24A-156 (2) Quantity Description Quantity Description
' *------------------------------ ------------------- -------------------------------------------------- w
c m
1 * LAV FCT CSDY WS L/HDL L-ARC PU CHR 3H a
m DEL3595LF-MPU-LHP (469985) z
1 * HDL CSDY MTL 2LVR CHR F/FCT 1 TWL BAR CSDY CHR 18" w
le a DELH297 (469044) DEL79718 (470049) u=i
o CASSDIY 8" CHROME LOW ARC 18" TOWEL BAR
LAVFAUCET W LEVER HANDLES 1 TWL BAR CSDY CHR 24"
DEL79724 (470182) w d
a 24" TOWEL BAR w N
LD 1 RB HK CSDY CHR SGL � n^
m
2 1 #TRAD FL MON TUB FLL TRM LE + DEL79735 (470403) 6j r Z
DELT4797-FL-LHP (S2613899) ROBE HOOK U p
o�
y 1 HDL CSDY MTL 1FRN CRV CHR 3" 1 TLT PPR HLD CSDY CHR
m DELH798 (470103) DEL79750 (470071)
y 1 RGH-IN VLV FLRMNT TUB FILL W/STP 1/2 TP HOLDER
o DELR4700-FLWS (500766) ALL CASSIDY ACC. IN CHROME
DELTA CASSIDY CHROME FLOOR MORE AVA.
E MNT TUB FILLER W/ LEVER HANDLES
m
® -T W J
1 SHWR ARM CHR
.° DELRP46870 (399851) 1 * TLT BWL CONNELLY EL HI-EFF COT ADA W
1 #SHOWER ARM FLANGE + TTOCT494CEFG01 (500948)
DELRP38452 (51236209) 1 * TLT TNK CONNELLY HI-EFF COT 1.28GPF
o
116" SHOWER ARM CHROME TTOST494MOI (500954) 0/�
m 1 * TLT ST EL CFWC SLW CLS PE COT V♦ LL
t TTOSS11401 (248628)
8 TOTO CONNELLY 12" ROUGH WHITE
o TOILET � _ "X•'{"
m 1 VLV TRM CSDY CHR MCHC 17 SRS
o° DELT17097 (470079) 1 #67 WHITE DUAL CLAW FOOT TU +
m 1 * VLV BDY MCHC UNIV RGH-IN W/STP 112" B05DGI1700DUAL (S2824135)
o; DELR10000-UNWS (316775) 1 #WHITE BALL &CLAW FEET +
B05DGIIMPDUWH (52824136) '
a° I SHWRHD TCH CLN SW CHR RECORE 67" WHITE DUAL CLAW FOOT
yT WHITE TUB NO HOLES
5 a DEL52683 (463851)
o SHOWER HEAD 52683
2-2 J Z ii
o0 W
0: 2
a 1 * RGH-IN VLV 3PRT 3/6FUNC DIV 1HDL 1/2" 0 Q
o� DELR11000 (433371) Z Q
Os
m = I DIV TRM CSDY CHR 2PRT/3FUNC I v L6
roy DELT11897-LHP (470409) Z
h
E € 1 HDL CSDY MTL 1LVR CHR 2" F/TUB HS/DIV
E n DELH597 (470423)
E DELTA DIVERTER TRIM & VALVE
� o CASSIDY CHROME
m�
> � I
41
h to v O d V
_ N
La 1 HS SET TEMPESTA AUTHNTC SHWR BAR CHR _ O
GR027609000 (471753) £
CC:'a GROHE HAND HELD CHROME Cn N
TEMPESTA RUSTIC 27609000 p p
m m ON BAR q. �
PE
ONE MU-
E� 1 * WALL ELL SPLY CHR 1/2" ADA 90DEG
DELU4980-PK
(68620) 0 0
L °3 WALL ELBOW FRO HAND SHOWER Z
N
a o° n
� h � Ln
Qo
�� -� u In
G > co
� Q g�
m o - — — el 3
o vmi � N
61
REVISED
11:46 am, Jul 07, 2015
}
t ms pran is me propnerary worn proauct or vaney none improvement,oral vnq.it is aenverea Tor me amtrea ana exciusroe purpose or supporting me conrracr oto or vnt,ano customer agrees mai me etemenrs or rms pran span nor oe repuotrsnea or presenrea to any
form for the purpose of enabling or supporting the work of competing project contractors without the permission of,and compensation paid to,VHI.
V
i1
� o
0
N
0
a
t�
Illlliili
1
1��'
Lo
rn
r
-n
d
N_
11 I,p�
N
a
F;�' .11 1
ar!
V' d
Valley Home Improvement, Inc. 19 NORFOLK SHOWER AND SCALE:SEE VIEW SHEET NUMBER
340 Riverside Drive, PO Box b0621, Northampton, MA 010b2 NORTHAMPTON, MA DATE:7.7.15
Office Phone 413.5b4.'7522 Fax 413.585.0820 FARMER FLOOR DETAILS DRAWN BY:S.G. 7
Find us on the web at: uuw.VallewHorneimprovement.com REV#8 r
W
z � #
m - Z
w
n j \
6 SOAP DISH
y W C7
W n m
CO
s;= 111 lij
J F-
° Z
U
m
c
h
R
d '
S --
TT
-- -
Y i
m II
y \ 1
yII�
� TILE WILL R A
a UNDER VANITY iI O
V-
` W
o GHLUTER
C ILE HERE
7.
C
TILE SCHEDULE = - - ----
°Q E aP i
ti Q
D
Item Description Qty U/M MARBLE ° ,j ! _j o W
m E THRE5HOLD 0 a
BATHROOM FLOOR: -�
i a O
o mISC E-CS IMPRONTA SCRAPWOOD 6x36" SLR(9 sf 108 SF j- cz, 'Q
°a per box) lip
E
50501 Chamois Flexcolor CQ I dal ! —� - z
SHOWER WALLS:
t`-AYNE EQUIPE EQT.?COI BLANCO N/L-�TTE ?x8" (10.76 107.6 SF -
i5 sf per box)
y WAYNE EQUIPS EQI_;COU BLANCO MATTE 'x8" BN 12 EA
MUCF025 0 WHITE 251_B ULTRACOLOR SANDrID C o
re GROUT(THIS GROUT NEEDS TO BE SEALED) — Q
- ui E
e SHOWER WALL ACCENT BAND (3 ROXVS -'-' m
�a o � o
E= HIGH)-. N a x
R BOYCE&BEAN AQU ATIC NON [RID WATER & LIGHT Ixl 3 ea � � U-- Z
0 o STRAIGHT-r1VLS 191 IS (I 3 ROTS PER SHEET) 41 0 0
3 "LE;1D TI14' ��PPROX. 3 ',WEEKS" } z 3
®� SHOWT-R PAN: r
' i3pr2 12" Square Irterlock Tile Java Grey Pebble 64 r fl-°,fl
00 - � ✓ _..
X0101 Alabastor Fle olor CQ 14=a1 2 E o N
ao ACPBA780701 701 �I:� : JUMBO CORNER SHELF m Ln
o *- ..
IL It
Subtotal IQ M
DISCOUnt20 Discos rl O L m
mo ate.
E�REVISED 2 LO
n° J
Jul 07, 2015 } m o u
t ms plan is me propnerary worx proaucr or vaney name improvement,mc.t vrrp.iris oetiverea ror me nmitea ana exctusve purpose or supporting me conrracr ota or vnt,ana customer agrees met me eiemenrs or mis plan snan nor oe repuousnea or presenreo rn any
form for the purpose of enabling or supporting the work of competing project contractors without the permission of,and compensation paid to,VHL
Valley Home Improvement, Inc. 19 NORFOLK SCALE:SEEVIEW SHEUNUMBER
-��/
340 Riverside Drive, PO Box 60627, Northampton, MA 01062 NORTHAMPTON, MA VAN I 1 I PLAN DATE:7.T.15
Office Phone 413.584.'1522 Fax 413.585.0820 FARMER DRAWN BY:S.G. 5
Find us on the web at: wuxv.Yalle Homelm rovement.com REr#8 ��«
i ms pran is me proprietary worx proauc(or vaney home improvement,mc.(vnp.iris ae verea ror me umaea eno exciusive purpose or supporting me contract wa or vnt,ano customer agrees roar me e(emems,or mis pran snap not oe repuonsnea or presentea m any
form for the purpose of enabling or supporting the work of competing project contractors without the permission of,and compensation paid to,VHI.
