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31B-166 20 ROUND HILL RD BP-2022-0010 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 31B- 166 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: Bathreno BUILDING PERMIT Permit# BP-2022-0010 Project# JS-2022-000012 Est. Cost: $37500.00 Fee: $243.75 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: VALLEY HOME IMPROVEMENT INC 077279 Lot Size(sq. ft.): 23740.20 Owner Hossein & Mahnaz Kazemi Zoning: URB(100)/ Applicant: VALLEY HOME IMPROVEMENT INC AT: 20 ROUND HILL RD Applicant Address: Phone: Insurance: P 0 BOX 60627 (413) 584-7522 Workers Compensation FLORENCEMA01062 ISSUED ON:7/6/2021 0:00:00 TO PERFORM THE FOLLOWING WORK:BATH RENO 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/Cllinhney: Rough: Oil: Insulatign:l, Final: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS.anc ' ;I Certificate of Occupancy si¢natu ' ,y4 • 7:).ftvFeeType: Date Paid: Amount: Building 7/6/2021 0:00:00 $243.75 212 Main Street, Phone(413)587-1240, Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner i �1. The Commonwealth of Massa used-. / ,(� Board of Building Regulations a d Sta,dard�G' `' FOR Ew l Massachusetts State Building Co 7., tip(3,' <2042/ SE Building Permit Application To Construct,Repair, Re a; :, i emolish a Revis d Mar 2011 One- or Two-Family Dwelling Ar 4,/NSA 2nn This Section For Official Use Only , 4qo�oq'�.4 Building Permit Number: 60 43A. t " Date Applied: 41/..) / loss I / 7-2-Z6Z/ Building Official(Print Name) Signature Date SECTION 1: SITE INFORMATION 1,1 Proper Address: 1.2 Asse„.ors Map&Parcel Numbers • 1.1 a Is this an accepted street?yes -no Map Nurnbet Parcel Number '1.3 Zoning information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public 0 Private 0 Zone: _ Outside Flood Zone? Municipal❑ On site disposal system ❑ Check if yes❑ SECTION 2: PROPERTY OWNERSHIP) 2.1 Owner)of RP�erd: . Name(Priam) City, State,ZIP k) c \X,.� . (2c'- Lt13 3 0— 85L No.and Street Telephone Email 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 ❑ Accessory Bldg. 0 ` Number of Units Other ❑ Specie: SIN LiAieA) . Brief Description of Proposed Work2: ' — !/0 -I_ Pr i r SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ 3 Z, opp 1. Building Permit Fee: $ Indicate how fee is determined: 13 Standard City/Town Application Fee 2.Electrical $ 2, 000 ❑Total Project Cost' (Item 6)x multiplier x 3.Plumbing $ 3i)500 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire • Suppression) $ Total All Fees:$ 1D — Check No?fi f q( Check Amount:a-'-th 3' Cash Amount: 6.Total Project Cost: . $ 37 �C/ . ,CI Paid in Full -0 Outstanding Balance Due:_ SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) 0 1, 2-1 �(2 IP2 -�V�r1 I\ r-1 Q License Number Expiration Date Name of CSL Holder r�rr,, List CSL Type(see below) P.a �Uw (pV()2�No.and Street Type Description / U Unrestricted(Buildings up to 35,000 cu. ft.) (Oo( ?nth WAA 0\(1o2 R Restricted I&2 Family Dwelling City/Town,St , M Masonry ?........... RC . ii non ng,Covering WS ' Window and Siding • SF Solid Fuel Burning Appliances q&S2l�152'_ I insulation Telephone ` Email address D Demolition 5.2 Registered Home Improvement Contractor(MC) `0 ��� g+\IOKA HIC Registration Number Expiration Date ITTC Comp Name or RTC Registrant Name Y .6 car° (.QO(02..:1 .c-for Ce_CY\'fP b\0(02- No. and Street Email ad,1,•ess 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 willresult in the denial of the Issuance of the building permit. Signed Affidavit Attached? Yes liti No . ❑ SECTION 7a: OWNER AUTHORIZATIONTOBE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,as Own of the subject -operty,hereby authorize -L 1 t'sex S l Verr r O._t-1 to act 'n y behalf,in al ers relative to work authorized by this building permit application. -�`,` 7 .t aner' ame(Electrons ignature). ate" SECTION 7b:OWNER'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'. A' application is ' e and acc at e best of my knowledge and understanding. 1 ,12 Print Owner's ofAuthorize. is e(El • ni •ture) Date NOTES: 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 e found at www.mass.stov/oca Information on the Construction Supervisor License can be found at www.mass.co dos . 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) (including.garage,finished basement/attics,decks or porch) . Gross living area(sq. ft.) Habitable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of haif'baths ____ Type of heating system Number of decks/porches Type of cooling system Enclosed Open 3. "Total Project Square Footage"may be substituted for"Total Project Cost" City of Northampton r ;y S ct Massachusetts ��� <� t , z tit * a 1 i, i j� w. 'At .5 1DEPARTMENT OF BUILDING INSPECTIONS tt?', : 212 Main Street • Municipal Building a. �..�..,1-... ..A lv v `rC rll� ,., j Ncr amptc. , v iG. ari CONSTRUCTION DEBRIS AFFIDAVIT (FOR ALL DEMOLITION AND RENOVATION PROJECTS) In accordance of the provisions of MGL c 40, 554, a condition of Building Permit Number is that all debris resulting from this work shall be disposed of in a properly licensed waste disposal facility, as defined by Wit c 111, 5 150A. The debris will be disposed of in: Location of Facility: \d U occ.�;-. _ 1 '�e \n , Q(`t'I \G', -Th J& The debris will be transported by: Name of Hauler: `lea 't kYu { , - Signature of Applicant: Date: The Commonwealth of Massachusetts Department ofIndustrialAccidents u 1 k= 1 Congress Street, Suite 100 �_ ) Boston, 02114-2017 INWW.Illass.gov/dia Workers'Compensation Insurance Affidavit:Builder s/Contractors/Elec -irians/Plunnbers. TO RE FILED Wi T€H THE r r,RMI T iNG AUTHORITY. Applicant Information Please Print Legibly Name (Rrsines/rrrganiiai.iim/individual): \)( ` Address: M() e 0,,c__- \r i.vr . p- 0 . C37C. (c)0(C Z, - , City/State/Zip `Orrxi(e Q, nfp2 Phone#: - S 1--_I S 2 2-- Are you an employer?Check the appropriate box: Type of project(r•quired): 1.M I am a employer with t.B employees(full and/or part-time).* 7. ❑New con r ction 2.0 I am a sole proprietor or partnership and have no employees working for me in 8. ® Remodeling any capacity.[No workers'comp.insurance required.] 9. ❑Demolition 3.1-1 I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 100 j Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will e:nsurcthat all contractors eitherhave workers'compensation insurance or aresole - 11.0 Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.0 T am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.EIROOf 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,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box 41 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. •tC ntrav'tors that check this'box must attached an additional sheet showing the name of the sub-contractors and state-whether or nut 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: A k ,t\cA.. rt '--Ila Y1(c_ ��rr e f> Policy#or Sell ins.Lie.#: 00� --,(`) ?j b2\ - Expiration Date: a ) I I,O a•Ak Job Site Address: ]\ (2\00.0 City/State/Zip: '( •41-ct 'l c1-0 Z p1 O(cC Attach a copy of the workers'compensation policy declaration page(showing the policy number and expir lion 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 do hereby certify under the p n and penalties perjury th t t information provided above is true and correct. Signature: it}e41r-- A re/M,ODate: b b2i2n2A Phone#: U1 - s -1 S 22— Official use only. Do not write in this area, to be completed by city or town official. City nr Town: Permit/License_. u Issuing Authority(circle one): J - 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: • Phone#: • City of Northampton s sr� Y '` Massachusetts A f-' * .y DEPARTMENT OF BUILDING INSPECTIONS �3•, \ 4514a ' 212 Main Street • Municipal Building Jjr .. Cz Northampton, MA 01060 HOMEOWNERS'EXEMPTION ELIGIBILITY AFFIDAVIT I, (insert full legal name), born (insert month, day, year), hereby depose and state the following: 1. I am seeking a building permit pursuant to the homeowners' exempt-ion to the permit equirements of the Massachusetts State Building Code, codified at 780 CMR 110.R5.1.3.1, in connection with a project or work on a parcel of land to which I hold legal title. 2. I am not engaged in, and the project or work for which I am seeking the aforementioned homeowners' exemption, does not involve the field erection of manufactured buildings constructed in accordance with 780 CMR 110.R3. 3. I qualify under the State Building Code's definition of"homeowner"as defined at 780 CMR 110.R5.1.2: Person(s) who owns a parcel of land on which he/she resides or intends to reside, o which there is, or is intended to be, a one-or two-family dwelling, attached or detached structures ac.-ssory to such use and/or farm structures. A person who constructs more than one home in a two-year i.eriod shall not be considered a home owner. 4. I do not hold a valid Massachusetts construction supervision license and, except to the ext: t that I qualify.for and will abide by the Massachusetts State Building Code's requirements for the supervision • the project or work on my parcel, I am not engaged in construction supervision in connection with any project or work involving construction, reconstruction, alteration, repair, removal or demolition involving any activi regulated by any provision of the Massachusetts State Building Code. 5. If I engage any other person or persons for hire in connection with the aforementioned project or work on my parcel,I acknowledge that I am required to and will act as the supervisor for said project or work. Signed under the pains-and penalties of perjury on this -day-of 20_ (Signature) • Commonwealth of Massachusetts 195 Division of Professional Licensure Board of Building Regulations and Standards ConstrOt%Ar i'pervisor CS-077279 T spires 06/21/2022 STEVEN A SvERMAN i, r j c � r PO BOX 6062Y7 r+ fr.* v FLORENCE MP 01062 bA,OlSS330� ✓ 11I Commissioner cjaida e 6/2-m2mi-7mogio-/ ac)c,lad«4.e/4- 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: 105543 P.O. BOX 60627 Expiration: 08/20/2022 FLORENCE, MA 01062 Update Address and Return Card. SCA 1 O 20M-05/17 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 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 (./'w iV (, �" 340 RIVERSIDE DRIVE a FLORENCE,MA 01062 Undersecretary Not valid without signature r • 1 cc W % j T W w 5 W N U N QZ g. fin.'+. , ;+..., U Q K • S 4 ¢� C #y '* Rem Q - { •' r 1 1 , -----444--),, :--I ,.. , . . .. .,,,,„.„,,..„......,,, , „ .. -- 1 0 , , :4:, -j------ _11 0 Z cn 0 cc i 'tom .;,, N 8. o 03 k .., ,,.,. ..., m 0 a CO aID Q ' e t.F s 'A.g .., _ 2 E a a o N k "j :;. , ^ -,'''';''i': ,-^^ Q' c6 • o .. 3 s, fA 4 o II ill . - CD O O U `� — O ® PROJECT PLAN �� PROJECT NOTES: a) o e- J nco Q e OWNER: Hossein and Mahnaz Kazem: O E THIS PLAN SET,COMBINED WITH THE BUILDING CONTRACT,PROVIDES BUILDING DETAILS FOR INDEX OF DRAWINGS - E ii PROJECT20 Round HIII RoadTITLESHEET > o x O THE RENOVATION PROJECT. THE LEAD CARPENTER SHALL VERIFY THAT SITE CONDITIONS, CONTRACT Z m0. ADDRESS: Northampton,MA 3D IMAGES 2 0 LL m AND DIMENSIONS ARE CONSISTENT WITH THESE PLANS BEFORE STARTING WORK.WORK NOT EXISTING CONDTIONS 3 S. N N°' -a�, SPECIFICALLY DETAILED SHALL BE CONSTRUCTED TO THE SAME QUALITY AS SIMILAR WORK BLDG PERMIT PROPOSED FLOOR PLAN 4 Q a ° THAT IS DETAILED.ALL WORK SHALL BE DONE IN ACCORDANCE WITH INTERNATIONAL ELEVATIONS 5 1 C DESIGNER: SAS COUNTERTOP PLAN 6 �' xoII \IL", �' BUILDING AND LOCAL CODES.y ►� min 3 s© L~"" ` Oao �� "` WRITTEN DIMENSIONS AND SPECIFIC NOTES SHALL TAKE PRECEDENCE OVER SCALED `2 E av m DIMENSIONS AND GENERAL NOTES.THE SALE PERSON/DESIGNER SHALL BE CONSULTED FOR a. a `' - ��` CLARIFICATION IF SITE CONDITIONS ARE ENCOUNTERED THAT ARE DIFFERENT THAN SHOWN, p ? Q a • t IF DISCREPANCIES ARE FOUND IN THE PLANS OR NOTES,OR IF A OLTFTION ARISES OVER THE - ►- a a T m� " " ' '� ' INTENT OF THE PLANS OR NOTES.CARPENTER OR SUB-CONTRACTOR SHALL VERIFY AND IS a w ng RESPONSIBLE FOR ALL DIMENSIONS(INCLUDING ROUGH OPENINGS). P c S a ALL TRADES SHALL MAINTAIN A CLEAN WORK SITE AT THE END OF EACH WORK DAY. N >0 o a s r-4 m$ c PLEASE SEE ADDITIONAL NOTES CALLED OUT ON OTHER SHEETS. Ct o O > M LL �42 This plan is the ptopriettay wuet<product of Ve6ey/louts hryarovement,Ino.(Vfh).n is delivered for the limited end esoluilve purpose of.upporiing the contract bid of VW,end euaternar agrees that the elements of this plan chili not be r.pu&/ehed or presented In any form for the purpose of enabling or supporting the work of competing project contractors without the pormisalon of,and compensation paid to,VHI, I 4 p 4 ' r ji L_y W:. le*, 4t- i i_ i''''' . ' ,t:' r s L. . 1 venom .. L __ . _, , ,..:„... . .. ., , , .... ____ ., ,,. , , , ... . , ,. _.._... . . , , ,„:,- 1 1 ,,,,,„ M .•.j. :, / F.. ::71-.•-'' .. , ,.,... . ,, , , , .„ ., _, mod _, � � is i. ,, , , , , \e r 11,, ii 4. , . : , ,.. ., ., ,.., ...,,,,. ... 1 1 „ 1 e Valley Home Improvement, Inc. \ V 13 �1 20 Round Hill Road SCALE:SEE VIEW SHEET NUMBER Northampton,MA 01060 3D IMAGES DATE:5/24/21 340 Riverside Drive,PO Box 60627,Northampton,MA 01062 Hossein and Mahnaz 2 Office Phone 413.584.7522 Fax 413.585.0820 Find us on the web at: www.ValleyHomelmprovement.com Kazemi DRAWN BY:C.M.S. \ i \ Rnvisinn#1 '' i This plan is the proprieta y 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 e-abling or supporting the work of competing project contractors without the permission of,and compensation paid to,VHI. e 1 I r m ,.-$ 1 �/ry gip'• EXT 2668 T 1 i — — , o ana.5',44-. . li C---7' C.)- O/��n a � ( J i ' o , C m X � z I IT N —,. - - - rn -- n 03 `la co 4-1: x oo jil . 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Kazemi Re vision J 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 erabling or supporting the work of competing project contractors without the permission of,and compensation paid to,VHI. 1 ci Z ❑ ❑ ❑ ❑ ❑ ❑ /1 ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ 1O1 ' Q O O O O O [ - 3 17 Z -t -t Z m 0 m F t= m rSi), x m * m m * N —1 O Cn Z = Z co -- m =O 2 O m 71 * m m D 73 D X X Z w i m m m m rn w Z W ' EXT 2668 7 - }.. - m O 0 .73 = O ittl .) ) tr # o u) > * (73 n n o O W O 0 Z 0 7 C CO 3 -I 7 \ D :1 O m C °' m 1 / \ \ L m N ={ --ICo i .ice / �� ` l x -i m N (3 CI _c: , r m c / -1 * N P = y I „ 0 \ 1� 2 �, c * 0 00 \ O m ° 0 >r i �y_ 2 I, i \ \ It \ \ ..-6, \ / -. K o off. -n 1 m O I? Jr m �' CA `., ` Q c m D * °° � � Z A CS) m 2n m Np \\Cf ((;; 20O _' _ \ -\ /- [---)- Cl)c m c\ I m© cs) j < co = c ( = m z - G� c .. a a N-1 61ol j 0 m K JJ X 0 I_B"..- � 1 w0 ' EXT 3068 EXT 3446 , - , 1 m I Valle Home Improvement, Inc. 20 Round Hill Road SCALE:SEE VIEW SHEET NUMBER Y P Northampton,MA 01060 PROPOSED FLOOR PLAN DATE:5/24/21 340 Riverside C rive,PO Box 60627,Northampton,MA 01062 Hossein and Mahnaz 4 Office P none 413.584.7522 Fax 413.585.0820 Find us on the!yelp at: www.ValleyHomelmprovement.com DRAWN BY:C.M.S. \ Kazemi , , , Rp����,��, J 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. r 80" ---- - WALL i - — • WALL — s r—rt---) . • • 17" • N • . _____________.,j/ ' -, , 42" 24" i n i i r 0-7-1 >-�li Ii .. 80" f ♦ i • ValleyHome Improvement, Inc. 20 Round Hill Road SCALE:SEE VIEW SHEET NUMBER p Northampton,MA 01060 ELEVATIONS DATE:5/24/21 340 Riverside Drive,PO Box 60627,Northampton,MA 01062 Hossein and Mahnaz 5 Office Phone 413.584.7522 Fax 413.585.0820 DRAWN BY:C.M.S. Kazemi Find us on the web at: www.ValleyHomelmprovement.com ♦ , Revision 4'1 This plan is the proprietary work product of Valley Home Improvement,Inc.(VHI).h 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. I. 1 1 [ --.\\- ....... Ni cn a) Q W fV =' a) a) 44H 0 Cl) 6u.tz Q a .i SD Q (D = CCU C C2 C Cl CD 3 • cr m- 03 . Cl) .-. (D Q A- i N C ' Cn • CD .Q Cl) C co = .P Cl) ? = C. X Cl) \k\11, \\'.5\ 2 D Wil z co = D o � IL rCJ S m X zz _ � [-- .., 22"% co - m i ,, ValleyHome Improvement, Inc. 20 Round Hill Road SCALE:SEE VIEW ' ' SHEET NUMBER p t Northampton,MA 01060 COUNTERTOP PLAN DATE:5/24/21 340 Riverside Drive,PO Box 60627,Northampton,MA 01062 Office Phone 413.584.7522 Fax 413.585.0820 Hossein and Mahnaz 6 Find us on the web at: www.ValleyHomelmprovement.com Kazemi DRAWN BY:C.M.S. Revision#1 i