Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
32C-063 (3)
-er. `d IN eSir N aS Ixik .0 r,J wa1 id Cc/r3 • A0-.54.^ Window World of Western Massachusetts WC 4 165641 : mac ta_ W�q,�q{,3 �_1 1029 North Rd.-Hampton Ponds Plaza CSL N 5701 t i. .}• �i dd �t Westfield.MA 01085 Frf*: s r. e'. 17.tEt�4 f Phone(413)485 7335•Fax(413)485-7055 a�9 -smeary flee 6edr Ior Left" Mauscaiseara www.wtndowwwtdofsprtngfi6ld corn NAT-41779-1 :::: Name: R It e., ek Lt ✓, y� Phone(H): 14 1 3 ? T 8 -i037 Install Addr. ',y g Jr , vv / N-L rA YiL aen.t n IAA Phone(W}: NI Addr. t' E-Mail: ( WINDOW WORLD VALUE Pt.US 4000 a 0000 SERIES PAQt AQES (•--'-- Series 2000 Mech.Frame Welded Sash $189 — MA.Energy Reg w/SotarZone+Argon $45 () S• eries 4000 Double Hung $205 Energy Star Upgrade $24 Series 6000 Doubt°Hung $239 Foam Insulation on Jambs $18 t Picture Window $329 1 ___Q_ Remove Window From Property $16 2 Llte Slider $329 Lifetime Glass/Seal Failure Warranty $18 3 Ute Slider(y.,'/e,'/.)('/e,'/a,'/3) 5520 Transferable Lifetime Warranty. $10 Awning $285 Er in Home Service $15 Casement ur ro, $285- IY Double Strength Glass $18 Twin Casement ot.w:ezw..)ram tearn $570 Total Options: $156 p Three the Casement in.or.•3w.4 $885 /( i SALE PRICE(Save 5O%) 1179 71 Basement Sliders<55 UI $239 Heat Buster Package Upgrade $20 Hopper M annem..oemNag•ndlt Et) $185 ..1. 1, 8;U1 "i♦ ..,.;...1 errs.:: Or- . Brat ern Specialty Window EPA LEAD SAFE Ir'.gAndorl $60 Bay/Bow Pa gonna net.In Casing&( .Capp $2875 EPA LEAD SAFE two.pr/ley/Sc.i ON. .e 5100 Garden(at.clawaoac•pa+or $1875 ,,f0e�ntedo,g�„�ti„M,Upgrade. MY HOME WAS BUILT IN THE YEAR Initial: Remove Existing Bay&Reframe $295 I decline third party verification(Initial): Roof for Bay/Bow Window S450 ___I hive reoehed o coot of the Lead braid hdmmatbi wphtel S• econd Floor Installation 1 1_$500 informing me of t h e p o t e n t i a l risk ce the lead hand exam from rendralion actNty is be Window Color 1'✓ _ W -L� $ certomail In my dwelling ant The EPA'Renovate ROT bracnwe. inigle ilndmq I Imme received a nosy d tie lead test rasdlisl. I WINDOW WORLD UPQRADES 1 Full Screen $25 SiBTt_ Date: — B• EIGE Color charge $35 Name(s1(Print): Ext.Color oaeissenxe $165 ( -MISCELLANEOUS LABIA } (_ Wbodgmininterkr4.01 atcrorioewewa $95 1Q( Full Exterior WhiteTrinvWreptsMOons'u'vq $757.25 Contoured/Flat Grids noehaiwarias $40 Color Other Than White $10 Prairie Grids isev+•Yrawrd Iru rca aa.l $69 Specialty Custom Exterior Trim/Wrap $ Diamond/Brass Grids clout IMP 569 e, ,„ net ETCO 530 —O• riel/Cottage Style wawa coron $30 O• bscure Glass Per Sash non elms $35 7-C1 � �` $100 U as u 'entoval $30 Tempered Glass Per Sash yontwW $65 Mull to Form Multi-unh $30 28 Glass nano swiss e M $129 install Interior Stops ewers Vert.) $45 Catalog Options $ Install Exterior Stops(*FIT! in) $45 • VINYL PATIO DOOR6-LH or FIN(Outside Looking h.) I Customer Provided StopsJTrim $20 includes:White Interior Casing and Exterior Tarn. Install Interior Casing S60 5 Ft.Sliding Patio Door amens $1250 _ Repair/Replace Sill or Jamb $75 6 Ft.Sliding Patio Door plow $1300 Mobile Home Conversion $200 plow 8 Ft.Sliding Patio Door run iwa 51500 Remove/Re-Install A/C or Awning S100 Patio Door Beige Color $125 Site Setup: $250.00 Patio Door Low-E/Argon $125 EPA Lead site setup&disposal fee: $i00 Heat Buster Package Upgrade . $215 EPA Lead,third party verification: .647"1:130 Patio Door-Grids tm,o,,.ri,•--...- ,r $100 Extra labor(Boron left for description)$ Woodgrain/Brown co)(Cot pit Imo $225 TatalLLmount Due$ Li.21 r y 3 Exterior Colors $395 .c.--:e. Patio Door Triple Pane Upgrade $250 50%Deaasit A o 2,I 27/ „_ Keyed Lori( $36 Foot Lock $51 --I.Cestt CO &A 410142-C /Jpvt e- to ,3 C Storm Door $ [ ]Finance-( )Wells Fargo ( )Other NO EXTRA WORK IF NOT IN WRITING/iNSTAU.ER NOTES ( 1 Chek made to W(ndow grd oM a 5-- t )CCU, - - - L.;)4" 4 3/. 3 /3`f /..._ Exp.Date: V-code: �.# z t rpv2 tV a}U n1 c U S CO k K Final Payment Amount:$ /U•4 j 4 • e"f ia C713 lb 1 to a paid la M.atsgra.um'instal:Wog Thug you. 1 Sales Rep Rocsrnmendedr 11 Interior Stops 1 1 Exterior Capping: Customer Declined (I Interior SLOW I)Exterior Cappog: St.Jude Children's Research Hospital / wait uaaactmeberfltksee SWIM nth work m aro Ada aemrrragr worm a der.S.s eiq*tenetWeNo .MyaemstMootedn°doomdasOMateneer* [ SHALL 1.77/ta¢ese33 Sri%d is teal mead ratan orthe Bad cad or any erne:ialmmurpe.rt de eoedo driver astir made railer didrtue!beerased h edrsrog d ow Cart of muab rite eetrgca mda pronged an Shack*,No lWdmom ehai te demoreled vna the wend is unnIDevaa m One setMatbon an al,pekoe N bane ehnwenwe cowecmn and eubccomrtoa she!bo egatere0 one sot anyivS4he abode mead or aebeeraetbr Q'deep to a realfiaSm a1dM be drand to Mee el CorsgsaMrks ad Salem Repatton Ten VIAPeas%Site 5170 ama..MA vita Otto&m)973-aner.Ile welt OM bean odor la as NOM d 0s carted&Id birivatel b Pe ewer of egg wail earrbwe.wwd W.Mmadaseaodor a itefon dC¢tter 142A dine genwe are b MIAMI to spit/*meataW MI rooked matruelte.eW d comes.ew el w Maeacrnrads Cal not be deemed rupannaab An dear in t'.3 mark donorie 1I,Its wrarrtnl weed to(*OAatn mom grsriYI.per<b4.4rdtei a 14741 de.Moaoa If the 12)Mare Ms gal mrntrlellen MAO pemlb to 0e aert drarlbed ands trAsiopecarel or anisette enre0btered dandam4 to le Meby Millet 1100 be Os ewesd a elsoatejulgeineed and nnowmsen%The Pen{71ASHt(9)ale not be seemed to ever a dam et oallaeeealrem tan posit,Yardweaftsed in 0Oapla 142A,14.111 . 'ad SO 011107 nay owe dh tw.acQce idler OW Pr la mtlelshtd Sr ems Walrus taro Mares date of tae Irmacflon Maas]eleee ken rat bon were s Xanrel M ea Me teen rddr0100 dale bonnietad bmbe:s ext T)r .. "MB NOT FOR MAIM / � . .� _ _ Gay �� I.A.1 _d/ _ ) „../ .7{.✓ �ec A,l(! Series ep. •. Owner Dan nmeMow_oaLai rte.em-re. `46(77-4t61 .- =0 �° - '- / _ h g r, 4,- M --ipatq kfoc- A WINDOW TO SUIT EVERY NEED r",...A., ''' -"'--,-..-_ ' '''''.--",`"..-....—.8.- ii. WE SELL i p DTI �l�.,�� ENERGY STAR / I , -I fit,. II// f J3� ' 6. t\\\ 3 1 x ,ro f.4\i, \l_ 4 \ sak-- h �1 ,1 Window World 4000 Exclusive Fea res: Window World 6000 Features: • Fusion-welded sashes and main ame for • Fusion-welded sashes and mainframe structure ..ded strength and rigidity. add strength and rigidity. Multiple extra-thick • Beve :. exterior mainfr..-- for a clean, extrusion walls provide additional durability and elegant look. insulation to the window frame. • Hidden screen track for clean lines and • Beveled exterior mainframe and sash and added beauty. hidden screen track for added beauty. • Sloped sill forces water to drain to the exterior • Double lift rails provide strength and of the window. stability for easy operation. • Double barrier weather seal at sash • Quad-4 weatherstripping at the header for perimeters help keep out dirt and protect added protection from the elements. against air infiltration. • Triple-barrier weatherstripping provides superior • Protective bulb at the sill seals out dust, dirt protection against dirt and air infiltration. and air infiltration. • Sloped sill enhances protection from the elements. 8 f_ • Choose one of our SolarZone Insulated Glass Packages to enhance the year-round comfort of your home while maximizing energy savings. s. The SolarZone Low-E Glass Package- Making the Difference. A warm-edge spacer system is just one way of increasing your window's performance. SolarZone Low-E glass is an excellent option to help increase your home's comfort and energy savings year-round. SolarZone Low-E glass is created by applying a microscopic, 1 . Heat Photographs(Infrared Thermography). undetectable metallic coating to the b Standard Clear Glass SolarZone Insulating Glass second surface of an insulated glass y ..." �- unit. This coating helps to block heat Low-E glass filters long- r,� gain in the summer while retaining wave radiation from the T furnace heat and allowing warm short sun.This reduces heat rk gain in the summer,• 1111 9 :. pst r wave solar rays in the winter. keeping your home cooler. r : ' The thermographs (left) clearly show I.: ,f * the effect that Low-E glass has when •. ;11 4° ' , contained in an insulated glass unit. The • • • •, , ' "" "" window on the left is a clear insulated glass r � 'i unit. The heat transmittance, indicated by i the green, yellow and orange colors from jf` !'- Heat scale the heat scale, is far more apparent than ",', f ' MINE. -.MIMINIMMINIMIIIM that of the window containing the SolarZone More solar heat Less solar heal Low-E takes on a new transmitted transmitted Low-E insulated glass unit. duty in winter months.It lets warm solar rays into SolarZone Insulated Glass Packages. your home while blocking The optional SolarZone Insulated Glass Package combines multi-layered, vacuum deposition the heat in your home from getting out. Low-E glass with argon gas and a warm-edge spacer system.These insulated glass packages have proven to be far more effective than ordinary clear glass units. The Window World Glass Performance Comparison National Fenestration Rating (NFRC), in with the U.S. 4000 DH 6000 DH g Council ( ) n conjunction U-Factor SHGC U-Factor SHGC Department of Energy (U.S. DOE), developed a rating system for window . . Zone .32 .30 .30 .27 product performance. ;_S�Iar.Zone ETC . • .30 < \- SolarZone Eli e .29 .19 One of the most critical NFRC tests is for the window's U-Value, which SolarZone TG2 - - .23 .24 measures a window's resistance to heat transfer. The lower the U-Value, SolarZone TG2 Elite - - 23 .18 Traditional Competitive Products the better the window is at resisting heat flow, which results in a window Clear Insulated .48 .50 .45 .55 with a greater insulating value. Single Pane .85 .61 .85 .61 SolarZone:Soft coat,multi-layer,vacuum deposition Low-E glass Another critical NFRC test measures the Solar Heat Gain Coefficient (SHGC). with argon gas and Intercept spacer System. SolarZone ETC:Soft coat,multi-layer,vacuum deposition Low-E glass This procedure measures how well a window blocks heat caused by sunlight. win,argon gas,Intercept Spacer System and carbonized ETC liners. SolarZone Elite: Soft coat,SHGC multi-layer,vacuum deposition Again, the lower the number, the less of the sun's solar heat the window Low-E glass with argon gas and Intercept Spacer System. SolarZone TG2: Soft coat,multi-layer,vacuum deposition triple- transmits into the home. pane unit with two surfaces of Low-E glass and two air spaces of argon gas and Intercept Spacer System. A quick comparison will show that p our choice of an optional SolarZone SolarZone TG2 Elite: Soft coat,multi-layer,vacuum deposition y triple-pane unit with one surface SHGC and one surface Low-E glass and two air spaces of argon gas and Intercept Spacer System. Insulated Glass Package will outperform clear or lesser Low-E glass Clear Insulated: Clearclouble-pane insulated glass unit. Single Pane: Clear,single-pane unit. packages, leading to increased energy savings. Consult your Window World representative to learn about the benefits offered by the optional Foam Spacer System within your climate zone. 11 :, , '::,..::,,.,...",,,i ' :1 t itkil ;... ,,,1 r 4.,• „,,,i i rs £ �� „�' ,P,l'.. ta "" t . u . in�ii c ' � yam �. '� 4 !ii. ' •' . ',.. I ' ‘.il'• •• .:' !,' •••,i '1H' I. .m. ' ..: , .• ...•, i ,,,„z 3' R 'r'!F .f` E` Y• g 'a �L'F"r..a" fl't`¢ yEjlE 1E t€ S€E ij f 't� i€fit t{ k a .•''''.•• 1-Ef '',1,,,t44,44, •d• lt tt i!j EI €,{t�R"E riJf�,S€+,Ii�; r k • ia iI � lE `J l IIW a t td s. .... i, , .:.'' : .v ,iit, �i.E„, i Bi^aitl t�i -t Saq(�y. ... . .. i 'ic; aid 44t�EiEF�44�4tik� €Eil€#€ !, `. E _ ( t 1 t t I1 Ott iEt, i.: " w: : _ �ii(�i�,t�i�EFL f€€1,i }�li€€.r ii � 1i lti } I1�t EJt 4 9t€, t= , [its:x,41111€fE141,i4'11 ti t 41(i€ 4iii. x a t r"€ I, €€€iI€ttE $4rt,,,4OFFi, �� f N .r tY �11 ti�4 v' �, iii€E s of d „,,,,."..1,,,(1111,111: ,J.,4,1.1-1.f.' �§ ti\,a� \ iF E• a> 0VA r} v \ fix\ iti E i E`� 14s E i y n, g 1 �,., s-, tit a P,y.a i;z S a 7 • 4 _ i y •, t I.1 �.,v "mss y �+ ia� v � "3 a. .� L ggRt A:. t}4 m p•w°rar4 `fit.'. Y w..:t, F! e' , •. ue T .., .•,z.� ." i:'r 1 7 LJ. t ' xeu•;' j F �. �paj I t:•'.• .n '.FC.• W 'was'., .•y.� J•,,,,. `.•'..' 0t6 d `^£i� 7: 't. i.S_ yr 'st, �' _ ten.. ' ,.�.4.1,:t.',"1:•:'4', —.,il. s�.a , 7 '' .yy. -• 1 FFF •/T4':....'' lit if i 1 , •+� —i. "' . .-•r• , S t r a RC w ti '� • . . r •s°e ,•. .•. a i .:13$•!..147".4-• T• qj'F � ' 1 x+a .;� �r�"aa•• • z-k� w t� .:a i� '•' r � ,.... _• . 4.-,4../.-„,,r‘:.,.,,i • � 'f"' #L TA •'E&r '.. - - .n :. .i ^•A •.• t r .4a'+_ .,, -L ..Y-• wa •. • ate "• °• g + •' '.y•��"°� Y` f - `1...... • -----'•-• '' lam" .� "x• .w •�4. o' a" rm 6 ''1,•••-- { �„r FS..� �: •� - TYS It - �'`'. � "g�,� •r 7,. ems !P *sr•9 • si C w cr 7 w `4 ,a� i.•� � [ 1.• ..e f x • , •i fi,•. 4t.: . _AC f CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYW) 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 be endorsed. If SUBROGATION IS WAIVED,subject to the terra and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER FORREST INSURANCE AGENCY 603 NORTH MAIN STREET CONTACT NAME: E LONGMEADOW, MA 01028 PHONE A/C No Eat): (413)858-2680 FAX(A/C,No): (413)858-2685 E-MAIL ADDRESS: INSURER(S)AFFORDING COVERAGE # INSURED INSURER A: Li.- WINDOW WORLD OF M .I In r-n WESTERN MASSACHUSETTS INC INSURER B: 1029 NORTH ROAD INSURER C: WESTFIELD MA 01085 INSURER 0: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 13054597 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 ADDL SUER POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MMIDD/YYYY) (MMIDDIYYYY) GENERAL LIABILITY EACH OCCURRENCE $ i DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $ CLAIMS-MADE OCCUR _MED EXP(Any one person) $ PERSONAL&ADV INJURY $ I GENERAL AGGREGATE $ PRODUCTS-COMP/OP AGG $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY JECT i LOC $ COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY (Ea accident) $ BODILY INJURY(Per person) $ ■ ANY AUTO IIIAUTOS OWNED T1 SCHEDULED BODILY INJURY(Per accident) $ AUTOS �._.-JI AUTOS PROPERTY DAMAGE NON-OWNED (Per accident) $ HIRED AUTOS AUTOS $ $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE — AGGREGATE $ EXCESS LIAB CLAIMS-MADE $ DED L I RETENTION$ $ $ WC STATU- OTH- A WORKERS COMPENSATION WC2-31 S-377947-0112 5/7/2012 5/7/2013 ,/ TORY LIMITS , ER — AND EMPLOYERS'LIABILITY YIN E.L.EACH ACCIDENT $ 100000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? I Y I N 1 A i E.L.DISEASE-EA EMPLOYEE $ 100000 (Mandatory in NH) If yes,describe under - E.L.DISEASE-POLICY LIMIT $ 500000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Workers compensation insurance coverage applies only to the workers compensation laws of the state of MA. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF NORTHAMPTON THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN CI CI TN: BUILDING DEPARTMENT ACCORDANCE WITH THE POLICY PROVISIONS. 212 MAIN STREET AUTHORIZED REPRESENTATIVE NORTHAMPTON MA 01060 ) (i1 ) (.- Jeff Eldridge �t C�(��' ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD CERT NO.: 13054597 CLIENT CODE: 1481715 Anne Chandler 5/9/2012 516:47 AM Page 1 of 1 This certificate cancels and supersedes ALL previously issued certificates. • gZX The Commonwealth of Massachusetts ►�,_--11 Department of Industrial Accidents . ti„ Office of Investigations `�,=,4 600 Washington Street ` — "= Boston,MA 02111 :a 1,1�- www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): W h , . n_ ) , WES lid!• AC(414SETTS Address: l 0 2a ',1vel {Zip City/State/Zip: W ES-rP l> Lij M A- U l 0$S Phone #: 413 `t S S — Z 3)5 Are you an employer?Check the appropriate box: • Type of project(required): 1.1 I am a employer with 4. I am a general contractor and 1 6. New construction employees(full and/or part-time).* have hired the sub-contractors 2.0 1 am a sole proprietor or partner- listed on the attached sheet. 7. 0 Remodeling ship and have no employees These sub-contractors have 8. D Demolition working for me in any capacity. employees and have workers' 9. Building addition [No workers'comp.insurance comp. insurance.: required.] 5. 0 We are a corporation and its 10.0 Electrical repairs or additions 3.0.1 am a homeowner doing all work officers have exercised their 11.0 Plumbing,repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.]f c. 152, §1(4),and we have no employees. [No workers' 13.IE Other R 'L ACE1"Ei'JT comp.insurance required.] VH t N 1DOW5 *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. I.Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. 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. Below is the policy and job site information. Insurance Company Name: I—I Bei2.7'l MuT AL 111St441PI VGAS -- Policy#or Self-ins.Lic.#: W/C 2.- 3 1 SS- 37"7 C q7 -013 Expiration Date: 5.-7-ZO 14 Job Site Address: 20 I-14MPTD 13 AVE 1k1]1T `+2— City/State/Zip: ND el-4 Hr►►P V/tJ MA 1 040 p Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance overage verification. I do hereby ce , un'er t e pains a d penalties of perjury that the information provided above is true and correct. te: 9- Si ig ature: Phone#: 413 '4 ' % - 733 Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: SECTION 8-CONSTRUCTION SERVICES x/8.1 Licensed Construction Supppe��rvisor. Not Applicable ❑ Name of License Holder: F-V 13E.12 [ E. J3k6I-1.617 570 License Nu(iber Dose ; kv-e. 'FeE D I 00 3,L-t S 00- 0103+ ( I Z / 1S- Add' ss Expiration Date '- / 41'5 li-ss--n'e 7 c Signature / Telephone A. Registered Home Improvement Contractor Not Applicable ❑ f (2.06E-2r Bus ) to S Co 4 Company Name Registration Number 1■410pOlni W -1--D D: wE s e-Cik) n'\ASS i e0C . 3 iI if Address k,\)ESTF IE%_D Expiration D to 1©2-01 IQ fai4 R ) Ml- 0lDg'5 Telephone tl3 `1 °733c SECTION 10-WORKERS' COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152,§25C(6)) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed Affidavit Attached Yes No ❑ 11. - Home Owner Exemption The current exemption for"homeowners"was extended to include Owner-occupied Dwellings of one(1) or two(2)families and to allow such homeowner to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor.CMR 780, Sixth Edition Section 108.3.5.1. Definition of Homeowner:Person(s)who own a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two family dwelling,attached or detached structures accessory to such use and/or farm structures.A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official,on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. As acting Construction Supervisor your presence on the job site will be required from time to time,during and upon completion of the work for which this permit is issued. Also be advised that with reference to Chapter 152(Workers' Compensation) and Chapter 153 (Liability of Employers to Employees for injuries not resulting in Death)of the Massachusetts General Laws Annotated,you may be liable for person(s) you hire to perform work for you under this permit. The undersigned"homeowner"certifies and assumes responsibility for compliance with the State Building Code,City of Northampton Ordinances,State and Local Zoning Laws and State of Massachusetts General Laws Annotated. Homeowner Signature SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House Ili Addition 1 1 Replacement rdows Alteration(s) l Roofing Or Doors Accessory Bldg. 1 1 Demolition 1 1 New Signs [I:3] Decks [El Siding[CO Other[O] /Brief Description of Proposed Work: I l ' ► I& &! k. Ih .�. r ' T Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roil -Sheet 6a. If New house and or addition to existing housing, complete the following: a. Use of building :One Family Two Family Other b. Number of rooms in each family unit Number of Bathrooms a Is there a garage attached? d. Proposed Square footage of new construction. Dimensions e. Number of stories? f. Method of heating? Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction i. Is construction within 100 ft.of wetlands? Yes No. Is construction within 100 yr. floodplain Yes No j. Depth of basement or cellar floor below finished grade k. Will building conform to the Building and Zoning regulations? Yes No L Septic Tank City Sewer Private well City water Supply SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT , 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. Signature of Owner Date I, CABE-(.T tjv (5 , as Owner/Authorized Agent hereby declare that the staterhents and information on the foregoing application are true and accurate,to the best of my knowledge and belief. Signed under the pains and penalties of perjury. 4. ` r i a Piinf��, e � -. jff Signature of Owner/Age Date • `Section 4. ZONING All Information Must Be Completed.Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size Frontage Setbacks Front Side L: R: L: R: Rear Building Height Bldg.Square Footage . Open Space Footage (Lot area minus bldg&paved parking) #of Parking Spaces Fill: (volume&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO O DONT KNOW 0 YES 0 IF YES, date issued: IF YES: Was the pen-nit recorded at the Registry of Deeds? NO 0 DONT KNOW O YES O IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO O DONT KNOW O YES O IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained O Obtained O , Date Issued: C. Do any signs exist on the property? YES O NO O IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES O NO 0 IF YES, describe size, type and location: E. Will the construction activity disturb(clearing, grading, excavation,or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES O NO 0 IF YES,then a Northampton Storm Water Management Permit from the DPW is required. • Department use only ity of Northampton Status of Permit: D E C E A V 1 uilding Department . • 212 Main Street Sewedaeptic A�ra hty SEP —9 2Q13 1 r Room 100 hamoton, MA 01060 T :S . fir. :> ••••- 13- 87-1240 Fax 413-587-1272 Platte Electric, Plumbing&Gas Inspections Northampton. 01C,50 tt#ie Specifj APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Property Address: This section to be completed by office 2.0 r'PTD h A / j 11- 4,2— Map Lot Unit � O -T14 .tmPTDiJ 1 /N 4 Q 1 0 ® Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: SCHOC -r ImDItSTri S 175- F br`r2-A-1_. sT 54 lrE "700 Name(Print) Current Mailing 3 �Addr�s� ) 3+ Cse e {'T��-�q.0-'� ) Telephone J Signature 2.2 Auiaorized Agent: ' e- H-f ��- O2fi NbgTH Rn ,E fl i& MA D1o&,--- Nam "rin / Current Mailing Address: • f 13A C- 7335 Signature ,/4: Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1 Bui.iing 5�-O (a)Building Permit Fee 2. Electrical (b)Estimated Total Cost of Construction from(6) 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) 5. Fire Protection # " 6. Total=(1 +2+3+4+5) 'lP 5a, 0(7 Check Number J ,el 5 This Section For Official Use Only Date Building Permit Number. Issued: Signature: Building Commissioner/Inspector of Buildings Date • tt File#BP-2014-0288 /opal APPLICANT/CONTACT PERSON ROBERT BUSHEY JR C l�~ ADDRESS/PHONE 1029 NORTH RD WESTFIELD (413)485-7335 0 PROPERTY LOCATION 20 HAMPTON AVE-UNIT 42 MAP 32C PARCEL 063 001 ZONE CB(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid Building Permit Filled out /07S ,,J�35" Fee Paid 1� Typeof Construction: INSTALL 18 REPLACEMENT WINDOWS New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 057011 3 sets of Plans/Plot Plan THE FO WING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON IN O ATION PRESENTED: pproved Additional permits required(see below) PLANNING BOARD PERMIT REQUIRED UNDER:§ Intermediate Project: Site Plan AND/OR Special Permit With Site Plan Major Project: Site Plan AND/OR Special Permit With Site Plan ZONING BOARD PERMIT REQUIRED UNDER: § Finding Special Permit Variance* Received&Recorded at Registry of Deeds Proof Enclosed Other Permits Required: Curb Cut from DPW Water Availability Sewer Availability Septic Approval Board of Health Well Water Potability Board of Health Permit from Conservation Commission Permit from CB Architecture Committee Permit from Elm Street Commission _ Permit DPW Storm Water Management De •lition Delay � Y Si. attire of Building Official Date Note: Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning requirements and obtain all required permits from Board of Health,Conservation Commission,Department of public works and other applicable permit granting authorities. *Variances are granted only to those applicants who meet the strict standards of MGL 40A. Contact Office of Planning&Development for more information. 20 HAMPTON AVE-UNIT 42 BP-2014-0288 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 32C-063 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: window replaced BUILDING PERMIT Permit# BP-2014-0288 Project# JS-2014-000485 Est. Cost: $8652.00 Fee: $35.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: ROBERT BUSHEY JR 057011 Lot Size(sq. ft.): 9278.28 Owner: SCHOCHET INDUSTRIES Zoning: CB(100)/ Applicant: ROBERT BUSHEY JR AT: 20 HAMPTON AVE - UNIT 42 Applicant Address: Phone: Insurance: 1029 NORTH RD (413) 485-7335 () WC WESTFIELDMA01085 ISSUED ON:9/12/2013 0:00:00 TO PERFORM THE FOLLOWING WORK:INSTALL 18 REPLACEMENT WINDOWS POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Service: Meter: Footings: Rough: Rough: House# Foundation: Driveway Final: Final: Final: Rough Frame: Gas: Fire Department Fireplace/Chimney: Rough: Oil: Insulation: Final: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occupancy Signature: FeeType: Date Paid: Amount: Building 9/12/2013 0:00:00 $35.00 212 Main Street,Phone(413)587-1240,Fax: (413) 587-1272 Louis Hasbrouck—Building Commissioner