Loading...
29-086 (6) 410 RYAN RD BP-2017-0487 GIS a: COMMONWEALTH OF MASSACHUSETTS Map:Block:29-086 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-2017-0487 Project 4 JS-2017-000806 Est.Cost: $2718.00 Fee: $40.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: ROBERT BUSHEY JR 057011 Lot Size(sq.ft.): 12501.72 Owner: KRAUSE GREGORY 3&KAREN L Zoning: Applicant: ROBERT BUSHEY JR AT: 410 RYAN RD Applicant Address: Phone: Insurance: 1029 NORTH RD (413) 485-7335 0 WC W E ST F I E L D MA 010 85 ISSUED ON:10/17/20I6 0:00:00 TO PERFORM THE FOLLOWING WORK:6 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 10/17/2016 0:00:00 $40.00 212 Main Street,Phone(413)587-1240, Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner Department use only �h City of Northampton Status of Perim Building Department atraPottExataxtoYeema N.4,1p ''P 212 Main Street Sete9,tieAvaitdbiflt7i v`� � Room 100 WAfeOF. ailaby8y ‘t;9Me Northampton, MA 01060 ty(q,$amgsialtus cyed" phone 413-587.1240 Fax 413-587-1272 ?faU'Sila praru } LIGATION 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 LUC tMgn TLd. Map Lot Unit tvcr4haroy+antair cto .)- Zone Overlay District Elm St.District CS District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Mr. t ters. km,4,se. i.lin 2yr. ., 12d . 6lr,ca Name(Print) Current Mailing Address: Sec c,Cmit,t1"1 'enc .E6- IOTA ekpM e Signature 2.2 Authorized Agent: it'aisEcIT E Bi16HEy tozet wc,12_ i4 R- kdESTFleLD AAA GIOfic Name(*Print) Current Haring Address: 41'b 4(5 ')335 Signature Telephone SECTION 3-ESTIMATED CONSTRUCTIONCOSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Bei.ding ti 0 0 (a)Building Permit Fee 2 Electrical (b)Estimated Total Cost of Construction from(6) 3 Plumbing Building Pernik Fee 4 Mechanical(HVAC) 5 Fire Protection ���...```��J //0 6. Totale(1 +2+3+4+5) 97(i - OO Check Number )y,y ,((JJ This Section For Official Use Only _ / Building Permit Nu ,- Date Issued: y / Senate /U�,� GZ „/ -/ /' jl petting Commissioner/Inspector of Buildings Date Section 4. ZONING ALL Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size Frontage Setbacks Front Side L. A L: IZ Rear Building Height Bldg. Square Footage Open Space Footage (Lot area minus bldg&paved Parking) r of Parking Spaces Fill: (volume&Location) A. Has a Special Permit/Variance/F ding ever been issued for/on the site? NO O DONT KNO O YES 0 IF YES, date issued: IF YES: Was the permit rec• ded at the Registry of Deeds? NO 0 a•NT KNOW O YES 0 IF YES: enter :..k Page and/or Document# B. Does the site contai a brook, body of water or wetlands? NO O DONT KNOW O YES O IF YES, has a •e it been or need to be obtained from the Conservation Commission? Needs to be •'tained O Obtained O , Date Issued: C. Do any signs - "st on the property? YES O NO O 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 IF YES,then a Northampton Storm Water Management Permit from the DPW is required. SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House 0 Addition ❑ Replacementtndows Alteration(s) n Roofing n Or Doors Accessory Bldg. D Demolition ❑ New Signs [Mg Decks ED Siding[DI Other[cri ir/Brief Description of Proposed i� Work: (a roc/kir-4g rnort+ t«,thrin/.,s i Alteration of existing bedroom Yes No Adding new bedroom Yes No j Attached Nan-liveRenovating unfinished basement Yes No I Plans Attached Roll -Sheet Ga 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 eamh family unit Number of Bathrooms c. Is there a garage attached? d. Proposed Square footage of new construction. Dimensions e. Number of stories? f. Method of heating? Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance- Masscheck Energy Compliance form attached? h. Type of construction I. Is construction within 100 ft.of wetlands? Yes No. Is construction within 100 yr. floodplain Yes No j. Depth of basement or cellar floor below finished grade k. Will building conform to the Building and Zoning regulations? Yes No. I. Septic Tank_ City Sewer Private well City water`Supply SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1, G Ye et V.air r:c- as Owner of the subject property hereby authorize Rc be,z-{ F , p,i;Sho to act on my behalf,in all matters relative to work authorized IV this building permit application. 5.0 Cb rc)-co.c{-1 Signature of Owner Date /0 -5 /I° I, ht 0 f5E l�1 5 NE i_ ,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. RbBECT OtASHEgq Pfint Name 724711 (/CCS i- (47 /0 -5 1 (7'Signature of Omer/Agent Date ISECTIONS-CONSTRUCTION SERVICES I �(I _°7 Licensed Construction Sup rvisn't Not Appticeble ❑ Nese Uoez eHolder: ides...;Zl 1 SkSP}j=;y _ License Number 12-7 ROoSUvr=ter ,Av .570 H Address Expiration Date FEGDI 16 11 ILLS NI4 01030 413 {55tc, L.. _ q Signature Te noir & l2 j ( y 14-Registered Hpme Improvement Contractor Not Applicable ❑ // 1RDELT St-+SNSy XYZ E ts 5 L' 4 I _...._ Covariant(Name Registration,u' ayumber, p W t1}t?1,) vk 512A--D DF iix/G.$TE 2T; M�4SS i 0 v l 3 ` ( 5 ! I B • Address EkoiratiOn Date IO't; :' GfmTTI eb wesiciGt..JA Vi S 'telephone 413'-lti67335 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 11. - Home Owner Exemption The current exemption for`homeowners"was extended to include Owner-occupied Dwellings of one(1) or two(2)familits 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 788. Sixth Edition Section 10833.1. Definition of Homeowner:Person(a)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 boom 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 milder the betide/az permit As acting Construction Supervisor your presence on thejob 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 Laws and State of Massachusetts General Laws Annotated. Homeowner Signature_ 055- C_cgilt cat-t ) The Commonwealth of Massachusetts -.=— Department of Industrial Accidents _ (true of Investigations 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/Organization/Individual): WI A)DOW hal n OF t,/E6T izi4 MA stACNN SETTS Address: 1020. NVQIU Ill) City/State/Zip: WESTFIEiLD MA- 0l0$S Phone #: 413 at 85 - 7335 _ Are JOU an employer?Check the appropriate box: • Type of project(required): I.SI I am a employer with (p 4. 0 I am a general contractor and I 6. 0 New construction employees(full and/or part-time).* have hired the sub-contractors 2.0 s ama sole proprietoror partner- listed on the attached sheet. 7. 0 Remodeling shipip and haveenono employees These sub-contractors have 8. Q Demolition workingfor me ini employees and have workers' any capacity. 9. ❑Building addition [No workers'comp.insurance comp. insurance.: required.] 5. 0 We are a corporation and its 10.0 Electrical repairs or additions 3.0.1 am a homeowner doing all work officers have exercised their 11.0 Plumbing,repairs or additions myself.