18C-058 (8) 150 PROSPECT AVE BP-2020-0920
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Biock: 18C-058 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: Bath reno BUILDING PERMIT
Permit# BP-2020-0920
Proiect# JS-2020-001570
Est.Cost:$8000.00
Fee: $65.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group VALLEY HOME IMPROVEMENT INC 077279
Lot Size(sa.ft.): 40336.56 Owner: MARKS CHRISTIAN
Zoning. URB(100)/ Applicant: VALLEY HOME IMPROVEMENT INC
AT. 150 PROSPECT AVE
Applicant Address: hone: Insurance:
P O BOX 60627 (413) 584-7522 Workers Compensation
FLORENCEMA01062 ISSUED ON:2/13/2020 0:00:00
TO PERFORM THE FOLLOWING WORK.-RENO AND REPAIRS TO WATER DAMAGED
BATHROOM
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. minding 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 Sip-nature:
FeeType: Date Paid: Amount:
Building . 2/13/2020 0:00:00 $65.00
212 Main Street, Phone(413)587-1240,Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
Depai finent use only
} y
City of Northa pto� Sta ofP 't�
Building Depa me t Curb W. ve ay Perm t
_ I FEB1 20 e.e se'ti -Avaifabil
212 Main Street we
P_.
-�
Room 100 II Va labilrt _�.. ."�=• Mate . e
Northampton, MA 0 of run o!rtr;tNsi= s o Structural Platls k
N.rna
phone 413-587-1240 Fax 413- = Stte:21 s
Other Spectty =
APPLICATION TO CONSTRUCT,ALTER,REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTIOP[1:-SITE INFORMATION ' '
. ... .
r �� " This section to be completedoffice
1.1 Property Address: l x 3, LA h L r
MapLot a ' - Clnifi
I 4Zone ' 4 �Overlay} rstrl
�€ rr
70
Lig
sc
V-
AE1 QisfncE.1 - ; . '4§ a,. 4�:cBbfARct:
SECTION 2:-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
154 ' /�
arae(Print) Current MailingAddress': l
�--v Telephone
Signature
2.2 Authorized Agent:
cJ'— . I Q C'r 02 t P O•�6`� �O(�a1 �'�Or>°r�C� (V1(� O►C�C�Z
Name(Print) Current Mailing Address:
AZO �-- 1+13-59q-`1522
Signature- Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official:Use Only
co pleted by permit applicant
1. Building
O (a)Building Permit Fee
2. Electrical / v (b) Estimated Total Cost of
Construction from 6
3. Plumbing nD0 Building Permit Fee .
4. Mechanical(HVAC) (/
5. Fire Protection
6. Total=0 +2+ 3 +4+5) Check Number _
This Secfion:For Offici �U
ase Only
Buildin Permit Number:
Date
g Issued:
Signature: 1 a0
Building Commissioner/inspector of Buildings nn Date
l�
EMAIL ADDRESS (REQU RED; EITHER HOMEOWNER OR CONTRACTOR)
SECTION 5-DESCRIPTION OF.PROPOSED WORK(check all applicable)
New House F-1Addition Replacement Windows Alterations) Roofing
Or Doors 0
Accessory Bldg. ❑ Demolition ❑ New Signs [E3] Decks [Q Siding [0] Other[Q]
Brief Description of Proposed
Work: �L�� IL �(J!r 1 ��..� �e� l.d��U.iI Z'� �c{vr�5 � ^ we}c^
Ac'a:)e A
Alteration of existing bedroom Yes No Adding new bedroom Yes No CP
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll -Sheet
New hodse and or addition to exrsung housing,;complete the folfowlnq:
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 cOMP.LETED 1NHEN
.OWNERS:AGENT OR CONTRACTOR.AIPPLIES:FOR BUILDING PERMIT
I, L (�"2)h 4-1 as Owner of the subject
property
hereby authorize (-= t 8�eQ-cr7 Si 1QerMCCI7?
o a on my behalf, in all matters relative to work authorized by this building permit application.
ignature of Owner ate
I, ( P��t'1 �I I�I�rY►1Qi'� V R9: 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
—S-Si7-3--
Signature
gnature er/Agent Date
City of Northampton
Massachusetts 3'Sr `•"���f.
< rk t DEPARTMENT OF BUILDING INSPECTIONS , t
212 Main Street • Municipal Building JLt
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 C"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
Type of Work: Est. Cost:
Address of Work-
Date
orkDate 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 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 �1cu ,r- 12V&'TMallk ail c 1055y3
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
/� '• jai. Massachusetts c ,
:c..
DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street •Municipal Building `�y-'t 11
1. '' .`t'3`�.- ,....-•%tom:
"Tr Northampton, MA 01060 bIY �
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:
(Please print house number and street name)
Is to be disposed of at:
�( - KkP- \C) �\bAl n4y
(Ple ` e print n� e and locatfon of facility)
Or will be disposed of in a dumpster onsite rented or leased from:
(Company Name and Address)
Signature of Kermit 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.
Commonwealth of Massachusetts ;
Division of Professional Licensure
Board of Building Regulations and Standards
Const`-,,pi pervisor
�J
CS-077279 �> I E�pires: 06/21/2020
STEVEN A SIL-VERMAN
268 FOMER ROD
SOUTHAMPTO V%,A--01073.= �O
'G7j7,SS3�O�S_
Commissioner
I
Office of Consumer Affairs and Business Regulation
One Ashburton Place - Suite 1301
Boston, Massachusetts 02108
6-' a
Home Improvementi`Conntractor Registration
�) Type: Corporation
� T�J Registration: 105543
VALLEYHOME IMPROVEMENT INC j i� Expiration: 07/16/2020
P.O.BOX 60627
FLORENCE,MA 01062 ( �
GV 10
� 4
� a
Update Address and Return Card.
1 C� 2OM-05/17
Me, �invrtcvacc�¢C°l�c ��¢i�¢rc�ell�
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
05543� 07/16/2020 One Ashburton Place-Suite 1301
VALLEY H0MEIrMPp-ROVEMENT:ZINC Boston,MA 02108
STEVEN A.SILVERMQTI171
o
340 RIVERSIDEDR' ! /
NORTHAMPTON,MA 01062 Undersecretary Not valid without signature
The Commonwealth of Massachusetts
Department of IndustrialAccidents
I Congress Street,Suite 100
Boston,MA 02114-2017
www mass.gov/dia
NVorkers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers.
TO BE FILED WITH THE PERMITTING AUTHORITY.
Applicant information Please Print Legibl
,fy
Name(Business/Organization/Individual): V OL L l-CLk o(y)G 122)2,—oJ2
Address: x-10 �Z��e✓s�c� _ ��►� 1�. O. P�nc (o0(s�21
City/State/Zip: T lOt-cn(.,c kR C>10(o'2_ Phone #: y l3-SSLI-7 S22
Are you an employer?Check the appropriate box: Type of project(required):
LE]I am a employer with 10 _employees(full and/or part-time).' 7. E)New construction
on
I am a sole proprietor or partnership and have no employees working for me in g. 0 Remodeling
any capacity.fNoworkers'comp.insurance required.]
3.❑I am a homeowner doingall work myself. t 9.
El Demolition
y [No workers'comp.insurance required.]
4.❑I am a homeowner and will be hiringcontractors to conduct all work on m 10❑Building addition
y 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.❑1 am a general contractor and T have hired the sub-contractors listed on the attached sheet.
These sub-contractors have employee.and have workers'comp.insurance t 13.�Roof repairs
6. We are a corporation and its officers have exercised their right of exe E]Other
❑ rPexemption per MGL e. 14.
152,§1(4),and we have no employees.rNo 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. Tf 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. pp
Insurance Company Name:
Policy#or Self-ins.Lic.#: 0b55o 3 b 2 Expiration Date: 0?
Job Site Address: City/State/Zip:
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 un r the pains and pe /ties of p r hat the information provided above is true and correct:
Si ature: Date: _
Phone#: L -5- 024-152 2—
Official
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#:
National Vinyl LLC. Dealer
7 Coburn Street Phone: 413-420-0548 Acknowledgement
Chicopee,MA 01013 Fax: 413-420-0560 DATE CREATED
1.30,2020
QUOTE EXPIRES
www.nvpwindows.com SHIP TO: 1 31,2021
BILL TO: 1599 Valley Home Improvement,Inc.
Valley Home Improvement,Inc. ShippingZone
340 Riverside Dr Loc-North
P.O.Box 60627 Florence MA 01062
Phone: 413-584-7522 Delivery Date
Northampton MA 01062 Mobile: 2020
Fax: Sales Person
Email: mitchL
valleyhomeimprovement.com
ORDER# STATUS CUSTOMER PO# ORDER DATE
308027 Ordered MITCHPARKER 216'2020
QUOTED BY TERMS SHIP VIA PROJECT NAME
Irider Net 10th of Month Delivered on NVP Truck MITCH PARKER
LineItem# Description \Tet Price Extended
100-1
Qty-: 1 Valley Home Improvement, Inc. $488.23 $488.23
Northwind III, Awning, Awning, 26.25 x 18.2
Overall Unit Size Frame Width = 26.25, Frame Height = -8.25
26.25" X 18.25" RO Deduction = -1/2" x-1/2", New Construction, Frame
PO; Type = Thermal Frame
26.75" X 18.75"
Color = Two Tone White / Commercial Bronze Exterior
White
Comment/Room: Full Screen, Fiberglass m
Unit 1: Glazing Type = Low E, Low E Softcoat, Gas 0T
None Assigned FIll = Argon
Unit 1 Glass: Glass Strengrh = Double Strength,Tw
I �
1 _ 26.25 ,
Unit Unit CPD Number = NVP-K-19-00359-00001, Unit Rp_2675
U-Factor = 0.26, Unit SHGC = 0.24, Unit VT = 0.43,
Unit CR = 62, Air Infiltration Rating = < 0.3
cfm/ft2, Meets Energy Star = Yes
Unit l Glass: CPD Number = NVP-K-19-00359-00001,
U-Factor = 0.26, CR = 62, SHGC = 0.24, VT = 0.43
Nail Fin Option = With J-Channel
d
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Page Printed On:2/6/2020 4:31:42 PM