23B-077 (4) �
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N DEPARTMENT OF BUILDING INSPECTIONS � +
212 Main Street Municipal Building . a,, — IMP Northampton, Mass. 01060
WORKER'S COMPENSATION I NSTJRANCE AFFIDAVIT'
L f/s GS O ALr 5 /f 1 /---/-=- &7"T , r/ rz_i_z ,t:'LL y::::%77/7-- /f Uz ftb7 2,7/ C
(Iicenseelpermittee) • .
with a principal place of business/residence at
3 ' o l //S 1.62. d zJ/' / j/, 7f/1, i-"/ ., Cllr (phone #) -8� - Z2___
. (street/ cit state :tip) 'ewe: G
d o hereby certify, under the pains and penalties of perjury, that:
N. I am an employer providing the following worker's compensation coverage for my
employees working on this job:
, EE. 44.5' S ��15. eo . tro. e ?6 G 556 1 gp/!./
. (insurance Company) (Policy Number) - (Expiration Date) .
( ) I am a sole proprietor, general cone actor or homeowner (circle one) and have hired
the contractors listed below who have the following worker's compensation policies: .
(Rune of Contractor) (insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) -
(Name of Contactor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Number) (Expiration Date)
(attach adclidcital sheet ifnecessaxy to ioohade informatian pertaiMiag mull cc gresto*_s)
( ) I am a sole proprietor and have no one Working for me.
( ) I am a home owner performing all the work myself
NOTE: pleazt be aware that while homeowners who enzploy petaorss to do maintenance, construction or repair work on a dwelling of
avot m or e than tame units in which the homeowner resides or on the grounds appurtenanttheto are not generally considered to be
e2:CI yers un the worko'a .mica Act (GL152rs I (5)), application by a homeowner fora licewe cr permit may evidence the
leia1 status of an employer ewdart o Workeia Comp*.mnticn Act.
I ua-de stand that a copy of this statement may be fcavrarded to the Dtoartmo of 1rcais!rial Ac idern' mace of In urae for the
coverage vcrifcaiica and that failure to aecti e coverage e under section 25A of MOL 152 can lead to tie imposidoa of criminal a
o- of a ;m of up to S1,500.0.0 u 0 andfor of up to can year and civil penalties is the form of a Stop W
EEO of SIO0.O0 a day against me.
Signori this j day of /74 ;No For departmental use only
i Perm it Number
Si b of L ' ermitt
1
.-
i ,;.�hpa► nrnt of Pui)iic Sal'et�
I`�, Siamutit s: ►c of utiLtts Builtiinl. Kc�grutalatittns anti{ Stantl 1
Construction - Dc Supervisor license
i
License: GS 77279 �r14
. t 00 1 4
7'
STEVEN Restricted A o; S 1IVEFMPN YI j
268 FOMER R 4
SOUTHAMPTON MA 01073 -a.ia '
Expiration: 6/21/20 ti
C-�-' iy . Tr#: 25795
. (111111 ISSI 011er
c.
i
R� aXiJFfik4tS License or registration valid for individul use only
HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to:
Registration: 131945
Board of Building Regulations and Standards °
Expiration 10/13/2010 Tr# 275412 One Ashburton Place Rm 1301
T pe Individual Boston, Ma. 02108 1 f
Type
fi .
STEVEN A SILVERMAN
STEVEN SILVERMAN
268 FOMER RD.
. , ., _. / ...tf i'Vr ' ( Xi izfla -
SOUTHAMPTON, MA 0:1073.•: • Administrator `Slot valid without signature
7
a '
•
I SECTION 8 - CONSTRUCTION SERVICES
.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder : Steven Si lverman - -- 077279
License Number
268 Fo r Ro <,•_, e, - MA n1 n 73 _._ 6/21/10
Address / I Expiration Date
/
// % 584-7522
r Telephone
9. Registered Home ImprovementContractort Not Applicable ❑
Steven Silverman___ - . 131945
Company Name Registration Number
268 Fomer Road 10/13j/0
Address Expiration Date
Southampton, MA 01073 Telephone 584-7522
1 SECTION 10- WORKERS' COMPENSATION INSURANCE AFFIDAVIT (M.G.L. c. 152, § 25C(6))
i Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit
I will result in the denial of the issuance of the building permit.
I Signed Affidavit Attached Yes No ❑
. - Home Owner Exemption
The current exemption for "homeowners" was extended to include Owner- occupied Dweltints ol'one (1) or two(2) families
and to allow such homeowner to engage an individual for hire who does not possess a license, provided that the owner acts
as supervisor. CMR 780 Sixth Edition Section 108.3.5.1.
Definition of Homeowner: Person (s) who own a parcel of land on which he /she resides or intends to reside, on which there
is, or is intended to be, a one or two family dwelling, attached or detached structures accessory to such use and/ or farm
structures. A person who constructs more than one home in a two -year period shall not be considered a homeowner.
Such "homeowner" shall submit to the Building Official, on a form acceptable to the Building Official, that he /she shall be
responsible for all such work performed under the building permit.
As acting Construction Supervisor your presence on the - job site will be required from time to time, during and upon
completion of the work for which this permit is issued.
Also be advised that with reference to Chapter 152 (Workers' Compensation) and Chapter 153 (Liability of Employers to
Employees for injuries not resulting in Death) of the Massachusetts General Laws Annotated, you may be liable For person(s
you hire to perform work for you under this permit.
The undersigned "homeowner" certifies and assumes responsibility for compliance with the State Building Code, City of
Northampton Ordinances, State and Local Zoning Laws and State of Massachusetts General Laws Annotated.
Homeowner Signature
- 70 - tori 5. er_sompTioN,OF PROPOSED WORK (cherk Art opptic,
Now ficw,e ::: Acdition Li 1 Relacemeat Windows A-teration(414
ROOf in!: r
0: Coors
Accessory Bldg. .11 Dernolitio ...::. New Signs ' 1 Decks - I Sidirg ) Othef 1
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et.)
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aa, If New house and or addition to existing housing, complete the following:
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SECTION 7a - OWNER AUTHORIZATION - TO DE COMPLETED WLIEN
[ OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
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Steven Silverntan, Valley Home Improvement, Inc
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Steven s.il_v_exxaan._Itar...ey_Home_impx.ox.ement ‘___Inc.._.______, ,.I-„ -, :•.; ,,- ..i.„,,-. 1
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Steven Silverma 1 _ 1/,
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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
parking)
# of Parking Spaces
f
Fill:
(volume & Location)
/
A. Has a Special Permit /Variance /Finding,ver been issued for /on the site?
f
NO DON'T KNOW ! YES
IF YES, date issued:
IF YES: Was the permit recorded at t Registry of Deeds?
NO DON'T KNO ' 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 permi been or need to be obtained from the Conservation Commission?
Needs to be obtai -d Obtained Date Issued:
C. Do any signs exis#ron 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:
it
Department use only
City of Northampton Status of Permit:
Building Department Curb Cut/Driveway ,Prmit
212 Main Street Sewer /Septic Availability
Room 100 Water /Well Availability
� Northampton, MA 01060 Two` Sets of Structural Plans
phone 413-587-1240 Fax 413-587-1272 Plot /Site PIaaS
Other Specify
APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 - SITE INFORMATION
1.1 Property Address: This section to be completed by office
7V o ei % 7// yA ) -/ Map Lot Unit
/`T� t /7 6E- n/4 / 062-- Zone Overlay District
Elm St. District CB District
SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT
2.1 Owner of Record: 1 %Z i-10 y 5 o/7/ �� j el A-
£ .) w y /s m /J f rn 74j.4-,4 , 1 S tie 0/Z vn/-- el / 2.
Name int) c'^- Current Mailing Address:
�1� td_ t,ticJ Telephone //""' 3 Z. Signature
2.2 Authorized Agent: Steven Silverman
Valle ome Im•rovem-,r c P.O. Box 60627, Florence, MA 01062
Name (Print f /� Current Mailing Address:
„/1 �l / 584 - 7522___
Signature r Telephone
SECTION 3 - ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost (Dollars) to be Official Use Only
completed by permit applicant
1. Building 1 / 500 (a) Building Permit Fee
2. Electrical ---. —_ (b) Estimated Total Cost of
Construction from (6)
3. Plumbing Building Permit Fee
4. Mechanical (HVAC)
5. Fire Protection
6. Total = (1 + 2 + 3 + 4 + 5) 12. C Check Number )462"7
This Section For Official Use Only
Building Permit Number: Date Issued:
Signature:
Building Commissioner /Inspector of Buildings Date
File # BP- 2010 -0726
APPLICANT /CONTACT PERSON VALLEY HOME IMPROVEMENT INC
ADDRESS /PHONE P 0 Box 60627 FLORENCE (413) 584 -7522
PROPERTY LOCATION 74 SOUTH MAIN ST
MAP 23B PARCEL 077 001 ZONE URB(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Penult Filled out / ` h ,,�[
Fee Paid 65-0 7 1U' 7
Typeof Construction:_ENLARGE 2 WINDOWS & INSTALL REPLACEMENT FRENCH DOOR
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/ Statement or License 077279
3 sets of Plans / Plot Plan
THE F LOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INATION PRESENTED:
Approved 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 , j
! `'i 2 7 2c2
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.
74 SOUTH MAIN ST BP- 2010 -0726
GIS #: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 23B - 077 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 -0726
Project # JS- 2010- 001078
Est. Cost: $12500.00
Fee: $75.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: VALLEY HOME IMPROVEMENT INC 077279
Lot Size(sq. ft.): 7623.00 Owner: WEISMAN EDWARD N & SIMONA POZZETTO
Zoning: URB(100)/ Applicant: VALLEY HOME IMPROVEMENT INC
AT: 74 SOUTH MAIN ST
Applicant Address: Phone: Insurance:
P O Box 60627 (413) 584 -7522 Workers
Compensation
FLORENCEMA01062 ISSUED ON:2/17/2010 0:00:00
TO PERFORM THE FOLLOWING WORK: ENLARGE 2 WINDOWS & INSTALL
REPLACEMENT FRENCH DOOR
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 $75.00
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Building Commissioner - Anthony Patillo
Paatr I iginn
ri g ic Wiiricl4m •cs. 1u #.il
NFRC
Premium Double Flung
8321 (PWS —A - -1 )
National Fenestration 6331 LE w /Argon Double Glazed
Rating Council® i
V l �d
Vinyl Frame
CERTIFIED
PAR -1
ENERGY PERFORMANCE RATINGS
U- Factor (U.S. /I -P) Solar Heat Gain Coefficient
0.28 El. 24
ADDITIONAL PERFORMANCE RATINGS
Visible Transmiti anc:e
0 . - - - --
Manufacturer stipulates that these ratings conform to applicable NFRC procedures for determining whole
product performance. NFRC ratings are determined for a fixed set of environmental conditions and a
specific product size. NFRC does not recommend any product and does not warrant the suitability of any
product for any specific use. Consult manufacturer's literature for other product performance information.
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1 Keylleam 6u req. i .....
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kMBeemEnvne 4 50
Materials. Data 1307
Member Data
Description: Member Type: Girder Application: Floor
Top Lateral Bracing: Continuous
Bottom Lateral Bracing: Continuous
Standard Load: Moisture Condition: Dry Building Code: IBC i IRC
Dead Load: 10 PLF Deflection Criteria: 11380 live, U240 total
Live Load: 40 PLF Deck Connection: Nailed Member Weight: 15.0 PLF
Filename: KYB1
Other Loads
Type Trib. Dead Other
(Description) Side Begin End Width Start End Start End Category
Replacement Uniform (PSF) Top 0' 0.00" 12' 0.00" 12' 0.00" 10 30 Live
Additional Uniform (PSF) Top 0' 0.00" 12' 0.00" 12' 0.00" 10 10 Live
Additional Uniform PLF) T. 0 0.00" 12' 0.00" 56 0 Live
/ .
1200
t /
1200
Bearings and Reactions
Input Min Gravity Gravity
Location Type Material Length Required Reaction Uplift
1 0' 0,000" Wa Dou4as-Fir-Larch 3.500" N/A 4573#
2 11' 6750" Wel Dou. as 3,500" N/A 4573# --
Maximum Load Case Reactions
tn,ed to apptymp pooh oads (or line toads) to earrymp members
Dead Live .
1 1798# 2775#
2 1798# 2775#
Design spans
11' 6150"
Product: W 6 x 15 (50ksi) ,
Component Member Design has Passed Design Checks.**
Design assumes continuous lateral bracing along the top chord.
Design assumes continuous lateral bracing along the bottom chord.
, .
Allowable Stress Design
Actual Allowable Capacity Location Loading
Positive Moment 13.22"k# 26.73'k# 49% 5.78' Total load D+1..
Shear 4.57k# 27.55k# 16% 0' Total load D+L
LL Deflection 0.2287" 0,3854" 11606 5.78' Total load L
TL Deflection 0.3769" 0.5781" U368 5.78" Total load D-11
Control TI Deflection
_ Ars prodnot names are naderoarks of thew respective owners
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O/' • , * -', CopyrIght (CI t$87-2011 by Keymerk Enterprises LLC ALL RIGHTS esERvEo
1
1 — Passtng is defined as when the -member, boor mist beam or potter, shown on this drawn meets applicable dawn Greene Cr f Loads Loading onderons, and Span, itsled on this sheet
; The dvagn roust be reytewed by a qualified esener or damp professionat as required for approval The design assures rodu* mstaaation according to Me manufacturer s
i _____ _ , _ _____ ________________ _ _