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17A-131 (8) 347 BRIDGE RD BP-2021-0060 GIS#: COMMONWEALTH OF MASSACHUSETTS MV.-Block: 17A- 131 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: window replaced BUILDING PERMIT Permit# BP-2021-0060 Project# JS-2021-000088 Est.Cost: $4235.00 Fee:$65.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: HOME DEPOT USA INC 187666 Lot Size(sq.ft.): 13939.20 Owner: BOSTON HELEN Zoning: URA(100)/ Applicant: HOME DEPOT USA INC AT: 347 BRIDGE RD Applicant Address: Phone: Insurance: 2.455 PACES FERRY RD NW (413)335-3702 O WC ATLANTAGA30339 ISSUED ON.7/20/2020 0:00.00 TO PERFORM THE FOLLOWING WORK.-INSTALL 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: 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 Sicnature: FeeType: Date Paid: Amount: Building 7/20/2020 0:00:00 $65.00 212 Main Street,Phone(413)587-1240, Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner The Commonwealth of Massachusetts ` Board of Building Regulations and Standards FOR ' Massachusetts State Building Code,780 CMR MUNICIPALITY USE uilding Permit Application To Construct,Repair,Renovate Or Demolish a Revised Mar 2011 One-or Two Family Dwelling C5 Thi S5qion For Official Use Only Buildin t Number: 7 r Datq Applied: c u ICoS 7-15-2020 Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Pro erty Address: 1.2 Assessors Map&Parcel Numbers 347 ridge Road 1-7/1 13 1 1.1 a 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❑ Private❑ Zone: _ Outside Flood Zone? Municipal❑ On site disposal system ❑ Check if yes❑ �'1 it SECTION 2: PROPERTY OWNERSHIP' Helenel�ilarsha ffoston Florence, MA 01062 Name(Print) City,State,ZIP 347 Bridge Road (413)727-3487 helen347@comcast.net No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK'(check all that apply) New Construction❑ Existing Building Owner-Occupied fl/I Repairs(s) ❑ 1 Alteration(s) ❑ Addition ❑ Demolition ❑ Accessory Bldg.❑ Number of Units 8 1 Other ❑ Specify. Brief Description of Proposed Work': Remove and Replace 8 windows SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only Labor and Materials) 1.Building S 4235.40 1. Building Permit Fee:S Indicate how fee is determined: 2.Electrical $ ❑Standard City/Town Application Fee ❑Total Project Costa(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: S 4.Mechanical (HVAC) S List: S.Mechanical (Fire $ Su ression) Total All Fees:S.�-�-- Check No.� Check Amount:__!� Cash Amount: 6.Total Project Cost: S 4235.40 0 paid in Full ❑Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) 187666 05/09/2021 _ Exterior Remodeling Group, Inc License Number Expiration Date Name of CSL Holder 23 Benham Street List CSL Type(see below) No.and Street Type Description Springfield, MA 01109 U Unrestricted(Buildings up to 35,000 cu.ft.) R Restricted 1&2 Family Dwelling City/Town,State,ZIP M Mason ry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances (413)335-3702 1 Insulation Tele hone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) 112785 04/22/2021 Home Depot USA, Inc HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name 2455 Paces Ferry Road scottdoughman@gopermits.org No.and Street Email address Atlanta, GA 30339 (860)952-4112 Cit /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.......... ❑ 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 Scott Doughman to act on my behalf,in all matters relative to work authorized by this building permit application. Helen &Marsha Boston 07/13/2020 Print Owner'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 application is true and accurate to the best of my knowledge and understanding. Scott Doughman 07/13/2020 Print Owner's or Authorized Agent's Name(Electronic Signature) Date NOTES: 1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration program or guaranty fund under M.G.L.c. 142A.Other important information on the HIC Program can be found at www.mass_gov;oca Information on the Construction Supervisor License can be found at wvnnv.mass.aov/dos 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) (including garage,finished basementlattics,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 hearing 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 • sus".�.'�'c •''` ti Massachusetts DEPARTMENT OF BUILDING INSPECTIONS ;+n 212 Main Street • Municipal Building yJJ. Cam Northampton, MA 01050 � �^4 HOMEOWNERS'EXEMPTION ELIGIBILITY AFFIDAVIT I Helen & Marsha Boston (insert full Iegal name), born _ (insert month, day, year), hereby depose and state the following: L 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 110.85.1.3.1, 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 110.83. 3. I qualifi/under the State Building Code's definition of"homeowner"as defined at 780 CMR 110,R5.1.2: Ferson(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 Iicense and, except to the extent that I qualifif 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 const uction 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 per jury on this 13 day of July 2020 . Helen & Marsha Boston (Signature) The City of Northampton Building Department ~ 212 Main Street fi Northampton. Massachusetts 01060 Phone (413) 587-1240 Fax (413) 587-1272 CONSTRUCTION DEBRIS AFFIDAVIT (FOR ALL DEMOLITION AND RENOVATION PROJECTS) In accordance with the provisions of MGL c40, 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, sl 50A. The debris will be disposed of in: Dump Location of Facility The debris will be transported by: Name of Hauler Signature of Applicant: Date: \ The Conunonwealth of Massachusetts Department of Industrial Accidents 0 1 Congress Street,Suite 100 Boston,MA 02114-20.17 www.mass.gov/dia 11-orkers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Lc2ib1y Name (Business/Organization/lndividual):Exterior Remodeling Group, INC Address: 23 Benham Street City/State/Zip: Springfield, MA 01109 Phone#: (413) 335-3702 Are you an employer?Check the appropriate box: Type of project(required): 1.❑1 am a employer with employees(full and/or part-time).* 7. New construction 2 I am a sole proprietor or partnership and have no employees working for me in any capacity.[No workers'comp.insurance required.] 8• Q Remodeling 9. ❑Demolition 3.O I am a homeowner doing all work myself.[No worker'comp.insurance required.]' 4.❑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'compensation insurance or are sole 11.Q Electrical repairs or additions proprietors with no employees. 12.0 Plumbing repairs or additions 5.V1 am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.F]Roof repairs These sub-contractors have employees and have workers'comp.insurance.* 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.0 Other 152,§1(4),and we have no employees.[No workers'comp.insurance required.] Any applicant that checks box gl must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. 'Contractors 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 the sub-contractors have employees,they must provide their workers'comp.policy number. I ant an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:Briggs Starr Insurance Agency Inc Policy#or Self-ins.Lic.#:R2WC081125 Expiration Date: 08/07/2020 Job Site Address: 347 Bridge Road City/State/Zip: Florence, MA 01062 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$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains andpenalties ofperjury that the information provided above is true and correct Signature: Eugeniu Ciubotaru Date: 07/13/2020 Phone#: (413) 3353702 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): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: CITY OF NORTHAMPTON SETBACK PLAN MAP:_ _ LOT:_ _ LOT SIZE: REAR LOT DIMENSION KEARYARD SIDE YARD SIDE YWD FRONT LIBACE; FRONTAGE____^,^_.,_., NDICATE LOCATION AND Dl ME NS)ONS OF 11 OLE E GARAGE.ADDITIONS OR ACCESSORY BUILDING. HE SURE TO INCLUDE FRONTAGE AND LOT SIZE(SQUARE FEET OR ACRIZS) Go Permits, LLC • 105 Buttonball Lane Glastonbury, CT 06033 r Scott Doughman Phone: 860-952-4112 Fax: 860-430-6719 scottdoughman@gopermits.org Re: Building Permit Application - Licenses Good day, Please find attached permit application, licenses and support documents. Home Depot is the General Contractor — HIC #112785 Exterior Remodeling is the sub-contractor. #CSSL-106106 / HIC# 187666 (Info attached) Once the permit is ready: • Please fax or e-mail a copy of the permit and receipt to the below address and mail the original to the homeowner: Fax: 860430-6719 Email: permits(ciD_gopermits.org • If you unable to mail the permit to the homeowner please send to the below address and we will insure the permit is at the home posted at the time of installation: Go Permits, LLC 105 Buttonball Lane Glastonbury, CT 06033 If we are required to pick up the permit in at the building department, please call 860-952- 4112 once it's ready and we will come in to get it. Thank you, Go Permits GATE(MMIDDVYYYY) e ASO d CERTIFICATE OF LIABILITY INSURANCE 0201. 20 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 poliicy(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 NAME: MARSH USA,INC. NAME. TWO ALLIANCE CENTER PHONE r►o 3560 LENOX ROAD.SUITE 2400E-MAIL ATLANTA,GA 30326 ADDRESS INSLARERM AFFORDING COVERAGE NAIL i CN I016/20694tMeD-GAW.-2421 INSURER A:Old Repubk warerlee Co 24147 INSIREDTHE HOME DEPOT,INC INSURER 8:New Ns Co 23541 HOME DEPOT U-SA,INC. USURER C:H&neRick IrWance Culkiny 2455 PACES FERRY ROAD D BUILDING C-20 ATLANTA,GA 30339 NSUTBRF: COVERAGES CERTIFICATE NUMBER: AT400435343!lM REVISION NUMBER: 25 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. 021111 LTRTYPE GF NSUiMICE POLICY NUMBER LINTS A X COMMERCIIAL GENEFMLLlA8ILTIY MWZY314574 037MW9 031012022 EACH OCCURRENCE >; 1000,000 CLAIMS-MADE P-1 OCCUR PFaMSES Eaoocurrenoe S 1,000.000 X SIR:S1,ODO,000 MED EXP iAny one S EXCLUDED PERSONAL 8 ADV NJIrRY S 1.000.OD0 GENU AGGREGATE LIMIT APPLIES PER GERSRULL AGGREGATE S 2 000,000 X POLICY❑3EICTT O. LOC PRODUCTS-COMP/0P AGG I f 2 OOD.DDO OTHER: Is A Atr101RDBlELSINUTY MWT8314573 03/01019 031012022S 1000.000 X ANY AUTO BODILY ecan)Y SNJJRY(Pur pS OWNED SCHEDULED SaF INSURED AUTO PHY DUG IAUUTTOpS ONLY AUTOS BODILY INJURY(Per am dani) S AUTOS ONLY AUT C1,4MA(iE >; f Iwo I OCCVR EACHOCCURRENCE _ EXCESS LMB CLAIMS-MgDE AGGREGATE 3 DED RETENTION s s B WORKERS COMPENSATION VIC 02 (AK,NH W, 03601,2021 X B ��RI�roAR, ]ECUTNE YIN WCO29WoM(WS) 03/01/2020 0X11=1 A s X700.000 OfF1CfRA1EMBERE7CCLJOED' N NIA EI-EACH ACCIDENT f (MandN" F1 (Mandatory NDISEASE-EA EMPLOYEE = 5ODO,000 nyes aesui a anew Cagrwed m Additional P 5 000.000 DE�•CRIPn0,4 OF OPERATIONS blow age El.DISEASE-POLICY LIMIT S C Execs Auo 297110011002020 03J rm 03101/2021 Lot 4 000.000 A Execs General LWxky MWZX 314580 031012019 03AV2022 In*: 8000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101.Ad tonal Remarks Scheduie,may be anadwd if mare space 6 n***4 EVIDENCE OF 3JSJRANCE CERTIFICATE HOLDER CANCELLATION HONE DEPOT FERRY A,NIC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE BUI2455 PACES FERRY ROAD THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ATLANTA.ING G20 ACCORDANCE WITH THE POLICY PROVISIONS- ATLANTA.GA 30339 A111HDR®REPRESEITATNE of Marsh USA Me. Marlastr Mukher)ee _".AL".00wt 'Jcu.LG-e%� V 1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD eJ CJIJyl2/??�GR/?.�CJ�P�Q�D ✓G�CJ a�G'�%�rl Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration type: Supplement Card HOME DEPOT USA INC Registration: 112765 P O BOX 105451 Exptration- 0412212021 ATTN: LICENSE MGMT TEAM ATLANTA,GA 30348 Update Address and Return Card. 8C.'A 1 O ZOM-0S.'17 Office of Consumer Affairs&aY mess Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for Individual use only TYPE:Supplement Cxd before the expiration dole. If found return to: Reoistration Office of Consurner Affairs and Business Regulation 112785 94/222021 1000 Washington Street •Suite 710 HOME DEPOT USA INC Boston,?AA 02118 RICHARD OLMSTEAD 2456 PACES FERRY RD C-11 HSC �fw.