Loading...
24D-214 (2) Customer: Tim I asn Project Name: Tash, I Im 4 Prospect Court Northampton MA Order Number: 739 Quote Number: 1169160 within the wall system. Neither Pella Corporation nor Pella Products Inc will be bound by any other warranty unless specifically set out in this contract. However, Pella Corporation will not be liable for branch warranties which create obligations in addition to or obligations which are inconsistent with Pella written warranties. Clear opening (egress) information does not take into consideration the addition of a Rolscreen for any other accessory] to the product. You should consult your local building code to ensure your Pella products meet local egress requirements. Per the manufacturer's limited warranty, unfinished mahogany exterior windows and doors must be finished upon receipt prior to installing and refinished annually, thereafter. Variations in wood grain, color, texture or natural characteristics are not covered under the limited warranty. Refer to Pella Corporate Warranty • This form constitutes a contract between Buyer and Seller. Prices are subject to change anytime after 30 days following date of estimate and does not guarantee availability of any product listed. Pella Products Inc. management has final authority on acceptance of this order. Your signature confirms the accuracy of the product(s) chosen. Pella Products assumes no responsibility for accuracy of take offs from drawing$ or blueprints or that the products listed will be sufficient to complete customer's intended project. The Buyer agrees that the Product(s) listed herein are correct, final and oannot be changed, returned or canceled. Deposits are partial payment of the contract and are not refundable. The Buyer agrees that if paying by credit card that authorization is granted to the seller to debit the Buyers credit card by signing this contract. The Buyer agrees that payment discounts do not apply when paying with a credit card. A 1 -1/2% SERVICE CHARGE per month (18% PER ANNUM) will be added to all outstanding balance past our stated terms, plus lawyer and account fees for collecting outstanding accounts. The Buyer agrees that the customer delivery date is a realistic estimate of when the product is to be delivered. Items remaining in our warehouse for more than 30 days beyond the agreed to delivery time will be subject to a storage and handling fee of 1% of the net amount of the order ($25.00 minimum charge). The Buyer agrees that the product can be without the Buyer present and agrees to accept the shipping documents as proof of delivery. The Buyer agrees not to hold the Seller responsible for any damage to driveways, sidewalks, trees and overhead wires caused by the Seller's delivery vehicles. The Buyer agrees to examine the product(s) upon delivery and within 7 DAYS OF DELIVERY provide the Seller notice of any discrepancy between the product(s) ordered and the products(s) delivered, including hardware. If the Buyer does not provide notice within 7 days the Buyer accepts the product(s) as is. El Project Checklist has been reviewed Order Totals Taxable Subtotal $11,418.72 Credit Card Approval Signature Sales Tax @ 6.25% $713.67 Non - taxable Subtotal $3 600.00 1 NI& get. / Total $15,732.39 Customer Name (Please print) P ep Name (Please print) Deposit Received f�� Amount Due $15,732.39 Customer Pella Sales Rep Signature Date 111 Date For more information regarding the finishing, maintenance, service and warranty of all Pella® products, visit the Pella® website at www.pella.com o,- ;., +o,1 ,,,, e onninnno no +aao,f o 7 ..f 7 . Date / a�/a*p*ewx�� Picam sx ill �� �� ~ � noa/ pat„ mon. moue m.^sta|/aoo^eamonth=mmm/neu|ms day uomta|mnon ^o,bo p^aoao,a��,ne oiins�U paymvn/is m ba ^aue Poo,. 4C,~c�mm�od w:m+asxeo 0u IC ome, roes |nCftnr6d m pay vo:'m.a|ux1w/o,aauuinhnano*nha0e, wt:2vtt per mnnm ( m"0 rAnnu|` *nd:aga\1 1 tooaasnnua�d 'nfttecm\achon nweumun/ao. Du^ m:/=mo011 01H, » .o,0 ''( 0( .1 ldV 20 0» reschodu|*. Vve tttann g0a1 ». 0» 3 r((». 3 d»» 31 »,» komwaiiatIw`. rnm�0iws�cu^ e LT) .ao, *^'mae, e x o/umeisnoamme ��n oonf.^n=daq, ve,ifica,inn. /2 cuo 111/ (1 0» 1 •,. l0C»U 0»»' 41 01 um 31 ooesn uo i11»'J 'l 01 0» litohil oo».< 0(1 o:an8eOfdc'. o o. ,» ,l»\ »iU 0101 »l 1' (.00 pi oduoio 1 b»»o 00,1/00 _l1 0 ,r,l 0 01 00 �oxe ^ panaundsamcsadjustn�^tts ate cov:i oy\,,fa/ and 4mmu'al loot. an*u t--;`autt. Comp/ete. , iea,«uta.yn, ^^e ,o b*.xaa|ied,w 1., l » (1 ,,l u» o2 r,» o 01 po'yuy**m°o/u°�oue��u�uedfv and nnu equs|to the caa m pmd"canm install": asyoxedu|ed be 200 uponVad compleu amanageme^i Type oi xautm|iation: mewc�n��u,cuac «e^' evtm�aimao^) L� et i,uenm and exE.tnmTmno*nniEqeiyamove existing wxictinwname. mma|| v=°w.^do n *in rough open/og e11 3 0 boln 100 01 »rot o»t300 ,. o.noo 1 2. r. pct,t }»u�n� ����pe;eomn o^�k��ame'en"m� � atiettiot st.opt,.:nscad nevi t,tr:;:idovti &,:tositing titindotiv tratne : exaxin;o,ep:ace (Intel imanmtt,mx)SoneQiotns joss wjU mzu, L axmpam�oioo�aucr #[_� nu/\�prk); ml tttt: 8. t....em uDneda^d "P,:,*:n,u F COI Lead invno, Homs^b,nohui - e vam Peen given mHorne oene, * ,i»1 11J t'37»'tO 0.0010, 1,,10) 010.40(0)' Py/z,VJh vv �waw/,Q �— -tmrtcxuom Sign on 1st day urinaa:azion anurencxe artmriva/J —� �— E"s u esomovnaove age18`aom*cttma ail umsa while Pa|iaemmoyees are inrthe �)eox�.an�un/va� i ] lace cmms . � a:ean x t ,/emo,e &^=inoeU }^en^,a^a=vano, trix`\fopp,cab/e | Re^^wo o^iodng s»uuen and awnings byc*noatn � L • L �.n epv u a*vo^:Qp,vuuanuaN m uu, 1 For ail needo, [ � Pm,/de s|| � n u/m*y naue»sai y m mat:3|| ittodoru w000 a/� other materials. uu�de cxhmne ` ' Please :TL: sure yot: ` m»u/ate ucduauikamuod pmuuct‘i ' | L Rwmo,e anup=m^n number J p,t.tpempe/aoon pmducE \ ! L cnnnm,th^t eo products ate mwomingotoa R*mov� cmpc.orlio, ',,ycuue and remove: oU old pmd:ct hom p,amioen cmin) p,odoct C o,oev aeo.uuuh*x. shrubs frog axehm 1. I, X 1»,,,» .1 ,»V,; »)11ll 0,00)101 10)1130flfl(13t(1( 0)11,0 F»COfllie.00)d [ ] a.�:g=m ou,a n|vmbmg o. n|oo m'*| .opn.00/chvn8enby appnpna� Ucen0e .0 13 L. == , lsmovE: auo/ treatments wail han.}mg* czndidoning vn|� R°movaan: 11,10110(0 11 .030001 oo m x316man R 3111 Lopl [ hmn .area awomnite necosoacy Office Order Copy / � � ���i: Branch Number: 73900 Order Number: 739J3BP05P ® Window Store Name: Quote Number: 1169160 Quote Description: Site Visit 12 -30 -09 Project Name: Tash, Tim 4 Prospect Court Northampton MA Customer Information Deliver To Address Order Information Tim Tash Lot # Sales Rep Name: Picard, Paul Gust Delivery Date: 03/02/2010 Address: Business Segment: Retail Quoted Date: 12/30/2009 4 Prospect Court 4 Prospect Court Market Segment: Single Family Replacement Contract Date: 01/05/2010 Order Type: Installed Sales Booked Date: Effective Discount: 0.045% Earliest LRD: NORTHAMPTON, MA 01060 NORTHAMPTON, MA 01060 Commission Split: Picard, Paul - 100% Contact Name: County: HAMPSHIRE Tax Code: MASS Tax Exempt #: Payment Terms: Deposit/C.O. D. Customer PO #: Day Phone: (413) 582 -0234 Owner Name: Accessories Managed Accessory Delivery Date Mobile Phone: Tim Tash Fax Number: E -Mail: Owner Phone: (413) 582 -0234 Great Plains #: 53H5820234 Customer Number: 3909037 Delivery Instructions: 91s to exit 20 Northampton. Continue on King Street (Rte 5) tum right on Finn Street. Antoher right on Prospect Street and quick right on Prospect Court. 2nd house on left. Installation Notes: Wells Fargo customer. No collection at install. 91s to exit 20 Northampton. Continue on King Street (Rte 5) tum right on Finn Street. Antoher right on Prospect Street and quick right on Prospect Court. 2nd house on left. Customer Notes: All windows will qualify for federal tax credit program. All windows will be Architect Series aluminum clad white with pre - finished white wood interior. All installation, disposal, insulation and permit fees as well as sales tax included. Printed on 01/05/2010 Office Order Copy Page 1 of 10 -- ,\ ✓tie eant-mortwec - da ofLita.urzclue.lei6 Board of Building Regulations and Standards H OME IMPROVEMENT CONTRACTOR t_ it' _ Registration: 142279 * 10 Expiration: 3/24/2010 Type: Supplement Card PELLA PRODUCTS, INC. PAUL PICARD 155 MAIN STREET GREENFIELD, MA 01301 Administrator License or registration valid for individul use only before the expiration date. If found return to: Board of Building Regulations and Standards One Ashburton Place Rm 1301 Boston, Ma. 02108 ` 40 s� - Not vali ' wi bout signature • • • • . . Pella Products, inc. 155 Vtaill Street cGreetifieid,, NIA 0 I 3i.ii I Pill)ne: 413-772-015:i CC;11: 413-S34-S79Q aa . . -- , . , .. ... — . ... . . . • ,. ,.... , - , . . . . .. , — — ,- . - ., — ... - . -.. . • .. , -. . - . .. - . . ... .... ,..:. . .. ... . . . . . T 4 J : - i , Hikiiirig h)specioi• 1.- rionl: ' \Viriitc -- installaticm Manage!' SiJ B-,i i. - Bditikiii.g Peri Aibfilicatioris . Desigiices b\-!.,da broelueis itiecn is , ihe business of bepiiicing, windrAvs and doors for oar cusiromers. (2.)ur process includes pro in a buildiab2 p, nar each ink', c,:r prdieci. • ara a ,e.e.usetil (foustruction Supervisor. Buddinc, pefait s , ,H be applied .L1P,:c 170') --i:';'() 21)(1 Otif fi iC., i-i: i 422.79 i'l(7!a.se find a cOpI 0 C NI 4,.....44: b tro: r IN - at' pa rl tl Icfl I alf PUN 1%," !",111.7 I ) 1 ..1 Bui LI i m,& k4.1,,tu lai mils .LinAL Si A std.trd tif f :0olstroctiort Sal pti L4ceo.s kritlr.3441161'. CQ Oil - ilitkrustrickozd r 4 r U•14:.i IG - 1 2 FM* ikidTle% :S: 1 R. %tro:1.1 k. GO DAVID C WHITE , ., ' , . ' to allure lib glimwitz 41 currunt egikAiut 121 /Lc tk.".4 CAFP'ENTER ST - o . . ;',.,,,-, MA ,,s.tellkussctikk SAVA' BOW ivg code ORAMSE hilA 013b4 :..- ' : .'... .1 ■ i5 (yaw 60 refit il Di &HA 1:1C1:11111.42. krfrIr fill: kAt clieW.ItkisAkt.‹.iirk litIPS k I:Apr..4mi 11.11+;91' ........._...._„_.....,....,......--- .—.. . Irrr.: • : Al.:"italk11 ' 0* iti be staffed 1) our installers \\I le are- dlt iteensed n1 d.eebt dance. 'oeito current building codes, inallowikg arc, t!opies of bier( earl ncenses. Piease icccpt these individnis as illy Desigalees, if )0ki irkiVe arl \ CI Ile:Sk On please contact Me USiiig thC nU4nherS listed abo - 1 - PAGE 01/01 PELLA PRODUCTS INC ./ 01r'' <009 11:17 4'1373633`30 The Commonwealth of Massachusetts GM Y le Department of Industrial Accidents . 1/4 ,�»- • Office of Investigations ry � ;. 600 Washington Street 11 1/4„.., " = : ` ` Boston, NIA 02X I1 ":; " www.mass.govfdia Workers' Compensation Insurance Affidavit: Bu,i lders/ Contractors /llectriciansl1'1umbers • jplicant information Please Print L - . "1i1 Na11ne (BusiuessiOrganization !indiv Address:_ ,. _ ..) ` 9r6'4'9 City /State/Zip r „ ' r ei M i.3 i'ho>ae #: �.3 Are you an employer? Check the appropriate box: Type of project (required): 1.4 I am a employer with ? m 4. 0 I a a general contactor 'and I. • ' -- 6. ❑ New- eonstruction employees (full and/or part- brute). *. have hired the sub - contractors 2.0 I en a sole proprietor or partner- listed on the attached sheet. 7. ❑ Re:modeling ship and have no employees These sub - contractors have 8. 0 Demolition working for me in any capacity. employees and have workers' Building addition [loo workers' comp. insurance comps. insurarnce.t required.] 5. 0 We are a corporation- and its 10.0 Electrical repairs or additions 3.0 I arm 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 Othe — _ comp. insurance required.] *Any applicant that chectca box 01 must also 611 out the section below showing their workers' compensation policy information. • t Homeowners who submit this affidavit indicating they are doing MI 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- eantractors and state whether or notthose cntilie8 have employees. If the sub- catttractors have employees, they must provide their workers' comp. policy number. • 1 am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site informations. Insurance Company Nae:�___, • � xn i t..2_ ,,f r" An Ce . .e7 n Policy # or Self -ins. I.if . #l: 1 ah fz2 hl f 7 'S! Expiration Date: d /' 6/ d 2I # n • Job Site Address: . • . AJ City /State/Zip. , fl. Nl.0 l , . M A , 0/060 6 Attach a copy of the workers' comp policy declaration page (showing the policy.uumbcr and expirtttiion date) -' Failure to secure coverage as required under Section 25A of NI% c. 152 can, lead to the imposition of criminal penalties of a fine up to 81,500.00 and/or one -year imprisotunent, as well as civil penalties in. the form of a STOP WORK, ORDF.R 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 Oillce of Investigations of the DIA for insurance coverage verification. 1 do hereby ce-. u , er the pains and penalties of perjury that the Information provided above is true and correct _spa , . _ r? •. A, ' .•,. �_ p ate: DEC 29 200! • phone_ - 'l - e�- / ,7 X a . Official use only. Do not write in this area, to be completed by city or town ocdaL 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 #: FROM Berkshire Insurance Group CMON)JAN 11 2010 8:37/ST. 134315 /No. 71527318832 P 2 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25 (2001/08) Page 2 of 2 INS025 (0108). FROM Berkshire Insurance Group (MON)UAN 11 2010 8:38,ST. 8:35/No. 7527318832 P 1 ACORD CERTIFICATE OF LIABILITY INSURANCE DATE 1 /20 ' PRODUCER (413)773 -9913 FAX: (413)774 -3872 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION MassOne Insurance Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE g Y HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 117 Main Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O. Box 638 Greenfield MA 01302 -0638 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: Continental Western Pella Products, Inc. INSURER B: ATTN: John Benjamin INSURER C: 155 Main Street INSURER D: Greenfield MA 01301 -3258 INSURER E: COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD'L POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR INSRD TYPE OF INSURANCE POLICY NUMBER DATE (MM /DD/YY) DATE (MMIDD/YY) GENERAL LIABILITY EACH OCCURRENCE $ - 1,000,000 X COMMERCIAL GENERAL LIABILITY PR MISES Ea occurrence) $ 300,000 A CLAIMS MADE X OCCUR CPA020470113 1/1/2010 1/1/2011 MEDEXP(Any one person) $ 15,000 PERSONAL &ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,,0,00; 000 GEN'L AGGREGATE LIMIT APPLIES PER: . PRODUCTS - COMP/OP AGG $ 2,000 , 000 E C 7 JECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT {Ea accident $ 1,000,000. _ ANY AUTO - _ ,__. A ALL OWNED AUTOS MAA020470213 1/1/2010 1/1/2011 BODILY INJURY (Per person) X SCHEDULED AUTOS X HIRED AUTOS BODILY INJURY (Per accident) X NON -OWNED AUTOS PROPERTY DAMAGE Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS /UMBRELLA LIABILITY EACH OCCURRENCE $ • OCCUR CLAIMS MADE AGGREGATE $ _ DEDUCTIBLE $ RETENTION $ . $ • A WORKERS COMPENSATION AND X I TORY LIMITS l IOER - - EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT OFFICER/MEMBER EXCLUDED? WCA020470513 1/1/2010 1/1/2011 E.L. DISEASE- EA EMPLOYEE $ 500,000:' It yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ 500,, 000 OTHER • DESCRIPTION OF OPERATIONS /LOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS Operations usual to the sales of windows & doors. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Tim Tash EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 4 Prospect Court 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT Northampton, MA 01060 FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Robin Sargent /RMS ACORD 25 (2001 /08) © ACORD CORPORATION 1888 1NS025 (0108).08a Page t at.2 PELLA PRODUCTS INC 155 MAIN STREET GREENFIELD, MA 01301 1 i rn TaS Li 9 Pcos ecT (tl,rf C11 a - fr ilk oIOW) 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 Licensed Construction Supervisor: i 1tVC.. Not Applicable ❑ Name of License Holder : J L J l a oq (1 II_ nn ff License Number 0.4 Sfree7" ' (n'efh+ e. M A O 130 ( 1.31. Address - Expiration Date Q `fi) 772 013 Sign Tele hone • 9... Registered .Home:;tmprovertientCtintractor, ;, r , ... .....' Not Applicable ❑ � e IIo, ProcLc*S Th . I'+2 279 Company Name Registration Number /S.S h r� S PP.�" Creenka /4,4 0I301 3.2 (/ • 20/ n Address � � � / Expiration Date 1 / N \1 rL /._, Telephone /5 772 _ \ 0/ s3 SECTION 10- WORKERS' COMPENSATION INSURANCE AFFIDAVIT (M.GL. 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 build' g permit. Signed Affidavit Attached Yes No ❑ The_currentexemption for "homeowners" was extended to include Owner occupied Dwellings 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 that the owner acts as supervisor. CMR 780, Sixth Edition Section 108.3.5.1. Definition 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 person who constructs more than one home in a two - year period shall not be considered a homeowner. Such "homeowner" shall submit to the Building Official, on a form acceptable to the Building Official, that he /she shall be responsible for all such work performed ender the building permit. As acting Construction Supervisor your presence on the job site will be required from time to time, during and npnn completion of the work for which this permit is issued. Also be advised that with referenceeto Chapter 152 (Workers' Compensation) and Chapter 153 (Liability of Employers to Employees for injuries not resulting in Death) of the Massachusetts General Laws Annotated, you may be 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 o ampton Ors mances, ' a - . • • , • x . • • tts-General -Laws- Annotated. Homeowner Signature t w . . SECTION 5- DESCRIPTION OF PROPOSED WORK (check all appIiabIeJ New House CD AdditionReplacement Windows Alteration(s) Roofing El Or boors ISE1 El Accessory Bldg. �� Demolition New Signs DzI] Decks [[� Siding [CD] Other [0] Brief Deaoiphgp,ofpm^^o`d /l / Work: u 4 �,, ^-� �m * - a^ °w! v w ��/�*�/ p� � ' `�~°m� �� Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basernent Yes No Plans Attached R0H - Sheet -- __- _ __ _. __-____-_--___- _ -_'n-: a. Use of buudirig: One Family Two Family Other b. Number of room 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. Masscheck Energy Compliance fomi attached? h. Type of construction i Is construction within 100 ft. ofwetlands? Yes No. Is construction within 100 yr. floodplain Yes No j. Depth of basement or cellar floor below flnished grade k. Will building conform to the Building and Zoning regulations? Yes No. I. Septic Tapk City Sewer Private well City water Supply CONTRACTOR APPLIES FOR BUILDING PERMIT 7 1 en Tas\n , as Owner of the subject property hereby authorize \ Yrokoc.V5 Tine. . to act on my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date r. g ilk r PrOlur , . , . Owner/Authorized Agent hereby declare that the statements nd information on the foregoing application are true and accurate, to the best of my knowledge and belief. Signed under the pains and penalties of perjury. Print Na t c, tti Kts., • Signature of Owner/Agent Date i Section 4. ZONING All 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 W . _, Setbacks Front Side L.,......_.... -j R :�,_._V.,.µ L !_...._..._ R ....,_......m i Rear __. _,_ _... Building Height Bldg. Square Footage i % Open Space Footage (Lot area minus bldg & paved parking) # of Parking Spaces Fill:.za ; M .._ (volume & Location) _ «._,,,w. _ _ ,_ A. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO 0 DONT KNOW 0 YES IF YES, date issued:; IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW 0 YES 0 IF YES: enter Book i Pagel and /or Document #����' B. Does the site contain a brook, body of water or wetlands? NO 0 DONT KNOW 0 YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained 0 , Date Issued: C. Do any signs exist on the property? YES 0 NO Q IF YES, describe size, type and location: n ° �iWany prnpncecl rha ?s to nr _ lttnn5 o signs intern pr a`nr thP prrir tty 7 YFS 0 NO 0 IF YES, describe size, type and location: E. Will the construction activity disturb (clearing, grading, excavation, or filling) over 1 acre or is it part of a common plan that will disturb over 1 acre? YES 0 NO 0 IF YES, then a Northampton Storm Water Management Permit from the DPW is required. City of Northampton ,-Wil, f�em� i.r 'Building Department ,,� - �C)rit ewayr 5 4 212 Main Street sewe ) ,e t+�Avairial i�y Yriti g Northampton, MA 01060 T e' '' - ',= f °'ti T - . :, r 9 p I�e2.Q 3- 587 =1240 Fax 413- 587 -1272 P1 t #Iit - is t �� � 1 s , 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 I Map Lot Unit `.Zone Overlay District EIm.St. District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: T- � 1 I rtl - -- "f 5b-- _ - — -- _. q-- P'a_S, eci Cour /inr t MA Name (Print) Current Mailing A dress: (`L O /l � / 0/060 'fie si r)ed Cc�n - rac+ Telephone ` �O Z 11�.� T Signature 2.2 Authorized Agent: / � f e. ((aTCOCLCIS / InC . /SS lia, -? ,tiLrer / ( )Veen - h ell /A 61301 Name (Pri V 1 Yk/l3� Current Mailing Address: NI 772 Signature TelephonL SECTION 3 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building # /6 c tJ ^ . • (a) Building "'Pemlit Fee ( - O n J W ��. l) 2. Electrical (b) Estimated Total Cost of . Construction from (6) 3. Plumbing _ Building Permit Fcc 4. Mechanical (HVAC) 5. Fire Protection 6. Total = (1 + 2 + 3 + 4 + 5) Check Number '5 S? 9 9 #35 — This Section For Offcial Use Only • Rate Building Permit Number: Issued: Signature: 1 Building Commissioner /Inspector of Buildings Date 4 PRbSPECT CT' I BP- 2010 -0681 GIS COMMONWEALTH OF MASSACHUSETTS . +r :Bioekt - 214 : 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 -0681 Protect # JS- 2010 - 000993 Est. Cost: $16000.00 Fee: $35.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: PELLA PRODUCTS, INC 091496 Lot Size(sq. ft.): 3615.48 Owner: TASH TIMOTHY C & MURIEL PINIER Zoning: URC(100)/ Applicant: PELLA PRODUCTS, INC AT: 4 PROSPECT CT Applicant Address: Phone: Insurance: 240 MOHAWK TRAIL (413) 772 -0153 WC GREENFIELDMA01301 ISSUED ON:1/20/2010 0:00:00 TO PERFORM THE FOLLOWING WORK: INSTALL 15 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: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occupancy Signature: FeeType: Date Paid: Amount: Building 1/20/2010 0:00:00 $35.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Building Commissioner - Anthony Patillo