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38B-047-005 t • eeelgYlir:riIca A—Inca A.ge.ca / � �� `fir 1 7 . _ QJJIIItd R:mov: lebel.aticr Mzi lnrpectioh; SAVE for future reler_nce P 0r Shleid CU 0 , CPU �0=A—i7Z , R Model 8108 Double rung Op°rating x Alum clad Thermzl Fram° I ,.-YF ;, ,.:n 3J4 Inch Glazing ZO—E .022Low—E Argon rill Grille in Alr Space ENERGY PERFORMANCE RA-: S D.30 u—r.1t�, 70 SDI�r:�^�:�,CD:�(i=:al ru SA—P I fhrlrisl ADDITIONAL PERFORMANCE RATINGS Ylslbls lt�sla'llua Lenlcos:(i:n P,aisl v.:. • r ('� 0.40 0 . tnullcunl rtpJl,¢I ht1 bit, rlin 3 tmbm a flcttlt Klfl:pnulufct br l.nrrieinq .i,✓t pnllcl n}rr per'crnaa.kFtC nlnjt to dglfr,/n.! 6I t' Lz rd al el to KrrntnW tadtor,t tnl tJultt pndret Gran kFR:dou.ol rtzv,.•r.ad 'T/r.lurf t Clttl All rcTV,l hI=ILLWt'of a,T jro-0ocl W.7 gttlit u.a, bn+It mmul.c:�nfl};1rAUR bl t5tlrnducl jtI nr.u+ef tnhrtft+ton, www,I+Ir.o , M,1tlt Dt c:nilt N.°_C,• C.`.G„ tr.! LE.C.C, /Jf tfflmtttlon R.awf,mentt ' (D P) �AS� I:is U l SV-Lf.-Uvx>rD11tj.Lt 1—17 . lJJ r 1 11 n-lcri tt� V•1 9..1t L.+IntJ r,trw,,„ �_� •��-;_1_ t E1�IScUmtlIYSi0 Nov 0614 07:23a P 1 HOME IMPROVEMENT CONTRACT PLEASE READ THIS � Sold,Fumished and Installed by: Branch Name:Boston North&South Date: !_ J TIM At-Home Services,Inc. d/bra The Home Depot At-Home Services Branch Number:31 and 33 908 Boston Turnpike.Unit 1,Shrewsbury,MA 01545 Toll Free 877-903-3768 Federal to#75-2698460:ME Lie*C 02139:Rt Cont.Lie#16&27 ,C��T Lie#HIC0565522:MA Home Improve nt Conntactor Reg.# 26893�j�j Installation Address: L- M Qr 1tJ a ( 1 City State Zap Purchaser(s): Work Phone: Hone Phone: Celk Phone: [ l ] [ Home Address: (If different from Installation Address) City State Zip E-mail Address(to receive project communications and Home Depot updates): ❑1 DO NOT wish to receive any marketing email,;from The Home Depot Proieet L,lormatton: Undersigned i."Customer").the owners of[he property located at the above installation address,agrees to buy, tad THD At-Home Services,Inc.("The Home Depot")agrees to furnish.deliver and arrange for the installation("Installation")of all materials described on the below and on the referenced Spec Sheer(s),all of which are incorporated into this Contract by[his refercnee,along with any applicable State Supplement and Payment Summary attached hereto and any Change Orders(collectively, "Contract'): Job#: (mans[uw-� 'P-4 nets Sec Sheens)#: Proiect Amount Roatin, Siding R'indows LJ Insulation 1/tA) ©Gutters/Covers ❑Entry Doors ❑ $ Roofir Siding M Alindows Insulation ❑Gutters/Covers ❑Entry Doors ❑ $ Roofing Siding Windows EJ Insulation ❑Gutters/Covers ❑Entry Doors❑ S ' Roofing Siding 0 Windows El Insulation i $ ❑Cutters/Covers ❑Entry Doors ❑ Miniamm25%Deposit of Contract Amount doe uponexm don of"contract. Total Contract Amount $ Maine Purdrsers rimy not deposit more than ontsthird of the Contract Amount Cusrorner agrees that, immediately upon completion of the work for each Product,Customer will execute a Completion Certificate (one for each Product as defined by an individual Spec Sheet)and pay any balance due. As applicable,each Customer under this Contract agrees to be jointly and severally obligated and liable hereunder. The Home Depot reserves the right to issue a Change Order or terminate this Contract or any individual Products)included herein,at its discretion,if The Home Depot or its authorized service provider determines that it cannot perform its obligations due to a structured problem with the home,environmental hazards such as mold,-asbestos or lead paint,other safety concerns,pricing errors or because work required to mniplete the job was not included in the Contract. Payment Summary; The Payment Summary it I :)-CM 2. included as part of this Contract, sets forth the total Contract amount and payments required for the deposits and final payments by Product(as applicable), NOTICE TO CUSTOMER You are entitled to a completely idled-in copy of the Contract at the time you sign. Do not sign a Completion Certificate(note: there is one Completion Certificate ror each listed Product as defined by individual Spec Sheets)before work on that Product is complete In the event of termination or this Contract,Customer agrees to pay The Home Depot the costs of materials,labor,expenses and services pro-tided by The Rome Depot or Authorized Service Prmider through the date of termination,plus any other amounts set forth In this Agreement or allowed under applicable lax, THE HOME DEPOT MAY WITHHOLD AMOUNTS OWED TO THE HOME DEPOT FROM THE DEPOSIT PAYMENT OR OTHER PAYMENTS MADE, WITHOUT LIMITING THE HOME DEPOT'S OTHER REMEDIES FOR RECOVERY OF SUCH AMOUNTS. Acceptance and Authorization: Customer agrees and understands that this Agreement is the entire agreement between Customer ar The Home Depot with regard to the Products and Installation services and supersedes all prior discussions and agreements,either oral or written.relating to said Product`and Installation.This Agreement cannot be assigned or amended except by a writing signed by Customer and The Home Depot.Customer acknowledges and agrees that Cust has read.understands,voluntarily accepts the terms of and has received y opy of this Agreement. l y A by: Submkte y _ 1115 2-01 C Sigztatttre_ t3ate Sales Consult ignature Date X Telephone No. Customer'%Signature Date Salmi;Consultant License No. CANCELLATION- CUSTOMER MAY CANCEL THIS its arplktnblci AGREEMENT WITHOUT PENALTY OR OBLIGATION r [ BY DELINER NG WRITTEN NOTICE TO THE HOME DEPOT BY MIDNIGHT ON THE THIRD BUSINESS DAY AFTER SIGNJNG THIS AGREEMENT. THE STATE SUPPLEMENT ATTACHED HERETO CONTAINS A FORM TO USE IF ONE IS SPECIFICALLY PRESCRIBED BY LAW IN �"-11r.n10 c—.m.. City of Northampton 212 Main Street, Northampton, MA 01060 Solid Waste Disposal Affidavit In accordance of the provisions of MGL c 40, S54, I acknowledge that as a condition of the building permit all debris resulting from the construction activity governed by this Building Permit shall be disposed of in a properly licensed solid waste disposal facility, as defined by MGL c 111, S 150A. Address of the work. /nom The debris will be transported by. The debris will be received by: Building permit number: Name of Permit Applicant � I 4—ap- Date Sign-ature of Permit Applicant ' rriC L.vuwtvrtll't:uic/L of 1t1ttSJ'UC11U.1'L'r1S- '/ • �� De par•fl 7TElItOfI11dL1S1`7'1QIf�CC1dE1::�'/' ' . Offtce of Lave r 1 Corc;r ass�h eel= `ucte 100 BOSfOIZ 1114-2017 Workers' Comp ensation-ID stirance Affidavit: Build ers/Contractors/Electricians/PIumbers AT)Dlicantlaformation' �Pfe"Is�ePrintLeeibly. j�j3II1/°�° •SS/Orgzsu:atioa/Intiividtul): �� •+�`"`�j,✓v / �J �'/(/�'1�'' ��Y �C�� a asst City/Statgzip: A-re you an'employcr? Check the appropriate bo Type of project(required}: I.(-] I a m a:rI1DIDyer with 4. Data a general contacior and I :mploy::'s (full and/or part-ti^„c).* have hired the'sub-contractors 6• New constuction 2.❑ I a a a sole'propriaor or pa:m-r- listed on the attached sh:°t. 7. []Remodeling s':.ip and nav:no cmplDy°°s - These sub-contactors nave g ]D-;volition Cori i^.� :or 1-11 zny capacity, emplo tie yees and 'nave workers' comp. insuranc 9. ❑3ui16ing aaatt,cn [No workers comp:insurance - 5• (]..W--are a cD-ooration and its . 10.[]Zlectzi:it repairs or additions 3.❑ i a n a hots°DVrd:r doing zll wDrl. pie:rs hav:'ex,:reis:d their 11:❑Plumoi.•.g repairs or adainons mys:lf; Tip w6rl:en'.comp, t?-h4 of axe 6�tion per MGL I iaura_nc:r:DUired.) t c• ld?, X1(4); a_nd.w:h'zve no • employees. [No workers” 13.Pon-, corner. insurance required.] A-ny zppiiez tt c:.:�•1;=c1s'oox=!rnat a>, fill out the se:;iOf below sho-;d g heir work-s''eomp=rsztion polity iniormztion. t'5omcour.e:a who sub-ti:: a z`tidavit indicating th:y z:doing zll work znd then hire outside eontzctors must submit a new z itdavit indi ng such. tCo1;�,ors tazt c..ccl:this box must zttach=d zn adLtion al sheet showing the uz.•re of the sub-=nt zwt s znd°s arc whciher or not those entices have mployr_s. If the sub-contzctors have employees;they must provide their wori-,s'eonip.policy numb=:. •• . I ari a;i ernpioycr that is providing tNOr I:ers' CO1rIDenSQtlon i12SuranCe for!ny employ-°eS. Below is the polity andjob site 1r,-s a_nce Company Ta_:n:: ?olicy y or Sal_`_`-ins. Li c. t-• 1/vL--� ��I =xp -anon Date:• ^/ ^� Job Sit:4daress: ' Ciry/ScatdZia: Attach a copy of the work= s' compensation policy d'eclzration page (showing the policy number :zpiration date). railur:to s:cur:covaag: as r:ouir:d under Section 25.A of MGL c. 152 can ]:ad to the imposition of e,mina] penalties of a nna'up to S1,300.00 and/or Dne-year impr'so' .:nt, as well as civil penalti:s in the form of.a STOP WORK ORD=R and a Fmt Of up to 5250.00 a day against•thc violator. 3:advis:d that a copy of th*s stal:m:nt m'y b:forward:d to the Omc: of Inv:s*igations of the DL4 for insuranc:,cowrag:,vcrincation I do Ircrcby cc r i, p end r eIri« f crjuriy that the irjorrrtafion provided above is rrre artd eorrccL 2 Oj��ial_sc only. Do not to=fe in lies ere=, to be cor. pleted by city or town City or Town: - P:r rSt�T re=ps: Issuing Authority (circle ont): 1.3card of Health 2. 3t ldlag Depz.-ti-nent 3. Ciryll"o`%-n Cltrk L'l°:,.ical rysp^ctor S.Plumbing aspactor 6.0ta: - -- - Contact Person: Phone R SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: /�f�) Not Applicable £ Name of License Holder: ✓'�(/ ^�/ ' License Number Address / 1 Expiration Date Signature Telephone 11,--6 � . .............. 9. Re isfered Home Im,Fovement Contractor Not Applicable £ -domDaLiv Name Registration Number Q /s Expiration Date - �'� Telephone SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c..162,§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 t. Signed Affidavit Attached Yes.. .. £ No...... £ 11: -':Home Owner:Egemption. 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 ' ows Alteration(s) ❑ Roofing ❑ Or Doors Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [C] Siding[C3] Other[0] Brief Descn n o Work: p r fiV7 492(14 Alteration of existing bedroom Yes No Adding new edroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet sa. if New house'and.or addifioh to eA bt q houslnq, complete the`followin`a: a. Use of building:One Family 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 as Owner of the subject property hereby authorize l to act on my behalf, in all matte lative to rized by this building permit application. Sig ure of Owner Date �✓ 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 and th pa' L and penalties of ` Print Name SigoWf in /Ag nt Date r Section 4. ZONING AR Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning Ibis column to be filled in by Building Department Lot Size Frontage Setbacks Front I 17-1 F- Rear Building Height Bldg.Square Footage % Open Space Footage % (Lot area minus bldg&paved L--J of Parking Spaces (volume&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO DONTKNOW 0 YES 0 |F YES, date ioued: IF YES: Was the permit recorded at the Registry of Deeds? NO K J DONTKMOvY 'ES �� IF YES: enter Book I Page and/or Document# B. Does the site contain a brook' body of water nrwetlands? NO 0 DONT KNOW C) YES IF YES, has u permit been ur need tobe obtained from the Conservation Commission? Needs tobeobta/ned x,� Obtained �~� Date Issued: �_� «�/ ' C. Do any signs exb ��exist YES �~� NO �~�� 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 0 IF YES, describe type � | ' ' E. Will the construction activity disturb(clearing, gradingexcavation,or filling)over 1 acre nrinit part ofa common plan �ha�v�||distudbover1aone? YES ��) NO K`_~] ' IF YES,then a Northampton Storm Water Management Permit from the DPW is required. ^ — C� �� - ti Department use only (n� of Northampton Status ofPermtt i # 4` 1{ DWilding Department Curb Gut/Dnyewsy Perrrri# t •9V1 �V l L -. X212 Main Street r ; SewerlSeptic fkvaifa�l(rfy L Room 100 WaterlWei[A�atlability a Ciec,r c, Northampton, MA 01060 Two Sets of StFUCtural Ptarrs' F r phone;4U.-b87-1240 Fax 413-587-1272 P[ot/StYe Plans OF- APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE,INFORMATION 1.1 Property Address: This sectwn to be completed V office Lot Urnt Zone Overta Distract y Eim St District CB District SECTION 2. PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 OwPAr of Record: Name(Print) Curr t gn dress: Telepho Si gnature 2.2 A d ent: ' � )wxf2yow, p ��„ cam- r� ---�� <��%� !/IK.II' r Name Current Maill g Address: i ature Telephone SECTION 3 -ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by erm�it applicant 1. Building /L is (a) Building Permit Fee 1�2 2. Electrical (b)Estimated Total Cost of Construction from 6 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) 5. Fire Protection 6. Total=0 +2+3+4+5) ° Check Number This Section For Official Use Only Building Permit Number: Date Issued: Signature: Building Commissioner/inspector'of Buildings Date 9 LYMAN RD-UNIT 9C BP-2015-0590 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 38B-047 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-2015-0590 Project# JS-2015-001122 Est.Cost: $1071.00 Fee: $35.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: HOME DEPOT AT HOME SERVICES 92937 Lot Size(sq. ft.): 5183.64 Owner: NAVARRO SANDRA zoning. URB Applicant. HOME DEPOT AT HOME SERVICES AT. 9 LYMAN RD - UNIT 9C Applicant Address: Phone: Insurance: 5 RIVERVIEW DR (401)935-2633 O Workers Compensation NORTH PROVIDENCER102904 ISSUED ON.1112012014 0:00:00 TO PERFORM THE FOLLOWING WORK.INSTALL REPLACEMENT WINDOW 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 11/20/2014 0:00:00 $35.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner