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F.I.D. No. 11-2320449 ��,A ^+� ME Lic.No.D07893
Job# j'y/3 OG 7 /� /�1,/ If NH Lic.No. — _-
( Tyr MA Lic.No.120456
s SALES: FOR ALL Hometrals" New York Dept.of Consumer
Cen
New York: SERVICE/REPAIRS Affairs Lic.No.0730686
800-942-6111 PLEASE CALL The Service Side of Sears Nassau Lic.No.H2704150000
Suffolk Lic.No.21194HI
Boston: 888-245-7294 190 Cedar Hill Road Yonkers 1397
800-SEARS-31 Marlboro,MA 01752 Westchester WC0613-H87
Hartford Area: New Jersey Lie.No.L011664
800-SEARS-99 WINDOW CONTRACT Connecticut Dept.of Consumer
Providence Area: said,Furnished 8 Installed by Bill-Ray Aluminum Siding Corp.of Queens,Inc. Affairs Lic,No.00532774
888-732-7751 A Sears Authorized Contractor VT Lic.No.
888-SEARS-51 40 Elmonl Road,Elmont,NY 11003 Rhode Island Lic.No.13707
SOLD
TO /I N/� f�R, IheDR1 f �/�REN AlI�i7`7� robA "- - DATE iV/ <_,
ADDRESS n 3� RUlE�fj i r/f RO D PHONE(Home)(Z,/i) 2(_
CITY F�11� /�C- STATE 1_4__ ZIP CIO(L PHONE(Work)
JOB SITE ADDRESS(If different)
APPLIED VINYL WINDOW SYSTEMS
General Description of Work at Above Address: Approx,Start Dated/�S—/Ll�
\ Type of Housetk-rrame; O Masonry Approx.Completion Date C'
SPECIFICATIONS
Sears approved materials will be furnished and installed to these specifications:
YES NO PLEASE READ CAREFULLY:ONLY THE ITEMS CHECKED"YES'ARE INCLUDED IN YOUR ORDER.
1. W ❑ Remove windows from openings where they now exist on:
2. -t ❑ FIRST LEVEL #Openings
� #New Windows
3 -N" 'T�!r SECOND LEVEL #Openings #New Windows
4. ❑ *-THIRD LEVEL #Openings #New Windows
5. 'R7 ❑ BASEMENT LEVEL #Openings G #New Windows G
6. ❑ R- OTHER #Openings #New Windows
7. ❑ k Removal of Metal or other units requiring modified installation #Openings #of Units
8. 1�t- ❑ Install new paintable Mouldings Inside Stops#of Openings I Clamshell or Casing#of Openings
9. El dr- Install new Master Frame #of Openings --
10. �R- ❑ New window units to have double strength insulated Pps 7/8"total thickness
11. Nl- ❑ New window units to have fusion welded sash# _
12. ❑ );�- New window units to have fusion welded frame#
13. J5�- ❑ New window units to have Clima-Tech packsye consisting of Low-E coated,
Argon filled insulated glass #of units-.(.e_-_
14.�-�] New window units to have Cam Lock(s)or Latch Lock(s)
15. ❑ New window units to have Obscured Glass# Half Full
16. ❑ New window units to have half(1/2)screen(full screen on casement�tYpe window)
17. � ❑ Install PVC coated aluminum to window frames Color _fit(1Z�- #of Openings
18. Ek- ❑ Caulk and seal windows with 3 point system
19. Ni- ❑ Remove and dispose of existing windows and/or storm windows
20. I' ❑ Color of windows to be White -"<- Beige
21. ❑ S/pyindows to have Grids Colonial Diamond El Full El
Additional info
22. ❑ Total#of Double Hungs Total#of Hoppers
Total#of Casements Total#of Awnings
Total#of Two Lite Sliders Total#of Three Lite Sliders Std.—or Equal_
Total#of Dead Lite/Pictures Total#of Basement Sliders
23. ❑ Special Order Windows(In Addition to Above)
24.. ❑ Clean up-All job related debris will be removed from property on completion of work.
