17D-021 (11) Branch Ofc: �f�C.c� ti�T/gnld SIDING SPEC SHEET Spec Sheet#:
Branch#: 5 DESCRIPTION OF WORK Job M d Z:
Customer Name: '7'Gr /jam Home Phone#:
Installation Address: /p Work Phone#:
Street Add-
NZ14% ti n?<¢ d h>9i ,'
Cey / r state / Zip CWe
Material Drop Location: Fle,11V4 Li9-Av.1J �� ju e- Dumpster Location:
VINYL SIDING
AREAS to be SIDED PRODUCT PROFILE/SIZE COLOR
Entire House Overbrook Clapboard Siding L i Awe..O
Front Valor Dutchlap Corners 1_1'o0ae0
Left Echelon
Back Beaded INSULATION
Right Valor T-3 3/8"P or 3/4"D
Other Other
Remove Existing Siding YesET No[::] If Yes: Aluminum Vinyl/Wood7
1. Ony where new siding is to be installed. Flome Depot will NOT remove asbestos material.
SOFFIT,FASCIA&FRIEZE BOARD Soffit Material: Premium Universal
AREAS to be COVERED
Entire Front Left Back Right Other Color
Soffit&Fascia e 8 8 F,;1 �1�7� fl�yer�c- ��lLee AD
Frieze Board ��cy
Cover Frieze Board with: PVC Alum.Coil F 7] or Vertical Siding
Soffit Only 8 8 H
Fascia Only
New Fascia Board 0 ❑
GUTTERS&DOWNSPOUTS SHUTTERS
Remove&Reinstall Yes No Remove&Reirfsta4 #Pairs
Existing Gutters ❑ F521 Existing Shutters Ell
Install Newt Install New
Yes No Color #Pairs Color
Gutters e (v/, Louvered Shutters Ep Grc4'C Down Spouts Raised Panel Shutters
2. In existing locations,unless noted otherwise below.
CUSTOM WRAP WITH PVC ALUMINUM COIL
WINDOWS Qty Color DOORS Qty Color
Single .3 �,, ° Single ,
Double / Single with 1 Side Lite / t
Triple / Single with 2 Side Lites /
Four/Five Single Garage/Patio Door
Bay/Bow Double Garage Door /
NON-WRAP Install Siding OVER window casings with custom trim: Yes No
OPTIONS: Install Siding UP TO window and door casings without wrapping: Yes No
PORCH CEILING GABLE VENTS FUR OVER MASONRY:
Premium Color: JV Qty YesEl No�
Universal P Location: Rectangles Location:
WRAP Qty Color Octagon= REMOVE&Rli
Porch Beams Qty
Porch Posts Color of Gable Vents Storm Doors
Knee Braces A,e, —� Storm Windows 3
crl-
Triangular Gable Vents 6l7/„ NV; * Awnings Z
ROTTED WOOD Rotted Wood will be replaced in the locations specified below:
4 The work does not include NON-VISIBLE rolled or damaged wood,for which there could be an additional charge.
Special Considerations: Gon>C_ I have reviewed and agree with the
I ob sp if ations gibed above.
custlysignaCure Date
SALES CONTRACT l
'\ ame: AM L/V 540W Date: z5/OD Sold,Furnished&Installed by
`) I'lie IIonic Depot Installed Sales
r ranch L mber: Job �7- MA I tome Improvement Contractor Reg.# 1 12785
Fed ID#58-1853319 RI Cont.Lic# 16427 CT Lic#565522
200 Butterfield Drive,Unit B Ashland,MA 01721
y w� (877)32-DEPOT,(508)881-6394 lax:(508)881-2906
Installation Address: O �D N s Q D —
"' City lo�C•'!L) ate S-Zip
Purchaser s SS#: Driver's License: a time Phone: i Home Phone:
'L
Home Address: T 7 ti o 64 /� M W��1��Yrrs6<t�9 /17/x' vr�6�4L
(ifdifferent from Installation Address) City O/ ,&State Zip
Proiect Information:
1/We 1"Purchaser"),the owners of the property located at the above installation address,offer to contract with The Ilonte Depot("Ifonte Depot")to
furnish,deliver and arrange for the installation of all materials as described on the attached Spec Sheet#- incorporated herein by
reference and made a part hereof.
Home Depot reserves the right to cancel this contract if,upon re-measure of the job,Ilonte Depot determines that it cannot perform its obligations
pursuant to the contract specifications.
Total Contract Amount:S ,*0
—
0
Form of Payment: Deposit: S -- Due on Completion: S
Circle Payment Form 4 Cash* Credit Card Cash* Credit Card Finance
" Cash means Personal Check,Cashiers Check or US Postal Service Money Order.
Purchaser agrees that,immediately upon satisfactory completion of the work,Purchaser will execute a Completion Certificate and pay any
balance due(unless thejob is financed.in which case,upon submission of the executed Completion Certificate,home Depot will be paid in
full by the lender). Purchaser also agrees to be jointly and severally obligated and liable hereunder.
Payment Options(subject to fund verification and/or credit approval):
By my/our signature below, 1/we authorize Home Depot and RMA llonre Services,Inc.,a Home Depot authorized contractor, to
verify and review my/our credit record with an independent credit reporting agency and release them from all liability incurred
from inadvertent omissions or errors.
I) Check,Cashiers Check or US Postal Service Money Order made payable to"The Home Depot":
Name of Financial Institution: Account#:
Phone: Fax: Checking_ S vings Other
Address: Date of Birth: L D
City State/Zip
2) Credit Card: circle one Home Depot Visa Mastercard Discover American Express
Account Number:
Name as it appears on card: Expiration date:
By my/our signature below,IAVe agree to allow Tire home Depot to charge S to the above referenced credit card prior to completion
of this job. If Purchaser is paying with a credit card,the Ft1LL CONTRACT AMOUNT must be charged at the time that this contract is executed.
Maine and Massachusetts residents will only he charged 113 of the contract amount at the time the contract is executed with the balance payable upon
completion of the job.
Cardholder's signature Date
3) Finance: If this is a finance transaction,the agreement for financing is contained in a separate document,which is
incorporated herein by reference and made a part hereof.
For Massachusetts Residents Only
Contractor,at owners expense,shall procure all permits required by law as follows: Owners who secure their own permits will be excluded from the guaranty
fund provisions of MSL Chapter 142A.
Unless otherwise noted within this document,this contract shall not imply that any lien or other security interest has been placed on the residence.
Entire Agreement
This agreement and its attachments,including any financing agreement,contain the complete agreement between the parties and cannot be
amended or modified unless in writing in a separate agreement signed by both parties.
NOTICE TO PURCHASER
Do not sign this contract in blank. l'ou are entitled to a copy of the contract at the time you sign. Keep it to protect your rights. Do
not sign any Completion Certificate or agreement stating that you are satisfied with the entire project before this project is complete.
Law prohibits home repair contractors from requesting or accepting a Completion Certificate signed by the owner prior to the
actual completion of the work to be performed under the contract.
)'on,the Purchaser,may cancel this transaction at any time prior to midnight of the third business day after the date of this contract.
See Notice of Cancellation for an explanation of this right. There will be a service charge equal to 25%of the contract amount if the
job is cancelled by Purchaser AFTER the third business day.
RY MY/OUIZ SIGNATIME ALLOW,I/WI[AGRIT 10 1117 ROUND HY"I I II?I FRMS 01:1 HIS CONTRACT I/Wli AC'KNOWLEDGI:RECHI'T OF A
COPY OF TIIIS CONTRACT AND TWO COMI'LI-fE111)COPIES 01: 1'Ill.NOITCI'OP C'ANCL:LLA"I ION. I/WI:AI.SO I1NDFRS'I'AND TIIA'I 'IIIH
AGREEMENT IS SUO1HCf O REV IPW O'MY/OIIR ' AM- Its 101t Y.
)928-00P01 CVSUBMITTED BY: [
�8-001`01 :42 CFmT&'
es C'onsuluun
ACCEPTED BY: -( ��5 Date: f N tJ
I lum i 'n•r -
_ Date: `
Iuntcowner - --. -- - ---
NO'UK F.:ADDI'1'IONA1,1'ERNIS,(ONDI I IONS AND WARRANIIFS ARI(SI'A'1'FI)ON PAGE 2 AND ARE PART OF IIIIS CONT RAC]'.
White-Branch file Ycllow-(kwomer Pink-Sales Consultant
07/2S/00 RA-SMl I-S('
_� Oy
9 (rxt� of Nart4anyton
$ B �lasaxcf[nactfa'
DEPARTMENT OF BUILDITNG INSPECTIONS
212 Main Street ' Municipal Building '
Northampton, Mass. 01060
WORKER'S COMPENSATION INSURANCE AFFIDAVIT
(licenseeJpermittee}
with a principal place of business/residence at:
(street/city/sta t ehip)
do hereby certify, under the pains and penalties of penury, that:
(—)-I am an employer providing the following worker's compensation coverage for my
employees working on this job:
NI-F T7 v 1nSCv 2oR2w 6co735--?-0--
(Insurauce 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 Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(Name of Contractor) (Insurance Company/Policy Number) (Expiration Date)
(attach additional sheet ifnocessary to iocl s infwntatioa pertaining to all ooatrad )
( ) I am a sole proprietor and have no one working for me.
( ) I am a home owner performing all the work myself.
NOTE:please be aware thrat whilo homwwncn who employ person:to do maimcanrrec coushvdion or repair work on a dwelling of
not more than three units is winch the homeowner resides or on the grounds appiden tat tbercto arc not ecowally eoondercd to be
eanployen under the workees oanpe ns4oa Act(GL152,ss 1(5))�application by a homeowwr fora license or permit may-id—tho
legal status of an employer under the Workipes Compomation Ad.
I understand that a copy of this statement may be forwarded to the Departmcu2 of Industrial Aeeidea&OfSoa of Imu vacs for the
coverage verification and that failure to soatre covorago under soction 25A of MGL 152 can lead to the in"sitioa of criminal peaelties
consisting of a fine of up to S1,500.00 and/or imprisonment of up to one year and civil penalties is the form of a Stop Work Order and a
fins of S 100.1)0.a day against rue.
For dgMtMnaW use only
Permit Number
/V`/ Wp# Lot#
Si of Licrosee/permittce Date
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder
License Number
Address Expiration Date
Signature Telephone
OT, � �� Not Applicable ❑
z.. E«E
Company Name Registration Number
Address Expiration Date
GO
Telephone
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...... ❑
tommal-
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 fob 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
L. -:DESGAII We
New House ❑ Addition ❑ Replacemen endows Alteration(s) ❑ Roofing ❑
Or Doors
Accessory Bldg. ❑ Demolition❑ New Signs [ ] Decks [ ] Siding[ ] Other[ ]
Brief Description of Proposed Work: o
Alteration of existing bedroom Yes No Adding nevi bedroom Yes No
Attached Narrative❑ Renovating unfinished basement Yes No
Plans Attached Roll ❑ - Sheet❑
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. Mascheck 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 AUTORIZATION -TO„BE COMPLETED WHEN
OWNERS AGENT OR CONT.RACTOR APPLIES POR BUILDING PERMIT
as Owner of the subject property
hereby authorize to act on
my behalf, in all matters relative to work authorized by this building permit application.
Signature of Owner Date
f6 Yele o6 CeY- G 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 penalties of perjury.
Print Name
Signa u e Owner/Agent Date
Section 4.
ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE
DENIED DUE TO LACK OF 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 Height
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 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 #
B. Does the site contain a brook, body of water or wetlands? NO 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:
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_
No
IF YES, describe size, type and location:
of Northampton
4 i ding Department
12 Main Street
Room 100
P=p F"" g ' ampton, MA 01060
o;; Y3 87-1240 Fax 413-587-1272
APPLICATION TO CONSTRUCT,ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1-SITE INFORMATION
" hi55 SeC 0 �
re
1.1 Property Address: x
'�'�{ii'�rt.'' �C� �;,—..�.a� �`✓ .���I'5t1"I�.t�—«�. .` .,..,,sr.
SECTION 2-.PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
U 0 0 79"
Na a(Print Current Mailing Address:
Telephone
Signature
2.2 Authorized Agent:
Name(Print) Current Mailing Address:
Signature Telephone
SECTION 1 ESTIMATED CONSTRUCTION'COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by ermit applicant
1. Building 5-575' C_�Oc;> (a) Building Permit Fee
2. Electrical /�° (b) Estimated Total Costof
Construction from 6
3. Plumbing Building Permit fee
4. Mechanical (HVAC)
5. Fire Protection
6. Total =(1 + 2 +3+4+ 5)
Check Number
This Sectlo4 For Official Use Only
Building Permit Number: Date Issued:
Signature:
Building Commissloner/Inspector at Buildings Date
105 STRAW AVE BP-2001-0383
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map-Block: 17D-021 CITY OF NORTHAMPTON
Lot:-001
Permit: Building
Category:replacement windows/siding BUILDING PERMIT
Permit# BP-2001-0383
Project# JS-2001-0616
Est.Cost: $11735.00
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: MARK J. AUDETTE 126893
Lot Size(q.ft.): 9583.20 Owner: MATHERS GAYLE
Zoning:URB Applicant: MARK J. AUDETTE
AT: 105 STRAW AVE
Applicant Address: Phone: Insurance:
345 GREENWOOD ST UNIT 1 Workers
Compensation
WORCESTERMA01607 ISSUED ON.10111100 0:00:00
TO PERFORM THE FOLLOWING WORK.-INSTALL REPLACEMENT WINDOWS & VINYL
SIDING
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 10/11/00 0:00:00 766 $25.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Building Commissioner-Anthony Patillo