29-106 (8) 540 RYAN RD BP-2017-1351
GIS#: COMMONWEALTH OF MASSACHUSETTS
Man:Block: 29- 106 CITY OF NORTHAMPTON
Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: Siding BUILDING PERMIT
Permit# BP-2017-1351
Project# JS-2017-002246
Est. Cost: $13500.00
Fee: $40.00 PERMISSION IS HEREBY GRANTED TO:
Const,Class: Contractor: License:
Use Group: WINDOW WORLD/ROBERT E BUSHEY JR 165641
Lot Size(sq.R): 21431.52 Owner: PURDY MARILYN A TRUSTEE
zoning_:- Applicant: WINDOW WORLD/ROBERT E BUSHEY JR
AT: 540 RYAN RD
Applicant Address: Phone: Insurance:
1029 NORTH RD (413)485-7335 0 WC
W ESTFI ELDMA01085 ISSUED ON:5/23/2017 0:00:00
TO PERFORM THE FOLLOWING WORK:INSTALL REPLACEMENT 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 Signature:
FeeType: Date Paid: Amount:
Building 5/23/2017 0:00:00 $40.00
212 Main Street, Phone(413)587-1240, Fax: (413)587-1272
Louis Hasbrouck-Building Commissioner
Depadment use only
City of Northampton Slams ofPermit
Building Department Cp¢rGdG9 #,rmlx'1
212 Main Street SevitenzeptltAvailef hty
Room 100 Wffia74VatiAv_aiIaL7My
i
Northampton, MA 01060 TwoSSFI,S i>thgg$lans -
phone 413-587-1240 Fax 413-587-1272 hfot ,
OMerspedfy
APPLICATION TO CONSTRUCT,ALTER,REPAIR,
RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1-SITE INFORMATION ("/' / 7-1 35
1.1 Properly Address' This section to be co pitied by office
Sy0 c d0 R `
(_ Map Aq Lot to Unit
I�, � G 1
�y� -}� �i Zone Overlay District
V
Y o r- `' Q IUn m s3 CAn(C) Ebn SL District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
►► 111 - F,yan RA
Name(Print) Current Mailing Address L`
S—
Q- ` »L,
/
)& Lc:cirri' C f Telephone l
Signature
2.2 Authorized Agent:
hiNam :D(5r:" t 13 Lcv 162-Ct )v:12-71-1 J) I.oE511=I-LD Anw lrl 0€S-
Name
e(Pont 1 �7 i/�/j/�7 ////9' Current Mailing Address'
�(jl'�4-j �,//.-U�O"o+-y 413 4<15 1 h3S
Signature / Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Bui ling ' f 66 (a)Building Permit Fee
2 Electrical (b)Estimated Total Cost of
Construction from(6)
3. Plumbing Building Permit Fee
4 Mechanical(HVAC)
5 Fire Protection
6. Total=(1 +2+3+4+5) t ?- SY',(y C ° Check Number{3i cQ Ya
This Section For Official Use Only
Building Permit Number. Date
Issued �/ yyy---777
Signature: �'� . ;
Building Commissioner/Inspector of Buildings Date
y4 ECTION 5-DESCRIPTION OF PROPOSED WORK(Check all applicable)
New House U Addition [ I Replacement Windows Alteration(s) Roofing [
Or Doors Cl
Accessory Bldg. ❑ Demolition New Signs [CD Decks [ILI Sidin• et Other(L
/Brief Desaipdon of Proposed (� < y �
Work: snSYc �\ tnC3\ fr. ()ICAC' '.("ne11 J1Ati/'�
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement Yes No
Mans Attached Roti -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 earn family unit Number of Bathrooms
c, Is there a garage attached?
d, Proposed Square footage of new construction Dimensions
,,. Number of stories?
f Method of heating? Fir aces 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 'niched grade
k. Will building conform to the Suildin and Zoning regulations? Yes No
Septic Tank City Sever Private well City water Supply
SECTION Ta.-OWNER AUTHORIZATION-TO BE COMPLETED WHEN .... ........
