37-083-004 BP 2022-0756
266GROVE ST UNIT 4 COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
37-083-004 CITY OF NORTHAMPTON
Permit: Exterior Res
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
BUILDING PERMIT
Permit# BP-2022-0756 PERMISSION IS HEREBYGRANTEI TO:
Project# WINDOWS/DOORS Contractor: License:
Est. Cost: WINDOW NATION LLC 116396
Const.Class: Exp.Date:05/20/2025
Use Group: Owner: KESSLER MICHAEL AARON &MAR A VERONICA
Lot Size (sq.ft.)
KESSLER MICHAEL AARON & MARI
Zoning: URB Applicant: VERONICAWINDOW NATION LLC
Applicant Address Phone: Insurance:
266 GROVE ST UNIT 4
NORTHAMPTON, MA 01060
575 UNIVERSITY AVE (866)217-9582 WC9064617
NORWOOD, MA
ISSUED ON:08/03/2022
TO PERFORM THE FOLLOWING WORK:
INSTALL 7 WINDOWS AND 1 DOOR
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:
Final: Final: Final: Rough Frame:
Gas: Fire Department Driveway Final: Fireplace/Chimney:
Rough: Oil: Insulation:
Smoke: Final:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOL• TION OF
ANY OF ITS RULES AND REGULATIONS.
Signature:
' r , '1 •
II
Fees Paid: $40.00
212 Main Street, Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
lc IJE`ED V-F,9c O
CYIL 6-Z7-22 l�&CE/V
t
The Commonwealth of Massach setts JUN i
Wf 11 ' OR
Board of Building Regulations and tan rds 2 3 �Q2Z IPALITY
Massachusetts State Building Code 780, Pr SE
Building Permit Application To Construct,Repair,Tteno elq,� • Revis d Mar 2011
One-or Two-Family Dwelling V1q n psoo^�s
This""Section For Official Use Only
Building Permit Number: (go., . -7sc/ Date Applied:
lie 0 ii.) es /�
Building Official(Print Name) Signature Date
SECTION 1:SITE INFORMATION
1.1 Property Addr ss• �^ -�^ 1.2 Assessors Map&Parcel Numbers
P rh�'�� ���s�< �'/ �
1.1 a Is this an accepted street?yes no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1
1.5 Building Setbacks(ft)
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public 0 Private 0 Zone: _ Outside Flood Zone? Municipal 0 On site disposal system 0
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP'
2.1Ania4eL: x,,,..... / .,e.... 1 1 <) 7 27 v IV- C/o6U
Name(Print) City,State,ZIP
2 >/� �7 4'7 / 757- b�,C-^y,%'
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK2(check a that apply)
New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) Alteration(s) 0 Addition 0
Demolition 0 Accessory Bldg. 0 umber of Units Other 0 Specify:
Brief Description of Proposed Work2: 1� ���-L2^ 4 G.,i/AJ , -24,' 2)
0-i/i)),Aii--// Jx f7rXX /. T✓
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1. Building $ /2 "LC7Z d7+ 1. Building Permit Fee: $ Indicate how fee is determined:
/ ❑ Standard City/Town Application Fee
2.Electrical $ ❑Total Project Cost3(Item 6)x multiplier x
3.Plumbing $ 2. Other Fees: $
4.Mechanical (HVAC) $ List:
5.Mechanical (Fire $ Total All Fees•l�ij
Suppression) NOV
Check No Check Amo1:4 Cash Amount:
6.Total Project Cost: $)2, 6,2 4 ' 0 Paid in Full 0 Outstanding Balance Due:
/
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor icense(CSL) /l j/ ' / '--2?
beE License Number Expiration Date
Name of CSL Ho 4. rG � /� i , )
1, IZ Z List CSL Type(see below) v
No.and Sirejjt / J_
T e Description
/ , ,/1 b tv2S /��/ Restricted 1&2 Family Dwelling
City/Town,State,ZIP M Masonry
RC Roofing Covering I
WS Window and Siding
- 4 2)2- 9� 2- SF Solid Fuel Burning Appliances
I Insulation
Telephone Email address D Demolition
5.2 Registered Home ve Home IImprooment Contracto (HIC) I 7/ Z l22-2,/
W`A/P� -1/ /V/t/ /V-,-I z li v HIC Registration Number Expiration Date
HIg, j or e ; tr y a% /�
Ny)No�ljj et .2.)b ., 2ozz 44‘. '7/2 _ Email address
City/Town,State,ZY1' Telephone
SECTION 6:WORKERS' COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152.g 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 Issuanc of the building permit.
Signed Affidavit Attached? Yes No .❑
SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
-
I,as Owner of the subject property,hereby authorize tZ17b/L -1 L
to act on mybehalf,in all m ers rel tive to work authorized by this building permit application
197 )a*Kt_ —ifs er>, 'zo-zi^ Z-7'9-.P -
Print Owner's Name(Electronic Signature) Date
SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION
By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information
contained in this application is true and accurate to the st of my knowledge and te understand6-7
ng.
A , AO/ 'b2 2--
Print • er's or Authorize Agent's Name E ectronic Signature' Date
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 can be found at
www.mass.gov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dps
2. When substantial work is planned,provide the information below:
Total floor area(sq.ft.) (including garage,finished basement/attics,decks or porch)
Gross living area(sq.ft.) Habitable room count
Number of fireplaces Number of bedrooms
Number of bathrooms Number of half/baths
Type of heating system Number of decks/porches
Type of cooling system Enclosed Open
3. "Total Project Square Footage"may be substituted for"Total Project Cost"
City of Northampton< AM,,_,� "•"
7, • o1, SAS,,,....-.,.,S/`,
/iv,- L.4k.,
Massachusetts t4}` S.- ,,
`:, ,�.4 DEPARTMENT OF BUILDING INSPECTIONS yt
\<..--t-A-._--4-:—i4'o:
` 212 Main Street • Munici al Buildin V' {S�
•
\ '.� p 4 6,;a r0p
Northampton, MA 01060 4.1i-.. 4‘
CONST
RUCTION DEBRIS AFFIDAVIT
(FOR ALL DEMOLITION AND RENOVATION PROJECTS)
In accordance of the provisions of MGL c 40, S54, a condition of Building Permit
Number is that all debris resulting from this work shall be disposed of in a
properly licensed waste disposal facility, as defined by MGL c 111, S 150A.
The debris will be disposed of in:
-- 7), _, efi,,,4,z- ,19--,u,„232,,__
Location of Facility: !'
The debris will be transported by:
Name of Hauler: 49—P a lio6f---/- re_ /' t-r' `-
Date: 21'�
Signature of Applicant. �r/�� 7^
, -4•!-:'.-1.-.::*....g..-tr.-...t.,
..,.--..••--•-r.......:.,:i;,..9...!:,-r-.;•.=-.7-r- .
-'''..-::- .Z.N-;t11.-a---U..,•.••::::-7.... ..k,F47-c Irrt.',....--.- -
-•,--.-.!:-....--.Z4M.,•Y.I.4.-'f•:(47; .-. .Z.
•:. .-:1‘.17. -':i ...:;---.7-t-„ _....,..-:*
.45.Z.F.11;11,
-- t':•••.:.7.4.4k-ls• ,-k-1.72-.it.'74
----2 i
---,.--........--. ._•,... . ..i.•":.Txu,:-
- '.- '.• .-4L,",t4AV&Vst.1'4'rek-- fi• ''r.''''' ..1
,g1:-..----- --.• : •.3".•:;;"..- -sf,..th-3.:-•:':• ik.--,...4. -.-, •••.1 4'1 t%:',-- ---.,.,.---es.c):-•-
7%.!'i i t'7f•i"..:"...TafC•i ,"::VV.-">..4.."`"Ntiet
.•.----;-•-•;-.---4'.:-.47.,j t ';' ..,\'.‘.4.,,kagiP4i•r=', ,.•gt, \K, >,,-„. tK ,. l'a.
4.2,::./1:XV 1, r. :......::::::Att•-t•.„..4.*;ik-fkz.`.s.tt,v;•:-;_l• '-,..,-n" •-... ''''
f..,....-:,,ISN 1 . ' .KiT:6:wt--sibsk,,,,,,pz,--.,.* 1.-,•;,.14 -..,•• ,-;..,„._,,. .41z-
, . 2. -,,, N*.sv:?... ....4-•Amk• .,-,,e,...--
•a-''
ff.ile -'1,-FZil 1 - - : "i'P::$1.-451tii s‘r .. I :-='" •x-
t .1-f.,.......- p.. ........
1 :::::,• ; :.
• . i--.4...".:::—...,.4 - ii
1 •:.-•,,:- L. '' . .
; ..; :.. ...•-• ..,....? . : .....NI .\ :if
1 ..
t t ..k.i :-.,.i
. I ••./
- .,........... .
i - B:Certifib!d--:'', •:
,
s.....-•—•..-,..,,,..,..-........„,"„10,0-..ra.,...1
ez-,-, • ?...W..., - ...4--'
1,....••-;"--- - Y-lf,E.ii,
....,_
— .. .
7-La '''''-ii‘,' • - '. _ • .
'''"-.. .-. '.--rr.n,.....(,-.71$Z,•Y tr.-zr,VI,/ -,,,,er.,_;1,7.-:
. ,L......--;,--,11\L'2(‘..• .t.k.:.. - WIND OIAT I\TA-TrONT
r.J..':::7:7&•' 'tt%....„._-::';:i. VTNYL DOUBLE JP-UMW •:. ;--
. . , .
TRAVT
:-'..litilna1.7-ert ..tration - •... . ,-. ;
REjng Ot.r.:Cil% Double Giazing..Arec4-2 Figi.Lomi E-i:-;-: ::::'• .•
9.L. -.-13-01$13-00001 2---•:' ...-::::...;-...;1` '
- • .!,,--y r : '•.r.j ;.::;,.:.
7,---Nr-r---R.GY PER.FORMANCE -LRA.11 NG
_ .... .......•
,
. -,. LI-Factor (U_S./I-P) •Solar Heat Gain C6effiTe tit:-ift,'-''..-:::-.'1:::
,....."..eD
0 E ..:„Lr,,W-._,„.!.;:,:::,.._-,:.:.. .q11-.3f:-."7:7!.'1,:.
•-7:
• "" 17- ) e
,,,_,, r..." :.-1;
# •._......-...., o ..—:--_-,-...-
'...pt!..
-
. . _ ...
Visible Transmittance Condensattoi14? $t414..c.gif'-4:::-,.,!i.;,
1.... „3".
. -•--.• ,..... .-:'4;•:; 71,..
.......,....___ ... .„... ..:.„.
...-. ts .,
--„-7,-fr: • . ',age Veltc gai.sakr<iX fth".:e_1:-',...f.1,:=4,
,----.Oa 3 yj..•,..1•11.7.1..1...gala.
•
'- ;:.'-'""L"'"'"'"'"'"4"."'W"'''.•••• ..• LI a. ra A.•:.:...t.t.n.s.-a.,aSlet Ink pra kr.ir Itri• FritC.-...:...•,.:,..':f..:144: ;-....'":.
r.r.=---.1•,"--,",*--,-"""•.--"-' ;_"-..,... ., „..,.... Pa I:.?aak-:no:t..vominetel art ir.r.•&X r• ::.-,....:"1:::,:-,f•
'"..7,‘,....".":.71,r":.:: -:::rr ::,:.;;•;7,-.;.,;..,....,,,,,,,,,........-f...,Surli
....t..i4.:7:-'-;:"":"::'''''.."--•".":"r."' :'..':!:,:;;It.i....11
I 6 57=-7 91-020 -• .•.:- :-
F=..,...:
. .
_....._
ENERGY STAR* Cortiliud in Alt 0 Status
i.
f
4 ' .
i
y0/7an d f u 4
YE{ i �! p
, i
r 4
! 4
3
,,,
r
vviii
r , fir _
ir
.. t�tt�trt; , \N1 t )( )tN NA 11f ?C".1
�1 � �* VINYL SLIDING DOOR
KI G YAL
baits!, VI0,ttt.fitt,i'
/,f) It,f"' .t.1t�J f)c►t4tiir. (: t tzinf .Arg()tl i-ftt,[.,ow t. r=tti
.14
ENERGY PERFORM AN RATINGS
ti Es.tc rit (U� .;',/1 '1') ',rilo 1-1(tot (: ,ilf't (: rUflf.l ii
0 . 28
ADOMONAL PERFORMANCE RATINGS
V€`,ftA ° Ii =;tr ,t titt. i o, ( r rir`i(Iti ittc ri r a..C� 1,1ti : .,
0 60 44
,,,,,, ,,,, t t,„ts r,„„ fit:.,GI,•4t 1Ftr'- -iti af cf'i,•et:1,.ir,t tt. :q,,i?a,dt 114 f1d fo,_ .b,t- : t
,'ia,•c s..i.'1 iix,k , .t.1140t f., f'dt 4,0/0,- ft 1f1. „I-Ut.,1, 'M+ •Se-Es3t1srttrf.•) S"t t(ir. •) t r.f
F,.,rr,r.rf -',ir0•.r,4 t?,+rty,- 4.-1.°1%gtt-f! M tArette:1 , - fA t . ,,,',4 r.'ri .t ,., . ,.I 0,7 ;- .t„t
'0,,7 ,,M -•.:e+ 7f.tte•}i 4 raaz ^,€tfz asfrtf ,s1 .,t f `. ,.4 i-`. ,1"f tti.5_- .f;.. ,..', • - „i .,'4s,1 ,,;I riz, ,
W' , ,""*, a'A •rff,i IA'd'ttd t i,a,.€rrt,,l tt,,44 18. I- f , ,,fk
w$
• 1070 North Farms RoadNAAI Date of Agreement:
Wallingford, CT 06492 April 26,2022
WIN DOW NATION Sales: 866-446-2846
License#: 197968 WINDOWS • SIDING • DOORS Service: 866-217-9582
PRODUCT SPECIFICATIONS
Buyer's Information and Buyer Contact Information: Buyer Email Information:
Description of Property: (757) 685-4633 Home greengenome@gmail.com
Michael Kessler (571)270-0568 Primary Mobile ' j )
Veronica Kessler I!
266 Grove St Apt 4
Northampton, MA 01060
Buyer(s) listed above hereby jointly and severally agrees to purchase the goods and/or service.
listed on the accompanying specification sheets, in accordance with the prices and to ii s
described in the Custom Remodeling and Improvement and the Product Specification s
(collectively, this"Agreement").
Windows - Ultravision inclusions: Beveled exterior frame with slimline look, Fusion welded frame and sas •s,
Limit lock on double hung windows, dual-fin wool pile weather stripping, cam-action lock, special formula uP C,
block and tackle balance system on double hung window, Integral lift rail, Intercept spacer system, reinfor.ed
meeting rail and bottom sash rail, , Dura-Sill engineered sloped sill, Soft-Seal straddle gasket, exterior cust m
capping,installation by factory certified crew,clean up and haul away of all job related debris.
DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES.
It is agreed and understood by and between parties that the Product Specifications, along with e
Custom Remodeling and Improvement Agreement, constitutes the entire understanding betwe-,
the parties, and replaces any and all prior negotiations,representations, or agreements, either
written or oral. The Product Specifications may not be changed, modified, or varied in any wa
(with exception that installation materials may be substituted with similar products when
inventory shortages exist)unless such changes are in writing and signed by both Buyer(s) and
Window Nation, LLC. Buyer(s)hereby acknowledge that Buyer(s)has read the Product
Specifications.
I have read and received each page of this 3 page Product Specification.
Window Nation Buyer(s)
Signature of Exterior Design Consultant Signature
Paul Cangialosi-License#On File
YOU,THE BUYER(S),MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD s USINESS DAY
AFTER THE DATE OF THIS TRANSACTION. SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN XPLANATION
OF THIS RIGHT.
April 26, 2022 www.windownation.com Pap 1 of 3
, 1070 North Farms Road VIVIV
Date of Agreement:
Wallingford, CT 06492 April 26, 2022
WINDOW NATION Sales: 866-446-2846
License#: 197968 WINDOWS - SIDING • DOORS Service: 866-217-9582
PRODUCT SPECIFICATIONS
Buyer's Information and Buyer Contact Information: Buyer Email Inform tion:
Description of Property: (757) 685-4633 Home greengenome(i)gmail com
Michael Kessler (571)270-0568 Primary Mobile
Veronica Kessler
266 Grove St Apt 4
Northampton,MA 01060
Work Order Details:
Model:Ultravision W:32"H:49" Location:Level 2,Bedroom(master)
j Quantity:2
• Style:Double Hung • Configuration:Equal Sashes
• Grids:None • Glass:Extreme 2 Pane/Low-E&Argon
• Screen:Half Screen
• Color:Interior White/Exterior White
Model: Ultravision W:32" H:49" Location:Level 2,Office
2 Quantity: 1
• Style:Double Hung • Configuration:Equal Sashes `
• Grids:None • Glass:Extreme 2 Pane/Low-E&Argon
• Screen:Half Screen
• Color:Interior White/Exterior White
Model:Ultravision W:28" H:37" Location:Level 2, Bathroom
3 Quantity: 1
• Style:Double Hung • Configuration:Equal Sashes
• Grids:None • Glass:Extreme 2 Pane/Low-E&
• Screen:Half Screen Argon/Tempered Full
• Color:Interior White/Exterior White
•
Model: Ultravision W:32"H:49" Location:Level 1,Dining Room
4 Quantity:2
• Style:Double Hung • Configuration:Equal Sashes
• Grids:None • Glass:Extreme 2 Pane/Low-E&Argon
• Screen:Half Screen
• Color:Interior White/Exterior White
•
April 26, 2022 www.windownation.com Page 2 of 3
1070 North Farms Road Date of Agreement:
Wallingford, CT 06492 April 26, 2022
WINDOW NATION Sales: 866-446-2846
License#: 197968 WINDOWS • SIDING • DOORS Service: 866-217-9582
PRODUCT SPECIFICATIONS
Buyer's Information and Buyer Contact Information: Buyer Email Information:
Description of Property: (757) 685-4633 Home greengenome@gmail.com
Michael Kessler (571) 270-0568 Primary Mobile
Veronica Kessler
266 Grove St Apt 4
Northampton, MA 01060
Work Order Details (cont.)
Model: Ultravision W:28" H:37" Location:Level 1,Bathroom
5 Quantity: 1
• Style:Double Hung • Configuration:Equal Sashes (�
• Grids:None • Glass:Extreme 2 Pane/Low-E&Argon
• ScreenColor: Screen
• Color:Interior White/Exterior White
Model: Ultravision W:60" H:80" Location:Level 1,Kitchen
6 Quantity: I
• Style:Sliding Glass Door • 5 Foot Door-60"x80"(2Panel)
• Grids:None • White Handle
• Glass:Extreme 2 Pane/Low-E&Argon
• Color:Interior White/Exterior White
j
Additional Items
1 -Frame Out SGD
Special instructions:
Told to remove blinds
Installation Details:
Window Removal Type:Wood Additional products needed in the future:No
Exterior Trim:G8
Exterior Trim Color:White Customer agrees to allow Window Nation to post a yard
Sealant: OSI Quad Max sign until 30 days after install: Yes
Insulation Around Window: OSI Quad Foam Year house was built: 1991
Clean Up and Haul Away:Yes EPA Lead Containment Required:No
EPA Lead Testing Required:No
HOA Approval Required: Yes
April 26, 2022 www.windownation.com Page 3 of 3
1070 North Farms Road Date of Agreement:
Wallingford, CT 06492 April 26,2022
WINDOW NATION Sales: 866-446-2846
License#: 197968 WINDOWS • SIDING • DOORS Service: 866-217-9582
CUSTOM REMODELING AND IMPROVEMENT AGREEMENT
Buyer's Information and Buyer Contact Information: Buyer Email Information:
Description of Property: (757) 685-4633 Home greengenome@gmail.com
Michael Kessler (571)270-0568 Primary Mobile
Veronica Kessler
266 Grove St Apt 4
Northampton, MA 01060
All home improvement contractors and subcontractors shall be registered. Inquiries about a
registered home improvement contractor should be directed to the Office of Consumer Affairs and
Business Regulation Home Improvement Contractor Program, 1000 Washington Street, Suite 710,
Boston, MA, 02118, 617-973-8787
Buyer(s)listed above hereby jointly and severally agrees to purchase the goods and/or services of Window Nation,LLC.
("Contractor")in accordance with the prices and terms described in this 6 page document and the Product Specifications,which
are incorporated as part of the Agreement(collectively,this"Agreement"). This Agreement represents a cash sale of goods and
services. Buyer(s)agrees to pay the cost of the goods and services purchased as described herein,regardless of timing or
approval of any financing Buyer(s)may seek for their purchase.
Sale Total $12,327.00
Setup&Disposal Fee $249.00 Estimate Project Start: 14-16 weeks
Permit Fee $0.00 Estimate Project Finish: 1 to 3 days after start
Total Sale Price $12,576.00
Sales Tax(0%) $0.00
Total Amount Due $12,576.00 Buyer(s)acknowledge that definite start and completion
Down payment-Charge $500.00 dates are NOT of the essence. Delays beyond Contractor's
Balance Due $12,076.00 control not included in calculating timeframes. See
COD(Payable at time of install) $3,500.00 Section 5 of the Terms and Conditions.
Amount Financed $8,576.00
This Agreement constitutes the entire agreement and understanding between the parties,and this Agreement replaces any and all
prior negotiations,representations,or agreements,either written or oral. No amendment,modification or waiver of this
Agreement shall be valid or effective unless in writing and signed by both parties. Buyer(s)hereby acknowledge that Buyer(s)
1)has read the entire Agreement and has received a completed,signed,and dated copy of this Agreement,including the two
accompanying Notice of Cancellation forms,on the date first written above and 2)was orally informed of his/her right to cancel
this transaction.
Buyer(s)also agrees and understands that if Buyer(s)finance the work with a third-party,the terms of that financing will be
contained on separate documents,including any finance charge.
Price includes all discounts and promotions.
I have read and received each page of this 5 page Agreement.
Window Nation Buyer(s)
Signature of Exterior Design Consultant Signature
Paul Cangialosi-License#On File
YOU,THE BUYER(S),MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY
AFTER THE DATE OF THIS TRANSACTION. SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION
OF THIS RIGHT.
April 26, 2022 www.windownation.com Page 1 of 5
. 1070 North Farms Road114/*Air
Date of Agreement:
Wallingford, CT 06492 April 26, 2022
WINDOW NATION Sales: 866-446-2846
License#: 197968 WINDOWS • SIDING • DOORS Service: 866-217-9582
PRODUCT SPECIFICATIONS
Buyer's Information and Buyer Contact Information: Buyer Email Information:
Description of Property: (757) 685-4633 Home greengenome@gmail.com
Michael Kessler (571)270-0568 Primary Mobile
Veronica Kessler
266 Grove St Apt 4
Northampton,MA 01060
Order Summary:
Ultravision Ultravision
6 Double Hung 1 Double Hung
Configuration:Equal Sashes Configuration:Equal Sashes
Grids:None Grids:None
Glass:Extreme 2 Pane/Low-E&Argon Glass:Extreme 2 Pane/Low-E&Argon/Tempered Full
Screen:Half Screen Screen:Half Screen
Color:Interior White/Exterior White Color:Interior White/Exterior White
Ultravision
1 Sliding Glass Door
5 Foot Door-60"x80"(2Panel)
Grids:None
Glass:Extreme 2 Pane/Low-E&Argon
Color:Interior White/Exterior White
White Handle
Total Order Summary of Units 8
Additional Items
1 -Frame Out SGD
Special instructions:
Told to remove blinds
Installation Details:
Window Removal Type:Wood Additional products needed in the future:No
Exterior Trim:G8
Exterior Trim Color:White Customer agrees to allow Window Nation to post a yard
Sealant:OSI Quad Max sign until 30 days after install:Yes
Insulation Around Window:OSI Quad Foam Year house was built: 1991
Clean Up and Haul Away:Yes EPA Lead Containment Required:No
EPA Lead Testing Required:No
HOA Approval Required:Yes
April 26, 2022 www.windownation.com Page 1 of 1
The Commonwealth of Massachusetts
-=14 Department of Industrial Accidents
~ a�� o 1 Congress Street, Suite 100
"• � Boston, MA 02114-2017
www.mass.gov/dia •
Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/PIumbers.
TO BE FILED WITH THE PERMITTING AUTHORITY.
AaplicantInformation
/ Please Print Levibly
• Name(Business/Organization/Individual): �1�//1'i�/d e72/- ./LJ lf0/V 1
Address: 712 M r el lGj 11/
Cit /State/Zip:/ � ' 'r � 12� Pone#: . `�CAI . 7 ��
Are you an employer?Check the appropriate box: Type of project(required):
1.IYI l inn a employer with Z1) employees(hill and/or pan-time). 7. El New constiaction
2 I am a sole proprietor or partnership and have no employees for me in •
'' •0p p p' p. working 8. �Remodeling
.• any capacity.[No workers'comp.insurance required.]
3.01 •
am a homeowner doing all work myself.[No workers'comp.insurance required.]r
9. 0 Demolition
4.0 i am a homeowner anti wilt(making contractors to conduct all work on my property. i will 10 Q Building addition
ensure that all contractors either have workers'compensation insurance or are sole I I.0 Electrical repairs or additions
proprietors with no employees. 12.0 Plumbing repairs or additions
5.0.1 am a general contractor and i have hired the sub-contactors listed on the attached sheet.
These sub-contractors have employees and have workers'comp.insurance.; 13•0
of repairs
6.❑We are n corporation and its officers have exercised their right of exemption per MGL c.
14. Other l / ��
152,§1(4),and we have no employees.[No workers'comp:insurance required.] ] j)t27Z—
'Any applicant that checks box al must also tilt out the section below showing their workers'compensation policy intonnatior.
'Homeowners who submit lids 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'crimp.policy number.
7,,
7 am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.n. �. '
Insuuance Company Name: 5e Lr-l/'r/�' _z....guram, Ca Li 2\ •l
1 I
L` 1 C � ( // Expiration Date: "r' --
Policy#or Self ins.Lie.#: Jk6 �% T' 7"
' ,,/ �!�f
Job Site Address:_ �b6 e-U�-DVi `� ' City/State/Zip 6L / i /✓/
Attach a copy of the workers'compensation policy declarati page(showing the policy number and expi ation date).010a/
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. .
I do hereby cer ' rrder the p 'ns and penalties of peditry that the information provided above is truel anted correct.�}
Sianature. , t•ll _ • Date: / v" "
Phone#: ✓Y� /� t�( � ]ice ---i / .ZJ _
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 S.Plumbing Inspector
6. Other
Contact Person: Phone It: e
111 Division of Occupational licensure
Board of Building
',�R,Uyegl Regulations and Standards
Const ion Sli fvi%or
.P
CS-116396 r 1g:spires:0512012025
BRANDON LOYLE LAND y
142 RHODE ttiIAND Aye
CUMBERIAItj RI 02894 + J 161
i f
Commissioner claeioa , `6'&,, a.
THE COMMONWEALTH OF MASSACHUSETTS
Office of Consumer Affairs and Business Regulation
1000 Washington Street- Suite 710
Boston,Massachusetts 02118
Home Im rovement ContractorRegistration
to : Type: Supplement Card
— R istration: 197968
WINDOW NATION LLC ',� F E:k6ifation: 02/12/2024
8110 MAPLE LAWN BLVD,#335 ;A Z� S —
FULTON,MD 20759 .p,
;�, a 1
Update Address and Return Card.
THE COMMONWEALTH OF MASSACHUSETTS
Office of Consumer Affairs&Business Regulation Registration valid for individual use only before the
HOME IMPROVEMENT CONTRACTOR expiration date. If found return to:
TYPE:Supplement Card Office of Consumer Affairs and Business Regulation
Realstratton Expiration 1000 Washington Street -Suite 710
197968 :; 0 2/1 2120 2 4 Boston,MA 02118
WINDOW NATION LLC
IA
i.BRANDON BOYLE `?
575 UNIVERSITY AVE G,, n - m64�rli `
NORWOOD,MA 02062 ..: . Undersecretary Not valid without signature
~� WI • OP'_C: . -.P'
�� CERTIFICATE OF LIABILITY INSURANCE i DBi,o4i9o21 !
FHIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THiS
CERTIEIATE DOES NOT AFFIRMATIVELY-OR NEGATIVELY-AMEND. EXTEND OR AI T=_R THE COVERAGE AFFORDED BY THE POLICIES
BELOW THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT SETWEEN THE ISSUING IHSURER(S), AUT:tORiZED
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
i this certificate does not confer rights to the certificate holder in lieu of such endorsemeni(sl.
PRODUCER 440-461-1101 !cor,rAcr Tim Fitzpatrick
•Va,•.1 5:
3 Associates,Inc. !PHONE110-461.1101 {;`AX 40-1 6 019?
23825 Commerce Park,Suite A tAvc.alo.am: :,A,c.Nol:
3each',voad,OH 44122 j a�oa�;s:jrusso@toddassociates.com
Timothy P.Fitzpatrick
rNSUP.ER(S)AFFORDING COVERAGE VAiC:
truURER.A:SaieCtIVe Ins.Co-of America 125T2
•ISURED i U18URER 3:Selective Ins.Co.of the SE 139926
Window?latfan Holding,LLC
'Ynuaw:lalfon LLC I t13URER C:
ifrkra Window Nation,lncj,
31 to aaale Lawn Slid..-435 i INSURER 0
Felton.?AD'_O7i9
t ttJSURER E:
•
I INSURER P:
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE?OLICIES OF INSURANCE US T EC SELCW HAVE SEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY :?ER:CD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT TERM OP. CCNCI T'CN OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH 7.-'IS
CERTIFICATE MAY SE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE 2PANS
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE SEEN REDUCED BY?AID(CLAIMS.
INsRI iADDLI SUER) i POLICY EFF ' POLICE/=XP f
3 TYPE OF INSURANCE I WO i wvn I POLICE!NUMBER I r wroor rcr!t I ImMIDOcr"71• LIMITS
A i I X I COMMER.CIALGENE_RALUAaILIrr I i i I I EEC _CC .=.ElCS I 5 1,000.000
I I I CLAIMS:I.acE OCCUR - I I 52423a78 i 08/04/20 21 1 0 8/04/2022 1 SeiCiises.a�c umrcai j i 500,000
_HI I I i.u_a BAR-.am.ono Doom ! s 1 i,000
` 3 1,000.000
{i j 1PERSONAL ACV INJURY I s
i
^y r'_AOGR=., AT_;0.11T AP^iES=E_• I 1 ' ; i BEN=RAL-„GR_•3;-_ 2.DDo.aaD
Li7 i 2,000,000
—J POLE/L x I IC ,;.,,Ft: i ^; :-C i r , ; =Ri;C.,CTS-..CLIPiCP a _�i o
Ar a.=at,50 SINGLE ,,h- 1,000.000
i AU TOh10alLE LIAi31LITY I•?a acdeentl
T x-I atP'AUTO I. g+127sT7:a:+'a9o":3 '08/04/2021 08/04/2022!sacI:,.,`uli" Per:among i
.��1?"5':r L-r i i°t =;.,L_J I ( i I EOCIL'rUR l., " Par ac=eerei
i450+ i i ,P?ra=d?rtl U0 ,,1
A i X UMBRELLA LIES I X CCCUP. f i i i t E.ACH:.CCURRENCE l i
•El s. cesst.as I ,cL-t,Ms.:IAGE1 I S2423578 j 08/04/2021 D8/0412022 Acc,_s,,_ i 10.000.000
I I OEo I X I RE-r=_a •1 mor s 01 . 1
B WORKERS COMPENSATION I i I X ' R ? ;
AND EMPLOYERS'uAelLrTY i I s�.Ai';7E I I= ! '
A YrN f L'IC90adalr(Aos) 08/0 /2021 08104/2022j=; =Ac r tcc:CENT 1 ; 1,000,000
ANY PrT_OPRI=TOR,PARTNEPJER`CUTl. ;i j' X 1 j ---
OrrICERISIEMBER:i(CLUDED? `al/.Al wc3as.otsINJ) 08/04/2021i08/04/2022i=. I 1,000.000
I((Mandatary m NH)
I CIS;.=�E• t1 !�Y=>;
Iif yes descnbeunder i 1,000.000
DESCRIPTION al:OPERATIONS below ! i I =._WISE-u-=CL:C':7.It- i
11 j ( 1
I I ! I
OESCRIP T ION OF OPERATIONS!LOCATIONS r VEHICLES(ACORD I0I.Additional Remarks Schedule.may taa attached if more.:pace is required)
Waiver of Subrogation is provided where required by written contract and as
permitted by law.
CERTIFICATE HOLDER CANCELLATION
BOSTBO4
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
• /G..sq- ?AZ-
AGOP,D 25(2016/03) 1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
••••:'.:::.''*-7,.."'S.::;11:,1.SIZT:1473.737-ti•-*
- : ',':,•.*,- .MkatiA' ,4-,tV:;-f-.;,-Ar..;:,,.,_, 474:-
• ,: :','•;•_,:rtuk , --1 .=-•,•,,..:_rm'..„,--,--._:,,,,. IR .5.,,.........1711,, • l•ii,--
.414,..4.41,11
•----'2*...-;.,•=', '..' .- y I ef.%:-.:-:71.4,-;:v•:,,--7-4-.4X4rAt.la1.7 ••<..*:) ARkla
f,"7-,,---i.,..,....,.., i •f.,,,..•:.:4;::•.. .:.t.:141.-$.-'-k3.„,..c... •;:, s . '
,. '':s-,N. I a-.,.,,:_t;,,, ,,." -:311,,t-4•.,,,, ••%t•c.,,,,,t s. ‘.,ti, ,.
,.. - 1'1.4.a 1 'r li,:;:•.7.t.tn.t....... ..i.,,....,71df-6 " ....4Kf...7.:„ ,"•.1. . , r-
: .._N-.••.P.:..-1.4 .1"•Wi,4.4;‘,...'i.,:".7.:VAN 'Vs\`"k -
Vt-g;".711 1 jAi"',4"';"1.1*.."-ft.-AIW-Wit+ .• *4.4,,t i
44W.7. [ ,,..e, ._.• 1\...eltfg•?':.41A4.s‘ • .k7
-' .1-.1i..mee''..e.t..Vir `•c •N-.4 ,
A T61::'i a I i r.:t-r , •:14,_v.__.',. ,..,,'
- /-..
1
1 1-1 ; .: /
1 31-.:•_I - , .40-:-„,-- II
i -...:.,• -
, ... . '-•-• AS'-4,...1t -NI•N j
... ...,-• 1 %,
•--7 :
1 21 Certified - ,
alt-, ilscke,,,,,, NAM/
,i.`:•• , ,2=---:-• ,
''...0.- -. -S..FRt_;"-• '":„''.' i.
c--..„...„,,,zi : WINDOW NTATIO.N. . 1
i..., -: -,_- ...-..,
VINYL DOUBLE HUNG
. ....,,,...._. __...,.......„...,1
U LTRAVIEW /.
natic,PalFerastraliGn -
Ra:ng Z.:my-Ice,® Double Glazing.Argon III.Low E • •
SU A-1301513-0000i
• '
. .
. • - -"' '..•'-
'• ENERGY PERFORMANCE - • ' TINGS. :,,,. ,
. . . ...._ ...._
,-• Li-Factor (U.S./I-P) : Solar Heat Galli Ctiefficientl-,'-,,s'
•
• '' i ,, ,.. •.......... , -,---
ca.. es-ii.- - ,....;f_-:_.-.:..i:.,,I,..,--r,i
.-
.
---.10 2.9 . .
: 0. --- ...a.:::-...1-:-.;f_-i-i.f•
. . .. .ADDI li LON AL PERFORMANCE'' -: IrXISEPq:::::':::':,_-::-j;
•...- ,
, V s b 1 e Transmittance 1Condensation-7 aSista ift-01_,•::
-. •
1• - 0 . 5 5 _ . ..„_,...
. _ .
..._. MA.ad,.tt•.ft-4 vg adotes,tt.1 It a-...-..ut.1 Xr,7..,sloe it.In L..dk reRc P"..,°..1"!ei5 f". ,-. •:• .7:la,
t.al..10,,,....,“.1.,,,b..1.,...i...1 pet,..,,a,.., Pa Its:...1.1.17:All:Jet::nn1117..„.1 fw...s....11.1r!..1,..setp!.... ..........i......2.
'''''''''""'"4.".'..."'"'. -.---.".''."""1 r".• t.A't t f,4W/ruagidgLig .! :...f
4... ....14...-..,..,.014.a el,......, - t ca .-,t,n3o•t •Aar,
igtr-•,„......,,,-.7''''''''"''''''' ''''."-%!,';'Ig:,...„.13.-.....,... 1657491-020
:4•=1.:.:'''... . :- •.: -.. • .
- - - - ---'
. ..
. -