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25A-163 (5) BP-2023-0828 239 NORTH ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 25A-163-001 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-2023-0828 PERMISSION IS HEREBY GRANTED TO: Project# WINDOWS/DOOR 2023 Contractor: License: WINDOW WORLD OF WESTERN Est. Cost: 6687 MASS INC 115719 Const.Class: Exp.Date: 04/30/2025 Use Group: Owner: TENEKJIAN MARK J&LAURA S LITWILLER Lot Size (sq.ft.) Zoning: URB Applicant: WINDOW WORLD OF WESTERN MASS Applicant Address Phone: Insurance: 641 DANIEL SHAYS HIGHWAY (413)485-7335 C5186654A BELCHERTOWN, MA 01007 ISSUED ON: 06/23/2023 TO PERFORM THE FOLLOWING WORK: REPLACEMENT DOOR AND 3 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: 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 VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: 1 4 t' 1 6o Fees Paid: $40.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner J The Commonwealth of Mass huss N 0 e !r, Board of Building Regulations aril to itkt �0 F'L R ';'re 'r � Massachusetts State Building Code, 7.i F' ,� UN IPALITY . t, ; 4 <4 USE Building Permit Application To Construct, Repair,Renovate.T'�' • a R• sed Mar 2011 One-or Two-Family Dwelling 4Oi0c6o./Ogs This Section For Official Use Only Building Permit Number: Sp- )-3 .. x�$ Date Applied: If , . / • � ",• , c• 6i1 a a3 Building Official(Print Name) I Signature , t Date SECTION 1:SITE INFORMATION 1.1 property Address; 1, , 3 1.2 Assessors Map Si Parcel Numbers GlNor ► " 1.1 a Is this an accepted street?yes A' no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 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' 2.1 Owner'of Record; °Zak Ira 111w i I e r a vi d Nct r k, , No r-� In a WI jo+O�t H )4 010640 Name(Print) Yoh e_ki,A e7 City,State,ZIP ,, 3G? Alov-444 S I- a0,2 4 2a a553 'aura 14w; tier Pgt at'I ,d.vvt No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building* Owner-Occupied 111� Repairs(s) 0 Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units 1., Other b/Specify: \C.W 4 , r1PYd--. Brief Description of Proposed Work': pa, -1 p r a y (Wd 3 w i14dta03 Me 1`I ev�'� N(e/V rtofii,� �,¢k _ SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ 6, G VI 1. Building Permit Fee: $ Indicate how fee is determined: ❑Standard City/Town Application Fee 2.Electrical $ ❑Total Project Costa (item 6)x multiplier x 3. Plumbing $ 2. Other Fees: $ 4. Mechanical (HVAC) $ List: 5. Mechanical (Fire $ Suppression) Total All F /IA Check No.� Check Amount: nv Cash Amount: l 6. Total Project Cost: $ 6 pG rl ❑Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) iata U15 N L1 M`1�QL �.�—{�5�. License Number Expiration bate Name of CSL Holder A List CSL Type(see below) U L•XL Q No.and Street Type Description Unrestr\"NL(L 0\001 U Restricted 1 2 Family up toel 35,000 Cu.ft.) City/To ,S 1P R Restricted 1&2 Family Dwelling M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances `'-lcb)49sS.119A LoNi.C)31,}l.» d Vilk. insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) 1 ' , 03(1'-k auaa w 0� �� HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name (c)U !jr310tiIcrrk.A.L.0M and Street Email address cv... 01001 "k- 3) 5`31335 City/Town, State,ZIP 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 EV No .0 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 W\ l-lUv to act onn my behalf,in all matters relative to work authorized by this building permit application. Print eer's Name(Electronic Signature) ate 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•• this ap• '• is true and accurate to the best of my knowledge and understanding. Ttemt //( c 3 Print 0 er 'o•uthori i-i A•=' s Name(Electronic Signature) ate 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 l'alf/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" The Commonwealth of Massachusetts t. ?=tri Department of.Indushza1Accidents 1 Congress Street,Suite 100 � j '` Boston,MA 02114-2017 •-,, www massgov/die Workers'Compensation Insurance Affidavit:Builders/Contractors/Electrirfanc%Plumbers. TO BE FILED WITH flit F RM! 1 NGIIt'1'HORTTY, Applicant Information �U Please Print Leabh, Name(Business/Orrani aation/indivirbml): 4i Oan�et Says 1 7 6 Address: Belchertd�"' A Q City/State/Zip; Phone#: 91',3 ,e85 71 3 �r Are you an employer?Check the appropriate box: Type of project(required): 1. II am a employer with 670 employees(full and/or part-time).* 7. 0 New construction 2.0 I am a sole proprietor or partnership andhave no employees working forma in S. 0 Remodeling any capacity.[No workers'comp.insurance required.] 3.0 I am a homeowner doing all work myself[No workers'comp.insurance required] 9. El Demolition 4.01 am a homeowner and will he hiring contractors to conduct all work on my property. I will 10 0 Building addition costae that all contractors either have we deers'compensation insurance or am sole MO.O Electrical repairs or additions ' proprietors with no employees. 12.❑Plumbing repairs or additions 5.0 I am a genera'contractor and lhave hired the sub-contractors listed on the attached sheet u repairs re airs These sub-contractors have employees and have workers'comp.insurance, ❑ 6.0 We are a corporation and its officers have exercised their right of exemption per MGL c. 14. Other R��la C('N9 F. j 152,§1(4),and we have no employees.[No workers'comp.insurance required:] • *Any applicant that"hf-1rs box#1 mast also fill out the section below showing their workers'compensation policy information t Homeowners who submit this affidavit indicating they are-doing ell work and then him outside corithactbrs must submit a new affidavit indicating such_ lContractors that check this box must attached an additional sheet showing the name of the sob-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 Maas providing workers'compensation insurance for my employees Below is the policy and job site information. �^ Insurance Company Name: PC E 1)V e r I Ca i i /r? o ra CJ C�IJ Policy#or Self-ins.Lic.#: / 6 ,. 4f 1'9 Expiration Date: t'v!O 7/c D fob Site Address: �� )C 1 v O l4 ( A sS ` City/State/Zip: At I -11 ow p-10 vl ( 11' 0/0 6� 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 foam of a STOP WORK ORDER and a fine of up to$250.00 a day agaipst the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification • __ .._. -r---_--- I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. .27 Signature: iftelfj i— Date: 67160 ° l/6/a 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): tDBoard of Health 20 Building Department 3❑City/Town Clerk 4.0 Electrical Inspector SCIPlumbing Inspector 6.0Other Contact Person: Phone#: City of Northampton MA p / X Massachusetts At'�' k. %v ,. • DEPARTMENT OF BUILDING INSPECTIONS ;} s:.. • `` 212 Main Street • Municipal Building J��L ate'' Northampton, MA 01060 f4-• �� CONSTRUCTION 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: Location of Facility: On 5QXa (,_, lA \-\(\q_,\c ` • \ Lk col The debris will be transported by: Name of Hauler: \)3 \ — cp 6747 .3 Signature of Applicant: ` Date: City of Northampton <S. 4, sus • Massachusetts �1 _ 4 .G DEPARTMENT OF BUILDING INSPECTIONS 9A 212 Main Street • Municipal Building -.N Northampton, MA 01060 �—*DO' HOMEOWNERS'EXEMPTION ELIGIBI I ITY AFFIDAVIT I, ,( „vet 941 f i ;l ie r d Ho r k le vi e k i c o (i sert full legal name), born (insert month, day, year),hereby depose and state the following: 1. I am seeking a building permit pursuant to the homeowners' • emption to the permit requirements of the Massachusetts State Building Code, codified at 780 CMR 110.R5. .3.1, in connection with a project or work on a parcel of land to which I hold legal title. 2. 1 am not engaged in, and the project or work for which I am seeki the aforementioned homeowners'exemption, does not involve the field erection of manufactured buildings const cted in accordance with 780 CMR 110.R3. 3. I qualify under the State Building Code's definition of"homeowne "as defined at 780 CMR 110.R5.1.2: Person(s)who owns 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 ne home in a two-year period shall not be considered a home owner. 4. I do not hold a valid Massachusetts construction supervision lic se and, except to the extent that I qualify for and will abide by the Massachusetts State Building Code's require ents for the supervision of the project or work on my parcel, I am not engaged in construction supervision in connection with any project or work involving construction, reconstruction, alteration, repair, removal or demol`tion involving any activity regulated by any provision of the Massachusetts State Building Code. 5. If I engage any other person or persons for hire in connection w th the aforementioned project or work on my parcel, I acknowledge that I am required to and will act as the supe isor for said project or work. Signed under the pains and penalties of perjury on this /4 day of e 20 023 c(St ature) ____.....140 WINDWOR-01 LAURA ACORO CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) �...-- 4/14/2023 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 CONTACT Laura Vlisseri NAME: Phillips Insurance Agency,Inc. PHONE FAX 97 Center Street (A/C,No,E,ry:(413�594-5984 i (NC,No):(413)592-8499 Chicopee,MA 01013 ,Do' iss:laura@phillIpsinsurance.com j INSURER(S)AFFORDING COVERAGE NAIC N INSURER A:EMCASCO Insurance Co INSURED -INSURER S:Employers Mutual Casualty Company Window World Of Western Massachusetts Inc INSURER C 641 Daniel Shays Highway INSURER D: Belchertown,MA 01007 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! TYPE OF INSURANCE :ADDL.SUER POLICY NUMBER POLICY EFF POLICY EXP , LIMITS LTR IINSD wVD (MM/DD/YYYY) (MM/DD/YYYYI A ,b COMMERCIAL GENERAL LIABILITY 1 EACH OCCURRENCE $ _ 1,000,000 CLAIMS-MADE X OCCUR 6Q44324 4/9/2023 4/9/2024 PREMISES TO RENTED occurrence) $ 500,000 MED EXP(Any one person) $ _ 10,000 1,000,000 PERSONAL&ADV INJURY $ GENIIAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY X i Ea X_: LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ B AUTOMOBILE LIABILITY I COMBINED SINGLE LIMIT 1,000,000 (Ea accident) $ ANY AUTO 6Z44324 4/9/2023 4/9/2024 I BODILY INJURY(Per person) $ OWNED -� SCHEDULED L-__I AUTOSRE ONLY X AUTOS ! BODILYpOR INJURYD (Per accident) $ _X AUTOS ONLY X AUTOS ONLY (Perr aE ident)AMAGE $ 1 I $ B X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 EXCESS LIAB CLAIMS-MADE 6J44324 4/9/2023 4/9/2024 AGGREGATE $ 1,000,000 DED X RETENTION$ 10,000 $ WORKERS COMPENSATION STATUTE ERH AND EMPLOYERS'LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE I E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A. (Mandatory in NH) _E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ { 1 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required)r P CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Northampton THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN p ACCORDANCE WITH THE POLICY PROVISIONS. Attn:Building Department 212 Main Street Northampton,MA 01060 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD DATE(MM/DD/YYYY) ACORD 02/I0/2023 �•-- CERTIFICATE OF LIABILITY INSURANCE ACCt#:2970777 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 CONTACT LOCKTON COMPANIES, LLC NAME: 3657 BRIARPARK DR.,SUITE 700 (NCNNo,Eut):888-828-8365 FAX No): HOUSTON,TX 77042 E.MAIL ADDRESS: NS ERITYCERTSIA.00KTONAFFINITY.COM INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Ace American Insurance Co. 22667 INSURED INSURER B: WINDOW WORLD OF WESTERN MASSACHUSETTS INC. 641 DANIEL SHAYS HWY INSURER C: BELCHERTOWN,MA 01007-9529 INSURER D: 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. I` TYPE OF INSURANCE 'NW ADDL BUBR WVD POLICY NUMBER (MkO�LICY E F (MM/DD)) LIMITS COMMERCIAL GENERAL LIABILITY I EACH OCCURRENCE $ CLAIMS- OCCUR DAMAGE TO RENTED PREMISES(Ea occurrence) $ MED EXP(Any one person) $ PERSONAL 8,ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PRO- [JOG IFCT PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY _ AUTOS ONLY (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ ', $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y� X STATUTE ER A ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? —N/A C5186654A 12/25/2022 10/01/2023 E.L.EACH ACCIDENT $ 1,000,000 (Mandatory in NH) If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-EA EMPLOYEE $ 1,000,000 E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more specs Is required) CERTIFICATE HOLDER CANCELLATION 2970777 Town fo Northampton SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED Building Dept BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN 212 Main St ACCORDANCE WITH THE POLICY PROVISIONS. Northampton,MA 01060 AUTHORIZED REPRESENTATIVE ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer AffaiSC&Business Regulation Registration valid for individual use only before the HOME IMPRO . '.tip ONTRACTOR expiration date. If found return to: Office of Consumer Affairs and Business Regulation Re.' ii a i•n 1000 Washington Street -Suite 710 !it` • 5 Boston,MA 02118 NICHOLAS DROST _-:-- ;' . VICHOLAS DROST .` , 102 OAKRIDGE DRIVELL.4v_ ;w a.j -('"Not U ` 3ELCHERTOWN,MA �'' Undersecretary Not valid without signature THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR TYPE:teporation Realst+attort112n 1851341 = :03_C_t4l2029 i ) WCommonwealth of Massachusetts �''`'-.3 "' INDOW WORLD OF WES R SAG(iUSETTS,INC. Division of Professional Licensure i -- ' act Board of Building`R�e�gul�ajtions and Standards 1:' ��.__ _y �•_ ` Ca nSlT�tti2Lr�'SLIAPNISor r �'j'Fi�f �'' .of TIMOTHY DROST r — _ CS-113719 `t,+x lyt�sires: 04/30/2025 641 DANIEL SHAYS H1�VY rv,.dG- ; "` NICHOLAS T:DROS.T : - BELCHERTOWN,MA 01007., : , Undersecretary 102 OAKRIDGE DR ` ' — BELCHERTOIp1 MA;'j,70 Ti J *fie ` `- Commissioner egaidG g BJf,»c.caL, ,.-- - t- T'.'°"_.i.'� M!Windows And Doors svffiEtni,DI r03gyint 650 WAst Market St MI ji1tD'OIS :milNFRC► Grate P � a50 VYest!AGritz,AA1080 /i ;' 165D Fenostraion DHNiNYUNo Grids AL/� �� • 1685 Rug camas Panel18,,2:Lice-4_(14",CTeer.LGE,Annealed);Lite,2: SLIDERVANYUOrids (1�'>CSaar,NpD}E,Anrteafed);Argon:37 1/2 X 37 Mane s th ttc p�Sonal Fene9G Pans(181:I.w-1:(1!8".f ar.l-MAnneldedp t.irt;i: 45112%45 ilZ ta(1,Aa1sOLWJ-00001 s that can be a ' (1B",Claat,NONS,Annsaisd)i Argon; tndiriduu produ:la may ba sukj*ct to YariCbn In porformane. re cleaner, - --_____ zn for drrtfernt taaovaa-0000s ENERGY PERFORMANCE RATINGS ~ ',wawa p awa roduct.ra►y aa s to varumen la p■r►aneanra :and doors U-Factor((1.SJi-P) vhen using a Solar Heat Gain Coefficient wows on the ENERGY PERFORMANCE RATINGS //�� ++��T U-Factor{U_S,tl-P) Solar Heat Gain Coefficient 1 V,L( 0.29 +� �! ADDITIONAL-PERFORMANCE RAT(N{iS ire generally O,2/ •`� Visible Transmittance -oduct ter_ Air Leakage(i1.SJi-P) locations in pppiTIONAL pERFORMANGE RATINGS n+r� Air Leakage{U.S.Ii-P) V �7 C Visible Transmittance .$rafpG9!! 'a"t R r; ,r�nn. q+aaraKsa+Ccawwmm.pp.c.�e reap araoMres ror a,xr�n+w wgwrrea,,a M�• '.-a:tar!mrueom�na'W�vsoKrersaru.roaeuraeleWin tymromamakab.v.Ucpw>cszs� pu.ct►'sl apes rtxvarm ale udatrttyaaiMProe..n/o•inv K2celwt Co:zuf taf 4 wf.lY prODu iwlinder fdaraned rpr pH/AM4A1 ydcrN.004 hi,bake Q■� •- annutsma•r vntmrb. ep.a �^ D:mit;,w��rl0aocwa"4": aaac a ar�i�+ { "e anarnot na,nerinvEwuwaax 4;Avi. ENFiifiY STAR`CSr(ifiEd in Nighii�ltted Regions. pedn4 nwrvteoo+tu+Rorsaramrav"'aranoautoaara ids.Use a k2CC ,r.r�dtaN Certi c.ati3 per ENEAGY STAR on ta&ragion9S resiltadas. t ., rm nr,Y;TAR-Gxi-mm(1+it ti Ohl 1!ihti:d hc•{linus. t:i•irih erin pot ENERGY STAR of tic.rsgrottc�: sir.altstias ``y/ v U { // �! fy, "1 �. ` • f tiri` �--� f ENERGY`, AR ' `+.. .. 1 II --- _ •.-I• (( anereistizee iaeaara Fars intorvtaeiboFk tosrin►praat teoia coaoseJ ti:elal esni pea0 dtCe r et p6rnded„cioCe1 7 6 —" ENERGY STAR ' " ..., -.2c„ t __ uxrgrdupstwrislow' ■Dertiftedltettlfieade Pert Grade +pp{ASp) DP(ASD} Water far salt itdart++epee tat>:1 oa►tee Ai prodoc a. �� LC-PG35' Para fotam ecs6n cemPlna weurKar to eti�s+ P(A 50.t3 Max Test Size Re o 5A3 +DP(A8D} ster P Fiarida ill -DP D I 6.08 dtt.t30 X?200 �rz.m-tos it ro 2iJ8r;p Pert Grare 35.Oti _ LC-PG3B 33.09 _ �.... •, stings are for individual windows and doors-on ly. For information regardaip rnuiled ax YtitJ IxeJ ' r stacked unks,please confect your sal!!representative.Pat and Nett DP irrtaed by M . ni test size.Tasted to AAN.AMtDMLVCSA t01/t.S.2/A44fl 05 Glass Aocordst to 72.0�1_.._»�' -' S ri4f Et300.AAMn re a may be concealed by.fazing bead or trackAmer.For and doors°y Fix inforn�Uon tegarc __midfad ddiirnral Information r r wins are for irxiiuidttel Wreset t Ouse visit www_t." d.com. or stardced unKe,please eordeat DurMA GSA te0 5 21A44C 05 AA!!!A glabel may bad �` r �png'^�aRation insiructtans, ttfie writ feet size.Tasted to AAMMN nlfotmallon rogerdeig 'G7856/ 3.1�1.1 oonceated by Gbin g bead DT tMek raen.Fix edditianai nrv,tad on :,nail le tatiation instructions.pious vies�nww.miwd.eom, en�rmts e:eo:ts aru sm..fe.c. 26772468.1.1.1 7,,sr.te]did.tale Window World of Western Massachusetts eiEn ns P,R«xr canmAno 641 Daniel Shays, Hwy,Belchertown, MA tILu_ , 2W 01007 U�JN/ 975 North Road,Westfield, MA 01085 itd Office: (413)485-7335 WINDOW WORLD www.WindowWorldofWesternMA.com CARE - Laura Litwiller and Mark Tenekjian Install Address: 239 North St Northampton, MA 01060 Contract Name: Laura Litwiller and Mark Tenekjian - Sales - Windows Design Consultant: Tim Drost Measured By: Measure Approved Date: 6/12/2023 Status: Quote Payment Method: 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 -Windows Setup and landfill disposal fee - Windows N 1 $250.00 $250.00 5-6 Ft. Patio Door-casing+capping TRIPLE PANE 5-6 Ft. Patio Door-casing+capping TRIPLE PANE N 1 $4,590.00 $4,590.00 Basement Slider- 1 panel (Min 11.5") Basement Slider- 1 panel (Min 11.5") N 3 $549.00 $1,647.00 Total Information Unit Total: 5 Subtotal: $6,687.00 Tax Rate: 0% Tax: $0.00 Total: $6,687.00 Amount Financed: $0.00 Payment Method: Deposit Amount: $0.00 Balance Paid to Installer upon Completion: $6,687.00 Renovation, Repair and Print Act (RRP) Compliance RRP Pamphlet Provided Date: Year Home Built: 1962 RRP Signed Date: Window World of Western Massachusetts vercoans 0'AV?common° �^ 641 Daniel Shays,Hwy,Belchertown,MA 975 North Road,Westfield, MA 01085 D p � Office:(413)485 7335 WINDOW WORL CARE $ www.WindowWorldofWesternMA.com Product Acknowledgements I 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 f Secondary Homeowner