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17A-299 (10) BP-2022-1000 157 HILLCREST DR COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 17A-299-001 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-2022-1000 PERMISSIONIS HEREBY GRANTEI TO: Project# DOORS Contractor: License: Est. Cost: 2649 LOWES HOME CENTERS INC 103003 Const.Class: Exp.Date:09/08/2022 Use Group: Owner: WIDER LAUREL &MARLENE B RASHELLE Lot Size (sq.ft.) Zoning: URA Applicant: LOWES HOME CENTERS INC Applicant Address Phone: Insurance: 1000 LOWES BLVD (413)272-8931 O WC016393105 MOORESVILLE, NC 28117 ISSUED ON:08/17/2022 TO PERFORM THE FOLLOWING WORK: 2 DOORS 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 VIOL TION OF ANY OF ITS RULES AND REGULATIONS. Signature: I I Ti I Fees Paid: $40.00 212 Main Street, Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner RECEIVED AUG 1 The Commonwealth of Mass hus MM FOR ° Board of Building Regulations a Stt#iutar �V�LDING INSPECTIONS'-UnICIPALITY Massachusetts State Building Co AMF70N,MA pt060 USE Building Permit Application To Construct,Repair,Renovate Or Demolish a `Revised Mar 2(JI1 One-or Two-Family Dwelling This Section For Official Use Only Building PermitNumber: _,161-1-.21'(Or Date Applied: J,t W,—i' ems /// �'I7'ZOZZ Building Official(Print Name) Signature Datc SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers 157 Hillcrest Drive /7A- v2-[q 9 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.Cr.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public 0 Private 0 Zonc: _ Outside Flood Zone? Municipal 0 On site disposal system 0 Check if}ems❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: Laurel Wider Florence,MA 01062 Name(Print) City,State,ZIP 157 Hillcrest Drive 646-201-6983 No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction ❑ Existing Building❑ Owner-Occupied ❑ Repairs(s) !15 Alteration(s) ❑ Addition ❑ Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify. Brief Description of Proposed Work2: REMOVE/REPLACE 2 EXISTING EXTERIOR DOORS.NO STRUCTURAL WORK BEING DONE. • SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ 2,648.50 1. Building Permit Fee:$ Indicate how fee is determined: 2. Electrical $ ❑Standard City/Town Application Fee ❑Total Project Cosh(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4. Mechanical (HVAC) $ List: 5.Mechanical (Fire Suppression) Total All Few Check No.I heck Atnoun '"f b Cash Amount: 6.Total Project Cost: $ 2,648.50 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) 103003 9/8/2022 Michael Burgamaster License Number Expiration Date Name of CSL Holder 22 Grainville Road List CSL Typc(see below) No.and Street Type Description Southwick,MA 01077 U Unrestricted(Buildings up to 35,000 cu.ft.) R Restricted 1&2 Family Dwelling City/Town,Statc,ZTP M Masonry. RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances 413-222-6324 burger78@msn.com i Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) 148688 10/17/2023 Lowes Home Centers HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name 1000 Lowes Blvd richard.chalone@lowes.com No.and Street Email address Mooresville,NC 28117 978-735-S907 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 MI 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 Richard Chalone to act on my behalf,,in all matters relative to work authorized by this building permit application. Loa/ W A 7f tztzZ Print Owner's Name(Electronic Signature) Dale 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 con aio his ap lice. i true and accurate to the best of my knowledge and understanding. ( t , it,lcint 8 jiz f zz. Print Owner's or Authorized cnt'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(HTC)Program),will Id have access to the arbitration program or guaranty fund under M.G.L.c. 142A.Other important information on the HIC Program can be found at www.mass.gov/oca Information on the Construction Supervisor License can be found at www.mass.eov/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 '� DEPARTMENT OF BUILDING INSPECTIONS 5 cJt : #) y 212 Main Street • Municipal Building j Northampton, MA 01060 Ursb x1", 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: i .C',rdab1Q 1ui1c yi 5 l 04(o 6-22 Main 5i. Nkmpd en rrn o 10 36 The debris will be transported by: ifilA0,1 f 4.(no-S`�l Name of Hauler: n v I 1L'12- Signature of Applicant: Date: The Commonwealth of Massachusetts Department of Industrial Accidents -t; .\ 151 Office of Investigations Lafayette City Center 2 Avenue de Lafayette, Boston,MA 02111-1750 = ' www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print I eeibly Name(Business/Organization/Individual): LOWES HOME CENTERS Address: 1000 LOWES BLVD City/State/Zip: MOORESVILLE,NC 28117 Phone #: 978-735-5907 Are you an employer?Check the appropriate box: Type of project(requir d): 1.0 I am a employer with 4. X❑ I am a general contractor and I 6. 0 New construction employees (full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. employees and have workers' Building addition [No workers' comp.insurance comp. insurance.t required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs •r additions myself [No workers' right of exemption per MGL y comp. 12.❑Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13. X❑Other Door repla ement comp. insurance required.] *Any applicant that checks box#1 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. tContractors 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-contradors have employees,they must provide their workers'comp.policy number. f I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: AIU INSURANCE COMPANY Policy#or Self-ins. Lic. #: WC035901712 AOS Expiration Date: 4/1/2023 Job Site Address: 157 Hillcrest Drive City/State/Zip:Florence, MA 01062 Attach a copy of the workers' compensation policy declaration page(showing the policy number and expira ion date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal pe lties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORD R and a fine of up to$250.00 a day against the violator. Be advised that 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 thej/ pains and penalties of perjury that the information provided above is true and correct Signature: gI l�f+ll I Date: 8/9/22 i Phone#: 978-735-5907 I Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(check one): 10Board of Health 211 Building Department 30City/Town Clerk 4.❑Electrical Inspector 5❑P►umbing Inspector 6.0Other Contact Person: Phone#: A`CORD® CERTIFICATE OF LIABILITY INSURANCE DATE CERTIFICATE 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 Marsh USA Inc. P PHHON: ONE FAX 100 North Tryon Street,Suite 3600 (A/C.No.Ext): (A/C,No); Charlotte,NC 28202 E-MAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC p CN102776519-Lowes-SI-22-23 INSURER A:National Union Fire Ins Co.of Pittsburgh PA 19445 INSURED INSURER B:Interstate Fire&Casualty Co 22829 Lowe's Companies,Inc. and subsidiaries INSURER C:AIU Insurance Co 19399 1000 Lowe's Boulevard INSURER D Mooresville,NC 28117 INSURER E: , INSURER F: COVERAGES CERTIFICATE NUMBER: ATL-004976909-11 REVISION NUMBER: 10 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 RESP T TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT T ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I EFF POLICY EXP NSR ADDLTYPE OF INSURANCE INSD WVDSUBR POLICY NUMBER (MM DDPOUCYIYYYY) (MM/DD//YYYY) LIM 5 LTR INSD WYD COMMERCIAL GENERAL LIABIUTY EACH OCCURRENCE $ CLAIMS-MADE OCCUR Self Insured-See below DAMAGE PREMISES(Ea O RENTED occurrence) $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PRO- JECT LOC PRODUCTS-COMP/OP AGG $ OTHER: $ A AUTOMOBILE LIABILITY CA7030892 (AOS) 04/01/2022 04/01/2023 COMBINED SINGLE LIMIT ! $ 5,000,000 I (Ea accident) C X ANY AUTO CA7030891 (MA) 04/01/2022 04/01/2023 BODILY INJURY(Per person) I $ A OWNED AUTOS ONLY SCHEDULED CA7030893 (VA) 04/01/2022 04/01/2023 BODILY INJURY(Per accident, $ HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) B X UMBRELLAUAB X OCCUR USZ00024220 04/01/2022 04/01/2023 EACH OCCURRENCE 1 $ 5,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 5,000,000 DED RETENTION$ $ C WORKERS COMPENSATION WC035901712 (AOS) 04/01/2022 04/01/2023 X STATUTE EORH C AND EMPLOYERS'LIABILITY Y/N WC035901713 (ND,WA,WI,WY) 04/01/2022 04/01/2023 2,000,000 OFFICER/MEMBEREXCLUDEDTECUTIVE N N/A E.L.EACH ACCIDENT $ (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 2,000,000 If yes,describe under 2,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A Excess Workers'Compensation XWC1647325 (FL) 04/01/2022 04/01/2023 (WC per statute) 3,000,000 A Excess Workers'Compensation XWC1647324 (AOS) 04/01/2022 04/01/2023 (WC per statute) 3,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Commercial General Liability policy is Self-Insured,effective 4/1/2022 to 4/1/2023. I CERTIFICATE HOLDER CANCELLATION 1 Lowe's Companies,Inc.and Subsidiaries SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE •ANCELLED BEFORE 1000 Lowe's Blvd. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Mooresville,NC 28117 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE I Wia../T.4% 7,4S7 €7,sc. ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: CN102776519 LOC#: Charlotte AC ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY NAMED INSURED Marsh USA Inc. Lowe's Companies,Inc. and subsidiaries POLICY NUMBER 1000 Lowe's Boulevard Mooresville,NC 28117 CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance Workers'Compensation and Excess Workers'Compensation policies include a self-insured retention of$2,000,000. General Liability:The insured is self insured for$10,000,000 each occurrence for the period of 4/1/2022 to 4/1/2023. The Automobile Liability policy evidenced above is subject to additional self-insured retentions excess of limits shown for various perils covered. ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD A • , DATE(MM/DD/YYYY) A(740 PRL' CERTIFICATE OF LIABILITY INSURANCE 06/09/22 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 provisionsor 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 LON TACT NAME: Mike Pelletier Rejean J.Remillard Ins Agency (a/c No,Ext): 413-789-3070 FAX No): 413-786-0193 1040 Springfield Street E-MAIL Feeding Hills,MA 01030 ADDRESS: mikep@rejeanremillard INSURER(S)AFFORDING COVERAGE NAIC ft INSURER A: Main Street American Assurance INSURED INSURER B: National Grange Mutual Burgers Home Improvements INSURER C: Acadia Ins Co 119 High St. 1st Floor INSURER D: Chubb Group Agawam,MA 01001 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLIQY 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 ADOLSUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR PRSORENTED PREMISES(Ea occurrence) $ 500,000 MED EXP(Any one person) $ 10,000 A Y Y MPK6213N 06/08/22 06/08/23 PERSONAL&ADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE $ 2,000,000 X POLICY PRO- JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER I $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1 $ (Ea accident) _ ANY AUTO BODILY INJURY(Per person) r $ 100,000 B OWNEDSONLY x AU SCHEDTOSULED Y M1T3385E 06/10/22 06/10/23 BODILY INJURY(Per accident) $ 300,000 AUTO X HIRED x NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY _AUTOS ONLY (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTIONS $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER _ ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 100,000 D OFFICER/MEMBER EXCLUDED? Y N/A 6S62UB-6R09227-A-21 10/02/21 10/02/22 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101.Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN LOWE'S COMPANIES,INC.&LOW'S HOME CENTERS,LLC ACCORDANCE WITH THE POLICY PROVISIONS. MAIL CODE:ISI 1000 LOWES'S BLVD AUTHORIZED REPRESENT — MOORESVILLE,NC 28117 7 l ...., I ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD F/�Ca9 Commonwealth or Massachusetts® Division of Professional Licensure Board of Budding Requtatoons and Standards C'onst►aICtiprl Supervisor CS-103003 Eapires 09/08/2022 MICHAEL W BURGAMASTERy 22 GRANVILLE ROAD SOUTHWICK MA 01077 6 0 ill Commissioner ( ela 1C - g/res, Kvimi-ietzzepeadi o-/./09ar)JaciteJe14, Office of Consumer Affairs and Business Regulation 1000 Washington Street- Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration _ Type: Supplement Card LOWE'S HOME CENTERS,LLC Registration: 148688 1 ( Expiration: 10/17/2023 1000 LOWES BLVDf r--SERVICES COMPLIANCEIv, -- MOORESVILLE,NC 28117 �! =` Update Address and Return Card. SCA 1 0 20M-05,17 Oft(cL✓6YC6itedifyigkfa &'6ifiMig 1l4jAion HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:Supplement Card before the expiration date. If found return to: R�qi rfLoa gApIration Office of Consumer Affairs and Business Regulation 148688 10/17/2023 1000 Washington Street -Suite 710 LOWE'S HOME CENTERS,LLC Boston,MA 02118 RICHARD CHALONE t t X✓'�^^V� 1000 LOWES BLVD /�,r.+r:%.i'c!»slfc' SERVICES COMPLIANCE Undersecretary Not valid without signature MOORESVILLE.NC 28117 STORE COPY INSTALLATION SERVICES CUSTOMER CONTRACT-MWORK-INT/EXT/PATIO DOOR L0 E LOWE'S OF HADLEY, MA,STORE # 1916 STORE PHONE: (413)588-0270 282 RUSSELL STREET SALESPERSON: EDWIN GONZALEZ HADLEY. MA 01035-0000 SALESPERSON ID:4079617 Document Print Date :08/09/2022 This is only a Quote for the merchandise and services printed below. This becomes an agreement upon payment and issuance of a Lowe's receipt, upon which the entire agree- ment, including the specifically completed pages of this document, the Terms and Conditions included with this document, the applicable portion(s)of Lowe's receipt, and any other addenda or attachments hereto,shall be referred to herein as this"Contract." PLEASE READ THIS ENTIRE DOCUMENT.INCLUDING THE"TERMS AND.cQNDITIONS."BE ORE SIGNING, Lowe's Registration or Contractor License Number/Lowe's Contractor Name Lowe's Home Centers, LLC's MA HIC NO.: 148688 Lowe's Home Centers, LLC's FEIN: 56-0748358 Customer Name Home Phone S LAUREL WIDER 646-201-6983 O Customer Address Other Phone 157 HILLCREST DR 646-201-6983 L City State/Province Zip/Postal Code D FLORENCE MA 01062 Installation Address T 157 HILLCREST DR O Installation City Installation State/Province Installation Zip/Postal Code FLORENCE MA 01062 MERCHANDISE AND INSTALLATION SUMMARY MERCHANDISE SUMMARY 15634 : 230612 : STK : 120Z DOOR AND WINDOW FOAM : 120Z DOOR AND WINDOW FOAM : DDP SPECLTY ELECT MATERIALS US-OTY 2 147316 :OCFZ0018 : STK: PELLA 3-IN X 50-FT WINDOW TAPE : PELLA 3-IN X 50-FT WINDOW TAPE : PELLA INSTALLATION ACCESSORIES-OTY 1 193584 : EC444 : STK : PFJCASE444 11/16-INX3-1/4-INX8-FT : PFJCASE444 11/16-INX3-1/4-INX8-FT : ECMD DISTRIBUTION -QTY 6 238353: 2866 : STK : 1INX3.51NX10-FT PVC TRIM BO : 1lNX3.5INX10-FT PVC TRIM BO: METRIE INDUSTRIES INC -QTY 6 333346: 1X4-PFJ8:STK: 1-4-8 PRIMED PINE : 1-4-8 PRIMED PINE : METRIE INDUSTRIES INC-QTY 6 737902 : ART10006096: STK : 1-6-8 AZEK TRADIT PVC BOARD : 1-6-8 AZEK TRADIT PVC BOARD : PARKSITE INC -QTY 2 1504921 : 1000008972 : STK : 150 SPD 72X80 SUNDEF AR : 150 SPD 72X80 SUNDEF AR : PELLA CORP 150 EAST PATIO DO - QTY 2 4065333 : 204383062503:SOS: NATURAL OAK MULTI PURP REDUC 3.8 : Natural Oak Multi Purpose Reducer:ZAMMA CORP- QTY 2 Store 1916 Project No. 743575038 for LAUREL WIDER Page 1 of 8 STORE COPY Materials Price $1467.26 INSTALLATION DESCRIPTION Door type : Patio Location of new door(s) : 2 Select new door : Sliding Sidelights or transoms : No Number of additional holes bored for accessories : None Install specialized mortise hardware : No Lead safe practices : No Total linear feet of custom trim to be Installed : 0 Deliver door: No Customer understands scope of the project : Yes Permit Fee :Yes Additional Mileage :0 Access fee : None Dump entry Fee :Yes Additional Work:build in jambs and custom exterior work Additional Work Charge :Yes Comments : Customer looking to get 2 vinyl patio sliders installed Labor Charges $1181.25 Detail Deduction -$ 0.01 Additional Specifications: Notation:Lowe's will not make structural modifications,remove cabinetry to accommodate new appliance.or upgrade electrical service. Additional Specifications: LEAD SAFE INFORMATION:Federal and applicable state laws require that You be provided with a lead hazard information pamphlet such as the Renovate Right:Important Lead Hazard information for Families,Child Care Providers and Schools.By signing this Contract,You acknowledge having received a copy of this information pamphlet before work began informing You of the potential risk of the lead hazard exposure from renovation activity to be performed in Your dwelling unit or facility.A copy of the pamphlet is also available at the following website: httos://www.et}a.gov/sites/Droductionifilesfijocuments/renovaterightbrochure.odf.For more information see:https://www.eoa.gov/lead,tead-renovation-reaair-and-painting-program. PHOTO RELEASE:Customer grants to Lowe's and Lowe's employees and independent contractors the right to take photograghs of the Premises where Installation Services will be performed and all work performed at the Premises related to this Contract,and irrevocably grants to Lowe's all right,title, interest in and to the photographs for use in all markets and media.worldwide,in perpetuity. Customer authorizes Lowe's to copyright,use and publish the photographs in print and/or electronically,and agrees that Lowe's may usp su h photographs for any lawful purpose,including,but not limited to,marketing,advertising.publicity,illustration,training and Web content.By initialing here,Customer agrees to the foregoing, /iv [Customer to initial to the left]. NOTICE TO CUSTOMER-PRICE CALCULATIONS:In order to properly perform the installation of certain Goods,the Contract Price ma include more Goods than actually will be installed based on the measured square footage of the Project Area.As a result,the parties agree that the lump-sum Price stated in this Contract is calculated upon both the value of the estimated Goods required to ful- fill the Contract(including waste),which may exceed the actual square footage of the Project Area,and the labor which may be estimated based on the amount of Goods required to fulfill the contract (including waste), By signing this Contract below.Customer acknowledges receipt of this notice and agrees and understands that the Price includes these costs which may not be refunded once the Installation Services are performed.. NOTICE OF ARBITRATION AGREEMENT This Contract provides that all claims by Customer or Lowe's will be resolved by BINDING ARBITRATION.Customer and Lowe's GIVE UP THE RIGHT TO GO TO COURT to enforce this Contract (EXCEPT for matters that may be taken to SMALL CLAIMS COURT). Lowe's and Customer's rights will be determined by a NEUTRAL ARBITRATOR and NOT a judge or jury.Lowe's and Customer are entitled to a FAIR HEARING.But the arbitration procedures are SIMPLER AND MORE LIMITED THAN RULES APPLICABLE IN COURT.Arbitrator decisions are as enforceable as any court or- der and are subject to VERY LIMITED REVIEW BY A COURT. FOR MORE DETAILS:Review the section titled ARBITRATION AGREEMENT,WAIVER OF JURY TRIAL AND WAIVER OF CLASS ACTION ADJUDICATION found in the Terms and Conditions of this Contract. Store 1916 Project No. 743575038 for LAUREL WIDER Page 2 of 8 STORE COPY TOTAL CHARGES OF ALL MERCHANDISE AND SERVICES .where applicable SUB-TOTAL S 2648.50 *TAX S 0.00 DELIVERY S 0.01 ORDER TOTAL S 2648.51 BALANCE DUE Work is to commence upon reasonable availablity of Contractor which is anticipated to be l 'I�ZAZ 2- {fill in date]. Estimated completion date is r d j_q/ Z O Z {fill in date]. t( / NOTICE TO CUSTOMERCIAA ran ,r' All items listed in this contract and specification sheet(s) are to be installed under conditions agreed upon at time of purchase and at the price appearing on this contract form. This assumes sound existing substructures, superstructure and points of attachments. Extra labor or material incident to installation necessitated by defective substructures, superstructure, points of attachment, or the moving of fixtures or appliances to be billed at extra cost to custom- er. IF THE CONTRACT TOTAL IS S1.000.00 OR LESS.Customer must pay in full. COMPLETE THIS SECTIQN ONLY WHEN THE CONTRACT TOTAL EXCEEDS S1.000.00: LI Customer to use the following payment schedule: (1) Deposit of$ to be paid upon signing contract. Any deposit collected at the time this Contract is signed will not exceed one-third(113) of the contract price;and (2) Payment of$ to be collected upon or after the commencement of work. I/We authorize Lowe's to do one of the following (check ap- propriate box below): [_] Charge my/our credit card for the amount of the payment indicated above upon or after the commencement of work: or (_I Deposit my/our check for the amount of the payment indicated above anytime upon or after the commencement of work;and (3) Final payment of$100.00,to be paid upon completion of the installation to both parties'satisfaction. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES AND UNTIL YOU HAVE READ THE TERMS AND CONDITIONS CON- TAINED IN THIS CONTRACT AND WHICH FOLLOW THE SIGNATURE PAGE(s). BY SIGNING BELOW, YOU ARE ACKNOWLEDGING THAT YOU HAVE READ, UNDERSTAND AND AGREE TO THE TERMS AND CONDITIONS SET FORTH IN THIS CONTRACT. YOU ARE ENTITLED TO A COPY Store 1916 Project No. 743575038 for LAUREL WIDER Page 3 of 8 STORE COPY OF THIS CONTRACT AT THE TIME OF SIGNATURE. NOTICE REGARDING ARBITRATION AGREEMENT FOR CLAIMS COVERED BY M.G.L.c.142A LOWE'S_AND OWNER HEREBY-MUTUAL LY__AG.R-EE-IN ADVANCE-THAT IN 1-HE-EVENT-LOWE'S-HAS A DISPUTE-CONCERNING-THIS-CON- TRACT, THAT LOWE'S MAY SUBMIT SUCH DISPUTE TO A PRIVATE ARBITRATION SERVICE WHICH HAS BEEN APPROVED BY THE SECRET- ARY OF THE EXECUTIVE OFFICE OF CONSUMER AFFAIRS AND BUSINESS REGULATIONS AND THE OWNER SHALL BE REQUIRED TO SUB- MIT TO SU ARB RATION AS PROVIDED IN M.G.L. c.142A. / By: Date: ./ q1 Z.Q 2 2-- Lowe's Home C�LC By: Date: 5 J(/ Owner t 1 By: Date: Co-owner or fitness THE SIGNATURES OF THE PARTIES ABOVE APPLY ONLY TO THE AGREEMENT OF THE PARTIES TO ALTERNATIVE DISPUTE RESOLUTION INITIATED BY LOWE'S PURSUANT TO M,G.L. c.142A. THE OWNER MAY BE PERMITTED TO INITIATE ALTERNATIVE DISPUTE RESOLUTION EVEN WHERE THE SECTION ABOVE IS NOT SEPERATELY SIGNED BY THE PARTIES. WITNESS OUR HAND(S)AND SEAL(S)BELOW THIS _- DAY OF.... uwS� 27Z-. Lowe's Home Centers,LLC By: (-�81"1- / /' (Seal) Print Name: �JC Fel 4"6-3 N. SSC Chit (Seal) Address Owner City ) State%Provence Zip r Postal Code Print Name (Seal) Co-Owner or Witness Store 1916 Project No. 743575038 for LAUREL WIDER Page 4 of 8