29-040 (2) 67 PIONEER KNLS BP-2017-0374
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 29-040 CITY OF NORTHAMPTON
Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: Door Replacement BUILDING PERMIT
Permit# BP-2017-0374
Project# JS-2017-000617
Est. Cost:$6370.00
Fee: $40.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Grouo: PELLA PRODUCTS, INC 096558
Lot Siae(sq. ft.): 11979.00 Owner: MAHAR MICHAEL J JR&ALICE L
Zoninv: Applicant: PELLA PRODUCTS, INC
AT: 67 PIONEER KNLS
Applicant Address: Phone: Insurance:
155 MAIN ST (413) 772-0153 Liability
G R E E N F I E L D M A01301 ISSUED ON:9/20/2016 0:00:00
TO PERFORM THE FOLLOWING WORK:REPLACING 1 SIDING DOOR USING EXISTING
OPENING - NO CHANGES TO STRUCTURE
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 9/20/2016 0:00:00 $40.00
212 Main Street, Phone(413)587-1240,Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
File#BP-2017-0374
APPLICANT/CONTACT PERSON PELLA PRODUCTS, INC
ADDRESS/PHONE 155 MAIN ST GREENFIELD (413)772-0153
PROPERTY LOCATION 67 PIONEER KNLS
MAP 29 PARCEL 040 001 ZONE
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT ^ Q y
Fee Paid C # �I S�U� Z/19
BuildinePermit Filled out ,/ (�� `� /(/
Fee Paid
TvoeofConstruction: REPLACING 1 SIDING DOOR USING EXISTING OPENING -NO CHANGES TO
STRUCTURE
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 096558
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION PRESENTED:
Ipproved Additional permits required(see below)
PLANNING BOARD PERMIT REQUIRED UNDER:§
Intermediate Project: Site Plan AND/OR Special Pennit With Site Plan
Major Project: Site Plan AND/OR Special Permit With Site Plan
ZONING BOARD PERMIT REQUIRED UNDER: §
Finding Special Permit Variance*
Received&Recorded at Registry of Deeds Proof Enclosed
Other Permits Required:
Curb Cut from DPW Water Availability Sewer Availability
Septic Approval Board of Health Well Water Potability Board of Health
Permit from Conservation Commission Permit from CB Architecture Committee
Permit from Elm Street Commission Permit DPW Storm Water Management
Demolitiol yn
Signa - :uild ng-a Ida Date
Note: Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning
requirements and obtain all required permits from Board of Health,Conservation Commission,Department
of public works and other applicable permit granting authorities.
*Variances are granted only to those applicants who meet the strict standards of MGL 40A. Contact Office of
Planning&Development for more information.
,....---,*---2::::)r, City of Northampton/fOrerie I"r ':;
r,r�- Building Departmentilk ,
`�pg'���6� 212 Main Street ( -
a Room 100
< <rs No hampton, MA 01060 Y 5
0Eitvirpp� eli .a . -587-1240 Fax413-587-1272 "�r ,.
APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION
1.1 Property�lAddress: "` « F x `tlo0 d tPmpleted by Office
6 t �t�Pcr 'Crib g4 `z r _. Unit
}Itrrent/4 ev-° G/Oka. •r *r z " bvenaypietrlct
cy�tea' •i s t
k+fbita.:4t CS District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
Ala m-, ni !�hm,- (0 / ?, 0nrer Kr1)5 :/Ore nip
N rint) Curenf aAin dress:- CrX.1W'•st
Telephone
Sig ure
2.2 Authorized Agent
Name(P -4 "-� Current Mailing Address:
Signureat /rmoi — r Telephone
SECTION 3•ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building (a)Building Permit Fee
2. Electrical (b)Estimated Total Cost of
.__..._..,_ Construction from(6)
3. Plumbing Building Permit Fee
4, Mechanical(HVAC)
.,---
5, Fire Protection pgy tel
6. Total=(1 +2+3+4+5) (,p ,3'70, Check Number 5 tt AR { V
Thts Section For Official Use Only
Building Permit Number - Date
Dated:
Signature:
Building Commissioner/Inspector of Buildings Date
Section 4. ZONING AU Information Must Be Completed.Permit Can Be Dented Due To Incomplete Information
_ ® Required Zon
OM
Tis coleusby m be tnkd ing in by
Building ikpanmenv
IMEMEllaMgal
MIIIIIENIMEMENEW
Setbacks Front ET1 = "TT]
Side L:LIIJ R:Li L:C�K:t EL r=
Rear C FE] C11
MEM Ell ELI MOM
liagiliaMilliffinalMIMMIIIIIIIMIIII
Open Space Footage C 1-1(Lot arra minus bldg,@ paved
-_-IIIIIIIIIINIIMISIMMEMNIMMIMIj
-----__.....__._l
A. Has a Special permit/Variance/Findi ever been issued for/on the site?
NO 0 DONT KNOW YES 0
IF YES, date issued:f 1
IF YES: Was the permit recorded at the Registry of Deeds?
NO Q DONT KNOW Q YES Q
IF YES: enter Book Page 1 and/or Document F
B. Does the site contain a brook, body of water or wetlands? NO 0 DONT KNOW Q YES Q
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Q Obtained Q , Date Issued
C. Do any signs exist on the property? YES Q NO 0
IF YES, describe size, type and Location: '
D. Are there any proposed changes to or additions of signs intended for the property? YES Q NO ei
IF YES, describe size, type and location:
E. Will the construction activity disturb(clearing,grading ex vation,or filling)over I acre or is it part of a common plan
that will disturb over I acre? YES Q NO
IF YES, then a Northampton Storm Water Management Permit from the DPW is required.
SECTION.5-DESCRIPTION OF PROPOSED WORK(check all applicable)
New House 0 Addition ❑ Replacemen ndows Alteration(s) n Roofing U
Or Doors „}�9Q
Accessory Bldg. ❑ Demolition ❑ New Signs [O] Decks IO Siding[0] Other[CJ]
' Brief Description of Proposed13�i4r4ny Sino:h ket,
Work: rep'v.rien5 15t•rl
. .ny dwe US,nj Rcts9';nj rvvnin5 A3 cist r, *)
E:'?Pair C. 33
Alteration of wasting bedroom Yes No Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll -Sheet
7qil,1'4 r`e61zf i . .i PI r 6 o S.,^ .- r Af^•-. n,n eY •1''f"::
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 stones?
if. Method of heating? Fireplaces or Woodstoves Number of each
g. Energy Conservation Compliance. Masscheck Energy Compliance form attached?
h. Type of construction
I 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.
f. Septic Tank City Sewer_ Private well City water Supply
SECTION Ta-OWNER AUTHORIZATION.TO BE.COMPLETEO WHEN
OWNERS.�AGENT OR COONW\"(�NTRACTOrtRAPPLES FOR BUILDING'PERMIT
{ 1
I, 1 � t `t 1 ' 'c , as Owner of the subject
property
hereby authorize - -3..LAkrr.., `-{2.t,;.etctj in-
t. .. .. my behalf,in all alters relative to work authorized by this building permit application.
,83)\,0_h,-.2 9/1li4 —
Signature of Omer Date
I,' t'. i't'r er sti4 ,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
Signegrr. •: the pains and •:nayias agory.
Punt Na• e
_-, /
Signature of Amer/Agent Date
SECTION 8-CONSTRUCTION SERVICES
11,1 Licensed Construction Supervisor: Not Applicable 0
Name of Lianas Holder:
License Number
a r _ mA �� l- a
Address -� Expiration Date
`
ted" I' `.. A773 t 157 x
re, ' Telephone
h' '`ttitt_eb:y.;1u3.:luY3eiwiisLyuli.cr t3.s,.. „-k.:i.;.. s-- r. -s,1.74s°; Not Applicable 0
1e �c rc� I.r is s nr 1
Company Name Registration Number
I a . ti C--r- r/ it * : t
Address yfj Expiration Date
Telephone 172' Il.5-7
SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M,G I. c. 162,§26C(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 (}f. No 0
t f ' Ctititto S Si(<)t'.'
The current exemption for"homeowners"was extended to include Owner-occupied Dwellings of one(i) 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 act§
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
respqnsible for all such work performed under the buntline permit
As acting Construction Supervisor 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'Compensation) and Chapter 153(Liability of Employers to
Employees for injuries not resulting in Death)of the Massachusetts General Laws Annotated,you maybe 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
ACME)a CERTIFICATE OF LIABILITY INSURANCE DAlfMt2a e
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 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 Robin Sargent
Berkshire Insurance Group, Inc. NPHONa SII, (813)993-9913 I I NRI.Nivea-36'2
117 Main StreetDRno ES:rsargent@berkehireinsurancegroup.coon
INSURER(S)WORDING COVERAGE MK II_
Greenfield MA 01301 mown A Massachusetts Bay Insurance Co 22306
INSURED INSURER B:The Hanover Insurance Company 10212
Pella Products, Inc. INSURER C: — — — _
155 Main Street INSURER o:............__ ._. _..._
INSURER E:
Greenfield ' MA 01301 INSURERF: I
COVERAGES CERTIFICATE NUMBER:16GL,AL,HC 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.
MSR AOGC bUBR .. .... POLICY EFF POLICY ENP - ._. ..-- ..•
LTR TYPE OF INSURANCE UNDO ant POLICY NUMBER IMMIOQ/YVYf IMMNOIYYVYI Hun
X I COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000
DM*n -SEWS.E _..
A .__ _ CLAIASNADE X OC<IJR 1E4 occunenx}-_. $ 100,000
Zm19429R0204 1/1/2016 1/1/2017 MED EXP(Anyone person) $ 10,000
PERSONAL a ADV INJURY $ 1.000,000
GEN'L AGGREGATE LI Mn APPLIES PER: .GENERPL AGGREGATE $ 2,000,000
_ POLICY X Id CT M LOC 2 PRODUCTS'COMP/OP AGO S 2,000,000
.OTNER: $ --
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT 13 1,000,000
CO cueen0
'ANY AUTO BODILY INJURY(Per person) $
A (r AALL UTOSMED AUT(O$VLEO ADN939977004 1/1/2016 1/1/2017 I BODILY INJURY(Per accidert I
I S HBtEO AUTOS X A%N4OWNED FRO iAMAGE S _..........
LLJI
S
UMBRELLA UAB I OCCUR EACH OCCURRENCE ':5_
EXCESS LAB i CLAIMS-MADE I AGGREGATE I
_....... 1 .._ _.
DED L REGENDOwS I
WORKERSCOMPE.NSATION
AND EMPLOYERS'I.WY/H
RITY TH-
x PER$TAPLI' :.-. IqR
_ ._.. _._.
ANY PROPRIETOR/PARTNER/EXECUTIVEE.L.EACH ACCIDENT $ _ 5_00,000
NIA
OFFICER/MEMBER EXCLUDED? N wm99399766 1 1
B Mandatory In NH) / /2016 1/1/2017 E.L.DISEASE-EA EMPLOYEE $ 5001000_
DE$ eiJbe OERAT10NSbeow
EL.DISEASE-POLICY LIAfiT S 500.000
1.1
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (AGGRO 101,AddlOonel Remste Schedule.may be attached M more space la require)
Operations venal to the sales and installation of doors and windows.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Town of Florence (Northampton) THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Building Commissioner's Office, ACCORDANCE WITH THE POLICY PROVISIONS,
212 Main St
Northampton, MA 01060 AUTHORIZED REPRESENTATIVE
Robin Sargent/ROE � . --42:41•7e-1—
1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD
INS026(201401)
The Commonwealth of Massachusetts
Department ofIndustrial Accidents
1--- Z Congress Street,Suite 100
• - S I, Boston,MA 0211 4-2 01 7
,s ypc- www.massgov/dia
Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers.
TO BE EU.FD WITH THE PERMITTING AUTHORITY.
Applicant Information Please Print Legibly
Name(R s nossfOrganizatio&lndividua05 Pella Products,Inc.
Address: 155 Main Street
City/State/Zip: Greenfield, MA. 01301 Phone i#:413-772-0153
Art you an employer?Check the appropriate box: Type of project(required):
i,CD I am a employer with 49 employees(fag eodbr pandme)* 7. 0 New construction
2. t am a sole thimi etor or partnership and have noemployees workingfor nth in r,�
�an capacity. 8. t.!Remodeling
Y p 7'.No workers'comp.insurance required.] �t
cram n homeowner doing all work myself.[No workers'comp.insumncc required]r 9. 1-,)Demolition
4.01 am a homeowner and will be hiring contractors re conduct all work on my ptapcny. I will 10 Q Building additioncontractors
ensure that all contractors either have workers'compensation insurance or ore sole I1.E]Electrical repairs or additions
proprietors with no employees.
12.0 Plumbing repairs or additions
5 Q 1 am a gunned contractor and]have hired die sub-contractors listed on 11w attached sheet.
These sib-contractors have employees and have workers'comp.insurance,: I3,QRoo{r¢pa1r5
6.0 Wc are corporation and its officers have CCOSCiStii their eight ofewomption per MCIL c 14.042her
154,§1(4d and we have no employees.No workers'coop-insurance required]
"Any applicant that checks box/01 must also fill out the section below showing their workers'compensation policy intonwtivn.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contmctots must submit a new affidavit indicating such,
:Connectors that chock this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have
employees. tithesub contractors have employees,they must provide their workers'camp.policy toothed'.
lam an employer that is providing workers'compensation insurance for my employees. Below is the policy and Job site
information.
Insurance Company Name: Hanover Insurance Group
Fahey#or Self-ins.Lie.# WON-9399766:04 OI Ai-2017
} Expiration Date:
Job Site Address: la ? ?it-in-err K 15 City/State/Zip, rig:^Pn Ce IYlf 0 'ItF:aa-
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to SI,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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance
coverage verification.
I do hereby,certify ander the pains and penalties ofperjury that the information provided above is trete and correct
Si¢nalure: "e al's - Q--C_. Date: 9/61/ ...
Phone#: Above
Official use only. Do not write in this area,to be completed by city or town official.
City or Town: Permit/Llcense# _
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector S.Numbing Inspector
6.Other
Contact Person: Phone#:
PELLA RODUCTSS, INC.
155 MAIN STREET
GREENFIELD, M.A. 01301
Date: %,(p1f(,
Subject: - Disposal of Debris
The purpose of this letter is to certify that nTI debris from any project
undertaken by Pella Products, be. 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
Debris 06-17.14 dam
Pella Products, Inc.
155 Main Street
Greenfield, MA 01301
Phone:413-772-0153
Cell:413-8344799
To: Building Inspector
From: Trevor Bross—Installation Manager
Date: February 23,2016
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 RIC# 182150. Please find a copy of my licenses below.
9 Massachusetts Department of Public Safety Canstruttion Supervisor
Board of Building Regulations and Standards ConstnMd to:
License: CS-oasssa Unrest:dod-Buildings of any use group which contain
dos utrn Supennsor � " less than 35,000 cubic feet(991 cubic meters)of
eacbsed apace.
TREVOR BROSS
1oEEORGESMA 01oGENFIELOMA 0ET yy
`f.✓v� 41,rFailure to possess a current edition of the Massachusetts
iiiiOn" Or
dm^nssrc^er State Building Code is cause for revocalion of this license.
uomoia
' - .. _.g.,_. ... DPS Licensing information visit:wW W.MASS.GOVIDFS
r 77e T., .tie tc,vtveni ll /1:;../r,:..L4
�- Ike atCansmatrAffiha&Eesinea Regafa5oo License or to izttation undid far indrvbiul only
6 DME lMPROYEMENTL"ONTRACTOR. before the mptretion dots_ If found return to:
Registration: Once e£Consenter Affairs and Business Regulation
�•�1.,,.;i: 9 142279 type: 10 Partials=-Suite 5170
'+_" Expiration arzusois Suppement Card Boston,MA 021I6
PEIlA PRODUCTS.INC.
TREVOR BROSS ---fr
155 MAIN STREETS
GREENFIELD,MA 01301 — Not valid without signature
Usderscretary
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:
Willard Brown CS106010 Vladimir Shevchuk CS5L099209
Scott Bowdish CSSL100232 Curt Boyle CS78514
Dave Rufther C857308 Bill Leger CS89338
Chris Gamache CS86946 Brian Thompson CS67121
Andy Kimball CS85981 John Joy CS004599
If you have any question,please contact me using the numbers listed above.
1\DATAFILEStShared13NSTALLATIONiPiictms\CSL scanslCSL-.Designees 2015v1.5oc
Contract - Detailed
ram
Pella Window and Door Showroom of Greenfield
240 Mohawk Trail Sales Rep Name: Lukomski, Adam
Sales Rep Phone: (413) 335-3237
Greenfield, MA 01301-3209 Sales Rep Fax: 413-774-6348
Phone: (413)774-7231 Fax: (413) 774-6348 Sales Rep E-Mail: alukomski@184.pellapdsn.com
Customer Information Project/DeliveryAddress Order Information
Alice Mahar Mahar Alice 67 Pioneer Knls Florence MA Quote Name: 1775577 Architect Series 413-584-3068
67 Pioneer Knls 67 Pioneer Knls
Order Number: 739P2JL031
FLORENCE,MA 01062-3412 Lot# Quote Number: 8189380
Primary Phone:(413)5843068 FLORENCE,MA 01062-3412 Order Type: Installed Sales
Mobile Phone: County: HAMPSHIRE Payment Terms: C.O.D.
Fax Number: Tax Code: MASS
E-Mail: Quoted Date: 8/23/2016
Great Plains#: 53H5843066
Customer Number: 1008076145 S ;La If 1.0 / 7b/!6
Customer Account: 1003978881
For more information regarding the finishing, maintenance,service and warranty of all Pella®products,visit the Pella®website at www.pella.com
Drntod ornanta r,.,,4..,M n,d-,;I,,. -_
Customer Michael&Alice Mahar Project Name: Mahar,Michael&Alice,1775577 Order Number: 739 Quote Number 8189380
Line Location: Attributes
10 Site Responsibilities Item Price Qty Ext'd Price
$0.00 1 $000
Customer Notes: HOMEOWNER-FOR YOUR INFORMATION LEGAL CONTRACT REQUIREMENTS FOR HOME IMPROVEMENT
CONTRACTORS IS DETAILED BELOW
THIS SITE RESPONSIBILITIES FORM IS PART OF YOUR CONTRACT WITH PELLA PRODUCTS INC.
155 MAIN STREET,GREENFIELD, MA 01301
HOME IMPROVEMENT CONTRACTOR REGISTRATION#142279 EXP.3-24-16 FEDERAL TAX ID#: 04-2303271
The law requires the following fourteen items to be included in any contract between the homeowner and a registered home
improvement contractor in all contracts for home improvement work subject to MGL c 142A
1. The complete agreement between the owner and a clear descdption of any other documents which are part of the agreement,
2. The full names,federal ID,addresses(not PO box#'s)of the parties,the contractors registration number,the names(s)of the
sales person(s))involved,if any and the date the contract was executed by the parties
3. The date on which the work is scheduled to begin and the date the work is scheduled to be substantially complete,
4. A detailed description of the work to be done and the materials to be used.
5. The total amount agreed to be paid for the work to be performed under the contract.
6. A time schedule of payments to be made under the contract and the amount of each payment stated in dollars,including all
finance charges,if any. My deposit required to be pad in advance of the start of the work shall not exceed one-third of the total
contract price or the actual cost of any material or egfipment of a special order or custom made nature,which must be ordered in
advance of the start of the work to assure that the project will proceed on schedule.No final payment shall be demanded until the
contract is completed to the satisfaction of all parties.
7. All parties must sign the contract.
8. There shall be a clear and conspicuous notice stating;
a. That all Home Improvement Contractors shall be registered and that any inquiries about a contractor or subcontractor relating to
a registration should be directed to,
Registrafion Division,Program Coordinator
One Ashburton Place S Room 1301
Boston,MA 02108
617-727-3200 x 25239
b. The contractors registration number must be on the first page of the contract,
c. The homeowners three day cancellation rights under MGL c93s48; NGK c 140D s 10or MGL c255D s 14 as may be applicable.
d. All warranties on the owners rights under the provisions of 780 CMRR6 and MGL c 142A
e. In ten point bold type or larger, directly above the space provided for the signature, the fdlcwing statement;
DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES
f. Whether any lien or seventy interest is on the residence as a consequence of the contract
9. An enumeration of such other matters upon which the owner and contractor may lawfully agree.
10. Any other provisions otherwise required by the applicable laws of the Commonwealth
11, Permit Notice:Every contract shall contain a clause informing the owner of thefollowing;
a. and all necessary construction related permits
b, that it shall be the obligation of the contractor to obtain such permits as the owners agent
c. that the owners who secure their own construction related permits or deal with unregistered contractors shall be excluded from
access to the Guarantee Fund.
12. Acceleration of payment: No contract shall contain an acceleration clause under which any pad or all of the balance not yet due
Gnr mora information regardingthe finishing, maintenance,service and Warranty of all Pella®products,visit the Pella®website at www.bells.con,
Customer Michael 8,Ake Mahar Projed Name: Mahar,Michael 8 Alice,17755/7 Order Number: 739 Quote Number: 8189380
may be declared die and payable because the holder deems himself to be insecure. However,where the contractor deems himself
to he insecure he may require asa prerequisite to continuing said work that the balance funds due under the contract,which are in
possession of the owner, shall be placed in a pint escrow account requiring the signatires of the home Improvement contractor and
the owner fa withdrawal.
13. No wry*shall begin for to he signing of thecontract and transmittal to the owner of a copy of such contract.
14. Arbitration: If the contractordetemlines that in the event of a dispute,the contractor wishes the dispute to be settled by
arbitration,tris factmustbe sign[ied on the contract and both the contractor ard owner shall sign this clause separately. The
contractor and the homeowner herebymutualy agree in advance that in the event that the contractor has a dispute concerning this
contract,the contractor may submit such dispute to a private arbitration service which has been approved by the Office of Consumer
Affairs and Business Regulation and the consumer shall be required to submit to such arbitration as provided in MGL c 142A
Owner:
Contractor:
Notice: The signatures of the parties above apply only to the agreementof the parties to alternate dispute resolution initiated by the
contractor. The owner may initiate alternative dispute resolution even where this section is not signed separately by the parties.
Site Responsibilities
1. 50%Deposit required at time of order.
2. Final payment isto be made to installation team on the morning of the last day of installation.
3. If the customer will not be present at time of install,payment is to be made prior.
4. Checks returned NSF will be assessed a fee of$50.00 to cover fees incurred by Pella. Failure to pay your final bill will result in
finance charges of 1-1/2%per month(18%Annual)and legal fees assodated in the collection of owed monies.
5. Due to inclement weather orsite conditions, it may be necessary to reschedule,
6. We cannot and will not guarantee specific dates or days of the week for installation.
7. Time given to complete a job is an estimate,extension of time is possible.
8. An install appointment will be confused at Verification. A courtesy reminder call will be placed l weekprior.
9. Unforeseen rot repair will be quoted on site as additional work via a Change Order.Rot repair or additional installation charges are
due at the time of installation and cannot be financed through Wells Fargo, Check or Credt Card Payments only.
10. Substantial completion is achieved when all available products have been installed and are operational. Items such as missing
or broken parts and service adjustments are covered by Warranty and do not affect the status of a project from being Substantially
Complete.
11. In the event that any products are unable to be installed,the final payment will be recalculated. The cost of the products not
installed will be subtracted from the balance due. A subsequent aid final payment equal to the cost of products not installed as
scheduled will be due upon final completion.
12. Order is not birding until approved by Pella Products management.
13. Pella will secure all necessary Building Permits.
14.We will not guarantee that existing window treahnents(i.e. Shades, Blinds,and Interior Shutters)will lit on new Pella
Windows/Doors.
Type of Installation:
-New Construction: (tear out installation-existing frame is disposed of)
- - •--- earcirc and warranty of all Pella®products,visit the Pella®website at www.pella.com
Customer:Michael&Ahce Mahar Project Name: Mahar,Michael 8 Alice,1775577 Oder Number: 739 Quote Number: 8189380
>4/Remove interior and exterior Trim,remove existing window frame,install new window in rough opening,trim both interior and
exterior of window/door,
Pocket Install: (sash replacement,existing frame remains)
_Remove interior or exteriorstops,install new window h existing sash opening,re-use existing or replace window stops(ulterior
or exterior). Glass bss will occur.
Lead Paint Discloser:
1.S Home was built prior to 1978,Pre Renovation Form signed and"Protecting Your Family From Lead in Your Home'
brochure has been given to the Home Owner.
2. Are there children under the age of 6 or women vrho are peg im rt?
Pella Will Owner VW
Authorizeinstall of Yard Sign on lst day of installation and remove 7 days afterward
X Firth(pant or stain)product purchased: Trim will be painted by customer
X_ Ensure someone over age 18 is present atoll limes wile Pella Employees are in the home
_X_ Cul-back or tie trees,bushes,shrubs from exterior wall
X_ Arrange to have alarm system disconnected and reconnected-
Pella Products can re-route alarm wires but can not reconnect contacts
_X_ Arrange to have any plumbing or electrical repairs or changes by appropriate licensed contracts-
$500 charge for site unprepared on 1 day job
_X_ Remove and reinstall existing window treatments,wallhangingsandairconditioningunits-
` 4-5 feet in front l 1 foot to side with dear path
_X_ Remove and reposition furniture in work area
_X_ Secure pets in a safe manner
_X_ Remove valuable/breakable items from work area
_X_ Remove snow from area of worksite if necessary
_X_ Deliver and unload products
X Place drop cloths in work areas
_X_ Remove and reinstall interior and exterior trim if applicable
X_ Remove and reinstall existing shutters and awnings by contract
X Remove existing product and adjust or modfy opening as neecbd
X- Provide all equipment necessary to install products
X Cut all wood and other materials outside of home
X_ Install all products purchased
_X_ Insulate ad caulk around products
X_ Remove stickers and perform initial cleaning of all glass surfaces
_X_ Demonstrate proper operation of products
X Confirm that all products are n workng order
_X_ Remove drop cloths,vacuum and remove all old products from premises
Signature:\
--- -----•-..a, hinn maintenance. service and warranty of all Pella®products,visit the Pella®website at www.pella.com
Customer:Michael&Alice Mahar Project Name: Mahar,Michael&Alice,1775577 Order Number: 739 Quote Number: 8189360
Line# Location: Attributes
15 Pre-Finish Disclaimer tern Price Qty Ext'd Price
$0.00 1 $0.00
Customer Notes: PRE-FINISH DISCLAIMER
Stained and paint color samples are produced as accurately as possible:however,actual colors may vary from batch. Because
wood is a natural product,each window or door will display its own personality with regards to variation in color,texture and grain
pattern. Natural wood variations include disfinctive grain patterns or unusual shadings in color. Due to the nature of using natural
products, Pella Windows and Doors cannot be responsible for the actual degree of variation that may occur in your purchase.
Line# Location: Attributes
20 Kitchen Architect, Double Sliding Door, French,Vent Right I Fixed, 71.25 X 79.5,White item Price Qty End Price
$6,999.83 1 $6,999.83
1:MO Vent Right/Fixed Double Sliding Door
PK It FrameX
Size: 711/I 79 1/2
816 General Informatics: Standard,Clad,Plne,5 7/8",4 9/16'
Exterior Color/Finish: Standard Enduraclad,White
Interior Color I Finish: Golden Oak Stain Interior
Glass: Insulated Dual Tempered Low-E NaturalSun Low-E Insulating Glass Argon Non High Altitude
-- - --= Hardware Options: Black,Handle Included,Handle Included.Matte Black
Viewed From Exterior Screen: Rolscreena,Wood Wrapped
Grille: No Grille,
Wrapping Information: Foldout Fins, Factory Applied, No Exterior Trim, Ready Trim Knock Down,Colonial,2 1/2'Colonial 2, Factory Supplied,Knock
Down,Oak,Golden Oak Stain,5 5/16',6 5/81, Factory Applied, Pella Recommended Clearance, Perimeter Length=302",Glazing Pressure= 190.
Frame Size:71.25"X 795"
PD-1 -Patio Door Install up to 6 FT in width Qty 1
PDB-PD Exterior Aluminum Capping(Coll Stock) Qty 1
For m ore information regarding the finishing, maintenance, service and warranty of all Pella®products,visit the Pella®website at www.pelia.com
Customer:Michael&Alice Mahar Projed Name. Mahar,Michael&Alice,1775577 Order Number: 739 Quote Number: 8189380
EXTTRIMI4-Kick board,up to 6-1/2 Inch match ext trim PVC Qty 1
LP-1 -Lead sale practices this opening Qty 1
Line# Location: Attributes
25 Kitchen Wood Products 3112 Ranch 1,Length: 96, Natural Stain.Wood Type: Oak Item Price Qty Eitel Price
$54.22 1 $54.22
1: Accessory
PK# Frame Size: 1 X 1
` -"---� General Information: Oak,31/2 Ranch 1.._, -J 616 Interior Color/Finish: Natural Stain lnlerior
Wrapping Information: Perimeter Length=0".
Viewed From Exterior
Frame Size:0"X 0"
Line# Location: Attributes
30 Kitchen Wood Products 2112 Colonial 2, Length: 96, Golden Oak Stain.Wood Type: Oak Item Price Qty EXPd Price
$48.78 1 $48.78
1: Accessory
PK# Frame Size: I X I
General Information: Oak,2112 Colonel
. - , ,I 816 Interior Color/Finish: Golden Oak Stain Interior
Wrapping Information: Perimeter Length=tl'.
Viewed From Exterior
Frame Size:0"X 0"
Line# Location: Attributes
35 Building Permit BPC•Permit-subject to change if actual cost greater than shown Item Price Qty Ext'd Price
$65.00 1 $65 00
For more information regarding the finishing, maintenance, service and warranty of all Pella®products,visit the Pella®website at www.pella.com
Customer Michael&Alice Mahar Project Name: Mahar,Michael&Al ice,1775577 Order Number: 739 Quote Number: 8169380
[Line# Location: Attributes
40 DS16•G National Installation Promotion Item Price Qty Ext'd Price
($157.13) t ($157.13}
Line# Location: Attributes
45 DS16•G Local Product Promotion Item Price Qty Exfd Price
($925.00.} i ($928.00)
Thank You For Purchasing Pella® Products
PELLA WARRANTY'
Pella products are covered by Pella's limited warranties in effect at the time of sale. All applicable product warranties are incorporated into and become a part of this contract.
Please see the warranties for complete details,taking special note of the two important notice sections regarding installation of Pella products and proper management of moisture
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 RolKreen[or 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 eatcrior 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.
INSYNCTIVE PRODUCTS'. In addition,Pella Insynctive Products are covered by the Pella Insynctive Products Software License Agreement and Pella Insynctive Products
Privacy Policy in effect at the time of sale..which can be found at Insynctive.pella.com. By installing or using Your Insynctive Products you are acknowledging the Insynctive
Software Agreement and Privacy Policy are part of the terms of sale.
For more information regarding the finishing,maintenance,service and warranty of all Pella.products,visit the Pella®website at wvnv pella.com
nilnnmc r...r..M n,.r.,;I, I on,,,, 1 4 I
Customer:Michael&Alice Mahar Project Name: Mahar,Michael B Alice,1775577 Order Number: 739 Quote Number: 8189380
Product Performance Information,
U-Factor.Solar Heat Gain Coefficient(SHGC),and Visible Light Transmittance(VLT)are certified by the National Fenestration Rating Council(NFRC).Manufacturer stipulates
that these ratings conform to applicable NFRC procedures for determining whole product performance.NFRC ratings are determined for a fixed set of environmental conditions
and a specific product size. NFRC does not recommend any products and does not warrant the suitability of any product for any specific use.
Design Pressure(DP),Performance Class,and Performance Grade(PG)are certified by a third party organization,in many cases the Window and Door Manufacturers Association
(WDMA). The certification requires the performance of at least one product of the product line to be tested in accordance with the applicable performance standards and verified
by an independent party.The certification indicates that the product(s)of the product line passed the applicable tests.The certification does not apply to mulled and/or product
combinations unless noted. Actual product results will vary and change over the products life.
For more performance information along with information on Florida Product Approval System(FPAS)Number and Texas Dept.of Insurance(TDI)number go to r, L
Refer to Pella Corporate Warranty
This form constitutes a contract between Buyer and Seller.Estimate 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 oftake 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%SERVICECHARGE per month(ISO 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 I°"p 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 products(s)
delivered,including hardware. If the Buyer does not provide notice within 7 days the Buyer accepts the product(s)as is.
This sales agreement consists of and is subject to the Terms and Conditions set forth on subsequent pages of this document as well as the terms and conditions of the applicable Pella
Product Limited Warranties available at pella.com/warranty and Seller's Installation Limited Warranty and Service Agreement and Seller's Finish Limited Warranty(if Seller is
providing finishing services)and referred to collectively as the"Contract".Please read the entire Contract carefully before signing.Contract mast be signedwithin thirty(30)days of
Quoted Date for pricing to remain firm. Contract becomes binding only upon execution by Pella Products,Inc.("Seller")management.
Buyer understands the Total Care Guarantee isthe Seller's Installation Limited Warranty and Service Agreement and Pella Product limited Warranty(ies)(int.)
*Buyer(s)has received the Seller's Installation limited Warranty and Service Agreement for Pella Products/�-LeitspOnt, iV��
*Buyer(s)has received the Pella Product limited warranty or reviewed at pella.con✓warranty(int) vyv--•
Product is finished by Pella and the finish is covered as set forth in the Pella Product warranty(ini' Yroduct is not finished by Seller or Pella and Buyer(s)will undertake prompt finishing in
For m ore information regarding the finishing, maintenance,service and warranty of all Pella®products,visit the Pella®website at www.pella.com
Customer Michael&Alice Mahar Project Name: Mahar,Michael&AIice,1775577 Order Number: 739 Quote Number: 8189380
Lead Safe Installation Customer Performance Expectations
In order to ensure a proper Lead Safe Installation, it is essential that we have you complete the below tasks prior to your installation:
2ALL furniture needs to be moved at least 8 feet away from any window or door being replaced
2ALL personal items, wall hangings, and collectibles must be removed prior to your installation date
VAII blinds and any interior window treatments need to be removed prior to your installation date
b` Any non-movable furniture (for example: pianos, entertainment centers, built in cabinets, etc) must be cleared of items and be surface dusted prior
to installation
Ni You will be responsible for replacing all fumiture and personal items after your installation
E Other items:
What to Expect the Containment/Work Area to Look Like
In order to ensure your safety,we will be taking measures to minimize dust/debris does not spread beyond our work area. This may include the
use of plastic sheeting on the floors and/or walls, caution signs, sealing of heating and cooling air vents, and asking that you turn off your HVAC
system during our work.
121 >During your Lead Safe Installation, you may also see your installation professional wearing Personal Protection Equipment.
N/For your own safety,we are not permitted to allow you inside the work area during the removal of your current product or the installation of your new
windows/doors.
By signing the form below, I am affirming that I understand all the expectations noted above and that I have agreed to have all items completed prior to
my installation commencing. I understand that failure to have these items completed will result in the re-scheduling of my installation and that my
installation date will be scheduled for the next available date.
Customer Signature Date
c„r mnrp information regardingthe finishing, maintenance,service and warranty of all Pella®products,visit the Pella®website atvwrw.pella.com
Customer:Michael&Alice Mahar Project Name: Mahar,Michael&Alice,1775577 Order Number: 739 Quote Number: 8189380
accordance with applicable instructions(int.)
.'Project Checklist has been reviewed
•��4C L. ''j � LdA)wsin ; Order Totals
Customer Name (Please print) Pella Sales Rep Name
(Please omit Taxable Subtotal $4,596.83
�. fix. t1 �. / ,4Q2�+^-�`„' Sales Tax @ 6.25% $287.30
Customer Signature Pella Sales Rep Signature
Ce ( r ZUl b �`7 (j16 Non-taxable Subtotal $1,485.87
\ Total $6,370.00
oatE' Date Deposit Received $3,185.00
Amount Due $3,185.00
Credit Card Approval Signature
For more information regarding the finishing, maintenance, service and warranty of all Pella®products,visit the Pella®website at www.pella.com