22B-057 40 SPRING ST BP-2021-1079
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:22B-057 CITY OF NORTHAMPTON
Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: BUILDING PERMIT
Permit# BP-2021-1079
Project# JS-2021-001822
Est.Cost: $11000.00
Fee: $72.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: CLEAN TECH CONSTRUCTION LLC 106150
Lot Size(sq ft.): 12545.28 Owner: GILLEMAN SARAH
Zoning: URA(I00)/WP(100)/WSP(100)/Applicant: CLEAN TECH CONSTRUCTION LLC
AT: 40 SPRING ST
Applicant Address: Phone: Insurance:
190 FEDERAL AVE (617) 271-0768 ('
QUINCYMA02169 ISSUED ON:3/31/2021 0:00:00
TO PERFORM THE FOLLOWING WORK:INSULATIONNVEATHERIZATION
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: ' . t •
FeeType: Date Paid: Amount:
Building 3/31/2021 0:00:00 $72.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
A4C
F,�_
Fij. ----.
The Commonwealth of Massach etts 29
I° Board of Building Regulations and tan �� FOIjc
o� M ICIPAL[TY
Massachusetts State Building Code, 7 e_p4 tr/,o�N UoE
MnT G141
Building Permit Application To Construct,Repair, Renovate Or tilof teri visedMar 2011
One-or Two-Family Dwelling °Toro Ns
ff��
This 5ction For Official Use Only
Building Permit Numberl3P Q'I'1;07/ Date Applied:
gUlit.) 407) �' ram-- 3 31-2ozI
Building Official(Print Name) Signature Date
SECTION 1:SITE INFORMATION
1.1 Property Address: 1.2 Assessors p& Parcel Numbers
40 SPRING ST FLORENCE MA 01062 av? 5 US 7
1.1a Is this an accepted street?yes no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use Lot Area(sq ft) Frontage(ft)
1.5 Building Setbacks(ft)
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public 0 Private 0 Zone: Outside Flood Zone?
_ Municipal 0 On site disposal system 0
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record:
SARAH GILLEMAN FLORENCE MA 01062
Name(Print) City,State,ZIP
40 SPRING ST 413-218-3435
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply)
New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) ❑ Alteration(s) 0 Addition 0
Demolition 0 Accessory Bldg. 0 Number of Units Other 1$! Specify: INSULATION
Brief Description of Proposed Work INSULATION,WEATHERIZATION FOR MA SAVE PROGRAM
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
I. Building $11,000 1. Building Permit Fee: $ Indicate how fee is determined:
2.Electrical $ ❑Standard City/Town Application Fee
❑Total Project Cost'(Item 6)x multiplier x
3. Plumbing $ 2. Other Fees: $
4. Mechanical (HVAC) $ List:
5. Mechanical (Fire $ Total All Fees: $
Suppression)
Check No. 30tICheck Amount. 7 - Cash Amount:
6.Total Project Cost: $11,000 0 Paid in Full 0 Outstanding Balance Due:
City of Northampton c?� °''' %" �� �.Massachusetts ,,,
Jit
A, ' .,
DEPARTMENT OF BUILDING INSPECTIONS 0
Syr 212 Main Street • Municipal Building ,,r ,,'��"
Northampton, MA 01060 'Ps"f, Alt''e
PROCEDURE FOR OBTAINING A BUILDING PERMIT FOR NEW
1 & 2 FAMILY DWELLING, ADDITIONS, POOLS, DECKS, ACCESSORY STRUCTURES,
FENCES, GROUND MOUNTED SOLAR, ETC.
I. Building Permit Application signed by legal owner and filled out by owner or authorized agent.
2. One set of plans and specifications of proposed work. (Digital and hard copy)
3. Site plan with location of proposed structure(s) and set backs.
4. Construction Debris Affidavit filled out and signed by applicant.
5. Worker's Compensation Insurance Affidavit filled out and signed by applicant.
6. Contractors must supply a copy of CS License, HIC Registration and proof of Liability Insurance.
7. Energy Conservation Compliance Certificate (new/replacement windows).
8. Home Owner's License Exemption Form filled out and signed by Homeowner (if applicable).
9. Note any Conservation and/or special permit requirements (if applicable). 10.
Driveway Permit (if applicable).
11. Proof of Water and Sewer entry fees paid (if applicable).
12. Trench Permit - public land by DPW / private land by Building Dept.
13. Stretch Energy Code -all new construction will require a HERS Rater Affidavit to be submitted with permit
application before issuance of permit.
14. Please provide the appropriate fee in the form of a check made payable to: The City of Northampton.
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
106150 5/24/2022
PATRICK MCDONOUGH License Number Expiration Date
Name of CSL Holder
List CSL Type(see below) I
105 MARSHHAWK WAY
No.and Street Type Description
U Unrestricted(Buildings up to 35,000 cu.ft.)
MARSHFIELD MA 02050 R Restricted 1&2 Family Dwelling
City/Town,State,ZIP M Masonry
RC Roofing Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
617-512-1509 CLEANTECHPERMITS@GMAIL.COM I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC)
196071 6/27/2021
CLEAN TECH CONSTRUCTION HIC Registration Number Expiration Date
HIC Company Name or HIC Registrant Name
190 FEDERAL AV _ CLEANTECHCONSTRUCTION@GMAIL.COM
No.and Street Email address
QUINCY MA 02169 617-271-0768
City/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 $I No 0
SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I,as Owner of the subject property,hereby authorize PATRICK MCDONOUGH/CLEAN TECH CONSTRUCTION
to act on my behalf,in all matters relative to work authorized by this building permit application.
SARAH GILLEMAN(signed authorization attached) 3/28/2021
Print Owner's Name(Electronic Signature) Date
SECTION 7b:OWNER' OR AUTHORIZED AGENT DECLARATION
By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information
contained in this application is true and accurate to the best of my knowledge and understanding.
/°a& 11-C.. 7t9it 3/28/2021
Print Owner's or Authorized Agent' ame(Electronic Signature) Date
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.mass.gov/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.) (including garage,finished basement/attics,decks or porch)
Gross living area(sq. ft.) Habitable room count
Number of fireplaces Number of bedrooms
Number of bathrooms Number of half/baths
Type of heating system Number of decks/porches
Type of cooling system Enclosed Open
3. "Total Project Square Footage"may be substituted for"Total Project Cost"
CITY OF NORTHAMPTON
SETBACK PLAN
MAP: LOT:
LOT SIZE:
REAR LOT DIMENSION:
REAR YARD
SIDE YARD SIDE YARD
FRONT SETBACK
FRONTAGE
City of Northampton
i1r
Massachusetts
DEPARTMENT OF BUILDING INSPECTIONS
n ` 212 Main Street • Municipal Building
Northampton, MA 01060
Property Address: 40 spring st
Contractor
Name: CLEAN TECH CONSTRUCTION
Address: 190 FEDERAL AV
City, State: QUINCY MA 02169
Phone: 617-271-0768
Property Owner
Name: SARAH GILLEMAN
Address: 40 SPRING ST
City, State: FLORENCE MA 01062
I, PATRICK MCDONOUGH (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 si nature
Date
3/30/2021