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BP-2023-0103 62 ACREBROOK DR COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 29-076-001 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-2023-0103 PERMISSION IS HEREBY GRAN ED TO: Project# WINDOWS 2023 Contractor: License: WINDOW WORLD OF WESTERN Est. Cost: 5356 MASS INC 115719 Const.Class: Exp.Date: 04/30/2025 KOLEMBA JUDITH &MICHAEL J IOLEMBA & Use Group: Owner: VALENTIN J KOLEMBA Lot Size (sq.ft.) Zoning: WSP Applicant: WINDOW WORLD OF WESTERN M SS Applicant Address Phone: Insurance: 641 DANIEL SHAYS HIGHWAY (413)485-7335 ECC-600-4001086-20 A BELCHERTOWN, MA 01007 ISSUED ON: 01/27/2023 TO PERFORM THE FOLLOWING WORK: WINDOW REPLACEMENT POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Service: Meter: Footings: Rough: Rough: House # Foundation: Final: Final: Final: Rough Frame: Gas: Fire Department Driveway Final: Fireplace/Chimney: Rough: Oil: Insulation: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VI I LATION OF ANY OF ITS RULES AND REGULATIONS. Signature: V >2 Fees Paid: $40.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner = The Commonwealth of Massachusetts 91 i Board of Building Regulations and Standards AN 2 J FOR Massachusetts State Building Code, 780 CMR 2O2,� MUNICIPALITY USE Building Permit Application To Construct, Repair, Renovate Or7Oprn 1 a_ Revised Mar 2011 One-or Two-Family Dwelling This Section For Official Use Only I Building Permit Number: ' )3— I() Date eA/////2Applied: !`Wi ) /ate /-27ZOz . Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers ed nGT rrOd&c K 1.la Is this an accepted street?yes eV no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq ft) Frontage(II) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public 0 Private 0 Zone: _ Outside Flood Zone? Municipal 0 On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 46141 /�22.7...LL-1 Owner'of R ord: /^ / �Name.(P int)k,/e vn UG1 City,State ZIP Ha o/o/' 4W ge rebre2cCe , r 17/3 S /36a4 L3vob cOmcaS/. iid No.and Street Telephone mail Address SECTION 3: DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building l Owner-Occupied ' Repairs(s) 0 Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units 't. Other ei✓Specify: 'Co..2. QUL • Brief Description of Proposed Work': en/rc door- ply tie - Nc,4r .frA/1...c1-ILl-' / SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) I� 1. Building $33-5--- 1. Building Permit Fee: $ Indicate how fee is determhned: 2. Electrical $ / ❑ 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) Total All Feed:,$1, Check No.4J -theck Amount: L� Cash Amount: 6. Total Project Cost: $ 5 2 �6 ❑Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) C•c T 4Vt-5 1 n NC.)v \ l OVX `c'l�5} License Number "� Expiration Date Name of CSL Holder List CSL Type(see below) i(3 ‘t--1&10fg � \�e No.and Street Type Description `�\ Q\��� Unrestricted(Buildings up to 35,000 Cu.ft.) City/Town,S 1P R Restricted 1&2 Family Dwelling M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances Ct"<<-'0)to S 1 S 12PY rr�.�S�to\A W opkt1 (Pfk Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) V�l��au?� w S1 �� HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name (oLk Voirm.� n�, nOc ulaY'k-e-r01 and Street Email address coo• L_L PAZ&_C) C1Qr �-k‘3)'&\?A 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 QV 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 to act on my behalf,in all matters relative to work authorized by this building permit application. a Print is Name(Electronic Signature) ate SECTION 7b:OWNER' OR AUTHORIZED AGENT DECLARATION By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information contained' this ap is true and accurate to the best of my knowledge and understanding. Print S er','o uthori.-I A i s Name(Electronic Signature) ate NOTES: 1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration program or guaranty fund under M.G.L.c. 142A. Other important information on the HIC Program can be found at www.mass.gov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dps 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) (including garage,finished basement/attics,decks or porch) Gross living area(sq. ft.) Habitable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of 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" ;, The Commonwealth of Massachusetts r - Department of Industrial Accidents r_�:4 Office of Investigations • a "': � Lafayette City Center 2 Avenue de Lafayette, Boston, MA 021.1.1-.1750 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organi.zation/Individual);Window World of Western Massachusetts Address:641 Daniel Shays Hwy City/State/Zip:Belchertown, MA 01007 phone #:413-485-7335 Arc you an employer? Check the appropriate box: - Type of project,(required): 1. t I am a employer with 40 4. 0 I am a general contractor and 1 employees (full and/or part-tune).* have hired the sub-contractors 6. ❑New construction 2.0 I am a sole proprietor or partner- listed on the attached sheet. 7. 0 Remodeling ship and have no employees These sub-contractors have 8. 0 Demolition working for me in any capacity. employees and have workers' 9. 0 Building addition. [No workers' comp. insurance comp. insurance.t 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 11,.0 Plumbing repairs or additions • myself [No workers' comp. right of exemption per MGL 12.[] Roof repairs insurance required.] t c. 152, §l.(4), and we have no Replacement employees. [No workers' 13.i Other comp. insurance required.] *.Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. 1 Homeowners meowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. 'Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: , %a.. -.- , r^ ' , Policy#or Self-ins. Lk. #:40e4,-a.M %ity/Oa -- J22.,d. .Expiration Date: 5/' /, .IR' --- job Site Address: 6j T -6 rW te-- r City/State/Zip:;.f/0re0 N 4 69/CS a Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 1.52 can lead to the imposition of criminal penalties of a. fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a line of up to$250.00 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 hereby certify under the pains and penalties of perjury that the information provided abov is true and correct. Signature: ' - Date: / all 020a Phone#: 413-485-7335 ______ Official use only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License # __ Issuing Authority(check one): 1.DBoard of Health 20 Building Department 3fCity/Town Clerk 4.0 Electrical Inspector 5 lambing inspector 6.DOther Contact Person: Phone#: ��"....141 WINDWOR-01 LAURA . CERTIFICATE OF LIABILITY INSURANCE DATE(MMfDD/YYYY) 6,-- � �� 4/28/2022 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 have ADDITIONAL INSURED provisl ns or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsem nt. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NRMECT Laura Misserl Phillips insurance Agency,Inc. PHONE FAX 97 Center Street (NC,No,Exty(413)594'�5984 (Am,Nel:(413)592-8499 Chicopee,MA 01013 E-MAIL ADDRESS: @P P laura hilli sinsurance.com INSURER(S)AFFORDING COVERAGE NAIC INSURER A:EMC Insurance Companies 21415 INSURED INSURERS:New Hampshire Employer Insurance Company __ Window World of Western Massachusetts,Inc. INSURER C: 1029 North Rd INSURERD: Westfield,MA 01085 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR j TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP INSD WVD POLICY NUMBER (MM/DDIYYYY) (MMIDD/YYYY) LIMITS A X COMMERCIAL GENERAL UABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR D531150 4/9/2022 4/9/2023 DAMAGE IES(EaE occurrence) $ 500,000 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X�POLICY X X LOC PRODUCTS-COMP/OP AGG $ - 2,000,000 OTHER $ A AUTOMOBILE LIABILITY (Ea accideD SINGLE LIMIT $ 1,000,000 ANY AUTO Z531150 4/9/2022 4/9/2023 BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUR ONLY X SCHEDULED NNE B� p X AUTOS ONLY X AUTOS ONNLY (Pe(aEcciRdent)AMAGE $ $ A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 EXCESS LIAB CLAIMS-MADE J531150 4/9/2022 4/9/2023 AGGREGATE $ 1,000,000 DED X RETENTION$ 10,000 • B WORKERS COMPENSATION X PER OTH- $ AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE ECC-600-4001086-2022A 5/7/2022 5/7/2023 1,000,000 OFFICER/MEMBER EXCLUDED? N N/A E.L EACH ACCIDENT $ (Mandatory In NH) E.L DISEASE-EA EMPLOYE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ + DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Workers Compensation Coverage Includes the following 3A States:MA,CT This certificate cancels and supersedes all previously issued certificates,only as they relate to workers compensation coverage. CERTIFICATE HOLDER CANCELLATION I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Northampton THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Attn:Building Department 212 Main Street Northampton,MA 01060 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD City of Northampton Massachusetts 5, ,: t 4 DEPARTMENT OF BUILDING INSPECTIONS tq 212 Main Street • Municipal Building vx_ �a Northampton, MA 01060 ''sy41/ CONSTRUCTION DEBRIS AFFIDAVIT (FOR ALL DEMOLITION AND RENOVATION PROJECTS) In accordance of the provisions of MGL c 40, S54, a condition of Building Permit Number is that all debris resulting from this work shall be disposed of in a properly licensed waste disposal facility, as defined by MGL c 111, S 150A. The debris will be disposed of in: Location of Facility: On-Do\a `Mek..\c S\(\01 ClOLAO The debris will be transported by: Name of Hauler: ,\rc Signature of Applicant: Date: �y & l Commonwealth Mac Division o1 Professionalor ssa Licensurhusettse Board of Building Regulations and Standards Const utAr3l�tipprvisor I CS•115719 �jt ires:0413012025 t1 "I )' NICHOLAS T DROST.' U ' 102 OAKRIDGE DR BELCHERTOlipl MAaO1007 i • 1 oiSS Commissioner as fi r}Gci«. Office of Constar or Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR TYPE:individual Hralstralicn 1zPi2kQ1) 201746 04/27/2023 NICHOLAS DROST NICHOLAS DROST ',•,rr ""r'• 102 OAKRIDOE DRIVE ;•_ BELCHERTOWN,MA 01007 Undersecretary • THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs&Business Regulation 4 HOMEIMPROVEMENTCONTRACTOR TWP_E:torporation Reaisti'ation77EXoiration 165641 s 03L1412024 WINDOW WORLD OF;WESTERN MASSACHUSETTS,INC. TIMOTHY DROST ‘, ?=;% ' 641 DANIEL SHAYS H4VY '�''" _ •'- BELCHERTOWN,MA 01007- ':.• F c.or Undersecretary thnc, , a',.r. rf ii.. .......S.i....................., MI Windows And Doors MI Windows Anti Doors �r! E 854 West 6Aarket St r - i -ia NFT2C Gratz,PA 17034 or destroy the ti,)41.',g;r, 650 WestG;A+erketSt1' � ..•- M Gratz,PA 17030 �1 ,650 '` : iancrat FenDHN1NYt-/ryo Grids rP �; 1685 R hg Paeaf7 :Lite.f:(t/8;quirt. itcuttm SLIDERVANYl 1Grids ,Ctaar,Nol�tE,Anne �t.ke.2 Wedorsifersentron *anei 1s2:1.b-tIW for E. 0'Libra argon:a7 in X 87 s that-07 be Ring miumer,>do i 11►pon;4S Vt X.t51f1 t ,aaacs.�os-0ooat le cleaner, reaiHauu ra m for(Wend a em's day bre salad to variation In porfcrmanee "` t6'00na-000°2 ENERGY PERFORMANCE RATINGS :anti d0015 iNeM4utt preswes taw be subset to vesiedan lit per(armM• Vhen using aU-Factor(U.S.11-P Wows on the ENERGY PERFORMANCE RATINGS � ) Solar Heat Gain Coefficient U•Factor(U.S.il-P) Solar Heat Gain Coefficient 0.2� V.27 �.�6a' ADDITIONAL-PERFORMANCE RATlNC3S- ire generally / oductcer- Visible Transmittance locations in ADDITIONAL PERFORMANCE RATINGS RCe Air Leakage(U.SA-P) Visible Transmittance Air Leakage(U.S.ii-Fs) 0.52 5 0.3 >ols. AA S 0 3kaeotAct n, RI;t s �Set 14 .rata.r , u tit,bake V.t 6 � � aessnareeunnylaimp/moodr anel notworrhit ale limner army ° InY1F."4"" c4n.v •- tRam+brnrsra� COMM to K0e3011 taRO Reoans o z +ftrlieereasserieetortMKtitOtNAbt+lMtN - —" Make �"-`�"~'� mC. ana liar natnstcu PIN a+ttetarnf rr .,7 aotsnostiearvst�te ftulna= �nraas ENFR(iY STAR`Certified in Highli�Itled Regions, Iris.Use a - erav Certific7d por ENERGY STAR en las regimes resaltadas. TNT Fi,Y STAR' l Celttiml rat Iit4itttlittted f;ugintts. fc,nfi:,,In pnc FNE.Cc STAR on Irr>r(•gion(, rEr:.ahstlas -grte!� 4 fy PPM., --:,,i";,,.:....,, ' ``' `3i ENERGY S R y 4-- NE;;y c i.AR ,+� •'�" OCenitiadtCattifcado For tab inf►rjue •tiaq sea iabet en Prodnat c 1 it&r.to.Mielert ■CaetlAedtCettl6eado Para ioformhcibn carrpkd�eoast ter la etignete del redacts. Fetfallitdsrntrties.e+afattdea►odset LC A rade `DP{ASD} DP(ASD} Para htatteacibn Isla attattkat to atitueu tel products. _ 33 30 _- S4+DP(ASO) -DP(' j "liter Max lost Size Report# Fondada iD Perf Grade t t3ate b0.t)0 X?200 acsrx.tn-iog a7 ry 1 LC-PG36 3i.09 35.09 f_._� _..._. — ...... 248e10 t .' s i ax est Pa �ll� • r wa iced units npfease eontaows and doors only. For mutton roBard muAed 73,0o X ea,40 F2 0.01.toadr�m ni tau aire.7ested to con Y sates representative.Pos and Neg OP hinted by i Far infotntatlon Martini)Waded ST M E130D.AAMA tab el rta4 bDt1WCSA� t 11. Soar track S,�er.For 3iadl 0 gs are for a1dlY�dtral windows and doers utN• bead or stacked unpe,please r rdect your sales representative.ADs and Na3 DP rkla d ddattxral information regard by o B n8 instartation instructions,please visit v+'F'+++.miwd.tom. tthe umt lest stsa.Teated read 161A.5.211W44 D5 AAtJIA label may be )6785673.1.1.1 aoneeaied by ptarinp bead or track filer.For adtiitiornl irdOrntation regarding _:nail inttst'ration instructions,please visa vwrw.rnhvd.eorn, >'r.tt.a on erm2orea:to:isAM nte ,.h, 26772468.1.1.1 7 relA°lam City of Northampton Massachusetts " 1[ A: s. f. * r DEPARTMENT OF BUILDING INSPECTIONS • 212 Main Street • Municipal Building ~J`� Northampton, MA 01060 4'. a / /HOMEOWNERS'EXEMPTION ELIGIBILITY AFFIDAVIT I, l..�i rd'I t Q! ((-ii9bQ (insert full legal name), born (insert month, day, yrur), here d ose and state the :ollowin f g 1. I am seeking a building permit pursuant to the homeowners' exemption to the permit re, irements of the Massachusetts State Building Code, codified at 780 CMR 110.R5.1.3.1, in connection with a pr. ect 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 home, ers'exemption, does not involve the field erection of manufactured buildings constructed in accordance with 780 i MR 110.R3. 3. I qualify under the State Building Code's definition of"homeowner"as defined at 780 CMR 110.' .1.2: Person(s)who owns a parcel of land on which he/she resides or intends to reside, on w ich there is, or is intended to be, a one-or two-family dwelling, attached or detached structures access 4 ry to such use and/or farm structures. A person who constructs more than one home in a two-year pe od shall not be considered a home owner. 4. I do not hold a valid Massachusetts construction supervision license and, except to the extent ' 't 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 r•gulated 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�day ofcp f(,'/,203 c�jo,2 o 4a'Y\ rA (Sr ature) 11, Window World of Western Massachusetts VETERans 0""Pr comma 641 Daniel Shays, Hwy,Belchertown, MA �� nS= J�f/ 01007v��. u.�N�i�/ 975 North Road,Westfield, MA 01085 Wat f Office: (413)485-7335 WINDOW WORLD CARE www.WindowWorldofWesternMA.com Judy Kolemba Phone: 4135843629 Install Address: 62 Acrebrook Dr Email: Bvgb@comcast.net Florence, MA 01062 Contract Name:Judy Kolemba - Sales - Doors Design Consultant: Tim Drost Measured By: Measure Approved Date: 1/20/2023 Status: Contract Payment Method: Check Lender: Contract Type: Sales Comments: Product Description Txbl Qty Price Extension Permit& Permit&Administrative Fee N 1 $200.00 $200.00 Administrative Fee Setup and landfill disposal fee - Setup and landfill disposal fee-Windows N 1 $100.00 $100.00 Windows Entry Door, Casing Entry Door, Casing + Capping left 36 REMOLDER 4=9 black exterior white interior Concorde 1/2 lite black caming NICKLE multipoint, REMOVE N 1 $5,056.00 $5,056.00 + Capping STAINGLASS INSERTS IN OLD DOOR Total Information Unit Total: 2 Subtotal: $5,356.00 Tax Rate: 0% Tax: $0.00 Total: $5,356.00 Amount Financed: $0.00 Payment Method: Check Deposit Amount: $600.00 Balance Paid to Installer upon Completion: $4,756.00 Renovation, Repair and Print Act (RRP) Compliance RRP Pamphlet Provided Date: Year Home Built: 0 RRP Signed Date: 111 Window World of Western Massachusetts ersRa s commnnu th" 641 Daniel Shays,Hwy,Belchertown,MA ����� 975 North Road,Westfield,MA 01085 WINDOW WORLD w. Office:(413)485-7335 CARE$) wwWindowWorldofWesternMA.com Product Acknowledgements I have received a copy of the lead hazard information pamphlet informing me of the potential risk of the lead hazard exposure from renovation activity to be performed in my dwelling unit. I received this pamphlet before work began. Primary Homeowner Secondary Homeowner Window World of Western Massachusetts vereAans P1eu4.4'commend 641 Daniel Shays, Hwy,Belchertown, MA 01007 wivoow w.n* 975 North Road,Westfield, MA 01085oR�� { W,tdow Office: (413)485-7335 CARE www.WindowWorldofWesternMA.com Preparing for Your New Windows and Doors Thank you for choosing Window World to complete your home improvement project.This letter is designed to simplify your upcoming installation experience by letting you know what to expect. 1. HOW LONG DOES IT TAKE? It takes approximately 4-20 weeks to receive your custom-made window order from the factory following your final measurement and your job exiting the Massachusetts State three day rescission period.A Window World associate will contact you shortly after your products have arrived to schedule the installation. Please note that we will make every effort to install your products within a reasonable time after they have arrived, but weather(rain, snow, high winds and extreme cold), high volume sales periods or other conditions (factory production delays,factory closure for holidays, shipping delays, etc.) beyond our control may govern the installation date. Homeowner understands and agrees that any such delays will not result in a discount from their contract total. 2. HOMEOWNER REQUIREMENTS: I understand that by signing this, I am certifying that I am the owner of the property listed on the contract. I agree that a property owner will be present for the duration of the installation to ensure that the work is performed to my satisfaction and to inspect the work completed. If a property owner is not present, the contractor will be released of liability for any installation issues.This allows us to better satisfy our customers and ensures that the windows or materials are installed in the correct openings. Customer must sign off on completion certificate and leave final payment with installer if he/she wishes to leave the job site prior to completion. Customer understands that by not being present at the time of installation may result in the automatic charging of the final payment to the credit card used for deposit. 3. UNFORESEEN CIRCUMSTANCES: If during the installation process a condition is found that would prohibit properly installing a window(i.e. wood rot,termite or other hidden damages, etc.),the installer will promptly notify the Homeowner as well as the Window World office of the problem.Any additional work that is required to properly complete the job will be discussed with the Homeowner and billed on a time and materials basis. In the event we have received the incorrect or damaged window for your job (due to an incorrect measurement or factory error), Window World will reorder the proper window and will schedule the installation as soon as possible. Window World expects payment on the work completed to date at the time of installation that is not affected by warranty issues. 4. WHAT YOU NEED TO DO PRIOR TO OUR STARTING THE INSTALLATION: • You will need to remove all curtains, shades, blinds, window air conditioning units etc. from the existing windows. • We also ask that you remove any pictures mirrors, etc. on nearby walls and tables. • Move all furniture away from the area around each window leaving approximately 3 ft in front of the window and 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 d©or installation and to arrange reconnection after installation is complete. 6. EPA-LEAD SAFE GUIDELINES: Homeowners of homes built before 1978 have received a copy of the lead hazard information pamphlet informing the Homeowner of lead hazard exposure from renovation activity to be performed in their home.The Homeowner understands and agrees to indemnify and hold Contractor, Contractor's representatives, and employees harmless for any lead paint health issues. 7. INSIDE INSTALLATION (Normal): If the windows are to be installed from the inside,the interior stop moldings will be removed from the existing windows and reused after the new windows are installed. Please note that the paint or stain on the trim/moldings may get chipped and would need to be touched up by the homeowner. 8. OUTSIDE INSTALLATION (Special): If the windows are to be installed from the outside, the existing window's wood "stops" will need to be removed. In addition, if there are existing storm windows in place outside of your current windows, these will need to be removed as well. Please note that the area(s) where the wood "stops" and/or storm windows were removed will need to be patched and painted by the Homeowner unless the exterior trim is to be installed by Window World. 9. UPON COMPLETION OF INSTALLATION: After the installation is complete, you will be asked to inspect the entire project with our Installer. An evaluation sheet will be provided for the Homeowner to sign after the final inspection is complete. Please make sure that any corrections have 41111, 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 1Ri../ik A t \ A/4„ 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 .n days. Any deposit required in advance of the start of the work SHALL NOT exceed 33 1/3% of the total contract price OR the actual cost of any material or equipment of a special order or custom-made nature, which must be ordered in advance of the start of the work to assure that the 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 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 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.