24A-094 (3) 30 DICKINSON ST BP-2020-0575
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:24A-094 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-2020-0575
Project# JS-2020-000987
Est.Cost: $11000.00
Fee: $71.50 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: VALLEY HOME IMPROVEMENT INC 077279
Lot Size(sa. ft.): 11020.68 Owner: MADELONI DAVID& BARBARA B
zoning: URA(100)/ Applicant: VALLEY HOME IMPROVEMENT INC
AT. 30 DICKINSON ST
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.INSULATION,DOOR, REBUILD LANDING &
STAIRS
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. miiwim,, 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:
FeeTvpe: Date Paid: Amount:
Building 11/5/2019 0:00:00 $71.50
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
�'; f, ,_ � DepaJJrtmerit use only
City of Northampton status of Permit
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A- Building DepartmentG-u-rb LIJDnveway Permit
-. 212 Main Street sewer/ ty _
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Room 100 WgtkN- .Vbll Availability
Northampton, MA 01060 aSes of Structural Plans
-�s
f phone 413-587-1240 Fax 413-587-1272P s e Plans
Other Spec
APPLICATION TO CONSTRUCT,ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1-SITE INFORMATION
1.1 PropertyAddress: *µ � This section to be completed by offices
3o Pckao son S - Ma t
rP
Lot unit
Z Zone50 1 OverlayDistnct -- a1-P l
v is P
3 r --
}E m SLC6stnct CB District
SECTION.Z--PROPERTYOWNERSHIP/AUTHORIZED AGENT:
2.1 Owner of Record:
t
Had e Ion 1 30 Dic inscn A2- 16�
Name(Pri Current Mailing Addre
�f�, !( Iq
Telephone
Sig ture
Authorized Agent:
1 �2r Ct P �4X ho�a1, Floret--)c-r_ 'MA' O%OG,2-
Name(Prin Current Mailing Address:
Signature Telephone
SECTI6Ph3-- ESTIMATED CONSTRUCTION COSTS-
Item Estimated Cost(Dollars)to be Officiat Use Only
completed by permit applicant
1. Building n� (a1 Building Permit Fee
2. Electrical ✓�l/ (b)Estimated Total Cost of
.G'onstructibn from(6): '.
3. Plumbing Building Permit Fee .
4. Mechanical(HVAC) I
5. Fire Protection
6. Total=(1 +2+3 +4+5) Ott, M I.
Check Number
Tliis Section'.FocOfficial Use Only
Date
Building Permit Number: Issued:
Signature:
Buil ing Commissioher/lhspector of Buildings Date
EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR)
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 F i
Frontage
Setbacks Front
Side L:= R:= L:= R:=-
Rear
Building
:=RearBuilding Height
Bldg. Square Footage % r-
Open Space Footage %
(Lot area minus bldg&paved �� E
adds )
#of Parking Spaces
Fill: ...,,._.......�_.._.._.� ._�.._...SI�._.._.. f
(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 ® DONT KNOW 0 YES 0
IF YES: enter Book Page and/or Document#1
1 I
B. Does the site contain a brook, body of water or wetlands? NO 0 DON'T KNOW (D YES l;
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 Q
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 i
that will disturb over 1 acre? YES ® 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 [❑] Decks [Q Siding [p] Other[p]
C V
Brief D scri do of Pro osed �,,p ( �,
Work: �� } �1� ✓ Yli + lCt if'ia'
Alteration of existing bedroom Yes No Adding new bedroom Yes _�_No
Attached Narrative✓ Renovating unfinished basement -Yes No
Plans Attached Roll -Sheet
sa If Newhouse and,or acfdition:'to ex strng hotrs r-
coMOleteatie following:
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
I, )CLV�- il /1G. \ Yi1[ ICAC l as Owner of the subject
property cc LL
hereby authori e �E�I c_7re�n S) JV erMCLr?
to act on ehalf, in all matters relative to work authorized by this building permit application.
Signa re of Owner D t
I, a-e.11_.f'1 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.
egon I Q-crrnan
Print Name
/////A�
Signatur of Mne'(/46ent OFDate
SECTIOhf 8-CONSTRUCTION SERVICES
8.1 Licensed Constructions Supervisor: C Not Applicable ❑ q
Name of License Holder:
License Number
c (o mer �hntic� A o i a� 3 (o I a I 1 ao
Address . Expiration Date
1►3-�8y-�5aa
Alh-
sigwfuAT phone
-.. ,v::.'-^c�xrT�—�e,--tip-.�-rz-`x...:�.�-�-Yom.•.--^�r•7?' ^ ,,'a' a'—^z—'�3 a} �,.,"S RealSteEed!'Nome.EmpEOveSnent COntractOt _ ._.: aR. ._. a �3''' F
�. tl - � Not Applicable ❑
I(AAEg
Company N e Registration Number
2-6 , bag (.00(0 -7 E[Q( .rtCG MR 010602 `I �
Address Expiration Date
Telephone�i�3-5gy-75z
SECTION 10�WORKERS'COMPENSATION.INSORANCEAFFIDAVIT(M.G,.L.c.152, 25G(6)1
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
1 '
City of Northampton
S,s• -.�,SF�
•`'
Massachusetts-
DEPARTMENT
assachusetts DEPARTMENT OF BUILDING INSPECTIONS
l uy F 212 Main Street • Municipal Building
k._ _' 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("FEC").
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
Type of Work m krrRy ' �y-��1'`s Est. Cost: CAM
Address of Work-
Date
orkDate 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:
a SICU OOM, 12V&Lin , , J-PC X055 y 3
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 Northampton
Massachusetts
�
DEPARTMENT OF BUILDING INSPECTIONS pfi
212 Main Street • Municipal Building
YS 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
..'. "F Massachusetts
DEPARTMENT OF BUILDING INSPECTIONS
- .y 212 Main Street •Municipal Building
Northampton, MA 01060
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:
Cx ir'lSCX1
(Please print house number and street name)
Is to be disposed of at:
AftjAfj� RW-A-AOJ)J� (ke \C)
(Ple ` e print ndFde and locaeon of facility)
Or will be disposed of in a dumpster onsite rented or leased from:
(Company Name and Address)
Z/*)" Al ,
Signat e o i pplic or ner 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.
The Commonwealth of Massachusetts
Department of IndustrialAecidents
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 PERMITTING AUTHORITY.
Applicant Information Please Print Le¢ibly
Name(Business/Organization/Individual): _Tm.Oto."N-e YI-P� , tl C_
Address: L) loegoa1
City/State/Zip: �F\i7tenCP, 0\bb2 Phone#: '-E13-5S`�'-ISaa
Are you an employer?Check the appropriate box: 'Type of project(required):
1.91 am a employer with I B mployees(full and/or part-time).* 7. ❑New construction
2.❑I am a sole proprietor or partnership and have no employees working for me in 8. Remodeling
any'capacity.(No workers'comp.insurance required.]
3.❑I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 9. El Demolition
10 E]Building addition
4.❑I am a homeor/ner 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 11.0 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 J
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.]
IL
*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: Aa(blf 751SC)acX 6 V-0t 1
Policy#or Self-ins.Lic.M CC 'EC&0302\5 Expiration Date: a I I ;
��ll
Job Site Address: DNC)LAnc- r C7'l' City/State/Zip: 4-6n ma 0 I G(a b
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expir tion 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
m
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.
I do hereby certify under thepainsenalties of erjury that the information provided above is true and correct
and
Simafore: 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:
r. r
Commonwealth of Massachusetts
®� Division of Professional licensure
Board of Building Regulations and Standards
Constr�Uy6(SNiSpervisor
if
CS-077279 _> �� Etpires: 06/21/2020
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STEVEN A SIL-VERMAtf
268 FOMER ftO'AD
SOUTHAMPTO .01073:% �O
•�fjI,SS�330�5
Commissioner l/"`^"
�a1 �li
Office of Consumer Affairs and Business Regulation
One Ashburton Place - Suite 1301
Boston, Massachusetts 02108
Home Improvements:Cor�tractor Registration
Type: Corporation
VALLEYHOME IMPROVEMENT INCz 17 Registration: 105543
P.O.BOX 60627 r
Expiration: 07/16/2020
FLORENCE,MA 01062 y j
Update Address and Return Card.
i 20��M-0511117 �p p
✓/t6 (:JML77LS2[GL�QCC2 4`���Q.1s12C/1CG1C`lri
Office of Consumer Affairs&Business Regulation
HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only
TYPE:,Corporation before the expiration date. If found return to:
Registration E iration
xP Office of Consumer Affairs and Business Regulation
05549 07/16/2020 One Ashburton Place-Suite 1301
4LLEYHOME(I'MeV :j INC Boston,MA 02108
"EVEN A.SILVERM4T1
0 RIVERSIDEDR
)RTHAMPTON,MA 01062 Undersecr Not valid without signature
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PROJECT NOTES: PROJ E GT PLAN £ X
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F 3 TH15 PLAN SET,COMBINED WITH THE BUILDING CONTRACT,PROVIDES BUILDING DETAILS FOR THE RENOVATION OWNER: MADELONI '3=
o INDEX OF DRAWINGS W p p
It t PROJECT. THE LEAD CARPENTER SHALL VERIFY THAT 51TE CONDITIONS,AND DIMENSIONS ARE CONS15TENT WITH TITLE SHEET > z T
1 1 THESE PLANS BEFORE STARTING WORK.WORK NOT SPECIFICALLY DETAILED SHALL BE CONSTRUCTED TO THE SAME PROJECT 30 DICKINSON 5T PROJECT SUMMARY 1
QUALITY A5 SIMILAR WORK THAT 15 DETAILED.ALL WORK SHALL BE DONE IN ACCORDANCE WITH INTERNATIONAL ADDRESS: NORTHAMPTON,MA MAIN FLOOR PLAN 3 L
If ` ♦` ` ._ ..__ BUILDING AND LOCAL CODES. Q
ELECTRICAL PLAN 4 C
0 0 _ t BLDG PERMIT:
a WRITTEN DIMENSIONS AND SPECIFIC NOTES SHALL TAKE PRECEDENCE OVER SCALED DIMENSIONS AND GENERAL O
Q 1 1 1 1 l 1 NOTES.THE SALE PERSON/DESIGNER SHALL BE CONSULTED FOR CLARIFICATION IF 51TE CONDITIONS ARE DE516NER: Q Ln
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lit � �- ENCOUNTERED THAT ARE DIFFERENT THAN SHOWN,IF DISCREPANCIES ARE FOUND IN THE PLANS OR NOTES,OR IFA � � �; •'
QUESTION AR15E5 OVER THE INTENT OF THE PLANS OR NOTES.CARPENTER OR SUB-CONTRACTOR SHALL VERIFY AND d� M
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o '( ALL TRADES SHALL MAINTAIN A GLEAN WORK SITE AT THE END OF EACH WORK DAY.
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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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Valley Home Improvement, Inc. 30 DICKINSON ST EXISTING SCALE SEE VIEW SHEET NUMBER
340 Riverside Drive, PO Box 60627, Northampton, MA 01062 NORTHAMPTON,MA 01062 DATE:9/17/2019
Office Phone 413.564.7522 Fax 413.585.0820 MADELONI CONDTIONS DRAWN BY:JTP 2
Find us on the web at: wuw.Valle Homelm provement.corn,
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FRAMING:
-- — — — — — -- _ INSTALL 2X6 KD RIPPED DOWN TO BRING PORGH FLOOR UP TO EXISTING RE FLOOR LEVEL IN HOUSE.m3149FXcn FRAME FOR NEW 2/8 X b/8 EXTERIOR DOOR IN EXISTING LOCATION, AT NEW FLOOR HEIGHT.
A FRAME NEW 36"X42" LANDING AND STAIRS TO GRADE. ALL MATERIALS TO
BE PRE55URE TREATED, RAILINGS ON BOTH SIDES.
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p NO SIDING WORK 15 INGLUDED OTHER THAN WHAT 15 NEEDED TO MORE a-
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\ I INSTALL 3.5" OF ROGKOOL INSULATION IN WALL5 (R15) W
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INSTALL 5.5" OF ROCKWOOL INSULATION IN THE FLOOR SYSTEM (R21)
INSTALL L005E FILL CELLULOSE INSULATION IN CEILING SYSTEM
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5HEETROGK & AGOU5TIGAL GEILING:
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INSTALL VAPOR BARRIER UNDERLAYMENT IN BOTH BATHROOM AND REG o
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INSTALL FLOATING LVT FLOORING TBD BY ALLOWANCE
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1X6 PRIMED FJP FLAT STOCK BA5EBOARD5
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SUPPLY & INSTALL (1) 2/8X61b THERMATRU 5262 WITH FIXED GRILLES. S E "
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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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Palley Home Improvements Inc.
30 DICKINSON ST SCALE:SEE VIEW SHEET NUMBER 340 Riverside Drive, PO Box 60627, Northampton, MA 01062 NORTHAMPTON,MA01062 ELECTRICAL DATA, DATE:9/17/2019
Office Phone 413.584.7522 Fax 413.585.0820 MAD E LO N 1 & AUDIO PLAN DRAWN BY:JTP 4
Find us on the web at: UUWA/alle HomeIm rovement.com