29-571 164 OVERLOOK DR BP-2017-0986
GIS a: COMMONWEALTH OF MASSACHUSETTS
Map:Block:29-571 CITY OF NORTIIAMPTON
Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: INSULATION BUILDING PERMIT
Permit 4 BP-2017-0986
Projects JS-2017-001696
Est.Cost: 5225200
Fee:$65.00 PERMISSION IS HEREBY GRANTED TO:
Const,Class_ Contractor: License:
Use Group: JOHN PERRIER 105319
Lot Size(sq.11.): 24175.80 Owner: Omar Santoyo
Zoning: Applicant: JOHN PERRIER
AT: 164 OVERLOOK DR
Applicant Address: Phone: Insurance:
18 BROADWAY POND RD (860) 930-7794 WC
STAFFORD SPRINGSCT06076 ISSUED ON:311120 1 J 0:00:00
TO PERFORM THE FOLLOWING WORK:ADD R-48 CELLULOSE INSULATION IN ATTIC
FOR WEATHERIZATION PURPOSES
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: Shit: Insulation:
Final: Smoke: Final:
THIS PERMIT MAY BE REVOKED BY 'FHE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occupancy Signature:
FeeType: Date Paid: Amount:
Building 3/1/2017 0:00:00 $65.00
212 Main Street, Phone(413)587-1240, Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
File 4 BP-2017-0986
APPLICANT/CONTACT PERSON JOHN PERRIER
ADDRESS/PHONE 18 BROADWAY POND RD STAFFORD SPRINGS (860)930-7794
PROPERTY LOCATION 164 OVERLOOK DR
MAP 29 PARCEL 571 001 ZONE
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid 06
Building Permit Filled out
Fee Paid
Typeof Construction: ADD R-48 CELLULOSE INSUL TION IN ATTIC FOR WEATHERIZATION
PURPOSES
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:
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
Deuolitio,
a de, 3-/-7/7
3-x-/
Sign. re of Building 0 ficial 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.
t-- f
I` t, The Commonwealth of Massachusetts
iO Board of Building Regulations and Standards FOR
at Massachusetts State Building Code,780 CMR MUNICIPALITY
Building Permit Application To Construct,Repair,Renovate Or Demolish a Revised Mar 2011
One-or Two-Family Dwelling
. .. ._. I This Section For Official Use Only
Building Pe nnitNumber: Date Applied:
Building Official(Print Name) Signature Date
SECTION 1:SITE INFORMATION
1.1 Pro.ert A.dress y 1.2 Assessors Map&Parcel Numbers
-
1.Ia Is this an accepted street?yes no Map Number Parcel Number
1,3 Zoning Information: IA Property Dimensions:
Zoning District Proposed Use Lot Area(sq ft) Frontage(ft)
1.5 Building Setbacks(ft)
Front Yard Side Yards Rear Yard
I
Required Provided Required Provided Required Provided
1.6 Water Supply: (M.C.L c,40,I54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public❑ Private❑ Zone: Outside Flood Zone?
Municipal 0 On site disposal systtm CI Check ifycsCI
SECTION 2: PROPERTY OWNERSHIP'
2.1wner`of Record: �
0ftl .4 man ij� o10if-bii a , /f" - a/66,2_Name Mint) Ci State, /l
atc ZIP
Jyl d a/biu1 cL.1- 'Y/3 — 31/C-5323
o.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORKS(check all that apply)
New Construction❑ Existing Building❑ Owner-Occupied ❑ Repairs(s) O Alteration(s) 0 Addition 0
Demolition 0 Accessory Bldg.0 Number of Units_ Other ❑ Specify:
Brief Description of Proposed Work2:
To Add R-48 Cellulose Insulation in Attic for weatherization purposes
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
I.Building $ 1. Building Permit Fee:$ _Indicate how fee is determined:
2.Electrical $ 0 Standard Ciry/rown Application Fee
...... 0 Total Project Costa(Item 6)x multiplier x
3.Plumbing $ 2. Other Fees: $
4.Mechanical (HVAC) $ List
5.Mechanical (Fire $
Suppression) Total All Feeessf,frl
Check No. gal Check Amount: oCCash Amount
6.Total Project Cost: $ 3 c-C2-' 0 Paid in Full 0 Outstanding Balance Due: —
NEGH
28 Spellman rd
Please Submit Stafford Springs,CI
Permits to: 06076
SECTION St CONSTRUCTION SERVICES
5.t Construction Supervisor License(CSL)
John Perrier 105319 12-12-2017
License Number Expiration Date
Name of CSL Holder
List CSL Type(see below)
18 Bradway Pond rd
Type Description
No.and Street U Unrestricted(Buildings up to 35,000 cu.It.)
R Restricted i&2 Family Dwelling
Cityfrown,State.ZIP M Masonry
RC Roofing Covering
Stafford Springs Ct 06076 WS Window and Siding
SF Solid Fuel Burning Appliances
1 Insulation
860-930-779C jperrier06076Qyahao.com D Demolition
Telephone Email address
5.2 Registered Home Improvement Contractor(BIC)
HIC Company Name or HIC Registrant Name 173021 8.27.2018
HIC Registration Number Expiration Date
Jahn Perrier
No.and Street jperrier06076(%yahoo.com
IS Bradway Pond rd Email address
Stafford Springs,Ct.06076
City/room,State,ZIP Telephone 860-930-7794
SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152.g 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...........❑
SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I,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
02/ 242017
Print Owner's Name(Electronic Signature) Date
SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION
By entering my name below,I 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
02/ 742017
Print Owner's or Authorized Agent's Name(Electronic Signature) Date
NOTES:
1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor
(not registered in the Home Improvement Contractor(HRC)Program),will not have access to the arbitration
program or guaranty fund under M.O.L.c. 142A.Other important information on the HIC Program can be found at
wwwmass.gov/oca Information on the Construction Supervisor License can be found at www,mass.eOV/dO
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 haiffbaths _
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"
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Permit Authorization Form
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Owner of the property located at:
(Owner's Name, printed)
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(Property Street Address) (City/Town)
herby authorize New England Green homes to act on my behalf and obtain a building permit to
perform insulation and/or weatherization work on my property.
(Owners Signature)
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(Date)