22B-112 53 Meadow St 53 MEADOW ST BP-2018-0138
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:22B- 112 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-2018-0138
Project# JS-2018-000250
Est. Cost: $119250.00
Fee: $780.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: VALLEY HOME IMPROVEMENT INC 105543
Lot Size(sq. ft.): 12806.64 Owner: BUNK BRIAN D&LAURA P SIZER
Zoning: URB(74)/URA(26)/WP(23)/ Applicant: VALLEY HOME IMPROVEMENT INC
AT: 53 MEADOW ST
Applicant Address: Phone: Insurance:
P 0 BOX 60627 (413) 584-7522
FLORENCEMA01062 ISSUED ON:
TO PERFORM THE FOLLOWING WORK:ADD A LEVEL ABOVE EXISTING GARAGE W
FULL BATH
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 $780.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
File#BP-2018-0138 53 dA-ci J r
APPLICANT/CONTACT PERSON VALLEY HOME IMPROVEMENT INC
ADDRESS/PHONE P 0 BOX 60627 FLORENCE (413)584-7522
PROPERTY LOCATION 53 MEADOW ST
MAP 22B PARCEL 112 001 ZONE URB(74)/URA(26)/WP(23)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid 7 t) O CY
Building Permit Filled out
Fee Paid , . - T ,
Typeof Construction: ADD A LEVEL ABOVE EXISTING GARAGE W FULL BATH ` '
New Construction * SEE MPI� ii.,it1 4 r4614.5
Non Structural interior renovations
Addition to Existing a+i't3 '+ b
Accessory Structure
Building Plans Included:
Owner/Statement or License 105543
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON \'a--3'
INF ATIONP SENTED: f s S
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
Demolition Delay
c7e..--, /lA."—At-N-g €411-7
Signature of BuildingOfficial
g 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.
Deca-rimenT use only
...-----
City of Northampton Status of Permit:
Building Department Curb Cut/Driveway Permit
i.,-•- ' , 212 Main Street Sewer/Septic Availability
(::k
\
\'\ 0 41.
1 '' Room 100 Water/Well Availability
f rthampton, MA 01060 Two Sets of Structural Plans
.,..,15 bfika -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 1p- 1 -1 E
This section to be completed by office
1.1 Property Address:
53 MeadoLo arecA- Map 4z=f). Lot //GI. Unit
'M'ertc-C-- Zone Overlay District
Elm St District CB District
SECTION 2-PROPERTY OWNEP.SH!PIAUTHOR:ZED AGEMT
2.1 Owner of Record:
exna_n ELY& Ar- . (&-2..,C,1-- 6:?:D\-Atia(A01.L:)Cr A-1,o,reacc HA- o
Name(„72,..,....P• ...-- ,) Current Mailing Address:
Telephone
Signature
2.2 Authorized Agent:
LD\-e_o:V\ein k-v cl-k-ri VC) ,e (cocc,,..)-) c,(0,-?c( 11/4-44 OO( ?—
Name(Print) Current Mailing Address:
9-_-71--, 7.X7.
Signa-tura, Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
: !te:-:- E, ,-.,:.:.-::r;c;El:•-;-c;ii,747,: 1,-,;-,,,-- :.177;t- , *:,.,_ ;-,,!1,,,
I. Puilding I 0&-/ 0°0 (a)Building Permit Fee
2. Electrical ii)-70 0 (b)Estimated Total Cost of
Construction from (6)
• P3 lum!!ncl5 () . Eulioing Permit Fee 1
I ) 50
4. Mechanical(HVAC) 5?00 1 SO
5. Fire Protection
6. Total=(1 +2 +3+4+5) ' 19) @-50 Check Number '-Y1 /7J
This Section For Official Use Only
Date
Building Permit Number:
!ssued: !
1 . i
DE.te ;
---
Section 4. ZONING Ait Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information
Existing Proposed Required by Zonhig
This column o be filled in by
Building Department
Lot Size
Frontage
Setbacks Front
Side L:L. ,_ L �
Rear
Building Height
Bldg.Square Footage m
~~
Op�G��F��� m ~
(Lot area minus bldg&paved
parking) |
of Parking Spaces
Fill:
(volume&Location)
A. Has a Special Permit/Variance/Fidi g ev r been issued for/on the site?
NO 0 KNOWDONT � �' YES `~// l
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0��/—\ DONT KNOW L/
YES /—\
IF YES: enter Book Page and/or Docurn•=nt #
E,. 'Does the site contain a brook, body of water or wetlands? NO DONT KNOW U YES � l
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained \�//—� Obtained /\.�—� Date !ssued��
,
C. Do any signs exist on the property? YES /—\ NO / `/
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property ? YES 0 NO
IF YES, describe size, type and location:
�
Will the construction activity disturb ( rinO. grmding tion. or�|!ino)over 1 �drporisaDar!crpr��'�~" "'~=
.„ *u [^�
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
New House [1] Addition g-'/ Replacement Windows Alteration(s) Roofing in
Or Doors D
Accessory Bldg. El Demolition Fl New Signs [0] Decks ED Siding[0] Other[0]
Brief Description of Proposed
Work: /7120-- -& 7JEZ_ /1fidve;-- e.-;---)e/c77,1/6 0 ;&---
Alteration of existing bedroom Yes 171\---lo Adding new bedroom i"-----Yes No
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: B Number of Bathrooms . S
c. Is there a garage attached?
d. Proposed Square footage of new construction. c2-8 Dimensions Z
e. Number of stories?
f. Method of heating? f1ItJ 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? No.
I. Septic Tank City Sewer Private well City water Supply
EC iiOi
7a- 'c. LETi
OV;:r-ZiERS A.C.ZI.4TO COWIRACTOR FO W;.•RUE! rtlt\r:PERT
I, XVI() Q:ar-r) .-- \--"CW-va- ,as Owner of the subject
property
-
hereby authorize 'CY\ \4".74.
o ac- wip? be It, in all ma"er relative to York authori7-• by this building permi application.
Signature of Owner Date
- • - - _ - _ ,
I, ,.)\-"-e' Ne\C*Th *\; , as Owner/Authorized
Agent hereby declare that the statements and information on the forecioine ephlicetion are true and ar.cur,f-','",e, to the test cfiy
and belief.
Signet uncer me pains and penalties of neriurv.
erint Name
512-7' g6/1-/6"- 7/2-7/7
Signature o wner/Agent Date
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable 0
•
Name of License Holder: ver, 4
License Number
\ \ \-1 \t
Address Expiration Date
Signature.71/
5-46„.t
Telephone
9. Registered Home Improvement Contractor: Not Applicable 0
k0c3-3(k3
Company genie Registration Number
, 6c* 42 Du7,D71 )1%- 5,002_ 1ln \
Address Expiration Date
Telephone
I —
SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152,§25C(C))
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 0
11. — Home Owner Exemption
The current exemption for"homeowners"was extended to include Owner-occupied Dweilinns of one(1) or two(2)families
and to allow such homeowner to engage an individual for hire who does not possess a license, rovided that the owner acis.
Itr.3er,-Ykor.CMR
(S)who ov,'n vesicles or ifiatitiS -"J (“1 Whidi thL7i1_,
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
res t onsible for all such work performed under the buildin. emir.
As acting Construction Supervisor your presence on the job site will be required-F,em time Lu tim;Juriog ai.d upoll
completion of the work for which this Dei-mit 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__
Massachusetts Department of Public Safeti
'14) Board of Building Regulations and Standard.i.
License: CS-079092
Construction Supe.visor
STEPHEN G FIFIELD - I
54 LONG PLAIN RD
S DEERFIELD MA 01373
• //: Expiration:
dorrmissioner 12/17/2013
CDT/
CefaMMag
'8 Office of Consumer Affairs and Business Regulation
, 10 Park Plaza - Suite 5170
Boston, Massachusetts
A',1 1 r
Home improvement Contractor Registration
Ragistration: 105543
Typt.: Prive Corr2or2tior.
Expir.ltion: 7/17/2018 T 419201
VALLEY HOME IMPROVEMENT INC.
STEVEN SILVERMAN
, _
P.O. Box 60627
FLORENCE, MA 01062
Update Addre and return card.Mark reason for change.
0
SCA 1 20M-05/11
Address n Renewal 7 Employment 7 Lost Card
0
Office of Consumer Affairs Se Business Regulation License or registration valid for individual use only
1-4)—d--P-1.-- HOME IMPROVEMENT CONTRACTnR before the expiration date. if found return to:
71.7.• Gr -af CO3170,7
-x-piration: 7/I-02U18 Private Corporation OtlAtC IV
Boston.MA 17,21115
wilt ay!..rmc. !!‘irprvamaNT!Nr,
-
STEVEN SlLVERMAN
I
140 Rivgrsd=nr ,
- - - -
t40,-Th?rop,on, mi.., (yl(:)P.1)
Undersecretary Not valid without signature
.. .
..:__..
• ,
of Industrial Accadents
, . ..
P--77-0 r•ri'...,,,9,:lis-,ri;TIv
-.4,---- -:„" ---e-'---ay--'-
600 Washiraton Street
'a
Boston, MA 02111
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Organization/Individual): . I, ' L i •C -.\- a a C.N.,' , `.,i -- 1-n(___,
Address: &\ qk -.)"-e_.1r: \o‘C 1/4.-)(.k Q ----
City/State/Zip: A- 10f-eace, c\(\ck_ o\-Phone#:
Are you an employer? Check the appropriate box: Type of project(required):
1.EA I am a employer with 1B 4. 0 1 am a general contractor and I
6. 0 New construction
employees (full and/or part-time).* have hired the sub-contractors
listed on the attached sheet. 7. 0 Remo
2.0 I am a sole proprietor or partner- Remodeling
ship and have no employees These sub-contractors have 8. 0 Demolition
working for me in any capacity. employees and have workers'
9. ri Building addition
[No workers' comp. insurance comp. insurance.
required.] 5. 0 We are a corporation and its 100 Electrical repairs or additions
3.0 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. ,
IContractors that check this box must attached an additional sheet showing the name of the sub-contractors arid state whether or not those entities have
employees. If the sub-contractors have employees,they must provide their workers'comp.policy number.
- . -- - - -- - -
Jan:an employer that is providing workers'compensation insurance for my employees. ''`elow is the policy and fob site
inform-ti,..1.
f r C'
Insurance Company Name: S-0( Di::\10- (kl_,(EDi_‘).c-ca 5-16— -1 . r P,'-- -
..---
r,
Policy if or Self-ins. i iC.if: r.),D:-1.F-DC-,'f-3)k-.):- ‘ '---' Expiration Date: c:T.--t I , 1
Job Site Address: 53 1-1(''2d62.0 (9-vier-I- City/State/Zip: RA:key-2c( H& 0
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 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 certify1_ikerr-the pains a#d penaltieka jperjuay that the information provided above is true and correct.
4c
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;i Le..„,....._ A....-.......,:.,-., .e.........-., __.....,-.. 1!
aO•aileltle 1-114“...111•, b u-am•.- u.. iv.... .
11 1. Board of Health 2. Build.inu Deloartr=nt 3. 1,- ://Town Clark 4. Elo,ctr:zol imszortox 5,1-7"..7...1_117*.f.7,-.5 inczy3c,-,c_vr li
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II 6. Other .,