38B-233 (6) Renewal
KIP
byAndersena -•=•
WINDOW' REPLACEMENT anMdetaent omganp
WoodNinyl Composite IF
Dual Argon Low E4 SmariSun
Double Hung
100-00473518-010
ENERGY PERFORMANCE RATINGS
U-Factor(U.S)/I-P Solar Heat Gain Coefficient
9 . 2 9 9 . 19 -
ADDITIONAL PERFORMANCE RATINGS
Visible Transmittance
a . 42
Manuhcturer copulates that these ratings confomt to epp4:ahU NFAG procedures for determining whole product
padorntsnee.NFAC rathtgsare determined fors faad amt o1 environmental condab..and a specs::product sae.
NmC does not recommend any product end does not warrant the auilahisy of any product for any specific use.
Coosua manutecturar's Worst—for what product performance Irtterma600.
♦ WWW.nttc.olg
' k >F This product meats Green
' Sears environmental �''-'�'•'...''�
standards ro' ener •+^°+ �.... .
eflieiency,heavy matab in yy-,s
'••.
the Itama and sash nk�;:�.:,•a>y,,�;�'y,j :-
material.pukaging,and ®' ;Yi:
iG�consumar educalbnal ,;':;y.;?;�t:.•i�.'`���rt"
G tr materials.
.w.------r
DESIGN PRESSURE(PSG MW I -1
h"n"w aew'o°aeacemtim
e 1
H-LC25 S wwwucaw�nta.
RbA D8 Sloped Sill DH IN
Testid roll AF5ffiaANtANJDI,WCSI�t01AS1A110LS I htarsdachrer st tes oonfonnum to tae spoticatua scumarns.
deers or exceeds M.E.C.,C.E.C,81.E.C.C.Air InWration requirements WDMA Nalmark Cartftsdiwt program.
Rene al Renewal by Andersen Corporation MA~tome Inlprwernent Contractor
�,Mder s �1 t :30 Forbes rd Northborout h,MA 0153' License#170810 (Expires 12,+23t2015)2*1
WIN40W aKPt.A#SMCNT •,..n .. f-`08i 351.2:200 Fax:(508)-886-7072 Federal ID a41-19184-13
Window Specification Sheet
litk�a't � 1,tr3t€° i7aic)Er! 1�;rc�c;raettt
JOSEPH SHARP BARBARA SHARP TuE, JAN 20, 2015
1ktVki lllg t'Iiri IOIillinIT8 atE;. aF-1 F'E;i l?l 'agtl rP to dtr g,r ld,.allsi�III ,c[�.H c',li'led k loli•,in ml c IILi t e lx1I$i I plik os la III It'14It W"-
on&III`Sizeitteati,in Sit,I-i and'itaetivr111amith tv',Cix,E ctt'tla, I,(trrtt)r.m±iwg ta.`` 11)3111IND(ilt'_4\IIIA )I+.Ii.l'A ft)1}I.I AN(iVilkt?<hAILA1,ill'ti,hier}a
lit a(:t+e itn 3uteate i;r,t t la plist.
WINDOW&DOOK DETAILS
FPG- ^,v n€� .n EYtflrEi7E lit,rcir C,a6tx 3 Hsrx arcs K i G1 �a v,Il. to Gass
F{.,p sa of :.rn u, e u uYfWnu¢C)erctr SttSa t,etal urxsar Ext int rrur ty+a ae.s 4«aE isF rlie. .assF� aasr Lrfie to nwsnx
...�. _.... ....,. .,.. .__.
#_ivtt1+ l t±r) afE €ai) CP0 su rail eyCrai lrrsttrt 56ppt3d ts¢i7 Irtt_Pme GNXV Cana. Standard FFF:i rcrm..8u #r.aw Yes
_ .�_ ..e.e. ...__.....en ..m
Lav#i'In t i r2 10 9,0 90 OB si ml 9t lI trE3L11 sE�•"I lot.Pine GN C tr Canvas t t rot 1 r.r F L"^G Srt,
_ k.avi. €(Yl; 27 pit) 87 06 sq rall 2S allrcac'st 9s e,t k3 Int.Fine (iPt cv Canvas Si,wnaarr
Living kil 'tti tat) 98 Do sq rail wj al tesaaw stmt slit triL Pine k1Pi Cv Canvas tSt-arrd i 3di FFfa f4r c
iivtru to-I b. tea) 87 tie s(1 , c< a } PCtdn if St rl4 n� -. ._
� $tn arz t ki 2 t ) 87 faE a alnat Int.Pine GN LV Canvas � _ ..�..�.,
Yes
k Bed t [ttl Sit tit) sqt Bg yy rani Uqlltal rrtscart sttluWs,Y3 Int.Pine GN t,V C.,EtF1v is StaCdam FFG
�o �..--• --.�..,<.. ..m.--..,,.___..._........w«. ,.. -....� .---�--'-_....._.,_ .,m.,..e..«... ..............>....--a,-.ate._...._._ .,..e_...�.«. .�.A....
......m»me,..,.P.. .m.....mm....m.m... ......_..�.... .....................n,.H....e e.-...P.a.4.e.<....P w...�....e ....�...,,..........,....»» .,..y......,...
3
..�.�...s..,...». .�..._...._..�.�. »»...�....�,�...-.«.a.,-.».�.....-, -...-. .�-�-`"--_-.,.. .J_........ .....tea._
» n
x
}
Total 7 $AY $t1W&RIV11111 OUT DETI;AILS
2 wk Get MR €P4 t
v�th rr AK#•sa. Nntrrasr tr.atsira ire r)zr 9 Cr✓f re lie Lue E, fterf Huclvar�
Rx'dri Chad" r4#r fYa,E krc+R Ettg t tt,. (a J R t ets (aria nr E taY t v a 7 Es i sr' t `l�s S M'srie S t.e�7n -xre,'rr' ck1 q,aPt +.rl,r
uutry I191 i3ay S?.t Uri f W F123:k� ,� lVr C :kt-3E. s V�Ita to WH
CV F FG ft Canvas
SPECIALTY WINDOW @ErAIIS»
>.tpt.fU'k i
[ i .RAY/HOW DDI 1 ION.AL WORK Nityrc5
� A'E ( I G3'w c 3
t t?�pt f
ADDITIONAL WORK DETA1I:`3-.
Please dt wuss at throat ea "Waasure
No Contractor will wrap eAlerior casings with coil stock t,olor of
OAwwr*awaEe tired cnr6tnx tcu d,ws not do any paOtlo)stai.ua6g,1r feaw vtiblipsrafiij ti¢an of xakirm skatem or wlndow trea f.rrec1.>.h nJwara ft 6 the re sponstGmty 0
itta t?rnevwnet to 4 ,&trio afantt s)siam and wtncfiow treafralentsfhatuwate ranxived pn r to:Frcfafir'a:fran, bye make no guararicee as to whether alarms or madow
treatiment's,(hardware WX fit after repttacenwn.f. CarSft>rnRrX'iS af5t7 ttffiM1^ar ;n$trine t:aSeS thetti kac.'tf f)e glass l[?SY_ ff there,as,Me amouN wrif be dependenf on the tyre
of exishm wimk)ws,type or tnstarta,on acrd window_, }Wte.isW rrkske r,o quarar tee as to me ar?wot of grass;uss. .;sl n er rs awatte,ana understands any and alt
uns8+an rots not inciude(f m th's ct}.trai.£:.ShuU0 arly rot txE fmInlO thee&wtfi be an additl)nrat i`hang&tot€ime and n,aterfals an1*esv so stated in this ccv)tract,
1'e s b6t S<actor Witt insulate,r:auik and seal°Twimla rs Witt:<31 rwAril system to grever;t water and air infiltration Hen;ov:al and JfsF x�t r t all paid relaletl debris; _»
Windows,donors,storm windo a and uac'.,ourn nightly iododetl- UP(-n e(,mp tetion tar the job and payrn,nt in full:a lariited warranty shad be issued
Building PeM111--contfactor V01 secute cam,and all perm tt; Tha tee for ille ISwmttfs)is wclutltM:t In Mf3 tolat C oritract price.
yes All discounts have been applied to this agre$3rTient.
I., \<, Owner agrees to be Uiesent on the final day of in&t.a€lation for f,rim tr spect,un rand to deiiver final pWImen,r finance fofnt(k.
9r r- s.rs, l..,xl,nwfa .,cxr.C',r. Esu .+t.E:e,n s9., tnt�,'ir.tl.:a rho.`�Ia.,e.a:it zt;*} .t ..t a� tt,ih~;t'.I'-ft 111 IViV"f 34)1i":1\F)t.34)t1tt Itk-19OLet:f.I`;Ci 1t akZ t.r.1.13_47.;�.a,r ... ,.- �u?i,•.
vet wan uxtl..—ill h t t,1111,r Ill n...rtls,g,� t+.,,,;, ri,a.iu,rd ,irt Lt aEE F ,.�,n,.i lr ti,ec r-, �s,�..�<k.ca.ex .a� -�r.u:E>.,r: h.rr .x$i:r.wi:<x 1tr :r1`•in�?..
Renewal by A.naierce»Corporation T.rc�•t: � ( I&taxes r -
Signature of Consultant aIgn:aturo Sq aWue
CATHIE.DiGRAZtA J )SEPH SHARP BARBARA SHARP
Print Flame of Consultant _ __. Print Narn Prim id trr,E m-
* [ tdx G � _ P�A Home lmo(vvement ccin'tract€�r
Renewal to Andersen Corporation License a 1deral lax ID 12123;2015f 1841
�°'3,�►1`If..��.t"5et1 }t � Federal Tax iQ#41-t9t8dt3
1.a'ICt UfIXV at BE Rf:r MfEkF _ ._..
3O Forties Fft1, NortttbCrougts MA 01 532
(.`06)351-2200 Fax(508)186-7,072
CL75'TOME.R WINDOW AND DOOR REMODELING AGREEMENT
Buyer(s)Name Crate'
-- ---- ------------------ -
JOSEPH SHARP - BARBARA SHARP JANUARY 20, 2 015
Buyer(s)Street Address city _ State Zips Code
! 56 OLIVE STREET-- - _ NORTHAMPTON -- -. MA L_-01060
Email Address Harne-t'glephone Number VNtstklCe41 Telephone fJum T
L.L,AMASiTERY@'YAHOO COM- -- -_-- 413-727-8263
Buyers)hereby jointly and savteralty agrees to purchase the goods andiot serves es of Herewai Nj Andersen C,orpotabon("Cortrrartor"r,in accordance with
the terms and c;andrtions described on the troi t and the reverse ct th s agreement ana on IN atta r ed sr ecifirat;:n sheet's'(c+.)Eteetively.this"Agreement?
Boyer s)hereby a9fees to sign a completion cemfic,ate alter Cortrac!Ioi has coo pjia"e.d rx!I r'oek a ndet ths AgreemLt nt.
r p�t�A µ ♦Q {� (� Est.Start Qate Method Of Payment
f Total Job Amount � 1�,+�9 945 fttOn9lt�tWAtG6Yt J aT
ti,_erx s t Beet weed}'t?',) -�- Chec"ash
3,83933 Ile t�..y_�� O.Gf3
— 16 Weeks
¢ ETa sraeta Stagy crt,Job(33'x)S 3,83933 Chr,,r _
Ealaar�On Subetamial � i Est..Install Time � C edit Card
Giamp:eiitan of Job t33'T) S 3,839_33 roe:d ---------__.-- 0£Ki
1-2 days 7,t rrdit,,:'rMi=_st@+ec"ei taiM;,e
see Mform
Buyer's)agrees and understands that this Agreement constitutes the entire understanding between the parties,and that them are no verbal understandings
changing or moddying any of the terms of this Agreement. No alteration to or deviation tram this Agreement will be valid without the signed,written consent
of both Buyers)and Contractor. Buyer(s)hereby acknowledges that Buyer(st 1)has read this Agreement,understands the terms of this Agreement,and has
received a completed,signed and dated copy of this Agreement,including the two attached Notices of Cancellation,on the date first written above and 2)was
orally informed of Buyer's right to cancel this Agreement. DO NOT S*N THIS CONTRACT IF THERE ARE ANY BLANK SPACES.
Renewal by Andersen Corporation Bf;yer(S)
�rticc' i flit' {! L7 -*-14 t sue-
S+gnature�Cst}tlrSMt€I2u12 �aigrtaPUrrs SO ja�Etitr�tM
X CATHIE DiGRAZIA JOSEPH SHARP _ BARBARA SHARP
Pi,r ied Nara,of Cca'isullam r'nterii N arrw
YOU THE BUYER($),L4AY CANCEL T"S TRANSACTION AT ANY TWE PRIOR TO MtDMGHT OF TIME THIRD 843FAMESS DAY AFTER THE DATE OF TMS TRANSACTt I.
SEE TtiE ATTACHED NOTICE Of CANCELLATION FORMS FOR AN EXPLANATION OF TWS RIGHT.
- ----- -- -------------- --- ------ -- - ------ - -- -- .__ _ - - ---____.--__- __-_-_-___ __-__-
N(YI]CAKOftAN IE1 3sYHON 1(F11(:f:OF t">NCF.7_L8'#`H>-.`X'' t
t
t}axc,a€"#'ransaccGm __.Va.arras catt.�att thlr, r t3afe:a4'rrncn�arcix.a You ntatp<.ntu^e%1 thu
tr��sa<�tiott,without atsy ptaatty u7,uidignssa'.w#thsn thrcye businets days tisrrt Mite � trans:at Warr,wishaae }prs.tikv x,7,r.,iigaUr a.within there fmstae+iv dz4�a 1'rnm the '.
ai>wr date-►f}cell raas Any pregteny irat#ed in.a'y pa}nrrnts snzdr ka}}ass nsder alaaee date.#f ' na 7,t,any pet tarstr tt adtd i',any pAy-iarntA utadc b yon under
the Crmir�ua of'5aie, Any ttegatiaixte#uxtrwnr't rrernaed h)'Yvan aeill she S'�meraet or 4alr, ud vat}o-Sotiartde itmtrumen(ererntrd t y}7,w viii be
ratnraed K ithi.#a Tilly.falharrisg ritlArt try tb-fltatavttor(,"'fetitr"; r#'year rrxttrmrd within Itl dap.,.rrstlrtc.i r,-ipt by rhr U`erstrartur t"hrat '', ytsur
tAm:ciiat3an xuatife,Aad ally""rity btterrat artaiag nut of d-naaxaetian Drill be r caex.enAaian-like,and arty atruritt,-W rnt akr#sing cwt of the trartskAt9i»a win be
eanretrd. if}Yes e..aatxly}wa txiatsrt mater available to t,e 5+o-aar at}-our rasrdasrmr�.in � mau+ritt#, if ysu era..7,i.yua muse msJ.:r aa^aii atria tw t�±ir##7,r at yn�r r,raidesrt�R#a
sttb taatiAlty aw Xaod.rottdh#tr'""-hen rec;ei-d,aas gtwda delivered ka you trader t suirstaatiaay As good rurtdii#tw as:♦vhtn rcee#ared,asy Xottds dtiia'errd sa xsu tinder
it&f`satraci or Safe;or you-as if yea v ash,cw+'rrSa#p ssith the of the r thi.t'ar+etraa a7,%alt;a.you mxy,it y..ir�h,ettcnlalr-ith the f the
Sl,ner-gardaa.X the return shipl—t of the gttadx at ttte Srurr'.t p+rsse axid rtrk. Seear regardittg rhr rrturu shipment of the gatal»at the Setter'.""hest and ri h.
If ttw da nrtke t w gtwds sva##sbte to the Seller and the"Steller doer+out pit,dw-ap I If pea do make(he Attnd*eta t bb,to the Heller gad Litt SAIrr doe*vat piek theta tip
v.iihin 20 daps of The date of WW StRire of Glance-Lias3.arn,too Wray yet .v7,dhipress r Wilkie TO Qa}s of t,7,dau of a u7,Etatiee€af t7aacei#at£aat +s cusp rctaia a7,d#Yp .e
rhr it aols
of the Rods without ally ktrtFt It ye €ail ta aa,r asstdab#r of the ga aaLM whhttut au}1'urttwr e.ldi atiott. if tiaa€vii to tuakr she prrt.ds a>akiah#e
to the Slel#rr,ar if;i*t.t agree.W retara the goad*:tes d-S*fler and fell to do a,the' to she.Sturm or it yrma Aurr.to,atom.the Surds to the S*B-Arid fait to da sa,then
;cw rental"U36#e f.r performaat r of All rrbligations under thr f nit acl.. to Va-.1 i yata yen at'[WAl,t #arrtn.rraae r of all nldiAat#oa>a s'drr ehr f�ostr-Ar:4. to:anrtrl
thin traysArtiaxi,mail vx dei#xee a signed Aad dated.°opy a€tin.ea R-ti"-tier I d",,Iran -naa,-.0! r delta e7,a siXxirat sad da ted eupy of ihre t Anceilztron_d'.
tar aray t bar weiss*a'rst ce,tar salad A tettry6rara to'(,aatrartar:Raaewat bs.Artdersert, a7,any<athrr written ot't:e,.n7,krnd a trtegra'r to C.;oaxrarStan Rene»ul by A'Arraen.
Ttl$raiwru#td. 'iNnrt#alx>ranSh,A3Ae6iaT�Z. i 3##Fnrlww ttxi.Vett6he.rsnSh,4Lt Eit3:S2. ;
I#"EBY C tNCfL ITUS T`r(A''l`'r"AG'T ON, t T HfALgi 4 AN(LL!`l3i*'€RtNS.i(_!'lC.th,
The Commonwealth of Massachusetts
Department of Industrial Accidents
w
Office of Investigations
I Congress Street, Suite 100
a Boston, MA 02114-2017
' Y www mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Organization/Individual): RENEWAL BY ANDERSEN
Address:30 FORBES ROAD
City/State/Zip: NORTHBORO, MA 01532 Phone #:508-351-2200
Are you an employer? Check the appropriate box: Type of project(required):
1.0 I am a employer with 30 4. ❑ I am a general contractor and 1 6. ❑New construction
employees (full and/or part-time).* have hired the sub-contractors
2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. 0 Remodeling
ship and have no employees These sub-contractors have g. ❑ Demolition
working for me in any capacity. employees and have workers' 9. ❑ Building addition
[No workers' comp. insurance comp. insurance.$
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 11.❑ Plumbing repairs or additions
myself. [No workers' comp. right of exemption per MGL 12.❑ 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 41 must also fill out the section below showing their workers'compensation policy information.
I 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:OLD REPUBLIC INS. CO.
Policy#or Self-ins. Lic. #:MWC 30293800 Expiration Date: 10/01/15
Job Site Address: _S 1�'� S`4 City/State/Zip: dr- - �t
Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Q(Ob 0
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 ertify nder the pains and penalties of perjury that the information provided above is true and correct.
Si ature: Date: s' J
Phone#: 508-351-2200
Official use only. Do not write in this area,to be completed by city or town official.
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 Supervisor: Not Applicable ❑
Name of License Holder: JAIME MORIN 90125
License Number
86 GARDINER ST N, M 01905 10-06-16
Address Expiration Date
617-966-0412
Signature Telephone,r"X
9.Restistered Home It1i arovemetnt Contractors Not Applicable ❑
RENEWAL BY ANDERSEN 170810
Company Name Registration Number
30 FORBES NORT ORO,MA 01532 12-23-15
Address Expiration Date
Telephone 508-351-2214
SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152,§25C(6))
Workers Compensation Insurance affidavit m e completed and submitted with this application. Failure to provide this affidavit will result
in the denial of the issuance of the buildin ermit.
Signed Affidavit Attached Yes....... No...... ❑
11 - Home Owner Exemption
TT current exemption for"homeowners"was extended to include Owner-occupied Dwellings of one(1) or two(2)families
to low such homeowner to engage an individual for hire who does not possess a license,provided that the owner acts
as su ervi CMR 780 Sixth Edition Section 108.3.5.1.
Definition of owner: 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, ne or two family dwelling,attached or detached structures accessory to such use and/or farm
structures.A verso who coy nets more than one home in a two-year period shall not be considered a homeowner.
Such"homeowner"shall submit to Building Official,on a form acceptable to the Building Official,that he/she shall be
responsible for all such work Derforme nder the building permit.
As acting Construction Supervisor your pres e on the job site will be required from time to time,during and upon
completion of the work for which this permit is issu .
Also be advised that with reference to Chapter 152(Wo rs' Compensation) and Chapter 153(Liability of Employers to
Employees for injuries not resulting in Death)of the Massac etts 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 c liance with the State Building Code,City of
Northampton Ordinances,State and Local Zoning Laws and State of Massach is General Laws Annotated.
Homeowner Signature
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
New House ❑ Addition ❑ Replacement VWndows Alteration(s) ❑ Roofing
Or Doors
Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [Q Siding[tom] Other(C]
Brief Description of Proposed
Work: REPLACE 7 WINDOWS-NO STRUCTURAL CHANGE
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 addition to existind housind.complete the follovw ina
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
JOSEPH&BARBARA SHARP as Owner of the subject
property
hereby authorize JAIME MORIN
to act on my behalf, in all matters relative to work authorized by this building permit application.
Signature of Owner Date
JAIME MORIN
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 under the pains and penal ' of perjury.
JAIME MORIN
Print Name
02/25/15
Signature of Owner/A41 Date
Section 4. ZONING All Information 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: L: R:
Rear
Building l-leight
Bldg. Square Footage %
Open Space Footage
(Lot area minus bldg&paved
parking)
#of Parking Spaces
Fill:
(volume&Location)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO 0 DONT KNOW 95 YES 0
IF YES, date issued:`'
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DONT KNOW YES 0
IF YES: enter Book Page and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO 0 DONT KNOW YES
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained 0 , 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.
F, Department use only
i y of Northampton Status of,Permit:
ilding Department Curb CuiJbf#yew*y Pellmt#
FEB 2 6 2015 212 Main Street ewerleptv>xyalliit '
Room 100 Water+' c11 Ayili#y
Electric, Plumbing&Gas Inspe ampton, MA 01060 Twa, retsf Structural PEelts
Northampton, 0 7-1240 Fax 413-587-1272 PlotlSi#e Flans
C)ther Spec f
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:
Map Lot Unit
Zone Overlay District
Elm St.District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
JOSEPH&BARBARA SHARP 56 OLIVE ST NORTHAMPTON, MA 01060
Name(Print) Current Mailing Address:
413-727-8263
Telephone
Signature
2.2 Authorized A-gent:
JAIME MORIN 30 FORBES ST NORTHBORO,MA 01532
Name(Print) Current Mailing Address:
508-351-2214
Signature Telephone
SE TIO E TIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by ermit applicant
1. Building 11,518.00 (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= (1 +2+3+4+5)
11,518.00 Check Number
This Section For Official Use Only'
Date
Building Permit Number: Issued:
Signature:
Building Comm issioner/I inspector of Buildings Date
56 OLIVE ST BP-2015-0828
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 38B-233 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: windows replaced BUILDING PERMIT
Permit# BP-2015-0828
Project# JS-2015-001597
Est. Cost: $11518.00
Fee: $35.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: RENEWAL BY ANDERSEN 090125
Lot Size(sq. ft.): 7448.76 Owner: SHARP JOSEPH G&BARBARA H
Zoning: URB000)/ Applicant: RENEWAL BY ANDERSEN
AT. 56 OLIVE ST
Applicant Address: Phone: Insurance:
30 FORBES RD (508)919-0900 WC
NORTH BOROMA01 532 ISSUED ON:212612015 0:00:00
TO PERFORM THE FOLLOWING WORK.-INSTALL 7 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:
FeeTyne: Date Paid: Amount:
Building 2/26/2015 0:00:00 $35.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner