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Palley Home Improvement, Inc 28 MOUNTAIN LAUREL PATH SCALE:SEE VIEW SHEET NUMBER
. FLORENCE,MA CROSS SECTION DATE:
340 Riverside Drive, PO Box 60621, Northampton,MA 01062
Office Phone 413.564.1522 Fax 413.585.0820 Soergel DRAWN BY:S.G. 4
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Valley Home Improvement, Inc. FLORENCE,MA DATE:
340 Riverside Drive, PO Sox 60621, Northampton, MA 01062 ELEVATION 3
Office Phone 413.584.'1522 Fax 413.585.0820 Soergel DRAWN BV:S.G.
Find us on the web at: www.\/alle Homelm roveme tt.com
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Palley Home Improvement Inc. 28 MOUNTAIN LAUREL PATH SCALE:SEE VIEW SHEET NUMBER
340 Riverside Drive, PO Box 6062"!, Northampton, MA 0106 FLORENCE, MA 2 MAIN FLOOR PLAN DATE:
Office Phone 413.584.1522 Fax 413.5b5.0520 Soergel DRAWN BY:S.G. 2
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NEW OPENING GUT IN FOR DOOR
REMOVE EXI5TIN6 WINDOW
REMOVE AND RELOCATE HEAT
DECK TO BE
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Valley Home Improvement Inc. 28 MOUNTAIN LAUREL PATH EXISTING SCALE:SEE VIEW SHEET NUMBER
i FLORENCE,MA DATE:
340 Riverside Drive, PO Sox 60621, Northampton, MA 01062
Office Phone 413.564.1522 Fax 413.585.0820 Soergel CONDITIONS DRAWN BY:S.G.
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Valley Home Improvement 4-14-15
v Y,3 e: 28 Mountain Laurel Path 2:25pm
Florence,MA 1 of 1
CS Beam 4.12.3.4
1anBeamEngine 4.12.5.1
Materials Database 1518
Member Data
Description:Soergel Gable Member Type: Beam Application: Roof
Top Lateral Bracing: Continuous Slope: 0.00/ 12
Bottom Lateral Bracing: Continuous
Standard Load: Moisture Condition: Dry Building Code: IBC/IRC
Snow Load: 40 PLF Deflection Criteria: L/240 live, U180 total
Dead Load: 20 PLF Deck Connection: Nailed Member Weight: 8.3 PLF
Filename: Soer el Gabl
Other Loads
Type Trib. Other Dead
(Description) Side Begin End Width Start End Start End Category
Replacement Uniform(PLF) Top 0' 0.00" 12' 0.00" 0 80 Live
Additional Uniform(PSF) Top 0' 0.00" 12' OAO" 2' 0.00" 40 20 Snow
Point(LBS) Top 6' 0.00" 1698 0 Snow
Point(LBS) Top 6' 0.00" 0 886 Live
Yd load from lidge above
12 0 0
12 0 0
Bearings and Reactions
Input Min Gravity Gravity
Location Type Material Length Required Reaction Uplift
1 a 0.000" Wall Steel N/A 1.500" 2557# --
2 12' 0.000" Wall Steel N/A 1.500" 2557# --
Maximum Load Case Reactions
Used for applying point loads(or line loads)to carrying members
Snow Dead
1 1335# 1222#
2 1335# 1222#
Design spans
1r 1.7W'
Product: 2.0 RigidLam LVL 1-3/4 x 9-1/2 2 ply PASSES DESIGN CHECKS
Connect members with 2 rows of 16d common nails at 12.0"oc
Minimum 1.50"bearing required at bearing#1
Minimum 1.50"bearing required at bearing#2
Design assumes continuous lateral bracing along the top chord.
Design assumes continuous lateral bracing along the bottom chord.
Allowable Stress Design
Actual Allowable Capacity Location Loading
Positive Moment 11687.# 16104.# 72% 6' Total Load D+S
Shear 23924 73934 32% -0.06' Total Load D+S
TL Deflection 0.5371" 0.809T' 0271 6' Total Load D+S
LL Deflection 0.2972" 0.6073'' 0490 6' Total Load S
Control: Positive Momerd
DOLE: Live-100% Snow-115% Roof=125% Wind-160%
All product names are trademarks of their respecfive owners John P.O'Leary
Seven D Wholesale
Copyright(C)2015 by Simpson Strong-Tie Company Inc.ALL RIGHTS RESERVED. Rock HI I I,CT
"Paining isdefined asvolen the member,fioor}olst,beam or giniec shown on this drawing meets applicable dedgn criteria for Loads,Loading Conditions,and Spans listed on this sheet The y
deal n must be reviewed a usIitad ded ner or ded n rofemonal as Wired fora royal.Thisdeal asaumea roduct inatallatlon accordin to the manufacturers Ificabons.
Valley Home Improvement 4-14-15
y-plea m 28 Mountain Laurel Path 2:24pm
Florence,MA I of 1
CS Beam 4.12.3.4
kmBeamEngine 4.12.5.1
Materials Database 1518
Member Data
Description:Soergei Ridge Member Type: Beam Application: Roof
Top Lateral Bracing: Continuous Slope: 0.00/ 12
Bottom Lateral Bracing: Continuous
Standard Load: Moisture Condition: Dry Building Code: IBC/IRC
Snow Load: 40 PLF Deflection Criteria: L/240 live, U180 total
Dead Load: 20 PLF Deck Connection: Nailed Member Weight: 5.2 PLF
Filename: Soer el Rid
Other Loads
type Trib. Other Dead
(Description) Side Begin End Width Start End Start End Category
Replacement Uniform(PSF) TOP 0' 0.00" 14' 0.W' 6' 0.W' 40 20 Snow
IT
O 1400
14 0 0
Bearings and Reactions
Input Min Gravity Gravity
Location Type Material Length Required Reaction Uplift
1 0' 0.000" Wall Steel N/A 1.968" 2583# --
2 14' 0.000" Wall Steel N/A 1.968" 2583# --
Maximum Load Case Reactions
Used for applying point loads(or line loads)to carrying members
Snow Dead
1 1690 886#
2 1698# 886#
Design spans
14 1.750"
Product: 2.0 RigidLam LVL 1-3/4 x 11-7/8 1 ply PASSES DESIGN CHECKS
Minimum 1.97"bearing required at bearing#1
Minimum 1.97"bearing required at bearing#2
Design assumes continuous lateral bracing along the top chord.
Design assumes continuous lateral bracing along the bottom chord.
Allowable Stress Design
Actual Allowable Capacity Location Loading
Positive Moment 91354 122354 74% 7' Total Load D+S
Shear 22224 4620.# 48% -0.06' Total Load D+S
TL Deflection 0.6737' 0.9431" L/251 7' Total Load D+S
LL Deflection 0.4427' 0.7073" U383 7' Total Load S
Control: Positive Moment
DOLS: Uve-100% Snow-115% Roof=125% Wind=1600/o
All product names are trademarks of their respective owners John P.O'Leary
Seven D Wholesale
Copyright(C)2015 by Simpson Strong-11e Company Inc.ALL RIGHTS RESERVED. Rocky Hill,CT
"Passing Is defined as when the member,Moor joist,beam or girder,shown on this drawing meets applicable design Were for Loads,Loading Conditions,and Spans listed on this street. OCy
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340 Riverside Drive, PO Box 60621, Northampton, MA 01062
Office Phone 413.584.1522 Fax 413.585.0820 Soergel DRAWN BY:S.G. is
Find us on the web at: ulww.Vall Homelm rovement.com a`°"°^"
form for the purpose of enabling or supporting the work of competing project contractors without the permission of,and compensation paid to,MI.
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Valley Home Improvement Inc. 28 MOUNTAIN LAUREL PATH SCALE:SEEVIEW SHEETNUMBER
FLORENCE,MA CROSS SECTION DATE:
340 Riverside Drive, PO Box bOb2i, Northampton, MA 01Ob2
Office Phone 413384.1522 Fax 413.585.0820 Soergel DRAWN BY:S.G. 4
Find us on the web at: wwwMall Hom Im rovement.com R.�bnr
form for the purpose of enabling or supporting the work of competing project contractors without the permission of,and compensation paid to,VHL
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28 MOUNTAIN LAUREL PATH SCALE:SEE VIEW SHEET NUMBER
Valley Home Improvement, Inc. FLORENCE,MA EXTERIOR DATE:
340 Riverside Drive, PO Box 6062'1, Northampton, MA 01062 ELEVATION 3
Office Phone 413.584.'1522 Fax 413.585.0820 Soergel DRAWN BY:S.G.
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FLOOR PLAN NOTES: W
I. ALL EXTERIOR DIMENSIONS ARE TO THE MAl. EXISTING EXTERIOR rwu
EXTERIOR LAYER. DIMENSION5 TO OPENING5"` 0 -.EXI5TNG 2x4 EXTERIOR WAu
ARE TO THE FRAMING,ROUGH OPENING. ® -FASnNG2.4 INTERIOR 112 WALL ud GAP W (�
INTERIOR DIMENSIONS ARE TO THE FINISHED I > N
WALL 4 0 --EXISTING 2x4 PLUMBING WAIL ur TILE
2.GONTRAGTOR SHALL VERIFY ALL DIMENSIONS � D V LU m LLI
' 0 --EXISTING 2X4 INTERIOR WALL
AND 15 RESPONSIBLE FOR ALL DIMENSIONS w
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INCLUDING ROUGH OPENINGS). _
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MISG NOTES:
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NEVV OFENING CUT IN FOR DOOR
REMOVE EX15TING WINDOW
REMOVE AND RELOCATE HEAT
DECK TO BE
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Valley Home Improvement Inc. 28 MOUNTAIN LAUREL PATH EXISTING SCALE:SEEVIEW SHEETNUMBER
FLORENCE,MA DATE:
340 Riverside Drive, PO Box 60621, Northampton, MA 01062
Office Phone 413.554.1522 Fax 413.555.0620 Soergel CONDITIONS DRAWN BY:S.G.
Find us on the web at: wuw.Valle Homelm rovement.com
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Valley Home Improvement Inc. 28 MOUNTAIN LAUREL PATH EXISTING SCALE:SEEVIEW SHEETNUMBER
FLORENCE,MA DATE:
340 Riverside Drive, PO Box 60621, Northampton, MA 01062
Office Phone 413.554.1522 Fax 413.555.0620 Soergel CONDITIONS DRAWN BY:S.G.
Find us on the web at: wuw.Valle Homelm rovement.com
Valley Home Improvement 4-14-15
�f &Ron, 28 Mountain Laurel Path 2:24pm
Florence,MA 1 of 1
CS Beam 4.12.3.4
I=DeamS*ne 4.12.5.1
Materials Database 1518
Member Data
Description:Soergel Ridge Member Type: Beam Application: Roof
Top Lateral Bracing: Continuous Slope: 0.00/ 12
Bottom Lateral Bracing: Continuous
Standard Load: Moisture Condition: Dry Building Code: IBC/IRC
Snow Load: 40 PLF Deflection Criteria: L/240 live, 0180 total
Dead Load: 20 PLF Deck Connection: Nailed Member Weight: 5.2 PLF
Filename: Soer el Rid
Other Loads
Type Trib. Other Dead
(Description) Side Begin End Width Start End Start End Category
Replacement Uniform(PSF) TOP 0' 0.00" 14' 0.00" 6' 0.W, 40 20 Snow
14 0 0
Q
14 0 0
Bearings and Reactions
Input Min Gravity Gravity
Location Type Material Length Required Reaction Uplift
1 0' 0.000" Wall Steel WA 1.968" 2583# --
2 14' 0.000" Wall Steel N/A 1.968" 2583# --
Maximum Load Case Reactions
Used for applying point loads(or line loads)to carrying members
Snow Dead
1 1698# 886#
2 1698# 886#
Design spans
14 1.7W'
Product: 2.0 RigidLam LVL 1-3/4 x 11-7/8 1 ply PASSES DESIGN CHECKS
Minimum 1.97"bearing required at bearing#1
Minimum 1.97"bearing required at bearing#2
Design assumes continuous lateral bracing along the top chord.
Design assumes continuous lateral bracing along the bottom chord.
