31A-166 (2) 88 MAYNARD RD BP-2017-0496
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:31A- 166 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: KITCHEN RENO BUILDING PERMIT
Permit it BP-2017-0496
Project# JS-2017-000817
Est. Cost:$53500.00
Fee:$347.75 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: VALLEY HOME IMPROVEMENT INC 077279
Lot Size(sq. ft.): 7492.32 Owner: WYATT KATHERINE
Zoning: URBp00)/ Applicant: VALLEY HOME IMPROVEMENT INC
AT: 88 MAYNARD RD
Applicant Address: Phone: Insurance:
P O BOX 60627 (413) 584-7522 Workers Compensation
FLORENCEMA01062 ISSUED ON:10/17/2016 0:00:00
TO PERFORM THE FOLLOWING WORK:KITCHEN REMODEL, INSTALL 5068 PATIO
DOOR TO ENCLOSE PORCH
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: 001: 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 10/17/20]60:00:00 $347.75
212 Main Street, Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
File a BP-2017-0496
APPLICANT/CONTACT PERSON VALLEY HOME IMPROVEMENT NC
ADDRESS/PHONE P 0 BOX 60627 FLORENCE (413)584-7522
PROPERTY LOCATION 88 MAYNARD RD
MAP 31A PARCEL 166 001 ZONE URB(1001
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLET s��
Fee Paid • /7 //77�
Buildinj>ermit Fille out 3'7I` j
Fee Paid
Tvpeof Construction: KI • N REMODEL,INSTALL 5068,vATIO DO,: TO ENC.OSE PORCH
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 FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INF03.MATION PRESENTED:
pproved 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
Demolition D
Sign of Building Taal 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&anted only to those applicants who meet the strict standards of MGL 40A.Contact Office of
Planning&Development for more information.
I ,n.J\ \ Department use arty
\ City of Northampton Status of Permit:
\ , Building Department Curb Cut/Driveway Permit
/^' ' 212 Main Street Sewer/Septic Availability
. Room 100 WaterM+ell Availability
i � ;' Northampton, MA 01060 Two Sets of Structural Plans
nnt//.\ phone 413-587-1240 Fax 413-587-1272 Plot/Site Plans
V « / Other Specify
LIGATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION
t,t Psopepriv Address: This section to be completed by office
SCJ enasnan.a Read liFsp Lot Unit
Zone Overlay District
_ Elm St District CS District
`
rrSECTION 2.PROPERTY OWNERSHIP/AUTHOREZED AGENT 1
2..1 Owner of Record: t
Sltrtncvt(lc (, 1ja34- ,i'g 0'14 . .s I. .i. . ii, OK 4 s
Na a( n q v - Current MailingAdd , :
"
<1 . `^A � h41•-The 108 Fn (k 10(000
Si 9- ✓ ( "telephone
Signature
2 2 Author'.id A.ent: MO
Name(Print) 11/ Current Mailing Address:
l Z�[j
�✓ � ./ 1 - 0u1' i itt
Signature Telephone
SECTION 3-ESTaEnATED CONSTRUCTION COSTS
I
hem Estimated Cost{Dollars}to be Official Use Only
completed by pa'mit applicant
1. Building iiiia-4 (a)Building Permit Fee
2, Electricaln (b)Estimated Total most of
I ( L„�O0 Construct=from ifi)
r....3. Plan:hingE_
.. i _.... rsr,.:ng.Ps�.,.:,r Fee
3, Oo�
4. Mechanical(HVAC)
5.Fire Protection /�` �/
6. Total=(it2`S+4+5j C . .la Check Number , 6,,e"1C1� 1'7737776
I This Taction For Official Use Only
1 Building Permk Numbers_ I Dai'I Booed'
Signature:
Bu;ving Cnmmea[u er,'inspenter of 3ui d(t s Dolt
Section 4. ZONING Ad Information Must Be.Completed.Permit Can Be Denied Due To Incomplete_h,formatinn
Existing Proposed Required by Zoning
This column to be filled in by
Bu;idingAroutment
Lot Size
Frontage
Setbacks Front
Side L: . L: R:
Rear ..
Building Height - l
Bldg. Square Footage
Open Space Footage
(Lotarca minus hidg&paved
pummel _.
#of Parking Spaces ' ^,
(volume&Lc on)
A. Has a Spedat Permit/Variance/Finding e r been issued for/on the site?
NO 0 DONT KNOW 0 YES 0
IF YES, date issued:
VF YES: Was the permit recorded at e Registry of Deeds?
Dolor/1 AV v YES
IF YES: enter Book Page and/or Document
B. Does the site contain a bro , body of water or.wetlands? NO p DON'T KNOW 0 YES Q
tlF YES, has a permit b en or need to be obtained from the Conservation Commission?
4 ioadc to[se& hs=e d U (Obtaeneri (T Data tanned:
C. Do any stens exis on the property? YES ( NO Q
iF YES, des be size,type and location:
D. Are there ii prOpeSed C`=• nges to r zefidthos fre tztanzaZfor Hst,pfsp n ? ,IS NO 0
F YE describe stye type Bud Location:
veil is portscruThon ECZIVIW mature(cIt ria gracing, e'^�c r .isn,or MIN) e 1 acre or p. of a common plan
�
raC dis4over i acre? - ESC NO 0
iF YES,then a leorh_npton Stems Water Management Pernittrnm the DPW is required.
I
SECTION 5-DESCRIPTION OF PROPOSED WORK{check all applicable)
New House Ei Addition ❑ Replacement Windows Alteration{sj L21 Roofing i
Or Doors ❑
Accessory Bldg. E Demolition Q New Signs 107 Decks ([] Siding f0) Other[CY1
Brief Description of Proposedn
Work: id ircHEN R64100a4 la . tok ba) 10 L"x)21nh , cipsPI L 6b &-
'i;o 90DRIe ENcrost Pbfocie
Alteration of existing bedroom Yes -fes No Adding new bedroom Yes imNo
Attached Narrative Renovating unfinished basement Yes _,--/C.Na
Plans Attached Roli She -
aa,ft New house and or addition to ena he4rsdnCr, ournpdete the.ollowhna:
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?
L Method of heating? _ Fireplaces or Woodstoves Number i each
g. Energy Conservation Compliance. Masscheci; Energy Compliance form attached?
It 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
SECTfOld Ta-OWNER AUTHORPPATSON-TG BE COMPLETED WHEN 1
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT f
I. \- z'thsoLbe tt
property �
hereby authorize 11I 1 `_!—. wain r Al,• tial_t
to ctnn y behalf,in all matte - rel.live to work authorized •. this building permit application.
S.v 1
tiGR n /67 2c[6
.Ignature oof Owner A _ Date
;- "- a.C -..M1.0 _.
I, bettey1 t,)\\ f("ril .as Owner/Authorized
Agent hereby Cedars thet the_statemer,ud rv'nrinqier,0i'he elttircisy it bsiisstinticr.L-is-(1d a. fn.he -.1:1:- L
Signe \der the pains and penalties of perjury.
ll
SECTiON 8-CONSTRUCTION SERVICES i
8.1 Licensed Construction Supervisor. Not Applicable 0
Name oflicense Holder: )kcV '(l JlA NST-t'QYlc.rm ne-
License Number
2-03 jt ' >«'k---. ` :it Val; \t. a.
C3 (a124I IEP
Addres Expiration Data
at J !u Telephone
9.RFeg�is�te_red Home I movement Contractor Not Applicable 0
o
T\113 1`\we. n—Art /d`ASSY3
Company Name Registration Number
P0 . )04::o 6' 't ?f17 tie
Address
/ /y - Ey itaUon Date
_
Hof e�,(/'g, C'�' V9 ( \b Z TTelephoneG t\—� s I
SECTION 10-WORKERS'COMREt4SAT1ON INSURANCE AFFIDAVIT(M.G.L.c.152,9'25C(61r
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 9L No 0
11. - Hoene Owner Exemption
The current exemption for i hr_neownere-was extended to include G-mer-: cr.. _ .,e ttr_ 0'00) .,. o( ) , dies
and to allow such homeowner to engage an individual for hire who does not possess a license,peuedded ebbs the owner ants
as seinervtbog.CMR 733, Nisei) E.dfefon SecUen 6 pgejliS.Il.
definition of Homeowner:Person(a)who own a parcel of land on which he!s0e 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
stmctores.)persona who const ski more thee nee hone in a twowvear period shall cwt he cor iderod a homeowner.
Such"homeowner"shall submit to the Building Official,on a form acceptable to the Building Official,that hg!rhe shall be
rerricaslicie sten cu Luca work performed under LCe-nar.pidinog ermrle"
As acting Cepnsfrnedon Supervisor your presence on me job sire will be required from time o time,during and upon
completion of the work for which this pemtit 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,ITU maybe liable for pnson(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 or Massachusetts General Laws Annotmed.
Homeowner Stenxt`ure ._._..._....._.. _
City of Northampton 212 Main Street, Northampton, MA 01060
Solid Waste Disposal Affidavit
pit
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: S rrotI nn o
The debris wiil be transported by: \)1_,I, gi 0 .L. ii
• The debris will be received by: to3I RtyA q
Building permit number: ���JJI V
Name of Permit Applicant \)0 1(11-6 1Q.611 rThr yiefid-,
D/ r6 7
i
Date Signature of Permit Applicant
The r^_.......eg,./tj, Lv7A'rhs5:nh11'1>'r
Department of jnd is. 2 J •eide^.La
025-s of Inyes Bois
_ 600 Washington Street
Boston, MA 02111
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
\'l
Name (Business/Organization/Ind ividual): la[UC`\ rcriic ,.1_xvt-cs\k—"tiAen4- . Tn
Address: :31t 1\2\t`?t✓e. cc ( •(\`)-(—
City/State/Zip: t \O/e tt. \aIPhone #: Lt 3-Sgt-l-iS2Z
Arerti�t you an employer? Check the appropriate box: Type of project(required):
1.t, I am a employer with 19 4. ❑ I am a general contractor and I
employees (full and/orpart-time).
z have tared the sub-contactors6. r New construction
listed on the attached sheet 7. ❑ Remodeling
2.❑ I am a sole proprietor or partner-
ship and have no employees These sub-contractors have 8. ❑ Demolition
working for me in any capacity. employees and have workers'
[No workers' comp, insurance comp. insurance.:
9. ID Building addition
required.] 5. 0 We are a corporation and its loll 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' 13.0 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 boxust 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 that is providing workers'compensation insurance for my employees. Below is the policy and job site
information. G
Insurance Company Name: Alf b ��e,, C� r l(l li'`-e
tit/ r[>._)p
O_ ' It
Policy#or Self-ins. Lie. #: �((�';O'O J L- �(�1�� :xpira an Dade,:I cI i 'l I i [, '/�
Job Site Address: ligg Int 2xz - City/State/Zip: IVQ/-tlILA >-rn 11/44(1-a Old)
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 form of a STOP WORK OP.I^ER ant! _a f.,=
of up to $250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of
Investigations of the DIA for insurance coverage'ger' on.
I do hereby comfy the pains a d penalhg8 perjury that the information provided above is true and correct
f to\� l La
Signature. I.r'!?I, J • 1Ly 'ii/.1; Date:
L\J�t ^ ��
Phone*: _i JJ ,T
I
Official use only. Do not write in this area,to be completed by rib,or toren official 1
City or Town: Permit/License n
Issuing Authority(circle one): ;'
I. Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector ri
6. Other
Contact Person: Phone r:
arice. U <i
rtt"so CS-077279
STEVEN A SILVERMAN ti
263 FOMER ROAD
SOUTHAMPTON MA 01373
Ni.—noilercr.F;tahon.
Commisstoner 06E2112013
;zui t rtnrLr/(l ; ((r/.; fr /// ( /i;
Ofnee of Consumer Affairs and Business Resin Mon
10 Park Plaza - Suite 5170
Boston, Massachusetts 02116
Home Improvement Contractor Registration
Registr2toc. IC5543
TypePrivate Corcoraticn
Exdratiorr. 71712013 Tr
VALLEY HOME IMPROVEMENT INC.
STEVEN SILVERMAN
P.O. Box 60627
FLORENCE, MA 01062
"" Office of Cornu r 1 R.�.r3 Lus .t,.1 R..� Cro License or ret siration ' rl for Mtn% dut!use unit,
" HC11E IMPRC HENT
Re-putt-mom Ion Yile: OM:: t .ontumm tr E :ev_.' f -.en
Exp Le e1-'^ - -u .r s
6rm 11A ) `1
o+wF T i,ar
If
STEVEN SILVERMAN {G/� f�•/
330 R nersitleOr. JOef)i: }L t/ /j( y'p r/..
N.rrnrn toC '_,L ti Wlelr.4t nGur-