31A-264 (2) 59 DRYADS GREEN ST BP-2021-1386
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 31A-264 CITY OF NORTHAMPTON
Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category:Porch Repair BUILDING PERMIT
Permit# BP-2021-1386
Project# JS-2021-002310
Est.Cost: $50000.00
Fee: $325.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: VALLEY HOME IMPROVEMENT INC 077279
Lot Size(sq. ft.): 7884.36 Owner: MILANI LILIANNA
Zoning: EU(1-00)/URC(100)/ Applicant: VALLEY HOME IMPROVEMENT INC
AT: 59 DRYADS GREEN ST
Applicant Address: Phone: Insurance:
P 0 BOX 60627 (413) 584-7522 Workers Compensation
FLORENCEMA01062 ISSUED ON:5/25/2021 0:00:00
TO PERFORM THE FOLLOWING WORK:RENO FRONT PORCH
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. I �
r •
Certificate of Occupancy Signature: i
FeeType: Date Paid: Amount:
Building 5/25/2021 0:00:00 $325.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
: I ,
,;,. cF/�
i 4lgy �0
FThe Commonwealth;of Massachusetts nn
Board of Building Regulations and Standards F °r_ c/J�,
MUNTFCilMassachusetts State Building Code, 780 CMR Ugg' Tyq�NOrN(I)
Mi'T c;,
Building Permit Application To Construct,Repair,Renovate Or Demolish a Revised Mar 201 0M,4 gSOF�T�� //
One-or Two-Fa9nily Dwelling. °so s F
This Section For Official Use Only �. -•./
Building emit Number: B 0-a 1 •- 131 Y " Date Applied:ie
EU1x-1 lKoSs C 5-25-2424
Building Official(Print Name) 1 Signature Date
SECTION 1: STTF.INFORMATION
1.1 Pr erty Address: I i 2 Assessors Mau R.Pµrcel Numbers _ L
5IP 1-L c B 6 rent n 3 l f 0 7
1.1 a Is this ari accepted street?yes 'n o I Map Number Parcel niumber
.1.3 Zoning Information: I 1.4 Property Dimensions:
Zoning District Proposed Use 1 Lot Area(sq ft) Frontage(ft)
1.5 Building Setbacks(it)
Front Yard Side Yards- I Rear Yard
Required Provided Required 1 Provided Required Provided
1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Zone: Outside Flood Zone? Municipal 0 On site disposal system 0
Public❑ Private❑ — Check if yes❑ p
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Rocnrd:
Li i i e •t .o t kan:t. -a.\<0-r enaVr1 r•1 1 '.1L),."--k--1.,Nat..,fr-t....rk-0,_ 9- Q\Ots'C:)
Name(Print) ' City,State,ZIP
S4 On-jacks G.rrece, 1 LI l3•bs• 551 8
No.and Street Telephone Finail Address
SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply)
New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition 0
Demolition 0 I Accessory Bldg.0 I Numb r of Units Other ❑ Specify:
Brief Description of Proposed_Work2: rzEmoi -I 01 r-02 f 4--i . ICJ2 -1 '."
c sA ir / N-; 1, ,t4. for--rBLt_ f -(7,7(r-� . .1 g47,loil i `y� tit ' "M
�Aiila 1k '' -- �- Z 101) i ` '" .Sri Lf4AAL 1441ir'''6
SECTION 4:ESTIMA`rED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labo and Materials
1.Building $LlI r c - I I. Building Permit Fee:$ Indicate how fee is determined:
D Standard City/Town Application Fee
2.Electrical $'J CC, ❑:Total Project Costa(Item 6)x multiplier x
3.Plumbing $ 2.':. Other Fees: $
4.Mechanical (HVAC) $ Lit:
5. .Mechanical (Fire $
Suppression) Total All Fees:$
Cheek No.41 7UC eck A:moun c flash Amount
6.Total Project Cost: . S�r 0u, LI paid in Full p Outstading Balance Due:
_
SECTION 5: CO*I UCTION SERVICES
5.1 Construction Supervisor License(CSL)
[ tJ` 21�i (0f2.4.
�V rl 1 v{ (rt License Number Expiration Date
Name of CSL Holder
List CSL Type(see below)
No,and Street Type Description
.._ ((nn,, (r �n�('� r, IJ Trr,rartri rtori iTh !dings nrtrn 741>tltl�,i fL 1.
OrPnC 4V c 0\0\1 •
._ Restricted
a e l �0 4N w ✓;vv ��.., .!
R RestrictedI&2FamilyDweiling
City/Town,State,ZIP ' ICI Masonry
Rc, rci n1imVt,gvering.
WS Window and Siding
• SF • Solid Fuel Burning Appliances
A c3�rJ A 1522-- i Insulation
Telephone Email address I D Demolition •
5.2 Reoistered Home Improvement Contracctoor(RIC) SS`k3 g+
\.10), er HIC Registration Number Expiration Date
_FTC Compaify Name or RTC Registr nt Name
NO.and Street ,t3-<aV t i z 4- Email 7 1'e$S
City/Town,State,ZIP Telephone
SECTION,6: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 wiliresult in the denial of the Issuance of the building permit.
Signed Affidavit Attached? Yes { I No._ "...... O
SECTION 7a:OWNER AUTHORIZATION'TOBE COMPLETED WHEN
OWNER'S AGENT OR CONTRAL 1 OR APPLIES FOR BUILDING PERMIT
1,as Owner of the subject property,hereby authorize l ��•,�,� �j i Y ��-1
to act on my behalf,in all matters relative to work authorized by this building permit application.
Print Owner's Name(Electronic Signature) Date
SECTION 7b:OWNERk OR AUTHORIZED AGENT DECLARATION
By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information
contained in this applicatioaccurate to the best of my knowledge and understanding,
er's or Au zedIIdØe(Electronie Signature) Date
NO I'ES:
1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor
(not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration
program or guaranty fund under M.G.L. c.142A.. Other important information on the HIC Program can be found at
www,rnass..aovioca Information on the Construction Supervisor License can be found at www.tnass.a.ov'dos
2. When substantial work is planned,provide the information below:
Total floor area(sq.ft.) (ineLidila giraEL;finished basement/attics,decks OI porch))
Gross living area(sq. ft.) Habitable room count
Number of fireplaces Number of bedrooms
Number of bathrooms Number of halfbadis
Type of heating system Number of decks/porches
Type of cooling system Enclosed Open
3. "Total Project Square Footage"maybe substituted for"Total Project Cost"
City of Liorthampton.
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islassachusetts
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IjAtit DEPARTMENT] OF BUILDING INSPECTIONS '',, t • •5
\% 4"-•*.i. .4, 212 Main Street • Municipal Building
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No„,.1-1.4„..., M Alnen -4.;_ri-4i).,
CONSTRUCTION DEBRIS AFFIDAVIT
(FOR ALL DEMOLITION AND RENOVATION PROJECTS)
In accordance of the provisions of MGL c 40, S54, a condition of Building Permit
Number is that all dObris resulting from this work shalt be disposed of in a
properly licensed waste disposal facility, as defined by MGL c 111, S 15.0A. •
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The debris will be disposed of in: i•
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Location of Facility: \Id Lk, ' octfi)....A_,s i gke 10 ,
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The debris will be transported by:
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Name of Hauler: NCLUei \-\OnA.0 --Tilk,ert34CM4R..54— .
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Signature of Applicant: . Date:
,•
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`' The Comu wnwealth of Afassachusetts
P-- '( Departmejzt ofindustrialAccidents
(.i . . 1 Cox' r ess Street Suite 100
il
° > e �, Boslon,1E4i4 02114-2017
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7 mi,ww.mass.gov/dia
Walkers'Conip sat?ion Insnra.,ure Affidavit;BuildersICantr-actors/Electa'irians/Plumberf.
TO BF:FIi,F.I)VQrlaTrr.f1 NUTTING ATJTTi-I( 1TV.
7 Applicant information •i •
/� �/'/�� p /-�� Please Print Legibly
Name(FlitsineNsiOrgsni/aiiriniintiivitiutai): \ � '-�.�.� , SQ ){ o-\i .�' e `.�!' is
Address: h�`���z' Y� `sC _�- 0 - 1-
City/State/Zip 4—k 0.rex X 9 k'4, -OUh2 Phone#: (-4,«--S`2,y--1 S2 2_
are you an employer?Check the appropriate box: Type of project(required):
I.5fI am a employer with ( employees(full and/or part-time).* 7. 0 New construction
2.0 I am a sole proprietor or partnership and have to employees'working forme in 8. ® Remodeling
any capacity.[No workers'comp.insurance required j
9. ❑Demolition
3.01 am a homeowner doing all work myself.(No workers'cori .insurance required:]t
10❑Building addition t
4.0I am a homeowner and will be hiring contractors to conducrall work on my property. I will
ensare:hat all oonsractors citherl ave workers'compensaciein insurance or are sole 1.1..C1 EkCtriCa]repaii•S'or additions
proprietors with no employees. 12.❑Plumbing repairs or additions
5.0 1 am a general contractor and i have hired the sub-contractors listed on the attached sheet. 13.❑1Zoof repairs
These sub-contractors have employees and have workers'cc,n,p.insurance?
6 DWe are a corporation and its officers have exercised their right of exemption per MGL c.
14.®Other
152,Qi(4),and we have no employees.[No workers'comp:insurance required.]
r' h» checks #1fill the scoot..-boor'..,showing their workers' policy information.
applicant that liu'R rra mL'st also uu nut �rruuu wave aalt:ir:v urarra'compensation
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
=Cuntrautors that ttctkt this box must attaebxdan additional sheet s]iuwing:the name of the sub-cuntrastuts and state'whether or nut'ttuse entities have
employees. If the sub-contractors have employees,they must provi le thew workers'romp.policy number.
I am an employer that is providing workers'compeu ation insurance for my employees. Below is the policy and job site
information. //�� ,(�
Insurance Company Name: A(C> Q X)St.VL 1 f1C(< C-grt 1
Policy#t or Self-ins.Lic.t#: Ob Gj�,C7 -0[.,\ Expirationi i I ao�4,
Date: c
Job Site Address: E �S G�Lif.Pe..--, City/State/'Zip: {OJ ii C eituppe DI Oa
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expirhtion 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. I `:1
I do hereby certi 5'un ains and pe ties it II/ 'ui the information provided above is true and correct.
/.
Signature: �, o
1--`". Date: 5 /— a j
Phone#: tit\ - —`1 S'22--
Official use only. Do not write in this area,to be toinpleted by city or town official
City nr Town; Permit/i,icense# „
Issuing Authority(circle one):
1.Board of-Health 2.Building Department 3.Cityfi'own Clerk 4.Electrical Inspector 5.Plumbing Inspector
6. Other
Contact Person: Phone#:
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Commonwealth of Massachusetts
Division of Professional Licensure
Board of Building Regulations and Standards
ConstpxTon p visor
CS-077279 6pires:06/21/2022
• STEVEN A S 'VERMAN ,
PO BOX 60627 ' -1
FLORENCE M4 01062 v I
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Commissioner c o t f. S&J.i
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Office of Consumer Affairs and Business Regulation
1000 Washington Street - Suite 710
Boston, Massachusetts 02118
Home Improvement Contractor Registration
Type: Corporation
VALLEY HOME IMPROVEMENT INC Registration: 106543
P.O.BOX 60627 Expiration: 08/20/2022
FLORENCE,MA 01062
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Update Address and Return Card,
SCA 1 Ca 20M-05117 �/7
✓//C Fo991,0ietaiteP.erli',! (1 .f1/(JO.SJCI.C/L/4.e'et f
Office of Consumer Affairs&Business Regulation
HOME IMPROVEMENT CONTRACTOR j Registration valid for individual use only
TYPE:Corporation before the expiration date. If found return to:
Registration Expiration Office of Consumer Affairs and Business Regulation
105543 08/20/2022 1000 Washington Street -Suite 710
VALLEY HOME IMPROVEMENT INC Boston,MA 02118
STEVEN A.SILVERMAN 4-1 //le
340 RIVERSIDE DRIVEJ � i
�u
FLORENCE,MA 01062 Not valid without signature
Undersecretary
1