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10D-009 (2) ,;,419 W ATER ST g BP-2010-0724 GIs #: COMMONWEALTH OF MASSACHUSETTS l�fa =ioc Ian - � Y CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category BUILDING PERMIT Permit # BP- 2010 -0724 Project # JS- 2010- 001077 Est. Cost: $46000.00 Fee: $276.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: VALLEY HOME IMPROVEMENT INC 077279 Lot Size(sq. ft.): 20734.56 Owner: WOOD ALISON S & GEORGE WRIGHT Zoning: URB(100) / /WP Applicant VALLEY HOME IMPROVEMENT INC AT. 119 WATER ST Applicant Address: Phone: Insurance: P O Box 60627 (413) 584 -7522 Workers Compensation FLORENCEMA01062 ISSUED ON :211712010 0:00:00 TO PERFORM THE FOLLOWING WORK.- REMODEL KITCHEN, ENCLOSE 6 X13 PORCH TO MUDROOM 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: Driveway Final: Final: Final: Rough Frame: Gas: Fire Department Fireplace /Chimney: Rough: Oil: Insulation: Final: Smoke: 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 2/17/2010 0:00:00 $276.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Anthony Patillo File # BP- 2010 -0724 APPLICANT /CONTACT PERSON VALLEY HOME IMPROVEMENT INC ADDRESS/PHONE P O Box 60627 FLORENCE (413) 584 -7522 PROPERTY LOCATION 119 WATER ST MAP IOD PARCEL 009 001 ZONE URBOOO)//WP THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid Ly Typeof Construction: REMODEL KITCHEN, ENCLOSE 6 X13 PORCH TO MUDROOM New Construction Non Structural interior renovations Addition to Existing AccessoKy Structure Building Plans Included: Owner/ Statement or License 077279 3 sets of Plans / Plot Plan THE FOL WING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFO ATION 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 Water Availability Sewer Availability Septic Approval Board of Health Well Water Potability Board of Health Permit from Conservation Commission Permit from CB Architecture Committee Permit from Elm Street Commission Permit DPW Storm Water Management Demolition Delay 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. Department use only City of Northampton Status of Permit: - - Building Department Curb Cut /Driveway Permit_ 212 Main Street Sewer /Septic Availa5i11' Room 100 1 414,'ter /Well Availability Northampton, MA 01060 Two Sets of Structural Plans phone 413- 587.1240 Fax 413. 587 -1272 Plot /Site Plans Other Spe APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION This section to be completed by office 1.1 Property Address Map Lot Unit __ !` m ' I , - ®�v �-� 3 Zone _Overlay District Elm St. District__ i _._ CB District_ _ SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record // f -- _W S0/L- W 0 }b -' U21t_ tUe- j& ffr- kg::�S� 50e Name (Print) Current Mailing Address: Telephone z g2 Signature L zt�� -- 2.2 Authorized Age t: St ven Silverman Valley 1H a Im rov nt, Inc. P.O. Box 60627, Florence, 0106 Name (Print) Current Mailing Address: 584 - 7522 Signature Telephone SECTION 3 - ESTIMA CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only completed by ermil a olicant Buiding 0 (a) Building Permit Fee 1 , 2. Electrical (b) Estimated Total Cost of 3 Construction from 6 3. Plumbing 7, � Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection 6. Total = (1 +2+3+4+5) K Check Number This Section For Official Use Onl Building Permit Number: Date Issued:_ _____. Signature: Building Commissioner /Inspector of Buildings Date Section 4. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION Existing Proposed Required by 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 % Open Space Footage % (Lot area minus bldg & paved p arkin g) # of Parking Spaces Fill: (volume & Location) A. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO DON'T KNOW YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO DON'T 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 arty proposed changes to or additions of signs intended for the property ?YES _ No IF YES, describe size, type and location: CT C'P1 . DESCMPT IO ". OF. I "N.10POSED 6 "-') K (5.h < 0, , If .I_.5 Eefec, k�tyr [lt;ca ! {rts:k Ac - Re;� I cement 4 indcwf. r! t�estiexr►(:.} I2txe {irc {, I._ Q, t: C)i3 - 0 f ide . _ I ��t^IFEFrr _ Nev; Signs f Decks ,� 5idirc I _ , m•:.�,� �F�_ -. tic, C (2 13 �r(.�f�� t_'� _. ��^�+ �� ON r? .._ �nwl c Rer►� ode ( e. I x C to Gt. If Ne ho use and or addit to existit }g housin complete the following i ! °_�, � .. s: •. ; {, e� ... , ...E � - q .i�� t? °so��� ,•p�, R t °r, ir, .,. v �. r'. °• I�tt' te�f; i� r'., c .1t� `' ___.. � _ '�' EC i ICN Ire . OWNER AU i I €CRIZA F :OPt • RED BE CpIMPLE f ED "v' H s OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT tltl C n � f /� �� /� ...r+ /� � C.i�D ©` t (j'V/� �•�. (:1�IA f C. J Uf p ! .F f -,• r- Steven Silverman, Valley Home Improvement, Inc r t;_ .'f' . ;2 -{ <. qst ..•e. °t.t °. ,'r:FE� . •;� t'te =, (...o`., eel. .. - ..�if,fF:. t {F e J HIDYYlf �kt�i". S�? �_ �tll eII.�se._.�I1,G',.�_�.._...__... �irFei �;- F4., EP<f e 't _si t;r {fi it j Steven Silverman - SECTION 8 - CONSTRUCTION SERVICES Naine of License Holder: Steven Silverman- 077279 S'gnalure Telephone 268 Fomer Road J� Expiration Date Southz�mpton, MA 01073 -Telephone 58 SECTION 10- WORKERS' COMPENSATION INSURANCE AFFIDAVIT (M.G.L. c. 152, § 25C(6)) � Comoensation Insurance affidavit must be cornrileted and submitted -with this appIttation. Failure to provide this affidavTt I L -Home Owner Exemultion The Current exemption for^homcownuo" was emended |oino]uJe [ono(1) or u,o(2)6on|icy and toul|mvsuchbomcovncr\oonga(g000 individual for hire who does not possess ulicense, provided that the owner acts Homeowner as supervisor. CMR780. Sixth Hition Section 1.08.3.5.1. Definition of Person (s) who own oparcel o[|undoowhich kc/sho resides orintcods to rcsido, on n|`ich there �corix intended to be, u one orz*n�mih/JoeUiog attached or detached s\rucmrrs accessory m such uscund/or/ann umc/uns. A person who constructs inore than one hoine in a two period shall not be considered a howcowner. Such ^humoowncr' shall submit to the Bui|din�0[6ciuL on u D,nn ucccp�b|c�o/�o Uui\dio�0f5cia| responsible for all such work performed under the buildinL perillito As acting Coqstruction Supervisot your presence nn the job site will bcnrqoiroJ from hme* time, 6orixgaxd upon completion of the vork for which this pcooitisissued. Also ho advised t with ncfie/ ncc\oChup|or\j2(YVurkuo'Cmopuuohoo) and Chapter 153(Uahi|ityoflEmp|o)uoto Employees for injuries nmrosuhing in Death) of the K8ussudhuset|yOouma| Laws Annotated, vou may be liable Bxpermn(x) you him to perfo v,ork 0uryou Linder this pcnnh. The Undersi2ned "horneowner" certifies and assunies respowqibilitv foi compliance with the State Building Codc, City ot' Northampton Ordinances, State and Local Zoning Laws and State of\4o,�uckuseosGcocm! Laws Annotated. Z �'C1iAMP� ass a Ch ns etl4 DEPARTMENT OF BUILDING I.NSPECTIONS 212 Main Street ' Municipal Building Northampton, Mass. 01060 WORIMR'S COMPENSATION T.NSURANCE AFFIDAVrr L /f� L5OAf 5 - H 11- ,21 1/ /fug - 1 f '/tZ ,1- y^z rZ 1 �f1 L (lic�nseelpermitzee} with a principal place of business/residence at: 3-to L��i✓T /,V (phone #) `j W `f" 2 Z (stmt /citylr -? /zip) DfoZ' t3 do hereby certify, under the pains and penalties of perjury, that: 00 I am an employer providing the following worker's compensation coverage for my employees working on this job: 4 (Insuran Company) (Policy Number) (E)piration Daze) () I am a sole proprietor, general contractor 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 Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (aftach ad&tionzi shed if necessary to include idbrmatioa pertaining to all coatraetots) () I am a sole proprietor and have no one working for me. () I am a home owner performing all the work myself. NOTE: please bs aware that while home —M who employ Pe== to do m9klcna acc� cortzmcdonor repair work on a dwelling of not more thaa throe units is which the homeowner resides or on the grounds appurtenant thereo are ad generally comAcred to be employers under the worker`s ape au4ca Ad (GL152,ss1(5)} application by a hotneowoet fora pease or permit may evid— tbx legal ciatun of an employer under the Worms Comprmatioa Act. I wand that a copy of this sut — cat may 1b fcawarded to the Depwtx.A of Tuarutrial Accident,' Of£oe of Insurance for the coverage vexificatioa and that failure to secure coverage undcr section 25A of MGL 152 can lead to the imposition of criminal penaldes consisting of a fine of up to $1,500.00 and/or kapr6oaxncrit of up to one year and civil pedaloes in the form of a stop Work Order and a fine of 5100.00 a day againA me Signed this _day of 1 'G'� For de u only Permit Number t; Mao # Signature of L a7seeRermittee i tSY N CO ti J � ,, r Y r •rs y fit. p, Z o ° o � � o ^�^ -•,._ � Y: o0 IS ° m d � t r to � ;, r N A - • 4 LO h Uj o ` co 0 .� t Q a iy- a to 0 Y q