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16D-011 (3) F+�•� F.�R- � - � tyJltitl -� Re„rov: izbei,atier rtr,nl Inspeclion; SAVE for future relercnce 1 r,1Je�;;::r 5hleid • . CPDb D50- —172 NFR Model 610 � • Double Hung Dp_ AlumT &km atinq Alum clad hermzi Frame I--•+-rY=•rr•c [..n 3/4 Inch ulS2lttg .. f�trrac�„a� ZD—c .D:Z Low _2 nt=�lt1!;r= A gon r=ill Grill_ in Air Space 1`) ENERGY PERFORMANCE RATINGS U—Fs:1,r Solt:Y:� C}n Caati::nl 0.30 ` 1 .70 0.18 N SA—Pl ( Ir l'oi1 ADDIi, ONAL PERFORMANCE RATINGS r - Ylslbit ir_tsrr;ilt::: Crnl:as:iicn A:sitttr,:: 4.0 0 9 nYIit trnr rip vtla hll ttn ntnpt cmbrn to t•,pntalt 17; . Lz d al.t tsrt a M44 1 .61 en1 Inl 1Q cult rrndttl r:rt. te!rna••^,'r/ .nt irrLutt s,f,i-tt nit VLMA t,t t:t UTUly of�{)n-0$91 d.^7 spcCit vn, :tsvlt mety lY:unr't LLnLn bl ebct/nluc!)trbnn•++ci inkrmt,w, vv.t.ntr-OM ' krtl, of titt[G[ t�,t �•• C.P.C., erd 1.E.Q.C. Jsr Initli[Ylton P•avtr.ments (D rlDt fp�� 1tAtOisLKSI'llttuK%vD11:JLt•1-1t 1 ! .` M..LCSS eta t:+n flout'-es . J e � It_t•tt t„t.-iatlt.ta sz 7L;_t_ t t1i)t5:-ILI :�iD Dec 1914 06:29a P 1 HOME IMPROVEMENT CONTRACT PLEASE READ THIS ,r� ,n j ` Said,Furnished turd Installed by: Branch Name:Boston North&South Date. t`'� THD At-Home Services,Inc. drula The Home Depot At-Home Services Branch Number:31 and 33 906 Boston Turnpike,Unit 1,Shrewsbury.MA 01545 Toll Cree 877-903-3768 Federal rD 4 75-269846(}:ME Lic 8 C 02439:RI Cont.Lich 16427 Cr Lic N HIC.0565522x MA Home mprovement Contractor Reg.M 126893 Installation Address: A F A�A Qt(~" City State Zip Porchawr(s): Work Phone: Home Phone: CellPhwe: [ J I J I ) Home Address: (if different from Installation Address) City State Zip E-mail Address(to receive project communications and Home Depot updates): Q 1 DO NOT wish to receive any marketing emails from The Home Depot Proiect Infortrotion: Undersigned("Customer"'),the owners of the property located at the above installation address,agrees to buy, and THD At-Home Services, inc. (-Me Home Depot")agrees to furnish,deliver and arrange for the installation("Installation")of all materials described an the below and on the referenced Spec Sheet(s), all of which arc incorporated into this Contract by this reference,along with any applicable State Supplement and Payment Summary attached hereto and any Change Orders(coilectiveK. "Contract"): Job k: no "n.ra. ) Products Spec Shmt(s)N: Pro ect Amount Roofing osiding El Windows 0 Insulation 69 [iGcners t Cov:ts CEniry Doors Q Roofing Siding Windows 0 Insulation $ ©Gutters t Covers []Entry Doors Roofing "Sidia,:,n Windows C1 kiwintion 0Gutte,x/Covers [)Entry Doors 0 Roofing 13Silftig Windows htsulation i]Garters,'Covers DErtry Doors ❑ ?vbsimtan25%DepositofCash-adAtnauttdueuponexoartion ofthiscontnrct. Total Contract Amount $ Maine Punitawrs may not deposit more trios orre-third of the Contract Amount Customer agrees t hat,irnmediately upon completion of the work for each Product,Customer will execute a Completion Certificate (one for each Product as defined by as individual Spec Sheet)and Pay any balance due. As applicable, each Customer under this Contract agree,to be jointly and severally obligated and liable hereunder. The Home Depot reserves the right to issue a Change Order or terminate this Contract or any individual Product(s)included herein,at its discretion,if The Home Depot or its authodzed service provider determines that it cannot peribrm its obligations due to a structural problem with the home,environmental hazards such as mold,asbestos or lead paint,other safety concerns.pricing errors or because work required to complete the job was not included in the�Cjontract. Payment Surnmarv: The Payment Summary 4 't 0�3'7 L. included as part of this Contract, sets forth the total Contract amount and payments r equired for the d--posits and final payments by Product(as applicable). NOTICE TO CUSTOMER You sire entitled to a completely filled-in copy of the Contract at the time you sigh. Do not sign a Completion Certificate([tote: there is one Completion Certificate for each listed Product as defined by individual Spec Sheets)before work on that Product is complete. In the event of termination of this Contract,Customer agrees to pay The Home Depot the costs of materials,labor,expenses and services prodded by The Horne Depot or Authorized Service Provider through the date of termination,plus any other amounts set forth in this Agreement or allowed under applicable law. THE HONIE DEPOT MAY WITHHOLD AMOUNTS OWED TO THE HOME DEPOT FROM THE DEPOSIT PAYMENT OR OTHER PAYMENTS MADE, WITHOUT LIMITING THE HOME DEPOT'S OTHER REMEDIES FOR RECOVERY OF SUCH AMOUNTS. Acceptance and Authorization: Customer agrees and understands that this Agreement is the entire agreement bctweca Customer and he Home Depot with regard to the Products and Installation services and supersedes all arior discussions and agreements,either oral or written,relating to said Products and installation.This Agreement be assigned or amended except by a writing signed by Customer and The Home Depot Customer acknowicdges and agrees t t Cu. Omer has rrad understands,voluntarily accepts the t s of and has received a copy of this Agreimmt. f 4,bn,. -uslomer's Signal !orate nt's Sie ature Date X Telephone No. Customer's Signature Date Sales Consultant Liana No. CANCELLATION: CUSTOMER MAY CANCEL THIS tors appiimrlct AGREEMENT WITHOUT PENALTY OR OBLIGATION BY DMINERING WRITTEN NOTICE TO THE HOME DEPOT BY MIDNIGHT ON THE THIRD BUSINESS DAY AFTER SIGNING THIS AGREEMENT. THE STATF, SUPPLEMENT ATTACHED HERETO CONTAINS A FOILNI TO USE IF ONE IS SPECITICALLY PRESCRIBED BY LAW IN ...rc rn.srn+c cm A Tip City of Northampton 212 Main Street, Northampton, MA 01060 Solid Waste Disposal Affidavit In accordance of the provisions of MGL c 40, S54, I acknowledge that as a condition of the building permit all debris resulting from the construction activity governed by this Building Permit shall be disposed of in a properly licensed solid waste disposal facility, as defined by MGL c 111, S 150A. Address of the work: The debris will be transported by. The debris will be received by. Building permit number: Name of Permit A licant korw- Date Nam pp Signature of Permit Applicant �` ,rrri: c..�rr�nturtrl't:cucrl vJ at1r1S'S'C1ClIU5'L'CfS,• � • DeDal'tllfellt Of�1ZdZLSfT ial f4ccider.:j'� Oelce Of II;V°Stioatin��'" 1 Coll;ress R7 ee `lzit 100 •- a BosioriZ117-2017 mass.00v/dia 'Workers' Compensation'ID=h-ranceA.r_ttda-,iL-: BuilderslCOIltraCtO:sfElecti-icianst lumbers �,DVlicant lniorm anon�� please Mnt Lezibiv r Kc71°.�• u:_sslorgz.�:z5on/"tudivid:=1>: %' y �� cr� J //�'i�'��_Y JC�� City/stattfaO Arc you zn'employ:r? Cnc:k the approprizte bo--r • r Type arojea( auired}: I.❑ I zit z :m6),yer ;i:z ' 4. zla z general conuacto�a-id I }P- e'v cons-tretiori c-t?loycc; (lull znd/or part-ti-c).` have Tared the`su�-cDnuacto;s o•• ❑ I ars a sol:propr.aor or pa Wcr- iis:ed on the 7. -Mocling sh p znd hzv:ro :..—,�l ogees These sue-cone acto navy' D--n,DiitiDa , •ao:ii^.•- .....c�a ��y Dapao;7. =r�loy:_s and nave',�'ori;c:s' .. �3t1`1oLnu au:.ii i D I • (]\D'J.'Dil:_:S' :D:TIp:1�SL'ra7:., CD'D. :^�:;12.-rCL.' •. . Do-oD:ztiDa and its. al o:additions �.❑ 1 an Z dDLTh f; ilvo ''i er M L azd,'�':tiavc ro ' -, ,' • employees. TiD wort•°rs'. 13, OL'^.°r����'��1 :DMa. h^r.-znc ecui:°d.) '�°�y zn?iiczat t._.�i:_cls box=! :c-st z�>. .iD J7t❑::._::1J�b:iJ14'SnJK;-'Ip•',_,;w - •. : .• '-. •- � J:1::; •n?:�z:iDa pDii:y.•io-tu:iDn. , Who all wo:1:tad t^._• ousi•.+_y .:.zt_.._d:a'Z:s box most z-,zz-:d zn snDU:ng t'no nz_- ,t_,c - w h: .:r or npt LhJS::iitit s hzw o ab-JJa:�cc;znd~3: -':7I0}':__. '.5:.._..:J-_....:__..,rS I12v:Ja7niD :S�Lh:Y:C19S:y,'JF'1J ...: -l• - - - rCtrl Gil _:7tD.'O1'_� Il:ct s JTOYIdI':� 1V0:1:_:S' , .J_1:,- Nori ,_• .._ . IF;;r� _jcr 1;:y•_ntolc ^s. Below s tl:^Doliry end joq co-parry Name: Poiiry ' or Sa -i^s. Liz. " / -1 _xa-a7on Dal- . -17' yttazh a Dopy of the worker' ;o=ner. anon Polity dcaz.-ation page(showing the policy numb°r znd =Piration crate), :DV=:a cIz, as r:011L:d 'InL. .._:tlon 25 G , ' i a -- A of 1vI L 15? c n 1-zd to imposition of -1 r-n>ltis of z to S1,500.00 zndlor oac-yea; =?:so :at, as A,:ll s zivil^pcazld-s ia ti;-io-n of a STOP WORK ORD-R zad z of up to 5250.00 a day>_ga_st tLe violate:. 3: that a Dopy of tr_s s`a!-^nt r^�y'os forward:d to th:Om:: of - Tzv:s:i.�ZtiD=.S I do i tl:_t..._ :jc^rrc:or. v red c5ove is .^e crtd Corr/�==�= Tat _sc o: 'o .:of i�,. ... ias_, - to 1 ed 5y_ r '.'° =-� 5e_or_o cr :.y o:tax;z oiJ:_.—. i 1,3:2:d DI _:?1`� ✓_ 1-^ a��_^Z:`erg >. �l�'/1 0\1� l l:.-1 _1C_..•:_1 ySDC_tDr �.?l'171binp TnSp_-tor CDr`_a:t Person Boone n: SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Anolicable £ Name of License Holder: j� License Nu er Address Expiration Date Signature Telephone 9.Re istered Home.lm rovement Contractor Not Applicable £ Comr)ahv Name Registration Numbe r ss Expiration Date Telephon SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.162,§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 per Signed Affidavit Attached Yes..... No...... £ 11. - Hame Owner Exemption. 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 W' Alteration(s) ❑ Roofing Or Doors Accessory Bldg. ❑ Demolition ❑ New Signs [O] Decks [C] Siding [o] Other[❑] Brief Descri Work: Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet 6a,if New house and or addifion to existing housinct, 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 I, /���^ , as Owner of the subject property hereby authorize to act on my behalf, in all matters r lative to work authorize by this building permit application. Signature of Owner Date 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 and pai and pe alties of e ' . Print Na Sign W—of /Agent Date Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning TIiis column to be filled in by Building Department Lot Size Setbacks Front Rear F-1 Building Height Bldg.Square Footage Open Space Footage % (Lot area minus bldg&paved L—J #of Parking Spaces (volume&Location) A. Has a Special Permit/Variamce/Rndinqever been issued for/on the site? x�� -� x�� \Y v�� � NO «�/ DON7KNO YES x�� IF YES, date issued:! ) IF YES: Was the permit recorded at the Registry nfDeeds? NO DONlKNUY 0 'ES _0__ _- IF YES: enter Book Page and/or Document# B. Does the site contain a brook' body of water nrwedands? NO 0 DONT KNOW 0 YES 0 IF YES, has permit been or need to be obtained from the Conservation Commission? Needs tubeobtained �~t Dbtained x�� Date � \�/ �~� ' C. Dn any d ��signs on the property? YES �_/ NO IF YES, describe size, type and iocation: D. Are there any proposed changes to or additions of signs intended for the property? YES 0 NO 0 IF YES, describe type ( � ' ' . __---_ --------_______-_-....___.........______-..........______� E. VW||the construction activity disturb(clearing, gradingexcavation,or filling)over 1 acre oriait 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. ^ — ` � pepartr�tent use onlx i F ' City of Northamptontattas of Perrrrt, 4 h�' ' u A i O�0 i S l\ I,a, Psi a 15r a s I G` Building Department CtrrB Cut/Driyeway Permtt F 212 Main Street SewerfSepttcAvai�atilltty Room 100 Wet�riVktetlRvailability t Northampton, MA 01060 Two,Sets c�> 5trttctural Plans I phone 413-587-1240 Fax 413-587-1272 PlotlSite Plans F APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION UBtil Thts section to be''completed by office 1.1 Property Address: Map_ Lot Urnt Zone Overlay Distract `` Elm St District CB District ' SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: qw, 62- Name( rint) Current Mailing Addr ss: Telephone Signature 2.2 A orize A ent: Name(P' Current Mailing Address: Name Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant 1. Building ,[ (a)Building Permit Fee �v 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 4 GREELEY AVE BP-2015-0708 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 16D-011 CITY OF NORTHAMPTON Lot: -000 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: window replaced BUILDING PERMIT Permit# BP-2015-0708 Project# JS-2015-001370 Est.Cost: $1171.00 Fee: $35.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: HOME DEPOT AT HOME SERVICES 105953 Lot Size(sq.ft.): Owner: BERGER DAN H C/O PRABHA SUBRAMANIAN Zoning. URB(100)/WP(5)/ Applicant: HOME DEPOT AT HOME SERVICES AT. 4 GREELEY AVE Applicant Address: Phone: Insurance: 5 RIVERVIEW DR (401)935-2633 O Workers Compensation NORTH PROVIDENCER102904 ISSUED ON:11612015 0:00:00 TO PERFORM THE FOLLOWING WORK.INSTALL REPLACEMENT WINDOW 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 1/6/2015 0:00:00 $35.00 212 Main Street,Phone(413)587-1240, Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner