29-178 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 handout 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?Of course not.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,taut we appreciate being able to concentrate on our work without interruptions and distractions.
This ensures a safe and quMity installation:`
14. Past.pule 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."
This Window World' Franchise is independently owned and operated by Window World of Western Massachusetts,Inc.under license from Window World,Inc.
WM WC 11-14
t
�y n Window World of Western Massachusetts M �%
) j HOUSEKEEPING
1029 North Road Hampton Ponds Plaza, • Westfield MA 01085
Phone (413) 485-7335 • Fax (413)-485-7055 NAT-41779-1
www.WindowWorldofSpringfield.com HIC# 165641 B
"Simply the Best for Less" CSL#57011 He�rch t'dpit
Customer: ._( ( t( yV. Phone (h)
Install Address: ) i_ � Pro 7r ter' f" E" � )o`.r r?_'". �.. , (40,Q Phone (w)
Bill Address: E-mail
WINDOW WORLD A ( 2 GLASS OPTIONS ADD U_VALUES �" I
2000 Series Mech. Frame Welded Sash $189 -'
4000 Series DH $215 SolarZone Glass Package* (LE) $79 ,.-
6000 Series DH (Triple Pane) $249 SolarZone Elite Glass Package* (LEE) $89
Picture Window $329 SolarZone Plus (Super Spacer) (LEEP)*$110
2 Lite Slider --- $329 __ SolarZone TG2 3 Pane Glass (6000 Only) $155
_3 Lite Slider /4,1/2,t/a> (1/3,t/s,1/3) $575
Awning _ $295 SolarZone TK2 3 Pane Glass/Krypton(6000 Only) $185
Casement LH RH $295 *All SolarZone packages include 112 screens,Foam Insulation on Jambs and Head,Double
Twin Casement(Requires 2 Value+)(0973) (0979) $590 Strength Glass,Double Locks(>29"),Lifetime Glass Breakage and Labor Warranty,Argon Gas
Three Lite Casement (Requires 3 Value+) $885 PRE 1978 BUILT HOMES (FEDERAL LEAD CONTAINMENT LAW) j
Basement Sliders <55 UI $239 MY HOME WAS BUILT IN THE YEAR INITIAL
Hopper(In existing wood) (Vent+$150) $195/$250 CJ EPA LEAD SAFE (Per Window) $60
Specialty Window $ EPA LEAD SAFE (Patio Dr/Bay 1 Bow/Garden) $100
Bay/Bow(Insulated seat,Int.Casing&Ext.Cap)8'Plus$3375
Garden Window(Insulated seat,Int.Casing&Ext.Cap) $1995 EPA Lead site setup &disposal fee: $100.00
Grids/Ext.Color/Int.Woodgrain/Colors calculated in WW Upgrades EPA Lead, third party verification: $475.00
Remove Existing Bay/Bow $250 1 decline third party verification ❑ (INITIAL):
Reframe&Retrim (stain/paint not included) $300 (Initial) I have received a copy of the Lead hazard information pamphlet
Roof for Bay/Bow Window $600 informing me of the potential risk of the lead hazard exposure from renovation activity to be
Second Floor Installation $500 performed in my dwelling unit,the EPA"Renovate Right"brochure.
Window Color , / ��,f " (initial)I have received a copy of the lead test result(s). j
Inside Outside
WINDOW WORLD UPGRADES Sign: 4 ;` r Date:
5 Name(s (Print)
Full Screens
$3
BEIGE Color charge $50 MISCELLANEOUS LABOR .,. .
Ext.Color(AT) (AB) (DC) (HK) (FG) (ER) (CG) $165 Full Exterior White Trim/Wrap (SMOOTH) (PVC) $79 '
Woodgrain Interior(LO) (DO) (CH) (FX) (RM) (SM) $95 Color Other Than White $10
Contoured/Flat Grids (TOP) (FULL) (ENDS) $49 Specialty Custom Exterior Trim/Wrap $
Prairie Grids (Single)/(Double)-(Flat)/(Contour) $69 Quick Trim (Int) (Ext) $30
Diamond/Brass Grids (TOP) (FULL) $120 Aluminum /Vinyl or Steel Out $50/$125
Oriel/Cottage Style (40/60) (60/40) $45
Obscure Glass Per Sash (BOT) (FULL) $35/$70 ? Mull Removal $30
Tempered Glass Per Sash (BOT) (FULL)$60/$120
Mull to Form Multi-unit $30
Catalog Options $ Install Interior Stops (WHITE VINYL) $45 I)
Install Exterior Stops (WHITE VINYL) $45
VINYL PATIO DOORS - LH or RH (Outside Looking In) Customer Provided Stops/Trim $20
(Includes: White Interior Casing and Exterior Trim.) Install Interior Casing $60
5 Ft. Sliding Patio Door(LH) (RH) $1250 Repair/Replace Sill or Brickmould $75
6 Ft.Sliding Patio Door(LH) (RH) $1300 Mobile Home Conversion $200
8 Ft.Sliding Patio Door(LH) (RH) $1500 Remove/ Re-Install A/C or Awning $100
Patio Door Beige Color $125
Patio Door Low-E/Argon $125 Site Setup, Removal, In Home Service, etc.: A-AA
Heat Buster Package Upgrade $215 Extra labor (Box on left f C descrip io '
Patio Door Grids (Regular) (Woodgrain) $100 Total Amount Due$ +
Woodgrain/Brown (LO) (DO) (CH) (FX) $225 50% Deposit Amount:
Exterior Colors $395
Patio Door Triple Pane Upgrade $250
Keyed Lock$36 Foot Lock$51 [] Cash
Storm Door Model $ [] Finance- O Wells Fargo ( ) Other
NO EXTRA WORK IF NOT IN WRITING! [] Check m WM #
CC
Exp. Date: r-codeW i
Final Payment Amount$ 2 _
To be paid to the installer upon installation.Thank You. i
rSales p Recom mended: [] Interior Stops [] Exterior Capping: WINDOW WORLD CARES
r Declined: [] Interior Stop [] Exterior Capping: St.Jude Children's Research Hospital $
WW of W. Massachusetts anticipates starting this work on '"7" ' and being substantially completed in`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 the work to assure that the project will proceed on schedule. No final payment
shall be demanded until the contract is completed to the satisfaction of all parties.
All home improvement contractors and subcontractors shall be registered and that any inquires about a contract or subcontractor relating to a registration should be
directed to:Office at Consumer Affairs and Business Re�i A,tion,Ten Park Plaza,Suite 5.170 Boston,MA 02116.Phone: (617)973-8700
No work shall begin prior to the signing of the d'oo�ttrac and transmittal to the owner of a Copy of such contract.
WW of W. Massachusetts under provision of Chapter 142A of the genera!laws is required to apply for and obtain all construction-related permits.WW of W. Massa-
chusetts shall not be deemed responsible for delays in the work described in this agreement caused by regulatory, permit granting agencies,authorities or individuals.
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 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 by chapter 142A,M.G.L.
You the buyer may cancel this transaction at any time prior to midnight of the third business day after the date of this transaction.
Notice of cancellation must be in writing postmarked no later than midnight of the following third business day.
THIS IS A CUSTOM ORDER NOT FOR RESALE!
r E Owner Date
Salesman lop, r Date Owner Date
This Window World'Franch independently owned and operated by Window World of Western Massachusetts,Inc.under license from Window World,Inc.
WM WC 11-14 White Copy-Original Yellow Copy-File Pink Copy-Customer
The Common wealth of Massalch usetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
kv Boston,MA 02111
4,,4wanass govvdia
Workers' Compensation lusurar-ce Affidavit~ Builder's/Contractors/Electricians/Plumbers
Applicant Information �. Please Print Le 'k
Name (Business/OrganizatiortiIndividual): " %g_ 'T� 4 ; _ 1��5 _j MA SSAc- 55TTS
Address: 102A 00114 PD
City/State/Zip: W F-6 "F I F i.--t> M P- U l 0$S Phone#: L4 1 3 ``t 15 - 7 3 3 5'
Are you an employer?Check the appropriate box: 'Type of project(required):
1.[ I am a employer with 4 4. [] I am a general contractor and 1
employees(frill and/or part--brne).'� have hired the sub ccnti2c.tots 6. Q New construction
2.® I item a sole proprietor or partner-
listed on the attached sheet. 7. Q Remodeling
ship and havd,no employees These sub-contractors have ! g. Q Demolition
working for me in any capacity. employees and have workers'
F h 9. Q Building addition
[No workers'comp. insurance comp. insurance.
required.] 5. We are a corporation and its 10.x] Electrical repairs or additions
3.[1.1 am a homeowner doing all work officers have exercised their 11.®Plumbingg,repairs or additions
i myself. [No workers' comp, iigbt of exemption per MGL 12.Q Roof repairs
i+ insurance required.]t c. 152,§1(4),and we have no
employees. [:AIL workers 13.2g Other R01.flCE^FJdT-
__ comp. insurance required.]
`Any applicant that checks box x1 must also fill out the sr.ron below showing their workers'compensation policy information.
±Homeowners who submit this affidavit indicating they av"doing al!work and then hire outille contractors must submit a new affidavit indicating such.
^Contractors that check this box roust attached an additional shit showing the name of the sub-contractors and state whetter or not those entities have
employees. If the sub-contractors have employees,they must provide their workers'comp.pc?icy number.
I am an employer that is providsng workers'cotnpe s ation insurance for my employees. Bdow is the policy and job site
information.
Insurance Company Name: L-1 0E-P-711 MkTU'AL iAL-514RI V69-
Polic;-#or Self-ins.Lie. #: _ c 2- 3 1 S- 317 q 47 -015 Expiration Date: ?—
Job Site Address:_ i , tX r � ,,L� t t City/State/Zip:t i J� —nit b l b b(a
Attach a copy of the workers' compensation policy,declaration cage(showing the policy number and expiration date).
Fai lure 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 o`this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
f do,iereby certify un r the p and of perjury that the anj`or»urtion provided above is true and correct
Sign,attire. Date: 1�
Phone#: b 5 - -733E
Dffwial use only. Do not write in this area,to be completed by city or town o,�tcial
City or Town: Permit/License#
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3. Cityr''I'own Clerk 4.Electrical inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone#:
SECTION 8-CONSTRUCTION SERVICES
-*,.I Licensed Construction Supe ison Not Applicable 0
Name of License Holder: E
License Number
570 t1
T
Address I Expiration Date
Signature Telephone
2 S
R_egistered Home Improvement Contractor. Not Appiicable ❑
JL T S4 f-14 a-fL
Comoany Name Registration Number
3
Address i Expiration Date
AA V- Telephone 4 t '-1&,4 733'!:'::1
SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.=.L.c.152,§25C(6))
Workers Compensation Insurance affidavit must be compieted and submitted vAth�dbis app4cation. allure to provide this affidavit will result
in the denial of the issuance of the building permit
Signed Affidavit Attached Yes. No_ _. -0
11. - Home Owner Exemption
The current exemption for"homeowners"was extended to include Owner-occupied-Dwe lirL-s_of one(1) or twc 2)farailies
and to allow such homeowm:r to engage an individual for hire who does not possess a license,provided that the owner acts
as supervisor. CMR 780, Sixtb Edition Section 108-3.5.1.
Definition of Homeowuer7 Person(s)who o-,Am 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 2ersov 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 acccptable to the Building Official.that he/she shall be
responsible for all such work performed under the build rwit.
As acting Construction Supervisor your pr�ence on the job site will be required from time to time,during,and upon
completion of the work for which this pernit is issued-
Also be advised that with reference to Chapter 152(Workers' CorrDensation) 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 per-form work-for you under this permit.
The undersigned"homeowner"certifies and assumes responsibilit,for compliance with the State Building Code,City of
Northampton Ordinances,State and Loca',Zoning Laws and State offMassachusetts General Laws Annotated-
Homeowner Signature
SECTION 5-DESCRIPTION OF PROPOSED WORK(check ali applicable',
New House Addition Replacement Windov-s Alteration(s) Roofing
E-1 ;
.4 Doom
Accessory Bidg. 0 i Demolition New Signs jol Decks Siding[M] Other[C:]
"ne, Desciiption of Proposed
Aiteration of existing bedroom —Yes No Adding new bedroom Yes No
Attached Narrative Yes
Renovating unfinished basement No
Plans Attached Roil -Sheet
6a. If New house and or addition to existing ho using, complete the following:
2- Use of building:One Farnilv Two f=amily Other
Number ofroorns in each fa; 6y unit- Number of Ba`hroorns
c- is there a garage attached? _ f
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?
ne,
h Type of constriction
i Is construction within 100 ft. of wetlands? Yes No- is construction within 100 yr. 'lloodplain Yes No
Depth of basement or cellar floor below finished grade
k- Will building conform to the Building,and Zoning regulations? Yes No
Seobc Tank— City Sewer Pnvate well City water Supply
SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
as Owner of the subject
property
hereby authorize F_
to act on my beh2Ff,—,,2 F12a�erbs e;e`iaLt1ve to—work 3, rued this building permit application.
Signature of Owner Date
i as Owner/Authorized
Agent hereby declare that the statements and ft-5orma'don on the foregoing application are true and accurate, to the best of my knowledge
and belief.
i Signed under the pains and penalties of penury-
' P�nt Name
Signature of Owner! gent Date
Section 4. ZONING AU Informati,)r Se Compteted. Permit,Can,Be Denied Due TO Incomp(ete information
troposed Required by Zoning
Tlu_';Column to be fffle7in by
Lot Si2e
Setbacks Front
Building Height
Bidg.Square Footage
Open Space Footage
of ParkiDg Spaces
/
A. Has aSpedai ever been issued for/oothe site?
/~-\
' 0 ��
NO \`� D0NTKNOYf \�/ Y�� \_/
}F YES, date issued:
IF YES: Was Lihe permit recorded at the Reggistry of Deeds?
NO � D0NTKN0Y 0 YE�
L
IF YES: enter Book Page end/or Document#
B. Does the site contain a b/ook, body of water o/wettandsl 140 /—\ DQNTKN0YY /—\ YES
IF YES, has a permit been orn`edl to be obtained. fuunthe �onservatjmn Commission?
Needs tubeobtaned Obtained /\ Date' ' '
C. Do any signs adst or, the property? YES /—\ NO 0
IF YES, describe size. type aod Locat�on:
D. Are there any proposed changes to or additions of signs-intended for the property ? YES 0 NO /~-\
|r7 YES, describe.-jjze. type and Location:
E_ 'vVodre.znom'CtiOnacbvnydi:;tu/b( :ng_0mding on, orh|8ng}overlacreoris it part ofa common plan
M�snv°VUimorb over ` acre? Y;__-S NO ( )
/F YES, then a Northam,ptonStonnvva�cr Management pa,nitovm the DPW iorequired-
Department use only
J . l `' t City of Status of Permit:
a Building Department �iC%O Cut�D6 l?ersnit
34
212 MaIft ai''eF'.k �3e 1NB1'1`�`eAtICAStail$kIIty
ns Room ,t� !St��ferr'WetrAvaiiabtttfy
t
Ga'�6 hamoton, MA 01060 ���r�sets c�€St tuVat F�ans'
P1Utnb`n9 ►,AP p1
tt;o �h2r�at°" one 413-587-1'240 Fax 413-587-1272 oft e Plans
>vo
d. Otheri I
r _
APPLICATION TO t;ONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH'A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION
This section to be completed by office
1.1 Prove Address:
I I l p V,i0 U r-5)D E l Map Lot Unit
RoprN cl Mpr Di 1 0061 Zone Overlay District
� ll
Elm St.District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT --
i
12.1 Owner of Record:
t Ou Lh (Slzxl�-R- 6&)4-S AE CW-
Name(Print) Current Viaii;n Address tom-
I �
13
5& (,C➢I-tr a C+ Telephone
Signature
2.2 Authorized Agent:
Name(Print) Current Mailing Address:
i
Signature Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS j
Item Estimated Cost(Dollars)to be Official Use Only
com pleted by ' it applicant
1 Bui..ing I I t/� � r o i (a)Building Permit Fee
2 Electrical (b)"J V (b)Estimated Total Cost of
Construction from 6
3 Plumbing Building Permit Fee
i
4. Mechanical(HVAC)
5. Fire Protection
r 6 Total=(1 +2+: +4+5) Check Number
This Section For Official Use Only
Date
Building Permit NUr fiber. Issued:
Signature:
Building Commissionerlinspector of Buildings Date
i
176 BROOKSIDE CIR BP-2015-1377
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:29- 178 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: windows replaced BUILDING PERMIT
Permit# BP-2015-1377
Project# JS-2015-002502
Est. Cost: $4910.00
Fee: $35.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: ROBERT BUSHEY JR 057011
Lot Size(sq. ft.): 16160.76 Owner: CROCKER ALICE
Zoning: Applicant. ROBERT BUSHEY JR
AT. 176 BROOKSIDE CIR
Applicant Address: Phone: Insurance:
1029 NORTH RD (413) 485-7335 () WC
WESTFIELDMA01085 ISSUED ON.613012015 0:00:00
TO PERFORM THE FOLLOWING WORK:IN STALL 12 PLACEMENT 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 6/30/2015 0:00:00 $35.00
212 Main Street, Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner