15-010 (3) BP-2023-1769
392 CHESTERFIELD RD COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
15-010-001 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-2023-1769 PERMISSION IS HEREBY GRANTED TO:
Project# INSULATION 2023 Contractor: License:
Est. Cost: 6740 SCOTT MCCRAY 117322
Const.Class: Exp.Date: 04/14/2026
Use Group: Owner: REYNOLDS TIMOTHY G & RACHEL A MAIORE
Lot Size (sq.ft.)
Zoning: WSP Applicant: PROSPECTIVE ENERGY SOLUTIONS INC
Applicant Address Phone: Insurance:
14 PINEBROOK CIRCLE (413)424-3600 WC533SB23J7Q013
GRANBY, MA 01033
ISSUED ON: 12/20/2023
TO PERFORM THE FOLLOWING WORK:
INSULATION/WEATHERIZATION
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 VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Signature:
a' • ,2 (PI •
Fees Paid: $65.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Office of the Building Commissioner
�� ,g6,3
C�/ Department use only
,o 04 Mrro City of Orth. • atus of Permit:
? • Buil•'ng D_,• . ut/Driveway Permit
I t 21 ' alft;�. - -t-werlSe:tic Availability
01 Roo ''/(0 / ater ',ell Availability
r / Northampton, + rgQ4 : Two ?ets of Structural Plans
,.,..�
� phone 413-587-1240 Fax J•,.. a72 PI• Site Plans
-410 osa/ate i Cher Specify
APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENO, E O r DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION
1.1 Property Address: /J This section to be completed by office
39 Z attsi Arful got Map Lot Unit
( i_G1-1 / rvipl O to 53 Zone Overlay District
Elm St.District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
.1 Mom cNv 3 q 2 rGts,.biryk., I II If(Ar , rv1I --
Name(Print) Current Nailing Address2 �It
Telephone 2✓' (14.3
Signature
2.2 Authorized Agent:
�
tileC�m w�J e !y , �b�Je- �� -G / 7l► mil--
Name(Print) Current Mailing
lit 3z/q 13oL/
ure Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building / 7 ,O L.� (a)Building Permit Fee
2. Electrical C.� (b)Estimated Total Cost of
Construction from(6)
3. Plumbing Building Permit Fee
4. Mechanical(HVAC)
5.Fire Protection
6. Total=(1 +2+3+4+5) Logo Li Check Number (O I
/� ) This Section For Official Use Only
Building Permit Number: ,f"f l i ' `7C/y Date
�° Issued:
Signature: /7/7 /2-20-zoZ3
Building Commissioner/Inspector of Buildings Date
C -OtOkiZA AA @ aSpe MI v41 n fq rovt
EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR)
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
New House ❑ Addition ❑ Replacement Windows Alteration(s) I Roofing
Or Doors 0
Accessory Bldg. ❑ Demolition ❑ New Signs [pj Decks [E] Siding [PI Other[ ) I Y1S U lai
./1/1A
Brief Description of Proposed \^ C ' �p
Work: `YJ CP.��LI.��M IA W .
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll -Sheet
6a.If New house and or addition tQ Qxistin9 housing, complete the following:
a. Use of building :One Family //' Two Family Other
b. Number of rooms in each family unit: Number of Bathrooms
c. Is there a garage attached?
d. Proposed Square footage of new construction. Dimensions
e. Number of stories?
f. Method of heating? Fireplaces or Woodstoves Number of each
g. Energy Conservation Compliance. Masscheck Energy Compliance form attached?
h. Type of construction
i. Is construction within 100 ft.of wetlands? Yes No. Is construction within 100 yr. floodplain Yes No
j. Depth of basement or cellar floor below finished grade
k. Will building conform to the Building and Zoning regulations? Yes No.
I. Septic Tank City Sewer Private well City water Supply
SECTION Ta-OWNER AUTHORIZATION-
1, '`a cke. I Met.'0 r ,as Owner of the subject
property
hereby authorize
to act on my behalf, in all matters r lative to work authorized by this bu dingja application.
-62 /0 7,2 7/
MN
1, ,as Owner/Authorized
Agent hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge
and belief.
Signed under the pains and penalties of perjury.
/0 9-/ 9
ge-o - Mee_try
1z/124043
Section 4. ZONING All Information Must Be Completed.Permit Can Be Denied Due To Incomplete Information
Existing Proposed Required by Zoning
This column to be filled in by
Building Department
Lot Size L 1 1
Frontage — —I I (-
Setbacks Front
I
Side L: I R:i —1 L: R:L._I I_____1 I I
Rear !— I I 1 1
Building Height I I I
Bldg.Square Footage r ; % 1 1 r I
Open Space Footage % _
(Lot area minus bldg&paved I I 1 I I
parking)
#of Parking Spaces L I — —�
Fill: I1
(volume&Location) J i 1
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO O DONT KNOW YES 0
IF YES, date issued:) 1
IF YES: Was the permit recorded at the Registry of Deeds?
NO O DONT KNOW 0 YES 0
IF YES: enter Book I —1 Pager —II and/or Document#i- `l
B. Does the site contain a brook, body of water or wetlands? NO O DONT KNOW IQ YES 0
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained O Obtained O , Date Issued: r C. Do any signs exist on the property? YES O NO 0
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property? YES O NO 1,E3--...._____/
IF YES, describe size, type and location: r
E. Will the construction activity disturb(clearing,grading,ex vation,or filling)over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES O NO T -�
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable 0
Name of License Holder: &�C'I/L/4 OS 117 D�?
License Number
Address Expiration Date
�
Let 2-1Q/3 /JL (
S na re Telephone
9.Registered Home Improvement Contractor: Not Applicable 0
Isla e •\tC_ 6AJIAq, 2,0-7 uJ
Company11,Nam//�� ' Registration Number
Oto
AddfeS �\ --Q I 2
s
Expiration Date
Telephone LW) (434(4 0())
SECTION 10-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 0
The Commonwealth of Massachusetts
�� Department of Industrial Accidents
9=4„..t..' Office of Investigations
, Lafayette City Center
++,—.14- 2 Avenue de Lafayette, Boston,MA 02111-1750
'''.4—'` www.mass.gov/dia
Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Organization/Individual): Prospective Energy Solutions, Inc
Address: 14 Pinebrook Circle
City/State/Zip:Granby, MA 01033 Phone#:413-434-3600
Are you an employer? Check the appropriate box:
Type of project(required):
1.❑� I am a employer with 5 4. ❑ I am a general contractor and I
employees (full and/or part-time).* have hired the sub-contractors 6. III 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'
[No workers' comp. insurance comp.insurance.$ 9. III Building addition
required.] 5. 0 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.❑Plumbing repairs or additions
myself. [No workers' comp. right of exemption per MGL 12.111 Roof repairs
insurance required.] t c. 152, §1(4),and we have no
employees. [No workers' 13.❑Other
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 am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name: LM INS Corp
Policy#or Self-ins. Lic.#:WC533SB23J7Q013 Expiration Date:02/17/24
Job Site Address: C( Z ClusitvRiej 4k. City/State/Zip:_ (_j /1',j}- Oi 0(j
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 fy under t ains and e Ides of pedury that the information provided above is true and correct.
Signature: Date: t.'1 a ck5
Phone#: 413-434-3600
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 20 Building Department 31:City/Town Clerk 4.❑Electrical Inspector 5Elumbing
Inspector 6.0Other
Contact Person: Phone#:
Commonwealth of Massachusetts
Division of Occupational Licensure
Board of Building Re ulations and Standards
Cons ton I
tC+�S SAitiervisor
= :y
CS-117322 V pires: 04/14/2026
SCOTT ANDfEW MCCRAY
14 PINE BROOK CIRCLE
GRANBY MAfj1033
.;.t.
Commissioner dui K. Y
Construction Supervisor
Unrestricted-Buildings of any use group which contain
less than 35,000 cubic feet(991 cubic meters)of enclosed
space.
Failure to possess a current edition of the Massachusetts
State Building Code is cause for revocation of this license.
For information about this license
Call(617)727-3200 or visit www.mass.gov/dpl
THE COMMONWEALTH OF MASSACHUSETTS
Office of Consumer Affairs and Business Regulation
1000 Washington Street - Suite 710
Boston, Massachusetts 02118
Home Improvement Contractor Registration
Z - -al
.„ _ "' Type: Corporation
w ++�t '-egistration: 207208
PROSPECTIVE ENERGY SOLUTIONS, INC. Expiration: 12/15/2024
14 PINEBROOK CIRCLE ••••••
GRANBY, MA 01033 = {
SS V
Update Address and Return Card.
THE COMMONWEALTH OF MASSACHUSETTS
Office of Consumer Affairs&Business Regulation Registration valid for individual use only before the
HOME IMPROVEMENT CONTRACTOR expiration date. If found return to:
TYPE:Corporation Office of Consumer Affairs and Business Regulation
Registration Expiration 1000 Washington Street -Suite 710
207208 12/15/2024 Boston, MA 02118
PROSPECTIVE ENERGY SOLUTIONS,INC.
t ,.. ` # 1
pia 7 MOW
SCOTT MCCRAY - /
14 PINEBROOK CIRCLE "-'— *mil �! ,ez!
GRANBY,MA 01033 :h ,. G ,r,�
Undersecretary of valid without signature