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17A-041 (6) BP-2024-0389 196 BRIDGE RD COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 17A-041-001 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-2024-0389 PERMISSION IS HEREBY GRANTED TO: Project# INSULATION 2024 Contractor: License: Est. Cost: 5600 J P GEORGE AND SON INC 099372 Const.Class: Exp.Date:02/11/2025 Use Group: Owner: LAURIE MATHERS JOSEPH & Lot Size (sq.ft.) Zoning: RI/URA Applicant: J P GEORGE AND SON INC Applicant Address Phone: Insurance: 64 HAYWOOD ST (413)774-3604 4220066477 GREENFIELD, MA 01301 ISSUED ON: 04/05/2024 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: Fees Paid: $65.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner 11 iLT igg0 The Commonwealth of Massachusetts -, „ID FOR Board of Building Regulations and Standards //1-2.- ' • ' :. ', : ty 7 5.ii. /./.. �� "�� � � MUNICIPALITY o s+• ,.• Massachusetts State Building Code,780 CMR USE c �O Building Permit Application To Constrict,Repair,Renovate Or Demolish a Revised Mar 2011 One-or Two-Family Dwelling a This Section For Offtciel Use Only .. o m i ;tiiaii gPetmkll umber:.•• gl' -z`'.' <3•sr9 j.D'ate.A d: • . '. 8 N ___,,-- , • : ' 4,. �Hnildiu OM art.Nam elnt(Pre) -&5 spout . . • Date: , SECTION 1z SITE INFORMATION 1.1 ' f,, • k Addr 1.2 Assessors Map&Parcel Numbers J9 'ridf ff `2 �/r '7(e /I'P us a Is this atfaccepted street?yes no MeP Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions; Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(It) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1 1.6 Water Suppiyt(M.O.L c.40.§54) 1.7 Flood Zone information: 1.8 Sewage Disposal System: Public Cl Private 0 Zone: �,. Outside Flood Zone? Municipal❑ the site disposal system O Check ifyesO _ SECTION O R'TY OWNS'. T • 2.Jos h er o'Re 'QMt- --s ivY•e7ce Al& d 10 ))- Name(mot) City.State,ZIP /90 tEri l 4/ 51/ A5 iln a'7 . No.and Street ✓ Telephone 7 Enid Address SECTION,3:a1ESCRIPTION OF PROPOSED WORK?-(check all that apply) : ' - New Construction CI Existing Building❑ Owner-Occupied ❑ Repairs(s) ❑ Alteration(s) 0 Addition CI Demolition ❑ Accessory Bldg.❑ Number of Units Other ® Specify:iiIS6/i //o/J Brief Description of Proposed Workz: f, a,, h i . �/�/.,o .3� �(/1/,A_/ore • G ,.• . SECTION*ESTIMATED CONSTRUCTION'COSTS,• - • Estimated Costs: Item chat 1Use.�C3* • . . (Labor and Materials) ,, .• . . - . . • I.Building ,$ .-C, 06 1, Building Ptantit Fee:.$ •. .'Indicate bow#fie is deterin d.. 2 Electrical $ ' ..CI Standard.City/TownApplicatitin Fee- .IITata Projea:Coat3(leaas xteu.Itiplier' - x , 3.Plumbing $ 2. Otber.Fces: $ ; . •. - 4.Mechanical (IIVAC) $ List: 5.Mechanical (Fire $ . . • . • Suppression) Total Ali pees: • .T. / / a Check Na.,3 Q 'Check Amount.( Cain Amouatr ; 6.'i'otel Project Cost $ 5, ( a i?Paid in Full • ©Outstanding Balance Duet - SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) MI Qii9 57+� a•,+ •�,�' ' p.RVI t f q� License Number CJ` Expiration Date Name of CSL Holder"" v �s �� tOti 40•3A1A)ONA Ikea". List CSL Type(see below) No.and Street Type Description Gcee.� eld/ Mik Unrestricted(Buildings up to 35.000 cu.ft.) COt�d R Restricted 1&2 Family Dwelling City/Town,S •te,Z I' M Masonry IRC Roofing Covering 4. 4eASA-ptA " WS Window and Siding SF Solid Fuel Burning Appliances (1,p3)53116112 a e__bvte--eu dsK.•toIM I Insulation _;lephone Email address L D Demolition 5.2 Registered Home Improvement Contractor(HIC) /5-6 r 86 _ 1-6/1/„j,5 • Ge.O'e r ..& Y1 j 1/1[ • HIC Registration Number Expiration Date HIC Co any me or HIC Re i trax ame e L yitattlpseargaLecedihati No. d Street Email address �s .attt� , 1 Oi C ( C311076 City/Town,State,ZIP `. r . , s1.c3, Telephone SECTION 6:WO'•41 ' 'C ENddSATION 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 Vt No 0 SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES F`O,R� BUILDING PERMIT I.as Owner of the subject property.hereby authorize �os91. l Geo to act on my behalf,in all matters relative to work authorized by this buil mg permit applica ion. Js A Rnc MorsJiodPrint Ou er s Name(Electronic Signa 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 c to the est of m knowledge and understanding. J / 6,-en qe , ,, j/2 Print Owner's or Authorized A e is N ie onic Si ature I 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" roctantoJ industrial Acc fs . .,, s Office of Investigations M . " fay c'i� Center --" . r 2 Avenge de Lafayette,e, Boston,MA 02111.1750 u.D'W!S&._ov/tea Workers'Co I pe sallon iiraow:,neeAffidavit I:vi m erW/Color ° e;.i,n /PJec eians/22nntbers ADDDkeant Information Plea e hint Le " I�t Name (Business/Organization/Individual):JP George&Son Inc Address:64 Haywood St City/State/Zip:Greenfield, MA 01 301 Phone#:423-774-3304 7,r you an employer?Cheek the appropriate box: .l.M.. 5 4. o Type of project(required): . I am a general contractor and I I am a employer with 6. [(New construction employees(full and/or part-time).* have hired the sub-contractors 2.0 I am a sole proprietor or partner- listed on the attached sheet. 7. Remodeling ship and have no employees These sub-contractors have 8. (3 Demolition working for me in any capacity. employees and have workers' 9. Building addition [No workers' comp.insurance camp.insurance.* Q 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 MOL 12.0 Roof repairs insurance required.]t c. 152,$I(4),and we have no 13.11 other INSULATION employees. [No workers' comp.insurance required.j *Any applicant nut checks box#1 must also fill out the section below showing their workers'compensation policy information. fi Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new aflsdavlt indicating such. iconnnotoas that check this box must attached an.additional sheet showing the name of the subcontractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their wotfreas'comp.polity number. rr • lam an employer that isproviding workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name;Arbella Policy#or Self-ins.Lie.#:4220066477 Expiration Date::8-1-2025 Job Site Address:N 4v City/State/Zip: I ie"1Ge 4''? G 1% Attach a copy of the waterer cmnpensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MOL 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 S250.00 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 cert&under t at,a aiad penalties of'perjury that the information provided above is twee and correct , Phone;#: 41 3 774-3604 Official use only. Do not write In this area,to be completed by thy or town ofctat City or Town: Permit/License# Issuing Authority(check one): IDEoard of Health 20 :ullding Department 3OCity1Town Clerk 4.0 Electrical °,i:specter S.wr lambing liaaspecter 6. Other Contact Person: Phone i#: 4kt r 7A `l V5 COMMONWEALTH ONW Mi/EEALT O �S�SACHUSE TS E3 f.kClt.Y�i,4�ES S 15:/SA qa ff 0.lY F A M 4. TOWIM ;ttff,/C ///a),i : , Massachusetts IN ACCORDANCE WITH THE PROVISIONS OF MGL Chapter 40,Section 54, A CONDITION OF BUILDING PERMIT NUMBER IS THAT THE DEBRIS RESULTING FROM THIS WORK SHALL BE DISPOSED OF IN A PROPERLY LICENSED SOLID WASTE DISPOSAL FACILITY AS DEFINED BY IvIGL Chapter 111,Section 1SOA. Brattleboro Salvage 437 Vernon St. Brattleboro, VT Dm ,o ,/DUMPSTER FIRM f 6;/ (" 77r-er7o ,/2� ? d/C2L3- CC 67 'hUCTi 7 'E ADDRESS ' LI'K Ring, JIC S MATURE OF Rittiiiir APPLOCANT 34,07-2k DATE A' mass save Savings through energy efficiency PERMIT AUTHORIZATION FORM 1, Joseph Mathers owner of the property located at: (Owner's Name) 196 Bridge Road Florence (Property Street Address) (City) hereby authorize the Mass Save® Home Energy Services Program assigned Participating Contractor to act on my behalf and obtain a building permit to perform insulation and/or weatherization work on my property. This form is only valid with a signed contract. The permit will be secured by the subcontractor, at no additional cost. Joe HaMeic Owner's Signature 02-24-2024 Date FOR OFFICE USE ONLY We have assigned the following Mass Save Home Energy Services Participating Contractor to the above referenced project: cPo/!;€ JOvt`- G Participating Contractor Date Document Ref:YQNJ8-QAQ6R-GVZUR-UX4UN Page 1 of 1 ia t•••,..."`..-.47;..trr.-,10,1141.• .., 0 c'-' ,...,, ilqi # ••al 1&:'.'-3-:',. • ' 4 s rn 0.* i ill tg,, ivisioA,os, .4. Ett 4 41 t 4. ta g - on '0 . ro ,, ,'...., : - ' '6's cliz 0 co To 1 0 .4•V' ro s ••••-ilk, 4-0:4". "6 c= Tm E i 4•Nst tu N 81 ,,,,: 4.+4 it•1 1 o ' a ' . . . . . ... te ,014 0 0......., ..3 .-4 titI CO 5 THE COMMONWEALTH OF MASSACHUSETTS D. fill 0 8 Office of Consumer Affairs and Business Regulation . I 1000 Washington Street-Suite 710 , Boston, Massachusetts 02118 Home ImproNierTi*TEContractDuRegistration '''''%,,---;:t:,-,1;.-;:::::::,:',:.-:-Lz.:'i-.7;,.,..V.2"... . : z.•.1.,‘'.'. :-•-•';'-;•; ..f.;:r'rr*.;t1;";:::`'z' i ,:.--iv•-;4'.:-: ::-.. ::-„,-.M- ` - 'v-•.,• -' -•,---.. •••;: -,.1' i li I" • i'-'''':( l';;;Z,Z,::::?- 3 , N g Type: Corporation '.5 7 Ti• I , .'"' 4 L- .,,- -t 7,'-‘''-,.----', ..".4-"-'-i J.:i.i.,..-Regiistration: 166686 qr— M I 5 g JP GEORGE&SON INC =:.•' --..--4.. •.,.„-,.... .1 . , . 1.;;;,' ';',;::-:'-zi.a,...'%-••. ...,,x-..-T.,-- -:,.„ Exprfahon, 07/24/2025 . .-> .. , .4 . . .'" ,--._GREENFIELD,MA 01301 ... '...,:•• ,"!...,.-Z.,.., 7... ,r,*•.•-;.."-...*.zr,.:,... 1 a i•••4 i! V a vi 14 r 2, j - -.... .,... t: .,A, g .... ,1„. .?..,.. a, ts E '1 a•=4•in 0 .'',..t,i".,';•••••1 ps .-.,.v.,--!••:, :, ' a Z to 3 '..--,- :..1-', • n P,,„,1 r Fa- . izb Update Address and Return Card. i li 1 8 62 to =a 1. S . g 121 a t.. 1= gvtK c J.,.,, =— THE COMMONWEALTH OF NIASSACHUSETTS i .g 8 .. . la 5 rtG ig- I' 4 i t • o . ea Once of Consumer AffairS&Business Regulation Registration valid for individual use only before the 7•,..• zu ts As. HOME IMPROVEMENTpONTRACTOR expiration date. It found return to: • •ur o i a TYPE:ppeporation Office of Consumer Affairs and Business Regulation .: a S §tg a Registtattoft -0;,Piiibimon 1000 Washington Street -Suite 710 to E .146118z"ti..i,07124/2026 Boston,MA 02118 ir ts 0, 1• , GEORGE&SONINOT1,-.42h T-,.?- • • 3EPH P.GEORGE ',-' r;i--- :•,!,:::-. ;•::' N. EENFELD,MA 01301-:;;Z-.5"2-'...:,'",•• ,-1';, Undersecretary ' -- Not yak without signature '' - Mass Save® Facilitated Services: Electrical Pre-Weatherizatiori CUSTOMER INFORMATION Customer Name Joseph Mathers Client#?or Site ID: 538400 Site Address: 196 Bridge Rd City: Florence State: MA ZIP: 01062 Phone Number: (413)222-4636 Email: mathersjlCjuno.cotn ELECTRICAL BARRIERS (To be filled out by the licensed contractor.) Roadblocks identified at home energy assessment: K&T wiring Recessed lights Knob and Tube Wiring To determine if there is any active knob and tube wiring,the contractor wit evaluate the following areas where eligible Mass Save® weatherzation recommendations have been made: Attic Floor Attic Wall Attic Slope Exterior Wall Basement I have performed my inspection and determined there is no active knob and tube wiring in the areas selected below: Attic Floor Attic Wall Attic Slope Exterior Wall Basement Contractor Notes: Attic is not accessible, per the rest of the inspection and my professional experience,ther is no active knob and tube Recessed Lighting IC Sign-Off The contractor will evaluate the number of recessed lights in the following areas identified by the Rome Energy Specialist: Company Name: Lieber Electrical Contractor Name: david lieber License Number. 11637b Contractor Signature. Date: Friday,March 1,2024 My signature confirms that I have performed my inspection of the electrical systems listed above and have corrected any barriers as indicated tI signature also confirms that I have read and agree to the Terms and Conditions outlined when submitting this form, a • o