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23D-134 Doors Consultation Into _ . Lead Number: 12040559 Date: 6.302011 Sales Rep: Thomas Smith Customer Name: PAT SCHUMANN Phone: (413) 586-6563 Address: 57 HINCKLEY ST City: FLORENCE State: MA Zipcode: 01062 Description Comments Qote 1 door opt1 Code Description Units Price Total D130 Doc - s FL Doors 1.00 $2 915 00 $2.9 5.00 Code I Type I Description Units RETAIL ITEMS Retail = $2 915 00 Volume Savings = $0.00 Employee Discount = $0 00 Offer Savings = $150.00 Marketing Offer = $13820 Tax = $0.00 TOTAL = $2 626.75 Use SPRAY TRCH 07/14/2011 08:23 8604665078 SEARS PAGE 01 RECEIVED 07/12/2811 17 :15 4137363962 MAJOR HOME I . - • , c, 03 197/12/2011 16:45 06,04665078 5E ALL 0' a` S NOTICE: Sears NED . r t P08 coons of • , . wPROP V. t SYSTEMS `�•i `I�G.�,�!rl�w ►.� Date: • "rAtrZr • Lacanun (�cef: t , Customer: t. tncteller: '" ;=i, Job 1.O. 8: G t3 t � 1 of Doer �'.� �m n Bade C) S • ❑ Garng. 0 Entry Door to 111 Storm Deer 0 ENTRY DOOR ORDER FORM PLEASE PILL OUTTHIS FORM COMPLETELY: .. r t ea *. W t • :J •- ' .. .• ❑ Blight 1t *Usti; . ed1g11a 8r+�e 0 Ctnsk Ca U ❑ 00 00 On kit ❑ �1 ❑ ❑ S,itln MOW VW tnsr2e c;».ar tietatrti NT 12* 74• ( CU 0%t eam 0 0 ❑arANDAno br 1712 Om V D S SW SiNgol'' 0 m g eode 00 r2 ❑o &mono 0 0 0 Fd OkkOliNt 600 as 24t auve Smooth EINNI 00 Stating 0 O f ] itYm e ©meter Zlarman p O 0 ❑ :. d ;' : g ee -Yf ': ': ry ;1?IEk� = 'L4• OHO on Geova sits (I 0 0 C O DWin r STANDARD '" )SIZES M rr m� n�uahr. lrr MD DJ Fold cum El 0 .. z7C3 Mountain toffy 11 © 0 opecintriliNoNurr, . • . Witte : (tam a H . � is their l *godNte,e LIM als) :,1 ' ❑0 Role Rome ❑ in D ,+ ht ::,.: ❑ NiCkeL 0 Select e R Wu d Frame OR ❑ SION .,.hams* • 1. CO Tudor Brow ❑ ❑ 00 OD Cod Spats ❑ 0 ❑ %oprn. t save Doers. O2 •u iw ° . O E ilw o © p Pw N, a e Double Doom: , ' 4W,1t 004 '0511d.us) , i i ?Y "! i1. ;' :: {: :: a WOW ' - Kay Oead urt Dee GJ00 ii '1)03721704/,e"� �, n rrbw w,o�.l�wa> s ` O"'� per, „brJeedeolt kirna GOWN! tI Helms L1, cm CINkfc+9 a> r •ae 0 0 NOW OaM 0 Doom IN 78"t7$k n µ,� ❑ p LiaiLt Oak ❑ i, ' , sides CI 0 Oak 4 - ta(1!^ ...., 4 rte - 3 00W ❑ 0 Dhrk Oak Sc lapea ... • HehtlleApit: itt 0 0 WOW 0 Sel•Ct i Outside 1 ji fide. P Doors: • .. 80 '-'4"0-41 r 313 14"' -) 11 0 0 ❑ 0 e M. D t °°e: Dowooltect wet 084 t 010r1 �� • • 1 -' • J..iA' . - nlandG - ,- , {'r;" © 11110 • 491100444 +(/t 1/Cye � 01 '� .r deaf vdh . Idd,. aao.i *kinid9: tabor woo** OM Full sa WW1 e018P ', 'a ©11e"' Wpm/ El Sees Mist 0 bow Mist & CO Mara D c • • ..,$1c1 Ckeen ClO M! � /u"'"9 C1 Date t7iwm . 0 Snow Itlsi & Few ❑ Accent 1 i t ©� D grow Mist a Light 4,1k i iko DOOM 0114. Full Stns C3 FOmst Owl ❑ St,ow MN a Otuc Height: 0801791/4' 0801 /11% % ❑ ML Berry ❑ Snow *eta C herry ❑ Decoudive - e ❑ 1 0 2 4111Wc od Faun* t)aptn: C etancaue a'J • , C191Lda BnnKe ❑LAM ❑caro tom' ntaar S1,�1s p NO O 0 y � • � oak (�Ctassic Door rN1 Mowry Clibm*Ine Sot , swam. 11 o•roo Wig ` — Whets t Inches [3«wk rww . , oak • ne> ww+ rtorpo iroy7fraowai .- --.'� peas ego • ❑ Ship 8ricltrtwld Loo 0 No ttrialuoola ile 1 0 1 :fonts • 91 i1 it as 1 .11_ e"" a ADA ,� ousontrwomoon a is t 0 Lark Hand tpht Hand o Vat Npfl d 0 RIP Hand a ., ceior�i t°pu°'''.n .��/��} ��Ur ,,y/�� ,�p.y e�1,�emq.w,c�.rq+.oMerTt4 t,wol vac r/.'bbh, S/" �.,d.r4w,, V �' 7�1 ".h t '7/9',==. ,,.,I 0r#N.7 N „,. „n+� , ,. ._ theawing SPECIAL D Rb ►N� ' - � / _ ❑ IIAA Hand ❑ ightHand CI L eft PBOM Hand c ] 1 ►7 (^ 1 '2 t, rev -{--( e164- _.._ am* eppeopoeN Ld' S V .. _ . �— 11/1011111/ — Hey 10/17/07 Z0 /T0 Soda SddWI 3W3H HOPdW Z9669ELE4. 5i: C TTOZ /ET /L0 Received on 7/14/2011 8:53:35 AM 5 IT POSSESS SHALL NOT DE E PURCHASED UNDER THIS AGREEMENT. SELLER ENTER YOUR UNLAWFULLY OR COMMIT MIT ANY BREACH OF THE PEACE TO RE- L °L NOTICUELMAIS_A_CAUSEMESIEEEMILY In addition to the Notice to euyei shown above, Massachusetts law requires that contracts for home in,prJverr.ent work state that all home im- provernent contractors and subcontractors shalf be registered and that any inquiries about a contractor or subcontractor relating to a reg- istratior• should be directed to Clirectcr. Norne lrnpro'ieme't ContraAoi Registration P.O. Rex 871 Taunton, MA 02780 -0371 Telephone:t5a8a821 -937 Please note th3towners who secure their own constracboir related permits or deal with unregistered contractors shatl be excluded front access to the Guarantee Fund. Notwithstanding any other language in the contract or associated documents Sears will not remove, replace, or install any j heating or air conditioning system, or arty portion thereof, if asbestos or asbestos - containing material is known or likely I to be present in that heating or air conditioning system. or any portion thereof if it is determined or reasonably suspected ! i that asbestos is present, either before commencement or during performance of the work, it shall be the customer's re- , sponsibitity to select, retair and pay all costs of a Division of Occupational Safety ( "DOS ") licensed Asbestos Contractor to remove all asbestos or verify that none is present in the components involved in the job. I' the determination or rea- i sonable suspicion at the presence of asbestos arises after Sears has started the work, Sears will immediately cease per - I forming the work until a DOS licensed Asbestos Contractor, hired by the custorner, removes all asbestos from the components scheduled for repair or replacement in accordance with 310 C.M.R. 7.00 and 453 C fi R. 6.00 or verifies that none is present. By sign ng the coriIract tirc i,ustorner agrees that it understands trte above DO N0T SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES stomers signature D e v.Istoneer s s re Date Accepted by Sears Home improvtrnert Products, Inc. ( "Sears') :in 0 .if • by -- � - -- -- Ii Dale MaragPmant Peprtsentative SUI.61.1 Ps./ :13,C lD N r-i r-I r-I rl 11 CV U I JUN 30,2011 11,25P 41.356 4477 _ v ., Page 9 MA Propac // JUa/ 1_7r04a ,}(��� Sears Home Improvement Products, Inc. _ ■ Na•7 ` 11 IS 1024 Florida 1024 l Fl 522290 C l J t V�"� . r: Central Parkway Cuctpme` i ed ph° CUSW s rxV Wori( Plums % ' 56 i on o s I Home Improvemeiit Products Longwood, FL 32752-2290 ( t> V Phone (800) 469 -4663 Stertt ESTIMATE MID PROPOSAL Contractor License/fieprstraunn Nome' `' n l r ' 1 G t ' t � Sr S r D o o r s HlC )148607; all p umbing and ate triCal Cr. rstate ' tip Code services per ied by licensed subcontractors 'j Aa GL 194 Q/0/06q ! Is igstalIation xit!t r :it I mils? FEIN 25. 169 8591 Installation Address Count; AJ C N o %, Billing A9n'eim It oirta ton; atavei ;City Sate role I Peolef ronsudadt Name & Licenxx Ns of aepli blc) i lila I ! A Sr✓Y Description of the Project and Desceiption of ihe Significant Materials to be Used an au pmentto be installed_ Entry Door 1 Vocation: p: - ntry Door 2 Location: Style. • 30 Style: e `gull Jamb :IL Frame Double Heritage El Patio F,,C [] Jamb ❑ L Frame Double l Heritage (] Patio 1 ❑CC Grained C [] Smooth ❑VL Smooth C Grained ❑CC Smooth ❑vL 5 .oth Colors Ext gtv7.,7IC Motiiet,Ant tt 5a It (41414€... Cot s Ext IN ' Cridleiind Colors t� Grid' rid Colors Ext L n/1 I nt'"v. Ext int t Glace Style C(„f � [`1Gaxc :yle Fi n h_ iSrght *au Q Antique Brass Sohn Nickel ed Bronze Firs J. 'el! Brass 0 Antiq.je Brass ESatm . cke' Aged Bronze 1 Standard Hardware Package [IStandlri dware Packag Additional Options: Additional Optic $,INSWING: 0 LH H ❑ OUTSWING: ❑ LH ❑ RH f INSWING: • I r OUTSWING: L7 LH ❑ RH Casing: ❑ 2.5 Modern 02.5 Colonial ❑ 3.5 Colonlat Casi g: L? 2.5 Mode .5 Colonial ❑ 3.5 Colonial Casing Color L,.)LP , C 2 * t r•J S1t1f. C.lttigt Cr lo•: 0 Door Cutdown Patio Door Screen Color ❑Door Cutdovn Patio clean Color ❑Standard Jamb 17 Extended Jamb Qi) Stf4 -- ��Stard=_rc Jamb c. - •aed Jamb Jamb Cladding Color' tLka 911C k 4J �l�j� f JJ Jan Cladding Color: I Door 1 SIDELITES STORM DOORS Location: j Mcdel Number: Model Numb- r _-, IDFull Jamb [J L Frame Double 1•h?ntage Patio Colors E In in CC Grained ❑CCSmacetll" OVLSmooth ❑Tinted ;cs: 08ronze 0Gray ■ een O Low 'E' Colors Ext ...... Int ❑Stan• rot Hardware Package ❑black White 'Gridl8lindColors OS •ciahyHardware: • • ' x !nt a55 Sli e i -_ —" doortTRAN9OM5 . _•.—''-' 'Finish. ❑Brght Brass 0 Antique Brass ©Satin Nickel O'Aged Model Number. PLEASE NOTE: Contractor is not liable for the condition or i Grid Calor !r,1 operation of rehung storm doors. I tyre L_____. - Additional work to De done: g g , . - jt• S t,Ly C A ) ' .,:j TL. ` I Work NOT to be done: ----H • SPECIAL INSTRUCTIONS: catiY4 '',- eig .61,1S • A l l of the above check boxes and the 'Work NOT to be done" section have been revreweli and explained to Ciistoprls) laic _ __ 1 1 APPROXIMATE START DATE and APPROXIMATE COMPLETION DATE: Ire work will start approximalely _ 1 i-4 ( pproxunate Start 1 • { Date) and will be substantially completed by approximately _ Z` iWb iApproximate Completion Date). These dates are Subject to change at the time the contract is accepted by Sears Home Improvement Products, Inc. ("Sears ") or at any other time by mutual written. agreement Customer r in derstands that the Approximate Start Cate is only an estimated date and the Customer will he contacted prior to this date to schedule the actual start date ! 1-- The TOTAL PRICE including all labor. material, taxes and arty applicable discount is S '41:174,,TM Contract Price ' I initial Payment (not to exceed 30% of Total Price unless Special Order) $ ' ENE State Sales Tax (_%) I Final Payment (balance payable upon completion of job) • _I ' , Local Sales Tax (_ %) $ t The initial Payment rstlue prior to Sears ordering products. , Total Amount e S ICI The norm and method by which the Customer(s) will pay is described m a separate C ah /Credit Card Payment Addendum made a part of and incorporated � into this contract by reference. L y _Customers) initial NOTICE TO BUYER; YOU, THE BUYER, MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY (FIFTH BUSINESS DAY IN ALASKA, FIFTEENTH BUSINESS DAY IN NORTH DAKOTA IF YOU ARE AGE 65 OR OLDER) AFTER THE DATE OF THIS TRANSACTION. SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. fall j Additional provisions of this contract are stated on the pages iallowing. r Customer(s) initia V4 r _ — OT abed LL d9Z:TT TTOZ'OE ROD 1024 Florida Central Parkway, Longwood, FL 32750 PH: 407- 551 -6000 October 2010 LETTER OF AUTHORIZATION I, Alfred W. Nyman, Jr., Assistant Secretary and Connecticut State Qualifier for Sears Home Improvement Products, Inc., grant permission to Nikole Easley to submit permits and licenses, pick up permits and licenses, make changes to permits, licenses and plans and initial changes made by the building department on behalf of Sears Home Improvement Products, Inc. I also grant permission to Nikole Easley to purchase permits and /or licenses with a company check, personal check, personal credit card or cash. I certifiy that the above information is true and correct. Pe ldst— ed W. Nyman, r., Assistant Secretary and Connecticut State Qualifier (HIC.067669) (HTG.0400133 -S1) Sears Home Improvement Products, Inc. STATE of Florida COUNTY of Seminole SWORN TO AND SUBSCRIBED BEFORE ME THIS 28th day of October 2010, by Alfred W. Nyman, Jr., Assistant Secretary for Sears Home Improvement Products, Inc. and who is X personally know to me or has produced a valid Drivers License. Seal: adx0) - PP i Print Name: Deborah P. ' t 'ps NOTARY PUBLtC$PATE Notary Public, State of Florida Deborah P. Phillips a Commission #DD689052 Commission #: DD689052 tir Expires: AUG.13, 2011 MY COMMISSION EXPIRES: Aug. 13, 2011 BONDED T$RU auerriC BONDING ca, INC. SECTION 8 - CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder : Ct . S r I c-h " / 6) 3 / ( �/�y License Number C___ vb p 4 -r bp , n n � � cS ,4 Address Expiration Date tc_c -,_SJ !-1 13 - 103 Signature Telephone 9. Registered Home Improvement Contractor: Not Applicable ❑ Q Q-0✓J MIL - `l F6,0-2 Company Name Registration Number Jr 7 �e ia-tre i , � o f-1, /1 U //' /1 Address / Expiration Date Telephone 11(00- (17.-ci `162Co SECTION 10- 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 D No ❑ 11. - Home Owner Exemption The current exemption for "homeowners" was extended to include Owner - occupied Dwellings of one (1) or two(2) families and to allow such homeowner to engage an individual for hire who does not possess a license, provided that the owner acts as supervisor. CMR 780, Sixth Edition Section 108.3.5.1. Definition of Homeowner: Person (s) who own 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 homeowner. Such "homeowner" shall submit to the Building Official, on a form acceptable to the Building Official, that he /she shall be responsible for all such work performed under the building permit. As acting Construction Supervisor your presence on the job site will be required from time to time, during and upon completion of the work for which this permit is issued. Also be advised that with reference to Chapter 152 (Workers' Compensation) and Chapter 153 (Liability of Employers to Employees for injuries not resulting in Death) of the Massachusetts General Laws Annotated, you may be liable for person(s) you hire to perform work for you under this permit. The undersigned "homeowner" certifies and assumes responsibility for compliance with the State Building Code, City of Northampton Ordinances, State and Local Zoning Laws and State of Massachusetts General Laws Annotated. Homeowner Signature �� �`cL` SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable) New House n Addition ❑ Replacement Wind Alteration(s) n Roofing n Or Doors LL - Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [q Siding [0] Other [d] Brief Description of Propos Work: - r t e-, t / / �Z z % (kid" Alteration of existing bedroo Yes ✓ko Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes t—No Plans Attached Roll - Sheet 6a. If New house and or addition to existing housing, complete the following: a. Use of building : One Family Two Family Other b. Number of rooms in each family unit: Number of Bathrooms c. Is there a garage attached? d. Proposed Square footage of new construction. Dimensions e. Number of stories? f. Method of heating? Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction i. Is construction within 100 ft. of wetlands? Yes No. Is construction within 100 yr. floodplain Yes No j. Depth of basement or cellar floor below finished grade k. Will building conform to the Building and Zoning regulations? Yes No . I. Septic Tank City Sewer Private well City water Supply SECTION 7a - OWNER AUTHORIZATION - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 7 1 Ll. f � C. lI u-/yt a IL L , as Owner of the subject property hereby authorize /\(/ /c` l J 1.t<.. s 6 7''U%lq`= --j- , '. to act on my behalf, in all matters relative te uthorized by this building permit application. Signature of Owner Date / I, /Y/ k_ v / 0,-.S' /e , as Owner /Authorized Agent hereby declare that the state rr nts and information on the foregoing application are true and accurate, to the best of my knowledge and belief. Signed under the pains and penalties of perjury. 1\(/ /ec(Q_ 1- -- -1- ", Print Name `" !/j /(M /li Signature of Owner /Agent Date Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size Frontage Setbacks Front Side L: R: L: R: Rear Building Height Bldg. Square Footage Open Space Footage (Lot area minus bldg & paved parking) # of Parking Spaces Fill: (volume & Location) A. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO 0 DON'T KNOW YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO O DONT KNOW O YES 0 IF YES: enter Book Page and /or Document # B. Does the site contain a brook, body of water or wetlands? NO O DON'T KNOW -YES O IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained O Obtained ( , Date Issued: C. Do any signs exist on the property? YES NO �.. IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property ? YES O NO G---- -- IF YES, describe size, type and location: E. Will the construction activity disturb (clearing, grading, excavation, or filling) over 1 acre or is it part of a common plan that will disturb over 1 acre? YES O NO IF YES, then a Northampton Storm Water Management Permit from the DPW is required. 4- / -� - os - 9 �_- Department use only G City of Northampton Status of Permit: 1 1. Building Department Curb Cut/Driveway Permit \(j 212 Main Street Sewer /Septic Availability • Room 100 Water/Well Availability �� - `' Northampton, MA 01060 Two Sets of Structural Plans • 1. phone 413 - 587 - 1240 Fax 413 - 587 - 1272 Plot/Site Plans Other Specify APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 - SITE INFORMATION 1.1 Property Address: This section to be completed by office frL Map Lot Unit Zone Overlay District Elm St. District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: {� m C�ic,Z 57 /6 riG /c le Sf .L Name (Print) 7 Current Mailing Address _ / � . q/3- o& - C�. cc 3 S 0 �- `��y c� e_4-- Telephone Signature 2.2 Authorized Agent: N ib / ETcS/� rG IQ. 3 P/ c -,t-+S II (9 Name (Print) / Current Mailing Address: . q `ff 410 Signature Telephone SECTION 3 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building (a) Building Permit Fee 2. Electrical (b) Estimated Total Cost of Construction from (6) 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection 6. Total= (1 +2 +3 +4 +5) Check Number/ 00 0 i3 3r This Section For Official Use Only Date Building Permit Number: Issued: Signature: Building Commissioner /Inspector of Buildings Date 57 HINCKLEY ST BP-2012-0131 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 23D - 134 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: REPLACEMENT DOOR BUILDING PERMIT Permit # BP- 2012 -0131 Project # JS- 2012- 000194 Est. Cost: $2626.00 Fee: $35.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: SEARS HOME IMPROVEMENT PRODUCT 100311 Lot Size(sq. ft.): 13939.20 Owner: SCHUMANN THOMAS K & PATRICIA H Zoning: URB(100)/ Applicant: SEARS HOME IMPROVEMENT PRODUCT AT: 57 HINCKLEY ST Applicant Address: Phone: Insurance: 51 BELAMOSE AVE (860) 620 -9036 () WC ROCKY H I LLCT06067 ISSUED ON:8/3/2011 0:00:00 TO PERFORM THE FOLLOWING WORK: REPLACE ENTRY 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: Driveway Final: Final: Final: Rough Frame: Gas: Fire Department Fireplace /Chimney: Rough: Oil: Insulation: Final: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occupancy Signature: FeeType: Date Paid: Amount: Building 8/3/2011 0:00:00 $35.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Louis Hasbrouck — Building Commissioner