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32A-158 (9) 15 HAWLEY ST BP-2019-0340 GIs#: COMMONWEALTH OF MASSACHUSETTS Map.-Block: 32A- 158 CITY OF NORTHAMPTON Lot: -000 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-2019-0340 Proiect# JS-2019-000550 Est.Cost: $2300.00 F : $40.00 PERMISSION IS.HEREB Y GRANTED TO: 4gng Class: Contractor: License: Use Group: WINDOW WORLD/ROBERT E BUSHEY JR 57011 Lot Size(sq.ft.): Owner: PRIESTLY MARA K Zoning:NB(101)/SI(0)/ Applicant. WINDOW WORLD/ROBERT E BUSHEY JR AT. 15 HAWLEY ST Applicant Address: Phone: Insurance: 1029 NORTH RD (413)485-7335 O WC WESTFIELDMA01085 ISSUED ON:9/24/2018 0:00:00 TO PERFORM THE FOLLOWING WORK.-INSTALL 2 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 9/24/2018 0:00:00 $40.00 212 Main Street,Phone(413)5874240,Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner SlEE FMf(- Department use only --� City of Northampton Status of Permit: Building Department Curb Cut/Driveway Permit i 212 Main Street Sewer/Septic Availability Room 100 Water/Well Availability Northampton, MA 01060 Two Sets of Structural Plans phone 413-587-1240 Fax 413-587-1272 Plot/Site Plans -- Other Specify 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 b ffice Linl �� Map Lot Unit J Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIPlAUTHORIZED AGENT 2.1 Owner of Record: Name(Print) Current Mailing Address: l See, Goiaal( \J Telephone Signature 2.2 Authorized Agent: ICA-Cl n OOV) Rc1 "eSAb6 d 'NIA U 10 55 Name(Print) Current Mailing Address: Vt�- 1� z� — 413��t�5 -133 Signature f Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building 11300,067 (a) Building Permit Fee 2. Electrical (b) Estimated Total Cost of Construction from 6 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection 6. Total=0 +2+3+4+5) �3 �� Check Number This Section For Official Use Only Building Permit Number: DateIssued: Signature: Building Commissioner/Inspector of Buildings Date EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) i 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 - —1 Setbacks Front Side L:=-- R:F- l L:= Rear Building Height r---� Bldg.Square Footage -- % C Open Space Footage % (Lot area minus bldg&paved parking) #of Parking Spaces Fill: volume&Location A. Has a Special Permit/Variance/Finding ev been issued for/on the site? NO & DONT KNOW © � YES IF YES, date issued:i IF YES: Was the permit recorded at the Registry of Deeds? NO © DONT KNOW a YES O IF YES: enter Book / Page and/or Document# B. Does the site contain a brook Iody of water or wetlands? NO 0 DONT KNOW © YES O IF YES, has a per...., bee.,or need to be obtained from the Conservation Commission? Needs to be obtained ! © Obtained Date Issued: s C. Do any signs exist on the property? YES 0 NO IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES 0 NO 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 E) IF YES,then a Northampton Storm Water Management Permit from the DPW is required. i SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Repiacement,W*dows Alteration(s) ❑ Roofing ❑ Or Doors [[Z� Accessory Bldg. ❑ Demolition ❑ New Signs [❑] Decks [0 Siding[❑] Other[17] Brief Description of Proposed r - , Work: .� psi-cljc'.t,01, OC /Gf!-S{fc 1 rt' 6 n (w/ Alteration of existing bedroom Yes No Adding new bedroom Yes No/ Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -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. 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, C'f Q Pf; C S+1Li as Owner of the subject property hereby authorize IkAer+ � to act on my behalf, in all matters relative to work authorized by this building permit application. ( See' CC)nfirCG(0 q .-)I Y J l � Signature of Owner Date 1, t1.Opert, 1�� �� as Owner/Authorized Agent hereby declare that the statementd 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. t Print Name m Signature of Owner/Agent Date i }. SECTION 8-CONSTRUCTION SERVICES 7 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder:. Robcr t BuS"q License Number f M otcjj -1 15 ©CA Address Expiration Date � —4 I L41L �2z 4-i 3 - 4, 5-.-13265 LOX2`6 l �q Signature Telephone 9.Registered Home Improvement Contractor: Not Applicable ❑ Ra>ext �5usfx\i1 bS b 41 Company Name I Registration Number window in odd of Initatf:rrn MASS Inc, _ 3114120 Address Expiration Date t 0201 N Orth R6 MMtfif\ a 4 L1QWSlephone 4{3•-4 55-1335 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....... 10, 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 108.3.5.1. 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 ClIx The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations I Congress Street, Suite 100 �` Boston,MA 02114-2017 www massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information q" Please Print Le0biy Name (Business/Organization/Individual): 1►'��11C��V'�i (��''(� Qi web-tKin MF'S Address: W2_01 01 W ort Rd City/State/Zip: N SAf r1C, M,4k . 5 Phone #: 41 3, Are you an employer? Check the appropriate box: Type of project(required): 1. I am a employer with b 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6. F-1 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 g. ❑ Demolition workingfor me in an capacity. employees and have workers' Y p tY• 9. E] Building addition [No workers' comp. insurance comp. insurance.t required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ 1 am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.X Other 9CCA QCf SYtf V\t comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: l...i-2,Y iq M �Atu cO �t'1SL1 rC1 n cf, _ Policy#or Self-ins. Lic. #: %i Cj 'J IS`" :�_l 1 CA+_1 .- C)19 Expiration Date: I + I Iq Job Site Address: �� �'���t�'�ey-Si of""+ 301 City/State/Zip:t)r(,�16,qll'4G4 /I h o l oQ o 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. Ido hereby certify unde th pains and p #ltis of perjury that the information provided above is true and correct. Si ature: Date: Phone#: 4-1 3 'i�S_ -1 3 � Official use only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License # Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: '�. �. • � l � � �- � r - MI Windows And Doors or de 1•. MI Windows And'Doors Mj 8501Nest Market St destroy 850 Weed Market St NFkC IPA 17030 NERC MI Gratz,PA 17030 - lsso 1885 tii��psi DfININYLlHo Grids ficulrta SLIDEFt2/VINYUQrids ae Panel 182:Lite4:(1J8'llim ,Glear,LOE,Anneat s that can be Panel 182:Us-1:(1B',Cisar,LOE,AnnwJed);Ute-2: {1 '.Ctear,NON>:.gtan d);grj 04;37112X37 ml tta 2: ,e cleaner, (1B",Ctear,NONE Anr led);Argon;45112 X 45112 Riau )n for dirfernt MEI,R�1a-0Daa�Op00Y rrtdlvJdual products mayl us_u to a Ien to and doors IndMrdual products may ba suklact to variation In performwKs ENERGY PERa=ORIyANCE Jhen using a Idows on the ENERGY PERFORMANCE RATINGS V-F$Ctor RATINGS (U'S'�l-p) Solar Heat Gain Coefficient U-Feer(U.SJI-P) Solar Heat Gain Coefficient 0.27 ent re generally 0.27 4.26 ADDlrlO 0.29 oduct cer NAL-PERFORMANCE locations in Visible T RATINGS ADDITIONAL PERFORMANCE RATINGS ratnsm+ttance Air e{U.S.1l-p ols. Visible Transmittance Air Leakage(U.S.11-P) C� ) a+a.;itaca,ror S10-3 it,bake 0.46 � 023 KeromcnK.Wft-ry,prtaA aeuWscorvorIIto 17j,a,o,IftI -]GFs rO[ recall Ml+ProeVCtaa eee rtotwarrant all canes Mr ease „ +�,n.'ae Wu,utt aarradamrnrntpuptnttmvWnonpaea rmmfpp7anuw•ROprodametoroaumnapwnwapmom ^rrwhcwrcrsxemreroramer Mora p;°�u±u ase pr...; " sae i pe dertrlNG.tl ReMlp/Na dIN"I"r l fo"W dranwavnsmu aanabone dad a apUft"sun rha. Proouetperfarr�nceirrorra y Georr,,se Co;.a,4 tiF1ZC aoaa nos taeammarm any proaues trip don not MAIM oa ruNb'ay of any�tJauu fdr any apoctk urs.ranr.+t wxv.rrm.orp anon. ris.use a J allntdatWfara runt�at r Prod PaP+xtaanCd rNomaCon. Nre •' r r 1 , + '-J , rot ENERGY STAN on W,4.ofjiow­1 rrvalfadas. � I • � ertargreaargoWH,;adowa ? nN D fell infor Grti6ed Ceni+icado tmatgvear.rovAvindowr ®Cettried/GnlfioaAO Para iaforFor macio" atron,sae 1a6e1 on product For fell infornratioa,no label an product COMPfe 49 OOpS" etiqueta def pro4ocro. Para id ernwici5n contpiata conow Is stiyflau dd produ te. Grade PG35' +DIS{A iia LC SD) -0P(ASD) , V Pert rade +DP(ASD) -DP(AIM) Water Max Test Size Rep r 50.13 Water LG-PG35 35.08 35.01) 8,00 40.00 X 72.00 A4U2..0+_1os•{r.ro F orida 10 5.43 ax est Ixe epo - a6rtgs are for in 20840 -�' P21111I t409474m 28124 individual windows and doors on 72.00 X 80.00 - r stacked units,Please contact our no test size S safes representative.�. For information regarding moped For rd mulled STIE1300TesteArfabelm�OMAJCSA tOS-2/A440-05tass P08 and s OP ' by Ratings are for individual w0dw a and doors only. regarding or stacked Links,please contact your sales representative.Pos and Nag DP lknitad by � ddditio,ral irtforrrratiMan aS'he concealed by giazi tread a track l R Fo tad the unit test size.Tested to AAMAANDMAICSA I011I.S.21AA40.05 AAMA label may be fe9ardm8 instaRatlon instructionsp lease vied nafl concealed by plating bead or track fifer.For additional information regarding .16785673.1.1.1 lfflv.miwd.com. Installation instructions,please visit www.miwd.com. Pruned on 26772468.1.1.1 " '°an srltno,as:lc:,sau a me 7rar101e 3:69:00 PM xora �F ROBERT It CERA\F\G ASE co�F��S 1%DA1Ry LN 10i1 ON1.y AND AC A MATTER OF INFORMATION EXTEND OR SOUtNWtCK MA NEGATIVELY AMEND, A OONTRAC THIS r-SIRrIFICA!'F IS ISSUED AS DOES NOT CONSTITUTE r• CERTIFICATE DOES NOV AFFIRI�AS��I�L� O BELOW. THIS CERTIFICATE A INSURANCE must REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les)se she terms and conditions of the policy, certain policies may require an endorsement. A certificate holder in Ileu of such andorsement(s), NAME: Lal PRODUCER PHONE 41. Forrest Insurance Agency AfC,No.Ext: E-MAIL __ -_Office of Consumer Affairs&Business Regulation 603 North Main Street ADDRESS: - East Longmeadow, Mass- 01028 ri0ME IMPROVEMENT CONTRACTOR r ' 4Registration. 165641 INSURER A:ArbE ` '`'`_ Type: INSURED INSURER e: Expiration: 3/15/2018 Private Corporation Window World Of Western Massachusetts, Inc. INSURER C: WINDOW WORLD OF WESTERN MASS INC 1029 North Road INSURER 1); ROBERT BUSHEY Westfield, Ma. 01085 INSURER EI 1028 NORTH RD INSURER F COVERAGES CERTIFICATE NUMBER: WESTFIELD,NLA 01085THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUEu rL, Undersecretary INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMLN t CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THe EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPE OF INSURANCE POLICY EFF P LILY EXP LIMITS LTR INSR WVD POLICY NUMBER (MMIDD/VYYY) (MN/DOryYYY) A GENERALLIABILITY X EACH OCCURRENCE $ 11000,OOO COMMERCIAL GENERAL LIABILITY 7520025998 04/09/18 04/09/19 PREMISES Ea occurrence $ 100,000 CLAIMS-MADE ®OCCUR MED EXP(Any one person) $ 10,000 PERSONAL a ADV INJURY S 1,000,000 GENERAL AGGREGATE S 2,000,000 GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG S 1,000,000 POLICY ECO, X LOC S AUTOMOBILE LIABILITY 1020063881 04/09/18 04/09/19 I 1,000,000 Ea accident) S ANY AUTO BODILY INJURY(Per person) S ALL OWNEDX SCHEDULED BODILY INJURY(Per accident) S AUTOS AUTOS X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ AUTOS (Per accident) $ A X UMBRELLA LIAO X OCCUR 4600055451 04/09/18 04/09/19 EACH OCCURRENCE S 1,000,000 $ EXCESS LIAS CLAIMS-MADE AGGREGATE S DED I I RETENTION S $ WORKERS COMPENSATION Certificate Of W A U- N- AND EMPLOYERS'LIABILITY Y/N TORY LIMITS I ER ANY PROPRIETORIPARTNERIEXECUTIVE Insurance To Follow E.L.EACH ACCIDENT S OFFICER/MEMBER EXCLUDED? N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE S It yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE•POLICY LIMIT $ , 1 IESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORO 101,Additional Remarks Schedule,H mom apace IB required) :ERTIFICATE HOLDER CANCELLATION :ity Of Northampton '-12 Main Street SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN forthampton, Ma. 01060 ACCORDANCE WITH THE POLICY PROVISIONS. Lttention: Building Department AUTHORIZED REPRESENTATIVE . r ®1988-2010 ACORD CORPORATION. All rights reserved. CORD 26(2010/05) The ACORD name and logo are registered marks of ACORD f' iV r ' *• � � 75/2/2018 E(MM/DD/YYYY) ACoR" CERTIFICATE OF LIABILITY INSURANCE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER FORREST INSURANCE AGENCY CONTACT 603 NORTH MAIN STREET PHONE t AIC, No): E LONGMEADOW, MA 01028 E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC# INSURERA: Liberty Mutual Fire Insurance 23035 INSURED INSURER B: WINDOW WORLD OF WESTERN MASSACHUSETTS INC INSURERC: 1029 NORTH ROAD INSURER D: WESTFIELD MA 01085 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 41675072 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 NTH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY YYY POLICY XP LIMITS LT COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMA E TO RENTED CLAIMS-MADE 7 OCCUR PREMISES Ea occurrence $ MED EXP(Any one arson $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY❑ JECT PRO LOC PRODUCTS-COMP/OP AGG $ PRO- OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea ccident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY APer accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ A WORKERS COMPENSATION WC2-31 S-377947-01 8 5/7/2018 5/7/2019 STATUTE ER AND EMPLOYERS'LIABILITY Y/N ANYPROPRIETOR/PARTNER/EXECUTIVE ELEACH ACCIDENT $1000000 OFFICER/MEMBEREXCLUDED? N/A . . - (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1000000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) WORKERS COMPENSATION INSURANCE COVERAGE APPLIES ONLY TO THE WORKERS COMPENSATION LAWS OF THE STATE OF MA This certificate cancels and supersedes all previously issued certificates,only as they relate to workers compensation coverage. CERTIFICATE HOLDER CANCELLATION CITY OF NORTHHAMPTON SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 212 MAIN STREET THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN NORTHHAMPTON MA 01060 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Jon Smith ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD L675072 1 1-377947 1 18-19 WC 1 n0254981 1 5/2/2018 4:39:52 PM (EDT) I Pana ' ^F 1 i Window World Of Western Massachusetts uu�4ue �,� 1029 North Roa 413-485-733 "Simply the Best for Less" westernmass@wmd0ww rl O d c0r Mara Priestly nara.priesly@gmail.com Estimate : Unit 30: Bill Address: Install Address: Estimate#E1535496026941 15 Hawey, 15 Hawley st unit 302 , Northampton,MA Northampton, MA Date of Estimate:8/28/2011 01060 01060 Valid Until:9/27/2011 'DESCRIPTIONCITY UNIT - • 4000 Series DH 2 330.00 660.00 SolarZone Low-E 2 110.00 220.00 Full Exterior Capping 2 110.00 220.00 Colonial Grids(Contoured/Flat) 2 75.00 150.00 EPA Lead Containment 2 60.00 120.00 Colored Exterior 2 165.00 330.00 Misc Labor 6 75.00 450.00 Permit 1 150.00 150.00 TOTAL AMOUNT $2,300.0( CUSTOMER Cash Amount $1.00 TOTAL PAID $1.0( CUSTOMER DUE $2,299.0( Vo extra work if not in writing 'ustomer Comments: nstaller Notes:Sabrina ustomer ID Details d Type* Driver's license d#* S51619350 d Issue State* Mass d Expiration Date 9072020 ales Rep Recommended: Interior Stops r Exterior Capping ustomer Declined: Interior Stops r Exterior Capping re 1978 built homes: 3.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. Pleas urvey 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 yoc iindows.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 presery rem.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 yot roperty.We are not responsible for any damage to plants,shrubs or landscaped areas. .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 sta 11 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 an ollect 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 i of 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 yo nderstand 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 t y to avoid such issues. .Our Work-site.We like to set up our work-site as close to your windows and doors as possible and generally your driveway is the best spot.If using the drivewa ill block a garaged car,please be ready to pull it out upon arrival. .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 th isconnection and reconnection of your alarm system. .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 wi ccommodate 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 omplete 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 ualityjob. .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 dal dthough there may not be a complete window,it will be weather-tight and secure for overnight.(Please no critiquing at this time). 0.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 whe ar ying 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.Man eople 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. 1.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 n unfortunate reality of remodeling,but we do our best to keep,things under control.We appreciate your patience and understanding,during the job and unt verything is finished.Even after we have cleaned up,it is advisable to survey the areas for something we may have overlooked(Le„kids rooms,baby's room). 2.*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 th alls 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 norma owever,we are not plaster experts,so the repair to those wails would best be left to the experts.In some cases,due to out of square openings,new trim is required t lake 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 trir fter 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,an rittle,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 c ie 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 wa rea we will advise you before we proceed.Should you decide to replace or repair anything,the price will be added to your balance. 3.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;ask the cre) order 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 ustomer constantly hovers over our shoulder.Like any professional,we're always happy to answer questions,but we appreciate being able to concentrate on of cork without interruptions and distractions.This ensures a safe and quality installation. 4.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,th urchaser agrees to pay all costs of collection,including a reasonable attorney fee.Return check fee is S50(fifty dollars). i`�w.i � � �"W Usk' U,✓/''�I Customer Signature Sales Person Signature .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 one.If you have any questions whatsoever,now is the time to ask. ✓indow 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 th ayments 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 nder 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 owne )r withdrawal. rbitration;Window World of Western Massachusetts and the PURCHASERS)hereby mutually agree in advance that in the event Window World of Western Massachusetts as 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 ecretary 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. t City Of Louis Hasbrouck<Iasbrouck@northamptonma.gov> 15 Hawley Street 1 message Louis Hasbrouck<Iasbrouck@northamptonma.gov> Thu, Sep 20,2018 at 1:35 PM To:westernmass@windowwodd.com Robert, The building at 15 Hawley Street in in the Central Business district. If the replacement windows for unit 302 are visible from the street, they need to match the existing ones. Send more information; locations of the windows in the building, cut sheets,etc.See attached. Thanks. Louis Hasbrouck Building Commissioner City of Northampton Town of Williamsburg (413)587-1240 office (413)587-1272 fax F yw, 15 Hawley GEarth.jpg 1327K DQ Mi- MI Windows and Doors Order # 261031938 A C K N 0 W L E D G E M E N T 1 of I Warehouse: 140 - Begins Xact Products, PA 09/14/18 Paradigm Quote: 2283365.1.PD.SINGLE 307335-001 ACCOUNTS PAYABLE PRIESTLY WINDOW WORLD OF WESTERN MASSACHUSSWINDOW WORLD OF WESTERN MASSACHUSSETTS 167 1029 NORTH RD SUITE IA 1029 NORTH RD SUITE 1A WESTFIELD MA 01085 WESTFIELD MA 01085 413-485-7335 413-485-7335 ...................................................... .. ...... .. ....................................... MI Route: A3 PO# PRIESTLY 167-4539 CSW 14 Order Type: Paradigm Terms: 1% 10 DAYS NET Rep#1186 Load Dt: 09/24/18 ** Quantities 2 Units ** Item Ord Shp B/O Description Unit Extended --".-...................................... ....... ..................... .................... .................... ............ .. 001 2 1650 REPLACEMENT WDW as entered: 46 1/2 X 60 5/8 id: 46 1/2 X 60 5/8 (4000) ,EX WDW,EXT HLF SCR,CLARITY,WH,BRZ LAMI ";rwn-u "),-fd NATE,MATTE TEXTURE,FINLESS,FOAM TP,NTLCKS,BRZ /Wli-,11/16 SCLP,3/3-3Wx1H/3WxIH,TNS,LOE,DSB,A RGON hV+r,�tat BR I0 U-F(.27) SHGC( .26) VLT(.46) 'As in Jim DP(+30.08/-35.09) STC(27.00) 1) Unit Net Price Breakout Som ' WWA:STD N4, WW:LOE 0 WW:FULL LAMINATE GRIDS WW:BRZ EXT Total Qtys 2 Goods Total: Sales Tax: Order Total: All ratings are for individual windows and doors only. For information regarding mulled or stacked units, please contact your sales representative. At sale, MIWD products are covered by a product warranty available either through your sales representative or at miwindows.com. Please promptly review Order Acknowledgements to confirm correct order information. MIWD must be informed of any changes to the order within 24 hours of receipt of the Order Acknowledgement, after such time Buyer is responsible for inaccuracies in the order. ................ ............ ...........