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17A-048 r BP- 2011 -0092 GIs #: COMMONWEALTH OF MASSACHUSETTS - CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Categor BUILDING PERMIT Permit # BP- 2011 -0092 Project # JS- 2011- 000174 Est. Cost: $7080.00 Fee: $35.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: Homeowner as Contractor Lot Size(sq. ft.): 11107.80 Owner: WALMSLEY CATHERINE A Zoning. URA(100) //RI Applicant: WALMSLEY CATHERINE A AT. 160 BRIDGE RD Applicant Address: Phone: Insurance: FLORENCEMA01062 ISSUED ON.8 11012010 0:00:00 TO PERFORM THE FOLLOWING WORK.-Window Replacement 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 Siinature: FeeType: Date Paid: Amount: Building 8/10/2010 0:00:00 $35.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Louis Hasbrouck — Building Commissioner City of Northampton q 00 ` Building Department epartment 212 Main Street Room 100 ;" Q Northampton, MA 01060 phone 413 - 587 -1240 Fax 413 - 587 -1272 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 'Bri d i e !zOl� MaP Lot Unit OuerlayDtstri Eim st, District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record f ID �niS�Yto ✓�n P GyA�rnS� � e� / loh /� /,`p a� .�o�Lt l 0 /O1v�;O Name (Print) a Current Mailing Add ss: Telephone Signature 2.2 Authorized Anent: Name (Print) Current Mailing Add ss: Signature Telephone SECTION 3:- ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only completed by ermit applicant 1. Building (a) Building Permit Fee 2. Electrical (b) Estimated Total Cost of Construction from 6 3. Plumbing Building Permit F66 4. Mechanical (HVAC) 5. Fire Protection 6. Total = (1 + 2 + 3 + 4 + 5) 6 Chedc Number This Section Far Official Use Onl Building Permit Number: Date Issued: Signature: Building Commissioner /Inspector of Buildings Date • i 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: r_.. -.-._i L: `` § R ' Rear - e Building Height Bldg. Square Footage % Open Space Footage % _-- - (Lot area minus bldg & paved p arkin g) # of Parking Spaces - - - -� Fill: I volume & Location A. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO Q DONT KNOW 0 YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO Q DON KNO Q YES Q IF YES: enter Book Pages and /or Document # B. Does the site contain a brook, body of water or wetlands? NO 0 DONT KNOW 0 YES Q IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained , Date Issued C. Do any signs exist on the property? YES 0 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 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 Q NO Q IF YES, then a Northampton Storm Water Management Permit from the DPW is required. t 3GRIPTION OF PROPOSED WORK {check all applicable) ❑ Addition ❑ Replacement ndows A ❑ T Roofing ❑ Or Doors dg. ❑ Demolition ❑ New Signs [O] Decks Siding [ED] Other [a lion of Proposed existing bedroom Yes No Adding new bedroom Yes No arrative Renovating unfinished basement Yes No ;hed Roll - Sheet fi is fait r ii l fo i i lnct 0 1, rit t eM e. bird of building: One Family Two Family Other nber of rooms in each family unit: Number of Bathrooms .here a garage attached? oposed Square footage of new construction. Dimensions lumber of stories? ,utethod of heating? Fireplaces or Woodstoves Number of each Energy Conservation Compliance. Masscheck Energy Compliance form attached? Type of construction Is construction within 100 ft. of wetlands? Yes No. Is construction within 100 yr. floodplain Yes No Depth of basement or cellar floor below finished grade Will building conform to the Building and Zoning regulations? Yes No. Septic Tank City Sewer Private well City water Supply TION 7a - OWNER AUTHORIZATION -;TO 8E - CbMP LET ED WHEN 4ERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT,' as Owner of the subject erty by authorize :t on my behalf, in all matters relative to work authorized by this building permit application. iture of Owner Date as Owner /Authorized it hereby declare that the statements afid info on on the foregoing application are true and accurate, to the best of my knowledge )elief. ad under the pains and penalties of perjury. ( 7 Aih fZ, ;1 e- u1 a J M 1 l Name ture of Owner /Agent Date SECTION 8 - CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor Not Applicable ❑ Name of License Holder f rj`l)iP W r! t;t✓ /3 �0 !7/ly License Number !l,� Address Expiration Date �o 7l 7 Signature Telephone gg __isirenlotn llgleimetOtttCfbr� } { xs.x Lx -;s f ,.... xk Not Applicable ❑ Company Name Registration Number Address Expiration Date Telephone SE CTION 10- 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 resu in the denial of the issuance of the building permit. Signed Affidavit Attached Yes....... ❑ No...... ❑ The current exemption for "homeowners" was extended to include Owner - occupied Dwellines 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 The Commonwealth of Massachusetts Department of Ind ustrial Accidents . Office of Investigati 600 Washington Street Boston, MA 02111 ,v r www.mass gov/dia -Workers' Compensation Insurance Affidavit: Builders / Contractors /Electricians/plumb.ers Applicant Wormtation Please Print Leiribiy Name ( Business /orgmization/individuat) . Address: City /StatelZip: Phone. #: Are you an employer? Check the appropriate box: T e of . ro (required). 1 4.. I am a general contractor and I p I 1. r_1 I am a employer with g f. ❑ employees (full and/or part time).* have hired the sub- contractors New construction listed on the attached sheet 7• ❑ Remodeling [Q I am a sole proprietor or partner- ship and have no e�ioyees These sub - contractors Dave. 8. [] Deznoltuon working for me is =y capacity. C_=__PIoyees: and have workers' 9 Building° addition _ comp. msm sP f _ . . [ workers' comb. msurance required ] 5. [] We are a corporation and its 10 Electoral repairs or additions officers havexercised their 11.[] P 3. }�-I am a homeowner doing all work lumbing repairs or additions . . myself- [No workers' comp. right of exemption per MGL 12.0.Roofrepairs insurance required.] t c. 152, § 1(4), and we have no emp loy ees. o workers'. Other comp. insurance reC* -6&j. *Any applicant Shat checks box #1 must also fill out the section below showing dairworktrs' compensation policy information t Homeowners who submit this a$tdavit.indicating they am doing all work and then hire outside contractors roust submit a new affidavit indicating such. :Contractors that check this box must attached an additional slhect showing the name of the sub-contractors and state wheiberor notthose entities have employees. If the sub - contractors have employees, tbey must provide their workers' comp. policy number. l'am an employer that is providing workers' compensation insurance foamy employees Below is the policy and job: site information. Insurance Company Name: . Policy # or Self -ins. Lic. #: Expiration Date: Job Si A ddress: City /state/Ztp: Attach a copy of the workers" compensation policy declaration page the policy number and: expiration date). Failure. to secure coverage. as required under.Sectioii`25A'ofMGL c: 132 eau lead the imposition of criminal penalties of a fine up to $1,500.00 and/or one. -year imprisonment; as well as civil penalties is the form of a STOP WORK ORDER and a fine of up to $250.00 a day against the violator. Be advised that a copy of this statement ma forwarded to tie Office of I`nvestieatioris of the - DIA for insurance coverage vcrficafion.� - - _ . .:. _ .: .,..: ,.._ 7 , .. . ..> t do hereby eertrj under the pains -an penalties ofperimy deaf the unformation�vravided abav� ttrus_asd 3i tare: // 'hone #: 13 _ 2 `r? O _4W use only, Do not write in this area, to be completed by city or town vffu iaL . ff j City or Town: PermitUcense # Issuing Authority (circle one): J. Board of Health 2. Building Department 3. City/Town Clerk .4. Electrical, Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone #: HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to act as his/her construction supervisor. The state defines "Homeowner" as, " Person(s) who owns a parcel on which he/she resides or intends to be, a one or two family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constricts more than one home in a two -year period shall not be considered a home owner." The building department for the City of Northampton wants person(s) who seek to use the home owner exemption, - to act as their own construction supervisor, to be aware that by doing so you become responsible for compliance with state building codes and regulations. The inspection process requires that the. building department be called to inspect work at various stages, which include foundation /footings (before backfill). sonotube holes (before your), a rough building inspection (before work is concealed), insulation inspection fif required) and a final building inspection The building department requires these inspections before the work is concealed, failure to secure these insuections can result in failure to obtain a certificate of occupancy until the work can be inspected. If the homeowner hires other trades to perform work (electrical, plumbing & gas) the homeowner will be responsible to make sure that the trades hired secure their proper �ermits in conjunction to the building permit issued, and that they get their required inspections. Failure of the individual trades to secure the permits and inspections as required can DELAY the project until such time as the proper permits and inspections are made L understand the above. .(Home owner /resident's signature requesting exemption) I will call to schedule all required building inspections necessary for the building permit issued tome. Date Address of work location . txt�r�£xr CZ��x�tx�x# PRIME WINDOWS, LLC CT Lic: 576 -416 920 CROMWELL AVE MA Lic: 139 -649 ROCKY HILL, CT 06067 800 - 717 -7222 • 860 - 257 -0244 • 860 - 257 -0246 FAX This agreement ' de i rdaXof , 20 ' between Prime Windows, LLC (referred to as the "seller ") and Homeowners: .C- (referred to as the "buyer ") Address: s'/ City, ST, Zip: 171 Home Phone: — c9-�- Work Phone: BUYER AGREES TO BUYAND SELLER AGREES TO SELL ALL NECESSARY LABOR AND MATERIALS TOTERFOR THE FOLLOWING WORK TO ..THE SPECIFIgAVONS, TERMS AND CONDITIONS BELOW: 1. Seller will 'remove � windows and storms and install custom replacement windows. 2. Windows st I will be double hung, two section sliders, three section sliders, hoppers, /- s `jl csmt/awn, I_ dae abs=rs a It, triple csmt/awn, quad csmt, �L p icture,B r. Special: bay, bow, garden ft patio slider. '� l 3. All windows will be of virgin vinyl — l l G in terior and t r % i'r exterio � f . 4. All windows will have dual glazed insulating glass t! ¢* Q ©te 5. windows will have 6. All double hung and two section sliders will have half screens and all other operating windows will have full screens. T Seller will remove doors and install custom replacement doors. 8. Door styles will be 9. Exterior trim on windows will be covered in aluminum coil stock. 10. Any debris caused by the installation and the old windows and doors will be hauled away. Spec I It :'�"� 1 T <70 t/e Oe �ti Q j 94- GL s'ry Start Date: - 7 2 - : : 2 f!� ' Completion Date: lr Note: Repairs of any existing damage or rot are not part of this agreement. Buyer is responsible for the painting and finish of any wood trim installed by the seller Including the head and seat boardf of bays and bows. Buyer is responsible for the removal and re- installation of any alarm systems and window fixtures affected by the window installation. Prime Windows, LLC assumes no responsib for plumbing or electrical work necessE ry to compete job. Any necessary plumbing or electrical work must be arrangedor and paid for by the customer. Prime Windows, LLC is not responsible for any painting, staining, finishing, wallboard compound or putty. The contract price includes reasonable labor and materials to complete Installation. Unforeseen necessary work, (i.e. rot repair, hazmat removal, etc.) will be an additional charge based on labor and materials.Prime Windows, LLC cannot be held responsible for removal of asbestos, lead pain?. or any other hazardous material or regulated material. We are not respon- sible for conditions beyond our control including condensation resulting from pre - existing conditions. Homeowner Initials All material is guaranteed to be as specified. All work to be completed in a workmanlike manner according to standard practices. Any alteration or deviation from the above spec must be trade in writing on an Add -on /Modification of ^nr+41a.7t for-. _ -1 _ - r.) .-rsr n" "r .. n.#. = + •`.� a t N t ^ _ii...."".`:�`: ^.e. ,.. CC: - B u n o.Fr. - ...,>i,y 9 .- �.`:.:' f... .�.,:?":U ^t .r.J, r. i,.: i^. ± ,'', i. . yr:�;�'.:�: :; :v�:��� ^ yu ° �JNr'ri delays beyond our control. OwnerE to carry fire', tornado and other .necessary insurance. Our workers are fully covered by Workmen's Compensation Insurance. Homeowner agrees to pay for all ,work as set forth below. If the homeowner defaults, homeowner agrees to pay all costs of collection, including reasonable attorneys fees, in addition to other damages incurred by contractor. A % per month service charge will be assessed for all payments not made within 10 days of due date per the schedule below: We propose hereby iA furnish material and labor - complete in accordance with the above specifications, for the sum of: dollars ($ id amount shall be paid as follows: , NOTE: This proposal may be withdrawn by us if not accepted within , la d 0 �� ✓ "'�� `' YOU, THE BUYER, MAY CANCEL THIS TRAACTIO AT N IOR Y TIME P ry s TO MIDNIGHT OF THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION. SEE THE ATTACHED NOTICE OF CANCELLATION FOR-AN EXPLANATION OF THIS RIGHT. (SATURDAY IS A LEGAL BUSINESS DAY IN CONNECTICUT.) THIS SALE IS SUBJECT TO THE PROVISIONS OF THE HOME SOLICITATION SALES ACT AND THE HOME IMPROVEMENT ACT. THIS INSTRUMENT IS NOT NEGOTIABLE, Work will not be begun until your right to cancel has expired an have paid a deposit of dollars ($ ), unless this agreement provides otherwise. - Signature of Contractor or authorized representative: (I/We) have read the terms stated herein, they have been explained to (me /us), and (I[We) find them to be satisfactory and hereby accept them. Signature of Homeowner(s): a . 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CITY OF NORTHAMPTON — Permit: PER SONS CONTRACTING WITH UNREGISTERED CONTRACTORS Buildin MG DO NOT HAVE ACCESS TO THE GUARANTY FUND cater ]BUILDING ( L c.142A) Permit # BP - 2 010 -0865 PERMIT Protect JS- 2010- 001287 Est. Cost: $10000.00 Fee:, $35.00 PERMISSION IS HEREBY GRANTED TO: Const. Class. Contractor: License: Use Group: WILLIAM PICHETTE 71053 Lot Size(sq. ft.): 11107 80 Owner: O'CONNOR LOTUS P Zoning: URA(100) //RI Applicant: WILLIAM PICHETTE AT: 152 BRIDGE RD Applicant Address: Phone: Insurance: P O BOX 454 (413 ) 628 -4787 ASHFIELDMA01330 ISSUED ON:41712 01 0 0.00 :00 TO PERFORM THE FOLLOWING WORK.- & SHINGLE ROOF 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 4/7/2010 0:00:00 $35.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Anthony Patillo � ` ~ Tn Incomplete Information Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due Proposed Required by Zoning Existing This column to be filled in by Building Department Lot Size Setbacks Front Rear Building Height Bldg- Square Footage Open Space Footage % ve L o Of Parking Spaces volume & Location ` ' ' ' A. Has a Special Permit/ Vbria been �suedfor/on the ��? NO »-� DONTKNOYY »~��'- ~~� »�� ,cu 0 IF YES, date issued: IF YES: Was t permit recorded at the Registry o[ Deeds? �� -"" �~� _uum7 KmoYY YES 0 IF YES: enter Book Pagel a and/or Document# D. Does the site contain abnook body NO �� ' / v�� DONTKNOYY «�/ YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needstmbapbtained » - � Obtained »-~� ' Date Issued: (---- -- ^-- ' -= "-� ' C. Dn any signs exist on the property? Y[S » NO �� |F YES, describe size type > -------------------------� ' ' ' ( _ ..... ____.... ...... ___ -' ~^"'=.==.vp,vpvu�ncnunges�ooraoo,t,onoo[sh��ih��l�0 --��y� Y[� � NO --,�-, �~/ |F YES, describe size type and koration- s. WiUthe construction ouUv<Y disturb (clearing, gradingexcava ar filling) over 1 acre orisK part ofaonmmn common maw«»u��dbovarImcr� YES� NO »T-� ~p= ^�� »�� |F YES, then o Northampton Storm Water Management Permit from the DPW is required. ,