32A-138 (111) BP-2007-0819
GIS#: COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
Lot:-006 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: BUILDING PERMIT
Permit# BP-2007-0819
Project# JS-2007-001338
Est. Cost: $25000.00
Fee: S100.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: Valley Home Improvement, Inc 060300
Lot Size(sq. ft.): 0.00 Owner: CHAMISA CORPORATION
zoning: ce Applicant: Valley Home Improvement, Inc
AT: 25 MAIN ST - #205
Applicant Address: Phone: Insurance:
P 0 Box 60627 (413) 584-7522 Workers
Compensation
F L O R E N C E M A 010 6 2 ISSUED ON:3/1/2 007 0:00:00
TO PERFORM THE FOLLOWING WORK:#205 - RELOCATE PARTITIONS, UPDATE
OFFICES & WAITING ROOM
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:
FeeTvpe: Date Paid: Amount:
Building 3/1/2007 0:00:00 $100.0022200
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo
File#BP-2007-0819
APPLICANT/CONTACT PERSON Valley Home Improvement,Inc
ADDRESS/PHONE P O Box 60627 FLORENCE (413)584-7522
PROPERTY LOCATION 25 MAIN ST-#205
MAP432A PARCEL 138 006 ZONE CB
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
BnildiggPermit Filled out �!�t�
Fee Paid al) `
Typed Construction; #205-RELOCATE PARTITIONS,UPDATE OFFICES&WAITING ROOM
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Str ore
Building Plans Included:
Owner/Statement or License 060300
3 sets of Plans/Plot Plan
THE FO OWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFO ATION 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 Streetnfission
Signature of Building Official Dar
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.
Version l.7 Commercial Building Permit May 15,2000
-a'rl'^'"t -i =F.= 443.
City of Northampton
Building Department
212 Main Street
Room 100
Northampton, MA 01060
phone 413-5871240 Fax 413.587-1272 _..
.
:PPLICATION TO CONSTRUCT, REPAIR, RENOVATE, CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING
OTHER THAN A ONE OR TWO FAMILY DWELLING
ECTION 1-SITE INFORM TIQ�N
.1 Property,Address" �(_- ?V J : . r.,. .ection to he completed by office
.s // /11Air���- 1 gide J
//lei 6
Zone �� ,rr �$ ve ristnd� `
lin rl O� )
r m a
r
ECTION.2-PROPERTY°OWNERSHIP/AUTHORIZED AGENT
.1 Owner of Record:
:ame(Print) ( Current Mailing Address:
inn!"a Telephone
.2 Authorized
Agent:
l. r A , 1<-
°Ll 1/4/
lame(Prin Current .0 •g 7Vs� V,06)1 V7? 0/00'
may/ /CIem cQfg/cif , Lzi - 7 5:1.2
Ignatu e �� Telephone
« 3S
ECTIOA'3'3*-ESTIMATED CONSTRUCTION COSTS
rem Estimated Cost(Dollars)to be " Official`Use Only
completed by permit applicant -
. Building
2. Electrical ;.(b)Estt Gd, 'Costof�
O� Limon ctiom(b3
ams„
3. Plumbing "Buddm¢PermYe
1. Mechanical(HVAC) 4le
s. Fire Protection .
3 Total (1 +2+3+4+5) a.r Q/�v Check Number.- " lf�
'z+ "This Section For Official Use.Only.'
3uilding Permit Number ' Date Issued:
ignafuFe:,.
C4t-A'T It BmfdingCdnmissionei1lnspector of Buildings Date
Versionl 3 Commercial Building Permit May 15,2000
CONS ORJa71'ON-$ERVICESCTS LESS
FOR PROJETHAN 35,000
UBI OF ENCLOSED SPACE. ,
tenor Alterations Existing Wall Signs Existing Ground Signs Additions 0 Roofing 0
0 0
xterior Alterations Demolition❑ New Signs [ ] Change of Use [ 3 Other [ ]
❑ 1 ��}} Accessory Building[ ] Repairs [ ]
RCW WBee- P-Tra.a: PC/069,e /,A>+8e/ .- 401414 iliC e'rti ) 9 !I/G)r/; AOM'
ECTION.5- USE GROUP AND CONSTRUCTION TYPE laco c,r&.c
USE GROUP(Check as applicable) CONSTRUCTION TYPE
Assembly ❑ Al ❑ A.2 ❑ A3 ❑ 1A i 0
A-4 0 A-5 0 1B 0
Business ,N[ 2A 0
Educational 0 2B 0
Factory ❑ Fl 0 F2 ❑ 2C 0
High Hazard 0 3A 0
Institutional ❑ 1,1 ❑ 1.2 0 1.3 0 ] 36 kw.
Mercantile 0 4 0
Residential ❑ Ril ❑ R2 ❑ R-3 0 5A ❑
Storage ❑ S•1 ❑ 32 0 56 ❑
Utility 0 Specify:
Mixed Use 0 Specify:
I
•
Special Use ❑ Specify:
PLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS ADDITIONS AND/OR CHANGE INUSE -
:isting Use Group: Proposed Use Group:
:fisting Hazard index 780 CMR 34): Proposed Hazard Index 780 CMR 34):
C bil.n3DISING.NEIGHT AND.AREA
BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION * s snxG ?1:. ---
oor Area per Floor(sf) 1p 4)/9r r
21113
,d 3rd $ �
d 4m 1
M1
ctai Area(sf) — Total Proposed New Construction (sf) .,y - ;, .w, bv.. , i.
.
)tai Height(ft) _ -
TotalHeightft ]
Versionl.7 Commercial Building Permit May 15,2000
Water Supply(M.G.L. c.40,§54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System:
Jblic ❑ Private 0 Zone: Outside Flood Zone 0 Municipal 0 On site disposal system ❑
S. NORTHAMPTON ZONING
Existing Proposed Required by Zoning
This column to be filled in by
Building Department
Lot Size ., ,,N
Frontage Iv U
Setbacks Front ,r It
Side L: R: L: R:
Rear
Building Height
Bldg. Square Footage
Open Space Footage
(Lot area minus bldg&paved
parking)
ii 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 t/ 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 th any proposed changes to or additions of signs intended for the property ?YES
No
IF YES, describe size, type and location:
Versionl 7 Commercial Building Permit May 15,2000
ECT $ESSION .05.0GN AI�U CONSTRUCTION SERVICES FOR t�Ut DINGS.,ANO STRUCTURES SUBJECT TO" ._
ONsT$ CONTRO PURSUANT TO 780 CMR 116(CONTAINING MORE THAN 35,000 C F,OF ENCLOSED SPACEr,-:
.1 Registered Architect:
Not Applicable 0
ame(Registrant):
'1 Registration Number
idress Y I
• Expiration Date
gnature Telephone
2 Registered Professional Engineer(s):
eme Area of Responsibility
ddress Registration Number
gnature Telephone Expiration Date
ame pi [ P Area of Responsibility
ddress Registration Number
Ignature Telephone Expiration Date
e
ame • Area of Responsibility
ddress Registration Number
'gnature Telephone Expiration'Date
ame Area of Responsibility
ddress Registration Number
gnature Telephone Expiration Date
.3 General Contractorcto
--111) U€y ft t -In via✓eoteevy, _Tr.) , Not Applicable ❑
Jmpa Name:
al 61 6O�17. /0 2Z'r✓ Mk CVO .)
esponsible In Charge of Construction
:dress
j/J} 37,4750);-
gnature
G ry )3nature Telephone
•
Versionl.7 Commercial Building Permit May 15,2000
CTION'lo STRUCTURAL`PEER RL.EVIEW(780 C R 11011) --'
dependent Structural Engineering Structural Peer Review Required Yes ❑ No 0
. ECT1011. 1rOWNER,AUTHORIZATION.b,TO BECOMPLETEDWHEN
WNERSTAGGEENT OR CONTRACTOR APPLIES FOR'BUIL"DING PERMIT 4723
/�� /�� /' 1 y �,/ /- , as Ownerofthe subject property
:reby authorize /V(LJ or)�///iT/IC// AK, 1%. J, stioe.ircl —P c to act on
y behalf, i all matters relative to or thorized by this building permit pplication. v
gnatur f Owner //���� /' ate
/'2/3M tcA1£/Jct71 , as Owner/ thorized Agent
areby declare that the statements and information on the foregoing application are true and accurate, to the es y
nowledge and belief.
igned under the pains and penalties of perjury
rip is2 //o/Jm kzTh, eC//c/71
Tint Name
/ • /L , 'MI Pan- ,a - a,•o7
gnature of Owner/Agent Date
E ,112 CONSTRUCTION SERVICES
0. - e• Construei•n •-rvis•r: // r Not Applicabl2e��❑�
ame of License Holder: WA- #9
ge atelf C60 • %CI
3 ��i� � License Num er
1/G /cuuerstde Ar• q/aa )ai
ddressExpiration Date
fiernJce (VIA- otos') ; YY-7,,
ignature - Telephone
3 ^.^x
Er9®..GTG^ksd OaRKe MP,ENSAT1oN1N5URANC AFFIDAVIT(MGL c.1520§12C(8)) ,
'a. $.4 am..-.n3aarier+IMf•eet..., ... _._ .•.ry ....-. .. . m. Ha.
Yorkers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit
vill result in the denial of the issuance of the building permit.
>igned Affidavit Attached Yes 0 No 0
112ce 111,..215 1
t BOARD OF BUILDING REGULATIONS
P. License: CONSTRUCTION SUPERVISOR
Number: CS 060300
�.. eirMdffia: 0922/1950
/ sec Expires: 09/222008 Tr.no: 1182.0
x - -.. _- -_ - Restricted: 1G
NELSON A SHIFFLETT
340 RIVERSIDE DR PBX60627 y� Lr /!
FLORENCE, MA 01062 Commissioner
c lite P��° A Z
A P Boar o ui ma e Regulations ani tan.ars str
ii q
��
One Ashburton Place - Room 1301
Boston. Massachusetts 02108
Home Improvement Contractor Registration
Registration: 105543
Type: Private Corporation
Expiration: 7/17/2008
VALLEY HOME IMPROVEMENT INC.
Nelson Shifflett _
P.O. Box 60627 _ --- ----- -
FLORENCE, MA 01062 -- -- --. -
Update Address and return card.Mark reason for change.
Address Renewal — Employment - Lost Card
OPS-CAI 0 SOM1404/OS-P08698
✓A.e6. nweeda ,,r' t(�sroc/w.> a
Board of Building R gulatiOns and Standards License or registration valid for individul use on Iv
5Q HOME IMPROVEMENT CONTRACTOR before the expiration date. I[found return [o:
Registration: 105543 Hoard of Building Regulations and Standards
Expiration: 7/172006 One Ashburton Place Rm 1301
Boston,Ma.02108
Type: Private Corporation
VALLEY HOME IMPROVEMENT INC.
Nelson Shiflen
340 RiversideDr ( ,,,,,---- —?A _
Northampton. MA 01050 Deputy Administrator Not without signature
to-ev
a4 ' fi CrifR of nrtl;antptnnattik
Wait r�9 iliaenedirsgte fa=
.. - DEPARTMENT OP BUILDING; INSPECTIONS
212 Main Street e Municipal Building
Northampton, Mass. 01060 ==�
WORKER'S COMPENSAnON ENSTIRANCE AFFIDAVIT
I, Nelson Shifflett _Valley Home Improvement Inc .
(Icznsc 1p.wittte)
with a principal place ofbusiness/residence at:
340 Riverside Drive, Northampton,MA 01060 (phoned) 584-7522
str^.eakitais:_tnn)
do hereby certify, under the pains and penalties of perjury, that
(N I am an employe:providing the following workers compensation coverage for m•=
employees working on this job:
A. I.M. Mutual Ins. Co_ WM28005610 01 2007 2/1/08
_....t
(insurance Company) (Peery :v.:
Nhcr) (Intraarafion Darr)
() I am a sole proprietor, general contractor or homeowner (a:cie one) and have ''aired
the contractors listed below who have the following workefs compensation policies:
(Name of Contractor) (insurance Company/Policy No mxr) (Expiration Dam)
(None of CactT'car) (tns rant Co.t.u:aiy'Pontry Number) :Expraaon Date)
(Name of Contractor) (lnsuana: Company/Policy Number) — tEx n:in Daze)
(Name of Contractor) (insurance Company/Policy Namber) (Expiration Date)
(auam additional sic=if=atom to mchtec Mormon paratagg to w maaw,:a)
{ ) I am a sole proprietor and have no one working for me.
( ) I am a home owner performing all the work myself
.NOTA plase be aware that while bmmwmaa.bo=player am to d ata n ,mom lima=au w:k w a dwethl for
rat rife then threeaab is ret&ttbe boweow s nada ca m the armadaapparta-smttorm us ori amcetWY coot m be
omaa uSde to mamacape=seim Act(GLr52yt(5)) npptiuoon bya emacomr fax Mame or perM maY etc the
legal 141010 atm=player under the Wakaa Comp®etien Aa.
I understood Mt a copy of 0:s mtme=may be forward=to tho Dgwmmt of loam=M=idas!Oboe of frost=for to
oov¢s{s vrioatiw and that fait tam=cova:ga unbar raxian25A;tMGL t52 coat fad to M Mat=data=pcdba
mairaag oft fine of up to{L$OO.00 saga'*Mamma of too ma Lad civil pcmltia mil=of a Step Wok Order and
Eno al 51.00.00•day ming m
Signed this /se' day of zoo/ For depetnets ,.ae only
Permit Number
HGL.Se 7 sH/ GL,7
`Yy1 • C ;iz 0.3-° w* 'v✓ lq
THIS WALL .-4-----,
RELOCATED C ` ''
THIS WALL REBUILT
FOR
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ffi
yil
pr
EIC �
i 1�4
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mage I micro by C5/TV
others
new 2x 2 suspended ceding
reuse sink and faucet exist door
I new base l wall cabs and laminate tops i — -- ��
- - - relocate door from 1.
p vinyflooran underlayment/refinish by others
yam)
�r�(I's1" 3 t49f{a 6 k0°C-11
H ---7 remove ad surface mount wire mold and conduit 3068
'� 4>
eMNea a. r/la
1. ebWkpanel
I1 I, euse entry door
1 _ t Liv I W II a and I -`_-
II ,
u, N I.� ' 1
{1hag 41
} - owners ��)
door
70 \ dv 6 �1
2668
<' new insulated partition I-
I
��) iamb and harp owners door
removed dedicated MIN.conduit,and wire isle /
I
mmeabb
rocka pi/1/4 do00yk,�
temoverk and I parallel x 3 ways/insulate for soundproofing
framing --.� OL
/� a/coax/phone
Fir ?
���J` el ` verity locations I•
.
0� phut; cmry •
\ 50 19)r C_ - elkninate v groove pbm and sheehock
\ / FFF""" hardwood floor refinish by / /
others
all surface thduresm remain {
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9 Is SOLIDAGO PHASE 1
e N y
minium' heal relocateby onions 111111111111E
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•
fridgeothers micro w osRV V_.
others
N
new 2x 2 suspended celing
N F reuse sink and faucet \ exist door
new base I wait cabs and laminate tops - -' ` 1
1 - relocate door from 1.
sip virryl door and undartaymeP. I refinish by others -
N \ ,.., ..
z ' ------11
- remove al surface mount wire mold and conduit 3068
11 l` _..
shelves I CP-
3
fi electric panel f(-1- -I a
reuse entry door A�
1 -box In waste Ilse and Meu----=�-- 1 I '
hew 1.1 L
s
ewlrsle f I
door
i 1111_K.,
hang r _ " ((5
111
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2668
1) new Insulated partition
iI)\
l jamb and hang owners door
remove all dedicated wiring.conduit,and wire mo II
N removeable '
N sheeUork and I parallel 2 x 3 walls/insulate for soundpraofmg
N framing _0
N I
c5/coax/phone
N
N l' 0 Cypvedfy locations
L.{ 7 )
C5/TV
/ C5/9V
cyry /
/ 0 I eliminate v groove pine and sheetrock
N /
/ hardwood floor refinish by
others
r
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all surface f lures to remain
N.
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SOLIDAGO PHASE 1
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