11C-065 (4) BP-2023-0925
82 FLORENCE ST COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
11C-065-001 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-2023-0925 PERMISSION IS HEREBY GRANTED TO:
Project# GARAGE CONVERSION 2023 Contractor: License:
VALLEY HOME IMPROVEMENT
Est. Cost: 37000 INC 077279
Const.Class: Exp.Date: 06/21/2024
Use Group: Owner: LARAREO WILLIAM
Lot Size (sq.ft.)
Zoning: URA Applicant: VALLEY HOME IMPROVEMENT INC
Applicant Address Phone: Insurance:
P 0 BOX 60627 (413)584-7522 0055030215
FLORENCE, MA 01062
ISSUED ON: 08/02/2023
TO PERFORM THE FOLLOWING WORK:
CONVERT GARAGE TO LIVING SPACE
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:
Final: Final: Final: Rough Frame:
Gas: Fire Department Driveway Final: Fireplace/Chimney:
Rough: Oil: Insulation:
Smoke: Final:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Signature:
Fees Paid: $240.50
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Office of the Building Commissioner
Z —OK
File #BP-2023-0925
APPLICANT/CONTACT PERSON:VALLEY HOME IMPROVEMENT INC
P O BOX 60627 FLORENCE, MA 01062(413)584-7522
PROPERTY LOCATION 82 FLORENCE ST
MAP:LOT 11C-065-001 ZONE
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Building Permit Filled out
Fee Paid $240.50
Type of Construction: CONVERT GARAGE TO LIVING SPACE
New Construction
Non Structural Renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/ Statement or License
3 sets of Plans/Plot Plan
Driveway Grade%
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON C.
'Lam{ .
INFORMATION PRESENTED:
X Approved Additional permits required(see below) C-v
PLANNING BOARD PERMIT REQUIRED UNDER:§
Intermediate Project: Site Plan AND/OR Special Permit With Site Plan
Major Project: Site Plan AND/OR Special Permit With Site Plan
ZONING BOARD PERMIT REQUIRED UNDER: §
Finding Special Permit Variance*
Received&Recorded at Registry of Deeds Proof Enclosed
Other Permits Required:
Curb Cut from DPW Water Availability 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
. 6 Y/ 7
Signa ure of Building Official Date
Note: Issuance of a Zoning permit does not relieve a applicant's burden tp 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.
1 R
ECE�vE°.
T The Commonwealth of Massachusetts 1 i
�. Board of Building Regulations and Standart JUL. 1 A 2023PO�.
;� Massachusetts State Building Code, 780 C .'+ ]tiTtIT�7C- LITY
l
s
Building Permit Application To Construct, Repair,Renovate S r t-p No . A r 'e -
One- or Two-Family Dwelling NOFTHA
MP
This Section For Official Use Only
t Building Permit Number: 1-3 - qZ 5 [Date Applied:
40 ' ' 1 r 9V- � 4,-, �s � o.
BtildingOfticial(Print Name) Signature � L_.a
SECTION 1:SITE T TORMATIO I
1.1 Property Address: . 1.2 Assessors �&Parcel Numbers
S .
l.1aIs this au accepted street'yes — „o Map Number Parcel Number
1.3 Zoning Information: 1.4 pper Dimensions:
Zoning District Propo .sc Lot Area(sq fel Frontage(ft)
1.5 Building Setbacks(ft)
Front Yard Side Yards Rear Yard
Required I 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:
Zone: Outside Flood Z re? ui
Public gr-- Private❑ — Mt cioal lebn site disposal system 0
Cheek iir $"yam i
SECTION 2: PROPERTY OWNERSIIP'
2.1 Owner'of Record:
U),IA et r- -e 0 eCaS W c k ) 3
Name(Print) City,State,ZIP" !
No.and Street Telephone .ma dress
SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply)
New Construction❑ Existing Building 0 Owner-Occupied 0 Repairsis) 0 Alteration(s) "Addition 0
Demolition 0 Accessory Bldg. ❑ Ywuber of Units Other ■ Specify: y
Brief .escription ofPropos d Work': ,({/ t/ . jt'er, 1f f . /2, ttre, ottlf
,:i I ''''ij A f i JOAtbi t,j `eon.. f.i 0 J ,.. ♦ , +� •
-4-- eti ie " , ' , (t ek- 0 tY' to er„,_,5-tiii 1" ..r'44 r Y
ECTION 4:ES`f LVIATL1J CONSTRUCTION C ti7S �!
Item Estimated Costs: Official Use Only
(Labor and Materials)
' 1. Building $ ' 6149 1. Building Permit Fee: S�__-_.Indicate how tee is determined:
2.Electrical $ �����p.�.� 0 Standard City/Town Application Fee —
/ �0 Total Project'Costs"(Item�6)x multiplier x
3. Plumbing $ 2. Other Fees: S
4. Mechanical (xl vrAC) S V v T jec_
S.Mechanical (Fire $
Suppression) ` Total All Fees,:,,$ U-,
Check Noy 3�1 n 2beck Amount: e'�
i 6.Total Project Cost: $ 'b74 011 i ❑paid in Full O Outstanding Balance Due:__,
SECTION 5: CCNSI't(IICTION SERVICES
5.1 Construction Supervisor License(CSL)
t• r ,,
C ' ,;-erN D l 1 YY .,_k— Lkcnsc Number Expo ation Date
Name of CSL Holder
lr}
List CSI.Type(see below)
Na.and Street ' Type Description
^ 010 � U Unrestricted(Buildin •u to 35,000 cu.R.)
t `'L R Restricted I&2 Family Dwelling
City/Town,Stare I M Masonry
RC Roofing Covering
WS Window and Siding
�{ ttzz SF Solid Fuel WI rung Appliances
:t3-Gs9 -)s�2- T TnsulatIon
Telephone Email address D Demciitlon
5.1 Registered More Improvement Contractor (RIC) 16 5'4 j'2-611 �j f
Nb �"_ ` "'" --c.._ - - -4-fl HTC Registration Number L�F piration Date r
• HI Compare Name or HIC Re ist ant ame
() . ec, ( `GO(ol
No.and Street Email address
ftpreaC6- 1111P" O k CI(02,
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 will result in the denial of the Issuance of the building permit.
Signed Affidavit Attached? Yes X No 7
SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I,as Owner of the subject property,hereby author ize ,(5�-�� t, -1 V L--1
to a m*half,in all matters relative to work authorized by this building permit application. /f/ y//
3/7
Pant Own 's Name(E ertronic Signature
Die
SECTION 7b:OWNER' OR AUTHORIZED AGENT DECLARATION
By entering ray name below,I hereby attest under the pains and penalties • .erjury that all of the information
contained in this application is true and accurate t•,:»,rest of know .2 apd understanding.
' 41/ t 7--.6;—o7493
Print Owner's or Authorized Agent's Name(Electronic Signature) Date
NOTES:
I. An Owner who obtains a building permit to do hia'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 be found at
WW tt_rntass gov/oca Information on the Construction Supervisor I ieince can be found at wwv.';nass.gov.'dcis
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 half/baths
Type of heating system Number of decks/porches
F Type of cooling system Enclosed Open
13. "Total Project Square Footage"may be substituted for"Total Project Cost"
The Commonwealth of Massachusetts
t = rr Department of Industrial Accidents
I =;;mil= ' 1 Congress Street, Suite 100
r ' Boston, MA 0211 4-2 01 7
6�y= WW mass.gov/dia
• Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers-
TO BE FILED WITH TH3? PERI\IITTL''IG AUTHORITY.
Applicant Information • Please Print Legibly
Name (Business/Organization/Individual): \I Q L'-e3 tT0M G ..l.Crt 1(Jy-ryO-e J-n r-r'l-1 , -�C-
Address: to 1:Zk vs\d-c -0(r1>,re- P 0. epc,K 1.,"0(o2-1
City/State/Zip:_t-\or-erxt. k.A} 01 PO-2- Phone #: 413-S`St-1--1 S22-
Are you an employer?Check the•appropriate box:
Type of project(required):
1.123:1 I am a employer with U employees(full zndlor part-time).' 7. ❑New construction
2.0I am a sole proprietor or partnership and have no employees working for mein 8. El Remodeling
any capacity.No workers'comp.insurance required./
9. ❑Demolition
3.0Tama homeowner doing all wont myself.[No workers'comp.insurance required]t
10❑Building addition
4.0I am a hcmcowncr and will be hiring contractors to conduct all work an my property. I will
ensure that all contractors either have workers'compensation insurance or are sole 1 1.❑Electrical repairs or additions
proprietors with no employees.
12.❑Plumbing repairs or additions
6.0 I ani a general contractor and T have hired the sub-contractors listed on the attached sheet. 13.nR00f repalrS
These sub-contractors have employees and have workers'comp.insnrnce.t
4
6.❑We arc a corporation and its officers have exercised their right of exemption per MGL c. 1 Other
152.§1(4),and we have no employees.No workers'comp.insurance requited./ _
*Any applicant that checks box 0=1 mast also fill out the section below showing their workers'compensation policy informadon. •
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 check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not 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: -P \C` (1 S tr(I_v- cc &i 5'C>t No
Policy#or Self-ins.Lic.#: - 0.(D o 3 v 2- 1 S Expiration Date: c2) F ) ,
Job Site Address: 32 't�nr-eriCt -iZciad City/State/ZipL1 4S MO C) C>c3
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$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.31 erification.
I do hereby certify an r the pains and per allies of p ' hat the information provided above l is true and correct.
Signature: � • 07,..)
Date: .31a`� I :'--
Phone#: `-t‘3-(-,',2q---1c: 22.
a
Official use only. Do not write in this area,to be completed by city or town official.
City or Town: Permit/License#
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#:
1
i
f
City of Northampton
�.,,
Massachusetts h,? _ c��c
• f t Z
ly lF ; DEPARTINT OF BUILDING INSPECTIONS [i,�f j
212 Main Street • Municipal Building vi \�/ `a
+..! Northampton, MA 01060 rf;,;ii-,ee;///6
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 MGL c 111, S 150A.
The debris will be disposed of in:
Location of Facility: Qfbe_,LL.A._.3 ) CL-rn-ri-r-4-7
The debris will be transported by:
Name of Hauler: 00(1A-A---- ThA.121,(JVC-11.1...1
Signature of Applicant: Date: 7- 607
Commonwealth of Massachusetts
0.,
Division of Occupational Licensure
Board of Building Re ulations and Standards
Cons lonf� visor
., .y
CS-077279 itplres 06121/2024
STEVEN A SI�•VER A ��1 ),!, 1 yt`*v'4t),
PO BOX 606717 I9•111 .ii �. s , ,,,;i °.-A,4';
FLORENCE M4 01062 i ',4
/ -,. -''P,7' •' 1,, ,,,,i lii 1��r.
THE COMMONWEALTH OF MASSACHUSETTS
Office of Consumer Affait,�s and Business Regulation
1000 Washingta,n-tatr t- Suite 710
BostorlEMassachosetfi 02118
Home Im roy.arrid T racTO egistration
f
rrl `-,x. 1 y. ` IA(,,,
.� �-,.� l,,;Type: Corporation
'.' > m 1_�_ - edisttation: 105543
VALLEY.HOME IMPROVEMENT INC r,„ i' ':-""' _"'=""f E l ation: 08/20/2024
P.O. BOX 60627 V.-vs.„,
-_ k- � .1.
FLORENCE, MA 01062 =`, -� . f`1)1‘1 \- ;-- -.'-'6 _-":, i /I,,'
"-t-_ "� � Update Address and Return Card.
•
•
THE COMMONWEALTH OF MASSACHUSETTS
Office of Consumer AffaiPk�B Business Regulation - Registration valid for individual use only before the
HOME IMPROVE ENTCONTRACTOR expiration date. If found return to:
1 PE;J.cic7'poc4tior3. Office of Consumer Affairs and Business Regulation
Realstiatiaii ::E i�tio 1000 Washington Street -Suite 71 D
� ' '' W-ppg itvj} Boston,MA 02118
/ALLEY HOME IMPR� f;44 T�,I-1Ct _ �
t •
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3TEVEN A. SILVERMAi,,,.
N' -, =r- •• - , /1.I4D RIVERSIDE DRIVE�',r ~-"' 'i.__'':'" ^G%�L
�„�s(CG ��Gfi�.k
'LORENCE, MA 01062 ',;�_ 7" 's: l °
i'.-'_"'' Undersecretary Not valid without signature