25. ❑ Insurance--All workmans compensation and liability is maintained -
-- ---------
26. ❑ Warranty-Mailed to customer upon completion and full payment is received nu Discoun s u3„e eeP nPrr a /�
27,.f�” ❑ Payments-(On non financed orders)is payable to installer on day of installation.
28. ❑ All Discounts have been applied. oeierren ray»e i.oreies wn Acrioe
Cash Sale Total$ Less deposit 33%$_72EYW Cash Balance$ s �00 Other Payment(if any)$fig
EJ CASH _5�-FINANCED$ 971*'1,C0 does not include interest Balance on Substantial Completion
If financed,balance payable in�F�ev/ monthly installments of approximately$ i per month,payable by"Owner"to contractor,but
if financed by Owner then Owner will pay said amount to the lending institution plus such interest and credit service charge of said lending institution
payable directly to the lending institution loaning such monies to"Owner"and will execute a Retail Installment obligation and any documents required by
such lending' tilution in connection with said loan.
29. ❑ Additional Information _ CR
30. ❑ Work Not to be Done ,^'D/ C�-/- P �/iL'�C G✓
CONTRACTOR IS NOT RESPONSIBLE FOR ANY EXISTING SECURITY SYSTEMS. PLEASE REMOVE ALL SHADES, VERTICALLS.I
BLINDS, CURTAINS, DRAPES OR WINDOW MOUNTED AIR CONDITIONERS, PRIOR TO THE INSTALLATION OF YOUR NEW WIN
LOWS, INSTALLERS ARE NOT RESPONSIBLE FOR THE REMOVAL OR INSTALLATION OF THESE TYPES OF ITEMS.
Notice:If financed,any holder of this Consumer Credit Contract is still CONDENSATION INSIDE THE HOUSE DOES NOT INDICATE A WARRAW
lest 10 all claims and defenses which the debtor could assert against TY PROBLEM.
the seller of goods or services obtained pursuant hereto or with the
proceeds hereof.Recovery by the debtor shall not exceed amounts paid SALESMAN HAS NO AUTHORITY TO CHANGE ANY ITEMS OR MAKE ANY
by debtor hereunder. REPRESENTATIONS OTHER THAN CONTAINED IN THIS AGREEMENT
AND "OWNER" REPRESENTS THAT NONE HAVE BEEN MADE TO OR
"OWNER REPRESENTS TO HAVE READ AND RECEIVED A DUPLF RELIED UPON BY "OWNER". YOU ARE ENTITLED TO A COMPLETELY
CATE ORIGINAL OF THIS AGREEMENT AND TO BE THE AUTHO- FILLED IN DUPLICATE ORIGINAL of THIS AGREEMENT.
RIZED AGENT OF ALL "OWNERS" OF THIS PROPERTY UPON "YOU, THE BUYER, MAY CANCEL THIS TRANSACTION AT ANY
WHICH THE WORK OR THE MATERIALS ARE TO BE SUPPLIED. TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY
NOTICE TO THE HOME OWNER(S),GUARANTOR(S),LESSEE(S), AFTER THE DATE OF THIS TRANSACTION. SEE ATTACHED
CO SIGNER(S). NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF
f`nntrartr r at thn „r„ n
ACORD,_ CERTIFICATE OF LIABILITY INSURANCE OPID L °ATE`�'M°Orrn
LPA-1 08/27/02
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
SCS Agency, Inc , ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
P,O, Box .220493 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR
11 Grace Avenue - Suite 3 0 0 ALTER THE COVERAGE AFFORDED EY THE POLICIES BELOW.
Graat Neck NY 11022-0493
Phones 516-466-6007 Fax:516-829-5857 INSURERS AFFORDING COVERAGE
INSUR}S0 - INSURER A: Hermitage Insurance Comp '—
Bil-Ray Aluminum Siding Corp. INSuHER8'. State Insurance Fund
o ueena, Inc. INSURER C: Scottsdale Insurance Company
D B�A Sears Home Central
40 alinont Road INSURER O; Zurich-American Insurance Co,
Elmont NY 11003 - •—•
INSURER E; Clarendon National Ins Cc
COVERAGES
THL POLICIES OF INSURANCE LIGTEO OELOW IAVC OCCN ISSUED TO THE INSURED NAMED ABOVE FOR T14E POLICY PCAI00 INDICATED.NOTNI7 H5'fANDING
ANY RF.OUIREMENT.TCTM On CONDITION Or ANY CONI RACT OR OTHER DOCUMENT WITH RESPCCTTO WHICH THIS CtHfIFICATE MAY BE ISSUFO OR
MAY PCRTAIN.Tf IC INSURANCE krFOHO(:U BY THE POLICIES DCS:.1ICE0 14CPCIN IS SUOXCT 1 O ALLL THE TERMS,EYCLUSION6 AND CONDITIONS OF SUCH
POLICIES.AGGREGATE LIMITS SS TOWN MAY HAVE OCEN REOUCEO BY PAID CLAIMS.
TYPE OF INSURANCE I POLICY NUMBER ATTC(MMOD I OATD`MM1ORAT10NI LIMR-S
I.TR DATE MEFFEYI' DATEIt5MMATI
GENERAL LIABILITY EACH OCCURRENCE S 11 000, 000
A X; COMMGRCIALGGNCnALLIAOILITY HGL431843 08/25/02 08/25/03 FIfiL-OAMAGG(Any onef,a) t _1. 00, 000
CLAIMS MAOF, I x OCCUR MFD EXP(Any one Pe,aonl $ - 5.1 000
PCRSONAL&ADV INJURY S 1,000, Q 0 o
GENERAL AGGREGATE 5 2 1 000, 0 0 0
GtN'L AGGREGATE LIMIT.APPLIES PER: PRODUCTS-COMPIOP AGG ;1,000, coo
POLICY 1 r"'. r... LOG --�— ----
CCr
AUTOMOUILE LIABILITY
_ COMOINEO SINGLE LIMIT S
ANY Au'10 (Eo jcclacnl)
AI.L OwNLI)iUT Or; I 7f
UODIL'f INJ UP.Y y�S
_CHCOULE0 AU tOS I I 11'?!oei 6onl-_- -----
J_r FIIRFi7.tU7O5 I 800I(.Y INJURY I
nGrl.O v�.,EU�u IQs IP^D=rCm)
i
I GARAGE LIABILITY j .L;TO ONLY._ ACCIUENf
'� II Amy.:UTL ! JTMC-THAN EA FC=
.%UTO ONLY. ..GG I._•-_..__—__ j
'XC CSS LI-LILIT'Y w�C:a OC CU:U2Ct:C_
A �X occwt CLAimSLaCii .CLS0009263 OS/'_ ,"0 OB/_'5/03 acc�eGATe Is Q00 000
5
OC OUCTInL C S
RETFNTION 5 S
WORKERS COMPENSATION AND 4 _TORN LIMITSI IuER• _
EMPLOYERS'LIABILITY
S 13232963 - N'C I 06/19/02 06/19/03 I E•L•E4CHACCIpcNT• SSOO,000�
E ,�-ccoi: sa�aL = orn�A I vy/14/02 05/14/03 I C.L.O'SCASC.CAcmrincd s SUO,OOD
+ C.L.OISCASE POLICY LIMIT S S O O, 300
i Ol'HEH I _
D Disabi1r- EeneFir- i 1194035-COI i iCi01,-01 1 1C/31/0C __atLto
OCSCfU f•TION U:Uf°_i..:TAG:+>:L G:.:•ilGn_^J Cn.: C:C.::_.__'.G`:C.`.=�=7='f:.._CFS=!.I r!i T!STE'.:.I.=;0'.151 C.':L
CERTIFICATE HOLDER I N ADDIRONAL INSURED;INSURER LE77E.R:_ CANCELLATION
BLANK_7 SHOULD ANY OF THE ABOVL•DCSCR18EO POLICIU BE CANCELLED BE°DRE Th IXPIRM1TIO
r DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MALI 30—DAYS WRITTEN
NOTICc ToTNCCCRTIFICATC HOLDER NA-MEDTO THE LEFT,M FAILURE T000SOSWILL
IMPOSE NO OBLIGATION O0.LIAQILITY of ANY pN0 UPON THE INSURER,ITS AGENTS OR
REPPE_SENTATIVES,
AUTHORIZED REPRESENTATIVE
I9ACORD
ACORO 2S-S(7/9T)
CORPORATION 19E8
a e Crzf�I Of NO tliallu moil
0
��CSII HCh IiS CttE y
DEPARTMENIT OF BUILDING INSPE'CT'IONS
212 Maul Street ' Municipal Building
Northampton, Mass. 01060
WORKER'S COMI'ENSA`IION INSURANCE AFFMAVIT
(11,,.nscrJpe,m 1 tree)
with a principal place of businesslFesidence at
(str.:eticity/statc.��p)� —
do Hereby certify, under the pairs and pen<Itics of perjury, 0m..
an employer providing the tolle vim" '.vol" is coverage for lily
employees worldrig on this job:
(Insurance C6mpany) (Policy Number) (Ex-piration Date)
O I am a Sole proprietor, general com: actor or homeowner (circle one) and have hired
the contractors listed below who have L11e following workers compensation policies_
(Name of Contractor) (Insuranc Corneae vToli(:Y Number) (Ex-p:muon Datc)
(Name of Counr ctor) (Tnsumrce Comp ury/PohcY Num;°r) (Expimtion Date)
(Name of Contractor) (Insurailc-�2 Corn-p2l" TTolic, Numlti:r) (Expiration Date)
(Name of Contractor) (Insurance Comp;,rY/Police Number) (ExpI7,ltion Date)
(a Ia 3t wit Deal skd ifr,ccc ziry to ixudc ioruu:i c--a nina :c ell os ado^)
O I un a sole proprietor znti have no one :working for me.
O I aril a home ow:ler pclforming, all the wol", r:vself.
NOTE:p(crac Ex atrar thy:�titi lc Ftimca�tizrri i'o r!oy IxZOm to :aaL anc,,o r'n zib cr repair«ork o a d«clling c
not rule than thr e tuiib i_n rouMcr rci((Cl cr oa dis ci u'_! urtcn f Ilxrcto E:L r�{ rurally occ,3 cCkfcd to L
employes undrr the tva:}u'i ar pc satim Ali(GL152 t(S)),a,:,, ,a;ic:;by n hotncocNYxr for a Lcrirc ct permit ir-,c iL n c Etc
legal etatu of an caavloya under tha Worry Cory iiou Aci
I uildc uud that a c ,y of thin date cd may to tlM I}ctxu tTCxz1 of Ir,du ri El Ac�'il,ritf Ofri oo of Inn__for tho
cover-agc vcn icatioc and that failure to!"Wort covcrEgc tu,,J-r scciioa 25A cif MGL 152 can Icad to itx impositim of c---'l pcualtics
oomiiting of a fine of up to S1,500.00 art3 or i iiso rnx of up to or.)—,ar e xj c ail pcnzltic!in�r f x n of a step W err Ord—_ and E
firto c(S 100.00 a aay m-_
....- Fcr dq'.srhmdal ui only
_ Permit Number
Lot
tgnatum of Liccnfcr Crnuttcc ����'
SECTION'8- CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder
License Number
r
Address Expiration Date
Signature Telephone
9.'Re istered H "'e Im'r vement Contractor Not Applicable E3
Company—Name T Q l ';!5^Z Registration Number
Address Expiration Date
Telephone z-
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....... EY'y No...... ❑
x � k ,4
Home ®wnerExemption
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 ft., 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(,
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 11 Addition El Replacement ows Alteration(s) El Roofing ❑
Or Doors
Accessory Bldg. ❑ Demolition❑ New Signs [ ] Decks [ ] Siding [ ] Other [ ]
Brief Description of Proposed Work- _,!L6_yj_ ve '---e f" A)
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative❑ Renovating unfinished basement _Yes No
Plans Attached Roll ❑ - Sheet
sa:Clf New.house.aAdibr`addition to exi`sting:hotising, complete 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
E. Energy Conservation Compliance. Mascineck Energy Compliance form attached?
yp� 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
_ _ t as Owner of the subject property
hereby authorize 1(o_ __ tc acs on
my behalf, in all matters relative to �,o �Ii!thonz d by this wilding permit application.
Signature of Owner Date
I, as Owner/Authorized Agent
here declare that t estate ents and information on the foregoing application are True and accurate, to the best of rr"y
knowledge and belief.
der the pains and penalties of perjury-
_... _ �D,�,., �, (�'--- ------ ---- ------- -- -- ------ ---- -- _
Print Name
<.
signature of Owner/Agent Date—__ _
». R
Section 4.
ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE
DENIED DUE TO LACK OF 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 DON'T KNOW YES
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW YES
IF YES: enter Book Page and/or Document #
B. Does the site contain a brook, body of water or wetlands? NO bON'T KNOW
YES
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained _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:__ .__ _
40 R
,Clty'of Northampton �Statusof P, rmr �
�#
- � Building Department Curb Cuts/D
j
n 212 Main Street Sew erfSep �eA �a;'
1 2003
w Roo 100 Water/W
JAN m ell Ava f ���
Nartharnpton, MA 01060 TwoSets oaf S;tr c ra Wars �
' 8- 7)1240 Fax 1587 7pone 2 Plot/Site Pla►is � � �
Other Spec fy �` 3 ' �� � > �'
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
Map (p ?Lots t Unit
Zone Overlay District
Elm St. District CB District
SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
��%l/�L1.-=1--1._1G'��t' t" I�(4 P f'f� �j�vN_LJ� F�f°_1_'-✓/� __ -��-SF' -- h --�—�;�,
idarne(Print) ent M il' ) ddress:
Telephone
Signature
2.2 Authorized Agent:
' -
Na to(� ent rA ailiat> Address:
Siva;,_. e TB)°phOn%
SECTION 3;ESTIMATED CONSTRUCTION COSTS
:-o-n =stlm3ter tc ua Official Use Only
�.i,mtlr� d pv � r , t --------
I
1_ uilding (:) Eui'ding Permit Fee
f_ :.rical �b� tini�,'ed Fotal Cost cf
— - -- --- — Co nst'uction from 6)
3. Plumbing -_i Building Permit Fee
4. Mechanical (HVAC1
Fire Protection
6. Tot
- (1 + 2 + 3 + 4 + 5) Check Umber
This Section For Official Use Only
Building Permit Number:-- Date
Signature:
Building Cornmissioner/Inspector of Buildings - ---_- _ —` Date
omTS PrT RU' BP-2003-0633
G1S#: COMMONWEALTH OF MASSACHUSETTS
� CITY OF NORTHAMPTON
Lot: -001
Permit: B u i I d i g
Category: BUILDING PERMIT
Permit# BP-2003-0633
Project# JS-2003-1042
Est. Cost: $9754.00
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group BIL-RAY CORP 120456
Lot Size(sq. ft.): 74923.20 Owner: MOORE KENNETH R&
Zoning: SR Applicant: BIL-RAY CORP
AT. 856 BURTS PIT RD
Applicant Address: Phone: Insurance:
190 CEDAR HILL (800) 732-7731 () Workers
Compensation
MARLBOROMA01752 ISSUED ON.1 115103 0:00:00
TO PERFORM THE FOLLOWING WORK.-INSTALL 15 VINYL 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:
Fee Type: Receipt No: Date Paid: Check No: Amount:
Building 1/15/03 0:00:00 8111 $25.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo