23D-090 (3) •
PRODUCT PERFORMANCE
Andersen' NFRC Certified Total Unit Performance (continued)
•
3 re1.1
Anderiere Product Glass Type mita
• LI-Factorl SHGC'
.
200 Serie:a
- : Clear Dual Pane 0.45 0_60 0.63
'; ; •Clear Dual Pane with Grilles 0.45 0.54 0-56
int-iiasti • _ law-E 0_30 032 0.55 a
Double-Hunt Window-; Low-E with Grilles 0.30 039 0.49 W
HP Low-E4 SmartSun 0.30 0.21 0.49
- : HP Lnw.E4 SinartSon w/GrOles 0.31 0.19 0.43 0 SI
• . Clear Dual Pane 0.45 0.61 0.64
Nan..fihe ; Clear Dual Pane with Galles 0.45 0_54 0.57 -
liouble-linne Window. Low-E 030 032 0.56 2
Low-E sorle Galles 0.31 0.29 0_50
Clear Dual Pane 0.44 0.63 0.66
Namilne! - Clear Dual Pane with Guiles 0.44 0.57 0.59
Transept Window . law-E 0.27 0.34 0.58 3
low.E with Galles 0.27 030 0.52 a 1-
_ Clear Dual Pane 0.45 0_60 0.63
_' Clear Dual Pane with Galles 0.45 0_54 .0_56
; Low-E 0.30 0_32 0.55 E
eliding Window
Lins,-E with Grilles 0.30 0.29 0.49 3. a
•,. , Low-E SnrortSun 0.30 0.21 0.49 a 3 gm
:. . Low-E SniartSun with Galles 0.31 0.19 0.43 E
• Clear Dual Pane 0.43 0.61 0.65
'••••.- Clear Dual Pane with Grates 0.43 0.55 158
Fixed;:War"Worn; • low-5 038 0.33 0.56 •
CareloharWmdow Low-E with Grilles 0.28 0.30 0.50
Low-E SmartSun 0_27 0.22 0.51 2 3 IS
law.E Sznartfam wah Gales 0.27 0.20 0.45 '2 3
- - Clear Dual Pane 0.44 0.61 0.64
; Clear Dual Pane will]Galles 0.45 0.53 0.56 -
Low-E 0.29 0.32 036
_
Low-E wth Galles 0.30 0.29 0.49 3 -2
Carting Patio Doors Low-E Sun 0_29 420 0.31 3 M
ung-E sun mill saes 0.31 Gas din
. Low-E&narrate' 0.28 0.21 0.50 M
: Low-E SmartSun oat Galles 030 0.19 0.44 3 E
'•,* .7 Clear Dual Pane 0.43 0.61 0.64 -
• Clear Dual Pane with Gales 0.43 0.54 0.56
Low-E 038 0.32 0.56
Low-E with Grilles 0.30 C120. 0.49 3 .7,1
Gliding Patio Doors tow-s&,n 0.29 0.19 030
Low-E Sun'nth Grilles 030 0.17 037 1111
low-E SmartSun 0.27 0.22 050 C 2 3
_7 , SaratiSint wulti Galles 039 0.19 0.44
Clear Dual Pane 0.43 0.45 0.47 -
'- • - Clear Dual Pane with Galles 0.43 0.39 0.40
• law-E 032 0.24 0.41 2 3
mbigea Jussini low-E with Wes 033 0.21 0.35
• .
Patin Demi, . Low-E Sun 0.32 oas 0.23 al a fa
_
-• • •
• : lowE Sun wall GIMES 0.34 0.13 0.19 -
lerw-E5mariSun 0.32 0.16 0.37 a al
Low.E3rnartSun ivhit Grabs 0.33 0.14 0.31
fa 4
Andersen.
Andersen NFRC Certified Total Unit Performance (continued) •
r"°
Andersen'Product ! Glass Type I U-Factors 1 SHGC2 1 VP I r rr Andersen'Product Glass Type U-Factor I SHGC' VP F
400 Serieb'
'AiclrlbMural
, j HP Lnwf4. 0.27 0.35 0.60 r; • i HP iron-E4 032 0.28 0.47 ' F? .
HP Low-E4 wfih Gilles 0.28 0.31 0.54 - HP Insw-E4 with Gr8les 032 025 0.42 :F'[Q
Circle Top" HP Low-E4 Sun 0.27 0.21 033 E HP Low-E4 Sun 0.32 017 0.26 Fit ,•
Casement Window HP Low-E4 Sun with Gulls 032 016 0.23 Caserierd Windom ' HP Low-E4 Sun with Grilles 0.29 0.19 0.30 T-. ' . 11 `�'-
j HP Low-E4 SmartSun 0.26 0.23 0.54 {i i•pg - HP low-E4 SmartSun 0.31 0.18 0.42
HP low-E4 SmartSun w/6s81es 0.28 021 0.49 P P '-. ' - ' HP iron-E4 SmartSun w/Grilles 0.31 017 038 "'E
i HP law-E4 027 0.35 0.60 r" HP Low-E4 0.32 0.28 0.47
HP Law-E4 with Grilles 0.28 0.31 , 0.54 F.7 - 1 . . • • HP tnwf4 with Grilles 0.32 025 0.42 • F;
HP 1mw-E4 Sun 0.27 021 0.33 F'; T •French Casement I HP Low-E4 Sun 0.32 0.17 0.26 !. )7 El
Circle&Oral Window HP Low-E4 Sun with Gilles 0.29 0.19 030 rl n Window HP Wv-E4 Sun with Gilles 032 016 023
HP Low-E4 SmartSun 0.26 0.23 0.54 HP Inw-E4 SmaIlSum 0.31 018 0.42 F•-
• HP tow-E4 SmartSun w/Grilles 0.28 0.21 0.49 E .- ; HP tow.E4 SmaTSun w/Gilles 0.31 0.17 0.38 •r}l
•.. HP low-E4 028 033 0.58 - - HP Low-E4 0.32 0.28 0.47 ".Ti'
• HP Low-E4 with Gilles 0.29 030 0.52 3 - HP tow-E4 with Grolier 0.32 0.25 0.42 '!E
HP low-E4 Sun 0.28 020 031 1t HP low-E4 Sun 0.32 0.17 026 ,j E
Arch Windolk ' 'Awning °�v HP law-E4 Sun with Gales 032 0.16 0.23 HP low-E4 Sun nth Grilles 0.29 018 028 i'.
HP Low-E4 SmartSun 027 0.23 0.52 F--, . -, HP Law-E4 SmanSen 0.31 018 0.42 i'F'i E
NP tow-E4 SmartSun w/Gilles 0.28 021 0.46 F i ' �1; HP Low-E4 SmartSun w/Grilles 0.31 017 038 [ n a
HP low-E4 0.27 033 0.58 ('] . - -. - . .r HP Lew-E4 031 032 0.55
• HP law-14 with Grilles 0.28 0.30 0.52 HP Low-E4 with Grilles 031 029 0.49 f'f
HP Law-E4 Sun 0.27 020 0.31 9 im Casement/Awning HP Low-E4 Sun 0.31 020 031 E'
•Flixifiirrie Widdow HP low-E4 Sun with Grilles 0.29 018 0.28 ^. Pichne window • HP low-E4 Sun milt Grilles 031 0.18 0.28 .r'F
HP law-E4 SmartSun 0.26 023 0.52
,•* HP iron-Ea smatlSun 031 0.21 0.50 E ft
HP taw{4 SmartSun w/Grilles 0.28 0.21 0.46 !i i HP Low-E4 SmartSun w/Gilles 0.31 019 0.44 17 E
• HP Low-E4 031 0.33 0.58 . HP Loo-E4 030 037 0.64 -. •
l HP low-E4 with Grilles 0.32 030 0.52 HP tow-E4 with Grilles 030 0.33 0.57 `'.•
' HP Low-E4 Sun 0.31 020 031 ' ' Pi - S HP Low-E4 Sun 031 022 036 .-F._1E
sprtngilne Window Specialty Window, HP tow-E4 Sun with Grilles 031 020 032 -F`�,
HP Low-E4 Sun web Grilles 033 0.18 016
HP law-E4 SmartSun 030 023 0.52 P '. n HP Low-E4 SmardSue 0.30 024 0.58 F.7 .r r
HP taw-E4 SmertSunw/Giles 032 0.21 0.46 7 , HP low-E4 SmailSun w/Grilles 030 0.22 0.52 1• roll
HP ImrE4 030 027 0.45 $'? ? - HP tow-E4 0.32 0.22 037 F -17,E
HP Low-E4 with Gilles 0.32 023 039 r '"`P HP Low-E4 with Gilles 033 020 0.33 -
HP Law-E4 Sun 031 0.16 0.25 Fl )' P 'Hinged Inswing. + HP Low-E4 Sun 0.33 014 021 -
Fr6nehwood':
Gliding Patio Door HP la 1'
law-E4 Sun nth Grilles 032 0.14 0.22. . `' Low-E4 Kg French Deer i HP L -E4 Sum with Grilles 0.34 013 0.18 -
i
HP I n r r F A SmartSun 0.30 018 0.41 I' ':: HP Low-E4 SmaASuru 0.32 0.15 D 33 ? 1•
•• :! HP tnw-E4 SmartSun w/Gilles 0.31 0.16 035 Tv :' •. • Hp L0wE4 Smarlsun w/Gsales 0.33 014 0.30 - •
HP Low-E4 031 014 0.41 P HP low-E4 0.33 0.25 0.41 c
/ - I HP Low-E4 with Grilles 032 011 035 : , FP law-E4 with Grilles 034 022 0.36 -
/csenehwoo r Hin • ! HP lae-E4 Sun 031 0.15 023 'M Hinged Ootrwing ' HP 10,44 Sun 0.33 0.16 023 - 1
( ' t% French Door• • HP law-E4 Sun with Griles 0.35 0.14 0.20 �t
;' Irwwln(Oath?Door HP low-f4 Sun with Grilles 0.32 0.13 0.19 s `'
HP law-E4 SmaslSen 0.30 0.16 037 ' °- - - HP Low-G4 SmartSun 0.32 017 037 j F. ..a
HP Low-E4 SmartSunw/Grilles 031 0.14 0.31 FT - e - !, HP lowE4 SmastSun w/GrNes. 0.34 0.15 032 - E m
IP10w-E4 0.31 025 0.41 1F` '•'� - HP Low-E4 0.33 023 038 . - air.
HP Inw14 with Grilles 032 021 035 P NI HP low-E4 with Grilles • 0.33 011 034 -
Frendhwood'Hinged HP low-E4 Sun 0.31 015 0.23 r •n Eked French Door- HP low-E4 Sim 033 014 0.21 -
Ootswing Patio Door i HP Low-E4 sun will Gilles 0.32 0.13 0.19 7 T1 i Sidelight HP Low-E4 Sun with Grilles • 0.34 0.13 0.19
HPlaw-E4SmartSun 0.30 0.17 0.37 fT -?j.i - - HP lire IA SnrattSun 032 0.15 034 -
• ' HP Low-E4 SmartSun w/Grillo 0.31 015 0.31 I" ' K.3 • Low-14 SeroiSun w/Grilles 033 014 0.30 -
HP Lurr-E4 0.31 0.22 037 4".! 'El . I - HP Low-E4 032 . 025, 0.41 -
j HP tnw-E4 with Galles 032 020 0.33 I<' i .f HP Low-E4 with Gilles 0.33 0.22 0.37 -
Frenchssood'' HP Law-E4 Sun 032 0.14 0.21 `l. I" F7eed Transom HP Lnsw-E4 Sun 0.32 0.15 0.23 -
r,, French Doti HP tow-E4 Sun with Gilles 033 0.14 0.20 Patio Door Sidelight HP Low-E4 Sun rolls Grilles 0.32 013 0.18 r_r.
-
HP Low-E4 SmartSun 0.31 0.15 0.33 `�1 c' - { HP law-E4 SmartSun 0.32 0.16 037
HP Lmwf4 SmartSun w/Gilles 0.32 0.14 0.29 F' .:'. 9 .. ..' HP Lae-E4 SmartSun w/Gilles 032 015 - 0.33 -
RP tow-E4 030 024 0.40 F '` ri - HP LOw-E4 035 0.26 0.44 -
HP Low-E4 with Grilles 030 021 035 f' ' .F HP low-E4 with GriRUs 036 023 0.38 -
HP jow-E4 Sun 0.30 0.15 022 f',�-� -- HP Law-E4 Sun 0.35 016 024 -
Frenchrrood' _ Folding Door -
Patio Door Trabsoin••• HP Law-E4 Sun with Gilles 0.31 0.13 020 t i, ` .14 HP Lorr-E4 Sun with Gilles 0.36 0.14 021
HP taw-E4 SmartSun 0.29 0.16 0.36 f' • .9".i - HP Low E4 SmartSun 0.34 017 0.39 -
' • HP Low-E4 SmartSun w/Grilles 030. 014 032 C i. . I] ' HP Low-E4 SmartSun w/Gilles 036 0.15 0.34 -
continued on next page
••For NFRC certified total unit performance on units with capillary breather tubes for high altitudes,please visit andersenwindows_com.
•'High-PerformanceLow-E4'-(HP Low-E4),'High-Performance'Low-E4'SmartSun"(HP Low-E4 SmartSun)and"High-Performance Low-E4"Sun'(HP Low-E4 Sun)are Andersen trademarks for'Low-E'glass.
' U-Factor defines the amount of heat loss through the total unit in BTU/hr sq.ft'F.The lower the value,the less heat is lost through the entire product Window values represent non-tempered glass.Use of tempered glass can
increase U-Factor ratings.See andersenwindows.com for specific performance values_Door values represent tempered glass_
o Solar Heat Gain Coefficient(SHGC)defines the fraction of solar radiation admitted through the glass both directly transmitted and absorbed and subsequently released inward.The lower the value,the less heat is transmitted
through the product
'Visible Transmittance(VT)measures how much light comes through a product(glass and frame)_The higher the value,from 0 to 1,the more daylight the product lets in over Use product's total unit area.Visible Transmittance
is measured over the 380 to 760 nanometer portion of the solaf spectrum.
•NFRC ratings are based on modeling by a third parry agency as validated by an independent test lab in compliance with NFRC program and procedural requirements.
•This data is accurate as of December 2010_Due to ongoing product changes,updated test results or new industry standards or requirements,this data may change overtime.Ratings are for sizes specified by NFRC for
testing and certification.Ratings may vary depending on use of tempered glass,different grille options,glass for high altitudes,etc. •
•PassiveSun'glass values are available online at andersenwindows.com_
277
Renewal ,; Renewal by Andersen Corporation
����' 104 Otis Street•Northborough,Massachusetts 01532 MA Home Improvement Contractor
byAndersen. b,��-x- Phone(508)351-2200•Fax(508)986-7072 MA License#170810(expires
WINDOW REPLACEMENT an AndersenCompany 12/23/2013)
Federal Tax ID# 41-1918413
CONTRACT AMENDMENT
This Amendment ("Amendment")is to the CUSTOM WINDOW AND DOOR REMODELING AGREEMENT("Agreement")by and
between Renewal by Andersen Corporation and Reyes Lazaro("buyers"). Contractor and Buyer(s)hereby agree to amend and modify the
Agreement as indicated below. Other than as specifically indicated below,all the terms and conditions of the Agreement will remain in full
force and effect. This Amendment is subject to the terms and conditions of the Agreement. The following additions,alterations,or deletions
to the products and services Buyer(s)ordered are being made:
Changing to a custom 5ft patio door with both sides operating and interior wood grills in prairie configuration. We are
also lowering the opening instead of putting in a new header and widening the opening.
As a result of these changes, the following terms of the Agreement are also changing (if there is no change, an item will be left blank or
marked as"N/A",indicating that no change applies:
NEW Total Job Amount: $7,750.00 Payment Method:
New Deposit Received(33%):$2724.00 Received Credit Card
New Balance at Start of Job(33%):$2513.00 Check/Credit Card
New Balance on Check/Credit Card
Substantial Completion of Job(33%):$2513.00
*Please Note-Your job will be delayed until amendment is
signed and received.
It is agreed and understood by and between the parties that this Amendment and the original Agreement constitute the entire understanding be-
tween the parties,and there are no verbal understandings changing or modifying any of the terms of this Amendment. Buyer(s)hereby acknowl-
edges that Buyer(s)has read this Amendment and has received a completed,signed,and dated copy of this Amendment on the date written below.
Renewal by Andersen Corporation Buyer(s)
By: OS l
Signature of Product Manager Signature Date
Mitchell Toro 8/20/2013
Print Name of Product Manager Signature Date
Renewal Renewal by Andersen Corporation MA Home Improvement Contractor
byAndersen. 104 Otis St. Northborough,MA 01532 License#170810 (Expires 12/23/2013)
wtwnow REPLACEMENT n„ (508)351-2200 Fax:(508)-986-7072 Federal ID#41-1918413
Window Specification Sheet
!Buyer(s)Name Date of Agreement
REYES LAZARO - IAuqust 1,2013
The buyer(s)listed above hereby jointly and severally agree to purchase the goods and/or services listed below,in accordance with the prices and terms described
on the Specification Sheet and the front and the reverse of the accompanying CUSTOM WINDOW AND DOOR REMODELING AGREEMENT,of
which the Specification Sheet is part.
WINDOW DETAILS
Style Full/ United Exterior Interior Hardware Hardware LowE4/ Grille Grille Temper/
Room S Style Detail Insert Inches Casings Sills Color Color Color Style Screens Smansun Grilles Sash l/3 Sash 2 Lifts Laminated
Library I FWO Equal Full Full Flat WH PN 7.R.Bron Newbury None SmartSun No ---- ---- No Temper
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Total 1 BAY&BOW DETAILS *See Bay/Bow Measure Sheet
Style Detail/ United Approx. Number Exterior Interior Center LowE/ Roof/ Hardware
Room Count Style 5lankers inch Casings Angle Lites Color Color Grilles End sashes sashes Screens Smartsun Soffit Color
0
0
SPECIALTY WINDOW DE;AILS
Fnv/ United LowE/ ADDITIONAL WORK DETAIL NOTES
Room Count Style Insert Inches SmartSun Grilles Grille Style Full frame cut in for the door
0
0
0
0
ADDITIONAL WORK DETAILS
I No Qty of 0 Sills 0 Sill noses to be replaced by Contractor.
2 No Contractor will remove metal frames of windows.
3 No Contractor will install new 0 paint-ready or 0 Stain-ready 0 Interior 0 Exterior casings in 0 Pine 0 Maintenance-Gee material
4 No Contractor will install new 0 paint-ready or 0 Stain-ready 0 Interior 0 Exterior stops in 0 Pine 0 Maintenance-Gee material
5 No Contractor will wrap exterior casings with coil stock of color.
'Owner is aware that Contractor does not do any painting/staining or removal/installation of alarm system/hardware.It is the
6 responsibility of the homeowner to have the alarm system/hardware removed prior to installation. Customer is aware in some cases there
will be glass loss.If there is,the amount will be dependent on the type of existing windows,type of installation,insert or full frame and
window style.We make no guarantee as to the amount of glass loss.Customer is aware and understands any and all unseen rot is not
included in this contract.Should any rot be found there will be an additional charm,for time and materials unless so stated in this contract.
7 Yes Contractor will insulate,caulk and seal windows with 3-point system to prevent water and air infiltration. Removal and disposal of all job related debris,windows,
storm windows and vacuum nightly included. Upon completion of the job and payment in full,a limited warranty shall be issued.
8 Yes Building Permit--Contractor will secure any and all necessary permits.The fee for the permit(s)is not included in the Contract Price and a separate check is
required at the time of sale for this fee. Check# 361 $ 35
9 Yes All discounts have been applied to this agreement.
10 Yes a No Owner agrees to be present on the final day of installation for final inspection and to deliver final payment/finance form(s).
It is agreed and understood by and between the parties that this Specification Sheet,along with the CUSTOM WINDOW AND DOOR REMODELING AGREEMENT,constitutes the entire
understanding between the parties,and there are no verbal understandings changing or modifying any of the terms.This Specification Sheet may not be changed or its terms modified or varied in
any way unless such changes are in writing and signed by both the Buyer(s)and Contractor.Buyer(s hereby acknowledge that Buyer(s)has read this Specification Sheet.
'Renewal by Andersen Corporation Buyer(s Buyer(s)
/(4itc/iel.� Pre-
B> /I
Signature of Project Manager 4 Signature Signature
MITCHELL TORO REYES LAZARO
( Print Name of Project Manager Print Name Print Name
1
Renewal ;.y�� A MA Home Improvement Contractor
byAndersen License#170810(Expires 12/23/2013)
wrsoow REPLACEMENT :,,,.n,�,..,�..,, ,,. Renewal by Andersen Corporation Federal Tax ID#41-1918413.
; 104 Otis St. Northborough,MA 01532
(508)351-2200 Fax(508)-986-7072
CUSTOMER WINDOW AND DOOR REMODELING AGREEMENT
I
'Buyer(s)Name Date:
REYES LAZARO - AUGUST 1, 2013
;Buyer(s)Street Address,City,State and Zip Code
172 FEDERAL ST. FLORENCE MA 01062
Email Address Home Telephone Number Work/Cell Telephone Number
Rlazaro @smith.edu 413-584-6382 917-543-7236
Buyer(s)hereby jointly and severally agrees to purchase the goods and/or services of Renewal by Andersen Corporation("Contractor"),in accordance
"with the terms and conditions described on the front and the reverse of this agreement and on the attached specification sheet(s)(collectively,this
_ "Agreement"). Buyer(s)hereby agrees to sign a completion certificate after Contractor has completed all work under this Agreement.
Total Job Amount$ 8,172.00 Amount Financed $ 0.00 Est.Start Date Method of Payment
Deposit Received(33%)$ 2,724.00 i...: Check/Cash
7-10 weeks
Balance Start of Job(33%)$ 2,724.00 Front Deposit(50%) $ 0.00
Est. Install Time it Credit Card
Balance on Substantial,,,.
Completion of Job(33%) 2,724.00 Completion (50%)$ 0.00 T B.D. If credit is selected,please
see Credit Card Payment Form.
Buyer(s)agrees and understands that this Agreement constitutes the entire understanding between the parties,and that there are no verbal
'understandings changing or modifying any of the terms of this Agreement. No alteration to or deviation from this Agreement will be valid without the
signed,written consent of both Buyer(s)and Contractor. Buyer(s)hereby acknowledges that Buyer(s)1)has read this Agreement,understands the
;terms of this Agreement,and has received a completed,signed and dated copy of this Agreement,including the two attached Notices of Cancellation,
on the date first written above and 2)was orally informed of Buyer's right to cancel this Agreement. DO NOT SIGN THIS CONTRACT IF THERE ARE
ANY BLANK SPACES.
;Renewal by Andersen Corporation Buyer(s) Buyer(s)
I; /�dc//27 �ay-a,-
By: .//a
i Signature of Project Manager ignature Signature
i MITCHELL TORO REYES LAZARO
I
Printed Name of Project Manager Printed Name Printed Name
( YOU,THE BUYER(S),MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY AFTER THE
s DATE OF THIS TRANSACTION.'SEE THE ATTACHED NOTCIE OF CANCELLATION FORMS FOR AN EXPLANATION OF THIS RIGHT.
I
I
NOTICE OF CANCELLATION I NOTICE OF CANCELLATION
;Date of Transaction 8/1/13 .You may cancel this Date of Transaction 8/1/13 . You may cancel this
!transaction,without any penalty or obligation,within three I transaction,without any penalty or obligation,within three
1!business days from the above date.If you cancel,any property I business days from the above date.If you cancel,any property
!traded in,any payments made by you under the Contract of Sale, I traded in,any payments made by you under the Contract of Sale,
and any negotiable instrument executed by you will be returned I and any negotiable instrument executed by you will be returned
;within 10 days following receipt by the Contractor("Seller") of i within 10 days following receipt by the Contractor("Seller") of
?your cancellation notice,and any security interest arising out of I your cancellation notice,and any security interest arising out of the
!the transaction will be canceled. If you cancel,you must make transaction will be canceled. If you cancel,you must make
;available to the Seller at your residence,in substantially as good available to the Seller at your residence,in substantially as good
;condition as when received,any goods delivered to you under condition as when received,any goods delivered to you under this
this Contract or Sale; or you may if you wish,comply with the Contract or Sale; or you may if you wish,comply with the
(instructions of the Seller regarding the return shipment of the I instructions of the Seller regarding the return shipment of the
!goods at the Seller's expense and risk. If you do make the goods I goods at the Seller's expense and risk. If you do make the goods
'available to the Seller and the Seller does not pick them up within I available to the Seller and the Seller does not pick them up within
120 days of the date of your Notice of Cancellation,you may I 20 days of the date of your Notice of Cancellation,you may retain
"retain or dispose of the goods without any further obligation. H' i or dispose of the goods without any further obligation. If you fail
you fail to make the goods available to the Seller,or if you agree I to make the goods available to the Seller,or if you agree to return
to return the goods to the Seller and fail to do so,then you remain I the goods to the Seller and fail to do so,then you remain liable for
!liable for performance of all obligations under the Contract. To performance of all obligations under the Contract.To cancel this
'cancel this transaction,mail or deliver a signed and dated copy transaction,mail or deliver a signed and dated copy of this
of this cancellation notice or any other written notice,or send a cancellation notice or any other written notice,or send a telegram
,telegram to Contractor: Renewal by Andersen,104 Otis St. I to Contractor. Renewal by Andersen,104 Otis St.Northborough,
Northborouch,MA 01532,BY NOT LATER THAN MIDNIGHT I MA 01532,BY NOT LATER THAN MIDNIGHT
OF 8/4/13 .(Date) I HEREBY CANCEL THIS TRANSACTION. I OF 8/4/13 .(Date) I HEREBY CANCEL THIS TRANSACTION.
Buyer's Signature Print Name Date I Buyer's Signature Print Name Date
1
The Commonwealth ofMonachusetts
l of Inda<riai cc
deats� •,
y — = f Investigations
= - = 600 WashIngtoi SYreet•
:-_ ` Boston,M� 0111
' www.masagov/dlo
Workers' Compensation.lnetera n ce s t:B 6ers/Ce cto 1eetrieicns/Phunbers
Applicant Information , Please Print Leask,
Name(Business/omedzat oniindividuai): R P d14P.W A,, \c H yr e r r i
Address: 1 0 \ , )4%s S . .
City/State/Zip: ka r. -L&I.r,1 (O Phone#: 5b$ -3 S l—ac)Q Q
Are you an employer?Check the appropriate box: Type of project(regmtred): .
1.0I am a Employer with 3 0 4. Q I am a general cow and I
employees(full and/orpant-time).e have hired the sub-contractors ''' r.„Nt:w constrvcti°n
2,0 I am a sole'proprietor or partner- listed on the attached sheet. 7, rraRefuodeang
ship and have no employees These sub-contractors have 8. 0 Demolition -
working for me in any capacity. employees and have workers'
[No workers'comp.insurance comp.insurance? 4• $addition
required.] 5. 0 We are a corporation and its 10.0 Electrical repairs or additions
3.0 I am a homeowner doing all work officers have exercised their , 11.0 Plumbing repairs or additions
myself. [No workers'corm. Hght of exemption per MGL 12.0 Roof repairs
insurance ]t c. 152,§1(4),and we have no
employees.[No workers' 13.❑Other"
' camp.insane=r'equir'ed.) •
*Any applicant that ihecmer box M1 mast also fill out the section below mowing*sk ived:us'computation policy hdbnation. •
t Homed mess who submit this affidavit indicating they are.doing all work and than bke outside oaetrsgtors most submit a new affidavit iodicrtiaa nick
:Contractors that check this box mast attached an additional sheet showing the Dame ofthe tub•contracton mid sale whether or not those entities have
easployees. mho sub!-ecofsCtn have employees,they.sant prwride their victims'comp.policy number.
. I seer an employer that bproviding workers'compensation resin once for my employees llealow is the po Y site
I�jorl�lo!. bQ Isurrnce Company Name: D`d, Ply \∎ G I
s. C 3 .
X
Policy#or Self-Ins.Lic.#: Vt.-M A lt C 1 1*4 q i1'O c •Expiration Date: 101- (— i 3 •
fob Site Address: \4 ) r_c—\ 5V. . city/StatelZip:— t o re Ace , 6u. d IOC
Attach a copy of the workers'compenation 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 aiminai 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 coverage verification.
r do hereby eery► the palm astd parses ofperfiery that the information provided above is a and rmct.
S' Dam 9 1 a 3 /1.3
•
Phone#: -._ -' 3 c(.-- (1 e -
JFclal are only. Da not write br this arm be completed by city or town official —
O,f —_ — - 1•
City or Town: • Permit/License# •
', laau;lug Authority(circle one): .
' 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector S.Phtmbbig Inspector
b.Other -
i
f:ontact Person: Phone#:
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: `n Not Applicable ❑
Name of License Holder: J b\�,Q 1/‘ '(.e 1—A (o cc) '3 r)
License Number
Address Expiration Date
/ , I � ' 3 ‘-aav) X SS� g;
Sign- Telephone
9.((Realetered Home Improvement Contractor: .. . '., Not Applicable ❑
V�PAe.wit,- ■0_,, A.A cer per-\ I 1–D 3, 0
Company Name Registration Number
INA 64_lS ST . ,D (` V, ko `,) . h'l RA- 6/J-- ..)- la -a- 3-13
Address Expiration Date
Telephone-5 -�-rioU
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 buildin permit.
Signed Affidavit Attached Yes No ❑
Ii.1,; .`+.i e ♦♦ i" igiiiiiiiii
-
The current exempti.• for"homeowners"was extended to include Owner-occupied Dwellings of one(1) or two(2)families
and to allow such hom-.wner to engage an individual for hire who does not possess a license,provided that the owner acts
as supervisor.CMR 781 Sixth Edition Section 108.3.5.1.
Definition of Homeowner. 'erson(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 . two family dwelling,attached or detached structures accessory to such use and/or farm
• structures.A person who const cts more than one home in a two-year period shall not be considered a homeowner.
Such"homeowner"shall submit to e Building Official,on a form acceptable to the Building Official,that he/she shall be
responsible for all such work perfo 1 ed under the building permit.
As acting Construction Supervisor yo Iresence on the job site will be required from time to time,during and upon
completion of the work for which this pe ; is issued.
Also be advised that with reference to Chapte 52(Workers'Compensation) and Chapter 153(Liability of Employers to
Employees for injuries not resulting in Death)o e 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 r...onsibility for compliance with the State Building Code,City of
Northampton Ordinances,State and Local Zoning Laws . 4 State of Massachusetts General Laws Annotated.
Homeowner Signature
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑
Or Doors
Accessory Bldg. ❑ Demolition ❑ New Signs [D] Decks [E] Siding[D] Other[0]
Brief Descripti�2 roposed 000 \6 S'hf`o c-stu rc,
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll -Sheet
6a.,if-Nein/house end"or addition-ts existlna housinai comielete`the following:
a. Use of building : One Family Two Family Other
b. Number of rooms in each family unit:. Number of Bathrooms
c. Is there a garage attached?
d. Proposed Square footage of new construction. Dimensions
e. Number of stories?
f. Method of heating? Fireplaces or Woodstoves Number of each
g. Energy Conservation Compliance. Masscheck Energy 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.
I. 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
I, ClA P l„ -Z-(xco , as Owner of the subject
property
hereby authorize -31)5 iP V 12 e. -Zc,‘
to act on my behalf, in all matters relative tb work authorized by this building permit application.
Signature of Owner Date
Y\ , as Owner/Authorized
Agent hereby declardi that the statements and information on the foregoing application are true and accurate,to the best of my know Mtge
ani belief.
Signed under the pains and penalties of perjury.
.J DS 1Q-e.
Print Name / ,�� � )/ 3
`zle) 3
Signature • •-r/Agent 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 I_ __ . , _ --
Frontage17___________.�__._i__ ��___.._�_- �_._._._. _____ .________._..___
Setbacks Front �`
Side L: ._.__....� R:1 —i L: . R:C—_J L___] ET__
Rear [iii ----.. 1-------j
Building Height
I I � L_
Bldg. Square Footage L i I-----1 % LT = I __I
Open Space Footage % _ _ }}
(Lot area minus bldg&paved ._ _ _. { _ —_ _ _!
parking)
#of Parking Spaces I J r i ----1
Fill: _.._-_.._____...,..__ .__._.. _._._.._.�._I,.__._._.__ . _
w 't
(volume&Location) I — . _ _.. :
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO 0 DONT KNOW ef • YES
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DONT KNOW YES
IF YES: enter Book Page[ and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO ® DON'T KNOW 0 YES
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained 0 Obtained , Date Issued:
C. Do any signs exist on the property? YES ® NO
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property? YES ® NO
IF YES, describe size, type and location: _ _ �� _
E. Will the construction activity disturb(clearing,grading, avation,or filling)over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES ® NO
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
R. C \ f y"m
----_. ' 1 i 1 r; z*'„a.1 . z ;6.4' `� "
{ Oi y of Northampton =� ;�
1 O IIding Department r e etf e � �` ,
Sp 242013
- 212 Main Street = iee= ? it''} � . , K'
Room 100 1 ` � u4"
Electric, Plumpin &Gas tns e � #
p fktlmham ton, MA 01060 , i i ' 7 ,
Northampton, MA 01060 p 1 f , pit:
phone 413-587-1240 Fax 413-587-1272 %�' .
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
r~ -
}a- i'(�e Celo. SA' . Map v' `ei Lot CIO 0001 Unit
V\o t,e Ac.e, IM-C./. (310(0 a : Zone Overlay District
Elm St District` CB District ' ~
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
Re ,.( pJ LU z.,_�(`0 . Ioki oik S .T ,L),-)f-A-003.1), ,, 01a-)--
Name(Print) Current Mailing Address: "A` l _ 5Y1/4-1 y lnlF�
Telephone
Signature
2.2 Authorized Agent:
JbscQh PP_ 2-2-o. _ 1(0? vent1 QAu M. 0-44e6v6 ANA
Name(Print) Current Mailing Address: 03A o
51)1 -3 s-k-JdoLD Y- 5-Cc) ?-1--Signature Telephone
SECTIO -ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building (a)Building Permit Fee
-r-, r �
2. Electrical (b)Estimated Total Cost of
Construction from(6)
3. Plumbing Building Permit Fee
4. Mechanical(HVAC)
5. Fire Protection �S
6. Total=(1 +2+3+4+5) '9, ?cc), c),_.) Check Number 0/904, i— 5
This Section For Official Use Only
Date
Building Permit Number: Issued:
Signature:
Building Commissioner/Inspector of Buildings Date
172 FEDERAL ST BP-2014-0364
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 23D-090 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category:REPLACEMENT DOOR BUILDING PERMIT
Peanut# BP-2014-0364
Project# JS-2014-000612
Est.Cost: $7750.00
Fee: $35.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: RENEWAL BY ANDERSEN 065272
Lot Size(sq. ft.): 22999.68 Owner: LAZARO REYES C/O PHIL COX
Zoning:URB(100)/ Applicant: RENEWAL BY ANDERSEN
AT: 172 FEDERAL ST
Applicant Address: Phone: Insurance:
104 OTIS ST (508) 919-0900 WC
NORTHBOROMA01532 ISSUED ON:9/24/2013 0:00:00
TO PERFORM THE FOLLOWING WORK:INSTALL REPLACEMENT DOOR
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 9/24/2013 0:00:00 $35.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner