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23D-148 (7) BP-2024-0319 111 HINCKLEY ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 23D-148-001 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-2024-0319 PERMISSION IS HEREBY GRANTED TO: Project# WINDOWS 2024 Contractor: License: WINDOW WORLD OF WESTERN Est. Cost: 18024 MASS INC 115719 Const.Class: Exp.Date:04/30/2025 Use Group: Owner: ALISE WILL, 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: 03/25/2024 TO PERFORM THE FOLLOWING WORK: 7 REPLACEMENT WINDOWS POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Service: Meter: Footings: Rough: Rough: House # Foundation: 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: 172- Fees Paid: $40.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner f / it.)—_ 14 The Commonwealth of Massachusetts , Wt Board of Building Regulations and/Standards �024 FOR Massachusetts State BuildingCode, 780 CMRr �.. MUNICIPALITY (//r,, .. USE Building Permit Application To Construct, Repair,Renovate Or Demolish a;,., , Revised Mar 2011 One- or Two-Family Dwelling This Section For Official Use Only Building Permit Number: 6.R .1 yo 3/9 Date Applied: 4-ui (xo55 //� 3-z5.26 zy Building Official(Print Name) Signature Date SECTION 1: SITE INFORMATION 1.1 Pro erty Address; 1.2 Assessors Map&Parcel Numbers 1!i /-1;0ct.1 I CI 5t 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 ClOn site disposal system 0 SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: A1` 0 uji F/oyeocc Mil 0 i0 Name(Print) City,State,ZIP /1/ Hi`vlc(.c ley ,51- 81go2098Fs3g 1i` 14111.27Gliolrnai (.(IOW No.and Street Telephone Email Address SECTION 3: DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building' Owner-Occupied itk Repairs(s) 0 Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units 't, Other /Specify: Vi2 \etLil l ile)Jvl Brief Description of Proposed Wqrk2: ? NI "aO1JS rep /4G6 olNwi I1,5&e coviirGcj Nem drdeit r-krt,g/ SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ /8' £a 1 1. Building Permit Fee: $ Indicate how fee is determined: 2. Electrical $ i ❑Standard City/Town Application Fee ❑Total Project Cost3 (Item 6)x multiplier x 3. Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire $ Suppression) Totat All Fees: ! t1(.66 p� l/ Check No. 5 (,,Check Amount: Cash Amount: 6. Total Project Cost: $ /U) 0c 7 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) r;� C.S"-" \ '11 va M C 0\GiL.S „,(---0 \-, License Number Expiration ate Name of CSL Holder List CSL Type(see below) U k Li Cfc'.vr,\c o, Q S \,J( No.and Street e. Type Description U Unrestricted(Buildings up to 35,000 cu.It)0�C ��� �1 ����,� R Restricted I&2 Family Dwelling � City/To ,S 1P M Masonry t _ RC Roofing Covering WS Window and Siding r SF Solid Fuel Burning Appliances 1< )t-as-tiv,c; Q.tLY'v,.v, c�trJNAA-` I.i:ov-k&(..n. 1 Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) .3°"‹.‘'" c\ HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name(tJ L A.k k)C,\V. S : �c�I�LC �.�� 'C‘..0-k 1V,2-,mt 4S C+��./ \I� ,v)t►�t ('t r t.F,irAft, and Street \ Email address Albt tlr .o Sc-rn.J._ZsN.P\t&. CSC1)1 �Lt�3) Si�l33ri 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 LW' 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 \J\c u tom\ ��c CU to act on my behalf,in all matters relative to work authorized by this building permit application. Print Oer's Name Signature) (Electronic( -Nii/o2q 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 iteati is true and accurate to the best of my knowledge and understanding. 3/ a� Print er' o uthon A 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" KaM; City of Northampton Massachusetts 4Sg .y. slC, (y ,g DEPARTMENT OF BUILDING INSPECTIONS x' rl y 212 Main Street • Municipal Building .)j a' ram* Northampton, MA 01060 rf,1 •- `.‘ 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: Otk.30 (- o\.c' . l.() e ���C1�� � . �;�-� �°c , `,.ACk The debris will be transported by: Name of Hauler: �> ��Q oti i) c c\ Signature of Applicant: Date: 3 iy/ai City of Northampton Massachusetts ' . r x a w`r pr DEPARTMENT OF BUILDING INSPECTIONS 'Pkk *,�' / 212 Main Street 4, Municipal Building 3a>.� �01 Northampton, MA 01060 ` J, / / HOMEOWNERS'EXEMPTION ELIGIBILITY AFFIDAVIT I O? i`,,q �1/ e' I (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 1 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 I/ day of Haroh ,20 Y\\- cue (Signature) The Commonwealth of Massachusetts Department of Industrial Accidents I Congress Street, Suite 100 i •:;g Boston, MA 02114-2017 www.mass.gov/dia _ Workers' Compensation Insurance Affidavit:Builders/(:ontractors/Etectricians/Plumhers. TO lIE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly ' Name(Business/Organization/Individual): Window World of Western Mass Address: 641 Paniel Shays Hwy City/State/Zip:Belchertown MA 01007 • Phone#: 413 485 7335 { Are you an employer?Check the appropriate box; i Type of project.(required): 1, .]am a employer with 5t7 employees(full and/or pan•tinte). = 7, New construction 2.01 am a sole proprietor tietor or partnership and have no employees for me in C , t_.a p 4n I Iworking t $. Remctcle.lilt�, any capacity.[No workers'comp.insurance required.] ( , ,i 101 am a homeowner doing all work myself,[No workers'comp.insurance required.] ' I 9. Demolition 4.0 1 nm a homeowner and will be hiring contractors to conduct all work on my property. I will 9 ion Building;addition 1 ensunc that all contractors either have workers'compensation insurance or are sole j 1 1.C]Electrical repairs or add WI 11.1'; • 1 proprietors with no employeex. 1 i �^-, ] 12.01'lumbing repairs or:ill]iti,inr, 5.I,..:I ant a general contractor and I have hired the sub-contractors listed on the attached sheet. { These sub-contractors have employees and have workers'comp,insurance. • .t i 1.3,Q Roof repairs i 6,0 We are t corporation and its officers have exercised their right of exemption per MUc,• I I4,r <)(het. Replacement......... ., 152,§1(4).and we have no employees.[No workers'comp,insurance required,] 1 ' :Any applicant:ihat checks box ail must also fill out the section below showing their workers'compensation policy information, Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicatinu.ach tContraeiora that check this box must attached an additional sheet showing the name of the sub-contractors and slate whether or not those entities huglt employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an emplvyerthat is providing workers'compensation insurance for my employees. Below is the policy and job site information, Insurance CompattyName: Indemnity Insurance Co.of North America • Policy#or Self-ins,tic.# C56098598 Expiration Date:_____ /2024 Job Site Address: /,/ a/ri C I -51 City/Stack/'Tip: Pore r/_,.,, 0/06a Attache 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,(ttt and/or one-year imprisonment,as well as civil penalties In the form of a STOP WORK ORDER and a fine al up to$2,50,ll()a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the IAA for instu'ttncc coverage verification. - I do hereby cer un erthe pains a d penal 'es of perjury that the information provided above is true and correct. Siun fur`` � , ,t Date: a F . -. Phone#: 413 485 7335 . Official use.only.•'Do not write in this area,to be completed by city or town official. • City or Town: 1 Permit/License#_ __......._..._.,..,. .... issuing Authority(circle one): I.Board ofl'Leal>l.h 2.Building Department 3.City/Town Clerk 4.Electrical inspector 5.Plumbing inspector 6.Other,.,_ Contact Person:, _m Phone#: .. a... . .. ,.._ 0 DATE IMMIDD/YYYY) 09/22/2023 A CCU?D `-- 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 bo endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require all 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 PHON` 3657 BRIARPARK DR.,SUITE 700 (NC No, FAX 3657 HOUSTON,TX 77042 N E-MAILRITTYCERTS©LOCKTONAFFINRY.COM INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:IndemnItyt_nsurance C4.of NorAj)America 43576 INSURED INSURER B: WINDOW WORLD OF WESTERN MASSACHUSETTS INC. 641 DANIEL SHAYS HWY INSURERC: BELCHERTOWN,MA 01007-9529 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POUCIES 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 ADDL8UBR ( EFF) (POLICY DIYYYFY) LIMITSLTR INSD WVD POLICY NUMBER COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE __ $ DAMAGE TO RENTED CLAIMS- OCCUR PREMISES Me®currrreecc1-. $ MED EXP(Any_one person) $ -- PERSONAL&ADV INJURY $ GENII AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PRO- FILOC I IFr:T PRODUCTS-COMP/OP AGG $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1F-e_arsl4en0 ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ — AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY .AUTOS ONLY JESLacgdSD(L__ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ �. EXCESS LJAB CLAIMS-MADE AGGREGATE __ $ _ DED RETENTION$ $ WORKERS'OMPENSATION - PER OTH- AND EMPLOYERS'LIABILITY YIN /X STATUTE ER _ . .. A ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? IL- E. EACH ACCIDENT $ �,000,000 (Mandatory in NH) NIA A X C56098598 10/01/2023 10/01/2024 Eyes,describe under EL DISEASE-EA EMPLOYEE DESCRIPTION OF OPERATIONS below $ 8,000,000 E.L DISEASE-POLICY LIMIT $ 8,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION 2970777 Town fo Northampton Building 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 ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD -.1111140 WINDWOR-01 LAURA AA `CORo CERTIFICATE OF LIABILITY INSURANCE DATE 4/14_/2023YY) 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). J - CONTACT Laura Misseri PRODUCER NAME:.. Phillips Insurance Agency,Inc. 97 Center Street /CC PHONE,Est):(413)594-5984 FAic,No):(413)592-8499 Chicopee,MA 01013 AD RIEss:laura@phillipsinsurance.com INSURER(S)AFFORDING COVERAGE _ NAIC#. 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: _ __ 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. _.. INSR1 ADDL SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MMIDDIYYYY{ (MMIDDlYYYY1 LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 --- - - DAMAGE TO RENTED 500,000 CLAIMS-MADE X 1 OCCUR 6Q44324 4/9/2023 4/9/2024 PREMISES(Ea occurrence). .$.. MED EXP(Arlyone person) $_ 10,000 PERSONAL$ADV INJURY _$ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE .__ $ 2,000,000 X POLICY r_X PERRCT rX I LOC PRODUCTS-COMP/OPAGG 4 2,000,000 _...I OTHER: $ COMBINED SINGLE LIMIT 1,000,000 B AUTOMOBILE LIABILITY ,_(Ea_pcciden0 .._.$. ANY AUTO _ 6Z44324 4/9/2023 4/9/2024 BODILY INJURY(Per person) $. - AIUTOS ONLY X SCHEDULED BODILY INJURY(Per accident) $ _X AUTOS ONLY X AO OS ONLY P r a�RztDAMAGE ( ) --— $ $ B X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 EXCESS LIAR CLAIMS-MADE 6J44324 4/9/2023 4/9/2024 AGGREGATE 1 1,000,000 DED X RETENTION$ 10,000 ,$ WORKERS COMPENSATION ANDD EMPLOYERS'LIABILITYSTATUTE ER PER OTH- Y_ I N ANY PROPRIETOR/PARTNER/EXECUTIVE I---1 N/A E.L.EACH ACCIDENT $_ _- MEo/MryE iMH EXCLUDED? E.L.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 If more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of Northampton ACCORDANCE WITH THE POLICY PROVISIONS. Attn:Building Department 212 Main Street Northampton,MA 01060 AUTHORIZED REPRESENTATIVE ;i:,v d-kL 1-1.,1_,, I ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Comm titwtrudtft of Ma sauna mus tts V/ Myosin at PrO1101 0aia)AJI LW itrtero L3oart'rJ of 6 WJdirtg'riuguiartium and:.tsttltJdidc CunstIroidtarlr il%p f,rviawrn /I' CS»1157.10 w1 i_? 1,443` OC iro 04J 6=125 102 OAKRIDC . T:4';? ' " ', BELCH ERTOV51 M IA;(01 7a ✓ ' q,,"'' % '1 )it '°•u'+ Iry } f d k r � Of ., t:arrrrrriamtttarttrdada AS Cat MLA. THE COMMONWEALTH Ot'.MASSACHUSETTS Ornate od Consumer Altairs&t9tasineras.Regulstion Ragiatr rthon valid for IrtdivIduarf use may tTefor,*the. 'FIOME IMP'f OVt„1 EJWT^CONTr ACTOR expiration date. If'found return tu: T'i ICE 6ailai• taitial. °thoo Of Cam Affairs and 0tosines d�tayyr,la;ttiion Mlr'g1ui rlitts 1000tM1�asf7iti tort Rtru*r�t -FtluiNr�7'M) 21.)I....1 114PN+2D2S Hi-Acton, NIA 0211a 'J ICI'ICtLA,S!MOST + i 'I yap { rC -,51 . T �I � `'•�" Ir`��- J f NICHOLAS DROST ; rt. I,, �'+ 1 ; f I D2 OAAK'RIDOE DRIVE yv ,r"r.m,,,,e,M �M14;�4c,i,' • i''1 r /� 4r� 1 3ELt;i1IEIRTOWN,MA t`100i ' ;ota a ��t 6artdorserreltroy Not valid without siggnlature THE COMMONWEALTH OF MASSACHiJSETTS °thee or CoresunierAffairs&Ousines Rogulation Registration valid for Individual use only before the NOMI:1MPROVt MENT,GQNT4tAC:TOR explratioo date. II round return to:. TYPE;Cuipoidtwo Office of Conrsuntor Affairs.and!luckless Ruauluttnr>I Registration Expiration 1000 Wauhi iatoil Street Suite 710 165641 : 03114,2026 Dolton,MA 02116 WINDOW WORLD OF WESTERN MASSACHHUSETTS.INC. 1 r T1h,1OTI1Y DROST ..15 641 DANIEL SHAYS HWY. •!I !, T .coo.,,, 641 t1ELCi-(ERTOWN,MA 01007 �Under aecrdtary Not:valid without signature -z;-• ""r - 1� . Mtttdows And i?oors : •a - I APc IL ,.�'� M660 West Market St A - 1 ir- R, Gratz.PA17030 f.i 1650 i. /' y A7 1665 • a"ooraf aian t�HNtNYL/NoGrids r ; ,. Ra*ngCour, t Panelit.2:Lila-4:itir.Claa o Grids ngal ;Lite,2; "tc41t b SLfDER2tY1NYLFGrlds B (1�',Claar,NDAtE,Artitea3ed};�9eh;37 42 X 37 stharcanbe tkBF� Farrell&2.Lire-i:(U8",Ciag,LGe.Annaafedj;Lrte-� Atf6ttq CxutlC�a (itg•,gpT�,Anrteslsd); ;d51tt X d5 9t2 r�r a 2tea3aolr cleaner, ... .-.--- -- fnd rfdvd du- ru<y ba Jo to mutton rn yurromurre m for dfernt tR8.fr is 2 t and loots trrIItv{dula preclude revy susjset to ma tuten in performance ENERGY PERFORMANCE RATINGS vhen using �1-Factar(i3.SJf-P) Solar Heat Gain Coefficient tdaws on the ENERGY PERFORMANCE RATINGS �-Factor{U.S.fI-g} Solar Heat Gain Caefttcient • .��" �_�� �i '� _ ADD(TIONA.L-PERFORMANCE RAT'i fGS re generally 4.27 0 odr�tcer- Visible Transmittance locations in ADDITIONAL PERFORMANCE RATINGS Air Leakage(t1,SJ1-P) Visible Transmittance Air Leakage{U.S.tI.P} �, 0.3 roll. {0.46 ,rasncr aArneauni,....tart: xeaeRear werasordettfcrwl4+m,ier htrbake ii� V �a a:ts6araear+►rer wf�"'" am � m r� at5ni tr ,l tP rk w onae,>umnrhfprsptmeansrscrrprcon(cras non Ids paeans lop*;maga Ak ricerda.¢saoy nous Wit: intt soarI .ii uxrtmat:44;xwinamraerytozze,ue�cu�wc r4'c�unxr t��rZttrg Fimeir+�+ a� 7te. 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Phone (w) Bill Address: 54 f/c.lfflLL D1/1 OitXu Z E-mail 6vcrrca 0.1)Mr _ r al'#;(j Iy, oyy You the buyer may cancel this transaction at any time prior to midnight of the third business day after the date of this transaction. Notice of cancellation must be in writing postmarked no later than midnight of the following third business day. THIS IS A CUSTOM ORDER NOT FOR RESALE! This Window World' Franchise is independently owned and operated by Window World of Western Massachusetts,Inc.under license from Window World,In, . AP Owner Da e ��cVlaw Z-Z1 -Z`� - — - S= !man Date Owner Da e Window World of Western Massachusetts Witujow 641 Daniel Shays Hwy. • Belchertown, MA 01007 Phone (413) 485-7335 • Fax (413) 315-3714 othi® www.WindowWorldofSpringfield.com Customer: Lisa ,/J Phone (h) _ Install Address: /1/ kk Y ,sf f/otd' ft. /'/4 O/06 Z Phone (w) Bill Address: I)! /4 'aklc y 75j f 2itenti AO OiU(o Z. E-mail To I a 1 Con-if:n c.) PC'C -. tr.) , to Li 3 gcmovc, &Styr( n4 sifekr - $599 k)►ndovo �1r 1f�, cook purr mac. s1. n4l - - -- - bi e - -�to a n3 •(a< x • You the buyer may cancel this transaction at any time prior to midnight of the third business day after the date of this tr; n .actio i Notice of cancellation must be in writing postmarked no later than midnight of the following third business day. THIS IS A CUSTOM ORDER NOT FOR RESALE! This Window World'Franchise is independently owned and operated by Window World of Western Massachusetts,Inc.under license from Window World,Inc Owner Da1Z c' Lib Z"ZO•Zy ✓L - - Salesman Date Owner Da Window World of Western Massachusetts F,F p s �, 641 Daniel Shays,Hwy, Belchertown, MA tt 1 01007 975 North Road,Westfield, MA 01085 Vinciaw Office: (413)485-7335 w tgato www.WindowWorldofWesternMA.com Lisa Will Phone: 8182098838 Install Address: 111 Hinkley St Email: lisawill27@hotmail.com Florence, MA 01062 Contract Name: Lisa Will - Sales -Windows Design Consultant: Tim Drost Measured By: Measure Approved Date: 2/19/2024 Status: Contract Payment Method: Credit Card 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 4000 Double Hung Double 4000 Double Hung Double Pane- New Construction ALL UNITS EXCEPT N 6 $1,299.00 $7,794.00 Pane- New BEDROOM ARE 30-1/2 X 58 , BEDROOM IS STAYING SAME SIZE AS EXSISTING Construction Full Exterior Full Exterior Capping Color: N 6 $275.00 $1,650.00 Capping pp g Install Interior Install Interior Casing flat band molding with 6 inch flat stool N 6 $275.00 $1,650.00 Casing Reframe/Retrim Reframe/Retrim CUT DOWN 4 UNITS TO 20 INCHES OFF FLOOR AND ADDING N 1 $2,000.00 $2,000.00 ONE UNIT IN PLAY ROOM ON LEFT WALL unit sizes 30-1/2 x 58 height Basement Slider - 1 panel (Min Basement Slider- 1 panel (Min 11.5") OR Fixed Unit N 1 $599.00 $599.00 11.5") OR Fixed Unit Misc labor-Windows resheetrock bedroom from corner to seam where's patio Misc labor- door was previously frame wall as nesscarry , WINDOW EXSISTING IN A N 1 $500.00 $500.00 Windows PREVIOUS PATIO DOOR OPEN AND WINDOW IS FLOATING , NEEED TO FIX WALL , CUSTOMER HANDLING ALL TAPING , PAINTING AND INTERIOR FINISH Total Information Unit Total: 21 Subtotal: $14,643.00 Tax Rate: 0% Tax: $0.00 Total: $14,643.00 Amount Financed: $0.00 Payment Method: Credit Card Deposit Amount: $1,500.00 Balance Paid to Installer upon Completion: $13,143.00 Renovation, Repair and Print Act (RRP) Compliance RRP Pamphlet Provided Date: Year Home Built: RRP Signed Date: Window World of Western Massachusetts rr Vf TfigRnf T COmrnn no 641 Daniel Shays,Hwy,Belchertown,MA "121 Widow j 01007 975 North Road,Westfield,MA 01085 WINDi�W WORLDa Office: (413)485-7335 CARE www WindowWorldofWesternMA.com Product Acknowledgements d 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 (77rit.A.0 W Cj, Secondary Homeowner Window World of Western Massachusetts 641 Daniel Shays,Hwy, Belchertown, MA 6T•RNiS+ 975 North Road,Westfield, MA 01085 Q/f�(� Office: (413)Q85-7335 W,NCAR E www.WindowWorldofWestern MA.corn 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 o.,�i iarinn chcipt will ha nrnviriarl fnr the Homeowner to clan after the final inspection is complete. Please make sure that any corrections have been made before the installer leaves the job site. When the job is complete, we ask that you pay the installer the remaining balance due on your contract. 10. METHOD OF PAYMENT: Our installers will accept your final payment in the form of check, money order, Wells Fargo financing, or Visa/MasterCard/Discover Card authorization. As a courtesy and to ensure the safety of our installers; please DO NOT pay your final payment In Cash. 11. REFERRALS: Our goal is that you are pleased with the work we have done and will refer us to your friends and neighbors.You will receive a $50 referral fee for each person you refer who purchases 8 or more windows. Please have your referral mention your name when contacting our office. We trust that your remodeling experience will be a pleasant one. If for some reason you are not completely satisfied, please contact our office. Your comments are welcomed and will be used to better serve you. Thank you for your business! Primary Homeowner Secondary Homeowner Design Consultant EPA "Renovate Right" Brochure can be viewed and printed from here: Renovate Right Brochure WW of W Massachusetts anticipates starting this work on and being substantially completed in days.Any deposit required in advance of the start of the work SHALL NOT exceed 33 1/3%of the total contract price OR the actual cost of any material or equipment of a special order or custom-made nature, which must be ordered in advance of the start of the work to assu_•e 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 112A of the general laws is required to apply for and obtain all construction-related permits.WW of W. Massachusetts shall not be deemed responsible for delays in the work described in this agreement caused by regulatory, permit granting agencies, authorities, or individuals. Notice: If the PURCHASER(S) obtains his own construction related permits for the work described under this agreement or deals with unregistered contractors, the PURCHASER(S) is hereby advised that in the event of a dispute,judgement and nonpayment, the PURCHASER(S) will not be entitled to make a claim or collection from the guaranty fund established l,y 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 transaction. Notice of cancellation must be in writing postmarked no later than midnight of the following third business day. THIS IS A CUSTOM ORDER NOT FOR RESALE This Window World® Franchise is independently owned and operated by Window World of Western Massachusetts, Inc.under license from Window World, Inc.