Loading...
42-013 (5) BP-2024-1199 276 WEST FARMS RD COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 42-013-001 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-2024-1199 PERMISSION IS HEREBY GRANTED TO: Project# door 2024 Contractor: License: WINDOW WORLD OF WESTERN Est. Cost: 6000 MASS INC 115719 Const.Class: Exp.Date: 04/30/2025 Use Group: Owner: THOMPSON. WAYNE &LACEY, CANDY Lot Size(sq.ft.) Zoning: WSP Applicant: WINDOW WORLD OF WESTERN MASS Applicant Address Phone: "'Durance: 641 DANIEL SHAYS HIGHWAY (413)485-7335 C56098598 BELCHERTOWN, MA 01007 ISSUED ON: 09/17/2024 TO PERFORM THE FOLLOWING WORK: REPLACEMENT PATIO DOOR POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring 1).P.W'. Building Inspector Underground: Service: Meter: Footings: Rough: Rough: (louse # 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: 17P Fees Paid: $60.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner r iC(..; SEP 1 6 2024 The Commonwealth of Mas chusej,4f: t ?r Auito",,,, PECTIpys FOR of Building Regulations and Stan oN.mA o,oso UNtCtPAht`i'Y Massachusetts State Building Code, 780 CMR USE Building Permit Application To Construct,Repair,Renovate Or Demolish a Revised Mar 2011 One-or Two-Family Dwelling % This Section For Official Use Only _ Building Permit Number: 111' -' )//9 Date Applied: Gieg_.____.,_7/1 IV?•�Building Official(Print Name) urc Date SECTION 1: SITE INFORMATION 1.1 Property Address: Rill 1.2 Assessors Map&Parcel Numbers all k) Fartm 5 C 1.1a Is this an accepted street?yes A no Map Number Pared Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq II) Frontage(11) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard ^ Required Provided Required Provided Required Provided 1.6 Water Supply: (M.G.1.,c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public 0 Private 0 Zone: _ Outside Flood"Lane? Municipal 0 On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Rt d: �JC, vie lh0vv1p 50v FIore1ce H6 o1060 Name t) City,State,ZIP I N F-0 r vlil Skid 1113 :;2175v2 105- e 4 eGink oo.c Vit No.and Street Telephone `l Email Addfe,s SECTION 3: DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building'FfJ„ Owner-Occupied 11� Repairs(s) 0 Alteration(s) 0 Addition ❑ Demolition 0 Accessory 1.31dg. 0 Number of Units \, Other VSpecify."'t'..1 )``tit C_+t.4 t it:ie ; Brief Description of Proposed Work2: p,-1 (� (4<o r G cf cc vv)e ►'1 1 A/'l'iv Ir7eite r-1', / __ SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ 6 / 00 1. Building Permit Foe: $ Indicate how fee is dctermincc: t ❑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: $ Check No.110 Check Amount: (( Cash Amount: _ 6.Total Project Cost: $ �; O 0 Paid in Full 0 Outstanding Balance Duc:_ SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) 3 S 1 q .A\(I';,r\,1vi,...i, )\ t-,t: •, License Number Expiration bate Name of CSL Holder La �� List CSL r Type(sec below) k No.and Street Typo Description U Unrestricted(Buildings up to 35,000 cu. ft.) rC�r' t"��ti G '�' > \ ` 1 L& t R Restricted 180 Family Dwelling City/To ,State; x —_ Si ale, ,, M Masonry ~'" / .RC Roofing Covering j" WS Window and Siding SF Solid Fuel Burning Appliances• __ `, ' ,;.% Insulation�t J}i`l��•`��� A>_`C`ik��lt�('J tarp\hl''•i�;2t.k:�'r�, �c I _ Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(RIC) i l; � '1 \t.+ .7t1 _�_ _..,4 W\5,C..3 C' \ 3�. �cS. I-IIC Registration Number Expirations pate;' HIC Company Name or HIC Registrant Nape 1(,,,Lk l c t S•S'c tt'...k .) :]..` t'dt�.V"'Er..4"_,�t_, 4t�`�r''.� * ;':r t, N .and Street ( \ Email address e CI OA t, •�-s-). �.:"�v.,'(Neer, l keet` k \3)L-0,c:>P,yam 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 EV 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.K I\hr,fit,\ kJ(It- k „ to act on my behalf,in all matters relative to work authorized by this building permit application. / (f 7.).e:C . C ty-s-,1:1--ra c��-) 6). 0f a 7 Print t7er '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 lit=ation is true and accurate to the best of my knowledge and understanding. r -- q igia "----- Print Ov ier' 'orAuthoriz d Cli-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(HIC)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/dpss 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" —_J City of Northampton ems-„ e.:�'." s• Mgr goy; +- .-4. , . 'x' Massachusetts �, I. k, • ti U. rr Attl>v, `t4 DEPARTMENT OF BUILDING INSPECTIONS {� ^;w'^+' `"i�, 212 Main Street • Municipal Building . ' "- Northampton, MA 01060 'rh fy•.i6k'°' 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: (' ,o \. \OQ S�.e , ((.1:1\Ap "\Ck \C•► `�� \ 'Z4 c‘..` .*4 }. E ` The debris will be transported by: Name of Hauler: V)r\A 04,-) \(.4_k c.. Signature of Applicant: / ' Z� Date: 9r q! °2 7 s City of Northampton 4 ,“° ` ' `U Massachusetts ,, \t:.;,s")....,;,,,,4)'. t! DEPARTMENT OF BUILDING INSPECTIONS J r '� \ 212 Main Street • Municipal Building �` �` },, - ,,}„ y Northampton, MA 01060 sl•;Y_ •-:NN.. HOMEOWNERS'EXEMPTION ELIGIBILITY AFFIDAVIT I, OC e rho o (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 I10.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 sha II not be considered a home owner. 4. 1 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 projector work. ( Signed under the pains and penalties of perjury on this { day of*Vern&C,2O7 `lot, C4 e x'1' t'rt-.e (Signature) The Commonwealth of Massachusetts " .;4 t i . Department of Industrial Accidents =% "` J Congress Street, Suite 100 ='1_ Boston,MA 02114-2017 �� 1, www.massrgov/dta Workers' Compensation Insurance Affidavit:Builders/Contractors/Eleetrieians/I'lumhers. TO BE FILED WITH THE PERMITTING AUTHORITY. • Applicant Information Please Print Legibly Window World of Western Mass Name(Business/Organixndon/Individual): _____ Address:641 Daniel Shays Hwy City/Stafe/�i�x Belchertown MA 01007 • Phone#: 413 4"7335 __ ; Are ye-)an trrnptoyer?Cbeck the appropriate box: I Type of project(required): 1 I.F.t ant a employer with 54 employees(full and/or part-time).* ) 7. :._J New construction 2.01 am a sole proprietor or partnership and have no employees working for me in 1 8. 0 Remodeling any.atpacity:NO workers'comp.insurance required.) i 3.01 am a homeowner doing all work myself.iNo workers'comp.insurence required.) + 9. 3 Demolition t 10 0 Building addition 4.01 ant a homeowner and will be hiring contractors to condud all work on my property. I will ► :--� ensure that all contractors either have workers'compensation insurance or are sole t 1 1.0 Electrical repairs or add lilt m i proprietors with no etnplayces. e j 12.0 Plumbing repairs or addition. 5.0 t ant it general contractor and 1 have hired the suh-contractors listed on the attached sheet. I These suh•eontractors have employees and have workers'camp,insurance.t 13.El Roof repairs G. We are u:curpnrntion and its officers have exercised their right of exemption per MGI.C. 14.2 Other Replacement_ .. • 152,§I(4),and we have no employees.iNo workers'comp,insurance requirul.l "Any upplicant that cheeks heed 01 must Ultra fill out the section below showing their workers'compensation policy infinnuttion. 4 I mtecwnerx who submit this affidavit indicating they are doing all work and then hire outside contra tore must subnnir to new affidavit indicating o-rich Contractors that check this box must attached an add)'timud sheet showing the mane of tlx:sub-contractors and State whether or not those cannot lun employees. if the sub-contractors have employees,they must provide their worker:'comp,policy another. 411011611.1110WAIIMM= l ant an etnployer,that is providing workers'compensation insurance for my employees. Below is the policy and fob site it{formation. Insurance•CompanyName: Indemnity Insurance Co.of North America N w..r Policy#or Self-ins..Lie.#: C56098598 Expiration Date:10/01/2024 .._y w._ lob Site Address:9-4i (0 W t a r Wi r' Rd City/Sttate/Zip:�' io '✓�c;c j d - 0 Q Attach•a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MOL c. 152,§25A is a criminal violation punishable by a fine up to:fit„i),()t) and/or one-year imprisonment,as well ass civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.0(0 day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insu tmce coverage verification. • Iv,yc,r, I do hereby cer ,on or the pains a d penal es of perjuly that the information provided above is true and correct. Signature; Dale: 9 IQ /d _ — _ . _ Phone#: 413 485.7335T._.......___.._--_.. __. Official uvtt only.'Do not write in this area,to he completed by city or town official. . 1 City or Town: 1 _ Pertnit/l.icense#. issuing Authority(circle one): 1.Board oWealth 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other o IContact Person: _�_._ ... ..._..___ ..__ ,..._. Phone#:_...............„._,..... . . ...... DATE(MMIDDIYYYY) w OS/22/2023 APR[) 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 poiicy(ies)must have ADDITIONAL INSURED provisions or bn Andorsed 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 CONTACTCO ..^. .--'�'----LOCKTON COMPANIES,LLC - —' 3657 BRIARPARK DR.,SUITE 700 I No,E,d)088-828-83e5 (NC.No): HOUSTON,TX 77042 E-MAIL ADDRESS: INSPERITYCERTSOLOCKTONAFFINTTY.COM INSURER(§IAEEQ)BDIJJG COVERk_GE.,_ _ NAIC tl �.- --JNS_VBER.6;J0d.44r0RY_I4a rtocP..9,01.I(?,tb.Am.dci_.. .... _ . I 45i75 INSURED INSURER B WINDOW WORLD OF WESTERN MASSACHUSETTS INC. 841 DANIEL SHAYS HWY INSURER C: BELCHERTOWN,MA 01007-9529 INSURER D: INSURER E: --' ---—•—• --`--' --- --- I INSURER P: 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 POI ICY 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'I I'R_TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. WSW ADDLBURR ••—'—"-P�LTC�EFF POLI YXh LTR E TYPE OF INSURANCE INSD WVD POLICY NUMBER '(MM/OD/YYYY) (MM/DDYYY) LIMITS _' — COMMERCIAL GENERAL UABILJTY 111 EACH OCCURRENCE E -544A-6Eni!TENTED_ . CLAIMS- OCCUR PREM,JSES(Ea occurrence) a MED EXP(Any non parson) $ PERSONAL&ADV INJURY S GENL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S I POLICY DRO• [OC PRODUCTS•COMP/OP AGG $ 1..�IIF(:T OTHER: S AUTOMOBILE LIABIUTY C81�NElTSINGi-ELIMIT--a - --- _ 1EtLectAde/IU____ __._ ._ ANY AUTO BODILY INJURY(Porpornon) $ OWNED SCHEDULED BODILY INJURY(Pot accidoni) $ AUTOS ONLY _ AUTOS HIRED NON-OWNED PRCPERTY DAMAGE 3 AUTOS ONLY — AUTOS ONLY _IPeraccldent).._ . .... 5 UMBRELLA LIAR l OCCUR _EACH OCCURRENCE S N excess use —'I(CLAIMS-MADE AGGREGATE S DED I I RETENTIONS S - _______ WOR'<ERS M ENSATION PER !FIT'AND EMPLOYERS'LIABILITY Y/N X 1 STATUTE_I • A ANYPROPRIETORIPARTNERIEXECUtlVE Il.— (Mand R/MCMBC•R EXCLUDED? N/A EL EACH ACCIDENT $ 1,000,000 (Mandatory In NH) x C56098598 10/01/2023 10/01/2024 _._ • _ - (f yes,describe wider DESCRIPTION OF OPERATIONS below EL DISEASE-EAEMPLOYEE ; 1,000;I00 EL DISEASE-POLICY LIMIT 1�QQI),I)QO ^DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Addltlonal Remarks Schedule.now be attached If mote specs Is required) — CERTIFICATE HOLDER CANCELLATION 2970777 - Town to Northampton SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED Building Dept 212 Main St BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DEI IVERFD IN Northampton,MA 1000 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE —�— ©1988-2016 ACORD CORPORATION. All right:;reserve,I. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD �.....1 WINDWOR-01 _ LAURA ACORQ DATE(MINA I)IYYVY) �- CERTIFICATE OF LIABILITY INSURANCE 4/9/2 124 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLC'E't.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE''I)LICIIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTr II)RIZED 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,n lorscd. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A stal•)I,lent on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER L cT Laura Misseri Phillips Insurance Agency,Inc. PHONE 413 594-5984 I Fes,Ne):(413)59Z 3499 97 Center Street (Arc,No,EId):( �.. .`____`____.____ ,(_ Chicopee,MA 01013 i,y,T;iss:laura@philllpsInsurance.com� INSURER(§)AFFORDING COVERAGE ._ __,_ NAICP INSURER A:EMCASCO Insurance Co 21107 INSURED JNSSU g0:Employers Mutual Casualty Company 21/15 Window World Of Western Massachusetts Inc INSURER C` 641 Daniel Shays Highway INSURER D: 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 POLI(Y I'LHIO[) INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WI III:H TFII(•. CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL TI i;: I ERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. _ SR ADDL SUER POLICY EFF POLICY EXP IN TYPE OF INSURANCE INSO w,ID POUCY NUMBER (MNVDDIYYYYI (MMIDDIYYYYII UMRs A X COMMERCIAL GENERAL LIABILITY' 1,000,000 EAClOCCURRENCE __.__ $ CLAIMS-MADE n OCCUR 6A44324 4/9/2024 4/9/2025 DAMAGE TTO RENTED 500,000 Imo EXP(Any one pr .n).,_, S 10,000 PERSONAL4AD_VINJURY $ I,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: _GENERAGGREGATE .. $ :,000,000 A� X POLICY X Jl El LOC PRO)UCTS.COMP/OP AGO S ',000,000 i OTHER: $ _ _ B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S t,000,000 _(EAAtddo01L ... ANY AUTO _ 6Z44324 4/9/2024 4l9/2025 BODILY INJURY_(Per person)_ $ 1,000,000 AUUT��O��S ONLY X SCHEDULED L�E�Dp ppB�O�DILY INJURY,(Pot Accident) $ X IH1U70S ONLY X AUTOS ONLY _(titer Men1Q/UAAGE-.- . 3 $ B X UMBRELLA UAB X OCCUR EACH OC_C_URRENCE __ __ $ ,000,000 EXCESS UAB CLMMS-MADE 6J44324 4/9/2024 4/9/2025 i,000,000 , AGGREGATE__ ...__. _ S E_X RETENTIONS 10,000 ii $ MPOYERS UABILITY Y f N __ON _.MIU[E__.l. I_SRH_.._. --- WORKERS /f ANY PROPRIETOR/PARTNER/EXECUTIVEygD N f A E...EACIB ACCIDENT _. $ ""antsstory I°NH) E_L QI,SF„/1SE_EA EMPLOYEE S If yyees describe under DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT S .,_.__ _ ...a DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached it more space Is required) CERTIFICATE HOLDER _CANCELLATIOK _ ..—_._- SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED III:FOR[THE EXPIRATION DATE THEREOF, Town of Northampton ACCORDANCE WITH THE POLICY PROVIS ONSCE WILL BE DELIVI RED IM Attn:Building Department 212 Main Street - . •...-- ---- Northampton,MA 01060 AUTHORIZED RREPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All right:;,D served. The ACORD name and logo are registered marks of ACORD Comr oine ewiti;of Mamuu,-.huoutts , Drvhionl of Profotiptoaaii t.18ensitfat t � at>?Irrt of fi(rrtdiuPll Repputation.talltt Sin rrcL. JW CanSt�iaLt t!q Ea�Ytip}avixur fi CS-115719 ,;:r, .a ;:$k� 1 E, ires:04,0012026 1JIOHOLA! •ter +N 4., 7az OAKRIDty 6111 ;Yfs . '1;,,,. ..1,$41 ., 13ELCHI-RTOW 11 Nig.ill �,b -f .:+ i.ti' f,A'�'I A. •;. :.i-•: b ;('•t7. it Commissioner of., i4 cyc„,,,k., . . . Ti lE COMMONWEAL 1'H OF.MASSACHUSS7TS ONilcu of Consumer Alf408.A Hus&noss Regutallon rieglsirallon valid for IuclivIciurt uso only ttafon>thn tIOME I IMPROVE p T COi•1TRACTOR ttr.xlratl.nn dale. LI'founcl return go: Y,Pi j40iF MI• Olficu of COItutnnrtr Affairs anti IUtiSlio S:6 Rogtdntn,�n J' 10010 WastliafitUn Strerat •Suite 730 3Qi'40=r Bonton,MA 0211.0 '4ICHOIAS DrIOS7 i s,..4;t': 'i ''..t. % '4414 ' • ........— ..: NICHOLAS DROST :.' : -.. A t. J .ar''f 1 " •,S'. '' , I 1 I o;R 0AKRlDGE:DfilVr''!% ..... .. r4�JIpm:.uf.a, '7a:v+"t ti' .�.. l N .!1 3ELCH111 •1'OWI�t,MA Q1'b h:;' -'t ' I t r. __ _ �_._. �_'" • U:sdorsacra1tLrr Not valid without sip is?lure THE COMMONWEAL'fit OF MASSACMUSETTS Otrice of Consumer Atfnsre,&Bualness ReUutatIon Roulslrot1on valid for Individual use only Ixdoro I . HOME IAIPROVENtEtNT•CONTRAGTOR oxpiratiorl de o. if rotent return tut TYPE:.ioi rattiult Office ofConsumer Anoka and ituslnvssRoyvt sum, Rep�lstfallun v Exialtettort 1000 Washington Street •Suite 710 f6( 41 .f.;!.03P1412020 Eloston,MA 02118 WINDOW WORLD OF.WESTEEiN_MASSACHUSETT S.INC. , • '1{ • TIMOTHY DROST "' -. •,;;I , • 041 DANIEL SHAYS HWY. .• •...4.+ d, j•'�1.,@,.• • OELCHERTOWN,MA 01007 --- Undonsocrelont Not valid without signature • . "�� q' 0-` "j'•Wlndou Woifd�CI-�F h + ` !..:: • 3.: '• W f0.:NCRb6ss\ ':''''0Ct.,.t., D DHNINYt/t�p'p►itla linirlaall---..�,� N!11(1t�2 it 4414•Ciw.kct7C3i)".aesw;;;cw. it"'CI .1 4.40;arsan;11 14 X 45. six r s'xts.tmc E4054IIpERFQR.14010ERATttaGS T U-Factor p} solar Rest Gain AD -.PEga;.PERFORMANCCE;RATthS7P,.: R Visible Transmittance : air i eakaq AttsAflj;,: t 0.51 41d,..Wi.14/Z a ,W y'v��Aat:a.r.a.lr • .aa icaaq, ' •act Y...t:411 r 2...rt .r, dtt 1� �•�" ' Gr.s '�atYf�itr!aM?11r6 ENERGYSUUC Ccrtiree wM0;,spled ftcgi8ni GneIcado pot fkLRGY5IARe :as regeaesresaliadar. I -.* T � ; ...(e\J .\ iii !V 144�Aa+ncawa.r»!$Ntl 4FL(+�Fad°`tt�bJ�4N -.WMa,F ) Parf titaCt. *OP fAD3. :•'CP(ate).. "vra. . T: A•PGsa' 0,1 55 f3 6 4 i€1 , e,;$ue Fcporn F Uda 1D src:OtTC il7*. '•ui n/�F.. 20&SG ZLU J 2r.8, , 'E, f cacbtw.:.�cu y;sW cPknr 60,0 l.00(.. lO x 1; /t y '4.l�%+a5 r s tKIE} IL. Ij6a'i „jr. Window World of Western Massachusetts I verrnnnc Venztio.691 Daniel Shays, Hwy,Belchertown,MA 01007 975 North Road,Westfield,MA 01085 cUW Office:(913)485-7335 G o Roc www.WindowWorldofWesternMA.com • . • Wayne Thompson Phone: 4132752105 Install Address: 276 W Farms Rd Email: sinsyclel@yahoo.com Florence, MA 01062 Contract Name: Wayne Thompson -Sales- Doors Design Consultant: Tim Drost Measured By: Measure Approved Date: 9/4/2024 Status: Contract Payment Method: Check Lender: Contract'Type: Sales Comments: Product Description Txbl Qty Price Extension Permit&Administrative Fee Permit&Administrative Fee N 1 $300.00 $300.00 Setup and landfill disposal fee Setup and landfill disposal fee N 1 $240.00 $240.00 8 Ft. Patio Door 8 Ft. Patio Door N 1 $5,460.00 $5,460.00 Patio Door Grids (both panels) Patio Door Grids (both panels) N 1 $0.00 $0.00 Total Information Unit Total: 3 Subtotal: $6,000.00 Tax Rate: 0% Tax: $0.00 Total: $6,000.00 Amount Financed: $0.00 Payment Method: Check Deposit Amount: $3,000.00 Balance Paid to installer upon Completion: $3,000.00 Renovation, Repair and Print Act (RRP) Compliance RRP Pamphlet Provided Date: Year Home Built: RRP Signed Date: Window World of Western Massachusetts iouR`°' "";° 641 Daniel Shays,Hwy, Bcichertown,MA ,`'—" i(` 975 North Road,01007 Westfield, MA 01085 WINDOWIO WWORLD i *Ala Office: (413)485-7335 CARE www.WindowWorldofWesternMA.com { 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 // J f Secondary Homeowner • • ( Window World of Western Massachusetts �� Ir V67ennna �l'4Mmnnn 64.1 Daniel Shays,Hwy,Belchertown,MA ?. s t='- % Wardziv 01007 '975 North Road,Westfield,MA 01085 Z Office: (413)485-7335 C WINO. ROES O x, www.WindowWorldofWesternMA.com . 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 1ft 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. B.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 oui Installer.An m,ah,atinn chant will hn nr,n.,ir1 ,A few thn Unmr.n,.,n,.r F,.r.,,.,. ..A...64...a....] : rt.... I.. .............•.. n, “_•__.. -- • �_.._ been made before the installer leaves the job site.when me joo is complete, we asK tnat you pay ure rnsLdner ant rt>ndnuny udraITLe uue Oil yuu, 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 550 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 7t)P97/V1 -- Secondary Homeowner Design Consultant I PA "Renovate Right" Brochure can be viewed and printed from here: Ilcenovat.e I tight Brochure �c,'t of W. I\ a;sachusetts anticipates starting this work on and being substantially completed in days.Any deposit required in of 1,0 start of the work SHALL NOT exceed 33 1/3%of the total contract price OR the actual cost of any material or luiprnont ',I a special order or custom-made nature,which must be ordered in advance of the start of the work to assure that the I i r,le'ct will P •oceed on schedule. No final payment shall be demanded until the contract is completed to the satisfaction of all .,rl ies All n>me improvement contractors and subcontractors shall be registered. No work shall begin prior to the signing of the i .ntt<ict air I Transmittal to the owner of a copy of such contract. WW of W. Massachusetts under provision of Chapter 142A of the , is required to apply for and obtain all construction-related permits.WW of W. Massachusetts shall not be deemed ,hc>n•:1b1r- 1•ur delays in the work described in this agreement caused by regulatory,permit granting agencies, authorities, or T ,livuln<tls ` ofice: If the PURCHASER(S) obtains his own construction related permits for the work described under this agreement c cl�alp wit unregistered contractors,the PURCHASER(S) is hereby advised that in the event of a dispute,judgement and t ,>np iymoi ., the PURCHASERS) will not be entitled to make a claim or collection from the guaranty fund established by chapter 12A, M.(3.1.. 1 on the btrvor may cancel this transaction at any time prior to midnight of the third business day after the date of this t i ans:tct.ioir. Notice of cancellation must be in writing postmarked no later than midnight of the following third business (Ias. I IS .\''t ;'Ui`I ORDER NOT FOR RESALE This Window World@ Franchise is independently owned and operated by Window World of Western • Inc under license from Window World, Inc.