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23B-077 (7)
74 SOUTH MAIN ST BP-2017-0786 GIS#: COMMONWEALTH OF MASSACHUSETTS Mao:Block:23B-077 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 Permit# BP-2017-0786 Project# JS-2017-001306 Est. Cost: $8500.00 Fee: $65.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: VALLEY HOME IMPROVEMENT INC 077279 Lot Size(sq.ft.): 7623.00 Owner: WEISMAN EDWARD N& SIMONA POZZETTO Zoning: URBp00)/ Applicant: VALLEY HOME IMPROVEMENT INC AT: 74 SOUTH MAIN ST Applicant Address: Phone: Insurance: P 0 BOX 60627 (413) 584-7522 Workers Compensation FLORENCEMA01062 ISSUED ON:12/14/2016 0:00:00 TO PERFORM THE FOLLOWING WORK:BATH REMODEL, FIXTURE SWAP OUT ADD NEW AWNING WINDOW 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 if 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 12/14/2016 0:00:00 $65.00 212 Main Street,Phone(413)587-1240, Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner File#BP-2017-0786 APPLICANT/CONTACT PERSON VALLEY HOME IMPROVEMENT INC ADDRESS/PHONE P O BOX 60627 FLORENCE (413)584-7522 PROPERTY LOCATION 74 SOUTH MAIN ST MAP 23B PARCEL 077 001 ZONE URB(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST MI'' LOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid i� O/ Building Permit Filled out �i Fee Paid Typeof Construction: BATH REMODEL,FIXT b "t ' ' AP OUT ADD NEW AWNING WINDOW 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 7TH OLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON IN ORMATION 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 J�/PPeerrrmit from Elm Street Commission Permit DPW Storm Water Management . of Delay c� /o?,/'f� ao/G Signature B ding trial 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. Deparment use only ''' City of Northampton Status of Permit: Building Department Curb Cut/Driveway Permit 212 Main Street Sewer/Septic Availability V p Room 100 WaterANell Availability / Northampton, MA 01060 Two Sets of Structural Plans �Q�' l ;,}Shone 413-587-1240 Fax 413-587-1272 PloUsite Plans � Other Specify <\\\\\ARP/L(�ATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1•SITE INFORMATION 1.1 PropertyAd"dressy: - - This section to be completed by office 7-1 .SjJf' 1 Hain J- flap Lot Unit F .ienc-C_— Zone Overlay District Elm St.Disaicf CB District SECTION 2-PROPERTY OWN!NERSKIP(AUTHOREZED AGENT 2.1 Owner of Record: �[ W t,�- I.L1194Th n 77 S. D c 7ott ni / ��/y��a Or 6a Name RV), y ' L Current Mailing Address: ,144 413 -Sid- IJP"D :144--- Telephone Signature 2.2 Authorized Agent: St Ikiem N-1X, P.o . 602C ((flea/ flCZ ncc_ 010 D1 , a Name(Print) Current Mailing Address: 4 13- Sgq- 15 as Signature Telephone I SEc.TiCN. ESTI[PeATEP CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building lJi /No (a)Building Permit Fee 2 Electrical 1 J.0 i (b)Estimated Total Cost of Construction from (6) I 4. Mechanical(HVAC) 5.Fire Protection C /� /o 5. Total=(1 +2+3+4+5) II Qr5OD Check Number 30 3Po1 V 5- ?Nis Section For Official Use Only Building Permit Number: Issued: Signature: 1 BuilSeng Commissioner/lnspeetor of Buildings Date Section 4. ZONING AU Information Must Be Completed. Permit Can Be Dried Due To Incomplete Information Existing Proposed I Required by Zoning This column to be Med in by Building Department - Lot Size Frontage Setbacks Loot Side L, R:. . . L: R: -_ ... . - � .. ._ .. Pear Building Height 4 Bldg.Square Footage ... ata ^ -. Open Space Footage td -.. . (Lotaraminus bldg&paved ' - . B ) _ #of Parking Spaces + Fill: _ _.. . _ . _... _._ .. ..... .. (volume&Loruinn) _._ _. _.... ___.. . A. Has a Special Permit/Variance/Finding ever peen issued for/on the site? NO 0 DONT KNOW O YES 0 _ IF YES, date issued: IF YES: Was the permit.recorded at the Registry of Deeds? . nv Li _..'ni inv2`V Vi YCY 0 / IF YES: enter Rook andlor Document 1:' B. Does the site contain a broo body of water or wetlands? NO 0 DONT KNOW 0 YES 0 EF YES, has a permit be or need to be obtained from the Conservation Commission? teeec.+c t,be td.F.im vnfearcere U , n'_te iss_red: C. Do any signs exist/oh the property? YES 0 NO V IF YES, descrUe size,type and location: -- ... . . .. D. Are there any nronoc 4 ch7tran e nr yd ._ .. +_ YET fl NO /'S IF YES, describe size, type and Location: `moi D. eel me conatrootten arra/Nature to.lervine,gracing, eXC2VErOil, or Sling)over 1 an a or 0s cpart ofacommon pian that veil dstum overt acre? YES 0 NO q y DT-YES,then a Northampton Stem,Water tv'Manaoe rent Permit loom the DPW is required. SECTEON 5-DESCREPT€oN OF PROPOSED WORK(check all applicable) New House C Addition 0 Replacement Windows A@teration(s)ig Roofing E Or Doors CI Accessory Bldg. El Demolition El New Signsigy [p3 Decks ED Siding@] Other(Qj Brief Description of Proposed tL •• r! Werk: Bnm AcG MAI SL °I nr ADA) M 4wApioc wax)» Alteration of edsting bedroom Yes _No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes _No Plans Attached Roll Sheer $t€f Flew house sed or eddlUon to exuetdno houushis, comodete the foNovred@uta_ 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_,J g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction i Is construction within 100 n.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 SECT@ON is•OWNER AETNORPZATPON•TO BE COINPLETED WHEN 1 OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT !I I. Ea- 4-.>lm �tt1G-rel ansTc.f the ;,.: property hereby authort>e 1' " !t_II It .R C's' '..* .— to act on my behalf,in all matte f atl e o work authorized iy this building permit application. ^rev_--_ t _ Signature of Owner Date tiR SVC. r) SL\Qe..v (Y P\ as Owner/Author—ed tt b _ Signed under the pains andn`penalties_of perjury. T — i. . SS k. d i , Pitt N s4 i. 7 i1/% fl" 6 fv 7 —_ SECTION 8-CONSTRUCTION SERVICES $.1 Licensed Construction Supervisor: Not Applicable ID Jame of license Holder: • .'t-'V-`li. . '�'Yl1CaY1 C:11 a ) 1 License Number 2-6.12) TCrt+`R%''t" ._ t��S r• .1` Y=L.. C .. C,tC577-D W2-0 Address /J f z Expiration Date �,J litj/ "C7 `;it- f�Jc Sig tent' TRhone p.Registered Home Improvement Contactor: Not Applicable 0 ` l Tu,nnccn IOSSY3 'company Name Registration Number Addreeis" �ry - Expiration Date lr..cvefn �ER r�C51:97, ...._Telephone 5�tt^ • • SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT KG.L,c, 152,E 25C(5)) 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 C£ No 0 LL -Horne Owner Exert elfin be carmat tyernptiGn;r: e.,: sr.. v a xGooedta:psi C..cre. Ee Dwellings ofo .,,oi2) arttim and to allow such homeowner to engage an individual for him who does not possess a licens provided that the owner acts as sutterviaar. Rt4ti� . gran &Edon" est ed MCILS I. Definition of ffomeownert 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 he,a one or two family dwelling,attached or detached structures accessory to such use and/or farm stmetures.A.beam schen constructs more than one home In a rive-Ver fettled skull net be enao@det-e.', a hormrt e mer. Such"homeowner"shall submit to the Building Official, on a form acceptable to the?wilding Official,that he/she shall hg F" :.iM Wit ari sue wvtk Pe'[e[set€ender teeai3Fir ermtt. As acting Consirzr lion Sagrersisor your presence on the)ob sire will be requited from time ro time,during and upon completion ofthe work for which this permit is issued_ Also be advised that withreference 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,yen enact'be Cole 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 soil State of Massachusetts General Laws Annotated. Ecneownef Stan. egr° City of Northampton 212 Math Street, Northampton, 1v 01060 Solid Waste 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 911, S 150k Address of thawork: 'H &)J h HCILn S The debris will be transported by: NCOL,ud k-GYl'iP Atm pvC xma)-- • The debris will be received by: r __� • a Building permit number: Name of Permit Applicant tilt, YIL ninitp,-cQrr ei ' I 2--/2-4 /ft /1 A //IA date SignatureofPermitApplicant 600 WaShingi.321 8172 22' Boston, MA 02111 w�s'.:zerass.gov�ilaa Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant information Please Print Legibly Name (Business/Organizationlndividual): \\ft(U'eL\ 4 .�`m- wno{O�...y /1e Address: € re CkC j(l�i<_ City/State/Zip: \" kpf€ntt al Ph e#: t-� 3 Arepr�you an employer? Checktheappropriate box: Type of project(required): 1.3 I am a employer with 7 S 4. ❑ I am a general contractor and I employees (full and/orpart-fie).= have hired the sub-contractors6. 11 New construction listed on the attached sheet. 7. ❑ 2.❑ I am a sole proprietor or partner- Remode.iag ship and have no employees These sub-contractors have S. ❑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 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers' camp. right of exemption per MGL 12.0 Roof repairs insurance required.] t 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. tContractors 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 ompleyer that Is,. vidine wpr,1."ens'e©r pe ..e .4i 35.'54..e any er y'ryee. &slow - the a djo site information. Insurance Company Name: ct4"YJY,t‘t?, ( rte. G YY'.t-rP Policy#or Self-ins.Lie. r:01717`oC' CZ 1'71 Expiration Date: J Job Site Address: / 1 CSOU4+) Thiun t( City/State/Zip: HOte.- C /ru-t©(4912- Attach -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 MGT_e. 152 can lead to the imposition of criminal penaties of a fine up to$1,500.000 anJosue-yea imprisomnent,as well as civil penalties in the form of a STOP ._,<O =4_a Br_ 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 .if the DIA for insurance coiseaage yefitica..o... I do hereby D-1115.751 drec -th Pains and_eenaltie6. perjmry that the inferiontion provided above is true and correct S;anan,e,,. ,ri /t . /,'r?� ( yef ' Date. 8/!(.0 mane a: _ _ ._ of _ " ,_ _ ._. ( ('in, cTs= ._. (7 ee , se;'. II. Board of Bealtn 2.B..rdr3rg I _ r asp 3. C1g/Term Clark 4-Eiertrisel 5 ep War 5 moi, li Corteet Person: -..e,ha`-i; J �.1rd _ S tizy a u = 3na S ares L'ceese. CS-077279 .rstra suCzrns a u STEVEN A SILVRMAN 268 POKIER ROAD ''� .3 SOUTHAMPTON MA 01073 Expv:dion' Cornm:ssioner 06/21/2018 f/ ,re 7% ( );«ir r>urrrfl/,/ r ; ' ilrr:,r rfr. s'1i; 7` Office of Consumer Affairs and Business Renulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 105543 Type: Pnvete Corporation Expiration: 7117/2018 Tr# 4B29: VALLEY HOME MPROVEMENT INC. STEVEN SILVERMAN P.O. Box 60627 FLORENCE, MA 01052 ium.s- ...1..121 2.n il.Of nn: Lost(lit d Otte.: Cone 'dire& H Rt_nl.rztun License or rett,istration valid for lndfoidnniuse only + u7ROV 3 is GO;t.-0T: br ,4u: u . Registration: 1055.0 02 TYPe Ofriata(t o tau.ner Aum/ anti Pusinns' ! Ixdon ExPiratian: r .+.v._o .,. 'J i. a _: 7/17121)1,i dose r MA 412i Ira VRLLE7 t171RtE1,,IRRO`I`MENT'ur. / a .,._ G VAN a,1rr •.. er /gyp 1i re 340 R”,ertideDI 4750 rs e.d',+aa -- I!•