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29-467 (6) 9 CRESTVIEW DR BP-2017-0038 GIS(1: COMMONWEALTH OF MASSACHUSETTS Map:Block:29-467 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: window replaced BUILDING PERMIT Permit# BP-2017-0038 Project# JS-2017-000062 Est.Cost:$6431.00 Fee: $40.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: WINDOW WORLD/ROBERT E BUSHEY JR 57011 Lot Size(so. ft.): 12240.36 Owner: KILBRIDE ROSEMARY&MICHELLE M Zoning: Applicant: WINDOW WORLD/ROBERT E BUSHEY JR AT: 9 CRESTVIEW DR Applicant Address: Phone: Insurance: 1029 NORTH RD 1413) 485-7335 0 WC WESTFI ELDMA01085 ISSUED ON:7/12/2016 0:00:00 TO PERFORM THE FOLLOWING WORK:INSTALLING 14 REPLACEMENT WINDOWS & 1 REPLACEMENT STORM DOOR 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 7/12/2016 0:00:00 $40.00 272 Main Street, Phone(413)587-1240,Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner Department use only City of Northampton Status ofPermit: -. Building Department cmbtutheeeway Permit 212 Main Street saer/SepticAselann'fity Room 100 Wafix/WeaitYP Ydyr Northampton, MA 01060 TWoSelsofsfa SlSags phone 413-587-1240 Fax 413-587-1272 Ptoi/Si�Plaras Cdher Specl'fy__ 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 vl l.r/StVlai(Yin Map Lot Unit F l o e nc e i r i n m ica Zone Overlay District Orn St District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 11 Owner of Record: rcemnry La11hnd{ I,YPs1V1 DLL_ Name(Pont) Current Mailing Address: Li1.3- sag- aIt-R S L. UC rrI R-. 1 'y Telephone Signature 2.2 Authorized Agent: -I 7 C. l' 'Ht: `] 102-Ck Iv i)F-TH !Lb eo=Slr-IEL Sc Name(Punt)Current Mating Address ( 11. tit 443 43S -i 535 Signature Telephone SECTION 3•ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1 Bui.iing 191 I a I (b (a)Building Pemld Fee 2. Electrical 'T (b)Estimated Total Cost of __.. Constriction tram(6) 3 Plumbing Building Permit Fee 4. Mechanical(HVAC) 5 Fire Protection �n "4` 3_ T + otale(4t 2+34+5)_��31 .CC) Check Number At-pS 4/0 m... This Section For Official Use Only Building Permit le Number Iss Issued Signature' Building Commissioner/lnspedor of Buildings Date SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) 1 • New House Li Addition I Replacemenf {indows Aheration(s) n Roofing n Or Doors IT4i Accessory Bldg. 0 Demolition I I New Signs [p] Decks [p Siding10j Other ,Brief DescSa o Work: S' M (� 14 rep�nvem- 1 - . .. r . . --1- - . la/M� nent ll Alteration of existing bedroom_ Yes No Adding new bedroom Yes No s 11 ` c1 }Y li Attached Narrative Renovating unfinished basement Yes No t (o1^ Pians Attached Roll -Sheet alA t 4 I Ga.If New house and or addition to existing housing, complete the following: a Use of building i One Family Two Family Other b. Number of rooms in each family unit Number of Bathrooms c Is there a garage attached? I I d. Proposed Square footage of new construction. Dimensions a Number of stories? I 1i f. Method of heating? Fireplaces or Woodstoves Number of each g Energy Conservation Compliance_ Masscheck Energy Compliance form attached? h. Type of construction I i Is construction within 100 ft.of wetlands? Yes Na 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 PERI M"R I, �GSSeJTV3Vy Kilt% rii-e . as Owner of the subject Property �p {�� �c ,/gyp hereby authorize 1 O i ,k ¶A \1 " A) - to act on my behalf,in all matters relative to work authorized b this building permit application. • b c L,rtr✓cif ) 7- 4, 14, Signature of Owner Date I, t 0 f5l 1 ',3iASI-tt'-J 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. ,^ Uf>c;C I 31,:4 HE_V 1 Pjint Name / / t✓�S (f 7 / J gnat ure of Owner/ gent 7 Date I Section 4. ZONING ALE Information Must Be Completed.Permit Can Be Denied Due To Incomplete Information Existrng Proposed Required by Zoning This column to be tilled in by Building Department Lot Size f Frontage Setbacks Front Side L: A L: R Rear Building Height Bldg.Square Footage - Open Space Footage i (Lot arm minus bldg&panel parking) _ ;<of Parking Spaces Fill: (volume&Lemon) A. Has a Special Permit/Variance/Finding evt been issued for/on the site? NO O DONT KNOW O YES 0 IF YES, date issued: IF YES: Was the permit recorded a e Registry of Deeds? NO 0 DONT 'OW O YES O IF YES: enter Book Page and/or Document it B. Does the site contain a beak, body of water or wetlands? NO O DONT KNOW O YES 0 IF YES, has a permit .--nor need 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 0 NO 0 IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES 0 NO O IF YES, describe size, type and location: E Wil the construction activity disturb(clearing,grading,excavation,or filling)over 1 acre or is it part of a mmmon plan that will disturb over 1 acre? YES O NO O IF YES, then a Northampton Storm Water Management Permit from are DPW is required. SECTION 8-CONSTRUCTION SERVICES A,- 8.1 Licensed Construction supervisor. Not Applicable ❑ Nameof License Holder_ I`(1tYr[LT L_ Dt;S 11EA/ License Number IG- / 'i ODS G'.: r-.LT Ab ,-. _ 5 Address Expiration Date i EEEDki(i HILLS 4174 0h7?v 9l3i;c-cF4-1 )tjli Signature Telephone �,,. <� I -7 0-( �' p-‘;.-4-;---- . Registered Home Improvement Contractor. Not Applicable ❑ R f EuCT Si&S4E'/ U-I-2._ I to' 5 L• (I I Compare Name Registration Number pumber by l n 7 b : h) sed GRL b,'�D vi- 5 .-7_;- : M 4 .-- - c "3 1 i; 1 5 1 I CJ Address Expiration Date I C71; v'CI�TIt 1 w E.574- is ,YIA r/n)jS Telephone={13 ti'S57335 SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L a 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 C No ❑ 11. - Home Owner Exemption The current exemption for"homeowners"was extended to include Owner-occupied Dwellivas of one(I) or two(2)families and to allow such homeowner to engace an individual for hire who does not possess a license,provided that the owner acts as supervisor.CMR 780. Sixth Edition Section 1083.5.1. 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 are-ssory to such use and/or farm strucnues.A person who constructs more than one home in a two-year period shall not he 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 buhldin2 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 Gable 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 La/ws/fandr / State of�Maassachusetts General Laws Annotated. Homeowner Signature (See c ' (ndf r l i ) The Commonwealth of Massachusetts. -- Department of Industrial Accidents e -"4'.6Office of Investigations 41/4 f,— ' 600 Washington Street Boston,MA 02111 - : , www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/OrganirauoMndividual): WI M DOW WpRLD 0'r WESTFRt. MASS4CHtk5ETT5 Address: 102-4 maim R7 City/State/Zip: WE67FIELI) MA- OtOSS Rhone#: 413 et45 - 7335_ _ Are you an employer?Check the appropriate box: - Type of project(required): I.® I am a employer with l,17 4. ❑ 1 am a general contractor and I employees(full and/or part-time).F have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet 7. 0 Remodeling ship and have no employees These subcontractors have g. ❑ Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers'comp. insurance comp.insurance.: required.) 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.0.1 am a homeowner doing all work officers have exercised their I 1 Plumbingrepairs or additions myself [No workers' comp. right of exemption per MGL 12❑Roof repairs insurance required)' c. 152, §1(4),and we have no employees. [No workers' 13.E1 Other REFI ME/JT VOWS comp.insurance required.) 'Any applicant that checks box#1 must also fill out the section below showing their workers compensation policy inforsntion. 'Homeowners who submit this affidavit indicating they are doing all work and ten hire outside connacors must submit a new affidavit i diradng such :Connectors that check this box must attached an additional sheet slowing the Tome of the subconwectors and state whether or not those entities have enwloyees. If the subcmnacmn have employees,they must number.provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below B the polity and job site information Insurance Company Name: LI BEAT) MttTUAL WStateuslCE Policy#or Self-ins.Lic.#: Si%C 2- ,;l71S- 377g1J7 -0j� Expiration Date: 5-7-an L ,- Job Site Address: 9 ( r r ZZi L r ' City/State/Zip : Florence rence MIp T O t oleo d 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$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 may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do.hereby cerdjp undeeps a pains and penalties of perjury that the information provided above Is ane and correct Signature: 1 (J"0 £ " p-- Date: 1h it, Phone#: 413 tit'4t5 - -inc Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/Ircease# Issuing Authority(circle one): I.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: . CERTIFICATE OF LIABILITY INSURANCE e"E(MMmp"Y"' 09/01/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER comfy 1Laurence R. Forrest Forrest Insurance Agency NAME:E 413 858 2680 FAX 413 858 2685 603 North Main Street EMAIeL REaU IMC.Rep ADDRESS: East Longmeadow, Mass. 01028 EalauvORDING COVERAGE I xsuR RaiC. INsuER A Arbella Protection Insurance Company INSURED INSURER s: Window World Of Western Massachusetts, Inc. INSURER c. 1029 North Road I Westfield, Ma. 01085 INSURER E: I „4,,,,,,,F. COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOP THE POLICY PERIOD INDICATED. NOTWITHSTANDING 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 TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ._. __. POLICY EFF - TYPE OF INSURANCE II POLICY NUMBER IMMJ DfYYVT N°IMODIYTYM L AR GENERAL x OCCURRENCE rams 1,000,000 XExs COMMERCIAL GENERALLIABILITY 17520025998 .09/09/1604/09/17 ii PREMISES(EaEo UrrmPEI ''S 100,000 ' CLAIMS«APE xIOCCUR MED ETA TAW one mmMmm 'IS 10,000 I PERSONAL&ARV INJURYIs 1,000,000 GENERAL AGGREGATE S 2,000,000 i GENII AGGREGATE I PRODUCTS-COMOP AGO 51,000,000 —1 I PPOLICE' pE[- F'PER LOC PJr _ COMBIxa AUTOMOBILE LLLinton - 11020018702 05/12/15 05/12/16 (Ea aW.$e.eSINGLE LIMIT IS 1,000,000 J1 ANYo TOjjj --I SCHEDU • LED UDOILY INJURY HPE, eFs+N $ A J'AUTOS • BODILY INJURY mereanene $ Ao 5 PROPERTY DAMAGE _.— _.AUOWxEO $ X HIRED AUTOS X _ AUTOS (PTI xcq A x UMBRELLA Luc IX 1 ' X0 OCCUR ,9600055451 09/09/16 4/09/17 EACH OCCURRENCE s 1,000,000 B I EXCESS �rI CLAIMS-MADE - AGGREGATE S RETENTION $ Is WORKERS COMPENSATION I certificate of I TSIC:uMls I toe ANY mETORPARTWwE.ECUTve YINRHA Insurance To Follow EACH ACCIDENT R ''$ GEFICEMMEMBER IMandatory in Nil) DISEASE-EA EMPLOYEE 5 i,yes(Hypes Geer DESCRIPTION of OPERATIONS b&Da j E .DISEASE POLICY LIMIT S DESCRIPTION DE OPERATIONS,LOCATIONS I VEHICLES(Misch ACORD WI,Addiional Re,I..n.Scladue,N more Amami,,Pul,al CERTIFICATE HOLDER CANCELLATION City Of Northampton SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 212 Main Street THE EXPIRATION DATE THEREOF NOTICE WILL BE DELIVERED IN Northampton, Ma. 01060 ACCORDANCE WRH THE POLICY PROVISIONS. Attn: Building Dept. AumoR¢ED REPRESENTATIVE Cip J�,� 0\ZWILIC „CCIR I7a�1 I 01988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD ACORO CERTIFICATE OF LIABILITY INSURANCE DATE MMIDWYYYVI 4/152016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCERCONTACT T INSURANCE AGENCY NAME. 603 NORTH NORTH MAIN STREET PHONE ku E LONGMEADOW, MA 01028 INC x0 EMAIL wc.No: ADDRESS: INSURER(SIAFFORDING COVERAGE NAICU INSURER A: Liberty Mutual Fire Ins 3360.0 INSURED INSURER B: WINDOW WORLD OF WESTERN MASSACHUSETTS INC — 1029 NORTH ROAD INSURERc: WESTFIELD MA 01085 INSURER 0: _ . INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: 29470857 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING 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 TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRrypE OF INSURANCE ADM_SUBR I POLICY EFF pIXJCY E%P LTR INSn MD POLICY NUMBER •IMMIDDM'YYI IMMIDMYYIYI LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCES CLAIMS-MADE OCCUR • DAETo HLNT EO �II I PREMISES(Ea occurrence I $ _ -__ - LIED EXP(Any one person) $ PERSONAL&ADV INJURY S GENT AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE _ E J POLICYPR ' -OC I PRODUCTS•COMPIOP AGG E - J JE OTHER $ AUTOMOBILE LIABILITY EO SINGLE LIMIT E (Eaacc IEse¢MNJlj• I ANY OWNED BODILY INJURY der person) S , ir� SCHEDULED BODILY INJURY(Per accident/ S AUTOSIRED ONLY AUTOS D AUTON ONLY PROPERTY DAMAGE AUTO$ONLV �AUTOG ONLY (Per accident/ -_ 5 UMBRELLA LIAR OCCUR i 'EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE DED RETENTIONS I$ A (WORKERS COMPENSATION I WC2-315-377947-016 ' 5/7/2016 5/7/2017 / PERTUTE I KH- AKI EMPLOYERS'LJABILIry Y N • VPROPRIETOR/PARTNERIEXECUTIVE EL.EACH ACCIDENT 5 1000000 IOFF:CERIMEMSER EXCLUDED? N NIA Il Mandatory In NH) EL DISEASE-EA EMPLOYEE S 1000000 yes,Tesoro*under DESCRIPTION OF OPERATIONS below I EL DISEASE.POLICY LIMIT 5 1000000 OESCRIP90N OF OPERATORS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks schedule.may be attached N more space Is required) WORKERS COMPENSATION INSURANC COVERAGE APPLIES ONLY TO THE WORKERS COMPENSATION LAWS OF THE STATE OF MA. This certificate cancels and supersedes all previously issued certificates,only as they relate to workers compensation Coverage. CERTIFICATE HOLDER CANCELLATION CITY OF NORTHAMPTON SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE BUILDING DEPT. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN MAIN ST. ACCORDANCE WITH THE POLICY PROVISIONS. NORTHAMPTON MA 01060 AUTHORIZED REPRESENTATIVE _ I ��� nr Liberty Mutual Fire Insurance /`�Nj✓lL//(h/j 4Cl//yT/- �/I ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 29410e57 I I-377947 I :6-17 WE saana -awleaLmergmutaa1-com i 4r5/20_e 12.19,28 Nt (PDT) Pdge 1 of Massachusetts-Department of PsSlic safety Scare of Buirdinc Regulations zee Standards :;cense:Gr-057011 t...ns ROBERT E Busifity,.>�� 127 ROOSEVZLTAVIEILL, Waft FIs MA-010$ -: srrots E;;ertattzr CG.—•,?sSicns: 00.12212017 i7„-Yi,.i.e.r.,.i.,I'r...ha,�.,II;..-,,,eLo Ofite of Consumer Affairs&Business Regulation -jHOME IMPROVEMENT CONTRACTOR -6,_sRegistration: 155541 Type: -:+ Expiration: 3(1572028 Private Corporation WINDOW WORLD OF WESTERN MASS INC ROBERT BtUSHEV 1029 NORTH RD WESTFIELD,MA 01085 Undersecretary I A/ (5 I 1 � , y i o t %,��; 11 '/ e. Window World of Western Massachusetts0 r 1 029 North Road Hampton Ponds Plaza, • Wesfield MA 01085 I !I V w t Phone (413) 485 7335 Fax (413) 315-3714 N10141779-1BB6 "Simply the Best for Less" _ www.WindowWorldofSpringfield.com HIC #165641 ! - , Customer {fr< I i;:L.' y /--..//11 I/b H `P Phone (h) { S ,! F -, 714 Install Address: / (1 ,7 j e/{t /• • / Phone (w) Bill Address: ji/L., ?'4'C ��Gb 2-- E-mail WINDOW WORLD ,..-- �, GLASS OPTIONS ADD U-VALUES '3 4000 Series DH $245 /-.7)( r]." 1 / 7 SolarZone Glass Package* (LE) $79 11 ..' " 6000 Series DH (Triple Pane) $279 / Picture Window , $359,777SolarZone Elite Glass Package* (LEE) $69� 2 Lite Slider $359 SolarZone TK2 3 Pane Glass/Krypton(6000 Only) $185 3 Lite Slider (V<,vz,rat gra.r/3,r/sr $619 *AN Sobrione packages include 1/2 screens,Foam Insulation on lambs and Head,Double Awning $295 SaengtkGlaas,Double Lacks(>291,Iihtime Glass Breakage and Labor Warranty,Argon Gas _Casement LH RH $295 PRE 1b78 BUILT HOMES (FEDERAL LEAD CCCOyONTAINM N Twin Casement(Requires 2 Value+) (0973)(0979) $590 MY HOME WAS BUILT IN THE YEAR j9 YtINITIAL _Three Lite Casement(Requires 3 Value+) $885 EPA LEAD SAFE(Per Window) See"- Basement Sliders<55 UI $280 EPA LEAD SAFE(Patio Dr/Bay I Bow I Garden) $44X- Hopper(In existing wood) (Vent+$150) $250 Specialty Window $ EPA Lead,third party verification: $47$.00 Bay/Bow(Insulated seat,Int.Casing&Ext.Cap) $3375 I decline third party verification E)(INITIAL): Garden Window(Insulated seal,Int Casing&Ed.Cap) $1995 (Initial)I have received a copy of the Lead hazardnofrmatm pamphlet informing me of the potential risk of the lead hazard exposure from renovation activity to be Grids/Ext.Comdint.Woodgrain/Colors calculated in WW Upgrades performed in my dwelling unit,the EPA"Renovate Right"brochure. Remove Existing Bay/Bow $300 Reframe 8 Retrim (stain/paint not included) $400 (initial)!have received aco of the le t st Roof for Bay/Bow Window $600 —�( ) Py A4'R'F![esult(s). Second Floor Installation $500 Sign: „Zit?'' f---* S a',. c�-. Date:‘,4-1--a) tf---/� Window Color (,)(H r I (, > /17 2yii / Name(s)(Pri .. y - i c if;r+6e Inside Outside WINDOW WORLD UPGRADES (/ MISCELLANEOUS LABOR nt Full Screens $45 T Full Exterior White Trim/Wrap{SMOOTH) (Pvq'$79 BEIGE Color charge $50 Color Other Than White Ext.Color(AT) (AB) (DC) (HK) (FG) (ER) (CG) $165 Specialty Custom Exterior Trim/Wrap $ Woodgrain Interior(LO)(DO) (CH)(FX)(RM) (SM) $95 Aluminum/Vin or Steel Out $50/$150 Contoured/Flat Grids (TOP) (FULL) (ENDS) $49 Y Prairie Grids(Single)/(Double)-(Flat)/(Contour) $69 Mull Removal $30 Diamond/Brass Grids(TOP) (FULL) $120 Mull to Form Multi-unit $30 _Oriel/Cottage Style (40/60) (60/40) $45 Install Interior/Exterior Stops !wHns JANA)$55 _Obscure Glass Per Sash (BOT) (FULL) $35/$70 Tempered Glass Per Sash (BOT) (FULL) $60/$120 Customer Provided Stops/Trim $45 . Catalog Options. _.._._.$. _. Install Interior-Casing . - $95 - VINYL PATIO DOORS -LH or RH (Outside Looking In) Repair/Replace Sill or Brickmould $75 (Includes:White Interior Casing and Exterior Trim.) Mobile Home Conversion $200 5 Ft./6 Ft.Sliding Patio Door(LH) (RH) $1500 Remove/Re-Install NC or Awning $100 8 Ft.Sliding Patio Door(LH) (RH) $1800 Misc. $ _Patio Door Beige Color $125 Patio Door SolarZone $125 Site Setup, Removal, In Home Service, etc.: teal Heat Buster Package Upgrade SolarZone Elite $215 Extra labor(Box on left for descrip ion)$ /5l .e Patio Door Grids (Regular) (Woodgrain) $100 Total Amount Due$ L"0 Woodgrain/Brown (LO) (DO) (CH) (FX) $295 50%Deposit Amount: $ Exterior Colors $395 Patio Door Triple Pane Upgrade $250 Keyed Lock$36 Foot Lock$51 (--- I] Cash /" Storm Door ;3 ,, Model a ;�pl, ; - fjtinance-( 7wells Fargo ( ) Other NOXXTRA-WORK IF NOT IN WEjfT1N�G��!------^—� �, I CC#H k a t md0 tit WM# - lir I ; r ti L 7 ' __ .'TI sC- Exp. Date V-code 1/1211 j ai I/l; G1 rb % r 14::'\.- Final Payment Amoum$ _ To be paid to the installer upon installation.Thank You. Sales Rep Recommended: [) Interior Stops -1 Exterior Capping WINDOW WORLD CARES Customer Declined: [) Interior Stop [) Exterior Capping] St.Jude Children's Research Hospital $ WW of W.Massachusetts anticipates starting this work on - - /(And being substantially completed in/ /days.Security Interest:Yes No Any deposit required in advance of the start of the work SHALLL NOT exceed 33 1/3%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 conTractis completed to the satisfaction of all parties. All home improvement contractors and subcontractors shall be registered and that any inquires about a contract or 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.Massa- chusetts 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 hind 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 ISA CUSTOM ORDER NOT FOR RESALE! /Q 11.17]1]1/ I) $iC ✓til']' , Owner Date t';/r( (-,? / /6> Salesman / riff Owner Date This Window Wod®Franchise is independently owned and operated by Window World of Western Massachusetts,Inc.under license from Window World,Inc. win We 03-16 White Copy-Original Yellow Copy-File Pink Copy-Customer Hayes Printing 81313-687•1 116 PREPARING FOR YOUR NEW WINDOWS AND DOORS Congratulations on your decision to increase the comfort level, value and appearance of your home. To maximize your investment and enable the installation to take place as smoothly as possible,we have created this handout to acquaint you with what to expect when our installers arrive. 1. Expected Delivery Time. All of our windows are custom made at one of our manufacturing plants located around the country and shipped to any of our over 200 Window World locations.The time between when your order is placed and when the windows are ready to be installed,though not guaranteed is typically 6 to 8 weeks.At that point we will call you to set an installation date.If for some reason you need to delay your installation for more than a couple of weeks after notification that we are ready to install your order we will be happy to work with you.We will need to collect the remaining balance before installation if the delay you request is more than three weeks. 2. Access to the Windows and Doors.We will need approximately 2 feet in front of each window, inside your home, so we can place our drop cloths and tools necessary to perform our work.When the old windows are removed,gusts of wind typically flow through your home. It is advisable to gather together important papers,and other small items that can be disturbed by the wind and relocate them.Computers and other electronic equipment should be covered or relocated temporarily. Please move aside any furnishings that are in the way of our work. If any furniture items are too heavy to move easily,we will gladly assist you. 3. Window Coverings.To gain access to the interior of the windows,we need all mini blinds,vertical blinds,roll-up shades,shutters,drapes and any other window covering removed prior to our installation.We are not responsible for removing or reinstallation of these items and are not responsible for damage resulting in the removal and reinstallation. We also are not responsible for any window covering alterations that may be required to reinstall them. 4. Plants and Bushes. Occasionally we need to work in planters and other landscaped areas of your home that are adjacent to the windows and doors. Please survey your yard prior to us arriving and look for potential problems. Some trees and vigorous bushes need to be pruned back to give us access to your windows. Delicate plants and shrubs in areas right below a window should be temporarily relocated it they cannot survive being stepped on and you want to preserve them.We strive to be careful when working around vegetation, but our priorities are to focus on our work,your windows and our safety while working on your property. We are not responsible for any damage to plants,shrubs or landscaped areas. 5. Arrival and Departure Times.We will advise you of the expected arrival time for our crew at the time we set up the installation date with you.We generally stay till the job is done, unless it will be a 2 or 3-day job, in which case we may work as long as there is daylight. It is our policy that our installers get a sign-off form and collect the outstanding balance at the completion of the job.We ask that you be available to approve the job and make final payment at the time of completion. If this is not convenient for you, we need to know before we start the job. Inclement weather and other unforeseen hindrances are a fact of life and as such we ask that you understand if the weather,traffic, etc.cause a delay or cancellation of an installation appointment.We typically do not schedule more than a day or two in advance to try to avoid such issues. 6. Our Worksite. We like to set up our worksite as close to your windows and doors as possible and generally your driveway is the best spot. If using the driveway will block a garaged car, please be ready to pull it out upon arrival. 7. Alarm Systems. For those of you who have alarm systems, the alarm company should be notified and advised of our job.They will be responsible for the disconnection and reconnection of your alarm system. 8. Where do we start?Upon arrival,the crew leader will survey the job and determine where to begin. If you have a preference,feel free to advise us and we will accommodate to the best of our ability. Because we work in stages (i.e., removal of old windows, setting the new window,wrapping of exterior, etc.),we don't complete the job one window at a time.The job moves along in a rolling progression where each operation is done on all windows at the same time.This produces a quality job. 9. If the job takes more than a day,will there be any openings in my house?Of course not.We only remove that which can be reinstalled in the same day.Although there may not be a complete window, it will be weather-tight and secure for overnight. (Please no critiquing at this time). 10. Pets. We love furry, four-legged creatures: however, we need your help in supervising them. We are not always able to close a gate or door behind us when carrying a window,so please keep them in a safe place.Our job description does not include scampering down the street after Fido with new found freedom. Many people say,don't worry, he doesn't bite, but many installers have been bitten. So please secure dogs that have an aggressive bark towards strangers. 11. Expect some dust, noise and general disruption of your living space. Construction work can sometimes be messy depending upon the scope of your job. It's an unfortunate reality of remodeling, but we do our best to keep things under control. We appreciate your patience and understanding during the job and until everything is finished. Even atter we have cleaned up, it is advisable to survey the areas for something we may have overlooked (i.e., kids rooms, baby's room). 12. *Damage to walls and old trim stops. For those of you who have old aluminum and steel windows and are replacing them due to sweating and damaging of the walls be advised that all water damage plaster will most likely fall out. In addition, all the patch work you have done over the years will fall out also.This is normal; however,we are not plaster experts, so the repair to those walls would best be Jeff to the experts. In some cases due to out of square openings, new trim is required to make the window look good. *Unless noted on the contract new trim will not be provided or Installed by us. You can expect to do some touch up painting on the trim after the installation of your new windows.This is not always necessary and is usually minor if it occurs. If your trim stops around your sashes are very old, dry,and brittle,they may snap and crack upon removal. If this happens, we can leave them off if you please,or for a small up charge, replace them with newer ones. Many of the old style stops are no longer available so we would replace the entire window with newer style stops. Should we discover any hidden damage to the frame or wall area we will advise you before we proceed. Should you decide to replace or repair anything,the price will be added to your balance. 13. Relax and enjoy the show.After we've been introduced to your home, feel free to run errands, take a walk, or just relax. If a question should arise; by all means ask the crew leader for clarification. We enjoy people who are interested in what we do,and most customers gued with the process.We do get nervous,however,when a customer constantly hovers over our shoulder.Like any professional, ways hep) o answer queeibns,but wiikeeciate being able to concentrate on our work without interruptions and distractions. This ensures a safe and quality installation. 14. Past Due Balances are subject to a service charge of 1.5% per month. In the event that this amount is placed in the hands of an attorney for collection,the purchaser agrees to pay all costs of collection, including a reasonable attorney fee. Return check fee is$50 (fifty dollars). Salesperson Home Owner P.S.Now would be a good time to review contract with the salesman to be sure of your order options and work to be done. Only the items and services on the contract will be done.If you have any questions whatsoever,now is the time to ask. Window World of Western Massachusetts may not require an acceleration of payments as specified in the payment section (front) for the reason that he deems himself or the payments to be insecure. However,where the contractor deems himself to be insecure he may require as a prerequisite to continuing said work that the balance of funds due under the contract,which are in possession of the owner,shall be placed in a joint escrow account requiring the signatures of the home improvement contractor and the owner for withdrawal. Arbitration: Window World of Western Massachusetts and the PURCHASER(S) hereby mutually agree in advance that in the event Window World of Western Massachusetts has a dispute concerning the contract, Window World of Western Massachusetts may submit such dispute to a private arbitration service which has been approved by the Secretary of the Executive Office of Consumer Affairs and Business Regulations and the consumer shall be required to submit to such arbitration in M.G.L.c 142A. Window World Owner Date Date NOTICE:The signatures of the parties above apply only to the agreement of the parties to alternate dispute resolution initiated by the contractor. The owner may initiate dispute resolution even "where this section is not signed separately by the parties." This Window World' Franchise is independently owned and operated by Window World of Western Massachusetts.Inc.under license from Window World,Inc. WMWC03-16