24B-005 (5) BP-2022-0171
75 BARRETT ST COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
24B-005-001 CITY OF NORTHAMPTON
Permit: Exterior Res
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
BUILDING PERMIT
Permit# BP-2022-0171 PERMISSION IS HEREBY GRANTED TO:
Project# WINDOWS Contractor: License:
Est. Cost: 11802 NORTH EAST SPECIALTY CORP 081031
Const.Class: Exp.Date:09/06/2023
Use Group: Owner: LAMOUR, ZILLA G& JOSEPH
Lot Size (sq.ft.)
Zoning: URB Applicant: NORTH EAST SPECIALTY CORP
Applicant Address Phone: Insurance:
148 DOTY CIRCLE (413)739-4333 VWC6003962-2021
WEST SPRINGFIELD, MA 01089
ISSUED ON:02/22/2022
TO PERFORM THE FOLLOWING WORK:
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:
Gas: Final: Final: Rough Frame:
Rough: Fire Department Driveway Final: Fireplace/Chimney:
Final: Oil: Insulation:
Smoke: Final:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Signature:
dr ' A .
Fees Paid: $40.00
2l2Main Street,Phone(413) 587-1240,Fax:(413)587-1272
Office of the Building Commissioner
f
�`\
The Commonwealth of Massachusetts / �'
Board of Building Regulations and Standards / FeB ,'FOR'
I <9 MUNICIPALITY
\i� Massachusetts State Building Code, 780 CMK�,
4 'T o`er,. <(9 /USE
Building Permit Application To Construct,Repair, Renovate=(�nt$lish a ,�evitd Mar 2011
One-or Two-Family Dwelling i
0,,, I,,
rti M
This Section For Official Use Only r''q o'h7%,ys
Building Permit Number: (Sly+ ,f?. _,1 7/ Date Ap lied:
lir
.P%, _9/0.;_44).
Building Official(Print Name) Signature '1 Da
SECTION 1: SITE INFORMATION
jrnrfpress: 1.2 A lessors Map&Parcel Numbers
e% S� Z y3 CO 6'
1.1a Is this an accepted street?yes no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use Lot Area(sq ft) Frontage(ft)
1.5 Building Setbacks(ft)
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public 0 Private 0 Zone: _ Outside Flood Zone? Municipal 0 On site disposal system 0
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP'
2 1 Owner'of Recor ��
i_cam DU a '1 2 4\\cam A)40 r1i r;�mp Ph .
Name(Print) City,State,ZIP
c ba rr --77- ST 6//3-6 7
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply)
New Construction 0 Existing Buildin Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition 0
Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify: (AD 1/ C(. (
ces
Brief Description of Proposed,Work2: pe o "T) Re r> ,K2 a-d
e L v{1c c so •',• , ca ) l'
Rrla(� hr a Gu l r►'c cx.0 a f d S C�1 (fit l i n e Sig
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials
1.Building $ fI 1. Building Permit Fee: $ Indicate how fee is determined:
❑Standard City/Town Application Fee
2.Electrical $ ❑Total Project Cost3 (Item 6)x multiplier x
3.Plumbing $ 2. Other Fees: $
4.Mechanical (HVAC) $ List:
5.Mechanical (Fire $ Total All Fees: $
Suppression)
Check No./MO Check Amount: �v Cash Amount:
6. Total Project Cost: $ ❑Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervis r License(CSL) C r 7/C:i 3)
c hei' ),� J License Number xpira ion Date
Name of CSL Holder C�l ^�J r`
f a� , List CSL Type(see below) t�
i � ' `7y C11\ Type Description
No.and Street / YP P
� f�� ��,f� � ! U Unrestricted(Buildings up to 35,000 cu.ft.)
L ` ` R Restricted 1&2 Family Dwelling
City/Town,State,ZIP M Masonry
RC Roofing Covering
— WS Window and Siding
�7 el/3/ /� �i�/ ) SF Solid Fuel Burning Appliances
�9 Y 3 3, /C` bt) �7 L YG�0��/[`kb 1 Insulation
_Telephone Email address ,,Cc,-r.1 D Demolition
5.2 Registered Home Improvement Contractor(HIC) ,---
C �� HIC Registration Number xpir ion Date
HIC,C panx me or HIC Re 'stra Name
No.and,Str %�
(1, ,) t.../ /) /,/ ,/ �r�/ : y j Email address
City own, State,ZIP -'7 L/J / Telephone
SECTION 6: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 ❑
SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I,as Owner of the subject property,hereby authorize
to act on my behalf,in all matters relative to work authorized by this building permit application.
Print Owner's Name(Electronic Signature) Date
SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION
By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information
contained 'n this application is true and accurate to the best of my knowledge and understanding.
'2/7/:. ?
Print wner's or Authorized Agent's Name(Electronic Signature) Date
NOTES:
1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor
(not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration
program or guaranty fund under M.G.L.c. 142A. Other important information on the HIC Program can be found at
www.mass.gov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dps
2. When substantial work is planned,provide the information below:
Total floor area(sq.ft.) (including garage,finished basement/attics,decks or porch)
Gross living area(sq. ft.) Habitable room count
Number of fireplaces Number of bedrooms
Number of bathrooms Number of half/baths
Type of heating system Number of decks/porches
Type of cooling system Enclosed Open
3. "Total Project Square Footage"may be substituted for"Total Project Cost"
The Commonwealth of Massachusetts
"1412 ,/ Department of Industrial Accidents
jl = 1 Congress Street, Suite 100
?;°r �' Boston, MA 02114-2017
'o = ,�r w ww mass.gov/dia
� V
We.Prkers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers.
TO BE FILED WITH THE PERMITTING AUTHORITY.
ABnlicant information Please Print Leg'`
�
Name (Business/Organization/Individual): /�E.��'��,.�
Address: I y4t. "�1y a-i
City/State/Zip:/A.), <SP 'CD, M4 co /Phone#: 4'/3 73 9"9'333
Are you an employer?Check the appropriate box: Type of project(required):
IX I am a employer with6 L) employees(full and/or part-time).*
7. ID New construction
2.01 am a sole proprietor or partnership and have no employees working for me in 8. 0 Remodeling
any capacity.[No workers'comp.insurance required.]
3.01 am a homeowner doing all work myself.[No workers'comp.insurance required.]t
9. ❑Demolition
4.01 am a homeowner and will be hiring contractors to conduct all work on my property. I will
10 0 Building addition
ensure that all contractors either have workers'compensation insurance or arc sole 11.0 Electrical repairs or additions
proprietors with no employees.
12.0 Plumbing repairs or additions
5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑Roof repairs
These sub-contractors have employees and have workers'comp.insurance.t
6.❑We are a corporation and its officers have exercised their right of exemption per MGL c.
14.0 Otherl,�//1'�)\-U;
152,§1(4),and we have no employees.[No workers'comp.insurance required.]
*Any applicant that checks box#1 must also fill 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.
$Contractors 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. If the sub-contractors have employees,they must provide their workers'comp.policy number.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information. n
Insurance Company Name: �4 M JTJC'-1 11
Policy#or Self-ins.Lic.#: li 'IV l_,( ( c3919 -a> \ Expiration Date: 4/�/,a
Job Site Address:'7 5 r ime / c:l - City/State/Zip: .khineeTo ilia
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under MGL 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 u ii
der the pain, and penalties of perjury that the information provided above is true and correct.
Signature: Date: /7/ .
Phone#: .7 j" 13.E 3
Official use only. Do not write in this area,to be completed 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
6.Other
Contact Person: Phone#:
•
,, ?) NESCO-1 a" a' Li
. ,44000Rici" DATE(MM/DDNYYY)
(,:,',.. E IRT l C.,,,A1"E. OF U AIM LEN' !I NS kJi RA FE I
' ovi 412021
— --
THIS CERTIFICATE IS ISSUED 44,S A ilfi KnER or INFORMATION ONLY AND colIVIERs NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NVOIIII AFFIRIMATIVELV OR NECIA11VELN AMEN), EXTEND OR AL TIER THE COVIINIAGE AFFOFIDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSU RANCE INII,ES VII(yr coNmni'llITE A CONTRACT BETWEEN THHE JII\U INSUREn(s), AUTHORIZED
REPRESENTATIVE of;I":)R OD If CER,AND THE CER'iliFICATE HOLDER.
. , ,____--.--........,—.............—______.....,......—____.,,,,,......_
IMPORTANT: If the cortilicai::,now is an AmilioNAL INSURED, the piDlicwies)must Imo ADDITIONAL iim.iiiED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and would:ions of The policy, certain policies may require an endorsement. A statement on
this certificate does not confer rights to the certificate holder In lien of such ea 4dOrSeaTteItAz
PRODUCER 413-73(-5359 Mil:\CT J Raymond i...ussier Ins Agcy ic
J Raymond Lussier Ins Ancy Inc I FAX
(A/CNo)413-732-2027
181 arkP Avenue,Suite 8 Pool\IE 413-IIM"--559
(="Ext.): ' ' - •-
PO Box 499 Jin1. s:it,..-i •ritm, nnce con
West Springfield, MA 0108499 Nkenim r-ie u J Raymond Lussier Ins bogey Inc - -----__LIAVRERM.M.EMPINgig2yER/3.pp_ NAIC#
INSURER A,coLoNY INS(iRA mc E c.:o ____
INSURED INsuR,ER B:SBtGtV In s..france Company_ 39464
Northeast Specialty Corp ...
...
Nestor iNsuRER c,AIM. Ildullial Ins.CO.
148 Doty Circle
West Springfield,MA 01089 INSURf.-R D:
INSURER I.:,_.
INSURER F:
-------------„-------_- -- r
COVERAGES CERTI FICATIEK11/1143ERL t:'llEVISIORI 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 PER! IN 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 . ADDL SUBR POLICY r+F PoLIGY EXP
LTR 'IYPE Or INSURANCE. POLICY NUMBER LIMITS
III/VD C.PIRMYYYY) OYMIDDYYYYL
A X COMMERCIAL GENERAL LIABILITY 1 000 000
EACH 0 CCURRENCf I
_
CLAIMS-MADE LX I OCCUR 101 PKG00941 79 fa°.03 03118/2021 03/18/2022 pD0AEMLGE,,,TO(FRENTED 1 , ,1 ,00 o
_ . 41.9.SIAlLei.L0 _
__
$ 5,000
-_-_ NIED•fajAny orie izelsonl____
PERpONAIL.:ADV INJURY ,,.. $ 1,000,000
— --- ---- --
GEN't.AGGREGATE LIMIT APPLIES PER: ' GENERAL. 2,00,0,000
AGGREGATE $
Xl POLICY Ti T.8, ( 1 LOG ..20CA lc .. KT:TS COM .'AGG $ 2,000,000
I OTHER: _ ,p
---- . ,....— ...
a AUTOMOBILE LIABILITY COMBINID SINGLE LIMIT 1,000,000
._...
ANY AUTO 2433825 03/11/2021 03/11/2022 QQ21,LIN,upx jper ersol_ $
— OWNED_ )7i-SCHEDULED
AUTOS ONLY •,.. AUTOS 80011.y IN_JURY.(pel accidenS) $
.__
X IAl!Iilgt ONLY X_ tsill0Patte fi5PEIIY DAMAGE
...( er slab:enti 1: __
$
- • -* „.„- ---
UMBRELLA LIAR OCCUR • EACH 0 CCENCE $
__.
EXCESS LIAR CLAIMS-MADE AGGREGATE $
DED T [RETENTION$ _
--
... WORKERS COMPENSATION 1.-..PER.!f_LE.1 GOTH„
AND EMPLOYE-TiS'LIABILITY ..._ --.. IL._
y/N VWC6003962.2021 07109/2021 07109/2022 100,000
ANY PR OPRIETOR/PAR1NERIEXECLMVE F "1 E.L.EAC.I.IACCIDENT $
-MBER EXCI I'DEO?
(CgalTZ:in NI I)-•-••- i j N i A
..._....
fil.DI SE.ASE EA EMPLoYEE $ 100,000
It yes,describe under 500,000 •
DESCRIPTION OF OPERATIONS blow E.L.QISEASE.•POLICY LIMIT $
. . .......---...---- --...,.....—.
SCRIPTION OF OPERATIONS I LOCATIONS!VEHICLES (ACORD 1111 Additional Remgtr%o Scherluk may be altxciled IF MOM space to Mitill'Od)
........---...-.*....—.....m.....,............---..........---....--.... ,—..................--.....m.-.......
;RTIFICATE HOLDER _ ......__ _... ......... — ...........__Sair.t.1....."' Leatt_m_ .......__ ....___
cUSTIVIE
SHOULD ANY OF THIE ABOVE DESCRIBED POLICIES ME CANCELLED BEFORE
THE EXPIRAMINI DATE '4111EIREOF, NOTICE WILL se. DELIVERED IN
ACCORDANCE MTN THE POLICY PROVISIONS.
------..-
_-_-.
AUTHORIZED REPRESENTATIVE
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@ 1988-2015 Acom CORPORATIO . All rights reserved.
ORD 25(201 tH403)
'filo ACORD name and logo are reo.,; (,,,recl ITK:irks of,4CORD
( Commonwealth of Massachusetts
Division of Occupational Licensure
Board of Building Re ulations and Standards
Consktionr5
.....�. rvisor
CS-081031
6cpires:09/06/2023
MATTHEW S fAR ,It J : :-
PO BOX 692', �I
BECKET MA11223 {i
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Commissioner d,�/, K. ta/ ,
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City of Northampton
op,T M n a+,,,.o
o, :�. Massachusetts
it r
�yfy pti DEPARTMENT OF BUILDING INSPECTIONS
/,"i
w 212 Main Street • Municipal Building
0.' L ` Northampton, MA 01060 ,y. .v,`,'r
CONSTRUCTION DEBRIS AFFIDAVIT
(FOR ALL DEMOLITION AND RENOVATION PROJECTS)
In accordance of the provisions of MGL c 40, S54, a condition of Building Permit
Number is that all debris resulting from this work shall be disposed of in a
properly licensed waste disposal facility, as defined by MGL c 111, S 150A.
The debris will be disposed of in:
Location of Facility: 7 ) .1i3cfrT[T (.37.
The debris will be transported by:
Name of Hauler: U5A Mao ii r-)5
Signature of Applicant: Date: /7 ,�.
CITY OF NORTHAMPTON
1 0"-- SETBACK PLAN
MAP: LOT:
LOT SIZE:
REAR LOT DIMENSION:
REAR YARD
SIDE YARD SIDE YARD
FRONT SETBACK
FRONTAGE
City of Northampton
OaY H A M14,,) ;2)
\,151
0.\..
�? 7 h;, SAS .. '., s/C
�'' Massachusetts �4 t._ '4,
G
.1 !I. DEPARTMENT OF BUILDING INSPECTIONS tb j°
ti��'- ' 212 Main Street • Municipal Building yvd•., �1.
\+r.as ram. Northampton, MA 01060 sd P�
HOMEOWNERS'EXEMPTION ELIGIBILITY AFFIDAVIT
I, (insert full legal name), born _ (insert month,
day, year),hereby depose and state the following:
1. I am seeking a building permit pursuant to the homeowners' exemption to the permit requirements of the
Massachusetts State Building Code, codified at 780 CMR 110.R5.1.3.1, in connection with a project or work on a
parcel of land to which I hold legal title.
2. I am not engaged in, and the project or work for which I am seeking the aforementioned homeowners'exemption,
does not involve the field erection of manufactured buildings constructed in accordance with 780 CMR 110.R3.
3. I qualify under the State Building Code's definition of"homeowner"as defined at 780 CMR 110.R5.1.2:
Person(s) who owns 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 home owner.
4. I do not hold a valid Massachusetts construction supervision license and, except to the extent that I qualify for
and will abide by the Massachusetts State Building Code's requirements for the supervision of the project or work
on my parcel, I am not engaged in construction supervision in connection with any project or work involving
construction, reconstruction, alteration, repair, removal or demolition involving any activity regulated by any
provision of the Massachusetts State Building Code.
5. If I engage any other person or persons for hire in connection with the aforementioned project or work on my
parcel, I acknowledge that I am required to and will act as the supervisor for said project or work.
Signed under the pains and penalties of perjury on this day of , 20_.
(Signature)
/NORTHEAST SPECIALTY CORPORATION d/b/a NESCOR 148 DOTY CIRCLE HOUSE � Window_CQ14r Int. Ext.�
1. WEST SPRINGFIELD CONDO /O )(White/White 0 Tan/Tan
I' II E s C 0 R 1-888-NESCOR-1 HISTORICAL Y or N 0 White/Bronze 0 Other
THE LEVEL BEST IN HOME REMODELING 1-413-739-4333 #WINDOWS MEASURE DATE MEASURE TIME
nescornow.com #SGD'S T z/,'/ ",,u
( I1o,1.v be40�,WA/
/tCi!-T 0r 7
rv4r M •rs. r Email: / All home improvement contractors and subcontractors en-
' gaged�/?R(Jb[� C-[!/'�+1.'-�fr, /"t•�� gaged in home improvement contracting,unless specifically
n exempt Iro registration by Provisions of Chapter 142A
Address:7 RaiK R�� S T Date: 3 a o Iron registration
the general laws,must be registered with the Common-
wealth of Massachusetts.Inquiries about registration
City: �QQ 1 AcMP TO(�( Home: and status should be made to the Director of Consumer
Affairs end Business Regulation,Ten Park Plaza,Suite 5170
State: M Zip:DI 0 G Office:, �3 SY�, S-7 7 Z Boston,MA 02116-Phone(617)973-8700
• ECONOLINE • SMART CHOICE
Double Pane•Clear Glass•Hollow Frame•Screwed Corners • HS19 Glass•Welded Frame•Insulated Frame
5 Year Warranty Lifetime Guarantee•Free Glass Repair•Free Screen Repair•Free Re-Caulking
• PERFORMANCE I PREMIUM
Double Pane•Normal Low E Glass•Hollow Frame Impacted Glass•Low E Argon Gas•Welded Frame•Insulated Frame
Welded Corners•15 Year Warranty Ufetime Guarantee•Free Glass Repair•Free Screen Repair•Free Re-Caulking
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U See Attachment
We Propose hereby to furnish material
1.First of all...No verbal agreements are recognized.Everything must be In writing on the contract.Please make and labor-complete in accordance with
H sure everything is written on your order.II something Is not on your work order,please do not request it from our staff. above specifications,f the sum of:
i I They are not allowed to give anything not on the contract.The salesperson's measurements above are approx ate bs
only and are not to be relied upon as we have n employeeee wh will e to your hem oyconlract for ion to yi��—
take the actual and precise measurement (y4 .� �!V
2.Pemits.We pull permits on all jobs wham they are required.Your permit cost is In addition to your contract price.It ($
L would be unfair for us to add a standard permit charge to all contracts,since prices vary greatly from dty to city end
INT
some cities do not require permits.It Is impossible for your representative to determine your permit cost.(usually Payment to be made as follows:
between S100 and S4a0).We only charge what the city charges us,plus a S39.00 service lee.Balance Is due upon
substantial completion and is not contingent upon final inspection or the occurrence of any other condition.Certain
cities require final Inspections.it is your responsibility to be home for your scheduled Inspection. Administration Fee
1013111111111..
3.Installation start time Is approximately 8 to 14 weeks after approval at measure,financing and/or HOA approval, 33%upon signing contract. $ 7 acre)
Sales reps are not allowed to change these times.You may not hear from us for a period of time while walling for your `
'NT materials to arrive.Don t worry!!We will cell as soon as possible to schedule your job.II you ere using our financing, 33%upon completion of measure. $
the clock doesn't start ticking until your loan is approved.If the start of your installation exceeds past the estimated
time above,we will credit your account S50.00 per week for every week that we fall behind.This contract cannot be 33%shall be made forthwith upon $
altered after the date of the measure. completion of work under this contract.
4.LEAD SAFE PAINT PRACTICES Vwe hereby acknowledge receipt ore copy of the pamphlet,"Renovate Right (�i
3y
rimportant Lead Hazard Information for families,child care providers and schools",Informing me/us of potential risk
or lead hazard exposure from renovation activity to be performed in my/our home.I/we received this pamphlet before Z
AMOUNT FINANCED $a the work began.
NOTICE: No agreement for home improvement contracting work shall require a down payment(advance deposit)of more than one-third of the total
contract price of the total amount of all deposits or payment which the r::-rtrnCtor:oust make,in advance,to order and/or otherwise obtain delivery
of special order materials and equipment,whichever amount is great..";
Acceptance of Proposal:I have read both sides of this document and accept the prices,specifications and conditions stated.I understand that upon
signing,this proposal becomes a binding contract.You are authorized to do the work as specified.Payment will be made as outlined above.You may
cancel this agreement if it has been signed by a party thereto at a place other than an address of the Seller,which may be his main office or branch
thereof,provided you notify the Seller in writing at his main office branch by ordinary mail posted,bye sent or by delivery,not later than mid-
night of the third business day following the signing of this agreement.Please refer to the Notice of ancell I .
DO NOT SIGN THIS CONTRACT IF THERE ARE ANY B K SPAC
By: HJ�
Purchas 1:
mtla)
Purchase
By:
•sman/Cx. - - �\
Massachusetts(Lic.#103713) nescornow.com Connecticut(Lic.#545323)
/S a�-.-e -.. �,� (2 7 1fl J 0/i'�� 4 ve
IN
ESCO
THE LEVEL BEST IN HOME REMODELING
ADDENDUM TO CONTRACT
//// This is an addendum to the contract dated ) / dv2 between Nescor and
J ce fi 2 ► ka444. avy where it has been joi tly ag eed that the following addendum shall
be made to the contract:
0,, 4/2 (1 '1 ei crd /7,4,- / ( -2 X 4:,,c) 74 ciOws
--,.. .> �v j le l �Jul 1-1-e,G i- %` e a / ? z- ///1 c2 C ,5`
. ct /..t., ell !�' / /7/ /// f( .'
All new products and w k c with Nescor's No-nonsense Lifetime Warranty against defects
Signed (Owner) Date a 0
Signed (Owner) Date / d
Signed NESCOR e `� Date / ? / �`
1 _'� The Commonwealth of Massachusetts
* ` FE8 Board of'Building Regulations and Standards FOR
' 2 MUNICIPALITY
t 2 2022 M sachusetts State Building Code, 780 CMR USE
1 -:,T or uilding Permit AppliOation To Construct,Repair,Renovate Or Demolish a Revised Mar 2011
;(1r?r ;1f 1Nr;t`--- ;One-or Two-Family Dwelling
---- M °jCT1)uNS This Section For Official Use Only
Building Permit Numberb°;= '01O i I Date A plied:
i 5,19,WIS
02
Building Official(Print Name) I Signature Date
SECTION 1:SITE LNFORMATION
1.1 Property Addressb 1.2 Assessors Map&Parcel Numbers
- 1
1.la Is this an accepted street?ycsiZ no Mapl�Tuunber Parcel A
umber
1.3 Zoning Information: 01.4 Property, Dimensions: K t 1 0
Zoning District Proposed Use, Lot Area(sq ft) Frontage(ft)
1.5 Building Setbacks(ft)
0
Front Yard , Side Yards Rear Yard
Required Provided Required Provided Required Provided
1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal,Sy to
Public 0 Private 0 Zone: tside Flood Zone?
N — hip
eck if ycs❑ Municipal❑ On site s V
s• s x cm 0
SECTION 2: ROPERTY OWNERSHIP
7 ocian . 1eY\i-4-1,-) M 0 flitloArpto h i 1 -All.
Name(Print) City,State,ZIP , ,
No.and Street Telephone Email Address
SECTION 3: DESCRIPTION OF PROPOSED WORK2(check all that apply)
New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) ❑ Alteration(s) Addition 0
Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify:
Brief Description of Proposed Work-;�.y \ � � C. � -{':k r r l 0 Y 1A)O 1
V\ I cJY AJ ac- A I
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Estimated Costs:
Item (Labor and Materials)o Official Use Only
1. Building $ 1 0 n 1. Building Permit Fee: $ Indicate how fee is determined:
} ❑ Standard City/Town Application Fee
2. Electrical $ ❑Total Project Cost; (Item 6)x multiplier x
3. Plumbing $ 2. Other Fees: S
4. Mechanical (HVAC) $ List:
5. Mechanical (Fire $
Suppression) Total All Fees: $
Check No.3a7i3theck Amount: 44ss
6.Total Project Cost: $ 10)
0 0 0 0 Paid in Full ❑ Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES 1
5.1 Construction Supervisor Lich se(CSL) j I (r) 2--Cffi Z ��
D'\ri ` Uh :1r Litcennsse Number Fxpi 'on Da't
ri
Name of CSL Holde v
ILA ^�� i,� List CSL Type(see below)
.and S et r , � �l t L T� Description.
on -W f V--A
`'� q1---+ UUnrestricted(Buildings up to 35,000 cu.ft.)
1�1 1 l l '1 lJ R
City own,State,ZIP ,Restricted 1 _Family Dwelling
w M . Mas`bnry
Cf% C �pr,ON r�'`ti�%G RC Roofing Covering
'� `�� �/l `3 �-* W S Window and Siding
1 C 0� SF Solid Fuel Burning Appliances
i-{01 n 1 n �4 5 � I Insulation
Telephone Email address D Demolition
Registered Home Improvement C ntractor(HIC)
r. 11 tfthC ("i i. Registration pLame HIC Re tra eI If traon Number Ex ate
TC
pan N
No.and Street Email address
City/Town,State,ZIP Telephone
SECTION 6: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 O
SECTION 7a:OWNE A HORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I,as Owner of the subject property,hereby authorize �'e';'"e 0.:` 1C k'ec
to act on my behalf,in all matters relative to work authorized by this building permit application.
Print Owner's Name(Electronic Signature) Date
SECTION 7b: OWNER'OR AUTHORIZED AGENT DECLARATION
By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information
contained in this ap : ration is true and ace , . o :best of my knowledge and understanding.
Ai I A. A,I iLtailkAII.4° a , 7 11-1 \'-.2--72--
Print •wner's u -fly' d Agent's Na ,mc Signature) Date
NOTES:
1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor
(not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration
program or guaranty fund under M.G.L.c. 142A. Other important information on the RIC Program can be found at
www.mass.gov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dps
2. When substantial work is planned,provide the information below:
Total floor area(sq.ft.) (including garage,finished basement/attics,decks or porch)
Gross living area(sq. ft.) Habitable room count
Number of fireplaces Number of bedrooms
Number of bathrooms Number of half/baths
Type of heating system Number of decks/porches
Type of cooling system Enclosed Open
3. "Total Project Square Footage"may be substituted for"Total Project Cost"