32C-296 (8) 40 VALLEY ST BP-2017-0664
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map:slock: 32C-296 CITY OF NORTHAMPTON
Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TTOTHE
GUAARAANTTY FUND D((MGL c.142A))
Category: window replaced BUILDING 1E RL T 42II l
Permit# BP-2017-0664
Project It JS-2017-001086
Est. Cost: $985.00
Fee:$40.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group; LOWES HOME CENTERS INC 049918
Lot Size(sj, ft.): 18817.92 Owner: EVERETT MALCOLM c.
zoning LlRCt93L/ Applicant: LOWES HOME CENTERS INC
AT: 4D VALLEY ST
Applicant Address: Phone: Insurance:
282 RUSSELL ST (413) 588-0270 WC
HADLEYMA01035 ISSUED ON:MI S/2016 0:00:00
TO PERFORM THE FOLLOWING WORK:REMOVE 2 WINDOWS REPLACE WITH NEW-
GARAGE AREA
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/Chinmey:
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 11/15/2016 0:00:00 $40.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Louis I lasbrouck-Building Commissioner
Department use only
City of Northampton Status of Permit:
! Building Department Curb CutDriveway Permit
�,,./ \ 212 Main Street Sewer/Septic Availability_,,,,,,,
Room 100 Water/Weli Availability
11Vf a -.s Nacthampton, MA 01060 Two Sets of Structural Plans
phon0-413-587-1240 Fax 413-587-1272 Plot/Site Plans
` moi!j Other Specify
(CATION TO CONSTRUCT,ALTER,REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION Li' / 7 G1'q
1,1 Property Address-. This section to be completed by office
LA)
VA.
- y c5“2—ret` Map LotUnit
F•b1` hmkA11PI r Mf G(0(=,(:) Zone Overlay District
_ Elm St.District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
oLK r Am yo �u v N�+ tea) M A
Name(Print) Current tart 4 ress'
Cult
_sc y12,
010-(0-0--
• -•-
ic �
.nal - 0 CcI-rViA : Teleph•ric
Signature
2.2 Authorized Anent' a69... {-LLS'Er4 AL--. Sr
Nam- - •Apr Curren oiling duress.
oat Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1, Building k9 c G`.7 0-t (a)Building Permit Fee
2, Electrical O (b)Estimated Total Cost of
Construction From(6) _
3. Plumbing Building Permit Fee
4. Mechanical(HVAC)
5 Fire Protection �( /,
6. Total a(l +2+3+4 +5) `f6.fsc Check Number a9SLi 4v-o
"C This Section For Official Use Only
Building Permit Number: Date
.. — issued: .`.
all
Signature: / ,.
Building Commissioner/Inspector of Buildings Date
•
Section 4, ZONING AU Information Must Be Completed_Permit Can Be Denied Due To Incomplete Information
._....�__...._
Existing Proposed Required by Zoning
This ci)earbein by
Building
p Ucpartrnentnl
Lot Size
Frontage
Setbacks Front
Side 12 R: L. R:
Rear
Budding Height
Bldg.Square Footage °e
Open Space Footage .n
Pit area mina:hag&pant
parking)
e of Parking Spaces
Fill:
ivnlumc&lncvtiou}
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO Q DONT KNOW Q YES Q
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DONT KNOW 0 YES Q
IF YES: enter Book Page and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO Q DONT KNOW O YES Q
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained O Obtained Q , Date Issued:
C. Do any signs exist on the property? YES Q NO Q
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property? YES Q NO 0
IF YES, describe size, type and location:
E. Will the construction activity disturb(clearing,grading,excavation,or filling)over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES Q NO Q
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
New House n Addition ❑ Replacemen endows Alteration(s) n Roofing ❑
Or Doors
Accessory Bldg. ❑ Demolition ❑ New Signs (p] Decks [ll Siding [17] Other[CD
Brief De not Prgpused �;` �c.�,. \ � E C �c s�r2uc. ta.1�
Work: ��"fQJG c7-. W�-^r a-AS x.-�CU ILIA b (�C� J
Alteration of existing bedroom Yes No Adding new bedroom Yes No Ca I�C(�Q.
Attached Narrative Renovating unfinished basement Yes _ No
Plans Attached Roll -Sheet
6a. If New house and or addition to existing housing, complete the following:
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. Masscheck 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.
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
I. J etf..\ , as Owner of the subject
property
hereby authorize J c k_ C-f, €10 VS c2T
to act on my behalf, in all matters relative to work authorized��-by this building permit pplirption.
XA✓�CtV O C01"-e Qrl.-.\ /If? i(o
Signature of Owner Date
I. — r j+T r \ Ov23 ,as Owner/Authorized
Age.reby de rat the statemen s and information on the foregoing application are true and accurate, to the best of my knowledge
and belief.
Signed under the pains and penalties of perjury.
rrali I L
PIM Arallirr
1 /NI 6
_-•nature •, 4 ner/Agent Date
•
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor `,.('�,. Not Applicable,
]�_ ❑
Name of License Holder_ SL -�X. s j'✓\ CS — `� Q`G`t y
License Number
i 5 5i + e1551W±AQ7cOo� M/+ cD o - / 2 �t 1/( )
_
Address ' h Expiration Bate
L/CS 15`55 ISG
signature Telephone
9,Registered Home Improvement Contractor: Not Applicable G
,_ ti- S / . alt 8
Company Name Registrratib eNU berms
fp to
Address�'s, ,,��- . J JI 7 3�t`,'c.fl - ,a'Zn Expiration Dat
yw,LLcG �.a Q G _ " Telephone O "1 ""'
SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.I.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 buil ing permit
Signed Affidavit Attached Yes No ❑
r
11. - Home Owner Exemption
The current exemption for"homeowners'was extended to include Owner-occupied Dwellings of one(I) or two(2)families
and to allow such homeowner to engage an individual for hire who does not possess a license,provided that the owner acts
as supervisor.CDR 780, Sixth Edition Section 108.3.5.1.
Definition of Homeowner: Person(s)who own a parcel of land on which he/she resides or intends to reside,on which there
is.or is intended to he,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 not be considered a homeowner.
Such"homeowner"shall submit to the Building Official,on a form acceptable to the Building Official that he/she shall be
responsible for all such work performed ander the building permit.
As acting Construction Supervisor your presence on the job site will he required from time to lime,during and upon
completion of the work for which this permit is issued,
Also be advised that with reference to Chapter 152(Workers'Compensation) and Chapter I53 (Liability of Employers to
Employees for injuries not resulting in Death)of the Massachusetts General Laws Annotated,you may be liable for person(%)
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
City of Northampton 212 Main Street, Northampton, MA 01060
Solid Waste Disposal Affidavit
In accordance of the provisions of MGL c 40, S54, I acknowledge that as
a condition of the building permit all debris resulting from the construction
activity governed by this Building Permit shall be disposed of in a properly
licensed solid waste disposal facility, as defined by MGL c 111, S 150A.
Address of the work: y�UAu t`/ Set . 1 :42U- gt-Vco.3 t Piick CIpbp
The debris will be transported by: CE1`SZAt_l_'d2,
(-14 12cs -sc
The debris will be received by: "?c) 04.
Building permit number: It0-1
Name of Permit Applicant ktketc, Oc -$
Date Signature of Permit Applicant
The Commonwealth of Massachusetts
Department of Industrial Accidents
n...---rot=s.
?__-tx Office of Investigations
tr
—. _ 1 Congress Street,Suite WO
/, Boston,MA 02114-2017
14- wwrumass gonvdia
Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name(Business.Organiaatiorilndiaidualk .'"NocCY(71.[, \ kcl -lq- W,s-
Cit' /State/Zi i' i s.
��"`"P}tone#.': c-f��1' ��
Are you an employer?Check the appropriate box: Type of project (required):
I.E I am a employer with 4. ❑ I am a general contractor and I ❑New construction
/bmployees(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 7 hese sub-contractors have g_ ❑Demolition
working for me in any•ca Tacit - employees and have workers'
4 7.
