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29-178 (3) BP-2023-1099 176 BROOKSIDE CIR COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 29-178-001 CITY OF NORTHAMPTON Permit: Exterior Res PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit# BP-2023-1099 PERMISSION IS HEREBY GRANTED TO: Project# WINDOW 2023 Contractor: License: WINDOW WORLD OF WESTERN Est. Cost: 1169 MASS INC 115719 Const.Class: Exp.Date: 04/30/2025 Use Group: Owner: TRUSTEE CROCKER ALICE Lot Size (sq.ft.) Zoning: WSP Applicant: WINDOW WORLD OF WESTERN MASS Applicant Address Phone: Insurance: 641 DANIEL SHAYS HIGHWAY (413)485-7335 C5186654A BELCHERTOWN, MA 01007 ISSUED ON: D8/17/2023 TO PERFORM THE FOLLOWING WORK: REPLACEMENT WINDOW 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: Final: Final: Final: Rough Frame: Gas: Fire Department Driveway Final: Fireplace/Chimney: Rough: Oil: Insulation: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: i �. . . ' . . ' Fees Paid: $40.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner f ern akt. os. cF/ The Commonwealth of Mass.chus; is 4061 ��� tico Board of Building Regulations .nd Sj- -•ards1 Olt Massachusetts State Building Co.•, 8ct e.� . (2 'MU ICIPALITY qr ''Vie USE Building Permit Application To Construct, Repair,Reno .•ej era •.lish . R vised Mar 2011 4/One- or Two-Family Dwelling .M,goF77o This Section For Official Use Only Building Permit Number: 6 ",, - /Gl �/ Date Applied: r..) 4?-0S, i .& 5- 17-2oz3 Building Official(Print Name) Signature Date SECTION 1: SITE INFORMATION 1.1 Pro erty A dress: , 1.2 Assessors Map&Parcel Numbers / i rode 5/cfe ,/ 1.la Is this an accepted street?yes .k no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public 0 Private 0 Zone: _ Outside Flood Zone? Check if yes❑ Municipal 0 On site disposal system 0 SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: AlA`Ce Croc r Flo rei4Ge H4 0/06 V Name(Print) City,State,ZIP 17' 8roo�5id. C'r if/35aa 60i ' rk)rie No.and Street Telephone Email Address SECTION 3: DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building' Owner-Occupied 'l L. Repairs(s) 0 Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units `.. Other III/Specify: VI?;kAG c,'&t,f le"A t '‘ Brief Description of Proposed Work2: / Ali /1 a/�W /QGemen I SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) _ 1. Building $ / /6 9 1. Building Permit Fee: $ Indicate how fee is determined: i ❑ Standard City/Town Application Fee 2. Electrical $ ❑Total Project Cost3 (Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5. Mechanical (Fire $ Suppression) Total All Fees: $ 411) Check No. UUI t' heck Amount: Cash Amount: 6. Total Project Cost: $ /j /6 9 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) C. 1�.5 911 . �, tea , K Ljvjf_AoL., ,', t>v\.-- License Number Expiration Date Name of CSL Holder List CSL Type(see below) U ` C �� ��.,,,- Type Description No.and Street -C,K,� Thi\ `fit G.. eA U Unrestricted(Buildings up to 35,000 cu.ft.) l R Restricted I&2 Family Dwelling City/Town,S IP M Masonry s�c. _ RC Roofing Covering WS Window and Siding i SF Solid Fuel Burning Appliances �y3)k-1�`S-`l'.1S ctzv-w,. t,,:\n.,010 ti Orkek (,A" I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) \� (,..e '� �� HIC Registration Number Expiration Date' HIC Companyan Name or HIC Registrant Name (LA-VC-))fLc\f 25, S\Net,,...kb .o-k Va-rrn.4.-ems C'.i ti\nlr.,6.t:c,,y,LA.4"i,,5 and Street Email address City/Town,State,ZIP Telephone SECTION 6: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 I I'" No ❑ SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,as Owner of the subject property,hereby authorize W\.I\A. Lk), 1'1uv & to act on my behalf,in all matters relative to work authorized by this building permit application. = �� pl, , ems) 1(/aPrint D4...).e._*>- er's Name(Electronic Signature) Date SECTION 7b:OWNER' OR AUTHORIZED AGENT DECLARATION By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information contained in this ap . all is true and accurate to the best of my knowledge and understanding. ' i q/a 1) Print er' o uthon A s Name(Electronic Signature) Date NOTES: 1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(H1C)Program),will not have access to the arbitration program or guaranty fund under M.G.L.c. 142A. Other important information on the HIC Program can be found at www.mass.gov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dos 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) (including garage,finished basement/attics,decks or porch) Gross living area(sq. ft.) Habitable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of half/baths Type of heating system Number of decks/porches Type of cooling system Enclosed Open 3. "Total Project Square Footage"may be substituted for"Total Project Cost" The Commonwealth of ti2`assachusetts Department of Industrial Accidents _e 1 Congress Street,Suite 1 0 = 3' Boston,1144 02114-2017 4, , wow mass.govidia Workers'Compensation Insnranee Affidavit:Builders/Contractors/Electririanef'1nmbers. TO BE F Llt1)WITH 1'1ilt;P I>!IG 4 ORITY., Applicant Information � ; Please Print Legbly '1'1d'j Name(Business/Organiaation/lndivtr nat); ,yil rye Address: kyk; I ;YV°alb;, City/State/Zip: Phone#: /3 �'�'� r7 '7 1 ' Are you an employer?Cheek the appropriate box: Type of project(req�ed): am a employer with• 0 employees(full and/or part-time).* 7. ❑New construction 2.0 I am a sole proprietor or partnership andhave no employees working forme in s. Remodeling any capacity.[No workers'comp.insurance required.] 9. ❑Demolition 3.0 I am a homeowner doing all work myself LNo workers'comp.loam-ones required.]t 10❑Building addition 4.0.I am a homeowner and will be hiring contractors to conduct all work on my property. IwilE ensure that ail contractors either have workers'compensation insurance or am sole I i.[]Electrical repairs or additions proprietors with no employees. 12.[(Plumbing repairs or additions 5.a I am a amoral contractor and I bays hired tire sub-contractors listed on the attached sheet These sub-contractors have employees and have workers'comp.insurance 13• Roof repairs 6.0 We are a corporation and its officers have exercised their right of exemption peiv!GL c. 14. `Other Rep! ' i'i `a,' ' 152,§i(4),and we have no employees.NO workers'comp,insurance required:] *Any applicant that checks box#1 most also till old the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are•doiag all walk and then hike outside edrithactbrs must subinit a new affidavit indicating such. t'Contractors 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. "kiwis the policy and job site information. Insurance Company Name: , ) E f/v i( r l car"1 11 S t/f rc/V1 Policy#or Sew ins.Lic.#: C'5 " " ; / if M' Expiration.Date: /0/c // ..') Job Site Address: / 7 6 / r r _____City/State/Zip: PO rel/1 G( /j4 0,06 o'7 Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGI,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 ag rst tiro violator,A copy of this statement may be forwarded to.the Office of Investigations of the DIA for.insurance coverage sera at nit. ...:.... , ,.:u.....w.,+..:w ..m:.. .+.tiini:,x+..ram.--,<.....t^.,+.•�:.... „ . ., ...........--....,..». ._ I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature: , " a e ' .. Date: " / y�a 3 �...._._.._._.__._..._.... Phone#, 413-485-7335 Official use only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License # Issuing Authority(check one): 1 DBoard of Health 20 Building Department 3fCity/Town Clerk 4.0 Electrical Inspector 5Fillumbing Inspector 61:Other Contact Person: Phone#: City of Northampton �0.TMA MY 0,, �,.... 1 at r 1i\ c�'r„+ *' 8 C. Massachusetts A,l : !,' ce, it tet'le�� C I, DEPARTMENT OF BUILDING INSPECTIONS iP% ..:', 212 Main Street • Municipal Building J� ,�Q n-.�, w Northampton, MA 01060 ".0 �Fy t *.» .• CONSTRUCTION DEBRIS AFFIDAVIT (FOR ALL DEMOLITION AND RENOVATION PROJECTS) In accordance of the provisions of MGL c 40, S54, a condition of Building Permit Number is that all debris resulting from this work shall be disposed of in a properly licensed waste disposal facility, as defined by MGL c 111, S 150A. The debris will be disposed of in: Location of Facility: Ort5oAc4 \16Q e _ lO9lp `Nf1Cim-N `O\- \--,;- ,ew t \o• C: ( a r t The debris will be transported by: Name of Hauler: \‘f\6.�-N,0 \))c>ra Signature of Applicant: / Date: -'/ y/02 City of Northampton u�H n rr roe t rf"� " r ~tA Massachusetts { (Iti d 61) DEPARTMENT OF BUILDING INSPECTIONS ;4 c 11;20,1 212 Main Street • Municipal Building 1'' ` •' •r Northampton, MA 01060 .M%�4C HOMEOWNERS'EXEMPTION ELIGIBILITY AFFIDAVIT I, I i CrUG(e..c r (insert full legal name), born _ (insert month, day, year), hereby depose and state the following: 1. I am seeking a building permit pursuant to the homeowners' exemption to the permit requirements of the Massachusetts State Building Code, codified at 780 CMR 110.R5.1.3.1, in connection with a project or work on a parcel of land to which I hold legal title. 2. I am not engaged in, and the project or work for which I am seeking the aforementioned homeowners' exemption, does not involve the field erection of manufactured buildings constructed in accordance with 780 CMR 110.R3. 3. I qualify under the State Building Code's definition of"homeowner"as defined at 780 CMR 110.R5.1.2: Person(s)who owns 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 home owner. 4. I do not hold a valid Massachusetts construction supervision license and, except to the extent that I qualify for and will abide by the Massachusetts State Building Code's requirements for the supervision of the project or work on my parcel, I am not engaged in construction supervision in connection with any project or work involving construction, reconstruction, alteration, repair, removal or demolition involving any activity regulated by any provision of the Massachusetts State Building Code. 5. If I engage any other person or persons for hire in connection with the aforementioned project or work on my parcel,I acknowledge that I am required to and will act as the supervisor for said project or work. Signed under the pains and penalties of perjury on this 27 day of fitcja5 / , 2072 I� (Signature) WINDWOR-01 LAURA A��.--R'DP CERTIFICATE OF LIABILITY INSURANCE DATD/YYYY) 4/14/214/2023 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 NANTACT Laura MissME: eri Phillips Insurance Agency,Inc. PHONE Fax 97 Center Street mac,No,Ext):(413)594-5984 (A/C,Ne):(413)592-8499 Chicopee,MA 01013 i I ��ARiss: aura@phllllpsinsurance.com —__ INSURER(S)AFFORDING COVERAGE NAIC INSURER A_EMCASCO Insurance Co INSURED INSURER e:Em to ers Mutual Casualty Company Window World Of Western Massachusetts Inc INSURER C: 641 Daniel Shays Highway INSURER O: Belchertown,MA 01007 }-- -- --- INSURER E: INSURER 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 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 ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP - - LTR 1NSD WVD POLICY NUMBER (MM/DD/YYYYI (MMIDD/YYYY1 LIMrTB A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 — CLAIMS-MADE X OCCUR 6Q44324 4/9/2023 4/9/2024 DAMAGE TO RENTED 500,000 ,_PREMI9E$(Ea occurs-�� S MEDEXP(Any_one person)_ _$ 10,000 PERSONAL d,ADV INJURY ; 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY I J jC I X)LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: B AUTOMOBILE LIABILITY $ COMBINED SINGLE LIMIT 1,000,000 (Ea accident) ANY AUTO 6Z44324 4/9/2023 4/9/2024 BODILY INJURY(Per person) ; OWNED AUTOS ONLY _X AUTOSULED IR o p BODILY INJURY(Per accident) $ X AUTOS ONLY X AUTO ONLY _irerracc de t- - -- E B X UMBRELLA LIAB X OCCUR EACH 1 $ 1,000,000 EXCESS LIAB CLAIMS-MADE 6J44324 4/9/2023 4/9/2024 OCCURRENCE AGGREGATE _ _t 1,000,000 DED X RETENTION$ 10,000 $ WORKERS COMPENSATION PER II II OTH- AND EMPLOYERS'LIABILITY LE.L.EACH ACCIDENT YIN ___. STATUTE _�1_ER___ ANY PROPRIETOR/PARTNER/EXECUTIVE E.L OFFICER/MEMBER EXCLUDED? I N/A ^_ (Mandatory in NH) E.L.DISEASE- EMPLOYEE $If yes,describe under EA --- DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT-$ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Northampton THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Attn:Building Department 212 Main Street Northampton,MA 01060 AUTHORIZED REPRESENTATIVE ®1" rkk1` t ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD DATE(MM/DD/YYYY) AL'(.) `D o2/ta2oz3 °41,1 CERTIFICATE OF LIABILITY INSURANCE Acct#:2970777 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 CONTACT NAME: LOCKTON COMPANIES,LLC PHONE -------FAX 3657 BRIARPARK DR.,SUITE 700 (A/C,No Ext) 888.828-8365 (NC,No): HOUSTON,TX 77042 E-MAIL ADDRESS: INSPERITYCERTSIaLOCKTONAFFINITY.COM INSURERS)AFFORDING COVERAGE NAIL M INSURER A:Ace American Insurance Co. 22667 INSURED - --- - -- WINDOW WORLD OF WESTERN MASSACHUSETTS INC. INSURER B: 641 DANIEL SHAYS HWY INSURERC: BELCHERTOWN,MA 01007-9529 INSURER D: INSURER E INSURER 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 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 ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP —"-- --' LTR INSD WVD POLICY NUMBER MM/DD/YYYY( ) (MM/DDIYYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED — CLAIMS- OCCUR PREMISES fEa occurrence) MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE OMIT APPLIES PER: GENERAL AGGREGATE POLICY PRO- LOC PRODUCTS-COMP/OP AGG $ r. OTHER: a AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) __ • ____ ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED --- — AUTOS ONLY _ AUTOS BODILY INJURY(Per accident) S HIRED NON-OWNED PROPERTY DAMAGE " AUTOS ONLY AUTOS ONLY (Per occident) $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ _ EXCESS LIAB CLAIMS-MADE AGGREGATE $ •__ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y'N X STATUTE ER A ANYPROPRIETOR/PARTNER/EXECUTIVE — -----" OFFICER/MEMBER EXCLUDED? —N/A C5186654A 12/25/2022 10/01/2023 E.L.EACH ACCIDENT $ 1,000,000 (Mandatory in NH) If yes,describe under E.L.DISEASE-EA EMPLOYEE DESCRIPTION OF OPERATIONS below $ 1,000,000 E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION 2970777 Town fo Northampton SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED Building Dept BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 212 Main St ACCORDANCE WITH THE POLICY PROVISIONS. Northampton,MA 01060 AUTHORIZED REPRESENTATIVE ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs&Business Regulation Registration valid for individual use only before the HOME IMPROVEMENT CONTRACTOR expiration date. if found return to: TYPE;ih‘widual Office of Consumer Affairs and Business Regulation fiegistreign Eapiniition 1000 Washington Street -Suite 710 301746 - 04ffit0iE Boston,MA 02118 VICHOLAS DROST i \IICHOLAS DROST 77 / /", /' ..,- 102 OAKRIDGE DRIVE ew,-,,,,,,s(a/././z0,4• i'if 3ELCHERTOWN.MA 011307 , s Undersecretary Not valid without signature THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR reEEZeirfporalion. Realsteal1On- 1- 16564.. .:F-:.-.1,031.i4/2024 Commonwealth of Massachusetts ft) Division of Professional bcensure WINDOW WORLD OF,:Wf tE=_8..TR. ACHiUSETTS,INC. I; Board of Building Regulations and Standards ,-...'. Constrmt-Arii§1.1 ' .,.. ',pry's or 4,1,7.2i,I L ra•- ',.-; ii•-••• /.. •...-I-I FM:.T. • •I'; 't TIMOTHY MOST ‘,... CS-115719 4..4 ,4/1., .1cf_pires:04/3012025 641 DANIEL SHAYS 1-Pirt. -7=-_-_-• ---C. f_cienAe.4/laiffs BELCHERTOWN,MA 01007.:,:,..;,_,, :: Undersecretary NICHOLAS 7:DROSt'x'14a,,,,'' 1.W1- '..- ' ._- 102 OAKRIDGE DR V`ok.f,:la-i- BELCH ERTOlji Me,j0p7r '1 --. •,".x.--7 Q.- Commissioner c f v,„A g Bleind.eo $V_ ` Mt fAtindows And boars r=s+ti�--b= - • $$ _ rtf suft ` ,f, Gratz,PAQa�i�o St MI Windows An• Giants :a or destroy the - � West MttltOt . ',` <i` . �\' }_ Iti m , •Gtttz,PA1T030 �I ; 1650 •j �_ a�.l^at 4xs N DHINYUNo Grids Fi. y 4` 168$ f Panel 1d2:Lite�l: 1NCfaar l patrtea{sdJ;Lle,2: SLIiDER2/1/114YUG rids MUM ('i',clear,nwNE,atnealect Argon:37 u2 x a7 fiClilt t O l � Para(1&2:LW11:(1t8",Ctetr,E.C6.Anneafsd):Lih'Z: s that can be �S�"� } ' edl;Aryan;45 ill%45 Sf2 Wirtduar produeta aataos maps *cleaner, .. .-...-•' m+Y ba c6 O34ird to rart�bn in Aorramarrce 3nfor dr'fFernT 14E44164230.44002vatisdea+ ENERGY PERFORMANCI RATi1e�S and doors sown)pis raw�'"' U-Factor(U.SJ1-P) Men using a n Sofar Heat Gain Coefficient ,lows on the ENERGY PERFORMANCE RATINGS V. ,l �y U-factor(U.S•►1-P) Solar Htt Grin Coefficient • ADDi7iCN p s 29 A1` ERFORMANCE RATi1dQS ire generally - 0.27 0.26 llisihie Trot:strliftacrce •oductcer- Air Leakage(U.S./1-P) locations in ADDITIONAL PERFORMANCE RATINGS A r A • Air Leakage(U.S.11-P) f�,7� �t�: Vislble'�f8nSR1tlt8[[tt� waloogrC0'411umatansrmroeeok,raamwp ea c ptWeikas i,I,SEldk2 0.46 m.r�r ?bonermaitvcaaaartiraaextrbestraritfort xtismaa T �70� °�iraaaes rocxa.rarr me w�a�llymaerc�nsa trany �, c ��.a brr9+�0 +�uam+e .. frlumance; +mxoa „a, mmv�aininro "°r'"a"x°s"` rtw 'weloa ENFRSY SIMI'Certified in Highbfilrted Fi gtons. r per'°ram. mrRwtr ts+c�et+ m rts-tJss=a �C vo Certifi�ad3 nor ENERGY STAR enia;regionssresaitadas. . -s t . Tttf f Y;TAR`Gt tirtiert in tirQ{slstltsti d I,,his as>. cc , nri, •rt' (srs FNERG�'STAR en ld r6gronPs roiatrsdas i i ENERGY"STAR -� �. - le f . ji +►� cnergrma•10•119;Areal „ Catitiad'Certcado • +�[ Tt l` %}AI '4� ` For fit!mfamutiaq sad,Fshe!an pcaEa^t Para irffomtacipq tarrpkta caes,dt to oisl�Kta del rrrA _. arlargy ru4a* riOwn to t:estliedtt:eitifeade Perf Grade +DP(AS D) -DP(ASD) Water Far full Hemratiep.aya IOW oketodust LC-PG Para Wavesei5n Miele,ceps bs to eti eut del prdAuc�. _ 3 � RNax Test Size Rep 50.13 S.A3 • • +DP QSD} Water A tt# Florida Jla Pert Grade i ( -DP(ASD) i 6.fJ6 40.00 X?2Q0rt.th-loser v 2pgg0 _/_ 35 09 LC-PCs35 �_ , 8 G(� r longs are fnr in:tn:l 3'2:; s and doors only. For a�f:nfiaan rogart II ::dt tsc est iza I,lei ` 29124 r stacked um2s,please eontaet 72.00 X 80 r4r nd fast size.Tested to 11A You sales representali te.Pos and Neg DP im3sed py SrMEt3f107eL d t.Ya(ma�bN4rCSA�Ore Q-0SGfasre ardoet¢to winsare for tdvidual windows and doors onN• For kdorrnatica regart3n _rrat9ed ddrtional information r Y Y 9 B bead or tnckfitler,Fw a stacked ante.pleas t ot>trtst your sales representative.Fos aired Nag AP meted tN r' gyp? r 9 ktstaaatkm instructions.Pkase vise www rrewd.com. unR test sire.Tested io A:A?AAAMDMAfCSA 1611i.5.?1A440-0`s A;ARIA label mty ae f R7856 I a3. . :t corscatled by ptatinp bead r#track filer.For add3ior>zl istfattrnGoa regsrtin9 (� Prettad on J r,nail testes:ion instructions,piens visit wwar.mnvd.ca-n, en22a,s a eo a�are Panted oft 26772468.1.1.1 irsrkataa19es7Pk oa-..r.c - .. e:473 a Window World of Western Massachusetts VFremans Pin"R rommnno 641 Daniel Shays,Hwy, Belchertown, MA 1 7 01007 975 North Road, Westfield, MA 01085 Windziv t(,(�l Office: (413)485-7335 CAR(E � www.WindowWorldofWesternMA.com Alice Crocker Phone: 4135229218 Install Address: 176 Brookside Cir Phone: 4137742326 Florence, MA 01062 Contract Name: Alice Crocker- Sales - Windows Design Consultant: Lanea Bushey Measured By: Measure Approved Date: 7/25/2023 Status: Contract Payment Method: Lender: Contract Type: Sales Comments: Product Description Txbl Qty Price Extension Permit&Administrative Fee Permit&Administrative Fee N 1 $0.00 $0.00 Setup and landfill disposal fee-Windows Setup and landfill disposal fee N 1 $0.00 $0.00 4000 Series DH Solarzone 4000 Series DH Solarzone N 1 $799.00 $799.00 Tempered Glass - Full Tempered Glass- Full N 1 $220.00 $220.00 Obscure Glass - 1/2 Obscure Glass - 1/2 N 1 $50.00 $50.00 Full Exterior Capping Full Exterior Capping -- Color: White N 1 $100.00 $100.00 Total Information Unit Total: 5 Subtotal: $1,169.00 Tax Rate: 0% Tax: $0.00 Total: $1,169.00 Amount Financed: $0.00 Payment Method: Deposit Amount: $0.00 Balance Paid to Installer upon Completion: $1,169.00 Renovation, Repair and Print Act (RRP) Compliance RRP Pamphlet Provided Date: Year Home Built: 0 RRP Signed Date: Window World of Western Massachusetts WTIMRnf a T CORImNnO 641 Daniel Shays,Hwy,Belchertown,MA _ �.; t ,West 14 01007 975 North Road,Westfield,MA 01085 Wind,014/ z Office:(413)485 7335 wNnow woke o { CARE www.WindowWorldofWesternMA.com 1 Product Acknowledgements I have received a copy of the lead hazard information pamphlet informing me of the potential risk of the lead hazard exposure from renovation activity to be performed in my dwelling unit. I received this pamphlet before work began. Primary Homeowner Secondary Homeowner Window World of Western Massachusetts P�nu�r comet.no 641 Daniel Shays,Hwy, Belchertown, MA _==� 01007975 North Road, Westfield, MA 01085 Wlieubmi th Office: (413)485-7335 w+rr;:,, wu+.o I www.WindowWorldofWesternMA.com CARE Preparing for Your New Windows and Doors Thank you for choosing Window World to complete your home improvement project.This letter is designed to simplify your upcoming installation experience by letting you know what to expect. 1. HOW LONG DOES IT TAKE?It takes approximately 4-20 weeks to receive your custom-made window order from the factory following your final measurement and your job exiting the Massachusetts State three day rescission period.A Window World associate will contact you shortly after your products have arrived to schedule the installation. Please note that we will make every effort to install your products within a reasonable time after they have arrived, but weather(rain, snow, high winds and extreme cold), high volume sales periods or other conditions(factory production delays,factory closure for holidays, shipping delays, etc.) beyond our control may govern the installation date. Homeowner understands and agrees that any such delays will not result in a discount from their contract total. 2. HOMEOWNER REQUIREMENTS: I understand that by signing this, I am certifying that I am the owner of the property listed on the contract. I agree that a property owner will be present for the duration of the installation to ensure that the work is performed to my satisfaction and to inspect the work completed. If a property owner is not present,the contractor will be released of liability for any installation issues. This allows us to better satisfy our customers and ensures that the windows or materials are installed in the correct openings. Customer must sign off on completion certificate and leave final payment with installer if he/she wishes to leave the job site prior to completion. Customer understands that by not being present at the time of installation may result in the automatic charging of the final payment to the credit card used for deposit. 3. UNFORESEEN CIRCUMSTANCES: If during the installation process a condition is found that would prohibit properly installing a window (i.e. wood rot, termite or other hidden damages, etc.),the installer will promptly notify the Homeowner as well as the Window World office of the problem.Any additional work that is required to properly complete the job will be discussed with the Homeowner and billed on a time and materials basis. In the event we have received the incorrect or damaged window for your job(due to an incorrect measurement or factory error), Window World will reorder the proper window and will schedule the installation as soon as possible. Window World expects payment on the work completed to date at the time of installation that is not affected by warranty issues. 4. WHAT YOU NEED TO DO PRIOR TO OUR STARTING THE INSTALLATION: • You will need to remove all curtains,shades, blinds, window air conditioning units etc.from the existing windows. • We also ask that you remove any pictures mirrors, etc. on nearby walls and tables. • Move all furniture away from the area around each window leaving approximately 3 ft in front of the window and lft on either side of the window to be replaced. • Secure any pets(and children)for their own safety and for the safety of our installers. 