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30C-058 (11) BP-2023-1455 376 FLORENCE RD COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 30C-058-001 CITY OF NORTHAMPTON Permit: Alts Renovations Repair PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit # BP-2023-1455 PERMISSION IS HEREBY GRANTED TO: Project# SIDING/WINDOWS 2023 Contractor: License: WINDOW WORLD OF WESTERN Est.Cost: 7986 MASS INC 115719 Const.Class: Exp.Date: 04/30/2025 Use Group: Owner: GOLDEN KEHNE DEBORAH L&JUSTINA B Lot Size (sq.ft.) Zoning: WSP Applicant: WINDOW WORLD OF WESTERN MASS Applicant Address Phone: Insurance: 641 DANIEL SHAYS HIGHWAY (413)485-7335 C56098598 BELCHERTOWN, MA 01007 ISSUED ON: 10/18/2023 TO PERFORM THE FOLLOWING WORK: SIDING AND WINDOW REPLACEMENT 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: 4r • . (frit g I 1 Fees Paid: $100.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner ., ,LT 1956 RECEIVED The Commonwealth of Massachu -tts W Board of Building Regulations and St;ndar s J 1 7 F I R Massachusetts State Building Code, 7,0 C R 023 MJNI• PALITY NORTHAMPTON!MA010 SE Building Permit Application To Construct, Repair,R-no • ised Mar 2011 One-or Two-Family Dwellin. 30 NS This Section For Official Use Only BuildingPermit Number: j9 .3 el —/41..55 Date Applied: gUi0a5 /Zi2 )D rf3-2oz3 Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 e Pro rt Address: 1.2 Assessors Map&Parcel Numbers 3?2 /QV?MC 1.la Is this an accepted street?yes_L 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❑ Zone: — Outside Flood Zone? Municipal 0 On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSIUIP1 2.1 Owner'of R ora,de o rloven� M i 0 f� 2 ✓v1 1 G 7L15I I`Name(Print) City,State,ZIP 37 0 F/oreVIC.0 RC/ y1358 8581,ii&1"ia f3ofdeh vvio.cd'j m �'laCC 1 No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK1(check all that apply) New Construction 0 Existing Building' . Owner-Occupied ' Repairs(s) ❑ Alteration(s) 0 Addition 0 Demolition Cl Accessory Bldg. 0 Number of Units 'L Other "Specify:'Y'..42, )\0iC i1CQO kl. Brief Description of Pr os Work': p Si' e,'03 and cx9 W i nC1jOGt/ 5 r(ap1Cicevheo /BEN J i.e4 L r-li,",L SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ 7, q g' 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 Fep r, Suppression) �L1I y _ /`� Check No. Check Amount: di, Amount: 6.Total Project Cost: $ !� q �� 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) ;� C.s— \k.5111 6%40ot-10 ti C kA p\CA.1 �,,e.n License Number Expiration Date Name of CSL Holder List CSL Type(see below) U 1 O) (NriL v c(Nz s1c-\J e No.and Street Type Description U Unrestricted(Buildings up to 35,000 cu.ft.) .-- -1c.OKC N.ti 7hi\ `C\f1 e_ . CAOCA R Restricted l&2 Family Dwelling City/To ,S k M Masonry iVi RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances `'kk3)k4S-'1 S 4.4.2_,f re..1-s LON A.tl t.+h N:l,%1=%r'SA.(z n I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) \Lc. L.3k--.1/41 U,, I,-.. .`)i W v;N CX t u% ' a,4—A c. HIC Registration Number Expiration Date' HIC Company Name or HIC Registrant Name (oLk ` )c'L[V.AA ¶ett c...kb \r4uJy )cure r,.1-=�i to.Mutt yti:4.c -lc4.l4 i'4l and Street Email address t3 cievQ , v.pap.._ClC 9 `,k‘3)t415' 1335 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 . ID" 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 \he•%t..t.\ V)t.)\-) to act on my behalf,in all matters relative to work authorized by this building permit application. CO�nele.e e �-c,\ ei ) 9/a 6/a 3 Print r's Name 6m (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' this ap! 'raft is true and accurate to the best of my knowledge and understanding. ,,., q/a 6Ia3 Print er' uthcri: Aame(Electronic Signature) to NOTES: I. 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/dns 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 a , -" a ..w i 4�'' � Massachusetts ' .. fr. s'!, 1) 4 i r '41i`, DEPARTMENT OF BUILDING INSPECTIONS D� �;n ;,-, 212 Main Street • Municipal Building it,„ c` ?, Northampton, MA 01060 ...•A.NQ' 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 ali 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: Oct50\ct ( .e 1p%lp \NACLNc\ cod► .-,;kg -, .c., , "\( s; ( •, ( ), The debris will be transported by: Name of Hauler: .\_L ( c n \ 0"X /-//7 Signature of Applicant: ��'"'� Date: �42 °/07 3 4 City of Northampton r 'or - Massachusetts1( �e}S'S`� ..slcifcc A r `,\ :`._ DEPARTMENT OF BUILDING INSPECTIONS T Ze ` 212 Main Street • Municipal Building �'- L' k-. c. _^ - Northampton, MA 01060 ....„. i,1/44 HOMEOWNERS'EXEMPTION ELIGIBILITY AFFIDAVIT I, Ji 5/i h`"r C.rv��,�e0 (insert 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' exemption to the permit requirements of the Massachusetts State Building Code, codified at 780 CMR 110.R5.1.3.1, in connection with a project or work on a parcel of land to which I hold legal title. 2. I am not engaged in, and the project or work for which I am seeking the aforementioned homeowners'exemption, does not involve the field erection of manufactured buildings constructed in accordance with 780 CMR 110.R3. 3. I qualify under the State Building Code's definition of"homeowner"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 one home in a two-year period shall not be considered a home owner. 4. I do not hold a valid Massachusetts construction supervision license and, except to the extent that I qualify for and will abide by the Massachusetts State Building Code's requirements 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 demolition 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 with the aforementioned project or work on my parcel,I acknowledge that I am required to and will act as the supervisor for said project or work. Signed under the pains and penalties of perjury on this O?6 day of,k2p/e111(eI , 20,1�J (Stature) ` • The Commonwealth of Massachusetts - !l Department of industrial Accidents 1 Congress Street, Suite 100 ' ' Boston,MA 02114-2017 nJ ., , www.mass.gov/dia wWorkers' Compensation Insurance Affidavit:Builders)Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicaaat Information Pltse Print Legibly Window World of Western Mass NAme(Business/Organization/Individual): Address:641 Daniel Shays Hwy City/State/Zip:Beiehertown MA 01007 • Phone#: 413 485 7335 � t Are you an employer?Check the appropriate box: t 50 t Type of project(required): 1 1,10.1 am a employer with employees(fall and/or part-time).* , 7, 0 New construction 2.01 am a sole proprietor or partnership and have no employees working for me in 1 8. 0 Remodeling any capacity.:No workers'vamp.insurance required..] s 3.0I am a homeowner doing all work myself.(No workers'comp.insurance required.] ' 9 Demolition rt,� j 10 0 Building addition 1 ant a homeowner and will be hiring contractors to conduct all work on my property. I will ensure alai all contractors either have workers'compensation insurance or are sole i 1 1.0 Electrical repairs or additions i proprietors with nn employees. 1 12.ElPlumbing repairs or Ai]; S.0I am a general contractor and I have hirtei the sub-contractors listed on the attached sheet. 1 These suh.contractors have employees and have workers'comp, t i 3. Roof repairs >V tap.insurance. { Replacement 6.0 We are ace ration and its officers have exercised their right of exemption 14.[()them_ �_,_�,.,.....,�... pt' per VIOL c. 152,l l(4).and we have no employees,[No workers'comp.insurance required.) '"Any applicant:that checks box itI must also fill out the section below showing their workers'compensation policy information, ' a Homeowners who submit this affidavit indicating they are doing all work anti then hire outside contractors must submit a new affidavit indicating such iContracion,that cheek this box must attached an additional sheet showing the mime of the sub-contractors and state whether or not(hoso entities'lave employees. ►f the subcontractors 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 Compar(y Name: Indemnity insurance Co.of North America • Policy#or Self ins.,Lic.#: C5d048598 Expiration.Date:10/01/2024 Job Site Address:3 76 f'O 1 o ce led City/State/Zip: fl r~en6e if g Q/0602 Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date), Failure to secure coverage as required under MOL c. 152,*25A is a criminal violation punishable:by a fine up to'$1,500,i10 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250,0(0 tt 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 • un erthe pains a d penal 'es of perjury that the information provided above is true and correct. Signature:'' ,,Ll,,.t t---�'� 9 /02 6o a 3J �i/� �tttc:413 488.7335 Phone#: „_..__,........ Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# ._..,-.,,,... r 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:.___._ w_� ,�{ DATE(MM/DD/YYYY) ! A+CG7R©� 09/22/2023 �---' 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: PHONE _ __. FAX 3657 BRIARPARK DR.,SUITE 700 (A/C,No,Ext):888-828-8365 (NC,No): H USTON,TX 77042 E-MAIL ADDRESS: ._INSPERITYCERTS@LOCKTONAFFINITY.COM INSURER(S)AFFORDING COVERAGE .._ NAIC -------------- INSURER A:Indemnity Insurance Co.of_North America 0.7676 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 PFRIOI INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THE 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 SUER LTR TYPE OF INSURANCE INSD VWD POLICY NUMBER POLICY M DD/YYEYYY POLICY EXP ( ) (MWDD/YYVY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS- OCCUR DAMAGETORENTED - - _PREMISES(Ea occurrence) $ MED EXP(Any ono person) $ PERSONAL&ADV INJURY $ - t GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE _ $ — POLICY n4tPRO- LOG PRODUCTS COMP/OP AGG $ -'OTHER: II -----.__. - _ AUTOMOBILE LIABILITY COMBINED SINGLE-LIMIT $ - ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Par accident) $ HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Per accident)_. _i UMBRELLA LIAB OCCUR EACH OCCURRENCE $ '� EXCESS LIAB CLAIMS-MADE AGGREGATE $ 1 DED RETENTION$ WORKERS COMPENSATION X I STAT PER OTH- I AND EMPLOYERS'LIABILITY Y N 'MUTE ER A ANYPROPRIETOR/PARTNER/EXECUTIVE _ OFFICER/MEMBER EXCLUDED? N/A x C56098598 10/01/2023 10/01/2024 E.L.EACH ACCIDENT $ 1,000,000 (Mandatory in NH) If yes,describe under E.L.DISEASE-EA EMPLOYEE $ 1,000,000 DESCRIPTION OF OPERATIONS below - 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 space is required) — CERTIFICATE HOLDER CANCELLATION 2970777 Town fo Northampton Budding Dept SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 212 Main St BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Northampton,MA 1060 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE J _ ©1988-2016 ACORD CORPORATION. All rights reserve'I. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD WINDWOR-01 LAURA. ACC) DATE(MM/DD/YYYY) �,... CERTIFICATE OF LIABILITY INSURANCE 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 no confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Laura Misseri Phillips Insurance Agency,Inc. PHONE jn/c,No):( 13)592-8499 97 Center Street (A/c,No,Ext):(413)594-5984 4 Chicopee,MA 01013 E-MAIL p ADDRESS:laura@phillipsinsurance.com INSURERS)AFFORDING COVERAGE NAIC# INSURER A_EMCASCO Insurance Co INSURED INSURER B_Employers Mutual Casual'(Company_ Window World Of Western Massachusetts Inc INSURERC: 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 INSUFANCE ADDL SUER POLICY EFF POLICY EXP LTR INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DDIYYYYI UMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 ]CLAIMS-MADE f X I OCCUR 6Q44324 4/9/2023 4/9/2024 DAMAGE TO RENTED 500,000 PREhII^FeaS1EQ occtLrre $ MED EXP(Any_one werson $_, 10,000 PERSONAL&ADV INJURY_ $ 1,000,000 _GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY 1—X PECOT- lX]LOC 2,000 000 PRODUCTS-COMP/OP AGG OTHER: B $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 _LEa accident) ANY AUTO _ 6Z44324 4/9/2023 4/9/2024 BODILY INJURY(Perpersoll -$ OWNED AUTOS ONLY X SCHEDULED -- - AUTOS BODILY INJURYlper accident $ X HIRED ONLY X AUTOS NON-SWNEONLY Y jerra cdent)AMAGE AUT $ _ 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 PER OTH- AND EMPLOYERS'LIABILITY Y/N _-_STATUTE_. ANY PROPRIETOR/PARTNER/EXECUTIVE H 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 $ 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 Town of Northampton THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 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 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:Individual Office of Consumer Affairs and Business Regulation Registration Expiration 1000 Washington Street -Suite 710 201746 041271206 Boston.MA 02118 VICHOLAS DROST 1 4r • VICHOLAS DROST 102 OAKRIDGE DRIVE , {- 3ELCHERTOWN.MA OT66 - Undersecretary Not valid without signature THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR TYPE: orporation, Registration= `Eitbiration Commonwealth of Massachusetts t65$4i'- ,031112024 kV) Division of Professional Llcensure WINDOW WORLD OF_WE RN ASSAGEIUSErTS,INC. I;�, ice:: Board of Building Regulations and Standards �� -=ee`� -sr 1: Cvnsirilt`t$t�r� i5pFrt�icor 'r�.y _1'jF�� . , CS-71S719 Y. -, TIMOTHY DROST . -- >>:--_ - 5c ires•04/30/2025 - f{,,,,,-- a,!--e--4� NICHOLAS T DROg ' i� �-. 641 DANIEL SHAYS Hl� ��' �4 � BELCHERTOWis1,MA 010#37;. ~-: Undersecretary 102 OAKRIDGE OR r - = - BELCHERTOi N MAf01 07/ •'' j t Commissioner doliG g Btnt.t. 2 r• �t::s, _ - - ' • a ., i i• MI Z4 °°° st tfrt ;t,Of vME SrJQ WBSt WindowsAn rs 1 : Gratz PA or destroy the �`,,Af/ West SrlcBt$t 1� :t� .- MILGratz,PA17030 fry:, 1650 ::oralFenONfatii OH/VINYL/No Grids A F 1885 • PIN Cocpr,.a Pane l/4:Litedt:(iis`.C1ear,L0F_Annealed);Lite•2: '‘~ SLIDER2NINYUG rids f ;Gina,r�[ptrE,Attsmaleti);Grids 3Y v2 X 37 r.otta •RAWFt panel 132:Lfae�t:(ita", eg , °4512 X 45 in cal talscsw,�ooa, s that can be a eltr,Cleer,N016,1i it Fndirtdud aero Na may W cuDjert ro vac slbn in For'vrmnnee ,e cleaner, n for daTfernt ~:z'�'r:ic >.. +4 to mignon to r. • ENERGY PER ORM�iNCE RA i1�ICsS ;anti doers trtdNiQOat Produeta my be eub�et iJ-Factor(i1,S.1r1-P) Sour Heal Gains CcetNcient Viten using - = . 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For iitformatian rogardaig-mulled - ax net I •. ` 29!2d r hacked uirits,Please eortaM yonrsaks rapresarttative.Pas and Ne dP •;, � d. by s� n51A3 E730D7 Tested co 9 lofted T2.00 X 80 . tutWpSq tool.&2raaee-as cfa�Acao and doara only. Fag intermatlon recardrnD rra>da ,� ddRiotta4 inforrs:at r Y rrceated 4Y el sg bead or track fitkx.F� • Romps are for irxssndcnal ,down ems.Poe arse Nag OP Imams ky i^ y e�aazirig ristaRatton instructions,please visa ww,v+siwd.cam. er stacked un><e, El t AAMA Y t 1 S 21A44G 05 OrI re gates may t���� / t tie iud tested by; to ad or teVD mnaaared ty pt»zrtr0 head or track MT.Far additional information regarding a ekes an Raiff cane$atlZri'itatmt on,please vial tnwar.nmski.eon• 9a1212018 a:10;12 Atl Printed an 26772468a'1 a1.1 mama 3 Pfil Window World of Western Massachusetts Pt,F VE 641 Daniel Shays,Hwy, Belchertown, MA .G ' a F� _ 01007 %+ ���975 North Road,Westfield,MA 01085 Windtgi/ i&i Office: (413)485-7335 WINDOW WORLD www.WindowWorldofWesternMA.com CARE Justina Golden Install Address: 376 Florence Rd Florence, MA 01062 Contract Name:Justina Golden - Sales - Siding Design Consultant: Tim Drost Measured By: Measure Approved Date: 9/15/2023 Status: Quote Payment Method: Lender: Contract Type: Sales Comments: Product Description Txbl Qty Price Extension Permit&Administrative Permit&Administrative Fee N 1 $200.00 $200.00 Fee Setup and landfill disposal Setup and landfill disposal fee-Windows N 1 $250.00 $250.00 fee -Windows Siding (NO STRIPPING Siding just back gable wall 4sq xd4 white , need to replace fascia on STRUCTURAL LAYER OF back gable and repair cutout on roof where old chimmneywas , wrap N 1 $5,600.00 $5,600.00 SIDING) new patio door 4000 Series DH Solarzone 4000 Series DH Solarzone N 2 $799.00 $1,598.00 Full Exterior Capping Full Exterior Capping --Color: N 2 $169.00 $338.00 Total Information Unit Total: 6 Subtotal: $7,986.00 Tax Rate: 0% Tax: $0.00 Total: $7,986.00 Amount Financed: $0.00 Payment Method: Deposit Amount: $0.00 Balance Paid to Installer upon Completion: $7,986.00 Renovation, Repair and Print Act (RRP) Compliance RRP Pamphlet Provided Date: Year Home Built: 0 RRP Signed Date: Window World of Western Massachusetts tic-moms 6.11"-iOi cummwno 641 Daniel Shays,Hwy,Belchertown,MA 975 North Road,Westfield,MA 01085 W. Vildindf" Office: (413)485-7335 WINDOW WORLD 04) www.WindowWorldofWesternMA.com CARE w 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 Secondary Homeowner Window World of Western Massachusetts ni c 641 Daniel Shays,Hwy,Belchertown, MA �•r�AA�•a r dow O]007 t!,975 North Road,Westfield, MA 01085 Win jl� Office: (413)485-7335 CARE ID 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 ift 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 sign 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. r 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 rA . Secondary Homeowner Design Consultant EPA "Renovate Right" Brochure can be viewed and printed from here: Renovate Right Brochure W W 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 pi ojoct 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 of doals 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 1-12A, M.G.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. TI HS 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.