36-152 (5) BP-2024-1192
32 WOODS RD COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
36-152-001 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-2024-1192 PERMISSION IS HEREBY GRANTED TO:
Project# DOOR 2024 Contractor: License:
WINDOW WORLD OF WESTERN
Est.Cost: 5325 MASS INC 115719
Const.Class: Exp.Date:04/30/2025
DONNELLY WILLIAM M&L ANN&ANDREW
Use Group: Owner: DONNELLY TRUSTEE
Lot Size(sq.ft.)
Zoning: SR/URA Applicant: WINDOW WORLD OF WESTERN MASS
Applicant Address Phone: Insurance:
641 DANIEL SHAYS HIGHWAY (413)485-7335 C56098598
BELCHERTOWN,MA 01007
ISSUED ON: 09/12/2024
TO PERFORM THE FOLLOWING WORK:
REPLACEMENT DOOR
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:
Fees Paid: $60.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
sF �FQ
P
/2
The Commonwealth of Mas us €�F �02i
{ � Board of Building Regulations and S �toiA, FOR
*44 Massachusetts State Building Code, 780 C�PTON MSpFc NICIPALtTY
, 0 USE
Building Permit Application To Construct,Repair,Renovate Or Demo evised Mar 2011
One-or Two-Family Dwelling
This Section For Official Use Only
Building Permit Number:l ' • 11 Gf Z- Date Applied:
SjAF/O- .9t-/2-zy
Building Official(Print Name) St re Date
SECTION 1:SITE INFORMATION _
1.1 Property Address 1.2 Assessors Map&Parcel Numbers
342 1,J oaa
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.O.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Zone: Outside Flood Zone?
Public 0 Private 0 Municipal 0 On site disposal system 0
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 Ow err of R d•
(�i s ifn 1/K16(1 r/o,e i1 c M q 0/066?
Name(Print) City,State,ZIP
&a Wood 5 Rd 4/3 .673"6 .410g f c�i'.7f ti 90 1‘32 3Uad, <&C/A
No.and Street Telephone Email Address
SECTION 3: DESCRIPTION OF PROPOSED WORK1(check all that apply)
New Construction❑ Existing Building' Owner-Occupied 111,, Repairs(s) ❑ Alteration(s) 0 Addition 0
Demolition ❑ Accessory Bldg.0 Number of Units �, Other /Specify:''C.. Otth('.ct.rflo
-Brief Description of Proposed Work2:
40A/ .( voted—i ig...
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Estimated Costs:
item Official Use Only
(Labor and Materials)
1. Building $ 5 3 02 1. Building Permit Fee:$ Indicate how fee is determined:
t Cl 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 F : I 1 0
Check No.Lheck Amount: Ulu Cash Amount:
6.Total Project Cost: $ C 3
I U ❑Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES •
5.1 Construction Supervisor License(CSL) Q
_-�:a:r j•s z �v-.i.1%. - License Number Expiration bate
Name of CSL Bolder
List CSL Type(see below) {1,
No.and Street Type Description
U Unrestricted(Buildings up to 35,000 cu.ft.)
' '� `� ` r .L } ~� 'No, Restricted I 4%2 Family Dwelling
City/'!'own,State, .IP ¢ M Masonry
' �!� RC Roofing Covering
•—' +. e` WS Window and Siding
SF Solid Fuel Burning Appliances
i +- ?r, �L..<.i :;e t .:141.t': :,z�'4a',�YOt trunk. I Insulation
Tolephoac Email address D Demolition
5.2 Registered Home Improvement Contractor(IRC) I
•,kit A.0'<-% HIC Registration Number Expiration Date
I ITC Company Name or HIC Registrant Name
;e ke"���,�`�-; c :yet . c Vie \C j?Ce�f �r..I et) lx?\r�,^9r�;ta�4t zFr lJ r�i
No.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 El 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`hv<c-tjt \k'lt ' )
to act on my behalf,in all matters relative to work authorized by this building permit application.
q/4/ 2
Print(tuner'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 in this ap ication is true and accurate to the best of my knowledge and understanding.
q/1/ /02sp
print()wafer' of�uthoiized AgeatA Name(Electronic Signature) Date
NOTES:
I. 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(141C)Program),will not have access to the arbitration
program or guaranty fund under M.Ci.L,c. I42A. Other important information on the HIC Program can be found at
w.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
•
; Massachusetts 4t �._ tce,
4 • � DEPARTMENT OF BUILDING INSPECTIONS
$ D� 1r f
Vic; f7 :
� 'v 212 Main Street • Municipal Building `�6,. rf0• M
Northampton, MA 01060 4.1;h;:S°
CONSTRUCTION DEBRIS AFFIDAVIT
(FOR ALL DEMOLITION AND RENOVATION PROJECTS)
In accordance of the provisions of MGL c 40, 554, 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: ((-v)o \ C4 \,6 t e In% `NAck `�� . \�::,(i i�;.�� •
The debris will be transported by:
Name of Hauler: r,v,
Signature of Applicant: / — ram` Date: 97q A2
City of Northampton
Massachusetts Sc,4S s��` ,
-,� *
DEPARTMENT OF BUILDING INSPECTIONS PI r'
v., '�.4 „. , 212 Main Street a Municipal Building Jay er0
Northampton, MA 01060 r ti4
HOMEOWNERS'EXEMPTION ELIGIBILITY AFFIDAVIT
1.!i I/i 0 �0'i aE j/ y (insert full legal name), born _ (insert month,
day, year),hereby depose and state the follvzfiing:
1. 1 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. 1f 1 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
/s�ai�d project or work.
Signed under the pains and penalties of perjury on this � day of 5,-- P �
(Signal a re)
•
The Commonwealth of Massachusetts
Department of Industrial Accidents
a I Congress Street, Suite 100
- 5 s
Boston,MA 02114-201 7
www mass,gov/dla
Workers Compensation Insurance Affidavit: Buildern/Ctmtractors/Eiectriciaiis/T'lumbers.
TO BE FILED WITH THE PERMITTING AUTHORITY.
Annlicantinformation Please Print Ltjhly
Name(Business/Organication/Individual):
Window World of Western Mass
Address:641 genie]Shays Hwyr...__..
City/State/Zip:,Belchertown MA 01007 Phone#: 413 485 7335 _ -`« w
rare you an employer"Chock the appropriate box: 1 Type of project(required):
I. employer am a with __utnployees(full and/or pari-:into). + 7, 0 Now construction •
.01 am a sole proprietor or partnership and have no employees working For me in i 8. 0 Remodeling
any capacity.[No workers'comp.insurance required.]
I. ,
l.0 t am a homeowner doing all work myself.iNo workers'comp.Insurance required.] °
9. 0 Demolition
.1 DI am a homeowner and will be hiring contractors to conduct all work on my property. I will
1 10 Q Building addition
ensure that all contractors either have workers'compensation insurance or arc sole i 1 1.0 Elcctncal repairs or additions
proprietors with no employees. i 12.0 Plumbing repairs or addition,
c DI am a general contractor and I have hired the sub-contractors listed on the attached shunt.
', I3,0 Roof repairs •
These sub-contractors have employees and have workers'comp,itisuntnce.i ' •
6 L_i Replacement
We are a•corpuralien and its officers hove exercised their right of exemption per MOL e, l 4.Q al her
152,§I(4).and we have no employees.[No workers'comp.insurance nx uinxL]
"Any applicant that checks box#1 must also]ill out the section below showing their workers'compensation policy intonation,
a llometment who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such
enintetois Mot check this box must auaelwd tin additional sheet showing the mane of tlx:sub.v urtrnctorsand slate whether or nut those entities have
uattployees. II' lx:sub•conlrnctors have employees,they must provide their workers'comp.policy number.
_ .. ._. r - - ..z=•.-:=
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and Job site
information.
lnrurance•CompanyName: Indemnity Insurance Co.of North America _ ____-__ ._
Policy#or Selff-ins..Llc,#: C56098598 Expiration.Date:1 0/01/2024
Job Site Address: .>'Q W O co/5 fZ,c City/State/Zip: 10 re.0CC 116 0/0 Q
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 c. 152,§25A is a criminal violation punishable by a fine up to Iii1,500,00
and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250,t)()a
day against the violator.A copy of this statement may be forwarded to the Office of Investigations ol'the DIA for insurance
coverage verification.
,_
�=mac.:'_:.=-.
I do hereby cer . un er the pains?id penal ex of perjury that the inf urination provided above is true and correct.i nature: t,� • Doc: q//�7c ?7 _ __..-.
Mont!#: 413 485.7335 ......---
I*
Official use•only, Do not write in this area,to be completed by city or town official.]
city or Town: r Permit/License# _. ....._
issuing Authority(circle one):
I :.Bead otlfeal h 2.Building l)eparunent 3.City/Town Clerk 4.Electrical inspector 5.Plumbing Inspector
44,Other
E'cnttact Person: Phone#:.___.._ .__.......__.___... . - . ._
DATE(MMIDD/YYYY)
` t t� 09/22/2023
A44 .---- CERTIFICATE OF LIABILITY INSURANCE Acct#:2970777
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POUCIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the pollcy(les)must have ADDITIONAL INSURED provisions or be endorsed.
If SUI3ROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on
this certificate does not confer rights to the certificate holder In lieu of such endorsement(s).
PRODUCER CONTACT
LOCKTON COMPANIES,LLC PHONE --
3657 BRIARPARK DR.,SUITE 700 PHONE
Ext):888.828.8365 FAX
No):
HOUSTON,TX 77042 E-MAIL ADDRESS;
INSPSRITYCERTS®LOCKTONAFFINITY.COM
_IN$URER(5I.AEE EDING COVERAGB _HAIG O..
- JNa/aEtt&LindemnileInallron .c eLHudhAmetdSa _43670
INSURED ..
INSURERS•
WINDOW WORLD OF WESTERN MASSACHUSETTS INC.
641 DANIEL SHAYS HWY INSURERC:
BELCHERTOWN,MA 01007-9529 INSURER 0:
INSURER E
INSURER P:
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS It;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 ..—.__..—"-'.'.. .�—+'ADDL 9UBR ---�— POLICY EFF POLICY EXP
TYPE OF INSURANCE
L'rR INSD WVD POLICY NUMBER (I/MIDD/YYTY) (MM/DD/YYYY) UMITB
I COMMERCIAL GENERAL UABIIJTY EACH OCCURRENCE $
CLAIMS. n OCCUR .AMAGE TO IT.NTE-O S._.PJ3EMl&ES(Ekoit,arens d__._-•
MED EXP�Any air person)._
PERSONAL&ADV INJURY $._..._.
GENt AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $
OLICY IF O• Doc PRODUCTS•COMP/OP AGO $
�CIT1.IER: $ I
AUTOMOBILE LIABILITY COMBINED SINGLE LIMI r $
JEJLE sldenU
ANY AUTO BODILY INJURY(Per person) $
--
OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Pa accident) $
HIRED NON-OWNED PROPERTY(XMAGE
. AUTOS ONLY AUTOS ONLY (20f Q lden0_—___ __.- s._. . .. ...
I $
UMBRELLA LIAB OCCUR EACH OCCURRENCE S
EXCESS WAB CLAIMS-MADE AGGREGATE S y
I)UD 1 RETENTION
WORKERS OMPENSATIOIII X I PER f 0TH-
AND I]MIPLOYERS'LIABILITY Y STAT()TE I I ER
A ANYPROPRIETOR/PARTVERIEXECUTLVE EL EACH ACCIDENT
OFFTCI.R/MEMDER EXCLUDED? N/A X C58098598 10101/2023 10l01l2024 $ 1,000,000
(Mandatory(n NH)
If yes,describe under EL DISEASE.EA EMPLOYEE _
DESCRIPTION OF OPERATIONS below $_ 1,000r 000
EL DISEASE-POLICY UMIT $ 1,000,000
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be Mtaehed A more space Is required)
CERTIFICATE HOLDER CANCELLATION
2970777
Town To Northampton SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
Building Dopt
212 Mein St BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELNERED IN
Northampton,MA 1060 ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
01988-2016 ACORD CORPORATION. All rights reserved.
ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
WINDWOR-01 — L• RA
'4cc)Ra CERTIFICATE OF LIABILITY INSURANCE DATE(IMMIWD(YYYY)
`--�- 4/9/2024
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
_NAME:-- -------- -
Phillips Insurance Agency,Inc. PHONE — FAX
97 Center Street JAlc,rro.E.tL(413)594-5984 cAle,Nei:(413) 924499 _
Chicopee,MA 01013 AEI{REss:I_auraephillipsinsurance.com _ _.`
INSURER()AFFORDING COVE LAAOB _— NAIVE. -_
-----.—.--__---- _. INSURER A:EMCASCO Insurance Co. _ __ _ �1M.__ .
INSURED INSURER B::Employ-ers_Mutual Casualt}(-Company ___2141i__ ,—,
Window World Of Western Massachusetts Inc INSURER C: —i_ -_- _ _„,.
641 Daniel Shays Highway INSURERD:
Beichertown,MA 01007 — — —_. . ._.._._ ..
INSURER E: — — - — - - - - ---
INSURER F: J
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS 1O CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATE D. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH TI•IIS
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 S_U_C_H POLICIES.LIMITS SHOW N MAY HAVE BEEN REDUCED BY PAID CLAIMS. ___
I TS -- — ADDL SUBR POLICY EFF I POLICY EXP
I TR TYPE OF INSURANCE INSD IAND POLICY NUMBER IMM/DD/YYYYI IMMIDD/YYYY) ^ UMRSy
A X COMMERCIAL GENERAL LIABILITY • 1,000,000
EACH OCCURRENCE 1__,._ _
CLAIMS-MADE X OCCUR 6A44324 4/9/2024 4/9/2025 DAMAGETORENTED 500,000
_ PREMISES(EILv1TeIL�)_,A _. ..
MED EXP(Any clan parson) $ -_ 10,000
.._ PERSONAL R.ADVJVJURY $ -1,000,OOO
GMAGGREGATE LIMIT APPLIES PER: GENERAI_AGGREG�E [_-_ ,_, 2,000,000
X POLICY LX J JECT [X l LOC PRODUCTS-COMP/OPAGO $ 2,000,000
OrH3R: $
B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000
_(EI Bachfsntl__---.—_ i____
ANY AUTO 6Z44324 4/9/2024 4/9/2025 BODILVJ JURY(t'4rye n1_ �___ . 1,000,000
A���U��rops OALY Xl AUpT�OSSVUyLEOp BODILY INJURY(Per acdde ri) $_�
_X Zfil ONLY LX AUTOS OVLY (Per o c trW1GE $______
Dv 1 $
B X UMBRELLA UAB X I OCCUR 1,000,000
__ EACH OCCURRENCE S ._.._.
_ _EXCESSUAB CLAIMS-.MADE 6J44324 4/9/2024 4/9/2025
AGGREGATE $
1,000,000
_
DED I X I RETENTIONS 10,000 $
WORKERS COMPENSATION I s7ATUT ER I I ERR" ____ __ _
AND EMPLOYERS'LIABILITY YIN _. -
ANY PROPRIETOR/PARTNER/EXECUTIVE I E.L.EACHA0CIDENT $_____
FILE+iMENBE EXCLUDED/ L_-TJ NIA
andatory in N EL OIsE6,5 -EAE t1�PLOYEE S__ .. .- ".
It yes.ro'.acrbe uccer
DESCRIPTION OF 0?ERATIOVS I:a'ow EL DISEASE.POLICY LIMIT S
{
l -. 1
DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Addlllunal Remarks Schedule,may be attached II more space Is required)
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES SE 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
ACORD 2t (2016/03) O 1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
•
Cominanwitulth arMaatineltnart►n
5 Division o1 Profet:*Nanal LWun sigh
Ro:inl of Building Re ulaUw►s ono alondortle
Cutisirt,ItttIM rt•itpprvim ar
cs-to571;;' ,.,,,�,;�`�: iros:O4,13Or2O25
tUCHOtAS TJROS.T ' l iv t?',.iltb',''.14,4
i�102 OAK1O DR , 401 = i,:.', ,1:y ui
RTCHrF MA arr i `r::a?/. . s}^
VNy ' r f ,�. ``N1'1r. t
i tio.? rl,a:L".<br r ,w_
Cornnrtssionor ?gall /: Sa,x1a,.
THE COMMONWEAL:CH Ott MASSACHUSETTS
Onto 01 Consumer Altairs&fluslnoas Regulation ttaglstral lon until for Individual use only before the
HOME IMPROVl;MI MT°CONTRACTOR eigalratlon dale. It found return to:
an
TY.R ;:11►01%IntAl., Oil NI of Cantatmar Aiit dra itnfi fl uslnost•Regulation
j A; ;: e14u1 1W30 Washington Street -Suite 710
i2 S%- ' }:gre177 ?'5 Bontan,MA 0211a
'1KGHOLA3 CMOs/ :. s , :. 'I
i, •1 .c/ '•—,. i
.1 7.et .i ,Iri 1
102 OAKrtIDGE aim/Er
ry. ,,.i,Km,e4 I '" ' ,:.i ,✓ ''�l`v
Undersecretary Notv&Jd without signaturo
laic COMMONWEALTH OF MASSACHUSETCS
Otrlco of Consumer Altolrs.&t ualnass Regulation IYaglalratlon valid for IndIvIdunl ace only bolore 111e
HOME IMPROVINENr'CONTRACTOia expiration date. I1round return to:
TYPE.ff..atppbr tiwt O1Qco of Consumer AfTolrsarid ttualnoss Roguivaon
Reglulrntlon, E iraii 1000 Waddington 8umot •Saila 710
165841'.. >: 03i44i202ei Balton,MA 0211I1
IAWNVDOW WORLD OF WESTERN,NASSACHHUSImS.INC. •
•
1 ,
TIMOTHY ORWT c • t',� •P� s';;,,l1
130.1 DANIEL S!IAYS!IWY •t
tJ6i_ct CRTOWN,MA 01007 th%deraecrelary Not valid without signature
•
•
" •,,N4°,11...:";4. ..1,-46ft.i:Window w,,,,,,s
-"'kri-cl,:-. '!,,#,•.....3... 181
...,, At • tire SL
j'fr 1 t, e .. giftt,ro SiC 2£5 59. •
4e00
41641kflres.D4Nr7 DKVINYI.Me Odes
•c'iNcNtc.N.,01- PMe1162 tilo-TMA!!CiseiRC.VC
•
4 --..emewlerikk Arycl.3,12 X 45
YE•A 218.'7i,15..cay,
........--...—....._..................—............ ... .
EN E F1GY 1>E13FOR MAN CE RATINGS s
--------- -
1-1'-FactOr(U,S,114) $olar Heat Gain Coefficient s..
0.27 4
0.28 i
A DIXTIONAL PERFORMANCkktATINGS .1
Visible Trensmittonee.•:;: Alt Leakage(U.S.A.P)
0.51 4 ;--:',
- S-0 3
.....„,„,....,,..,....-.....:,..-. .-tn. :.....- 7
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Window World of Western Massachusetts .`• �:
VOfQMl15 ' 1 COrtltnnno
641 Daniel Shays,Hwy,Beichertown,MA
01007
975 North Road,Westfield,MA 01085 ,
Wat&W
�, Office: (413)485-7335 WIND(v Wc)R
CARE
www.WindowWorldofWesternMA.com
William Donnelly Phone: 4135864708
Install Address: 32 Woods Rd Email: Bdonn90123@aol.com
Florence, MA 01062
Contract Name: William Donnelly-Sales- Doors
•
Design Consultant: Grace Drost Measured By:
Measure Approved
Date: 7/24/2024 Status: Contract
Payment Method: Lender:
Contract Type: Sales
Comments:
Product Description TxblQty Price Extension
Permit& Permit&Administrative Fee N 1 $300.00 $300.00
Administrative Fee
Setup and landfill Setup and landfill disposal fee N 1 $250.00 • $250.00
disposal fee
Patio door wlblinds (5- Patio door w/blinds (5-6 ft) (Double Pane white inside and out with a N 1 $4,775.00 $4,775.00
6 ft) screen and with a white handle)
Total Information
Unit Total: 2
Subtotal: $5,325.00
Tax Rate: 0%
Tax: $0.00
Total: $5,325.00
Amount Financed: $0.00
Payment Method:
Deposit Amount: $0.00
Balance Paid to Installer upon Completion: $5,325.00
Renovation, Repair and Print Act (RRP) Compliance
RRP Pamphlet Provided Date: •
Year Home Built:
RRP Signed Date:
Window World of Western Massachusetts vsrcaans Onti commano I
641 Daniel Shays,Hwy,Belchertown, MA 01007 975 North Road, Westfield, MA 01085
WINDOW WORLDWeticiow
L Office: (413)485-7335 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 ,.
vawnans•` P rnmmmm
641 Daniel Shays,Hwy, Belchertown,MA — 43
01007
975 North Road,Westfield, MA 01085 5777
WIND, V we>rt i)
,Q� ! Office:(413)485-7335 CARE dl
j 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
Pv lliatlnn cheat will ha r rrnQAeA fnr fhn Llnmonumor to ctnn efFnr ff,n W,..1 1..r,.n.-Fi.... 1,- .....-....1..4.. nl........ -1... ........ w-s. -.-.. ------....-- 1-_..-
been made before the installer leaves the lop site. Wnen the joo is complete,we asK VIOL you pay use IIULotICI UIC ICIIIPII el.Iy uoIall..-c uua yvui
:ontract.
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
S50 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
)/1 194012.191--
Secondary Homeowner
Design Consultant
•
1 PA "Renovate Right" Brochure can be viewed and printed from here:
Itenovate [tight Brochure
of \•\• D c:;sachusetts anticipates starting this work on and being substantially completed in days.Any deposit required in
lvanc.• et ,he start of the work SHALL NOT exceed 33 1/3%of the total contract price OR the actual cost of any material or
c H!ulpment id a special order or custom-made nature, which must be ordered in advance of the start of the work to assure that the
1 I nlec t will n oceed on schedule. No final payment shall be demanded until the contract is completed to the satisfaction of all
I lilies All pane improvement contractors and subcontractors shall be registered. No work shall begin prior to the signing of the
'mac.t ait transmittal to the owner of a copy of such contract.WW of W. Massachusetts under provision of Chapter 142A of the
,•nerai lase. , Is required to apply for and obtain all construction-related permits.WW of W. Massachusetts shall not be deemed
..p0n•.114( t n-delays in the work described in this agreement caused by regulatory, permit granting agencies, authorities, or
I IIIrnlllnls p otice: If the PURCHASER(S) obtains his own construction related permits for the work described under this agreement
c dull` wit I unregistered contractors, the PURCHASER(S) is hereby advised that in the event of a dispute,judgement and
I •;npay inei, • the PURCHASER(S)will not be entitled to make a claim or collection from the guaranty fund established by chapter
I..A. vl (
l I)u t he bit vc.r may cancel this transaction at any time prior to midnight of the third business day after the date of this
t t ansactioti. Notice of cancellation must be in writing postmarked no later than midnight of the following third business
II`; is,1 I:1 tOM ORDER NOT FOR RESALE This Window World®Franchise is independently owned and operated by Window World of Western
Inc under license from Window World, Inc.