[No workers'comp. right of exemption per MGL 12❑ Roof repairs insurance required.]r c. 152,§I(4),and we have no employees. [No workers' 13.ES Other R CFJMENT comp.insurance required.] • wapow5 'Any applicant that checks box el must also fill out the section below showing their workers'compensation policy infomation. t Homeovmas who submit this affidavit indicating they are doing all work and that hire outside contractors must submit anew affidavit indicating such. Contracwm that check this box must attached an addidaul sheet showing the name of the sub-connatars and state whether or not those entities have employees. lithe 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 B the policy and job site information Insurance Company Name: 1-1 BER-TV MIRTUAL lM Sl4RF1NGE Polies#or Self-ins.Lic.#: We 2- 31S- 377 q117 -01(0 Expiration Date: 6-7-2D I_ 1_ Job Site Address: 1110 Rol n 12-d- City/State/Zip: Ncr#h r..„q*cn,M'R COE? 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 MOL c. 152 can lead to the imposition of criminal penalties of a fine up to S1,500.00 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,teeeby cent'awief,e f°q aqd p of perjury that the biforms:ion provided above is:me and correct s gnome: 11 111✓v I 6'-r,QC4 / Dae: /0 7 /G Phone#: 413 4g 5 - ?335 Official ase only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# 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#: 0 M CERTIFICATE OF LIABILITY INSURANCE DATE'M"AO"""" 04/01/2016 THIS CER11FICATE 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: H the certificate holder le an ADDITIONAL INSURED, the po0ry(1es) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and condmpns of the coley. certain poncles may reruns an endorsement A statement On Nis certificate does not confer right* to the certificate holder In lieu of such endorsemant(sl. PRODUCERA"'"Or Laurence R. Forrest NAME. Forrest Insurance Agency wlore 413 858 2680 �.. nz 413 858 2685 603 North Main Street E-MAlxi.P.Em. ._„' " CIL,NAI. ADDRESS: East Longmeadow, Mass. 01028 INSURERISI SWOPPING COVERAGE I-� MAICI wsusSRAIALbe11a Protection Insurance Company _ INDEED psUREA x: j Window World Of Western Massachusetts, Inc. INSURER C: 1029 North Road ERP. Westfield, Ma. 01085 INSURER!: • WURSR Ft COVERAGES CERTIFICATE NUMBER: 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 'PINCH THIS CERTIFK:ATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TaROLXY F Spun up rt I TYEE OF MSURAMcE '-4OSA *ND .._— Ham I OFryµ9OtfYm (uwoorTYI yam A GENERALLIASertt x I EACH OCCURRENCE s 1,000,000 I'---XT—y...0OMMERCUL GENERAL!melon 7520025498 Q4/09/16;04/09/17 RRRMsm7,0coi s100,000 (Ci t-MACE q COCUR MED RAP IA,Vone wrong y 10,000 J_ I PERSONAL 8 ADV INJURY IIs 1,000,000 ( 2 :GENCRAL AGGREGATE Is ,000,000.. servvAODREGATeusmAwuesPEn. PPDbacrscnuPIOF ACG 's 1,000,000 POLICY _— PECT X LOG E IAUTOMOULEUAOIUTY 11020018702 05/12/15 05/12/16 OMaweRLR'_IMIT 1,000,000 WasttdolE AUTO ,BODRviWuSNRY IPer uersml ALL MENDE 1 ;SCHEDaeo NJMOE `'q AUTOS faOnnv INJURY lifer na4enn X HIRED AUTOS xII"I1 AUTOS xsO Ia3PemvO_GE—' —"'— A oe IPa,,.ca_yAM A ' x timsamuwika Ix I Occup 4600055451 ,09/09/16 04/09/17 EACH OCCURRENCE '' s 1,000,000 E EXCESS LUN J I CLAWS.w>4 I ASSR£GATE • CONPINS llONRETENTION s s Certificate Of J— I Twc srATO- _ WORKERSND EMPLOYEmM :r L .IY Om Lmvs PPR ANY PRw.uELOIwARmEPIExECUTME Insurance To Follow EL.EACH ACCIDENT s OFFICER/MEMeER EXCLUDED? "/AI pAarMAISRPY In Ml I EL DISEASE.EA EMPLOYED IS I II Yp.mem.mar I �......�.__ OEORpnon or OPEeAttoNS abet et DISEASE.PMWv LIMIT 1 OESCRIPTIOM OF DPERATIONSI LOCATIONSIVE'HCLES IARwhumORO fol.sessions;Remrrts YNeuM.a SAA.MARIS nN"wl CERTIFICATE HOLDER CANCELLATION City Of Northampton . 212 Main Street SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Northampton, Ma. 01060 ACLDaFX DANCE W( THE POLICY PROVISIONS. Attn: Building Dept. AUTRofaeo REPReseNTAUvE 0 nn 0Q it tLIVECCR t '62:!?1thii ®1988-2010 ACORD CORPORATION, All rights resolved. ACORD 25(2010/08} The ACORD name and logo are registered marks of ACORD 4 FYY ACCORD CERTIFICATE OF LIABILITY INSURANCE INA <INWDEF5 Y 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 policypes)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 endorsemen4s), PRODUCER FORREST INSURANCE AGENCY CONTACT 803 NORTH MAIN STREET PHONE FAX E LONGMEADOW, MA 01028E MRL Ert' IA/C Nol: ADDRESS: .� INSURER(e},A.FOROINO COVERAGE HAICO INSURER A: Liberty Mutual Fire Ins 33600 INSURED INSURER ea WINDOW WORLD OF WESTERN MASSACHUSETTS INC 1029 NORTH ROAD INSURER C: I _ WESTFIELD MA 01085 INSURERD: INSURERE: 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 VMICH 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. ITRg0. ABSide POUdY EFF IXlC'1 BY %P Mem OF INSURANCE NSD D POUCY NUMBER �(MWOQIYYYYI IMM/DD/YYYYI LIMITS 1 COMMERCIAL GENERAL UABILtTYEACH OCCURRENCE IS '�PREAiETEAEN IED CLAIMS-MADEiti _ OCCUR PFy'EAGE6 9Bocwr9 _ MED EtP{Poy one pe,san} $ GENE AGGREGATE LIMIT APPLIES PER'. GE PERSONAL Ace RE INJURYTEz NEPAL AGGREGATE _ _ POLICY: IJET LOC I PRODUCTS-COMP/P AGO OTHER :0.VNMOBILEUAep:.TY -..—_ C•W INED l ..LE LV r "- stAcacenTr ANY AUTO BODILY INJURY(Pan person) 7-- OWNED SCHEDULED BODILY INJURY{Per MCDentl _ AUTOS ONLY AUTOS HIRED NON-OWNED ( PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (PKIccFOMU I UMBRELLAWe OCLM EACH OCCURRENCE I- -- EXCESS - EXCESS'IAB CLAIMS-MADE AGGREGATE DEP 1 RETENTIONS ER YR A WORKERS COMPENSATION — --WC2-31S-377947-016 5!1/2016 5/7/2017 AND EMPLOYERS'LIABILITY J atATUTX 5R V OPRIETO WPPRMEWyELOTIVE YIN E L EACHACCIDENT f 1000000 OFF IC-ER/MEMBER EXCLUDED? » NIA (mandatory In NH) EI.DISEASE.EA EMPLOYE EII 10{0^ 000 IOLSCRIPTION OF OPERATIONS belwv E L.DISEASE POLICY LIMIT 1000(100( 1 1 DESCRIPTION OF OPERATIONS'LOCATORSI VEHICLES(ACONO 101,AMMIonal RnMMf S[MONe.maybe.XarMd 11 more apaoa Is ropui,d) WORKERS COMPENSATION INSURANC COVERAGE APPLIES ONLY TO THE WORKERS COMPENSATION LAWS OF THE STATE OF MA. This certificate cancels and supersedes a 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 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN BUILDING DEPT. ACCORDANCE WITH THE POLICY PROVISIONS. 