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35-104 (2) INSULATION SIDING CO, INC. 56 FRANKLIN STREET EASTHAMPTON, MASSACHUSETTS 01027 EASTHAMPTON OFFICE:527-0044 WESTFIELD OFFICE: 568-6411 Contractors license #101858 Proposal Submitted to Phone Date Kathleen Prindle "Purchaser" 413-584-2232 Home 19/17/04 Street Job Name 66 Drewsen Drive 413-210-2232 Cell City,State and Zip Code Job Location Job Phone Florence, MA 01062 1 Contractor hereby submits to Purchaser specifications and estimates for INSTALLATION OF VINYL SIDING-MAIN HOUSE I-We will install new Vinyl S'ding on all exterior walls. Homeowner will have choice of color.style.and brand name. 2.We will naml all sidng approximately 16-24"on center using aluminum nails LLQQLI;I4UjjQd,-manth tho 3.We will install a 3/8"insulated Styrofoam backer behind the sid'ng. FFF 6" ,7 P-- n VI/ I F 4.Wood trim around(2)dQors well be covered with White aluMinum cool stock matpri;;I- I U)I I 5.Wood trim soffit and fascia will be coverpd with alum4num coil stock and perforated V i A 8062i.MQWdrii wood ,;Qff*t areas to inrreasp attoc ventelation. .. U,6&--LCL 6.Any caulkbng that needs to be done will be done with Silicone Caulking, 0400n,OD -.2 7.Any existing wood that is loose will be re nailed, 8-Any exast*ng wood that is deteriorated which needs to be replaced so that we can perform our work will be replaced, This does not include any structural or dimensional lumber. 9.We will install (3)gable end louvers in designated areas, 1-0.We will install (7)vinyl lute blocks behind light foxtures. 1:1.We will install White Mastic Fluted or Traditional corner posts on all corners, lc >12.We will remove and reinstall existing gutters and downspouts- 13, We will rem,nve and (1jmqpQse of(2)pair~_Qfexisting shutter�a and (2)new paers of hpa)j�j duty X'nyl "Gorar6n"Shutters, Homeowner will have choice of color and style, Oe,,-14.Areas to be Covered on Fronj Porch will he as follows•Ceiling will be coyered with vinyl soffit material and wood beams will be covered with aluminum coil stork material. 15,Job site will Ue cleaned upon completion mob 16-Vinyl Siclung has a"Manufacturer's Lifetime Warranty". PRICE-$5,632.00 — owNEg OR CONTRACTOR WILL BE RESPONSIBLE FOR ANY FEES REQUIRED FOR BUILDING PERMITS. OWNER OR CONTRACTOR WILL BL RESPONSIBLE FOR ANY ELECTRICAL OR PLUMBING WORK(IF NEEDED). A CERTIFICATE OF INSURANCE FORWnRUnnnnrc COMPENSATION AND LIABILITY WILL BE FORWARDED UPON REQUEST, T , DALEY INSURANCE AGENCY OF WEST SPRINGFIELD. MA IS OUR AGENT. WE PROPOSE to furnish material and labor,complete in accordance with above specifications,fur the sun'i of: $5,632.00 0 dollars($ _5 % Down,Balance Due-Upon-,--------., ),payment due upon receipt of invoice. If payment late,interest at 11/2%may be added. Completion of Job NOTE:This proposal may be withdrawn by us if not.qccepted within THIRTY days. Ed Losacano,Owner Contractor Salesman ril e t rin e 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. R.C.I ROOFING 40 MAINE AVE. P.O. BOX 309 =C=ESTIMA EASTHA MPTON, MA 01027-0309 � TE PHONE (413)527- 4775 � FAX (413)527-8469 (} Date: AUGUST 19, 2002 Estimate To: KATHY PRINDLE Estimated By: MARK DELISLE 10 LYMAN AVE. APT. E Start Date: EASTHAMPTON, MA. 01027 Job Location: 66 DREWSON D]CAE:T�iA>�,gTL1N,---MA.-_0�.66.0 W/Uee,,le a i7,1,* 0, 6..� Job Phone: 413 527-0685 JOB DESCRIP77ON N 0 ALL ROOFTNG RETATED DFBRIS WILL BE REMOVED BY R.C.I. ROOFING, 30 YEAR TAMKO MATERrAT, WARRANTY INCLUDED, -5 YFAR R.(-'. T. WORKMANSHIP WARRANTY WCLUDRD. ALL WORK To B-F PERFORMED ACCQRQI1lG TO MANUFArTURERS SPECIFICATIONS, SPECIAL ITEMS NEEDED Additional information pertaining to this Job Estimate TERMS OF PAYMENT 30%PRIOR TO START Total Estimated 70%UPON COMPLETION Job Cost $2,300.00 REGISTRATION 11126235 CONST.LICENSE/074334 Authorized Signature FEDERAL ID f 04 3418839 f INSURED BY HACKWORTH INSURANCE(413)527-9907 ORIGINAL-ESTIMATOR COPY ._ a4.rttnarPro •�� 9 ; �lasscattsctts' DEPARTMENT OF $UILDINO INSPECTIONS 212 Main Street a Municipal Building Northampton, Mass. 01060 WORI{ER'S COMPENSATION INSURANCE AFFIDAVIT 9100(7% rQ (11CCOSa/C"."'ttte) with a principal place of business/residence at: 14O -MC"%YN O-\JE- F V•h YOa _ OloLbhone#) IV/3-,5Z7- 77-7- (atrrcdcity/statr/rip) do hereby certify, under the pains and penalties of perjury, that: amAn employer providing the following worker's com ensation coverage for m P P 8 Y employees working on this job: 20L,t,� WC-1-315-311 in•of l 10- 5-07K. • an=raace CcmpUW) (Poliry.Number) (Expiration D=) ( ) I am a sole proprietor, general contractor or homeowner(circle one) and have hired the contractors fisted below who have the following worker's compensation policies: (Name of Contractor) (Insurances Compauy/PoGcy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (attach additional shod if neo=ary to iochxrc iorectaaticn patainiag to all wa"ctors) ( ) I am a sole proprietor and have no one working for me. O I am a home owner performing all the work myself. NOTE:phase be swan thg whir*bomoowoeta who aaploy pusons to do mainteasaae,coasbroesioe or rW4t work Oa a d-Iliat of oat moc•*thaw throe vans is which the hom*owocr raids a m the VVU0 s appurtcoad tb,,to arc not ecaaally COWidcmd to be cmployra under th*WWWS parVensdion Ad(GL152fa 1(S)).appliatioo by a.honwoww for a ticcuse ae permit-ay evida=tho kgal ctdue Oran emplOyac uadar the Workees C.ompeasatioa Act I undo WA"that a Copy of this s:tatemmt may be forwarded to the Depertmeet*f radu sbW Ao i&a Woo c f laswaaa_ra the covxage v-ciliasioo sad that failure to cocttrt:oovecago utsda•soetioa 23Aot Mt7L 152 can tad b tba'im�posdioa oCaimioal praaltia oo=W8 Of a•time Of UP to 51„500.00 sadly 6Tdso—=A of tip to one year and civil peaaltics in the form of a Stop Walt Order and a ' fim OC3100.00 a day against tae. For dwutmr W tun only permit Number WO Lot# Signature of L1cc S*ddPermittee 1 „ 1 r $.1 License nnstri!ction Supervisor:' Not Applicable 0 Name of License Holder; CYl act. 5\ 41 Lk. 33 LI Ucense Number Address Expiration Date (4 ��� j 441.may■S ... Lr1•, 'FJ 1 Signature Telephone ON Not Applicable O Com2any'Name Registration Number r1.�j , _ - ��- QL1 'Address r+ Expiration Date �i d t�Ckt 4P1�, i aw F_ �C t�Yl Tele hone A e� RP•. .. 1r Y t I 1 I i $: I_.•pi .. 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.:'....'..,.'-13 : No...... 0 a ,N 9 1, 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;p,rovided that the owner acts as suuervisor.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 that is,or is intended to be,'a one or two family dwelling,attached or detached structures accessory+to such use and/or farm,,_ structurdss.`�l Berson who'constructs more than one home in a two-year period shall not be consldered 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. compledon'of o work for which this permit is issued. Also be dyised 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 maybe liable for person(s) you hire to perform work for you under this permit. The uddersigned"liomeownee,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 Paws Annotated. s Homeowner Signature ,. kop 17 . r {1 1 y ..y. ..,y .*,.. New House O Addition O Replacement Windows [AIteratlon(s)O Roofing Or Doors O Accessory Bldg. O Demolition0 New Signs [ ] Decks [ ] Siding[ Other( ] Brief Description of Proposed Work: P U(el- ? " �- Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative 0 Renovating unfinished basement Yes No Plans Attached Roll 0•Sheet 0 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? 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 0 N�R � E rr0azkL;� D E h:: 4.1 W VY jV C70 ., PERM(T 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 LM i'�W' no , as Gwner/Authorized Agent hereby declare that the statements and information on the foregoing ap tion'are true and accurate, to the-best of my knowledge and belief. Signed under the pains and penalties of perjury. Print Name Signature of Gww/Agent Date .Section 4. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN-BE DENIED DUE TO LACK OF INFORMATION Existing Proposed Required by Zoning ' This colutaa to be filled in by ».�•.�._..,, . Building Deg}i4=M: Lot Size Frontage Setbacks ; E= yam'Ig L: R: L: PL B [' Building Height Bldg.Square Footage % Open Space Footage (Lot area minus bldg do paved akin #of Parking Spaces Fill: volume do Location A. Has a.Special Permit/Variance/Finding 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 of Deeds? NO DON'T KNOW YES ... IF YES: " enter Book Page and/or Documeht# 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 Conservatioq Dommission? Needs to be obtained Obtained , Date issued: C. Do any signs exist on the property? YES NO +r- 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: _ Q14 of Northampton iii ding Department X12 Main Street Room 100 r NOV 19 2002 No'r�Nmpton, MA 01060 phone 41;3.582=1240 Fax 413.587.1272 &-66STRtl'CT,ALTER, REPAIR, RENOVA�E OR DEMOLISH A ONE OR TWO FAMILY DWELLING X' o e camp t 1.1 Property Address: SECTION`2,- PROP �P/AUTHO„F ZED° NT 2.1 Owner of Record: Name(Print) r _� , Current Mailing Ad ress: toZ7 Telephone Signature �{ 2.2 Authorized Agent: �� r ox "016v Name(Print) Qurrent Mailing Address: . Signature Te'rephone SECTION 3=ESTIMATED COAST R =ON C0SrT Item Estimated Cost(Dollars)to be :Qfiial Use'On.)y completed by ermit applicant 1. Building '(a)Building°Permat'Fee• 2. Electrical (b) Estimated TotaLCost:of Construction f r(m...fi.to 3. Plumbing Building-Permit Fee 4. Mechanical(HVAC) 5. Fire Protection 6. Total =G + 2 + 3 +4+ 5)1 Check-Number ThPs Section For.Official Use,Onl Building Permit Nur0er^ Date Issued � "4 Signature d� a�, ¢Wldi' �44� 1."ssl nerllpsl � e,.ot 6,.1u d ng$:. :> Ate BP-2003-0513 G1S#: COMMONWEALTH OF MASSACHUSETTS CITY OF NORTHAMPTON Lot: -001 Permit: Building Category: BUILDING PERMIT Permit# BP-2003-0513 Project# JS-2003.0855 Est.Cost: $2300.00 Fee: $25.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Groin RCI ROOFING 126235 Lot Size(sg. ft.): 8015.04 Owner: PRWDLE KATHY Zoning: SR Applicant: RCI ROOFING AT. 66 DREWSEN DR Applicant Address: Phone: Insurance: P O BOX 309 (413) 527-4775 Workers Compensation EASTHAMPTONMA01027-0309 ISSUED ON.11119102 0:00:00 TO PERFORM THE FOLLOWING WORK.-SHINGLE ROOF OVER 1 EXISTING LAYER 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 Sienature: Fee Type: Receipt No: Date Paid: Check No: Amount: Building 11/19/02 0:00:00 646 $25.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo Gl itp of Narthaiitptan z = � � �1'rlassachitsetts s _ DEPARTMENT OF BUILDI,\TG INSPECTIONS INSPECTOR '212 Main Street • Municipal Building 5 `' Norftunpton, MA 01060 HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to act as has/her construction sups: sor. The state defines "Homeowner" as, "-Person(s) who owns a parcel on which he/she resides or intends to be, a one or two fami1y__ _ 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 home owner." The building department for the City of Northampton wants any person(s)who seek to use the home owner exemption, to act as their own construction supervisor, to be aware that by doing so you become responsible for compliance with state building codes and Ogulations. The inspection process requires that the building department be called to inspect work at various stages, which include foundation/footings (before backfill), sonotube holes (before pour), a rough building inspection (before work is concealed) insulation inspection(if required) and a final building inspection.;The building department requires these inspections before the work is concealed, failure to secure these-inspections can result in failure to obtain a certificate of occupancy until the work can be inspected. If the homeowner 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 r 4ittA�r nT t.. 2O GGa py R ti Crib of �c>z fl1a�ll�tolt _ B,. ,E �Zaoaitr}Insrila' _ c,•• - i o DEPARTMENT OP DUILDI]-,IC INSPECTIOI.,S 212 Alain Strcct ' Dfunicipal Building Northampton, Mass. 01060 tip'O MCER'S CO ilQ EN S A'n0 N MS URA CE A =- r�.,Nrrr (li ccnsccJpct'mi rice) v,rILh a principal place cf business residence at: /� r QSi�[L r'Yl(� 'D phone:.') (sat/ ty/9i�-/ap) do hereby cerdi -, under thc.pain5 and penalties of perJury, :hat I am an employer providing the followinc,xvorkces comocnsadon cove zsc for Iny emplovecs worlang on tilis job: Qrsu.rn=Con - •) (Policy Numbcr) (r:-pinion D2--) ( ) I am a sole propriccor, general cony-acror or holneow-Der (ci cie one) and have hired the contractors listed below vqbo hive the folloVU' q- worker's comoensadon policies: (I+81I1C of CO '^CiOr) (lnR]rancC. Coino3,n)-/PGUci jZLi-mh--) Datc) CNa me of Conn-acior) (Ins-wanec Company/Policy Numcrr) expiration Date) (Name of Coaa-acid') (Lztsuranc; Company/Poky N=b-j) (Exairsaoa Daic) (Name of Contractor) (Insurance Comrzay/Poliey Numb;r) (Expiration Da1c). (aII�.ab��i-:oc31 z�,if ncCCUn to lad cL iafo�u�oa pertLia.:sss to all war—..�o�) O I am a sole proprietor and bane no one worldD8 for me. ( ) I am.a home owner performing all the work myself. NOTE:ple be Lw7=ti—ML]C 1 �7 K-bO GsPlay P<—roOj to do = C=^.Z QQ c rCP it v-or-k oa r d%•<iLF of pot mete t!`a t'so tmr�is%I-b36 the bomoownc r=dc.a cc tba{Jaime xppurt<a rs ibccto L c oo(C=�r.1ty cc=.d=cd to L- edtployce ury e the.,a S r w Act(GUI 52,=I(5)} =P U=boa by a homcoax fcr a be=_a pe=lt t=y a id==IL•e Icy!ataar<of La-=Player wader dxc Woricola Comveooa6oa.Ar - [uadcztaad that a oopy of tb Li.cna—,d may be f.--,ded to(be popartm,.a2 of Ad--&OIL—or taaY•ooe for the oovcr xSc vcr Tlc=ioa a_yd Uu L•iltnc to soauc`eoverase t=ile wawa 23 A of MOL 152 na Ied to the imp=l ioa of aiminal Pa=lsio evilly mg of a rise of up to S 1_�Oo.00 aadlor®Prisocsm� of up Lo ooe year Lend aril pmLtao is Cx form of a Stop Work Chile aad a f=of s 100.00.d'-y aptiast tzK For dcgarca— u.c ocJI PcrMjI Number Lot ¢ Sign.,-'WTc of crmiucc e -- SECTION 8-CONSTRUCTION SERVICES + 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: License Number Address Expiration Date Signature Telephone 9at2e'isfei l me Tm"Eai errient Coiitractar �; ., Mk 7g)-I, w Not Applicable ❑ 1 f Lo C Company Name Registration um er - -- Address Expiration Date Telephone SECTION 10-WORKERS'COMPENSATION'INSURANCE"AFFIDAVIT`(M.G.L.6.452,125C(0)) 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.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 r SECTION,5-DESCRIPTION OF,PROPOSED (check all applicable) New House ❑ Addition E] , Replacement Windows Alteration(s) Roofing ❑ Or Doors M Accessory Bldg. ❑ Demolition ❑ New Signs [[3] Decks [p Siding ] Other[C7] Brief Description of Proposed ° r 1 Work: �Y-17 �`� ��� c�a d 1 ✓mil Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet sa ff Nev+ F ouse4an, cir:�a dot o�%# ezistiac fiousll ct.:comp e e tti fatfa�irelrta: 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 Za-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENTOR CONTRACTOR APPLIES FOR BUILDING PERMIT I, 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 I Inc as Owner/Authorized Ageril lie e by-declare that the statements and i formation on the for goi g applicati n are true and accurate,to the best of my knowledge and belief. Signed under the pains and penalties of perjury. Print Name Ll Signature of Owner ent 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 I Setbacks Front Side L: R:' L.€ R Rear Building Height = -- Bldg.Square Footage -j 1 % '— s Open Space Footage % ' (Lot area minus bldg&paved parking) #of Parking Spaces I � Fill: I ! I (volume'&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO Q 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 0 IF YES: enter Book Page? and/or Document# B. Does the site contain a brook, body of water or wetlands? NO 0 DON'T KNOW 0 YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Q Obtained Date Issued: 3 C. Do any signs exist on the property? YES Q NO 0 IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES 0 NO Q 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 NO Q IF YES,then a Northampton Storm Water Management Permit from the DPW is required. —jCi# of Nortoampton P ding Departmentkf a. e 12 Main Street ew se°t► r a ,-- j Room 100 r��e . uarait ,r C4 No pton; 1VIA 01060 esoS# y r�laris .x NQ� } tone 413.587- 240 Fax 413-587-1272 PCot51# # n � 'X� Otlie �iecf � � = i't1GA �5N 7©tcQekft$L6T;I�LTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION ce 1.1 Property Address: This section to be completed by offi NIaP Lot Unit ��©�C.I�.�C t �'�� Zoe , Overla�CDistrrct ' x ElmSt Distract _._ _ CH DisYrtcE SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT: 2.1 Owner of Record: Name(Print) Curre t ailing Add Telephone Signature 2.2 Authorized Agent: 10N&I�L C) Name(Print) Current Mailing Address: —'-rC� Si nature Telephone—� SECTION 3-ESTIMATED-CONSTRUCTION COSTS Item - Estimated Cost(Dollars)to be Official Use Only completed bv permit applicant 1. Building O (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 Date Building Permit Number. Issued: Signature: ` Building Commissioner/Inspector of Buildings- Date 66 DREWSEN DR BP-2005-0583 GIS#: COMMONWEALTH OF MASSACHUSETTS MapBlock: 35- 104 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Buildiinci DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: BUILDING PERMIT Permit# BP-2005-0583 Project# JS-2005-0770 Est. Cost: $5682.00 Fee:$25.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: All Star Insulation & Siding Co Inc 101858 Lot Size(sq. ft.): 8015.04 Owner: PRINDLE KATHLEEN A Zoning: SR Applicant: All Star Insulation & Siding Co Inc AT. 66 DREWSEN DR Applicant Address: Phone: Insurance: 56 Franklin Street (413) 527-0044 Workers Compensation EASTHAMPTONMA01027 ISSUED ON:11112104 0:00:00 TO PERFORM THE FOLLOWING WORK:INSTALL 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: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occupancy Signature: FeeType• Receipt No: Date Paid: Check No: Amount: Building 11/12/04 0:00:00 30824 $25.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo