 7-27- 313/
Client Number: q 330W 3
Work Description:j) /2 ,r SsiaLS2. 9" rrt j((-i ,vL
4) W..046-- cAo „o 1, 4,12 C ets ea (-4 Jolty /9 aa)
dp itzdal /o" A) 4 lirc, 77--1o,f rTs-224Th S'5w• ey.
ihs "( 7 to A!/dam, 451a-
tri) 02 r
%'irm,ea • 4H-) 1 C:y4a.q.si- � N� AL20 - \) I/8,71-
G ;J S2 Li., q Co, I L(4112Sid y'412)
("` -l1 ns.,ls/2 /baa€Az.Yt S'. %/r 12-1< ,C h-444- Cm° 239. (c)
a) 144 SirA7Q &Sea en} 114141 Nhoote (f) 72,4.?
Job Total: $ - f 1: Incentivelsmount:5 Aill .G0 1-GFO- 2g;.(,c
Customer Cost• .S33,8,94 Install Date: 9 -f0 &in
.R.-1 -r o e 'ome Energy Report fora detailed description of work to be preformed iocip 3.,•c'D
TOTAL CONTRACT PRICE AND PAYMENT SCHEDULE
The contractor agrees to perform the above described work,furnishing the materials and labor specified above for the total price
listed abov . • of the full amount is expected upon completion,by check,cash or credit.
go70rra ,"s;- P4
The customer agrees to pay the balance of the cost upon completion of the job.
Cas's (rob' '---..,
Customer signature:r SAM k$, ' lli r Date: 11,0/y6
N ' /
Contractor signature: Date: 5/fD(l6
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GT 06076yyy... aadP , xUndersecretary L ' A,', .
City of Northampton
a Massachusetts e? ®
11P i-i
i
, ` w[� DEPARTMENT OF BUILDING INSPECTIONS , '`&
\ 212 Main Street a Municipal Building
<:.. !-- 7 Northampton, MA 01060 SdV 301
Property Address: / ii !iy 2 7rf /d
Contractor Jo fin /�
Name: Onrri v L..,
NEGH
Address: 28 Spellman Rd
Stafford Somas,CT 06076
City, State:
Phone:
P rtY
Pro a Owner ,T
Name: �( ata lOLL1d1 F412 ( IQQLur-62c
Address: + (� /�'--1-too fl ( '.4-'
City, State: -1�/Y,�r�i I a 17)-2n 010vi z-
I, " / "/I f ,�biYX-P— (contractor) attest and affirm that the building I intend to
insu does not ave 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 / -
a
Date
S 3i — / (.42