29-413 L
c
Home lmprovement ..�
Northampton, MA 01060
(413) 584-6571
PROPOSAL St ISIVITIT-17)1-0 Z PI 10 NT
S IREFT JIM NAMF
('rrY. U.". nd Z111 CODE JIM LOCA I IOIN
JoB Flom.
We 1 11Y3-ehy submit specifications laylld '141imitcs lot-:
1)Le
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0 1'J!j I "�O
von A/
+ DON? Tki wi Cq�� V 14-L A�vmtej 1,j1,je,1aAjs aJ1, Ix
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664 ve"'r-s. F'4vaj- g)Oacs "C-Lec Ale-J4 061od-
X/ck
k V-f-f-
aly 4!�4 c k C)
zizc
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VC, (11-)'rOPOSe herehy to furnish material and labor-complete III ALUOrdamt-with the above specifications.for the sum A
1)(Olary
Payments to he made'Lc follows:
--------------
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it
All All worktoh—impictedirio w,rk-like nimmura—m1mg Authorized
T,'k,wk,rd prurtices. Arty altercations or deviiitioi)trom shove specilicutinns 1111"111t,eXl,,costs Will he
'-XuUfed only upon written orders,and will become an extra dharg•aver amt shove tlir rsliniate. All
egr"?Ilertts ctlntifigent upon strikes.,acciderils or delays he ond Note 'Mis prol—sal may bc
v our(wilrtd it, tuv tire,torruid,
mil w1wr ne(es-ry IIIsUrctnCe, Our workers arc fully covered by workmen's •wnp(Ti,ri(m histir.in,c withdrawn by us it not ac,cptcd w][hm
�cccptcmcc of(proposal-Thep,CIf IC.jkj joll,
Irr'conditions are sart.,faclory alid are hereby nWLCJ)(•d. Yoll WC;1111110117,rfl I,'
do the work ac specified. Payment will lie made;L'outlined above
Corbett Home Improvement '
Northampton, MA 01060
(413) 584-6571
JOIN NAN11- --
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[IIAII-nP PLANS luN YIIUNF - --
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ITlth) 1„turui�li uwlenal,Lull ul aerunlali— with the ah"" "[W—li, ill,dl, fn[Ilir ;uui ut-
-_ /v'�I �y�lJi✓F�''i /�G�L.'j� �/� '�]'�"Lf V/� 1 1OI
All w��rk I hi ��inl li k•�1 iu a wi rA-like in nnu ��nlinE Aulh�xi mil -
i
i;es Am ❑Ilrrutli,i s ur dry wtugi from uh—r Alai lieulu nip urvnlvwl.,cxini—sU will
huu w-m,n,ad,Y :mil will hru wr ill',IM Ih.uk. VII aill.Ih vU lh lmi,o,. All
i.0 f�ni.q��ui ari k<s,,�c n�lrni�ur drlay�hey�w�i ur n�w[ul Ow[wr l c,ury lirc_b"rn.ul, A„Ir ILIa hrulxisal Iu:ry he
. .._.,., .uaarunre Our w�ukrrs urr fully cu verr�l by Wurkwr n's C'i�i nl�r ns,Onm In,ur.�uce w'illur,iwu by u�if u�ri aeCelN ril willuu Jayc.
I C cptLri1cc of J)roposal-"hhe ahnVT hnu•x .h1uhivWill
awl arc Ilrrehy e Cej)IVd. Yuu.Orr a illOrizr,l Iu til�uau (�
1 1 1, �lxrit led_ Payniclo will he Made Le uuOliord ahi�yr
(�ii�) of yRrf a111Pfol) -.
-Ql a�incll ncc(!a '
I
DEPARTMENT OP UU(LDf-)\�G JNSpECT,or<'s �
212 Main Street ' Municipnl BuildinG
Northnmplon, 1 fnss. 01060
r- WOMCER'S COMTENSATTON IJNSUI CF AF DAM'
(li ccns�J frrml ttcc)
%� Li pruicipal plat.- oI busI0cSS/rCSldencc 2t
(su-C—�c�ty/staicizi p)
do hereby certify, under the p?.ins and penalties of perjury, -h2:
( ) I am an employer providing tllc following worker's colnocnsruon cove Ike for Illy
Ctuployccs wori ng on Lins job
(lnsti-�ccc Coo=-,,) (pclic; Nu--ter) -- (r:-pircion Due)
( ) I am a sole proonetor, nSeneral contractor or homeowner (ci cie one) amd have hired
the cony actors hired below who have the follo%vinQ worker's GomJenS2non policies:
(N�ruc o.Co ' �c;o;1 (In2nn Comoi��i c c, '�'urn�c) �_x:��ra.:o❑ I��tc)
of Coo�acor) -- (tnsuuanc (—L.\-Du lion Date)
-- (Name of Connaeto,) (lasuranc:- Comp-a-u)/Poi;c) N rb_s) (ExPir uon Date)
c of Contractor) (-n fanCz Comcw}'/Pohcy Numbs) (E.xpir-aijon Darr)
to me!u�ialo(ZU_i to'E ooaxq.)
`� I am a sole propne-tor and have no Oae work;Dg for me
( ) I am a home owner performing all the work; myself.
NOTE:plc be ecvarc th.•-L-Jc boa�Hbo a= loy pcso�w Jo•-•;.-,.-,,,,-Y rcpau..orx o-j�d—LL^Z or
ux mac .t=a.Ij to-DCb the bo aootva tvdo a oa th<p-a.tac-�purtcn r1 heco ox C- u-U.e elm d.7ed LO be
eazployc�u5? the •o i sz oca:;�lim Act(GLI 52-=1(5)�npptjcauon try n bomi*,rer e t,e=:a permit n_7 e dean he
lcjg. t,^«of e.o -raloyx uod< tto Work.ce'Compoas,yioo^'e-
I undonaod tha>ooyy of tbi ant m n m..y bo fo.-h,..ny„4 to Lb.D'.�of Offioo of(,--for the
covQ isc vm(icsLOO"ttu L•iltre to coeure tovcrnse order soaioc)5A of 1.40L 131 ci lad to the Lmposaioo of crua=J pc-iIb-
coaluxl g of a rroc of UP to s 1'500.00 erwor of up w ooc year cad C—j pcn.fdo Cx form of a Stop WO"{ ord-and a
clan o(.'s 100.00 r d_y aPuma a),-
fj�e `A..� C'c-rm;t Numtxr _.
Lot "
Signacun of LICQLSC,cJPCrmiticc �� F
Signature of Owner/Agent Date
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supprylso r: Not Applicable ❑
Name of License Holder: N P,/t13��� 00 ` S-0
iLicense Number
Address Expiration Date
Signature Telephone
9: a iisterEd,'HomeTii rov
it1 n won . ir. Not Applicable ❑
Company Name Registration Number
4-/ ,(�--b s -- S-- V
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 of the-building permit.
Signed Affidavit Attached Yes....... No...... ❑
.....................................................
.....................................................
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. Aperson 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
_
, ./
SECI ION 5- DESCRIPTION OF PROPOSED WORK(check all applicable)
New House Ej Addition E) Replacement Alteration(s) 0 Roofing
Windows Or Doors
AcCesSory Bldg. D DemolitionD New Signs Decks Sidingx, Other [
ft ) Ofp
posed 1 s;
JVY4���_��
e^/song bedroom_____.Yes No Adding now bedroom Yes No
marative Renovating unfinished basement Yes No
'wu �nocnegRoU Sheet
oa It
ooi|Uing One Fami|y Two Family Other
/uoms in each family Number ofBat room
ya,age attached? _______
i4ua/e footage of new construction. Dimensions
)i ooncs?
Fireplaces at m/oodstoms Number of each
_oxscr�ahon Compliance. Moschcck Energy Compliance form attached?
�~ --fconstruction
� 'sc.)u/un ovknin 100 ft. of wetlands? ____ Yes Nn. Is construction within lOO yr. Moodplain ,es _No
�1 aycmeoco/ c6/a/ Muo/ melmw hmsocdy/aUe
...u/xg cuorn/mrothe Building and Zoning regulations? Yes No
-anx ____ City Sewer Private weV______ City water Supply
______
SECTION 7a - OWNER AUTHORIZATION -TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
as Owner of the sub)ec,
m uk monru /e(ahvciu work oud'oozcU by dh/sbo//dmg pcnn/1apphcaUm/.
OWner Date
�
as Owner/Authorized Ayer),
`e,ch` 1ec|orc that the statements and information on the foregoing application are true and accurate, 0o the best n1my know|edyeang
�'m^',
,if''� : 'xoc, cno pains and penalties of pequry.
^ /
. '. .,
^ , ^
"
Section 4.
ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED
DUE TO LACK OF INFORMATION
This colinin to be filled in by
BUilding Department
Setbacks Front
Side L: R
Height
opcii Space 1oorage /0
XC2 WHIUS bldg&, paved
ol P"111111" spaces
� Has Special Pennb/Vahance/Finding ever been issued for/on the site?
NO DON'T KNOW YES ___________
lF YES, date issued: ___
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW YES
IF YES: enter Bonk Page Document #
u Does the site contain brook, body of water orwedonds? NO DON'TKNOVV
YES
IF YES, has permit been o/ need to be obtained from the Conservation Commission?
Needs to be obtained _____0btained Date Issued: ___
� Do any signs exist on the property? YES NO
IF YES, describe size, type and location:
D. A there any proposed changes tooradditions of signs intended for the property ?YES ___
No ��
IF YES, describe size, type and |ocadon:_________
.v
Department bse vpiy
City of Northampton Statu's ofelxnit r`' "
Building Department Curd Cutt/DnvewaP.e[ni
212 Main Street
-C� 1 C
$eWr/Sep +� a ��l
Room 100 yi/ater/ Ve! v `Iabil � r
Northampton, MA 01060 Two 9efif triictural
phone 413-587-1240 Fax 413-587-1272 Plot/SItePlans
t b
APPLICATION TO CONSTRUCT,ALTER, REPAIR, RENOVATE O !Q OuSl1IE Fj LY DWELLING
i
E
3 0 2003
SECTION 1 - SITE INFORMATION
1.1 Property Address: N0gW*Pf6Mp eted y office
MnpTNeM-10N,k4A 01090 _.._.�
/ Map tot Unit
Zone Overlay District
Elm St.District CB District
SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT
2..II Owner of Record:
VamrPnnr) Current Mailing Address: _
Telephone
su
2.2 Authorized Agent: kk
J
C-Z=
Name ;Print_) Current Mailing Address:
/--/ 5 `� 7
��gnature Telephone
SECTION 3 - ESTIMATED CONSTRUCTION COSTS
aert Estimated Cost(Dollars)to be Official Use Only
-completed by ermit applicant
Building (a) Building Permit Fee
1-iectricai (b) Estimated Total Cost of
Construction from 6
"lumbing Building Permit Fee
Mecnanical (HVAC)
r,rotection
2 + 3 + 4 + 5) 1 a % Check Number
This Section For Official Use Only
3uildinq Permit Number: _ Date Issued:_ _
Signature:
Building Commissioner/Inspector of Buildings Date
129 SANOY`HILL RD BP-2004-0358
GIs#: COMMONWEALTH OF MASSACHUSETTS
lk;
29-413 , CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category: BUILDING PERMIT
Permit# BP-2004-0358
Project# JS-2004-0514
Est. Cost: $12895.00
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: Ed Corbett Jr 116069
Lot Size(sq. ft.): 13285.80 Owner: GOGOL CYNTHIA R&ALAN W SCOTT
Zoning:URA Applicant: Ed Corbett Jr
AT. 129 SANDY HILL RD
Applicant Address: Phone: Insurance:
4 Reed Street (413) 584-6571
NORTHAMPTON MAO 1060 ISSUED ON.9130103 0:00:00
TO PERFORM THE FOLLOWING WORK.-INSTALL REPLACEMENT WINDOWS,RE-ROOF &
VINYL SIDING
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:46/,C
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occu anc re:
FeeType• Receipt No: Date Paid: Check No: Amount:
Building 9/30/03 0:00:00 2075 $25.00
212 Main Street,Phone(413) 587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo