29-202 (6) File #BP-2022-0221
APPLICANT/CONTACT PERSON:VALLEY HOME IMPROVEMENT INC
P O BOX 60627 FLORENCE. MA 01062(413)584-7522
PROPERTY LOCATION 43 BEATTIE DR
MAP:LOT 29-202-001 ZONE
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Building Permit Filled out
Fee Pa id $585.65
Type of Construction: MASTER SUITE ADDITION
New Construction
Non Structural Renovations ��h
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:
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 Special Penn it With Site Plan
ZONING BOARD PERMIT REQUIRED UNDER: §
Finding Special Penn it Variance* -iZ 51C,►.-,rkTU12a-
Received&Recorded at Registry of Deeds Proof Enclosed OF �g�'' ►c2
Other Perm its Required:
Curb Cut from DPW Water Availability Sewer Availability
Septic ApprovaI Boa rdoIHealth 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
3-)b 2oza
Signature of Building Official 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 ofMGL 40A.Contact Office of
Planning&Development for more information.
i
The Commonwealth of Massachusetts` qq
(_ Board of Building Regulations and Staxidarclry,. 4 u i
u Massachusetts State Building Code, 780 CMR,, o,�R / S?L r
'� 9T vie .
Building Permit Application To Construct,Repair,Renovate Oryg vs�rhr4, - -d Mar 2011
One-or Two-Farnil✓Dwelling. �..A;q F
This Section For Official Use Only ''% —
Building Permit Number. ,-7.1 a �/ 1 Date Applied:
Building Official(Print Name) Signature Date
SECTION 1: SITE INFORMATION .
1,1 Primo-iv n_dtlrc c I 1 1 &s .cn ro?flan tee Parcel lhimb.rs.
i-,1 ��
i 1 a is this an accepted s%1•eet''yes no Map l•ju,:ii-ber ParcelNTu-74bel-
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed L'se Lot Area(sq ft) Frontage(ft) .
1.5 Building Setbacks(ft)
Front Yard Side Yard!, I Rom. Yard.
Required Provided Required Provided I • Required Provided
1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public❑ Private O Zone: — Outside Flood Zone? Municipal 0 On site disposal system 0
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP'
1.1 Owne:i^.f Record:
• Name(Rizzi) 4ity,State,ZIP
c th,c- 1..t i.t1�j-,_U.7 6 Zcts-k-Cc,rr. e rta,i•cc.v�1
No. and Street Telephone Email Ad ess
SECTION 3:DESCRIPTION OF PROPOSED WORK= (check all that apply)
New Construction 0 Existing Building 0 Owner-Occupied 0 i Repairs(s) 0 Alteration(s) 0 Addition 0
Demolition 0 I AecE:SsolyBldg. 0 Number ofUnits Other 0 Specify:
Brief Description of Pro• posed Work2: mot r� "'+o r- /iv
•
fig m
__M_____1014.3,io
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Estimated Costs:
.Item and Materials Official Use Only •
1. Building Permit Fee: $ Indicate how fee is determined:
I.Building S '7 Z
a Standard City/Town Application Fee
2.Electrical $ -715 ❑Total Project Costa(Item 6)x multiplier x
3.Plumbing $ ('IIVO 2. Other Fees: $
4.Mechanical (HVAC) $ Ili("CV List: ' •
S.Meehan teal (Fire S
S +ression) Total All Fees:S Q5, (�`�
Check No1k Check Amount: 5 Cash Amount:
. 6.Total Project Cost: - $ 0! K 1 0 Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1. Construction Supervisor License(CSL)
E�V�s'Z - .k.-I License Number Expiration Date
Name or CSL Holder
List CSL Type(see below)
P gcci 2 __
No.and Street - Type Description
0r Q 4 "� U Unrestricted(Buildings up to 35,CJnn cu.'t.)
Ci lTown,St j l Restricted 18421'ar,ilvDwelling_
�' / M . Masonry
/ RC , Ritunng cavcr.r'
A WS Window and Siding
H'5-S244
'SF 'Solid Fuel Burning Appliances
71522 1 insulation
hone Email address D Demolition •
egistered Home Improvement Contractor(H7C)
t r� Sy3 SIZOtz022.- .
fC Compp 1:i1C Registration Number Expiration Date
er Frame or HTC R_gist tName
No.and Street Email address --
413-S3t-e22.
CityiTovm,State, ZIP Telephone j
SECTION-6:WORKERS' COMPENSATION INSURANCE AFFIDAVIT(M.G.L.•c.I 52.§ 25C(6)) mm
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 thebuilding permit.
Signed Affidavit Attached? Yes lif No 0
SECTION 7a:OWNER AUTHORIZATION TOME COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
• I,as Owner 'of the subject property,hereby authorize 1 c i -
to act on m .ehal f,in all tters rela• o work authorized by this building permit application.
rrintOwner'st:••• (FJectronicSign ). Date
SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION
(By entering my name below,Thereby attest udder the pains and penalties of perjury that all of the information
wined in this application is true and ac the „st of„, •• yl e d undP sta Inge
`t-M tasrty 1Fo� &6- wr t4-4-r5 , 1 't/ V i Z.Z.
Print Owner's or Authorized .nt's Name( ecar mrc i,...,'~r 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 CHIC)Program),will not have access to the arbitration
program or guaranty tiwad under M.G.L.c. I42A Other important information on the Hit Program can be found at
www.mass_sov/cca Info matida on dii Construction Supervisor License•can be found at www:mass.Qovidns .
. 2. When substantial work is planned,provide the information below:
Total floor area(sq.ft.) (inchi i ing.garage,finished basement/attics,decks or porch) .
Gross living area(sq.ft.) Habitable room count
Ayer of fireplaces Number of bedi auuta
Number of bathrooms Number of ha1$'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
' SsM
r .7s�`.;:. Massachuset s I, <<
(:1.1101.1Y..:
, ti �� _ M ;:_ `t'` DEPARTMENT OF 9OILDING INSPECTIONS •% f
" 212 Main Street • Municipal Building ,-.. ��
�'•:� ::C:`::__^~O.. � n,nen `f^ram_+•;,^OQ
CONSTRUCTION DEBRIS AFFIDAVIT
(FOR ALL DEMOLITION AND RENOVATION PROJECTS) •
In accordance of the provisions of MG!. 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 M•GL c 111, S 154A. .
•
The debris will be disposed of in:
Location of Facility: \JQ U DC's3(i 1 lb,
The debris will be transported by:
•
Name of Hauler: I •brio •
Signature of Applicant: Date: g" of -,?,,oOZ,2,