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Office Order Copy Branch Number: 73900 Order Number: 73913GP171 ?00,,, Window Store Name: Quote Number: 433180 L) f' 1 7 Quote Description: Architect Series Project Name: Gibbs, P. Candee 147 Hinckley Florence MA 01062 Customer Information Deliver To Address Order Information P.Candee Gibbs Lot # Sales Rep Name: Picard Paul CustDel veryD ate: 08/2412009 __- -- Address: - Basin - r' F E, 6, "4 ° `. — 147 - Hinckley Street 14 inckley Street 1 Ularketlegment: Replacement - Contract Date: 0613 Order Type: Installed Sales Booked Date: 06/30/2009 Effective Discount: 0.000% Earliest LRD: 07/20/2009 FLORENCE, MA 01062 FLORENCE, MA 01062 Commission Split: Picard, Paul - 100% Contact Name: County: HAMPSHIRE Tax Code: MA Tax Exempt #: Payment Terms: Deposit/C.O.D. Customer PO #: Day Phone: (413) 586 -0787 Owner Name: Accessories Managed Accessory Delivery Date Mobile Phone: P.Candee Gibbs Fax Number: E -Mail: Owner Phone: (413) 586 -0787 Great Plains #: 53H5860787 Customer Number: 3366312 Delivery Instructions: 91 S to exit 20 Northampton, tum right at light by Dana Chevy, left at 1st light on Jackson Street, at stop go straight across (crossing Prospect) this will bring you to Rte. 9. At stop tum right (only option) then quick left on Nonottuck Street (by high school) continue 3/4 mile tum left on Hinckley Street house on left. Installation Notes: 91S to exit 20 Northampton, tum right at light by Dana Chevy, left at 1st light on Jackson Street, at stop go straight across (crossing Prospect) this will bring you to Rte. 9. At stop tum right (only option) then quick left on Nonottuck Street (by high school) continue 3/4 mile tum left on Hinckley Street house on left. Printed on 07/11/2009 Office Order Copy Page 1 of 10 ,'UL -- ^hrn v U L _ 1 1 LJ�;; Town of Florence Building Inspectors Office Thank you for reviewing our building permit request for P. Candee Gibbs 147 Hinckley St. Florence MA. Please direct any questions or concerns, you may have to me, Lauri Rice, at the Pella Products Inc., Greenfield, MA retail showroom. All customer and project information is located in this particular office, therefore I will be able to answer any questions or address any concerns there may be more efficiently. I have included a self addressed stamped envelope for the return of the permit. Thank you for your anticipated cooperation. Sincerely, Lauri Rice Pella Products, In 240 Mohawk Trail Greenfield, MA 01301 413-774-7231 413-774-6348 PAGE 01/01 PELLA PRODUCTS INC 06/04/2003 11:17 4137363350 The Commonwealth of Massachusetts =A y , Department of Industrial Accidents 1. . —At= k „ Office of investigations iiie l `' 600 Washington Street -� II Boston, M4 02111 :;:' " " www.mass.gov/dia • Workers' Compensation Insurance Affidavit: Builders/ Contractors /Llectxicians/Piwmbers A'i�blican I nformation Please Print L •'bl Name Business/Or izatio ndividual 1114_,_,,,,,,g C — � S'an n!l . ) f ,� Address:_ 2.3`,: ∎ fee_e9 _ City /State Ph one #: l '- ' erg- / ' Are you an employer? Check the appropriate box: Type of project (required): 1.54 I am a emplo with 4. [] 1 am a general contactor and I. . ---- -- 6. 0 NeW- construction. employees (full and/or part-time)."' have hired the sub - contractors 2.0 I am a sole proprietor or partner- listed on the attached sheet. 7. 0 Remodeling ship and have no employees These sub - contractors have 8. 0 Demolition working for me in an employees and have workers' Y capacity. P s t3' 9. 0 Building addition [No workers' comp. insurance comp. insurance t required.] 5. 0 We are a corporation and its 10.0 Electrical repairs or additions 3. ❑ I am a homeowner doing all work officers have exercised their 11,0 plumbing repairs or additions myself. [No workers' comp. right of exemption per MOL 12.0 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 scetion below showing their 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. IContractors that check this box must attached an additional sheet showing the n•um of the sub-contractors and state whether or not those entities have employees. If the subcontractors have employees, they must provide their workers' comp. policy number. • X am an employer that is providing workers' compensation insurance for my employee.. Below is the policy and job site information. f Insurance Company Narne: tr i dr v c4rf cc l' A a �' n — Policy # or Self -ins. W. #:J) C_A ' j,, Expiration Date: 4 /-- U f Q1 L7 Job Site Address: • City /State/Zip, s . - . , , Attach a copy of the workers' compensation policy declaration page (showing the policy wnnber and expiration date) - Failure to secure coverage as required under Section 25A of MOL c. 152 can lead to the imposition of criminal penalties of a f the up to $1,500.00 and/or one -year imprisonment, as well as civil penalties in the form of a STOP WORD. ORDER and a ;Fite 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 oldie DIA for insurance coverage verification. 1 do hereby ce r u , er the pains and penalties of perjury that the information provided above is tore and correct. 5_ {,a _.. , f /9 •_ �, � .„ .ate: DEC 9 2008 Official use only. Do not write in this area, to be completed by city or town ofciaL City or Town: _ - Permit/ icen #_ _ 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 Phone: 413 - 772 -0153 Cell: 413- 834 -8799 To: Building Inspector From: David White — Installation Manager Date: January 19, 2009 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 #091496 and our HIC, # 142279. Please find a copy of my licenses below. 11't441t'hW +SCI 6 IA:11'Itf14'FItdMI Pn1blIti Restrialad .5u. PC1 ? Ltn;o4:11..1 014.1411m. Ft+` .ul 11 la .Litt 40a11 1l* 1_. oristruction 'Supoer ,aixr5r Lhcensc. OOP- Llitrt41t9ttrs4 LPG k.,;• a' QS, 01401, 1L - 1 2 Fam1ly Wives Restr6_1ax1 ia,: CN. DAVID C WHITE t 4 CAFt EVTER ST r I?fltIutt tJ1 plb n curtitni ci1111un ut ilu: ORANGE L'E MA 01364 Ml:aksacltuxth'+iatl Iliuliliil* t,'i1t11.: 1 i titlutic tor rtinca51+tn ieC ttatr Iicenuc. R e f e r lei: ' Writ * . A1a:tt Girt: UPS 74 Q.4449 Each installation will be staffed by our installers who are all licensed in accordance with current building codes. Following are copies of their current licenses. Please accept these individuals as my Designees. If you have any question please contact me using the numbers listed above. -1- PELLA PRODUCTS INC 155 MAIN STREET GREENFIELD, MA 01301 C i 4 -( O- ` -`l e d 0 (Yin, t k,„ • 6d 1 n (AAOJv' P +6 . n1A of n6) O Subject: Disposal of Debris The purpose of this letter is to certify that all the debris resulting from any project undertaken by Pella Products Inc. in your Town will be transported to a dumpster at our main facility at 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 • SECTION 8 - CONSTRUCTION SERVICES 8.1 1,lconsed constr„ tion 5 r ervisor: NotAppfieable D • rvesn cgnt�eHard 6,..., . I. - L ' , t v 9 l L { Q (P License Number ■ (k_f ! f 5'1 *-CJ. 6 0 (. c:. OVA / - 31 - a o 1 t_ Addr ©ss /1 t s. • ' c, td Expiration Date j �,J� q 3 ���pis Signature Telephone :. R. :rod ' !Ain t.l •v` lit err .i, , �.- it Not Applicable ❑ I tf t 5 A . j - 7c Company Name Registration Number ( Address Expiration Date N • eV C 1 X Telephone L f 1.3 °'/ 74,° ()I 5 3 SECTION 1O. WORKERS' COMPENSATION INSURANCE AFFIDAVIT (M.G.I.. c. 162, § 25C(@)) ' — -- Workers Compensation Insurance affidavit moat be completed and submitted with this application_ Failure to provide this affidavit will result in the denial of the Issuance of the butl'in_ permit. Signed Affidavit Attached Yes v No O 121 � Ba0e L)ywneir EAern fiCai The current exemption for "homeowners" was extended to include Owner- occupted»wellines 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 tba t miler aeis as ur pervi C1 VMR 780, Sixth Edition Sec i n 108.3.53 DGlinition 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 erson Jo constructs mor ham one home i 1 : two- ear eriod - 1 ,11 not be cnnsiderreti a homeowner, Such "homeowner" shall submit to the Building Official, on a form acceptable to the Building Offieialtk)at he /she shall he res nsib1afor all such work performed and the bulldln}; ep rnii t As acting Copstruetl Sup eryisir 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' Compensations) and Chapter 153 (Liability of Employers to _ Employees for injuries not resulting in Death) of the Massachusetts General Laws Annotated, you may he 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 fipp ZLc'TL82CT1' XVd TZ :OT LOOZ /ISO /50 SECTION 5• DBSCRIPTIQN OF PRQPOSED WORK (check an.appt]cabtn) New House 0 Addition J Replacementt indows Alteration(s) El Roofing n Or Goons [LJ]1 • Accessory Bldg. ❑ Demolition El New Signs (tom] Decks [[::] Siding CO] Other [lnj Brief Description of Proposed Work: fe- -V l(, . a , °i'1 4J.. -- - 1 . • c ° . w (CuYne u.: +,:f Alteration of existing bedroom Yes No Adding new bedroom Yes No . Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll - Sheet ea if ew hduse.an or addit[ri 7 Tiixit , -, .-- .,,.� _ _,�'ftl: r 0 . 1 ` cam J! �. . �'�I'11� '�• ., it9'; ; 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. Massoheck Energy Compliance form attached? , h. Type of construction 1. 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 AUTHORIZATION - TO BE COMPLETED . WHEN OWNERS AGENT OR CONTRACTOR � - APPLIES FOR BUILDING PERMIT Y `1(� e e y I, ( t —__ , as Owner of the subject property hereby authorize , k, . ( l • A to act on my behalf, in all matters relative to work authorized • y this building permit application. Signature of Owner Data W_ 1, �(� J /\ ( sL n (' . ,, 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. Sign dduunder the pains and penalties of perjury. Print Nama a , 4..) - , Signature of Owner /Agent Date ' C 00 I ZLZTLSCTf XVd TZ :OT L007,%f0/ 0 • City of Northampton Y XI N,404 dW'�'�'.�{Y L .�' ' 11� III II�� Building Department � ��� ,'.c.Tv ���i , I ti I� III H 4 Y"^ i f � lid �ri"5 1 '1 r M '� a ti i Y ',4Y 212 Main Street 0 µ i a �. IWII Room 100 I rw�;,�fF�a �ir<'� ,r� � i, I Northampton, MA 01060 , Q i u vu1 1N uI • • phone 413 -587 -1240 Fax 413- 587 -1272 c , I�I ,I ' i�tlp ' i APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 - SITE INFORMATION • 1,1 Property Address: This section to :be completed by office L - 1 1 t4 t L ( Map Lot Unit VIVA Overlay District Elm St,'Dietrlvt` CBIDistrlct SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 • ner of Record: • 6 • v ` 1 4-1 ri l Y l.t,c=l e " Fi O ! c r'1(e Name (Print) Currant Moiling Ad Elsa_ "g - j,.t�� 1 Telephone Signature _ 2. uthorized Agent: l (� +� 1 5 5 � G�� �= bs IA V�'1l Name (Print) . 41, Current Moiling Address: Si Telephone SECTION 3 - ESTIMATED CONSTRUCTION Cr. :"LS Item Estimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building (a) Building Permit Fee 2. Electrical (b) Estimated Total Costa ___- _ 1 I Construction from (8) — 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection 2 + + 4 + 5 i Cheok Number This Section For Official Use On! Building Permit Number: I Isssusu ed: Signature: Building Commissioner /Inspector of t3ulldinga Date TOOEI ZLZTL85CTt7 XVd TZ :OT 2,007,5 170/0 147 HINCKLEY ST BP- 2010 -0112 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 23D - 151 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- 2010 -0112 Project # JS- 2010 - 000128 Est. Cost: $13849.00 Fee: $35.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: PELLA PRODUCTS, INC 142279 Lot Size(sq. ft.): 18513.00 Owner: DAVIS DEBRA L & PATRICIA CANDEE GIBBS Zoning: URB(100)/ Applicant: PELLA PRODUCTS, INC Al: 1'47 HiiVC:`+L.1_ i "2,7" ! Applicant Address: Phone: Insurance: 240 MOHAWK TRAIL (413) 772 -0153 WC GREENFIELDMA01301 ISSUED ON:7/29/2009 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: OK S (1A i(o Le ci (S THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. ' Certificate of Occupancy A. ( Signature: FeeType: Dat Paid: Amount: Building 7/29/2009 0:00:00 $35.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Anthony Patillo