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32C-079 (5) 10 WILSON AVE BP-2017-1319 GIS a: COMMONWEALTH OF MASSACHUSETTS Map:Block: 32C-079 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: windows replaced BUILDING PERMIT Permit# BP-2017-1319 Project# JS-2017-002184 Est.Cost: $12196.00 Fee: $40.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: PELLA PRODUCTS, INC 096558 Lot Size(sq.ft.): 5096.52 Owner: BARRY MICHAEL S& REBECCA L Zoning: URCOOOV Applicant: PELLA PRODUCTS, INC AT: 10 WILSON AVE Applicant Address: Phone: Insurance: 155 MAIN ST (413) 772-0153 WC GREENFIELDMA01301 ISSUED ON:S/15/2017 0:00:00 TO PERFORM THE FOLLOWING WORK:REPLACE 4 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: OI: 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 5/15/2017 0:00:00 $40.00 212 Main Street.Phone(413)587-1240, Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner C r l J $ Buty of ilding ildrn9 Departm ton Sit 212 Main Street Room 700 phone 413-587-1240 3587 1Pton, MA 01080 _. AP 1240 Fax 413-587-1272 PLICA TION 70 CONSTRUCT c �� ALTER,REPAIR,RENOVATE pERgOLISHA ONE OR iW0 FAMILY DWELLING 1 .50- 4VC 7' 3 ' LLiN �Or4l r" M rk.l3 , . '"`s'z;r rbrr ryvr x%,]JF r.It �7:iii:::,y .r'IF�teJ �s 2.7 Own . r `'2, .. P is s �' 1,x "•��F JFiirti? amu(Print) — a " t :tl l.7Ut XqE ; /L a -- . '►. $" attire }..x/i ' _2.2AUMoriz zL10 a I /34 6 4vc G y arra(Pen eMailing Address- .444' y l55 Alir �7-yi r9 41/ . /�j� .e / 1p p�rTi/ nEosmmrr• :fed b tetlb os•-frDmoit laars..)npo hnet r�- fur # , "� ,' 4 laila 5. tl Aof t h .! zr 4. Mechanical(HVAC) 1 Fn . 3i 7 s{ :TFire Protection y"� a� $ � 7-ta4-ICr• x • "am xt r dqSuirtlurpPe nk ' 'teeaSgnaf yat�. ;4e-kas.44±.541-tilL4 all r'9 -1 r";-nemrnuetm oet# �;^ t . , "' a Y Se,-1. Date Section 4. ZONING AU Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning This column to be filled in by rBuilding Department Lot Size L 1 Frontage Setbacks Front Side L: K: L: Lt�ar Building Height ' ij L_J Bldg.Square Footage Open Space Footage (Lot area minus bldg&paved pahing) #of Parking Spaces F Fill: (volume&Location) A. Has a Special Permit/Variance/Findin ever been issued forton the site? NO 0 DONT KNOW YES 0 IF YES, date issued:L IF YES: Was the permit recorded at theR Istry of Deeds? NO 0 DONT KNOW YES O IF YES: enter Book 1 Page j and/or Document B. Does the site contain a brook, body of water or wetlands? NO O DONT KNOW UJ' YES O IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained O Obtained O , Date Issued: L C. Do any signs exist on the property? YES 0 NO 6 IF YES, describe size, type and location; D. Are there any proposed changes to or additions of signs intended for the property? YES O NO es IF YES, describe size, type and location: [ E. WII the construction activity disturb(clearing,grading,ex vation, or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES © NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. rA' ^ ate=-4 :-_'a'...,???...-7„74-2. r,� ,.e,4,: [ rk'OVII a i0.10 )` ' fa7 ; 2IEi jd11.11A4 QTR' Ls aw t^' awn% s-w.°d''. .. ry; •t ..stssxMkk'a .4,,ust New House ❑ Addition 0 Repiacemen ndows Alteration(s) 0 Roofing 0 Or Doors j19 Accessory Bldg. 0 Demolition El New Signs [D] Decks [Ca Siding[0] Other[CO Brief Og criPtian of Proposg� dei Jdt s3s .9,'kcvAk, work: t Pnk ro Y 1 mina`.' . t.a,ci 'y314ins l I,05 Gan7A Pack mc, i Alteration of existing bedroom`Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet 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? 1. Method of heating? Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Masstheck 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. I. Septic Tank City Sewer Private well City water Supply _psaf tt / 't/iii:ir.t trOl ':F incl ......-r ,C Tlr#1 L4t,}. S.. fIC4IS 1- :f. e „�PRX 'I')mL1-ii-7:1,;51.) l tj(m ]in4r m .Z4Jt..,ti > i nn C^I'1n.- I ST. SsocY`y .as Owner of the subject Property hereby authorize ---f'..X..,S--Can. vP'tcru+.c' *TS inc . to act on my my behalf,in all matters relative to work authorized by this building pe it application, S1gnature of Owner Date MIIIIIIMIIIIIIIMIIIIIIIIMIIIMINIC- I, �el IC Pi cd0c t :2✓l C / 7o rw fr<,5 ,as Owner/Autnorized Agent hereby declare that the statementttss<r»°and 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. P untams � ^ t /31/7 J Date (( 1007th NeO'47O 8.1 Licensed Construction Supervisor: \ Not Applicable ❑ Name of License HoldeG 'f(r ruS CS-09 (LOSS License Number /() Oenvy S7 L—rec n e7`/ 7)/4' O/3/ 0320i !I Address Expiration Date II13 ` 9 .0iS3 . .a„ro '-� .,/..li.eine Not Applicable 0 Pet//— ?coc/0ra ._ii)tC )Vac'�7? Company Name //^I Registration Number /55949A-, S"J� t y-�� n/4 4 1/2;7,47 S/ 03J y fool2 Address - Expiration Date Telephone j3 . 77a ?Is:3 44,10,-;"4” 1 iti ;71,(na ill (•3 fI naa +k iz t.'I kL}f(i t 4 4 a=r+y"+ 'fa;q-tST try,. 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...... ❑ a l _ a L"fps •`� ft ..� •__ 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 789. Sixth Edition Section 108,3.5.1. Definition of Homeowner:Person(s)Mm 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 fano structures.A person who Constructs more than one home in a two-Wear period shall not be considered a homeowner, Such"homeowner"shall submit to the Budding Official,on a form acceptable to the Building Official that he/lshe shall be ;emulsible for all such work performed under the building 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 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 Northampton Ordinances,State and Local Zoning Laws and State of Massachusetts General Laws Annotated. Homeowner Signature Pella Products, Inc. 155 Main Street Greenfield, MA 01301 Office:413-772-0253 Cell:413-834-8799 To:Building inspector From: Trevor Bross—Installation Manager Date: February 223 2017 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 I-IIC#142279. Please find a copy of my licenses below. tConstruction supenSsor Board of y _ Restricted to LipMFC Unresta0 . t.. _ lass mann 36 36.W0 . . 3 x S v. t:o enclosed space. s b � ok'Th �:Olrinitiitbnel } Each installation will be staffed by our installers who are all licensed in accordance with current building codes. Below listed are our installers and their license numbers. Please accept these individuals as my designees. Willard Brown C5106010 Vladimir Shevchuk CS5L099209 Aaron Torres C5108472 Scott Bowdish 0551100232 Bill Leger CS89338 David Ruffner C557308 Brian Thompson CS67121 Ilya Katykhin CSFA106240 Igor Kravchuk CS094911 The Commonwealth of Marotelumetts i Dq arfweat of latlastrial Accidents e_ I Congress Street,Sour IX Boston,MA 02114-2017 www.lwasagow''a W.rtaa'c upcaaation la.arsaa Affidavit TO RR EKED VRIT THE PERMITTING AUTHORITY. Aooigat Idermatia. Play Paan I.r>,=. Name - : Pelta Pto leetkl lc. Address: 155 Main Steel City/SIatetZip: G,eerlfeld, MA 01301 Phone L 413-772-0153 Aa ass atom Chad Oa appTY 46 Type.tpraka2(sellare0 'EJIa..a7la,awar 48 —,J- -atraawaapeaa..l• 7. coostnearn Sna 701aasole pssapsa anthem mcaviares maim km io g-Rine-illy In meat IP undar an.int ;IJ as wo.aadaaa.�s,.a pla.'.tm coma asea�4i a 9- ❑Oanotitioo 401 maa Yaa_aad.a a Sag a pada, at a ay aaa,. 1.a 10 1:1[Wilding addition me Y anaafi=can tar tele'aremsm area ase Sc 11.❑Beancal lep.irs or additions ninon wit in=Porn Mat as 12.0Plumbing repairs or additionss names a®:v d l law Oe an®matewts on nand ma 13.0Roof repos T&aa sob—canon Ste a.pbse ad Scaate'an.Wee« &Owear.omit=de atfasrae exact a Sae apt ofcapia pYQ.a 14.004hz tsG fuR ad.eloopwa.do,a filo wawa`coop ass sari •Aa magical Ytan ma+a®s de Stem baba ASS Sr.a*m'cassaim wavy.d®aa I Bora=.aa rte la Cara:.dal*fir n a l%r oar te as lac®d asp ist lama•aw affidavit alta act Y Saida be as madman aadeaa lay b.S ac as NES mea slam data a m lode maks lac caplaa'a tilt aa.o.ma lac caplatcs.tete'aa pant gal ware camp play sat_ I s a employer Seshp.s.iasr snorters'compassion Inner filo sop esoplop__ rata is die porn Artie site isfi+mmaa lam C�my Nona Federal Insurance Connery Policy a aselfia.lic-t 71746014 / Eapfatim alt 01-01-2018 fobSitAdd.nt: /(� '22,1/5cIt rr ............._City/Stale/Zip: &id/4,9,1)4v- )M06iota Alm a espy ad the workers'aaaspearetin policy dahnli !age(Swag she lacy sober sad espied" t 41e). Fare a comae aavage as required oder MGL c. 152,Pm is a a®{violation paaiatalde by a floe wp to$1 WO) .War aloe-yea inpiste,as well as aril penalties in Por form ofa STOP WORK ORDER and•fine of pp w£25000• day waist tic violator A copy of this statement may be fended to the Office of Investigations of the DU for msm.ne caw verification lbbely ter,f r ';' p�antedate ofpaim7 Sat tbrisfa.watS.p.-.ai Saw a eve a/Sanas Dam 1'hoaw 6.1•:44+eve• ... _. Officio/use only Po at.nae it Sia any,to be caapiled by rib or d..a ell Clv or Tower Pe aitill®af Imam A.thodty(ride o.eg .... L Owed of Reith L Balding Dena-teen 3.00/Ten Clerk 4.Electrical lawns- 5.Pl.mhieg Ingwdur 6,Other Cwlact Perna: Phone p: PELLA PRODUCTS INC. 155 MAIN STREET GREENFIELD, MA. 01301 Date: V-1///7 To: i C/ /GO14Ar �l Subject: Disposal of Debris The purpose of this letter is to certify that all debris from any project undertaken by Pella Products, Inc. in your town will be transported to a dumpster at our main facility; 155 Main Street, Greenfield, MA. Pella Products, Inc. is under contract with Waste Management of Massachusetts For the disposal of the contents of this dumpster. Very truly yours, PELLA PRODUCTS, INC. John P. Benjamin Accounting Manager From:Berkshire Ins Agency 413 447 1977 01/30/2017 13:05 #476 P.003/005 A`CO,RIS CERTIFICATE OF LIABILITY INSURANCE DA1/30/2017 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 tNSDRER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(les)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 cerffcate does not confer rights to the certificate holder In lieu of such endolsemenUs). PRODUCER7,0. Rabin Sargent Berkshire Insurance Group, Inc. taSPRON EEK {413}773-9913 —_- I ,x01.,(1131/P8-31172 117 Hain Street AEocum.rsargent€berkshi reinsuranoegroap.tom IN6URER()AFF04wNa COVERAGE MAKS Greenfield MA 01301 umuRMA Groat Northern Insurance Co_ _ 20303 MSua6D nen:Federal arai Ins¢zaaca CO. 20.281 --� Pella products, Inc. INHsRC:_sV 155 Hain Street INSURER D: INSURER E: _Greenfield MA 01301 IMEURERF; COVERAGES CERTIFICATE NUMBER:170c,AL,WC REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED SELOW HAVE SEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOUMTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OE 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 CONDInONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IMMRR Anal SUDS POLICY BW room eV TYPE OF INSURANCE 960 VAT POUCV MUMPS Iag1TY0 MMWWYO 1.11111E X lOW1ERtlALOGNERAL-----, [Itt FApA To erNCf ,000,000 A _ _ 1CvwsmaOE X OCCUR PRF IEE D. 1 -. 1,000,000 36043418 1/1/2017 1/1/2018 MED Epp(my ma pews( 5,000 __. PERSONAL&ADV INJURY 1.000,000 GERI.AGGREGATE LMIAPPLIES PER. OWNERAL AGGREGATE 2,000,000 nor IX REQ' FX LOC PRODUPX CTS-COMWAGc�—..2.000,000 01HYR AU1O1,11O0ILE LIABILITY CCOMBIN PED SINGLE OMIT 1400,000 A X HNYAUTO _ OOJLY!A1RY(PerosamI AAUTOSUT OWNED ".. SCPEDAUTOS EO 73596416 1/1/2019 1/1/2010 BOON INJURY(Pet xivLMl (MED ALTOSNCNOW1EO Pial FATY mance �....AUTOS SW ss.IXrI VP.&ak 8,000 MMORELLA UAB _OCCUR EAC4 OCCURRENCE EXCESS LIB CLAWS-MADE _ _ -- _. _r _,,,,,, AGGREGATE --- DEO Io 1RETEN11ON4 welt MS CpIDEX84ipNPER ceSPLOTERE`LM&LnY Vs X &TAME-) V414- MP PROPRIETORAARmtrccxrCLMVEEL EACH ACCCENt 500,000 B OFFICER/SEWER EXCLUDED' I N I to IA „�MNpyiinnNHI 71]46014 1/1/2017 1/1/2010 EL DISFASF-EA EMPLOYEE 500,000 4.DOWunder oESPMRnION OF OPERgIORD below RL DISEASE-POLICY LWT 500,000 CEeCRIPtiN Or OPERATORS I LOCATORS'VEHICLES(ACORO IM,AtNIUM41 R4mnto SrsMN,TOY N 011101•4 Mmon SPau IS ngUit04) Operations usual to the sale F installation of doors & windows. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCAETh POLICIES BE CANCELLED BEFORE City of Northampton THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 212 Main SGCBet ACCORDANCE WITH THE POLICY PROVISIONS. Northampton, MA 01060 AUTHORIZED REPRE4Ex'TATFE c /�! -t- - Robin Sargent/ENS C1988-2014 ACORD CORPORATION. All rights reserved. ACORD 26(2014101) The ACORD name and logo are registered marks of ACORD INS02512o14011