Loading...
36-233 (3) Unada — Zones EFURP ener9Ystar.nrcan—rncan.gc.ca ENERGY STAR [ Regions 10, �4 ee;Oudlifed Remove labei.after final inspection;SAVE for future reference Weather Shield 0131060=A-172 IVFRC Model 8108 double Hung Operating Alum clad Thermal Frame rker<11Ft!ritxtmatkn 3(d inch Glazing . rmyq cammo ZO—E .022 Low—E Argon Fill Grille in Air Space ENERGY PERFORMANCE RATINGS . 0 30 U—Facle� 70 Sol a�H��du Coefficient. S — tricl'SI ' ADDITIONAL PERFORMANCE RATINGS Visible Transidluce Condensation Resistance 0.40 0 Itiaeufeeturae alpufehs that dkess ratings mlomm ti applicable NFRC procedures for delenWaing whole product 04199 pedo mma.HFKC ratings ere determined for a txed at of eafito eentd andiilons and sspped0e ppmddet Ares HFRC does not r onurtend wry preddit and'does net wsaent the tullebitty of my pradeet 101 Say spedh use. Coasull msnuleelurees tterahtra lot Mhet ptoducl petlonttsnee intimation. www_ntro.o Meats or exceeds M.E,C, C.E.C.,and I.E.C.C.Air Infiltration Re uiretaenls (D P) (PSO Tested to ANSUAAMAINW11111A 101I.S.2-97 H-1.05 44xW Tested to AAMANDMARSI .. _� 10111621AL40—US + 3u H—LC351119X2290(44x90) ti9S� - flue NoNs Strgdwst Fadormae.Per ASHA MIC 01!201 ' ��zd�d�_i_� ataescazatlHSro - HOMZ)11?Ir1iMOVEMENT CONT"CT SASE READ TUIS Sold,Furnished and knatalled by, Branch Name:Borten 1•lorth South Datr �� THID At-Home Services,Inc. d/b/a The Home Depot At-Home Services Branch Number:31 and 33 908 Boston TSunpike,Unit 1,Shrewsbury.MA 01545 Toll Few 877-9M-3758 Pcdcrol ED ti 75-2698460:ME Lie*C 02439:RI Cont.Lida 16471 !� t; ,. CT Lie#EUC.0565522;MA donne,Improvement contractor Reg.#126893 YnstaUdon Addsew: rJ �L.rt C11V1t�h1 Q:� A t ') City State Zips Purchrrser(s)i Work Phone: a i bore: Ceti lPt omm- -F2 i Eli" 5 C C ] f ] l E ] Roane Address: (If different from Ertstallation Addreas) City state Zip E-mail Address(to receive project communications sod Home.Depot updates): ©T DO NOT wish to receive any marketing entails from The Home Depot i'xmeet�nfarmntion; Undersigned("Custawer"),the owners of the property located at the above installation address,agree to buy, and THD At-Nome Services,Inc.("The Home Depot")agrees to furnish.deliver and arrango for the installation('YnstaMMon")of all materials dasc ribed on the below and on the referenced Spec Sheet(s).811 Of which are incorporated into this Contract by this reference,along with any applicable State Supplement and Payment Summary attached hereto and any Change Orders(collectively. "Contract"): Job#: ant`"°"sw&_ r roduets, Sec Sheets u: Pr t Amount Rooting ElSiang IQ Windows El Tnaufa bn f ��� OCutt2rs t Covers ❑8avy Dnvra © �� Roofing Siding LJ Winduvrs C3 Insulation EIGutters I Covers❑Entry Doors ❑ Raoling Siding Windows lnsulation EIGulters I Covers EjEntry coma E Roofing Siding El Windowx U t�sulation $ r f QGutters I Covers OEnuy Doors ❑ [:#UrChR=3nWMAdepodtratmathat+onehhixdartheConhactA-MOV A T4� ntractAlnount Customer agrees that,immediately upon completion of the work for each PioduCl,Customer will execute 8 Completion Certificate (one for each Product as defined by at) individual Spec Sheet)and pay any balance due. As applicable,each Customer under is Contract agrees to be jointly and severally obligated and liable hereunder, The Home Depot reserves the right to iysue a Change Order or terotii ute this Contract or any individual Produc(Cs)included herein,at itti discretion,If The Home Depot or its authorized service provider determines that it cannot perrorin its obligations due tP a structural problem with the home,environmental harards such m mold,asbestos or lead paint,other safety concerns,pricing errors or bmausc work required to complete the lob was not included in the Contract. XWTmertt stunamt.. The Payment summary#_included 45 Pan of this Contract. hats forth the total Contract amount and payments required for the deposits and final payments by Product(as applicable). NOTICE TO CUSTOT1%R You are entitled to a completely f9leda copy of the Contract at the time you sign. Der not sign a Completion Cerdficate(note; There is one Completions Certificate for each listed Product as defined by individual Spec Sheets)before work on that Product is complete. It,the event of termination of this Contract.Customer agrees to pay The Horne Depot the casts of materials,labor,expenses and services provided by The}fume Depot or Authorized Service Provider throulgh the date of termination,plus any other amounts set forth ire this Agreement or allowed under appilcable law. THE HOME DEPOT MAY WITHHOLD AMOUNTS OWED TO THE HOME DEPOT FROM THE DEPOSIT PAYMENT OR OTHER PAIYMENIS MADE, WITHOI:IT I.IIV rMG THE HOW DEPOT'S OTHER REMEDEE3 FOR RECOVERY OF SUCH AMOUNT& Acceo ce anti Author��aahon: Customer agrees and understands that this Agreement in the entire agreement between Customer an3'C�te Home Depot with regard to the Products and Installation services and supersedes all prior discussions and agreements.either oral cr writteat,eclat-^ rasaid Products and installation.This Agreement cannot be assigned or amended except by a writing signed by Customer and c Depot.Customer acknowledges and agrees that Customer has read,understands,voluntarily accepts the terms of and received copy of this Agreement. AA pte Submitted by: Cho en's Si Date sales Gonsil=V s Signature Date Telephone No. CustOrJter'a signature late Sales Consultant license No. C�9aKELI A T ON CUSTOMER MAY CANCEL THIS (05 applicabie) AGREEMENT W1TYICOUT PENALTY OR OBLIGATION DFLTVEJUNG WRITTEN NOTICE TO THE ROME DE POT-13 X MID NIGHT ON 9H THR BUSINESS j f DAY AFTER SIGNING THIS AGREEMENT. THE STATE SUPPLEMENT ATTACHED HERETO CONTAINS .A FORM TO USE IF ONE 1$ SPECIFICALLY PRE KRIBED BY LAW IN CUSTOMER'S STATE. NOTICE:ADDIT OVAL TEti14tt3 AND CONDITIONS Ally STATED ON TCIS RE VERSB BIDE AND AxE PART 0F'17i38 Car MA,CT whit^—R-Mh F'N Y-Aaw—cumornar The Commonwealth ofMassachlrsem Department o_f Industrial Accidents 0fJ1ice of Investigations 600 Washington Street ' Boston,MA 02111 www.mass.gov1dia Workers' Compensation Insurance Affidavit: Builders/Contractors/E leetri.eians/plumbers A licant Information Please Print Le .b Name(Business/Organization/Individual): MA Address: ' City/State/Zip: II Phone#: Are yo employer?Check the appropriate box: Type of project(required): 1. am a employer with 4. [] I am a general contractor and I p * have hired the sub-contractors 6. F1 New construction employees(full and/or part-time). 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g. []Demolition working for in an capacity. employees and have workers' g Y F tY• 9. ❑Building addition; [No workers' comp.insurance comp. insurance.t required.] 5. [] We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I L Plumbing repairs or additions myself ' . right of exemption per MGL Y �o workers comp. 12.E]Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.(�Other 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: ff Policy#or Self-ins.Lic. ( � -- Ex p iration Dat • Job Site Address: f L / �lJ�l �i/ ^ City/State/Zip: 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 hereby certif y ease a ns pen f perJury that the informaetrion provided above is a an correct Si afore: Date: Phone#: Official use only. Do not write in this area,to be completed by city or town oJjiciaL 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#: SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Su rvisor: /yam Not Applicable £ of •p Name of License Holder: ^!� 'S.�' l,u`� License Number Address Expiration Date Signature Telephone _..._, _... .. 