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30A-076 (20)
340 RIVERSIDE DR BP-2019-1005 GIs#: COMMONWEALTH OF MASSACHUSETTS Mao Block:30A-076 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL e.142A) Cateega:window replaced BUILDING PERMIT e of BP-2019-1005 Project# JS-2019-001656 BAS—Olt—U90-0 Fee SI00 00 PERMISSION IS HEREBY GRANTED TO: Const Class, Contractor: License: Use Gro= STEVEN SILVERMAN 77279 Lot Size(sa fu: 19994.04 Owner: VALLEY HOME IMPROVEMENT INC Zonina: SI(109)/WP(4L / Applicant: STEVEN SILVERMAN AT. 340 RIVERSIDE DR Applicant Address: Phone: Insurance: PO BOX 60627 (413) 584-7522 O WC FLORENCE ,MA01062 ISSUED ON:3/15/10190:00:00 TO PERFORM THE FOLLOWING WORK.-ADDING A 4X4 TWIN DH WINDOW IN BRICK WALL POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Iasinewr of Wiring D.P.W. Building Inspector Underground: Service: Meter; Footings: Rough: Rough; House# Foundation: Driveway Final; Final: Final: Rough Frame: Gas: Fig Department Fireplace/Chimney: Rough: Oil: Insulation: Final: Smo e: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of OCCI DI Pncy Signature: FeeType• Date Paid: Amount; Building 310/20190:00M $100.00 212 Main Street,Phonc(413)587.1240,Fax:(413)587.1272 Louis Hasbrouck—Building Commissioner File#BP-20194005 APPLICANT/CONTACT PERSON STEVEN SILVERMAN ADDRESS/PHONE PO BOX 60627 FLORENCE , (413)584-7522 Q PROPERTY LOCATION 340 RIVERSIDE DR MAP 30A PARCEL 076 001 ZONE SI(109)'WP(481/ THIS SECTION FOR OFFICIAL USE ONLY PERMIT APPLICATION CHECKLIST NCLO D REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out vi Fee Paid Tvreof Construct- n' ADDING A 4X4 TWIN DH WI IN BRICK WALL New Construction Non Structural interior renovations Addition to Existing Accessory Structure Buildine Plans Included, Owner/Statement or License 77279 3 sets of Plans/Plot Plan THE LLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF RMATION 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 AND1OR 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 Demolition Delay 3151 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. r 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 Cornmercial Building Pemut May 15,2000 Department use only City of Northampton Status of Permit: Building Department Curb Cut/Dnveway Permit - 212 Main Street Sewer/Septic Availability Room 1O0 Wamr/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 OCCU ANC UIL NG OTHER THAN A//JJONNE OR TWO FAMILY DWEL NO SECTIONIp -SREINPORMATION Pal9,1n6_ MAA 1 4 2019 1.1 Property�Address: J rte This se tion be completed by office 01 ' v IV �t.rCrb�d L- De-kt - Map 30/9 Lk IT.pF6UILDING INSPECTION+ IY NORTHAMPTON,MAO)w Zone Overlay District - -- - Elm St District CB Dictrict SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: n Stl.>e nea , PA - 6C16 tootoz;l tc_ e Cif M43 a ro z Name(PnnOCurrent Mailing Address', ({F/(pII 4{13- SgH- 522 Signature V Telephone 2 2 Authorized Agent n c� Ive rr�Ay� PD. 64" ((00027 'Pta-eve rnaot bZ Name(Print) Current Mailing Address: L113-5 `1--_7S2-2- Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed bermitapplicant 1. Building 3 000 (a)Building Permit Fee 2. Electrical - (b)Estimated Total Cost of Consbuction from 6 3. Plumbing - — _ Building Permit Fee 4. Mechanical(HVAC) -- - - - - 00 00 5 Fire Protection _. . _ -_ 72 /nl 6. Total=(1 +2+3+4+5) 000 Check Number _I This Section For Official Use Only Building Permit Number Date Issued Signature'. Building Commissioner/lnspeclor of Buildings Date IMI+c)'1(-C), vaiUc, Kari-ovyLprwerinn-�,Co" Version 1.7 Commercial Building Permit May 15, 2000 SECTION 4 CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000 CUBIC FEET OF ENCLOSED SPACE Interior Alterations ❑ Existing Wall Signs ❑ Demolition❑ Repairs Additions ❑ Accessory Building❑ Exterior Alteration JA Existing Ground Sign❑ New Signs❑ Roofing[] Change of Use❑ Other❑ Brief Description Enter a brief description here. Of Proposed Work: RDO xY' IwiN bH vi.00ta iN 0uR 01(y L✓l , SECTION 5-USE GROUP AND CONSTRUCTION TYPE USE GROUP(Check as applicable) CONSTRUCTION TYPE A AssemblyElA-1 ❑ A-2 1:1A-3 ❑ 1A ❑ A4 ❑ A-5 ❑ 1 B ❑ B Business 2A ❑ E Educational ❑ 2B I ❑ F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑ H High Hazard ❑ 3A ❑ 1 Institutional ❑ 1-1 ❑ 1-2 ❑ 1-3 ❑ 3B ❑ M Mercantile ❑ 4 ❑ R Residential ❑ R-1 ❑ R-2 11R-3 11SA ❑ 5 Storage ❑ S-1 ❑ S-2 ❑ 5B ❑ U Utility ❑ Specify: . M Mixed Use ❑ Specify: S Special Use ❑ Specify COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS ANDIOR CHANGE IN USE Existing Use Group: Q Proposed Use Group _. . - Existing Hazard Index 780 CMR 34): . Proposed Hazard Index 780 CMR 34) SECTION 6 BUILDING HEIGHT AND AREA BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY Floor Area per Floor gin 1s 2m 3° Total Area(so Total Proposed New Construction(d) Total Height(0) Total Height ft 7.Water Supply(M.G.L.e.40,§54) 7.1 Flood Zone Information: 7.3 Sewage Disposal System: Public ❑ private ❑ Zone Outside Flood Zone[] Municipal ❑ On site disposal system❑ Version1.7 Commercial Building Pemdt May 15,2000 8. NORTHAMPTON TONING Existing Proposed Required by Zoning This column m be filled in by Buddivg Department Lot Size Frontage Setbacks Front Side L — R: L:_ . R: Rear Building Height _ Bldg.Square Footage - % - - -- Open Space Footage % - (Lmare ue bldg a paved _ arlon ,m #of'Parking Spaces - --- Fill: valame BLocation A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO O DONT KNOW O YES O IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO O DONT KNOW O YES O IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO O DONT KNOW ® 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 O 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 O IF YES, describe size, type and location: E. Will the construction activay disturb(Gearing,grading,excavation,or filling)over 1 acre or is it part of a common plan that will disturb Merl acre? YES O NO O IF YES,than 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 Archltept: Not Applicable ❑ Name(Registrant)'. Registration Number Address 6yiramn Date Signature Telephone 9.2 Registered Professional Englneer(s): Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Exaston Date Name area of Responsibility Atltlmss Registration Number Signature Telephone Expiration Date Name Area o/Responsibility Address Registration Number Signature Telephon¢ Eviration Date 9.3 General Contractor.] V416 me Znroye1w4 Not Applicable Company Name' Responsible In Charge of Con.M,- on _ Srevr _ 5)Lv%tvAnl _ Adtlress Sf9 N-T�r33 5'gmhr¢ Telephonic Version 1.7 Commercial Building Perit Mav 15,2000 SECTION 10-STRUCTURAL PEER REVIEW(780 CMR 110.11) Independent Structural Engineering Structural Peer Review Required Yes © No Q SECTION 11-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTORAPPLIES FOR BUILDING PERMIT I, ,1 �11� �✓f'�-r'1 ___ _ as Omer of me subject property hereby authorize V �� to act on my behalf,in all matters relative to rk au qy this building permit application. _ signature' of o ne Date y— — as Owner/Authonzed 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 penury _ _... vry S)L ✓h/�rq �Print Name - Sgnatureof Cwne/Agent ^i We SECTION 12-CONSTRUCTION SERVICES 101 Licensed Construction Supervisor: 1 Not Applicable ❑ Nameoi Liom"Holder 1� �1 ✓Yt��"b _ -._ .. _.�Z�,� • _—. License Number, ;tog a ow-73 (o/,11 ),-2 0-0-C, Addr as F�:piration Date —Signature Telephone SECTION 17-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152,§25C(61) 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 peril. Signed Affidavit Attached Yes (9' No O 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: 340 Rl\tCvSiCt(__ D The debris will be transported by: \�Q 400,&-j4Ytti.proThe debris will be received by: Building permit number: \] Name of Permit Applicant �y Date Signature of Permit Applicant ®� Commonwealth of Massachusetts Division of Professional Licensure Board of Building Regulations and Standards C o n s t riled o r(i5 0 pee ry i s o r f CS-077279 Elwes,'. 0612112020 7 ra STEVEN A SI�ERMAN'rt 268 FOMER ROjID SOUTHAMPTON�v1A 010]J a /moss 1i0�0 Commissioner Office of Consumer Affairs and Business Regulation One Ashburton Place - Suite 1301 Boston, Massachusetts 02108 Home Improvement Contractor Registration Type: Corporation Registration: 105543 VALLEY HOME IMPROVEMENT INC - Expiration: 07/16/2020 P.O.BOX 60627 FLORENCE, MA 01062 Update Address and Return Card. 60A 1 0 20M 05'l Office of HOME AMairs8 BusinessCONTRACTOR Regulation HOMEIMPROVEMENT ation beforeteexpirationvalid for ude. dual Iffounaonly etur TYPE:Qa'ooraExp before the expiration rude. Mfoundreturn to: Registration Expiration Mice of Consumere-Suite 13.and Business Regulation 105543- - 07/162020 One Ashburton Place-Suite 1301 VALLEY HOME IMPROVEMENT INC Beaton,MA 02108 STEVEN SILVERMAN 340 RIVERSIOEDR NORTHAMPTON,MA 01062 Not valid without signature Undersecretary The Commonwealth oteMassuchusens; Department oflndustrial Accidents I Congress Street,Suite 100 Boston, MA 02714-20177 www.mass.gov/dia R otkets Compensation Insurance Affidavit.Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information \' Please Print LeeiblV Name (Business/Ofgawzation/Individual): VQ,�IZU t»�C .�m J'�i 0�2 i1'1 Crl-1 ZnC Address: J-k01"�tVL'✓S\(�( �rtve 1� n E>c-c tcroto-a-I City/State/Zip: k-k0(,0CC kPf 01002 Phone#: 4.13-S8y--IS2z Arc yaa an employer?Check the appropriate bur: Type of project(required): [.Mlamacmplover-ah 7. E]Newcoosttuction 2.�lamasolc proprietor or parmeaship and haveno employees working formein 8. Remodeling say capacity.FN-workers wmp.ismance requirN.l 3�lem ahome,wner doing all work myself.[?lo workeri comp.insurance requireddt 9. Demolition 4.❑I am a homcowma and will be hiring conaacmrs to conduct aU work on my property. [will 10 Building addition cusum drat au is nnacmrs either have workers'compansaticn insmanoe ec are sole l L[]Electrical repairs or additions pmprierors with no employees. 12.E]Plumbing repairs or additions 5.[]1 am s gene,]convactnr and 1 have hired the sub-conuacmm load oa the attached sheet. ?Tea.mh<no Necmrc have empinymn and have wnrkcrs'cramp.ho—r-ce: 13.E]Roof repairs bF1 We area coryocation and its officers have exercised their right of exeurptionpev MGL c 14.QOdca 15211(4),and we have m employees.INo workers'comp.twsmace regai,,tij *Any applicant that checks box#1 must also fill out the section below showing their workns'compensation policy iafomvdon. t Homeowners who sab nit pais affidavit indicating they are doing all work and then hrze outside connactors must submit a new affidavit Iu h-ting such. tCoa viesors that check this be.must anached anaddaional sheet showing the name of tae sub-contmcmrs and state whether or not those entities have emp]oyces. if the sob-coptrzaors have anployees,thry.most provide Acir workersamp,policy number. I am an employer that is providing workers'compensation insurance far my employees. Below is the policy and job site injormahon. (n Insurance Company Name: -Ae-br LL 7—An w' aro—v—)(—t— C-1 U sp Policy#or Self-ins.Lip.#: 0C)CJCJ0 2b t7"Z \S/ Expiration Date: Job Site Address: 34U �Ilh'./51Gt.L V/� City/State/Zip: PoiCP2,6e MCL. 01 Z) Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required trader MGL c. 152, §25A is a criminal violation punishable by a fine up to$1,500.00 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify un ,the pains a7alties afro hat the information provided above is true and correct m ' A� Date' al ra I r Phone# S2Z Oficial use only. Do not write in this area,he be completed by city or town official. City or Town: Peemit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing inspector 6.Other Contact Person: phone#: