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17A-119 (7)
BP-2021-2124 46 CLAIRE AVE COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 17A-1 19-001 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-2021-2124 PERMISSION IS HEREBY GRANTED TO: Project# WINDOWS Contractor: License: Est. Cost: 3954 HOME DEPOT USA INC 106106 Const.Class: Exp.Date:09/29/2022 Use Group: Owner: ANNESE, DREWCILLA Lot Size (sq.ft.) Zoning: RI/URA Applicant: HOME DEPOT USA INC Applicant Address Phone: Insurance: 2455 PACES FERRY RD NW (413)335-3702 0 XWC-1647259 ATLANTA, GA 30339 ISSUED ON:11/01/2021 TO PERFORM THE FOLLOWING WORK: 5 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. Signature: I cgo 4 • r 4 '1 ♦ I � Fees Paid: $40.00 212 Main Street, Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner City of Northampton Status of Permit Department use only RECEIVED Building Department Curb Cut/Driveway Permit 1212 Main Street Sewer/Septic Availability Room 100 Water/Weil Availability NOV - 2021 Northampton, MA 01060 Two Sets of Structural Plans phon 413+587-1240 Fax 413-587-1272 Plot/Site Plans Other Specify =7 OF E ;II VTHq ,r � 1� ^TIOwS l?�1PPHC,�rT-iar.t'!Y_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 Z6 c to-1 r „S' , Map ( Z Lot ( � ` Unit Flo,en C c /t 1 0/06 L Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: 'p/,..„4„-G//1a A n cS . 1/6 Claire ^r 5/0re44e--c /`'r v /ob Name(Print) Current Mailing Address: 141C-95a Q1/// /) Telephone Signature 2.2 Authorized Agent: 6-kr, /a s 6, e-7 ,6 a)/ Z. (/a)/ 4 e) Cr Name(Print) Current Mailing Address: < a0 33 Sbd-- 957-- L1/1z- Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building 3� s-,p (a)Building Permit Fee 2. Electrical ' (b)Estimated Total Cost of Construction from(6) 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) �' ` V 5. Fire Protection 6. Total=(1 +2+3+4+5) Ql 3 9 5-1(, 0 v Check Number a3Vt0 This Section For Official Use Only f-d/I• 01 / c� Date Building Permit Number: ' J Issued: Signature: /7-2 11" i Zo i Building Commissioner/Inspector of Buildings Date 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 r been issued for/on the site? NO 0 DON'T KNOW YES IF YES, date issued: IF YES: Was the permit recorded at the Regis ry of Deeds? NO O DONT KNOW YES 0 IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO ® DON'T KNOW (YES O 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 ® NO IF YES, describe size, type and location: E. Will the construction activity disturb(clearing, grading,excav n, 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 D Addition ❑ Replacementyll s ows Alteration(s) ❑ Roofing Or Doors ((��' Accessory Bldg. ❑ Demolition ❑ New Signs [Qj Decks [0 Siding[f7] Other[O] Brief Desfc�ription of Proed -,•- Work: ieRe - �wa� , `aee Jov; d•�''�s /r 'E�' /�i�G l✓`1 �''U S`�Lte%Gv.a 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 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 BUILDING PERMIT I Vr€,,-/G, 7/4- 4n/ICS- - , as Owner of the subject property hereby authorize 4 - - tr 4 s4 G / b ergo/ to act my be f, in all matters relative to work authorized by this building permit application. Ad) z/ Signature of Owner Date Geac`d G. Cr4 i✓t e / g/' ,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 under the pains and penalties of perjury. ($ealf C, C*IC,r JA- Print Na e Signal of 0 g Date SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: �, "(]ram, Not Applicable 0 Name of License Holder: rC /k e J '�h O' '` 7�'I'I DZk" ✓ /V./ Y4 License Number 2 3 6e sl 3rci S c;), e lad /f* o J)v9 9/7 T1z z_ Addres Expiration Date GriteN?) Sao- 9CZ• z Signa ure Telephone 9. Restistered Home Improvement Contractor: Not Applicable 0 9€p..7L use- ��c, it 2 Clitanv Name v Registration Number 2-95-5 ACC3 � ,�a� d /� �/ff 30 3 3 9 Li Zz/t 3 Address Expiration Date 1?‘0 - 9S2- 'wZ 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 LU No ❑ 11. - Home Owner Exemption The current exemption for"homeowners„was extended to include Owner-occupied Dwellings of one(I) 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,Sta and Local Zoning Laws and State of Massachusetts General Laws Annotated. Homeowner Signature (4//i4"19 City of Northampton 212 Main Street, Northampton, MA 01060 Solid Waste Disposal Affidavit In accordance of the provisions of MGL c 40, S54, I acknowledge that as a condition of the building permit all debris resulting from the construction activity governed by this Building Permit shall be disposed of in a properly licensed solid waste disposal facility, as defined by MGL c 111 , S 150A. Address of the work: 1/6 C/QI/e 7D.- cc The debris will be transported by: 6 .eir►iv Ca-u,bJ- The debris will be received by: ilvote., °eroa (I SA Building permit number: Name of Permit Applicant !d L, C;eet Date Signature of Permit Applicant City of Northampton eat,,Mpgp 5 Massachusetts �w?S • I � 1 DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building Northampton, MA 01060 s{y { INSPECTOR Louis Hasbrouck Chuck Miller Building Commissioner Assistant Commissioner HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to act as his/her construction supervisor. The state defines "Homeowner" as, " Person(s) who owns a parcel on which he/she resides or intends 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." The building department for 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 pour), 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, G va L• [ s2i �. / ;�i` ( ' understand the above. (Home owner/resident,s signature requesti exemption) I will call to schedule all required building inspections necessary for the building permit issued to me. Date /' l' ?wl/ Address of work location `7' 5/7"CC-/' r/D7e4ee /YI/I" e/g6 Departntent of Industrial Accidents Office of Investigations 1 , Lafayette City Center 2 Avenge de Lafayette, Boston,MA 02111-1750 www-ntass.govidia Workers'Compensation Insurance Affidayit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Leeiblv Name(Husincsi.Orsanthationindrviduao:home Depot USA. inc. Address:2455 Paces Ferry Rd City/Statolip:Atianta, GA 3(1339 phone#:biJ3- 52.4112 Art you an empktyer?fleck the appropriate box: Type of project(requIrrd): 1. I am a employer with 4. 1 am a general contractor and I New employees(full andfor part-tirne).° have h 6. constructionired the sub-contractors 2.;..] I am a sole pmprietor or partner- listed on the attached sheet. 7. Remodeling ship and have no employees These sub-contractors have 8. — Demolition working for me in any capacity. employees and have workers' 9. Building addition [No workers'amp.insurance comp. insurance.", required.] 5. pi We are a corporation and its 10._ Electrical repairs or additions am a homeowner doing all wink officers have exercised their II. Plumbing repairs or additions nsyself. [No workers' conip. right of exemption per MGL 11 Roof repairs insurance required.j C. 152.*1(4).and we have no BA other Windows employees.. [No workers' comp.insurance required.' 'Any appiuussi that cheeks bun 41 sugar alsoEUoat th litin Licto* 1:tuning their uuri.ab'cansprissation policy Aniuttualim. *tionseuvanun rho xibnaii thut.affidavit inalseuting tho use doing all voirk W4 dial hire uidnide imattacturn snug iug or*sitIodul,it indicating such_ :Contractuni that chock the bon mud attained au ustain.unal itot%WS ang thg Mineulthe usb-contniensra and shag%huller ut snit chose t.146i143,611-C 4.Wk15.4.14... If the miti-euraxacturs haw employ ix,-they rnt L that owslict-3:cutup policy nunsba i ant an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Coinpany Name:Nattona1 Union Fire Insurance Co. Policy#or Self-ins.Lie.#:XWC 164/259(0SI)(MA) Expiration Dare:31/22 Job Site Address: 44 Cf4/re Vitt e CityiState:Zip: rip re-4e e /r111- cv/06 Attach a copy of the workers'compensation policy declaration page(shelving 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$1,500.00 and'or tme-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a tine of up to$250.00 a day against the siokuor. Be advised that a copy of this statement may be forwarded to the Office of In\4.:•,tigations of the DIA fur insurance coverage verification. Ida hereby certi&sander the pains and penalties of perjury that the information provided above is true and correct. Sipature: Dale: 2f 136U- b2-41 12 Phone#: Official use only. Do not writ'e in this area,to be completed by city or town officiaL Cu y or Town: Permit/License# Issuing Authority(check one): 10 Board of Health 2D Building Department laity/Town Clerk 4.0 Electrical Inspector 5.alusnbMg Inspector 6.00ther Contact Person: Phone IV: Go Permits, LLC 105 Buttonball Lane G Glastonbury, CT 06033 PERMITS Scott Doughman Phone: 860 952 4112 " Fax: 860-430-6719 scottdoughman@gopermits.org Re: Massachusetts Solid Waste Affidavit Good day. Please find attached locations where the installers can bring their debris from the jobs. These are all Home Depot USA, Inc. locations. • 72 Shaker Road, Unit 2 Enfield, CT 06082 • 32 Scotland Boulevard Bridgewater, MA 02324 • 375 Airport Drive Worcester, MA 01602 • 12 Linscott Road Woburn, MA 01801 • 50 Maria Ave Johnston, RI 02919 Thank you, Go Permits Go Permits, LLC G � 105 Buttonball Lane � Glastonbury, CT 06033 Scott Doughman Phone: 860-952-4112 Fax: 860-430-6719 scottdoughman@gopermits.org To Whom It May Concern, If you have any questions or require any further information for this building permit application, feel free to call me at your convenience and I would be happy to assist you. Once the permit is ready: 1. You can call me at (860-402-3293) to process the credit card payment. 2. Please mail the original permit to the owner. 3. Also, please email or fax a copy of the permit and receipt to: Email: permits@gopermits.org y Fax: 860-430-6719 (Attention: Scott Doughman) If fax or e-mail is not an option, please mail a copy of the permit and receipt to: Go Permits, LLC 105 Buttonball Lane Glastonbury, CT 06033 Thank you! David Anderson, Permit Expediter Go Permits, LLC Phone: 860-402-3293 davidanderson@gopermits.org WINDOW SPECIFICATION SHEET - Spec.Sheet#: 1-1X4BQPJ4 Sheet: 1 of 1 Customer: Drewcilla Annese Job#:1-1x4 BQPJ4 Consultant: Kyle Harmon Date: 10/21/2021 New Window Existing Window Hinge Locations Measurements Grids Product Options Labor Options From outside, Left to Right Bays,Bows Location Color Rough Opening #of bars #of bars Csmnts,1 Pnl, use L,R or S Glass Mlsc Items Hardware Code Screens For doors use v ° ° Mull "S"=stationary or Style Wraps dE % Q u Q ° "X"=operating Room Floor Code (Y/N) Style Code Series Code_ 1 _ _ 5 t- vi U o- > -I > x° STD,White,TMP:Full, WRAP,LSR 1 SUN 1st SB-DH V DH 8100 WH WH 28 51 79 GlassPack:Standard STO,White,TMP: WRAP,LSR 2 SUN 1st SB-DH V DH 8100 WH WH 28 51 79 Bottom, GlassPack: Standard STD,White,TMP: WRAP,LSR 3 SUN 1st SB-DH Y DH 6100 WH WH 28 51 79 Bottom, GlassPack: Standard STD,White,TMP: WRAP,LSR 4 SUN 1st SB-DH V DH 6100 WH WH 34 51 85 Bottom, GlassPack: Standard STO,White,IMP: WRAP,LSR 5 SUN 1st SB-DH V OH 6100 WH WH 30 51 81 Bottom, GlassPack: Standard SPECIAL CONSIDERATIONS: 1:White,2:White,3:White,4:White,5:White Wrap Color Interior Casing Type Bay or Bow window: Seatboard material(vinyl only-Birch or Oak) Bay Project Angle(30 or 45) Bay Flanker Type(DH,SH,or Csmnt) Top of window to soffit(Inches) If tied to soffit,color of soffit material I have reviewed and agree with all the job specifications above and the Construct Roof(Yes or No)' Special Terms and Conditions on the following page Garden Window: Seetboard Material(vinyl only-White Plonite,Birch or Oak)