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05-062 (9) NEW DOOR RADIANT HEAT FLOOR OEXISTING CLOSET [01 CE O O / F I® DRAWERS 40"TALL !\ v ` FULL HTG CAB. \\ 0 NEW DOOR _ °° 1ST FLOOR BATH `NEW 5-0 SHOWER REMOVE CLOSET/RELOACTE DOOR BATH SPECIFICATIONS NEW TOTO 1.6 TOILETS THROUGHOUT CLEAR FRAMELESS DOOR ASTER BATH TWO TUBS TO REMAIN/NEW W96 VALVE TRIM AND HAND HELD SPRAY CORNER BENCH REGROUT/CAULK EXISTING TUB TILE ACCESORIES TO INCLUDE NEW CURVED SHOWER RODS GUEST BATH CHOICE OF VANITIES WITH GRANITE TOPS AND UNDERMOUNTT SINKS NEW BEVEL EDGE MIRRORS THROUGHOUT DELTA FAUCETS OR EQUIV. P���L�® $�`T'� REMODEL TILE FLOORS THROUGHOUT NEW WIRING THROUGHOUT INCLUDING PANASONIC FANS ON TIMER,HEAT LAMPS, NEW RECESSED LIGHTING. NEW DOOR RADIANT HEAT FLOOR O q OO EXISTING CLOSET 9 I DRAWERS 40"TALL (3i 1 l� FULL HTG CAB. \\ o ( ! I \� NEW DOOR\ L aST FLOOR BATH -- `NEW 5-0 SHOWER REMOVE CLOSET/RELOACTE DOOR BATH SPECIFICATIONS NEW TOTO 1.6 TOILETS THROUGHOUT CLEAR FRAMELESS DOOR ASTER BATH sir--� TWO TUBS TO REMAIN/NEW W96 VALVE TRIM AND HAND HELD SPRAY CORNER BENCH REGROUT/CAULK EXISTING TUB TILE ACCESORIES TO INCLUDE NEW CURVED SHOWER RODS GUEST BATH CHOICE OF VANITIES WITH GRANITE TOPS AND UNDERMOUNT SINKS NEW BEVEL EDGE MIRRORS THROUGHOUT DELTA FAUCETS OR EQUIV. PACI�.I® BATH FLEA REMODEL NEW TILE FLOORS THROUGHOUT NEW WIRING THROUGHOUT INCLUDING PANASONIC FANS ON TIMER,HEAT LAMPS, NEW RECESSED LIGHTING. A f } e _ WINDOW TO REMAIN _i I i 36"WALL CABINETS I + j L--_ -- - - ; J 110 - ' U AA t TILE BACKSPLASH BEHIND RANGE JJ HARDWOOD FLOOR TO REMAIN J i ) INSTALL OWNERS LIGHT FIXTURES d:l 1--fwp I NEW GRANITE TOPS THROUGHOUT 4"314"BACKSPLASH INSTALL OWNERS TECH LIGHTING 1t NEW CUSTOM MADE SUMMIT WOODWORKS CABINETS THROUGHOUT � I '3329 0l I _ ---- -7----------- P 11" KIT -LJEN nEMOT"EL PAC s-< BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 060300 A FS Birthdate: 09/22/1950 Expires: 09/22/2008 Tr.no: 1182.0 Restricted: 1G NELSON A SHIFFLETT 340 RIVERSIDE DR PBX60627 4Z�— FLORENCE, MA 01062 Commissioner Boar o Bulk da in an S)tanrs One Ashburton Plac- - RID 1301 Boston. N1assachv:set`s 02 10S Home 17crov-1men: Lor_t.:ac='or Re�-::?siratlor F.egistraticn: —_ =ciraticrT _ VALL-Y HOME IMPROVE?P41=- i INC. _ Nelson Sniriett P.O. lox 60627 FLORENCE, MA 01062 - --- — - cdate address and return carp.Mar'- .eason for chance. Address Renewal — E..mnio%ment Lost Card GPs-C.:: C, 50M-OaO�-OCc69a — — – i a.` Board of Building Re;uiations and Scandares License or re;istration valid for individui use )ni% =_ rOME IMPROVEMENT CCNTRACTOR before the>_xpirarion date. If found return to: i Registration: 05V<3 Board of Budding Re-ulations and Standards 1 Expiration: n One Ashburton P!ace Rm I- N 7/17!2..08 n ti a.03108 _� Boston,. I Type: Private Corccration ;crnamo;cn Deputy administrator Not ?> 'without Signature r O4CtlAM1PTO �� �`� CCx�J �tf �Il"Z�1j�311�J�IIIt 12 - ' B �Iasat:cllasctis co DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street ` Municipal Building ' Northampton, Mass. 01060 WORIMR'S COMPENSATION INSURANCE AFFIDAVIT 1, Nelson .Shifflett - Valley- Home Improvement Inc. (Iicenseelpermittee} with a principal place of business/residence at: 340 Riverside Drive, Northampton,MA 01060 (phone#) 584-7522 (so-c--ucitws-'o -6dp) do hereby certify, under the pains and penalties of perjury, that: ()o I am an employer providing the following worker's compensation coverage for my employees working on this job: A.I.M. Mutual Ins. Co. WMZ8005610 01 2008 2/1/09 (Insurance Company) (Policy Number) (Expiration Date) ( ) I am a sole proprietor, general contractor or homeowner(circle one) and have hued 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 Compatiy/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Nturher) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Dace) (attach additional sheet if necessary to inchx6 information pertaining to all vrs) ( ) I am a sole proprietor and have no one working for me. ( ) 1 am a home owner performing all the work myself. NOTE:plmse be aware that while 11e01CO-A-0 a who employ per a to do,naixxtea n oe� ctioo or repair work on a dwelling of not morn than three units in which the homeowner resides or on the gtouad3 app rtenmt thereto an not generally eomickred to be employers tmdrer the worker's aampes soon Act(GL152ts l(5))�application by a homeow=for a license cc Parma may evidence the legal status of an employer under the Woricces compensation Act. I understand that a copy of thin statement may be forwarded to the Dt putmcrd of Dial Acctdea&OfSoc of Insurance for the coverage verification and that failure to scauro coverage under s0Woa 25A of MGL 152 can lead to thra imposition of chin!penalties coasisfring of a fine of up to$1,500.00=Nor imp:iso of up too=ymr and civil penalties in the fotm of a Stop Work Order and a find of 5100.00 a day agaiwt tam. Signed this day of W For dq;artan=t:il use Cray Permit Number Maw L©t A/E L-501V Sif1�t�L ! SECTiON'8 -CONSTRUCTION SERVICES. .1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder : Nelson Shifflett 060300 Valley Home Improvement, Inc. License Number 340 Riverside Drive, Northam,=r, on{ MA 011160 9/22/08 Address Expiration Date 584-7522 Signature Telephone 9. Re'`steretl(ioine`1" rovement.Con fie actor „ Not Applicable ❑ Valley Home improvement, Inc 105543 Company Name Registration Number 340 Riverside Drive 7/17/08 Address Expiration Date Northampton, MA 01060 Telephone 584-7522 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....... lift No...... ❑ 11. HomMwner :Xemp�Ytion The current exemption for"homeowners"was extended to include Owner-occupied Dwellings 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-vear 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 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 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 ! �, '`CTtGN %• GJEa%RPT{t�:'. CAF PC#€3PQSE�YrpP.1;frher<elc:stt ry �t§se;±htc� !'Now E{et.se tiiti r A.EersEinl(s� _ � �# auEirr Ell EEr Doors Accessory Bldg. 0 De nwlitiom:! Ncvr Sigros Decks Ir � Siding[ 1 C3t1ar r .1 rI , An / 3 G ! i Y :'i /� VE;; k .. _ f•( I B�r1� Ilc� `lf E C � lc,'.f ✓�� .1' li�l;ttC< . '�°�I:BCrd'�4 ,� �__._ .. .:_..�._ f.� t�'!4 �r t F.II r.li�lsC.� Isa•1trBtiC. .�. �z<.. plans- {:L1l, :fBrC E N(; . If New 130UsE alid o addition t existing h6usin COO ICte the Imiligg UF&',+ of Cne : r in ly T<<2, r rally 0•1�1r r ! l F p::17 .�B..t j F".k E: (i IS � °u t q v r +,CA yF:e of 11 11`,tf" l v tt Gi{ t f 4 s1GLU Ir1^' ti c; a b 1 1 I ,x 1 a P' {� EB i R erg I, C a �..E 6r:BGry ..230 p is _. >,.., . ._...- _.. _._. EP a=wi+_ Kr ate u 4,.+ttitp I uuaII,-e ICkrFT1 8`.taC1-1ca f y k t4:tt1 1 11u.)`{ cIt' o f l6[ i? N No. hi r'-ir'Istrur'E!.l11 g 00;t"r. `l dt"olatcl .?,rI 1 of :1i3^,wment r Cel%ar E,nor roel ,W,, �Is""v}hed t, av, tO ,,!.t Bl):1I 11 S: Fd :I,"4p, ::lL7:t{ �'? - ....,,ye'. .r."(}L14 acBa'$k (!:;'y "�"P"wf`_d.----__ ��r`VL��'� N1'y! _. C t-Y Vo'i'Itl`vr S001)''y SECTION 7a -OWNER AUT11ORIZATION •TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERre11T 0 subject aL F !� I;y ;`.B, r'lk'B3e- Nelson, Shi f f lett, ValleY Home : ripx©v meet. Tic. „ cy =PE can �_au lr'^? A 0 ,ri"IZr-I � , r t t 2 ey_Haztte- x:Epx_avernex f; , 4-: !ii Itcy h � 4 d r >t rld iFtJ1 "vti-al rn (IC; i1 l w<.tiJ1 rtu L to �1 U ( -,ed -j s_r tI"'_ !1_;8:._ cs.'j c1'riit'- `1t E tj.Imo'y. f e_lson Shile.tt ..-- -- r � 3- 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:A L: R: Rear ri r� 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 t--- DON'T KNOW YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 1-1� 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: 4 � s Department use only City of Northampton Status of J� rmlt: Building Department Curb Cut/Drivgv�ay Permit 212 Main Street &gwer/SepticAvailaDility! Room 100 Wat iPNell.Availability Northampton, MA 01060 Two Sets of Structural Plans phone 413-587.1240 Fax 413-587.1272 Plot/Site Plans„ Cther Specify APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Property Address: This section to be completed by office Lot Unit Zone Overlay District Elm St.District ,CB District SECTION 2- PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Name Print) r C u rrnt Mailing/address: X__ir�11J ��G� r I r ������W Telephone Signature 2.2 Authorized Agent: Nelson Shifflett Valley Home Improvement± nc, P.O. Box 60627, Florence, MA 01062 Name(Print) Current Mailing Address: 584-7522 signat re 'Ell Telephone SECTION 3 -ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building (a)Building Permit Fee V003 2. Electrical (b)Estimated Total Cost of /0 003 Construction from 6 3. Plumbing �.�0 Building Permit Fee 4. Mechanical (HVAC) 5 5. Fire Protection Hof n. Total =(1 +2 + 3.+ 4 + 5) Check Number This Section For Official Use Only - Building Permit Number:_ Date Issued: Signature: Building Cemm;ssioner/Inspector of Buildings gate File#BP-2009-0090 APPLICANT/CONTACT PERSON Valley Home Improvement,Inc ADDRESS/PHONE P O Box 60627 FLORENCE (413) 584-7522 PROPERTY LOCATION 503 AUDUBON RD MAP 05 PARCEL 062 001 ZONE RR THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid uildin Permit Filled out ee Paid . � Ttipeof Construction: Remodel Kitchen and 3 Baths 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 INFO ATION 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 Demolition Delay 07k o 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. BP-2009-0090 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-2009-0090 Project# JS-2009-000119 Est. Cost: $55000.00 Fee: $330.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: Valley Home Improvement, Inc Lot Size(sq. ft.): 65340.00 Owner: PACILIO MARTHA N Zoning: Applicant: Valley Home Improvement, Inc AT. 503 AUDUBON RD Applicant Address: Phone: Insurance: P O Box 60627 (413) 584-7522 FLORENCEMA01062 ISSUED ON:712312008 0:00:00 TO PERFORM THE FOLLOWING WORK.-Remodel Kitchen and 3 Baths 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 si nature: FeeType• Date Paid: Amount: Building 7/23/2008 0:00:00 $330.0024433 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo