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;' We hereby submit specifications and estimates for: $ ,
+ .n `: 3 1!^ ...Y'^ � i_.- =t F#i•i r � }t.-,` � . . '� . ..-
Ik1ALexA�29-dC Stainless Steel Liner:
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fgot C it (6-1 r 608.40
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Tee'Cove w; 21,40
Rertc2vabe Tee w? 61.30
13.90
1 -Storrn,Collar 20.10
I 13x13 Top Plate 26.55
Rain Cap _ 52.95 ,-
r 804.60 Subtotal,
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`20:00 Permit
+ 600:00 LaWr
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G� $1;42A.60 TQTAL
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complete in accordance with above specifications, for the sum of:
We Propose hereby to furnish material and;labor
dne Thousand Four Hundred Twenty-four and 601100 $ 1,424.60
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dollars($. ).
Payment to be made as follows:
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Deposit of$450.00 required prior to ordering,materials with balance of $974.60 due on completion.
All at is guaranteed to be as specified.All work to be completed iq a workmanlike
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manner,according,to standard practices. Any alteration;or deviatbn from 2bove,specifications Authorized
i involving extra,costs will be executed only,upon written orders, and will become an`extra Signature
ctrarge over and above::the estimate. All agreements contingent upon strikes, accidents,or, -
beyond control, Ownerto car fire,.tomado and other necessa insurance: Our Ngte:This pr sal e y
r defays carry ry withdr ri b us if not a ted within days.
worid}rs are fully covered by workman's'compensation Insuranq. # Y P
i Acceptance of Proposal The above prices,specifications
I' ' and conditions are satisfactory and are hereby accepted.You are authorized to do the Signature
work as specked.Payment will be mad :as oath above. i
Date of Acceptance: c��—D z Signature
To
1800225-8980
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sue ° eg Crxt IafOtZ ���111�7IIII
B �{X3a HCll ttSf114
m DEPARTMENT OF BUILDrNG INSPECTIONS
212 Main Street ' Municipal Building '-o
Northampton, Mass. 01060 y
WORKER'S COiMMENSA`zION INSURANCE ArrMAV .r
(lic nsc J, ittcc)
vntL a principal place of businessJresidence U-1
t° �1� ��/ ► -uOc _tm, C)! (Phoner�) Z�_4i 7-99ZTD
�^ (stmt/city/statrJzip)
do hereby certify, under the pains and penalties of peguy, that:
( am an employer providing the follo`ving worker's compensation coverage for my ,
employees working on this job:
(In"L=ce Company) (Policy Number) (Expiration Date)
( ) I am a sole proprietor, general contractor or homeowner(circle one) and have hired
the contractors listed below who have the following worker's compensation policies:
(Name of Contactor) (Insuanc� Corlmany-'Polk.� Date)
(Name of Contractor) Insur2nc Comp'-'11WP0Lcr Nitrk- r) (Expiation Datc)
(Name of Contractor) (Insurance Compauy/Poky Numb--1) (Expi-atop Date)
(Name of Contractor) (Insurance Como=y/Policy Number) (Expiration Date)
(attach additiccil lhcet ifne�e to maucic informati cxi pa�to all ctxrh-adon)
O I am a sole proprietor and have no one working for Inc.
( ) I am a home owner performing all the work myself.
NOTE:picric be awacn that wh Jc hoaxoµncrs who canplay perrom to cio maintr_uncr constR=oo a repair Nvork oo a d,4tlling of
not morn than thtuo units in t;cinch the bomoouvcr resides or oa the gro t appur�thc:cto arc oot gc rally 000sidcrcd to be
cmployrrs under the wor t oomp=uiicn Act(G Li 52-m t(5)),appLicaflon by a homco mcr for a license oc perruit tray evidence the
]cgal ctahra of an omployor underthn WO&C(�a Compmzation Act
I undcntand that a copy of this raicmcnt may bo forvrded to the of A,,66m�Offioo of Lnwrioo for the
eovcm91_va ificatioc and that failure to saxurc oovcrago under section 25A of biGL 152 can Iesd to tho"imposition of aiminxl penalties
oomist m of n f ne of up to S 1,500A0 and(or of tip to one year nod civil pcmtiia in the form of a Stop Work Order and a
find of . day t pin&trio.
For dcPartmc°tal uao only
Permit Thurber
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. y Tel.No. Alterations
NORTHAMPTON, MASS. l! 1 r�'aUb tg Additions
' �
APPLICATION FOR PERMIT TO ALTER Repair
ff Garage
1. Location l (ls VL Lot No.
2. Ownees name � M Address (� % / I/� �� /Dr,frte
3. Builder's name 0 1 QS 1►Mn S Address l>�S //�1�1. ���1c1, %1'fi�9• f1��s(,
Mass.Construction Supervisor's License No. ���-� - ' Expiration Date
4. Addition
5. Alteration
6. New Porch
7. Is existing building to be demolished?
8. Repair after the fire
9. Garage No.of cars Size
10. Method of heating
11. Distance to lot lines
12. Type of roof
13. Siding house
14. Estimated cost:- I l+`►�e o-rC.skl mo'c/
f ,��� 60 The and igne ertifies the above statements are we to the best of his, her
knowle ge an li r
Signature of responsible app,icant
Remarks VG l t /�S u"I�t�IS /ltt1 rUG Y� i s/t
10. Do any signs ebst on the property? YES NO
IF YES,describe size,type and location:
Are there any proposed changes to or additions of signs intended for the property?YES NO
IF YES,describe size,type and location:
11. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE To
LACK OF INFORMATION.
This —.Lw= to be filled in
by the Building Department
Required 1
Existing Proposed By Zoning
Lot size
Frontage
Setbacks
- side L: R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&paved parkingi
# of Parking Spaces
#- of Loading Docks
Fill:
(vol- me--& location)
13 . Certification: I hereby certify that the in orm tion contained herein
is true and accurate to the best of my kno led
D21TE: ?r-��" �000 APPLICANT's SIGNATURE
NOTE: Issuanoa of a zoning permit does not relieve a applio s den to oomph► w.
zoning requirements and obtain all required permits rom th oa of Health, Conservation
Commission, Department of Publio Works and other pplioa a permit granting authorities.
FILE #
File No.
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: Je- A vl-- WOPIW- W
Address: �) /�1✓�- ' �t,�Uet Ib tJ MA"6116&elephone: ✓� 7'�,5
2. Owner of Property: Em dif t h-z-
Address: `t J-FG�'l hl-CACC Telephone:
3. Status of Applicant: Owner _Contract Purchaser Lessee
Other(explain):
4. Job Location:
Parcel Id: Zoning Map# Parcel# District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property
6. Description of Proposed US 6or oject/Occupation: (Use additional sheets if necessary):
ive- ol &-V1flLa=- FLU C 6-1 1 IrV flt-eyl- 1441 C-f-
7. Attached Plans: Sketch Plan Site Plan Engineered/Surveyed Plans
Answers to the following 2 questions may be obtained by checking with the Building Dept or Planning Department Files.
8. Has a Special PermitNariance/Finding ever been issued for/on the site?
NO DON'T KNOW ✓ YES IF YES,date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW YES
IF YES: enter Book Page and/or Document#
9. Does the site contain a brook, body of water or wetlands? NO L-1-z DON'T KNOW YES
IF YES,has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained ,date issued:
(FORM CONTINUES ON OTHER SIDE)
12 ALLISON ST BP-2001-0201
GIs#: COMMONWEALTH OF MASSACHUSETTS
fr"\4qq.Block-. - 121 CITY OF NORTHAMPTON
Lot:-001
Permit: Building
Cate o : CHIMNEY RELINE BUILDING PERMIT
Permit# BP-2001-0201
Project# JS-2001-0324
Est.Cost: $1424.00
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: ACE CHIMNEY SWEEPS 118355
Lot Size(sq.ft.): 100 1 8.80 Owner: HEINZ ADELA K
Zoning.URB Applicant: ACE CHIMNEY SWEEPS
AT. 12 ALLISON ST
Applicant Address: Phone: Insurance:
115 MAIN BLVD (413) 547-8500 Workers
Compensation
LUDLOWMA01056 ISSUED ON.8122100 0:00:00
TO PERFORM THE FOLLOWING WORK.-RELINE FURNACE FLUE W/STAINLESS STEEL
LINER
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Inspector of Buildings
Underground: Service: Meter:
Footings:
Rough: Rough: House# Foundation:
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:
Fee Type: Receipt No: Date Paid: Check No: Amount:
Building 8/22/00 0:00:00 4933 $25.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo