23B-050 (3) 45 BERKSHIRE TER BP-2019-0998
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:23B-050 CITY OF NORTHAMPTON
Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL e.142A)
Category: INSULATION BUILDING PERMIT
Permit# BP-2019-0998
Project# JS-2019-001644
Est Cost $1200.00
Fee $65.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Groin JAY BOLAND 101880
Lot Size(sa ft.): 6534 00 Owner: CAHILLANE MARIA T
zoning: llRsnool/ Applicant: JAY BOLAND
AT. 45 BERKSHIRE TER
Applicant Address: Phone: Insurance:
233 COLLEGE HWY (4131 203-2454 (1 WC
SOUTHAMPTONMA01073 ISSUED ON:3/13/2019 0:00:00
TO PERFORM THE FOLLOWING WORK:BLOWN IN CELLULOSE AND INSULATION
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector
Underground: Sere lee: Meter:
Footings:
Rough: Rough: House# Foundation:
Driveway Final:
Final: Final:
Rough Frame:
Gas: fire Department Fireplace/Chimney:
Rough: OV; 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:
FeeTvpe• Date Paid: Amount:
Building 3/13/20190:00:00 $65.00
212 Main Street, Phone(413)587-1240, Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
Q� I q
City of North mpt In - 9
Building Dep rtmt NAfl 12 20111 r212 Main S reef! A, , � N
'♦� Room 1 0
Northampton, 1v(p, 0 =roil nlnr,inlsa m
phone 413-587-1240 F x 41A-_581— °N rnA
�M1F
APPLICATION FOR INSULATION FOR A ONE OR TWO FAMILY DWELLING ONLY
SECTION I -SITE INFORMATION INSULATION PERMIT
1.1 Progerty Address: This section to be completed by office
qS S�", - Map � 3� Lot Ii Unit
N Ite� rr� �idrD �
Tone Overlay District
Elm SL District CB District
SECTION 2-PROPERTY OWNERSHIPIAUTHORIZED AGENT
2.1 Owner of Record I/
yokvfiPn �C1h� llan� �� �efkShln Tel � n1�1 0%6
Nam/e�(Pl�ntl)_ Currglt Mjailig(�tlOtlr �I
(-}"("'f(,(���� Talept/h'one "$a'
Signature
2.2 Authorized A ent: ,
W Cl Int wv! v
Name(Print) I Crrert Mai-ng Addres
gn
Signature Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed bennilapplicant
1. Building (a)Building Permit Fee
2. Electrical (b)Estimated Total Cost of
Construction from 6
3. Plumbing Building Permit Fee
4. Mechanical (HVAC) ���
5. Fire Protection l�
6. Total=(1 +2+3+4+5) 1 Check Number
This Section For Official Use Only
Date
Building Permit Number: Issued:
Signature: 3J- )3 2017
Building Canmisssmardnspeckv m Buildings Date
EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR)
SECTION 4-CONSTRUCTION SERVICES
8.1 Licensed ConslruoS is - qq Not Applicable
erName of License HolIQ (bl5'
License N tuber
n If�o� � .wtR�o✓� Ma o10�3 J ��J /a6
ess . t Expiration Date
Signa re Telephone
m i ''rd Coriftati Not Applicable ❑
Gwte Ene✓w oIo o�S ISP- I93TsXJ
Com an Name � Registration Number
3 Ca�l�se lelg MA 01613 /ac
ddress Expiration Date
Telephon . b t
SECTION 5-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.151,§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....... gr� No-.... ❑
Brief Description of Proposed Work NOTE: INSULATION ONLY
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.
Signed under the pains and penalties of perml,
s a� `�
Print Name
Signature
I, ofOwnerl Date
OOCAk n \l &WV
as Owner of the subject
property
hereby authorize
to act on my behalf,in all matters relative to work authorized by this building permit ap licah
Signatu 'o
ref Owner Date
RISE60 Shawmut Road, Unit 2 1 Canton,MA 020211339-502-6335
ENGINEERING' www.RISEengineering.com
OWNER AUTHORIZATION FORM
1. r�07t-t ,4 ('-'A ic Lvr>�5
(Owners Name)
owner of the property located at:
�fS c/� L'S //7 /-_ I�
(Property Address)
�_-
(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. This form is only valid with a signed contract.
The Permit will be secured by the Insulation contractor, at no additional cost. It is the homeowner's
responsibility to close out this permit by econtacting their municipality at the completion of this work.
Owner's Signature
l a�3o�lb
Date
62016
DowSign Envelope b:109676CE-E4B&4C268E6M1BB&Vw176
2018 WEATHERIZATION
mass e
s savBARRIER INCENTIVES
fY'MaSeypNhwaf
Based on your Energy spaciaestt racammgrdations,your home can bwonrt nom program-eligible tnsuLYlon and/or air sealhg
imorcvements Before moAm forward please follav all the instructions bolos,to remedbte your vreathedzetion berrlere.
CUSTOMER INSTRUCTIONS
1.Hire a quatifled licensed contractor to ev"M and/or remediate the weatherization barrier(f).
1 Submt ngrwd and compiaMd capias of this form and a copy of the Pass contractor 1.1ca(s)widen 60 days of your)Ware Ene,W
Assessment to:RISE Eryloeetrg,60 Sh.,not Rd,We 2,Canton,MA 02021
Or amzW ro CdumbWtasMAlafo'M1RI56ellglniatlngsam.
3.The weathertaton incentive will be detluctad from the customer co-parnoi nt amount of tine weatherizatbn work.A rebate eheck
will loin issues in the event the mum sacoods tM customer's co-payment amount.
0.Comdete thii reconvnended vreatherization imlxovamelss.
Customer Na., Marla Cahlanie Cllsnt IX or site ID: 441360
Ste A evr 45 Berkshire Terrace atv: FlaeyDe stere:-MA zIP.01062
:m.w�.-exmreram11ac ryrtcghW OI.ODr11
1 o0f °10
Phone lwmben.. 11= ey Emait we&
C mWNmMe>.'w&A till +NRR^- EDT
To determex if there is any actw knob and Buba waking,tine wnbactol'wa awluete the foWomn"arms where etgbl Mass Seer
weaMerveton remrvnwdators haw bawl made
0At0csbar 07 k:Wall OAtkslcpe MEslerbr Well ❑easemart OOtMr: OOter
.. ..n �.:v�retresaorrmx
❑ I rave PedcwOad my inspection NW datenrersa0 there is ra active knob aro tuiw wirwg h the araaf 4eNRM below.
OAttic Floor ❑Attic Well OMtcsiopa IlEstwdr War ❑Bassmwt ❑OMer ❑Otlar
n:n vs111x.,ro,Aman w.+.r.:n
0 1 here read erd agree ro to Tema and Cowatims on the locker this form.
Conbsctor Namc Peal A.N2an¢yk
Address:13 Massasoit Street at)c NDrftIapwn stagy MA zw 01060
ConfPenY Name Sarna 88 Lkerse Number 20228
ar.-
cener.fegr6fgaMme �./'�'... r y/ � :• � ;. .. m3�` '.
Hlgb Owbon Matetddw Catbaeear b to eervke end re-ewkate t e selected matlariwl ystarh(f)andfeduce era carbon monm ide IawL
asmeasumcl in the udaRed ala gae w below1D01swts pwrNlUn rppmx
daR 14asrw Cw4actorb ro correct t)e draft h the selected Ronal Refer to table on reverse far aoapMlNe dreRfangas.
HaaiMg W11ahm I
NoelRrlMr:'ItNtN y—_.{ � _ i
:.opean
Spblaga:Contractor is to const[Ne spillage of Ma gases h taselected mechwecal syYar(s).Must rot willefte,60 secerak wopensi n.
O Heatng Svetem ❑ Hot WetertkeM 0 Otisr.
O 1 saw pedormetl re elspaPtlon to
saw twl to sena noted h iha.rest 9eyCMd abate.
❑I save read and.gra tie tem
rs and Condilindftioms an the back or res form.
Contractor Name:
Address: City. statc_ZIP:
Cons,seny Name: License Nwnber.
CgnbasserglgrWQM Mae, v v
candnued on back
Cpapel of 2)
EdMCL
? 1A ISSUES THE A s
S ry
rgpls
atm rAM�
September 24, 2018
To Whom It May Concern,
On my making an electrical inspection of the wiring method, no
evidence of Knob &tube wiring was found in the exterior walls of this
residence at 45 Berkshire Te e, Florence, MA. 1
1.q&u g:A6 6r o iG
Peter A. Nikonczyk CI 23
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