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23A-256 (3) BP-2022-0046 15 MAPLE ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 23A-256-001 CITY OF NORTHAMPTON Permit: Exterior Res PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit# BP-2022-0046 PERMISSION IS HEREBY GRANTED TO: Project# windows Contractor: License: Est. Cost: 1 1 178 NORTH EAST SPECIALTY CORP 081031 Const.Class: Exp.Date:09/06/2023 Use Group: Owner: NAUMOWICZ THERESA M&TIMOTHY Lot Size (sq.ft.) Zoning: URB Applicant: NORTH EAST SPECIALTY CORP Applicant Address Phone: Insurance: 148 DOTY CIRCLE (413)739-4333 VWC6003962-2021 WEST SPRINGFIELD, MA 01089 ISSUED ON:01/18/2022 TO PERFORM THE FOLLOWING WORK: 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: Gas: Final: Final: Rough Frame: Rough: Fire Department Driveway Final: Fireplace/Chimney: Final: Oil: Insulation: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF 1‘1ORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: icmteL yg J7i, • Fees Paid: $40.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner (-- The Commonwealth of Massachusetts KTi& u = Board of Building Regulations and Standards FOR • Massachusetts State Building Code, 780 CMR MUNICIPALITY USE N Building Permit Application To Construct, Repair,Renovate Or Demolish a Revised Mar 2011 One- or Two-Family Dwelling }',Section For Official Use Only Building Permit Number: _CP- 22..4 y Date Applied: 4,JO a 3 qq-7OZZ Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1, lro qty Ad,dess etelej 1.2 Assessors Map&Parcel Numbers 1.la Is this an accepted street?yes no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public 0 Private 0 Zone: _ Outside Flood Zone? Municipal❑ On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'ofRecord:. moy A)au mow] M o` . n J/)( 3 Name(Print) City,State,ZIP 15 cL.O) 13 -09b No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Buildin r, Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify: f I l�LL5 Brief Description of Propo d Work': • l(1 mem. W‘tl6e3w s J--c?4c-ra2 ., I SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ ' 1 ` 1. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical $ ❑ Standard City/Town Application Fee ❑Total Project Costa (Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire $ Suppression) Total All Fees: $ Check No a 9I Check Amount: 1V Cash Amount: 6. Total Project Cost: $ 0 Paid in Full ❑Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES ; 5.1 Construction Supervis r License(CSL) Ct �' - t 31 Ma_i77hv� • Ca�"•%rl 'L License Number xpira ion Date Name of CSL Holder/9 ?7y � ` ) !" 1� 2 List CSL Type(see below) L�/ � No.and Street Type Description %�; s j) ! ` // �l !��`�(� U Unrestricted(Buildings up to 35,000 Cu.ft.) 1 L/ ` GY✓ R Restricted 1&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding --7 e�i c3/7 `/ / /, {ram ) SF Solid Fuel Burning Appliances 39!� ).3 3/ 'J7f',(err g 0 / I Insulation Telephone Email address felony D Demolition 5.2 Registered Home Improvement Contractor(HIC) )_ e;5(101C HIC Registration Number xpi on Date HICEp pan me or HIC Re 'stra Name / / /...1C-)7)/ C/k ///i - - - ' r - env No.and..Str Email address .,�) 5 ,4 it) 1(),/lJ�/ 7 1-% j City/Town,State,ZIP Telephone SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.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 . 0 SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,as Owner of the subject property,hereby authorize to act on my behalf,in all matters relative to work authorized by this building permit application. S//- (161/71- 1(17 Print Owner's Name(Electronic Signature) Date SECTION 7b:OWNER' OR AUTHORIZED AGENT DECLARATION By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information containe • is application is true and accurate to the best of my knowledge and understanding. i/C-/-- --__ ________ Print a 's or Authorized AgName Electronic Signature) s ( gn re) Date NOTES: 1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration program or guaranty fund under M.G.L.c. 142A. Other important information on the HIC Program can be found at www.mass.gov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dps 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) (including garage,finished basement/attics,decks or porch) Gross living area(sq. ft.) Habitable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of half/baths Type of heating system Number of decks/porches Type of cooling system Enclosed Open 3. "Total Project Square Footage"may be substituted for"Total Project Cost" CITY OF NORTHAMPTON SETBACK PLAN MAP: LOT: LOT SIZE: REAR LOT DIMENSION: REAR YARD SIDE YARD SIDE YARD FRONT SETBACK FRONTAGE r i roe. City of Northampton Massachusetts �÷5 .., cfc c. k_ V' DEPARTMENT OF BUILDING INSPECTIONS A. ti U j 212 Main Street • Municipal Buildingv�. C�� Northampton, MA 01060 j4ii" Imo 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: 15- Ha* M- j"` The debris will be transported by: Name of Hauler: USIA 0, 0\ec- jit4za Signature of Applicant: 3 �\____. Date: • The Commonwealth of Massachusetts a —6.941== Department of Industrial Accidents t: 1 Congress Street, Suite 100 3���:�+�e` oston9 MA 02114-2017 a �a�� Q vW wwwmass.gov/dia Wwrkers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information q�` r Please Print Legibly Name (Business/Organization/Individual): / )F.::��` O Address: { /c$ a .C"���f �? e.. Ci /State/Zi Phone #: ,-3 3 (3< Are you an employer?Check the appropriate box: Type of project(required): i f I am a employer with6 employees(full and/or part-time).* 7. ❑New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in 8. Remodeling any capacity.[No workers'comp.insurance required.] 9. ❑Demolition 3.0 I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 10 E Building addition 4.1:11 1 am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.Q Electrical repairs or additions proprietors with no employees. 12.El Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑Roof repairs These sub-contractors have employees and have workers'comp.insurance.t � �l 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.❑Other (�l, / 0tills 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. i l4 )) VI1 -. Ti) 'Insurance Company Name: . i � Policy#or Self-ins.Lie.#: V lk) y( CO ( • \ Expiration Date: -2/V9ca Job Site Address:% /'/� f City/State/Zip: rlore nee Ha.©1c1O Attach a copyof the workers' �ovvdpensation policydeclaration page(showingthe policynumber and expiration date). P Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify un the pains and penalties of perjury that the information provided above is true and correct Signature: /C( /h Date: j/q/R Phone#: ,3 9 5/33 3 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: City of Northampton 'p Massachusetts +Ss • sc." ; DEPARTMENT OF BUILDING INSPECTIONS . n *' ieefr� t 212 Main Street • Municipal Building S0 A. �a. Northampton, MA 01060 XSfr, � )1,° HOMEOWNERS'EXEMPTION ELIGIBILITY AFFIDAVIT I, (insert full legal name), born _ (insert month, day, year),hereby depose and state the following: 1. I am seeking a building permit pursuant to the homeowners' exemption to the permit requirements of the Massachusetts State Building Code, codified at 780 CMR 110.R5.1.3.1, in connection with a project or work on a parcel of land to which I hold legal title. 2. I am not engaged in, and the project or work for which I am seeking the aforementioned homeowners'exemption, does not involve the field erection of manufactured buildings constructed in accordance with 780 CMR 110.R3. 3. I qualify under the State Building Code's definition of"homeowner"as defined at 780 CMR 110.R5.1.2: Person(s) who owns 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 home owner. 4. I do not hold a valid Massachusetts construction supervision license and, except to the extent that I qualify for and will abide by the Massachusetts State Building Code's requirements for the supervision of the project or work on my parcel, I am not engaged in construction supervision in connection with any project or work involving construction, reconstruction, alteration, repair, removal or demolition involving any activity regulated by any provision of the Massachusetts State Building Code. 5. If I engage any other person or persons for hire in connection with the aforementioned project or work on my parcel, I acknowledge that I am required to and will act as the supervisor for said project or work. Signed under the pains and penalties of perjury on this day of , 20 . (Signature) • NORTHEAST SPECIALTY CORPORATION d/b/a NESCOR 148 DOTY CIRCLE HOUSE Li' Window Color Int. Ext. , o� _ �o< �o I' '�,. CONDO El 63'White/White ❑Tan/Tan �.' WEST SPRINGFIELD 1-888-NESCOR-1 HISTORICAL Y orN 0 White/Bronze 0 Other THE LEVEL BEST IN HOME REMODELING 1-413-739-4333 #WINDOWS 4 X MEASURE DATE MEASURE TIME nescornow.com #SGD'S - 4 r ; ,tZ t Q,OO A^ Mr./Mrs.: (y\<o. ^h AUU.U,,,; .c2 Email:-•no“.,mow;c2 e coo-ot• AU home improvement contractors and subcontractors en- gaged in home improvement contracting,unless specifically Address: I 5 IIV1 A NI .14 Date: 1'as [ a ci I z g exempt from registration by Provisions of Chapter 142A of the general laws,must be registered with the Common- City: F 1 6 r er, Cam'- Home:,i1 ? 3 S 0f wealth of Massachusetts.Inquiries about registration {1 c l and status should be made to the Director of Consumer State: Zip: Affairs and Business Regulation,Ten Park Plaza,Suite 5170 0 I 0 Z Office: Boston,MA 02116-Phone(617)973-8700 III. ECONOLINE PeSMART CHOICE Double Pane •Clear Glass • Hollow Frame • Screwed Corners HS19 Glass•Welded Frame• Insulated Frame 5 Year Warranty Lifetime Guarantee•Free Glass Repair•Free Screen Repair•Free Re-Caulking III PERFORMANCE III PREMIUM Double Pane• Normal Low E Glass• Hollow Frame Impacted Glass•Low E Argon Gas•Welded Frame•Insulated Frame Welded Corners• 15 Year Warranty Lifetime Guarantee•Free Glass Repair•Free Screen Repair•Free Re-Caulking •a a)a) 3... co O C co In o D coto Q '�65 O r-. 0 E o I—� o C7 Z o too n. Q, o c� E ,0 Z +, N .5 a).E E •O o -D m o ox 1- v 0 o H r— o s C O C.)) 0O a) N•oe i ' IDS >� do 7� CD In co .4., a Z '0 0 p••�n - a`0i EQ.g U ,o M V ty Cl. N CC ow u u) ro m W H }' o co ° X 1 ps <1•, 2 4.c: JG X -il t y 1 14 V t { ,V J ii- --7 2 ,00, ,,i- .BLS 36 X to E 4 p,,�� �LS 36 x 4� 5 POr�l, a �5 3/, X41 I v f , 6 Q„. a-(-s 3 b x 47 V , 7 e cl, a4S 3i X4/ v' 8 perch L S 3( x to v y ,,• r, p 9 t o rc ti` a i.,5 3 , X41 V' ,✓ f 10 1 oc��. a,.5 lc Xi{o v 11 pcc D.LS “ Xti7 u f Port `) �-S 3b X ? i r 12 See Attachment We Propose hereby to furnish material 1.First of all...No verbal agreements are recognized.Everything must be in writing on the contract.Please make and labor complete in accordance with 4 sure everything Is written on your order.If something Is not on your work order,please do not request it from our staff. above Specifications,for the sum of: ,,t They are not allowed to give anything not on the contract.The salesperson's measurements above are approximate only and are not to be relied upon as we have an employee who will come to your home after contract formation to take the actual and precise measurements. oilers ffit i 2.Pemits.We pull permits on all jobs where they are required.Your permit cost is in addition to your contract price.It ($ _ n�; _ would be unfair for us to add a standard permit charge to all contracts,since prices vary greatly from city to city and 'vim some cities do not require permits.It is impossible for your representative to determine your permit cost.(usually Payment to be made as folio s:` between$100 and$400).We only charge what the city charges us,plus a$39.00 service foe.Balance is due upon substantial completion and is not contingent upon final inspection or the occurrence of any other condition.Certain cities require final inspections.It is your re nsibili y to be home fo your s heduled inspection. Administration Fee tS '2'Z — Li I5Iw 3.Installation start time is approximately I a measure,financing and/or HOA approval. 33%upon signing contract. $ I riii Sales reps are not allowed to change these times.You may not hear from us for a period of time while waiting for your , materials to arrive.Don't worry!!We will call as soon as possible to schedule your job.If you are using our financing, $3flf '). o the clock doesn't start ticking until your loan is approved.If the start of your installation exceeds past the estimated 33/o upon completion of measure. $ !l i SS time above,we will credit your account$50.00 per week for every week that we fall behind.This contract cannot be4 altered after the date of the measure. u 33%shall be made forthwith upon $ nmmnlaf;nn of ,nrte,m.+nr fhln..n..+r,n+ tt, t0� NORTHEAST SPECIALTY CORPORATION d/b/a NESCOR CONTRACT CONTINUATION r nl.0c______,0, )a lon '~ ES CO Purchaser 1 Signature: f'THE LEVEL BEST IN HOME REMODELING Purchaser 2 Signature: NESCOR Rep.Signature: n/A4 a gi nescornow.com • ECONOLINE 111 SMART CHOICE Double Pane • Clear Glass• Hollow Frame•Screwed Corners HS19 Glass•Welded Frame•Insulated Frame Lifetime Guarantee•Free Glass Repair•Free Screen Repair•Free Re-Caulking 1111 PERFORMANCE, PREMIUM Double Pane• Normal Low E Glass• Hollow Frame Impacted Glass•Low E Argon Gas•Welded Frame•Insulated Frame Welded Corners • 15 Year Warranty Lifetime Guarantee•Free Glass Repair•Free Screen Repair•Free Re-Caulking i u) i o 4. a-0 0 w @ co o p a O 7a) 0R E Z - e 3-> co E E '13 3 13 m Z o o L. 0 0 I- 1-A o CDC - Z .a o --0_0 v Q g v 1 v)E o, E 01) V) ro Cl) ¢ d !X a) c §Q to E .0 '� 5 a) o m t,� C7 �i o _ qo U c '� W H ~ cn ° x 1 L'R © i4 ), cjx$„ ` 3IFI14 � tq at/ 1 o 2 L (S D t1 agx..Cs• )11 i i} ✓ v Of 3 L. 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