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23D-081 (17) BP-2023-1673 73 WARNER ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 23D-081-001 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-2023-1673 PERMISSION IS HEREBY GRANTED TO: Project# SKYLIGHTS 2023 Contractor: License: WINDOW WORLD OF WESTERN Est. Cost: 14450 MASS INC 115719 Const.Class: Exp.Date: 04/30/2025 Use Group: Owner: KERSTEN ELAINE RENATE Lot Size (sq.ft.) Zoning: URB Applicant: WINDOW WORLD OF WESTERN MASS Applicant Address Phone: Insurance: 641 DANIEL SHAYS HIGHWAY (413)485-7335 C56098598 BELCHERTOWN, MA 01007 ISSUED ON: 11/28/2023 TO PERFORM THE FOLLOWING WORK: 2 REPLACEMENT SKYLIGHTS 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: II Ir V )2 . ''1 • I Fees Paid: $40.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Buildinc Commissioner / ,490 The Commonwealth of Massac settee 2 Board of Building Regulations and Staitda4, 6��0 FO' Massachusetts State Building Code, 780 C t',yq��to�� �3 M NIC!'ALITY ry Building Permit Application To Construct,Repair,Renovate Or c-' ,+ ' Revis d Mar 2011 One-or Two-Family Dwelling ��'Oso�°^�s This Section For Official Use Only Building ermit Number:(Z05 .60.....1 ) •(G/ 7� Date A lied: A1M1 3 / ..Z 8 Z82023 Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 P rty Address: ! 1.2 Assessors Map&Parcel Numbers (hrk1er (5 1.la 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) 1.5 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? Check if yes❑ Municipal 0 On site disposal system 0 SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: kin 0 e Ke v-61-6 0 Flo m vi Ge H 4 o/o6 a Name(Print) City,State,ZIP 75 NottelOC r S I- y/3(95 /a? fod ieed h►a rd l e t,20' . '4e1 No.and Street Telephone Email Address SECTION 3: DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building' Owner-Occupied Itl., Repairs(s) 0 Alteration(s) ❑ Addition 0 Demolition 0 Accessory Bldg. ❑ Number of Units V, Other "Specify:%C..F-cA t;'"; le V;.14 Brief Description of Proposed Work2: ,5 /' b •15 r igia ce 41cf — SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ /1/ 0 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 Fees: Check No. 6i 3 Check Amount: -s" Cash Amount: _ 6. Total Project Cost: $ ) y/ 40-0 CIPaid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) C.S— \L..S�11V1 (,�_. .. �.�. .. <<,:) M .e'1(-)\C.L• Yr'i>var License Number Expirhtion Date Name of CSL Holder A u List CSL Type(see below) U k ). `c-s C-o\ S' \"Jv_ No.and Street (J Type Description U Unrestricted(Buildings up to 35,000 cu.ft.) 0)`C_L I T`'\ M1 G- • ak0d-1 R Restricted 180 Family Dwelling City/To ,S M Masonry i _ RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances Q r- )t-aS•IYjS 4.12-,C-Iv..V5c". LONA.AZ. ILL ( A I Insulation Telephone Email address D_ Demolition 5.2 Registered Home Improvement Contractor(HIC) W0u' a HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name lDLl c� Q 5�(.CS 5.\� 't4�`1 V)—•Y,r%.� Ii-Ntarlr�bt_:c.•:c'::� `.._� and Street Iy� Email address _t.4)claA%kv,42_.A— . -v.Pat& c c\01 '3) 5' k7 xS 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 la" 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 �\j1/4.A,:u\ i css,)1,e.., to act on my behalf,in all matters relative to work authorized by this building permit application. ////7 A Print er'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 i this ap ' 'all is true and accurate to the best of my knowledge and understanding. --"" i /(//7 /023 Print er' o Authon Ag�Tf's Name(Electronic 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 44.1A MY Massachusetts DEPARTMENT OF BUILDING INSPECTIONS �� 212 Main Street • Municipal Building 7') aewerrr �,•✓� ✓.; +� ,pNorthamton MA 01060 •�.�.,✓ 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 disnocc r=� properly licensed waste disposal facility, as defined by MGL c 111, S 150A. The debris will be disposed of in: Location of Facility: Ctt.5Q\a \Q`�e 1os3 'MC _M-N ��:�1.. �, .� :c ;. ;01i \. The debris will be transported by: Name of Hauler: ‘ c c o \ *X, , I1/7 /a3 Signature of Applicant: Date: City of Northampton 1v--A Mp,o 01- � i � Massachusetts` ;+F.1,t .,'' 4• DEPARTMENT OF BUILDING INSPECTIONS\� . ;t 212 Main Street Municipal Building t^^ Northampton, MA 01060 HOMEOWNERS'EXEMPTION ELIGIBILITY AFFIDAVIT I, F/a 1 r7 e ke rr rem (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 qualifyy 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 17 day of 0Vo ve'66f,200?;3 c.(St ature) • The Commonwealth of Massachusetts '`" - Department of Industrial Accidents I Congress Street, Suite 100 Boston,MA 02114-2017 �,go www.mass,gov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. • TO BE I+ILED WI'1H THE PERMITTING AUTHORITY. Applicant:Information Please Print Let;iblY Name(Business/Organization/Individual): Window World of Western Mass Address:641 paniel Shays Hwy City/State/Zip:Beichertown MA 01007 Phone#: 413 485 7335 • Art you an•omplayer7 Check the appropriate box; l Type of project(required): • 1.�.1 am a employer with 50 employees(full and/or part-time).* • 7. 0 New construction 2,0 1 am a sole proprietor or partnership and have no employees working for me in ' 4 R. 0 Remodeling any capacity.INo workers'comp.insurance required.] :t.o1 am a homeowner doing all work myself,INo workers'comp insurance required.] ' 9. :-1 Demolition 4 1 am a homeowner and will be hiringcontractors to conduct all work on my1 b Building addition • } � property, twill ensure that all contractors either have workers'compensation insurance or are sole # 1 1.0 Electrical repairs or addition., • i proprietors with no employees. • ] 12.0Plumbing repairs or add tl ion r 5.01 ant a general contractor and t have hired the sub-contractors listed on the attached sheet. These sub'cantractors have employees and have workers'comp,insurance.t { 13.❑Roof repairs 14.©Other_Replacement 6.0 We are acorporation and its officers have exercised their right of exemption per MO-e, —— 152,f 1(4),and we have no employees.INo workers'comp,insurance required,I *Any applicant,that checks KA*1 must also fill out the section below showing their workers'compensation policy information,q,Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating midi tContraetors that check this has must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities hvv o employees. If the soh-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./iti*• information, insurance Cotnpatty Nante: Indemnity Insurance Co.of North America • • Policy#or Self-ins..Lic.#`C56098598 Expiration bate:10/01/2024 y Job Site Address: 73 Ha r V e r 5 City/Statc/'Iiir: /i,' reri il�} t0 i(( 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 e.15.2,§25A is a criminal violation punishable by a fine up to 1;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$2 5t1,(t(t:o 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 er the pains0a t!penal 'es of perjury that the info/motion provided above is true and correct. Signature; Date: �—— J one#: 413 4$5.7335 _w_....._...... ., . __ -..ti, , .,,, _ ,.,,s.. _ _...m..,,.,.__....-m._ ..._-- -MIVItedrfir n,i Official use.orrly.'Do not write in this area,to be completed by city or town oflf/icial. 1 4i City or Town: i Permit/License# _.,..�,... Issuing Authority(circle one): i I.Board of:Heald) 2.BulidingDepartment 3.City/Town Clerk 4.Electrical inspector S. Plumbing inspector 6.Other ,i 11 il Contact Person: ..,,.,... __ ___ . _ . _,........_._..._._..._.._.._._. Phone#: DATE(MMODNYYY) 09/22/2023 12 a CERTIFICATE OF LIABILITY INSURANCE Acct#:2970777 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THI CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIE 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 oe this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: LOCKTON COMPANIES,LLC PHONE FAX 3657 BRIARPARK DR.,SUITE 700 (ANC,No,Ext):888.828-8365 INC,Ney HOUSTON,TX 77042 E-MAIL ADDRESS: INSPERITYCERTASLOCKTONAFrINITY.COtd INSURER(S)AFFORDING COVERAGE _ NAM St I I _INSURE&A:IndempitTL0.surance Co.of North Amer A3'75 ica INSURED INSURER B: WINDOW WORLD OF WESTERN MASSACHUSETTS INC. - 641 DANIEL SHAYS HWY INSURERC: BELCHERTOWN,MA 01007-9529 INSURER!): INSURER E: INSURER F: I 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 PERIOI.' INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THI`• CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE 1'I tJMf. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR - --ADDL SUBR ---VI POLICY EFF l POLICY EXP .-- LTR TYPE OF INSURANCE INSD VD POLICY NUMBER (MMlOD/Y1'YY) (MMIDDIYYYYj LIMIT" COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE. I+ } RENTED CLAIMS- OCCUR ,PREMISES octurn+nce) $ MED EXP JAny ono pnraon) S PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PRO- r}OC PRODUCTS-COMP/OP AGG $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE I_IMI I $ lEa accident)_ ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) '$ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE 4 AUTOS ONLY AUTOS ONLY (Pet accident) UMBRELLA LIAR OCCUR EACH OCCURRENCE j EXCESS UAB CLAIMS-MADE AGGREGATE S DED RETENTION$ WORKERS COMPENSATION X PERTUTE r 1IOTH- AND EMPLOYERS'LIABILITY Y'N STAI1ER- A ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? —N/A E.L.EACH ACCIDENT S' �,WQ,000 (Mandatory in NH) X C56098598 10/01I2023 1010112024 If yes,describe under E.L.DISEASE-EA EMPLOYEE $ 1,000,000 DESCRIPTION OF OPERATIONS below • E.L.DISEASE-POLICY LIMIT $ I.000,f10A DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space is required) CERTIFICATE HOLDER CANCELLATION 2970777 Town fo Northampton SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED Building Dept 212 Main St BEFORE THE EXPIRATION! DATE THEREOF,NOTICE WILL BE DELIVERED IN Northampton,MA 1060 ACCORDANCE WITH rHE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2016 P.COF'D CORPORATION. All rights reserve'I ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD WINDWOR-01 LAURA A� � CERTIFICATE OF LIABILITY INSURANCE DA4/14/DD/YYYV � _ a/'�4/zoz3 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 POLICIE; 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 or this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Laura Misseri Phillips Insurance Agency,Inc. PHONE FAX ! 1 (Arc No):(413)592-5499 97 Center Street (A/c No,Ext:(413 594-5984 Chicopee,MA 01013 now Ess:(aura@phillipsinsurance.com INSURER(S)AFFORDING COVERAGE j NAIC U INSURER A:EMCASCO Insurance Co _ INSURED INSURER B: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._—1— —___ 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 INSR ADDL SUBR POLICY POLICY EXP LT TYPE OF INSURANCE - - LTR INgp yryp POLICY NUMBER IMM/DD/YYTYYYI (MM/DD/YYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 —1 CLAIMS-MADE LJ OCCUR 6Q44324 4/9/2023 4/9/2024 RREM 9ES�a oocurrenw $ 500,000 MED EXP(Any one person) $_ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: 2,000,000 PRO- GENERAL AGGREGATE_ S_. - X1 POLICY L X J JECT IXI LOC PRODUCTS-COMP/OP AGG $ 2,000,000 1 OTHER: $ B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 (ELaxi-dent),_..--. $ ANY AUTO 6Z44324 4/9/2023 4/9/2024 BODILY INJURY(Per person) $ OWNED AUTOS ONLY X AUTOSULED - - - BODILY INJURY(Per a_cd_dent)_$ X HIRED X NON-OWNED ROPERTY DAMAGE i AUTOS ONLY AUTOS ONLY er accident .$ B X UMBRELLA LIAB X OCCUR 1,000,000 — EACH OCCURRENCE _ $ EXCESS LIAB CLAIMS-MADE 6J44324 4/9/2023 4/9/2024 AGGREGATE $ 1,000,000DED X 1 RETENTION$ 10,000 WORKERS COMPENSATION T I STATUTE L _L_E6H AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE EL.EACH ACCIDENT .$,..OFFICER/MEMBER EXCLUDED? N/A - (Mandatory in NH) EL DISEASE-EA EMPLOYEE $ If yes,describe under --- DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ ,__—_ _ DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached It 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 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 :HE E::°:Nlthr.iuvrE LTH OF MASSACHUSFTTS Office of Consumer Affairs&Business Peculation Pegistration valid for individual uae only before the HOME IMFROVEMENT CONTRACTOR expiration date. if found return to: TYF€:i`?dkidUai Office of Consumer Affairs and Business Regulation Registra:iQII Expiration 1000 Washington Street -Suite 710 411746 O4/8f12025 Boston,MA 02118 'J CHOLAS DROST PCHOLAS DROST n 102 OAKRIDGE DRIVE ,.sr .t'' ioi' 3ELCHERTOyuN.MA 01007 Undersecretary Not valid without signature THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs&Business Regulation Hafil=IMPRFIt� TYP_OVEMEE: orporatioqCONTRACTOR Reoisti'attvn-:T"FPWiratian 165641 ,0311412024 Commonwealth or Massachusetts g WINDOW WORLD OF:WE$3TR �SAG{iUSE us,iNC. �, Division at Professional Licensure t; _ - _ �;t Board of$utiding Regulations and Standards F-; l I:I Const;.utt.M I§ilp,rvisor iltti x. CS-1 TIMOTHY •, �j i r 15719 4- <� , l:icoires:0413012025 64 DANiELDROST SHAYS HWI:� y :: i/.04viea i NICHOLASTDROST, l —, ; B1:LCHERTOWN,MA 41007.-, Undersecretary 102 oAKRlDC�1:DR — — BELCHERTOiN3l MAf0100Tr ' .} Commissioner de8G 4 Wen . VS:VS( VS c_S Tested Pert ormanc e Glass Description Laminated Impac While.t Snagdozol i.inlInM,d 4.4 ed (VELUX Glazing Code) (04) (06) Laminat (10) 1 ii 9 1 (08) - . Thermal Performance'Ali Wd inamusiparfonnanca _._ _ -1 ti-Factot t, ' , . Li 41 .:"4,i t. - , SHOC :1 2.• 0 23 1.1 21 VT 0 S, n i.1 5 47 ., UV Protection% 99 9 i . 99 9 49 4 1 '2.• .4 N:fk II 1., I . 4 Fading Pioction% kr...I.11 sr or 0.,,,,,iip•r on,1,,,ir• 83 1 ,-,4 88 4 u . aco-Fori Ar, Accoustor-41RaTtings SIC , 33 1 fl cuss, ' . . 01TC , •-•:,4 , - ..... __...1 - Certified Aar Ineftraoon/Exfiltration C PAW& I 0 05 I 0 01 'J OS Certified Water Resistance Learn I is 1 *(.: 1 •s _ - 1 Certified Stractural Performance Obvii') 1 Perionnarco Grads oi OP in accordance ear AAAMMOMACSA In',1 S:4-4 4 1. Trmian S.rrt Negative Design Pressure -Up‘in ii4..n — 7 7 SO6 6 6'. , .. • 4 { MOO 105 61:. '0', , . ---•---- 4 . . CO6 n• 0• f,• I • . • Tested Se Poe***Design Pressure•Download iry.n.l.vineo. SOS 300 ;10 f)( --1- + 1 . • ,--. .i. MOO 400 230 400 ., . C86 . ,) , f I i f ,. I ,I Fall PrOtection Testing Results tested Sie Tonne*206 It 4,'/b.4)4'00900 horn OleaCillied height 10 fOkidliD Ca 1461t,vofflr,o'4.o..44.tf o..4 .. ....- 1600 lb,It •, 1 ,I tt' I 1600 lbf fr T ,, 504 If dool 1 , , , a•.11., , ,,• , : • • i Wind-Bane Debris Impact Rating,foe Inspect(Oil Glaa_ing I Cycle Pressure ;1 Maximum Wind i Florida Pentailet rich VI. 1. lostict Skze Mtrisit• Level " 1 Zona Approval &turret'.an.1n-4 1 ----•— SO6 . -.- . . 1.4041 . ' .. 1 06 -1.44,-. "i'arr,...-,.4-,' A,t, ,• I .. I 06 &lass Ye re 1 "firl,a- .4"A. ,fvrf .kr.1.7 64"litlatel;"-etaI%Urrlt•14.,..e.: . .,-•• OS as Sane as 04 .e.m orn,te wsieelarer, 10 lass 7 e'lrlpe•r(1 with t Qr 366 .1.4e, Jew 1.v.,,,,,ate1 ...,....e..pm..... i 7 ',"V'' ,- • ,,,-•• ! IP glass. biome ell 04.wan'619 coat,ny un 4ntenur larnenatet1 4U....1.-C i •".,•4'0%1'4 t''.•.1"..,41.4 Jail.'14'kW fpffrrt Wald at, .f.for'hi,,,P S..111.; Ja;f t,at f r,ra41,a 1. •, '''' -Ka- etr.r.r,f 4 drir~ Window World of Western Massachusetts veuwwas PN �T commnna 641 Daniel Shays,Hwy, Belchertown, MA O1OO7975 North Road,Westfield, MA 01085 WCILLIOU/ �� Office: (413)485-7335 voNoow CAR woRis e www.WindowWorldof WesternMA.corn Elaine Kersten Phone: 4136954102 Install Address: 73 Warner St Florence, MA 01062 Contract Name: Elaine Kersten -Sales-Other Design Consultant: Tim Drost Measured By: Measure Approved Date: 11/6/2023 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 - Windows Setup and landfill disposal fee - Windows N 1 $250.00 $250.00 Solar Skylight (operating) Solar Skylight (operating) N 2 56,000.00$12,000.00 Misc labor Roofing Misc labor- Roofing jamb out skylight box with azec and N 2 51,000.00 $2,000.00 new casings Total Information Unit Total: 3 Subtotal: $14,450.00 Tax Rate: 0% Tax: $0.00 Total: $14,450.00 Amount Financed: $0.00 Payment Method: Credit Card Deposit Amount: $7,000.00 Balance Paid to Installer upon Completion: $7,450.00 Renovation, Repair and Print Act (RRP) Compliance RRP Pamphlet Provided Date: Year Home Built: 1900 RRP Signed Date: Window World of Western Massachusetts rcreR«ns PIZ?common° 641 Daniel Shays,Hwy,Belchertown,MA !,n 1 01007 "�, k is 975 North Road,Westfield,MA 01085 Wàtdcui Office:(413)485-7335 WINDOW WORLD www WindowWorldofWesternMA.com CARE Product Acknowledgements • 1 have received a copy of the lead hazard information pamphlet informing me of the potential risk or the lead hazard exposure from renovation activity to be performed in my dwelling unit. I received this pamphlet before work began. Primary Homeowner 4.4\ Sr condar;: Hcmeowner Window World of Western Massachusetts tPl iR v101.1wns P �communn 641 Daniel Shays,Hwy, Belchertown, MA 447, r' 01007 •n '•�y i • 975 North Road,Westfield,MA 01085 Watikuu K� Office: (413)485-7335 WINDOW WORRLLC www.WindowWorldotWesternMA.com C A R C 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 he 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 cluttlkon 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 ,j i t,' F Secondary Homeowner Design Consultant 1 � PE) Q"7) S EPA "Renovate Right" Brochure can be viewed and printed from here: Renovate Right Brochure Vv•0.7 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 edui,unent 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 respunsible for delays in the work described in this agreement caused by regulatory, permit granting agencies, authorities, or indiriduals. 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.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 ti ansaction. Notice of cancellation must be in writing postmarked no later than midnight of the following third business des. TI HIS IS A CUSTOM ORDER NOT FOR RESALE This Window World® Franchise is independently owned and operated by Window World of Western t1.;s>.,rchusetts, Inc.under license from Window World, Inc.