Loading...
36-135 (3) „;.Brtmld, .ate,traeriittats bj:. .. .. Branch Nome; .Date: d Cj THO At-Home Services,Inc. d/b/a The HomeDepot At-Home Services ` 345A Creeuv Sret,Woester,MA 01607 Branch Natabor �''(- Jab# �$ Toll Free(800)657-5182; Fax;506-75(',-2$59 federal ID 0 75-269NO ME Lic#C 02439 Rl Corr.tacM 16427 t CTUe9565522; MA Harm Ir toveamtCoMxdyat tug#126893 lattatlattawAidreess `} ?t� C]QK .i . .4 l.n (Z r1UC�1►11 t�1D6 City. Stan Zxp _ Laat4DliYr,dl);lvrr'r poreaaase(ak Lta. KIM,M Work Visaing. HOIasP . Home Addle”. — J t[f dift font from Instillation Address) City State Zip E-mall Add"(to receive updates and proinotions from The home Depot); Project IePormadon: ilWe/You("Pludotlm ),the owners of the ppmroper)'lacaled at the above installation ad*css,offer to contract with THD Ai-Horrte.SmNiocs.Inc.("Tlaw�,Dlo�plt""}to finsdsh,delrvor and arrange for the justalladfla of all materials as described on the attached Spec Shea# L:��'l1 ddsr inwiporated herein'by refesonee std mastic a part hereu{ Roane Depot reserves the right so exam this contract K upon rio4supection of the job,House Depot determines that It cannot perform lit oblWWoaa due to a structnrai problem With the home,pricing eptars or because work re9aired to complete the job was not included to the Spec Street or Contract DEPOSIT PA"VMRNT OP'IYONS .. - (9tiDjeot m ttNd vtaMauou andkr credit spprwJ.) CONTBAcr AAmOUNt s 1. Chaois4,Cahiae Check or US-r'aW service Kom order (Made payahle m The nano Depotl tuns DEPOSIT 3 I +-4 a 91. a u �a i +N lAiaiir BALANCE DUE. Vbs hfag rCad Diicvw Anmsican Expraa ON COMYL1TION S-2-19i—LA— The Ham*Depot Moan kopnwamnat Loan items Depot C'ad'r tMlatuium 25%stCeatiiet A1u*sxt due atoat 4—Amager 0 Edsrtai Acsosm (RIL a,HbCC–'�'31tiLf en"dox of"asaltlll' Avaraa2tie Credit;S (iQL bt HOCC ONLY) Indicate Pay=;;Method Far Aaca oxp.Dow. DALANCE DUE OW COItiPLCTIOIV: Name as it appears an cut t R e t`p z . q- •"By uty/our Aputure belo4,if We agree to allow Home Depot to 35L-7 Charge above rafbnwced credit Eon the deposit indicated. •wires yet prW i w dlgat W uat iaf>uaanloa font ymr clardc to mslte a onetime dwtroadc kW'1340stare --%_1 (Lad irttafar from your wcowt dr to platen lire paymmx u a otsaeit tmrstion.Wfaa we use tataeaadars flora y"cbetlt to gA„or FIDC .Au>1kWrbuitlDU Glades maim sa.alacaaoie fund transfer,fbodt tuy be wwkh wa(iota Flow Pi t your"Mmt u sow as the pvymant is mca"d.and you will are rauiveyarchedthack. [� Ptncbaaer agten that,himediately upon completion of the wo&.P=haw will execute a Completion Ceri irate and pay any balance dae. lh rchaarr alaoavvU to be jointly and severally obligated and liable beroutiftr. &Wn Ameeaueast:This sp etan. and its artachmmoats,including any 8nanciig 690"et t,contain the complete agreement between the parties and can not be amended or nwddW unless its writing in a separate agreement signed by both por ies. NOTICE TO PURCELAS$R Do not sign tits contract below You strati G: You are entitled to a eom fills"espy of the coatraet at the time you 24PL Keep 1t to propist Ygptr tea. Do met saga a CaaWle" bo ki11a projat#e completes Lary p home r�epatr ciaa0:*d0,m<t+aat pl� t ae�tl taaCoompleflom Car4fte a siped by tba owner prior to the actual comptleeftibonn at to w'o'k to be part You aelmy rascal this tranjusiliin any time prior to roidnlgbt of the third baldoess day after the date of this contract. Sae Notice of Cancellation imr.,aa eaphoodan od this right. There WW be a service charge equal to 10%of cite contract snooat if job is cancelled k Perebaaer AFTER the third bathers day,bat BEFORE moterlab are ordered.Thane wilt be a service charge equal to 25 X.of the colatr itct,dent K job N caneelle4 by Parchoser AFTER o ate ioia are ordered. BY MY)OUR SIGNATURE BELOW,IlWL UNDERSTANO THAT THE AGREEMENT MAY BE SUBJECT TO REVIEW OF MYIOUR CREDIT HISTORY AND I/WE AUTHORLM HONM DEPOT fO 'VERIFY AND REVIEW MYKfUR CREDIT RBCORD WITIi AN It3DEPENDENT C'REDfT REPORTING AGENCY AND RELEASE T[3EM FROM ALI. LIABILITY INCURRED FROM INADVERTENT OMISSIONS OR ERRORS, BY MYFOUR SIGNATURE BELOW,VWE AGREE TO BE BOUND 13Y THE TERMS OF THIS CONTRACT. VWL ACKNOWLEDGE RECEIPT CIF A COPY Of THIS CONTRACT AND TWO COMPLEMIT COPIES OF THE NOTICE OF CANCELLATION. — t SUBMMTED BY: -- ( +� Dote. Conwfmat ACCEPTED B'Y;>= DIU: _- aer Date:- f 3 top s ' NOTICE,ADDITIONAL TERI►'15 AND CONDITIONS ARE STATED 43N THE R'EN'LWE SIDE AND ARE PART OF THIS CONTRACT 941-07 rev4.2-07 GSC Whilo-9na+phfille Yellow–Customer Pink–SwagClluukant 9 -d KH3 13rN3SUI dH WHBO:9 8008 SO ReW r.,�, Void;"fBtrtiatied rata XiistatlistTby: . Branch Noma_�L�►T�-� Data: ��� 3! r TlID At.Home Services,Inc. f I d/bla The Home Depot At-Hama Services (_ 345A Greenwood Street,Woucester,MA 01607 BranchNarober: ��+ D1+s.. Job#: � ,,� "1 �G7 Toll Free(600)657-51874 Fax:506-756.2854 Fedual TD r 75.2698460 ME Lk 0 C 02434 RT.Cunt.Lill 16427 C7'[A��56552L• MA home tmprnvempa t:Uniraclur Rag.k 126A93 InattllintienAddresa: ..�+�+� �f2.C�'21'_."S�CS�-�Lf.�.0-�Q. �,i�.(�K� tylY�1 014fo.Z, City state lip Last 4 Diets o(Odwees yPunbner(sY• Uc.F&Esp.MoNrt Work Phony Home Pbsme: LO house Address: (]fdiffamat from lnsulletion Address) ��—City State Zip i 9y, E-mail Address(to rweivr updam and promotions;from T be Home Depot): Project I4fbrmatfon: ItWeNnu C Purchaser"),live owners of the property located at the above installation address,offer to cnnt+act with TTID At-Home Services,Inc.(� nS"1 Q furnish,deliver and strange for etc ittatatlat+on of 411 materials as described on the attached Spec Sheet if_—.t (� �-?_..._,tacaaporeucd hereia6y reference and made a part hmof. Hoene Depot reserves the sf&to cancel this contract If upon re+tsspectlon of the job,Home Depot determines that it cannot perforai Us obligations due to a structural problem with the been%pricing errors or because work required to complete the job was not Included in the Spec Sheet ar CetltrseL DEPOSIT PAYMENT OPTIONS (Subject to tied veritkatioo ands,ore&appraval.) CONTRACT AMOUNT $_ I L Chock-.T aettiaa Ctrxktr US Poarar Satvtca Motes Order (Maio payable to The Ham Cwpot)- MESS DEPOSIT 3 -7.R 9 2. Crack Card—and/or orbs pays xe opbow-Circle the ndow BALANCE nut Vin MaalerOW Di*mtr Anwrfost ON COMPLETi ON $r,-4 tfLe Name Doiwt RoYua tmpaovpgaot Lose dame Do",Crodu cio*_ 1 tMitdrwaa 25%of Contract Amount due upon "access Q Esisdaa Account (ML N - _..J exeerdosof this contract. Indicate Payment Method For Aecm F-,*Deft: BALANCE DUE ON COMPLETION: Ntum,g it appeiue as card: � �e fZ -By tnylow signalmbelow,Mc agree to allow Hound Depot 60 ��,/,�r��rj 3rd p3 b$pk,3EJb`? charge the a referencceeedd txedlt ca far the deposit indicated —*QZ you provide a shalt as 00*wIt,.you authorim oa efter ��se-�y�.+ o '- -e1 �D�! to um iidbumwoo thin your chra.-k ib mile.a care.dme dafiooia c6alldwn swulmri (sort tnnefar from yaw eceamt to to proeeer the payment at■ ttw¢k irsawlia .Men we oar inlbrmanoo assn goer deuce to HIi.or HUCC.Authorization Codes make rn deeoonie Cued ttamfa,hater way he wiatdtawn fens your acaaad as earn to toe paywArlt is I'Keived,and you will out Deposit I al Payment salve yoardeok back. - # # b 03 bk,3 Purchaser agrees that,immediately capon completion of the work.Purchaser will execute a Completion Certificate and pay any balance due. Purchaser aloe apeca to be Jointly and severally obligated and liable hereunder. &jre Agroeotetttt This agreement and its attachments,inchrding any financing agreollml,Contain the cOmPlete agreement between the parties and cam not be ammuded or modified:mless in writing in a sepacus agreement signed by both parties. NOTICE TO PURCHASER Do not sign tbis contract before you read IL You are entitled to-geomplet0y fBkdrba copy of the contract at the time you saitpptna Keep it to rotett your right& Do net align a Comp]r1Hen Certificate before this project Is COMPkte. Law riMbks borne repaircoatinctgrs from requesting or accepting a Compktiow Certldcate signed by the owner prior to Hutt setud complation of the wotk to be perforated wader the cotttrouL You may caseel this transaction any time prior to midnight of the third business day after the date of this eeatract. See Notice of Cancellation for on attphinaden of this rigIlL Tbere will be a sawlee charge equal to 10%of Out contract amount If job is cancelled icy Purchaser AFTER the ddrd bualnom day,but BEFORE materials are ordered.There will be a service charge equal to 254Yo of the contract amount If job is cancelled by Purchaser AFTER materials are ordered. BY MYlOUR SIGNATURE BELOW,UWE UNDERSTAND THAT THE AGREEMENT.MAY HE SUBJECT TO REVIEW OF MY/OUR CREDIT HISTORY AND UWE AUTHORIZE HOME DEPOT TO VERIFY AND REVIEW MY/OUR CREDIT REcoR.D WTI'ii AN INDEPENDENT CREDIT REPORTING AGENCY AND RELEASE THEM FROM ALL LIABILITY INCURRED FROM INADVERTENT OMISSIONS OR ERRORS. BY MY/OUR SIGNATURE BELOW.UWE AGREE TO BE BOUND BY THE TERMS OF THIS CONTRAC'T. UWE ACKNOWLFDGE RECEIPT OF A MFY OF T141S CONTRACT AND TWO COMPLETP.D COPIES OF THE NOTICE OF CANCELLA11ON. .,. SUBMtTTFD AY:_-,�tV6� � _ Date: udoial ACCEPTED BY. � _.^ Date: 1'd _Puf. _ +_ nae< —— Date: ��----- NOTICE:ADDITIONAL TERMS AND CONDITIONS ARE STATED ON THE REVERSE SIDE AND ARE PART OF T1I18 CONTRACT 9.21.07 rev 42.07 C-SC White-Branch Fie Yellow-Customer Pink T go"Cdtioultora S ,d Xd3 13CM3Sd°i dH WH9T :9 8002 SO ReW HOME OWNER EXEMPTION ACKNOWLEDGEMENT Fas f Massachusetts allows the homeowner the right under 780CMR 1083).4 to er construction supervisor. The sta te defines "Homeowner" as, "Person(s)a parcel on which he/she resides or intends to be, a one or two family ttached 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 for the City of Northampton wants 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 pour) a rough buildin; 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 permit issued to me. ` Date Address of work location ti _ of The Conin.arzx�ea%tIz ��assaclzuse:.�s s Devartrnew of Irzdttstr is?_4 ccidents „- � O�Jce of I7zi'eSti,�LrOnS 600 lT'aslzington Srreer _ – — Boston, M-4 02111 www.rn ass.-oz/dia 'Workers' Compensation Insurance Affidavit: Builders/Contractors,'Electricians/Plumbers .�,nalicant Information Please Print Legibly Name (Basin esslOrganiza-io:v'Individual): _ Are ddss: P Clty;/Stat 'Zip: Phone n: r2. e yo an employer?Check the a propriate box: Type of project(required): I am a employer with--t 4. ❑ I am a general contractor and I 6 ❑New construction employees (full and/or part-time).* have hired the sub-contractors I am a sole proprietor or partner- listed on the attached sheet. ❑ Remodelina ship and have no emplovees These sub-contractors have S. ❑Demolition working for me in any capacity. employees and have workers' 9 ❑Building addition [No workers' comp.insurance comp. insurance.+ required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions ❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions 3. myself. [No workers' comp. right of exemption per MGL 12.❑Ro repairs n insurance required.] t c. 152, §1(4),and we have no If employees. [No workers' 1'- ther corny. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. wCont:actors 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 providin;workers'compensation insurance for my employees. Below is thepolicy and job site information. Insurance Company Name: Policy r or Self-ins. Lic.#: Expiration Date:/ Job Site Address: lD`t �-, �(�f �'— City/StateiZip: n o&,a Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to 51,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to 5250.00 a day a ainst the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of Lk r insurance coverage verification. I do h r tify un th pans and penalties of perjury that the information provided above i true and correct. ianature Date: O LS Phone=: O�jicial use only. Do not write in this area, to be completed by city or town official Citv or Town: Permit/License issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector 5. Other Contact Person: Phone T: SECTION 8-CONSTRUCTION SERVICES 11 Licensed Construction Suoer Asor: Not Applicable ❑ Name of License Holder License Number Address Expiration Date Signature Telephone l i 9.Registered Home Improve entContractorR . ... ".. _ .Q . .. _ Not Applicable ❑ 1 e= ( � Company Name Registration Num er Address / Expiration Date Q1!� )/Telephon �O 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 ermit. Signed Affidavit Attached Yes....... No...... 0 M-=No ne ©wner.Ejobm Lion 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 1083.5.1. 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-year 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 S=CTION 5- D=SCRIPT!ON OF PROPOSED WOFK(check all ano!icabie) I+ New House Addition Replacement Win w I s Alteration(s) Roofing Or Doors Accessory Bldg. I! Demolition ❑ New Signs [0] Decks [Q Siding [Cl Other[=] Brief Description of Proposed— K) W c rk: 1�( Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet Sa'. If New house and"or addition to tin housing compfets th6 fo[oiyincv a. Use of building : One Family iz 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. flocdplain 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 BEIILDING PERMIT 1 �J flh I�iGl� as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit applicati 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. Signed and the pains and penalties of perjury. P -me t Signature cf caner/Agent Oate ° ^ ' ~ | Sec"Jon 4. LUNIN(i All!Information Must Be r_omDje-e,_i. Per-mit Can Be Denied Due To Incorntilete Information Exisnriz Proposed Required bv Zonina This column to be f-Illed in by Building Department Lot Size Frontaae Setbacks Front Rear L Zonin en t Buildinz Height Open Space Footage % Idg paved (Lot area minus bId2 paved aces #of Parkina Spaces (volume Location) A. Has aSpeclaL Permit/Variance/Finding ever been issued for/on the site? NO 0 DON7 KNO0/ 0 YE] 0 |F YES, date bsued IF YES: Was the permit recorded at the Registry of Deeds? NO t~/�� uun / xnuvv 0 YES !F YES: enter Bonk ! / Page and/or Document#/ �------- B. Does the site contain a brook, body of water orwetlands? NO �-� DONTKNOYY /~� YES v�� �-/ IF YES, has permit been or need to be obtained from the Conservation Commission? ' Needs tubeobtained /~~\ Obtained /-� Date |ssued' /---------- �-� �~/ ' ' i--_-_________� C. Do any signs exist on the property? YES 0 NO ._ IF YES, describe size' type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES ��»�� NO ���� IF YES, describe size, type and iocation� --- E� Will the construction activity disturb(clearing, grading vabon. nr�Uing)over 1aoeo,��po�ofsconnnon�an matwU|disturb over I acne? YES ���'l NO /~��� lFY�S�'8���'No�����cnS6��'0V��'���g�enfPenn��nm�eDPVViu�quied. 4 L Department use only T` City of NofttamPion Status of Permit: �RNiI�inn� nAr-art-n=r, Curb Cut(DrvewayPermit � 212 Main Street Sewer/Sepfrc Avaiiabitity Room 100 Water/WeltAvailability 1 � 2 N,ortha pton, MA. 01060 Two Sets of Structural Plans p� phoned-687 240 Fax-413-587-1 272 Plot/Site Plans Other Specify }Z LI�i i"CONSTRUCT,ALTER,REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECt10N 1 -SITE INFORMATION 1.1 Property Address: This section to be completed by office Map Lot Unit LS ��Z �'C,� Zone Overlay District r Elm St.District CS District SECTION 2-PROPERTY OWNERS HIP/AUTHORIZED AGENT 2.1 Owner o ecord: o? &EV511 aak aftze Name(Print) Current rlailin g SLl SOL _ Telephone Signature 2.2 Authorized A ent: (/,&I Kba#0CJ:(k ULM rin Current Mailing Address: a: Signaru e Telephone SEC ON 3-ESTIMATED CONSTRUCTION COSTS Item I Estimated Cost(Dollars)to be Official Use Only completed by permit aDolicant 1. Building / _ ! (a).Building Permit Fee 2. Electrical 1P ! (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) &451 .s Check Number 96 This Section For Official Use Only Date Building Permit Number: Issued: Signature: Building,ComrTiissionerflnspector of ui aings Date BP-2008-1034 GIS#: COMMONWEALTH OF MASSACHUSETTS CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Pernut: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Cate, rv: BUILDING PERMIT Permit# BP-2008-1034 Project# JS-2008-001537 Est. Cost: $6451.00 Fee: $25.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: HOME DEPOT AT HOME SERVICES 126893 Lot Size(sq. ft.): 15768.72 Owner: ZEITLER BRUCE A&LINDA J Zoning:URA Applicant: HOME DEPOT AT HOME SERVICES AT: 264 BROOKSIDE CIR Applicant Address: Phone: Insurance: 345 GREENWOOD ST UNIT 1 (508) 341-9401 Workers Compensation WORCESTERMA01607 ISSUED ON.511912008 0:00:00 TO PERFORM THE FOLLOWING WORK.-INSTALL 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: FeeType: Date Paid: Amount: Building 5/19/2008 0:00:00 $25.0022731 212 Main Street,Phone(413)587-1240,Fax: (413) 587-1272 Building Commissioner-Anthony Patillo