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ALL INFORMATION MUST BE COMPLETED; PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION. 12. This column to be filled in by the Building Department. Existing Proposed Required by Zoning Lot Size Frontage Front: Setbacks: Side: L: R: L: R: Rear: Building Height Bldg Square Footage % Open Space: (Lot area minus bldg and Paved parking) # of Parking Spaces # of Loading Docks Fill: (volume & location) 13. Certification: I hereby certify that the information contained herein is true and accu . to to the best of my knowledge. DATE: 3 /Z/2 APPLICANT'S SIGNATURE 1� / ' "4/4„/ NOTE: Issuance of a zoning permit does not relieve an applicant's burden to comply with all zoning Requirements and obtain all required permits from the Board of Health, Conservation Commission, Department of Public Works and other applicable permit granting authorities. FILE # Page 3 of 3 THIS FORM IS PART OF THE SIGN PERMIT APPLICATION File No. ZONING PERMIT APPLICATION PLEASE TYPE OR PRINT ALL INFORMATION 1. Name of Applicant �T S 1 LV riIAP V rib L L Y d` p yo ' Vt Address: 3 ID ) � v 5 } le 0 (L,i 1l'G> Telephone: 1 5 - e) — 7 53. �. 2. Owner of Property: S A GA Caw NY1(AW\ C)1 � a1 s 'J 9A W P-& IA) -N rM P Address: 15 H AAA P TOPS A v Telephone: 5- 93 t? 7 3. Status of Applicant Owner X Contract Purchaser Lessee Other(explain): CON 4 I A 4. Job Location: 1 S W A AP Ok) 'Sve Parcel ID: Zoning Map # Parcel # District(s) (TO BE FILLED IN BY THE BUILDING DEPARTMENT) 5. Existing Use of Structure /Property: 13 (a S 1 J FSS R . 0) 0 k .-/q )1 dA) 6. Description of Proposed Use/Work/Project /Occupation: (Use additional sheets if necessary) t:A,PQE11-- 1 CAf \ O 3u1 ►J6 W it,i 3E R •E'ii1oo i El ; W lit r 41 A NP fA N'l i , W Z - FR TWO 1Co x5 (3kuSt ,1 Li' in 5 ( ' 6N as A, S (6n1s TrR h w/ Grb WNELM L /6N7i 7. Attached Plans: 1/4- Sketch Plan Site Plan Engineered /Surveyed Plans 8. Has a Special Permit/Variance/Finding ever been issued for /on the site? NO DONT KNOW , YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO DONT KNOW YES IF YES: Enter. Book Page and/or Document # 9. Does the site contain a brook, body of water or wetlands? NO x 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 10. Do any signs exist on the property? YES ) NO — ` IF YES: Describe the size, type and location: �v r>T B in I djri? 1. J ti 1 6 6 U % 1 d i r1 _ 77 )( 3 CZ `t r3 v> Are there any proposed changes to, or additions of, signs intended for the property? YES >< NO IF YES: Describe the size, type and location: � V Mil B U, 1 ® 1 (7 f )C. J / S S1 Are Cif klAI 1 cl 'n = 14' x 5 — 5�e. � ) JA(i Page 2 of 3 GE��ED City of Northampton � . , `4°""° ` Aletn q 'S 0 Massachusetts a PARTME OF BUILDING INSPECTIONS . �" -' 1N SPECI � 12 Main Street • Municipal Building tr � ; o f6U1l I 01 Northampton, MA 01060 INSPE T. - - cation for a Permit to Place or Maintain a Sign Or other Advertising Device, or Marquee /�/� / �i (Application to be filled out in ink or typewritten) Number . o.P%..! n . `.✓. L; Plans must be filed with the Building Inspector Erection ( ) before a permit will be granted. Alteration (% ) Repair ( ) Repainting ( ) Removal ( ) FEE PAGE PLOT Northampton, Mass. 20 ..... To the Building Commissioner: Application for a permit to place or maintain a sign or other advertising device, or marquee. BUSINESS NAME W R S z ( 11 tAP 1. Location, Street and No. 15 RIVAe TORJ AVE 2. Owner's name SAGA CM. MUM C?STI.0.11J - 3. Owner's address (5 1.-V1aP.T.Q'tJ fiv 33 I 4. Maker's name V'� l 1-z y tattoll 1- � yy ,,,�y. 0`�Ei , 5. Maker's address 3 10 R Ive v^ S; d2, Or. Q (0 6 6. Erector's name v Z `l -ty .11 T i mp vo°11 {,1, 7. Erector's address S i n '' SIGN KIND OF SIGN (Designate) 1. Sign will be (check one) illuminated ..2 .. Non - illuminated 2. Will sign obstruct a fire escape, window or door? ...14D Marquee 3. Lower edge will be ..l0.ft....0...ins above the public way. Projecting 4. Upper edge will be ..b . ft....a..ins above the public way. Roof 5. Height ...a .ft.. 4i..ins Width .l.6.ft..:(1.ins Temporary 6. Face area ..$®sq. ft. Wall X - . .... 7. Inner edge will be 3...ins from the building or pole. Ground 8. Outer edge will be ..':...ins from the building or pole. Other 9. Face of building or pole is N /i..ins back from the street line. 10. Sign will project ...0..ins beyond the street line. 11. Sign will extend ....Q.ft ....ins above the building or pole. , 12. Of what material will sign be constructed? Frame ... � , n / . 0 Face.. Rikatn .. &Li t, M 1Q IAN 13. Estimated cost $ 12 The undersigned certifies that the above statements are true to the est of his knowledge n belief. (Signature of Owner or gent) Page 1 of 3 File # BP- 2011 -0745 rA APPLICANT /CONTACT PERSON VALLEY HOME IMPROVEMENT INC (? ADDRESS/PHONE P 0 Box 60627 FLORENCE (413) 584 -7522 1 f PROPERTY LOCATION 15 HAMPTON AVE � , - MAP 32C PARCEL 038 001 ZONE CB(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out (J' r Fee Paid a / o i s430 Typeof Construction: REPLACE FRONT WALL SIGN - WRSI /WHMP New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 3 sets of Plans / Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION 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 Demolit' n Delay ffi5,0cLice.,_ 701 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 Map 32C Lot038 Zone CB(100)/ Massachusetts Date issued 3/25/2011 0:00:00 Inspector of Buildings Permit # BP- 2011 -0745 Permit Fee$30.00 SIGN PERMIT Business WRSI/WHMP Address 15 HAMPTON AVE Applicant Installer VALLEY HOME IMPROVEMENT INC Applicant Installer Address P 0 Box 60627 Work Description REPLACE FRONT WALL SIGN - WRSI/WHMP Estimated Cost Building Department Approval by: ValleyHomelmprovement,Inc. P.O. BOX 60627, NORTHAMPTON, MA 01062 2 413 - 584 -7522 FAX 413 - 585 -0820 DESIGN / BUILD ADDITIONS • RENOVATIONS Sean O'Mealy WRSI 15 Hampton Ave Northampton, MA 01060 March 4, 2011 Revised Proposed Remodel of Building Facade and Signs Scope of Work: • Existing pebbled panels removed • New MDO %" panels installed in existing metal framework, along with white PVC 1x trim, pre - primed cove and crown molding (see sketch). • Reinstallation of metal sidewall cap • Sidewalk staging allowance • Lighting Allowance included • Quantity Two: 16' x 5' x 4" thick , Brushed Aluminum Signs with Color vinyl oval decals; logos will require final approval by client prior to install. Brushed aluminum will have random swirl pattern applied, and sealed with clear coat finish. Raised "rivets" will be applied to three edges of each sign. Each Sign is centered on length of building. • Painting of Facade (two coats, white acrylic latex primer and top coat) • Building Permit • Disposal of all construction debris Steven Silverman Valley Home Improvement J 4i? - ain,iii (:(1; 1 a ti o(tc1e:Aie o / z 1: aftice Consutner A ft airs and 1 usiness Regulation 10 Park Plaza - Suite 5170 Ilioston, Massachusetts 0211() lIonte Improvement Contractor Registration Regtstratfon: 131945 Type. individual Explratiort 10113/2012 Tr# 204590 STEVEN A. SILVERMAN STEVEN SILVERMAN 268 FOMER RD. SOUTHAMPTON, MA 01073 1:11CiatV Address and return cord. \lark reason for change, tddress Rene1/41/4a1 EmployMent Lost Card .4: ()Ince of Con,omer & s Lit'olsv: or registration . 1/4 alid for intik idol use onk HOME IMPROVEMENT CONT1RACTOR before the e1/4,piratinn date, If found return to: Registration; 131945 Type: Office of Consumer Affairs and Busines 14egulat inn Expiration: 18113/2012 ir.or,noual 10 Park Plata - Suite 51 .S' Reston. N1 "1/4 t0.116 STEVEN S=i, %/ERMAN STEVEN SIVERAIAN 268 OM SOUTHAmPTC% MA. 01073 /-• Laticr Nast 1/4a id 1/41/4 about inture th. p,Artniolt PoldlY iu liutted. Build's-tit,: tot,i 77279 Re'st•i't.tee to, 00 STEVEN A SILVERMAN 268 FOMER RO SOUT1 tAmrYroN, IVtA 01C73 e-ttto,t,estso 6/21,.2012 Tr 26888 . .. . • „ ., , • .11.1,,i2 Coninsoinvealia of illassacints•,21ts •., „......_.... _ ...Department of Industrial Accident's tsT•I'M'' .Al2- --,.......4 , - (ttfice of Investigations 7-4 600 illashingtoti Street ) BOSID,T; 4L-1 02111 liqiqt%lidaSS.gOVi Workers' Corripensaiion lusitrance Affidavit: Builders/ContractorsiElectricians/Plumbers Applicant Information Please Print Legiblv —. — Name (13asinessiOrganizatiorifindiVidual): Valley Home Improvement, Inc. Address:__ 340 Riverside_Drive_ — City/Statel2..i _ Phone: t 413-584-7522 Ar you an only loyer? Check the app rolyi iate box: — 1 1 Type of project (required): ... i . I 1 an , a nian w i t h 42. 4. 0 1 ,-..T. a general coat iceor and I i , „l'av'" hired the sub-c:ontraci Drs ' i c Li New cm-sal-let:10n (nil npriftnr rnrt-iiirte)." t ' ' lIsied On ail: -fiiili.,,hcd sheet 1 7. E11 Rennodeliig 1 , 2. r 1 I am a w in r ,,, o rielor (ff parther- 1 Those sub-contactors v ship ar d have no einplovees have { S 0 Demolition . 1 erniPloy.-es and hai,:e wonice 1 working for me in, any cafre,city I 9. 0 Building 2ddition No rer, comp comp. insurance: [ woks' , in fur ince 1 .1 • 1 — — 5. 1,: Vie are a corporation and it . i '"...i.., ''''' repairs or additions, 1 requtt di ,, 1 3L1 1 am a borinicyrner doing -.ill :No: I.. fiffli.,3T5 LI Ve C'XCTc.,ist:d 111CiT ) u pi 1 myself [1` work cecrop. 11:,,Ln cu ..--i...---1 i ri 4 12.0 Roof repairs . rowralln I 'l C.. 152, §I14), and we have no 1 ,____, 1 - employees. [No workcrs' 1 13 1 °Lher - COMei itiStdralitte required.] i *Any applicant that checks bex i'il must 'Zs lilt out atc sec n beit showing thief,- work c nsatin po;icy informaticc. I HoradiDWIIC16; who submit this affidavit imlicating thcy are doing all tvovh: and the hire cut:tide contractors must submit a nay affidavit indicating 5116:1', 1 62oritractzirs that c1 this box must atu:zhed an atkliticitai st showing the name of file stib-co nactors and state whet= ornct these entities have cmploy=s. lithe sub-ctintactoes have CITIployces, hheyrrn s.71. prsvidt their workers' ,:017311 policy rtumbst. .1 am an egyloyer dear is providiig n'ers' ,...,,c:np.?n,...'refifen ingnmo.ce for "By employges, Below is the policy gnd job siz.z in ..h„,,,„,.., c c: Peerless Insurance Company or Self-ins, Lic. i'.1';._WC_8605501 -- Eii Dale: za jzo 1 a_ ______ -- 01 ,Silte, Mdcessi_ Attach a copy of the in a.oinperi,3anon,1::. .1122:",:a'ralical page (:312)vriTig the policy nilfriber and expiration t-i. Faiinre Y 1 . - : „ - : S ,7; i: ! ;', )52 iinii locel. I.0 tke insposition of crimiiial 'nerialfies iv; , fine - up to S1,500,0.) anclion on eeyficc irecrisononem, as wel : fis civil t.:...,`"naltizis in the foto offi STOP WORK ORITiE1 l. al...' a firp oil to S250.00 a day against lii„: violinhor. ilte ficliiiied linct a copp el this iTtiattlreftt Mar b„ forivarfled to the Office of 1..-,,, of 1e Pik f-- i- rr,- , ,,, ,-- f' , , , ,-3, - 1 , -,: , --,=:-. — - - ' ° - '---- '''-' Z ! •],:,:t - ,...„‘! , ,t.t,:j,..._ N cift _413-584-- 22 , t..1 q 0 _IT tem! .nse o:ly.. Do in:o J in ;.'!.1.:s eerenn .b ..b7/7,ify V 16[6 ii ;■ .. . it ; , ;6;0,...1 i; 0; 1;62.6,:t1; 2, 16.6......; . :V:: ". ' ' 6 ' 6 : - 6- '-' '6 ". 66' i'i :,7 .:if':: - .'t - c*tt'• TVffit's.'‘,. t':, , ;',!...:,, • ''.,,- ,,-...,.::-. '..r.. ,., . e , Cont. _ -' o _.-—....._ .,......,...... . . ., . _ , , ,. a wea \ Office of Consumer Affairs & Business Regulation License or registration valid for individul use only ' HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: 105543 Type: Office of Consumer Affairs and Business Regulation Expiration: 7/17/2012 Private Corporation 10 Park Plaza - Suite 5170 Boston, MA 02116 VALLEY HOME IMPROVEMENT INC. Nelson Shifflett / 340 RiversideDr. 1 Northampton, MA 01060 Undersecretary N �� alid without signature Versionl.7 Commercial Building Permit May 15, 2000 SECTION 10- STRUCTURAL PEER REVIEW (780 CMR 110.11) Independent Structural Engineering Structural Peer Review Required Yes O No 0 SECTION 11 - OWNER AUTHORIZATION - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT St60 )1 41 } L y , as Owner of the subject property c -re,�✓ov S /L. L � rlr hereby authorize to action my behalf, in all matters relative to work authorized by this building permit application. �C r /.:7- /P ,- .6g -e kt, /l7 20/ Signature of Owner Date J / bVt /" , as Owner /Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief. Signed under the pains and penalties of perjury. S E S /L L/ Print Name I 3 f Odd Signature of Own ent Da e SECTION 12 - CONSTRUCTION SERVICES • 10.1 Licensed Construction &wervisor: Not Applicable ❑ Name of License Holder : J ttvloU J f L U 1£1 -Il'i 1 ' 7,r7 7 License Number rcrr � Uii1! -1 miefoA) 67I . 7.W/ Z-- Address Expiration Date Signature 1 T elephone SECTION 13 - WORKERS' COMPENSATION INSURANCE AFFIDAVIT (M.G.L. c. 162, § 25C(6)) 1 Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed Affidavit Attached Yes No 0 • • Version1.7 Commercial Building Permit May 15, 2000 SECTION 9- PROFESSIONAL DESIGN AND CONSTRUCTION SERVICES - FOR BUILDINGS AND STRUCTURES SUBJECT TO CONSTRUCTION CONTROL PURSUANT TO 780 CMR 116 (CONTAINING MORE THAN 35,000 C.F. OF ENCLOSED SPACE) 9.1 Registered Architect: Not Applicable Name (Registrant): A Registration Number Address Expiration Date Signature Telephone 9.2 Registered Professional Engineer(s): Name Area of Responsibility tv Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility { Address Registration Number Signature Telephone Expiration Date 9.3 General Contractor A 1y 4 t( (M ) 4 b v ?A Not Applicable ❑ Ccmpaiiy itaiiie: I Responsible In Charge of Construction F ec'A G(112 7 340 e s r Address / 6-11g Signature Telephone Versionl.7 Commercial Building Permit May 15, 2000 S. NORTHAMPTON ZONING Existing Proposed Required by Zoning This column to be filled in by ^� Building Department Lot Size � / C�3 Aoe9 N IL Frontage Setbacks Front Side L: R: L: R: Rear Building Height ' i N C, Bldg. Square Footage S g % J Open Space Footage (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 0 DONT KNOW 1 0 YES Q IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO O DONT KNOW 0 YES 0 IF YES: enter Book Page and /or Document # B. Does the site contain a brook, body of water or wetlands? NO 111 DON'T KNOW 0 YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained 0 , Date Issued: C. Do any signs exist on the property? YES NO 0 r IF YES, describe size, type and location: 2, I7 X �� J I (,N () 1 C� �ocii rf' D. Are there any proposed changes to or additions of signs intended for the property ? YES , NO O YES ' 2_ (t, xJ 6YLtSk2 n tl(Ufb^, S S v l y‘! oc ^ (s pIJo_ �ti' k) biz e If. E. Will the construction activity disturb (clearing, grading, excavation, or filling) over 1 acre or is it part of a common plan that will disturb o' :r 1 acr< YES ` to IF YES, then a Northampton Storm Water Management Permit from the DPW is required. Versionl.7 Commercial Building Permit May 15, 2000 SECTION 4- CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000 CUBIC FEET OF ENCLOSED SPACE Interior Alterations ❑ Existing Wall Signs ❑ Demolition ❑ Repairs ❑ Additions ❑ Accessory Building ❑ Exterior Alteration Existing Ground Sign ❑ New Signs ❑ Roofing ❑ Change of Use ❑ Other ❑ Brief Description Enter a brief description here. _ OfPropos dWork: RX MOO C 1 - LA FfI rn.-_, ()F BLtILbk., d fir IrylL ) L NGk) 1 X J ' 5 ! ( . N5 2b f._Gr uric, i E 1 c'(I 1)5' _ SECTION 5 - USE GROUP AND CONSTRUCTION TYPE USE GROUP (Check as applicable) CONSTRUCTION TYPE A Assembly A -1 ❑ A -2 ❑ A -3 ❑ 1A ❑ ❑ A -4 ❑ A -5 ❑ 1B ❑ B Business 'g- 2A ❑ E Educational ❑ 2B 1 ❑ F Factory ❑ F -1 ❑ F -2 ❑ 2C ❑ H High Hazard ❑ 3A ❑ 1 Institutional ❑ 1 -1 ❑ 1 -2 ❑ 1 -3 ❑ 3B ❑ M Mercantile ❑ 4 ❑ _ R Residential ❑ R -1 ❑ R -2 0 R -3 ❑ 5A ❑ S Storage ❑ S -1 ❑ S -2 0 5B ❑ U Utility ❑ Specify: M Mixed Use ❑ Specify: S Special Use ❑ Specify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS, ADDITIONS AND /OR CHANGE IN USE Existing Use Group: Proposed Use Group: Existing Hazard Index 780 CMR 34): Proposed Hazard Index 780 CMR 34): SECTION 6 BUILDING HEIGHT AND AREA BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY Floor Area per Floor (sf) , 3 `i0 ,st 1 1\1 IC ,r- 2nd ---"" 2nd t C: rd .3rd 3 N — J 4w • 4th N f A Total Area (sf) ( Total Proposed New Construction (sf) Total Hzioht (ft) i - / ' / Total Height ft N / - 7. Water Supply (M.G.L. c. 40, § 54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System: Public ❑ Private 0 Zone Outside Flood Zone0 Municipal ❑ On site disposal systemO i Version1.7 Commercial Building Permit May 15, 2000 Department use only �, Ci of Northampton Status of Permit: 7, uil, ing Department Curb Cut/Driveway Permit 2 Main Street Room 100 Sewer /Septic Availability Water/Well Availability •■�� Northampton, MA 01060 Two Sets of Structural Plans phone 413 - 587 -1240 Fax 413 - 587 -1272 Plot/Site Plans Other Specify APPLICATION TO CONSTRUCT, REPAIR, RENOVATE, CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING SECTION 1 - SITE INFORMATION 1.1 Property Address: This section to be completed by office 15 I lM1((Q TC-J AV EtJlrl.E Map 32 C — 03 — Lot Unit Zone C. j3 Overlay District Elm St. District CB District SECTEON 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: Name (Print) 5t1Ah.1 Cl r Ly Current Mailing Address: SAn1 r ,moo Signature / / / / w� j Telephone 5 V 7 ! t 2.2 Authorized Accent: �ti r ci D P �1 l 'a�� � i k? Nerve (Print) j'rt\("r) S I L\) t � l� Current Mailing Address: l�lUP /t ✓`iPTON O/2— Signature 11 1 Telephone J �` - J;1 SECTION 3 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building I / fr/� VL (a) Building Permit Fee 2. Electrical ! 0 U 0 (b) Estimated Total Cost of IP l Construction from (6) 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection 6. Total = (1 + 2 + 3 + 4 + 5) 1 `g ( 3 C Check Number 10 s oi This Section For Official Use Oniy Building Permit Number Date mm � 1 issued Signature: Buiiding Commissioner /Inspector of Buildings Date File # BP- 2011 -0744 APPLICANT /CONTACT PERSON VALLEY HOME IMPROVEMENT INC ADDRESS/PHONE P 0 Box 60627 FLORENCE (413) 584 -7522 PROPERTY LOCATION 15 HAMPTON AVE MAP 32C PARCEL 038 001 ZONE CB(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out 0 d/bg Fee Paid Typeof Construction: CHANGE FAQADE PANELS 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 FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFQ MATION PRESENTED: FA C Ate 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 z�-- 3/ Z / Signatur 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. 15 HAMPTON AVE BP- 2011 -0744 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 32C - 038 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 -0744 Project # JS- 2011- 001237 Est. Cost: $18800.00 Fee: $108.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: VALLEY HOME IMPROVEMENT INC 077279 Lot Size(sq. ft.): 5401.44 Owner: SAGA COMMUNICATION OF N E INC Zoning: CB(100)/ Applicant: VALLEY HOME IMPROVEMENT INC AT: 15 HAMPTON AVE Applicant Address: Phone: Insurance: P O Box 60627 (413) 584 -7522 Workers Compensation FLORENCEMA01062 ISSUED ON:3/25/2011 0:00:00 TO PERFORM THE FOLLOWING WORK:CHANGE FA(ADE PANELS 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 3/25/2011 0:00:00 $108.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Louis Hasbrouck — Building Commissioner