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25C-091 (8) CIS CONTRACT made the S� day of tj n r/,m6 4/. in the,year O5 between New England Sash, Inc.and c l (OWNERS) (HOME PHONE) (BUSINESS PHONE)'«� F S a OMS1`�/tA 1 15 ' o r`e�►Le r✓A Ql x.62 ��,TREES (TOWN) (STATE) (ZIP) >used in this contract,the words we,us or our refer to New England Sash,Inc.and the words you and your refer to the customer.' 'e agree to furnish all labor and material necessary to install the following described,windows I Triple Glass with d Double Low E with ❑Krypton Gas lrgon Gas. Other(See Addendum) otal Units: #of Units:r11 Grid4Y /N Window Color:Sq'R Wks� Material: 3S 4c). Sy We do not do any painting or staining. )ouble Hung Units: � Q �r� :Installation:. � L� 1, 5q WA are not responsible forcondltions or circumstances V q q'3ICtUre Units: g from or due to pre-existing conditions.Our limited war,- rarity is herein incorporated by reference. - �opper Units: Sales Tax:. . ... Sliding Units: 2-liter , 3-lite 1 1-lite: d 2-lite Owning Units: ---.-... 'asement Units: -• 1- e: 2-'e: 3-Ilte 4-lite Total Bay/Bow Units:DH I CS: 3-liter 4-1ite> b-liter Price: G 3 Z,'4 a 0 ►o-z arden Windows: Deposit I'(SA Exterior Finish; Roof �90_ff1T ° i:4-a ction K e s: Y/N With Order Entry Doors: Steel Fiber Style: Z'(�;() Balance Due Storm Doors: Alu ood Core Style: Upon Delivery Sliding Glass Doors: # Inside Looking Out Right Active Left Active q tj�a Balance Due,. Capping N # Capping Color: W h Upon;Flnal (46tt Additional Notes: 0.vN i a 'M1 yl ► w+, °�0 � � CL �� h� awr,� a-_ 11 ht � S are, v c S .. C111 U di>u � V ke. 12. L'. a DEPOSIT WITH ORDER ❑ CASH q-QWFOX # VISA BALANCE DUE CASH ❑ FINANCE You agree to pay cash according to the terms shown above or,if your credit is approved,to sign a note provided by us for payment of the amount due. The installation will begin on or about (0 l$wks and will be substantially completed on or about t L c .It is understood by you that the following contingencies could materially change the estimated completion date stated above:customer's inability to obtain or q alify for financing;inclement weather; strikes or other labor disruption;non-availability of materials;acts of God. We represent that we carry Workers'Compensation and Public Liability insurance in the amount of$100,000-1,000,000. BY SIGNING BELOW,YOU ACKNOWLEDGE THAT YOU OWN THE ABOVE PROPERTY AND THAT YOU AGREE TO ALL OF THE TERMS OF THIS CONTRACT,INCLUD- ING THE ADDITIONAL TERMS LOCATED ON THE REVERSE SIDE OF THIS PAGE.YOU ALSO ACKNOWLEDGE THAT YOU HAVE RECEIVED A FULLY COMPLETED COPY OF THIS CONTRACT AND TWO COMPLETED COPIES OF THE NOTICE OF CANCELLATION,AND THAT YOU HAVE BEEN ORALLY INFORMED OF YOUR RIGHT TO CANCEL. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. IN WITNESS WHEREOF,the parties have hereunto signed their names this day of �Q► N�'r in the year of 0S Signed - Signe .0 MARKETING REPRESENTATIVE OWNER By Signed AUTHORIZED SIGNATURE TITLE OWNER NOTICE OF CANCELLATION NOTICE OF CANCELLATION DATE OF TRANSACTION DATE OF TRANSACTION YOU MAY CANCEL THIS TRANSACTION,WITHOUT ANY YOU MAY CANCEL THIS TRANSACTION,WITHOUT ANY PENALTY OR OBLIGATION,WITHIN THREE BUSINESS PENALTY OR OBLIGATION,WITHIN THREE BUSINESS DAYS FROM THE ABOVE DATE. DAYS FROM THE ABOVE DATE. IF YOU CANCEL,ANY PROPERTY TRADED IN,ANY PAY- IF YOU CANCEL,ANY PROPERTY TRADED IN, ANY PAY- MENTS MADE BY YOU UNDER THE CONTRACT OR MENTS MADE BY YOU UNDER THE CONTRACT OR SALE, AND ANY NEGOTIABLE INSTRUMENT EXECUTED SALE,AND ANY NEGOTIABLE INSTRUMENT EXECUTED BY YOU WILL BE RETURNED WITHIN TEN BUSINESS BY YOU WILL BE RETURNED WITHIN TEN BUSINESS DAYS FOLLOWING RECEIPT BY THE SELLER OF YOUR DAYS FOLLOWING RECEIPT BY THE SELLER OF YOUR CANCELLATION NOTICE,AND ANY SECURITY INTEREST CANCELLATION NOTICE, AND ANY SECURITY INTEREST ARISING OUT OF THE TRANSACTION WILL BE CAN- ARISING OUT OF THE TRANSACTION WILL BE CAN- CELLED.TO CANCEL THIS TRANSACTION, MAIL OR CELLED.TO CANCEL THIS TRANSACTION, MAIL OR DELIVER A SIGNED AND DATED COPY OF THIS CANCEL- DELIVER A SIGNED AND DATED COPY OF THIS CANCEL- LATION NOTICE OR ANY OTHER WRITTEN NOTICE, OR LATION NOTICE OR ANY OTHER WRITTEN NOTICE, OR SEND A TELEGRAM TO: NEW ENGLAND SASH INC., 1331 SEND A TELEGRAM TO: NEW ENGLAND SASH INC., 1331 s Date: 4129/05 Time 7:37 AM, Tv : .Paee: 002-003 Clio t 79-M. NATE CERTIFICATE CF LABIL► TY 04�$�� 1 PAOtwc>Sa +'•"E:CERTIRCATEIS ISSUED ARA MAITER OF INFORMATION RC Knox&Carnpany,lac. 0NLYAND CONFERS NO NGHTS UPON THE.CERTIRCATB -Ono Goodwhi8giwro•: : t9:.i! ]EFL THIS CERTIFICATE DOES NOT AMEND,EXTEND DA A:TER THE COVERAGE AFFORDED BY THE POLICIE5 BELOW. Hanford,CT .06`908.4306; _ li24=7600• INS%(RE AFFORDING COVERAGE '. NAIC INBlS9ED INGuneq At MA nad Riak W/C TBA National Ensryy Systems Inc New EnOiand.Sa$h hm. wc�raFaa: , —. 1331 Grattan Stmat Womcastor,MA 01604-2266 . o (COVERAGES_ f IHH PDLICI6 OF.wsuRANcE LISTED MOW HAVE-aEM ISSUED TO.THE IIVST.IR®WM ET]ABOVE FOR THE POLII^iY PERIOD INDIII NOTMMSTANDING ANY FIMUIROAENT,TERRA OR CONDITION OF ANY CONTII OR OTHER DOCUMHtf,"WITH RE'6PECTTO VMW THIS CERTIFICATEMAY BE MWED OR MAY.PERTAIN,THE INSURANCEAFFORDED BYTHB POLICIES DMFUBW HEREIN IS V•B J MTTO ALLTHETERIAS,EIfCLUSN7N5 AND CONDITIONS OF SUCH i'. POLICIES.af,I3GRB3ATE LIMITS SHOWN MAY HAVE BM REDUCED BY PAID CLAIMS. TYPBOFM IMPANCE Po1.1CYNUYmm j 14i^ LIWrS.: GENl�ALLIAllm.l'TY E'AM C CC�NCE B CMWEFlC4{LOENERALUMLnY TO S j CIJYMS MADE M.00C4IR MED E7Qi au Peon) S PMW0k&&ADV PIIURY S QENEMILAGIi EGUE g' -GEN7-AGQl:EGkTEUWI'APPUE9P8� - PRmUCI9-CaNP AM S POLICY LOC 1' ."' AiUI'0110®Q.ELIAINLJIY -..„ NEtl®NSLEUW'1' II ANY-AWTOiajeldeC) g' ALL OWNED ALITOB SCHEDULED ALRO9' BODILY INJURY 6 UiA.�:N.aJHY •g . ffy N -LAVNtO AU I Od TP®r aaiduiq j PRCPERTYDAMA9X S' F'r ecddanq QAMGEUAOBJ7Y ! AUTOONLY-EAAOC7DENT S, ANYAUM- EAAM g } AUTO U& M S UA�LIrY EACH OCCURRENCE S 1OCCIR•1 CLAIME MADE AL? OiITE S i I)mU I1I31 E S F-rENnCN s . ' wow couPetveaT�N Anm CAPPLIGAT'ION 04/29f 05 ' 04J29p8 g "uuc STATU- CiH- ANY CUTNE ` a 3+$�r '; EL EACH ACCIDENT Si Q0 000 ! OFFICEAIMEMBER EI(CI11D®7 i a -F A EMPLOYE 8100 000 ELDItMASE-PCUCMU& s500000 • oeac�'rwNOFOr�na-norre.r>_ocaTrora+�vEwaes�oaa.uglonle:AOa®erarmgNrtr�:y,���pAOVlmons . .:, .. '' . . ' i 06MOICA7-E HOLDER CANCEi:_-TTON ! SNOLLL.D:1'•""OFTHE ABM nESCIPI ED P*QUClEB 9E<0.NCELLED I CRE 31 E g>a2IHAl7CiN DATETHFF.[?i7F,"THEI6SI.RNGINBURERWILLENOEAYORTOMAX in DAYSWRIITSN H0710E 7G Rrw CERIIFlG4TE-HOLDER NANEO 7o tt EiEFr,aUr FALLIYIE TO Do So SHALL - IYPOr.E Nc.)i 3UGATION OR UAmurrOF.ANYIONb UPON THE INSUFlEA,ITSAGENTS oR REPRESENL417VE5 H� 1tt•. _ 09 suaeR VINYL ME`TMPd-k - YP7 * Fi1.LED'LOW E2•: MR U-factor (tJs.Id—.F� ot�r-Heat+Baia.Coen ie AD] WCE MENU , •44., .. , • O�i...if" i,r 1. Melble T"ranemit9an�e - ptuhatW pe�fatpter►� i�a now MR TF I" u ptod�taha tar r t urn-cam; . 321145 T'imE:s; .x:56 .PM'- Tcl:;.'• .:�=9, 15087i2 52.6 ~la" S A`�R".p-• irRT.el 'E il •1�. 'i..iFjl•U T.Y I N S UP AN .'.m• . . , ' THS CERflFICATE IS ISSUED ASA MATTER OF INPOPHAAT1aN AG Kn &C+ampateg,iris. ONL'Y,PiNWOONFERS NO R IGHTR UPON THE-00MECASE One a odwin uir• •:. - HOLDE=R.Ti4b CERMNOATE DOES.NOT AUEND,EXIISM OR - 4• ALTER THE COVERAGE AFFORD®BY THE POUOISE BE'.:OW. Harms ,rC:1' �Bl034$05 :. B6D; 78m1 • IF1Sl1REiiS ARFOFIDIN[�COVERAGE•. RIAIC# l•. . III _ IIL9URER/l Tile @�11e irrnuranco Co n - i�®$Mal Energy 9 IqS Inc• v ,apl9UF1@ as-o�vrAm6-P"�a&houranom CD • ;I- ..• '��1'if�SB111��_ d , PIBLIF]Eflfi '• ' ns� INBUFIER 0: COVERAG&S THE POUCH OF INSURANCE L:HTED'SHAW.HAVE Mao WKIED TO THE INBUR®NAMEDAMWE FOR THE POLICY PERIOD IMMATECL NOTWIMiSTANOWG ANY RMUIRMd NT-,TERN OR CONDITION OF ANY CONTf ACT OR OTHER OOwMENT WITH Rm2EGTTO WIC H THIS 02ITTIFICATE MAY aE LSWED OR. MAY PERTAIN,THE&MRANCEAFFORDEO HYTHEPOUC ES OEBCRIMI HERMI 1S alIWWtTO ALLTHETERMS,EKDLUSS ANOCONMMNSOFSUCji POLIDM AGIGREGP.TE Llurrs SHOWN MAY HAVE BEw s mjgM 8Y P1AIO CLAIIAB. TYPEORINBURNw1CF . ' POI1O'IBAIBEA Sam P UYITS A. aLUn�mr F8Fig25t I• XD/Iip4 • - 1DHt(05 eu*+ CE CCMMKFdAL QE NEPA-uAmUj.Y (1(1 OOQ CLAM'B'W= ®oCXXIR um E76+t+ one a•®on) st 0 OOD ! ` :�• PER9oNAL AAW KAJRY S 1 GENERALAOWIEOATE mum GEM-AGGIREGATEUMITAPPLIMPEF IGTB-C w ACd S2' PGULY ALTT1OU6011 E UA8ll.[TY COMBINED 81NCIEUU ANY'AUTO _ , iT_ ALL OW{MAUTCS BUDILYINAW SCHEDUMALTTOB - Lw.. S• HHMAUTOS • PFtpPERl'YDAMAC� .• ' r ' AUTDONLY-SkACCIDEW S fUl`!ALlTQ •' •• ERAC� 6- AM 6 " B EKc8mUU Wl.LAUA=XY I7Vt6821' t�t� - tQ-ttA EACH 10E i XD OCCUR ' .0-aAMMAOE AOOREOATE i6 U00 WWiIE#BCOIIPfiN8A77DMMD I' T�- am- EpPLAYEE1e:LuUJLnY GLlAI O t9�. 'lE.CUTNE ELEAC&1ACY DENT S tryae do. umw: tat i -EJL Eu $ r ° !3P 81 CM flow EL'GBEA6E-P�IGYUUrr° is OPWATIONS/LOCA MOWIVE14 Lmais A OY1s6nO lrI.GM IALPRCJW9DM _ 00• Supp arned lnsurigw, Nt�iionaLEnsegy3ys�mc Owe=Corning,inc Neer 1 d Sab,Inc — _�cta�liAr�-HatL�–_•• .cAiacei�iTaow '.• {'•' '- .. - • '- .' • sNOtx.pwa,rc>='rr>EASOVi:nfiac�aP�cESeErrwr�=�+rn�°�aa�IRancu PATE THEHEIS;-fie L'sLmiQ,Nmnm @N.l.mm=vDH TO YAtL GAYS WfiTf tFJi NGI1C ETA THL CgKTW:CA=HOLLER NAUM TO THE LEFT EDT FALL UliE TO DO OD BHA' IYPO NO C F31 tGATION CIR LL4BIUTY OFAIriYK1tID UPCA!TH6 W6LWER,:tTEACENTS OR Ar. ,' fffspAE9EM'CA'CNE .. . ,CORD,Z5 t20D1/M,1 .12 14�NAMpl, of 'Narf4allipfan Grif �IIASSAC�liStt�3 w � DEPARTMENT OF BUILDING INSPECTIONS INSPECTOR 212 Main Street • Municipal Building ' Northampton, MA 01060 `. r HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to act as his/her construction sups— isor. The state defines "Homeowner" as, "-Person(s) who owns a parcel on which he/she resides or intends to be;'a one or'trvoy _ - 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 r..egulations. The inspection process requires that the building department be called to inspect work at various stages, which include foundation/footings (before backfil1), 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 I, 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. D-ate Address of work location r 's , . tA �t }rp�. r•- i rp4 O� :_ ti (yii� Pf �\Tr rfl}a111�tOil 9 ' E -61 X.-cchnscIf _ j yr DEPARTMEKT OP DUILDD\10 INSPECTION'S - 212 Main Strcct ' D-funicip.al Building j Northampton, Mass. 010GO __WO-RxaR'S CONTENSr-MV AITU)AVIT. rAIC Oj per>niltcc) %vith a principal place of businessfresidencc at: - - Ct7 ' U)dFcce-6Ye4 4 MA 'LAIC q (phone==) H, (sa�ticirJlslatcrap) . do hereby cerzif--, under dic.pzins and penalties of per7wy, h:l ( ) I am an employer providing the following 1workcr's comoerlsEJo, cove lge for in) emplovecs worlang on ti>is job: k AM 69r,DMI'l -Ak t� d,3 (Insvr�c Conte (Policy Nu-a�cr) (T':-pircion Daz.^.) O I am a sole proprietor, general contractor or homeOWMer (circle one) and have hired the contra ors listed below rrbo have the follo%viog workel's comoen_aaon pokiest i (N=, of Co_CMaor) (IRsuranc: colDo3sr)-i Ouc-, NU-Mbc:) (E':-pl jucn Dnic) (Name of Concraaor) Ra7w-ancz- ComoazyRokv Nttmbc-r) (—E.-oim6on Dale) (Name of Coa> cl&) (Lzuuranc; Compan}-/Polio• Numb i) (Expirz6os Dalc) (Nzme of Conaaaor) (Insurancc ComoaayNoLcy Numkr) (Etpirdon Date). (.aACb A oc=.1 tuei,if nee....to a�e}v-�iafocm+�oa patnia�.n6 to..11 ocaa-rr:a) i O I.am-a sole-p-FOpnetof and have no one woridng for me. ( ) I am:a home owner performing all the work myself. NOTE:pl. =be aw-uc tbx-i J.bemco-m=-to cmplay pc-:.=to da „-• -r�ao a rcair ror c on.d.�en_�of one mat lh=Lb-o,-—M,is«bch the botnoowac rtada a oa the p Quaff zpputtcc =}bcaa z c ox C=c:-ty oee_daod to he eixploy,=once the wai e c=*c=-,;m Aa(GL152=1(5)1 appiin.000 by.bomwwac fcr c 6c=--or permit oar e�idm the legal 0--u-of as-=ployx under d1 Wockc eL Coc=pom.Lioo AcL I and—%—d d-a copy of th6 mt,c¢ma=,y bo roa-,.,vded w tbo Dop.�or luaus .l Aa A--'ofs-or 1,=..00+for%j- cova zee verir olioa.ad th:t L-ihae to too=tovcra ye uadcr u=joa 25A or MGL 152 da Icy to the im;01iti0a of crLOI l Pea4l6e3 ooati:.ing of.rtoe crop to s1300.00.ndlor m=priso=Me-n of uP to one yur e.od civil pea.ltio is 6.roan of.slop Wort;ordc.ad+ rim of S 100.00.day aF,aiasl me For -�•�v.e only - �r= permll NLLmbcr ' 1`�.7lJS—_ LOl S; Lure of LieQisceJPermittec Mte SECTION 8'-*CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: License Number Address Expiration Date Signature Telephone e ift,e, SWU Not Applicable ❑ Company Name Registration um er MA Cat E,O, 16V 5(f Address Expiration D to Telephone 71� �b SECTION 10-WORKERS'CO1gPENSyAT10R,hINSI1RANCE AF tE7A1f1 F 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 1083.5.1. 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 bundine 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 SECTI ON 5.DESCRIP.TION��6F'PROPO8ED;WORK.lchec�CatFaptSlicabte) New House ❑ Addition ❑: Replacement Windows Alteration(s) ❑ Roofing ❑ Or Doors Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [p Siding[Zl] Other[p] Brief Description of Proposed Work: Alteration of existing bedroom Yes _No Adding new bedroom Yes No . Attached Narrative Renovating unfinished basement Yes _No Plans Attached Roll -Sheet 6aSM (3.Y1fIV�FS°v SX�Ei t 'r i �. Q' 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 i 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 L 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. 1. Septic Tank City Sewer Private well City water Supply SEGTIONTa�,°OJI1[NERAt1THORIZ,4T[O,N� �G���E"CQMPG.'EFED�^�W�I�EN' OVIfNERSAGEN�'OF2�'Of�TFL4C'1vORx�t)?PLIES FOEt�B�I1Nt#PEEM17 a ti 1 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 � as OmMr/Authorized Agent here declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief. Signed der the pains and penalties perjury. Print Na k/1 � Signature f 0+"W]Agent Date t Section 4. ZONING All Informatihh 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 Setbacks Front . Side L:= R:1 I 'LL---J R-= Rear Building Height ----_.-_ Bldg.Square Footage Open Space Footage % (Lot area minus bldg&paved _ parking) #of Parking Spaces Fill: r ! (volumeB&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO Q DONT KNOW 0 YES Q IF YES, date issuedd IF YES: Was the permit recorded at the Registry of Deeds? NO Q DONT KNOW 0 YES Q IF YES: enter Book Page; ( and/or Document#,II------� B. Does the site contain a brook, body of water or wetlands? NO Q DONT KNOW 0 YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained Date Issued: P C. Do any signs exist on the property? YES 0 NO Q IF YES, describe size, type and location: i D. Are there any proposed changes to or additions of signs intended for the property? YES NO 0 IF YES, describe size, type and location: I 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 r NO 0 i IF YES,then a Northampton Storm Water Management Permit from the DPW is required. Nort Pmpton B jidiri�q Department X11.Main Street Room 100 Z+lort iarrip om MA 01060 phone 413-587-1 0 Fax 413-587-1272 APPIL`I.0[ON TO COIfISTIttCl°,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING 7. : SE1CTION 1 ,SITE INFQRMATION ,: _1.1 Property Address: Y � Ild TT K SEOTIO. 2 1?ROPE}ZTYOWNERSHIPFAUTFIORIZF AGENT 2.1 Owner of Record: Name(Print) Current Mailing Address: r Telephone j Signature �� 2.2 Authorized A erit: Name rint) Current Mailing Address: �- Sig at re Telephone SEG7 CON'3 a:ESTIM AtED3I O tSTRUGTION:'Ott'v Item Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant 1. Building ( (a)Bnilding,Perm Fee 2. Electrical (b 'Estirrrated Total Cost of °Gonstruciion frtir[,6' 3. Plumbing Bdildiag;Permrt Fee,. 4. Mechanical(HVAC) 5. Fire Protection 6. Total=0 +2+3+4+5) r -Check.Number - . _. � _ _ Tkiis Secti©irFor.�'Eficralailse;Or�t BurldirgEPermrtiNumbec Iss'u'ed:' Signature: r r Building Commissioner/lnspector of:Bu7dings Date 44 LINCOLN AVE BP-2006-0570 GIs#: COMMONWEALTH OF MASSACHUSETTS Map.-Block:25C-091 CITY OF NORTHAMPTON Lot:-001 Permit: Building Category: BUILDING PERMIT Permit# BP-2006-0570 Project# JS-2006-0831 Est.Cost:$7276.00 Fee: $25.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: NEW ENGLAND SASH INC 104098 Lot Size(sq.1): 8102.16 Owner: SKIBISKI JOHN F REALTY Zoning_URB Applicant. NEW ENGLAND SASH INC AT. 44 LINCOLN AVE Applicant Address: Phone: Insurance: 1331 GRAFTON ST (508) 792-9181 WC WORCESTERMA01604 ISSUED ON.•1111612005 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 11/16/2005 0:00:00 $25.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo 44 LINCOLN AVE . q BP-2006-0570 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 25C-091 CITY OF NORTHAMPTON Lot:-001 Permit: Building Category: BUILDING PERMIT Permit# BP-2006-0570 Proiect# JS-2006-0831 Est.Cost: $7276.00 Fee: $25.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: NEW ENGLAND SASH INC 104098 Lot Size(sq.ft.): 8102.16 Owner: SKIBISKI JOHN F REALTY Zoning:URB Applicant. NEW ENGLAND SASH INC AT- 44 LIN�COL_!- A Applicant Address: Phone: Insurance: 1331 GRAFTON ST (508) 792-9181 WC WORCESTERMA01604 ISSUED ON:1111612005 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: - O►t I I 0b1 OL THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. r' Certificate of Occupancy Si nature: ��fV FeeType: Date Paid: Amount: Building 11/16/2005 0:00:00 $25.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Building Commissioner-Anthony Patillo