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36-073 (10) FF+)M : BILL DREW - ► FRX N0. : 413-315-3550 Mar. 26 2006 10:03PM PB bOME iMPROVIMENx CONTRACT Date: 5 Z S G Branch Nurtfb >ntd,l uiI![$�toyf cr: _,_,_�76/ �4�,a Graonwood Str me Services 6 T'011 FXe 8 `iI Worcester,MA 01607 Feders7 lD b 75-26981600 Ue# 802a3 508-756-2859 CT Uc N 565522; MA II.,ne Improvcm 0 CouirnctorR Ucij 16427 '! qt•#126893 Installation Address: 'T i ,_Q n / t�� �ZZZ-.4J cg tf-1,4 G ! 6{7 F_ City State Zip Purchasers: Last 4 Di .ts,ofDriver's Lie it&EXFL Mo/Yr. Work Phone. Rome Phone: �4 12c E5CL4 EL_t f- s o o (y1�J597-afz3 (w�)E,p3-goo Home Address: (If different from Installation Address) City State Zip E-mail Address(to receive updates and promotions from The Home Depot): Pro'ect Information: I/WefYou("Purchaser"),the owners of the property located at the above installation address,offer to contract with Home Depot U.S.A.,Inc.("Home Despot" to filmisb,deliver and arrange for the installation of all materials as described on the attached Spec Sheet#:_A eg :2 RRI> incorporated herein by reference and made a part hereof. Rome Depot reserves the right to cancel this contract if,upon re-inspection of the job,Home Depot determines that it cannot perform its obligations due to a structural problem with the home,pricing errors or because work required to complete the job was riot included in the Spec Sheet or Contract. DEPOSIT PAYMtNT OPTIONS (Subja:t to fund vevficatioc and/orcrcdit approval.) CONTRACT AMOI N I $ C{ 3 1. Chcck, hicrs Chock or U Postal Service Money Order (, payable to'llic Home Depot). xL)E'SS DEPOSIT S .5,(85- 2. Credit Caret•and'orotbcrpaymcnt options-Circle Oor Mow . - Visa MasterCard Discover American Express .. BALANCE DUE The Y.orno Improvement Loan Tic Hole Depot Credit Card ON COMPLETION $ (-04268— U New Acmuxt 0 ExUting Account (HIL&IIDCC ONLY) Minimum 25%of Contract Amount due uptm execution Avanable Credit:S (HII,&HDCC ONLY) A this contract. Accts: ____.—__..._._.-..._ ....._--Exp.Datc. Indicate Pavment Method For Name ss it appears on card:_.-.. BALANCE DUE ON COMPLETION: `By my/our signature below,I/Weagreetoa llowIlomeDepottochargethcabove referenced credit card For the deposit indicated. Cardholdec's$ignarurc Date HIL or HDCC Authorization Codes Deposit Final Payment Purchaser agrees that,immediately upon satisfactory completion of the work,Purchaser will execute a Completion Certificate and pay any balance due. Purchaser also agrees to be jointly and severally obligated and liable hereunder. Entire A rcement.This agreement and its attachments,including any financing agreement,contain the complete agreement weep t e parties and cannot be amended or modified unless in writing in a separate agreement signed by both parties. . NOTICE TO PURCHASER Do not sill this contract before you read it. You are entitled to a completely filled-in copy of the contract at the time you sign. ICeep it to protect your rights. Do not sign a Completiou Certificate before this project is complete. Law prohibits home repair contrstctorg from requesting or accepting a Completion C.crtificate signed by the owner prior to the actual completion of the work to be performed under the contract. You may cancel this tratmaction at any time prior to midnight or the third business day after the date of this contract. See Notice of Cancellation for an ezplanatinn of this right. There %,ill be a service charge equal to 25%of the contract amount if the job is cancelled by Purchaser AFTER the third business day. BY MY/OUR SIGNATURE RELOW,UWE AGREE TO BE BOUND BY THE TERMS OF THIS CONTRACT. IlWL ACKNOWLEDGE RR711111T OF A COPY OF THIS CON'T'RACT TWO COMPLETED COPIES OF THE NOTICE OF CANCELLATION. BY MY/OUR SIGNATURE BELOW, I/w U DE _ D T T THE .AC4RMMENT IS SUBJECT TO REVIEW 01: MY/OUR CREDIT HISTORY AND I/WL_RUTH Z E DEPOT T VERIFY AND REVIEW MY.tOUR CRfsINT RECORD WITH AN INDEPF.NDL'NT CREDIT R PO GENCY vD I LL ASE THEM FROM ALL LIABILITY LNCURRED FROM INADYLIt l bNT OMISS 01v OT S IS CONTRACT JF THERE ARE ANY BLANK SPACES. SUBMITTED BY: Date: ACCEPTED BY y/ s t Date: wn Date: HOISIVOV/nCC NOTICE!AMMONAL TYRNU,CONrT)rTIONS AND WAI ANT1ES ARA STATED ON TI1F:14EVME SIDE AND ARE PART OF THIS CONTRICT White_9ramh File Yenow-t]sstom.: Pink-Sala Con=1uw 12-5-05 C-SC � � �Ti Iassac3�icsetfs - ` DEPARTMENT OF BUILDITIG INSPECTIONS INSPECTOR '212 Main Street • Municipal Building '>a North,-unpton,MA 01060 HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to act as i:is/lien construction sups:".:;I r. The state defines "Homeowner" as, "Person(s) who owns a parcel on which he/she resides or intends to be, a one or tivofia -My- — 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." The building department far the City of Northampton wants-any person(s)-who-seek-to use the home owner exemption, to act as their own construction supervisor, to be aware that by doing so you become responsible for compliance with state building codes and regulations. The inspection process requires that the building department be called to inspect work at various stages, which include foundation/footings(before backfill), sonotube holes (before dour), a rough building inspection (before work is concealed), insulation inspection(if required) and a final building inspection.:The building department requires these inspections before the work is concealed,failure to secure these inspections can result in failure to obtain a certificate of occupancy until the work can be inspected. If the homeowner hires other trades to perform work(electrical, plumbing&gas) the homeowner will be responsible to make sure that the trades hired secure their proper permits in conjunction to the building permit issued, and that they get their required inspections. Failure of the individual trades to secure the permits and inspections as required can DELAY the project until such time as the proper permits and inspections are made I, understand the above. (Home owner/resident's signature requesting exemption) I will call to schedule all required building inspections necessary for the building perma - issued-to me _ - Dates Address of work location r (rii II{ TrrriIjfdmptoll _ _ P E � 1.�c�ccllatrtla" _ _ W a DEPARTMENT OP BUILDrl,IC INSPPCTION's 212 Alain Strcct Municipal Building NorLhampLon, Mass- 01060 W(DRICCI IS CONITENSA-f7O.N 13� SURACE AFFIDAVIT lam' IOil -- _ - - --. (li ccvsxlpera>;ttcc) principal place of busioess/residence at: - �1one:- � (szl-�t1d rJ lsza-lc�ri p) do hereby cerdf;, under chc paint :md penalties of perjury., :hat I - (,� I am an employer providing the followinglworkcr's comocnsado, coverage for 111) employees worlong on ulis job: i (insures Conr2�) (Polio: ( ) I am a sole propr;ctor, general coneaetor or homeowner (ci cie one) rnd Have hired the conuaCors its below wbo hive the `ollowing worker's camnen—sadon policies: (iNamC of Con=do-) (Insumnc:. COIno1 ryPt oUc-,- ?�7LSIIICC') (t';J7FJ Q? l� IC) (Name of Contrclor) (Ins.uzn Comisa.a)iPolim, \tlminr) Dale) (Name of Connacto,-) Omsw-ante Company/Pot;q- Numb,-r) CExpimdon Daic) (N2mC of Contractor) (Losumn= Company/PoUcy Numb:r) (Expirtioa Datc). I (an�.-3�i�ocal v'ca.if acces._^y-co cx?u�infoca,�'i on petasa:,.as to..11�o�err�:�) i ( ) I.am a sole proprietor and have no one working for me- ( ) I am.a home owner performing all the work myself. NOTE:pte3e)x aw ut[fi•• . }c hem^ very—bO C=PtoY Pl= T eo do -• c�-�r 00 e my a•.rorz oa a d.•eJl_C of aoe etoce tb:s t`.�oe uat�is u'sh the bomo"•ac r=de oc w the p-=o6 z7P U-Na-r,.o c..-c Doc C—_.=Dy W--d In be eixploycs —the..uS,eh c=-k- oa Act{GLI152=1(5)).appiin_6oa by a bomeoQaa fe c tic.._-^-or penaa r._-y evrdco=tb= Iesal c.-..,,of as c=ployor uodrr dw Wk e,Cocageosalioa Ad i I uadc,t�d t6.e.a Dopy of ku+ct.®�ay.y be roc>.vded to tba Dctwrtmcox or IamcYSic!ncddcsj Offioe or l+zsa.r.aoe rot tt,. � covez.p^e re"if elioa aad tiu f-iltat to ta�uc 1�v���c�UOn 25 A of I.iQL!52 an ted to the i�zpos2ioa or eimiasl pensl2ia coati iag oC a fiat crup w S I X00-00 undloc i=pr6oaai=orup Lo Doc)T1 nod evil pmjtio i.d.roan of.Stop Wort Ordc+mod j f=Of S 100.00 a CLZy rp.i=CDC Pcrmit Numb-= Ifzp.' Lot Y S;pkz of Lim cm-iu= SECTION 8 CONSTRUCTION SERVICES " 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: License Number Address Expiration Date Signature Telephone w axe v ks 92eQ ere orne:mprcnremerrt.Gon ra o• Not Applicable ❑ D-- Company Name Registration Num er -— �L4`r�fC'1' Adddr s e 0 -T LILV) � 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 building permit. Signed Affidavit Attached Yes......, Ir' No...... ❑ Eno W 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 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-vear 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 building 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 be 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 r j SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House [] Addition ❑; Replacement Windows Alteration(s) Roofing Or Doors Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [p Siding Other[dl Brief Description of d Work: Alteration of existing bedroom Yes No dding new bedroom Yes No - Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet sa:t 'Nevi iiause$and orbaddi 16 to x in Rio sing.=compl n.,% _ 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'BtALDING.PERMIT as Owner of the subject property hereby authorize to act on my behalf,in all matters relative to work authorized by this building permit applic tion. 3 U Signature of Owner Date 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. $igne der the pain and penalties of perjury. ' Prin a ig ature of 0 er/Ag nt Date Section 4. ZONING All Informatihh 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 Size Frontage ' Setbacks Front i I Side L: R: i L: R: � f Rear Building Height Bldg.Square Footage % ;--' Open Space Footage % (Lot area minus bldg&paved i 1 r} -- azkin i E #of Parking Spaces Fill: ' (volumes&Location)4` i A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO Q DONT KNOW 0 YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO Q DONT KNOW 0 YES 0 IF YES: enter Book Page, and/or Document#^ B. Does the site contain a brook, body of water or wetlands? NO DONT KNOW 0 YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained Date Issued: C. Do any signs exist on the property? YES 0 NO 0 IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES NO 0 IF YES, describe size, type and location: E. Will the construction activity disturb(clearing,grading,excavation,or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES 0 r NO 0 i IF YES,then a Northampton Storm Water Management Permit from the DPW is required. � � �-� Departmeitt.,useoril} ' City of Nortf ampton Building Department ,` 212 Main Street u� 3 Room 100 a _ : Northampton;AMA 01060 ' phone 413-587-1240 Fax 413-587-1272 a APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Property Address: t Thts section to-,be Completed by office 4. Untt. Zo�ie w Overlay D►strict © C,Q_� Iin 5t Distracts CB-DWtnct SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: L41 Name(Print) Current Mailing Addres Telephone Signature 2.2 Authodmed A ent: 3 N� pns, ra� Arcs 01&D7 Name( 'nt) , Current Mailing Address: 'S�ignaturej Telephone SECTI 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only com leted by ermit applicant 1. Building (a)Building Permit Fee 2. Electrical (b)Estimated Total Cost of Construction from'6 3. Plumbing Building Pennit Fee 4. Mechanical(H\/AG) 5.Fire Protection 6. Total=(1 +2+3+4+5) Check Number Thin Section For Official'Use Only" Date Building Permit Number. Issued: Signature: r i Building Commissioner/Inspector of Buildings Date 411 WIESTHAMPTON RD BP-2006-1055 GIS#: COMMONWEALTH OF MASSACHUSETTS CITY OF NORTHAMPTON Lot:-001 Permit: Building Category: BUILDING PERMIT Permit# BP-2006-1055 Project# JS-2006-1560 Est.Cost: $16453.00 Fee: $25.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: HOME DEPOT AT HOME SERVICES 126893 Lot Size(sq.ft.): 26789.40 Owner: ETCHELLS MAUREEN C Zoning: SR Applicant: HOME DEPOT AT HOME SERVICES AT. 411 WESTHAMPTON RD Applicant Address: Phone: Insurance: 345 GREENWOOD ST UNIT 1 (508) 341-9401 Workers Compensation WORCESTERMA01607 ISSUED ON:41512006 0:00:00 TO PERFORM THE FOLLOWING WORK.-INSTALL VINYL SIDING 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 4/5/2006 0:00:00 $25.0012059 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo