23D-104 (2) 17 NUTTING AVE BP-2003-1167
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:23D- 104 CITY OF NORTHAMPTON
Lot:-001
Permit: Building
Category: BUILDING PERMIT
Permit# BP-2003-1167
Project# JS-2003-1828
Est. Cost: $40000.00
Fee: $125.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: Valley Home Improvement, Inc 060300
Lot Size(sq.ft.): 8015.04 Owner: CALDANARO ANTHONY J JR&
Zoning: URB Applicant: Valley Home Improvement, Inc
AT: 17 NUTTING AVE
Applicant Address: Phone: Insurance:
P 0 Box 60627 (413) 584-7522 Workers
Compensation
FLORENCEMA01062 ISSUED ON:6/20/03 0:00:00
TO PERFORM THE FOLLOWING WORK:ADD DORMER (BATH) & RECONFIGURE 2ND FLR
TO ADD BEDRM
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: Receipt No: Date Paid: Check No: Amount:
Building 6/20/03 0:00:00 16686 $125.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo
File#BP-2003-1167
APPLICANT/CONTACT PERSON Valley Home Improvement,Inc
ADDRESS/PHONE P 0 Box 60627 (413)584-7522
PROPERTY LOCATION 17 NUTTING AVE
MAP 23D PARCEL 104 001 ZONE URB
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid a.i(P, faS—
Typeof Construction: ADD DORMER(BATH)&RECONFIGURE 2ND FLR TO ADD BEDRM
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 060300
3 sets of Plans/Plot Plan
THE FOLLOWING 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 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 Commi ' n
e_‘'/, ...f„ --
Zo 2oc:2 1
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.
0,
11
Department use only
City of Northampton Status of Permit:
Building Department Curb Cut/Driveway Permit
-
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
y thex-Specify _ _____
APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE 01t S ail :O 3 FA kit( DWELLING
ij
..i
J U N 1 8 2003
SECTION 1-SITE INFORMATION 1 1
1.1 Property Address: ViriOiE l8Vt'Qtlibeikfdptpleted by office
( ►OTHAWIONir' olro
17 Nutting Avenue Map 69,51) Lot _��9-� Unit
Northampton, MA 01060 Zone Overlay District
Elm St. District CB District
SECTION 2- PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record: 17 Nutting Avenue
Anthon Caldanaro & Bosiljka Glumac Northampton, MA 01060
Name(P in Current Mailing Address:
,.i ' s 585-3719
_. -. _._,..._,_,... .,___ , Telephone
Signatu e
2. A_ on - A: -n : Nelson Shifflett
Valley Home Improvement. Inc. P.O. Box 60627, Florence, MA 01062
Name(Print) Current Mailing Address:
584-7522
Sign u Telephone
SECTION - ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars) to be Official Use Only
completed by permit applicant
1. Building (a)Building Permit Fee
02r5;0a 0
2. Electrical (b) Estimated Total Cost of
�c77 Construction from(6)
3. Plumbing /® V °� Building Permit Fee
4. Mechanical (HVAC)
5. Fire Protection
6. Total =(1 + 2 + 3 +4+ 5) ye/dad Check Number /6 ,47 25 --
This Section For Official Use Only
Building Permit Number: //67 Date Issued:
ISignature:
Building Commissioner/Inspector of Buildings Date
S
Section 4.
ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE
DENIED DUE TO LACK OF INFORMATION
Existing Proposed y/ Required by Zoning
'I This column to be filled in by
bee
I Building Department
Lot Size
Frontage e v
� .
Setbacks Front
Side L: R: L:
Rear —_.
Building Height
Bldg. Square Footage
Open Space Footage
(Lot area minus bldg&paved
parking)
#of Parking Spaces
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 __A 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 any proposed changes to or additions of signs intended for the property ?YES _
No
IF YES, describe size, type and location:
'ECTION 5- DESCRIPTION OF PROPOSED WORK(check all applicable)
New House 0 Addition 0 Replacement Windows Alteration(s) 0 Roofing 0
Or Doors 0
Accessory Bldg. 0 Demolition❑ New Signs [ ] Decks [ ] Siding[ ] Other[
Brief Description of Proposed Work: 0 e c? ract .' J — ,Qea,.] .3 fti ome) ua r 710
G e 44 — fl)c uJ s o ic eft i.- vrS s..s u
Alteration of existing bedroom Yes No A ding new bedroom Yes No
Attached Narrative u Renovating unfinished basement Yes No
Plans Attached Roll L - Sheet❑
6a. If New house and or addition tQ.existing housing. complete the following:
a. Use of building: One Family Two Family Other
b. Number of rooms in each family unit: Number of Bathrooms
c. Is there a garage attached?
