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32C-158 (11) 0 , , HP Officejet 4300 series 1250 Personal Printer?Fax/Gopier?Scanner Fax Log for Nov 05 2007 8 : 53a Last Transaction Date Time Type Station ID Duration Pages Result Nov 05 08 : 50a Fax Sent 14134200560 3: 02 4 OK �sX WINDOW WORLD HIC#104000 56 Dimock St. Leeds, MA 01053 Telephone 586-8712 CONTRACT Date fJ C elt 20 0 r• , This agreement,between �G' 6 C I< ..�t�L l t,n G (Own r) of /7 �n.r►e t /ifJZ, . .��*'.� l�r,:'Li�� , and (Address) WINDOW WORLD OF LEEDS, MASSACHUSETTS. Phone SPECIFICATIONS J f X1.4 LL — 2L-e+ceane.•1 L.J'm41apf L-42 �,� LJ/y r�t� tJ ' itJ,:L.L I�c..-�-%tJ�1 i 1 •' �� Cep 4: /.yam t .h�lV+� Ll-Jc� Crl/C°/'L N % �;�✓ fr ' Rat 1yoe,c �i Li!tS _��c�/yt L low on the premises located at ✓7 a total cost of �`� t�r— With this order owner pays down the sum of$ Owner agrees on completion of said work by the Contractor to pay the sum of$ S '7[eLe-- C/o dollars Owner agrees that in the event of any breach of this agreement by him after acceptance he will pay 70%of the total contract price because vinyl replacement windows are custom measured and made for owners home and will fit nowhere else. Performance of this agreement is made subject to labor strikes,fires,wars,acts of God,and the Contractor's ability to obtain material. This Contract constitutes the entire understanding of the parties,and no other understanding,collateral or otherwise shall be binding unless in writing signed by both parties. WINDOW GUARANTEE Window World's glass is guaranteed for 20 years from date above not to fog up between the panes of glass. All other parts will be supplied free of charge for life. Service will be free of charge for 1 year from date above. Guarantee does not cover broken or cracked glass after 90 days from date above or any damage resulting from neglect,abuse,or acts of God. Condensation build up on the glass is caused from high humidify levels and poor ventilation within the home therefore there is no guarantee that this condition will not occur. In witness whereof,I have ereunto sigQpd my name this day of L) z"'01, by Owner ( ontracto rized Agent) y ( ) (Joint Owner) -°Pf?TM-NT OF EUIr ID= G E Sr^r 02,1iS �S P`rTC ?L Main S rntct • Municipal B uildin_ Nonbampton, MA 01060 ACKNOWLEDGEMENT• The State ofMassachusetts allows the homeowner the right under 78flCNR 108.3.4 to act a JL.-Is/ner construction sup-: , :sore The state defines "Homeowner" as, "person(s) who owns a parcel on which he/she resides or intends to be, a one or two famHy dweHlizg, 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 I home owner." The building-department for the City of Northampton wants any per sons)who seek to use the horde'owner exemption, to act as their own conduction supers:so: 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 back-II). so-notube holes (before flour). a rouz-h building insaection (before work is co-ncealed�.insulation--insaecti.an-(if rera.uir-ed)ancfaTniaLbu diva.insnectio.n. The building department regdires these inspections before the work is concealed, failure to secure these inspections can result in failure to obtain a certificate of occupane uma--thee-wo :ra-n--be-insz)ected-- If the h=eow-ner 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 1, 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 77ie ComtnonweaZzh of1111assack.-iser.s De p m--m en:of I,,-das-zria-1-.4 cc-*de ,-,s 0i:z12-ce of Inveszi,=ions 600 Washir.gron Street Eoston,-4L4 02111 Workers'Compensation Insurance Affldavit: Builders/Contractors/1 lectricians/PlumbeArS -kDpUcant Information Please Print Le,-JbJv Name WINDOW WORLD -ae(3usiness/Orzmizati../Idiid��)- 56 Diniock Stmet Address: Leeds, NIA 01053 986-8?12 City/State/Zip: vou an employer?Check the appropriate box: rr. Type of project(required): 1.❑ 1 am a employer with 4- El I am a general contractor and I consL-uction employees(fuIl and/or part= e). have hired the sub-contractors 6• El-Ne-w 2 i a�a a sole proprietor or partner- listed on:he sh----+- 7 Remode sl:ip,a---d have no loyecs These sub�-cont-actors have d worlang-I for me in any capacity e=ployees and have worL-, 8- 1 eMO!i-LL012 : -- -- rNo workers' OMP. Cc=.MSUr-=Ce.- 9. Building-addition rtcquirtd--] 5. ❑ we are a corporanon and its ctzical rcnairs or additio= rep or J r -,,:C, --c oficcrs have exer.-iced their I am a Homeowner d(>i-,-(,all work Plumbic r�pa=' or additions myself r-N-o co=. right of exemption per MGL insurance t c. 152,§I(4),and we have no 12.0 Roof I repairs e=ployees. [-No workers' 13. Other cc=.insurance required-] Mon 0V Y jppli—t mat Mccl=Box wl,n1u,a= out Me S-- ,ow sno,%me th err wort--s'C o rnp==on.p o a cv=ortz 'Hotneownc=vmosubT=iztis,,Ind,,,iti,,di, are doingaE wont and tb=hire outside coat--o=nuLst sub=zit a new affidavit indica=g such. *Cont actors dial caeck this box must attached an additlanal sheet showing the name of the sub-con=c=and=r.-wilcther or not those entities have -npioy-- if the sub-contzacton-have=7p1oves they m, =provide theme er worl-=,cc=.policy nu=c-. lam an employer that isproijdi1z,.,7 worke7-s,compensation insurance for my employees. Below is the PO&CY andjoh,size iJZf0rM4d0JFZ. Inc once Company-Name: Policy#or Self-ins.Lic. Expiration Date: Job Site Address-- city"State/ZiP.- Attach a copy Of the Workers' compensation policy declaration page(showing the policy number and expiration date). Fail-are to se=cove-.age as required under Section 25A of M&L c. 152 can lead to the imoosmon of criminal penalties of a fme up to$1,500-00 and/or one-year 7*n4msonmenf,as-eLT as civil-nenalzies in the form of a ST OP WOPUK ORDER and a Ln-e of up to$250-00 a day again =st the violator. Be advised that a copy of this statement may be for�mrded to the Office of Investigations of the DLk for instzrancc cc)ve--aore verification. Ido hereby certify under thepains andpenakies ofper jury that the LnformarLo?r provided above is true and correct ate Phone#- S Y� 7/ t t-LY1=M,LUC 0TVY. L)G not write in Via area, to he cv-piezea P,v city or town o&zciat icza-g 1 _9 City or Town; 'ermit/License# -Y�-n S=_ (circle Issuing Authority(circle one): Authority 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Elec,ical Inspector 5.Plumbing Inspector 6- Other o Contact Person: SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: License Number Address Expiration Date Signature Telephone 9.Rep isteredHome'lrnprmemenfContractor. " ' Not Applicable ❑ /O `/O O 0 Company Name Registration Number WINDOW WORLD T�id�p .Address 56 Dimock Street Expiration Date Leeds, ILIA 01053 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.-HIoir to Omer Ege p + n 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-vear period shall not 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 Slate of Massachusetts General Laws Annotated. Homeowner Signature SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement i s Alteration(s) Roofing Or Doors Accessory Bldg. ❑ Demolition ❑ New Signs [❑] Decks Siding[❑] Other[❑] Brief Description fo Pr000se5L. / �Y Work: --f fti.`�/ A� L V / -1-S' Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet 6a_ if New,house and or;ddi on to existing h6:sirg, corr:�Iete the follawi-1g: a. Use of building : One Family Two Family Other b. Number of rooms in each family unit: Number of Bathrooms Ic. 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 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 1 J (ti S�_Ll as �rlAuth�orized ge n ereby declare that the statements and information on the foregoing application are true and accurate, to the best ge elief. Signed under the pains aria penalties of perjury. Print Name Sig re Owne gen Da ^ Section 4. ZONING AU Information Must Be Completed. Permit Can Be Denied Due Td Incomplete Information Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size S backs Front et Re Building Height Bldg. Square Footage Open Space Footage % (Lot area minus bid.-&paved [F 8,Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? �� �� NO \^��� DONTKNOYY \~� YES \_� IF YES, date issued: `------------- IF YES: Was the permit recorded at the Registry ufDeeds? NO [ ] DONTKNOW YES~� IF YES: enter Book Page i and/or Document# ' �� D. Does the site contain a brook, body of water orwetlands? NO \~~��� DONTKNOYY \_� YES IF YES, has a permit been nr need tobp obtained from the Conservation Commission? ' Needs to be obtained 0 Obtained �/-� Date Issued: /-----------. /~� C. Do any�gnsexist on the prope�y? YES NO \+� IF YES, describe size, type and kocation: D. Are there any proposed changes to or additions of signs intended for the property YES 0 NO 0 IF YES, describe size, type and location: ' E. Mill the construction activity disturb(clearing,gradingexcavation, or filling)over 1 acre oriuit part nfanonnnnnplan that will disturb over 1acre? YI:_U ( ) NO (��� �� |FYIES.!F�6n--a-Nort6��tohSf&FF�TW5�7-Nana-gemdn—f Permit from the DPW iorequired. d Department,use only City or Northampton Status of Permit: Building Department Curb.Cut(Driveway Permit ` 212 Main Street SewertSepticAvailability Room 100 Waterl.W611 Auailabitit3 Northampton, MA 01060 Tnn a Sets nf.Structural-Plan s-- ' phone 413-587-1240 Fax 413-587-1272 PtqfjSy Plans APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING 1 , ntrsl SECTION 1 -SITE INFORMATION 1.1 Property Address: Tn s seclon to be completed by office Map_ Lot Unit / Zone Overlay District Elm St District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: cc�� phi c1Q-- Name(Print) Current Mailing Address. Telephone Signature 2.2 Authorized Agent: �J oil N JC--l1 j -20GlC. -7 L r� S /Yli�li Name(Print) Current Mailing Address: � __ _ c5 P �t J✓ 71�i ture Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by ermit 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) S / �S Check Number S ✓ This Section For Official Use Only Date... Building Permit Number: Issued: Signature: Building=c6`­mrFj-s-s—ionCr11nspe or o uilaings - Date BP-2008-0635 GIS #: COMMONWEALTH OF MASSACHUSETTS CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: BUILDING PERMIT Permit# BP-2008-0635 Project# JS-2008-000965 Est. Cost: $5485.00 Fee: $25.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: John Corbett 104000 Lot Size(sq. ft.): 3920.40 Owner: SALLOOM ROGER W zoning URC Applicant: John Corbett AT. 15 KINGSLEY AVE Applicant Address: Phone: Insurance: 56 Dimock St (413) 586-8712 LEEDSMA01053 ISSUED ON:111112008 0:00:00 TO PERFORM THE FOLLOWING WORK.-INSTALL 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 1/11/2008 0:00:00 $25.002748 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo