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A �1 'V%VZ pue'/HA{o P/q 7oelluoo ayl buluoddns',, MO IZI V I 177 1 {o asodind anlsnpxa pue palling ayl Jo{paJangap fa e o P 7 47 / 41 ' NNIM 2/ 215 '7UI 'jU2U.1gAoidwI 2wOH halleA IHA :�9 NN"(3 5111 IIH)'oul'luawano.dw1 awoH g A{ lon wd joM,Ge audwd a si us id s1 FEDERAL STREET ul IL CL N r O Z I J O V Existing Structure II PORCH ADDITIO ,Z/L 6-,LL 292'TO PROPERTY LINE r Cr r of Xarf4amvton _ + �iassac(tttsctfs m DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street ' Municipal Building- ' Northampton, Mass. 01060 WORKER'S CONTENSATTON INSURANCE AFFIDAVIT �, 5 I-V r ,/t/f�'v� ' (iicenscelperm;ttee} with a principal place of business/residence at: 1,1114 (phone#) (�f/city/5' {P'L1pS do hereby certify, under the pains and penalties of perjury, that: 0 I am an employer providing the following worker's compensation coverage for my employees working on this job: fGi�TZ�"i�l %�G� i,L�I� Uzi ire z 1 05 (Insurance Company) (Policy Number) (Expiration Date) ( ) I am a sole proprietor, general contractor or homeowner(circle one) and have hired the contractors fisted 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) (anaclt addidonal shad if nee eery to include information pertaining to all cactraetors) ( ) 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 v6lo homeowners who employ persom to do m_i+++__M_a�caosuvcdon cr rcpair work on a dwelling of not moue than three units is which the hon=t kmw resides or oa the vvjzkds appu[tnusnt therdo errs not gcoerally 000sukmd w be employ=under the worif4es, ion,Act application by a homeowner for a iiicease or pemili may evidence the legal statue of an employer under the Worms Compamatioa AcL I uoderatand that a copy of this sratemmt may her forwarded to the Dcpwtmca of rndtshia!Aodd=&dfsoc of&m==for the oovaage wificaiioa and that failure to segue oowmgo under sectioa 25A of MGL 152 can lead to the imposdiot of ociminsl penalties oomistiag of a fim of up to$1,500.00 attdlor of up to one yt w and civil penalties in the farm of a Stop Work Order and a fma o(5100.00 a day against me. 'z c signed _day of ,;�L l^,. " L�) / For dq=tmmw use coly Permit Number Mao Lot# 91gnature of La w ertaittee �p ' Office o Consumer tf irs and lsiness Regulation� 10P,=l k, Plaza - Suite 5 I70 Boston�n Massac usetts 02116 Home nipr v'c i'ient Cqrktr4ctor Registration istration Registration: 131945 Type: Individual Expiration: 10/1312014 Tr# 232370 STEVEN A. SILVER AN STEVEN SILVERMAN ._._- ... 268 FOMER RD. SOUTHAMPTON, MA 01073 r . Update address and return card.Mark reason for change, Address Renewal i Employment Lost Card DPS-CAI 0 was o a- r s {?€five of Consumer affairs Business Regulation License or re+�istratiou valid for individui use only rHOME IMPROVEMENT IENT CtJNTRACTt tR before the expiration date. If found return to: m Office of Consumer AtEairs arttf Business Be ulatiosa 12egistratisrn: 131945 Type:Exptratian, 1t3t13/2o14 Ittd+vtetuaE 10 Dark Pts -Suite 5170 Boston,NIA 02116 STEVEN A.SIL1JIwRMr1 STEVEN SILVERMAN � �� { 268 FOMER RD, SOUTHAMPTON,MA GI073 Undersceretary !ot °sfa!-without signature f f �' 8.Y u --fink k5'�k r...a-.A:`'^ai•''� s`Y.$'G�"` .., - n a m `F�S . . SECTION 8-CONSTRUCTION SERVICES Name of—Licen�eHoLcLer : Steven_S_jJVe_rMan 1-7conse Number Address Expiranon Dare Signatur'eVU" Telephone Steven ---S—ilverma 131945 qpmpany Name Registration Numbcr 268 Fomer--RoAd Address Expiration Date Southampton MA 01073 SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L. c. 152,§25C(6)) Workers Compensation Insurance affidavit must be con-pleted and submi"ted with th"s appitcation. Failure to provide this a-ficavit will re-sult in the denial of the issuance ofthe building permit. The current exemption for^homco.wnecs' was extended^uinclude [one(>) or uxn(2) fam3ics and to allow such homeowner to enaa ge an individual for hire,,vho does not possess a license, provided that the owner acts as supervisor. CN4R 780. Sixth Edition Section 108.3.5.1. Definition of : 9exxon(x)`vhon*nupmrc} o[|vn600whichhei'skuosidcsorbn/codxtorcsidc' unnhicbthero is, or is intended to be, a one or two farnfiv dwellin,,attached or detached mruciures accessory to such use and/or I'arm structures. A person who constructs more than one home in a two-year period shall not be considered a honteowner. Such "homeowner"shall submit (o the Buildin-Official,on u [bnn acceptable/o the BuiNiog Official, responsible for all such work performed under the buildini! perynita Asactinc,ConstritetionSuperN,iso your presence nn the job site will hr required from time to time.during Ind Upon Completion uf the work for which this permit ioissued. Also be advised that with reference to Chapter 152(Workers' Compensation) undCbapler lj33 (Liability^fEn`yinyrry /m Employees for injuries not resulting in Death)of the NIIuxxuohxyetmGcncrx| Laws Annotated, vott may be liable/Orpursvn(s) you hire/operform work for you under this permit, The undcnioned ^^homou*oe,^'certifies and nuwo pnnxibUiry for compliance with the State Building Code` City of Nonbannpu»nOrdinances, l�av, and �rn,cnF\;oeuchxs�nsGcomo| Laax �nnn`mcd� Homeowner Signature hle;w H..u.,L- ... A;:dsti G.et _. r"?e.pIGe[i11�.!�ek Wit &Y, f: w�i,�fi;�.rt�;.�� F�eyr°�r•t� p" New iF,ns Qecki S-1dir CM{:E," { ;Ftr, ;_,', :,,sr :'r. {. r�`fi: ".•�<' /J )11_ 1y(- 1 (lf'C--" .._Al �.. fit'°� • r . -• ..� s '°r':_. r... =sr .d e.;': 6�-. If New house and or addition to existing g ousinr complete the follow . Ci ft•:ry _•C;. :_f.r,, t; �i rt{i=-. 10 '! ��t k.,,, .,o.'. . `' _ `V"t iS W. ". . I >k=. a 'tt.EtCa 6a.i, �i. !€'< f"r r t+.? `" tw {�t�,C�'rt.�. �,,^'i. ��;��t-'f, "E:::IaaC. .,i' Y:. Hl�'. o*yVotes SECTION as •OWNER AUTHORIZAMN •TO BE COMPLETED WHE14 OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT ` vexs wtnn ax-A L.e5l1f� 10LIL) L c . . . ,w., t { t .,r Steve ilveratian, vall Home Improvement, Inc. K1 1`f S,t.e.'iCS rMan.s—VAl1ey$[>me Im�}LC1XeffiG�I1ti� �C_. �.h �C`=ris` _t_ - _.ar k��ttrc nt. ��rf>;.at i•;,'si¢ r tfiC f,tir, ;au ,_ :rift ,.�xl�+.;•. r .'�� ,i�;.,i ��t. ,`r= ktc, t:,°.Etr �. . �: ttaY Steven Silverman Ff ... E / t .� � .. � ri, ..; R '� T 1 R� ) a •' i �� H�i n. ,�,� t • t•R s; �{ Y � c � �� � :x � ;t � 1''� � �.. . .x �* t. r � 5 Section 4e ALL INTORMATION MUST BE C0 EPLETED9 or PERMIT CAN BE DENIED DUE TO LACK OF IlF'0RMATION Existing Proposed Required by Zoning This column to be filled in by Building Department 3 8i `� Lot Size Frontage 7s � Setbacks Front LA LD Side L: 17 R:Z S L: 17 R:t-Sr Rear Z1L 21 Z Building Heights 1 Bldg. Square Footage �)y y 3 % if-00 ;� 1 Open Space Footage r % f Q• (Lot area minus bldg&paved 1 j,?31 9 310't 91(0.1 parking) #of Parking Spaces L' Fill: volume&Location A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO ✓ DON'T KNOW YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO DON'T KNOW YES 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 arly proposed changes to or additions of signs intended for the property?YES No IF YES, describe size, type and location: 1 , Department use only g4 City of Northampton Status of Permit: APR 112a uilding Department Curb Cut/Driveway Permit ons 212 Main Street Sewer/Septic Availability „�. Room 100 Wbjr7Well Availability x Northampton, MA 01060 4 bets of Structural Plans phone 413-587-1240 Fax 413.587-1272 Plot/Site Pi Other Specify, F- APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION This section to be completed by office 1.1 Property Address: (� 8� Fed erg l y�� _ l Map Lot Unit 1 �Q— Zone Overlay District Elm St. District_ CB District _ SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Name(Print) Current afl r�Add �— Telephone' ��– Signature 2.2 Authorized Agent: Steven Si verman Valley Home Improvement- P.O. Box 60627, Florence, MA 01062 Name(Print) Current Mailing Address: 584-7522 Signature Telephone SECTION 3.- ESTIMATED CONSTRUCTION CASTS Item Estimated Cost(Dollars)to be Official Use Only completed by ermit a olicant 1. Building � �l C� (a) Building Permit Fee 2. Electrical �Cl� (b) Estimated Total Cost of Construction from 6 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) I 5. ,ire Protection, 6. Total = (1 + 2 + 3 + 4+ 5) )�J Check Number I I This Section For Official Use Only_._ I Building Permit Number: Date Issued: Signature: Buildirg Comm;ssioner/Inspector of Buildings Date �J.� ,� 4 File#BP-2014-1049 APPLICANT/CONTACT PERSON VALLEY HOME IMPROVEMENT INC .X ADDRESS/PHONE P O BOX 60627 FLORENCE (413)584-7522 PROPERTY LOCATION 184 FEDERAL ST MAP 23D PARCEL 123 001 ZONE URB(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid T_ypeof Construction: ADD 7 X 8 TO REAR PORCH New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included• Owner/Statement or License 077279 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFg MATION 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 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 o 'tion y Signature of Buildi g ficial 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 of MGL 40A.Contact Office of Planning&Development for more information. 184 FEDERAL ST BP-2014-1049 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 23D- 123 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Buildinq DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: renovation BUILDING PERMIT Permit# BP-2014-1049 Project# JS-2014-001805 Est. Cost: $24600.00 Fee: $147.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: VALLEY HOME IMPROVEMENT INC 077279 Lot Size(sq.ft.): 38681.28 Owner: WINN STEVEN A&LESLEY FARLOW Zoning:URB(100)/ Applicant: VALLEY HOME IMPROVEMENT INC AT: 184 FEDERAL ST Applicant Address: Phone: Insurance: P O BOX 60627 (413) 584-7522 Workers Compensation FLORENCEMA01062 ISSUED ON:412212014 0:00:00 TO PERFORM THE FOLLOWING WORK:ADD 7 X 8 TO REAR PORCH 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: Driveway Final: Final: Final: Rough Frame: Gas: Fire Department Fireplace/Chimney: Rough: Oil: Insulation: Final: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occupancy Signature: FeeType• Date Paid: Amount: Building 4/22/2014 0:00:00 $147.00 212 Main Street, Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner