38B-231 (3) BP 2024-0682
58 FORT ST COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
38B-231-001 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-2024-0682 PERMISSION IS HEREBY GRANTED TO:
Project# DECK REPAIRS 2024 Contractor: License:
Est. Cost: 16900 VALLEY HOME 077279
Const.Class: Exp.Date:06/21/2024
MUZIO CHERYL ANN &ANDREA JANE FISKE CO-
Use Group: Owner: TRUSTEES
Lot Size(sq.ft.)
Zoning: SC/URB Applicant: VALLEY HOME IMPROVEMENT INC
Applicant Address Phone: Insurance:
P 0 BOX 60627 (413)584-7522 61162301-1
FLORENCE, MA 01062
ISSUED ON: 05/31/2024
TO PERFORM THE FOLLOWING WORK:
NEW DECKING AND CABLE RAILING
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector
Underground: Ser%ice: 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: /2.
Fees Paid: $110.50
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
/
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The Commonwealth of MassaciiusetjGs 1114Y 3
Board of Building Regulations and Sta duds
OR
tJ
Massachusetts State Building Coda, 7g6 Q 0494 i CIPALITY
USE
Building Permit Application To Construct, Repair,Rent ! /sed Mar 2011
One-or Two-Family Dwelling Mgot40/vs
This Section For Official Use Only --
Building Permit Number: 6A4y.'a JIP. Date Applied:
� /
Co i rJ /:o,s /�2 5 3 l-Zpzy 1
Building Official(Print Name) Signature Date
SECTION 1:SITE INFORMATION
•
1.1 Property Address: 1.2 Assessors Map&Parcel Numbers
- Par-- -
1.I a Is this an accepted street?yes no Map Number Parcel Number
- i_-1:3 Zoning informations I:4 Property Dimensions:
Zoning District Proposed Use Lot Area(sq it) Frontage(ft)
1.5 Building Setbacks(ft)
Pront Yard Side Yards Rear Yard I
Required Provided Required Provided Required I 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? Municipal 0 On site disposal system ❑
_ Check ifyes❑
SECTION 2: PROPERTY OWNERSHIP'
2 Owner' f R cord.
Name(Print t City,State,ZIP
CA Rfk gv 'l3- - 1082
No. and Street Telephone Email Address
SECTION 3: DESCRIPTION OF PROPOSED WORK;(check all that apply)
New Construction 0 Existing Building4 Owner-Occupied 0 Repairs(s) CI i Alteration(s) 0 Addition 0
Demolition 0 Accessory Bldg. 0 Number of Units Other ❑ Specify:
Bri tDescription of Proposed Work2:
! . LU N)roc tr\_Q -;— ( 71t- Y.-Q.1.V1'LC.i OEN djCk tYl. 'c-V'o rvit rei
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1.Building $ I.(p t9 U 0 1. Building Permit Fee:S Indicate how fee is determined:
2.Electrical S CI Standard City/Town Application Fee
CI Total Project Cost' (Item 6)x multiplier x
3.Plumbing $ 2. Other Fees: $
4.Mechanical (HVAC) $ List:
5.Mechanical (Fire S 1 0,/p
•
Suppression) Total All Feed,:,$ fl q/
o Check Na y1 U� heck Amount: Cash Amount:
6.Total Project Cost: S 1 () l UC) p Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)'`
p C1 21`i Co.(Li 1 zoz-4
St•,{-Gr1 A. S License Number Expiration Date
Name of CSL Hol
List CSL Type(see below)
p.() . gore (co(Ovi No.and Street Type Description
�.� pt O'. b2 Li Unrestricted(Buildings up to 35,000 Cu.It)
Ci �1Tow , tart,ZIP R Restricted I&2 Family Dwelling
n M Masonry
f / RC Rooting Covering
///jjj��� WS Window and Siding
SF Solid Fuel Burning Appliances
LtUb-S424=-S2.7- T Tnsulation
Telephone Email address D ! Demolition
5.2 Registered Home improvement Contractor(MC)
\Jt".(..163 tC r%t Ton .rcrn-c� �If 1L. O�vSN�N $LLD ion 2y
�Q'�V HIC Registration Number Expiration Date
MC Company Name or HIC Registrant Name
P-o. cvx l c) co VT
No.and Street Email address
Flor•e_nc< ()no o to(o'Z 4-tk -SVl-1S2Z
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 O
SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I,as Owner of the subject property,hereby authorize V Wt. 40✓,rr%Ot.r1
to act on i chaff,in all matters relative to work authorized by this building permit application.
2Zi/20
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 th b t of any knowledge and understanding.
Sre VO' / S"2o- 2L
Print Owner's or Authorized Agent's Name(Electronic Signature) Date
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 M.G.L. c. I42A. Other important information on the HIC Program can be found at
ww w.rnasc go\ rca Information on the Construction Supervisor License can be found at .a w.mass.go' cps
2. When substantial work is planned,provide the information below:
Total floor area(sq.ft.) (including garage,finished basement/attics,deck.e or porch)
Gross living area(sq. R.) Habitable room count
Number of fireplaces Number of bedrooms
Number of bathrooms Number of half/baths
Type 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
F •�� SAS � SAC
Massachusetts
j;t:' i DEPARTMENT OF BUILDING INSPECTIONS w.
1.1 t ' i. 212 Main Street • Municipal Building J�;•.,_ �V
.r Northampton, MA 01060 �rtygjt^��
CONSTRUCTION DEBRIS AFFIDAVIT
(FOR ALL DEMOLITION AND RENOVATION PROJECTS)
In accordance of the provisions of MGL c 40, S54, 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: \111/Ae3 . X\ INIv ec►,
The debris will be transported by:
Name of Hauler: 41-W3 34/1,47��rrNt-no �
Signature of Applicant: Date:
The Commonwealth of:Alassac husetts
{ Department of Industrial Accidents
1 Congress Street,Suite 100
1.17
Boston, MA 02114-2017
' r wine nnass_gor dia
1S W1.rrt I'vowelization lnsuranrr Afforlat it Suilditr'(-untrsrinr ailectri ins;l'lumbe i.
TO HE 111.ED 11 i 1'11 1 t3E PERYI I1-11M;Al [MOk1T1.
Ant,Ilicant information �-c� Please Print Leg-i�bh,
Name 1ihnurtess.O niraum Individual►: J M j.�JtT �1•f!.0
Address: c-b. 6(>4r (-DU(O —
p\Uto2-
City."Statezip: 'c riThO' Phone ;.: cS�y-
Are)ua an emple)er'("berth the appropriate bat:
QQ Type of project(required):an:a t 7tpkn•a ugh AZ •rcrOyo ems 1S 1.n0 er rout-brra r' ?. D Ncv coristrtx-non
,D}ant a 4.11:}xuprecta ur pa.-tnc. sad ha.r nip cKet+vi vrli:c !vt uk ui — 8. (A Rentoelrlint► -any krapaxti).(\t:x tuixra•n .ire4=rltx rcywrrni l
3.0}—� y. � Demolition
1 em s humvMan&lag all ruck myself-}\u rcnl<.:+ ..•::�.tts arax. i�arreJ.:•
4.0 1:oat a lrui>St-s.taer and r,!I t'c 3cma-.z as:Wm L:t:atlr;t xt'tk •r my,r r_••}�.at} I+.J:
10 Q Building addition
trnaun•that all cuntracI n t'ttht:tavc wurirn':+rout tnaabon tn>uraz>. -or an .t,li I 1.iJ Elecmcal repairs or addltIorb
prvprtctun w the au 4.323131uy�t-..
12.0 Plumbrrn2 repairs or additions
3�! un a gvncral s vatra:ivt and I have huttl the%ub—vatrs lt•n Laird Lin tin•attach-d six cl l 1�ROuf repairs
Tl eau atd,tvotracwn tans ' acn and hoot porker,'.urnt.istar-ac..
14.❑Other
A.Q tl r sec a tvmp.rratrun and d., ttati-fl..d thrn at:a.•r-o ixm.Esc lt(.t.:
132, 1441.and r e tune nu catplhntca !No x trkAxs comp tr suram>.•c retr.i:nv.I
'Any a1+}Many ant charts Mar.-1 rrrtni Ain fill out the xtthin lz•Iu+a sb s m?therm%otter.*can -n-.ytrun}x'{ic infirrtration.
'htumttrmncra wbu s•,rbaut this affidavit Inds atug the)are dt'ui all murk and they l rn i.'hide contractor>aunt>ulxrui a aem i1riJa%rt udlitauaj such
tC vntra.un that sin:-t thn but wawa attached as aatu'buati+h.-i slew jax:la; seine:1 ti.aa'.a-.-t-t5-a•t.t.s and state r h.-th to at+r thus. rrri:bc.I.rnu
t^ luyct>. Lithe e uis-ctaotracan kr.iav caLr:sons.Ilse!, moat ynt ti xle them tatui 'wrap ;v1a t=rev':
I am an employer that is providing t priers'compensation insurance for my employees Below is the polity and job site
Information_
Insurance Company Name- t tG" ^�Si
4": t
1(1
Polies =or Sclf=ius.L . r, T� po \~ Expiration Date_ 2. 1202,5
lob Site Address: r J� TVr" Cit.:SL3te:Zip: 1404)
Attach a copy of the isorkersa compensation policy ticclaration page(.shooing the policy number and et pirati date.
Failure to secure cos era, as reyt ued under MGL c. 152.§25A is a eriminAl's iulabon punishable by a fine up to S1.500.00
an f'or tote-}'imp imprisonment.as Kell as aytl p lti. in the f y-m of a STOP WORK ORDER and a file of up to S230.00 a
day against the violator.A copy of this.tatiancnt may be fom arcked to the Office of Investigations of the DIA for insurance
coy craw verification.
•
I do hereby certify under dr Ap and penalties perils nforrnation provided above is/ true and correct.c
StSignature: p� D.:tt.: trIt\ c1
Phone 4: to 2 •
'E :-11522
Official use only Do nut write in this area.to be completed by city or tort official
City or Tuley n: Perini licciase;t
Issuing Authority(circle one):
1. Board of health 2.Building Department 3.titer-Town Clerk 4. Electrical Inspector S. Plumping Inspector
6 Other •
Contort Person: none
\Commonwealth of Massachusetts
��� Division of Occupational Licensure
Board of Building Re ulations and Standards
If'
Cons ton Svisor
-� r
CS-077279 's• f tpires:06/21/2024 .
STEVEN A SI}�VER :,:' GG••''
PO BOX 606 i:i r • .' p �`rrx' . .r1
FLORENCE MA 0106 `' '
•x.vr;•.G'....;>,,�)� I-Il ..."
�LI,V4lil
i
Commissioner vP„ 2 p. �•• .... .,
THE COMMONWEALTH OF MASSACHUSETTS .
Office of Consumer AffaiiBusiness Regulation
1000 Washingt4Atrgypt�- Suite 710
BostorMa&sacklusetts9 118
Home Impro -e:e .1jac o 'egistration
, - ' ---__.-- ,7)
r
t
r � _ .t _ s r t Type: Corporation
VALLEY HOME IMPROVEMENT INC ma's ...... eaiSl ation: 105543
_A E iJ alion: 08/20/2024
P.O. BOX 60627 _.a..
FLORENCE,MA 01062 �� : . p !w
17
Update Address and Return Card.
THE COMMONWEALTH OF MASSACHUSETTS
Office of Consumer Affaii$,8 Business Regulation Registration valid for individual use only before the
HOME IMPRQVEMENT'CONTRACTOR expiration date. If found return to:
T_XP.E:_ .ocpordtiotl Office of Consumer Affairs and Business Regulation
E . . Efatip 1000 Washington Street -Suite 710
S , - gf .j Boston,MA 02118
ALLEY HOME IMPR, M � 'Tz+Cf.
i� tw_ 114 �j y
TEVEN A.SILVERMARk ` . 51?-i^ '- !✓ A- 1 lififge , .10 RIVERSIDE DRIVG‘;::. .,-.."-�' 1,(0.,..o'a.� .
oREyCE,MA 01062 ;>, :; Undersecretary Not valid without signature -