31A-125 Valley Home Improvement, Inc.
P.O. BOX 60627, NORTHAMPTON, MA 01062
413 -584 -7522
FAX 413 -585 -0820
DESIGN / BUILD
ADDITIONS • RENOVATIONS
Neil Kudler and Nancy Flam
10 Jewett Street
Northampton, MA 01060
584.1395
March 7, 2012
Basement Remodeling / Design Specifications:
• Create 9'6" x 6' Conditioned Wine Cellar;
o Wood Storage racks (6) for up to 576 bottles
o Cork flooring
o Rigid foam Insulation/ vapor barrier and white painted walls
o Overhead fluorescent lighting on switch
o 400 Cu ft Max. Wine cooling unit /ducted to exterior
• Electrical Work
o Remove old knob and tube wiring ; $300 Allowance included.
o Install surface mounted fluorescent lighting (6) on switch for main room "
o New overhead light for main stairwell
o New dedicated 110 line for wine unit on GFCI breaker
• New white vinyl hopper windows installed (5)
• Rebuild stairs at bulkhead access ; rebuild lower section of interior stairwell; new sheetrock throughout
stairwell
• White latex primer sprayed onto entire rough ceiling to brighten space
• Re -build bulkhead door; insulate and weather seal.
• Plywood shelving storage units created (5); ; 8' L x 16" D x 6' H
• Build root cellar with ventilation and wood shelving, and overhead Tight
• Epoxy thinset floor product applied to existing concrete slab to make it more even and uniform /painted with
manufacturer's approved floor paint
• Oil Tank Removal; assumes no more then 5 gallons of sludge in tank; $7 /gallon thereafter.
• Content manipulation (see Allowance sheet), product delivery, job site cleanup and disposal of construction
debris
• Repair to landing outside basement door entrance; $200 Allowance for labor
• Building permit
• NOT INCLUDED: Associated costs for work performed by Leader Basement Systems, e.g., Clean Space Liner,
SaniDry, perimeter drain, etc.
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$MW i r_ ` — DEPARTMENT OF BUILDING INSPECTIONS 4 ` —
212 Main Street 'Municipal Building
Northampton, Mass. 01060
WORKER'S COMPENSATION INSURANCE AFFIDAVIT
I, /(/ELSo/ 5II /' t LL/i � V,4'1 IL / Z ,/trj!/F 7, c_
(llcensee/permittee)
with a principal place of business/residence at:
3 `f0 )//izies / 6 i�/l/ f,//o�/7i ,i n'ld (phone #) 58 g / , ,
(str /city tt2.tehip) D/ O
do hereby certify, under the pains and penalties of perjury, that:
I am an employer providing the following worker's compensation coverage for my
employees working on this job:
Acadia Insurance Company WCA5029908 2/1/2013" '
(Insurance Company) (Policy Number) (Expiration Date)
( ) I am a sole proprietor, general contractor or homeowner (circle one) and have hired
. the contractors listed below who have the following worker's compensation policies:
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Instcra.nce Company/Policy Number) (Expiration Date)
(Name of Contractor) (Instuance Company/Policy Number) - (Expiration Date)
(attach additional sheet if necessary to include information pertaining to all contractors)
( ) 1 am a sole proprietor and have no one working for me.
( ) 1 am a home owner performing all the work myself.
NOTE: please be aware that while homeowners who employ persons to do maintenance, construction or repair work on a dwelling of
not mote than three units in which the homeowner rides cr on the grounds a ppuxtenant1hmteto are not generally considered to be
employers under the worker's ration Ad (GL152,ss 1(5)), application by a homeowner for a license cr permit may evideaco the
legal status of an employer under the Worker's Compensation Ad..
I understand that a copy of this statement may be forwarded to the Department of Industrial Aocidmt3 Office of for the
coverage verification and that failure to secure coverage under sectioa 25A of MOL 152 can lead to the imposition of criminal penalties
consisting of a fine of up to $1,500.00 and/or imprisonment of up to one year and civil penalties in the form of a Stop Work Order and a
fine of 5100.00 a day against me.
Signed this . / 51" day of / 20/2. Far we only
Permit Number _
i ! . ' ,i4d. Map# . Lot #
Signature of L .. • ermittee .
SECTION 8 - CONSTRUCTION SERVICES
.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder : S tetsen Silverman 077279
License Number
268 Fomer Ro outhampton, MA 01071 6/21/12
Address, Expiration Date
584 -7522
Signat Telephone
9. Registered Home Improvement Contractor: Not Applicable ❑
Steven Silverman _ 131945
Company Name Registration Number
268 Fomer Road 10/13/12
Address Expiration Date
Southampton, MA 01073 Telephone 584 -7522
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 )Zfl No ❑
11. Home Owner Exemption
The current exemption for "homeowners" was extended to include Owner- occupied Dwellings of one (1) or two(2) families
and to allow such homeowner to engage an individual for hire who does not possess a license, provided that the owner acts
as supervisor. CMR 780, Sixth Edition Section 108.3.5.1.
Definition of Homeowner: Person (s) who own a parcel of land on which he /she resides or intends to reside, on which there
is, or is intended to be, a one or two family dwelling, attached or detached structures accessory to such use and; or farm
structures. A person who constructs more than one home in a two -year period shall not be considered a homeowner.
Such "homeowner" shall submit to the Building Official, on a form acceptable to the Building Official, that he/she shall be
responsible for all such work performed under the building permit.
As acting Construction Supervisor your presence on the job site will be required from time to time, during and upon
completion of the work for which this permit is issued.
Also be advised that with reference to Chapter 152 (Workers' Compensation) and Chapter 153 (Liability of Employers to
Employees for injuries not resulting in Death) of the Massachusetts General Laws Annotated, von may be liable for person(s)
you hire to perform work for you under this permit.
The undersigned "homeowner" certifies and assumes responsibility for compliance with the State Building Code, City of
Northampton Ordinances, State and Local Zoning Laws and State of Massachusetts General Laws Annotated.
Homeowner Signature
t t
CTION 5. DESCRIPTION OF PROPOSED WORK (check all applicable)
I .. .
g
New House 0 Addition 0 Replacement Windows 1 Atteration(p
sit Roofin E3
Or Doors
Accessory Bldg. D ; DemolitionO New Signs : j Decks { } Siding ( i Other : I
; 9-tc' Dety:. on of Propottt,ert Arotk Aril ;4 ,rj 1 ne, 4- k col ( / ic, 0, -E, b A c.,..,- ire ,]-(-- ' /1/41 o ,Ssii it cii,p ( 14)collt
, J . D._ )
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r.ir1:)' P.,,Ivisla bflr.tW41 - 74 NO Ar:rtitp. new ofIrtroc.r*" No
"AttaLrice, Narra(tytr: Rertjvatr-p, ..,:riftnislretti boseurtnt.
Pb' s tktta:hod Port Snr.t0, .
63,1f New house and or addition to existing housing, complete the following:
Use ot ow Ichng : Cr I ly Two ramrly
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Type
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I I. Septic 74;erk C;;14 Sewe 1 %tate %Ne'd C,1;4 water Strop y ...._....._
SECTION 7a - OWNER AUTHORIZATION . TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
he i'iutrtriri7e St '-ven Silverman, Valley_ Home.. ,Improvement, _ Inc. . , . . _. ,,,, _ . ...c,.....7..t on
rtr,t be,-trlf, itt ' ,-1- t 1., , elmive to %N .A., autriol2ed tn, Inis 1;.ad oforrit aopricaticto
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HE1 occ!ille , J7-a ,. ... Ile terrivits :MC nrorrrtatton e-r the toreRoir; R appitoatron :no tIttre ore.] ii1;e,ur t4te:1, lo he I.);;;$,t rt1 Fey
krcwlec go End belief.
ard tit..- u'
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Section 4.
ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE
DENIED DUE TO LACK OF INFORMATION
Existing Proposed Required by Zoning
This column to be filled in by
Building Department
Lot Size
Frontage
Setbacks Front
Side L: R: L: R:
Rear
Building Height
Bldg. Square Footage
Open Space Footage
(Lot area minus bldg & paved
parking)
# of Parking Spaces
Fill:
(volume & Location)
A. Has a Special Permit /Variance /Finding ever been issued for /on the site?
NO DON'T KNOW YES
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW YES
IF YES: enter Book Page and /or Document #
B. Does the site contain a brook, body of water or wetlands? NO DON'T KNOW
YES
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained , Date Issued:
C. Do any signs exist on the property? YES NO _
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property ?YES
No
IF YES, describe size, type and location:
Department use onl
D
E E'VE Ci of Northampton Status of 1 r
Bu (ding Department Curb Cut /b uay , it
12p 12 Main Street Sewer /Septic Ayalla f Ey
BAR Room 100 -I; /Well Availability
NGu4spEC '''s th.mpton, MA 01060 ,Sets o 4 ctural Plans
OFg �. _ #mot
►iJ =° 1 � 4 - :7.1240 Fax 413 - 587 -1 272 Plot / Site P � � `' '
Other Spec
APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 - SITE INFORMATION
1.1 Property Address: This section to be completed by office
O TEA ET J Map Lot Unit
Zone Overlay District
Elm St. District CB District
SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT
2.1 Owner of Record:
Name (Prin er Current Mailing Address:
4 Telephone
Sign
2.2 Authorized Agent: Steven Silverman
Valley Horn- ImP rovemen . Inc. P.O. Box 60627, Florence, MA 01062
Name (Print) Current Mailing Address:
AN
584
Signature Telephone
SECTION 3 - ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost (Dollars) to be Official Use Only
completed by permit applicant
1. Building ')_ C) (51)0 (a) Building Permit Fee
2. Electrical (j (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) 't 7- i FOO Check Number d y ��j /36 / : c
This Section For Official Use Only
._ Building Permit Number: Date Issued:
Signature:
Building Commissioner /Inspector of Buildings Date
File # BP- 2012 -0775
APPLICANT /CONTACT PERSON VALLEY HOME IMPROVEMENT INC
ADDRESS/PHONE P 0 BOX 60627 FLORENCE (413) 584 -7522
PROPERTY LOCATION 10 JEWETT ST
MAP 31A PARCEL 125 001 ZONE URB(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out Cp W� - ,y / i
Fee Paid 7tiJ �! �'' t
Tvpeof Construction: ADD WINE & ROOT CELLAR IN BASEMENT
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/ Statement or License 077279
3 sets of Plans / Plot Plan
THE FOL ING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFO ATION PRESENTED:
Approved Additional permits required (see below)
PLANNING BOARD PERMIT REQUIRED UNDER:§
Intermediate Project: Site Plan AND /OR Special Permit With Site Plan
Major Project: 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 Water Availability 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
ems ip
ture of Building Official Date — 14---1 9Th
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.
10 JEWETT ST BP- 2012 -0775
GIS #: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 31A -125 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: renovation BUILDING PERMIT
Permit # BP- 2012 -0775
Project # JS- 2012 - 001359
Est. Cost: $21800.00
Fee: $130.80 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: VALLEY HOME IMPROVEMENT INC 077279
Lot Size(sq. ft.): 6751.80 Owner: KUDLER NEIL R & NANCY A FLAM
Zoning: Applicant: VALLEY HOME IMPROVEMENT INC
AT: 10 JEWETT ST
Applicant Address: Phone: Insurance:
P 0 BOX 60627 (413) 584 -7522 Workers Compensation
FLORENCEMA01062 ISSUED ON :3/12/2012 0:00:00
TO PERFORM THE FOLLOWING WORK :ADD WINE & ROOT CELLAR IN BASEMENT
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.
Certificate of Occupancy Signature:
FeeType: Date Paid: Amount:
Building 3/12/2012 0:00:00 $130.80
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Louis Hasbrouck — Building Commissioner