31A-184 (2) 45 WASHINGTON AVE BP-2017-1010
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 31A- 184 CITY OF NORTHAMPTON
Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGLLcc.1144/2�A)
Category: INSULATION BUILDING PERMIT
Permit# BP-2017-1010
Project# JS-2017-001747
Est. Cost: $2568.00
Fee: $65.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: JOHN PERRIER 105319
Lot Size(sq.ft.): 11674.08 Owner: MOSLER SUSAN C/O TRACY GREEN
zoning; URB(100)/ Applicant: JOHN PERRIER
AT: 45 WASHINGTON AVE
Applicant Address: Phone: Insurance:
18 BROADWAY POND RD (860) 930-7794 WC
STAFFORD SPRINGSCT06076 ISSUED ON:3/10/2017 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: Rouse# 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 Occu.anc Si•nature: G ���m /' ,o ''..Us
FeeType: Date Paid: Amount:
Building 3/10/2017 0:00:00 $65.00
212 Main Street, Phone(413)587-1240. Fax:(413)587-1272
Louis Hasbrouck- Building Commissioner
File#BP-2017-1010
APPLICANT/CONTACT PERSON JOHN PERRIER
ADDRESS/PHONE 18 BROADWAY POND RD STAFFORD SPRINGS (860)930-7794
PROPERTY LOCATION 45 WASHINGTON AVE
MAPS PARCEL 184 001 ZONE URB(100)1
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT '�
Fee Paid u Li (i1'
Building Permit F'illed out
Fee Paid
TamaConstruction: ADD R-4: CELLUL{, .. 't SUL.ATION IN ATTIC FOR WEATHERIZATION
PURPOSES
New Con4 ruction
Non Structural renovations
Addition to Existing
Accessory Structure
BuildingPla Incl dedh
Owner/Statement or License 105319
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION PRESENTED:
t 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
De oIi 'on Delay
�� 3-1o17
Signature of Buildi 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.
The Commonwealth of Massachusetts
FOR
Board of Building Regulations and Standards MUNICIPALITY
USE
State Building Code,780 CMR USE
Building Permit Application To Construct,Repair,Renovate Or Demolish a Revised Mar 2011
One-or Two-Family Dwelling
This Section For Official Use Only
Building Permit Number. Date Applied:
Building Official(Print Name) Signature Date
SECTION I:SITE INFORMATION
1.1 PT'soperty Address: 1.2 Assessors Map&Parcel Numbers
S k)avthkin tint, --4k
1.1a Is this an accepted street?yes no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use Lot Area(sq n) Frontage(3)
LS Building Setbacks(ft)
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
1.6 Water Supply:(M.D.L c.40,454) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public 0 Private❑ Zone: _ Outside Fines'Zone? Municipal O On site disposal system 0
Check dyes°
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'ofRecord:
(LI ( 1 i'-EPYI /1/164/1414/R-sn /�I P
N (Print) City,State,ZIP
10. 72 A� 7<9/- 7 ''
No. Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK'(check all that apply)
New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) ❑ Alteration(s) ❑ 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 weatberization purposes
SECtION 4:ESTIMATED CONSTRUCT/ON COSTS
Item Estimated Costs: Official Un Only
(Labor and Materials)
I.Building S I. Building Permit Fee:$ Indicate how fee is determined:
2.Electrical $ 0 Standard City/Town Application Fee
D Total Project Costt'(Item 6)x multiplier _x
3.Plumbing $ 2. Other Fees: $
4.Mechanical (HVAC) $ List:
5.Mechanical (Fire $
Suppression) Total All Fees: f ,fr(/�,�
Check No./73/ Amount 0 Cash Amount
6.Total Project Cost: $ t�S - 0 Paid in Full 0 Outstanding Balance Due:
NECH
28 Spellman al
Please Submit Stafford Springs,Ct
Permits to: 06076
SECTION S: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
lobo Perrier 105319 12-124017
License Number Expiration Dale
Name of CSL Holder
List CSL Type(see below) I
IS Brad way Pond rd
Type Description
No.end Street U Unrestricted(Buildings up to 35,900 cu.h.)
R Restricted 1&2 Family Dwelling
City/DivanState,ZIP M Masonry
RC Roofing Coveting
Stafford Springs Ct 06076 WS Window and Siding
SF Solid Fuel Burning Appliances
1 Insulation
864930.7794 jperrierO60768yaboo.wm
Tel hone Email address D Demolition
5.2 Registered Home Improvement Contractor(RIC)
HIC Company Name or HIC Registrant Name 173021 8-27-2018
111C Regisaation Number Expiration Date
John Perrier
No.and Street jperrter06076 8yahao.eom
18 headway Pond rd Email address
Stafford Springs,Ct.06076
City/Town,State,ZIP Telephone 860.930-7794
SECTION 0:WORKERS'COMPENSATION INSURANCE APP'WAVIT(M.G.L.e.152.§2$C(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 CI
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
03/ 1 /2017
Print Owner's Name Electronic Si_ ure Date
SECTION lb:OWNER'OR AUTHORIZED AGENT DECLARATION
By entering my name below,l hereby attest under the pains and penalties of perjury that all of the infomtation
contained in this application is true and accurate to the best of my knowledge and understanding.
Lynn Ford
031 /2017
PrintOwner's or Authorized Agent's Name(Electronic Signature) Date
NOTES:
I, 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(IRC)Program),will llgj have access to the arbitration
program or guaranty fund under M.G.L.c. 142k Other important information on the HIC Program can be found at
wwsv mass.Rovtoca Information on the Construction Supervisor License can be found at www.moss.gov/dps
2. When substantial work is planned,provide the information below:
Total floor area(sq.ft.) (including garage,finished basementtattics,decks or porch)
Gross living area(sq.ft.)_ Habitable room count
Number of fireplaces Number of bedrooms
Number of bathrooms Number of halftbaths_
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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STAFFORD SPRINGS CT 08078
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' Z•74---'0 expiration• 8/27/20113 Tnd V dttai `'tea ° "t;
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New England Green Homes
Permit Authorization Form
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City of Northampton
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7Massachusetts '
(v =Ct1 � DEPARTMENT OF BUILDING INSPECTIONS �
l` y.
L y;y 212 Main Street * Municipal Building i. ,ngC
; Northampton, MR 01060 � L `
iN0.
Property Address: 5 (F u J Ili(l f zY1 -t�1i t,�"
Contractor J
Name: uI)ii v;� Pc,,tcri V )\--- ,,��11
Address: )13 /3h�Rt/-U )0-2. a, VOL-
City, State. .At 4 I, ✓ JD)))(41 _, _ Al o ()=g.
Shone: 411/5 - ' 1-(11 ' ,r)'-033
Property Owner /'
Name: —t'a CLj I`;? V 2 2,e1
Address: c 60 (A) 0Th._A ]rLd-i - Iii-4-"
City, State:, ]!V b1 r'7 d_04)(mf2 y i ) /U2 1 [0
I, j OY,l i !" E li/n !( - (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.
....---2.-- ,
Contractor signature /'----- 7 /}
Date ') 1 1 GL//