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35-134 (10) 14 WESTWOOD TER BP-2020-1170 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 35-134 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: Porch Enclosure BUILDING P E R M I T Permit# BP-2020-1170 Proiect# JS-2020-001973 Est.Cost:$13450.00 Fee: $87.43 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: WALTER MAREK III 055201 Lot Size(sq. ft.): 9670.32 Owner: QUINN WILD KATHLEEN Zoning.:- Applicant: WALTER MAREK III AT: 14 WESTWOOD TER Applicant Address: Phone: Insurance: 73 SOUTHAMPTON RD (413)527-7667 O Workers Compensation WESTHAMPTONMA01027 ISSUED ON:5/29/2020 0:00:00 TO PERFORM THE FOLLOWING WORK.•CONVERT FRONT SCREENED ROOM INTO 3 SEASON ROOM 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 5/29/2020 0:00:00 $87.43 212 Main Street,Phone(413)587-1240, Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner Department use only City of Northampton4Sjatus of Permit: Building Department �qf' ,b qut/Driveway Permit L 212 Main St Se` /Septic Availability 4� 111 t Room 100 ti���F ���C W er/WeN Availability Northampton, MA 0 �,�,���,� T o Sets of Structural Plans phone 413-587-1240 Fax 413- -q lot/SXe Plans 0'cT�soCNs Othof Specify APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR-DE OLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Property Address- This section to be completed by office Map Lot_ Unit Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner pf Record- Nam `�(Prin A Current Mailing Address: v 7Telephone Si nature 2.2 Authorized A eKok t --".K � Name(Print) Current Mailin Address: G Lllll� 5 ') v � Signature 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. Electrical z (b)Estimated Total Cost of L, Construction from 6 3. Plumbing Building Permit Fee �^7 4. Mechanical(HVAC) v�( 5. Fire Protection 6. Total=0 +2+3+4+5) Check Number TThis Section For Official Use Only q Building Permit Number: �J� V Issued: ed: Signature: VV v G Building Commissioner/Inspector of Buildings Date EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) 1 s Y , � , I i i [ +41A 4 4. j I Z;GC. ?, JJ 'aieu;t,{L,�3 A ntR,i".6t 1 _ ,treniiam LO covv.,ie^Li' 'oh'1.:'=!S' i# bfJi•r.... i i;47: �1 �;.�,: . .. Bei M. :y�,i rAEf-1V!_ _ .� t SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) Roofing ❑ Or Doors 0 Accessory Bldg. ❑ Demolition ❑ New Signs [O] Decks Siding 11A Other[a Brief Description of Proposed Work: Cnh(f'-(t T&�r t Alteration of existing bedroom Yes I><—No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement es CJ 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? /� I f. Method of heating? fy or,P__ 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 authorizeCi to act on my eha in all ma ers rel ive to work authorized by this building permit application. /V Signature of Owner Date 1 as Owner/Authorized Agent hereby declare th t the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief. Sign.ed une pains an penalti of perjury. (//�lJ/ Print Na e C" J Signature of Own r/Agent Date y?t+ iY4v 4 IA r. V.,r �• .. t" t r C.=r.;^� •` . ,.: _ . Cc fi't.'3vt �� �: „:5 t , ,.`ata c t.��'i iYl� t,E'. s°•..Il i ql' 'f..f'. �,'� 1�?f i.J t..i r..:���'.-.._ '. _ �.:. i_..�:qt7+ .��i f1r:�lF• .f� 1 (+,. •, 'J• � }t: ;)� tt: is - - -- t� ��d'ti.. .fit;: it i ,. ;3(3•"'p�•-, _. .-J^-�Z / j I r _ . . .- - i ! to r',,,...,>;. ''"W: .;i :St irt:n'1 � ..,�r:.. -.__._. .-_.. -. --' lr.C• c>"2 _....___ -. .. _. .... ..__..__ .. ! . i • :c, �.. .. . _v' p, � •s. .,';+.fit .. _. . I , .:^t' ��. phi"• i' ,:t.fs ;�7.sr�Cl1- t'ti�nfr'►.. �U :�XI .:t ,,� ��e?�W21-:.a'�'�µ '�;t1�GjE.��,.i� �CJ�3�1� � t �+.:'^..'r:2d:•t eit ;""� �ti'JUa!l�n,.' yjrz.7 iUF :r.' z,e' ; ,• --, 71R rl''� t 1 rr�'�v�QU •�-'•_� �..•r, ^t'..1�+�:U. �R rs;,�.. .;� � ,�':'. A. ?' 'r } ::j'' ,."(�J Z._,_D SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction _ Su }rvisor: � Not Applicable ❑ Name of License Holder: 3y "�)0 ' Licens Nuer fib i3 (3p Add ss Expiration ate � ��- L,//3ct>1 95-35 Signature Telephone 9.Re Istered Home Improvement Contractor: Not Applicable ❑ 1Sg932 Company NameRegi tratr,;�umber �3 C) � Address I Expirati Date We �,� J Vu1 Telephone 113 Gj�1 ci 5r 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...... ❑ city of Northampton Massachusetts DEPARTMENT OF BUILDING INSPECTIONS m 212 Main Street eMunicipal Building ,.; 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 construc ion work being performed at: (Please print house number and street name) Is to be disposed of at: U (Pleasf print name afid locatioh of facility) Or will be disposed of in a dumpster onsite rented or leased from: 6��4 W' 1►' �C� �P � (Company Name and Address) / Jd> c Z Signature of Permit Applicant or Owner D to 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. i The Commonwealth ofMassachusetts ' BepaNnient of.Industrial Accidents I 1 Congress Street,Suite 100 Boston,MA 02114-2017 iwlviv.Mass.goyldia Workers'Compensation Insurance Affidavit:Builders/Contractors/E teetricians/Plurnbers. TO BE FILED WITH THE PERMTTING AUTHORITY. Appliennt Information l/ Please Print Legibly Name(Business/Organizatiotvindividual): G l` C.• i Address:_ Cuut�,qyyk-z, Ci /State � ' � 3 t ty /Zi :p LV � VJI�� Phone#: L(I 3 G»t GI Are you an employer?Check the appropriate box: Type of project(required): II am a employer with_ _ employces(fullaudlor part-time).* 7. ❑Nevi construction 2. I am a sole proprietor or partnership and have no employees working for me in g- ❑Remodeling any capacity.[No workers'comp.insurance required.] 9. ❑Demolition 3.L]1 am a homeorvnerdoing all work myself.[No workers'comp.insurance required.]1 4.❑t am a homeowner and writ!be hiring contractor to conduct all work on my property. i will 10[:]Building addition cvswe that all contractors either have workers'compensation is urance or are sole 11.0 Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.❑I am a general contractor and I have lured the sub-contractors listed on the attached sheet. 13.❑Roof repairs Ilrese sub-contractors have employees and have workers'comp.insurance.* b.❑We are a corporation and its officers have exercised their right of exemption perb101,c. 14.❑Other _ - 152,§10),and we have no employees.[No workers'comp.insurance required.] Any applicant that checks box ill must also till out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. 1C011tr3ct0rs that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. Ifthe sub-contractors have employees,they must provide their workers'comi policy number. I ant an employer that is providing workers'compensation insurance for my employees. Below is the policy andjob site information. E� I_;-- C_ Q Insurance Company Name:( G. ' 1 Policy#or Self-ins.Lie.#:W� pc) - O'Q 1c' ',;oA- Expiration Date: 0- 10 a, Job Site Address: 1 q �rJ J\L'�J' `p�� U'`'L City/State/Zip 1J�t--�'--` " I T"' ` UNO, Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGI,c. 152,§25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify rnrr er the pains rd penal ' f perjury that the information provided above is trite and correct. Signature: Date: Phone#: �j 3 1>1 q 3 Sri Official use only. Do not write in this area,to be completer)by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector ti.Other Contact Person: Phone#: I I I tii.t!45 ` .',i ) _iS�.l-�li.%i Sa-• r'i. �' ='_;,UYnTI { i? �� ��+• , .. 'dt�l. 'ty+,S"3i ii. ... - (()� is ...,` .t�fE :z.t• +t)f k .� �;�`4.i„�„ .rttc � �i`i;1} .+`�" t..-�.+t1 i;.w,t!L; 1;3!f?i6 S.' ,.5...1,;' S;+ ^.},3+.;w sy • u;, t �. fr, ^.+Zttt: 'tii '.,:i:., !t:;r z r,.J. ...,., ft'9• "Yf..�r .. n.'. .-1, ,�°74 { -'i' .1'1S' :!. '.r 's:,;} .�•} t,.>" .. 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Li ?.C7 t. • ;a- ^.r..') la.ix 'rc t.. • to :f>•r!L'' . . :�li';�.. t .._r. rlJij j:.l .nh .=p43 ,r:Cr i 'r• _. ^, � � ... .. -..;t".. 4`,. �i!•-. ,:MIS,. �:oti i.'. ry• !. ..��,, , t. tr t .. _ ',y T�. :Y. ,_ 1 � 2]As .,YY71.0�•'., ,'*e.• -acn i .f ,; v . , t•!`• '-i!)ft'i�'+'`i°i: i�e14tQ'.' ,.-i+.'a ,,:: ,,r., s `�+ .unnuvnwcmuvi mo�aau woeua ' 1 Division of Professional Licensure � r H!�Kft'6'"er HE-156708 4 E tpires:06/23/2021 WALTER L MAREK,lit 73 SOUTHAMPTON ROO WESTHAMPfl* MA 01027 'ilv\ } Commissioner ti(„u /.�y +*�-- Commonwealth of Massachusetts Division of Professional Licensure Board of Building Regulations and Standards ConstrijOPOn tilpervisor CS-055201 er Aires: 06/23/2020 Ui WALTER L MAREK,III { 73 SOUTHAMPIrON ROAD WESTHAMPTON�.M'A 0102T `07co•.1:10w Commissioner C4 .741' irzni�ni«ill'�/. Ala1inc1iii//i Office of Consumer Affair§&Business Regulation HOME IMPROVEMENT CONTRACTOR TYPE:Corporation Roggistration Expiration 159488 04/29/2022 W.MAREK INC IRAN, � `.- 1 - WALTER MAREK iii 73 SOUTHAMPTON RD. WESTHAMPTON,MA 01027 Undersecretary A� CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 02/06/2020 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAM K.S.K.INSURANCE AGENCY,INC. PHONE 413 527-7859 FAX 413 527-8314 203 Northampton St. E=L P travissias ksk-insurance-com P.0.Box 597 INSURERQ INSURERAFFORDING COVERAGE MAIC Easthampton MA 01027 IN - PHENIX MUTUAL INS CO INSURED IN -ASSOCIATED EMPLOYERS INSURANCE CO W.Marek Incorporated INSURER c: 73 Southampton Rd INSURER 0: Westhampton MA 01027 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE DDL UB POLICY EFF POLICY EXP LTR POLICY NUMBER LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 A CLAIMS-MADE a OCCUR DAMAGE TO RENTED ce ran 1 $SO,000 CPP0719447 11/01/2019 11101/2020 MED EXP(Any oneperson) $5,000 PERSONAL 8 ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY 7 PRO- JECT F�LOC PRODUCTS-COMPlOP AGG $1,000,000 OTHER $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS ) NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS $ $ UMBRELLA LIABOCCUR EACH OCCURRENCE EXCESS LIAB HCLAIMS-MADE AGGREGATE $ WORKERS COMPENSATION X I PER 1'R AND EMPLOYERS LIABILITY Y I N Al ITE ANY L OFFICERIMEM ER�EXCLUDED?ARTNERIEXECUTIVE Y NIA WCC-500-5014290-2020A 02/10/2020 02/10/2021 E.L.eACH ACCIDENT 100,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEQ$100,000 If yes,describe under DESCRIPTION OF OPERATI NS be4owE.L.DISEASE-POLICY LIMIT 1$500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) GENERAL CONTRACTOR CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.A AUTHORIZED REPRESENTATIVE���,^ yR/�T�V�i�rIC <DA> ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD �..1s' .'.iii-<%fs#i.:j tL)iit•..01j V..A}Srl Eaj'j+,a :AUBQ. i c akc.'s:'.irt G7;-G n£:iF,136 ylt;:'t:. gc G''W-t:;_%!,1 f ° l:i U i;!', oL iH;i`:Tomo tic?,fS"r_: b;}i i!: 8 19`c [ fC" r I:L . .. t t ' ' a�'. V .,Sa ,+.. �r-•E.;,, �,..t cf r"rn` 4U":r.•' ,'r.• p1� t..,fY .1•s<t ta. �r.P,�, a.�s„. .:t3J t f f r � f i n3 t is ` , ' -. 70-7 .. r-nfq..•+tie:,-• _.__ ._ ___..._.__._.. -__ CL , ». x......_..._. _.1 P 1%r r r"ti 0u7,j..J1 ¢lr i4 1 =L:Cfts VIVA . i`'''+4 7 n'; V, Jtsi. _ 'r; iL !) _+S F i_'rf E tt!: Z 1 3 Lk `):O'? fir. a'i WO'j 3' 1%' r'A :Jet '.• S C�.i n �r "t 1', r14'r, , -r E ULA ' 'L . 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Number Line Label Qty UOM Family/Part Number Unit Extended 1 3.0000 EA Combo Unit 8300 NC Fixed Combo Unit Detail Overall Net Size: 32 1/2"W x 72 1/2"H Rough Opening Size:33 x 73 Horizontal Mull Type:Zero Degree Jamb Receiver:3/4 Interior Receiver Exterior Trim: Brickmould(908)w/Sill Nosing ® Unit 1 -8300 NC Casement Performance Level: Standard Net Size:32 1/2"W x 53"H Vinyl Color:White Glass Options: Double Glazed, LowE-Annealed(Standard),Argon Gas Grid: Queen Anne-Cont-No Grid Hardware:White Screen: Full, Extruded Frame-Fiberglass Mesh Spacer Blocks:Yes Unit 2-8300 NC Fixed Casement Performance Level: Standard Net Size: 32 1/2"W x 19 1/2"H Vinyl Color:White Glass Options: Double Glazed, LowE-Tempered, rgon Gas Grid: Queen Anne-Cont-No Grid Screen: None Spacer Blocks:Yes Application version 8.0.0.75 Printed on 5/19/2020 Proudly Manufactured by Paradigm Windows 1 Il %1 West Street 'Nest Hatfield, MA 01088 Quotation RK Miles, Inc. (WHUnited States} 802 352-1952 Quote ID SQAD003271-1 P.O. Number Line Label Qty UOM Family/Part Number Unit Extended 2 1.0000 EA Casement 8300 NC Casement Performance Level:Standard Net Size:32 1/2"W x 53"H Vinyl Color:White -' Glass Options:Double Glazed, LowE Tempered, gon Gas Grid: Prairie-Cont-No Grid Hardware:White Screen: Full, Extruded Frame-Fiberglass Mesh g" Jamb Receiver:3/4 Interior Receiver Spacer Blocks:Yes Exterior Trim:Brickmould(908)w/Sill Nosing Sash Reinforcements: Rails Only 3 1.0000 EA Combo Unit 8300 NC Combo Unit Detail Overall Net Size:64 1/2"W x 52 1/2"H Rough Opening Size:65 x 53 Vertical Mull Type:Zero Degree Alignment:Align at Sill Jamb Receiver:3/4 Interior Receiver Exterior Trim:Brickmould(908)w/Sill Nosing Unit 1 -8300 NC Casement Performance Level: Standard Net Size:32 1/4"W x 52 1/2"H Vinyl Color:White Glass Options:Double Glazed, LowE-Annealed(Standard),Argon Gas Grid: Prairie-Cont-No Grid Hardware:White Screen: Full, Extruded Frame-Fiberglass Mesh Spacer Blocks:Yes Unit 2-8300 NC Casement Performance Level: Standard Net Size:32 1/4"W x 52 1/2"H Vinyl Color:White Glass Options:Double Glazed, LowE-Annealed(Standard),Argon Gas Grid: Prairie-Cont-No Grid Hardware:White Screen: Full, Extruded Frame-Fiberglass Mesh Spacer Blocks:Yes Application version 8.0.0.75 Printed on 5/19/2020 Proudly Manufactured by Paradigm Windows