The URL can be used to link to this page

BP2011-0493p � sK♦ GIS #: 7 Lot: -001 Permit: Building Category: Permit # BP- 2011 -0493 Proiect # JS- 2011- 000808 Est. Cost: $3800.00 Fee: $55.00 Const. Class: Use Group: BUILDING PERMIT PERMISSION IS HEREBY GRANTED TO: Contractor: License: VALLEY HOME IMPROVEMENT INC 077279 Lot Size(sq. ft.): 4138.20 Owner: ONEILL MARY E Zoning: URC(100)/ Applicant. VALLEY HOME IMPROVEMENT INC AT. 22 FORT HILL TER Applicant Address: Phone: Insurance: P O Box 60627 (413) 584 -7522 Workers Compensation FLORENCEMA01062 ISSUED ON. 121112010 0:00.00 TO PERFORM THE FOLLOWING WORK: REPLACE /REPAIR SHEETROCK & OAK FLOORING POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Underground: Service: Meter: Rough: Rough: House # Driveway Final: Final: Final: Gas: Fire Department Rough: Oil: Final: Smoke: Building Inspector Footings: Foundation: Rough Frame: Fireplace /Chimney: Insulation: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occupancy Signature FeeType: Date Paid: Amount: Building 12/1/2010 0:00:00 $55.00 BP- 2011 -0493 COMMONWEALTH OF MASSACHUSETTS CITY OF NORTHAMPTON PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Louis Hasbrouck — Building Commissioner File # BP -2011 -0493 APPLICANT /CONTACT PERSON VALLEY HOME IMPROVEMENT INC ADDRESS/PHONE P O Box 60627 FLORENCE (413) 584 -7522 PROPERTY LOCATION 22 FORT HILL TER MAP 38B PARCEL 025 001 ZONE URC(100) THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid Typeof Construction: REPLACE /REPAIR SHEETROCK & OAK FLOORING New Construction Non Structural interior renovations Addition to Existing Accessory Structure Buildiniz Plans Included: Owner/ Statement or License 077279 3 sets of Plans / Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFOVAIATION PRESENTED: pproved Additional permits required (see below) PLANNING BOARD PERMIT REQUIRED UNDER:§ Intermediate Project: Site Plan AND /OR Special Permit With Site Plan Major Project: Site Plan AND /OR Special Permit With Site Plan ZONING BOARD PERMIT REQUIRED UNDER: Finding Special Permit Variance* Received & Recorded at Registry of Deeds Proof Enclosed Other Permits Required: Curb Cut from DPW Septic Approval Board of Health Water Availability Sewer Availability Permit from Conservation Commission Well Water Potability Board of Health Permit from CB Architecture Committee Permit from Elm Street Commission Permit DPW Storm Water Management Demolition Delay l 0 136 1 Signature of Building Official Date Note: Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning requirements and obtain all required permits from Board of Health, Conservation Commission, Department of public works and other applicable permit granting authorities. * Variances are granted only to those applicants who meet the strict standards of MGL 40A. Contact Office of Planning & Development for more information. City of Northampton Building Department 212 Main Street Room 100 Northampton, MA 01060 phone 413 - .587.2,240 Fax 413 - 587.7.272 Department use only Status of Permit: Curb'Cut /Driveway Per Sewer /Septic Availability..__. llyoer /Well Availability Two Sets of Structural Plans_ _ Plot/Site Plays' Other 'Specify_ APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING C u SECTIO N 1 - SITE INFORMATION This see: #'sor? to be completed by office 1.1 Pro er . d ress: Map — Lot __Unit - .._. C✓ Zone Overlay District Elm St. District — _ __ CB District, _..- SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record Name (Print) _ Current Mailing Address: C�rti1 LI ftiy .A �8 i Telephone — — Signature 2 2 Authorized Agent: Steven Silverman i V alley Home Im p roveme nt, In P.O. Box 60627, Fl MA 010 Name (Pr' ) Current Miailing Address: µ 58 -7522 - — Signature Te;e hone p SEC TION 3 - ESTIMATED CONS COSTS Item Estimated Cost (Dollars) to be Official Use Only completed b ermit applicant . Building (a) Building Permit Fee 2. Electrical (b) Estimated Total Cost of Construction from 6 3, Plumbing Building Permit Fee I 4. Mechanical (HVAC) 5. Fire Protection 6. Total =(I +2+3 + 4 +5) - Check Number 9 This Section For Official Use Onl Building Permit Number: Date Issued: Signature: L Building Commissioner /Inspector of Buildings Date Section ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED r r OF O, I A. Has a Special Permit /Variance /Fyfiding ever been issued for /on the site? NO DON'T KNOWS YES l IF YES, date issued: IF YES: Was the permit record d at the Registry of Deeds? NO DON KNOW YES IF YES: enter Book! Page and /or Document # B. Does the site contain a brook, body of water or wetlands? NO DON'T KNOW YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained Date Issued: C. Do any signs exist on the property? YES NO IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property ?YES _ No IF YES, describe size, type and location: Existing Proposed Requiredby Zoning This column to be filled in by Building Department Lot Size Frontage Setbacks Front Side L: R: L: R: Rear Building Height Bldg. Square Footage % "IT Open Space Footage %,' (Lot area minus bldg & paved p arkin g) # of Parking Spaces r (v i .i l urne &Location) / I A. Has a Special Permit /Variance /Fyfiding ever been issued for /on the site? NO DON'T KNOWS YES l IF YES, date issued: IF YES: Was the permit record d at the Registry of Deeds? NO DON KNOW YES IF YES: enter Book! Page and /or Document # B. Does the site contain a brook, body of water or wetlands? NO DON'T KNOW YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained Date Issued: C. Do any signs exist on the property? YES NO IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property ?YES _ No IF YES, describe size, type and location: SECTION 7,1 - oVM9 R AU T IiORIZ.AT�Oti TO BE COMPLETED ilIE J OWNERS AGENT OR CION T RAC:TOP APPLIES FOP BUILDING PERMIT s ; Steven Silverman, Valley Horne Improvement, Inc 660-116 1)9 - Ste_ven__Silvem - in, V allev Hearne Trnrovernent. Inc :; Y . ,i � 1 � �F k �lvo r��,� urn . t� m_. lF�rk ��_�. r�c�,��, SECTION 7,1 - oVM9 R AU T IiORIZ.AT�Oti TO BE COMPLETED ilIE J OWNERS AGENT OR CION T RAC:TOP APPLIES FOP BUILDING PERMIT s ; Steven Silverman, Valley Horne Improvement, Inc 660-116 1)9 - Ste_ven__Silvem - in, V allev Hearne Trnrovernent. Inc :; SECTION 8 - CONSTRUCTION SERVICES i .1 I..ICt;m od Construction Supervisor: Steven Si lverman__ 2 68 Tromer Road, " yrc,cc 58 -752 9.,,R isteripd_HQm lmpro tLee!ll nt_~' gntractor_: S _S 1 s,omparly dame 26. Fom er _Ro Sou P>sA 01 073 Tcicpl:orn: 5 Plot. F..;,p 1ca010 ._. -. 077279 6/21/1L Net Ap�,)1 Ll 1 1_Q Expiratior f)atc - - -- SECTION 10• WORKERS' COMPENSATION INSURANCE AFFIDAVIT (M.G.L. c. 152, § 25C(8)) '•,`l�rwers Com ensa icy Irist.irar e aff; davit r - riust be cornoloted and su :x- njtted e�,�ilhw this apokcation. I- ailure to pro,idt -.�ti� afiiu lsiiii res - ,iit in the cer�iai of the issuarce o" tiic buiiding permit. Affidavit Attached Yes....... X No...... 0 11.. -biome Owner Excmt)tion 11-ii; Cirrenf f ,c lnp.tion wvas tstendcd to include Owner- occimied Dwwcflani =s of one ( I ) ale' w � ") ILi- i1i111 .S �lncl to allow such homeowner to :.myllac all individual for hire who does not possess a license, 11!:In�iclet3 tha the of nec .fits its aaitcrwisoi C:'w'il� `7810. Sixth Edition Section iti8.3,S.i. _�_� I)efinition of Homeowner Person (s) who owwn a parcel of hand on wvhich hc'shc r: sides or intends to resiA t, o:] v,hich tliorc is, or is intended to be, a one or two family dwvellina. attached or detached structures accessory to such ttse and/ or Ibl iii structures. A et who constructs snore than one hone in a two -wear period shall not lic considered is ltossacowvriei Such ' homotm ner�' shall submit to the Building- Official, on a form acceptable to the Building Official, th he/she shall he respolisil)le for all such work performed nntler the buildin +' permit. As acting Construction Supervisor your presence on the soh site wvill be required from time to time, durim a.nd a pool completion of the work, for which this perinit is issued. Also be advised that with reference to Chapter '152 (Workers' Coinpensation) and Chapter I; (;Liability of F.mph,,nt.rs to t ?IllploVees for injuries not resulting in Death) ofthe :4lassacluisetts General Law %s Annotate 1. you may he 11a bkl l'o naasol"(S you hire to perform work for you tinder this pern;it. The undersigned "horneowner" certifies and assumes es responsibility for copl.ance with the State Buildin f=_ Code, C ay of Northampton Ordinances, State and Local Zoning l_awvS and State: Of M ISS�ICJIUSz °'us General La`vs .'` 1 1110tutCa. i I I i Ilon3cz3wvner tii�itatztre P , I g 01110 of Consumer Afl', and Ifusiness Re 70 10 Par Suite 5 1 k Boston, Massachusetts 02116 1 llom e till proveme, nt ("ontractor Reg"istration Fiewssaton 131945 Too WG=al Exmi 1O, TV STEV', A, P( tit._ 268 MMER RD, SOUTHAMPTON, MA 01073 I 1AWe Addmm and r"um card, NAK r"son Nr chungv, Address ' Empivymew Lo��t Card IJ':vm" ur vtflid P r imfikidul tv'" tm� b,Jory the , kph'a0on date. If found r-.1urn to Oft of C:onsmwr Affairs and Busjut�s.� Reguhtiml 10 Pnh Ph" - SHE 500 1400on NI A oil 16 Not valid tN ithout "ignawro 0ti FI 01M E IPA PROVEMNE N' T CON TRA OR Type Expiration: 10/112012 STEVEN A SILVERMAN STEV,E,'IN ��. Sk,I)ERMAN SiPVEN 5iLVEFz' ya FOMER RO it 1 C M3 FCMER RD, SOL)TI'lAMPTON, NIA SOUTHA%IP70N MAOIGT3 IJ':vm" ur vtflid P r imfikidul tv'" tm� b,Jory the , kph'a0on date. If found r-.1urn to Oft of C:onsmwr Affairs and Busjut�s.� Reguhtiml 10 Pnh Ph" - SHE 500 1400on NI A oil 16 Not valid tN ithout "ignawro 0ti lot! Oqnqn�clwn Yw�a'" STEVEN A SILVERMAN ya FOMER RO it 1 C SOL)TI'lAMPTON, NIA , ' XJ T or 20868 4 CtilUfP� O O `$ � � �tassacfinsetis m DEPARTMENT OF BUILDING 1_ 212 Main Street~ ' Municipal Building ' Northampton, Mass. 01060 W C'OW ENSATION NSITRA CE A F + Ate' . (licevse�J''permittt;e) with a principal place of buswess/residence al: 3 ttv /0/ hone #) f�'f' p) 4 >ac: c3 do hereby certify, under the pains and penaltti;es of perjury, that: 'j I am an employer providing the followinig worker's compensation coverage for my employees working on this,job: (Insurance Company) (Policy Nuruber) (Expiration Daze) ( ) I am a sole proprietor, general contract�2r or homeowner (circle one) and have hired the contractors listed below who have the following worker's compensation policies: (Name of Contractor) (Insurance Company/Policy Nu>mbcr) (Expiration Date) (Name of Contractor) (Insurance Conzpa.ny/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Cor pany/Policy Number) (Expiration Date) (Name of Contractor) (Insurance CoEipamf/Policy Number) (Expiration Date) (atlach ndditieml shzed ifnec�saryto ioeluiie inf«znataoo t au ocatrj o s) () I am a sole proprietor and have no crie workin for me. () I am a home owner performing all the work myself NOTE: please be aware that while homcow=m vbo employ gcaaars to do = �* *_ Y=ce, coastvctioa or repair work on a dwzlling of not more than Yhrca traits is which the homeow= resides or ca the Srou,6 a,=danant thado are not generally c onsidemd to be exnployrcrs under the worker's .lion Act (GL152,ss luatioa by a homeow= for a licecse or permit may evi'cenc� the legal tutus of as employeruedarthe Wosa,wez Co Act. I ur derit=d that a copy of this Wit.,,.=n may ba f � 4o tla of in strial Acti&V& Office of lasuraace forth® coverage verification and that failure to secure m mragc uadw sedian 25A of MGL 152 can lead to the imposiFioa of a imu ml penalties cc cf a . of up to S 1,SGO.Go andlct � firm of 5100.Q0 a day against me. o f arplo one year and civil pcaaltia in the form or a Stop Work Ordu and a Signed this � _day of e 4 - . � Far de use only Permit Number Map# Lot # Signature "of LL erzr4it#