+YlL•� ATLANTA,GA 39339 Undersectailary Not valid without signature EXTER-2 OP ID:FC DATE(MWDWfYYY) A4CORO' CERTIFICATE OF LIABILITY INSURANCE 11(1912019 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 pollay(Iss)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms end conditions of the policy,certain policies may require on endorsement. A statement on this certificate does not confer rights to the certificate holder In Ileu of such endors s. PRODuccR pebble Marino _..__ PAX Canary Blomslrom Ins,Agency B88 Springfield SU q 41!1789.3 __ -.__._ (roc,Nola-413-786-7004 Feeding�Ite,MA 010 0.2161 dtnalin Dana blomstrom.com _ _ . _ 1 UBO )APf4tt"O COVEnAOF .__...W _ "qo---- _ ealuasN�yCCntRlala*IMISUItiwna6 CO. --. --.-- - 34784 ExteriorRemodelin a tNauacn g rouptna. xrouRE�a1 _ _ Eurrnlu Clubotaru 23 Benham St Springfield,MA 01109 INSUIIER 21 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 REOUIREMENT,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. E7(CLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. _ �.___ gtlA TYKOFNiMIRANCE ADDL BUB POLICY NUMBER VV3LiC fF 1dYEXP LIMITS COMIN O LU GENERAL LIABILITY EACH OCCURRENCE S CLAa.�dd+1DE Ll OCCUR I8 _ffoENoffri _�REMI✓�IEay.�r i — _—____ MED EXP ass p"a M PERSONAL A ADV INAW t GEK AGGREGATEppLRIA4p7.MPLa PER: GENERAL AOOREOATE s POLICY❑JECT LOC PRODUCTS-OOMPIDPAGO 16 OTHER = _ AUTOMOBILE LIABLN COMBINED SINGLE LI a 11000.00 LEswpdpxL_ _ A ANY AUTO VN420 11/09/2019 1110912020 BODILY INJURY(Par pmm) _ µOWNED X SCHEDULED BODILY INJURY(Poe acadwo) e X HIREOAUTOS X AUTOS O PROPEFCT�AMA�^-" -- • jeer tKCWMD : UlaplaLLA LIAR OCCUR a —.._.._. lg8 CLAMIS•MAIJE EACH OCCURRENCE It EIrC6aa _. AGGREGATE a DED RETEM N S YIORIIW DONPENSATION a AtnLiA,OYalt6'IJABIUTY YIN TE TNERIER Mtr/IrDIrJPAREXECUTNE GiAL10Y1BrfREXCLUDED? LINIA EL.EACH ACCIDENT elan puwm 6.1-DISEASE-EA EMPLOY >i OF OPERAT S b.Rlr( EL DISEASE.POLICY a DESCRIPTION OP OPERATIONS 1 LOCATIONS r VEISCLES(AGGRO tot,AA011IOMI Remarks Schedule,maybe 61111010d M mors a p*cq 1s(squired) CERTIFICATE HOLDER CANCELLATION HOMEDE3 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE ETDATE THEREOF, NOTICE WILL BE DELIVERED IN Home Depot USA,Inc, ACCORDANCDANCWITH WITH 7HE POLICY PROVI Home Services COmpIICance C-11 SIONS. 2455 Paces Ferry Rd AU rHORQED RE PRO, Atlanta,GA 30339 —__ ACORD 25(2014/01) 0 1988.2014 ACORD CORPO ---- _ The ACORD name and logo aro registered marks Of ACORD RATION. A4 rights reserved I.CK 1 INUA I C Ur LIADIL1 1 T INOUKA111VG _ aa11»pose "0 CERTWICATE IS ISSUED AS A NATTER Of INFORMATION ONLY ANQ CONFERS NO RIGHTS UPON TME C[RTIFICAW HOLDER THIS CERMCAT11 OOLti*Of AFFIRMATIVELY OR NEGATIVELY AMEND, EIITENO OR ALTER flit COVERAGE AFFORDED OY TME POLICIES UVOW. TNIt CE11TWI ATE Or INSURANCE DOES NOT CONSTITUTE A CONTRACT UTWEEN THE ISSUING WSURER(S), AUTHORIUD RIEPRESENTAVOW aR PRODUCER,AND THE CI<RTI€ICATE HOLDER- _ MIIPORTANT: Of Ow coA tah h*Ww is an ADDITIONAL Mi8URE0.the pohtyltasl must 0Y .a ADO:TIONAL INSURED pre,vlstens at M•ndessed, 0 WBROOATION M WANED,sub*t to the amts and condetions of Me pobcy.tartan pe(Wot May rativbs an endorsMnsat A statam*M on Oft ce"ca"fess rm panfar r s so the cstlwm*h0krar to f*u of such snOwsemsM{s� Oww"'tNrfimqpss A,SUIIr Imuritirow Agy,Inc 19M B"lon Rd Sulfa t _ 413-541"S2 r 413-503.1137 Wltbraham IAA 011095 -- App X19$s �btlSlii"mtsl�trfnsuraMtl.tiBiM Jk"ta,t,arroaCsOt@r[IIA4t - .... tAttr !1lltl!!!tA WESTERN WORLD *twaro EXTERIOR REMODELING GROUP INC 23 BENHAM ST SPRINGFIELD MA 01104 C an~a. 004meA f reustst r COVERAOCS CERTIFICATE NUI SER: REVISION 7141515 10 CfAlIFY THAT i HE MXIES Of 04VAAHtE LISTED*FLOW HAV4 WE%ISSL"10 TnF 06URED kAmb ABOVE"A T1+E 1MICY PF.RJOIi 114MATED r:'LlIM11/3IMMO ANY PIOVIIREMNI.IEIdA OR CON04110e' OF AkY UATRla7 OR OTHER DOCUMENT 1MTH RCMCT 10 WhICH T-45 tx 010CAIL V1AY ESI: 9S4UE9 OR UfAY PEAIAK 1HE IkSVRAWE A69f( t*D 8Y 1H: IA Cs€$LESCR(SfD MFAiN IS 9USACI 10 ALL 914 ILRMS. 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Aurc+u,Itiw ItYLwIArld:rlutallrf � ' l t fa..'w�t,�rkT i ;pfsR:fltipNls►9fl[4tA7fOt ,ktA :loww"lM Rai i t Ce"&lt-LA tV La%U;t M s dewKr✓dM 015t wl a of orfumo'sA f l ms"u-nt7.''Y tAuf S OR - — O[t[RliteN 0l olftUTioNS I tACaft0ltt l YENCaE! 4At01w/sT.Addeo"a..,.+b scn..w.,vr b..n **a 4 4 ft*,~ D AT440ME SERVICES,INC AND THE HOME DEPOT ARE INCLUDED AS ADDITIONAL IN3URANCE WITH RESPECTS TO LMILITY INSURANCE V4%VAJI FOR ONMNO OPERATION AND COMPLETED OPERATIONS ENDORSEMENTS CERTIFICATE HOLDER CAkCELLATIM T110 AT HOME SERVICES INC SHOMD MV Cf TIH A&M DESCROD 000"IE1 N CANCAuED DCFOR! Attn:InstAfief Relations Dept. TIM 13"ATICN DATE TMRUW, 1110TiCE VV9 L Be SELIVERED IN Home Services Compli3nce C-11 ACCORDAw wm TME POLICr pQ0vwDks. 0$5 Pates Ferry Rd Iattta Go 30339 aurtwatoatratxsltAnst THOMAS J BRI a Inti-2015 ." hts roferwd ACORO 25(2016103) The ACORG name and�we reglesiltod Nuitts es ACDRD � ►.so b..y..y f bcwn rr+.sr.s sa,�,..�.,,0014-684"cow;t I Iwv«..«n bbv r"wf.2w-HTf !57i,791O THIS CERTIFICATE IS ISSUEO AS A MATTER OF 110011WAT104 ONLY ANO CONfM NO RI(PaS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AFFOWATTVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. T1115 CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT IIETWEEN TILE MSU" tNSVRERFS?. AUTHORt2ED REPRESENTATIVE OR PRODUCER,AND THE CERT'IFICA'TE HOLDER 164PORtANT: 0 Ow ctn tate hok,IW is Det ADOMONAL WSMIED,the pof cy{1n);;M to s-dwsed K SUMROOAt1ON IS WAIVED,suk Jecf to tit Writs nrtd conditions of"r policy,crNsln POW"mar toqui►e an vedorsetnaot. A tts""Wr"M t"CertMcme dors not Corny rights to the CvW%WW_ate ho41sT in lieu of such sndwtatn+enf.sT- Ht00uf t-1 BRIGGS STARR INSURANCE AGENCY INC IWA BOSTON RA s?s+IOIIf1+gtOMtttsrJt awc s WILBRAHAM MA WN$ I%SVRAWF Ce a73i►� srwwso asw/t• EXTERIOR REMODELING GROUP INC „ ?71sE kifARn ST **Max PlG3FI' IAA 011 COWMAGO _ CERTIFCATF WUM :_"WI RtVg10N dt' THIS 15 10 URN"ml THE i'[kZWS ISM YE LOW HAVE KEN ISSUED TO T"t a EO,%AW-")a&7*t HIR Tw POI IGY atuxx) Mit.}ICATEV. 040t TNSTANDINo AW RM, r t .'. (tfttt OR CCti OVIi tl► ANY C)NIP/V OR OTWR 00CLWIN'%-#TH of,sptcr to WltCri tH�$ CERTAKATE WAY K I MIEO O4 MAY PERIAN THE pt9trgS+ OM AFFOAMD h' THE PM S DEME{;mfRL!N I$ Sl>g ECT to AL1. 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CERTIFICATE HOLDER CANCELLATION SHOULD AL"DF TME AEOYE DESC*MD Oft"S"CAN"LL190 UP one INC UP WAT" DATE THEREOF, WOM VnL AL OtLIVVWb pl HOME DEP01 USA INC NOME SERVICE COUPt."CE C•11 AtCURDA%Ct*nt..twE►or_>t:Y►«oaggyy. 24'-.5 PACES FERRY RD •urwoonm�+IrtA1wE ATLANTA GA ' '" D."..1,r r .CaCU,>`+et -Rasa ri u."-•W-C>ZIB" *IM 2014 ACORD CORPORATION Ab dgtft hseYvld, ^CORD 25(2014M rna ACORD name WW woo ave Mrstamd milfts of ACORD -Al O 7" CERTIFICATE OF LIABILITY INSURANCE 0021 1120 o0 YYrn 02^7tfi,V 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 H SUBROGATION IS WAIVED,subject to the terrrls and conditions of the policy, certain policies If be endorsed. this Certificate does not confer r: hts to the cartifieate Folder in Iieu of such endorsement(s). 7 raquiro an endorsement A A ataterrrerTt on PRODUCER COJITACT MAP"ah JaA,INC. N _�_ TWO ALLIANCE CENTER Not FAX - 3560i.FNDXROAD,SUfTE24oJ --- WC,Nag ATLANTA,GA 30326 ~ ss- _ MINiI1NItflAttOlnMlaIWt a CNI07642013HpreD(;gW 2G27 a1WM61A:Did RMIED._. - _.^. �111Wran0eCD 21/47 THE HOME DEPOT,INC. rtwltpt�:I vrHBIHpItiNYpCO _ 23M1 HOME DET•OT U.S.A.,INC C: re 2455 PACES FERRY ROAD %'ILDING C•20 sauilMto: ATLANTA,GA 30339 COVERAGES CERTIFICATE NUMBER: AIL-03435343433 REVISION NUMBER: 25 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOT4NTHSTANDING ANY REOUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESP'EGT CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALLTO THEWHICH TERMSTHIS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOVA MAY HAVE BEEN REDUCED BY PAID CLAIMS -� TYPE OF fNEURANCa ICY NIAIBER Y EFf f-RIS-iIL`Y E%P L111111311A' X ;CONMERCIALGENERAL LIAAUTY i MIM2Y 314574 r----r- -. _. QWr&9 I0301/= EACHOCCUNIIENCB i _ I,OP3,000 CLA?MSAtAOE I X I OCCUR DAMAGE TO r,IeoalllrnM t 1,000,001 X SNt¢tppOpOQ —..— - MtT0E7rY anI __ [XCLUDEO ,..(ARV Paaon f PERsoNu a ADV KKNIY t _ i.eoo t>OD OEN4 AOGRE't�i1`1T�E pLMYpIT.APPLIES PER: E GEFI6AALAtipREGAT _ t 2,000.000 X i /_J A CT LOC �COMPJOPAGO t 2.000,000 i AumroeseLutalm 931457 1 1 03p1I1072 t {`000,000 x i ANY AUTO wu41RJVRl IYN Pa�H 7r ov}flEo scH,eoux.ED _ S[lF INSURED AUTO PHT DMG — --- - HED ONLY FAUTOS eDDILY IuuRv iwr.o,.unq t ..�ALIT06 ONLY AUTOS ONiLY 1MMF"AUAN t OCCtiI? t(AGNOCCl1RRENCE _ i tUlt Ss LN18 CLAIII&MADE i A00F4!QATE t DIED RETENTION Fl WORKERSCONPENSATIONWC 02 1096DO4(M I X AND EMPLOYER$'LIABRITYI mum 9 arvvr-RGA?sETC*VPARTNER&XECUTNE YrN wC0rt j(1M) I,03PDt,2W 1e3Q1( 1 :7F;ICERIpEM8EPEXCLLUED1 a MIA E.L EACH ACCIDENT _ 51000,000 (Mina"N NH) ILL.DISEASE-EA n y..,da.wm.u~+der i S�OOO,OCO RIPTIOON OF RJlTgIJS WowlConorwwonAdilitionilPap � E.L DISEASE•POLICY LIMIT t 5.�1.OtA C E4d95 A1lD 29T1100i1002000 owl{0211 `03,Qir"I Lent 4,000,000 A E)a u General UaWq Mvax 314510 03/OIi20i9 j 03A112fY12 lir>at 8,000. DESCRIPTION OF OPCRATION1 I LOCATIONS VEHICLES IACORD tet.Addbmnl M waft teleduk}rY be A V .p.e.I.-quftwl EVIDENCE OF INSURE NCE CERTIFICATE HOLDER CANCELLATION HOME DEPOT USA,INC 2455 PACES FERRY ROAD SHOULD ANY OF THE ABOVE OCZCRMED POLICIES MM CANCELLED BEFORE; BUILDINGC20 THE EXPIRATION DATE THEREOF. NOTICE WILL sE DELIVERED IN ATLANTA,GA 30338 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA ku Me"Stll MUkheq(Ev C 1988-2016 ACORD CORPORATION. AH rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: CN101642069 LOC S Atlanta AC Rd ADDITIONAL REMARKS SCHEDULE Page 2 of AGENCY - 11x+1 INC. NAMED INSURED MARSH THE HOME DEPOT,H)C I POLICY NUMIM - HOIIIE DEPOT U SA.,INC. 2455 PACES FERRY ROAD BUILDING C-20 CARRIER NAICOM EFFECTIVE DATE:ATLANTA.GA 3R33g ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: -25 FORM TITLE: Certificate Of Liability Insurance workm ca roensawn C000nuec Cw—+Mn—Insenmce CMPNY of Non M*nca Policy Numper YARCs6B27716(AL ARFL N),IAKS.KY IAMtS,MO.NE.M4fffiOILSC.SaTkWV,M) E%M.e L ae.W QWD Evr&w Dab 03fj1r212t (EL)LgroL 35.000.000 Carlar:New Ha Wjm IrtsurIIme caRp" FGIPI Mlm6er UPC 023096003(OC.DE.A.Itµt0,MN,MT,NY.M) ESed-Dare 03o1n0P ExPiraw Date.03.1Qti2021 (Ell UmE$5.000.000 CWW,ACE American Iaslroa Cong" Platy Mater ACU 066822753(OSt)WL GUt 0P M,MMI Epache Dene:am'1020 EAprdm DOW O,y0112021 (ELI!bra$4,000,030 SIR S1.000.000 SIR br die kips of AZ,QUJC ORYA WA Caner kaWwF hm Fn Itwanw 7 PdcY Number i(VYC'6555356(OSI)(COCT.GA.WW,W,,ON,PA,Ln) PNI-10rDale 03.1)1/?D2Ci Eayrab3n Darr Olwtwl (EU tmu.S4,000,00D 31,000,000SIRIKIiii moICO,ME.W.MI,ORPA UT S750.000 SIR IbM dried GA 4,350.000 SIR brM SW o1 CT Ca 1w NaWW U*n Fire Mk ante ompoY PQkY Nunber XNC 6558357(050(MA) Eftlift Ode:W/2020 Exau bw Deb;03R r"I (tU LmR S4,5w w0 SIR WOW TX ErooDYers XS YklclRriq: CYIM:MV6 Unim kwrwa COYMY PObcy Number TNS COKIW(7X ERectwe Ode.03:O1Q= EApmm Dai*'03x3?.QD21 (ELI Ura S10.110.L00 SIR S+A00.000 ACORD 101(2008!01) Q 2008 ACORD CORPORATION. Ail The ACORD name and logo are registered marks of ACORD ngftta��� < M Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CSSL-106106 Construction Supervisor Specialty EUGENIU CIUBOTARU !t 23 BENHAM STREET SPRINGFIELD MA 01109 expiration: Commissioner 0912912020 t MASSAGE - DRIVER'S - LICENSEi34 l rvrz ;L 091.15120165431 �yw' ; s ,2,�-- �i29IC198 +1 l -'��•i2LUGl:NIU� • ,•,. r��la'�. 'L• . t;.�{la 23 BENHAIM SPREE -7" . i . '. SPRINGFIELD,MA O1t09Zi01 .. -. US&ISA s5KI 6!..v iort .00 Otft*of Consumes parrs Business Regulation HOME IMPROVEMENT CONTRACTOR TYPE: =;�o ra t fto € kation 187666 05109/2021 EXTERIOR R 0aING.3"ROU , INC ' GEMLi CIUBOT RU 23 BEWAM S T SPRINGFIELD, MA 01109 UnderSeCreta) auuiori Go rermus Li.i; co putt permits using my Lb License m 6 ana my HIC Registration # 18 66 "�• ^••-^^*ions please call me at: N / 3 ) 335`370a Lnsuu'ier t-ompany r4aw, �'-�io� Vu j� Home Improvement Agreement: Pagel Home Depot License #'s - For the most current listing www.Homedepot.com/LicenseNumbers MA: 107774, 112785 Ronald Engelbrecht ale person Name: Registration No. if applicable): Home Depot U.S.A., Inc. ("Home Depot") or Service Provider named below will furnish, install and/ or service the equipment listed below at the price, terms and conditions as outlined on this form. Boston Helen and Marsha I lNew England South 1-19GC8XTA ustomer Last Name Customer irst ame tore ranc FITCustomer Tad/ 347 Bridge Rd I Florence MA j 101062 Customer Address City State Zi � 1 1 (413) 727-3487 helenb347@comcast.net Home Phone# Work Cell Phone# Customer Email Address NOTICE OF RIGHT TO CANCEL: YOU MAY CANCEL THIS AGREEMENT WITHOUT PENALTY OR OBLIGATION BY DELIVERING WRITTEN NOTICE TO HOME DEPOT AT: 908 Boston Turnpike Unit 1 1 IShrewsbury IMA 01545 Address City State Zip Or Email: customercancellationnortheast@homedepot.com Service Provider Email Address BY MIDNIGHT ON THE THIRD BUSINESS DAY AFTER SIGNING, UNLESS THE STATE SUPPLEMENT PROVIDES A DIFFERENT CANCELLATION PERIOD. THE STATE SUPPLEMENT CONTAINS A FORM TO USE IF ONE IS SPECIFICALLY PRESCRIBED BY LAW IN YOUR STATE. YOUR PAYMENT(S) WILL BE RETURNED WITHIN TEN (10) BUSINESS DAYS AFTER HOME DEPOT'S RECEIPT OF YOUR NOTICE. YOU MUST MAKE AVAILABLE FOR PICKUP BY HOME DEPOT OR SERVICE PROVIDER, AT YOUR SERVICE ADDRESS, AND IN SUBSTANTIALLY THE SAME CONDITION AS WHEN DELIVERED, ANY MERCHANDISE OR MATERIALS DELIVERED TO YOU. OR YOU MAY CONTACT HOME DEPOT FOR INSTRUCTIONS REGARDING RETURN SHIPMENT AT HOME DEPOT'S EXPENSE. THE LAW REQUIRES THAT THE HOME DEPOT GIVE YOU A NOTICE EXPLAINING YOUR RIGHT TO CANCEL. PLEASE SIGN BELOW TO ACKNOWLEDGE THAT YOU HAVE BEEN GIVEN ORAL AND WRITTEN NOTICE OF YOUR RIGHT TO CANCEL. Acknowledged by: 07/12/2020 Customer's Signature' - Date Contract Price and Payment Schedule : Payment of the Contract Price is due upon signing unless a different payment schedule is required by law, specified below or in a payment addendum. Contract Price: $ 14235.40 Includes all applicable taxes. Excludes finance charges.' Sales Tax: $ 0.00 (If applicable) *Maximum deposit ONLY applicable in MD, MA, ME (33%), NJ, Wl (99%) Dep. 125.0 % Deposit Amount $ 1058.85 Remaining Balance $ 3176.55 The Home Depot-2455 Paces Ferry Road, N.W. Bldg. B-3,Atlanta, Georgia 30339-Customer Care: 1-800-466-3337 With Grids We Glass Package Glazing S cer /G U SHGC U (all with Argon) Fact Fact SHGC NUM Im ning_ 6500 Base ProSolar Supercept 718" 026 0.23 c o 0 _ - 0.26_0.21 0 seemmeent_1 6500 Base ProSolar - - Supercept -718" 0.26 0.24 c 0 0_26_ 0.22 nsom _ - 6500 Base - ProSolar-J y Supercept 1' 027- 0.32 0.27 T{ 0.29 - ible-Hung 6500 Base J ProSolar _ Supercept 718" 0.29 0.26 0 0.29 0 24 - lure Casement (NH) 6500 Base ProSolar Supercept 7/8" 0.26 0.28 c 0 0.26 0.2_5 o o 0 lure �_ 6500 Base ProSolar Supercept 718" 0.27- 0.29 0 0.27 0.26 c! a anel Slider 650_0 Base _ ProSolar _Supercept 718" _0.29 0.26 0 0.29 023 0 0 anel Sliders 6500 Base(s 21 SO) Pro Solar Supercept 718" 0.29 0.26 0.23 a a . li 1 • • ' rden Door(CH) 6500 Energy Star ProSolar SUN Super Spacer 1" 0.30 0.24 0 0 0 0 0.30 0.21 0 0 0 io Door[NOVO 6500 Base Pro Solar Super Spacer 1" 1 0.28 0.26 c 0.31 0.23 0 0 0 Homes located everywhere EXCEPT:Arizona,California,Idaho,Nevada,New Mexico,Oregon,Utah,and Washington. Hing(Inc Hopper) 6100 Base Pro Solar Intercept 718" 0.27 0.24 c. c 0.28 0.21 0 cement 6100 Base Pro Solar Intercept 7/8" 0.27 0.24 0 �ble-Hung 6100 Energy Star Pro Solar _Supercept -314" 0.30 0.30 - 0.30 0.27 0 0 ture Casement(No Hinge)u`6100 Base .a. Pro Solar Intercept 7I8" 027 0.28 0 0 0.27 0.25 0 o a lure - - 6100 Base Pro Solar Intercept 314" 027 0.31 a 027 028 0 0 anel Slider 6100 Base Pro Solar Intercept 314" 0.30 028 0 0.30 0.27 c anel Seder 6100 Base Pro Solar Intercept 314" 0.30 0.29 0 0.30 027 0 1 Homes located everywhere EXCEPT:Arizona,Calffomia,Idaho,Nevada,New Mexico,Oregon,Utah,and Washington. io Door[NOVO 6100 Energy Star Pro Solar Super Spacer 1" 1 0.28 0.26 0 0 0.28 0-23 Em. io Door NARROW FRAME 6100(PD05)Base Pro Solar Intercept 314"10.28 0.30 0 0 0.28 0.26 0 0 • Homes located only in following markets:Dallas,Denver,Detrol;Phi14 Northern NJ,Long Island,NY. ning 6200 Base Pro Solar SHADE Supercept 314" 0.27 0.25 o c 0 0 026 0.23 o 0 0 sement 6200 Base x� Pro Solar SHADE Supercept 314" 0.26 0.18 0 c 0 0.29 0.17 o lure Casement-NH 6200 Base Pro Solar SHADE Supercept 3/4" 025 0.21 0 o c 0 025 0.19 0 0 0 ture Window -s 6200 Base Pro Solar SHADE Supercept 3/4" 0.26 0.24 o o o c 0.126 0.22 0 0 0 gle Hung 6200 Base Pro Solar SHADE Supercept 314" 0.28 0.23 �� o 0 0 0,28 021 a o gle Slider _6200 Base =_ Pro Solar SHADE Supercept 314" 0.28 0.23 0 o a 028 0.21 • a anel Slider 6200 Base Pro Solar SHADE Supercept 314• 028 0.23 0 0 n 028 021 • o • 2 ' Homes located in coastal areas. nin9-_ SB+300VL Energy Star PS SUN/Lami Supercq 0.23 010 c a 0.26 0.21 e 01 01 :ement SB+300VL Base PS/Lami Super 0.23 o 0 0 0 0.25 0.21 = 0 0 - �ble Hung SB+300VL Base - PS/Lami Super 0.25 o 0 0 0 0.29 0.23ler SB+300VL Base PS/Lami Interce9 025 0 e ;, o_ 0.29 0.io Door SB+300VL ETC 366 PS Shade/Lami Super 0 0.19 0 0 e 0 • •ten Door(CH) SB+300VL Base PS/1-ami Super Spacer 1• 0.30 0.28 © e 0.30 0.25 c o -._ _- _.._z one_ - _- __ �-1 1_y1. As indicate Energy Star certified for that zone WINDOW SPECIFICATION SHEET - Spec.Sheet#: 1-19GCSXTA Sheet: 1 of 1 CUStoMer: Helen and Marsha Boston ,lob#: 1-19GCBXTA Consultant: Ronald Engelbrecht Date: 07/12/2020 New Window Hinge Locations Existing Window Measurements Grids Product Options Labor Options From outside, Left to Right Bays,Bows Location Color Rough Opening #of bars #of bars Csmnts,1 PH, use L,RorS Glass Misc Items Hardware Code Screens For doors use _ Mull "S"=stationary or g t E LL v N m a "X"=operating Style Wraps Room Floor Code (Y/N) Style Code Series Code E _ _ ci v a STD,White, GlassPack: WRAP,LSR DINE 1st SB-DH Y DH 6100 WH WH 36 46 82 Standard STD,White, GlassPack: WRAP,LSR KITCH 1st SB-2P Y 2 PNL 6100 WH WH 50 36 86 Standard X S NL STD,White, GlassPack: WRAP,LSR BSMT Basem �BH Y �BH 6100 WH WH 34 14 48 Standard ant STD,White, GlassPack: WRAP,LSR BSMT Basem BH Y SH 6100 WH WH 34 14 48 Standard ant STD,White, GlassPack: WRAP,LSR BSMT Basem BH Y BH 6100 WH WH 34 14 48 Standard ant STD,White, GlassPack: WRAP,LSR BSMT Basem BH Y BH 6100 WH WH 34 14 48 Standard ant STD,White, GlassPack: WRAP,LSR BSMT Basem BH Y BH 6100 WH WH 34 14 48 Standard ant STD,White, GlassPack: WRAP,LSR BSMT Basem �BH Y BH 6100 WH WH 34 14 48 Standard ant —LL—1 SPECIAL CONSIDERATIONS: 1:White,2:White,3:White,4:White,5:White,6:White,7:White,8:White Wrap Color Project Notes: nterlor Casing Type Bay or Bow window: eatboard material(vinyl only-Birch or Oak) y Project Angle(30 or 45) y Flanker Type(DH,SH,or Csmnt) Top of window to soffit(inches) If tied to soffit,color of soffit material I have reviewed and agree with all the job specifications above and the Construct Roof(Yes or No)" Special Terms and Conditions on the following page Garden Window: eatboard Material(vinyl only-White Pionite,Birch or Oak) Go Permits, LLC 105 Buttonball Lane Glastonbury, CT 06033 Scott Doughman Phone: 860-952-4112 Fax: 860-430-6719 scottdoughman@gopermits.org Building Department: Please see attached application and payment • Please fax or e-mail a copy of the permit and receipt to below and mail original to the homeowner: Fax: 860-430-6719 (Attn: Scott Doughman) Email: scottdoughman@gopermits.org • If you're unable to email or fax us a copy of the permit, please mail the original permit to the below address and we will insure the homeowner receives it. Go Permits, LLC 105 Buttonball Lane Glastonbury, CT 06033 Thank you! Go Permits, LLC