Loading...
16A-021 425 SPRING ST BP-2019-0955 G1S#: COMMONWEALTH OF MASSACHUSETTS Map-.Block: 16A-021 CITY OF NORTHAMPTON Lot--001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Gategprv:lN$ULATIGN BUILDING PERMIT Permit# BP-2019-0955 Project JS-2019-001591 Est Cost: $5503.00 Fee $65.00 PERMISSION IS HEREBY GRANTED TO: ConstClass Contractor: License: Use Group VALLEY HOME IMPROVEMENT INC 077279 Lot Size(sa ft.): 79279.20 Owner: LACY RICHARD I&DAWN G METZGE Zoning URA(l3S)/WSP(l35)/ Applicant: VALLEY HOME IMPROVEMENT INC AP 425 SPRING ST Applicant Address: Phone: Insurance: P 0 BOX 60627 (413) 584-7522 Workers Compensation FLORENCEMA01062 ISSUED ON:3/612019 0:00:00 TO PERFORM THE FOLLOWING WORK.AIR SEALING BASEMENT„ SEALING AITTIC AND CHIMNEY, INSULATE DOOR 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/Cbimney: Rough: M, 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: FeeTvpe: Date Paid: Amount: Building 3/6/20190:00:00 $65.00 212 Main Street, Phone(413)587-1240,Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner __i� r`L ` t-_.;I � -- Department use only R E V L I V E v Cit of Northampton Status Of Permit r'" Bu ding Department Curb:Cut/Driveway Permit 'I 12 Main Street Sewer/Septic Availability MAR 5 2019 Froom 100 WatenWell Availability. Orth mpton, MA 01060 Two Sets of Structural Plans or=T n ruanmu - - -1240 Fax 413-587-1272 Plot/Site Plans a..gn,n^nniom.wnomero Other Specify APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A/ONE O/Ry TWO FAMILY DWELLING SECTIONI -SITE INFORMATION 1.1 Prooe tv AddJdress: \n' I {` �T�his/�section to be completed by office 42S cJ�fit-l+Q J'I� I rIp'('+QMr2.Q� Map— l �— Lot &� 1 Unit �nC' LJ lone Overlay District M O O Et.SL Dlstriq CB Dlebict SECTION 2-PROPERTY OWNERSHIPIAUTHORIZEDRGENT 2.1 Owner of Record: Wil —rA SaV,e -4t"aw r, ro vle� Name dot) Current Mailing Mouses Telephone F/'=/,� Signature 2.2 Authortoed Agent G t2i Sid Name(Print) Current Mailing Address: ( 4131 99Z — Abo9 Signature TelepA SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be _ Official Use Only completed by permit applicant 1. Building. (a)Building Permit Fee 2. Electrical (b)Estimated Total Cost of Construction from 6 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) 5.Fire Protection 6, Total=(1 +2+3+4+5) 5 5 a2- Check Number /,sl This Section For Official Use Only Date Building Permit Number: Issued: Signature: 3-L 10iq 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 11vs column to Be find in by Building Department Lot Size Frontage Setbacks Front Side L R'__ L: . R _ Rear- Building earBuilding Height Bldg. Square Footage _. Open Space % _.. (Int area minus bldg&pevcd parking) .. ,.•._ N ofParking Spaces - - Fill ...... _..._.._.......__... (volume@Location A. Hasa Special Permit/Variance/Finding ever been issued for/on the site? NO O DONT KNOW © YES O IF YES, date issued:, IF YES: Was the permit recorded at the Registry of Deeds? NO O DONT KNOW Q YES O IF YES: enter Book Page. and/or Document#+. B. Does the site contain a brook, body of water or wetlands? NO O DONT KNOW Q YES O IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained O Obtained O , Date Issued: C. Do any signs exist on the property? YES O NO IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES O NO O IF YES, describe size, type and location: E. NAZI the construction activity disturb(clearing,grading,excavation,or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES O NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. SECTION 5-DESCRIPTION OF PROPOSED WORK!check all applicablel New House ❑ Addition E] ReplacementWindows Alterations) ❑ Roofing ❑ Or Doors o Accessory Bldg. ElDam ❑ New Signs [m Docks [p Siding[C31 Other IQ Brief Description of Proposetl / / ' 8 y./r f�� all• /, I L (� IAaPA/T Work: L�` uugqCPDi: .n �AQyn� L1.0 {f�C 14G/a4. 8 Alteraefio�o of ew'?;ting bedroom+ ct Ves o Adding new betlroom_Yes No Attached Narrative Renovating unfinished basement _Yes No Plans Attached Rall -Sheet ea. If New house and or addition to existing housing, complete the following: a. Use of building :One Family Two Family Other b. Number of roams 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 farm attached? K Type of construction I. Is construction within 100 ft.of wetlands?_Yes _No. Is construction wthin 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 COMPLETEDWHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1 as Cwner of the subject property hereby authorize to act on my behalf,in all matters relative to work authorized by this building permit application. Signature of Owner Date I as Owner/Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowtedge and belief. Signed under the pains and penalties of perjury. Print Name Signature of OwnerlAgent Date SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: `/',t I Not Applicable ❑^t Name of License Holder: 'T�l_ Q E, _A : l , CS License Number e26$ fou err R� �0i 6 /2! /2oZo Addre/s�s, g(�jJ}�'' Expiration Date sgr 7�--64,�r, a 413) 22,4-x-522 Telephone 7— e.Registered Home�Impprovement Contractor. + Not Applicable ❑ 10$$43 Company Na Registration Number 34n ': /( b / 202-0 Address ( � . Expiration Date 0 ((-)b' 2 TNephon&l 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 fone(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 1083.5.1. 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 hom owne . Such"homeowner"shall submit to the Building Official,on a farm acceptable to the Building Official that he/she shall be responsible far 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 maybe 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 City of Northampton Q+' Massachusetts �r (�- A t DEPARTMENT OF BVII.DZNG INSPECTIONS = 212 Nein street Municipal Building Northampton, NA 01060 ✓ :y,�����D Debris Disposal Affidavit In accordance of the provisions of MGL c 40, 554, 1 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. The debris from construction work being performed at: 425 5 V-;V'g C I-- U_ HA 01062 (Please print house numbs street name) Is to be disposed of at: Ua < <� �!�A j'wg (Pleas int name an cation of ility) I Or will be disposed of in a dumpster onsite rented or leased from: (Company Name and Address) Signat a of Permit Applicant or Owner Date If, for any reason, the debris will not be disposed of as indicated, the Applicant or Owner shall notify the Building Department as to the location where the debris will be disposed. Coduand- 11 t It Massa chusefls Dlv s n of orofessio nal Lmenv,re Board of Building Ergulahons and Standards Constdjc dl�Silpervisor CS V)77279 _ Egp res. 06/21/2020 STEVEN ASILVERMAN— / 268 FOMER ROAD SOUTHAMPTONMA 01073 �J Commissioner ✓"� Office of Consumer Affairs and Business Regulation One Ashburton Place - Suite 1301 Boston, Massachusetts 02108 Home Improvement Contractor Registration Type: Corporation Registration: 105543 VALLEY HOME IMPROVEMENT INC - - Expiration: 07/16/2020 P.O.BOX 60627 - -FLORENCE,MA 01062 Update Address and Return Card. OHlce of Consumer Arfalrs 8 Badness ReguloUon HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:Corooratian before the expiration date. If found return to: Registration Exon Office of Consumer Affairs and Business Regulation jrr; an-. - 07/161202C One Ashburton Place-Suite 1301 VALLEY HOME IMPROVEMENT INC Boston,MA 002108 N'W// / '{✓'�/�if STEVFNA SILVFHNANf / / 310 RIVERSIDFOR NORTHAMPTON r<A 01062 Undersecretary Not valid without signature The Comtaoawealth of Massachusetts 't Department of Industrial A ccidents / Congress.Street. Suite 100 Roston .SIA 02114-2077 ivivininass.gav/dia 1\orkees'C'ompensatlon ins or ance AHill r%it: Builders/Contractors/Elecnacians/Plumbers. TO BE FILED 1111 H THE PER NUTTING At THORM. \umlicaro Information Please Prior Le dish NamelBnaines'ora'anii,m. inamfu:U: ,jQ(�-C, �C4'1C .1-YYa fJ rO dEJvl r,'T4 SraC J .Address. PyiO ry-z✓Ssdr �- .rc 1� (l. gcx- (cYT(o2-I City/State/Zip: Pbrenc,( 0) 0102 _ Phone i,,. 4l- - '� I--IS22- ire you an employer)Chock do apple box � (] type of Protect (required): I ®ton.a mplme oam_ _ampmyaslnalam.m pan aura` 7. ❑New eonsvualmt ❑I. , ,depio t pemvssl/p: dh _ ,,emplo Alno fmaab, 8. �' Remodeling Pi x � p. mymrcil 9. ❑D Itolton ❑I..,n ,.ri hu,all wootaly,cI [A k I _l IU❑ Bouldni adtntion ;mIjol Ie,ll tobxxr, all lorall Coturk. M1 1 ,. ttun ser IL❑FLwlril rcpaifror audit inns p i,a.,lm.ahh,, ......loge.. 12.❑Plumb...¢repairs of additions 50 eN 1 dl1 l a th, - cdstmCI 113 DRoofrep,un, I -ry 1 , I. �.-: r❑o La"i cad it,ettia >l l- ._mpw.e per tier e. 14_❑Othor _ 1.'__511i4aaa o:mplo M1 ,6c¢'c p. .oumyuimal �� i •AIpphcaa,Oat clarcks bog r I nutia fill tor n" l sha—icfir, k o.npem p1 .o. 'Home,xiaroa,ul,mul thka[[Uav d t, l., acec :Ilu. ,'of NeonMulct .tc shalla , , njs '-1Il uv6 ll e11,ad-1,lob,.x n[. h.l ,adO,uaol:b hho ' 'l ab. ,l ad sa<whe;hn , tha. ria"li�a o pl : . nhv=ah .Leve enpl ,p d M1_ a,k� or play a - [amm,employer!burls'providing nmrkers'compensution Insurance fur myemployees. Retmv if the policy andjob site irrjorrnatiorl. p hasunirco Con,pam'Nnvm; POI,'v v if S,p of Lr r: _ OIJi'DC.>O 3 0 Z_A�J_ 6<pl ato..Date._ ,2-Ll cJ?C ')C Inh Site Add rdss _ City Suite Zip Attach a copy of the worker: compensation policy declaration pepic ishowing the policy a round,and expiration dstel. Fulure to secure wve fage at ifu ad under MGC c 151, `SA is a criminal violation punishable by a fine up to 5!500.00 and;of ouc-year imprisoument as well as civil pdnahice in the foal of a STOPVA'ORF ORDER and a C t,ot'up to S1 B.00a dap against dte cinleten A copy of this-te ememt mnv be foravatded to the Office of lux rna,luaus of the DIA for inaerance coverage cn'itleanon_ Idohnell, in ifyun erdlepomsmWpe ahr"'O' it hotthemfornmtiou provided above is true and correct. S adorer= ._ � %�R Phare bLA cost- 1°J2Z _ Offre d use entl I) rzt t mrite a rl s tire..v b conrp/eled by cru or turn official Cit'or Town: Pe rnsibLicense R Issuing Authmits (circle one): I. Ron.d of Health Y.Building Depar hien, 3.Cin;1Town Clerk 4.Lbretr'inl Inspector 5.Plumbing Inspector M1.Otl... Contact Person: phone b: