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16C-001 (7) BP-2023-0500 352 SPRING ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 16C-001-001 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-2023-0500 PERMISSION IS HEREBY GRANTED TO: Project# 2023 WINDOWS Contractor: License: Est. Cost: 4792 HOME DEPOT USA 1NC 106106 Const.Class: Exp.Date: 09/29/2024 Use Group: Owner: S KENT CHRISTOPHER B &BRENDA Lot Size (sq.ft.) Zoning: WSP Applicant: HOME DEPOT USA INC Applicant Address Phone: ' Insurance: 2455 PACES FERRY RD NW 860-952-4112 WLRC50668058 ATLANTA, GA 30339 ISSUED ON: 04/24/2023 TO PERFORM THE FOLLOWING WORK: REPLACE 5 NON-STRUCTURAL WINDOWS POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Service: Meter: Footings: Rough: Rough: House# Foundation: Final: Final: Final: Rough Frame: Gas: Fire Department Driveway Final: Fireplace/Chimney: Rough: Oil: Insulation: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: (CIZ1/4-• ST', • 6 1 � Fees Paid: $40.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner i . -0 The Commonwealth of Massachusetts FOR Board of Building Regulations and Standards MUNICIPALITY Qrs) ry • Massachusetts State Building Code, 780 CMR t USE ,-,.,Building Permit Application To Construct, Repair,Renovate Or Demolish a Revised Mar 2011 /I w One-or Two-Family Dwelling . ! This Section For Official Use Only Buj1 lig Permit Number:(j{-20?.2—c0S1) o Date Applied: gum.) (S ) /1/12 LI-ZLI ZZ3 Building Official(Print Name) Signature Date SECTION 1: SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers 37 ..Si:70)." Si ti,'r/C'a'7' - ", /6C --ON - o o j 1.la Is this an accepted street?yes ✓ no /O6" Map Number Parcel Number 1.3��ng Information: 1.4 Property Dimensions: (J 3• 368 acres Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public 0 Private 0 Zone: _ Outside Flood Zone? Municipal 0 On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1,.QQwwnerr of Record:, Name(Print) City,State,ZIP 352 Ser4 ,S' r y/3-6.7s SYSl c/k 6,4sb , ...,I. ct.SA No.and Street Telephone Email A dress SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building❑ Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units Other 4pecify: fed aceivw-fri 'i'''el" Bri f Description of Proposed Work2: 46 sq-ade.,tel cActile,0 t/r.Fat c — o.r , go _ SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ Y7 92 ,av 1. Building Permit Fee: $ Indicate how fee is determined: ❑ Standard City/Town Application Fee 2.Electrical $ ❑Total Project Costa(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: _ 5. Mechanical (Fire $ Suppression) Total All Fees: $ 6. Total Project Cost: $ y�9� Up Check Noy 26r heck Amount 09. Cash Amount: 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) /vb !0 6 9' /2Sj17 'I u 1004 cs,r w License Number Expiration Date Name o1'CSL Holder �� 3�sz ✓� List CSL Type(see below) Noland Street Type Description A' 'r/n� / Qf 0 6 C U Unrestricted(Buildings up to 35,000 cu.ft.) /V G Restricted 1&2 Family Dwelling City/Town,State,' M Masonry RC Roofing Covering (W Window and Siding / � SF Solid Fuel Burning Appliances r� —�SZ" �/12 pe//n113� o$1efnV/ O9 I Insulation Telephone Email dddrLss D Demolition 5.2 Registered Home Improvement Contractor(HIC) , 85" y12.-3 7D/ .0:e HIC Registration Number Expiration Date HIC Company Name br HIC Registrant Name No..a�nr►d Street Em'6i1 address A/(a 64 . a339 86a- 9Sz -y/�z 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 PK- 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 to act on my behalf,in all matters relative to work authorized by this building permit application. 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 a . e� th- i of my knowledge and understanding. Print Owner's or Authorized Agent's Name Elec omc Sign, 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 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 Oates FN N'' 5 S V Massachusetts h4., Al._ 't" % hi G � � � 14 . 1 DEPARTMENT OF BUILDING INSPECTIONS 7i . ' �'' 212 Main Street • Municipal Building J` ca \ �" Northampton, MA 01060 ss ... `yO CONSTRUCTION DEBRIS AFFIDAVIT (FOR ALL DEMOLITION AND RENOVATION PROJEC'1 ,) 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: I/" ciSll "G Location of Facility: Z Shy 'd 14- 2- //1 6e%i Cr m 6 2-- The debris will be transported by: Name of Hauler: EA. Ten' " O `'`�y � � Signature of Applicant: 4#✓ '/ aa"`'`''C7:4' Date: Li'/!- �3 The Commonwealth of Massachusetts D= Department of Industrial Accidents �L Office of Investigations S.94 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 Legibly Name (Business/Organization/Individual): Home Depot USA, Inc. Address:2455 Paces Ferry Road City/State/Zip:Atlanta GA 30339 Phone#:860-952-4112 Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. 0 I am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6. El New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. D Remodeling ship and have no employees These sub-contractors have g. 0 Demolition working for me in any capacity. employees and have workers' 9. El Building addition [No workers' comp. insurance comp. insurance. required.] 5. 0 We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.] t c. 152, §1(4),and we have no 13.®OtherWindow Replacement employees. [No workers' 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. $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 am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Indemnity Insurance Company of North America Policy#or Self-ins. Lic. #:WLRC50668058 Expiration Date:311/2024 Job Site Address: 352, Seri-' City/State/Zip: iCk/r"CG It( ©/062- Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties 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 ORDER 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 the pains and penalties of perjury that the information provided above is true and correct. Signature: Date: q— / - Phone#: 860-952-4112 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): 1OBoard of Health 20 Building Department 31:City/Town Clerk 4.0 Electrical Inspector 50Plumbing Inspector 6.DOther Contact Person: Phone#: ca d CERTIFICATE OF LIABILITY INSURANCE DATE"lIVOISYYYN 02412023, 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 INSURERS), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: if the certificate holder Is an ADDITIONAL INSURED,the polcylas)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WANED,subject to the teens 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 suds endonMnent(s)_ PNOOUCER CONTACT MARSH USA NC NAME: NIC TWO ALLIANCE CENTER K_ out I w'N*L 35N3C LEND%ROAD,SUITE 240C MOSEY ATLANTA GA 39326 INSUREINSI AFFCROMIG COVERAGE NAIL a C741C1642069•t4.reCGAW•22-25 MURESA:OdRt licInalla eCo 24147 MSUIEDrr£HIM DEPOT,INC, RIMER a:Indemnity NI CO Of Na Mecum ln 43575 HOME DEPOT U.SA.INC, POURER C:ACE Motel IMuf lceCorsenr 22567 2455 PACES FERRY ROAD BUILDING C-29 ROUSER CI ATLANTA.GA 30339 NISI ERE- MINER F. COVERAGES CERTIFICATE NUMBER: ATI.05072125.15 REVISION NUMBER: 7 THIS IS TO CERTIFY THAT THE POLICES 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 Cl AR IS. ADOLIIMMIC Nell TYPE OF NOLNU MCE .aso VAR POLICY NUMBER laWalvy8FrFelRWOOfYYYYl Ln A x DDIMERCW.mB MM.U .IT1f MINN 316648 O301 0022 001.2025 EACH OCCURRENCE $ I JEOOOO DANAlse 1U 1iTED I CLAIMSJAAO E3occult MENSES IFSocawrenoti 1 1000,000 X SR$1,000033 NEDEXP CAM mepeIGIII 1 EXCL.UDED ". PERSONAL I ADN INJURY I 1.03Ja00 GEM AGGREGATE LIST APPLIES FER GENERAL AGGREGATE t 2.000.000 POLICY❑sera a I.00 PRODUCTS-COIRi'OP AGG I 2.00011430 OTHER $ A AUTOMOBILEunjJTY 41WT6316619 031012B22 C0,41rl2F5 FLIASIIRDINGLE LINT $ 1.( .08a X ANY AUTO BODILY INAIRY(PH potion) $ '—' OWNED SCHEDULED SELF PISURED AUTO PRY CMG BDOILY�. OS I.ONLY �� A4ftfJOl-0Y1M® PR WNTY E IGE nlS I AUTOS ONLY AUTOS ONLY [Pr...seat1 e A iRBRELL.*URI 1 ors"is MWZX316647 C0*Ev24122 03a12025 EACH OCCURRENCE 6 la,aoo,oaa X EXCESSLMI rV40E AGGREGATE $ ISMS GOO _DEDI Imo► 1 B WORKERS COMPENSATION SCFC506611196IYA) 03.012073 03A1,2024 X IB EMPLOYERS LIAIMUTYSETA I I ER C AI YI N w EACHRCS3666150 GMT) 01�01Qa23 03101.2024 MONO ELACCIDENT t OFFICERAEiNERE*CLUDEDT N N 1 A M`rPROPRETOR�f+ kECUT:YE Aw^tiNsey N NMI E L DISEASE-EA EMPLOYEE 8 520.600 If Yea sisals*under Cont xrd on AONtonN Psge 5,033,000 DESCRIPTION OF OPERATIONS bats. L DISEASE-POLICY LIMIT f a I I DESCRIPTION OF OPERATIONS(LOCATIONSI VEMICUSII(ACCO°i•n,AMMAR/Rekrka at#emia,may be Mntdm r men woe W warYeo EVIDENCE OF NSURAMCE CERTIFICATE HOLDER CANCELLATION HOME DEPOT USA.NC SHOULD ANY Of THE ABOVE DESCRIBED POLICIES BE CANCEtl®BEFORE 2456 PACES FERRY ROAD BUILDING C-20 THE EXPIRATION DATE THEREOF. NOTICE WILL SE DELIVERED IN ATLANTA GA 30339 ACCORDANCE WRN THE POLICY PROVISIONS. M TVICIMfDIEPREMFIITATIVE I 7€a1rok 1 e.g"dPr '7 fee. 011156-2014 ACORD CORPORATION. Al rights reserved. ACORD 25(2016A3) The ACORD name and logo are registered melts of ACORD AGENCY CUSTOMER ID: eM101E42069 LOG H. Atlanta ACORO ADDITIONAL REMARKS SCHEDULE Page of 3 AGENCY NAMED M3URED ItARS^Ua& THE HONE DEPOT.NC HOME DEPOT USA.NZ PO CY ruNBER 2455 PACES FERRY ROAD BLALDING C.20 ATLANTA GA 30339 CARRIER NAIL CODE EFFECTIVE DATE ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE. Certificate of Liability Insurance bakes:cr•persiton Coiruee Camr Safety haxora.Cas.aty Camraem Miey%Per LDSa048399 AL AR AZFLD.LAILKS.ttY LANSA40.Nt;NE.NA1.10.0CSC.S0,714YAMY WYI Ethics*Dale.53012223 ElpraionCale 1Y012C24 (ELl tat f5.02C CCO Camay Sally Mama Casuaty Crrinrei Pricy Nato-SPt-068190OS1I ICAOR.INA; Etkco.e oat 03+01QG23 Eaprabr Dee 23.01 2E24 +:EI.1/FM 55.000.000 SIR$1.0X.000 timer ACE A nercm rsua-ce CsnSsri flair.N:ntr',dC c5i.6R809'5 OS1 EA1II M!OH in Moe Date 23,012:21 Eapratan Cow 01,012:2t E1.1 tal f4,000000 SIR ST0210.000 SIR IGAI S750000 Camay Ivermly IrsLxart.e Conea'y al Aa*t*,Mrrn Rslrcr Ntnter WLRC'SC668091 AKCO.CTDCDE.HI"WAD MEMO*WAN,PARI'VTI Effect*Date 33417:23 Uptown Cat 11.01 QC24 (EL tent SS000.X03 TX EnplrArs XS haenri Camr2umn►mevn Tsui arFvv Pricy',Utter 1.4&1138319.TX! Baca*Cot 03A12023 E:rpraeon Date 03'012}24 (ELI txt St OX X0 SIR SS'S 000 ACORD 101 (2008/01) C 200E ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 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: 112785 P O BOX 105451 Expiration: 04l22/2023 ATTN: LICENSE MGMT TEAM ATLANTA.GA 30348 Update Address and Return Card. Moe of Consumer u a auele se tlsrdrlen HOME IMPROVEMENT CONTRACTOR Rsgisaaeon valid for Individual use only TYPE:Suoolansnt Card before the expiration date. W found*seam to: Opine of Consumer Affairs and Business Regulation 112755 0412212023 1000 Waahkagbn Street -Suit 710 HOME DEPOT USA INC Boston,MA S2118 RICHARD OLMSTEAD 1 2455 PACES FERRY RD GI 1 HSC ATLANTA,GA 30339 Urxler3etsetary Ot valid with signature A RU CERTIFICATE OF LIABILITY INSURANCE [ DATE 1!$1 yy /2023 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. TIeS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURERIS►,AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED.the pokcy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED. subject to the terms and conditions of the policy.certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(e). PRODUCER FACT Deborah Marino Canary Blomstrom Insurance Agency PHONE sox 868 Springfield Street uLC.No E ti.013)750.9022 Wc,No(413)786-7004 Feeding Hills,MA 01030 , dmarino@canarydomstrom.com Nsystaisi AEPORONG COYERAut NAIL r NSURER A.NGM Insurance Co. 14788 INSUNEO riskierRC•Arbella Protection Insurance Company 41360 Exterior Remodeling Group Inc. MauRER C AIM Mutual Insurance Co. 21 Benham St NBVRER G Springfield,MA 01109 INSURER t SURMA _OVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERICO INDICATED. NOTWITHSTANDING ANY REOUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS :,CLU:SIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAD CLAM$. INMR TYPE OF INSURANCE POLICY EFF POLIt`Y EXP LTR MID NVD POUCY NUMBER IIMAINVYYYYI MIBIEMYYYY1 MAIM A X COMIMRC5AL GENERAL Lwea TY 1,000,000 EACH OCCURRENCE. s CLvVASJNUt a OCCUR MPP3376W 7r2712022 7127/2023 DAMAGLSE5 tE TOE RENTED l I 500,000 PREI/ .,or auniu�s MEC ESP:a.' ore xrsoni I 10,000 PERsYTNAL 6 ALI'.INJL'Y I 1,000,000 -EN1 ACCREC.ATE LIMP APPLES PER GENERAL ALLRECATE I 2,000.000 ICY p I.O,; P.' 2,000,000 PR70UCTS-COMDP AGO IITHFR ,S e AUTOMOBILE LNAMILITY tS1N(LE LIMIT I 1,000,000 AP&AUTO 1020110392 1I11712022 $11712023 WIN y mince iPer ORui e t OWNED SCHEDULED AUTOS C. ' X hAUUTTO.QS�y�,Ep BOORY INJURY,Fur aa:,urrrtl S X MA CK'+ X now TC6 ONLY IPte afec t RTY o ,1 , I UMBRELLA LMS OCCUR EACH OCCURRENCE S EXCESS use CLA4Ms.s.DE A:;GHL:;ATL 1 DEC I I RETENTIONS • C MO EMPLOYERS'",M,WARM X I S ATUTP I I t AM•PROPRIE CR,PARTsERE%EcuTttis WCC-500-502Hd43-2023A 1(25/2023 112512024 5,00,000 Ain PROIRErig EACLUCED% Y N A El EACH ACCJOfsa �acc�s DISEASE-EA EMPLOYEES �0,000 fI. N1PIIDNOfCPERAIIONSoda* Ei DISEASk-POLICY LIMIT j 500,000 I OESCRPTION OF OPERANONO LOCATIONS'YEHICLES tACORO 101.AOGEo-+ai Re-eras Scr ec 10'may be attached N more seete is required) Home Depot U.S.A.Inc.is named as Additional Insured with respects to General liability. Eugenio Ciubotaru as excluded from the Workers'Compensation Policy, CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRBBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE TREOF,Home Depot U.S.A.Inc ACCORDANCE WITH THE POLICY PROVISIONS NOTICE 1NLL 8E DELIVERED IN 2455 Paces Ferry Rd C-11 Atlanta,GA 30339 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) V1 1988-20 1 5 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD r tre+Maud"Mina x riM t,ocu m.c,lhca co=c+wt:)1'4:M.ire co,Potikr%03,164 I sc reaua and dY 3nmm,ai Stanciamis VIIP Public Safety ,, I M ~ * le,.4 ^taere- Mass. Licensee Details Demographic Information ru1i Name EUGENIU CIUBOTARU Omer Name License Address Information City: S nt+g"eid State MA Ziptode 01109 C untry fated States License Information L.censeNo CSSL-t06106 LIcenseTipe Construction SuoecvsorSpec:att; Profession Baiting Licenses Date of Last Renewal 10.'13r2022 issue Date t 12:2017 E peat'on Date 9,29 2024 L cense Status Active Today s Date 10 14:2022 Secondary License Type Doing Buskness As Status Change Reason License Renetva, Preres 51teInforimrtisn Licensee. CiUBOTARU,€U6E-NiU Retabonsi p: Attribute Of pcertse No: CSSL-106106 No Available t ocumenis -i:YI,Mvr IPCommonwealth of Massachusetts Division of Occupational Licensure Board of Building Re ulations and Standards Constructiupei' ,r Specialty CSSL-106106 . , �� elcpires: 09/29/2024 EUGENIU CIt BOT•1. .lot 23 BENHAM $T • ! 1 SPRINGFIEL��;M • -'•t -` ipt .:: I, a :, ,i 0IJ�'Ai1 J CQ......:..Siv wr mot.. ri y _1~-r� ,fir. Construction Supervisor Specialty Restricted to: C SSL-WS -Windows and Siding Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. For information about this license Call (617) 727-3200 or visit www.mass.govfdpl Office of Consumer Affairs and Business Regulation 1 WO Washington Street-Sate 710 Boston,MaSsadtusetts 02118 Home lmcuovement Conuacior Regrabation ve cc.t:c,ar+ce, E'KTEf7K R trEte000.14000011e,tv,C nnpikyrr 1871966 23 SPOON rr E+Oooton 35tO12323 SPRs Gc D.Me of toy Add+o.aft*;Anton Ca.a. Moo Ca+rw aaw s NOM SIONO'irllwon CONTNACTOs oeeya+tuau wad wr loOoduu oar onto ME%Cort.o atm bee,dt.emn.isn 9oti.N 4.wa now"ro MNifilidat d Wit: �E a...44 Or Ca... an.M o.a w i.na . ne %vv..l nn omval 4uhe £XTLA$ 0 r N.J'«£i,H��3O0t4.roC acwtun.NA$07td nse+ 7+0 ELOEM$Jai CT$o ...•. 9s4iY3rlw O WA Ow* Not.aLd$NOrout signol0n IlAtirsermury • i &PI en Lu Q ,t aucnorizeiio Permits LLC pun rtnus P F� using my License FI 106106 ana my H1C Registration # / $$ 6 6 6 "�•�cuestions please call me at: ((4 / 3) 3 3 S 3 ?09, Lnsuiner k.,ompany IN Bin.. Q o R. Rout EXTEREM-01 MARDEI A�CORO CERTIFICATE OF LIABILITY INSURANCE DATarino2z Yl 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(ees)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 Neu of such endorsement(s). PRODUCER 5ASIVCT Deborah Marino Canary Blomstrom Insurance Agency PHONE FAX 81i8 Springfield Street L tw E.rt1413)750.0022 I FA,riot 1413)786-7004 Feeding Hills,MA 01030 Asy_dmarinorCanaryblomstrom.Com NMANRISI AFFOIeoINo COYERAoE NAIL! INSURetA.NGM Insurance Co. 14786 INSURED tnsunnn e•Arbelia Protection Insurance Company 41360 Exterior Remodeling Group Inc. INSURER C 21 Benham St NIVREA Springfield,MA 01109 NSVRtR t eisuele 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 REQUIREMENT, TERM OR CONDITION Of ANY CONTRACTOR 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 PAD CLAIMS. INSR hoo1..3een' NeXT EPP POLa:Y FRP LTA. TYPE OF IN MO DOD O POLICY NUMB a ilMa�rYYYYI I1414DELTYrri Laws A X COMMERCIAL GENERAL LABILITY 1.000.000 GLAIrA,.Al4UL MUD" MPP3376W 712712022 7:2712023 D.wAGEESU a TO RENTED ! 500,000 P+7£MR 2cmm+ar I MEE EXP?.I',Y 9P11 ntaur» ,I 10.000 r...- t'€HOUNW.A NJ':INALATY ! 1,000.000 OEM AGGREGATEGATE LIME-AFNLIES PER GENERAL AGGREGATE 1 2,000,000 PGA ICY a 71CA :or; 2,000.000 i PRODUCTS-..41NF'C7P AGO-I OTHER 8 `TOMOBLE LAAIJTY EnA accident SINUiE uu1T ! 1.000,000 ANY ALTO 1020110392 Sf1712022 8/17/2023 UUDLY INJURY it"er rat»c.• A! ^' OWNED SCHEC U.ED 1ALJTOr3 OIL', AUTOS BODILY INJURY I NI Ao_a1.fa ! X AUTOS cio X I+AJ T4-G50NlY PROPERTY i'Lt;caro'IJ MAIM ! UMBRELLA LAB :.'000R EACH OCCURRENCE I EXCE55 tMS C.-AIMSMIC E AGGRL-t3ATL f DEG I I RETENTION E t AND EEMPLLOYC EERRi'LMMMN 13�QITY TATUTE 1 1[l"• ANY PROPRIE'OR,PARTAERETECUTI Y N A E1 EAdtt AO(',IDENT aCER A E%OL UDEB% ^ I E,LD4S£ASE-EAEMPLCYEE I yy�,CC5�c'*Y 4fl CEOCttIPIiiN CF OPERA!IONS,Sow a A$L•^OLerY LIMIT• t 1 DESCRIPTION OF OPERATIONS LOCATIONS I VEHICLES IACORD 101 Oulditxsul Reesarts Scrvduie+say be attached if mon spats Is"squbed4 Home Depot U.S.A Inc.Is named as Additional Insured with respects to General Laabiluty CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICES BE CANCELLED BEFORE Depot U.S.A.Inc THE EXPIRATION DATE THEREOF. NOTICE WLL BE DELIVERED IN Roma Paces U.S. . Cr11 ACCORDANCE MITH THE POLICY PROVISIONS. HISS Atlanta,GA 30339 AUTHOSIZED REPRESENTATIVE l r tr. ii t, ACORD 25(2016103) 01988.2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered mares of ACORD ■ Off Afface of Consumer i Bus ■ ness Regulation (OCABR) HIC Registration Complaints Registration # 112785 Registrant HOME DEPOT USA INC Name Courtney Howe Address 2455 PACES FERRY RD C-11 HSC City, State Zip ATLANTA, GA 30339 Expiration Date 04/22/2025 Complaints Details No complaints found for this registrant. Go Permits, LLC 105 Buttonball Lane GO Glastonbury, CT 06033 PERMITS Scott Doughman Phone: 860-952-4112 Fax: 860-430-6719 scottdoughman@gopermits.org Re: Massachusetts Solid Waste Affidavit Good day, Please find attached locations where the installers can bring their debris from the jobs. These are all Home Depot USA, Inc. locations. • 72 Shaker Road, Unit 2 Enfield, CT 06082 • 32 Scotland Boulevard Bridgewater, MA 02324 Gallant Moving & Storage • 375 Airport Drive Worcester, MA 01602 Euro-American Worldwide Logistics • 12 Linscott Road Woburn, MA 01801 Silvas Transport Inc • 50 Maria Ave Johnston, RI 02919 Vito's Express Thank you, Go Permits e - ome I epo - erma T a ue of Products Manufactured by Simonton )ated: 5/30/2018 Without Grids With Grids Style Glass Package Glazing Spacer lG V SHGC U SHGC '.A I N S S lair with Argon/ Fact Fact ' C'C 6500 wning 6500 Base ProSolar Supercept 7/8" 0.26 0.23 , • • • 0.26 021 • • •� asement 6500 Base ProSolar Supercept 7/8" 0.26 0.24 • • • •� 0.26 0.22 • • • • ransom 6500 Base ProSolar Supercept 1' 0.27 0.32 • • 0.27 0.29 • • ,ouble-Hung 6500 Base ProSolar Supercept 7/8" 0.29 0.26 • 0.29 0.24 • • • icture Casement (NH) 6500 Base ProSolar Supercept 7/8" 0.26 0.28 • • 0.26 025 • • • • icture 6500 Base ProSolar Supercept 7/8" 0.27 0.29 • • 0.27 0.26 • • Panel Slider 6500 Base ProSolar Supercept 7/8" 0.29 0.26 • 029 0.23 • • • Panel Sliders 6500 Base(s 21 Sgft) Pro Solar Supercept 7/8" 0.29 0.26 0 0.28 0.23 • • e ,500 DOORS arden Door(CH) 6500 Energy Star ProSolar SUN Super Spacer 1" 0.30 0.24 I •I Ill 0.30 0.21 I •I •I •I 0 atio Door INOVO 6500 Base Pro Solar Super Spacer 1" 0.28 0.26 0 0.31 0.23 • 0 0 0 1 00 Homes located everywhere EXCEPT:Arizona,California,Idaho,Nevada,New Mexico,Oregon,Utah,and Washington. wning(Inc Hopper) 6100 Base Pro Solar Intercept 7/8" 0.27 0.24 0 0 o t 0 0.28 0.21 0 0 a • asement 6100 Base Pro Solar Intercept 7/8" 0.27 0.24 • • o c 027 0.22 • • • • git% tTu 6100 Energy Star Pro Solar Supercept 3/47"--0.3Q} 0.30 • 0.30 0.27 a _ • • iure Casement(No Hinge) 6100 Base Pro Solar Intercept 7/8" 0.27 0.28 • • 0.27 0.25 • • • • iicctuurre-��� 6100 Base Pro Solar Intercept 3/4" 0.27 0.31 • • 0.27 0.28 • • J'.�pSLSlwler� 6100 Base Pro Solar Intercept 3/4" .30) 0.28 • 0.30 0.27 • Panel Slider 6100 Base Pro Solar Intercept 3/4" 0.30 0.29 • 0.30 0.27 • 100 Doors Homes located everywhere EXCEPT:Arizona,California,Idaho,Nevada,New Mexico,Oregon,Utah,and Washington. atio Door INOVO 6100 Energy Star Pro Solar Super Spacer 1" 0.28 0.26 • •_ 0.28 0.23 ® 0 0 0 atio Door NARROW FRAME 6100(PD05)Base Pro Solar Intercept 3/4" 0.28 0.30 I• • I �0.28 0.26 I 0 0 I 6200 Homes located only in following markets:Dallas,Denver,Detroit,Phila,Northern NJ,Long Island,NY. wning 6200 Base Pro Solar SHADE Supercept 3/4" 0.27 0.25 _ • •V • 0.26 0.23 • • • • asement 6200 Base Pro Solar SHADE Supercept 3/4" 0.26 0.18 a • a • 0.29 0.17 • • • • icture Casement-NH 6200 Base Pro Solar SHADE Supercept 3/4" 0.25 0.21 • • a •_ 0.25 0.19 • • • • icture Window 6200 Base Pro Solar SHADE Supercept 3/4" 0.26 0.24 • • • • 0.26 0.22 • • • • Ingle Hung 6200 Base Pro Solar SHADE Supercept 3/4" 0.28 0.23 • • • • 0.28 0.21 • • • + ingle Slider 6200 Base Pro Solar SHADE Supercept 3/4" 0.28 0.23 0 0 • 0.28 0.21 • • • Panel Slider 6200 Base Pro Solar SHADE Supercept 3/4" 0.28 0.23 a a • 0.28 0.21 • • • i to r m B re a k e r Plus 300VL Homes located in coastal areas. wning SB+300VL Energy Star PS SUN/Lami Supercept 1' 0.26 0.23 • • • • 0.26 0.21 • • • • asement SB+300VL Base PS/Lami Super Spacer 1" 0.25 0.23 • • • • 0.25 0.21 • • • • ouble Hung SB+300VL Base PS/Lami Super Spacer 1' 0.29 0.25 • • • • 0.29 0.23 • • • • rider SB+300VL Base PS/Lami Intercept 1' 029 0.25 • • • • 029 0.23 • • • • atio Door SB+300VL ETC 366 PS Shade/Lami Super Spacer 1' 0.30 0.19 • • • • _ arden Door(CH) SB+300VL Base PS/Lami Super Spacer 1' 0.30 0.28 • a 0.30 025 • • • • Dots indicate Energy Star certified for that zone Please Note: Simonton Windows may substitute East&West windows given the requirements of each order. liniAir,";' r2/.7Zi,Irl:2;4:17MZTV:14Mk- .. 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Or31:.s....'.., .1 . . ., • .).A'*4.:1.•'.-',, c.A.a1IVI.J. tailtii t.;,V,.. et,-4.2 44 . . , liviliganym- °Lug ..;,.. 04 -=' mi 39 ' A 5 n ,n.t...qac,,7 44 :-,af - c 4-,q ei.:oatuic701Pail, WINDOW SPECIFICATION SHEET - Spec.Sheet#: F33301695 Sheet: 1 of 1 Customer: Chris Kent Job#:F33301695 Consultant: Ronald Engelbrecht Date: 04/05/2023 New Window Existing Window Hinge Locations Measurements Grids Product Options Labor Options From outside, Left to Right Bays,Bows Location Color Rough Opening •of bars #of bars Csmnts,1 Pnl, use L,R or S Glass Misc Items Hardware Code Screens For doors use c m Mull "S"=stationary or W� LL E '4 o 4 o "X"=operating C Room Floor Code WrapsStyle co 4 5 £ .jy � 2 .t (Y/N) Style Code Series Code u § = 5 1—c i 3 _ .� > 2 3 > xo STD,White, GlassPack: WRAP,LSR 1 LIV 1st 1 PNL Y 2 PNL 6100 WH WH 58 30 86 Standard X S STD,White, GlassPack: WRAP,LSR 2 LIV 1st DH- V DH 6100 WH WH 30 58 88 Standard ALDER STD,White, GlassPack: WRAP,LSR 3 LIV 1st DH- V DH 8100 WH WH 30 58 88 Standard ALDER " STD,White, GlassPack: WRAP,LSR 4 LIV 1st DH- Y DH 6100 WH WH 30 58 88 Standard ALDER • STD,White, GlassPack: WRAP, 5 LOFT 2nd DH- Y DH 6100 WH WH 42 62 104 Standard HIGH,LSR ALDER SPECIAL CONSIDERATIONS: 1:White,2:White,3:White,4:White,5:White Line Level Notes: 1.Rip for rotten sill 2.Sill rot for rip Wrap Color 3.Sill rot for rip 4.Sill rot for rip Job Level Labor&Notes: Loft window must be installed from outside ladder with 23x38 loft opening Interior Casing Type Bay or Bow window: Seatboard material(vinyl only-Birch or Oak) Bay Project Angle(30 or 45) Bay Flanker Type(DH,SH,or Csmnt) Top of window to soffit(Inches) If tied to soffit,color of softl material I have reviewed and agree with at the job specifications above and the Construct Rod(Yes or No)• Special Terms and Conditions on the following page Garden Window: Seatboard Material(vinyl only-White Pionite,Birch or Oak) ` • Home Improvement Agreement: Page 1 Home Depot License#'s -For the most current listing visit www.Homedepot.com/LicenseNumbers MA: 107774, 112785 Ronald Engelbrecht Salesperson Name Registration#(Req. in CA,CT,ME,MD,MI,NJ,DC) Home Depot U.S.A.,Inc.("Home Depot") or Authorized 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. 1. Service Provider Contact Information The Home Depot The Home Depot Service Provider Contact Name Service Provider Company Name (203) 265-7037 customercancellationnortheast@hom MA: 107774, 112785 Phone# SgRiTecnvider Email Address Service Provider License#(s) 2. Customer Information Kent Chris New England West F33301695 Customer Last Name Customer First Name Store#/Branch Name Customer Lead/PO# 352 Spring Street Florence MA 01062 Customer Address City State Zip (413) 695-5451 ck6256@gmail.com Home Phone# Work Phone# Cell Phone# Customer Email Address 3. NOTICE OF RIGHT TO CANCEL YOU MAY CANCEL THIS AGREEMENT WITHOUT PENALTY OR OBLIGATION BY CONTACTING THE SERVICE PROVIDER OR STORE DIRECTLY; EMAILING SERVICE PROVIDER AT: customercancellationnortheast@homedepot.com OR DELIVERING WRITTEN NOTICE TO HOME DEPOT AT: 1070 N. Farms Road, Unit 3 Wallingford Wallingford CT 06492 Address City State Zip 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: 04/05/2023 Customer's ignature Date . • • ri ?IA17.4?:. 111;1' Ma 1.61 Pi11.2.1$1 i. ir lift it:.4 y., fV, ^TO ( V . 11(.i "jt : • . lo; to) v.0)1/Gig Y)1 lrtT• - VV • VLV 4 I , it)) • - z ' • ••.:• • • • ;•:,! t . , ••':1':1 • • ,.;•ry • rp, FV. 7'1! tT ,../[ :,)/ T •q; . • f(4 j rifflf.tPts • •V et ..; 1 :) i •• 11-1';YA 71(.) 1'1-Cole 4,1-Y()') In() T14...ril fj .,)"T .111..);(.1 I k * :1111:141110i,i'l 1 :4 /51-7r..! JPI la 3,c1.0# 3')1 /$ d 4111 11% 1( ';lag 1 tUfl J i-r; !'(v/ ,1 jT LA IF .) ,fAl71...!..11(1 r C I ON; r ' • :111-1 ;`', TAT 1".1.1 liff 10 1'14.,41/11111 '03; :1Ti.1.? :ffiT .(10151..14 1 13'.);,./:> 411(1 %-..3•41'1()5-M 10.f 1:1 ,,, 'fa e1lfP'4. .) .1$:!`i 11.11'1) 1(1? 'el .4(4) 11 31f()!•.' 4/, .e.°21 7 0', e',e,1/1;0., )ti (011 I:11 .41111 ; 11 ti 1/e 11 U .(1 (8)11 $4 1:41 J (1);•`. .;:11;0•If t 111.1 ; 114 ; /J. )1"/W-1?. $41'301 ,1 .,i1.51;',;-. Hi) ;,i() .(1: 54:171,11c fol'i-1(1;00.) "<iffii1`lf,31S; A071 JO ifi fll();:i It ;Cre si /Ai --0,,11. )411(1 /,31,q11.;•.•: 1(;y 1""ftr(), 1. '101 ..111D -10413if :}1/01-1 _,AST ; ..191;19:11M ',4() I11;7) .J() Il I3;)C1.1.W41)./AD/ 31 Ii ) I I ) ' 1 , 1,11 st. 01 •1.0 ): ! ' 't • , • � Home Improvement Agreement: Page 2 4. Description of Work to be Performed A detailed description of the work to be performed is included in the paragraph entitled Scope of Work, Specification, Customer Summary Sheet, Quote Form, Estimate, Invoice or Measure which is included in this Agreement. 5.Anticipated Delivery Date/Installation Schedule Approximate Start Date: 10/02/2023 Approximate Finish Date: 11/01/2023 All dates are approximate and subject to change based on unforeseen events including inclement weather, permitting delays, and delays in confirming insurance coverage of Your claim for any repair, if applicable. 6. Electronic Records Authorization You are entitled to a paper copy of this Agreement if you choose. If you consent to an e-mailed copy, your consent applies to this Agreement and all subsequent documents and written communications related to this Agreement. By contacting your Service Provider,you may update your email address,withdraw your consent,or obtain a paper copy of the Agreement or related documents at no charge. By providing your consent and verifying your email address above, you confirm that you have access to a computer that can receive and open emails and PDF documents. 7. 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: $ 4792.75 Includes all applicable taxes. Excludes finance charges.* Sales Tax: $ 0.00 (If applicable, total amount of taxes included in Contract Price) Maximum deposit ONLY applicable in MD, MA, ME (33%), NJ, WI(99%) Deposit% 25.0 Deposit Amount$ 1198.19 I Remaining Balance $ 3594.56 8. Finance Charges Any interest payments or other finance charges will be determined by Customer's separate cardholder or loan agreement, to which Home Depot is NOT a party, and will be in addition to Customer's payment under this Agreement. Customer is subject to the terms and conditions of the cardholder or loan agreement, as applicable. No funds should be made payable to Service Provider, however, Service Provider may collect Customer's payments made payable to Home Depot. 9.Acceptance and Authorization By signing below, you authorize Home Depot to: (a) arrange for Service Provider to perform any Services or (b) order and arrange for the delivery of special order merchandise, including special order merchandise that may be custom made, as specified in this Agreement. Do not sign if blank or incomplete. (Service Provider's or permitting information may need to be provided to You later.)By signing,you acknowledge that: (i)You have read,understand, and accept this Agreement in its entirety, including the General Conditions and State Supplement, if any; (ii) You are receiving a complete copy of this Agreement; (iii)all rights and interests under this Agreement are solely vested in the person listed as"Customer" above; and (iv)Electronic signatures will be deemed originals for all purposes. X �_�____-- 04/05/2023 Customer's Signature Date X /s/The Home Depot 04/05/2023 The Home Depot Digital Signature Date For questions related to your installation, contact Service Provider at (203) zbb-/U� For any other concerns, contact The Home Depot at 1-800-466-3337 )t.k ja t A (A,/%1(J C.tA VI it‘ IOC ‘11, n:, ECL dtiGeirti. t.cpttGq flieflifri;ffir GOJSPICI ?.6L./.!Cf; ;1; 1(,,J;4 i)g j . ) I.) 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";,;(7.r.f•;(;g11.,,; 1' L) .: ttql)01.•11 01 #01.r N, • i'113,•"; ttlit.(10.1 61114,1,1 14, Scope of Work Kent Chris New England West F33301695 Customer Last Name Customer First Name Store#/Branch Name Lead # Job#: (Internal Reference) Products: Spec Sheet(s)#: Project Amount Reference) F33301695 Windows Entry Doors F33301695 4792.75 Windows Entry Doors Windows Entry Doors Windows Entry Doors Windows Entry Doors Sales Tax 0.00 Total Contract Amount 4792.75 Notes: Warranty: The warranty on the work identified above is listed in the General Terms and Conditions, or if applicable, specified in the following documents: Simonton 6100 Warranty Name(s): ,1 ti 1 The Home Depot General Terms & Conditions 1. DEFINITIONS: "Agreement" means (I) the Home Improvement Agreement between You and Home Depot, (II) the following listed documents, and (III) any documents referenced in or attached to any of the following listed documents: (a) any Change Orders; (b) the State Supplement, if any; (c) these General Terms and Conditions ("General Conditions"); (d) extended installation warranty documents, if any; and (e) the Scope of Work. "Defect" means any Services that are found to be non-compliant with manufacturer's installation instructions. "Home" means the real property, fixtures and any physical improvements where the Services are performed. "Services" means(i)the delivery and furnishing of goods, equipment, materials, and hardware; and (ii)any related labor and services, including without limitation, construction, consultation, fabrication, erection, installation, inspection, maintenance, repair, and testing. "Scope of Work" means a detailed description of work or Services to be performed, including, but not limited to, any quotes, schedules, invoices, specification sheets, proposals, confirmation emails or otherwise. "Service Provider" means an independent contractor, authorized by Home Depot, and its employees, agents, and subcontractors. "Work Area" means any property, buildings, or structures necessary for the staging, temporary storing and performance of the Services. "You"/"Your" means the customer identified in the Agreement 2. HOME DEPOT'S RESPONSIBILITIES: Home Depot or Service Provider will complete the Services in a workmanlike manner and in accordance with applicable law without causing damage to Your Home,provided, however, that Home Depot or Service Provider will not start or continue with any Services upon discovery of any condition at Your Home that Home Depot or Service Provider deems in its sole discretion to be hazardous, unsafe or, materially changes the Scope of Work. Unless specifically contracted to do so, neither Home Depot nor Service Provider is obligated to repair such pre-existing hazardous or unsafe conditions. 3. ASSIGNMENT/SUBCONTRACTING: Home Depot and Service Provider may assign this Agreement, or any right herein, or any monies due or to become due hereunder, and may delegate or subcontract any obligations or Services hereunder without Your consent. This Agreement will not be assigned by You without first receiving Home Depot's written consent, which may be denied in Home Depot's sole discretion. 4. YOUR RESPONSIBILITIES:(a)Payment: You agree to pay Home Depot in full for the Services pursuant to the terms of this Agreement. (b) Safe Access: You agree to provide Home Depot and Service Provider Safe Access to Your Home. Safe Access means safe and complete access to the Work Area, including,without limitation: (1) obtaining in advance of the Services consent,permission,or relief from any covenants,easements,restrictions,or other legal encumbrances affecting the Work Area; (2) providing the location of utilities, whether underground, concealed, overhead or visible, to Home Depot or Service Provider; (3)removing from the Work Area physical impediments, hazards, and building code or zoning violations that affect directly or indirectly the Work Area; (4) removing unsafe working conditions and hazardous materials, including environmental hazards, from the Work Area; (5)providing sanitary facilities to Home Depot or Service Provider convenient to the Work Area(or, alternatively, paying for the rental costs of such facilities);(6)providing all utilities, including without limitation, power,water,ventilation and climate control,in and for the Work Area;(7)removing from and protecting against minors, pets, guests and visitors in the Work Area; (8) keeping permits, if required, visible at all times; (9) disengaging, suspending or terminating any security systems protecting the Work Area; (10)providing adequate temporary storage space as needed for Home Depot's or Service Provider's performance of the Services; and(11) not interfering, impeding, impacting or otherwise disrupting the Work Area at any time during Home Depot's or Service Provider's performance of the Services. (c)No Performance: Services are to be performed by Home Depot or Service Provider. If You attempt to perform or assist with the Services in any way, You assume all risk for property damage and for injury to Yourself and others. �`� The Home Depot General Terms & Conditions 5. MODIFICATIONS AND CHANGE ORDERS: Without invalidating this Agreement, You may authorize Home Depot or Service Provider to perform Services beyond the scope of the Agreement("Change Order").A Change Order will be issued by Home Depot or Service Provider on behalf of Home Depot, which You may accept by signing. Upon Your signing of the Change Order,it will become part of this Agreement, subject to all of the terms of the Agreement. Change Order may also result from Home Depot or Service Provider encountering conditions at the Work Area that impact, impede or otherwise interfere with the performance of the Services, requiring an increase in cost, time,or both. Following the discovery of any conditions that impact, impede or otherwise cause the Work Area not to have Safe Access, Home Depot may immediately ask for a Change Order or discontinue the Services without further obligation to You.Home Depot may also ask for a change order in the event of errors or omissions in measurements or quantities used to determine the Contract Price. If You decline a Change Order request, You or Home Depot may terminate this Agreement. 6. TITLE AND RISK OF LOSS: The title to and risk of loss for any materials or goods provided to You that originate from Home Depot will pass to You when paid in full by(1)You or(2)the Service Provider as part of the Services. Title to any other materials or goods provided by Service Provider will pass to You upon completion of the Services. 7. WARRANTY LIMITATION ON WARRANTIES AND DAMAGES: (a) Warranty: Unless otherwise stated in the Agreement, Home Depot warrants for 1 year from the completion date (the "Warranty Period") that all Services will: (i) be performed with good workmanship and (ii) conform to the requirements of the Agreement. During the Warranty Period and within a reasonable time after receiving notice from You of a warranty claim, Home Depot may, at its sole discretion (I) correct or replace each Defect, (II) authorize the correction or replacement of each Defect; or (III) remove each Defect and refund all or a proportional amount of the Contract Price thereof to You; provided, however, that all warranties are voided if(1) anyone other than Home Depot or Service Provider performs work upon or otherwise modifies any materials or Services provided under this Agreement; or (2) You fail to pay Home Depot in full as provided in this Agreement. Any warrantable corrections, replacements or repairs made in accordance with this Agreement will not extend the Warranty Period. (b) Limitation on Warranties: THE WARRANTIES PROVIDED IN THIS AGREEMENT ARE STRICTLY LIMITED TO THE FOREGOING EXPRESS WARRANTIES CONTAINED IN THIS PARAGRAPH IN THE WARRANTY SECTION OF THE AGREEMENT, IF ANY. YOU ACKNOWLEDGE AND AGREE THAT NO OTHER WARRANTIES ARE MADE OR GIVEN BY HOME DEPOT OR SERVICE PROVIDER,INCLUDING ANY WARRANTY FOR FITNESS OF PURPOSE, WARRANTY OF MERCHANTABILITY,OR ANY OTHER ORAL,EXPRESS OR IMPLIED WARRANTIES. HOME DEPOT'S EXPRESS WARRANTIES ARE VOIDED FOR ANY DEFECT CAUSED BY ABUSE, MISUSE, NEGLECT, ACTS OF GOD, LACK OF PRESCRIBED OR STANDARD MAINTENANCE, OR IMPROPER CARE/CLEANING. ANY MANUFACTURER'S WARRANTIES PROVIDED FOR GOODS, MATERIALS, OR EQUIPMENT WILL BE PASSED THROUGH BY HOME DEPOT TO YOU, AND YOU AGREE TO LOOK SOLELY TO SUCH MANUFACTURER FOR REMEDY OF ANY DEFECT IN SUCH GOODS, MATERIALS, AND EQUIPMENT. HOME DEPOT MAY ASSIST YOU WITH WARRANTY CLAIMS AGAINST MANUFACTURERS. (c)Limitation on Damages.Home Depot will not be liable to YOU for indirect, incidental, special, punitive or consequential damages RESULTING FROM PERFORMANCE OF THE SERVICES, including, BUT NOT LIMITED TO, damages for lost opportunities, OR lost profits. 8. TERMINATION: This Agreement may be terminated by Home Depot for its convenience, and by either party for cause if the other party fails to correct a material breach within ten (10)days after receiving notice from the non-breaching party identifying the breach.In the event Home Depot terminates this Agreement because You fail to provide Safe Access to perform the Services, or if either party terminates the Agreement because You decline a Change Order request resulting from unforeseen, hazardous, or unsafe conditions or conditions that materially changes the Scope of Work,then You will pay Home Depot for Services provided through the date of termination plus any costs or expenses incurred by Home Depot or Service Provider as a result of the termination. The Home Depot General Terms & Conditions 9. CHOICE OF LAW: SEVERABILITY: This Agreement will be governed by and interpreted in accordance with the laws of the State where the Project is physically located. The parties intend for the terms and conditions in the Agreement to be complementary, consistent, and enforceable under applicable laws. In the event any term or condition in the Agreement violates applicable law, such term or condition will be severed from the Agreement, but only to the extent necessary to avoid such violation, without invalidating any other terms and conditions of the Agreement. 10. ENTIRE AGREEMENT: This Agreement is the final, integrated, and exclusive expression of the parties' understanding, which supersedes all prior offers, orders, understandings, representations, proposals, confirmations, and negotiations between the parties, whether oral or written. No course of dealing, usage of trade, course of performance, course of conduct, or any other evidence of additional or different terms will be admissible to contradict or vary any term in the Agreement. 11. SECURITY INTERESTS: LIENS: If You make all payments as required under this Agreement, no security interest will be placed against Your property by Home Depot. If a security interest is placed on Your property, it creates a lien, mortgage, or other claim against Your property to secure payment and may cause a loss of Your property if You fail to pay as requested. After paying on any completed phase of the Services and before making any further payments, You should request from Home Depot or Service Provider a signed, unconditional release from, or waiver of, any right to place any claim against Your property applicable to the work then completed. You may ask an attorney about Your rights to discharge security interests. 12. RETURNS: Custom order merchandise (i.e., goods that are custom made, uniquely altered, colormatched, shaped,sized,or otherwise uniquely designed or fitted to the requirements of a particular space)is non-returnable, and its Contract Price cannot be refunded unless Home Depot or Service Provider(1) incorrectly ordered item, or (2) damaged item beyond repair. Special or custom order merchandise may be returned, and a refund for all or part of the Contract Price provided, in the discretion of Home Depot. Please contact The Home Depot for additional details concerning returns. 13. AGREEMENT/SERVICE ORDER COMMUNICATION PREFERENCES: You can visit www.homedepot.com > In-Store Special Orders at any time to access Your account for the following: (1) Update Your Agreement/ Service Order Communication Preferences(email,text,Auto Call); (2)Contact Home Depot for order assistance; (3) View latest order status; or (4) Take action to schedule pickup for Your Service Orders. To stop any of the following communications You may visit www.homedepot.com > In-Store Special Orders to access Your account to update Your Agreement/Service Order Communication Preferences, contact The Home Depot, and take action on orders. If You signed up to receive updates about Your Agreement/Service Order(s) via: (a) Text Message Communications, You may receive multiple messages per order (including current and future orders) via automated technology to the mobile phone number You provided. The total number of messages received depends on the number of orders placed and order activity. Standard message and data rates apply. Not all carriers covered. You can text STOP to 97710 to stop (You will be sent a confirmation message). Call 1-877-467-2581 or 1-800-466-3337 for help; (b) Electronic voice communications (Auto Call), You may receive multiple pre-recorded phone calls per order (including current and future orders) via automated technology to the phone number You provided. The total number of calls received depends on the number of orders placed and order activity. You can press 9 during a call to opt out or call 800-HOME-DEPOT for help; or (c) Email Communications, You may receive multiple Emails per order (including current and future orders) via automated technology to the Email address You provided. The total number of Emails received depends on the number of orders placed and order activity. 14. LEAD PAINT:Homes built prior to 1978 may require additional testing to determine if lead paint is present, and additional precautions if lead paint is present. You will be informed by Your Service Provider of any additional costs resulting from lead paint requirements prior to performing the Work. For additional information, visit www.epa.gov/lead/renovation-repair-and-painting-program. Go Permits, LLC 004 105 Buttonball Lane Glastonbury, CT 06033 \sssot)ERIVIITS 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 supporting documents. Home Depot USA, Inc. sold the job and is the G.C. HIC 112785 Exp. 4/22/23 Workers Comp — Ace American Insurance Co. Policy WLRC50668150 (MT) Exp. 3/1/24 Eugeniu Ciubotaru of Exterior Remodeling is the sub-contractor. CSSL-106106 Exp. 9/29/2024 / HIC 187666 Exp. 5/9/23 Workers Comp.Associated Employers Ins. Policy WCC-500-5028443-2023A Exp. 1/25/24 All licenses and insurances are 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: 860-430-6719 Email: permits(a�gopermits.orq • If you unable to mail the permit to the homeowner please send to the below address and we will ensure 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 to get it. Thank you, Go Permits