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24C-076 (3)
BP-2022-0768 24 MASSASOIT ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 24C-076-001 CITY OF NORTHAMPTON Permit: Exterior Res PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit# BP-2022-0768 PERMISSION IS HEREBY GRANTED TO: Project# DOOR Contractor: License: Est. Cost: 5622 PELLA PRODUCTS, INC 096558 Const.Class: Exp.Date:03/01/2024 Use Group: Owner: FRATKIN ELLIOT M& MARTHA A NATHAN Lot Size (sq.ft.) Zoning: URB Applicant: PELLA PRODUCTS, INC Applicant Address Phone: Insurance: 155 MAIN ST 6H15382 GREENFIELD, MA 01301 ISSUED ON:06/28/2022 TO PERFORM THE FOLLOWING WORK: PATIO DOOR 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: Final: Final: Final: Rough Frame: Gas: Fire Department Driveway Final: Fireplace/Chimney: Rough: Oil: Insulation: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: • r . y2 . �� 15, Fees Paid: $40.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner F3--„__0j,_//:-EC _ The Commonwealth of Massach i setts fUN Board of Building Regulations and .tan rds 2��2 pp><I I Y Massachusetts State Building Code 78%r USE TOP. Building Permit Application To Construct,Repair, - •, i, i', "a Revi ed Mar 2011 One-or Two-Family Dwelling •TON•MA p crio 0 2 This S For Official Use Only Building Permit Number: 60-A 2,- -700 Date Applied: kui &)53 1l'" G.ZS-ZOZZ Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers oZ`j G- /c7P Ly M0. .uso.%lr Sk FJ� A. MMa 'LU ro c6007 , or,0 I 1.la Is this an accepted street?yes if no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: ex 2(1c,i l.e,s2%ciN}t'1 _. Zoning District Proposed Use Lot Rhea tsq`1t) Fr ge(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Wait!.Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage sposal System: Public Private CI Municipal Outside Flood ne? Municipal On site disposal system 0 Check if yes SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: Dio•F F(ck1 K;n No(thok-Mpior\ t-itA o1 o w Name(Print) City,State,ZIP 2-14 t-AotSSC o •v1- S-k- 413-53I-93 42.01F(aVV-:n 0ctrvt;l-cv% No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(checyall that apply) New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg. ❑ Number of Units Other 0 Specify: SAi d vncc Dour Brief Description of Proposed Work': et(A u.0 in 01 Ord S 1 i C&in 9 Pat4(C) OW U r V Si'n 9 exisf() 0 Peninri in1 ith (lU CkreiVICVeS 140 FLa 'u►I d r n9 g P-4 0(4" U =' 2q SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ S(Q 22 , S 1 1. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical $ , UU 0 Standard City/Town Application Fee 0 Total Project Cost3(Item 6)x multiplier x 3.Plumbing $ D. U 1) 2. Other Fees: $ 4.Mechanical (HVAC) $ 0,W List: 5.Mechanical (Fire $ Suppression) 0. 0 0 Total All Fees: $1 b �Z sl Check No.15 1Q Check Amount: Cash Amount: 6.Total Project Cost: $ 5 ❑Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) Tv'-&)G✓ Sic 5* License Number Expiration Date Name of CSL Holder (.J List CSL Type(see below) No.and Street Typ Description (^j-nth(1 ot 1 A /� o' 301 Unrestricted(Buildings up to 35,000 Cu.ft.) City/Town,State,ZIP N l/"� R Restricted 1&2 Family Dwelling M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances 4/a-73(o-cfIzei \'6aetllaQ&Lle5' Ccr I Insulation Telephone ( Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) 1 L 2 7-7ef 3/2 31'Zu 19cRot P(O Cr ' HIC Registration Number Expiration Date HIC Company N ame orjlIC Registrant Name �1r,11,n Sr pe/Ms'FS@penCISCl/eS'Cam No.and Street / Email address v�.n4t'�lck MA- 0130 N 13--7 362—q z 3q City/Town,State,ZIP Telephone SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152.§ 25C(6)) Workers Compensation Insurance affidavit must be ompleted and submitted with this application. Failure to provide this affidavit will result in the denial of the Issu a of the building permit. Signed Affidavit Attached? Yes No ❑ SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,as Owner of the subject property,hereby authorize �l of 6006(.4-5 to act on my behalf,in all matters relative to work authorized by this building permit application. .gee-afifAVato24 / /4/77 Print Owner's Name(Electronic Signature) Date SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information contained' i pplication is true ate to the best of my knowledge and understanding. Print Owner' or Authorized Agent's Name(Electronic Signature) Date NOTES: 1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration program or guaranty fund under M.G.L.c. 142A.Other important information on the HIC Program can be found at www.mass.gov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dps 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) (including garage,finished basement/attics,decks or porch) Gross living area(sq.ft.) Habitable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of half/baths Type of heating system Number of decks/porches Type of cooling system Enclosed _ Open 3. "Total Project Square Footage"may be substituted for"Total Project Cost" DocuSign Envelope ID:381703F0-8449-4E1D-80CB-D9438C387CC8 41: -. Pella Products Inc. ?"A' 155 Main Street Greenfield, MA 01301 To Whom it may Concern: Elliot Fratkin , 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; 24 Massasoit St Northampton, MA 01060 Please accept this letter in place of my signature on the permit application. Thank you, DoeuSipned by: Signature: 4V'aciin, -6C092B3AA173475._ Date: 6/8/2022 �', PELLPRO-01 CHRISTINE ACORO CERTIFICATE OF LIABILITY INSURANCE DATDIYYYY) `� 12/6/2021 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 UtreCT Christine Sullivan Phillips Insurance Agency,Inc. PHONE FAX 97 Center Street (A/C,No,Ent):(413)594-5984 FAX No):(413)592-8499 Chicopee,MA 01013 AD jgLFss:christine@philIipsinsurance.com INSURER(S)AFFORDING COVERAGE NAIL i INSURER A:EMC Insurance Companies 21415 INSURED INSURER B:Union Insurance Co of Providen Pella Products,Inc INSURERC: 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 POLY EFF POLICY EXP UNITS INSR MID QW DI iDD/YYYY) (MMIDYYYYI A X COMMERCLAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR 6A15382 1/1/2022 1/1/2023 DRAEtAIEES(Ea om rPence) $ 500,000 _MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY I X I JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ A AUTOMOBILE LUABILTTY (Ea B accideniSINGLE LIMIT) $ X ANY AUTO 6215382 1/1/2022 1/1/2023 BODILY INJURY(Per person) $ —_ OWNED ONLY _AUUTOpSyUyLEEDp BODILY INJURY(Per accident) $ 1,000,000 A�TOS ONLY _AUTOS ONLY erzycat) E $ $ A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 4,000,000 EXCESS LIAB u CLAIMS-MADE 6J15382 1/1/2022 1/1/2023 AGGREGATE $ DED X RETENTION S 10,000 Aggregate $ 4,000,000 B N PER OTH- AND EMPLOYOERS'UABI�LITY Y INSTATUTE ER . ANY PROPRIETOR/PARTNER/EXECUTIVE 6H15382 1/112022 1/1/2023 E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,descnbe 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 THE EXPIRATION DATE THEREOF,City of Northampton ACCORDANCE WITH THE POLICY PROVISIONS. WILL BE DELIVERED IN 212 Main St Northampton,MA 01060 AUTHORIZED REPRESENTATIVE /r ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD The Commonwealth of Massachusetts ==. Department of Industrial Accidents k\ Office of Investigations ziN Lafayette City Center == �, 2 Avenue de Lafayette,Boston,MA 02111-1750 www.mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information Please Print I egibIN Name(Business/organization/Individual):Pella Products,Inc. Address:155 Main St City/State/Zip:Greenfield,MA 01301 Phone#:413-774-0153 Are you an employer?Check the appropriate box: Type of project(required): 1.1=1 I am a employer with 50 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. El New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. I.Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. employees and have workers' [No workers'comp.insurance comp.insurance.t 9. El Building addition 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 11.0 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' 13.0 Other comp.insurance required.] 'Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and 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:01-01-2023 Job Site Address: 2-Lk M ta,,s of s o l City/State/Zip: N o f thAMQfGl1 frtA 01 U(4 d 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. do hereby certify under/the pains and penaltie o ' I ry that the information provided above is true and correct. Signature: ;%'-? .,t.� -A>4 Date: (1,1 Ll(ZZ Phone#: Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(check one): l❑Board of Health 20 Building Department laity/Town Clerk 4.0 Electrical Inspector 5.DPlumbing Inspector 6.0Other Contact Person: Phone#: PELLA PRODUCTS INC. 155 MAIN STREET GREENFIELD, MA. 01301 Date: (el k\jzi To:CRu ( - ,U;A(AmnI- 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. Joy Grover Accounting Manager Pella Products, Inc. 155 Main Street Greenfield, MA 01301 Office:413-512-5968 Cell:413-834-8799 To: Building inspector From:Trevor Bross—Installation Manager Date: February 17,2022 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 Division of Occupational Llcensure y Unrestricted -Buildings of any use group which contain Board of Building�.R`�ulations and Standards less than 35,000 cubic feet(991 cubic meters)of enclosed i Constr An nfS visor space. CS 096558 Etpires:03/01/2024 TREVOR BROSS ` 10 GEORGE STREET GREENFIELO'ftA Mel - a tr/I 11'l 1, Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. Commissioner 'S. ,. / ''- For information about this license Call(617)727-3200 or visit www.nniss.gov/dpl THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs&Business Regulation Registration valid for individual use only before the HOME IMPROVEMENT CONTRACTOR expiration date. If found return to: TYPE:Supplement Card Office of Consumer Affairs and Business Regulation Registration Expiration 1000 Washington Street -Suite 710 142279 03/23/2024 Boston,MA 02118 'ELLA PRODUCTS.INC. -REVOR BROSS 55 MAIN STREET 3REENFIELD,MA 01301 Undersecretary Not valid without signature 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 C589338 Christian Lambert CS065102 Robert Kairnes CS113305 Igor Kravchuk CS094911 Contract - Detailed ?‘ Pella Window and Door Showroom of Greenfield Sales Rep Name: 240 Mohawk Trail Sales Rep Phone: Greenfield, MA 01301-3209 Sales Rep Fax: Phone:(413)774-7231 Fax: (413)774-6348 Sales Rep E-Mail: Customer Information Project/Delivery Address Order Information Elliott Fratkin Fratkin Elliott 24 Massasoit St Northampton MA Quote Name: 250 Sliding Patio Door 24 Massasoit St GF 24 Massasoit St Order Number: 739X3GR01 I NORTHAMPTON,MA 01060-2016 Lot# Quote Number: 15613508 Primary Phone:(413)5313893 NORTHAMPTON,MA 01060-2016 Order Type: Installed Sales Mobile Phone: County: HAMPSHIRE Wall Depth: Fax Number: Owner Name: Payment Terms: C.O.D. E-Mail: emfratkin@gmail.com Elliott Fratkin Tax Code: MASS Contact Name: Owner Phone: (413)5313893 Cust Delivery Date: 11/18/2022 Quoted Date: 6/7/2022 Great Plains#: 1006736229 Contracted Date: 6/8/2022 Customer Number: 1010577530 Booked Date: 6/9/2022 Customer Account: 1006736229 Customer PO#: Customer Notes: Installation includes removal of old patio door,installation of new patio door Long carry around house to back door Deposit check$2811.00 Balance Due$2811.51 COD For more information regarding the finishing,maintenance,service and warranty of all Pella®products,visit the Pella®website at www.pella.com Printed on 6/11/2022 Contract-Detailed Page 1 of 10 Customer: Elliott Fratkin Project Name: Fratkin Elliott 24 Massasoit St Northampton MA Order Number: 739X3GR011 Quote Number: 15613508 Line# Location: Attributes 10 Patio Door Pella 250 Series, Double Sliding Door, Fixed/Vent Left,95.5 X 79.5,White Item Price Qty Ext'd Price [ $5,362.57 1 $5,362.57 • I 1:9680 Fixed/Vent Left Double Sliding Door Frame Size: 95 1/2 X 79 1/2 PK# General Information: Factory Assembled,Standard,Vinyl,Nail Fin,Foam Insulated,5",1 1/8",3 7/8",No Sill Pan Exterior Color/Finish: White 2116 Interior Color/Finish: White Glass: Insulated Dual Tempered Low-E Advanced Low-E Insulating Glass Argon Non High Altitude Viewed From Exterior Hardware Options: White,Keylock Included,White,White,Steel Screen: Sliding Screen,White,Premium,InViewTM Unit Accessories: No Accessory Option Performance Information: U-Factor 0.29,SHGC 0.28,VLT 0.51,CPD PEL-N-251-00057-00001,Performance Class R,PG 35,Calculated Positive DP Rating 35,Calculated Negative DP Rating 35,Year Rated 11 Grille: No Grille, Wrapping Information: Pella Recommended Clearance,Perimeter Length=350". Rough Opening: 96"X 80" PD-2-Patio Door Install 8FT in width Qty 1 LP-1-Lead safe practices this opening Qty 1 EXTTRIMI9-5/4 x 4 Exterior Style PVC Qty 1 EXTTRIMI5-Kick board to match ext trim PVC Qty 1 Line# Location: Attributes 11 Jamb Ext. Wood Products Stop Square 1, Length: 96, Bright White.Wood Type: Pine Item Price Qty Ext'd Price $43.79 3 $131.37 1: Accessory Frame Size: 1 X 1 PK# General Information: Pine,Stop Square 1 Interior Color/Finish: Bright White Paint Interior 2116 Wrapping Information: Perimeter Length=0". Viewed From Exterior For more information regarding the finishing,maintenance,service and warranty of all Pella®products,visit the Pella®website at www.pella.com Printed on 6/11/2022 Contract-Detailed Page 2 of 10 DocuSign Envelope ID:381703F0-8449-4E1D-80CB-D9438C387CC8 tusturner. culuu rraucin rroject Name: Elliott Fratkin-24 Massasoit St,Northampton,MA Order Number: 739 Quote Number: 15613508 ❑Project Checklist has been reviewed Elliot Fratkin Mitchell Rousseau Order Totals , t0ineccnNAme (Please print) r_.Pigta,y pep Name (Please print) II Taxable Subtotal $3,145.92 'Elliot FrA.kik. htkL ..LL teewSSt-au Sales Tax @ 6.25% $196.62 Cvgfaft38t rgrhg[ttre "7'ePfa'§a1'e rrep Signature 6/8/2022 6/8/2022 Non-taxable Subtotal $2,280.00 Total $5,622.54 Bocusioned by: Date L Deposit Received $0.00 eject Fretick Amount Due $5,622.54 'CireYitftWikfi i?oval 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 6/8/2022 Contract-Detailed Page 8 of 8