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23D-068
30 WARNER ST BP-2016-1500 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block:23D-068 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 Permits BP-2016-1500 Project# JS-2016-002561 Est. Cost: $2190.00 Fee: $65.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: JOHN PERRIER 105319 Lot Size(sq.ft.): 19471.32 Owner: HICKOK MARY H Zoning: URB(100)/ Applicant: JOHN PERRIER AT: 30 WARNER ST 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 if 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 6/16/2016 0:00:00 $65.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner File#BP-2016-1500 APPLICANT/CONTACT PERSON JOHN PERRIER ADDRESS/PHONE 18 BROADWAY POND RD STAFFORD SPRINGS (860)930-7794 PROPERTY LOCATION 30 WARNER ST MAP 2313 PARCEL 068 001 ZONE URB(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid CP" 15j3 '$(/5' Building Permit Filled out Fee Paid Tvoeof 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 INFORMATION PRESENTED: Vnpproved 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 �,-. ela �� Datto 5- Signature of Bui din ffici e 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. 1-44 The Commonwealth of Massachusetts I r Board of Building Regulations and Standards FOR MUNICIPALITY Massachusetts State Building Code, 786 CMR USE Building Permit Application To Constmct, Repair,Renovate Or Demolish a Revised Mar 201One-or Two-Family Dwelling This Section For Official Use Only Build. g Permit Number Date Applied: Building Official(Print Name) Signature Date SECTION I:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers I.1a Is this an accepted street?yes _ no_ Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq h) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard 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 0 Private d Zone: Outside Flood Zone? _ Municipal d On site disposal system C Check ifyesd SECTION 2: PROPERTY OWNERSHIP' 2. sr er of Recon - . . ',. : _,(I/A _ jName(Print) a Z', 4_ /22 ( / �?c ._ 30 hiquil No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(cheek all that apply) New Construction C Existing Building C Owner-Occupied C Repairs(s) C Alteration(s) d Addition C i Demolition 0 Accessory Bldg.0 Number of Units Other ❑Specify:__,,, Brief Description of Proposed Work'; To Add R-38 Insulation to open attic SECTION 4:ESTIMATED CONSTRUCTION COSTS item Estimated Costs: Official Use Only Labor and Materials I. Building I $ 1. Building Permit Fee: _Indicate how fee is determined: 2.Electrical I $ d Standard City/Town Application Fee ❑Total Project Cost'(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) List: 5,Mechanical (Fire Su•+ scion) Total All Fees:$ Check No.PP Check-7 Amount: Cash Amount: 6.Total Project Cost: S � 6( ❑Paid in Full Cl Outstanding Balance Due:_ NEGH 28 Spellman rd Please Submit Stafford Springs,Ct Permits to: 06076 SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) John Perrier 165319 12-12-2015 License Number Expiration Date Name of CSL Holder List CSL.Type(see below) 18 Bradway Pond rd Type Description No.and Street Unrestricted Buildin s u r w 35,000 cu.h. fl Restricted 1&2 Faintly Dwellin: City/Town,State,ZIP MIZMI. Mason Raafrn:Coverin: Stafford Springs Ct 06076 WS Window and Siding SF Solid Fuel Burning Appliances t Insulation 860.9304794_ jperrier06076@yaboo.com Tele. one Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) HIC Company Name or HIC Registrant Name 173021 8-27-2016 HIC Registration Number Expiration Date John Perrier No.and Street jperrier06076@yaboo.com 18 Bradway Pond rd Email address Stafford Springs,Ct.06076 City/Town, State,ZIP Telephone 860-930-7794 SECTION 6: WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 752.§25C(6)} Workers Compensation Insurance affidavit must he 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 111No U SECTION 7s:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRA(!OR APPLIES FOR BUILDING PERMIT 1,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/ ) /2016 Print Owner's Name(Electronic Signature) _ Date SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION By entering my name below,l 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/ 9)1 /2016 Print Owner's or Authorized Agent's Name(Electronic Signature) Date NOTES; 1. An Owner who obtains a building permit to do hisrber own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC)Program),will Z have access to the arbitration program or guaranty fund under M.G.L.c. I42A.Other important information on the HIC Program can be found at www.mass.aov/opg Information on the Construction Supervisor License can be found at www mass eov/dos 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" J Installation Agreement Contract Paanu'anes .i kit ' h`i;1)11 Lk) corrifAcrOR New England Green Homes 1(855)7EARTH7 Toll Free 413-244-2003 Info@negreenhomes.com Customer Name: f � �v.l�O �y�/ address: 3o Iitit+,v.n15L e" , !//'t'"CSC'.e, / !^'r�`• 5 ..... .�/ }jome Phone: Cell: 1./J 7i -R" "- 74ee-- Client Number: q 3153 Work Description: �•� ,4r Itiao4Q 9Y_'40 bo1/4 �H, i t-, iat f'a ( 3) ,41--"g 31c t l i gdd 91' YTy., 1 ;?t/4/ c4tr -ce..' 5 ' l_L- �'"r ' r<iL{r:r tNn 7c' Y l<.. itigi es. cash 21. PLXrP C>=,kg.: itJ/r}. il"' �.ol. ' (.N* S 'd1 rt-J/je'c LLy- IA%.� A 5 C ( ) 1 i-14, (h&j;Jo (hr„f j; tut / )F Job Total: -2 i.. <,: .centive Amount: /oe9S• 6 D R-re) = 4 '.5V4r.) Customer Cost:$ ��' ,,,Ar{stall Date: Ci-1J Ain Please ReTer to uieTRome Energy Report for a detailed description of work to be preformed 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 above. Payment of the full amount is expected upon completion,by check,cash or credit. The customer agrees to pay thebalanceof the cost upon completion of the job. Customer Signature: r '„ " `�`"` . Date: 'l l n I lco Pelt Contractor Signature: .L. X , Date: Cilah lJ ityro cfc hc. �ikn, },'" '° I 6/LC r r ,� n.M�;. 2a* The Consoisrmalth ofionacL i— } enol Fare ".- --. thwa�al�ror�ll ojllatrl*W.g '�/�+ l Corsi Sand SSIff ./ DmraI,NA 031147017 ammaragettils Workers'Campanian LMunoce Affidavit:BamKvConu el«v!I[+Nn.l lima?nln6en Anima bftw aUw tlla0 PATI Loth Now pwattaroneveas .p:IW°°VIM&'vw Noma Addnott t$81�mynJ PwW rc ryn aMW a Phone ll:O.Cle MJ.ra t•WV•ft auk a,aPp+rlda bat I T)In vlpyfn(Oeeelrr7 1.0Ila•turbo.We 4 4. 0 l ere.slael emmaot ma l c, Nn.aoramum terrors Mil aWaant+ael• Mnldlta au n$cotwnle LO l inn PAW/Wring a Pun. IINdm WrwfM duel. 7, []R.ondpli.s 44tIns ao iaar mb•oaaalolee tart Q platy Ib aer mod*, and hew Mtn 1. 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IMI {� WS* I MOMM-SIP w V nw IWIIIIIIt ;1--:z .OII Mat.MIj. . 1 _.-......_r IEMY q { ... w c' •t. r IG mommmtmot IM wMpnA �II. t . as A rumen waists n e. MMC1Yej_ I ry'^ II .OI! i rr—nwr,...«w,....+Mrw wwr in..r.I.w•..41...».w.em.w....mo, o nsowe swcnuraM SIR,�,MptquMEMMMMMroM IIM 0r1M+MM wn MMMR Mui N ir1r.II11 N MgpAg04YrMM1 KIOIOIMMMtrT111far IIq/MMIMII AtiViNM-ssAs. Wct--d. 14 A. 1 0 1MISH/POMP tAi1110AARYIG AIMit mama * I#IM>4I*1 Th*MMOMO MnYYWIEMMINdIMNYMdMOME 221e 2J'b0'-1J ,>0C'Jd t.9 Irby 5 t* � CSSI '105319 JOI IN API:HRH H w" 1R BROADWAY FOND ROAD SIAPPORU SPRINGS C1' 0607( 1�. .<.:..... . 12/12/2017 t .+2G-'_. E. . ,=i '1 .'b�. "` a ae � 04 'ka47171A9 0/0/ ' * irti ~"e4P. 11 er AfFairs &"Business tehu�,.tkn - C ME3IMPROVEMENT CONTRACTOR 9 aegastration 173Q21 T�`f „ prat}an 8727/2016it: indiyiduaI Na r ..y a,l.. E ZRIE.R y Sm ,I -d b+ 6�lhA IIY t ?i'A `+ a , Ct 06076 jM1rk f �T . - r.,, City of Northampton rTee\ s, sio4N ^' S, MRMassachusetts A. 21 Sc ‘ r a o c?..,DEPARTMENT OF BUILDING INSPECTIONS � \""lhe 212 Main Street • Municipal Building . BNorthampton, MA 01060 �k WD' Property Address: 30 10 0 A,Y t.- Contractor Name: ,ilio) &'y)a/1a1 6vx n Y)uc Address: ) �a � y!tc ',(i /9( p-rc City, State: e -11211,17 hp(2) (t( ,/)O Phone: Property Owner / ( / J� Name: y'( Address: . O Li30 4 Ai_V- City, State: ` 11 ifs (X f7 ((r {-7/.7�1 1„ j oho -i V rut* (contractor) attest and affirm that the building I intend to insulate does not have 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 ----- Date Date ' 31 / C