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32C-293 (4) 20 VALLEY ST BP-2017-1307 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block:32C-293 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category:window replaced BUILDING PERMIT Permit# BP-2017-1307 Project# JS-2017-002164 Est. Cost:$6877.00 Fee: $40.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: WINDOW WORLD/ROBERT E BUSHEY JR 57011 Lot Size(sq. ft.): 6882.48 Owner: DANIELS MARC F&MARCIA A Zoning: URC(I00)/ Applicant: WINDOW WORLD/ROBERT E BUSHEY JR AT: 20 VALLEY ST Applicant Address: Phone: Insurance: 1029 NORTH RD (413) 485-7335 () WC WESTFI ELDMA01085 ISSUED ON:5/11/2 01 7 0:00:00 TO PERFORM THE FOLLOWING WORK:INSTALL 13 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 ft Foundation: Driveway Final: Final: Final: Rough Frame: Gas: Fire Department Fireplace/Chimney: Rough: Oil: Insulation: Final: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occupancy Signature: FeeType: Date Paid: Amount: Building 5/112017 0:00:00 $40.00 212 Main Street,Phone(413)587-1240, Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner Department use only C City of Northampton StatilsoPPenmt Building Department filrtb& . 212 Main Street Sewer/Sepbc Availability Room 100 W r7WelFAvspebil@7 Northampton, MA 01060 Tin Sft dgitO.Rans phone 413-587-1240 Fax 413-587-1272 P1ot/Sdepfeits Osier Spmfy APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 4.A h- 63y7 1.1 Property Address.- This section to be completed by office 0 v0..vv-,yf.5* Map 3aG Lot a93 Unit ` \ Zone Overlay District NO` \flClm kN pc, N(D.) an Sb DWriet CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: me � . c-C, O nkei a� �1Pa\ s: S� Name(Print) Current Mailing Address p_ ( 6.S".2_ Lc tits CI) Telephone �t )��� Signature 2.2 Authorized Agent: ,G-ot§r i'-7 ta .3:L.5HE- 1 102E1 iuijT1411-1) bdr STFIlaD ,bipA et IU6S Name(P�rrnn/, / A n Current Mailing Address : 4J (`.' -iz �Lt..-�iL, L134's5 "l .;35 Signature - Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1 Bulling ( 1 n c (a)Building Permit Fee 2. Electrical (b)Estimated Total Cost of Construction from(6) 3 Plumbing Budding Permit Fee 4 Mechanical(HVAC) ab 5. Fire Protection ,p (a/� /y� 6. Total=(1 +2+3+4+5) k�, 1 Q t CheckNumber-� g90 4) This Section For Official Use Only Building Permit Number Date Issued: Signature: sir- 7 ? Building Commissioner/inspector of Buildings Date SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement iydows Alteration(s) Roofing O Or Doors L f\ li Accessory Bldg. ❑ Demolition New Signs [DI Decks [D Siding[0] Other[IJ ,(Brief Description of Proposed I Work: \3 ` ` ae,t',f` e c\ir L6t r\AN DS Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roil -Sheet Ga. If New house and or addition to existing housing, complete the following: a Use of building_One Family Two Family Other b. Number of rooms in each family unit Number of Bathrooms c. Is there a garage attached? d. Proposed Square footage of new construction. Dimensions e Number of stories? Method of heating? Fireplaces or Woodstoves Number of each g Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of comb action Is construction within 100 ft.of wetlands? Yes Na Is construction within 100 yr. floodplain Yes No Depth of basement or cellar floor below finished grade k. Will building conform to the Building and Zoning regulations? Yes No. I. Septic Tank_ City Sewer Private well City water Supply SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR; APPLIES FOR BUILDING PERMIT I,• Met 1—C MG (hta,1S , as Winer of the subject property 2 �-�j hereby authorize t�J C- \ r' r'r �� \r V 1'1 to act on my behalf, in all matters relative to work a orized by i building permit application. CDIP e �.rift/redl Signature of Owner /Date '-7 It7 }Z D fy_edirli '. v S frit`-r .as Owner/Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief Signed under the pains and penalties of perjury- ) ILb I t„S IiE�/ Print Name c 51( , -) Signature of Owner/Agent Date Section 4. ZONING All Information Must Be Completed.Permit Can Be Denied Due Ta Incomplete Information Existing Proposed Required by Zoning This coin=to be filled an by Building Department Lot Size Frontage Setbacks Front Side L: R: L: IC Rear Building Height Bldg.Square Footage % I ' Open Spare Footage (Lot arca minus bldg&paved parking) of Parking Spares Fill: illLombard A. Has a Special Permit/V Hance/Finding ever been issued for/on the site? NO O ,NT KNOW O YES 0 IF YES, date issued: / IF YES: Was thq'permit recorded at the Registry of Deeds? NO DONT KNOW 0 YES 0 IF YES: iviter Book Page and/or Document l� # B. Does tt /site contain a brook, body of water or wetlands? NO O DONT KNOW O YES O IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained O Obtained O , Date Issued: C. Do any signs exist on the property? YES O NO O IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES O NO O IF YES, describe size, type and location: E. Will the construction activity disturb(clearing,grading.excavation.or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES O NO O IF YES,tike i a Northampton Storm Water Management Permit from the DPW is required. SECTION 6-CONSTRUCTION SERVICES X8.1 Licensed Construction Supervisor. Not Applicable ❑ Name of License Holder_ ROPIr—in L l�ilbi}tc/ License Number a-7 0.100.43 E: 4 A1V 57o � � Address Expiration Date EEEDi'.J6 HILLS ?VIA CIo3ti 413 45g5471-.) • Signature Telephone 1/r 12A, ) I 9 /9.Registered Home Improvement Contractor. Not Applicable ❑ t oO rTn 5' rti 312_ _ I 5L' LII Company Name Registration Number vvin;D01+i wtSiLp Ur bf,ESit!e_.) iN ASS iNc 3115 ) 18 Address Expiration Date I0201 ,vJlCm 5 i) WE'57c Telephone 1-/ 7-33C SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L e.152,§250(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 `('(I No...... ❑ 11. - Home Owner Exemption The current exemption for"homeowners"was extended to include Owner-occupied Dwellings of one(I) or two(2)families and to allow such homeowner to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor_CMR 780. Sixth Edition Section 108.33.1. Definition of Homeowner.Person(s)who own 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 verso])who constructs more than one home in a two-year period shall not be considered a homeowner. Such`homeowner-shall submit to the Building Official,on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. As acting Construction Supervisor your presence on the job site will be required from time to time,during and upon completion of the work for which this permit is issued. Also be advised that with reference to Chapter 152(Workers'Compensation) and Chapter 153(Liability of Employers to Employees for injuries not resulting in Death)of the Massachusetts General Laws Annotated,you may be liable for person(s) you hire to perform work for you under this permit The undersigned"homeowner"certifies and assumes responsibility for compliance with the State Building Code,City of Northampton Ordinances,State and oral Zoning Laws and Stale of Massachusetts General Laws Annotated Homeowner Signature ( 9e,e V \`c cric c) • The Commonwealth of Massachusetts Department of Industrial Accidents t, �—�� Office of Investigations t — ' 600 Washington Street Boston,M4 02111 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Leaibh' Name(BeeinesseOrgnixariowndividualy WINDOW IvDID Ti DF WESTPRA) MA S$ACWM SETTS Address: l 024 NVQ-iii ltd City/State/Zip: W ESTFI eLD Nit A 010 ES Phone#: 141 3 Y 15 - 7335_ Are you an employer? Check the appropriate box: -... Type of project(required): I.® I am a employer with V) 4. Q I am a general contractor and 1 employees(full and/or part-rime).• have hired the sub-contractors6. 0 New construction 2.0 I am a sole proprietor or partner- listed on the attached sheet 7. 0 Remodeling ship ad have no employees These subcontractors have g. 0 Demolition working for me in any capacity. employees and have workers' 9. 0 Building addition [No workers'comp. insurance comp.insurance.: required] 5. 0 We are a corporation and its 10.0 Electrical repairs or additions 3.0.1 am a homeowner doing all work officers have exercised their I I.0 Plumbing repairs or additions myself[No workers'comp. right of exemption per MGL 12.0 Roof repairs insurance required]' c. 152,51(4),and we have no employers. [No cockers' Il.®Other Rf5911ifie/w6JT W IS VOWS comp. insurance required] _ 'Any applicant that chutes boa Y I mus also fin our the section below showing their workers'0001$1261000 policy information t Homeowners wf.o submit this affidavit indicating they art doing all work and then hire outside coometors must submit a Dew affidavit adoeng such :Contractors that cheek this box must attached in additional sheet showing the name uf the subcontractors rad axe whether or not dose amities have employees. If the sub.mvasx have employees,they must provide their waders'coox policy nuntec I am an employer arm is providing workers'compensation Sarcasm for my employees. Below a She porky and Job site _ information. Insurance Company Name: I-I SE0P7 MICTUAL IALStARN4CE _ Polio nor Self-ins. Licc/.��4: WC_2- 315- 37'7 q t{'7 -0E0 Expiration Date: 5-7-an ,E 8- Job Site Address: (Q0 \iaItq 5k• _city/state/zip:NC e-t-c-Q irk(tell (•1 R Ov ) Attach a copy of the workers'compensa policy declaration page(slowing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MOL c, 152 can lead to the imposition of criminal penalties of a fine up to 51,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to 5250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do'.nobby certify /th/e palnsia of penaWa of perjury that the infonwaion provided above o true and cornea .. Signature: , ,y ,.!�S J'-i, r1ir r-- Date _. Phone P: 1113 445 - 7335 Official use only. Do not write al this area,to be conpleaed by city or town official City or Town: Permit/License R Issuing Authority(circle one): I.Board of Health 2.Building Department 3.City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6.Other _ Contact Person: Phone#: CERTIFICATE OF LIABILITY INSURANCE DA""0`D""" 03/31/2017 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(les) must be endorsed, li SUBROGATION IS WAIVED, sublect 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). Pnooucat w. Laurence R. Forrest ' Forrest Insurance Agency MG" PAP '-' MIS..Ec,Enp 413 958 2680 IAm.xepal3 856 2685 603 North Main Street ss. ACOA East Longmeadow, Mass. 01028 INSGRER(S)APMrmniNG COVERAGE ............ roe _, WEIMER A:Arbella Protection Insurance Company WSW" mApAbam, Window World Of Western Massachusetts, Inc. xsvRERm 1029 North Road Ix51)1RER o: Westfield, Ma. 01085 *sums E. "RH"E. COVERAGES CEw FICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES Off 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 1O 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.LIMO'S SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, LWI I �OF"UMW" 'ffi$ WVD NN.GY NIJ SER t onYrt! twxm YeLTET On x ..... Lxma A I GENERAL LIABILITY xR�11'@1 ' PACK OCCURRENCE IS 1,000,000 I COMMERCIAL GENERALLusiurr 7520025998 04/09/17 04/09/18 °gEM�sie E.Emw'tDmnul s 100,000 ICLAIM/LOA" R OCCUR MED EXP{Anypp OM Man" E 10,000 ■ PERSONAL a ADVINtURY s 14000,000 GENERAL AGGREGATE s 2,000,000 'GEN'L AGGREGATE LIMITAPPLIES PER. _ PROOUCTS-COMP/0 AGO G 1,000,000 IC I POLICY Eo t T R LOIENEDGINO&ERMrt ELLRY 1020018702I04109/17oa/o9/16 le.cUM�Dme„o Ia 1,000,Poo I AUTDMDBLLMa AUTO { EOBKYKLVM mmw.am ; ALL OWNED SCHEM A" I eooav"PRP" A .m. Is AUTOS X ATub G-O PROPERTY DAM� X HIRED AUTOS X AUTOS JPA„sw..,l E A x UMBRELLA LIAS IX occue 4600055451 04/09/17 04/09/18 FACIA OCCURRENCE s 1,000,000 ES ne,s,Uae ! CLAaSMADE AGGREGATE E OE RETENTION s $ -. WORKERS• COMPENSATION Certificate Of 1 W5L1IMP OER TOPV LIMIiti ER AND EMPLOYERS.warn O FIGERIME ETOwNARTNEFUEXECUTrve v'x Insurance To Follow EL.EAG"ACCIDENT S oPRCEDMEMRH! EXCLUDED, x,A A. I„*.es• or'>In bb KO assasE.En EMPLOYEE x I DE%CMRiKW OF WERATONS bene EL.OASEAGE-POLJC BLET I "SCRIPT"OF OPERATIONS t LOCA-AIS,VENKI£5 IMMO,AGGRO ler,kd n N.WW,M ALWedMe.C swam Ipaee ia mle."0 CERTIFICATE HOLDER CANCELLATION City Of Northampton 212 Main street SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE DEREOF, NOTICE WILL BE DELIVERED e Northampton, Ha. 01060 ACCORDANCE WRRTHEPOLICYPROV.SIONS. AVIHORVEO REPRESEKTSi1VE Attention: Building Department ) 01988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD A Rod Ie a CERTIFICATE OF LIABILITY INSURANCE DA vastot _ 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 MOWER 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 FORREST INSURANCE AGENCY ::ref 603 NORTH MAIN STREET imoNE FAX E LONGMEADOW, MA 01028 U Xo£4 - ..... WC,Nor _ ADDRESS: ........ ....... INSURER(B)APFoRoING COVERAGE NAICY _ _INSURER A: Liberty Mutual Fire Insurance 23035 INSURED (ISMER$: WINDOW WORLD OF WESTERN MASSACHUSE I I S INC 1029 NORTH ROAD INSURERC: WESTFIELD MA 01085 INSURERD: INSURERS: INSURER F'" COVERAGES CERTIFICATE NUMBER: 35323654 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 8Y PAID CLAIMS. 1UCY ENE LIR TVP OF INSURANCE V FWD POUCY NUMBER 1MAUDCDfYYYY) IroMMOdYYTt'1 UNITS COMMERCIAL GENERAL tiASUnY EACH O_^CURREN(£ F I CLAIMSMAOE I I OCCUR PREMISES.EI*I amens) 5 MED EXP(Any urs person) $ ....... PERSONAL&ADS INJURY 5 GENS AGGREGATE LMIT APPLIES MR: { GENERAL AGGREGATE S PO IO? iiL'Lf _.....LOC i PRMVICTS-COMMOP AGG E OTHER: $ COMBINED SINGLE LJWT AUTOMOBILE LIABRItt ......... JEa accident) S ANY AUTO BODILY INJURY(FW person) S. OWNED SCHEDULED BWtY INSURY(Per accident S. AUTOS ONLY AUTOS E NED PROPERTY°OSS S AUTOS ONLY AIJIMOS ESONLr - mam fPer al ( ,.- 5 UMBRELLA UAB _ OCCUR EACH OCCURRENCE S EXCESS LAB CLAIMS-MADE AGGREGATE S i DED RETENTION$ _ S . A I WORKERS COMPENSATION WC2-31S-377947-017 5/7/2017 5/7/2018PER OTH- ANDEMPLDYERD'LILBRltt ✓fSATUT[ ER �- I ANYPROPRIETORPARTNERIEXECUTIVE YIN EL.EACH ACCIDENT 5 1000000 OFFICERIMEMIEREXCLUDEDA V N/A (Mandatory in NH) E.L.DISEASE.EA EMPLOYEE 5 1000000 If yes desc1be under DESCRIPTION Of OPERATIONS NANw EL DISEASE.POLICY LIMIT s 1000000 I DESCRIPTION OF OPERATONS I LOCATIONS I VENICLES (ACURD101.Additional Remarks Schedule,may be macM1W if mole space is relying] WORKERS COMPENSATION INSURANCE COVERAGE APPLIES ONLY TO THE WORKERS COMPENSATION LAWS OF THE STATE Or MA This certificate Cancels and supersedes all previously issued certificates,only as they relate to workers compensation coverage. CERTIFICATE HOLDER CANCELLATION CITY OF NORTHHAMPTON SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE DATE THREOF, BUILDING DEPT. ACCORDANCEIWIH THE POLICY PROVISIONS.S WILL BE DELIVERED IN 212 MAIN STREET NORTHHAMPTON MA 01060 AUTHORIZED REPRESENTATNE I Liberty Mutual Fire Insurance 01988-2015 ACORD CORPORATION. All rights reserved ACORD 25(2016703) The ACORD name and logo are registered marks of ACORD S A23654 1 a-377 41 I 11-19 NC I u@70256 14/?Mflo1] 6:30:34 AM IMOT) 1 Page I or 1 gs Massachusetts-Department of Public Szteti7 Board of Building B guiavars and S andiras License CSMs7M11 ,.,s ROBEKC EBUS9H Y,ABr�— 127ROOSEVELfl iptD �• Feeding Mb BIA70IO1M'- • 92..._fitly.- Expiration e runissianne 06128/2017 T7Ac'F.cuuc,.:u,,.cr(i/,.ic/(;;nrbn.rit, Office of Consumer Affairs&Business Regulation }IOME IMPROVEMENT CONTRACTOR nr� :Registration: 165641 Type: 5 Expiration: . 3!15!2018 Private Corporation WINDOW WORLD OF WESTERN MASS INC ROBERT BUSHEY 1029 NORTH RD WESTFIEID,MA 01085 Undersecretary -�- ticrsecretary Three Lite Casement (Requires 3 Value+) $945 _ Full Exterior White Trim/Wrap (SMOOTH; (PVC) S79 Basement Sliders <55 UI $280 Color Other Than White S10 Hopper(In existing wood) (Vent+$150) $250 Specialty Window $ Specialty Custom Int./Ext. Trim Wrap $ Bay/Bow(Insulated seat,Int.Casing&Ext.Cap) $3475 Aluminum/Vinyl or Steel Qut S501$150 Garden Window flnsulated seat,Int Casing&Ext.Cap) $1995 Mull Removal - $30 Grids/Ext.Color,9nt.Woodgrain/Colors calculated in WW Upg-ades Mull to Form Multi unit i $30 Remove Existing Bay/Bow $400 Reframe& Retrim (stainipaint not included) $400 Customer Provided Stops/Trim $45 Roof for Bay/Bow Window $600 Install Interior/ Exterior Stops (WHITE VINYL)$55 Second Floor Installation $500Woodgrain Interior Stops $75 t'-) Window Package $ -3gas Install Interior Casing $95 Window Color ( - ' .f,---= r / t---1_,.) !+� Repair! Replace Sill or Brickmould $75 Inside' Outside Mobile Home Conversion $200 WINDOW WORLD UPGRADES Remove! Re-Install A/C or Awning $100 Full Screens $45 BEIGE Color charge $50 EXTRA LABOR MUST BE IN WRITING Exterior Color $165$9 ,. �Aw ��h %��-/Z Woodgrain Interior $95 V )6144 Contoured/Flat Grids (TOP) (FULL) (ENDS) $49 in 7 /c -/ Prairie Grids (Single)/(Double)-(Flat)!(Contour) $69 ��� Diamond/Brass Grids (TOP) (FULL) $120 Oriel/Cottage Style (40/60) (60/40) $60 Obscure Glass Per Sash (BOT) (FULL) $35/$70 Tempered Glass Per Sash (BOT) (FULL) $60/$120 Catalog Options $ PRE 1978 BUILT HOMES (FEDERAL LEAD CONTAINMENT LAW) MY HOME WAS BUILT IN THE YEAR , , INITIAL;; '-, .. EPA LEAD SAFE (Per Window) $60 i ' r•:' / .2 EPA LEAD SAFE (Patio Dr Bayi Bow!Garden) Sales Rep Recommended: [] Interior Stops [-]Exterior Capping:L Customer Declined: [] Interior Stop [] Exterior Capping: EPA Lead, third party verification: $4Th-OO I decline third party verification ❑ (INITIAL): Site Setup. Removal, In Home Service, etc.: .$250.00 :initial)I have received a copy of the Lead hazard information pamphlet Extra labor (Box above for description)$ informing me of the potential risk of the lead hazard exposure from renovation activity to be Total Amount Due$ c, .::;fin;,^" • performed in my dwelling unit.the EPA"Renovate Right"brochure. 50% Deposit Amount: S . ril (initial)I have received a copy of the lead test result(s). ,,3V0 [] Cash • /:' / J"" lll���,,, Sign: . . )<''7 ,t RL...e, Date: ' 2`y(--r [] Finance- ( ) Wells Fargo ( ) Other t C .------ /� [] Check made to Window World of WM # Name(s)(Print) -�?4 IQIt.y Al 1`u,vd.i [I CC# - - - Exp. Date: V-code If tenants reside in home, Renovate Right Booklet left with: Final Payment Amount$ / 7 ..c---;(J© To be paid tc the installer upon nstallation.Thank You. or left at: WINDOW WORLD CARES St. Jude Children's Research Hospital S WW of W. Massachusetts anticipates starting this work on (9--?-/) and being substantially completed in;' ,_days.Security Interest:Yes No 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 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 and that any inquires about a contract or subcontractor relating to a registration should be directed to:Office of Consumer Affairs and Business Regulation,Ten Park Plaza, Suite 5170 Boston,MA 02116. Phone:(617)973-8700 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.Massa- chusetts 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 by chapter 142A, M.G.L. You the buyer may cancel this transaction at any time prior to midnight of the third business day atter 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! /7/.6-t-tni a '' 41-2i4,-7 er Date /lc Ci7Cel L7 --.Z /.-/) '. Salesman Date Owner Date This Window Wodd''Franchise is independently owned and operated by Window World of Western Massachusetts,Inc.under license from Window World.Inc. wM WC 08-16 White Copy-Original Yellow Copy-File Pink Copy-Customer Hayes Printing 888-667-1116 4. Plants and Bushes. Occasionally we need to work in planters and other landscaped areas of your home that are adjacent to the windows and doors. Please survey your yard prior to us arriving and look for potential problems. Some trees and vigorous bushes need to be pruned back to give us access to your windows. Delicate plants and shrubs in areas right below a window should be temporarily relocated if they cannot survive being stepped on and you want to preserve them.We strive to be careful when working around vegetation, but our priorities are to focus on our work, your windows and our safety while working on your property.We are not responsible for any damage to plants,shrubs or landscaped areas. 5. Arrival and Departure Times.We will advise you of the expected arrival time for our crew at the time we set up the installation date with you. We generally stay till the job is done, unless it will be a 2 or 3-day job, in which case we may work as long as there is daylight. It is our policy that our installers get a sign-off form and collect the outstanding balance at the completion of the job.We ask that you be available to approve the job and make final payment at the time of completion. If this is not convenient for you, we need to know before we start the job. Inclement weather and other unforeseen hindrances are a fact of life and as such we ask that you understand if the weather, traffic, etc. cause a delay or cancellation of an installation appointment. We typically do not schedule more than a day or two in advance to try to avoid such issues. 6. Our Worksite. We like to set up our worksite as close to your windows and doors as possible and generally your driveway is the best spot. If using the driveway will block a garaged car. please be ready to pull it out upon arrival. 7. Alarm Systems. For those of you who have alarm systems,the alarm company should be notified and advised of our job. They will be responsible for the disconnection and reconnection of your alarm system. 8. Where do we start? Upon arrival,the crew leader will survey the job and determine where to begin. If you have a preference,feel free to advise us and we will accommodate to the best of our ability. Because we work in stages (i.e., removal of old windows, setting the new window,wrapping of exterior. etc.), we don't complete the job one window at a time.The job moves along in a rolling progression where each operation is done on all windows at the same time.This produces a quality job. 9. If the job takes more than a day,will there be any openings in my house?Of course not.We only remove that which can be reinstalled in the same day.Although there may not be a complete window. it will be weather-tight and secure for overnight. (Please no critiquing at this time). 10. Pets. We love furry, four-legged creatures; however. we need your help in supervising them. We are not always able to close a gate or door behind us when carrying a window,so please keep them in a safe place.Our job description does not include scampering down the street after Fido with new found freedom. Many people say, don't worry, he doesn't bite, but many installers have been bitten. So please secure dogs that have an aggressive bark towards strangers. 11. Expect some dust, noise and general disruption of your living space. Construction work can sometimes be messy depending upon the scope of your job. It's an unfortunate reality of remodeling, but we do our best to keep things under control. We appreciate your patience and understanding during the job and until everything is finished. Even after we have cleaned up, it is advisable to survey the areas for something we may have overlooked (i.e.. kids rooms, baby's room). 12. *Damage to walls and old trim stops. For those of you who have old aluminum and steel windows and are replacing them due to sweating and damaging of the walis be advised that all water damage plaster will most likely fall out. In addition,all the patch work you have done over the years will fall out also.This is normal: however,we are not plaster experts, so the repair to those walls would best be left to the experts. In some cases due to out of square openings, new trim is required to make the window look good. *Unless noted on the contract new trim will not be provided or installed by us. You can expect to do some touch up painting on the trim after the installation of your new windows.This is not always necessary and is usually minor if it occurs. If your trim stops around your sashes are very old, dry, and brittle, they may snap and crack upon removal. If this happens. we can leave them off if you please, or for a small up charge, replace them with newer ones. Many of the old style stops are no longer available so we would replace the entire window with newer style stops. Should we discover any hidden damage to the frame or wall area we will advise you before we proceed. Should you decide to replace or repair anything,the price will be added to your balance. 13. Relax and enjoy the show. After we've been introduced to your home, feel free to run errands. take a walk. or just relax. If a question should arise; by all means ask the crew leader for clarification.We enjoy people who are interested in what we do,and most customers are intrigued with the process.We do get nervous. however,when a customer constantly hovers over our shoulder. Like any professional. we're always happy to answer questions, but we appreciate being able to concentrate on our work without interruptions and distractions. This ensures a safe and quality installation. 14. Past Due Balances are subject to a service charge of 1.5% per month. In the event that this amount is placed in the hands of an attorney for collection, the purchaser agrees to pay all costs of collection, including a reasonable attorney fee. Return check fee is $50 (fifty dollars). Salesperson Home Owner P.S. Now would be a good time to review contract with the salesman to be sure of your order options and work to be done. Only the items and services on the contract will be done. If you have any questions whatsoever, now is the time to ask. Window World of Western Massachusetts may not require an acceleration of payments as specified in the payment section (front) for the reason that he deems himself or the payments to be insecure. However,where the contractor deems himself to be insecure he may require as a prerequisite to continuing said work that the balance of funds due under the contract,which are in possession of the owner,shall be placed in a joint escrow account requiring the signatures of the home improvement contractor and the owner for withdrawal. Arbitration: Window World of Western Massachusetts and the PURCHASER(S) hereby mutually agree in advance that in the event Window World of Western Massachusetts has a dispute concerning the contract, Window World of Western Massachusetts may submit such dispute to a private arbitration service which has been approved by the Secretary of the Executive Office of Consumer Affairs and Business Regulations and the consumer shall be required to submit to such arbitration in M.G.L. c 142A. Window World Owner Date Date NOTICE: The signatures of the parties above apply only to the agreement of the parties to alternate dispute resolution initiated by the contractor. The owner may initiate dispute resolution even "where this section is not signed separately by the parties." This Window World'.Franchise is independently owned and operated by Window World of Western Massachusetts,Inc.under license from Window World,Inc. WM'NC 08.16