35-134 (6) 14 WESTWOOD TER BP-2019-1056
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:35- 134 CITY OF NORTHAMPTON
LLov -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-2019-1056
Proiect# JS-2019-001722
Est Cost:$2520.00
Fee:$40.00 PERMISSION IS HEREBY GRANTED TO.
Const.Class: Contractor: License:
Use Group: WALTER MAREK III 055201
Lot Size(sa.R.1: 9670.32 Owner. WEAVER JENNIFER
zonmw Applicant. WALTER MAREK III
AT. 14 WESTWOOD TER
Applicant Address: Phone: Insurance:
73 SOUTHAMPTON RD (413) 527-7667 0 Workers
Compensation
WESTHAMPTONMA01027 ISSUED OM3129/2019 0:00:00
TO PERFORM THE FOLLOWING WORK.INSTALL 6 REPLACEMENT WINDOWS IN
BEDROOMS
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:
FeeTvpe: Date Paid: Amount
Building 3292019 0:00:00 $40.00
212 Main Street.Phone(413)587-1240,Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
GC 1,041 JO it
Department use only
—s City of Northampton Status of Permit:
' .rf Building Department Curb Cut/Driveway Penni)
A
212 Main Street Sewer/Septic Availability
Room 100 WaterAivell Availability
Northampton, MA 01060 Twa Sets of Structural Plans
_ phone 413-587-1240 Fax 413-587-1272 Plot/Si[e Plans
Other Specify
APPLICATION TO CONSTRUCT,ALTER II `/L—REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
L-
SECTION 1 .SITE INFORMATION I V L D
7.1 PraosrtrAddmss: (� Thls section to be WMP~by officeMAR 2 6 2019MaF
I�/�11A� , I LoOverla
t i 3�{ Unit� `/ �r1r(A DFPT OF 6UILDINC.INSPEODON9 yDlehlCt
r4 11 e.� V 1"V NORTHAMPTON.MAO
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SECTION 2-PROPERTY OWNERSHWfAUTHOPoffD AGENT
2.1 Owner of Record:
Te- vV' - W-(t Vf-v- to ?"Vv li 11 I(L l ras{{nnx+QFoK , k4A
Name(Print) Curren Malllrg Addrell
� , , n 413- 42fn -3o(0(r
Sgnalure
� h�/�- Talaglae
2.2 Authorized Alund: �f -23 ^ I�
Nems(P nll Current Mailrg Ad6eea: I KO�t/
Ln q)) q�3
Signature Takphone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by Partmit applicant
1. Building a DID'00 (a)Building Permit Fee
CJt
2. Electrical (b)Estimated Total Cost of
Construction from 6
3. Plumbing Building Permit Fee ,y/
4. Mechanical(HVAC) V'
S.Fee Protection
6. Total=(1 +2+3+4+5) Check Number a
This Section For Official Use Only
Building Permit Numb er: Date
Issued:
Signature: El 3.29'20/9
Building Commissionerlospector of Buildings Dale
W rflard 3 @ Qrr ,(L
EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR)
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SECTION 5-DESCRIPTION OF PROPOSED WORK Icheck all aooliceblal
New House ❑ Addition ❑ Replacement N[Indows Albrsdat(s) Rooeng Q
Or Doors [R�
Accessory Bldg. ❑ Demolition ❑ Now Signs [[3) Decks [p Siding[p] Other jE:q
Brief Description of Proposed �f' a�,l 6 V!r\NI 1`2.Yll(�,Ulyn�' (w.�IrJv,.s Ir 3t1X.(a��S
Work: —�
Alteration of roasting bedroom_Yes No Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll -Share
So. It New house and or addition to"Istina housing, complete the following:
a. Use of building:One Family Two Family Other
b. Number of roorns in each family unit Number of Bathrooms
c. Is there a garage attached?
d. Proposed Square footage of new construction. Dimensions
e. Number of stones?
I. Method of heating? Fireplaces or Woodstoves Number of each
g. Energy Conservation Compliance. Masscheck Energy Compliance form attached?
K 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 fioor below finished grade
k. Will building conform to the Building and Zoning regulations? Yes No.
I. Sepbc Tank CitySewer Private wall City water Supply
SECTION?a•OWNER AUTHOR17ATION•TO BE COMPLETED WHQI
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERYfr
as Owner of the subject
property
hereby authorize \,,J&\4tr W,afcK- tv,<
to act on my behaff,M all matters relative to work authorized by this building permit application.
UJ--Ca 3- 17- 41
S / Date
OEM-
I, I �/ 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 underains erjury.
and Ities of p
PrIM Nam,,
Signature of Ovsae/Agent
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SECTION S-CONSTRUCTION SERVICES
8.1 n ed Constru Ion Sue // 00
Nrot Appitcabb
Nero of Cleanse Noldar: u `3 O S 5 1
73 � 1 Elhvlon 6 13 ao
��Zh- tom Nl3 Dg5-35 E*MM Dide
Sanalum T-lahune
9.laidsterad Home lmtowmqmtContractor Not Applic" O
s .� M `rNa0 R 1 tra' n N
1umber
� —
Addrep E)pwaboh Date
k�2 Telapbm,a`II3 ll °ISs�
SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.O.L a 152,§25C(S))
Workers Compensation Insurence a0ldavit must be completed and submitted with this application.Failure to pmwde his alfMavll will result
in the dental of the Issuance of the building permit
Signed Affidavit Attached Ves....... NO...... ❑
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Commonwealth of Massachusetts
®- UNISInn of Professional Licensure
foisting Engineer
HE-156708 ESpues0612312019
WALTER L MAREK,M
77 SOUTHAMPTON ROAD
WESTHAMPTON/M'A`OZ/
e�tO
Commissioner ✓"'
Cerorounwea0h of Massachusetts
0hrision of Professional licensure
Board of Building Regulations and Standards
Constructibn'Sapervisor
CS455201 ESpires:06/23/2020
WALTER L M
.
72 SOUTHAMPTON ROAD
WESTHAMPTON�M'A10A�/02]
Commissioner CJ—
Ola.a Consumes affairs t Business Rgl4ean r
HON E IN PRONEM ENT CONTRACTOR
TYPE:Co-ooraton
Rsoisbslion EKWMAM
159480 04r4212a
W.MAREK INC.
M SOUTHAMPTON
W LTER REK III RD. �] -cc1
WESTHAMPTON,MA 01027 UnOawcmt01y
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City of Northampton
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AFFIDAVIT
Home Improvement Contractor Law
Supplement to Permit Application
The Office of Consumer Affairs and Business Regulation("OCABR")regulates the registration of contractors and
subcontractors performing improvements or renovations on detached one to four family homes.Prim to
performing work on such homes,a contractor must be registered as a Home Improvement Contractor("HIC").
M.G.L.Chapter 142A requires that the"reconstruction, alteration, renovation,repair,modemixetlon,conversion,
improvement,removal,demolition,or construction of an addition to any pre-existing ownenoccupled building containing
at least one but not more then lour dwelling units...."to structures which are adjacent to such residence or building'be
done by registered contractors.
Note:If the homeowner has contracted with a rporudon or LLC,that entity musts be registered.
Type of Work: '' IAerLL eN` Est.Cost: rJ�Jd�
Address of Work: I L4
Date of Permit Application: 3a
1 hereby certify that:
Registration is not required for the following reason(s):
_Work excluded by law(explain):
_Job under$1,000.00
_Owner obtaining own permit(explain):
_Building not owner-occupied
Other(specify):
OWNERS OBTAINING THEIR OWN PERMIT OR ENTERING INTO CONTRACTS WITH UNREGISTERED
CONTRACTORS OR SUBCONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK ARE NOT
ELIGIBLE FOR AND DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND
UNDER M.G.L.Chapter 142A.SUCH OWNERS ALSO ASSUME THE RESPONSIBILITES FOR ALL WORK
PERFORMED UNDER THE BUILDING PERMIT.SEE NEXT PAGE FOR MORE INFORMATION.
Signed under the penalties of perjury:
I herebygpply for a building permit as the agent of the owner:
is W, AV'C, � l 0h
Date Contractor Name HIC Registration No.
OR:
Notwithstanding the above notice,I hereby apply for a building permit as the owner of the above property:
Date Owner Name and Signature
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Debris Disposal Affidavit
In accordance of the provisions of MGL c 40, 554, 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.
The debris from construction work being performed at:
/K ��vtiace
(Please print house number and street name)
Is to be disposed of at:
(Pleas print name and loMion of facility)
Or will be disposed of in a dumpster onshe rented or leased from:
(Company Name and Address) /l /
344
Signature of Permit Applicant or Owner Dat
If,for any reason, the debris will not be disposed of as indicated, the Applicant or Owner shall notify the
Building Department as to the location where the debris will be disposed.
Order#225554 Quotation Page 1
- From Factory will Ship ToOrder Information
RX Miles, Inc. (WH) R.K. Miles, Inc. (WH) Date 3/07/2019
PO Box 1125 21 West Street Ord Type contrsctor2
616 Depot Street Route 5 South Route T2
Manchester Center,VT 05255 West Hatfield, MA 01088
Fax: 802 3382-6436 Po 6 *f 171 7 7 �i �i �i d
Customer Comment - -
MAREK/14 WESTWOOD TERRACE
Products Manufactured by
Phre Paradigm Window Solutions Portland, ME 04103
e Qty Dewdpbon color WkIth Heicht Unit Cost Net
r 6 Rpt 83M Double Hung-Plemlum Deelgi White TTT 35 314 45112
RO 36 46714
LOWE WArgon Top
Lauf dArgon Baran
® No Cxio Tap
No Grid emmi
Oarhle Lack
Vrnl Slap(Dade)
56 Angle
FiGag16s5 FJ Saeai
U4 ACTOR 036
Line Ilam Total 0.00 0.00
r Order Totals -
Total 0.00
Sales Tax 0.00
Grand Total 0.00
8564 -R05
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