Loading...
32C-063 (8) vw e5i-r aSS tAiiv1p0vsi war Id car, E�9 54^ Window World of Western Massachusetts HIC rr 165641 v .--• `F Window .'T 1029 North Rd.-Hampton Ponds Plaza CSL 4 57011 r ��.' tici le' Westfield,MA 01085 4rr.lE9 ft4 Phone(413)485-7335•Fax(413)485-7055 i'sEe n"� snrloryttes soar rot Lass" www.wlndowvwaidofsprtngfietd.com (MOeoc�tz j NAT-41779.1 a ��,�- tcs emtegru Name: • It a' l' tj ✓;t Phone(H): L j 3 ? T r- 937 Install Addr- g w ,, / a rn / uL 'a a wt,f le ,Phone(W): BIll Addr. E-Mail: Series 2000 Mech.Frame Welded Sash Stag _ MA.Energy Reg wl SolarZone+Argon 545 77 Series 4000 Double Hung $205 Energy Star Upgrade $24 Series 6000 Doubts Hung $239 Foam Insulation on Jambs $16 - _ t 4-1. Picture Window $329 —C Remove Window From Property $16 2 Lite Slider $329 Lifetime Glass I Seal Failure Warranty $16 3 Ute Slider('/.,'/r,'/.)('/,,'h,'13) $520 Transferable Lifetime Warranty. $10 — Awning 5285 it in Homo Service $15- Casement ur RN $285 Double Strength Glass $16 Twin Casement m.o+.+awwtcv a $570 j $ Three Lite Casement weoan.svdame $885 ( I SALE PA CE(Saw 90k} 879 79 Basement Sliders<55 Ui 5239 Heat Buster Package Upgrade $20 Hopper en eoGnp wood)We.xlr al $185 ''7' , 8: I • •.:^•1 Irr: J!-.: . r. r Specialty Window EPA LEAD SAFE,r..wnao.•l $60 Bay/Bow peera.ad s-r,ea astwe Alan..cad $2875 EPA LEAD SAFE game a r err r eo.r t7edrd 5100 Garden(en coder a tea ceoernoe $1875 yrye�,K.�„e cameramen MY HOME WAS BUILT IN THE YEAR - Initial Remove Existing Bay&Reframe $295 I decline third party verification(initfail: Roof for Bay/Bow Window $450 Mal))r tine meted a copy of the lied retard Ittlomialba refleihbat Second Floor tnstallati $509 Worming me d fns potential roc of tM lead imam Mantra kern renoniim adhrty to be ).'11- oedortneotorr Owellfng IntTMEM'wade Rohl'bradan. Window Color r"�L' r"''" g bsId °°11 teatmt l tees mocked easy d the lead tee risultig. WINDOW WORLD I,PORADES I Full Screen $25 fie: BEIGE Color charge $35 Name(s)(Print): Ext.Color rain ee reef pia CFO en rot $165 ( MISCELLANEOUS LABOf1 J <_ wbodgrafn interior rwI(oO 09r/ileac eat $85 /0/ cull Exterior White Tim/Wrap tsworwro^rq ST5 23/ Contoured/Flat Grids=ft tRILItl3lpliT $40 Color Other Than White 510 Prairie Grids Ce ei.viDOw.i rr.a coot ri $69 Specialty Custom ExteriorTrlm/Wrap $ Diamond/Brass Grids nos Few 569 _rut nt (E $30 Oriel/Cottage Style aoenreror m $30 Obscure Glass Per Sash aeonotre4 $35 Q "�-- ` > $100 (� U Li 'emo rgl $30 Tempered Glass Per Sash laort wui $65 _ Mull to Form Mufti-unit $30 .28 Glass rs000 mod*rot $129 Install Interior Stops horseseevu 545 Catalog Options $ Install Exterior Stops darns w ru $45 VINYL PATO 00OR8-W or RH(DuteMo Loeidtrg In) Customer Provided Stops/Trim $20 Includes:White interior Casing end ExtaytorTrim. Install Interior Casing S60 5 Ft.Sliding Patio Door mows $1250 Repair/Replace Sill or Jamb $75 6 FL Sliding Patio Door 5-11044 S1300 Mobile Home Conversion $200 8 Ft Sliding Patio Door smear $1500 Remove/Re-Install A/C or Awning S100 Patio Door Beige Color $125 Site Setup: $250.00 Patt Door Low-EJArgon $125 EPA Lead site setup&disposal fee: $1p0TOD — Heat Buster Package Upgrade - $215 EPA Lead,third party verification: .$4i e0 — Patio Door Grids .•,otAeod n 3100 Extra tabor(Box on left for description)$ Woodgralrv8rown att ns n $225 Total Amount Due$. L f Z,`-q'� Exterior Colas $395 ' Patio Door Triple Pane Upgrade $250 _ 50%Oeoesf Amou $ .2-�..// 2.7 1 —_ Keyed Lock $36 Foot Lock $51 i..}1.esir So W'44lptcJS D e J.oJ 6 3 C Storm Dow S t )Finance-( )Wolfs Fargo ( )Other NO EXTRA WORK IF NOT IN WRITING/INSTALLER NOTES ( I Check made to Windo-ia_WosI&gt WM 4 �.;74.- 4 Oc-,^3'I'S/ j L FjrpCDate:_ V-code: _.,f zy 5 00!Ut'41C, D'5 COWil • l! - 1h jJ4 l/2 -> f FinatPaymentAmount:3.._l�,r_C11 jt 2 6113 - j To ea mad to Ott insider tot,:, ,T em va+ }SateS Rea Recommeederi I!Interior Stops I Exterior Capcing: r Customer Declined• I I interior Sroee 1 I Exienor Cap trgc _ St Jude Chlldren'a Research Hospital e'etdW.Mnoott alb ertkjresa cued At*stew ad add Aeldredif mmpcad h ea)1.Sa.bl sd.aet Voeb .tat mac noire in dale d ea staid teeex seat NOT wise 33 Id%des tcaf correct irinOeeo WOW cod darsu5itderevlP reteemead wooer made ad"olidi net be Wired awdeeod!to din d eeoktt CZ=et,040.1 do madder meads.WS*Armed dal is dmwreed mot no wield a moeee to its**bean on dramas N home ezoiweneeli arcades ind oteuntraeea it etdstaed*X to a":1 tweets - • OW I tonal elbbrendo•wining ba.e S rimdsai to 6nratveenlse d Comma:Aden end Roam Regiatm ter Vet Pita Ads sire BMA MAe7tie(taw 1817)MITE Newet she Wt.Pia to en dining of Samw7ad Rod eemente el to eweof*coprd sx%eaMGW*one.Maidetanno ed:r meteor,dDmzear 14A dsu wed bus h stands Vol/bard deli+ , A r d}f r a l metes)s-rshad t e n c h M V dw.Mmactews5..I net b.deemed rWeneNa e n oRry,n el/ask estate'sits pmrnml cum by tes•Attry,pevat metre MAMMA Windt/NY hddi- Ifs Melee it Ito rillOIAR ifei ddrio to we genetnrWan rrMAd welts toe the dirt de:netted ter Wsasreeeedor d o d o etch doesiteeddasssdds.de otsgluRRiSi O *Mod eatla se Redd•add*hideTed lad nS,rrent fie FUlttlie.59010111nOt be willful Ot tab•doOlt a Oothleree Imo the pasted/We eggettned to Ototples 142A,OWL Tae Po Oow dhysed alts emdfm et ant ens tomb tedttlpte o ateeidbmieadart ante to dale doe iraesadtn Sots it earxladan lac be toddy et pddematad roper See rP6Merd4 fir AlieningP6d taattetd Ad ,y • ORDER NOT FOR RESALE! ifge Z7 A/If _.111111111111111,11, - a Sates ep. Owner / nyy �/y Date . muss coo,-°dodo r.ew Ca+-rule Vr Cr'/�yl7d` r " `- /1q r , The Commonwealth of Massachusetts is --- ,,,!,, Department of Industrial Accidents -'`_ Office of Investigations __ _'L.:* 600 Washington Street ` .-.1-:,:�+ Boston,MA 02111 V. ..3 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/organization/Individual): WIN ht h�I 41F WESTER h4A SS4CKI4 SETTS Address: I 02-q jJ VQ- {Zip City/State/Zip: W EsTF 1 t t..t) MA- 0 1 0$S Phone #: 413 `t SS — 7 3 3 5- Are you an employer?Check the appropriate box: Type of project(required): I.[1 I am a employer with 2. 4_ ❑ 1 am a general contractor and I employees(full and/or part-time)." have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity_ employees and have workers' 9. []Building addition [No workers'comp. insurance comp. insurance.: required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑.1 am a homeowner doing all work officers have exercised their 11.0 Plumbing.repairs or additions myself.[No workers'comp. right of exemption per MGL 12.0 Roof repairs insurance required.]* c. 152, §1(4),and we have no employees. [No workers' 13.[E Other REPISCFMEr4T W 1 AVOWS 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 t t3 P T'/ Mtal4AL 1,4$1 P l'4CE Policy#or Self-ins.Lie.#: W e_Z— 3 1 S- 3779 i7 -U1 g Expiration Date: `5` -7-7'Q 14 Job Site Address: \ ' k [ 'Ave. U�N l l City/State/Zip: p■cYLi,titi100 I tAt O.0 Q C) 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.rtereby certify under the pains and penalties of perjury that the information provided above is true and correct Sil afore: /„/ "" £ Da -: G '11 t i Phone#: 4 %3 L i s - '1335 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#- 1 SECTION 8-CONSTRUCTION SERVICES ,L/8.1 Licensed Construction Supervisor Not Applicable ❑ Name of License Holder: % ``o ilk �% \?J■ j■r\`e, --70 License Number. VD A,�,. F ,\n\a��� ; �� . 0\030 (n I as i 10 Addre Expiration Date X13 4 - t S% (J zure Telephone .Registered Home Improvement Contractor. Not Applicable ❑ Koh b��h e <S�2. t �5 Company Name Registration Number ‘►nc 1,t�coac o- \\)kr5 -ev' 1 �. k,oo- 3 (l5 ])2.\ Address 1On'`� ``,� ,,�1 i�,\ n1,\ { /� �1 '2 Q Expiration Date OVW\V.lJl. YVt\e-^V 1 ` 1\)' 0)V fc-il elephonef U'48 13 j 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 40 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 1083.5.1. 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- ear i eriod 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 Lmployees 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 SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition I I Replacement?ows Alteration(s) J Roofing I Or Doors I Accessory Bldg. ❑ Demolition I I New Signs [DI Decks [Q Siding[Qj Other[CA ; Brief Description of Proposed ` _ �r ,n^ �' Work: `�L.; ` �� 1 1 VV\� • 3 I ,l Y 1 Alteration of existing bedroom Yes__No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roil -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 stones? 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 1, , 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. Signature of Owner Date l `hQ ACS r`e ,as Owner/Authorized Agent hereby declare that the statements an Friformation on the foregoing application are true and accurate,to the best of my knowledge and belief. Signed under the pains and penalties of perjury. Pyint Name .1 Ld 4, c : ii 19 . 2-3 - 13 Signature of• erlAgent 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 % T 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 O DONT KNOW 0 YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO O DONT KNOW O YES O IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO O DONT KNOW O YES O IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained O Obtained O , Date Issued: Do any signs exist on the property? YES O NO O IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES O NO O 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 O NO O IF YES,then a Northampton Storm Water Management Permit from the DPW is required. Department use only City of Northampton Status of Permit: Building Department ' ut1 y`P !,I 212 Main Street S '"MailC bib yr <' v I I p� Room 100� A r r�� ` Northamoton, MA 01060 -- one 413-587-1240 Fax 413 587-1272 lot *" Ele Inc, Plumbin�" x Northa s('06eettii�m� E i f rr� ton VI 01060 ,. .._ .. ,. APPLICATION TO ONSTRUCT,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 1 vIAa-IQ Cb� , \• \T 'JO Map Lot Unit WOW40 'q 1 MP• C)\ (C O Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: � - G \ N:�uSc tiOE�-(��, Sv,x"T-- 700 Name(Print) Curren Mailing Add ss: Eot Telephone Signature 2.2 Authorized Agent: c� CI* \02-CI YkC \kkSk `aka,, '{Pt. 01©05 Name(Print) Q Current Mailing Address: 717; tt 13 L frS 733< Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Bui.iing ls7 Zy a�. (a)Building Permit Fee 2. Electrical lip (b)Estimated Total Cost of Construction from(6) 3. Plumbing Building Permit Fee 4. Meciianical(HVAC) 5 Fire Protection �I 6. Total=(1 +2+3+4+5) 1,7,-q g - VV Check Number AC�? 426*e This Section For Official Use Only Date Building Permit Number. Issued: Signature: Building Commissioner/Inspector of Buildings Date 20 HAMPTON AVE B P-2014-0556 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 32C-063 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: window replaced BUILDING PERMIT Permit# BP-2014-0556 Project# JS-2014-000485 Est.Cost: $6248.00 Fee: $35.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: ROBERT E BUSHEY JR 57011 Lot Size(sq. ft.): 9278.28 Owner: SCHOCHET INDUSTRIES Zoning: CB(100)/ Applicant: ROBERT E BUSHEY JR AT: 20 HAMPTON AVE Applicant Address: Phone: Insurance: 1029 NORTH RD (413) 485-7335 0 WC W ESTFI ELDMA01085 ISSUED ON:10/31/2013 0:00:00 TO PERFORM THE FOLLOWING WORK:INSTALL 13 REPLACEMENT WINDOWS - UNIT 30 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 10/31/2013 0:00:00 $35.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner