Loading...
23D-196 47 WARNER ST BP-2016-1345 GIS#: COMMONWEALTH OF MASSACHUSETTS Map-.Block: 23D- 196 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: Windows replaced BUILDING PERMIT Permit# BP-2016-1345 Project# JS-2016-002311 Est. Cost: $4830.00 Fee: $40.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: ROBERT BUSHEY'JR 057011 Lot Size(sq. 1): 25047.00 Owner: GALVIN JOHN&MARY F Zoning. URB(100)/ Applicant: ROBERT BUSHEY JR AT: 47 WARNER ST Applicant Address: Phone: Insurance: 1029 NORTH RD (413) 485-7335 O WC WESTFIELDMA01085 ISSUED ON.5/17/2016 0:00:00 TO PERFORM THE FOLLOWING WORK:INSTALL 10 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 5/17/2016 0:00:00 $40.00 212 Main Street,Phone(413),587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner - f Dow1 ent use only G City of Northampton States of Pemut 6 Z��b Building Department di 3� ' rr# 212 Main Street Avalwility Room 100 1+ aferlWeiTvailabity d Northamoton, MA 01060 xwnSe#saStrtrcutatPJarts phone 413-587-1240 Fax 413-587-1272 PIotlSitetars t2tErer Speafy. APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Prooertv 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 of Record: Name(Print) Current iI"ng Add r ss" `"-`' i. :z i ' = Telephone Signature I 2.2 Authorized Agent: T p Name(Print) Current Mailing Address: Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only com feted by permit applicant 1. BuiJing 4 OU (a)Building Permit Fee 2 Electrical �.J I (b)Estimated Total Cost of Construction from 6 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) 5. Fire Protection 6. Total=0 +2+3+4+5) ®, Check Number This Section Fo Official Use Only Date Building Permit Number. Issued: Signature: Building Commissioner/inspector of Buildings Date I Section 4. ZONING Ail 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 I Building Height Bldg.Square Footage % Open Space Footage % (Lot area minus bldg&paved parking) r of Parking Spares Fill: (volume&Location) A. Has a Special Permit/Variance/Finding e r been issued for/on the site? NO O DONT KNOW O YES O IF YES, date issued: i IF YES: Was the permit recorded at e Registry',of Deeds? NO O DONT KN O YES 0 IF YES: enter Book Page and/or Document# B_ Does the site contain a broo , body of water or wetlands? NO O DONT KNOW O YES O IF YES, has a permit n or need to be obtained from the Conservation Commission? Needs to be obtain O Obtained) O , Date Issued: C. Do any signs exist on the property? YES O NO O IF YES, describe size, type and Location: D. Are there any proposed changes to or additions ojl signs intended for the property? YESO NO O IF YES, describe size, type and location: E. Will the construction activity disturb(clearing,grading, xcavation,or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES O NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable New House F-1 Addition F__J Replacemenf*ndows FAIteration(s) F Roofing Or Doors Accessory Bldg. ED Demolition El New Signs [C31 Decks [Q Siding 001 Other[Ell Brief Description a,Proposed r Work: Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes 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? f. Method of heating? Fireplaces or Woodstoves Number of each g. Energy Conservabon Compliance. Mas$check 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. 1. 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 It as Owner of the subject property hereby authorize to act on my behalf,in all matters"relative to worTauthorized by th4&uilding permit application. Signature of Owner Date as Owner/Authorized Agent hereby declare that the statements and information on the foregoiilqg application are true and accurate,to the best of my knowledge and belief. Signed under the pains and penalties of perjury. P nt Name 1 Signature of Own gent Date SECTION 8-CONSTRUCTION SERVICES 1 Licensed Construction Supervisor. Not Applicable ❑ N - Name of License Holder: license Number C Address Expiration Date i Signature Telephone 1 c Registered Home Improvement Contractor Not Applicable ❑ Company Name Registration umber Q � vv t Address Expiration Date s i lr L 3`a Telephone I Li 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 homejin 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 Officials that he/she shall be responsible for all such work performed under the buil fte permit. As acting Construction Supervisor your presence on thejob 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 Mate of Massachusetts General Laws Annotated_ Homeowner Signature The CommonweaJt* of Massachusetts Department of IndustriaI Accidents Office of Investigations 600 Washington Street Boston,AIA 02111 www.massgov/dia Workers' Compensation Insurance Affidavit:'Builders/Contractors/Electricians/PIumbers Applicant Information Please Print Legibly Name(Business/Organization/individual): W I N DOW Y�jULb (jF ti1Emg ssAC14456TT3 Address: 102-q NuC14 R-13 City/State/Zip: W F_S1T 1 t;l-lj MIA- MSS ',Phone #: L113 Areyou an employer?Check the appropriate box: Type of project(required): 1.[9 I am a employer with 4. ❑ I am a general contractor and I 6 ❑New construction employees(full and/or part-time).' have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the lattached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g, ❑ Demolition workingfor me in an capacity. employees and have workers' any ty- � 9. ❑ Building addition [No workers'comp. insurance comp- insurajnce.- reguired] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑.I am a homeowner doing all work officers have' exercised their 11.❑ Plrunbing repairs or additions myself.[No workers'comp. right of exeroption per MGL 12❑ Roof repairs insurance required.]t c. 152, §1(4),and we have no 13M Other R ►9t!T employees. tNo workers' w!A VOWS 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 najne of the sub-contractors and state whether or not those entities have employees. 1f the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that it providing workers'compensation insurance for my employees. Below is the policy andiob site information. Insurance Company Name: Ll BEATy MI:tTUAL 1w%JS t,RANCF- Policy#or Self-ins. Lic.#: W C-,2— 3 1 S- 3Z7 9!17 -01(o Expiration Date: S--7 _4t Job Site Address: �� � City/State/Zip:_ ,(t��'.(tieP/ YYl d��7G 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 MGI,c. 152 can lead to the imposition of criminal penalties of 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. Ido.iereby certify under a pains and pe of perjury that the information provided above is true and correct Si e: IDate: Phone#: "1 13 140o 5 • '733 QKwial use only. Do not write in this area,to be completed by city or town offwial City or Town: Plrmit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Window World of Western Massachusetts Z 1029 North Road-Hampton Ponds Plaza,•Westfield MA 01085 — Sx�ti dw *16 Phone(413)485-7335; Fax(413)315-3714 NAT-41779-1 t3Ffivi B$. "Simply the Best for Less" www.WindowWorldofSpringfield.com NIC#165641 CSL#57011 Customer: L•4( f� a Phone(h) r .+ Install Address: — Phone(w) Bill Address: i: .i __ E-mail WINDOW WORLD GLASS OPTIONS ADDU VALUES 4000 Series DH $245 _r SolarZone Glass Package* {LE) $79 6000 Series DH{triple Pane} $279 LEE SolarZone Elite Glass Package* $89 Picture Window $359 g (LEE) 2 Lite Slider $359 SolarZone TK2 3 Pane Glass/Krypton(6000 Only) $185 3 Lite Slider (1/4,112,114) (113,1/3,1/3) $619 'All SolarZone packages include 112 screens,Foam Insulation on Jambs and Head,,Double Awning $295 Strength Glass,Double Locks(>29'),Lifetime Glass Breakage and Labor Warranty,Argon Gas Casement LH RH $295 PRE 1978 BUILT HOMES(FEDERAL LEAD CONTAINMENT LAW) Twin Casement(Requires 2 Value+)(0973)(0979) $590 MY HOME WAS BUILT IN THE YEAR = INITIAL:. Three Lite Casement(Requires 3 Value+) $885_ EPA LEAD SAFE(Per Window) Hopper(In existing wood)(Vent+$150) $250 $ O4 Basement Sliders UI $280' EPA LEAD SAFE[Patio Dr/Bay/Bow/Garden) $104°- ` :. Specialty Window $ EPA Lead,third party verification: 7-5$0 Bay/Bow(Insulated seat Int.Casing&Ext.Cap) $3375 1 decline third parry verification [J(INITIAL): Garden Window{Insulated seat,Int.Casing&Ezt.Cap) $1995 (Initial)I have received a copy of the Lead hazard i ori oration pamphlet nforr ng me of the potential risk of the lead hazard exposure from renovation activity to be Gads/EM.colorant.woodgmtnJrolors calculated to ww upgrades performed in my dwelling unit,the EPA'Renovate Right'brochure. Remove Existing Bay/Bow $300 Reframe&Retrim(stainlpaint not included) $400 Roof for Bay/Bow Window (initial)I have received a copy of the lead test result(s), $600 Second Floor Installation $500 Sign: Date.- Window Color />,` ! Inside Outside Name(s)(Print) 4 WINDOW WORLD UPGRADES MISCELLANEOUS LABOR Full Screens $45 Full Exterior White Trim/Wrap(SMOOTH)(PVC) $79 BEIGE Color charge $50 Color Other Than White $10 Ext.Color(AT)(AB)(DC)(HK)(FG)(ER)SCG) $165 Specialty Custom Exterior Trim/Wrap $ Woodgrain interior(LO)(DO)(CH)(FX)(RA(} Aluminum/Vin !or Steel Out $50($150(SM) $95 Contoured/Flat Grids(TOP)(FULL)`XDS) $49 Y Prairie Grids(Single)/(Double)-(Flai)/(Contour) $69� Mull Removal $30 Diamond/Brass Grids(TOP)(FULL) $120 Mull to Form Multi-unit $30 Oriel/Cottage Style(40/60)(60/40) $45 Install interior!Exterior Stops(WHITE VINYL)$55 Obscure Glass Per Sash(BOT)(FULL) $35/$70 Tempered Glass Per Sash(BOT)(FULL)$60/$120 Customer Provided Stops/Trim $45 Catalog Options $ Install lnterior Casing $95 VINYL PATIO DOORS-LH or RH(outside Looking In) Repair/Replace Sill or Brickmould $75 (Includes:White Interior Casing and Exterior Trim.) Mobile Home Conversion $200 5 Ft./6 Ft.Sliding Patio Door(LH)(RH) $1500 Remove/Re-Install A/C or Awning $100 8 Ft.Sliding Patio Door(LH)(RH) $1800 Misc. $ Patio Door Beige Color $125 Patio Door SolarZone $125 Site Setup,Removal,In Home Service,etc.: — Heat Buster Package Upgrade SolarZone Elite$215 Extra Tabor(Box on left for description)$ Patio Door Grids(Regular)(Woodgrain) $100 Total Amount Due$ Woodgrain/Brown(LO)(DO)(CH)(FX) $295 Exterior Colors $395 50%Deposit Amount:$ Patio Door Triple Pane Upgrade $250 Keyed Lock$36 Foot Lock$51 []Cash Storm Door Model $ []Finance-O Wells Fargo ( )Other NO EXTRA WORK IF NOT IN WRITING! []Check made to Window World of WM# []cc# ' Exp.Date: V-code Final Payment Amount$ To be paid to the installer upon installation.Thank You. Sales Rep Recommended:[]Interior Stops [-]Exterior Capping: WINDOW WORLD CARES Customer Declined: []Interior Stop [,]Exterior Capping: St.Jude Children's Research Hospital $ WW of W.Massachusetts anticipates starting this work on -and being substantially completed in `bays.Security Interest:Yes No Any deposit required in advance of the start of the work SHALL NOT exceed 331/3%of the total contract price or the actual cost of any material or equipment of a special order or custom made nature,which must be ordered in advance of the start of the work to assure that the project will proceed on schedule.No final payment shall be demanded until the contract is completed to the Satisfaction of all parties. All home improvement contractors and subcontractors shall be registered and that any inquires about a contract or subcontractor relating to a registration should be directed to:Offfee of Cdnsumeii Affairs and Business-Reitilation,Ten Park Plaza;Suite 5170 Boston,MA 02116.Phone:(617)973-8700 No work shalt begin prior to the signing of the contract and transmittal to the owner of'o copy of such contract. WW of W.Massachusetts under provision of Chapter 142A of the general laws is required to apply for and obtain all construction-related permits.WW of W.Massa- chusetts shall not be deemed responsible for delays in the work described in this agreement caused by regulatory,permit granting agencies,authorities or individuals. Notice:It the PURCHASER(S)obtains his own construction related permits for the work described under this agreement or deals with unregistered contractors, the PURCHASER(S)is hereby advised that in the eventof a dispute,judgement and nonpayment,the PURCHASER(S)will not be entitled to make a claim or collection from the guaranty fund established by chapter 142A,M.G.L. You the buyer may cancel this transaction at any time prior to midnight of the third business day after the date of this transaction. Notice of cancellation must be in wilting postmarked no later than midnight of the following third business day. THIS IS A CUSTOM ORDER NOT FOR RESALEI Owner Date Salesman Date Owner Date This Window Worlda Franchise is independently owned and operated by Window World of Western Massachusetts,Inc.under license from Window World,Inc. wM WC e3-16 White Copy a Original Yellow Copy-File Pink Copy-Customer Hayes P-Mg 888-6871116 i .