212 MAIN ST. NORTHAMPTON MA 01060 AUTNURIZEn REPRESENTATIVE ! {,Q�AAAIX//l ( Liberty Mutual Fire Insurance �' ©1953-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2013103) The ACORD name and logo are registered marks of ACORD 2919006'7 I 1-17790 I IF-17 WC I shackxr gadalelIbe[[ymucual.con, I sll5/2016 I2:19'1S AN )PINT} I Page I of 2 City of Northampton 212 Main Street, Northampton, MA 01060 Solid Waste Disposal Affidavit In accordance of th4 provisions of MGL c 40, S54, I acknowledge that as a condition of the bilildIng permit all debris resulting from the construction activity governed by this Building Permit shall be disposed of in a properly licensed solid waste disposal facility, as defined by MGL c 111 , S 150A. Address of the work ( 0 R:\\(`n The debris will be transported by: N e itS I fi. CC u\TA I N The debris will be re lceived by: x(,11 t I bfl _ \A\nrz (7 ('°2-qN©I?TR 'ZS) Building permit number: Name of Permit Applicant CDI/)t',Yf" F uShPy /0 /cf ly Date Signature of Permit Applicant ZetiO 39r'd Q-LdrJ1 MOQNIM SSBLSBtETP EDT 9 I91/VI/91 Massachusetts-Department of Public Safety Board of Building Regulations and Standards License:CS-057611Pi r ROBERT E B 127 ROOSEVECFAVE__.-,_::'; Feeding gids FfA`-OE03O Commissioner0612&/2099 ;� "-lir7,-.:/,.1r,r:n....e,//A,�^.%/r.::..Atte/0 ,=_, Office of Consumer Affairs&BusinessRegulatlon 1.1.`11744,,L=._ 71OME IMPROVEMENT CONTRACTOR . rRep stration:3/t 65641 Type: Private Corporation WINDOW WORLD OF WESTERN MASS INC ROBERT BUSHEY 1029 NORTH RD WESTFIELD.MA 01085 - Undersecretary. .Tilt * I' �,h fl Window World of Western Massachusetts n ` 1029 North Road-Hampton Ponds Plaza, • Westfield MA 01085 ,L EP, u.1`" (hikIrrr: SFr �, I A - `. HiscaFh 11''ilal ,!-/_ff�fll//YW{/ `l �;� Phone (413) 485-7335 • Fax (413) 315-3714 Nar-atns-t :;:rt1• iiti BBB "Simply the Best for Less" www.WindowWorldofSpringfield.com HIC # 165641 GOOD p y CSL#57011 HOUSEKEEPING Customer: (irt r 3cj Phone (h) Install Address: 44th / 4A. g4 A/o10 0106 2 Phone (w) y i � Bill Address: E-mail WINDOW WORLDGLASS OPTIONS ADD U-VALUES 4000 Series DH $245 I Li 70 6 SolarZone Glass Package* (LE) $79 6000 Series DH (Triple Pane) $279 k SolarZone Elite Glass Package* (LEE)Window S359 g $89 2 Lite Slider S359 - SolarZone Triple Pane Glass Package $99 3 Lite Slider (1;4,1:a,1;4) Oa vs,1t3) 5619 *AI/So/aloe packages include 1;2 screens,Foam Insulation on Jambs and Head,Double Awning $295 Strength Glass,Double Locks(>29"),Lifetime Glass Breakage and Labor Warranty.Argon Gas Casement LH RH $295 MISCELLANEOUS LABOR Twin Casement(Requires 2 Value+) (0973) (0979) $590 Three Lite Casement(Requires 3 Value+) $885 Full Exterior White Trim/Wrap islaCCrH iwCi $79 41 714 Basement Sliders <55 UI $280 Color Other Than White $10 Hopper(In existing wood) (Vent+ S150) $250 Specialty Custom Int./Ext. Trim Wrap $ Specialty Window $ Aluminum /Vinyl or Steel Out S50/$150 Bay/Bow(Insulated seat,Int.Casing&Ext.Cap) S3475 Mull Removal $30 Garden Window;Insulated seat.Int Casino&Ext.Cap) S1995 - 3rics/Exl.Color/tnt.Woodgra'/Colors calculated in WP/upgraces Mull to Form Multi unit $ad Remove Existing Bay/Bow $400 _ Customer Provided Stops/Trim $45 Reframe&Retrim (stain/paint not included) $400 Install Interior; Exterior Stops M'HrrE VINYL)$55 Roof for BayiBow Window $600 Woodgrain Interior Stops $75 Second Floor Installatio S500 4 1--- _ Install Interior Casing $95 Window Color / Repair; Replace Sill or Brickmould $75 inside Outside Mobile Home Conversion $200 WINDOW WORLD UPGRADES _ Remove! Re-Install A/C or Awning $100 Full Screens $45 - BEIGE Color charge $50 EXTRA LABOR MUST BE IN WRITING - Exterior Color $165 Woodgrain Interior $95 Contoured/Flat Grids (TOP) (FULL) (ENDS) $49 Prairie Grids(Single)i(Doubie)-(Flat)/(Contour) $69 Diamond/Brass Grids (TOP) (FULL) S120 Oriel!Cottage Style (40;60) (60/40) $45 Obscure Glass Per Sash (BOT) (FULL) $35/$70 Tempered Glass Per Sash (BOT) (FULL)$60,IS120 Catalog Options S I PRE 1978 BUILT HOMES (FEDERAL LEAD CONTAINMENT LAW) MY HOME WAS BUILT IN THE YEAR 5✓ > INITIAL: EPA LEAD SAFE (Per Window) $60 Sales RepRecommended: Interior Stops Exterior Capping: EPA LEAD SAFE ;Patio Dr,'Bay!Bow i Garden) $100 [] p [] ppg Customer Declined: [] Interior Stop [] Exterior Capping: EPA Lead, third party verification: • '.475.00 I dec]ine third party verification ❑ (INITIAL f Site Setup, Removal, In Home Service, etc.'. $250:04 4nitial)I have received a copy of the Lead hazard I or".tion pamphlet Extra labor (Box above f1�rr c�escription)S _ in orrtfmg e of the potential risk of the lead hazard exposure from renovation activity to be Total Amount Due$ Y:/ 6 performed in my dwelling unit,the EPA`Renovate Right"brochure. 50% Deposit Amount: $ ' (initial)I have received a copy of the lead test result(s). [} Cash k.Ci,11 C C -7 ,,.r,t �/I ,� � Date: q (2 ! t( H Finance- ( )Wells Fargo ( ) Other Sign: 7��., � . [] Check made to Window World of WM # Name(s)(Print) [I CC# Exp. Date: V-code It tenants reside in home, Renovate Right Booklet left with: -- Final Payment Amount$ 1= i --o be paid to the installer upon installation.Thank You. WINDOW WORLD CARES or left at: St.Jude Children's Research Hospital $ WW of W. Massachusetts anticipates starting this work on ./- C and being substantially completed in days.Security Interest:Yes No 1 Any deposit required in advance of the start of the work SHALL 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 contract is completed to the satisfaction of all parties. 11 All home improvement contractors and subcontractors shall be registered and that any inquires about a contract or subcontractor relating to a registration should te 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 generat taws is required-to apply for-arid of tin of c tfl7 ih-related perrrf'rts.WW'of W.Massa chusetts shall not be deemed responsible for delays in The work described in this agreement caused oy 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. •j 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 RESALEI 1 ` ...,. .;...7. j r Owner Dare Salesman Date Owner Date This btiindow Worlds Franchise is independently owned anc operated by Window World of Western Massachusetts,Inc.under license from Window World,Inc. WM WC 06-76' Whites(:nrnr-rlrininnl Yc ... 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 if 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 after 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 left 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 are intrigued with the process.We do get nervous, however,when a customer constantly hovers over our shoulder.Like any professional, we'relyays happy to answer •uestions,but we,.•.-ciate being able to concentrate on our work without interruptions and distractions. " aensCt#�3'tt safe arnd qua. ',t !..4 sir`: 14. Past'bue Balances are subje •Ce 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 Worlds Franchise is independently owned and operated by Window World of Western Massachusetts,Inc.under license from Window World,Inc. wr,r we 06-16