30C Customer: Justina Golden Project Name: Golden Justina 376 Florence Rd Florence MA 01062 Order Number: 739R2LS051 Quote Number: 10837178
r
. Project Checklist has been reviewed
_� U S�n a..(mac 1�1i►� l'�i/hk/►,^( �� "brdeil To�a��
Customer Name (Please print) Pella Sales Rep Name (Please print) Taxable Subtotal $6,689.16
laz'rta � Sales Tax @ 6.25% $418.07
stomer Signa a Ila Sales Re ture
Non-taxable Subtotal $2,325.85
l I L v / 1/a6/ayia Total 8
Date DaDeposit Received $0.00
mount Due $
Credit Card Approval Signature 75�f6 }
71� 3 -7-73 . 6-z' �r`ft 1-
For more information regarding the finishing, maintenance, service and warranty of all Pella®products, visit the Pella®website at www.pella.com
Grin}nil nn 1110r,1011R r\..+.4-4 n___ A/ _s
Customer: Justina Golden Project Name: Golden Justina 376 Florence Rd Florence MA 01062 Order Number: 739R2LS051 Quote Number: 10837178
LP-1 -Lead safe practices this opening Qty 1
MP-4-Modified Pocket Installation up to 90 UI wiwrap Qty 1
Lrne# Location: Attributes:
25 Piano Room Proline, 2-Wide Casement, White !;7 �j )( S.�j Item Price Qty Ext'd Price
$2,688.60 1 $2,688.60
E[I
1:SlzeNon-Standard Size Left Casement
PK# General Information: Clad,6',311/16'
2021 Exterior Color J Finish: Standard Enduraclad,White
Interior Color/Finish: Dark Mahogany Stain Interior
Glass: Insulated Low-E AdvancedComfort Low-E Insulating Glass Argon Non High Altitude
Hardware Options: Wash Hinge Hardware, Fold-Away Crank,Brown, No Limited Opening Hardware
Screen: Full Screen, Brown,InViewTM
Viewed From Exterior Performance Information: U-Factor 0.25,SHGC 0.27,VLT 0.50,CPD PEL-N-1400469-00001,Performance Class R,PG 50,Calculated Positive DP
Rating 50,Calculated Negative DP Rating 50,Year Rated 08, Egress Does not meet typical United States egress, but may comply with local code
requirements
Grille: No Grille,
Vertical Mull 1: FactoryMull,Standard Joining Mullion, Mull Design Pressure-20
2:SlzeNon-Standard Size Right Casement
General Information: Clad,6',311/16'
Exterior Color I Finish: Standard Enduraclad,White
Interior Color/Finish: Dark Mahogany Stain Interior
Glass: Insulated Low-E AdvancedComfort Low-E Insulating Glass Argon Non High Altitude
Hardware Options: Wash Hinge Hardware, Fold-Away Crank,Brown, No Limited Opening Hardware
Screen: Full Screen, Brown, InViewTM
Performance Information: U-Factor 0.25,SHGC 0.27,VLT 0.50,CPD PEL-N-14-00469-00001,Performance Class R, PG 50,Calculated Positive DP
Rating 50,Calculated Negative DP Rating 50,Year Rated 08, Egress Does not meet typical United States egress,but may comply with local code
requirements
Grille: No Grille,
Vertical Mull 1: FactoryMull,Standard Joining Mullion, Mull Design Pressure-20
LP-1 -Lead safe practices this opening Qty 1
MP-4-Modified Pocket Installation up to 90 UI w/wrap Qty 1
Line# Location:' „ Attributes
26 Interior Stops Wood Products Stop Square 1, Length: 96, Dark Mahogany Stain.Wood Type: Pine Item Price Qty Ext'd Price
$38.00 $304.00
1: Accessory /D
PK# General Information: Pine,Stop Square 1
2021 Interior Color/Finish: Dark Mahogany Stain Interior
Viewed From Exterior
For more information regarding the finishing, maintenance, service and warranty of all Pella®products,visit the Pella®website at www.pella.com
Prinluil nn 11logr)n1R (`^nfrn f r)..+^iI^A r)- 7 -t 4 4
Customer: Justina Golden Project Name: Golden Justin 376 Florence Rd Florence MA 01062 Order Number: 739R2LS051 Quote Number: 10837178
Line# Location: Attributes
15 Mosaic Bathroom Proline, 2-Wide Casement, White 5g,S )C -4 ,S Item Price Qty Ext'd Price
$2,707.57 1 $2,707.57
1:SlzeNon-Standard Size Left Casement
Do-
PK# General Information: Clad,5',311/15'
2021 Exterior Color/Finish: Standard Enduraclad,White
Interior Color/Finish, Dark Mahogany Stain Interior
Glass: Insulated Tempered Low-E AdvancedComfort Low-E insulating Glass Argon Non High Altitude
Hardware Options: Wash Hinge Hardware, Fold-Away Crank,Brown, No Limited Opening Hardware
Screen: Full Screen, Brown, InVieWTM
Viewed From Exterior Performance Information: U-Factor 0.25,SHGC 0.27,VLT 0.50,CPD PEL-N-1400473-00001,Performance Class R, PG 50,Calculated Positive DP
Rating 50,Calculated Negative DP Rating 50,Year Rated 08,Egress Does not meet typical United States egress,but may comply with local code
requirements
Grille: No Grille,
Vertical Mull 1: FactoryMull,Standard Joining Mullion, Mull Design Pressure-20
2:SlzeNon-Standard Size Right Casement
General Information: Clad,5',311/15'
Exterior Color/Finish: Standard Enduraclad,White
Interior Color/Finish: Dark Mahogany Stain Interior
Glass: Insulated Tempered Low-E AdvancedComfort Low-E Insulating Glass Argon Non High Altitude
Hardware Options: Wash Hinge Hardware, Fold-Away Crank, Brown, No Limited Opening Hardware
Screen: Full Screen, Brown,InViewTM
Performance Information: U-Factor 0.25,SHGC 0.27,VLT 0.50,CPD PEL-N-14-00473-00001, Performance Class R,PG 50,Calculated Positive DP
Rating 50,Calculated Negative DP Rating 50,Year Rated 08, Egress Does not meet typical United States egress,but may comply with local code
requirements
Grille: No Grille,
Vertical Mull 1: FactoryMull,Standard Joining Mullion, Mull Design Pressure-20
MP-4-Modified Pocket Installation up to 80 UI w/wrap Qty 1
LP-1 -Lead safe practices this opening Qty 1
Line# Location: Attributes
20 Pencil Bathroom ProLine, Casement Right, White 125.025 X Item Price Qty Ext'd Price
$1,600.56 1 $1,600.56
1:SlzeNon-Standard Size Right Casement
PK# General information: Clad,5',311/15'
--•, 2021 Exterior Color I Finish: Standard Enduraclad,White
Interior Color l Flnlsh: Dark Mahogany Stain Interior
Glass: Insulated Tempered Low-E Advanced Comfort Low-E Insulating Glass Argon Non High Altitude
Hardware Options: Wash Hinge Hardware, Fold-Away Crank,Brown, No Limited Opening Hardware
Screen: Full Screen, Brown, InViewTM'
Viewed From Exterior Performance Information: U-Factor 0.25,SHGC 0.27,VLT 0.50,CPD PEL-N-14-0047300001,Performance Class R,PG 50,Calculated Positive DP
Rating 50,Calculated Negative DP Rating 50,Year Rated 08, Egress Does not meet typical United States egress,but may comply with local code
requirements
Grille: No Grille,
For more information regarding the finishing, maintenance, service and warranty of all Pella®products,visit the Pella®website at www.pella.com
r).;-44-- 4 4/MC MA40 ---& n_._:1_.J n-_- ^ -L
Contract - Detailed
Pella Window and Door Showroom of West Springfield Sales Rep Name: Schulz,Jonathan
69 Ashley Avenue Sales Rep Phone: 413-736-9239
West Springfield, MA 01089 Sales Rep Fax: 413-736-3390
Phone: (413) 736-9239 Fax: (413) 736-3390
Sales Rep E-Mail: jschulzc@pellasales.com
Customer Information Project/Delivery Address Order Information
Justina Golden Golden Justina 376 Florence Rd Florence MA 01062 Quote Name: Golden Justina 2192834 Bathroom Window
376 Florence Rd 376 Florence Rd
Order Number: 739R2LS051
FLORENCE, MA 01062-2636 Lot# Quote Number: 10837178
Primary Phone:(413)5858581 FLORENCE,MA 01062-2636 Omer Type: Installed Sales
Mobile Phone: County: Payment Terms: c-68$ �JS+�y
Fax Number: Tax Code: MASS
E-Mail:-diya€elii@vwcizoaxsL ',,st;nG .014e r, Quoted Date: 11/21/2018
Great Plains#: 53H5858581 v Yo; �M' i,Q,M„
Customer Number: 1007889489 ����_ 1�GG
Customer Account: 1003763173 ?It
Customer Notes: Previous Pella Customer. House built 1950. Includes installation,building permit,sales tax,and disposal. C,P—r> sk�y 0��,
Line# Location: Attributes
10 Kitchen Proline, Double Hung, White 5,S >e H{ 5- 0Z5 Item Price Qty Ext'd Price
$1,664.28 1 $1,664.28
1:SlzeNon-Standard Size Double Hung,Equal
PK# General Information: Clad,6',3 11/15'
2021 Exterior Color/Finish: Standard Enduraclad,White
HQ Interior Color/Finish: Dark Mahogany Stain Interior
Glass: Insulated Low-E AdvancedComfort Low-E Insulating Glass Argon Non High Altitude
Hardware Options: Cam-Action Lock,Brown, No Limited Opening Hardware,Order Sash Lift
Screen: Full Screen,White, InViewTM
Viewed From Exterior Performance Information: U-Factor 0.26,SHGC 0.29,VLT 0.55,CPD PEL-N-35.00374-00001,Performance Class LC, PG 35,Calculated Positive DP
Rating 35,Calculated Negative DP Rating 35,Year Rated 08111, Egress Does not meet typical United States egress,but may comply with local code
requirements
Grille: No Grille,
PF-1 -I or Pocket Installation Qty 1
LP-1 -Lead safe practices this opening Qty 1
EAC4 -Exterior Aluminum Capping(Coil Stock) Qty 1
For more information regarding the finishing, maintenance, service and warranty of all Pella®products, visit the Pella®website at www.pella.com
0�;_4 a.... .14 ncInn-Io r .ti r)^4-;1-4 0.., 4 „s
' DATE(MM/DD/YYYY)
AC RV CERTIFICATE OF LIABILITY INSURANCE
1z/27/zo17
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: if the certificate holder is an ADDITIONAL INSURED,the policy(les)must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on
this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER NAME:CONTACT Robin Sargent
Berkshire insurance Group,Inc. PAHCN Ext).. (413)773-9913 FA
No: (413)774-3872
117 Main Street ADDaRESS. rsargent@berkshireinsurancegroup.com
INSURER(S)AFFORDING COVERAGE NAIC M
Greenfield MA 01301 INSURERA: Citizens Ins.Company ofAmer 31534
INSURED INSURER B: Allmerica Financial Benefit 41840
Pella Products,Inc. INSURER C: Hanover Insurance Company 22292
155 Main Street INSURER D:
INSURER E:
Greenfield MA 01301 INSURER F:
COVERAGES CERTIFICATE NUMBER: 18GL,AL,WC REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
EF
LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDD/1'YYY MM/DD/YYYY LIMITS
X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
15AMAUE 10 REN I ED 100,
CLAIMS-MADE �OCCUR PREMISES Ea occurrence $ O
MED EXP(Any one person) $ 10,000000
A ZBND45939500 01/01/2018 01/01/2019 PERSONAL&ADV INJURY $ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
POLICY [g IRE4 -1 LOC PRODUCTS-COMP/OP AGG $ 2,000'000
OTHER: Damage t0 Rented $ 100,000
AUTOMOBILE LIABILITY GOAABt ) G6EbIM1T $ 1,040.000
Ea accident)
X ANY AUTO BODILY INJURY(Per person) $ ^_
B OWNED SCHEDULED AWND45948700 01/01/2018 01/01/2019 BODILY INJURY(Per accident) $
AUTOS ONLY AUTOS —^
HIRED NON-OWNED PROPERTY DAMAGE $
AUTOS ONLY AUTOS ONLY Per accident
UMBRELLA LIAR OCCUR EACH OCCURRENCE $ _
EXCESS UAB CLAIMS-MADE AGGREGATE $
DED RETENTION$ $
WORKERS COMPENSATION XJ STATUTE ERH
AND EMPLOYERS'LIABILITY Y i N 500,000
ANY PROPRIETOR/PARTNER/EXECUTIVEE.L.EACH ACCIDENT $
D OFFICERIMEMBEREXCLUDED? Y� N/A WHND376502 01/01/2018 01101/2019
(Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000
If yes,describe under 500,000
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
Operations usual to the sale&installation of doors&windows.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN
Town of Florence(Northampton)Building Commissioners Office, ACCORDANCE WITH THE POLICY PROVISIONS.
212 Main St
AUTHORIZED REPRESENTATIVE
Northampton MA 01060
O 1988-201/5 ACORD CORPORATION. All rights reserved.
ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
UT
I Congress Street, Suite 100
Boston, MA 02114-2017 t
www mass gov/dia
Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Orgmization/Individual): Pella Products, Inc.
Address: 155 Main Street
City/State/Zip:Greenfield, MA. 01301 Phone#:413-772-0153
Are you an employer? Check the appropriate box: Type of project(required):
1.Q I am a employer with 52 4. Q I am a general contractor and I 6 Q New construction
employees (full and/or part-time).* have hired the sub-contractors
2.Q I am a sole proprietor or partner- listed on the attached sheet. 7. Q Remodeling
ship and have no employees These sub-contractors have g. Q Demolition
working for me in any capacity. employees and have workers' 9 Q Building addition
[No workers' comp. insurance comp. insurance.t
required.] 5. Q We are a corporation and its 10.❑ Electrical repairs or addition
3.❑ I am a homeowner doing all work officers have exercised their I Ln Plumbing repairs or addition:
myself. [No workers' comp. right of exemption per MGL 12.Q Roof repairs
insurance required.] t c. 152, §1(4),and we have no
employees. [No workers' 13.nOther
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.
tContractors 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 providing workers'compensation insurance for my employees Below is the policy and job site
information.
Insurance Company Name:Hanover Insurance Group
Policy#or Self-ins. Lic.#:WHND376502 Expiration Date:01/01/2019
Job Site Address: '1�7 iv F/Q r^,.-c f City/State/Zip: J,,%k lit A 0i oG;1,
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$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fin
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.
I do hereby certify d the pains and p n of perjury that the information provided above is true and correct.
Signature: Date: 1
Phone#: Above
Official use only. Do not write in this area,to be completed by city or town official.
City or Town: Permit/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#:
PELLA PRODUCTS INC.
155 MAIN STREET
GREENFIELD, MA. 01301
Date: ltl -t
To:
Subject: Disposal of Debris
The purpose of this letter is to certify that all debris from any project
undertaken by Pella Products, Inc. in your town will be transported to
a dumpster at our main facility; 155 Main Street, Greenfield, MA.
Pella Products, Inc. is under contract with Waste Management of Massachusetts
For the disposal of the contents of this dumpster.
Very truly yours,
PELLA PRODUCTS, INC.
John P. Benjamin
Accounting Manager
Pella Products, Inc.
155 Main Street
Greenrield, MA 01301
Office:413-773-1157 Ext.317 Cell:413-834-8799
To: Building inspector
From:Trevor Bross—Installation Manager
Date: March 5, 2018
Subject: Building Permit Applications & Designees
Pella Products Incorporated is in the business of replacing windows and doors for our customers. Our process includes
providing a building permit for each and every project.
I am a licensed Construction Supervisor. Building Permits will be applied for using my CSL#CS-096558 and my
HIC# 142279. Please find a copy of my licenses below.
Cormwnwesith of Massachusetts Construction Supervisor
Division of Prollossiaifitf Lkensure Restricted to:
Board of efld StaiftdardsUnrestricted-Buildings of any use Stoup which contain
less than 35,000 cubic feet(991 cubic teeters)of
enclosed space_
Titell Mt
'a
Falkwo to poglsoss a CldfrlMtA� > 1 #
cdff misstof eir _ WlWs
Office of Consumer Affair
&Business Reyuiation
HOME IMPROVEMENT CONTRACTOR Registration valid for Individual use only
TYPE:Supplement Card before the expirsuon date. If found return to:
Realstratfon Fxpirsdon Office of Consumer Anal and Business Reyulauon
142279 03/23/2020 One Ashburt Piave e1301
PELLA PRODUCTS.INC, Boswton, f
TREVOR BROSSCC(i'
155 MAIN STREET Not Valid without signature
GREENFIELD,MA 01301 Undersecretary
Each Installation will be staffed by our installers who are all licensed in accordance with current building codes. Below
listed are our installers and their license numbers. Please accept these individuals as my designees.
Willard Brown CS106010 Vladimir Shevchuk CSSL099209
Scott Bowdish CSSL100232 Bill Leger C589338
David Ruffner CS57308 Brian Thompson CS67121
Igor Kravchuk CS094911
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable 0
Name of Llcgnse Holder: 71&jc)c erc,�5 d.5` a-q(0 s f f-
License Number
Address Expiration D
Tignatuf /oe'-Telephone
9.Registered Home Improvement Contractor: Not Applicable 0
?t ?f t1a 0 ck5 VX
Company N,ame Registration Number
Address Expiration Date
Telephone(�((3) 11-5- l -7
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.
1 Signed Affidavit Attached Yes....... K No...... 0
`
Section 4. ZONING AU 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
Rear
Building Height
Bldg.Square Footage %
Open Space Footage %
(Lot area minus bldg&paved
of Parking Spaces
(volume&Location)
A. Has aSpecial Permit/Variance/Finding ever been issued for/on the site?
�� ��
NO �� DONT KNOW K�� YES ��
IFYES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO ����»~� DON7KNOVV »�� ��
YES ��`
IF YES: enter Book Page and/or Document#
��{�� ��
B. Does the� vm� ��site NO «�� DONTKNC�� YES «^~�
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained �� Obtained �� Date�-� «�� , '
�� ��
C. Do any�gnnedstonthe proper�? YES �~� NO VC�
IF YES, describe size, type and Location:
D. Are there any proposed changes to or additions of signs intended for the property? YES NO
\FYES, describe size, type and Location:
E. Will the construction activity disturb(clearing,gradingexcavation,orfilling)over 1acre oriuhpart ofacommon plan
that will disturb over 1acre? YES K l NO &*�l
�� ��
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
3
Department use only
City of Northampton Status of Permit:
-- � Building Department Curb Cut/briveway Permit
212 Main Street Sewer/Se{tic Availability
Room 100 Water/WelI Availability
Northampton, MA 01060 Twosets rofstructwral F+laras
phone 413-587-1240 Fax 413-587-1272 Plot/Site Plans
Other Spac lty _
APPLICATION TO CONSTRUCT,ALTER,REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION ' v
/V/,X
1.1 Property Address:
This section to be completed by office
' �t�Q
3 ((o ftor-.Ncr. Izc,( Map `-nLot V 6 v Unit
F�ufchc� �tA Cii o(o;L
Zone Overlay District
Elm St District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2. �
rt l(ca l loc�UCT S 1 k c- -UU l�5 /L1grn S�- 6sr'.a K Ld A4 G r3G 1
,.� Name(Print) Currentcling Address:
14cl f
Telephone
Signature
2. !� Gw��c' G Ktiwrc�
-ry 3-7L iF[or a qe—e— AAA 0104 Zr
v Na a(Print) Current Mailing Address:
qlb. S 6- 5'.
Sig a re Telephone
SE ION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building —C(/ , 06 (a)Building Permit Fee
2. Electrical �P (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) `?y(F. 0 O Check Number
This Section For Official Use Only
Building Permit Number: DateIssued:
Signature: /2-
Building Commissioner/Inspector of Buildings Date
EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR)
376 FLORENCE RD BP-2019-0663
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 30C-058 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: window replaced BUILDING PERMIT
Permit# BP-2019-0663
Proiect# JS-2019-001081
Est.Cost: $7546.00
Fee: $40.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: PELLA PRODUCTS, INC 096558
Lot Size(sq.ft.): 61419.60 Owner: GOLDEN JUSTM
Zoning:URA(100)/WSP(95)/ Applicant: PELLA PRODUCTS, INC
AT. 376 FLORENCE RD
Applicant Address: Phone: Insurance:
155 MAIN ST (413) 772-0153 WC
GREENFIELDMA01301 ISSUED ON:12/5/2018 0:00:00
TO PERFORM THE FOLLOWING WORK.-REPLACING 4 WINDOWS USING EXISTING
OPENINGS
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 DeRjrtMent 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:
FeeTyne: Date Paid: Amount:
Building 12/5/2018 0:00:00 $40.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner