31B-103 (3) BP-2023-1441
145 STATE ST COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
31B-103-001 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
Permit # BP-2023-1441 PERMISSION IS HEREBY GRANTED TO:
Project# BATH RENO 2023 Contractor: License:
VALLEY HOME IMPROVEMENT
Est. Cost: 24150 INC 077279
Const.Class: Exp.Date:06/21/2024
Use Group: Owner: SCIARRA GINA LOUISE & WILLIAM SCHER
Lot Size (sq.ft.)
Zoning: URC Applicant: VALLEY HOME IMPROVEMENT INC
Applicant Address Phone: Insurance:
P 0 BOX 60627 (413)584-7522 0055030215
FLORENCE, MA 01062
ISSUED ON: 10/17/2023
TO PERFORM THE FOLLOWING WORK:
BATH RENO
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:
Final: Final: Final: Rough Frame:
Gas: Fire Department Driveway Final: Fireplace/Chimney:
Rough: Oil: Insulation:
Smoke: Final:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Signature:
A �. .
• . - •
1 ,
Fees Paid: $157.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
uocupign envelope iu: rHo ioi-af-uuocj+murowL-ao ini Ino 4Y1...c
CeI'
The Commonwealth of Massachu etts cc t!'�
''''..6) Board of Building Regulations and tams.. ds 1
Massachusetts State Building Code, 0` , . ' 6�0 `' I ETA; L[TY
Building Permit Application To Construct, Repair, Renov l. +olish a , t evise, Mar 2011
One-or Two-Family Dwelling ���oti''Nsp '
This Section For Official Use Otil y - _.,__—�...-1
Building? it Number: 3" / Date Applied:
=00 ss ____/ /� /6-17-26Z3
Building Official{Print Name) Signature late
SECTION 1:SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map &Parcel Numbers
I.1 a Ts this an accepted street'?yea no Man Number Parcel Number
1.3 Zoning Information: ' 1.4 Property Dimensions:
Zoning District Proposed Use Lot Area(rq ft) Frontage(It)
1.5 Building Setbacks(ti)
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
l
1.6 Water Supply: (M-at c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public 0 Private 0 Zone: , Outside Flood Zone? Municipal❑ On site disposal system 0
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record: f—_--
I(Q M 1r'1Cr' +- 6tr ctt tV-SCiG eve). Vf`T;T antf l'tIA PA,A nICIA
Name(Print) City, State,ZIP
S - -EY e.kr)-S2o• 1529
No.and Street Telephone Email Ad dregs
SECTION 3:DESCRIPTION OF PROPOSED WORK (check all that apply)
New Construction 0 1 Existing Building pd I Owner-Occupied 0 1 Repairs(s) 0 ! Alteration WAS Addition 0
Demolition ❑ Accessory Bldg. ❑ J Number of Units Other 0 Specify: --- . ,,,-
Brief Description of Proposed Work2: RE- t_1 Gl2c G L 4v.l IZ00r TV 41, e' / 5 r X 31
51`I_OW 42. , 1\1 P-_C A:NI E-A 1-0 " rub )64. N° c lv 6 c Tb ,-5'TRuliustflL
•F Pt n 1n^ 14 6 . C li lol{" G DQ-1?i r 73 2'' 4 V w i- To r 4 15 r
SECTION 4: ESTIMATED CONSTRUCTION COSTS
I item f Estimated Costs: Official Use Only
(Labor and Materials)
I. Building $ Zi) 0 0 b 1. Building Permit Fee: S Indicate how tee is determined:
2.Electrical $ 0 Standard City/Town Application Fee
0 Total Project.Cast](hem 6)x multiplier x
3.Plumbing S 3, ' 5 C 2. Other Fees: S
4. Mechanical (HVAC) $ List:
5.Mechanical (Fire S
Su ression Total All Fees:/S
2 Check No. Ii''1 , eels Amount: , J Cash Amount:
G. Total Project Cost: S ISp paid in Full ❑ Outstanding Balance Due •
UocuSign t nveIope lu: t-Ab1bUtie-UU Z-44tru-at./.il-9b1A1 ii i4l.t
SR 1 iO'4 5: 4.ONS'CkttiCTHON SERVICES
5.1 Construction Super>istir License ft:SL,y ) 0"17 7q�� 424 12f
\ , t_ir.ns,:Nucnb.r 1 Expiration Date
Name olCSI. fluid
^ / �,�,�,+ I.isi (Si.Type tree below it
\ .0 • 1 (Lt,.)I .�-7 ,
Type I Description
No,and Street / y ,
F10(e.1(.,C- rrN0_ O,O( )L ____ R RestrirtrtieI,ctz.2f Kenai Dwelling
C M,II. ,n,State.7,11' M 11aaonrY
d ; I RC Rotating Covering
t -- WS Window and Shun'. - S1.._ Solid fuel Ruining A fliances
a3 Pf
I ..Insulation
Telephone _��_____-_ Finail address D Demolition
5.2 Registered Himie improvement Contractor(ilIC) , 1 (
2-9
1 .. ei 4tiw'Y' eiLA"- .._ i II IC Registration Number Fxpirutiuo Dute
i11C Comps ,'able.or Name
(//IIIR:R�egisstt(jj/�ir'
No,and Street 1
I�p { i(( '} Email athb ts3
t.'ityiTown State ZIP Telephone 1
4
SECTiON 6: WORKERS' COMPENSATION INSURANCE , FFIDA1 iT(M_G.L.r. 152. § 25C(6))
Worker.Compensation Insurance affitla'it must be completed and subinitted with this application, Failure to provide
this affidavit will result in the dental of the Issusnec of the building permit.
Signed Affidavit Attadied7 Yes.... _... No......,. .... 0
w_ _ SECTION la OWNER AIITHORI1ATION TO RE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
( n° s`t?Ili'the subject piopett�,hereby authorize \kklijeNt yL,+i„,,-]O.. e-C),pCri-L t‘... "-"
ii,WiLiotoiEttdtbel, in all matters relative to Work.authorized by ell `l+di.lziin pexrni(appl ty 12023
atcasr=_toe O-t2c-
Pr;ni e hs:lei., Name tt:lectronic Signatui.i flue
. SECTION Tb:O%%NER' OR AUTHORIZED AGENT DECLARATION
By ent.ring my name below, I hereby attest under the pains and penalties of perjury that ate of the inttnination
contained in this application is true and ace 'ate tii die best of my kn nvledge and understanding.
_sYl" -VA3f\) S i kstV tit.fil Qri ifil . /0' 6 - -10 Z.;
Print Owner's is or.Authorized Agent's Name 'cctroni Si.„ a tti ) t n.n
i NOTES:
I. An Owner who obtains a building permit to do hiilhcr own won:. or an owner who hires an unregistered ctxiuractar
(not rcgi taxed in the i ionic imprtnemncnt Ctxitractor(I IU i Program).will not hale access to the arbitration
program or guaranty fund undo-M.G.L. c. I42A. Dthet important information on the I IIC Program ran be fund at
Information on the Construction Supervisor License can be found at
2. When substantial work is planned,provide the in limitation below:
Total floor area(Aq. h.) (including garage, finished hasenienuauics,decks or porch)
(irons living area isq. IL) Habitable room count
Number of f ircplaces Number of bedrooms
Number of btnthriloms Number of Itnlfitiatlts
Type of hutting system Number of decks, porches
Type of cooling Ay le i Unclosed Open
3, -Total Project Square.Footage"inay tic siiiistinireit ton it--T ;il Pi,il.t. C.t ,pa'
DocuSign Envelope ID: FA51(iCI3I-UC:b1-41tiU-ttai2-Yb1A11Ati14ut
City of Northampton
"' Massachusetts
•
DEPARTMENT OF BUILDING INSPECTIONS Ns
,` � '^' 212 Main Street • N onicipel Huilding 0. C
Northampton, MA 01060 rsNK \q'
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
properly licensed waste disposal facility, as defined by MGL c 111, S 150A.
The debris will be disposed of in:
Location of Facility: \la 11,C _.
The debris will be transported by:
Name of Hauler: \lathe-LP XYur c-- V
Signature of Applicant: if Date: l lQ 123
DocuSign Envelope ID:FA516C87-DC52-42B0-8D32-961A11AB14CE .
Commonwealth of Massachusetts
9 Division of Occupational Licensure .
Board of Building Regulations and Standards
ConstiOn$visor
.r
CS-077279 , _ 4 ],.,, icpire61'21/2024
STEVEN A S.VERINA " ' � ''
•
PO Box 808 +,�
FLORENCE MA 01062I+A• ?' t. f - K
' s'
t
THE COMMONWEALTH OF MASSACHUSETTS
Office of Consumer Affairs and Business Regulation
1000 Washing i- t,- Suite 710
Bostorw-Massacl _sett 0 118
Home Improver , :�: tacitii __Begistration
e �F_r_ - '+ � _- p 'k
,....,
t7� :: D;" " - '•_,Type: Corporation
05543
VALLEY HOME IMPROVEMENT INC f-1i -r: - .,. a egis lion 8/2012
i.,,,,; %,... M, LOU ation: 08/20/2024
P.O. BOX 60627
''L. `Cr::.-•• . �:• ": - f
FLORENCE, MA 01062 �a..-r'N t.�.. 'Al ---1 V r"r,:
. „- .. ,' .
``"t..._. Update Address and Return Card.
THE COMMONWEALTH Of MASSACHUSETTS
Office of Consumer Affal?&,a Business Regulation Registration valid for individual use only before the
HOME IMPROVEMENT CONTRACTOR expiration date. If found return to:
TYPE:.toc,&ation Office of Consumer Aliairs and Business Reguiatior.
Re�stfa--'tkftt"'i"-,E4W1l tion 1000 Washington Street -Suite flu
Boston,MA 02118
VALLEY HOME IMPRQU,E#+1 t4:11
STE VCN A.51LVERMA• :-_�,.1' ^, �it IN�
340 RIVERSIDE DRIVE.----. '=t`' „,.A'ci.�i;(ec.--(t �— 1/ >
FLORENCE, MA 01062 _2.7-.,' ' ,;.` +
Undersecretary Not valid without sianature
DocuSign Envelope ID FA516C87-DC52-4260-8D32-961Al IABI4CE
The Commonwealth of Massachusetts .
Department of Industrial Accidents
wl_ 1 Congress Street,Suite ilia
=:�=�=i
Boston, MA 40
wwly.mass.0211gov/d-2r.'uI 7
Workers' Compensation Insurance Affidavit: Builders!Contractors/ElectriciansiPlnmbers.
TO BF,FILED WITH THE PERMITTING AUTHORITY.
ADnlicant Information I ` - Please Print Lezibly
Name (Business/Orgauizrion/Tndividual): a •e� TYt7MG �m,e D-€ra'iz eZ-I . �r"iG
Address: 3`-i0 R'k,...-ev-s,,dc r't.-c 1?-.0• EDtatc Cv0(o2:7
City/State/Zip: t'1U' r u. kn- al 002 Phone #: 4 t- -<'S4l--1 S2Z
Are you an employer?Chet);the appropriate box: Type of project(required):
t I es a employee wi. . 4 9 employees(fill andlorpart-time}.• 7- ❑New e0t1strUutiun
2.0 I am a sole proprietor or partnership and have no employees working for rue in ii. fEl Remodeli rig
any ccpacity.No workers'camp.insuu-nce retuirea.]
i.❑T am a homeowner doing all work myself.[No workers'comp.insurance required.]I
9. ❑Demolition
10 0 Building addition
4.17 I am a homeowner and will be hiring contractors to conduct all work on my prapcny. I will
ensure that all contactors either bate workers'co rpetsation iasute.>7ce or are sole 11.0 Electrical repairs or additions
proprietors with no employees.
12.❑Plumbing repairs or additiou5
5.0 I am a general contractor and l have tired the sub-contractors listed on the attached sheet 13 Roc:fr airy
These.rile-_nntractnrihaveemployees and havewcrkrr.'tom;.lnc:trance.: ❑ repairs
6.0 W e are a corporatioc audits officers have exercised riot:right of exemption per MGL c. 3 4.O Culler
152.§1(4),and we have aui elnpluyer_s. No workers'comp.insurance required.]
`Any applicant that checks box#1 must also fill out the secton below showing their workers'compensation policy ntfarrnaaua.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outstide coottartors must submit a new affidavit indicating such.
:Contractors that check this box must attached an additional sheet showing du name of the sub-contractors and state whether or not those entities have
employees. If the sub-contractor have employees,d!ey musr 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 the
information. qq
Insurance Company Name: tl-+r'76,1C '3 cle i r c.L r 4'1 ironva
Policy#or Sclf-iris.Liic.`#:_ OlDc-D O 3 b 2 1 S .Expiration Date: o?) i )Qa.V
lob Site Address; VA' S City/Stato/Zip; Qf- rti,
Attach a copy of the workers' compensation'policy declaration page(showing the policy number and crpiretIon 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 S250.00 a
day against thc violator.A copy of this statement may be forwarded to thc Office of Investigations of the DIA for insurance
covcrag:verification.
I do hereby certify ur .r the pains and pe !ties of p ' hat the information provided above is true and correct.
1b1 i —
Signatrse,_ � /Y Date' i�J (�
Phone#: l ` 5- :.)g,-l`'I 22-. •
Official use only. Do not write in this area, to be completed by city or town official.
Ciry or Town: Permitfi.iceose# •
i .Issuing Authority(circle one):
1. Board of Aealth 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6, Other
Contact Person: Phone#: