10B-089 1`\
A a, iV1:tssachusetts - Department of Public SafetN
Board of Building Regulations and Sta11tlat't1s
Construction Supervisor License
License: CS 77279
Restricted to: 00 ,
STEVEN A SILVERMAN
268 FOMER RD
SOUTHAMPTON, MA 01073
I
Expiration: 6/2112010
Cuntmisiuncr Tr##: 25795
B � kfldi rrl cgd4/ttioyf 1Pg
HOME IMPROVEMENT CONTRACTOR License or registration valid for individul use only
before the expiration date. If found return to:
Registration. 131945 Board of Building Regulations.and Standards
Expiration: 10/13/2010 Tr# 275412 One Ashburton Place Rm 1301
Type; Individual Boston,Ma.02108
STEVEN A. SILVERMAN
STEVEN SILVERMAN
268 FOMER RD
SOUTHAMPTON MA.01073
Administrator
Not valid without signature
w
SECTION 8 -CONSTRUCTION SERVICES
.1 Licensed Construction Supervisor: Not App'icable 13
Name of 1_icense bolder : Steven Silverman__ _077279
License NLArnber
268 Fomer Road _o.u_ hamptaxx.,_._.tvrA 0� 073_. .._.___ 6/21/10
---- -
r^,ddress Expiration Date
_�_._ 5 84-7522
Signature I elephone
i
9.Registered Home Improvement Contractor: Not Applicable ❑
_Steven 5 Uverr an___ 131945
___.._.. __ ____._ .,_.__ _--
Company Name Registration Number
268 Fomer ,Road _ __....__. 10/...7 3.11
A;dress Expiration Date
Southampton, MA 01073 Telephone 584-7522
SECTION 10-WORKERS' COMPENSATION INSURANCE AFFIDAVIT(M.G.L. c. 152, § 25C(6))
Workers Compensation Insurance affidavit rnust 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....... N 1o......
11. - Home Owner_Exemption
The current exemption for"homeowner;" was extended to include Owner-occupied Dwellings of one(1) or two(2) families
and to allow such homeowner to crigaage an individual for hire who does not possess it license, provided that the€caner nets
as supervisor. CMR 780 Sixth Edition Section 108.3.5.1.
DeCnition 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 hoincowner.
Such"homeowner"shall submit to the Buildint,Official, on a farm acceptable to the BUildin-Official,that he/slie shall be
responsible for all such work performed under the building 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 E'niployers w
Employees for injuries not resulting in Death)of the Massachusetts General Laws Annotated, volt may be liable for persons)
you hire to perform work for you under this permit.
The undersigned"homeowner"certifies and assumes responsibility for compliance with the State Building Cade, City of
Northampton Ordinances, State and Local Zoning Laws and State of Massachusetts General Laws Annotated.
Homeowner Sionatare
`
AcceLsory Bldg. :1 DPITIOlitiorrD New Signs Decks Siding Other
63. If New house atid or addition to existine housin complete the following:
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
Steven
.tr
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 filled in by
Building Department
Lot Size
Frontage
Setbacks Front
Side L: R: L: R:
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 Permit/Variance/Finding ever been issued for/on the site?
NO DON'T KNOW YES
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW YES
IF YES: enter Book Page and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO 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:
C. Do any signs 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_
No
IF YES, describe size, type and location:
� T
Department use only
`Gity of Northampton Status of Pe r%ii
wilding Department Curb Cut/D 'Wi lay Permit
212 Main Street Sewer/Septic Ayaila6 ility
Room 100 Wer,/Well Availability`
,,i .. � r�����orthampton, MA 01060 Twto�Sets of Structural Plans
3\ ``phone 41.3-5.$7.1240 Fax 413-587-1272 Plot/Site P19m,
Other Specify je
APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION
This section to be completed by office
1.1 Property Address:
Z Z5- Map Lot Unit
i
A r �� �C� J Zone Overlay District
C J Elm St.District __, CB District
SECTION 2- PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
-Name(Print) Current Mailing Address:
Telephone3�
Signature
a CF
;2.2 Authorized Agent: Steven Silverman
Valley Home Im rove n Inc.- P.O. Box 60627, Florence, MA 01062
Name(Print T Current Mailing Address:
-- 584-7522
Signature Telephone—]—_SECTION 3 - ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by ermit applicant
1. Building (a) Building Permit Fee
2. Electrical (b) Estimated Total Cost of
Construction from 6
3. Plumbing Building Permit Fee
4. Mechanical (HVAC)
5. Fire Protection
6. Total =(1 + 2 + 3 + 4 + 5) Check Number
This Section For Official Use Only
Building Permit Number: Date Issued:
Signature: _ - --- — — ---
Building Commissioner/Inspector of Buildings Date
225 ATtIf' BP-2009-1006
GIs#: COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: BUILDING PERMIT
Permit# BP-2009-1006
Project# JS-2009-001449
Est. Cost: $2000.00
Fee: $35.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: VALLEY HOME IMPROVEMENT INC 131945
Lot Size(sq. ft.): 15071.76 Owner: TENNYSON LISA BETH
Zoning: URB(100)//WP Applicant: VALLEY HOME IMPROVEMENT INC
AT. 225 MAIN ST
Applicant Address: Phone: Insurance:
P O Box 60627 (413)584-7522 Workers
Compensation
FLORENCEMA01062 ISSUED ON.61112009 0:00:00
TO PERFORM THE FOLLOWING WORK.-INSTALL REPLACEMENT WINDOWS
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 6/1/2009 0:00:00 $35.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo