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18-002 (27) 82 PINES EDGE DR BP-2017-1086 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 18-002 CITY OF NORTHAMPTON Lot: -000 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: window replaced BUILDING PERMIT Permit# BP-2017-1086 Project# JS-2017-001854 Est.Cost:$10619.00 Fee: $40.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: HOME DEPOT AT HOME SERVICES 99209 Lot Size(su. ft.): Owner: DOWNES ANNE M Zoning: Applicant: HOME DEPOT AT HOME SERVICES AT: 82 PINES EDGE DR Applicant Address: Phone: Insurance: 5 RI V ERVIEW DR (401)935-2633 O Workers Compensation NORTH PROVIDENCERI02904 ISSUED ON:3/29/20170:00:00 TO PERFORM THE FOLLOWING WORK:INSTALL 10 REPLACEMENT WINDOWS POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Service: Meter: Footings: Rough: Rough: House# Foundation: Driveway Final: Final: Final: Rough Frame: Gas: Fire Department Fireplace/Chimney: Rough: Oil: Insulation: Final: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occupancy Signature: FeeType: Date Paid: Amount: Building 3/29/2017 0:00:00 $40.00 212 Main Street, Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner I r-- �`j� Department use only ----" G�tyoNorthampton Status of Permit: t H 29201• 1 7 %ildi1hig Department Curb Cut/Driveway Permit 21 Main Street Sewer/Septic Availability I I r' Room 100 Water/Well Availability N— prth�mpton, MA 01060 Two Sets of Structural Plans phone-4-1-3-587-1240 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 6. 10-17 - t0 Go 1.1 Property Address: This section to be completed by office G C yy11 Map Lot Unit Pius Ulm Zone Overlay District Elm SL District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: kWNF DouJN 7 42- 12 Nt5 gbke- DE Name(Print) Current Mailing nAd r mP -„ h1 - I©�OG Nl '� C � TeleP o! Signature I a -2- 1 C.-"rr 2.2 Authorized Agent: a)t elp '194 9o2 -n TPK Name(Pri Current Mailing Address: tc �S 7 -6 )-11--Rrad//� �S'1" - (e/sic- - Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building /P 4)4 -60 (a)Building Permit Fee 2. Electrical 7 (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) //) 6 AI- p/1 Check Number _p 9W A9LI This Section For Official Use Only Building Permit Numb- Date Issuetl'. Signature �/3 ; / --/ Building Commissioner/Inspector of Buildings Date Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning This column In he filled in by Building Department Lot Size Prantaec Setbacks From Side L: R: L: R Rear Building Height Bldg. Square Footage Lk Open Space Foulage ,n (Lor area minus bldg 5 pored pirklncl it of Parking Spaces Fill'. (/„more&L„emiem) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO O DONT KNOW O YES O IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO O DONT KNOW O YES O IF YES: enter Book Page and/or Document it B. Does the site contain a brook, body of water or wetlands? NO O DONT KNOW O YES O IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained O Obtained O , Date Issued: C. Do any signs exist on the property? YES O NO O IF YES, describe size, type and Location: D. . Are there any proposed changes to or additions of signs intended for the property ? YES O NO O IF YES, describe size, type and location: E. Will the construction activity disturb(clearing,grading,excavation. or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES O NO O IF YES,then a Northampton Storm Water Management Permit from the DPW is required. SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House I I Addition ❑ Replacement dows Alteration(s) ❑ Roofing ❑ Or Doors Accessory Bldg. ❑ Demolition ❑ New Signs [C] Decks [p Siding[Dl Other[p] }} ////��// Brief Descr'ptio of P op% - _ _ I M Ci/JL✓-7;741 — Work: N �I CCN ./[ ... `� .r:/ /l[Y�✓ tor Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet Ga. 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 a Number of stories? 1. 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��lAG TENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, ✓ ir jt pfrode ,as Owner of the subject property hereby authorize )&) Alit) TP--0/4? —' 97-'1r_ D Yy i' to act on my behalf, in all matters relative to work authorized by this building permit application. Ott ( nT2Prer- 3 -o3 - 1 ? SigMilill nature of Owner �//� ,+ �� y���T/2_ Date I, I2�EANPf '�V I tyY 1 ,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 'ns a d penalties of perjur . Print Names I�,/ s -2&-1-7 Signature of Owner/Agent Date SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: v// gY, /i Not Applicable El Name of License Holder: ✓L 3 P1 m4%//��Z th -11 1/\ oqq oq License Number Jiro PRCL&4-7h, DK to-)2 -17 Address Expiration Date Fe i t- 1)41.5 /4i4 - 91039 Signature Telephone LI I 9. Registered Home Improvement Contractor: Not Applicable ❑ 'rN t'ab4 3 Company Name Registration Number GDS/ 1p [irk Y� -t (Addddr{��js�s,,/,, /��[ F02,41 {� /�j Expiration Date ✓ "/✓'"% I11 ' � ) 54 elephone20121/ SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L. c. 152,§25C(6)) Workers Compensation Insurance affdav' must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the build' g permit. Signed Affidavit Attached Yes No ❑ 11. - Home Owner Exemption The current exemption for"homeowners'was extended to include Owner-occupied Dwellings alone(I) 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 108,33.1. 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 ur detached structures accessory to such use andl'or farm structures. A person who constructs more than one hone in a two-Pear 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 tor 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 pemiit The undersigned"homeowner"certifies and assumes responsibility for compliance with the State Building Code,(ity of Northampton Ordinances, State and Local toning Laws and State of Massachusetts General Laws Annotated. Homeowner Signature City of Northampton 212 Main Street, Northampton, MA 01060 Solid Waste Disposal Affidavit In accordance of the provisions of MGL c 40, S54, I acknowledge that as a condition of the building permit all debris resulting from the construction activity governed by this Building Permit shall be disposed of in a properly licensed solid waste disposal facility, as defined by MGL c 111 , S 150A. Address of the work: aSZ ) (1\)4.J' F,Dq`L����" Q The debris will be transported by: /1/411-",T4 /Yt I ry i The debris will be received by: Wg4ca Building permit number: �J �/� Name of Permit Applicant d`l J / 01 3_Z?7 7 71)711:C9 Date Signature of Permit Applicant anoqm — 111/1!/.1.1j11:3111/1::: "On r II Iozad,ui o rugnmiu r. .mnad_(-E: d .gaaL. ,_Uj nro „Cp, )v uu).ntlo([Uu;plruf 'L (ppati plooF, :(aun aRrp).Cicanpnv;;;DfrsV nsnaol_giu..rad1x1_ ,;a.,)iT r ..-quo //OW/ /0.11p iq pazapdum>aq fl 'nom Tit It?.?il.fai lult off ;Imo osn fib ' alb -pg L — / laddfdd l ni.0 s)d.tuqo papiAehici Hictfoutiofici.q(>a(7 r nGad! ��su)n .n -dud/ t(ec( 1 q fill I- OO11UDI cFS: um:nsur 101 F1C1 ail)0=cam n .Ili1`aa(* Cr 911 rd Dad? :..¢1111- ( i Il,]40tir7l rne)mc 1L1. [ ( 1 -drt c31 ?ne2J fdOi_ u ( 1 IdUN r - I al:p:u�d r 13 pv //:r 0 61.�izm C1 ( a.Cq,igcyvrd ri;.)tn1.: r ( o -n-1DI‘ ra -unba r ..iac>.vr n Ii.i et, iodup u(an lyd _ put: aymnu qnd I i 1"d:quoits) nnu m(aap.Cagod uam 'nndmoa , I Moat a Jn 111 q _s ,( „ 5 4, _z_ -05 .,L1 ,arl1 U r.1d�; � �G�( 7 7��[ rX , r.:1�a S , :.3H0d ( u ( a„ urs puCpun Sdyeid alp c! 1i0/311 s.vaab1(fuadin.rof aa11i7msc n'ffico.SJav.mnr.',wyiao.rJ..�toq(.rn.Po/drna mr um I• nq, .i, �iry 'II �;Pii i- iI. c/n-0Q/VI M ' ` 'er e� s nDdar}o l 1 `i sucl , Lcryw^Idn �I 111 ..:ndac u,alq 1 d r Ix- r 1 m;lp r u, !1np l� 0i iiHigotidoairlium:rd TT p@RB II -. 3V � '.(pc..1lnba ) oxd,)nod .- 11aoian I I ..nr ;r1 _4h�slO uW( l l ) rgir r , t Ir -nsoL (Ul1aL( t1 0) rSal (' naJ;=1rFindLsuadl ro Ai Jo) . ❑(.:,ii a ;.pjn ( . agi. ,(0 AC-0M CERTIFICATE OF LIABILITY INSURANCE °P�i1M`°°""" L---- 5xnC9n 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}, AUTHORIjED REPRESENTATIVE OR PRODUCER.AND THE CERTIFICATE HOLDER. IMPORTANT: if the certificate holder la an ADDITIONAL INSURED,the policylies) must 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 endorsementla). PRODUCER CONTACT PHOS. MARSH USR INC. TWO ASLµ.NCE CENTER ry ate Itiw N. 3id0LENOXROAD,SUITE 1400 a.M IL ATIANTA,GA 30325 .a{W REES INBURERIaIAe£eamNO COVEMOE NAICF 120492-HonfDGAW'47-0E INSURER A:ad Rowoliclnseance Do BIM INSURED INSURER e:APOmen((Menta Commw 142151 THE VMS DEPOT,WC, i HOME DEPOT USA N6. DaauwERC:New Hw sM Rd Co- 2455 PACES ERRY ROAD IN VRER a: BUILDING C.20 (^� ATLANTA,(2A 30939 !RORERER E: I INEYRIIER F: COVERAGES CERTIFICATE NUMBER: ASL003I453SI-14 REVISION NUMBER:2 THIS IS TO CERTIFY THAT rata POLICIES OF INSURANCE USTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NONA'1 HSTANOING 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*EN REDUCED BY PAID CLAIMS. ItPRI TYPE OP INBUaANC POpCY@BFP OLICYEMP 1 I'INfP`WVO, POLICY.YUMBER 1IIPTTIW r IPOUCIIYYYI' UNITS A X ,COMMERCIAL GERERAt UAdIUTY IUWZ1'31022 D31Di/22CE --010E2018 l RRACNGCCOR ENCF I &0 EE02 I GLAMS-MACE OCCUR �, ETo NrEp , la UNITS OF PCtct XS I Lleg PAria gee eel PERECPAnPw1 EXCLUDED ICE BIR:SIN°ER CCC 1 UPa 9,000,000 GEAGGREGATE UM T AP%JES PER IGENERAL AGGREGAIE 1 9,000,000X I ronCr �T ac {PROOU -Magog ere Sam, 020 IG -,(R ! ! 1 I A AUTOMOBILEIunFUTV MWT23ICC21 10310112011 034IR018 1 O(9NSIINNEEO5INd.E LIMIT N ANY Ault Ptstudent) IIUURY(PR Mien)AUTOS OWNED ITh SCHAUTOULECS SELF MSURELI AUTO PHY CMG BODLYINJURY(Per uawEnl' II`IASOAUTOS I ATOSWNED 7 PERITnr EEC 99 LVHaPa-MONS OCCURLAIM$-MADEiI ! 1 AGGREGATE I EACH OCCURRENCE ) I I 1 ODI. 8 weal RSCOMPExSAtmN WLRC49112'p01TN1 03[01Q214 03iOi2010 X I STATUTE_,,,, ER f AND EMPIAYPA£a Emu TY YtXt TINY PRopRETORarNEI+EX!Miv2 N NnA SVC�102423{AN,NII-NEVE 639112pII 0391tNi8 E L EIiOVCCEOENT ` fr20 • OFRCEWMa,MeER EXCLUDE° — • (Mandatary In Nal WC 023102424(WI} 031010017 0101p010 EL CISE.aSE-EwEMPLOYEE 19CC.009 I I yes depute,miler FCENnd cm PageAddiih,aII C ESCRIPTION OF OPERATIONS aglow EL DISEASE-ROUGE/IJMITI 4 UC9 DM I I ! M DESCRIPTION OF OPER/MONS r LOC/MONS I VEHICLES IACORD In AdESErul RsmM1s SeluduN,nut es Meted Il man spats Es am:Mad) avioENCE OF INSURANCE CERTIFICATE HOLDER CANCELLATION HOVE DEPOT USA,INC SHOULD ANY OP THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 24%9ACPS FERRY ROAD THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ATLANTA,GA 30339 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTAT1E of Marsh USA Inc. ManaeN Atukhwte ,,,btayase .,yaGatat+,a. 0 1980-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo am registered marks of AGGRO Rs,'ANCf CUSTOMER ID: I;172 LOC 0: Arldrta ACO ADDITIONAL REMARKS SCHEDULE Rage ZNCl I NAME°INSURED „1.01 NumDE,� 11:i TO ;S: F'ACA, 3Luarr Cd IfA,1 :6333 CARRIER 3A.e:Cee i =ELiNE D47 ADDITIONAL REMARKS THIS ADOITIONAL REMARKS FORM ISA SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TILE: Certificate of L'atiSt/Insurance tamer in�mniry,ers:am�v anon Ca nrnue 'n omn'/II AOT ASe.'ca auAn�e' y ?glee lumbar MLR 34911123';Ats1 R.LJR.}.:6,fl X. MC.9FN;ID 13.S3S3C.AN N'i e mlate:13011W] -urzlbn Dam e'l01.1013 (EI-•Lest SI ORAD Rae Camra Naw lamcemn:naranceCamean Psi Number NC 313102412 CC.0E.1,irI,MO aiN.RTn'I'LLI tc-0e01i2017 Elprann Dale 010112013 DELI eat 31300,]W ..sr ICE 4nancan'nsunrca 33matly ?sae(`tuner NCO 331189203IP:,C}:L.`IC:n./A Erec',CAR:0101,2017 Evc ton Cate:0.10V29fa EUL ,L 5b:C0.:C, SG 3Lii! Occ 3l d or Te Ales S1aZ CA 3.3C CP.ii NA Cama:NatieraI'an Eire lnsunnce Commie . roc,1unta.ono iiaN U,'CSp IC0,:17GA.NE'M.W/0H'iui Eateclrve Dale;01/01i1017 ucnatan Cala:0901401a See Um SI,000 lea SI MOM 3318 I0r IM stales L CO.MEM!MI,CIRRA UT 1750.000 SIR or al vete at 3A 1130.000 RIR Woe sate 01 CT _ mer rueaaI Orlon Rte mmnrce Cnmaay Adel Numb x'NO i333'IS•GSSI!NUI secm:a_PAv.01I Gonon)aad30'PGH SEL) 11,10010 �i1 cu0,<O 13 Emwyeo e3:rarer* :a erlmrCs IJnoarnuance:nmcens tRef x mbar TNS 043613201 7; EimMe Dale 97,1,20,7 1 ,'en Oaie'.)a0111013 or 1:a;c01Cn 1 "GOND ACORD 1O1 (2000101) N 3000 ACORD COR?ORATION. All rights reserved. The AGORD name and logo are registered marks of ACORD Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 126893 Type: Supplement Card Expiration: 8/3/2018 THD AT HOME SERVICES, INC. RICHARD TROIA 2455 PACES FERRY ROAD, HSC C-11 ATLANTA, GA 30339 Update Address and return card. Mark reason for change. Address Renewal Employment Lost Card Office of Consumer Affairs& Business Regulation License or registration valid for individual use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation Registration: 126893 Type: 10 Park Plaza -Suite 5170 Expiration: 8/3/2018 Supplement Card Boston, MA 02116 THD AT HOME SERVICES, INC. IHE HOME DEPOT AT HOME SERVICES _ RICHARD TROIA C- 2455 PACES FERRY ROAD, HSC - - - ATUiNTA, GA 30339 its' ✓F"E' '� undersecretary i of valid without stGMature • Du not(amme ling final code ins3e Son.Save Zabel focthra reference. e'".g>m I ._,,.sup caimdcaindi". 3 1 1 j 1 G_.1)%tom3vkiliS t e te,,{ ' YL Y p en .of .art- e e---e--e--1 _ cei .a 77-. 1) 4 r _ [lt T 3 1i"Wn::- 6 I 'U w.#f3 "avr. ,. urto = c f 'ughn4 1141* 1Y I � �I fl$ e .,,r :-, gin S ' I : r-,Faz:_:e- I AND-N-74 - i 1 '+:'audNnyioaita IF I • — 9 Dual Argon gonlLaw-E4 SrnartSun I is -'^`x '-. Podue.7ype; Double Hung EN IGY P-.'-HFO:L;,,OCF hT,7.itiTeS - 11 U-FactorSolar Hat Gain Coefficient _ o 4 %4 Oa 1 {US./I-PI i CMeic.17321 I _. ADDITIONAL F1L ORNIANCE RSTIN= Visible Transmittance 1 .r.--rvs—rs»+ee..-$--f.,>= ttt L '--Cd-12t- -e '.c 12- " -.. Andersen Ccmor horc 46C Sanas w=awaktt 1. ,.. _'ma . r rviu.=- :zomma.". I Stannard I Rating I ttasr.a. : 1 I FNIyF,'l'.:S ID ii i:N0.K@ R.reCdxt`- .ati G^ sn3st zcr_..:x„masr-se I e>,sr=rm 1 1 1 - 1 trio , „4*..-., I. r. , It . IA. I33 * - ',St ks. ,, 46-6 ic, VIADIgi, a+‘ :$ ft, , s„, tita „ se I Ild TON PREr 4. . 4. e 100 BURL NG $ 4.. FEEDING Hill, „ ‘-'‘' MA t 104 ..k. A: -< 4- t•°233 .. + I iii rkt* •3 ;#40 r 3 II” iv 3 . .1 1.1 'f."It.• C g 1'54'::tIC N.6.,' t„.6't 1 6.1\ 4.' te4t6“ :}4tr,‘P \1\ 4 j, Ex I i 3 f. - ' !Vtjots, 41.6, 171201 r , ;$ .,.., 4.. ..t." :33 3 3 *;VI , '"* * .3_ 3,43?. - .re,f 4.3 24s -^%.:,,,,, 21 , itka"7."44$7;hfr, i,,, - -"t • Itti ,‘ kt ;',^3.e ,' 'r, 1 '‘‘brn,k,'-, ,- 2 ' "". " • -'' 6.0 a are,Q;tk i" ' ....'ko ' • ,- r At'1-, L'''' P'WsAsLf I ;Cr" ...'-'4.'''' .3 3.t ,3,3 ,p /'' 6.6 ‘. f i Y6 S .'tNid,.rel 6 a ,a„,..r- ,6* ,:: ,16. I, 4kt!$ ,1•46‘i,446.! ii. Home Depot Contractor License Numbers: MA Home Improvement Contractor Reg.#126893 Salesperson Name and Registration Number: Timothy Drost : HIS 0553710, R-R-073-15-00005 Home Improvement Agreement Home Depot U.S.A., Inc. ("Home Depot") or Service Provider named below will furnish, install and/or service the equipment listed below at the price, terms and conditions as outlined on this form. Customer Information: Anne Downes Boston North 9903398 Flrst Name Last Name Branch Name Lead if 82 Pines Edge Dr NORTHAMPTON MA 01060 Customer Address City State '.p (413) 221-5588 Home PM1one# Work Phane# Cell Phone# annedownes82@gmail.com Customer E-mail Address NOTICE OF RIGHT TO CANCEL: YOU MAY CANCEL THIS AGREEMENT WITHOUT PENALTY OR OBLIGATION BY DELIVERING WRITTEN NOTICE TO HOME DEPOT AT: 908 Boston Turnpike Unit 1 Shrewsbury MA 01545 Address GIB State Zip or Email CustomerCancellationNorthEast@homedepot.com 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 DEPOTS RECEIPT OF YOUR NOTICE. YOU MUST MAKE AVAILABLE FOR PICKUP BY HOME DEPOT OR PROFESSIONAL, 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 DEPOTS EXPENSE. THE LAW REQUIRES THAT THE CONTRACTOR 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: X 03/12/2017 a.mmer are nre oate 1 Contract Price and Payment Schedule: Payment of the Contract Price is due upon completion unless a different payment schedule is specified in the State Supplement. 10619.00 Includes all applicable discounts, rebates, and , taxes. Contract Price $ Excludes finance charges.* Minimum °/deposit$ Due Immediately Remaining balance $ Due upon completion Finance Charges *Any interest payments or other finance charges will be determined by Customer's separate cardholder or loan agreement, to which The 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 payment(s) made payable to The Home Depot. Insurance proceeds will❑will not be used to pay some or all of the total amount of sale. Description of Work to be Performed: Installation of Windows A more detailed description of the work to be performed is included in the section entitled Scope of Work which appears on page 3 of this Agreement. Anticipated Delivery Date/ Installation Schedule Approximate Start Date: 05/07/2017 Approximate Finish Date: 06/04/2017 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. 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. By initialing this paragraph, I consent to receive only electronic records related to this transaction. — IInitial Acceptance and Authorization: By signing below, you authorize Home Depot to (a) arrange for Service Provider to perform Installation and/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/permitting information may need to be provided to You later.) By signing, you acknowledge that you have read, understand, and accept this Agreement in its entirety, including the General Terms and Conditions and State Supplement, if any. You further acknowledge receiving a complete copy of this Agreement. Keep it to protect your legal rights. Kr 03/12/2017 cusaome,,Signature Dale X Co-Signer(If applicable) Dale XIS 03/12/2017 Sales Consultant's signature _.__._.. Dale License number(s) held by or on behalf of the Home Depot: 2 Andersen Wood SPEC SHEET SC: Timothy Orosl Measure Tech INSTALLER: Brunn Name. Boston xoHh loo+. 9903398 weaned Bo ISM: Shp To Locaran Customer Name. Anne Downes Dale 031122017 Pageof SPEC REFF+I 3 SPEei+ Nun, Canal LWI Mtn OPTIONOPTIONS Barn In Or 3111.11lenel g Wyyq. WN Wen. FULL ildwled Vgww PrvYw �����y gRl INSERTSSI in MSC ea, mS SW in CON AER TRW VIPcalm.Nn ^"'7 ac swum hllam ) MEASUREONLY ONLY man Cast Dm,"Pow ana ort 0 .Ceum(aR BASH PACK% PIrl pap) OPTIONS leut pii`up1 OPTIONS. niTssm 3,er, TN SC Standard it Bets I Boo leer s dig os Pattern MAC Loam., Emu, Sense ITEcia.Eden,33,33 J.,Sumer( (WIDTP Size Gad Emenor intern, Van Rom Van Rau a Leber (VM(te Type Styht Colo Colo Line,Sao AW . 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