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32A-078-012
BP-2022-1619 20 GRAVES AVE COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 32A-078-012 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-2022-1619 PERMISSION IS HEREBY GRANTED TO: Project# DOOR 2022 Contractor: License: Est. Cost: 4201 LOWES HOME CENTERS INC 117055 Const.Class: Exp.Date: 08/02/2025 Use Group: Owner: J SULLIVAN STEPHEN Lot Size (sq.ft.) Zoning: URC Applicant: LOWES HOME CENTERS INC Applicant Address Phone: Insurance: 282 RUSSELL ST (413)588-0270 WC035901712AOS HADLEY, MA 01035 ISSUED ON: 12/13/2022 TO PERFORM THE FOLLOWING WORK: REPLACEMENT DOOR POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Service: Meter: Footings: Rough: Rough: House # Foundation: Final: Final: Final: Rough Frame: Gas: Fire Department Driveway Final: Fireplace/Chimney: Rough: Oil: Insulation: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: i O TAD,R • Fees Paid: $40.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner • _AIL / ,.'"/ OFF iL, The Commonwealth of Massachusetts��T' oc Board of Building Regulations and Standard �r o, c� ' Q<2 '�FOI i' .(1. Massachusetts State Building Code, 780 CMR tiq^1��/;,ti f C EALITY Building Permit Application To Construct,Repair,Renovate Or Den'vA io eviscd Mar 2pI1 One-or Two Family Dwelling ,s0 �/� This Section For Official Use Only 6 Build!' Permit Number )-—(( `Cf Date pplied: GUIa.) -I Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 PropertXdr s: 1.2 Assessors Map&Parcel Numbers 1.1a Is this an accepted street?yes no Map Number Parcel Number 1.3 Zoning Information: 1A Property Dimensions: Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public 0 Private 0 Zone: _ Outside Flood Zone? Municipal❑ On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Ow of Record3u/Ji V.1,,#7 Y/� ( A87J,th1(PM-i JI,/i &Obl) Name int) zn City,State,ZIP 19 I'`,Jr— YKJ � 1d�)i y u No.and Street ^ Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building❑ Owner-Occupied 0 Repairs(4-liff Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg.0 Number of Units Other 0 Specify. Brief Description of Pro Work2: �i nyj //I //ha. afftyPdfd�12 i � 0� a4c..4_, SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ y�jb/ D� 1. Building Permit Fee:$ Indicate how fee is determined 2.Electrical $ C7� ❑Standard City/Town Application Fee 0 Total Project Cost3(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire $ Suppression) Total All Fees:$, 6.Total Project Cost: $ ,t��p�. Check No. 51 1(� ecit Amount: 4 Cash Amount: Cl Paid in Full 0 Outstanding Balance Due: PI SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor (CSL) ) '�O /�ke/ Licen a GC/�) License Number irat on Date Name of CSL Hold � / ]ii/c ., i �j�� /�/1m`�/ List CSL Type(see below) No.and Waft t (�C Type Description ma�//�/, �tL/ er: /n�� U Unrestricted(Buildings up to 35,000 cu ft.) City/Town,State,e t� R Restricted l&2 Family Dwelling M Masonry RC Roofing Covering WS Window and Siding /} J�D�� /� � SF Solid Fuel Burning Appliances V•J �% igi l/etWjreQd U*Lf I Insulation Telephone mail address J V , My% D Demolition 5.2 istered Heo rovgmentCi�actor(HIC) ,, `cf (; HIC Comp `I�n1W/n eh Ar HIC RegiiC//s11,„_�,�tram ame�`11 HIC"�R'egishatiojn�Number E irau to No.and S)reyt^�v �// / , e„o/ n 97 2 Email address City/`Toowwnn,,C State,ZIP 1 (�, /�/ % 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 Issuanc of the building permit. Signed Affidavit Attached? Yes No ❑ SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APP IES FOR BUILDING PERMIT I,as Owner of the subject property,hereby authorize to act my behalf,in all matters relative to work authorized by this building permit application. ,,.. t.. /4-7'7 S-Ad YIA-) /42/ Print Owner's Name(Electronic Signature) ate 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. A( ,(1-1 - '7-6 I r3 �•=-/- Print Owner's or Authorized Agent's Name(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 foultd 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" ' I The Commonwealth of Massachusetts Department of Industrial Accidents 1111, Office of Inveztigulions Lafayette City Center 2 Avenue de Lafayette, Boston,MA 02111-1750 uWmimass.gov/dia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly 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 employees(full and/or part-tune)." have hired the sub-contractors 6. 0 New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. employees and have workers' 9 El Building addition [No workers' comp.insurance comp. insurance. required.] 5. ❑ We are a corporation and its 10.❑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. XO 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 fleet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. insurance Company Name: AIU INSURANCE COMPANY Policy#or Self-ins. Lie. #: WC035901712 AOS Expiration Date: 4/1/2023 Job Site Address: c 0 K./y'//3 :e City/State/Zip: Si dYr Attach a copy of the workers' compensation policy declaration page(showing the policy number and expi lion date).°400 Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal p.nalties 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 O' IItl' 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 Offi e of Investigations of the DIA for insurance coverage verification I do hereby v under the pains _ p of perjury that the information provided above is true and correct ��Si nature: 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: Permitilkense # Issuing Authority(check one): 10Board of Health 20 Building Department 3fCity/Town Clerk 4.0 Electrical Inspector 51a'lumbing Inspector 6.0Other Contact Person: Phone#: • TIE COMNONINEN2111 OF MASSACILKSETTS Office of Consumer Mai(tril Business Rawlslion 1000 Waste jet-&Se 710 Bastridluset2118 Henze invovemesisliksharion ---..,sil-_, -b---' -- --4-7, :11—'12 :-. _-- ___ ..:, .7-,....___•.-_-_-_---.....74:--l_i, 1:"4. I:L..--tr-:=Z--tt-2:6 -.'-- i_i-..11gir Smpollsomat Cad , a r -*.tr --% •k. ..,...g 1 WNW LOWS ROUE WI EL CEIVI- LC ',:xt ' .• IOW NES IO SERVICES OIXOLLARGS 1:-.:-.7-. r:-4 MOORESVILLZ ITC 231.17 .?"0. 7-----/E i-:.: 4 ;--17 --f=f-f--4•-7-c. ,-.-::*-1' . _.: ilipieleAdflussaodatena- -d. IHEC01111101111112:413iitIFINIPMMINIUBEM OlikestGaimernfitsfselmenislilliglebas 111011.611omildlrbliddlatirsoalls,„-rwe et:, Oliiimilnimelot tiallE 111111716=01118"1"Capi =11111=awilfhisandlliskos Regfaft-i Reilliiillel-;-B111160R 11111111111110111Cre AMOS • 14M1181_:to-1111110023 Beigon.111* Loses Home ceifiAsetia __ -.;- NEKIEDESSCHO -1- ---:•=1; _ -- - --• i„..-2.-: --= - alofits441.-SAfib. SERVICESCOMPUNICE .z...;;7,-: mooresvamic am',- -* . - Untiaismelaw Nava/id desist sIgnatwe 0 Ac R CERTIFICATE OF LIABILITY INSURANCE OATE(MMIDINYYW) 03/23/2022 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: 100 North Tryon Street.Suite 3600 (A/C.PHONE ,Extt; FAX No Charlotte.NC 28202 E-MAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIL I CN102776519-Lowes-SI-22-23 INSURER A:National Union Fire Ins Co.of Pittsburgh PA 19445 INSURED INSURER B:Interstate Fire a Casually Co 22829 Lowe's Companies.Inc. and s.lbsidiaries INSURER C:MU Insurance Co 19289_ 1000 Lowe's Boulevard Mooresville,NC 28117 INSURERD: INSURER E: 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 1THE 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 POLICES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY EXP LIMBS LTR NSD MIND POUCY NUMBER (�Iffl yyYY► tsMm yyyyt COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S CLAIMS MADE OCCUR Self Insured-See beim DAMAGE TO RENTED PREfASES(Es occurrence) S MED EXP(My one person) S PERSONAL BADV INJURY f GENL AGGREGATE UNMAPPLES PER GENERAL AGGREGATE f POLICY JECT LOC PRODUCTS-COMP/OP Ad) f _ _ OTHER: S A Airroatosix( Y 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) f A OWNED SCHEDULED CA7030893 (VA) 04/01/2022 04/01/2023 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE S AUTOS ONLY AUTOS ONLY (Per accident) f B X M ORELLAMB X OCCUR USZ00024220 04I01//2022 04/01/2023 EACH OCCURRENCE S 5,000,000 EXCESS MS CLAIMS-MADE AGGREGATE S 5,000,000 DED RETENTIONS S C WORKERS COMPENSATION WC035901712 (AOS) 04/01/2022 04/01/2023 X AT PER OTH- ER AND EMPLOYERS'LIABIL Y/N WC035901713 (ND.WA,WI,WY) 04/01/2022 04/01/2023 STUTE2,000,000 ANYPROPRIETORiPARTNER/R/EXECUTIVE EL.EACH ACCIDENT S OFFICER/MEMBEREXCLUDED? N N/A (Mandatory in NH) EL.DISEASE-EA EMPLOYEE S Z000,000 If yes,describe under - DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S 2,000,000 A Excess Workers'Compensation XWC 1647325 (FL) 04/01/2022 04/01/2023 (WC per statute) 3,000.000 A Excess Workers'Compensation XWC1647324 (AOS) 04/01/2022 04/01/2023 (WC per statute) 3,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS!VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Commercial General Liability policy is Self-Insured,effective 4/1/2022 to 4/1/2023. CERTIFICATE HOLDER CANCELLATION Lowe's Companies,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 POUCY PROVISIONS. AUTHORIZED REPRESENTATIVE :zzianQ� - 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 027 765 1 9 LOC#: Charlotte AC o® ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY NAMED INSURED Marsh USA Inc. Lowe's Companies,Inc. —-_ and subsidiaries POLICY NUMBER 1000 Lowe's Boulevard Mooresville,NC 28117 CARRIER J NAIC 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 induce a self-insured retention of$2.000,000. General L abiity:Tie insured is self insured for$10.000,000 each occurrence for the period of 4/1/2022 to 4i1f2023. The Automobile Liability policy evidenced above Is subject to addit oral self-insured retentions excess of limits shown for vanous perils covered. ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AcoRO CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 09/14/2022 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: tf 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 Diane Gendreau,CISR NAME: Nicholson Associates,Inc. PHONE (203)877-2741 FAX (203)877-9004 (A/C.No.Est): (A/C,No): 395 New Haven Ave. E-MAIL d. endreau nicholsonassoc.com ADDRESS: g P.O.Box 5189 NSURER(S)AFFORDING COVERAGE NAIC X Milford CT 06460 INSURER A: Selective Insurance Co of S.C. 19259 INSURED INSURER B: EAST COAST MILLWORK,LLC INSURER C 14R PEACH ORCHARD RD INSURER D INSURER E: PROSPECT CT 06712-6001 INSURER F COVERAGES CERTIFICATE NUMBER: 9/22-23 GL Auto Umb 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. INSR ADDL SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE ,INSD 1/1/VD POLICY NUMBER (MMIDD/YYYY) (MMIDD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE D CLAIMS-MADE XI OCCUR PREM SESO(EaENTE occu occurrence) , $ 500,000 MED EXP(Any one person) $ 15,000 A Y S 2040386 09/22/2022 09/22/2023 PERSONAL BADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 3,000,000 POLICY PRO- 3000,000 JECT LOC PRODUCTS-COMP/OP AGG' $ , OTHER- COMBINED AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accdent) X ANY AUTO BODILY INJURY(Per person) $ A OWNED SCHEDULED Y S 2040386 09/22/2022 09/22/2023 BODILY INJURY(Per accident) $ _ AUTOS ONLY _ AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONI Y AUTOS ONI Y (Per accident) Medical payments $ 5,000 X UMBRELLA LIAB OCCUR EACH OCCURRENCE E 2.000,000 A EXCESS Lwe CLAIMS-MADE S 2040386 09/22/2022 09/22/2023 AGGREGATE $ 2,000,000 DED RETENTION S. $ WORKERS COMPENSATION \/I PER I OTH- AND EMPLOYERS'LIABILITY YIN I�f STATUTE ER A ANY PROPRIETOR/PARTNER/EXECUTIVE Y NIA WC 9084546 06/04/2022 06/04/2023 E.L.EACH ACCIDENT $ 500,000OFFICER MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 500.000 If yes.describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY UMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Lowe's Companies,Inc.and Lowe's Home Centers.LLC are named as additional insureds as respects general liability and auto liability. This insurance is primary over any other available insurance coverage. 10 Day Notice of Cancellation for Non-Payment of Premium. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Lowe's Companies,Inc.and any and all subsidiaries ACCORDANCE WITH THE POLICY PROVISIONS. 1000 Lowe's Blvd AUTHORIZED REPRESENTATIVE Mooresville NC 28117 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD Commonwealth of Massachusetts Division of Occupational Licensure Board of Building Regulations and Standards Consttion Sispervisor CS-117055 spires; 08/02/2025 KYLE R SEARLES 14R PEACH ORCHARD ROAD PROSPECT CT 06712 ff 40/.f,v,iP Yl. Cornmissioner &nch . 1 4,0 STORE COPY INSTALLATION SERVICES CUSTOMER CONTRACT- MWORK - INT/EXT/PATIO DOOR Iou1E�� LOWE'S OF HADLEY, MA, STORE # 1916 STORE PHONE: (413)588-0270 282 RUSSELL STREET SALESPERSON:CHASE FORBUSH HADLEY, MA 01035-0000 SALESPERSON ID: 2195341 Document Print Date :12/03/2022 This is only a Quote for the merchandise and services printed below. This becomes an agreement upon payment and issuance of a Lowe's receipt, upon which the entire agree- ment, including the specifically completed pages of this document, the Terms and Conditions included with this document, the applicable portion(s) of Lowe's receipt, and any other addenda or attachments hereto,shall be referred to herein as this"Contract." PLEASE READ THIS ENTIRE DOCUMENT.INCLUDING THE "TERMS AND CONDITIONS." BEFORE SIGNING. Lowe's Registration or Contractor License Number/Lowe's Contractor Name Lowe's Home Centers, LLC's MA HIC NO.: 148688 Lowe's Home Centers, LLC's FEIN: 56-0748358 Customer Name Home Phone S STEVEN SULLIVAN 781-264-2982 O Customer Address Other Phone 20 GRAVES AVE 781-264-2982 L City State/Province Zip/Postal Code D NORTHAMPTON MA 01060 Installation Address T 20 GRAVES AVE O Installation City Installation State/Province Installation Zip/Postal Code NORTHAMPTON MA 01060 MERCHANDISE AND INSTALLATION SUMMARY MERCHANDISE SUMMARY 40179 : BE365 V CAM 619 : STK : SCH SN ELECTRONIC DEADBLT CAMELOT : SCH SN ELECTRONIC DEADBLT CAMELOT : SCHLAGE LOCK - QTY 1 810313 : F51 V BWE 619 GSN : STK : SCH SN BOWERY ENTRY : SCH SN BOWERY ENTRY : SCHLAGE LOCK - QTY 1 913238 : 45904362R : SOS : WTS PLATINUM SG STORM DOORS : 36 x 80.5 Aluminum Storm Door : LARSON MANUFACTURING CO INC - QTY 1 913242 : 20297817 : SOS : QUICKFIT HARDWARE : Brushed Nickel Handle Kit : LARSON MANUFACTURING CO INC - QTY 1 986161 : SOS : WTS TT REEB ENTRY HOM PNT LLT : 37 5/8 x 95 1/2 Single Door w/T : REEB MILLWORK OF NEW ENGLAND - QTY 1 Materials Price S 3146.82 Store 1916 Project No. 755641237 for STEVEN SULLIVAN Page 1 of 8 CUSTOMER COPY INSTALLATION DESCRIPTION Door type: Exterior Location of new doors): Front_Door Select new door : Single Pre-Hung Hardwood door : No Sidelights or transoms : Yes Total number of sidelights and transoms : 1 Number of additional holes bored for accessories : None Install specialized mortise hardware : No Install storm door : Install new storm, screen or security door Select storm door : Storm Door Lead safe practices : Yes Total linear feet of custom trim to be Installed : 0 Deliver door : Yes Customer understands scope of the project : Yes Permit Fee : Yes Additional Mileage : 0 Access fee : None Dump entry Fee : Yes Additional Work : threshold support/reuse existing trim Additional Work Charge : Yes Comments : No Comment Labor Charges S 1054.20 Detail Deduction -$ 0.00 Additional Specifications: Notation:Lowe's will not make structural modifications,remove cabinetry to accommodate new appliance,or upgrade electrical service. Additional Specifications: 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 to be performed in Your dwelling unit or facility.A copy of the pamphlet is also available at the following website: httos://wwvw.eoa, ov/sites/production/files/documentshenovaterightbrochure odt.For more information see:httos://www,epa.gov/leadrtead•renovation-repair-and-oainting•progranl. PHOTO RELEASE:Customer grants to Lowe's and Lowe's employees and independent contractors the right to take photograghs of the Premises where Installation Services will be performed and all work performed at the Premises related to this Contract, and irrevocably grants to Lowe's all right, title. interest in and to the photographs for use in all markets and media, worldwide.in perpetuity. Customer authorizes Lowe's to copyright. use and publish the photographs in print and/or electronically, and agrees that Lowe's may usp,suctiphotographs for any lawful purpose, including, but not limited to,marketing,advertising,publicity,illustration,training and Web content.By initialing here,Customer agrees to the foregoing. / .(Customer to initial to the left]. NOTICE TO CUSTOMER-PRICE CALCULATIONS: In order to properly perform the installation of certain Goods. the Contract Price may include more Goods than actually will be installed based on the measured square footage of the Project Area.As a result,the parties agree that the lump-sum Price stated in this Contract is calculated upon both the value of the estimated Goods required to ful- fill the Contract(including waste).which may exceed the actual square footage of the Project Area.and the labor which may be estimated based on the amount of Goods required to fulfill the contract (including waste). By signing this Contract below,Customer acknowledges receipt of this notice and agrees and understands that the Price includes these costs which may not be refunded once the Installation Services are performed.. 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 or- der 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. Store 1916 Project No, 755641237 for STEVEN SULLIVAN Page 2 of 9 • STORE COPY TOTAL CHARGES OF ALL MERCHANDISE AND SERVICES 'where applicable SUB-TOTAL S 4201.02 *TAX S 0.00 DELIVERY $ 0.00 ORDER TOTAL S 4201.02 BALANCE DUE Work is to commence upon reasonable availablity of Contractor which is anticipated to be (7 3/Zo Z 3 _(fill in date]. Estimated completion date is 2/ 3/ZU 23 [fill in date]. NOTICE TO CUSTOMER All items listed in this contract and specification sheet(s) are to be installed under conditions agreed upon at time of purchase and at the price appearing on this contract form. This assumes sound existing substructures, superstructure and points of attachments. Extra labor or material incident to installation necessitated by defective substructures, superstructure, points of attachment, or the moving of fixtures or appliances to be billed at extra cost to custom- er. IF THE CONTRACT TOTAL IS $1,000.00 OR LESS. Customer must pay in full. COMPLETE THIS SECTION ONLY WHEN THE CONTRACT TOTAL EXCEEDS $1,000.00i j Customer to use the following payment schedule: (1) Deposit of $ t 100. 35 to be paid upon signing contract. Any deposit collected at the time this Contract is signed will not exceed one-third (1/3) of the contract price: and (2) Payment of S_2.700. 61 to be collected upon or after the commencement of work. I/We authorize Lowe's to do one of the following (check ap- propriate box below): [4] Charge my/our credit card for the amount of the payment indicated above upon or after the commencement of work: or [_.] Deposit my/our check for the amount of the payment indicated above anytime upon or after the commencement of work: and (3) Final payment of $100.00. to be paid upon completion of the installation to both parties' satisfaction. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES AND UNTIL YOU HAVE READ THE TERMS AND CONDITIONS CON- TAINED IN THIS CONTRACT AND WHICH FOLLOW THE SIGNATURE PAGE(s). BY SIGNING BELOW, YOU ARE ACKNOWLEDGING THAT YOU HAVE READ, UNDERSTAND AND AGREE TO THE TERMS AND CONDITIONS SET FORTH IN THIS CONTRACT. YOU ARE ENTITLED TO A COPY Store 1916 Project No. 755641237 for STEVEN SULLIVAN Page 3 of 8 • STORE COPY OF THIS CONTRACT AT THE TIME OF SIGNATURE. NOTICE REGARDING ARBITRATION AGREEMENT FOR CLAIMS COVERED BY M.G.L. c.142A LOWE'S AND OWNER HEREBY MUTUALLY AGREE IN ADVANCE THAT IN THE EVENT LOWE'S HAS A DISPUTE CONCERNING THIS CON- - ----T--RACT;-T-HAT tOWE'-S MAY-SUBMW SUCH-DISPUTE-TO-4-PRIVATE-ARBITRATION-SERVICE WH1C}TT4AS BEEN AI-PHOVEDBY-THFStCHbT= ARY OF THE EXECUTIVE OFFICE OF CONSUMER AFFAIRS AND BUSINESS REGULATIONS AND THE OWNER SHALL BE REQUIRED TO SUB- MIT TO SUU H AR TRATION AS P OVIDED IN M.G.L. c.142A. BY: Date: 1 Z/o 3 Zo 2 z l Lowe's Horn Cen ers. LLC By� Date: /,tom S, Owner By: Date: Co-owner or Witness THE SIGNATURES OF THE PARTIES ABOVE APPLY ONLY TO THE AGREEMENT OF THE PARTIES TO ALTERNATIVE DISPUTE RESOLUTION INITIATED BY LOWE'S PURSUANT TO M.G.L. c.142A. THE OWNER MAY BE PERMITTED TO INITIATE ALTERNATIVE DISPUTE RESOLUTION EVEN WHERE THE SECTION ABOVE IS NOT SEPERATELY SIGNED BY THE PARTIES. WITNESS OUR HAND(S)AND SEAL(S) BELOW THIS 3ro DAY OF Pece.• 4cr- , 2, . Lowe's Home Centers, LLC (Seal) Print Name: Lib 4,S C )"v r L 2€ t RLS Se(( Sfrecj' (Seal) Address Owner 16 bn�- OLo City ) State/Province Zip/Postal Code Print Name (Seal) Co-Owner or Witness Store 1916 Project No. 755641237 for STEVEN SULLIVAN Page 4 of 8 • STORE COPY Print Name Customer acknowledges receipt of a true copy which was completely filled in prior to Customer's execution hereof. You the customer may cancel this transaction at any time prior to midnight on the third business day after the date of this transaction. See the attached Notice of Right to Cancel for an explanation of this right. Store 1916 Project No. 755641237 for STEVEN SULLIVAN Page 5 of 8