29-089 (6) 22 BRIERWOOD DR BP-2016-1061
GIs#: COMMO,NWEALTH OF MASSACHUSETTS
Map:Block: 29-089 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: renovation BUILDING PERMIT
hermit# BP-2016-1061
Project# JS-2016-001807
Est. Cost: $32000.00
Fee: $208.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: VALLEY HOME IMPROVEMENT INC 106006
Lot Size(sq. ft.): 16291.44 Owner: KOSTEK EUGENE R&CHRISTINE PASEK
ZoninL Applicant: VALLEY HOME IMPROVEMENT INC
AT. 22 BRIERWOOD DR
Applicant Address: Phone: Insurance:
P O BOX 60627 (413) 584-7522 Workers Compensation
FLORENCEMA01062 ISSUED ON:3/7/2016 0:00:00
TO PERFORM THE FOLLOWING WORK.-REMODEL BATHROOM
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 3/7/2016 0:00:00 $208.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
File#BP-2016-1061
APPLICANT/CONTACT PERSON VALLEY HOME IMPROVEMENT INC
ADDRESS/PHONE P O BOX 60627 FLORENCE01062(413)584-7522
PROPERTY LOCATION 22 BRIERWOOD DR
MAP 29 PARCEL 089 001 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: REMODEL BATHROOM
New Construction
Non Structural interior renovations
Addition to Existing
Accessoty Structure
Building Plans Included:
Owner/Statement or License 106006
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFq.P 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
ay
3-4-r-`�
lure A-guildlnfcfricil 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.
Department use only
ty of Northampton status of Permit:
B iIdIng Department Curb Cut/Driveway Permit
212 Main Street Sewer/Septic Availability
MODi 2016Room 100 Water/Well Availability
N hampton, MA 01060 Two Sets of Structural Pians
nrr r e
n, rnt c `tp 41 587-1240 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 PropeEN Address: This section to be completed by office
Y1C' Z)oca, Map Lot Unit
Zone Overlay District
Elm St District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
Name(Print) �! Current Mailing A dres y
_ Lty-5-- tgq-- 1�t
Telephone
Signa re "
2.22Authorized Agent:
' p�
e Print) Current Mailing Address:
'-i U2 34-`752Z-
Signature Telephone
SECTIO[ 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
com leted_by permit apelicant
1. Building -TIP C L, 00 (a)Building Permit Fee
f
2. Electrical I (b)Estimated Total Cost of
Construction from 6
3. Plumbing �. a.• �� Building Permit Fee
��� Oi✓F
4. Mechanical(HVAC) J�
5. Fire Protection -61 W24
6. Total=(1 +2+3+4+5) �OCaD. Check Number t
This Section For Official Use Only
Building Permit Number: Date
Issued:
Building Commissioner/Inspector of Buildings 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
Frontage
Setbacks Front
Side L: R L: . R:
Rear
Building Height 1A
Bldg.Square Footage %
Open Space Footage %
(Lot area minus bldg&paved
park,in )
#of Parking Spaces
Fill:
(volume&Location)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO f DONT KNOW 0 YES 0
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DONT KNOW V YES 0
IF YES: enter Book Nage 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 0 NO
1F 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
:hof}kill Hien r3�over 1 acre? YES { ) 110
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
New House ❑ Addition ❑ ReplacementwindowsAlterations) Roofing ❑
Or Doors
Accessory Bldg. ❑ Demolition ❑ New Signs [o] Decks [0 Siding[0] Other[p]
Brief Description of Proposed ZGKoi�C-L
Work:
Alteration of existing bedroom Yes No Adding new bedroom Yes —X—No
Attached Narrative Renovating unfinished basement Yes -No
Plans Attached Roll -Sheet
6a. If New house and or addition to existing housings 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-OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
as Owner of the subject
property
hereby authorize
to act on my behalf, in al matter klative to wo prized ky this building permit application.
Signature of rwner Date
..wvy'. anc— as Owner/Authorized
Agent hereby declare that the stdtements andinformation on the fo going application are true and accurate,to the best of my knowledge
and belief.
Signed Linder'is t-Sins and pe ralficc
"Name
Signature of Owner/Agent Date
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: `— Not Applicable ❑
Name of License Holder: �)a nxc\ �� F "'1 '®� G
License Number
or
ress _ Expiration Date
Signature Telephone JJ/
9.Registered Home Improvement Contractor: Not Applicable ❑
� a V� \m ��vne �VA 0NO\ M��L� 10 55 q_3
Company Na a Registration Number
Address i! 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 Exemdon
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, Siyth 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 wbo 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
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
^ }»µ Boston,MA 02111
www.mass.govIdia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Organization/Individual): V OL.� IC-t-�, C-MIC
Address:
City/State/Zip: f` aC �Vhone#: ( �
Are you an employer? Check the appropriate box: Type of project(required):
1.M I am a employer with (� 4. ❑ I am a general contractor and I
employees (full and/or part-time).* have hired the sub-contractors 6. ❑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'
[No workers' comp. insurance comp, insurance.
$ 9. ❑ Building addition
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.❑ 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.
'*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 number.
I am an employer that is providing workers'compensation insurance for my employees. Below is thepolicy and job site
information.
Insurance Company Name: bf'
_ w _ 1 ,
Policy#or Self-ins. Lic. #: �0 0C �QYZ_ i' �
Expiration Date: � � 17
Job Site Address: ���(( �� City/State/Zip:�( ( (� c �VI,0 b2—
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 v rification.
I do hereby certify the pains a`d penalti perjury that the information provided above is true and correct
Si afore: ~ �; �` ' ^,
Date:
Phone#: \2D"SS14,r�cb,�
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#.
City ofNorthampton 212 Main Street, Northampton, MA 01060
Solid Waste Disposal Aff da>>it
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 111, S 150A.
Address of the work: 16rkeyz—' ., Ci D"
The debris will be transported by:
The debris will be received by:
Building permit number:
Flame of Permit Applicant 44-,, n&-4—
Date Signature of Permit Applicant
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o L ` PROJECT. THE LEAD CARPENTER SHALL VERIFY THAT 51TE CONDITIONS,AND DIMENSIONS ARE CONSISTENT WITH TITLE SHEET > Z z
t 1 l 1 1 THESE PLANS BEFORE 5TARTIN6 WORK.WORK NOT SPECIFICALLY DETAILED SHALL BE CONSTRUCTED TO THE SAME PROJECT 22 BRIERWOOD DR PROJECT SUMMARY 1
QUALITY AS SIMILAR WORK THAT 15 DETAILED.ALL WORK SHALL BE DONE IN ACCORDANCE WITH INTERNATIONAL ADDRE55: FLORENCE,MA EXISTING MAIN FLOOR
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o WRITTEN DIMENSIONS AND SPECIFIC NOTES SHALL TAKE PRECEDENCE OVER SCALED DIMENSIONS AND GENERAL
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n o NOTES.THE SALE PERSON/DESIGNER SHALL BE CONSULTED FOR CLARIFICATION IF SITE CONDITIONS ARE DE5IGNER: In
cCA PS ENCOUNTERED THAT ARE DIFFERENT THAN SHOWN,IF DISCREPANCIES ARE FOUND IN THE PLANS OR NOTES,OR IF M-
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QUESTION ARISES OVER THE INTENT OF THE PLANS OR NOTES.CARPENTER OR 5UB-CONTRACTOR SHALL VERIFY AND �
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15 RESPONSIBLE FOR ALL DIMEN5101,15(INCLUDING ROUGH OPENINGS). O > m
a m ALL TRADES SHALL MAINTAIN A GLEAN WORK 51TE AT THE END OF EACH WORK DAY. �` In
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Valley Home Improvement, Inc. 22 BRIERWOOD DR EXISTING SCALE:SEEVIEW SNEETNUMBER
340 Riverside Drive, PO Box 60627, Northampton, MA 01062 FLORENCENA 01062 DATE:3/1/2016
Office Phone 413.584.7522 Fax 413.585.0820 Kostek CON DTIONS DRAWN BY:S.G. 2
Find us on the web at: Luuw.Valle Homeim rovement.com
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FLOOR PLAN NOTES: g
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m I ALL EXTERIOR DIMENSIONS ARE TO THE MAIN z :
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ro EXTERIOR LAYER. D1MEN510N5 TO OPENING5 ARE TO w It
m THE FRAMING,ROUGH OPENING. INTERIOR ai
° DIMENSIONS ARE TO THE FINI5HED WALL.
° 2.LEAD CARPENTER 5HALL VERIFY ALL DIMEN51ON5 wm
H AND 15 RE5PON515LE FOR ALL DIMENSIONS
(INCLUDING ROUGH OPENINGS).
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GENERAL NOTE5: a
FRAME IN NEW HALLWAY WALL 0 o 0
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r THE LEAD CARPENTER SHALL FULLY COMPLY WITH THE 2009 HALF WALL WITH GAP INSTALL NEW DOOR IN `---
n IRC AND ALL ADDITIONAL STATE AND LOCAL CODE
REQUIREMENTS. EXISTING OPENING
° WRITTEN DIMENSIONS ON THESE DRAWINGS SHALL HAVE
PRECEDENCE OVER SCALED DIMENSIONS.THE GENERAL �� ��
3' 4"-rte 2'-8" 4'-2 1/2" 5 1/2"
CONTRACTOR SHALL VERIFY AND IS RESPONSIBLE FOR ALL MOVE EXISTING WINDOW
DIMENSIONS(INCLUDING ROUGH OPENINGS)AND
° CONDITIONS ON THE JOB AND MUST NOTIFY THIS OFFICE OF
S ANY VARIATIONS FROM THESE DRAWINGS.
EXT 2556 NEW 3068
- -
'- THE GENERAL CONTRACTOR IS RESPONSIBLE FOR THE
DESIGN AND PROPER FUNCTION OF PLUMBING,HVAC AND NEW PREFAB NEO
o ELECTRICAL SYSTEMS.THE LEAD CARPENTER OR O
° SUBCONTRACTOR SHALL NOTIFY THE OFFICE WITH ANY ANGLE SHOWER
PLAN CHANGES REQUIRED FOR DESIGN AND FUNCTION OF
yPLUMBING,HVAC AND ELECTRICAL SYSTEMS. TILE SHOWER WALLS a NEW TUB 54"
° DESIGN CRITERIA: 2009 IRC AND IBC ALONG WITH STATE r
AND LOCAL AMENDMENTS
? ROOF: SNOW LOAD DETERMINED BY AMENDED I.R.C. ;
6 FLOOR: 40 PSF LL. T—
° SOIL: '2,000 PSF ALLOWABLE(ASSUMED). NEW TILED FLOOR `
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4 FROST DEPTH: 4'-0" � G I
THIS STRUCTURE SHALL BE ADEQUATELY BRACED FOR WIND NEW TOILET /� -- NEW DUAL VANITY,
a LOADS UNTIL THE ROOF,FLOOR AND WALLS HAVE BEEN
E PERMANENTLY FRAMED TOGETHER AND SHEATHED. _____- I Q p
_> REG. MED'5 ABOVEINTERIOR FINISH NOTES:
1
a FORA T STSCALE;S ARE NOT TO
IC DEPICTION ON ONLY Y.PLAN UPDATES M NOT BE NEW CORNER PEDESTAL SINK - Elevation 4 i
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o REFLECTED IN RENDERINGS.RENDERINGS SHALL NOT BE G C
o;2 USED FOR CONSTRUCTION.
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o EXTERIOR FINISH NOTES: 4) ('4NEW TOILET-- O
m RENDERINGS ARE NOT TO SCALE;ALL RENDERINGS ARE m 5 1/2' m w _ ( \`X W W O
°g FOR ARTISTIC DEPICTION ONLY.PLAN UPDATES MAY NOT BE
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SEE FINISH AND PIANS&SCHEDULE FOR SPEC'S NEW
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ELECTRICAL NOTES: ® i 3: w y
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a 1.ALL APPLIANCES 8 UTILITIES TO HAVE DEDICATED j !i W
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m.y CIRCUITS PER CURRENT ELECTRIC,CODE
STANDARDS AT TIME OF INSTALLATION. SEE MFG'S - - rz CO 0 c
E SPECS FOR OTHER REQUIREMENTS _ N LL
m 2.ELECTRICAL RECEPTACLES IN BATHROOMS, LGT - -
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o KITCHENS AND GARAGE5 SHALL BE G.F.G.1.PER
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m 3 3.SMOKE AND GO DETECTORS WILL BE PROVIDED j
AND INSTALLED IN ACCORDANCE WITH NFPA
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` 4.CIRCUITS SHALL BE VERIFIED WITH HOME OWNER
0 o PRIOR TO WIRE INSTALLATION.
ELECTRICAL P_
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u S.FINAL 51,NITGHES FOR TIMERS AND DIMMERS {�' '
o SHALL BE VERIFIED WITH HOME OWNER. /� I n — '" -ice ( N t
m b.ALL SURFACE MOUNTED FIXTURES TO BE O d O
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E$ PURCHASED BY HOMEOWNER. A N '
a 8.BATH VENTILATION TO BE BATH VENT 5PEG HERE, �' W
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AND 15 PURCHASED BY V141 OR HOMEOWNER _ } Z =
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®= 9.UNO-ALL SWITCHES TO BE 48"O/C A5F. OUTLETS
m TO BE 15"O/C A5F. OUTLETS OVER - %" tL1 ci t6
o COUNTERTOP5 TO BE 3"ABOVE COUNTER FROM
CL
BOTTOM.(A5F=ABOVE SUBFLOOR)
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DATA/GABLE: n
2�'e 1.LOCATION OF PHONE/CABLE/ETHERNET GABLES N to
m o TO BE CONFIRMED WITH HOWE OWNER PRIOR TO
o y INSTALLATION IF APPLICABLE. Q
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