38B-043 (2) 10 LASEL'L AVE t BP-2020-0407
GIS#: 'COMMONWEALTH OF MASSACHUSETTS
Map:Block: 38B-043 CITY OF NORTHAMPTON
Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category:renovation BUILDING PERMIT.
Permit# BP-2020-0407
Project# JS-2020-000686
Est. Cost: $31100.00
Fee: $202:00 PERMISSION IS HEREBY GRANED TO:
Const.Class: Contractor: License:
'Use Group: VALLEY HOME:IMPROVEMENT INC 077279-
Lot Size(sq.ft.): 4007.52 Owner: .COTE KEVIN f
Zoniniz: URB000)/ Applicant: VALLEY HOME IMPROVEMENT INC
AT: 10 LASELL AVE
Applicant Address: Phone: Insurance:
P O BOX 60627 . (413) 584-7522 Workers Compensation
FLORENCEMA01062 ISSUED ON.913 012019 0:00:00
TO PERFORM THE FOLLOWING WORK:REMODEL FRONT ORCHES IN EXISTING
FOOTPRINT
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: Ins lation:
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 9/30/2019 0:00:00 $202.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
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File#BP-2020-0407
APPLICANT/CONTACT PERSON VALLEY HOME IMPROVEMENT INC
ADDRESS/PHONE P O BOX 60627 FLORENCE (413)584-7522
PROPERTY LOCATION 10 LASELL AVE
MAP 38B PARCEL 043 001 ZONE URB(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
E D REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out ZZ _
Fee Paid
Typeof Construction: REMODEL FRONT PORCHES 1 ISTING FOOTPRINT
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 077279
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED•ON
INFORMATION 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
Demolition Delay
0
Sign ture of Building Official Date
Note: Issuance of a Zoning permit does not relieve a applicant's burden to comply pith 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 4 A.Contact Office of
Planning&Development for more information.
Department
& 1
City of Northampt n _ t� P rrniL r
Building'Nepartm nt curb Cuf1D vew Perrnlf l s, 'L f t S
212 Main S'tree SEP 4n�k``Ise cAv �labitlty 4
Yj F 3r _ Room 100 iw t�NN I
v i bllfy ' x x r }z
§e. �-3� - -._r,.,r�e a a. � :�[.•e i h . k x r`.n x �r" �- i'' ,
1 `��° ✓S— '�` Northampton NIA 106 P Two Sets fT op
str cturaF Pfans k� r k ^:j, 7. .
phone 413-587-1240 Fax - _r0 N, ans i
'titer= i'- �-�-
7
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APPLICATION TO CONSTRUCT,ALTER, REPAIR,RENOVATE OR DEMOLISH A:ONE OR TWO FAMILY DWELLING
SECTION??-SITE INFORMATION.
Ee:te`d;b ;;offi:c.:e =
1.1 Property Address: l�
LEI
fl P
(� Map Lot_
y
I,A S L AVZoFle :. Oveilayt?rstnct..a-.
�.
'NMIElm5E D.isfnct r .•: = ;_CB District
SECTIONI2:--PROPERTYOWNERSHIP/AUTHORIZED AGENT:
2.1 Owner of Record:
6-vin (01C All s a "C4 ovz'n 89 kb/JA-v Wo fix ` (066jr?_rX O L
Name(Print) Current Mailing Address:
Telephone
Signature
2.2 Authorized Agent:
•C x �o�a�r '1oret-�c� MC+
Name(Print) Current Mailing Address:
4lb-5'gq-`1522
Signatur Telephone
SECTIO.N`3=ESTIMATED GONSTRUCTION`COST.S:
Item Estimated Cost(Dollars)to be : Official:Use.Only
completed by permit applicant
1. Building2q, �bO : (ay Building Permit Fee
2. Electrical '4 S-0 O (b) Estimated Total Cost of
-.Construction from 6
3. Plumbing Building-Permit Fee .
4. Mechanical(HVAC) � y
5. Fire Protection i :•
02 4 02
6. Total=0 +,2+3 +4+5) 4 31 100 Check Number
:.:
This.Section:For:Official:Use On( I'
.:. ..� •..� :.. . ..:.:.: ; : :; . . ._ � Date • � �. : .
Building -Number: Issued: ' `•
Signature: Vu 1 30
lu
Building Commissionedrnspector of Buildings Date
EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR)
Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information
.Existing PeR sed Required by Zoning
This column to be filled in by
Building Department
Lot Size
Frontage ' I '
Setbacks Front # s
Side L:= R: i L:f 1 R:�._.. s
Rear
Building Height i
Bldg. Square Footage _ % I €
Open Space Footage %
(Lot area minus bldg&paved
arldn )
#of Parking Spaces 3
Fill: �..�..�.._........_,w.�._ _. f ....�....�._{�,,�V..._�._... ._.�,._
(volume&Location)
A. Has a Special Permit/Variance/Finding ever been/15
een issued for/on the site?
NO 0 DON'T KNOW 0 YES 0
IF YES, date issued:l
IF YES: Was the permit recorded at the Registry. of Deeds?
NO 0 DONT KNOW 0 YES
IF YES: enter Book Pager and/or Document#,
B. Does the site contain a brook, body of wate or wetlands? NO 0 DON'T KNOW YES
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained btained , Date Issued:
C. Do any signs exist on the property? Y S 0 NO 0
IF YES, describe size, type and loc tion: _
D. Are there any proposed changes to r additions of signs intended for the property? YES NO 0
IF YES, describe size, type and , cation:
E. Will the construction activity disturb clearing, grading, excavation, or filling)over 1 acre or is it part of a common plan
that will disturb over 1 acre? YE NO 0
IF YES,then a Northampton.Sto Water Management Permit from the DPW is required.
•1 1
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SECTION 5-DESCRIPTION'OF.PROPOSED WORK(check all applicable)
New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑, Roofing ❑
Or Doors 0
Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [M* . Siding [0] Other[
Brief Description of Proposedp�
Work: Y�IO�t-1- lriLoN1 ���C] S IN 5pgA G �p(7�P I�IN� A
Alteration of existing bedroom Yes No Adding new bedroom Yes `C No
Attached Narrative Renovating unfinished basement Yes -74' No
Plans Attached Roll -She
. I
:sar[fiNevirhoase_ardor°actditioi -tai=`ex�sttr� tz:h:os[rtc;cmplefe=t)i<e falConr�nc>:
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?
d. Proposed Square footage of new construction. Dimensions
e. Number of stories?
f. Method of heating? Fireplaces or Woodstoves Number of each
g. Energy Conservation Compliance. Masscheck Energy Compliance form attached?
h. Type of construction
1
L Is construction within 100 ft. of wetlands? Yes No. Is construction within 100 yr. oodplain 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. Septic Tank City Sewer Private well City water Supply
I
-SECTION•7a.-OWNER AUTHORIZA:T.ION=TO•BECOMPLETED'.WHEN
.O.WNERS:AGENT•0R:CONTRACTOR.ApPLIES'FOR:BUIL•DING-PERMIT
I, n (Ove- d— 1.'l yn, , as Owner of the subject
property
hereby authorizb\ 1+=I %e,,sCn �►1V ec��rC��
to act on my beha , ' all matters relative to work authorized by this buildina permit application.
4-Sign�it ulre'ildf-Owme
1, 2,kin ijet'rnaa, V 141 1: as Owner/Authorized
Agent hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge
and belief.
Signed under the pains and penalties of perjury.
�-e�er1 ��Iy�erma�, � •
Print Name
Signature of Owner/Agent Date
i
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder: C\1` .S ►1 LIYl 1� r1 01�a�9
License Number
�Soj-� Oxn a- �On Hfif o 16-7 X01 a i 1 ao
Address Expiration Date
AM z
at a V Telephone
9�ReQi'steEed:Hame. mpraue nent'Con#�actorNot Applicable El
q LAP,LA �QW, Sn ov-D\iemen,4- — -- I Ca 55 q,
Company Naffie A Registration Number
2.6 , &M (000DD YlU,-COCC Q)Q(02 `I � 11 ► zo
Address Expiration Date
Telephone �3-5g�-7JzZ .
SECTION'IO=WORKERS'COMPENSATION.INSORANCEAFFIDAVIT(M.G..L.c.152;§,25C(6))
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...... ❑
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City of Northampton.
�,�=•4^=�^
Massachusetts-
DEPARTMENT
assachusetts DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street • Municipal Building Lt
Northampton,,.MA 01060
AFFIDAVIT-
Home Improvement Contractor Law
Supplement to Permit Application
The Office of Consumer Affairs,and Business Regulation("OCABR')regulates the registration of contractors and-
subcontractors performing improvements or renovations on detached one to four family homes.Prior to
performing work on such homes, a contractor must be registered as a Home Improvement Contractor('TUC").
M.G.L. Chapter 142A requires that the"reconstruction, alteration, renovation,repair, modernization,.conversion,
improvement, removal, demolition, or construction of an addition to any pre-existing owner-occupied building containing
at least one but not more than four dwelling units....or to structures which are adjacent to such residence or building'be
done by registered contractors.
Nate:If the homeowner has contracted with a corporation or LLC, that entity must bI registered
Type of Work _ Est. Cost:
Address of Work: d 4 =00 e -' t A S �L A V
Date of Permit Application:
I hereby certify that:
Registration is not required for the following reason(s):
_Work excluded by law(explain):
_Job under$1,000.00
_Owner obtaining own permit(explain):
Building not owner-occupied
Other(specify):
OWNERS OBTAINING THEIR OWN PERMIT OR ENTERING INTO CONTRACTS WITH UNREGISTERED
CONTRACTORS OR SUBCONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK ARE NOT
ELIGIBLE FOR AND DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND
UNDER M.G.L.Chapter 142A.SUCH OWNERS ALSO ASSUME THE RESPONSIBILITES FOR ALL WORK
PERFORMED UNDER THE BUILDING PERMIT.SEE NEXT PAGE FOR MORE INFORMATION.
Signed under the penalties of perjury:
I hereby apply for a building permit as the agent of the owner:
1tiybSC maI4- c 3
Date Contract6r Name MC IZegistration No.
OR:
Notwithstanding the above notice,I hereby apply for a building permit as the owner of the above property:
Date Owner Name and Signature
' I
City -of Northampton
- r 155"; 5��•:
Massachusetts
DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street a Municipal Building
Northampton, MA 01060 !3�Y••;�jC�
Massachusetts Residential Building Code
Section 110.R5.1.2
Homeowner: Person(s) who own a parcel of land on which he/she resides or intends to reside,
on which there 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.
Section 110.R5.1.'3.1
Any homeowner performing work for which a building permit is required shall be exempt from
the licensing provisions of 780 CMR 110.R5,provided that if a homeowner engages a person(s)
for hire to do such work, then such homeowner shall act as supervisor.
Such homeowner shall submit to the Building Official, on a form acceptable to the Building
Official, that he/she shall be responsible for all such work performed under the building permit.
As acting Construction Supervisor your presence on the job site will be required from time to
time, during and upon completion of the work for which this permit 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.
i
City of Northampton
' Massachusetts
DEPARTMENT OF BUILDING 'INSPECTIONS
` 212 Main Street •Municipal Building Jik Jc4.
Northampton, MA 01060
Debris DisposalAffidavit
In accordance of the provisions of MGL c40, 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.
The debris from construction work being performed at:
(Please print house number and street name)
Is to be disposed of at:
r (kc \C) ,
(Pleaje print nd a and locatton of facility)
Or will be disposed of in a dumpster onsite rented or leased from:
(Company Name and Address)
i
Signature ermit Applicant or Owner Date
If, for any reason, the debris will not be disposed of as indicated, the Applicant or Owner shall notify the
Building Department as to the location where the debris will be disposed.
The Commonwealth of Massachusetts
Department of IndustrialAccidents
1 Congress Street,Suite 100
Boston,MA 02114-2017
www.mass.gov/dia
N-Yorkers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers.
TO BE FILED WITH THE PERMITTING AUTHORITY.
Applic ant Information Please Print Legibly
Name(Business/Organization/Individual): \�l iIII� ;1(]f ,iJt z\l-en l n, - e-Th L
Address: 2,6.&>A �oUloa-7 31-10 ��UfXS ��r�y�
City/State/Zip: V`c7(encg, JA\A- O\bb2 Phone#:
Are you an employer?Check the appropriate box:
Type of project(required):
LgI am a employer with * mployees(full and/or part-time).* 7. ❑New construction
2-❑I am a sole proprietor or partnership and have no employees working for me in 8. 2g Remodeling
any'capacity.[No workers'comp,insurance required.]
9. El Demolition
3.F�I am a homeowner doing allwork myself.[No workers'comp.insurance required.]t
• 10 E]Building addition -
4.F-1 I am a homeowner and will be hiring contractors to conduct all work on my property. I will
ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions
proprietors with no employees.
12.F�Plumbing repairs or additions
5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet 13.❑ repairs
re airs
These sub-contractors have employees and have workers'comp.insurance.$
6.F-1Weare a corporation and its officers have exercised their right of exemption per MGL c. l4•F]Other
152,§1(4),and we have no employees.[No workers'comp.insurance required.]
IL
*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.
$Contractors 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.
Insurance Company Name: ( ��a Thsocaae- 6 a� 1
Policy#or Self-ins.Lie.M 0 Q'E�&Q50 Expiration Date: a I 12PZC3
Job Site Address: d a�& '1 Pk City/State/Zip: My"'
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expirati n date).
Failure to secure coverage as required under MGL c.152,§25A is a criminal violation punishable by a fine up to$1,500.00
m
and/or one-year imprisonment,as well as civil penalties in the forof a STOP WORK ORDER and a fine of up to$250.00 a
day against the.violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance
coverage verification.
I do hereby certify under the pains and penalties of erjury that the information provided above is true and correct:
J
Si afore: Date:
11111011
Phone#:
Official use only. Do not write in this area, to be completed by city or town official
City or Town: Permit/License#
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone#:
Commonwealth of Massachusetts
®�
Division of Professional Licensure
Board of Building Regulations and Standards
Cons t\ictl Sri_pe_rvisor
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CS-077279 _ ES ices: 06/21!2020
STEVEN A SILVERMAN
268 FOMER Ro D ' �% y
s
SOUTHAMPTO "01073 = ll5 , .
m
Commissioner Ail
Office of Consumer Affairs and Business Regulation
One Ashburton Place - Suite 1301
Boston, Massachusetts 02108
Home Improvement,:Contractor Registration
r-- •—� Type: Corporation •
VALLEYHOME IMPROVEMENT INC " {� u Registration: 109543
P.O.BOX 60627 r R r Expiration: 07/16/2020
t 1
FLORENCE,MA 01062U.
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Update Address and Return Card.
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✓/�e [�M7rn.Grtc�L¢C/J�c�.���¢Jj¢c�cccJell� .
Office of Consumer Afairs&Business Regulation
HOME IMPROVEMENT CONTRACTOR Registration valid.for individual-use only
TYPE:%Corporation before the expiration date. If found return to:
Reoistr.`ationN Expiration Office of Consumer Affairs and Business Regulation
.0548 07/16/2020 One Ashburton Place-Suite 1301
%LLEYHOMEeEIQGEMEN FII C Boston,MA 02108
EVEN A.S1 LV
0 RIVERSIDEDR����l
)RTHAMPTON,MA 01062 Undersecretary Not valid without signature
This plan is the proprietary work product of Valley Home Improvement lnc.(VHI).It is delivered for the limited and exclusive purpose of supporting the contract bid of VHI,and(customer agrees that the elements of this plan shall not be republished or presented in any
form for the purpose of enabling or supporting the work of competing project contractors without the permission of,and compensation paid to,VHI.
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10 LASSEL ST.. SCALE:SEE VIEW SHEET NUMBER
Valley Home Improvement, Inc. NORTHAMPTON,MA 01060 EXISTING DATE:9/25/2019
340 Riverside Drive, PO Box 60627, Northampton, MA 01062
Office Phone 415.584.7522 Fax 413.585.0820 Alisa Wagman and Kevin Cote CO N DTIO NS DRAWN BY:S.G. 2
Find us on the web at: uuwMalle Homeim rovement.com
This plan is the proprietarywork product of Valley Home Improvement,Inc.(1/1-11).it is delivered for the limited and exclusive purpose of supporting the contract bid of VHI,and customer agrees that the elements of this plan shall not be republished or presented in any
form for the purpose of enabling or supporting the work of competing project contractors without the permission of,and compensation paid to,VHI. 9
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Palle Home Improvement Inc. 10LASSELST. I SCALE:SEE VIEW SHEET NUMBER
NORTHAMPTON,MA 01060 PROPOSED W/ DATE:912512019
340 Riverside Drive, PO Box 60627, Northampton, MA 01062
Office Phone 413.584.7522 Fax 419.585.0820 Alisa Wagman and Kevin Cote DIMENSIONS DRAWN BY:S.G.
Find us on the web at: wwwYalle Homelm rovement.com I
This plan is the proprietary work product of Valley Home Improvement,Inc.(VHI).It Is delivered for the limited and exclusive purpose of supporting the contract bid of VHI,a nd customer agrees that the elements of this plan shall not be republished orpresented in any
form for the purpose of enabling or supporting the work of competing project contractors without the permission of,and compensation paid to,VHI.
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Valley Home Improvement, Inc. 10 LASSEL ST. 1 QST FLOOR SCALE:SEE VIEW SHEET NUMBER
NORTHAMPTON, MA 01060 DATE:912512019
340 Riverside Drive,PO Box 60621, Northampton, MA 01062 i I
Office Phone 415.564.1522 Fax 415.585.0820 Alisa Wagman and Kevin Cote F RAM I N G PLAN DRAWN BY:S.G. 4
Find us on the web at: uuw.Valle Homelm rovement.com IRmNim 9-0
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This plan is the proprietary work product of Valley Home Improvement,Inc.(VNI).It is delivered for the limited and exclusive purpose of supporting the contract bid of VHI,and customer agrees that the elements of this plan shall not be republished or presented in any
form for the purpose of enabling or supporting the work of competing project contractors without the permission of,and compensation paid to,VHI.
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Valley Home Improvement, Inc. 1AMPTON,MA FRAMING 3CALE:SEEVIEW SHEET NUMBER
NORTHAMPTON,MA 01060 DATE:9/30/2019
340 Riverside Drive, PO Box 60621, Northampton, MA 01062 ELEVATIONS
Office Phone 413.584.1522 Fax 413.5808
5. 20 Alisa Wagman and Kevin Cote DRAWN BY:S.G.
Find us on the web at: wwwYalle Homelm rovement.com
This plan is the proprietary work product of Valley Home Improvement;lnc.(VHl),it is delivered for the limited and exclusive purpose of supporting the contract bid of VHI,and customer agrees that the elements of this plan shall not be republished or presented in any
form for the purpose of enabling or supporting the work of competing project contractors without the permission of,and compensation paid to,VHI. N
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Valley Home Improvement, Inc. 1AMPT N,MA CGI FRAMING DATE:SEEVIEW SHEET NUMBER
NORTHAMPTON,MA 01060 DATE:9125/2019
340 Riverside Drive, PO Box bOb27, Northampton, MA 01Ob2 I
Office Phone 413.584.1522 Fax 413.585.0820 Alisa Wagman and Kevin Cote DEPICTIONS DRAWN BY.S.G. 6
Find us on the web at: www.Valle Homelm rovement.com