17A-147 (4) __A_Reg-#104098 RI Reg.#12999
New England Sash, Inc. Federal ID,#04-2889905 CT Reg.#547271
a Main Office: Branch Office:
1331 Grafton Street
Worcester, MA 01604
508-792-9181 •800-300-7274
THIS CONTRACT made the day of inrt�he year between New England Sash, Inc.and
UI 17 t 1I✓t!�L Q` c7�1 n®Y /��r �7 ' gloa Zz
(HOME OWNERS) (HOME PHONE) (BUSINESS PHONE)
BEET) (TOWN) (STATE) (ZIP)
As used in this contract,the words we, us or our refer to New England Sash, Inc.and the words you and your refer to the customer.
We agree to furnis o Material necessary to install the following described windows at: �LJ
Double H.P.
Total Units: Glass Glass Grids: Y Window Color r E' Material: G
Double Hun Units: / We do not do any painting or staining. Installation: r
We are not responsible for conditions or circumstances . 97
Picture Units: beyond our control including condensation resulting from Total Contract:
^� or due to pre-existing conditions.Our limited warranty is
Hopper Units: ` herein incorporated by reference. Sales Tax:
Sliding Units: `— 2-lite"----3-lite:
Awning Units:
� -
Casement Units: ` 1-liteS,�-liter 3-lite�Iite:"- Total /p
Bay/Bow Units: DH/CS \� 3-lite: _4-lite: N'—_.,lite: "--Price: JGf d 11W.ae
Garden Windows: tRoof � 3-lite: - 4-lite: �=liter Deposit 1010,11 Exterior Finish: Soffitt Total Projection: Knee Brackets:Y/ N With Order: 5350,600
Entry Doors: Steel Fiber Style: Scor 3 Add Deposit live''r/y
Storm Doors: Alum W. Core Sty le: Due Date: `� i l?
Sliding Glass Doors: # Color\_ \� Balance Due
Cappin .Y/N # On Delive : 3Dz
r
Additional Notes: } n1d wnckwn on 1'
'�(►
Idh//1:i3/2��1JW44 '1D:3b 7812732266 80P�uCORSO Pr1GE E1
u CERTIFICATE C'fF �,.IiA31L1�'Y INSiU(�/�►NCE --- DATE(MA1lDDIYVYY)
PROUIICER 05/13/2004
(781)273-3200
(76x)273-060D THI CER i ICA EIS 3 U AMAT{EROFINFORMATIO
Bonacnrso TnsUranea Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
891 Cambridge ytroet HOLDER,THIS CERTIFICATE DOES NOT AMEND,EXTEND OR
ALTER THE COVERAGE AFFORDE!p DY THE POLICIES BELOW.
P-fl. Box x502
Burlington, RA 01643 INSURERS AFFORDING COVERAGE NAIC 0
tNBUltaa New England Sash Inc & Nefiiona! Ehergy Systems INS/ A;
Penn-America insurance Company
1331 Grafton Street INSURER B; American Home Assurance Comp4n
Worcester, RA 01604
INSURER 0:
INSURER D:
INSURER E;
COVERAGES
THE POLICIES OF IN.9URANC9 LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIQC INDICATED,NOTWITHSTANDIN
ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERM$,EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES,AGGREGATE LIMITS SHOWN GRAY HAVE BEEN REDUCED BY PAID CLAIMS.
LTR NSR TYPE OF INSURANCE POLICY NUMDER PAT p TE jM W W XIMN
_ ooryyl LIMITS
198NERALLIABILITY FAC6291975 03/10/2004 03/10/200$ EACHOCCURRENCE 11
X COMMERCIAL GENERAL L11ABL IY 2,000.000
CLAIMS MADE OCCUR P9E 1X1 An �t a S 50,000
i i�
A (Any porsm) S 5,000
PERSONAI.&ADV INJURY S 2,000,000
GENERAL AGGREGATE S 2,000,000
GEM(AGGREGATE LIGHT APPLIES PER; PRODU0T9-OOMP/OP A00 S Inc in GA
POLICY PE?4 I=
AUTOMOBILE L"IIJTY
COMBINED SINGLE LIMIT
ANY AUTO (Ea eaddent) S
ALL OWNED P.LITOS
SCHEDULED AUTO$ BODILY INJURY(Par(Par parson)
MIRrCD AUTOS
BODILY INJURY S
NON-OWNED AUTOS (Per seddent)
PROPERTVDAMAGG $
j (Per aoddent)
GARAGE LIABILITY AUTO ONLY-EA ACCIDENT 3
ANY AUTO
OTHER THAN EA ACC $
AUTO ONLY: AGO $
PXCE33IL MBRELLA LIABILITY EACH OCCURRENCE $
I
OCCUR d CLAIMS MADE AGGREGATE
i
$
i RDEDUCTIBLE $
RETENTION 7 $
WORKERS COMPENSATIONANO WC 7694762 04/29/2004 04/29/2005 1 ToRYLIMITS ER
EMPLOYERS'LIABILITY $ .
B MANY PROPRIETORIPARTNERrEXECUTIVE E.L.EACH ACCIDENT Soo 0 0 0_0
OFFICE 1EMBER EXCLUDED? F.L.DISEASE-EA EMPLOYE 3 500,000
!SPSC:,AL PROVISIONS ONS below
H,U,.DISEASE-POLICY LIMIT 5 500,000
OTMER
6136!OPMEN UP i
RATIONS!LOCATIONS I V W -ChIS!EXCLUSIONS APOEO BY ENDORSEMENT I SPECULL FROV)bION3
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE AX*VE 013CRIDED►0610183 BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF,THE ISSUANG INSURER'INLL ENDEAVOR TO MAIL
DAYS WRITTEN NOVICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENIATIM.
SPECIMEN AUTHORIZED REPRESENTATIVE.
Michael 8omacorso
ACORD 25(2001108) OACORD CORPORATION 1289
Dec 02 ,04, 11 : 25a p'
oy`� T
Bfi ag
Grit, Of 'Na-t4aillpfoil
9 6 �xsaac}lnBCtis'
e
m DEPARTMENT OF 13UILDMO INSPECTIONS
212 Main Street ' Municipal Building
Northampton, Mass. 01060
WORICE S COMTENSKMN INSURANCE AFMA.VIT
(licensecJperruiaee)
with a principal place c f businesslresidence at:
(phone#}_
(st=Ucity/stRfd2iP)
do hereby certify, Llnde-the pains and penalties of perjttty, that.
( ) Z am as employer 1 roviding the followilg worker's compensation coverage for my
employees working on :his job:
FfiC49� 4-?6 311b S
(Iavamnee Company) (Policy Number) iris n bate)
( ) I am a sole proprie:or, general contractor or homeowner(circle one) and have hired
the contractors listed b,:Iow who have the following workees compensation policies:
(Nnme of Contractor) (Insurance Cornpaay/Policy Number) (Expiration hate)
(Name of Contractor) _ (Insurance Compai y/Policy Number) (Expiration Date)
(Name of Contractor) Gaisilrancn—C mpauy/Policy Numb(2r) (Expiration bate)
(Name of Contractor) (fnsumncc Comtaay/PoEcy Number) (Expiration Date)
(attach additional z!xd ifnxcniry o include inforntalioa perta nirg to all wctra rn)
( ) I am a sole proprie or and have no one working for me.
( ) X am a home ownel performing all the work myself.
NOTE:plc-sc be amts that wh le homeowtxr,3 who employ Pc=w to do=acuxnee,mnsYVction or repair work on a dwcliing of
cwt moc a then threw units in which tie hotnoowner asides or ort tic grounds aPpu'j',,"i thacto en not&weeny ooarider d to be
VloYtr3'n14 the-Mk-tat Oath?rsation Act(GL152 es 1(5)},application by a homoow=for a fiomx or pawn ruay evidc=the
legal"" of an oovployer under th,Workor's Compemalioa Ace.
1 understand thsd a copy of this 1 i�may bo fwwnrdod to the O partm of lndi dial Aocidw&offioe of Umlm m for tike
O0V-gc vailxtxt'On ctnd that fad=:to t oatre covrtMgo under section 25A of MOL 152 can lead to tbc-imposidon of aimie d pto&lcs
eanisting of a fine Of UP to S 1,300_)0 a yce iarprisovmcal of up to one YW and civil p®ltia is the form of a Stop Work Order and a
fins of S 100.00 a day agniast the
n Fad tt oatY
permit Number
Map:t Lot#
Sid of I-i
Dec 0i?, 04. 11 : 24a p. 6
p ' '.- :tw
8.1 Licensed Construction Supervisor: Not Applicable 0
Name of License Holder
License Number
Address _ Expiration Date
Signature Telephone
Not Applicable El
Company Name Registrat on N mber
1331 CSR f� ,�� i�c► 2�'eS�'ci , >�►. U l Dy i d�
Address Expiration Date
Telephone k 1 m fv�
�1f0�RKERS'COMPEN: 'A1[ON N�SW�tq A*Efl:AyIT M G:L,c;152.§25ty('6)}
Workers Compensation Insurance affid; vit must be completed and submitted with this application. Failure to provide this affida
will result in the denial of the issuance )f the building permit.
Signed Affidavit Attached Yes.x.. ❑ No...... ❑
ii II
The current exemption for"ho neowners"was extended to include Owner-occu ied Dwellings of one(1) or two(2)familic
and to allow such homeowner o engage an individual for hire who does not possess a license,provided that the owner acts
as supervisor.CMR 780, Si a th Edition Section 108.3.5.1.
Definition of Homeowner:Pe rson(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 o•two family dwelling,attached or detached structures accessory to such use and/or farm
structures.A person who con!truets more than one home in a two-year period shall not be considered a homeowner.
Such"homeowner"shall subm t 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 Supet visor your presence on the job site will be required from time to time,during and upon
completion of the work for wh ch this permit is issued.
Also be advised that with refer mce to Chapter 152(Workers'Compensation) and Chapter 153 (Liability of Employers to
Employers for injuries not rest Ming in Death)of the Massachusetts General Laws Annotated,you may be liable for person(;
you hire to perform work for y)u under this permit.
The undersigned"homeowner' certifies and assumes responsibility for compliance with the State Building Code,City of
Northampton Ordinances, Stab and Local Zoning Laws and State of Massachusetts General Laws Annotated.
Homeowner Signature
Dec A2, 04, 11 : 23a p. 5
ORe ....n <.k..._..��. .,. ti
mom RUN-
New
K,. ...Gnwa�!$ P... _ .i ai'•.*"iSF�,Rik"rx. .t.. t.eNxwpq.p .:..F.?('IAt �UW:52iei. INS, 5'q'
..Y.'..RSr�4CVasn.�S:J.��ilnCU$. :Mt,,,�;lS.....�sr_�e�.::.w,£ wNtr..:,;�5!. .:.:'irh::.h, .,d xh;ti •'!T•..,a-: x ;,.r r.i4u tuh,fn,:ami_ mPH:.
House ❑ Addition ❑ Replacement Windows Alteration(s)❑ Roofing ❑
Or Doors X
Accessory Bldg. ❑ DemolitionE New Signs [ ] Decks [ J Siding[ J Other[ ]
Brief Description of Proposed Work: /Ill `L5 C Se (' `
Alteration of existing bedroom Y(s 4_No Adding new bedroom Yes ,C No
Attached Narrative❑ Renovating unfinished basement Yes K _.No
Plans Attached Roll❑•Sheet u
dioristtn"gt .
a. Use of building: One Family _ Two Family Other
In. Number of rooms in each family ur it: Number of Bathrooms
c. Is there a garage attached? _
d. Proposed Square footage of new cc nstruction. Dimensions
e. Number of stories?
f. Method of heating? Fireplaces or Woodstoves Number of each
g. Energy Conservation Compliance._ Mascheck Energy Compliance form attached?
h. Type of construction
i. Is construction within 100 ft.of we*lands? Yes No. Is construction within 100 yr. floodplain Yes
j. Depth of basement or cellar floor b;low finished grade
k. Will building conform to the Buildir g and Zoning regulations? Yes No .
I. Septic Tank City Sewer_ Private well City water Supply
iV
�#iQftlZ/5 10 Y T TO Bl;GOMPLEnb WREN
WP
tP�� � �' R4JlLDRRIVII`T ;.
I' as Owner of the subject proper-
hereby authorize _ _ to act
my behalf, in all matters relative to wor c authorized by this building permit application.
Signature of Owner Date
as 9*A+er/Authorized Agent
hereby declare that the statements anc information on the foregoing application are true and accurate, to the best of my
knowledge and belief.
Signed under the pains and penalties o perjury.
luiss Lt)OL
Print Name
Signature o /Agent Date
Dec 02, 04. 11 : 23a p, 4
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
arkin
#of Parking Spaces
Fill:
volume&Location
s A. Has a Special Pertait/Variance/Finding ever been issued for/on the site?
NO C ON'T KNOW YES
IF YES, date issued:_
IF YES: Was the permit recorded at the Registry of Deeds?
NO E ON'T KNOW YES
IF YES: enter Bool Page — and/or Document #
B. Does the site contain l brook, body of water or wetlands? NO DON'T KNOW
YES
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtain,:d Obtained Date Issued:
C. Do any signs exist on the property? YES _ NO
IF YES, describe siza, type and location:
D. Are there any proposed changes to or additions of signs intended for the property?YES—
No
IF YES, describe siz:, type and location:
w
Dec ,02 04 11 : 22a p• 3
- r �� o� Northampton
r P
r— it il�g p
De artment r
2 Main Street
viJfTNoa Pton,1MA 01060
phone 413587- 240 Fax 413.587-1272 e
APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SEtI(iN+1 �sl �INFORMATION
1.1 Property Address: !,$
6
f istnct u,� e �w
r
SECTION 2- PROPERTY OWNERSHIP/4UTHO T
'01.
2_1 Owner of Record:
b_6A&)A/A M 'CoAM)bR_
Narne(Print) Current Mailing Address:
Telephone j
Signature 'T I,3 b V
2.2 Authorized Agent!
6 rc-
Nam (Print) Current Mailing Address:
Signs ure Telephone
SECTION 3 :ESTIMATED CONSTkJJdT ON't T5
Item Estin sated Cost(Dollars)to be Official Use Only
comr feted by ermit applicant
1. Building `(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
kil-
6, Total = (1 + 2 + 3 + 4 + 5) ^a� Q�--- Check Number
ThisSe.ctton;:For Offfbial.
Use, .6 l
tilJdlr�g PermEt;Number Date Issued::; :
I -- - -
4
�ii��e_.o. � 3�i��•.f✓'Qt�t�i$S,��:�MPiF1��.p.S.;R@C oK Offr�+1'} I -t�` ��.� .,,.. �f�.��s�,.J :°c+s r ;1:.„
I I
256 CHESTNUT ST BP-2005-0654
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map-Block: 17A-147 CITY OF NORTHAMPTON
Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: BUILDING PERMIT
Permit# BP-2005-0654
Project# IS-2005-0872
Est.Cost: $10052.00
Fee:$25.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Groin NEW ENGLAND SASH INC 104098
Lot Size(sq.ft.): 22346.28 Owner: O'CONNOR ED&DEANNA
Zoning:URA Applicant: NEW ENGLAND SASH INC
AT. 256 CHESTNUT ST
Applicant Address: Phone: Insurance:
1331 GRAFTON ST (800) 300-7274 WC
WORCESTERMA01604 ISSUED ON:1218104 0:00:00
TO PERFORM THE FOLLOWING WORK.-INSTALL 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: Receipt No: Date Paid: Check No: Amount:
Building 12/8/04 0:00:00 801 $25.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo
Inc. _-,A Reg..#104098 RI Reg.#12999
New England Sash, I Federal.)D,#04-2889905 CT Reg.#547271
d Main Office: Branch Office:
1331 Grafton Street
Worcester, MA 01604
508-792-9181 •800-300-7274
THIS CONTRACT made the 36 day of in the year between New England Sash, Inc.and
ffloa
(HOME OWNERS) (HOME PHONE) (BUSINESS PHONE)
/
W or BEET) (TOWN) (STATE) (ZIP)
As used in this contract,the words we,us or our refer to New England Sash, Inc.and the words you and your refer to the customer.
We agree to furnis o tyaterial necessary to install the following described windows at:
Double H.P.
Total Units: Glass Glass Grids: Y Window Color E' Material: .
Double Hung Units: / We do not do any painting or staining. Installation:
We are not responsible for conditions or circumstances
Picture Units: ��`� beyond our control including condensation resulting from Total Contract:
or due to pre-existing conditions.Our limited warranty is
herein incorporated by reference.
Ho er Units:
Sales Tax:
Sliding Units: ��- 2-lite7�-lite:
-
Awning Units: 1-liter�,&liter
Casement Units: ---_ \� 1-lite-�,Z-liter 3-liter: �--liter Total
Bay/Bow Units: DH/CS '-- 3-lite: �4-lite: ' :Iite: rice: /0, &el
Garden Windows: ---••- �'-- 3-lite: '*--�4-lite: '--.F21ite: Deposit 100ji 1
Exterior Finish: Roof Soffitt Total Projection: Knee Brackets:Y/ N With Order:
Entry Doors: Steel Fiber Style: p? Add Deposit b0l"Very
Storm Doors: Alum W. Core Style: Due Date: 3 aw, 6 kI
Sliding Glass Doors: # color—, i\ Balance Due
C�a �► k`t�
Cappin :Y/N # e- On Deli ve : �
Additional Notes: o r' -
►-
'P�q owe n n / A-607 OF
e
1)19en _ ,
e� c
q. kp G1 n 4/ e. �Ailk
EPOSIT I H OORDER ❑ C S r Y' �� BALANCE DUE P11.5ASH ❑ FINANCE
You agree to pay cash according to the terms shown above or, if your credit is approved,to sign a note provided by us for payment of the amount due.You also agree to sign a
completion certificate upon completion of the work.If you fail to make payments when they are due,then we may immediately stop work.We may choose to not start work again until
you are current with the payments and we feel secure in obtaining the remaining payments.If there is any stoppage of work due to the preceding,such delay shall automatically extend
the,date of substantial completion.
Payments due and unpaid under this agreement shall bear interest from the date payment is due at the annual rate of 18%or at the maximum legal rate,whichever is less.In the event
that we incur costs or expenses in collecting such payments due and unpaid,you shall pay such costs and expenses including reasonable attorney's fees.In addition,you understand
that by failing to pay according to the above terms,the seller may have a claim against you which may be enforced against your property in accordance with the applicable liens laws.
The installation will begin on or about 6711(1A.6 and will be substantially completed on or about o( ��,�.It is understood by you that the following contingencies
could materially change the estimated completion date stated above: customer's inability to obtain or qualify for financing; inclement weather; strikes or other labor disruption;
non-availability of materials;acts of God.
We represent that we carry Workers'Compensation and Public Liability insurance in the amount of$100,000-1,000,000.
ALL RESIDENTIAL CONTRACTORS AND SUBCONTRACTS ARE REQUIRED TO BE REGISTERED WITH THE MASSACHUSETTS BOARD OF BUILDING REGULATIONS AND
STANDARDS, UNLESS SPECIFICALLY EXEMPT FROM REGISTRATION, INQUIRIES CONCERNING REGISTRATION SHOULD BE DIRECTED TO: DIRECTOR, HOME
IMPROVEMENT CONTRACTOR REGISTRATION,ONE ASHBURTON PLACE,nooki 1301,DOSS f;L 1A 02r.18(617)7 7-'0698.
CONTRACTOR OR SUBCONTRACTOR IS OBLIGED TO OBTAIN THE FOLLOWING PERMITS:M S uI/ �V`m IF WE DO NOT OBTAIN
THESE PERMITS,AND YOU OBTAIN THEM,OR IF WE ARE NOT REGISTERED WITH THE BOARD OF BUILDI G REGULATIONS,YOU WILL NOT BE ENTITLED TO OBTAIN
ANY BENEFITS FROM THE GUARANTEE FUND ESTABLISHED UNDER MASSACHUSETTS GENERAL LAWS,CHAPTER 142A.
ANY DEPOSIT REQUIRED UNDER THIS AGREEMENT TO BE PAID IN ADVANCE OF THE COMMENCEMENT OF WORK SHALL NOT EXCEED THE GREATER OF ONE-THIRD
OF THE TOTAL CONTRACT PRICE OR THE ACTUAL COST OF ANY MATERIAL OR EQUIPMENT WHICH HAS TO BE SPECIAL ORDERED OR CUSTOM MADE,WHICH MUST
BE ORDERED IN ADVANCE OF THE COMMENCEMENT OF THE WORK,IN ORDER TO ASSURE THE PROJECT WILL PROCEED ON SCHEDULE.NO FINAL PAYMENT MAY
BE DEMANDED UNTIL THE AGREEMENT IS COMPLETED TO THE SATISFACTION OF BOTH OF US.
C YOU MAY CANCEL THIS AGREEMENT IF IT HAS BEEN SIGNED BY A PARTY THERETO AT A PLACE OTHER THAN AN ADDRESS OF THE SELLER,
WHICH MAY BE HIS MAIN OFFICE OR BRANCH THEREOF, PROVIDED YOU NOTIFY THE SELLER IN WRITING AT HIS MAIN OFFICE OR BRANCH BY
ORDINARY MAIL POSTED, BY TELEGRAM SENT OR BY DELIVERY, NOT LATER THAN MIDNIGHT OF THE THIRD BUSINESS DAY FOLLOWING THE
SIGNING OF THIS AGREEMENT.
BY SIGNING BELOW, YOU ACKNOWLEDGE THAT YOU OWN THE ABOVE PROPERTY AND THAT YOU AGREE TO ALL OF THE TERMS OF THIS
CONTRACT. YOU ALSO ACKNOWLEDGE THAT YOU HAVE RECEIVED A FULLY COMPLETED COPY OF THIS CONTRACT AND TWO COMPLETED
COPIES OF THE NOTICE OF CANCELLATION AND THAT YOU HAVE BEEN ORALLY INFORMED OF YOUR RIGHT TO CANCEL.
DO NOT SIGN THIS CONTRACT IF TH 5E ARE ANY BLA K SPACES.
IN WIT S WH REOF,the parti ave hereunto signed their names this �3 111- d f in the year ofZ
Signed Signed
MARKETING REPRESENTATIVE OWNER
Signed
Accepted:New England Sash,Inc.