31 Franklin StThe Cozntnonwealth of Massachusetts
Board of Building Regulations and Standards FOR
Massachuseti§ State Building Code, 780 CMR MUNICIPAI,ITY
Building Permit Application To Construct, Repair, Renovate Or Deanolish a RevisediSE Mcar 2011
One- or Two -Family Dwelling
This Section For Official Use Only
Building Permit Number: Date Applied:
Building Official (Print Name) Signature
Date
SECTION 1: SITE INFORMATION
1.1 1'rhper y Add ss: 1.2 Assessors Map & Parcel Numbers
i"t-n i
1.1a Is this an accepted street? yes no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use
1.5 Building Setbacks (ft)
Front Yard
Required i Provided
Lot Area (sq 0) Frontage (it)
Side Yards
Required Provided
Rear Yard
Required I Provided
1.6 Water Supply: (M.G.L c. 40, §54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public ❑ Private ❑ Zone: Outside Flood Zone?
(heck if yes❑ Municipal ❑ On site disposal sys�cmo
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner' of R cord:
Name (Prizft) City, State, zu,
No. and Street rY�f' v��� G 0 M C' a 5 "�vL ej
Telephone Ernail Address
SECTION 3: DESCRIPTION OF PROPOSED WORK (check all that apply)
Neww Construction ❑ Existing Building' Owner -Occupied ' Repairs(s) ❑ Alteration(s) ❑ Addition ❑
Demolition Cl Accessory Bldg. ❑ Number of Units_ � Other M/Specify:
Brief Description of Proposed Workz:
Item
1. Building $
2. Electrical $
3. Plumbing $
4. Mechanical (HVAC) $
5. Meohanical (Fare
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Estimated Costs:
,abor and Materials Official Use Only
1. Building Pennit Fee: $ Indicate how foe is determined
6. Total Project Cost: Is /0 0 /�
❑ Standard City/Town Application Fee
❑ Total Project Costa (Item 6) x multiplier x
2. Other Fees: $
Total All Fees: $
Check No. Check Amount: Cash Amount:
11 Paid in Full 13 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
.5.1 Construction Supervisor License (CSL)
1.93�� �. , �r I z� •. License Number yn Expiration ate
Name of CSL Holder
No. and Street
City/Town, S , 1P
List CSL Type (see below)
Type Description
U Unrestricted Bui Idingg ue to 35,000 cu. ft,
R Restricted l&2 Family Dwelling
M MAgNiry
WS Window and Sidizi
SFI Solid fuel Burning Appliances
�`W fivn� Email address D
5.2 Registered. Home Improvement Contractor (HIC)
HIC Company Name or HIC Registrant Name
. and Street
City/Town, State, ZIP Telenhone
Demolition
HIC Registration Number Expiration
rN
Email address
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 ....... , ., ,
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 )
to act on my behalf, in all matters relative to work authorized by this building permit application. / �]
/C7la Ably
PrintZrier'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
containedi this ap it a is true and accurate to the best of my knowledge and. understanding.
Print er' o util i d"A s Name (Electronic • g ( Signature) Date
NOTES:
I . An Owner who obtains a building permit to do his/her own work, or an owner who hires an unregistered contractor
(riot registered in the Horne Improvement Contractor (HIC) Program), will not have access to the arbitration
program or guaranty fluid under M.G.L. c. 142A. Other important information on the HIC program can be found at
wwwxia.ss. ov/oca Information on the Construction Supervisor License can be found at www.ma.ss, ov/d is
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 ofhalf/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"
City of Northampton
Massachusetts
D-'PARTMENT OF .BUI.LDZNC INSP.ECTXONS
212 Main Street a Municipal Building
Northampton, MA 01060
d
`4`5t
P% IL.
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 III, S 154A.
The debris will be disposed of in:
Location of Facility: 0
The debris will be transported by:
Name of Hauler:
Signature of Applicant:
Date:
-� City of Northampton
s
^ Massachusetts
D PART.ONT OF BUILDING INSPEcTIONS
212 Main Street m Municipal Building
" Northampton, MA 01060
Ala n
day, year), here
HOMEOWNERS' EXEMPTION ELIGIBILITY AFFIDA VTT
depose and state the following:
s .."'
