18C-098 (4) 30 FRANCIS ST BP-2020-0517
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 18C-098 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-2020-0517
Project# JS-2020-000890
Est.Cost: $1162.00
Fee: $40.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: HOME DEPOT AT HOME SERVICES 104327
Lot Size(sg. ft.): 7492.32 Owner: AELAN PALMER
Zoning: URB(100) Applicant. HOME DEPOT AT HOME SERVICES
AT: 30 FRANCIS ST
Applicant Address: Phone: Insurance:
5 RIVERVIEW DR (401)935-2633 0 Workers Compensation
NORTH PROVIDENCER102904 ISSUED ON.1012312019 0:00:00
TO PERFORM THE FOLLOWING WORK.-INSTALL 2 REPLACEMENT 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:
FeeTvpe: Date Paid: Amount:
Building 10/23/2019 0:00:00 $40.00
212 Main Street, Phone(413)587-1240, Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
Department use only
City of Northampton Status of Permit:
Building Department Curb Cut/Driveway Permit
212 Main Street Sewer/Septic Availability
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 6-a— P-6- 517
1.1 Property Address: qThis section to be completed by office
L
r Map 0 C� Lot Unit
c� Zone Overlay District
Elm St.District CB District
SECTION 2-PROPERTY OWNERSHIPIAUTHORIZED AGENT
2.1 Owner of Record-
Name(Print) Currerit M ilin A d ss:
,
Tel phone
Signature 2;
2.2 Authorized Anent:
Name P Current Maili Address:
Signat re Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building /_ � (a)Building Permit Fee
[2
2. Electrical (b)Estimated Total Cost of
Construction from 6
3. Plumbing Building Permit Fee T
4. Mechanical(HVAC)
5.Fire Protection
6. Total= (1 +2+3+4+5) F Check Number
This Section For Official Use Only
Building Permit Number: Date
Issued:
Signature: 1013310
Building Commissionedlnspector of Buildings Date
)2
�dA*77j,? ',-�* @
EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR)
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
New House ❑ Addition ❑ Replacemen20110 W' ows Alteration(s) Q Roofing
Or Doors
Accessory Bldg. ❑ Demolition ❑ New Signs [❑] Decks [❑ Siding[❑] Other[a
Brief Descri t' n r s L '�,�/� `A�� f'��� N� �l7�ie
Work: �� ` f'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
as Owner of the subject
property
hereby authorize
to act on my behalf, in all matters relative to work authorized b this building permit application.
Signature of Owner Date
4 :Y
I, as Owner/Autho AIQ�
Agent hereby declare that the statements and information on the fo egoing application are true and accurate,to the best my knowledge
and belief.
Signed under the painsa ena ies of perjury.
Print Name
Signature of Ow ent Date
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisoor� Not Applicable ❑
Name of License Holder
License Number
Address Expira ion Date
Signature fTelephone
9.Registered Home Im rove e t Contractor: Not Applicable ❑ �---�
Company Nanie � Registration Number
Addr ss Expiration Date
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 buildin rmit.
Signed Affidavit Attached Yes....... V, No...... ❑
City of Northampton _
Massachusetts
F.i G
m; 3.
DEPARTNSNT OF BUILDING INSPECTIONS �s x
212 Main Street • Municipal Building
Northampton, MA 01060 sst yy ��^J
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, conversion,
improvement, removal, demolition, or construction of an addition to any pre-existing owner-occupied building containing
at least one but not more than four dwelling units....or to structures which are adjacent to such residence or building"be
done by registered contractors.
Note:If the homeownerhascontracted with a corporation ration or LLC,that entity must he registered.
Type of Work: !N e�',/�nv� 2//L ESt.Cost: 2 '
�90-
Address of Work: 4r�p
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 pe it as the agent of the owner:
Date 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
City of Northampton
Y •"� Massachusetts
ti. G
`i DEPARTMENT OF BUILDING INSPECTIONS y; r
212 Main Street •Municipal Building Jd, OD
Northampton, MA 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:
(Please print house number and street name)
Is to be disposed of at:
7
(Please print name and location of facility)
Or will be disposed of in a dumpster onsite rented or leased from:
(Company Name and Address)
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.
Home Improvement Agreement: Pagel
km
Home Depot License #'s - For the most current listing www.Homedepot.com/LicenseNumbers
MA: 107774, 112785
Ronald Engelbrecht
Salesperson Name: Registration No. (if applicable):
Home Depot U.S.A., Inc. ("Home Depot") or Service Provider named below will furnish, install and/
or service the equipment listed below at the price, terms and conditions as outlined on this form.
Palmer Michael and Aelan New England South 1-MROWI8P
Customer Last Name Customer First Name Store # / Branch Name Customer Lead/ PO#
30 Francis Street Northampton —� MA 01060
Customer Address City State Zip
(413) 584-8706 mpalmer4@yahoo.com
Home Phone# Work Phone# Cell Phone# Customer Email Address
NOTICE OF RIGHT TO CANCEL: YOU MAY CANCEL THIS AGREEMENT WITHOUT PENALTY
OR OBLIGATION BY DELIVERING WRITTEN NOTICE TO HOME DEPOT AT:
908 Boston Turnpike Unit 1 Shrewsbury MA 01545
Address City State Zip
Or Email: I customercancellationnortheast@homedepot.com
Service Provider Email Address
BY MIDNIGHT ON THE THIRD BUSINESS DAY AFTER SIGNING, UNLESS THE STATE
SUPPLEMENT PROVIDES A DIFFERENT CANCELLATION PERIOD. THE STATE SUPPLEMENT
CONTAINS A FORM TO USE IF ONE IS SPECIFICALLY PRESCRIBED BY LAW IN YOUR STATE.
YOUR PAYMENT(S) WILL BE RETURNED WITHIN TEN (10) BUSINESS DAYS AFTER HOME
DEPOT'S RECEIPT OF YOUR NOTICE. YOU MUST MAKE AVAILABLE FOR PICKUP BY HOME
DEPOT OR SERVICE PROVIDER, AT YOUR SERVICE ADDRESS, AND IN SUBSTANTIALLY THE
SAME CONDITION AS WHEN DELIVERED, ANY MERCHANDISE OR MATERIALS DELIVERED
TO YOU. OR YOU MAY CONTACT HOME DEPOT FOR INSTRUCTIONS REGARDING RETURN
SHIPMENT AT HOME DEPOT'S EXPENSE.
THE LAW REQUIRES THAT THE HOME DEPOT GIVE YOU A NOTICE EXPLAINING YOUR RIGHT
TO CANCEL. PLEASE SIGN BELOW TO ACKNOWLEDGE THAT YOU HAVE BEEN GIVEN ORAL
AND WRITTEN NOTICE OF YOUR RIGHT TO CANCEL.
Acknowledged by: X 09/29/2019
Customer's Sign ture Date
Contract Price and Payment Schedule : Payment of the Contract Price is due upon signing unless a
different payment schedule is required by law, specified below or in a payment addendum.
Contract Price: $ 11162.00 Includes all applicable taxes. Excludes finance charges.*
Sales Tax: $ 10.00 (If applicable)
*Maximum deposit ONLY applicable in MD, MA, ME(33%), NJ, Wl(9991o)
Dep. 1 25.0 % Deposit Amount $ 290.5 Remaining Balance $ 871.50
The Home Depot-2455 Paces Ferry Road, N.W. Bldg. B-3, Atlanta, Georgia 30339-Customer Care: 1-800-466-3337
460FI HDE Customer Agreement(24 Jul.18) v 0.1.8
Home Improvement Agreement: Page2
Finance Charges:
*Any interest payments or other finance charges will be determined by Customer's separate cardholder
or loan agreement, to which The Home Depot is NOT a party, and will be in addition to Customer's
payment under this Agreement. Customer is subject to the terms and conditions of the cardholder or
loan agreement, as applicable. No funds should be made payable to Service Provider; however, Service
Provider may collect Customer's payment(s) made payable to The Home Depot.
Insurance proceeds will will not -, be used to pay some or all of the total amount of sale.
Description of Work to be Performed:
Installation of windows
A more detailed description of the work to be performed is included Int the section entitled cope o
Work which appears on page P--� of this Agreement.
Anticipated Delivery Date/Installation_Schedule
Approximate Start Date: 11/24/2019 Approximate Finish Date: 12/22/2016
All dates are approximate and subject to change based on unforeseen events including inclement
weather, permitting delays, and delays in confirming insurance coverage of Your claim for any repair, if
applicable.
Electronic Records Authorization:
You are entitled to a paper copy of this Agreement if you choose. If you consent to an e-mailed copy, your
consent applies to this Agreement and all subsequent documents and written communications related to
this agreement. By contacting your Service Provider, you may update your email address, withdraw your
consent, or obtain a paper copy of the Agreement or related documents at no charge. By providing your
consent and verifying your email address above, you confirm that you have access to a computer that can
receive and open emails and PDF documents.
By initialing this paragraph, I consent to receive only electronic records related to this transaction.
Initial
Accepttance_and_Authorization:
By signing below, you authorize Home Depot to (a) arrange for Service Provider to perform Installation
and/or (b) order and arrange for the delivery of special order merchandise, including special order
merchandise that may be custom made, as specified in this Agreement. Do not sign if blank or
incomplete. (Service Provider's/permitting information may need to be provided to You later.) By signing,
you acknowledge that you have read, understand, and accept this Agreement in its entirety, including
the General Terms and Conditions and State Supplement, if any. You further acknowledge receiving a
complete copy of this Agreement. Keep it to protect your legal rights.
X 09/29/2019 The Home Depot
Cuttomer't Sigpdture Date Service Provider Name
X 09/29/2019 908 Boston Turnpike Unit 1
-Si (if applica e) Date ervice Provider Address
X 09/29/2019 1 Shrewsbury MA 01545
STgnature OnLSehalf of Home Depot Date City State Zip
HIS 0554523, R-1-073-13-00004
Service Provider Phone Number Service Provider License Number
The Home Depot-2455 Paces Ferry Road, N.W.Bldg. B-3,Atlanta,Georgia 30339-Customer Care: 1-800-466-3337
4601`I HDE Customer Agreement(24 Jul.18) v 0.1.8
WINDOW SPECIFICATION SHEET - Spec.Sheet#: 1-MROWI8P Sheet: 1 of 1
Customer: Michael and Aelan Palmer Job#: 1-MROW18P Consultant: Ronald Engelbrecht Date: 09/29/2019 ,
New Window
Existing Window Hinge Locations
Measurements Grids Product Options Labor Options From outside,
Left to Right
Bays,Bows
Location Color Rough Opening #of bars #of bars Csmnts,1 Pnl,
use L,R or S
Glass Misc Items
Hardware
Screens Code
For doors use
LC _ Mull "S"=stationary or
° E ° o ° o
w Style Wraps m m $9 `o z W r c "X"= operating
H Room Floor 1 Code (YM) I Style Code Series Code E u') 3 = 5 i—'c6 I U 3a 8 > x° > _
FULL SCR,STD,White, LSR
1 KITCH 1st DH N DH 1200 WH WH 20 54 74 F, WH,W C ALL 1 1 ALL 1 1 GlassPack:Standard
GBG H
FULL SCR,STD,White, LSR
2 KITCH 1st DH N DH 1200 WH WH 20 54 74 F, WH,W C ALL 1 1 ALL 1 1 GlassPack:Standard
GBG H
SPECIAL CONSIDERATIONS:
Wrap Color
nterior Casing Type
Bay or Bow window:
atboard material(vinyl only-Birch or Oak)
ay Project Angle(30 or 45)
ay Flanker Type(DH,SH,or Csmnt)
Top of window to soffit(inches)
It tied to soffit,color of soffit material 1 have reviewed and agree with all the job specifications above and the
Construct Roof(Yes or No)' Special Terms and Conditions on the following page
Garden Window:
atboard Material(vinyl only-White Pionite,Birch or Oak)
Office of Consumer Affairs and Business Regulation
1000 Washington Street - Suite 710
Boston, Massachusetts 02118
Home Improvement Contractor Registration
Type: Supplement Card
Registration: 112785
HOME DEPOT USA INC
P O BOX 105451 Expiration: 04/22/2021
ATTN: LICENSE MGMT TEAM
ATLANTA, GA 30348
Update Address and Return Card.
SCA t Ca 2OM-05/17
Office of Consumer Affairs&Business Regulation
HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only
TYPE:Suoolement Card before the expiration date. If found return to:
Registration Exoiration Office of Consumer Affairs and Business Regulation
112785 04/22/2021 1000 Washington Street -Suite 710
HOME DEPOT USA INC Boston,MA 0 118
i
RICHARD TROIA
2455 PACES FERRY RD C-11 HSC
ATLANTA,GA 30339 UndersecretaryNot valid without signature
s-
The Co)im.-,o:tlt;eufth ofliltttssaehrisetts
:y p :
Department of IndustrirtlAccirlents
I congress Street,Suite 100
J. Bostrtz, A14 02111-2017
>vlvls:rt riss.gou%flia
11 urkers'Compensation insurance Affidavit:i3nilder's/Coniractnrs(Electricians/Ylnmhers.
TO BE HtUN)WITH TTE PERl11TTI\i,AU"1 110Rt7'11.
An ilicant Information Please Prir_t Legibly
Name (Business/Orgmiz:rtiLn/lmlividual):
! Address:
6,0 -T
pity/Statellip54�Plionc 0-
;ti re ynu nn cmplu;c:.'Clicck the upprapriat ifoc: j
Type of project(required):
L❑I am a e=mployer with employ:es(fall and/or p3n•time)` i
7. []New construction
` 2.�]1:ur.a snfe proprietor ur paGnership and have no entployea>:working for;,::m
^n••c, [No:vorkers'com a. C] Remodeling
� Pa=� p insurance rc;luirv�d.j
3.n 1 am a i;nmeowner doing all:work myself:!No v:cnccrs`coma.insurrtce rc�;umed.l r y• El Demolition ,
I�1 ;
a.�l am a homc0%rner and;will L�hiring contractus.o conduct all work on my o cny. I will 10 Building addition
� pr r..
