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43-033 (9)
BP-2024-0525 483 PARK HILL RD COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 43-033-001 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-2024-0525 PERMISSION IS HEREBY GRANTED TO: Project# WINDOWS 2024 Contractor: License: Est. Cost: 13100 PELLA PRODUCTS, INC 096558 Const.Class: Exp.Date: 03/01/2026 Use Group: Owner: PEPPARD GRAY CAROLYN &GEORGE Lot Size (sq.ft.) Zoning: WSP Applicant: PELLA PRODUCTS, INC Applicant Address Phone: Insurance: 155 MAIN ST 413-512-5968 6H15382 GREENFIELD, MA 01301 ISSUED ON: 04/30/2024 TO PERFORM THE FOLLOWING WORK: REPLACING 6 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: 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: /6-7 Fees Paid: $40.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner r \N, ftL, The Commonwealth of Massacb is �' olio A,I", Board of Building Regulations and Stan "'•ek �'� � R 1W Cl) LITY Massachusetts State Building Code, 780��C �G�( c�y� US ` Building Permit Application To Construct,Repair,Renovate'I'.., 1'lish a evised ar 2011 One-or Two-Family Dwelling ' ,ti'liSA� N.This Section For Official Use Only it, S BuildingPermit Number:Nu� •'�p�-.2.y- 5�6 Date Applied: t�vi,v Koss �`�/� `,1 9-34 200Y Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map& Parcel Numbers 1-1`br IPQC N; Ili PU`Ce.aC�_ 4,�w 1.1 a Is this an accepted street?yes ,/� no Map Number Parcel Number 1.3 Zoning Informst�•gn• 1.4 Property Dimensions: Zoning District) Proposed Use 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❑ Private 0 Zone: _ Outside Flood Zone? Municipal❑ On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 1 Owner'of ecord: ( �l u� Pf -cr1 � vroo e t ..1 - Name( ) City,State,ZIP (-1K CV 141112c), ut?-sg-7-q eep at94-All lei No.and Street Telephone Unairlidditss SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) ,I Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg. ❑ Number of Units Other ❑ Specify: Brief Description of Proposed Work2: `120 to t ,)„„,..„.t -S .t 61v4 511 (1Q (7)Qattl.rI • �c)c t s� U k �1-41 Ncou2 c. V v-Fret C 6 SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ 13�1rY, UC 1. Building Permit Fee: $ Indicate how fee is determined: ❑Standard City/Town Application Fee 2.Electrical $ ❑Total Project Costa(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire $ Suppression) Total All Fees: $/� /\ Check NILI kheck Amount:44D Cash Amount: 6.Total Project Cost: $ kY,,UU 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) C13_�^(.� c 3 1 1 I a(•0 Mijiu be d 53 License Number Expiration Date Name of CSL Holder t 0 C�0 - 4 List CSL Type(see below) 1 o.and Street J Type Description f U R Unrestricted(Buildings up to 35,000 cu.ft.) (an �'� `� ` (�`�` ‘a)(1 Restricted I&2 Family Dwelling ity/Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances L113''—na—C,l 0-fyki,1c ,0.5We• X tCG1" I Insulation Telephone Email address D Demolition 5.2 Registered- t, � Home �om eImprovement Contractor(HIC) I �(,�— (v3 c9CP L , C"' HIC Registration Number ExpirationDate IC y Name or HI Registrant Name 1 S j `c n ' ecCtM:�- eefilget-Sakko• C+vr., and Street Qcci I ; ^ (DI Sol Lt ) ? .-6 I mail address City/Town,State,ZIP 1 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 1,as Owner of the subject property,hereby authorize3.12.,_ 1WC%/) to act on my behalf,in all matters relative to work authorized by this building permit application. Print Owner's Name(Electronic Signature) Date SECTION 7b:OWNER1 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 ap lication is true and acc e to the best of my knowledge and understanding. LI) I a-3 Print Owner's I Authorized Agent's Name ontc ignature) Date NOTES: I. 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"maybe substituted for"Total Project Cost" DocuSign Envelope ID:218101C2-7445-4FDD-A502-3AF8A67F2859 Pella Products Inc. 155 Main Street Greenfield, MA 01301 To Whom it may Concern: I,George Peppard , 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; 483 Park Hill Rd Florence, MA, 01062 Please accept this letter in place of my signature on the permit application. Thank you, —DocuSigned by: Signature: —D16D250C1E83440_. Date: 4/3/2024 DocuSign Envelope ID:218101C2-7445-4FDD-A502-3AF8A67F2859 Contract - Detailed �j Pella Window and Door Showroom of Greenfield `/y014 155 Main Street Sales Rep Name: Rousseau, Mitchell Sales Rep Phone: 413-768-8379 Greenfield, MA 01301 Sales Rep Fax: Sales Rep E-Mail: mrousseau@pellasales.com Customer Information Project/Delivery Address Order Information George Peppard George Peppard-483 Park Hill Rd,Florence,MA,U Quote Name: George Peppard-483 Park Hill Rd,Florence, 483 Park Hill Rd 483 Park Hill Rd Order Number: 739Z3DR121 FLORENCE, MA 01062-9750 Lot# Quote Number: 17980588 Primary Phone:(413)5879750 Florence, MA 01062 Order Type: Installed Sales Mobile Phone: County: Payment Terms: C.O.D. Fax Number: Tax Code: MASS E-Mail: peppardgray@gmail.com Quoted Date: 3/26/2024 Great Plains#: 52H5879750 Customer Number: 1007950346 Customer Account: 1003895811 Customer Notes: need to confirm orientation of opening Line# Location: Attributes 10 Impervia, Casement Left, 37 X 45.25,White Item Price Qty Ext'd Price 1:Non-Standard SizeNon-Standard Size Left Casement $2,446.79 —Wir $4,893.58 ie PK# Frame Size: 37 X 45 1/4 General Information: Standard,Duracast®,Block, Foam Insulated, 3 1/4", 1 15/16" 2163 Exterior Color/Finish: White Interior Color/Finish: White Glass: Insulated Dual Low-E NaturalSun+Low-E Insulating Glass Argon Non High Altitude 3r Hardware Options: Standard,Wash Hinge Hardware,Fold-Away Crank,White,No Window Opening Control Device,No Limited Opening Hardware Viewed From Exterior Screen: Full Screen,InViewTM Performance Information•• GC 0.40,VLT 0.49,CPD PEL-N-277-01652-00001,Performance Class LC,PG 50,Calculated Positive DP Rating 50,Calculated Negati , ear Rated 11,STC 28,OITC 25,Clear Opening Width 26.75,Clear Opening Height 40.5,Clear Opening Area 7.523438,Egress Meets Typical 5.7 sqft(E)(United States Only) Grille: GBG,No Custom Grille,3/4"Contour,Traditional(3W3H),White,White Wrapping Information: No Exterior Trim,Pella Recommended Clearance,Perimeter Length= 165". Frame Size:37"X 45.25" MP-4-1 Wide Modified Pocket Installation Qty 1 EXTTRIM10-PVC Ripped for stops 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 4/3/2024 Contract-Detailed Page 1 of 8 DocuSign Envelope ID:218101C2-7445-4FDD-A502-3AF8A67F2859 Lusturrrer.ueurye repparu riujeut Name: George Peppard-483 Park Hill Rd, Florence,MA,U Order Number: 739Z3DR121 Quote Number: 17980588 Line# Location: Attributes 20 Impervia, Casement Left, 37 X 45.25, White Item Price Qty Ext'd Price $2,613.79 $2,613.79 1:Non-Standard SizeNon-Standard Size Left Casement 14 r-' PK# Frame Size: 37X451/4 V '"--, 2163 General Information: Standard,Duracast®,Block,Foam Insulated,3 1/4", 1 15/16" 1 Exterior Color/Finish: White Interior Color/Finish: White Glass: Insulated Dual Low-E NaturalSun+Low-E Insulating Glass Argon Non High Altitude 37- Hardware Options: Standard,Side Pivot Hardware,Easy-Slide Operator,White,No Window Opening Control Device,No Limited Opening Hardware Viewed From Exterior Screen: Full Screen,lnViewTM Performance Informatio HGC 0.40,VLT 0.49,CPD PEL-N-277-01652-00001,Performance Class LC,PG 50,Calculated Positive DP Rating 50,Calculated Neg e ,Year Rated 11,STC 28,OITC 25,Clear Opening Width 31.5,Clear Opening Height 40.5,Clear Opening Area 8.859375,Egress Meets Typical 5.7 sqft(E)(United States Only) Grille: GBG,No Custom Grille,3/4"Contour,Traditional(3W3H),White,White Wrapping Information: No Exterior Trim,Pella Recommended Clearance,Perimeter Length= 165". Frame Size:37"X 45.25" MP-4-1 Wide Modified Pocket Installation Qty 1 EXTTRIMI O-PVC Ripped for stops Qty 1 Line# Location: Attributes 25 1111111111111111111111. Impervia, Casement Left, 29 X 37,White Item Price Qty Ext'd Price 1 -- $2,275.40 $6,826.20 1:Non-Standard SizeNon-Standard Size Left Casement • PK# Frame Size: 29 X 37 2163 General Information: Standard,Duracast®,Block,Foam Insulated,3 1/4", 1 15/16"Exterior Color/Finish: White Interior Color/Finish: White Glass: Insulated Dual Low-E NaturalSun+Low-E Insulating Glass Argon Non High Altitude 29" Hardware Options: Standard,Side Pivot Hardware,Easy-Slide Operator,White,No Window Opening Control Device,No Limited Opening Hardware Viewed From Exterior Screen: Full Screen,lnViewTM Performance Informatio C 0.40,VLT 0.49,CPD PEL-N-277-01652-00001,Performance Class LC,PG 50,Calculated Positive DP Rating 50,Calculated Nega ive DP Rating 60,Year Rated 11,STC 28,OITC 25,Clear Opening Width 23.5,Clear Opening Height 32.25,Clear Opening Area 5.263021,Egress Meets Typical for ground floor 5.0 sqft(El)(United States Only) Grille: GBG,No Custom Grille,3/4"Contour,Traditional(2W2H),White,White Wrapping Information: No Exterior Trim,Pella Recommended Clearance,Perimeter Length= 132". Frame Size:29"X 37" MP-4-1 Wide Modified Pocket Installation Qty 1 EXTTRIMI O-PVC Ripped for stops 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 4/3/2024 Contract-Detailed Page 2 of 8 DocuSign Envelope ID:218101 C2-7445-4FDD-A502-3AF8A67F2859 L ustuiTler.ueurye repparu riuject(Jame: George Peppard-483 Park Hill Rd,Florence,MA,U Order Number: 739Z3DR12I Quote Number: 17980588 George Peppard Mitchell Rousseau Order Totals Customer Name (Please print) Pella Sales Reap Name (Please print) Taxable Subtotal $9,315.76 ��Docusigned by: P�Uocusigned y: Sales Tax @ 6.25% $582.24 of .C2/1 haat rbtAssu u. NeetifleWeityletilAre PelleAe9A iiltap nature Non-taxable Subtotal $3,202.00 4/3/2024 4/3/2024 Total $13,100.00 Dat�ocusigned by: Date Deposit Received $6,550.00 () Amount Due $6,550.00 t'reateeifftCAMM9val 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 4/3/2024 Contract-Detailed Page 8 of 8 Commonwealth of Massachusetts k...0 Construction Supervisor jt, d Standards Division of Occupational n Unrestricted-Buildings of any use group which contain less than Board of Building Regulations a and 35,000 cubic feet(991 cubic meters)of enclosed space. Cone tC fit,'-firs- a CS-096558 4. �c Gpi, 03/01/2026 TREVOR BROSS w 10 GEORGE STREET p "^ GREENFIELL 1A 01301 . .' r ?b o a ;6/,1 V3"13J ±rniiiha Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. Commissioner et/ Contact OPSI:(617)727-3200 or visit www.mass.gov/dpl/opsi THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs and Business Regulation 1000 Washington Street-Suite 710 Boston,Massachusetts 02118 Home Improvement,Contractor_Registration • Type: Supplement Card PELLA PRODUCTS.INC. Registration: 142279 155 MAIN STREET _ " `; Expiration: 03/23/2026 GREENFIELD,MA 01301 Update Address and Return Card. 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 A and>Business Regulation Registration - Expiration 1000 Washington et • e 710 142279 -- 03/23/2026 Boston,MA 0 8 PELLA PRODUCTS,INC. TREVOR BROSS 155 MAIN STREET .1-`1; GREENFIELD,MA 01301 Undersecretary thout signature Lr The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Lafayette City Center 2 Avenue de Lafayette, Boston,MA 02111-1750 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Pella Products, Inc Address: 155 Main st City/State/Zip:Greenfield MA. 01301 Phone #:413-774-7231 Are you an employer? Check the appropriate box: Type of project(required): 1.0 I am a employer with 70 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6. New construction listed on the attached sheet. 7. © Remodeling ?.El I am a sole proprietor or partner- ship and have no employees These sub-contractors have 8. ❑ Demolition workingfor me in anycapacity. employees and have workers' P h' $ 9. ❑ Building addition [No workers' comp. insurance comp. insurance. 10.❑ Electrical repairs or additions required.] 5. El We are a corporation and its 3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.❑ 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. :Contractors 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: EMC Insurance Company Policy#or Self-ins. Lic. #:6 H 15382 Expiration Date: 1/1/2025 Job Site Address: 483 Park Hill Rd City/State/Zip:Florence, MA 01062 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 fine 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 under the pains and penalties of rjury that the information provided above is true and correct. Signature: �, ��/� Date: 4/17/24 Phone#: 413-512-59 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): 10Board of Health 20 Building Department 30City/Town Clerk 4.0 Electrical Inspector 50PIumbing Inspector 6.0Other Contact Person: Phone#: PELLPRO-01 CHRISTINE ACORO CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYVYJ 12/14/2023 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 Phillips Insurance Agency,Inc. r NAME:E 97 Center Street (A/C,No,Est):(413)594-5984 I FAX (A/C,No):(413)592-8499 Chicopee, MA 01013 E-MAILss:christine@phlllipsinsurance.com INSURER(S)AFFORDING COVERAGE NAIC p INSURER A:EMC Insurance Companies 21415 INSURED INSURER B:EMCASCO Insurance Co 21407 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. PM I TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS INSO WVD 4MM/DDKYYY) (MM/DDIYYYY) A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR 6A15382 1/1/2024 1/1/2025 DAMAGETORENTED 500,000 PREMISES(Es occurrence) $ MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY X LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 (Ea accident) $ X ANY AUTO 6Z15382 1/1/2024 1/1/2025 BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOSS E BODILY INJURY(Per accident),$ AUTOS ONLY AUTOS ONL� PROPERTY a�dentDAMAGE A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 4,000,000 EXCESSUAB CLAIMS-MADE 6J15382 1/1/2024 1/1/2025 AGGREGATE S 4,000,000 DED X RETENTION$ 10,000 $ B WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTNE Y/N 6H15382 1/1/2024 1/1/2025 E.L EACH ACCIDENT 500,000 i OFFICER/MEMBER EXCLUDED? N NIA ---- (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POUCY 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 Town of 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 PELLA PRODUCTS INC. 155 MAIN STREET GREENFIELD,MA. 01301 Date: LA ` olq To: I auyN C) t. l 0(--ct v-2 o`? la YY\c v . 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. - -z. - Joy Grover Accounting Manager •