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18C-103 Customer Project: Mirochnichenko, Igor Quote No.: 33JM11 Alternate No.: 2 • i U tide View Item Qty. Description Unit Price Extended Item# 65 Qty: 1 Labor materials & Disposal to install one designer dh in bath as a 120.00 120.00 Location: Labor replacement Notes: Thank You For Your Interest In Pella Products Prices are subject to change anytime after 30 days following date of estimate. This estimate does not guarantee availability of any product listed. Pella Products assumes no responsibility for accuracy of take offs from drawings or blueprints or that the products listed will be sufficient to complete customer's intended project. CUSTOMER SHOULD REVIEW ALL QUANTITIES AND SIZES FOR THEIR ACCURACY. YOUR SIGNATURE CONFIRMS THE ACCURACY OF PRODUCTS CHOSEN. PELLA PRODUCTS INC. MANAGEMENT HAS FINAL AUTHORITY ON ACCEPTANCE OF ORDER. NO CANCELLATIONS OR REVISIONS CAN BE ACCEPTED ON ANY DATE AFTER THE MANUFACTURERS LAST REVISION DATE. All prices quoted based on total package price and subject to change if total package not purchased or contents of package change. THE SALESPERSON HAS REVIEWED THE IMPORTANCE OF OUR (VERY) SATISFIED POSITION ON THE FUTURE SURVEY MAILING. ( 7P, �F..k Taxable Subtotal $ 6,891.69 Customer Signature Pella Sales Representative Signature MA at 5.00% 344.58 None at 0.00% 0.00 None at 0.00% 0.00 r I Non- taxable Subtotal 5,220.00 Q2 / 2/ 280Y' 2l �jl / a(� Total $ 12,456.27 Date Date l ` Deposit Received $ 0.00 5 20(3 o toZ Zt O-O 3 21 oqo 7 ,J ti ol;±'v- Proposal - Page 4 of 4 ustomer Project: Mirochnichenko, Igor Quote No.: 33JM11 Alternate No.: 2 tside View Item Qty. Description Unit Price Extended Notes: Item# 41 Qty: 2 Left Hinge Casement, Frame:34 X 56: Architect Series Classic, Clad, 607.61 1,215.22 Location: Bedroom Model 2, Putty (PR0140), 5/8" InsulShld IG Glazing, Wood Rolscreen, R.O: 2' 10 -3/4" X 4' 8 -3/4" Champagne Hardware, Fins (per design) WallCond: 4-9/16" Notes: Item# 45 Qty: 1 Fixed Casement, Frame:31 -1/2 X 37 -1/4: Architect Series Classic, Clad, 365.70 365.70 Location: Kitchen Model 1 , Putty (PR0140), 5/8" InsulShld IG Glazing R.O: 2' 8-1/4" X 3' 2" WallCond: 3- 11/16" Notes: Item# 50 Qty: 1 Vent -Equal Sash 50:50 Top:Bot Sash Split Precision Fit Window, Make 449.89 449.89 Location: Bath Size:31 -1/2 X 37 -1/4: Designer Series, Clad, Model 2, Putty (PR0140), R.O: 2' 8" X 3' 1 -3/4" Single Clear Glazing, Champ HC LowE DGP, Half Screen, Champagne Hardware, Tilt -only Slimshade - Low E Notes: Item# 55 Qty: 10 Labor materials & Disposal to install one casement new construction window 485.00 4,850.00 Location: Labor Based on more than 7 unit Notes: Item# 60 Qty: 1 Labor materials & Disposal to install one fixed casementin kitchen as a 250.00 250.00 Location: Labor replacement Notes: Proposal - Page 3 of 4 ustomer Project: Mirochnichenko, Igor Quote No.: 33JM11 Alternate No.: 2 utside View Item Qty. Description Unit Price Extended Item# 20 Qty: 1 1.t -Lefinge Casement, Frame:34 X 56: Architect Series Classic, Clad, 607.61 607.61 j Location: Kitchen Model 2, Putty (PR0140), 5/8" InsulShld IG Glazing, Wood Rolscreen, R.O: 2' 10 -3/4" X 4' 8 -3/4" Champagne Hardware, Fins (per design) WallCond: 4-9/16" � i ( Notes: 17C, ( Z V2 Item# 25 Qty: 1 Left Hinge Casement, Frame:34 X 56: Architect Series Classic, Clad, 607.61 607.61 Location: Dining Model 2, Putty (PR0140), 5/8" InsulShld IG Glazing, Wood Rolscreen, R.O: 2' 10 -3/4" X 4' 8 -3/4" Champagne Hardware, Fins (per design) WallCond: 4-9/16" Notes: Item# 30 Qty: 2 Left Hinge Casement, Frame:34 X 56: Architect Series Classic, Clad, 607.61 1,215.22 Location: Master Bedroom Model 2, Putty (PR0140), 5/8" InsulShld IG Glazing, Wood Rolscreen, R.O: 2' 10 -3/4" X 4' 8 -3/4" Champagne Hardware, Fins (per design) WallCond: 4-9/16" Notes: Item# 35 Qty: 1 Right Hinge Casement, Frame:34 X 56: Architect Series Classic, Clad, 607.61 607.61 Location: Office Model 2, Putty (PR0140), 5/8" InsulShld IG Glazing, Wood Rolscreen, R.O: 2' 10 -3/4" X 4' 8 -3/4" Champagne Hardware, Fins (per design) WallCond: 4-9/16" Notes: Item# 40 Qty: 1 Left Hinge Casement, Frame:34 X 56: Architect Series Classic, Clad, 607.61 607.61 Location: Office Model 2, Putty (PR0140), 5/8" InsulShld IG Glazing, Wood Rolscreen, j R.O: 2' 10 -3/4" X 4' 8 -3/4" Champagne Hardware, Fins (per design) WallCond: 4-9/16" Proposal - Page 2 of 4 r Proposal PELLA PRODUCTS, INC. 6 9 Ashley Ave. West Springfield MA 01089 Phone: 413-736-9239 Fax: 413-736-3390 Customer Project / Ship -To Proposal Mirochnichenko, Igor Date 02/19/2004 No. 33JM11 Alternate No. 2 , , Need Date 00 /00 /00 Sales Rep. Name Prepared by Owner: Mr. Igor Miroshnichenko Payment Terms Bus. Phone: ( ) - Bus. Phone: Architect Bus. Fax: ( ) - Home Phone: (413) 584- 0429 Cellular: ( ) - Comments: Outside View Item Qty. Description Unit Price Extended Item# 10 Qty: 1 Left Hinge Casement, Frame:34 X 56: Architect Series Classic, Clad, 607.61 607.61 Location: Living Model 2, Putty (PR0140), 5/8" InsulShld IG Glazing, Wood Rolscreen, R.O: 2' 10 -3/4" X 4' 8 -3/4" Champagne Hardware, Fins (per design) WallCond: 4-9/16" Notes: Item# 15 Qty: 1 Right Hinge Casement, Frame:34 X 56: Architect Series Classic, Clad, 607.61 607.61 Location: Living Model 2, Putty (PR0140), 5/8" InsulShld IG Glazing, Wood Rolscreen, R.O: 2' 10 -3/4" X 4' 8 -3/4" Champagne Hardware, Fins (per design) WallCond: 4-9/16" Notes: Proposal - Page 1 of 4 4 lttM1Pi 0 �� E B �x?D� �I11TBI� � -_..-t- * =u a �� a / `r % 1 f�� B .xssxtf(ttactta , =�• . DEPARTMENT OP BUILDITNG INSPECTIONS . , 212 Main Street • Municipal Building ' o Northampton, Mass. 01060 '' No " WORKER'S COMPENSATION INSURANCE A eFIDAVIT 1 , 1 f fvvr b 1 6AI-4 --- E4 sit ti (J6 ,41/4".c-- , clilermittee) with a principal place of businesslresidence at: 1 SS V ' . 61 e Cv1 J GUU 1,414 G 66 1 (phone #) 4i _'1 114 (street/city/state/zip) do hereby certify, under the pains and penalties of perjury, that: ( )'0 1 am an employer providing the following worker's compensation coverage for my employees working on this job: - (Insurance Company) (Policy Number) (Expiration Date) ( ) 1 am a sole proprietor, general cont.I actor or homeowner (circle one) and have hired the contractors listed below who have the following worker's compensation policies: (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) t. (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (attach additional the if necessary to include infocmitioa patnining to all ccotractors) ( ) 1 am a sole proprietor and have no one w orking for me. ( ) 1 am a home owner performing all the work myself. NOTE: please be aware that while homeowners who employ persons to do mainteruace, construction or repair work on a dwelling of not more than three units in which the homeowner resides cc on the grounds appurtenant thereto arc not generally coasidacd to be employers under the worker's comptasation Act (GL152,n 1(5)), application by a homeowner fora License oc permit may evidence the legal statics of an employer wader the Wacker's Compensation Ad.. I understand that a copy of this statement may be forwarded to the Department of Industrial Accident? Offioe of Imurinw for the coverage verification and that. failure to sxure coverage under section 25A of MOL 152 can lead to the imposition of criminal penalties ` ooesistatg of a fine of up to S1, 500.00 andloe imprisonment of up to one year and civil penalties in the form of a Stop Work Ordei and a fine 0(5100.00 a day against me. For departmental use only Permit Number W ]�. t- - 1 L'k 7 ) I f f� ZcG� - -- Lot # ;..,,, .Signature of Licensee/Permittee i to SECTION 8r- ,CONSTRU,CTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder : License Number Address Expiration Date Signature Telephone .:R •4 - "MCA rtiu= "men ®° arA; I',`' " Not Applicable ❑ 1.v14 13\��5 �- c.. r Z S t s 4 Company Name Registration Number Address "� 413-'7'1 A-i ri 1 Expiration Date 0 c 21�.� 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 No ❑ 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 SECTION 5 D 5C 0t fireictPROPOSED WORK (c heck all applicable) New House ❑ Addition ❑ Replaceme Windows Alteration(s) ❑ Roofing ❑ Or Doors f� Accessory Bldg. ❑ Demolition❑ New Signs [ ] Decks [ ] Siding [ ] Other [ ] Brief Description of Proposed Work: 1 _ v 2. (L „/ 5 . 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 ho gMfi l a`ra=dditVOI fo e tiiitlidosing, complete" the4f6iI &gift : 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. Mascheck 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 OWNEftAUTHORIZATION = TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR-BUILDING PERMIT ( c i? `7L) n) t vl e �'.i� , as Owner of the subject property hereby authorize 7/ Y/S C.. to act on my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date t L 1, 1 Ce011 M C D Gv(1 �` L /';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. CCV cPr - V C Print Name I ( C■iyr k c A Cit - 7 " Ta • (z) 7 4 Signature of Owner /Agent Date Section 4. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO LACK OF 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 DON'T KNOW YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 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 DON'T 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 — No IF YES, describe size, type and location:_ City of Northampton 4 Building Department 212 Main Street Room 100 €� Northampton, MA 01060 p 413-587-1240 Fax 413587 1272 f5 APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1- SITE INFORMATION 1.1 Property Address: This section'tobe completed by offce Map jEot #v h f Unit 24 Vi e,, • (D f 1 l {(�` \`C fr /� w - l`j V ZOne $ a011 ay ti15t 1C � L Eim';_t:_ istrict CB,Di §tact SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: Name Print) Current Mailinq Address: /Uo f D 1/ d t 06 o Telephone Signature 4 t y S'4 - (34 7 - 1 2.2 Authorized Agent: ( inn Name (Print) \ C Maili Ad ess: U t0 Signature - vt -rt; (� C y� ✓� Telephone " - ` SECTION 3 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building I '7 (a) Building Permit Fee 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) 1 Z., � , 5 ( J , Z', Check Number This Section For Official Use Only Building Permit Number: Date Issued: Signature: Building' Commissioner /inspector of Buildings Date • 45 GLEASON RD BP- 2004 -0896 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 18C -103 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: BUILDING PERMIT Permit # BP- 2004 -0896 Project # 3S- 2004 -1333 Est. Cost: $12457.00 Fee: $25.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: INSTALLERS, INC 129154 Lot Size(sq. ft.): 7143.84 Owner: MIROSHNICHENKO IGOR A Zoning: URB Applicant: INSTALLERS, INC AT: 45 GLEASON RD Applicant Address: Phone: Insurance: 155 MAIN ST SUITE A (413) 774 -7197 Workers Compensation GREENFIELDMA01301 ISSUED ON :3/19/04 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: ©/;" i-( -(a •0 r/ r THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occupancy signature: FeeType: Receipt No: Date Paid: Check No: Amount: Building 3/19/04 0:00:00 14826 $25.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Anthony Patillo