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23C-058 (4) BP-2024-0398 170 WILLOW ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 23C-058-001 CITY OF NORTHAMPTON Permit: Exterior Res PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit# BP-2024-0398 PERMISSION IS HEREBY GRANTED TO: Project# WINDOWS 2024 Contractor: License: WINDOW WORLD OF WESTERN Est.Cost: 4179 MASS INC 115719 Const.Class: Exp.Date: 04/30/2025 LACEY EDWARD L & SANDRA J& PATRICK J Use Group: Owner: MCGRATH Lot Size (sq.ft.) LACEY EDWARD L& SANDRA J&PATRICK J Zoning: WP/WSP Applicant: MCGRATH Applicant Address Phone: Insurance: 170 WILLOW ST FLORENCE, MA 01062 ISSUED ON: 04/05/2024 TO PERFORM THE FOLLOWING WORK: 3 REPLACEMNT WINDOWS POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Service: Meter: Footings: Rough: Rough: House # Foundation: Final: Final: Final: Rough Frame: Gas: Fire Department Driveway Final: Fireplace/Chimney: Rough: Oil: Insulation: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: !�s Fees Paid: $40.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner E1 �; The Commonwealth of Massachusetts • '08 c Board of Building Regulations and Standards - 4 FOR �' Massachusetts State Building Code, 780 CMR �'�'� NICIPALITY J USE Building Permit Application To Construct,Repair,Renovate Or Demolish a Revised Mar 2011 One-or Two-Family Dwelling This Secti n For Official Use Only Building Permit Number: 4 ji if.-�,� Date Applied: kzZ, /7 Z LI- 5-202.1/ Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Property Adc)ress: 1.2 Assessors Map&Parcel Numbers /7'o ,4211,7w Dr 1.1a Is this an accepted street?yes no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public 0 Private 0 Zone. _ Outside Flood Zone? Municipal 0 On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: � ��� M td wa j- 1 a a r ' cJrc laCCA-f /o r O/C6 ? Name(Print) ,J City,State,ZIP l 7 d /41 l/Ow 3 F 1/i.3 3-e g g £'c h ci/l e- No.and Street Telephone Email Address SECTION 3: DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building', Owner-Occupied '0.,. Repairs(s) 0 Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg. ❑ Number of Units V, Other "Specify:V..0-0(10 Cf10_141 & Brief Description of Proposed Work2: 1. 3 ici(✓ItOto S 1740lacevr-eyr 1— mew ,f eter-ter, _( SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ 4 / 79 1. Building Permit Fee: $ Indicate how fee is determined: 1 ❑Standard City/Town Application Fee 2.Electrical $ 0 Total Project Cost3(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5. Mechanical (Fire $ Suppression) Total All Fees:Afil y�, Check N4 1 Check Amount: Cash Amount: 6. Total Project Cost: $ 1/ r I / j ❑Paid in Full ❑Outstanding Balance Due: I SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) ( S— \."-. `111 At _ A 04 N Q)41 O\OL, `(--i> .. License Number Expiration Date Name of CSL Holder List CSL Type(see below) U 10- aVI�c� 1� �e No.and Street �, Type Description U Unrestricted(Buildings up to 35,000 cu.ft.) O C &1`j C 7)\I\ T\C oA061 R Restricted l&2 Family Dwelling City/Town,S IP V M Masonry I RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances <AV3�k$S• 5 4.vv'vy..Vtil)10\AAu' Lt:LAA,(A. 1 Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) W 1 . ,\ � A �v`-�1c. \cold---t 1 01 t`-l� DI.):.?4, ' HIC Registration Number Expiration Date` HIC Company Name or HIC Registrant Name (0L\\ ----)Ctrv.)2.- S\ �..-S u re,.k-5 cap l�oc �\nbc4,4,1-. y-(c-4.(;)i 41 and Street 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 liY' 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 V.)\.1\A, u\ 11.1t>U\.? to act on my behalf,in all matters relative to work authorized by this building permit application. 3.e.. C -e% ems) 3 lay/a Print O er's Name(Electronic Signature) Date SECTION 7b:OWNER' OR AUTHORIZED AGENT DECLARATION By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information contained' this ap itatil3.4 is true and accurate to the best of my knowledge and understanding. Print er' uthori4AginifNamc(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(H1C)Program),will not have access to the arbitration program or guaranty fund under M.G.L.c. 142A. Other important information on the HIC Program can be found at www.mass.gov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dps 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) (including garage,finished basement/attics,decks or porch) Gross living area(sq. ft.) Habitable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of half/baths Type of heating system Number of decks/porches Type of cooling system Enclosed Open 3. "Total Project Square Footage"may be substituted for"Total Project Cost" City of Northampton 9 r Irr-- 40T4k,'�, Massachusetts '"' r r (, l DEPARTMENT OF BUILDING INSPECTIONS PI,),.,: P. * !t s F'0 � 212 Main Street • Municipal Building rJ�ti. CD ' Northampton, MA 01060 J"' ^0 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 ,j 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: 0450 a 0Q . (Alp \N1&\c\ (b‘.., ,c)Lk .c\k,Q k, \\ ,('''.. ( ,,k,(VV `1`. The debris will be transported by: Name of Hauler: VZ\r\A.0-N,,.; \Zk:k Signature of Applicant: i'�`�G`� Date: , 31a6/a (/ City of Northampton '', Massachusetts +7 . s•c>, az, Ftat DEPARTMENT OF BUILDING INSPECTIONS 7 212 Main Street • Municipal Building ��iG't Northampton, MA 01060 ' •+ 1a0 wo HOMEOWNERS'EXEMPTION ELIGIBILITY AFFIDAVIT I L` diva rd J-ip ild ra .<acej (insert full legal name), born (insert month, day, year),hereby depose and state the following: 1. I am seeking a building permit pursuant to the homeowners' exemption to the permit requirements of the Massachusetts State Building Code, codified at 780 CMR 110.R5.1.3.1, in connection with a project or work on a parcel of land to which I hold legal title. 2. I am not engaged in, and the project or work for which I am seeking the aforementioned homeowners'exemption, does not involve the field erection of manufactured buildings constructed in accordance with 780 CMR 110.R3. 3. I qualify under the State Building Code's definition of"homeowner"as defined at 780 CMR 110.R5.1.2: Person(s) who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one-or two-family dwelling, attached or detached structures accessory to such use and/or farm structures.A person who constructs more than one home in a two-year period shall not be considered a home owner. 4. I do not hold a valid Massachusetts construction supervision license and, except to the extent that I 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 a'6 day of Ha r� ,2 y o C X\-- el -) (St ature) The Commonwealth of Massachusetts • Department of Industrial Accidents 1 Congress Street, Suite 100 Boston, MA 02114-2017 '" r ..o, www.mass,gov/dia Workers' Compensation Insurance Affidavit:Builders/Contrectors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant:Information Please Print Legibly_ Name(Business/Organization/Individual); Window World of Western Mass address:641 Daniel Shays Hwy City/State/Zip:Belchertown MA 01007 Phone#: 413 485 7335 Are you an•unrttloycr Cbeck the appropriate box; ; Type of project(required): • a 1 am a employer with $� employees(full and/or pan•time).* • �l 7, 0 New construction 2,Diem a sole proprietor or partnership and have no employees working for me in 8. Remodeling any capacity.1No workers'comp.insurance required.)• 9. 3.0I am a homeowner doing all work myself.(No workers'comp.insurance required.) ° Uemolftion 4.0 i am a homeowner and will be hiring contractors to conduct all work on my property. i will 10 Building addition ensure that all contractors either have workers'eotllpcmmtion insurance or arcade 11.0 Electrical repairs or addition', proprietors with no employees. • 12.0 Plumbing repairs or addirion, 5.01 ant a general contractor and i have hired the sub-contractors listed on the attached sheet. These sub-contractors have employees and have workers'comp,insurance. t I Roof repairs • 14.©Other Replacement "' 6. We are a:corporation and its officers have exercised their right of exemption per MCit.c. 152,*I(4),and we have no employees.iNo workers'comp.insurance required.' *Any upplicant-that checks box 01 must also fill out the section below showing their workers'compensation policy information, .p Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new nflidavit indicating such Tontractors 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(he 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, insuranceCompanyName: Indemnity Insurance Co,of North America Y4 Policy#or Self ins.:L.ic.#: "6098598 Expiration.sat 10/01/2024 Job Site Address: /70 hie,�"c l) 5 1- City/State/Zip: F./Orel/tee H' 0/06 Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL e.152,§25A is a criminal violation punishable by a fine up to ail, ('0.0 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$2:10,()(l:t day against.thc violator.A copy of this statement may be forwarded to the Office of Investigations of the L)iA for insurance coverage verification. .1 do hereby cer un er the pains a d penal 'es of perjury that the information provided above is true and correct, sigttaturti. 1 /1--e—� Dtttc, Phone#; 413 485.7335 -_ .__. Official use.oniy. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# _... 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:�__ __ ..�_, _ �__ ._..,_w._ __._. Phone#:.....__._.._,�_..._.. _... .. .... DATE IMM/DD/YYYY) AC RL 09/22/2023 �--- 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 NAME: PHONE .. —..._ ... FAX 3657 BRIARPARK DR.,SUITE 700 (A/C,No,Ext):888-828-8365 )(A/C,No): H USTON,TX 77042 E-MAIL ADDRESS: INSPERITYCERTS@LOCKTONAFFINITY.COM INSURER(RAFFORDINGCOVERAGE NAIC# INSURER A:Indemnity Insurance Co,of Not1llA-metica—. __ 43575 INSURED WINDOW WORLD OF WESTERN MASSACHUSETTS INC. INSURER e: 641 DANIEL SHAYS HWY INSURERC: BELCHERTOWN,MA 01007-9529 INSURER D INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE 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 1HE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR - -T POLICY EFF (MI POLICY EXP LTR TYPE OF INSURANCE INSD 1NVD POLICY NUMBER (MM/DD/YYYY) /VYYY) LIMITS COMMERCIAL GENERAL LIABILITY f EACH OCCURRENCE $ CLAIMS- OCCUR DAMAGE TO RENTED $ PREMIS ESLEcoccurrenncel. MED EXP(Any one,Person) $ PERSONAL 8 ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE_ $ POLICY [PRO- LOCFr.T PRODUCTS-COMP/OP AGG $ 1 1OTHER: -- AUTOMOBILE LIABIUTY - COMBINED SINGLE LIMIT $ SEe_aCcident) ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ NON-OWNEDHIRED PROPERTY d DAMAGE ONLY AUTOS LYY acciently S $ UMBRELLA U.AB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS MADE -- — AGGREGATE $ BED RETENTION$ $ WORKERS COMPENSATION X I PATUTE -I ERH- AND EMPLOYERS'LIABILITY Y31_ A ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? _NIA EL EACH ACCIDENT $ 1,000,000 (Mandatory in NH) x C56098598 10/01/2023 10l0112024 It yes,describe under EL DISEASE-EAEMPLOYEE $ 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION 2970777 Town fo Northampton Building Dept SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 212 Main St BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Northampton,MA 1060 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD '`�....N WINDWOR-01 LAURA , 1.4COIrc3' DATE(MMIDD/YYYY) 4.._ CERTIFICATE OF LIABILITY INSURANCE 4/14/2023 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 Missed Phillips Insurance Agency,Inc. PHONE FAX 97 Center Street (A/c,No,Ext):(413)594-5984 I lac w):(413)592-8499 Chicopee,MA 01013 ADDRlESS:Iaura@phllllpsinsurance.com INSURER(S)AFFORDING COVERAGE NA IC# INSURER A:EMCASCO Insurance Co _ . INSURED INSURER B:Employers Mutual CasuaI y Company _ Window World Of Western Massachusetts Inc INSURER C: 641 Daniel Shays Highway INSURER D: Belchertown,MA 01007 — — ---------.__ INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER /MM/DD/YYYYI (MMIDD/YYYY), UNITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR 6Q44324 4/9/2023 4/9/2024 DAMGSFO ARENTErgn )__. $-_-- 500,000 MED EXP(Any one aersonL _ ____. 10,000 PERSONAL&ADV INJURY -_- 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE ;_ 2,000,000 X POLICY L x j PE X LOC PRODUCTS-COMP/OP AGG $ __ 2,000,000 OTHER: $ B . AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 (Ea accident) _ ----_ .. ANY AUTO _ 6Z44324 4/9/2023 4/9/2024 BODILY INJURY Leer person)_ $ OWNED ONLY X AUUTNOSyUyLEEDpBODILY INJURIaRer X AUTOS ONLY X ARoC ONNLY (fReOP RTY DAMAGE cGdenti$ -_ $ B X UMBRELLA LIAB X OCCUR 1,000,000 EACH OCCURRENCE _ $ EXCESS LIAB CLAIMS-MADE 6J44324 4/9/2023 4/9/2024 1,000,000 AGGREGATE _ $_ . _. DED X RETENTION$ 10,000 $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y(N STATUTE_- __ ER ANY EXCLUD ?PROPRIETOR/PARTNER/EXECUTIVE N/A ---_ $ — - — OFFICER/MEMBER E.L.EACH ACCIDENT (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 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 -,..,.. „,..........„ 4. Cornmonweatich of Ma sail GI IIltriettS Div,,.,,4,of Profinseionat Lic misfire •• E3oatr1 of nuudirpfl Rrogidall one:anal tflaindords Co El S W444411 rtil'pgrvin or OS.'1157.0 . 0, pireg:041,030J425 NicHoLAN Tairiod...i' ,'. 6.%.:-: 72 102 f),AICRIDCili DR ii,':'',„\il„• ',,, 17 i,' ,';',&i.i,,'„,,i,4-'114'1,34•iii'''L BELCHERTOVV 11.44(011 ' -:::.'r :i'..,„' ',•!;.^ co',3%.',', i 1)- •-,,,,..,'„A N tfi:i'.'N',%'" - ,r.t,,,,Ci fhtic.i.0:1,0 •Viii:;!',1A.,.. ill't,i'n COMMialtiOtter . .— -------------- THE COMMONWEALTH OP MASSACHLISETTS Oft ice of Consumer Agana.&D ti s Irtes.s Regulation Registration valid for Individual us o only hefoi n tho HOME ititPROVEMP4r CONTRACTOR expiration date, If iound return to: TYPErtfahldual 011ie or COIMURIllit Affairs and Duslitosi Hooknatiion altritrOgFtt.''.EairldiQg 101)0 Via shin WO II Street -Suite 710 O 0:',--,,,,,Av.p4072925 Roston, AAA o2118 •.:1?..:. ',,il/ 'I NICHOLAS DROST , ./ il ii / ,,, .) /1/Ai" r. NICHOLAS MOST ' .--:-. :;:• ."? / , /el,. 102 OAKRIDGE DRIVE'',' -4,N, - , ica 1 i.:•pg,aisfi'.; i Vit:/T -) f P.ii. .. LDHIERTOWN,MA 0100/.„..",, UndOrSinCrOlnry. Not valid without signature THE commoNweALTH Of MASSACHUSETTS. Office of Consumer Affairs&Business Regulation ltoulstrallort valid tar individual use only lrolorbb the HOME,IMPROVEMq111 CONTRACTOR expel:Watt date. lb tumid return to: TYPE:Coe pcgalkko I. Office of Consumer Affairs end ebtusi moss Re6rulcilboe Rogistrattort EXPiration 1000 Washington Street -Suite 110 165641 03i14/2026 Eloston,MA 02118 WINDOW WORLD OF WESTERN,MASSACI,IUS Eli S.INC. , .... TIMOTHY DROST , . , i• ,. c.,ii 1 641 DANIEL$11AYS Fivvy BELCHERTOWN,MA 01007 Undersecretary Not valid without signature,. F E T T- '--.i.... iiii MIYY7�}dCWS ARd DoorssuFfnt,Dr P � 88DY1�88t AI{8rk9t$1 - 11il{Windows An• t3oisrs 0; 1#1 0rat2,PA170330 or destroy the )' eSOWaet Asiarket St I • �~ •• 4, •Y PIEGratz,PA17030 R T{ t _ 4650 r [3HNHVYUNo Grids fr —ii, 1685 Re a Pane1E.2:Lita-1:(1/s',cteer,LQE,Rnneated);Lite-2: r!.\ SLit}ER2MNYLK3 Tics ('/'.Clear,NONE,Annealed);krgori;37112 X 37 licultta NelkoflalFerteMkPinei 1d2t t t1=t�J$=��,tlir.LCEr�lttlYSeil�i Lite' IdEI AQf6a34D1t ■nnt 4512 x451t1 s ihat Can be i4{jt{k1C�� {��•. ae ` el;Ag071; fndlW4ud pros la may ba aubjaet to variation In poreetmanee ,e cleaner, anfordi-fiernt • faa.t�2r6m>a2 � ENERGY PERFORN)AI+iCE RATINGS ;anti doors lndtvtQal products raw ba= !e"men in na anto U-Factor 5.lI-P Olen using a N^ 1 Solar Heat Gain Coefficient ENERGY PERFORMANCE RATINGS tdowson the .�'` U-Factor(11.S.tl-P) Solar Heat Gain Coefficient .- Q.� ADDl7lONAL-PERFORMANCE RATINGS '•r ally 0.27(O RATINGS Visible Transmittance Air Leakage{U.S 1I-P) locations in ADDITIONAL PERFORMANCE RATINGS �.�� _ Air Leakage(U.S.II-P) akt�.� io)s• : -. 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Ftxvrtorrriattast rNil DPrtw8edBdRional inforrrra iorrr Yorstackede. e,tad t condset/0Mb repro.S.2i,ve.Fos and A!y DPrrbted by .�' egartinyvrvrsta,Agarrnnirisais,please vi#wwrr-miwd.com. ur st test site.Tested to AAMAlMit)MAfCSJ+it11A.S.2jA444ma AAtre Abel may tse ��� �7 Q. ); 1. t the ronccalea trY gtat7ig bentr m track fi3er.For atlditiotr,,l irf7smat,oa regarding 3+ Printed on :,nail ercia anon vtst lazi rsb pkiser ict vtwet.Fr addisn, enulors a to,s are Printed all 26772468.1.1.1 7f6t2nt 6 3'6903 PM tit Window World of Western Massachusetts tP ri 641 Daniel Shays,Hwy, Belchertown, MA r...���. 01007 975 North Road,Westfield, MA 01085 wind. �,(� Office: (413)485-7335 CAR E ) www.WindowWorldof WesternMA.co m Edward and Sandra Lacey Phone: 4135888880 Install Address: 170 Willow St Florence, MA 01062 Contract Name: Edward and Sandra Lacey - Sales-Windows Design Consultant: Tim Drost Measured By: Measure Approved Date: 3/19/2024 Status: Contract Payment Method: Cash 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 $100.00 $100.00 4000 - 2 Lite Slider Double Pane 4000 - 2 Lite Slider Double Pane N 2 $1,199.00 $2,398.00 4000 Series DH Solarzone 4000 Series DH Solarzone N 1 $849.00 $849.00 Full Exterior Capping Full Exterior Capping -- Color: N 3 $184.00 $552.00 Total Information Unit Total: 7 Subtotal: $4,099.00 Tax Rate: 0% Tax: $0.00 Total: $4,099.00 Amount Financed: $0.00 Payment Method: Cash Deposit Amount: $0.00 Balance Paid to Installer upon Completion: $4,099.00 Renovation, Repair and Print Act (RRP) Compliance RRP Pamphlet Provided Date: Year Home Built: 0 RRP Signed Date: Window World of Western Massachusetts ,,.,,,,,,,,s M^�R ammpno 641 Daniel Shays,Hwy,Belchertown,MA i._„/�. 01007 �U�Vst/ 975 North Road,Westfield,MA 01085 ) ct?�a Office: (413)485 7335 WINDOW wERco www WindowWorldotWesternMA.com CARE $ 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 CZ/ rtA C> , Secondary Homeowner Window World of Western Massachusetts etenwns t COOT innnn 641 Daniel Shays,Hwy,Belchertown, MA 1 u_.,/_._,(1�K�// 01007 LU 975 North Road,Westfield,MA 01085 Q/jl,(� Office: (413)485-7335 W1NCAR E 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 ift on either side of the window to be replaced. • Secure any pets(and children)for their own safety and for the safety of our installers. 5.ALARM SYSTEMS: It is the responsibility of the Homeowner to inform the alarm company of the upcoming window or door installation and to arrange reconnection after installation is complete. 6. EPA-LEAD SAFE GUIDELINES: Homeowners of homes built before 1978 have received a copy of the lead hazard information pamphlet informing the Homeowner of lead hazard exposure from renovation activity to be performed in their home, The Homeowner understands and agrees to indemnify and hold Contractor,Contractor's representatives, and employees harmless for any lead paint health issues. 7. INSIDE INSTALLATION (Normal): If the windows are to be installed from the inside, the interior stop moldings will be removed from the existing windows and reused after the new windows are installed. Please note that the paint or stain on the trim/moldings may get chipped and would need to be touched up by the homeowner. 8. OUTSIDE INSTALLATION (Special): If the windows are to be installed from the outside,the existing window's wood "stops" will need to be removed. In addition, if there are existing storm windows in place outside of your current windows,these will need to be removed as well. Please note that the area(s) where the wood "stops"and/or storm windows were removed will need to be patched and painted by the Homeowner unless the exterior trim is to be installed by Window World. 9. UPON COMPLETION OF INSTALLATION:After the installation is complete,you will be asked to inspect the entire project with our Installer. An 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 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 CC/it( Secondary Homeowner Design Consultant (2551 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.