24D-121 (6) 200 KING ST BP-2017-1200
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:24D- 121 CITY OF NORTHAMPTON
Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: Plumbing BUILDING PERMIT
Permit# BP-2017-1200
Project# JS-2017-002028
Est.Cost: S7250.00
Fee:$100.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: VALLEY BUILDING COMPANY INC 095905
Lot Size(sq. ft.): 11586.96 Owner: GELINAS PETER
zoning: HB(100)/ Applicant: VALLEY BUILDING COMPANY INC
AT: 200 KING ST
Applicant Address: Phone: Insurance:
P O BOX 246 (413) 584-7710 WC
HAD LEYMA01035 ISSUED ON:4/24/2017 0:00:00
TO PERFORM THE FOLLOWING WORK:BATHROOM & KITCHEN UPDATES, FIX
ELECTRICAL
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 42420170:00:00 $100.00
212 Main Street.Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
File#BP-2017-1200
APPLICANT/CONTACT PERSON VALLEY BUILDING COMPANY INC
ADDRESS/PHONE P 0 BOX 246 HADLEY (413)584-7710
PROPERTY LOCATION 200 KING ST
MAP 24D PARCEL 121 001 ZONE HB(1001/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid
Typeof Construction: BATHROOM&KITCHEN UPDATES, FIX ELECTRICAL
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 095905
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFO ATION PRESENTED:
pproved 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
- ololition Delay 7—
tJ
Siy . re of Bui .ingO ictal 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.
Versionl.7 Commercial Building Permit May 15,2000
_ - Department use only
• City of Northampton Status of Permit:
A Building Department Curb Cut/Driveway Permit
�t !'b" 212 Main Street Sewer/Septic Availability
_ Room 100 Water/Well Availability
_ Northampton, MA 01060 Two Sets of Structural Plans
phone 413-587-1240 Fax 413-587-1272 Plot/Site Plans
Other Specify
APPLICATION TO CONSTRUCT, REPAIR,RENOVATE,CHANGE THE USE OR OCCUPANCY OF,OR DEMOLISH ANY BUILDING
OTHER THAN A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION
1.1 Property Address: This section to be completed by office
.-)06 K.,5 ft Map Lot Unit
iter-tA —r -- A^h cfCCD Zone Overlay District
Elm St.District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
Vu l fed (+v?ii,s 6. /,; VO, ('6X =a��i f-,dh7, M 66'35—
Name(Print) Current Mailing Address:
I1f3 )iry-7716,
Signature _ " _ Telephone
2.2 Authorized Agent:
0071/ 0, ,dt„ (c /v4;/ ; (c'l / �ti�, l�Jl u16/ov,
Name(Print) Current Mailing Address:
Cil 57`I--'7(G
Signature (IN Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building 3 i5 p (a)Building Permit Fee
2. Electrical f SCC (b)Estimated Total Cost of
Construction from(6)
3. Plumbing d CCL. Building Permit Fee
4. Mechanical(HVAC)
5.Fire Protection 6��
6. Total=(1 +2+3+4+5) 7.-}c2 Check Number 7c *
This Section For Official Use Only
Building Permit Number Date
Issued
Signature:
Building Commissioner/Inspector of Buildings Date
Versionl.7 Commercial Building Permit May 15,2000
SECTION 4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000
CUBIC FEET OF ENCLOSED SPACE
Interior Alterations 0 Existing Wall Signs 0 Demolition dRepairs❑ Additions Accessory Building
Exterior Alteration ❑ Existing Ground Sign 0 New Signs❑ Roofing Change of Use❑ Other 0
Brief Description Enter a brief description here. Apt U^:-/ - Par„}, dx-fl-,nv,,, ¢ kkk L,.
Of Proposed Work: tp44cS r m.,vr), urei k Lein' xn, 6r a? r/rc4r,r,( 40fI.
SECTION 5-USE GROUP AND CONSTRUCTION TYPE
USE GROUP(Check as applicable) CONSTRUCTION TYPE
A Assembly A-1 0 A-2 ❑ A-3 ❑ 1A I 0
A-4 ❑ A-5 0 1B ❑
B Business 0 2A 0
E Educational ❑ 2B I ❑
F Factory 0 F-1 0 F-2 ❑ 2C 0
H High Hazard 0 3A 0
I Institutional ❑ I-1 0 1-2 0 1-3 ❑ 3B ❑
M Mercantile 0/ 4 0
R Residential E R-1 0 R-2 0 R-3 0 5A 0
S Storage ❑ S-1 0 S-2 ❑ 5B 0
U Utility ❑ Specify:
M Mixed Use ❑ Specify:
S Special Use ❑ Specify:
COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND/OR CHANGE IN USE
Existing Use Group: /V /A Proposed Use Group:
Existing Hazard Index 780 CMR 34): Proposed Hazard Index 780 CMR 34):
SECTION 6 BUILDING HEIGHT AND AREA # /Vy t {,^i cr A(1rr4 .
I
BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY
Floor Area per Floor(sf)
151
131
2 d 2nd
3rd 3rd
4th 411'
Total Area(sf) Total Proposed New Construction(sf)
Total Height(ft)
Total Height ft
7.Water S pply(M.G.L.c.40,§54) 7.1 Flood Zone Information: 7.3 Sewage LNSposal System:
Public Private 0 Zone Outside Flood Zone Municipal 0. On site disposal system❑
Version!.7 Commercial Building Permit May 15,2000
B. NORTHAMPTON ZONING
Existing Proposed Required by Zoning
c liV 41-55ti This column to be filled in by
Building Department
Lot Size Q-CC 7 i
•
Frontage
Setbacks Front
•
Side L: R: L: R:!.
Rear '
Building Height
Bldg. Square Footage %
Open Space Footage %
(Lot area minus bldg&paved
parkin&
#of Parking Spaces
Fill:
(volume&Location)
A. Has a Special Permit/Variance/Findin ver been issued for/on the site?
NO O DONT KNOW YES O
IF YES, date issued:
IF YES: Was the permit recorded at the Regi try of Deeds?
NO 0 DONT KNOW YES O
IF YES: enter Book Page and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO 0/ DONT KNOW O YES O
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained O Obtained O , Date Issued:
C. Do any signs exist on the property? YES O NO V
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property? YES O NO el
IF YES, describe size, type and Location:
E. Will the construction activity disturb(clearing,grading,ex ation,or filling)over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES O NO
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
Versionl.7 Commercial Building Permit May 15,2000
SECTION 9-PROFESSIONAL DESIGN AND CONSTRUCTION SERVICES-FOR BUILDINGS AND STRUCTURES SUBJECT TO
CONSTRUCTION CONTROL PURSUANT TO 780 CMR 116(CONTAINING MORE THAN 35,000 C.F.OF ENCLOSED SPACE)
9.1 Registered Architect:
Not Applicable ❑
Name(Registrant)
Registration Number
Address l
Expiration Date
Signature Telephone
9.2 Registered Professional Engineer(s):
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
9.3 General Contractor
UAIl`') (^'4r t4ir— (a Not Applicable 0
Company Name:
MA(t
Responsible In Charge of Construction
{ ah‘, 1-b4, Mir /C 3)
Address ,�/ j
/� 41
�o.yo- 7�3
Signat're Telephone
Versionl.7 Commercial Building Permit May 15,2000
SECTION 10-STRUCTURAL PEER REVIEW(780 CMR 110.11) ^/
Independent Structural Engineering Structural Peer Review Required Yes 0 No 0J
SECTION 11 -OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I, Un"t� as Owner of the subject property
hereby authorize Mr N }z'et' to
act or b: alf,in .II matters relative to work authorized by this building permit application.
•// / � l aG—/7
Sig•. re ofs t, Date
h Ut,JIC) (L,10im gym. c ,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.l
Print
h-ao- 1�
Si. . ure of Own gent Date
SECTION 12-CONSTRUCTION SERVICES
10.1 Licensed Construction Supervisor:I Not Applicable ID
l�a
Name of License Holder: if- Lit"— (5 - 065-cl&C
License Number
Fe, P,ck ��� //kJ it /1/14- 6(03- Cc l7
Address Expiration Date
`113- 3Jo-77y
\
/ Signature ,r �///(/// Telephone
SECTION 13-WORKER6'COMPENSA ION 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 buil ng permit.
Signed Affidavit Attached Yes No Q
City of Northampton 212 Main Street, Northampton, MA 01060
Solid Waste Disposal Affidavit
In accordance of the provisions of MGL c 40, S54, I acknowledge that as
a condition of the building permit all debris resulting from the construction
activity governed by this Building Permit shall be disposed of in a properly
licensed solid waste disposal facility, as defined by MGL c 111 , S 150A.
Address of the work: aCCI kr" ,�-
The debris will be transported by: A'4c.1" Tr rA
The debris will be received by: A' -J A 1(4-)
Building permit number:
Name of Permit Applicant Uc, 1 I4di., (c
Date Signature of Permit Applicant
The Commonwealth of Massachusetts
1 — =. Department of Industrial Accidents
e�=� Office of Investigations
9�;__ I Congress Street,Suite 100
="hl= Boston,MA 02114-2017
.*� www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name(Business/Organization/Individual): Uri/fr) /844/8”.f1. l0, Pt o
Address: P G C u - 2-i/
City/State/Zip: tit.( /Vat07e/2,c Phone#: t'1( 3- CP7- 77(0
A,rree/you an employer? Check the appopriate box: Type of project(required):
I.L`� I am a employer with 4. ❑ I am a general contractor and 1
employees (full and/or part-time).*
have hired the sub-contractors 6. El New construction
2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. [l}Remodeling
ship and have no employees These sub-contractors have S. ❑ Demolition
working for me in any capacity. employees and have workers'
[No workers' comp. insurance comp. insurances' 9. ❑❑Ey e�B,uilding addition
required.] 5. ❑ We are a corporation and its 10. lectrical repairs or additions
3.❑ I am a homeowner doing all work officers have exercised their 1 Dumbing repairs or additions
myself. [No workers' comp. right of exemption per MGL
12.0 Roof repairs
insurance required.] t c. 152, §l(4),and we have no
employees. [No workers' 13.n Other
comp. insurance required.]
'Any applicant that checks box N1 must also fill out the section below showing their workers'compensation policy information.
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 art employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name: (,•b,r J, /'Avf--
Policy#or Self-ins. Lic. #: G,‘,.>- 3(I- CG//C ) 6)7 Expiration Date: /-6 -/Y
Job Site Address: 006 f(,.7 =r City/State/Zip: //-r-I'i,.,.n/l._ X44Crr-vci
Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to 51,500.00 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. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby cenif 1 i a pains n penalties of perjury that the information provided above is true and correct.
Signature: l Date: tt-w 77
Phone#: cif 3--Sf"1- 77(/
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):
I. Board of Health 2. Building Department 3.City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector
6.Other
Contact Person: Phone#:
WORKERS COMPENSATION AND EMPLOYERS LIABILITY
INSURANCE POLICY 1,Liberty Mutual.
INSURANCE
AR INFORMATION PACE
175 Berkeley Street Boston,MA 02116
Issued by LIBERTY MUTUAL FIRE INSURANCE 16586
Policy Number WC2-31S-601163-017 Issuing Office 016C
RENEWAL OF: WC2-31S-601163-016 Issue Date 01-06-17
Account Number 1-601163 Sub Account 0000
1. Insured and Mailing Address
VALLEY CONSTRUCTION COMPANY INC
RISK ID 000994581
1'O BOX 246
HADLEY,MA 01035
Status 03 – CORPORATION
Other workplaces not shown above. SEE ITEM 4. PREMIUM- EXTENSION OF INFORMATION PAGE
2. Policy Period:The policy period is from 01-10-2017 to 01-10-2018 12:01 A.M.standard time at the
Insured's mailing address.
3. Coverage
A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the states
listed here: MA
B. Employers Liability Insurance: Part Two of the policy applies to work in each state listed in Item 3.A. The limits
of our liability under Part Two are:
Bodily Injury by Accident $ 500, 000 each accident
Bodily Injury by Disease $ 500,000 policy limit
Bodily Injury by Disease $ 500,000 each employee
C. Other Slates Insurance: Part Three of the policy applies to the states, if any, listed here:
SEE END WC 20 03 06B
D. This policy includes these endorsements and schedules: SEE EXTENSION OF INFORMATION PAGE
4. Premium: The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and
Rating Plans. All information required below is subject to verification and change by audit.
Code Premium Basis Total Rate per $100 Estimated Annual
Classifications Number Estimated Annual Remuneration of Remuneration Premium
See Extension of Information Paye
Minimum Premium $ 500 (MA) Total Estimated Annual Premium $ 4, 522
Premium will be billed ANNUAL
Producer 0004-026083 17\r?Ira r'\I "
MARTIN J CLAYTON INSURANCE AGENCY �-�—t s= �F
INC
1649 NORTHAMPTON ST JAN 1 7 27117
P O BOX 989 � U
!i lSv 5 u b
WC 00 00 01 A p 1987 National Council on Compensation Insurance,Inc. WC 00 00 01 B(CA)
Ed. 07/01/2011 All Rights Reserved Page 1 of 1
a,eke Davy
-NOTE—
THIS PLAT IS COMPILED FROM DEEDS, PLANS AND OTHER SOURCES AND IS NOT
TO BE CONSTRUED AS AN ACCURATE SURVEY AND IS NOT TO BE RECORDED.
BUILDING LOCATION ACCURACY IS NOT GUARANTEED
NOTE:
PROPERTY LINES SHOWN ARE APPROXIMATE,A FULL FIELD SURVEYREQUIRED TO
ACCURATELY DETERMINE
THEIRIR LOCATION.
NOTE:
SUBJECT TO EASEMENTS AND
RIGHTS OF WAYS OF RECORD,
garage extends 1't over
property line. a full field
\ survey is required to
accurately determine its
location.
--- gorage
A
apProx. c°c arlvew0Y
bit. con 119't
5-
O
approx. location of Ni
abutters deck & N
stairs
ir
BOOK 8031,
ZPAGE 14 %$206
rJ
_J
95'±
KING STREET ROUTES 5 & 10
SEE: PLAN BOOK 147, PAGES 42-47
TO: EASTHAMPTON SAVINGS BANK AND
FIRST AMERICAN TITLE INSURANCE COMPANY
TO THE BEST OF MY INFORMATION, KNOWLEDGE AND BELIEF
I HEREBY REPORT THAT I HAVE EXAMINED THE PREMISES AND BASED ON EXISTING
MONUMENTAJ1ON ALL VISIBLE EASEMENTS, ENCROACHMENTS AND BUILDINGS ARE LOCATED ON
THE GROUND AS SHOWN AND THAT THE BUILDINGS ARE ENTIRELY WITHIN THE LOT LINES.
EXCEPT AS NOTED. I FURTHER REPORT THAT THE PROPERTY IS NOT LOCATED WITHIN
A FLOOD PRONE AREA AS SHOWN ON FEDERAL FLOOD INSURANCE MAPS FOR
COMMUNITY #250167
�� GAOEE—
SURVEYO THIS DOES FOR MORTGAGE LOAN PURPOSES ONLY
AND DOES NOT CONSTITUTE A PROPERTY SURVEY
x or ry,`� —MORTGAGE LOAN INSPECTION PLAT—
NORTHAMPTON, MASSACHUSETTS
RANonu pi PREPARED FOR
IZER VALLEY BUILDING COMPANY, INC.
/J5a]2 SCALE: 1"=30' FEBRUARY 25, 2014
es d* %
o s.„,001- HAROLD L. EATON AND ASSOCIATES. INC.
--- REGISTERED PROFESSIONAL LAND SURVEYORS
235 RUSSELL STREET — HADLEY — MASSACHUSETTS
2 Assessment and Sales Report
Location&Ownership Information
Address: 200 King St, Northampton,MA 01060-2583
Map Ref.: M:024D 8:0121 L:0001 Zoning: URC
Owner 1: Valley Building Co Inc
Owner 2:
Owner Address: Po Box 246,Hadley,MA 01035
Property Information
Use: Apartment Bldg-4-8 Units Style:
Levels: 0 Lot Size: 0.27 Acres(11587 sqft.)
Year Built: 1900 Total Area: 0 sqft.
Total Rooms: 0 Living Area: 0 sgft.
Bedrooms: 0 First Floor Area: 0 sqft.
Full Baths: 0 Addl Floor Area: 0 soft.
Half Baths: 0 Attic Area: 0 sqft.
Roof Type: Finished Basement: 0 soft.
Heat Type: Forced Air Basement: 0 sqft.
Fuel Type: Basement Type:
Exterior: Attached Garage: 0
Foundation: Other Garage: 0
Air Conditioned: No Fireplaces: 0
Condition:
Assessment Information
Last Sale Date: 2/28/2014 Last Sale Price: $380,000
Last Sale Book: 11592 Last Sale Page: 242
Map Ref.: M:024D B:0121 L:0001 Tax Rate(Res): 16.69
Land Value: $180,560 Tax Rate(Comm): 16.69
Building Value: $176,940 Tax Rate(Ind): 16.69
Misc Improvements: $0 Fiscal Year: 2017
Total Value: $357,500 Estimated Tax: $5,966.68
Sales History
Recent Sale#1
Sale Price: $380,000 Sale Date: 2/28/2014
Buyer Name: Valley Building Co Inc Seller Name: Demers Family Realty
Lender Name: Easthampton Svgs Bk Mortgage Amount: $360,000
Sale Book: 11592 Sale Page: 242
Recent Sale#2
Sale Price: $335,000 Sale Date: 10/2/2003
Buyer Name: James R Demers Seller Name: Douglas L Hebert
Lender Name: Guaranty Resdntl Lndg Mortgage Amount: $301,500
Sale Book: 7504 Sale Page: 211
Recent Sale#3
Sale Price: $335,000 Sale Date: 10/2/2003
Office of Consumer Affairs and Business Regulation
10 Park Plaza - Suite 5170
Boston. Massachusetts 02116
Home Improvement Contractor Registration
Registration 160358
Type. Private Corporation
Expiration: 7/16/2018 Trp 419291
VALLEY BUILDING COMPANY INC
PETER GELINAS
P.O. BOX 246
HADLEY, MA 01035
update Address and return card.MarF reason for change.
Address Renewal Employment lost Card
Office f('orminser Affairs fl Ho.in Regulation n License or eg`t ation valid for individual use only
HOME IMPROVEMENT CONTRACTOR before die expiration dale. If found return in:
Registration: 160358 Type: Office of Consenter Affairs and Business Regula don
Expiration: 7/16/2018 Private Corporation 101'arF Plaza-Suite 5170
Boston.MA 02116
VALLEY BUILDING COMPANY INC
PETER GELINAS
8 BAYBERRY LN
HADLEY MA 01035 Undenecret:n Nut ra lid w illiout signature
® ^.1assach usetts Depart^ien: of ?oonc Safety
Boar.J o^ Bustling Regulat:ons 3rtl Stanoards
._icons CS-095905
MATTHEW J STONE
373 GRANBV RD `A••^i►
SOUTH HADLEY MA 01075
Mf- s - `_6/06/2018
.m
,o m: sinner LA_