06-022 (25) 44 EVERGREEN RD 204 BP-2019-1505
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map-.Block:06-022 CITY OF NORTHAMPTON
Lot:-000 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category:window replaced BUILDING PERMIT
Permit# BP-2019-1505
Proiect# JS-2019-002438
Est.Cost:$2956.00
Fee: S40.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor. License:
Use Group WINDOW WORLD/ROBERT E BUSHEY JR 57011
Lot Size(w.ft.): Owner: NAHMIAS ROCHELLE
Zoning:URA(99y Applicant. WINDOW WORLD/ROBERT E BUSHEY JR
AT. 44 EVERGREEN RD 204
ApplicantAddress: Phone: Insurance:
1029 NORTH RD (413)485-7335 O WC
WESTFIELDMA01085 ISSUED ON.71312019 0.00.00
TO PERFORM THE FOLLOWING WORK.INSTALL 4 REPLACEMENT WINDOWS
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector or Wiring D.P.W. Building Inspector
Underground: Service: Meter:
Footings:
Rough: Rough: House# Foundation:
Driveway Final:
Final: Final:
Rough Frame:
Gas: Fire Department Fireplace/Chimney:
Rough: Oil: Insulation:
Final: Smoke: Final:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occupancy Signature:
FeeType: Date Paid: Amount:
Building 7/320190:00:00 540.00
212 Main Street Phone(413)587-1240,Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
1--- — ----]
— tuINROc�r
1. Department use only
j- City of Northampton ]ell
Per ie
Building Department JUN 2 7Drl way Permit
(. •,A 212 Main Street ptic vailability
{. Room 100 — —_ A liability
Northampton, MAP1060 ` Two.$e"Ld of S ructural Plans
phone 413-587-1240 Fa: =587-1272 � - o e ns
Other Specify
APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION V p-1-r /-
AT
1.1 Property Address: T(hiis section to be completed by office
1I4b �vt�'Tezn Com+ ""���#A' Mapes Lot 0 Unit
l'-eaS MA 01053 Zone Overlay District
Elm St.District CS District
SECTION 2-PROPERTY OWNERSHIPIAUTHORIZED AGENT
1 Ownar of Rec1o1rd: n y. I , I/
wd.e� rT! I (1MIiI�, �m9muM 'clYt.Gy1Qd 2W1k W.Ct-S MQ-
(5eC C.OnSraC�� A I'I) ow)
Telephone
Signaw.
2.2 Authorized Agent:
1029 North Rd WeStififkA MA 010$5
Hems m CurmMelling Address:
i 413-485-7336
SignatureTelephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit a plicant
1. Building ] q5 V (a)Building Penult Fee
2. Electrical of D (b)Estimated Total Cost of
Construction from 6
3. Plumbing Building Permit Fee
4. Mechanical(HVAC) Q
5.Fire Protection
6. Total=(1 +2+3+4+5) Check Number
This Section For Official Use Only
Building Permit Num er: Data
Issued: �^
Signature:
Building CmnmissionwnssPector of BUIMings Data
EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR)
SECTION 5-DESCRIPTION OF PROPOSED WORK Icheck all applicable
New Norse ❑ Addition ❑ Replacement Windows AHerationls) ❑ Roofing ❑
Or Doom JM-
Accessory Bldg. ❑ Demolition ❑ New Signs 101 Decks [(-3 Siding[01 Other[a
Brief Description of Proposed Iu�Q. 14,) w Il�IOU.�
Work:
Alteration of existing bedroom_Yes--XNO Adding new bedroom Yes X N
Attached Narrative Renovating unfinished basement Yes , —No
Plans Attached Roll -Sheet
so.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. Of one
e. Number of stones?
I. Method of heating? Fireplaces or Woodstoves Number of each_
g. Energy Conservation Compliance. Masscheck Energy Compliance form attached?
h. Type of construction
1. Is wnstructlon within 100 ft. wetlands?_Yes _No. Is construction within 100 yr. floodplain_Yes_No
1. Depth of basement or callar floor below finished grade
k. Will bullding,66nfonn to the Building and Zoning regulation? Yes No.
1. SeptIcTank CltySewer Private well City water Supply
SECTION?a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I,�ff�'1L��.(� IV(AJ IPt11(L� ,as Owner of the subject
property
hereby authorize lOinJo)) l>Javld o(( 1)15km M
-
to
act on my behalf,in all matters relative to work authorized by this building permit application.
( ser cormol0 bl bg
Signature of tO,,.w-�ner �j `,,,, to
I, �ol/Crt Bu4q .as Owner/Authorized
Agent hereby declare that the statemen 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 pedury.
enwtt
Print m.e
Signature df Owner/Agent
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: y. r� Not Applicable ❑
W Name Llwnso Holder: Rol RmsheV
f License Number
_12 pct rq Ln OiurffiwcdV, MR mizxi 5-1011
Atltlreae Expiration Dab
s Telephone 4$5 335 1 Z`6 I Ott
G.J4
9.Rsaletered Home Improvement Contractor: Not Applicable ❑
Robert PxesYlfV Ib5bb,1
Company Nam Registration Number
Window Worlfl (A Wn-Verr\ MLQSS Inc. 3114 /20
Address Expiration Date
(029 T`i orcin RA westtel d MA 0108f lephone M3-4&S•1335
SECTION 10.WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.C.132,725C(6))
25C(8))
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this alfidavH will result
in the denial of the Issuance of the building peril.
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 site.such homeowner in engage an individual for hire who does not possess a license,provided that the same,¢b
as supervisor.CMR 780, Sixth Edidon Section 1083.5.1.
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•two-year period shall not be considered a homeowner.
Such"homeowner•shall submit to the Building Official,on a for acceptable to the Building Oficial,that he/she shall be
resppnsihle for oil such work performed under the building permit.
As acting Construction Supervisor your presence on the job site will be required from time in 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 my 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 ofMassaehusettr
Department of IndustrialAccidents
I Congress Street,Suite 100
Boston,MA 02174-2017
wwsamass.gov/dia
NAurkent Compensation Insurance Affidavit:Builders/Contractors/Eimtricians/Plumbers.
TO BE PILED WITH THE PERMITTING AUTHORITY.
Applicant Information Please Print Legibly
Name(Bminess/OrganiratioModividual):Window World of Western MA
Address:1029 North Road
City/State/Zip:Westfield, MA 01085 Phone#:413-4857335
Aro nu as smplayerr Check the appropriate box:
Type of project(required):
I.Olamaemployerwith 20 oo loymo(fullanNmpm-dme).• 7. ❑New construction
1❑Ivnaeoleproprictormpmnahipmdb. enom ib wahinsferment 8. Remodeling
my estuary.[No wodmn'comp.insmenc re,mood.] 9. ❑Demolition
1M 1 em a he.doing all work myself.[No werkme'wmp.inamance rewr essil t
10❑Building addition
4.❑1amehomwwnmsel willbehisingweders,smconductallwestm or praperry. twill
me wt dl conb.cmrs eiwm haveworte:i compenaaam tmmmm m m este 11.❑Electrical repairs or additions
pmpridors wim no employca. 12,❑Plumbing repairs or additions
5{:]I sm a gmeml conbeeter end I have hired fie subcmfiactma Berea on the attached Amt. 13.❑Roofrepairs
Them u ibcomse ctors have employees and have workers'pomp.inwmce.t
CEI We amacvwomees aM iu in.have esemised Nor right of sometimes per MGL a 14.E✓ Otin Replacement Window:
152,41(4),and we have.employees.Mo woAt.'cone.inmsmce: coria.)
•Any splicmt aM checks W.#1 most also fill out the section below showing their wmkan'con,menlon polity infomufim.
t Rememorms who submit this affidavit indicting they ere doing ell work and Is.her oupide comrecmn most submit a new affidavit indiestin8 sucts.
rCmmmon am chat Nu bex mut attached an addithwal ahcot abewin8 the some of the subcontrutws and mate whether os not those onfifies have
eo,,loytta. If Ne mbranwemn have employcw,Nry move Provide Neir workers'comp.Whey numbor.
I am an employer that is providing workenN eompensation insurance for my employees. Below is the policy andjob site
information.
Insurance Company Name:Liberty Mutual Insurance
Policy#or Self-ins.
''L''ic.M WC2.31 S-3779(447--020 �l',1' n Exp rmion Date:05/0J7-120 ,B
Job Site Address: af10 L\je4rt" I�(.7 Dtl City/Stale/Zip] PPCLJr mhl' to
Attach a copy of the workers'culapenestion policy desdarstion page(showing the policy number and expiratloa date).
Failure to secure coverage as required under MGG c. 152,§25A is a criminal violation punishable by 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 S250.00 a
day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance
coverage verification.
I do hereby certify under d7ains ant1/ff�eaanalNes ofperjury that the information provided above is due and correct.
S' m A/ 1 /IAl �f1.lL Date ISI _
Phone 013 857335
Oficial use only. Banner write in this area,to be c'ompletedby city or town oJrciaL
City or To": Permit/License#
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector
6.Other
Contact Person: Phone#:
AFFIDAVIT
In accordance with the provisions of MGL c 40, §54, 1 acknowledge, as a
condition of the Building permit, all debris resulting from construction activity
governed by this Building Permit shall be disposed of at
�(AWAwl 14 11 (1601
(NAME OF FACILITY)
a properly licensed solid waste facility as defined by MGL C 111,§150A.
Date Signature of Permit Applicant
PRINT OR TYPE THE FOLLOWING INFORMATION:
ROKAT I_ OAS)WU 5)P-
(NAME OF PERMIT APPLICANT)'
(�14IL6/ 600 . marl!
(}}TYPE OFM TERIAL BE DISPOSED
�019
An f ikr r/.6, gd ;�66k IIIA-
(PROPER"DDRESS)
MI Windows And Doors
650 West Market sit M1 Gr*U,PA17O3O
- or MI Windows And Doors 1650
S50 West Market In
or destroy the M Gats,PA 17030 :aDalsamM�a3o+ DMNINYLMO Grids
�,e Cwed® Pme1182:Lda-1:(tlk',C4v,LOEMw;3710 X 37
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sthatwnbe penticor1e (ir.ci-rNONE'MnWsd).Are°^ — _ ENERGY PERFORMANCE RATINGS
e deaner, +r++maaa h F„r°rm.m• U-Factof U.SJI-P Solar Neat Gain Coefficient
et for differet yd%mw a•°1^#rt °" ( )
anddoors TINOS 0.27 0.29
men usmsa
ENERGY PERFORMANCE RA dent
dowse the Olaf Neat Gain Coefficient ADDITIONAL-PERFORMANCE RATINGS`
U-Faeto.(U.gJI-P) 0.26 Visible Transmittance Air Leakage(U.S./I-P)
repenenlly 0.27 0.52 :5.0.3 0.3
AW mi ORMANt.E RATINGS �l S/ J
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'n/�/ fill Window World Of Western Massachusetts
vV "1 1029 North Road
Y`1lll 413 115-7335
amoebas uaa...^ wastommass@windowworld.com
Rochelle Nahmias
Rocholle.ot@gmall.com
Estimate:Bedroom
Bill Address: Install Address: Estimate#51561221830292
46 Evergreen Rd,Building(blue)Unit 204A 46 Evergreen Rd,Building(blue)Unit 204A
Leeds,MA Leads,MA
101053 01053 Date of Estimate:6/22/2019
Valid Until:7!22!2019
DESCRIPTION QTY UNIT RATE(S) AMOUNT($)
4000 Series DH 4 389.00 1,556.00
SWarZone Low-E 4 110.00 440.00
Full Exterior Capping 4 110.00 440.00
Install lateriortEiderior Stops 4 80.00 320.00
Permit 8 Administrative Fee 1 200.00 200.00
TOTAL AMOUNT $2,956.00
CLSTOMER PAYMENT DETAIL
Credit Card Amount $1,500.00
TOTAL PAID $1,500.00
CUSTOMER DUE $1,456.00
'No extra work if not in welting
'Customer Comments:
'Installer Notes:
Customer ID Details
Id TypeDrivers fluarse
Itl#' S2333
Id issue State' Mass
Itl Expiration Date 23445
Sales Rap Recamannual :
r Interior Stops r- Exterior Capping iYJ,„,t,
Customer Declined:
T Intenor Stops r Exterior Capping r'A.-P'✓..
Pre 1979 built homes:
MYM1omewafbmHintnepar 1980 iwxa) ��^c./,./L l✓✓.,..e
U_�..r,NJ,,...., gnmmp aeelne mim eerlyvedrram
windows.Delicate planes and shrubs of areas rigU below a window should be temporarily relocated ifthey cannot survive being stepped on and you want to preserve
them.We strive to be careful when working around vegetation,but am priorities are in focus on our work,your windows and our safety while working on your
property.We are cwt responsible for soy damage to planes,shruhs or landscaped areas.
5.Arrival and Departure Times.We will advise you of the expected arrival time far our crew at the time we set up the installation data with you.We generally stay
till the job is done,unless it will be a 2 or 3-day job,in which case we may work ai long as there is daylight.It is our policy that am installers get a signoff foot and
collect the outstanding balance in the completion ofthejob.We ask that you be available to approve thejob and make final payment at the doe ofcompletion.If this is
not convenient for you,we need to know before we seen the job.Inclement weather and other unforeseen hindrances are a fact of life and as such we ask that you
understand if the weather,traffic,M.cause a delay or cancellation often Installation appointment.We typically do not schedule more than a day or two in advance an
by in avoid such issues.
6.Our Work-site.We like to set up oro work-site as close to your windows and doors as possible and generally your driveway is the best spot If using the driveway
will block a garaged car,please be ready to pull it out upon arrival.
7.Alarm Systems.For those of you who have alarm systems,the alarm company should be notified and advised of am job.They will be responsible for the
dismaiectjon and tawmcection ofyourat=system.
g.Where do we start?Upon arrival,the crew leader will survey the job and determine where to begin.If you have a preference,feel flee to advise as and we will
accommodate to the best of our ability.Because we work in stages(i.e.,removal of old windows,setting die new window,wrapping of exterior,em.).we dont
complete the job one window at a time.The job moves along in a rolling progression where each operation is done on all windows at the sane time.This produces a
qualityjob.
9.If the job takes more than a day,will there be any openings in my house?Of course not.We only remove that which can be remsalled in the same day.
Although there may not be a complete window,it will be weather-tight and secure fm overnight(Please no critiquing at this tine).
10.Pet..We love finny,four-legged creatures;however,we nets)your help in supervising them.We are not always able to close a gate or door behind us when
carrying a window,so please keep them in a safe place.Our job description does not include scampering down the sneer after Fido with new found freedom.Many
people my,don't worry,he doesn't bite,bat nary installers have been bureau.So please sexual dogs that have an aggressive bark towards strangers.
11.Expect some dust,noise and general disruption of your living space.Construction work can sometimes be messy depending upon the scope ofymu job.it's
an unfbnunate reality of remodeling,but we do our best to keep,things under con"].We appreciate your patience and mdersanding,during the job and=Ill
everything is finished.Even after we have cleaned up,it is advisable to survey the sea for something we may have overlooked(Le„kids moms baby's room).
12.*Damage to walls and old trim slops.For those ofyou who have old aluminum and Reel windows amd are replacing them due to sweating and damaging ofthe
walls be advised that sit 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 nano;
however,we are not plaster experts,ser the repair to those wails would best be left to the experts.In some cases,due to out ofsquare openings,new Trim is required to
make the window look good."Unless road on the contract new trim will not be provided or installed by us.You can expect to do some touch up painting on the trim
after the installation of your new windows.This is no always necessary and is usually minor if it occurs.lfyour trim stops sound your sashes are very old dry,and
brittle,they may snap and crack upon removal.If this happens,w,can leave them offifyou please,or fee a small up charge,replace them with newer one .Many of
die old-style stops are no longer available so we would replace the entire window with newer style stops.Should we discover any hidden damage to the frame or wall
smut we will advise you before we proceed Should you decide to replace or repair anything,the price will be added to your balance.
13.Relax and enjoy the show.After we've been inuroduxd to you home,feel five to nm most take a walk,or just telae Ifa question should arew;ask the crew,
leader for clarification.We enjoy people who are interesteJ in what we do,and mast customers are intrigued with the process.We do gar nervous,however,when a
customer constantly hovers over our shoulder.Lake any professional,we're always happy to answer questions,but we appreciate being able to eonxentmtc on our
work without intemgnions and dunections.This counts a sate and quality installation.
14.Post 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 atonney,fm collection,the
purchaser agrees in pay all costs ofcollectim,including a reasonable auomey fee.Return check fen is$50(fifty dollars).
Customer Signature Sales Parson Signature
P.S.Now would be a good lime to review contract with the salesman to be sure of your order options and work to W done.Only the items and services on to contract will be
done.If you have any questions whatsoever,now is Me time to ask.
Window Wood of Western Massachusetts may not require an acceleration of payments as arrested in the payment section(foal)fon Me reason Mal he deems himself or the
paymann to lie insecure.However where the conbacer deems himself to be Marcum he may require as a prerequisite to continuing said work met Me balance of funds due
under the cunham,which are in possession of Me owner,shall b r placed in a jam escrow account requiring toe signatures of toe home improvement contractor and the owner
for withdrawal.
Arbitration;Willow Wald of Western Massachusetts and the PURCHASERS)hereby mutually agree in advance mat In toe event Window Wood of Western Massachusetts
has a dispute concerning the contract,Window Wand of Western Massachusetts may submit such dispute to a private amen ton service which has been approved by the
Secretary of the Executed Office of Consumer Affairs and Business Regulations and the consumer shall be required to submit to such arbitration in M.G.L.c 142A.
Window World Owner
Data..................... .. .............Date
NOTICE.The signatures of the patios above apply only to the agreement of Me parties to animate dispute resolution initiated by Me contractor.The owner may initiate
dispule resolution ever strime this section is not signed separately by Me banksa