32A-058 (8) ld%k*-
}lrlpanre dome hniF► .�.ner
Tel(413)331-0357,(413)883-3802
Fax(413)331-4358
Email:seraiv@alliancehomemc.com
www.a Ilia ncehomei nc.com
I request that you grant a modification to waive the requirement for control construction for the
replacement of 3 windows at 50 Union St Apt#22 in Northampton, because the work is of a minor
nature,will not affect health, accessibility, life and fire safety,or structural requirements and is
impractical in that the cost of control construction is considerable when compared to the cost of the
proposed work.Thank you for your consideration. "Mass Amendments, sections 107.1 allows for an
exclusion from control construction for this project"
Respectfully,
Sergiy Suprunchuk
Alliance Home Improvement Inc
536 East Main St
Chicopee MA 01020
lll�i(1A. All home improvement contractors and subcontractors engaged in
home improvement contracting, unless specifically exempt from
registration by Provisions of Chapter 142A of the general laws,
16%W V�� � must be registered with the Commonwealth of Massachusetts.
Inquiries about registration and status should be made to the
,oWJaancL-if®rrae lrr�pnaaa�a r����
f Director. Home Improvement Contract Registration, One
F a.yaurta.aor auaamaurnaaa..
Ashburton Place,Room 1301,Boston,MA 02108(617)727-8598
536 East Main St.
Chicopee,MA 01020
Phones:(413)883-3802
(413)331-31-4358 you Cdn pay more,but you Cari't buy bees\^ MA Lic#154218 CT Lic#0635847
www.AllianceHomeinc.com
-SIJBIMITTEDTO: C u.. 'I LA f 1 6`1 Irk�Vir)Cphone: ,�'7 "I �I V Cell:
�Vvi,%Qlvl 6S Ii
1
Email: _ t� Gi WiG� t' 6
We her dy s bmit sp cJfi ations..arld estimates for. ork to be performed and materials to b sed I
1 v Li ti L r L 1/
- /
0 L41 r 1
t.
,I Iri
(.a
Ikr
❑Aluminum Trim ❑Alliance Trim ❑Flat Coil ❑PVC Coil ❑G8 Coil Color: ❑Corners Color: —
INDOWS Grids:❑YES *0 ❑Flat ❑Contour ❑Colonial ❑Diamond ❑Other:
:]How many?� ❑D/H ❑PIC_ ❑2LS ❑3LS_ ❑Csmt ❑2Lt/CSmt ❑3Lt/Csmt_
❑AWN ❑HOP ❑BOW(4 or 5 lines) ❑Bay Full Screen: YES ❑NO
❑Wood grain Interior: Color: Exterior Color:❑YES NO Color: Mull:❑YES ❑ 0 ❑How many?
❑Glass Option: Type: 61imaTech ❑ClimaTech TK2 ❑ClimaTech TG2
❑ENTRY DOOR:❑YES O ❑Type: ❑Style:
❑STORM DOOR:❑YES VNO ❑Type: ❑Style:
F-1 Material Location: ❑Waste Disposal:
WORK SCHEDULE
P/gp�s d 5ta a mpf on,Sc ule-The following schedule will be adhered to unless u6 antes d the roccj�d�stontrol arise:
u/ / Date when contractor will begin contracted work. "/ —'Date when contracted work will be substantially completed.
Contracted work may not begin until both parties have received a fully executed copy of the contract,and the three day rescission period has expired.The Owner hereby acknowledges and agrees that the scheduling dates
are approximate and that such delays that are not avoidable by the Contractor including,but not limited to strikes,Acts of God,shortages of materials,accidents,and all other delays beyond its control,shall not be
considered as violatiog this grjement.
NTY T�
WARRA I\,AP—
All materials have 1 Warranty or as otherwise specified by manufacturer.Labor and workmanship have a warranty of one full year from the date of installation.
All work to be completed in a workmanlike manner according to standard practices.Any alteration or deviation from the above specifications involving extra costs will be executed only upon written orders,and will
become an extra charge over and above the estimate.
PAYMENTS We propose hereby to furnish ma i la /-�gcom e in accordance with
Payments to be made as follows: abo specciificatio Jforr the su
%($ )upon signing Contract; 1/ ^ �" L� l
upon delivery?£.
1 �oo/� h� /
E-�`°I$ � )upon iobCOm`Pletio J� �'�'-i`- ter, Name of Salesman /v- �)/ -�
ry($ )shall be made forthwith upon 2(� g JJ' -2,�
completion work under this contract. Authorized Signature t
The customer hereby understands and agrees to pay finance charge of 1.5%per month(or annual percentage rate of 18%)on the outstanding balance not paid wi 30 days aftepl9pletion of work.All payments
received after 30 days after completion of work shall be applied first to unpaid finance charges and then to outstanding balances.In the event of default,custoar hereby unde nds and agrees to pay,in addition to the
outstanding indebtedness,all costs associated with collection including reasonable attorney's fees.
Acceptance of Proposal:I ha�e read both sides of this document and accept the prices,specification and conditions stated.I understand that upon signing,this proposal becomes a binding contract.You are authorized to
do work as specified.Pa nts will be made as outlined above.You,the Buyer,may cancel this transaction at any time prior to midnight of the 3rd business day after the date of this transaction.Cancellation must be done
in writing. DO NOTES T�HIIS CO/NTRACT IF THERE ARE ANY BLANK SPACES.
Signature Y y Date I w Signature Date
NOTICE OF CANCELLATION:YOU MAY CANCEL THIS TRANSACTION,WITHOUT ANY PENALTY OR OBLIGATION,WITHIN THREE BUSINESS DAYS FROM THE ABOVE DATE.IF YOU CANCEL,ANY PROPERTY
TRADED IN,ANY PAYMENTS MADE BY YOU UNDER THE CONTRACT OR SALE,AND ANY NEGOTIABLE INSTRUMENT EXECUTED BY YOU WILL BE RETURNED WITHIN TEN BUSINESS DAYS FOLLOWING RECEIPT BY THE
SELLER OF YOUR CANCELLATION NOTICE,AND ANY SECURITY INTEREST ARISING OUT OF THE TRANSACTION WILL BE CANCELLED.TO CANCEL THIS TRANSACTION,MAIL OR DELIVER A SIGNED AND DATED COPY
OF THIS CANCELLATION NOTICE OR ANY OTHER WRITTEN NOTICE,OR SEND A TELEGRAM TO:ALLIANCE HOME IMPROVEMENT,INC.,536 EAST MAIN ST.,CHICOPEE,MA 01020
(Date.Sunday and holidays excluded) I HEREBY CANCELTHIS TRANSACTION (Buyers Signature) )
f� 1 .211 Ta. ' /' ��� ��
The Commonwealth of Massachusetts
Department of Industrial Accidents
_ a Office of Investigations
z; 600 Washington Street
Boston, MA 02111
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
1
Name(Business/Organization/Individual): t l �/ i t�1.� �✓ ���-�G _ 44
Address: �� �� S M&Lw ✓1
� r
City/State/Zip: c c Phone#:
Are you an employer?Check he appropriate box: Type of project(required):
1.❑ I am a employer with 4. F-1 I am a general contractor and I
employees (full and/or part-time).* have hired the sub-contractors 6. ❑New construction
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, F-I Demolition
working for me in any capacity. employees and have workers' 9. ❑Building addition
[No workers' comp. insurance comp. insurance.1 .
required.] 5. We are a corporation and its 10.0 Electrical repairs or additions
3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions
myself. ' . right of exemption per MGL
Y �o workers comp. 12.❑Roof repairs
insurance required.) t c. 152, §1(4),and we have no \
employees. [No workers' 13. ] Other (� C�
comp. insurance required.)
'Any applicant that checks box 11 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 anew affidavit indicating such.
,Contractors that check this box must attached an additional sheet showing the nacre 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: C 1 rCz'C', C✓P Cc,CIA
Policy#or Self--ins.Lic.#: UJ `� U"�v'�G �> Expiration Date: 121LS
Job Site Address: _1 z v`'t G( t G'r N
_ � City/State/Zip:
Attach a copy of the workers' compensation policy declaration age(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 D msur coverage verification.
I do hereby c t nder t ze penalties ofperjury that the information provided above is true nd cor
Signature: Date: t)112 `�
Phone#: L 3 _ 3
FOther e onli. Do not write in this area, to be completed by city or town offcciaL— wn: -_- _ __ _- Permit/License#
thority(circle one):
Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
onacerson: Phone#:
Version 1.7 Commercial Building Permit May 15, 2000
SECTION 10-;STRUCTURAL PEER REVIEW(780 CMR 110.11;)
Independent Structural Engineering Structural Peer Review Required Yes No
SECTION 11 -OWNER"AUTHORIZATION-TOsBE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I, ... __:_. . .. ....._ _ w__ _. .__ __M.... as Owner of the subject property
hereby authorize _.__..._...m _ .M-, .,_.... .. , . .. _.......
act on my behalf, in all matters relative to work authorized by this building permit application.
Signature of Owner Date
as Owner/Authorized
Agent hereby declare that the state ents and information on the foregoing application are true and accurate,to the best of my knowledge
and belief.
Signed under the p4is§, en I
L
ArinN /f caner/ ent Date
SECTION 12-CONSTRUCTION.SERVICES -
10.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder.'. .. .. ..... .. . .__ L L�J 1 _.. _ .,. _ /.D..._1.. `�..._. ..
License Number
2,C � ..
A ess. Expiration Date
Signatur Telephone
SECTION 13'-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 0
Versionl.7 Commercial Building Permit May 15,2000
SECTION 9-PROFESSIONAL DESIGN AND CONSTRUCTION'.SERVICES-,FOR BUILDINGS AND STRUCTURES SUBJECT TO
CONSTRUCTION CONTROL PURSUANT TO 780 CMR 116(CONTAINING MORE THAN 35,000 C.F.OF ENCLOSED SPACE)
9.1 Registered Architect:
.. ._.._.. _..._._.. _....,.__....._.__._....._. ._�__.,�....__,__..w...___,,�__._.._�.._,..�..._....�._..�„_._.._.� Not Applicable ❑
Name(Registrant):
Registration Number
Address
Expiration Date
Signature uTelephone ._
9.2 Registered Professional Engineer(s):
Name Area of Responsibility
_............-_._._,_ ...._..___ ....._.,,
Address Registration Number
Signature Telephone Expiration Date
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
Name Area of Responsibility
Address Registration Number
_.._.._.._____._ _....0 _._..._.__..._...._............ .....
Signature Telephone Expiration Date
_..._..._ _w._.._ .____.
-.....
Name Area of Responsibility
Address Registration Number
_._... _._._._. ...
Signature Telephone Expiration Date
9.3 General Contractor
1.
Not Applicable ❑
Company Name
ResponsibM In Marge of Const tion
_Addr_ss �-
Signature Telephone
Version 1.7 Commercial Building Permit May 15, 2000
8. NORTHAMPTON:ZONING
Existing Proposed Required by Zoning
This column to-se filled in by
Building Department
Lot Size
Frontage
Setbacks Front
Side L. __, R.:_.__„_ L:L R:1-----
Rear
Building Height .. W”
Bldg. Square Footage _....., %
Open Space Footage %
- (Lot area minus bldg&paved
#of Parking Spaces I
Fill:
(volume&Location)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO DONT KNOW 0 YES 0
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DONT KNOW 0 YES 0
IF YES: enter Book Pager _ and/or Document#,
B. Does the site contain a brook, body of water or wetlands? NO v DONT KNOW YES
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained , Date Issued:-
C. Do any signs exist on the property? YES NO
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
_ 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 0 NO
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
Version 1.7 Commercial Building Permit May 15,2000
SECTION 4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000
CUBIC FEET OF ENCLOSED SPACE ==
Interior Alterations ❑ Existing Wall Signs ❑ Demolition❑ Repairs❑ Additions ❑ Accessory Building❑
Exterior Alteration ❑ Existing Ground Sign❑ New Signs❑ Roofing❑ Change of Use❑ Other
Brief Description 'Enter a brief description here.
Of Proposed Work:
SECTION 5-USE GROUP AND CONSTRUCTION TYPE
USE GROUP(Check as applicable) CONSTRUCTION TYPE
A Assembly ❑ A-1 ❑ A-2 ❑ A-3 ❑ 1A ❑
A-4 ❑ A-5 ❑ 1B ❑
B Business ❑ 2A ❑
E Educational ❑ 28 ❑
F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑
H High Hazard ❑ - --- 3A ❑
Institutional ❑ 1-1 ❑ 1-2 ❑ 1-3 ❑ 3B ❑
M Mercantile ❑ 4 ❑
R Residential ❑ R-1 ❑ R-2 ❑ R-3 ❑ 5A ❑
S Storage ❑ S-1 ❑ S-2 ❑ 5B ❑
U Utility ❑ Specify:
M Mixed Use F-1 Specify
SSpecial Use ❑ Specify:��...-.a..�.._.�,�.•.�„wa....w....��.o._..s.._,.,� - ��.c __-,,_.�.,..._ .��w�-_.._,._� .�._._� .,_n_.,e,
COMPLETETHIS SECTION IF EXISTING:BUILDING UNDERGOING':RENOVATIONS,ADDITIONS AND/OR;CHANGE IN USE
Existing Use Group _ ___.. _........ __._..... __...._ _..._ Proposed Use Group:
Existing Hazard Index 780 CMR 34) ,,.,,,_.-... _ Proposed Hazard Index 780 CMR 34): _..,,_., _.,•
SECTION 6 BUILDING HEIGHT AND AREA
BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY
Floor Area per Floor(so
_ 1st
1sr
2nd 2nd .
3rd 3rd
4 n 4m
Total Area(sf) Total Proposed New Construction(sf)
. . ......... _._.. ........
Total Height(ft)
---- - Total Height ft
7.Water Supply(M.G.L.c.40,§54) 7.1 Flood,Zo ne
. ,Information: 7.3 Sewage Disposal System:
Public E] Private ❑ Zone Outside Flood Zone❑ Municipal ❑ On site disposal system❑
Version 1.7 Commercial Building Permit May 15, 2000
Department use,only
F,,.�i City of Northampton status of Perrnit
L � Building Department Curbt�uf/Dnueway Perrnrt
` 212 Main Street Sewer/Septiq,vailabifity-
JAN
2 2 Room 100 W6ter/We11 Avallablhty
Northampton, MA 01060 Two Sets of StructuraC Plans
Elect ic.
speoMh 413-587-1240 Fax 413-587-1272 Plof/sit
e Plans
1,,lA 01060
Other•Specify
APPLICATION TO CONSTRUCT,REPAIR,RENOVATE,CHANGE THE USE OR OCCUPANCY OF,OR DEMOLISH ANY BUILDING
OTHER THAN A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE
IN
1.1 Property Address: This section to be completed by office
10t .22 Map Lot Unit
/Y d 4kc(-� Zone Overlay District
- Elm St:District` CS District`
SECTION 2 PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record
------
Name(Print) Current Mailing Address
�1 Al
Signature Telephone
2.2 Authorized Agent:I �
Name(Print) (� Current Marling Address: _,
Signature Telephone
SECTION 3'-ESTIMAT D'CO STRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by ermit applicant
2
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 w.... __
6. Total=(1 +2+3+4+5) Check Number
This Section Foe Official Use Only.
Building Permit Number Date
Issued
Signature:_ _
Building Commissioner/Inspector of Buildings Date
File#BP-2015-0750
APPLICANT/CONTACT PERSON SERGIY SUPRUNCHUK
ADDRESS/PHONE 536 EAST MAIN ST CHICOPEE01020(413)883-3802
PROPERTY LOCATION 50 UNION ST-UNIT 22
MAP 32A PARCEL 058 000 ZONE URC(100)
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid
Tyaeof Construction:_INSTALL 3 REPLACEMENT WINDOWS
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 104327
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFO ATION PRESENTED:
Approved Additional permits required(see below)
PLANNING BOARD PERMIT REQUIRED UNDER:§
Intermediate Project: Site Plan AND/OR Special Permit With Site Plan
Major Project: Site Plan AND/OR Special Permit With Site Plan
ZONING BOARD PERMIT REQUIRED UNDER: §
Finding Special Permit Variance*
Received&Recorded at Registry of Deeds Proof Enclosed
Other Permits Required:
Curb Cut from DPW Water Availability Sewer Availability
Septic Approval Board of Health Well Water Potability Board of Health
Permit from Conservation Commission Permit from CB Architecture Committee
Permit from Elm Street Commission Permit DPW Storm Water Management
n el
Signature of Building O ficial Date
Note: Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning
requirements and obtain all required permits from Board of Health,Conservation Commission,Department
of public works and other applicable permit granting authorities.
* Variances are granted only to those applicants who meet the strict standards of MGL 40A. Contact Office of
Planning&Development for more information.
50 UNION ST-UNIT 22 BP-2015-0750
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 32A-058 CITY OF NORTHAMPTON
Lot: -000 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL 042A)
Category: windows replaced BUILDING PERMIT
Permit# BP-2015-0750
Project# JS-2015-001455
Est. Cost: $2295.00
Fee: $55.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: SERGIY SUPRUNCHUK 104327
Lot Size(sq. ft.): Owner: KHABIBULLINA GALIYA
Zoning URC(100)/ Applicant. SERGIY SUPRUNCHUK
AT. 50 UNION ST - UNIT 22
Applicant Address: Phone: Insurance:
536 EAST MAIN ST (413) 883-3802 WC
CHICOPEEMA01020 ISSUED ON.112312015 0:00:00
TO PERFORM THE FOLLOWING WORK.-INSTALL 3 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 1/23/2015 0:00:00 $55.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner