18C-155 (4) BP-2023-1762
30 WARBURTON WAY COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
18C-155-001 CITY OF NORTHAMPTON
Permit: Agricultural All
Bldgs
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
BUILDING PERMIT
Permit # BP-2023-1762 PERMISSION IS HEREBY GRANTED TO:
Project# KITCH& BATHS RENO 2023 Contractor: License:
VALLEY HOME IMPROVEMENT
Est. Cost: 172000 INC 077279
Const.Class: Exp.Date: 06/21/2024
Use Group: Owner: FISHER-KATZ, DIANE E. & BROWN, MAREN T.
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: 12/20/2023
TO PERFORM THE FOLLOWING WORK:
RENOVATE KITCHEN AND 2 BATHS
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: ' Q
) d'
At,
Fees Paid: $1,118.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Office of the Building Commissioner
ri' C
of �� 1‘
c18
,, TheCommon;�ealth of Mali �µ bF r _ _
r Board of Building ing RegulationsN
and St. /<o, FOR
,s Massa.chusetts State Buildug Code, 780 C AToN Mg°pFC7.pro
�cIPAITY
'
'
Building Permit Application To Construct,Repair,Renovate Or Dem� s a s .evised Mar 2011
One- or Two-Famay Dwelling
This Sect.oza. For Ofticaal Use Only
Buildthg Permit Number: ) )"/70 . - 1 Date Appli ed: .
I �� f
3
Building Official(Prime Name) I Signature Da
SECTION 1:SITE TisTOFMATION
Li Property Address:`_ 1.2 Assessors Map&Parcel Numbers
*30 W(Y.v^ .1/. r-% L ti—
1.1 a is this ar accepted street?yes no Map Number ?arcel Number
1.3 inning Information: 1.4 Property Dimensions:
Zoning-Diiistrict Proposed Use Lot Area ilia,10 Frortaat fr.i
1.5 Building Setbacks(ft)
Front Yard Side Yards Rear Yard
Rehired [ Provided Required Provided Required Provided
1.6 Water Supply: (1v1.G.L.c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public❑ Private❑ Zone: _ Outside Flood Zone? Municipa.. ❑ On site dis?osal sv.:ztem 0
tML�cli.if yeS❑
SECTION 2: PROPERTY OWNERSHI "
!1 Ownert otRecord: J�, },,,,
eil i%'awf1 }' iarv.. t` ., 2- 1`*.�u' .4'1�. '"l V Y`try- cJ1OltoO
' Name(Print) City,State;ZIP
li.ii'1 1-tc.C\ tit3 .. 41'�- t3-4 1
No.and Streo' Telephone Email Address
SECTION 3:nESCprnTION OE PROPOSE.DWORKa(check an that apply)
New Construction 0 I Existing Building g Owner-Occupied 0 Repairs(s) 0 Alteration(s) 01 Addition 0
Demolition 0 ? Accessory Bldg. 0 Number of Units Other 0 Specify
Brief Description of Proposed Wolk': It..,'► tO : 'L. , c 11 etl»1 vii;A s ,,,) s
lir t:Ov 1 4 5 lu.ct.41 A! - 41G 1m,Ni j .
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
I.Building = $ ( S ( At6 1. Building Permit Fee. $ Indicate bow fee is determined:
0 Standard City/Town Application Fee
. 2.Electrical . S
6 t 0 C ❑Torai Project°Cost---`(Item'6)x multiplier x .
3. Plumbing $ 1 51 ()O 6 2. Other Fees: $
4.Mec€,rrr i al (IPvTAC) • $ List:
5.Mechanical (Fire S
Suppression) Total Al Fees: A�nn
Check_No.4(414vWheck Amount: l)k‘D
6. Total Project Cost: $ i "'1 ) 0V1) ❑Paid in Full 0 Outstanding Balance Due:
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SECTION 5: CONSTRUCTION SERVICES
S.1 Construction Supervisor License(CSL) ,
LicenseNUbe, I..xpiratioeDate
Name of CSI.Holder
�•) List CST.Type(nee below)
3 , (Ut z
No. anti Street Type [ Description
( .-, C.
�- L Unrest cted(Buildings up to 35,000 Cu.fr...)
--�— ' i t Restricted E&.2 FamilyIDwellire
City/Town;Star. —r.... 'vi �IWfasonry
RC Roofing Covering
WS Window and Siding
SF Solid Burnin2Appliances
'insulation
1-7.1ephore Ernai] aaaress D "Dermot ition
5.2 Recistered( Home Improvement Contractor(MC) 6 (4 )
HIC Registration Number Expiration Tate
• RTC Campan N_rie or HIC Registrant'Came
1
0 O( 1
Na.and Street
_Drt`_n.C.L.- 01.G- Olw aA✓Z Email address
City!Town,State,ZtP Telephone
SECTION 6:WORKERS' COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152.§ 25C(6))
Workers Compensation Insurance affidavit must be ccrrrpleted and submitted with this application. Failure to provide
this of idatiit will result in the denial of the Issuance oftne bui;ding penwt.
Signed Affidavit Attached? Yes No..... ..... 0
SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BuILU.rNG PERMIT
I,as Ok-ner of the subject property,hereby authorize • .tYrl tk1'1 . V i-4
to act on my behalf,
in all matters zeta e work authorized by this building permit application.
-anti 1 3J//f/ 3
Owner's`Name(Electronic Signature) D&e
SECTION 7b: ' R' 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 a phi :on i e an ate to the best of my knowledge and understanding.
Print "s . I 'Aker eed Agent's I ainc(Elecffontc&matxre) Date
NOTES:
I. An Owner er who obtains a building pee it to do his'her awn 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 information on the HIC Program can be found at
a-w w.rtass.gcvlocs Information on the Construction'Supervisor License can be found at WWw mass.stov: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 Emplaces Number of bedrooms
Number of bathrooms Number of half/baths
Type of heating system Number of decks/porches
Type of cooling sytem Enclosed Open
3. "Total.pi-eject Square Footage"may be substituted for"Total Project Cost"
The Commonwealth of Massachusetts
t , 1?elral rtzent of Industrial t_cidetzfs
- �1 1 Congress Street,Suite 100
•, � Boston, 14f4 02114-201?
Tc'}vw.772ass.govlia
Workers' Compensation Insurance Affidavit:-BUilders/Cenn3ctorsiElectrieinnsiPlutubers.
TO BE FILF.n WITH TILE PER.MI'I E G AUTHORITY.
Applicant information Please Print Legibly
Name (BusinessiOrgariza.non/'.,ndividual):,_ \!Q.1 tcJ c J� :Y1 G �:L ri.p 3-4-€+M C y-1-1 , "i''1 C.
Address: 5"Ac) R..k.� ✓ vfit 1Dr-ti�s-c. ? 0. x c Coa(.Z 1
City/State/Zip:r tOTer(. . t-1 O}stoic Phone#: 4{,16-Ss4--I 52 -
Are you an employer'Check the appropriate box; - Type
Type of project(required):
1.0 I am a emp oyer with i o cm;.loyees(fail Indio: art-time).' ?. Q New consu ction
2.0 I am a sole prop/clot or pattisexsaru and have no employees working for cte in S. El Remodeling
any capacity.;'\o wore ers'comp. insurance required./
9. ❑Demolition
1.0T am a homeowner dui:4 al wok myself.E'Tu warkecs cam: insurance ragtime')t
10 D Building addition
4.0I ant in homeowner and will be hiring contractors to conduct all w0_-1• co my property. I will
ensure that all cootracto.:either have workars'compensation insurance or are Role 11.0 Electrical repairs or additions
ro rietors with no e=n l .ecs
p p p 12.0 Plumbing repairs or additions
5®1 am a general contractor and T have iii-e1(no sub-cnntrsctors listed on Me attached s ect. 13 EIRoof repairs
Theo cub-snob-actors have em e pinye .and have xxrrkers'cramp.in.,-ante
6 O we are a ccxporatiu and its officers have eterdsed.their sight of exemptionMv:per C.c, 14.0 Odra
152,YI(4),add we have no employees..(No wut$ers'comp.insurance requircdl .
'Any applicant that checks box#1 must also fill out the se.:donbelow sho-wing their walkers'cnmpcnsation policy infra radon.
:Homoowners who submit this affidavit inrii;atag they axe doing all work and then hire outside contactors mast submit a new&Ida-Fit indiction:;sack.
:Contractors that check this box most attached an adctioo.at sheet showing ttc Dane of the sub-coatrrtors and state whether of not those entities have
employees. If fie sub-contactors I-eve employees.,they must p-cvide their wnrce-s'comp,policy number
I ant an employer that is providing workers'compensation insurance for my employees. Below is rise policy and job site
information.
Insurance Company-Name: -A vAceta. ti'l s1/4-=' `'2 C.t.._ �.`-1„'"mil,o — .
Policy#or Self-ins.Lie.4: 0 tb D 3 b 2. Expiration Date: `021 1 ! .G9•
Ci /Statefz 010 CD
i � � �
Job Site Address ,1 .)'S L-4(r•r ty, �:
Attach a copy of the workers'compensation policy de ation page (showing the policy mntber and etpil-ation 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 maybe forwarded to the Office of Investigations of the DJ A for insurance
c overage,cxcrification,
l`do hereby certzfy un er the pains and pe Ries of p �v1 l a, hat the information provided above is true and correct
sisignature,: i`? Daze: 10 _
Phone 4: JLt . - c..t24--I S'2.Z
Official use only. Do not write in this area,to be completed by city or town ofj..cial.
City or Town: Perrni('License 4
Issuing Authority(circle one):.
1.Board of Health 2.Building Department 3..City(Towrt Clerk 4.Electrical Inspector 5.Plumbing inspector
6. Other .
Contact Person: Phone#: .
City of Northampton
Plassac'nusetts
%CM
;fit DEPARTMENT OF BUIL DI Ng INSPECTIONS
272 Main Street 4, Municipal Buildimg
Nrthampt-i,n, MA 3IQS0
CONSTRUCTION DEBRIS AFFIDAVIT
(FOR ALL DEMOLITION AND RENOVATION PROJECTS)
ln 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 MGLc 111, S 1S0A.
The debris will be disposed of in:
Location of Facility: 4) e),A, cy4-1-1.
The debris will be transported by:
Name of Hauler: tqalto,t, aKfleCAYtra_e-A...#—'
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Signature of Ap.plicant: ,
-\
Commonwealth of Massachusetts
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It Division of Occupational Licensure
Board of Building Regulations and Standards
Const ionll rb visor
f
CS-077279 "c tpires:06/21/2024
STEVEN A SI VERhAA �� i? jll( r, i+ rl
. FLORENCE IIIi'L1 010621 * ', O% 91411.11. j �
a,yr�!R `,; �,a J�U Ott",,i.� .l!
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THE COMMONWEALTH OF MASSACHUSETTS
Office of Consumer Via.
AffaI and Business Regulation
1000 Washingt,n r ,- Suite 710
Boston;;=Mas aohusett 02118
Home Im ro e rrt T'f tr' ,,egi tration 1r — = . �Y Type: Corporation
VALLEY HOME IMPROVEMENT INC hif '','� =_ = e ist ation: 105543
!,;1 = �= .:� Ejativn: 08/2012024 P.O. BOX 60627 _
FLORENCE, MA 01062 `�.. ,�-=Y{'.- T- .✓� r�� I,i
.... / Update Address and Return Card_
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THE COMMONWEALTH OF MASSACHUSETTS
Office of Consumer Affair's,,$Business Regulation - Registration valid for individual use only before the
HOME IMPROVE ENT`CONTRACTOR expiration date. If found return to;
ll'P.E. rpc`aratio Office of Consumer Affairs and Business Regulation
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13fSdtlFitl elk='-= P;et atiop 1000 Washington Street -Suite 710
1 i 4-Y" �_'lliPg,01 47r1 Boston,MA 02118
4k_LEY HOME IMPR,�7IM.... T I .1_�-;�,i 1
C±�. tt
rEVEN A.SILVERMPit�� - `"
IO RIVERSIDE DRIVEY� ,'=;'�,"'W�" �'/ C, - �� 41, �-ORENCE, MA 01062 •:, Gam"' CL.�" �"'6` ���"
s .'`` "f' Undersecretary
rY Not valid without signature •