36-212 (4) 25 BIRCH LN BP-2018-1303
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map-.Block:36-212 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
permits BP-2018-1303
Project# JS-2018-002323
Esc Cost$1024.00
Fee:$40.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: ROBERT BUSHEY JR 057011
Lot Size(sp It.): 77101.20 Owner: RYAN R ALLISON
Zoning: Applicant: ROBERT BUSHEY JR
AT. 25 BIRCH LN
Applicant Address: Phone: Insurance:
1029 NORTH RD (413) 485-7335 O WC
WESTFIELDMA01085 ISSUED ON:6/11/2018 0:00:00
TO PERFORM THE FOLLOWING WORK:INSTALLING ONE REPLACEMENT WINDOW
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: Houses 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 6/11/20180:00:00 $40.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
JIIN - SCikol No anipton
Buildin par ment
:kQM01vM Str et
l
^n, o
Northampton, MA 01060
phone 413-587-1240 Fax 413-587-1272 1
APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION 69 11—/ 3 0 3
1.1 Property Address: This secaon to be completed by 181ce
Map Lot a (} llnX
l�LA Zone O"day DistrictT
�V 1 ppm f - � 1 O� Elm 8t DIMCt CS DIMCt-
SECTION 2-PROPERTY OWNERSHIPIAUTHORRED AGENT
2.1 Owner of Record:
A-111b-gy) L4AM 6%rr` Lit
Name(Pmt) Cummt lu"- :dress:
(�kQ comrad) Telephone
Signature
2.2 Authorized Agent:
1029 North Rd WeStfitkA MA 010x5
Name(Pnnp Current Meiling Address:
� 413-485.73 6
Signature - telephone
SECTION S-ESTIMATED CON8TRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by Permit applicant
1. Building t O 2-4 -OD
(a)Building Permit Fee
2. Electrical V V (b)Estimated Total Coat of
Construction from 6
3. Plumbing Building Permit Fee ' /
4. Mechanical(HVAC) [ o
5.Fire Protection
6. Total=(1 +2+3+4+5) Check Number
This Section For ORlelal Use Only
Building Penna Nu Date
Issued:
Signal
Bull&9Co elorreNlnspecmr of BuIldings
Dela
EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR)
Section 4. ZONING Ali Information Must be Completed.Permit Can Be Denied Due is Incomplete Infonnatton
Existing Proposed Required by Zoning
Thu cohmn tote filled in by
BuiWmg neparlmmn
Lot Size l
Fronto _.._. L .__
Setbacks Front
Side L=R:i_. R:I�_ _
Rear
Building Height
Bldg.Square Footage .. r. .I
Open Space Footage % _ --
(W wee mines bids&paved
BfkN
q ofParking Spam
Fill:
volume&Lacadon _. ... _ ._. - ._. .
A. Hasa Special /laeiance/Finding e r been issued for/on the site?
NO O KNOW O YES O
IF YES, date issued:
IF YES: Was the rded at a Registry of Deeds?
NO ONT KN W O YES O
IF YES: enter { Pagei and/or DocumentAB. Does the site cont , body of water or wetlands? NO O DONT KNOW O YESIF YES, has a por need to be obtained from the Conservation Commission?
Needs to be obO Obtained O Date Issued:C. Do any signs axisoperty? 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. WIII the constmction activity disturb(d dng,grading, xcavallon,Drilling)over 1 acre or is k part are common plan
that will disturb over t acre? YES NO
IF YES,then a Northampton Storm Water Management Permit from the DPW Is required.
