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24D-024 (2) BP-2023-0452 205 PROSPECT ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 24D-024-001 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-2023-0452 PERMISSION IS HEREBY GRANTED TO: Project# DOOR 2023 Contractor: License: WINDOW WORLD OF WESTERN Est. Cost: 4580 MASS INC 115719 Const.Class: Exp.Date: 04/30/2025 Use Group: Owner: LESKO JILL C Lot Size (sq.ft.) Zoning: URB Applicant: WINDOW WORLD OF WESTERN MASS Applicant Address Phone: Insurance: 641 DANIEL SHAYS HIGHWAY (413)485-7335 C5186654A BELCHERTOWN, MA 01007 ISSUED ON: 04/13/2023 TO PERFORM THE FOLLOWING WORK: DOOR REPLACEMENT POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Service: Meter: Footings: Rough: Rough: House# Foundation: Final: Final: Final: Rough Frame: Gas: Fire Department Driveway Final: Fireplace/Chimney: Rough: Oil: Insulation: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: Off, I � . �� • yQ . Fees Paid: $40.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner r 1 The Commonwealth of Massachusetts 4p - Board of Building Regulations and Standards A 3 ;' FOR QV Massachusetts State Building Code, 780 C14 R M NICIPALITY U E Building Permit Application To Construct, Repair,Renovate Or't ;ettsglLS h� ised/Mar 2011 r�Sa .. One-or Two-Family Dwelling '�"44 0ir?'�c�,vs This Section For Official Use Only Building P it Number: — �j L,5). Date Ap lied: / :,VttJ (IZ, Li- 13-ZOZ3 Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Pro�perty Address: 1.2 Assessors Map& Parcel Numbers 2O5 PrO5 J 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❑ Zone: _ Outside Flood Zone? Municipal 0 On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSIiIr 2.1 Own rt of Record: l 1&es ko (Nord t'\cc wt p- ova hl 14 0 14 , ‘Matne(Print) City,State,ZIP o205`Pro,5fec,� 5+ LIi3 sa4s(95-�j!esko? I cu3 A.. LA,CA2 No.and Street Telephone Email Address SECTION 3: DESCRIPTION OF PROPOSED WORK2 (check all that apply) New Construction 0 Existing Building' Owner-Occupied 'lk Repairs(s) 0 Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg.0 Number of Units 1, Other III/Specify:VIZ Ca.A. •Yl. Brief Description of Proposed Work2: doo r 'vr°-p/a ce vii P vl 4'- ,4/ W .!^hitter' "g SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ k S“ v 1. Building Permit Fee: $_� Indicate how fee is determined: t ❑Standard City/Town Ap lication Fee 2.Electrical $ ❑Total Project Cost3(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire $ Suppression) Total All Fees: $r- 141) `� Check No.' 7 Check ount: Cash Amount: 6. Total Project Cost: $ 4, i O V 0 Paid in Full 0 tstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) b ,s— 1k-5 rl l l �:_ . j M\Q),(A p\O._ , 'c`L>i?\-- License Number Expiration bate Name of CSL Holder k°- - � � �1 u J List CSL Type(see below) (� `f" e Description and Street �� Type Descr Ption U Unrestricted(Buildings up to 35,000 cu.ft.) )Qc),,Ck\,(1 � -"t-Th`.i--`\I Q . C\CCfl R Restricted l&2 Family Dwelling City/Town, S IP t M Masonry , ZA--_ RC Roofing Covering L., WS Window and Siding SF Solid Fuel Burning Appliances `1t3)L&S-'11).35 Q.12V'v r..VS c t,,;\A.?(."ZCi lz i.)Ack (.vsl 1 Insulation Telephone Email address D Demolition 5.2 Registered1 � Home Improvement Contractor(HIC) ` � \ o�c.- HIC V� ��1 01 I A ap Registration Number Expiration Date HIC Company Name or HIC Registrant Name and Street [ S./4 cPr.,�5 G. li:\^��t��:i.L:ctir(�.Cc,rtl N.- Quo�-�r)Li �i'v% C 1/4. C \C1ZY� \-F\3)La5.13 `` Email address 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 . EV 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 \X ,Z u ,,,`)ON) a,. to act on my behalf,in all matters relative to work authorized by this building permit application. C�� C_cp� c /j/io/a 3 Print Owner's Name ) nature(ElectronicSi Date Signature) 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•1 this ap. - . ". is true and accurate to the best of my knowledge and understanding. 6. -11 /,o i a Print I er : o •uthori i-s A i 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" The Commonwealth of Massachusetts • tit ==!t, Department of IndustrialAccidents 1 Congress Street,Suite 100 EEg Boston,MA021142017 ,:`.7 www.mas&goi/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electririaw,I'iumbers. TO BE FILED WITH ma;PERMITTING 4.8 THOI2ITY. Applicant Information ° Please Print Legibly Name(Business/Oiganizationfndivirina1): �18,�1'S "c 64-� own, MA 01 Address: 43eldlert City/State/Zip: Phone#: 1//3 8,5 j 3 . Are you an employer?Check the appropriate box: Type ofproject(required): 1.[I am a employer with k6) employees(fall and/or part-time).* 7. ❑New construction 2.0 I am a sole proprietor or partnership andhave no employees working forme in 8. [I Remodeling any capacity.[No workers'comp.insurance required.] 3.0 I am a homeowner doing ail work myself[No workers'comp.insurance required.]t 9. []Demolition 10 0 Building addition 4.0 I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or am sole 11.0 Electrical repairs or additions proprietors with no employees. 12.[J Plumbing repairs or additions 5.0 ram a general contractor and I have hired the sub-contractors listed on the attached sheet 13. ROof repairs These sub-contractors have employees and have workers'comp.insurance,t �t 6.0 We are a corporation and its officers have exercised their right of exemption per MGL c. 14. 'Ot6rer �'�/ (��'' 152,§I(4),and we have no employees.[No workers'comp.insurance required] *Any applicant that cheeks box#1 must also fill out the section below showing their workers'compensation policy infnnnafinn. t Homeowners who submit this affidavit indicating they ane doing all work and then hire outside cdritracters must submit a new affidavit indicating such. iConiractors that check this box must attached an additional sheet showing the name of the sub-contactors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'camp.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: ,9L E i2 yr!e r lca -5(A Ka Policy#or Self ins.Lic.#: C 5 / > a J e3 Expiration Date: 0/0 i/ 02 Job Site Address: 0W5 PrOS r C� 5 4- City/, WZip:��Gl W /0-L I'1 2vt 4" 0/ 06'�Attach a copy of the workers'compensaolicy 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$1,500.00 • and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage v• a is. • t do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature: �i' � !�' Date: L///C/Q 3 Phone#: 413-485-7335 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License # Issuing Authority(check one): 1.D.Board of Health 20 Building Department 31:City/Town Clerk 4.0 Electrical Inspector 51=ilumbing Inspector 6.DOther Contact Person: Phone#: City of Northampton 0.KMAmp i�?,rd off; S,s .. SfG Massachusetts 4$' r{c * c; { ;4' DEPARTMENT OF BUILDING INSPECTIONS y f n � 212 Main Street • Municipal Building uti �a ' Northampton, MA 01060 tgY _ i�4 // HOMEOWNERS'EXEMPTION ELIGIBILITY AFFIDAVIT I, 17/ J1,e 5 k-Lo (insert full legal name), born (insert month, day, ,hereby depose and state the following: 1. I am seeking a building permit pursuant to the homeowners' exemption to the permit requirements of the Massachusetts State Building Code, codified at 780 CMR 110.R5.1.3.1, in connection with a project or work on a parcel of land to which I hold legal title. 2. I am not engaged in, and the project or work for which I am seeking the aforementioned homeowners' exemption, does not involve the field erection of manufactured buildings constructed in accordance with 780 CMR 110.R3. 3. I qualify under the State Building Code's definition of"homeowner"as defined at 780 CMR 110.R5.1.2: Person(s) who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one-or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a home owner. 4. I do not hold a valid Massachusetts construction supervision license and, except to the extent that I qualify for and will abide by the Massachusetts State Building Code's requirements for the supervision of the project or work on my parcel, I am not engaged in construction supervision in connection with any project or work involving construction, reconstruction, alteration, repair, removal or demolition involving any activity regulated by any provision of the Massachusetts State Building Code. 5. If I engage any other person or persons for hire in connection with the aforementioned project or work on my parcel, I acknowledge that I am required to and will act as the supervisor for said project or work. Signed under the pains and penalties of perjury on this /0 day of fip r" / , 2002 0 Le 1- (Si ature) -�"'.ioN WINDWOR-01 LAURA '4�v � CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 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(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Laura Misseri Phillips Insurance Agency,Inc. PHONE FAX 97 Center Street (A/c,No,Ext):(413)594-5984 (A/c,No):(413)592-8499 Chicopee,MA 01013 ADDRESS:laura@phillipsinsurance.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:EMC Insurance Companies 21415 INSURED ,Now shi F ' INSURERS: H mp rP molwp I mince-Company Window World of Western Massachusetts,Inc. INSURER C: 1029 North Rd INSURER D 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 TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD (MM/DD/YYYY) IMM/DD/YYYY) A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR D531150 4/9/2022 4/9/2023 DAMA SESO(Ea NTErIrl e) $ 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 PE� X LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 (Ea accident) $ ANY AUTO Z531150 4/9/2022 4/9/2023 BODILY INJURY(Per person) $ AUTE X AUOTOSOSD ONLY X AUTOSUyLED BODILY INJURY(Per accident) $ X AUTOS ONLY yONNE PROPERTY accRentDAMAGE $ $ 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 AND EMPLOYERS'LIABILITY Y/N ION X STATUTE PER ERH ANY PROPRIETOR/PARTNER/EXECUTIVE A--EC'C�OA400i0862022A 5///ZU22 5/7/2023 1,000,000 OFFICER/MEMBER EXCLUDED? N N/A E.L.EACH ACCIDENT $ (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 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 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Northampton THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN p ACCORDANCE WITH THE POLICY PROVISIONS. Attn:Building Department 212 Main Street Northampton,MA 01060 AUTHORIZED REPRESENTATIVE I ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD DATE(MM/DD/YYYY) _ 7 02110/2023 ACORL] CERTIFICATE OF LIABILITY INSURANCE Acct#:2970777 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT LOCKTON COMPANIES,LLC PPHON:O N E FAX 3657 BRIARPARK DR.,SUITE 700 (A/C,No,Ext):888-828-8365 (NC,No): HOUSTON,TX 77042 DRESS: NSPERTDYCERTS@LOCKTONAFFINITY.COM INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Ace American Insurance Co. 22667 INSURED INSURER B: WINDOW WORLD OF WESTERN MASSACHUSETTS INC. 641 DANIEL SHAYS HWY INSURER C: BELCHERTOWN,MA 01007-9529 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY 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 ADDL SUBR POLICY EFF POLICY EXP LTRINSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED CLAIMS- OCCUR PREMISES(Ea occurrence) $ MED EXP(Any one person) $ PERSONAL 8 ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PRO- LOC IP(:T PRODUCTS-COMP/OP AGG $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION I �/ PER OTH-. AND EMPLOYERS'LIABILITY YIN /� STATUTE ER A ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? —N/A C5186654A 12/25/2022 10/01/2023 E.L.EACH ACCIDENT $ 1,000,000 (Mandatory in NH) If yes,describe under E.L.DISEASE-EA EMPLOYEE $ 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION 2970777 Town fo Northampton SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED Building Dept BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 212 Main St ACCORDANCE WITH THE POLICY PROVISIONS. Northampton,MA 01060 AUTHORIZED REPRESENTATIVE ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD City of Northampton /I ?/�`.a ti Massachusetts +- - Sj''t e 4-__A' „.) I � DEPARTMENT OF BUILDING INSPECTIONS ;. . x iv hit \ it 4 a : ' " ,R. 212 Main Street • Municipal Building w� a� ��� Northampton, MA 01060 ssfrA; • ,,‘4fi 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: Oa ,0_\a ( %1 \NC\rIL`;- ct:\ \-,,. A c`R-01L Ct1L-k0 The debris will be transported by: Name of Hauler: 0-\Nn \ko.,(*X, 4//0` Signature of Applicant: Date: THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affeffirs&Business Regulation Registration valid for individual use only before the HOME IMPRO N' CONTRACTOR expiration date. If found return to: T1fPJ , idtiai Office of Consumer Affairs and Business Regulation RegistffffiDb= Eitpliation 1000 Washington Street -Suite 710 Jov 4 ; I 5 Boston,MA 02118 VICHOLAS DROST r , ., VICHOLAS DROST 1 \ ,:1--,1 102 OAKRIDGE DRIVE t , ,( mk 1 '/ j 3ELCHERTOWN.MA 0100 I. : . ': Undersecretary Not valid without signature THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs&Business Regulation HOME IMPROVEMENt CONTRACTOR TYP_E:1ibrrporafiot� Reaistittloh= Ilef Commonwealth of Massachusetts t65$ -1-'-` 0.------2024 Division of Professional Licensure WINDOW WORLD OFW17€S_l ftN_+�ASSAACFIUSETTS,INC. Soara of Building Regulations and Standards �' `, =- I Constru ti r{iS�iipnv sor i � j ="; �, 't TIMOTHY DROST 1 -= C5.115719 .xt; r, 5A ires:04/30/2025 841 DANiEL SHAYS HWY _, ... ai�Gr,al ,r{ NICHOLAS TDROST _� BELCHERTOWN,MA 010U7 _ Undersecretary 102 OAKRIDGE DR V4 ,a ; - BELCHERTOl 1 MA`50q00r� ixe y _. _ Commissioner �/ ��n�2 /i �J G i7t.�.e,? - - P:sV ._y- .. suffibent,or + ► ' MI windows And Doors Ml Windows AticraOfs ,: i35atn+est Markac st . l F72C}-' Gratz,PA 1 7030 ordestroythe 1ii.iAi-, 650 West Market st ,• • 4 i- Gran,AA1709II frr{ll 1650 AJr�4i:- 1685 • oratrnq DHNIfVYt1Nt:Grids SLIDEff?N(NYLIGrtds - t'anrt11C2;Lite-4:(1/2",Clear O ad).Lite-,2: S tint c (1 ;Ciaar,NONE.Mnea4ed};Argon;3712 X 37 s that can 6e Parfet 184:Lite-t:(118"Atear,LOE.Anneaisd};Lite•2: cleaner, Rafing a . (1!B",Clear. .Anneale5):anion;451/2 X 45 112 Individual ro aaceasws opoa� )n for dr7ferot a �wta may w cu61•si to nriatbn fn p.rfonnantc te'Q0�o sari ENERGY PERFORMANCE :and doors tndMQuu products nay b••�+1s13 t0 it�raian to performance ANCE RATINGS Men usinga iJ-Factor(iJ.SJf-!� wows on the ENERGY PERFORMANCE RATINGS �� ) Solar Heat Gain Coefficient U-Factor(U.S.II-P) Solar Heat Gain Coefficient A`� ire generally 0.27 0.26 ADDITlQNAIr-PERFORMANCE RATINGS 'oductcer- Visible Transtni locations in ADDITIONAL PERFORMANCE RATINGS ittartce Air Leakage(U.S.!I-P) Visible Transmittance Air Leakage(U.$.Il-P) 4, 2 rots. • - ."`a`a"'..........i ar .,m ..ss.. ...rne.... �' �■�� �' • =•'-xanwre n""n° puraaa azaaoe.r'nr Me ,yr «'►aana Mcam lost mess molds tol a=tiff10eraeraaular° atiYfQ"taemceuet 'm"'+>ciairo.raramrerror,�roran,apa,rnrwnce;nn„aroay lm'MK•41"4�.c+.sz co.,w art tC R#�.artr •e vra OW Olt at toumnror�xr� ua�.P wr. " "°�°n xis.Use a •., "or i:NfR6Y STAR`Cerffied in Hlghlifihted Regtotls t CCrlifica?is por ENERGY STAR en'tas regioees resaitadas i TFl(Ft,Y STAR`Ccfidli.rl.in.tir4lf]ii1ilicd f;e1fsiifs. I,:ittfi .tln Pot ENEf({iti'STAR pn 4as s&+}iono cosc�.ltadas: P71111111 T �j�/ /%_ ! / f y MI ENERGY rAf ^40. ^�`" rdCertiedlCettincado rm t$b iaFitwatica sea 1a3eI on product anannitar.wheriadari tit CertMedi ett�aado Pain inForma eompiern saasitlla la t4ignera let pmducoo for full intasreatiaa,sea labsi of Want Pelf Grade Para nuacibnmmPtata.amain la etitntta iei praducto. �` LC-PG35' }DP{ASD} -DP(ASD} Max Test Size ; sport. 3543 50.13 f *DP ASD 1 -DP(A 0 s Water-1 Report# lc arils it) Pod Grade ( ) 6.08 48.t30 X 72pp l Aast2.at-t�dr ro 2d940 l.+C-t��3s 35.0e ss.ae 3 _ c/bs1i+� I Waft teat - -. 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Orestes on enzdeur 9:t0:is AM 001;eft. f26772468.1a1"1 =tee=Printed Window World of Western Massachusetts : UETERRflS OUP)CommRRI, 641 Daniel Shays, Hwy,Belchertown, MA �� ��• 01007 975 North Road,Westfield, MA 01085 WINDOW WORLDWilUICAU ,d Office: (413)485-7335 CARE www.WindowWorldofWestern MA.com Jill Lesko Phone: 4135845195 Install Address: 205 Prospect St Email: jlesko@kingcushman.com Northampton, MA 01060 Contract Name:Jill Lesko - Sales - Doors Design Consultant: Lanea Bushey Measured By: Measure Approved Date: 3/28/2023 Status: Contract Payment Method: Credit Card Lender: Contract Type: Sales Comments: Product Description Txbl Qty Price Extension Permit&Administrative Fee Permit&Administrative Fee N 1 $200.00 $200.00 Setup and landfill disposal fee -Windows Setup and landfill disposal fee- Windows N 1 $200.00 $200.00 5-6 Ft. Patio Door-casing+capping 5-6 Ft. Patio Door-casing+capping N 1 $4,180.00 $4,180.00 Total Information Unit Total: 2 Subtotal: $4,580.00 Tax Rate: 0% Tax: $0.00 Total: $4,580.00 Amount Financed: $0.00 Payment Method: Credit Card Deposit Amount: $2,290.00 Balance Paid to Installer upon Completion: $2,290.00 Renovation, Repair and Print Act (RRP) Compliance RRP Pamphlet Provided Date: Year Home Built: 0 RRP Signed Date: l _ Window World of Western Massachusetts € , ,ERA 5 piaucrcommnnn 641 Daniel Shays,Hwy,Belchertown, MA < , _�- 01007 ►`` U 975 North Road,Westfield,MA 01085 Q/j�� Office: (413)485-7335 WINDOW WORLD CARE $ wwWindowWorldofWesternMA.com w. Product Acknowledgements I have received a copy of the lead hazard information pamphlet informing me of the potential risk of the lead hazard exposure from renovation activity to be performed in my dwelling unit. I received this pamphlet before work began. Primary Homeowner PA " IL—° Secondary Homeowner Window World of Western Massachusetts VBTERRR9 foRucp cornmano 641 Daniel Shays, Hwy,Belchertown, MA 01007975 North Road,Westfield, MA 01085 Witujow z&i Office: (413)485-7335 WINDOW WORLD ) www.WindowWorldofWesternMA.com CAR Preparing for Your New Windows and Doors Thank you for choosing Window World to complete your home improvement project.This letter is designed to simplify your upcoming installation experience by letting you know what to expect. 1. HOW LONG DOES IT TAKE? It takes approximately 4-20 weeks to receive your custom-made window order from the factory following your final measurement and your job exiting the Massachusetts State three day rescission period.A Window World associate will contact you shortly after your products have arrived to schedule the installation. Please note that we will make every effort to install your products within a reasonable time after they have arrived, but weather(rain, snow, high winds and extreme cold), high volume sales periods or other conditions (factory production delays,factory closure for holidays, shipping delays,etc.) beyond our control may govern the installation date. Homeowner understands and agrees that any such delays will not result in a discount from their contract total. 