42-020 865 WESTHAMPTON RD BP-2019-1453
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:42.020 CITY OF NORTHAMPTON
Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: Door Replacement BUILDING PERMIT
Permit# BP-2019-1453
Project# JS-2019-002357
Est.Cast: $4690.00
Fee:$40.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: WINDOW WORLD/ROBERT E BUSHEY JR 57011
Lot Size(sp.ft.): 29098.08 Owner: BLAIR DAVID A&JACOUELINE P
Zoning, Applicant: WINDOW WORLD/ROBERT E BUSHEY JR
AT: 865 WESTHAMPTON RD
ApplicantAddress: Phone: Insurance:
1029 NORTH RD (413)485-7335 0 WC
WESTFIELDMA01085 ISSUED ON.612012019 0:00:00
TO PERFORM THE FOLLOWING WORK.REPLACE 2 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 Oocuoancv Signature:
FeeTvpe: Date Paid: Amount:
Building 6/2020190:00:00 540.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
-bcs02 s
Department use only
City of Northa ptostatu o!Pe it:
+ Building Depa me Curb uVD eway Permit
212 Main St set JUN 1 0 9%mifSeptb Availability
Room 10 WaterlWell vailabiliry
Northampton, M. 01 ave_. tsof Vuctural Plans
phone 413-587-1240 F 413-507;6272 _ _ _ VSae Pla is
Other Specify
APPLICATION TO CONSTRUCT,ALTER, REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
wx lR _ ly53
SECTION 1 -SITE INFORMATION
1.1 Property Address: This section to be completed by offlosv.5� wkbl-"tvn (�� . Map ya Lot 06;0Unit
M
F�Urla CG , A 0100, zone Overlay District
Elm St.District Ca District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1^Owner of Record:
fAL.rIIL tw't, bCa'_ 81tls 102SiYyimnFDY1 K4 1-1orlrlc� Mk
Nam(Prim) CTe
(See GOnSra(i) Telephone R' O(W.�1L
Signature
2.2 Authorized Agent:
1029 N(STY1n Rd WeStfidd MA 01085
Name ptl Current Mailing Address:
413-485--1336
gnemre Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed rb, rmit applicant
1. Building tlV't0 / (a)Building Permit Fee
2. Electrical (b)Estimated Total host of
Construction from 6
3. Plumbing Building Permit Fee
4. Mechanical(HVAC) ofo
5.Fire Protection
6. Totel= 1 +2+3+4+5 / Check Number
This Section For Official Use Only
Building Permit Numb Date
Issued: n X7/1 p
Signature:
Bulkling Commissionadlnspactor of Buildings Date
EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR)
�r;
SECTION$-DESCRIPTION OF PROPOSED WORK(check all applicable
New House ❑ Addition ❑ Replacemeri gindows Alteratlon(a) Roofing E]
Or Doors ,6�
Accessary Bldg. ❑ DemOligan ❑ New Signs [OI Decks [O SIdIng[p) Other[[:i
Wirt Description of Proposed �IaLL/ rt\
Work: l rb/
Alteration of existing bedroom_Yee !I( 4o Adding new bedroom Yes N
Attached Narrative Renovating unfinished basement Yee No
Plans Attached Roll -Sheet
ea.If New house and or addition to exlstina 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 Compltance 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_ CitySewer Private well City water Supply
SECTION To-OWNER AUTHORIZATION•TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I, �A 11.C.1� .IYIUP_ 'lJ�/ as Omer of the subject
property �
hembyauthorim0iy&) 630✓w n� l �KJ-y1 UI/Y
to act on my behalf,in all matters relative to work a ed by this building permat application.
(set, Gontrac0
signature of Owner
I, P Olbert \7UbV as Owner/Authorized
Agent hereby declare that the startamentS 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.
w4aft ,
PrintImall
/
Signature df OsnedA11ent Dere
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Super iwr: �c tom,, Not Applicable ❑
Name of License Holder: ROI k {�ct l'Jv
License Number
12 Dalry Ln ernmon
-1 ithwid< MA m -1 51011
Addmss Expiration Date
Sign �mi Telephone 485-� 335 X2`6 119
0.Reaistered Home Imprbv(.ment Contractor. Not Applicable ❑
RObt-rt 13(jSVWN Ib5b41
Company Name Registration Number
Window World cif Westem MASS Inc. 3114120
Address Expiration Date
1029 N O'fth R6 W-6t{it\ d NAA 010 Mlephrone 413-AS-1335
SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 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 permit.
Signed Affidavit Attached Yes....... No...... ❑
11. - Home Owner Exemotion
The current exemption for"homeowners"was extended to include Owner-occupied Dwellings of one(1) or two(2)families
and to allow such homeowner in engage an individual for hire who does not possess a license,provided that the owner seat
an 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 in such use and/or farm
structures.A person who constructs more than one home in a two-year period shill 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 budding permit
As acting Construction Supervlmr 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) end Chapter 153(Liability of Employers to
Employees for injuries act resulting in Death)of the Massachusetts General Laws Annotated,you inner be debts for person(s)
you hire to perform work for you under this permit.
The undersigned"homeowner"certifies and examines 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
' \ The Commonwealth ofMassachuselts
Department of Industrial Accidents
1 Congress Street,Suite 100
Boston,MA 01774-20177
wnimmass gov/dla
N urken'Compeoution Insurance Affidavit:Builders/Cootmctors/Elearleians/Plumben.
TO BE FILED WITH THE PER114MING AUTHORITY.
Applicant Information Please Print LmibW
Name(Business/OrganixotioMndividuaq:Windim,World of Western MA
Address:1029 North Road
City/State/Zip:Westfield, MA 01085 Phone#:413485-7335
Are you as empbyert Caeok tie appropriate bas:
Type of project(required):
1,E]I sat a�owl,with 20 empleyeea(full mdtm pan-hand, 7. ❑New construction
2.❑Imawle MopnemrorpnmvrhipaM veme::gloy workwg hurrain 8. ❑Remodeling
my eapacity.Ilio wmkri eomp.insur nce required.]
a.❑I nn a wmmw,.eraeing all watt ruyxll Mo worsen comp.insarao<e rgairea.]r
9. ❑Demolition
4.❑IamaIwnaowvm willhhiringmvmmmatocendmtallworkmmy .Property. swill 10❑Building addition
etome Wi all comaetma eiNm have wertm conWntmtim immmu ru are rule l l.❑Electrical repairs or additions
propn.with on c:rWloyeea. 12.❑Plumbing repairs or additions
5.01 w a geoert mereasor tied I have hired the subeontracmr lia[N on the mashed sheet.
There:ubconuactma have rr,leyemanit have woken'cmtq.ma,nmce,i 13.[]Roof repairs
6.[]We arta tion and Theme.have eaercisW their right 14.❑r OtherReplawnsenl Window:
soman sigh eruption per MGL c.
Isz,41(4).and we have m emploreea.IN.worker'mrtm.imutmce nquird.]
"My applicant Net checks box#1 matt elm fill nut the serum below showing their wmken'compematinn policy mfemahov.
t Homeawnrs who submit this affidavit indicating they are doing 01 work and that hire ou:nide contrmnm must submit a new amdwo indiwaag such.
iConmctor that eheek Nis box must a uthe l m additional sheet showing the tome of the sub-e ennadms and state whether or not Nose entities have
employees. If the mbcontracmn have amployeas,they must provide their workers'mrup.policy numM.
I at an employer coatis providing workers'compensation insurancefor my employees. Below is the policy and jab site
info-
-d-Insurance Company Name:Liberty Mutual Insurance
Policy#or Self-ins.Lic.M WC2-31S-377947-02M 019 Expiration Date:05/07M
Job Site Addreas:865 Westhampton Road City/State/Zip:Fbrenee, MA 01062
Attach a copy of the workers'compensation policy declaration page(shoeing the policy number and expiration date).
Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by 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.Acopy of this statement may be forwarded to the Office of Investigations of the DIA for insurance
coverage verification.
I do hereby certify ane7.�/�fire pains and penaides ofperjury that the information provided above is nue andcorrecm
Simla llyllaljyj. L' Date blallq
Phone#:4134857335
Official use only. Do not write in this area,to be completed by city or town offciaL
City or Town: Permit/License#
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3.City/To sm Clerk d.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone#:
ACORO® CERTIFICATE OF LIABILITY INSURANCE °Ahouovl°sm
THIS CERTIFICATE IS ISSUED ASA 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.
--------------
IMPORTAN : If the certificate holder Is an ADD TIONAL INSURED,the poiicylies)must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED,subjectlo 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 endoreemengs).
PRODUCER
NAME:
Forrest Insurance Agency PXORHA 11 413458-2680 Re: 413468.2686
603 North Mein Sl
East Longmeadow,MA 01028 AooRlsa:
IRSUR! 8 A RgROC°VEM°! XAMY
INSURER A: ARSELLA PROTECTION INSURANCE CO.
INSURED INsuaeR a: LIBERTY MUTUAL FIRE INSURANCE CO.
WINDOW WORLD OF WESTERN INBIIRMC:
MASSACHUSETTS INC INSURERS:
1029 NORTH RD
WESTFIELD,MA 01085 INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THATTHE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT TERM OR CONDITION OFANY CONTRACT OR OTHER DOCUMENT IMITH RESPECT TO NMICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSUMNCEAFFORDED BYTHE POLICIES DESCRIBED HEREIN IS SUBJECTTOALLTHE TERMS.
EXCLUSIONSAND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
LTp TYpE OF INSURANCE RED mmi POLICY NUMBER Y YYID IlMlla
X COMMERCMLMMEIGLMBal1Y EACH OCCURRENCE t 1,000,000
CWMS#IADE ❑X OCCUflUD—
PREMISEa EY t 100,000
MEDEXP f 10,000
A 7520026998 04/09/19 04/09/20 PERSONAL S ADO INJURY S 1,000,000
GEN'L AGGREGATE LIMRAPPLIES PER GENERALAGGREWTE S 2,000,000
POLICY WT I]'-CPRODUCTS COMPIOPAGG $ 1,000,000
O HER: $
AU10M EN EMBIUW Ee xclEeM a 1,000,000
BODILY INJURY IPS awn) S
AHANYAUTO
owNEo x AUTOS LEO1020003881 04109119 0411 BODILY IRJURY IPerxciow) t
S DNLY AUTOS HIRED X NONOYMED S
AUTOS ONLY AUTOS CRAY flpS we
f
X UMBRELUMB x pCCUR EACH OCCURRENCE 3 1,000,000
A "Cos MB CIAILDE 4600065451 04109H9 04/09120 AGGREGATE s
DEO I I RETENTIONt 1 S
MRNERSC°MPENSAIgN 78"TArTUTE
AND EMPLOYERS'LIABIUTY YIN
ANY PROPRIETORJPMTNERADECUTIVE E.L.EACH ACCIDENT S
OFFICERIMEMBER EXCWDEM ❑ RIA Certificate TO F090W
IWnnean In NHI EL°ISEASE-EAEMPLOYEE S
ffyu UP¢mb,uMa
DEetRIPTION OF OPEMTIONe pFbr. E.L.OISEASE POLICYLIMIT f
DMMPRON OF OPEMTNMl6I LOORGONS I VEHICLES(ACORD 101,ANOYonI RwRrI a[MedWq nuy be adI Ninon apu 4 NN UYN)
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN
Town Of Northampton ACCORDANCE WITH THE POLICY PROWSIONS.
212 Main Street
Northampton,Ms.01060 AUTXORMEO REPRESENTATIVE
Attention: Building Department,
C 1988-2015 ACORD CORPORATION. All rights merved.
ACORD 25(2016103) The ACORD name and logo are registered marks ofACORD
ACC)-R& CERTIFICATE OF LIABILITY INSURANCE 7/512DD"1"Y'
5
THIS CERTIFICATE RI ISSUED ASA 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 INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIfUZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: H the cerNRcale holder Is an ADDITIONAL INSURED,Me pollcy(les)most have ADDITIONAL INSURED provisions or be endorsed.
N SUBROGATN]N IS WAIVED,subject W Ma terms and condmom of Me policy,cetteln policies,may 10"Irs en anderssmenl. A slide o nt on
this carllficets does not Cmlfer rights to the Certificate holder in lieu of such endorsamen •.
WIDOucEe FORREST INSURANCE AGENCY
603 NORTH MAIN STREET PNoxEe �,
ir
E LONGMEADOW,MA 01028 a --- - -
m AFPoROMaeOYEMae SEC.
eMMEAA: Liberty Muhsal Fire Insurance 23035 -
Wel D WURFA6:
WINDOW WORLD OF WESTERN MASSACHUSETTS INC
1029 NORTH ROAD alauREac: _ -
WESTFIELD MA 01085 IxeuReno: _ _
IWYRER Q: _
INSURER F:
COVERAGES CERTIFICATE NUMBER: 48525837 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 RAW RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY MUNN.THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDRIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PND CLAIMS.
LIN 1We mmwM pglcy WlNgEn WTa
DDMMp1CNLe01FAALQA9Yry EACHOCCURRENCE P
CWMSVAADE F-1 OCCUR PREMI9E9 eo vu {
MED EXP {
PERSONA &ADVINAIRY a
AEML/yORELNTELRIrr AFFUEe PE1L OENERALAOGRESATE {
U. jE 10C FROOUCIS-COAIP/OPAOO {
OTHER', a
ANOMDBIEELIAMUTYIN O N UUS euverc
a
ANY ALTO ECCSINMRI( ;-.mnl a
.NEO BaHEnIRED BDgLY 1NJURYHW eRNOR {
AUTOS ONLY AMOS
HIRED N.YIOBHFD {
AUTOS ONLY AUV08 MY
f
e11BREW LWI OCCUR FAGHgX:11X1ENCE a
6YCESSUA9 clzlOROE AOOREOF.TE a
BED RETE. a
A wOnxmacexPExeAnox WC2-315.377947-019 572019 5/712020
ANBEWEOVERS'UA9ARY
ANYPRWPoEfOH?ARINERe1 CU11VE r-'� E.L.EACH ACCIDENT
aIODD000
CfFlCEwMEMEEgE%CLUemt uY NIA
(MxMtlnyln HH) E.L.pBFABE-EA EMPLOYE S
UI0e»1Se umx
OE9CNI"M CF OPERATXINS Mbx aL 015EASE-POLICYLP.Irr f
DEWRFMN W OPEMTIONSI LOWTOXSIVENICLEB IACORD 101.bNab:ul Rm:Y SdxM,M,MYOe YtlH,W Xmonepw le,pu6M1
WORKERS COMPENSATION INSURANCE COVERAGE APPLIES ONLY TO THE WORKERS COMPENSATION LAWS OF THE STATE OF MA.
This Certificate Cancels and supersedes all previously issued cedificales.only as May relate to mraem Compensation Coverage.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
TOWN OF NORTHAMPTON THE EXPOU110111 DATE THEREOF, NOTICE WILL BE DELIVERED IN
ATTN: BUILDING DEPARTMENT ACCORDANCE WITH THE POLICY PROVISIONS.
212 MAIN STREET
NORTHAMPTON MA 01060 AUMORIEEDREPRESENTATNE
.ten Smith
01988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD
usssaT I vavnn I lies ae 1 nmTom 1 W/2us e:se:ss m @ml I Xew L of 1
AFFIDAVIT
In accordance with the provisions of MGL c 40, §54, 1 acknowledge, as a
condition of the Building permit, all debris resulting from construction activity
governed by this Building Permit shall be disposed of at
lwAsTE /i6AL. i1 /41 ;N 11 , 171001
(NAME OF FACILITY)
a properly licensed solid waste facility as dfined b MGL C 111/§150A.
41AI r
Date Signature of Permit Applicant
PRINT OR TYPE THE FOLLOWING INFORMATION:
QOaF1ri E ?AS 3 —
(NppA''MJJE__OFF PERMITAPPL ANn'
l7Y�L1 .11 YA.TIISr
F MATERIAL TO BE DISPOSED OF)
22 6 lie. vvrohrn j . I army M o)wq,
(PROPERTYADDR SS)
MI Windows And Doors
Wi �� 650 West Market St
"-..'"•'�•'"� MI ndows And Doors
NPN Gratz.PA17030
66 650 West Market St 1650
or destroy fie M` 'Getz,PA 17030 DHNINYLINo Grids
:o`aralFema.3m ParWl4t:lite-1:112•�gev,L�.Ann
NPSD 1665 Na:�9Cw01e 0A'M..NOtEAmmalod);Argon:;3377�1n%37
SLIDER2NINYL3Grlds a Maa.klcrosmaaon
N6Annealedl�L01n1
aIM SW4tre6T ana,162: vAMOR;
4512%052
cbmnbe wgamaw.eo..dve•rm a•.ubPew.wWvn�n y+ormarx.
ENERGY PERFORMANCE RATINGS
YdRnM. MB+.31fa7Ld�7
color ai0erm mm.le N pee.uaa mw a w»a1 M vexne^M••d°'"""Le U-Factor(U.S.A•P) Sotar Heat Gain Coefficient
aoddoors27
men using. ENERGY PERFORMANCE RATINGS 0. 0.29
'dON5Onno Solar Heat Gain Coe r,,,nt I L
U-Factor N,s.n•Pl ADDITIONALPERFORMANCE RATINGS'
e genealty
0.27 0.26 Visible Transmittance Air Leakage(U.Shc-P)
Jaud Cer- RATINGS 0.52 <_ 0.3
owdonsm ADDITIONAL PERFORMANCE a U.BJI�)
Alf Leakage( ...r•r.rawrsa+a..rr,M•m..m.apme Paarra..rirvpveermsu
ViisibleTnnsmiUanee '3 F^,.�a�waaarM ire•re.....r.r...�m...aaa+eeo.«>aa�ex
als. 5 0 a4rfe•1Oweac"' ea.wsra++seaenpaaarrwwaew ra-u
0.46 aa.rm, ,a..MMa.�n
t,bake varaeaaa�m
ryrpp eaeo. lar P°faOedmmrmaasi A.�ryra ENERGY STAI .
