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17A-185 (4)
a e Crif� �f �'Tcr#Ilaillp for( B E -q;isaArhnzrlla' — DEPART ME1-fT OP DUILDMIC INSPPCT101.'S — 212 Alain Strect ' Municipal Building Northampton, Afass. OIOGO WOMCER'S COWTENSA`SAON. LNSURANCE AI�A�rjj- . ISI- (Ii�ns�Jpermi tics) f' 9� O I30 1 r Cf _ ��r �i`C'�c✓; l rY.� (phone') :�//3 -..77 ^ ty/Halt/a P)' do hereby certify, under d c.pa_u>.s and penalties of pcgilf-y, .h ! Y` ( ) I am an employer providing the follo%vinL %�-orkcr's coinoens don cove age for lily etupiovecs worUng on tills job: (Lauw-an= Comm) (Policy N, ter) -- FExplizLibn Dztc) O I am a sole proprietor, general contractor or homeow-Der(ci:c;e one) aid have hired the coati actors listed below wbo have the follov'U" g Worker's cow ne rs2aon a!icies: (i+flIDC Oi CO:=ci0r) (Ins-rant:: Comoan)•/PObcy-?,,tumL---) - (N-c of Coo[raaor) - (ins-,lra-ncc Comoaav/Polic-; Nulmrr) (-EaDir Lion Date) (Name of Coal-r-acor) (LaRLraace Compzo)-fPoL-q- Numb r) (ExPirmion Datc) . I (Name of Contractor) (Losuranc-- Comcany/PoUcy Numbcr) - (Expi-anon Datr). (attach .A-1*bocal:b<�ifnoca��•co ax?v�inforZtaaoo pcstasnins to.11 ooa7-r�z) _ O I am a sole proprietor and have no one worming forme. ( ) I am..a home owner performing all the work myself. NOTE:piesc be ca at tt..v{ 1e 6cmrAV ncra who eapioy pezoni to So c_s,�o c rtna work oc a d-xI.1;or cot error-the t!sc tints is Koch the bornoo vnct r.z 6.cc oa the pvun xpputtenstl tb-- o ztoo(Ca-ally ocr=;d.-cd w be cixploycn t,✓-tSc w :rr -Y-=!ic.Act(GL!Y2-s r(S)} zppticaboo by n ha...rcr:Gc=---or permi (=7 c.76—t:c hrsa cu-m.of en e-tployW uodcr dw worlcera Compe�AY- I uoj=w-.ad the a copy o!th.-I—-y bo ror .rd d to tbo pc -,-t (err Ioduu;d A.,'-- offiou or t>a.r.aoe ror the covcr�c va'F'c:a'ca,,.td a"G dLTc to`==tcOvcT tn3r',,ct= Oc 2 S A nr h(OL 152 Qa Icd to the�i on of eiminal pcu�hia coos a orup to S1 500.00.:td/or=Pri oCup to ooc year Lod aNil pemhio in be room ore Stop wort Ordc and, oCSIOO.QO a apiust tnc For d�u, only Pczmll Nl1 b= - - 3� G� Map::_ Lot i 9na turc f c trru tt - J Project: Erdman,Harley Order No: .� View Item Qty. Description Unit Price Extended Item#20 Qty: 4 Vent-DH Luxury Edition Precision Fit Window,Make Size:37-1/4 X 796.15 3,184.60 Location:Master Bedroom 56-112: Architect Series, Wood,Model 3,Primed Wood,White,Half Vent ILO: 3' 1-3/4" X 4' 9" /match Half Vent, 5/8" InsulShld IG Glazing,Half Screen, White Hardware, 7/8" ILT Traditional -top sash only Grille(Grille Lites Wide=03, Grille Lites High Upper Sash=02), Std Primed Interior Notes: Item#30 Qty: 1 INSTALLATION 1,220.00 1,220.00 Location: Installation Notes: Item#40 Qty: 7 PREMIUM WINDOW PROMOTION (50.00) (350.00) Location:Promotional Discount Notes: Thank You For Purchasing Pella Products A 1-1/2% SERVICE CHARGE per month (18% PER ANNUM) will be added to all outstanding balance past our stated terms, plus lawyer and accountant fees for collecting outstanding accounts. This order form constitutes a contract between buyer and seller. Deposits are partial payment of the contract and are not refundable. PELLA PRODUCTS INC. MANAGEMENT HAS FINAL AUTHORITY ON ACCEPTANCE OF ORDER. YOUR SIGNATURE CONFIRMS THE ACCURANCY OF PRODUCTS CHOSEN. NO CANCELLATIONS OR REVISIONS CAN BE ACCEPTED ON ANY DATE AFTER THE MANUFACTURERS LAST REVISION DATE. THE SALESPERSON HAS REVIEWED THE IMPORTANCE OF OUR(VERY) SATISFIED POSITION ON THE FUTURE SURVEY MAILING AND THE IMPORTANCE OF DELIVERY INSTRUCTIONS. ITEMS REMAINING IN OUR WAREHOUSE FOR MORE THAN 30 DAYS BEYOND THE ESTIMATED AGREED TO DELIVERY TIME WILL UBJECT TO A STORAGE AND HAND G FEE. THIS FEE WILL BE 1% OF THE NET ON THE ORDER($25.00 MINIMUM Taxable Subtotal $5,223.05 ature ella Sale resentative Signature MA at 5.00% 261.15 None at 0,00% 0.00 None at 0.00% 0.00 Non-taxable Subtotal 1,220.00 Contract-Page 2 of 3 Contract PELLA PRODUCTS, INC. 240 MOHAWK TRAM., GREENFIELD, MA. 01301 Phone: (413)774-7231 Fax: (413)774-6348 Customer Project/Ship-To Order Erdman,Harley Date 00/00/00 No. 71 586 C,5 0 el Need Date 00/00/00 Sales Rep.Name Prepared by Payment Terms Owner: Mr.Harley Erdman Architect Bus. Phone: ( ) - Bus.Phone: (413) 586-0509 Dist. Order No. Bus. Fax: ( ) - Home Phone: Cellular: ( ) - Home Phone: ( ) - Comments: The installation will include;removal of all existing double hung sash&removal of window stops,insulation and caulking as needed,re-apply window stops for 7 Architect Series Double Hung wood exterior precision fit windows. 11 material will be cut outside of the home,drop cloths will be used by installers throughout the project and installers will perform initial window cleaning and show omeowners proper operation of windows and door. 11 installation areas will be kept clean throughout the project and vacuumed daily and after completion. Installation does not include exterior aluminum wrap. 11 7 windows will be Pella®Architect Series windows and have light pattern of 6 over 1 with 7/8" ILTgrills. Exterior color for 7 windows will be maintenance free white luminum clad(frame only and primed wood sash interior will be factory primed and ready for paint. ella Products will apply for building permit. utside View Item Qty. Description Unit Price Extended Item# 10 Qty: 3 Vent-DH Luxury Edition Precision Fit Window,Make Size:37-1/4 X 796.15 2,388.45 Location:Living Room 56-1/2:Architect Series,Wood,Model 3,Primed Wood,White,Half Vent R.O: 3' 1-3/4" X 4' 9" /match Half Vent, 5/8" InsulShld IG Glazing,Half Screen,White Hardware, 7/8" ILT Traditional-top sash only Grille(Grille Lites Wide--03, Grille Lites High Upper Sash=02), Std Primed Interior Notes: Contract-Page 1 of 3 91te eommowweala 0 4&4e& Board of Building Regula ions and Standards One Ashburton Place - Room 1301 Boston, Massachusetts 02108 Home Improvement Contractor Registration Registration: 142279 Type: Private Corporation Expiration: 3/24/2008 PELLA PRODUCTS, INC. GARY SHERMAN _ -- 155 MAIN STREET GREENFIELD, MA 01301 Update Address and return card.Mark reason for change. DPS-CAJ 0 50M-04/05-PC8698 [� Address E] Renewal M Employment Lost Card . _.---- --------- ------ --------/. ..__------...._ _.----._- .._.. .-_....._--- ----------.... ----- J/LG ?6'rIUIYI,OI/.Cl/P,CLGL/L 0�i7/(.QiJ:1C7,C1211d�(d Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: 142279 Board of Building Regulations and Standards Expiration: 3/24/2008 One Ashburton Place Rm 1301 Type: Private Corporation Boston,Ma.02108 PELLA PRODUCTS, INC. GARY SHERMAN 155 MAIN STREET GREENFIELD,MA 01301 Administrator Not valid hout signature . a SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor Not Applicable ❑ Name of License Holder: License Number Address Expiration Date Signature Telephone 9.Registered Home Improvement Contractor. Not Applicable ❑ Petlo. Qob &6s -Tnc _ Q1_/ 0�1P, I? Como any Name Registration Number 03/AH ��oa Address Expire n Drat Telephone `Y13'7V-OAS 3 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...... ❑ 11. - Home Owner Exemption 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-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 w„ SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑ Or Doors 25 Accessory Bldg. ❑ Demolition ❑ New Signs [r-3] Decks [[] Siding[0] Other[C]J Brief Description of Proposed '/ Work: Rjrd1AGr 7 8acts LLBi✓idOWS [n e°Xisfiv�e, 4en;.^a C /V0 M%I�W-eir air Fru#"e w°rk Need Alteration of eAsting bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet ea.ff 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 la-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS 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. Signature of Owner Date I U&S C as Owne uthorized Agent-)hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my edge MZ'Uelief. Signed under the pains and penalties of perjury. I�tn�e 1 l�. we( l Prink a S gnature of I e t Date s � Section 4_ ZONING All Information 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 Side L: R: L: R: Rear Building Height Bldg.Square Footage % Open Space Footage % (Lot area minus bldg&paved parking) #of Parking Spaces Fill: (volume&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO Q DONT KNOW ® YES O IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO O DON'T KNOW � YES IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO K) DONT KNOW © YES 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 NO IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES 0 NO e 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 © NO ON IF YES,then a Northampton Storm Water Management Permit from the DPW is required. f y � Department use only of Northampton Status OfPorft* ilCling Department Curb Cry Permit 212 Main Street SeweNSepftAvailability i 0oom 100 VtfaUemiWer Avagab rly Neltha on, MA 01060 Two Sets of Struc turai Plans phone 741, 7-1240 Fax 413-587-1272 PwSite Plans Other Specify APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Property Address. This section to be completed by office t'13 yo r}h M91 Ir 5�- Map Lot Unit No f t h ar y 6y) / Zone Overlay District Elm St.District CS District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record Aarlv'C4 4-8 wra 1 '13 f6r h Name(Print)I Current Mailing Address: L-1 13- 5 86- OSOq Telephone Signature 2.2 Authorized Agent: Pella pro ducts 2 roc, I S Soh f•. Cjm^e,en'�re/d Name Current Mang Address: Llt5 • 7 7a- o15 '� Sig tune Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS 7 Item Estimated Cost(Dollars)to be Official Use Only completed by rmit applicant 1. Building / �� 00 (a)Building Permit Fee (7 2. Electrical (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) 7�� Check Number This Section For Official Use Only Date Building Permit Number: Issued: Signature: Building Comnessioner/Inspector of Buildings Date 173 NORTIi BP-2007-0113 GIS#: COMMONWEALTH OF MASSACHUSETTS Ma :Bl t:r7f5. :.r CITY OF NORTHAMPTON Lot: -001 Permit: _ _j q Category: BUILDING PERMIT Permit# Protect# _ '17-0173 --- Est.Cost: $6 Fee: $25.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group:_ PELLA PRODUCTS, INC 142279 Lot Size(sq. IL.2 40 Owner: ERDMAN HARLEY M& zoning UR?'. Applicant: PELLA PRODUCTS, INC AT. 173 NORTH MAPLE ST Applicants, r.. Phone: Insurance: 155 MAIN (413) 772-0153 WC GREENF ; 301 ISSUED ON.713112006 0.00.00 TO PL*r; . / THE FOLLOWING WORK.-INSTALL REPLACEMENT WINDOWS POST TV 0 IT IS VISIBLE FROM THE STREET Inspector W Inspector of Wiring D.P.W. Building Inspector Undergrou r. 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 PEI: 13L+'+' REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF 1i AND REGULATIONS. Certlf cat= y Signature: FeeType: Date Paid: Amount: Building 7/31/2006 0:00:00 $25.00208 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo