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32A-205 (9) BP-2023-0077 36 BUTLER PL COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 32A-205-001 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-2023-0077 PERMISSION IS HEREBY GRANTED TO: Project# WINDOW 2023 Contractor: License: Est. Cost: 5586 PELLA PRODUCTS, INC 096558 Const.Class: Exp.Date: 03/01/2024 GREGORY, PATRICK BOLTON &JUSTINA W Use Group: Owner: GREGORY Lot Size (sq.ft.) Zoning: URC Applicant: PELLA PRODUCTS, INC Applicant Address Phone: Insurance: 155 MAIN ST 6H15382 GREENFIELD, MA 01301 ISSUED ON: 01/26/2023 TO PERFORM THE FOLLOWING WORK: REPLACEMENT WINDOW 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: I # . • Fees Paid: $40.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner / !�/ / . The Commonwealth of Massachusettg-;.,r,. 0 ,t I W Board of Building Regulations and Standarka /rh/v, R Massachusetts State Building Code, 780 CMR °tiC ,,q A�oT U E�ITY o� 7o Building Permit Application To Construct,Repair,Renovate Or Demolis a% Re/ised Mar 2011 One-or Two-Family Dwelling This Section For Official Use Only Buildin Permit Number: �Q-p o �1 Date Applied: etisf.., .Z-5•5 / - /-2 -20z3 Building Official(Print Name) Signature bate SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers 7)60 Me r -Filke San. -zt)6—CO 1.1 a Is this an accepted street?yes X no Map Number Parcel Number 3 Zoning Information:. 1.4 Property Dimensions: Zoning 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 Provi ed 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 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' Record: Tustina 6rl`C'Crr Norfi n ' IYl } ,Dicyd) Name(Print) City,State,ZIP �Ca 1Ull-er Pl . UP-5 -45'71 relortVSmith,et�l No.and Street Telephone E ail Address SECTION 3:DESCRIPTION OF PROPOSED WORK"(check all that apply) New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units Other t®Specify:q Pero -1,04/0, Brief Description of Proposed Work2:--Ae an ni2 One_ ©pfntn s ()�t nD n -to -k-h-e �u►�1►n9s i cv.arJ U liat=ti Oa(o SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ 5,'3O(D 10 l 1. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical $ 0 Standard City/Town Application Fee Cl Total Project Cost3(Item 6)x multiplier x 3.Plumbing $ / ' 2. Other Fees: $ 4.Mechanical (HVAC) $ ,ffList: 5.Mechanical (Fire $ Suppression) Total All FeesAfi , o/- Check No l(I Check Amount: 6.Total Project Cost: $ / 1 S61P 0 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License CS(CSL) `a' (IJ a JJ -1-feu()r S License Number D Expi atio Date Name of CSL Holder / ' I b &cry `ree� List CSL Type(see below) (� No.and Street Type Description Unrestricted(Buildings up to 35,000 Cu.ft.) C�tr�er�fit I�1 O� ) Restricted 1&2 Family Dwelling City/Town,State,ZIP M Masonry J�,/ RC Roofing Covering :'' WS Window and Siding S41 1 ll; parn( , 0 1)A� Solid Fuel Burning Appliances Insulation Telephone Email d i dress C U D Demolition 5.2 Registered Home Imprroovement Contractor(HIC) 1 L I as t79 0 3 3/09q T'e L k2 -td.lo'- lC HICRegistratiion Number (Expiration Date HIC Compatw Name or HIC Registr t Name LESI n e 4a 1e5. No. 111 It I /h`-')O) 413-5ia-`` (d mail address City/Town,State,ZIP Telephone 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 affidavit will result in the denial of the Issuance of the building permit. Signed Affidavit Attached? Yes No 0 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—M M�� ofr Ra l la pro/els, to act on my behalf,in all matters relative to work authorized by this building permit application. ritin-aiL 8}?2Qin� ao > ho 0111'l dC 3 Print Owner's Name Ectro c Si ture 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 ue d accurate to the st knowledge and understanding. I tivor- azss q oilii lo3 Print Owner's or Authorized Age s Name(Electronic Signa Date 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 'rotPella Window and Door Showroom of West Springfield Sales Rep Name: Sanderson, Thomas 69 Ashley Avenue Sales Rep Phone: 910-514-8012 West Springfield, MA 01089 Sales Rep Fax: Phone: (413) 736-9239 Fax: (413) 736-3390 Sales Rep E-Mail: tsanderson@pellasales.com Customer Information Project/Delivery Address Order Information Patrick Gregory Gregory Patrick 36 Butler Place Northampton MA Quote Name: Impervia Fixed Springline Window 36 Butler PI 52 STORE 36 Butler PI Order Number: 739Y2BS011 NORTHAMPTON, MA 01060-3308 Lot# Quote Number: 16336363 Primary Phone:(413)5864571 NORTHAMPTON, MA 01060-3308 Order Type: Installed Sales Mobile Phone: County: HAMPSHIRE Payment Terms: C.O.D. Fax Number: Tax Code: MASS E-Mail: jgregory@smith.edu Quoted Date: 12/29/2022 Great Plains#: 53H0000712 Customer Number: 1007552118 Customer Account: 1003295810 Customer Notes: Impervia Fiberglass Fixed Springline Window White/White Grilles Between the glass Pocket Installation New Interior Stops 50%Due at signing,50%due upon completion Line# Location: Attributes 10 3rd Floor Landing Impervia, Direct Set, Fixed Frame Springline, 895.350 X 1746.250, White Item Price Qty Ext'd Price rame Radius= 1 r.62: $6,070.73 °.1 $6,070.73 1:35.2568.75 Fixed Frame Direct Set Springline PK# Frame Size: 35 1/4 X 68 3/4 X 51 1/8 2127 General Information: Fiberglass,Block,Foam Insulated,3 1/4", 1 15/16" 96 Exterior Color/Finish: White Interior Color/Finish: White I. . .► Glass: Insulated Tempered Low-E Advanced Low-E Insulating Glass Argon Non High Altitude Performance Information:'U-Factor 0.26,SHGC 0.29,VLT 0.55,CPD PEL-N-127-02501-00004,Performance Class CW, PG 30,Year Rated 11 Viewed From Exterior Grille: GBG,No Custom Grille,3/4"Contour,Sunburst(3W2H),White,White Wrapping Information: No Exterior Trim, Pella Recommended Clearance,Perimeter Length=193". Frame Size:895.350 X 1746.250 For more information regarding the finishing, maintenance, service and warranty of all Pella®products,visit the Pella®website at www.pella.com Printed on 1/11/2023 Contract-Detailed Page 1 of 8 DocuSign Envelope ID: 144C0E8B-9411-48D5-A2E4-E6661CBEA029 wustotner. Justine uregury rroject Name: Gregory Justina 36 Butler Place Northampton MA Order Number: 739Y2BS011 Quote Number: 16336363 ❑Project Checklist has been reviewed Justina Gregory Tom Sanderson Order Totals Customer Nape—DocusigHiErefP print) Pella Sales a Na (Please print) usronmeny: Taxable Subtotal $3,874.51 silkStilut artitrti Thoot SA.IAJ.t,V'Sbin, Sales Tax @ 6.25% $242.16 ^9^G9 c`D^GG^o2 rs-tR�Ps1 i§�tZtleo Customer signature Pella Sa. 1 b/2023 1/6/2023 Non-taxable Subtotal $1,470.00 Total $5,586.67 Date ,—DocuSigned by: Date Deposit Received $2,793.00 A Sfilnq, Amount Due $2,793.67 Credit Card ApprbVi4a9 qN "Y- ** The date given for installation and/or delivery is an approximate date. Due to unprecedented demand and global shortages of raw materials, your installation and/or delivery date is subject to and likely to change. Pella Products Inc. cannot be held responsible for any additional costs, or lost time associated with manufacturing delays outside of our contract. Although we will do our very best to meet these dates, we ask for your understanding and patience during these times. ** Initials Below: r—DS For more information regarding the finishing, maintenance, service and warranty of all Pella®products,visit the Pella®website at www.pella.com Printed on 1/6/2023 Contract-Detailed Page 7 of 7 DocuSign Envelope ID: 144C0E8B-9411-48D5-A2E4-E6661 CBEA029 Pella Products Inc. 70* 155 Main Street Greenfield, MA 01301 To Whom it may Concern: Justina Gregory , 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; 36 Butler PI Northampton, MA 01060 Please accept this letter in place of my signature on the permit application. Thank you, ,—DocuSigned by: Signature: SfttA-a. '—F0CB3F65DE95483_. Date: 1/6/2023 ��—....N PELLPRO-01 CHRISTINE A�ORO CERTIFICATE OF LIABILITY INSURANCE DATE D/YYYY) 1/3/2023 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 Agency,Inc. PHONE FAX 97 Center Street (A/c,No,Ert):(413)594-5984 ,(A/C,NO(413)592-8499 Chicopee,MA 01013 Mass:christine@phillipsinsurance.com INSURERS)AFFORDING COVERAGE NAIC M INSURER A:EMC Insurance Companies 21415 _ INSURED INSURER B:EMCASCO Insurance Co 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—HE 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. LTR TYPE OF INSURANCE INSD INVD POLICY NUMBER I R IO/DoMIDDIYYYYYY) IFF MMIDDIYYXYY) LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR 6A15382 1/1/2023 1/1/2024 DAMAGE TO RENTED 500,000 PREMISES(Ea occurrence) $ MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENI AGGREGATE UNIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY X lj ra LOC PRODUCTS-COMP/OP AGG I1 $ 2,000,000 OTHER: $ A AUTOMOBILE LIABILITY (Ea accidenDt SINGLE LIMIT) $ 1,000,000 X ANY AUTO 6Z15382 1/1/2023 1/1/2024 BODILY INJURY(Per person) $ OWNED SCHEDULED AUTEO�S ONLY AUUTNOpSyyNENO , BODILY INJURY(Per accident) $ AUTOS ONLY _ AUTOS ONLY (�OraccidentDAMAGE $ $ A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 4,000,000 EXCESS LIAB CLAIMS-MADE 6J15382 1/1/2023 1/1/2024 AGGREGATE $ 4,000,000 DED X RETENTION$ 10,000 $ B I WORKERS COMPENSATION y PER AND EMPLOYERS'LIABILITY Y/N X H STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTNE 6H15382 1M/2023 1/1/2024 500,000 FFICER/MEMBER EXCLUDED? N N/A E.L.EACH ACCIDENT $ (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) Installation Floater$100,000 Included Operations usual to the sale and installation of doors&windows. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cityof Northampton THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN p ACCORDANCE WITH THE POLICY PROVISIONS. 212 Main St Northampton,MA 01060 AUTHORIZED REPRESENTATIVE ✓Y yy'' I,wl,, ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD PELLA PRODUCTS INC. 155 MAIN STREET GREENFIELD, MA. 01301 Date: l)I 1 10Oa� To: 019 1QorTI C.b D f (9)a n )-- UVo acti]p1Dn► m n 3iLQQ 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. Joy Grover Accounting Manager Pella Products, Inc. 155 Main Street Greenfield, MA 01301 Office:413-512-5968 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. Commonwealth of Massachusetts Construction Supervisor Division of Occupational Ucensure Unrestricted -Buildings of any use group which contain Board of Building Re f fauons and Standards less than 35,000 cubic feet(991 cubic meters)of enclosed 1 Cons ipn S visor space. CS•096558 `i. !Spires:03101/2024 TREMOR BRASS µ A t 10 GEORGE ETRE 1 GREENFIELO")tA ? �' Ae Ai/ Agri iv.03- Failure to possess a current edition of the Massachusetts �t�- State Building Code is cause for revocation of this license. Commissioner 4.. i&nt .t4. G For information about this hcerrst! Call 017)7274200 or visit www.rnass4osedpr THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs&Business Regulation Registration valid for individual use only before the HOME IMPROVEMENT CONTRACTOR expiration date. If found return to: TYPE:Supplement Card Office of Consumer Affairs and Business Regulation Registration Expiration 1000 Washington Street -Suite 710 142279 03,23/2024 Boston,MA 02118 'ELLA PRODUCTS.INC { f -REVOR BROSS ,r— f 55 MAIN STREET o A r'' -0 \ — 3REENFIELD,MA 01301 ��._-.- Undersecretary Not valid without signature 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 CS89338 Christian Lambert CS065102 Robert Kairnes CS113305 Igor Kravchuk CS094911