9,Re istere Ho e!Im roV went Contra Not Applicabl�£� � CornDany Name �-�` � Registration Npmb�er� s 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 Signed Affidavit Attached Yes.. . No...... £ 11. .Home"0 : ner,Egempti<ort 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, SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Win Alteration(s) ❑ Roofing ❑ Or Doors Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks Siding [O] Other[o] IgBrief Desc i !] 7'l�l / Work: Alteration of existing bedroom Yes No A ding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet sa. If New house+and or addition to'ezistinq_housing,carnrilete 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 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 wlyo as Owner of the subject property �}- hereby authorize to act on my behalf,jrryall m elative to work authorized by this building permit applicati n. Signature of Owner Date (� e as Owner/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 un r e psi and penalties of G/ Print Name Signat of Owner/Agent Date Section 4. ZONING Ali Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning Tbis cohimn to be filled in by Building Department Lot Size Frontage Setbacks Front Rear Building Height Bldg.Square Footage 0/ Open Space Footage % (1,ot area minus bldg&paved #of Parking Spaces (volume&Location) A. Has a Special Permit/Varianoe/Fimding ever been issued for/on the site? x_� ~� x_� YY �~� � NO «�/ DON7KNO Y�� �~� IF YES, date issued.! i IF YES: Was the permit recorded at the Registry ofDeeds? NO K J DONTKNOv� 'ES �� IF YES: enter Book Page and/or Document# �� �� B. Does the d ��site NO t�� DDNTKNO\� �~� YES ��, IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs tubeobtained _�»,� Obtained �^~�� Date . � � ' C. Do any signs exist on the property? �� ��YES �~� NO v�� |F YES, describe size, type and location: 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. Will the construction activity disturb(clearing, gradingexcavation,or filling)over 1 acre orioit part ofa common plan ' that will disturb over 1acre? YES NO IF YES.then a Northampton Storm Water Management Permit from the DPW is required. ^ — k 4 department use only City of Northampton Status ofPrmrt { ' W" , Building Department Gtrr) LutlDriye�tvay Perrrslt 212 Main Street Sewer/SepticAvallablirty � 1. Room 100 a/Vater/1lkfelCAuailabllty orthampton, MA 01060 Two 82ts o structural Plans ' _ f F 1 _- - - -- pho r Fax 413-587-1272 P[ot/Slte Plans ' gCi _ f Qt)rtEr�158C1fy'F r APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION - This section to'be completed by office: 1.1 Property Address: y�.��_ 7v Zone Overlay District Elm St; District - _.:. SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: k4yl-- Name(Print) Telefh6rre ZJ Signature 2.2 ALttUerii7ed ent: + Nam t) - Curren pliAddre ,00ignafure' t' Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS. Item Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant 1. Building CL-A (a)Building Permit Feb 2. Electrical /! v (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: Date Issued: Signature: Building Commissioner/Inspector of Buildings Date 18 DIAMOND CT BP-2014-1044 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 36-233 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Buildinc4 DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: window replaced BUILDING PERMIT Permit# BP-2014-1044 Project# JS-2014-001799 Est. Cost: $12008.00 Fee: $35.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Groin HOME DEPOT AT HOME SERVICES 082485 Lot Size(sq. ft.): 43647.12 Owner: TRIENENS WILLIAM J Zoning: Applicant: HOME DEPOT AT HOME SERVICES AT. 18 DIAMOND CT Applicant Address: Phone: Insurance: 24 SUNRISE DR Workers Compensation PROVIDENCER102908 ISSUED ON:411112014 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 SiEnature: FeeType• Date Paid: Amount: Building 4/11/2014 0:00:00 $35.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner