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18C-147 UNIT 6 BP-2024-0413 162 PROSPECT AVE COMMONWEALTH OF MASSACHUSETTS UNIT 6 Map:Block:Lot: CITY OF NORTHAMPTON 18C-147-001 Permit: Alts Renovations Repair PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit# BP-2024-0413 PERMISSION IS HEREBY GRANTED TO: Project# SOUND DAMPENING 2024 Contractor: License: Est. Cost: 8000 VALLEY HOME 077279 Const.Class: Exp.Date: 06/21/2024 Use Group: Owner: JANE CAREY, Lot Size (sq.ft.) Zoning: URB Applicant: VALLEY HOME IMPROVEMENT INC Applicant Address Phone: Insurance: P O BOX 60627 (413)584-7522 6H62301-1 FLORENCE, MA 01062 ISSUED ON: 04/09/2024 TO PERFORM THE FOLLOWING WORK: ADD SOUND DAMPENING 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: Fees Paid: $65.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner /71.)...,VN r�� / / 4f/0/9 \`` t 14 The Commonwealth of Massac �' is �a ,truk Board of Building Regulations and$ ds `9� � FOR • O „" MUNICIPALITY Massachusetts State Building Code, 78�&. ,,i ct. USE Building Permit Application To Construct,Repair, RenovaieC, Jemolish a Revised Mar 2011 One-or Two-Family Dwelling ' 0` ; ' This Section For Official Use Only Building Permit Number: f A Sf- 11/.5 Date Applied: /4 & /77 Building Official(Print Name) Signature Date SECTION 1: SITE INFORMATION 1.1 P[ C 4.. e() s�� /� 1,2 Assessors Map&Parcel Numbers 1.1 a Is thisQ an accepted street?yes no Map Number Parcel 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 Yards 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 El Private❑ Zone: Outside Flood Zone? Municipal 0 On site disposal system 0 Check ifyes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: -&ne- Core l�or �4•.-. eN Mr Name(Print) City, State,ZIP 16 Z 1404ap `t c'aspecis Pr.v 866- 7-I4'- 9-X ) `-3 =�`‘! fu::1 cap, No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORD(check all that apply) New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify: Brief Description of Proposed Work': PA 6OU A'- h..ctrt e(1`.•.) Ijl,.cif ecii fro -ft.-)a (-5 c.tt s SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ 9 K 1. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical $ 0 Standard City/Town Application Fee 0 Total Project Cost'(Item 6)x multiplies x 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire $ Suppression) Total All Fe.e7. $ Check NC ?IQheck Amount:(I Cash Amount: 6. Total Project Cost: $ 0 Paid in Full El Outstanding Balance Due: SECTIONS: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) 077279 6 21 24 ........... Steven Silverman License Number Expiration Date Name of CSL Ilolder List CSL Type(see below) U PO Box 60627, No.and Street l)pe Description Lt Unrestricted(Buildings up to 35,000 cu. ft.) Florence MA 01062 R Restricted I&2 Family Dwelling City/Town,State P Masonry RC hoofing Covering WS Window and Siding SF Solid Fuel Burning Appliances 413-584-7522 info valleyhomeimprovement.com I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(RIC) 105543 8-20-24 Valley Home Improvmeent _ HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name Po Box 80527 info©valleyhomeimprovement.com No.and Street Email address Florence MA coon 413-584-7522 City/'Town,State, ZIP Telephone SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152.125C(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 0 No...........❑ SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1,as Owner of the subject property,hereby authorize to act on my behalf in ll matters relay ,e to work authorized by this building permit application. j/Z 5-ed e Print Owner's le(Electronic Signature) Date SECTION 7b:0 R'OR AUTHORIZED AGENT DECLARATION By entering my name below,I hereby attest under the pains and penalties of p jury that all of the information contained in this application is true and accurate to the st of my kn wl d understanding. 5 rtVN1\) si t., VYt4IJ Print Owner's or Authorized Agents Name(Electrons ignature) Date NOTES: I. An Owner who obtains a building permit to do his/her own work,or an 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 fund under M.G.L.c. 142A.Other important information on the HIC Program can he found at Information on the Construction Supervisor License can be found at, 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) (including garage,finished basement/attics,decks or porch) Gross living area(sq. ft.) Habitable room count Number of fireplaces_ Number of bedrooms Number of bathrooms Number ofhalfibaths _ Type of heating system Number of decks/porches Type of cooling system Enclosed Open 3. "Total Project Square Footage-'may be substituted for"Total Project Cost" City of Northampton 4t114‘ Massachusetts DEPARTMENT s DEPARTMENNTorthOtimpF BUILDINGten, — , ;k4 14 : 01:061PECTIONS ;--- . 212 Main Street • Municipal Building CONSTRUCTION DEBRIS AFFIDAVIT (FOR ALL DFIVIOL ITION 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: Valley Recycling Northampton The debris will be transported by: Name of Hauler: Valley Home Improvement vilv Signature of Applicant: / / Date: / .; 9-1••. t..\ .• The Commonwealth of_tlasstichusetts Department of Inditstriral.4ccidents 1 Congress Street,Suite 100 Boston,MA 0211.1-2017 www pores goi ilia %1 Laken'Cnmlpen'ttion to seer Asti it-Kuildtrrxa'(-aatrartorvEtectrtieinat'Ptt ri. it)BE EILLD V.l I I! I HE PF.R.1MI lint;t;Al I JIORi fl. Applicant Information 1 Please Print Leeiht% Name 1 Business. n Or_t zwu n l sc'a:tt'u is l: ll4`{ 1 '.I Address: -0_ v ' DU(O p1C�lo'Z. Lity.State:'Zip: tDrer (t� (��+- Phone n: `�,k3- 1G52.2- \r:,ve an ernpta.cr.'(heck are approprisr<hat: T►pe at project(required): i.®J Jdt a 4t•�i^. IS ¢-r{vit:r_-a 19tr.1 and.21 raft-T:rrx'7 T. 3 ctl[tsIr]rc Uutx _`0 I Jnt a.x':a f r:+l+r:t:t.tr t.>r prrxr.h:ft arty ha t t:u ctry:+l‘...tra H arkirr l.'t tr' sn K. 0 Rr!ntxjelin:4 art t_{_:It I\.,t. ecru,.I-t.uranci rcyurrol z Demolition!JAI a 7tarcr.Y K:h7 .tRa an hull in ael �.••. . l.;a' .,tt tr.,a: .t rrtJ.; I)]Bu]lthej at:chi:en 4.0!Ant a!lc t> K710 Jnd..rtl't':tlt rl,,: a_7.a,lor,7;p c.n.h.a.1 J.It'a t7AL,n t':1:ttte tf•_11 al.l.tntra"ti,r.either lt:ttl•...1riL-t st Ty'111.aT:,,n Ln-.ur_•:--c - :Ire _ f Electrical rep3RS or addit]ctr:s prornctvn u la:salt.•I-g'1 Ct.16. `J 1 2.0 Plun*'m;repairN or:ttltsitutrt_i ant a I J general nt:ar !or and i htti lurtid the auU-to�nttat!vra IuitJ vt:the a:tadiet11J1rrt. ` Tt�t74 13 Roof repairi ,il-etTtL'a.t.ira1 arkaT, L tT1Ip �•-I 1.1. odic, n.0`At arc J cer ,.stare and IL,ori:r;a ha,e tcnn,eti tdv-ctt..[r.t.;la-t::,c 171e17 l',t,.t.. Anj.c h S I'A{t 2rlt t')a'C?.(No SIt':L:n Larry :.:t;2.::h'L' I 'Ar:'. 3.rr1I =t:ktl.±•..t.l.boo:=1 :n!s:,11 al.t'tt I9 tKsl the Not.Iron Iv Itt.4 .lows Its ti:,-r .orl ter,,'cc•rrtpctt.al1.•r;.•ttal trtl.Ir:nitttrrn. lum'tt ntr.t+hu.Ubattt all.,alt7Juttt Wall:au:3y,they are Lion. all tturl ttd then htrt:nuLvtk'ct•tltlaLtot,atuat aubrtut a nee a1ridat It lath eatin;aucll, t utth-x'.ur.07.41 this);ht.iw.t',Air.]attached nt:ai,hineel .i:aY;Ni''t•Jgag:Ix 71a777117:i LS..t1_+:c,:trr...,t:'r,sari 4.11c a.Nclher trt nx,1 tthU.a•.�I °It.-a 11a •. .szploLciy, Ifrttile I tttnl:3Ctl. il`-'.e,rck!.CV,t14:)1:7117J1;I+rat'.;t:1:7C.rtr +.ts,+ .enap.'I n.•cl.arth:r l am an employer that is proridin+ workers'compensation insurance for my employees_ Below is the policy and job site inform Insurance Cotttpan''Name: tt`-tC— S1 C Pultcy 4Yt Solt=ins.L:ti. =: 140 ti E.tptrattec D:re; G , 12.025 Job Site Addres.,: f(s0 PI suk 2tg:_ Attach a copy of the isarkers'campentatiun policy declaration page(ls.hossing the policy number and expirat au date). Failure to secure co%crage required under MGL c. 152.;25A is s cricumil aiolati. n punish-Age bo a Iic up to S1.5()0_00 and or one-}'ear unprn.onment,a_•well as cavil penalties:n the them of:i STOP WORK ORDER and it line of up to S250.00 a iLiy against the 1 tolattor. A copy of this statement may be fora art:ciJ to the Office of inNestte:ttxnl of theDIA for insurance s!coke a%% ll ritiltton. ` 1 du hereby certify under ik s and penalties pet** eforrnation prep ded abuse is true and correct. S,4tttturf: Dot::. 1/L/1202/ Phone=: L11t2r SjLk-"-I S2Z Ofcial use only. Do not write in this urea.to be completed by city or town official. ('it) Tns*n: rermit lirri se t Issuing Authority (circle one): ' 1. Board of lienith 1. Building I)rpttrtment J.('ity,'1-n►sn Clerk 4. Electrical to+pector 5, Plumbing Inspector G.Other t'suktack Is s►ts; ___ ._...__. �._.__. .-_. Phone Stz.�.