23A-199 (4) 49 BEACON ST COMMONWEALTH OF MASSACHUSETTS BP-2021-1952
Map:Block:Lot:23A-199-
001 CITY OF NORTHAMPTON
Permit: Exterior Res
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
BUILDING PERMIT
Permit# BP-2021-1952 PERMISSIONIS HEREBY GRANTED TO:
Project# WINDOWS Contractor: License:
VALLEY HOME IMPROVEMENT
Est. Cost: 13500 INC 077279
Const.Class: Exp.Date:06/21/2022
Use Group: Owner: GRINNELL WILLIAM D
Lot Size (sq.ft.)
Zoning: URB Applicant: VALLEY HOME IMPROVEMENT INC
Applicant Address Phone: Insurance:
P 0 BOX 60627 (413)584-7522 0055030215
FLORENCE, MA 01062
ISSUED ON:09/29/2021
TO PERFORM THE FOLLOWING WORK:
9 REPLACEMENT WINDOWS
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.
Signature: I . „2 r .
i Il
Fees Paid: $40.00
212 Main Street,Phone(413) 587-1240,Fax:(413)587-1272
Office of the Building Commissioner
49 BEACON ST COMMONWEALTH OF MASSACHUSETTS BP-2021-1952
Map:Block:Lot:23A-199-
001 CITY OF NORTHAMPTON
Permit: Exterior Res
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
BUILDING PERMIT
Permit# BP-2021-1952 PERMISSIONIS HEREBY GRANTED TO:
Project# WINDOWS Contractor: License:
VALLEY HOME IMPROVEMENT
Est. Cost: 13500 INC 077279
Const.Class: Exp.Date:06/21/2022
Use Group: Owner: GRINNELL WILLIAM D
Lot Size (sq.ft.)
Zoning: URB Applicant: VALLEY HOME IMPROVEMENT INC
Applicant Address Phone: Insurance:
P O BOX 60627 (413)584-7522 0055030215
FLORENCE, MA 01062
ISSUED ON:09/29/2021
TO PERFORM THE FOLLOWING WORK:
9 REPLACEMENT WINDOWS
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.
Signature:
Fees Paid: $40.00
212 Main Street, Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
"tic:Commonwealthui'Massachusetts
Board of Building Regulations and Standards E Olt
�E'J/ z.
Massachusetts State Building Code, 780 CMR M[JNIFO ITY
1' 2021 USE
- l3uildi g Pe mit Application To Con,ctruci,Repair, Renovate Or(Demolish a RevisedMa.' 2011
I °E T()FIRM_Dry
One-or Two-Family I)w•ellirtg
1_�~ �T 'oN Mp oo,•spf � S This Section For Official Use Only -
Buildin Permit tuns.. :"s 1 .1-I' /4 5)- Date Applied:
Evik,..) x ./7/72 q-299-a)Z1
Building Official(Print Name) Signature Date
SECTION 1: SITE TWORMATTON
1,1 Preripti,kv Address; l?+ssessars Map&Perce?Numbers t`
t.la is this an accepted street?yes, no Adap 1krobe+Y Parcel Number
1.3 Zoning information: ' 1.4 Property Dimensions:
Zoning D ismd Proposed the 1 Lot Area(sq III Frontage(ft)
1.5 Building Setbacks(ft)
Front Yard I Side Yards Pear Yard
a
Required 1 Provided i Received Provided Required Provided
1.6 Water Supply: (M.6,1.c.40,i54) 1.7 Fluud Zone Information: I.$Sewage Disposal System:
Public 0 Private CI Zone: _ Outside Flood Zone? Municipal❑ On site disposal system 0
Check if yes❑
_ SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Reci
k. 1.CLYYL U✓t t~t1/1Qjj T L(rf'.a f 1 +txf 010b2-.
Narne LkCk(Pr' C�� 4 C9#y,Sta+e,71P
No.(and Street Tcicpltone Email Address
—
SECTION 3:DESCRIPTION OF PROPOSED WORK'(check all that apply) j
New Construction 0 Existing Building O Owner-Occupied ❑ Repairs(s) 0 1 Alteration(s) 0 Addition ❑
Demolition 0. Accawory Bldg.CI :', Number of :its __ t Uth— Li Specii
Brief Oescripti on of Proposed W ork2: IA SiWk 1 6 fliii!
P_ i!� $ 7 J.l 40
- PIC:1452. 30
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item i Estimated Costs: Official Use Only
,ItL.abcx•and MateriaLi1,
1_.Building s t3 50 L1 1. Building Permit Fee: $_. indicate how fee is determined:
�
,� 0 Standard City/Town Application Fee
2.Electrical �_ $ _ 0 Total Project Costa(Item 6)x multiplier x
3.Plumbing $ 2. Other Fels: $
4. Mechanical (HVAC) $ List:
5.Mechanical (Fire I
Suppression) S i Total All Fees: $
' Check No i heck Amount:
6.Total Project Cost: i $ 1 31,5 CD .a aid in Fur ID O.ut Landing Balance Due:
City of Northampton
Massachusetts Olgr--
f� DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street • Municipal Building•i-- Northampton, MA 01060
CONSTRUCTION DEBRIS AFFIDAVIT
(FOR ALL DEMOLITION AND RENOVATION PRO,TE.CTS)
In accordance of the provisions of MGI r 4n, S54, a condition of Building Permit
Number is that all debris resulting from this wbrk shall be disposed of
in a properly licensed waste disposal facility, as defined by MGI c 111, S 150A.
The debris will be disposed of in:
Location of Facility: IC/ 12e.cfi C-L-A-- 3 - 17-A v to A) `-
The debris will be transported by:
Name of Hauler: v' tc/t1f/t._L_ 747kLpik-uvcry-tz4t.4.____edi,
C
Signature of Applicant: Date: 1 1 ? ?- ,/r
k�! Commonwealth of Massachusetts
Division of Professional Licensure
Board of Building Regulations and Standards
C o nsi�rjv`fi 'i�{S{ rvisor
1
CS-077279 ? ; cpires:06/21/2022
• STEVEN A SO/ERMA,N,
PO BOX 6062J :` ,i n ,_r'rs 4''
FLORENCE MA 01062 1,
fir,,;t. =mot •
11 k
Commissioner ei
•
•
•
Office of Consumer Affairs and Business Regulation
1000 Washington Street - Suite 710
Boston, Massachusetts 02118
Home Improvement Contractor Registration •
Type: Corporation
Registration: 105543
VALLEY HOME IMPROVEMENT INC Expiration: 08/20/2022
P.O.BOX 60627
FLORENCE,MA 01062
Update Address and Return Card.
SCA 1 Cs 20u-05!'7
Fivnmayme eaA ✓fig«-1<iczc4.4;:s//t
Office of Consumer Affairs&Business Regulation
HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only
TYPE:Corporation before the expiration date. If found return to:
Registration Expiration Office of Consumer Affairs and Business Regulation
105543- 08/20/2022 1000 Washington Street -Suite 710
VALLEY HOME IMPROVEMENT INC Boston,MA 02118
•
///
STEVEN A.SILVERMAN /C/`�/1 .
340 RIVERSIDE DRIVE .1.� (4 gr„
FLORENCE,MA 01062 • Undersecretary Not valid without signature
The Commonwealth of Massachusetts
1,i—.7, != Department of Industrial Accidents
'Eli - ; 1 Congress Street,Suite 100
t‘,4„..c_
Boston, MA 02114-2017
wwwmass.govldia
Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plunzbers.
TO BE FILED WITH THE PERMITTING AUTHORITY.
Applicant Information Please Print Legibly
Name (Business/Organization/individual): JaI.t, lA -k>c- e. -Trr er-7:>-12(Y1Crr-1 , r)C.
Address: 5` iO Q\ve.ece) Ckt —D. trt..rc ? Q. 60tc (c te,zi
City/State/Zip:T1Orirxx, i--U') 01 G(c2- Phone #: 4 t3- E 4-1 S2Z
4.re you an employer?Check the appropriate box: l Type of project(required):
1.EO I um a employer with 1 0 employees(roll aud/or part-time/.* 7. ❑New construction
2.0 I am a sole proprietor or partnership and have no employees working fur me in 8. J Remodeling
any capacity-.[No workers'comp.insurance required.]
3.0l am a homeowner doing all work myself:[No workers'comp.insurance required.]t 9. ❑Demolition
10❑Building addition
4.0 I am a homeowner and will be biting crmtractors to conduct all work on my property. I will
ensure that all contractors either have workers'compensation insurance or arc sole 11.❑Electrical repairs or additions
proprietors with no employees.
12.❑Plumbing repairs or additions
• 5.1:::1 I am a general contractor and T have hired the sub-contractors listed on the attached sheet.
These sub-contractors have employees and have workers'comp.insnranee.- 13.QROOf Tepail;S
6. Are are a corporation and its officers have exercised their right of ex14. Olher
❑ ,h exemption per MGL c.
152,il(4),and we have no employees.[No workers'comp,insurance required.]
*Any applicant that checks box ar1 must also fill out the section below showing their workers'compensation policy information.
t Homeowners who submit this affidavit indicating they arc doing all work and then hire outside contractors must submit a new affidavit indicating such.
1Cuntractors that check this box must attached an additional sheet showing the name of the sub-courracturs and state whether or not those entities have
employees. 'Vale 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: -Av 6,`t :11:_Yl S_,ro L L-1,rv,
Policy#or Self-ins.Lie.#: Ob CJ 50.' (3'2. \5 ,, Expiration Date:__ c?1 1 ) t oi ti a-
Job Site Address: COr Ci rStatc/Zi
ri' p:f(vferx< 5100602-
Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by a fine up to S1,500.00
and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to S250.00 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 ceri�ify un .r the pains and pe hies of p rr hat the information provided above is true and correct.
Signature: . '� �[/ I/PK) Date: 9 j 1 �-0D-
1 �
Phone#: L "j- S24—`152 Z
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#:
49 BEACON ST COMMONWEALTH OF MASSACHUSETTS BP-2021-1952
Map:Block:Lot:23A-199-
001 CITY OF NORTHAMPTON
Permit: Exterior Res
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
BUILDING PERMIT
Permit# BP-2021-1952 PERMISSION IS HEREBY GRANTED TO:
Project# WINDOWS Contractor: License:
VALLEY HOME IMPROVEMENT
Est. Cost: 13500 INC 077279
Const.Class: Exp.Date:06/21/2022
Use Group: Owner: GRINNELL WILLIAM D
Lot Size (sq.ft.)
Zoning: URB Applicant: VALLEY HOME IMPROVEMENT INC
Applicant Address Phone: Insurance:
P O BOX 60627 (413)584-7522 0055030215
FLORENCE, MA 01062
ISSUED ON:09/29/2021
TO PERFORM THE FOLLOWING WORK:
9 REPLACEMENT WINDOWS
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.
Signature:
0, V . ).2 •
II
Fees Paid: $40.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
49 BEACON ST COMMONWEALTH OF MASSACHUSETTS BP-2021-1952
Map:Block:Lot:23A-199-
001 CITY OF NORTHAMPTON
Permit: Exterior Res
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
BUILDING PERMIT
Permit# BP-2021-1952 PERMISSIONIS HEREBY GRANTED TO:
Project# WINDOWS Contractor: License:
VALLEY HOME IMPROVEMENT
Est. Cost: 13500 INC 077279
Const.Class: Exp.Date:06/21/2022
Use Group: Owner: GRINNELL WILLIAM D
Lot Size (sq.ft.)
Zoning: URB Applicant: VALLEY HOME IMPROVEMENT INC
Applicant Address Phone: Insurance:
P O BOX 60627 (413)584-7522 0055030215
FLORENCE, MA 01062
ISSUED ON:09/29/2021
TO PERFORM THE FOLLOWING WORK:
9 REPLACEMENT WINDOWS
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.
Signature: r
el ' r • >23-11 •
a
Fees Paid: $40.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner