16B-060 (8) 9 HAYWARD RD BP-2020-0577
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 16B-060 CITY OF NORTHAMPTON
Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: Ramp BUILDING PERMIT
Permit# BP-2020-0577
Proiect# JS-2020-000989
Est.Cost: $16500.00
Fee: $110.50 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: VALLEY HOME IMPROVEMENT INC 077279
Lot Size(sa.ft.): 15333.12 Owner. ADAMS BRIAN &PHIPPEN EDITH M
Zoning: URB(100)/ Applicant. VALLEY HOME IMPROVEMENT INC
AT. 9 HAYWARD RD
Applicant Address: Phone: Insurance:
P O BOX 60627 (413) 584-7522 Workers Compensation
FLORENCEMA01062 ISSUED ON.11/5/2019 0:00:00
TO PERFORM THE FOLLOWING WORK.-ADD RAMPS, ALTER CLOSET, REPLACE
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# 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 11/5/2019 0:00:00 $110.50
212 Main Street, Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
*Departrr�erttuse"on[y G. � '4`" r
`4.}?;is si *tt "".kg .c N°.•xs s '' tit t 5
City of Hort amp n A-
D jof Permtt� L� �¢ ,
Y Building art ent r cut/ eWay Permit
..•q 212 Mai S;et /VoS se use UcAaifabil�y
�4+� r
:r Roo 12019 ter IIAvailabif ty ,u !� s' ` P z
7 t, � rtt•P �• x L
Northamptfi0 aS solxStructuralPfans > Y `�, kxaI3�3• fit(
phone 413-587-1240 Fax 7o �� lot/S2fans F ;i`� t ,
ItrQ �'/ r
vt�oN CthekSpecify'
APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR LISH A ONE OR TWO FAMILY
DWELLING
"SEc.16'. 1-SITE 1NFORMATI01�f
This section to 6e completed byoce_ PZi
s
I r i rf660: V_v51F 9� E1.1 Property Address �K. cif{
nit iR.P� E M:
-'`O(PXZC't- :ZoFle P OverlayDrstrIetr ;5
sEtmBtr:Qistnct CBDistrfct
SECTION Z' PROPERTY OWNERSHIPlAUTHORIZED AGENT' .
2.1 Owner of Record:
�an { ms + Morey Phi We) q 4a Liwa ut VAc)rn,nce-
N tint) �2L
Current Ma ' g Address:
Telephone
Signature
2.2 Authorized Agent:
tiger P-oRorer--)cc a►(�(�2_
Name(Print) CurFent Mailing Address:
413-58y-`1522
Sig Telephone
SECTION 3=ESTIMATED CONSTRUCTION'COSTS:
Item Estimated Cost(Dollars)to be Officiat.Use•Only
completed by permit applicant
1. BuildingVry (a)Building Permit Fee
2. Electrical (b)Estimated Tdtal Cost of
`:> .C'onstructibn from 6 •. '
3. Plumbing 2V Building Permit Fee
4. Mechanical(HVAC)
5. Fire Protection i
6. Total=(1 +2+3+4+5) Check Number
This.Section'.Fbr:Official:Use Only
Permit- Date
Building. Issued:
Signature: Wji
Building Commissioher/Inspector of Buildings Date
J wxif� @ �1a11 � �mAr�,r -iC�n�
EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR)
' G
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
i
Side L:= R:= L:!__.I R:= ED
Rear
Building Height I
Bldg. Square Footage -- % J
Open Space Footage %
(Lot area minus bldg&paved
arldn )
#of Parking Spaces
Fill: _. f
volume&Location)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO 0 DON'T KNOW 0 YES
IF YES, date issued:
IF YES: Was the permit recorded at the Registry. of Deeds?
NO 0 DONT KNOW Q YES 0
IF YES: enter Book Page and/or Document#1
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: F-
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 a 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 E-1
Accessory Bldg. ❑ Demolition ❑ New Signs [❑] Decks [0 Siding [O] Other[Q]
Gym w _ r
Brief De�sgietion of Proposed �. `
Work: MU VLtrCiWt t fA,- tvf �ULQ� 6 C�'1 W(Y�J
Alteration of existing bedr om Yes No Adding new bedroom Yes _�No
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll -Sheet �4
6a.If New House-and.or addition to.extstrrg hots[ng, complete thefollovitng:
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 �► et'M
to be in all matters relative to work authorized by this building permit a licat n.
Signat O Date
I. 7eA�1f �I I�►erman V}�� as Owner/Authorized
Agent hereby declare that the statements 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.
Print Name
Signat r of Own /Agent Date
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Constructions Supervisor: Not Applicable ❑ q
Name of License Holder: C 1T�V`f'.rZ S l l�{'Irl ZCl�r1 0 a J
License Number
� 101 Iaa
Address Expiration Date
Lk 1-;5-58 9--1 5
Signa ne,
-�
Rdgis -H .arrie.[mptoVeirrien ;Contractor �__ � `ter} '� �.__ Not Applicable ❑
In ��em ��- Iy 55 q3
Company NaFfie Registration Number
ft - mac. Couo;g F lo(en cG MR U)C)X 2- `I `
Address p/ Expiration Date
Telephone
SECTION 40=WORKERS'COMPENSATION-INSURANCE AFFIDAVIT(M.G.L c.452.; 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
City of Northampton
Massachusetts
Ulmy DEPARTMENT OF BUILDING INSPECTIONS
.� J :
J�
3-' 212 Main Street • Municipal Building y
Northampton, _MA 01060
AFFIDAVIT.
Home Improvement Contractor Law
Supplement to Permit Application
The Office of Consumer Affairs 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('TEC").
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.
Nate:If the homeowner has contracted with a corporation or LLC, that entity must be registered
Type of Work: 1,n1 WlbV'kW 1VOkLY)� ( AC �Est.Cost:
Address of Work `TLIEPLX t
Date of Permit Application:
I hereby certify that:
Registration is not required for the following reasorl(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 BUILDING PERMIT.SEE NEXT PAGE FOR MORE INFORMATION.
Signed under the penalties of perjury.
I hereby apply for a building permit as the agent of the owner:
ev&nn 4 1n c. 1055 X13
Date Contract6r Name HIC 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 Nor_thamptrT
Massachusetts
"c
135
DEPARTMENT OF BUILDING INSPECTIONS ?
212 Main Street • Municipal Building Jim f�
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.
City of Northampton
{ = a Massachusetts
i l G.
DEPARTMENT OF BUILDING INSPECTIONS .
212 Main Street •Municipal Building
-, Northampton, MA 01060 byes.
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:
vl �Acj Lux'L A-d k' -C'
(Please print hou number and street name)
Is to be disposed of at:
- Kk- ND
(Ple ` e print nd e and loc on of facility)
Or will be disposed of in a dumpster onsite rented or leased from:
(Company Name and Address)
Signature r i plicant or Owner D 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 Industrial Accidents
I Congress Street,Suite 100
Boston,MA 02114-2017
www mass.gov/dia
'Porkers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers.
TO BE FILED WITH THE PERMITI'7NG AUTHORITY.
Applicant Information Please Print Legibly
Name(Business/Organization/Individual): \fl t fl,-P11 1't�Y If -ip�p.��Qm Pt t 1b L
Address: p O bcx, �000�1
City/State/Zip: V\a(er)C:e. V4W 0�bb2 Phone#:
Are you an employer?Check the appropriate box:
Type of project(required):
1.9I am a employer with 18 mployees(frill and/or part-time).* 7. ❑New construction
2.❑I am a sole proprietor or partnership and have no employees working forme in $, 01 Remodeling
any-capacity.[No workers'comp.insurance required-]
3.F1 I am a homeowner doing all work myself.(No workers'comp.insurance required.]t 1• El Demolition
10 E]Building addition
4.[:]l am a homeowner and will be hiring contractors to conduct all work on my property. I will
ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions
proprietors with no employees.
12.❑Plumbing repairs or additions
5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet 13.❑Roof repairs
These sub-contractors have employees and have workers'comp.insurance$
6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.❑other
152,f 1(4),and we have no employees.(No workers'comp.insurance required]
It
*Any applicant that checks box#1 must also fill out the section below showing their woikers'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: 7Ix1S(_)6a"e_
Policy#or Self-ins.Lic.M 0�c,&d 3 O'Z-\5 Expiration Date:
Job Site Address: "OULA � Aa PiNt— City/State/Zip: D(Dn2koLer a 0(vz—
Attach a copy of the workersl mpensation 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$1,500.00m
and/or one-year imprisonment,as well as civil penalties in the forof 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
Si ature: +' fI / Date:
Phone#:
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 4:
Commonwealth of Massachusetts
Division of Professional Licensure
Board of Building Regulations and Standards
Con st`�&flvSb'pe jvisor
If
CS-077279 > E-Aires:06/21/2020
1 iz
STEVEN A SIWERMAN
268 FOMER ROD
SOUTHAMPTON'YA'•01073 >C
47�SS3�O�S
Commissioner
��7�P CJ4��2��?ia/IC1tP�Cl'��a' �iG�(% Crill?L�e'c�iGc�
Office of Consumer Affairs and Business Regulation
One Ashburton Place - Suite 1301
Boston, Massachusetts 02108
Home Improveme ti:Contractor Registration
Type: Corporation
VALLEYHOME IMPROVEMENT INCX 17 Registration: 105543
L
P.O.BOX 60627 r ,� Expiration: 07/16/2020
FLORENCE,MA 01062 �, y
u�•y `yali
Update Address and Return Card.
I G 20M-05117 ,
✓� intinncretcw_¢Cl�n�./,��¢.sj¢�tielli .
Office of Consumer Affairs&Business Regulation
HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only
TYPE:%Corooration before the expiration date. If found return to:
Registration. Expiration Office of Consumer Affairs and Business Regulation
"05 07/16/2020 One Ashburton Place-Suite 1301
VALLEYHOME- 2� Ed: INC Boston,MA 02108
STEVEN A.SILVE Iv1;4Tla
340 RIVERSIDEDR
NORTHAMPTON,MA`0 62 Undersecretary Not valid without signature
Pill
/^ Pl ;ria �1r� _.
Joe_
VALLEY HOME IMPROVEMENT, INC. OF
340 Riverside Drive P.O. Box 60627 SHEET NO
NORTHAMPTON, MASSACHUSETTS 01062 CALCULATED BY DATE -TEL (413) 584-7522 FAX (413) 585-0820
www.valleyhomeimprovement.com CHECKED BY DATE --
SCALE
V
I
Brian Adams& Morey Phippen
9 Hayward Ave
Florence, MA 01062
September 30, 2019
CONSTRUCTION SPECIFICATIONS
Demolition
Remove and discard approximately 4'of built-in cabinetry(where the cabinets stop), (1)full height cabinet, utility sink,
recycling cabinet,vinyl flooring in hallway and necessary framing and drywall for new entry door.
Remove and discard door between living room and sunroom.
Remove and discard tub/shower, shower controls and vinyl tile wall panels.
Remove and discard double casement window and interior and exterior trim.
Framing
Frame new door opening into garage
Garage Entry- Frame a 36"x42" landing with pressure treated framing and CDX plywood top ramp in the garage
Rear Ramp- Frame new landing to be 42"x42" with a 6' ramp to grade for rear entry into sunroom with pressure treated
lumber—approximately 2/12 pitch (Does not meet ADA). Ramp and landing to be free standing and not attached to the
ground or house.
Decking&Railing
Install and in-stock Timbertech gray decking and matching composite fascia to rear ramp. Picture frame decking and
install with hidden fasteners. Perimeter decking will be fastened through the face of the decking board.
Railings on rear ramp by allowance-to be 1.25" metal, round, painted, custom fabricated and attached to the left side
of the ramp/landing and the sunroom wall.
Install a Brosco WM231 wood railing on the garage wall
Doors
Supply& install (1) 3/0 x 6/8,Thermatru Smoothstar, 6 panel fire door, right hand swing,4 9/16"jamb and On-Guard
Primed standard brickmould exterior casing.
Supply& install (1) 3/0 x 6/8,Thermatru Smoothstar,full view, left hand,4 9/16" primed jamb, single bore, reuse
existing lockset.
1
c
Windows
Supply&install (1) Harvey,vinyl, new construction, double casement,triple paned window in existing rough opening.
Electrical-All work by allowance
Install new(2) light switches at new garage entry to existing hall light and to existing garage light.
Flooring
Install new vinyl flooring in entry and hall by allowance.
Drywall
Patch drywall in garage with 5/8" drywall, apply tape and (1) coat of joint compound with no sanding.
Patch drywall on walls and ceiling as necessary in hall at new garage entry.
Demobilization
Dispose of all construction materials and debris and clean up job site
2