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Renewal Renewal by Andersen Corporation MA Home Improvement Contractor
byAndersen. 104 Otis St. Northborough,MA 01532 License#170810 (Expires 12/23/2015)
WINDOW REPLACEMENT a.ArulcG] p,,) (508)351-2200 Fax:(508)-986-7072 Federal ID#41-1918413
Window Specification Sheet
IBu er(s)Name Date of A reement
CHRISTINE NOLAN WED, AUG 6, 2014
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
Approx. Exterior/Interlor Color Hardware Hardware LowE4/ Grille Grille Glass
Room # U.I. Window/Door Style Detail casings Ext-Int Color Style Screens Smartsun Grilles Sash 1/3 Saah 2 Lifts Options
Living 1 127 New GT full frame 1:2:1 Ext.Wrap H/w White iStandand FTS SmartSur GBG 2/4 2/4 Yes No
Living 1 73 DB sq rail equal insert sloped sill Ext.Wrap H/w White Standard FTS SmartSur GBG 3/2 3/2 No No
Dining 2 90 DB sq rail equal insert sloped sill Ext.Wrap H/W White Standard FTS SmartSur GBG 4/2 4/2 No No
Kitchen 1 69 DB sq rail equal insert sloped sill Ext.Wrap H/W White Standard FTS ISmartSur GBG 3/2 3/2 Yes No
Kitchen 1 1 90 DB sq rail a ual insert sloped sill Ext.Wrap H1W White Standard FTS martsu GBG 4/2 4/2 No No
Bath 1 1 1 70 DB sq rail equal insert sloped sill Ext.Wrap NH/WI White Standard FTS IsmartSur GBG 3/2 3/2 No No
Office 2 1 86 DB sq rail a uaI insert sloped sill Ext.Wrap H/W White Standard FTS martsu GBG 3/2 3/2 No No
Hall 1 82 DB sq rail equal insert sloped sill Ext.Wrap H/W White Standard FTS IsmartSur GeG 3/2 3/2 No Temper
Bed 1 2 82 1 DB sq rail equal insert sloped sill Ext.Wrap H/w White Standard FTS martsu GBG 3/2 3/2 No No
Bath 2 1 72 DB sci rail equal insert sloped sill Ext.Wrap H/W White Standard FTS martsu GBG 3/2 3/2 No Temper
Bed 2 2 82 DB sq rail equal insert sloped sill Ext.Wrap H/W White Standard FTS 6martSur GBG 3/2 3/2 No No
Bed 2 1 72 DB sq rail equal insert sloped sill Ext.Wrap H/w White Standard FTS SmartSur GBG 3/2 3/2 No Temper
Total 16 BAY&BOW DETAILS *See Bay/Bow Measure Sheet
Style Detail/ Approx. Approx. Number Frame Window End Center LOWE/ Roof/ Hardware
Room Count Style Flankers U.I. Caaln s An le Lftes Interior Ext/Int Color Grilles sashes sashes Screens Smartsun SoffR Color
SPECIALTY WINDOW DETAILS
Full/ Approx. LowE/ Specialty BAY/BOW ADDITIONAL WORK NOTES
Room Count Style Insert U.I. I SmartSun Grilles Grille Style Ext/Int Color Customer is aware that with ba y/Ix,w windows under 72 inches
there will besignifimra glass lose.
ADDITIONAL WORK DETAILS: Piz replace casing in bathroom.All wrap to be black.
I No Contractor will wrap exterior casings with coil stock color of
Owner is aware that Contractor does not do any painting/staining or removal/installation of alarm system or window treatments/hardware.It is the
responsibility of the homeowner to have the alarm system and window treatments/hardware removed prior to installation. We make no guarantee as to
2 v whether alarms or window treatments/hardware will fit after replacement. Customer is also 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 and window style.ft 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 charge for
time and materials unless so stated in this contract.
3 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,doors,storm windows and vacuum nightly included. Upon completion of the job and payment in full,a limited warranty shall be Issued.
4 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# 4401 $ 35
5 Yes All discounts have been applied to this agreement.
6 ✓ Ycs 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 anyway 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
l Sheet.
Renewal by Andersen Corporation Buyers) Buyer(s)
Signature of Project Manager Signature Signature
MARC FIESTA CHRISTINE NOLAN
Print Name of Project Manager Print Name Print Name
lyeneWa' y Corporation Federal Tax ID#41.19184131
MA Home Improvement Contractor
!Andersen. Renewal b Andersen Go oration License#170810(Expires 12/23/2015);
WINDOW ePI_ACCMEMT n„.4".4..�,��<.,.i�q•i����
104 Otis St. Northborouch.MA 01532
(508)351-2200 Fax(5081-986-7072
CUSTOMER WINDOW AND DOOR REMODELING AGREEMENT
I
Buyer(s)Name Date:
CHRISTINE NOLAN - AUGUST 6, 2014
Buyer(s)Street Address City State Zip Code
30 HAMPDEN ST NORTHAMPTON MA 01060
Email Address Home Telephone Number Work/Cell Telephone Number
413-584-9449 413-320-9505
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.
Est.Start Date Method of Payment
Total Job Amount $ 22,289.00 Amount Financed$ 22,289.00
Deposit Received(33%)$ 0.00 Check/Cash
10-12 weeks
Balance Start of Job(33%)$ 0.00 Deposit at signing$ 11,144.50 Check#
Balance on Substantial At Substantial Est Install Time Credit Card
Completion of Job(33%)$ 0.00 Completion$ 11,144.50
2-3 days If credit card is selected.please
see Credtt Card P fmant forma
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 terns 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)
By
Signature of Project Manager Signature Signature
MARC FIESTA CHRISTINE NOLAN
Printed Name of Project Manager Printed Name Printed Name
I
YOU,THE BUYER(S),MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION. j
SEE THE ATTACHED NOTICE OF CANCELLATION FORMS FOR AN EXPLANATION OF THIS RIGHT.
IL---------------------------------------------------------------------------I
li NOTICE OF CANCELLATION NOTICE OF CANCELLATION
Date of Transaction 8/6/11 You may cancel this I Date of Transaction 8/b/14 You may cancel this
transaction,without any penalty or obligation,within three business days from the I transaction,without any penalty or obligation,within three business days from the j
above date.If you cancel,any property traded in,any payments made by you under I above date.If you cancel,any property traded in,any payment.made by you under
the Contract of Sale,and any negotiable instrument executed by you will be I the Contract of Sale,and any negotiable instrument executed by you will be
returned within 10 days following receipt by the Contractor("Seller")of your I returned within 10 days following receipt by the Contractor("SeBer") of your
cancellation notice,and any security interest arising out of the transaction will be I cancellation notice,and any security interest arising out of the transaction will be
canceled. If you cancel,you most make available to the Seller at your residence,in I canceled. If you cancel,you most make available to the Seller at your residence,in
substantially as good condition as when received,any goods delivered to you under I substantially m good condition as when received,any goods delivered to you under
this Contract or Sale;or you may,if you wish,comply with the instructions of the I this Contract or Sale;or you may if you wish,comply with the instructions of the
Seiler regarding the return shipment of the goods at the Seller's expense and risk. I Seller regarding the return shipment of the goods at the Seller's expense and risk. ail
If you do make the goods available to the Seiler and the Seger does not pick them up If you do make the goods available to the Seller and the Seller does not pick them up
within 20 days of the date of your Notice of Cancellation,you may retain or dispose I within 20 days of the date of your Notice of Cancellation,you may retain or dispose
of the goods without any further obligation. If you fail to make the goods available I of the goods without any further obligation. If you fail to make the goods available
to the Seller,or if you agree to return the goods to the Seller and fail to do so,then I to the Seller,or if you agree to return the goods to the Seller and fail to do so,then
you remain liable for performance of all obligations under the Contract.To cancel I you remain liable for performance of all obligations under the Contract.To cancel j
this transaction,mail or deliver a signed and dated copy of this cancellation notice I this transaction,mail or deliver a signed and dated copy of this cancellation notice .j
or any other written notice,or send a telegram to Contractor:Renewal by Andersen,I or any other written notice,or send a telegram to Contractor: Renewal by Andersen,I
1 104 Oti.St. Northborough,MA 01532,BY NOT LATER THAN MIDNIGHT OF 1 104 Otis St.Northborough,MA 01532,BY NOT LATER THAN MIDNIGHT OF
8/9/14 Date I HEREBY CANCEL THIS TRANSACTION. I .(Date) I HEREBY CANCEL THIS TRANSACTION.
i (Date) 1 '
Buyer's Signature Prin Name Data Buyer's Signature Print Name Data
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston,MA 02111
IF www mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information \0%- 4
(� Please Print Legibly
Name(Business/Organization/Individual): &,o ew CA l—'✓\�p P`���
Address: 3o �-Oc- Oe,s
City/State/Zip: A 0 hone#:
Are you an employer?Check the appropriate box: Type of project(required):
1.yJ 1 am a employer with 3 J 4. [:J I am a general contractor and I
employees(full and/or part-time)-* have hired the sub-contractors 6. ❑New construction
2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. remodeling
These sub-contractors have
ship and have no employees 8. El Demolition
working for me in any capacity. employees and have workers'
insurance.:
9. Q Building addition
comp.[No workers' comp.insurance p•
required.] 5. E] We are a corporation and its 10.El Electrical repairs or additions
3.❑ I am a homeowner doing all work officers have exercised their
ri t of exemption r MGL 11.0 Plumbing repairs or additions
myself.[No workers comp. p 12. Roof re
insurance required.]t c. 152, §1(4),and we have no � p�
❑Other
employees,[No workers' 13.
comp.insurance required.]
*My applicant that checks box#I must also fill out the section below showing their workers'compensation policy information.
t 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 subcontractors 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 it the policy and job site
information. `
Insurance Company Name: Q 1 c1
�
Policy#or Self-ins.Lic.#:_rnl1J cs 30(� G( 06 Expiration Date:
Job Site Address: 31) VAT c City/State/Zip: A,a
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expirat on 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 maybe forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do here y ;!;under the pains and penalties of perjury that the information provided above is true and correct
Si afore. Date:
Phone#: a� 1 — 0'),4 u Z,
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
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder: JAIME MORIN 90125
License Number
86 GARDI T. LYNN, MA 01905 _ 10-06-14
Address Expiration Date
617-966-0412 _
Sign r Telephone
8 Realstered Home Improvement Contractor Not Applicable ❑
RENEWAL BY ANDERSEN 170810
Company Name Registration Number
30 FORBES OAD ORTHBORO,MA 01532 12-23-15
Address Expiration Date
Telephone 508-351-2214
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....... 7 No...... ❑
11, -
Home Owner Exemotion
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 L cal Zoning Laws and State of Massachusetts General Laws Annotated.
Homeowner Signature
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all auplicable) 71
New House ❑ Addition ❑ ReplacementAindows Alteration(s) ED Roofing
Or Doors
Accessory Bldg. ❑ Demolition ❑ New Signs [O] Decks [Q Siding [O] Other[EJ
Brief Description of Proposed
Work: REPLACE 16 WINDOWS- NO STRUCTURAL CHANGE
Alteration of existing bedroom Yes X No Adding new bedroom Yes X No
Attached Narrative Renovating unfinished basement Yes X No
Plans Attached Roll -Sheet
Fla. if New house and or addition to existing housino, 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
CHRISTINE NOLAN as Owner of the subject
property
hereby authorize JAIME MORIN
to act on my behalf, in all matters relative to work authorized by this building permit application.
Signature of Owner Date
JAIME MORIN as Owner/Authorized
Agent hereby declare that the statements 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.
JAIME
MORIN
Print Name
Signature of Owner/Agent Date I/ 1
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 0 DON'T KNOW YES
IF YES, date issued:'
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DON'T KNOW kA 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 0 Obtained 0 , 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,excavation,or filling)over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES 0 NO
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
..
����;����� ..._. T
t, „ � I�epartrn�int c� only
v .
ity of Northampton Statuscs �it:
uilding Department Qetrb brlveway ermit W
SEP 2014 ' 212 Main Street ewetlSeptidAvaliability
Room 100 1"ter/lrtell Auailability
0.::t PlU rthampton, MA 01060 Tvvo Sits of Structural 'farts 0AW a -587-1240 Fax 413-587-1272 P€CWSitdFlans
G3tfter Spy
APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION
This section to be completed by office
1.1 Property Address:
30 HAMPDEN ST Map Lot Unit
NORTHHAMPTON,MA 01060
Zone Overlay District
Elm St.District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
CHRISTINE NOLAN 30 HAMPDEN ST NORTHAMPTON, MA 01060
Name(Print) Current Mailing Address:
413-584-9449
Telephone
Signature
2.2 Authorized Anent
JAIME MORIN 30 FORBES ROAD NORTHBORO,MA 01532
Name(Print) Current Mailing Address:
508-351-2214
Signature Telephone
SE TI 3,/ESTIMATIED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by ermit applicant
1. Building $22,289.00 (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) Check Number
This Section For Official Use Only
Date
Building Permit Number: Issued:
Signature:
Building Commissioner/Inspector of Buildings Date
ow
30 HAMPDEN ST BP-2015-0311
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 38D-023 CITY OF NORTHAMPTON
Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: windows replaced BUILDING PERMIT
Permit# BP-2015-0311
Project# JS-2015-000582
Est.Cost: $22289.00
Fee: $35.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: RENEWAL BY ANDERSEN 090125
Lot Size(sq. ft.): 14897.52 Owner: NOLAN PATRICIA&DENNIS NOLAN&ROBERTA NIEZGODA&C
NOLAN
Zonin-p. URB(100)/ Applicant: RENEWAL BY ANDERSEN
AT. 30 HAMPDEN ST
Applicant Address: Phone: Insurance:
30 FORBES RD (508) 919-0900 WC
NORTH BOROMA01532 ISSUED ON.911812014 0:00:00
TO PERFORM THE FOLLOWING WORK.INSTALL 16 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 9/18/2014 0:00:00 $35.00
212 Main Street, Phone(413)587-1240, Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner