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35-243 (13) 35 LADYSLIPPER LANE COMMONWEALTH OF MASSACHUSETTS BP-2021-1743 Map:Block:Lot:35-243-001 Permit: Exterior Res CITY OF NORTHAMPTON PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit# BP-2021-1743 PERMISSION IS HEREBY GRANTED TO: Project# Contractor: License: Est.Cost: 6153 NICHOLAS DROST 115719 Const.Class: Exp.Date:04/30/2025 Use Group: Owner: PETER BLOOM Lot Size (sq.ft.) Zoning: WSP Applicant: NICHOLAS DROST Applicant Address Phone: Insurance: 102 OAKRIDGE DR 4134857335 BELCHERTOWN, MA 01007 ISSUED ON:08/18/2021 TO PERFORM THE FOLLOWING WORK: 3 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. Signature: ( C`j�- Q �i Fees Paid: $40.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner ADepartment use only `- City of Northa •ton ' CF tatus of Permit: "_,N, Building Depa me `/V, : , t/Driveway Permit 212 Main -.treat OR --. top . Availability (� Room 00 �8 Water ell ' ailability :;r , t,. r ,, , Northampton;-ki I <909 Two ets • Structural Plans ' ` ,...0. y' phone 413-587-1240 Faxes �t) •' PI. Site 'lens N n•Qv/Ais,o, • her S•ecify T APPLICATION TO CONSTRUCT,ALTER, REPAIR, RENOVA �° •'M• ISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Property Address: This section to be completed by office Sr) izcll ee )ryyy- 1 n Map 3h" Lot 2"/ 3 unit +�'`'yv� �`��J�'GGOO u 1 Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: (PQOc %\cort M Led '° 9(2.(- l,x). Name(Print) TeleCurren,.I 4 •• 1 S. (Sec C�Qf'tra(�� alp 1 — phone Signature 2.2 Authorized Agent: --1 N� ( ca .01 Qv dooh Or. 1& 4* � ' Name"( ht)Pri Current Mailing Address: P `.reCCO c4 4l ~ 4ctS -133 ignatu Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant _ 1. Building '$Gal`J 5" (a)Building Permit Fee 2. Electrical (b)Estimated Total Cost of Construction from (6) 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) 5. Fire Protection �2L (-1-0 � oa 6. Total=(1 +2+3+4+5) ��0 15 3 0G Check Number � � ,7/�' I This Section For Official Use Only fl,O AI .,I 1(4 Date Building Permit Number: �✓% l Issued: Signature: v ► 1 j .�,Ct ' 0• /� c Building Commissioner/Inspector of Buildings Date EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House [] Addition Replacement Windows Alteration(s) Roofing Or Doors D Accessory Bldg. ❑ Demolition ❑ New Si ns [10] Decks [C] Siding[O] Other IJ Brief Description of Proposed Work: `J CZZ(i\'?rQ \J o — ( c Oc 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 (- QC;( ( j-( , as Owner of the subject property hereby authorize 1i i c3 World d L3 M Yka55 to act on my behalf, in all matters relative to work authorized by this building permit application. (J n'trQ(i-') ' _JG1 Signature of Owner Date 11111111.111111111111.11111111111111111111111111111 -11 I, \,\&, C ,as Owner/Authorized Agent hereby declare that the statements ana iiuuui,..--ion on the foregoing application are true and accurate,to the best of my knowledge and belief. Signed under the pains and penalties of perjury. Print.Neale1 V6009 1 Signature di Owner gent Date SECTION 5: CONSTRUCTION SERVICE S 5.1 Licensed Construction Supervisor(CSL) Al j cslo 4z •Ogi- License Number Expiration Date Name of CSL-Holder List CSL Type(see below) U IKZ OGAL.Ci c. a RC,:� c..t ir( 1.1a#-/'�r"A_01 Op"'r __ IRress Type Description i.J unrestricted/up to 35,000 Cu.Ft.) St natur Restricted 1&2 Family Dwelling M Masonry Only � ..�_ ._ ..Tfb" RC Residential Roofing --- Telephone Covering_ WS Residential Window and Siding SF Residential Solid Fuel Burning Appliance Installation ... D Residential Demolition 5.2 Registered Home Improvement Contractor(IIIC) Company Name or HIC.Re istrant Name Registration Number I1zt.�X�, c: GIO1nf.(knc ►, MA of 2L % �. rr dr ._._ yi3 A486-733 5 Expiration Date Si ature / Telephone SECTION 6: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 toc. No Cl SECTION 7a:OWNER AUTHORIZATION,TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR.APPLIES FOR BUILDING PERMIT I,_9Q --_- , as Owner of the subject property hereby authorize \Q�3 tress to act on mybehalf,in all matters �1� 0 � 1Clf`�l"rill 11�0(�d. relative to work authorized by this building permit application. -'ts C. Con ULV 1 Signature of Owner Date - SECTION 7b:OWNER1 OR AUTHORIZED AGENT DECLARATION I, ._ ;()m_f U is dako. vjoi. ,as Owner or Authorized Agent hereby declare that the statements and information on the foregoing application arc true and accurate,to the best of my knowledge and behalf. Print • / Signat -• o • • or Aut iotized Agent Da/6419a91. (Signed under the pains and penalties of perjury) _ _ NOTES: 1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration program or guaranty fund under M.G.L.c. 142A.Other important information on the HIC Program and Construction Supervisor Licensing(CSL)can be found in 780 C.'MR Regulations l 10.R6 and 110.R5,respectively. . . . . SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor:► Not`Applicable 0 v1 '�:-f Name of License Holder: lQ, �( �, �cJ ` i 5-\el „} License Number ,�n Aaar s I Expiration Date • Sign Telephone 9. Registered Home Improvement Contractor: Not Applicable 0 Li 61 Company Name Reg s ation-Number �I irytc'v'l i Jorld Inits5 Cerra MaSS 111C, 0111 CO-6 `Address (y�� �/� `,\ yp,, Expiration Date i i Deed d ( uJl Vt\ j e PcIG (k � phone 4 3-4tS-1535 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 14, No 0 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 AFFIDAVIT In accordance with the provisions of MGL c 40, §54, I acknowledge, as a condition of the Building permit, all debris resulting from construction activity governed by this Building Permit shall be disposed of at an,61a _ (NAME OF FACILITY) a properly licensed solid waste facility as defined MGL C 111 §150A. Date / Sig er ture of t App PP PRINT OR TYPE THE FOLLOWING INFORMATION: (NAME OF PERMIT APPLICANT) (TYPE OF MATERIAL TO BE DISPOSED OF) li L (PROPER it i D S) - City of Northampton s s s,6- ' � Massachusetts �<4? �. { A.;.° w: ,1 DEPARTMENT OF BUILDING INSPECTIONS 9 ? +► '' 212 Main Street •Municipal Building vg-, . .�+re "`�, Northampton, MA 01060 �4.1/1 ,'y�`.14 Debris Disposal Affidavit In accordance of the provisions of MGL c 40, S54, I acknowledge that as a condition of the building permit all debris resulting from the construction activity governed by this Building Permit shall be disposed of in a properly licensed solid waste disposal facility, as defined by MGL c 111, S 150A. The debris from construction work being performed at: L ��O(Please prir us umber and street name) Is to be disposed of at: Ce,)1. C, (& I—(ecc &-_ �o) Ci EC (Please print name and location of facility) Or will be disposed of in a dumpster onsite rented or leased from: (.J;ndc , Cold (Company Name and Address) iet_C (C)24/ ignature o ermit Applicant or Owner Date If, for any reason, the debris will not be disposed of as indicated, the Applicant or Owner shall notify the Building Department as to the location where the debris will be disposed. c 4. Ot t t i�t€c�t�s ttc € o�rrs tot: aofY<iesflYarkettit issumdent,� �� iJI itC�� cctz;PA E7030 ,; atflows t Cori c ti Wit itarite4 � } - 465f i• lc Of a -. �s t t: li Ww•I'w tr PA '' Zational_e �y� f�f�f/VfN`YfJf+le tsrttfe ri 4f - - _ `Lr' ` E•is-r^ ( PattBtSt :i,iEb-�t:(1/8 CErar'LDt<.,.+�itCtP.aied}iLit 6 �,f F �tsa htc�r4 , ys ! 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[/�� / manufaCnNer s;maturd oth 7,ftt bake �/s —6r c w+a rr e veer ,raaan. sL tar er praauc performancenv� Rut pro re ae,80010 10 Ptn tt atA t e.3A not. r �K- �' ft :':'17 1•10I.01 oftE�O C tar C lu,,3�write slr4,4 t , u et c r F,.itk._€_,,,,,, toy prove F _ r ,',K <i t. f ancaraar6 e 1 rF jc altted Regions. f r 1,. nt....,., x>rer,su .r ta,w to worm . =� .� ' �sn lad iDnes resaltadas, Wis.Use a F < r` -_- x tsos resdtt+desPliag - • 4.- r t tit , �r ( tti 1 1 - � --- - \ t�• F 4 ENERGY STAR j- 7. - it. 4.,J17f r ;� energystacgev.`windows .y I L 1 :j P�CertifedCettificado / �,.� For tali information,see label an product EfIERGY STAR h Para informer i6n complete,consulter la etirlueta del protium. P at CertifiedlGR"dieado enerovsw.ormewtnriows Perf Grade +DP(ASD) I -GP ASD ( ) 11 Water e lot tact infbmutiac,sei bt is cdpueta det producto. LC-PCs35k ! 35.30 50.13 I pima iatosntasi�a@ Max Test Size Report# .43 Water F FloridaF!�itD -DP(ASD) t 40.00 X 72.00 � i _ Aaar2.o1-'tog-07.to 2 -/- :LexcrIT.4!-GestGra3-d5el'ie- }DP(ASD) 35AS S.AB 35'� STC f f� C atings are for individual windows end doors only, for information regarding mulled 269724 8 f r r stacked units,please contact your sales representative.Pos and Rteg DF limited by ¢e.Tested a M M/JGSA 1 f! ZIA4 0-05 GI nit tests Y It FUWD Oi .S, 4 ass Accordingto 72.00X -flQ STM E7300.AAMA label maybe concealed by sent ng bead or track fd er.For For inormation regarding mulled dd clonal information regarding installation instructions,please nisi wvow.miwd.com. Ratings are for individual vdlnd and doors o roseatative.Pas and{Veg el 1'anyed by a s/� 7 ar afzctctsd Untfi,ptea6E Gantact ckfi sales rep l tii V ( �. E unit test sloe.Tested t6 �r�ryfOMAtCSA 401A.S.2fA440- regarding $i Y be Pnmed on the Gantllaf®d by r i0 bead 0r track filler•FQT adddFDnai information ou 8112/2016 8:10:12 AM tease vis>q vrNw.mnrrd,wm• nail installation instructrons,P pd11%4 on 2aa a 248 e c c . 716 3:69:03 PM rs,Mx. j The Commonwealth of Massachusetts f LL= ==l Department of Industrial Accidents cs Office of Investigations Lafayette City Center �1 2 Avenue de Lafayette, Boston,MA 02111-.1750 ,, 1 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual):Window World of Western Massachusetts Address:641 Daniel Shays Hwy City/State/Zip:Belchertown, MA 01007 Phone #:413-485-7335 Are you an employer? Check the appropriate box: Type of project(required): 1.0 I am a employer with 40 4. 0 I am a general contractor and.I employees (full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ i am a sole proprietor or partner- listed on the attached sheet. 7. 0 Remodeling ship and have no employees These sub-contractors have 8. 0 Demolition working for me in any capacity. employees and have workers' insurance.$ 9. ❑ Building addition comp. [No workers' comp. insurance required.] 5. We are a corporation and its 10.0 Electrical repairs or additions 3.❑ 1 am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.] t c. 152, §.1(4),and we have no Replacement employees. [No workers' 13.®Other p comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. 4 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:A.I.M. Mutual Ins. Co. Policy#or Self-ins. Lie.ff#::,WMZ-800-8007695-2021 A Expiration Date:05/07/2022 Job Site Address: Led )1n( '' City/State/ZipN10(0 y , t.'b 0!06a Attach a copy of the workers ompeVVnsation 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 certify under the pains and penalties of perjury that the information provided above is true and correct. Signature:�1Cl-O(, Date: Cif(O f&O&.I Phone#: 413-485-7335 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License # Issuing Authority(check one): tD.Board of Health 21:Building Department 3EICity/Town Clerk 4.0 Electrical Inspector SE'lumbing Inspector 6.DOther Contact Person: Phone#: -, WINDWOR-01 HRY TAL ,AC'C)/Zv CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYVY) 4,11%.• 4/6/2021 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). CONTACT Laura Misseri PRODUCER NAME: Phillips Insurance Agency,Inc. 97 Center Street 1H°,N A/C, Exty(413)594-5984 FAX(NC,No):(413)592-8499 Chicopee,MA 01013 EUDRESS:laura@phillipsinsurance.com INSURER(S)AFFORDING COVERAGE NAIC f/ INSURERA:State Automobile Mutual Ins Co INSURED INSURER u:State Auto Property&Casualty Window World of Western Massachusetts,Inc. INSURER C:A.I.M.Mutual Ins.Co. 33758 1029 North Rd INSURER D: 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 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. INSR ADDL SUBR POLICY EFF ' POLICY EXP LIMITS LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER IMM/DD/YYYYI (MMIDD/YYYYI A X COMMERCIAL GENERALUABIUTY EACH OCCURRENCE $ 1,000,000 ]CLAIMS-MADE f Xi OCCUR PBP2891125 4/9/2021 4/9/2022 DAMAGE TO RENTED 500,000 _PBF, BE;?Ei occurrence) $ MED EXP( n one person) __..$ 10,000 PERSONAL&ADV INJURY_.._$ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 2,000,000 X l POLICY X 1 Fjltef I X 1 LOC PRODUCTS-COMP/OP AGG $ 1,000,000 OTHER: $ B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 _(Ea accident)._ _ - ANY AUTO BAP2480934 4/9/2021 4/9/2022 BODILY INJURY(Per person)-_$ OWNED SCHEDULED AUTOSRE� ONLY X AUTOSSyy p BODILY INJURY-(PereccldontL_$ X AUTOS ONLY X. AUTOS ON V PROP_(Perr acEcidenY 1�AMAGE $- $ A X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $_ 1,000,000 EXCESS LIAB CLAIMS-MADE PBP2891125 4/9/2021 4/9/2022 AGGREGATE $.. _ 1,000,000 DED X RETENTION$ 0 $ C WORKERS COMPENSATION X STATUTE X ERH AND EMPLOYERS'LIABILITY Y/N 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE WMZ-800-8007695-2021 A 5/7/2021 5/7/2022 E.L.EACH ACCIDENT $- OFFICER/MEMBER EXCLUDED? N N/A 1,000,000 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE$ If1,000,000 yes,describe DESRIPTION OF OPERATIONS below EL.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Workers Compensation Coverage Includes the following 3A States:MA,CT CERTIFICATE HOLDER CANCELLATION -- SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Evidence of Insurance ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE /'. ' F/V /I I't",'' i ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Window World of Western Massachusetts vs Ennns 01'1 commnno 641 Daniel Shays, Hwy, Belchertown, MA �A 01007 n� i.- 1029 North Road, Westfield, MA 01085 W jl� Office: (413)485-7335 CARE R<, c� www.WindowWorldofWesternMA.com E� CD Peter Bloom a Phone: 4135887411 Install Address: 35 Ladys;ipp r Ln Email: pbloom@smith.edu Florence, MA 01062 Contract Name: Peter Btoo - Sales - Bays I Bows Design Consultant: Tim Drost Measured By: Measure Approved Date: 8/4/2021 Status: Contract Payment Method: Credit Card Lender: Contract Type: Sales Comments: Product Description Txbl Qty Price Extension Permit&Administrative Fee Permit &Administrative Fee N 1 $200.00 $200.00 Setup and landfill disposal fee Setup and landfill disposal fee N 1 $250.00 $250.00 4000 Picture Window 4000 Picture Window N 3 $1,190.00 $3,570.00 Woodgrain Int. Hillside Oak Woodgrain Int. Hillside Oak N 3 $250.00 $750.00 Colored Exterior Colored Exterior clay N 3 $250.00 $750.00 Install Interior/Exterior Stops Install Interior/Exterior Stops N 3 $80.00 $240.00 Full Exterior Capping Full Exterior Capping N 3 $131.00 $393.00 Total Information Unit Total: 10 Subtotal: $6,153.00 Tax Rate: 0% Tax: $0.00 Total: $6,153.00 Amount Financed: $0.00 Payment Method: Credit Card Deposit Amount: $3,000.00 Balance Paid to Installer upon Completion: $3,153.00 Renovation, Repair and Print Act (RRP) Compliance RRP Pamphlet Provided Date: Year Home Built: 0 RRP Signed Date: Window World of Western Massachusetts UtttHa„t p nuct curnnAno 641 Daniel Shays,Hwy,Belchertown, MA u__!�._, 01007 LUl1(t! 1029 North Road,Westfield,MA 01085 WINDOW WORT D ci Office: (413)485 7335 CARE Ste) www.WindowWorldofWesternMA.com Product Acknowledgements 1 have received a copy of the lead hazard information pamphlet informing me of the potential risk of the lead hazard exposure from renovation activity to be performed in my dwelling unit. I received this pamphlet before work began. Primary Homeowner Secondary Homeowner Window World of Western Massachusetts as Csnnns 04R11kr COrmlInny �����,�,//�� 641 Daniel Shays,Hwy,Belchertown, MA ���� 01007 1029 North Road,Westfield, MA 01085 p/ � Office: (413)485-7335 w'NTIOVCAR`E "` www.WindowWorldofWesternMA.com Preparing for Your New Windows and Doors Thank you for choosing Window World to complete your home improvement project. This letter is designed to simplify your upcoming installation experience by letting you know what to expect. 1. HOW LONG DOES IT TAKE? It takes approximately 4-20 weeks to receive your custom-made window order from the factory following your final measurement and your job exiting the Massachusetts State three day rescission period. A Window World associate will contact you shortly after your products have arrived to schedule the installation. Please note that we will make every effort to install your products within a reasonable time after they have arrived, but weather(rain, snow, high winds and extreme cold), high volume sales periods or other conditions(factory production delays,factory closure for holidays, shipping delays, etc.) beyond our control may govern the installation date. Homeowner understands and agrees that any such delays will not result in a discount from their contract total. 2. HOMEOWNER REQUIREMENTS: I understand that by signing this, I am certifying that I am the owner of the property listed on the contract. I agree that a property owner will be present for the duration of the installation to ensure that the work is performed to my satisfaction and to inspect the work completed. If a property owner is not present,the contractor will be released of liability for any installation issues. This allows us to better satisfy our customers and ensures that the windows or materials are installed in the correct openings. Customer must sign off on completion certificate and leave final payment with installer if he/she wishes to leave the job site prior to completion. Customer understands that by not being present at the time of installation may result in the automatic charging of the final payment to the credit card used for deposit. 3. UNFORESEEN CIRCUMSTANCES: If during the installation process a condition is found that would prohibit properly installing a window (i.e. wood rot, termite or other hidden damages, etc.),the installer will promptly notify the Homeowner as well as the Window World office of the problem. Any additional work that is required to properly complete the job will be discussed with the Homeowner and billed on a time and materials basis. In the event we have received the incorrect or damaged window for your job (due to an incorrect measurement or factory error), Window World will reorder the proper window and will schedule the installation as soon as possible. Window World expects payment on the work completed to date at the time of installation that is not affected by warranty issues. 4. WHAT YOU NEED TO DO PRIOR TO OUR STARTING THE INSTALLATION: • You will need to remove all curtains, shades, blinds, window air conditioning units etc.from the existing windows. • We also ask that you remove any pictures mirrors, etc. on nearby walls and tables. • Move all furniture away from the area around each window leaving approximately 3 ft in front of the window and lft on either side of the window to be replaced. • Secure any pets(and children)for their own safety and for the safety of our installers. 5. ALARM SYSTEMS: It is the responsibility of the Homeowner to inform the alarm company of the upcoming window or door installation and to arrange reconnection after installation is complete. 6. EPA-LEAD SAFE GUIDELINES: Homeowners of homes built before 1978 have received a copy of the lead hazard information pamphlet informing the Homeowner of lead hazard exposure from renovation activity to be performed in their home. The Homeowner understands and agrees to indemnify and hold Contractor, Contractor's representatives, and employees harmless for any lead paint health issues. 7. INSIDE INSTALLATION (Normal): If the windows are to be installed from the inside, the interior stop moldings will be removed from the existing windows and reused after the new windows are installed. Please note that the paint or stain on the trim/moldings may get chipped and would need to be touched up by the homeowner. 8. OUTSIDE INSTALLATION (Special): If the windows are to be installed from the outside, the existing window's wood "stops" will need to be removed. In addition, if there are existing storm windows in place outside of your current windows, these will need to be removed as well. Please note that the area(s) where the wood "stops" and/or storm windows were removed will need to be patched and painted by the Homeowner unless the exterior trim is to be installed by Window World. 9. UPON COMPLETION OF INSTALLATION:After the installation is complete,you will be asked to inspect the entire project with our Installer. An evaluation sheet will be provided for the Homeowner to sian after the final inspection is complete. Please make sure that any corrections have been made before the installer leaves the job site. When the job is complete, we ask that you pay the installer the remaining balance due on your contract. 10. METHOD OF PAYMENT: Our installers will accept your final payment in the form of check, money order, Wells Fargo financing, or Visa/MasterCard/Discover Card authorization. As a courtesy and to ensure the safety of our installers; please DO NOT pay your final payment In Cash. 11. REFERRALS: Our goal is that you are pleased with the work we have done and will refer us to your friends and neighbors. You will receive a $50 referral fee for each person you refer who purchases 8 or more windows. Please have your referral mention your name when contacting our office. We trust that your remodeling experience will be a pleasant one. If for some reason you are not completely satisfied, please contact our office. Your comments are welcomed and will be used to better serve you. Thank you for your business! Primary Homeowner Secondary Homeowner Design Consultant 1. �v 1 EPA "Renovate Right" Brochure can be viewed and printed from here: Renovate Right Brochure WW of W. Massachusetts anticipates starting this work on and being substantially completed in days.Any deposit required in advance of the start of the work SHALL NOT exceed 33 1/3%of the total contract price OR the actual cost of any material or equipment of a special order or custom-made nature, which must be ordered in advance of the start of the work to assure that the project will proceed on schedule. No final payment shall be demanded until the contract is completed to the satisfaction of all parties. All home improvement contractors and subcontractors shall be registered. No work shall begin prior to the signing of the contract and transmittal to the owner of a copy of such contract.WW of W. Massachusetts under provision of Chapter 142A of the general laws is required to apply for and obtain all construction-related permits.WW of W. Massachusetts shall not be deemed responsible for delays in the work described in this agreement caused by regulatory, permit granting agencies, authorities, or individuals. Notice: If the PURCHASER(S)obtains his own construction related permits for the work described under this agreement or deals with unregistered contractors, the PURCHASER(S)is hereby advised that in the event of a dispute,judgement and nonpayment, the PURCHASER(S) will not be entitled to make a claim or collection from the guaranty fund established by chapter 142A, M.C.L. You the buyer may cancel this transaction at any time prior to midnight of the third business day after the date of this transaction. Notice of cancellation must be in writing postmarked no later than midnight of the following third business day. THIS IS A CUSTOM ORDER NOT FOR RESALE This Window World® Franchise is independently owned and operated by Window World of Western Massachusetts, Inc. under license from Window World,Inc.