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36-261 (12)
163 MAPLE RIDGE RD BP-2017-0161 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 36-261 CITY OF NORTHAMPTON Lgt: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: INSULATION BUILDING PERMIT Permit a BP-2017-0161 Project/I JS-2017-000257 EstCost: $30Q6-00 Fee:$65.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: JOHN PERRIER 105319 Lot Size(sch ft): 55756.80 Owner: CAVANAUGH PAMELA& DANIEL P Zoning: Applicant: JOHN PERRIER AT: 163 MAPLE RIDGE RD Applicant Address: Phone: Insurance: 18 BROADWAY POND RD (860) 9304794 WC STAFFORD SPRINGSCT06076 ISSUED ON:8/8/2016 0:00:00 TO PERFORM THE FOLLOWING WORK:INSTALL 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 8181`20160:00:00 865.00 212 Main Sheet,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner File#BP-22017-0161 APPLICANT/CONTACT PERSON JOHN PERRIER ADDRESS/PHONE 18 BROADWAY POND RD STAFFORD SPRINGSO6076(860)930-7794 PROPERTY LOCATION 163 MAPLE RIDGE RD MAP 36 PARCEL 261 001 ZONE THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT �) l6J'` Fee Paid ,(J 7 I ' Building Permit Filled out Fee Paid Typeof Construction: INSTALL INSULATION New Construction Non Structural interior renovations Addition to Existing Accessory StrgoSure Building Plans Includgd:: Owner/Statement or License I Q5319 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION 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 .r* :on relay Sig . ure t Budd g Official 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. REC_Y D AUG 4 2016 he I . monweahh of Massachusetb Boldo Building Regulations and Standards FOR hi] neve or aunn;uc"saE tach sett*State Building Code,7811 CMR MUNICIPALITY usr'nsamrcy;caw cissas USE Building Permit App 'cation To Construct,Repair,Renovate Or Demolish a i Revised Mar 201) One-or No-Family Dwelling This Section For Oficial Use Only Building Permit Number. Date Applied: — ... Building Oficial(Peat Nene) Signature Due SECTION I:SITE INFORMATION 1.1 Propejlrrl�rey9J��','yq//Q� 1.2 Assessors Map&Parcel Numbers 1.11 le NL an accepted yea/t M Moo Number Panel Numbs 1.3 Zoning Information: 1.4 Property Dlmensiom: • Zoning Diruid Ptoposcd Use La Arta lse h) v Fmnmge(h) • 13 Building Setbacks(n) From Yard Side Yards Rear Yard Required Periled Required Provided Required Provided 1.6 War Supply:(M.G.L e.40,154) 1.7 Flood Zone Information: 1.8 Sewage Disponi System: Public Privet Zone: _ 'Dui"Flood Zone? MunIcipu O On site disponi system D Check if rein SECTION 2: PROPERTY OWNERSHIP' t"I Oretr I C(2: © ,{ .(0. IJG11") nip- =f '1 L[ i�— ( i d�o Z Nan(Peng CI Serie.LII I LO 3 McY,t' l&IAil- Kt- LI/ 3-5730- 75- 75 bo - 75 75 No. Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK'(cheek ah that apply) New C owbczion D Existing Building 0 Owner-Occupied 0 Repair(r) D Aluestioo(s) O Addition D Demolition 0 Accessory Bldg.❑ Number of Units Other 0 Specify: Brief Description of Proposed Wort': To Add & Improve 11-Value Insulation in home for weatherization purposes. SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estlmat�Costs: Omelal Use City (Labor ed Matain(s) 1.Building S I. Building Pem'h Fee:f Indicate how foe Ir determined: ' 2.Electrical S O Star/dud City/Town Application Foe C Total Project Case(Item 6)a multiplier a 3.Plumbing S 2. Other Fees: $ 4.Mechanical (HVAC) S List 5.Mechanical (Fire S Taal All Fees: Suppression) Check No. Cheek Amount Cash Amount: 6.Toad Prefect Cost S .36th O Paid in Fal ❑Outmoding Balance Due: NEON 28 Spellman rd Please Submit Stafford Spriage,CY Permits to: 06876 SECTIONS: CONSTRUCTION SERVICES 5.1 Co.nSen Supe rleer Uc..0(CSL) John Pewter 103319 I2/124013 LiemR Number Expiration Dee Nae of CSL Howe Ig B,Wawy Pone rd Lin CSL Type Dec below)__I ' Type Desaipnoe No.ard Sam U Unrestricted Buildings up to 37,000 Cu.6.) R Restricted Id12 Ramat Dwelling City/Town,Sane,ZIP M Magary RC Roofing Cmerine Salford Springs Ct 06876 WS Window and Siding SF Solid Fuel Burning Appliances t Insulation M50-930-77Pe'" EailVaea76w'abeosom D Demolition Unborn' Email addreaddressd 5.3 Rgietered Home Improvement Contractor(HIC) HIC Company Name or HIC Registrant Name 173021 0-27.2016 John Pear HIC Realmmlon Number Expiration Doe No.and Sbuu Il 7aYaaawr 10 Bredwry Peed rd Email althea Safford Spdogs,Ce 06076 Cay?own,State,ZIP Telephone 0608.30.7774 SECTION 6: WORKERS'COMPENSATION INSURANCE APFIDAI T(M.OLL a 151 g JSC(t)) Workers Compensation Insurance affidavit must be completed and submitted with this application, Pel lure to provide this affidavit will result In the denial of the Issuance of the building permit. Signed Affidavit Attached? Yes , No...........❑ SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,as Owner of the subject properly,hereby authorize New England Green Homes to art on my baba in all maws relative to work authorized by this building permit application. John Perrier Print Owner's Name(EI ark Sigature) SECT ON 71e,OW NERI OR AUTHORIZED AGENT DECLARATION By amain my name below,I hereby atm under the pains and peoahies ofpetjury that all of the information contained in thio applicsmoa is true and accurate to the best of my knowledge end understanding. Lynn Ford (2016 Pimwaw Oer', A umSignature)orata Agent's Name is Siture) 7 D NOTES: I. An Owner who obtains a building permit to do hiaihet own work,or an owner who hires an umglmered contractor (not registered in the Nome Improvement Contactor(HIC)Program),will gghave access to the arbitration program or guaranty fold wader M.G.L.c. 142A,Other Impwiwlt intensive on the HIC Program an be found at www naassov/pd Infomation on the Construction Supervisor License can be found d www fastens/doe 1. Wim substantial work Is planned,provide the information below: Total floor ma(,q.h.) (including garage,finished hassemenuaNn,decks or porch) Gros,living wee(sq.h) Habitable room count Number of fireplaces Number of bedroorne Humber of belvooma Number of half/baths Type of beating sya= Number of decks/porches Type of codes quern Enclosed_ Opo 3. "Tonal Project Square Poolge"may be subsdoted for"Tots'Project Cori" I 14 The Commonwealth ofMassachusetts Print Four a/ Department of Industrial Accidents = U .1 Office((Investigationse— .1I Congress Street,Suite 100 — ' Boston,MA 02114-2017 www.mangol✓dia Workers' Compensation Insurance Affidavit; Builders/Contraetors/ElecMclana/Plumbers Aaallcaut Information Please Print Legibly Name IBurioeer/Ommizaibniodivldtu8;New England Green Homes Address:18 Bradway Pond rd City/SialtiZip:Stafford Springs CT 08076 Phone n:8801830-7794 Are you an employer?Check the appropriate box: LID an a employer with 4 _ 4. 0 I em a general contractor and I Type of project(required): eernla (full red-limo). r have hired the eubcamactors 6. 0 New concoction 2.0 I em sole a sole proprietor q a partner- listed on the attached sheet. 7. 0 Remodeling ship and have no employee. These subconrraclon have 8. 0 Demolition working for me in sty tapwcity, employees and have workers' 9. [No workers'comp,insurance comp. Insurance) Building addition ro required.] 5. ❑ We area corporation and Its 10.0 Electrical repairs or additions 3.0 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 MOL 12.0 Roof repairs insurance required.]? c. 152, §1(d),and we have noMaulatlon cmployem.[No workers' 13.2)other comp insurance required.' - !Any applicant cow dads boa el muco also till me an region actor rhvwina lair*RAS'eoneen.em policy inMmelial 'Hmmwara vNw submit title affidavit lndioeng they um doing ill neck and awn hire airsick ma,nmo MOH sub/11a•new affidavit Indianan such. kainn waw tut Merit pia be.mon.oeched in sddldond sites showing me name of rico submweaar and shoe.hnhet et as uwte enure have woployeet If do subnasion bene employes,they mustprovide their news'comp.polky Bamber. I am an retai0yer Marls prwidhy workers'compensator'fawrme for my employers deiow is the polky aedlob sae Itf/ore.aloa Insurance Company Nnme:Sens Policy#or Self-in.s. Lic.A:NEWC634886 Expiration Drte:S/1213/7 Job Site Address:All Streets le ,.City/Stale/Zip: )X.2 4i( ,(7. ,I{J p—1,r 13" Attach a copy of the worker.'compensation policy declaration page(*bowing the policy number and expiration defer), Failure to secure coverage as required under Section 25A of MOL c. 152 can lead to the imposition of criminal peraltla of e fine up to S1,500.00 and/or one-year imprisonment,as well es civil pe antes In the form of a STOP WORK ORDER and a fine of up to S250.90 e day against the violator. Be advised that a copy of Nis statement may be forwarded to the Office of investigations of the DIA for insurance coverage verification. • I do hereby arab,e r der rheperm a ofperjury Mcrae Information provided above is truemraearnct v.LL! x• �/ / [Ilafi._ _ _ _ R, 16 er Phone 0.413-244-2003 Official use only. Do nor write N Ifs area,to be complete by city or tows offkial City or Town: Permlt/Lkense 0 hawing Autaorify(circle one): 1.Board of Hahh 2.BaU dkg Department 3.City/Town Clerk 4.Electrical Inspector S.Piosnbbig Inrp.etor 6.Oilier Contact Person: Phone Or Installation Agreement Contract aNE„E'NNOLANJ "" GREENH0ME5 New E.ngtand Green Homes 1(855)7EARTH7 Toll Free 413-244-2003(Zr+n) - Info@negreenhomes.com Customer Name: / rJCy+y� t C,a Vct nn ctuy/v� / - Address: 110 3 ma /Q, 1Ci i 1-ln/¢a�CP Home Phone: �� )) ry, Cell: V 3 ,5 pIa - 7S 7 C Client Number: 7/l ) 9 Sriri Work Descriptions i7-I v .a / /0 ?SD ai c' 10 we, /ttc: Seilu(to5.n 913 SD //oy. 73 eiefri2i% , 401-161 Lis . )lL utakI-, k!I cid/it -)c. .00 CO 7' )- fu1%-24054 s14;rts (Teel sr,i. Mc ) 237. 6S- Job fJob Total:$ 300 Incentive Amount: $ /t1Q./r7 4-$�s S-0 ^ 02469. 1 / Customer Cost:$ 539 �� install Date: e Refer to th H me_ rre)rgy Report fora 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 t ttoogAv lhebalance oft cost upon completion of the job. Customer Slgnature•,InDate: Contractor Signature: 4K------C. Date: 3/.7/rb