22B-027 19 CORTICELLI ST BP-2019-1122
GIS a: COMMONWEALTH OF MASSACHUSETTS
Map:Block:22B-027 CITY OF NORTHAMPTON
Lot-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL 042A)
Category' window replaced BUILDING PERMIT
Permit# BP-2019-1122
Proiect# JS-2019-001823
Est Cost_E2900 00
Fee 540.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor., License:
Use Group: WALTER MAREK III 055201
Lot Size(sq. ft.): 10715.76 Owner: ABRAHAMSON WENDY
Zoning: URB(100)/ Applicant: WALTER MAREK III
AT. 19 CORTICELLI ST
Applicant Address: Phone: Insurance:
73 SOUTHAMPTON RD (413) 527-7667 0 Workers
Compensation
WESTHAMPTONMA01027 ISSUED ON.-4/11/2019 0:00:00
TO PERFORM THE FOLLOWING WORK:REPLACE LIVING ROOM 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:
FeeType: Date Paid: Amount:
Building 4/11/20190:00:00 $40.00
212 Main Street,Phone(413)587-1240,Tax: (413)587-1272
Louis Hasbrouck—Building Commissioner
60"l-1,006tzc
C E I V E
Department use only
- - City of No he tus Permit:
..r - BuildingD parnt rbC r"eway Permit
212MaiStR 1 0 2019 ptl;AvailabilityRoor�} 10ate ell Availability
Northampton{ IMO
of structural Pians
phone 413-587-124 Fai1493.387=427�.vrcn Plare
Pacify-
APPLICATION
amAPPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION b�� '//
1.1 Property Address: \ This section to be completed by office
S.+ Map 6?'-10 Lot 0-27 Unit
Nl /+ (�10 Zone Overlay District
-
R) N
Elm St DlsMcl CB District
SECTION 2-PROPERTY OWNERSHIPIAUTHORIZED AGENT
2.1 Own r^ ecord: r1,
Nann �pnni) �VL14A._1!� Current Mailing Address'.
//��^(�/ Telephone
Signature
2.2 Authors ad
Name(Print) J Curren)Mailing gtleress_ ��
Signature Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed tv nermit applicant
1. Building �G (a)Building Permit Fee
2. Electrical 1 (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) I Check Number
This Section For Official Use Only
Date
Building Permit Number. Issued: /p
Signature:
Building Commissionerllnspector of Buildings Data
I,J Mare'\13 @
EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR)
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
New House ❑ Addition ❑ Replacemem�ndows Alterations) ❑ Roofing ❑
Or Doo s
Accessory Bldg. ❑ Demolition ❑ New Signs [I71 Decks [M Siding IO] Other[O]
Brief Description of Proposed n _ L �l^ ��
Work: RC1 C2 Iyinr
,l
Alteration of existing bedroom_Yes No Adding new bedroom Yes No
Attached Narrative Renovating unfinished basemen) Yes No
Plans Attached Roll -Sheet
like.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 Woodsloves Number of each
g. Energy Conservation Compliance. Masscheck Energy Compliance form attached?
h. Type of construction
I. Is construction within 100 0.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 Ta-OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT W
I, We,JN ,as Owner of the subject
property 1I ' IL, 1{�unvj /
hereby authorize VV
to arc/�t�o/n/'m�^y�be If,in all in em elative to work authorized by this building pprmifap�licalioq.
Signature of Owner Drat/tee (`1/
WIt'44: roc ,as Owner/Authorized
Agent hereby declare that the statements and information on the foregoing application are tme and accurate,to the best of my knowledge
and belief.
Signed and rp the pains and penalties of perjury.
Print N�a Io V"1
Signature of OwnedAgent
SECTION 8-CONSTRUCTION SERVICES
Na eor ConefruQ 1 Fmk- C� },�)
Nems of Lieanr Ilelder:
Li�erw Num er
?3 S� Z� ( d t 6 a3 oo
�i�� ti13 q)1 95-32 Emmen
si9euu,e Telopmos
Re Ia m+Ynnewmn t Contractor: Not ApOkeble ❑
W WiarcVL ' c, M433
C R I tre n Number
3 in 01 ao
Atltlress (� Egwa6 t Data
4 0 Telephone ll3 11 R
SECTION 16-WORKERS COMPENSATION MSURMICE AFFIDAVIT(M.6.L e.154 5254[6))
Workers Compenee8on true rance affidavit must be completed and subm(Ded with this appkallon.FeBure to provide this affMevil will result
in the deme)of the issuance tithe building permit
Si9md Affidavit Attached Yes....... No...... ❑
City of Northampton
r [aassachuaetta (i)
OF BUILDING INSPECTIONS212 N n Street eN icial Builtl ngNorthampton, Na 01060
Debris 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.
The debris from construction work being performed at:
10\ Lfi�\co -\ S�c.
(Please print house number and street name)
Is to be disposed of at:
Vol IIPA R
(Please qrint name apd locatiori of facility)
Or will be disposed of in a dumpster onsite rented or leased from:
l.� 11/1c,rtit �5-c.
(Company Name and Address)
I
Signature of Permit Applicant or Owner Date
If, for any reason, the debris will not be disposed of as indicated, the Applicant or Owner shall notify the
Building Department as to the location where the debris will be disposed.
Order#225556 Quotation Page 1
From Factory will Ship To Order Information
R.K. Miles, Inc. (WH) R.K. Miles, Inc. (WH) Date 3111/2019
PO Box 1125 21 West Street Ord Type contracto2
618 Depot Street Route 5 South Route T2
Manchester Center, VT 05255 West Hatfield, MA 01088
Phn: 802 362-1952
Fax: 802 j62-6436 PO# *1/1 1 /�1 �1 1
Customer Comment
MAREKICORTICELLI
Products Manufactured by
Phn: Paradigm Window Solutions Portland, ME 04103
Lne ty ription orWidth Height Unit Cost et
..Mu,kl*
2 1 NC 8300-Mulled 3 Wide(113,113,113) White TTT 81112 41112
RO e2 42
Factory Mull
314/aero Rme wSpacw Blocks
OBse Brick wWSiN Nose
J-Tmn rxe'(I'l)
CTIC 0.5116-X 4334'U4'ACTOR 26
Line Item Taal 0.00 0.
2 1 NC 8300 Double Hung-Premium Desigr White TFT 273MS 41112
LOWE WAg-Top
LOWS WArgm Baton
CoaairW3W x2H Top
No Grid Barom
Skgk Lock
FibagW5 Lacking Haff Scre
Line lmm Tara) am 0.
2 1 NC 8300 Double Hung-Premium Desigr White TTT 27 3116 41 112
Lw EWArym Tap
LowE WArgm Bonar
Cavared 3W x2H Top
No Gold Baran
Skgk Lok
Fiberglass Lmklrg HaffScrem
Line ran Taal 0.00 0.
2 1 NC 8300 Double Hung-Premium Deeigr White TFT 27 still 41112
LME WArgm Tap
L.E WArgm Bottom
Caaaxad 3W x2H Tap
S,igiBottari
Skgle Lk
Frbeylass L¢kirg HaMSoear
Line Iter Taal am 0.
Patten Taal 0.00 000
8564 -R05
City of Northampton
% •+ Massachusetts x¢='•" >•- kr
I c
x
DNPMIMNNT OF BUILDING INBPBCTIONS
212 Main Sf ee[ • Nwicipal Building yOs C�
Northampton, MA 01060 sryi'yj(r0
AFFIDAVIT
Home Improvement Contractor Law
Supplement to Permit Application
The Office of Consumer Affairs and Business Regulation("OCABR")regulates the registration of contractors and
subcontractors performing improvements or renovations on detached one to four family homes.Prior to
performing work on such homes,a contractor must be registered as a Home Improvement Contractor("HIC").
M.G.L.Chapter 142A requires that the"reconstruction,alteration, renovation,repair, modernization,convemion,
improvement, removal, demolition, or construction of an addition to any pre-existing owneroccupied building containing
at least one but not more than four dwelling units....or to shuctures which are adjacent to such residence or building"be
done by registered contractors.
Note:Lfthe howl eo`wne(\lh\as cIonfr(�act with a corporation or LLC,that entity mull be registered
Type of Work: W.nW`^'71��r �-1G�� CC^} Est.Cost
Address of Work: �I�1, 1 ��•l J\
Date of Permit Application:
I hereby certify that:
Registration is not required for the following reason(s):
_Work excluded by law(explain):
_Job under$1,000.00
Owner obtaining own permit(explain):
Building not owner-occupied
Other(specify):
OWNERS OBTAINING THEIR OWN PERMIT OR ENTERING INTO CONTRACTS WITH UNREGISTERED
CONTRACTORS OR SUBCONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK ARE NOT
ELIGIBLE FOR AND DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND
UNDER M.G.L.Chapter 142A.SUCH OWNERS ALSO ASSUME THE RESPONSIBILITES FOR ALL WORK
PERFORMED UNDER THE BUILDING PERMIT.SEE NEXT PAGE FOR MORE INFORMATION.
Signed under the penalties of perjury:
I hereby apply for a building permit as the agent of the owner:
rd (o,�IQ W. A+ l Z �, 17�9n
Date r Contractor Name HIC Registration No.
OR:
Notwithstanding the above notice, I hereby apply for a building permit as the owner of the above property:
Date Owner Name and Signature
The Com maawtahk ofMassaehrmo
Depo/atatt ofladustrniafAccidazie
1 CoagMMmrse;Stride 100
Boston,MA 02114-1017
wwmmasa gav/dla
Wworkers,Compensation Immanence Afdavfk
TO BE FUJW Wr1H THg PERM IING AUTHORTIY.
ApaRcaut Ldonnaths, Pleaft print
Name
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avraa a.mpbr.rt Crwa eeappopLb bo Type of project(ra9rlreo
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i.❑tam.adapiapietrorp a�ipodlavammRbys..oLboa��m 8. ❑Remodeling
arm' ptovmdoo•e.mP®aaw.agoimdl 9. ❑Demolition
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ta"p10b1 vftaOeql� t20Phmbmgrepevsoradditions
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lnsmame companyNamc a
Policy#or Self-ms.la #:�1. .}O� '" OF Bxpiodi- ae- b
Job Site Address: iI-p-\ C �—. 1. City/Staml7„ I .fe�v W�a
Attach a copy of the wohers'camp®wtlon policy dedareUm page(dwwagthe Policy amber and aaptrsuea aaoe).
Failure to sramre coverage as requucdmaterMQ,c 152,§25A is a a®iraal violation punishaMe by a fore up to$1.500.00
and/or me-year ivgniso®ant,as wall to civil Penalties in the form of a STOP WORCORDBR and a fore of op to$950.00 a
day spinet the violator.A copy of(hie statment may be forwarded to the Once oflavesdPlioos of the DIA for inamaoce
coverage veri8eaum
Ida hereby wsdertAw ofpwjmydwdwkfamadompmm�wdadrataolw;elandowrart.
5iianame: Dore
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City or Torre: PermeMAcerae#
IsmingAo&orliy(urda one)
1.Board ofHeaab 2.Handmg Deparmmr S.Cltyfrowm Clerk a Electrical laepeemr S.PrmwagInspector
6 Omer
Contact Perron: Phone#:
an& CERTIFICATE OF LIMLrrY INSURANCE
02/20=19
TN6 CBOlICK111 gpll®ASANATTEIOF MIOb1ATM ONLY AMD COMPNONO MGM UPCNTHECBt7NCAM HOLDER THIS
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6AMMID mmmmmvMtASSOCIATED EMPLOYERS INSURANCE CO
W.Mitek IneoepanMl
738ouM mplon Rd
Wauhampton MA 01027
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