38B-044 (7) BP-2022-1544
155 SOUTH ST COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
38B-044-001 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-2022-1544 PERMISSION IS HEREBY GRANT D TO:
Project# ROT REPAIR Contractor: License:
VALLEY HOME IMPROVEMENT
Est. Cost: 24600 INC 077279
Const.Class: Exp.Date: 06/21/2024
Use Group: Owner: CHARREN DEBORAH A
Lot Size (sq.ft.)
Zoning: URB Applicant: CHARREN DEBORAH A
Applicant Address Phone: Insurance:
155 SOUTH ST
NORTHAMPTON, MA 01060
ISSUED ON:12/06/2022
TO PERFORM THE FOLLOWING WORK:
ROT REPAIR TO DORMERS
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:
Vip,}L, . 591Ti
Fees Paid: $172.20
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Office of the Building Commissioner
I
The Commonwealth of Massachusetts
- _ 't Board of Building Regulations and Standards FOR.
MUNI
1 Massachusetts State Building Code, 780 CMR COY
I h� USE
Building Permit Application To Construct,Repair,Renovate Or Demolish a Revised Mad.2011
One-or T wo-Family Dwelling
This Section For Official Use Only
Building Permit Number: _& ? • I5'( 1 l Date Applied:
1<.) &OS . /ZZ 12-6-ZOaz .
Building Official(Print Name) Signature Date
SECTION 1: SITE INFORMATION___ _
1.1 Property Address: 1.2 Assessors Map&Parcel Numbers
I 55 fe, bi-- - —
1.1 a Is this an accepted street?yes no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
i
Zoning District Proposed Use Lot Arca(so ft) Frontage(ft) i
1.5 Building Setbacks(ft)
Front Yard Side Yards Rear Yard
Required i Provided Required 1 Provided Required Provided
1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public 0 Private 0 Zone: _ Outside Flood Zone?
,__r_-__n Municipal 0 On site disposal system 0
1 Check a yes°
1 SECTION 2: PROPERTY OWNERSHIP'
2.1 Owned of Record: n,,
1,n�l�trlry` Jr1► r��f! C (,i rfer o('- O- 4T� !' la U(o(oo
Name(Print) City,State,ZTP
tc65 - - ut3-St4-S igi3No.and Street Telephone F.rnail Address
SECTION 3•DESCRIPTION nF PROPOSED WORu2 (check all that apply)
New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Al.teration(s) 0 Additinn 0
Demolition ❑ Accessory Bldg. ❑ Number of Units___.-___ Other ❑ Specify:
Brief Description of Proposed Work2: ROT �>r ►414 OF _2- dX� -P'1 L't/Z.$ — SI,D»rGT
F _ !„^ . 1V n 5rit i c.Tt
, x 1 srl .-) C, a)E)1 A (s. u r- , 28
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
I.Building , $ 2-1- U ; I. Building Permit Fee:S Indicate how fee is determined:
'
2.Electrical $ 0 Standard City/Town Application Fcc
•
".1---____._.._ '❑Total Project'Cos0•(Item'6)x multiplier x
3. Plumbing S t— 2. Other Fees: $
4.Mechanical (I IVAC) $ T ist: .
5.Mechanical (Fire -- -- —
i Suppression) i $ ' Total All Fees`` 11��
Check No_41 . heck Amount:1
6. Total Project Cost: $ 2,4 (oi o 0 Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES _
5.1 Construction Supervisor License (CSL) 1 1 1 !� 6, r12/ )_.,0 E,5
jam. I-- C�l\ 1-���.-�. License Number Expiration Dare
Name at CSL Holder
c)-G ,(a c A (.001 �1 __ .�___. List CSL Type(aec below)
No. and Street Type Description
( 0 ( � U Unrestricted(Buildings up to 35,0O0 cu.ft.)
�'�Q�C.� �"'��`� R Restricted I&2 Family Dwell
agi
City/Town, to l ' M Masonry
�,/y.iffV RC Rooting Covering •
WS Window and Siding
r�
SF Solid Fuel Burning Appliances
(i,1 j . 1 22-- 1 Insulation
Tel ep-S '�
hone Email address I 17 Demolition
5.2 Re: stered Horne Improvement Contractor(HIC) �c��rf�u f?�Ci2f
���� �1"`. -r1'�•-,+r'L `-•4-`r) Fite Registration Number Expiration Date
• • FTT Comp Name or HTC Registrant'Tame
•eD (OO(o 1
No.and Street Email address
iDife 00(2.-
Ctty/Tovtnt,State,ZIP Telephone
SECTION 6: WORMERS' COMPENSATION INSURANCE AFFIDAVIT (M,G.L.c. 152. 125C(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 0
SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMITs
1,as Owner of the subject property,hereby authorizes?.
u` k'Yry,,10"1 - V I-d-..L
to act on my behal>~in all matters relative to work authorized by this building permit application.
fr,,i.e. /'• s.4-,1.��,�.. '
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 perjury that all of the information
contained in this application is true and accurate to the best o y knowle a rstanding.
•
S 7114.A) SA" q./l) % lr,1 //`"/7—aZd?,a
Print Owner's or Authorized Agent's Name(Elearoni ?gnaturc) Date
NOTES:
1. An Owner who obtains a building permit to do his'her own work,or an oscaer who hires an unregistered contractor
(not registered in th,eHornc Improvement Contractor(I-DC)Program),will not'nave access to the arbitration
program or guaranty fund under M..G•L.c. 142A Other important iufisrmation on.the HIC Program can be found at
vx- - .mass QovIota Information on the Construction Supervisor License can be found at www.mass.i ov/dps
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 bedrooms
Number of bathrooms Number of ha117baths
Type of beating system Number of decks/porches
Type of cooling system Enclosed Open
3. "Total Project Square Footage"may be substituted for"Total Project Cost"
The Conunotz weulth of Massachusetts
l Department of industrial Accidents
(1 . C;), 1 Congress Street, Suite 100
c's ti . . �=- &' Boston,.11L•4 02.114-2017
7�,, :vr,r .rtass.gov/dia
.r
Workers' Compensation InsIlL2nce.Affidavit;Builders/Contractor-siElectr'clians/f'lutttbers.
To BE FCLED WITH THE PERMITTING AUTHORITY.
Applicant Information l Please Print Legibly
Name ('3usiuessiOrganizvaon;'Individual): \ja 1 l't3 t"Tc—nc. Ira- ler-D-12 ICY)C("1-; , h..hC_
Address: F.-"AO R ✓s•\G\ ri`-t_ • t. e:)cxc ( o co Z-1
City/State/Zip: ‘-Ior-e+icc. ke- 01 Q(a2- Phone 4: t3-SS4-1522-
Are you an employer?Check``the•appropriate box: Type of project (required):
• I.EL I ar'a employer with__ 1. employees(full andiorpart-time).* 7. 0 New construction.
2.0 I am a sole proprietor of partnership and have no employees working for me in 8. 0 Remodeling
any aepaciry.INo:vorke: 'cornp.insurance require);
9. ❑Demolition
3_ 1 am a aomcowner doing all work myself.[Noy workers'comp.insurance required.)I
10❑Building addition.
4.DI am ahom.cor:r and will be hiring contractors to conduct nil-work on my proper,. I will
ensure that all contractors either have workers'compensation insolence or arc sole i i ❑Electrical repairs or ad e'i tions
proprietors with no employees.
12.E Plumbing repairs or ad 'eons
5.1:::1 I art a general contractor and I have hired the sub-contras:ors listed on the attached sheet
Those,xuh-cvrerantnrc have empinycrs and have workers'comp.insurance.: 13.nROof repairs
6.0 We are a co_peration audits officers have exercised their high_of exetiaptionper MGL c_ 14. Other
152,§1(4).and we have no employees.INo workers'comp,insurance reouired.i •
`Any applicant that checks box'1 must also fill out the section below showing their workers'compensation policy information
t Homeowners who subunit this affidavit indicating Cony are doing all work and thet bile outside contractors most submit a new affidavit indicating such.
IContractors that check this box must attached ao additional sheet shcwiag the name of the sub-contractors and stare whether or not nose entities have
employees. If the soh-contractor have employees,they must provide their workers'comp.policy number.
I an:an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name: -A1/b&,\C. ��)(1Si.>r'C0.v-Z C.L el rot No
Policy#or Self-ins.Lic.#:_ OO c3c O 3 CD 2. \S Expiration Date: 02) f' 1 O 77
Job Site Address: ,55 �. +-N City/State/Zip. ��`,f' I A 1 C)t 0(0O
Attach a copy of the workers' compensadon policy declaration page(showing the policy number and expiry on date).
Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to$1•,50C.00
andior one-year imp:-sonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$25C.00 a
day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DL'.for insurance
coverage.v erification.
r
I do hereby certify un er the pains and pe /ties of p/� ' . hatat the information provided above is true and correct 1
Signature: ��/' d"' /d/ p? Date: UU b t2Z•
Phone#: Li 3— SL-1---1c32Z.
t, ,t
Official use only. Do not write in this area,to be completed by city or town off.cial.
City or Town: •Permit/License 4
Issuing Authority(circle one): • •
1.Board of Health 2.Building Department 3.•City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other i�
Contact Person: Phone#:
City of Northampton _. .
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212 Main Street e Municipal Building
Northampton, MA 01060
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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, 5 150A.
•
The debris will be disposed of in:
\l 1
Location of Facility: v,0 Li ei .` ell..L.),(2.6,...fL3 MO/441CLYY1-140e-')
L.) }
The debris will be transported b.y:
Name of Hauler: \)0.),t0j &IA-k-- "l'‘._-(2V-C -ril4----
Signature of Applicant: --?
Date: .
/
--'---
Commonwealth ot Massachusetts
1.7) Division of Occupational Licensure
• Board of Building Rectulations and Standards
Consktielonir611/1—rvisor
s,
• .'.14',.p
CS-077279 .,: . _.1... ..411::;.:1 . ,pires: 06/21/2024
STEVEN A svOttiiA, i.;.:.'llItl.,'" 7,; ; ,::'}•04::',"' ,-
PO BOX 6062A i i',0,11 i•• Ili 3 'I.,j" 11., . 1.4: '
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THE COMMONWEALTH OF MASSACHUSETTS
04:1!•,,
Office of Consumer Affafks and Business Regulation
1000 WashingtoaAtr_eet,- Suite 710
Bostory -Mqssachusetis-7:021 18
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(rj :_ ;-.74i ...771"ita-al-iLie rr,1 ation: 105543
VALLEY HOME IMPROVEMENT INC 1,,\ liz..:...:-.-.,...;.*,!..1 ,... ...2.:4-•---77L-1 E 6j ation: 08/20/2024
P.O. BOX 60627 TF.-.::::.- ..-..i. i. 7-; :":::::,.":7.7 ..Jj
FLORENCE, MA 01062 , e -...—.Z:... 17 /7, =:-:-._7 if ,,),
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Update Address and Return Card.
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THE COMMONWEALTH OF MASSACHUSETTS
Office of Consumer AffaiFss& Business Regulation Registration valid for individual use only before the
HOME IMPROvEktgt CONTRACTOR expiration date. If found return to:
TYPErNifiaation Office of Consumer Affairs and Business Regulation
..„2.,__._.._, .
. -. 7 ,114E, ,ut . , 1 1000 Washington Street -Suite 710
11111°77!.ItPrk21/1:QA-4 Boston,MA 02118
VALLEY HOME IMPRw ,w,,n. r,4T IN.:-....:-.1,.--71 '..P
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STEVEN A.SILVERMPO.,).`1/•'.,,...,:::-,LALIS.,-,,.'--:7 ;•:..:
340 RIVERSIDE DRIVE t;c:.. ..,.•-...-.1..,..._•-•, ..;_‘•* ,,,,,„,,,„„a.(2,,,ez,„.4• 1.
FLORENCE,MA 01062 ..-•••• "..-..-:-- ..'.... L. .Undersecretary Not valid without signature
OMS Ver.0003.17.00(Current) VALLEY HOM.IMPROVEMENTS
Product availability and pricing subject to change. DIEHIL PROJECT
Quote Number*5GQQ4KY
LINE ITEM QUOTES
The following is a schedule of the windows and doors for this project. For additional unit details, please see Line Item
Quotes. Additional charges,tax or Terms and Conditions may apply. Detail pricing is per unit.
Line#1 Mark Unit: Net Price: 659.46
Qty: 1 Ext. Net Price: USD 659.46
M ARV I N Stone White Exterior
White Interior
Elevate Double Hung
Rough Opening 30"X 44 1/2'
1 Top Sash
Stone White Exterior
White interior
IG 1 Lite
Low E2 w/Argon
Stainless Perimeter Bar
Bottom Sash
Stone White Exterior
White Interior
IG 1 Lite
Low E2 w/Argon
Stainless Perimeter Bar
White Weather Strip Package
White Sash Lock
Exterior Aluminum Screen
At i,?wej From.The Exterior Stone White Surround
FS 29"X 44" Bright View Mesh
RO 30"X 44 1/2" 6 9/16'Jambs
Egress Information Jamb Extension from 4 9/16"to 5 9/16"
Width:25 7/8' Height:17 3/32" Najling Fin
Net Clear Opening:3.07 SgFt Note: Unit Availability and Price is Subject to Change
Performance Information
U-Factor:0.28
Solar Heat Gain Coefficient:0.32
Visible Light Transmittance:0.54
Condensation Resistance:56
CPD Number:MAR-N-272-00895-00001
ENERGY STAR:N,NC
• Project Subtotal Net Price: USD 659.46
6.250%Sales Tax: USD 41.22
Project Total Net Price: USD 700.68
•
OMS Ver.0003.17.00(Current) Processed on:11/4/2022 8:50:45 AM Page 3 of 6