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29-304 (3) J INSU&TION AUG 20M � SIDING CO., INC. q 716-c6 56 FRANKLIN STREET EASTHAMPTON, MASSACHUSETT I EASTHAMPTON OFFICE: 527-0044 WESTFIELD OFFICE: 568-6411 Contractors license #101858 Proposal Submi t' o �1 � P e 5253 Horm Date Jim & Kathy, r-�=y- ^Pvrchoser' July 25, 2002 "ttJob Nome Ac► brook Drive 413-773-8428 Work ChState and Tip ��dd�� Job Location. Job Pfione F orence, Ma O�t)6c) Contractor hereby svbmits to Pvrchase► specifications and estimates for: NEW BAY WINDOW 1. We will rerave and dispose of exiting wood and or /aluminum window. 2. We will install (1) Anderson Tilt-Wash Bay with Picture Window and (2) Double Hung Flankers. Rough opening for the unit will be 8'-0 5/8" x 4'- 6 3/4". Projection will be 14 7/8". Model # TW30-DHP 311042-20, Unit will have a 30 degree angle. 3. Hamowner will be responsible for any painting or staining. 4. Window unit will have full screens and full grid work. 5. We will install fiber glass insulation around unit installed and seal with Silicone Caulking on interior and exterior. 6. Window unit will have High Performance glass. 7. We will install aluminum coil stock around outside perimeter of window installed. PRICE: $3,852.00 ** A CERTIFICATE OF INSURANCE FOR WORKMAN'S COMPENSATION AND LIABILITY WILL BE FORA-JARDED UPON REQUEST. ** T.P. DP.LEY INSURANCE AGENCY OF WEST SPRINGFIELD, MA IS OUR AGENT. ** HOMEOWNER WILL BE RESPONSIBLE FOR ANY FEES REQUIRED FOR BUILDING PERMIT IF NEEDED. $3,852.00 WE PROPOSE to furnish material and laSTf.Nff)pI"li&n(McgCance with above specifications, for the sum of: dollars ($ ), payment due upon receipt of invoice. O If payment late, interest it 1 1/2%may be added. N TE: This proposal ma be withdrawn by us if not accepted within Thirty days. 4 Edwin Losacano, Owner Contractor Salesman Jim & Kath Q'Lf-- Acceptance by Purchaser, and Title "You may cancel this agreement if it has been consummated by a party thereto at a place other than an address of the seller, which may be his main office or a branch thereof, provided you notify the seller in writing at his main office or branch by ordinary mail posted, by telegram sent or by delivery, not later than midnight of the third business day following the signing of this agreement. See the attached notice of cancellation form for an explanation of this right." SUBJECT TO TERMS AND CONDITIONS PRINTED ON REVERSE SIDE. oQ'� pTo 6 �laeaarflnsrtte DEPARTMENT OP BUILDING INSPECTIONS 212 Main Street a Municipal Building ' Northampton, Mass. 01060 ~ ' WORKER'S COMPENSATION INSURANCE AFFIDA.VTT I, ED LOSACANO2 OWNER OF ALL STAR INSULATION & SIDING CO., INC. : (lic�nscc/permitcee) with a principal place of business/residence at: 56 FRANKLIN STREET, EASTHAMPTON, MA (phone#) 413-527-0044 (strcxt/city/state/zip) do hereby certify, under the pains and penalties of perjury, that: (X) I am as employer providing the following worker's compensation coverage for my employees working on this job: - A 2- �©o�7�idoaoo (Insurance Company) (Policy Number) (Expiration Date) ( ) I am a sole proprietor, general contractor or homeowner (circle one) and have hired the contractors listed below who have the following worker's compensation policies: (Name of Contractor) (Insurance Company/Policy Nurxlbcr) (Expiration Date) (Name of Contractor) (Insurrncc Companyffla icy Number) (Expiration Date) ,r.. (Name of Contractor) (insurance Compwy/Poticy Number) (Expiration Date) (Name of Contractor) (Insurance Compazy/Policy Number) (Expiration Date) (attach additional sbeet if noCesu y to wcrude tafortssatioa pertaining to all o0aftcton) O I am a sole proprietor and have no one worldng for me. ( ) I am a home owner performing all the work myself NOTE:please be aware that wl;ilo bo aoowacn wbo employ persam to do mxiaxeasacS Coast=oa or r Mdr wont on a d—Uiag of no moue than throe units in which the bomeowna rtisidcs or oo use grnuar}s apptutaoaai thereto are Cot Svwz ly 000sidered to be employers under tho wocicer's ooa*c nstion Act(GLI52,m 1(5)),application by a homeowocr for a Uccase or perald may evident mho legal stanu of an employx und#r the W ork*ea Compemation Act. I und=VAMd that a Copy of thin eiataman may be forwardad to the Daparta,coQ of Indtiut:id Accidents'Otiioe of Imurtwoe for the coverage ymficatioa and that fad=to seatre coverago=dc r section 25A of MOL 152 can lcad to the i ion of criminal penalties 000sisting of a fine of up to$1.500,00 andlor impr isot>meat of up to one yt w and civil ptmariies in the form of a Stop Work Order atsd a fm o(4100.00 a day against me dA(z4)a-4L: � For dgmtmmW use only Permit Number /�J Lot# T/ Map# ___._ *41113M of LiocnsedPetmittoe «b Section 4. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size Frontage Setbacks Front ' Side L• R: L: R: Rear Building Height Bldg. Square Footage % Open Space Footage % (Lot area minus bldg&paved parking) #of Parking Spaces Fill: volume&Location A. Has a Special Permit/Variance/Fin in ever been issued for/on the site? NO DON'T KNOW YES IF YES, date issued: IF YES: Was the permit recorded at the Registry eeds? NO DON'T KNOW YES IF YES: enter Book Page and/or Document # B. Does the site contain a brook, body of water or wetlands? NO DON'T KNOW YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained , Date Issued: C. Do any signs exist on the property? YES NO IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property ?YES _ No IF YES, describe size, type and location: �; Af I Ml S' Tr8ON$TRUCTION'SERVICES ' 1 Lionel Construction Supervisor: Not Applicable ❑ Name of License Holder : License Number ' Address. t Expiration Date 3 Signature y Telephone i E ANY Vil R0tIr11' "1 ".�1y"����' "�� Not Applicable ❑ a r ru^.x ua,r� v�, M a; y a� � Company g /o/ blame Registration Number (L ex Address Expiration 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 Z the building permit. Signed Affidavit Attached Yes....... No...... ❑ f lei i ,wlx ,, �,1 e� r A i x 'M" ti'Orn 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 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 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 �E &N 5- DESCRIPTION OF PROPOSED WORK(chick all applicable) New House ❑ Addition ❑ Replacemen Windows Alteration(s) ❑ Roofing ❑ Or Doors Accessory Bldg. ❑ Demolition[] New Signs [ ] Decks [ ] Siding[ ] Other ( ] Brief Description of Proposed Work: N t?U) Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative 0 s Renovating unfinished basement Yes No Plans Attached Roll 0 • Sheet 0 o�'additi`orl tofextsti`Iri °housing, ComP1e1e2"the folt_�f 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. Mascheck Energy Compliance form attached? 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. as Owner of the subject property hereby authorize to act on my behalf, iniall matters relative to work authorized by this building permit application. Signature of Owner Date 1, 4!�-Orzcll w Z., ` t ,2 as.Lw4a"/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. Print Na Signat a of Owner/Agent Date t .s 7 Tr Fw City of Northampton Bbilding Department 212 Main Street Room 100 orth'ampton, MA 01060 pne...413 5 7-'1240 Fax 413.5871272 APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING f. SECTION 1--S1TE INFORMATION 1.1 Proper This set i g-. t { �a a Y ��7'0 Zone I ktt tot Elm St. District CS District' SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Name(Print) ss:r Current Mailing _ �`� eace, I449 Signature Telephone '5 2.2 Authorized Agent: ILML Name(Print) Mailing Address: it i T #t J413)5064 Signature Telephone S �QN 3 - ESTIMATED CONSTaUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only com feted by ermit applicant 1. Building C 00 (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) Check Number This Section For Official Use Only [Building Permit Number: b3 1 _ Date Issued: signature: Building Commissioner/Inspector of Buildings Date BP-2003-0178 Gls4tr COMMONWEALTH OF MASSACHUSETTS CITY OF NORTHAMPTON Lot: -001 Permit: Buildings Category: BUILDING PERMIT Permit# BP-2003-0178 Proiect# JS-2003-0336 Est. Cost: $3852.00 Fee: $25.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: All Star Insulation & Siding Co Inc 101858 Lot Size(sg.ft.): 1 2763.08 Owner: OTEARY JAMES H&KATHRYN D Zoning:URA Applicant: All Star Insulation & Siding Co Inc AT. 406 ACREBROOK DR Applicant Address: Phone: Insurance: 56 Franklin Street (413) 527-0044 Workers Compensation EASTHAMPTONMA01027 ISSUED ON:8121102 0:00:00 TO PERFORM THE FOLLOWING WORK.NEW BAY WINDOW 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: Fee Type: Receipt No: Date Paid: Check No: Amount: Building 8/21/02 0:00:00 27427 $25.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo