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17A-197 (8) BP-2024-1010 149 NORTH MAPLE ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: I7A-197-001 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-2024-1010 PERMISSION IS HEREBY GRANTED TO: Project# WINDOWS 2024 Contractor: License: WINDOW WORLD OF WESTERN Est.Cost: 3996 MASS INC 115719 Const.Class: Exp.Date: 04/30/2025 GRIMALDI KATHERINERYAN & JOHN OLSON Use Group: Owner: PICKARD Lot Size (sq.ft.) GRIMALDI KATHERINE RYAN &JOHN OLSON Zoning: URB Applicant: PICKARD Applicant Address Phone: Insurance: PO BOX 154 WILLIAMSBURG, MA 01096 ISSUED ON: 08/14/2024 TO PERFORM THE FOLLOWING WORK: 4 REPLACEMENT WINDOWS POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Service: Meter: Footings: Rough: Rough: House # Foundation: Final: Final: Final: Rough Frame: Gas: Fire Department Driveway Final: Fireplace/Chimney: Rough: Oil: Insulation: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: 7 2_ Fees Paid: S60.00 • 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner RECEIVED The ommonwealth of Massachusetts 2 2024 Bo rd o Building Regulations and Standards FOR aUG Ma sack setts State Building Code, 780 CMR MUNICIPALt'I'Y USE o�PT.OF ruu nip: ,��- pplication To Construct, Repair,Renovate Or Demolish a Revised Mar 2011 RTHAMPIION.MA01(00 One-or Two-Family Dwelling This Section For Official Use Only Building Permit Number: hAe2y. /0/0 Date Applied: S , P/P" 540e � Building Official(Print Name) ignature Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers IN a 1 t1 o p)e 3 ' 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 FloodZone? Municipal 0 On site disposal system 0 Check iffyeses❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of ord• ok vl 0 ,C VC(rd FIorevice I-I O (c6 sNim e(Print) City,State,ZIP ILO N Hatokk 3 k N13 556) iocR v k-�(�r vioe YiE e �'voa► W(tit No.and Street Telephone Email Addret SECTION 3: DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building* Owner-Occupied 'I Repairs(s) 0 Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units `. Other b/Specify: Ne.-e-V 6t C_$t t IC 4 t Brief Description of Proposed Work2: l'rJ t (.;f 3 rep ly C.,G lfl&v) F SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) I. Building $ 3 p q G 1. Building Permit Fee: $ Indicate how fee is determined: 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 $ Total All Fees �O df111)Suppression) Check No. Check Amount: Cash Amount: 6. Total Project Cost: $ 3 , 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) `mil\0�.c\tAck`,, yc'i>v 1-, License Number Expiration Date Name of CSL Holder List CSL Type(see below) No.and Street < Type Description U Unrestricted(Buildings up to 35,000 cu.ft.) 1(7c).C �(1 Th'\ ��f\ (? , CA06. ` R Restricted I&2 Family Dwelling City/To ,S iP M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances C•1‘3) k%S,`l jS '?.2,rsty.A5 c k?\Hack)4i,4`Vk I,. t 1 Insulation telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) W\1.AtJ - Az.,i--A c� HIC Registration Number Expiration Datd" HIC Company Name or IIIC Registrant Name (L k-\k ---.)cX.r s.A.'_Q S\t\(. S uJ (\ and Street y V�ir rv's,4-:, (1-' ti2-\r���0034,1':t,,-(: ' ��' [ t15 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 fa'? No ❑ SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,as Owner of the subject property,hereby authorize \&&i. Lk% .t` t'i\�\�, to act on my behalf,in all matters relative to work authorized by this building permit application. 7/C e c' tv�,\,rt, cam ) 3/ /c24I Print Or's Name Signature)(Electronic Si Date b'n ) SECTION 7b:OWNER' OR AUTHORIZED AGENT DECLARATION By entering my name below,I hereby attest under the pains and penalties of pet jury that all of the information contained i this aprtatio is true and accurate to the best of my knowledge and understanding. Print eri uthorid At 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 IBC Program can be found at www.mass.gov/oca Information on the Construction Supervisor License can be found at www.tnass.gov/dos 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 H ANy /°� �i idZs SAS'�"s�C`. /Id -, Massachusetts �+,r w f,iG, a ;} DEPARTMENT OF BUILDING INSPECTIONS �' �� w 1212 Main Street • Municipal Building .4 �' Northampton, MA 01060 srNIli • ;.�'' 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: Or t->e Cti \64k; c l( l i ` (\ct» c,A \\, c \\ , ' The debris will be transported by: Name of Hauler: VO‘f\ . 0\ic: \j3c,'--` N. Signature of Applicant: Date: 713 r 4.? q City of Northampton µ(MA•C Massachusetts ��� ''% ' DEPARTMENT OF BUILDING INSPECTIONS % . 212 Main Street • Municipal Building yJ , CD �.,�k,»1 Northampton, MA 01060 4% '- j''' HOMEOWNERS'EXEMPTION ELIGIBILITY AFFIDAVIT 0 L 0 Pr C-k 2 VQ (insert full legal name), born _ (insert month, day, ye ,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. 1 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 3 I day of jA,!_y ,20g.V Y\.r.t (Si ature) The Commonwealth of Massachusetts v, l,�, Department of Industrial Accidents t —:;i,,_ ' I Congress Street, Suite 100 "1i: Boston, MA 02114-2017 ".'�- '' www.mass.gov/dia --i�1., Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Lcliblv • Name(Business/Organization/Individual): Window World of Western Mass • Address:641 Daniel Shays Hwy City/State/Zip: Belchertown MA 01007 Phone#: 413 485 7335 {3 Are you an employer?Chock the appropriate box: ? Type of project (required) I.1l ant a employer with 50 employees(full and/or part-lime)."• 7. New construction 2.01 am a sole proprietor or partnership and have no employees working for me in i 8. Remodeling any capacity.[NO workers'comp,insurance required.] j 9. D Demolition 1 3.0 I am a homeowner doing all work myself.(No workers'cow.insurance required.] ' i 1 4.0I am a homeowner and will be hiring contractors to conduct all work on my property. 1 will 10 s Building addition i ensure that all contractors either have workers'compensation insurance or arc sole 1 11.0 Electrical repairs or add i ti,+i i • ! proprietors with no employees. ' • t J 12.EI Plumbing repairs or adtlitv't • 5.C i em a general contractor and I have hired the suh-contractors listed on the attached sheet. i { These sub-contractors have employees and have workers'comp,insurance.t a 13.El Roof repairs 14 r- Oahe). Replacement 1 6.[3 We are a corporation and its officers have exercised their right of exemption per MCI,e -""""'" "' 152,ft I(4).and we have no employees.(No workers'comp.insurance required.] 1 *Any upplicantshot checks box tf 1 must also fill out the section below showing their workers'compensation policy information. 'Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such iConaraetors that check this box must attached an additionut sheet showing the name of the sulr•contiTICIMS umd stale whether or not those entities hu'c employees. If the,tub•ccnuractars have employees.they must provide their workers'comp.policy number. ..... - _-_ 1 am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. insurance CompanyName: Indemnity Insurance Co.of North America C56098598 10/01/2024 Policy#or Self ins..Lic.#: Expiration Date.:_ ____ Job Site Address: /Lig Al Ha p 1� 5 T City/Stntc/I.,ip: F�U re 0 '.,, J 4 of O 2 Attach a copy of the workers'compent§ation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to$1.d)O. (t 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.i)()•o day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the l.)IA for in.surnncc coverage verification. .1 do hereby cer u er the pains a d-penal es of pedury that the information provided above is true and correct. •Signature; Date: 7 /3 i /e ..................... Phone#: 413 485.7335 _ l Official use only.'Do not write in this area,to be completed by city or town official. • City or Town: ' Permit/License#_ � .,__ ...__ Issuing Authority(circle one): 1e Board of:Hei lth 2.Building Department 3.City/Town Clerk 4.Electrical inspector 5.Plumbing inspector 6.Other ' Contact Person: _ ..____ Phone#:..-v.__.____.._ -___ . DATE(MMIDDIYYYY) AC,C,Rn� n9127J2D23 `-- 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 PHOE: PHONE 3657 BRIARPARK DR.,SUITE 700 VC�, o.Eut1:888-828-8365 I FAX (I ,Not: HOUSTON,TX 77042 E.WJL ADDRESS: JNSPEIBTYCERT_SOLOCKTONAFFMTY.COM-- _—---- ___ - INSURER(S)AFFORDING COVERAGE NAIC*/ INSURER A:Indemnity Insurance Co.of North America 43575 INSURED INSURER B WINDOW WORLD OF WESTERN MASSACHUSETTS INC. 641 DANIEL SHAYS HWY INSURER C: BELCHERTOWN,MA 01007-9529 INSURER D: ( tt INSURER E: INSURERF: 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 POI ICY PERIOD—I INDICATED. NOTWITHSTANDING ANY REQUIREMENT.TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO W IICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN.THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL III 'TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. — I INTR Mf1I R TYPE OF INSURANCE IN POLICYSLIBR SD D ...--_ POLICY NUMBER (#D�Y) ( W)- MUTE COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S DAMAGE TO RENTED - l CLAIMS- OCCUR PREMISES(Ea occurrence) S MED EXP(Any ono person) $ PERSONAL&ADV INJURY I$ OEMLAGGREGATEELLIIMIITAPPLIES-P-ER: GENERAL AGGREGATE t- I S _ OLICY I IrRO• 1 HOC PRODUCTS•COMP/OP AGG $ I IIFCT 'THER: S AUTOMOBILE LIABILITY CUMBINEU SINGLE LIMIT S v (Ea nocident). ANY AUTO BODILY INJURY(Per person) S OWNED SCHEDULED BODILY INJURY(Per accident) S AUTOS ONLY — AUTOS HIRED NON-OWNED PROPERTY DAMAGE S - AUTOS ONLY — AUTOS ONLY .(Per acodent) S UMIRMU _ u AR OCCUR EACH OCCURRENCE S - BxSuokB CLAIMS-MADE AGGREGATE S RS C BETA IIOON X g b1TE I R"- - — - AND EMPLOYERS'LIABILITY Y� A ,ANYPROPRIETOR/PARTNERIEXECUTIVE �c)FFICCWMCMBER EXCLUDED? NIAEL EACH ACCIDENT = 1,000,000 J(Mandatory in NH) % C56098598 10101/2023 10101/202a _._- _. -_ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-EA EMPLOYEE $ 1,000,000 E.L.DISEASE-POLICY LIMIT $ 1,000,000 —DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more spare is mooned)) CERTIFICATE HOLDER CANCELLATION -_ 2970777 Town to 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 roserve.l. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD ___.—'1 WINDWOR-01 _ LAURA a RCP' CERTIFICATE OF LIABILITY INSURANCE DATE(MW^OnYYY) 4/9/2r)24 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 Iat ILICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHI IRIZED ' 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 a n:lorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A star,thient on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Laura Misseri NAME: Phillips Insurance Agency,Inc. PHONE FAX 97 Center Street (A/C,No,Ext):(413)594-5984 I (A/c.No):(413)592 3499 Chicopee,MA 01013 A DRESS:Iaura@phillIpsinsuranee.com INSURER(S)AFFORDING COVERAGE _ NAICa INSURER A:EMCASCO Insurance Co 211/07 INSURED INSURER S:Employers Mutual Casualty Company 21'15 Window World Of Western Massachusetts Inc INSURER C: 641 Daniel Shays Highway INSURERD: Belchertown, MA 01007 - — INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: - — t THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLI( Y PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WI Il l-I THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL TFI': I ERMS, • EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPE OF INSURANCE bisR ADDL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS ___ILTR INSQ WVD IMM/DD/YYYYI (MM/DDIYYYYL- A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE _ $ 1,000'000 CLAIMS-MADE [TO I OCCUR 6A44324 4/9/2024 4/9/2025 DAMAGE TO RENTED 500,000 gntlSE�-(Ettecrrenc�)— $ MED EXP(Any o pores,____ $ , 10,000 ne: PERSONAL IIADV INJURY_ $ 1,000,000 GEM_AGGREGATE LRCTIMpIT.APPLIES PER: GENERAL AGGREGATE _ $ ',000,000 X POLICY X JE X LOC PRODUCTS-CAMP/OP AGO $ ,000,000 OTHER. $ B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ I,000,000 (Ea.eccdootL__. .- __.. ANY AUTO i6Z44324 4/9/2024 4/9/2025 BODILYINJURYJPerperson).- $ 1,000,000 - OWNED X SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ X HIRED �( NON•OWNED PROPERTY DAMAGE -- AUTOS ONLY AUTOS ONLY (Per accident) $ $ __ _ B I X UMBRELLA LIAB X OCCUR EACH OCCURRENCE ., ,000,OOO EXCESS LIAB CLAIMS-MADE 6J44324 4/9/2024 4/9/2025 AGGREGATE 000,000 � 1 DED 1^ 1 RETENTIONS 10,000 —_ _ WORKERS COMPENSATION TH- STATUTE .L.. .PER I �ER_—. ' AND EMPLOYERS'LIABILITY Y I N ANY PROPRIETOR/PARTNER/EXECUTIVE N/A E.L EACH ACCIDENT__ -_ $ OFFICER/MEMBER EXCLUDED? -- (Mandatory in NH) E.L_DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below _ E.L.DISEASE-POLICY LIMIT $ 1 1 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached it more space is required) CERTIFICATE HOLDER CANCELLATION _ __— -.- SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED I3EFORI.. Town of Northampton THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVF RED IN p ACCORDANCE WITH THE POLICY PROVISIONS. Attn:Building Department 212 Main Street - - "' Northampton,MA 01060 AUTHORIZED REPRESEN1ATIVE A,•:.V .-y' Iv. ACORD 25(2016/03) CO1988-2015 ACORD CORPORATION. All right; eserved. The ACORD name and logo are registered marks of ACORD Cwnnin wt Rini of Maamarhuantta ;N I7rvtr,Inn of Prornl;l.lonal lie elisions Berrie of(ioildlit,i liraluJittlune.anti agenda de Con u tru61itirr4 ftiyp}rvis or CS-115719 (4Ji E'jt,•pires:O413012625 T NICHOLAS A ,,'J .; •:� ROST • ,. i{. 102 OAKRIDGE OR i �r; sr ' pJ , p; BELCH ERTOiN_ J MA'i,'Oa0_L :► " 1. 'y;n }tV' dV4 Corrinrialgioner J�.•`���,, irra.ra„ THE COMMOIWJEAI:rH OF MASSACHUSETTS Otlico of Consumer Affairs&tiusinoss Regulation Regisfrutlon valid or individual use only helm a tlrr. HOME IPAPHOVt M<;NT CONTRACTOR expiration dale. II found return lu: TYPE:IirdivicitiaI Oflico of Consumer Al Mire and ElusInos Row rint.nnt, H.^Ulratt•.tipn' l00t)Washington Street -Sulte 710 20 i 746 S4/71!2C%'ti F3 nnton,MA 0211E VICHOLAS U?IO31 • 4VICIIOIAS DROST • t I �r t 102 OAKRIDGE DRIVE r'��"" `'n��vrMi t _� ':Lin sELCI1I ATOW1&MA 01002. .•.. .. • Undersecretary Not valid without signature THE COMMONWEALTH OF MASSACHUSETTS Office 01 Consumer Affairs&/Amines Regulation Registration valid for Individual use only boloro the HOME IMPROVEMENT CONTRACTOR expiration data. II totted return lo. TYPE:Q..tpOialoLot Office of Consumer Affairs and ISusIness Revolution Registration • . ENS1011l n 1000 Washington Strout •Suite 110 I6Seel .03(1412026 tloston,MA 0211E WINDOW WORLD OF WESTERN.MASSACHUSETTS.INC. TIMOTHY DROGT • • 641 DANIEL SHAYS HWY , :� . • 0ELCHLRTO+VN.MA 01007 Undeteeetelary Not valid without signature 2f1 a', -? 1...: Window Wortd �V1SC�I --- titStntrr Si_ A'frt,-e: Nom)Wit,tsbab,NC?a659 4000 Frer.3 o' D1IYINYL'No Cries ® n•t.ow,A"rt.An"a+.ao:No,:a1 is x as ie...4 :no..m.,. ENERGY PERFORMANCE RATINGS U-Factor(U.S.I•P) JSolar Heat Gain Coefficient 0.27 0.28 ADDITIONAL PERFORMANCE RATINGS Visibia Transmittance Alr Leakage(u.S.n.P) 0.51 <_ 0.3 V....,,.•,..,....,....00 —.......... ,.•...,... s..Fw:e...* .m.~.ewe n rte.•%e sr,..•-nr....i...w .iw t.n :~:ee Grp.*•Nowspo,•••,r.t.Pe eel" at✓1...wMw L NC RC'SING Certaed on Hpnh.tttled Regan. Ce t Mx ado pot f NLRG Y STAR...las req.atrt s.e saa.das. ` � I 1 V ty.r pt-� ` - Ytw ENERGrSTAR T • j--� l .wvenrn•M.w« pt-4,14C..ita• K ! For Iva ab,.ran wie...n pr1.c1 7ti has iatatwMM amyl"t:.su4,a✓gtw!a M p.s.� 1 6 Per(Grsde �.DP(ASD) .OP(ASO) Witt, R•PG40* 50.1 55t 6G - -5asx Test Slre Rpor•g Florida ID STC%aiTC ): 36.),X60.00 vie:=.•.04 ,,' 20840 27a124.0 PaYgfant.x na.[.a'n,..„..cps vO•x i cr r f--�4VF'a•Sr.tya`.'.iyr-t.euttad.d .e".eUase ary;'..x."""4ta"&"„H a 1:7 P0 Mtt.-A.t t% ta.WWI r teraCSA.''vl.t5aAM0”GMAtYYdr]VA.,..,ic /i.YA ..... zt vro'rra�aprc�pn•ra::� Window World of Western Massachusetts 641 Daniel Shays, Hwy. Belchertown,MA .FA� _ =zz ul�,/�,,,, 01007 woz� Windex 975 North Road, Westfield, MA 01085 in t�,� Office: (413)485-7335 CARE www WindowWorldotWesternMA.com John 0 Pickard Phone: 4135591009 Install Address: 149 N Maple St Email:johnoeme@gmail.com Florence, MA 01062 Contract Name:John 0 Pickard -Sales-Windows Design Consultant: Tim Drost Measured By: Measure Approved Date: 7/24/2024 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 $300.00 $300.00 Setup and landfill disposal fee Setup and landfill disposal fee N 1 $100.00 $100.00 4000 Series DH Solarzone 4000 Series DH Solarzone N 4 $899.00 $3,596.00 Total Information Unit Total: 5 Subtotal: $3,996.00 Tax Rate: 09%0 Tax: $0.00 Total: $3,996.00 Amount Financed: $0.00 Payment Method: Credit Card Deposit Amount: $1,900.00 Balance Paid to Installer upon Completion: $2,096.00 Renovation, Repair and Print Act (RRP) Compliance RRP Pamphlet Provided Date: Year Home Built: RRP Signed Date: Window World of Western Massachusetts eu vOTSw�nS W R 641 Daniel Shays, Hwy,Belchertown, MA lK( tv 0l007 975 North Road, Westfield, MA 01085 /l",/ ;. W 7CU. Office: (413)485 7335 WINDOW W; CARE www.WindowWorldofWesternMA.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 ,„,•„q„s „ 641 Daniel ShaysoHy.Belchertown, MA �1007 975 North Road,Westfield, MA 01085 witufrav u,(� Office: (4]3)485-7335 C A R E`�' www.WindowWorldofWesternMA.com i 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 out 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 550 referral tee for each person you refer who purchases 8 or more windows. Please have your referral mention your name when contacting our office. We trust that your remodeling experience will be a pleasant one. If for some reason you are not completely satisfied, please contact our office. Your comments are welcomed and will be used to better serve you. Thank you for your business! Primary Homeowner Secondary Homeowner Design Consultant 1-72.1x)-f- I.PA "Renovate Right" Brochure can be viewed and printed from here: Renovate Eight Brochure 11'W of W. I lassachusetts anticipates starting this work on and being substantially completed in days.Any deposit required in iidvance of he start of the work SHALL NOT exceed 33 1/3% of the total contract price OR the actual cost of any material or tluipment of a special order or custom-made nature, which must be ordered in advance of the start of the work to assure that the I inject will r oceed on schedule. No final payment shall be demanded until the contract is completed to the satisfaction of all I .►rties. All tame improvement contractors and subcontractors shall be registered. No work shall begin prior to the signing of the ontract awl transmittal to the owner of a copy of such contract.WW of W. Massachusetts under provision of Chapter 142A of the e general lav ; is required to apply for and obtain all construction-related permits.WW of W. Massachusetts shall not be deemed t•tsponsible for delays in the work described in this agreement caused by regulatory, permit granting agencies, authorities, or i Idividuals. Notice: If the PURCHASER(S) obtains his own construction related permits for the work described under this agreement t i'deals wit.1 unregistered contractors, the PURCHASER(S) is hereby advised that in the event of a dispute,judgement and onpaymen , the PURCHASER(S) will not be entitled to make a claim or collection from the guaranty fund established by chapter 112A, M.G.!,. lou 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 (IaV. "f ills IS A CI s fOM ORDER NOT FOR RESALE This Window World® Franchise is independently owned and operated by Window World of Western Liss,ichuset i,. Inc.under license from Window World, Inc.