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38B-184
�mtimm�im�im ° � � I o I i to to remain � new vinyl window n valve custom vanity w/ drawer med cab above the floor an ub wall o,F rr�z S'C�, hc linen :"IV. I I new door otty/ Aalfs Bath install new underlayment and vinyl floor in kitchen #'w CSFA-060300 NLLSON AS11IFFLETt,___� PO BOX FLORENCE INIA"W0 0912=014 C yj I/Y I(vf"w 41h Office of Consumer Affairs and Business Regulation 10 Park Plaza Sui te 5170 Boston, Massachusetts 02) 116 Home Improvement Contractor Reaistration Registration: 105543 Type,- Private Corporation Expiration: 7117/2016 Tr# 254029 VALLEY HOME IMPROVEMENT INC. STEVEN SILVERMAN P.O. Box 60627 FLORENCE, MA 01062 Update Address and return card. Mark reason for change. Address Renewal E mptoyment Lost Card Office of(.'onsurner Affai" Rusi4ess RcL' a 'Ulati :. License or registration valid for individul use only before the expiration date. If found return to: 140ME IMPROVEMENT CONTRACTOR egistration. 105543 Type: Office of Consumer Affairs and Business Reoulation Oq lR F A':,,,txpi ration: 7117=16 Private Corporation 10 Park Plaza-Suite 5170 02116 Boston. I N VALLItY HOME IMPROVEMENT INC, STEVEN SILVERMAN 340 RiversideDr. Northampton,MA 01060 Undemecrelary ature SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: \_ 1 Not Applicable ❑ Name of License_Hool_der: _�°t ��x1 �j\\ T Q(p b3 co 0,� k ( License Number P.o •6cx. I CD(02l IF k )rec.(r Yi0.. ON O b2 Ct [22 l l� Address Expiration Date L113-'SS4-1 Szz_ Signature Telephone 9.Registered Home Im rove f Contractor: Not Applicable ❑ al Inc_ 10�s�3 Company Nafne Registration Number Vick, 0\02- -1 ) 1-11 Address Expiration Date Telephone�k6'-C4 1cp2.Z SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152,§25C(6)) 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...... ❑ 11. - Home Owner Exemption The current exemption for"homeowners"was extended to include Owner-occupied Dwellines of 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 buildine 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 SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing Or Doors ❑ Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [M Siding[p] Othe ❑1 r Brief Description of Proposed _II Work: 'q Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet 6a. If New house and or addition to existing housing, complete the following: a. Use of building :One Family Two Family Other b. Number of rooms in each family unit: Number of Bathrooms c. Is there a garage attached? d. Proposed Square footage of new construction. /� Dimensions e. Number of stories? 41 // - f. Method of heating? Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction i. Is construction within 100 ft.of wetlands? Yes No. Is construction within 100 yr, floodplain Yes No j. Depth of basement or cellar floor below finished grade k. Will building conform to the Building and Zoning regulations? Yes No. 1. Septic Tank City Sewer Private well City water Supply SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, T3W as Owner of the subject property C w'U r hereby authorize Wi t� n lct to act on my behalf,in all matters r,plative to work autho ' ed by this building permit application. Signature f Owner Date I, �bcr\ShtL�\ek� y Ol,��t H tCDtY�C �iM P� ,'��(LC. as Owner/Authorized Agent hereby declare that the statements an nformation on the foregoing application are true and accurate,to the best of my knowledge and belief. Signed under the pains and penalties of perjury. Print Name Signature of Owner/Agen Date Section 4. ZONING All Information Must Be Completed.Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size Frontage Setbacks Front Side L: R: R: Rear I P Building Height / Bldg. Square Footage Open Space Footage (Lot area minus bldg&paved arkin .l #of Parking Spaces Fill: volume&Location) A. Has a Spec' l Permit/Variance/Finding ever been issued for/on the site? NO DONT KNOW 0 YES 0 IF YES, date issued: IF YES: Was the pefnit recorded at the Registry of Deeds? NO DON"r 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 'C.) DONT KNOW 0 YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained 0 Obtained Q , Date Issued: C. Do any signs exist on the property? YES 0 NO C IF YES, describe size, type and location: D. Are there any proposed changes to or additions of si s intended for the property? YES Q NO 0 IF YES, describe size, type and location: 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 over 1 acre? YES Q NO Q IF YES,then a Northampton Storm Water Management Permit from the DPW is required. Department use only orthampton Status of Permit: ��' V Mail' I Department Curb Cut/Driveway Permit Dain Street Sewer/Septic Availability OCT ZU�4 :� m 100 Water/Well Availability North mp on, MA 01060 Two Sets of Structural Plans b� 0 Fax 413-587-1272 Plot/Site Plans Northam ton,,MA 01100 60 Electric,Plumbing Gas Other Specify. APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION �`�V �l '6W"/ This section to be completed by office 1.1 Property Address: - 64y - f Map Lot Unit N© r Aow Zone Overlay District Elm St.District CS District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Name rint) Current Mailing Addres Telephone Signature 2.2 Authorized Agent: A ccti Q-o.6cs� l�o�a� orencc �-(� o�otE,2 Name(Printy Current Mailing Address: 43-�,8�-`122 Sign t re Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant 1. Building -?T(2 J (a)Building Permit Fee 2. Electrical (b)Estimated Total Cost of Construction from 6 3. Plumbing �jy�� Building Permit Fee 4. Mechanical(HVAC) 5. Fire Protection 6. Total=0 +2+3+475) S (7 () Check Number This Section For Official Use Only Date Building Permit Number: Issued: Signature: Building Commissioner/inspector of Buildings Date File#BP-2015-0403 APPLICANT/CONTACT PERSON VALLEY HOME IMPROVEMENT INC ADDRESS/PHONE P O BOX 60627 FLORENCE (413)584-7522 PROPERTY LOCATION 29 FORT ST MAP 38B PARCEL 184 001 ZONE URB(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 Typeof Construction: REMODEL BATH&RELOCATE VANITY 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 FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORM ATION PRESENTED: proved 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 D 1 Sign e o uil mg fi ial 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. 29 FORT ST BP-2015-0403 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 38B - 184 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-2015-0403 Project# J7-2015-000723 Est. Cost: $15000.0,; Fee: $90.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: VALLEY HOME IMPROVEMENT INC 060300 Lot Size(sq. ft.): 7840.80 Owner: AALFS JANET E&JANIS A TOTTY Zoning-: URB 10f; Applicant: VALLEY HOME IMPROVEMENT INC AT. 29 FORT ST Applicant Addre.;s: Phone: Insurance: P O BOX 606- (413) 584-7522 Workers Compensation FLORENCEfvl/,01062 ISSUED ON.1011612014 0:00:00 TO PERFO."41 THE FOLLOWING WORK.REMODEL BATH & RELOCATE VANITY POST THl S ( DSO IT IS VISIBLE FROM THE STREET Inspector of P!ii 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 PERM 1'i JAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS ,ES AND REGULATIONS. Certificate of ipancy Signature: FeeTy pe: Date Paid: Amount: Building 10/16/2014 0:00:00 $90.00 212 Main Street, Phone(413)587-1240, Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner