36-063 Windows
Consultation Info
Lead Number: 16883397 Date: 3/13/2014 Sales Rep: Matthew Gelinas
Customer Name: TERESE KATZ Phone: (413)586-3822
Address: 1021 Burts Pit Rd
City: Florence State: MA Zipcode: 01062
Worksheet Summary
Description Comments
w/o slider and front
Proposal
Code Description Units prig' Total;"
W010 Wincore. WB MAX(Wincore) 1.00 $7,411.95 $7,411.95
W020 Wirw=e. WB PLUS(Winoore) 1.00 $7,354.25 $7,354.25
W751 Additional Labor. Lead Safe-Windows 9.00 $55.00 $495.00
Discounts
RETAIL ITEMS
Retail= $15,261.20
Volume Savings= $2,289.18
Employee Discount= $0.00
Offer Savings= $0.00
Marketing Offer= $0.00
Additional Discount= $0.00
Instant Rebate= $800.00
Tax= $0.00
TOTAL= $12,172.02
Floor
5 4 3 2
Kitchen 2
bathroom bedroom
a
t
t
b
4
living room bed bed
2
6 1 2
i
1 house
03/13/2014
Customer Signature Date Customer Signature Date
2 of 2
JOB NUMBER: 16883397-0001
PROPOSAL DATE: 3/13/2014
WINDOW ORDER ADDENDUM
1 WP—DOUBLE HUNG 1 40 W X 44 H
WHITE
LOWE/ARGON/CLEAR _
FULL SCREEN
TWO CAM LOCK
MAX CLEARANCE DIMENSIONS=[34.75 X
14.5625]
2 WP—DOUBLE HUNG 4 36 W X 44 H
WHITE r !f
LOWE/ARGON/CLEAR
FULL SCREEN
TWO CAM LOCK
MAX CLEARANCE DIMENSIONS=[30.75 X
14.5625]
3 WP—DOUBLE HUNG 1 28 W X 45 H
WHITE
OBSCURE
OBSCURE BOTTOM SASH `
FULL SCREEN
TWO CAM LOCK
MAX CLEARANCE DIMENSIONS=[22.75 X
15.0625]
4 WP—SLIDER 1 32 W X 33 H
WHITE
LOWE/ARGON/CLEAR e
FULL SCREEN ' '
MAX CLEARANCE DIMENSIONS=[10.5 X
27.75]
5 WM—PATIO DOOR 1 70 W X 78 H
WHITE
LEFT OPENING
LOWEIARGONILAMI
FOOTBOLT
6 WM—END VENT 1 94 W X 49 H
WHITE
1/4-1/2-1/4 END VENT
LOWE/ARGON/LAMI
HALF SCREEN
TOTALS: 9
COMMENT:
1 of 2
Job Number: 16883397
NOTICE TO BUYER
1. DO NOT SIGN THE AGREEMENT IF ANY OF THE SPACES INTENDED FORTHEAGREED TERMS TO THE EXTENT OF THE AVAILABLE INFORMATION
ARE LEFT BLANK.
2. YOU ARE ENTITLED TO A COPY OF THIS AGREEMENT AT THE TIME YOU SIGN IT.KEEP IT TO PROTECT YOUR LEGAL RIGHTS.
3. YOU MAY PAY OFF THE FULL UNPAID BALANCE DUE UNDER THE AGREEMENT AT ANY TIME,AND IN SO DOING YOU SHALL BE ENTITLED TO
A FULL REBATE OF THE UNEARNED FINANCE AND INSURANCE CHARGES.
4. YOU MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY[FIFTH BUSINESS DAY IN ALASKA,
FIFTEENTH BUSINESS DAY IN NORTH DAKOTA IF YOU ARE AGE 65 OR OLDER]AFTER THE DATE OF THIS TRANSACTION.SEE THE ATTACHED
NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. FAILURE TO EXERCISE THIS OPTION, HOWEVER, WILL NOT
INTERFERE WITH ANY OTHER REMEDIES AGAINST THE RETAIL SELLER YOU MAY POSSESS. IF YOU WISH, YOU MAY USE THIS PAGE AS
NOTIFICATION BY WRITING"I HEREBY RESCIND"AND ADDING YOUR NAME AND ADDRESS.A DUPLICATE OF THIS RECEIPT IS PROVIDED BY
THE SELLER FOR YOUR RECORDS.
5. IT SHALL NOT BE LEGAL FOR THE SELLER TO ENTER YOUR PREMISES UNLAWFULLY OR COMMIT ANY BREACH OF THE PEACE TO
REPOSSESS GOODS PURCHASED UNDER THIS AGREEMENT.
NOTICE TO MASSACHUSETTS RESIDENTS ONLY
In addition to the Notice to Buyer shown above, Massachusetts law requires that contracts for home improvement work state that all home improvement
contractors and subcontractors shall be registered and that any inquiries about a contractor or subcontractor relating to a registration should be directed to:
Director,Home Improvement Contractor Registration
P.O. Box 871
Taunton,MA 02780-0871
Telephone: (508)821-9315
Please note that owners who secure their own construction-related permits or deal with unregistered contractors shall be excluded from access to the
Guarantee Fund.
Notwithstanding any other language in the contract or associated documents, Sears will not remove, replace, or install any heating
or air conditioning system, or any portion thereof, if asbestos or asbestos-containing material is known or likely to be present in that
heating or air conditioning system,or any portion thereof. If it is determined or reasonably suspected that asbestos is present,either
before commencement or during performance of the work, it shall be the customer's responsibility to select, retain and pay all costs
of a Division of Occupational Safety ("DOS") licensed Asbestos Contractor to remove all asbestos or verify that none is present in
the components involved in thejob, If the determination or reasonable suspicion of the presence of asbestos arises after Sears has
started the work, Sears will immediately cease performing the work until a DOS licensed Asbestos Contractor,hired by the customer,
removes all asbestos from the components scheduled for repair or replacement in accordance with 310 C.M.R. 7.00 and 453 C.M.R.
6.00 or verifies that none is present. By signing the contract the customer agrees that it understands the above.
DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES
C 03/13/2014 03/13/2014
Customer's signature Date Customer's signature Date
Accepted by Sears Home Improvement Products, Inc.("Sears")on 03/13/2014 by:
Date Management Representative
SWl-MA (Dig.) Rev 08/13/12 Page 3 of 3
11'11 111 1 1 111'11 Job Number: 16883397
APPROXIMATE START DATE and APPROXIMATE COMPLETION DATE:
The work will start approximately 1-2 WEEKS (Approximate Start Date)
It will be substantially completed by approximately 3-4 WEEKS (Approximate Completion Date)
These dates are subject to change at the time the contract is accepted by Sears Home Improvement Products, Inc. ("Sears")or at any other time by mutual
written agreement. Customer understands that the Approximate Start Date is only an estimated date and the Customer will be contacted prior to this date to
schedule the actual start date.
ASBESTOS ABATEMENT:This Estimate and Proposal assumes that there are no asbestos containing materials ("ACMs") that would be disturbed in the
performance of the installation work. If upon further inspection by the contractor or others it is learned that ACMs have to be disturbed to perform work,then
Customer must arrange and pay for abatement of asbestos by a qualified person prior to the start or continuation of work. If Customer fails to arran e for
necessary asbestos abatement within thirty (30) days, Sears may cancel this contract upon Customer(s)initials '--_
written notice to Customer.
The TOTAL PRICE including all labor,material,taxes and any applicable discount is$ 12,172.02 Contract Price $12,172.02
Initial Payment(not to exceed 30%of Total Price unless Special Order)$ 3,651-61 State Sales Tax( 0.00 %) $ 0.00
Final Payment(balance payable upon completion ofjob)$ 8,520.41 Local Sales Tax( 0.00 %) $ 0.00
The Initial Payment is due prior to Sears ordering products. I Total Amount Due $12,172.02
The form and method by which the Customer(s)will pay is described in a separate Cash/Credit Customer(s)initials
Card Payment Addendum made a part of and incorporated into this contract by reference.
NOTICE TO BUYER: YOU, THE BUYER, MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY
(FIFTH BUSINESS DAY IN ALASKA, FIFTEENTH BUSINESS DAY IN NORTH DAKOTA IF YOU ARE AGE 65 OR OLDER)AFTER THE DATE OF THIS
TRANSACTION.SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT.
ADDITIONAL PROVISIONS
Proposal and Approval.Sears offers to furnish the materials and arrange for their delivery and installation as specified on the first page and/or the attached
sketches and specification sheets for the TOTAL PRICE shown.This offer must be approved by the Installation Department. If this is a credit sale or a payment
on completion sale,it must be approved by the Credit Sales Department. If this proposal is not approved or the installation cannot be made in accordance with
the law,this offer will be withdrawn and any payments you have made will be refunded to you.Any materials left over after the installation has been completed
are Sears property and will be removed by Sears.
Installation. I understand that Sears will not install the materials but will arrange for the installation. Sears is not responsible for materials or installation NOT
furnished or arranged by Sears. Sears'installation contractor(s)will obtain all building permits required by local law. For homes located in historic or landmark
zoning districts,Customer will be responsible for obtaining required approvals and related permits prior to the commencement of work on this contract.
Authorization. I authorize Sears to: (1)arrange for a contractor(licensed where required by law)to make the installation of materials; (2) issue a work order
for this installation to a contractor; (3) inspect the installation; and (4)pay the contractor when the installation is complete if I have signed a certificate that the
installation has been completed to my satisfaction.
Delays in Installation.I agree that Sears is not responsible for delays in delivery or installation due to weather,fire,strikes,war,government regulations or any
causes beyond Sears'control.
Oral Agreements and Changes in Contract.I understand that there are no oral agreements between Sears and me. Everything I expect Sears to do has been
included in writing in this contract. Nothing can be changed in this contract unless it is in writing on a separate form accepted by me and Sears.
Responsibility of Buyer. I agree that any information or measurements that I give to Sears are correct and complete. I am responsible for any special work
described in this contract.
Electrical & Plumbing Service. I will provide adequate electrical and/or plumbing service(s)to run any newly installed appliances or other furnishings. If the
electrical and/or plumbing service(s)do not meet the standards of the utility company or electrical and/or plumbing codes, I will make the necessary changes at
my expense unless Sears has agreed in this contract to make the changes.
Payment.I will pay Sears the cash price that covers the price of material and installation as shown on the first page.
Warranty Information.Appropriate product warranty documents will be given to me by Sears.Sears'Warranty on Installation is:
SEARS'LIMITED WARRANTY ON INSTALLATION
In addition to any manufacturer warranty extended to you on the product(s)used(which warranty becomes effective the date the merchandise is installed),if the
workmanship(or application)of any Sears'arranged installation proves faulty within(i)one year for Weatherbeater Value Line,(ii)two years for Weatherbeater
Plus,or(iii)three years for Weatherbeater Max,and Weatherbeater Stormbeater,then upon notice from you Sears will cause such faults to be corrected by repair
at no additional cost to you.If Sears determines that repair is not commercially practicable or cannot be timely made,then,at Sears'sole discretion,Sears may
elect to provide replacement or refund.Service under this Limited Warranty is available by calling Sears Home Improvement Products at 1-800-222-5030,
Option 4.This warranty gives you specific legal rights,and you may also have other rights that vary from State to State.
SW1-MA (Dig.) Rev 08/13/12 Page 2 of 3
1111111111111111 Office Location:HARTFORD
Proposal Date 03/'13/2014 JJobNUmber 16883397 Sears Home Improvement Products,Inc.
Customer Name `��' P.O. Box 522290
TERESE KATZ 1024 Florida Central Parkway
Customer's Home Phone Customer's Work Phone Longwood, FL 32750-7579
(413) 586-3822 Home Improvement Products phone(800)469-4663
Street Address ESTIMATE AND PROPOSAL Contractor License/Registration Number
1021 BURTS PIT RD MA(148607)
City State Zip code Windows All plumbing and electrical services performed by
FLORENCE MA 101062 Is installation within city limits? licensed subcontractors
Installation Address County HAMDEM (Yes/No): YES FEIN 25-1698591
Billing Address(if different from above) City State Zip Code Project Consultant Name&License No.(if applicable)
MATTHEW GELINAS
Description of the Project and Description of the Significant Materials to be Used and Equipment to be installed
1. Remove existing units to be replaced.(PLEASE NOTE:The removed units are likely to be damaged.)
2. Prepare openings as necessary to receive replacement units. (No finish work other than normal installation is to be done unless otherwise noted below.)
3. Installation includes the clean-up of alljob-related debris upon completion of the job.
4. (If applicable)After the completion of the project,the customer will be responsible for the application and removal (storage)of shutter panels. In the event
that the project requires the installation of storm shutters or egress windows, Sears Home Improvement Products, Inc. ("Sears") will not re-install any
affected security bars.
5. (If applicable) In the event Sears is unable for whatever reason to obtain the proper permits prior to the commencement of any work,Sears will refund any
previous payment and this contract will be automatically cancelled.
Summary of Window Order Addendum(see detailed Window Order Addendum for more information):
Type: WB PLUS (WINCORE) Quantity: 7
Type: WB MAX (WINCORE) Quantity: 2
Type: Quantity:
Type: Quantity:
Type: Quantity:
The Window Order Addendum is made a part of and incorporated into this contract by
Customer(s)initials —T,<—reference.
� ) 0
V �V
Additional work to be done: J
Work NOT to be done:
GARAGE WINDOWS
SPECIAL INSTRUCTIONS:BATHROOM WINDOW TO BE BOTOM OBSURED
All of the above check boxes, "Work NOT to be done," "Additional work to be done," and Customer(s)initials
"Special Instructions"sections have been reviewed and explained to me.
SW1-MA (Dig.) Rev 08/13/12 Page 1 of 3
1 o24 Florida Central Parkway,Longwood,FL 32750 PH:407-551-6000
June 2011
LETTER OF AUTHORIZATION
I, Alfred W. Nyman, Jr., Assistant Secretary and Connecticut State Qualifier for Sears Home
improvement Products,Inc_, grant permission to Nikole Easley to submit permits and licenses,
pick up permits and licenses, make changes to permits, licenses and plans and initial changes
made by the building department on behalf of Sears Horne Improvement Products,Inc.
I also grant permission to Nikole Easley to purchase permits and/or licenses with a company
check,personal check,personal credit card or cash
I certifzy that the above information is true and correct.
n 1
c
Alfred W.Nyman,Jr.,Assistant Secretary and
Connecticut State Qualifier(FUC.0607669,
HTG_0400133-S1)
Sears Home Improvement Products,Inc.
STATE of Florida
COUNTY of Seminole
SWORN TO AND SUBSCRIBED BEFORE W THIS 16th day of June 2011,by Alfred W.
Nyrman,Jr.,Assistant Secretary for Sears Home Improvement Products,Inc.and who is X
personally know to me or has produced a valid Drivers License.
Seal:
1i0TMPIIffidt:,STATR0FF1,=A Print Name: Deborah P.Phillif s
Deborah P. Phillips Notary Public,State of Florida
cammbdoa#DD689052 Commission#. DD689052
&phu: AM.13,2011'
ffi, tvarra�mas�a�ase,nze MY COM11rffSSION EXPIRES:Aug.13,2011
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction,Supervisor: Not FS plicable ❑
Name of License Holder: V 5 ` �' K 6`+� �✓G`1 w�- " /03 V l
� ) License Number ,l
W/4 oloo
Address Expiration Date
0-6,36-
Signature Telephone
9.Registered Home Improvement Contractor: Not Applicable ❑
.150 k�07
Company Name Registration Nu ber
C"
Address / Expiration bate
Telephone
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....... Q— 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.
Derinition 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 5 (1 L ( i-1("4y t,-L 4
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
New House ❑ Addition ❑ Replacement Win Alteration(s) ❑ Roofing ❑
Or Doors
Accessory Bldg. UemolMon New Signs JIM Decks )'g Siding ln] MerIUM
Brief Description of Proposed r
Work: Irk ,r = l� 0 c
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement Yes No
Plans A tadned Ron -Sheet
ea. 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
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
1, T9y R-S
as Owner of the subject
property
hereby authorize ��tl a/ yt"�� �d �yl�� �� a--Slay
to act on my behalf, in all matters relative to work authori ed by this building permit a0lication.
Signature of Owner Date
I, I kc l L =O-5I C, as Owner/Authorized
Agent hereby declare that the 'gis 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.
Print Name
t� 31 11,q
Signature of Owner gent 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
Arkin
#of Parking Spaces
Fill:
volume&Location
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO 0 DON'T KNOW YES Q
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO ® DON'T KNOW O YES 0
IF YES: enter Book Page and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO 0 DON'T KNOW YES
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Q Obtained 0 , Date Issued:
C. Do any signs exist on the property? YES 0 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, excavation, 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.
------- -- Department use only
City of Northampton Status of Permit:
Building Department Curb Cut/Driveway Permit
C 212 Main Street Sewer/Septic Availability,
%' Room 100 Water/Well Availability
! - orthampton, MA 01060 Two Sets of Structural Plans
F? ' 13-587-1240 Fax 413-587-1272 Plot/Site Plans
Other Specify
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
K' . Map Lot Unit
Zone Overlay District
Elm St.District CS District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
Name(Print) Current Mailing Address:
`'- 19�-�- ��-
Telephone
Signature
2.2 Authorized Agent:
4 /k
Name(Print) Current Mailing Address:
L
Signature Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by ermit applicant
1. Building I a l� (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=0 +2+3+4+5) I I'12 Check Number
This Section For Official Use Only
Building Permit Number: Date Issued:
Signature:
Building Commissioner/Inspector of Buildings Date
1021 BURTS PIT RD BP-2014-0989
GIs #: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 36-063 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Buildinq DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: window replaced BUILDING PERMIT
Permit# BP-2014-0989
Project# JS-2014-001711
Est. Cost: $12172.00
Fee: $35.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: SEARS HOME IMPROVEMENT PRODUCT 103054
Lot Size(sq. ft.): 16465.68 Owner: KATZ DAVID A&TERESE
Zoning: Applicant: SEARS HOME IMPROVEMENT PRODUCT
AT. 1021 BURTS PIT RD
Applicant Address: Phone: Insurance:
51 BELAMOSE AVE (860) 620-9036 O WC
ROCKY HILLCT06067 ISSUED ON:312712014 0:00:00
TO PERFORM THE FOLLOWING WORK.-INSTALL 9 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 3/27/2014 0:00:00 $35.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner