24C-046 (8) 345 ELM ST BP-2001-0812
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 24C-046 CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category.renovation BUILDING PERMIT
Permit# BP-2001-0812
P,oject# JS-2001-1519
Est. Cost: $65000.00
Fee:$325.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: Valley Home Improvement, Inc 060300
Lot Size(sq.ft.): 10280.16 Owner: BROWN FLORENCE&GORDON
Zoning:URA HD Applicant: Valley Home Improvement, Inc
AT: 345 ELM Si
Applicant Address: Phone: Insurance:
P 0 Box 60627 (413) 584-7522 Workers
Compensation
FLORENCEMA01062 ISSUED ON:4/25/01 0:00:00
TO PERFORM THE FOLLOWING WORK:INTERIOR REMODEL , KITCHEN, BATHS,
REPLACEMENT WINDOWS
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Inspector of Buildings
Underground: Service: Meter:
a,2,►2/N1 Footings:
Rough: ,J' 7' i .. Rough: 5 31'► House# Foundation:
Final: Final: 7/3/o i
1/1.3/oI I?�t,�f3 OK \i//27�. d Rough Fame:NC -a V -of�-�� j
S- 'I f L.L Ok 7-9-Di ,
Gas Fire Department Fireplace/Chimney: -
Rough: Oil: Insulation: OK f, --/ — G( �'(�h
Final: Smoke: Final: Or //-P9.0/ frees
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occupancy signature: .---- e—" I
Fee Type: Receipt No: Date Paid: Check No: Amount:
Building 4/25/01 0:00:00 13428 $325.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo
File#BP-2001-0812
APPLICANT/CONTACT PERSON Valley Home Improvement,Inc
ADDRESS/PHONE P 0 Box 60627 (413)584-7522
PROPERTY LOCATION 345 ELM ST
MAP 24C PARCEL 046 ZONE URA HD
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out g(/
�0 (13,92l5
1/ g�
Fee Paid �j LZ ,9
Typeof Construction: INT RIOR REMODEL,KITCHEN,BATHS,REPLACEMENT WINDOWS
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 060300
3 sets of Plans/Plot Plan
THE OLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION:
Approved as presented/based on information presented.
Denied as presented:
Special Permit and/or Site Plan Required under: §
PLANNING BOARD ZONING BOARD
Received&Recorded at Registry of Deeds Proof Enclosed
Finding Required under: § w/ZONING BOARD OF APPEALS
Received&Recorded at Registry of Deeds Proof Enclosed
Variance Required under: § w/ZONING BOARD OF APPEALS
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 Commissi Permit from CB Architectur ommittee
1s
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.
l) Cr�
t5 11 woi o� • thampton Status of Permit: Department use only
:. department Curb Cut/Driveway Permit
il'� r,R > > 200 21� . N n Street Sewer/Septic Availability__._,-,-.
100 Water/Well Availability
i North.mpt.•n, MA 01060 Two Sets of Structural Plans__
J n`�'�`Rifefef42 • •' -12. 0 Fax 413-587.1272 Plot/Site Plans_..__._.
()N,"1 nIf>FO Other Specify
APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 - SITE INFORMATION i
1.1 Property Address: This section to be completed by office
345 Elm Street Map Lot_._ ;
Northampton, MA 01060 Zone Overlay District.
Elm St. District CB District
SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record: 345 Elm Street
Florence,. ordon Brown Northampton, MA 01060
Name(Prig. Current Mailing Address:
y.� — Telephone
,. Sii .a /re - 586-6731 666-a, 73i)
2.2 Authorized Agent: Nelson Shifflett
Valley Home Improvement, Inc . P.O. Box 60627, Florence, MA 01062
Name(Print) Current Mailing Address:
584-7522
Signature ( Telephone
SECTION 3 - ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost (Dollars)to be Official Use Only
completed by permit applicant
1. Building v� (a) Building Permit Fee
2. Electrical 5 Oa v (b) Estimated Total Cost of
Construction from (6)
3. Plumbing id/0
aO Building Permit Fee
4. Mechanical (HVAC)
5. Fire Protection C
6. Total =(1 + 2 + 3 +4 + 5) &.S Oa° Check Number 1310E IS 3a 5
This Section For Official Use Only
Building Permit Number: Date Issued:
--
Signature:
Building Commissioner/Inspector of Buildings Date
Section 4.
ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE
DENIED DUE TO LACK OF INFORMATION
Existing Proposed Required by Zoning
This column to be filled in by
Building Department
c � �
Lot Size
Frontage Q
Setbacks Front - I
Iftj
Side L: R: L: R:
1 Rear ►()\ (\if\nn��
11
Building Height
Bldg. Square Footage l"
Open Space Footage
(Lot area minus bldg&paved
parking)
#of Parking Spaces
Fill:
(volume&Location)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO ✓ DON'T KNOW YES AW Tee e S Jr+ c1'h)
C!)V'eft
IF YES, date issued:
/-ks/14 cc 147
IF YES: Was the permit recorded at the Registry of Deeds? n„r,-�Cuc
NO DON'T KNOW YES /WO '?�ti�N"lAir
/dSkitc
IF YES: enter Book Page and/or Document #
B. Does the site contain a brook, body of water or wetlands? NO DON'T KNOW
YES
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained , Date Issued:
C. Do any signs exist on the property? YES NO
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property ?YES
No
IF YES, describe size, type and location:
'ECTION 5- DESCRIPTION OF PROPOSED WORK(check all applicable)
New House 0 Addition 0 Replacement Windows Alteration(s) 0 Roofing 0
Or Doors ❑
Accessory Bldg. 0 Demolition❑ New Signs/� [ ] Decks [ ] Siding[ ] Other[ ]
Brief Description of Proposed Work: /1)/,SL. )*II 2f Pei ie / If *- ,& /O?k,C„<„,/a4,Jo I r
Alteration of existing bedroom Yes 'No Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement Yes I/ No
Plans Attached Roll ! - Sheet r✓
6a, If New housejnd or addition to existing housing, complete the following:.
a. Use of building: One Family Two Family Other_
b. Number of rooms in each family unit: /d. Number of Bathrooms__
c. Is there a garage attached? /JO
d. Proposed Square footage of new construction. N/ Dimensions
e. Number of stories?
f. Method of heating? F/7/W • Fireplaces or Woodstoves Number of each
g. Energy Conservation Compliance. fr//i Mascheck Energy Compliance form attached?
Type of construction c 5
i. Is construction within 100 ft. of wetlands? Yes �o. Is construction within 100 yr. floodplain Yes No
j. Depth of basement or cellar floor below finished grade Ai/I
k. Will building conform to the Building and Zoning regulations? I— Yes No .
I. Septic Tank City Sewerr/ga Private well City water Supply
SECTION 7a - OWNER AUTHORIZATION - TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I, Florence & Gordon Brown , as Owner of the subject property
hereby authorize Nelson Shifflett, Valley Home Improvement, Inc. to act on
m behalf, in all matters relative to work authorized by this building permit application.
Signature of Owner Date
I, Nelson Shifflett, Valley Home Improvement, Inc. , 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.
Nelson Shifflett
Print Name
Signature of 0 /Agent Date
SECTION 8 - CONSTRUCTION SERVICES
,1 Licensed Construction Supervisor: Not Applicable 0
Name of License Holder: Nelson Shif f let 060300
Valley Home Improvement, Inc. License Number
320 Riverside Drive 9/02
Address Expiration Date
Northampton, MA 01060
Signature Telephone
77, /2 584-7522
Regjlste H Improvement Contractor.: Not Applicable 0
Valley Home Improvement, Inc. 105543
Company Name Registration Number
320 Riverside Drive 7/17/02
Address Expiration Date
Northapton, MA 01060 Telephone 584-7522
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 kfl No 0
11. - Home Owner Exemption
The current exemption for"homeowners"was extended to include Owner-occupied Dwellines of one(1) or two(2)families
and to allow such homeowner to engage an individual for hire who does not possess a license, provided that the owner acts
as supervisor.CMR 780, Sixth Edition Section 108.3.5.1.
Definition of Homeowner: Person(s)who own a parcel of land on which he/she resides or intends to reside,on which there
is,or is intended to be, a one or two family dwelling, attached or detached structures accessory to such use and/or farm
structures.A person who constructs more than one home in a two-year period shall not he considered a homeowner.
Such"homeowner"shall submit to the Building Official,on a form acceptable to the Building Official,that he/she shall be
responsible for all such work performed under the building permit.
As acting Construction Supervisor your presence on the job site will be required from time to time, during and upon
completion of the work for which this permit is issued.
Also be advised that with reference to Chapter 152(Workers'Compensation) and Chapter 153 (Liability of Employers to
Employees for injuries not resulting in Death)of the Massachusetts General Laws Annotated,you may be liable for person(s)
you hire to perform work for you under this permit.
The undersigned"homeowner"certifies and assumes responsibility for compliance with the State Building Code,City of
Northampton Ordinances,State and LocalZoni g Laws and State of Massachusetts General Laws Annotated.
Homeowner Signature 41 g •
bt.�s+ �41 ' (Zt7 ttf twt1 anipfhIT - Y
�'t 4`j • 3 .11iassachnsetts 1-__..__J
DEPARTMENT OP BUILDING INSPECTIONS
212 Main Street ' Municipal Building '
Northampton, Mass. 01060 �"
WORKER'S COMPENSATION INSURANCE AFFIDAVIT
I, ._Nelson A. Shiff let t /. Valley Home Improvement, Inc. ___
(liccnci'/permittee)
with a principal place of business/residence at:
320 R versj de Drive, Northampton, MA 01060 (phone#) (413) 584-7522
(sti- f,i/cit;;/stateeJ p)
do hereby certify, under the pains and penalties of perjury, that:
(X I am an employer providing the following worker's compensation coverage for my
employees working on this lob:
American International Companies WC 6554540 00 02/01/2002
(Insurance Company) (Policy Number) -- (Expiration Date)
( ) I am a sole proprietor, general contractor or homeowner(circle one) and have hired
the contractors listed below who have the following worker's compensation policies:
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(attach additional sheet if necessary to include infortnai on pertaining to all contractors)
( ) I am a sole proprietor and have no one working for me.
( ) I am a home owner performing all the work myself.
NOTE:please be aware that while homeowners who employ persona to do mairaenance,constriction or repair work on a dwelling of
not mote than throne units in which the homeowner resides or on the grounds appurtenant thsreto are not generally considered to be
employers under the waiter's campeasation Act(GL152,sa 1(5)),application by a homoawncr for a license oc permit may evidtnoe the
legal status of an employer under the IA/Mares Companation Act.
I understand that a c py of this statement may be forwarded to the Dcpertmast of Industrial,& deata'Office of Insurance for the
coverage verification and that failtne to segue coverage under section 25A of MOL 152 can lead to the imposition of criminal penalties
consisting of a fax of up to S 1,500.00 and/or imprisonment of up to one year and emir penalties in the forts of a Stop Work Order and a
line of S100.00 a day against me.
Signed this c)' day of 40,4,/ - , 200 1 For departmental use only
Permit Number
�? —. Mapes_ Lot#Signature of Li ermi ee —~
• •
t e 9 x �i r iba r "�
YL S jt ...r
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HEAT PIPES
r 1 I RELOCATED
--$--
® - TE TOILET USIN
NEW VINYL FLOOR, o o _�
,I - TOE KICK HEATER _—
c ,SE1T FLANGE - �� --�.
M NEW 6'D DOOR .a T ---- ;, �,p{!v •E
,.-. - 7---, . .AttW CE/[/t! F/O.' CUSTOM PAINT GRADE TILE TOPS u
`p.r. � / REVERSE LANDING CABINETSD
4" .- NEW AM. STD SINK `n I CHOICE OF DOOR
STYLE 42" WALL CABSTO - APR 19 2001 ; ■��
'1 �3'4 CEILING k- ".
-(p>- NEW WINDOW ,�,�
i 1 e \ i_ I ` I I ' ._, -0-[ DENORTHAMPTON,MN-*
INSTALL OWNER'S o 0 o
,-� NEW BATH FAN 1 APPLIANCES (°°1 I OWNER'S BENCH
EXIST. STAIRS /ll ` GAS RANAGEo RE COAT METAL ROOF
\I � •
TILE FLOOR .
HALF WALL WITH RAISE / )
/-c- ---- 1 1, s
PANEL AND HANDRAIL CAP 24" DESK / CAB ABOVE NEW DOOR AND ENTRY
Li I
PHONE
\ / 3( BRICK STEPS AND LANDING
•4� {ipe:
- WROUGHT IRON RAILS
CASED OPENING S
NEW STRIP OAK FLOORING 1 l REPAIR STUCCO TO
REMOVE RADIATOR THROUGHOUT MATCH
l A / a
NEW FOUNDATION
T. STAT FOR FHW ZONE AND INSULATION
(— DUMB WAITER DETAILS ENTIRE AREA -�
0 I ,TO FOLLOW
I REC. ALL SURFACE FIXTURES
' EXCEPT PANTRY
NEW CABS AND <-}-.
SOAPSTONE TOPS
NEW COMPACTOR
i $ � S CASED OPENING
I I _ NEW CASEMENTS TO MATCH
l l - { .
BROWN KITCHEN REMODEL
REVISED 3-27-01 509LC 3ig'
ys
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-- 72" CUSTOM VANITY MARBLE
TOP / UNDERMOUNT SINKS
CLOSET SHELVING BY
REC. CREATIVE SPACE 4" 12'11
T
HEAT LAMPS (> .. 14 11 j
( / OFFICE
/
_ 4' FLOR
RECESSED MED CABS BEVEL N FLOOR TO BE REFINISHED
l HEAT LAMPS ® EDGE MIRROR 1 o new ceiling
\ -9-
)_
and
S INFILL DOOR molding
, -o- \ n_
oak flooring ELECT.LAUNDRY VALVE
NEW POCKET DOOR , I I /
l
REC. �220 EXIST. ELEVATOR
/\ 2' FLOR ; L
FRAMLESS 42 X 42 ENCLOSURE N1 l EXIST DOOR_/
' VALVE
REC. s ' 1 WALL REMOVED
-6-.TOT01.6 REC.TILE 60 X 42 PERSONAL E . , ,N
SHOWER SHOWER0
LINE OF FLOOR TRANSITION
OPEN TO CEILING TILE BENCH
T. STAT TO NEW FHW
REUSE DO R -0 BASEBOARD MSTR BEDROOM,
c�i OFFICE AND BATH / CLOSET
NEW CLOSET / SHEL ING BY 0
•
CREATIVE SPACE -
12'4
BROWN MASTER BATH
SCA1J 'W'• REVISED 3-27-00
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