13-066 NOTICE OF RIGHT TO CANCEL
Your Right to Cancel
You are entering into LOWE'S Installed Sales Contract Number S` dP.Vci3 (the "Contract ") that
may result in a lien or security interest on your home in which property (the "Property" ) is to be in-
stalled pursuant to the Contract. You have a right to cancel the Contract, without cost, penalty or ob-
ligation, at any time prior to midnight of the third business day after the latest of (i) the date of the
Contract, which is 11ee_p 17 t (year), (11) the date you received this Notice
of Right to Cancel, and (iii) if you have paid or will be paying for the Contract by using your LOWE'S
private label credit card, the date you received your Truth -In- Lending disclosures in connection with
such credit card.
Effects of Cancellation
If you cancel the Contract, the lien or security interest on your home is also canceled. Within 20 cal-
endar days (except in Connecticut where the period is 10 business days) of receiving your notice of
cancellation, we must take any necessary steps to reflect the fact that the lien or security interest on
your home has been canceled, and we must return to you any money or property you have given us
or anyone else in connection with the Contract.
How to Cancel
If you decide to cancel the Contract, you may do so by notifying us in writing, by mail, telegram, or personal delivery, at:
LOWE'S ff 19 g 35Se ((S 09(Ite 4 /L1,1 -._ l63S •
You may use any written statement that is signed and dated by you and states your intention to can-
cel, or you may use this notice by dating and signing below. Keep one copy of this notice no matter
how you notify us because it contains important information about your rights. To be effective, you
must drop your cancellation notice in the mailbox, file it for telegraphic transmission, or deliver it to us
by other means at the above address no later than midnight of iW c --e/4 f E' a i 0?01(,
(year) (or midnight of the third business day after the latest of the three events listed above).
1 WISH TO CANCEL.
(Customer's /Resident Owner's Signature) (date)
Print Name _ _
ACKNOWLEDGEMENT OF RECEIPT OF DISCLOSURES AND CERTIFICATION
On this 17th day of December, 2011 (year), each of you hereby acknowledges receipt of two (2) cop-
ies of the foregoing Notice of Right to Cancel; each of you who is a party to the Contract hereby ac-
knowledges receipt of one (1) copy of the fully executed and dated Contract; if any of you has paid or
will pay for the Contract by using your LOWE'S private label credit card, you hereby acknowledge
having received the Truth -In- Lending disclosures in connection with such credit card; and you certify,
represent and warrant to LOWE'S that you are all of the customers who signed the Contract and all of
the persons who own and reside in the home in which t e Property is • be installed pursuant to the
Contract.
(SEAL) / 1 _ � (SEAL)
Print Name Print Name
_(SEAL)
Witness
Print Name
VOTE : Each Customer who is a party to the Contract and each Resident Owner of the home must sign above.
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to recover its reasonable attorneys' fees and expenses as provided by N.C. Gen. Stat. Section 6 -21.2 or other controlling law. The parties agree that this arbitration agreement is made in connection with a
transaction involving interstate commerce and shall be governed by the Federal Arbitration Act, 9 U.S.C. Sections 1 -16 (as may be amended) (FAA), but if for any reason the Federal Arbitration Act does not
apply, then this arbitration agreement shall be goverened by the laws of the State of North Carolina.
16. GOVERNING LAW AND SEVERABILITY. This Contract shall be interpreted under and governed by the law of North Carolina, without regard to the choice of law rules of any state, except that the ARBIT-
RATION AGREEMENT, WAIVER OF JURY TRIAL AND WAIVER OF CLASS ACTION ADJUDICATION is governed by the FAA. If any provision of the Contract is contrary to any law to which it is subject,
such unlawful provision shall be ineffective without invalidating the other provisions, which shall remain in full force and effect.
17. CREDIT CARD / FINANCED TRANSACTIONS. If Customer uses a credit card or obtains financing to pay some or all of the Price, then Customer acknowledges that the terms of his or her cardholder
agreement or financing documents may change the total amount of money Customer must pay to the credit card provider or lender, including any interest charges and fees. Customer acknowledges that his or
her cardholder agreement or financing documents may have other terms and conditions to which Customer will be subject. Customer also acknowledges that Lowe's is not a party to any such cardholder or fin-
ancing agreement.
18. WAIVER OF LIENS. Because responsibility for paying the Installer on Customer's behalf belongs to Lowe's, Lowe's will require the Installer, on behalf of itself and any of the Installer's subcontractors, ma-
terialmen or suppliers, as a condition precedent to payment by Lowe's on Customer's behalf, to fully and unconditionally relinquish, waive and release any and all mechanic's liens, materialman's liens and oth-
er liens in the Premises which the Installer or its subcontractors, materialmen or suppliers might have or acquire in the future, by operation of law or otherwise, as a result of this Contract.
19. UNAVOIDABLE DELAY OR FAILURE IN PERFORMANCE EXCUSED. Any delay or failure by Lowe's or the Installer in performing this Contract because of strike, fire, flood, epidemic, acts of terrorism,
acts of God, inability to obtain Goods in a timely or commercially feasible manner, or any other causes beyond the reasonable control of Lowe's or the Installer shall be excused and shall not be breaches of
this Contract.
20. ENTIRE AGREEMENT / CHANGES IN WRITING. Customer and Lowe's agree that this Contract accurately states the entire agreement between Customer and Lowe's concerning the Goods and Installa-
tion Services and replaces and supersedes all prior agreements and understandings relating thereto, both oral and written, and all oral agreements and understandings entered into at the same time as this
Contract. Any additions or changes to this Contract, or any waiver of rights under this Contract, must be in writing signed by Customer and Lowe's.
21. CAPTIONS. Titles or captions of sections contained in this Contract have been inserted only as a matter of convenience and in no way define, limit, extend, describe or otherwise affect the scope or mean-
ing of this Contract or the intent of any provisions hereof.
22. ADDITIONAL INFORMATION. All contractors and subcontractors must be registered by the Administrator of the Board of Building Regulations and Standards. Inquiries about a contractor or
subcontractor relating to a registration should be directed to the Administrator of the Board at One Ashburton Place, Room 1301, Boston, MA 02108, (617) 727 -8598.
23. QUESTIONS OR CONCERNS. Customer should speak to the Lowe's salesperson whose name appears on this Contract and the manager of the Lowe's store at the address and /or phone number on the
front page of this Contract, regarding routine matters such as scheduling, any requested changes to Customer's order, or any concerns Customer may have about this Contract, the Goods or the Installation
Services.
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- Premises will not interfere with performance of the Installation Services. Customer agrees to provide power to, as applicable, climate control in, the work areas. Customer agrees not to allow unattended minors
at the Premises while the Installer is present. Customer agrees to control and keep pets away from work areas. Customer agrees to keep posted permits on display at all times. Customer agrees that if Cus-
tomer or anyone Customer controls interferes with or delays performace of the Installation Services, Customer may be subject to transportation /storeage charges or other resulting charges. Customer agrees
not to assign or transfer this Contract. Customer agrees that any claim against Lowe's or the Installer under this Contract should be made to Lowe's within thirty (30) calendar days of the date Customer first
becomes aware of a problem. (Lowe's will attempt resolution of any claim(s) within sixty (60) calendar days of receiving Customer's notice.) CUSTOMER ASSUMES THE RISK AND THE FULL LIABILITY OF
PHYSICALLY ASSISTING WITH DELIVERY OF THE GOODS OR WITH PERFOMANCE OF THE INSTALLATION SERVICES.
12. MANUFACTURER WARRANTY FOR GOODS.Customer is entitled to any warranty provided by a manufacturer of the Goods sold under this Contract. The Installer will provide Customer with any manu-
facturer consumer warranty information accompanying the Goods, and Customer may also obtain such information by contacting Lowe's. LOWE'S DOES NOT WARRANT THE GOODS AND EXPRESSLY
DISCLAIMS ALL WARRANTIES, EXPRESSED OR IMPLIED. TO THE FULLEST EXTENT PERMITTED BY LAW.
13. LOWE'S WARRANTY FOR INSTALLATION SERVICES / LIMITATIONS OF LIABILITY. Lowe's does warrant that the Installtion Services will be performed by the installer in a good and workmanlike
manner. Lowe's warranty for Installation services shall extend for a period of one year from the earlier of (1) the date the Certificate of Completion is signed by Customer or (2) the date that Lowe's determines
that the Installation Services have been completed, or for such greater period as may be required by applicable law governing consumer warranties for workmanship (the "Warranty Period "). LOWE'S WAR-
RANTY THAT THE INSTALLATION SERVICES WILL BE PERFORMED BY THE INSTALLER IN A GOOD AND WORKMANLIKE MANNER DOES NOT COVER, AND LOWE'S WILL NOT BE RESPONS-
IBLE FOR, ANY DEFECT IN SUCH INSTALLATION SERVICES DUE TO (1) ANY DEFECT, WEAKNESS OR DANGEROUS CONDITION, INCLUDING BUT NOT LIMITED TO, MOLD, ROT, ASBESTOS OR
INFESTATION IN THE PREMISES' STRUCTURE, SUBSTRUCTURE, SUPERSTRUCTURE OR POINTS OF ATTACHMENT, OR OTHER PRE - EXISTING PHYSICAL OR ENVIRONMENTAL HAZARD, OR
(2) ABUSE, MISUSE, NEGLECT, OR IMPROPER CLEANING. LOWE'S WARRANTY FOR INSTALLATION SERVICES SHALL BE IN LIEU OF ANY OTHER WARRANTY, EXPRESSED OR IMPLIED, TO
THE FULLEST EXTENT PERMITTED BY LAW.
Customer acknowledges and agrees that Customer shall be limited to seeking recourse or remedy exclusively from Lowe's or the Installer (as applicable) and that no affiliate of Lowe's shall have any liability
under this Contract. Customer must give Lowe's written notice within the Warranty Period of any warranty claim relating to Installation Services. Customer agrees that its sole and exclusive remedy against
Lowe's for a warranty claim is reinstallation in a good an workmanlike manner, including the repair or replacement of any Goods if and to the extent resonably necessary to correct the defective Installation Ser-
vices. CUSTOMER SHALL HAVE NO OTHER REMEDY FOR A WARRANTY CLAIM, INCLUDING WITHOUT LIMITATION REMEDY FOR LOSS OR DAMAGE CAUSED BY NORMAL WEAR AND TEAR,
LOSS OR DAMAGE WHICH HAS NOT BEEN REASONABLY MITIGATED, OR LOSS OR DAMAGE CAUSED BY ACTS OF GOD. IN NO EVENT SHALL LOWE'S BE LIABLE FOR INDIRECT, PUNITIVE,
CONSEQUENTIAL OR INCIDENTAL DAMAGES (SUCH AS, WITHOUT LIMITATION, LOST PROFITS, LOST SALES, AND INJURIES TO PERSONS OR PROPERTY), EVEN WHERE LOWE'S HAS BEEN
ADVISED OF THE POSSIBILITY OF SUCH DAMAGES. WHERE, DUE TO OPERATION OF LAW, SUCH DAMAGES CANNOT BE EXCLUDED, THEY ARE EXPRESSLY LIMITED IN AMOUNT TO THE
PURCHASE PRICE. In connection with any warranty claim, Customer agrees, at no cost to Lowe's or the Installer, to prepare the Premises and the reinstallation area in the manner described in Section 11 of
these Terms and Conditions.
14. DISPUTE RESOLUTION FOR CLAIMS COVERED BY M.G.L. c.142A. Most questions or complaints are resolved informally. If Customer has a question or complaint, Customer agrees to contact the
Lowe's salesperson whose name appears on this Contract and the manager of the Lowe's store at the address and /or phone number on the front page of this Contract. If Customer has a complaint which can-
not be resolved informally, The Home Improvement Contractor Law (M.G.L. c.142A) may provide Customer with the right to request arbitration through a private arbitration program approved by the Director of
the Office of Consumer Affairs and Business Regulation, as an alternative to court action. The same right is not afforded to Lowe's unless the "Notice Regarding Arbitration Agreement for Claims Covered by
M.G.L. c.142A" on the front page of this Contract is signed and dated by Lowe's and the owner. If allowed by statute or applicable law, the arbitrator may awared statutory damages and /or reasonable attor-
neys' fees and expenses. If Customer fails to pay Lowe's in accordance with this Contract, Lowe's shall be entitled to recover its reasonable attorneys' fees as provided by N.C. Gen. Stat. Section 6 -21.2 or
other controlling law. To the fullest extent permitted by law, Lowe's and Customer agree that no class action lawsuit or class action artibration of any type may be pursued by or on behalf of the Customer or
ordered by a Court or arbitrator(s) under this Contract and, in addition, that there shall be no joinder of parties, except for joinder of parties to the transaction covered by this Contract.
15. ARBITRATION AGREEMENT, WAIVER OF JURY TRIAL AND WAIVER OF CLASS ACTION ADJUDICATION FOR CLAIMS NOT COVERED BY M.G.L. c.142A: All claims by Customer or Lowe's con-
cerning this Contract which cannot be resolved informally, and which are not covered by M.G.L. c142A or subject to the jurisdiction of a small claims court, shall be resolved by binding arbitration conducted by
a single arbitrator under the current applicable rules, procedures and protocols of JAMS, Inc. (JAMS) (www.jamsadr.com) (as amended) or the American Arbitration Association (AAA) (www.adr.org) (as
amended). The parties agree that if JAMS or AAA are unable or unwilling to arbitrate the matter, the parties will agree upon a single arbitrator with a nationally recognized arbitration firm to arbitrate the matter.
Claims to be resolved by binding arbitration include, but are not limited to (1) all claims directly or indirectly related to the signing of this arbitration agreement, the validity or scope of this arbitration agreement,
or any attempt to set aside this arbitration agreement, (2) all federal or state law claims relating directly or indirectly to this Contract (including this arbitration agreement), the information Customer gave Lowe's
before entering into this Contract and /or any past agreement or agreements between Customer and Lowe's, (3) at counterclaims, cross - claims and third -party claims. (4) all common law claims of any kind in-
cluding claims based upon alleged product defect, contract, tort, fraud, or other intentional torts, (5) all claims based upon a violation of any state or federal constitution, statute or regulation, (6) all claims as-
serted by Lowe's against Customer, including claims for money damages to collect any sum Lowe's claims Customer owes Lowe's, (7) all claims asserted by Customer individually against Lowe's and /or any of
Lowe's employees, agents, directors, officers, shareholders, managers, members, parent company or affiliated entities (herein collectively referred to as "related third parties ") or the Installer, including claims
for money damages and /or equitable or injunctive relief, (8) all claims asserted on Customer's behalf by another person, (9) all claims asserted by or on behalf of a Customer as a private attorney general
against Lowe's, related third parties and /or the Installer, (10) all claims arising from or relating directly or indirectly to the disclosure by Lowe's, related third parties or the Installer of any non - public personal in-
formation about Customer, and /or (11) all other claims arising under or related to this Contract whether or not set forth above. If the dispute falls within the jurisdiction of a small claims court the claimant may,
at its option, choose to arbitrate or file a small claims action. Any appeal of a judgment from a small claims court shall be resolved by arbitration as provided herein.
Binding arbitration means that Customer waives: (1) any right to a jury trial; (2) any right to bring a lawsuit in a court (other than a small claims court as described above); and (3) any right to
seek relief in any other forum or from any other agency. Any claim not decided by a small claims court will be decided by an arbitrator selected as set forth immediately above. Lowe's and Cus-
tomer agree that binding arbitration provides a simple, cost efficient method to resolve disputes quickly. Lowe's and Customer agree that no class action lawsuit or class action arbitration of
any type may be pursued by or on behalf of the Customer or ordered by a Court or arbitrator(s) under this Contract and, in addition, that there shall be no joinder of parties, except for joinder of
parties to the transaction covered by this Contract. By agreeing to binding arbitration Customer and Lowe's waive any right to bring or participate in a class action lawsuit or class action arbitra-
tion regarding any claim.
How Arbitration Works:
Lowe's may demand arbitration by sending written notice to Customer at the address listed in this Contract. Customer may demand arbitration by sending written notice to Lowe's at the following address: Mail
code NB6LG, P.O. Box 1000, Mooresville, NC 28115. The arbitration shall be held in the city or county where the Premises are located or in such other convenient location as the Customer and Lowe's may
mutually agree. Lowe's shall pay the filing, administrative, hearing and arbitrator's fees associated with the arbitration. Customer shall not be required to reimburse Lowe's for these expenses even if Lowe's
wins the arbitration. Unless the arbitrator's award or controlling law specifically provides otherwise, Lowe's and Customer will each be responsible for its own attorneys' fees and other expenses, such as wit-
ness and expert witness fees. At the timely request of Customer or Lowe's, the arbitrator will provide a written explanation of the award so long as such requirement is consisent with the then current rules, pro-
cedures and protocols of the arbitration entity selected by the parties as set forth above. The arbitrator's award may be filed with and enforced by any court having jurisdiction. If allowed by statute or applicable
law, the arbitrator may award statutory damages and /or resonable attorneys' fees and expenses. If Customer fails to pay Lowe's in accordance with this Contract, Customer agrees that Lowe's shall be entitled
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TERMS AND CONDITIONS
1. "LOWE'S" DEFINED. Within this Contract (as defined on the front page of this Contract), the term "Lowe's" shall refer to Lowe's Home Centers, Inc., a North Carolina corporation.
2.GENERAL DESCRIPTION. By this installed sales contract (the "Contract "), Customer agrees to purchase and Lowe's agrees to sell the goods and /or materials (the "Goods ") and the services to install same
(the "Installation Services ") in or on the above - identified premises (the "Premises ") for the stated total cash price (the "Price ") and according to the specifications and other provisions of the Contract docu-
ments, including (a) this Contract form, (b) the Addendum, if and to the extent applicable, (c) any attached sketches, materials lists, floor plans, and /or specification sheets; and (d) the applicable portion(s) of
Lowe's receipt.
3. INSTALLATION SERVICES. Customer authorizes Lowe's on Customer's behalf to (a) arrange for the Installation Services to be performed by an independent contractor (the "Installer ") (licensed when leg-
ally required), (b) issue a work order to the Installer to perform the Installation Services, (c) have the Installer's work inspected, should Lowe's in its discretion choose to do so (it being agreed that Lowe's has
no obligation to do so), and (d) pay the Installer after completion of the work and after receipt of a certificate, signed and dated by Customer, that the work has been satisfactorily completed (the "Certificate of
Completion "). Customer understands that Lowe's will rely upon the Certificate of Completion in paying the Installer for the Installation Services. CUSTOMER AGREES THAT THE INSTALLER WILL PER-
FORM THE INSTALLATION SERVICES ACTING AS AN INDEPENDENT CONTRACTOR FOR CUSTOMER AND NOT UNDER THE SUPERVISION OR CONTROL OF LOWE'S. Customer agrees that the
Installation Services do not include architectural /engineering services or structural changes to the Premises or any other services beyond the ordinary and routine installation of the Goods as specifically
provided in this Contract. Customer is responsible, at Customer's cost, for providing any necessary architectural /engineering services or structural changes to the Premises or any other services not specifically
identified in this Contract.
4. GOODS. Lowe's will arrange for delivery of the Goods to the Premises. Customer agrees Lowe's owns all Goods until installed into the home, building, or on customer's property. Customer agrees Contract
is being offered for the total Price (per below). Customer further agrees any surplus materials upon completion of the installation services shall remain the property of Lowe's and, if instructed by Lowe's, such
surplus materials shall be returned to Lowe's by the Installer. Upon request from the Customer at the time of job completion, Lowe's. in its discretion, will allow all or part of unused, receipted surplus materials
to be retained by the Customer.
5. PRICE. The Price covers the Goods, Installation Services, and applicable taxes. The Price assumes sound existing substructures, superstructure and points of attachments. The Price shall be increased by
the cost and reasonable profit to Lowe's of having to provide additional Goods and /or Installation Services as a result of defective substructures, superstructures, or points of attachments or the existence of
any other Undisclosed Condition (per below). In the event of an Undisclosed Condition or the foregoing, Customer will execute a change order or a new replacement contract upon Lowe's request.
6. DISCOUNTS and PROMOTIONS. From time to time, Lowe's provides various promotions, offers and discounts that may apply to Goods and /or Installation Services. See specific promotion, offer and dis-
count for terms and conditions that may apply. All discounts are taken at the time of Customer's purchase. Applicable discounts or discounted Prices will appear on the Lowe's receipt and /or on the Contract.
7. PAYMENT. If the Price is $1,000.00 or less, payment of the Price by Customer to Lowe's is due in full uopon execution of this Contract. If the Price is over $1,000.00, Customer may choose to pay in full
upon execution of this Contract, but Lowe's may not require Customer to do so. If the Price is over $1,000.00 and Customer does not pay in full at the time of sale, Customer agrees to pay Lowe's according to
the payment schedule set forth in this Contract. Customer agrees to pay a deposit upon execution of this Contract equal to one -third of the Price. Customer agrees to make a payment for the balance of the
Price less the final payment at least one day after the date this Contract is executed and prior to the commencement of the Installation Services. Customer agrees to make the final payment upon completion of
the Installation Services and Customer's satisfaction. Payment for a new replacement contract is payable according to these Terms and Conditions. Payment for any change order is due at the time of that
change order. Lowe's will send to Customer by U.S. Mail a receipt evidencing Customers purchase after Payment is processed.
8. LICENSES, PERMITS, SAFETY RULES, BUILDING CODES, ZONING ORDINANCES, AND OTHER LAWS. The Installer shall be solely responsible to Customer for obtaining any and all licenses, regis-
trations and certifications which are legally required to perform the Installation Services. The Installer shall also be solely responsible to Customer for the Installation Services being performed in compliance
with all applicable safety rules and all existing buidling codes, zoning ordinances and other laws. Lowe's shall be responsible to Customer for obtaining building permits which are legally required to perform the
Installation Services where Lowe's is legally required to obtain such permits. Where Installer is required to obtain such permits then Installer will be responsible to Customer for obtaining such permits. Custom-
ers who secure their own building permits will be precluded from claiming against certain state guaranty funds relating to home improvements. Neither the Installer nor Lowe's shall be responsible for any pre-
existing violations of safety rules, building codes, zoning ordinanaces or other laws and shall not be required to address or correct same. If prior to the completion of work a change occurs to any applicable
safety rule, building code, zoning ordinance or other law which requires additonal Goods and /or Installation Services to perform this Contract, Customer agrees to pay Lowe's the cost and reasonable profit for
such additional Goods and Installation Services and to execute a resulting change order or new replacement contract as requested by Lowe's. No additional work will be performed under this Contract due to
any change to any applicable safety rule, building code, zoning ordinance or other law that occurs after the completion of work.
9. CUSTOMER'S WARRANTY AGAINST VIOLATIONS OF EASEMENTS, COVENANTS, AND THIRD PARTY RIGHTS. Customer warrants that performance of Installation Services will not violate any exist-
ing real property easements, covenants, homeowner's association rules or rights of third parties holding an interest in the real property being improved.
10. UNDISCLOSED CONDITIONS IN PREMISES. If any defect, weakness or dangerous condition including, but in no way limited to, mold, mildew, rot, asbestos or infestation ( "Undisclosed Condition ") is dis-
covered or identified in the Premises' structure. substructure, superstructure or points of attachment at any time prior to commencement or completion of the Installation Services, Customer must remedy the
Undisclosed Condition at Customer's sole cost and expense and to Lowe's sole satisfaction. If Customer refuses to permit inspection of the Premises as set forth below, Lowe's may terminate or rescind this
Contract without remedy or recourse by, or further obligation to, Customer, except as expressly provided below. If Customer and Lowe's disagree as to whether an Undisclosed Condition exists, Lowe's may in
its sole discretion obtain the services of an inspector to inspect the Premises at Lowe's sole cost and expense, and if Lowe's chooses to do so, such inspector's report shall be final and conclusive as to wheth-
er an Undisclosed Condition exists. In the event of any Undisclosed Condition that Customer does not remedy to Lowe's sole satisfaction, or any failure by Customer to perform any other obligation of Custom-
er under this Contract, then at Lowe's option (i) Lowe's may rescind this Contract and return the Price to Customer without further cost or obligation by either Customer or Lowe's if Lowe's notifies Customer of
its election to rescind this Contract prior to the earlier of delivery of the Goods and the Installer beginning performance of the Installation Services. or (ii) Lowe's may terminate this Contract without remedy or
recourse by, or further obligation to Customer, except as expressly provided below if Lowe's notifies Customer of its election to terminate this Contract after the earlier of delivery of the Goods and the installer
beginning performance of the Installation Services. In the event that Lowe's terminates the Contract as provided in this Section, then Customer may return the Goods (other than Goods that have been "custom -
made") in their original, unopened condition, to Lowe's for a refund or credit. Any such return must be made within 30 days after Lowe's terminates this Contract. Customer will be charged a 15% restocking fee
on any such returns. Goods not in their original, unopened condition, and custom -made goods, may not be returned. "Custom- made" goods include goods that have been uniquely altered, color- matched,
shaped, sized, cut or otherwise designed or fitted to accomodate the requirements of a particular space or environment. Examples of custom -made goods include, but are not limited to, cabinets, countertops,
floor and wall coverings, and window treatments. If Lowe's terminates this Contract as provided herein, Lowe's shall have no obligation to refund any portion of the Price (except as expressly provided herein)
and shall have no obligation to restore the Premises to their original condition. Notwithstanding the foregoing, and alternative to rescinding or terminating this Contract as described above, upon discovery or
identification of any Undisclosed Condition in the Premises, Lowe's may in limited circumstances and markets, and in Lowe's sole discretion, authorize the commencement or continuation of Installation Ser-
vices upon Lowe's receipt of Customer's written agreement (to be furnished to Customer by Lowe's) to release and hold harmless Lowe's and installer from any and all liability arising out of or related to the Un-
disclosed Condition and Customer's remedy of Undisclosed Condition.
11. CUSTOMER'S RESPONSIBILITIES: Customer agrees to pay Lowe's according to these Terms and Conditions. Customer agrees to facilitate the location of utility lines. Customer is responsible for identi-
fying property lines. Customer agrees to ensure that work areas are free of vermin and pre- existing physical or environmental hazards, and building /zoning code violations. Customer agrees to provide the In-
staller with access to work areas during working hours and to provide access to sanitary facilities or to pay the rental costs for such facilities. Customer agrees to ensure that any security system at the
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MIT TO SUCH ARBITF3M!ON AS PROVIDED IN M.G.L. c.142A.
By: - 1 4 7 ' ()v_ Y‘"` _ Date:___ //7/ /
Lowe's Ho '0 Centers, Inc -
- Date: /` /7 /(
Owner
By: _ Date:_ —
Spouse
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_ l i DAY OF D`'Z iy I (
Lowe's Home Centers, Inc.
i
By: �1� )1 ! �i -e�?� (Seal)
7
Print Name: 714 . . S_ t I ,? r'
�✓� (Seal)
Address Owner
-f7A-die Al A (k 2—.
City State / Province Zip / Postal Code Print Name
(Seal)
Co -Owner or Witness
Print Name
Customer acknowledges receipt of a true copy which was completely filled in prior to Customer's execution hereof. You the customer may cancel this transaction
at any time prior to midnight on the third business day after the date of this transaction. See the attached Notice of Right to Cancel for an explanation of
this right.
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f BALANCE DUE I I
Work is to commence upon reasonable availablity of Contractor which is anticipated to be / 1/ 7/ / ( [fill in date].
Estimated completion date is \/ ( 7/ ! 1 [fill in date].
NOTICE TO CUSTOMER
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 $1,000.00 OR LESS Customer must pay in full.
CQMPLETE THIS SECTION ONLY WHEN THE CONTRACT TOTAL EXCEEDS $1.000.00:
1r�'� Customer to Pay in Full; OR
[_] Customer to use the following payment schedule:
(1) Deposit $_ to be paid upon signing contract. Deposit should be 1/3 the total contract price; and
(2) Payment of $ to be paid anytime after this Contract is signed and before commencement of installation, I/We authorize Lowe's to do
one of the following (check appropriate box below):
[_] Charge my /our credit card for the amount of the payment indicated above anytime after the date this Contract is signed; or
[_] Deposit my /our check for the amount of the payment indicated above anytime after the date this Contract is signed; and
(3) Final payment of $100.00 to be paid upon completion of the installation and 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
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 MUTUALLY AGREE IN ADVANCE THAT IN THE 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-
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Materials Price f $ 566.361
INSTALLATION DESCRIPTION
Stock or SOS : Stock Door Type : Patio
Select Location : Back Door Select New Door : Sliding
Number of Doors to Install : 1 Side Lights or Transoms : No
Hidden Damage Description : None 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 : Yes
Customer Understands Scope of the Project : Yes Permit Required : Yes
Who Will Obtain Permit : Lowe's Permit Fee : Yes
Additional Miles Traveled over 20 : 0 Bring Up To Code Description : None
Local Disposal Fee : Yes Describe Other Work Needed : build in jambs on interior, custom exterior trim
Other Work Charge : Yes Comments : No Comment
Labor Charges $ 610.85
Detail Deduction -$ 0.00
Additional Specifications:
Notation: Lowe's will not make structural modifications, paint or stain or remove /reinstall security system equipment. Customer is responsible to advise if prop-
erty is governed by Historic District Regulations.
Additional Specifications:Federal law requires Lowe's to provide you with the pamphlet Renovate Right: Important Lead Hazard Information for Families,
Child Care Providers and Schools. By signing this Contract, Customer acknowledges having received a copy of this pamphlet before work began informing
Customer of the potential risk of the lead hazard exposure from renovation activity to be performed in Customer's dwelling unit.
TOTAL CHARGES OF ALL MERCHANDISE AND SERVICES
'where applicable
SUB -TOTAL $ 1177.21
*TAX $ 0.00
DELIVERY $ 0.00
ORDER TOTAL $ 1177.21
Store 1916 Project No. 342828203 for DEBRA CRUZ Page 2 of 7
STORE COPY
INSTALLATION SERVICES CUSTOMER CONTRACT - MWORK - INT /EXT /PATIO DOOR
LOWE'S OF HADLEY, MA, STORE # 1916 STORE PHONE: (413) 588-0270
LOW 282 RUSSELL STREET SALESPERSON: JASON MCKINNON
HADLEY, MA 01035 -0000 SALESPERSON ID: 1557195
Document Print Date : 12/17/2011
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 CONDITIONS." BEFORE SIGNING.
Lowe's Registration or Contractor License Number / Lowe's Contractor Name
Lowe's Home Centers, Inc.'s MA HIC NO.: 148688 Lowe's Home Centers, Inc.'s FEIN: 56 0748358
Customer Name Home Phone
S DEBRA CRUZ 413 - 586 - 3120
O Customer Address Other Phone
18 LAUREL LN
L City State / Province Zip / Postal Code
D NORTHAMPTON MA 01060
Installation Address
T 18 LAUREL LN
O Installation City Installation State /Province Installation Zip /Postal Code
NORTHAMPTON MA 01060
MERCHANDISE AND INSTALLATION SUMMARY
MERCHANDISE SUMMARY
3691 : STK : OAK SHOE 129 11/16X7/16X8' : OAK SHOE 129 11/16X7/16X8' - QTY 1
11241: P LPR 1.000 3.000 8. : STK : 1X3X8 TOP CHOICE EWP PREM S4S : 1X3X8 TOP CHOICE EWP PREM S4S : HANCOCK LUMBER COMPANY -
QTY 3
19038 : 1X6 8ARMWD : STK : 1X6X8 ARMOUR WOOD : 1X6X8 ARMOUR WOOD : FLETCHER WOOD SOLUTIONS - QTY 2
26452 : 1X4 8ARMWD : STK : 1X4X8 ARMOUR WOOD : 1X4X8 ARMOUR WOOD : FLETCHER WOOD SOLUTIONS - QTY 3
193569: 35170FJPMD : STK : PFJ CASE 351 2- 1/2X11/16X7 : PFJ CASE 351 2- 1/2X11/16X7 : EMPIRE COMPANY, INC. (THE) - QTY 3
326434: 7481 71 61 341 3 : STK : 6' TSTAR ADV LOWE AR GBG NO SCR : 6' TSTAR ADV LOWE AR GBG NO SCR : PELLA VINYL PATIO DOORS EAST -
QTY 1
Store 1916 Project No. 342828203 for DEBRA CRUZ Page 1 of 7
..,.�� .413, eai:'0.� , <+, ,- 0660 tUSTALL'E.D SALES' . P /3
-alsovorwseale4 4 "�` QO Licer se or arc istratitm valid tor ttidividtti use a1ASy
,\ Mee of Commoner Attain &. Warless Regulation e
' before the eapitatiett date. if found return to:
,* , ". ,-.,. R� HOME IMPR VENIENT CONTRACTOR
1/4
; IE, :-.. ' R gig tasttaatlost :..45592F T YPe: Offtt~e of Conwmer A,ETaIrs end Bvsir� R i td . � 4 , 1 __ Expiration: .4t1112013 118k 10 T•erk PIASe -Suite 5110 xti trtt
':::: ;.:: •� :; .,.,, Heston, MA f1211b
B 5 ' v ER$ 1- oone,11 0g9vtmL iTS
MICHAEL SURGA A S '3rR?.:.; .s �� O
119 HIGH ST 1ST let :i '� .o rs
AGAWAM, MA n1aaT .,,, >.., .': • :. � filat >v'
Undcrnecre a 1 s" , litre
. �. -
1 1assachuxtts - Department of Public
1/4!) Board of Building Regulations and Staind;trds
Construction Supervisor License
Lice CS 103003
Restricted to: 00
II
MICHAEL. BURGAMA8TER
1 10 HIGH STREET 1ST FL,
AGAWAM, MA 010Q1
expiration: 9/8
( ■1II,mirvl,rnrr Trti: 103003
•..new,........- ......._ —._.. _,.__.,. ,
Office of Consumer Affairs t& business Regulation License or registration valid for individul use only
11{GME IMPROVEMENT CONTRACTOR before the expiration date. If found return to:
Office of Consumer Affairs and Business Regulation
-
.5.-... Registration: 148688 Type: 10 Park Plaza - Suite 5170
• ,. Lxpiration -lb/ 13/2011 Supplement card Roston, M11 A 02116
LOWE'S HOMES CENTERS INC '
PATRICK GALLAGHM '
136 TURNPIKE RD. SUITE 100 ,:- - . 5_
SOUTH BOROUGH, MA 01772 — ..
Undersecretary Not valid without signature
DEC-24-2011 07::? Fr 0 iii : BURGEHOME IMPROVEMENT 41378E7078 To:14135880278 Pa9e:1/2
2011-12-21 12:40 Lowes 1916 ISO 413 588 0278 » 867078 P 3/3
,. .. , . .
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atite omd tonna exployees Tiz: sub-con inuants have .8. 0 Deineliiicol - . -
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raysel; No wadi& cciv. . . deitce exemptioii per MM. 110.ixifrepairs - . ' • .
insionnoe "mini] t ' , : c. 117, fl (4) and 'ire have nd .
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.elty or Town; . . '• ' Permit/poet:se 0, : .
Lamina Authority (circle one): ' ' , • -
, .1. Board of enIth Z Bualdhig Department 3. City/Torn Clerk .4. EItesicalppeetor 5. Plumbing impeder
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— .
Contset Person; Phone g: '
.....—„_
. • .
SECTION 8 - CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder : (Ck -kPEL el)2, --, p(1'( , 1n3OC'3
License Number
• ■ ' ` J t& Ft_. L . G.S► lia L • 11 (i .CR. IZ
Address � -7 - Expiration Date
..-.0•'' .2z.z.(G3Z`-1
ignature elephone
9. Registered Home Improvement Contractor: Not Applicable ■
N.I � k( InrIPPOvE(Y)e, rs •
Company Name Registration Number
Address __ . . Date
li ►...imor ,_... -... Telephone 4415222. 1'J ,Y L
SECTION 10- WORKERS' COMPENSATION INSURANCE AFFIDAVIT (M.G.L. c. 152, § 25C(6))
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result
in the denial of the issuance of the building permit.
Signed Affidavit Attached Yes ) No ❑
11. - Home Owner Exemption
The current exemption for "homeowners" was extended to include Owner - occupied Dwellings of one (1) or two(2) families
and to allow such homeowner to engage an individual for hire who does not possess a license, provided that the owner acts
as supervisor. CMR 780, Sixth Edition Section 108.3.5.1.
Definition of Homeowner: Person (s) who own a parcel of land on which he /she resides or intends to reside, on which there
is, or is intended to be, a one or two family dwelling, attached or detached structures accessory to such use and/ or farm
structures. A person who constructs more than one home in a two -year period shall not be considered a homeowner.
Such "homeowner" shall submit to the Building Official, on a form acceptable to the Building Official, that he /she shall be
responsible for all such work performed under the building permit.
As acting Construction Supervisor your presence on the job site will be required from time to time, during and upon
completion of the work for which this permit is issued.
Also be advised that with reference to Chapter 152 (Workers' Compensation) and Chapter 153 (Liability of Employers to
Employees for injuries not resulting in Death) of the Massachusetts General Laws Annotated, you may be liable for person(s)
you hire to perform work for you under this permit.
The undersigned "homeowner" certifies and assumes responsibility for compliance with the State Building Code, City of
Northampton Ordinances, State and Local Zoning Laws and State of Massachusetts General Laws Annotated.
Homeowner Signature
A
SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable)
New House ❑ Addition ❑ Replacemen lindows Alteration(s) Roofing El
Or Doors LJ
Accessory Bldg. ❑ Demolition ❑ New Signs [D] Decks [Q Siding [p] Other [p]
Brief Description of Proposed
Work: 'htXY1("1vI4 -j1) c\Ac . P1=4T O ST'Q OCT \1 t2 (x,-11 ∎t( .
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll - Sheet
6a, If New house and or addition to existing housing, complete the following:
a. Use of building : One Family Two Family Other
b. Number of rooms in each family unit: Number of Bathrooms
c. Is there a garage attached?
d. Proposed Square footage of new construction. Dimensions
e. Number of stories?
f. Method of heating? Fireplaces or Woodstoves Number of each
g. Energy Conservation Compliance. Masscheck Energy Compliance form attached?
h. Type of construction
i. Is construction within 100 ft. of wetlands? Yes No. Is construction within 100 yr. floodplain Yes No
j. Depth of basement or cellar floor below finished grade
k. Will building conform to the Building and Zoning regulations? Yes No .
I. Septic Tank City Sewer Private well City water Supply
SECTION 7a - OWNER AUTHORIZATION - TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I, k' '(:) CAUL_ , as Owner of the subject
property
hereby authorize 1__a>,1 - `5) 40X. CeNTV1 • 1NC'.
to act on my behalf, in all matters relative to work authorized by this building permit application.
Signature of Owner Date
i, LA t.)0,-E---1 2.A.-imen , as Owner /Authorized
Agent hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge
and belief.
Signed under the pains and penalties of perjury.
‘
Print ►a `e
i If �:ti,
S'g F a re of Own: r /Ag nt Date
Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information
Existing Proposed Required by Zoning
This column to be tilled in by
Building Department
Lot Size
Frontage
Setbacks Front
Side L: R: L: _ R:
Rear
Building Height
Bldg. Square Footage
Open Space Footage
( Lot area minus bldg & paved
parking)
# of Parking Spaces
Fill:
(volume & Location)
A. Hasa Special Permit /Variance /Finding ever been issued for /on the site?
NO 0 DON'T KNOW 0 YES 0
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO Q DON'T KNOW 0 YES Q
IF YES enter Book Page and /or Document #
B. Does the site contain a brook, body of water or wetlands? NO Q DON'T KNOW 0 YES Q
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Q Obtained Q , Date Issued:
C. Do any signs exist on the property? YES Q NO Q
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property ? YES Q NO Q
IF YES, describe size, type and location:
E. Will the construction activity disturb (clearing, grading, excavation, or filling) over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES Q NO Q
IF YES, then a Northampton Storm Water Management Permit from the DPW is required.
„jaq.. t ,K
rys
f i i
. ,,i
:,
_ Department use only
_.,. - rte'*. e,.- �
_ .
G ,.. City of Northampton Status of Permit:
Ls
Building Department Curb Cut /Driveway Permit
212 Main Street Sewer /Septic Availability
Room 100 Water/Well Availability
,N ,rthampton, MA 01060 Two Sets of Structural Plans
"' of
DEC 2 8 201
-587 -1240 Fax 413- 587 -1272 Plot/Site Plans
Other Specify
APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 - SITE INFORMATION
1.1 Property Address: This section to be completed by office
1 , i_PrUZE.i,_. LJ�► . Map Lot Unit
No0■T4 kPi'MP t ( MT O O(QO Zone Overlay District
EIm St. District CB District
SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT
2.1 Owner of Record:
D€ 02.)./z- \ Lp,<)P - A vV
Name (Print) Current Mailing Address:
5 00. "TV- 'PtC'- Telephone
Signature
2.2 Authorized Agent:
Na _ (r ) Current Mailing Address:
,2 ,,a .✓ ,6-_. „ - `-11?) .()Z`1CD
$i. at re Telephone
ECTION 3 - ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost (Dollars) to be Official Use Only
completed by permit applicant
1. Building \' \ - 11 .Z., (a) Building Permit Fee
2. Electrical (b) Estimated Total Cost of
Construction from (6)
3. Plumbing Building Permit Fee
4. Mechanical (HVAC)
5. Fire Protection _
6. Total = (1 +2 +3 +4 +5
( 5) 5111 . 2 ' , Check Number /1/ C-- 43,j
This Section For Official Use Only
Date
Building Permit Number: Issued:
Signature:
Building Commissioner /Inspector of Buildings Date
18 LAUREL LN BP -2012 -0602
GIS #: COMMONWEALTH OF MASSACHUSETTS
Map :Block: 13 - 066 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: REPLACEMENT DOOR BUILDING PERMIT
Permit # BP- 2012 -0602
Project # JS- 2012- 001045
Est. Cost: $1177.00
Fee: $35.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: LOWE'S 103003
Lot Size(sq. ft.): 19166.40 Owner: CRUZ DEBRA
Zoning: SR(100) //RI/WP Applicant: LOWE'S
AT: 18 LAUREL LN
Applicant Address: Phone: Insurance:
282 RUSSELL ST (413) 588 -0270
HADLEYMA01035 ISSUED ON:12/28/2011 0:00:00
TO PERFORM THE FOLLOWING WORK: REPLACE PATIO DOOR
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector
Underground: Service: Meter:
Footings:
Rough: Rough: House # Foundation:
Driveway Final:
Final: Final:
Rough Frame:
Gas: Fire Department Fireplace /Chimney:
Rough: Oil: Insulation:
Final: Smoke: Final:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occupancy Signature:
FeeType: Date Paid: Amount:
Building 12/28/2011 0:00:00 $35.00
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Louis Hasbrouck — Building Commissioner