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134 SPRUCE HILL BP-2022-0331 134 SPRUCE HILL AVE COMMONWEALTH OF MASSAC H U S ETTS Map:Block:Lot: 29-234-001 CITY OF NORTHAMPTON Permit: Exterior Res PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit# BP-2022-0331 PERMISSION IS HEREBY GRANTED TO: Project# windows Contractor: License: Est. Cost: 2390 LOWES HOME CENTERS INC 112271 Const.Class: Exp.Date:09/01/2023 Use Group: Owner: W HINDLE JAMES K& EMILY Lot Size (sq.ft.) Zoning: WSP Applicant: LOWES HOME CENTERS INC Applicant Address Phone: Insurance: 1000 LOWES BLVD (413)272-8931 O WC016393105 MOORESVILLE, NC 28117 ISSUED ON:04/05/2022 TO PERFORM THE FOLLOWING WORK: REPLACE 2 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: Gas: Final: Final: Rough Frame: Rough: Fire Department Driveway Final: Fireplace/Chimney: Final: Oil: Insulation: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: )2 • Fees Paid: $40.00 212 Main Street, Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner 1WI - I ' '. --: r. . - )1( _ Va) ' Zr f WA. CL 4 1 L 1,4W 1 ;ZIA 1,1 nlv-edts, 3oto (i 7,b 1 g s. :" The Commo/i lirt hh of Massachusetts t 1„ r ., Board of Building Regulations and Standards FOR ' Massachusetts State Building Code, 780 CMR MUNICIPALITY USE —� �.. :.Building Permit Application To Construct,Repair,Renovate Or Demolish a Revised Mar 2011 LL__ One-or Two-Family Dwelling � ,1_____ This Section For Official Use Only ___Balding P it Number:6 P A. - �` Date Applied: I �)l���s j/: y-q-zozz Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 PSQpfrt, P►�(�s Q 1.2 Assessors Map&Parcel Numbers 3 1.1a Is this an accepted street?yes no Map Number Parcel Number 13 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq II) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public 0 Private 0 Zone: _ Outside Flood Zone? Municipal 0 On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Ownle�' f Record: :la MIA. c)---4 r)61)e_._— 4ilitila 0/UP D101,2_ Name(hint) City,State,ZIP 1,341- SO(UN iJ ) I E --24/3 ae>03 I-1-1NnLE 1 ,a 6rnQnt. No.and Street Telephone Em tl Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction❑ Existing Building 0 Owner-Occupied ❑ Repairs(s) 0 Alteration(s) 0 Addition ❑ Demolition 0 Accessory Bldg.0 Number of Units Other 0 Specify. Brief Description of Proposed Work?: Q `Q,f/)('//,/# bait/Q civA5 y-) ,S0 (ye*uraL ti 1K.h.P>x_q do/U SECTION 4:ESTIMATED CONSTRUCTION COSTS Estimated Costs: Item Official Use Only (Labor and Materials) 1.Building $ Q2.3qj� . I. Building Permit Fee:$ Indicate how fee is determined: 2.Electrical $ ❑Standard City/Town Application Fee ❑Total Project Costa(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4. Mechanical (HVAC) $ List: 5.Mechanical (Fire $ 0 fi,Suppression) Total All Fees: $ 'L l 6.Total Project Cost: $ •f) Check No. '501 Mica'Amount: v Cash Amount: �-39() 0 Paid in Full 0 Outstanding Balance Due: • SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) )1� 1 1 61 J 023 kGI/ I a/1 m, F.�(rye/ X/ License Number Expi tion Date Name of CSL Holder )v/ P re Q�ilf , List CSL Type(see below) No.and Street Type Description J 524 U Unrestricted(Buildings up to 35,000 cu.ft.) C)---" R Restricted 1&2 Family Dwelling ay/Town,State,ZIP M Masonry ' RC Roofing Covering ' WS Window and Siding `/'� � � D� �u���' ����� SF Solid Fuel Burning Appliances ______ - I Insulation Telephone Email adcir D Demolition 5.2 71s teKed Home Improvement Contractor(HIC) 1/ g1,� I 0/7/Z3 U-AZ -i „- HIC Registration Number Expiration Date HIC Coµn tm e pr HIC Registran q ( UW JVQ`- ��Cha>d. ChA) hf4C �s, 9 j rL , No.a ¢m vi il� v Cov17 / . 735. 35 59D/ Email address City/Town,State,ZIP Telephone SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152.§ 25C(6)) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the lsrsuanne of the building permit. Signed Affidavit Attached? Yes 1�" No .❑ SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1,as Owner of the subject property,hereby authorize ?4 (J )t )"d C J tra—.) to act on my behalf,in all matters relative to work authorized by this building permit application. 1/ 1 n - 312 Ci) zz Print Owner's Name(Electronic Signature) Date SECTION 7b:OWNER' OR AUTHORIZED AGENT DECLARATION By entering my name below.I hereby attest under the pains and penalties of perjury that all of the information contained in this application is true and accurate to the best of my knowledge and understanding. rt 0)10'4 Print Owner's or Authorized AgentaVjra,-., me(Electronic Signature) Date NOTES: 1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration program or guaranty fund under M.G.L.c. 142A.Other important information on the HIC Program can be found at www.mass.gov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dps 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) (including garage,finished basement/attics,decks or porch) Gross living area(sq. ft.) Habitable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of half/baths Type of heating system Number of decks/porches Type of cooling system Enclosed Open 3. "Total Project Square Footage"may be substituted for"Total Project Cost" C�*►trn s,* ettA /Mas;.t.:-vt<ertfr Drr+s+nn of PrOtelliSo0741 Lccensure Board of Building Regutaboos and Stancl.r s CS 112271 Expires: 09'101 r2O21 RAILAN Al FERREIRA 401 PLEASANT STREET LEICESTER MA 01524 !"'7iT m t s stoner 1, it A, t r ;:fttf F Public Safety LAIL.4.„ q 0 Mass.Gov Home State Agencies Mass. Licensee Details .Demographic Information Full Name: RAILAN M FERREIRA Owner Nurnc License Address Informatik um [City: LEICESTER State: MA (Zipcode: 01524 Country: United States License Information License No: CS-112271 License Ty pe. Construction Supervisor Profession: Building Licenses Date of Last Renewal: 8/9/2021 Issue Date: 6/8/2018 Expiration Date: 9/1/2023 License Status: Active Today's Date: 9/9/2021 'Secondary License Type: Doing Business As: Status Change Reason: License Issuance Prerequisite Information No Prerequisite Information No Available Documents Close Window .��C' /ill/l?/i?('//(—,ec/ l if/icb),-) /e /(4-3e//i Office of Consumer Affairs and Business Regulation 1000 Washington Street- Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration Type: Supplement Card LOWE'S HOME CENTERS,LLC Re 148688 1000 LOWES BLVD Exxpiration:piration: 10/17/2023 SERVICES COMPLIANCE MOORESVILLE,NC 28117 Update Address and Return Card. SCA 1 a 2C1d-05-17 •7/:04E'6YC6ittif fiKr ff & fgtifigi iiteijugtion HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:Supplement Card before the expiration date. If found return to: Reols_tra ion Expiration Office of Consumer Affairs and Business Regulation 148688 10/17/2023 1000 Washington Street -Suite 710 LOWE'S HOME CENTERS,LLC Boston,MA 02118 04462... RICHARD CHALONE 1+I��^w'^V 1000 LOWES BLVD Vilfrafr SERVICES COMPLIANCE Not valid without signature MOORESVILLE.NC 28117 Undersecretary • ~� ATE(M ACORE, D MfDDIWYV) � CERTIFICATE OF LIABILITY INSURANCE DATE - 03/23/2 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Marsh USA Inc. NAME: PHONE FAX 100 North Tryon Street,Suite 3600 (A/C.No.Eat): I(A/C,No): Charlotte.NC 28202 E-MAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC It CN102776519-Lowes-SI-22-23 NSURER A:National Union Fire Ins Co.of Pittsburgh PA 19445 INSUREDLcwe's Companies,Inc. INSURER B:Interstate Fire&Casualty Co 22829 and s.ibsidiaries INSURER C:MU Insurance Co 19399 1003 Lowe's Boulevard Mooresville,NC 28117 INSURER D: INSURER S: INSURER F: COVERAGES CERTIFICATE NUMBER: ATL-004976909-11 REVISION NUMBER: 10 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH 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. MISR ADDL SUBR POLICY EFF POLICY EXP li TYPE OF INSURANCE yyVD, POLICY NUMBER IM4IDO/YYYY1 IMM(DD/YYYY1 LINTS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ Self hsurDAMAGE TO RENTED i CLAIMS-MADE ( OCCUR S belowPREMISES(Ea occurrence) S LIED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEM_AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 1 PRO- POLDY JECT LOC PRODUCTS-COPAP/OPAGG S OTHER: $ A AUTOMOBILE LJABIJTY CA7030892 (AOS) 04/01/2022 04/01/2023 COMBINED SINGLE LIMIT $ 5,000,000 (Ea accident) C X ANY AUTO CA7030891 (MA) 04/01/2022 04/01/2023 BODILY INJURY(Per person) $ A owNED Y SCHES DULED CA7030893 NA) 04101/2022 04/01/2023 BODLY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY _ AUTOS ONLY (Per accident) S B X UMBRELLA MS X OCCUR USZ00024220 04101/2022 04/01/2023 EACH OCCURRENCE $ 5,000,000 EXCESS LtAS CLAIMS-MADE AGGREGATE $ 5,000,000 BED RETENTIONS S C WORKERS COMPENSATION WC035901712 (AOS) 04/01/2022 04/01/2023 X PER OTH- ERAND EMPLOYERS'LIABILITY STATUTE C ANYPROPRIETOR�PARTNER/EXECUTiVE Y/N WC035901713 (ND.WA,WI,WY) 04/01i2022 04/01/2023 EL.EACHACCDENT S 1�'� OFFICERMEMBEREXCLUDED? N N/A _ -- -_ (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ Z.000,000 It yes describe under 2,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S A Excess Workers'Compensation XWC1647325 (FL) 04/01/2022 04/01/2023 (WC per statute) 3,000,000 A Excess Workers'Compensation 1 XWC1647324 (AOS) 04/01/2022 04/01/2023 (WC per statute) 3,000.000 DESCRIPTION OF OPERATIONS I LOCATIONS!VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Come-eraal General Liatnhty policy is Self-Insured,effective 4/1/2022 to 4/1/2023. CERTIFICATE HOLDER CANCELLATION Lowe's Comoanies,Inc.and Subsidiaries SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1000 Lowe's Blvd. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Mooresville,NC 28117 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE .745.7171. /�7 PLC, ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD • AGENCY CUSTOMER ID: CN1 027 7651 9 LOC#: Charlotte AcO)RD ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY NAMED INSURED Marsh USA Inc. Lowe's Companies,Inc. and subsidiaries POLICY NUMB[R 1000 Lowe's Boulevard Mooresville,NC 28117 CARRIER MAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance Workers'Compensation and Excess Workers'Compensation policies include a self-insured retention of S2.000.000. General L abitr The insured is sel'insured for 810.000.000 each occurrence for the period of 4/1/2022 to 4i1I2023. The Automobile Liability poicy evidenced above is subject to addrt onal self-insured retentions excess of kmits shown for various perils covered. ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD The Commonwealth of Massachusetts tt= Department of Industrial Accidents m —_,� �' Office of In 't tigutiuns ai �- W Lafayette City Center 2 Avenue de Lafayette. Boston,MA 02111-1750 ,i wwwmass.gov/dia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Leiibly Name(Business/Organization/Individual): LOWES HOME CENTERS Address: 1000 LOWES BLVD City/State/Zip: MOORESVILLE,NC 28117 Phone #: 860-505-9314 Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ® I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g. ❑Demolition working for me in any capacity. employees and have workers' Building addition [No workers' comp. insurance comp. insurance.t required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152,§1(4),and we have no employees. [No workers' 13. x0 Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the cub-contradors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: AIU INSURANCE COMPANY Policy#or Self-ins. Lic. #: WC035901712 AOS Expiration Date: 4/1/2023 Job Site Address: I3°�f'S p at 5- �f i 1 L.-- City/State/Zip (Nb1 0 �/{.�A- 0 r u-C_U� Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification I do her• . L- under th pains and ,.,alti of perjury that the information provided above is true and correct AllSi a tore: / �si ``� Date: _ — Phone#: 860-505-9314 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(check one): tO Board of Health 20 Building Department 30City/Town Clerk 4.0 Electrical Inspector 50Plumbing Inspector 6.0Other Contact Person: Phone#: The Commonwealth of Massachusetts Department of Industrial Accidents -3111 1 Congress Street, Suite 100 �= I eras : Boston, MA 02114-2017 www.mass.gov/dia N.V.v.kers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print 1 e ibls Name (Business;Organization/Individual): OMEGA BUILDING COMPANY INC. Address: 516E FRANKLIN STREET CitvlState/Zip: WORCESTER,MA 01604 Phone b`: 508-314-9431 Are you an employer?Check the appropriate bar: Type of project(required): LID I am a employer with 2 employees(full and/or part- 7. ❑ New construction )❑lam a sole proprietor or partnership and have no employees working for me in f ❑ Remodeling any capacity.[No workers'comp.insurance required.] 9. ❑ Demolition -O I am a homeowner doing all work myself.[No workers'comp.insurance required.]' io ❑ Buildingaddition 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 are sole 11.0 Electrical repairs or additions proprietorswith no employees. 12. Plumbing repairs or additions ❑I am a general contractor and I have hired the sub-contractors listed on the attached ,beet.These sub- ntracturs have employees and have workers'comp.insurance.' 13 ❑Roof epa irs w 6.11 '❑ 11®whet We are a corporation and its officers have exercised their right of exemption per MGl c. *Any applicant that checks box R1 must also fill out the section below showing their workers'compensation policy information. Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. *Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employee,. It the stub-contactors have employees,they must provide Ihed workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees.Below is the policy and job site information. Insurance Company Name: A.I.M Mutual Insurance Company Policy#or Self-ins. Lic.#: 6262634 Expiration Date: 2/1/2022 Job Site Address: I a gal-4t v City/State/Zi tJJ ( 0 I () L Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152 ✓325A is a criminal violation punishable by a tine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under ties .oi,ns and penalties of perjury that the information provided above is true and correct. • Signature __- 'I Date: Phone# E,08-314-9433' 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#: ' 1 (MMlDIY --- A`CORE) DATE CERTIFICATE OF LIABILITY INSURANCE (MMLDDYYYI /Y THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Marsh &McLennan Agency LLC-New England PHONE NadII �Shea FAX 100 Front St, Ste 800 A/c.No.Ext);888-850-9400 WC.Noi:866-795-8016 Worcester MA 01608 AD DEDR SS: MMA.NewEngland.CLines@marshmc.com INSURER(S)AFFORDING COVERAGE NM, INSURER A:Covington Specialty Insurance Company 13027 INSURED OMEGABUILD1 N Omega Building Company, Inc. stIRERe:Nautilus Insurance Company I 17370 516b Franklin St INSURER C:Associated Employers Co 99999 Worcester MA 01604 MSURER0: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:1245085827 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. LTR TYPE OF INSURANCE RED DM POLICY NUMBER (Y IIDINYYTYt IM IDD/YYYY► UNITS A X COMMERCIAL GENERAL LIABILITY Y L326000295 6/13R021 6/13/2022 EACH OCCURRENCE $1,000,000 CLAMS-MADE X J OCCUR DAMAGE TO RENTED PREMISES(Ea occurrence) $100.000 MED EXP(My one person) $5,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLES PER: GENERAL AGGREGATE $2,000,000 POLICY X ITT LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER $ AUTOMOBLELMaLITy COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ OWNED -SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) f B UMBRELLA LIAM OCCUR AN1241436 a/13/2021 8/13/2022 EACH OCCURRENCE $3,000,000 X EXCESS UM CWMSJNADE AGGREGATE $3,000,000 DED RETENTIONS $ C WORKERS COMPENSATION N 5024321 2/1/2022 2/1/2023 X ME X FOR AND EMPLOYERS'LIABILITY Y/N ANYPROPRIETOR/PARTNER'EXECUTIVE EL.EACH ACCIDENT $500,000 OFFICER/MEMBEREXCLUDED? N/A -- (Mandatory In NH) EL DISEASE-EA EMPLOYEE $500,000 If yes.describe under - - - !DESCRIPTION OF OPERATIONS below EL.DISEASE-POUCYmar ,$500,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached it more space is required) Certificate Holder is included as additional insured,on a primary and noncontributory basis,as respects the general liability if required by written contract. Waiver of subrogation applies in favor of the additional insured as respects the general liability if required by written contract. Lowe's Companies Inc&any&all subsidiaries are included as additional insured,on a primary and noncontributory basis as respects the general liability if required by written contract,for work performed by named insured.Waiver of subrogation applies in favor of the additional insured as respects the general liability if required by written contract.30 day notice of cancellation except 10 day notice for nonpayment. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Lowe's Companies Inc&any&all subsidiaries Mail Code: ISI 1000 Lowe's Blvd AUTHORIZED REPRESENTATIVE Mooresville NC 28117 - ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD City of Northampton yri, /4. t( Altit Massachusetts ,�5 ��. DEPARTMENT OF BUILDING INSPECTIONS iJt ma .1) - c. z 212 Main Street • Municipal Building 'v Northampton, MA 01060 s3'p �,.3'` CONSTRUCTION DEBRIS AFFIDAVIT (FOR ALL DEMOLITION AND RENOVATION PROJECTS) In accordance of the provisions of MGL c 40, S54, a condition of Building Permit Number is that all debris resulting from this work shall be disposed of in a properly licensed waste disposal facility, as defined by MGL c 111, S 150A. The debris will be disposed of in: Location of Facility: c. -- nsa-c bare= �'/d O/(0 /40 The debris will be transported by: Name of Hauler: u ja___te. Signature of Applicant: Date: .3/P9PA Store 2386 LOWE'S OF WARE, MA 348 PALMER ROAD WARE, Massachusetts 1082 LowEls ,. Contract Prepared for: James Hindle 134 spruce hill ave florence, Massachusetts 01062 9784732993 Prepared by: Steven Lockwood (413)277-4000 steven.lockwood @ lowes.corn Store 2386 LOWE_S OF WARE_MA-Contract-328134-Page 1 of 28 LowEs MASSACHUSETTS SERVICES SOLUTIONS INSTALLED SALES CONTRACT LOWE'S AUTHORIZED REPRESENTATIVE SALES ID DATE CUSTOMER NAME Steven Lockwood 3070929 03/07/2022 James Hindle SIOHE NO. SIHEEI ADDRESS SIREEI ADDRESS 2386 348 PALMER ROAD 134 spruce hill ave CITY STATE ZIP CITY STATE ZIP WARE MASSACHUSETTS 1082 florence Massachusetts 01062 TELEPHONE TELEPHONE (413)277-4000 9784732993 EMAIL EMAIL steven.lockwood@lowes.com hindle.james@gmail.com LOWE'S CONTRACTOR LICENSES LOWE'S REPRESENTATIVE LICENSE z CREDIT/DEBIT CHECK LCC CARD GIFT CARD 1/148688(home improvement contractor),3070929 /i35194 This is only a quote for the merchandise and services printed below.Lowe's does not offer services to paint,seal or stain fences, This becomes an agreement upon payment and issuance of a Lowe's receipt,upon pay-ment,the entire agreement,including the specifically completed pages of this document,the Terms and Conditions included with this document and any other addenda and attachments hereto,shall be referred to herein as this"Contract."PLEASE READ THIS ENTIRE DOCUMENT,INCLUDING THE "NOTICES.""TERMS AND CONDITIONS,"AND"ADDENDUM"CONTAINED WITHIN THIS CONTRACT ON THE FOLLOWING PAGES BEFORE SIGNING. INSTALLATION STREET ADDRESS CITY STATE ZIP 134 spruce hill ave florence Massachusetts 01062 MERCHANDISE AND INSTALLATION SUMMARY:(I.E. ITEM NUMBERS, COLORS, DIMENSIONS, CONSIDERATIONS): Windows Product Store 2386 LOWE_S OF WARE_MA-Contract-328134-Page 2 of 28 Windows Project Installation of two windows. Two in the House will be Pella 250 series windows. Pella 250 Series I Double Hung 131 X 36.5 I White Pella 250 Series I Double Hung 126.75 X 36 I White General Information: PSE Exclusive Bundle Northern Standard Vinyl Block Foam Insulated 3 1/4" 3 1/4" Sill Adapter Included Head Expander Included. Exterior Color/ Finish: White. Interior Color/Finish: White. Glass: Insulated Dual Low-E Advanced Low-E Insulating Glass Argon Non High Altitude Double Strength. Hardware Options: Comfort Lock Home Comfort Tilt Latch White Standard Vent Stop No Limited Opening Hardware. Screen: Half Screen InViewTM. Performance Information: Combination U-Factor 0.27 U-Factor 0.27 Combination SHGC 0.28 SHGC 0.28 VLT 0.53 CPD PEL-N-211-00072-00004 Satisfied Energy Star Zones Northern,North Central Performance Class R PG 35 Calculated Positive DP Rating 35 Calculated Negative DP Rating 35 Lead Times: 82 Days. SOS Number: 943071 WTS Pella 250 Window PSE Proposal and pricing dependent on installer second measure to ensure suitability, sizing, and estimated installation costs. Store 2386 LOWE_S OF WARE_MA-Contract-328134-Page 3 of 28 Installation Process • Remove& haul away existing windows • Check existing windows for leaks and evidence of pest infestation • Install new windows&accessories, including caulk, stops, and fasteners • Follow Lead Safe Practices (if required) • Follow Health and Safety Guidelines Clean-up/Final Inspection • Complete final clean-up and haul away all job-related debris • Test product& perform complete inspection with customer • Review warranty information Project Preparation Process • Dedicated project support staff keeps you up-to-date through every process • Installer conducts Pre-Installation Inspection • Provides appropriate protection to home during installation • Obtain &post any necessary permits • Perform Lead Assessment(if applicable) Work is to commence upon reasonable availability of Contractor and/or any special order or customer made Good(s)which is anticipated to be 06103/2022.Estimated completion date is 06/26/2022.COVID-19 has affected manufacturers and labor markets, with the production of fence,deck and generator material experiencing significant delays and installation start dates that are at least four(4)months away in most cases.Please also note that weather can delay start dates for these and other exterior categories,particularly in colder climates. CONTRACT TOTAL $2,390.00 Paid upon signature of Installed Sales Contract(33%) $755.70 Paid upon or after commencement of work(67%) $1,534.30 Paid upon completion of Installed Services to both parties satisfaction $100.00 Store 2386 LOWE_S OF WARE_MA-Contract-328134-Page 4 of 28 NOTICES LEAD SAFE INFORMATION. Federal and applicable state laws require that You be provided with a lead hazard information pamphlet such as the Renovate Right: Important Lead Hazard Information for Families, Child Care Providers and Schools. By signing this Contract, You acknowledge having received a copy of this information pamphlet before work began informing You of the potential risk of the lead hazard exposure from renovation activity performed in Your dwelling unit or facility. A copy of the pamphlet is available at the following website: www.lowes.com/EPARRP. For more information see: https://www.epa.gov/lead/lead-renovation-repair-and-painting-program. NOTICE OF ARBITRATION AGREEMENT: This Contract provides that all claims by Customer or Lowe's will be resolved by BINDING ARBITRATION. Customer and Lowe's GIVE UP THE RIGHT TO GO TO COURT to enforce this Contract (EXCEPT for matters that may be taken to SMALL CLAIMS COURT). Lowe's and Customer's rights will be determined by a NEUTRAL ARBITRATOR and NOT a judge or jury. Lowe's and Customer are entitled to a FAIR HEARING. But the arbitration procedures are SIMPLER AND MORE LIMITED THAN RULES APPLICABLE IN COURT. Arbitrator decisions are as enforceable as any court order and are subject to VERY LIMITED REVIEW BY A COURT. FOR MORE DETAILS: Review the section titled ARBITRATION AGREEMENT, WAIVER OF JURY TRIAL AND WAIVER OF CLASS ACTION ADJUDICATION found in the Terms and Conditions of this Contract. 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 CONTRACT, THAT LOWE'S MAY SUBMIT SUCH DISPUTE TO A PRIVATE ARBITRATION SERVICE WHICH HAS BEEN APPROVED BY THE SECRETARY OF THE EXECUTIVE OFFICE OF CONSUMER AFFAIRS AND BUSINESS REGULATIONS AND THE OWNER SHALL BE REQUIRED TO SUBMIT TO SUCH ARBITRATION AS PROVIDED IN M.G.L. c.142A. THE SIGNATURES OF THE PARTIES BELOW APPLY ONLY TO THE AGREEMENT OF THE PARTIES TO ALTERNATIVE DISPUTE RESOLUTION INITIATED BY LOWES, PURSUANT TO M.G.L. c. 142A. THE OWNER MAY BE PERMITTED TO INITIATE ALTERNATIVE DISPUTE RESOLUTION EVEN WHERE THIS SECTION IS NOT SEPARATELY SIGNED BY THE PARTIES. If customer has a complaint which cannot 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 this Notice is signed and dated by Lowe's and Customer. All claims by Customer or Lowe's concerning 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 as set forth in the Terms and Conditions. B l�''"''(�� �� 03/07/2022 Y Date.. Lowe's Representative a By: "-""'4134I4X, Date: 03/07/2022 Customer PRICE CALCULATIONS. If this Contract includes Goods and related Installation Services sold by unit of measurement, such as per square foot, the Price may include more Goods than the actual measurements of Your project area. The Price includes the total amount of Goods required by Lowe's to fulfill the Contract (including surplus materials and overages) (together the "Estimated Product")and the Installation Services required based upon this total amount of Goods. For instance, a 120 square foot room may require 140 square feet of carpet to properly match the carpet seams, pattern, or unique room characteristics, and the Price would include Installation Services based upon the 140 square feet of carpet. The total amount of Estimated Product is based upon the total Goods recommended by the Installer, based on the Installer's assessment of unique characteristics of Your project. If any usable Goods are left over, Lowe's may, at its discretion, initiate a Price adjustment. Lowe's will not adjust the Contract Price for the related Installation Services. By signing this Contract, You acknowledge You are aware of Your project area measurements and the amount of Estimated Product, and that the Estimated Product may exceed Your actual project area. If Your project includes the installation of flooring materials, by signing this Contract You further acknowledge having received a completed Flooring Detail Diagram (the "Diagram") prior to execution of this Contract. Upon request, Lowe's can provide You with additional copies of the Diagram, which identifies the square footage of Your project area and the square footage of the Estimated Goods. PHOTO RELEASE. By signing this Contract, You grant to Lowe's, its representatives, and Installer the right to take and use photographs, videos, or other representations of the Premises before and after the Installation Services and all work performed at the Premises related to this Contract (the "Content"). Lowe's irrevocably keeps all rights (including the copyright), title, and interest in the Content for use in all markets and media, worldwide, in perpetuity. Lowe's can use the Content, in any form or medium, internally for any purpose (e.g., customer service, planning, and claims. NOTICE REGARDING PAYMENT SCHEDULE. If the Contract Price is$1,000 or less, payment of the Price by Customer to Lowe's is due in full upon execution of this Contract. If the Contract Price exceeds $1,000, Customer shall use the following payment schedule: (1) Deposit of $ 755.70 [enter 1/3 of the contract Price] to be paid upon signing this Contact. Any deposit collected at the time this Contract is signed will not exceed one-third (1/3)of the Contract Price; Store 2386 LOWE_S OF WARE_MA-Contract-328134-Page 5 of 28 Rev.03/02/2021 (2) Payment of $ 1534.30 [enter 2/3 of the contract Price minus $1001 to be collected upon or after the commencement of work. Customer authorizes Lowe's to charge Customer's credit card. or deposit Customer's check, for the amount of the payment indicated in this section anytime upon or after the commencement of the work; and (3) Final payment of$100 to be paid upon completion of the Installation Services to both parties' satisfaction. NOTICE OF CUSTOMER'S RIGHT TO CANCEL. If this is a "door-to-door sale" as defined by 16 C.F.R. §429.0(a), or if this Contract is signed by Customer at a place other than the address of the seller as set forth in M.G.L. c. 93 § 48, You, the Customer, may cancel this Contract at any time prior to midnight of the third business day after the date of this transaction. See the notice of cancellation form sent as an attachment to this Contract for an explanation of this right. By executing this Contract, Customer acknowledges receipt of two (2) completed copies of the Notice of Right to Cancel form and certifies Lowe's has informed Customer orally of his or her right to cancel. NOTICE TO CUSTOMER. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. Lowe's Home Centers, LLC EXECUTION DATE: 03/07/2022 LOWE'S AUTHORIZED REPRESENTATIVE SIGNATURE OWNER'S SIGNATURE CO-OWNER SIGNATURE ,?Per` KnwoiY QahnPA.A-i/i1 a Customer acknowledges receipt of a true copy of this contract which was completely filled in prior to Customer's execution hereof. Store 2386 LOWE_S OF WARE_MA-Contract-328134-Paae 6 of 28 Rev.03/02/2021