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37-007 YANKEE HOME IMPROVEMENT, INC. All home improvement contractors and subcontractors MA# 160584 CT# 0673924 CSL# 089442 engaged in home improvement contracting, unless specifi- 82 INDUSTRIAL DRIVE, NORTHAMPTON MA 01060 catty exempt from registration by Provisions of Chapter 142A 1 - 877 88YANKEE 1 - 877 - 889 - 2653 of the general laws, must be registered with the 413 341 - 5259 Commonwealth of Massachusetts. Inquiries about registra- tion and status should be made to the Director, Home Improvement Contract Registration, One Ashburton Place, Submitted / - " ^^ Room 1301, Boston, MA 02108 (617) 727 -8598 To: -` . / twA 4 c / HavYi -,f X13 s /, C. - EMAIL J 1L& C PHO /'` ..` N 713 / DATE p yi /1 X 3 CELL PHONE 1. (Gs� �-+ !? We hereby submit pecifications and est for work to be a / / and mptertala to be used: ` 1,� ' �- t��{ - ,� .5 z ;P /% �rtt,i F f • . ;�V'G i re' i ,7 - - 1CT f < 1 _ — ..�Z ,f I f4` /( fC t'' fr' /In. t -j ru p c ` - ( f3[ G04,-,0- ?t �' 7 1 l � r� ` �Cj t $/� 331 { l j i 3 Or wr;�i'idat'S ' i et. - , , - — 0., 1 a - Cep -: ..1 kbla U M Pel '16,c e- f' o9 C a -r ; / ( 01 r ''ca'Ir I-- d111 C? , .11-t ,r ca- 4,-A v i N cry, -1- i La- 6'411)4:- WORK CH DULE C , r 1 t begin the work or order the materials before the third day following the signing of this Agreement, unless sp _ .. • he . • or oat begin the work on or about ( date). Barring delay caused by circumstances beyond Contractor's control, the work will be completed by (date). The Owner hereby acknowledges and grees that the scheduling dates are approximate and that such delays that are not avoidable by the Contractor including, b of fled to strikes, Acts of God, shortages of mated - als,accidents, and all other delays beyond its control, shall not be considered as violations of this Agreement WARRANTY The Contractor warrants that the work furnished hereunder shall be free from defects in materials end workmanship for a period of following completion and shall comply with the requirements of this Agreement In the event any defect in workmanship or materials, or damage caused by the Contractor, its subcontractors, employees or agents. Is discovered after completion of any job, including cleanup, the Contractor shall, at its own expense, forthwith remedy. repair, correct, replace, or cause to be remedied, repaired or replaced, such dam- age or such defect in materials and workmanship. The foregoinn warranties shall survive any inspection performed in connection with the agreed -upon work. We Propose hereby to fumish material and labor - complete in accordance with above specifications, for the sum of: --- - ^-~^e; dollars ($ - ). Payment to be made as follows: 3 r� % ($ . Crtr ) upon signing contract; YANKEE HOME IMPROVEMENT, IN < i � Name of Contractor/Designated Registrant 7 % ($ ' `��- ' ) ) u pon �e on of 41 e ... -�> ; 82 INDUSTRIAL DRIVE �. Street Address % {$ )Ru pon completion of . i+ t NORTHAMPTON, MA 01060 413- 341 -5259 / , City/State Phone t,. % ($ �O� s ) shall be made forthwith upon 160584 completion of work under this contract. Registration No. 1 Notice: No agreement for home improvement contracting work shall require a down Name of Salesman / �, payment (advance deposit) of more than one -third of the total contract price or the ,--� total amount of all deposits or payments which the contractor must make, in advance, Authorized Signature to order and/or otherwise obtain delivery of special order materials and equipment.f whichever amount is greater. T Acceptance of Proposal 1 have read both sides of this document and accept the prices, specifications and conditions stated. I understand that upon signing, this proposal becomes a binding contract. You are authorized to do the work as specified. Payment will be made as outlined above, You may cancel this agreement if it has been signed by a party thereto at a place other than an address of the Seller, which may be his main office or branch thereof, provided you notify the Seller in writing at his main office or branch by ordinary mail posted, by telegram sent or by delivery, not later than midnight of the third business day following the signing of this agreement. Please refer to the Notice of Cancellation that accompanies this contract; con- tents of which are referred to above and incorporated herein by reference. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. ilk d J/s C Signature ' t �� " `. ,c1. -.` ,> Date `l W 1 VA Signature Date STATE OF CONNECTICUT 228054 DEPARTMENT OF CONSU1VIER PROTECTION 165 Capitol Avenue + Hartford Connectjcut 06106 Attached is your Home Improvement Contractor Registration. This registration is not transferable. For questions, contact the Trade Practices Division at (86o) 713-6110 or email ' Visit our web site to verify registrations and download applications at .ct.gov/dcp. S'F.A'IL ()F ('()NNIA'1 1)1 PiR1111 \I 01 t 0\■1 III R 1`11011 ( HON YANKEE HOME IMPROVEMENT INC 82 INDUSTRIAL DR STE 2 YANKEE HOME IMPROVEMENT INC 82 INDUSTRIALDRiSTE 2 NORTHAMPTON, MA 01060-2389 NORTHAMPTON, MA '01060-2389 I I , - Itit 1 12r#2000 ' i 11/56 1 t SIGNED ;::•:: " .. 4 , :' , ....2:" ''\/--,177,7s, i 'ir: : : ': :1 7 -*1 7 ' 7 : ? 7:-',"7:.,:-.,'\,', / -- : 7,-,-.7.;,: :" ;,,-5:7, ; -.„,` 7 ":".N, 7" . : A: :' ,, N7 -- ",! -'7 7 ,-- ? --, Th '" i ?...:''''' . ''..7: , 4 oy 4 A * A * 41 41 , s,. S s, A ,, _** .1 ** 81 11,* *., l •,...* *._,* * A ,..* _16,2* ..*_ 9„ J Jr is __ _ —___. ._.., _ _ _ _ _ __ ___. __. ■ _ ___ ___ , STATE OF CONNECTICUT + DEPARTMENT OF CONSUMER PROTECTION ....z f t , ' Be it known that ... — • YA.1■TICEE HOME IMPROVEMENT INC ... , .:. 82 INDUSTRIAL DR STE 2 'E.'` -......i NORTHANIPT#Wim.8‘01060-2389 ' ',, -:•,,' . , ,fit--, --, ■•.:': 1 , is certified by the Departmen',: tioliqpins4riker t0tection as a registered ,,,,„,_. _ _ _ _ ) E , . , •... -,- ..-' V , 'I ; 4r ',. -':- HOME IMPROVE r'1 T CONTRACTOR 1 :: : • ifl ,-.., I RegiSttt41 / cif4,*7 39 1 1 '■,;; ' ,. \- 7 ....:.' .:J: ----,......_ tt, '„,,--‘• Effective: 12/01/2010 : -.-:.,•;:- Expiration: 11/30/2011 a-....,.. — 4-.-" , -........ i 4 00, -,- . , li ... A Jerry Farrell, Jr., Commissioner : 11 na. - 7. - - -,,,, 4 `To 4V 4V 4 4". 0 4 4 \*. :4" ,.. 4"; 4 1 4"*. : 41 _.- 4VIii: ,i(V 7.firc.. , .".1,Nii ...- it ...;.: ' ' 4. itE ,, , : ,,,,,,:,:„.,.:., ,,„ ,,.,,,:,„:. : ,...,,..:,:,.... \ .,:,., ,,' \ ,,,:,,,,,,," :,:'' ...,,,/,‘,.".._:-/...." ': ,/,'`,...'"_!.:---../.\::_:; f - ‘,:_:::-/, ' ' •-•:-:1- ' , - ■ - _ - Massachusetts - Department of Public Safety Board of Building; Regulations and Standards Construtilizin Supervisor License License: CS 89442 ReS 1Ict 'rgiSEYtg, f � F'I: GERAp ♦ ti k e a t i PO BOX EAS tar O'tszy )* .t Expiration: 3/1912012 c onimis iont4 Tr#: 18580 07 7 t0e2-~W)Preiieedi We11 Office of Consumer Affairs and Business Regulation e 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 160584 Type: Private Corporation Expiration: 8/7/2012 Tr# 201019 YANKEE HOME IMPROVEMENT INC GERARD RONAN - 82 INDUSTRIAL DRIVE _ NORTHAMPTON, MA 01060 Update Address and return card. Mark reason for etrange. Li Address 11 Renewal r Employment 11 Lost Card rws-CM iOM-cwor-ciovio • ISSU(U PY THE STOCK 1NSURA'aCF: COMPANY I'I CiNt ,I r ( x0k1f ':1sY ;RAN ITE STATE INSURANCE COMPANY .0070887-00 WC 009 -94 - 3691' 3102 0 -66- 1010 +t`1t:OROnki■ i ' . 1) u, ur+ 1+ . .v:+ . of M 1, NAMLt_ IR:b 11 r. PJ` Y ANKEE HOME IMPROVEMENTS C H A RT I S 2 INDUSTRIAL AVE UNIT 2 NORTHAMPTON, MA 01060 -0000 A Charts company EXECUTIVE OFFICES: SEE EXTENSION OF ITEM 1. OF THE INFORMATION PAGE - WC990610 178 Water Street New York, NY 10038 I.D# 811334 #: KING & CUSHMAN INC WORKERS COMPENSATION AND EMPLOYERS PO BOX 447 LIABILITY POLICY INFORMATION PAGE NORTHAMPTON, MA 01061 -0447 R DR I ON I RENEWAL NUMBER 70494 OTHER WORKPLACES NOT SHOWN ABOVE: SEE EXTENSION OF ITEM 1. OF THE INFORMATION PAGE - WC990610 ITEM 2 POLICY PERIOD 1201 A.M. standard time at the insured% mailing address FROM 10/02/10 m 10/02/11 REM 3 A. Workers Compensation Insurance: Pert One of the policy applies to the Workers Compensation Law of the states listed here: MA B. Employers Liability insurance: Part Two of the policy applies to the work M each state Listed in item 3.A. The limits of our liability under Part Two are Bodily Injury by Accident $ 100,000 each accident ' Bodily injury by Disease $ 500.000 policy Omit Bodily Injury by Disease $ 109,00a each ampioyea C. Other States Insurance: Part Three of the policy applies to the states. if arty. listed here: SEE ENDORSEMENT - WC200306A 0. This policy includes these endorsements and schedules: SEE EXTENSION OF ITEM 3.D. OF THE INFORMATION PAGE - W0990612 ITEM 4 The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating Plans. Ail information required below is subject to verification and change by audit. Premium Saws Rate Per Estimated Classifications Coda Number n ToMI RRemuneratton silo OF Re Premium � ,,_ T E 1 Annual .3 Year muneratlan ® Annual ID 3 Ye SEE EXTENSION OF ITEM 4. OF THE INFORMATION PAGE - WC7754 TAXES /ASSESSMENTS /SURCHARGES $18 EXPENSE CONSTANT IEXCEPT WHERE APPLICABLE DY STATE) 8 MA MINIMUM PREMIUM S t'j0O MA TOTAL Emma ANNUM. PREMIUM $ 3 . 1 C If indicated below, interim adiustmenta of premium shall be made; Semi - Annually ❑ Ouartady monthly timed r PREMIUM 10/19/10 ASSIGNED RISK 56 .r "MI .M. issue Date Issuing Dallas Authorized Representative we On et • YANKEE HOME IMPROVEMENT, INC. All home improvement contractors and subcontractors MA# 160584 CT# 0673924 CSL# 089442 engaged in home improvement contracting, unless specifi- 82 INDUSTRIAL DRIVE, NORTHAMPTON MA 01060 cally exempt from registration by Provisions of Chapter 142A 1 - 877 88YANKEE 1 889 - 2653 of the general laws, must be registered with the 413 Commonwealth of Massachusetts. Inquiries about registra- tion and status should be made to the Director, Home Improvement Contract Registration, One Ashburton Place, Submitted 6 6 Room 1301, Boston, MA 02108 (617) 727 -8598 To: f 1 EMAIL C. / r CeMt PHOtJ 8 j j 2 ( � / DATE / r")�� fJ / � y CELL PHONE 4 113 3 Se th / 3 - We hereby submit pecifications and estim es for work to be ormed and m eriafs to be used: R A' 1 f i �� M � ' - 4 ' r s ' s ` r �'o-/:' -- 1-6- / .mo ,1 R r/yi_ e ,�e •t, U.it s"'1r .,,, f- -4 -,E- ( _____ ATtr 1C tqp cil Gt.1.41rif d .sew- ' . T-,,s4, i1 ! 3 pH wMd uj © 4na. O a d / 7 ' i cet, - ,-j 0Khct, iti6_,e,. F .2 Ads sell g �,ra �rara s I _ WORK H ULE C r I t begin the work or order the materials before the third day following the signing of this Agreement, unless spa iji h n. Contractor will begin the work on or about (CJ �f! (date). Barring delay caused by circumstances beyond Contractor's control, the work will be completed by / (date). The Owner hereby acknowledges and grass hat the scheduling dates are approximate and That such delays that are not avoidable by the Contractor Including, bu of li ited to strikes, Acts of God, shortages of materi- als,accidents, and all other delays beyond its control, shall not be considered as violations of this Agreement. WARRANTY The Contractor warrants that the work fumished hereunder shall be free from defects in materials and workmanship for a period of following completion and shall comply with the requirements of this Agreement. In the event any defect In workmanship or materials, or damage caused by the Contractor, its subcontractors, employees or agents, is discovered after completion of any job. including cleanup, the Contractor shall, at its own expense, forthwith remedy, repair, correct, replace, or cause to be remedied, repaired or replaced, such dam- age or such defect in materials and workmanship. The foregoing warranties shall survive any inspection performed In connection with the agreed-upon work. We Propose hereby to furnish material and labor - complete in accordance with above specifications, for the sum of: dollars ($ ). • sr Payment to be made as follows: 4 1 % (s J U'de( ) upon signing contract; YANKEE HOME IMPROVEMENT, IN . Name of CG �Q r !�I 4'!)f ; 82 INDUSTRIAL DRIVE Contractor/Designated egistrant % ($ )upon Zorri o f /` �g� Street Address ' /o ($ 4"C > 3 ` ) upon completion of Je t I NORTHAMPTON, MA 01 Q�9 413 -341 r City /State Phone 20 % ($ : R�r ) shall be made forthwith upon 160584 completion of work under this contract. Registration No. // Notice: No agreement for home improvement contracting work shall require a down Name 0_f S_alesm /4 an J payment (advance deposit) of more than one -third of the total contract price or the total amount of all deposits or payments which the contractor must make, in advance, Authorized Signature _ — to order and/or otherwise obtain delivery of special order materials and equipment, whichever amount is greater, Acceptance of Proposal I have read both sides of this document and accept the prices, specifications and conditions stated. I understand that upon signing, this proposal becomes a binding contract. You are authorized to do the work as specified. Payment will be made as outlined above. You may cancel this agreement if it has been signed by a party thereto at a place other than an address of the Seller, which may be his main office or branch thereof, provided you notify the Seller in writing at his main office or branch by ordinary mail posted, by telegram sent or by delivery, not later than midnight of the third business day following the signing of this agreement. Please refer to the Notice of Cancellation that accompanies this contract; con- tents of which are referred to above and incorporated herein by reference. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. Signature Pc.) L t P/ ` Date l 0 b g I l Signature Date . . •,.. . . . ,\ The Commonwealth of Massachusetts —,..--.... Department of Industrial Accidents • Office of Investigations 600 Washington Street . • lerl-f= $ Boston, 111A 02111 . . . ' www.mass.gov/dia • ,,...,, , • -Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name pusineseorganilationfindiviansD: - yAve.e..._c- if r - 6,. i' t-Z-91•4(4)..1 • • Address: i: 2 :1. rizr/4-e: .D4), ,vc .. • - City/State/Zip: dam,, mA „. oi ei c 0 Phone.#: -- -03 - 3 'I I - 3 '`.; `/• - . , . . ' Are you an employer? Check the appropriatelox: • . •Type of project (required): 1 ,‘ 1. iEt 1 am a employer with € 4.. 0 1 am a general contractor and I 6. [ .. 3 Nr .. . . . 013. have hired the sub-contractors employees (full and/or part-time).* 2.0 I aril a Sole proprietor or partner- listed on theattached sheet: 7. [,31 RemodelirT-, ship and bave no employees These sub-contactors have .8. 0 Deinblition . ' wortting for me in any capacity. ePA: workers' : , - • , - - .•.. • , 9: El Buildiiag middle:in corcp.insirranc ... _ . [No worIcers' comp-. insurance _ e.t adcritions requirecL] - 5. 0 We are a corpyi-ation and its 10.0 Bectdcal repairs or 3. 0 I am a homeowner dOing ill work officers haitEtercised their . 11.0 Plumbing repairs or additions ]nyself. [No workers' comp. . . right �f exemption per MGL 12 E Roof repair' s • insurance required.] t ' . c. 152, § 1(4), and we have no • ., - , . . . .. ' 13.11 Other 5' whs./ ocp.aS einployeas. [No wcnicers' " . Con2p insurance reqUired.j. . • . • • • I . • - . . *Any applicant-that checks tex Almitst also fill out the section belowshowing theiworiotss' compensation policy informatiam t Homeowner* who submit Lira gradivitiosficatini they are doing all work and thee hire outside contractors must submit anew affidavit indicating such I-C.ontractors that check this box must attached an arklitional Sheet showing the name of the suli-conuactors and state whether or notthoseentities have enployees. If the sub-contractors luive employees; they roust provide their wcakers' comp. policy number. lam an employer that Is providing workers' compensation insurance for my entplOyees. Below is the policy izndjob:site informatio" n. . . Insurance Company Name: Al I DZ: , f; 77=17 ...rA16 A A.g C ci Co . -. . : .' , • . - Policy # or Self-ini. Lic. #: 'J / LI 3 C. / i . . Expiration Date: - / it 12/ 2 ,..").1( • , ..., . • _ _. • — — ,.,, Job Site Address: 4 r- e (.._— it- ki- 4 . . ' : C'ity/Stafe/ZiP:ri-- AL 40;e:C6 c 4 ?-4 114 , 4) le 4: 2 Attach a copy of the workers' • compensation policy declaration page (showirig the policy iminlier and:expiration date). Failure to secure Coverage . as reqUired 'Under Sectiiiii25A 117101;C: 152 can lead to the iiii — dining Penalties of a fine up to S1,500.00 and/or one-year impri.sonraen4 as well as Civil penalties in the form of a STOP . WORK-OltDER and a fine of up to $250.00 a day against the violator. Be advised tbat a copy of tbis statement may be forwarded to the•Office Of eiiiii toYflisliii`..64iiii . . '"!::77,7 rid keEby.011.i1,5 u • the pains s un:d perteilde.i olperjiniihirithe hit provieedTribaveziitinfelnidiarreci.L_____ _. . , : _ , . . . ...,....._ , • . . . • 7 Siw -thre: _ ‘ . ' . i -/ '2c i (.2 • Phone #: 1 413 - 3 '3' l -52 5 ' : ! .-' .: ' '-. • -- • .. . . . - Official Use only Do not write in this; area, to be Congaed by city ii to W ii City or Tovvit: Permit/License # ---..-- Lssuing Authority (circle one): '- ' • , . .. ' .I. Board of Health 2. Building Department 3. City/Town Clerk 4. Electricalinspector 5. Plumbing Inspector 6. Other • Contact Person: . . Phone #: 6- . • • SECTION 8 - CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder : � A L A/ A /,l C5 ei License Number £.2, 2 z,(.0 D ' .. 14(e A �rpY I r'I . / f tl / 2 cv Address _-., Expiration Date ✓ �r�w___ _.... /3 • -3tf./ ature Telephone s r � y x,:r' . . k , �+ r y am s �Y y - „` �` t. ��1` �` �_ � �1±ro± I�st3s�� `��.a?,:n� °�s�Ias�>.,.::�Lc �be.������s.�����`�s ;�����'�. �: ,:. Not Applicable ❑ _efit2 E M c r / tic, 6 L f Company Name Registration Number 2 .1_AbOt t 67 CL, .�, . e MC p r t r 4( N7,4 / 7 / 2c: / 2_ Address Expiration Date Telephone y t -- 3 41 • 5,757 SECTION 10 WORKERS' COMPENSATION INSURANCE AFFIDAVIT IM.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 ❑ 154, 4f ! .4 . 3 $ • 1 I 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 buildine 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 SECTION 5 DESCRIPTION OF PROPOSED WORK (check, all applicable) New House [] Addition ❑ Replacement lindows Alteration(s) [J Roofing ❑ Or Doors Accessory Bldg. ❑ Demolition ❑ New Signs [CI] Decks LE] Siding 01 Other [0] Brief Description of Proposed Work: �N TACL ' " 'Q kJ/ 1ii..>c^.W5 AlmW / o■JC5 < VI- I til a��X - 1 <f' %`j Alteration of existing bedroom Yes k _ No Adding new bedroom Yes X No Attached Narrative Renovating unfinished basement Yes X. No Plans Attached Roll - Sheet .„< 2 =L1 3, . 2..?.i....� •.�". �� .... a. Use of building : One Family Two Family Other b. Number of rooms in each family unit:_ Number of Bathrooms c. 1s there a garage attached? d. Proposed Square footage of new construction. Dimensions e. Number of stories? f. Method of heating? Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction ._ i. Is construction within 100 ft. of wetlands? Yes No. 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? Yes No . I. Septic Tank City Sewer Private well City water Supply SECTION 7a OWNER AUTHORIZATION BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FORBUILDING PERMIT I, AOiE'1 E` " TA'uf7p , as Owner of the subject property hereby authorize ,tejt~ - + .' 1' At C. to act on my behalf, in all matters relative to work authorized by this building permit application. u Ce 777 4c = Signature of Owner Date 1, ' C) we N ° NM`f''CY v = Me- tt % , 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. o 'k?AL' fa 12. L A Ir`1 Print Name a e of Owner /Agent Date Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning This column to be filled in by Building Department ' Lot Size i .. _. . 1 1 �---- i. , _...�.