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C y N cr„i m d O A) y 3 3 n = d y a a m m n m = = .• • Z n c o c Cl) cm- -4 ,c� -< _, p o O o °o Q) CO ED 0 o o 1" 0O -< m m Cn ...5., a T m co `4^ O 0 ?� Cn 3 CD _. 3 c a N c'') O c > v 3. > 0 o W r l� � w n � '< v t0 m u, cn wo a* m w - L. a ° °o m 0 n (7) o 3 D Z 7:.-- 5— 0 0 00 3 a r -p m 0 Cl) 0 0 -a -I m 03 C) 0 C) g D CI -. c 0+ D) of .Z7 D S a y x x = O = o C0 = O r m m ^► m C) co '+ - 5.1-1 X c < a V o - °- D -I n 3 Cn r p 0 ° <• s = O g �° A PP. m °: f° •Z Cl) o �, m 11 - - xk 0 m t3 T of O 01 5 73 7 -, CO N 1� m K 2 o = m > oo w o W N IV ' O -I 0 0 o N N w � N O �-I -n m N 2 m m ° al m m m `' z c° z 71 z -< -� 5 PELLA PRODUCTS INC 155 MAIN STREET GREENFIELD, MA 01301 e,rc, -tlL 3 1v 1i l LC . 6'(11v -w) + MA s IC4-, Subject: Disposal of Debris The purpose of this letter is to certify that all the debris resulting from any project undertaken by Pella Products Inc. in your Town will be transported to a dumpster at our main facility at 155 Main Street, Greenfield, MA. Pella Products lnc.is under contract with Waste Management of Massachusetts for the disposal of the contents of this dumpster. Very Truly Yours, PELLA PRODUCTS INC. John P. Benjamin Accounting Manager • • • To Whom It May Concern: I, Peet , as property owner, give permission to our contractor, Pella Products, Inc., to obtain a building permit for the installation of windows or doors in my home, located at '3©O F m S-Frech Ajor-F kcoA-7 f o , /hI'4 o bCO . Please accept this letter in place of my signature on the permit application. Thank you, K Please Print Name X—S\2) Homeowner's Signature ate �, The Commonwealth of Massachusetts �, ,:,,,;;T:,-.7.74:„-:.;..:;:.. Department of Industrial Accidents i.. =I' Office of Investigations �� �r' 600 Washington Street a w Boston, MA 02111 ' ` www.mass.gov/dia Workers' Compensation insurance Affidavit: Builders/Contractors/Electrjrciai ./Plumbers Applicant Information ' Please riot Legibly Name (Business/Organization/Individual): � = 1 SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable £ C c Name of License Holder: 01.0 akt C- 1 License Number s c ( ( Ia cic■ Address Expiration Date CaC1JhtJ9 �71.� 777 -G /S � Signature Telephone 0 C caw 9.Registered Home Improvement Contractor: Not Applicable £ 1 1c/- Z70 Company Name /} I Registration Number Ac-S- /1/(1(./37-7 5� ) CSC« Ili !' f (3u / � ( �C/ Address _ C Expiration Date CCAtC C tJ 1�'Ws Telephone ?/_) / 12 SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152,§25C(6)) Workers Compensation Insurance affi avit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the b ilding permit. Signed Affidavit Attached Yes.... . £ No £ 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 SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) El Roofing 0 Or Doors Accessory Bldg. ❑ Demolition ❑ New Signs [D] Decks [Q Siding[D] Other[D] Brief Description of Proposed(\ +1 // r / Work: -3-1.t U t p--.) S-(..ii<CG � �N cto, (.(., f 1A('C✓11°x: /,/t lj , us, `ec(3 i7 Alteration of existing bedroom Yes ,v No Adding new bedroom Yes No \i r--A1-1 g Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet 6a. If New house and or addition to-existing housing, complete the following: a. Use of building : One Family NZ Two Family Other b. Number of rooms in each family unit: Number of Bathrooms c. Is 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-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, �� ( -( W >e 1--Lrri(61,4 , as Owner of the subject property hereby authorize Pe(lA Prod(4.c + 5 r61 c_ \e„ to act my behalf, in all matters relative to work authorized by this building permit application. c _ �i `� ig ture of Owner Date I, ( ( '1 (,`1U- , . , 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. 0i) c. Daii\ Print Name Jai c.1kJ ii,49, /l J�-//_`- Signature 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 Frontage Setbacks Front Side L: R: L: R: 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 0 DON'T KNOW ® YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DON'T KNOW 0 YES IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO Q DON'T KNOW 00 YES Q IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained 0 Obtained 0 , Date Issued: C. Do any signs exist on the property? YES 0 NO 0 IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES 0 NO Q IF YES, describe size, type and location: 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. � 17- Department use only _ '_....-------\777-r\', : .city b. Northampton Status of Permit: r_- B ildint Department Curb Cut/Driveway Permit / ,L0 12 ain Street Sewer/Septic Availability t� `i. (! — Ro•m 100 Water/Well Availability '■! \.' rt i n, MA 01060 Two Sets of Structural Plans (/3yd ,0 Fax 413-587-1272 Plot/Site Plans 1[�C.pw�p t0 ,„"���� Exec NottY�u3T'� Other Specify APPLICATION TO CONSTRUCT,ALTER,REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Property Address: This section to be completed by office ga) Lim vA CC f Map Lot Unit Pr 441a,b in 1 W 0 IQ(3 C Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: ( / 5& erckc \ \ ( j� 1r �(','1 s�Lrr,LLL1h1` :2)00 �1�J � r { r ✓I/t1 /��(�I I��� /u' f�l' yL Name(Print) Current Mailing Address: I JI ,� yl3 -222 - /�jV Telephone i ignat... .�1 2.2 Authorized Agent: ��[[ / / �cLt 1C ii,�Li� /�-S •/1,(4.4}1 1 - (,�..�;, }, i ( :` i+'1 t Name(P nt) \ Current Mailing Address: (^, I C. it Li/3-1-72 - 00--3 1 r Signature Telephone 4 Ti 1 SECTION 3-ESTIMATED CONSTRUCTION COSTS �� 93 4 Item Estimated Cost(Dollars)to be Official Use Orly1 completed by permit applicant 1. Building (a) Building Permit Fee 2. Electrical (b) Estimated Total Cost of C Construction from (6) 3. Plumbing Building Permit Fee u 4. Mechanical(HVAC) 5. Fire Protection C) 6. Total=(1 +2+3+4+5) § ( , 00 Check Number qqqp7(2 (k5.5.--- This Section For Official Use Only Building Permit Number: Date Issued: Signature: Building Commissioner/Inspector of Buildings Date 300 ELM ST BP-2014-0605 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 31A-328 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: window replaced BUILDING PERMIT Permit# BP-2014-0605 Project# JS-2014-001013 Est. Cost: $8800.00 Fee: $35.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: PELLA PRODUCTS, INC 091496 Lot Size(sq.ft.): 5837.04 Owner: SETERDAHL PETER Zoning:URB(l00)/ Applicant: PELLA PRODUCTS, INC AT: 300 ELM ST Applicant Address: Phone: Insurance: 155 MAIN ST (413) 772-0153 WC GREENFIELDMA01301 ISSUED ON:11/13/2013 0:00:00 TO PERFORM THE FOLLOWING WORK:INSTALL REPLACEMENT WINDOWS 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 11/13/2013 0:00:00 $35.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner