30B-097 (6) 139 FEDERAL ST BP-2020-0474
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 30B-097 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-2020-0474
Proiect# JS-2020-00072
Est.Cost: $36500.00
Fee: $237.25 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: VALLEY HOME IMPROVEMENT INC 077279
Lot Size(sq.ft.): 9888.12 Owner: BRUMBERG MARK D& DONNA B LILBORN
Zoning. URB000)/ Applicant. VALLEY HOME IMPROVEMENT INC
AT: 139 FEDERAL ST
Applicant Address: Phone: Insurance:
P O BOX 60627 413 584-7522 Workers Compensation
FLORENCEMA01062 ISSUED ON.10/16/2019 0:00:00
TO PERFORM THE FOLLOWING WORK.- CONVERT SINGLE FAMILY INTO TWO
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector
Underground: Servic : Meter:
Footings:
Rough: Rough House# Foundation:
Driveway Final:
Final: Final:
Rough Frame:
Gas: Fire Department Fireplace/Chimney:'
Rough: Oil: Insulation:
Final: Smok : Final:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occupancy signature:
Feer e: Date Paid: Amount:
Building 10/1 /2019 0:00:00 $237.25
12 Main Street, Phone(413)587-1240, Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
File# BP-2020-0474
APPLICANT/CONTACT PERSDN VALLEY HOME IMPROVEMENT INC
ADDRESS/PHONE P O BOX 6 627 FLORENCE (413)584-7522
PROPERTY LOCATION 139 F DERAL ST
MAP 30B PARCEL 097 001 Z NE URB 100 /
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION C
CLOSED QUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid
Typeof Construction: -CONVERT SINGLE FANALY TWO
New Construction
Non Structural interior renovations
Addition to Existing_
Accesso 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 PERM IT 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 PER IT REQUIRED UNDER: §
Finding Special Permit Variance*
Received&Re orded at Registry of Deeds Proof Enclosed
Other Permits Required:
Curb Cut from PW 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
Demolition Delay
Si ature of Building Official VU Date
Note: Issuance of a Zoning pe mit 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 form re.information.
Department
� ,r
City of orth mpton V Stagy of Permit, � hn �. � ��
f � Building Dep rtmentCurb ut/prt�eWay Permit�xl
f. Y rr :�'k� ' a'9lc iu3. n5 a �S y rsr y} it
'1 12lain tre�CT Se r/SeUcAvailabt{ �fi . � a ,.,y3tr { , + s$rA Rom 00 2019 Wa r/V1/ IlAvai�laLbilrty ' ''
Northampton 'M � Setso�f�StructuDIA
ralPtans���h����y�'
_, .. phone 413-5�7-1240 F TIONS
.,-.--,.��,i'' �_', a S tb�S'��Ya`� v..�r'`r�3'$rr �%�•rr r � t'�r fd4'.
4
APPLICATION TO CONSTRUCT,ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION t-SITE.INFORMATION.:
This section to be completed by office � s '
1.1 Property Address:
Q e (� .. 't L4 Lot yIr� Umtvl "
(3 l F-eG[CrG�-,( U Map
� � t•_
sELm.SQ74 J
rsfnct:, .,.,i:•._ e,:t�r:CB D+strwt: 3- - y;
SECTIO[ 2--PROP ERTY'OWNERSH I /AUTHORIZED AGENT:..
2.1 Owner of Record:
�iac(L, tn, ►:�q TFed kal %rencc I(le= Qi oCoZ
Na Print) Current Mailing Ad ress:
�(�- 31f l-
Telephone
2.2 Authorized Agent:
�►er P-o•(�ox (00(Oa1, Rorer-)c.L M(k of c)C.-2
Name(Print) Current Mailing Address:
j" X13-5'81- 522
Signature Telephone
SECTION 3'=ESTIMATED CONSTRU' TION COSTS. '
Item Estimated Cost(Dollars)to be Official]Use.Only
completed by permit applicant
1. Building _3CD� roo : (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) 3 6 Sca Check Number Lp
This.Section:For:Official:Use Onl .
Date
Building Permit-Number: (sued:
Signature: jX0
�d I�
Building Commissic her/lnspector of Buildings - Date
EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR)
Section 4. ZONIN 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
, t
Lot Size \ l
Frontage ' I ! ! E
Setbacks Front
t
Side L:�u ''\R L:£ R:� a
Rear \' f
Building Height
Bldg. Square Footage
Open Space Footage
(Lot area minus bldg&paved \ i
arida )
#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 0 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 0 DON'T KNOW 0 YES 0
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 0
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 0
IF 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 common plan
that will disturb over 1 acre? YES 0 NO 0
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 ❑ Replacement Windows Alteration(s) Roofing ❑
Or Doors 0
Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [E Siding [O] Other[0]
Brief Description o Proposed
Work: Qtyll)ouct N/D 7D FAM1LX l FU ye
Alteration of existing bedroom ;K,— es No Adding new bedroom Yes —'K—Noy Z� 9�
Attached Narrative Renovating unfinished basement Yes X No
Plans Attached Roll -Sheet
--ir_--v--..-_� :. 'N=c — '.�-.r_:s
saffiAievirhouse artd,a�c atlitionaextsfrng hos1.
rtc�,comlalefe= tie` o7owiri :
a. Use of building: One Family Two Family '�( Other n
b. Number of rooms in each family u it: Number of Bathrooms 1 f�c�r2
d. Proposed Square footage of new onstruction. G Dimensions
e. Number of stories? y
f. Method of heating? ryi/W — 01c. 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 wet ands? Yes �_No. Is construction within 100 yr. floodplain Yes No
j. Depth of basement or cellar floor below finished grade 7
k. Will building conform to the Building and Zoning regulations? X Yes No .
I. Septic Tank City Sewer Private well City water Supply
SECTION 7a.-OWNER AUTHORIZATIO K;n TO BE COMPLETED.WHEN
:.OWNERS:AGENT-OR:CONTRACTOR APPLIES:FOR BUILDING PERMIT
1, MaAAC Z>(Uy��QX� ( l�,�nC ��l a r 1J as Owner of the subject
property
hereby authorize GI erm
to act on my behalf, in atters relative to work authorized by this building permit application.
er-ion, Date
I, 14-T as Owner/Authorized
Agent hereby declare that the staterner is 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.
-e�er1 � I vier •
Print Name
Signature of Owner/Ag nt Date
SECTION 8-' CONSTRUCTION SERVICES -
. 71
8.1 Licensed Constructions Supervisor: C y Not Applicable ❑ q
Name of License Holder
License Number
Address Expiration Date
x.13--58�I-�5aa
Signature hone
i
^. Y, i_i�` Lei
rte'
�RfZegisteEedAFlorne[mpraremenContractort � .._ _-s = �, .°X _ Not Applicable ❑
Lone, ►1��o��mend- I C�55N3
Company Nafhe Registration Number
Pl `I I I 1 I Zo
Address Expiration Date
Telephone q'3-59q-75z
SECTI01410=WORKERS?COMPENSATION.INSURANCEAFFIDAVI.T(M.G.L c.t52; 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...... ❑
i
�,rwew..,,,<,.4.rayaorfiyy.; j
City of Northampton
w Massachusetts 3'' `• `�'�.
DEPARTMENT OF BUILDING INSPECTIONS �?
212 Main Street • Municipal Building ♦S .
rT _ Northampton,..MA 01060 `+.
AFFIDAVIT-
Home Improvement Contractor Law
Supplement to Permit Application
The Office of Consumer AAirs and Business Regulation("OCABR")regulates the registration of contractors and-
subcontractors performing improvements or renovations on detached one to four family homes.Prior to
performing work on such homes, a contractor must be registered as a Home Improvement Contractor("HIC").
M.G.L. Chapter 142A requires that the"reconstruction,alteration, renovation,repair, modernization, conversion,
improvement, removal, demolition, or construction of an addition to any pre-existing owner-occupied building containing
at least one but not more than four dwelling units....or to structures which are adjacent to such residence or building"be
done by registered contractors.
Note:If the homeowner has contracted with a corporation or LLC, that entity must be registered
CON\114,T. JiftE ,
Type of Work:1'0 LA t- Est.Cost:
Address of Work: C't V-2
Date of Permit Application:
I hereby certify that:
Registration is not required for the following reasoi.(s):
Work excluded by law(explain):
_Job under$1,000.00
_Owner obtaining own permit(explain):
Building not owner-occupied
Other(specify):
OWNERS OBTAINING THEIR OWN PERMIT OR ENTERING INTO CONTRACTS WITH UNREGISTERED
CONTRACTORS OR SUBCONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK ARE NOT
ELIGIBLE FOR AND DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND
UNDER M.G.L.Chapter 142A.SUCH OWNERS ALSO ASSUME THE RESPONSIBILITES FOR ALL WORK
PERFORMED UNDER THE UILDING PERMIT.SEE NEXT PAGE FOR MORE INFORMATION.
Signed under the penalties of perjury:
I hereby apply for a building ermit as the agent of the owner:
v�m allk dil c 0 5y3
Date Contract6r Name HRC Registration No.
OR:
Notwithstanding the above notice,I hereby apply for a building permit as the owner of the above property:
Date Owner Name and Signature
City of Northampto-
Massachusetts5�5,
` DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street • Municipal Building JLt
Northampton, MA 01060
Massachusetts Residential Building Code
Section 110.R5.1.2
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.
Section 110.R5.1:3.1
Any homeowner performing work for which a building permit is required shall be exempt from
the licensing provisions of 780 CMR 110.R5, provided that if a homeowner engages a person(s)
for hire to do such work, then such homeowner shall act as supervisor.
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.
i
City of Northampton
Massachusetts
DEPARTMENT OF BUILDING INSPECTIONS `. ;"
y 212 Main Street •Municipal Building
a
Northampton, MA 01060 'mss Y �~,
Debris 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 111, S 150A.
The debris from construction work being performed at:
act 6A
(Please print house number and street name)
Is to be disposed of at:
'VqDtQ Vc \C)
(Ple ` e print ndFde and loc on of facility)
Or will be disposed of in a dumpster onsite rented or leased from:
(Company Name and Address)
Signatu ffWiYAppIicanf Y Ow r to
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.
The Commonwealth of Massachusetts
Department of IndustrialAccidents
1 Congress Street,Suite 100
Boston,MA 02114-2017
www.mass.gov/dia
Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers.
TO BE FILED WITH THE PERNTrMG AUTHORITY.
Applicant Information Please Print Legibly
Name(Business/0rganization/Individual): ,',I , -MAI•ipnp.\l-P,fYI-P.f- t Th C.
Address: p,0 .bDN
City/State/Zip: IF k1Pnuc, t4l 0�bb2 Phone#: �13-5g`�'`ISaa
Are you an employer?Check the appropriate box:
Type of project(required):
1.KI am a employer with I B mployees(full and/or part-time). 7. [J New construction
2.[:]I am a sole proprietor or partnership and have no employees working for me in $, 2g Remodeling
any'capacity.[No workers'comp.insurance required.]
3.M I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 9. El Demolition
10E]Building addition
4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will
ensure that all contractors either have workers'compensation insurance or are sole 11.E]Electrical repairs or additions
proprietors with no employees. 12.❑Plumbing repairs or additions
5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet 13.❑Roof repairs
These sub-contractors have employees and have workers'comp.insu anceJ
6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.❑Other
152,§1(4),and we have no employees.[No workers'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 the policy and job site
information.
Insurance Company Name: V10t
Policy#or Self-ins.Lic.M 00'� Expiration Date: 07 l { ;
Job Site Address: V:�) 1 TDf di r•C-. C YPPA— City/State/Zip: BofpyyL ft– 0% 02,
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance
coverage verification.
Ido hereby certify under the pains and penalties of erjury that the information provided above is true and correct
Signature: +f �p Date: Z
(�
Phone M `1 l)-Ssq---I 59a
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#1:
Commonwealth of Massachusetts
Division of Professional Licensure
Board of Building Regulations and Standards
Const\ Upervisor
II
CS-077279 1? E fres: 06/21/2020
C 'i� _
STEVEN A sOVERMAN'.�
268 FO MER R0�4D
SOUTHAMPTON--yA-.010_73 �O
4,01,SS3jO�s
T ,
Commissioner C z
Office of Consumer Affairs and Business Regulation
One Ashburton Place - Suite 1301
Boston, Massachusetts 02108
orae Improvement-,Contractor Registration
Type: Corporation
VALLEY HOME IMPROVEMENTy,INC LI Registration: 105543
P.O.BOX 60627 r Expiration: 07/16/2020
FLORENCE,MA 01062
_
Update Address and Return Card.
20M-05/17 ,
Office of ConsumerAPfairs&Business Regulation
HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only
TYPE:-Corooration before the expiration date. If found return to:
Registr.`ation. Expiration Office of Consumer Affairs and Business Regulation
.05 07/16/2020 One Ashburton Place-Suite 1301
VALLEYHOME.'REQUENEhJ. INC Boston,MA 02108
STEVEN A.SILVER'NIATI '� (`5�
340 RIVERS
IDEDR��'`��s�
NORTHAMPTON,MA 01062 Undersecretary Not valid without Signature
This plan is the proprietary work product of Valley Home Improvement,Inc.(VHI).It is delivered for the limited and exclusive purpose of supporting the contract bid of VHI,and customer agrees that the elements of this plan shall not be republished or presented in any
form for the purpose of enabling or supporting the work of competing project contractors without the permission of,and compensation paid to,VHI.
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Valley Home Improvement, Inc. 139 FEDERAL ST. EXISTING SCALE:SEEVIEW SHEETNUMBER
340 Riverside Drive, PO Box 60621, Northampton, MA 01062 NORTHAMPTON, MA 01060 DATE:10/1=019
Office Phone 413.584.1522 Fax 413.585.0820 LILBORN AND BRUMBERG CON DTI O N S DRAWN BY: 2
Find us on the web at: uuw.Va11eL4Horre1m rovement.cornC.M.S. R,v-nn 91-
This plan is the proprietary work product of Valley Home Improvement,Inc.(1/1-11).It is delivered for the limited and exclusive purpose of supporting the contract bid of VHI,and customer agrees that the elements of this plan shall not be republished or presented in any
form for the purpose of enabling or supporting the work of competing project contractors without the permission of and compensation paid to,VHI.
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n the web at: www.ValleL4HOmelmprovement.com C.M.S.
This plan is the proprietary work product of Valley Home Improvement,Inc.(VHI).It is delivered for the limited and exclusive purpose of supporting the contract bid of VHI,and customer agrees that the elements of this plan shall not be republished or presented in any
form for the purpose of enabling or supporting the work of competing project contractors without the permission of,and compensation paid to,VHI.
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NORTHAMPTON, MA 01060 DATE:10/10/2019
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This plan is the proprietary work product of Valley Home Improvement,Inc.(VHI).It is delivered for the limited and exclusive purpose of supporting the contract bid of VHI,and customer agrees that the elements of this plan shall not be republished or presented in any
form for the purpose of enabling or supporting the work of competing project contractors without the permission of,and compensation paid to,VHI.
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N, MA DECK FRAMING & SCALE SEE VIEW SHEET NUMBER
NORTHAMPTON, MA 01060 DATE:10/10/2019
340 Riverside Drive, PO Box 60621, Northampton, MA 01062
Office Phone 413.564.1522 Fax 413.565.0620 LILBORN AND BRUMBERG FOOTING PLAN DRAWN BY: 5
Find us on the I.veb at: UALWA/alle Homelm rovement.cornC.M.S.
This plan is the proprietary work product of Valley Home Improvement,Inc.(MI).It is delivered for the limited and exclusive purpose of supporting the contract bid of VHI,and customer agrees that the elements of this plan shall not be republished or presented in any
form for the purpose of enabling or supporting the work of competing project contractors without the permission of,and compensation paid to,VHI.
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Valley Home Improvement, Inc. 139 FEDERAL ST. SCALE:SEE MEW SHEET NUMBER
340 Riverside Drive, PO Box 60621, Northampton, MA 01062 NORTHAMPTON, MA 01060 2ND FLOOR EGRESS DATE:10110/2019
Office Phone 413.584.1522 Fax 413.585.0820 LILBORN AND BRUMBERG FRAMING DEPICTIONS DRAWN BY: 8
Find us on the web at: uuw.Valle Homelm provement.com C.M.S.
This plan is the proprietary work product of Valley Home Improvement,Inc.(VHI).It is delivered for the limited and exclusive purpose of supporting the contract bid of VHI,and customer agrees that the elements of this plan shall not be republished or presented in any
form for the purpose of enabling or supporting the work of competing project contractors without the permission of,and compensation paid to,VHI.
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Valley Home Improvement, Inc. 139 FEDERAL ST. SCALE:SEE VIEW SHEET NUMBER 340 Riverside Drive, PO Box 60621,, Northampton, MA 01062 NORTHAMPTON, MA 01060 DECK FRAMING DATE:10/10/2019
Office Phone 413.584.1522 Fax 413.585.0820 LILBORN AND BRUMBERG ELEVATIONS DRAWN BY:
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Find us on the web at: UUW.Valle HomeImprovement.comL I C.M.S.
This plan is the proprietary work product of Valley Home Improvement,Inc.(VHI).It is delivered for the limited and exclusive purpose of supporting the contract bid of VHI,and customer agrees that the elements of this plan shall not be republished or presented in any
form for the purpose of enabling or supporting the work of competing project contractors without the permission of,and compensation paid to,VHI.
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Palley Home Improvement, Inc. 139 FEDERAL ST. SCALE:SEE VIEW SHEET NUMBER 340 Riverside Drive, PO Box 60621, Northampton, MA 01062 NORTHAMPTON, MA 01060 STAIR FRAMING DATE:10/10/2019
Office Phone 413.534.1522 Fax 413.555.0620 LILBORN AND BRUMBERG ELEVATIONS DRAWN BY: 7
Find us on the web at: uuw.VaJ1ei4HomeImprovement.com C.M.S.