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23A-199 BP-2022-1409 49 BEACON ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 23A-199-001 CITY OF NORTHAMPTON Permit: Alts Renovations Repair PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit # BP-2022-1409 PERMISSION IS HEREBY GRANTED TO: Project# 2022 RENO Contractor: License: VALLEY HOME IMPROVEMENT Est. Cost: 111300 INC 077279 Const.Class: Exp.Date: 06/21/2024 Use Group: Owner: GRINNELL, WILLIAM D. WEAVER, DANA 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: 10/31/2022 TO PERFORM THE FOLLOWING WORK: RENO 2ND FLOOR BEDROOM & BATH,ADD CO& SMOKE DETECTORS 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: Final: Final: Final: Rough Frame: Gas: Fire Department Driveway Final: Fireplace/Chimney: Rough: Oil: Insulation: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: 14 ! . . Fees Paid: $723.45 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner fiAns4-4 r� -C E V 9 '' The Commonwealth of Massachus tts 202 jFo Board of Building Regulations and St dar OCT 8 C ALITZ' Massachusetts State Building Code, 7 .0 . r r z Building Permit Application To Construct,Repair,R no _ Re ised a,!2011 ICDING INSPE TIONS One- or Two-Family ily Dwellin -- NORTHAMPrON MA 01 lI This Section For Official Use Only Building Permit Number: $Q ZO2--I L4-O Date Applied: dt� Jtc Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Pr gierty Address: , 1.2 Assessors Map&Parcel Numbers 1.1 a Ts this an accepted street?yes no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: /Ai ,3 ac4z- i,ys J Zonine.District Proposed Use Lot Area(sq ftl Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply: (M.G.T_c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Zone: Outside Flood Zone? Public 0 Private 0 — Cheek ifyes❑ Municipal 0 On site disposal system 0 SECTION 2: PROPERTY OWNERSHIP1 2.1 Owner'of Re rd: U.l lltawt r l n lntU c tcye r cC X Q- Ca O(o� Name(Print) City,State,ZIP Lk.C1 Ca•-,Sk- Love- 5 g 2� No.and Street Telephone Email Address SECTION 3:DESCRIPTION nE PROPO-SEED WORK1(cheek all that apply) New Construction❑ Existing Building❑ Owner-Occupied 0 Repairs(s) 0 Alteration(s) Cl Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units Other ❑ Specify: Brief Description of Proposed Work2: 2. (W oO�1_ C r-OOP.., f3 1•i 0 S t4Ci 1..'ML L1464i 6c5 . CO 4- 5),�OZc E-C---_ 'c Gj r J ' c CoVe-, . SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ $� 00 1. Building Permit Fee:$ Indicate how fee is determined: 0 Standard City/Town Application Fee 2.Electrical $ 41 30D ❑Total Project'Cost3'(Item'6)x multiplier x 3. Plumbing $ (a, S O O 2. Other Fees: $_ 4.Me auicai (II AC) . i t t O D O T ist: 5.Mechanical (Fire V Total All Fees:$ Suppression) Check No.N 3 L(,j'Check Amount:.?a3. 115. 6. Total Project Cost: $ I 3 0 0 ❑:Paid in Full . . 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License (CSL) 0 i 3.Plq 6/2/ 12oZ.-y Nf.i�s-rek c...r l ,4'n-s, ,4—,- Li CMS e Number Expiration Date Name of CSL Holder List CSL Type(see below) V `':' CA (6DU Dfl No. and Street Type Description LiUnrestr.cted(Buildings up in 35,000 cu.fl.) r am" �� r R Restricted i&2 Family Dwelling City/Town . IP M Masonry RC Roofing Cove,ing. WS__._ Winslow era Siding i`` c � SF Solid Fuel Burning Appliances 1.So'iT152 I insulation Tel cDhonc Email address I D Demolition • 5.2� ered Rome Improvement Contractor(HIC) r , Ti- ,�. -,� Igt54 x �-� HIC Registration Number Expiration Date. HT Comparjy Name or HIC Registrant%ame No. and Street Email address City/Town,State, ZIP Telephone SECTION 6: WORKERS' COMPENSATION INSURANCE AFFIDAVIT(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 . ❑ SECTION 7a;OWNER AUTHORIZATION TO BE COMPLETED WHEN OS ER'S AGENT OR CONTRACTOR APPI,IFS FORBUILDLNG PERMIT I,as lwner of the subject prop ry hereby authorize$ eXM cat I�..)tif -r, V t- y to on b in all matt lative to work authorized by this building permit application. Print Owner's Name(Electronic Signature) Date SECTION 7b: OWNER'OR AUTHORIZED AGENT DECLARATION By entering my name below, I hereby attest under the pains and penalties of perj t all of the information contained in this application is true and accurate to. knowla ge• erstanding. -- i- 8e3 if Si L V k4 if fir) 4 ?--zse.;_;t , Print Owner's or Authorized Agent's Name(Electronic Signature) Dare NOTES: 1. 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 MG.L.c.142A. Other important information on the HIC Program can be found at wv,w.mas .gcvInca Information on the Construction Supervisor License can be found at www.rrass _;v•dps 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) (including garage,finished basementiattics,decks or porch) Gross living area(sq.ft.) Habitable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of half7baths Type of heating system Number of decks!porches — Type of cooling system Enclosed Open 3. "Total Project Square Footage"maybe substituted for"Total Project Cost" The Commonwealth of Massachusetts gil�: _ Department of Industrial Accidents -t_firtm I Congress Street, Suite 100 . V,14—) Boston,Mil 02114-2017 �F www.n:ass.gov/dla Workers' Compensation Insurance Affidavit: Builders]Contractors/Electricians/Pluntbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information • Please Print Legibly Name(Business/Organization/Individual): \Q f l-Cc) t'rOcn G 'TYv't er-0.4 e r n z r' i . 'Tr-IC- J Address: -\O R1/4 ✓ ,\Gkz ri�cc. P. O. Fpcc CAO(c21 City/State/Zip: t-\Drencc k 0) 002- Phone#: t-t,t3-SS4-7 S22- Are you an employer?Check die-appropriate box: Type of project(required): I I am a employer with !e employees(full and/or part-time).* 7- 0 New construction I am a sole proprietor or partnership and have no employees working for me in S. El Remodeling any capacity.[No workers'comp.insurance required.l 9. ❑Demolition 3.0T am a homeowner doing all work myself.[No workers'coma.insurance required.)t 10 0 Building addition • 4.01 am a hom:owncr and will be hiring contactors 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. 12.0 Plumbing repairs or additions 5.0 I am a general contractor and T have hired the sub-contractors listed on the attached sheet. ]3.nRoof repairs These sub-rnntiactora have employees and have workers'crimp.insurance? 6.0 eareacorporationanditsofficershaveexercisedtheirrightofexemptionperMGLc. 14. Other \ 152.§1(4),and we have no employees.[No workers'comp.insurance required.l *Any applicant that checks box#1 must also El out the section below showing their workers'compensation policy information. t Homeowners whe submit this affidavit indicating they are doing all work and then hire outside contractors most submit a new affidavit indicating su:h. tCootractors 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, lam an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Comjany Name: -Aybe\,\C_ "lf1 Sti.tr0.y-2 ( i v C t \O h Policy#or Self-ins.Lic.#: 0b cDC O ' (2 \\S Expiration Date; o?) € C)e.�3 Job Site Address: '1 q eCk.0 9- City/State/Zip: FtC.vey'tCC ma U t 0627 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 $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 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. Ido hereby certify un er the pains and pe ties of p r hat the information provided above is true and correct. 5iEnature: �- /�j? ,#,(/? Date: CA I 2V22 Phone#: Lk I J-S 4---1 S2 2- . Official use only. Do not write in this area,to be completed by city or town official City or Town: -PerrmitiLicense# Issuing Authority(circle one); 1.Board of Realth 2.Building Department 3:City/Town Clerk 4.Electrical Inspector 5.Plumbing inspector 6. Other Contact Person: Phone#: • • City of Northampton Massachusetts �w� ef 3 j c A=7 dint .c `- 1_ DEPARTMENT OF BUILDING INSPECTIONS y . m 212 Main Street • Municipal Building j_. s ` Northampton, MA 01060 r1�T�h • CONSTRUCTION DEBRIS AFFIDAVIT (FOR ALL DEMOLITION AND RENOVATION PROJECTS) In accordance of the provisions of MGL c 40, 554, a condition of Building Permit Number is that all debris resulting from this work shall be disposed of in a properly licensed waste disposal facility, as defined by MGL c 111, S 150A. The debris will be disposed of in: Location of Facility: LIC,t3 The debris will be transported by: Name of Hauler: \ICLUQ,j 00(1A-_. UG • Signature of Applicant: Date: Commonwealth of Massachusetts �� Division of Occupational Licensure • Board of Building Re ulations and Standards Cons y Hilelivisor f CS-077279 i }} Ikpires: 06/21/2024 l.4 F� •( r M + `.•,. STEVEN A SIA.Vir,stll ,� J PO BOX 606 r I t r.f i I (' 5 3 `. •.%� FLORENCE IAA 0106 l + •f,,' .r ''; -I d r+ tW 1;. Co...:ussio ner .a9,. 0- e Y.. .A•• I ..�s' 1 THE COMMONWEALTH OF MASSACHUSETTS ,�1 Office of Consumer Affaiis at l'IN nd Business Regulation 1000 Washing Eyre- Suite 710 Bosto ;-MassaGhset •u 02118 Home Im roe tb... ra of F egistration . � _ . M' wy j f 7 a iw .+ i ='.: .;;, _ „..0 Type: Corporation VALLEY HOME IMPROVEMENT INC ,� t•--•- -..`' - e ist ation: 105543 +.A , :..n: ,:: :::: E pj ation: 08/20/2024 P.O. BOX 60627 \'�1 " ' • i ; . :,, FLORENCE,MA 01062 - ^ "_:--.��:' i,, d - ~T° ft ..._ Update Address and Return Card. THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affaile,$Business Regulation - Registration valid for Individual use only before the HOME IMPROVEth ''CONTRACTOR expiration date. If found return to: TYPE: &orittioil Office of Consumer Affairs and Business Regulation Regist ate �iERbui'ati 1000 Washington Street -Suite 710 $ '�'_ 2UI Boston,MA 02116 VALLEY HOME IMPR .. Trn1 -_ l�;'' STEVEN A.51LVERMAit '� b 340 RIVERSIDE DRIVE',:. --} / " C� FLORENCE,MA 01062 =.;`• - '"`A�'`"`?'.,. Undersecretary Not valid without signature