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29-449 (5) �hcavu�c - Window World of Western Massachusetts Ilk 1029 North Road Hampton Ponds Plaza, • Westfield MA 01085 �rrr °? NousE*EEON� 40 Phone (413) 485-7335 • Fax (413)-485-7055 NAT-41779-1 BBB www.WindowWorldofSpringfield.com S�.J�de��dre�s "Simply the Best for Less" ; Research Wldmrfs Customer: rt "` _l Phone (h) Install Address: i �� � '` �"; Phone (w) Bill Address: -E-'mail Color #UNITS TOTAL Prodigy or 4000 Energy Plus(1) (.046 w/ 1 1/2" tot. thick.) 510.x510.00 540.00 Prodigy/Charter oak Window World 4000(2)with 3/8" Fan Fold Underlament (.046) 390.00 420.00 Charter oak Window World 2000(3)with 3/8" Fan Fold Underlament (.044) 360.00 N/A odyssey Window World 1500(4)with 3/8" Fan Fold Underlayment (.042) 330.00 N/A Coventry f, f Window World 1000(Not sold at this location) N/A ' • - • • • - UNIT $550.00 Additional for all Masonry Substrates UNIT $75.00 _:?` ;• :, Remove Old Vinyl & Dispose UNIT $50.00 Remove Old Aluminum & Dispose UNIT $25.00 Remove Cedar Shakes& Dispose UNIT $65.00 Db6'1PPSTER FEE (5 Square or More) Each $500.00 Vinyl Soffit& Fascia Soffit Width 0"- 13" Per LN FT $9.50 • '• .• ', Over 14"-24" Per LN FT $11.00 •• - • ' • Over 24"-38" Per LN FT $13.00 Fascia or Frieze Wrap up to-8" Per LN FT $8.00 Over 8" Per LN FT $8.00 Vinyl Soffit or Porch Ceiling Only SQ FT $6.00 Beam 2 Sided Per LN FT $3.50 Beam 3 Sided Per LN FT $5.50 Window Wrap Each $75.00 Bow or Bay Window Wrap Each $250.00 . - Build out Window Casings Each $35.00 Wrap Entry Door(side lite$35 extra) Each $100.00 Wrap Sliding Door(up to 8') Each $200.00 Wrap Each Single Garage Door Each $300.00 Wrap Each Double Size Garage Door Each $375.00 Existing Gutters&Downspouts-{Remove&-Reinstall) Per LN FT $2.50 New 2 x 3 Downspouts Per LN FT $7.00 New 5K open trough Seamless Gutters(Add$2.00'for SST Hangers or wedges) Per LN FT $9.00 Restricted Accessibility for Materials& Labor/ Inner City Each $750.00 Excessive Height Over 33 Feet Each $500.00 Remove& Reinstall Existing Storms, Pair of Shutters Each $40.00 Remove& Reinstall Awnings Each $75.00 New Solid Vinyl Window Shutters(measured) Per Pair $55.00 New Solid Vinyl Door Shutters Per Pair $250.00 Gable Vents(No Circular or Triangular) Each $50.00 Dryer Vent Each $40.00 (�, �, � Mount Masters Each $20.00 Rotted Wood On fascia Per LN FT $8.00 Rotted Wood on Soffit Per SQ FT $8.00 Add Wood on Open Rafters Per LN FT $8.00 ELECTRIC & BUILDING PERMIT EACH JOB $350.00 i Electric Charges for Light Fixtures 3 Items Max EACH $250.00 Each Additional Item over three EACH $75.00 (1)Std. 16'8" panel. Double 6", Single 7"Clap, or 5" Dutchlap available. $ (2)Std. 12' panel.Also 16'8" &25' panel length for a 15%surcharge (2)Styles: 12', 16' &25' panels in Double 4 1/2"Oak Grain Clap or Dutch NO EXTRA WORK IF NOT IN WRITING! WINDOW WORLD CARES St. Jude Children's Research Hospital $ Sales Rep Recommends Accepted: Owners Int: - Customer agrees to the terms of payment as follows: Extra Labor $ Declined: Int: Total Amount $ r f Custom Order Deposit 1/3 $ Ck# Due on Delivery 1/3 $ � Ck# Credit Card Expiration Date Balance Paid to Installer upon Completion $ Amount Financed $ WW of W.Massachusetts anticipates starting this work on 2 ! and being substantially completed in LL,Jays.Security Interest:Yes No Any deposit required in advance of the start of the work SHALL NOT exceed 331/3%of the total contract price or the actual cost of any material or equipment of a special order or custom made nature, which must be ordered in advance of the start of the work to assure that the project.will proceed on schedule. No final payment shall be demanded until the contract is completed to the satisfaction of all parties. All home improvement contractors and subcontractors shall be registered and that any inquires about a contractor subcontractor relating to a registration should_ be directed to:Office of Consumer Affairs and Business Regulation,Ten Park Plaza,Suite 5170 Boston,MA 02116.Phone: (617)973-8700 No work shall begin prior to the signing of the contract and transmittal to the owner of a copy of such contract. WW of W.Massachusetts under provision of Chapter 142A of the general laws is required to apply for and obtain all construction-related permits.WW of W.Massachusetts shall not be deemed responsible for delays in the work described in this agreement caused by regulatory,permit granting agencies,authorities or individuals. Notice:If the PURCHASER(S)obtains his own construction related permits for the work described under this agreement or deals with unregistered contractors,the PURCHASER(S)is hereby advised that in the event of a dispute,judgement and nonpayment,the PURCHASER(S)will not be entitled to make a claim or collection from the guaranty fund established by chapter 142A,M.G.L. You the buyer may cancel this transaction at any time prior to midnight of the third business day after the date of this transaction. Notice of cancellation must be in writing postmarked no later than midnight of the following third business day. .. THIS IS A CUSTOM ORDER NOT FOR RESALE! t' ` Owner Date Salesman Date Owner Date This Window World Franchise is independently owned and operated by Window World of Western Massachusetts,Inc.under license from Window World,Inc. WM Siding 04-15 White Copy-Original Yellow Copy-File Pink Copy-Customer The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations IF 600 Washington Street Boston,MA 02111 www.mass govA is Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Aa>alicant Information Please Print Legibly Name(Business/Organization/individual): VSO I Al DnUJ h I-b ()F W1rST�R.t�? A4A SS��Nyt5�TT3 Address: 102A N V 91W WD City/State/Zi W F-STf-11 l-fj M r D t 0$S Phone#: L113 ''r ,S — ?33 Are you an employer?Check the appropriate box: Type of project(required): L I am a employer with ?- 4. ❑ I am a general contractor and I 6 Q New construction employees(full and/or part-rime)." have hired the sub-contractors 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. 7. Q Remodeling ship and have no employees These sub-contractors have g. Q Demolition working for me in any capacity. employees and have workers' 9 Q Building addition [No workers'comp.insurance comp. insurance.* required.] 5. Q We are a corporation and its 10.Q Electrical repairs or additions 3.❑.I qua homeowner doing all work officers have exercised their 11.❑Plumbingrepairs or additions [No workers'comp. myself. right of exemption per MGL 12 Q Roof repairs insurance required-]t c. 152,§1(4),and we have no 13 0 Other Rn p,��,r employees. [No workers' W 11t�OwS comp.insurance required.] *Any 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 sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide then workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the poluy andlob srte information. Insurance Company Name: I-16E9:7'V M6CTUAL 1>\I5t4AWeF- Polic%/#or Self-ins.Lic.#: M/C Z-- 3!1 S- 377 a,7 -o Expiration Date: 5--7 Job Site Address: �` �� Q� � ['� City/State/Zip: '1()Y Yl C� (6 Attach a copy of the workers'compensation 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 criminal penalties of a fine up to$I,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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do'rereby certify u the pains and Wallies of perjury that the information provided above is true and correct signatu e: Phone# 3 40o Offrcial use only. Do not write in this area,to be eonpWed by city or town o fflc d City or Town: Permitt icense# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone# SECTION 8-CONSTRUCTION SERVICES 1 Licensed Construction Supervisor. Not Applicable ❑ Name of Ueense Holder: 1�0 ART E dR$i4kV License Number 12-7 RODSE-Ve T AVF 57011 Address Expiration Date FEEDW6 14ILLS MA 01030 413 J55&Ci-)L l Signature Telephone '2-S J I "7 .Registered Home Improvement Contractor. Not Applicable ❑ R�BE2r Bu.sl+>✓y S2 Company Name Registration umber W I�D� W rnRl—D o- W e STE2)% M ASS 1,0 C, 3 T 15) ) Go Address Expiration Date IDA NOM QD WEsTlvl6tZ-1- MA DID65. Telephone 4 i?L4f657339' 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....... No...... 0 i 1. - 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 10835.1. 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 Officials 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 assachusetts General Laws Annotated. Homeowner Signature c t i i SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition F-1 Replacement Windows Alteration(s) ED Roofing 0 Or Doors C7 Accessory Bldg. C] Demolition F-1 New Signs [Q] Decks (Q Siding IM Other(tom] Brief Description of Pr po V Work: VA Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet 6a- 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 900 fL of wetlands? Yes No. Is construction within 900 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. 1. 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, A-11 n) . P—/w as Owner of the subject property hereby authorize to act on my behalf,in all matters relative to work authorized Yy this building permit application. C s-e c 1;AA+rc,Cfl Signature of Owner Date 1, T IJ NEfU 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. Py nt Name �' ,g�4'7 Signature of owner/ gent Date Section 4. ZONING ALL information Must Be Completed.Permit Can Be Denied Due To Incomplete Information Existirmr 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 parkin,a #of Parking SpaCCS Fill: (volume&Location) A. Has a Special Permit/VariancelFin ing ever been issued for/on the site? NO O DONT KNOWS O YES O IF YES, date issued: IF YES: Was the p/brook, t the Registry of Deeds? NO O OW O YES O IF YES: enter Page and/or Document# B. Does the site cont of water or wetlands? NO O DONT KNOW O YES IF YES, has a pe d to be obtained from the Conservation Commission? Needs to be obtained O Obtained O , Date Issued: C. Do any signs exist on the property? YES O NO a IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES O NO O 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 O NO O )F YES,then a Northampton Storm Water Management Permit from the DPW is required. Depart ftnt use only r-- —. City of Northamptons Building Department ow 11411114 2 77 12 Main Street AUG ` Room 100 OHM r W North moton, MA 01060 � '� ��" -1240 Fax 413-587-1272 T;r,i_ 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 Prooertv Address: \j��.w Map Lot Unit m n o l o`o a Zoe Overlay District Eim St District CS District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: S r-�(Print)'�-1 � te' Name Current g Addrg s �_ co R., s C � (JC erA�) 1--' ��..� �j Telephone Signature 2.2 Authorized Agent: R©DEP-T E 13u s N E- 10M tv OM " wF=1STfj eLD AAA 010'69- Name(Print Current Mailing Address: Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only com leted by rmit applicant 1. BuiJing C�1 C� v (a)Building Permit Fee 2_ Electrical I (b)Estimated Total Cost of Construction from 6 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) 5. Fire Protection 6. Totai=(1 +2+3+4+5) Gheck Number This Section For Official Use Only Date Building Permit Number. Issued: Signature: Building Commissioner/Inspector of Buildings Date it 16 CRESTVIEW DR BP-2016-0234 GIS#: COMMONWEALTH OF MASSACHUSETTS Ma:Block:29-449 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: vinyl siding BUILDING PERMIT Permit# BP-2016-0234 Project# JS-2016-000390 Est. Cost: $8995.00 Fee: $35.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: ROBERT BUSHEY JR 057011 Lot Size(sg. ft.): 10018.80 Owner: LEE ERIC Zoning: Applicant: ROBERT BUSHEY JR AT. 16 CRESTVIEW DR Applicant Address: Phone: Insurance: 1029 NORTH RD (413) 485-7335 () WC WESTFIELDMA01085 ISSUED ON.812512015 0:00:00 TO PERFORM THE FOLLOWING WORK.INSTALL REPLACEMENT VINYL SIDING 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 Sisnature: FeeType• Date Paid: Amount: Building 8/25/2015 0:00:00 $35.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner