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24D-259 (6)
135 CRESCENT ST BP-2017-0193 GIS#: COMMONWEALTH OF MASSACHUSETTS Mao:Block: 24D-259 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category:renovation BUILDING PERMIT Permit# BP-2017-0193 Project# JS-2017-000326 Est.Cost: $1090.00 Fee:$65.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: BRYAN HOBBS 83982 Lot Size(sq.ft.): 26789.40 Owner: LOWENTHAL JAMES D& Zoning:URB(100)/ Applicant: BRYAN HOBBS AT: 135 CRESCENT ST Applicant Address: Phone: Insurance: 346 CONWAY ST (413) 775-9006 WC GREENFIELDMA01301 ISSUED ON:8/76/20I6 0:00:00 TO PERFORM THE FOLLOWING WORK:AI R SEAL &WEATHERIZATION 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 8/16/2016 0:00:00 $65.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner File#BP-2017-0193 APPLICANT/CONTACT PERSON BRYAN HOBBS ADDRESS/PHONE 346 CONWAY ST GREENFIELD01301 (413)775-9006 PROPERTY LOCATION 135 CRESCENT ST MAP 24D PARCEL 259 001 ZONE LIRB(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUTFee ?- 0/ Building Permit Filled out (dam Fee Paid Typeof Construction: AIR SEAL&WEATHERIZATION New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owned Statement or License 83982 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFOQMATION PRESENTED: 4/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 De 8. i[ior Sig . e of Building 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. Department use only ECEIVED City of Northampton Status of Permit Building Department Curb CutlDriveway Permit Alk 1 5 2016 - 212 Main Street Sewer/Septic Availability Room 100 WatersWeil Availability Northampton. MA 01060 Two Sets of Structural Plans Darr.OFKKLINGINSPE ,1. NORM/170Tcs MA GI ISA r r- •13-587-1240 Fax 413-587-1272 PIaUSite Plans Other Specify APPLICATION TO CONSTRUCT,ALTER,REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 property Addresg'. This section to be completed by office ,35Cre-sn n 4 S1• Map Lot Unit J or`fta a n-i p-Jon Zone Overlay District _ Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 24 Owner of Record: )eskyirs Loco-n/-1411a. ! 135-CrrsrenJ SI. +<I Nor4ha.-r+ip-ion Name(Print) Current Mailing Address. .y Y!3- S,i— >z9z Telephone Signature 2.2 Authorized Agent Bryan G.Hobbs Remodeling 346 Conway St Name(Print) Greenfield,MA 01$01 Current Mailing Address. s pits Signa e - Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1 Building j .9) (J 0 (a) Building Permit Fee f 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) 4/ 0 el O. 00 Check Number dyer,2 This Section For Official Use Only Building Permit Number: Date Issued: Signature: _ Building Commissioner/Inspector of Buildings Date Section 4. ZONING Ad Information Must Be Completed. Permit Can Be Dented Due Ta Incomplete Information Existing Proposed Required by Zoning This column to he filled in h> Building Department Lot Size Frontage Setbacks Front Side L: R: L: R: Rear Building Height Bldg. Square Footage Open Space Footage ro (Lot area minus bldg&paved peeking) of Parking Spaces Fill: (volume&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? `'� NO DON'T KNOW O YES Q IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO Q DON'T KNOW O YES Q IF YES: enter Book Page and/or Document B. Does the site contain a brook, body of water or wetlands? NO Q DON'T KNOW Q YES Q IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Q Obtained Q , Date Issued: C. Do any signs exist on the property? YES Q NO Q IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES Q NO Q IF YES, describe size, type and Location: E. WUl the construction activity disturb(clearing,grading excavation,or fifing)over:acre or is it part of a common plan that will disturb over 1 acre? YES Q NO Q IF YES,then a Northampton Storm Water Management Permit from the DPW is required. SECTION S-DESCRIPTION OF PROPOSED WQRK(check all applicable) New House n Adtlition ❑ OrCoors Replacement Windows Alterations) n Roofing U Or Dogrs ❑ t Accessory Bldg. ❑ Demolition ❑ New Signs [CI Decks [Ci Siding[m) Other ] ♦ c!L4 It Brief DescripJipn of Proposse�ed - �q Work. 12.-(Y ,./2-0- -1(,./2-0- -1(//7 Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet Sa.if New house and or addition to existing housing, complete the following- s 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 1. 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 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 matters relative to work authorized by this budding permit application. 5'-C-e— ct.-11o-c&ed Signature of Owner Date I, �r �L a7 i-1D b 1M-i ,as Owner/Authorized Agent herebyteclare 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, 81'9O.r1 &Jo & ;tf Print Name /� -� hf r G Signature of0 gent - Date 8/61./1/ lc SECTION 8-CONSTRUCTION SERVICES 8.1 licensed Construction Sueervisor: Not Appplicata° 0 Name of License Holder 0,631*02- License Number Bryan G.Hobbs Remodeling �� t 346 Conway St. Address Greenfield,MA 01301 Expiration Date f -(�rr&O VI3-115 -9ooc. Signatu a Telephone p.Reaistared Home Improvement Contractor: F Not Applicable 0 r s. 5c., Comaanv Name Registration Number Bryan G.Hobbs Remodeling ( til 2-3 l 1 t? Address 346 Conway ST: Expiration Date Greenfield,MA 01301 Telephone 16". 71.5".r 04 SECTION 10-WORKERS' COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152,§26C(6)) Workers Compensation Insurance affdav ust be completed and submitted with this application. Failure to provide this affidavit will result in he denial of the of Signed Affidavit Attached issuance the bull g permit. Signed No ❑ 11. - Home Owner Exemption The current exemption for"homeowners"was extended to include Owner-occupied Owellines of one(I) 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 85 supervisor,CMR 780, Sirth Edition Section I08.3,6d. 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-sear period shall not be considered a homeowner. Such`homeowner"shall submit to the Building Official,on a form acceptable to the Building Official that betshe shall be responsible for all such work performed under the bnIldine 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 _ The Commonwealth of Massachusetts Department of industrial Accidents • t."s'erd= t Office of Investigations -`rel= ? 600 Washington Street %;r12:24141=7 a _s =? Boston, MA 02111 www.massgow'dia Workers' Compensation Insurance Affidavit Builders/ContractorsfElectricians/Plumbers Applicant Information Please print Legibly Name (Innams organizatiodlnmviaml): Bryan G. Hobbs Remoaeling 346 Conway St. Address: Greenfield,MA 01301 City/State/Zip: Phone tt: 913 S-(1 JO I.i% Are you an employer?Check the the appropriate box: Type of project(required): $) 1 I am a employe with :0 4. ❑ I am a general connataw and 1 6. ❑New construction employees(fill and/or pan-time).' have hind the sub-contractors 7. ❑ Remodeling2.❑ I am a sole proprietor orparmer- listed on the attached sheet t ship and have it employees These subcontractors have 8. 0 Demolition working forme in any capacity workers' comp.insurance 9. 0 Building addition [No workers'comp.iusuraoce 5. 0 We arca corporation and its • required.] officers have exercised then l0.❑ Eketrical tep®s or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.0 Plumbing repairs or additions myself.[No workers' comp. c. 152,§1(4),and we have no 12.0Roof repairs :wewanec raryued-]t employees. [No workers' 13J Other ✓i 5.-1[L41✓i" comp.insure=required.] 111✓ ;i'AI•n V 'by applcmt tot/latch box NI moo Aso 611 oto the section below sowing their wmkm'comp meson policy mina: Henzeovma who saint this.magna iudtcenag they we doing an net and then bion oamide uatrsmm mut submit a in affidavit mincing nock ;Contractors Gm cheek ton box miss stead an additional sheet.bo whet the tam of he suGmvowbn end their workers'eon.policy mformesloa l am an employer that le providing workers'compmsSon Insurance for my employees. Below is the policy and Job the Informalaa A (� r� /1 Instance Company Name: ill (-)L.41 F-W In.SI Ara 1'1n.:', t =nisiflari .') L Policy a or Self-ins.Lief: 1`ZL42G5I sqk i Expiration Date: It%/[l 11.6 JanSite Address: 135 CVC..}CGl't'I4 Cltylstaielzip:f\t'6(tjr<larrFe4Dvr/Mi-'ioi6i.0 Attach•copy of the workers' compensation policy declaration page(showing the policy number sad entrant on date). Failure to sewn coverage as required under Section 25A of MGL c. 152 can lead no the imposition of criminal penalties of a fine up to 51,500.00 and/or one-yea imprisonment, as well as civil penalties ha the form of a STOP WORK ORDER and a fine of up to 5250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA fir insurance coverage verification. I do booby ser*,urder the paw and Jpena/hies ofperjary that the information provided above Ls true and correct 17 • Situates: er✓ &1L A7c'Gc pate: RI Pi/ L Phone {rn 5- g a o i • Official we may. Do net oche In Mir area,to be completed by city or town official City or Town: PermWIJeense W Issuing Authority(circle one): 1.Board of Health Z.Building Department 3.Cityrl'own Clerk 4.Electrical Inspector 5.Plumbing Inspector &Other Contact Posen: ?hoot 1/: City of Northampton 212 Main Street, Northampton, MA 01060 Solid Waste Disposal Affidavit In accordance of the provisions of MGL c 40, S54, I acknowledge that as a condition of the building permit all debris resulting from the construction activity governed by this Building Permit shall be disposed of in a properly licensed solid waste disposal facility, as defined by MGL c 111 , S 150A. Address of the work: t35 (rrjccrrf .4- The debris will be transported by: 66rc1-- �o jab/ The debris will be received by: C©%-/- r /C 4 C. PhIpas et I Corr .a7/1 Building permit number: Name of Permit Applicant gr y a r Flo 8 / p/rc gn , h1� Date Signature of Permit Applicant „, , / City of Northampton R . ., 4.,.67' 1 L) 't Massachusetts h.s. 4 x 21 k. ri 1, DEPARTMENT OF BUILDING INSPECTIONS v s ..16,i-1-,* `/* 212 M Northampton,MunicipalMA 0suildt g "C � Property Address: ( 35 Crrsne n-4 5-1 a Contractor Name: Coon C. FIetas 9e•^odebro9 346 Conway St. Address: Greenfield MA 01301 City, State: Phone: 413 - ill — i OJ & Property Owner ` Name: )&n"Cs L�weviAk'et ( Address: 15 5 C 1res C t; n 4 3+ • m City, State: 1O r-{ k o-r✓-I y{O y2 Yc t 10 Ca 0 I, Fj YLjO..n LI a b bJ (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 5 ( k7S Date 8 t 8 1 r(l( RISE90 Sllamnut Road,Unit 21 Canton,MA 020211339502-S335 ENGINEERING www.RJSEenglneertng.com Eons'e._yen"eir . OWNER AUTHORIZATION FORM I. ` V ry ". 'LAV-: , (Owner's Name) owner of the property located at 13s i 15-77 . • (Property Address) ,:...L _ ‘NK—Ar 0 lD 106 (Property Address) Bryan G.Hobbs Remodeling 346 Conway St hereby authorize Greenfield,MA 01301 (Subcontractor) an authorized subcontractor far RISE Engineering,to act on my behalf to obtain a building permit and to perforin work on my property.This form is only valid with a signed contract. 1 wners ' nature Date