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31A-138 Z;\1 )5L VISA Mastell I DISC•VER QUENNEVILLE ROOFING ■ SIDING ■ WINDOWS T 160 Old Lyman Road • South Hadley, MA 01075 1.800.NEW ROOF • 413.536.5955 Email: info@1800newroof.net Website: www.1800newroof.net Winner of the MA Construction Supervisors Lic. #070626 MA Registration #120982 TORCH H AWARD Member of the Home Builder's Association of Westem Mass. CT Registration #575920 Member of the Building & Trade Association Proposal Submitted To: Date Phone #'s C 531` Eileen S \ \tVo.'n 011512,019. H: W: Street Email: (I) Forbes Ave. ESolltvGn 11 a3C ■ c CGirr City, State, Zip Code Job Name /Location: NO(' l r\ , �A , 0 1 06 , SU\\1 iian /� o,rn Orin Proposal to furnish and install the following RePl•c►(` e Y win is c\oobte hon c■no oC'e Pic ._xL10603 - tie 5 w1■dou3S in We- boc dinin3 coOM. Inst-Ullin: I De .4 do vbte hons ekna one t11 c_ tom; n d") ht 11 W ■n6owS 1 eod S3.€ (t5Sa) i ndu t t ia 5 dreenS , No r�t'1ds , !\ C $n %‘11c) 10w c', R 1( Fa—niter ir\Suta ed, ex eeior ii.m a—pped In wind ©Lls hive Q tl y �t`�.nS et -btu I ► ce+t me rt n +y (`®c3 h �( one) Nakioncx1 v'n11; 4At %o V)c.w Gamest- bedmorn Sit9e ndoc.J 4 ?rice clvd S 011 toxe - , Pecm►tS, CJc s1'.manship cnd havliin. I\Q to re rr,O\re cm1 Glebe i s from Pct H-y. Ask us about affordable bank financing We propose hereby to furnish materials and labor - complete in accordance with above specifications for the sum of: Total Due ($ 1 1 ?)(dl ACCEPTANCE OF PROPOSAL: The above prices, specifications and conditions are Down Payment ($ 3 ,' 1 3 ) satisfactory and are hereby accepted. You are authorized to do work as specified. Payment will be 1/3 down at start of job, and balance due upon completion. Balance Due Upon Completion ($ [°) ) Date: lb / � ( - Signature: • _ ) � p / Date: tO/ 15/ 1a Estimator: (Print Name) f(a.lri L L o, I'ry,�te lie (Sign Name) ,r[l itt. Estimates are honored for sixty (60) days from above date ATTENTION HOMEOWNERS: Please cover all personal belongings in the attic, garage or storage areas due to the possibility of roofing debris or dust coming in through cracks of the wood. Adam Quenneville Roofing will not be responsible for debris or dust in the attic or storage areas. _ _ _ _ ___ ___ _ _ _____ __________________ ___ . , _ -- - ____ _____ _________________ D estin y ®Wthdow Options Special Decorative Glass Sometimes a home demands a more expressive level of design. Talk to your Destiny° Dealer about decorative glass options like beveled or leaded glass, as well as over 50 glass colors to satisfy even the most discriminating taste. Decorative glass is typically used as an accent in your Master Bath, Stairwell, Bay or Bow window, or in Transoms. This option offers multiple colors, 4 „„,,, ,,,„, textures and caming to make your decorative glass special to you and your home. i� ' -, __ _ il 1111111111 7 . . i . , Et,.. `` i _ _ _ , , ,,40.-- ,,, , • II 1 , ,. , , t.... liko 40 Al • j ('�' . r i 1;i -- ... + 3 - "-# 11 a lp' , 1 '1 r Ai Ll i . Tl'' ft; f ... + , ' - _ r • . Standard Grid Patterns Performance Values 1 ' `,/��/ Double Hung Window Values - I , I ! /� as tow as .16 No Grids With Grids II A 1 . ' i .,-- = . ;, ,,,,,,c.; Glass Package U -Value SHGC U -Value SHGC SotarBond 0.27 0.28 0.27 0.25 �;� -I i \ SolarForce 0.23 0.24 0.24 0.22 �'� ryD KryptoLite X24 0.2 0.22 Colonial Prairie Ladder Diamond n li M mllimm c (Must use flat -ili- Krypto ,L AX 0.16 0.17 0.22 Standard Grid Styles grid style) ""�':;,::.`,�' Picture Windo , .. y "eiGYMnrawu¢t ATWGs as low as .14 No Grids With Grids I. a waote(Wn sd.rotcan�ame M 0.16 0.24 Glass Package U -Value SHGC U -Value SHGC ,.. _ - -r _ �, ^ '��� "' ; . �om«uir[mawaxaaaaucs ''^ r *We n SotarBond 0.25 0.30 0.25 0.27 , -- 1 [ _ 0 .40 n _ w -_ S o l arForce 0.19 0.26 0.21 0.23 Contoured GBG with fish mouth Flat Grid Simulated Divided Lite (SDL) KryptoLite 0.15 0.26 0.16 0.23 design for authenticity KryptoLiteMAX 0.14 0.26 0.16 0.26 _ The Commonwealth of 1MIassaclzusetts - Depaftnent of Industrial Accidents ice- - • O ffice of Investigations • 600 Washington Street ' ` x � Boston, MA 02111 - www.massgov /die • Workers' Comp I Affidavit: Builders! Contractors /EIectricians /Plumbers Applicant Information - - - Please Print Lecribly Name (B usiness /Organization/Individual): • Adam 1 aennev Room & S i d l n i Inc, Address: 1 ( - v !I LG nl An - k vAd - - City /State /Zip: Stil ll Al a I A2 '-1710% Phone #: 4/ 3 -- 6 - 36 - 6 ` 5 5 Are you an employer? C heck theeappro box:. Type of : - ro"ect (required): 4. I am a general contractor and I of project q ) 1 _1g I am a. employer with j • 6_ ❑New construction employees (full and/or part-time).* h ave hired the sub - contractors _3_Q, I am a. sole proprietor or partner listed on the attached sheet • 7: Q Remodeling . ship and have no employees - - These contractor• have • g_ Q Demolition working for me in any capacity. - employees and have Workers' 9_ Q Building addition - [N ' workers' comp_ insurance comp. ;ncrrrance. -, ` required] - 5. Q We are a corporation and its 10.0 Electrical repairs or additions 3.0 I am a homeowner doing all work officers have exercised their 11.0 Plumbing repair s or additions myself_ o workers' co right of exemption per MGL y [N comp. 12.0 Roofrepairs • insurance required] t - - c._ 152, § 1(4),_and we have no - -- - employees. [No workers' 13.0 Other . . - comp. insurance required.] Any applicant that checks box 01 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 rmut submit a new affidavit indicating suck -7 Contractors that check this box must attached an additional sheet showing the norm oftbe sub - contractors and state whether or not those entities have employees. If the sub - contractors have employees, they mustprovide their worlo rrs' comp. policy number. l am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. A� n J - - Insurance Company Name: • R J. /- -M tt 1LAQ- i L.-ri Sara 11 a Policy # or Self -ins. Lic. #: A ui go] a S IO It rt Expiration Date: 4 - a I - g2 O t 3 Job Site Address: - - City /State /Zip: Attach a copy of the workers' compensation policy declaration page (showing the :policy number and expiration date). Failure to secure coverage as required under - Section 25A of MGL c. 152 can lead -to the imposition of criminal penalties of 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.. Be advised that a copy of this statement may be forwarded to the Office of Investigations of tine DLk.for insurance coverage verification. - do hereby certify under thepains andpenvftiFs ofperjury that the information provided above is true and correct Signature: - Date: - Phone # - • - - ; 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): I_ Board of Health 2. Building Department 3. City/Town CIerk 4.. Electrical Inspector 5. Plumbing Inspector 6.Other - _ - Contact Person: - Phone #: I y ° � "� Massachusetts 'f `i '' DEPARTMENT OF BUILDING INSPECTIONS ,,k = ` 1 212 Main Street • Municipal Building °y, a `zt Northampton, MA 01060 s P - \ - 1.. INS PECTOR Louis Hasbrouck Chuck Miller Building Commissioner Assistant Commissioner 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 any 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 f /f (before backfiti), 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 permits 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 me. Date Address of work location Department of Industrial Accidents (.r r { Office of Investigations 600 Washington Street ' Boston, MA 02111 0 „7e, www. mass.gov /dia Workers' Compensation Insurance Affidavit: Builders / Contractors /Electricians /Plumbers Applicant Information C Please Print Legibly Name (Business/Organization/Individual): A (�(11'Yl (}(;1 -Q f n'�v I (t - �( 7n y 3 / ding (, _ Address: j 1p() C t[1 La'YyYI R h City /State /Zip: ..a L �_ � , p 4,0 Phone #: q / 3-- 53 - 5c(55 Are you an employer? Check the appropr box: Type of project (required): 1. ❑ I am a employer with 4. n I am a general contractor and I 6. (full and/or part-time).* have hired the sub - contractors C New construction 2.n I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub - contractors have 8. n Demolition working for me in any capacity. employees and have workers' 9. n Building addition [No workers' comp. insurance comp. insurance.t required.] 5. n We are a corporation and its 10.0 Electrical repairs or additions 3. n I am a homeowner doing all work officers have exercised their 11. Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12. oof repairs insurance required.] t c. 152, § 1(4), and we have no 13. ❑ Other 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. Contractors 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. Insurance Company Name: 1 � rn rujuo t Policy # or Self -ins. Lic. #: (,J C. "RN (0 ( ( ) ( Expiration Date: l-/' oa C ] / 3 Job Site Address: (Oa ho --ear City/State /Zip: L 1 ' mg j1l1 • /'JA ((0(06 Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of 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. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify nder the pains and penalties of perjury that the information provided above is true and correct. Signature: Date: l Ul — 7// Phone #: (I/ 3`' 53Co fs_ - - 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. Bo of Health 2. Ruilydino Department 3 City/Tnwn Clerk 4, Electrical Inspector 5. Phirnhing Inspector 6. Other • II n� 44. SECTION 8 - CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: II ` Not Applicable ID Name of License Holder : f( i'fl ( / .1{� 7(5(0 License Number k Ctl � a���3 Address Expiration ate Si yl Telephone 9 :Registered Home Improvement Contractor _ Not Applicable ❑ =9G.m rA1.)-P nc n 11€ i a0q e) Company Name Registration Number 5/ Add re s �� L( �� Expirati. Date Telephone SECTION 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 result in the denial of the issuance of the building permit. Signed Affidavit Attached Yes No ❑ 11. Hoxne Owner Exemption 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 108.33.1. 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 ( C ,''l(c SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable) New House J Addition + I Replacement indows Alteration(s) n Roofing r Or Doors Accessory Bldg. n Demolition n New Signs [❑] Decks [Q Siding [❑] Other [❑] Brief Description of Proposed Work: Re 1G C t 1\c:I I t i rvl(5w S : feG`nO 0 0- Of'Zjk Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll - Sheet r - 6a„ If New house' and' or addition to existing housing,- complete th 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 ORCONTRACTORAPPLIES FOR BUILDING PERMIT j �Q� S U/ if von , as Owner of the subject property //,�� J hereby authorize "K vl CirYL ,(/� I (1 to act on my behalf, in all matters relative to work authorized by this building permit application. SQ p Cinl OC't_ i0`1- 1 1Z Signature of Owner Date iJrk(,r hpr)ne1n[k. , 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 under the pains and penalties of perjury. t'lkm 00 1K, Print Name /6/,7/1 Z Signature of Owner /Agent Date 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 S gl s s Lot Size ° I ` - Frontage Setbacks Front I Side L: R: L :. : ', R: E Rear Building Height f ---- 1 . Bldg. Square Footage Open Space Footage % _ (Lot arca minus bldg & paved . _ >._ 1 „-- parking) I r--- 1 r-- # of Parking Spaces Fill: (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 DONT KNOW 0 YES Q IF YES: enter Book i i Page; s and /or Document # B. Does the site contain a brook, body of water or wetlands? NO Q DONT KNOW Q YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained Q , Date Issued: C. Do any signs exist on the property? YES 0 NO Q IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property ? YES Q NO Q 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. Departmeit use only — RECEIVED City of Northampton Status of Permit: Building Department Curb Cut/Driveway Permit p. 212 Main Street • Sewer /Septic Availability • - OCT 2 2 2012 Room 1 00 Water/Well Availability Northampton, MA 01060 Two Sets of Structural ;Plans - DEPT. of BUILDING iNSPECTpN6hne 413- 587 -1240 Fax 413 -587 -1272 Plot/Site—Plans - . NORTHAMPTON, MA 01060 Other Specify _ APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 SITEINFORMATION This section to be completed by office 1.1 Property Address: cpa --- .Ave. Map Lot Unit, N Or--Vt ■ „S-P7ir I cr Pr GI b(.00 Zone Overiay District I-"" Elm St. District CB District , SECTION 2 - °PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: Ei kern Si)IIlV( 11 Loa 1y-! s Pine e. Na (Print) Current Mailing Address: �. �, 1 413 3 i - =7d Telephone 2.2 Authorized Agent: i rkm 01 re,r(1P ,, 1-12 I too 3 'la i. •. 1 ad l - Name (Prin Current Mailing Address: L I1 - 53 r -- 5 6 1 Signa re 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 t \+3 (D y, C)(> 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) 1 (I 30 ._ Number T � 3 6 - - - This - Section For Official Use Oniy< —_ . Building Permit Number: - I Signature: Building Commissioner /Inspector of Buildings Date • 62 FORBES AVE BP- 2013 -0481 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 31A - 138 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-2013-0481 Project # JS- 2013- 000764 Est. Cost: $11364.00 Fee: $35.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: ADAM QUENNEVILLE 070626 Lot Size(sq. ft.): 7230.96 Owner: SULLIVAN EILEEN Zoning: URB(100)/ Applicant: ADAM QUENNEVILLE AT: 62 FORBES AVE Applicant Address: Phone: Insurance: 160 OLD LYMAN RD (413) 536 -5955 () Workers Compensation SOUTH HADLEYMA01075 ISSUED ON:10/23/2012 0:00:00 TO PERFORM THE FOLLOWING WORK:INSTALL 13 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: 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 10/23/2012 0:00:00 $35.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Louis Hasbrouck — Building Commissioner