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29-252 (2) NEW RECESSED L16HT ABOVE TUB j PRINCETON TUB 5' Ii SUBWAY TILE,AND BULLNOISE ABOVE TUB SUN TUBE(IN HALLWAY) i i I NEW VANITY LIGHT / 5. 011 30110AW I ; I NEW RECESSED MEDICINE CABINET II W v_ z I - _ NEW 30"VANITY 3DR,1 DR GREY REM TOP i 51NGLE UNDERMOUNT i SINK r i rte- - - ATH S ' o O o — I - m I F- _ INEW LIGHT IN CLOSET 2468 —0 NEW SHELVING IN CLOSET NEkN POCKET DOOR I 12'x12"TILE of ELECTRIC HEAT MAT PROP05ED PLAN 56ALE 1/4 NEW POCKET DOORS Q CL05ET AND BATH ENTRY PROP05E17ORTHOGi �l-SIG l50ETRIG 50ALE: 1/2'-=1 = ' I w: G I This plan is the proprietary work product of Valley t J Valley Home Improvement, Inc DONOHUE HomeJmprovement,tnc.(VHt).tts A'^'N delivered for the limited and exclusive purpose of LAST REVISED: 340 Riverside Drive, PO Box 60621, Northampton, MA 01062 ' .bq OVERLOOK supporting the contract bid ofVH1,and D R O 1 O Q PLAN s customer agrees that the elements of this plan shat! r __ 5 E L/ `� Office Phone 413.584."7522 Fax 413.565.0620 DRIVE not be republished or presented in any farm Find Us on the web at: uuwYalleyHomelmprovement.com 1 / 1 A A for the purpose of enabling or supporting the work of �I DATE:10/26/2014 FLORENCE, 1'7/1 competing project contractors without the i permission of,and compensation paid to,VHl. 5'_0" ee�c 2514AW I / �U1v O I i i I � i i ATH i � I \ -- II 1 L L I J 2465 2 1.011 1 L. 1 i i I i I i i 1 i I i 1 EX15TINO G HOGRAPHIG X15TI FLOOR FLA G 150MET IC 5GALE: 1/4 - 1 5GALE:1 I _ i This plan is the proprietary work product of Valley �- i DR,4Y�lN BY: 500 1lailey dome Improvement, Inc. iDO>�o�+uE I Hnmelmprovement,tnc.(VHI),Itis EX15T1G G® D1T1® 5 delivered for the limited and exclusive purpose of !; LAST REVISED: 340 Riverside Drive, PO Sox 6062'1, Northampton, MAO 1062 i 69 OVERLOOK I supporting thecontrectbidofVHl,and Office Phone 413.554.1522 Fax 413.585.0820 i customer agrees that the elements n this plan shat! Al DRIVE not be republished or presented in any form Find us on the web at: u�L wNalleyHomeimprovement.com i I se of enabling or the work of! �LORENGE, �>al comp purpo 9 9 sting project contractors without the j j DATE:10/25/2014 I .mission of,and compensation paid to,VHI. The Cove monwealkh of Hassaach useits E.: Depazm2ent of du�a' aalrdcc e is "y'�EE a s :. Office o 1��es aa�ia s 4 600 Washington Street Boston,1 A 02111 dia Workers' Compeusation.Insurance Affidavit: Bu-Uders/Con tract ors/EieetriciaIIns/.Plumbelrs An-oiicaut Information Please Print Le!Zibiy Name(Business/Organization/Indiviiival): % � I[: �- Address: J i�� IC(G� j� !��S )Imo=./ City/State/Zip: /1!�� n%�'�i�J AI 111 671 0 6 0 Phone#: i;3- 75 l 2— Are you an employer?Check the appropriate box: Type of project(required): 1. 1.am a employer wih J — 4. ❑ I am a general contractor and I 6. E]New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ 1 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.❑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.❑Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.F]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 thdat isproviding workeess'compensadon insurance for my employees. Below is thepolicy andjob site information. Insurance Company Name: Policy#or Self-ins.Lie.#: 1,,4)L C��1 j O Expiration Date: Job Site Address: k)b qv UL City/State/Zip:9—Aa&Ja Cp - Attach a copy of the workers,compeasatflon policy d eclarati®uu page(Showing the policy number and expiration d2te). 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 h reby c * er t"a r�ai�ss and enaldes`a p� r Mat the information provided above is Inane and correct Si afore: ��/il / i> �f Date: 1 Phone#: - Official use only. Igo not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/-1 T own Clerk 4.electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone r: SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: \ Not Applicable ❑ Name of License Holder: akC\1efl �����,� � q—I �;�9 License Number Address Expiration Date Afff A )01 /1 Signature Telephone 9.Registered Home Imorovement Contractor., Not Applicable ❑ Company Name Registration Number/ Addres s � � � f l�'/ j Expiration Date 06f!9LC-- 6\06 2. Telephone 5&A 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...... ❑ 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,you 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 _ SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition Replacement Windows Alteration(s) Roofing ❑ Or Doors El Accessory Bldg. ❑ Demolition [D New Signs [O] Decks [Q Siding[p] Other[a Brief Description of Proposed p ����,, Work: g�TW ��.� 1/i � 1 F1 xluk�5 I� .Wryrt'�. }���"E Alteration of existing bedroom Yes No Adding new bedroom Yes Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet 6a.If New house and or addition to existing 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 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 6f k o �� ��%��� ,as Owner of the subject property hereby authorize V t- -1 to act on my behalf,in all matters relative to work authorized by this building permit application. Signature of-oVvnW Date I, (1 ✓�'t' YET '1 � Jili!i�3, as Owner/Authorized Agent hereby declare that the statements and information on a foregoing applic tion are true and accurate,to the best of my knowledge and belief. Signed under the pains and penalties of perjury. r Print Name Signature of Owner/AgeW Date Section 4. ZONING Alt Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning Thi column to be filled in by B Ming Department r Lot Size Frontage Setbacks Front Side L _R: L: R: Rear Building Height Bldg. Square Footage % �f Open Space Footage (Lot area minus bldg&paved parking) / #of Parking Spaces i Fill: volume&Location A. Has a Special Permit/Vari;ance/Fin ng ever been issued for/on the site? NO 0 DONT KNOW 0, YES 0 IF YES, date issued: IF YES: Was the permit record at the Registry of Deeds? NO 0 DON 0 YES Q IF YES: ente/aina Page and/or Document# B. Does the site c , body of water or wetlands? NO 0 DON'T KNOW 0 YES l IF YES, has a r need to be obtained from the Conservatio n Commission? Needs to be 0 Obtained Q , Date Issued: C. Do any signs a perty? YES 0 NO 0 IF YES, de ribe size, type and location: D. Are there ny proposed changes to or additions of signs intended for the property? YES 0 NO IF Y , describe size, type and location: E. Will,{he construction activity disturb(clearing,grading, excavation, or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES 0 NO V IF YES,then a Northampton Storm Water Management Permit from the DPW is required. (� Department use only t!� City of Northampton Status of Permit: Building Department Curb Cut/Driveway Permit OCT 3 2014 212 Main Street Sewer/Septic Availability Room 100 Water/Well Availability C lectric, Piurn��ir�g£a s Inspections Northampton, MA 01060 Two Sets of Structural Plans Nor r m,-i n r .;11 Dft. 13-587-1240 Fax 413-587-1272 Plot/Site Plans Other Specify 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 9 Map Lot Unit F l©rep,--i c.-c Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: _N e-tt(,~ + �tr try ld'��c�1.� �� t VC`�✓1C1c� v�L �G'f lc .�" iL � Name(Print) Current Mailing Address: Telephone Signature 2.2 Authorized Agent: / Name(Print) / Current Mailing Address: Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed IbMermit applicant 1. Building I �) (a)Building Permit Fee 2. Electrical i // (b)Estimated Total Cost of t ► I i o o Construction from 6 3. Plumbing /_I / Building Permit Fee 4. Mechanical(HVAC) 5. Fire Protection 6. Total=(1 +2+3+4+5) Check Number This Section For Official Use Only Building Permit Number: Date Issued: Signature: Building Commissioner/Inspector of Buildings Date File#BP-2015-0505 APPLICANT/CONTACT PERSON VALLEY HOME IMPROVEMENT INC ADDRESS/PHONE P O BOX 60627 FLORENCE (413)584-7522 PROPERTY LOCATION 69 OVERLOOK DR MAP 29 PARCEL 252 001 ZONE THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid Typeof Construction: REMODEL BATHROOM New Construction Non Structural interior renovations Addition to Existing Accesso1y Structure _Buildinp,Plans Included: Owner/Statement or License 07727_9_ 3 sets of Plans/Plot Plan THE FOL WING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF 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 t' De y Signature of Bwldi g 6fficiaT 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. 69 OVERLOOK DR BP-2015-0505 GIs#: COMMONWEALTH OF MASSACHUSETTS MU.-Block:29-252 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-2015-0505 Project# JS-2015-000950 Est. Cost: $21700.00 Fee: $130.20 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group VALLEY HOME IMPROVEMENT INC 077279 Lot Size(sq. ft.): 16727.04 Owner: DONAHUE NELLIE&ERIN Zoninp,: Applicant: VALLEY HOME IMPROVEMENT INC AT. 69 OVERLOOK DR Applicant Address: Phone: Insurance: P O BOX 60627 (413) 584-7522 Workers Compensation FLORENCEMA01062 ISSUED ON.1013012014 0:00:00 TO PERFORM THE FOLLOWING WORK:REMODEL BATHROOM 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 10/30/2014 0:00:00 $130.20 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner