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'U13888D9983 2/1/01 (1—nSu=ce Cow) (Policy Naut r) (Expiration Date) I am a sole proprietor, general contractor or homeowner(circle one) and have hired the contractors listed l e ow who have the followin worker's compensation policies: (Name of Contractor) (Insurance CompanyiPol.icir Number) expiration Date) (Name of Contractor) (1usw-ance C,omparty/'oUcy NNumbe) (Expiratioa Date) (Narne of Contractor) (insuranc—c Cornf z ii?olicy 1,4-umber) (, xpuation Daie) ,Name of Contractor) (Insurance Conirdany olicy Number) Y (F-xpiLrration.late) (attach additiouii shact ifnez enjuyto inc1w is in`ormataoe pev �to alt ors) I am a sale proprietor and have no one working for me. I am a home owner.performing all the work myself. NOTE.ply be stw=that.vebire hottscowacrs who employ bus to do r.a h,t=x a conmuctioa or fcgai work on a dwc€iing of- rot:taocc lhaa t1tft units in VAUch tha hom�r=dcs or 00 6--Winds ap r sat t€secety=not gmetaI€y 000zdered to be etnp€oyris UD'kx the worry's onaT=aaUcar,Act(CsL152,z1(5));a Mli=oo by a hot weer fuse lis x Oc pa-zad may evidence the legal datus of anemployor under&a Woais x convaweicm Ao 1 ua4erxtancd3 xt a copy ot'thia ctatemcW may be fmwasa W to tht Dgwxtmca of 1 rie1 Aa-i&a&Office of?arm for the, 'Coveagc vrsilic dIOG and that ful=to sectut covetW>=der sect on23A of MOL 152 cau€tid to the kapontion of cr=mal penalties coauting of a foie of up to S 1,300.00=Nor i of up to ow year and civil penalties in dr-form of ac Stop Wmk orb'-d s- o(3100,00 aday apinst Signed this' � Mt13y of 2000 For dyad use owy PeTmit Number .7,tgnatim ofd P.ITtkl f _ _ �EC#`I(l�i'�-C{IlVS'TRU�C'C1QN SER1i1GES .1 Licensed Construction Sufrervisur: Not Applicable CI : ,r G 060300 Name of tcense Holder ;_Nelson Shif1eLL s Valley Hoene Improvement;, Inc . License Number _ 320 Riverside Dri_ve _.. _ 9/00 f tams Expiration Late - r dd � l i NoNort hamaton, MA 0100 re___w Telephone .�✓ 584--7522 / 1 `ro ° Not Applicable 0 Valley Home Improvement , Ins. 105543 ny m vmpa Nae mm Registration Number _320 Riverside Drive 7/17102 r i Address Expiration Date orthapt on, MA 01060 Telephone^ 584..7522 j SECTION 10-Vfit3RKERSY COMPENSATION INSURANCE AFFIDAVIT(M.G L. c,152,§25C(0)) Workers Oompensation insurance affidavit must be completed and submitted with this applicat=on. Failure to provide this affidavit will result in the denial of the issuance of the building permit. I I Signed Affidavit Attached Yes--.. No-.... El _! Z he current exemption for-homeowners"was extended to include Owner-occupied Dwellings of one(1) or two!2 i farriilies and to allow such homeo«ner to engage an individual for hire who does not possess a license, provided that the owner acts as supervisor.CNIR 780, Sixth Edition Section 108.3.5.(. 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 fancily dwelling,attached or detached structures accessory to such use and`or farm structures. 4 person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shad 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 he 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 Heath)of the Massachusetts General Laves 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 r TC IAN 5-DESCAIPT10N Of PROPOSED W- RKIgheck all pgUc_abie) 3 New House 0 Addition 0 Replacement Windows Alteration(s) 0 1 Roofing 0 l yOr Doors 13 I k Accessory Bldg. to D lit o-bd PO0&IL' New IS,&F�k] , Decks [ Siding[ flt,�;++er x Brief Description of Proposed Work; �ev a Alteration of existing bedroor /Yes � No Adding new bedroom Yes _ v�No ? Attached Narrative Renovating unfinished basement Yes moo Plans Attached Roll Sheet I a . 1f..stew.h t se A 1 .0-..., 0,111 : t ' h'clM C "t t+ ` �� �' in Y. Use of building : One Family--1/ Two Fam'sly rtt Er b, rl,amber of rooms in each family Unit:__.__­____ _ __ Number of Bathrooms 1 n c. is there a garage attached? /f cJ- Proposed Square footage of new construction.. ----- e, fv+.jmb r of stories? t !'alethoc of heating? Fireplaces or WoodstoveS Nurr7be,of each g. energy Conservation Compliance. � Mascheck LEnergy Coi ip.ianc e form attached? s T fv;^,e or construction i. Is construction within I00 ft. of wetlands?.,_ Yes �/_ �o. is construction within 1.00 yr. f oodpla n Yes----- -�`o j t 7 D p of basement or ceIlar floor below inished grad k. Jv'ffl buiidirsg conform to the Building and honing regulations? Yes No 1 1. Septic lank City Sewer_ �/ Private well- City water Supply.,.__G�. SECTION'7a- WI NER ALITfiORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES fOR BUILDING PEf MIT 1 Pamela Schwartz & Joel Feldman as owner of the subfect pro=z)er v nee byauthonze Nelson Shifflett, Valley Home Im rovemen Inc . _ . t a ( my I<eha+f, all r tters relative to work authorized by this building permit application. { 1 Ii Sign re of Owner date E Nelson Shifflett Valley Home Improvem_nt, In� . as Owner/Authorized Agent t eby decCar� that the staternents and information on the foregoing application are true and accurate, to the best of my knovr edge and belief. i SiR red uncle= the pains and penalties of per ury, i i Nelson Shfflett — — _--------------------- Print Narne .n S i Signature of utwne . P ` Bate fi Section 4. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION Existing Proposed Required by Zonin„__..'u_- Phis c€luumn to be rr3le(i in bs Building 11c-parftnent __. _ f Lot S IZ€. i ( ” r TN E I'rc�tita €= Setbacks Front I E i Side i_: R. .: Rear l Building Height BIdg.Square Footage °ro I Open Space: Footage � % €Lt}t area minus bldg&paved ark tiw l of Parking Spaces A. Has a Special Permit/Variance/Finding ever been issued tor;on the site? NQ l/ DON'T KNOW _. _. YES IF YES, date issued; IF YES: Was the permit recorded at the Registry of Deeds? NQ Il— DON'T KNOW —_. _ YES IF YES; enter Book gage _. and/or Document B. !Does the site contain a brook, body of water or wetlands? N _�� DON'T KNOW �_-- YES IF YES, has a permit been or reed to be obtained from the Conservation Commission? Deeds to be obtained Obtained — Date Issued: C, Do any signs exist on the property? YES NQ IF YES, describe size, type and location:- —.-- - T_-- -- D, Are there any proposed changes to or additions of signs intended for the property ?YES No IF YES, describe size, type and location:--.,-- 1 flf I~lflrthampt4n , l ding Department � Z � 1 2 Main Street � � u �� i SEP 1 3 Roflrr 100 h ptfln MA 01060 44 gUll�aG INSpE p -1240 Fax 413-587-1272 APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION I-SITE INFORMATION r 11 Property Address. '�' is ssctie�n�oti� ��i?��ted b��►#ic+� 48 Monroe Street Map Lot , � trrt _ m_ Northampton, MA 01060 Zone Overlay District lm,St.13€strict R Distri #= _ SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT { ,I Owner of Record: k € Patnela Schwartz -- .__Monroe_ Ure -- - - - - .- Name(Pr' ;, Current Mailing Address: j Northampton, MA 01060 1 Telephone ,. ure 886-7113 1 2.2 Author ed Agent: Nelson ShiffleLt< j 1 Valley HoirEe Imprpyemen- , Inc. P.O. Box 60627, Florence, MA 01062 Name(Print) Current Mailing Address: � 884- 7522 r SignatUIc % Telephone � SI3 - ESTIMATED CONSTRUCTION CO T !ter Estimated Cost(Dollars; Lo be Official Use Only completed by permit applicant i, Bail (a) Building Permit Fee I co 2. =4ectrscaG ©�� (b)Estimated Total Oust of /_V w 4010/c i / Construction from 6 �—T Plumbing Building Permit Fee t 4- `Vxech3ntcal (HVAC) J. Fire Protection - 6 ota! ( +2 3 + _ i Check Dumber 1 _ This Section For Official Use Only, Building Permit Number; � � Date issued: } I Signature: w. _ L uildin Comm+ssioneritnspector of Buildings Hate File#BP-2001-0255 APPLICANT/CONTACT PERSON Valley Home Improvement,Inc ADDRESS/PHONE P O Box 60627 (413)584-7522 PROPERTY LOCATION 46-48 MUNROE ST MAP 38B PARCEL 101 ZONE URB THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Buildiny,Permit Filled out Fee Paid 19-11 i ypeof Construction: REBUILD 2 STORY PORCH(SAME FOOTRPINT)&INSTALL BULKHEAD New Construction Non Structural interior renovations Addition to Existing Accessojy Structure Building Plans Included: Owner/Statement or License 060300 3 sets of Plans/Plot Plan THE EpLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION: Approved as presented/based on information presented. Denied as presented: Special Permit and/or Site Plan Required under: § PLANNING BOARD ZONING BOARD Received&Recorded at Registry of Deeds Proof Enclosed Finding Required under: § w/ZONING BOARD OF APPEALS Received&Recorded at Registry of Deeds Proof Enclosed Variance Required under: § w/ZONING BOARD OF APPEALS 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 Signature of Building icial 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. 46-48 MUNROE ST BP-2001-0255 G1S#: COMMONWEALTH OF MASSACHUSETTS MU.Block: 38B- 101 = 30v'Jd CITY OF NORTHAMPTON I Lot: -001 Permit: Building Category:renovation BUILDING PERMIT Permit# BP-2001-0255 Project# JS-2001-0431 Est. Cost: $26000.00 Fee: $130.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Groin: Valley Home Improvement, Inc 060300 Lot Size(sq. ft.): 6795.36 Owner: FELDMAN JOEL&PAMELA SCHWARTZ 1�� Zoning:URB Applicant: Valley Home Improvement, Inc AT. 46 - 48 MUNROE ST Applicant Address: Phone: Insurance: P O Box 60627 (413) 584-7522 Workers Compensation FLORENCEMA01062 ISSUED ON:9115100 0:00:00 TO PERFORM THE FOLLOWING WORK.REBUILD 2 STORY PORCH (SAME FOOTRPINT) & INSTALL BULKHEAD POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Inspector of Buildings Underground: Service: Meter: Footings: Rough: Rough: House# Foundation: 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: Fee Type: Receipt No: Date Paid: Check No: Amount: Building 9/15/00 0:00:00 12479 $130.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo 46 COLUMBUS AVE BP-2001-0255 GIs#: COMMONWEALTH OF MASSACHUSETTS Map-Block: 38B- 129 CITY OF NORTHAMPTON Lot: -001 Permit: Buildinq Categ_orv:renovation BUILDING PERMIT Permit# BP-2001-0255 Project# JS-2001-0431 Est.Cost:$26000.00 Fee: $130.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: Valley Home Improvement, Inc 060300 Lot Size(sq. 8.): 10018.80 Owner: FELDMAN JOEL&PAMELA SCHWARTZ Zoning URB Applicant: Vallev Ho m rovement Inc AT. 46 COLU S AVE UV Applicant Address: Phone: Insu P O Box 60627 413 584-7522 Workers Compensation FLORENCEMA01062 ISSUED ON:9115100 0:00:00 TO PERFORM THE FOLLOWING WORK.REBUILD 2 STORY PORCH (SAME FOOTRPINT) & INSTALL BULKHEAD POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Inspector of Buildings Underground: Service: Meter: Footings: Rough: Rough: House# Foundation: 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: Fee Type: Receipt No: Date Paid: Check No: Amount: Building 9/15/00 0:00:00 12479 $130.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo 22 COLUMBUS AVE BP-2001-0255 GIS#: COMMONWEALTH OF MASSACHUSETTS MaQBlock:38B- 124 CITY OF NORTHAMPTON Lot: -001 Permit: Building Category:renovation BUILDING PERMIT Permit# BP-2001-0255 Proi ct# JS-2001-0431 Est.Cost:$26000.00 Fee: $130.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: Valley Home Improvement, Inc 060300 Lot Size(sq.ft.): 9626.76 Owner: FELDMAN JOEL&PAMELA SCHWARTZ Zoning.URB Applicant: Valley Home Improvement, Inc AT. 22 COLUMBUS AVE Applicant Address: Phone: surance: P O Box 60627 (413) 584-7522 Wor ers Compensation FLORENCEMA01062 ISSUED ON:9115100 0:00:00 TO PERFORM THE FOLLOWING WORK:REBUILD 2 STORY PORCH (SAME FOOTRPINT) & INSTALL BULKHEAD POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Inspector of Buildings Underground: Service: Meter: Footings: Rough: Rough: House# Foundation: 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 SilInature: Fee Type: Receipt No: Date Paid: Check No: Amount: Building 9/15/00 0:00:00 12479 $130.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo Valley Home Improvement, Inc. Nelson Shifflett r-,©0 _ . , ,� ��- ti ,DIA f rod