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09-008 (5)
562 KENNEDY RD BP-2021-1498 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block:09-008 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 Permit# BP-2021-1498 Project# JS-2021-002488 Est.Cost: $45780.00 Fee: $40.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: PELLA PRODUCTS, INC 096558 Lot Size(sq.ft.): 277477.20 Owner: GRINNELL FRED B JR TRUSTEE Zoning: RR(100)/WSP(100)/ Applicant: PELLA PRODUCTS, INC AT: 562 KENNEDY RD Applicant Address: Phone: Insurance: 155 MAIN ST (413) 772-0153 WC GREENFIELDMA01301 ISSUED ON:6/16/2021 0:00:00 TO PERFORM THE FOLLOWING WORK:INSTALL 17 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. V . • Certificate of Occupancy sign:►lu+ •• ' I FecType: Date Paid: Amount: Building 6/16/2021 0:00:00 $40.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner f \. .� G"A' �"4;� Department use only ?� M�row City of Northarrl t^ S Status of Permit: '- Building Departm (-,^ rb Cut/Driveway Permit 212 Main Street > ', , Se' er/Septic Availability i it '(f -�f 1 Room 100 -,, )M ter/Well Availability `' - <: a ' Northampton, MA 01060 y c, "'Two Sets of Structural Plans -.._r< phone 413-587-1240 Fax 413-587- '27"4, Plot/Site Plans Other Specify APPLICATION TO CONSTRUCT,ALTER,REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Property Address: This section to be completedpl by office . &2/�L�r7e�y ,41 Map 01 Lot 0 D Unit /e.d-d,S' / 1/A O /0� Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: ,ed 44 n.�,// A.D So 53S /weed P /Pr, U/as3 Name(Print) Current Mailing Address: a, a_ Adimet �/3 S�� o f// , Telephone Signature 2.2 Authorized Agent: /9e//a— ArVeli[.Elf � C- /SS 41i40r9 IT �5,)-.8. nAAI. I11'0 i.fo I Name(Print) Current Mailing Address: . 44/.? 772-!.7/s Signatu a 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 7�7Pa . 0A 2. Electrical (b) Estimated Total Cost of Construction from (6) 3. Plumbing Building Permit Fee ) J,O 4. Mechanical(HVAC) C(.Yi�' 5. Fire Protection 6. Total=(1 +2+3+4+5) 17(C7FO . Op Check Number -7a666 This Section For Official Use Only 1a®-4/Ng, Date Building Permit Number: Issued: Signature: /4/----/' ' 6- I G-ZOZ l Building Commissioner/Inspector of Buildings Date EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size Frontage Setbacks Front Side L: R: L: R: Rear Building Height Bldg. Square Footage Open Space Footage (Lot area minus bldg&paved parking) #of Parking Spaces Fill: (volume&Location) A. Has a Spe ial Permit/Variance/Finding ever been issued for/on the site? NO DON'T KNOW 0 YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO O DONT KNOW 0 YES O IF YES: enter Book Page and/or Document tt B. Does the site contain a brook, body of water or wetlands? NO er DON'T KNOW © YES O IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained O Obtained © , Date Issued: C. Do any signs exist on the property? YES © NO 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 IF YES, describe size, type and location: E. Will the construction activity disturb(clearing, grading, exca tion, or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES O 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 ❑ Addition ❑ Replacement W dows Alteration(s) n Roofing in Or Doors Accessory Bldg. ❑ Demolition ❑ New Signs [El] Decks [M Siding[p] Other[El] Brief Descriptiop of Proposed • Work: /i¢CL /2 Proposed. Gt.( ii94 iC l 1Tli>�Y D ��i.��i/ (�%, /1//� �1 jlfq �E Alteration of bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet 6a. If New house and or addition to existing housing, complete the following: 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 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. I. Septic Tank City Sewer Private well City water Supply SECTION 7a -OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, f ! Ze ( 71/ j7,e`1 , as Owner of the subject property �/� /l hereby authorize f/ iL , ie1 i�e 1/rIC to act on my behal , in all matters relative to work authorized by this building permit application. Ste'P !L/1/i/&d �/Z l Signature of Owner Date I /° /` L ,4ef e c j'd , 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 under the pains and penalties of perjury. Tie v it K#moCs Print Name WC/2"/ Signatu er/ en Date SECTION 8 -CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Noto Applicable El of License Holder: 7 tier / 'i ff 1_ of 6 S-Sat License Number l 6eo/je_. %Tr 6--reg, i4e/e/ 4/i9 U/fo 3///27 Address Expiration Date Sig 9. Registered Home Improvement Contractor: Not Applicable 0 /2e//a_ p�'oottteR r,'ic /V2Z=7 .7 Company Name Registration Number ?'/2.3z2 Addy's //�� AA Expiration ate c-s-rc r L/d J/ l/�32 / Telephone 7/'in/is-7 X 7 SECTION 10-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 buildin permit. Signed Affidavit Attached Yes No 0 Pella Products Inc. 155 Main Street Greenfield, MA 01301 To Whom it may Concern: I, �r?Q' 7 I , as property owner, give permission to our contractor, Pella Products Inc. to obtain a building permit for the installation of windows and/or doors in my home. Located at; c2. IAA. on et c r Qo� Lead' s / P© Ad,t 5 3 Please accept this letter in place of my signature on the permit application. Thank you, Signature: �•J Date: • Contract - Detailed fo I Pella Window and Door Showroom of West Springfield Sales Rep Name: Lukomski, Adam 69 Ashley Avenue Sales Rep Phone: (413) 335-3237 West Springfield, MA 01089 Sales Rep Fax: 413-774-6348 Phone: (413) 736-9239 Fax: (413) 736-3390 Sales Rep E-Mail: alukomski@pellasales.com Customer Information Project/Delivery Address Order Information Fred Grinnell Grinnell Fred and Sarah 562 Kennedy Rd Leeds MA Quote Name: Lifestyle Series 413-586-0111 PO Box 535 562 Kennedy Rd 562 Kennedy Rd Order Number: 739W2EL151 LEEDS, MA 01053 Lot# Quote Number: 13926540 Primary Phone:4135860111 Leeds, MA 01053-9756 Order Type: Installed Sales Mobile Phone: County: Payment Terms: C.O.D. Fax Number: Tax Code: MASS E-Mail: Quoted Date: 4/10/2021 Great Plains#: 53H0000454 Customer Number: 1002384000 Customer Account: 1000334498 For more information regarding the finishing, maintenance, service and warranty of all Pella®products, visit the Pella®website at www.pella.com Printed on 4/23/2021 Contract-Detailed Page 1 of 21 Customer: Fred Grinnell Project Name: Grinnell Fred and Sarah 562 Kennedy Rd Leeds MA Order Number: 739W2EL151 Quote Number: 13926540 Line# Location: Attributes 10 Front Entry Lifestyle, 3-Wide Inswing Door, 109.875 X 81.5,Without HGP, Brown Item Price Qty Ext'd Price $11,564.73 1 $11,564.73 PK# 2085 1:3682 Fixed Inswing Door : Frame Size: 36 X 81 1/2 r General Information: No Package,Without Hinged Glass Panel,Clad, Pine,7 7/8",6 9/16",Standard Sill,Black Finish Sill Exterior Color/Finish: Standard Enduraclad,Brown Interior Color/Finish: Early American Stain Interior Glass: Insulated Tempered Low-E Advanced Low-E Insulating Glass Argon Non High Altitude Performance Information: U-Factor 0.28,SHGC 0.22,VLT 0.41,CPD PEL-N-221-00392-00001, Performance Class LC,PG 50,Calculated Positive DP Viewed From Exterior Rating 50,Calculated Negative DP Rating 50,Year Rated 08111 Grille: No Grille, Vertical Mull 1: FactoryMull, Standard Joining Mullion-Doors, Mull Design Pressure-20,Overall Thru Direction-Vertical 2:3882 Left Inswing Door Frame Size: 37 7/8 X 81 1/2 General Information: No Package,Without Hinged Glass Panel,Clad, Pine,7 7/8",6 9/16",Standard Sill,Black Finish Sill Exterior Color/Finish: Standard Enduraclad,Brown Interior Color/Finish: Early American Stain Interior Glass: Insulated Tempered Low-E Advanced Low-E Insulating Glass Argon Non High Altitude Hardware Options: Standard,Satin Nickel,Order Handle Set, Multipoint Lock, No Integrated Sensor Screen: Hinge Screen,Brown,Satin Nickel,InViewTM Performance Information: U-Factor 0.28,SHGC 0.22,VLT 0.41,CPD PEL-N-221-00392-00001, Performance Class LC,PG 50,Calculated Positive DP Rating 50,Calculated Negative DP Rating 50,Year Rated 08111 Grille: No Grille, Vertical Mull 2: FactoryMull, Standard Joining Mullion-Doors, Mull Design Pressure-20,Overall Thru Direction-Vertical 3:3682 Fixed Inswing Door Frame Size: 36 X 81 1/2 General Information: No Package,Without Hinged Glass Panel,Clad, Pine,7 7/8",6 9/16",Standard Sill,Black Finish Sill Exterior Color/Finish: Standard Enduraclad,Brown Interior Color/Finish: Early American Stain Interior Glass: Insulated Tempered Low-E Advanced Low-E Insulating Glass Argon Non High Altitude Performance Information: U-Factor 0.28,SHGC 0.22,VLT 0.41,CPD PEL-N-221-00392-00001, Performance Class LC,PG 50,Calculated Positive DP Rating 50,Calculated Negative DP Rating 50,Year Rated 08111 Grille: No Grille, Wrapping Information: Foldout Fins, Factory Applied, No Exterior Trim,6 9/16", 7 7/8", Factory Applied, Pella Recommended Clearance, Perimeter Length=383". Frame Size:109.875"X 81.5" EAC-1 -Exterior Aluminum Capping(Coil Stock) Qty 1 EXTTRIMI5-Kick board to match ext trim PVC Qty 1 PD-3-3-Wide Patio Door Install Qty 1 For more information regarding the finishing, maintenance, service and warranty of all Pella®products, visit the Pella®website at www.pella.com Printed on 4/23/2021 Contract-Detailed Page 2 of 21 Customer: Fred Grinnell Project Name: Grinnell Fred and Sarah 562 Kennedy Rd Leeds MA Order Number: 739W2EL151 Quote Number: 13926540 Line# Location: Attributes 15 Interior Trim Wood Products 31/2 Craftsman 2, Length: 144, Early American Stain.Wood Type: Item Price Qty Ext'd Price Pine $106.90 4 $427.60 1: Accessory I PK# Frame Size: 1 X 1 L, J 2085 General Information: Pine,3 1/2 Craftsman 2 Interior Color!Finish: Early American Stain Interior Wrapping Information: Perimeter Length=0". Viewed From Exterior Frame Size:0"X 0" Line# Location: Attributes 20 Interior Trim Wood Products Stool Round 2, Length: 96, Natural Stain.Wood Type: Oak Item Price Qty Ext'd Price $121.52 1 $121.52 1: Accessory PK# Frame Size: 1 X 1 2087 General Information: Oak,Stool Round 2 Interior Color/Finish: Natural Stain Interior Wrapping Information: Perimeter Length=0". Viewed From Exterior Frame Size:0"X 0" For more information regarding the finishing, maintenance, service and warranty of all Pella®products, visit the Pella®website at www.pella.com Printed on 4/23/2021 Contract-Detailed Page 3 of 21 Customer: Fred Grinnell Project Name: Grinnell Fred and Sarah 562 Kennedy Rd Leeds MA Order Number: 739W2EL151 Quote Number: 13926540 Line# Location: Attributes 35 Master Bedroom Lifestyle,2-Wide Casement, 58 X 47,Without HGP, Brown Item Price Qty Ext'd Price $3,128.13 1 $3,128.13 1:2947 Left Casement = PK# Frame Size: 29 X 47 �•'• 2087 General Information: No Package,Without Hinged Glass Panel,Clad,Pine,5",3 11/16" Exterior Color/Finish: Standard Enduraclad,Brown Interior Color/Finish: Linen White Paint Interior Glass: Insulated Low-E Advanced Low-E Insulating Glass Argon Non High Altitude Hardware Options: Wash Hinge Hardware, Fold-Away Crank, Champagne, No Limited Opening Hardware, No Integrated Sensor Viewed From Exterior Screen: Full Screen,Linen White, InViewN Performance Information: U-Factor 0.29,SHGC 0.27,VLT 0.51,CPD PEL-N-14-00677-00001, Performance Class LC, PG 50,Calculated Positive DP Rating 50,Calculated Negative DP Rating 50,Year Rated 08111, Egress Meets Typical 5.7 sqft(E) (United States Only) Grille: No Grille, Vertical Mull 1: FactoryMull, Standard Joining Mullion, Mull Design Pressure-20, Overall Thru Direction-Vertical 2:2947 Right Casement Frame Size: 29 X 47 General Information: No Package,Without Hinged Glass Panel,Clad,Pine,5",3 11/16" Exterior Color/Finish: Standard Enduraclad,Brown Interior Color/Finish: Linen White Paint Interior Glass: Insulated Low-E Advanced Low-E Insulating Glass Argon Non High Altitude Hardware Options: Wash Hinge Hardware, Fold-Away Crank, Champagne, No Limited Opening Hardware, No Integrated Sensor Screen: Full Screen,Linen White,InViewn, Performance Information: U-Factor 0.29, SHGC 0.27,VLT 0.51,CPD PEL-N-14-00677-00001, Performance Class LC, PG 50, Calculated Positive DP Rating 50, Calculated Negative DP Rating 50,Year Rated 08111, Egress Meets Typical 5.7 sqft(E) (United States Only) Grille: No Grille, Wrapping Information: Foldout Fins, Factory Applied, No Exterior Trim,6 9/16", 7 7/8", Prep For Stool Three Sided Jamb Extension, Factory Applied, Pella Recommended Clearance,Perimeter Length=210". Frame Size:58"X 47" FF-7-2 Wide Full Frame Tear Out Installation Qty 1 EAC-1 -Exterior Aluminum Capping(Coil Stock) Qty 1 For more information regarding the finishing, maintenance, service and warranty of all Pella®products, visit the Pella®website at www.pella.com Printed on 4/23/2021 Contract-Detailed Page 4 of 21 Customer: Fred Grinnell Project Name: Grinnell Fred and Sarah 562 Kennedy Rd Leeds MA Order Number: 739W2EL151 Quote Number: 13926540 Line# Location: Attributes 40 Master Bedroom Lifestyle,4-Wide Casement, 116 X 47,Without HGP, Brown Item Price Qty Ext'd Price $5,570.54 1 $5,570.54 1:Non-Standard Size Left Casement PK# Frame Size: 29 X 47 • 2087 General Information: No Package,Without Hinged Glass Panel,Clad,Pine,5",3 11/16" L .�• � • Exterior Color/Finish: Standard Enduraclad,Brown Interior Color/Finish: Linen White Paint Interior Glass: Insulated Low-E Advanced Low-E Insulating Glass Argon Non High Altitude Hardware Options: Wash Hinge Hardware, Fold-Away Crank, Champagne, No Limited Opening Hardware, No Integrated Sensor Viewed From Exterior Screen: Full Screen,Linen White,InViewn" Performance Information: U-Factor 0.29,SHGC 0.27,VLT 0.51, CPD PEL-N-14-00677-00001, Performance Class LC, PG 50,Calculated Positive DP Rating 50,Calculated Negative DP Rating 50,Year Rated 08111, Egress Meets Typical 5.7 sqft(E) (United States Only) Grille: No Grille, Vertical Mull 1: FactoryMull, Standard Joining Mullion, Mull Design Pressure-20, Overall Thru Direction-Vertical 2:2947 Right Casement Frame Size: 29 X 47 General Information: No Package,Without Hinged Glass Panel,Clad,Pine,5",3 11/16" Exterior Color/Finish: Standard Enduraclad,Brown Interior Color/Finish: Linen White Paint Interior Glass: Insulated Low-E Advanced Low-E Insulating Glass Argon Non High Altitude Hardware Options: Wash Hinge Hardware, Fold-Away Crank, Champagne, No Limited Opening Hardware, No Integrated Sensor Screen: Full Screen, Linen White,InViewTM Performance Information: U-Factor 0.29, SHGC 0.27,VLT 0.51,CPD PEL-N-14-00677-00001,Performance Class LC, PG 50,Calculated Positive DP Rating 50,Calculated Negative DP Rating 50,Year Rated 08111, Egress Meets Typical 5.7 sqft(E)(United States Only) Grille: No Grille, Vertical Mull 2: FactoryMull,Standard Joining Mullion, Mull Design Pressure-20, Overall Thru Direction-Vertical 3:2947 Left Casement Frame Size: 29 X 47 General Information: No Package,Without Hinged Glass Panel,Clad,Pine,5",3 11/16" Exterior Color/Finish: Standard Enduraclad,Brown Interior Color/Finish: Linen White Paint Interior Glass: Insulated Low-E Advanced Low-E Insulating Glass Argon Non High Altitude Hardware Options: Wash Hinge Hardware, Fold-Away Crank, Champagne, No Limited Opening Hardware, No Integrated Sensor Screen: Full Screen,Linen White, InViewTM Performance Information: U-Factor 0.29,SHGC 0.27,VLT 0.51,CPD PEL-N-14-00677-00001, Performance Class LC, PG 50,Calculated Positive DP Rating 50,Calculated Negative DP Rating 50,Year Rated 08111, Egress Meets Typical 5.7 sqft(E)(United States Only) Grille: No Grille, Vertical Mull 3: FactoryMull,Standard Joining Mullion, Mull Design Pressure-20, Overall Thru Direction-Vertical 4:Non-Standard Size Right Casement Frame Size: 29 X 47 General Information: No Package,Without Hinged Glass Panel,Clad,Pine,5",3 11/16" Exterior Color/Finish: Standard Enduraclad,Brown Interior Color/Finish: Linen White Paint Interior Glass: Insulated Low-E Advanced Low-E Insulating Glass Argon Non High Altitude Hardware Options: Wash Hinge Hardware, Fold-Away Crank, Champagne, No Limited Opening Hardware, No Integrated Sensor Screen: Full Screen,Linen White, InViewTM Performance Information: U-Factor 0.29,SHGC 0.27,VLT 0.51, CPD PEL-N-14-00677-00001, Performance Class LC, PG 50,Calculated Positive DP Rating 50,Calculated Negative DP Rating 50,Year Rated 08111, Egress Meets Typical 5.7 sqft(E)(United States Only) Grille: No Grille, Wrapping Information: Foldout Fins, Factory Applied, No Exterior Trim,6 9/16", 7 7/8", Prep For Stool Three Sided Jamb Extension, Factory Applied, Pella Recommended Clearance,Perimeter Length=326". For more information regarding the finishing, maintenance, service and warranty of all Pella®products, visit the Pella®website at www.pella.com Printed on 4/23/2021 Contract-Detailed Page 5 of 21 Customer: Fred Grinnell Project Name: Grinnell Fred and Sarah 562 Kennedy Rd Leeds MA Order Number: 739W2EL151 Quote Number: 13926540 Frame Size: 116"X 47" FF-9B-4 Wide+Full Frame Tear Out Installation Qty 1 EAC-1 -Exterior Aluminum Capping(Coil Stock) Qty 1 For more information regarding the finishing, maintenance, service and warranty of all Pella®products,visit the Pella®website at www.pella.com Printed on 4/23/2021 Contract-Detailed Page 6 of 21 Customer: Fred Grinnell Project Name: Grinnell Fred and Sarah 562 Kennedy Rd Leeds MA Order Number: 739W2EL151 Quote Number: 13926540 Line# Location: Attributes 45 Master Bedroom Lifestyle,4-Wide Casement, 116 X 47,Without HGP, Brown Item Price city Ext'd Price $5,749.40 1 $5,749.40 1:Non-Standard Size Left Casement PK# Frame Size: 29 X 47 • , - • , 2087 General Information: No Package,Without Hinged Glass Panel,Clad,Pine,5",3 11/16" Zs .�• ., • Exterior Color/Finish: Standard Enduraclad,Brown Interior Color/Finish: Linen White Paint Interior Glass: Insulated Tempered Low-E Advanced Low-E Insulating Glass Argon Non High Altitude Hardware Options: Wash Hinge Hardware, Fold-Away Crank, Champagne, No Limited Opening Hardware, No Integrated Sensor Viewed From Exterior Screen: Full Screen,Linen White,InViewTM' Performance Information: U-Factor 0.28,SHGC 0.27,VLT 0.51,CPD PEL-N-14-00685-00001, Performance Class LC, PG 50,Calculated Positive DP Rating 50,Calculated Negative DP Rating 50,Year Rated 08111, Egress Meets Typical 5.7 sqft(E) (United States Only) Grille: No Grille, Vertical Mull 1: FactoryMull, Standard Joining Mullion, Mull Design Pressure-20, Overall Thru Direction-Vertical 2:2947 Right Casement Frame Size: 29 X 47 General Information: No Package,Without Hinged Glass Panel,Clad,Pine,5",3 11/16" Exterior Color/Finish: Standard Enduraclad,Brown Interior Color/Finish: Linen White Paint Interior Glass: Insulated Low-E Advanced Low-E Insulating Glass Argon Non High Altitude Hardware Options: Wash Hinge Hardware, Fold-Away Crank, Champagne, No Limited Opening Hardware, No Integrated Sensor Screen: Full Screen,Linen White, InViewn" Performance Information: U-Factor 0.29, SHGC 0.27,VLT 0.51, CPD PEL-N-14-00677-00001, Performance Class LC, PG 50,Calculated Positive DP Rating 50, Calculated Negative DP Rating 50,Year Rated 08111, Egress Meets Typical 5.7 sqft(E)(United States Only) Grille: No Grille, Vertical Mull 2: FactoryMull,Standard Joining Mullion, Mull Design Pressure-20, Overall Thru Direction-Vertical 3:2947 Left Casement Frame Size: 29 X 47 General Information: No Package,Without Hinged Glass Panel,Clad,Pine,5",3 11/16" Exterior Color/Finish: Standard Enduraclad,Brown Interior Color/Finish: Linen White Paint Interior Glass: Insulated Low-E Advanced Low-E Insulating Glass Argon Non High Altitude Hardware Options: Wash Hinge Hardware, Fold-Away Crank, Champagne, No Limited Opening Hardware, No Integrated Sensor Screen: Full Screen,Linen White, InView" Performance Information: U-Factor 0.29,SHGC 0.27,VLT 0.51,CPD PEL-N-14-00677-00001, Performance Class LC, PG 50,Calculated Positive DP Rating 50,Calculated Negative DP Rating 50,Year Rated 08111, Egress Meets Typical 5.7 sqft(E) (United States Only) Grille: No Grille, Vertical Mull 3: FactoryMull,Standard Joining Mullion, Mull Design Pressure-20, Overall Thru Direction-Vertical 4:Non-Standard Size Right Casement Frame Size: 29 X 47 General Information: No Package,Without Hinged Glass Panel,Clad,Pine,5",3 11/16" Exterior Color/Finish: Standard Enduraclad,Brown Interior Color/Finish: Linen White Paint Interior Glass: Insulated Low-E Advanced Low-E Insulating Glass Argon Non High Altitude Hardware Options: Wash Hinge Hardware, Fold-Away Crank, Champagne, No Limited Opening Hardware, No Integrated Sensor Screen: Full Screen,Linen White,InViewTM' Performance Information: U-Factor 0.29, SHGC 0.27,VLT 0.51,CPD PEL-N-14-00677-00001,Performance Class LC, PG 50,Calculated Positive DP Rating 50,Calculated Negative DP Rating 50, Year Rated 08111, Egress Meets Typical 5.7 sqft(E) (United States Only) Grille: No Grille, Wrapping Information: Foldout Fins, Factory Applied, No Exterior Trim,6 9/16", 7 7/8", Prep For Stool Three Sided Jamb Extension, Factory Applied, Pella Recommended Clearance,Perimeter Length=326". For more information regarding the finishing, maintenance, service and warranty of all Pella®products, visit the Pella®website at www.pella.com Printed on 4/23/2021 Contract-Detailed Page 7 of 21 Customer: Fred Grinnell Project Name: Grinnell Fred and Sarah 562 Kennedy Rd Leeds MA Order Number: 739W2EL151 Quote Number: 13926540 Frame Size: 116"X 47" FF-9B-4 Wide+Full Frame Tear Out Installation Qty 1 EAC-1 -Exterior Aluminum Capping(Coil Stock) Qty 1 For more information regarding the finishing, maintenance, service and warranty of ail Pella®products, visit the Pella®website at www.pella.com Printed on 4/23/2021 Contract-Detailed Page 8 of 21 Customer: Fred Gunnell Project Name: Grinnell Fred and Sarah 562 Kennedy Rd Leeds MA Order Number: 739W2EL151 Quote Number: 13926540 Line# Location: Attributes 50 Master Bathroom Lifestyle,2-Wide Casement, 50 X 47,Without HGP, Brown Item Price Qty Ext'd Price $3,375.21 1 $3,375,21 •� 1:2547 Left Casement PK# Frame Size: 25 X 47 ••• 2087 General Information: No Package,Without Hinged Glass Panel,Clad,Pine,5",3 11/16" • Exterior Color/Finish: Standard Enduraclad,Brown Interior Color/Finish: Linen White Paint Interior CY Glass: Insulated Tempered Low-E Advanced Low-E Insulating Glass Argon Non High Altitude Hardware Options: Wash Hinge Hardware, Fold-Away Crank, Champagne, No Limited Opening Hardware, No Integrated Sensor Viewed From Exterior Screen: Full Screen,Linen White, InViewTm Performance Information: U-Factor 0.28,SHGC 0.27,VLT 0.51,CPD PEL-N-14-00685-00001, Performance Class LC, PG 50,Calculated Positive DP Rating 50, Calculated Negative DP Rating 50,Year Rated 08111, Egress Does not meet typical United States egress, but may comply with local code requirements Grille: No Grille, Vertical Mull 1: FactoryMull,Standard Joining Mullion, Mull Design Pressure-20, Overall Thru Direction-Vertical 2:2547 Right Casement Frame Size: 25 X 47 General Information: No Package,Without Hinged Glass Panel,Clad,Pine,5",3 11/16" Exterior Color/Finish: Standard Enduraclad,Brown Interior Color/Finish: Linen White Paint Interior Glass: Insulated Tempered Low-E Advanced Low-E Insulating Glass Argon Non High Altitude Hardware Options: Wash Hinge Hardware, Fold-Away Crank, Champagne, No Limited Opening Hardware, No Integrated Sensor Screen: Full Screen,Linen White, IriViewTM Performance Information: U-Factor 0.28,SHGC 0.27,VLT 0.51,CPD PEL-N-14-00685-00001, Performance Class LC, PG 50,Calculated Positive DP Rating 50, Calculated Negative DP Rating 50,Year Rated 08111, Egress Does not meet typical United States egress,but may comply with local code requirements Grille: No Grille, Wrapping Information: Foldout Fins, Factory Applied, No Exterior Trim,6 9/16", 7 7/8", Prep For Stool Three Sided Jamb Extension, Factory Applied, Pella Recommended Clearance,Perimeter Length=194". Frame Size:50"X 47" FF-7-2 Wide Full Frame Tear Out Installation Qty 1 EAC-1 -Exterior Aluminum Capping(Coil Stock) Qty 1 For more information regarding the finishing, maintenance, service and warranty of all Pella®products, visit the Pella®website at www.pella.com Printed on 4/23/2021 Contract-Detailed Page 9 of 21 Customer: Fred Grinnell Project Name: Grinnell Fred and Sarah 562 Kennedy Rd Leeds MA Order Number: 739W2EL151 Quote Number: 13926540 Line# Location: Attributes 55 Master Bathroom Lifestyle, Casement Right,25 X 35,Without HGP, Brown Item Price Qty Ext'd Price $1,744.01 1 $1,744.01 I 1:2535 Right Casement tr) PK# Frame Size: 25 X 35 Cr) 2087 General Information: No Package,Without Hinged Glass Panel,Clad,Pine,5",3 11/16" Exterior Color/Finish: Standard Enduraclad,Brown I Interior Color/Finish: Linen White Paint Interior Glass: Insulated Tempered Low-E Advanced Low-E Insulating Glass Argon Non High Altitude Hardware Options: Wash Hinge Hardware, Fold-Away Crank, Champagne, No Limited Opening Hardware, No Integrated Sensor Viewed From Exterior Screen: Full Screen,Linen White, InViewTM' Performance Information: U-Factor 0.28, SHGC 0.27,VLT 0.51,CPD PEL-N-14-00685-00001, Performance Class LC, PG 50,Calculated Positive DP Rating 50, Calculated Negative DP Rating 50,Year Rated 08111, Egress Does not meet typical United States egress,but may comply with local code requirements Grille: No Grille, Wrapping Information: Foldout Fins, Factory Applied,No Exterior Trim, 6 9/16", 7 7/8", Prep For Stool Three Sided Jamb Extension, Factory Applied, Pella Recommended Clearance,Perimeter Length=120". Frame Size:25"X 35" EAC-1 -Exterior Aluminum Capping(Coil Stock) Qty 1 FF-4-1 Wide Full Frame Tear Out Installation Qty 1 For more information regarding the finishing, maintenance, service and warranty of all Pella®products, visit the Pella®website at www.pella.com Printed on 4/23/2021 Contract-Detailed Page 10 of 21 Customer: Fred Grinnell Project Name: Grinnell Fred and Sarah 562 Kennedy Rd Leeds MA Order Number: 739W2EL151 Quote Number: 13926540 Line# Location: Attributes 60 Master Bathroom Lifestyle, 2-Wide Casement, 50 X 35, Without HGP, Brown Item Price Qty Ext'd Price $3,043.30 1 $3,043.30 fuTil 1: 2535 Left Casement PK# Frame Size: 25 X 35 2087General Information: No Package,Without Hinged Glass Panel,Clad, Pine,5",3 11/16" Exterior Color/Finish: Standard Enduraclad,Brown Interior Color/Finish: Linen White Paint Interior Glass: Insulated Tempered Low-E Advanced Low-E Insulating Glass Argon Non High Altitude Hardware Options: Wash Hinge Hardware, Fold-Away Crank, Champagne, No Limited Opening Hardware, No Integrated Sensor Viewed From Exterior Screen: Full Screen,Linen White, InViewlM Performance Information: U-Factor 0.28, SHGC 0.27,VLT 0.51,CPD PEL-N-14-00685-00001, Performance Class LC, PG 50, Calculated Positive DP Rating 50, Calculated Negative DP Rating 50, Year Rated 08111, Egress Does not meet typical United States egress, but may comply with local code requirements Grille: No Grille. Vertical Mull 1: FactoryMull, Standard Joining Mullion, Mull Design Pressure-20, Overall Thru Direction-Vertical 2: 2535 Right Casement Frame Size: 25 X 35 General Information: No Package,Without Hinged Glass Panel,Clad, Pine,5",3 11/16" Exterior Color/Finish: Standard Enduraclad, Brown Interior Color/Finish: Linen White Paint Interior Glass: Insulated Tempered Low-E Advanced Low-E Insulating Glass Argon Non High Altitude Hardware Options: Wash Hinge Hardware, Fold-Away Crank, Champagne, No Limited Opening Hardware, No Integrated Sensor Screen: Full Screen.Linen White, InViewTM Performance Information: U-Factor 0.28,SHGC 0.27,VLT 0.51,CPD PEL-N-14-00685-00001, Performance Class LC, PG 50, Calculated Positive DP Rating 50, Calculated Negative DP Rating 50, Year Rated 08111, Egress Does not meet typical United States egress, but may comply with local code requirements Grille: No Grille, Wrapping Information: Foldout Fins, Factory Applied, No Exterior Trim, 6 9/16", 7 7/8", Prep For Stool Three Sided Jamb Extension, Factory Applied, Pella Recommended Clearance, Perimeter Length= 170". Frame Size:50"X 35" FF-7-2 Wide Full Frame Tear Out Installation Qty 1 EAC-1 -Exterior Aluminum Capping(Coil Stock) Qty 1 For more information regarding the finishing, maintenance, service and warranty of all Pella®products, visit the Pella®website at www.pella.com Printed on 4/23/2021 Contract-Detailed Page 11 of 21 Customer: Fred Grinnell Project Name: Grinnell Fred and Sarah 562 Kennedy Rd Leeds MA Order Number: 739W2EL151 Quote Number: 13926540 Line# Location: Attributes 65 Top of Stairs Support Product, 3-Wide Direct Set,99.937 X 47, Brown Item Price Qty Ext'd Price $5,044.29 1 $5,044.29 • 1:33.312547 Fixed Frame I . . PO 7 Frame Size: 33 5/16 X 47 208 GenerallInformation: n: Interior Glazed, Factory Assembled,Standard,Clad,Pine,5",3 11/16" Exterior Color/Finish: Painted,Standard Enduraclad,Brown 33: `� �:�` 5 Interior Color/Finish: Linen White Paint Interior Glass: Insulated Dual Low-E Advanced Low-E Insulating Glass Argon Non High Altitude Performance Information: U-Factor 0.29,SHGC 0.32,VLT 0.62,CPD PEL-N-18-02773-00001,Performance Class CW,PG 75,Calculated Positive DP Viewed From Exterior Rating 75,Calculated Negative DP Rating 75,Year Rated 08111 Grille: No Grille, Vertical Mull 1: FactoryMull, Standard Joining Mullion, Frame To Frame Width-0",Mull Design Pressure-20 2:33.312547 Fixed Frame Frame Size: 33 5/16 X 47 General Information: Interior Glazed, Factory Assembled,Standard,Clad, Pine,5",3 11/16" Exterior Color/Finish: Painted,Standard Enduraclad,Brown Interior Color/Finish: Linen White Paint Interior Glass: Insulated Dual Low-E Advanced Low-E Insulating Glass Argon Non High Altitude Performance Information: U-Factor 0.29,SHGC 0.32,VLT 0.62,CPD PEL-N-18-02773-00001,Performance Class CW,PG 75,Calculated Positive DP Rating 75,Calculated Negative DP Rating 75,Year Rated 08111 Grille: No Grille, Vertical Mull 2: FactoryMull, Standard Joining Mullion, Frame To Frame Width-0",Mull Design Pressure-20 3:33.312547 Fixed Frame Frame Size: 33 5/16 X 47 General Information: Interior Glazed, Factory Assembled, Standard,Clad, Pine,5",3 11/16" Exterior Color/Finish: Painted,Standard Enduraclad,Brown Interior Color/Finish: Linen White Paint Interior Glass: Insulated Dual Low-E Advanced Low-E Insulating Glass Argon Non High Altitude Performance Information: U-Factor 0.29,SHGC 0.32,VLT 0.62,CPD PEL-N-18-02773-00001,Performance Class CW,PG 75,Calculated Positive DP Rating 75,Calculated Negative DP Rating 75,Year Rated 08111 Grille: No Grille, Wrapping Information: Foldout Fins, Factory Applied, No Exterior Trim,6 9/16", 7 7/8", Prep For Stool Three Sided Jamb Extension, Factory Applied, Pella Recommended Clearance,Perimeter Length=294". Frame Size:99.9375"X 47" FF-9B-4 Wide+Full Frame Tear Out Installation Qty 1 EAC-1 -Exterior Aluminum Capping(Coll Stock) Qty 1 For more information regarding the finishing, maintenance, service and warranty of all Pella®products, visit the Pella®website at www.pella.com Printed on 4/23/2021 Contract-Detailed Page 12 of 21 Customer: Fred Grinnell Project Name: Grinnell Fred and Sarah 562 Kennedy Rd Leeds MA Order Number: 739W2EL151 Quote Number: 13926540 Line# Location: Attributes 70 Stairs Lifestyle, Casement Right,29 X 47,Without HGP, Brown Item Price Qty Ext'd Price $1,965.28 1 $1,965.28 1:2947 Right Casement PK# Frame Size: 29 X 47 2087 General Information: No Package,Without Hinged Glass Panel,Clad,Pine,5",3 11/16" Exterior Color/Finish: Standard Enduraclad,Brown l ', Interior Color/Finish: Linen White Paint Interior Glass: Insulated Tempered Low-E Advanced Low-E Insulating Glass Argon Non High Altitude Hardware Options: Wash Hinge Hardware, Fold-Away Crank, Champagne, No Limited Opening Hardware, No Integrated Sensor Viewed From Exterior Screen: Full Screen,Linen White,InViewT"" Performance Information: U-Factor 0.28,SHGC 0.27,VLT 0.51,CPD PEL-N-14-00685-00001, Performance Class LC, PG 50,Calculated Positive DP Rating 50,Calculated Negative DP Rating 50,Year Rated 08111, Egress Meets Typical 5.7 sqft(E) (United States Only) Grille: No Grille, Wrapping Information: Foldout Fins, Factory Applied,No Exterior Trim, 6 9/16", 7 7/8", Prep For Stool Three Sided Jamb Extension, Factory Applied, Pella Recommended Clearance,Perimeter Length=152". Frame Size:29"X 47" EAC-1 -Exterior Aluminum Capping(Coil Stock) Qty 1 FF-4-1 Wide Full Frame Tear Out Installation Qty 1 For more information regarding the finishing, maintenance, service and warranty of all Pella®products, visit the Pella®website at www.pella.com Printed on 4/23/2021 Contract-Detailed Page 13 of 21 Customer:Fred Grinnell Project Name: Grinnell Fred and Sarah 562 Kennedy Rd Leeds MA Order Number: 739W2EL151 Quote Number: 13926540 Line# Location: Attributes 75 Bottom of Stairs Lifestyle, 2-Wide Casement,50 X 47,Without HGP, Brown Item Price Qty Ext'd Price $3,708.68 1 $3,708.68 1:2547 Left Casement PK# Frame Size: 25 X 47 •\ 2087 General Information: No Package,Without Hinged Glass Panel,Clad,Pine,5",3 11/16" Exterior Color/Finish: Standard Enduraclad,Brown I Interior Color/Finish: Linen White Paint Interior 0• Glass: Insulated Tempered Low-E Advanced Low-E Insulating Glass Argon Non High Altitude Hardware Options: Wash Hinge Hardware, Fold-Away Crank, Satin Nickel, No Limited Opening Hardware, No Integrated Sensor Viewed From Exterior Screen: Full Screen,Linen White,InViewn, Performance Information: U-Factor 0.28,SHGC 0.27,VLT 0.51,CPD PEL-N-14-00685-00001,Performance Class LC, PG 50,Calculated Positive DP Rating 50, Calculated Negative DP Rating 50,Year Rated 08111, Egress Does not meet typical United States egress,but may comply with local code requirements Grille: No Grille, Vertical Mull 1: FactoryMull,Standard Joining Mullion, Mull Design Pressure-20, Overall Thru Direction-Vertical 2:2547 Right Casement Frame Size: 25 X 47 General Information: No Package,Without Hinged Glass Panel,Clad,Pine,5",3 11/16" Exterior Color/Finish: Standard Enduraclad,Brown Interior Color/Finish: Linen White Paint Interior Glass: Insulated Tempered Low-E Advanced Low-E Insulating Glass Argon Non High Altitude Hardware Options: Wash Hinge Hardware, Fold-Away Crank, Satin Nickel, No Limited Opening Hardware, No Integrated Sensor Screen: Full Screen, Linen White,InViewTM Performance Information: U-Factor 0.28,SHGC 0.27,VLT 0.51,CPD PEL-N-14-00685-00001, Performance Class LC, PG 50,Calculated Positive DP Rating 50, Calculated Negative DP Rating 50,Year Rated 08111, Egress Does not meet typical United States egress, but may comply with local code requirements Grille: No Grille, Wrapping Information: Foldout Fins, Factory Applied, No Exterior Trim, 6 9/16", 7 7/8", Prep For Stool Three Sided Jamb Extension, Factory Applied, Pella Recommended Clearance,Perimeter Length=194". Frame Size:50"X 47" FF-7-2 Wide Full Frame Tear Out Installation Qty 1 EAC-1 -Exterior Aluminum Capping(Coil Stock) Qty 1 For more information regarding the finishing, maintenance, service and warranty of all Pella®products, visit the Pella®website at www.pella.com Printed on 4/23/2021 Contract-Detailed Page 14 of 21 Customer: Fred Grinnell Project Name: Grinnell Fred and Sarah 562 Kennedy Rd Leeds MA Order Number: 739W2EL151 Quote Number: 13926540 Line# Location: Attributes 76 Bottom of Stairs Lifestyle, 2-Wide Sash Set, 50 X 47,Without HGP, Brown item Price Qty Ext'd Price U $2,866.54 1 $2,866.54 1:2547 Fixed Sash SetPK# Frame Size: 25 X 472087 General Information: No Package,Without Hinged Glass Panel,Clad,Pine,5",3 11/16"Exterior Color/Finish: Standard Enduraclad,Brown Interior Color/Finish: Linen White Paint Interior Glass: Insulated Low-E Advanced Low-E Insulating Glass Argon Non High Altitude Performance Information: CPD Not Rated, Performance Class LC, PG 50,Calculated Positive DP Rating 50,Calculated Negative DP Rating 50,Year Viewed From Exterior Rated 08111 Grille: No Grille, Vertical Mull 1: FactoryMull,Standard Joining Mullion, Mull Design Pressure-20, Overall Thru Direction-Vertical 2:2547 Fixed Sash Set Frame Size: 25 X 47 General Information: No Package,Without Hinged Glass Panel,Clad,Pine,5",3 11/16" Exterior Color/Finish: Standard Enduraclad,Brown Interior Color/Finish: Linen White Paint Interior Glass: Insulated Low-E Advanced Low-E Insulating Glass Argon Non High Altitude Performance Information: CPD Not Rated, Performance Class LC, PG 50,Calculated Positive DP Rating 50,Calculated Negative DP Rating 50,Year Rated 08111 Grille: No Grille, Wrapping Information: Foldout Fins, Factory Applied, No Exterior Trim, 6 9/16", 7 7/8", Prep For Stool Three Sided Jamb Extension, Factory Applied, Pella Recommended Clearance, Perimeter Length= 194", Glazing Pressure=65. Frame Size:50"X 47" FF-7-2 Wide Full Frame Tear Out Installation Qty 1 EAC-1 -Exterior Aluminum Capping(Coil Stock) Qty 1 Line# Location: Attributes 80 Down Stairs Lifestyle,Casement Right,29 X 47,Without HGP, Brown Item Price Qty Ext'd Price $2,132.02 1 $2,132.02 1 1:2947 Right Casement PK# Frame Size: 29 X 47 2087 General Information: No Package,Without Hinged Glass Panel,Clad,Pine,5",3 11/16" Exterior Color/Finish: Standard Enduraclad,Brown I / Interior Color/Finish: Linen White Paint Interior Glass: Insulated Tempered Low-E Advanced Low-E Insulating Glass Argon Non High Altitude Hardware Options: Wash Hinge Hardware, Fold-Away Crank, Satin Nickel, No Limited Opening Hardware, No Integrated Sensor Viewed From Exterior Screen: Full Screen,Linen White, InViewTm Performance Information: U-Factor 0.28,SHGC 0.27,VLT 0.51,CPD PEL-N-14-00685-00001, Performance Class LC, PG 50,Calculated Positive DP Rating 50,Calculated Negative DP Rating 50,Year Rated 08111, Egress Meets Typical 5.7 sqft(E)(United States Only) Grille: No Grille, Wrapping Information: Foldout Fins, Factory Applied,No Exterior Trim,6 9/16", 7 7/8", Prep For Stool Three Sided Jamb Extension, Factory Applied, Pella Recommended Clearance,Perimeter Length=152". Frame Size:29"X 47" For more information regarding the finishing, maintenance, service and warranty of all Pella®products, visit the Pella®website at www.pella.com Printed on 4/23/2021 Contract-Detailed Page 15 of 21 Customer: Fred Grinnell Project Name: Grinnell Fred and Sarah 562 Kennedy Rd Leeds MA Order Number: 739W2EL151 Quote Number: 13926540 1Project Checklist has been reviewed i' 4 C.,/ %Pt el Q (( Ad --1 L . I`�ot�+e 44,' Order Totals mer Name )(Please print) Pella Sales Rep Name (Please print) Taxable Subtotal $26,450.82 ��/4/ ail � Sales Tax @ 6.25% $1,653.18 Customer S t Pella Sales Rep Signature Non-taxable Subtotal $17,676.00 A7- ' - LI , 3 _ ( Total $45,780.00 ate Date Deposit Received $22,890.00 Amount Due $22,890.00 r it Car r al Signature For more information regarding the finishing, maintenance, service and warranty of all Pella®products, visit the Pella®website at www.pella.com Printed on 4/23/2021 Contract-Detailed Page 21 of 21 Pella Products, Inc. 155 Main Street Greenfield, MA 01301 Office:413-773-1157 Ext.317 Cell:413-834-8799 To: Building inspector From:Trevor Bross—Installation Manager Date: February 21, 2021 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 HIC#142279. Please find a copy of my licenses below. Commonwealth of Massachusetts Construction supervisor 1 Division of Professional Licensure Unrestricted -Buildings of any use group which contain Board of Building Regulations and Standards less than 35,000 cubic feet(991 cubic meters)of enclosed Ccnstrile }1fi rvis0r space. /f CS-096558 Expires:0:P01,2022 TREVOR BROSS 10 GEORGE STREET GREENFIELD MA 0130, L ,, ♦ t i4.,. a Failure to possess a current edition of the Massachusetts Commissioner ,,_,AAA4./4"""4---- State Budding Code is cause for revocation of this license. For information about this license ' L Call(617)727.3200 or visit www.mess.govldpl J Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:Corporation before the expiration date. If found return to: Registration gxpiration Office of Consumer Affairs and Business Regulation 142279 03/23/2022 1000 Washington Street -Suite 710 PELLA PRODUCTS,INC. Boston,MA 02118 ELW IN HERRINGSHAW i P 155 MAIN STREET .4 r.af l 'QG/os GREENFIELD,MA 01301 Undersecretary Not valid without signa e 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 CS106010 Vladimir Shevchuk CSSL099209 Scott Bowdish CSSL100232 Bill Leger CS89338 Christian Lambert CS065102 Robert Kairnes CS113305 Igor Kravchuk CS094911 PELLA PRODUCTS INC. 155 MAIN STREET GREENFIELD, MA. 01301 Date: 05/2/ To: (1//r ,( /v0/ 71 rzi, -o74 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. Denise Chartier Accounting Manager The Commonwealth of Massachusetts Department of Industrial Accidents — i=? Office of Investigations Lafayette City Center 2 Avenue de Lafayette, Boston,MA 02111-1750 ~4 ' www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors7Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): PELLA PRODUCTS, INC Address: 155 MAIN STREET City/State/Zip:GREENFIELD, MA 01301 Phone #:413-772-0153 Are you an employer?Check the appropriate box: Type of project(required): 1.EJ I am a employer with 50 4. % I am a general contractor and I 6. New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. 0Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition workingfor me in anycapacity. employees and have workers' P h * 9. ❑ Building addition [No workers' comp. insurance comp. insurance.* required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 1 I.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.]t c. 152, §1(4),and we have no 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. :Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: EMC INSURANCE COMPANIES Policy#or Self-ins. Lic. #:6H15382 Expiration Date:01-01-2022 Job Site Address: 2 ,i 4'd p' 'd City/State/Zip: tee if MA OM.53 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 certi y u der the pains and penal?* s of perjury that the information provided above is true and correct Signature:` Date: 6./S/21 Phone#: % 7-72., V/ Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(check one): ID Board of Health 20 Building Department 3❑City/Town Clerk 4.0 Electrical Inspector 51Ell'Iumbing Inspector 6.0Other Contact Person: Phone#: i'...mN PELLPRO-01 CHRISTINE 4 2 RLY CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) �'� 12/21/2020 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 have ADDITIONAL INSURED provisions or 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 Christine Sullivan NAME: Phillips Insurance Agency,Inc. PHONE FAX 97 Center Street (acp,�N�o,Ex*(413)594-5984 (A/c,No):(413)592-8499 Chicopee,MA 01013 ADDRESS:christine@phillipsinsurance.com INSURERS)AFFORDING COVERAGE NAIC t INSURER A:EMC Insurance Companies 21415 INSURED INSURER e:Union Insurance Co of Providen Pella Products,Inc INSURER C: 155 Main St INSURERD: Greenfield,MA 01301 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 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. INSR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD (MWDD/YYYYI (MM/DD/YYTY) A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR 6A15382 1/1/2021 1/1/2022 PRM EORae nce) $ 500,000 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X JET LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 (Ea accident) $ X ANY AUTO 6Z15382 1/1/2021 1/1/2022 BODILY INJURY(Per person) $ - OWNED SCHEDULED AUTOSO ONLY AUTOSNN BODILY INJURY(Per accident) $ AU- TOS ONLY _ NOB-OWNED ONLYY erPROPERTYaccident) DAMAGE $ A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 4,000,000 EXCESS UAB CLAIMS-MADE 6J15382 1/1/2021 1/1/2022 AGGREGATE $ 4,000,000 DED X RETENTION$ 10,000 $ B WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER Y/N 6H15382 1/1/2021 1/1/2022 500,000 OFFICER/PMEMBER EXCLUDED?ECUTIVE N I N/A E.L.EACH ACCIDENT $ (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500'000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Installation Floater$50,000 Included Operations usual to the sale and installation of doors&windows. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Leeds(Northampton)BuildingCommissioners THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN I P ) ACCORDANCE WITH THE POLICY PROVISIONS. Office 212 Main St Northampton,MA 01060 AUTHORIZED REPRESENTATIVE t I ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD