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17C-247 (5) Town of Florence Inspector of Buildings office, Pella® Windows & Doors Ell Thank you for reviewing our building permit request for Valle Dwight located at 73 North Main St.... Please direct any questions or concerns, you may have to me, Lauri, at the Greenfield, MA retail showroom. All customer and project information is located in this particular office, therefore I will be able to answer any question or address any concerns there may be more efficiently. Thank you for your anticipated cooperation. Sincerely, Lauri-Ann Rice Pella Products Inc.. 240 Mohawk Trail Greenfield, MA 01301 Phone 413-774-7231 Fax 413-774-6348 240 Mohawk Trail Greenfield,MA 01301 VIEWED TO BE THE BEST.® Phone:413.774.7231 Fax:41 3.774.6348 01/18/2008 ' 16:24' 4137743872 MASS ONE INS PAGE 01/03 ACOR . CERTIFICATE OF LIABILITY INSURANCE I/ PRODUCER (413)773-9913 FAX: (413)774-3872 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION XamsOne Imaxtrance Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 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 INSURERA:Acadia Insurance Cqi!4pany 31325 P+alla Products, Inc. INSURER B: ATTN: John Sen j=in INSURER C: 155 Main Street INSURED D: Greenfield MA, 01301 INSURER E; 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, A L12M.MAY HAVE BEE D P INSR AOD'L POLICY EPPECTtVE POLICY EXPIRATION TYPE OF INSURANCE POLICY NuMBSR DATE MMfoom DATe MM/DpIYY LIMITS GENERAL.LIABILITY $ 1,000,000 COMMERCIAL GENERAL LIABILITY DAMAGE TO oENTED $ 250,000 A CLAIMgMADE EOCCUR CPA0204'70111 7./1/2008 1/1/2009 MEDEXP ZAAv i;IMA $ 10,000 y 1,000,000 -- _0511406LAMIRECATE $ 2,000,000 GEN'LAGGRFGATE LIMIT APPLIES PER a 2,000,000 POLICY X PRO E LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 ANY AUTO (Ee ecddent) A ALL OWNED AUTOS MAA020470211 1/1/2003 1/1/2009 BODILY INJURY � 3CHEDULEDAUT05 [per person) $ X HIRED AUTOS BODILY INJURY x NON-OWNEDAUTpS (Per accident) – .— PROPERTY DAMAGE 5 (Per accident) GARAGE LIABILITY AUTO ONLY-EAACCFDENT $ ANY AUTO OTHERTHAN $ AUTO ONLY: AGG S EXCESWUM13RELLA LIABILITY S OCCUR El CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE S A WORKERS COMPENSATION AND R C STATU- I OTH. EMPLOYERS'LIABILITY ANY PROPRIETaRfPARTNER/EXECUTIVE E.L.EACH ACCIDENT _500,000 OFFICER/MEMSEREXCLUDEOT RCA020470511 1/1/2008 1/1/2009 E.L.DISEASE-EAEMP Y $ 500,000 If Yes,describe under SPECIAL PROVISIONS E.L.DI En E•P 1 a 500,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSrM£NTISPECIAL PROVISIONS Operations usual tO the Sale & installation of doors & windows CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Valle Dwight EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 73 North Maid Street 1-0 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT Florence, MA 01062 FAILURE TO 00 S0$HALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVE$, AUTHORIZED REPRESENTATVE y� ? ACORD 25(2001108) @ ACORD CORPOAATION 1988 INS025 piaepas P$gs I oil The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ' 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): { Address: 5 0 Ck- / City/State/Zip: l`° ,..f i' i E- t I C ��!� >Il!::�c 1 Phone #: ► 1 -C_ 1 `�1 Are you in employer?Check the appropriate box: Type of project(required): 1.❑"I am a employer with � '=j 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. t 7. ORemodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.0 Plumbing repairs or additions myself. [No workers' comp. c. 152, 51(4), and we have no 12.F-1 Roof repairs insurance required.] t 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. TContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. t Insurance Company Name: C_CA, [1S tL(tC ( Co Policy#or Self-ins. Lic. #: LX i C, - r}��..� _ L�c�-� C� `�� \ Expiration Date: OI C, t Job Site Address: [--n , r�_l l T C_ C -F,r' -�� 1 City/State/Zip: 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 sins and p nalties of perjury that the information provided above is true and correct. Signature: �,>' .t( (..��-' Date: - '- 0 C _ Phone#: Official use only. Do not write in this area,to be completed by city or town official. 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#: Y�t 11111' 0 1 Board of Building Regulations and Standards ids One Ashburton Place - �- Room 1301 Boston, Massachusetts 02108 Home Improvement Contractor Registration Registration: 142279 PELLA PRODUCTS, INC. Type: Private Corporation Expiration: 3/24/2008 GARY SI-IERMAN _ 155 MAIN STREET ----- _ GREENFIELD, MA 01301 t> scrA oqro -PcEic,se Update Address and return card.Nlark reason for change. Address U — _ _. Renewal _ Lost Card / ..._..imp oyment `/'b ��CYJ/l7YGO97,lC4;CY!`I Of��i/ L-1 �� hoard of Building]tcgulalions and Standards HOME IMPROVEMENT CONTRACTOR License or registration valid for individul use only f before the expiration date. If found return to: 1,12279 Board of Building Regulations and Standards _ .: � Registration; Expiration: 3/24/2008 One Ashburton Place Rm 1301 Type: Private Corporation Boston,iyla. 02108 'ELLA PRODUCTS, INC. .GARY SHERMAN 55 MAIN MAO ,REENFIELDLD, 1301 Admiuish'utor Not valid thout signaturc �, :��rie Ca-»c/icurcu�eczll� a�;Gl,��/�./ivael�J Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: -_ Registration: 142279 Board of Building Regulations and Standards Expiration: 3/24/2008 One Ashburton Place Rm 1301 Type: Supplement Card Boston,Ma.02108 PELLA PRODUCTS, INC. PAUL PICARD 155 MAIN STREET GREENFIELD, MA 01301 " cf%� Adminisnator Not valid without signature i`. Pella Windows & Doors t— if -e- M A or 4 �vYa J k?_ r ri, u� v c� C Subject: Disposal of Debris i The purpose of this letter is to certify that all debris from any project undertaken by Pella Products, hic. in Berkshire and Franklin counties will be transported to a dumpster at our plain facility at 155 Main Street, Greenfield, MA. Pella Products„ Inc. is Linder contact with Waste Management of Massachusetts for the disposal of the contents of this dumpster. I Very truly yours, PELLA PRODUCTS, INC. i ; Contract for Customer Dwight, Val Project: Dwight, Valle Order No: Outside View Item QtY Description Vnit Price JExtende d Item#65 Qty: 1 Winter promotion (995.00) (995.00) Location: Picture Not Available Notes: Thank You For purchasing Pella pr©ducts 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 drawings 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 cannot 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 accountant fees for collecting outstanding accounts. The Buyer agrees that the need 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 delivered 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 product(s) delivered, including hardware. If the Buyer does not provide notice within 7 days the Buyer accepts the produ�t(s) as is. -__-- Taxable Subtotal $4,487.51 Custo er Signature I a Sales entative Signature MA at 5.00% 224.38 None at 0.00% 0.00 None at 0.00% 0.00 / Non-taxable Subtotal 1,625.00 l � Total $ 6,336.89 Date Date Deposit Received $0.00 Contract-Page 4 of 5 Office Order Copy ' PELLA PRODUCTS, INC. 240 MOHAWK TRAIL GREENFIELD, MA. 01301 Phone: (413)774-7231 Fax: (413)774-6348 --_ /_���!'� Customer Project f Ship-To Carder Dwight,Valle Dwight,Valle Order No. 73938AP03I Order Date 01/09/2008 73 North Main Street 73 North Main Street Customer No. 53H5844165 Need Date 02/06/2008 Tax Code MA Sales Rep. Code 41 FLORENCE,MA 01062 FLORENCE,MA 01062 Taxable no Sales Rep.Name Picard,Paul(53)L. HAMPSHIRE HAMPSH Tax Exempt No. Window Store 000003 Terms Code C.O.D. Territory Lic.No.: P.O.No.: Customer Type Ship To County HAMPSH MDR Code SP Prepared By Paul Valle Owner:Ms.Valle Dwight Overall Disent. 0.083 % Architect Name Bus. Phone: (413)584-4165 Bus. Phone: (413) 584-4165 Comm. Split 41: 100. % Dist. Order No. Bus. Fax: ( ) - Home Phone: Cellular: ( ) - Home Phone: ( ) - Delivery Instructions: : 91 S to exit 20. Right at light by Dana Auto,left on Hatfield Street,right on Locust(turns into N. Main Street). Go through center of Florence,house on fight before Look Park. Narrow Driveway. Comments: Project Manager notes state change hardware to satin nickel, but after conversation with homeowner regarding price difference, that hardware will remain champagne. +flu#side V" Item Qty.' DeseriPtion Unit 'rice ' Extended Item# 10 Qty: 2 Vent-DH Standard Jambliner Precision Fit Window,Make Size:27 X 597.36 1,19=1.72 Location: Kitchen 52-1/2:Architect Series, Clad,Model 3, White, Half Vent/match Half Vent, 0.00 0.00 R.O: 2' 3-1/2" X 4' 5" 5/8" InsulShld IG Glazing,Full Screen. Champagne Hardware, 3/4" REM 597.36 1,194.72 Traditional Grille( Grille Lites Wide=03, Grille Lites High Upper Sash=02, 0.000% Grille Lites High Lower Sash=02 > Notes: Office Order Copy-Page 1 of 5 780 CMR: STATE BOARD OF BUILDING REGULATIONS AND STANDARDS THE MASSACHUSETTS STATE BUILDING CODE Si nature Telephone 3,2 R2egistered Home Improvement Contractor: Not Applicable ❑ 11(c I)fc�CAuc_ Company Name Registration Number Address Expiration Date Signature Telephone Ll 7 1 53 780 CM[R: STATE BOARD OF BUILDING REGULATIONS AND STANDARDS APPENDIX B SECTION 4-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...... ❑ SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New Construction ❑ Existing Building ❑ Repair(ss)/ 11 Alteration(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other M Specify: Brief Description of Proposed Work: SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant 1. Building (a)Building Permit Fee Multiplier 2. Electrical (b)Estimated Total Cost of Construction from 6 3. Plumbing 4. Mechanical(HVAC) Building Permit Fee 5. Fire Protection (a)x(b) 6. Total=0 +2+3+4+5) Check Number SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT as Owner of the subject property hereby authorize to act on my behalf,in all matters relative to work authorized by this building permit application. Signature of Owner Date a WIN 11111101:144 W-A.ZM 11611 h C i 5'S Male) 64 -_6 d i 7 A as Owner/Authorized Agent hereby declare that the statements and information on the foregoing application arekrue and accurate,to the best of my knowledge and belief. 780 C1tiIR: STATE BOARD OF BUILDING REGULATIONS AND STANDARDS APPENDIX B ti s The Commonwealth of Massachusetts State Board of Building Regulations and , Standards Massachusetts State Building Code 780 CMR FOR MUNICIPALITY APPLICATION TO CONSTRUCT,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING This Section For Official Use Only Building Permit Number: Date Issued: Signature: Building Commissioner/Inspector of Buildings Date SECTION 1 -SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Number: 1 0 r i'tiIL n �� 01A A Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(so 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 ❑ Zone: Outside Flood Zone ❑ Municipal ❑ On site disposal system❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner Jof Record: J Name(Print) Address for Service: cif Signature Telephone 2.2 Authorized Agent: OctLt_cn Name P Address for Service: Signature Telephone // L 73 NORTH MAIN ST BP-2008-0663 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 17C-247 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Cate<ory: BUILDING PERMIT Permit# BP-2008-0663 Project# JS-2008-001011 Est. Cost: $6337.00 Fee: $25.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: PELLA PRODUCTS, INC 142279 L,ot Size(sq.ft.): 19819.80 Owner: O'DONOGHUE PHILIP C& Zoning: URB Applicant: PELLA PRODUCTS, INC AT: 73 NORTH MAIN ST Applicant Address: Phone: Insurance: 240 MOHAWK TRAIL (413) 772-0153 WC GREENFIELDMA01301 ISSUED ON.112412008 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: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occupant Sillnature: FeeType: Date Paid: Amount: Building 1/24/2008 0:00:00 $25.0028915 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo BP-2008-0663 CIS#: COMMONWEALTH OF MASSACHUSETTS CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS I'ernut: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Cate,f,yory: BUILDING PERMIT Permit# BP-2008-0663 Project# JS-2008-001011 Est. Cost: $6337.00 rce: $)2x.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: PELLA PRODUCTS, INC 142279 Lot Size(sq. ft.): 19819.80 Owner: O'DONOGHUE PHILIP C& 7,onin : URB Applicant: PELLA PRODUCTS, INC AT. 73 NORTH MAIN ST Applicant Address: Phone: Insurance: 240 MOHAWK TRAIL (413) 772-0153 WC GREENFIELDMA01301 ISSUED ON:112412008 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: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occupancy Sil4nature: FeeType: Date Paid: Amount: Building 1/24/2008 0:00:00 $25.0028915 212 Main Street,Phone(413) 587-1240,Fax: (413) 587-1272 Building Commissioner-Anthony Patillo