31A-166 (6) 88 MAYNARD RD BP-2018-1278
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,REPAIR BUILDING PERMIT
Permit# BP-2018-1278
Project# JS-2018-002276
Est Cosy, $11000.00
Fee: $77.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group STEVEN SILVERMAN 77279
Lot Size(sp.ft.): 7492.32 Owner: WYATTKATHERRNE
Zoning:URB000)/ Applicant: STEVEN SILVERMAN
AT. 88 MAYNARD RD
Applicant Address: Phone: Insurance:
268 FOMER RD
SOUTHAMPTONMA01073 ISSUED ON:6/512018 0:00:00
TO PERFORM THE FOLLOWING WORK REPLACE DECKING AND STEPS OF FRONT
ENTRY, NO CHANGE TO FOOT PRINT
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 6/5/2018 0:00:00 $77.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
File#BP-2018-1278
APPLICANT/CONTACT PERSON STEVEN SILVERMAN
ADDRESS/PHONE 268 FOMER RD SOUTHAMPTON
PROPERTY LOCATION 88 MAYNARD RD
MAP 31A PARCEL 166 001 ZONE URB((00)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
OSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid
Typeof Construction: REPLACE DECK STEPS OF FRONT ENTRY NO CHANGE TO FOOT PRINT
New Construction
Non Structural interior renovations
Addition to Existine
Accessory Structure
Buildine Plans Included:
Owner/Statement or License 77279
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFOIfMATION PRESENTED:
Approved Additional permits required(see below)
PLANNING BOARD PERMIT REQUIRED UNDER:§
Internediate 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
molition Delay
veofB ildin ficial 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.
Department use nnly
[ RECEIVE of lorthampton Status of Permit:
Bu din Department Curb Cut/Driveway Permit
31 2018 12 ain Street SewerlSeptic Availability
�AY Ro m100 Water/Well Availability
Nort amp n, MA 01060 Twa Sets of Structural Plans
DEPT.OF nuaVIW -1 0 Fax 413-587-1272 Plot/Site Plans
NORTHAMPTON.MA 01050 (her Specify
.APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR N40 FAMILY DI'VELLiNG
SECTION i-SITE INFORMATION
1,1 Property Address: � M n�✓QI This section to be completed
dd-by office
Map 3i,¢ Lot �V Unit
Zone Overlay District
Elm St.District CB District
SECTION 2.PROPERTY 01fVNERSHIPIAUTHORIZED AGENT
2.1 Owner.'.Record:
hCt�-ltevine ��" `BR M�tlana�l2� 17x-Fha��,.ofLn �-1i3- )oma
Nam (Pont Current Ma" gAtl ess:
W 7- X76—IC) 83
Telephone
Signature
2.2 Authorized Agent: - r
t er Po•6owt�oroa� P1otet-rcMRoto�2 !'
Warne(Pont) �Q0 Current Mailing Address:
`$3 SSLf-'15Ja
Signature Telephone
SECTIOtt 3•iwTNaATED CONSTRUCTiCCJ C To
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building 11 606 (a)Building Permit Fee
2. Electrical (b)Estimated Total Cost of
Conairuotlon from (61
3. Plumbing Building Permit Fee
4. Mechanical
5,Fire Pmtecfion
6. Total=(1 +2+3+4+ 5) (!OU Check Number 3b/9
This Section For Official Use Only
Building Permit Nur;,ber Dete
Issued:
Signatui
Surdin ommisinnarllnspector of Buildings Date
Section 4. ZONING All Information Must Be Completed.Permit Can Be Denied Due To I neomplete Information
Existimg Proposed Requued by Zoning
'@ie column to be fdkd in by
Building ncParYnenf
Lot Size
Frontage
Setbacks Front
Side L: - R: L: R:
RP.r
Building Height
Bldg. Square Footage %
Open Space Footage % i
(tut Brea mins bldg#Paved
eking)
#ofParking Spaces
Fill:
(volume&Loeafion
A. Has a Special Permit/Variance/Finding ever be n issued for/on the site?
NO O DONT KNOW Q YES Q
IF YES, date issued:
IF YES: Was the permit recorded at the R istry of Deeds?
HO DONT KNOVd YES
IF YES: enter Book Page and/or Document#
B. Does the site contain a brook, bod of water or wetlands? NO DON'T KNOW YES
IF YES, has a permit been or ed to he obtained from the Conservation Commission?
Needs to 6e obtained Obtained O Date [slued:
C. Do any signs exist on the roperty? YES 0 IJO Q
IF YES, describe siz , type and location:
D. Are there any pro Deed changes to or additions of signs intended for the property? YES V NO 0
IF YES, aesci De size, type and iocavon:
— -- _.r,;... _s — r c,. ,pen
thatwilldt wbaver1acre? YES`O JO O _,
IF YES,then a Northampton Stone Water management Permit from the DPW is required.
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all aonlicablel
New House ❑ Addition ❑ Replacement Windows Alteration(s) 1' Roofing ❑
Or Doors E
Accessory Bldg. ❑ Demolition ❑ New Signs jo] Decks (� Siding iC7] Other[[]J
Brief Description of Proposed
Work: RCFL&(-C PISGI d6 4 STt' OF F+LrNT L�r(Zy- f D C.Nfl� ae
;� ; r✓o cum E
Alteration of eusting bedroom_Yes 7A No Adding new bedroom Yes -,/— No
Attached Narrative Renovating unfinished basement Yes NorD 57,9 ].f CTU4 IL
Plans Atth dR ll -Sheet til0 r'e 10✓V, '6 _
Oa.if Nev✓house and or addItlon to ezlsting housing complete the follottl
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?
it. Proposed Square footage of new construction. Dimensions
e. Number of stores?
f. Method of heating? Fireplaces or Woodstoves Numberof each_
g. Energy Conservation Compliance. Masscheck Energy Compliance farm attached?
h. Type of construction
I. Is construction within 100 ft.of wetlands? Yes We. 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. =epiic TsnkCifY Sewer -...ata weii City e:aier Suppiy_
SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I, 1�A91.1 LPN LM l�} as Owner of the subiect
property C
hereby authorize t �C'3g'2A1 rT�trL'✓I'I"@h
to act on my behalf,in all matters relative to war authorized by this building permit application.
Signature of Omer ` 1 Date
@Y� t^ and mfonnyN'Z as Gansu .,c�oriaau
Anent hembv declare that,the statemenafuor,an thabrec r-appiwauon aie au=end acwi>s.to the bas.of my knavaledca
Signed under the pains and penalties of perjury.
�V2XYr`G�
Print IJame
I
/ 5'
SECTION d-CONSTRUCTION SERVICES
o.t Licensed Construction Supen isor: Not Applicable 11Nameoi License Roltler: S\l�Vdfl ..J1`��,'�V'V1Q'-�� f�7—I �D 9
n C License Number
ae CCriVP� i;` J.1� fit, � l; -� so
AtlEress� ^ ,A,/ /� E.piraiion Gate
F���
Signatu a Telephone
9.Registered Rome Improvement Contractor: Not A.ppfloable ❑
�1\�hvv�rti IO�Sy3
Company Name Registration Number
Address r Exprafon Date
Ai�e��� YEIIy��t`G� Telephane��f`-1iJ��-
SECTION 10-WORKERS' COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152,§25C(0)1
Workers Compensation Insurance affidavit must be completed and submitted with this application.Failure to provide this affdavitwill result
in the denial of the issuance of the building permit
Signed Affidavit Attached Yes....... % No...... ❑
Home Owner E+ gee nflo m
TI- -'r_ ._. - oft ., .. --e _ d-d ro iv_I�d per-ucr�tr ed Dwe[ra ee c ¢ [ , Ina_.Jiee
<n-r - ,:.� �- vr:,
sad to allow such hpmec car to eag ge au individual for hire who does got possess a Loma,,pe`vddeel ih€C dee oaose eels
as£upen'laor.CUR 790, Sixth Edition Secdor,EPS.3.5.1.
Definfitdon ofldomeowner:Person(s)who own&parcel ofland on which he/she resides or intends to reside,on which there
is,or is intended to be,a one or two family dweWug attached or detached strucams,accessory to such use and/or farm
structures.A go r=m"^who tru t then one h ame in a two-year period€hall net he con€ldered a hnmepwner.
Such`Ttomeowner"shall submit W the Building Official, on a form acceptable to the Building Oficial.fhat Ile/sire shah be
nerprmal,le f 11 suchwork pformaed a odorth e buiidi PernalL
As acting Cousin uctlan Supervisor year presence on die jbe site will be required fiorn time to rime,during and upon
completion of the work for which this pemut is issued
Also be advised that with reference to Chapter 152(Workers'Compensation) and Chapter 153 (Liability of Employers to
Employees for injuries ant resulting in Death)of the Massachusetts General Laws Annotated,you may be liable for person(s)
you hue to perform work for you under this permit
The undersigned"homeowner"certifies and assial responsibility for compliance with the State Building Code,C5ty of
Northarapthn Ordin&nces,State and local Zoning Laars and State of M rosachuse'ts Genual Laws Annotated.
1-s�eoaaer Ss e
City of Northampton 3121,4ain Street, Northampton, MA 01060
Solid Waste Disposal Afndaeit
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
^G, L''�ffc 111, S 150A.
jVUI
Address of the work: AL bd ICI�C�
The debris will be transported by:
The debris will be received by:
Building permit number: p ' ��
Name of Permit Applicant vYiQQIlA �rwfl ��t� �?1�PXYtQJ17�
5hLdl)
Date Signature of Permit Applicant
The Commonwealth ofMassachusett
r- Department ofladustrial Accidents
. �u'` 0rpee ofInves4igations
600 Washing-ton Street
- Boston, MA 02111
wvrw.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Organizatiou/Individual):
Address:
( C \ yCity/State/Zip: hone
Areir
you an employer? Check the appropriate box: Type of project(required):
1.3 I am a employer with y ZJ 4. ❑ I am a general contractor and I
employees(full and/or part-time).* have hired the sub-contractors 6. E]New construction
2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling
ship and have no employees These sub-contractors have g. ❑Demolition
workingfor me in an capacity. employees and have workers'
- Y P ty 9. ❑ Building addition
[No workers' comp.insurance comp. insurance.t
required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions
3.❑ I am a homeowner doing all work officers have exercised their I1.❑Plumbing repairs or additions
myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs
insurance required.] t c. 152, §1(4),and we have no
employees. [No workers' 13.❑Other
comp.insurance required.] 11
*Any applicant d at checks box In most also fill out the seetion below showing thew workers'compensa6m policy ivfoemazioa
t Homeowners who submit this affidavit indicating they are doing all work and Nen hire outside contractors most submit a new affidavit iodinating such. '
tConiractms that check this box must attached an additional sheet,bowmg the name of the sub-contractors and state whether or not tbose entities have
employees. If the sub-contractors have employees,they roast provide their workers'camp.policy number.
I am an employer that k providing workers'compensation insurance far my employees. Below is thepolicy and job site
information.
tn�
Insurance Company Name: 91"J bQ 1.�C�. CSl�fC2 -t'_ L7 f CXJ�
Policy M,. rSa: . a. r,a1 __Expi-rmon Date: '1 9 -
Job
_Job Site Address:�� no City/StateMp:_ , ' ,tn V/
75L
Attach a copy of the workers' clompensation policy declaration page(showing the policy number and eapilrafion date).
Failure to secure coverage as required under Section 25A of MGL c.152-canlead 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 fire
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 $cation.
I do hereby cerfify the pains o dpenaki perjury that the information provided above is true and correct
Signature" [- - dl .7J'A��^' Date
Phone#: U� Cb aa
Official use only. Do not wrihB in this area, to be completed by city or town official
City or Town: PerntttUcense 4
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3.City/T'owu Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: :,Sole R:
®� Commonwealth of Massachusetts
Division of Professional Licensure
Board of ls.dding Regulations and St,odardx
C o n s t�yct�rf ISr iS j,�ry i s o r
i
CS-077279 ,> h E4[pires. 06121/2020
STEVEN AS'LVERMAfJ� � .
268 FOMER RO
SOUTHAMPTON--r,A 01073>
COmrn Is510ner
� ��ie �paayi>72o�nnu�Ea� a�C>GZa��i�e�
L14—
Office of Consumer Affairs and Business Regulation
10 Park Plaza - Suite 5170
Boston, MassaChpsetts 02116
Home Improvement goniactor Registration
€ - Registration: 105543
Type: Private Corporation
Expiration: 7/17/2018 Tr# 419291
VALLEY HOME IMPROVEMENT INC 7
STEVEN SILVERMAN hi
P.O. Box 60627 = �:
FLORENCE, MA 01062
' Update Address and return card.Mark reason for change.
scat r mMosnr [] Address D Renewal ❑ Employment n Lost Card
Cdonne . a/Cr " c/auvefG
Off fCovsumer Afi a&Businmc,aess Re ulafion License or registration valid for individual use only
HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to:
Registration -105543 Type: Office of Consumer Affairs and Business Regulation
Expirat1cm 7L17/2018 Private Corporation 10 Park Plaza-Suit.5170
d _— i Boston,MA 02116
VALLEY HOME IMPROVEMENT INC.
STEVEN SILVERMAN
340 RlversideDr
Northampton,MA01060 Undersecretary Not valid without signature