24D-129 (2) 237 STATE ST BP-2017-1155
GIS#: COMMONWEALTH OF MASSACHUSETTS
Mao:Block:24D- 129 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGLLc.1144/2�A)
Category: INSULATION BUILDING PERMIT
Permit# BP-2017-1155
Project# JS-2017-001956
Est.Cost: $3900.00
Fee: $65.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: ROBERT HUNTER 88742
Lot Size(so. ft.): 6534.00 Owner: STEIN JUDITH
Zoning: URC(I00)/ Applicant: ROBERT HUNTER
AT: 237 STATE ST
Applicant Address: Phone: Insurance:
P O BOX 10432 (413) 575-1097
HOLYOKEMA01041 ISSUED ON:5/23/2017 0:00:00
TO PERFORM THE FOLLOWING WORK:430 SQ FT OF R30 CELLULOSE IN ATTIC, 824
DENSE PACK CELLULOSE IN EXTERIOR WALLS
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 5/23/2017 0:00:00 $65.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
File#BP-2017-I 155
APPLICANT/CONTACT PERSON ROBERT HUNTER
ADDRESS/PHONE P O BOX 10432 HOLYOKE (413)575-1097
PROPERTY LOCATION 237 STATE ST
MAP 24D PARCEL 129 001 ZONE URC(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICAT !...w..- KLIST
ENC OSE REQUIRED DATE
ZONING FORM FILLED OUT
Fee Pal
Buildin+ Permit Fill'. out ate
Pee Paid '
T w Construction; 430 SO FT OF R30 CELLULOSE IN Are 824 DENSE PAC.. CELLULO'::. IN
EXTERIOR WALLS `Or
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 88742
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INION 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
Deft a ' ron !
Signanr• of Building 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 MOL 40k Contact Office of
Planning& Development for more information.
•
Department use only
City of Northampton Stator or Permit - 1'
ii60 Building Department Curb,C t'Orlveway PuarmM1
\� 21?. Main Street Sewer/Septic Avadabllity
0� Room 100 WatenW 11Aratat ty=
Nartharnpton, MA 01060 Two-S®ts ofStmduraI Plans
phone 413-587-1240 Fax 413-587-1272 Plot/Site Plans > P-
Other Sleocity y.,,_ 'ran #
APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION
This section to be completed by office
1.1 Pro•eAd.ress
;3 { 1_ ~ 51 / / � V /OO Map "tc/ / Lot IL 7 Un
it
NOE/11 .4) .
?one Overlay District
Elm St.District CS District_
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 1
2.1 Owner
Ut ' , -- - 'S fin r (1,iii es- 7
, eee�
I �� Carrell Ad s'
(Print)! �n"Ing-�`"` -3 — 1LE$i
tTelephone
nature
2.2 Authorized Agent:
£6Fleet rn-Fer „ - 7emaoc)elrr, fur _. Po U'ox 1o912. (-(+(yofre. A4 01°Y (
Name(Print) Current Mailing Address:
, a1- 4-z-
w yn-4- S- l0 i7
sgnak Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Budding (s)Budding Permit Fee
*3i"UJ
2. Electrical (b)Estimated Total Cost of
Construction from(6)
__
1 Plumbing Building Permit Fee
4. Mechanical(HVAC)
5. Fire Protection AOate�.7
6. Total=(1 +2+3+4+5) 43100... >�•e� FA
Check Number i
This Section For Official Use Only 14111111111111,
Building Permit NumberDate
-- Issued:
Signature:
Building Commissionar/Inspector of Buildings Dale
G„dr
(Mfg- of Narffittmpfan
MISS/trhuaetfa 7 a,�
DEPARTMENT OF BUILDING INSPECTIONS 1F
r ais
212 Main Siren • Municipal Building ''thrid”
Norlhamplon, MA 01060
LOUISHSBROUCK BUILDING PERMIT FEES Phone: (413)587-1240
BUILDING COMMISSIONER Effective July 21,2008 Fn: (413)587-1272
•
DEMOLITION $ 20.00 ACCESSORY STRUCTURE
$ 35.00 PRINCIPAL BUILDING—Residential
$200.00 PRINCIPAL BUILDING-Commercial
'NEW CONSTRUCTION $ .50 per square foot for? 'floor
.30 " " " 2n°floor
.20 " " " '4 floors,attic,basement,garage
STRUCTURAL ALTERATIONS IN ALL USE GROUPS
$6.00 per thousand dollars of estimated cost or fraction thereof,
with a minimum fee of$55.00
$25.00 W000BURNING STOVE
'NEW ACCESSORYSTRUCTURES one hundred twenty(120)square feet and over
$ .20 per square foot with a minimum fee of$25.00
'NEW ACCESSORY STRUCTURES under one hundred twenty(120)square feet
$25.00 per inspection
*SWIMMING POOLS $30.00 for above ground
$60.00 for in-ground
'SIGNS B AWNINGS $30.00
'DECKS $50.00
REPLACEMENT WINDOWS $35.00
SIDING&ROOFING
Residential $35.00 per structure
Commercial $55.00 min.per structure OR$6/K of estimated cost
TENTS $25.00
*ZONING REQUEST FORMS $15.00 (includes home occupation registration)
REISSUE OF LOST PERMIT $25.00
CERTIFICATE OF ANNUAL INSP. $100.00 (minimum)
Temporary Certificate of Occupancy $25.00
PERMITS REQUIRING ONLY 1(1)INSPECTION WILL BE A MINIMUM OF$25.00;ALL OTHERS WILL
HAVE A$50.00 MINIMUM. PERMITFEES SHALL BE PAID TO THE ORDER OF THE City of Northampton
AND SUBMITTED,WITH THE COMPLETED PERMIT APPLICATION,TO THE OFFICE OF THE BUILDING
INSPECTOR. WORK STARTED WITHOUT PERMIT IS SUBJECT TO DOUBLE NORMAL FEE.
!! NO CASH -CHECKS OR MONEY ORDERS ONLY!!
•Filing deadline Is 12:00 pm(noon)on Wednesday.
Section 4. ZONING All 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 Dcpanmcnt
.
Lot Size ...._ _.. .
homage _...
Setbacks Front
Side L: R: L: R:
Rear
Building Height
Bldg Square Footage
Open Space Footage
(Lot area minus bldg&paved
parking)
at of Parking Spaces •
---
Fill: __.. ..._....
(volume&Location)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO 0 DONT KNOW Q YES O
IF YES, date issued:
IF YES: was the permit recorded at the Registry of Deeds?
NO 0 DONT KNOW 0 YES 0
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 0
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained O Obtained O , Date Issued:
C. Do any signs exist on the property? YES O NO 0
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property? YES O NO (�
IF YES, describe size, type and Location: +c
E. Will the construction activity disturb(clearing,grading,excavation,or filling)over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES O NO C4
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
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SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: '' Not Applicable 0 (,
Name of License Holger IlnLMl y H//4+I4er CS — egg 79Z
11 License Number
3,>< I
�0o132-- f0170fte a44 oioyl r /up / tot!
Addressn`� // r Expiration Date
--ti (4 A `off- 57-c- I04 "
Signet e Telephone
9.Reaistered Home Improvement Contractor Not Applicable ❑
Pfec,cte. 200061gfel Z.t tS2922_
Company Name Registration Number
Z( go oStMet f if—e- to M /s
Address _ Expiration Date
4011•0 Ice /44 opTeleP hone? 57s -�o
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 ct No 0
11. - Home Owner Exemption
The current exemption for"homeowners"was extended to include Owner-occupied Dwellings of one(I) 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. A person who constructs more than one home in a two-year period shall not he 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 ofthe 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,von 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: 73 54te S9. No,M4zw/,710.-,
The debris will be transported by: Pie cl3?o.2 2e41 oc)e/t.ay Su c,
The debris will be received by: K + W m4 ti s W,.1 t Ser;,iy r(cJ
Building permit number:
Name of Permit Applicant ),hpsr g.caeer strc,ziow 2e.+roc)e(•y Sw.
Date Signature of Permit Applicant
arm The Commonwealthof/nvestigations of Massachusetts
Department of Industrial Accidents
•
Office
A sl IC
sa :NW 1 Congress Street, Suite 100
e Boston, MA 02114-2017
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name(Business/Organization/Individual) Precision Remodeling, Inc.
Address: 21 Roosevelt Ave.
City/State/Zip: Holyoke, MA 01040 Phone #:413-575-1097
Are you an employer? Check the appropriate box:
contractor and I Type of project(required):
I.❑ 5 4.I am a employer with ❑ I am a general
employees (full and/or part-time).* have hired the sub-contractors 6. ❑ New construction
listed on the attached sheet. 7. ❑ Remodeling
2.❑ I am a sole proprietor or partner-
ship and have no employees These sub-contractors have 8. ❑ Demolition
working for me in any capacity. employees and have workers'
9. ❑ Building addition
[No workers' comp. insurance comp. insurance.;
required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions
3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions
myself [No workers' comp. right of exemption per MGL 12 ❑ Roof repairs
insurance required] t c. 152, §1(4),and we have no Insulation
employees. [No workers' 13.❑� Other
comp. insurance required.]
*Any applicant that checks box q I must also fill out the section below showing their workers'compensation policy information.
r 1 lomeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have
employees. If the sub-contractors have employees,they must provide their workers'comp.policy number.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name: Guard Insurance Co.
Policy# or Self-ins. Lic. #:PRWC710203 Expiration Date: 12/16/2017
Job Site Address: 237 State St City/State/Zip: Northampton, MA 01060
Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration 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 certify under the pains and penalties of perjury that the information provided above is true and correct.
11April 2017
Signature:
Date:
Phone#: 4135751097
Official 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):
I. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone#:
A Worker's Compensation and EmoloYer's Liability Poll
Berkshire Hathaway
� NorGUARD Insurance Company - A Stock Co.
o PolicyNumberPRWC71D203
Insurance Renewal of PRWC670727
;mg GUARD Companies NCCI No. [25844]
Policy Information Page
[[i]Named Insured and Mailing Address Agency
Precision Remodeling Inc THE DOWD AGENCIES, LLC
21 Roosevelt Ave 14 Bobala Road
Holyoke, MA 01040 Holyoke, MA 010411900
Agency Code: MADO W D 10
Federal Employer's ID 04-3317682 Insured is Corporation
Risk ID Number 273479
[2] Policy Period
From December 16, 2016 to December 16, 2017, 12:01 AM, standard time at the insured's mailing
address.
[3] Coverage
A. Workers' Compensation Insurance - Part One of this policy applies to the Workers' Compensation
Law of the following states: Massachusetts
B. Employer's Liability Insurance - Part Two of this policy applies to work in each of the states listed
in item [3]A. The limits of our liability under Part Two are:
Bodily Injury by Accident - each accident $500,000
Bodily Injury by Disease - each employee $500,000
Bodily Injury by Disease - policy limit $500,000
C. Other States Insurance - Part Three of this policy applies to all states, except any state listed in
item [3]A. and the states of North Dakota, Ohio, Washington, and Wyoming.
D. This policy includes these endorsements and schedules:
See Extension of Information Page - Schedule of Forms
[4] Premium
The Premium Basis and, therefore, the premium will be determined by our Manual of Rules,
Classifications, Rates, and Rating Plans. All required information is subject to verification and change by
audit. (Continued on another page)
Total Estimated Policy Premium $ 9,640
Total Surcharges/Assessments $ 513.00
Total Estimated Cost $ 10,153.00
INTERNAM$_....XX Page - 1 - Information Page
MSA : PRWC710203 WC 000001A
Date : II/11/2016
MANOTE
Issuing Office: P.O. Box A-H, 16 S. River Street, Wilkes-Barre, PA 18703-0020 • www.guard.com
v Massachusetts Department of Public Safety
Board of Budaing Regulations and Standards
• License. CS-088742
constr.,ction Super.rso,
ROBERT R HUNTER •y Y- Tt
P.O.BOX#10432 ` 1 •,r.,
HOLYOKE MA 01041
( 'tea l _.pvxioc
Commis-one, 01/161010
gul
Office of Consumer Affairs 8 BusinessRegulation
HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only
Type: Corporation before the expiration date. If found return to'.
S2SIVMRIIOR Fsuiration Office of Consumer Affairs and Business Regulation
152922 10132018 10 Park Plaza-Suite 5170
Boston,MA 01116
Precision ling,inc
Robert Hunter
21 Roosevelt Ave \P r'CQ1a--- auk Holyoke,MA 01041 Cl !"`w"I+
Undersecretary Not valid without signature
APPENDIX 16.2
KNOB & TUBE WIRING
During the Energy Survey of your home, indications of`knob and tube' wiring were found, This old style of
wiring involves individual wires that are run through walls and ceilings in a house, with ceramic`knobs' and
-tubes' to prevent contact with wood framing. The knob and tube wiring that has been noted may or may not
appear to be active. Even if the observed wiring appears to be inactive,there may still be active knob and tube
circuits hidden inside walls or other inmin-rivet areas of the house.
Program guidelines require that you have the home checked by a licensed electrician and certified as being
free of all scale knob 6 tube wiring, before insulation and/or air sealing work can be done. Your electrician
should fit out and submit a copy of this document to Program Designee in order to verily the absence or
inactivity of the knob and tube wiring in the areas of your home where we are proposing insulation to be
installed. Due to the liability involved In signing such a form,we suggest you show or describe this
form to your electrician before hiring him to inspect your home to be sure hash*Is willing to sign it.
Your home could benefit from insulation and/or Sr sealing in the:
❑ Attic •• Only after this certification is received by Program Designee can a
❑ Walls Contract be issued for energy saving Insulation and/or air sealing
❑ Basement work. ••
Electrician's Certification
(This form Is Invalid when any qualifications or alterations are added.)
Company Name 8 Address ; (i 9 f= 5e r J('f:'� ,l /e c 7�l G
( `15 1iJK1 7 ) it ,0/ow fpi (/!'Ch
Electrician's Name �{�ti ;)i4 'e//e City License s 59/1/11-
I have performed an inspection of the wiring at the home of:
(f Ai) / fl-Uc^?t' a, ;1;7 7 ) 7r 57/111 in -41‘41719pfi>v'-
((Tuner's Name) (Street Address) (City)
Upon completion of my inspection I have found that there is no active knob and tube wiring in the area(s) noted
below.lo
c}� i Attic
Electrician's Signature / %l male l/ )2--1
2013 Mass Sere Home Energy Services Program NC Participwon.Agmnncm,LO
City of Northampton
fr.:-
� a s`'� ` ,
Massachusetts
;1:1 it Fp,+C`•
f
DEPARTMENT OF BUILDING INSPECTIONS 5
\� tM + 212 win Street tbnicipa1 Building }�'*•f.
Northampton, M. 01060 xO '
Property Address: 237 State St, Northampton, MA
Contractor
Name: Precision Remodeling, Inc. / Robert Hunter
Address: 21 Roosevelt Ave.
City, State: Holyoke, MA 01040
Phone. 413-575-1097
Property Owner Carol Avanti, POI
Name:
Address: 382 Moragan Rd.
City, State: West Springfield. MA
I Robert Hunter (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.
Please see attached Electrician Affidavit
Contractor signature
Date
23 May 2017