23A-134 (30) BP-2024-1595
77 PINE ST COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
23A-134-001 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-2024-1595 PERMISSION IS HEREBY GRANTED TO:
Project# CABINETS 2024 Contractor: License:
Est.Cost: 44500 VALLEY HOME 077279
Const.Class: Exp.Date:06/21/2026
Use Group: Owner: HILL INSTITUTE
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: 12/12/2024
TO PERFORM THE FOLLOWING WORK:
INSTALL STORAGE CABINETS, ADD GLASS DOOR AND PARTITION WALL -EXIT SIGN
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector
Underground: Scrs ice: Meter: Footings:
Rough: Rough: House # Foundation:
Final: Final: Final: Rough Frame:
Gas: Fire Department Driveway Final: 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.
Signature: !�/
J
F_
Fees Paid: $333.75
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
/ ;
7-7
The Commonwealth of Massa husetts 3 2O24
Vii4.1J, Office of Public Safety and inspec ors
Massachusetts State Building Code(780 CM
z+a Building Permit Application for any Building other than a One-or Two- eljAling
(This Section For Official Use Only)
Building Pennit Number? /595 I Date Applied: I Building Official:
_ SECTION 1:LOCATION
AS Purr $k. �tca�rc_t- c.e QPr- �lQlsz2. ��t�—T��f,�}at.z s
No.and Street City/Town Zip Code Name of Building(if applicable)
Assessors Map# Block#and/or Lot #
SECTION 2:PROPOSED WORK
Edition of MA State Code used If New Construction check here Cl or check all that apply in the two rows below
Existing Building Repair 0 Alteration RI Addition 0 Demolition 0 (Please till out and submit Appendix 2)
Change of Use 0 Change of Occupancy 0 Other 0 Specify:
Are building plans and/or construction documents being supplied as part of this permit application? Yes jB No 0
Is an independent Structural Engineering Peer Review required? Yes 0 No 0
Brief Description of Proposed Work:
22' LF L til)0 A — CAB N
L �
�U✓1 L O1 g IA) Ns lrn L t, - L K - _s 16A) RA l/r _ Ake:A ,Mrs -
SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR
CHANGE IN USE OR OCCUPANCY
Check here if an Existing Building Investigation and Evaluation is enclosed (See 780 C.Wt 34) 0
Existing UseGroup(s): ____....,...,._-_ Proposed UseGroup(s): _.._._._....__
SECTION 4:BUILDING HEIGHT AND AREA
Existing Proposed
No.of Floors/Stories(include basement levels)&Area Per Floor(sq.ft.)
Total Area(sq.ft.)and Total Height(ft)
SECTION 5:USE GROUP(Check as applicable)
A: Assembly A-1❑ A-2 0 Nightclub 0 A-3 0 A-4 0 A-3❑ I B: Business 0 I E: Educational 0
F: Factory F-1 0 F2 0 1 H: High Hazard H-1 0 H-2 0 H-3 0 H-4 0 H-5 0
I: Institutional i-I❑ 1-2 0 1-3 0 1-4❑ M: Mercantile O R: Residential R-ID R-2❑ R-3 0 R-4 0
S: Storage S-1 ❑ S?0 U: Utility 0 Special Use 0 and please describe below:
Special Use Description:
SECTION 6:CONSTRUCTION TYPE(Check as applicable)
IA 0 IB 0 HA 0 iIB0 I iilAC IiIB0 IV I VA VB 0
SECTION 7:SITE INFORMATION(refer to'780 CMR R 105.3 for details on each item)
Water Supply: Flood Zone Information: Sewage Disposal: Trench Permit:
Removal:
A trench will not be Licensed Disposal Site 0
Public 0 Check if outside Flood Zone 0 Indicate municipal 0 j
f ii�ate❑ or indentify Zone: nr on site system❑ l required CI or trench or specify
permit is enclosed 0
Railroad right-of-way: Hazards to Mr Navigation: )vlA Historic Commission Review rro rt...:
Not Applicable 0 Is Structure within airport approach area? is their review completed?
or Consent to Build enclosed 0 Yes❑ or No 0 Yms 0 No 0
SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY
I d i t j m i of Code:_, Use Group(s): __. Type of Construction:
I the building contain an sprinkler System?: __Special Stipulations:
t\curtail, Load per Hour and Assembly space:
Fdrtt t
SECTION 9: PROPERTY OWNER AUTHORIZATION
Name and Address of Property Owner
Ml 3,r,ckt S 3 Picvt, 6- 'Flovet-x_42... O I Ofp 2
Name(Print) No.and Street City/Town Zip
Property Owner Contact Information:
(645 lea yt3.5B1_ naT - -
Title Telephone No. (business) Telephone No. (cell) e-mail address
If a usable,the pro erty owner hereby authorizes:
Name Street Address City/Town State Zip
to apply for and act un theproperty owner's behalf,in all matters relative to work authorized by this building permit application.
SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 1)
If a building is less than 35.000 cu.tt.of enclosed space and/or not under Construction Control then check here O.
Otliertv iNe provide cun.tructio t control torten(sett section 107 in the code)as required.
10.1 Registered Professional Responsible for Construction Control (the professional cuurdinating document submittals)
' Name(Registrant) Telephone No. e-mail address Registration Number
Street Address City/Town State Zip Discipline Expiration Date
10.2 General Contractor
Company_ me
Name of Person Re.petn.ible fur Construction license No. and Type if Applicable
i2.()( 02(-1 (00[O2"7 f tckcs— 011_ 0 1002--
Street Address City/Town !st,,tt• lily
Telephone No.(business) Telephone No.tell) e-mail 1 i Tress
SECTION 11:WORKERS'COMPENSATION INSt.R.1\. IU.)AVt I (M.G.L c.152.§25C(6)
A Worker~'t.'untpensalion Insurance Affidavit from the MA Department of Industrial Accidents must be con,l,letrtl and
submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit.
Is a signed Affidavit submitted with this application? Yes IX No D
SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE
Item Estimated Costs:(Labor
and Materials) Total Construction Cost(from Item 6)=S
1. Building 9 CVO
Building Permit Fee=Total Construe n t {Inrre
2.Electrical S 21 506 appropriate municipal f tor) 33 3•-/
3. Plumbing S 3 1 4-lj(I { ,
4. Mechanical (HVAC) $ Note:Minimum fee=$ coot a ity)
3. Mechanical (Other) $ Enclose check payable to
6. Total Cost $ leYI 54 b (contact municipality)and write check number here //a`lf(!
SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT
By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information contained in this
application is true and ac.curate to the best of m wlcdge nt. crstanding.
Sr fr M
Sib Ua 'n) b eci '-
l. --
_..__ -__— . . aI
Please print and sign name "Title 'I elephone xlo. Date
Street Address City/'linen State Zip Email Address
Municipal Imtprctur to fill nut this section upon application approval: /�/j< /2-/2 2oZy
Name Date
City of Northampton
Massachusetts
w
}
r1
• DEPARTMENT OF BUILDING INSPECTIONS SI
212 Main Street • Municipal Building
Northampton, MA 01060 :,y 3. .i%s
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: Vk CA-C8CIa.,A
The debris will be transported by:
Name of Hauler: \ �J- .P "'
Signature of Applicant: /4/ Date: 1k 12S\2-y
.X
•• The.•Commonwealth of:llassachusetts
Departnlc'nt of Industrial.-1 ec•idents
1 Congress Street,Suite 100
• Boston, .tit.-# 02114-201
►ss► ir.mass,gas•rrtlia
11 inter.•t .112spr trvai inn Ensur.►act-.LSlid it: 13tfiltlCrl t untractors k.lt:ttritian.l'11►mite
h.
IO BE FHA...1)11II11 IIf£ Pk.RN1111-INC.*.t IHIO111t1.
\pltlirant Iufurrtt:lti,tn 1 � .-�- Please Print 1.i^i7bl.
\jffie;Li t+s:.r>(l' J,i:�J!r.•n 1.12. V,1�.1` TDU �mp/(��e.. L.l- C
Address: -(J. tQUcD a7 �..1
o‘U to2_
City State.Zip: '-lQrexY...,C. Phune L-tt S22—
trr ma cmpienrr'(bncl Iisr 4pp/uprrateN►t:
Ile
1 a pruiect Irryuiredl
i:r:s.-rr.1:y•: +:::, 68 .: s',..1 arur,... ._:•i na s. > \ •as ,..cut atr::.'t:l
14%s-..•. ^rl•{n:at s:a a:::a.:+tt.; ,r.L'J••:......ip r:.a• ....►r t:n S. t _
xrr:.K.cha_
xi; t:a:1; I\.' .etaet>'a_ ... -..r.:a tty::rrd
• l_:,t a!P:r:d.'i Aaa:r•:1: .. a,•la.. •+:!: ,N.••,.:•..+ . i .. 4 i kl:aalt.a•1:
;'•'1' x^s.,:.•n::•-•• r•��:. '1�- . -re: .. ......_ _ ?1 I ljU:lll::: »liL'a::ai7
s.•t.a:. .....t .•:K:ni!n..'k.t: r• ,+n...+ .• •1.7. ..:•r..:_.... • _ .. • :t.1 Uo--t:i sI r-cy^.2.:1 or attar:as^,
12 1 Pit1:::ht: r: add it!Intl
!S:i a :,tI iI u.i:I:'r:1:>I a:N:,ILs% is i d Ilse :n:the.,Mi.i:..1•ir.a! —J
I Le-:+.�I-:••cCxa:."t,:-'.'C-:r1..' _ :r:. 1:_.• . ••ri:... .:c:......-raa.a .J xt'n2 :,,t;:•
t 1 !4 _1111it.-
_i:t. ea r:.:7•.'r.:xr..1:...as:•t:..�aa,.:aau,..t F::.—_!. ::.a.. t'�•a;ta a s.. . -- —
1.'_. ..{t:...r.. ,
fir'• ::I•rl:a..a' ..sf.".ti1.!',•c :r.,.l:!.. !:. u..!;si:a:..:r r. 1,•.:1,.•a :,._'!'. rb.- .^r at•.I.•r.t•!s• s r'
!!.'sr:,•,.:.rr• •I sul•:tu! si d•,asf s:..t.al:r:,:t!,ai r,:dorre4 a'::.•.,tA:real thin:112:i 1.:c:!>..5.a•r,:?tr.t:•n a:rst•.i:va::J r•.:,. :,l:d_•.•.cJ:;:,t:s:�+_•!:
.:.•,s.'.r+s::_.:h.•s. zax.. .:t!. ..: . ..::•.' r•_r.J ,.. ,sc::x 'y,I•!. .. I:_•Ir-+'-
t::qln•a.+ 11:,....!•a a.1: is4-..•::CIs,.:c-.. as ...� t•ra'......._,: wcrs.. .. :1• ?r.:•. .�.•Y:.
I ant an employer that pruriding N'errAer►'rl.nipestaaIis n inanrance for net erl,lot era. Belo,,i. the policy and juh site
information.
I:1.er./n:a(trtr
t 7•t-ins L ( lQa3v�. - I:,rtralto D,i:c: 2.1
.14.41 Site
Pt�'.ti� •• -
$3 vL Vs. -• __-_--_CIt, Lip,.t.lcxerICIL_ m o o(02-
attach a cup) of the workers'compensation pulie, declaration pit'(shim ing the policy number and expiration date).
F:ntl:ls: to ac:art:ila\er.rp.:J> 1-cs sied unJe .1t;L L. t... :25A :'.S►r?:::1:i.! :is.. .t:Va r alil> :1i+�C sr. d :f::L• up Ii's i.5f).Lr 11
ili1J lai.4.*-1►3r lit:p rz.t'c.ssiit.,J., :ai.11 Fa1 'Jlttc, at,ls. I1r71if lr:J STOP tt•(.sRK ORDER,r::.l J :Is,:ut .a'u%S2 314)2
131� :1•_,11:1M I7C l;l`!Jtor..t ct'p this s1Jtcfllict lii.l♦ C,ti a,f•s src..J:. '.l:i I)tt:c:Oi Uf the h1A !"or inNur'J:s.t
co%t rai:\Cltlsatlaln.
I do hereby certify render th p s land penalties perjtt • nfarmatian provided abate is true and correct.
: it las 12,E
Plicath ::: L'`4?4-
O ficial ta.only. Du not write in this area.ldt be itntpletel by city or them etfliciat
( its or Tits is: I'tnssit Limn,: n
Issuing authurit (circle une):
I. liaard of Ileahh 2. 13niIdint;llclrlrtml•nt 3.('its•l"nmsn Clerk •t. t•iritrirai Impectur 5, Pttntibing In,hrcIur
h.Other •
tuNtaCl F't'tr►ttt: ltt+tt+t+. t; ...... _ ._ ._ ....._ _ ...._...__.... .-.... I
CONSTRUCTION CONTROL WAIVER
From: V k1 1��(-ly r pfz0va t/C,
l / �
To:
Building Commissioner
City of Northampton
212 Main Street
Northampton. MA 01060
The Massachusetts Building Code,section 107.1 allows for an exclusion from requirements for
construction control in certain situations. In accordance with code section 104.10, I request that you
grant a modification to waive the requirement for construction control of the project at
43 P N E S1p - - F L 0it'EYv C
because the work is of a minor nature,will not affect structural elements, health, accessibility, life or fire
safety, and will be done in accordance with the prescriptive requirements of the code.
Thank you for your consideration.
Respectfully,
I - 11-- ID'
S rtvgyv S i L iErz yj vii0 V TA/6