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41-039 1411 WESTHAMPTON RD BP-2017-0180 GIS#. COMMONWEALTH OF MASSACHUSETTS Map:Block: 41 -039 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-2017-0180 Project# JS-2017-000291 Est. Cost: $8170.00 Fee: $35.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: use c RENEWAL BY ANDERSEN 090125 Lot Size(so. R.): 191228.40 Owner: MARTIN GEORGE&HANNIA L GONZALEZ Zoning: Applicant: RENEWAL BY ANDERSEN AT: 1411 WESTHAMPTON RD Applicant Address: Phone: Insurance: 30 FORBES RD (508) 919-0900 WC NORTH BOROMA01532 ISSUED ON:8/9/20I6 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: FeeTvpe: Date Paid: Amount: Building 8/9/2016 0:00:00 $35.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner 1 ,_ _ e ty of Northampton Status of Permit Departrnent use ONy B ilding Department Curb Cut/Driveway Permit. AUG 9 2016 212 Main Street Sewer/Septic Availabifdy Room 100 WaterfWef Availability ,OF Kernel tKernel wens 0ampton, MA 010.7-1240 Fax 41036-587-1272 Plot/SiteoSets of Plans ural Plans. NORWPMPTOl4:ni:,i 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 4.1 Property Addre>}_s: 1411 WESTHAMPTON ROAD Map Lot Unit FLORENCE, MA 01062 Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: HANNIA GONZALEZ 1411 WESTHAMPTON RD FLORENCE, MA 01062 Name(Print) Current Mailing Address: 413-585-0195 Telephone Signature 2.2 Authorized Agent: JAIME Ma• N 30 FORBES ROAD NORTHBORO,MA 01532 Name(Print) Current Meiling Address'. 508-351-2214 SignatureTelephone SECTI 3- TIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building g,170 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) 8,170.00 Check Number roe, 4-.47is This Section For Official Use Only T�" Building Permit Number: ()ate Issued: Signature: Building Commissioner/Inspector of Buildings Dale 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 Sizc Frontage Setbacks Front Side L: R: L: R: Rear Building Height Bldg. Square Footage Open Space Footage (Lot area minus bldg&posed parking) #of Parking Spaces Fill: (volume&Location) A. Has a Special Permit/Variance/Findin er been issued for/on the site? NO Q DONT KNOW YES Q IF YES, date issued: IF YES: Was the permit recorded at the Re " of Deeds? NO Q DONT KNOW YES Q IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO Q DONT KNOW YES Q IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Q Obtained Q , Date Issued: C. Do any signs exist on the property? YES Q NO er IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES Q NO IF YES, describe size, type and location: E. Will the construction activity disturb(clearing,grading,enc on,or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES Q NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House n Addition ❑ Replacement Windows Alteration(s) n Roofing in Or Doors Lxl Accessory Bldg. ❑ Demolition ❑ New Signs [O] Decks ID Siding[O] Other[O] Brief Description of Proposed Work: RFPI ACFI WINnOW-NO STRIICTIIRAI 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 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 HANNIA GONZALEZ ,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. SEE CONTRACT 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 penalties of perjury. JAIME MO' . t Print Name 5V8 � �� Signature of Owner/•;-nt Date SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder JAIME MORIN 90125 License Number 86 G• ••INE• STREET LYNN, MA 01905 10-06-16 Addre Expiration Date \ 508-351-2214 TC ‘ Telephone 9.Realstered Home Improvement Contractor' Not Applicable 0 RENEWAL BY ANDERSEN 170810 Company Name Registration Number 30 FORE- Rs • a NORTHBORO,MA 01532 12-23-17 AddressExpiration Date Telephone508-351-2214 s CTION 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 35 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 imended 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 buildinr 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 he 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 rhe C•,emu.eaa.Irw dx neat ltr Derr-mat.Derr-mat.tenant. ,inifitnel tte_se Office alAniseeds= 7E-4F.= - SMO Wain Ii am.Sinai Sas AG 02.111 innitanzeltiee Weans'Com?eaaf$o iaurance ATIdavii:Hailde:*Cw¢nx7aa/tilearltIni/Phembm awollrM103�vtmtlF� _ftfie Tare r6.vtwnitmwnenviachre,,4:, RENEWAL BY ANDERSEA — —tom ddnesi30 FORBES ROAD ._,�� City/Sts lip' NORTHBORO,MA 01,236__ —_ phone ii: 508-351-2200 Are 4.11CalwwWWfwel ►3w a6rnh I TSRdpyn•I^etwA9 30 q. ❑ 1am•Waal"trawa.r.11 1 1 kin tat& ndi :Int Swine sib-censor, 6 ❑\ew '� splay:wI an4or petal" I Rsnadii% ?.❑ f m.colrpupaemapemer- I.nlrm dr aged dan % '' �I .hip mad lives.mpiooea Tle+s.rbwtimers No S ❑Dwnokil wails Br me in am - workers*cram.imam 9 ❑thadift Ache= [No Nylon'lwm%ar�tf�a 5. ❑ WI ST a:aTeaarao owl iii iP,L1-,FMebiul MINIS ke.AIi1L.rr a•'V•La I (Meal nave wemotthe: 3,0 lam•bowenso..oslpsll..k 1400/ 'pet 1.1O4 I I.❑PhwhmdrepMs or salaam Ary•L(No worlwri®9,_ e.152 41(44 aad wA Memr u❑Roof maim lava afoul] r e•s rve wta. • 13 0 Otter saw aemiere+mNaled.' I An+44a9. ejn+h-,is vm4ti14av(we raw abs ioa+G Wv x.ata. '+Ywailm r lamS.T"AO iaarea awe tL:aei.Ccaup re a.Only ail*al ad as aim meal..ssa.at as rmraaa✓alb Kay rah Is!aae eavs..1Ur►...w .a to.MS.W.arr:rmr.rme c ae ab.-d.mc ad Om lunar:"a(9 p.lad..ms,m l oaf ea espd. rtdr prevdlry..A.a`ngea.rmbs isra.4far rp''wipes Maestr 416.p.fdryadd id sle ffin.elsa I.wrapn Cowpony Mire, OLD REPUBLIC MB.CQ_ , Folk3 iw Wi-im L¢.6.__ItAICL3056370). FsyeI ofm• 10-01_16 _ .—__ /ab Sba meet 1411 WESTHAMPTON ROAD c, 7 FLORENCE. MA 016C2 Amen con atria meanie emlpponedso p.M7 wximan.pet(.tar dle p.& nM.:aY eaplmtlo•lyes Hoon in beancwrwie asrequioni uncle Sectwn 25A ofMCd.a:)52 an Wed.the apa>. a atafalmai wade%ofa foe up to Slj(rC.W.werwwyew wpm: Jca,m well eachi1 p..ram:in the hem of SOW NUBS:+JMDEH..1s Bre cutup WCSO(p a dq wind the vibaw'. Re tivmal eatscup)urea.prwotm Ma l be irwadad whe Odd Limey Crc of the INS for insane a em saps vwlficamn Irotwo,rryaw..arraasSn Vada.tithe LywioAm prerY(/ A .ras+Naa mac 508-3512200 Wad De Meal*Mt WI are.a be mired4.1 CMS-or Ten PamaW..kaa.a Snubs AadimBS(ehal.ams} L Board ammo 2.BmYtis Dt n.a.o . :34.11•••Cat4.Blawlnl knpeSe 5.Palsg Snq..epr i1M.r` Caanet Hasr Renewal Agreement Document and Payment Terms byAndersen. dba:Renewal by Andersen of Boston Hannia Gonzalez Y� 1 legal Name:Renewal by Andersen LLC 1611 Westnampton Road _144170810 Florence, MA 01062 e, 30 Forbes Road I Northborough,MA 01532 H 1613)585-0195 Phone'.508-351-2200 I Far 1508)986-0672 I RbABostonOperaliionsalAndersenCorp.coos Customer(s) Name: Hannia Gonzalez Contract Date: 07/15/16 Customer(s) Street Address: 1411 Westhampton Road, Florence, MA 01062 Primary Telephone Number: (413)585-0195 Secondary Telephone Number: Primary Email: h.gonzalexecomcast.net. Secondary Email: Buyer(s)hereby joindy and severally agrees to purchase the products and/or services of Renewal by Andersen LLC d/b/a Renewal by Andersen of Boston("Contractor"), in accordance with the terms and conditions described in this Agreement Document and Payment Terms,Notice of Cancellation, Itemized Order Receipt,Warranty,Sales Cost Savings.Terms and Conditions of Sale, Owner or Builder, and any other document attached to this Agreement Document, the terms of which are all agreed to by the parties and incorporated herein by reference(collectively,this"Agreement"). Buyer(s) hereby agrees to sign a completion certificate after Contractor has completed all work under this Agreement. Total Job Amount: $8,170 By signing this agreement,you acknowledge that the Balance Due, and the Amount Financed must be made by personal check,bank check,credit card,or cash. Deposit Received: $2,723 Balance Due: 55,447 Estimated Start: Estimated Completion: Amount Financed: SU 8-10 weeks 1-2 days Method of Payment: Credit Card We schedule installations based on the date of the signed contract and secondarily on Notes: the date in which we complete the technical measurements.The installation date that Deposit pd via AMEX we are providing at this time is only an estimate.We will communicate an official date $2,723. and rime at a later date. Rain and extreme weather are the most common causes for 1/3 due 0 install delay. 1/3 due 0 completion Buyer(s)agrees and understands that this Agreement constitutes the entire understandings between the parties and that there are no verbal understanding changing or modifying any of the terms of this Agreement. No alterations to or deviations from this Agreement will he valid without the signed,written consent of both the Buyer(s)and Contractor.Buyer(s)hereby acknowledges that Buyer(s) I)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. NOTICE TO OWNER: Do not sign this contract if blank.You are entitled to a copy of the contract at the time you sign. YOU,THE BUYER,MAY CANCEL THIS TRANSACTION AT ANY TIME NOT LATER THAN MIDNIGHT OF 07/19/2016 OR THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION, WHICHEVER DATE IS LATER. SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN eFHIS RIGHT- Cnatnmer(s) dba.Rcnewa�a by An eNen0ff Boston , (44. --�'S -/bi-_ its-- L/C) Signature of Sales Person Signature Signature George Holt Hannia Gonzalez Print Name of Sales Person Print Name Print Name 07/1sn 6. _ _ . . Page 2 / 11 Renewal Itemized Order Receipt brAndersen. dba:Renewal by Andersen of Roston nannia Gonzalez ?R a _ Legal Name:Renewal by Andersen LLC 1011 Westhampton Road - ` `xteF 170810 Florence MA 01062 WINDOW OYmmnn 30 Forbes Road I Nonhborwgn,MA01532 H-1413)585.0195 Phone.508 351-2200 I Fax'.(508)986-70721 RbABostonOperanons©AndersenC orp.con ID#: ROOM: DETAILS: # Room Field 101 Kitchen M 5c WINDOWS:O PATIO DOORS:O SPECIALTY:0 MISC:2 TOTAL 58,170 Renewal by Auden( ucmmined to our eintonun afro. by ALFA ,,,plying mid the ru and had Jah murk prizetub;pecked by the EPA. 07/15/16 Page 4 / 11 ` fi fb i of• n-i I cm g I, n, 'if J 3 �t 4J 5 l Ci I atJ �tu'u 1'iaM I 4 "W�� 41 1 �� s ter/a: -Wrccrc-moi. _,.4 e AND-N-39 VInyINJoad Composes Maloaal I a�I Dual Argon Low-E4 SYnartsun i , I Product Type: Picture, ^ . ENERGY PERFORMANCE RATINGS .... >TINGS ^ I lJ-Fector (Solar Haat Cain Coaffolent t. 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