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36-113 (8) 207 BROOKSIDE CIR BP-2019-0598 GIs#: COMMONWEALTH OF MASSACHUSETTS Ma:Block:36- 113 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL 042A) Category:window replaced BUILDING PERMIT Permit# BP-2019-0598 Proiect# JS-2019-000966 Est.Cost: $6605.00 Fee:$40.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: WINDOW WORLD/ROBERT E BUSHEY JR 57011 Lot Size(sq.ft.): 16770.60 Owner., MANN ANNE-MARIE Zoning: ADDlicant. WINDOW WORLD/ROBERT E BUSHEY JR AT. 207 BROOKSIDE CIR Annlicant Address: Phone: Insurance: 1029 NORTH RD (413) 485-7335 0 WC WESTFIELDMA01085 ISSUED OM-11/14/2018 0:00:00 TO PERFORM THE FOLLOWING WORK.-INSTALL 7 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 enartment Fireplace/Chimney: Rough: il: 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: FeeTyue: Date Paid: Amount: Building 11/14/2018 0:00:00 $40.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner 0 ws City p rRECEfV u o a-,Y Cit of Northa to f Building Depa me 212 Main St eet ewe Sip l� llty ' Room 10 NOV 1 3 20 at# oil- Northampton, il Northampton, M 01 0 Tier cif y eras f ; =_ phone 413-587-1240 F 41 a NG iNs x � NORTHAMPTON,MA 0s!t a T ".t x 3 ,1 A APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION (bo-I q-b—q 0 1.1 Prog)erty Address: -�Thiis section to be completed by office 9"0 CAii`C-Alle Map Lot l Unit L -4 Zone Overlay District L Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: .Pvy-lo Nan-e, N— Name(Print) Current Mailing Address: � (See cowtra i) Telephone Signature 2.2 Authorized Anent: gnbf,y- ' (�A-Chf� 1029 Fortin Rd "eStfiC)id MA 010$5 Name(Print) Current Mailing Address: 413--4�5�1335 Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building ( _ / _/"� (a)Building Permit Fee 2. Electrical (b)Estimated Total Cost of Construction from 6 3. Plumbing Building Permit Feel/ 4. Mechanical(HVAC) �p 5.Fire Protection 6. Total=0 +2+3+4+5) `j I Check Number of This Section For Official Use Only BuildingPermit Number: Date Issued: Signature: Building Commissioner/Inspector of Buildings Date EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) 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 R...._ L:`. .. _. R: Rear Building Height Bldg.Square Footage ? Open Space Footage _w. . (Lot area minus bldg&paved parking) #of Parking Spaces Fill: i 1 volume&Location) A. Has a Special Permit/Variance/Finding er been issued for/on the site? NO O DONT KNOW O YES O IF YES, date issued: IF YES: Was the permit recorded at the Registry\fromthe NO O DONT KNOW © IF YES: enter Book and/or Document# B. Does the site contain a brook, body of water or DONT KNOW O YES O IF YES, has a permit been or need to be obtairvation Commission? Needs to be obtained © Obtained © , Date Issued C. Do any signs exist on the property? YES Q NO 0 IF YES, describe size, type and location: I D. Are there any proposed changes to or additions of signs intended for the property? YES O NO 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 Q NO Q IF YES,then a Northampton Storm Water Management Permit from the DPW is required. SECTION 5-DESCRIPTION OF PROPOSED WORK(check all auclicabie) New House ❑ Addition [] Replacement V�idows Alteration(s) Roofing E] Or Doors Accessory Bldg. ❑ Demolition ❑ New Signs [p] Decks [p Siding[Q] Other[pj Brief Description of Proposed ` Work: Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet ea.JUN hause and or;addition#o existina hou6ina,comWete the.followina: a. Use of building:One Family Two Family Other b. Number of rooms in each family unit: Number of Bathrooms c. Is there a garage attached? d. Proposed Square footage of new construction. Dimensions e. Number of stories? f. Method of heating? Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction I. Is construction within 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 I, jpvin as Owner of the subject property hereby authorize to act on my behalf,in all matters relative to work authorized by this buildi g Oermit application. d Signature of Owner Date f.©wt 1 U3u6 f ,as Owner/Authorized Agent hereby declare that the statementil 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. nhipit Print Name ��wi Signature of Owner/Agent Date SECTION 8-CONSTRUCTION SERVICES 7 8.1 Licensed Construction Suppervtissot�or: Not Applicable 13Name of License Holder: Robert l"mUAf— License Number l2 Dai Ln Sb�a �c MSC olo -1 5-1011 Address Expiration Date 4C6S3 335 b Z� Iq L24�— Signat6WTelephone 9.Reaistened�Home Improvement Contractor: Not Applicable ❑ R obert F�(asY ,�i I b5 b 41 Company Name Registration Number Windnw Worlrt cif' Inlestern MASS Inc. 31 I+ �20 Address Expiration Date offi lephone 4i3-4%S-1335 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...... ❑ :� rBom 1 Ezt W013 The current exemption for"homeowners"was extended to include Owner-occupied Dwellings of one(1) or two(2)families and to allow such homeowner to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor.CMR 7% Sixth Edition Section 108.3.5.1. 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 accessory to such use and/or farm structures.A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official,on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. As acting Construction Supervisor your presence on the job site will be required from time to time,during and upon completion of the work for which this permit is issued. Also be advised that with reference to Chapter 152(Workers'Compensation) and Chapter 153(Liability of Employers to Employees for injuries not resulting in Death)of the Massachusetts General Laws Annotated,you may be liable for person(s) you hire to perform work for you under this permit. The undersigned"homeowner"certifies and assumes responsibility for compliance with the State Building Code,City of Northampton Ordinances,State and Local Zoning Laws and State of Massachusetts General Laws Annotated. Homeowner Signature ( �; The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations kvi 1 Congress Street, Suite 100 Boston,MA 02114-2017 www.massgov/dia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Avolicant Information q Please Print Legibly Naive (Business/OrganizationAndividual): W� �(lC't� of V V'e btiUjn MP( Address: M2_4 N or t'n Rd Ci /State/Zi : W A f A 0QSS Phone#: Are ou an employer? Check the appropriate box: Type of project(required): 1. I am a employer with b _ 4. n I am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6. C3 New construction 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. Demolition working for me in any capacity. employees and have workers' [No workers' comp. insurance comp. insurance. 9. Building addition required.] 5. [] We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑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 employees. [No workers' 13.Vk Other_&Ips QCf_%� ` t comp. insurance required.] j *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. ff the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employee& Below is the policy and job site Information. Insurance Company Name: L bertq Mut ico 1 nsuro nct, Policy#or Self-ins. Lic.