Loading...
15B-005 (2) i 603 SPRING ST BP-2020-0683 GIS#: COMMONWEALTH OF MASSACHUSETTS Mapalock: 15B-005 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: INSULATION BUILDING PERMIT, Permit# BP-2020-0683 Project# JS-2020-001074 Est.Cost: $9000.00 Fee: $65.00 PERMISSION IS HEREBY GRANTED TO. Const.Class: Contractor: License: Use Group: JAY BOLAND 101880 Lot Size(sq.ft.): 40075.20 Owner: KELLOGG CHRISTOPHER Zoning: URA(100)/ Applicant: JAY BOLAND AT. 603 SPRING ST Applicant Address: Phone: Insurance: 233 COLLEGE HWY 413 203-2454 0 WC SOUTHAMPTONMA01073 ISSUED ON:12/3/2019 0:00:00 TO PERFORM THE FOLLOWING WORK:BLOWN IN INSULATION AND AIR SEALING POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Budding Inspector Underground: Service: Meter: Footings: Rough: Rough House# Foundation: Driveway Final: Final: Final: Rough Frame: Gas: Fire D artment Fireplace/Chimney: Rough: Oil: Insulation: Final: Smok : Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occupancy signature: FeeTyne: Date Paid: Amount: Building 12/3/2019 0:00:00 $65.00 12 Main Street, Phone(413)587-1240, Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner ----U'-FCY? City of Northampton REC E I V E D Building Department 212 Main StreetIN LA TION � Room 100 NAV 1 Northampton, MA 01060 phone 413-587-1240 Fax 413-5 7-1 of Bul DING INSPECTtON3 NLY --- NORTHA PION,MA 01060 APPLICATION FOR INSULATION FOR A ONE OR TWO FAMILY DWELLING ONLY SECTION 1 -SITE INFORMATION INS ULA TION PERMIT 1.1 Property Address: This section to be completed by office 4 Map Zy Lot 4005 Unit Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: c/q /, M <: +4 P-/,s /�e //O✓✓ P 63 SJR r i rL� ,S4. I-2-eOU, /'1 q Name(Print) Current Mng Addd�ress: 0105*3 �cf{�ic�lec� ( 3 )� 58(0 - O(oS Telephone Signature 2.2 Authorized Apent: �m-e Eh �d lot,�7 0� a 33 6l/eyPy� Name(Print) ,y Current Mailing Address: Lg13 ) X03 � ysy Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building IL (a)Building Permit Fee 2. Electrical (b)Estimated Total Cost of Construction from 6 3. Plumbing Building Permit Fee us-"O(D 4. Mechanical (HVAC) 5. Fire Protection 6. Total= 0 +2+3 +4+5) 4r c7 000 �' Check Number This Section For Official Use Only Q Date Building Permit Number: 6P_0 (J Issued: Signature: lu Building Commissioner/Inspector of Buildings Date EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) SECTION 4-CONSTRUCTION SERVICES 8.1 LjqLntio Construction Sugervis Not Applicable C Nam of License Helder la(16 _0 I q5 -cense Number Y 2J ip_ 4(4d �1,1!A 010-3 I�Z 1;6 Address. -J Expiration Date elephohe t Nat Hcib V'-- 16 Ll Registration Number azz cc Ijc Expiration Date Teiephoneia-jo )(Iry SEMKIN 5-QRS'COPAPENSATION 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 i in the denial of the issuance of the building permit. i Signed�kffidavit Attached Yes....... GK'- No...... Brief Dascription Of Proposed Work yw 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. Prot Nwim sqnskn of ownerYAR1011 -F I— `w' Date as Owner of the subject oroperty riereby ,at&artze 'ILI to act 6�n my behalf,in all matters relative to work authorized by this building permit application. ft+jaCil,e.6 /I/i (-/ // 7 S4iaturelof bww Date City of Northampton Massachusetts L DEPAR2MCNT OF BULDING INSPECTIONS �T *, 212 Main Street s Municipal Building Northampton, Mh 01060 Y Property Address: 603 Sp rj�14 sT 4-e-eQls� M/' 0105-,3 Contractor Name: / i khe/l m-o (5v �o�u�Zv✓l Address: a-3 3 �O 11,e y e it4W LJ VIJ City, state: Sou���- y0��l , ✓�1� l d 3 Phone: �'�13 ) 0Zo.3 -c,2(-/S Property owner Name: hrl-S Ke/ Address: �0 6 3 S� City, state: 1, �!YIA,wn �'/ TL �� (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 signature Date mass save BARRIER INCENTIVES Saving,through energy efficiency Based on your Energy Specialist's recommendations,your home can benefit from program-eligible insulation and/or air sealing improvements.Before moving forward,please follow all the instructions below to remediate your weatherization barriers. CUSTOMER INSTRUCTIONS 1. Hire a qualified,licensed contractor to evaluate and/or remediate the weatherization barrier(s). 2.Submit signed and completed copies of this form and a copy of the paid contractor invoice(s)within 60 days of your Home Energy Assessment to:RISE Engineering,60 Shawmut Rd,Unit 2,Canton,MA 02021 Or email to Colum biaGasMAInfo' RISEengineering.com. 3.The weatherization incentive will be deducted from the customer co-payment amount of the weatherization work.A rebate check will be issued in the event the amount exceeds the customer's co-payment amount. 4.Complete the recommended weatherization improvements. Customer Name: Chris Ke11oga __ Client#or Site ID: 488037 Site Address:. 60.3 Sorina street City: Leeds State: MA Zip: 01053 Phone Number: 413-586-4965 Ernail: cteonst@yahoo.com r Customer/Homeowner Signature:_ °L . vim' - Z 4� te � Date: � r % To determine if there is any active knob and tube wiring,the contractor will evaluate the following areas where eligible Mass Save weatherization recommendations have been made: ❑Attic Floor ❑Attic Wall ❑Attic Slope ❑Exterior Wall ❑Basement ❑Other. CI Other: lt<have performed my inspection and determined there is no active knob and tube wiring in the areas selected below. 12'Attic Floor G-Attic Wall 13'Attic Slope W,55terior Wall basement 210ther� � � ��❑Other: it I have read and agree to the Terms and Conditions on the back of this form. Contractor Name: CA!ES-Te" e (2C- Address: © � Sf7 _ ST City: r 1n11e--,C._ States- /"A zip: Company Name: C 6 (r=e//`O7C- ' C CEO(G<. (cc-7r'GfGrcC_,License Number: � - f �P' Contractor Signature: Cta.51!;7� ✓<��2-- Date:/ W Y. High Carbon Monoxide:Contractor is to service and re-evaluate the selected mechanical system(s)and reduce the carbon monoxide level, as measured in the undiluted flue gas,to below 100 parts per million(ppm). Draft Failure:Contractor is to correct the draft In the selected flue(s).Refer to table on reverse for acceptable draft ranges. Existing CO ppm: Revised CO ppm: Existing Draft Pa: I =Revised Draft Pa: Heating System j Not Water Heater Other: Spillage:Contractor is to correct the spillage of flue gases in the selected mechanical system(s),Must not spill after 60 seconds of operation. ❑ Heating System O Hot Water Heater O Other: ❑ 1 have performed my inspection and have corrected the items noted in the areas selected above. ❑ 1 have read and agree to the Terms and Conditions on the back of this form. Contractor Name: Address: City: State: ZIP: Company Name: License Number: Contractor Signature: Date: Continued on back (page 1 of 2) DocuSign Envelope ID:8EB198D6-524E-4719-9867-6AEDEC8B3AOA RISE ENGINEERING OWNER AUTHORIZATION FORM 1, Chris Kellogg (Owner's Name) owner of the property located at: 603 Spring Street (Property Address) Leeds, MA 01053 (Property Address) hereby authorize (Subcontractor) an authorized subcontractor for RISE Engineering, to act on my behalf to obtain a building permit and to perform work on my property. This form is only valid with a signed contract. DocuSigned by: re 8/27/2019 1 8.56 PM EDT Date RISE Engineering, a Division of Thielsch Engineering, Inc. 60 Shawmut Road Unit 2 1 Canton, MA 020211339-502-6335 www.RISEengineering.com