5. ALARM SYSTEMS: It is the responsibility of the Homeowner to inform the alarm company of the upcoming window or door installation and to arrange reconnection after installation is complete. 6. EPA-LEAD SAFE GUIDELINES: Homeowners of homes built before 1978 have received a copy of the lead hazard information pamphlet informing the Homeowner of lead hazard exposure from renovation activity to be performed in their home. The Homeowner understands and agrees to indemnify and hold Contractor,Contractor's representatives, and employees harmless for any lead paint health issues. 7. INSIDE INSTALLATION (Normal): If the windows are to be installed from the inside, the interior stop moldings will be removed from the existing windows and reused after the new windows are installed. Please note that the paint or stain on the trim/moldings may get chipped and would need to be touched up by the homeowner. 8. OUTSIDE INSTALLATION (Special): If the windows are to be installed from the outside, the existing window's wood "stops" will need to be removed. In addition, if there are existing storm windows in place outside of your current windows, these will need to be removed as well. Please note that the area(s)where the wood "stops"and/or storm windows were removed will need to be patched and painted by the Homeowner unless the exterior trim is to be installed by Window World. 9. UPON COMPLETION OF INSTALLATION: After the installation is complete,you will be asked to inspect the entire project with our Installer. An evaluation sheet will be provided for the Homeowner to sian after the final inspection is complete. Please make sure that any corrections have been made before the installer leaves the job site.When the job is complete,we ask that you pay the installer the remaining balance due on your contract. • 10. METHOD OF PAYMENT: Our installers will accept your final payment in the form of check, money order, Wells Fargo financing, or Visa/MasterCard/Discover Card authorization. As a courtesy and to ensure the safety of our installers; please DO NOT pay your final payment In Cash. 11. REFERRALS: Our goal is that you are pleased with the work we have done and will refer us to your friends and neighbors.You will receive a $50 referral fee for each person you refer who purchases 8 or more windows. Please have your referral mention your name when contacting our office. We trust that your remodeling experience will be a pleasant one, If for some reason you are not completely satisfied, please contact our office. Your comments are welcomed and will be used to better serve you. Thank you for your business! Primary Homeowner Secondary Homeowner Design Consultant EPA "Renovate Right" Brochure can be viewed and printed from here: Renovate Right Brochure WW of W. Massachusetts anticipates starting this work on and being substantially completed in days.Any deposit required in advance of the start of the work SHALL NOT exceed 33 1/3%of the total contract price OR the actual cost of any material or equipment of a special order or custom-made nature, which must be ordered in advance of the start of the work to assure that the project will proceed on schedule. No final payment shall be demanded until the contract is completed to the satisfaction of all parties. All home improvement contractors and subcontractors shall be registered. 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. Massachusetts 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 doals 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. TI HIS IS A CUSTOM ORDER NOT FOR RESALE This Window World® Franchise is independently owned and operated by Window World of Western Massachusetts, Inc.under license from Window World, Inc.