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13-025 (2) PREPARING FOR YOUR NEW WINDOWS AND DOORS Congratulations on your decision to increase the comfort level, value and appearance of your home. To maximize your investment and enable the installation to take place as smoothly as possible, we have created this page to acquaint you with what to expect when our installers arrive. 1. Expected Delivery Time. All of our windows are custom made at one of our manufacturing plants located around the country and shipped to any of our over 200 Window World locations. The time between when your order is placed and when the windows are ready to be installed, though not guaranteed is typically 6 to 8 weeks. At that point we will call you to set an installation date. If for some reason you need to delay your installation for more than a couple of weeks after notification that we are ready to install your order we will be happy to work with you. We will need to collect the remaining balance before installation if the delay you request is more than three weeks. 2. Access to the Windows and Doors. We will need approximately 2 feet in front of each window, inside your home, so we can place our drop cloths and tools necessary to perform our work. When the old windows are removed, gusts of wind typically flow through your home. It is advisable to gather together important papers, and other small items that can be disturbed by the wind and relocate them. Computers and other electronic equipment should be covered or relocated temporarily. Please move aside any furnishings that are in the way of our work. If any furniture items are too heavy to move easily, we will gladly assist you. 3. Window Coverings. To gain access to the interior of the windows, we need all mini blinds, vertical blinds, roll -up shades, shutters, drapes and any other window covering removed prior to our installation. We are not responsible for removing or reinstallation of these items and are not responsible for damage resulting in the removal and reinstallation. We also are not responsible for any window covering alterations that may be required to reinstall them. 4. Plants and Bushes. Occasionally we need to work in planters and other landscaped areas of your home that are adjacent to the windows and doors. Please survey your yard prior to us arriving and look for potential problems. Some trees and vigorous bushes need to be pruned back to give us access to your windows. Delicate plants and shrubs in areas right below a window should be temporarily relocated if they cannot survive being stepped on and you want to preserve them. We strive to be careful when working around vegetation, but our priorities are to focus on our work, your windows and our safety while working on your property. We are not responsible for any damage to plants, shrubs or landscaped areas. 5. Arrival and Departure Times. We will advise you of the expected arrival time for our crew at the time we set up the installation date with you. We generally stay till the job is done, unless it will be a 2 or 3 -day job, in which case we may work as long as there is daylight. It is our policy that our installers get a sign -off form and collect the outstanding balance at the completion of the job. We ask that you be available to approve the job and make final payment at the time of completion. If this is not convenient for you, we need to know before we start the job. Inclement weather and other unforeseen hindrances are a fact of life and as such we ask that you understand if the weather, traffic, etc. cause a delay or cancellation of an installation appointment. We typically do not schedule more than a day or two in advance to try to avoid such issues. 6. Our Worksite. We like to set up our worksite as close to your windows and doors as possible and generally your driveway is the best spot. If using the driveway will block a garaged car, please be ready to pull it out upon arrival. 7. Alarm Systems. For those of you who have alarm systems, the alarm company should be notified and advised of our job. They will be responsible for the disconnection and reconnection of your alarm system. 8. Where do we start? Upon arrival, the crew leader will survey the job and determine where to begin. If you have a preference, feel free to advise us and we will accommodate to the best of our ability. Because we work in stages (i.e., removal of old windows, setting the new window, wrapping of exterior, etc.), we don't complete the job one window at a time. The job moves along in a rolling progression where each operation is done on all windows at the same time. This produces a quality job. 9. If the job takes more than a day, will there be any openings in my house? No. We only remove that which can be reinstalled in the same day. Although there may not be a complete window, it will be weather -tight and secure for overnight. (Please no critiquing at this time). 10. Pets. We love furry, four - legged creatures; however, we need your help in supervising them. We are not always able to close a gate or door behind us when carrying a window, so please keep them in a safe place. Our job description does not include scampering down the street after Fido with new found freedom. Many people say, don't worry, he doesn't bite, but many installers have been bitten. So please secure dogs that have an aggressive bark towards strangers. 11. Expect some dust, noise and general disruption of your living space. Construction work can sometimes be messy depending upon the scope of your job. It's an unfortunate reality of remodeling, but we do our best to keep things under control. We appreciate your patience and understanding during the job and until everything is finished. Even after we have cleaned up, it is advisable to survey the areas for something we may have overlooked (i.e., kids rooms, baby's room). 12. *Damage to walls and old trim stops. For those of you who have old aluminum and steel windows and are replacing them due to sweating and damaging of the walls be advised that all water damage plaster will most likely fall out. In addition, all the patch work you have done over the years will fall out also. This is normal; however, we are not plaster experts, so the repair to those walls would best be left to the experts. In some cases due to out of square openings, new trim is required to make the window look good. *Unless noted on the contract new trim will not be provided or installed by us. You can expect to do some touch up painting on the trim after the installation of your new windows. This is not always necessary and is usually minor if it occurs. If your trim stops around your sashes are very old, dry, and brittle, they may snap and crack upon removal. If this happens, we can leave them off if you please, or for a small up charge, replace them with newer ones. Many of the old style stops are no longer available so we would replace the entire window with newer style stops. Should we discover any hidden damage to the frame or wall area we will advise you before we proceed. Should you decide to replace or repair anything, the price will be added to your balance. 13. Relax and enjoy the show. After we've been introduced to your home, feel free to run errands, take a walk, or just relax. If a question should arise; by all means ask the crew leader for clarification. We enjoy people who are interested in what we do, and most customers are intrigued with the process. We do get nervous, however, when a customer constantly hovers over our shoulder. Like any professional, we're always happy to answer questions, but we appreciate being able to concentrate on our work without interruptions and distractions. This ensures a safe and quality installation. 14. Past Due Balances are subject to a service charge of 1.5% per month. In the event that this amount is placed in the hands of an attorney for collection, the purchaser agrees to pay all costs of collection, including a reasonable attorney fee. Return check fee is $50 (fifty dollars). Salesperson Home Owner P.S. Now would be a good time to review contract with the salesman to be sure of your order options and work to be done. Only the items and services on the contract will be done. If you have any questions whatsoever, now is the time to ask. Window World of Western Massachusetts may not require an acceleration of payments as specified in the payment section (front) for the reason that he deems himself or the payments to be insecure. However, where the contractor deems himself to be insecure he may require as a prerequisite to continuing said work that the balance of funds due under the contract, which are in possession of the owner, shall be placed in a joint escrow account requiring the signatures of the home improvement contractor and the owner for withdrawal. Arbitration: Window World of Western Massachusetts and the PURCHASER(S) hereby mutually agree in advance that in the event Window World of Western Massachusetts has a dispute concerning the contract, Window World of Western Massachusetts may submit such dispute to a private arbitration service which has been approved by the Secretary of the Executive Office of Consumer Affairs and Business Regulations and the consumer shall be required to submit to such arbitration in M.G.L. c 142A. Window World Owner Date Date NOTICE: The signatures of the parties above apply only to the agreement of the parties to alternate dispute resolution initiated by the contractor. The owner may initiate dispute resolution even "where this section is not signed separately by the parties." l Ir y Window World of Western Massachusetts HIC # 165641 ► �� aiziout � 351 Walnut Street Ext • Agawam, MA 01001 CSL # 57011 r , II Phone (413) 786-9900 •• Fax (815) 366 8039 �� www .windowworldofspringfield.com • GOOD 'Simply the Best for Less" i HOUSEKEEPING': NAT- 41779 -1 r Name: i i ti p ,, f . ,a�' k „ % . Phone (H): c.><. / - * ½i , Install Addr: ji (; . 1 s /':`. > r a ' =/ Phone (W): Bill Addr: Ail' r I t) , f ,:" G',,,< . , i'? ( 1. 7 E -Mail: 1 WINDOW WORLD I---1 VALUE PLUS/TAX CREDIT PACKAGES 1 Series 0200 Single Hung $189 - 7 (/' Solar Glass w /Low E r $5 4' lc t" Series 2000 Mech. Frame Welded Sash $189 MA. Energy Reg. Upgrade F $14 L/ Series 4000 Double Hung $200 L (' Foam Insulation on Jambs $16 Series 6000 Double Hung $240 Remove Storm Window $16 Picture Window t .; / 1 -. $329 r Lifetime Glass / Seal Failure Warranty $16 2 Lite Slider $329 Transferable Lifetime Warranty $10 3 Lite Slider (1/4,1/2,1/4) ('/3,'/3,'/6) $520 Home Delivery / Mail Parts Warranty /$15 Awning $285 Double Strength Glass M; $16 Casement LH RH $285 Total Options: $158 Twin Casement (Requires 2 Value +) (0973) (0979) $570 , i„,.. e-' SALE PRICE (Save 50 %) $79 < v ''i f Three Lite Casement (Requires 3 Value +) $885 Heat Buster Package Upgrade $20 6000 Series Window Upgrade $40 1 BAY / BOW / GARDEN 1 Hopper (In existing wood frame only) $1 85 Bay (Insulated seat, Int. casing & Ext. Capping) $2650 Specialty Window $ Bow (Insulated seat, Int. casing & Ext. Capping) $2950 (. l ,. t/' 4 -r � Garden (I nt. casing & Ext. Capping) $2100 Window Color r 1 ( Inside outside Remove Existing Bay & Reframe $295 1 WINDOW WORLD UPGRADES 1 Roof for Bay /Bow Window $450 Full Screen $25. Woodgrain (LO) (Do) (CH) (Fx) (RM) (SM) $450 BEIGE Color charge $3g Second Floor Installation $500 . Ext. Color (AT) (AB) (DC) (HK) (FG) (ER) (CG) $165 1 PRE 1978 BUILT HOMES (Federal Lead Containment Law) I-- Woodgrain Interior (LO) (DO) (CH) (FX) (RM) (SM) $95 .. -/-, , 7 r� Flat Grids (TOP) (FULL) (ENDS) $40 L ;, EPA LEAD SAFE (Per Window) '', .> $817/ L'' C ontoured Grids (T t1 OP) ( LL) (ENDS) ' $40 `w EPA LEAD SAFE (Patio Dr / Bay / Bow / Garden) $100 ' Prairie Grids (single) /(Doubie) (Flat) /(conto $69 z MY HOME WAS BUILT IN THE YEAR /`" / `, i- 'In* al: Diamond /Brass Grids (TOP) (FULL) $69 I decline third party verification (Initial): ' ` f" Oriel/ Cottage Style (40/60) (60/40) $30 -I MISCELLANEOUS LABOR Obscure Glass Each,(o (FULL) !.cr 1 .1 " $35 ; q G- Full Exterior Capping (SMOOTH) /(PVC) $75 Tempered Glass Each (FULL) $65 Storm Capping (SMOOTH) / (PVC) $50 Triple Glazed TG2 (Argon) (6000 only) $155 Choose One: (White) / (Beige) / (Brown) Triple Glazed TK2 (Krypton) (60000n4) $195 Specialty Capping /Custom Trim $ I VINYL PATIO DOORS - LH or RH (Outside Looking In) Metal Window Extra Labor $100 Includes: White Interior Casing and Exterior Trim. Mull Removal $30 5 Ft. Sliding Patio Door (LH) (RH) $1250 Mull to Form Multi -unit $30 6 Ft. Sliding Patio Door (LH) (RH) $1300 Install Interior Stops (WHITE) /(UNFINISHED) $45 8 Ft. Sliding Patio Door (LH) (RH) $1500 Install Exterior Stops (WHITE) / (UNFINISHED) $45 9 Ft. Sliding Patio Door (LH) (RH) $1800 Install Interior Casing $60 Patio Door Beige Color $125 Repair / Replace Sill or Jamb $75 Patio Door Low -E /Argon $125 Mobile Home Conversion $185 Heat Buster Package Upgrade $215 Remove / Install NC $100 Patio Door Grids (Regular) (Woodgrain) $100 Woodgrain /Brown (LO) (DO) (CH) (F)Q $225 Site setup & disposal fee (or): $250.00 EPA Lead site setup & disposal fee: ', scl!: the Patio Door Triple Pane Upgrade $250 EPA Lead, third party verification: '. -, • • NO EXTRA WORK IF NOT IN WRITING / INSTALLER NOTES Extra labor (Box on left for description) $ Total Amount Due $ 2 5') 4,‘„,- -- y, 's',N-4-e-,d -,-:, 7 c i.sq' , IP' , I 1 ' ' ` 5 0% Deposit Amount: $ t , ? V ( , ` - °' i Sales Rep Recommended: [ ] Interior Stops [ ] Exterior Capping: [ ] Cash Customer Declined: [ ] Interior Stops [ ] Exterior Capping: [ ] Finance - ( ) Wells Fargo ( ) Other (Initial) I have received a copy of the Lead hazard information pamphlet [-- rCheck made to Window World of WM # / 1 informing ma-of the potential risk of the lead hazard exposure from renovation activity to be [ ] CC #: - - - perfor In my dwelling unit.:The EPA "Renovate Right" brochure. Exp. Date: V-code: (initial l have r, eived a copy of the lead test result(s). R Final Payment Amaarrt $ 7" f( $dry' Date: To be paid to the installer upon completion. We do not accept cash as final payment. Thank you. 4—_ ,<' 1 WINDOW WORLD CARES Name(s) (Prlr St. Jude Children's Research Hospital WW of W. Massachusetts anticipates starting this work on t% ` / ` — 1 `and being substantially completed in / f days. Security Interest: Yes No . Any deposit required in advance of the start of the work SHALL NOT exceed 33 1/3% of the total contract price or the actual cost of any material or equipment of a special order or custom made nature, which must be ordered in advance of the start of work to assure the project will proceed on schedule. No final payment shall be demanded until the contract is completed to the satisfaction on all parties. All home improvement contractors and subcontractors shall be registered and that any inquiries about a contract or subcontractor relating to a registration should be directed to: Office of Consumer Affairs and Business Regulation, Ten Park Plaza, Suite 5170 Boston, MA 02116. Phone: (617) 973 -8700. No work shall begin prior to the signing of the contract and transmittal to the owner of a copy of such contract. WW of W. Massachusetts under provision of Chapter 142A of the general laws is required to apply for and obtain all required construction - related permits. WW of W. Massachusetts shall not be deemed responsible for delays in the work described in this agreement caused by regulatory, permit granting agencies, authorities or individu- i als. Notice: If the PURCHASER(S) obtains his own construction related permits for the work described under this agreement or deals with unregistered contractors, the PURCHASER(S) is hereby advised that in i the event of a dispute, judgement and nonpayment, the PURCHASER(S) will not be entitled to make a claim or collection from the guaranty fund established *Chapter 142A, M.G.L. You the buyer may cancel this transaction at any time prior to midnight of the third business dad the date of the transaction. Notice of cancelation must be in writing or postmarked no tater than midnight of the following third business jay.-'fHI • - A CUSTOM ORDER NOT FOR RESALE! / O Date /l ,- <{ x, J- J , �... Sales Reg. Date / ner Date White Copy - Original Yellow Copy - File Pink Copy - Customer Rev. 0711 The Commonwealth of Massachusetts �..: Department of Industrial Accidents • : i Office of Investigations •-T . _ 0 600 Was/dngto Z St; eet Boston, MA 02111 °�„ + ` , www.mass.gov /dia Workers' Compensation Insurance Affidavit: Builders / Contractors /Electricians/Plumbers Applicant Information Please Print Legibly Name ( Business /Organization/Individual): WIN 1 i i , . t i; t_ 1 ' E. S T ear An • SSAC -M E I i S . QC , Address: I 0 2-9 •OaTI -} 1.0 A-D • City /State /Zip: W ES T p l E i-D ; MA. Q i C SS Phone #: M 13- 4 5 -- -733 Are you an employer? Check the appropriate box: 4. I am a general contractor and I Type of project (required): 1. I am a employer with Z ❑ employees (full and/or part- time).* have hired the sub - contractors 6 El New construction -• 1-1 * - -- listed on the attached sheet. 7. Ell Remodeling -. L_J t ana a sole proprietor or partz:er- 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.: 9• ❑ Building addition required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.1 i 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' 13.1A Other RE nilCitit, comp. insurance required.] IN i J ) &S ` ■r.y applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. 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. am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: LI (3E2._TP -) )AkTi il-L i S IkRA1JJCG — r o licy # or Self - ins.. Lic. #: W C 2 - 3 i S - 317 9 t4 ` - 01 i2. Expiration Date: S - 2-0 13 Job Site Address: 4(02 N )„,0Y ' ST City /State /Zip: WI nom ' nomprrn Mr9 0 1(0too • ttach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). ` air re to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a ne up to 81,500.00 and/or one -year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to 5250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of n;- estications of the DLA. for insurance coverage verification. do hereby certify : der the pains and senalties of � perjury that the information provided above is true and correct. I Z biunature: a. ;i �L Date: lip _ I hone #: ` i3 -L i g5 - 1335" Official 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 #: SECTION 8 - CONSTRUCTION SERVICES X 8.1 Licensed Construction Supervisor. i Not Applicable ❑ Name of License Holder : tZ V b e1 1/ s i,�� i LicenmP Number 117 Coos- v-C11 PWC s 11 Address Expiration Date «eki frills , rya ©lo30 2 Signature Telephone J 28/ 20 J) 3 ' 14141 ,!Z� y /9. Registered Home Improvement Contractor: Not Applicable ❑ 69tr+6v .5h \ (05 — G.1 Company Name Registration Number Yvl ndniu yvorld cr wcsj MR Address U I p c } p / ' ,i r� Expiration Date 102q NO 0 AVri I � //`` l, I d MP Telephone 4 48S - �3 3 J ) (sl I L 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 building permit Signed Affidavit Attached Yes No ❑ 11. - Home Owner Exemption 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 1083.5.1. Definition of Homeowner: Person (s) who own a parcel of land on which he /she resides or intends to reside, on which there is, or is intended to be, a one or two family dwelling, attached or detached structures accessory to such use and/ or farm structures. A person who constructs more than one home in a two -year period shall not be considered a homeowner. Such "homeowner" shall submit to the Building Official, on a form acceptable to the Building Official, that he /she shall be responsible for all such work performed under the building permit. As acting Construction Supervisor your presence on the job site will be required from time to time, during and upon completion of the work for which this permit is issued. Also be advised that with reference to Chapter 152 (Workers' Compensation) and Chapter 153 (Liability of Employers to Employees for injuries not resulting in Death) of the Massachusetts General Laws Annotated, you may be liable for person(s) you hire to perform work for you under this permit. The undersigned "homeowner" certifies and assumes responsibility for compliance with the State Building Code, City of Northampton Ordinances, State and Local Zoning Laws and State of Massachusetts General Laws Annotated. Homeowner Signature SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable) New House n Addition I 1 Replacement VJ r'ndows Alteration(s) n Roofing n Or Doors JJ Accessory Bldg. 1 1 Demolition 1 1 New Signs [0] Decks [El Siding [0] Other [0] Brief Description of Proposed �� P I Q��� U fr n�aiAis Work: 01 l v [ Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roil - 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 . 1. 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 , as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application_ (XC (Tnt((X D) Signature of Owner Date I, RO Der.t biaNA J , 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. Qof 61dilby Pyint Name ,L, twi Signature of Owner /Agent Date 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 ° ro (Lot area minus bldg & paved parking) # of Parking Spaces Fill: (volume & Location) A. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO 0 DONT KNOW Q YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO O DONT KNOW O YES 0 IF YES: enter Book Page 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 0 , Date Issued: C. Do any signs exist on the property? YES 0 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 acre? YES O NO 0 IF YES, then a Northampton Storm Water Management Permit from the DPW is required. • ., � ant i ar : ' City of Northampton t rmit , �. ���� Building Department Curb CuttDrnr y �t , , ;, . J 212 Main Street S r rcAu�tfi y a t� �_ Room 100 tirtf Ay+ �pF 8 6'N :NS,0106NS a NOR, PSOri, orthampton MA 0 1060 two wit ptt ofSt ralPl phone 413 - 587 - 1240 Fax 413 - 587 - 1272 PIot/Sat "!laps i* her Sp cif , 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 completed by office 4 („ 2 1 0 k, nq 5 T. Map Lot Un 1\1011 hamPr n Vl Zone, Overlay District � 4 i � � �,, Elm St. District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: «n MO rYUr igQn 167 NQx.Jr )g ST o1 o(0 Name (Print) Current Mailing Address: 5tt i ntr - t G 1. T elephone � ,.. � 1 / l Signature 3 2 l �� `7 1U 2.2 Authorized Agent: VObtrt 6 bu,51ley \ c "2q Norte 1Z-V, °I ° S 5- Name ( int) Current Mailing Address: o f - 7)1‘ 1 13- 18S - X3 5 Si nature Telephone ill SECTION 3 - ESTIMATED CONSTRUCTION CASTS Item Estimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building (a 1 Q-2_ 0 (a) Building Permit Fee 4 2. Electrical (b) Estimated Total Cost of Construction from (6) 3. Plumbing Building Permit Fee . 4. Mechanical (HVAC) 5. Fire Protection 6. Total = (1 + 2 + 3 + 4 + 5) S l Vv Check Number J 53 s I JCJ J This Section For Official Use Only Building Permit Number: Date Issued: Signature: Building Commissioner /Inspector of Buildings Date 462 NORTH KING ST BP- 2012 -1120 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 13 - 025 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- 2012 -1120 Project # JS- 2012- 001919 Est. Cost: $8492.00 Fee: $35.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: ROBERT BUSHEY JR 057011 Lot Size(sq. ft.): 22781.88 Owner: MARKARIGAN KEN Zoning: Applicant: ROBERT BUSHEY JR AT: 462 NORTH KING ST Applicant Address: Phone: Insurance: 1029 NORTH RD (413) 485 -7335 0 WC WESTFIELDMA01085 ISSUED ON:6/14/2012 0:00:00 TO PERFORM THE FOLLOWING WORK: INSTALL 26 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. Certificate of Occupancy Signature: FeeType: Date Paid: Amount: Building 6/14/2012 0:00:00 $35.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Louis Hasbrouck — Building Commissioner