23B-043 (4) 51 LOCUST ST BP-2016-1247
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:23B-043 CITY OF NORTHAMPTON
Lot: -001 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-2016-1247
Project# JS-2016-002141
Est. Cost: $1286.00
Fee: $40.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: HOME DEPOT AT HOME SERVICES 99209
Lot Size(sq. ft.): Owner: KAMEL MOHAMED S&PAULA D
zonim4:NB/URB Applicant: HOME DEPOT AT HOME SERVICES
AT. 51 LOCUST ST
Applicant Address: Phone: Insurance:
24 SUNRISE DR Workers Compensation
PROVIDENCER102908 ISSUED ON.4/25/2016 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 4/25/2016 0:00:00 $40.00
212 Main Street, Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
; =1V5Q
Departmentuse only
APR 2 5 2016 ity of Northampton status of Permit
wilding Department Curb Gut/Driveway Permit
nEF.v 212 Main Street SewerLSepticAvailability
Room 100 Water/Well Availability
Northampton, MA 01060 Two Sets of Structural Plans
phone 413-587-1240 Fax 413-587-1272 Plot/Site Plans''
Other Specify
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
IP Zone Overlay District
Elm St.District CB.District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
/""1 13-�►a'►'1 � -LAG
Name(Print) Current
Current Mailing Address: A
�T—%% &!/y}� T phone f'!( P/,944
Signature
2.2 Authavized ent:
Name(Print Current Mailing Address:
Signatu Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit
applicant
1. Building l7 !i v (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) Check Number
This Section For Official Use Only
Building Permit Number: Date
Issued:
Signature:
Building Commissioner/Inspectorof Buildings 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:l..,. .. . R. .. L 111111111.111.. R: ..
Rear
Building Height
Bldg.Square Footage %
Open Space Footage
(Lot area minus bldg&paved
parking)
#of Parking Spaces
Fill:
(volume&Location) ... I:
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO 0 DONT KNOW 0 YES 0
........................................._..............................
IF YES, date issued:;
_1111..__..._................ .. i
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DONT KNOW Q 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 0 YES 0
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Q Obtained , Date Issued
C. Do any signs exist on the property? YES 0 NO 0
.................
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 0
1.111. .. . ..... .. ......... ....... . ._
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 Q NO 0
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
..n
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
New House ❑ Addition ❑ Replacement W' ows Alteration(s) ❑ Roofing F7Or Doors
Accessory Bldg. ❑ Demolition ❑ New Signs [p] Decks Siding[O] Other[E3]
Brief Description f Prop d �,l
Work: 9 V
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 existing housing, 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
PI, / ' '0 �"�m f-9 k� ,,,qZ_ as Owner of the subject
property ) de ',,D ��9
hereby authorize
to act on my behalf, in all matters relative to work authorized by this building permit application.
Signature of Owner Date
I, ��% 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 upldpr Xains and penaltigzxf perjury.
Print Name
Signat of wner/Agent fDDatte
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Sujperviiissor: Not Applicable £
Name of License Holder: // �/�. �/L ''v/
'11'//—Z^�� `%�✓
License Number
Addres , ! � /yExpiration Date
Signature Telephone
9.Registered Home Inniprovemenj Contractor Not Ap lic ble £
Company Name Registration Number
AdidreLstion Date
Telephong, - i/1;
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...... £
11. - Home 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
I
I
n
Ile Comrzonweafth of Massaclir ser
Deptarinzer_t of.IndusuzalActdexa-
m - Office ofInvesikations
1 Coawess Street;Sine 100
3osssmr;,M4 0-M14_2017
Fi%or..wTs'Car.3aeusntian IesuranceAffidavit.
Pbt Lw&W
Name(Brsiuess/C.—gui7c onlF&riduei) P?e- 11w,04- tf T 1✓1�-�l9 r� Se---fl.-� �
Address:–
CI�y/�i'ic^aeI717:1 t`�S'v� ja-q -1 h� 01 ru �} FhOne,#�-:
1 a__re You an employer?Check tae a6ropriate bo.-
Typo of project(required): ?
I.Q I am aloyar wwtia - 1 mn a general contractor and I Q
�` a_aieyaes(i+1r lorpari a}.= hw,'e hired the sub-contractor 6. New construction
I a t_sole proprietor or partner- listed on the attached sheet 7. Q Remodeling
ship and hwre no employees These sub-contract=hava g- ❑Demolition
wor�g for me in any capacity. employees ad hate vtof care 9- ❑Building addition '
['SIG i'Orsei�' COtnp. 'n'scseCe COME).nS-LTXMC6.=
recessed_) S.[( Yore are a corporation mid its MCI Electzicalrepais oradtlitions
3.El I am a homeolvner doing aL vtoL', oIICers kava e:{ert ised tbsff 1LQ Plumbing repairs or additions
=;wL-:. Flo weiker' comp_ of exemption per 1rIGL
SLTanCe rcGIIi12��t t Un R
c.152,
§-(�,and we have no I3_ Ocher
employees.E- 0 woe?-cars'
comp.nraace required.) i
:i�.1 soatieaot h2zcheck3 bar-,i o3tl Oso tilt otrethe s fiaabetow showingtbeir:ro,='comnensaduaQoticyinfa-mation.
t uo�,eo:vtus wire snnautiais Ldavit iadisatiin=theyire dohg2H work wdthca bre outside mobuctummustsabmitaurw afndwkindiCaziDgamb.
tConmecton-thatcheck ursbxmustatt_ch:damadditioaaisbeasaotaiagthen=eofthesob-coubactorandstatewhetherornotbuseentitiesh ie
csptage;.':i the sail-co�beet cm&l Xcs,they must pio%idc their wwt:W comp.paUcyu=ber.
I arta aiz er.ployer that it pr ovWvW tporkers'compensation hwtrwice far my employees �eZow Is the polZ�y anrF job sr#e
int or�narion. n ,�
Iastnance Company Name• - /1(L= 1�
Policy'Sr ar Self-k&Lir.n— s �% 5757 `47 E?CpsetionDate: i f
job Site Address: City/state/Vw:
&ttaeh a copy of toe worlrers'compembon poucy declararion page(shozviag the policy a-MMber and expiradon date).
catlins to secure coverage as required under Sectaon.?aA of MOL a.1572 can leadtp$e imposition of crmminial penalties of a
fim e up to 31,S00.00 and/or orae-year imprisoameA as well as civil penaIties in the dim of a STOP WORM ORDER and a fine
of uo to$250.00 a dap 8.9a_insi the violater. Be advised that a copy of this statmaeat maybe forwarded to the Office of
fuvestigations of ft DTA.for insurance coverage verificadon. E
I do herebyc 'ins p o erjiuythat the irforruationpravided above is true and aarreoL
LlT
.-
Sirmait "? N'i'l✓ D e:
Phone= 0-01 E 9r6 6—
i
t
Offleiat use ordy. .Do not write in this area,to be completed by cuy or totr+n o,WaL f
City or Town: PwmiitlLicense#
Issuing Authoritg(circle oni): i
i.Board of Health 7 Bur7ding Department I City/Toran Clerk 4.Rleet;ical Inspector 5.Plumbing Inspector
G.Otber
ContactPcrson: Phono#:
i
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: f'fm r
The debris will be received by:
Building permit number:
Name of Permit Applicant I � dq--
pP � �
Date Signature of Permit Applicant
Apr 15 16 07:43a
p,2
HOME IMPROVEMENT CONTRACT
PLEASE READ THIS
Sold,Famished and Installed by:
Branch Name.Basten North&South Date-A-iiOUL TED At-Homy Services,Inc.
fNb/b The Home Depot At-Rome Services
Branch Number:31 and 33 908 Boston Turnpike,Unit I.Shrew3buiry,MA 01545
Toll Free 877-903-3768
Federal W '5-2698460,ME Lic 0 C 02439;Rl Coal.Lie#16427
CT Lie#HIC0653-11;M A Home Inipmveimmi Ccnw.ctar Reg.4 126843
Installation Address: _5� n(o
City state Zip
Purchaser(s): Work Phone. Flame Phone: Cell Phonet
Home Address: L4,-0 villya)ce-
(if differeqi from histallatior Address) City State Zip
E-mail Address(tcrc.eivc orojeci communications and Home Depot updates):
D I DO NOT wish to receive:trity marketing emaik from The Home Depot
MmInformation: Undctrwgned f_'Custotner**),the owners of the property located at the above installation address.agrees to buy,
ne Services,Inc.("The Home Depot")agrees to furnish,deliver and arrange for the installation("Installation")of
all mauxtais described on the below and on the referenced Spec Shcet(s),all awhieb are incorporated into this Contract by this
reference.along with any applicable State Supplement and Payment Summary attached hereto and any Change Orders(collectively,
"Contract"):
job C twim.,WA' Products: S .Sbeetls)#i Proiect Amount
ding XlWindow; 0 Insulation
naunemC:
icuv�ri ❑EntrymElors
1'3
❑
R
C] oDfing ElSiding L3 Windows El laialali'v-1 -
nGtliLers1Covtrs ClEntryEDgx•s ❑
URoofing Li-siding El'Alirtcicm's 11 lrisuh_ifi�rw
_]Rcinring L NVi"JCWSL1_1-L-;L1Uticn
EIGuacrs f Cov-is ClUntry Doors L3
1%7irfinitim 25%DepcEdt iff Contract ATrouiiidue spun exectakin orthis contract. Total Contract Amount $
Maine Purchmers any not drpcLji more than ont-third of the Contr3dAmount. I
Ctwomer agrees that,immediately upon completion of the work-for each Product, Customer will execute a Completion Certificate
(one for each Product as defined by an individual Spec Sheet)and pay any balance due. As applicable,each Customer under this
Contract agrees to he jointly and severally obligated and liable hereunda.-
The Home Depot rescrve,,,the right to isur a Change order or terminate this Contract or any individual Prcduco(s)included herein.at
its discretion,if The Horne Depot or its authorized service provider determines that it cannot perform its obligations due to a structural
problem with the borne,environmental hazar,1%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 Contract.
Payment SurrlmaEvL.: The Payment Summary# i 2_,6,nj 37 included as part of this Contract, sets forth the total
Contract amount w-KI payments required for the&posits and final payments by Product(is applimble).
NOTICE TO CUSTONIER
You are entitled to a completely rifled-in copy of the Contract at the time you sign. Do not sign a Completion Certificate(mite:
there is one Completion Certificate for each listed Product as defined by indivIdtat Spec Sheets)before vrork an that Product
is complete.
In the event or termination of this,Contract,Customer agrees to pay The Dome Depot the costs of makriats,labor,expenses
and services provided by The Home Depot or Authorized Service Provider thrmilh die date of termination,plus any other
amounts set forth in this Agreement or allowed under applicable la-w. THE HOME DEPOT MAY V91THROLD AMOUNTS
OWED TO THE HONIU DEPOT FROM THE DEPOSIT PAYINIENT OR OTHER PAYMENTS MADE, WITHOUT
L12MITtNG THE HOME DEPOT'S OTHER REMEDIES FOR RECONIERY OF SUCH AMOUNTS.
1,ceeptr
qnce and Authorization: Customer a- ,r
greei and understands that chi; A cot is the entire agreement between Customer
and The Rome De"with regard to the Products arid Inslallation servicesZ'' es all prior discussions and ugreements,either
�"' It -Sc
oral cr written,relating to mid Procacis xid lnitalhiiion,This Agrcenl.Tcann. igred or amended except by a writing&]plet]
'a""'
"T o e
by Customer itti(I'Me Home Depot.Gistorrzr acknowledges and agTCeS I iat C lit r'has read.understands,voluntarily accepts The
C
terms of aid has received a copy of this Agreement
Ace pled by: Submitted
X
Z/
X7 t 4y/n
141 Dalt Salcx(f I's Signature Dale
Customer',soig<- - �X
Teicp & .1),
Customer's Sicnoture Date Sales Consultant License No.
C-,kNCf LLATION: CUSTOMER MAY CANCEL THIS
AGREEMENT WITHOUT PENALTY OR OELK I
BY DELITERING WRITTEN NOTICE TO THE L40NIE
]DEPOT BY MIDNIGHT ON THE THIRD BUSINESS
DAY AFTER SIGNING MS AGREEMENT-
STATE SUPPLEMENT ATTACHED HERETO
CONNTALNS A FORM TO USE IF ONE IS
SPECIFICALLY PRESCRIBED BY LAW IN ;
VI 1Q-lTA4r7Q?Q
Simonton Windows
6500 VantagePointe
R. r - � i. � ' s Argon Lovv-E.No Laminated Glass
Dou�le Nang ��„/. 1,8 Cas g
ka
',Nin Grids
'vent ara de dobia guillottna Vini!o 3.18 m m Vadrio-Arg6n Lo':-E Sin
R r�raxr� viwr:o larninado Con rejillas
CPD:SSP-A-44-21042-00002 07-75 DH
ENERGY PERFORMANCE RATINGS
EVALUACION DE RENDIMIENTO ENERGETICO
U-Factor Solar Heat Gain Coeffident
0.29 1 .65 _ 0.24
ADDITIONAL PERFORMANCE RATINGS
a
EVALUACION SUPLEMENTARIA DE RENDIMIENTO
Visible Transmittance
0.45
Marc'a:w:re:stp';'ves a^af lr�—a ratings cOnarrro:r.spc:i:ab:a.FRi;p:.-rad:,-Az;;r dalarr.-:n ny aticia pradw't paTJrr arca.',,FRC:aing ara
det2r!r e (or a rxac set Iarnra,r.en%.;andr„aa acd a spA i,fc,r,cuots--3.'c FRC actin-ot re.:cr ms:n':any prrd,c and dc6s. of aarrart 7:a
SCCasi!:ry-af zm_'c-ocu:(`cr aryspF Fc;:sa Cc-s4t xa^i,!a:h:ra!s`i:=�t;;re'cr aC-a-prad:�:'.par'c-rzr;a rrxzat:ar,.:r.,�:s^f:c arg
-,..:'3C--..rta a95pu!a�U9 Va�J:ES:�''�G:a.._�..i�pf:r:2..T:2!:li's_. al^,v3;���:Ca,-a.antar'1;.•,..•.?.'9!',C:,Ti:e....:[:a. ai;,rod'.:..._a5 va±Ci a3
1':7-:.LLi'f nJ yaran32a CUa a!CrrCUt Saaad::UaCr 7a.eur.'JSir 5SCaC^.,::.Co.':SI:!la:on al f..IeW da:tab::C2n:d pa:a al ase a�fJp:adv Ca
Unit qualifies for ENERGY
STARe region(s):Northern,
North Central,South Central,
r Southern.
STC:29
IND:Rein 00/Glass ProSolar/H-LC25
P.+.2 51-2 5 Tested Size:48”x 80”
Florida Product Aporovai:FL5167
Applicable Test Standard(s): ANSI/AAAAA/NWWDA 101/I.S.2-97,AAMAMDMA/CSA
101A.S.2/A440-05,AAMAMIDMA/CSA 101/I.S.2/A440-08,
A440S1-09 Canadian Suppl
8858790/01 g0333 HS Howard 6400094A
r:eeo:-s ace;; ,css.o.e E%E:L S-A-^;91.eu! :ea:r-:re
ZLa'de eS:a ettade:a E%ER3', AA?i£Pa-a rC.^.::,8;T.AS ac2r;a I cst v:S:p u`v4 Bnvr—s;ar gcv