29-585 103 WOODS RD BP-2017-0142
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:29-585 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category:ADDITION BUILDING PERMIT
Permit# BP-2017-0142
Project# JS-2017-000231
Est.Cost: $149000.00
Fee:$968.50 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: VALLEY HOME IMPROVEMENT INC 077279
Lot Size(sp. ft.): 20386.08 Owner: BALDWIN MARK 1&MARY K
Zonin Applicant: VALLEY HOME IMPROVEMENT INC
AT: 103 WOODS RD
Applicant Address: Phone: Insurance:
P 0 BOX 60627 (413) 584-7522 Workers Compensation
FLORENC EMA01062 ISSUED ON:8/8/1016 0:00:00
TO PERFORM THE FOLLOWING WORK: CONSTRUCT 24 X 16 BEDROOM/BATH
ADDITION & DECK
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 8/8/2016 0:00:00 $968.50
212 Main Street,Phone(413)587-1240, Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
Sete—Men%sr
File# BP-2017-0142 T mi-rf\\(�;.,�NQ
APPLICANT/CONTACT PERSON VALLEY HOME IMPROVEMENT INC 0 2 CAN / C0(M
ADDRESS/PHONE P 0 BOX 60627 FLORENCE01062(413)554-7522
j • %
PROPERTY LOCATION 103 WOODS RD
MAP 29 PARCEL 585 001 ZONE r
THIS SECTION FOR OFFICIAL USE S)NLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT ("J//�
Fee Paid c?v1'AJS v'7NCT/Cc5
Buil¢ine Permit Filled out
Fee Paid
Typeof Construction; CONSTRUCT 24 X 16 'EDROOM/BATH ADDITION&DECK
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Stricture
Bing Plans Included:
Owner/Statement or License 077279
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION PRESENTED:
Approved V 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
f'
S tic Approval Board of Health Well Water Potability Board of Health
Permit from Conservation Commission Permit from CB Architecture Committee
Permit from Elm Street Comm'cion Permit DPW Storm Water Management
Demolition Delay
f ����� yg /�
ignature of Building 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.
•
RtCH Fn itDepartment use onlits/of Northampton Status of Permit:
PUG — 12016 tiding Department Curb atlDrlveway Pem,it
212 Main Street Sewer/Septic Availability
Room 100 WaterNVeil Availability
sPECriONS
Nomrinit°n'ro"HwmAtio No hampton, MA 01060 Two Sets of Structural Plans
phone 476-587-1240 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 {p7V-e-LLQ,^.,,ry,, JJ This section to be completed by office
l03 euoods RMap Lot Unit
1"lOfPr1(.L Zone Overlay District
Elm St.District CS District
SECTION 2-PROPERTY OWrNERSHIPfAUTHORIZED AGENT
2A Owner of Record: 11.1 F-ANi t(rty
Km 41-timt ZQ awin 103 U3c 1s ea flotencr ?'kt Q)o&z
Name P'nt) _ Current Mailing Address:
q13- 554- 7012-
`/ _ /tom' Telephone
Signature
2.2 Authorized Agent:
c efaen \verrna///n P.o.6ci thooa7 Floreoce f-ta ao6Z-
Name(Print) //, ✓u Current Mailing Address:
/
Signature
�7y/ I/ Telephone
Ty13-Sg4- 75aa
SECTION!3-ES11234.TED CONSTR ICTFOIiI COSTS
Rem Estimated Cost(Doliars)to be Official Use Only
completed by permit applicant
1. Building ` ,.1 O J l\ (a)Building Permit Fee
I i J
2. Electrical I I (b)Estimated Total Cost of I
I I L^ ) 00D I Construction from(61
4. Mechanical(HVAC)
5. Fire Protection 1 , C0c).
6. Total =(1 +2+3+4+5) Loi. oOD Check Number 357,35 0 y6gr 66
This Section For Official Use Only
Building Permit Number: Date
Issued:
•
Signature:
Building Con.CommicsionerInspector of Buildings _as
Section 4, ZONING AU Information Mutt Se Completed.Permit Can Be Denied Due To Incomplete Information
Existing Proposed Requited by Zoning
This coiwm to be Hlled iv by
Building Bepanw®t
9Lot Size
Frontage UU �.(o
Setbacks Front
Side L:_. R L:
Rear
Building Height �4g. —......
Bldg.Square Footage f13, gr q�' 12-14l J to I q,b
Open Space Footage B Oq % /
{Lnareaainusbldg&roved i b 0 �(� LI it &
pm.Grt4) �I tut" • 7.0 ..
#of Parking Spaces 3. 3
Fill:
(volume&Location)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO CD DONT KNOW T'' YES 0
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
tic' {v; DON'T KR sit Unest J
PF YES: enter Book Page and/or Document if
B. Does the site contain a brook, body of water or wetlands? NO 0 DON'T KNOW Q YES 0
PF YES, has a permit been or
need to be obtained from the Conservation Commission?
Heeds to be obtained !�h h4Fxfner# ( t_iste ficelepk
C. Do any signs exist on the property? YES 0 NO
IF YES, describe size,type and location:
R tat three ^u nrn i chtnigns t., .-..PS of tinitir .ni ^sf orthe nimmanty? Yon (Th
IF YES, describe Roe, type and location:
t. mil,[rx ca ucnon - ivi,,ds_urt iresermt,grasinwietion, or Milian)over 1 pare or is it part of a common pion
that will disturb over I coral YES 0 NO
IF YES,then Northampton Storm Water Management Permit from the DPW is sequined.
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicabts)
New House C Addition Replacement Windows Alteration(s) C Roofing C
Or Doors ❑
Accessory Bldg. ❑ Demolition ❑ New Si.: s (0) Decks )[j Siding ICI) Other)Cil
.C1_ .
Bhef Description of Proposed + p
Work: pp 2.q" X � (�hfY�Z ��fl1�10{•� ��� � t�.(C
Alteration of existing bedroom Yes -No Adding new bedroom X Yes No
Attached Narrative Renovating unfinished basement Yes Bs No
Plans Attached Roll ' heat}
6a.ff New house end or edditEon to eldstinct housing. COMAete the fogowh=,o:
a. Use of building : One Family Two Family Other,
h. Number of rooms in each family unit: Number of Bathrooms �— -2-
taIS
c. Is there a garage attached? y
d. Proposed Square footage of new construction. 3lfi \ Dimensions al (.:
e. Number of stories? bt"
f. Method of heating?o Pyn4<y _
�Ky� ��i�ti�� �-� •v ai �>(Fireplaces or Wocdstpves �w � Number of each
f
g. Energy Conservation Compliance. t C 10 . Masscheck Energy Compliance form attached? N°
h. Type of construction VV'Lob FR 144 c.
i. Is construction within 100 ft.of wetlands? 'Yin Yes No. Is construction within 1001x. floodplain _Yes )(NO
I. Depth of basement or cellar Sour below finished grade
k. Will building conform to the Building arid Zoning regulations? r` _Yes No.
I. Sepifc Tana City Sewer T"^: Private wail City water Supply ,,7/1
SECTION 7a•OWNER AUTNORt k nON TO SE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT !
. 1 \UAk 1'1-ttlftf t1;oAlldLU _en. .._..,......._ or
. e ,.
-. e t
_... .
j
hereby
\I
l authodze `t 4...1 L dl_ 0 t ? _f/' •
to act o my behalf,in all'.^rs relative to work au prized by this building permit application.
SI na re of Omer Date
e n �� YVYY Q✓�
\h i lI. N c int 10rOLle- 7�� - asOvon rlAutnodz d
Age hereby 'e_la t _ ._ n orgt t , .1 the _ _ n_ - ti _nnd_ _ _ I
Signed under the pains and penalties of perjury.
apAyal ` tad f
Salina
f q �1 i
of n;! '
SECTION 6•CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable El\
Name of LicenseHolder im'l } e"• � 7 __
yy License Number
Nall: ♦ ii rr" CY_`rk >`1w }2) \
Address iff r A 1j- Expiration Date
IfIl71!