SECTION 9-DESCRIPTION OF PROPOSED WORK!check all applicable
New House ❑ 1 Addition ❑ Roplecomendows Aftarahon(s) ❑ Roofing ❑
Or Doore
Accessory Bldg. ❑ Demolition ❑ New Signs ]p] Docks [p Siding[D] Other=
Brief Description of Proposed rI
Work IRo
Alteration of existing bedroom_Yes_No Adding new bedroom_Yes No
Attached Narrative Renovating unfinished baseent _Yes No
Plans Attached Roll -Sheet
ea.MNowchouo*-mtd;or=addhion3oJazIBE[no.howirik.MDNA&tbotz lhtwina:
a. Use of building;One Famlly Two Family Other
b. Number of moms in each family unti: Number of Bathrooms
c. Is there a garage attached?
d. Proposed Square footage of new consWction. Dimensions
e. Number of dodos?
I. Method of heating? Fireplaces of Woodstoves Number of each
g. Energy Conservation Compliance. Masschedr 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 COMPLETEDWHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I,
1Q u.r s pr1 `���� as Owner of the subject
property �^
hereby authorize f rJT € Bis l-
to act on my behati,in all mothers relative to work authorized by Ode bonding permit application.
SPP. corrtYOCi) 1.,1LI f
Signature of Owner Date
I._ QbQ,]'t F�iUbY1PV 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.
t
Print Name
Signature of Owner/Agent Dare
SECTION S•CONSTRUCTION SERVICES
8.1 Licensed Construction Suoenria r: (�� c Not Applicable ❑
Nem,of Licence Helder: Ro I air ty
License Number
MR nlo�� 5-1011
Address Egmatlun pate
SignatureT 413' 4k5-� 335 efephOnS IDX281 Iq
Not Applicable ❑
Robes+ Bua) 1fV 1105641
Comoamr Name Registration Number
WIr&Nt Wodfi of Westrrn MASS Inc. 3114120
Address Expiration Date
J61-Cl
N ortV� RA ayeat{;rl d N1A 010$�lepnene 413 sees 11035
SECTION 10.WORKERS'COMPENSATION INSURANCE AFFIDAVIT(MAL c.152,§25C(8))
Workers Compensation Insurance affidavit must be completed and submitted with this applicator.Failure to provide this afkdavlt will reauk
in the denial of the Issuance of the building permit.
Signed Affidavit Attached Yes....... No...... 0
The current exemption for"homeowners"was extended to include Owner•occualed DweWues of one(1) or two(2)families
and to allow such homeowner to engage an individual for him who does not possess a license,or"Ided that the owner acts
as supervisor.CMR 780. Sixth Edition Section 1083.5.1.
Deffali on of Homeowner.Person(s)who own a parcel of Ind 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 co atruets more than one home In a twotvear paried shall not be eM red a h naso ner.
Such"homeowner"shag submit to the Building Official,on a form acceptable to the Building Officia4 that he/she shell be
reenssisAW fee all each work performed under the buditt permit
As acting Coustraetion Suoeryleor yourpresence 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 ofBmployers to
Employees for injuries not resulting in Death)of the Massachusetts General Laws Annotated,von may be Wble for person(s)
you hire to perform work for you under this permit
T'he 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
The Common wealth of Massachusetts
Department oflndustrialAccidenta
OJJ4ce of Investigations
1 Congress Stree4 Suite 100
Boston,MA 02114-2017
UIV www.mass gov/dia
Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
NameV%��rtl(UAt "(VO pi W cttrr\ MP�
Address: i 62Q N Orth 9,6
Ci /State/Zi : 1N 1fifid MA S Phone#: l 4$S 1335
Are ou an employer?Check the appropriate box: Type of project(regWrad):
1. I am a employer with b 4. ❑ I am a general contractor and I 6. ❑New construction
employees (full and/or part-time).* have hired the subcontractors
2.❑ I am a sole proprietor or partner- listed on the attached sheet 7. ❑Remodeling
ship and have no employees These sub-contractors have g, ❑Demolition
wo for me in an capacity. employees and have workers'
tkinB n P tY• 9. ❑Building addition
[No workers' comp. insurance comp.insurance?
required.] 5. ❑ We are a corporation and its l0.❑Electrical repairs or additions
3.❑ 1 am a homeowner doing all work officers have exercised their 11.E]Plumbing repairs or additions
myself [No workers' comp. right of exemption per MGL 12.❑Roof repairs
insurance required.] t c. 152,§1(4),and we have no 13.�Other P1 QCC(Yt{X\'!"
employees. [No workers'
comp,insurance required.]
*Any appacmt that chocks bac#1 moat also 8a out the well=below showing their workers'compensation policy information.
t trvneowras who submit this affidavit indicating they are doing all week and then him outalde ocntrectora moat submit anew affidavit indicating such.
tConhacto ,that chock this box must attached anaddhioml sheet showing the rave of the sub-eentractotsand state whether or not those,eatitiea have
employees. If the wbcontreclms have employees,they coast provide,than wodmm'comp.policy number.
I am an employer Mat is providing workem'wmpmsadon insurance jar my employees. Below is the poficy andjob site
inforaemfom t,����
insurance Company Name: U V>ea Mut u l:0 I nsuro ne f. _
Policy#or Self-ins. Lic.#: (f\I C,2-315-?j 1-1 Cl 6,-1 18 _ Expiration Date: 5 -1 rQ _
Job Site Address: Q i r�` Lv\ City/State/Zip: NYI •1.(fj OI LX,Z
Anach a copy of the workers' compensation policy declaradon 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 my be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby certify un the pal s andpe(+�/des f peryary then the inforat4don provided above is orae and correct.
Siguturc ate:
Ph -
OJJ'icia/use only. Do not write in this area,to be completed by city or two official.
City or Town: Permit/License#
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#:
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csawgn flDbecOB/ffi2D79 KATE OF LIABILITY INSURANCE °•^NY°°^^n
03/23/2018
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1T pglpyW NEGATNELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
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COVERAGES CERTMiCATE NUYBER: REVISION NUMBER:
M IS TO OERTDY THAT ME POLICIES OF INSURANCE UrTM BE1DW-HAVE SON ISSUED TO THE INSURED NAMED ABOVE FON THE POLICY PERID
INDICATED. NOTWITHSTANDING ANY REOUIRENENT, TERM OR CONDITION OF ANY CQRRACT OR OTHER DOCUMENT WOH RESPECT TD WHICH THE
CERTIFICATE NAY BE MUM OR NAY PERTAIN, THE INMIRFNCE AFFOROED BY THE FOLICEB ME IBEO HEREIN 18 SUBJECT TO ALL ME TERMS,
EXCLUBIONBANDCONORIONB OFSUCII POLICIES.L1,1138HOWN MAY HAVE SEEN REDUCED BY PND CLMMU
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CERTWICATE HOLDER CANCELLATION
City Of Northampton
212 Main Street SHOULD ANY OF THE ABOVE DESCRIBED POLCEE BE CNYO LI® BEFORE
THE EXPIRATION DaT9 TmRE01, HDImE WNL BE a,1,,,0 W
Northampton, Me. 01060 ACCORaANDEWRHTIEPOMDYPRDWRH6.
Attention: Building DYpartmaat
1888-8010 ADDING CORPORATION. All HVITs amend.
ACORD28(201M06) TM ACORD name and IOpo am m9laslad marks W ACORD
acoiz�s' CERTIFICATE OF LIABILITY INSURANCE °A�(R"IDD"""")
5/2
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 pollcy(les) must have ADDITIONAL INSURED provision or be endowed.
H SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,Certain policies may require an endorsement A statement on
this cartlNcate does not confer rights to one cartlReats holder In lieu of such endoreamen s.
PRODUCER FORREST INSURANCE AGENCY
803 NORTH MAIN STREET PHONE FAX
E LONGMEADOW, MA 01028 .MNL sm
IN6UR B AFFdipNIGOWERAGE HAKE
INSURERA: Liberty Mutual Fire Insurance 23035
INSURED INSURER B:
WINDOW WORLD OF WESTERN
MASSACHUSETTS INC INSURER C:
1029 NORTH ROAD INSURER D:
WESTFIELD MA 01085 IMURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: 41675072 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,
INBR TYPEOF maUMNCE APOLICYBRIF PCUC EXP
PoIKY NUMBER LIMITS
WMMEMIALGE"ERAL WBILITY EACH OCCURRENCE f
.-I.—DE71 OCCUR f
MEDERP( f
PERSONAL S ADV INJURY f
GEN'L AGGREGATE LIMIT APPLIES PER: GENERN-AGGREGATE $
POUCYE jlcT E]LOC, PRODUCTS AGOG S
OH.
S
AuyoMcalLEUANUTr
COMBINED SINGLE LIMITS
ANY= BODILY INJURY Ew Psi—) S
OHNE➢ SCHEDUIFD BODILY INJURY(PEreWOMII $
AUT
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HIRED NON-0YMED PROPERTY DAMAGE S
AUTOS ONLY AUTOS ONLY P
8
UMBREllAl1AB p;CUR E4GH OCCURRENCE $
EXCEssum CW 4AADE Ld
AGGREGATE f
DEO I I RETENTION $
A MRN WMPF "B M WC2-318-377947-018 5NI2018 57//2019 V 1 U6. 1 JAI
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ANYPRCPRIEmRNARTNERIEECUTNE El FACHACCIDENT $1000DD0
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muien:,in"HI E.L.DISEASE EAEMPLOYEE $
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OEBCRIPTI OF OPEMTI N EFIu EL DISEASE POLICY LIMIT 1$1000000
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WORKERS COMPENSATION INSURANCE COVERAGE APPLIES ONLY TO THE WORKERS COMPENSATION LAWS OF THE STATE OF MA
This Certificate cancels and Supersedes all previously issued canificates,only as they relate to workers Compensation Coverage.
CERTIFICATE HOLDER CANCELLATION
CITY OF NORTHHAMPTON SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
212 MAIN STREET THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
NORTHHAMPTON MA 01080 ACCORDANCEINTHTHEPOLICYPRONMONS.
AUTHORWICREPRIES ATNF
Jon Smith ;'
ACORD 28 2018/03 ®1988-2018 ACORD CORPORATION. All rights resarvetl.
) The ACORD name and logo are registered marks of ACORD
4167s72 11-]7]911 111-11 - 1 n01s1981 15/2/0938 4:35:12 M 1C1 I I., I of I
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Window World Of Western Massachusett.
u1029 North Ron
411 3-485-733
y suee u.- westernmass@windowworld.cor
,Ilison Ryan
illisonryan@yahoo.com
Estimate : Bedroon
Bill Address. Install Address: Estimate#El 52759691/
25 Birch La, 25 Birch Ln,
Northampton, MA Northampton, MA Date of Estimale: 5129/2011
01062 01062 Valid lank.62812011
IESCRiPTION
4000 Casement 1 359.00 359` .00
woodgram Interior L 165.00 165.00
')olored Exterior 1 165.00 165.00
s;. 1 110.00 110.00
x,3one Law-E .
Misc Labor 1 75.00 75.00
Perms 1 .:150.00 150.00
TOTALAMOUNT $1,024.Ot
CUSTOMER PAYMENT DETAIL
Credit Card Amount $350.00
TOTAL PAID $350.0(
CUSTOMER DUE $674.0(
to extra work If not in writing
:ustomer Comments:
retailer NouncBronze exterior colonial cherry interior right hinge
ustomer ID Details
d TypeDrivels license
W 526383982
d Issue State' Mass
it Expiration Date 222022
afes Rep Recommended:
- Interior Stops f• Exterior Capping .
ustomer Declined:
- Interior Stops r Exterior Capping
re 1978 built homes:
y M1ome was built In Ne year 1985 (Initla)
,m.,n ....— ..—,,,aa ,.
mperty.We are not responsible for any damage to planes,shrubs or landscaped areas.
.Arrival and Departure Times.We will advise you ofthe expected arrival time for our crew at the time we set up the installation date with you.We generally an
II 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 at
ollect 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.Ifthis
of convenient for you,we need to know before we start the lob.Inclement weather and other unforeseen hindrances are a fact of life and as such we ask that yc
ademtand if the weather,mi etc.cause a delay or cancellation bran Installation appointment.We typically do not schedule more than a day or two in advance I
y to avoid such issues.
.Our Work-site.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 drivewa
ill black a garaged car,please be ready to pull it out upon arrival.
.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 th
iseonnection and reconnection of-your alarm system. -
.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 wi
ecommodate to the best ofour ability.Because we work in stages(i e.,removal of old windows,setting the new window,wrapping of exterior,etc.),we don
oreplete 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
ualifyjob.
.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 da,
although there may not be a complete window,it will be weather-tight and swore for overnight.(Please no on iquing in this time).
0. Pets.We love furry,four-legged creatures;however,we need yew help in supervising them. We are not always able to close a gate or door behind us who
saying a window,so please keep them in a safe place.Our jab description does not induce scampering down the street after Fido with new found freedom.M,
eople say,don't worry,he doesn't bite,but many installers have been bitten.So please secure dogs that have an aggressive back towards strangers.
\I
1.Expect some dust,noise and general disruption of your living space.Concoction work can sometimes be messy depending upon the scope of yourjoL.w
n unfortunate reality of remodeling,but we do our best to keep,things under control.We appreciate your patience and understanding,during the job and um
verything is finished.Even atter we have cleaned up,it is advisable to survey the areas for something we may have overlooked(Le„kids rooms,babes mom).
2.*Damage to walls and old Mm stops.For those ofyoo who have old aluminum and steel windows and are replacing them due to sweating and damaging of th
calls be advised that all water damage plaster will most likely fail out.in addition,all the patch works you have done over the years will full out also.This is nornla
oweveq we are not plaster experts,so the repair to those wails would best be left to the expects.In some cases,due to out of square openings,new trim is required t
rake the window look good."Unless noted on the contract new trim will not be provided or installed by as You can expect to do some touch up painting on the our
der the installation ofyow 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,an
rittle,they may snap and crack upon removal.If this happens,we can leave them off ifyou please,or for a small up charge,replace them with newer ones.Many r
re 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 wa
rea we will advise you before we proceed Should you decide to replace or repair anything,the price will be added to your hot once.
3.Relax and enjoy the show.After we've been introduced to your home,feel free to run errands,take a walk,orjust relax.Ifa question should arse;ask the cen
ceder for clarification.We enjoy people who are interested in what we do,and most customers ace intrigued with the process.We do get nervous,however,when
ustomer constantly hovers over our shoulder.Like any professional,we're always happy to answer questions,but we appreciate being able to concentrate on or
rork without interruptions and disha ndons.This ensures a safe and quality installation.
4.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,th
urchaser agrees to pay all costs ofcolleetion,including a reasonable attorney fee Return check fee is$50(fifty dollars).
Customer Signature Sales Person Signature
.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
one.If you have any questions whatsoever,now Is the time to ask.
/crow World of Western Massachusetts may not require an acceleration of payments as specified In the payment section hrano for the reason tat he deems remain or in
ayments 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
rider 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 owne
n withal sc al.
radiation;Window Word of Western Massachusetts and the PURCHASERS)hereby mutually agree in advance that in the event Window World of Western Massach users
as a dispute concerning the contract,Window Word of Western Massachusetts may submit such dispute to a private arbitration service which has been approved by the
ecrera ry of the Executive Office ef Consumer Affairs and Business Regulations and the consumer shall be required to submit to such arbitration in M.G.L.c 142A.
/iM aw World Owner
,ate..................... ...... .......Date
OTICE:The signatures afthe parties above apply only to the agreement of the parties to alternate dispute resolution initiated by the contractor.The owner may inare fe
ispate resolution even'whers this section is not signed separately by the parties."