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17A-084 (2) form for the purpose or enabling orsuppnrting the work of competing project contractors without the permission of,and compensation paid to,VHI. 15h 1 r! ra, I• 4 Olh lf'9 aTfl 1 in 2011 a, Valley Home Improvement, Inr. 15 CAROLYN STREET ®Loan PLAN _LAN DATE:11/5/2015+GALE:SEEVIEW SHEETNUMBER 340 Riverside Drive, PO Box t;>0621, Northampton, MA 01062 FLORENCE,MA 01062 1 _ Office Phone 413.534."1522 Fax 413.585.0820 Pi DAB f�BE DRAWN BY:S.G. us oil on the web at: u�!/.YalleyHomelmprovement.com form for tl re purpose of enabling or supporting the work of competing project contractors without the permission of,and compensation paid to,VHI. - II} IIIIIIIIIIiIII III 1111 I �� _I` I� 111 iL Ill. � I III 111-III II! 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I II Ii.I=III III IiG III Ii!=III III _n ITI IL!-III IIL-III I f IIL-11 I L=11.1=III-1. 1,1 A � M U% c o� o°o N_ O O Valle,L.1 �I ome Improvement Ins°. 15CAROLYNSTREET _3CALE:SEEVIEW SHEE'fNUMBER �. � FLORIENCE,MA01062 CROSS SECTIONS DATE:11/5/2015 340 Riverside Drive, PO box :,0621, Northampton, MAO 1062 Office Phone 413.5841522 Fax 413.585.0820 DAUBS +BRAWN BY:S.G. Find us on the web at: www.ValleuHomeimprovement.com ` form for the putposG ofenabling or supporting the work of competing project contractors without the permission of,and compensation paid to,VH1. AN kJ "Ad Pi 15 CAROLYN STREET S"ALE:SEEVIEW SHEET NUMBER Valley Home Improvement, Inc. FLORENCE,MA 01062 FLOOR FRAMING I)ATEA 11512015 540 Rivemide Drive, FO Box 60621, Northampton, MA 0 1062 Office Phone 4,13.584,7522 Fax 413.585.0520 UAUBE PLAN C RAWN BY:S.G. 7 - - - - --- •---•-• •--r •r �• rr ,,„y ----u ur v—,anu cusrurnei agrees roar me etemenrs or rats plan snau nor oe repuensneo or presenroa in any form for the purpose of enabling or supp oiling the work of competing project contractors without the permission of,and compensation paid to,Ml. Vr 7 lit iii , z O � rn ).. F.: hl Iii Ill r a d ?o _ O ill (n G — F3 °' c.' O In N ITI n, [it rD _i z ni rf! L nt lit ' z tip _ ci s I O O q rn Fit ..- 3: ;it ui ni Ill C Q I UJ -U O --: IIr LII LJr -;U j 3 lit jtl _ U i r ll 70 In o - r- rn J U r IJJ ® L W r rn ° PAD C � \ i ME dJ'4 O� Lit A � T nt � m 5 N In L < t:n X � ` C \\ _, co 1 (l. TJ nl roil U1 in rn - k, .t_ t� cu J 1 C` nl �• U Ill lit en TJ z (fN C) -p 2 n it -=1 G Fi o rn u T lit Q ill Q) z ;tn q O O J k n ` iii iu 41 a, v o :`I J O ID Valley flame Improvement, Inc 15CAROLYNSTREET ' ���'®� SCALE:SEE VIEW SHEET NUMB— ER i 340 Riverside Drive, PO Box 6062'7, Northampton, MA 01062 FLORENCE,MA 01062 INTERIOR DAiE:11/5/2015 Office Phone 413.584.7522 Fax 415.585.0820 ���g� ELEVATIONS DRAWN BY:S.G. Find us on the Web at: "v.).ValleyHomeimprovement.com i G J� ........,_.�...................r...N..........,,.Nl.�,.�,.y.,.�,,.,�,.,a,,..,,��..:..,a:,u—xu,,,rl uylays nlm ule erements or rms pran snau nor oe rapuoasnsa or presonrea w any Conn for the purpose of enabling or supporting the work of competing project contractors without the permission of,and compensation paid to,Ml. Ll _h it i � 4 i U; r, It I 1 m II' ) � � -C RIIIIII nl W 1 p _O I =n -i hi r 17` ni O - - ,' .. ._ _. r ci cj �. — �� I b tj - z I' _ UJ A I t TI 1; -rt rn G r j P rn ril [ z I I ]I -C7 th i O 0 t.1 1 0 Z I 1 Z ( - r r _ iJ < - , - 3 r U Z ll, �.) EP (> to O ' rn HIM I U ill I �- I r — u, nl 11 73 [_IC - EEH U; I III If7 t t Cl �- ) Z :. ill TTR 1-1 r- - I I i.c� 'rii u - f 111 I I - li I I I : I I I pppi�l� p1'i! I / I [I 11 I I I 10 1 O® ni ;. 6_' rn z s; 1 O In rn jn cy 1> O �_ [ mr Q n J v nt _ c 7J v O C7 ri Irl .NC _L� T) ril U� O i tP I L i) p L -1 Z ni n iu C, A D of -[ 70 Fit lVi ;0 la 71 lP C 171 { •? 11 j O lip ' O CI z l> n r- 1II I U1 iTl 1 O r is c. it ° o A = m i� rn SC-ALE:SEE VIEW SHEET NUMBER Valley Ho e Improvement, Inc. 15 CAROLYN STREET EXTERIOR 340 Riverside Drive, PO Box 00621, Northampton, MA 01062 FL®RENCE,MA01062 ItATE11/5/2015 Office Phone 413.584.1522 Fax 413.585.0820 DAUBS ELEVATIONS DRAWN BY:S.G. Find us on the web at: uuia l.italle MomeImprovement.com PVI'Ipl,tin _- uj y 4,T ct i I I I Or4 I I i 6i Lli „ --- — -- 7 T cy _ �_- r.>- I �F6 i I E L v Sirnpic.°2nae J m. aszi c, ELECTRICAL DATA & i n; AUDIO NOTES: i HOME OW JN OWNER SHALL DO A ALK-THRU WITH / i e RELEVANT INSTALLERS TO VERIFY THE EXACT 7 a �, £ �! % ^i �= ~ w // a "f W 0 cz LOCATION FOR OUTLETS,LIGHTS,SWITCHES, € €�.¢ p-tE��i � �� � `�` W 0 GABLE,DATA,PHONE,AUDIO,VACUUM,ETC. 1e e t Q I cv:>1 p�l P i iyj ELECTRICAL NOTES: / `\ = z `\ I J U 1.ALL APPLIANCES G UTILITIES TO HAVE DEDICATED N. 0 W i o CIPOUITS PER CURRENT ELECTRIC.CODE nF STANDARDS AT TIME OF INSTALLATION. SEE M FG'S I,� r : c - n C.) O E SPECS FOR OTHER REQUIREMENTS r..,, in CL 2.ELECTRICAL RECEPTACLES IN BATHROOMS, 1 ' m LL KITCHENS AND GARAGES SHALL BE G.F.G.I.PER o NATIONAL ELECTRICAL CODE REQUIREMENT5. ! i t 3.SMOKE AND CO DETECTORS WILL BE PROVIDED h AND INSTALLED IN ACCORDANCE WITH NFPA % ° I I REGULATIONS 4.CIRCUITS SHALL BE VERIFIED WITH HOME OWNER o PRIOR TO WIRE INSTALLATION. _ ! O d r i v _ G t rte. I Ltl 5.FINAL SWITCHES FOR TIMERS AND DIMMERS o SHALL BE VERIFIED WITH HOME OWNER. ( o 1 ii1 E b.ALL SURFACE MOUNTED FIXTURES TO BE SELECTED AND PURCHASED BY7f-c G r•, r: .-_ _ ___. ___ _ ___ ___ _ _ ._ .._ _. .__.. _... 2 r 1.ALL DECORATIVE FIXTURES TO BE SELECTED AND 0 PURCHASED BY O EOtY'_'. C 0 8.BATH VENTILATION TO 5= 3 AND 15 PURCHASED BY s H �:�''� - ?� ' 1 Z 0 9.UNO-ALL SWITCHES TO BE 48"01C ASP. OUTLETS I 4< f- c TO BE 15"O/C ASP. OUTLETS OVER tV 8 LOU T la OFS 1 O BE 5 ABOVE COUNTER FROM c O OI � 1n7F FI]UYC S6BFLO&l4f Ln DATA/CABLE: ��,¢¢ O t t6 ° 1.LOCATION OF PHONE/CABLE/ETHERNET GABLES Y Y m o TO BE GONFIRMED WITH HOWE OWNER PRIOR TO _ •>m !a ! INSTALLATION IF APPLIGfBL°_. — - --_ -�- . _ t c FLOOI PLAN NOTF-5: I _ m 0 I• ALL EXTERIOR DIMENSIONS ARE TO THE MAIN ! I' �II f )•- I Cp, Z EXTERIOR LAYER. DIMENSIONS TO OPENINGS ARE TO m THE FRAMING,ROUGH OPENING. INTERIOR _ `o I DIMEN51ON5 ARE TO THE FINISHED WALL. I ! __. - - 1 �."A °�I cfj 2.CONTRACTOR SHALL VERIFY ALL DIMENSIONS AND 19 r �i✓ ✓lo . d W U` RESPONSIBLE FOR ALL DIMENSIONS(INCLUDING �-` �" y ���IIII > N L o ROUGH OPENINGS). ��- m -- - - '----- —--- - - - - - �_ uj co a V L i`V-aL = �__-�_�.s� G• Y _-__--_ _ i - _ a"' 4E 2 �:7i_`_ _ _I "G:i -_-_ _� -___-_ _- __- � `- Z `0 1 ®TAGS: 'l — J w z EXIS`mc-:r;;r.JC ;TC REMAIN—� I a a r<E;.✓O•.;�S�vi�.G✓!,I� .Aeu?•.DC THE LEAD CARPENTER SHALL FULLY COMPLY WITH THE 2009 : IRC AND ALL ADDITIONAL STATE AND LOCAL CODE Br.Sc; °h-;r;1vDGiN NELLPEIXOVEDIMODiFIED a REQUIREMENTS. JELDINIIN INS.STEEL DOOR WRITTEN DIMENSIONS ON THESE DRAWINGS SHALL HAVE PRECEDENCE OVER SCALED DIMENSIONS.THE GENERAL ! / CONTRACTOR SHALL VERIFY AND IS RESPONSIBLE FOR ALL ?WJE n N ' NT n ,r DIMENSIONS(INCLUDING ROUGH OPENINGS)AND CONDITIONS ON THE JOB AND MUST NOTIFY THIS OFFICE OF ' u 3 ANY VARIATIONS FROM THESE DRAWINGS. F-4 6 THE GENERAL CONTRACTOR IS RESPONSIBLE FOR THE DESIGN AND PROPER FUNCTION OF PLUMBING,HVAG AND 50LAR 7U BE --°--- oELECTRICAL SYSTEMS.THE LEAD CARPENTER OR I > t �I u_ 15-_P5 0 SUBCONTRACTOR SHALL NOTIFY THE OFFICE WITH ANY x6 Ci f6"a EXT "`'A!-5 " PLAN CHANGES REQUIRED FOR DESIGN AND FUNCTION OF DENS=- i I 9 .la ,�B R21 Dc.he AK GEL.!N5 _ i PLUMBING,HVAC AND ELECTRICAL SYSTEMS, j/2'-T HE ATHING � 4"WHIT E VINYL TO M�:TGi-I E::{5T. ZI: i � - DESIGN CRITERIA: 20091RC AND IBC ALONG WITH STATE i AND LOCAL AMENDMENTS r;_°1N HARVEY MAGI-!5TR WINDGW ROOF: SNOW LOAD DETERMINED BY AMENDED I.R.C. L i FLOOR: 40 PSF LL. W00D INT GLAD EXT. I SOIL: '2,000 PSF ALLOWABLE(ASSUMED). ; I FROST DEPTH: 4'-0" OPTIONAL STORAGE SHELVES -- --- - New 264 --- i 1 THIS STRUCTURE SHALL BE ADEQUATELY BRACED FOR WIND MARMOLEUM FLOORING- r, LOADS UNTIL THE ROOF,FLOOR AND WALLS HAVE BEEN t PERMANENTLY FRAMED TOGETHER AND SHEATHED. ii f i nZ NEW HYDRO GASEBOARD TO RUN LENGTH OF ROOM ;{I d INTERIOR FINISH NOTES: a RENDERINGS ARE NOT TO SCALE;ALL RENDERINGS ARE "n FOR ARTISTIC DEPICTION ONLY.PLAN UPDATES MAY NOT BE n REFLECTED IN RENDERINGS.RENDERINGS SHALL NOT BE !L USED FOR CONSTRUCTION. W SEE FINISH PLANS &SCHEDULE FOR SPEC'S oEXTERIOR FINISH NOTES: - k Y '�� F �'�d f"a I LA _ _ _ - — z>; u cc RENDERINGS ARE NOT TO SCALE;ALL RENDERINGS APE � � FOR ARTISTIC DEPICTION ONLY.PLAN UPDATES MAY NOT BE w o REFLECTED IN RENDERINGS.RENDERINGS SHALL NOT BE USED FOR CONSTRUCTION. IE 0 h -SEE FINISH AND PLANS&SCHEDULE FOR SPEC'S T u- 4 N t j �14s 6EfiERAL 5TT180L LEC-EMS L � © I o 1K J c Ln U MB^IEM.WW.L iii NEVIPT ` ® �i O O O a �I5TE61MT.I,Nl ® 2x5Td6 ': 1 i�G$ ((� � oma �� 7 C O c VJ E u E cl .� xar lxr.lv,u � aSTawec.� 110b9 E U BiT 1 WtLL O � � NE1iHT.WM1nrtHHWO HP '�� y L slonealow�.�oanaeaeLO I 11DbD �., UN 7a ID Q i In- � c'9 exr.Faaxonnon Wn.� (� NIO F-W ��i I NEi 0.4LRLa rp�e c�o AK IN- cL c M �f oil Z � o FOR ILLUSTRATION ONLY NO SCALE RF �O:-Z � mOu - 9 cunucct u,u w vi-ii,ano cusromer agrees mar me atemenrs or rnrs plan snau nor oe repuonsnea or presenrea 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 M z N O N � r O � A r fps O Y m n A .YOI O tp p — m 1; In O o A m O C Z LI, N Z m 2 U, A A Y � F O z t7 O rn r U, O m 1111 p m N A III Y D o N zym mcoraO N Y O = O d � tom N b TY! rn m rn p A z 1 III zV\ rn O u Y , cn Z T N O = L rn N N D z n n, tip nt t nCo � � t JI{ p i.fTlII � r- c. J, (S Ul PI lil in .t rli lP ili 1, t , - q i tt -! iU !u fl 1 /�/ / , O ;q tS nt O C,, Cam• / i., , pp Y; t3 rn i'I H p� '41 3° ° r , V � „ --- ---- —_ - - --- - EXT 3068 — -- _ I � t r'm �I T r r r1l 1',I� I i•.III I yrss< 1Tj / - � rt DIY ' z � '.' a�' •irk ,_ �r nt � •tY. l�Y.r (t . fit, r7�1�4F 4'� �U, Y Valley Home Improvement In(-,. 15 CAROLYN STREET DEMO PLAN SC:ALE:SEEVIEW SHEET NUMBER FLORENCE,MA 01062 DATE:11/5/2015 340 Riverside Drive, PO Box 60621, Northampton, MA 01062 Office Phone 413.584.1522 Fax 413.585.0820 I�3/F�UBE►@ g► D+LAWN BY:S.G. AG Find us on the web at: u)LwWalle HomeImprovement.com R, man / I � W m III Lq.S �GcI/� W I LLI N I W r � g o M W � 14 �� � ^t � of Northampton Lu � Building Department f Plan Review O 212 Main Street z � Northampton, MA o1060 6— J ,•ice i/.,.�'� �_,`-;��„`�.�r?�� ri•.�.r*^^.rt - _ ----- _—' -- C ,fir'% / -•. �-; „•_,a,�y�p�:<?.+;``..,��, _ -� � 2 o N ti.l Lu ul c �i rPg` Tom" J V vo t _ r r O O ay U I 4" j f2ROJEC NOTES: F ®J E CT PLAN � E M - E G EQ THI5 PLAN SET,COMBINED WITH THE BUILDING CONTRACT,PROVIDES BUILDING DETAILS FOR THE RENOVATION OWNER: VALISE INDEX OF DRAWINGS > `O O o TITLE SHEET �• z PROJECT. THE LEAD CARPENTER SHALL VERIFY THAT SITE CONDITIONS,AND DIMENSIONS ARE GON515TENT WITH PROJECT SUMMARY 1 p� 3 THESE PLANS BEFORE 5TARTIN6 WORK.WORK NOT SPECIFICALLY DETAILED SHALL BE CONSTRUCTED TO THE SAME PROJECT 15 GAROLYN STREET DEMO PLAN 2 N QUALITY A5 SIMILAR WORK THAT IS DETAILED.ALL WORK SHALL BE DONE IN ACCORDANCE WITH INTERNATIONAL ADDRESS: FLORENCE,MA N FLOOR PLAN 4 MAIN BUILDINv AND LOCAL GODE5. I 5LD6'PFRMii: EVATION5.gym b O CN CN - ELECTRICAL C • w FLOOR INTERIOR EL j i t g WRITTEN DIMENSIONS AND SPECIFIC NOTES SHALL TAKE PREGEDENGE OVcR SCALED DIh EN510N5 AND GENERAL I I -- -- y I FLOOR FRAMING PLAN T GR055 SECTIONS b NOTES.THE SALE PER50N/DE516NER SHALL BE CONSULTED FOR CLARIFICATION IF 51TE CONDITIONS ARE DESIGNER: y ENCOUNTERED THAT ARE DIFFERENT THAN SHOWN,IF DISCREPANCIES ARE FOUND IN THE PLANS OR NOTES,OR IF A - - dJ CS F QUESTION ARISES OVER THE INTENT OF THE PLANS OR NOTES,CARPENTER OR SUB-CONTRACTOR SHALL VERIFY AND Q IS RESPONSIBLE FOR ALL DIMENSIONS(INCLUDING-ROUE-H OFENIN65). It ALL TRADES SHALL MAINTAIN A GLEAN WORK SITE AT THE END OF EACH WORK DAY. I i 'Z5 o i N q li I i PLEASE SEE ADDITIONAL 1JOTEB CALLED OU7 ON OTHER SHEETS. II I � R13 s p I ( �— — — - - - — — — — m © ial City of Northampton 212 Main Street, Northampton, IV+A 01060 Solid baste disposal Affidavit In accordance of the provisions of MGL c 40, S54, I acknowledge that as a condition of the building permit all debris resulting from the construction activity governed by this Building Permit shall be disposed of in a properly licensed solid waste disposal facility, as defined by MGL c 1 11, S 15OA. Address of the work: The debris will be transported by: G The debris will be received by: Building permit,number: Dame of Permit Applicant Date Signature of Permit Applicant 4C6ty 6�34*dar.FF6 EGF�.F"v%S-li41w6FB F6�i1K:&(e"�'S+.fsf:%,c" �^a"iW.'4E15 s0 ; raSaagtojW � tee�t Bosta1'r;, MA 02111 www.mass.gov/dia u « � � � t�rsJt��_i iC ARj2iieant Information Please Print LLg bh Name (Business/Organization/Individual): \��$,�,��':� �� �� ,i TUB } "��,� 1 o C., Address: j'�� w`f�`j'�C�� J� VhCity/State/Zip: A- �C�'-P_aCe, �� 1�. one#: Are you an employer? Check the appropriate box: Type of project(required): 1. I am a employer with 4. ® I aim a general contractor and I I M11 6. ❑ employees (full and/or part-time). have hired the sub-contractors New construction 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 coma. insurance.t ,. 4 i rI- ' - required.] D. ❑ die are a corporation and its ��•El L.cc-Mlcal>:epa�rs 3.❑ I am a homeowner doing all work officers have exercised their I LE] Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] c. 152, §1(4), and we have no employees. [No workers' 13.❑ 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. +Contractors 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 member. I am an employer that is providing workers'compensation insurance for my employees. Below is thepolicy and job site information. Insurance Company Name: L3mpucajr 6(' G c -P b Policy#or Self-ins. Lic.#: i ��J��` 1 Expiration Date: Job Site Address: � �A Ala 10 r��PG City/State/Zip-pcyplul �1, 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 verification. I do hereby certify a the pains a4d penalti, perjury that the information provided above is true and correct. Sianature: p 9Jkrf i , / -.i Date: I' +22 Phone#: Official use only. Do not write in this area,to be completed by city or town officials P:-va_/Lflcense Issuing Authority(circle ogee): 1.Board of Health 2.Building Department 3, City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 5. Other ECentact Person: Phone#: SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑^� Name of License Holder: S ��L� 11�� V Vl�� t 1 �� �-J�9 License Number sa- _ (0 Address Expiration Date Signatur Telephone 9.Registered Home Improvement Contractor: Not Applicable ❑ Company Name Registration Number Address Expiration Date 9 ic-v 2.6c �h 0\0 Z Telephone. ) ll --ic-�)-D:D 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 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 109.3.5.1. 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 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 SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition 6 Replacement Windows Alteration(s) E] Roofing E] Or Doors ❑ Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [M Siding[O] Other[a Brief Description of Proposed Work: l U l L U b 460/ LA Ujbf-y 6 0 •Ti Ott Alteration of existing bedroom Yes No Adding new bedroom Yes -?') N 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 y Two Family Other b. Number of rooms in each family unit: Number of Bathrooms c. Is there a garage attached? °IEs d. Proposed Square footage of new construction. lit) S r- Dimensions [0 X)2— e. Number of stories? f. Method of heating? ��W L Fireplaces or Woodstoves N Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction `* W C*0 - ST)C-tt $U LLT 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 �f' I[11*--,;1 \ , k. Will building conform to the Building and Zoning regulations? v Yes No . I. Septic Tank City Sewer Private well City water Supply �r SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, U as Owner of the subject property hereby author e 1 to act on my b half,in all afters rel ive to work authorized by this building permit application. Signature of O er 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. Print Name 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 13,Q's 5_s f( Frontage Setbacks Front �� o Side L: /0' R: .22r L: f0 R: 2 Rear 06't!` O i Building Height Bldg. Square Footage % Open Space Footage % (Lot area minus bldg&paved �)t� 9 I , 11'8J_: 90 parking) #of Parking Spaces Fill: volume&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO 0 DON'T KNOW YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT 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 DON'T KNOW Q YES 0 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 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 0 NO IF YES, describe size, type and location: E. Will the construction activity disturb (clearing,grading, excavation, or filing)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES V NO (' ) IF YES,then a Northampton Storm Water Management Permit from the DPW is required. "N05TV4AMPMTON Department use only of Northampton status of Permit: ding Department Curb Cut/Driveway Permit 12 Main Street Sewer/Septic Availability Room 100 Water/WellAvailability ampton, MA 01060 Two Sets of Structural Plans phone 413-587-1240 Fax 413-587-1272 Plot/Site Plans Other 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 Map Lot Unit Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Rec d: Name(P'nt) Current Mailing Addrais: . Telephone Signatu 2.2 Authorized Aclent: I Name(Print) Current Mailing Address: 7522 zo 4//Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant 1. Building U 0 D (a)Building Permit Fee 2. Electrical ' �L1G (b)Estimated Total Cost of 1 Construction from 6 3. Plumbing 3 Building Permit Fee Soy 4. Mechanical(HVAC) 5.Fire Protection a �� �� 6. Total=0 +2+3+4+5) Check Number This Section For Official Use Only Date Building Permit Number: Issued: Signature: Building Commissioner/Inspector of Buildings Date File#BP-2016-0643 `�N APPLICANT/CONTACT PERSON VALLEY HOME IMPROVEMENT INC ` ADDRESS/PHONE P O BOX 60627 FLORENCE01062(413)584-7522 /&kf-7 PROPERTY LOCATION 15 CAROLYN ST MAP 17A PARCEL 084 001 ZONE RI(100)/URA000)/WSP(93)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Z ' < e � 7� Asa Building Permit Filled out Fee Paid Typeof Construction: CONSTRUCT 10 X12 MUDROOM/LAUNDRY ROOM ADDITION New Construction Non Structural interior renovations Addition to Existiniz 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 INF RMATION 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 ri��4la Signature of Bui ding 6fficiar' 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. 15 CAROLYN ST BP-2016-0643 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 17A-084 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: ADDITION BUILDING PERMIT Permit# BP-2016-0643 Project# JS-2016-001076 Est. Cost: $28700.00 Fee: $186.55 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: VALLEY HOME IMPROVEMENT INC 077279 Lot Size(sq. ft.): 13808.52 Owner: NOONAN MARY FITZGERALD&MICHAEL J&JAN E DUNPHY Zoning: RI(100)/URA(100)/WSP(93) Applicant: VALLEY HOME IMPROVEMENT INC AT. 15 CAROLYN ST Applicant Address: Phone: Insurance: P O BOX 60627 (413) 584-7522 Workers Compensation FLORENCEMA01062 ISSUED ON.11119/2015 0:00:00 TO PERFORM THE FOLLOWING WORK.•CONSTRUCT 10 X12 M U DROOM/LAU N DRY ROOM ADDITION 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 11/19/2015 0:00:00 $186.55 212 Main Street,Phone(413)587-1240, Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner