Loading...
17A-097 (9) 37 GRANDVIEW ST BP-2018-1102 GIs#: COMMONWEALTH OF MASSACHUSETTS MV-.Block: 17A-097 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-2018-1102 Pro ject# JS-2018-001982 Est.Cost:$900.00 Fee:$65.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: PAUL SCHMIDT 103635 Lot Size(sa.ft.): 9365.40 Owner. CHAMBERLIN ASANTI zoning RI(t00)XRA(I00)/WSP(4z)/ Applicant: PAUL SCHMIDT AT. 37 GRANDVIEW ST Applicant Address: Phone: Insurance: 24 CHESTNUT ST (413) 247-5739 WC HATFIELDMA01038 ISSUED ON.412612018 0:00:00 TO PERFORM THE FOLLOWING WORK.*AI R SEALING - 96 SQ FT OVERHANG R-99 FIBERGLASS THEN 2" RIGID BOARD - FIRE RATED 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: O_1: 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: FeeTvoe: Date Paid: Amount: Building 4/26/2018 0:00:00 565.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner `d .{r I'1 ,• IMI Ci of Northampton l ,s Bu ding Department em - 12 Main Street ;I� - Room 100 Northampton.. MA 01060 phone 413-587-1240 Fax 413-587-1272 APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Property Address. ./This sermon to He �� 37 �f2�Tc1 ,e ,) S-� Ma—W-' Lot---0t7--una ZoneOeadae+0 . _ Elm SL Diaidc: Ca Distdct SECTION 2-PROPERTY OWNERSHIPIAUTHORREDAGEtyT 2.1 O er of eeortlee_ortl: //� Name(Pont) Cun nt Mailing Address �G 0a . ot— ( �� Telephone Signature JJ s. r 2.2 Authorized Agent: s�� YYLQ_. �->7�YC./'e./✓1-Q.ilt C.-w�cS,Tjy/'G ) 6 -4etd M4 Name PCurrent Mailing Address: 67 p.3rS' nature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed ov perm it applicant 1 Building �� (a) Building Permit Fee 2 Electrical (b) Estimated Total Cost of Construction from 6 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) fr`� 5. Fine Protection "!N 35 6. Total-(1 +2+ 3+4+ 5) Check Number p-f ,j This Section For ORtctal Use Only Date Building Permit Number: Issued. Signatu — �ZS/dig Budd'iriammmswnefitmpectmofBuRdings Data EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) Section 4. ZONING all infamutwn Must Be Cmpleted.Permit Can lie Dented Due To Incxrq l e Infomvtt Existing Proposed Required by Zoning Thismlumv w be fled i¢try swmmgmep®m�t Wt Size FrantaRe Setbacks From _.... _._._. Side L _ R: - . L. . R. Building Height - - -__--" Bldg.Square Footage Open Space Footage % .__.. [IAl_mimabidg&pevd N of Parkin S A. Has a Special Permit/Variance/Fin�di^r�(v,2ver been issued for/on the site? V NO O DONT KNOW YES O IF YES, date issued:. IF YES: Was the permit recorded at the Registry of Deeds? NO © DONT KNOW YES IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wettands? NO O DONT KNOW (D YES O IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained © Obtained 0 , Date Issued: C. Do any signs exist on the property? YES O NO 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: E. Will the consaucgon activity disturb(clearing, grading,ehon,w filling)over 1 acre or Is n part of a common plan that will disturb over 1 acvs7 YES NO IF YES,then a Northampton Storm Water Management Pennd from the DPW is required. SECTION S-DESCRIPTION OF PROPOSED WORK(check all soolicahle) New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑ Or Doors ❑ i __'' // _ l Accessory Bldg. ❑ Demolition ❑ New Signs !�] Decks [p Siding�Other[ Brief Description of Proposedcy Work / W —SC 2q, 12 Alteration ofexisting bedroom___--:Yes No Adding n bedroom Ves No l P✓'r; ✓44L / Attached Narrative Renovating unfinished nascent Yes ✓ No l n p J Plans Attached Roll -Sheet j St. It KBW // a. Use of building : One Family Two Family Other / b Number of roams m each famil1 unit Numoer o`Bathroorns / i c. Is there a garage attached' d. Proposed Square footage of new construction. Dimensions e. Number of stories' Method of heatingh fireplaces or Woodstoves Number of each g. Energy Conservation /below Masscheck Energy Compliance form attached' Type of construction Is construction within s? Ves Nc. Is construction within 100 yr floodplain_Yes No Depth of basement or w finished gradeH. Will building conform tand Zoning regulations% Ves NoSeptic TankPrivate well City water Supply SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT as Owner of the subject property '1 II _ hereby authorize �� l i->'C)I.1`11. (/2"✓C/1' /T'�' L h✓1LY-41-tb,-S -�-/l � I to act on my behalf. in all matters relative to work aut prized by this building permit apple at L) Signature of Owner Date I. S r M! as Owner/Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurateto the best of my knowledge and belief. Sig�n'p)p under the pains and penalties of perjury. !'LY,cC l �Cltm i-�-�- aunt Name Sig ure of Own I to Date SECTION 8•CONSTRUCTION SERVICES SE Licensetl Construction / Not Applicable ❑ Name of License Hold er d lo-3&z5— License o-3&z5— License Numb cf a� o2ci Adtlres Expiration Difte Sileature t, Telephone 9.R�edtk>� Not Applicable ❑ Sbj- 44orylL �rnon rrunf �nhaeFa< s, �n � /7y�iS Co /� Registration Number a � �s_� lrul/ S�✓eei 4-2 i Address Expiration Date SECTION 70-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152, Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will resulf. inthe demal of the issuance of the building permit. Signed Affidavit Attached Yes....... G No...... City of Northampton Massachusetts 'e ss 212 eair. S OF Besu—NG INSPECTIONS p. 212 Main Street •Munaclpai Building J` b �\ NOtthamp[on. MA 03060 Debris 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. The debris from construction work being performed at. 3 �./Q�✓ e� 1 S {� _. (Please p4rint house number and street name) Is to be disposed of at: ` eanc�� ve Qcr ..r�[ cnC (Please print name and location of to lity) Or will be disposed of in a dumpster�onsite rented or leased from. (Company Name and Address) 0 Signature of f Pe r�riit Applica-nf or Owner Date If, for any reason, the debris will not be disposed of as indicated. the Applicant or Owner shall notify the Building Department as to the location where the debris will be disposed. City of Northampton Massachusetts Ar ; DEPAAT04.'NT OF BUILDING INSPECTIONS ,t 212 Neil Street • nicipal euiltling e Northa ton, NA 01060 * 2 \ .AFFIDAVIT Home Improvement Contractor Law Supplement to Permit Application The Office of Consumer Affairs and Business Regulation I"OC ABR") regulates the registration of contractors and subcontractors performing improvements or renovations on detached one to four family homes. Prior to performing work on such homes, a contractor must be registered as a Home Improvement Contractor("HIC'). M.G.L.Chapter 142A requires that the`reconstruction, alteration, renovation,repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units....or to structures which are adjacent to such residence or building"be done by reeistered contractors. Note:If the homeowner has contracted with a corporation or LLC, that enfity must be registered ii n oc Type of Work: SU.(p—,{�L��� _ __ _Est. Cos[: .Address of Work: 3 1/ Date of Permit Application: — I hereby certify that: Registration is not required for the follouving reasoms1- Work excluded by law(explain)- Job under SL000.00 Owner obtaining own pettnit (explain c Building not owner-occupied Other(specify): OWNERS OBTAINING THEIR OWN PERMIT OR ENTERING INTO CONTRACTS WITH UNREGISTERED CONTRACTORS OR SUBCONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK ARE NOT ELIGIBLE FOR AND DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER M.G.L.Chapter 142A.SUCH OWNERS ALSO ASSUME THE RESPONSIBH,ITES FOR ALL WORK PERFORMED UNDER THE BUILDING PERMIT.SEE NEXT PAGE FOR MORE INFORMATION. Signed under the penalties of perjury: I hereby apply for a building pe t as the age t of the own r Date Contractors me ��,}t2Cc-(oK.Sa HIC Registration No. OR: Notwithstanding the above notice, I hereby apply for a building permit as the owner of the above property Date Owner Name and Signature (Aumbta Gas ul MaSstICIILLSCM: 60 Shawn t Rca1 ori , S11111 NIA 02021 A NS,,,Comr�ony OWNER AUTHORIZATION FORM Asanti Chamberlin (Owner's Namei owner of the property located at: 37 Grandview Street (Street) Florence, MA 01062 mown. State zipi hereby authorize S' L (Subcontractor'; an authorized subcontractor for RISE Engineering to act on my behalf to obtain a building permit and to perforin work on my prep r, s rom cn . ;abd with a signee contract_ The Permd will be secured by the insuiahor :ontracro a;no additional cost. It is the homeowner's responsibility to close out this permit by contacting their municipality at the completion of this work. -Customer Signature V// ?//r -;qrt Date 4/1 712018 the f onanuanrpltlr ., ihn xn 1x-6¢11 Depurunenr :,j luoLn fent Ya a/eon - Jifftre nJ lu rr+li,galinnr . � �. r,ue HnsLarvru+f Slreer Rmmn 111 02111 N orl < mupensation Insuranct lllidanr lluildcr. ( omractorslElea•rriciansJPlumber. 4onlicant Information _ SGL name Imp- verneot Contractors Inc 24 Chestnut Street t IL+ Nmlc J.q• Hatfield MA 07038 4'3-247-5739 sn wu an ourploaer?i heck du api n1n lyn '0 111oler16-e4-111+11 _ _ 110111.. 0011-3., Insulation lam nn'rrirr thm i+P,, lyd.rg wod rr+' .nnpen+aoion ur;nv.e i r nt1 :n+phr-ees. Belau f. the polka and job life mirk.. -tfnu. Selective Ins,ranc WC9024456 , + I l,r; 0212312019 4tialh a o'p' of the *i nrkerv' -ompen+-tron poli¢+ d.......ou11 pu Ke++In:n mg th-p-lic, number and lyfirutwn date). I L " a. a: : -'aw cyui: . ,.1tle1 Sr+ ,u.. � �, v.,u> ... f Irina-:. Ixnahw", I„ : ,e pm` rue ni,r , -.0 rolin, I "o . ,111![1!, V,uRK ORN li ns up 1: � ul „ ,.ow I: it- 1A ,� _+ h -a++.: .olh,Oihcc td1hereh: <nyfynder Il puirn andyrvznlrrr, ,+ J r - /unnun„:r1 ,wiled-hair-n tootanAcnrn,1 y �3 1ff (11ju and nor un1; 1) nw mriar v»1h)r rr. ., :nprL vr✓ x wn v ,qli,"d Ii � (it. ur town: rernrn.t.:c.mr s 1"uing :wthonn l,.rrh io,r � i. @>a1d M Ik.Ith 2 nuiidmP Hepmtmaw >. i o, 1 1.+1. , :rrk 1. hlrl-i noa! Insp�rur ^. Plumbing Inalmau+ I h.Orher I' C unl8ci Peres¢ Phone w I� n rrd CERTIFICATE OF LIABILITY INSURANCE "r`_5°, 1 -- - -- CHIS CERTIFICATE 5 ISSUED ASA MATTER OF INFORVATION ONE, A4 E E YR R9 NO RIGHTS VERA THE CERTIFICATE HOLDER PO THIS CERTIFICATE CCR NOT AFFIRMATIVELY INS,RAN OR NEOATPIE-.' AS- FNP OR 4� "FR THE COVERAGE AFFORDED DY 'HF F0RI IF-, RFI RE THIS CFRTIFICATE OF INSURANCE ODES iC :.4h On'aA 9FTWEEN *�E RSJIN6 INSURERr&. AUTHOR12ED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER IMPORTANT f Ue ceedcate hol F is an ADDITIONAL NS�l Pl ondas1I f SURROpATI ON IS WAIVED sub as 'c ..le terms end w-Uitlons of pra policy,ve to pal ces nn, e< rncp rs�me ��a emem or th s cortifieate tloes nog 'Tlft,l rlgbzs is the certlllcate holder in lieu Oi such entlmsemcntisi. veI S 'I, f . 1a. ae waDba.av Tq ne__ con a•.,eanr.vcoamnz mV caaeE >_ Norvham,.r YA at0er -1 IN o _p ,. s Comlica DL s rtx s va_e - ns ,,,+ .. SuetheaeC eiY14 SJL io - 2G r„as_nu_ __neat r.,, ea MR CERTIFICATE NUMBER "'� +` COVERAGES `xr, y REVISION NUMBER. OA ,� . � .. :A. ,.r+12 '..+ ...g ' � r,< , <..t tea✓ +.eu rur esianrtt au ue. .,.. , A eo4N 8CA'-n>A yrYl % .p0 nl v i a.a . _..m. _ xas_ -rtua cis he-ot, .no, t ._ 1 3r. ,e. w __.a_ cs ' CERTIFICATE ROIOER !:ANCELIA'ION 4! ABOVE P.SrR9FO➢OLICIFEBE-AIC-ILEOOEFOXE •%ORA ^u IA'E ULREUI NOTICE WIG 0E 'EIIVEREO IN JR1A4:,c M1.- F POiICT PROVI810NS i T `^f i”.f {^r iJt sTt :oc�6. 1r �5 y '. '98&t01b ACORD CORPORATION. All rlghls reserved ACORD 25(2014,01) The ACORD name and Ioyo aye-eglsterea meas W AOORO 'N5035 + _