-#: CA+1 Expiration Date: tq Job Site Address: rA t j� XX dE, CA Y CAC City/State/Zip:�-0(-C VY e ,M V4()( Ufj 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certifyer the pain n enalties of perjury that the information provided above is true and correcx ;7 Signature: Date: Phone#: 4-t3- AI sS --1 3 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: s MI Windows And Doors t 650 west Market St * M. a Gratz,PA17030 St Hint,or MI Windows An ois . , _ Esso �p ydot Market St or destroy the 14 Gratz,PA 17030 :auo1•M Fexlesbaton DHtYINYUNo Grids �,�� � Panel 1Q.2:Lite-1:(1i$",Ctear,LOE,pnnealed);Lite-2: NFRC 1685 (118",Cl9ar,NONE,Annea11ed);Argon;37112 X 37 S1.1 *A); Mei n416o3em o3ool )!J1r�Or1, Ot A);t 121 Individual products may be subject to variation in perrormanee fituit to fii{1�$4tt{Afi pool u2:Lita•n:{118",i���L�' s that can be { R N r, tr-NO"l ENERGY PERFORMANCE RATINGS +e cleaner, rite to P*rW farK• U-Factor(U.S.11-P) Solar Heat Gain Coefficient 112 in for differnt ktdlvldu� duets may be• and doorsTINGS hen0.27 en using a ENERGY PERFORMANCE RA cient !lows on the Solar Heat GainGoetfl U.Factor(U.S.II-P) ADDITIONAL,PERFORMANCE RATINGS 01.26 Visible Transmittance Air Leakage(U.SJI-P) ire generally 0.27 /� •oduct cer- ANAL PERFORMANOE RATINGS 0.52 .. 0.3 locations in fw.a••' irL��I(aga(U•S•'I"r� a+ eacruretrqutateat+utausaratlnpseonrormtoappncaasWncproceduresrocdewffw%wn:aer�rcaan Mance All eea5nnat".wits Ramps an dmre,"a rare two sa of arWirannunu�conn"aria a speenc pr a=s e °nC�cee not ncomr.na any prdauet arra aces nawamnt ane eudaoaq at any product ra cry sFecaa:vee Ca:.:u Visible Transm /t, /� rtan�Aaetunrsuurnuretoranar�oduetpartmmanrairtarmaoon. )ots. U a\.1► ww rrtrc orp ht,bake e4� ooMotmee'aM ens apaandP U".C*" CM t t Allt t t t taara+»todatanp t'nK s/sp nastttranalwt aanyPr atOr padon"'na' WN tarn° tea a rprda+apan°rro"rcohtomtrwn. i nr ala rill nidratt tier a S wradreattl iris.Use a • 'i � ener0ystardovJwindows (81 CsKtriedlCeKi6cado For lull information,see label at product Para inforetatiar complete,consulter IS etigtuta del producto. a � � snateYtt',de/wla/W ea a tettifrisdf�rti8oado Perf Grade +DP(ASD) -DP(ASD) Water low ell ptrdttot �..e.,_ LC-PG35e 35.30 50.13 5.43 Fat isll in ti sW 16�gseut deli Max Test Size Report# Florida!D Pala ittfetaaeca61► water 40.00 X 72.00 ad312.01.orW r0 20M - 0) P(AS li.08 Pert rade ` 35 08 atings are for individual windows and doors only. For information regarding mulled LC-PG 'J r stacked units,please contact your sales representative.Pas and Neg DP tmled by ePO nit test size.Tested to AAMANYDMA/CSA 1011I.S.21'A"(1-05 Glass Accordingto ax est - STM E 1300.AAMA label may be concealed b ng bead or track offer.For ,01.10i•sT RD f1WU0d Y Y 9i regarding ddi�iona!information regarding installation instructions,please visit www.miwd.com. 72. tion cella anti ' Ni6 a�doors°"�e °and Nog DP !6785073.1.1.1 Printed on ales retie iabal Y a.,t�d units,please eortbtct V0ur CSA101A.S.21 n ro�r� 8112/2016 8:10:12 AM Tasted to AAMAIWD ultB ted g bead r>f track fiber•f add x the Instaiiiiition ktstrudions,Pietase viell`e^m ""*d ert c,nail Tenons aas:oa PM om'wc. 26772468.1.1.1 ahtzoss CERTIFICATE OF LIABILITY INSURANCE °A1 tiam "'fm 103/23/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERMCATE DOES NOT APPIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. TW CERTIRICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURERSBL AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. I an ADDITMAL P3UREIX, the las must be ondwn& If SUBWOAMON 18 WAIVEDo MWto tM temae and condWans of the poft, analn PoRdes may molm an anderaenant. A sMtement on thb ar1118ate dose rat ooMer rights to the cera ate holder in Hsu of suoh endorsament(s). PRoouceR NAae Laurence R. Forrest Forrest Insurance Agency 413 858 268013 858 2685 603 North Main Street East Longmeadow, Maes. 01028 0+suseR(a1 AFRORDINe aoVERASx NAIL N WOUNMA:JlXbella Protection Insurance Coappany INEUM USURER e Window World Of Wasters Massachusetts, Inc. MURERc: 1029 North Road NSUMMaI Wast:field, Ma. 01085 IMPOSE: N1WROl F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS 19 To CERM 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 18 SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY"AVE BEEN REDUCED BY PAID CLAIMS. LTR YMOPIMYRANCa m wyo POLICYNUWBR IMM Y►ry1 (YW00/YYYY) UMC A esNSRALUAsaaY x EACHOOMMRENOE S 1,000,000 COMMERCIAL GENERAL LIABILITY 7520025998 04/09/18 04/09/19 —c--'—PREMIsa Eaoa WON $ 100,000 CLAM-MADE ®OCCUR MaOm(Any mu p " E 10,000 PERSONAL A AoV OWURY s 1,000,000 SOR[RALASOFAUTE 6 2,000,000 GENT.AGGREGATE UMITAPPUES PER; PRODUCTS•OOMPIOP AGS 8 1,000,000 POLIcr PRO.in" LOc a AuroMoaEJSLUIskrtY 1020063881 04/09/18 04/09/19P&apdderiOS 1,000,000 ANY AUTO ODDLY INJURY(Pa Pte) 8 A OOWEDx � D GODLY INJURY(Par aoddV4 8 AUTOSOS x HIRED AUTO X AUTOS ED S AUNaRauILIAs x OCCUR 4600055451 04/09/18 04/09/19 EACH OCCURRENCE S 1,000,000 g Exna UAB CLAN0 MAGE AGGREGATE S DED I I RETENTION 8 8 womalRecompomTm Certificate Of AND O;IPLOYERE'LM1N.nY VIN L I AWP 10 1 AR7WL%SSYJMUTrA N/A =naurance To Follow E.L.NAONACCroENr S (Mandab"inNle E.L.0180ASE.EAEMPLOYEE S Itdada tlat -, un DESCRIPTION OF OPERATIONS bNaw E.L.DISEASE.POLICY LIMIT E 11SCRITNINOPOPOIAMMILOCAT1011SIVOIICLEB(AtWOACORD IN,AdditWRwouftSModitN:ronspew bmq w) ,ERTIFICATE HOLDER CANCELLATION :ity Of Nosthwvt on :12 Main Street SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE ORMW4 D IN torthampton, Ma. 01060 ACCORDANCE WITH THE POLICY PROVMW 6ttention: Building Department AUTHOR=REPRESENTATIVE 01886-2010 ACORD CORPORATION. All rights reserved. CORD 25(2010/06) The ACORD name and logo are registered matt of ACORD AC RL�` D"TE(MMIDDN'YM CERTIFICATE OF LIABILITY INSURANCE 1 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 cerdficate holder Is an ADDITIONAL INSURED,the policy(les)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 endorsemen s. CON PRODUCER FORREST INSURANCE AGENCY 803 NORTH MAIN STREET PHONE FAX E LONGMEADOW, MA 01028 .MAIL FA D INSURE 8 AFFORDINGCOVERAGE NAICM INSURERA: Liberty Mutual Fire Insurance 23035 INSURED INSURER B WINDOW WORLD OF WESTERN MASSACHUSETTS INC iNsuRERc: 1029 NORTH ROAD INSURERD: WESTFIELD MA 01085 INSURER 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. ILSR DDL SUER TYPEOPINSURANCE POLICY NUMBER �� POLICYYEPF Y LIMITS COMMERCINLGENERALLIABIUTY EACH OCCURRENCE $ DAMAGE TO RmqTM5 CLAIMS-MADE F-I OCCUR $ MED EXP ane n S PERSONAL&ADV INJURY S GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ POLICY❑jECa F LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILELIAMILITY C(Ea I IN LIM $ ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) a AUTOS ONLY AUTOS HIRED NON-OVVNED PROPERTYDAMAGE $ AUTOS ONLY AUTOS ONLY Pr. a der UMBRELLA LIASOCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS-MADE AGGREGATE $ DED I I RETE N $ A WORKERS COMPENSATION WC2-31 S-377947-018 5/7/2018 5/7/2019 FgTATU E AND EMPLOYERS'LIABIUTY Y/ ANYPROPRIETORIPARTNERIEXECUTIVE E.L EACH ACCIDENT $ O OFFICERIMEMBEREXCLUDED9 Y NIA (auuwauxy In NH) E.L DISEASE-EA EMPLOYEE $1000000 If ya describe under DESCRI I OF OPERATIONS be E.L.DISEASE-POLICY LIMIT $1000000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Addhboal Remarks Schedule,may be attached H more space is required) WORKERS COMPENSATION INSURANCE 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 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 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORMO REPREBENTATIVE Jon Smith ®1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD 1675072 1 1-377947 1 18-19 RPC 1 n0254981 1 5/2/2018 4:39:52 PH (EDT) I Paqe 1 of 1 !J. ..-. dog Window World Of Western Massachusett: �1[ tu1 111 1029 North Roa 413-485-733 ^srmptyrn.aNer«tsss^ westernmass@windowworld.cor %nn Marie Mann lclough623@gmail.com Estimate :Whole hous( Bill Address: Install Address: Estimate#E153990166242� 207 Brookside Circle, 207 Brookside Circle, Florence, MA Florence, MA Date of Estimate: 10/18/201£ 01062 01062 Valid Until: 11/17/201£ DESCRIPTION • • 4000 Series DH 6 330.00 1,980.00 SoraaZ w 9 ' 110.00 ° 9 :00 Full Exterior Capping 9 110.00 990.00 EPA`Lead Containment 7 6{3;00 .` ; 420.00 Install Interior Stops 3 80.00 240.00 4000-'3 LiteSlider 1, 1,585:00 ` �' 1,585.00 Permit 1 150.00 150.00 Setup ar�randtt disposal fee , 1 250.00 ' ,'„ . 250.00 TOTAL AMOUNT $6,605.0( CUSTOMER Credit Card Amount $3,000.00 TOTAL PAID $3,000.0( CUSTOMER DUE $3,605.0( Vo extra work if not in writing 'ustomer Comments: / nstaller Notes:Exsisting vinyl replacement...cameo trim..remove exsisting 3 panel slider and install correct size 3 panel slider in living good ustomer ID Details d Type IlDriverslicense d#* S245 d Issue State* Mass d Expiration Date 234rt ales Rep Recommended: — Interior Stops r Exterior Capping ustomer Declined: \ Interior Stops r Exterior Capping re 1978 built homes: 1.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.Pleas urvey 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 yoL iindows.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 presery iem.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 yoL roperty.We are not responsible for any damage to plants,shrubs or landscaped areas. .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 sta 11 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 an 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.If this i of 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 yo nderstand 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 t y to avoid such issues. .Our Work-site.We like to set up our work-site as close to your windows and doors as possible and generally your driveway is the best spot.If using the drivewa iill block 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 isconnection 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 ccommodate 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 omplete 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 ualityjob. .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, ,% there may not be a complete window,it will be weather-tight and secure for overnight.(Please no critiquing at this time). 0.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 whe arrying 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.Man eople 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. 1.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 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 unt verything is finished.Even after we have cleaned up,it is advisable to survey the areas for something we may have overlooked(Le„kids rooms,baby's room). 2.*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 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 fall out also.This is norma owever,we are not plaster experts,so the repair to those wails would best be left to the experts.In some cases,due to out of square openings,new trim is required t lake 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 trir fter 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,an rittle,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 c ie 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 balance. 3.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;ask the crel ;ader 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 ustomer constantly hovers over our shoulder.Like any professional,we're always happy to answer questions,but we appreciate being able to concentrate on of cork without interruptions and distractions.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 of collection,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. Jindow 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 th 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 nder 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 x withdrawal. .rbitration;Window World of Western Massachusetts and the PURCHASERS)hereby mutually agree in advance that in the event Window World of Western Massachusetts as 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 ecretary 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.