�__. a Frontage ..... J TT-- _ ,____.. Setbacks Front "' E1 7 a Side L:1 R: I L:1 R:r J 1 ,_ Rear = = M i Building Height } i i Bldg. Square Footage 1 E`1 % E I I i Open Space Footage % --- ---- (Lot area minus bldg & paved = I f _.. —.... parking) • # of Parking Spaces = 1L-1 ~, Fill: (volume & Location) - i -- ---- -- . a A. Has a Special Permit /Variance /Findin ever been issued for /on the site? NO 0 DONT KNOW YES 0 IF YES, date issued: I IF YES: Was the permit recorded at the Registry of Deeds? NO ® DONT KNOW 0 YES 0 IF YES: enter Book 1 Pagel , Document # , B. Does the site contain a brook, body of water or wetlands? NO 0 DONT KNOW t YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained 0 Obtained , Date Issued: C. Do any signs exist on the property? YES 0 NO 410 IF YES, describe size, type and location: W V~ -^ D. Are there any proposed changes to or additions of signs intended for the property ? YES Q NO IF. YES, describe size, type and location: 1 I E. Will the construction activity disturb (clearing, grading, excavation, or filling) over 1 acre or is it part of a common plan that will disturb over 1 acre? YES 0 NO IF YES, then a Northampton Storm Water Management Permit from the DPW is required. P 'I ' wY , ,, , I " y # ,r 1 , - �� ^�., Building Department - � �� City of Northampton , q 2�t � ,r∎ ■ - 212 Main Street T .,'4'' �� Room 100 Northampton, MA 01060 a , ' phone 413 -587 -1240 Fax 413 - 587 -1272 - _.._ ' ..,. _,..N a = A �w,. -_,-0,„,..,21...21.1 APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 - Si 'i t INFORMATION .. I 1.1 Property Address: „,,4,,A1.13•;,:1, Thie s ectIntt to be completed by office 7-- td 'AI CC = ' ice ' t' , `U fG D.r',IUC (_ - 1V79:55. G /C�4- i '� " , � / rl ' L ' ” s b 1 iB Ct SECTION 2 - PROPERTY OWNERSHIPIAUTHORIZED AGENT 2.1 Owner of Record: /Co BED€? T ` — i ,r ti p Lam'' / i — 'E //CG ,& iz -r =-ACC f {F COi' Name (Print) Current Mailing Address: Ce= y /--3 .5E 7 9j/ t-1/_3 -- 3.,i'± - c) 4 / `-i - C GCki 7 Cy Telephone Signature 2.2 Authorized Ascent: y y G/OCAK'D /i. Id Y ?N /'CC'4.' � (-- Alf 'Ya_- ; 1 �^+-' .rash I. f:� Di,..' sks.. rH�'{/ufd71 A/ /'q. l Name (Prin) Current Mailing Address: / '0 - . -3 ii f - c,- -- ,'5`i • nature Telephone SECTION 3 - PS11MilATEDCONSTRUCTION DOSTS; ' i Item Estimated Cost (Dollars) to be Official Useanly completed by permit applicant _ 1. Building (a) Building' Permit Fee 2. Electrical (b) Estimated Total. Cost of . ' 'Cortsfruction from, (6) 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection ( ) tu E �Ft� 7 This Section ForiOfficla ck Nu 6. Total - 1 + 2 + 3 + 4 + 5 Ch Use Onl Building Permit Number: Issue Issuedt . Sign ature: c:: / /6/ 10 Solidingi 'Corn r'nissioner)Inspector of Buildings Date RD BP- 2011 -0461 GIS #: COMMONWEALTH OF MASSACHUSETTS ip:Ii1oc 37 007 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: BUILDING PERMIT Permit # BP- 2011 -0461 Project # JS- 2011- 000743 Est. Cost: $50842.00 Fee: $70.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: YANKEE HOME IMPROVEMENT INC 89442 Lot Size(sq. ft.): 196020.00 Owner: TRUMP ROBERT & ROBERT TRUMP TRUST Zoning: SR(100) //WSP Applicant: YANKEE HOME IMPROVEMENT INC AT: 601 FLORENCE RD Applicant Address: Phone: Insurance: 82 INDUSTRIAL DR, UNIT 2 (413) 584 -8318 WC NORTHAMPTONMAO1060 ISSUED ON:11/16/2010 0:00:00 TO PERFORM THE FOLLOWING WORK: INSTALL REPLACEMENT WINDOWS, SIDING & GUTTERS 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: Date Paid: Amount: Building 11/16/2010 0:00:00 $70.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Louis Hasbrouck — Building Commissioner