42-163 (4) 997 WESTHAMPTON RD BP-2021-0067
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:42- 163 CITY OF NORTHAMPTON
Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: ADDITION BUILDING PERMIT
Permit# BP-2021-0067
Project# JS-2021-000096
Est.Cost: $184618.00
Fee: $1040.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: FIVE STAR BUILDING CORP 085319
Lot Size(sa. ft.): 158166.36 Owner: BOWMAN CASSIDY
Zoning: Applicant: FIVE STAR BUILDING CORP
AT. 997 WESTHAMPTON RD
Applicant Address: Phone: Insurance:
123 UNION ST (413) 527-4060 O WC
EASTHAMPTONMA01027 ISSUED ON.7/23/2020 0:00:00
TO PERFORM THE FOLLOWING WORK-2 STORY ADDITION -2 CAR GARAGE, 2 BATHS,
5 ROOMS
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:
FeeType: Date Paid: Amount:
Building 7/23/2020 0:00:00 $1040.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
ZDK
File# BP-2021-0067
APPLICANT/CONTACT PERSON FIVE STAR BUILDING CORP
ADDRESS/PHONE 123 UNION ST EASTHAMPTON (413)527-4060.()
PROPERTY LOCATION 997 WESTHAMPTON RD
MAP 42 PARCEL 163 001 ZONE
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT A�
Fee Paid
Building Permit Filled out
Fee Paid
!ypeof Construction: 2 STORY ADDITION-2 CAR GARAGE.2 BATHS,5 ROOMS
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 085319
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION PRESENTED:
Approved Additional permits required(see below)
PLANNING BOARD PERMIT REQUIRED UNDER:§
Intermediate Project: Site Plan AND/OR Special Permit With Site Plan
Major Project: Site Plan AND/OR Special Permit With Site Plan
ZONING BOARD PERMIT REQUIRED UNDER: §
Finding Special Permit Variance*
Received&Recorded at Registry of Deeds Proof Enclosed
Other Permits Required:
Curb Cut from DPW Water Availability Sewer Availability
Septic Approval Board of Health Well Water Potability Board of Health
Permit from Conservation Commission Permit from CB Architecture Committee
Permit from Elm Street Commission Permit DPW Storm Water Management
Demolition Delay
17/L
ao
Sig ature of Building Official Date
Note: Issuance of a Zoning permit does not relieve a applicant's burden to comply with all Zoning
requirements and obtain all required permits from Board of Health,Conservation Commission,Department
of public works and other applicable permit granting authorities.
*Variances are granted only to those applicants who meet the strict standards of MGL 40A.Contact Office of
Planning&Development for more information.
rte_ The Commonwealth of Massachusetts
53
3 Board of Building Regulations and Standards FOR
Massachusetts State Building Code,780 CMR MUNICIPALITY
a USE
0 0 Building Permit Application To Construct,Repair,Renovate Or Demolish a Revised Mar 2011
One-or Two-Family Dwelling
This Section For Official Use Only
ermit Number: 7 Date Applied:
L&—�,
-r��
Building Official(Print Name) Signature Dat
SECTION 1:SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map&Parcel Numbyr
997 Westhampton Road,Florence,MA 01062
Lla Is this an accepted street?yes x no Map NuAer Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use Lot Area(sq ft) Frontage(ft)
1.5 Building Setbacks(ft)
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public IN Private❑ Zone: _ Outside Flood Zone? Municipal® On site disposal system ❑
Check if yes®
SECTION 2: PROPERTY OWNERSHIP'
7.1 nwnPrl of Rarnrd-
CINSSI i1 ,)1v��►J
Name(Print) City,State,ZIP
No.and Street Telephone _uiau Auaress
SECTION 3: DESCRIPTION OF PROPOSED WORK'(check all that apply)
New Construction® Existing Building® �NumberofUnits
Ownr-Occupied ❑ Repairs(s) ❑ Alteration(s) ❑ Addition
Demolition ❑ AccessoryBldg. ❑ Other ❑ Specify:
Brief Description of Proposed Work: 2 Story 2000sgft (1000per floor) addition to existing single family home.
Consisting of 2 car garage,2 bathrooms,5 Rooms(1 Bedroom).
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1.Building $ 160,818.00 1. Building Permit Fee:$(0`0401ndicate how fee is determined:
2.Electrical $ 8,500.00 ❑Standard City/Town Application Fee
Potal Project Cost (Item 6)x multiplier 160 x G•SO
3.Plumbing $ 10,300.00 2. Other Fees: $
4.Mechanical (HVAC) $ 5,000.00 List:
5.Mechanical (Fire
Suppression) $ N/A Total All Fees:$ 1 Qyd•C )
Check No.JWCheck Amount:/0_40_4 Cash Amount:
6.Total Project Cost: $ 184,618.00 Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL) CSL#085319 1/13/2021
Kevin Perrier License Number Expiration Date
Name of CSL Holder
List CSL Type(see below) U
123 Union Street
No.and Street Type Description
U Unrestricted(Buildings up to 35,000 cu.ft.)
Easthampton,MA,01027 R Restricted 1&2 Family Dwelling
City/Town,State,ZIP M Masonry
RC Roofmg Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
413-527-4060 K12errier@fivestarcorp.net I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC)
162559 11/29/2021
Five Star Building Corp /Kevin Perrier HIC Registration Number Expiration Date
HIC Company Name or HIC Registrant Name
123 Union Street, Ste. 200 Kperrier@fivestarcorp.net
No.and Street Email address
Easthampton,MA,01027 413-527-4060
Ci /Town,State,ZIP Telephone
SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.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...........❑
SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
1,as Owner of the subject property,hereby authorize Five Star Building Corp.
to act on my behalf,in all matters relative to work authorized by this building permit application.
Cassidy Bowman 7/16/2020
Print Owner's Name(Electronic Signature) Date
SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION
By entering my name below,I hereby attest under the ains and penalties of perjury that all of the information
contained in this application is true arW a urate to best of my knowledge and understanding.
Kevin Perrier 7/16/2020
Print Owner's or Authorized Agent' ame(EI tronic Signature) Date
Iff NOTES:
1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor
(not registered in the Home Improvement Contractor(HIC)Program),will not 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.maaL og v/oca Information on the Construction Supervisor License can be found at www.mass.gov/dps
2. When substantial work is planned,provide the information below:
Total floor area(sq.ft.) 2000 S ft (including garage,finished basement/attics,decks or porch)
Gross living area(sq.ft.)1500 Scf t Habitable room count 5
Number of fireplaces 0 Number of bedrooms -.
Number of bathrooms 2 Number of halfibaths 0
Type of heating system Forced Hot Water Number of decks/porches 0
Type of cooling system N/A Enclosed Open
3. "Total Project Square Footage"maybe substituted for"Total Project Cost"
Initial Construction Control. Document
v To be submitted with the building permit application by a
Registered Design Professional
aV for work per the ninth edition of the
Massachusetts State Building Code, 780 CMR, Section 107
Project Title: Date: JULY E�,`fir'
Property Address: 01Q - WMT-H f-rPN P'P
Project: Check(x) one or both as applicable: X New construction X Existing Construction
Project description: APD1'(iDN �MOPO L,tb SlmGl.f; )cT'
I MA Registration Number:` �f S QExpiration date:-01 f ttY am a registered design professional,and I have
prepared or directly supervised the preparation of all design plans,computations and specifications concerningl:
XArchitectural Structural Mechanical
Fire Protection Electrical Other:
for the above named project and that to the best of my knowledge, information, and belief such plans,
computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780
CMR), and accepted engineering practices for the proposed project. I understand and agree that I (or my
designee) shall perform the necessary professional services and be present on the construction site on a regular
and periodic basis to:
1. Review, for conformance to this code and the design concept, shop drawings, samples and other
submittals by the contractor in accordance with the requirements of the construction documents.
2. Perform the duties for registered design professionals in 780 CMR Chapter 17,as applicable.
3. Be present at intervals appropriate to the stage of construction to become generally familiar with the
progress and quality of the work and to determine if the work is being performed in a manner consistent
with the approved construction documents and this code.
Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107.
When required by the building official,I shall submit field/progress reports(see item 3.)together with pertinent
comments,in a form acceptable to the building official.
Upon completion of the work,I shall submit to the building officia 'F' ns uction Control Document'.
`6.,eIRF0 Al�Ly
Enter in the space to the right a"wet" or �y��QV%f Le�lelm/°.�
electronic signature and seal: NO,952164
Enfield,cr
001) 843 124, • S 5-L (",AOL--M
M� ��
Phone number. Tcmail. � f
Building Official Use Only
Building Official Name: Permit No.: Date:
Note 1.Indicate with an Y project design plans,computations and specifications that you prepared or directly supervised.If'other'is
chosen,provide a description.
Version 01 01 2018
The Connnonivealth of Massach usetts
Departinent of Industrial Accidents
a I Congress Street, Suite 100
Boston, MA 02114-2017
„M w w m nt ass.go vldl a
Workers'Compensation Insurance Affidavit: Builders/Conti•actors/Electricians/Plumbers.
TO BE FILED'1VITH THE PERNUTTING AUTHORITY.
Applicant Information Please Print Legibly
Name (Business/Organization/In(lividual): Five Star Building Corp. _
Address: 123 union Street, Ste 200
City/State/Zip: Easthampton, MA 01027 Phone 4: (413) 527-4060________
Arc you an employer?Check the appropriate box: Type of project(required):
L❑X 1 am a employer with 40 employees(full and/or part-time).* 7. ❑New construction
2.❑1 am a sole proprietor or partnership and have no employees working forme in 8. X❑ Remodeling
any capacity.[No workers'comp.insurance required.]
9. Ll Demolition
3.❑I am a homeowner doing all work myself.[No workers'comp.insurance required.]t
100 Building addition
4.❑1 am a homeowner and will be hiring contractors to conduct all work on my property. 1 will
ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions
proprietors with no employees.
12.n Plumbing repairs or additions
5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑Roof repair's
'these sub-contractors have employees and have workers'comp.insurance.:
6.❑we are a corporation and its officers have exercised their right of exemption per MGL C. 14.❑Other
152,§1(4),and we have no employees.[No workers'comp,insurance required.]
*Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
:Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have
employees. If the sub-contractors have employees,they must provide their workers'comp.policy number.
I ata an entployer that is providing workers'compensation insurance for mY employees. Below is the polish and job site
infarmation.
Insurance Company Name: Hanover Insurance
Policy#or Self-ins.Lic.#: WHND 22326301 Expiration Date: 5/09/2021
Job Site Address:
997 Westhampton Rd City/State/Zip:_ Florence, MA 01062
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to$1,500.00
and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a
day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance
coverage verification.
Ido hereby certify rattler the pains and penalties ojpetjurp that the information pzronirled above is tare and correct.
Signature' Kevin Perrier Date: II nd 0
Phone#: (413) 527-4060
Official use only. Do not write in this area,to be completed by city or town official.
City or Town: Pernnit/License#
Issuing Authority(circle one):
1. Board of Health 2. Building Department 3.City/Town Cleric 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Pet-son: Phone#:
i
Commonwealth of Massachusetts
Division of Professional Licensure
Board of Building Regulations and Standards
Constr:ucttori Supervisor
CS-085319 F_icp fres: 01/1312021
r.
KEVIN A PERRIER
123 UNION ST f t I
EASTHAMPTON MA 01021
.L1�4
Commissioner CL
..:.::.Office of Consumer Affairs and Business Regulation
1000 Washington Street - Suite 710
Boston, Mas§achusetts 02118
Home Improvement?Corttractor Registration
u Type: Corporation
r
Registration: 162559
FIVE STAR BUILDING CORP.
123 UNION ST Expiration: 11/29/2021
SUITE 200
EASTHAMPTON,MA 01027 ' ~" -
Update Address and Return Card.
SCA f 0 20M-05!17
.7/J•H �l7LYJ;i�72,'�lGCL<f'lLfr�/l�,!%ilCrY.SIJ.CJI.1GJe9��i
Office of Consumer Affairs&Business Regulation
HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only
TYPE.,Cornoration before the expiration date. If found return to:
Registry h Expiration Office of Consumer Affairs and Business Regulation
1$2 11/29/2021 1000 Washington Street -Suite 7i0
FIVE STAR BU1t6tNG ; Boston,MA 02118
KEVIN PERRIER"
123 UNION ST
SUITE 200 ` f Undersecretary Not valid without signature
EASTHAMPTON,MA 01027
i
CITY OF NORTHAMPTON
SETBACK PLAN
MAP:_ _ LOT:_
LOT SIZE: 3.63 Acres
REAR LOT DIMENSION 440ft
REAR YAO 110ft
w
SIDE YARD 145ft SIDE YARD-i0ft _
66'
I
� I
FRONT:SETBACK_ 692ft
FRONTAGE 67ft
Initial Construction Control Document
To be submitted with the building permit application by a
Registered Design Professional
for work per the ninth edition of the
Massachusetts State Building Code, 780 CMR, Section 107
Project Title: Date: Jut-Y a,WW
Property Address: 9q-.� w&%>T+t"Mi� i tt-n Fld �
Project: Check(x)one or both as applicable: X New construction X Existing Construction
Project description: I DD I T DN 14tWO 1, th S i u 6kt; FAUA i Y (z-ES 1 PVF W,/,
I MA Registration Number:`52JS¢Expiration date:B�31/Jh am a registered design professional,and I have
prepared or directly supervised the preparation of all design plans,computations and specifications concerning':
)(Architectural Structural Mechanical
Fire Protection Electrical Other:
for the above named project and that to the best of my knowledge, information, and belief such plans,
computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780
CMR), and accepted engineering practices for the proposed project. I understand and agree that I (or my
designee) shall perform the necessary professional services and be present on the construction site on a regular
and periodic basis to:
1. Review, for conformance to this code and the design concept, shop drawings, samples and other
submittals by the contractor in accordance with the requirements of the construction documents.
2. Perform the duties for registered design professionals in 780 CMR Chapter 17,as applicable.
3. Be present at intervals appropriate to the stage of construction to become generally familiar with the
progress and quality of the work and to determine if the work is being performed in a manner consistent
with the approved construction documents and this code.
Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107.
When required by the building official,I shall submit field/progress reports(see item 3.)together with pertinent
comments,in a form acceptable to the building official.
Upon completion of the work,I shall submit to the building offici F' ns ction Control Document'.
tERE�AR
Enter in the space to the right a"wet" or c,��Q N L fF,
electronic signature and seal: No.952154
Enfield,C7
Phone number: 1744 Email: S f 5L Com'11UL. OF
Building Official Use Only
Building Official Name: Permit No.: Date:
Note 1.Indicate with an')e project design plans,computations and specifications that you prepared or directly supervised.If'other'is
chosen,provide a description.
Version 01 01 2018
tSTEAM
IV
B
UI LOING CORP
Date: July 16, 2020
Location: 997 Westhampton Rd,Florence,MA 01062
Waste Disposal Affidavit
Pursuant to the provisions of, MGL c40. S54, I acknowledge as a condition of this
Building Permit Application for the above referenced project, all debris resulting from
the construction activity governed by this Building Permit shall be disposed of in a
properly licensed solid waste disposal facility or recycling facility, as defined in MGL
cl11, S150A.
To this end, I certify that I have retained the services of a Mass State Licensed Waste
Carting Company DBA: Cassella Waste Management to perform said services, invoices
or receipts available upon request.
Carting CO.Address: 295 Forest St., Peabody, MA 01960
Contact Person: Mike Burns Phone# 508-326-2235
Signature of Permit Applicant: Kevin Perrier President
Date: 7/16/2018
123 Union Street, Suite 200;Easthampton,MA 01027
Ph: 413-527-4060—Fx: 413-527-4061