Allowable Stress Design
Actual Allowable Capacity Location Loading
Positive Moment 91354 122354 74% 7 Total Load D+S
Shear 22221 46204 48% -0.06' Total Load D+S
TL Deflection 0.6737' 0.9431" 0251 7 Total Load D+S
LL Deflection 0.4427' 0.7073" U383 7 Total Load S
Cordrol: Posftive Moment
DOLs: Live=100ah Snow--115% Roof=1250/. Wind=1601/o
All product names are trademarks of their respective owners John P.O'Leary
Copydght(C)2015 by Simpson Strung-lie D Wholesale Company Inc.ALL RIGHTS RESERVED. Rocky Hill,CT
'•Pa�tng is defined as Men the member,floorlolst,beam or girder,shown on Iola drawing meets applicable design crleda for Loads,Loading Conditions,and Spans listed on this sheet The y
des? n mua!be reviewed b a ualifled desi ner or deal n rofesslonal asre ulretl fora vat.This deal n assumes induct inatellation accordin to the manutadurers specifications,
Valley Home Improvement 4-14-15
gBea . 28 Mountain Laurel Path 2:25pm
Florence,MA 1 of 1
CS Beam 412.3.4
lanBeamEngine 4.12.5.1
Materials llatalse 1518
Member Data
Description:Soergel Gable Member Type: Beam Application: Roof
Top Lateral Bracing: Continuous Slope: 0.00/ 12
Bottom Lateral Bracing: Continuous
Standard Load: Moisture Condition: Dry Building Code: IBC/IRC
Snow Load: 40 PLF Deflection Criteria: L/240 live, U180 total
Dead Load: 20 PLF Deck Connection: Nailed Member Weight: 8.3 PLF
Filename: Soer el Gabt
Other Loads
Type Trib. Other Dead
(Description) Side Begin End Width Start End Start End Category
Replacement Uniform(PLF) Top a 0.00" 12' 0.00" 0 80 Live
Additional Uniform(PSF) Top 0' 0.00" 12' 0.00 2' 0.00" 40 20 Snow
Pant(LBS) Top 6 0.W, 1698 0 Snow
Point(LBS) Top 6' 0.00" 0 886 Live
ant load from ride above
12 0 0
Q
12 0 0
Bearings and Reactions
Input Min Gravity Gravity
Location Type Material Length Required Reaction Uplift
1 a 0.000" Wall Steel N/A 1.5w, 2557# --
2 12' 0.000" Wall Steel N/A 1.500" 2557# --
Maximum Load Case Reactions
Used for applying point loads(orline loads)to carrying members
Snow Dead
1 1335# 1222#
2 1335# 1222#
Design spans
12' 1.750"
Product: 2.0 RigidLam LVL 1-3/4 x 9-1/2 2 ply PASSES DESIGN CHECKS
Connect members with 2 rows of 16d common nails at 12.0"oc
Minimum 1.50"bearing required at bearing#1
Minimum 1.50"bearing required at bearing#2
Design assumes continuous lateral bracing along the top chord.
Design assumes continuous lateral bracing along the bottom chord.
allowable Stress Design
Actual Allowable Capacity Location Loading
Positive Moment 116874 16104.# 72% 6' Total Load D+S
Shear 23924 73934 32% -0.06' Total Load D+S
TL Deflection 0.5371" 0.8097" L/271 6' Total Load D+S
LL Deflection 0.2972" 0.6073" U490 6' Total Load S
Control: Positive Moment
DOLS: live=100% Snow--115% Roof=125% Wind=160%
All product names are trademarks of their respective ousters John P.O'Leary
Seven D Wholesale
Copyright(C)2015 by Simpson Strong-Tie Company lnc.ALL RIGHTS RESERVED. Rocky Hill,CT
Passing Is defined as when the member,floorjoisl,beam or girder shown on ihisdravang mcets applicable detlgn criteria for Loads,Losding Condidona,and Spans listed on this sheet The y
deal n must be reviewed a ualified dell nee or deaf n rofessional as re aired fora revel.This deal sesames duct Inatallafion accordin to the manufacturers Iflcaaona
ee L6�Qe-r-,/,
NOTE—
D , PLANS AND OTHER SOURCES AND IS NOT
ATE SURVEY AND JS NOT TO BE RtkfORDED.
ACCURACY IS NOT GUARANTEED
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SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder: 11 6 6n �`\\�tL r 0 Go—w
-A0n,\k License Number
_p o . x c�lna1 1�7 O\®bZ 9 122 l 1
Address —' Expiration Date
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Signature Telephone
9.Registered Nome irnorovernent Contractor: Not Applicable ❑
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Company Rafne Registration Number
PPj (&-Y" V�a ac)(02- -I l rI 1 1
Address Expiration Date
Telephone,4�20"5s��S�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...... ❑
It.`- Home,.WW1 kXe TJtf 6
The current exemption for"homeowners"was extended to include Dwellireffs of one(1) or two(2)families
and to allow such homeowner to engage an individual for hire who does not possess a license,lyraWded that the owner acts
as supervisor.CIVIR 790_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 he
responsible for all such work performed under the buildinu 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 F7
S0440-PA Or Doors ❑
Accessory Bldg. ❑ Demolition ❑ New Signs [❑] Decks [❑ Siding[Cp] Other[L7J
Brief Description Prop os�d �V U�l c� \ 'V'a Dl�c / /0�IL/
Work: �� c1l) l� � � � /'G� d�
Alteration of existing bedroom Yes 1, 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 hous!n ; complete the f®CEow€r>c:
a. Use of building :One Family_-4z�Two Family Other
b. Number of rooms in each family unit: Number of Bathrooms
c. Is there a garage attached? _ yo ,
d. Proposed Square footage of new constructioj(/,/)lJ� Dimensions
�o�X/y �,✓�.� /6X/y Q�c
e. Number of stories?
f. Method of heating? /�' UN �f 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 I/ No. Is construction within 100 yr. floodplain Yes No
j. Depth of basement or cellar floor below finished grade �U tv /`J
k. Will building conform to the Building and Zoning regulations? y Yes No.
I. 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
l `/ p'r j �oc %� as Owner of the subject
property
hereby authorize % w` « l cal �6 mar,L
to act my behalf,in all matters relative to work autho ' ed by this building permit application.
Signature of Owner Date
as Owner/Authorized
Agent hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge
and belief.
Signed under the pains and penalties of perjury.
\le, 500
Print Name
-�3 poi 5
Signature of OwneAd6t 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
V Building Department
Lot Size
Frontage
Setbacks Front
Side L:-J� =. R.//S.: L � ,.� R:
Rear . .'.
Building Height �..._
Bldg. Square Footage . :....,
Open Space Footage °
(Lot area minus bldg&paved C
parking) ! 7,�
#of Parking Spaces
Fill:
(volume&Location) __...,..-.. _...- _._.
A. Has a Spec' t Permit/Variance/Finding ever been issued for/on the site?
NO DON'T KNOW Q YES Q
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DONT KNOW 0 YES Q
IF YES: enter Book Page and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO 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 � , bate 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 0 NO Q
IF YES, describe size, type and location:
E. Will the construction activity disturb (clearing,grading,e),cavation, or filling)over I acre or is it part of a common plan
that will disturb over i acre? YES 0 NO
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
Department use only
�-- C of Northampton Status of Permit
Building Department Curb Cut/Dnvevray Permit
212 Main Street SewerlSeptic Availability, ..
ROOM 100 Water/Well Availabilit)
North a pton, MA 01060 Two Sets of Structural Plans
__ --pLT ►�s
413'-587--1240 Fax 413-587-1272 Plot/site Plans
_�- y y- Other Specify
APPLICATION TO CONSTRUCT,ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION
1.1
This section to be completed by office
Property /
1p �064 �s I h rc � �1 Map f"')01 Lot Unit
J' �Olfnl GL' m 4- 0/0 6 ? Zone Overlay District
Elm St.District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
7
2.1 Owner of Record: 19 Am/-YIi�S�'�
Name(P'nt lz '�?/ Current Mailing Address:
v// E 51/3
Telephone
Signature
2.2 Authorized Agent:
�OMIfL� C�ObZ,
Name(Print Current Mailing Address:
Signature Telephone
SECTION 3-ESTEMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by ermit applicant
1. Building Z O (a)Building Permit Fee
2. Electrical (b)Estimated Total Cost of
dd Construction from 6
3. Plumbing Building Permit Fee
4. Mechanical (HVAC)
5. Fire Protection
6. Total=0 +2+3+4+5) J Check Number
i
This Section For Official Use Only
Building Permit Number: Date
Issued:
Signature:
Building Commissioner/[nspector of Buildings Date
File#BP-2015-0969 1 �
APPLICANT/CONTACT PERSON VALLEY HOME IMPROVEMENT INC
ADDRESS/PHONE P 0 BOX 60627 FLORENCE01062 (413) 584-7522
PROPERTY LOCATION 28 MOUNTAIN LAUREL PATH-600 FLORENCE RD
MAP 37 PARCEL 022 000 ZONE
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: CONSTRUCT 12 X 14 SUNROOM&ENLARGE DECK 10 X 14
New Construction
Non Structural interior renovations
Addition to Eaistina
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
INFORMATION P,`RESENTED:
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: § '' f � 1``�t (.1 E'
Finding Special Permit Variance*f
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
Signature of Building Official Date i E
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 infonnation.