31B-036 (4) . ., . • . '.
. -----, ,
0 A 3'0 BUMP OU
,-----------,,,,
r _________u 0 '
wainscot to match 1 . dense pack ceiiuiose in outside web
vinyl floor , -
ro -176.111 ) 4 1 ! 1 )
.II 71 J 1 ' 1
I
I__ _ 1
0
1'6 X 132 DiNiNG ROOM -
136 X123 X86 KITCHEN ,..„,,,,,, , t.
-..., 1
,w,„
7,
,:•\ -\. . ..;;,/ //./.,
sheetrock ceilina.
1 i 0On .. ;
i tali
ilr4
1 II 00° sheet rock ceiling new vinyl floor II
new red oak floorii
I
I , .
. I
1 '
,
CH iMN EY M ,
,
., ' t ....
$$$ , SS , , 0 4 I
F
A, N, ,
, , r
ENTRY NO WORK HERE : l
-? ,,,,, 0 : ,
PANTRY
vinyl floor 1 ,
PANTRY
- -
' '
I i
1 z ,
• . 1 1 1_ , ___.[ 16611: BATH
' `- -- - '
' ll N IIoo
r ,
11 .
,
,
7 \
7 .-- _________ PfiNTO WATER DAMAGE REPAfiR
. .
•
. .
, „ p
"
(iitg of Narillampion
‘! - . ) - 11. 4c t
t %Pie I
) 3,
jaiassachnsetts ---=_-_—iralaga:
DEPARTMENT OF BUILDING INSPECTIONS
. 212 Main Street ' Municipal Building
Northampton, Mass. 01060 No "
WORKER'S COMPENSATION MISTJRANCE APHDAvrr
1., A/2 0 /Li 5j? / 1 ... Tr ' ,i,,"/-7--7.....,S j-/ hi f2z
Oicensee/xmittee)
with a principal place of business/residence at:
3 ‘7 ,e,i1/2".-.5 i:D /.;'V-iii/2 „M 414 (plione#) 58 7 7
( -fr•hip) 6 16 e 0
do hereby certify, under the pains and penalties of perjury, that:
(X) I am an employer providing the following worker's compensation coverage for my
employees working on this job:
(10 tit ';?6 6 556 /
(Insurance Company) (Policy Number) (Expiration Date)
( ) 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 Co'mpany/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Nurn_ber) (Expiration Date)
(attach additional sheet if necessary to include information pee-Witting to all contractors)
( ) I am a sole proprietor and have no one working for nie.
( ) 1 ara a home owner perforing all the work iilYSelf.
NOTE: pl=f. b f....7. ta.1.1, la wIto ,-- oluy 1....rsorei to do a-a comiruczion or repair work on a ciwalling of
not mo-e. than throe units in which tha hotter rat ide of on 0....A., 70. ;1p:tit= --• tb.,..--- aro r.ft i samar.c.11y =t--aid..-- to be
empiontra mid= din wnt ontn7=ati= A. (C-L152,f.s 1(5)), application by a botneowna for a 11(x c prait may ect the
lava stunts of an elnploytot urai.er thee Woriteea Compensation Am.
I understind that a copy of this v may L,,_,-- a-vs--4.-d-sd to tho Departm--nt of Inclusti al Ao..dears' Co of Limtram= for t!:to
vl verificion and Past failure tote coverago under sbmion 25A of MGL 152 can lead to the impoeition of aiminsi penalties
consisting of a fine of up to $1,500.00 and/or iropsbonn=i of up to oon y and civil p:salties in the form of a Stop Work Ord„. r and a
fine of 5100.00 a day against me,
le
Signed this - -4 day of /44 :; 6 I For departmental use ody
Permit Nurnb
TV/ ‘4.477/47-1-- --!-:
1
/ ,, 0- i ,i / . MaP4 Lot #
Siati-
. '
e owvino/nwecda ol,-/LeZamacluz.4e,a
Office of Consume Affairs & Business Regulation License or registration valid for individul use only
-,-,---"\ r
i HOME IMPROVEMENT CONTRACTOR
Registration: : 105543
Type: Office of Consumer Aff
- ... Vi---- - F Expiration: - 7/17/2012
Private Corporation before the expiration date. If found return to:
airs nd Business Regulaton
i
10 Park Plaza - Suite 5170
Boston, MA 02116
VALLEY HOME ImpRoVEMEW-:::INt.
Nelson Shifflett
,3
340 R <,71„1/,---'71
iversideDr . . '----?.::::: ., ./',..../-----:'P„,_____ 7 ("--/ 1 ..,.."7
Northampton, MA 01060 ,:-..-.'-,_--.-
Undersecretary Nfivalid without signature
oi ,,, , , er ...-"? 7slasstachtiNett', - 9:1:31?Ullt 1)f ?;hit:
BoArti of Builtlin2 Reuulations 2n(iSttiochtrth ! ■
co,riruc6,:),-, :;3_,pel'i:SOr LICeriS
C;(1?- ::ind Two- Fm ly T22s
a
1 icens9: CS 60300
-..
NELSON A SHIFFLETT
340 RIVERSIDE DR PBX60627
FLORENCE, MA 01062
__.-. -.-----'— -----------'-- Ep;rLtcn: 9/22/2012
2383
SECTION 8 - CONSTRUCTION SERVICES
.1 Licensed Construction Supervisor: Not Applicable
- I
Narrie of License Holder : Nel son 5hifflet- t__ - - - 060300 _ -
i Valley Horne Improvement, Inc. L ccnso Number
i 340 Riverside Driv_e, Northampton, MA _ 010 . 6Q ! 9/22/F ,
Address Exolraf.l.ou Date
584 -7522
S ?rfa ;ur T r,IF��7cr�
r ,
9, Registered Home Improvement Contractor_ Not, Al pI'.ccab e [1
Valley ,._. Home Iretpr.ovement _Inc.. - _ - _ -- _ _105543
Company Name Registration Number
340 Riverside Drive 7/1711;
Address { Ex. U -a.ion Date
1 Northampton, MA 01060 1e;e1one 584 -7522
L SECT0N 10- WORKERS' COMPENSATION INSURANCE AFFIDAVIT (M.G.L. c. 152, § 25C(6))
Workers Compensation Insurance affidavit rust be completed and submitted trls application. Failure to provide this at'`ica•v t
1 will result in the denial of the issuance of the building permit.
Signed A ff ?d•avit Attached Yes No 1�
- Home Owner Exemption
The Cur eri exemption for "homeowners" vas extended to include Owner- occupied Ds'I'eitinas of one (1) or [vvtti,2) flami1ies
and to allow such homeowner lo engage an individual for hire who does not possess a license, provided that the owner 2cts
as supervisor. CMR 780. Sixth Edition Section 108.3.5i.
+ Definition of Homeowner: Person (s) who own a parcel of land on ;which he silo resides or intends to reside..:! .;Lich ;here
is, or is intended to be, a one or two family d4 \'eliinu, attached or detached structures accessory to such use an l;' or farm
structures. A pet-sw1 who constructs more than one 'lotto: atl a lw o-vear period skill Hot L . consideriil a r.+ f .
Stich "homeowner" shall submit to the Building Official, on a firm acceptable to the Ltuildinvg Official, that he `sh . s1ud1 be
responsible for all such work performed under the boildini 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- or Employers to
l_ of .�.� Death) o ftt ( e %i 1 t. + - 1 s rt r r c+rt Ii �Y .• le tt fx 1\i le r e t 3i
a_liit)tv�� � s�)� injuries not ice. �cn 1 1: L,� i+�..y�a� of the �:..e.,......�.....w...... Y
...:r , ......�. t. _ v9 It .., Pe le � ! t
you nitC 10 p :1IO1m \ Ottti for you
Thc .:` der x_.T d " i - .. nc1 _.mill _ and asswres cl'ro li..n e. thC
_
. ; and
�'i:z1. �,.�,: L. �r.�.,n�.T4:..i... ::3.,. and , Lo c;11 Zoning t _t. t : f ,( icy Ar f,. l • 71S10i'd.
1 low cowuer Sint at are _ -...- -...
in'', PRo { se -s
t•1 f. , " E t;.�EF /. rwe te;Et ° f� I r G:Ei� t v;it dcw ::. i :.: fi:,eo(N, i_ Po(Hrr, r
Cow
Eiez. Nev;
.. If New hQit C add or addition toe (ift n cOr p Ote die . foll_c w_is.
, e r
8 &
, a e. pere� _ G R�...¢ e." .
= CTi R 7 01 ' R 3 «: AUTiiCRIZAT.Cti TO CC FCO PLC1 D " ee rw
OWt' EE S .CC\ a OR CONTRACTOR AP CS r`IR rUIL."+Nr' C
en-,?(.641 '` 7
, = Nelson S ifflett, Valley Home Improvement, Inc;
L i
Neisork_Shitiiet , i;Bey__Hoxite_ provexruex t .._.
` .
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 fihled in by
Building Department
Lot Size
' —
Frontage
Setbacks Front
Side L: D: L: R:
Rear
n�
� ��
_
Building Height
Bldg. Squar Footage
Open Space Footage Y6
(Lot area minus bldg & paved
parking)
#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:
4 . ^
IF YES: Was the permit recorded at the Registry of Deeds?
4
NO DON'T KNOW YES
IF YES: enter Book Page and/or Dnournent#
B. Does the site contain a brOOk, body of water or wetlands? NO *~ DON'T KNOW
YES
IV YES, has a permit been or rteed to be obtained from the Conservation Connnnissioo7
Needs to be obtained Obtaimcd . rimta
C. Do any signs exst 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:
rt
i t
. : fr
I
_ 13_ epartment use onIy _
0
0 of Northampton iStatus of Permit:
i • . :
4il• NiNc04\
Sul lina De _artment
\ b P Curb Cut/Driveway Permit
. 21• Main Street Sewer/Se.ptic Availability
vgik ° 00 01 , 1 "r ib a' Dril 100 Water/Well Availability . .. I
.' rthampton, MA 01060 Two Sets of Structural Plans
. '
..0 Fax 413-587-1272 lPlot/Site Plans
•' • ' r ..,ther Specify . .1
,.._._ __ ............
APrL1CATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
- ....... ___
•
SECTION 1 - SITE INFORMATION
1.1 Property Address: 0091 (4d//44 6 , 11 44A4
This section to be competed by office
1 ....-Z‘' ../ 92 7 /(-1-1-- 57 Map Lot
l . tf)PiZ.T44 - A- oio 6 0 Z one , Overlay District
Dm St. District
CB District
I SECTION 2 - PROPERTY OWNERSH1P/AUTHORIZED AGENT
- - 1
I 2.1 Owner of Record:
A :
_,K,Arn-01 ,,,A,f7-z) n Vistfeil. tb__M?J74.tfigu),Ikkaucio
i Na 'lle (Pr' .., Cu re , t Vailiqg Address: /
...
! 2.2 Authorized Agent: Nelson Shifflett
Valley Home Improvement, Inc. P.O. Box 60627, Florence, MA 0106_2
i Nrimo (Prim) Currert "...Za:lii.s ,ACdress:
584-7522
I -
! SigriLtuie 1/ Te;opho,le
SECTION 3 - ESTIMATED CONSTRUCTION COSTS 1 .
I iten i Estima'..ed Cost (Dollars) tc bc,,'
1 , , C.:Ornpleted :Dv permit apolicilt I
1, ding (a) Building Pern Foe
i / a , 00 0
1 2. Hectrical C. Estimated Total Cost of
I I ____22_..0 Construction from (6)
— —
50 Building Permit Fee
I
1 4. r (1-1VA0) i t
j - . :!' .:'(..' t -, • i ■
4 5) 1 / 12() 1 Cl l' be r 011/ 7, lifi
— - _ - -
_
This ectiormi Piir OfficIE-1 Use Only
FT:rmit Nu:Tter: Date i
i
I Signature: _
5,J;.atrfp.-xlmmsmIHelrispi,;z.-t:)(d:7A.,dici.q-i, --
_.
File # BP- 2011 -0796
APPLICANT /CONTACT PERSON VALLEY HOME IMPROVEMENT INC
ADDRESS/PHONE P 0 Box 60627 FLORENCE (413) 584 -7522
PROPERTY LOCATION 10 MYRTLE ST
MAP 31B PARCEL 036 001 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 di 70 090 "
Typeof Construction: REPAIR WATER DAMAGE KITCHEN /BATH
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/ Statement or License 060300
3 sets of Plans / Plot Plan
THE F ING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INF ATION 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
Demoliti� elay /
ire of But ding 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.
. .
. ,.
10 MYRTLE ST 1 BP-2011-0796
GIS #: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 31B - 036 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: renovation BUILDING PERMIT
Permit # BP-2011-0796
Project # JS-2011-001311
Est. Cost: $15000.00
Fee: $90.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: VALLEY HOME IMPROVEMENT INC 060300
Lot Size(sq. ft.): 4530.24 Owner: RISTAU RAMONA M C/O RAMONA M PINTO
Zoning: URC(100)/ Applicant: VALLEY HOME IMPROVEMENT INC
AT: 10 MYRTLE ST
Applicant Address: Phone: Insurance:
P 0 Box 60627 (413) 584-7522 Workers
Compensation
FLORENCEMA01062 ISSUED ON:4/6/2011 0:00:00
TO PERFORM THE FOLLOWING WORK REPAIR WATER DAMAGE KITCHEN/BATH
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: "; _ j) _./ t
Rough Frame:
Pill
Gas: Fire Department Fireplace/Chimney:
Rough: Oil: • Insule:tion:
Final: Smoke: Final: r i— /54C, tyx,„.,
THIS PERMIT MAY BE REVOKED BY THE CITY • ' ORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND ' . . • ° ' • ■ S.
V
-
./' y
Certificate of Occupan !A „AO, 11 :i! nature: ;04,1446
: AO 4.01Aotorlioo
Imp-
FeeType: Da • Pais : Amount:
Building 4/6/2011 0:00:00 $90.00
212 Main Street, Phone ei13) 587-1240, Fax: (413) 587-1272
Louis Hasbrouck - Building Commissioner
litrikr-
_ ...