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02-003 (3) BP-2024-0502 t ( ORTH FARMS RD COMMONWEALTH OF MASSACHUSETTS V. Map:Block:Lot: 02-003-001 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-2024-0502 PERMISSION IS HEREBY GRANTED TO: Project# DOORS 2024 Contractor: License: Est.Cost: 14150 RENEWAL BY ANDERSEN 090125 Const.Class: Exp.Date: 10/06/2024 Use Group: Owner: K DEROSE CHARLES W&LEILA Lot Size (sq.ft.) Zoning: WSP Applicant:. RENEWAL BY ANDERSEN Applicant Address Phone: Insurance: 30 FORBES RD 508-351-227 MWC314158 NORTHBOROUGH, MA 01532 ISSUED ON: 04/24/2024 TO PERFORM THE FOLLOWING WORK: REPLACE PATIO DOORS 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/Chimnep: 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: 7)E. Fees Paid: $40.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner If_pc sible__please email .copy of the issued permit to permits@gopermits.org. Thank you. e The Commonwealth of Massachusetts J Board of Building Regulations and Standards FOR , !k , I4assathusetts State Building Code, 780 CMR MUNICIPALITY APR 2 4 4 USE Building Permit Application To Construct, Repair, Renovate Or Demolish a Revised Mar 2011 E__ One-or Two-Family Dwelling . bUn irjSPEC7IO143 o, en This Section For Official Use Only Building Permit Number: 8P ? `1-5"03- Date Applied: KUir-a.)),3 9-24-2021 Building Official(Print Name) Signature Date SECTION 1: SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map& Parcel Numbers 6 Mortil For As 1.1a Is this an accepted street?yes ✓ no Map Number Parcel Number 1.3 Zoning Information: 1.4 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 0 On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP1 2.1 Ownerl of Record: �lOb Z L e lA #D e roSc I F°(e/'(e /(,� Name(Print) City,State,ZIP C1-1- NpM FRro^s Rid t{13- 4*8-6fia Kderese. ?re4.cowl No.and Street Telephone Email Address SECTION 3: DESCRIPTION OF PROPOSED WORK2 (check all that apply) New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units Other DIY-Specify:rceaceMe4f Brief Description of Proposed Work': _ &w G- c 1Q€ftec� 2 ed.,. JN(s l: j /.lt. h, .k i o 5 la C a,t A ' u (e/6- •f , 23 . SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ /y /47.do 1. Building Permit Fee: $ Indicate how fee is determined: ❑ Standard City/Town Application Fee 2.Electrical $ D.Total Project Costa(Item 6)x multiplier x 3. Plumbing $ 2. Other Fees: $ 4. Mechanical (HVAC) $ List: 5. Mechanical (Fire $ Suppression) Total Alie $ Check No. LO Check Amount:CIA a Cash Amount: 6. Total Project Cost: $ y' �Sp g'i ❑Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) 010/25 /o •0`-Zy 7:aints, Mori n License Number Expiration Date Name of CSL Holder List CSL Type(see below) (Ns 36 F.bes R J No. and Street Type Description bD/th4 5 IN M F} 0 6,2 Unrestricted(Buildings up to 35,000 cu.ft.) R Restricted 1&2 Family Dwelling City/Town,State,nor M Masonry RC Roofing Covering 42111 Window and Siding /� L� SF Solid Fuel Burning Appliances r60 'l5zk/(2 anew"(k OnerGrbcnC poE(M.7b or, I Insulation Telephone Email address J D Demolition 5.2 Registered Home Improvement Contractor(HIC) to 12-tt- z5 gGK✓KQQ Ly d[f &i HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name /� ?o ry rise S R d (c�o6401 by et444 n�+r.pagtetsji, e No.and Asstreet Email addr s V IVO(tf, bo#ki I'Mbit o.SS - r o-9S2- 4410-- 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 Issuance/ of the building permit. Signed Affidavit Attached? Yes .......... CY No 0 SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,as Owner of the subject property,hereby authorize to act on my behalf,in all matters relative to work authorized by this building permit application. 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 - of my knowledge and understanding. Cam,«t J L. Ccq r 5t' i Ali - a 3-2 y Print Owner's or Authorized Agent's Name ectro•c 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" City of Northampton ?at �M � S.S....."�_ 3'�C:. " 1.- Massachusetts 42 m._ i ( f t DEPARTMENT OF BUILDING INSPECTIONS c' e rn .. rf 1&° 212 Main Street • Municipal Building yJ. cam 4' Northampton, MA 01060 J..2 10, '' 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: 7o F'v i IS- /Vv/S+ hv/do 4 Pi 0/5-3 2- The debris will be transported by: Name of Hauler: W44 /ltA-- f''!GA /` / 0 All Signature of Applicant: lir Date: ! 23 y The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Lafayette City Center 2 Avenue de Lafayette, Boston,MA 02111-1750 `. _. wx*►t:mass.gov/dia Workers'Compensation Insurance Affidavit: Builders/f'ontractorslElectricians/Plumbcrs Applicant Information Please Print Legibly Renewal by Andersen Name (BusinessOrltanizationi1ndividual): Address: 30 Forbes Rd. City/State/Zip:Northborough, MA 01532 Phone #:508-351-2277 Are you an employer? ( heck the appropriate ro mate box: p I P 1 Type ot project(required): I. lama employer with 30 4. ❑ t am a general contractor and l employees(11tll andior part-time).* have hired the sub-contractors 6. ❑New construction listed on the attached sheet. 7. D Remodeling 2.❑ I am a sole proprietor or partner- ship and have no employees These sub-contractors have R. Demolition workingfor me in anycapacity. employees and have workers' ' P tY 9. Building addition [No workers' comp. insurance comp. insurance.: required.) 5- ❑ We are a corporation and its IOU Electrical repairs or additions 3.0 I am a homeowner doing all work officers have exercised their I i.❑Plumbing repairs or additions myself. [No workers' comp_ right of exemption per MGL 12.0Roof repairs insurance required.]* c. 152.*1(4).and we have no Replacement employees. [No workers' 13.�other comp. insurance required.] • *Any applicant that checks box at must also fill out the section below showing their workers'compensation policy information. Honieowners who submit this affidavit indicating they arc doing all work and then hire outside contractors must submit a new a rida.it tndacating such. :Contractors that check this box must attached an additional sheet showing the mine of the sub eo ntnwturs and state whether or nut those entities have employees. If the sub-contractors Kase eiliplutees.then must provide their wurkets'comp. i am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Old Republic Insurance Co. Policy#or Self-ins. Lic.#: MWC 314158 22 Expiration Date: 10/01/2024 Job Site Address:6P'3' Now col OAS iQ e ►J Cit'State"'7ip plow/ice m49 0/a i 2. Attach a copy of the viorkeri'compensation polity declaration page Ishosing the policy number and expiration date). l adore to secure coverage as requited under Section 23A of MtiL c. 152 can lead to the imposition of criminal penalties of a tine up to Sl.5(0.f(1*odor one-year imprisonment as well as Civil pe r altics in the Corm of a STOP WORK ORDER and a fine of tap to S230.00 a day against the violator Be ads iscd that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance e<.>tetor>C v<tification. I do hereby certify under the pains and penalties of perjure'that the information provided above is true and correct. Signature n .' y�d2 (t.te 10/10/23 ltht n 3 o .- nt5 Z— 4.//2 Official use only. Do not write in this urea.to be completed by city or town official (its or loon: Permit:l.icense p issuing authority (cheek one): �" I❑Board of health 20 Building Department 3❑('it}i l ow n Clerk a.❑Electrical Inspector 5E1'lumhing Inspector 6.00ther ("(Intact Person: Phone b: U.S. Canada ENERGY ENERGY ix o STAR STAR Andersen' Andersen NFRC Certified _o `o u u w m v6.0 v4.1 Product Line& Glass Grille Type Products " " m t3 �- a ',I Product Type Type Directory Number a r f c u m LI _ Q r m m > m m Z u u r^ N N N 2 rn Sinxd ated Divided Lire or Installed Interior Removable AN0.N-13-01521-00003 0.25 1.42 0.37 0.45 30 <0.2 - - - - - �' " Full Divided Lite AND-N-13-01527-00001 0.29 1.65 0.37 0.45 25 <0.2 - - J ' x a 3 Finelight'"(grilles-between-the-glass) AND-N-13-01533-00001 0.25 1.42 0.43 0.52 33 <0.2 - - - 3.9 Tempered Glass-wl No Grilles and Grilles Less Than 1" No Grilles AND-N-13-01382-00001 0.28 1.59 0.32 0.55 23 <0.2 - - - - iu Simulated Divided Lite or Installed Interior Removable AND-N-13-01382-00002 0.28 1.59 0.28 0.48 21 <0.2 I. - - - oFull Divided Lite AN0.N-13-01 38 8-0WOt 0.30 1.70 0.28 0.48 19 <0.2 - - - - Finelight'"'(grilles-between-the-glass) AND-N-13-01400-00001 0.28 1.59 0.28 0.48 21 <0.2 ' - - - - No Grilles AND-N-13-01383-00001 0.29 1.65 0.19 0.30 14 <0.2 '. - - Simulated Divided Lite or Installed Interior Removable AND-N-13-01383-00002 0.29 1.65 0.17 0.26 13 <0.2 g - rn Full Divided Lite AND-N-13-01389-00001 0.30 1.70 0.17 0.26 12 <0.2 - - Finelight°'(grilles-between-the-glass) AND-N-13-01401-00001 0.29 1.65 0.17 0.26 13 <0.2 - - No Grilles AND-N-13-01384-WW1 0.28 1.59 0.21 0.49 17 <0.2 . ' - - Simulated Divided Lite or Installed Interior Removable AND-N-13-01384-00002 0.28 1.59 0.19 0.43 16 <0.2 . - o IO-' Full Divided Lite AND-N-13-01390-00001 0.29 1.65 0.19 0.43 14 <0.2 I. - - Frnelight'.(grilles-between-the-glass) AND-N-13-01402-00001 0.28 1.59 0.19 0.43 16 <0.2 - - No Grilles AND-N-13-01381-00001 0.29 1.65 0.52 0.61 34 <0.2 Z3 Simulated Divided Lite or Installed Interior Removable AND-N-13-01381-00002 0.29 1.65 0.46 0.53 30 <0.2 - g 4 Full Divided Lite AND-N-13-01387-00001 0.31 1.76 0.46 0.53 28 <0.2 - - a Finelight""(grilles-between-the-glass) AND-N-13-01399-00001 0.29 1.65 0.46 0.53 30 <0.2 - t No Grilles AND-N-13-01537-00001 0.24 1.36 0.31 0.54 28 <0.2 ui o Simulated Divided Lite or Installed Interior Removable AND-N-13-01537-00002 0.24 1.36 0.28 0.47 26 <0.2 I - \ r �1 D w Full Divided Lite Zoo se AND-N-13-01540-OOIX11 0.28 1.59 0.28 0.47 21 <0,2 I. e ell - Finelight"'(grilles-between-the-glass) AND-N-13-01546-00001 0.24 1.36 0.28 0.47 26 <0.2 Perms-Shi d® Gliding Pat' Door No Grille AND-N-93-04538-OOW1 1.31� 0.21 0.48 23 <0.2 r+r Simulated Divided Lite or Installed Interior Removable AND-N-13-01538-00002 0.23 1.31 0.19 0.42 22 <D2 - E S ,Full Divided Lire AND-N-13-01541-00001 0.28 1.59 0.19 0.42 16 <0.2 ' I - Finelight""(grilles-between-the-glass) AND-N-13-01547-00001 0.23 1.31 0.19 0.42 22 <0.2 '.I - (No Grilles AND-N-13-01536-00001 0.24 1.36 0.47 0.59 37 <0.2 - - - - Z3 F Lu Y, S Simulated Divided Lite or Installed Interior Removable AND-N-13-01536-00002 0.24 1.36 0.41 0.52 34 <0.2 - - - - Z3 3 0 ▪ = Full Divided Lite AND-N-13-01539-00 W 1 0.29 1.65 0.41 0.52 27 <0.2 - - - - I a 3 Finelight""(grilles-between-the-glass) AND-N-13-01545-00001 0.24 1.36 0.41 0.52 34 <0.2 - - - - Z3 3.9 Tempered Glass-wl Grilles 1"or Greater Simulated Divided Lite or Installed Interior Removable AND-N-13-01382-00003 0.28 1.59 0.25 0.42 19 <0.2 I,I ' - - 3 Full Divided Lite AND-N-13-01394-0W01 0.29 1.65 0.25 0.42 18 <0.2 I - - 0 Finelight'.(grilles-between-the-glass) AND-N-13-01406-00001 0.30 1.70 0.28 0.48 19 <0.2 III - Simulated Divided Lite or Installed Interior Removable AND-N-13-01383-00003 0.29 1.65 0.15 0.23 12 <0.2 r; I - 3 o Full Divided Lite AND-N-13-01395-00001 0.30 1.70 0.15 0.23 11 <0.2 N u Finelight""(grilles-between-the-glass) AND-N-13-01407-00001 0.30 1.70 0.17 0.26 12 <0.2 N - - F. Simulated Divided Lite or Installed Interior Removable AND-N-13-01384-00003 0.28 1.59 0.17 0.37 15 <0.2 N - - C Full Divided Lite AND-N-13-01396-00001 0.29 1.65 0.17 0.37 13 <0.2 N - o▪ m Finelight'.(grilles-between-the-glass) AND-N-13-01408-00001 0.29 1.65 0.19 0.43 14 <0.2 N - - Simulated Divided Lite or Installed Interior Removable AND-N-13-01381-00003 0.29 1.65 0.40 0.46 27 <0.2 N I o▪ i Full Divided Lite AND-N-13-01393-00001 0.30 1.70 0.40 0.46 25 <0.2 tI I J a Finelight""(grilles-between-theglass) AND-N-13-01405-00001 0.30 1.70 0.46 0.53 29 <0.2 •II II �r Simulated Divided Lite or Installed Interior Removable AND-N-13-01537-00003 0.24 1.36 0.24 0.41 24 <0.2 1; w r5 w Full Divided Lite AND-N-13-01543-00001 0.28 1.59 0.24 0.41 19 <0.2 N - - x 3 FinelightTM(grilles-between-the-glass) AND-N-13-01549-00001 0.27 1.53 0.28 0.47 22 <0.2 rI - - - - This information is for reference only. Data is current as of December 15.2014 and is subject to change. Performance varies by unit size and options selected. Page41 of 55 see Pagel for moreinformesvr For specific unit performance information, please contact your dealer or Andersen Sales Representative. r NI? RENEWAL • mai byANDERSEN / k RILL SWAG WINDOW&DOORREPUfMENT Re: Massachusetts Solid Waste Affidavit Good day, Please find attached location where the installers will bring their debris from the jobs.These are all Renewal by Andersen location. • WASTE MANAGEMENT—30 FORBES RD, NORTHBOROUGH, MA 01532 When filling out any solid waste affidavit, it's the installer whom will be removing the garbage and dumping the trash at the Renewal by Andersen dumpster locations closest to that job. Thank you, Go Permits Agreement Document and Payment Terms / DBA:RENEWAL BY ANDERSEN OF BOSTON Leila Derose u Legal Name:Renewal by Andersen LLC 677 North Farms Road RENEWAL RENDEwA HIC#170810 Florence,MA 01062 byA30 Forbes Road I Northborough,MA 01532 C:(413)478-6462 Phone:(508)351-2200 Fax:(508)9867072 rbaboston@gmail.com Leila Derose 04/19/24 BUYER(S)NAME CONTRACT DATE 677 North Farms Road, Florence,MA 01062 (413)478-6462 BUYER(S)STREET ADDRESS PRIMARY NUMBER SECONDARY NUMBER lkderose@rcn.com PRIMARY EMAIL SECONDARY EMAIL NOTES: Buyer(s)hereby jointly and severally agrees to purchase the products and/or services of Renewal by Andersen LLC d/b/a Renewal By Andersen of Boston("Contractor"),in accordance with the terms and conditions described in this Agreement Document and Payment Terms,any documents listed in the Table of Contents,and any other document attached to this Agreement Document,the terms of which are all agreed to by the parties and incorporated herein by reference(collectively,this"Agreement"). Buyer(s)hereby agrees to sign a completion certificate after Contractor has completed all work under this Agreement. TOTAL JOB AMOUNT: $14,150 By signing this Agreement,you acknowledge that the Balance Due,and the Amount Financed must be made by personal check,bank check,credit card,or cash. DEPOSIT RECEIVED: $0 BALANCE DUE: $14,150 Estimated Start: Estimated Completion: 10-12 weeks 1 day AMOUNT FINANCED: $14,150 We schedule installations based on the date of the signed contract and secondarily on the date METHOD OF PAYMENT: Financing in which we complete the technical measurements.The installation date that we are providing at this time is only an estimate.We will communicate an official date and time at a later date. Rain and extreme weather are the most common causes for delay. NOTES: Buyer(s)agrees and understands that this Agreement constitutes the entire understandings between the parties and that there are no verbal understandings changing or modifying any of the terms of this Agreement. No alterations to or deviations from this Agreement will be valid without the signed,written consent of both the Buyer(s)and Contractor. Buyer(s) hereby acknowledges that Buyer(s)1)has read this Agreement,understands the terms of this Agreement,and has received a completed,signed,and dated copy of this Agreement,including the two attached Notices of Cancellation,on the date first written above and 2)was orally informed of Buyer's right to cancel this Agreement. NOTICE TO BUYER: Do not sign this contract if blank. You are entitled to a copy of the contract at the time you sign. YOU, THE BUYER, MAY CANCEL THIS TRANSACTION AT ANY TIME NOT LATER THAN MIDNIGHT OF 04/23/2024 OR THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION, WHICHEVER DATE IS LATER. SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. SIGNATURE OF SALES PERSON SIGNATURE SIGNATURE Brian Soares Leila Derose PRINT NAME OF SALES PERSON PRINT NAME PRINT NAME 04/19/24 Page 2 / 25 - II' Itemized Order Receipt ,'y,// P p DBA:RENEWAL BY ANDERSEN OF BOSTON Leila Derose RENEWAL Legal Name:Renewal by Andersen LLC 677 North Farms Road HIC#170810 Florence,MA 01062 brANDERSEN 30 Forbes Road I Northborough,MA 01532 C:(413)478-6462 Phone:(508)351-2200 I Fax:(508)9867072 I rbaboston@gmail.com ID#: ROOM: SIZE: DETAILS: PRICE: 101 Dining Patio Door Gliding 200 Series Narroline 2 Panel Active/ Stationary, Clear Andodize Sill, Exterior Canvas, Interior Pine, Performance Calculator PG Rating: 40 I DP Rating: + 40 / - 40 Glass, All Sash: Tempered High Perf. SmartSun Glass, Hardware, Newbury® , Antique Brass, Screen, Gliding, Full Screen, Grille Style, No Grille, Misc, Custom, Replacement of interior casing that does NOT require a knife to be made (insert application)., Notes, Interior casing needs to be mahogany, 102 Dining Patio Door Gliding 200 Series Narroline 1 Panel Stationary, Clear Andodize Sill, Exterior Canvas, Interior Pine, Performance Calculator PG Rating: 40 I DP Rating: + 40 / - 40 Glass, All Sash: Tempered High Perf. SmartSun Glass, Grille Style, No Grille, Mlsc, None , WINDOWS: 0 PATIO DOORS: 2 ENTRY DOORS: 0 SPECIALTY: 0 MISC: 0 TOTAL $14,150 Renewal by Andersen is committed to our customers'safety by complying with the rules and lead-safe work practices specified by the EPA. 04/19/24 Page 3/ 25 Payment Authorization Form kr6Egt DBA:RENEWAL BY ANDERSEN OF BOSTON Leila Derose RENEWAL Legal Name:Renewal by Andersen LLC 677 North Farms Road HIC#170810 Florence,MA 01062 brANDERSEN 30 Forbes Road I Northborough,MA 01532 C:(413)478-6462 RUHMEIVIONLOOMENMICIT Phone:(508)351-2200 I Fax:(508)986-7072 I rbaboston@gmail.com Leila Derose BUYER NAME 677 North Farms Road Florence ADDRESS CITY MA 01062 (413)478-6462 STATE ZIP CODE PHONE NUMBER 1 PHONE NUMBER 2 10yr 9.99% $14,150 FINANCE PROGRAM` FINANCE PLAN#' CONTRACT BALANCE Brian Soares 04192024000021 SALES REP APPLICATION ID OFFER EXPIRATION DATE *If your financing is pending,the Finance Program and Finance Plan Number are subject to change PAYMENT SCHEDULE ($14,150) CASH DEPOSIT(1) FINANCED DEPOSIT(2) SUBSTANTIAL COMPLETION(3) FINANCING $0 $4,716 $9.434 (1) CASH DEPOSIT: Renewal by Andersen requires thirty-three percent(33%)of the purchase price paid at Agreement Signing. Buyer(s)may pay through the following payment methods: cash,check,debit card,or credit card("Cash Deposit"). (2) FINANCED DEPOSIT: Renewal by Andersen requires thirty-three percent(33%)of purchase price advanced when the windows and/or doors are ordered. For Buyer(s)that receive approved financing through a Renewal by Andersen lender("Lender"),the Lender will advance this required amount directly to Renewal by Andersen("Financed Deposit"). For open-end credit loans,the Lender will not extend credit to the Buyer(s)and. For all financings,the Buyer(s)will not owe any payments until Substantial Completion(as defined in item 3 below)and the Lender has delivered the remaining balance to Renewal by Andersen. (3) SUBSTANTIAL COMPLETION: Renewal by Andersen requires the final payment(which shall be delivered by the Lender in the case of projects financed through Lenders)on the day of installation when all windows and/or doors included in this Agreement have been installed into their openings and any interior and exterior trims have been applied("Substantial Completion"). If there are Change Orders associated with the project covered by this Agreement,the difference in the Job Amount will be reconciled in the final payment requested from the Buyer(or the Lender in the case of a project financed by a Lender)upon Substantial Completion. BY SIGNING BELOW, I/WE,THE BUYER(S): 1. Buyer(s) authorize Renewal by Andersen to transact payments, including with Lenders, based on the amount(s),form of payment(s), and timing as specified in the Payment Authorization Schedule above and, if applicable,final payments in the amount requested by Renewal by Andersen upon the execution of a Change Order. 2. For Buyers that finance a project through a Lender, Buyer(s): (i) understand that the Lender will disburse the Financed Deposit and final payment at Substantial Completion to Renewal by Andersen as specified in the Payment Authorization Schedule,(ii) understand that the Lender will not extend credit to the Buyer(s)for open-end credit loans,(iii)the Buyer(s)will not owe any payments until Substantial Completion,and (iv) acknowledge the use of the loan proceeds for payment upon Substantial Completion will constitute reaffirmation by all Buyer(s) of the loan agreement with the Lender. 3. Buyer(s) agree to notify Renewal by Andersen in writing of any change in payment method at least three business days' prior to the respective payment due date. 4. Leila Derose 04/19/24 BUYER NAME _ SIGNATURE DATE 04/19/24 Page 4/ 25 Go Permits, LLC 1310 105 Buttonball Lane III Glastonbury, CT 06033 PERMITS ' Scott Doughman Phone: 860-952-4112 Fax: 860-430-6719 scottdoughman@gopermits.org Re: Building Permit Application - Licenses Good day, Please find attached permit application, licenses and supporting documents. Renewal by Andersen sold the job and is the G.C. and CSL - CSL #CS-090125 -- Exp. 10/06/24 - HIC #170810 -- Exp 12/22/2025 - Workers Comp - #MWC 314158 23 — Exp. 10/01/24 Old Republic Insurance Co All licenses and insurances are attached. Once the permit is ready: • Please fax or e-mail a copy of the permit and receipt to the below address and mail the original to the homeowner: Fax: 860-430-6719 Email: renewalbyandersenAgopermits.orq • If you unable to mail the permit to the homeowner please send to the below address and we will ensure the permit is at the home posted at the time of installation: Go Permits, LLC 105 Buttonball Lane Glastonbury, CT 06033 If we are required to pick up the permit in at the building department, please call 860-952- 4112 once it's ready and we will come to get it. Thank you, Go Permits Commonwealth of Massachusetts Cal1�1cDuI rlaOr { ub Division of Occupational Licensure Unrestricted-8u gs of any use group which contain ! Board of Building Reguiations and Standards less than Sa,000 cc feet r'3S't c:'sc.e:� "' e )of d B I . Constkiltilbri rSkipervisor space CS-090125 etpires: 10106I2024 JAIME L MORIN ` t 54 NOTTINGNAM RI) I RAYMOND NM 03077 , et I ° 3� failure to possess a current'Abort of the Missadhuaatts ,, "� State S td*ng Code es cause for revocation of tree ficentre. Ccr::miss:o,cr 1°. UCands.A., For information about this 6sense Cap(017)727-3200 or visit www.mass.govid$ Uttice of Uonsumer Affairs ana business Kegulation 1000 Washingto .. rget - Suite 710 Boston,.Massachusetts 02118 Home Improvement a. tractor Registration i i _llaittior tel,�, spl�eletNlr:iw , '-at t4 i NI , ,+Type: Supplement Card RENEWAL BY ANDERSEN LLC _w ='=�= anon: 1212 10 30 FORBES ROAD E ' ation: 1 /22/2025 NORTHBOROUGH, MA 01532 r. �"" lem iIremsom raw. . .r:..'.,... } Update Address and Return Card. THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs&Business Regulation Registration valid for individual use only before the HOME IMPROVEMENT CONTRACTOR expiration date. If found return to: TYPE: Supplernent Garet Office of Consumer Affairs and Business Regulation Bggi;aratiotl F.1Sairati n 1000 Washington Street -Suite 710 1/0810 1a2212025 Boston,MA 02118 ENEWAL BY ANDERSEN LL 3 L AIMEMORIN +rr 2 t"� S>". ,'-. 0 FORBES ROAD , *, /t i ORTHBOROUGH,MA 0153T. ,�; Undersecretary Not valid with ut signature 1/4,e RENEWAL fri• bYANDERSEN MINN vaillileiamlinalleil To Whom It May Concern: This letter will authorize the following person!s) to act as wogs)on behalf of Renewal by Andersen LLC, 9900 Jamaica Ave Soutn, Cottage Grove MN 55016 to pull for perrnits and inspections with respect to the installation, maintenance and repair of windows and entry tinny.; MAccArhusetts State Home improvement Contractor license nortIhr. 170810 and Conbtrcction Supervisor License number CS-090125. It you have any questions, please call me at 508,351-2277 ext 6 Authonzed person(sl: Go Permits LLC Sarah Ha rnmad David Anderso". Maureen Kivel Scott Doi..ghman Ryan Bdndo Sovannara Kuy Mark Fester Glynn Norgan ienniter k.vinke We rIc..roi Hoiden Gerald Cramer Nick Raeo Danel Vickerrnan Stephen Wilder Katie Grocott Bonnie Myers Carrie Fag,"o Michael Rogers Rachel Orloff Arnie Morin Renewal ny Andersen LLC HIC 170810 CSL—CS090125 Local District Offic_e Address 30 Forbes Rd Northborough, MA 01532 A ^ Page 1 of 1 ♦D 9/21 CERTIFICATE OF LIABILITY INSURANCE D0 /DDIYYYY) AC p 9/21/2023 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 Willis Towers Watson Certificate Center NAME: Willis Towers Watson Midwest, Inc. PHONE 1-877-945-7378 FAX 1-888-467-2378 c/o 26 Century Blvd (AlC.Na.Est) (AIC,Nor P.O. Box 305191 E-MAIL ADDRESS: certificates@willia.cem Nashville, TN 372305191 USA INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: Old Republic Insurance Company 24147 INSURED INSURER B: Renewal by Andersen LLC - - -- - - - ---- 30 Forbes Road INSURER C: Northborough, MA 01532 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:W30224860 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR XISD WVD POLICY NUMBER (MM/DDIYYYY) (MM/DDIYYYYI X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 3,000,000 CLAIMS-MADE X OCCUR DAMAGE PREMISES(RENTED occurrence) $ 500,000 A MED EXP(Any one person) $ 10,000 MWZY 314161 23 10/01/2023 10/01/2024 PERSONAL BADVINJURY $ 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 6,000,000 X POLICY JJEECT LOC PRODUCTS-COMP/OP AGG $ 6,000,000 OTHER $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 5,000,000 (Ea accident) X ANY AUTO BODILY INJURY(Per person) $ A OWNED SCHEDULED MIS 314159 23 10/01/2023 10/01/2024 BODILY INJURY(Per accident) $ _ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION X PER OTH- ANDEMPLOYERS'LIABILITY STATUTE ER A ANYPROPRIETOR/PARTNER/EXECUTIVE YIN E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBEREXCLUDED? n NIA MWC 314158 23 10/01/2023 10/01/2024 1,000,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below I E.L.DISEASE-POLICY LIMIT $ 1 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORR/IIZZEDD�REPRESENTATIVE I J Evidence of Insurance ea `I'Ui.be Aktf 1 ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD SR ID, 24694639 BATCH: 3138744