Signe Lire Telephone
•
9,Registered Homs Improvement Contractor: Not Applicable 0
9.C"Ceti 1A\Axil' (Th — 1055[63
Company hang Registration Number
c 43O rte. 6d'- r _ ?it7 jis
Address
�y - Expiration Date
1
�\Dt`r.'>s 5);'.\-\
Telephone '" u
SECTION 19-WORKERa COMPENSATION INSURANCE AFRICA/IT(M.G.L.c. 152,§25C(6))
Workers Compensation Insurance affidavit must be competed 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 t7 No ❑
1.1. — Home Owner!- Exemption
The carr„ri exemption for 'homeowner;'. extended to include Deramencenunint dargellings„tae Oa or rwo 2)families
sod to allow such homeowner to engage an individual for hire who does not possess a license,granddad dun the owner acts
as supervisor.Gitfif.MT SUM Edition Section{C6.3.S.T.
Befintttan of Homeowner:Person(a)who own a parcel of land on which he/she resides or intends to reside,on which theta
is,or is intended to be,a one or two family dwelling,attached or detached structures accessory to suck use and/or farm
structures.f person who constructs mare than One borne in a twonee etuad shall not be considered a homeowner,
Such"homeowner"shall submit to the Building Official,on a form acceptable to the Building Official that helpbe shall be
srctfs e woe'ec eaeee wont nerforree. rder the he er'tcs perp t.
As acting
�Construction Supervisor your museum on the lob site will be retuned from time to time doting and^_poi
completion of the work for which this permit is issued.
Also be advised that with reference to Chapter 15.2(Workers' Compensation) and Chapter 153 (Liability of Employers to
Employees for injuries not resulting in Death)of the Massachusetts Cenral Laws Annotated,you ran be Rabic(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.
Eomeowner Signature ...
City of Northampton 212 Mein Street, Northampton, MA 01063
Solid Waste Disposal Affidavit
In accordance of the provisions of MGL c 40, S54, I acknowledge that as
a condition of the building permit all debris resulting from the construction
activity governed by this Building Permit shall be disposed of in a properly
licensed solid waste disposal facility, as defined by MGL c 111, S 150A
Address of the work: i b2-2 (J ^O
The debris vrill be transported by: \)014.); Sikert\rimbuf-
The debris will be received by: % cLU �
�
Building permit number: a
•
Name of Permit Applicant k ineieth
] r,r
Date Signature of Permit Applicant
The Cc,,,:/l:....,_i13ry of_asst':_/„ 22r_
• - Depulttnineili o✓fIndustrial Ace ideris
Office e lir ;JYesfigai ons
600 Washington Street
Ir,-c-=' - Boston,MA 02111
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Organization/Individual): \la U-Ci„, VICKIIC IVY)c)y'l ,rPre , Zn L
Address:_.. , ' it ....VS_ AC .. it
OZ-
City/State/Zip: /V \t3t'.4rtLc c\. DI Phone #: 1,- , `-�:7rS4-riCS2 -
Are you an employer? Check the appropriate box; Type of project(required):
1.M I am a employer with IB 4. D I am a general contractor and 1
employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction
2.❑ I am a sole proprietor or partner- Listed on the attached sheet. i. 0 Remodeling
ship and have no employees These sub-contractors have 8. 0 Demolition
wow for me in anycapacity. employees and have workers'
B P' ry 9. 0 Building addition
[No workers' comp. insurance comp. insurance.#
required.) 5. 0 We are a corporation and its 10.1-1 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 MGL 12.0 Roof repairs
insurance required.] 't c. 152, §1(4), and we have no
employees. [No workers' 13.01 Other _
comp. insurance required.]
*Any applicant that checks box Pt must a'so till out the section below showing their workers'compensation policy¢rf«aatiorl
r Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
tContractors that chock this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have
employees. Ifthe sW-contractors have employees,they must provide their worker'comp.policy number.
lam an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information. rt �
Insurance Company Name_ rnt,l(J,' 0' . ' {f1- k._"tU'1(°c2 `) CA'P ,
L li-7
Policy#or Selz-ins. Lie.:: �4.� 00--6 .....,
0 - 1� .,,mor.Date. - t t e t t
lob Site Address:_, City/State/Zip:
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 font of a STOP WORK ,.R..,.n ,,,nd _....:
of up to$250.00 a day against die violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the.DIA for itsura....e,cov erage(- .i .
I do hereby certify { the pains a Idpenaf/i`j¢, perjury that the information provided above is true and correct.
•Si$pahre; s s<rl• +ra y/ .� — Pa. to
Phone a: st1�� �� �4T
II
Official ase only. Do not write In this area,to be completed by city or town official 11
City or Town: Permit/License# I,
Issuing Authority(circle one): I)
I. Board of Health 2.Building Department 3. City/Town Clerk 4,Electrical Inspector 5, Numbing Inspector ]1
6,Cath.,.
iji
Contact Person: Phone#: ii
*Aa<sac t se L,^_ * H Puc S✓tty
Hoard 3t .(61'ngHr a.n 7.3na a 1Hds
I -HeHse CS-077279
STEVEN A SILVERMAN
268 FOMER ROAD
SOUTHAMPTON MA 01073
Eto.ra;rte
Co**susvono. 09r21201a
j%rr., ,r1f jet/ lr`.
i..=r Office of Consumer Atratrs atnd Business Retzu!atiop
10 Park Plaza - Suite 570
Boaton, Massachusems 0'1lti
Home Improvement Contractor Registration
ReSistra.Icn. lC6343
Type Puvate Cofooraricn
Ewratior 7 f7, ata
VALLEY HOME IMPROVEMENT INC.
STEVEN SILVERMAN
P.O Box 60627
FLORENCE, MA 01062
t pJ.; ld.trau and nsarn :.0^d-SIH oaa.0 rr
tddre.r Rc c Lfl k.111,11,13h nr I_,6„ t and
tff.e,.ri(Enus,lirr %Sa*r S ii6,11116114 ft _xiaziaEiz.• rc,istrution.a3Gi for HoiHrtfuli use ooh
HC IMPROV MENT CCNTRACTCR orpnr xplrndon date. if found e turn w:
Registration. -„ Type Of±;rr of( o Ti ij flier.k oTHSInier kftinn grid BustheH R is row
Esp#ratlon: SO:8 o ccre'Cn la VHF 1.1,1).1-11(1111(1 6111
SnWwo.}tt HZ1to
Ya11c rvCMS. .^PRCV=,SMEMT INC ,r
I,STEVEN SILVERMAN
3 FisersdeCrO . ,;„72,.„ , /1 ///
N.Ht an p. : ..£rv. I frr.avc.an... - f ♦ tv-aiki w Wow i nt[ute
0/9/2016 City of Northampton Mail-103 Weals Road
�s. 1 �j4��xorCitY Louis Hasbrouck<thasbrouck@northamptonma.gov>
vaiAirsthmrtplort
103 Woods Road
1 message
Louis Hasbrouck<Ihasbrouck@northamptonma.gov> Thu, Aug 4 2016 at 11:23 AM
To: Steven Silverman <Steven@valleyhomeimprovement.com>
Cc: Sarah LaValley <slavalley@northamptonma.gov>
Steve,
the work at 103 Woods Rd. needs to be reviewed by the conservation commission. We'll hold the permit
application until we hear from you or Sarah LaValley.
Louis Hasbrouck
Building Commissioner
City of Northampton
Town of Williamsburg
(413) 587-1240 office
(413) 587-1272 fax
•n 103 Woods needs cons com.pdf
86K
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