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24D-259 (7) 135 CRESCENT ST BP-2017-0218 GIS#: COMMONWEALTH OF MASSACHUSETTS Map-Block: 24D-259 CITY OF NORTHAMPTON Lot: -001 Permit: Building Category: INSULATION BUILDING PERMIT Permit# BP-2017-0218 Project# JS-2017-000375 Est. Cost: $4932.72 Fee: $65.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: BRYAN HOBBS 83982 Lot Size(sq. ft.): 26789.40 Owner: JAMES LOWENTHAL Zoning: URB(100)/ Applicant BRYAN HOBBS AT: 135 CRESCENT ST Applicant Address: Phone: Insurance: 346 CONWAY ST (413) 775-9006 WC GREENFIELDMA01301 ISSUED ON:8/19/2016 0:00:00 TO PERFORM THE FOLLOWING WORK: AIR SEALING,ATTIC FLOOR OPEN BLOW CELLULOSE, INSULATE ATTIC ACCESS PROPAVENT 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/4 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: FeeTvpe: Date Paid: Amount: Building 8/19/2016 0:00:00 $65.00 212 Main Street, Phone(413)587-1240, Fax: (413)587-1272 Louis Hasbrouck-Building Commissioner File-BP-2017-0218 APPLICANT/CONTACT PERSON BRYAN HOBBS ADDRESS/PHONE 346 CONWAY ST GREENFIELD (413)775-9006 PROPERTY LOCATION 135 CRESCENT ST MAP 24D PARCEL 259 001 ZONE URB(I00)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee paid (t ff o 4,3 Building Permit Filled out Fee Paid Typeof Construction: AIR SEALING.ATTIC FLOOR OPEN BLOW CELLULOSE, INSULATE ATTIC ACCESS PROPAVENT New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 83982 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO TION PRESENTED: Le<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 y.%• delay / 647.1,/7 Sign. ure o Buil.ing O win 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 E�t-�iC-.E< t�-' City of Northampton Status of Permit Building Department Curb Cut/Driveway Permit P y B Zti212 Main Street Sewer/Septic Availability Room 100 Water/Well Availability -: % N. hampton, MA 01060 Two Sets of Structure/Plans awl `, • - 13-587-1240 Fax 413-587-1272 Plot/Site Plans Other Specify APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1,1 pro�pryerty Address: t + This section to be completed by office 13 1 C Cr (GYt4 S+ Map_..._.,. ... Lot..... Unit No d a4/71.f9-1-on Zone Oveday District Elm St.District CS District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT L1 Owner of Record: ...�..�.. ,Ja-.mcs Low0144I'vzJ 155 Cresco -4A tori/ edierieri Name(Print) Current Mailing Address.r 7/13 `fn_ Lib fi p Telephone l ( U Signature Z,2 Authorized Awad' Bryan G.Hobbs Remodeling Name(Print) Greenfield,MA 01301 Current Mailing Andress. jrni,,eta- 140104 yr;-"275^rt as Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to he Official Use Only completed by permit applicant 1. Building ('s r432r '72- (a) Building Permit Fee D 2. Electrical (b)Estimated Total mast of Construction from (6) 3. Plumbing Building Permit Fee 4, Mechanical(HVAC) 5. Fire Protection n. 6. Total=(1 +2 +3+4+5) 'ell . 7 Check Number � . (�- =jzThis Section For Official Use Only Building Permit Number'. Date Issued: Signature: Building Commissionerbnspector of Buildings Date Section 4. ZONING AU Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning This column to be tilled in by Building Department Lot Size Frontage Setbacks Front Side L: R: L: A: Rear Building Height Bldg. Square Footage % Open Space Footage (Lor area minus bldg&paved parking) • _ #of Parking Spaces Fill: (volume&Iot:adonp A. Has a Special Permit/Variance/Finding ever been issued forron the site? \' NO 0 DON'T KNOW O YES O \11'x' IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW Q YES O IF YES: enter Book Page and/or Document # B. Does the site contain a brook, body of water or wetlands? NO O DONT KNOW Q YES O IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Q Obtained O , Date Issued: C. Do any signs exist on the property? YES O NO O IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property ? YES O NO IF YES, describe size, type and location: E. WO the construction activity disturb(clearing,grading,excavation,or filling)over t acre oris it part of a common plan that will disturb over I acre? YES Q NO Q IF YES, then a Northampton Storm Water Management Permit from the DPW is required. SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows rations) Li Roofing ❑ Or Doors 0 _ J Accessory Bldg. ❑ Demolition ❑ New Signs (Cl] Decks [0 Skiing[o] Other[6..; Wea-U erfZA:f 1e4 Brief Dp&cription of Proposed, Work ftgaryle&f+n r actffiF. 4 tour er£ri kbi:o teL ts11t ecit Elm atte.3 S prOr7 vena , Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet Ba. If New house and or addition to existing housing, complete the following. a. Use of building t 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 stones? f. Method of heating? Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. — ,_.Masscheck Energy Compliance form attached? h. Type of construction i. Is construction within 100 ft.of wetlands? Yes No. Is construction within 100 yr. floodplain Yes_Na j. Depth of basement or cellar floor below finished grade k. Win building conform to the Building and Zoning regulations? Yes No I. Septic Tank City Sewer Private well City water Supply SECTION la-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 building permit application. Stu a—E a-CAec Signature of Owner Date I._6t-L1 6.11 (Jot , as Owner/Authorized Agent herebytlleclare 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 r t e rt y b5 .-.-.. Print Name ki Signature of ewnerlAgent Date SW 1k SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable 0 Name of License Holder'. 06331'82_ License Number Bryan G.Hobbs Remodeling /2 / 346 Conway SI Address Greenfield,MA 01301 Expiration Date _610,64164yi3- 7 '75- 10o6 Signature Telephone 9.Registered Home Improvement Contractor: Not Applicable r3��z Company Name Bryan G.Hobbs Remodeling Registration Number 346 Conway Si. 7(131/ Address Greerrffetchn Expiration Datbi Telephone`" .775'c(46 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. Signed Affidavit Attached Yes ' \ No...... ❑ 11. - Home Owner Exemption The current exemption for"homeowners"was extended to include Owner-occupied Dwellings 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 as supervisor.CMR 780, Sixth Edition Section 108.3.5.1. Definition of Homeowner:Person(s)who own a parcel of land on which he/she resides or intends to reside,on which there is,oris 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 period 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 building 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 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 byeMGL c 111 , S 150A. Address of the work: IS'] (1-CS(CM-I ,5-1 /r-1110. pia/7 The debris will be transported by:�q gryr.�n Flo b The debris will be received by: (onayl(-IC Pts7wa/ (ompa-4rref Building permit number: �/ Name of Permit Applicant gni(2.4"7 Alt 1=7 kf Date Signature of Permit Applicant City of Northampton Massachusetts 'A' ryyy// x Ii i� DEPARTMENT OF BUILDING INSPECTIONS S0 IT 212 Main Street • municipal Building sr ..)C‘et[ ..)C‘ Property Address: L'1 (rCJCe, tel-‘ s-f. NIor41is rv1 y1cY Contractor Name: Bryan G. Hobbs Remodeling Address: 346 Conway St. '--"EkEtenfrelatM7t301 City, State: Phone: (113 . 775 .. r DQ 6 Property Owner Name: Ja .' 7CJ (moo(Ai C✓iC ly2 ( Address: (3j (11-r, LC4't�„5-1 City, State: N6 r- 44,71tn y Lvn r3Y(,o,-n 0012121 (contractor) attest and affirm that the building 7 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 7= Date e/i (e6 RISE ' . k 60 Shawmut Road,Unit 2!Canton,MA 02021 1339502.6335 ENGINEERING www.RlsEengineertng.com eftcen. !,r I.en. OWNER AUTHORIZATION FORM I. S.`tAC S •NLills, (Owner's Name) ' owner of the property located at: 13S �4- 1, 57 --/ C1 — C\ (Property Address) ' - -;0-krIt,50 (Property Address) t�) Bryan G.Hobbs Remodeling 346 Conway St. hereby authorize Greenfield,MA 01301 (Subcontractor) r ' an authorized subcontractor for RISE Engineering,to act on my behalf to obtain a building permit and to perform work on my property. This form is only valid with a signed contract. 12(Kis Sture J Date The Commonwealth ofMassachusetts Department of Industrial Accidents Office of Investigations �g ;,� 600 Washington Street �`���'� Boston,MA 02111 www.massgovidia Workers' Compensation Insunnce Affidavit: Builders/Contractors/Electrlcians/Plumbers Applicant Information Please Print LeEfbly Name (B usinens/Orprdratiodlffividal): Bryan G.Hobbs Remodeling 346 Conway St. Address: Greenfield,MA 01301 City/State/Zip: Phone#: ( 7"1711S-C(0C}(G' Arerryt you an employer?Chee/kk the appropriate box: Type of project(required): 113 I a u a employer with 4. ❑ 1 am a general contractor and 1 6. ❑New mmhnelion employees(fab and/or pan-time), have hired the sub-contractors 2.0 I am a sole proprietor or pima- listed on the attached sheet 1 7. ❑ Remodeling chip and have in employees Tae sub-contrauors have 8. ❑Den»lidon working for me in any capacity. workers'comp. insurance. 9. ❑ Building addition [No workers' comp. insurance 5. 0 We area corporation and its - ued.] officers have exercised their 10.0 Electrical Impairs or addition requ 3.❑ I am a bomecwner doing all wink right of exemption per MGL 11.0 Plumbing repairs or additions myself.[No workers' comp. c. 152,0(4),and we have no 12.0 Roof repair. insurance required.]1 employees. [No workers' 13.®Other ol.5. --110. I comp. insurance required.] 4i1v SCA) .' y *Any.pplmr dirt climb box 01 mea also 80 m me magi®wow tromp Ca wwktrf compacCan policy mtomanoa I Homeowners oda atm*this.®davit indicting they aredump all wink and than bine made cabman Amin submit.new affidavit Indicating such 1C®a.ebon mar chock Ai hot mat stashed so addition&.hem towing the In order sub-ia n.aa.and Moir aorta'cam.laity tfonn.eob I am a employer that Isproriding woNres'compensation invarancefor my employees Below bay polity and Job.rhe Minton. //yy /1 Insurance Company Name: Al'fl G,VAKP lac(_Ka 0i.:� no/1-Ien/id:f Polity#or Self-®a.l.ic0: 17...2l.0 C /5 17 q M j iration ExpDate: I C/2.0116 Joh Site Address: 151 r'Jor(f ST X43 ciry/Statezc,rWor ].'t,priar, M$? Of OC 0 Attach a copy of the worker.' compensation policy declaration page(showing the policy number and expiration date). Fail=to secure coverage as re mired under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to 51,500.00 and/or one-year imprisonment, as well as civil pwalda in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of tis statement may be forwarded to the Office of Investigation of the DIA for insurance coverage verification. I do hereby cenify'under the meths and amide of perjury that the fnformt tion provided above is true and correct sieaatme: nye Date: 8/ 9/it- Phone V: / 9/it- Phone#: 41 — 1 '1 5- ' 1 006) Official ate only. Do me..wli',ln mit era to be completed by cay or town officiaL City or Town: permft/{.Itease# Main Authority(etude one): 1.Board of Bwdth 2.Building Department 3.CItytTown Clerk 4.Electrical Inspector 5.Plumbing Inspector S.Other Coataet Person: Phone ft: w BERKSHIRE HATHAWAY Worker's Compensation and Employer's Liability Policy tat INSURANCE AmGUARD Insurance Company .. A Stock Company 1'!_+.jt GUARD COMPANIES Polley Number R2WC648612 Renewal of R2WC513915 NCCI No. [21873] Policy information Page (AR) i[I]Named Insured and Mailing Address Agency Bryan G Hobbs A. H. RIST INSURANCE AGENCY INC. 346 Conway Street 159 Avenue A Greenfield, MA 01301 P4 Box 391 Turners Falls, MA 0137E Agency Code: MARISTII Federal Employer's ID 01-3527850 Insured is Individual Risk ID Number 842909 Additional Names of Insured (N2) Bryan G Hobbs Remodeling Contractor Locations on Policy (L2) 171 Wells Street . Greenlleid, IAA 0 301 0.0/20/2015 - 10170120161 [21 Policy Period From October 20, 20I5 m Ocober 20, 2016, 12:01 A . stancard time at the insured's mailing address. [32 Coverage • A. Workers' Compensation Insurance - Part One of Lois gohicy applies to the Workers' Compensation Law or the following states: Massachusetts B. Employer's kiabilitv ltisurance - Part Two of oils policy eppiob Lu .,o,'„ II each of the slates listed • in item [3)A. Tho limits of our liability under Part Two are'. Soddy injury by Accident - each accident 6500,000 Bodily Injury by Disease earn employee $500000 Bodily Injury by Disease - policy Unlit 5500,000 Refer to Residual Market Limited Other States Insurance Enoorsemert-WC2003068 0. This policy induces these endorsements and Sc heduies: See Fxtanfitnn of information Page -Schedule of Forms [41 Premium The Premium Sasis and, therefore, the premium vile be determined by our Manual of Rules, Classifications, Rates, and Rating Plans- Ail required information is subject to verification and Chance by audit. (Continued on another cage) Total Estimated Policy Premium 3 10,916 Total Surcharges/Assessments $ 599,00 Total Estimated Cost 5 13,515.00 • NIERi'A.USE OR Paq,4- . - I nfnrmn,ni'i Page IDA 0.2WCG4MI2 tits 0/28/.935 WC.0000078 ANOTE Issuing Office: P.O. Sox A-H, 16 S. River Street, Wilkes-Sarre, PA 18703-0020 • www.oua.d rnm • nib/e aaraar<taear/e<rf r/<� ilQ <r ad) Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 139564 Type: DBA Expiration: 7/23/2017 T# 267354 BRYAN G. HOBBS REMODELING BRYAN HOBBS 346 CONWAY ST GREENFIELD, MA 01301 Update Address and return card_Mark reason for change. Al °j :ron^°s'^ —T. Address J Renewal f, Employment Lost Card % %/, F, :, ///1/�/1, ..,,,./..,,, Office of Consumer Affairs&Business Regulation License or registration valid for individul use only 'r $GME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: 440A5Vipteglatretion: 139584 Type: Office of Consumer Affairs and Business Regulation ^-".'Expiration: 7/23/2017 OSA 10 Park Plaza-Suite 5100 RYAN C,HOSES REMODELING Boston,MA 02116 RYAN HOBBS %6 CONWAY ST REENFIELD,MA 01301 Undersecretary Not valid without signature • • • Massachusetts Department of Public Safety to Board of Building Regulations and Standards License CS-083982 BRYAN G HOBBS 346 CONWAY STREET GREENFIELD MA 01301 Expiration: Commissioner 08/0212018