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31A-283 S I is b ,ir 1 �i AC12 Series Vinyl Replacement Windows Dependable quality at F t an affordable price. ` R Strong and Durable , urable " t; ,�� : , � • Multi- chambered Frame and Sash: Provides . ` ' t ) a 1 b t increasedMllgidity and energy efficiency t .. - • Fusion- Welded Construction: Creates a ; ! ? i I I, r , (( rat strong weather -tight seal P • Maintenance Free Vinyl Frame: Will not 1 > �� :71! rot, peel, flake or corrode, therefore never .* E '' i i r: needs painting l� $ 5' t • Beveled Exterior Profile: Gives your home a, a clean, contemporary look at an affordable price 1-. ._ • Sloped Sill: Prevents water from building up in ---- ---- - - vas the sill and leaking into the home , i •�., ti Easy to Operate and Maintain ' ■ a • "` • Tilt -in Sashes: For easy cleaning from inside the a i t °, • Block and Tackle Balances: For smooth, easy i '- " . Beige ' at 4 White Contour operation - • Grilles are sealed inside the glass for easy cleanin: ( COI rS Colors reproduced as closely ' as printing will allow. Energy Savings 7 • Available with 5/8" insulated glass for improved Ve comfort or 5/8" LoE insulated glass with Argon White Beige Gas for superior comfort and energy savings • Dual weatherstripping provides an energy efficient, weather -tight seal Limited Lifetime Warranty* Peace of Mind Guaranteed protection for you and your home. We know you have a choice when it comes to home i improvement projects. That's why at The Home Depot® ;' : Product we are committed to providing quality products and ! Limited Lifetime Warranty on vinyl parts covers peeling, flaking, chipping. blistering and corrosion. services by offering Total Project Management, a 3 Limited Lifetime Warranty on hardware and parts (locks, fasteners, rollers, balances, etc.) covers rusting and corrosion. , Professional Installation, and superior Product and " h ' Limited Lifetime Screen Warranty covers t he aluminum frame andthe fiberglass mesh against tears, punctures and insect damage. Craftsmanship Warranties. Its our complete solution - � from start to finish. Now, that's peace of mind. l's All installation services performed through The Home Depot, are performed by independent contractors, as applicable. License numbers held by or on behalf of THD At-Home Services, Inc: AL 02073; AZ: ROC223472, ROC218039, ROC193323; CA: 836021, 881834; CT: 565522; DC: H1054000954; DE: 1997112310; FL: CRC1328370, CRC046858, CCC1325818, CCCO58327, CCC1326270, CCC1325540; IA: 87256-05 ; 1A: HI 0550419; MA: 126893; MD: 52036; ME: CO2439;,,MI: 2104158225; MN: BG20268257; MS: R05788; ND: 29346; NE: 032-009450777; N): 13VH01058300; NYC: 1201902; NY/Buffalo: 536671; NY/Nassau: HI8G1650000;INY /Rockland: H9403- B6-00A0; NY /Suffolk: 27587 -H; NY/Westchester County: WC 11245 -HOON; NV: 0065776, PROUDLY MADE IN 0057766; OR: 158651; RI: 16427; SC: 22647; TN: 59337; TX: 3710; UT: 5604067-5501; VA: 2705073411A; WA: HOMED WI: 850869;W\': WV033268. Other license numbers available USA upon request. Changes to product(s) may have occurred since time of printing. Features and options may not be available in all markers. Consult your THD At -Home Services representative prior to purchasing. The Home Depot is a registered trademark of Homer TLC,1nc. (c)2007 Homer TLC, Inc All rights reserved. THD -155 (8/07) • • • ' ` : • VBMENT CONTRACT RECEIVED PL' SE READ THIS Sold, Pumished and Installed by: A►ate: THD At.Hprae Services, Inc. 5 2011. �AGr�:w o'�t HOME Depot At..-Home MA �� Toll Free (800) 657 -5182; Fax (S08)756-8823 Branch - 31 ._ .. Federal IDs 75-269846(k ME Lie s C 02439; RI Cora_ Lk* t 6427 DEPT. OF BUILDINGINSFECT,,GdS LTLic #AICO56552 ;MA HIT TnPovementCon # 126893 •�, •MPT•N MA 01u6n beta( alien , , - . "M r i i c, V • t e Cs. WR f ey∎I IV( 4.. City Zip Pr:rchsep(a)'• Work Mawr Heron Phone: Cell Phone: - •'•l.,_ [ I [ ) [ ) [ ] [ a Home Address: (If dit'terent from Installation Address) City State Zip E•nselI Address (to nsceive project communications and Home Depot updates); D I DO NOT with to receive any marketing emtils from The Home Depot f Imtat : Undersigned ( "Customer"), the owners of the property located at the above installation address, agrees to buy, an D At- ome ervices, Inc, ("The Horne Depot") agrees to furnish, deliver and arrange for the installation ( "Installation") of all materials described on the below and on the referenced Spec Sheet(s), all of which are incorporated into this Contract by this reference. along with any applicable State Supplement and Payment Summary attached hereto and any Change Orders (collectively, Contract "): lobs: Miami Aim) 1 Pr , 5 � 7, . , - #: • net Aesdpat III Roofing •Sielirrg wdows R Insulation - I CS C IEUtr y D°3° El _ $ 1743 ■ . , _ • kilos S Windows • Insulation 72/(> Mutes / Comm DEntry Doors fJ ORoofiag USidmg U Windows O tnwlation OGuuets /Covers 013ntry Doors ( $ °Rooting USiang ll Windows O'inwLaidn UCxmen I Coves QEntry Doors ❑ $ Mutants 5% Deposit otCamaeiAimed neuponmend n rt this contract 'rtsa Con tract Amount $ airtime Ptaehasexsmay not deposit roes* don ono-third stMrCatstvaetAinowet. Customer agrees that. immediately upon completion of the work for each Product, Customer will execute a Completion Cenifncate (one for each Product as deemed 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 Product(s) included herein, at its discretion, if The Home Depot or its authorized service provider determines that it cannot perform its obligations due to a structural problem with the home. environmental hazards such as mold. asbestos or lead paint, other safety concerns, pricing errors or because work required to complete the job was not included in the Contract, Pavmemt Stmtmerv_ The Payment Summary * ` � ' ( e S (. , 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 trHed - time copy of the Contract at the me you sign. Do not sip a Completion Certificate (note: there Completion " tcate for each Product as defined by individual Spec Sheets) before work on that Product is In the event of termination of this Contract, Customer agrees to pay The Home Depot the costs of materials, labor, expenses and services provided by The Horse Depot or Authorized Service Provider through the date of Seaadnadoa, plus any other amounts sat fault in this Agreement or Mowed miter law. THE HOME DEPOT MAY WITHHOLD AMOUNTS OWED TO THE HOME DEPOT FROM THE miter OR OTHER PAYMENTS MADE, WITHOUT LIMITING THE HOME DEPOT'S OTHER REMEDIES FOR RECOVERY OF SUCH AMOUNTS. A eft tad Authorisation: Customer agrees and understands that this Agreement is the entire agreement between Customer ands! is Florae Depot with regard to the Products and Installation services and supersedes all prior discussions and agreements, either oral or written, relating to said Products 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 Customer has read. understands, voluntarily accepter the tetras of and has received a copy of this Agreement. X ik C rd $ e a F`� :nsttlre C ; s Sigrremre Date Satins t s Date �W Telephone No. Customer's Signature Dan • Sales Consultant License ado_ CANCELLATION: CUS'T'OMER MAY CANCEL TAMS tae applicable) AGREEMENT WITHOUT PENALTY OR OBLIGATION BY DELIVERING WRITTEN NOTICE TO THE HOME DEPOT BY MIDNIGHT ON THE THIRD BUSINESS DAY AFTER SIGNING THIS AGREEMENT. THE STATE SOPPLEMEOIT ATTACHED HERETO CONTAINS A FORM TO USE IF ONE IS SPECWICAI.LY PRESCRIBED BY LAW IN • CUSTOMER'S STATE. NOTICEs ADDITIONAL TERMS AND CONDITIONS ARE STATED ON THE REVERSE SIDE AND ARE PART OF THIS CONTRACT tad7 -10 C-SC While - Branca Fire Yellow - Customer 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 constructs 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 backlit!), sonotube holes (before pour), a rough building inspection (before work is concealed), insulation inspection (if required) and a final building inspection. The building department requires these inspections before the work is concealed, failure to secure these inspections 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 iermits 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 I, 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 to Date Address of work location The Commonwealth of Massachusetts Department of Industrial Accidents . P 5= l Office of Investigations • t 1� _ t� 600 Washington Street Boston, MA 02111 • www.massgov /din -Workers' Compensation Insurance Affidavit Builders/ Contractors /Electricians/PIumb.ers - Applicant Information - Please Print Legibly Name ( Business /Organization/Indivirl Address: - City /State/Zip: Phone. #: - - Are you an employer? Check the appr.: . or: Type of project (required)• r 1.0 I am a employer with 4 ■ I am a gen=e- contractor and I 3' 6. 0 New coristtaction employees (full and/or part time)." have hired th- sub- contractors 2- 0 I am a sole proprietor or partner- listed on the: • • sheet 7. ❑. Remodeling These sub -co. • . ctors have , ship and have no employees 8. 0 Deno�rtton working for me in any 0.3 _ •_ havve workers' - - 9 rkuig Y P t3' ": ' d tidir [No workers' camp. insurance ance _ . comp. II a ..... require:LI - 5. 0 W a corporation its 10.0 Electrical repairs or additions officers have 4xer" t heeir 11. - Plumb' repairs 3.0 I am a homeowner doing all work f ❑ ?ng eP ' or additions myself [No workers' comp. . exemption ` < MGL 12:0. R repairs insurance required.] f . : .c: 152, §1(4), .. , we .. ye -, o • _ employees. [N • • • ,.y ' 13.0 Other r comp. mcnsance . ,... J. 'Any applicant :that checks box #1- must .also fill out the section belowshowiug thecrwodoss' - eon reasation po mfarmatzon t Homeowners who submit this afdavit:indicating they are doing all work and the. hie outside contactors - sfu a new affidavit indicating such. • :Contactors that check this box must attached an additional sheet showing the name of the sub - contractors and whether ornot.t hose entities have employees. If the sub - contractors have employees, they nisi provide their workers' comp. policy number Iam an employer that is providing workers' compensation insurance for my employ Below is the policy and job: site information Insurance Company Name: . Policy # or Self-ins. Lic: #: Expiration D Job Si Address: City /Stn .. - Attach a copy of the workers' compensation policy declaration page the policy n .., . : and _expiration date). Failure to secure coverage: as reqUir'etriiiidei Sectron`25AofMGL c 152 can lead. to the imposition of v•••,;..' : -;.r i: es of a fine up to 51,500.00 and/or one -year imprisonment, as well as civil. penalties in the form of a STOP WORK- ORDER and a fmr of up to 5250.00 a day against the violator Be advised that a copy of this statement may be forwarded to the Office of .. vestieations of tl e bIA for nisurance coverage verification: . - .r f ro. kereb _ cerh under the and:carivrt y fy pains and pena lties:ofperjury thaftheirrfornratioa�rovirled .abavpittr Signature: D Phone #: _ • • - Official use only. Do not write fri this area, to be completed by city or town afficraL 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 #: • SECTION 8 - CONSTRUCTION SERVICES 8.1 Licensed Construction S •_ -,. isor: Not Applicable ❑ Name of License Holder : • 1 Y\ -F- if y 7 7) 1 License Number ?AZ rl — 1 d gilk) Address Expiration Date / • Signat "e Telephone S Redistere =Horn+ = mtirove"rrterh eaont �actb x <Y ` S2; -_ €.. &_ zz ., ,: Not Applicable ❑ i \ 1 Company Name Registration Jmbe Address )1D.' Expiration Date VvOr DI lephone — SECTION 10- WORKERS' COMPENSATION INSURANCE AFFIDAVIT (M.G.L. e. 152, § 25C(6)) Workers Compensation Insurance affidavit ust be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the buildi permit. Signed Affidavit Attached Yes No ❑ OfMteMptlan 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 1 _,I SECTION.5- DESCRIPTION OF PROPOSED WORK (check all applicable) New House ❑ Addition ❑ Replacement Wi ows Alteration(s) ❑ Roofing ❑ Or Doors Accessory Bldg. ❑ Demolition ❑ New Signs [O] Decks [C] Siding [0] Other [El] Brief Description of I , Proposed°'' e-{— Work: 1 iy �' Jia � • , All ' - �� (U M1011/ . Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll - Sheet sat iiiM: aiidf `fir c1i fiefa st s f i to o e ii Italia : 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 Ta - OWNER AUTHORIZATION - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, 6,g_ CQ r L , as Owner of the subject property 11 hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application. ittii Signature of Owner Date I, i AV E:1 )01.e , as Owner /Authorized Agent hereby declare that the s atements and information on the foregoing application are true and accurate, to the best of my knowledge and belief. Signed under the pains and to ties of pe • • • , � ri Print Name 4 41 11 11 1 M, /./ , — , MEP Signature of Owner /A =nt Date N. Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Ex Proposed Required by Zoning, This column to be fll' iit by Building Department Lot Size i .. _...a ......._ —_—.-. Frontage '. _ _,_ Setbacks Front i i 1 1 Side L:i R ;`. , L:= _., R. ; , , Rear Building Height f ; = , 1 Bldg. Square Footage % 1- - F i ( F Open Space Footage % (Lot area minus bldg & paved `_ ? S i _ '. parking) # of Parking Spaces i I Fill: i (volume & Location) A. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO 0 DONT KNOW 0 YES 0 IF YES, date issued:I I IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW 0 YES 0 IF YES: enter Book F P ager i and /or Document # B. Does the site contain a brook, body of water or wetlands? NO 0 DONT KNOW Q YES 0 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 I 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 0 IF YES, then a Northampton Storm Water Management Permit from the DPW is required. r a -nwm� lit ; t se" g€� 'soil a , RECEIVE C •f Northampton s ®, ` 1 7� t uil ling Department ' 4 2 2 Main Street -� -'z 5 2011 Room 100 :E O N • rth . mpton, MA 01060 - DEPT. auuni - �R', 58 -1240 Fax 413- 587 -1272 . e . NORTHAMP ON MA 01060 APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 - SITE INFORMATION This section to be completed by office 1.1 Property Address: Map .. -. Lot Unit y j Zone Overlay District Elm St District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: ---1E.>_1n kk, L . leiti.#9 i biz) 1-gre-_Lirrivtiftia kl'IrLrtifo, I Name (Print) Current Mailing Address: j 7 4 (9 1 dri- Telephone Signature 2.2 Authori • ent: Name (Print) / Curr Mailing Ad ress: / rqE- > - Signature -' Telephone SECTION 3 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building -� (a) Building Permit Fee 2. Electrical (b) Estimated Total Cost of Construction from (6) 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection 6. Total= (1 +2 +3 +4 +5) x"743"' Check Number i4)1-'7 This Section For Official Use Only Date Building Permit Number: Issued: Signature: 7 ," ir,. % -s� Building Commissioner /Inspector of Buildings Date File # BP- 2012 -0060 APPLICANT /CONTACT PERSON HOME DEPOT AT HOME SERVICES ADDRESS/PHONE 345 GREENWOOD ST WORCESTER (401) 935 -2633 0 PROPERTY LOCATION 106 WASHINGTON AVE MAP 31A PARCEL 283 001 ZONE RR(7)/URA(93) //WP THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out Fee Paid Typeof Construction: Replace 7 Windows New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 3 sets of Plans / Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INF PRESENTED: (/Approved Additional permits required (see below) PLANNING BOARD PERMIT REQUIRED UNDER:§ Intermediate Project: Site Plan AND /OR Special Permit With Site Plan Major Project: Site Plan AND /OR Special Permit With Site Plan ZONING BOARD PERMIT REQUIRED UNDER: § Finding Special Permit Variance* Received & Recorded at Registry of Deeds Proof Enclosed Other Permits Required: Curb Cut from DPW Water Availability Sewer Availability Septic Approval Board of Health Well Water Potability Board of Health Permit from Conservation Commission Permit from CB Architecture Committee Permit from Elm Street Commission _ Permit DPW Storm Water Management Demolition Delay Signature of Building Official Date Note: Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning requirements and obtain all required permits from Board of Health, Conservation Commission, Department of public works and other applicable permit granting authorities. * Variances are granted only to those applicants who meet the strict standards of MGL 40A. Contact Office of Planning & Development for more information. 106 WASHINGTON AVE BP- 2012 -0060 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 31A - 283 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: windows replaced BUILDING PERMIT Permit # BP- 2012 -0060 Project # JS- 2012- 000091 Est. Cost: $1743.00 Fee: $35.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: HOME DEPOT AT HOME SERVICES Lot Size(sq. ft.): 37330.92 Owner: BARNETT MICHAEL J & JOANNA V Zoning: RR(7)/URA(93) //WP Applicant: HOME DEPOT AT HOME SERVICES AT: 106 WASHINGTON AVE Applicant Address: Phone: Insurance: 345 GREENWOOD ST (401) 935 -2633 0 WORCESTERMA01607 ISSUED ON: 7/20/2011 0:00:00 TO PERFORM THE FOLLOWING WORK: Replace 7 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 7/20/2011 0:00:00 $35.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Louis Hasbrouck — Building Commissioner - R.