Loading...
17A-216 (2) 154 NORTH MAPLE ST BP-2020-0561 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 17A-216 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: REPLACEMENT WINDOWS/DOORS BUILDING PERMIT Permit# BP-2020-0561 Project# JS-2020-000969 Est.Cost: $16368.00 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.): 19558.44 Owner: Mary Ellen Walsh Zoning: URB(100)/ Applicant: WINDOW WORLD/ROBERT E BUSHEY JR AT. 154 NORTH MAPLE ST Applicant Address: Phone: Insurance: 1029 NORTH RD (413) 485-7335 O WC WESTFIELDMA01085 ISSUED ON.11/4/2019 0:00:00 TO PERFORM THE FOLLOWING WORK.-INSTALL 8 REPLACEMENT WINDOWS & 3 ENTRY DOORS 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 Si(_nature: FeeType: Date Paid: Amount: Building 11/4/2019 0:00:00 $40.00 212 Main Street, Phone(413)587-1240, Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner Department use only City of North mpton V so rmit: Building De artment Cut/ riveway Permit 212 Maln,:'Street OCT 3 Se er/S tic Availability i Room 100, ?019 W ter/W II Availability Northampton, MA 01011`11:111, T o Se of Structural Plans hone 413-587-1240 Fax 41 -5T-1'27 SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement windows Alteration(s) ❑ Roofing ❑ Or Doors ,M Accessory Bldg. ❑ Demolition ❑ New Signs [O] Decks [Q Siding [0] Other[p] Brief Description of Proposed Work: � ' ) , .. h S 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? Fi of places or Woodstoves Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction i. Is construction within100 ft. of etlands? Yes No. Is construction within 100 yr. floodplain Yes No j. Depth of basement or ce r 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,� �)�� h Y 1 , as Owner of the subject property \ �' /� hereby authorize ��(nd&Go ItA . I d (Jf' Yi'D Nr to act on my behalf, in all matters relative to work authorized by this building permit application. LSe.P. C,otrca )o 1 Signature of Owner D e I, 1�Ne r A- �1SY1{'� as Owner/Authorized Agent hereby declare that the statementd 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. 1 t Print N me i Signature f Owner/Agent Dat /f SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: Rb ct1J15�1�y1 License Number _Y2, DCo' Ln 9ci -VnNirk MPS o�ovi 15, 1011 Address Expiration Date zN1�S--I Sign ure r Telephone r 9.Registered Home Impryement Contractor: Not Applicable ❑ R obat - I bS b 41 Company Name Registration Number "indow wod(A of, Wtf t-nrt1 MQ,SS Inc. 3114 12-0 Address Expiration Date A 019 N Oft R(� Wk, -f\ d �A Cl10SS�lephone__413'-�SdS'I - 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 W Department of Industrial Accidents a I Congress Street, Suite 100 A, Boston,MA 02114-2017 1� Syey'e www mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name (Business/Organization/individual):Window World of Western MA Address:1029 North Road City/State/Zip:Westfield, MA 01085 Phone#:413-485-7335 Are you an employer?Check the appropriate box: Type of project(required): 1.❑✓ I am a employer with 20 employees(full and/or part-time).* 7. ❑New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in 8. ❑ Remodeling any capacity.[No workers'comp.insurance required.] 3.F_1 I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 9. ❑Demolition 4.F1I am a homeowner and will be hiring contractors to conduct all work on my property. I will 10 [:] Building addition ensure that all contractors either have workers'compensation insurance or are sole I L❑Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. These sub-contractors have employees and have workers'comp.insurance.: 13.❑Roof repairs 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14. Other Replacement Window: 152,§1(4),and we have no employees.[No workers'comp.insurance required.] Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Ilomeowners 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 joh site information. Insurance Company Name:Liberty Mutual Insurance Policy#or Self-ins.Lic.#:WC2-31 S-377947-020 Expiration Date:05/07/20 Job Site Address:1!2A [l. ���lt�G L� C4- /�City/State/Zip: ��;i'e0-6 � A (.U,k Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL 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$250.00 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. Ido hereby certify undert0 pains and penalties of perjury that the information provided above is true and correct ,�,�Si natur : Date: jU 1 l 1 Phone#:41 -485-7335 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#: z 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 INA sTC A 64 W FVw1 rN) V �. ► �: (NAME OF FACILITY) { a properly licensed solid waste facility 'fined by, MGL C 111,,§150A. F r 1 d .w l 14A;, !l 1 JJJ Date Signature of Permit Applicant PRINT OR TYPE THE FOLLOWING INFORMATION: (NAME OF PERMIT APPL CANT) r a)t (TYPE OF MATE IAL TO BE DISPOSED OF) 64 n rii aM 'I-. 1L- ae- M (PROPERTYA DRESS) ACUR" CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) `"'-" ' 04/02/19 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 policy(ies)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 endorsement(s). PRODUCER UON TACT NAME: Forrest Insurance Agency A/C No.Ext: 413-858-2680 ONE arc NoI: 413-858-2685 603 North Main St E-MAIL East Longmeadow, MA 01028 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC p INSURER A: ARBELLA PROTECTION INSURANCE CO. INSURED INSURER B: LIBERTY MUTUAL FIRE INSURANCE CO. WINDOW WORLD OF WESTERN INSURER C MASSACHUSETTS INC INSURER D 1029 NORTH RD WESTFIELD, MA 01085 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEDABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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. INW ADUL 6U13H POLICY EFF POLICY EXP LTR TYPE OF IN INSD WVD POLICY NUMBER MMIDD/YYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE OCCUR PREMISES Ea occurrence $ 100,000 MED EXP(Any oneperson) $ 10,000 A 7520025998 04/09/19 04/09/20 -PERSONAL BADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMITAPPLIES PER. GENERALAGGREGATE $ 2,000,000 POLICY❑ PRO- ❑ JECT LOC PRODUCTS-COMP/OPAGG $ 1,000,000 OTHER $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 ANY AUTO BODILY INJURY(Per person) $ A OWNED Ix SCHEDULED 1020063881 .04/09/19 04/09/20 BODILY INJURY Per accident) $ AUTOS ONLY AUTOS I X HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident $ X UMBRELLA LIAR X1 OCCUR EACH OCCURRENCE $ 1,000,000 A EXCESS LIAB CLAIMS-MADE 4600055451 04/09/19 04/09/20 AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ N/A Certificate To Follow E.L.EACH ACCIDENT $ (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Town Of Northampton ACCORDANCE WITH THE POLICY PROVISIONS. 212 Main Street Northampton, Ma.01060 AUTHORIZED REPRESENTATIVE Attention: Building Department, ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD ,naco,Rc�� CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) TH5/5/2019 IS 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 policy(ies) 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 endorsement(s). PRODUCER FORREST INSURANCE AGENCY CONTACT 603 NORTH MAIN STREET NAME: E LONGMEADOW, MA 01028 PHONE �_— _ A/C�I _Ext' FAX INSURERS AFFORDING COVERAGE NAIC# INSURED ----- ---- — INSURER A: Liberty Mutual Fire Insurance 23035 WINDOW WORLD OF WESTERN MASSACHUSETTS INC INSURER B: 1029 NORTH ROAD INSURER C: WESTFIELD MA 01085 INSURER D INSURER E: EEL=== COVE RAGESINSURER F CERTIFICATE NUMBER: 48525637 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. ILTI ADDL BR _ LTR TYPE OF INSURANCE POLICY EFF POLICY EXP COMMERCIALGENERAL LIABILITY POLICY NUMBER MM/DD/YYYY I MM/DD/YYYY LIMITS EACH OCCURRENCE $ CLAIMS-MADE OCCUR A •E TE PREMISES(Ea occurrence $ MED EXP(Any one person) $ GEN'L AGGREGATE LIMIT APPLIES PER: PERSONAL&ADV INJURY $ POLICY D PERCO-- LOC GENERAL AGGREGATE $ _ OTHER: PRODUCTS-COMP/OP AGG $ _ AUTOMOBILE LIABILITY $ COMBINED SINGLE LIMIT $ ANY AUTO Ea accident OWNED SCHEDULED BODILY INJURY(Per person) $ AUTOS ONLY AS UTO — ----- HIRED NON-OWNED BODILY INJURY(Per accident) $ AUTOS ONLY - AUTOS ONLY PROPERTY DAMAGE $ --- Per accident UMBRELLA LIAB $ OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE — DED --- AGGREGATE $ RETENTION$ —.- A WORKERS COMPENSATION WC2-31S-377947-019 5/7/2019 5/7/2020 PER OTH- $ AND EMPLOYERS'LIABILITY Y/N ✓ STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED9 N/A E.L.EACH ACCIDENT $1000000 (Mandatory In NH) If yes,describe under E.L.DISEASE-EA EMPLOYEE $ QQ900� DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1000000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attachod if 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 TOWN OF NORTHAMPTON SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ATTN: BUILDING DEPARTMENT THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 212 MAIN STREET ACCORDANCE WITH THE POLICY PROVISIONS. NORTHAMPTON MA 01060 AUTHORIZED REPRESENTATIVE Jon Smith ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 1852563% 1 1-377997 1 19-20 WC 1 n0270258 1 5/5/2019 7:59:95 PM (PDT) I Page 1 of 1 lcordeN l tire: VU f€Mwe And Doors Nit mows - .0 0 West FiFeFket i =di r,' t Mt 550i/vest Attf jypOfS nC - ;PA 17030 Drat? Pq�j030tSt Ikt r. tD NY R2WILtQsl �; is ar + rst7 t t arvnarPao-aKv! E Nyt� T=TY p $2:Cit �N6 t�� a t=: itrE leave-. o-, err... ra t neiE t I t Fanet�vtaer,�� fff8",Cefea,,LCg,Anreatedktite� _..y;. .. _ .. l;Argon,371/2 X 37�: ion fof Giff�rgs; is and doors M.�(ki,2tti-00392 a$ 7 ttlliitl0yl Pr 276 L1C,7l zro ae.a ireye be su4Eet tc vaftion in performance odu:ts a e su6j p3o0Q007 _ N Y Y tn(i•trs,g tri$f1E ° ._s x• FGFKFOI tri NCE RA t INPI e e r` RtCt4 t11�� - - U ac fire'{ .5.�1`R Solar "t itjt,�s E.t3� i O-`SFR@�f €ii �y j ar Heat G..- V. 7 Ga Coefficient are 8eneraRy rt fl . odact ter- 0 f ■ � t - 0.29 s tocdaons in _ — ___..__— ---__ _ tt1 i[�E E j"J"1AL-F�EI�FORMI6{nfCE ADF�ITEONAL PEIFGRMANGE RATINGS Visible Transmi RATINGS` ooL. '� ti`s " ?�f`GEF iltE .r"€�� Ar`r Leakage(U.S.(f-P) ttance Air Leakage ;ht,bake 0.46 e 0■ {U.S./i-�� cVmwerscpwztes inzttnere race 3 �'n-ESIZe. .NFRC RarY-s arG aa:e, Bs roraDrm fo aPF6raIDe NFRC LEFi.z`:,�:.BP£'t.:._3cfi €r£Yirjf EeiiQ.^n.4 F,tpCYE4l6 tlFRC CEQrEEtOr Ga.87 p -- `recarror6 any WaQw.tnnu-gocs rmr• osei ct Eavirar✓rcnr� �WEs ire aetErmnr Cn rewnC Mme rQQutt uc . pru6riMPASttLe er�i 1Q E.�EEUfs Geer&fi QMf Of tfK9."Off.Rlefu'E' "".the itc 1pet�C Y3lYCO75uR` M311,1aaurars irtEraturE rurD[nerpD 1,,Ir y�aryp��Ito SSFP .'Sr't^v rfstECn .r..ER L`ty p. .1<'F".t�Qf 4fi3S r41iTt'tt4C,"31 Qf .?vCfDt '. oris.Usea r � t4r[azirefaC�i[ Q:6Q1tCtpetforeurteetmati■tor.. WNtiM2Dr8 1a�6tRafCEV(G?aGilr a,pIE— i War; .4r� I -. '' �, energystacgovlvindewa ,lj ;�'�+fs'�1 enttggetu�eeheiedswe ror full info(nrariDn,seas fa @rJ Cortif■ed//Certifieado Para infomlaci6n cam hel on r Ceefifiedl;Egih�do tnr full intomutien,eae hbal on product Afera,consnttar la etigrtUdel Producro. l Para itdorniecibn eomgieia,consnhar la etiqueta def producto. Perf Grade LC-PG35* {DP(ASi}) Petfi Grade +DP(ASD) -DP(ASD) Water 35.30 'DP(ASD) Water n Max Test Size 50.i3 LC-PG35 35.09 35.09 8.08 Report# 5.43 _ 40.00X 72.00 aas�2.o7.10g-07_ Florida tD Max Teat size eport# - STC/Ot C ro _ 72.00X60.00 mss pt-1o9.e tm 29!24 atings are for in �' 20840 r stacked units, dual windows Ind doers on -/ it test size Please contact Yor sales re �' For information re Ratings aro for i,please ont act y and doors prey. For information regarding matted rested to AAt� MAtC Presentative,Aos and Ne ardin mulled ur stacked uritis,please cpMA Your sales representative.Pos and Neg el (mated by BTW E730c• sled label ma�� WCS ed bIl'S'yA4gdP"Glass q�cord9��e by unit test Brie.Tested to AlaA4A/YItDMAfCSA 70fA.S.2/A440 OS AAMA label may ddd10nal information re Concealed y 9larin the 9 mstaliation inst 9 bead or track filter.For Wait concealed by giatg bead ortrack filler.For additional information regarding instructions, installation instructions,please visit www.mWd.corn. �S 785s 73.�n Please visit www miwd tom x3 26772488.1.1.1 Pnrtted on V v �' 1 Printed on 71s12016 3:69:0.t PM 811212078 8:10:12 ArA u� Window World Of Western MA 1029 North Road 413-485-7335 westernmass@windowworld.corld.com Mary Ellen Walsh Mewalsh2l@gmail.com Estimate: Partial 1 st floor Bill Address: Install Address: Estimate#E1572353590416 154 N Maple St, 154 N Maple St, Florence,MA Florence,MA Date of Estimate: 10/29/2019 101062 01062 Valid Until: 11/28/2019 DESCRIPTION • • 4000 Series DH Solarzone 8 549.00 4,392.00 EPA Lead Containment 8 65.00 520.00 Colonial Grids(Contoured) 8 75.00 600.00 Full Exterior Capping 8 121.00 968.00 Entry Door,Casing+Capping 3 2,580.00 7,740.00 Storm Door 2 799.00 1,598.00 Permit&Administrative Fee 1 200.00 200.00 Setup and landfill disposal fee 1 350.00 350.00 TOTAL AMOUNT $16,368.00 CUSTOMER PAYMENT DETAIL Cash Amount $1.00 TOTAL PAID $1.00 CUSTOMER DUE $16,367.00 *No extra work if not in writing *Customer Comments: *Installer Notes:Partial instal, ..1 v 1 H......SAVE FRONT DOOR......paying at end Design Consultant-Tim Drost HIC:165641 FEID#27.1993659 Customer ID Details Id Type* Driver's license Id#* S24444 Id Issue State* Mass Id Expiration Date 23e54 Sales Rep Recommended: r Interior Stops r Exterior Capping Customer Declined: DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. Customer Signature Sales Rep Signature NOTICE: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 dispute resolution even"where this section is not signed separately by the parties." This Window World®Franchisees independently owned-and operated by Window World of Western Massachusetts,Inc.under license from Window World,Inc.