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
coca ( G a as Owner Of the subieci
property •
...
hereby authorize ' A ff .cR
to act on my behalf,in all matters relative to work authorted b ilding permit application.
Signature of Owner Date
f51-11:5- ',3 c' 5 Ht '-j ,as OwneriAutharized
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.
Pant Name
/Signature ofOwrter/A9ent .... ........Date � (,,,.t jam.._
Section 4. ZONING Nl Information Must Be Completed.Permit Can Be Denied Due To Incomplete Information
Existing Proposed Required by Zoning
Psis column to be filled in by
Building Department
Lot Size
Frontage
Setbacks Front
Side L: fe L: It
Rear
Building Height
Bldg.Square Footage
Open Space Footage % f
(Lot area minus bldg&paved I
parking)
of Parking Spaces
(volume&Lomvon) I
A. Has a Special Permit/Variance/Ending ever been issued for/on the site?
NO O DONT KNOW O YES O
IF YES, date issued:
IF YES: Was the permit recorded at Nit-Registry of Deeds?
NO O DONT -•W O YES O
IF YES: enter Book Page and/or Document#
B. Does the site contain . 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 obtained O Obtained O , Date Issued:
C. Do any -gns exist on the property? YES O NO O
IF , 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. 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 8•CONSTRUCTION SERVICES
Licensed Construction Supervisor. Not Applicable U
Name of License noisier; )ZI)Prt"i.I tE bk.('}dt�
License Number-
70 II
Address Expiration Date
1E6Ects_... Id ILLS. ... G.O-3i„l 911 A1558r;19 •
3lgnature .. Telephone /. zr
Al 24.1
Registered Home Improvement Conimcter. Not Applicable 0
in'oe'E Cr b LUQ.i'cvf z1b 5L '4 )
Company Name Radisha ion Number o
w .J73aw o:,cK+L.D o - I.. 471z_; Mr-14b i;- L: 3/ 151 18
Address Exfration Date
10-2.ivf,KIT) 5'_D wat.5i4iir— ,'vi,9 0IPS , Telephone 1-112,4 f; /33
SECTION ilk WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L C.162,§25C(6)1
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.
Si.ned Affidavit Attached Yes No C. ........
11. - Home Owner Exemption
The current exemption for`homeowners"was extended to include Owner-gccupied 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 snnervisor.CMR 780, Sixth Edition Section 108.3.8.1-
Definition of Homeowner-Person(s)vac own a parcel of Sand on which hetshe 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 peISpp who contracts more than one home int a two-year period shall pot be considered a homeowner.
Such"homeowner"shall submit to the Building Official,on a form acceptable to the Building Official,that be/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,von may be liable for person(s)
you hire to perform work for you under this permit
The undersigned"homeowner"cadfies 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 Ammeter'.
Homeowner Signature 4. _ -„
Tke Commonwealth of Massachusetts
t , Department of Industrial Accidents
ie. •t
>._N` Office of Investigations
,J 4 600 Washington Street
:v, _
Boston,MA 02111
' www.mass.gov/dia
Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name(Business/OrganiratioMndividuaq: W , pop, , pi k r WE ,. M • _ CI-11456 . S
Address: I 024 0111211I 27 _
City/Stare/Zip: WE57F ELD Mt4 Ot0$$ Phone ti: 413 `t IS - 7335
you an employer?Are
Check the appropriate (required):
of project(requed):
1.ig I am a employer with IS 4. ❑ I am a general contractor and I 6. ❑New construction
employees(full and/or pan-time).' have hired the sub-contractors
2.0 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. 0 Building addition
[No workers'comp.insurance comp.insurance.:
renes] 5. 0 We are a corporation and its i0.0 Electrical repairs or additions
3.0.1 am a homeowner doing all work officers have exercised their 11.0 Plumbingrepairs or additions
myself.[No workers'comp. right of exemption per MOL 12.0 Roof repairs
insurance required.]t c. 152,§I(4),and we have no
employees.(No workers' 13.I Other REPLACEMENT
MttFDDw7$
comp. insurance requiredl
'Any applkmt that checks box el must also fill our 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"Mirror'indicating such.
:Contactors that check this box must attached an additional sheet showing the mune of the svbconosaors and ane whetNe or not those entities have
emplor,.a. If the sub-contractors have employees,they most provide their workers'comp.policy number.
I am an employer that is providing workers'compensation inaoronce for nm employees. Below is ate porky and job site
information.
Insurance Company Name: LI SERI) MtLTUAL IAISu9ANCE ...
Polio#or Self-ins.Lic.e: We 2.- 315- 317147 -04 Expiration Dare: 5-7-2D.tS—
lob Site Address: C' o r a s w A _city/state/zip: Iv}OL{^t�MMA bictaaa
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 tan 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.4ereby certify the paain' ofpesjnry dal the information provided above is awe and correct
Signature: G.
++ .. vvfm /4,. _ Date: 5 -/ ? - ( '7
Phone#: Li la 4B 5 --7335 _,
d
Official use only. Do not write in this area,to be completed by city or town official
City or Town: Perni0Lieense it
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 A:
e
Massachusetts-De:arimer t of?colic Sa?so:
Oa:3 Ot .--:_- -:Y^cell=2.IC^_ =lam ?9^C12:.^_5
L CS-031011 r+-,
Lp
ROBERT SBUSflY,JR:n
127 ROOSEVELT/WE__..
FredingHUh l7`A`'01630
s 211"v.
-
J�Pi.�111W-tiy� 6::2i'201
Cornrmssianer 06/28/2077
7/ F. .”D/y n=
."--__Office of-Consumer Affairs&Business Regulation
\ ,—
-HOME IMPROVEMENT CONTRACTOR
2e91stration 165641 Type:
Expiration 3/15/2018 Private Corporation
WINDOW WORLD OF WESTERN MASS INC
INO RD ROBERTTH y —
1029 NORTH RD
WESTFIELD,MA 01085
Undersecretary
CERTIFICATE OF LIABILITY INSURANCE asmatav°"""
03/31/2017
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 INSIMUR(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIflCATE HOLDER.
IMPORTANT: It the cenifcnle 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 Ihin certificate does not confer rights to the
cenigcate holder in lieu of such endorsement(s).
PRoeucER wore Laurence R. Forrest
Forrest Insurance Agency nose 2680 .. 1 Ax 3 858 2685
413 85'8 Iac.sss
603 North Main Street ENA4 "'
AMR Ess: -. _,
East Longmeadow, Mass. 01028 INSuRERIS)AWONmxn*OVERAGE
xAlc•
NSURER A:Arbella Protection Insurance Company ,
stems —...._.. _..... . . _ ........
INSURERS.
Window World Of Western Massachusetts, Inc. "wsceWRC,
1029 North Road nrwRER o.
Westfield, Ma. 01085 INSWIERE:
xlsuRenE
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAW 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.
Abet a WA I POIXVRRP FOLCV ExP
LTA TV$ OF W5ORANCE nn MICR NUMBER pom0MYYYI 4sawvtVn LBma
A p
GENERAL LRERRY - x Eaal occunRENCE j 51,000,000
I COMMERCIAL GENERAL LIABILITY '.7520025998 04/09/17 09/09/18 DAMAGE-10 RENttn
g DAMAES IRLNIE Mncel 5 100,000
Goa
I I CLAIMS:MADE IX OCCUR MED ESP(Any olIfler,n) 5 10,000 .........
_ PERSONAL S ACV INmAR 5 1,000,000
GENERAL AGGREGATE s 2,000,000
sEHL AGGREGATE OMIT APPLIfSAEG PRODUCTS-COMWOP AGG 5 1,000,000
POLICY 1JEc T WC
WM/MOBIE LMaeIrY 1020018702 04/09/17 04/09/18 mace fit)
Is NGLL LIMIT $ 1,000,000
raNma
ANY UNE
ROSILY INJWY(Par PoIwn)
— FL NEO AUTOS LEO
A X M,O ( ecomuci YihW a-- IS
, X ufOnVTOti pppX ' NgWNED IPP,aaentj IS _.
AUTOS 1
A xI UMBRELLA OM/ IX OCCUR 4600055451 04/09/17 04/09/18 EACH OCCURRENCE s 1,000.000
Bwe r CLAIMSMAOE AGGREGATE is
mTENTION 5 IS
WORKERS COMPENSAtION I Certificate Of STATU- OTR.
1
AND EMPLovens'tiAenm v __LIMITS R I
I rod FT0PRETOaTITNERoiECUTIVE IN'.NA Insurance To Follow EL EACH ACCIDENT I.$
R ERwa
NMI f.L DISEASE-EA EMPLOYEE I5
I OEECAII=TOI W OPENnWS oepw EL LKEASE-POMMY LAST `,5
I
DESORPTION OF OPERATIONS I LOCATIONS/VEWCLES/Attach ACORO lie.NMbml Remota Seuvue,1 rttP1M is rtmmu)
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 W
Northampton, Ma. 01060 ACCORDANCEWEDI TIE POLICY PROWSONS,
AIRNORIIID REPRESEM(ilvE
Attention: Building Department
@19$82010 ACORD CORPORATION. Ag rights reserved.
ACORD 25(2010/08) The ACORD name and logo are registered marks of ACORD
A ® CERTIFICATE OF LIABILITY INSURANCE
4/28/2017
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS 140 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 poiicylies)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 endorsements).
PRODUCER FORREST INSURANCE AGENCY dON1ecr
603 NORTH MAIN STREET `ISE No EMT: --- rex
--
E LONGMEADOW, MA 01028 Ea - --
ADDRESS:
INSURER(S)-AFFORDING COVERAGE NAC N
INSURER A: Liberty Mutual Firelnsurance 23035
INSURED INSURER .w
WINDOW WORLD OF WESTERN MASSACHUSETTS INC `- -- - -
1029 NORTH ROAD
WESTFIELD MA 01085 INSURER V:
INSURER E:
INSURER F.:
COVERAGES CERTIFICATE NUMBER: 35323654 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAW 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.W�
INP' Ado.yno ..POLICY. Mrmorr rl
LTR TYPE OF INSURANCE.. ipso SUM NUYBER r wins
COMMERCIAL GENERAL SMBaRY 1 EACH OCCURRENCE $
CAIMSMADE II I OCCUR 4WEMISESSEn Dornwcel __$ _.....
1 __ -- -. MED EXP(Any one person) S
I
I—_'_- _ PERSONAL B ADO INJURY 15_
GEN'L AGSREGATEf LIMIT APPLIES PER'. I GENERAL AGGREGATE f5
__I POLICY l jE�T LOC i PRODUCTS-SOWNOPAGC 5 ..
.._ .....
OTHER 5
I AUmpioase umsuTY COMBNEU Swat LIMIT $
(Ea
IANY AUTO BODILYLYINJURY OSP person) S
OWNED AUtOSULEO UOOILY INJURY SW ambp) S
I_I AUTOS ONLY �AUIOS _. .
AIRED AGN-0W.YEO I PROPERTY DAMAGE ($
AUTOS ONLY __AVfO501JLY (PoracddN).........
S
I UMBRELLA LIAB IOCCUR EACH OCCURRENCE 5
EXCESSLIAB I CLAIMS-MADE I AGGREGATE 5
__..
DEDSC.........P RETENTIONS { .. $
A AND
IfhC2-31fr3T'/94T-0tT 511t2017 5Rt2Di5 J STATUTE ERN-E
AND EMPLOYERS' Y - -
ANfPRCPRImOWPARTNEARTNER/EXECUTNE YIX EL.EACHACCIDENT E 1000000
RWEROEREXOIUDEPI Y Ni
(Mandatory
- - -- -
(Mandatory IO NN) Et DISEASE-EA EMPLOYEE $ 100000
000
[DESCRIPTIO woe.
OPERATIONS bolos I EL DISEASE-POLICY LIMIT 5 1000000
I
i
DESCmFTON OF OPERATIONS/LOCATIONSI VEHICLES(AODM 101,motions Rosario Schedule,mann/Sachet/M Mote space Is required)
WORKERS COMPENSATION INSURANCE COVERAGE APPLIES ONLY TO THE WORKERS COMPENSATION LAWS OF THE STATE OF Mk
This certificate cancels and supersedes all previously Issued certificates,only as they Sate to workers compensation coverage,
CERTIFICATE HOLDER CANCELLATION
CITY OF NORTHHAMPTON 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 PROVBIONB.
212 MAIN STREET
NORTHHAMPTON MA 01060 —
MONORZEORENY6HtTATNE p e
-C.P/7-e.e d. F-o-a---"
I Liberty Mutual Fire Insurance
611986-2015 ACORD CORPORATION. All rights reserved.
ACORD 25(2016103) The ACORO name and logo are registered marks of ACORO
3,n-,Esa I 1-377 3 113 16 NC I n021025E 14aer>m+ 6:30:39 Ts IPV!) I ;woo I or 1
vvinaow vvorld 2000 with 318" Fan Fold Underlayment (.044) 600.00 Odyssey/Carvewood 1`f it.-7.(eber '
Tyvek 50.00 I' 1/
VINYL SHAKES OR SCALLOPS
Triple 5" or Double 7" UNIT $800.00
With 3/8 Insulation &STD Corners . INSTALLATION OPTIONS
Additional for all Masonry Substrates UNIT $75.00
Remove&Dispose Existing Siding UNIT $75.00 _ .i .;
Remove & Dispose Existing Siding(RRP) UNIT $100.00
Vin I Soffit& Fascia Soffit Width 0"- 13" Per LN FT S9.50 f (
Porch Post Wrap S 13.50 Per LN FT Over 14"-24" Per LN FT $11.00 _
Add: S 2 Per LN FT to R&R Railin.s Over 24"-38" PerLN FT $13.00
Fascia or Frieze Wrap up to-8" Per LN FT $8.00
I Over 8" Per LN FT $8.00
Vinyl Soffit or Porch Ceilin2Only SQ FT $6.00 _ _
Beam 3 Sided Per LN FT $5.50
Window Wrap Each $75.00
Bow or Bay Window Wrap Each , S250.00 -
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) PerLN FT, $2.50
New 5K open troLgh Seamless Gutters(Add 52.00'for SST Hangers or wedges) Per LN FT $9.00 r a
Excessive Height Over 2 FloorNictirian Each $500.00
Remove& Reinstall Awnings ,.,{. „ Each S75.00
New Solid Vinyl Window Shutters(measured) A, 00 N el ui) p Per Pair _ S55.00 ,
Gable Vents (No Circular or Triangular) Each 350700
Dryer Vent Each $40.00
Mount Masters/J Block Each $20.00
Rotted Wood On Fascia Per LN FT $8.00 _
Rotted Wood on Soffit Per SQ FT $8.00
QisposallDumpster Fee Each $595.00 $595.00
BUILDING PERMIT Each $250.00 $250.00
Misc.
Misc.
_ -
Misc. I
PRE 1978 BUILT HOMES (FEDERAL LEAD CONTAINMENT LAW) WINDOW WORLD CARES
MY HOME WAS BUILT IN THE YEAR INITIAL: St.Jude Children's Research Hospital $_
EPA Lead,third party verification: $450 -
decline third party verification (lN1TlAL): Customer agrees to the terms of payment as follows:
(Initial)I have received a copy of the Lead hazard information pamphlet / Extra Labor S
informing me of the potential risk of the lead hazard exposure from renovation activity to Pe 1 1
performed in my dwelling unit,the EPA`Renovate Right"brochure. C� Total Amount $ I
(po
(initial)I have received a copy of the lead test result(s) Custom Order Dept Isis t 1/3 $ � ° Ck#
Sign: Date: l Dte Due on Delivery 1/3 $ ./) Ck#
Namels)(Prirti -
If tenants reside in home,Reiovato Right 3ooklet eft with: Credit Card Expiration Date
Balance Paid to Installer upon Completion $
or eft at:
"" Amount Financed $
NO EXTRA WORK� IF NOT IN RITINGI 3/4
114-i
:e._ a 7i-co ,P
t 1-1,r-ri.-174)
.,ew ,/mss ,s, n ,.-.5---,7 , �`� CD°
qi2t r"-
�Il r��✓a tea z'it,P`,e
WW of W. Massachusetts anticipates starting this work on /- -� �'/17 and being substantially completed in ays.Security Interest:Yes No
Any deposit required in advance of the start of the work SHAL NO exceed 33 1/3%of the total contract price or th 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 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.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!
.Dumpster or Disposal Trailer for siding material only. Customer is responsible for any extra charges due to any non siding items
such as mattresses. air conditioners, refrigerators,tires, etc.
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This Window Wodde Franchise is independently owned and operated by Window World of Western Massachusetts,Inc.under license from Wirdow World,Inc.
wM Siding 02-17 White Copy-Original Yellow Copy-File Pink Copy-Customer
pruned back to give us access to your siding area. Delicate plants and shrubs in areas rignt next to siding snouia oe 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 your siding and our safety while working on your property. We are not responsible for
any damage to plants, shrubs, or landscaped areas.
G• 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. It is our policy that our installers get a sign-off form and collect the outstanding balance at the completion of the
job. We need you to 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. We ask you to
understand the weather, traffic, etc. can cause a delay or postponement of an installation.We typically do not schedule more than
a week in advance to try to avoid such issues.
�• Our Worksite. We like to set up our worksite as close to your home 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.
3. Exterior Wall Decorations. Please have all items hanging on the walls on the outside of your home taken down to prevent them
from falling. We are not responsible for anything falling off shelves, hooks. or the like while working on your home.
7. 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 siding,
preparing the substrate, wrapping of exterior, etc.), we don't complete the job one side at a time. The job moves along in a rolling
progression where each operation is done on all sides at the same time. This produces a quality job.
3. 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 supplies, 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.
9. 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. Even after we have cleaned up, it is advisable to survey the areas for something
we may have overlooked.
10. Pre-Existing Damage/Issues.We are not liable for any pre-existing damage or issues with the home.This includes but not limited
to, rotted wood, damage caused by pests, old and/or brittle materials on the home. Any additional work not previously described
on the contract will be subject to a change order.
11.Window World is NOT responsible to damage to LAWN or DRIVEWAY due to material and dumpster placement.
12. 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're always happy to answer questions, but we appreciate being able to concentrate on our work without
interruptions and distractions. This ensures a safe and quality installation.
13.Customer must be available on day of completion to do final walk around, and to make final payment.
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 a the cost of collection, including a reasonable attorney fee. Return check
fee is $50 (fifty dollars).
15. Dumpster or Disposal Trailer for siding material only. Customer is responsible for any extra charges due to any non siding
items such as mattresses, air conditioners, refrigerators, tires, etc.
Salesperson Home Owner
P .S. Now would be a good time to review contract with the salesman to be sure of your order options and work to be done.
Only the items and services on the contract will be done. If you have any questions whatsoever, now is the time to ask.
Window World of Western Massachusetts may not require an acceleration of payments as specified in the payment section (front) for
the reason that he deems himself or the payments to be insecure. However,where the contractor deems himself to be insecure he may
require as a prerequisite to continuing said work that the balance of funds due under the contract,which are in possession of the owner.
shall be placed in a joint escrow account requiring the signatures of the home improvement contractor and the owner for withdrawal.
Arbitration: Window World of Western Massachusetts and the PURCHASER($) 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 /Date Owner/Date
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