48-017 (2) 218 DRURY LN BP-2017-1509
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block:48-017 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 WINDOWS/DOORS BUILDING PERMIT
Permit# BP-2017-1509
Project# JS-2017-002523
Est.Cost: $7225.00
Fee: $65.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: SEARS HOME IMPROVEMENT PRODUCT 097519
Lot Size(sq. ft.): 21997.80 Owner: BARRETT MARGARET L
Zoning: Applicant: SEARS HOME IMPROVEMENT PRODUCT
AT: 218 DRURY LN
Applicant Address: Phone: Insurance:
51 BELAMOSE AVE (860) 620-9036 O
ROCKY H I LLCT06067 ISSUED ON:6/27/2017 0:00:00
TO PERFORM THE FOLLOWING WORK:REMOVE & REPLACE 2 WINDOWS 1- PATIO
DOOR, SAME SIZE
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 et 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 6/27/2017 0:00:00 $65.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
I
'- Department use only
,,rriist City of Northampton Status of Perna
l)-6r-
�' f 29 Building Department Curb Cut/Driveway Permit
'o� Al 212 Main Street Sewer/Septic Availability
Room 100 Water/Mt/ell Availability
a Northampton, MA 01060 Two Sets of Structural Plans
I phone 413-587-1240 Fax 413-587-1272 Plot/Site Plans
Other Specify
v/e
APPLICATION TO CONSTRUCT ALTER, REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION 00- I lISO
1.1 Property Address. This section to be completed by office
Map 4-3 Lot 17 Unit (
218 Drury Lan e
Zone Overlay District
P_Int St.District CB District
SECTION 2 PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record-p: ---- - - - - - --- _ -
Pery varret+ zr ZDrury Lana
Name(V J + Current Mailing A
roe ' 3 • X883
: e SS
rt +aGA P phonn
3g„alar --- - i
/
2 2 Authorized Agent: p2�( TYlo t4'Ip$017 'Road
cJios Sve- c- J howipson , C"T o6Z77 r
ay Pri Current Mailing Address
i8 3
,./PASA -Sears A Telephone
• 753 . 04G-a
urn . •
SECTION 3 ESTIMATED CONSTRUCTION COSTS
Item t stimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building 41 Ili
ZZS (a)Building Permit Fee
2 I loctncal (bl I stimated total Cost of
Construction from(6)
3. Plumbing ------ Building Permit Fee
4. Mechanical(HVAC)
5 Fire Protection 4
6 Total (1 + 2 +3+ 4 + 5) "7i2Zz� — Check Number k70
OC
This Section For Official Use Only
Building Permit Number: Issue
d
Ar
/ //f_ er
_
Signature �1,
Building CommissionerrInspector of Buildings Date i
l SVFG' 0S. 1 ca Gma,i 1 , 0nvvt
EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR)
Section 4. ZONING All Information Must Be Completed. Permit Can Re Denied Due To Incomplete Information
_.. Isistinv. _--.. Proposed fAyuned ha lrnnt ,.._.
try cabana is tam. . _
midday'dual
Lot Size
Montagu.
Setbacks Front
Side I.: R:
Rear
Building Height
1311 .. Square. tramme__
Open Space Footage
1Lvamu minus .S limed
1AeI
Of Pirkin_tipcc;
Fill:
�I(1.auuoi
A. I las a Special Permit/Variance/Finding ever been issued for/on the site?
NO O DONT KNOW 40 YES O
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO O DONT KNOW O YES O
IF YES: enter Book Page and/or Document
B. Does the site contain a brook, body of water or wetlands? NO O DONT KNOW YES O
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained O Obtained O , Date Issued:
C. Do any signs exist on the property? YES (3 NO ty/
IF YES, describe size, type and location: r
D. Arc there any proposed changes to or additions of signs intended for the property ? YES O NO (25
IF YES, describe size, type and location:
L.. Will the construction activity disturb(clearing.grading o satiation_or filling)over 1 acre or is it pan of a common plan
that will disturb over 1 acre° YES O NO
II- YES,then a Northampton Storm Water Management Permit from the DPW is required.
SECTION 5-DESCRIPTION OF PROPOSED WORK(check ail applicable)
New House Addition Ll Replacemen(Windows Alteration(s) Roofing p i
Or Doors ftSl
Accessory Bldg. I I Demolition New Signs 107 Decks II) Siding[CI Other 101
emo e 'Ref) ace_ zWJ;n ours l..' Patio 'boor)
Brief D senptieno mposcd a -'
Work-Y2 ``),.5e -,Sticn.ct`c.,ct IU �E c�a ,3b inaS�rr l�.Fa wt t y
Alteration of existing bedroom Na Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement '-----ft
Pians Attached Rosi -Sheet
Oa. If New house and or addition to existing housing, complete the following:
a. Use of building:One Family - Two I-amity Olhnr
H Number of rooms in each only unit: Namber id Bathrooms
c. Is there a garage attached?
d_ Proposed Square footage of new construction. -Dimensions.
e Number of stories? ON
f_ Method of heating? Flropiaces or Woodstoves Number of each
g. tnergy Conservation Cemptianc€. Mass hack Energy Compliance form attached?
P. Type of construction
I. Is construction within 1r1! I.ct wetlands? Yes No. Is construction within 100 yr. floodplain Yes No
i. Depth of basome. or cellar floor below finished grade
k. Will buntline .onform to the Building and Zoning regulations? Yes No
I I. Septi ank City Sower. Private well City water Supply,
SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I I. Pelc:3y 33Gr rev as Owner of The cid-iee"
property +
nerehyaulhoh<Sears Rowse tut - Lu.L05 Svec- Seas IAlen�-
to act on my behalfin all attars retain to work auto tit*
by this building,ennri applicatmn.
g
hi--tiac4ted ettyl a ` G/ zo/ x-oi 1
Signature el Owner Data
I. L L0C Svec' - gears Atli- asOWt1 OthorVer..�;
Agent hereby declare that the statements and Information on the forng appleation arc true and accurate,to the best of my kMJ*fudge
and belief.
Signed tin the pains and penalties of perjury.
� ubos 5vec-
hn�-me / Sea,r5
- ASen+ 6120 12, 011
USignature ofOwncv .on _ Date _.
SECTION e-CONSTRUCTION SERVICES
8.1 Licensed Construction1Sup visor: G�p�� C��� p } Not Applicable ( I
Name of License Helfer (... V�rl�- - 9ars Arr eVT ` 915IC)
82-1 74) w)pson Boas! l senseNumber
77oni pSOK? / CT o6Z731/ ZO/
nacos.: Sears F xpo-anon oa.e
'► -1:10-eta- 860• /53 .045Z
Telephone
9. Registered Home Improvement Contractor: Not Applicable 11
/ 4?Co 7
Com an Name1 ,Sea rS Registration Number
SeAr5 ovne _Limp - c tbL 'ec - A8eei+ /D1/// 201 7
A __,"V • 7 Tio�psan Road OGD Ixpiration 11 Date
tiOrnP5 0Y / CT 06 277 lelephon753.0o�45Z
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. I allure to provide this affidavit will result
s.the den al of the Issuance of the build ng permit_
Signed Affidavit Attached Yes (ry No t t
rr`
City of Northampton
rmCMassachusetts
4'� 4 r DEPARTMFNr OF BUILDING INSPCCSSONS
pj .r 219 MA Street • Municipal Building
7.t.057"nI N MA tYampton, 01060
'Y AFFIDAVIT
florae Improvement Contractr Lore
Supplement to Permit Application
The Office of Cot tsunmr Abaits and BusLw s Regulation COCABK"1 ro ulur s the registration ul contractor\ and
>uhcontruelors perlilrmind improventonts or noes at ions on detached one Io lour thntily homes. Prior to
pedbrming work on such home'.a contractor mtu t he re+tostered as a Honk Improvement (.00 actor l UC"i_
M.G.L. Chapter 142A requites that the"reconstruction, alteration, renovation, repair, modovnieation, conversion.
improvement, removal,demolition, or construction of an addition to any pre-existing owner-occupied building contairvng
at least one but not mom than four dwelling units.._or to structures which arc adjacent to such residence or building'be
done by registered contractors
A ate:11 the homeowner has contracted with n carpmwUnn or LLC,that en/kr crust be registered.
Iy pe of Wor44 a Wind OW5 IN' Pett 100r Esl. Cost: no7 ZZS
Address ofWork21RLrCt r Y Lame AkrMa&vic"ovA ,Mc - tSiO$27
Date of Permit Application'. 6 1 ?i0 Z-01
1 hereby eta nix that:
Registration is not required for the following reasunpp.
Work excluded 1yy law(cox Iaitt1.
lob under S1,000.00
Owner obtaining own pemr'ri (cvplaitp_
Building nor owner-occupied
Other(specify):
OMNERS0131AINING'EHEIROWN PERMITlilt E NIFIRING 6ii) CUNT'R CTSVA 11111:ARECISTFRED
CONTRACTORS OR StBCONTRACTORS FOR APPLICABLE.HOME IMPROVEMENT WORK ARE NOT
ELIGIBLE FOR AND DO NOT HAA I ACCESS 10 TIIE.ARBII'RA'1'ION PItOCRAM OR GE ARAM'Y EL AD
UNDER M.G.L.Chapter 142.\.SUCD OWNERS ALSO ASSUME TIIE RESPONSIB,ILECES FOR A1.1.WORK
PERFORMED ENDER'titE BUILDUC PERMIT.SEF: NEAT PACE FOR MORE ISFOKMA I ION.
Signed umier the persalt ie of poljury.
r
herb apply for ahuihlim permitets the;tge of the exact
SAa�
6700/00/7 . tSll4ncc4 . 148601 __
Date Contractor,Name IIIC Registration Na
OR:
Notwithstanding the the above notice. I hereby apply fora building Permit as the owner of the abolc properly:
NA
Date Owner Name and Slgnamre
City of Northampton
L Massachusetts
DEPARTMENT OF BUILDING INSPECTIONS
�.-` 219 Main Street .Municipal Building
—af Northampton, MA 01060
Debris Disposal Affidavit
In accordance of the provisions of MGL c 40, 354, I acknowledge that as a condition of the building
permit all debris resulting from the construction activity governed by this Building Permit shall be disposed
of in a properly licensed solid waste disposal facility, as defined by MGL c 111, S 150A.
The debris from construction work being performed at:
2ISspr_ ury k-aina
(Please print house number and rcet name) II
•
Is to be disposed of at: 3p — 1 F-v_c_K 1 v\
Liv
365 tel Iver$r 4y Ave vi 1.•
(Please print name and&ation of facility)
Or will be disposed of in a dumpster onsite rented or leased from.
(Company Name and Address)
/ / Segrs
f.i. .4r._% s_ - /6/ zo/ 0oi7
- . - of •ermi pplica or Owner
If, for any reason, the debris will not be disposed of as indicated, the Applicant or Owner shall notify the
Building Department as to the location where the debris will be disposed.
(
The Commonwealth of Massachusetts
Department of Industrial Accidents
/ Congress Street, Suite 100
aj
Boston, Mil 02/14-2017
www.nets:s.gor/din
- \loiters(torn pen sa timl Insurance Affidavit: Builders/(tont ratio's/Electricians/Plumbers.
I 131. FILED t\I HI 'lilt I'1'.Its1I Tf6G AI '111012111.
Applicant Information Please Print Legible
Name a+u.iress/()marlaa(iaa9ndkiduul l:Sears Home Improvement Products Incorporated
Address: 1024 Florida Central Parkway
(1t Slaic//ip: Longwood, FL 32750 Phone 860-753-0452
)..pm CHINO%ii&niploitr?(hecku„enn,,,n..muov Ty pe of project (required):
..,r, ..,neap I - C No :1
ulrucmon
7 0 I J111 a sole proppartrmship nnd hc‘c no cmplaccc; kielar mein 8 Rcmodelina
p. .l. [No k on . 1, cd
0I neo„ I ,orkn .I IN nkat m '.... ,c. enuii-d 9. ❑ Dnnol bion
0 Q Building 1t'addition
.1 I , I'her nd all k a
Iudl -
cibuic
ue :1u. rola-h,,. , L. . .. ,n al. Ic 11-❑ Electrical repairs or additionsplop:L -
mN..�Idi no.,orm.cc.
12_❑Plumbing repairs or additions
s ❑I .I Kt,dimnl..c hued b conirc& the. :acned.n..l 1: Roof repairs
s u: K I nthe ,c�
. , IL�OdrerRC?t aq
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uI rlld:cl and I :_ hcc .I.dill_ all riot: d lull d.. na., sibsithnui nc . 1+ indmulnm cu.11
(occratoc.thci.h.ck rl .ho.11111,E: Cited .dd , :d,M1ce Ile - and uhall. tlo,.. n..M1a,.
.ml , II I.cub-u .. .I:,a nP, I. , p I ,. ika poi il,Fa.
/nor an emplurer that is providing workers'corrrprncariut,insurance ce lar,,n employees. Be/ow is the policy and job cite
i,fornuniun.
Insurance('olnpan) Name: Ace American Insurance Company / Phone : 866-283-7122
Policy:-or Self--Ins. I.ie. WLRC48609247 -spirnion Date: 08/01/2017
Job Site Address:Z 18- .Drc&ry La_ V, e. cin torte./il H I_)0.✓hrI,�40MCa_.
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Attach a copy of the wnt orkers' compensapolicy declaration paps(shun ingthe policy number and e'pii(tion dale). CIQGO
Eailur t e cr Le as requited under MUI. '�A is a H trial violation punishablea line up to S1.50000
and rone-c wimp nment.as ' ell a en it penalties in the toms of a S10 VPURR (IRDIR and a line of up to 5250 NI a
da} against the c iolator. A copy of this statement ma> be fbinarded to the Office of IIne tigations of the DI A for in>urance
coverage verification.
/do here/,,cert `uc er are pains )c1 penalties of perjury that/,�ythee inJurrnarinu provided above� A Ince and co'r`rect.
Si3nature Iistei � • rrn+ Date. e / Lt//
Phone .aserril
452
Officialese unit Dolot write in this 'ren.to hecc fpfeted by in Iowa official _
- ,
Ity or Town: Perm il/License fi
Issuing Authority (circle one):
I. Board of Health 2. Building Department 3.City/Town(lett 4. Electrical Inspector S. Plumbing Inspector
b.Other
Contact Person: Phone It:
RESET FORM
R"' CERTIFICATE OF LIABILITY INSURANCE
Mr]M,f nn.,,.
THIS CERTIFICATE IS ISSUED ASA 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:11 the certificate holder is on ADDITIONAL INSURED,the palicylies)must have ADDITIONAL INSURED provisions or be endorsed II
SUBROGATION IS WAIVED,subject to the terms and Conditions of the policy,certain policies may require an endorsement A statement on this -
certificate Sacs not confer rights tv the certificate holder in lieu 01 such endorsomentis).
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0,198E2015 ACORD CORPORATION.All rights reserved_
ACORD 25(2016103) The ACORD name and loon are registered marks of ACORD
AGENCY CUSTOMER ID: 5/00000 34159
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ADDITIONAL REMARKS SCHEDULE Page of
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See Cer(.,tic ate Number: 5/000322/480
see eel 111 ale Number: 1/0063221480 ""F n-rE
ADDITIONAL REMARKS
THIS ADDITIONAL REMARKS FORM ISA SCHEDULE TO ACORD FORM,
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['roposal Data 06/10/2017 Job Number 22281063 Sears Home Improvement Products,Inc.
Customer Bseairs PO.
102A6)xFlor572790ida
r�EGev BARRETT J ARCentral Parkway
Custorner S Home Phone Customers Work Phone HomeImprovement Products
Longwood. FL 32750-7579
ffI
(413) 203-5883P Phone(800)469:4663
Street Address ESTIMATE AND PROPOSAL Contractor l lcense!Rogrstration Number
218 DRURY Le MA(148607)
city State Ap Code Windows All plumbing and electrical services performed by
F ASTHAMPTON MA 01027 Is installation within city limits? licensed subcontractors
Installation Address County HAMPSHIRE (Yes/Not. res FEIN 25-1698591
;Idling Address(f different from above) city Stam /ip Code Protest Consultant Name&license No (if applicable)
STEPHEN PRES2 34971
Description of the Project and Description of the Significant Materials to be Used and Equipment to he installed
1 Remove existing units to be replaced.(PLEASE NOTE: The removed units are likely to be damaged.)
2 Prepare openings as necessary to receive replacement units. (No finish work other than normal installation is to be done unless otherwise noted below.)
3. Installation includes the clean-up of all job related debris upon completion of the job.
,. (If applicable)Aflcv the completion of the project.the customer win be responsible tor the application and removal(storage)of shutter panels. In the event
that the project requires the installation of storm shutters or egress windows. Sears Home Improvement Products. Inc. ("Sears") will not re-install any
affected security bars.
5. (If applicable) In the event Sears is unable for whatever reason to obtain the proper permits prior to the commencement of any work.Sears will refund any
previous payment and this contract will be automatically cancelled.
Summary of Window Order Addendum(see detailed Window Order Addendum for more information):
Type: BB PLUS (wINCORE) Quantity: 3
Type. _— Quantity:
Type: Quantity
Type Quantity
Type Quantity: _...
The Window Order Addendum is made a part of and incorporated into this contract by
Customer(s)initials
reference.
Additional work to be done:APON INSPECTION SEARS BILL INSTALL 2 WINDOWS AND 1 PATIO SLIDING DOOR UNIT
Work NOT to be done.
:N1' OTHER MORN OUTSIDE THE SCOPE
SPECIAL INSTRUCTIONS:TWO BATHROOM wINDOwss AND ONE PATIO SLIDER IB DINING AREA
All of the above check boxes. 'Work NOT to be done" 'Additional work to he done. and
Customer(s)initials
-Special Instructions'sections have been reviewed and explained to me.
$WF MA (Dig.) Rev 06/07/2016 Page .1 of 3
1111111111 11E1 Job Number: 22281063
APPROXIMATE START DATE and APPROXIMATE COMPLETION DATE:
The work will start approximately 6/14/2017 (Approximate Start Date)
It will be substantially completed by approximately 7/14/2017 (Approximate Completion Date)
These dates are subject to change at the time the contract is accepted by Sears Home Improvement Products, Inc. ("Sears")or at any other time by mutual
written agreement.Customer understands that the Approximate Start Date is only an estimated date and the Customer will be contacted prior to this date to
schedule the actual start date.
ASBESTOS ABATEMENT: This Estimate and Proposal assumes that there are no asbestos containing materials ('AGMs')that would be disturbed In the
performance of installation work. If upon further inspection by the contractor or others it is learned that AGMs have to be disturbed to perform work.then
Customer must arrange and pay for abatement of asbestos by a qualified person prior to the start or continuation of work. If Customer fails to arrange tor
necessary asbestos abatement within thirty (30) days. Sears may cancel this contract upon Customers)initials 17 S
written notice to Customer.
1 he TOTAL PRICE including all labor. material.taxes and any applicable discount is S 7,225.32 Contract Price $7.225.32
Initial Payment(not to exceed 30%of Total Price unless Special Order)$ 2,167.60 State Sales Tax( 0.00 %) S 0.00
Final Payment(balance payable upon completion of job)S 5.057.72 Local Sales fax( 0.00 %) S 0.00
The Initial Payment is due prior to Sears ordering products. Total Amount Due $7,225.32
The form and method by which the Customerls)will pay is described in aseparate Cash/Credit Cuslorrzr(s) �
inilids PA
Card Payment Addendum made a part of and incorporated into this contract by reference. `
NOTICE TO BUYER: YOU, THE BUYER, MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY
(FIFTH BUSINESS DAY IN ALASKA, FIFTEENTH BUSINESS DAY IN NORTH DAKOTA IF YOU ARE AGE 65 OR OLDER)AFTER THE DATE OF THIS
TRANSACTION.SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT.
ADDITIONAL PROVISIONS
Proposal and Approval.Sears offers to furnish the materials and arrange for their delivery and installation as specified on the first page and/or the attached
sketches and specification sheets for the TOTAL PRICE shown.This offer must be approved by the Installation Department.If this is a credit sale or a payment
on completion sale,it must be approved by the Credit Sales Department. If this proposal is not approved or the installation cannot be made in accordance with
the law.this offer will be withdrawn and any payments you have made will be refunded to you.Any materials left over after the installation has been completed
are Sears property and will be removed by Sears.
Installation. I understand that Sears will not install the materials but will arrange for the installation_Sears is not responsible for materials or installation NOT
furnished or arranged by Sears. Sears'installation contractor(s)will obtain all bulding permits required by local law. For homes located in historic or landmark
zoning distorts_Customer will be responsible for obtaining required approvals and related permits prior to the commencement of work on this contract.
Authorization.I authorize Sears to (1)arrange for a contractor(licensed where required by law)to make the installation of materials', (2)issue a work order
for this installation to a contractor, (3)inspect the installation: and(4)pay the contractor when the installation is complete if I have signed a certificate that the
installation has been completed to my satisfaction.
Delays in Installation.I agree that Sears is not responsible for delays in delivery or installation due to weather,fire.strikes,war.government regulations or any
causes beyond Sears'control.
Oral Agreements and Changes in Contract.I understand that there are no oral agreements between Sears and me.Everything I expect Sears to do has been
included in writing in this contract. Nothing car be changed in this contract unless it is in writing on a separate form accepted by me and Sears.
Responsibility of Buyer. I agree that any information or measurements that I give to Sears are correct and complete. I am responsible for any special work
described in tris contract.
Electrical& Plumbin Sgerre ice. I will provide adequate electrical and/or plumbing service(s)to run any newly installed appliances or other furnishings. If the
electrical and/or plumbing service(s)do not meet the standards of the utility company or electrical and/or plumbing codes. I will make the necessary changes at
my expense unless Sears has agreed in this contract to make the changes.
Payment. I will pay Sears the cash price that covers the price of material and installation as shown on the first page.
Warranty Information.Appropriate product warranty documents will be given tome by Sears.Sears'Warranty on Installation is:
SEARS'LIMITED WARRANTY ON INSTALLATION
In addition to any manufacturer warranty extended to you on the product(s)used(which warranty becomes effective the date the merchandise is installed),if the
workmanship(or application)of any Sears'arranged installation proves faulty within(i)one year for Weatherbeater Value Line, (ii)two years for Weatherbeater
Plus.or(iii)three years for Weatherbeater Max.and Weatherbeater Stormbeater,then upon notice from you Sears will cause such faults to be corrected by repair
at no additional cost to you. If Sears determines that repair is not commercially practicable or cannot be timely made,then.at Sears'sole discretion.Sears may
elect to provide replacement or refund.Service under this Limited Warranty is available by calling Sears Home Improvement Products at 1-800-222-5030,
Option 4 This warranty gives you specific legal rights.and you may also have other rights that vary from State to State.
Din MA (Dig.j Rev 06/07/2016 Page 2 of 3
111111 III Job Number 22281063
NOTICE TO BUYER
1. DO NOT SIGN THE AGREEMENT IF ANY OF THE SPACES INTENDED FOR THEAGREEDTERMS TO THE EXTENT OF THE AVAILABLE INFORMATION
ARE LEFT BLANK.
2. YOU ARE ENTITLED TO A COPY OF THIS AGREEMENT AT THE TIME YOU SIGN IT.KEEP IT TO PROTECT YOUR LEGAL RIGHTS.
3. YOU MAY PAY OFF THE FULL UNPAID BALANCE DUE UNDER THE AGREEMENT AT ANY TIME,AND IN SO DOING YOU SHALL BE ENTITLED TO
A FULL REBATE OF THE UNEARNED FINANCE AND INSURANCE CHARGES.
4 YOU MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY[FIFTH BUSINESS DAY IN ALASKA,
FIFTEENTH BUSINESS DAY IN NORTH DAKOTA IF YOU ARE AGE 65 OR OLDER]AFTER THE DATE OF THIS TRANSACTION.SEE THE ATTACHED
NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. FAILURE TO EXERCISE THIS OPTION, HOWEVER, WILL NOT
INTERFERE WITH ANY OTHER REMEDIES AGAINST THE RETAIL SELLER YOU MAY POSSESS. IF YOU WISH, YOU MAY USE THIS PAGE AS
NOTIFICATION BY WRITING"I HEREBY RESCIND"AND ADDING YOUR NAME AND ADDRESS.A DUPLICATE OF THIS RECEIPT IS PROVIDED BY
THE SELLER FOR YOUR RECORDS.
5. IT SHALL NOT BE LEGAL FOR THE SELLER TO ENTER YOUR PREMISES UNLAWFULLY OR COMMIT ANY BREACH OF THE PEACE TO
REPOSSESS GOODS PURCHASED UNDER THIS AGREEMENT.
NOTICE TO MASSACHUSETTS RESIDENTS ONLY
In addition to the Notice to Buyer shown above. Massachusetts law requires that contracts for home improvement work state that all home improvement
contractors and subcontractors shall be registered and that any inquiries about a contractor or subcontractor relating to a registration should be directed to'.
Office of Consumer Affairs and Business Regulation
Ten Park Plaza.Suite 5170
Boston. MA. D2116
Telephone. (617)973-8700
Please note that owners who secure their own construction related permits or deal with unregistered contractors shall be excluded from access to the
Guarantee Fund.
Notwithstanding any other language in the contract or associated documents, Sears will not remove. replace, or install any heating
or air conditioning system, or any portion thereof, if asbestos or asbestos-containing material is known or likely to be present in that
heating or air conditioning system, or any portion thereof. If it is determined or reasonably suspected that asbestos is present,.either
I before commencement or during performance of the work, it shall be the customer's responsibility to select, retain and pay all costs
of a Division of Occupational Safety (°DOS°) licensed Asbestos Contractor to remove all asbestos or verify that none is present in
the components involved in the job. If the determination or reasonable suspicion of the presence of asbestos arises after Sears has
started the work,Sears will immediately cease performing the work until a DOS licensed Asbestos Contractor,hired by the customer,
removes all asbestos from the components scheduled for repair or replacement in accordance with 310 C.M.R. 7.00 and 453 O.M.R.
6.00 or verifies that none is present. By signing the contract the customer agrees that it understands the above.
DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES
P.e0 0e/10/7017 06'10/2017
Customer's signature Date Customer's signature Date
Accepted by Sears Home Improvement Products. Inc.("Sears")on 06'10.2017 by
Date Management Representative
SW1 MA (Dig.) Rev 06/07/7016 Page 3 of 3
1024 Florida Central Pkwy ORDER: 222810630001
ongwood. EL ORDER DATE: 6/10/2017
EST. DELIVERY DATE: 6/12/2017
ORDER CONTACT: STEPHEN PRFS7
WINDOW ORDER ADDENDUM
INVOICE INFORMATION SHIPPING INFORMATION
[HARIFORD]
SHIP VIA:
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22281063000 6/10/201! 22281063 0
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MAX CLEARANCE DIMENSIONS=[30 75 X
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LIGHT WOODGRAIN
HIGH I OPENING
LOWE/ARGON/I FFP
DOUBLE SIRENGTH
KEYED LOCK SET
MATCH PRODUCT
EOOTBOLT
I ight Woodgrain Innterior
TOTALS: 3 SUBTOTAL:
TOTAL:
COMMENT:
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