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22D-059 (2) 33 FLORENCE RD BP-2019-0388 GIs#: COMMONWEALTH OF MASSACHUSETTS Map-.Block:22D-059 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-2019-0388 Project# JS-2019-000628 Est. Cost: $3000.00 Fee: $65.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: PAUL SCHMIDT 103635 Lot Size(sg.ft.): 18687.24 Owner: DIHLMANN ROBERT A&BARBARA J LAWLESS-DIHLMANN& DIHLMANN&B CUNNINGHAM&B DIHLMA Zoning URA(100)/WSP(100)/ Applicant. PAUL SCHMIDT AT. 33 FLORENCE RD Applicant Address: Phone: Insurance: 24 CHESTNUT ST (413) 247-5739 WC HATFIELDMA01038 ISSUED ON:10/1/2018 0:00:00 TO PERFORM THE FOLLOWING WORK:334 SQ FT, 13"LAYER, R-45 ADDED TO ATTIC FLOOR, OPEN BLOW CELLULOSE 136 SQ FT TO PERIMETER OF CRAWL SPACE RIGID BOARD 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: Firs LDegartnlent 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 Oppygancy §lUgature: Feer e: D& Paid: Ajpq t: Building 10/1/2018 0:00:00 $65,00 212 Main Street,Phone(413)587-1240,Fax: (413)587-12.72 Louis Hasbrouck—Building Commissioner i I _ Deparwient use only Cityof N rtha ECEIVEI of Permit EC Building C epa meet (qut/Dri vay P n;t 212 M n St eel � tio Availabity Roo �o SEP 2 7 2018 ell Availabi�_ Northampt , M 01060 wo Sol As of Structuraf€mss,._.__ phone 413-5$7-12 i= CD � PE CTio~Si Plans— NORTHAMPTON,MA 01060 APPLICATION TO CONSTRUCT,ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING .......�._. __._._.___-.__ ........... . SECTION 1 -SITE INFORMATION �j®' "rte ✓ 1.1 Property Address This section to be coon~by office Map- 6224 o Lot�� i ink Lo _ C �, Zone O�re4y �QJ l.�- El", St.Disir+ct CB District SECTION 2-PROPERTY OWNERSHIPIAUTHORIZED AGENT i 2. 1 n r o d: J )z4 L_+ Name{Pr" U Current Ma i � ress _...... Telephone Signature _ 2.2 64thorized Aaent: Sabi- J Y1e 1 !�')n►•ir �r`i'•i rLQ')1f � Y�L C';�+�`� C � � ►'"'�.71�.u� ..fit ���z rr��4 ur'ent Mailing Address nature ?eleptlone SECTION 3-ESTIMATED CONSTRUCTION COSTS item Estimated Cost(Dollars)to be Official Use Only m leted by permit applicant i Building (a)Building Permit Fee i 2. Electrical __. (b) Estimated Total Cost of ConsVucbon from 6 3 Plumbing Building Permit Fee 4 Mechanical(HVAC) V 5. Fire Protection 16. Total=(1 +2+ 3+4+S) Check Number This Seedw For Offlcbd Use Orft Building Permit Number, Date Issued Signature: Building Commissioner/inspector of Widings Da EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) J Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due 7o Incomplete Information Foisting Proposed Required by Zoning 'Ibis column to be filled in by Building Department Lot Size Frontage Setbacks Front Side 1..:,_. R:�_�._ Rear Building Height Bldg.Square Footage % Open Space Footage °fo (Lot area minus bldg cot Paved j Parking) f #of Parking Spaces Fill: volume&Location A. Has a Special Permit/Variance/Findin ver been issued for/on the site? NO O DON?KNOW 0 YES O IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW YES IF YES: enter Book Page and/or Document# B. Does the site contain a brook, Body of water or wetlands? NO ti.../ DONT KNOW a YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained Date Issued: C. Do any signs exist on the property? YES NO N-12 "" IF YES. describe size, type and location. D. Are there any proposed changes to or additions of signs intended for the property? YES 0 NO IF YES, describe size, type and location: E. Will the constui1ion activity disturb{ring, grading,,tp,.exp"tion,or filling)over 1 acre or is it part of a oommon plan that will disturb over 1 acre? YES NO .' IF YES, then a Northampton Storm Water Management Permit from the DPW is required SECTION 5-DESCRIPTION OF PROPOSED WORK I check all gooficabie) i Addition ❑ Replacement New House 0 Windows Alteration(*) 1 Roofing Or Doors Accessory Bldg. Demolition t 1 Now Signs ©] Docks Siding Other[ 1"V) .A q 74 Q4 CL112- Brief D cription of Proposed /13 wo I P"y Ft . C-) o 67C' Ck� gX 11 CL b Alteration of existingwf- 43 bedroom Y es No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes ✓ No Plans Attached Roll -Sheet 6a. If Now ho r%L wmplsilv the folkmidng use and or MWIILW to holl a Use of building Une i arnily two Farnily Number of rooms in each family uniti__, Nurnoer of Bathrooms Is there a garage attached? i d Proposed Square footage of new construction. Dimensions e, Number of stories? f Method of heating) Fireplaces of Woodstoves Number of each g Energy Conservation Compliance, Masscheck Energy Compliance form attached? h. Type of construction Is construction within 100 ftW . of well ds? Yes No is nStru(110rwithin. 100 yr floodplain Yes No ft Depth of basement or cellar flo below finished grade, k. 0 f t th wilding and Zoning regulations, Will building conform 0 .......... Yes No i Sewer Septic Tank ity Sewer Private well Cty water Supply SECTION?a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN 1 OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT as Owner of the subject 1 property hereby authorize If to act on my behalf, in all matters relative to work-autAorized by this building permit application. Signature of Owner Date I as Owner/Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate.to the best of my knowledge and belief. Sig/nod under the pains and penalties of perjury. ............... .. ............ Prim Name 1 Sig&fure of Own e(/Wnt Date ............ SECTION 8-CONSTRUCTION SERVICES 88.,1 Licensed Construction 5u Isor: 1 Not Applicable 0 Name of License Holder cZi :hm; cz /b ucense Number i X2 Addres Expiration[) to S eture Telephone j i ._......... S.Registered}come I Not Applicable c '_12b� T'Tt31Yl.�. _Li"Y� 12)41L 12U, .._._2; n6A Comnanv NameRegistration mber Expiration Cfate .._ _ _ ___ ___ . SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152,§25c($)) 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 buildinplpermit. Signed Affidavit Attached Yes....... No.,... e RISE OWNER AUTHORIZATION FORM I. Robert Dihlmann (Owner's Name) owner of the property located at: 33 Florence Road (Property Addr�, Florence, MA 01062 (Property Address) hereby authorize (Subcontractor) an authorized subcontractor for RISE Engineering. to act on my behalf to obtain a building permit and to perform work on my property ,.iris form is only valid with a signed contract. I Owners Signature: bate RISE Engineering, a Division of Thielsch Engineering, Inc. 60 Shawmut Road Unit 2 ; Manton: MA 02021. 1 339-502-6335 www.RISEengineering.c orn City of Northampton Massachusetts DEPARTMENT OF BUILDING rNSPSCTIONS 212 Mair. Street 0 Munio,_pal Bu..iding Northampton. MA 01060 AFFIDAVIT Home Improvement Contractor Law Supplement to Permit Application The Office of Consumer Affairs and Business Reguiation "(WABR") 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 he reinstered a,, a Horne 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 re red contractors, Vote:If contracted with a corporation or LL( that entity must be registered 4 l'ype of Work S(,t�0_4_7 Q-)r) :est Z- � Address of Work: VA Q_.", .................... Date of Permit Application: I hereby certify that: Registration is not required for the following: reasoni s) Work excluded by law(explain) Job under$1,000.00 Owner obtaining own permit (explairl,i ........................ .........------- Building not owner-occupied Other(specify):___ ........ OWNERS OBTAINING THEIR OWN PERMI'l OR ENTERING INTO ONTRACTS WITH UNREGISTERED CONTRACTORS OR SUBCONTRACTORS FOR APPLI(ABLE 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 Al.-SO ASSUME;"THE RESPONSIBILITES FOR ALL WORK PERFORMED UNDER THE BUILDING PERMIT. SEF NEXT PAGE FOR MORE INFOKNIATION. Signed under the penalties of perjury: I hereby apply for a building pep;tmt as theaj�eru of thc o it I L 'Date Contractor Nime HIPC Registration No. OR: Notwithstanding the above notice. I hereby appiv for ;i I)uildinv permit as the owner of the above property: Date Owner Name and Signature City of Northampton Massachusotts DSPA.Rn ENT OF BUILDING INSPECTIONS 212 Mair. Street •Municipal Bux.id.inq �'Q- 0 Northampton. MA 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 C� (Please print house number and street name Is to be disposed of at: (Please print name and location of facility; Or will be disposed of in a dumpster onsite rented or leased from (Company Name and Address; ignature of a i# pplican 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 1f CRY Of Louis Hasbrouck<Iasbrouck@northamptonma.gov> ........ Knob and tube affidavit 1 message Louis Hasbrouck<Iasbrouck@northamptonma.gov> Mon, Oct 1, 2018 at 12:20 PM To:Jeannette<jnetlawrence@gmail.com> Cc: Kim Carson <kcarson@northamptonma.gov>, Meghan Cahill<mcahill@northamptonma.gov> Jeannette, We need a knob and tube wiring affidavit for the job at 33 Florence Road.The house was built in 1920.The type you sent the last time is fine. I'm sorry this is a pain but we had a fire on South Street about a month ago that was attributed to knob and tube wiring that was covered with cellulose insulation. It's not clear if the insulation was the direct cause but we need to be very careful.We now check the age of every house that's being insulated. Thanks for your time. Louis Hasbrouck Building Commissioner City of Northampton Town of Williamsburg (413)587-1240 office (413)587-1272 fax Knob-tube affidavit Northampton.pdf 79K C,a AbAn', so j,3;o m-, : t2a P t , PL*Saft -a**Mwe Poe PORSAiatto t L IN c OMPOWWO a' � f MW Xmas 3W 1 ITITIT }meq •` O D Rw acuey N 60u8jou , r• WOW go. w low. OHS . . r NOLLVZM3H 3M , 111:111: