29-437 51 ELLINGTON RD BP-2017-1496
GIS#: COMMONWEALTH OF MASSACHUSETTS
Mao:Block:29-437 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 re (paced BUILDING PERMIT
Permit# BP-2017-1496
Project# JS-2017-002492
Est.Cost: $7000.00
Fee: $40.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: WINDOW WORLD/ROBERT E BUSHEY JR 57011
Lot Size(sq. ft.): 10018.80 Owner: MELO JOSE C&MARIA L COSTA
zoning Applicant: WINDOW WORLD/ROBERT E BUSHEY JR
AT: 51 ELLINGTON RD
Applicant Address: Phone: Insurance:
1029 NORTH RD (413) 485-7335 O WC
WESTFIELDMA01085 ISSUED ON:6/23/2017 0:00:00
TO PERFORM THE FOLLOWING WORK INSTALL 9 REPLACEMENT WINDOWS**note -
.030 windows required**'
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: Housea Foundation:
Driveway Final:
Final: Final:
Rough Frame:
Gas: Fire Department Fireplace/Chimney:
Rough: O1: 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 6/23/20170:00:00 $40.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
1. ... DepartMeat use only
Jr.;;,,, 2 2 ! qty of Northampton Sfxss o!?eumt
Building Department Ceapp «paiow ..
212 Main Street Se $goicAvai 0Eisty
Room 100 PIaFwANeglkva
Northampton,MA 01060 OyfSdyi. 4s -
phone 413-587-1240 Fax 413-587-1272 Vb25N0fettm-
CYtSjaep }
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 compleMd by office
5 ti - u ngi cn ed AMP A4 Lot 451 Una
NDr naii1ptal IYit3 01002 ZoneOVedayDistrict
Elm St District CB District
SECTION 2-PROPERTY OWNERSHIPtAUTHORIZFD AGENT
2.1 Owner of Record:
-(auYa CC -A r)1 thii,n� mi ?i( .
Name tenni Current MaAridLtI -1 ; /n3�
666,1 LC id-FaC1") Telephone .. —.
Signature
2.2 Authorized Agent
— , O�cc SHi,-j ..�...._ I6ent1 IintCT14 41)t}i 4e56 D/ 135 t£LD .t-iyt Gi065
Name(Pn t) Current Mailing Address
Signature Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cosi(Dollars)to be Oficial Use Only
completed by permit applicant
1. Buiding (a)Building Permit Fee
2 Electrical (b)Estimated Total Cost of
Construction from(6)
3 Plumbing Building Permit Fee
4 Mechanical(HVAC)
5 Fire Protection44
6. Tatai=(1 +2+3 +4+5) 1OX.nu Check Number L3 q1 J
This . tion For Official Use Only
Building Permit Number Date
Issued:
675
,.^)`�r//�
Signature: O ' Q I
Or
Building Commissioner/Inspector of Buildings Date
e
J j ofe j - 03 g cc)t� a cos 2 �/t'Qp
Y
SECTION 5-DESCRIPTION OF PROPOSED WORK I check all applicable)
New House UAddition Repiacement,Windows Afterationis) n Roofing rl
(IIj� t-1 Or Doors [�
JI Accessory Bldg. ❑ Demolition 0 New Signs 10] Decks to Siding Kg] Other[03
/Beef Oesanpbon of Proposed 1
Work ,nSnketl Iti lacy ent 1ndoas Non-Si-rwiliroa
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement _Yes No
Pians Attached Roil -Sheet
Ga.If New house and or addition to existing housing,complete the following:
a. Use of building:One Family Two FamilyOther
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?
t Method of heating? Fireplaces or Woodstoves Number at 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. f}oodplain_ „Yes_No
I. 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 la-OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
,as Owner of the subject
property
hereby authorize `�a`yt I l rptA11("y�Oa y --
to act on my behalf,in at wagers relative to work autii6rized by this building permit apldication.
Signature of Owner Date id j(Q-(
KO PtIvOiC11 13ti5 Her-j , as Owner/Authorized
Agent hereby declare that the statements and information on the foregoing application re true and aroirate,to the beet of my knowledge
and belief.
Signed under the pains and penalties of parlor/.
ltjt Pw514E
Ilim t Name
advij d C ...
Section 4. ZONING An Information Must Be Completed.Permit Can Be Denied Due To Incomplete Information
E dsfing Proposed Required by Zoning
This column to be filled in by
Building Department
Lot Size
Frontage
Setbacks Front
Side L: R L: IL
Rear
Building Height
Bldg.Square Footage
Open Space Footage
(Lot area minus bldg&paved
parking)
if of Parking Spaces
Fill: -
(volume&in®on)
A. Has a Special Permit/Variance/Finding ever been issued for sn the site?
NO O DONT KNOW O YES al
IF YES, date issued:
IF YES: Was the permit recorded at the Registry • Deeds?
NO O DONT KNOW O YES O
IF YES: enter Book Page and/or Document#
B. Does the site contain a brook, body •'water or wetlands? NO O DONT KNOW 0 YES O
IF YES, has a permit been or n.—a to be obtained from the Conservation Commission?
Needs to be obtained • Obtained O , Date Issued:
C. Do any signs exist on the property? YES O NO O
IF YES, describe siz-, type and location:
D. Are there any proposed changes to or additions of signs intended for the property? YES O NO 0
IF YES, describe size, type and Location:
E. W II the construction activity disturb(Wearing,grading.excavation,or filling)over t acre oris it part of a common plan
that will disturb over acre? YES O NO O
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
1 SECTION 8-CONSTRUCTION SERVICES
48.1 Licensed Construction Suplervisor. Not Applicable ❑
`" �� Name of Ocense Holger: I�DDI:tZ E Sk Itt'-j
License Number
1221 �OD5�uFL Ali _
.570 I
Address Expiration Date
PEED No HILLS eel O o30 LI13 -�5c o4
signature iephone Lr I25 ) 9
•
/9.Registered Home Improvement Contractor. Not Applicable 0
KO()Ear FtLLSW ; 3-12. I to SU q I
Company.Name Rentshelion Number
bvini'Dljl,J t,Jt LD OY Gv'eS��f..� 'tirte./s ln: L 3115 i le
Address Expiration Date
115'K{ (''''ti FT)) alb w 2SiTft t..-i":3 ,VA 1)I055 Telephone 413kit S7335
SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L a 152,§25C(6))
Workers Compensation Insurance affidavit must be completed and submitted with this application.Failure to provide this affidavit will result
M 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 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 730. Sixth Edition Section 10835.1.
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 iu 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 .l SE' 1-1� LU 6)
tThe Commonwealth of Massachusetts
Ia -- = Department of Industrial Accidents
1 Office of Investigations
m— ' 600 Washington Street
Boston,MA 02111
_ ,• www.nrass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name(Badness/OrganinNYupg
timandividuaq: WIDOW IT lif WEST IZO MASCIIGHtIS5fl
Address: 1020. NVR-f]$ gip
City/State/Zip: W£STFIELI> MA Ol0$S Phone#: X13 '-r45 - 7335 —
Are you an employer?Check the appropriate box: • 'type of project(required):
1. I am a employer with (i) 4. ❑ I am a general contractor and 1
employees(full and/or part-time).• have hired the sub-contractors 6. ❑New construction
2.❑ I am a sole proprietor or partner- listed on the attached sheet 7. ❑ Remodeling
ship and have no employees These sub-contractors have 8. 0 Demolition
workingfor meacapacity. employees and have workers'
any 9. ❑Building addition
[No workers'comp.insurance comp. insurance.:
required.] 5. ❑ We area corporation and its 10.0 Electrical repairs or additions
3.❑_I am a homeowner doing all work officers have exercised their H.0 Pluntbingrepa rs or additions
myself.[No workers'comp. right of exemption per MGL 12❑ Roof repairs
insurance required.]' c. 152,§1(4),and we have no
employees [No workers, 13.11 Other R Mit
t s DoW'/5
uMENT
comp.insurance required.]
I a
*my applicant that checks box#1 must also fill our the section below slowing their workers'compensation policy information.
'Homecwaers who submit this affidavit indicating they am doing all work and then hire outride common must submita new affidavit mdicaung such.
Contractors that check this box must attached an additional sheet showing the name of the subcontractors and state whether or not those endues lave
employees. If the sub-conmmors have employees,they must provide their workers'comp.policy number.
I ant an employer that is providing workers'compensation insurance for my employees Below is the policy andlob site
information.
Insurance Company Name: L1 BEA711 MILTUAL IMS14.ftMtCE
Polio, #or Self-ins.Lire- #: Hie 2—� 31Sj-/13/7titt7-0fl Expiration Date: c--�,7- .ig� -- �y
Job Site Address: 51 E\ tiII(q C 1 Ker cirytstate/zip:N1ne 1 )OmpMt III1I 0Ioi2
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 S1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up to S250.00 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.4ereby cerdfy lerthe pains/el perm ofpedury that the information provided above is mat and correct
Signature: (!6 (`7.7 /- fie_ (, -2° -1)
Phone#: H13 y45 - ?33S
Official we only. Do not write in this area,to be completed by city or town official
City or Town: Permit/License#
Issuing Authority(circle one):
I.Board of Hath 2.Building Department 3.City/fown Clerk 4.Electrical Inspector 5.Plumbing Inspector
6. Other I
LContaet Person: Phone#: J
furrni
CERTIFICATE OF LIABILITY INSURANCE o3j31seire
/2017
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 INSURERIS), AUTHORIZED
REPRESENTATIVE OR PRODUCER.AND THE CERTIFICATE ROUTER.
IMPORTANT: If the cenlncate holder Is an ADDITIONAL INSURED, the poIIcy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to
the terms and condl*ons of the poesy, caws policka my require an eodomeme.M. A MaIelhem on this cerWketa does not confer debts to Me
certificate holder in INu Of such endorsement(s).
ucEIIpzrPO Laurence R. Forrest
Forrest Insurance Agency °"°IN 413 858 2680 ”s413 858 2685
mrc Esso
603 North Main Street Earssomas
East Longmeadow, Mass. 91028 INSIMEPtS)AGrwall444COVERMAI wlcr
assure A:Arbella Protection Insurance Company
MejPED .—...... _. .—._. .._ ._... ......_
o
Window World Of Western Massachusetts, Inc. wnsRe —'
SURER C
1029 North Road IxsuntRo: _
Westfield, Ma. 01085 INac
msuneR 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 RHE 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 Sy THE POLICIES DESCANTED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE SEEN REDUCED BY PAID CLAIMS.
(NCR I MIA
ADM SUr LIBYEFF rouerei—'-^
TYPE INSURANCE LUSTS L'Ip WV!) POLICY NUMBER (MWOOMYYI WW➢OMM1YI
A ,GENERAL Lemanx sacs occur/hexerWR s 1,000,000
_X COMM=_RCALGENI:RAL unELITY 7520025998 04/09/17 04/09/18 _EM SES TEPOrnrfOrkftl s 100,000
5 CtflSMAnx IX OCCUR I MEDExP(As ox mmm �$ 10,000 _
PEPSONALS ADV INJURY rt 1,000,000
I GeNERALAG4REGATE s 2,000,000
eau rocemAT—E reit APPLIES,PEP. PPOOuCT5,COMP/OP A6S N 1,000,000 l
r_.I Pouc' Cd'& IR 1''o s
�— M$TO OSILe Maga C ... .awNapsw:aEuan
.II 1020018702104j09{i9 04104/18 IE .• 1 is 1,000,000
ANY AUTO t W INJURYWar Potmal $
— AtLOWIRO `
SZNE
E° i I e0 Aga,(Pet+
Gmmll a
AUTOS X , TO6 I— NON-OWNED Tr SPERTYDAMAGE I°X HIRED AVMS X ALMS QH e+
ia
AiX UMRRELLALue IX occuR 4600055451 104/09/1904/09/18 ,EACH OCCURRENCE IS 1,000,000
E CESSL+O ti CIAIMSMAOE AaCRECATE S
1 RETENTION s a
WONLESS COMPEx miON Certificate OfAnwe viwis
o EMPLOYERS'LIABILIT Yl,t _. To
ANY PROPRIETOWPArn1iYEA
NEcvrIvs N{ Insurance To Follow s,.EACH ACCIDENT ',s
ISSITLIalory m NIS E L DISEASE,EA EMPLOYEE 1
a
otafrartniO OPERAP.WS aebw Dr£ASE CLKV LMMS ,s
I
I
DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Amen SCOW/lot baM,ul nw,bsaryetivb,it mOrt SINN i•WO'S)
CERTIFICATE HOLDER CANCELLATION
City Of Northampton
212 Main street SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Northampton, Ma. 01060 ACCORDANCE Vent THE BoUCt PROvrroNs
AlTItRmn MerearreTNe
Attention: Building Department _
1
U 1988-2010 ACORD CORPORATION. An rights reserved.
ACORD 25(2010/05) The ACOHO name and logo are registered marks Of AGGRO
AC R CERTIFICATE OF LIABILITY INSURANCE EN aRAMOIN;Y)
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER TILS
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 INSURERISI, AUTHORIZED
REPRESENTATIVE OR PRODUCER AND THE CER73FICATE HOLDER
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)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 FORREST INSURANCE AGENCYnCT ..... ._
603 NORTH MAIN STREET PRONE o q FAAXX.Nex
E LONGMEADOW, MA 01028 Mai/ -""—
AWDMES3:._
INSURERIS)AFFORINNGcOVERAGE NMC
INSURER A: liberty Mutual Am Insurance 23035
INSURED INSURER a
WINDOW WORLD OF WESTERN MASSACHUSETTS INC - _1029 NORTH ROAD INSURERS:
WESTFIELD MA 01085 INSURER D: _
eisuRE{E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: 35323654 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 AU-THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POI M IES.LIMOS SHOWN MAY HAVE BEEN REDUCED RY PAID CLAIMS.
