24A-121 44 CALVIN TER BP-2017-1122
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:24A- 121 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-2017-1122
Project# JS-2017-001908
Est.Cost: $1627.00
Fee: $65.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: JOHN PERRIER 105319
Lot Size(so. ft.): 9365.40 Owner: JACKSON DAVID C&ELAINE M STINSON
Zoning: URA(100)/ Applicant: JOHN PERRIER
AT: 44 CALVIN TER
Applicant Address: Phone: Insurance:
18 BROADWAY POND RD (860) 930-7794 WC
STAFFORD SPRINGSCT06076 ISSUED ON:4/10/2017 0:00:00
TO PERFORM THE FOLLOWING WORK:ADD R-48 CELLULOSE INSULATION IN ATTIC
FOR WEATHERIZATION
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: 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 4/10/2017 0:00:00 $65.00
212 Main Street, Phone(413)587-1240, Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
File it BP-2617-1122
APPLICANT/CONTACT PERSON JOHN PERRIER
ADDRESS/PHONE 18 BROADWAY POND RD STAFFORD SPRINGS (860)930-7794
PROPERTY LOCATION 44 CALVIN TER
MAP 24A PARCEL 121 001 ZONE URA(I0Q)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid 4 (j,
Building Permit Filled out 6
Fee Paid
Typeof Construction:_ADD R-48 CELL SULATIQN IN ATTIC FOR WEATI IERIZATION
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Buildjna 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:
proved 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
D n 'tion En ay A
al
'-o
Sig . we of Bui -nL, fficial 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
w, Board of Building Regulations and Standards FOR
Massachusetts State Building Code,780 CMR MUNIUSE LITY
Building Permit Application To Construct,Repair,Renovate Or Demolish a Revised Mar 2011
f One-or Two-Family Dwelling
This Section For Official Use Onl /
may} ,-7�{ /t
�.:... .. •uiiding Permit Number: Qr^ tt[.7 � 1 Date Applied:
77,1 1
Building Official(Print Name) Signature Date
SECTION is SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map&Parcel Numbers f
I.la Is this an accepted street?yes_ no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimension:
Zoning District Proposed Use Lot Area(sq ft) Frontage(h)
1.5 Building Setbacks(ft)
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
1.6 Water Supply:(M.G.L c,40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public 0 Frivats 0 Zone: _ Outside Flood Tone? Municipal 0 On site disposal system ❑
Check if es0
SECTION 2: PROPERTY OWNERSHIP'
OwneentR rd:
wn d J ciao c- � try i 7YV 1 • 0106,6
Name(Print) aR 51ate.ZIP
N
C(0/2 v n „d.± 4f3 -3,762 -72x3 7—
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply)
New Construction❑ Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition 0
Demolition 0 Accessory Bldg. 0 Number of Units_ Other 0 Specify:
Brief Description of Proposed Worte:
To Add R-48 Cellulose Insulation in Attic for weatherization purposes
SECTION d: ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1.Building $ 1. Building Permit Fee:S___Indicate how fee is detemtined:
0 Standard City/Town Application Fee
2.Electrical $ 0 Total Project Cost'(Item 6)x multiplier__x
3.Plumbing $ 2. Other Fees: $
4.Mechanical (HVAC) S List:
5.Mechanical (Fire
Suppression) Total All Fees:gq $
Check No. 0 i Cheek Amour*4,,c Cash Amount
6.Total Project Cost: $ +(p2-4 0 Paid in Full O Outstanding Balance Due:. '
NEGH
28 Spellman rd
Please Submit Stafford Springs,Ct
Permits to: 06076
SECTION S: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
John Perrier 105319 12-12-2017
License Number Expiration Date
Name of CSL Holder
List CSL Type(see below)_I_
IS Hradway Pond rd
Type Description
No.and Street U Unrestricted(Buildings op to 35,000 mil)
It , Restricted I&2 Family Dwelling
City/Town,State,ZIP M Masonry
RC Roofing Covering
Stafford Springs Ct 06076 WS Window and Siding
SF Solid Fuel Burning Appliances
I Insulation
8W930-7794_ jperrim96076 )yahoo.com p DemolitionTel ,hone Entail address
5.2 Registered Home Improvement Contractor(HIC)
HIC Company Name or HIC Registrant Name 173021 8-27-2018
HIC Registration Number Expiration Dam
John Perrier
No.and Street
18 Bradway Pond rd jperrl Emailr0606(dyanoo.eom
Stafford Springs,Cl.06076 Email eddrws
City/Town,State,ZIP Telephone 860-930-7794
SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.e.752.({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 APPLES 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/)52017
Print Owner's Name Elecdonic Si: arure 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
03/ ✓ /2017
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(HIC)Program),will nor have access to the arbitration
program or guaranty fund under M.G.L.c. 142A.Other important information on the HIC Program can be found at
www.mass.gov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dos
2. When substantial work is planned,provide the information below:
Total floor area(sq. fl.)i (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 ofbalfbaths
Type of heating system Number of decks/porches
Type of cooling system Enclosed Open
1. "Total Project Square Footage"may be substituted for"Total Project Cost"
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JOHN A PERRIER ." '.:
I8 BROAD WAY POND ROAD
StAFFORD SPRINGS Cr 09016
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DEPARTMENT OF BUILDING INSPECTIONS n
:,cy,-j„g.'. 212 Main Street • Municipal Building L\ Cm
Northampton, NA 01060 70
Property Address: 4/LI l'71) ✓�J
Contractor
Name: 111 3e�
\)/(� � _ ��/
Address: / Q /J/ tjf(�a�/�,,l����l Pa7td / f(9_City, State: _m�� %,..r op &t Qc' c1'2
Phone: `7/3 z% y ” 3rc J
Property Owner / / ,,
Name: /ti Lr '/J00�d( °V
Address: l y ( t/ L9/1 L
City, State: ./t47-441.a27/10/1)90 rA(1//1- 9/Q6a
I, J/,)V)fl *I'rl,Q/' (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
r
Date
373//