29-031 BP-2022-0220
14 PIONEER KNOLLS COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
29-031-001 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
Penn it# BP-2022-0220 PERMISSION IS HEREBY GRANTED TO:
Project# RENOVATION Contractor: License:
VALLEY HOME IMPROVEMENT
Est. Cost: 71400 INC 077279
Const.Class: Exp.Date:06/21/2022
Use Group: Owner: D HANNULA CATHERINE L&DANIEL
Lot Size (sq.ft.)
Zoning: WSP Applicant: VALLEY HOME IMPROVEMENT INC
Applicant Address Phone: Insurance:
P O BOX 60627 (413)584-7522 0055030215
FLORENCE, MA 01062
ISSUED ON:03/10/2022
TO PERFORM THE FOLLO WING WORK:
RENO KITCHEN,BATH AND BUILD NEW DECK
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:
Gas: Final: Final: Rough Frame:
Rough: Fire Department Driveway Final: Fireplace/Chimney:
Final: Oil: Insulation:
Smoke: Final:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Signature:
,M
' I9-'1 .
Fees Paid: $464.10
212 Main Street, Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
File #BP-2022-0220 Z - V`K(
APPLICANT/CONTACT PERSON:VALLEY HOME IMPROVEMENT INCcvic=(,J
P O BOX 60627 FLORENCE, MA 01062(413)584-7522 f ��
PROPERTY LOCATION 14 PIONEER KNOLLS
MAP:LOT 29-031-001 ZONE
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Building Permit Filled out
Fee Paid $464.10
Type of Construction: RENO KITCHEN, BATH LD N DECK
New Construction
Non Structura I Renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/ Statement or License
3 sets of Plans/Plot Plan
THE FO OWING ACTION HAS BEEN TAKEN ON THIS.APPLICATION BASED ON
INFO ATION PRESENTED:
Approved Additional permits required (see below)
PLANNING BOARD PERMIT REQUIRED UNDER:§
Intermediate Project: Site Plan AND/OR Special Perm it With Site Plan
Major Project: Site Plan AND/OR SpecialPennit With Site Plan
ZONING BOARD PERMIT REQUIRED UNDER: §
Finding Special Permit Variance*
Received&Recorded at Registry of Deeds Proof Enclosed
Other Perm its Required:
Curb Cut from DPW Water Availability Sewer Availability
Septic Approval Board of Health Well Water Potability Board of Health
Permit from Conservation Commission Permit from CB Architecture Committee
Permit from Elm Street Commission Permit DPW Storm Water Management
Demolition Delay
3- ID-ZO2Z
Signature of Building Official Date
Note: Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning
requirements and obtain all required permits from Board of Health, Conservation Commission,Department
of public works and other applicable permit granting authorities.
*Variances are granted only to those applicants who meet the strict standards of MGL 40A.Contact Office of
Planning&Development for more information.
The Commonwealth of Mass chus
UTFEA
Bou-d of Building Regulations d St dai�R — Q Fok
Massachusetts State Building C de, Zrp CMR �Q USE
•a
Building Permit Application To Construct, > MP,p
Repai eP4 � • h a Re ised Mar 2011
N N
One-or 7 0-FQIIIIlV DlV2jIIlY, . MSPFCTIq 07060Olys ^^
This Section For Official Use Only
Building Permit Number:V• of?,^ .2 A Q Date Applied:
4"uis—.$ 4:r>" /./.. .7 3 -1p-ZpZZ
Building Official(Print Name) Signature Date
_ SECTION 1: SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map& Parcel Numbers
Iy Pl(]fcr.►- kr O tt3
-
i Al a is this an accepted street?yes_ _ -o - laQ.ap Number 7'.aaeel 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 Yard;; Rear Yard
Required Provided Required Provided Required Provided
1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public 0 Private 0 Zone: ____ Outside Flood Zone? Municipal 0 On site disposal system 0
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP'
21 Ow' riofR rd
ca + � 0.otlu1_ tlOr 0 Ot062-
• 2�Tame(Printj City, State,ZIP
kLA R(x\cam \c-ic \-- ;Z(b-342-RGbq
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK1(check all that apply)
New Construction❑ Existing Building Cl Owner-Occupied 0 Repairs(s) 0 Alteration(s) ❑ I Addition ❑
Demolition 0 Accessory Bldg. 0 Number of Units . Other O Speciiy:
Brief Description of Proposed Work2:__ /eve, lithe, _, _in 5 II MIA/ !A" .
l_ ,t!b G
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use,Onl
--,__- . (Labor and Materials) y
l Building />^_/���� 1. Building Permit Fee:$ Indicate how fee is determined
r- / fl Standard Cityt3bam Application Fee
2.Electrical $ U l v ❑Total Project Costa(Item 6)x multiplier x
3.Plumbing • $ (MOP 2. Other Fees: $ -
4.Mechanical (HVAC) $ List: •
5.Mechanical (Fire $ _f - `
Suppression) Total All Fees:,$lj J
Check No.ia' heck Amount: 'I up[Y•Cash Amount:
6.Total Project Cost: . $ 7/1 Li(ft) , 6 Paid in Fa. -p Outstanding Balance lie:
64. (C)
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL) - `2J-�C� lzC ��yL. 1
ac,...r ._.( - \I .Al\lex �1 License Number Expiration Date
•
Name of CSL Holder
,�
—7 List CSL Type(sec below)
P•r �(v., (n002 { Type Description
No.and Street '
IJ U'r.:•es tri cted(Raildi ngs up to 35,000.cu.if.}
'BO/Pr/CC_ MA 0\C,Co` I R Restricted I&2 Family Dwelling
_ City/Town,Stat ,ZIP M .; Masonry •• __
_RC Rnc"ngCuu ring
--- WS Window and Siding
SF "Solid Fuel Burning Appliances
14Vb—S2 71522— ( t insulation
Telephone Email address i D Demolition
5.2 Re 'stered Rome improvement Contractor(RIC) QSrJ g ����
ti HIC Registration Number piration Date
C Comp Name or WC Registr nt Name
•
- )O'° (r,0(o /Cx—)C�(Y\P b 1 v��
No.and Street �l�s -���� Err ail address
City/Town,State,ZiP Telephone .
• SECTION-6:WORKERS' COMPENSATiON-D SURANCE AFFIDAVIT(14I.G.L••c.152.§ 25C(6))
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide
this affidavit willresuit in the denial•of the issuance oftihe building permit.
Signed Affidavit Attached? Yes .. 111 No .O
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 p-_ t 5j ` Xl 1\Vex_mC-lj-1
to act o y behalf,in all tters to work authorized by this ••n. permit application.
Print Owner Name(Electronic Signature). Date
SECTION 7b:OWNrERI OR AUTHORIZED AGENT DECLARATION
By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information
I. ontained in this application is true and accurate to the best of my knowledge and understanding_
( t*e ,io-fIaniula eehtiAL‘it id /34104- ! •-
Print Owner's or Authorized Agent's Name(Electronic Sispatrre) Da
NOTES:
1. An Owner who obtains a building permit to do his/her own•work,or au 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 hand under M.G.L.c. 142.A.Other important information on the HIC Program can be found at
74 %.mass�eovloci Information on the Construction Supervisor License can'be found at www.mass.nov/dns
2. When substantial work is planned,provide the information below:
Total floor area(sq. ft.) (incIuding.garage,finished basement/attics,.decks or porch)
Gross living area(sq.ft.) Habitable room count
Ntntiber 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"maybe substituted for"Total Project Cost" .
City of Northamptori
10%\ ----
Massachusetts ,f s_ .. ,.
DEPARTMENT OF BUILDING INSPECTIONS ? i_j" ..-
41*ItIWI 212 Main Street a Municipal Building J �b/r
WZi .:cry ptc. , b 7•
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
from 1� V ..J�� 1?
properly licensed waste disposal facility, as defined by MGL c 111, S 15OA. •
The debris will be disposed of in:
Location of Facility: \lQ U -RQCQ Co 1 �-\-e \C) , Q�`4'1 '
2,0-(4,--,
The debris will be transported by:
Name of Hauler: `�UUk 6(-Ym4 .� (t'i tits - • •
Signature of Applicant: i Date: J — ,A °R
The Commonwealth of. fassaehusetts
f~� .Deparinterzt of Industrial Accidents
�Y
� -'�.' � • .1\ Congress Street, Suite 100
Boston,MA 02114-2017
?MTV.lrcass.gov/dia
Ws•s'J:ers'Cnl1ip.r_rlsaFtrut IItSE2!'a.nJ:L' 8llilrleF•s/CorilrartorsrElectrirlssnr(Plumbers.
'TO i Rr.FILED WITH T HF, AUTHORITY.
Applicant Information Please Print Legibly
�} �i�� - T.JTr C Nam e lnumincvt; g iirraniiaiirmiintnvtrii raij' t J� �, ��'���,��' ,��jI41S L
Address: _ �7 , Q- 0 . (2)C : Co O Cn 2.,R--
City/State/Zip O.OJ >Y 2Csa__\4(A-0\ k 2-- Phone#: S2 2_
Are you an employer?Check the appropriate box: Type of project(required):
1.1:ErI am a employer with ( employees(toll and/or part-time).` 7. New Construction
2.0 I am a sole proprietor or partnership and have no employees working for me in 8. ®Remodeling
any capacity.[No workers'comp.insurance required.)
9. ❑Demolition
3.1 I I am a homeowner doing all work myself.No workers'cUc1p.insurance r'egnued.1•
I0 0 Building addition '
4.01 am a homeowner and will be hiring contractors to conduct all work on my property. I will
etisorethe all ars either•have w3tk-oe'compensation insurance or aro co!e 11.0 Electrical rrfairs or.ad-ditions
propriettns with noemployees. 12.El Plumbing repairs or additions
5.0 i am a general contractor and T have hired the sub-contractors listed on the attached sheet 13.1:Roof repairs
These sub-contractors have employees and have workers'comp.insurance?
6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.❑Other
152,VI(4),and we have no employees.[No workers'comp.insurance required.)
'Any applicant that checks box 41 must also fill out the section below showing their workers'cempcosation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new atrtdavit indicating such.
-Cvnvracto s tax cheek this bent most attached=additnsnai sheet showing the name of the star-contactors and state-whether ur not those entities have
employees. If the sub-contractors have employees,they must provide their workers'comp policy number.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name: A,1 1Civ Art' _.e Policy or Self ins.Lit;.#: DC)S Sc 3 b Z 1 S Expiration Date: a 1 1 I a a
Job Site Address: ILI 91.. ynel VS • City/State/Zip: l()A-he1 r1. 14 O)excC
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expir lion date).
Failure to secure coverage as required under 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 under th i and penaltie fperjuly orn:ation provided above is truecorrect.and
- Date: 12'+�tr 1 �'_
Signature: -
B
Phone 4: U,\2 SS"1— ',S 22—
Official use only. Do not write in this area, to be completed by city or town official
City nr Tnrwn• Permit/i,icensr_.# rt
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 4;
Commonwealth of Massachusetts
Division of Professional Licensure
Board of Building Regulations and Standards
Consty.,i tl ii'SiJp visor
CS-077279 -. Etpires:06/21/2022
STEVEN A SVERMANI,I, ! f lf,+ ,
PO BOX 6D67 - } n '.t , c
FLORENCE M9}010621�F Oy
q4
✓ ?' ii -i
�OJ.SS 4. •
Commissioner c,Va
Office of Consumer Affairs and Business Regulation
1000 Washington Street - Suite 710
Boston, Massachusetts 02118
Home Improvement Contractor Registration
Type: Corporation
VALLEY HOME IMPROVEMENT INC Registration: 105543
P.O.BOX 60627 Expiration: 08/20/2022
FLORENCE,MA 01062
Update Address and Return Card.
4 1 C' 20M-0S/17
Office of Consumer Affairs&Business Regulation
HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only
TYPE:Corporation before the expiration date. If found return to:
Registration Expiration Office of Consumer Affairs and Business Regulation
105543 • 08/20/2022 1000 Washington Street -Suite 710
VALLEY HOME IMPROVEMENT INC Boston,MA 02118
STEVEN A.SILVERMAN A 1 ���
340 RIVERSIDE DRIVE- • �J ��-�
FLORENCE,MA 01062 Undersecretary Not valid without signature