Z�"-
--lust 1,11 conuac;orseither havenmrlxrs'eornpvn.sarfon insumnceuraresole 1 l.❑Electrical repairs or additions
P,
ors:with no employees.
12.0 Plumbing repairs or additions g
encml contractor 1 have hired the sulrcomractors listed on tl%e anached sheet, :
These sub-cemractors have employees and have workers`comp.insurance.: 13.�E]XRf repairs
t.(�1Jeart a corporationsnd its officers hntie exercised their right ofescmption per:,,IGL c. 11• er {.
152,S 1(4),and the have leo employees.(No r;orkcr>'coair�.insurance rLtGuire'd.l
i `Any applicant that checks cox 4l must also till 01st the section belowShutving I.'ueir:workers'compel setion policy inlorrruiion.
Homeowners who submit this affidavit indicating thuyar,doing all%,cork and Ulan hire outside uonuuetors frust submit a new aftdavit indicatinv such, {
rCGntmctors tint check!his bOx must attached an additional shea sho%ving tile name of the sub-contractors and state%whether or not those t:mirics have
empluyecs. If rile sub ontretors have employees,they must provide their:voile:r;'comp policy number.
It—Ill raft etliplQper that is providing,workers,com.pensulion insurance for my employees. Belo)v is the policy and job site r
inforinalion.
Insurance Company`:uric: 1�1�J-4- C? h7)b VA2 61 /1,m � )�
!! --�-1'►� 1
Policy;#or Self-ins.Lie.'; zKq
7 Expiration Date: ! `!
Job Site Address:
C�ity/State/Zip:
Attacll n copy ofthe workers'com ensaton policy declaration page(showinu te policy n
umber attd expirati sa�te�), t
�3
Failure to secure coverage as required under.,AGL c. 152,525A is a criminal violation punishable by a fine up to$1.500.00 1)0 10
and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORD:ORDER and a fine of up to$250.00 a
day.1gainst the violator.A copy of this statement may be forwarded to the Office of lnvestigetions of the DIA for insurance
coverage ver;caiic,�.
tai
t da ltereJlr cerrifp t t1le ains tt(l of p 1tfry that fire injarnralintr provider!above is tr;re rrrtd correct.
Signntttre• [
1]ate• i�„ —
Phone r iJ,— ' — E
Official use only, Do prof:write in this area,to be co/:tpleted by eltV or town off,•ciaL
City or Town: ?Permit/License:!t_
issuina Authority(circle otic):
1.Boatel of Benith 2.Building D=epartment 3.CitytTown Clerk 4.Electrie;3l Inspector 5.Plumbing Inspector
6.Otheri
C.}atact;ersurr: Phone 4:
i i
Simonson Windows
6500 Vantage?ointe
vfKc Double-Hung Vim/. 1/8"Gass Argon Low-E No Laminated Glass
Wi,h Grids
:a i"Pjg a fa Vertara,fie doole guillotine Vni!o 3.'.8 mm Udr10 Argbn Lour-E Sin
vidro laminado-Con rejillas
• 1 a - CPD:SBP-A-44-21042-00002 07-75 DH
ENERGY PERFORMANCE RATINGS
EVALUACION DE RENDIMIENTO ENERGETICO
L'-Factor Solar Heat Gain Coefficient
-.cxr-� J.,aa;iacs:3anarcia as°rar:ia Scar
0.29 1 .65 0.24
ADDITIONAL PERFORMANCE RATINGS
ati
EVALUACION SUPLEMENTARIA DE RENDIMIENTO
• Visible Transmittance
de_s'isiGia
0.45
mar .&L-ec 26pu!am rat:rese,sings conform;c 3cp!naola 4FRC pr:v adwer'or detarm:ning ahols product performance.NERC afrgs are
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Unit qualifies for ENERGY
STARO region(s):Northem,
North Central,South Central r
Southern.
37
P. STC:29
21 QtlrtiEl,td
DP.-+25/-25 IND:Rein 00/Glass ProSolar/H-LC25
Tested Size:48"x 80"
Florida Product Approval:FL5167
a
r
Applicable Test Standard(s): ANSI/AAMA/NWWDA 101A.S.2-97,AAMANVDMA/CSA
101/I.S.2/A440-05,AAMA/WDMAfCSA 101/I.S.2/A440-08,
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8858790/01 80333 HS Howard 6400094A
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