36-230 (6) BP-2021-2049
40 WINTERBERRY LN COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
36-230-001 CITY OF NORTHAMPTON
Permit: Addition
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
BUILDING PERMIT
Permit# BP-2021-2049 PERMISSIONIS HEREBY GRANTED TO:
Project# DECK Contractor: License:
VALLEY HOME IMPROVEMENT
Est. Cost: 84000 INC 105543077279
Const.Class: Exp.Date:08/20/202206/21/2022
Use Group: Owner: MCMULLEN DAVID C& SAMANTHA S EARP
Lot Size (sq.ft.)
Zoning: WP/WSP Applicant: VALLEY HOME IMPROVEMENT INC
Applicant Address Phone: Insurance:
P O BOX 60627 (413)584-7522 0055030215
FLORENCE, MA 01062
ISSUED ON:10/21/2021
TO PERFORM THE FOLLOWING WORK:
DECK ADDITION WITH SCREENED PATIO BELOW
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.
Signature: I
.11
Fees Paid: $546.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
Z -014
File #BP-2021-2049
APPLICANT/CONTACT PERSON:VALLEY HOME IMPROVEMENT INC
P O BOX 60627 FLORENCE, MA 01062(413)584-7522
PROPERTY LOCATION 40 WINTERBERRY LN
MAP:LOT 36-230-001 ZONE
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Building Permit Filled out
Fee Paid $546.00
Type of Construction: DECK ADDITION WITH SCREENED PATIO BELOW
New Construction
Non StructuralRenovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/ Statement or License
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION PRESENTED:
X Approved Additional permits required (see below)
PLANNING BOARD PERMIT REQUIRED UNDER:§
Intermediate Project: Site Plan AND/OR Special Permit With Site Plan
Major Project: Site Plan AND/OR SpecialPermit With Site Plan
ZONING BOARD PERMIT REQUIRED UNDER: §
Finding Special Permit Variance*
Received&Recorded at Registry of Deeds Proof Enclosed
Other Perm its Required:
Curb Cut from DPW WaterAvailability Sewer Availability
Septic Approval Board of Health Well Water Potability Board of Health
Permit from Conservation Commission Permit from CB Architecture Committee
Permit from Elm Street Commission Permit DPW Storm Water Management
Demolition Delay
. (Pk ', ir )079•0/ 1
Siu ture of Building Official a Date
Note: Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning
requirements and obtain all required permits from Board of Health, Conservation Commission,Department
of public works and other applicable permit granting authorities.
*Variances are granted only to those applicants who meet the strict standards of MGL 40A.Contact Office of
Planning&Development for more information.
eti, r/S (.1 2rYtN-Li
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.RECEIVE
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z., The Commonwealth of Massachusetts OCT 1 5 '
. Board of Building Regulations and Stan..eds IR-
iwMassachusetts State Building Code, 780 l ' MUNIA Y
DEPT.OF E9L IL 1 E
Building Permit Application To Construct,Repair,Reno • - IIrNoPenhrAn►04IM�orosTp► Mar 011
One- or Two-Fancily Dwelling.
This Section For Official Use Only
Building Permit Number:/ P— -I-• A.0( t Date Applied:
• '� 1' 32`� )D/o-I AI
BuildingOfficial(Print Name) ( Signature -U Date
` I
SECTION 1: SITE INFORMATION
1.1 Property, Address: 1.2 ASSessors Map x,Parcel NIEmber&
4U kt1A--e..✓ht.rrui LRxve.— '✓CP '0
1.l a Is this an accepted street?yes ./ -no • Mai)Nye P.arrr�l Nu +,bey
.1.3 Zoning information: 1.4 Property Dimensions: I
, Zoning District Proposed Use Lot Area(sq ft) Frontage(ft)
1.5 Building Setbacks(ft) _
Front Yai d r-----Side Val-ds Rea:Yard
i
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❑ Private❑ Zone: _ Outside Flood Zone? Municipal 0 On site disposal system 0
Check if yes
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record:
SO M�ee. -W'W.t-0-r� 4- DCAAA McHUti(r1 �u' Xk,. _ InASI--
Tti z-r4P-ii riot) City..S$ae, I ii. �T
v 1.UVwt cv___ LLee r .-- 6 t 1 Slci- (Hullo
No. and Street Te:e•.Dhene Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK' (check all that apply)
New Construction❑ Existing Building 0 Owner-Occupied 0 Repairs(s).❑ Alteration(s) 0 Addition ❑
Demolition ❑ Accessory Bldg. ❑. Number of Units_ Other D Specify:
. Brief Description of Pro osed Wo• 2: G j i ' 7 r C4 -
•
. SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
_: ..- �.:-:... ... _ (Labor�ndlvtrials}.. ___.____.._..... _.__. ..__.._. _.. _. . _
I.Building $ 1.. Building Permit Fee: $ Indicate how fee is determine&
'CI Standard CitytI'own Application Fee •
2.Electrical $ V 3(7 ❑Total Project Cost'(Item 6)x multiplier x
3.Plumbing $ 7l'0 2. Other Fees: $
4.Mechanical (HVAC) $ List: .
5.Mechanical (Fire $ •
Suppression) Total All Fees: $
Check No.ya.?l I Check Amount: '7(/Casb Amount:
. 6.Total Project Cost: $elf,0_ • P ia Full. . 0�d ng Balance Due: • .
.._ _
SECTION 5: CONSTRUCTION SERVICES
Ts
.1 ennstruction Supervisor License(CSL) , ;-.1 ,,,
. 011 2,1 9 LAZI. 12,0ZZ
, a k
License Number Expiration Date
Name at CSL Haider
List CSL Type(see below)
--
No and Street Type Description
I
TJ MA- DtO(p
-Li R Restricted I 4:2 Family Dwelling
Cit /To ZIP ii M Masonry
_ „,4.____..
RC . Ruoring,.Covel ing
WS Window end Siding .
- ' SF " Solid Fuel Burning Appliances
4 te5-st-t-7622— 1 1 Tnsulation '
. Telephone Email address i D 1 Demolition -
5.2 Reaistered Home Improvement Contractor(HJC) ‘.CYSS(A' 31Zolzo2-2- .
-'`f_j-r-litAll-- 'RTC Registration Number Expiration Date
XIC C p Name or MC Registr nt Name ,
Y.L- k5c,c ‘)c)(02,---) c-koicrice_CY\A; ct xo b7.-
No.and Street Email address
41F)-SS,1-1S2.2.
City/Tomm,State,ZIP ielephclrie
SECTION 6:WORKERS' COMPENSATION INSURANCE AFTIDAVIT(M.G.L. e. I.52. 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 builchg pen-nit.
Signed Affidavit Attached? Yes ...........lif
SECTION 7a:OWNER AUTHORIZATION TO-BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR A.PPLIES FOR BUILDING PERMIT
I,as Owner of the subject property,hereby authorize kA-T__ t c•-,..\.e.1/4....,e,r)c-,1 k toty-r,,ii-,\
to act on my beh.a4 in all matters relative to work authorized by this building permit application.
EL SetMAA fk4 eeti90 i oirio ( ,
Print Owner's Name(Electronic Sip e) Date .
SECTION 71):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 in this application is true and accurate to th' o inyknow dge derstanding
3-'mvov S)Lv tYL MO .
/6- o--074,11 ..
Print Owner's or Authorized Agent's Name(Electronic igiaair Date
NOTES:
I. An Owner who obtains a building permit to do his/her own-work,or an owner who hires an unregistered contractor
I (not registered in the Home Improvement Contractor(RIC)Program),will nut have access to the arbitration
program or guaranty Rind under M.G.L.c. 142A.Other important information on the BIC Program can be found at
...
www.mass,i6VIcca InformatiOn on the Construction Supervisor License-canbe found at www.masssovidos
. 2. When substantial work is planned,provide the information below:
Total floor area(ail ft.) {including garage,finished basement/attics)decks or porch)
Gross living area(sq.ft.) lla.bi table room count
Number of fireplaces Number of bedrooms
Number of bathrooms Number of half/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
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L T `' DEPARTMENT OF BUILDING INSPECTIONS iAst }
212 Main Street w Municipal Building [\
CONSTRUCTION DEBRIS AFFMAVIT
(FOR ALL DEMOLITION AND RENOVATION PROJECTS)
In accordance of the provisions of MGL c 40, S54, a condition of Building Permit
NumbPr is that all debris resulting from this work shall be disposed of ii2
properly licensed Waste disposal facility, as defined by IVICL c 111, S 1.50A. .
The debris will be disposed of in:
Location of Facility: \la to,A -( oclucii._,Ks t ice , Q(-M.Q --,
'J
The debris will be transported by:
Name of Hauler: 11 A . 4 . ,c- 't AsA—
Signature of Applicant: Date: M" O 2---a oo1
`~=` The Commonwealth of Massachusetts
Ti Department ofIndustrrialAcciden.ts
1 •_off ?� -`1 1 Con ress Street Suite 100
y Boston,MA 02114-2017
r,*`= l WWW.Mass.gov/din
I.1"artitrs' Coti>p.e sait a Frsurance Affidavit"//udders/Conh ar.tors/E1 ' s/PIuinbe,rs.
TO 13F.Fi i,'rD VI%i T it T(IF PM'RM T T iNG AIJTHORI V.
Applicant Information Please Print Legibly
Nan
Address: �� �4 �,� �,�r 1�C1" , P- 0 • C34, (c)0 Co 2R-
City/State/Zip AOre.rLC P _ 1,0 G11 (& Phone#: q,p2j- s53,`:(_1 S2 Zr
Are you an employer?Check the appropriate box: Type of project(required):
1121i am a employer with I 1} employees(full and/or part-time).* 7. 0 New construction
2.0 I am a sole proprietor or partnership and have no employees working for me in 8. M Remodeling
any capacity.[No workers'comp.insurance required.]
9. ❑Demolition
3.0I am a homeowner doing all work myself No workers'comp.insurance requited l
10 Q Building addii.ion.
4.0I am a homeowner and will be hiring contractors to conduct all work on my property. I will
tonsure that all torrtd•aotors cifheT/Save workaa'compensation iaaswa,ce or are sole • • 1.1..0 Electrical repairs er.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. I3.❑Roof repairs
These sub-contractors have employees and have workers'comp.insurance?
6.a We are a corporation and its officers have exercised their right of exemption per MGL c. 14. Culler
152,§1(4),and ive have no employees.[No workers'comp.insur2.ocerequired.]
`Any applicant tua:checks box411 must also fill out the section billow showing tht:irwor ors'compensation policy information. •
t Homeowners who submit this affidavit indicatiog they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
t•Censtravons that ehcdr•his box Est attal_±edanadditnmai shot showing the name of the strbi:vatt.uttns'and state-whether rrrnut 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( ,L\ SU,.t rl( 61.r
Policy#or Self=ins.Lie.#: 00 Sc-*) 3 C72\ Expiration Date: t9 ) h 10)0 ',,),
Job Site Address: LAU )Jr1,r"C.4..`raGe'' . � — City/State/Zip: 130,r .11A ett-, I"p4 DI�L
Attach a copy of the workers'compensation policy declaratioia page(showing the policy number and ezpirn 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 inthe form of a STOP WORK ORDER and a fine of up to$250.00 a
day aglinst the violator.A copy of this statement may be forwarded to the Office of Investigations of the D/A.fbr insurance` .
coverage verification.
I do hereby certify and d penal • of pelj formation provided above is true and correct.7 �
"-,_.Signature: --- Date: ---- - -- ;70
p f — (�
Phone#: kAk23' SS`1-`--I 22- •
Official use only. Do not write in this area,to be completed by city or town official
City nr Town: Permit/I,kense# -
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#:
Commonwealth of Massachusetts
Division of Professional Licensure
Board of Building Regulations and Slandards
Cons r,i6tr`11i`51,S' zvisor
J
CS-07727E -5' spires: 06/2112022
•
STEVEN A SI, IERMAN 7 s
PO BOX sos t< ;`. --
FLORENCE Mg 0186� 2 .a: .1;
OISS330 °-�•F �.
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Commissioner ,•
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Ka/2-i/220-"beoe 16ti,
• Office of Consumer Affairs and Business Regulation
1000 Washington Street - Suite 710
Boston, Massachusetts 02118
Home Improvement Contractor Registration
Type: Corporation
Registration:
VALLEY HOME IMPROVEMENT INC 9 105543
P.O.BOX 60627 Expiration: 08/20/2022
FLORENCE,MA 01062
Update Address and Return Card.
1 Ca 20M-05/17
Famx acrueed,9477,-/Za-.:¢c &e/.4
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:
Reclstration Expiration Office of Consumer Affairs and Business Regulation
10554d;-, -- 08/20/2022 1000 Washington Street -Suite 710
VALLEY HOME IMPROVEMENT INC Boston,MA 02118
fif
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STEVEN A.SILVERMAIV • VIA" �+J
340 RIVERSIDE DRIVE. :
FLORENCE,MA 0l062 Undersecretary Not valid without signature