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46-050 99 ISLAND RD BP-2021-1106 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block:46-050 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: ROOF BUILDING PERMIT Permit# BP-2021-1106 Project# JS-2021-001866 Est.Cost:$40.00 Fee:$40.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: FREDDY CAMPOVERDE 106011 Lot Size(sq. ft.): 3484.80 Owner: BASS KATHRYN Zoning: Applicant: FREDDY CAMPOVERDE AT: 99 ISLAND RD Applicant Address: Phone: Insurance: 20 TATTAN FARM RD (508) 873-1884 WC WORCESTERMA01605 ISSUED ON:4/2/2021 0:00:00 TO PERFORM THE FOLLOWING WORK:STRIP & SHINGLE ROOF 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. )2 Certificate of Occupancy Signat ,p a' ,n„ . FeeType: Date Paid: Amount: Building 4/2/2021 0:00:00 $40.00 212 Main Street, Phone(413)587-1240,Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner RECEIVED APR - 22021 The Commonwealth of Massachusetts _ Board of Building Regulations and Standll .OF BUILDING wsPECr g„ F R 7 ORTHAMPTON,MA 01 IC ALITY / Massachusetts State Building Code, ,80 CM. . u E Building Permit Application To Construct, Repair,-Renovate Or Demolish-a Revised Mar 2011 One-or Two-Family Dwelling This Section For Official Use Only Building Permit Number: (2,P' i /ate Date Applied: / /�c=U 1/3 1 K,057 //<� `7-Z-ZOZ1 Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Asses r�Map& Parcel Number �-- 99 Island Road (Q 0 1.la Is this an accepted street?yes X 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: Kathryn Bass Northampton,MA 01060 Name(Print) City, State,ZIP 99 Island Road 413-586-8303 Alizerin(n%gmail.com No.and Street Telephone Email Address SECTION 3: DESCRIPTION OF PROPOSED WORK'(check all that apply) New Construction❑ Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) ❑ Addition ❑ Demolition 0 Accessory Bldg. 0 Number of Units Other 21 Specify: Re-roof Brief Description of Proposed Work': Remove existing shingles and replace roof SECTION 4:ESTIMATED CONSTRUCTION COSTS Estimated Costs: Item (Labor and Materials) Official Use Only 1. Building $ 7,500.00 1. Building Permit Fee: $ Indicate how fee is determined: ❑Standard City/Town Application Fee 2.Electrical $ 0 Total Project Cost'(Item 6)x multiplier x 3. Plumbing $ 2. Other Fees: $ 4. Mechanical (HVAC) $ List: 5. Mechanical (Fire �� Suppression) Total All Fees:1$ (� Check No}331' Check Amount: Cash Amount: 6.Total Project Cost: $ 7,500.00 0 Paid in Full 0 Outstanding Balance Due: City of Northampton / 4 S [[ Massachusetts 44� DEPARTMENT OF BUILDING INSPECTIONS ` 212 Main Street • Municipal Building ,P Northampton, MA 01060 JS ••arj‘�J PROCEDURE FOR OBTAINING A BUILDING PERMIT FOR NEW 1 & 2 FAMILY DWELLING, ADDITIONS, POOLS, DECKS,ACCESSORY STRUCTURES, FENCES,GROUND MOUNTED SOLAR,ETC. 1. Building Permit Application signed by legal owner and filled out by owner or authorized agent. 2. One set of plans and specification of proposed work(digital and hard copy). 3. Site Plan with location of proposed structure(s)and setbacks. 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. SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) CSSL-106011 6/2/21 Freddy Campoverde License Number Expiration Date Name of CSL Holder List CSL Type(see below) U 20 Tattan Farm Road No.and Street Type Description U Unrestricted(Buildings up to 35,000 cu.ft.) Worcestor,MA 01605 R Restricted 1&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances 508-873-1884 Greta(it)goldengrouproofing.com I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) 174718 3/11/23 Golden Group Construction Corp. HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name 20 Tattan Farm Road Greta(a.,goldengrouproofing.com No.and Street Email address Worcestor,MA 01605 508-873-1884 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 ll No ❑ 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 Golden Group Roofing Corp. to act on my behalf,in all matters relative to work authorized by this building permit application. Kathryn Bass 3/30/21 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. Leah Visconti 3/30/21 Print Owner's or Authorized Agent's Name(Electronic Signature) Date NOTES: I. 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 Massachusetts * - '� DEPARTMENT OF BUILDING INSPECTIONS 5fit 212 Main Street • Municipal Building Northampton, MA 01060 �t4 0° CONSTRUCTION DEBRIS AFFIDAVIT (FOR ALL DEMOLITION AND RENOVATION PROJECTS) In accordance of the provisions of MGL c 40, S54, a condition of Building Permit Number is that all debris resulting from this work shall be disposed of in a properly licensed waste disposal facility, as defined by MGL c 111, S 150A. The debris will be disposed of in: Location of Facility: 20 Tattan Farm Road, Worcestor, MA 01605 The debris will be transported by: Name of Hauler: Golden Group Construction Corp. Signature of Applicant: Date: 3/30/21