30C-083 BP-2024-0205
144 CLEMENT ST COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
30C-083-001 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-2024-0205 PERMISSION IS HEREBY GRANTED TO:
Project# BATH RENO 2024 Contractor: License:
Est. Cost: 12900 VALLEY HOME 077279
Const.Class: Exp.Date: 06/21/2024
Use Group: Owner: DAVIS J MICHAEL&ALINE LABORWIT-DAVIS
Lot Size (sq.ft.)
Zoning: SR Applicant: VALLEY HOME IMPROVEMENT INC
Applicant Address Phone: Insurance:
P O BOX 60627 (413)584-7522 6H62301-1
FLORENCE, MA 01062
ISSUED ON: 02/28/2024
TO PERFORM THE FOLLOWING WORK:
RENO BATH
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: 0
I
Fees Paid: $83.85
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
'i ,/\��O
; �
The Commonwealth of Massaclii ° \
TilBoaid of Building Regulations andSta' ' `��c'Q ' FOR
Massachusetts State Building Code, 78 C1440A PIC
ISPEAi ITY
Building Permit Application To Construct,Repair,Renovate . �o ish a,,Revised Mar-2011
One- or Two-Family Dwelling - /
This Section For Official Use Only
Building Perm/it Number: ,8/�. `rl-'1O,�' Date Applied:
Ie...., , /!%jz 2-27.ZCzy
Building Official(Print Name) Signature Date
SECTION 1:SITE INFORMATION
1.1 Property Address:
1 � GemGn t-+ 1.2 Assessors Map & Parcel Numbers
1.1 a Ts this an accepted street?yes no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use Lot Area(sq ft) Frontage(ft)
1.5 Building Setbacks(ft)
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
1.6 Water Supply: (M.G.L c.40,04) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public 0 Private 0 Zone: Outside Flood Zone?
('heels if yes❑ Municipal 0 On site disposal system 0
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record:
t eet /t 2[ Da V 1 S i OJL"n c m - C( 0(0 2—
Name(Print) City,State,ZIP
l t y /nefloi- ' q 3... b• 54(1if
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) 0 Alteration(s) 0 i Addition 0
i
Demolition 0 Accessory Bldg. 0 j Number of Units Other 0 Specify:
Brief Description of Proposed Work2: 1,W% oO>l.. OF 21ir F L HALL A tI ro.
NV D C,r4,AO tSr - "re. riz,i N"-u s N 0 G1,4 AN t'�� To �"'X.,T' td l-
i<r (Y TOL ES 1N 5>Avh r 1.0C.A Tlty)
I SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs:
(Labor and Materials) Official Use Only
1.Building $ 1,0 N 5 0 6 1. Building Permit Fee: S Indicate how fee is determined:
El2.Electrical S Ub Standard City/Town Application Fee
0 Total Project Cost' (Item 6)x multiplier x
3.Plumbing S C 1 VV U 2. Other Fees: S
4.Mechanical (HVAC) $ List:
5.Mechanical (Fire S Total All Fees:$ 4 /'
if',
Suppression) Q
Check No.1j� eck Amount: O. 'tsh Amount:
6. Total Project Cost: S lc^1 ' ( Paid p in Full. 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor license(CSL) 0-1-7 al9 (p 121 12O2,4
-r_.,..1_Cl ♦A A\h°.A,-r'r-1 ia..e., License Number Expiration Date
Name of CSL Holder
List CSL Type(see below)
P.b . GO,c (Lou,
No.and Street Type I Description
O b2_ U i Unrestricted(Buildings up to 35,000 Cu.ft.)
tVf' .r. c., p` R Restricted 1&2 Family Dwelling
City/Tow , tate,ZiP ,1 J lv1 Masonry
RC Roofing Covering
i' � /fr ���S Window and Siding __.
SF Solid Fuel Burning Appliances
'-tt -Sq'(-k iS22- 1 insulation
Telephone Email address D — Demolition
5.2 Registered Home improvement Contractor(HiC)
rJ irrve..,tm rrvc..,/.1, "�rv... tra�t 8 2y
�V Inc(it Registration Number Expiration Date
HiC Company Name or HiC Registrant Name
Q.O. Pw,c (.0(..> co?-1
No.and Street Email address
-tc)r,er-I.ct riser otOto7-- yv5-Si'Lk-1S2Z-
CitylToHn, State,LIP Telephone
SECTION b:WORKERS'COMPENSATION INSURANCE AFFiDAViT(M.G.L.e. 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 . ,C1j' No . 0
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 authorize V k' ti {vta m Si k qeyy 10 r-•, __
to act on my behalf,in 1t.
hers relative to work authorized by this building permit application.
44,1 -,,i1
Print Own sName(Electronic ignature) Date
SECTION 7b:OWNER' OR AUTHORIZED AGENT DECLARATION
By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information
contained in this application is true and accurate to th b t of my knowledge and understanding.
.STL-V b7u / L! yL. N • ', '' -A
!Print owner's or Authorized Agent's Name(Electronic Signature) 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(I11C)Program),will not have access to the arbitration
program or guaranty fund under M.G.L.c. I42A. Other important information on the II1C Program can be found at
www.mass.goifcca Information on the Construction Supervisor License can be found at www.mass.eov dps
2. When substantial work is planned,provide the information below:
Total floor area(sq.ft) _(including garage,finished basementlattics, 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
Type or cooling system . Enclosed Open
3. "Total Project Square Footage"may be substituted for"Total Project Cost"
City of Northampton
#� M 'Oy Of
Massachusetts(SJ�N DEPARTMENT OF BUILDING INSPECTIONS in
'''^ :. 212 Main Street a Municipal Building�; ' .fi �,i Northampton, MA 01060
CONSTRUCTION DEBRIS AFFIDAVIT
(FOR ALL DEMOLITION AND RENOVATION PROJECTS)
In accordance of the provisions of MGL c 40, S54, 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: ialAe3 eQ.C36A..r\_5S 1 NCV-4-‘04vLekc,-,
The debris will be transported by:
Name of Hauler: 5lo � vtrJer-r-v-n.4 Irt(—
Signature of Applicant: Date: A"?-1 \al"\
I
The Commonwealth of:%lassaclutsetts
• Department of Industrial.-tecidents
1 Congress Street,Suite 100
Boston, f_4 02114-2017
www moss govidia
=�rya:.•:.
auftrrs't'umpt Lion Ifl d i rr .1fl-iaias it: Bnitderr•Y•strait,sm'!.!n-tric-ians`Ptursthers.
TO HE FILED\ I I II 1 I-iE PER.11I"111.1(;
Applicant Information Please Print Lct'ibR
iVaItll I
Bu L^aCSS(.)f'''' SIzaLo[7, \30 0/ 33srk
Uri
C.—
Address: 9_b. 16(.44 (pOCO
oNU102
City,'StatelZip: IOT�XlCL gyp'' PhoneL�:J-
..rr,.na on can en!Cherirtiac appespriate baa: Ty pe of project(required)
0 I aat 0 crtpLL,T.—nI ) Ate) tsfvirinl,vv-a 1s14/1 and plat"f:reel 7. J Nc construction
2 1 a:n a.Nok pntprunor ur pa.McYala*=.12t.ms au uvl tu+c.�w Sri ut_ lot nri Lni 8. Remodeling
urn c- tt) (No world-r rout*.uacr_r tn.-guard I •
9_ Li Demolition
1D I...us a hvi3acwwl3Vt&fag:ali wuci rnws:11.i.\,.wcsiw- .us* an—arm—. >y:rarcd.
I 0 Building addition
-1.0 I_m 3 Ixn330...+sc7 and wtft tat hn- co/ttrxhra:C conJt 1 mil v.t'k on vr, ,:,,-tut. I.1
onure that 311 cur_tra-tun crthci tram•wvrirn- trouracc or an:x,.l, .�Electrical i-ep.�7rs or additions
prat nclors w tth tat:a411.0yee..
I2.a Plumbin repairs or addition.
3.0 I am 3 '.%Dt ra)cuntna tur and 1 live Lund the sub-untrm tors Lsz d vtt the;tut hod shreL
Ticatrb•iu>:tncrontatatcplusrr.,and Ent+4ur1arrs•ci+rr.cur c_ ifJRLauirep3Frs
6.0'a z y cv r a t1,•c it 313m Lt!:U ounce a bast treat-titi tiara ,-t :u txm p t \!c L
14. Othrt
15 Ctfa1_;ralwr has cnoc-ntployrea.INoikur r .vtnp.utstu-m.crctntt•taLl
'Ar at+pLca1 tlltt A U:as has=l rntt ala,fill out fix s.v'tu,n trh,a hhtnt try tlrc_i Mir►cray.t+mp.mlu.n to.nxtnti.m.
t Bunt V.Ther uhu st:bmn Ctrs aMidatrt truhcaung they src du:r.c u irk:aid thou l t t uulsadt.cot-amours nuc.t subetut a Dank allidsttt tnthr..tiu:g iu..h
:C•onEaraun that rtatx-k the.boa hulas att.chest sa -1�.,lsbuesa.1!aloe show in.;du:most.a lac w'>:rat7tsUtca rn•1 sure whether at not thus.:ca2t,51rawc
1..=ptutine, if t}x suet+--suclrx'raa kiwi r0rlt tia,tile) nuai pre .eels 7h v .urf. .+:xtp pvdtxc otznuz
l am an employer that is providing workers'compensation insurance for my employees Below is the policy and job site
information.
Insurance Corny say>iatne:
Policy ;or Sell=ins_ Lc_ t l0 kA I a3(3\-- k E.tprratioti Date: 2. l 1202
Job Site Address: l'1rtsk G7r Cit :StateZip: Ft(ke'YZ(„ . 1
Attach a copy of the workers' compensation policy declaration page(showing the polio' number and espiration date►.
Failure to secure coverage as required ranter MIGL c. 152. §2.5A is a criminal punishable b\ 3 flue up to SI.5(0.00
and'or one-yc r inytiSiirdcre3L as well as civil poia.lttcs in the lane of a STOP WORK ORDER and a tine of up to 2 O.f10 a
day against the violator. A copy of this statement may.he forwarded to the Office of investigations of the DIA for insurance
coverage verification.
I do hereby certifr under tit p and penalties perju .Rforrnation provided abut•e is true and corner/.
'
Siynanlrr: Date.: 02) 1 I
Phone.: t'1 SSLl
Official use only_ Do not write in this area.to be completed by city or worn official
C its'or Tcrntt: Perrnitt'Lirtusc
• Issuing Authority (circle one):
1. Board of health 2. Building Department 3.City rrtm11Clerk 4. Electrical inspolor 5, Plumbing Inspector
ti.other
t'ontatt Cap i; Nutot
•
Commonwealth of Massachusetts
`1) Division of Occupational Licensure
J Board of Building Regulations and Standards
f'IIf
Constlon$ ,rvisor
NS y
CS-077279 ',• ,, t;:itplres: 06121/2024
STEVEN A SI VER t -, s ." .;!.4
PO BOX 6062T IA r ,,;•l F ,ti
FLORENCE OA, 0106 ,.I.,`^a �'-' � c. , •
f.f vd'l0' ,r 1 ,,
Commissioner v '•:, d
vi i
THE COMMONWEALTH OF MASSACHUSETTS
Office of Consumer Affairs and Business Regulation
1000 Washingt ' r�'t,,- Suite 710
Bosto E-Massachuseits=02118
Home Im Irore_; t �'fEaottaa egistration
':n 41 ,W.._...;1 it!
• ice./
�� Type: Corporation
1 S .,. =^ edistiation: 105543
VALLEY HOME IMPROVEMENT INC 1_k E pitation: 06120/2024
P.O. BOX 60627 �� �''
FLORENCE, MA 01062 ti� -km- =;. f"'"
\:it \-- . .,,__ j,/,,/
� �--
Update Address and Return Card.
THE COMMONWEALTH OF MASSACHUSETTS
Office of Consumer Affaiflq.Business Regulation Registration valid for individual use only before the
HOME IMPROVEMENT'CONTRACTOR expiration date. If found return to:
TXPEi p>-al6on Office of Consumer Affairs and Business Regulation
Registratidh_.. .. -E —ati 1000 Washington Street -Suite 710
tl i_'=r' }j Boston,MA 02118
1LLEY HOME IMPR 2 FM T I�'I • I -i'
4
I-EVEN A.5ILVLRMA( � 4k :-. -- -_------...----- -=----- --
k0 RIVLrtSIUt UR►Vt��f ' ,.v ���,,.�t �L i ,
-ORENCE,ivENs MA 01062 — ((��
'` '' ` Undersecretary Not valid without signature •