23A-143 (6) BP-2024-0330
119 PINE ST COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
23A-143-001 CITY OF NORTHAMPTON
Permit: Exterior Res
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
BUILDING PERMIT
Permit # BP-2024-0330 PERMISSION IS HEREBY GRANTED TO:
Project# WINDOWS/SOORS 2024 Contractor: License:
Est.Cost: 14400 VALLEY HOME 077279
Const.Class: Exp.Date: 06/21/2024
Use Group: Owner: T BUSH JANET C&BOOKER
Lot Size (sq.ft.)
Zoning: URB Applicant: VALLEY HOME IMPROVEMENT INC
Applicant Address Phone: Insurance
P 0 BOX 60627 (413)584-7522 6H62301-1
FLORENCE, MA 01062
ISSUED ON: 03/26/2024
TO PERFORM THE FOLLOWING WORK:
3 REPLACEMENT WINDOWS AND 2 ENTRY DOORS
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: $40.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Office of the Building Commissioner
,1.-- 1-7EC----L—_''' TV-477---. --
x^,, The Commonwealth of Massachusetts MAR Z 024 y _..__._
ts� Board of Building Regulations and Standards FOR !
Y
1 Massachusetts State Building Code, 780 CM.R -- M JUS A 'IT
va nuitniNc IN
P •noN
Building Permit Application To Construct,Repair,Renovate Or Deiii.6'lfal tt.M seamai2011
One- or Two-Family 17weIling _
i This Section For Official Use Only
Building Permit Number: &/ -*aiW'4, 0 Date Applied:
Wel. ..1 ib55 1// 3 Zt zoZii
Building Official(Print Name) Signature Date
SECTION 1:SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map&Parcel Numbers
1.1 a Is this an accepted street'?yes no Map Number Parcel Number
_- .W_i 3-Znitin information: 1.4-Property Dimensions:
Zoning District Proposed Use Lot Area(sq ft) Frontage(tt)
1 Building Setbacks(ft)
Front Yard Side Yards Rear Yard ,
Required Provided Required Provided Required Provided
I
1.6 Water Supply: (M,G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public 0 Private 0 'Lone: — Outside Flood Zone?Check if yes❑ Municipal 0 On site disposal system 0
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record:
i3CXX.e..4.--).-aUCIAA- ‘"% 10ferie. MCA,-- 010 (0 2---
Name(Print) City.State,ZIP
No. and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK2 (check all that apply)
New Construction 0 Existing Building 0 j Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition 0
Demolition 0 Accessory Bldg. 0 Number of Units _ Other 0 Specify:
Brief Description of Proposed Work2: 12 PLIAcC 3 li l NOOI JS TW 0i..._
LAN ri il-N I)00i-5 e. D' T rAC,I, c ,AILA Gt. N O
C\Nino 6 co Sr cCt.. Ai f I SIim% 06 • ts(0 CM) rtlY\JO
S)*L�-
SECTION 4:ESTIMATED' CONSTRUCTION COSTS
Estimated Costs:
Item (Labor and Materials) Official Use Only
1. Building $I L 1 oOC) 1. Building Permit Fee:$ Indicate how fee is determined:
2.Electrical S V 0 Standard City/Toven Application Fee
V 0 Total Project Cost3(Item 6)x multiplier x
3.Plumbing $ `-' 2. Other Fees: $
I 4.Mechanical (HVAC) $ List:
5.Mechanical (Fire $ — go
Suppression) Total AllFees: '
!�tt Check N iq�• Amount: Cash Amount:
6.Total Project Cost: S 1,4 4 OC) 0 Paid in Ft. 0 C7utataridiug Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSI.)
�` C 0-1-7 21 i (0Ili 1zozy
A J to r'- Q-e' License Number Expiration Date
Name of CSL Holder
List CSL Type(see below)
So-0C t. 7C)(41'
No.and Street Type Description
0 b2 U Unrestricted(Buildings up to 35,000 cu.ft.)
�Ltaf-Gr'G^� R Restricted I&2 Family Dwelling
City/Tow , tate,ZTP A ,(// M
t Masonry -v...._.__....__ ..
f/{`/ RC Roofing Covering
✓" WS Window and Siding
SF Solid Fuel Burning Appliances
4(b-SVA—iSZ2 T Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC)
10 SIB IcL Tm�� crr,.c.,Ar• HTG Registration Number Expiration Date
ITC Company Name or HIC Registrant Name
P b. P�c,tc tQ o (o 7r71
No,and Street Email address
F-t.Or•ey-\c< olft oto(o'Z -ScER-1S22-
Cit'/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 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 BIZ,
to act on my behalf,in all matters relati e to/w -authorized by this building permit application..//
4 .dam 3/ /
Print Owner's Name ectriye ,i ature Datg'
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 st of my knowledge and understanding.
SM.-Vo7v li YL.174ty JtS'2 /
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(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 HIC Program can be found at
wWw.mass.go\ '(ea Information on the Construction Supervisor License can be found at www.mras,.L!. , dns
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
Type of cooling system , Enclosed Open
3. "Total Project Square Footage"may be substituted for` Total Project Cost"
City of Northampton
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Y i Massachusetts w� s '�1
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DEPARTMENT OF BUILDING INSPECTIONS ?'
sue
ifig6
212 Main Street • Municipal Building
� Northampton, MA 01060 SJry;':00
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 al
properly licensed waste disposal facility, as defined by MGL c 111, S 150A.
The debris will be disposed of in:
Location of Facility: 1911e.J e„ vLe e
The debris will be transported by:
Name of Hauler: ittlkli ,moo. rr-ticn- Ire. .
/ I
Signature of Applicant: I' Date: 31 U4 l02
__. The Comntonl.'ealrh of Alassachusetrs
••
-i= Department of Industrial Accidents
-" I Congress Street, Suite 100
Boston, MA 0211,1-2017
t.
www.ntass_gor/dia
►f corkers-('omprmatima h sui awc. .&tIdavit: Sniktert -tvittrtrinrs"Ek isitiatWPtnrnbrn.
TO BE FILED 1ti t 1 H THE Pkl(11I n IM;:%I I HOR1•T1.
Applicant Information � Please Print Lei bh,
Name t Business Orpnizanori tavisl divai l: �ko`} C._7� .-+�z r!t 1 Ivj-- t t C
Address: c_b, 6(44 (po(o
City,'StatelZip: \.OTec1(_C- (nOr Phone =r: 1c32.2— --
_ire too do eaptmer"Chic the appropriate boa:
y Q T,pe of project(required):
i.®1 a erryakn-e:uvlb L(� Crrci,)pvcs iiJI :ci im l+urt-F::rx J' ?. 0 New cofnntrt .tic!1
_...�� 1 are:3 MAC proprietor or partnership a ai)1a)t OL`ril p 1� N tardy: it.7 vK':Il p. gl RCtilWClidg
are)i'-7ar1). [NU .erixn•lYmp tnvtannee roaurrccl.1
9_ 0 Demolition
10! > a a hstmlV'sel dvtag ali a,L.tk 2111►act1.?.Ncp warlos ;.rn;t
I 0 0 Budding,addition
i d m a C I i a l [trvehe,and A ill hva a.�h-aeturs St)c vvtctt aal w.rZ.�c ra. '
`XLiC that all Luntralo a cab::have rvriLr'currriw-n,a;r.in tnur_n.i L'r arc xsi; I IC)nlictncaI r-epxrrs or additions
tintpnelen%leh
12.0 Plumbing repairs ur additions
!.0I amp a y_n<nt iunlrawrund I have land the sdb-e xllraetur,lutcJ on the atLihett sheet Z -
Tl oe sett-eacaryrun i a tzphrrcr,:rat fir.:'were:.,'comp. e_iaaa nee_ 1_. ,Roof repairs
b.❑ A c arc a L.-tapes tea and:Ia.et:I ha'C.cien—d Ffiv nrl3 per VA:L.e
14_no...,
1J_;144r.end vieh:ncniemployerlINu' urtus cep 7cAtsm^cr_aurnt:1
a;.r+Lerar that eheeka bc. 'I mint atset flit our the,ectucn Nato., nlrnv Ira:thin V,cn- -r''cOrnivcrtvalmn policy infemnatcn
Hu :v4-flee Who 6L'btnit dua al1lti:111 irltt_e-atlnlj they are dwlr'i all u orl and then hire coULvde•contraelun uic?t aubirit 2 aevv altlJev et indicant_aue'h
tC un�aC ic*ra that Cisetk Ihta bu*Re;ai aRa cinch as a51L-hunaJ st-t-s stx,Y i3.3 d3c zi t c•f n c sub xLYs.ixs tree!.Urn*fiche to pact hhtt.;
e:aptuNere_ if the st:b--etmlrzeaxs have e-.agto+tsa Itr<j alum t'aa tttk 1 i .ucL.:a nrarb+ir.
I um an employer that is providing ranters'compensation insurance for my employees R.elow is the policy and job site
information_
Insurance Company N i ie: t,G Tt{�Sl1YQZY�t�
Policy =or Sell-tna. Li:. =: �Q Ts lO ,C \ Expiration Date: 2.11 IZo2$
Job Site Address: ft`e'\ City:'Statc.Zip: eel' (}reye_ (AA-0100Z-,
Attach a copy of the workers' compensation policy declaration pate(showing the policy number and expiration date).
Failure to secure coverage as required MU-rr MGL c_ 1 2_ is a criminal\iol:athon punishable by a fine up to S1,500_00
au:!'or one-year imprisonment.as will as cavil pcmalri s in the form ofa STOP WORK ORDER and a tine of op tan S250.00 a
(by against the violator.A copy of this statement m;tv be forwarded to the Office of Investigations of the DIA for insurance
coverage verification.
I do hereby cetfify render tit p and penalties perja .nfarmation prmvded above is true and evrrecL
�.��
Sivature: G D!tr_. c A
Phone.. L1(� J�q�� •
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SZ� •
Official use only, Do not write in this area,to be completed by city or town official
City or Tcrnts: Pent ill icvitsc!E
Issuing Authority(circle one): •
I. Board of Health 2. 13uitdin}l Deportment 3, City1tus►n Clerk d. Eh-orient Inspector S. Plumbing Inspector
fi.tither
Cotttaet later >ii P 0;
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N
Commonwealth or Massachusetts
Division of Occupational Licensure
:::• Board of Building Re ulations and Standards
If'
Cos ion$n rvisor
. �w
CS-077279
>, it:; , Elpires:06/21/2024
a'1/. �,>
STEVEN A S)*VER1� 1 --
le
PO BOX 606 ,-q t i �' r '�
c
FLORENCE Ifil'A 010821 •'.� :r u;` 'K
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vv —:aol 'rcr _ - T,, ii W'i;'R.,^.:..;
THE COMMONWEALTH OF MASSACHUSETTS
Office of Consumer Affai 'nd Business Regulation
N.1000 Washin ^ s rco
g t,- Suite 710
Bosto ;-Massachus_ ett 92118
Home Impro _amen tra ee_r- egistration
i -n - �_ _
,i
J :ri Type: Corporation
--- • - ~ e i5t anon: 105543
VALLEY HOME IMPROVEMENT INC
`_i, , E e anon: 08/20/2024
P.O. BOX 60627 -- .,_, t_; .= i
FLORENCE,MA 01062 `p — - .`�'�`y ''
`5. r --=,-,,,;t %,,,ter. .
't .._--)-• Update Address and Return Card.
THE COMMONWEALTH OF MASSACHUSETTS
Office of Consumer Affairs,,$Business Regulation Registration valid for individual use only before the
HOME IMPROVEMENT CONTRACTOR expiration date. If found return to:
TYPE.t'or.poration Office of Consumer Affairs and Business Regulation
Registratida Eris"fratipn 1000 Washington Street -Suite 710
t '" y. Boston,MA 02118
/ALLEY HOME IMPRQ. EMIT III. 7 `I
is ttt `: � Y'
iTEVEPI A.SILVERMAIIr ..,.
�`k_,„.9 j.i _
I4D RIVERSIDEIJKIVt „'t„ .,Ty4 �1 ora. „ -
=I_ORENCE, MA 01062 ;•;.�' ''..' Y Undersecretary Not valid without signature