38B-127 (5) BP-2024-082.5
4000LUMBUS AVE COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
38B-127-001 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-2024-0825 PERMISSION IS HEREBY GRANTED TO:
Project# PORCH REPAIRS 2024 Contractor: License:
Est.Cost: 8400 VALLEY HOME 077279
Const.Class: Exp.Date:06/21/2026
Use Group: Owner: JOELSON JOHN M&JOANNE LEVIN TRUSTEES
Lot Size(sq.ft.)
Zoning: URB Applicant: VALLEY HOME IMPROVEMENT INC
Applicant Address Phone: Insurance:
P O BOX 60627 (413)584-7522 61-162301-1
FLORENCE, MA 01062
ISSUED ON: 06/28/2024
TO PERFORM THE FOLLOWING WORK:
PORCH REPAIRS
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 Driven ay 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: 77"P
Fees Paid: $65.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Office of the Building Commissioner
uut_uaiyn Cnvewpe iu.DColvoLJJv-r rev—rcO) ..Urmrcv itivoruoa
,� rib: Ccrnmon.+wealth of Massac . -ett 11
;4 sere. Board of Building ReguliUens and+tan rds` ON 2 7 'OR +
t{ ,}� 202Q UN -IPAL1TY i
\ : ` Massachusetts State Building God 780 NS USE
' nFPT
13ut!dngYer i.t?'iop:ieatiunToConstruct, Repa -, : noN QI7L'rt • Revi. ! :rar201:
One-or Two-Family Dwelling HAnm,oN•aorcrio4
Th. e;.tion For Ot"t°'_c:al Use Only
BuildingPermit Number i 1 a "(4
--- r _• 61 2.9.12.132 4 to Z7-ZOz41
CVIN 053 -
Bailarng Official(Print Name) Sia-,azus Date
SECTION 1:SITE INFORMATION A A~
1.1 Fruperty address; 1.2 Assessors Map& Parcel Numbers
.._`fit COlOrnt�®.> °nun
I I a is this ar accepted street?yes ate Map>'urber Pare1'4t.-Whet•
1.3 Zoning,Information:---,- 1.4—Property-Ditm:minas: — -
Zoning District Proposed Lc i :.:.4 ACC],cs4 fu) Frzniage(9)
1.5 Building Setbacks(lit)
From Val Side Y:i.t, Rear',raid
Required 1 P:u ided Required j Provided Regened Provided
1.6 Water Supply: (M.G.L c. 40.§54) 1 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Zone: Outside Fi'x.d Zen e
Pub to D Pr.�are O — Mtxninpal O On site d:sp,sal syst:m 0
SECTION 2: PROPERTY"OWNERSHIP'
2.1 O«ncr'of Record: .
' jQt-pr \—G.•••/ s.r NO. 10- f4.rt fl' Ot0(o 0
arr,e i P tt 1 City,Stan,ZIP
LAO COAL.eN-- 3 C_ 4( 8?5'- 2Q7
N.J. ,itri ;rrert Telephone Euuli Address
SECTION 3:DESCRIPTION OF PROPOSED WORK'(check all that apply)
New Construction 0 Existing Building b °wmcr-Occupied a Repaiis(s; & Alteration(s) C I Addition 0
Demolition 0 Accessory Bldg 0 i Number of C'.its Other 0 Specify:Brief Description of Proposed Work2: R E Nt,l►GE FILOkiT PDRC_ Q .1NEr,. ` :
fAL
PvaD 1 ,a,Gs To At'- 5,,5 5 dis Poked St OS .
SECTION 4:ESTTLATED CONSTRUCTION COSTS
Estimated Costs:
Item Official Use Only
(Labor and Materials)
I. Building s 8 goo I. Building Permit Fee: S Indicate bow iec is determined:
- 0 Standard City/Town Application Fee2.Electrical S ` 0 Total Project Cost' (hem 6)x rulltipi c _-__x ._
_
3.Plumbing S 2. Other Fees: S
4.Mechanical (H/AG) S Lin::
5. Mechanical (Fire $ Tuts: All F+-
SulilpreSSioc
No.Cheek .,.Atnount:_Li _cosh Amount____
6. Total Project Cost' 4Od p p;r41 14 Fc:_ 0 Cru:Flauding Balance Due.
Uocus+gn envelope IL):ti2tSA;iU-iU-h 1bU-42tid-AL:113-tf4tU14UUI-UtSb
SECTION 5: CONS'RUCTION SERVICES
5.1 C7 :1 .( ,ction Snpervlsor License(CSL) ' 0-1 i 2.-1 c�i Lo III 12.444y
t�� C _ ` ,
C: ��.tL� n f� ' l .'� �Y1�0..n ' License`�Iar.,h.i t-�:ps:zikli i)_�
Ni cr_e of CSL Holder i
fist CSL TI,y:e ts;.c:._-..-x i
No.anit suet, Tyne L�:�-truce
F1.0i-Gr1G�= �'1 r' C)\C�b2. _ U Ui::•_stria:e iB=sitdin�s c :o 33 WO cu. .j
___ R Rcctritted I&2 Family Dwelling
1 t_ ! �e'•+p,�;:Is. i.t}> ft / / /, M NLisonty --
A1"/f ! ;/1 RC F;,oi'g t_ever ing
�f`t!; //11 r ✓ _-- I WS il:1 ldo*and Siding —
SF I Solid Fuel teeming Appliance
4t3-Sgt41S22- I 1insulation i
T:4i-drone F.ma,i adurc>s D ! Uemnbtion
5.2 Registered Home improvement Contractor(IJIC)
Ni l-Ir—rt t..'LinXervC-s-� mac.. 1 `1� B12.0_ 0?Y
'Qr� tI1C Rtgi35-aUo:i hhuribti EY.iriratian Dal-
1flC CoTranyNam: Dr HIC Registrant Name
No.and Strcet I'-nsi1 ad=L
'tv.re...r\Ct tMP o unto'-- 'ivy-Sgt-k--IS2z
City ITown.State.ZIP Telepn:4-t
SECTION 6: WORKERS'COMPENSATiO\ iNSURANCE AFFIDAVIT(N1.G.L c. 152.§ 25C(6))
Workers Ccrnptrsa::un Insurance of idavitmust be completed and submitted will this application. Failure to provide
this aficavit will result in die denial of the Issuance of the Wining permit.
Signed Affidavit Attached? Yes ...... .. Dr No........... C
SECTION 7a: OWNER AiITHORIZATION TO BE COMPL,F.TF.D WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I. as Owner of the subject property,hereby authorize 1}Att., vet-% k,1\te✓,nor-.s
to act on my behalf;in all manors relative to work authorized by tins building per n t aplilicat uo_
ilk
Par,P,_
nt Owaa dame(Elect:otie Siszaw 6/20/2024r) Date
SECTION Tb: Q SNER1 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 h RE of my knowledge and understanding.
Srt-v0v A. S/L 1/0YLA 4/ - 1 104' 6- ai-A*7.y
t
Pant Owner's a Authorized Agent's Name(Recuotatc Signature) Date
NOTES: — -- -—
1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered cnntracior
;not registered in the Home Improvmaent Contactor(HIC)Program). will nothove access to the arbitration
program or guaranty fund under L&G.L.c. 142A. Other important information on the HIC Program can be found at
u'r rnas> novioca Information on the Construction Supervisor License can be found at wwx.tr_ass s.o;.tips
2. When substantial work is planned,provide the information below:
Total floor area;sq.ft.) (including garage,finished bascmentiattics,decks u:porch)
Gross Living area(sq. ft.) Habi:alb room count
Number of fireplaces Number tit-bedrooms
Number of bathrooms Number abaft/baths _
Type or heating system Nunhbc: of decks!porches
Type or cooling system lineosed Open
3. "Tutu!Project Square Footage"n ny be substituted for -Tour: Project Cost"
City of Northampton
.� F ►_.assachusetts vS • -- SC'`�.
- ; `` DEPARTMENT OF BUILDING INSPECTIONS �, 3!
t '� ::- ' 212 Main Strcot • Municipal Building s.,. `2,
Northampton, MA 01060 �r►ryY N^�
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:
Location of Facility: IO Ut etc36.A. i N0,-.1- C�ry .}-t,►-,
The debris will be transported by:
Name of Hauler: 4v-Core r-r-,C.r\' (--
Signature of Applicant: a 1. Date: d— d/, 702,1
The Commonwealth ctlth of Afa scchusetts
Department of Industrial Accidents
• I Congress Street,Suite 100
1 Boston,:tf.402114-.201
`=• ttrrc'w.nutss.gos/din
%4 urkrrs'( wn,r•axttinzs .kf vomit_Strildein'f-t=rzetarsi'Elertrit�a s,`Yh�r.�fsrn.
1() KE FILED NII'H 1 PI_RMIIlt'a,:\t11-10KIT1.
Applicant Information n
1 Please Print Le--iblt,
Name ti3uupcss or`�.^•ritir�n IndcvId1:al1: ki.Me V L cJ t-- 1�}(1 C S9� C.
Address: 9.b. 6 l„0O(.0 2"7
City.:State;Zip: (11Thc' Phone `�j— Cj "l- -1 52` -
_lrr lac an cmpl r..art Chad the appropriata bet:
T)jst of project(required):
s amtaL•n t s tib L8 cc�wayan,.�7 w luti•Frn><•7 7. J NCa1 COlbtrUCtJOn
r au wk pruprictal Ui partncraka+zoJ tialt av asapluyala ua+riuc :W trn o . 21 Remodeling
nsy a a�.l�o%atta7,'r' urm
y.irticc rcyucca1 - \/\�
•
0 1.=a lion:sr+aac dale==all I.,rl,=pelf.?No*in Loa c.�:L-+.a_,o:.:�a::rt:unJ.J
9. 0 Demolition
4.0 1`lilt a 1e+ .lKac7:nd,111 bersig 0371±PJGIvra!i ido.t all*Inkun a+I-.•r7n I u;14 f1
I0 Buildi `�addition
mule that all aurtr'Jctars��;have uaricra•ctar;,rccra x:a lrt:.ur_' ..x+F: 1 i Fry...trical rep:o'r5 or additions
prae tors u l tl%exa=player.
