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38A-043
2 LAUREL ST BP-2018-1159 GIS 4: COMMONWEALTH OF MASSACHUSETTS MO.Block: 38A-043 CITY OF NORTHAMPTON Lot-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: window replaced BUILDING PERMIT Perrnit4 BP-2018-1159 ProiectN JS-2018-002079 Est. Cost: $8324.00 Fee: $40.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: PELLA PRODUCTS, INC 142279 Lot Size(sa.ft.): 11194.92 Owner: ZUCHOWSKI EDWARD S&JUDITHA Zoning: URB(100)/ Applicant: PELLA PRODUCTS, INC AT. 2 LAUREL ST Applicant Address: Phone: Insurance: 155 MAIN ST (413) 772-0153 WC GREENFIELDMA01301 ISSUED ON:5/7/2018 0:00:00 TO PERFORM THE FOLLOWING WORK.-REPLACE 5 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 N 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 5/7/2018 0:00:00 $40.00 212 Main Street, Phone(413)587-1240, Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner 10, 4va6 r L) Ci of Northampton Bu ing Department MAY - 4 2018 12 Main Street Room 100 orth mpton, MA 01060 DRT C=Dun DING I t-5 -1240 Fax413-587-1272 "'p—MPTON. APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING 1.1 ProperlyAddress: a, L'O. .(6 1Jor�ho.mpEon "a o SIJ U 2.1 Owner of Record: �1v[O�11�„o.,pr•o�or ame(Pnnt) p,i Current Mailing Address: 5O'1 - DaS7 TNephone 1 Signature 2.2 Authorized Anent: Te 95 ll7 Ee� a2 h� ��reeneAd l�� 1 Name(Pdn Curren)Mailing Atl ess: Com) 11a- o1s Signature Telephone {_ P Item Estimated Cost(Dollars)to be n°" ,' _` OifiBi• x ' completed bermita licant - p « a 1. Bulling ay , 2. Electoral •(h) „- •'stof v,c 3. Plumbing ”. 't, _- '• 4. Mechanical(HVAC) (� s 5. Fire Protection x _ 6. Total (1 +2+3+q+5) 5 , Building Penn U4urilbe x Signa s r Section 4. ZONING Ali Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning This column to be fille in by Bu�ildingneparh-rent Lot Size Frontage U Setbacks Front O O Side L:= R:0 L:= R= C� Rear Building Height Q Bldg. Square Footage Open Space Footage O r� / (I.a ares minus bldg ffi pavN arkin #ofPwklag Spaces Fill: volume&Location A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO O DONT KNOW O YES O IF YES, date issued:F- IF YES: Was the permit recorded at the Registry of Deeds? NO O DONT KNOW O YES O IF YES: enter Book F--- Pagel and/or Document#�� B. Does the site contain a brook, body of water or wetlands? NO O DONT KNOW O 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: C. Do any signs exist on the property? YES © NO O 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 O 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 arse? YES O NO O IF VES, then a Northampton Storm Water Management Permit from the DPW is required. S New House ❑ Addition ❑ Replacement ntlows Alterations) E] Rooting ❑ Or Doors /"' Accessory Bldg. ❑ Demolition ❑ New Signs [3] Decks [p Siding[07 Other[a Brief Descripption of Proposed work: GeDln�;.ra to . et OW Q V) e,<' rA oOP,r )ngp "0 416AC; k(VJ G4.av�aye Alteration of eAsting 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? f. Method of healing? 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. I. Septic Tank_ City Sewer_ Private well^ City water Supply_ I, as Owner of the subject property ,f� ereby authorize W�.,L-C v.. —49,C cts Inc, - to act y behalf, in in tters relative authorized by this building permit application. Signature of Owner Date 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. Signed underthe pains and penalties of perjury. revor. P7rO2 Pdnt Name d^, � kir Signature of OfertAgent Dale 8.1 Licensed Construction Supervisor: n �y� Not Applicable ❑ Name of License Holder: 1 YLV'J� I�r V Y.'7 Coa J6 O /� License Number 10 Clev 51 re - exj-exu'A t30\ 3 i a0 Address Expiation Date T Nir l7 " 153 Signature elephone f� Not Applicable D q� 6iruGT YB 061 V(OS Ihc . IH901-7 CI Company Name Registration Number 155MAS 5t Eree ,� e\� \u r4 DtZn\ 3�a3I2D Address ff Expire ion Da e TelephcrTeUi3)"7 7a"!71$j 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...... D The current exemption 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 I. Definition of Homeowner:Person(s)who own a parcel of lend 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 under the building permit As acting Construction Supervisor your presence on thejob site will be required from time to time,during and upon completion ofthe 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 perfom,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 ofMassacbusetts General Laws Annotated. Homeowner Signature Contract - Detailed Pella Window and Door Showroom of West Springfield Sales Rep Name: Schulz, Jonathan 69 Ashley Avenue West Springfield, MA 01089 Sales Rep Phone: 413-736-9239 Sales Rep Fax: 413-736-3390 Phone: (413) 736-9239 Fax: (413) 736-3390 Sales Rep E-Mail: jschulz@pellasales.com j @pellasales.com Customer Information Project/Delivery Address Order Information Edward Zuchowski Zuchowski Edward 2 Laurel St Northampton MA Quote Name: Zuchowski Edward 2047145 Architect Windows 2 Laurel St 2 Laurel St Order Number: 739R2ES141 NORTHAMPTON, MA01060-3634 Lot If Quote Number: 10001831 Primary Phone:(413)5840257 Northampton, MA 01060-3634 Order Type: Installed Sales Mobile Phone: County: Payment Terme: CO D. Fax Number: Tax Code: MASS E-Mail: Quoted Date: 4/3/2018 Great Plalns•: 52H5840257 Customer Number: 1008675581 Customer Account: 1004669874 Customer Notes: Housebuilt1938. Building Permit$40 plus$10 processing. Replacing older Pella. Deposit received 0425/2018. $4,162.39, Remainder due upon completion. $4,162,39. Pella Architect Series-Exterior Pocket Installations into older Pella(wood exterior), 1. Remove existing storms,sashes, and jamb liners. 2. Install new windows(insulate and caulk as necessary) 3. New interior stops.V Lead Safe T V For more information regarding the finishing, maintenance, service and warranty of all Pella®products,visit the Pellao website at www.pella.com Pnntedon 4/75/7018 ConlrAM-lleteiled P.— 1 ,d in Customer: Edward 2uchowski Project Name', 2uchowski Edward 2 Laurel St Northampton MA Order Number. 739R2ES141 Quote Number: 10001831 Lineg Location: Attributes 10 Kitchen Architect, Replacement Double Hung, 43 X 44,White Item Price Qty Ext'd Price $2,06645 1 $2,06645 / 1: Non-Standard SlzeNonShndard Size Double Hung,Equal PKN Frame Slze: 43X44 2005 General Infomxtlon: Standard.Style,Clad Pine,43/4 31/4" V Exterior Color Finish: Painted,Standard Enduraclad,White 1 Interior Color/Finish: Early American Stain lnterlor Sash 1 Panel: Ogee,Ogee, Standard, No Sash Lugs '—" Glass: Insulated Dual low-E Advanced Low-E Insula�t�ipygg Glass Argon Non High Altitude Dewed From Exterior Hardware Options: Spoon-Style Lock,Antique Brass. o Limited Opening Hardware,Order Sash U8,No Integrated Sensor Screen: Full Screen,Standard EnduraClad,While,✓✓Standard, InViewe" Performance Information: U-Factor 0.29,SHGC 0.28,VLT 0.53,CPD PEL-N-233-0025300001,Performance Class CW, PG 45, Calculated Positive DP Rating 45,Calculated Negative DP Rating 45,Year Rated 08111,Egress Does not meet typical United States egress,but may comply with local code requirements Grille: RMB,No Custom Grille,3/4",Traditional(4W2H/4W2H),Early American Stain.White,Shipped In Unit Wrapping Information: No Exterior Trim,Pella Recommended Clearance,Perimeter Length=174". l U L Frame Size:43'X 44,7343" PF-2- Her Pocket Installation Ory 1 LP-t -Lead so�h practices this opening Ory 1 I"fL STDPS Libeg Lbdetidn: Attributes 15 Deer Room Architect, Replacement Double Hung, A7:�X 52, White Item Price Qty Ext'd Price 1 u� $2,16452 2 $4529.04 1: Nonstandard SlzeNon-Standard Size Double Hung,Equal PKN Frame Size: 4712 X 52 2005 General Information: Standard,Style,Clad,Pine,43/4",3114" Exterior Color Finish: Painted Standard Enduraclad,White ✓ Interior Color/Finish: Golden Oak Stain lntenor✓ j Sash I Panel: Ogee,Ogae,Standard,No Sash Lugs Glass: Insulated Dual Low-E Advanced Law-E Ini latimo Glass Argon Non High Altitude Viewed From Exterior Hardware Option: Spoon-Style Lock,Antique areas, No Limited Opening Hardware,Order Sash Lim,No Integrated Sensor Screen: Full Screen,Standard EnduraClad,White,Standard, InViewTM ✓ Performance Information: U-Facior 0.29,SHGC 0.28,VLT 0.53,CPD PEL-N-2330025300001,Performance Class CW,PG 45,Calculated Positive DP Rating 45,Calculated Negative DP Rating 45,Year Rated 08111,Egress Does not meet typical United States egress,but may comply with local code requirements Grille: RMB,No Custom Mle 3/4",Traditional(4W2H/4W2H),Golden Oak Stain,White,Shipped In Unit Wrapping Information: No Exterior Trim,Pella Recommended Clearance,Perimeter Length=199'. Frame Size:47.5'X 52.7343' is PF-2-Ex or Pocket lnstalhtlon city 1 LP4 -L ad soh or, this opening Ory 1 FG For more information regarding the finishing, maintenance, service and warranty of all Pella®products,visit the False,website at www pella.com Printed on 4/152018 n ,urea.nateilon Dom,.., o _. 4A Customer: Edward Zuchowski Project Name: Zuchowski Edward 2 Laurel St Northampton MA Order Number. 739R2ES141 quote Number: 10001831 Llni Location: Attributes 20 Kitchen Architect, Large Awning Vent,27.5 X 29.25,White Item Price qty EXt'd Price T 81830.18 2 $3,66036 1: Nom-Standard SlzeNonStandard Sloe Vent Awning PKN Frame Size: 2712X29114 y General Information: Standard,Clad,Pine,5",311116'2005 Extedor Colorl Finish: Painted,Standard Enduraclad,White Interior Color I Finish: Early American Stain Interior 1 Sash I Panel: Ogee, Ogee, Standard Glass: Insulated Dual Low-E Advanced Low-E Insulating Glass Argon Non High Altitude Viewedram EkZ HardwareOptions: Antiek Fold-Away Crank,Antique Brass,No Limited Opening Hardware, No Integrated Sensor,Sil Screen: Full Screen,Champagne,InView- �1 Perfomwnce Information: U-Fodor 028,SHGC 0.26,VLT 0.48,CPD PEL-N-30.13229-00002,Performance Class LC,PG 40,Calculated Positive DP U,A Rating 40,Calculated Negative DP Rating 40,Year Rated 08,Egress Not Applicable Grille: RMB,No Custom Grille,314",Top Row(3WiH),Early American Stain,White,Shipped Separate W rapping Information: No Exterior Trim,311116',S, Factory Applied,Pella Recommended Clearance,Perimeter Length=114" Frame Size:27.5'X 2925' 'f2°' pf, N6A3 ' 7W] S PF-2-F dor Pocket Installation Oty i LP-1-Lead safe practices this opening Oty, 1 LIni Location: Attributes 25 Building Permit BPC-Permit-subject to change if actual cost greater than shown Item Price qty EXt'd Price $50.00 1 $50,00 For more information regarding the finishing, maintenance, service and warranty of all Pella®products, visit the Pella®website at wvw.pella.com Printed on 4/252018 Cnnharr-nmt ilad D, c ,a ,m Customer. Edward Zuchowski Project Name: Zuchowski Edward 2 Laurel St Northampton MA Order Number. 739R2ES141 Quote Number 10001831 Project Checklist has been reviewed i ,C�aS mame z� �+�y�b l �G Order Totals Customer N (Please prim) ` eIla Sales a ame Reass ae�q Taxable Subtotal $6,366.93 � �i< GN/tF'�Vl� �/cM/JhlPr♦ Kat Z Sales Tax @ 6.25% $397.9 Customer SignaturePella Salea Rep Signature Non-taxable Subtotal $1,559.92 Det��///� J� Z��t Total $8,324.78 Deposit Received $4,162.39 �Annount Due $4,162.39 Credit Card Approval Signature For more information regarding the Waning, maintenance, service and warranty of all Pella®products,vaitthe Pella®website at vpella.com Printsdon 4125r2n1R .__ — 1.. - - _ - - The Commonwealth of Massachusetts Department of IndustrialAccidents OJjtce of Investigations u,p I Congress Street, Sujfe 100 Boston, MA 02114-2017 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Bosiness/Organization/IndiWdual): Pella Products, Inc. Address: 155 Main Street Cjt3,/S •Greenfield MA. 01301 _..- _- __- . .Pbone-"-443--772-0153 ------ --.-- — Are you an employer? Check the appropriate box: Type of project(required); 1.X I am a employer with 52 4. Q I am a general contractor and I employees (frill and/or part-time)" have hired the sub-contractors 6. E]New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ©Remodeling ship and have no employees These subcontractors have S. ❑ Demolition working for me in any capacity. employees and have workers' rNo workers' comp. insurance camp. insurance.[ 9. F] Building addition required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additioi 3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or addifroi myself. [No workers' comp. right of exemption per MGL 120 Roof repairs insurance required.] t c. 152, §1(4), and we have no employees. [No workers' 13.0 Other comp. insurance required.] 'Any appheantthat checks box#1 must also 511 out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicetivg they are&mg all work and Nen arc outside contractors must submit a new affidavit indicating such. =Contractors that check this has must allached an additional sheet showing the Dame of the subcontractors and state whether or not Nose entities have employees. If the sub-covtracmrs have employees,they mustprovide their workers'comp.poary number. I am an employerthat is providing workers'compensation insurance for my employees Below is the policy and job site information. Insurance Company Name:Hanover Insurance Group Policy#or Self-ins. Lic. #:WHND376502 Expiration Date:01/0\'1/2019 Job Site Address: a- La..L. -ce.� moi' City/State/Zip: Qo(\namp on OUP 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 in of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the OtHce of Investigations of the DIA for insurance coverage verification I do hereby certify the pins and p ojperjury that the information provideld�above is true and correct. Sienatwe: ll� Date -1 /a.(y C"an Phone 4, �ACrr�� Offkhd 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#: A� CERTIFICATE OF LIABILITY INSURANCE 28017° THIS CERTIFICATE IS ISSUED ASA 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 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(les)must have ADDITIONAL INSURED provisions or he endorsed. It SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies my require an endorsement A statement on this certificates does not confer rights to the certificate holder In lieu of such endoreemengs). PRODUCER HANE:QIJNTAAT Room Sargent Berkshire lnsuenw Group,Inc. PNNCOxx (413)])3-9913 nF Na: (413)774-3872 11]Main Street nwREss. Icaryeld'oerkshirelnsumnwgroup.wm INSURERS)AFFgiOING COVERAGE NAIOY Greenfield MA 01301 INSURERA: Chirens Ins.CompanyofAmer 31534 INSURED INSURER B. AllmanW Financial Benefit 41840 Pella Products,Inc. INSURERC' Hanover Insurance Company 22292 155 Main Street msuxeR o INSURERS: Greenfield MA 01301 INSURER F: COVERAGES CERTIFICATE NUMBER: 18GLALWC REVISION NUMBER: THIS IS TO CERTIFY THATTHE 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 MICH THIS CERTIFICATE MAYBE 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 CI AJM$. /NSIR LTR TYPE OF INSURANCE /x50 nNo P SYNUMBER Ili (.Ms.) LIMITS X COMMERCIALGENEFNLWRNTY E HGCCURRENCE 3 [000,000 DAMAREPOKEnto CUIMSMADD ®OCCVR PREMISES 1.ma,nenra S 100,000 Mw E<P(k,Y one parson) a 10,000 A ZBNN5939500 01/01/2018 0110112019 PERSONALSADVMIDRY s 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERA-AGGREGATE a 2000,000 7CGLICV ®JPET [g LCC PRODVCIS-CCMPNPAGG E 2,000,000 OTHER. Damage to Rented s 100,000 AUTOMOBILELABILJIY ECMBMEB9IXOLELMIT E 1,000,000 NYaV10 NORLYINJURY(n Pgsonl I B OVILEO sCXEOULED AWTID45948)00 0110112018 01/0112019 eoD"DiuRY mai ADTos ONLY auios AUTCa GNLV <Uios oNEb va°, "e.Tr DAMaGE a a UMBRELLA LNB OCCUR EACHOCCURRENCE $ EXCESS LIAO CLAIMSMADE PGNEGAU, E DED RETENTION E S WURDERS COMPENSATION X yY 1UTE EP AND EMPLOYERS LIABILITY YIN $00,000 C NVPROPRIEioRmZL`uPrExeY❑ N4 VMND376502 0110[/2018 01/0112019 GUTrvE EL FACHACCAENT E OFFCERrt.1 RFR ExcwDEDv 500000 IM anEXin ory In NX) EL CISEPSE.FA EMPLOYEE E .A. m DESCRIPTION OF1 �CpERATIONS[elcw EL.OISEhSE-POLICY LIMIT E 500000 DESCRIPTOR OF OPERATORS I LOCATIONS I VEHICLES(ACCED 101,Additional Remade Si may M iii Ilmam spa¢la NHI Operators usual to me sale 8instillation or dour;8 WIndPNS. CERTIFICATE HOLDER CANCELLATION SHOULDANYOF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Ci(y Of Northampton ACCORDANCE WITH THE POLICY PROVISIONS. 212 Main St AUTHORIZED RFDRESENTAPYE Northampton MA 01060 81988-201/5 ACORD CORPORATION. All rights reserved. ACORD 26(20`16103) The ACORD name and logo are registered marks of ACORD PELLA PRODUCTS INC. 155MAIN STREET GREENFIELD, MA. 01301 Date:, To: —.- 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 - 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:March 5, 2018 -_. . .... ..—Smeject-thpiding Permit Appiic3Tiong8, 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 HIC#142279. Please find a copy of my licenses below. Cap, }Onrw"" t A P Mitis pp Cwnamlieil W sul5euifw R�iVx'ted�: 9�rWy 1U":=34=l%ab Wi et4 tltontan i r 4 e"`ased°Pw'' a. nr9u of fansumx Nralrfa&gYnMM §w 'fyppplyry us•MI NOMEIt�yft: NENnT �CaC B9stioulLGw�CnE9t k , Ebuis"v aIiir4tumAt.o': A~ 1279 WY . Imn PEttAPFDDUCTS.NCTREVOR BROSS 155 MAIN STREET 1Y1IhOUt Signature G9EENPIELp.MA 91301 Urxlarseesd�Y Each Installation will be staffed by on installers who are all licensed in accordance with current building ('.odes. Below listed are our installers and their license numbers. Please accept these individuals as my designees. Willard Brown CS106010 Vladimir Shevchuk CS51099209 Scott Bowdish CSSL100232 Bill Leger CS89338 David Ruffner CS57308 Brian Thompson 0567121 Igor Kravchuk 05094911