44-105 399 ROCKY HILL RD BP-2019-1181
GIs#: COMMONWEALTH OF MASSACHUSETTS
Mao:Block:44- 105 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit, Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Cateaorv: INSULATION BUILDING PERMIT
Permit# BP-2019-1181
Proicct# JS-2019-001915
Est. Cost:$10818.00
Fee:$71.50 PERMISSION IS HEREBY GRANTED TO:
Const,Class: Contractor: License:
Use Group: VALLEY HOME IMPROVEMENT INC 077279
Lot Size(sa.&): 77972.40 Owner: TOWLES KATHLEEN D&ANNA M BRICK
Zoning, Applicant: VALLEY HOME IMPROVEMENT INC
AT.- 399 ROCKY HILL RD
Applicant Address: Phone: Insurance:
P O BOX 60627 (413) 584-7522 Workers Compensation
FLORENCEMA01062 ISSUED ON.•412412019 0:00:00
TO PERFORM THE FOLLOWING WORKATIC AIR SEAL AND ATTIC INSULATION
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:
Drivexay 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 S anamre•
FeeTYpe: Date Paid: Amount:
Building 4/24/2019 0:00:00 $71.50
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck-Building Commissioner
The Commonwealth of Massachusetts
° Board of Building Regulations and Standards FOR
oMassachusetts State Building Code,780 CMR M[TNI�AL=
t, Building Permit Application To Comstruct,Repair,Renovate Or Demolish a Revised Mm 2011
?o M One-or 7bra-Family Dwelling -
�" ':-This Section For OfHcia]Use DW
De Applied:.
Z-32o1q
N
iBdilding 0 'el(PridtName) . . ; ...,—' . . . �:Sigoab¢d .:.. .:..:>•.. :. : ... .., Date
.".'SECTION 1:SITE INFORMATION
1.1 Property Address: 1.2 Ass o Map&Parcel Numbers
399 vc). ,, Hf11R../ ttlorev-Ce- / 47 105
I.la Is this an accepted s[reet7 yes,_,L,_, no Map Numb. Parcel Numb.
1.3 Zoning Information: 1.4 Property Dimensions:
ZoniogDistrict Proposed Use Lot Arca(sq ft) Frontage(ft)
1.5 Building Setback.(ft)
Frurn Yazd Side Yards Res,Yard
RcgWmd Provided Required Provided Requhed Provided
1.6 Water Supply:(M r4.L e40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public❑ PrivaR❑ Zone:_ OotsideFleod Zone? Municipal O On site disposal system 0
Checkifyss0
.. .. .: . ,
'SECTION 21 PROPERTY OWNERSH]P' -
2.1 Owners of Record: r-
14n1-lti1PPt, Ce. HA (�IOE2
oma(Nint) ca y,S ate zu
1413- S94- 21s}
No.and Street Telephone F.nrail Address
SECTION 3:DESCRIPTION ONPROPOSED WOW(check all that apply) -
New Construction 0 14astmg Building O- I Owner-Occupied ❑ Repays(s)�❑4 Alteralion(s) 0 Addition 0
Demolition O Accessory Bldg.❑ Number ofUuits Offier yrr SpxAy:
Brief Description of Proposed Works: " 0 ,'r I
SECTION,4:ESTIMATED CONSTRUCTION COSTS -
Estimated Costs: "
Item - Official Use Only .
(Labor and Materials
1.Building $ I. Building PeunkFee:$_Indicate Low fee is determined:
2.Electrical $ ❑Standard City4own Application Feo .._.
0 Tout Project Cost'(Item 6)i multiplier x'
3.Plumbing $ 2. Other Fees:
4.Mechanical (HVAC) $ List
5.Mechanical (Fire $ Total All Fees:$
Suppression) CheckN.M, Check Amount: l��cash Amount:_
6.Total Project Cost'. $ 1081$ . 36 ❑paid in F5il1 0 Outstanding Balance Due:
` :- SECTIONS: CONSTRUCTION SERVICES
5.1 Construction Supervisor Licenge(CSL) WDlidon}
C]'I we/ �erV Cr.I'IM a N ber Exp- s-- 'on Date
Name of CSL Holder
e(seebelow)�_
No.and t'�p rinn2� dl
No.end Street ;-Description
Umestri A l u d n o 35,000 c¢8CiTy/Town,Store,ZIP Restricted 1&2 Femil MaloRoolm CovWindow and Si 'Q/�•JomI�, ,�, Solid Fuel Buming Appliances
413-584-�sz 2. ` &,fQwlfea�ww.-iw.orov .n.ea'�. Insulation Tel one )3�iei1 ad emolidon
5.2 Registered Home Improvement Contractor(HIC)
� ILOSS 43
S 1pr�o o ,- 11 _ HICRegisuationNumber Esp'uadonDate
HIC yNeme or HICRegL •mtName l
P
ryp,and so-eet 0 x G n 2} <T¢ve�va�lew Rail d mA wen uuf> u ,
as
%- LQyek_CR_ }.(xF 106Z 413-584 -�SZZ
City/Town, State ZIP Tel hone
SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L c.152.§25C(6)
Workers Compeasadoa Insurance affidavitmust be completed and submitted with this application Failure to provide
this affidavit will result in the denial ofthe Issuance ofthe building permit
Signed Affidavit Attached? Yes..........�Y No...........11
SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FORBUHAING PERMTT
I,as Owner oftbe subject property,hereby authorim
toact /my behalf,in all matters relaattive m work authorized by this building permit application.
Print Owner's Name(Elecnonic Sigoatere) Dan,
SECTIOrN 7b: OWNER'OR AUTHORIZED AGRNT DECLARATION
By entering my name below,I hereby attest under the pains andpenaltim ofperjurythat all ofthe information
contained in this application In true and accurate to the est ofmy knowledge and understanding.
Punt Ownet's or ANhorixd Agent's a�+,lectronic e) 2 Z Date
. .NOTES: .
I. An Owner who obtains a building permit to do Mather own work,or an owner who hires an unregistered contractor
(tot registered in the Home Improvement Contractor(HIC Program),will nnthave access to the aibitration
program or guaranty fund under MG.L,c. 142A.Other important information on the HIC Program can be found at
wwwmmss eov/oca Infomta[ion on the Construction Supervisor License can be found at www mass oe v/dos
2. When substantial work is planned,providothe information below:'
Total floor area(sq.ft.) (including garage,fmished basement/attics,decks or porch)
Gross living area(sq.ft) Habitable room count
Number offireplaces Numberofbedrooms _
Number of bathrooms Number of balf/baths
Type ofliealing system Number of decks/porchea
Type ofcooling system Enclosed Open
3. `Total Project Square Footage"may be substituted for"Total Project Cost"
it®f Conimoow ea 11 h oRnassarbusel is
1 Divlsan of Prolessolel Licensure
Eoard of Budding Reguiauons end Sla ntlams
CansiwSYlcn'S`0perviwr
i
CS-077279 E3�1ues. 0 6121/2 0 2 0
STEVEN A SILVERMAN
266 FOMER ROAD
SOUTHAMPTONN,A 01073:
Commissioner C14
Office of Consumer Affairs and Business Regulation
One Ashburton Place - Suite 1301
Boston, Massachusetts 02108
Home Improvement Contractor Registration
Type: Corporation
VALLEY HOME IMPROVEMENT INC - Registration: 105543
Expiration: 07/16/2020
P.O. BOA 60627 --
FLORENCE.MA 81062
Update Address and Return Card.
OHi[e al Consumef AHeirs 8 Business flegNatiun
HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only
TYPE:Corddo3tbri before the expiration date. If found return to'.
Reyi,stration Eix i von Office of Consumer Affairs and Business Regulation
105513'sr.- 07j 16%1020 One Ashburton Place-Suite 1301
VALLEY HOME rAPROVEMENT INC Boston.MA 02100
SfEVEH2 SILVIFRMIAN
340 RIVERSTF011.
NORTHAMPTON.MA oio6z unadfaanrarary Not valid without signature
ACC)R& CERTIFICATE OF LIABILITY INSURANCE
wro9nma
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURERIS),AUTHORUSID
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT. Nth.eeHM;;.holder Is an ADDITIONAL INSURED,the Imliry(lea)must have ADDITIONAL INSURED provisions a bo endorsed.
N SUBROGATION IS WAIVED,subject to the term.and conditions of the paoy,oerialn policies may require an andonameM, A Statement on
this wrtltieate does not carts rights to the certhicate holder in Neu of such endonsi maot(s).
PRODUCER NAME. Rate.GrynW.I.
Webber B Gdmeil Pxal1E (d13)SB6-0111 Cxe Id13)S68b461
8No&IG,Seem Ag0PE66: bpynkicm.@Hebbeondgnnoell.com
IxaURFRpIAFroRD.la coveRAae 4Am.
NON18mptnn MA 01060 Madness AIbBNe PrmBLtlnn 41360
INSU. xw ts", Mole Indemnity 10017
Velloy Home Ynpmvement,Inc. NSURPAC:
Atm:Steven SiNermm FISURE.D'
P 0 Box 80627 .IaURFR E:
Florence MA 01062 NUMBER F:
COVERAGES CERTIFICATE NUMBER: EV211QO REVISION NUMBER:
THIS IS TO CERTIFY THATTHE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEDABOVE FOR THE POLICY PERIOD
INDICATED, NOTMI"STANDINGANY REQUIREMENT,TERM OR CONDITION OFANY CONTRACT OR OTHER DOCUMENT WITH RESPECTTO WHICH THIS
CERTIFICATE MAYBE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLU610NSAND CON091ONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PND CLAIMS.
LIR TYPE a a011RANCE ppLILV NInIBE. "No al UNITS
COMY61LYLLaXEML LAS— EAd OCCURRENCE 3 I'am'ODB
CLAIMSMFOE ®OCCUR PRBABEe E.xamnm f 100,000
MED Exv An m ,wni b 5,000
A 8600063755 02OV2019 02101)2020 PCRSONALSAOVINJURY L 1.000,000
GENLAGGREGATE LMRAPPLES FER'. GEHERALAGGREGATE f 2,000.DDO
POLICY®jER�d LOC PRCDUCTG�GOMPgPAGG f 2,000,000
OTXER:
AIITOxONL.LMeYTY M w L f 1,600,000
ANTAUTO sonaywURY(Pvpnm) S
A OWNED SCHEDULED 1020037691 0210112019 0210112020 awav HNURv IPn.we=..11 S
MIiOe Ol0.Y AUTOS
HIREDNMHCW O DMDAVAGE b
AUTOS ONLv pUTW ONLY ..l
Uninst ed muton"I b 100,000
UN.RELI. °CLLR EACH OLCURPFNCE f 5,000,000
A ExOEsa MAe CIvv.F 460DG63756 OM112019 0210112020 AGGRFWTF b 5,000,000
DEO RETENTIM 1 10,000 b
NaRXwswNPFdIeATgnXPER I oil-
AN.
wAND EMPLOYERY LMBLRV y(N STAME ER
ANY PN0PPSTMPARTNE.EC1NE EL.EAGHACCD. f 1,000,000
B OrFICERvEMEER ExOWam O XIA 422005123] OW(H III 0210112020, +,000,000
ILe,dYuy M NH) EL.DISEASE-EAEMKOYEE $
If,looms mdv, 1,000,000
°ESCRIFOON OF OPERATKKA 1.60 EL.05EASE-POLICY Our b
OEBCRW M OF OPERATIONS I LOCAMNS I vFMCLEB(ACon.111,Atld...1 RXrIYIS&hvduN.MW elhtlxd H mm amu Is nWv-Ii
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EVIRATION DATE THEREOF,NOTICE WILL BE DELNERED IN
TD+m of Oman ACCORDANCE WITH THE POLICY PROVISIONS.
14 Court Square
AUTHORIZED REPmd ENTATNE
GrcwSaM MA 013W
01988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25(201610]) The ACORD name and logo are registered marks of ACORD
a\ The Cnnuumilrealth of.Wassachusetts
Department offndusbia/Accidents'
I Congress Street,Suite 100
�`�'9'S•
City of Northampton 212 Main Street, Northampton, MA 01060
Solid Waste Disposal Affidavit
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: 39ct Po,,Ld 4111 k2 d I k 01L09 Z
The debris will be transported by: ya ffJ W ouzo wIk& UP n pmt -
The debris will be received by: 6o.0 C A '� IVOYw�ph
Building permit number: �J V
Name of Permit Applicant
41221 ��g
Date Signature of Permit Applicant