29-464 (5) 31 CRESTVIEW DR BP-2017-0867
GIS u: COMMONWEALTH OF MASSACHUSETTS
Map:Block:29-464 CITY OF NORTHAMPTON
Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: INSULATION BUILDING PERMIT
Permit BP-2017-0867
Project k JS-2017-001465
Est.Cost:$3600.00
Fee: $65.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: VALLEY HOME IMPROVEMENT INC 108772
Lot Size(sq.ft.): 10018.80 Owner: TORREY JEFFREY A&KELLY S&SUSAN E BANCALE
zoning_ Applicant: VALLEY HOME IMPROVEMENT INC
AT: 31 CRESTVIEW DR
Applicant Address: Phone: Insurance:
P O BOX 60627 (413) 584-7522 Workers Compensation
FLORENCEMA01062 ISSUED ON:I/18/2017 0:00:00
TO PERFORM THE FOLLOWING WORK:AIR SEAL ATTIC BASEMENT AREAS, INSTALL
GABLE VENTS, INSULATE SILL, INSTLATE ATTIC WITH 11" CELLULOSE TO BRING LEVEL TO
R49
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 1/18/2017 0:00:00 $65.00
212 Main Street.Phone(413)587-1240, Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
File#BP-2017-0867
APPLICANT/CONTACT PERSON VALLEY HOME IMPROVEMENT INC
ADDRESS/PHONE P O BOX 60627 FLORENCE (413)584-7522
PROPERTY LOCATION 31 CRESTVIEW DR
MAP 29 PARCEL 464 001 ZONE
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid 's
Building Permit Filled out
Fee Paid
Typeof Construction:_AIR SEAL ATTIC BAS T REAS, INSTALL GABLE VENTS, INSULATE SILL
INSTLATE ATTIC WITH II"CELLULOSE To: ! G LEVEL TO R49
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 108772
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INF9RMATION 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
40eD-
Signa f'uilding Official 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.
_Oepartamenl use ofy
City of Northampton status of Permit'
Building Department Curb CuVDnveway Permit
1 Z 2011212 Main Street 6ewerISepho Availmbillty
r Room 100 WaterWell Avall,bihly ii/
I1 Northampton, MA 01066 Two Bids of SirbcturaI Plans s r t.
1 1 phone 413-587-1240 Fax 413-587-1272 Plot/9tte Plans
OtherSpecify„ , 5r' ,_
APPLICATfON TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION l
1.1 Property Address: This section to be completed by office
31 Cres-tvlae DC Map Lot Unit_.
FICtreilCet MA 0(0603- 7.one Overlay District
Elm St District CS District.
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
k it 1f�rrcL 3! Cres(v(ete, Dr, Fttxence, MAOtcxo-
Nam (Print > Current Ma ling Address:
�t Telephone
// Sig atYe
2.2 Authorized Agent:
John Oernersk, 340 Rtv�tde Dr. Po Box, (06.032
, Name(Pri Current Mailing Address:
WWW �.�rt.._ y)3-581-75aa
Si' ire SIP telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
I. Building $ r 60
(a)Building Permit Fee
3000
2. Electrical '-fP (b)Estimated Fatal Cost of
Construction from(6)
3. Plumbing Building Permit Fee
4. Mechanical(HVAC)
5. Fire Protection / / -"_
6. Total=(1 +2+3+4+5) $%WI CO Check Number YIP e 0
This Section For Official Use Only
Building Permit Number Date
_........ Issued:
Signature: _
Building Commissioner/Inspector of Buildings Date
,raspy (ifit3�. of iatartfteimptun
G 4 dilassarf)uaettt
Citi„))...-wl..--11"\Thc:,;;,.
DEPARTMENT OF BUILD/NC /NSPEL'TIONS f-I\rjt 212 Main Street • Municipal Building
Northampton, MA 01060
LOIISFHASBROUCK BUILDING PERMIT FEES Phone: (413)587-1240
BUILDING COMMISSIONER Effective July 21,2008 Fax: (413)587-1272
•
DEMOLITION $ 20.00 ACCESSORY STRUCTURE
$ 35.00 PRINCIPAL BUILDING—Residential
$200.00 PRINCIPAL BUILDING-Commercial
'NEW CONSTRUCTION $ .50 per square foot for 1st floor
.30 " " 2"a floor
20 " " " " '/,floors,attic,basement,garage
STRUCTURAL ALTERATIONS IN ALL USE GROUPS
$6.00 per thousand dollars of estimated cost or fraction thereof,
with a minimum fee of$55.00
$25.00 WOODBURNING STOVE
*NEW ACCESSORYSTRUCTURES one hundred twenty(120)square feet and over
$ 20 per square foot with a minimum fee of$25.00
'NEW ACCESSORY STRUCTURES under one hundred twenty(120)square feet
$25.00 per inspection
'SWIMMING POOLS $30.00 for above ground
$60.00 for in-ground
'SIGNS&AWNINGS $30.00
'DECKS $50.00
REPLACEMENT WINDOWS $35.00
SIDING&ROOFING
Residential $35.00 per structure
Commercial $55.00 min.per structure OR$6M of estimated cost
TENTS $25.00
'ZONING REQUEST FORMS $15.00 (includes home occupation registration)
REISSUE OF LOST PERMIT $25.00
CERTIFICATE OF ANNUAL INSP. $100.00 (minimum)
Temporary Certificate of Occupancy $25.00
PERMITS REQUIRING ONLY 1 0)INSPECTION WILL BE A MINIMUM OF$25.00;ALL OTHERS WILL
HAVE A$50.00 MINIMUM. PERMIT FEES SHALL BE PAID TO THE ORDER OF THE City of Northampton
AND SUBMITTED,WITH THE COMPLETED PERMIT APPLICATION,TO THE OFFICE OF THE BUILDING
INSPECTOR. WORK STARTED WITHOUT PERMIT IS SUBJECT TO DOUBLE NORMAL FEE.
I! NO CASH -CHECKS OR MONEY ORDERS ONLY!!
Filing deadline is 12:00 pm(noon)on Wednesday.
r
Section 4. ZONING AU L rormacion Muni tie Cameteted Prompt Can be Derma Due To Incomplete Information
I_.—_ ___-- .- _
I -rVistmg Proposed Roomed by forting
Els pramero IA race m to
I oI 9/c1
1rcoo
ScIhads Front
>Wc ( ... Ill I R:
Ideal
f
Building I!eight --
Ilidg-Sym
rr w
a I outage j try
rspace I 'kc
ii 04 ti o. _._
i S opus bil iu
m .ed
molar
I-
n
e of lhdinu Ppm_._._
ir III
a,t4
A. Has a Special Permit/Variance/Findin ever been issued for/on the site?
NO Q DONT KNOW YES 0
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO Q DONT KNOW Q YES 0
IF YES: enter Gook Page and/or Document #
*SiB. Does the site contact a brook, bolls of water or wet ands? NO �C DGR KNOW Q Q
IF YES, has a permit been or need to be obtained from the Conservation Commission'
Needs to be obtained Q Obtained Q .�D�atte Issued.
C Do airy signs exist on the property? YES Q NO i/Y.
IF YES, describe size. type and location_ t" y
D. Are there any proposed changes to or additions of signs intended for the property ? YES Q NO IX7
IF YES. describe size, type and location'. �-+•
E Writhe nossncticon actrety doted : rearing graded -.vale^ or Ong,over I acre or IS°part of a common plan
ton disturb over asses YES Q NO 94
FYt S tries a Non l' Stony Water Mneagemern Ptc ma.rum me Jn, s emuved
r
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
1
New House In I Addition Replacement Windows Alteration(s) n Roofing '
Or Doors C
Accessory Bldg n Demolition n New Signs !DI Decks 10 Sid g i Other
Brief Deschqiron of Prcpo ed Ar a r e nen area_I f h5 a s/ a aye Y 5 insu '' -
a
Work Cllt tr :\ / „ ? Lose brt h'49
Alteration of existing bedroom Yes X No Adding new bedroom Yes � N
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll Sheet
sa 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 tamely unit Number of Bathrooms
c Is there a garage attached,
d Proposed Square footage of new construction Dimensions
e Number of stones,
f Method of beating? _ Fireplaces or Woodstoves __— Number of each
g Energy Conservation Compliance. Masschec& Enemy Compliance form attached,
h Type of consiruClion
Is construction within 100 ft of wetlands? Yes _ No. Is construction within 100 yr floodplain Yes No
Depth of basement or cellar floor below finished grade
k Will building conform to the Building and Zoning regulations, Yes No
Septic Tank City Sewer Private well City water Supply
SECTION Ta •OWNER AUTHORIZATION TO BE COMPLETED WHEN
i OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
IKettyT
- as Owner of the subtest
property p�
herb a ro ze �n i IP(A _L1 RNe1n 6/ 17) -( "FI
�to� on y behalf in all m eis relative tow k authorized by his buidnog pe mltj.pptroatton.
PSe tie e. : I 5117 --.._ _ ---- -
Signature of Owner Date
M(Ztty,t _1�rt N(LJe.N1e' Jelin De, l�-sk-a as Owner-Authonzed
Anent c -add declare Iliat+1'0 sc tt: e ens and 'nfoletlon on the foregoing appl catinn are true and acfcrate to the best of my knowledge
and twliet
Sig
astir' g e p _•re' tr ea 12'pe :Dry.
',.r � _m 7l Date,/5"
l
Sm n L Jne
•
•
E:..ON Z-CCJSTRJC.1CN SERVICES
E.1 Licensed Construction Supervisor: i Not Appicable ❑
Name of License Holder � (� j/S�l,/ _.CR —/OS'?2_�
Lmcre Number
qa Dun . . Sr _ FIooencz 1`1Kcioo z 9121/15Adore s `Expiration Date
a _ L/13 SYy- 75 3
Si nah - Telephone
J
9.Registered Home Improvement Contractor: Not Applicable 0
QGl' kk'14s1�1h��eniL - znc ios%u3
I Company a Registration Number
P,o : (oCloa7 fl oLerce Ha 016)&2_ -71/7110
Addre s Expiration Date
It : I
II . Talephonv/3-cRil-7S2
�
SECTION 10.WORKERS'COMPENSATION INSURANCE AFFIDAV T(M.G.L.c.152,§25C(6))
Workers Compensatmn 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 penmt
Signed Affidavit Attached Yes No..._. ❑
11. Home Owner Exemption
The current exemption for-homuownerj'or as extended to include Owner-occupied Dwell inns alonet1) or tant2i(firm lies
and to alluv such hamcooncr to eneapc an indix:deul for hire who does not posts a license.provided that the owner acts
as super:Gnr.C MR 780. Sixth Edition Section 108.3.5.,
Definition of Homeowner Person ls1 sho own a pared or a on'Mach he she resi,.L: or intends to reside,on which alive
_ t- ud to be,a one or ..r , lauhiy d..hchip4;„a.rached chruched cr or farm
., 'iconsidered A person who constructs more than one home in a tw -veer period shall not he a homeowner.
�
hh-: tthil.hrif IPt,;is tarn accc e r..o the Pauli thci i that hekhe shah hi,
sp
reon;ibie fur all such work performed under the buiMing permit. - _
As acting Convtrot-nonSupervisor your presence on the jun site :i11 be required i... a 10 tine.during ane upon
completion f te x
v, . s hick th f iss
n a ued.
Also Kv v with reference to CiLtpthr 152 t A onke , CI ,esa .v ,..d Chapter 1. 1 ..thflip, fEm; lcn erst
pt 'nitwits .. t ) .th rthro,. r4.s Ge:te s:mnrt_ m may be Itble r -us1N1
you hire pert, ..r e.ori ibr,.w:under this permit.
then umI1) certifies and hhunch rehhht rho t' fsr wtpitan cc'V it.[ Suite Buidin;.Code,City at-
HLaaHniptan f a:u.ance S e.. d..ova! Vonina i q e and SL±te Malssachuseths General l aws Annotated.
Homeowner Signature
F2¢ c,v.^B:F:rs roomier of /.f4s5&:Cf]¢>gG'ct9
--_ Department al Industrial Accidents
6069 Wasnxnbton Street
Rostra,MA 02111
www.d:8 aS.S.go v/dt w^.
. .,..nee..., _„ A. LAT,,r c Affidavit: f,iZdCCS/ 4s ecitiT fL:Ce 'iefanLff-oer9
ADElieant information Please Print Le2ibiy
Name (Business/Organization ndividual): Ai[(Gil-eU ktirnti. .1-WiCro(CiA'riAlie rior , To L,
l
Address: :J•--kb Q\t..-2e-co /\z �O`\�-2._p
City/State/Zip: t \ofefLC \ 1 `Ck_ 0I Ph e #: L{`3-- o�l-1 �ZZ
Are you au employer? Check the appropriate box: Type of project(required):
1.11,.] I am a employer with I B 4. ❑ I am a general contractor and 1
employees (full and/or part-time).''
have hired the sub-contractors 6. ❑ New conatmction
listed on the attached sheet. 7. ❑ Remodeling
2.❑ I am a sole proprietor or partner-
ship and have no employees These sub-contractors have g. ❑ Demolition
working for me in any capacity. employees and have workers'
coin insurance.« 9. ❑ Building addition
[No workers' tromp.insurance p' s- z_ .
required.] 3. ❑ We are a corporation and its ie.0 J':ee.Cert'cpa�.n e. ofditloos
eq ]
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
c. 152, 1 , and we have no
insurance required.] t (4)
employees. [No workers' 13.�Other Zpsula-kat-ion
comp. insurance required.]
*Any applicant that checks box#1 must also fill out section below showing their workers'compensation policy infonnatioa
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
>Confactors 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 that is providing workers'compensation insurance for my employees. Below is the policy and job site
information. A
Insurance Company Name: FixbeVA� Lin „'nnCe G COUP
t
Policy 5 or Self-ins. Lie. 0OCJSO6O"Z 1E Expiration Date: a 1 I I i7
Job Site Address: 31 Cres1vLet ) d - City/State/Zip: Fors to MA ol-(e
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 forth 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 hereby certify tri the pains and penalties o perjury that the information provided above is true and correct
ILO A
SS
CP
Signature: - lir 11i11ri22 /G'A . 141'"- ild%^' Date: I /5 / (7
Phone#: -l`-J"� J O`l^1J
Official use only. Do not write in this area, to be completed by city or town official
g r------or 7n-r• = r,gJ_iee,se#
i1 Issuing Authority (circle one):
I
1. Board of Health 2.iBuiiding Department 3.City/Town Clerk 4.Electrical inspector S.Plumbing inspector
II 5. Other
Co:.raet Person: Phone#:
� Massachusetts Department of Public Safety
Board of Building Regulations and Standards
License: CS-108772
Construction Supervisor
JOHN DEMERSKI "
72 DUNPHY DRIVE i=
, FLORENCE MA 01062 1 ;of _ - f_ , •
p 8 /
k'
IN..../...r". Expiration: I _
Commissioner 07/2112019
ilarisroti
Office of Consumer Affairs and Business Regulation
10 Park Plaza - Suite 5170
Boston, Massachusetts 02116
Home Improvement Contractor Registration
_ - Registration: 105543
Type: Private Corporation
Expiration: 7/17/2018 Tr# 419291
VALLEY HOME IMPROVEMENT INC.
STEVEN SILVERMAN
P.O. Box 60627
FLORENCE, MA 01062 --
Update Address :vss and return card.Mark reason for change.
,.r..., eaace. , ❑ Address l Renewal TTI Employment Lost Card
a%b.'C',-.,/,/,,r,ezpratia r t,//G,.,crb.ce//,
Office of Consumer Affairs&Business Regulation License or registration valid for individual use only
1 :° HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to:
a Registration: 105543 Type: Office of Consumer Affairs and Business Regulation
'. . t Expiration: 7/17/2018 Private Corporation 10 Park Plnza-Suite 5170
� Boston,MA 02116
VALLEY HOME IMPROVEMENT INC. / //6, / [
STEVEN SILVERMAN dJJ / �, i
340 Pav id=Dr. if". 111.111 / 1�1/T
_ _ _ JI<'vU >'lJi%I
Alocthampion,MA 01060 CndersecretaryNot valid without signature