2. HOMEOWNER REQUIREMENTS: I understand that by signing this, I am certifying that I am the owner of the property listed on the contract. I agree that a property owner will be present for the duration of the installation to ensure that the work is performed to my satisfaction and to inspect the work completed. If a property owner is not present,the contractor will be released of liability for any installation issues.This allows us to better satisfy our customers and ensures that the windows or materials are installed in the correct openings. Customer must sign off on completion certificate and leave final payment with installer if he/she wishes to leave the job site prior to completion. Customer understands that by not being present at the time of installation may result in the automatic charging of the final payment to the credit card used for deposit. 3. UNFORESEEN CIRCUMSTANCES: If during the installation process a condition is found that would prohibit properly installing a window(i.e. wood rot,termite or other hidden damages, etc.),the installer will promptly notify the Homeowner as well as the Window World office of the problem.Any additional work that is required to properly complete the job will be discussed with the Homeowner and billed on a time and materials basis. In the event we have received the incorrect or damaged window for your job (due to an incorrect measurement or factory error), Window World will reorder the proper window and will schedule the installation as soon as possible. Window World expects payment on the work completed to date at the time of installation that is not affected by warranty issues. 4. WHAT YOU NEED TO DO PRIOR TO OUR STARTING THE INSTALLATION: • You will need to remove all curtains, shades, blinds, window air conditioning units etc.from the existing windows. • We also ask that you remove any pictures mirrors, etc. on nearby walls and tables. • Move all furniture away from the area around each window leaving approximately 3 ft in front of the window and lft on either side of the window to be replaced. • Secure any pets (and children)for their own safety and for the safety of our installers. 5. ALARM SYSTEMS: It is the responsibility of the Homeowner to inform the alarm company of the upcoming window or door installation and to arrange reconnection after installation is complete. 6. EPA-LEAD SAFE GUIDELINES: Homeowners of homes built before 1978 have received a copy of the lead hazard information pamphlet informing the Homeowner of lead hazard exposure from renovation activity to be performed in their home.The Homeowner understands and agrees to indemnify and hold Contractor, Contractor's representatives, and employees harmless for any lead paint health issues. 7. INSIDE INSTALLATION (Normal): If the windows are to be installed from the inside,the interior stop moldings will be removed from the existing windows and reused after the new windows are installed. Please note that the paint or stain on the trim/moldings may get chipped and would need to be touched up by the homeowner. 8. OUTSIDE INSTALLATION (Special): If the windows are to be installed from the outside, the existing window's wood "stops" will need to be removed. In addition, if there are existing storm windows in place outside of your current windows, these will need to be removed as well. Please note that the area(s) where the wood "stops" and/or storm windows were removed will need to be patched and painted by the Homeowner unless the exterior trim is to be installed by Window World. 9. UPON COMPLETION OF INSTALLATION:After the installation is complete, you will be asked to inspect the entire project with our Installer. An evaluation sheet will be provided for the Homeowner to sign after the final inspection is complete. Please make sure that any corrections have been made before the installer leaves the job site.When the job is complete, we ask that you pay the installer the remaining balance Clue on yuui 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 (LC( 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 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.