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30A-081 (2) Page No. of Pages firopo at CT.REG.NO. 0621848 VISTA HOME IMPROVEMENT COLOR WIDTH MA REG.NO. 162058 1346 Elm Street West Springfield, MA 01089 INSULATION Toll Free: 1-888-597-2323 • Local: 413-382-0249 FAX: 413-382-0241 Proposal Submitted To Homeowner Work To Be Performed At Name 4t T1 I� .%D ) Street Street a .!S _� M1 _ City State City_F 1Rj N'P'_ ,__ _ State b l'0 __— Date of Pla - Date 7_ /3 /3,__ Telephone 4)3 S % /. PALE I•s ,T ltt\t‘ Do !vC C, We hereby submit specifications and estimates for: X i121 MI g _ ---- .... -.arc—x.- ___ 7 ror ., Lim '•-=. .a.I tot T_71....r. ,..�. — = 7-------.-.:7:=:==.-..;,...-...;,- - �7 r'. h\ C p. A f is_b 0 dl-h VQ UJ t)M 2 Aprl Ftit—feLT/P9A-- • - 0 0 4) :6,.. ,. , '. i_it, II) . I I,, _ it , / s L ,:.[ t - NA t' , A Ilk /Pi__ fJJAt.E. If • AA ~E ' - M . 1/24' ktif typin u/V13,,.�t Lt r 1 + ►,Q , ,L--Any -' /!7I 1./_ I.am' -- ' /i _... � / i (--- A ‘ E/i� 1 ,' at 0 - p_ Ul x b / s •MM9/i± ,s U An ,y 9 _ i tr",-; ' ,r7-4 i-C_ f, r r. ■ I A U - / ./ - t- -r .t. L 'Ali it L MK j211 C L. zAt ct-opa ,4t CLi AN' i l) • ii / W l L11J r j,yL tl/C, •a ' i • A I► te4 I1.;r_ .4 ?' , A4M ' . l / 0l' ' , 1t : ./. Date work will start Date work will be completed 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 specifications must be made in writing on an Add-on/Modification of Contract form and may become an extra charge over and above the amount stated herein. This agreement is contingent upon delays beyond our control.Owners to carry fire,tornado and other necessary insurance.Our workers are fully covered by tic/' 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 col- \ Q. lection,including reasonable attorneys fees,in addition to other damages incurred by contractor.An 18%per month service charge will be assessed for all payments .......,_not made within 10 days of due date per the schedule below: °=a propooe hereby to furnish material and labor-complete in accordance with the above specifications,for the sum of: - ' . -- -- r. – – l. _ Ira t a Silt_ ..1 \X ~ 1 11 y� _F i, . 5 Said amount shall be paid as follows: 1 ;n 7- _._ _ I 2 Z,., D Note:This proposal may be withdrawn by us if not accepted within______days. YOU,THE BUYER,MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY AFTER THE DAY 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 I - -b ENT IS NO ' c•TIABLE. Signature of Contractor or authorized representative: titi/ 44 /, 4 '(I/We)have read the terms stated herein,they have been e •I:1-d to(me/us),and(I/We)find them to be satisfactory and her-< accept them. / / G_ Signature of Homeowner(s): X_ /s— Adi — X SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: o O X el c L \ ‘(.X 61-C License Number l'-- ("W eArn S3C- �� 5fpf1( c) ic)(10- (-) o 9 1 •) 11115) Address I Expirati n Dat q —3S---(5)'–(1.9 Signatu . -• one W9ckV,\ ,_ K 9.Re•istered Horn- Im•rovement *• - tor: Not Applicable ❑ ompanv Name I \(.0 Registration Number 1 -1Q --1 v-n -c -c.-` 1,0 51 f d vir i4 i ' I a I 1 `1 Address n \ Exp ration date -01-1 , ct Telephone 4L _�1 \t3y 9 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. - Home 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 108.3.5.1. 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 t SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing rIgi Or Doors D Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [C] Siding[0] Other[p] )Brief Description of Proposed 5 ? t Y�� Cl� �jYl\�� J � ' '' c1 Work: \Ge �- we r �\e s��(t V\ V-c5\ f�-�� e�iS�tn3 c e Ucn*t G-11 Alteration of existing bedroom Yes No Adding new bedroom Yes No Shl rT Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet 6a. If New house and or addition to existing housing, complete the following: 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 OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, 5"-> CYIt-,c 'A \'� � S \ Cl\ \ ,as Owner of the subject property {� hereby authorize '�c)`(-\0.`n Q 6A— l�# "o'Me. (`cl(DV-0k j ' i'Y)`P. to act on my behalf, in all matters relative to work authorized by this building permit application. Can*-c - -- x'10 9 I ( 3 Sig ature of Owner Date I \G'k.'C1 `lL' C�U i`,�� ; � ( -o ICc' vv\e_Y1 - , as Owner/Authorized Agen hereby declare that the statements and information on the foregoing applications are true and accurate, to the best of my knowledge and belief. Signed under the pains and penalties of perjury. Prin .me Si. - re 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 Lot Size Frontage Setbacks Front Side L: R: L: R: Rear Building Height Bldg. Square Footage Open Space Footage (Lot area minus bldg&paved parking) #of Parking Spaces Fill: (volume&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO DON'T KNOW 0 YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW 0 YES IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO ® DONT KNOW YES 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 © NO IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES ® 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 0 NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. Department use only RED ..._ City of Northampton Status of Permit: Building Department Curb Cut/Driveway Permit , 212 Main Street Sewer/Septic Availability JUL 25 2013 Room 100 Water/Well Availability Northampton, MA 01060 Two Sets of Structural Plans DEFT.eU TO"'' `'""``O' �� N ON,MA 010 ne 13-587-1240 Fax 413-587-1272 Plot/Site Plans —�— Other Specify 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 k 4 (' 5 &u Y-6 Map Lot Unit 1.CC,(IC \C\1 A- U lC°� Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: '� tOcl(Print)V1 �r JC3�\.1 �� °, �f��1 C�1 S Current t Ma •• �1ress:1 - Telephone ignature 2.2 Authorized Agent: Vv5ko. my )ruve vvie-M- )3L &.:1 v i � - W S.rh d 6- Name(Print) Current Mailing Address:/Th 21"e-,6-01 ature 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) 38' Lis- Check Number a7,5-If 3 5- / This Section For Official Use Only Building Permit Number: I sssuu ed: Signature: Building Commissioner/Inspector of Buildings Date 16 HIGH MEADOW RD BP-2014-0091 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 30A-081 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: ROOF BUILDING PERMIT Permit# BP-2014-0091 Project# JS-2014-000176 Est. Cost: $38675.00 Fee: $35.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: VISTA HOME IMPROVEMENT 106156 Lot Size(sq. ft.): 350658.00 Owner: HIGH MEADOW REALTY TRUST C/O SIMON AHTARIDIS Zoning: SR(101)/WSP(23)/ Applicant: VISTA HOME IMPROVEMENT AT: 16 HIGH MEADOW RD Applicant Address: Phone: Insurance: 1346 ELM ST (413) 382-0249 WC WEST SPRINGFIELDMA01089 ISSUED ON:7/25/2013 0:00:00 TO PERFORM THE FOLLOWING WORK:STRIP & 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 7/25/2013 0:00:00 $35.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner