24D-292 (10) 152 CRESCENT ST BP-2019-0749
GIs#: COMMONWEALTH OF MASSACHUSETTS
MQBlock:24D-292 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-2019-0749
Project# JS-2019-001232
Est.Cost: $4013.00
Fee: $65.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Groin JOSEPH GEORGE 99372
Lot Size(sa. ft.): 4965.84 Owner: CHAPUT CHRISTOPHER R
Zoning:URB(100)/ Applicant. JOSEPH GEORGE
AT. 152 CRESCENT ST
Applicant Address: Phone: Insurance:
64 HAYWOOD ST (413) 774-3604 WC
GREENFIELDMA01301 ISSUED ON:12/26/2018 0:00:00
TO PERFORM THE FOLLOWING WORK:DENSEPACK 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:
FeeTyne: Date Paid: Amount:
Building 12/26/2018 0:00:00 $65.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
RECEIVED A
Department use only
pn DEC 2 6 2018 C ty of Northampton Status of Permit:
Bt ilding Department Curb Cut/Driveway Permit
212 Main Street Sewer/Septic Availability,
DEPT OF BUILDING INSPECTIONS Room 100 WaterMell-Avallability.
NORTHAMPTON,MA 01060 iampton', MA 01060 Two Sets of Structural Plans
phone 413-587-1240 Fax 413-587-1272 PlotfSite Plans
Other Specify_
APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION I-SITE INFORMATION 'Nol
1.1 Pteperty Address:
This section to be completed by office
Map P-c-'P Lot Unit
Nortkvron) Zone Overlay District
0100 F-IM St.District ca District
SECTION2-PROPERTY OWNERSHIPJAuTHORIZED AGENT
2.1 Owner ojRecord:
41'o cvfcm, 3� 1
Name(Print) Current Mailing Address: o�
c
- See, ALA044 Telephone
N13)
Signature
2.2 Authorized-Actent:
- - TIDSe644 HrAylwoo�t
Name(Print) Current Mailing Ad-dress:
Signature
(11131-77if A01t
S
i
Telephone
OC-TION 3-�ESATED �MUCT
CON toN COSTS
Item Estimated Cost(Dollars)to be Official We Only
4. Budding com)Ieted b armit a licant
13, (a)Building Permit Fee
2. Electrical
(b)Estimated Total cost of
3. Plumbing Construction from 6)
Building Permit Fee
4. Mechanical(
5-Fire Protection
..............
6. Total=0 +
31 4 1 Check Number
This Section For Official UseOr
Building Permit Number Date
Issued:-
81 nature:
Building COmmisslonedinspectOr Of Buildings ------------
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
New House [] Addition ❑ Replacement Windows I Alterations) ❑ Roofing ❑
Or Doors 171
Accessory Bldg. ❑ Demolition ❑ New Signs [lam] Decks [Q Siding[0] Other[aQ
�nStn on
Brief
Description of Proposed
Work V Q�4 (�f \o6f 4 " in
Alteration of existing bedroom V Yes t` No Adding new bedroom'` Yes No
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll -Sheet
sa.if New house and or addition to existing housing, complete the following:
a. Use of building:One Family Two Family Other
b. 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? Fireplaces or Woodstoves Number of each
g. Energy Conservation Compliance. Masscheck Energy Compliance form attached?
h. Type of construction
i. Is construction within 100 ft.of wetlands? Yes No. Is construction within 100 yr. floodplain Yes No
j. Depth of basement or cellar floor below finished grade
k. Will building conform to the Building and Zoning regulations? Yes No.
1. Septic Tank City Sewer Private well City water Supply
SECTION Ta-OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR 13UILDING PERMIT
1, �-i'(i 5� (1\�p U� ,as Owner of the subject
property r�
hereby authorize SoSee� �orl&
to act on my behalf,in all matters relative fo work authorized by this building permit application.
See � v►��,ec� ��-�o� LsDid'
Signature of Owner Date
1, 30Sf-6 (TQoISIL ,as Owner/Authorized
Agent hereby deblare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge
and belief.
Signed under the pains and penalties of perjury.
uoSe-1, Geow-
Print Name \1�4�
Signature of 3W.—rftet Date
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder:
dos 6 kotc?- CS31 01`131a
License Number
a< t oo ArtCet-AiW-401301 a.-11-_'doll
Address Expiration Date
Signature ephone
9.Reuistered Home improvement Contractor: Not Applicable ❑
I P. Georg W Sof\1 Trnt, MW
Company Name Registration Number
(A d\ 5+«t'� &re-enf�e 1dl MR 01301 7-)S-ati IS
Address 9
j '7 Expiration Date
Telephone 41;3-774-3604
SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.I.-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....... ® No...... ❑
11. -Home towner Exemption
The current exemption for"homeowners"was extended to include Owner-occupied Dwelliiihs of one(1) 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 1083.5.1.
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 fano
structures.A person who constructs more than one home in a two year period shall not be 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 of the 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,you may be liable for person(s)
YOU hire 10 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
y Massachusetts
_�'•� DEPARTIOW OF BDILDING INSPECTIONS r I
ti f s y� 212 Main Street • Municipal Building
,=r Northampton, MA 01060
Property Address
Contractor
Name: JOSeeh George Geode oft�, Spn, 'IR(.
Address:
City, State: �r �n ►8j�, MA 01301
Phone: 74- %o4
Property Owner
Name: ckP kokr C60%,fi
Address: IS a` Wimi St
City, State: !`����tn��o�alli r 019 '0
I, 30� (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.
Contractor signature
Date b—f o 5-
� `
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: 1C resce �j S}
The debris will be transported by: ;3,f, Georje a,,n , Son , Tn
The debris will be received by: B rt;' le6oro -W v je
Building permit number:
Name of Permit Applicant 30S?rk
Gj"Date Signature of Permit Applicant
'- TIze Conzrtzonwealth of! assczclzrrsetts Print Form j
yepcu sxeFzL o• 3zzci» 's¢I ceWerzis i
Oj 17ty iioo CeiT41ZS
- _ - i0i2�ai-a S eet,a e 100 {'
OSLi3;Z, �rK 9174 j ('
z=c�Ji_if?G�4 �{12��t�_�'�..s5`o.1l}i'.- ��'-:�•Q'L}�'n j�i:�3='L�`GY�e_�rj�l�v'YJ/L'..t}�c-z'�fe:�O�•$��c��1��'3aS�.�f��ct9' ,t��.' �
er }�52 0� Meas? rr Leets
ate_
�45n�ir{3usincssiQr�aPi��tionl7ndi:ieaatl_J-�-GsOrg8 and Son. Inc_1 JOsaDh George
ddi c55-`'- Haywood Street !�
L i?r'Si_Le/Lip Creeniizid/MA/0 1301f
Phone=::(!7 3)-77R-360
t:_>Gii an employer? Cher-It the appropria�e bo :
Type of project(required):
i
.1v1 I am a employer a ith"_ -`- [� I am a general coni:actor and I
� emplotsee;(6111 and/or part Lima).= have liired the sub-con�.actors
o_ consu action I�
_ listed an the auached sheer- ?_ �Remodeling
s 4
1 am;Sole pr opriEtor or partner
ship and have no employees These=ub-co_ntracrors haveempioS. Q Demolition
working for me in any capachy— COMM-,inS and have�vorlcers- g- Q Buildinz addition !
�o,,0 serf comp-insurance eo>np_ins[!rance= 111
j required_j 1_ LI -ewe are a corporation and it< I D_[]ZE Iecincal repairs or additions
I am a nomeo.,ner doing€II t.=orh o c xs hal=e exercised etleir 11_C{ Plumbing repairs or additions
_ysel L-o v orters'comp_ nazi Di e:"�al1ptioz pe-1�SGT i
e. i a i ''_ e have no -.�itoai repair
and v
i insu!-ance recltli�d j' t-I' I�_ f�
emplotiees.�L o vorlcers- Insuiai[on
' Other f
comp-insurance required I
tit'mpi icon a that checia hot=-i must also 1111 out-atn sea:ion below siiowin_their woekcre compensalioa policy information. �t
into submit flies_nidavh 1ntlicad n_dtey am doing at!wor~and alien hire mislde contractors attstsubmit a n`r---Mi davir indicating suer.
=ontnc;ars that check chis hoc must attached an additional shat shtotriaa tim nam--or circ sub-cuntrarots and stoic niictlicr ornoUltosC en dies ha-ge
einDiot'eeS_ if die sub-cdnLaictors have employees,Uleb muni provide th-lir-work--is-comp_police number_ II
it
razz azz efnpin.Jer tharisprovidln,;zvo,--hers=cotz�DetiSaila37 I37SIIi tl}2C2j01'��2V 21�?A10�>ees Bdloiv is_Izap011r1>and jolt Site !1
%:fi�rmaiior,
l:lsu—,--ceCoinpakyNarne:Arbella=orSel
Policy _ -0- 6 �7 0
�-int T is-
Massachusetts Department of Public Safety
Board of Building Regulations and Sta-idards
License: CSSL-099372
Construct;on Supervisor Specialty
JOSEPH P GEORGE
64 HAYWOOD STREET
GREENFIELD MA 01301
Expiration:
Commissioner 02/11/2019
''//,�r,n.,,rr„u«,lrl r��^lCtrl�aclr,fell
Office of Consumer Affairs&Business Regulation
r HOME IMPROVEMENT CONTRACTOR Registration valid for Individual use only
- TYPE:Corporation before the expiration date. H found return to:
Rggistration Expir t Office of Consumer Affairs and Business Regulation
_ 156686 07/24/2019 10 Park Plaza-Suite 5170
JP GEORGE&SON INC Boston,MA 02116
0,JOSEPH GEORGE C`"`7 QS�•tj
64 HAYWOOD ST
GREENFIELD,MA 01301 Undersecretary Not Va d without signature
RISE "
ENGINEERING
OWNER AUTHORIZATION FORM
1, Christopher Chaput
(Owner's Name)
owner of the property located at:
152 Crescent Street
(Property Address)
Northampton, MA 01060 ,
(Property Address)
hereby authorize a, cl ��� U�d SDS, I� t`
(Subcontractor)
an authorized subcontractor for RISE Engineering,to act on my behalf to obtain a building
permit and to perform work on my property.This form is only valid with a signed contract.
Owne s Signatu
1-�, L05/a01
Date
RISE Engineering,a Division of Thielsch Engineering, Inc.
60 Shawmut Road Unit 2 ( Canton, MA 020211339-502-6335
www.RISEengineering.com