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09-006 (3) - - - _ --._ - _- I III I I i 27 5/16 -- - r- I 1 � 1 I I , I \ \\ 1 1 I __. I I I I l ZZ I , l ; I � i I � � .� IL %� ws S" 1' 1 Y " tr vv N 1! a"r `�'c"y.x " `��6`S '.;w r, M. ' ,w k € cf•� 5` e S �t�l .�r: I_. 1 v t % {'_..,", # r�z kdi #: I {. > .f I _. >...... .. _.., t._ t' a•w - it 14W it M " s o� E i t t P j'3`' Aq , I I � ii I I _..._..... ....-.._.._...- --- - _ T3Y �H' r �/ M} This plan is the proprietary work pn,r1.a � 'I�` � � � �®YemeI IL Inc• JOHN AND GERRY Home improvement,Inc.(VHI) Ilis delivered for the limited and exclusr 1 - Office Riverside Drive, F Box 6062-1, Northampton,5 MA 500820 L EEDa M KENNEDY ROAD customer er agrees that the clenio i W I purpose g ot s pl I r° Find us on the web at: wu wYalleyHomelmprovement.com competing project contractors wiihw !;I I 1�, <TE. 5/15/ 014 ,permission o,and compenSEW017 11, i1' .............. ...... ---------- ;t.< rn -TI -n X 70 > 70 A 70 U,' C, 0 0(P 0 z A m-1. 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JOHN AND BERRY Home Improvement Inc.(V141) It IS delivered for the limited and 400 KENNEDY ROAD Supporting the contract bid of 1//-I/, 540 Riverside Drive, PO Box 60621, Northampton,MA 01062 Offl,--e Phone 413.554.-1522 Fax 413.555.0520 LF-F-05 MA customer agrees that the efaments not be republished or pre sen ecy it, for the purpose of enabling o� Find us on the web at: UUWA'alleyHoMeimprovement.com competing project contractors withow I permission of,and compense.tion DATE 5/15/2 .......... - ------- � � �assarflnsetts DEPARTMENT OF BUILDIII(,-, INSPECTIONS 212 Main Street ° Municipal Building ' Northampton, Mass. 01060 °'M SY•', WOREEW S COMPENSATION INSURANCE AIFMAV LT 11,&1— r`1 ,ltd ' (licenstrrJpermittee} with a principal place of business/residence at: : 11114 (phone#) (stt�dcity!s` fP rip do hereby certify, under the pains and penalties of perjury, that: 0 I am an employer providing the following worker's compensation coverage for my employees woridng on this job: (insurance Company) (Policy Number) (Expization 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) (inannce Company/Policy Numb,--r) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (attach additioaal shod ifne=sary to kchWc information pertaining to all caatma m) ( ) I am a sole proprietor and have no one working for me. ( ) I am a home owner performing all the work myself. NOTE:please be aware that while hoa=wners who eat*loy p==to do makd==sn cac&u tion-or repair wOrk on a dweWag of not roe's thaa !Mite ie Vii^"tt--h -^-:13--0 griU"app Jrac;xu xhtmo am W 3=�t to i t �1'w'�F_„4?.�'w?r:�:,°"`£c.�•�..®rr.•a:�.�{,i;lve L`Sr E ror�„�.�..:...si r�j�,v,.�--.`.��,s i.0:a u�..�.:��`.:'�+•i.E:`.}E�.�°iw.i%1� legal statue of an employer under the W arLam-'s Comp=satioa AcL i Lm&2 .tea 6 i a copy of brie=r =^p*Y may be fwwardad to the Dop—m-u ---d df lzastnial Ac=4=a 05ce cf Ir=m=for the covmp veri&catien sad tbst failure to sire coverage under s&cdon 25A ofMOL 152 can lead to the=Pa=On afcaimbul peaalties coasisisg of a Sae of up to 51,500.00 GnNor m-'+t of up to o^i yrsr and civil peasriies is the form of a Stop Work ostler and a f=of 3100.90 a&-y agate tare Signed 'r dny©f ; %E'C `?�1 , L'�}l 1 rw�—-ri ,; Permit N=be r C1 r l /Y/if�l<y✓l i Ian L 1t# Tigaatzre ofLicerse&Per I: t ` .1 -riqqLrs--d Construction Supervisor Not -`,.,1nP icable ED ; turt gnatur Telephone 9. Registered Home Improvement Contractor: Not Appilcabje 0 Steven Silverman- 131945 Company Ntarne Ra�7ist�,atior, Number 268 Fomer Road 1011-3/Zt Address Expiration Date SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L. c. 152, §255-C(6)) Workers Compensation Insurance affidavit must be cornpleted and su!Dmitted with th�sapplicati-cn. r-ailure to provide, this affid"awt will result in the denial of the issuance of the building perrn�t. 11.,- .Ho me Owner Exemption Tbcuonont exemption for'hmneo,mms" was extended minclude fame(}) or tnn(2} famUica and to a!}m*such hocncownex\o en-aaeuo individual for hire who does not possess u license, provided that the wvvner acts as supervisor.CNTR 780. Sixth Edition Section 108.3.5.1. Definition of : Person(s)n600mnupmzr| o[|audonvvhichho�hcreoidcsorintcodscureddo`onwbiobtbere is, mris |utcndcd to,be. 000co/'rro [bmil."' d`rcUixa'emJhcdordc/nchodxm./ixre"accex,",y'n such usound/m-fbnn ar""n"Ire Such shall submit 1othe Building 0fffidu!,nna<von acceptable tu the uouu/ogOfficial, responsible for all such work performed under the buildin!,� pernii Anucdn- yourprmncron the Jnh"kcv°i|>6e renuit-eJhamc|meuodmc'during and upon completion of the work for which this permit is issued. Also hc advised that with reference raChapter ]52(Workmg' Cumpr:,osmion) and Chapter |j� (Liubi|ity off Employers tu (hrinjorics not resulting in 0c:tb)of the Muoacbxy-nsGenom\ L`rs Annotated. k,rpor»on(d }'uuhiruto perform n/ork For you tinder this punvh, The uodcmi2ncd^^homen`vnc/^uenifim and assumou responsibility for compliance with the State 8uUdixo Code,Cir�Vo11- \oc-�| Zorh`o ( n`"� on� �rn�r,�`�o�mrhc��sQcn�rc| L�n'. �nnnsu�� B Dili au�ac� Si��u�ur�________ IJ5_ C4, __. Mile e,, . If New house zmA or aclditiota to existing, lousing. complete the follewTtis: ,:Yet ,t. ,P,`,;, ..l4vrf•ti° +' i r ^ r e .,_.. w"aEh 1.: I i��`p C'.+:^,d f. { tt •',t;'.6 ea.{( "p..,, .._..,.. _.. _............ .. .......____.. , . „ -F ! :t 3 ! 1. :.. -c.._ i ! . _ � . a:QI:.,.f.➢.':i a'V �.�iP.:tl �.�.t'� ',k. ;;P� e".u.�'...;Ek�,.� '�'�t ____� �`�::, f:P P.nJ!!:�E:�L':@:,7l1 1� ., .IS�� ,4)�"r'i. f...:.tw.ifr3hV�! ��.. _...__.__.._�:.- S .`P '8! C €4: ';r E°r:s (.:s < �.. .... e :.I. S ECTEClq 7a -OWNER AUTHOR[ZA T ION "FO BE COUTEETED WHEN 4 OVYW'ERS AGENT OR CONTRACTOR!-;PFUE75 FOR BUILDING Pcpr.§IT Steven Silverman, V,al ey Home Inp rolvement, .,Inc. f � y S,te_ t- WV steve;4 Silverman i 5�6 l ALL ENTFORMATION MUST BE COMPLETED, or PERNHIT 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: i' Rear % Building Height Bldg. Square Footage % Open Space Footage (Lot area minus bldg&paved parking) #of Parking Spaces Fill: (volume&Location A. Has a Special Perm it/Variance/Findin ever been issued for/on the site? NO DON'T KNOW YES IF YES, date issued: IF YES: Was the permit recorded a the Registry of Deeds? NO DON'T OVA' i'ES IF YES: enter Book Page and/or Document # B. Does the site contain brook, body of water or wetlands? NO DON'T KNOW YES IF YES, has a ermit been or need to be obtained from the Conservation Commission? Needs to be tained Obtained , Date Issued: C. Do any sign- exist 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 — iv u IF YES, describe size, type and location: ______-------- I Departs lent use or, City of Northampton (Status o= 1,-ermit: Building Department Curb Cut/Driveway Permit I�` t 212 Main Street Sewer/Septic Availabiiity U MAY 232014 ., Room 100 Wader/Well Availability " Northampton, MA 01060 Two Sets of Structural Plans El ctric,Plumbing&Gas ins actions lS_1. r�orth� pton,MA01p�n 13-587.1240 Fax 413-587-1272 Plot✓Site Other Specify_ __ APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY Wt WELLING SECTION 1 -SITE INFORMATION 1.1 Property Address: This section to be completed by office Map Lot Unit Zone Overlay District Elm St. District G8 District SECTION 2- PROPERTY OWNERSH AUTHORIZED AGENT 2.1 Owner of Record: Z dan lsakaW\e-C -� ann t H( n&1 4&n &Pn. v LOAS N< 01 b --Name(Print Current Nailing Address: I Telephone Signature 2.2 Authorized Agent: Steven Sil a an//allev Fi 'te T ro rra�"F n eR P.O. ;oar 60627, F nr,e nce Name(Print) Current Uailing Address: _ 564-7522 Signature Telephone SECTICtyl 3 - Em—z7fMATED COIF€STPUCT€ON COSTS I;__ E� :. �s�;,r:a eo Ccsi(Doiiars) c be Ofriciai Use Only completed by errnit applicant I 1 . Building f 1 Y o��i (a) Building Permit Fee 2. Electrical I Vl/ (b) Estimated Total Cost of 1► Construction from (6) 13. Plumbing � �/� Building Permit Fee � 4. N(lechanical (IHVAC) 4 6. Total =(1 + 2 + 3 + A + 5) J3, Ched k Number 0 � I i hFs Section For Officlal Use Only Building Permit Number: Date Issued: I Signature: --- ! Bu;ldng Ccrnm;ssioner/Ins'pector of BuiIdings ct File#BP-2014-1246 APPLICANT/CONTACT PERSON VALLEY HOME IMPROVEMENT INC ADDRESS/PHONE P O BOX 60627 FLORENCE (413)584-7522 PROPERTY LOCATION 400 KENNEDY RD MAP 09 PARCEL 006 001 ZONE RR(100)/W SP(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 Tvpeof Construction:_REMODEL BATHROOM 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 INFO.RMATION 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 Demolitio Delay S-- :30 Sig re o Build ng Offic al 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. 400 KENNEDY RD BP-2014-1246 GIs#: COMMONWEALTH OF MASSACHUSETTS MW Block:09-006 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-2014-1246 Project# JS-2014-002099 Est. Cost: $23000.00 Fee: $138.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: VALLEY HOME IMPROVEMENT INC 077279 Lot Size(sq. ft.): Owner: MANDEL GERALD&JOHN LATAWIEC Zoning: RR(100)/WSP(100) Applicant: VALLEY HOME IMPROVEMENT INC AT. 400 KENNEDY RD Applicant Address: Phone: Insurance: P O BOX 60627 (413) 584-7522 Workers Compensation FLORENCEMA01062 ISSUED ON.513012014 0:00:00 TO PERFORM THE FOLLOWING WORK:REMODEL BATHROOM 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 5/30/2014 0:00:00 $138.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner