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35-261 (5) BP-2022-1463 56 WEST PARSONS LN COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 35-261-001 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-2022-1463 PERMISSION IS HEREBY GRANTED TO: Project# DOOR Contractor: License: Est. Cost: 5135 PELLA PRODUCTS, INC 096558 Const.Class: Exp.Date: 03/01/2024 Use Group: Owner: J SIDOTI MICHAEL M&AMY Lot Size (sq.ft.) Zoning: WSP Applicant: PELLA PRODUCTS, INC Applicant Address Phone: Insurance: 155 MAINST 6H15382 GREENFIELD, MA 01301 ISSUED ON: 11/10/2022 TO PERFORM THE FOLLOWING WORK: REPLACE SLIIDING DOOR 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: Final: Final: Final: Rough Frame: Gas: Fire Department Driveway Final: Fireplace/Chimney: Rough: Oil: Insulation: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: ,(el • i . � . 'I • Fees Paid: $40.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner if /3` 1 / cp\ The Commonwealth of Massachusetts /t.. , Hf°�_, Board of Building Regulations and Standar,, 4/0k _ Massachusetts State Building Code,)1180 C .. ' 9 • USE Building Permit Application To Construct,Repair,Reriovitej c- olish ace Revised r 2011 One-or Two-Family Dwelling - .4 ;,/),',v,-; n� g/f This Section For Official Use Only ^'g4,'�,Fcri /? Buildin Permit Number: �U/"A2"I[io3 Date Applied: 0 ohs L 405S ��l� 1!-ID ZDZZ Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Proper Address: 1.2 Assessors Map&Parcel Nu er 5(2 W YOrcOhs Ln, f l b nee M P Ott�a . -act/ C D 35W/01 Ll ) 1.1 a Is this an accepted street?yes 1C no Map Number Parcel Number .3 Zoning Information 1.4 Property Dimensions: --x;St1n4 oning District Proposed Use J Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public 0 Private 0 Zone: Outside Flood Zone? _ Municipal 0 On site disposal system ❑ Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' Owner'of R ord: Vk 1 Oil tao ► Vlore ee_, MA olfoa Name(Pint) City,State,ZIP U KY5(h m 6te A mil Irn No.and Street Telephone Email Addres SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition 0 Demolit on 0 Accessory Bldg.0 Number of Units Other 0 Specify: Brief Description of Proposed Work':'e �(1 e4 Sl q Ag(zw'r9 eYi$fi C en wi-N1 10 s ha r (u T ae r 0,A3 r- SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $5136,00 1. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical $ /�11� 0 Standard City/Town Application Fee �L'J 0 Total Project Costa (Item 6)x multiplier x 3.Plumbing $ 25 2. Other Fees: $ 4. Mechanical (HVAC) $ X l List: 5.Mee 1 anical (Fire $ 11,qr Suppression) /(`/�) Total All Fees: $ 6.Tote Project Cost: $ Check No15aI 1Check Amount: qO 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) 0--�l.t'1(05bo I I PLicense- Number bb pi do Date `"T Name of CSLPzolcre(*rO �`^ �' ��� List CSL Type(see below) u No.andSttreet��J Type Description A 2�� U Unrestricted(Buildings up to 35,000 cu.ft.) r��tel d ► NL �lJ Restricted 1&2 Family Dwelling ity/Toate ZIP M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances 413-51,9"50/j?; I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) aol a �t-oct t n o • I C Registration Number E iratt'on to IIIS.C6mpinyRA aNameor -1-t:trapt Name 1 C yd e9 V'1 kim 0180 1 I,+' _C-,U� N 1 Email address City/Town,State,ZIP =,1) y I Telephone �Q SECTION 6: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 afioavit will result in the denial of the Issuance of the building permit. Signed Affidavit Attached? Yes 019 No .❑ SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,as Owner of the subject property,hereby authorize�el1r,L tQ c )n a.. to act on my behalf,in all matters relative to work authorized by this building permit application. IAiCI 0 S dbfi See- -e:h-Pd Inia'1la, Print Ow-lees Name(Electronic Signature) Date SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information contained in this application is true and accurate to the best of my knowledge and understanding. `f ^(Trevor1r( oc.4)la�-�cad is . a Print Owner's or Authorized Agent's Name(Electronic Signature) a e NOTES: 1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration program or guaranty fund under M.G.L.c. 142A.Other important information on the HIC Program can be found at www.mass.gov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dps 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) (including garage,finished basement/attics,decks or porch) Gross living area(sq.ft.) Habitable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of half/baths Type of heating system Number of decks/porches Type of cooling system Enclosed Open 3. "Total Project Square Footage"may be substituted for"Total Project Cost" Contract - Detailed df0Pella Window and Door Showroom of Greenfield Sales Rep Name: Rousseau, Mitchell ® 240 Mohawk Trail Sales Rep Phone: 413-768-8379 Greenfield, MA 01301-3209 Sales Rep Fax: Phone: (413) 774-7231 Fax: (413) 774-6348 Sales Rep E-Mail: mrousseau@pellasales.com Customer Information Project/Delivery Address Order Information Michael Sidoti Sidoti Michael 56 W Parsons Ln Florence MA Quote Name: Michael Sidoti-56 W Parsons Ln,Florence, MA, 56 W Parsons Ln BILL LEGER GARAGE 56 W Parsons Ln Order Number: 739X3KR261 Florence, MA 01062-3668 Lot# Quote Number: 16112578 Primary Phone:(413)3202544 Florence, MA 01062 Order Type: Installed Sales Mobile Phone: County: Hampshire Payment Terms: C.O.D. Fax Number: Tax Code: MASS E-Mail: mike.sidoti@gmail.com Quoted Date: 10/16/2022 Great Plains#: 1006962529 Customer Number: 1010784994 Customer Account: 1006962529 Line# Location: Attributes 10 None Assigned Pella 250 Series, Double Sliding Door, Vent Right 1 Fixed, 1816.10 X 2019.30, White Item Price Qty Ext'd Price $4,965.52 1 $4,965.52 1:7280 Vent Right/Fixed Double Sliding Door io PK# Frame Size: 71 1/2 X 79 1/2 co 4g? 2124 General Information: Factory Assembled,Standard,Vinyl, Nail Fin, Foam Insulated,5", 1 1/8",3 7/8",No Sill Pan Exterior Color/Finish: White Interior Color/Finish: White Glass: Insulated Dual Tempered Low-E Advanced Low-E Insulating Glass Argon Non High Altitude Hardware Options: White,Keylock Included,White,White,Steel Viewed From Exterior Screen: Sliding Screen,White,Premium, InViewlM Unit Accessories: No Accessory Option Performance Information: U-Factor 0.28,SHGC 0.28,VLT 0.52,CPD PEL-N-251-00047-00001,Performance Class R,PG 35,Calculated Positive DP Rating 35,Calculated Negative DP Rating 35,Year Rated 11 Remake: , Grille: No Grille, Wrapping Information: Pella Recommended Clearance, Perimeter Length=302". Frame Size: 1816.10 X 2019.30 PD-1 -Patio Door Install up to 6FT in width Qty 1 EXTTRIMI5-Kick board to match ext trim PVC Qty 1 EXTTRIM20-5/4 X 6 Exterior Style PVC Qty 1 For more information regarding the finishing, maintenance, service and warranty of all Pella®products,visit the Pella®website at www.pella.com Printed on 10/27/2022 Contract-Detailed Page 1 of 8 ' DocuSign Envelope ID:9306DA7B-1223-43D3-A6FF-DEBFA79830BA uustorner: ivncnaei oluou rroject(Jame: Sidoti Michael 56 W Parsons Ln Florence MA Order Number: 739X3KR261 Quote Number: 16112578 Michael Sidoti Mitchell Rousseau .Order Totals Customer Name (Please print) Pella Sales Rep Name (Please print) Subtotal DocuSlgned by: ,—DoeuSigned by: Taxable Subtotal $2,810.35 -- Il�.i�tad, 5ae{i hi{-dt.t,l.1, leebtsst,attk