23A-074 (2) 52 MAIN ST-FLORENCE BP-2018-1017
GIS a: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 23A-074 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Categorv:REPLACEMENT DOOR BUILDING PERMIT
Permit# BP-2018-1017
Pro ject# JS-2018-001846
Est. Cost: $8436.00
Fee: $40.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor. License:
Use Group: WINDOW WORLD/ROBERT E BUSHEY JR 57011
Lot S;ze(sa. ft.): 16117.20 Owner: GOUGEON ROBERT
ZoningG!1000) Applicant. WINDOW WORLD/ROBERT E BUSHEY JR
AT. 52 MAIN ST- FLORENCE
ApplicantAddress: Phone: Insurance:
1029 NORTH RD (413) 485-7335 n WC
WESTFIELDMA01085 ISSUED ON:4/9/2018 0:00:00
TO PERFORM THE FOLLOWING WORK INSTALL 4 REPLACEMENT PATIO DOORS
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:
FeeTvpe: Date Paid: Amount:
Building 4/9/20180:00:00 $40.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck-Building Commissioner
(�cplat�� t yrs
City of Northampton � d
Building Department I axa'i�
212 Main Street IWMELLING
RDom 100
N
orthampton, MA 01060phone 413-587-1240 Fax 413-587-1272
APPLICATION TO CONSTRUCT,ALTER REPAIR,RENOVATE OR DEMOLISH A ONNjE OR TWO FAMILY7
SECTION 1 -SITE INFORMATION " — ( _/01
1.1 Property Address: yT�hisD�on to be cgnpletad�Wca
g
52 Main St _ FIOn¢n ( L MapVI Lot (J _
Zone Overlay Dlslyd
Elm at District CS Olstdd
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
Eobert bourf,on 52 MG n St
Name(Prim) Current Meiling Address:
(see cowad) Telephone 5b3 - 6512-
Signature
22 Authorized Arent
knbft-� I029 Nelyth Rd We5tCiCklA MA 01085
Name(Pdn Current Mailing Address:
4t3-�+85 1336
Signature Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Olgcial Use Only
cors feted bv Penmit applicant
1. Building 4 4.36 a- (a)Building Permit Fee
2. Electrical V (b)Estimated Total Cast of
Construction from 6
3. Plumbing Building PermR Fee
4. Mechanical(HVAC)
5.Fire Protection V
6. Total=(1 +2+3+4+5) 8436."' Check Number
This Section For Oficial Use Only
Building Permit Number: Date
Issued:
Signature:
Bulltling mi i narMapaclor of Buildings Date
EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR)
Section 4. ZONING Alt information Must Be Completed.Permlt Can Be Denied Due To incomplete Information
Existing Proposed Required by Zoning
]Lin tyloma m be lines to by
Building D,xvtnot
Lot Size .. _.... ._ _ _.
Frontage
Setbacks Front
Side L: - R: __ L:.. _ R: _ J.
Rvar
Building Height
Bldg.Square Footage
Open Space Footage % ._
(lut area minus bids&pared _.
mkin
#
of Parking S aces -
Fill:
volume&Location .. . ___.
A. Has a Special Permit/Variance/Finding ever bee salted for/on the site?
NO O DONT KNOW O YES O
IF YES,date issued:
IF YES: Was the permit recorded at the R 'stry of Deeds?
NO O DONT KNOW YES O
IF YES: enter Book Page and/or Document#;
B. Does the site contain a brook, of water or wetlands? NO O DONT KNOW O YES O
IF YES, has a permit been need to be obtained from the Conservation Commission?
Needs to be obtained O Obtained O , Date Issued:
C. Do any signs exist on a property? YES O NO O
IF YES, describe ze, type and location:
D. Are there any p ed changes to or additions of signs intended for the property? YES O NO O
IF YES, d size, type and location:
E. Will the construction ac"disturb(clearing,grading,excavation,or filling)over lam or is K part of a common plan
that will disturb over t acre? YES O NO O
IF YES,then a Northampton Stone Water Management Permit from the DPW is required.
SECTION S.DESCRIPTION OF PROPOSED WORK(check all applicable
New Nauta ❑ Addition ❑ Raplacemen�ndcws Alteradon(a) ❑ Roofing
Or Doo s
Accessory Bldg. ❑ Demolition ❑ New Signs Im Decks [[7 Si01ng LD Other
"a'
Description of Prp posed Qr "
Work: lnstn tl 4 f YPD L c2rnk V t CIDorS
Alteration of wasting bedroom r Yes_Yj No Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll -Sheet
ea.ft New house and or addition to egtistina housinG.:aamolew thaftl lna:
a. Use of building:One Family Two Famity Other
b. Number of moms in each family unit: Number of Bathrooms
c. Is there a garage attached?
d. Proposed Square footage of new conswcgon. Dimensions
e. Number of stories?
f. Method of heating? Fireplaces or Woodstoves Number of each,
g. Energy Conservation Compliance. Masscheck Energy Compliance tone attached?
h. Type of construction
I. Is construction within 100 S.of wetlands?_Yes _No. Is construction within 100 yr. floodplain_Yes_No
j, Depth of basement or cellar floor below finished grade
k. Will building conform to the Building and Zoning regulations? Yes_No .
I. Septic Tank_ City Sewer Private well_ City water Supply
SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I. R6Lbu- G(,i ) f,�n as Owner of the subject
ProParY 7
hereby authorize _ �U�f rt USYI
to act on my behalf,in all matters relative to work autho' ed by this building permit application,
(ser. Contract-) 412-11�r
Signature of Owner Dow
I, 9.dgert 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 pantries of perjury.
Print Name
412-1
Signature of Owner/Agent Date
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor'
l � Not Applicable ❑
Name of License,"older: ROhI°f1 F—zU-,b"
Licanse Number
-) 5-1011
Addres - Exoimtion Date
r �2) / 4 Y3 4k5 335 19
Signature telephone to X2`6 1
P.Ratilataiap:Neem hnerovemant Contraotm. Not Applicable ❑
Rolxrt 131 )6Y N Ib5641
Company Name Registration Number
Window WorkA (A Western MIISS Inc, 3114120
Address EWiretion Date
11J1q N Ofth RfY WESIF�P�d KlA X106 slew one M3 4$51335
SECTION 18-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.e.152,§25C(8))
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 pemit.
Signed Affidavit Attached Yes....... No...... ❑
11. -Home Owner Remotion
The current exemption for"homeowners"was extended to include Ownermeculded Dwellings ofone(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 sucervisar.CMR 788. Sixth Edition Section 18835.1.
DefiWtiOn of Homeowner:Person(a)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/in farm
structures.A person who constructs more than one home in a two-vear period shag not be considered a homeowner.
Such"homcowner"shall submit to the Building Official,on a form acceptable to the Building Official,that he/she shag he
responsible for all such work performed under the b"ag permit
As acting Construction Sppervisor 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 Cdtavter 152(Workers'Compensation) and Chapter 153(Liability of Employer to
Employees for injuries not resulting in Death)of the Massachusetts General Laws Annotated,You may be gable 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 Loaf Zoning Laws and State of Massachusetts General Laws Annotated.
Homeowner Signature
The Commonwealth of Massachusetts
Department oflndustrialAccidents
Office of Investigations
Congress Street, Suite 100
Boston,MA 02114-2017
IF www.massgov/dia
Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information ,1 Please Print Leiribly
Name (Business/Organization/Individuel): Wif'a�b\N W(w-�A of WtcSt n MR
Address:_ 102q N Or-1'h Rd
Ci /State/Zi : 1N A 01OSS Phone#: 6034`65 1335
Are ou an employer? Check the appropriate boa:
L., 4. I am a eral contractor and I Type of project(required):
1. I am a employer with�1 ❑ g° 6. ❑New construction
employees (full and/or part-time)." have hired the sub-contractors
2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling
ship and have no employees These sub-contractors have g_ ❑Demolition
working for me in any capacity. employees and have workers'
o workers' co co insurance.t 9. E]Building addition
re tap, instvance t°P
required.] 5. ❑ We are a corporation and its 10.❑ Electrical repots or additions
3.❑ I am a homeowner doing all work officers have exercised their 11.El 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_ &Qja _D0L fit
comp.insurance required.]
'Any applicautthd checks bas#1 must also fill out the nation below showing their workers'compensetionon.
poli informati
Homeowners who submit this affidavit indicating they are doing all work and then him outside connections;most submit a new affidavit indicating such.
1C antesclors that check this bas most atmchdl an additional shat showing the name of the subeontmcWraand state whether or not those entities have
employes. If the sub-wnaractors have employees,they must provide their workers'comp.policy amber.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
informadom
Insurance Company Name: Utiter MuticO iu1 &trance 4
Policy#or Self-ins. Lic. #: kN G7-3(S-31 1941 — 011 Expiration Date: t5 1 [ 0
Job Site Address: 5Z, Main St City/State/Zip: Fi Orend MA 010 02
Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby eesorunloftserjury that the information provided above is orae and correct
51grui tue' "!/tel ' ✓ j— Date: 1155
Phone#: 4-(3- A'SS -13?35
O,Ofcial use only. Do not write in this area,to be completed by city or town ojjWal.
City or Town: Permit/License#
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3.Chy/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phmse#t
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COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS 15 TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REOUIREMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
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CERTIFICATE HOLDER CANCELLATION
City Of Northampton
212 Mein Btm.t SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATON DATE THEREOF, NOTICE WILL BE DELIVERED N
Northampton, Ma. 01060 ACCORDANCE WITH THE POLICY PROVISIONS.
ALOXOPMpP[MEEEM�iNE
Attention: 8uildinq Dmpartment
®I48&2010 ACORD CORPORATION. AITRI
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CERTIFICATE OF LIABILITY INSURANCE 31/2017
03/33/208.
THIS ICATE DOE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO HE C UPON THE CERTIFICATE THE P. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EMEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(B), AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER,
IMPORTANT: It the B.Mflcete holder IB An ADDITIONAL INSURED, the pollcy(ise) MUM Be endorsed. If SUBROOATION IS WANED, sub1M to
the terms and conditions W the Ron", ceMin polloke may require an enEoraomeM. A stetemeM on this Genera. Boo• not confer r4lus to the
c lcM hol in Ileu Otsuchondo..rn(s).
PRODUCERLaurence R. Forrest
YE:
Forrest Insurance AgencyRR°•� 913 858 2680 iAs,N,"413 858 2685
603 North Main Street
pORE88:
East Longmeadow, Mass. 01028 IMURERM)AP.GRDlx.COVERAeE
IN•URERA:Arbella Protection Insurance Company
INSURED ;
Window World Of Western Maseachusetts, Inc. NBuneR e
IMILREPIC
1029 North Road
INSUREGO
Westfield, Mn. 01085 .Ran E:
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
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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 SV PAID CIAIMS.
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PERSI ADV INJURY S 1,000,000
GENERALAGGPEGATE s 2,000,000
GEN,AGGREGATE LIMIT APPLIES PER: PRODUCTS COe%OPPGG i 1,000,000
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CERTIFICATE HOLDER CANCELLATION
City Of NortAsepton
212 Main street SHOULD ANY OF THE ABOVE DESCRIBES POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED M
NOrtha tOn, Ma. 01060 ACCORDANCE WITH THE POLICY PROVISIONS.
AU MDREPREMMLTYE
Attention: Building Department X7/4
0198&2010 ACORD CORPORATION. All rights roserveB.
ACORD 25(20IOMS) The ACORD name and 199.are 1e91e emod marks of ACORD
CERTIFICATE OF LIABILITY INSURANCEA EmMTMYYYT
—� A 2812 n
HIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS
�;ERTIFMATE 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 Etre celtlfica s holder Is an ADDITIONAL INSURED,the policy(ias)must have ADDITIONAL INSURED provisions or be endorsed.
N SUBROGATION IS WAIVED,subject m the terms and condmarre of this Polley,certain Policies may require an endorsement A statement on
this certficaaa does not confer rights to the certificate holder in lieu of such endoreemen s).
PREMMAOEA FORREST INSURANCE AGENCY
603 NORTH MAIN STREET xE PAx
E LONGMEADOW, MA 01028
INSURE 8 AFFOggXG GOVFIGOE NAM#
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INSURED MEURERB:
WINDOW WORLD OF WESTERN MASSACHUSETTS INC
1029 NORTH ROAD IxsuRERc:
WESTFIELD MA 01085 IxsuRm D:
MSVRERE:
F:
COVERAGES CERTIFICATE NUMBER: 35323656 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
CERTFICAM 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.
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WORKERS COMPENSATION INSURANCE COVERAGE APPLIES ONLY TO THE WORKERS COMPENSATION LAWS OF THE STATE OF MA
This certificate cancels and supersedes all previously issued cemficetes,"as May relate M workers compensation Dunnage.
CERTIFICATE HOLDER CANCELLATION
CITY OF NORTHHAMPTON SHOUIDANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
BUILDING DEPT. THE E%PIMTION DATE THEREOF, HOME WILL BE DELIVERED IN
212 MAIN STREET ACCORDANCE Wfi11 TIE POLICY%tOVBIONB
NORTHHAMPTON MA 01060
AUTxORILEpREPRFnExrATVE
Lite Mutual Fire Inaurence� ����
O 1988-4015 ACORD CORPORATION. All rights reserved.
ACORD 25(201(I/03) The ACORD name and logo am registered marks of ACORD
35323659 I 1-311991 I 11-1E TIC 1 n1211256 1 1/29/toll 6:3831 AN (PUS) I Peg¢ 1 of 1
Window World Of Western Massachusetts
W 029 North Road
417335
�•pr m.•iwwr.o^ westernmass@windowworld.worltl.com
Robert Gougeon
tdrosthomeser ices@gmai1.com
Estimate: Robert Gougeon
Bill Address: Install Address:
152 Main St, 52 Main St, Estimate#E1521659391014
Florence,MA Florence,MA Date of Estimate:3/21/2018
01062 01062 Valid Until:4/20/2018
DESCRIPTION Oly UNIT RATES� AMOUNTS)
6 Ft.Patio Doorcasing+capping 4 1,989.00 7,996.00
Tax Crack Glass 4 110.00 440.00
TOTAL AMOUNT $8,436.00
CUSTOMER PAYMENT DETAIL
TOTAL PAID $0.00
CUSTOMER DUE $8,436.00
'No extra work if not in writing
`Customer Comments:
'Installer Notes:
Customer ID Details
Id Type` Drivel's finsr..
Id#' 527623544
Id Issue State' Mass
Id Expiration Date 5302019
Sales Rep Recommended:
r Interior Stops r Exterior Capping
Customer Declined:
F Interior Stops r Exterior Capping
Pre 1976 built homes:
Myhomew.sbulaicu rear two (initial)
_ pniAagl tlecnne mim paM vermcavon
(initial)I reFetl wry of Ne Lead hazartl r
. pamhnomng meother porantarisk of the lead M1azeeeposure Rom renovation aNvtly robe perlormetl In my
ewellng unitThe EPA'persuade Rgnn rarochure was received befoe 0e w *bresana
J
rt
al l have received a eopy unc a leaa testreseliesl.
WW of W.Massachusetts anticipates staling this work on
b.Our Work-site.We like to setup our work-site w close to your windows and doors as possible and genemlly 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 ofyouralarm system.
8.Where do we start?Upon arrival,the crew leader will survey the job and determine where to begin.Ifyou 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
qualiwFm.
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 complete window,it will be weather-fight and secure for overnight.(Please no critiquing at this time).
10.Pets.We love Harty,Cour-legged creatines;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 Nem 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 first have an aggressive bark towards strartgers.
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.Its
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 F.,,kids morns,baby's room).
12.*Damage to walls and old trim stops.For Nose of you who have old aluminum and steel windows and are replacing them due to swearing and damaging of the
walls be advised that all water damage plaster will most likely fail out,in addition,all the patch works you have done over the years will fall out also.This is normal;
however,we are not plaster experts,so the repair to Nose wails would best be left to the experts.In some cases,due to out of square openings,new nim 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 ifit occurs.If your trim stops around you sashes are very old,any,and
brittle,they may snap and crack upon removal.If dtis happens,we can leave Nem off if you please,or for a small up charge,replace Nem 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 Gee to ran errands,take a walk,or par relax If a question should arise;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 mr attorney for collection,the
purchaser agrees to pay all costs of collection including a reasonable attorney fee.Return check fee is$50(fifty dollars).
Customer Signature Sales Person Signature
P S.Now would be a good time to review contract with the salesman to be sure of your order retire and wool to be done.Only the items and services oa 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 offunds 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.
Arbitragon;Window Word of Western Massachusetts and me PURCHASERS)hereby mutually agree in advance that in the event Window Word of Western Massachusetts
has a dispute concerning the contact.Window World of Western Massachusetts may submit such dispute to a private arbitration service which has been approved by the
Secretary of the Exerove 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
Dare..................... ._.._........_.. ..._.._.......Date
NOTICE:The signatures of the parses 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 samon is not signed separately by the parties."
This Window Wardle Franchisees Independently owned-and operated by Window Wood of Western Massachusetts,Inc.under license from Window Wood,Inc.