32-011 STORE COPY
BY 61--€2e1 A Date: 6
Lowe's Home Centers. Inc.
v.'ner
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6 0 5 Cf-
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Zip PoQtai Cr'r
co-o Wtres
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. 329790653 for MARCIA RUSSELL Page 4 of 7
STORE COPY
•
� 7
'9?; dot o; fl'_ y, t:;nt il': nod r an tirne ;nn elate th C 'act Is signed: and
S of y nr Si On On to be Jofl complet •'f of the':nstc and both parties' Satbstacn'
D, : s T f ,° THIS CONTRACT I HEf:f- ARE ANY BLANK SPACES AND UN [IL YOU - ?A READ THE TERMS AND CONDITIONS CON-
' D IN THIS CONTRACT AND WHICH FOLLOW THE SIGNATURE URE 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
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-
TRACT, THAT LOWE'S MAY SUBMIT SUCH DISPUTE TO A PRIVATE ARBITRATION SERVICE WHICH HAS BEEN APPROVED BY THE SECRET-
ARY OF THE EXECUTIVE OFFICE OF CONSUMER AFFAIRS AND BUSINESS REGULATIONS AND THE OWNER SHALL BE REQUIRED TO SUB-
MIT TO SUCH ARBITRATION AS PROVIDED IN M.G.L. c.142A.
Store 1916 Project No. 329790653 for MARCIA RUSSELL Page 3 of 7
STORE COPY
9 Iio•;y ti�I�.°� i d�fri i.+rLvv! ire ii.is
fork. C" r to L f;s(s Twmc P� t)
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"f • :ion la
errs Is governed by historic uistnct n c:gulations. 1
Cara Provides and c c,rs j, s:gning this Contract. C us'ol acknowledges having received a copy of this pamphlet befo: work began informing I
Io J the potential i e - d hazard . 2 renovation o p•. in Customers dwelling a
,_,t, �, �iu�l ",Sr< u � Icciu exposure from a�ti'vIl y t w be performed We i1 unit.
TOTAL CHARGES OF ALL MERCHANDISE AND SERVICES *where applicable
SUB -TOTAL $ 925.10
*TAX $ 0.00
DELIVERY $ 0.00
ORDER TOTAL $ 925.10
BALANCE DUE
Store 1916 Project No. 329790653 for MARCIA RUSSELL Page 2 of 7
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8XERCHA%DISE SUMMARY
10495 : 19495 : STK : 6-0 WH RETRO FCH DOUBLE SCREEN : 6-0 WH RETRO FCH DOUBLE SCREEN : JELD-WEN,MILLWORK MASTERS-KNOX - QTY
81310 : 06650-390 : STK : PB DEADBOLT DBL : POLISHED BRASS RESIDENTIAL DOUBLE-CYLINDER DEADBOLT : KWIKSET - QTY 1
131139 : 131138 : STK : 1X8X8 TOP CHOICE EWP PREM S4S : 1X8X8 TOP CHOICE EWP PREM S4S : IRVING FOREST PRODUCTS (MAINE) - QTY 3
177941 : 042049951165 : STK : PB COMBO SGL POLO : POLISHED BRASS RESIDENTIAL ENTRY DOOR KNOB WITH DEADBOLT : KVV|KSET'QTY 1
221690 : 60FH15RLE+ : STK : 6' RB STL FRCH 15 LT RH LE P : 6' RB STL FRCH 15 LT RH LE P : JELD-WEN,MILLWORK MASTERS-KNOX - QTY 1
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Materials Price 4G1 1Q
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Store 1816 Project No. 329790663 for MARCIA RUSSELL Page 1 of 7
- 6204'2,MOIL eaid df ._ G"(.Q adt eOa
Office of Consumer Affairs & Business Regulation License or registration valid for individul use only
OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to:
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1� - � Office of Consumer Affairs and Business Regulation
V11 / Registration: 148688 Type: 10 Park Plaza - Suite 5170
'< °•/ Expiration: 10/18 /2011 Supplement Card
pp Boston, MA 02116
LOWE'S HOMES CENTERS INC
JAMIE SPOFFORD
136 TURNPIKE RD. SUITE 100 '�!/f� /
SOUTH BOROUGH, MA 01772 Undersecretary Not valid without signature
05/13/2011 19:21 14135661236 STANWAS PAGE 01/01
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� 10 Park Plaza - Suite 5170
'N 1. Boston, Massachusetts 02116 .
Home Improvement Cpntr ctor Registration
4 : i Registration: 132315
t/ 2 t� P ,:.. Type: Individual
( `' Expiration: 1/3/2013 /3/2013 Ti # 207836
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STANLEY WASILEWS i:4: �
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LONCMEADOW MA 01 106 � �: ,,s� .� 1r'f`" _ - - --
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Undersecretnry —
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-‘ Office of Consumer Affairs & Business Regulation License or registration valid for individul use only
before the expiration date. If found return to:
0ME IMPROVEMENT CONTRACTOR
Office of Consumer Affairs and Business Regulation
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Registration: 148688 Type:
I0 Park Plaza -Suite 5170
-.P % Expiration: 10/18/2011 Supplement Card Boston, MA 02116
LOWE'S HOMES CENTERS INC
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JAMIE SPOFFORD
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136 TURNPIKE RD. SUITE 100 .�/,--- >66_-- --- ' - of
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SOUTH BOROUGH, MA 01772 Undersecretary Not valid without signature
2010-12-21 . 10:32 413 231 5562 4 0660 INSTALLED SALES P 1 / 2
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The Commonwealth of Massci.chusetts
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,Departinent of Industrial .A.ecidentr
• .7,..:.7.i4 0.7 -7 7 rer- Office of Investigations .
600 Washitrton Street
,;. •T-ii-."•,'" 4, Boston ...414 02111
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of he worker s' compensation policy ckdaration page {showing the policy DAIBItI
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~ SECTION 5: CONSTRUCTION SERVICES .
5.T ...r Licensed Construction Supervisor (CSI.) 1 .._ �u : tt.,o/s
l)t Y k$�I'(.€,l.' Lime Number Exptrahon Date
1 ter of CSL- Holder C.ai.TCr�l�it%tt(Do■.J .--
V .' IJOCA) r Of /0 L List CSL Type (sec below) .1d .
Ad / Type - -- Desc iption Ad �,� U Unrestricted (up m 35.000 Cu. Frt.)
e r • R W.6E iorea 144 Ftut D welling •
• Signature
iii -op4v 5� ,. M Masonry Only
RC Residential Roofiy Covering
Telephone r WS Residential Window and Sidi
SF Residential Solid Fuel Burning Appliance Installation
D Residential Demolition .
5 2 R red How Improvement Cointrat;tur (IUC)
C C o , an ame or HIC Re: 'trunt iyimnp, . Registration Number
I. - I- . 110 S I u,. .. �0�� k / Zap
Ad• r l
#���tiN 1 tit 3 ;/ tf ,21 o Expiration Date
Sin ! , 0 .� ITSIIM Telephone
SECTION , 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 Ne ..,,., 0
SEC T ON 7a: OV N R AUTHORIZATION TO BE COMPLETED WHEN -- _"""..
I
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT ,,
I, _,•,.,,, i J u SS t .(,C U. _. � , us Owner of the subject property hereby
authorize + S 0 . ■ . 4.A, to act on my behalf, in all matters
relative to work authorized by this building permit application. r�
_Se QC2_ �- /5/2oH
Si m w cu of O hate
SECTION 7b: OWNER' OR AUTHORIZED AGENT DECLARATION
. 1 /VA ` ec5FR
I, _. fume , as Owner or Authorized Agent hereby declare
that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and
behalf
5 O / I
ign , . "'`Authorized Agent Date
:vi 'nd r the • ' s and .enaltiesof,•'in -
NOTES:
I .. An Owner who obtains a building permit to do his/her own work, or an owner who hirer; an unregistered contractor
(not registered in the Home Improvement Contractor (HIC) Program), will _i have aooasb to the arbitration
program or guaranty fund under M.C,L,. c. 142A. Other important information on the RIC Ftogratrt and
Construction Supervisor Licensing (CSI.) can be found in 780 CMR Regulations 1 1016 and 110.RS, respectively,
2. When substantial work is planned, provide the information below:
Total floors area (Sq. Ft.) .. , (including garage, finished bment/attics, deelcy or porch)
Cross living area (Sq. Pt,) 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 he substituted for 'Total Project Cost"
Z!? d 9£Z499S£4 « 8L20 885 EL, OSI 9464 sari °1 EL :04 02- 90-4402
30 /TO 39Vd 5- 1MHVIS 963T99!=ic:Tt'T TO:VO TTtf'. 33/5f
41t
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- E IVED
JUL - 6 6 2011
0 • • ; ealth of Massachusetts
' of � a •. • ' egulations and Standards FOR
. ssac usetts State Building Code, 780 CMR, 7` edition MUNICIPALITY
/.\\,_ '7. ' ' USE
Building Permit Application To Construct, Repair, Renovate Or Demolish a Revised January
One- or Two - Family Dwelling 1, 2008
This Section For Official Use Only
Building Permit Number: ^ Date Applied:
Signature: 6 7/35/0 ,, o I f
Building Commissioner/ Inspector of Buildings Date
SECTION 1: SITE INFORMATION
1.1 Props rtyAddress: 1.2 Assessors Map & Parcel Numbers
1 Y ST
EAT
1.1 a 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 ❑ Private ❑ Zone: Outside Flood Zone? Municipal ❑ On site disposal system ❑
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 O 1 of Record: SSEL-.., — —
Name (Print) Address for Service:
Signature Telephone
SECTION 3: DESCRIPTION OF PROPOSED WORK (check all that apply)
New Construction ❑ Existing Building ❑ Owner- Occupied ❑ Repairs(s) Alteration(s) n ' Addition ❑
Demolition ❑ Accessory Bldg. ❑ Number of Units Other ❑ Specify:
Brief Description of Proposed Work 1 EMe\l E . i 1 E , , s'T14 - A - ? A T T E G `) c .
IU 0 ___ CRCS.)�t, (, (+kA1 CY€ .
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1. Building $ 4 9' 5 j o I. Building Permit Fee: $ Indicate how fee is determined:
2. Electrical $ ❑ Standard City/Town Application Fee
❑ Total Project Cost (Item 6) x multiplier x
3. Plumbing $ 2. Other Fees: $__
4. Mechanical (HVAC) $ List:_
5. Mechanical (Fire $ -
Suppression) Total All Fees: $
� � � Check No. Check Amount: „Cash Amount:
6. Total Project Cost: $ ❑ Paid in Full ❑ Outstanding Balance Due: .
r
141 FAIR ST EXT BP-2012-0016
GIS #: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 32 - 011 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: REPLACEMENT DOOR BUILDING PERMIT
Permit # BP-2012-0016
Project # JS- 2012- 000024
Est. Cost: $925.00
Fee: $40.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: LOWE'S 132315
Lot Size(sg. ft.): 411206.40 Owner: RUSSELL GARY & M PRONOWICZ C/O MARCIA D RUSSELL
Zoning: SC(100)/ Applicant: LOWE'S
AT: 141 FAIR ST EXT
Applicant Address: Phone: Insurance:
282 RUSSELL ST (413) 588 - 0270
HADLEYMA01035 ISSUED ON:7/6/2011 0:00:00
TO PERFORM THE FOLLOWING WORK: REPLACE PATIO 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:
Driveway Final:
•
Final: Final:
Rough Frame:
Gas: Fire Department Fireplace /Chimney:
Rough: Oil: Insulation:
Final: Smoke: Final:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occupancy Signature:
FeeType: Date Paid: Amount:
Building 7/6/2011 0:00:00 $40.00
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Louis Hasbrouck — Building Commissioner