Al
(insertfull. legal name), born _ (insert. month,
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 I10.R5.1.3.1, in connection with a project or work on a
parted of land to which I hold legal title.
2. 1' am not engaged in, and the project or work far which I am seeking the aforementioned homeowners' exesnptiorr,
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 sha 1.1 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 day of tC 6E'r- 20
,
(Sa ature)
ine 1. u mtonweatrn oJ.i1'. aNNUC,i' ?warts,
Department of Industrial Accidents
Office of Investigations
Lafayette City Center
2Avenue de Lafayette, .Boston, MA 02.711-1750
www 0116a1'1s.J;ov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/g'iun.ii R,
Name (I3usitiess/Organization/Individual): Window World Of Western Mass
Address:641 Daniel Shays Hwy
/State/Zip: Belchertown MA 01007 phnnP �4• 413 485 7335
Are you an employer? Check the appropriate box:
0 I am a employer with 50 4. ❑ I am a general contractor and I
employees (Pull and/orpart-time).*
2• ❑ I am a. sole praprietor or partner-
ship and have no employees
working for me in any capacity.
[No workers' contp. insurance
required.]
3- ❑ I am a homeowner doing all work
thyself: [No workers' comp,
insurance required.] T
have hired the sub -contractors
listed on the attached sheet.
These sob -contractors have
employees and have workers'
comp. insurance.t
5. ❑ We are a corporation and its
officers have exercised lhcir
right of exemption per .MGL,
c..152, § 1(4), and we have no
employees. [No workers'
rat 1.,h,11Y
Type of protect (reclatire fi! ,
6. ❑ New construction
7. ❑ Remodeling
& [] Demolitioia
9. ❑ Building addditiojt
10.0Electrical rep,iii-s it Miiiow,
11.0 Plumbing rep iir:s o,
12.0 1loofrepa irs
13.0 Othcr•replact--,Nrnen,
comp. Insurance required.] L
*Arty applicant that checks box # t must also till out the see tion below showing their, workers' compensation policy inforntatioit.
l' Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must subunit c. new �rFiidavi I mclic:u.ii u� Ii_
Contractors that check this box must attached an additional sheet showing. the natne of the sub -contractor's and State whether or not diosC' C11liliCS i.
employees. If the sub -contractors have einployces, they Must provide their workers, comp, policy ntunber.
T ant an erraployer that is Providing workers' cot<rrpensation insurance
information. ,b
for ruy etnplol�ees. below is tltc� polio, crrail �: � iyQ, �::........
Insurance Company Name: Indemnity Insurance Co. of North America
Policy # or Self -ins, Lic. #: C72408342
Expiration Date:10/01 /202
Job Site Address: :3 f FCa � -tl
City/StatelZip:lvr.� "..ram_ l/d
Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiraluE R,
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of crirniwi l perno ; .s 0';r
hnc u.p to $1,500.00 and/or one-year imprisonment. as well as civil penalties in the form of a STOP WORK. OIMFIT,:,td iioi.
Of Lip to $250.00 a. day against the violator. Be advised that a copy of this statement may be forwarded to tite 01 we
4Investigations ot'the DIA for insurance coverage verification,
l rlus hre ',t'by Cert!10 Under the paints and penaldes (1 pea�jmry that the in rination provided above 4v if, are
/ o /
413 485-7335
triol We rttaiy, l}'ra not write in tier"s ar(,a, to be completed 1)y city orr tows, qf�cia�
City or Town:
Fsylting.Autbority (cbe k one):
I.❑.hoard o.t' l=lea.lth 20 Building! Department
Inspector• 6,00ther
contact Ptarsoll:
Permit[Licennse It
300ty/ 'own Clerk 4.® ElectrjeaR l:uspectaar° ,��IE�Nta rrAlirE: �I
Phone #;
Acct#: 29/01/1 IJ61GllLUG4 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATELDER. THIS
HOLDER, CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE CpVERAGE AFFORDED HO POLICIES
BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), rAllTHORI;ZED
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 staterneni; an this
certificate does not confer rights to the certificate holder in lieu of slrrh anrinrcnmd..+��,
PRODUCER
LOCKTON COMPANIES, LLC
3657 Briarpark Dr., Suite 700
Houston, TX 77042
INSURED
WINDOW WORLD OF WESTERN MASSACHUSETTS
641 DANIEL SHAYS HWY
BELCHERTOWN, MA 01007-9529
888-828-8365 FAX _ — - —'-4i— -
insperitycertsQlocktonaffinity.com
INSURERS AFFORDING COVERAGE NA1C r!
Indemnity Insurance Company of North America 43575
OVERAGES " r r
CERTIFICATE NUMBER; THIS IS TO CERTIFY REVISION NUMBEFZ: 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 GLAIMS.
R ADD R
R TYPE OF INSURANCE POLICY NUMBER POLICY EFF POLICY EXP - — — --- COMMERCIALGENERALLIABILITY MM1DDlYYYY MMIDDIYYYY LIMITS
OCCUR EACH OCCURRENCE $_ CLAIMS -MADE DA A R N
PREMISES. (Ea occurrence) � $
GGEE..11N'L
MED EXP (Any one person)
g
$ _—
$
$
AGGREGATE LIMIT APPLIES PER:
POLICY ❑ JERT LOC
OTHER:
LIABILITY
ANY AUTO
ALL OWNED SCHEDULED
AUTOS OS
NON -OWNED
HIRED AUTOS AUTOS
UMBRELLA LIAR
OCCUR
EXCESS LIAB CLAIMS -MADE
PERSONAL & ADV INJURY
GENERAL AGGREGATE
AUTOMOBILE
PRODUCTS - COMPIOP AGG
COMBINED SINGLE LIMIT
Ea accident
$ _
$ —
$
^---
BODILY INJURY (Per person)
BODILY INJURY (Por accident)
PROPERTY DAMAGE
Per accident
EACH OCCURRENCE
— �---
$
$
DED _ RETENTIONS
AGGREGATE
AND EMPLOYERS' LIABILITY x PER
ERH_�
ANY PROPRIETOR/PARTNER/EXECUTIVE Y r N
A OFFICER/MEMBER EXCLUDED? N r A C72408342 10/01/2024 10/01/2025 E.L. EACH ACCIDCNT $ 1,001woo
(Mandatory in NH)
IF yes, describe under E.L. DISEASE - EA EMPLOYEE $ 1.000,000
DESCRIPTION OF OPERATIONS below —
--
E.L.DISEASE- POLICYLIMIT S 1,000,000
DESCRIPTION OF OPERATIONS! LOCATIONS r VEHICLES tACORD 101, AddltIona[ Remarks Schodule, may ho attached If more spaoe is required)
%ICK I ur[L-A I t MULDER
Town to Northampton
Building Dept
212 Main St
Northampton MA 1060
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED
IN ACCORDANCE, WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
(5— —+a�
wlN bwoR-o 1 L AU R
�...-.-- CERTIFICATE OF LIABILITY INSURANCE DATE 11,'°'YYYY,
419 i2° 324
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDE Z. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE' f 1LICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTF��](ORIZE'D
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 4. n lorsed,
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A stag rl,lent ran
this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER CONZACT Laura Missed— — --
Phillips Insurance Agency, Inc. NAM — —_ _
97 Center Street PHONE;arc, No, -xt : 413 594-5984 —_. _. i 'FAX —
Chicopee, MA 01013 -E- ArL _1: _)_ Itl ---- — m I (Arc,_Na):(413) 5g'1_.8499
-A ngIF,% @P.,. Ilipsinsurance.c0m
-
__ INSURERS) AFFgR�ING COVERAGE_, ..... _ NAIC iF_
INSURERA:EMCASC0 insurance Co2ie'07
INSURED�.
INSURERB:Employers Mutual Casualty Cv_mpany _ 2 i� 15
Window World Of Western Massachusetts Inc INSC.URER
641 Daniel Shays Highway — —----.-----.__
Belchertown, MA 01007 INSURERD:
INSURER E
INSURER F : ---- __
— -- a.crc� rrlvH t q IVUMt3ER: 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 f'ENIOD
INDICATED, NOTWITHSTANDING ANY REQUIREMENT; TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WI Ih ;H THIl;
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL TI I:': PERMS,
_EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
VTR TYPE OF INSURANCE ADD SUBR —" ._--.___.-___.
POLICY NUMBER POLICY EFF POLICY EXP
A X COMMERCIAL GENERAL LIABILITY LIMITS _
EACH OC(:LfRRENCE —_ S 1,000,DOp
CLAIMS -MADE OCCUR 6A44324 4/9,12024 4/9/2025 DAMAGE TO RENTED 500,000
PR_..E..MI.SES.( f10-IX:.Urr8R4ej- 3
GEN'L AGGREGATE LIMIT APPLIES PER:
X POLICY � JEC� LOC
OTHER:
B AUTOMOBILE LIABILITY
ANY AUTO
kAXTTVS
SCHEDULED
AUTOS
X AUUTOpSW Ep
X �11T05 ONNAR X OCCUR
CLAIMS -MADE
ETENTION $ 10,00Q
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
FlCE MEMBER EXCLUDED?ECUTIVE j`—j N I A
{ ands ory a NH) 0
ifYes. desorfha „prior
4/9/2024 I 4/9/2025
4/9/2024 1 4/9/2025
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Town of Northampton
Attn: Building Department
212 Main Street
Northampton, MA 01060
person)___
10,000
NJURy
_..
1,000,000
GATE__--.._.
.,000,0oa
PMP AGG
$
,',000,000
$
E LIMIT
1,000,000
er ace{deny
5 .
3E
3
E
5
1,000,000
1,000,000
;s
LOTH-
�R -.
...�-----
EMPLCIYC�
$
ICY LIMIT
$
_ .._...».�.
SHOULD ANY OP THE ABOVE DESCRIBED POLICIES BE CANCELLED III_FORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIV( hF D IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
ACORD 25 (2016103) 01988-2015 ACORD CORPORATION. All right% 1 nserved.
The ACORD name and logo are registered marks of ACORD
;c a-131
DiNqA 10 17 01 Prormt1Nfl
l4i) : 4 aw lnurtsff .
J, A:
aoia OTMIUMT9
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102 0AKRlD0h;):R)
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W,
eZ'
TIV COMMONWaALTH OFTNIASSACHUBUTS
011,100 Of COnsumcir AMpirs & ORegl4j,
HOMIll U;PRovl;,. �R�--'r,,CONTRACTDR
Vlcllfawl,l mlosT
G? QAK:Ri
MA 0,1,
'rFI:C COMMOMYEAUN I OF MASIDAcmuserrs
011'Z A
110MCIMPRQVEMl NrcONTRACTOR
Van
WINDOW Uvo
ryal
lqC,
Tl:,M,O'r)-ly DROST
G4 I DANIEL qj'jjAYS trjUt�Y, A f.
ELCHER70M, MA, 6 6o7.
ROWSH,ralloll vallicl fwr loom OU'Al mm aill, rl (N
dialiv, It iho"mi MALorn tin
Or COlftfuimur Arlroks
1'(1'00 VAIS11141 UNIT FrOrPLA ' o LuRri 71, Q
Not-Willid without, sigrialupri,
ROUNIMIDA VaM Flar WdlvWujj jj,,o,ojjtW
"Pir-11100 dAt0- 1FAIMId rolurn lo-,
OU900 Ot COJISU11100 Afkilrs qi)kd Bu&lr%vss Ragujntrsjtj
io0ownhhugtoustrool "Buitu'r10
NoMon, MA b21118
Not valicl witlIGLItslign -
sture
Windsor Pinnacle Select Line
Triple Gazed Energy Efficiency Table 2023
D.
Select Casement
Chickness
3.lmrrr
4"
Triple
366 / 180/Air
1 0.24
0.17
366 / 180 / Argon
0.22
0.16
Select Awning
3.1mm
11/4"
Triple
366/1,80/Air
0.24
0.17
366/1801Argon
0.22
0..16
Select Casement
Picture
3.9mrr7
1114"
Triple
366 / 180/ Air
0.23
0.20
366/180/Argon
0.20
0.19
Clad Direct Set
3.9rnrn
11/411
Triple
366/180/Air
pp23
0.2.1
366/1801Ar on
0.20
0,21
Clad Radios &
Low -Profile Direct Set
3.9mrn
11/4"
Triple
366/180/Air
0.2.1
0.22
366/180/Argon
0. 181
0.22
Nancy Reeves
Install Address: 31 Franklin St
Northampton, MA 01060
Contract Name: Nancy Reeves -Sales -Windows
Design Consultant: Tim Drost
Date: 10/23/2024
Payment Method: Credit Card
Contract Type: Sales
Comments:
low World of Western Massachusetts
Daniel Shays, Hwy, Belchertown, MA
01007
75 North Road, Westfield, MA 01085
Officer (413) 485-7335
ww.WindoWWOrldofWesternlvlA.coin
Phone:4133201582
Email: nrreeves@comcast,net
Measured By:
Measure Approved
Status: Contract
Lender:
ue rcr:nns P i � tinmm inn
WfPtQnN 4'V zR I_
CAR E{J
Product
Description
TxblQty
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
$250.00
$250.00
Windsor Pinnacle
Windsor revive replacement; PREFINISHED white in out double hung SDL
Select
GRID 1 VERTICAL PER SASH
N 2
$2,518.00
$s,o36.ao
Windsor Revive
Windsor Revive Replacement PREFINISHED white, white exterior NO SDL
Replacement
double hung REINSTALL WOOD STORM ON ALL
N 2
$2,231.00
$4,462.00
Total Information
Unit Total:
5
Subtotal:
$10, 048.00
Tax Rate:
0%
Tax:
$0.00
Total:
$10, 048.00
Amount Financed:
$0.00
Payment Method:
Credit Card
Deposit Amount:
$5,000.00
Balance Paid to Installer upon Completion:
$5,048.00
Renovation, Repair and Print Act (RRP) Compliance
RRP Pamphlet Provided Date:
Year Home Built:
RRP Signed Date:
low World of Western. Massachusetts
I Daniel Shays, Hwy, Belchertown, MA
01007
75 North Road, Westfield, MA 01085
Office; (413) 485-7335
rww.WindowWorldofWesternMA.com
-- -------
Product Acknowledgements
I,01 1 have received a copy of the lead hazard information pamphlet informing me of the
Potential risk of the lead hazard exposure from renovation activity to be performed in my
dwelling unit. 1 received this pamphlet before work began.
Primary Homeowner
Secondary Homeowner
rennx,s P��`'f cvnu�u,ni,
WINUOV, W IRLD,
CARE$
a
Wind
64
1
Preparing for Your New Windows and Doors
v l:tl;Rfln5 W"' 'r Cl,n}Ina_ nn
., ktolgv � t
CARE
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 Ift 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.
S. 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.
!. 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 sign 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 clue 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 requ iro I n
advance of the start of the work SHALT. NOT exceed 33 1/3% of the total contract price OR the actual cost of any material c r
equipment of a special order or custom-made nature, which must be ordered in advance of the start or the work to assure I hal. the
project will proceed on schedule. No final payment shall be demanded until the contract is completed to the satisfaction () .111
parties. All home improvement contractors and subcontractors shall be registered. No work shall begin prior to the signi€,,-j of I])(,
contract and transmittal to the owner of a copy of such contract. WW of W. Massachusetts under provision of Chapter 14; ' of I,he
general laws is required to apply for and obtain all construction -related permits. WW of W. Massachusetts shall not bo cle( trod
responsible for delays in the work described in this agreement caused by regulatory, permit granting agencies, a.uthoritie or
individuals. Notice: If the PURCHASER(S) obtains his own construction related permits for the work described under this it Iroomfult
or deals with unregistered contractors, the PURCHASER(S) is hereby advised that in the event of a dispute, judgement a€ld
nonpayment, the PURCHASER(S) will not be entitled to make a claim or collection from the guaranty fund established ])y ,l is )tr+r
1.42A, M.G.L.
You the buyer may cancel this transaction at any time prior to midnight of the third business day after the dat,> of this
transaction. Notice of cancellation must be in writing postmarked no later than midnight of the following t.hiril lousiness
day.
THUS IS A CUSTOM ORDER NOT FOR RESALE This Window World® Franchise is independently owned and operated by Window World nI "--s€.earn
Massachusetts, Inc. under license from Window World, Inc.