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29-202 BP-2022-0221 43 BEATTIE DR COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 29-202-001 ' CITY OF NORTHAMPTON Permit: Addition PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit # BP-2022-0221 PERMISSION IS HEREBY GRANTED TO: Project# MASTER SUITE ADDITION Contractor: License: VALLEY HOME IMPROVEMENT Est. Cost: 90100 INC 077279 Const.Class: Exp.Date:06/21/2022 Use Group: Owner: FORRAY WILLIAM Z& LINDSAY FOGG-WILLITS Lot Size (sq.ft.) Zoning: WSP Applicant: VALLEY HOME IMPROVEMENT INC Applicant Address Phone: Insurance: P O BOX 60627 (413)584-7522 0055030215 FLORENCE, MA 01062 ISSUED ON:03/24/2022 TO PERFORM THE FOLLOWING WORK: MASTER SUITE ADDITION 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: Gas: Final: Final: Rough Frame: Rough: Fire Department Driveway Final: Fireplace/Chimne3r: Final: Oil: Insulation: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: • )2 css Fees Paid: $585.65 212 Main Street, Phone(413)587-1240,Fax:(413)587 11272 Office of the Building Commissioner File #BP-2022-0221 APPLICANT/CONTACT PERSON:VALLEY HOME IMPROVEMENT INC P O BOX 60627 FLORENCE, MA 01062(413)584-7522 PROPERTY LOCATION 43 BEATTIE DR MAP:LOT 29-202-001 ZONE THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Building Permit Filled out Fee Paid $585.65 Type of Construction: MASTER SUITE ADDITION t New Construction `q� Non Structural Renovations 44 ``J^3 Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFj/RMATION PRESENTED: V 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 SpecialPennit With Site Plan ZONING BOARD PERMIT REQUIRED UNDER: § Finding `s Special Variance* JrZ. 5 IC,+-,Y4Tu es- Received&Recorded at Registry of Deeds Proof Enclosed Or 19136..)71c2g ©R Other Permits Required: Curb Cut from DPW WaterAvailability 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 Managemegt Demolif n Delay it/. .Z i! od? I)1 Signature of Build' g O 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. 19 , . The Commonwealth of Ivlassacbusettj 49 (, .1g.. Board of Building Regulations and Standards, o'" �, ' VEUNIC:r . L r �; Massachusetts State Building Code,780 CI �,o1...op /? SE. r 2, Building Permit Application To Construct,Repair,Renovate Or • ,,., ,,• - Rev, -d Mar 2011 Ore-or Two-Family Dwelling o�.Mq'OF , This Section For Official Use Only .'06o• s Building Permit Number: 6,-7).~ a i/7— ---1 Date Applied: 411....) ' J2o7s 3-Zi1-ZOZ2 BuildingOFic:al (1nnzNar-ne) Signature Date SFCT1ON 1:SITE TNFORMATTON 1,1 PTc►nrrty Arldr .,s: 1.2 ,Avcu unr�Map Rr Parcel Nurolbs.rs . (.4. .._ • . i --O Z_ I.la Is this an accepted street'i yes no - Mail Nu.-nbei Parc& aT -rebel 1.3 Zoning Information: 1.4 Property Dimensions: 1 Zoning District Proposed Use.... ... Lot Area t4 fi s _._._ ) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yard, Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public 0 Private O Zone: — Ourside Flood Zone? Municipal 0 On site disposal system 0 Check if yes _ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner"or Record: Nay' � OC Rity,State,ZIP No.and Street Telephone Rmail,aiaaress SECTION 3:DESCRIPTION OF PROPOSED WORK'(check all that apply) New Construction❑ 1 Existing Building CI Owner-Occupied 0 Repairs(s) CI Alteration(s) 0 Addition 0 Demolition D Acc.;.,sor•/Bldg. Cl Number ofUnits other O SpecifJe Brief Description of Proposed Work': i 4(?T'4 e. 'ro-k_ �:-� c -e f /IV ' L i tiv 1 iith i' . /1 .-AG 1;, A - 4 i 'i , ' �! MME di oz.. 1 . . .- /11 _ 114M.z i C - , - SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only .;:<-�,�„.:.> (I=L^rand A•'raterrzls) 1.Building 5 1 2 G4 I._Building Permit Fee: $ Indicate how lee is determined: a Standard City/Town Application Fee ' 2.Electrical $ -7,SAP 0 Total Project Cost3(Item 6)x multiplier x 3.Plumbing $ ( /a/ 2. Other Fees: $ 4.Mechanical (HVAC) $ Ili WV List: ' • S.Mechanical (Fire $ Total All Fees: $ �I� Svppression) �✓' " Check No44 Cher-le Amount: 5 Cash Amount: . 6.Total Project Cost: , $ 401 (0 1 ,p Paid in Frill 0Ou Balance Ike G241,t .lot • SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) .011 2:19 (012( !zoz2.. eV it 1 Jf(Y ar\ 1 License Number Expiration Date Name or CSL Holder List CSL Type(sea below) P c4c, (c0 02,1 Type Dasaripiion No.and Street U TT rest,;,- e,4 03uildings up to.35,000 ea.ft 1O CPfC_-- VA Qv° it ' Restricted 1842 Family Dwelling ,, City/Town,St M . tutasonry :' • • ' RC , Roaring CiIvering _.- WS Win low and Siding 14VSF `Solid Fuel Burning Appliances ' 1�� 1 Insulation Telephone Email address T3 Demolition 5.2 Rec,istered Home Improvement Contractor(HIC) 3120t200-- 7� 11Q�1 , � �� HTC Registration Number Expiration Date 1C Comp ., Name or HTC Registrl�nt Name G cln7 'tort' ce_CYI blob-a- No.and Street Email sd'''ess City/Town,State, ZTP Telephone S-ECTION-6:WORKERS' COMPENSATION INSURANCE AFFIDAVIT(M.G.L. (1.452.§ 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 bai!ding pemtit. Signed Affidavit Attached? Yes No .0 SECTION 7a:OWNER AUTHORIZATIONTOBE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT j I,as Owner of the subject property,hereby authorize. 4 -T i ��Y to act on m ehalf,in aU nets rela' o work authorized by this building permit application. , CL/1 S'1G!/(2/' 3-- 0' o?, • t Owner's e(Electronic Sip e) Date SECTION 7b:-OWNER1 OR AU rHORIZED AGENT DECLARATION By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information stained in this ap lication is true and accur the est of ad d undue g. ., LtivDzftty &E—IMt4-47-5 t ?,, V.,i Ilitx.*h -y c1 r�' 6 Print Owner's orAuthorized is Name( ea i ranic Date NOTES: ` I. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration ' program or guaranty fund under M.G.L. c. 142A Other important infnrmation on the HIC Program can be found at www.mass_.zev/eca Information on the Construction Supervisor License-can be found atwww.mass.nov/dos 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) (including,garage,finished basement/attics,decks or porch) Gross living area(sq.ft.) Habitable room count Number of fireplaces Number of bedrnurris Number of bathrooms Number of hhaif'baths • T)pe of heating system Number of decks!porches . Type of cooling system Enclosed Open 3. "Total Project Square Footage"may be substituted for"Total Project Cost" � City of Northampton 4.f,, �, Massachusetts ��: s- �� I(,' .I ; ` DEPART NT OF .9GILDING INSPECTIOI S ' 5�1 � 212 Main Stzeet w Municipal Building Jr `b CONSTRUCTION DEBRIS AFFIDAVIT (FOR ALL DEMOLITION AND RENOVATION PROJECTS) In accordance of the provisions of MGL c 40, S54, a condition of Building Permit Numbe-r is that ali debris resulting from this work shalt be disposed of in a properly licensed waste disposal facility, as defined by MCI_c Ill, S 150A. The debris will be disposed of in: Location of Facility: \i(,I U - OC(1 .uk_s 1 4�- -e IC) , 1'1 The debris will be transported by: Name of Hauler: `kJiej 4 C n ts4- • Signature of Applicant: / Date: " 01 "c2gOZc72- The Commonwealth ofMassachusetts (f �. �:, Y7. Department of Industrial Accidents • '' Itj 1 Congress Street, Suite 100 `-> - Boston,MA 02114-2017 www.mass.gov/dia Workers' Compensation insurance Affidavit Builclel-s/Card-actor•s/ElectricianslPluinbers. TORFFii,F.ii WITH THE?RR MTTTiN( AUTHORITY. Information Please Print Legibly Name `f'SIIV1TiC.tiV1'1r4i1111 Y.a1.11117/iL107VTLltlitll- �OJt- —ON jp ro\Jryvy k.,1_ , C Address: v-(2. \ac-c___.- �r '.C . Q- O . [`)4. ( )0(c)• -- City/State/Zip Orr ce_‘,1, b2. Phone#: 14, SS`i--1 S2 Z. Are you an employer?Check the appropriate box: Type of project(required): 1.ts I am a employer with i P __employees(full andlor part-time).* 7. D New construction 2.12 I am a sole proprietor or partnership and have no employees working forme in 8. ® Remodeling any capacity.[No workers'come.insurance required.] �--� 9. ❑Demolition 3.{ {I am a homeowner doing all work myself[No'workers'comp.insurance 1 equired.l+ 1 iv j Building addition 4.0 I am a homeowner and will be hiring contractors to conduct all work on my property. I will n cnstare that all contractors eil�ler•ka re worker'compensation insurance or we solo • - 1 i,.L�Electrica1 repairs.ar acl{litions proprietors with no employees. 12.❑Plumbing repairs or additions 5.0 T am a general contractor and T have hired the sub-contractors listed on the attached sheet 13.0Roof repairs These sub-contractors have employees and have workers'comp.insurance? 6,❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.❑Other_ 152,[11(4),and we have no employees.[No workers'comp.insurance required] 'Any applicant that cheeks box t$1.-not also fill out the section below showing their workers'compensation policy information. Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. <'Contrartmrs that r' et c•this box must atta nhtdav additiunai sheet showing the name r>f the soh- untractins and-stathwhethet uraut those entries Have employees. If the subcontractors 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 hsfornration.Insurance Company Name: A()PIS 71.r,5L,'t l Y\( C2rdl-te Policy#or Self-ins.Lic.#: Od')Sn 3 Expiration Date: a) I rD O Job Site Address: 1-1-) Re'P ti>> . City/State/Zip: 1)(),;14-1'1( ,j1A peon, 1"t' 01 O(cC Attach a copy of the workers'compensation policy declaration page(showing the policy number and expir lion 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 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.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 . s and penalties o erjury J 'l , ,ormatian provided above is true and correct • / / Date: Qf- . .a?,lL _ _. Phone#: rt‘ £& �I¶22— Ofcial use only. Do not write in this area,to be completed by city or town official City or Town; Permit/T,icense•# 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 Const�r�jc�t t {Sj Tvisor CS-077279 �T z- ires:0612112022 STEVEN A Sft•VERMAN r, ( f t w� PO BOX 60627 .1 27 FLORENCE M3 01062 1 i Y tOjS33C)-u�� i. } i i Commissioner �l /'i. bjEkr LLD— • • e=7.2,,2_,„,..e/t2 Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration Type: Corporation VALLEY HOME IMPROVEMENT INC Registration: 105543 P.O.BOX 60627 Expiration: 08/20/2022 FLORENCE,MA 01062 Update Address and Return Card. t 1 C! 20M-05/17 ✓1k°s ra9vncri.avezl%r 94.1Saauavf°r e14 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: • Reoistration 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_ • '� 9 340 RIVERSIDE DRIVE- . 'CG. �i FLORENCE,MA 01062• Undersecretary Not valid without signature The following neighbors have no objections to the City of Northampton moving forward with the permitting process for the proposed addition at 43 Beattie Drive, Northampton, MA. I l ' ik otBeattie Drive, Northampton, MA /l.lr? Signature. , . a ,,� Date: .. // i 1 I 060"--7C) rrticky- —ta'of4 Beattie Drive, Northampton, MA Signature: I /CP4/ r r c'11 co.4 v,› .p Date: jam/ I c 'Jf 106 Brierwood Drive, Northampton, MA Signature: Date: 3(2o ` z I 2W 64 r of 114 Brierwood Drive, Northampton, MA Signature: ' Date: 3 ((! 2 Z- 11. -0-45cIceviit of 160 Acrebrook Drive, Northampton, MA Signature: Date: 3h !'.'2• I IL rn. Acrebrook Drive, Northampton, MA Signature: Date: �3/1/2Z