Sales Tax @ 6.25% $175.65 reigeatetre 'RellaatessR3ap4 ignature Non-taxable Subtotal $2,149.00 10/18/2022 10/18/2022 Total $5,135.00 ,Datgocusigneaby: Date Deposit Received $2,567.50 kaug,t, S.11bti Amount Due_ $2,567.50 t'retfittlfartfAfrtftwal Signature For more information regarding the finishing, maintenance, service and warranty of all Pella®products,visit the Pella®website at www.pella.com Printed on 10/18/2022 Contract-Detailed Page 7 of 7 DocuSign Envelope ID:9306DA7B-1223-43D3-A6FF-DEBFA79830BA Pella Products Inc. 155 Main Street Greenfield, MA 01301 To Whom it may Concern: Michael Sidoti , as property owner, give permission to our contractor, Pella Products Inc. to obtain a building permit for the installation of windows and/or doors in my home. Located at; 56 W Parsons Ln Florence, MA, 01062 Please accept this letter in place of my signature on the permit application. Thank you, -DocuSigned by: Signature: dL St fi —F33391 E6C05F4A6_. Date: 10/18/2022 PELLA PRODUCTS INC. 155 MAIN STREET GREENFIELD, MA. 01301 Date: ID arowa To: O(In do Mill S1et, NortfrilnpttP, O10(eO 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 they disposal of the contents of this dumpster. Very truly yours, PELLA PRODUCTS, INC. Joy Grover Accounting Manager City of Northampton ' Massachusetts j z DEPARTMENT OF BUILDING INSPECTIONS } 1:4 ) y ?" 212 Main Street • Municipal Building Northampton, MA 01060 CONSTRUCTION DEBRIS AFFIDAVIT (FOR ALL DEMOLITION AND RENOVATION PROJECTS) In accordance of the provisions of MGL c 40, S54, a condition of Building Permit Number is that all debris resulting from this work shall be disposed of in a properly licensed waste disposal facility, as defined by MGL c 111, S 150A. The debris will be disposed of in: Location of Facility: The debris will be transported by: Name of Hauler: Signature of Applicant: Date: Pella Products, Inc. 155 Main Street Greenfield, MA 01301 Office:413-773-1157 Ext. 317 Cell:413-834-8799 To: Building inspector From:Trevor Bross—Installation Manager Date: February 17, 2022 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. WV Commonwealth of Massachusetts Construction Supervisor Division of Occupational Licensure Unrestricted -Buildings of any use group which contain Board of Building RRea„ations and Standards less than 35,000 cubic feet(991 cubic meters)of enclosed i C ona st( cit oon Srvisor space. .y CS-006558 { ires:03/0112024 TREVOR BRASS h,`, 10 GEORGE ETRE r it' GREENFtELDJIAA 0 es. sM1(II.t.VA13rl �}�i0y�nn Failure to possess a current edition of the Massachusetts Commissioner " ll R VE+++tix. State Building Code Is cause for revocation of this license. ___ f((fl�ll For information about this license Can gni)7274200 or visit www.mass.gov/dpt THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs 8,Business Regulation Registration valid for individual use only before the HOME IMPROVEMENT CONTRACTOR expiration date. If found return to: I TYPE:Supplement Card Office of Consumer Affairs and Business Regulation Registration Ex anion 1000 Washington Street -Suite 710 142279 03'23/2024 Boston,MA 02118 'ELLA PRODUCTS,INCs; ,/-----":,:i',"..;,''''..z-, ,--'• ,—, ,-,, -REVOR BROSS / f / _ 55 MAIN STREET C ,•r.L.n 1 •` ,•0.,e4rrir 3REBNFIELD,MA 01301 _ / Und �thout si t ,r 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 Brow6 CS106010 Vladimir Shevchuk CSSL099209 Scott Bowdish CSSL100232 Bill Leger CS89338 Christian Lambert CS065102 Robert Kairnes CS113305 Igor Kravchuk C5094911 �-� PELLPRO-01 CHRISTINE ACORO CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 12/6/2021 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(ies)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 CONTACT Christine Sullivan NAME: Phillips Insurance Agncy,Inc. PHONE FAX 97 Center Street (A/C,No,Ext):(413)594-5984 ,No):(413)592-8499 Chicopee,MA 01013 pDss:christine@phillipsinsurance.com INSURER(S)AFFORDING COVERAGE NMC/ INSURER A:EMC Insurance Companies 21415 INSURED INSURER B:Union Insurance Co of Providen Pella Products,Inc INSURERC: - 155 Main St INSURERD: Greenfield,MA 01301 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD (MI11DDIYYYY1 IMMIDD/YYYYI A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE E 1,000,000 CLAIMS-MADE X OCCUR 6A15382 1/1/2022 1/1/2023 DAMAGESEERa EoNccTuEDe nce $ 500,000 MED EXP(My one person) S 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 3 2,000,000 pRa 2,000,000 X POLICY X J JECT LOC PRODUCTS-COMP/OP AGG S OTHER: $ A AUTOMOBILE LIABILITYa COMBIacc,iidentSINGLE LIMIT X ANY AUTO 6Z15382 1/1/2022 1/1/2023 BODILY INJURY(Per person) .-$ OWNED SCHEDULED 1,000,000 AUTOSREp ONLY AUTOS yy p BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS ONgY (Per a T nt)AMAGE $ A X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 4,000,000 EXCESS LAB CLAIMS-MADE 6J15382 1/1/2022 1/1/2023 AGGREGATE $ DED X RETENTION$ 10,000 Aggregate $ 4,000,000 • B WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER 6H15382 1/1/2022 1/112023 ANY PROPRIETOR/PARTNER/EXECUTIVE EL EACH ACCIDENT S 500,000 FFICER/MEMBEREXCLUDED? NIA Mandatory In NH) EL DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Installation Floater$50,000 Included Operations usual to the sale and installation of doors&windows. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town Florence(Northampton)BuildingCommissioner's THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ( p ) ACCORDANCE WITH THE POLICY PROVISIONS. Office ' 212 Main Street Northampton,MA 01060 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD The Commonwealth of Massachusetts __, — Department of Industrial Accidents -_ +_' Office of Investigations =` 1=�) Lafayette City Center 4 •"rl 2 Avenue de Lafayette, Boston,MA 02111-1750 '�� www.ntass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name iBusiness/Organization/Individual): Pella Products, Inc. Address:155 Main St City/State/Zip:Greenfield,MA 01301 Phone#:413-774-0153 Are you an employer?Check the appropriate box: 'Type of project(required): 1.0 I an a employer with 50 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I art a sole proprietor or partner- listed on the attached sheet. 7. ❑� Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition workingfor me in anycapacity. employees and have workers' P tY 9. ❑Building addition [NO workers' comp.insurance comp.insurance.: required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I an a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152,§1(4),and we have no employees. [No workers' 13.0 Other 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. InsuranceCompany Name: EMC Insurance Companies Policy#o Self-ins.Lic.#:6H15382 Expiration Date:01-01-2023 Job Site dress: City/State/Zip: Attach a opy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to ecure 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 fine of up to$ 50.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigat ons of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of rjury that the information provided above is true and correct. ir Signature: R Date: l o/ 7/aoaa Phone#: Ar; 54Ul3 Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(check one): 1❑Board of Health 2111 Building Department 3❑City/Town Clerk 4.0 Electrical Inspector 5.d'lumbing Inspector 6.0Other Contact Person: Phone#: