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23B-082 63 NONOTUCK ST BP-2017-1029 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block:23B-082 CITY OF NORTHAMPTON 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# BP-2017-1029 Project# JS-2017-001772 Est.Cost: $3046.00 Fee: $65.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Grono: BRYAN HOBBS 83982 Lot Size(sq. ft): 10018.80 Owner: HAGGERTY RICHARD P&TABITHA Zoning: URB(I00)/ Applicant BRYAN HOBBS AT: 63 NONOTUCK ST Applicant Address: Phone: Insurance: 346 CONWAY ST (413) 775-9006 WC GREENFIELDMA01301 ISSUED ON:3/16/2017 0:00:00 TO PERFORM THE FOLLOWING WORK:INSULATE ATTIC - 6" CELLULOSE 304SF, AIR SEALING, 11" AIIC FLAT KNEE WALL 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: OI: 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 3/16/2017 0:00:00 $65.00 212 Main Street,Phone(413)587-1240, Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner File# BP-2017-1029 APPLICANT/CONTACT PERSON BRYAN HOBBS ADDRESS/PHONE 346 CONWAY ST GREENFIELD (413)775-9006 PROPERTY LOCATION 63 NONOTUCK ST MAP 23B PARCEL 082 001 ZONE URB(I00)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid / Building Permit Filled out /LC/J Fee Paid Typeof Construction:_INSULATE ATTIC-6" CELLULOSE 304SF,AIR SEALING, 11"AIIC FLAT KNEE WALL New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 83982 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO ATION PRESENTED: 1 Approved_ Additional permits required(see below) PLANNING BOARD PERMIT REQUIRED UNDER:$ 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 1frjionDelySig . ur • sliding Officia 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 City of Northampton Status of Permit: <lb / Building Department Curb CuttDriveway Permit ' 212 Main Street Sewer/Septic Availabilby / Room 100 Water/Well Availability Northampton, MA 01060 Tyo Sets of Structural Plans ` , , phone 413-587-1240 Fax 413-587-1272 Plot/Site Plans Other Specify APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOUSH A ONE OR TWO FAMILY DWELLING SECTION 1 •SITE INFORMATION p? 3 t- 0 1.1 "'rename Atltlrsae: This section to be completed by office -5 Nor o uc ' '{ tome `, Map Lot Unit LcY'ecic e , A\ Zone Overlay District 1 Elm St District CS District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT $1 Owner of Record: 1QN\C WA Vcxc ckeit7 V3- VlonaAuuc St ctcsrene,AAA Ott) Name(Print) ii Current Mailing Address. See. A` . �'h uar i --w71(.Hj Telephone i 1-5,_ z 25-70 Signature 't 7.2 Authorized Attent: —3t rUn s exr ode1;n 3�i Ccmv.\Qy Sf ceen etdIkAPT - Name PrintCurrent Mailing Address: &in boa-.s- X U -"17 5-Citi 1p Signature Telephone ,SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only com.fatsd . .<rmit a•.licant _ 1. Building 33'1 6 (a)Building Permit Fee 2. Electrical (o)Estimated Total Cost of Construction from (6) 3 Plumbing Building Permit Fee 4. Mechanical(HVAC) 5. Fire Protection �a ��y// y/�'/ate 6. Total=(1 +2+3+4+5) 30LI (fl Check Numberp`(Q � 3 o3 This Section For Official Use Only Building Permit Number:)/'J] Date Signature'. L ,iO/G'/C//////�A/T 1-' 3 _-/6 — t 17Building Commissioner/Inspector of Buildings / Date Section 4. ZONING All Information must Be Completed. Permtt Can Be Dented Due To Incomplete Information .1011111M® Required by Zoning This column w be filled in by n Building Department ill 4- Setbacks From Side Rear Building Height GaaallNMINIFAFMIMIMMI - Open Space Footage - ,E- Op area minus bldg et paved rkin; Mine 1111.11.111111111111111 A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO C DON'T KNOW +;i YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW �4ff YES 0 IF YES: enter Book Page and/or Documents B. Does the site contain a brook, body of water or wetlands? NO ® DONT KNOW i) YES 4 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained 0 Obtained 0 , Date Issued: C. Do any signs exist on the property? YES O NO 04 IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES © NO �b;�� IF YES, describe size, type and location: E. WO the construction activity disturb(clearing,gradi e ovation,or filling)over t acre oris it part of a common plan that will disturb over 1 acre? YES 0 NO IF YES,then a Northampton Storm Water Managem nt Permit from the DPW is required. SECTION S-DESCRIPTION OF PROPOSED WORK(check all abolicable) New House C Addition ❑ Replacement Windows Alteration(s) C Roofing 0 Or Doors 0 `/ Accessory Bldg. ❑ Demolition ED New Signs ICI Decks [f; Siding[I) Other Brief DesaiPtiOn of Praaaooss0� a t+_ 777 ��a Work; 1f1t iny_ A ', 30L sc , kr SG\•nci , k ock.1ic 1u#'0e-uS 0.0 Alteration of existing bedroom Yes eg, No Adding new bedroom Yes h No Attached Narrative Renovating unfinished basement T Yes /v No Plans Attached Roll -Sheet Se.If New house and or addition to existing housing. complete the fotiowIng. a. Use of building!One Family /C 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. ie ensions N/Pt e. Number of stones? f. Method of heating? •replaces 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 wetla , . Yes No. Is construction within 100 yr. floodplain Yes_No j. Depth of basement or cellar •or below finished grade k. Win building confo o 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 CONTRACTORTiAPPLIES FOR BUILDING PERMIT I,� (< cd ____ asq_eir as Owner of the subject property - hereby authorize tr ,eiar, RObis neAree €1 I 09 to act on my behalf, in all matters relative to work authorized by this building permit application. Sae ALJ31Ori all/7M 3- 8 -f '- Signature of Owner44���� Date 1, 0.n tiOYx3S , as Owner/Authorized Agent hereby declare 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. Aryan Ebbs __ Print Nef Signature of Owner/ Date SECTION 8.CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor Not Applicable ❑ Hama of License Holder: Bryan G. Hobbs Remodeling (\ g"2)C (xa License Number Greenfield,MA013111 5/2- /S. ATExpiration Date l/ kskal‘) Li(3- M3- goo((' Signature Telephone 9 Reotstered Nome improvement Contractor. Not Applicable ❑ / Bryan G.Hobbs Remodeling ? 9 565/ CompanvNang 76 `_i °t Registration Number Greenfield,NIA 01301 7/a3j� Address /(y1 �] Q��/� Expiration a e (( Telephorte I>� 75 Ns SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L,c.162,§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 /AY 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 he,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 shalt 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 hermit- 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 persons) 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 150k Address of the work: (o3 \Iwo-u k S r,� Rama e The debris will be transported by: N/A The debris will be received by: Building permit number: Name of Permit Applicant 3 - g - I7- zt„„ i,kchb.„ Date Signature of Permit Applicant City of Northampton �eilt 1Sr.�7 T Massachusetts ! DEPARTMENT OF BUILDING INSPECTIONSa d. ti l U.W. 212 Main Btxoet . Munacip>i Building w 9 ! �, i'Noctnbmpton,lBA 010}60 I ti Property Address: 'O�i !VO(\OfUCk- Sim, P veYc,Q, Contractor ( Name: Ir\1(.>.t-\ �Co\\O�K C� enAVY—NC�:Eit11'1Ci 3 Address: "Ib �MU.)cs.� D-Ik- - City, State: G 10d.ii1CVQ\di &kJ\n Phone: `k.\--2> - nhri ' SON.° PropertyaOwner �7 `_ a �CNa Name: �11C�11V w--1 Address: (o` lvO`1(i*Y l,r -"NW. y �LA�'2V1cr }Lk-3/4c\ City, State: ic1r'CY-eAnc,Q ✓ A?c . 17&(\ As)k y (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 Date J ._cv 13_ RISE60 Shawmut Road, Unit 21 Canton,MA 02021 1 339502-6335 ENGINEERING www.RlSEengineering.com OWNER AUTHORIZATION FORM Richard Haggerty (Owners Name) owner of the property located at: 63 Nonotuck St. (Property Address Florence, MA 01062 (Property Address) hereby authorize JI ♦ b n / 41/701 1 in (Sub •ntractor) / 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. E-SIGNED by Richard Haggerty Owner's Signature February 24, 2017 Date C. K. The Commonwealth of Massachusetts -V �7A Department of Industrial Accidents -1,f FS 1 Congress Street,Suite 100 s:::s 1'_=G{�� Boston,MA(12114-2017 _' www.mass.goi/dla Workers'Compensation Insurance Affidavit:General Businesses. TO BE FILED WITH TRE PERMITTING AUTHORITY. Applicant Information _1,, Please Print Lenib's, Business/Organization Name: fyAn 110161)5 IOe Q\W10\ Address: C COO .I• t f. J city/statelzip:6-veev-,E1 et a , M A ....._ Phone#: Ll l3 --.11 -a 0 b to Are you an employer?Check the appropriate box: Business Type(required): 1,([y f am a employer with CO employees MA and] 5- 0 Retail rr or part-time)." 6. 0 Restaurant/Bar/Eating Establishment 2.❑ I am a sole proprietor or partnershipand have no 7. 0 Office and/or Sales(mel real estate,auto,etc.) employees working for me in any capacity. [No workers'comp. insurance required] 8. Non-profit 3.❑ We are a corporation and its officers have exercised 9. 0 Entertainment their right of exemption per e. 152,§1(4),and we have 10.0 Manufacturing no employees. (No workers'comp.insurance required)" ,i n Heal6`r Care 4.❑ We are a non-profit organization,staffed by volunteers, t-I with no employees. [No workers'comp.insurance req.] 12.2 Other ,11551 k C\Rc.el 'Any applicant that checks boa#i mast disc till om the section below showing their workers'compensation policy int emation. "If the corporate officers have exempted themselves,MP the corporation has other employees,a workers'compensation policy is required and such an organization should check box I. lam an employer that is providing workers'compensation insurance for my employees. Below is the policy information. I Insurance Company Name: (-)i rnio LAEMLI�-- ;y U ra i e fC . Insurer's Address: c/o A .1 6,`7l= 1nsuarce r'x�`}.exty Jam. . City/State/Zip: k- oX 9)011 i '' its � . L4!'s Policy#or Self-ins.Tic.re /1.119\2, t OC, 6_J',, 2- 5 ,Expiration Date: {0{ a Attach a copy of the workers'compensation policy declaration page(showing the policy number and expi {1 ation date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine 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 fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby ceunder the pains and enaities of perjury that the infi tmatton provided above is true and correct pita 5i afore: r, Ob Date: ra - t--1-4 rOffrcial use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Licensing Board 5.Selectmen's Office 6.Other ' Contact Person: Phone e: wuw.mesaRovidia ACORd nimmaitiggi ` ,- THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POL BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHOr REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policypes)must be endorsed, If SUBROGATION IS WAIVED,subb the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer right* certificate holder In lieu of such endorsement(s). PROou$R Tracey Auklewicz A.H. Rist Insurance Agency, Inc. PHONE Px, (413)863-4373 IWG NN:(a13)E63-saes 159 Avenue A E�MIAIL P.O. Box 391 iuuomeeee mx0CoD706s Turners Falls HA 01376 NsURER(slAFPORoINo COVERAGE W POURED INBURERA:Liberty Group Bryan Hobbs dba MURES 6. _ Bryan G. Hobbs Remodeling newness: _ 346 Conway Street insult RO: ., ,,.,,, NSURER e: Greenfield MA 01301 IrvsUREn F: _ COVERAGES CERTIFICATE NUMBER:201T CERT REVISION NUMBER: TRIS is TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PI INDICATED. NOTWITHSTANDING ANY REQUIREMENT.TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WH/CA CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED SY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TI EXCLUSIONS AND CONDITIONS CF SUCH POLICIES.LIMITS SHOWN MAY NAVE BEEN REDUCED BY PAID CLAIMS, Dr TVH a Oe INSURANCE awntier—— LI rs t Dome ILA IRM WYD POLICY NUMBER IMMO I IM J GENERAL LIASILRY EACH OCCURRENCE 1,00 IX^�COMMERCIAL GENERAL WADDED, DAMAGETOREMED 30 A CLAIMSMADE 1 OCCUR I BXeS60a48e0 108/04/201608/04/20171 MED EPP/Any one pass) 1 L 1 ,PERSONM.E PDVINJU*Y 1,00 ~J GENERAL..AGGREGATE 2,00 GENT AGGREGATE LM?APPLIES PER —1 ° (PRODUCTS.COMP/OP AGG 2,00 1 POUCY 'Kra I Iwo - _ I j AUTOMOBILE LIABILITY I ( COMBINED SINGLE LIMIT $ 1,00 (Ee=Haas) ANY AUTO GODLY INJURY(Par moon) $ A TALL OWNED AUTOS A1020738 1/02/2017 US/02/2018 3x1LY INJURY EPEE mmene S r I SCHEDULED AUTOS I PROPERTY DAMAGE 6 X HIRED AUTOS i(Pe eNtlMQ X NOMOWNED AUTOS I 4 a a ..— A X UMBRELLA UAB 1X OCCUR EACH OCCURRENCE b 1,00( EXCESS LLA= CLAMS-MADE W1056004890OB/04/2016 6{04/2010 AGGREGATE $ 1 00( DEDUCTIBLE X RETENTION $ 10,000 E WORKERS COMPENSATION SIC STAN. I Ori-" AND EMPLOYERS'GAMUT! YIry TORVI WITSR ANY PRRPRIETORIPARTNERRYECUTVE £L EACH ACODEM L OPPICERMEHBER ET:MOOED? NIA IMOPebry In NH) I E.L DISEASE•EA EMPLOYEE S oEIb e Mwtler EL.OIBEA9E- seRIP ON OF CP2RATICeFMpw PalcruMT S 1 o6BCRPfi OF OPEMtCNS 1 LntATWNSIvnsIClE6 vouch Atom141,AakamM Remarks SEneWKN n ,k more space RNro4i c1aseificstion: Carpentry 6 IneulAPPOD CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFI THE EXPIRATION DATE THEREOF, NOTICE WILL SE DELIVERED ACCORDANCE WITH THE POLICY PROVISIONS. Bryan Hobbs 346 Conway Street Greenfield, MA 01301 AUTHORIZED REPRESENTATIVE t Tracey Xuklewlcz/ANP 7---1........", 9. '�+.+l-G- ACORD?6(2DBB1Dg) The ACORD name and logo are registered marks of ACORDORD CORPORATION. All rights rens ACORD{none6(2 9 • • Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-083982 Golnsir,,,i onflSi]Su ri'/IW; BRYAN G HOBBS ' 348 CONWAY STREET GREENFIELD MA 01301 NI-M l�� Expiration: Commissioner 05/0212018 • • ae VCele,� io»rn»a»rueatt/ 0/ CA(aidackeietti Office of Consumer Affairs and Business Regulation - 10 Park Plaza - Suite 5170 r Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 139564 Type: DBA Expiration: 7/23/2017 Tr8 287354 BRYAN G. HOBBS REMODELING BRYAN HOBBS 346 CONWAY ST — - ------ — GREENFIELD, MA 01301 Update Address and return card.Mark reason for chant SCA 1 t, 20M-0511 _ Address J Renewal _ Employment L Lost( ///, n,,,,„„„we //b y-/7,.,m,,hoc,/4 '-c Office of Consumer Affairs&Business Regulation License or registration valid for individul use only yOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: 139564 Type: Office of Consumer Affairs and Business Regulation 'Expiration: 7/23/2017 DBA 10 Park Plaza-Suite 5170 Boston,MA 02116 BRYAN G.HOBBS REMODELING BRYAN HOBBS 346 CONWAY ST GREENFIELD,MA 01301 tinder-secretary Not valid without signature