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06-026 (2) 62 LEONARD ST BP-2019-0735 GIS#: COMMONWEALTH OF MASSACHUSETTS MakBlock:06-026 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL e.142A) Category: window replaced BUILDING PERMIT Permit# BP-2019-0735 Project# JS-2019-001208 Est.Cost: $2507.00 Fee: $65.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: SEARS HOME IMPROVEMENT PRODUCT 097519 Lot Size(sq.ft.): 23217.48 Owner., CAISSE SUSAN D Zoning:URA(109)/ Applicant. SEARS HOME IMPROVEMENT PRODUCT AT. 62 LEONARD ST Applicant Address: Phone: Insurance: 827 THOMPSON RD (860) 753-0452 O WC THOMPSONCT06277 ISSUED ON:12/21/2018 0:00:00 TO PERFORM THE FOLLOWING WORK.-INSTALL 2 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: Fe, eType: Date Paid: Amount: Building 12/21/2018 0:00:00 $65.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner 6vorV 0 awls Department use only L , ar,r City of Northampton R E I VlCurb of P rmit: Building Department ut/D iveway Permit 212 Main StreLtDEC 2 0 7 Sep c AvailabilitRoom 100Well Availability Northampton, MAF.UII mw; Structural Plans phone 413-587-1240 Fax2 ns 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 62 [..eonara Map 6L� Lot DA�p Unit l S ' Q 0 OG 2Zone T Overlay District___________. I`- '_` Elm St. District CB District SECTION 2 -PROPERTY OWNERSHIPIAUTHORIZED AGENT 2.1 Owner of Record: Gz Namc(Print) Cu nt Mailing Addr s: Telephone ' 4 4 Signature 2.2 Authorized Agent. f t, j, 8 Z 7 7 o w ps o yl Road 0 c_ -� - _ - omt3s 1_. c_77 !_�6 Z_ 7.7 Na (Pri t) Current Mailiness: i — -u- --- -- --- --960 • 7G3 - Telephone SECTION 3 -ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars)to be Official Use Only completed by permit applicant ?. Building (a) Building Permit Fee 2. Electrical (b) Estimated Total Cost of Construction from 6 3. Plumbing Building Permit Fee — iv()06 4. Mechanical (HVAC) 5. Fire Protection //�� 6. Total = 0 + 24 3 +4 + 5) 2 S V Check Number This Section For Official Use Only :EateBuilding Permit Number:_____ d: __ Signature: / /Z- 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 to be tilled in by Building Department Lot Size Frontage Setbacks Front Side L: R: L: Rear Building Height Bldg. Square Footage 0/1, Open Space Footage % (Lot area minus bldg&pay ed parkins.) # of Parking Spaces Fill: (volume&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO 0 DON'T KNOW YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO Q DON'T KNOW YES 0 IF YES: enter Book Page and/or Document # B. Does the site contain a brook, body of water or wetlands? NO O DON'T KNOW � YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained 0 Obtained 0 , Date Issued: C. Do any signs exist on the property? YES 0 NO 0 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 ( 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 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 ❑ Addition [—] Replacemenindows Alteration(s) ElRoofing Or Doors Accessory Bldg. ❑ Demolition ❑ New Signs [E:I] Decks [[] Siding [0] Other [0] Brief Des r tion of Pro a e Work: 17 5Ta �z� �?�Ip lac�v>rl,eVl,-� _Xi n o w5 L�'F�G-f-c�r ` � ' �a Alteration of existing bedroom Yes No Adding new bedroom Yes X No Attached Narrative Renovating unfinished basement _ Yes Plans Attached Roll - Sheet 6a. If New house and or addition to existing housing, complete the followin a. Use of building : One Family_ Two Family Other b. Number of rooms in each family unit:_ Number of Bathroo 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. Z Masscheck Energy Compliance form attached? h. Type of cons/car __ __i. Is constructietlarids? Yes No. Is construction within 100 yr. floodplain Yes No j. Depth of basfloor below finished grade k. Will buildingBuilding and Zoning regulations? Yes __ No . I Septic Tankewer _ Private well _ _ City water Supply SECTION 7a -OWNER AUTHORIZATION -TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT S a Ca i SC_=0 ___ _ __ __ as Owner of the subj( property (s?Q k5 T' L hereby authorize -S ears) A,, �� �.1�� to act on my behalf in all m tters elative to work auth ,razed by th building permit application. i9 nature of Owner Date as Owne iya? er ereby declare that the statements and information on the foregoing plication are true and accurate, to the best of and belief. Signed un er the pains and penalties of pe, 'ury. Print Nam(; SECTION 8- CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: , Not Applicable LJ Name of License Holder:.h-- Lot) SV eta- - –( / 5 19 8 +7 D M P ' !C J 0 '? [� License Number . / /` CCC��� CCC.... ... - -� 06 27 Off'- !C/ Ad ss Expin 8KD • 7G 3 . 04!!- ;_Z Teleph ne 9. Registered Home Improvement Contractor: LL Not Applicable ❑ Searc, , a - L(;5 ec- 1-490- Company tTame Registration Number ears - _ -- v� - ' -- --------- -- -- ---- - 6 �ae- 37— Address ,, p1U` 86-- Expir ion D` D Telephone 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 in the denial of the issuance of the building permit. Signed Affidavit Attached Yes....... xNo...... ❑ City of Northampton .01 Massachusetts .;_ DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building --'� Northampton, MA 01060 AFFIDAVIT Home Improvement Contractor Law Supplement to Permit Application The Office of Consumer Affairs and Business Regulation ("OCABR") regulates the registration of-contractors and subcontractors performing improvements or renovations on detached one to four family homes. Prior to performing work on such homes, a contractor must be registered as a Home Improvement Contractor("MIC"). M.G.L. Chapter 142A requires that the "reconstruction, alteration, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner-occupied building containing at least One but not more than four dwelling units....or to structures which are adjacent to such residence or building" be done by reuistered contractors. Note: If'the homeowner has contracted with a corporation or LLC that entity must he registered. Type of Work: CZ. � c� aeCE►rn V1Cost: Address of Work: Date of Permit Application: 1 hereby certify that: Registration is not required for the following reason(s): Work excluded by law (explain): Job under $1,000.00 Owner obtaining own permit (explain): Building not owner-occupied Other (specify): OWNERS OBTAINING THEIR OWN PERMIT OR ENTERING INTO CONTRACTS WITH UNREGISTERED CONTR-ACTORS OR SUBCONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK ARE NOT ELIGIBLE; FOR AND DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER M.G.L. Chapter 142A. SUCH OWNERS ALSO ASSUME THE RESPONSIBILITF.S FOR ALL WORK PERFORMED UNDER THE BUILDING PERMIT. SEE NEXT PAGE FOR MORE: INFORMATION. Signed under the penalties of perjury: GAY I hereby apply for a builZ"14305 * g pe mit as the gent of the owner: S v ec.- i2 t _ / gG'D � Date Contractor Name I IIC Registration No. OR: Notwithstanding the above notice, I hereby apply for a building permit as the owner of the above property: A)A Date Owner Name and Signature City of Northampton �4x. r, C� J Massachusetts ' DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street •Municipal Building Northampton, MA 01060 Debris 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. The debris from construction work being performed at: Leo Y)ct r S+' '+ (Please print house number and street name) Is to be disposed of at: -E V) — ru G�— I V, 33 G bt V) '1 v rs 1 '�X A V e r1 (A � IWO&IM= )'x4 A- - 6 2 09 d (Please print name d location of facility) Or will be disposed of in a dumpster onsite rented or leased from: (Company Name and Address) / l � na r nt or Owner Date If, for any reason, the debris will not be disposed of as indicated, the Applicant or Owner shall notify the Building Department as to the location where the debris will be disposed. The Commonwealth of Massachusetts `---r Department of Industrial Accidents 1 Congress Street, Suite. 100 Foston, MA 02114-•2017 w�v www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Conti- actors/Electricians/Plumbers-TO BE FILED w rill THE PERMITTING AUTHORITY. AM icant Information -- ---�_— --------- - _ --- 'lease Print Lc iQ lily Name (13usiness/Organization/Individual): Sears HQme Improvement Products Incorporated Address: 1024 Florida Central Parkway City/State/"Zip: Long1.wood, FL 32750 Phone /1: 860-753-0452 Are you an employer?Check the appropriate box: Type of project (required): 1 E I all,a employer with _ _employees(full and/or part-(ime).* 7. ❑ New construction 2 ❑I ant a sole proprietor or partnership and have no employees working for nu in 8. ❑ Remodeling any capacity.[No workers'comp. insurance required.] 9. [] Demolition 3.Q 1 am a homeowner doing all work myself.[No workers-comp.insurance required.]' 10 ❑ Building addition 4.❑ I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or arc sole 11.❑ Electrical repairs or additions proprietors with no eniployces. 17.L__!Plumbing repairs or additiotls 5.❑ I ant a general contractor and I have hired the sub-conu'actors listed on the attached sheet. I'hese sub-contractors have entployces and have workers'comp.insurance. 13.❑Roof repairs 14.RjOthekz).R� G.N We are a corporation and its officers have exercised their right of exemption per MGL c. 1.52-,§1(4),and we have no entployces.[No workers'comp.insurance required.] ` 'Any applicant that checks box Hl must also fill out the section below showing,(herr workers-compensation policy information. r liontcowncrs 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 most attached an additional shcct showing the name of the:sub-contractors and state whether or riot those entities have employees. If the sub contractors have employees,they must provide their workers'comp.policy number. /am an employer that is providing workers'compensation insurance for niy employees. Below is the policy and job site in furnration. Insurance Company Name:' Ace American Insurance Company / Phone : 866-283-7122 Policy 4 or Self-ins. L.ic. #: WLRC65226236 l xpiration Date: 01/01/2019 Joh Site Address:_.2_-.ham(:ohQ_r�.- r City/State/"Lif „ S 3 {� 010G3 , Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). I ailurc to secure coverage as required under MGL c. 152, j25A is a criminal violation punishable by a fine up to $1,500.00 and/or otic-year imprisonment,as well as civil,penalties in the form of a STOP WORK.ORDER and a fine of up to$250.00 a (fay against the violator. A copy of this statement may be forwarded to the. Office of Investigations of the DIA for insurance coverage verification. I do herebv cer4i y ur der the pal and penalties ol'peri rry that the information provided above is true and correct. —� - Phone ll: 0-753 0452 Official use only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License # Issuing Authority(circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5, Plumbing Inspector 6.Other Contact Person: Phone ly: r-n um Al DATE(MM/DD/YYYY) A�RO CERTIFICATE OF LIABILITY INSURANCE F 08/09/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this w certificate does not confer rights to the certificate holder in lieu of such endorsement(s). c PROOUCFR CONTACT _NAME: _ _ Aon Risk services Central, Inc. -- ----3--- - - _.... - - Chicago it. office a�No.Exp (866) 283-7122 I FAX No) (800) 363 0105 m _.___. --- 200 East Randolph F-MAIL. o Chicago IL 60601 USA ADDRESS: _ INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A: ACE American Insurance company 22667 oINSURER Sears Holdins Corporation B: ACE Fire Underwriters Insurance Co. 20702 dba Sears Home Improvement Products, Inc - suss— ------suss- --- --.---- ------- ------- -- -- ----- - Attn: Risk Management E.3-219A INSURFRC: 3333 Bever/ Road : Beverly INSURER D:D: uoffman Estates IL 60179 USA INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570072659454 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 CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Limits shown are as requested �NSR ADD[ SUBRI POLICY EFF POLICY FXP -R TYPE,OF INSURANCE NSD WVD POLICY NUMBERMMIDDIYYYY MM/DDIYYYY LIMITS A X COMMFRCIAI.GENERAI.LIABILITY HDOG71. 7614 1 1 011012019FACH OCCURRENCE $5,000,000 r _ - Cl AIMS-MADE I XDAMAGE IO RENTFD. OCCUR $5,000,000 PREMISES(Fa occurrence)_ MED EXP(Any one person) FXCI tided PERSONAL.8 ADV INJURY $5,000,000 GEN'L.AGGREGATE LIMIT APPLIES PER: GF..NERAI AGGREGATE $5,000,000 PROLOGPOLICY ( ]JECT f !LOC PRODUCES COMPiOPAGG $5,000,000 ti OTHER. AISA H2515989S 08/01/2018 01/01/2019 COMBINED SINGLE I,IMII O AUTOMOBILE LIABILITY $5,000,000 A TSA H25159871 08/01/2018 01/01/2019-lEaaccldePil- AANYAUTO TSA 1125159883 08/01/2018 01/01/2019 BODH Y INJURY(Per person) 0 Z X OWNED --"SCHEDULED BODII.Y INJURY(Per accident) N AUTOS ONLYAUTOS -suss NON-OWNED PROPERTY DAMAGE V X HIRED Al1TO5 X - Perccident w ONLY ..__AUTOS ONLY ( _a.__—_ d UMBREI LALIAB Ir I{ OCCUR FACH OCCURRENCE U EXCESS LIAR -._I CLAIMS-MADE AGGREGATE -- - - - DFD RETENTION A WORKERS COMPENSATION AND wcuc65226273 08/01/2018 01/01/2019 X ATUTE O EMPLOYERS'LIABILITY YIN OH, WA, WV -�PER ST- E I EF2TH- _ - - ANY PROPRIETOR;PARTNER!FXFCUTIVF ( -1 F L.F.ACH ACCIDENT $2,OOO,000 A OFFICER/MEMBERFXCLUDED7 I N—I NIA WLRC65226236 08/01/2018 01./01./2019 ___ __— __ -.. (Mandatory in NH) 111 All Other States F . DISFASFEA EMPLOYEE $2,000,000 If yes.describe under ... _ DESCRIPTION OF OPERATIONS below F.L. DISEASE-POLICY LIMI r $2,000,000_ nESCRIPTION OF OPERATIONS I LOCATIONS I VF.HICI.ES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Alfred W. Nyman, 7r. License # CMC1249510, CGC012538, CCC1329316 located @ 1024 Florida Central Parkway, Longwood, FL 32750. Dell R. Hoyt license #CGC1S1/994 located @ 1024 Florida central Parkway, I.ongwood, FI. 32750. �I CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THF ABOVE. DESCRIBED POLICIES BE CANCELLED BEFORE THF EXPIRATION DATE -rHFREOF, NOTICE WILL. BF DELIVERED IN ACCORDANCE WITH THE. POLICY PROVISIONS. Sears Home Improvement Products AUTHORIZED REPRFSENTATIVF 1024 Florida Central Parkway p Longwood FL 32750 USA ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 570000034159 LOC#: �- ADDITIONAL REMARKS SCHEDULE Page of AGENCY NAMED INSURED Aon Risk Services central, Inc. Sears Holdings corporation POLICY NUMBER See Certificate Number: 570077659454 CARRIER 77�1 See certificate Number: 570072659454 I.1:1ECIw1,'DAI ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance INSURER(S)AFFORDING COVERAGE NAIC# INSURFR INSURI:R INSURFR INSURER ADDITIONAL POLICIES Ifa policy below docs not include limit information,refer to the corresponding policy on the ACORD certificate form for policy limits. I'(II,IC1' I'ULI('Y IN'SR ADUI, SUBIt POLK'1,NU;NIBFR EFFIE('"I"IVE EXPIRATION LINIll:s I:1'R ll'PI(OFIN'SURANCF INSD %V%1) DAF F. DAIT (SIM/UIl/1'1'11') Ipt n7/UU/A"1'1'YI WORKERS COMPENSATION B N/A scEc65226315 08/01./207.8 0]/01/1019 W1 ACORD 101(2008101) ©2008 ACORD CORPORATION.All rights reserved. The ACORD name and logo are registered marks of ACORD f 1,T)A1 tJf3 JP,ck if yl {i�i3`+ i LtS r Board uB110dwq Rclkdatsr, , �'S 097519 LUBOS SVEC 827 THOMPSON ROAD THOMPSON CT 06277 Job:24904807 Page 1 of Y 'II'III'IIII"II Off ce Location: HARTFORD Proposal Date 11/20/2018 Job Number 24904807 Sears Home Improvement Products,Inc. Customer Name 5!9eairrs BOX 522290 102 SUSAN CAISSE 1024 FI OIZIDA CP.NTRAL.PARKWAY Customer's Home Phone Customer's Work Phone LONGWOOD, FL 32750-7519 (920) 889-8414 Home Improvement Products PHONE(800)469-4663 Street Address Contractor License/Registration Number 62 LEONARD ST ESTIMATE AND PROPOSAL MA(14860!) City State Zip Code LEEDS MA 01053 Is installation within city limits? Installation Address County HAMPSHIRE (Yes/No): YES Billing Address(if different from above) 77- State Zip Code Project Consultant Name&License No.