9. ❑ Building addition
(No workers comp.insurance comp. insurance.,
required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions
3.0 I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions
myself. (No workers' right of exemption per MGL 7 comp. 12.0 Roof repairs
insurance required.]` c. 152, §1(4),and we have nc -,ria
employees. [Nap workers 13-Other _W a
comp. insurance required.]
*Any applicant that checks box sl must al:o fill out the Section Mow sholine their workers':.smpc SOssa policy information.
s Hammers who submit this affidavit indcating they are doing all work and then houtside conuawtsmut:ut nt a new affidavit indicating such.
rContmelom 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. Maw sub-contractors haw anploycc.,they oma provide their worker_ comp-policy ne nsber.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name:_ . AL CLA,jat "Wks. 0,Q !Sib
^ _
Policy f/or Self-ins. k
I . its V LiOo - 9-`t L 1320 t(:)6 Expiration Darcy �/9 J f�( 3
lob Site Address Lk) 0/44--°-e4 1-17- City State/Zip: Lt-42CC
U- _/" k ON GO
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 NIDE c. 152 can lead to the imposition of criminal penalties ofa
tine up to$1,$00.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up to 5250.00 a day against the violator. Be advised that a copy oft is statement may be forwarded to the Office of
Investigatio
s of
i
Signature;ebyc ertThe 1. o'for luaus - coverage perjury
I "arm'an Ides of peryury that the information provided abo. •is Re and correct.
Dant: // a lCo
Phone 4: 417 . ' ; 1 "SC,
•
Official use only. Do not write in this area,to he 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#:
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--it ` 'F"i' CERTIFICATE OF LIABILITY INSURANCE °".Y
8111/2016
CCFCIFICATE IS ISSUED AS A MATTER OF INFORMATIONEN CONFERS NO RIGHTS UPON THE CERTIFICATEHOLDERS
CERF.CATEDOES NOT AFFIRMATIVELYTLC AMEND, EXTEND OR ATTER THE COVERAGE AFEDED BY THE PUCIES
BELOW THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THEISSUiNGNsuRcRSS}.AUTHoRZED
REPRESENTATIVE OR
PRODUCER,AND THE CER'iIFiCATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policyliesj must he endorsed 11 SUBROGATION IS WAIVED sublet:to
the term, and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not canter rights to the
certit calx holder in Iieu of such endorsement(s).
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OnsrrancU Center of New England.Inc Ne . 804 243-81
1020 Suffield Street �? �o.r.n.t 134 ,n ,.ry„r. (41 J)T31-4639
,Agawam,MA 01001 n0ORE96r
INSURERISI AFFORDING COVERAGE NAIcP
I u ;INSURER A Nautilus Insurance Co
Surrn
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Jodor.Home Improvement INSURER c Aim Mutual Ins Co-Assigned Risk
c/o Mark S Jodoin
137 Porter Lake Drive INSURE 0;
Longmeadow,MA 01106-1246 1 INSURER 1.
iINSUR€Rr
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
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IND IPU NORNERSSUEr) ORANYG MAE REQUIREMENT TERM OR CONDI OF BY E POI ICIES R DESCHERRIBED
DOCUMENTEISUBJE PECTLL Y E TERM S
exel UNIONS MAY BE ITIIONS r MAH PERTAIN THE INSURANCE AFFORDEDB THE POI PAID AIMS HEREIN IS SUBaECI [BALL THE THRMS,
EXCLUSIONS AND CONDITIONS DF SUCH and_Inas
LIMITS DROWN MAY HAVE BEEN P,L'UVCY E l PAIL EPOY CXI'
;UNE 1E LeuBR rat Err MWDYExv OROS
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Vennor#16430
Lowe's Cornpanies Inc_anal any and an stinsni aiies are named as additional insured as respects to General Liahihty and Auto Isab YIy per Mass BurnapAs
jALeo Fonns CAPPOL and MM99h1 an APPIsanio Mass.State Laws as per wanton contract only
CERTii!CA It HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELED BEFORE
L.Owe'eCompdnieslDa THE EXPIRATION HALE: I HEREOF, NOTICE WILL 6F EFL IVERE° IN I
Aitn: S Insurance(Merl ACCORDANCE'WITH THE POLICY PROVISIONS.
'Vendor Compilanre..IRLsk Mgnr4 Lowes Commands Inc
Post Office Pok I'll1A UTNOEFflO ReeRisFUTAAWF
North Wilkeshoro NO 28656.0001 .
IC11988-2014 ACORD CORPORATION. All hnlits reserved.
ACORD 25(2014'01) The ACORD name and logo are registered marks of ACORD
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A d CERTIFICATE OF LIABILITY INSURANCE G'E 2�"G"e '
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
IMPS ENT'ATIVE OR PRODUCER,AND TIE CERTIFICATE HOLDER.
IMP° ANT:If the certificate holder is an AODITONAL INSURED,the poticyQes)must have ADDITIONAL INSURED previsions or be endorsed.If
SUB DATION IS WAIVED,sutyMt to the Terms and condltoes of the Polley,certain noddles may require an endorsement A stataRleM on this C
ce . does not confer rights to the certificate holder to lieu of such entlmsement(s). n
PR0a¢w CONTACT IR
son Ris services South, Inc. FIX v
Eharlo NC office I Iein (666) 33-)az2 (Ay pat Laoo) 363-0105 9
1111 Re opolitan Avenue, Suite 400 ESS I
chariot NC 28204 USA
n6UREa(SI AFrORDMG COVERAGE NAIL•
ROMEO MNnERA steadfast Insurance company 26387
Laves Coepanies, Inc. INSURER a; National Union Fire InS Co of Pittsburgh 19445
and its 66reel diaries
1000 Lowk Boulevard NonFP C: New Naupshire Ins Co 23841
Akuresv'PP le NC 28117 USA *LRAM n•
NmnER e:
INSURER F:
COVERAGES CERTIFICATE NUMBER:570061530649 REVISION NUMBER;
THS IS CERTIFY THAT THE POLICES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
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INDICAT D.NOTWHSTANDWG ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTWF TE MAY BE ISSUED OR MAY PERTAIN.THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS.
OCCLUSIONS AND CONDITIONS OF SUCH POLICIES.UNITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Limns shown are as requested
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5II 1 MI EL.DISEASE-EA EMPLOYEE SZ,000,000
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1 ARS EL Disease - Policy 53,000,000
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CERTIFICATE HOLDER CANCELLATIONI 10Tonto .WF CF me move DESCRIBED POLICIES BE CANCELLED BEFORE THE
EEPRAI N DOTE TNEIEOF. NOTICE WILL BE OEUVEA® n ACCORDANCE coni THE
PaEN:Ywansoxe
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Core Svilie NG 28117-8520 NKA rrre (" fg - pVartie f..�Y A . dI nil a
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01986-2015 ACORD CORPORATION.All rights reserved.
ACORD IL5(2016/03) The ACORD name and logo are registered mania of ACORD
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of Consumer Affairs&Basins,Regelatiou License or.rsrttnion valid for iadtvidoi ase only
' 'ME IMPROVEMENT CONTRACTOR before the expiration date if found return ta:
Office of Consumer Affairs and Business Regulation
�\\.../ Lamborn mboa: twigs Type: 10 Park Plaza-Suite 5170
ExPisalloze vontrair, SuPMement Card Boston,MA 02116
LOWE'S HOMES CENM'YY94
11000E SPOFFOa G � _.
1111(10 LOWES BLVD
(MOORESVILLE,NC 28117 Undersecretary valid without signature
LOWE'S CONTRACT# 0012233
MASSACHUSETTS SERVICES SOLUTIONS INSTALLED SALES CONTRACT
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C.µers (,4lierzt-Mi I 'flci94t Image Y✓F,E,--
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NOTICE TO CUSTOMER-PRICE CALCULATIONS:In order to properly pmMnli the installation Of Certain Goods,the Centred Pee may inpude more
Goods than x9rely it Ce imtaPe0 based On the meastmd square footage of the Pros Area.As a resuk,the parties agree that the katp.sum Puce
slated in this Contact is calculated upon bath the value ofMtimated Gums required to NM the COMM(inducting waste).which maymooed the actual
square footage of the Picked Area,and the Isboc which may be eitirrated 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 tat the Puce'intIudes these cos,which may
not be refunded once the Installation Services are performed. �p
Contract Total -lp !` � t9
Are permits required for this installation?:(L}'tes [ I No 'applicable fax included9
NOTICE TO CUSTOMER:Federal law Requires Lowe's to provide you with the pamptn Renovate R(ghe By signing this Contract Customer
acknowledges having received a copy of this pamphlet before work began infant/big Customer of the potential risk of the lead hazard exposure
from renovation activity to be perforated In Customers dwelling unit
NOTE:If rotted wood is discovered during installation additional charges will+pply.You will be given a quote aq a change order
must be completed and signed by the customer for any additional charges. Customer must initial.
'Rey week n marenal not sneased w not lMNdtd in ms epe:eCC Any cheeses x add*nna will be at an additional tlwmefsr the melena!
PHCTO Rayne,Customer grants to Lowe's and Loss's employees and independent onacln the not to take pilo graplu of the Premises where
installation Services will be performed and all work performed at the Premises related to this Conked,and irrevocably gnat to Lowe's all tgM,title and
interest in and to the photographs for use in all markets and media.worldwide,in unmet/My.Customer authorizes Lowe's to Copyright use and publish the
photographs in pnnt and/or elecmiwlly,and agrees That Lowe's may use such photographs for any lawful purpose,- but not limited to,marketing,
advertising,publicity,illuerelion,training and Web content.By hauling here,Customer agrees to the foregoing. •(Customer to initial to the left).
Work Is to commence upon reasonable availability of contractor and/or any special order o/fo, ome} r made (a)which is anticipated to be
d Ills✓ (fit in date].EstimaEstimatedcomg4etlon data N t/ (reg N date}
Saul estimated substaiMI completion date is not dote essence.A statement of xray contingencies NM would matenMy(Menge sad estimated substantial
completion date is as follows:
(if applicable mem a statement of eutfi contingencies).
IF THE CONTRACT TOTAL IS$1,000.00 OR LESS Customer must pay in full.
COMPLETE THIS SECTION ONLY WHEN THE CONTRACT TOTAL EXCEEDS$1,000.00:
Oealmner to Pay in Sul; OR j I Customer to use the following payment schedule:
t) parrs .. to be pair upon signing contract Deposit south be 1P3 the IOW wMact amici and
(2)PoymaNM$ lobe PaidanyWne atter th emitter is Signed an before 0Mnteencemelttotinstallation,VAR authorize Lowe's
to de One of the following(check appropriate box below):
( I Charge my/our credit card for the amount at the payment indicated above anytime after the date this Contract is signet;
or
I I Oepash my/aur check for the amount ofthe payment indicated above anytime after the date this Contract is signed;and
(31 Final payment of$100,00 to be paid upon Wmpeeon REM itilallaticn and both parties'satisfaction,
N.y . :- —.sr,. :Y. :arm. _..:i a a sni ..:o,: -*war '�'M.G 1 c142A
LOWS S AND OWNER HEREBY MUTUALLY AGREEtN ADVANCETHAT IN THE EVENT LOWE'S HASA DISPUTE CONCERNINGTHIS CONTRACT.THAT
LOWE'S MAY SUBMIT SUCH OtSPUTE TO APRIVATE ARBITRATION SERVICE WHICH HAS BEEN APPROVED BY THE SECRETARY OF THE EXECUT-
VE(FEIC F SU (,AFFAIRS AND BUSINESS REGULATIONS AND THE OWNER SHALL BE REQUIRED TO SUBMIT TO SUCH ARBITRATION
ASPROV 0 ,a1 /�
ByLLC b&
Lowe's Home Centers,LLC /,Dale: •
JJIYa rf epryte:.
OwGNA SIGNATURES
V"
BYEOWE'S PURSUANT
TIMPARTIES ABOVE THE OYER MAXTTHE NTTO OF THE PATERN TIO ALDISPUT RESOLUTION
ENEVEN TION IEITIATED
HE
BY LTWNA PURSUANT TM.G.L. SI THE OWNER MY BEIPERMITTED TO INITIATE ALTERNATIVE DISPUTE EVEN WHERE THE
SECTION ABOVE IS NOT SEPARATELY SIGNED BY THE PARTIES.
DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES AND UNTIL YOU HAVE READ THE TERMS AND
CONDITIONS CONTAINED ON THE REVERSE SIDE OF THIS PAGE AND THE FOLLOWING PAGES OF THIS CONTRACT.
BY SIGNING BELOW,YOU ARE ACKNOWLEDGING THAT YOU HAVE READ,UNDERSTAND AND AGREE TO THE
I TERMS AND CONDITIONS SET FORTH ON THE REVERSE SIDE OF THIS PAGE AND THE FOLLOWING PAGES OF THIS
CONTRACT.YOU ARE ENTITLED TO A COPY OF THIS CONT.R%CT AT T IE TTIME OF SIGN TURE. '
WIT H-'Df)AND SEALS)8EL.OW THIS / DAY OF AJEWarthicam/ _ Pe/PGA .
L - 9
. Cs, , C i
- _rid
Lowe's Authorized Representative Cosor Yet
Customer acknowledges receipt Of a true copy of thiswhich was completely filled in prod to Customers execution
hereof.You,the buyer,may
cancel this transaction et any time prior to midnight of the mire business day after the date of this transaction.See the attached notice of cancellation
form for an explanation of this right.
55102 REV. 12/13 FILE COPY1"'"yie.titifeyw°ma i.Dire°e°i'.M°m"
Quote hnpY/sstsrv.lowes.com/m2o_a/mediumQuote.jsp?projectId=15...
Buck to Quote
LOWES HOME CENTERS.LLC 91916 SPECIAL
LOWES 282 RUSSELL STREET ORDER
HY(;( Tp�VINC HADLEY,MA 01035-0000 PepHoafpat
ec4
USA
Date:M111//099(2016 (413)588-0270
Projecl9l 490286816 Description:
Customer Name: EVERETT MAC
Customer Phone: (4131584-0068
Customer Address: 40 VALLEY ST
NORTHAMPTON,MA 01060
USA
Line Item Product Code
Unit Price Quantity Total Price
Frame Size Description
0001 Manufacturer:ThermaStar by Pella IR)
Size=273/4-in W x 53 rouble Hung NFRC:U-Factor:0.30.SHGC:0.49,VLT:59.CR:56
I/2-in H rouble Hung DP35:Size Tested 36-in x?2-in
***Performance values only valid for a single window and do not apply to
Billions *
I•
oduct:Windows
ype:Double Hangs
I anufacturer:ThermaStar by Pella(R)
I I nergy Star(R)Qualified Products Only:Yes-I would like to view only the units that
qualified for Energy Star(R)
nergy Star(R)Zone:Northern
r oom Location:garage
I aterial:Vinyl
dual Frame Type(Overall Width):Replacement Frame(3 1/4-in OAW-No Fin)
loped Sill Adaptor:Yes-Included
I dad Expander:Yes-Included
onfiguration:One Wide
•ctual Frame Size Width:27 3/4-in
Actual Frame Size Height:53 1/2-in
its Opening Width:28-in•r'
I its Opening Height:53 3/4-in 47.-•
dual Vent Size:1/2 Vent
xterior Finish:White
Interior Finish:White
lazing:NaturalSun Low-E
rgon Gas Filled IG:Yes-Argon Gas
empered Glass:Annealed
'Iles Between Glass Type:None
I ardware:I Cam/Keeper Lock Set
I ardware Color:White
creep:Half Unit Fiberglass Screen
/Design Performance:Standard
$217.792 $435.58
1 oft
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