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SIDING 0 Contractors/Reprocessed Q Dealers/Co-Extrusion 0 Specialty/Virgin LI Polymer/Lifetime Transferable
Grade Size Color
Insulation U Tyvek ja Polar Board U High Density Poly Stirene/Green Board
C
Strip YES U NO NP Gable Vents(Louvers) YES QV, NOLI
J Blocks&Dryer Vents YES til NO Cl Porch Interim YES LJ NO LI
I Color
Shutters YES U NO 9 #of Pairs Louvered or Raised Panel
Gutters&Downspouts YES I$ NO 0 L]Lite CiHeavy(Seamless) '` ;r ry r_�, r
-
ALUMINUM TRIM Wrap Window&Door Casings(PVC with Anderson Bends) Color-Wrap windows&Door Casings(Flat Coil) Color Lu
SOFFIT FACIA Used Vented Soffit? YES LI NWU Color Cover Porch Ceililng? YES R_ NO Q Wrap Beams&Posts YES LI NO LI
Locations
WINDOWS Type Slimline Montdaire-Grids YES LI NO Q Configuration
How Many D/H-2 LS- KS- CAS_ HOP- BOW(4 or 5 lite)_ Bay- AWN
Casings Covers YES U NO El U Flat Coil El PVC with Anderson Bends Color
DOORS Steel Core Entry#- Style_ Storm-#Style
ROOFS Shingle LI Strip LI 0 Color Ice Barrier YES Ll NO 0 Ridge Vent YES LI NO LJ
We Propose hereby to fumish materials and labor-comple"In accordance with ve specificatio s for the sum of:
0
4
jf j ij,
dollars($ j
ACCEPTANCE OF PROPOSAL:The above prices,specifications and conditions are satisfactory and are hereby accepted.You are authrolzed to do
work as specified.Payment will be 113 down at start of job,and balance due upon completion.
11
Phone#
Date: Signature:
www.sturdyhome.com All home improvement contractors and subcontractors
®YP.O.Box 51033•Springfield, MA 01151 engaged in home improvement contracting,unless specifically
�i exempt from registration by Provisions of Chapter 142A of the
A o F i r+ SIDING W t N o 0.5 general laws, must be registered with the Commonwealth of
1-877-3-STURDY Massachusetts.Inquiries about registration and status should
413-543-1681 be made to the Director, Home Improvement Contract
Registration,One Ashburton Place, Room 1301, Boston, MA
MA.REG.#143777 Member Better Business Bureau 02108 (617)727-8598
CT. REG.#601525 Fully Licensed&Insured
PHONE DATE
Submitted to:
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SIDING ❑Contractors/Reprocessed ❑ DeaIemCo-Extrusion ❑Specialty/virgin O Polymer/Lifetime Transferable
Grade ` ti. w," Size c.s Color
Insulation O Tyvek Q,Polar Board ❑High Density Poly Stirene/Green Board E
YES O NO fr Gable Vents(Lowers) YEStr NOD
Strip '
J Blocks&Dryer Vents YES M' NO O Porch Interiors YES❑ NO❑
Shutters YES O NOb #of Pairs Color Louvered or Raised Panel
Gutters&Downspouts YES 91 NO❑ O Lite dHeavy(Seamless)
ALUMINUM TRIM Wrap Window&Door Casings(PVC with Anderson Bends) Color Wrap windows&Door Casings(Flat Coil) Color =,1r€_' r`+ '
•,la.�_ _ d "V 'iY.'1'"w�.G+mw'$ 114JI ./
- _ Board of Building Regula ions and Standards
- - One Ashburton Place - Room 1301
Boston, Massachusetts 02108
Home Improvement Contractor Registration
Registration: 151711
Type: Private Corporation
Expiration: 626/2008
STURDY HOME IMPROVEMENT
ADAM LUCEY
PO BOX 51033
INDIAN ORCHARD, MA 01151
Update Address and return card.Mark reason for chau.iae.
Address Renewal Employment Lost Car(!
