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25C-252 (11) 37 FAIR ST BP-2018-1391 GIS#: COMMONWEALTH OF MASSACHUSETTS Map�Block:25C-252 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit. Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Cate2orv:INSULATION BUILDING PERMIT Permit# BP-2018-1391 Project# JS-2018-002469 Est Cost $2600,00 Fee:$65.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group PAUL SCHMIDT 174415 Lot Size(sp. IT): 21170.16 Owner: KARNEY STEPHEN Zoning,SCH00)/ Applicant. PAUL SCHMIDT AT. 37 FAIR ST Applicant Address: Phone. Insurance: 24 CHESTNUT ST (413) 247-5739 WC HATFIELDMA01038 ISSUED ON:612712018 0:00:00 TO PERFORM THE FOLLOWING WORK 1384 SO FT INSULATIO ON 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 6/27/2018 0:00:00 $65.00 212 Main Street,Phone(413)587-1240,Far:(413)587-1272 Louis Hasbrouck-Building Commissioner File q BP-2018-1391 APPLICANT/CONTACT PERSON PAUL SCFMIIDT ADDRESS/PHONE 24 CHESTNUT ST HATFIELD (413)247-5739 PROPERTY LOCATION 37 FAIR ST MAP 25C PARCEL 252 001 ZONE SCO 00)" THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED Qk;:-- � Fee Paid 1 D S. Building Permit Filled o Fee Paid TvoeofConstructi0n: 1384 SO FT INSULATIO ON EXTERIOR WALLS New Construction Nan Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 174415 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO ATION PRESENTED: 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 emolition Delay r i na re of Rdir frenal Dat Note: Issuance of a Zoning permit does not relieve a applicant's burden to comply"7th 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. ity of Northampton V 'B uilding Department RDWELLING 212 Main Street Room 100 N hampton, MA 01060 587-1240 Fax 413-587-1272 APPLICATION TO CONSTRUCT,ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO F SECTION 1-SITE INFORMATION 1.1 ProcerN Address: yTill Sade w be ft dise 2 ^� • �J•O-tel r' S—f "� L. j5 thtit ml C�I d(O O Else V I r Elm at Dbtrict CB Dbtrkt SECTION 2-PROPERTY OWNERSHIPIAUTHORIZED AGENT 2.1 Own of ord: I/ Name(Pont) � / Current Mailing �3 T+'R� Telephone Signature s, 2.2 horized at : SVI" /YI[!, PYC J'2/✓L{�"f' L'�r�S,T.�/G ed �,S2iirw1 t/ cl, u+ st zxf der d 1r?4 Name 'M Current Maling AOEress: nature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only com feted by permit applicant 1. Building coo r.0 (a)Building Permit Fee 2. Electrical (b) Estimated Total Cost of ConekuMion frim 3. Plumbing Building Permit Fee /1 4. Mechanical(HVAC) V 5. Fire Protection 6. Total=(1 +2+3+4+5) Check Number Tide Sesion For fl/lefet Ill Only Date Building Permit Number. Issued Signat Building Cam Pectpr of Buil pate EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) Section 4. ZONING AR Information Ann Se Compteted.penMt Can as Dented Due To Incomplete Information Existing Proposed Ratified by Zoning Thisco.wbe®Mdmby awa�g Dr�m�t Lot Size Frontage Setbacks Front Side L: —: R: -- L:- R- . itis Building Bldg.Square Footage -.. _ % Open Span:Footage ___ % _ (I.ot aasminor bldg&pavcd _ ___ . .. of Parking Susces FW: A. Has a Special Permit/Variance/Fi7ver been issued for/on the Site? NO O DONT KNOW YES O IF YES,date issued:'. IF YES: Was the permit recorded at the Regl try of Deeds? NO © DONT KNOW YES IF YES: enter Book Page and/or Document If B. Does the site contain a brook, body of water or wetlands? 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 O Obtained ® , 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? YE O NO Q IF YE, describe size,type and location: E. W11 the construCtion activity disturb(�ring,grading, or fllNng)over 1 ase a Isit ivart of a summon plan that will disdx6 over 1 ova? YES NO IF YES, than a Northampton Storm Water Management Permit from the DPW is required. SECTION e-DESCRIPTION OF PROPOSED WORK toheck all amlira6k1 New House ❑ Addition ❑ Replacement Windows Alteretlon[s) ❑ Roofing ❑ Or Doors D AccessoryBldg. ❑ Demolition ❑ New Signs [01 Deeks [0 SidinglgljOther[®f Brief Description of Propos Work' Alteration of existing bedroom_Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basemen[ Yes ✓ No Plans Attached Roll -Sheet Be.It, _ ;.. . a. Use of building '. OneFani Two Family Other In Number of rooms in each family unit: Number of Bathrooms c. Is there a garage attached? d. Proposed Square footage of new construction. Dimensions e. Number of stories? f Method of heating?7Zoning Fireplaces or Woodatoves Number of each g. Energy Conservatio . Masschack Energy Compliance form attached? h. Type of construction Is construction withill s? Yes No. Is consiructioo within 100 yr. floodplain_Yes_No I. Depth of basement below finished grade k. Will building confor to ng and Zoning regulations? Yes No Septic Tank_ Private well City water Supply SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1, as Owner of the subject property ' I hereby authorize -i-K)YY1,Q.. -h'1O�1i✓'f,�Y /7i' �✓YIYLt e'lZzl'S 1-11 to act on my behalf, in all matters relative to work autt n'zed by this building permit application. 4� Q+hnlC-ha d. (�g-/ 9-1r Signature of Owner Date 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. SigjQ under the pains and penalties of perjury. npiG 1 4 L' M 1,14— PrinsName Sig ure of Own / nt Date SECTION 8•CONSTRUCTION SERVICES 8.1 Licensed Construction Su 'sor: Not Applicable 11o Name of License Holder'. �� lo,3�e 3 5 License Num 7P61-2 e s/nuf S� f c1 rr)+? vi�8� ac -2Ci i Atldres Expiration D to S store Telephone 9.Redafrad,NIaesr / Not Ap�plliicaabblle�/❑ SSI- I.rYIOYI�I(�rrU ./%n�YAC�FOGS� .ln i / "7 `/ /—,5-- TySom an Name Registration mber Address C M /� �j+ �/ q�•// Expiration ate SECTION 10•WORKERS'COMPENSATION 64SURA14CE AFFIDAVIT(M.G.L.c. 152,§25C(6)) Workers Compensation Insurance affidavi ust be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the buildi permit. Signed Affidavit Attached Yes....... No _. ❑ City of Northampton s � Massachusetts '^f '•;� t DSPER39ffiIT OF BUILDING INSPECTIONS 212 Nein Street oN ninlpal Building ' 2 Northampton, M 01060 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 cons. uotion work being performed at: (Please rint house number and street name) Is to be disposed of at: �] AA --rrgt hy`� 75 e � (Please print name and to tion off city) Orwill be disposed of in a dumpster onsite rented or leased from: (CompannyyName and Address) '/ 7 �AppflcaW Signature ofor 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 DIn'"230117T OF BUILDING ZNapFCTZONa 212 Main Street • Municipal Building northamptOn, ! 01060 AFFIDAVIT Home Improvement Contractor Law Supplement to Permit Application The Office of Consumer Affairs and Business Regulation ("OCABR")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 preexisting owneroccupied building containing at least one but not more than Pour dwelling units....or to structures which are adjacent to such residence or building"be done by re contractors. Note:If the homeowner has contracted wid th a corporation or LLC. that entity mast be registered. Type of Work: I44 1��'1{uN it4 [ice `Esti Cost: ruU Address of Work: 37 h na ✓ �fi }v Date of Permit Application:__ I hereby certify that: Registration is not required for the following reason(s). —Work excluded bylaw(explain):_.. _Job under 51,000.00 Owner obtaining own permit explain)- —Building explain)_Building not owner-occupied Other(specify): OWNERS OBTAINING THEIR OWN PERMIT OR ENTERING INTO CONTRACTS WITH L 4REGISTERED 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 RESPONSDHLITES 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 t as L v7the a�entpof the er {�N L/ Mi t Date Contractor Nime �T,(-{ac.{•oKS� 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 t Numbly ( uls "I %,Qa SSaCI]t1SCCUS 60 Shawmut Rcad Unit 2 Cantor MA 02021 A NIS C,.., OWNER AUTHORIZATION FORM Carol Karney (Owner's Namer owner of the property located at 37 Fair Street (Street) Northampton, MA 01060 (Town, State, Zip) hereby authorize 5b (Subcontractor) an authorized subcontractor for RISE Engineeringto act on my behalf to obtain a building permit and to perform work on my property. This torn, is only valid with a signed contract. The Permit will be secured by the insulation contracto,. at no additional cost. It is the homeowner's responsibility to close out this permit by contacting thev municipality at the completion of this work. -Customer Si nature -Sign Date 5/10/2018