29-092 (9) BRIERWOOD DR BP-2019-1164
GIs#: COMMONWEALTH OF MASSACHUSETTS
Mao:Block:29-092 CITY OF NORTHAMPTON
Lot-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL 042A)
Category: INSULATION BUILDING PERMIT
Permit# BP-2019-1164
Project# JS-2019-001885
Est.Cost: $2500.00
Fee: $65.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Groom JAY BOLAND 101880
Lot Si_ze(sa. @.): 13198.68 Owner., DREW HOLLY
onin : Applicant. JAY BOLAND
AT: 46 BRIERWOOD DR
A1lplicantAddress: Phone: Insurance:
233 COLLEGE HWY (413) 203-2454 O WC
SOUTHAMPTONMA01073 ISSUED ON:4/1912019 0:00:00
TO PERFORM THE FOLLOWING WORK:BLOWN IN CELLULOSE AND AIR SEALING
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspectorof Plumbing Inspector of Wiring D.P.W. Building Inspector
Underground: Service: Meter;
Footings:
Rough: Rough: House N Foundation:
Driveway Final:
Final: Final:
Rough Frame:
Gas: Fire Fire Department Fireplace/Chimney:
Rough: Q% Insulation:
Final: oke: Final:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occupancy Signature:
F eTYpe• Date Paid: Amount:
Building 4/19/20190:00:00 $65.00
212 Main Street,Phone(413)587-1240, Fwr:(413)587-1272
Louis Hasbrouck—Building Commissioner
Day
City of No ham
Building D art ant
212 Main Stre t APR 1 8 9019
Room 00 ."
Northampton, A r INSPeC TIONS
'< phone 413-587-1240 az 4iti2+ +""+n
l
APPLICATION FOR INSULATION FOR A ONE OR TWO FAMILY DWELLING ONLY
SECTIONI -SITE INFORMATION INSULATION PERMIT
This section to be completed by office
1.1 Property Address: .
Map OI—t2q Lot (3 Cj
-�— Unit
Zone Onreday District
✓. Elm SL District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of R cord:
�- ,Ord" J 0 teYl
N.me(P1m 111/./' I Cuvent Mailing Atltlress:
P, I'TLnj i") Telephone
Signature
2.2 AUth.hil Agent:
�( M M. 1� 4.L110,175 3 ca//w Nr oU7
Name(Prinp ` Curre�{ Ing Adpress', C
/ CI 03
Signature Telephone
SECTION SPMA D CONSTR TION COSTS
-
Item Estimated Cost(Dollars)to be Official Use Only
completed by ermit ap licant
1. Building (a)Building Permit Fee
- 2. Electrical (b)Estimated Total Cost of
Construction from 6
3. Plumbing Building Permit Fee
4. Mechanical(HVAC)
S. Fire Protection
6. Total=(1 +2+3+4+5) Check Number
This Section For Official Use Only
Date
Building Permit Num r: Issued
Signature'
Building Commissionedinspector of Buildings Date
EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR)
S ECT10N 4-CONSTRUCTION SERVICES
d.'. Licensed Construction >o'.AceP:-ably C
rime of Lmense Holder
pca[ion,s!e
9 Reois*r He IWA.ovemem Cnntrartoo Not Applioaoe -
>—� _ X _._i _s .. __ -. 1 i 1
o n,, Name ' Regstra Samoe:
_ ..�> .. Epire4D�
SECTION 5-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152,§25C(6))
cartes Comoensauan hso......Rica,:mus,be cc piewd a-d suc,lac w.to Ibis apo-caFlon_Failure to provtce tvls a a .e... ,a,,l
a-a.a`tee'ss::a e cl^y pear"
_e a
.'..acnac -
bine£Description of Proposed Work
I
� 1aW � ivi Ce aSe an Gtl ✓ Seo i)
rt aeoest olAa nct%
-.:he aby 1a a.e Ta. 5e state�mens art orma:o^cr c,zpcag a;pbcacoo are , e anc accura,c.to Ina oast o m .rc::ceops
^zoo a Ne Pana 5 e per.oles of pa^L r`.
�ar
as 0.,ne-ofma saoiert
or my beralf.in ell matt s•ela:ne to work autco ze ' by o-s btiiioino permit pli allga //a/J
t I,-un ' — - l/w^ /y -
:aaaeor0"v Date
RISE60 Shawmut Road.Suite 2 Canton,MA 02021
ENGINEERING"
OWNER AUTHORIZATION FORM
i, Holly Drew
(Owner's Name)
owner of Me property located at:
46 Brierwood Drive
(Street)
Florence, MA 01062
('town,State,Zip)
herhv 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.
Ther Permit will be secured by the insulation contractor, at no additional cost. It is the homeowner's
responsibility to close out this permit by contacting their municipality at the completion of this work.
C115'1'OMER OAA RE
SIGN DATE
07/20/2017
vowu
�+•tfw.•q.s•�n•+.tP„■ay aata...soon'c�..t.+�af...s:wq.r�-�T
7we1Fw•44TwMgr+l+eti..w,+�•�.�q+M.srpfy►
�vII�quaAp+R.rRl�+�o�af.wa4o�6gt1�PP�P.A+�v�w9q�giawl���.
•.D'9RSwdaA'4*Pq�R�D"Ap®iWS�A a�9+'V A�i�Pq�w' �.A+M�q
W'9fYlfare��Lgap�gigTppu�O*4Yf24�fl'�7011#M�g9�f�ggq�j
�9
00w••nor+�`w+.w�•w•w#�w�.�..+.....w�.sr..
07)
"P�..
.wKr-4+mwvrwr >~eow+Aet+amK=.r+#+e.��w+tq+y+rp.�..�
aiOQlt
mitogQ.f{ �
'IelFP�q��PR��q�M!l�RIlvw�grt.��l
w nta�>rlTwiQ'Zt s�wWaWmpbtr
nm
.wpnmaw POPPWQ'tt "PORI-*
�R�!lHQ.i rt h.rr�sr��wrw�+�++�•�tQrr
=Pxomao -6
rprm��r..#..terepwwr
tea❑ z aaas iia t
xt.�.»twln.A•.tt �w�r.t+wa■to+■�tt.
vV --wv
�wRI
.PRWI PRM--Nm
ainf�a�c�a.�.����ate►
L�t`tQAY!(w�
lFo�NTP��f4