PS-CA1 0 50M-05/06•PC8490
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Board of Building Regulations and Standards License or registration valid for individul use only
HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to:
Registration 151711 Board of Building Regulations and Standards
One Ashburton Place Rm 1301
Expiration: 6/262008 Boston,Ma.02108
Type: Private Corporation
STURDY HOME IMPROVEMENT
ADAM LUCEY
34 FRONT ST
INDIAN ORCHARD.MA 01151 Deputy Administrator Not valid without signature
07/02/2007 13:37 FAX 413 543 4918 UXGBAKD 1NSUKA@I b I�uut pavoom
CERTIFICATE OF LIABILITY INSURANCE 07/at 7.
Pno (413)543-3344 FAX 4131)843-4e91a t7 C iPlCA 1SRO hS UPON MST'RON
1 PPM SYREET AGENCY HHOLDDEIL TIM CERTMAT6 DOES MT OR
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P.O.am 51088
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n� 5 ralveloent. Inc. t MAMA: W@StSM W004 Ins.
P.O. Box S1033 Its: Granite Std durance Co-
Lathan Orchard. MA 01151 ua:
sQ:
I'ME POLMS OF DURANCE LffnED 88-OW HAVE SEEN ISSUED TO TM VMM 1 AAA W ABOM FM THE POUCY PERIOD 00"TED-HO7VWff R TNVlNG
ANY REQUOMENT.TERM OR CumunrIDN OF ANY ComT AGT OR OTNl:9t DOCU Pfr WITH RESP[CT TO WHICH 7M CERTOWATE MAY BE 1 MIM OR
MAY PERTAIN.THE FAIRAWCE AFFORDIM BY THE POLCISS DESCMM HERM 15 r'rO ALL TM T8*0,EXCLUSK NS AND CONOrTIONS OF SUCH
POLICIES.AGGREGATE LJl n SHOWN wAY HAVE!'f> : REDUCED BY PAD CLAIIBS.
mwt TAMOFMMUROMM laucrmu om ICY Lam
vism LUSeasTY NPM79233 08102/2886 8810W007 "C" s 1.000,000
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ACORD 25( owtmg) Fat (413)343-3200 41At�RD t�OR/►TK�ti 9888
i
The Commonwealth of Massachusetts
Department of Indushid Accidents
Office of Investigations
600 Washington Street
Boston,MA 02111
www massgov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
,Applicant Information ) Please Print Lezibly
Name(Business organization/lnaividtud): 4 C. ^ i"
Address: � �
City/State/Zip: ( ���' l Phone#: �2S 2/-� J3 (L
Are an employer?Check the rate box: Type of project(required):
1 I YOU
a employer with-J7 4. ❑ I am a general contractor and I 6. ❑New construction
employees(full and/or part-time).* have hired the
2.❑ I am a sole proprietor or partner- listed on the attached sheet.t 7.�"Remodeling
ship and have no employees Theme sub-contractors have 8. El Demolition
working for me in arty capacity. w��'gip.insurance. 9. ❑Building addition
[No workers'comp.insurance 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions
required.] officers have exercised their
3.111 am a homeowner doing all work right of exemption per MGL 11 E1 Plumbing repairs or additions
myself.(No workers'comp. c. 152,§1(4),and we have no 12.❑Roof repairs
insurance required.]t employees.(No workers' 13.❑Other
comp.insurance required.]
*Airy applicant dW checks box#1 must also fill out the section below showing 8ieir wwkers'aompensation policy information.
t Homeowners who submit this affidavit indicating they are doh all wwk and then hire outside contactors must sWxmit a new affidavit indicating such.
:Contractors that cbeck this box must malted an additional shat showing the name of the sub�xs and their werkas'M np.policy won.
lam an enpkgoer that is provh ft workm' hwuraawe for uy en*1"eeL is the policy and job site
inform don.
Insurance Company Name:
Policy#or Self-ins.Lic.#: E on Date:
Job Site Address: City/state/Zip:
Attach a copy of the workers'compensation policy declaration page(showing the policy armber 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 ono-year imprison mwt,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 the pains and penalties of perjury that the infornatlion provided above is true and correct
Signature: �--? Date:
Phone
offidd use only. Do not write in this area,to be compiled by city or town offi*i
City or Town: PermitUcense#
Issuing Authority(circle one):
1.Board of Healtb 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 Supervisor: Not Applicable
Name of License Holder: �_
J license Number
Address t ! Expiration Date
Signature Telephone
8.Registefed Home Improvement Contractor: Not Applicable ❑
Company Na@e _ Registration be
Address , t J / ry Expiration Date
AAA./ r� �J�-� -� t Telephone/.<�1� r
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. - Home Owner Exemption
The current exemption for"homeowners"was extended to include Owner-occupied Dweltings of one(l) 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 7801 Sixth Edition Section 1 08.3.5.1.
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 heath)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 F__J Addition E] Replacement Windows Alteration(s) F__J Roofing
Or Doors
Accessory Bldg. 0 Demolition New Signs [O] Decks t0 Siding j Other[L7J
Brief Description of Proposed
Work: (� ( °l ��f%�� �1 si `f -'� �; t T/'t. 5j z "� n�.�;C?
Alteration of existing bedroom Yes No Adding new bedroo Yes No
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll -Sheet
6a.If New house and or addition to existing housing, complete 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
as Owner of the subject
property
hereby authorize t try
to act on my behalf,in all matters relative to viork authorized by this bui ing permit application.
Signature of Owner Date
1 • ,fir
4'_ a. .ierlAuttwrized
Agent hereby declare that th sta nts and information on the forerfing application are true and accurate,to the best'otmyimoWMTge
and belief.
Signed under th ains and per►alties o
7-F '
Print Name
Signature of Owner/Agent Date
Section 4. ZONING All Information Mint Be Completed.Permit Can Be Denied Due To Incomplete Information
Existhig, Proposed Required by Zoning
This column to be filled in by
Building Department
Lot Size
Frontage
Setbacks Front
Side I,: R: L: R:
Rear
Building Height
Bldg. Square Footage %
Open Space Footage %
(Lot area minus bldg&paved
parking)
#ofParking Spaces
Fill:
(volume&Location)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO 0 DONT KNOW YES O
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DONT KNOW O YES O
IF YES: enter Book Page and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO DON T KNOW O YES O
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained O Obtained Q , Date Issued:
C. Do any signs exist on the property? YES O NO
IF YES,describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property? YES a NO
IF YES, describe size, type and location:
E. Will the construction activity disturb(clearing,grading,a avation, or filling)over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES Q NO
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
z
Department use only
City of Northampton Status of Permit:
Building Department Curb Cut/Driveway Permit
212 Main Street Sewer/Septic Availability
Room 100 Water/Well Availability
Northampton, MA 01060 Two Sets of Structural Plans
Phone 413=587-1240 Fax 413-587-1272 Plot/Site Plans
a Other Specify
APPLI MN TP T,ALTER,REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION
1.1 Property Address: This section to be completed by office
Map Lot Unit
Zone Overlay District
Elm St.District CB District
SECTION 2-PROPERTY OWNERSHIPIAUTHORIZED AGENT
2.1 Owner of Record: _
a
Name(Print) Curre M ilia re c
G- -
_ (Zi � aC <
Telephone
Signature
2.2 Aulhorized Agent.
Name(Pri Current Mailing Address:
SignatLW Telephone
SECTION 3-ESTIMA CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
com feted by rmit 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=0 +2+3+4 +5) Check Number
This Section For Official Use Only
Date
Building Permit Number: Issued:
Signature:
Building Commissioner/Inspector of Buildings Date
#w— BP-2008-0096
GIs#: COMMONWEALTH OF MASSACHUSETTS
AM9 �.� �� 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-2008-0096
Project# JS-2008-000149
Est. Cost: $35000.00
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: STURDY HOME IMPROVEMENT 151711
Lot Size(sa.ft.): 6577.56 Owner: GOLOB BERNARD M
Zoning:URB Applicant: STURDY HOME IMPROVEMENT
AT. 159 BRIDGE ST
Applicant Address: Phone: Insurance:
P O BOX 51033 (413) 543-5906 WC
INDIAN ORCHARDMA01151 ISSUED ON:7127120070:00:00
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: Date Paid: Amount:
Building 7/27/2007 0:00:00 $25.002048
212 Main Street,Phone(413) 587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo