11A-031 (3) 11 LEONARD ST BP-2017-1316
GIS#: COMMONWEALTH OF MASSACHUSETTS
Mao:Block: 11A-031 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: KITCHEN RENO BUILDING PERMIT
Permit# BP-2017-1316
Project# JS-2017-002181
Est. Cost: $30200.00
Fee: $196.30 PERMISSION IS HEREBY GRANTED TO:
Cons.Class: Contractor: License:
Use Grouo: VALLEY HOME IMPROVEMENT INC 077279
Lot Size(sq. ft.): 10367.28 Owner: ROSEN JEFFREY&PAMELA A TORRE
zoning: URA(loo)/ Applicant: VALLEY HOME IMPROVEMENT INC
AT: 11 LEONARD ST
Applicant Address: Phone: Insurance:
P O BOX 60627 (413) 584-7522 Workers Compensation
FLORENCEMA01062 ISSUED ON:5/15/2017 0:00:00
TO PERFORM THE FOLLOWING WORK:KITCHEN REMODEL - NEW WINDOW AND SINK
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 5/15/2017 0:00:00 $196.30
212 Main Street, Phone(413)587-1240, Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
File# BP-2017-1316
APPLICANT/CONTACT PERSON VALLEY HOME IMPROVEMENT INC
ADDRESS/PHONE P O BOX 60627 FLORENCE (413)584-7522
PROPERTY LOCATION I I LEONARD ST
MAP I I A PARCEL 031 001 ZONE URA(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid t( ��(
Building Permit Filled out 1\/I
Fee Paid
Tyoeof Construction: KITCHEN REMODEL-NEW WI DOW AND SINK
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
INFORMATION 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
!s n ora ey
�� 5-/A / 7
Signature of Building 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.
----
Department use only
City of Northampton Status of Permit:
Building Department Curb CuVDth'ewy Perm
n 212 Main Street Sewer/Septic Availability
" A Room 100 Water/Well Availability
tiNorthampton, MA 01060 Two Sets of Structural Plans
r/ _`"" phone 4t3-587-1240 Fax 413-587-1272 PIOUSite Plans
/ Other Specify
I APPLICATION TO CONSTRUCT,ALTER, REPAIR,RENOVATE On DEMOLISH A ONE OCC TWO FAMILY DWELLING
L _
I
SECTIONlt SITE INFORMATION I
1.1 Properly kdCre_r:—
_ _. . _- This section to be completed by office.. _
1 \stOPOS6 Mao I A _ Lot .0 / Unit
tatetkaS Zane Overlay District
Elm St.District_,,,
SECTION 2.PROPEF..TY OWNERSH@P/AUTHORrZED AGENT
2.1 Dames of Record:
cy Y-rocre. t Se“ es)Y .. l t Leona/Id Si- i -ccz s 1114 OioS;
Name(P1nt) - Current Mailing Address: .
J 8'1- ro9'3
! `fi
t-1 t �
,.L.:. Telephone '
Signature - -
>v Autharso A rant i�
O u` '.r " ur tl�, D. s i (-on< OM O)OIO2 _.
Name(Pant) del//i current Mailing Mdres„
v!3-S8N S2z
( Signature Telaohnrn-,
1 item Estimated Cost(Dadaist to be I Official Use Only
I _ completed by parmlt applicant
1. 8ulldlog1 2 (a a� (a)SaddamPermit Fee
' 2. Electeat ( l a 0 I t lc r.r 'Mint
l) V I Construction fromtett
I Pandang i... 3 oU() Em!Idtnc¢P rmtt F:,.c
4. Mechanical(H:AC)
5.Fire Protection I!
S. Total=./14-2434-4÷5) i ir '3(li a.th7 1 Check Number '..
r9( 3D i
I
___ . two soottoo F Ottly i
I
j amesna - :or orSWdlns I
Section 4. ZONING A11 Information Mus:Be CompPeted. Permit Can ee Denied Du",To Incomplete Iroo ion
Existing Proposed Required by Zoning
This column to r5llcdinby
Builtin;De cu:
Lot Size _ . .
Frontage
1
Setbacks Front '
Sade
Rear
Building Height ... . . ' .. _.
Bldg.Square Footage I
Open SpaceFoot e ',5
(Lmarawnusbfl 8yiaved _____ ,
•
` d of Parking Spaces e •
Fill: -...
(vaunt rtocadon) I .—_. .. _ ._ . . . __
A. Has aS^-pecial Perrnit/Variance/Finding-ser been issued for/on the site?
NO 0 DONT KNOW a YES Q
;F YES, date issued:
IF YES: Was,he permit recorded at he R eistry of Deeds?
IF'?ES: •,.ver _-.,_k VL_c M1•- and/Or ..K.cuiment
B. Does the site contain a broo:, body of water or wetlands? NO 0 DONT KNOW 0 YES 3
PF`ee :P.P7P7PP _. ., cbu„ r_ d from the Couservatfon Commission?
Needs aL a tied L'12.to fissuec:
C. Do any signs exist .. the property? YES J No 0
IF YES, describe size, type and location:
D. Are:here
4 : ?
ane location:
...:. FiLF,Ft,...o: z (%
:.P 11=S, rtenb N(p. he .n Storm ln' - r M 1ternert r nom the!:)P oei':'ed_
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' 'ri:N6:i g7 4 ]C3 3a al' 04?Y721093111 ciel'3aai#O•EA 91041.353
. __.,t -ML Aper A9.,f o j. 1 e'•
i
-ON =,�—. iau%rYInOeJ 6cluod pue buipilne Gig Cl uU0 tteo fiu!Flln4 no y
opet pays!! u Atte 4011 JeItaa Jo)uawsegioµ1d&0 'l
- eN SON -utEldpooLI, ON 004 wygm OOfOpOSUoa Sl.'ON Sa„ � LSpnei}am)0 1=130: elk M uOlnrulsuoa ei _-1
ucgom;sueo/o edit” 9!
Lpayoeue uuo)901.tedwo3 R6aou3 yoau:Jss2Nl ".aauei du!o3 UOpWNa<_ue3 l5.raua 'b
goes pJagwnN seetlopootiry as smeldan /,6uneay/o potpen ;
. esac0]slo JagwnN 'a
"—'suelsuetut:. 'uagortatma Meu;o e6eoo3 a.JSnbS pescdoJd 'P
Lpagsepe stetfi e e.tel si 'o
woorose;O:!egmny :inn Net Nets of swOOJ 3a S7wnN -q
Jay',GAnted aml /tilted aup: Purprrngio asp
:CePgU:JP;acp mg949uq'ta ' ..gticy mwisIxe cn°1oPJ,", a54 pa,119 esn0q WSN 30 tS
_ .. . �. ___ .laa43 Ifo&P&yoelei sueld
-oN` $a}, tuawssaq Cgsuun Bupeaousy (�.� onijeJJepl P94oeRtl
lei seek, tuomp&q mau6upoy ON setuaoapaq EGgsxa pa uogsJa;iy
9/ a' Gifu/ Oda b�2bl-7hul3Wont/ CnaN - '13v0Utrii ciat-1t7� t'u
pasodmAO]
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ril ay;O (Ci eulPt$ 01 s>gaap [C7 suelxd rxaN u9i711owafl D 'spl@ luossetloq
0 s leo&40
E 6uPmov� (c)uoi;zaa;ryf spAcpum wawaoelda� uonPpy _ esec,y nna,N
(s1q'--!4c^s It EU-)>PCMMM 's31d0'd?dO Nail=.&35Eo•BS` 11_333
SECTION 8.CONSTRUCTION SERVICES
8,1 Licensed ConsructIonn$$yu`uaervipan 11 Not Applicable� ,:❑'�
Name_of License Holder: 1 :(ti �l kei(Phfhet 1"a nil 9
License Number
_ _"t_ T l " t\42') S ..yam aMskn Yjla-. AM. . 10
Address t E:yirztion Date
jilt
/R//
4( �/ % Vis✓`C 1 4 Tnt
Sign:ere Telephone
p. ffienietaded Home Improvement Cor ree^ar: Not Applicable 0
"t 1 \`f x`1ecE 1OSSY3
Company Name Registration Number
r . ') .v 017 7/121/8
Address �/� - Expiration Date
trri
_.. f red eakffi rf" C{Ld 6kb teserIie Telephone
SECTION It-WORKERS'COMPENSATION INDURANCE AFFICA.WT(1di.O.L.c. 152,5 25C(E))
Workers Compensation Insurance affidavit must ba completed and submitted with this application.Failure to provide this affidavit Mk result
in the denial of the issuance of the building permit.
Signed Affidavit Atleehad Yes D-A' No U
. HGate O per Exemption
s w ninCilininnnnr ninagni••. indiViinni r.in ntn nnin Snpothers a—_c 5 4L LL Wta r .rY et
r r : Ci A 7ri7. Ci-ah Tiffiiiail Section 1813.5.1,
Defnideust rsf Ro neowwer:Person(s)who ohm a p_reei offtoad mi-which he/she resides as in minds so reside, on which there
is,or is intended to be,a one or two family dwelling,atieched or detached structures accessory to such use and/or farm
structures. 4 nersod who a..snets more c.n nue;',SintiS tc_.,.., cAtio . lot be thithAfeered+kmmeahsnier.
Satoh '1101 e ' Is•t1 ._.�c72Ui s.,..esiz tans folic}aecepthoze 'o to Bthrthieuff Oftleial,51 Reich.;shah
ai 9 r ft a aharp w
:at 4 . Nunn. - _
As 'acting Cun2tt _ttan iathenvlor your Disenor on the jun sirewll be required: .:n rime, o time,daring anti upon
horepletion.sf"Fe work for which this pe:rtht is i581tti.
ALSO be advised that with reference to Chapter 152(Workers'Compensation) and Chapter 153 (rteability ofEmployets to
Employees for injuries not resulting in Ent)of the Massachusetts General Laws Annotated,Ted zea'be/table for person(s)
you hire to embryo work for you under this permit
The undersigned"homeowner"certi➢Ses end assumes responsibility for cornpisnee with the State Euilding Cede_City of
.: arriLuirioron C ,—t, wa'__ea gLau,and Suit ofMassacnuserts Genevni Laws a „oratosi.
aHorarththePT
Ci // of Not thaaapton 212 Main Street, Noritrampton, M? 01060
Solid Waste Disposal Affidavit
In accordance of the provisions of MGL c 40, 354, I ac«ow;ecge that as
a condition of thofl building permit all debris resulting from the construction
•activity governed by this Building Permit shall be disposed of in a sropetty
licensed solid waste disposal facility, as defined by MGL c 111, S 150A
Address of the.work: vi!td SI' -PtzS
The debris will be transported by: E 1. _14671 P in i?ria Yai>on
The debris will be received by: VI 1
Building permit number.
Name of Permit Applicant 1 . . IL AliIi�0Yt
C JI « ill 1 di
v, t3 Skil 10-;_ ofHos sit fa siprc nt
osr:c.n,MA 02111
wo.m...2.ss..gov/diat
Workers' CoropeHsoVontnsurskr,c ifl alt: -', deers/Ceolsnstor€ 'i u5._anst?lansbe:s
Ar',t,Cleamtfyafo oaken Please Print Leglbly
?ate . it n V�.�.,,,„ "P._ _ I -T
l't41Ln\ ksos it y$Yi on,o cork, . Tin
Address: z3ic�.} T).
Address:
City/St e Zig: Y \C3f '2Ce.. Z I Phone f 5 L� 1,`cz' _
Are you as ewnppayer? Check the appropruate bon Type of project(required):
1.1 i am a ener with9u,io i 4. 0 Cm a gement contractor and 1 6. ❑Net construction
- ed the sub o n oc ''p f isiu/o.pert tin ej'
s
2.❑ am i..}Trop/ for or partner-
These
d cm the 1�ar eCt. d 3. '-.,
ship and have no employees These sub conftaclors have 8. 0 D molition
working far me in -y capacity. employees and have workers'
comp.insurance.),
0 Dimling addition
[No workers' corns.ic,uraace
regdr-ed J 5. 0 We area corporation and its 10.n Hlecttieal repairs or additions
3.0 T&to a homeowner doing all work officers have exercised their 11.0 Blumbinz repairs or additions
myself.No workers' coley,_ right of exemption per MOL
110 Roof rep*t5
insurance required.]i C. 152, §1(4),and we have no
employees. [No workers' 13. Other
comp.insurance required.]
*Any applicant that checks ben«1 must also rill out the section below showing their workers'compensation policy infonnadea
F
Homeowner a who submit this atndevit indicadno they are doing ail work and then hire outside ern Actors must submit a new affidavit indicating such.
rContaetoro that check this bre must attached an additional sheet showiag the name of the sub-eonnact ors and state whetter ornot those endde.9 have
employees. If Meson-contactors have employees,they most provide their wmies'coup.policy number
thria
i--
:.2
1!:= 1:'ir ..-(d .1w4-. Cull .. IQY >`'E 1.1
PoiSeyor Self-ins. L ".;i✓ � (.)rth haa
;,Date, a H i 8
oh sti..t A::cies: \\ t°I')fl�,. Vt Civ atelZin: -e I\413 o]c&3
+e>ti ..0.6 the .. ^1 c. asf•_ r„.u- e'like nue ny az?„Ana,dor,a jete).
Pai1nt.ese.curecpo e _
der Se_ o ,.,,fMG-c. 1 _ ono lead to ie,now: icyofc men ' - .,
, es
fine Ltit to"sl 51O.Vv midio o ;-fair _3TLor fit - I-i-as civ 3 i me j:.T z- form of a STOP i pn O» c'r d _g__
of up to$250.00 a day against the violator. Be advised d that a copy of this s atom nt may be f-sr&led to the Office of
:Trint.a6onn of•h_£ Rfor ins'uan aze'iyerif zticn -...
_y _ a✓ .. L xer.: tesc,or,ems_ea Lm
SWx e.:e anti r=art.
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31
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dam.
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.rC of_nuricirng Ricgrirarsoics .:n0 Standards
AAA. CS 077279 z�
Construct—on Supervisor :n.'}"'+r 3
STEVEN A SILVRt.SAN = �
369 FOMER ROAD
SOUTHAMPTON MA 31:17,2u1 -
1`,'"1..r1/4 � rxpi anon:
Csnmissionmr 0612112013
J `.-/
trirrfrifff-
Office of Consumer r ff irs end Business i gul'_rion
10 Park Plaza - Suite 5170
Boston, Massachusetts 02116
Home
Improvement contractor Registration
-. - — ior 1055h3
Pdv le Comoration
-atic1 711712013 Tit 4 r.3231
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