Loading...
36-103 (4) HOME IMPROVEMENT INSTALLATION CONTRACT Aft law Branch Name . L Ww✓> Dater-24•-Z t-t'Z_ Sold,Furnished&Installed by The Home Depot Installed Sales Branch Number: �) Job#: Z�7t 13 345 Greenwood Street,Unit 1 Worcester,MA 01607 Toll Free(800)657-5182; (508)756-6686; Fax:508-756-2859 Federal Ill#75-2698460 RI Cont.Lice 16427 CT Lie#565522 ,%A Home Improvement Cattracior Reg.#126893 Installation Address: � �1 rs�.Zto << /°/� 6"o6 7 City fate a p�fQP� Purchase s: SS#: Driver's License: Work Phone: �11 Home Phone: // Ltv�v�13 ( } ( ) ( ) Home Address: �+ - (if different from Installation Address) City State Zip Project Information I/We("Purchaser"),the owners of the property located at the above installation address,offer to contract with The Home Depot("Home Depot")to famish,deliver and arrange for the installation of all materials as described on the attached Spec Sheet# ('/-1 1 X ,incorporated herein by reference and made a past hereof. Home Depot reserves the right to cancel this contract if,upon re-inspection of the job,Home Depot determines that it cannot perform its obligations due to a structural problem with the home or because work required to complete the job was not included in the contract. DEPOSIT PAYMENT OPTIONS (Subject w fwd venfica im aendkr credit approval) SALE AMOUNT S VgR 1. Cluck,Cashiers Check or US Postal Service Money Order (made payable to The Home Depot). CONTRACT AMOUNT $ 7MYR 2. Credit Card*and/or other payment options-Circle One Below •DEPOSIT S d Visa Mastercard Discover American Express ome Imement Luau ome Depot Credit Card BALANCE DUE �- � --- ON COMPLETION S.�621 Av�aiila<ble Credit:S- (HIL&HDCC ONLY) -25%of Contract Amount due upon execution of Acc III r r.•]C SL( r 1 tG)lr Esp.Due- this contract(unless project is financed through Name as it appears on card: Chevy Chase,in which ease no deposit is required). ' y/our sigruoae be ,UWc The Home De to cl age the Indicate Payment Method For f credit «ue d above. BALANCE DUE ON COMPLETION E tf—Z 4, G'lJtr L :Vt . Due If this is a finance transaction,the agreement for financing is contained in a document,which is incorporated herein by Reference,and trade a part hereof. At-Home Services Credit/Loan Application Ref.# Purchaser agrees that,immediately upon satisfactory completion of the work Purchaser will execute a Completion Certificate and pay any balance due(unless the job is financed,in which case,upon submission of the executed Completion Certificate,Home Depot will be paid in full by the lender). Purchaser also agrees to be jointly and severally obligated and liable hereunder. For Mass.Residents OnIY: Contractor,at owners expense,shall procure all permits required bylaw as follows: Owners who secure their own permits will be excluded from the guaranty fund provisions of MSL Chapter 142A. Unless otherwise noted within this document,this contract shall not imply that any lien or other security interest has been placed on the residence. Entire Aereement: This agreement and its attachments,including any financing agreement,contain the complete agreement between the parties and can not be amended or modified unless in writing in a separate agreement signed by both parties. NOTICE TO PURCHASER Do not sign this contract before you read it. You are entitled to a completely filled-in copy of the contract at the time yoo sign. Keep it to protect your rights. Do not sign any Completion Certificate or agreement stating that you are satisfied with the entire project before this project Is complete. Law prohibits home repair contractors from requesting or accepting a Completion Certificate signed by the owner prior to the actual completion of the work to be performed under the contract. You may cancel this transaction at any time prior to midnight of the third business day after the date of this contract. See Notice of Cancellation for an explanation of this right. There will be a service charge equal to 25%of the contract amount if the job is cancelled by Purchaser AFTER the third business day. BY MY/OUR SIGNATURE BELOW,UWE AGREE TO BE BOUND BY THE TERMS OF THIS CONTRACT. UWE ACKNOWLEDGE RECEIPT OF A COPY OF THIS CONTRACT AND TWO COMPLETED COPIES OF THE NOTICE OF CANCELLATION. BY MYIOUR SIGNATURE BELOW, UWE UNDERSTAND THAT THE AGREEMENT 1S SUBJECT TO REVIEW OF MY/OUR CREDIT HISTORY AND IIWE AUTHORIZE HOME DEPOT AND RMA HOME SERVICES,INC.,A HOME DEPOT AUTHORIZED CONTRACTOR,TO VERIFY AND REVIEW MY/OUR CREDIT RECORD WITH AN INDEPENDENT CREDIT REPORTING AGENCY AND RELEASE THEM FROM ALL LIABILITY INCURRED FROM INADVERTENT OMISSIONS OR ERRORS. SUBMITTED BY: Dater —07 Ssk onw t X. -91-^ ACCEPTED BY:. Date: C' U Homeow � Date: ;?;—•.%i—''::: : J : t=i CFiti Homeo r NOTICE:ADDITIONAL TERMS,CONDITIONS AND WARRANTIES ARE STATED ON THE REVERSE SIDE AND ARE PART OF THIS CONTRACT MFR#063 cm NFRC r�wens C'arninq 6500 Renovations Double Hung - Vinyl Low E (SC) -Argon National Fenestration Rating Council • •Energy savings will depend on your specific climate,house and lifestyle •For more information,calk—8 0 0—GET—PINK or visit NFRc's web sb at www.Mre.org o u-Faclor 0 . 33 Solar Heat Gallo . 3 0 Visible . 4 9 Coefficient Transmitlanc -------------- 0 . 31 0 . 52 Manufacturer stipulates that these ratings conform to applicable NFRC procedures for determining whole product energy performance.NFRC ratings are determined for a fixed set of environmental conditions and specific product sizes. North Central uth f�®® Product meets Energy Star Northern, for al,region(s):o Southern Northern, Central, Southern IND: FEIN 00/GLASS DS/R—R25 DP G Test Size: 48 x 80 Order #: 95856701000111- 50500 :,/ie �'�iro�nunu�.czll� a�� �rx;�uar�uiP,lld ZX Board or Building Regulations and Standards 'S HOME IMPROVEMENT CONTRACTOR Registration: 126893 Expiration: 08/03/2002 Type: Supp.3ment Card Home Gepet At-Home Services MIKE BEDAr:. 3200 COBB GALLF_Ri.A PMjuY#?- ALTANTA,GA 30339 Admin;strator O���t PT0 9 e Gxf� Ci11t�JDtt � �latasaclinsctts' m DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street ' Municipal Building ' Northampton, Mass. 01060 ' WORKER'S COMPENSATION INSURANCE AFFII?AVTT I, upolie— c n4= Y�c e s �-M C (liceMserlpermittee) with a principal place of business/residence at: h �F l len a i a t4 &-50 ( hone#) t - (6t=UCity/slatel2ip) do hereby certify, under the pains and penalties of perjury, that: (`'Y/I am an.employer providing the following worker's compensation coverage for my employees working on this job: U(r--Q t N lA-- 5:,r-e,4 � 3�x 0, -5- 0,006D,53 3 -311c, /03 ' J(Insurance Co ) (Policy Number) (Expiration Date) ( ) I am a sole proprietor, general contractor or homeowner (circle one) and have hired the contractors listed below who have the following worker's compensation policies: (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) ,f (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) - (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (anach additioasl sheet ifnecessary to hxJ%% a infamstion pertaining to ail coati d ) ( ) I am a sole proprietor and have no one working for me. O I am a home owner performing all the work myself. NOTE:please be aurae that while homeowacrs who employ pasom to do rmimmam= o=zvcdoo or repair work on s dwelling of not more than throe units is which the homeowner resides or oa the grouts appurtenant thersto an not generally ooandered to be employers under the vmrk&ez oompeasation Act(G1.152,ss 1(5)),application by a homeovmer for a license cc permit may evideam the legs!status of an employer under the Wodcaes compeasdion Act. I andestand that a copy of this cu emeei may be forwarded to the Depwt.c of Industrial Ac6dcn&011ioe of rauxance for the coverage vmficaiion And that failure to acatr c coverages under sectioa 2$A of MOL 152 an lead to the imposition of aiminai peaalries ooasisfiag of a fine of up to SI,300.00 mdroi of up to one year and tin?pemW in the form of a Stop Wodc Order and a fine of 3100.00 Idly agninA tae For depsrtmCal use only Permit Number CA Mai{ Lot# _ Signahu�e ofLicrosee/Permittee e SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable 0 License Number Address Expiration Date Signature Telephone 9. Reaistered Home Improvement�ontractor: Not Applicable 0 Company Name' Registration Nu ber 71 Address Expiration Dat� Telephone V/F,4/o/ SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152,§25C(6)) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. 11. - Home Owner Exempflon The current exemption for^bnoeoxmmo was extended tvinclude one(1) u, own(2)families and to allow such homeowner mengage an individual for hire who does not possess ulicense,provided that the owner acts Homeowner:as supervisor.CMR 780, Sixth Edition Section 108.3.5.1. Deflnition of Person(s)who own a parcel*[land ou which he/she resides m intends m reside,nowhich there is,or is intended to be,a one or two family dwelling,attached or detached structures accessory to such use and/or farm structures.A person who constructs more than one home in a two-year period shall Rot be considered a homeowner. Such"homeowner"shall submit to the Building Official,on a form acceptable to the Building Official, responsible for all such work performed under the buildinz permit. As acting Construction Supervisor your presence oo the job site will 6c required from time m time,during and upon completion of the work for which this permit inissued. Also ho advised that with reference in Chapter)52(\mmkuo' Cumyooxatim) and Chapter l53 (Liability of Employers to Employees for injuries not resulting in Death)of the Massachusetts General Laws Annotated,you may be liable tozprmoo(m) you hire to perform work for you under this permit. The undersigned"homeowner"certifies and assumes responsibility for compliance with the State Building Code,City of Northampton Ordinances, State and Local Zoning Laws and State of Massachusetts General Laws Annotated. Homeowner Signature SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement endows Alteration(s) ❑ Roofing ❑ Or Doors Accessory Bldg. ❑ Demolition❑ New Signs [ ] Decks [ ] Siding[ ] Other[ ] -- ------------------------------- Brief Description of Prop sg '/ Work: l hv Alteration of existing bedroom—_—_Yes ✓_No Adding new bedroom------Yes —__ No Attached Narrative Renovating unfinished basement No Attached Plans Attached Roll -Sheet 6a, If New and or addition to existing housing, complete the follawina: a. Use of building : One Family-_ -- Two Family—_--_—Other—__—__- b. Number of rooms in each family unit:-_—__—__—_- Number of Bathrooms—__—__—___ c. Is there a garage attached?_-_ —_ d. Proposed Square footage of new construction.--_—_--__—__—____ Dimensions e, Number of stories? f. Method of heating? __—__— Fireplaces or Woodstoves------_---Number of each—__- g. Energy Conservation Compliance. Mascheck Energy Compliance form attached?_—__--_--_- h. Type of construction_—__—__—__- i. Is construction within 100 ft.of wetlands? Yes —__—No. Is construction within 100 yr. floodplain--__-Yes---No j. Depth of basement or cellar floor below finished grade----__—_----_- —_ k. Will building conform to the Building and Zoning regulations? --------Yes --No. No. I. Septic Tank—_— City Sewer_—__— Private well_—_—_ City water Supply SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT —__---- ��,1-�_�----_ �O_J -- I as Owner of the subject property — hereby authorize to act o Vbeh f, in I matters relative work authorized by t is building permit appl cation. � - seQ=-�° ------------------------------------------------------- Signature of Owner Date as Owner/Authorized gen ere by declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge elief. Signed under the pains and penalties of perj ry. Print Name -- - ----- - ---------------------------------------------------------- SignAt6re 8f Own /-Agent Date Section 4. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size Frontage Setbacks Front Side L: R: L: R: Rear Building Height Bldg.Square Footage % Open Space Footage % (Lot area minus bldg&paved parking) #of Parking Spaces Fill: volume&Location A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO DONT KNOW YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO DONT KNOW _ YES IF YES: enter Book Page_ and/or Document# B. Does the site contain a brook, body of water or wetlands? NO DONT KNOW YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained— _, Date Issued: C. Do any signs exist on the property? YES _ NO IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property?YES No IF YES, describe size, type and location:_ _ C}epartmentuse only i of Northampton Status of Permit It Y P wilding Department Curb Cut/Driveway-Permtt i 212 Main Street ,SewerlSepticAvallability _ _ I� JUN 1 ? wC2 i Room 100 water/Well Avallabillb No hampton, MA 01060 Two Sets,of Structural Plans 413 587-1240 Fax 413-587-1272 Plot/Site Plans' _ Mnp,i 5%1:,T,y "AA 0:.,0:7 Other.Specify-- APPLICATION TO CONSTRUCT,ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Property Address: This section to be completed by office Map ---------- Lot--------------Unit---- -- ?qq Fvr3 � © Zone_ _� Overlay District___—_____ !! / // Elm St. District_----___ CB District--------- SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Name(Print) Current Mailin ANdress: 1 05 �� — --- -- ..................._ Telephone Signature 2.2 Authorized Agent: ---M t—� '--------------------- -- --6`Fee -_4 -_�_ ---G�_e►-SST Name(Print) Current Mailing Address: 4w� 3--e ----------------------- ---- 5-og 31D l---------------------- Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant 1. Building G a9 (a)Building Permit Fee , 2. Electrical (b)Estimated Total Cost of Construction from 6 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) 5. Fire Protection 6. Total=(1 +2+3+4+5) Check Number �S This Section For Official Use Only Date Building Permit Number:__—__ Signature: --------------------------- ------ Building Commissioner/Inspector of Buildings Date BP-2002-1111 GIS#: COMMONWEALTH OF MASSACHUSETTS CITY OF NORTHAMPTON Lot: -001 Permit: Building Category: windows replaced BUILDING PERMIT Permit# BP-2002-1111 Project# JS-2002-1781 Est. Cost: Fee: $25.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: HOME DEPOT AT HOME SERVICES 126893 Lot Size(ssq.ft.): 1 6770.60 Owner: FOLEY DEBORAH.J Zoning:_URA Applicant: HOME DEPOT AT HOME SERVICES AT. 947 BURTS PIT RD Applicant Address: Phone: Insurance: 345 GREENWOOD ST UNIT 1 (508) 341-9401 Workers Compensation WORCESTERMA01607 ISSUED ON.6112102 0:00.00 TO PERFORM THE FOLLOWING WORK:I NSTALL REPLACEMENT WI NDOWS 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: Fee Type: Receipt No: Date Paid: Check No: Amount: Building 6/12/02 0:00:00 2857 $25.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo