22B-017 (5) BP-2021-2105
70 MEADOW ST COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
22B-017-001 CITY OF NORTHAMPTON
Permit: Alts Renovations
Repair
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
BUILDING PERMIT
Permit# BP-2021-2105 PERMISSIONIS HEREBY GRANTED TO:
Project# WINDOWS/DOORS/STEP Contractor: License:
VALLEY HOME IMPROVEMENT
Est. Cost: INC 077279
Const.Class: Exp.Date:06/21/2022
Use Group: Owner: BURKE, JAMES M
Lot Size (sq.ft.)
Zoning: URB Applicant: VALLEY HOME IMPROVEMENT INC
Applicant Address Phone: Insurance:
P O BOX 60627 (413)584-7522 0055030215
FLORENCE, MA 01062
ISSUED ON:10/28/2021
TO PERFORM THE FOLLOWING WORK:
REPLACE WINDOW, DOOR, REBUILD STEPS
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: •
� 1
1'
Fees Paid: $65.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
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City of F
Northampton i i,. ,,it ) ,Ti
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ir-',- ..,..:A,- , -- .- 212 Main Street / 7 2sk.,,.,;;./.. ?-.. ....:,:.Y ,. ,,,;.::.:„:::,i.• ,,,,,,:i,,::,,,:, ,::,,:::,s:4: :-.,-,:-:,:,,...:,:;;;(,,.,,,,-,,,,,..::::,,
: ' iH'i. '' 71:i.
Room 109 ?v.6 6 :ellA 110:ll,,lpf, - ', ,..,.,, i,, ...;,I!R ,. ...;
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Northampton, Miik 016.2 oPstifiz,phone 43-587-124° F Nr,/Ns.i.rAw,.4.-- , i :, :::-.•,,,;- '1,:-.3:7,...,,"-:-, , ,: ..•..,'..: ..•-!,,4,it. :•:i•-..':•••,..
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APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1-SITE INFORMATION.
— :,,,, .."--,-, ,,,•••••,-,Map ,
f d by:affice;,':-,,-
.; This Seetionta;iieopTP1E,:..,,z ,„,„:,,,-, R..!;..i,,i.,;:14.,•:•i..L.,,,-:,-,,..:::::.,,,,,,,,, .
1.1 Property Address:
.::',,-!:'':'51-:--7,-:--:: ,6 ,,,I: ..:„:"•-„ . ,4.•:.w ' •,,:
/70 *eCi.CiO2A-) 5-f-- .•,,- ,,T, ,:::-.-, ::,..:,,,,, ,,..,.....,,,.:,,,,,,,„
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Elm St.District -:,',..' ,-." ',','-'', CB D....Let:Lot: k•k::-...:..::.,. ,-.A.,:: .. „..,.. ,„
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record: r, *
tut lite:017 (r7r.,p-e,K3 -lb Viatticai . 1 t- keeter)(( 144 Oi 061
Nyr(Prin ,,-• ,..--- Current Mailing Addreq a 9 ..... 6,7(..„
Telephone
Sig.nature ,
2.2 Authorized Acient:
hI/ILci,0,(9... 0,(s. (6,o(oD,-), 1-----k ore i.--)cr._ •111A.- 010G.J-2-
3\re,,,lei-N Q-)t i\I rrria_r-) ,
Name(Print) .1/ " ' ' IS
t+ 520—5%q--1 2-1
i
/ ,. Current klat Ring Address:
S;gnature Teiephone
SECTION:3-ESTIMATED CONSTRUCTION COSTS .
item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant .
1, Building /610061 . (a)Building Permit Fee
-
2. Electrical (b)Estimated Idle(Cost of
,
'. ConstructiOn from(6)' . . .
.m.
Building Permit Fee,
3. Plumbing 4/66c i
4. Mechanical(HVAC)
.,.
5. Fire Protection
= + Number !
6. Total (I ±2+3 +4B) z/v3 .3 3
/0, 0 I' 0 , Check Number
This Section For Official Use Only
,r, .. • Dale. : ,
Building Permit Number., 6 P-a i' ( 11") ' ":lesued:
d"
Signature: / Zig-/742
-Building Commissioner/Inspector of Buildings • , Date -
EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR)
- SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
New House Addition Replacemengndows Alteration(s) Roofing
Or Doors
Accessory Bldg. Demolition New Signs [O] Decks 14„.._ Siding [DI Other(El
Brief DesAiption of Proposed
Work: t<CF a 4 44.. c..0.A01-, L.,..) 'Nt,a(..)., , cs-.0 4.,.+- d&.(0,- .c.
......
Alteration of existing bedroom Yes X No Adding new bedroom Yes 144,•_,„" .
Attached Narrative Renovating unfinished basement Yes ---'"- No
Plans Attached Roll -Sheet
fa--.11f isi e4.fi e iiieAdf-be-kiditilifi.1643tistirig hotiliki:-Gorfipiete'llie fdlloWincf:
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?
n. 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, Lki i\A k CO-le-1 'a,c iIrrNittyle p----5 , as Owner of the subject
property
hereby authorize\„.)1+3_i S ,fri Si kier-,-7-7ccr-)
to act on myi rt behaj,in all er relative to work authorized by this building permit application.
,,%
ti i /
Signature of iewner Date
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I, aeA.)-Cti Si I ,ie.,r-ir?0,0,. V)--1-i . , 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.
SA--eQ-e-r-1 to,'errYlarN , .
Print Name f' i
44
it / —Signature of OwnedAgent Date
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder t\ 0-1y /0-1
License Number
• P c (.c-cc2.--1 to Ia r l
Address Expiration Date
•
Si re "1,0 /1 LO-7D—
\ ,.I hone
'ice Y
!9.:Registeced Haute:lmpraueriieritCoritraetar�,=,,, •::. ,; � :a�'�`:, ,�,, , ,., -_ J Not Applicable 0
\n. Puy cv e o,rov-em ,4- I OSSLI
Company Narfie Registration Number
Q-o - (000 o(er2c( GLIR olovl jwt o Z
Address ,r •Expiration Date
Telephone `1}3-5g'1-7E-2Z
SECTION 10-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 will result
in the denial of the issuance of the building permit.
Signed Affidavit Attached Yes 'O No......
•
•
City of Northampton
Massachusetts
. • 1311 ,
•••ti'
v:4 4 DEPARTMENT OF BUILDING INSPECTIONS
*;
212 Main Street I'Municioal 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:
Reackw
(Please print house number and street name)
Is to be disposed of at:
P-Ctr-V1.(Sl9k g -e. \C) )C)/A41(k-M-0C- -)
(P1 e print ne e and location of facility)
Or will be disposed of in a dumpster onsite rented or leased from:
(Company Name and Address)
7— a2k4A1
Signature' it A plicant ner ate
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.
•
•
1
The Commonwealth of Massachusetts
1 Wit—(" Department of Industrial Accidents
�i 1 Congress Street, Suite 100
'� Boston,MA 02114-2017
—,, www.mass.. -
Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers.
TO BE FILED WITH THE PERMITTING AUTHORITY.
Applicant Information --� Please Print Legibly
Name (Business/Orgarizationflndividual): 11-e�.� - b clt- `l{l�toro,\A-en le + , c
1
Address: p_t7. tooca -7 . -61_kc gk e.C \2A.'- r-i\se
City/State/Zip: 1;'` fence, \-t r 0\bb2 Phone#: Lk,1 -SSH— - a'D'
Are you an employer?Check the appropriate box
Type of project(required):
1.gi am a employer with. 18 employees(full and/or part-time).` 7. 0 New construction
2.0 I am a sole proprietor or partnership and have no employees working forme in 8. IN Remodeling
any capacity,[No workers'comp.insurance required-]
3.0I am a homeowner doing all work myself,[No workers'comp.insurance ]i 9. ❑Demolition
10 0 Building addition
4.❑I am a homeowner 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 11.1:1 Electrical repairs or additions
proprietors with no employees.
12.'Plumbing repairs or additions
5.0 1 am a general contactor and I have hired the sub-contractors listed on the attached sheet 13.❑Roof repairs
These sub-contractors have employees and have worker'comp.ins»-ante$
, 6.❑We are a corporation and its officers have exercised their right of ex°option per MGL c. 14.['Other
152,11(4),and we have no employees.[No workers'comp.insurance required.]
*Any applicant that checks box#1 must also fill out the section below showing their walkers'compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors most submit a new affidavit indicating such.
tContractors that check this box must attached an additional sheet showing the name of the lab-contactors and state whether or not those entities have
employees. lithe sob-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: / ‘C)-e11Q. J fSUr2rye. &im lo
Policy#or Self-ins.Lic.4: O O3 C 2- 5 Expiration Date: a! 1 I 0,91
Job Site Address: '7) Z"C:1A(I,Ai 'k•-• City/State/Zip: ' --' .0reji,.( t lam- of 0 2...
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 8250.00 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 pains and penalties of erjury that the information provided above is true(and correct
rr�1,1/ iSignature: A' - i�g�'/1/ Date: 12 1?J i 1207C)
Phone#: 4 ICJ`6 1 --I ugh
. Official use only. Do not write in this area,to be completed by city or town official.
City or Town: Permit/License 4
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
l ! Division of Professional Licensure .
Board of Building Regulations and Standards
Ccnstr th §iipe,rvisor
J
CS-077279 �� " " t Tres; 06f2112020
STEVEN A S ILVE RMA11�--; y t..rT t ,
263 FOMER ROAD s.., : 13.
SOUTHAMPTON+1A 81073 . �131
O1.SS3;0 „1ir t- ,._
Commissioner t
— 1
......°74 Fo/2-v-i2,o-zz.aieadle/ 4,,,lei4,
Office of Consumer Affairs and Business Regulation
One Ashburton Place - Suite 1301
Boston, Massachusetts 02108
Home ImprovernetContractor Registration
I
.;-, - Type: Corporation
3
VALLEY HOME IMPROVEMENT INC _j l 4F; +. ;f y Registration: 1d554B O
J "�;..r� � I f Expiration: �'z9�o $[Zr-A
P.O.BOX 60627 I - 1r"t
FLORENCE,MA 01062 ; \ `;.,-
i � -- ��
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' /7
`�1� J
-ya,,,
��� Update Address and Return Card.
zags-eas!17 i
✓??e Fasw,nevarca a>,..tra�j tael4
Office of Consumer Affairs&Business Reautation •
HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only
TYP,E:•Corporation before the expiration date. if found return to:
Registration\ Expiration Office of Consumer Affairs and Business Regulation
105543 i 07/16/2020 One Ashburton Place-Suite 1301
a — Boston,MA 02108
.LEY HOME8MERQVEI E x•rNc
:\
VEN A.SILVERIJ�PT1=;>,:;- ,P r'f9 _ A A L7 !'/!f`f ,
RIVERSIDEDR. ,
1THAMPTON,MA 01062 Undersecretary Not valid without signature
Customer
QUOTATION
21 WEST ST.
/� HAYFIELD,MA 01088
1�. 'l , L_ PATTY JORDAN
r, jardanpta:;rkmiies.com
Creation Date
12;''2312020
BILL TO: SHIP TO:
VALLEY NOM.E-12-23-2020
SUMMERS JOB
Phone: Fax: Phone: Fax:
QUOTE NAME PROJECT NAME CUSTOMER PO# DATE REQUESTED
VALLEY ITOMF-12-23-2020 SUMMERS JOB
•
SALES REPRESENTATIVE TERMS SHIP VIA QUOTE NUMBER
jordanprarlanilcs.cum 720K2Q
lineltern# Description Net Price Quantity'' Extended Price
1-1 $991.65 1 S991.65
CommentfRoom: Product: 8300 Series,Double Hung, NC
None Assigned RO:92.125"x 56.375"
I I Overall Size: 91.625" x 55.875"Unit 1,3:TTT Unit Size:28"x Unit 2:TTT Unit Size:35.625"x 55.875"
Double Hungl.FixedaDouble Hung, Combo Fixed Type: Standard
Sash Split: Custom
c
Mulls: 0 Degree,Vertical,Performance Level:Standard, F
Glass Options: Double Glazed. LowE,Argon, Annealed,Unit 1 Lower Sash I _t •
Lower Glass. I Upper Sash Upper Glass,3 Lower Sash Lower Glass,3 Upper -
Sash Upper Glass:SS tt ;�
Unit 2 Glass:DS
3-'4"IG Thickness,Clear Opening:22.625"x 22.5225",3.539Sq ft
Unit 1,3:Ratings:U-Factor=0.28, Unit 2:Ratings: U-Factor 0.25, Unit
I,3:SHGC—0.25, Unit 2: SHGC__0.33, Unit 1,3: VT_0.47
Unit 2:VT=0.62
Vinyl Color: White
Locks: Standard,Single
Hardware: White,
Screen: Full Screen.Extruded-Fiberglass,
Surround(Jambs/Receivers): Receiver. 3.4".4 Sides.
SETUP: $0.00
LABOR: $0.00
CUSTOMER. SIGNATURE rY /3u git, DATE 1/41/2020 FREIGHT: $0.00
DEPOSIT: ($0.00)
BALANCE: $1,053.63
We appreciate the opportunity to provide you with this quote! SALES TAX: $61,98'
SUB-TOTAL: $991.65
TOTAL: $1,053.63
Last Update: 12/23/2020 8:04:48 PM Page 1 Of 1 Printed: 12/23/2020 8:05:08 PM