12.0 Plumbing rtpatrs or additions
< I:Jn a r.Laeral ctrdlt .lar and I thvr turvd rix..it-tiwtra l_•r.toad ur t c.it t i d alhal
FZ+x at>;f awcrirua 1 �c.—t+v�ct5 +!hs�t tvrkaz,'alvaF
l 3.Roof repair
nOther
6.❑A c arc a ay.• r..aauc_,Id affirm tea..c:ice d l:a= h .el.�.r,tYm pp- c
3'LIIa tta I.ear nee hatir Its Iaphrtirea.•1..'a`u tvt r cv^rp. malrdw.c retain-al I
'Ally applicant that iha:ls hoe x i:cum tibia fill a ui the 1r•ivu slut,.Ina th',-r I.art.T•iurrwraniwr.iv{iey iakmna±iart
J Huax^t:uvrra u'h a St:bawl LSia at*Ida1'll tyr_a:s'thcY rn duals all V earl:anti then}lire uuuiiii:aa.nLra•turf ciu.+1 lubrau Ia Oa N affidavit tttlaa'L:C such.
LCun.7a lain Li:!Ott aka t+ux ztims3 aux.-1 %!as al:.tiDaral.l xr>tx u inn't><V tic alcha>at..-irR-x ken›-red'Lae whetba:ul }caw
du:aubtaru•:_•^ h-a<v-rrlat+m.try crc.t4 reap•,I.lc thcs I>wKl ten"• wane a cz
I am on employer that is prtorldine workers'compensation insurance for arc employees. Below is the policy and job site
information.
lnsusimee Company Norrlr:
Policy= Se!f=ins. Lk.=: 1p k'k -- .=tiger-icy+Date: 2.1 I 1202$
Job Site Address: kAO CO1.4.)04 S ate_ City'Stste Zip: V40 MP- Ok O49-a
Attach a copy of the workers' compensation policy declaration page(ihotying the policy number and eipirat on date)..
Failure to secure co% rage as require!under NIGL c. 152. is a crimi_nitl‘wlatzuu punishable by a fine up to 51.50(1.00
autt'oor one-ye-as imprisonment as call as dcii ptnaltios in the form of a STOP WORK ORDER and a fmJe of up to S230.00 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 tar p and penalties padre reformation provided above is true and correct.
Si3nd.FtlJY.
• (Zb
Phone Y: t''`k k:--7)cj22-
f Official use only. Do not write in this area,to be completed by city or town official
City or Town: Permiut iretr,t
Issuing Authority (circle one):
I. Board of IIealth 2, Building Department 3.City rrtmn Clerk 4. Electrical Inspector S. Plumbing Inspector
6.Other
'csxtxVI Palsy : ._____ It toot 4:
j
Commonwealth of Massachusetts
Division of Occupational Licensure
Board of Building Re ulations and Standards •
•
Const iorlirSUp' rvisor
44.
CS-077279 ". ;;"/v •1tpires:06/21/2024
•
STEVEN A MANEF,4,,• 540��iii ;, . h,3;1 }.�,. ,
PO BOX 606 i.1 ir- i ,,, ''�1 `i l' '"'• '
FLORENCE IN'�A 0106 s+ } + tt' lj
's: .yr/df Z- a;t j �� .,,
M(11.1.vdi� l `
Commissioner ', n f c-,��,.•,:n.
THE COMMONWEALTH OF MASSACHUSETTS
Office of Consumer Affai S and Business Regulation
. 1000 Washingtret - Suite 710
. BostorpMassad usettsr fl 118
Home Impro .....l�te9_ . C'a 'v1 ,e istration -
--)
f'^I Z ~.- I'!` Type: Corporation
f .I '. �I� yp u
VALLEY HOME IMPROVEMEt•1T INC J a station: 8120/2
•�-k _ E kjiation: 06/20/2024
P.O. BOX 60627 ... 1�
FLORENCE, MA 01062 �� � : —`1 441 •
\-t.tr ..., ;`i1 '
Update Address and Return Card.
•
THE COMMONWEALTH OF MASSACHUSETTS
Office of Consumer Affaifsti&Business Regulation Registration valid for individual use only before the
HOME IMPROVE&LEN CONTRACTOR expiration date. If found return to:
E:_ rpo5t tiod Office of Consumer Affairs and Business Regulation
'-ti— 1000 Washington Street -Suite 710
Rea><sttatl n=.- ER�IfStio �
41; # '-_` ' : .i . 97 Boston,MA 02118
'ALLEY HOME IMPRI�J dE -T IIl.'" •
:TGVEN A.SILVERMAr ' ^7 tf
AO RIVERSIDE DRIVE'r =` am'^'-"a,l .
COREAICE,MA 01062 .: ,,-''..p'� 1lndersecretary Not valid without signature