ALfwl
d. Proposed Square footage of new construction. $O s,Z 1 Dimensions
e. Number of stories?
f. Method of heating? F� - Fireplaces or Woodstoves Number of each
g. Energy Conservation Compliance. ,41 fa Mascheck Energy Compliance form attached?
Type of construction L./ 3
i. Is construction within 100 ft. of wetlands? _Yes t --171-o. Is construction within 100 yr. floodplain Yes No
j. Depth of basement or cellar floor below finished grade
k. Will building conform to the Building and Zoning regulations? —'es No .
I. Septic Tank City Sewer 1/ Private well City water Supply l/-
SECTION 7a -OWNER AUTHORIZATION -TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I, Anthony Caldanaro & Bosiljka Glumac , as Owner of the subject property
hereby authorize Nelson Shifflett, Valley Home Improvement. Inc. to act on
my beh- , in all matters relative to work authorized by this building permit application.
& l 4 -0 3
Signature of Owi Date
I, Nelson Shifflett, Valley Home Improvement, Inc_ , 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.
Nelson Shifflett
IPrint Name
I
I SECTION 8 -CONSTRUCTION SERVICES
.1 Licensed Construction Supervisor: Not Applicable 0
Name of License Holder: Nelson Shif f lett 060300
Valley Home Improvement, Inc. License Number
340 Riverside Drive, Northampton, MA 01060 9/22/04
Address Expiration Date
584-7522
Signature Telephone
Not Applicable 0
Valley Home Improvement, Inc_ 105543
Company Name Registration Number
340 Riverside Drive _ 7/17/04
Address Expiration Date
Northampton, MA 01060 Telephone 584-7522
SECTION 10-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
11. - Home Owner Exemption
The current exemption for"homeowners"was extended to include Owner-occupied Dwellings of one(1) or two(2)families
and to allow such homeowner to engage an individual for hire who does not possess a license, provided that the owner acts
as supervisor.CMR 780, Sixth Edition Section 108.3.5.1.
Definition of Homeowner: Person(s)who own a parcel of land on which he/she resides or intends to reside,on which there
is,or is intended to be,a one or two family dwelling,attached or detached structures accessory to such use and/or farm
structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner.
Such"homeowner"shall submit to the Building Official,on a form acceptable to the Building Official,that he/she shall be
responsible for all such work performed under the building permit.
As acting Construction Supervisor your presence on the job site will be required from time to time,during and upon
completion of the work for which this permit is issued.
Also be advised that with reference to Chapter 152(Workers' Compensation) and Chapter 153 (Liability of Employers to
Employees for injuries not resulting in Death)of the Massachusetts General Laws Annotated,you may be liable for person(s)
you hire to perform work for you under this permit.
The undersigned"homeowner"certifies and assumes responsibility for compliance with the State Building Code,City of
Northampton Ordinances, State and Local Zoning Laws and State of Massachusetts General Laws Annotated.
Homeowner Signature
�S NAM P�.
=0 04 --- _ .
�.4 � 1� 14$ GitR i1 Northampton _*=L
W ti�vll =r
B ;�i/ tt_,(j*� Alassachasetts ='=�
mow► ��.. 1^
t.:�`>4_sill• _—
"" DEPARTMENT OP BUILDING INSPECTIONS 4
212 Main Street ' Municipal Building
Northampton, Mass. 01060 mil
WORKER'S COMPENSATION INSURANCE AP'F'mAVTT
I, Nelson A. Shifflett / Valley Home Improvement, Inc.
(licensee/permittee)
with a principal place of business/residence at:
Riverside _Drive_, Northampton, MA 01060 (phone#) (413) 584-7522
(str ..t/city/state/zip)
do hereby certify, under the pains and penalties of perjury, that:
Q0) I am an employer providing the following worker's compensation coverage for my
employees working on this iob:
American Int' l Companies WC00260737000 2/1/04_
(Insurance Company) (Policy Number) (Expiration Date)
( ) I am a sole proprietor, general contractor or homeowner(circle one) and have hired
the contractors listed 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)
(attach additional sheet if neoeaary to include information pertaining to all 000trattors)
( ) 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 while homeowners who employ persons to do maintenance,construction or repair work on a dwelling of
not more than throe units in which the homeowner resides or on the grounds appurtenant thereto are not generally considered to be
employers under the welter's compensation Act(GL152.ss 1(5)),application by a homeowner for a license or permit may evidence the
legal coitus of en employer under the Workers Compensation Act
I understand that a copy of this statement may be for warded to the Departmme of Industrial Accidents'Oboe of Insurance for the
coverage verification and that failure to secure coverage under section 25A of MGL 152 can teed to the imposition of criminal penalties
consisting of a fix of up to$1,500.00 and/ex imprisonment of up to one year and civil penalties in the form of a Stop Work Order and a
fine of 3100.00 a day against me.
Signed this it day of 3 I For deportment use oIy
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FUTURE DORMER/BATH
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BEDROOM MASTER BEDROOM '9
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WALK IN CLOSET
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LIVING AREA •
1640 sq ft
71cax41/ le/),i fv_r- .%1Wsc 0', a/ OWIW0761)
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9 a,191 gm 045103
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s .r' pew., t%..•_.
CHECK FLASHING REAR OF ~*
NEW ANDERSEN WINDOW SIDING TO MATCH HOUSE
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%PEi 48"TILE SHOWER ( Ci 1, t
I ' ,� 8'-5 9/16 \/ 5-0 CAMBRIDGE TUB/TILE t 1
I 1 0 10 r-- WALLS 12'-9 1/2"
� � I /\ ' 'NEW FAO) + I I i
1 � 'r� /REC. GLASS ENCLOSURE \ i 1 I
: FLOOR TO REMAIN
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v TILE FLOOR 13'-9 1/2" 1 v'� v
TOTO TOILET 1--n \ INFILL DOOR r ,
_______,)1
LINENS �� NEW OFFSET BEDROOM 1
MASTER BEDROOM SWANSTONE VANITY TOP
\V ' I e/ 7 rti' ,
\ \N _ Ul 1. READY FOR CARPET NEW CLOSET
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EXTEND A.C. AND HEAT N HARDWOOD FLOOR \ NEW SMOKE DETECTORS �_ `
RETURN ZONE DAMPER I • ENTIRE HOUSE EXIST `�S�$
REPAIRS TO FOLLOW ' \.., . 0 S \
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O III \vo....1- 0 1 ( REC. HARDWOOD LANDING A O
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4 STUDY 3
D.H. WINDOW, 11'-9 7/8" �>t/ NEW SIX PANEL PINE DOORS / ' _i /i
C ON RIDt� THROUGHOUT STAIN :!1 \
3-0 POCKET DOOR s CABINET 5 /, CARPET HERE
GRADE COLONIAL TRIM TO
�b 1' MATCH i_Th/ iv
BLOW INSULATION IN FLOOR [_. EXISTING WALL REMOVED EXISTING CLOSET NEW `7
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SYSTEM BELOW I \� SHELVING /
� BEDROOM 2
VENTING OCTAGON WINDOW 1_' `r' I J
FLUOR UGH K------7
CLOSET� LTI / 15'-61/2"
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j ALL SHELVING BY CREATIVE / SKYLIGHT `-- — �1 30 X45 VENITN SKLIGHT
SKYLIGHT
SPACE 0 60"WALL 0
60"WALL .J FULL HEIGHT WALL �I v v � -" , v v ..v v v y v y �� v v v v v . � �v � •� � � �
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BEDROOM REMODEL
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BUILDING DEPARTMENT
NORTHAMP'TON► MA
These documents shall be =t�on�+,file of ot t ao
workand shall beopenta tarof Buildings.of the
Any changes mode rc s�'e' wings
rovci of the
construction,must haVe writ•an ap,•
Inspector of Buildings.Plan vst canfor to Moss
State Bui Vo46
Q3
irivoCtor of Buildings