(if applicable) Billing Address(if different from above) DANIEL MCDONNELL HIS.0S60733 Description of the Project and Description of the Significant Materials to be Used and Equipment to be installed Interior Products / Exterior Products IIome Warranty ❑Vinyl Siding ❑Rooling ❑HVAC ❑Kitchen Remodeling ❑Countertop ❑Whole House Floating Windows ❑ARIC Insulation ❑Cabinet Refacing ❑Flooring ❑System ❑Painting ❑Doors ❑Garage Doers ❑Bathroom ❑Appliance SPECIAL INSTRUCTIONS: UPON INSPECTION SEARS WILL INSTALL NEW WINDOWS. WE WILL REMOVE OLD WINDOWS AND ALL JOB RELATED DEBRIS. MOLD REMEDIATION: This Estimate and Proposal assumes that no mold remediation will be needed during installation work. If, upon inspection by the contractor or others, it is learned that mold remediation is necessary then Customer must arrange and pay for such remediation by a qualified person prior to the start or continuation of work. If Customer fails to arrange for necessary mold remediation within thirty (30) days, Sears may cancel this contract upon written notice to Customer. ASBESTOS ABATEMENT:This Estimate and Proposal assumes that there are no asbestos containing materials("ACMs")that would be disturbed in the performance of the installation work. If upon further inspection by the contractor or others it is learned that ACMs have to be disturbed to perform work, then Customer must arrange and pay for abatement of asbestos by a qualified person prior to the start or continuation of work. If Customer fails to arrange for necessary asbestos abatement within thirty(30)days,Sears may cancel this contract upon written notice to Customer. The TOTAL PRICE including all labor,material,taxes and any applicable discount is $ 2,S07.42 Contract Price $2,507.42 Earnest Money $ 5oo.00 State SaleST ax $ 0.00 'INITIAL PAYMENT(Not to exceed 30%of TOTAL PRICE;payment is due prior to Local Sales Tax $ 0.00 ordering of product;excludes HVAC in which the INITIAL PAYMENT is 100%.) $252.23 Initial Payment Subtotal $ 752.23 FINAL PAYMENT(balance payable upon completion of job) $ 1,755.19 Total Amount Due $ 2,507.42 'The Initial Payment is due prior to Sears ordering products.A Cancellation Fee of up to$ 500.00 plus any incurred materials costs,up to 30% of the Total Price,may be assessed. Financing: The form and method by which the Customer(s)will pay is described in a separate Cash/Credit Card Payment Addendum made a part of and incorporated into this contract by reference. All of the above check boxes(and associated Product Addendurri"Work NOT to be done:","Additional work to be done:","Special Instructions: "Mold Remediation","Asbestos Abatement,"and"Financing:"sections have been reviewed by and explained to me. Product Addendum(s)is/are made a part of and incorporated into this contract by reference. Customer(s)initials � - NOTICE TO BUYER: YOU, THE BUYER, MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD(3) BUSINESS DAY, FIVE (5) BUSINESS DAYS IN MARYLAND, (FIVE (5) BUSINESS DAYS IN ALASKA, SEVEN (7) BUSINESS DAYS IN MARYLAND, FIFTEEN(15) BUSINESS DAYS IN NORTH DAKOTA IF YOU ARE 65 OR OLDER) AFTER THE DATE OF THIS TRANSACTION. SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. SKI-(Dig.) Rev 10/16/17 Job:24904807 Nage 2 of l Window Addendum Consultation Info Lead Number: 24904807 Date:720/2018 Sales Rep: DAN1EL Mr::DONNELL Customer Name: SUSAN C'.1wSL' Phone: 92 ;8898414 Address: 62 Lc,ONARu sr City: I LEER S I State: MA Zipcode: I '1` Description of • Description 1. Remove existing units to be replaced. (PLEASE NOTE: The removed units are likely to be damaged.) 2. Prepare openings as necessary to receive replacement units. (NO finish work other than normal installation is to be done unless otherwise noted below.) 3. Installation includes the clean-up of all job-related debris upon completion of the job. 4. (If applicable)After the completion of the project, the customer will be responsible for the application and removal (storage)of shutter panels. In the event that the project requires the installation of storm shutters or egress windows, Sears Home Improvement Products, Inc. ("Sears")will not re-install any affected security bars. 5. (If applicable) In the event Sears is unable for whatever reason to obtain the proper permits prior to the commencement of any work, Sears will refund any previous payment and this contract will be automatically canceled. Summary of Window Order Addendum (see detailed Window Order Addendum for more information): Type: KB PLus Quantity: 2 Type: Quantity: Type: Quantity: Type: Quantity: Type: Quantity: APPROXIMATE START DATE and APPROXIMATE COMPLETION DATE: The work will start approximately 2-4 WEEKS (Approximate Start Date) It will be substantially completed by approximately 3-1 `I' ` ' (Approximate Completion Date) These dates are subject to change at the time the contract is accepted by Sears Home Improvement Products,Inc.("Sears")or at any other time by mutual written agreement.Customer understands that the Approximate Start Date is only an estimated date and the Customer will be contacted prior to this date to schedule the actual start date. The TOTAL PRICE including all labor,material, taxes and any discount is $ 2,507.42 Contract Price $ 2, 507.42 Initial Payment(not to exceed 30%of Total Price unless Special Order) $ 7 '` State Sales Tax ( u n %)$ 01. Final Payment(balance payable upon completion of job) $ 1, 5 s.i Local Sales Tax ( 00 0/0)$ 0.00 The Initial Payment is due prior to Sears ordering products. Total Amount Due $ 2, 507.4-1 Job:24904801 Page 3 of 7 Additional work to be done: N rw Work NOT to be done: Removal or moving or any walls; flooring, painting, wallpaper work; repairs of water or termite damage to sub-floors or walls; electrical or plumbing work outside of this kitchen or bath project. SEARS' LIMITED WARRANTY ON INSTALLATION In addition to any manufacturer warranty extended to you on the product(s)used(which warranty becomes effective the date the merchandise is installed),if the workmanship(or application)of any Sears'arranged installation proves faulty within(i)one year for Weatherbeater Value Line,(ii) two years for Weatherbeater Plus,or(iii)three years for Weatherbeater Max,and Weatherbeater Storm,then upon notice from you Sears will cause such faults to be corrected by repair at no additional cost to you. If Sears determines that repair is not commercially practicable or cannot be timely made,then,at Sears'sole discretion,Sears may elect to provide replacement or refund.Service under this Limited Warranty is available by calling Sears Home Improvement Products at 1-800-222-5030,Option 4.This warranty gives you specific legal rights,and you may also have other rights that vary from State to State. Proposal Gode pescription Unit ooMeasouree Units> W020 Wincore. WR PLUS(Wincore) 1.00 Warranty Weatherbeater Plus W751 Additional Labor. Lead Safe-Windows Each 2.00 Job:24904801 Page 4 of I 1024 Florida Central Pkwy ORDER: 249048070001-B Longwood, FL ORDER DATE: 11/20/2.018 sears , EST. DELIVERY DATE: 11/21/2018 ORDER CONTACT: WINDOW ORDER ADDENDUM INVOICE INFORMATION SHIPPING INFORMATION [HARTFORD] SHIP VIA: �., 24904807000 11/20/2018 0 1-B ..... 1 DOUBLE HUNG 1 2.7 W X 45 H WHITE LOWE/ARGON/LEEP DOUBLE STRENGTH -- FULL SCREEN MAX CLEARANCE DIMENSIONS=[21.75 X 15.0625] 2 SLIDER 1 57 W X22 H WHITE LOWE/ARGON/LEEP DOUBLE STRENGTH FULL SCREEN MAX CLEARANCE DIMENSIONS-[23 X 16.751 TOTALS: 2 COMMENT: Job:24904801 page 5 of ADDITIONAL PROVISIONS Proposal and Approval.Sears offers to furnish the materials and arrange for their delivery and installation as specified on the first page and/or the attached sketches and specif cation sheets for the TOTAL PRICE shown. This offer must be approved by the Installation Department. If this is a credit sale or a payment on completion sale, it must be approved by the Credit Sales Department. If this proposal is not approved or the installation cannot be made in accordance with the law, this offer will be withdrawn and any payments you have made will be refunded to you.Any materials left over after the installation has been completed are Sears property and will be removed by Sears. Installation. I understand that Sears will not install the materials but will arrange for the installation. Sears is not responsible for materials or installation NOT furnished or arranged by Sears. Sears' installation contractor(s)will obtain all building permits required by local law. For homes located in historic or landmark zoning districts; Customer will be responsible for obtaining required approvals and related permits prior to the commencement of work on this contract. Authorization. I authorize Sears to: (1) arrange for a contractor (licensed where required by law) to make the installation of materials; (2) issue a work order for this installation to a contractor; (3) inspect the installation; and (4) pay the contractor when the installation is complete if I have signed a certificate that the installation has been completed to my satisfaction. Delays in Installation. I agree that Sears is not responsible for delays in delivery or installation due to weather,fire,strikes,war, government regulations or any causes beyond Sears'control. Oral Agreements and Changes in Contract. I understand that there are no oral agreements between Sears and me. Everything I expect Sears to do has been included in writing in this contract.Nothing can be changed in this contract unless it is in writing on a separate form accepted by me and Sears. Responsibility of Buyer. I agree that any information or measurements that I give to Sears are correct and complete. I am responsible for any special work described in this contract. Electrical & Plumbing Service. I will provide adequate electrical and/or plumbing service(s) to run any newly installed appliances or other furnishings. If the electrical and/or plumbing service(s) do not meet the standards of the utility company or electrical and/or plumbing codes, I will make the necessary changes at my expense unless Sears has agreed in this contract to make the changes. Payment.I will pay Sears the cash price that covers the price of material and installation as shown on the first page. Warranty Information.Appropriate product warranty documents will be given to me by Sears.Sears'Warranty on Installation is displayed in the Product Addendum. (Dig.)Rev 06/07/17 Job:24904807 Page 6 of 7 NOTICE TO MASSACHUSETTS RESIDENTS ONLY In addition to the Notice to Buyer shown below, Massachusetts law requires that contracts for home improvement work state that all home improvement contractors and subcontractors shall be registered and that any inquiries about a contractor or subcontractor relating to a registration should be directed to: Office of Consumer Affairs and Business Regulation Ten Park Plaza, Suite 5170 Boston, MA. 02116 Telephone: (617)973-8700 Please note that owners who secure their own construction-related permits or deal with unregistered contractors shall be excluded from access to the Guarantee Fund. ----------------------------------------------------------------------------------------------------- Notwithstanding any other language in the contract or associated documents, Sears will not remove, replace, or install any heating or air conditioning system, or any portion thereof, if asbestos or asbestos-containing material is known or likely to be present in that heating or air conditioning system, or any portion thereof. If it is determined or reasonably suspected that asbestos is present, either before commencement or during performance of the work, it shall be the customer's responsibility to select, retain and pay all costs of a Division of Occupational Safety ("DOS") licensed Asbestos Contractor to remove all asbestos or verify that none is present in the components involved in the job. If the determination or reasonable suspicion of the presence of asbestos arises after Sears has started the work, Sears will immediately cease performing the work until a DOS licensed Asbestos Contractor, hired by the customer, removes all asbestos from the components scheduled for repair or replacement in accordance with 310 C.M.R. 7.00 and 453 C.M.R. 6.00 or verifies that none is present. By signing the contract the customer agrees that it understands the above. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES NOTICE TO BUYER 1. DO NOT SIGN THE AGREEMENT IF ANY OF THE SPACES INTENDED FOR THE AGREED TERMS TO THE EXTENT OF THE AVAILABLE INFORMATION ARE LEFT BLANK. 2. YOU ARE ENTITLED TO A COPY OF THIS AGREEMENT AT THE TIME YOU SIGN IT. KEEP IT TO PROTECT YOUR LEGAL RIGHTS. 3. YOU MAY PAY OFF THE FULL UNPAID BALANCE DUE UNDER THE AGREEMENT AT ANY TIME, AND IN SO DOING YOU SHALL BE ENTITLED TO A FULL REBATE OF THE UNEARNED FINANCE AND INSURANCE CHARGES. 4. YOU MAY CANCEL THIS TRANSACTION, WITHOUT ANY PENALTY OR OBLIGATION, WITHIN THREE (3) BUSINESS DAYS, FIVE(5) BUSINESS DAYS IN MARYLAND, (FIVE (5) BUSINESS DAYS IN ALASKA, SEVEN (7) BUSINESS DAYS IN MARYLAND, FIFTEEN(15) BUSINESS DAYS IN NORTH DAKOTA IF YOU ARE 65 OR OLDER) FROM THE ABOVE DATE. SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. FAILURE TO EXERCISE THIS OPTION, HOWEVER, WILL NOT INTERFERE WITH ANY OTHER REMEDIES AGAINST THE RETAIL SELLER YOU MAY POSSESS. IF YOU WISH, YOU MAY USE THIS PAGE AS NOTIFICATION BY WRITING "I HEREBY RESCIND" AND ADDING YOUR NAME AND ADDRESS. A DUPLICATE OF THIS RECEIPT IS PROVIDED BY THE SELLER FOR YOUR RECORDS. 5. CANCELLATION FEE. I UNDERSTAND THAT SEARS, UPON ENTERING INTO THIS AGREEMENT,WILL PROMPTLY INCUR SIGNIFICANT COSTS TO START MY PROJECT. FOR THIS REASON, I AGREE THAT SEARS HOME IMPROVEMENT PRODUCTS WILL RETAIN AS A CANCELLATION FEE THE "EARNEST MONEY" AMOUNT SHOWN AS PART OF THE TOTAL PRICE IN THE EVENT THAT I ELECT TO CANCEL THE AGREEMENT AT ANY TIME AFTER THE EXPIRATION OF ANY LEGAL RIGHT OF RECISION. THIS CANCELLATION FEE WILL BE IN ADDITION TO ANY AMOUNTS I MAY OWE, AND WHICH I AGREE SEARS MAY RECOVER DIRECTLY FROM MY INITIAL PAYMENT, FOR MATERIALS ALREADY ORDERED BY SEARS PRIOR TO CANCELLATION. 6. IT SHALL NOT BE LEGAL FOR THE SELLER TO ENTER YOUR PREMISES UNLAWFULLY OR COMMIT ANY BREACH OF THE PEACE TO REPOSSESS GOODS PURCHASED UNDER THIS AGREEMENT. C 2 ii 1 Customer Signature Date Customer Signature Date Accepted by Sears Home Improvement Products,Inc.("Sears")on _;20 L 8 by 0>�" -)v Date Management Representative wCw 7700 Series Vinyl Double Hung Window ��(icoii Fenestration MNYL FRAttE•'_0'.!!EIARGOYCI EAR-ORDS i Vertical Slider Window C PD:'11CW--M 30 ..00198—00002 ENERGY PERFORMANCE RATINGS U—Factor(U.S.1—P) Soiar Heat Gain Coefficient 0 .30 0 .21 ADDITIONAL PERFORMANCE RATINGS Visible Transmittance 0 .41 lac'eie=slipI an at tral these raliogs cmt'vi.ic 3 plu've f4FRC praceduros for del enni ing iffol= �,t uerfor n e NFRC ra ingsare da er t ie.`o ted e[at i LcimPl13i couditlans a n n 1i c craduc sl.e JRC does not teca nn.ml,n,t aroduet 31ad do s nul nar an:,Ire suial li+,ar may I o"or en e.l,;>. consu!:nenafaciver s I E Njip,for i at Rodoa performance m u at;C� STAR"" In All + States ;sign Pressure:+25 1 —25 aximum Size:52 x 72 3C:None +sting Standard:AkAA/WDr1AICSA 101!IS21A440-05 :st Lab: ARCHITECTURAL TESTING INC.