14-002 BP—' 022-1144
1051 CHESTERFIELD RD COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
14-002-001 CITY OF NORTHAMPTON
Permit: Alts Renovations
Repair
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
BUILDING PERMIT
Permit# BP-2022-1144 PERMISSION'S HEREBY GRANTE,a TO:
Project# NEW DECK/DECK Contractor: License:
Est. Cost: 52044 JASON BOULANGER 114940
Const.Class: Exp.Date:06/12/2024
Use Group: Owner: COLLIN HAYES
Lot Size (sq.ft.)
Zoning: WSP Applicant: JASON BOULANGER
Applicant Address Phone: Insurance:
102 WARREN ST (413)695-1108 SOLE PROPRIETOR
WEST SPRINGFIELD, MA 01089
ISSUED ON:09/14/2022
TO PERFORM THE FOLLOWING WORK:
NEW DOOR, BASEMENT WINDOWS, DECK ADDITION AND NEW GARAGE
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:
Final: Final: Final: Rough Frame:
Gas: Fire Department Driveway Final: Fireplace/Chimney:
Rough: Oil: Insulation:
Smoke: Final:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOL; TION OF
ANY OF ITS RULES AND REGULATIONS.
Signature:
i j, 2
�C1 -
Fees Paid: $338.00
212 Main Street, Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
File #BP-2022-1144 Z—OK
APPLICANT/CONTACT PERSON:JASON BOULANGER
102 WARREN ST WEST SPRINGFIELD, MA 01089(413)695-1108
PROPERTY LOCATION 1051 CHESTERFIELD RD
MAP:LOT 14-002-001 ZONE
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Building Permit Filled out
Fee Paid $338.00
Type of Construction: NEW DOOR, BASEMENT WINDOWS, DECK ADDITION AND NEW GARAGE
New Construction
Non Structural Renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owne r/ Statement or License
3 sets of Plans/Plot Plan
TOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
IN RMATION PRESENTED:
4,
Approved Additional permits required (see below)
PLANNING BOARD PERMIT REQUIRED UNDER:§
Intermediate Project: Site Plan AND/OR Special Permit With Site Plan
MajorProject: 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 WaterAvailability 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
(64\1,...,
1, . . 9 i as
Signature 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.
zc9____:!7z�p RECEIVED
Ec IV CJ
- a 1 I ,,t1.1 w d ri 0t
et
The Commonwealth ssac se e
W
Board of Building Regulation and tan i s 1 3 2022 FOR
ICIPALITY
Massachusetts State Building ode 780 CMR USE
Building Permit Application To Construct, epaiP,ERtimmoticREktire. R vised Mar 2011
One-or Two-Family NORTHAMPTON.MA ptpgp NS
This Section For Official Use Only
Building Permit Number: 60- -//yy Date Applied:
jr51\1044 dg,31 b 'it 94 i 1/ a
Building Official(Print Name) Signature I Di
SECTION 1:SITE INFORMATION
1.1 Property Address: 1 Assessors Ma &Parcel Numbers
/OS/ C!estrr t/off ref4S5LSso Y M99 19 parc.c,j OIL
1.la Is this an accepted street?yes }( no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property imensio S•
W5 gesl'derrh'a1 to sl pg 21 S•i �,
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 Providec
20 F-i- al F4- i 5F4- aa(i)t-192(2) 20 F+- ?vr
1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public 0 Private Zone:�//A Outside Flood done? Municipal❑ On site disposal system X
Check if yes
SECTION 2: PROPERTY OWNERSHIP'
2.1 O ner'of Record:
Go/J,, like f /1Or7IA411,1o.7 / �i/9, D/0 6 2
Name(Print) City,State,ZIP
/OS/ C%sireedi ./1 47y-5'0—J ? d',4 j r1I r r.1m,/ •eo+7
No.and Street Telephone Email ddress T
SECTION 3:DESCRIPTION OF PROPOSED WORK'(check all that apply)
New Construction 0 Existing Building Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition 0
Demolition 0 Accessory BldgX Number of Units Other 0 Specify:
Brief Description of Proposed Work': Yft574, S'/j/p/ d ig1 7240 .10/44 Ali,4
On GX io✓ I'4/j, 7 g 1ct// pact 13 r'IA i 2 PLACE. gi*SEn+kn+r win,00,,os
,Bv; ,freli/yrr�'L - P%fry 41'4 hick,/
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1.Building $ 5•716 yy,s. 1. Building Permit Fee:$ Indicate how fee is determined:
2.Electrical $ 7 ❑Standard City/Town Application Fee
❑Total Project Costa(Item 6)x multiplier x
3.Plumbing $ 2. Other Fees: $
4.Mechanical (HVAC) $ List:
5.Mechanical (Fire $
—
Suppression) Total All Feesai
ov Check No.`nV Check Amours 3 Cash Amount:
6.Total Project Cost: $
Say 0 ity 0 Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
e1 41So/1 o V 4AQe( License Number Expiration Date
Name of CSL Holder ✓✓
/62 agrien 5 /• List CSL Type(see below) V
No.and Street j' Type Description
Fi0/ Ae. O/ U Unrestricted(Buildings up to 35,000 Cu.ft.)
!II/ f� / a!Js? R Restricted 1&2 Family Dwelling
City/Towt State,ZIP M Masonry
RC Roofing Covering
WS Window and Siding
�/�o WO ,4.oA� / SF Solid Fuel Burning Appliances
7 u''�SAM'7 ,lqN I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC) /4991� �/./7.,73
140A /OY!/4 I HIC Registration Number Expiratioi Date
HIC Company Name or HIC R trant Name
oA frkN Ja,or Yfo 6r ,' •�s,
No.and Street Email addr s
A'•fegew i4g, DI 57
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 No ❑
SECTION 7a:OWNER UTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING/ PERMIT
I,as Owner of the subject property,hereby authorize OktSe h ./ d t g11
to act on my behalf,in all matters relative to work authorized by this building permit application.
-h Ietr I yts 91►2/7-2--
Print Owner's N (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.
9ve •1�.
Print Owners or Authorized A is Na ectronic 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"
-- The Commonwealth of Massachusetts
v Department of Industrial Accidents 1
s ',41 ��' Office of Investigations
i - a Lafayette City Center
:s= 2 Avenue de Lafayette, Boston,MA 02111-1750
No www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Organization/Individual): Rapid Quality Construction LLC
Address:102 warren st
City/State/Zip:west springfield, ma 01089 Phone #:413-6951108
Are you an employer? Check the appropriate box: Type of project(required):
1.❑ I am a employer with 4. ❑ I am a general contractor and I
employees (full and/or part-time).* have hired the sub-contractors 6. ❑New construction
2.❑■ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling
ship and have no employees These sub-contractors have 8. ❑ Demolition
working for me in any capacity. employees and have workers' 9. ❑ Building addition
[No workers' comp. insurance comp. insurance.
required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions
3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions
myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs
insurance required.] 1 c. 152, §1(4),and we have no 13.❑ Other
employees. [No workers'
comp. insurance required.]
*My applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
1 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 am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name:
Policy#or Self-ins. Lic. #: Expiration Date:
Job Site Address: City/State/Zip:
Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of 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. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby certify a er the ains and penalties of perjury that the information provided above is true and correct
Signature: ,7 Date: 9'./°.•22—
Phone#: y73 -6 f5 ia? 1
Official use only. Do not write in this area, to be completed by city or town official.
City or Town: Permit/License #
Issuing Authority(check one):
1❑Board of Health 2❑Building Department 3,❑City/Town Clerk 4.1:Electrical Inspector 5Elumbing
Inspector 6.0Other
Contact Person: Phone#:
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r-�r7-� To the best of my knowledge these plans are drawn
Ti ..-t='.z"YI.I_r: .�- i't� _,,,,,t ice :--- to comply with owners and/or builder's
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= builders expense and responsibility.The contractor Q
I..rr r1T1-Lr17 i.r-tr-i 1 r t I h'TT' .h r Lr'- shall verify all dimensions and enclosed drawing.
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to avoid mistake,thw maker ran mt guarwntww f] Uti W Z
against human error.The contractor of the job must < CIa Q
check all dimensions and other details prior to s.
construction and be solely responsible thereafter. rc W
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S 72'55'34" E 302.78'
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LOT 1
105,879± SQ. FT.
2.4307± ACRES
JOAN C. do JOHN SARAFIN
BOOK 2910, PAGE 99 (PORTION) it
PLAN BOOK 144, PAGE 39
ASSESSOR'S MAP 14, PARCEL 002
PORTION OF
N BOOK 2910, PAGE 99
PLAN BOOK 144, PAGE 39
PARCEL A
0
^' 12,846± SQ. FT.
(to be conveyed)
S 79'02'20" E 121.49'
bo m///////:
/
(to be demolished) w
w
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w
in 8
at� J
rn 33.63'
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.d well
dwelling #1051 /
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120
24 32' —N 75'15119 9" W 1�1.64' 102'---�
1902 CHESTERFIELD ROAD