Loading...
06-022 (23) 46 EVERGREEN RD BP-2019-0720 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 06-022 CITY OF NORTHAMPTON Lot: -020 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: windows replaced BUILDING PERMIT Permit# BP-2019-0720 Proiect# JS-2019-001179 Est.Cost: $4510.00 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.): Owner: OBOYLE LAUREN Zoning:UFA Applicant. WINDOW WORLD/ROBERT E BUSHEY JR AT. 46 EVERGREEN RD Applicant Address: Phone: Insurance: 1029 NORTH RD (413) 485-7335 O WC WESTFIELDMA01085 ISSUED ON.12/18/2018 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 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 Sianature: FeeType: Date Paid: Amount: i Building 12/18/2018 0:00:00 $40.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner i W//j1DGU s Department use only City of Northampton Status of Permit: " l Building Department Curb Cut/Driveway Permit A. 212 Main Street Sewer/Septic Availability �L •. / Room 100 Water/Well Availability Northampton, MA 01060 Two Sets of Structural Plans phone 413-587-1240 Fax 413-587-1272 Plot/Site Plans Other Specify APPLICATION TO CONSTRUCT, LTE DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION hK 1 1.1 Property Address: This section to be completed by office DEPT.OF GUIL DING;INSp Lot Q'�/� Unit �� CCCJJJJ NORTHAMPTON.'AA tai IIII Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Lauren Obo�yie 46 Everqree_nr Rd Unit 106 Name(Print) `� l Current Mailing Address: (See ,unka( � Telephone Signature 2.2 Authorized Agent: I62CI f orcin red "eS�fif1d IMA 010165 Name(Print) t?z/ Current Mailing Address: 413- �t�5 -1335 Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building 1/[10,10- (a)Building Permit Fee 2. Electrical �T 7 (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) 5 I 0°� Check Number 3 This Section For Official Use Only Date Building Permit Number: Issued: Signature: / 7- 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 I --J Side L:�---7 R: Rear --1 Building Height --� Bldg. Square Footage Open Space Footage % (Lot area minus bldg&paved _j C parking) #of Parking Spaces Fill: volume&Location A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO © DONT KNOW © YES O IF YES, date issued:; IF YES: Was the permit recorded at the Registry of Deeds? NO O DONT KNOW O YES O IF YES: enter Book i Page` — and/or Document# B. Does the site contain a brook, body of water or wetlands? NO O DONT KNOW O YES O IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained O Obtained O , Date Issued: C. Do any signs exist on the property? YES © NO IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES © 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 ❑ Addition ❑ Replacement r�Windows Alteration(s) El Roofing ID Or Doors 9 Accessory Bldg. ❑ Demolition ❑ New Signs [O] Decks [M Siding[p] Other[a Brief Description of Proposed Work: =�Sta.I IG_t;0 ( j Alteration of existing bedroom Yes No Adding new bedroom Yes �_No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -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 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, Law-ere obo4iP_- as Owner of the subject property hereby authorize �`C e_f to act on my behalf, in all matters relative to work authorized by this building permit application." Signature of Owner Date as Owner/Authorized Agent hereby declare that the statement 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 Date r SECTION 8-CONSTRUCTION SERVICES 7 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: ROS rt License Number R on-1 -1 S�Oi 1 Address/ Expiration Date Signature Telephone 9.Registered Home Improvement Contractor: Not Applicable ❑ Rob>°xt tb(_Ish \! 1105b41 Company Name Registration Number W in6ow Word cif' I cst-exrn ftp )S Inc, 314 1 ci Address Expiration Date 029 N oftin �,(A MJ&e\ d J4 g lephone_M3•14rtS'13"35 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...... ❑ 11. - Home Owner Exemption 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 780, 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 I Congress Street, Suite 100 M Boston,MA 02114-2017 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information q" Please Print Legibly Name (Business/Organization/Individual): N%��(��� N(l( '� O'� yVft�rn M�( Address: �O Z.q N Orcin R6 City/State/Zip: N 61- jd MA MCAS- 5 Phone #: 's - Are you an employer? Check the appropriate box: Type of project(required): 1.X I am a employer with_b 4. ❑ I am a general contractor and I employees (full and/orpart-time). * have hired the sub-contractors 6. ❑ New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. p Remodeling ship and have no employees These sub-contractors have g. ❑ 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.❑ 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.AOther comp. insurance required.] N iY *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. If 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 employees. Below is the policy and job site information. Insurance Company Name: U b2yt' Mutuw Ins ra nct, Policy#or Self-ins. Lic. #: %i C,Z-__-�rS-_2,_1 -1 CA+1 C)( &9 Expiration Date: I q Job Site Address: '-(6 Lye.r!-ez rl a"C"I UJ;f I U City/state/Zip: L e-e c1SI MAI Ou o 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. Ido hereby certify un er the pains,a7d p aloes of perjury that the information provided above is true and correct Sia e: � Date: 1 y l tur Phone#• 4-1�J' 6f''S Official use only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License # Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: , , ,. ;; t - � 9, �� � i r P or destroy the MI Windows Aea MI Windows And Doors M 850 West Market St NF{tC 650 West Market St NFRC ■ ■t -Gratz,PA 17030 Gratz,PA 17030 ficuttto 1685 `aecralreUatoll DH/VINYU 0 sthar NatiorleFW*Mr ion SLIDER21VINYL1Grids RzirgC ® Panel! NO Grids can be R Panel U2:Lite4:(1W,Clear.LOE,Anneabd);Lite-2: (118'&2:Life-1:(1/8-,Clear{LOE, e cleaner, rtDCatnelQ, ,Clear,NoNE,Anneafed. A^Oe�e�.Lite-2: m for differnt "�� (1/8-,Clear,NONE.Anneated);Argon;451/2 X 451/2 ),Argon,371/2 X 37 MR-A-215-00I Mglvidual M8r'A.2164•y4034MM and doorsProducts nt lndlvldutl products may be aAact to vsrtClon in perfortnance May bs subject to v■rl■tlon to perform■nce Men using a ENERGY P tdows on the ENERGY PERFORMANCE RATINGS ERFORIVlgNCE RATINGS U-Factor(U,S,/1_pj Solar Heat Gain CoeMC1e 1.11-Factor(U.S./1-P) Solar Hest Gain Coefficient 0.2'r nt regenerally0.27 0■26 ! I oduct car- ADDITIONAL•PERF 0.29 locations in ORMANCE ADDITIONAL PERFORMANCE RATINGS Visible Transmi RATINGS' Visible Transmittance Air Leakage(U.SJI-P) rtance Air Leakage ols. 0.52 g (U.sJI_P) t bake 0.46 0 3 A arn„rernrer eaP,sates roar mese n 0■� pe:;o:mance.I+FRC Ra' encs toraorm e! ■ Menurequflr =ni..iL23 not re[ QetelQenlD(Gfe eXlQJp![p1E M'(onrllEnfel ConQQ,pnlenQ A„ s9pulltsreletttlelenQeimsfcvf@toepprCatNaNFRCpropaurolforOeteroWmpstmroprosuet °" "Q>usrProauctandnoesrotwgo$el proeeduresforceteromnng�py,,ePrco�;t i PeRam■flce.NFIiC Re�lat we QetsnAypatOratae/yytfMNrpMlaMat CeflQrlQflt snef epedtk proeuct eRe. //AM)pgwerY me iWleDtKyol `PBcdr 'S.Usea ! RCQoaanQtr4e0mmtmuyprotwetangQQpnoptvreROlar,dgtlt8t,otuyprQQuctmrvwspmum.cont ISEraturer■ramerp"'I �m �rProavurorsr. p"''":s' - QlfntdetturlN lleRtWl lbr pfetlutl palfeneanN IMQIQIatIDe. a'+M.nfrC.erd p m�tE'Nprmatwn. y�FEErnC . .t JIhCAfO I FNr.R(',YSTAR' CcrtdiPd in � r 1 on , t {. 5 '• 1 / f iY�• / ' t ` ••.�- �,y � energyspar9ov/windows ':� �v� emreystac�ovAvindewe p ®Cettified/Cettfieado For fell inforntetioa,see label on pro®c ertif'"Tetlifieado Para infomta--h compleres oousla lar el ell rota dot Prod min.inlorntetion,ae label on eredud, Para ida ntac n complete.consulter la etiqueta del Padua. Pere Grade +DP 9 P Ilcro. � LC-PG3S* (ASD) -DP(ASD} Pert Grade +=!ASD) -DP(ASD) Water r 3S 30 Water LC-PG35 Max Test Size Re o 50.13 35.08 6.08 40.00X 72.00 A ', ep Florida ID 5.43 etc set at epo _ / = o9r7+o 20840 72.00 X 60.00 F2=.0140e•174%0 _ 28/?A .allnas are for Intl• r stacked units, mdual windows a P contact ours doors r 0rmation re Ratings are for individual windows and doors oI For information reprdirtg mulled Od ten$,� Tested to For inf S7M E1300. AAMA DMq gA 101/alas.?%fie.POs and Neg DP limited 6 arding Mulled or stacked urtlts,please contact your sales representative.Pos and Neg DP 9mited by � dddional inf AAINA label maybe concealed 6 y unit test s¢e.Tested to AAMANUDMAlCSA 101A.S.2/A84Q05 HAMA label maybe °rmation regardin insta y glazing b ed oGtrack Accordingtoconcealed by glattirtg bead or track filter.For addWrial information regarding g Ration instructions, installation instructions,please visft www.mitvd.com. ) Please visit w Av.miwd com. '6X85673.1.1.1 26772468.1.1.1 Printed an Printed on 716/2018 3:68:0 PM 8!12/1016 8:10:12 AM .. � t � .. � � u � CERTIFICATE OF LIABILITY INSURANCE03/23/n201°" "20A1 8 "f THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. TNS CERTIFICATE DOES NOT AFFIRMATIVELY OR M13ATMLY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(8h AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. I an must be endoreld If SUBRDGAIWN IS WAIVED, subOd to the terms and oondNbns of the pOEoy, ssrlaln poEldes may reolm an sndorsemulL A statement on thio osrtlEwta does not oonfor right to the certHlaats holder in Esu of suoh endorsomenX4 PRoouoER tam Laurance, R. Forrest Forrest Insurance Agency , 418 858 2680 413 858 2695 Ma 603 North in Street Will AWYJM East Longmeadow, Maas. 01028 aRivaea(si A"ORDINs CoveaAaB "AICs !nRSRA:Arbella Protection Insurance Comany INSURW MURs1 s: Window World Of Western Massachusetts, Inc. Illsuasic: 1029 North Road mamBao: Westfield, Ida. 01095 01810110811 OJN1RaR r I COVERAGES CERTIFMAM NUMBER: REVISION NUMBER: THIS IS TO 511TIFY THAT THE POLICIES OF iNERANCE UBTED 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 HAVE BEEN REDUCED BY PAID CLAIMS. LTR rtmorwOURANae ow wV0 POLICYNUYG1Et ( _.. iMtiIDD/rYYY) unn A ava"L L"U" x BACK OCCURRXNQa a 1,000,000 COMM"GSNERALLMSIUTY 7520023998 04/09/18 04/09/19rRaL118 ,,,r, = 100,000 CLADA84AADI ®cc" MED ERP piv a s p mo i 10,000 PERSONAL&ADv INJURY a 1,000,000 sBNRALAesRasATa s 2,000,000 sENL AGGREGATE OMIT APPLIES PER: PRODUCM•CDMNOP AW E 1,000,000 rm= 7 JSEcr FZ7 Loc s AurososEaLMssnr 1020063881 04/09/18 04/09/19 amMM a 1,000,000 ANY AUTO 8WLY INJURY(PErpe" a �0 � g AUTBSE Y OAAJRY(PM ka11Mi0 a NON4WAIND PROPERTY MOM X HIREDALMTQB X AUTOaaomtlen a a Ag ILA�a S OCCUR 4600035431 04/09/18 04/09/19 P.ACK000URRNN s 1,000,000 H E>a�UAs CLNM"ADE AGGREGATE a DEDS R8T'iNTarl S woaNRR I Certificate Of I AND EMPLU"Mv LMaRrrY ANV PpOPRI010"�Va YIN Insurance To Follow LL EACH ACCIDENT a SER B>tCLUD6D1 ❑ NIA (Mfaetlsy 1A W4 El.DIBEAsn•EA EMPLOYEE a n�s.aea�.,mtl« DEaCRaK10N OP QPBRATIONs Mbw E.L Dwnu•PCLICY Lturr is INOaPTON OP OPBRATIOta ILOCAMMIVMCUM(A1deq ADORD 101.AdOahnN RN,wb ea:.au..E nen�pn h ngWn:q 207111;ICAIT HOLDER CANCELLATION :ity Of nort hompton SHOULD ANY OF THE ABOVE DESCRIBED POLICEM BE CANCELLED MORE .12 Malin Street THE EXPIRATION OATS THEREOF, NOTICE WILL BE DELIVERED al forthamptson, Ida. 01060 ACCORDANCE WITH THE POLICY PROVSIONL ►ttention: Building Department AUTRORI280 REPIII'.SENTATIVII ®TOSS-2010 ACORD CORPORATION. All rlghta reserved. CORD 25(2010156) The ACORD name and logo are registered marks of ACORD ACC)R& CERTIFICATE OF-LIABILITY INSURANCE °"TI1(wNDD"'""' 01 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: B the certificate holder Is an ADDITIONAL INSURED,the policy(les)must have ADDITIONAL INSURED provisions or be endorsed. N SUBROGATION 18 WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODucwt FORREST INSURANCE AGENCY Mr 603 NORTH MAIN STREET PHONE F E LONGMEADOW, MA 01028 E.MAa " INSURERS)AFFORDING COVERAGE NAICS INSURERA: Uberty Mutual Fire insurance 23035 INSURED WINDOW WORLD OF WESTERN i suRERB MASSACHUSETTS INC INSURERC: 1029 NORTH ROAD INSURER D: WESTFIELD MA 01085 INSURER E. INSURER F: COVERAGES CERTIFICATE NUMBER: 4le7ao72 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. ILTR NSR TYPE OF INSURANCE POLICY NU POLICY EFF POLICY LIMITS COMMERCIALGENERALLMINLITY EACH OCCURRENCE S CLAIMS-MADE ED OCCUR ENTER $ MED EXP one partim $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY ERC F LOC PRODUCTS-COMP/OP AGG S a AUTOMOBILE UABILnY C SINGLE I $ ANY AUTO 130DILY INJURY(Per person) S OWNED SCHEDULED 130DILY INJURY(Per aodderlt) $ AUTOS ONLYAUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY a UMBRELLAUA13OCCUR EACH OCCURRENCE $ EKCMSUAB HCLAIMS-MADE AGGREGATE S DED I I RETENTION a A WORKERS COMPENSATION WC2-31 S-377947-018 5/7/201$ 5/7/2019 V TTE AND EMPLOYERS'LIABILITY ER ANYPROPRIETORIPARTNER1EXECUTIVE Y�" E.L.EACH ACCIDENT $1000000 OFFICERIMEMSEREXCLUDED? Y❑ N/A (Myyaesnssdstory In NH) E.L.DISEASE-EA EMPLOYEE $ DE86R1 Odesarbe F UnderOPERATIONS below E.L.DISEASE-POLICY LIMIT $1000 00 DESCRIPTION OF OPERATIONS r LOCATIONS!VEHICLES(ACORD 101,Additional Remarks Schadide,may be attached H more space Is requlred) 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 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 212 MAIN STREET ACCORDANCE WITH THE POLICY PROVISIONS. NORTHHAMPTON MA 01060 AUTHORIZED REPRESENTATIVE Jon Smith ®1988 2015 ACORD CORPORATION. All rights reserved. ACORD 25(2018(03) The ACORD name and logo are registered marks of ACORD L675072 1 1-377947 1 18-19 SC 1 n0254981 1 5/2/2018 4:39:52 PM (EDT) I Paae 1 of 1 Window World Of Western Massachusett: �l Gur 1029 North Roa 413-485-733733 8rmplyx�seetraters~ western mass@windowworld.cor _auren Oboyle aureneoboyle@gmail.com Estimate :Whole uni Bill Address: Install Address: Estimate#E154214414860' 46 Evergreen Rd, Unit 106 48 Evergreen Road, Building B Unit#106 Leeds,MA Leeds, MA Date of Estimate: 12/3/2011 01060 01060 Valid Until: 12/13/201£ DESCRIPTION • • 4000 Series DH 7 330.00 2,310.00 SotarZtzne'ltativ EAL 7' 1OOU`{ 770.00 Full Exterior Capping 7 110.00 770.00 Instal!Intetrcxl Storrs, 560.00 Permit 1 100.00 100.00 TOTAL AMOUNT $4,510.0( CUSTOMER Check Amount $2,255.00 TOTAL PAID $2,255.0( CUSTOMER DUE $2,255.0( Vo extra work if not in writing 'ustomer Comments: installer Notes: ustomer ID Details d Type I briver's license d#* S24677 d Issue State* Mass d Expiration Date 222022 ales Rep Recommended: Interior Stops r Exterior Capping _ ustomer Declined: Interior Stops t- Exterior Capping re 1978 built homes: ,01'1'✓L/ y home was built in the year 1987 (initial) (initial)I decline third party verification 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 /ill 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 dai ,lthough 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 /ails 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 iake 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( 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 cre) .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 /ork 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. ✓indow 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 Ir 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. ✓indow World Owner ,ate..................... .................................................... Date OTICE: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 ispute resolution even"where this section is not signed separately by the parties." hio%M­1n...W-1,M)C.onnhicenc inf4ene-4—fh.n...—4- 1 nnor +f 4 by Wi—In...1A/—W of%A/..f.—RAn....1.ienffo Inr i—A.,liro ..from%A/in.fn...WnAA Inn Comrtwnwealth of Massachusetts s Otv+ston of sPtofessionalLloensure Board of'But dmo Regulations and Standards �oasstrt►�on'Snpe-a:s�- C5457011 Expires;06/28,j2Q19 ROBt3tT;E � � , 12 DARYI N BOUTHNIICK SAA CommissionerCAL SCA t O 20VAW177 00be M CohNtnw Al(�a!�BuslnMa ltaDWaeon NOMENAPA10116 1RY IT.AiONTAACfOR Sti1NEmbation WINDOW WORLD AFR1J4EMM MASS INO ROBERT BUSIW JR: 1079:MORTH RO C 1 WESTFIELD.MA 01085 Undwam"