17D-088 BP-2022-0064
1 11 STRAW AVE COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
17D-088-001 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-2022-0064 PERMISSIONISHEREBYGRANTED TO:
Project# ADD SCREEN PORCH Contractor: License:
VALLEY HOME IMPROVEMENT
Est. Cost: 30000 INC 077279
Const.Class: Exp.Date:06/21/2022
Use Group: Owner: FAYTELL DAVID & DANI PERS FAYTELL
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:01/20/2022 .
TO PERFORM THE FOLLOWING WORK:
ADD ROOF AND SCREEN PORCH OVER DECK
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:
Gas: Final: Final: Rough Frame:
Rough: Fire Department Driveway Final: Fireplace/Chimney:
Final: Oil: Insulation:
Smoke: Final:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Signature: `a&A,.., yCJ • i 1 •
Fees Paid: $195.00
212 Main Street, Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner.
f
. 1 . IV '.
The Cansirnornwealta of Massachusetts ! / •✓q/�/ 2 Fd
`� °j . Board of Building Regulations and Standa/ds /
`� 1�/r" Massachusetts State Building Code, 780 C111•.R.i-a,:;;F-_ acp CI ALI Y
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Building Permit Application To Construct,Repair,Itenovate-'0443 t1v4,N evise Mar '011
11 One- or Two-Far;tily Dwelling. ''. `.AI•n�q onoNs
This Section For Official Use Only ,
Building Permit Number_ ! ,A D--Cfc, j bate Applied:
• #,IP71,
,.,, _ /PO
Buildin ONcial(Print Signature 's
g Name) bane
SECTION 1: SITE.'INFORMATION
11.1 Prt'pi riy Address; • 1.2 Assessor&Map&Parcel'Numbers .
__ --1-V‘` -r0w
1.1 a Is this an accepted street?yes.. Ti o Map lataa- er fair,.NLmbea-
•1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use Lot Area(sq ft) Frontage(ft)
1.5 Building Setbacks(ft)
1 Front Yard Side Yards Rear Yard
Required Provided Reauirod Provided • Required ' Provided
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1.6 Water Supply; (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public 0 Private 0 Zone: _ Outside Flood Zara? Municipal 0 On site disposal system 0
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP'
1 24, ,Ovsne:1 of eco d:
1.U��1 ti- +10,1,) 1-V3e"f �c, rive- c)‘o tzz.
- Name Taut. City,State,Z P .
^) (_
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK' (check all that apply)
New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s).❑ Alteration(s) 0 i Addition 0
Demolition 0 Accessory Bldg. ❑ Number ofUnits 1 Other D Specirc
Brief Description of Proposed Work2: AAA (Wig. g �,e_re.h po'c a '..^
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials) •
1 Building S ..2''< 1. Building Permit Fee:$ Indicate how fee is determined:
O tandard City/Town Application Fee •
2.Electrical $ 0 Total Project Costa(Item 6)x multiplier x __
3.Plumbing $ 2. Other Fees: $ _
4. Mechanical (HVAC) $ ` List: -
S.Mechuiical (Fire --$ ,/>
Suppression) Total •
AIi Fees: nn� i/
Check No.141 OUheck Amount:_J V Cash Amount:
. 6.Total Project Cost: 1 S '3Q/(C 0 Paid in Full 0 Outstanding Balance Due:
SECTIONS: CONSTRUCLICN SFR\ICES
5.1 Car€Ltrr.chair Srrpet tcar License(CSL,) ,� C1 - T
1
e Lict•.r_sc Nucib.r Expiration Date
N c e o1"CSL&icier •
Lit CSL Type(Sc: below)
, No And Screei .l.ype + .Description
, `i ' 1J`\� U Un.-estrieted( lding upte;t rr.J cu. )
' '' r-- R Restricted IRt.7Family Dwelling
Cjt�TrTev' St�U LW `
�//l/11)
r'7 iicttll.n�iuv - rs
WS Window and Sidingt t`2 �� C SF ' Solid Fuel Burning Appliances
`1t�J.. Lt 1v2� I Insulation
Tciephcme Email address D Dernclition
5.2�ered Home Improvement Contractor(MC) f
__ ' �� . \+`t'XY�..t1.j MC Registration Number Expiration Date
'TC Comp Name or T-ITC Registr nt Name •
.c>_60ic IcOo2Z,? c-�O.r _ir")Ce t 010( -2-
No.and Street F
c rnail aa4,•ees•
. City/Town,State,ZIP T&ephone
• SECTION 6:WORKERS' COMPENSATION:INSURANCE AFFIDAVIT(M.G.L. c. 152.g 25C(6))
Workers C.ompens-:lion insurance affidavit must be completed and submitted with this application. Failure to provide
this affidavit will result in the denial'of the Tssuance-of the building permiL
W
Signed Affidavit Attached? Yes .......... ,j No .0
SECTION 7a:OWNER AIJTHORIZATTON TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I,as Owner of the subject propetty,hereby authorize \I vklv__ ST-i 1\�,e. rye a-
to t on mych� p �Ja .al;,in tiers relative to work authorized by this building permit application.
.e�/f
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Print O -ner's Name(Fie,. onic Signature). Date .
. i SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION
By entering my name below,I hereby attest under the pains and peualties of perjury that all of the information
containedin this application is n-ue and accurate to the bast of my • owle and understanding.
JrL 17) gILLY4i fti ,Li!/1r I/ I- I3-' ort)a,
Print Owner's or Authorized Agent's Name(Elec. ..l e) 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. I 42A.Other important information on the IIIC Program can be found at
w w-w.mass.aov/ora Information on.the Construction Supervisor License can be found at www.mass.sovfdt,s
. 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
*Numbs of bathrooms Number of Lal$'batts
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"
r
City of No'1:vtiL'a [�:pt L�.' _
et:: Massachusetts ,�v`
.., ..k.itt '. .;', n '
{i' 1.;' DEPARTMENT OF ,SIJTTD�-l�TG INSPECTIONS �. ' j `„i
`� 212 rain Street c. MLni cinal Su+.iding �• `/
\.-:f�5c.a t _ - 1z CiO6C 'o'•.•..... l
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CONSTRUCTION DEBRIS Az n JAVIT
(FOR ALL DEMOLITION AND RENOVATION PROJECTS)
In accordanfe of the provisions of MGL c 40, S54, a condition of Building Permit
f f a!! debris
f r f work i n � f• �.
Number _ is that debris resulting from this snail be disposed-of in a
properly licensed waste disposal facility, as defined by MG-L c 111, S 1S0A. •
The debris will be disposed of in:
\jd U& "VOCb�'.o i �- IC> , Q44-h , n
Location of Facility:�:
The debris will be transported by:
Name of Hauler: `I GOYl4 _C k1 vt).irt'a'4— • _....
Signature of Applicant: " Date: / —i 02,1)
t"—' -`- The Commonwealth of�fMasscwii..u.setEs
(rl r. Departrrrent of Industrial Accidents '
� ' -: '_tip 4 1 Congress,S'treet,Suite 100
,1 ,iii)- -' Boston,MA 0211 4-2 01 7 .
.;?•` � wtww.ttlass.gov/dia
•CT.-`--yam.
1I7arker-.s'Crtmpensa(toa Insurance Affidavit:lluilden/Coian-aci:aasi.Et iri::ns(Piurabers.
•'i'i i 81.fli.e.T)V.4 T i-i'MP,i=i.RTAiTTTNG tuft ril)RITV.
Applicant Information Please Print Legibly
Name(is:iyineNianreanimi.;onii nil ivitiirai): `ialteL) `r i ---vz �1 or(�.Ka.r -,e6. c
Address:1kt) (<tv t': fr--- .-- {i S'-r , Q- 0 . (2)0 (n. 3(c)Z ,-
City/State/Zip ,�—C�10�2.— Phone#: q,��— ..-,c2,`I_`1 S2 2__
Areyou an employer?Check the appropriate box: •Type of project(required):
11NI am a employer with t) employees(felt ar,dlor part-lime).* 7. 0 New construction
2.0 I am a sole proprietor or partnership and have no employees working forme in 8. ®Remodeling
any capacity.[No workers'comp.insurance required.]
t-7mRd
9. ❑Demolition
3.t 1 I a a homeowner doing all work myself. n worjecs'comp.insurance:emir-eel
4.0I am a homeowne_and will be h ring contractors to conduct all work on my property. I will
10 El Building addition
gnat'etiietat;otaratractcrseit}acl-have workers'cornpensa-.4ac•litrarraeceor are sole - - 11.0E1cctirical repairs-Or additious
propiietois with no employees. 12.:Plumbing repairs or additions .
5.171 T am a general contractor and 1 have hired the sub-contractors listed on the amtehed sheet. 13.0ROOf repairs
These sub-contractors have employees and have workers'comp.insurance.1
6.El 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.insuance_equired.] . .
'Ally applicant that checks box 41 must also tll out the aeclicr,below showing their:..c,kcrs'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 dheair this bcut mast attached-ma-additional sheet showing the name of tat s46-unntrautors and state•whether or'not t:mmot entiti tt have
employees. If the sub-cono'actors have employees,they must provide their worker'comp.policy number.
I an:an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name: A(hielka._ ,Ste, r 63rrf
Policy n oI Self-ixw.L ic.0: LJV S(7' V 2_Y - Expiratiou Date: a ) 1 1, 0 4N,,Job Site Address: 11\ C31 Y UUL.�J 1tT\j - _City/State/Zip: (), h l J
4401 Cl(—
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 DL4 for insurance
coverage verification.
I do hereby certify under the pains and • ofperjur. hat the 'ilfi provided above is true and correct
Suture: /I /" e"
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Phone 4: t? I
- ' - - 22 — .
Ofcial use only. Do not write in this area,to be completed by city or town official
City or Totem: Permit/T,icensr#
Issuing Authority(circle one): It
- 1.Board of health 2.Building Department 3.City/T'own Clerk 4.Electrical Inspector 5.Plumbing Inspector
6. Other
Contact Person: - Phone 4:
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its Commonwealth of Massachusetts
f.; . Division of Professional Licensure
Board of Building Regulations and Standards
Constr0Vs1S'pp 1visor
CS-077279 �� .; : 6cpires:06/21I2022
STEVEN A S2IVERMANf
PO BOX 606 �/�V • .'
FLORENCE MAO'1062'Arc' „s, < ;�
b��553� ir,i
Commissioner 2io.A S. $�tisimcltca
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�/T& g/32,/-7Ao-/moeil e r�ia iGGc /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.
A 1 is 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 100o Washington Street -Suite 710
VALLEY HOME IMPROVEMENT INC Boston,MA 02118
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STEVEN A.SILVERMAN
4.t,,340 RIVERSIDE DRIVE
FLORENCE,MA 01062 Undersecretary Not valid without signature