L
IFR TYPE OFIN$URANCE .,LICE EP POU EXP DMS
,. • „„ POLICY NUMBER 1 USW M.ID M*AI
COMMERCIAL.GENERALW&LITY FADE!OCCURRENCE F
CLAIMS-MADE I 1 OCCUR I PREM SES I E_E�ice 6
MED EXP poy one
.. _ ... _ •
PERSONAL SADE POURY1 �g
GENT AGGREGATE LEAPT APPLIES PER GENERAL AGGREGATE 5
- i1ECT ILOC: . PRODUCTS.-GOMPtOPBGG S
II OTHER:
AUTOROBILE WBLITYAM&NEO. GLE LIMIT
EAwid J -_-
1ANY AUTO - L ROPILY*LARY(Per pm)
ONMEO SCHEDULED BODILY INJURY(Per POd U
:AUTOS ONLY '. -AUTOS
'T• - PREO NON SONLY � —AUTOS ONLY 1AUYOSONLY } uvea.ern) _ _,�
UMSRELLAUAtl O:LUR IEACH OCCURRENCE
EXCESS LMB 1 CLAIMS-MADE AGGREGATE.
OE() RETENTIONS
[ EnW
WC2-3t6-3n$47-0lI sn/201T 5,712018 / SMcipcE 1 FRDEMPLOYERSIJASIUTY'PROPRIETORNATNERJEXECUTIVE rLxEL EACH ACCIDENT 1000000
FCERIMEMBEREXCLUDEO? Y NIA NNW E WEEASE-EAEMPKOYEE 1000000
es deepCe undo.SCRIPTION OF OPERATIONS Cekw I EL DISEASE-POLICY LIMIT` 1000000
•
DESC.$ fl $W OPERAIfer4SI LOCATIONS t VEHICLES IACONO WE MOWN,Rulehs saNed.a say be ylNUiN if mon e.ceh misted)
WORKERS COMPENSATION INSURANCE COVERAGE APPLIES ONLY TO THE WORKERS COMPENSATION LAWS OF THE STATE OF MA.
This certificate cancels and supersedes a8 previously issued certificates,only as they relate to Wcekers compensation coverage.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY CITY OF NORTHHAMPTON THE EXEXPIRATIIOON DATE THEREOVE F. NOIBED TICE POLICIES
BE FDEIIVERREEDDI
6 UI LDI NG DEPT. ACCORDANCE WITH THE POLICY PROVISIONS.
212 MAIN STREET
NORTHHAMPTON MA 01060 AUHWRDEOREPRESETATNE
Pitt-C. /-T'""-/[...B�a
Liberty Mutual Free Insurance
151988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25(2016/33) The AGGRO name and toga are registered marks of ACORD
35323m4 11-xrl90 I v-]B DAF, III02TOue I meson e.3O:34 M IPlml I Paco 1 of 1
*friout
= Window World of Western Massachusetts _`-,;. ` 1029 North Road-Hampton Ponds Plaza, • Westfield MA 01085 °� i ,-
Phone (413) 485-7335 • Fax (413) 315-3714 NAT-41779-1 :—_ BBB-
- www.WindowWorldofSpringfield.com HIC# 165641 .map.
"Simply the Best for Less" CSL#57011 HOUSEKEEPING
Customer: tr,i0L/Yr/ ,(1 Phone (h) 1r3- 2. t 9-z3scInstall Address: -f9J,i /I?i, Phone (w) 9 17- 7' ‘, 7 - /i /
Bill Address: 4 , -1:'21 U{[, ' e,Z E-mail hi/C(4 0 T
WINDOW WORLD GLASS OPTIONS ADD U-VALUES
4000 Series DH $295544d
6000 Series DH (Triple Pane) $309 SolarZone Glass Package* (LE) S79 , vii)
Picture Window $394 SolarZone Elite Glass Package* (LEE) S89
2 Lite Slider $359 SolarZone Triple Pane Glass Package S99
3 Lite Slider A1,41,(/* (1/3,1/3,113) $716 - -►AN SolarZone packages include 1.12 screens,Foam Insulation on Jambs and Head,Double
Awning . . .. $295-. t -•4•r.'-Strength Glass.Double Locks(>29"),Lifetime Glass Breakage and Labor Warranty,Argon Gas
Casement LH RH $315 MISCELLANEOUS LABOR
Twin Casement(Requires 2 Value+)(0973) (0979) $630 .
Three Lite Casement(Requires 3 Value+) $945 _ Full Exterior White Trim,Wrap (S.00'1-1) (PVC) $79 ., i
Basement Sliders <55 UI $280 Color Other Than White $10
Hopper(In existing wood) (Vent+$150) $250
Specialty Window $ Specialty Custom Int./Ext. Trim Wrap $
Bay!Bow l.%aced seat.Int Casing&Ext.Cap) $3475 Aluminum /Vinyl or Steel Out $50!$150
Garden Window prsulated seat,lrt Casing&Ext cap) $1995 Mull Removal S30
Cries.ExtCokx,lntWooygain;CdcrscaculatedinwWUpgrades Mull to Form Multi-unit $30
' Remove Existing Bay/Bow $400 Customer Provided Stops/Trim s/Trim $45
Reframe& Retrim (stain/paint not included) $40 1 P -
Roof for Bay,/Bow Window $600 '' Install Interior! Exterior Stops (WHITE VINYL)$55 ',
Second Floor Installation $500 _ Woodgrain Interior Stops $75
Window Package $ Install Interior Casing $95
Window Color 1A) trr / (A)k Repair i Replace Sill or Brickmould $75
Inside Outside Mobile Home Conversion $200
WINDOW WORLD UPGRADES Remove/ Re-Install A/C or Awning $100
Full Screens $45
BEIGE Color charge $50 EXTRA LABOR MUST BE IN WRITING /40/,,,Exterior Color S165 "!/
Woodgrain Interior $95 j l Sy.3 3 i I—i 4 /4 i
1 Contoured/Flat Grids (TOP) (FULL).(ENDS) $49-_- --e1---' `
Prairie Grids(Single)/(Double)-Mat)/(Contour) $69 r, ,I
Diamond; (�
Brass Grids (TOP) (FULL) S120 i 5..2.I/ .. �j 64.71 7., L
P / /
Oriel/Cottage Style(40160) (60140) $60
Obscure Glass Per Sash (BOT) (FULL) $35/$70
Tempered Glass Per Sash (BOT) (FULL) $60./5120 /
Catalog Options $ (.3 t4/1 34-1,40)• yt r P (0--6
PRE 1978 BUILT HOMES (FEDERAL LEAD CTAINMENT LAW) �t f MY HOME WAS BUILT IN THE YEAR )'?'i INITIAL,:' , c7 g 4/yrj/F' , /0, . r--5c9. .—)
EPA LEAD SAFE (Per Window) $60- 1
EPA LEAD SAFE (Patio Dr!Bay!Bow;Garden) $#90 Sales Rep Recommended: []Interior Stops [ - erior G Ing: /.v.
Customer Declined: [] Interior Stop [] Exterior Capping:
EPA Lead, third party verification: $45170"--
I decline third party verification Q (INITIAL): Site Setup, Removal, In Home Service, etc.: -$fig.1, -
(Initial)I have received a copy of the Lead hazard information pamphlet Extra labor (Box above for description)$
informing me of the potential risk of the lead hazard exposure`rom rencvatior activity to ce Total Amount Due $ /2f,°Q't9
performed in my dwelling unit,the EPA'Renovate Right'brochure. 50% Deposit Amount: $ IPS-00J OD
(initial)I have received a copy of the lead test result(s).
[] Cash
J ► �` j/j
_ /�- j [],Finance- ( )Wells Fargo ( ) Other Z i
Sign: y t� Date:
�% [ Check made to Window World of WM#
Name(s)(Print) [] CC# - - -
Exp. Date: V-code
If tenants reside in home, Renovate Right Booklet left with:
Final Payment Amount$ --1C 0
To oe paiC to the irlstalle•upor installation.ThanK You
or left at: WINDOW WORLD CARES
St.Jude Children's Research Hospital $
WW of W.Massachusetts anticipates starting this work on / - (' - 1 i'and being substantially completed in ll;'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'rill proceed on scnedule. 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 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 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!
'''. i/1 '
,1. owner - Date
rir CF.' oti. ...- 1 - 17
/Salesman Date Owner Date
This Window World'Franchise is independently owned and operated by Window World of Western Massachusetts,Inc.under license from Window World.Inc.
WM WC 08-16 White Copy-Original Yellow Copy-File Pink Copy-Customer Hayes Pnnling S68-667-'116
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 daylicht. 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. 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 S50
(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.uncer license from Window World,Inc.
WM WC 08-16