38B-126 (4) 34 COLUMBUS AVE BP-2019-0107
GIS#: COMMONWEALTH OF MASSACHUSETTS
Mks :Block: 38B- 126 CITY OF NORTHAMPTON
Lot--001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit. Buildinq DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category INSULATION BUILDING PERMIT
Permit# BP-2019-0107
Proiect# JS-2019-000177
Est Cost$2763.00
Fee: $65.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group, JOHN PERRIER 173021
Lot Size(A.R.): 9539.64 Owner: SPECTOR LEE A&REBECCA S NEIMARK
Zoning:URB(100)/ Applicant: JOHN PERRIER
AT. 34 COLUMBUS AVE
ApplicantAddress: Phone: Insurance:
18 BROADWAY POND RD (860) 930-7794 WC
STAFFORD SPRINGSCT06076 ISSUED ON.713012018 0:00:00
TO PERFORM THE FOLLOWING WORK INSULATION IN ATTIC
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 SLe atur
FeeTvve: Date Paid: Amount:
Building 7/30/2018 0:00:00 $65.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
9
z]J M
ao
The Commonwealth of Massachusetts
Board of Building Regulations and Standards FOR
82 Massachusetts State Building Code, 790 CMR MUNICIPALITY
zR USE
aBuilding Permit Application To Construct,Repair,Renovate Or Demolish a Revised Mar 2011
HOne-or 75vo-Fam11y Dwelling
Q This Section For Official Use Only
G Build!OF hNum Date Applied:
1
6---il LrujORMial(Print em Signature Dine
SECTION 1:SITE INFORMATION
1.1 Property Address: 1.2qyu ap&Parcel Numbey, /'
I.I a Is this an accepted street?yes_ no Map Number Pence]Number
C/
1.3 Zoning information: 1.4 Property Dimensions:
Zoning District Proposed Use Lot Area(sq R) Frontage(ft)
1.5 Building Setbacks(ft)
Front Yard Side Yards Bear Yard
Required Provided Required Provided Required Provided
1.6 Water Supply:(M.O.I,c.40,154) 1.7 Flood Zone Information: 1.9 Sewage Disposal System:
Public❑ Private❑ Zone: _ O.mde Flood Zone? Municipal❑ On silt disposal system ❑
Check if es[3
SECTION 2: PROPERTY OWNERSHIP'
0 :n Rem LLU*� IUO t ed�71Y1 Q/ I�
Neme� (Poolr City,Stale.Z
87 //
No.and SIMM Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK'(check aB that apply)
New Construction❑ Existing Building❑ OwnerAccupied ❑ Aepairs(s) ❑ Altemti0n(s) ❑ 1 Addition ❑
Demolition ❑ Accessory Bldg.13 Numbtr of Units_ Other O Spedly:
Brief Description of Proposed Worle:
To Add/Achieve R49 Cellulose Insulation in Attie for weatherization purposes
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Estimated Costs:
Item Labor and Materiels Official Use Orally
1.Building $ 1. Building Permit Fee:$_indicate bow fee is determined:
2.Electricalg 13 Standard City/room Application Fee
O Total Project Cost (Item 6)x multiplier_x
3.Plumbing S 2. Other Fees: S
4.Mechanical (HVAC) $ List:
5. Mechanical (Fire $
Suppression Total All FeesrS._I
a ��
check No.h4tCThe'ek Amowt(�1_� Cash Amotmn_
6. Total Project Cost: $ 1/1 ❑Paid in Full ❑Oustanding Balena Due:
NEOH
28 Spellman rd
Please Submit Stafford Springs,Cl
Permits to: 06076
SECTIONS: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
John Perrier 105319 12-12-2019
License Number Expiration Data
Name of CSL Holder
List CSL Type(see below)_I
13 Bradway Pond rd Type Description
No.and Street U Unrestricted(Buildings no to 35,000 cu.ft.
R Restricted 1d2 Family Dwemn
CityNown,Sister,ZIP M Meson
ry
RC Roofing Covering
Stafford Springs Ct 06076 WS Window and Sidln
SF Solid Fuel Burning Appliances
I Insulation
413244.200.3_ jperrier06076@yahoo.com
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC)
HIC Company Name or HIC Registrant Name 173021 8-27-2018
Sohn Perrier HIC Registration Number Expiration Date
No.and Strcet jperrier06076( "bw.com
18 Bradway Pond rd Email address
Stafford Spring%CL 06076
Ci (Town,State ZIP Tel hone 413-244.2003
SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152.1 25C(6))
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide
this affidavit will result in the denial ofthe Issuance oftho building permit.
Signed Affidavit Attached? Yes..........0 No...........❑
SECTION 7m OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
1,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.
�,Rt ` e�" �(q N�ihar - 0-)/Y/2018
Print Owner's Name EleeoonicS more Date
SECTION 7b: OWNER'OR AUTHORIZED AGENT DECLARATION
By entering my time 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.
John Perrier
011le /2018
Print Owner's or Authorized is Name Electronic Si atureOnto,
NOTES:
1, An Owner who obtains a building permit to do his/her own work,or an ownar who hires an unregistered contractor
(nm registered in the Home Improvement Contractor(HIC)Program),will W 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 envlata Information on the Construction Supervisor License can be found at www.masssov/dos
2. When substantial work is planned,provide the information below:
Tonal floor arca(sq.ft.) (including garage,finished basementlattics,decks or porch)
Gross living area(sq.ft.) Habitable rooms count
Number of tbeplaces Number of bedrooms
Number of bathrooms Number of half/baths
Type of heating system Number of decks/porches
Type of cooling system Enclosed Open
3. "Total Project Square Footage'maybe subntimted for"Total Project Cost"
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JOHN'PERRIER
JOHN PIjpRl16 BRAbNVAdA'
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$odrd of4kf0dr6.9 Rego4ons and Sla4dards
Construedo tid;pr Speci4y
CSSL=705319 $l!W Expires: 1@J72l2019
JOHN A PERAIER
la BROADWAYPONDR"D ' _
STAFFORD SRw.NGS GT 0507'6 '
Commissionef ''
New England Green Homes
Permit Authorization Form
1 Rebecca S.Neimark ,Owner of the property located at:
(Owner's Name, printed)
34 Columbus Ave,Northampton
(Property Street Address) (City/Town)
herby authorize New England Green homes to act on my behalf and obtain a building permit to
perform insulation and/or weatherization work on my property.
(Owners Signature)
(Date)
City of Northampton
r S/
{ `t, Massachusetts
a' s
212 Min S of BvkMniciUrw� ZNBunii,
212 Win .icer! •Nun a 01 auilainq JC C
Noctf,en¢Con, He 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 construction work being performed at:
3q C6101)Mul &0- _
(Please print house number and strect name)
Is to be disposed of at; /7
(Please prin ame and location of facility)
Or will be disposed of in a dumpster onsite rented or leased from:
(Company Name`end Address)
Sign a of Permit pelican weer 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.