Loading...
17C-234 (6) 33 BARDWELL ST BP-2017-0883 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: I7C-234 CITY OF NORTHAMPTON Lot:-00) PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.1144/2�A�c.142A) Category:INSULATION BUILDING PERMIT Permit d BP-2017-0883 Project# JS-2017-001498 ,Est.Cost.$4811 00 Fee:$65.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Groan: BRYAN HOBBS 83982 Lot size(sq,i4.): 26179.56 Owner: DREESZEN CRAIG A&DIANE BOW MA Zoning: URB(100)/ Applicant BRYAN HOBBS AT: 33 BARDWELL ST Applicant Address: Phone: Insurance: 346 CONWAY ST (413) 775-9006 WC GREENFIELDMAO1301 ISSUED ON:1/23/2017 0:00:00 TO PERFORM THE FOLLOWING WORK:AIR SEALING, AIR SEALING, 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.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: FeeType: Date Paid: Amount: Building 1;23/20170:00:00 $65.00 212 Main Street,Phone(413)587-1240,pax:(413)587-1272 Louis Hasbrouck—Building Commissioner File#BP-2017-0883 APPLICANT/CONTACT PERSON BRYAN HOBBS ADDRESS/PHONE 346 CONWAY ST GREENFIELD (413)775-9006 PROPERTY LOCATION 33 BARD W ELL ST MAP I 7C PARCEL 234 001 ZONE URB(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid Typeof Construction: AIR SEALING,AIR SEA ATION New Construction / Non Structural interior renovations It `^'/".�/. Addition to Existing I� `/ l/� Accessory Structure Building Plans Included: L� Owner/Statement or License 83982 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF R TION PRESENTED: 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 Di PIC /,23-/7 Signature of tuilding 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 C \ City of NorthamptonWir Status of Permit: � 232�\1 \ Building Department Curb Cut/Driveway Permit 212 Main Street Sewer/Septic Availability /�: / Room 100 Water/Well Availability Northampton, MA 01060 Two Sets of Structural Plans N.- Other 413-587-1240 Fax 413-587-1272 PIONSite Plans Other Specify APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Property Address-.2 . c This section to be completed by office '3GardWQ-\\ E, Map Lot Unit ¶\orcite_ MA 610th Zone Overlay District Elm at.District ca District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record; Crcxyc3 - ZeSle.rl 33 I rr\well a. Astarte, p 01$2. Name(Print) J Current Mailing Address: C (� MQ Q r'1 lA.TW'CY .2- . siTh Telephone 5 V 1`-1 _ I p---rb0I Signature J � ( 2.2 Authorized Anent: /' (� �YL)O-.rh ��� �e'(1i�� MCI IS % emoo ciA S . cceen QkO 018OI Name P t Current MailingAddress: r 0--, 413 -TM- ec CO Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building L\ O I I 1 C2 (a) Building Permit Fee 2. Electrical O (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) L( y,nn it , Check Number 6.,/i/e7i j(V/i6 This Section For Official Use Only Date Building Permit Number: Issued: Signature: Building Commissioner/Inspector of Buildings Date Section 4. ZONING An Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning This column to be filled in by / Building Department Lot Size )'Niikl Frontage Setbacks Front Side L: R: L:• R: Rear . Building Height Bldg.Square Footage % Open Space Footage % (Lot area minus bldg&paved parking) #of Parking Spaces Fill. (volume&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO ® DON'T KNOW YES o IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO O DONT KNOW It YES IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO O DONT KNOW 0 YES O IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained O Obtained © , Date Issued: C. Do any signs exist on the property? YES ® NO IF YES, describe size, type and Location: 1 D. Are there any proposed changes to or additions of signs intended for the property? YES O NO Y. ) IF YES, describe size, type and location: /C�' E. Will the construction actvity disturb(clearing,grading, =.,ravation, or filling)over 1 acre or is it part of a common plan that will disturb over t acre? YES ® NO I 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 n Addition ❑ Replacement Windows Alteration(s) ❑ Roofing n Or Doors ❑ Accessory Bldg. ❑ Demolition ❑ New Signs [D] Decks [q Siding to] Other Brief Description of Proposed ` 1 Work: O Proposed . IN2(" cz-'9 . 1Y�StA\aTy(1 Alteration of existing bedroom Yes \/ No Adding new bedroom Yes Na ✓ Attached Narrative Renovating unfinished basement Yes No • Plans Attached Roll -Sheet 6a. If New house and or addition to existing housing, complete the following: a. 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. V/ Dimensions a. 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 i. Is construction within 100 ft. of wetlands? Yes Na. 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 I. Septic Tank_ City Sewer Private well City water Supply SECTION 7a-OWNER AUTHORIZATION•TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTORAPPLIESFOR BUILDING PERMIT I, Cr o \ a F J re_e_ C Z Q'n as Owner of the subject property \ \ hereby authorize 210V (,.n tVo\dc �� �\ • CH to act on my behalf, in all matters relative to work authorized by this building permit application 1 Signature of OwnerJAL' r \\� \(__ y r-"� b� Date t- I, Riga t OOS as Owner/Authorized Agent hereby declarethat 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 cx,, Abbbs Print Name Signature of Owner/Agent % Date SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable 0 Name of License Hostler- Bryan G. Het-isRozBdeljn'a 0 C , 39 C O a 346 Cc. ... ... License NumberDD Greenfield,rMA rlh4t 5j-2—\\p p Address Expiration Date v� n y, Li\i - llS' `10O1/ Sign e urTelephone 9.Realstered Home Improvement Contracton Not Applicable 0 139 5(oL\ Company Name Registration Number CC . " 7�z � 3`\ Address � IY�(� Expiration Da Telephone' \3. `-6,gcoW 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 0 11. — Home Owner Exemption The current exemption for"homeowners" was extended to include Owner-occupied Dwellings of one(1) 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,or is intended to be,a one or two family dwelling,attached or detached structures accessory to such use and/or farm structures. 4 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 by MGL c 111 , S 150A. Address of the work: A' fC t�t2A +• The debris will be transported by: 0/A The debris will be received by: Building permit number: Name of Permit Applicant - I ?' n a . . Ar .111. Date Signature of Permit Applicant v, City of Northampton � ' 'lc Massachusetts :' i c- 8• (Y S«iW DEPARTMENT OF BUILDING INSPECTIONS O y s�')",ffi 212 Main street • Municipal Building sF aC' • � Northampton, !a 01060 301 Property Address: � IX � aY UuiQ t1 c t 5 Plwort-c Contractor ) \ \ —R�m Name: ��(�UN�n �*]nb l`nC� Address: ��� LA b \ c r(.UfAJ�-( ��*-• 1 City, State: Cr\Ce 1(\C\Ca ,J�J^ � 3\S5el\ Phone: 't\3 '-11c —('1 coc0 Property Owner _ Name: zrCS teed '.Yl J Address: 6,QJQ '^ �k, c h€1'C -. City, State: C \O,r ,i2JAC..Q, IAAQ` I, k--7YO..n -O��VJD (contractor) attest and affirm that the building I intend to insulate dries 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 I .61 Date 1 i Ci, Y� RISE60 Shawmut Road, Unit 2 I Canton, MA 02021 i 339-502-6335 ENGINEERING' www.RlSEengineering.com OWNER AUTHORIZATION FORM G,4-s-rl9- �i^ iS ill (Owner's Name) owner of the property located at: 33 617,-7 > �� (Property Address) 7 /LT—IL/ c-rb ) �✓��� 69I (Property Address) 11 n .9 p hereby authorize \)y kU,r.Ar. S6bs Renodolt. (Subcontralctor) 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. The Permit will be secured by the insulation contractor, at no additional cost. It is the homeowner's responsibility to dose out this permit by contacting their municipality at the completion of this work. Owner's Sig aturre�y I - �/ ( i� f/ h Date 6.2016 The Commonwealth of Massachusetts !la 'ei Department of Industrial Accidents to= Office of Investigations iii , 4 600 Washington Saleet Boston,MA 02111 www.massgov/dfa Workers'Compensation Insurance Affidavit Buildere/Contraeton/Elect iclansMumben Applicant Information Pleastjrint Idgibiv Name @triol avorg oixation/Imfividtui): Bryan a Hobbs Remodei;ng 346 Conway St. Address: Greenfield,MA 01301 /i CStylStatejZip: Phone#: "jl3115--1 God' Are you an employer? Cheek the appropriate box: Type of project(required): 1.1,1 I am a employer with 6 4. ❑ 1 am a general;onsets and I 6. ❑ New cournuedon employee;(tall and/or pan-time).' have breed the subcontractors 7. ❑ Retmdetiog 2.❑ t am a sole proprietor or partner- listed on the smashed sheet ship and have no employees These sub-contractors have 8. 0 Demolition working fir me in any capacity. workers' comp.Ounce. 9. 0 Building addition [No workers' comp.insurance 5, ❑ we area corporation and its • required.] officers have exercised their 1 D.❑ Electrical repairs or addition; 3.❑ I am a homeowner doing all work right of exemption per MGL 11,0 Plumbing repairs or additions myself. [No workers' comp. c. 152,41(4),and we nave no 12.0_Roof repairs jesuitic required.]t employees. [No wrnkers' 13.ai Other o1SL-ketIJrtl comp.insurance required.] /d Ir f CA1t+t r5 • iiy aPPliccant est dada Ion NI must.1.o Si . t m.ma=below twins their woman'mmpmaaeon policy lmmmat w IHomeowners who attnh this affidavit indicaMg they an doing en work and to aha=side cermet=mut submit.sew affidavit indnaina such 'Cmttaotres that daektfetbs mat matted an additional ahem allowing Ore nom oft a ab-comm=on and men workers'coma policy teammate= l am an employer that ft providing workers'cnmpamavbn insurance for soy employers Below it the polity and Job sits information. p� '=surtocc Company Name: A ill C-A-?A k-) 11 ],c( Ara u o;, 0-0/r)er itI �. 'alley II or Selfis.Lrc.4: r2.2(R/t�j i 5 q l a Expiration Dam: I NW] 13 ob Site Address: CityiStatr2ip: iteaeh■copy of the workers'composition policy declaration page(showing the policy number and expiration date). allure to secure coverage as required under Section 25A of MGL c. 152 co lead to the imposition of criminal penalties of a ae up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fere `up w 3250.00 a dry against the violator. Be advised that a copy of this statement may be forwarded to the Office of veadgadons of the DIA fax insurance coverage verification. to Aaaby certify and the paha end perlda of petjury that the information provided above/r nue rad;eman mature: e 6 Ys1--+C.a- Date: /01,2114 rmcn: L-0 fig 5, cloaca Official use only. Do nor write in MI,area,to be completed by city or town official City or Town: Permit/License If Owing Authority(circle one): t.Board o(Health 2.Binding Department 3.City/fovea Clerk 4.Electrical Inspector 5.Plumbing Inspector 1.Other :O&M Peron: Phone N: • so Massachusetts Department of Public Safety IV Board of Building Regulations and Standards License: CB-083982 0 Cons.ruci;on Supervisor BRYAN G HOBBS 346 CONWAY STREET GREENFIELD MA 01301 N —Z ,• CA_— Expiration: . Commissioner 05/02/2018 _ A R' CFI-7e1Li112.77'14111Uealtll o/C/Ilai,iacilll.ief V--1-1.1 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 Tr# 267354 BRYAN G. HOBBS REMODELING BRYAN HOBBS 346 CONWAY ST GREENFIELD, MA 01301 Update Address and return card.Mark reason for change. Address Renewal _ Employment H. Lost Card SCA, , 20 M•0511 -T/. r,..,,n(.,rInd7/r/-(Gr.,.,rittra i Office of Consumer Affairs&Business Regulation License or registration valid for individul use only [TOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: 44-Registration: 139564 Type: Office of Consumer Affairs and Business Regulation j _'Expiration: 7/23/2017 DBA 10 Park Plaza-Suite 5170 Boston,MA 02116 BRYAN 0.HOBBS REMODELING BRYAN HOBBS 346 CONWAY ST ` GREENFIELD,MA 01301 Undersecretary Not valid without signature ACOROe THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INStRiER(SI, AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER C ncr Tracey Kuklewicz FAX A.R. Rist Insurance Agency, Inc. INgpNC.N,yFnt. 1413)863-4373 I rX,C NPL 1413)863-9650 159 Avenue A E-MAIL P.O. Box 391 rusTomPa1D 400009069 Turners Falls MA 01376 INSURER(S)AFFORDING COVERAGE MWOR NI$URE0 asuRBRA;T.i.berty Croup Bryan Robbs dba INSURER!: Bryan G. Hobbs Remodeling INSURER C: 346 Conway Street INSURER9: INSURER$: Greenfield MA 01301 INSURER Rr COVERAGES CERTIFICATE NUMBER:2017 CERT REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. WLTR Tn OFWSURANCE INge „.„ POLICY NURSERPO EFF YEYPI LIMITS X IERAL LIABILITYCOMMERCIAL GENERAL EACH OCCURRENCE $ 1,000000( LIABILItt 300 OAMA 'IU NEW cO� I 0 I'� PREM) l / 01 A I CLAIMS-MADE x OCCUR BK85E004898 08/04/201608/04/2017 MED ExP(My„ open„ ) $ 15,001 IF- PERSONAL&ADM INJURY S 1,000,001 `GENERAL AGGREGATE S 2,000,001 GEMS AGGREGATE LIMIT APPLIES PER PRODUCTS.COMP/OP AGO $ 2,000,001 [pour( Ire& in LOC I ....� 6 ......._ AUTOMOBILELIABILITY ' I COMBINED SINGLE LIMIT E 1,000)001 ''(Es acodmll ANY AUTOI 1P.r I 3 A AU-CANNED AUTOS - . 029738 01/0212D1491/02/2018-EOLVLYMJURY BODILY INJURY(PeraccanW S I X SCHEDULED AUTOS PROPERTY DAMAGE HIRED AUTOS (Per c aenl) 6 © © NON"OWNED AUTOS IS ©Masa PCYal fmM _ s A Q INCE S UAB x OCCUR EACH AGGREGATE OCCURRENCE $ 1.000,CO( IEXCESS UAB LUIMSMAOE Btl46084898 •9/04/201608/04/2017:AGGREGATE 'b 1,000,001 DEDUCTIBLE 3 RETENTION 6 10 000 , s NtlRKERS COMPENSATION f yy%$TIILL 0TH. ANDEAPLOYERfUASI 1TY TORYIIMas IFR ANY OFFICER/MEMBER EXCWDEWECUTivE r'i NIA I Et EACH ACCIDENT $ (MBndetOry In NHI EL.DISEASE-EA EMPLOYEE S OESaePscTIGN uOnd OPERATIONS below EL DISEASE-POLICY LIMIT $ — DESCRIPTION GPOPERATIONSILOCATIDNS I VEHICLES(AUICM1 ACORD 101,AEENonMR*M,rtf ScMBrb.Kanen span Isr. uIAtl: Classification: C&tpentry S Insulation CERTIFICATE HOLDER CANCP I ATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTCE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Bryan Hobbs 346 Conway Street AUTNDW2do REPRESENTATIVE Greenfield, MA 01301 C. Tracey Kuklewic2/DNP / s y Q y -C- _ ACORO 25(2009/0$) The ACORO name and Dare registered marks RD CORPORATION. All rights resetvod. 1E5025mm::sr o9