coeurmpapss�saaFvnsr�'Msawrp.-
rOne. .n .near aarrwaCcrfifi�do por ENERGY STAR on[as regiones renaltadas
s.Use ararf
.MIM as
fxlse6Lr0eal.
�®a ...\ T � rmhNinkmwwa ae htal e"Iretlwt
® �/ .. t,. Pua inlnmusiA�wmpeu.weWrnla MWiMa dN PieEeta
-�O
■pdas4randeed. Ped Grade +DP(ASD) -DP(ASD)
.n.n.eua•.n.iree.. Water
bi fall irnmewaw l•bNvo_p e4ad l7rad.am. LGPG39 3A30 50.13 5.43
Para iid.mmNM v.mpletarnmoerab NNc � ax est Size eporgl Florida lD -
DP(AS D) Water 40.00X7200 "+mnlam-si�o 20540 .I-
•DP(ASD) 5.06 _
ped rads 3506 35.08 aNgc ve for ind'mdual wntlaeaand doors
LC TC 1DITC F ares. For idorma are m,DP meed
r NackM unite.Pleat eorihIX yournlp ruryaee2ativa.Pas ontl Np DP enlled by
ex est ire
epoMl 26124 arae eine.Teaedie AAM lWAX&A101n.S.vMa0 GhiUAveordepro
FNaeLMlOef"' ® STME1300.AAMAlabdmaybeeenceaM bygeanp beadortrackfi9a.Far
72.00%80.00 mallnd dtlziomlifRommetion regardng immFation inemetione,pbatevieb MWN.mmd.rom.
doors W. For iMo pea
1en,pp anaad by
Rftinga are ivr mdrddiil Mindows sM gs AAMA I1bN May be 16785673.1 .1.1 Pvm•e v"
or Backed uNtc,please AAMAANDMNC c rap llk nnatiee Pda end Nag .
and tact a¢e.Testedto p, mom N-1 10111 S.]lAaeD
^ vpsededby9leEVbeaa or track Mac FOrwadcoln. ilapmabon 2
&tY10168:10:13 MI
II kemadw Nat el-ns.pkace d.il wa+v Fdm.c en
28772468.1 .1 .1 iamn.aY:el PM
I
Window World Of Western Massachusetts
1029 North Read
7335
pq� owworl -7335
SmpylbMbLw•' W851BTmd55aWIndOW WOfId.COm
Jackie & Dave Blair
J.blair2O@icloud.com
IBill Address: Install Address: Estimate: Penial
865 Westhampton Rd, 865 Westhampton Rd, Estimate#E1560300500704
Florence,MA Florence,MA Date of Estimate:6/11/2019
01062 01062 Valid Until:7(11/2019
DESCRIPTION 07Y UNIT Rl AMOUl
6 Ft. Patio Door-casing+capping 2 1,999.00 3,998.00
Solar2one Low-E in Patio Door 2 150.00 300.00
Interior Woodgram Upgrade(Patio Door)(Hillside) 1 192.00 192.00
Permit 8 Administrative Fee 1 200.00 200.00
TOTAL AMOUNT $4,690.00
CUSTOMER PAYMENT Dll
Finance Amount Financed
TOTAL PAID $0.00
CUSTOMER DUE $4,690.00
'No extra work If not In writing
'Customer Commenb:
'Install.,Notea:Bolh lee„hull
Customer ID Delete
Id TypeOmer$license
Itl#' S244
Id Issue Slate' Masse
to Expiration Date 23333
Sales Rep Recommended: ryry
r Interior Stops r Exterior Capping_
��%lY'��l➢./4
Customer Declined:
r Interior Stops I— Exterior Capping
Pre 1978 built homes:
MyhomewasblIwll in
the her 1W0
QmIlalll Oetllne WN pang venfica4an
(imlieg have rer mesas o/Ihebe M1 e inlwman pemWel infamina me MIM1e rala,liel risk INtlre Intl M1emtlexposure hdn renoveEm etllvRybMpertormaL in my
dxa'Iing unit.the EPA R¢rovap RlgM'dpcM1ure waerewlve]bekre Me vah began. iha EpA'Rameb RpTbatlwmm�b NerwE eMpnMM npm Mm.nupe'llaeeeu•FellG
property.We are not responsible fm any danugew plants,sbmbs w landscaped areas.
5.Arrival and Departure Times.We will advise you ofthe 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 am polity that our Managers get a sign-offform and
collect the outstanding balance at the conviction ofthejob.We ask thin you be available to approve the job and make fetal payment at the time ofcontpletion.If this is
not convenient for you,we need to know before we but 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 ofan Installation appon=mt We typically do not schedule more than a day or two in advance to
try to avoid such issues.
6.Our Work-site.We like to set up our work-site as close m your windows and doors as possible and generally your driveway is the best spot.timing the driveway
will black a garaged ear,please beready to pull it out upon arrival.
7.Alarm Systema.For those of you who have statin systems,the alarm company should be notified and advised of ourjob.They will be responsible for the
disconnection ami rekaruiection ofyouralarro 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 ofour ability.Because we work in stages(i.e.,removal of old windows,seting the new window,wrapping of exterior,etc.),we don't
complete thejob one window at a time.The job moves along in a noting progression where each operation is done on all windows at the same time.This produces a
qualityjob.
9.If the job takes more than a day,will there be any openings in my house?Of worse not.We only remove that which can be reinstalled in the same day.
Although there may not be a complete wmdow,it will be wedither-tight and secure for overnight(Please an critiquing at this time).
10.Pets.We love forty,four-legged creatures;however,we need your help in supervising them.We we not always able to close a gate or door behind us when
carrying a window,so please keep them in a safe place.Ourjob 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 yaw living space.Construction work can sometimes be messy depending upon the scope of yourjob.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 atter we have cleaned up,it is advisable to survey the areas for something we may have overlooked(Le„kids moms,baby's mord.
12.*Damage to walls and old trim stops.For Mase ofyou who have old aluminum and steel windows and are replacing them due m sweating and damaging ofthe
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 fag out also.This is normal;
however,we are not plaster experts,so the repair to those wails would best be left to the experts.In some cases,due to out ofsquare openings,new trim is required to
make the window look good."Undess noted w 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 ofyour new windows.This is not always r eeessary and is usually rninor if it occurs.Ifyour him stops around your sashes are very old,dry,and
brittle,they may snap and crack upon removal.Ifthis happens,we can leave them offifyou please,or for a small up charge,replace them with newer ones.Many of
the old-style steps are no longer available so we would replace the entire window with newer style stops.Should we discover any hidden damage to the fiame 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 mn errands,take a walk,orjust bass.Ifa question should atise;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 interrulmons and disaracco n.This ensures a safe and quality mstataren.
14.Past Due Balances are subject to a service charge of 1.5%per month.In the event that this amount is placed in die hands of an anomey for criterion,the
purchaser agrees to pay all costs ofwllection,including a reasonable attorney fee.Return check fee is$50(filly dollars).
9
Customer Signature Sales Person Signature
P.S.Now would be a good time to review contract with me salesman to be sure of your order options and work 0 be done.Only Me Items and services on be contract will be
done.If you have any questions whatsoever,now is the time to ask.
Window Wotltl of Western Massachusetts may not require an acceleration of Payments as specified in the payment section(hong for the reason that he deems himself or me
Payments to be insecure.However,where me contractor deems himself to be insecure he may require as a prerequisite to continuing and work mat the balance of funds due
under the contract,which are in possession of the comer,shall be placed in a joint escrow account reaching the signatures ofthe home improvement contractor antl the owner
for mundrewal.
Arbitration,Window World of Western Massachusetts and the PURCHASERS)hereby mutually agree in advance mat in me event Window World of Western Messachuseds
hes a dispute concerning be contract,Window Word of Westam Messarlmsetls may submit such dispute to a private arbitration service which hes been approved by the
Secretary of the Executive Office of Consumer Attain:and Business Regulations and the consumer shall be required W submit to such amination in M.G.L.c 142A.
Window World Owner
Data__.____........ I........I.......... ........Date
.......................
NOTICES The signoWres ofthe partes above apply only to the agreement of me portae to alternate dispute resolution initiated"a contractor.The owner may initiate
becole resolution even'where this section is not signed separately by me parties'
This Window Wadi Franchisees independently owned-and operated by W ndow World of Western Massachusetts,Inc.under license from Window World.Inc.