Valley Home Improvement, Inc. 19 NORFOLK SCALE:SEE VIEW SHEET NUMBER
340 Riverside Drive, PO Box 6062 1, Northampton, MAO 1062 NORTHAMPTON, MA ELECTRICAL PLAN DATE:7.7.15
Office Phone 413.584.'7522 Fax 413.585.0820 FARMER OPTION 2 DRAWN BY:S.G.
Find us on the web at: uuw.Valle Homeim rovement.com REVtl8 ���
_
I
rn
�
� 01
rn
�l
O �
K3
U1
�a
v
w
rrl
C
3
y
0
rn,
p
V
O
�.a
t71
Valley Home Improvement, Inc. 19 NORFOLK SCALE:SEE VIEW SHEET NUMBER
340 Riverside Drive, PO Box 6062 1, Northampton, MAO 1062 NORTHAMPTON, MA ELECTRICAL PLAN DATE:7.7.15
Office Phone 413.584.'7522 Fax 413.585.0820 FARMER OPTION 2 DRAWN BY:S.G.
Find us on the web at: uuw.Valle Homeim rovement.com REVtl8 ���
r ms plan is me proprietary worK proaucr or vauey rrome improvement,mc.t vrrq.it is oeavereo ror me nmreo ana extrusive purpose or supporting me contract ota or vin,ana customer agrees mar me erements or mrs pran snap nor oe repuonsnea or presenreo in any
form for the purpose of enabling or supporting the work of competing project contractors without the permission of,and compensation paid to,VHL
Valley Home Improvement, Inc. 19 NORFOLK SCALE:SEE VIEW SHEET NUMBER
340 Riverside Drive, PO Box 60621, Northampton, MA 01062 NORTHAMPTON, MA DATE:7.7.15
Office Phone 413.584.1522 Fax 413.585.0820 FARMER DRAWN BY:S.G. 3
Find us on the web at: www.Valle Homeim rovement.com REV#8 PW�P
r ms pran is me propnerary work prooucr or vaney nome improvement,mc.I vrrq.it is oeuverea Tor me mmirea ano excrusrve purpose or suppomng me contract Dto or yr o,ano customer agrees marine eremenrs or rms pan snap nor oe repuonsnea or presenteo in any
form for the purpose of enabling or supporting the work of competing project contractors without the permission of,and compensation paid to,VHt.
N
rn
O
U)
GN
Orn
O
rn
rn
io
<
co
rn
i
d
7u
-�
<
rn
a
P
O
-73
-
r
v
-
_
O
O
n
�
U)
i
I
�y �
u
o
i
QZ
z
O
--
_.
}
�,
- -
-
12' 0"
�-
w
�►
+rte
rV
w
C
Cm
V
N
O
w
tst
Valley Home Improvement, Inc. 19 NORFOLK EXISTING SCALE:SEEVIEW SHEETNUMBER
340 Riverside Drive, PO box 60627, Northampton, MA 01062 NORTHAMPTON, MA DATE:7.7.15 CONDITIONS
Office Phone 413.584.1522 Fax 413.585.0820 FARMER DRAWN BY:S.G. 2
Find us on the web at: www.ValleL41-lomeimprovement.com REV#a %A ,
W
' z r
..
t
bJ W
0
C
y °
_
--_
(7 of Northampton
-, i �,u - I gu Iding Departm�n W Uj
- T _
m _ w
o i
i 1 Plan Review , U,
L}1 212 Main S'tret W
t'
- North a m pton,
8�(3
o�
r
Q
7
t € t it•
u w
G
i - f
r
a
r Z Z
53 0
LU
i
t 1 i
t t
,
t
C
Z /� J
n ii J
o - O
O U-
r
a� L a 1L
� I
$ r @
T
tl 7JL1-
U.
am rtJ
1 �
la T J f
m h -.�--' - - .__ -re ��r4 _— Z
I
m a
1
a
f ;
N o
AV
}
O V
v
F
U T
U u�
GENERAL NOTES: s 2
PROJECT PLAN � E M cl
E
THIS PLAN SET,COMBINED WITH THE BUILDING CONTRACT,PROVIDES BUILDING DETAILS FOR THE RENOVATION OWNER: DEYLIN FARMER � 'C E
E> x PROJECT. THE LEAD CARPENTER SHALL VERIFY THAT 51TE CONDITIONS,AND DEMENSIONS ARE CONSISTENT WITH ,, Z =
THESE PLANS BEFORE STARTING WORK.WORK NOT SPECIFICALLY DETAILED SHALL BE CONSTRUCTED TO THE SAME PROJECT 19 NORFOLK
m QUALITY AS SIMILAR WORK THAT 15 DETAILED.ALL WORK SHALL BE DONE IN ACCORDANCE WITH INTERNATIONAL ADDRESS: NORTHAMPTON,MA O tV
n BUILDING CODES AND LOCAL CODES. Q p
°o BLDG PERMIT: x
> j WRITTEN DIMENSIONS AND SPECIFIC NOTES SHALL TAKE PRECEDENCE OVER SCALED DIMENSIONS AND GENERAL O N
L' : � NOTES.THE SALE PER50NIDE51GNER 5HALL BE CONSULTED FOR CLARIFICATION IF 51TE CONDITIONS ARE DESIGNER: DAN BRADBURY 0 u1
r o * ENCOUNTERED THAT ARE DIFFERENT THAN SHOWN,IF DISCREPANCIES ARE FOUND IN THE PLANS OR NOTES,OR IF A
QUESTION AR15ES OVER THE INTENT OF THE PLANS OR NOTES.CARPENTER OR 51,113-CONTRACTOR SHALL VERIFY AND BUILDER: VALLEY HOME IMPROVEMENT N M
m m
15 RESPONSIBLE FOR ALL DIMENSIONS(INCLUDING ROUGH OPENINGS). >
`o ALL TRADES SHALL MAINTAIN A GLEAN WORK SITE AT THE END OF EACH WORK DAY. VENDORS: O Q v
m PLEASE SEE ADDITIONAL NOTES GALLED OUT ON OTHER SHEETS. PLUMBING FIXTURES: N
S m CABINETS: REVISED /�/��
COUNTERTOPS:
c o TILE: 11:45 am, Jul 07, 2015 (� m o
}
j. The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
,t Boston, MA 02111
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Organization/Individual): (f r14- , t�
Address: k Q,-e_
City/State/Zip: �c�t nc� �, `(lam ���h ne
Are you an employer? Check the appropriate box: Type of project(required):
1.[% I am a employer with r 2� 4. ❑ I am a general contractor and I 6. ❑New construction
employees(full and/or part-time).* have hired the sub-contractors
2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling
ship and have no employees These sub-contractors have g, ❑ Demolition
working for me in any capacity. employees and have workers' 9. ❑ Building addition
[No workers' comp. insurance comp, insurance.,
required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions
3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions
myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs
insurance required.] # c. 152, §1(4), and we have no
employees. [No workers' 13.0 Other
comp. insurance required.]
*Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
lContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have
employees. If the sub-contractors have employees,they must provide their workers'comp.policy number.
I am an employer that is providing workers'compensation insurance for my employees Below is the policy and job site
information.
Insurance Company Name: `De MG`
Policy#^r Self inc. Tic.#: coq-Dc`)C)6 a7 i Expiration Date:
Job Site Address: 1� Y J� City/State/Zip:1\ kw)gj Y k_, 61U,0
Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage rification.
I do hereby certify the pains a{d penalti, ,
Of
perjury that the information provided above is true and correct
Si mature: 1 `' �.` �' Date:
Phone#:
Official use only. Do not write in this area,to be completed by city or town official
City or Town: Permit/License#
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone#:
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor:
�y��y Not Applicable ❑
Name of License Holder: l`/``mil A�� ��\ '®(,0 C)C)G
` License Number
dress tt Expiration Date
Signature - Telephone
9 Registered Home Improvement Contractor: Not Applicable ❑
Company Name Registration Number
Address Expiration Date
Telephone
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 Exe>l ption
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.
Defmition 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 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 meth 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 ail applicable)
New House [❑ Addition ❑ Replacement Windows Alterations) Roofing ❑
Or Doors C) "'���"'"���
Accessory Bldg. ❑ Demolition ❑ New Signs [❑] Decks [[] Siding[0) Other[[I
Brief Description of Proposed
Work: MgS-z!LZ_ 31,A-VA i4-&t07E.L_
Alteration of existing bedroom Yes__X1 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?
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.
I. Septic Tank City Sewer Private well City water Supply
SECTION 7a-OINNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
(y)C_ 7_ as Owner of the subject
property
hereby authorize VU ujL
to act on my Ja If in all matteLii relative to work authoriz d by this building permit application.
Signitmlei'ofOwner Date
I, �� 1 e` � fie ��Z" � Pvh .. L�7 � .`'} ►t- i" S1'1� as Owner/Authorized
Agent hereby declare that the stAtements an tion on the fo going application are true and accurate,to the best of my knowledge
and belief.
Signed ufll`er_`e i✓ iris Fnd pena!'i—of nerifurn' �
Name �
_V-7 /IS
Signature of Owner/Agent 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 1
Frontage
Setbacks Front
Side L: R: L: R: .
Rear
Building Height
N
Bldg.Square Footage %
Open Space Footage %
(Lot area minus bldg&paved
kin
#of Parking Spaces
Fill:
(volume&Location)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO 0 DONT KNOW YES O
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DONT KNOW O YES 0
IF YES: enter gook 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 0 , Date Issued:
C. Do any signs exist on the property? YES 0 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:
E. Will the construction activity disturb(clearing, grading,excavation,or filling)over 1 acre or is it part of a common plan
thrf�ai±!dis* orb over 1 acre? YES �} NQ
IF YES,then a Northampton Storm Water Management Permit from the DP1N is required.
Department use only
City of Northampton Status of Permit:
ilding Department Curb Cut/Driveway Permit
12 Main Street Sewer/Septic Availability
`t`4 Room 100 WaterANell Availability
mpir.9s 1nsP
mpton, MA 01060 Two Sets of Structural Plans
-1240 Fax 413-587-1272 Plot/Site Plans
EtBCtri jyorthamPtO
Other Specify
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 ProRerty Address: L
�a/-- -- ;, C" Map Lot Unit
Zone Overlay District
Elm St District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Recojrdd:� iq
`�YVl�irl �-- \✓t `�''1 �G1r�ltxL l 1 Nf � SA U' 1 r4(YLt P 1!`y—6tO4'o
Name(Prin) Current Mailing Address:
Telephone
Signs e
2.2 Authorized Agent:
�n F)fCAbQr � ,�z la $ n� �z �� sv� c� (00G,0- t c ��= ,
blame(Print) Current Mailing Address:
-- 9Q:5- J94--`7522-
Signature Telephone
SECTION 3-ESTIItriATED 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 �2Go Building Permit Fee
4. Mechanical(HVAC) 1 i OOH
5.Fire Protection
6. Total=0 +2+3+4+5) C ,CC) Check Number
This Section For Official Use Only
Date
Building Permit Number: Issued:
.Sint•.=t?ira,
Building Comr-iiissioner inspector of Buildings Date
File#BP-2016-0028
APPLICANT/CONTACT PERSON VALLEY HOME IMPROVEMENT INC
ADDRESS/PHONE P O BOX 60627 FLORENCE01062(413)584-7522
PROPERTY LOCATION 19 NORFOLK AVE
MAP 24A PARCEL 156 001 ZONE URA000)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out y O
Fee Paid
Typeof Construction: REMODEL MASTER BATH
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
INF9AMATION 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
Demolittu Delay
44wft4e�oftuildi6 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.
19 NORFOLK AVE BP-2016-0028
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:24A- 156 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL 042A)
Category:renovation BUILDING PERMIT
Permit# BP-2016-0028
Project# JS-2016-000047
Est. Cost: $30000.00
Fee: $180.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: VALLEY HOME IMPROVEMENT INC 077279
Lot Size(sa.ft.): 13764.96 Owner: FARMER DEVLIN&TAMSIN
zoning.URA(100)/ Applicant: VALLEY HOME IMPROVEMENT INC
AT: 19 NORFOLK AVE
Applicant Address: Phone: Insurance:
P O BOX 60627 (413) 584-7522 Workers Compensation
FLORENCEMA01062 ISSUED ON.711012015 0:00:00
TO PERFORM THE FOLLOWING WORK.-REMODEL MASTER BATH
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 7/10/2015 0:00:00 $180.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner