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32C-140 (49) 351 PLEASANT ST BP-2019-0395 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 32C- 140 CITY OF NORTHAMPTON Lot:-000 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: window replaced BUILDING PERMIT Permit# BP-2019-0395 Project# JS-2019-000635 Est.Cost:$6679.00 Fee: $100.00 PERMISSION IS HEREB Y GRANTED TO: Const.Class: Contractor: License: Use Group: HOME DEPOT AT HOME SERVICES 98785 Lot Size(sq.ft.): Owngr: TARLOW KMIjEN Zoning: GB(93)/URC(7)/WP(l) Applicant. HOME DEPOT AT HOME SERVICES AT. 351 PLEASANT ST Applicant Address: Phone: Insurance: 5 RIVERVIEW DR (401)935-2633 () Workers Compensation NORTH PROVIDENCER102904 ISSUED ON.101512018 0:00:00 TO PERFORM THE FOLLOWING WORK.-INSTALL 3 REPLACEMENT WINDOWS POST THIS CARD SO IT IS VISIBLE FROM THE STVET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Service: Meter; Footings: Rough: Rough: House# Foundation: Driveway FReal: Final: Final; Rough Frame: Cas: Fire Department Fireplace/Chimney: Rough Insulation: ]Final: S o ce: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occugancy Si nat r : FceType: Date Paid: Am2gvt. Building 10!5/2018 0;00:00 $100,00 212 Mair,Street,Phone(413)587,1240,Fax: (413)587.1 72 Louis Hasbrouck—Building Commissioner GcJ�yp�(,US ` Re�rtrtTent use City of Northampton Std' Building DepartmE nt SEP 2 8t 212 Main Stree S U1, Room 100 ton MA 0' 06d) EaT.of suiLDwc h * Northamil'llans ., pNORTHAMPTON phone 413-587-1240 Fax 4 - - Ptotl � APPLICATION TO CONSTRUCT,ALTER, REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION C-01w ~i9-3 9s 1.1 Property Address: This section to be completed by office Map�- Lot Unit Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Z � / Name(Print) � � //r/ Current MailinjAs �Tv Te phone //f� �� (a Signature 2.2 Authorize A en Na Current Mailing Address: ". )*q-1 Signature All Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building /n 71- (a)Building Permit Fee 2. Electrical (/G / (b)Estimated Total Cost of Construction from 6 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) T " 14 5. Fire Protection 6. Total= 0 +2+3+4+5) 7 Check Number l This Section For Official Use Only Building Permit Number: Date Issued: Signature: /b l Building Commissioner/inspector of Buildings Date L6,LWPj- 12-7 @ EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) f Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete 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 0 DONT KNOW Q YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO Q 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 DON'T KNOW Q YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtainedQ Obtained ® , Date Issued: C. Do any signs exist on the property? YES 0 NO 0 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: 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 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 ❑ Addition Replacement W' Bows Alteration(s) Roofing Or Doors Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [0 Siding[01 Other[a Brief Des Work: Alteration of existing bedroom Yes No Adding new bedroom Yes No 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, 4e4� " ' as Owner of the subject property � % /`'L Z_ - hereby authorize / `� ��l�Z.`'� to act on my behalf, in all matters relative to work a thorized by this building permit application. Signature of Owner Date I as Owner/Authorized Agent hereby creclare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief. Signed un ains d penalties of perdu , 1'a_, ��/ nt Nam Signature of Ow nt Date SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Su ervisor: Not/A�pplicabl ❑ Name of License Holder: � , r��'/`` /S Ci v License Number 41-22 Address Expiration Date Signature Telephone y 0/ 9.Registered Home ImWpyernentC retract r: Not Applicable ❑ Company Name Registration Number Address Expiration Date 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. Signed Affidavit Attached Yes..... No...... ❑ City of Northampton Massachusetts DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building Jib Northampton, MA 01060 AFFIDAVIT Home Improvement Contractor Law Supplement to Permit Application The Office of Consumer Affairs and Business Regulation("OCABR")regulates the registration of contractors and subcontractors performing improvements or renovations on detached one to four family homes. Prior to performing work on such homes, a contractor must be registered as a Home Improvement Contractor("HIC). M.G.L.Chapter 142A requires that the"reconstruction, alteration, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units....or to structures which are adjacent to such residence or building"be done by registered contractors. Note:If the homeowner has contracted with a corporation or LLC, that entity must be registered^�?� Type of Work: AI/AIDt/A` �G'J!� L� Est. Cost: � ` 1-1-7- Address of Work: _��✓ f /tL Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): _Work excluded by law(explain): _Job under$1,000.00 Owner obtaining own permit(explain): Building not owner-occupied Other(specify): OWNERS OBTAINING THEIR OWN PERMIT OR ENTERING INTO CONTRACTS WITH UNREGISTERED CONTRACTORS OR SUBCONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK ARE NOT ELIGIBLE FOR AND DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER M.G.L.Chapter 142A.SUCH OWNERS ALSO ASSUME THE RESPONSIBILITES FOR ALL WORK PERFORMED UNDER THE BUILDING PERMIT.SEE NEXT PAGE FOR MORE INFORMATION. Signed under the penalties of perjury: 1 hereby apply for a building pe i as the agen f the owner: . Date Contractor Name HiC Registration No. OR: Notwithstanding the above notice, I hereby apply for a building permit as the owner of the above property: Date Owner Name and Signature City of Northampton �. Massachusetts w � DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building Northampton, MA 01060 Massachusetts Residential Building Code Section 110.R5.1.2 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 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 not be considered a homeowner. Section 110.R5.1.3.1 Any homeowner performing work for which a building permit is required shall be exempt from the licensing provisions of 780 CMR 110.R5, provided that if a homeowner engages a person(s) for hire to do such work,then such homeowner shall act as supervisor. 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 under the building permit. As acting Construction Supervisor your presence on the job site will be required from time to time, 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 153 (Liability of Employers to Employees for injuries not resulting in Death) of the Massachusetts General Laws Annotated, you may be liable for person(s) you hire to perform work for you under this permit. City of Northampton Massachusetts DEPARTWNT OF BUILDING INSPECTIONS ) 212 Main Street •Municipal Building y Northampton, MA 01060 Debris 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. The debris from construction work being performed at: '-3,,f?'7 (Please print house number and street name) Is to be disposed of at: VA�7;-r All 41m-�,,4 Al print name and location of facility) Or will be disposed of in a dumpster onsite rented or leased from: (Company Name and Address) Signature of Permit Appl nt or Owner Date 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 d I Congress Street,Suite 100 Boston,MA 0211 4-2 01 7 r www massgov/dia NVorkers' Compensation Insurance Affidavit:Builders/Contractors/Electricions/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name (Business/Organization/Individual): Address: City/State/Zip: Phone#: Are you an employer?Check the appropriate box: Type of project(required): I.[]i am a employer with employces(full and/or part-time).* 7. ❑New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in 8. ❑ Remodeling any capacity.[No workers'comp,insurance required] 9. ❑Demolition 3.F1 i am a homeowner doing all work myself.[No workers'comp.insurance required.]t 10❑Building addition 4.11 1 am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.❑1 am a general contractor and 1 have hired the sub-contractors listed on the attached sheet. 13.❑Roof repairs These sub-contractors have employees and have workers'comp.insurance.- 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.❑Other 152,01(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box#1 must also till out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. ''Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employces. if the sub-contractors have employces,they must prov5dc their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. I nsurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct Signature: Date: Phone#: Official use only. Do not write in this area,to be 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#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and,if necessary, supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. in addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston, MA 02114-2017 Tel. #617-727-4900 ext. 7406 or 1-877-MASSAFE Fax#617-727-7749 Revised 02-23-15 www.mass.gov/dia a Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However,the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary, supply your insurance company's name,address and phone number along with a certificate of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number.In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary). A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture(i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street Boston,MA 02114-2017 Tel. # 617-727-4900 ext. 7406 or 1-877-MASSAFE Fax#617-727-7749 www.mass.gov/dia Form Revised 02-23-15 Job Contacts Sunday,September 09,2018 Go Comments Lead: 10825893 Advanced Search 12:08 PM (w a . Homeowner M/M KAREN A TARLOW Sale Amount $6,679.73 Balance Due: $5,009.80 Commissions Homeowner2 M/M Product Andersen Windows(8%) Documents Job Site Address 351 Pleasant St Status Sale/Material Ordered Job Issues Northampton,MA 01060 Branch New England South Siebel Lead ID Siebel# Siebel Order# Measure# Order Detail County HAMPSHIRE 1-6GHA04L 1-14057173029 175664 88571350 Billing Address 351 Pleasant St '�� : Payments NORTHAMPTON,MA 01060 Commission Rate Permits Consultant Name Term Date Split Comp Plan PO Primary Phone (413)259-1646 JOSEPH SULLIVAN 100.00%Straight Commission Work Phone Ext. 0 Result Combo Cell Phone � .s�; ,.* xK` �� Work Phone 2 Sale Date 8/30/2018 FUP Date Services Cell Phone 2 Credit Date 8/30/2018 FPD-Customer Show Map Email ktarlow@music.umass.edu RTP Date 8/30/2018 Post Install Date Cross Street Start Date FPD-Home Depot TouchPoints Inspection B-Back No Update Job #�tea,&..,`��' � F,�.r ; v,a ¢,#�%��».� <,, ���+`.,�� {rwt a 3t t �"e r y Referral Store 8452-HADLEY Work Orders Base Store 8452-HADLEY Lead Paint:Assumed-LSWP Requir /l Lead Source 0390 HD.com Services Web Page Lewis 9/6/2018 3:35 PM,Material Ordered No 8/30/2018 11:00 AM JOSEPH SULLIVAN Peter Talbot Install 9/5/2018 3:45 PM Order Received-PSG No 8/30/2018 11:00 AM JOSEPH SULLIVAN Peter Talbot Install 9/5/2018 3:45 PM Measure Complete No 8/30/2018 11:00 AM JOSEPH SULLIVAN MKHAI BUTLER 8/30/2018 2:41 PM Released to Production No 8/30/2018 11:00 AM JOSEPH SULLIVAN MKHAI BUTLER 8/30/2018 2:36 PM Order Entry No 8/30/2018 11:00 AM JOSEPH SULLIVAN JOSEPH SULLIVA 8/30/2018 11:48 AM Credit Pending No 8/30/2018 11:00 AM JOSEPH SULLIVAN JOSEPH SULLIVA 8/30/2018 11:48 AM Sale Pending No 8/30/2018 11:00 AM JOSEPH SULLIVAN JOSEPH SULLIVA 8/30/2018 11:48 AM Sent to the Field No 8/30/2018 11:00 AM JOSEPH SULLIVAN JOSEPH SULLIVA 8/30/2018 11:48 AM Lead Entered No I I I I I Close �— Print Cft Of F Louis Hasbrouck<Iasbrouck@northamptonma.gov> _........ . .111..... ............... _.. .... . ............ __ ........ ..... .... __.. .............................. __..... ........_ Windows 351 Pleasant St Northampton 1 message Louis Hasbrouck<Hasbrouck@northamptonma.gov> Mon, Oct 1, 2018 at 10:28 AM To:richardt1127@gmail.com Cc: Kim Carson<kcarson@northamptonma.gov> Richard, You submitted a building permit for windows at 351 Pleasant St.You used a one-two family application;that's a commercial building.We need the unit number,and the permit fee will be$100, not$40 because it's commercial. You can mail a check for$60. Louis Hasbrouck Building Commissioner City of Northampton Town of Williamsburg (413)587-1240 office (413)587-1272 fax V ` V RECEIVED 0C - 4 2018 DEPT OP GUILDING INSPECTIONS NORTHAMPTON,MA01060 AT-HOME seRv�c�s Job# To whom it may concern, Re:address: Concerning the above location,We give the Home Depot approval to install Number of windows Ta/tk $-2—�•e�, Style (Double Hung/Casement,name type) /"o Color Q C) Manufacturer 411),juse.-I W Exterior finish as agreed to be PVC(wrap trim)? color We agree to the grid or lack of grid configuration M-0 Are grids between the panes of glass? As stated these proposed windows do meet with the Condo Management approval. Signe Print name �. Title Phone# Date: Home Improvement Agreement: Page 1 Home Depot License Number(s): Visit www.homedepot.com/c/SV_HS_Contractor_License_Numbers for latest license info MA: 107774, 112785 Salesperson Name: Joseph Sullivan� I Registration No. (if applicable): --� Home Depot U.S.A., Inc. ("Home Depot") or service provider named below ("Service Provider") will furnish, install or service the equipment listed below at the price, terms and conditions as outlined on this form. TARLOW I KAREN 1New England South 1-6GHA04L Customer Last Name Customer First Name Store # / Branch Name Lead/Customer Order# 351 Pleasant St Northampton MA 01060 Customer Address City State Zip (413) 259-1646 413-539-0395 ktarlow@music.umass.edu Home Phone# Work Phone# Cell Phone# Customer Email Address NOTICE OF RIGHT TO CANCEL: YOU MAY CANCEL THIS AGREEMENT WITHOUT PENALTY OR OBLIGATION BY DELIVERING WRITTEN NOTICE TO HOME DEPOT AT HOME DEPOT USA INC., 2455 PACES FERRY ROAD, BLDG. B-3, ATLANTA, GEORGIA 30339 or EMAIL he Home Depot @ customercancellationnortheast@homedepot.com BY MIDNIGHT ON THE THIRD BUSINESS DAY AFTER SIGNING, UNLESS THE STATE SUPPLEMENT PROVIDES A DIFFERENT CANCELLATION PERIOD. THE STATE SUPPLEMENT CONTAINS A FORM TO USE IF ONE IS SPECIFICALLY PRESCRIBED BY LAW IN YOUR STATE. YOUR PAYMENTS WILL BE RETURNED WITHIN TEN (10) BUSINESS DAYS AFTER HOME DEPOT'S RECEIPT OF YOUR NOTICE. YOU MUST MAKE AVAILABLE FOR PICKUP BY HOME DEPOT OR SERVICE PROVIDER, AT YOUR SERVICE ADDRESS, AND IN SUBSTANTIALLY THE SAME CONDITION AS WHEN DELIVERED, ANY MERCHANDISE OR MATERIALS DELIVERED TO YOU. OR YOU MAY CONTACT HOME DEPOT FOR INSTRUCTIONS REGARDING RETURN SHIPMENT AT HOME DEPOT'S EXPENSE. THE LAW REQUIRES THAT HOME DEPOT GIVE YOU A NOTICE EXPLAINING YOUR RIGHT TO CANCEL. PLEASE SIGN BELOW TO ACKNOWLEDGE THAT YOU HAVE BEEN GIVEN ORAL AND WRITTEN NOTICE OF JYPUR RIGHT TO CANC . Acknowledged by: LOA 08/30/2018 C st er's Signature Date Contract Price and Payment Schedule : Payment of the Contract Price is due upon signing unless a different payment schedule is required by law, specified below or in a payment addendum. Contract Price: 16679.73 ilncludes all applicable taxes. Excludes finance charges.* Sales Tax: 0.00 (If applicable) *Maximum deposit ONLY applicable in MD, MA, ME(331yo), NJ, Wl(99%) Dep. 125.0 1 % Deposit Amount 11669.93 Remaining Contract Balance 15009.79 The Home Depot-2455 Paces Ferry Road,N.W. Bldg.B-3,Atlanta,Georgia 30339-Customer Care:1-800-466-3337 Customer Agreement(C,E,I)(31 Jan.18) v 50.1.2 Home Improvement Agreement: Page 2 " Finance Charges : Any interest payments or other finance charges will be determined by Customer's separate cardholder or loan agreement, to which Home Depot is NOT a party, and will be in addition to Customer's payment under this Agreement. Customer is subject to the terms and conditions of the cardholder or loan agreement, as applicable. No funds should be made payable to Service Provider; however, Service Provider may collect Customer's payments made payable to Home Depot. Insurance proceeds will will not V be used to pay some or all of the total amount of sale. Description of Work to be Performed : A detailed description of the work to be performed is included in the paragraph entitled Scope of Work or Specification which is included in this Agreement. Anticipated Delivery Date/Installation Schedule Approximate Start Date: 10/25/2018 Approximate Finish Date: 11/22/2018 All dates are approximate and subject to change based on unforeseen events including inclement weather, permitting delays, and delays in confirming insurance coverage of Your claim for any repair, if applicable. Electronic Records Authorization : You are entitled to a paper copy of this Agreement if you choose. If you consent to an e-mailed copy, your consent applies to this Agreement and all subsequent documents and written communications related to this Agreement. By contacting your Service Provider, you may update your email address, withdraw your consent, or obtain a paper copy of the Agreement or related documents at no charge. By providing your consent and verifying your email address above, you confirm that you have access to a computer that can receive and open emails and PDF documents. B ini ' lin this paragraph, I consent to receive only electronic records related to this transaction. nitial Acceptance and Authorization : By signing below, you authorize Home Depot to: (a) arrange for Service Provider to perform any Services or (b) order and arrange for the delivery of special order merchandise, including special order merchandise that may be custom made, as specified in this Agreement. Do not sign if blank or incomplete. (Service Provider's or permitting information may need to be provided to You later.) By signing, you acknowledge that: (i) You have read, understand, and accept this Agreement in its entirety, including the General Conditions and State Supplement, if any; (ii) You are receiving a complete copy of this Agreement; and (iii) all rights and interests under this Agreement are solely vested in the person listed as "Customer" above. I . J X " /30/2018 The Home Depot Cu m is Signatu Date Service Provider Name X 1 08/30/2018 908 Boston Turnpike Unit 1 CVEiOner (if applicable) Date Service Provider Address X 08/30/2018 Shrewsbury MA 01545 *Signature On Behalf of Home Depot Date City State Zip MVendor/Service Provider Phone # Service Provider License Number The Home Depot-2455 Paces Ferry Road,N.W.Bldg. B-3,Atlanta,Georgia 30339-Customer Care:1-800-466-3337 Customer Agreement(C,E,I)(31 Jan.18) v 50.12 Andersen Wood SPEC SHEET SC: Joseph Sullivan Measure Tech: INSTALLER: Branch Name: New England South Job#: 1-6GHA04L Prepared By: ISM: KAREN A TARLOW 08(30/2018 SPEC SPR Ship To Location: Customer Name. Date: Page 1 Of 1 SHEET# REF# w raw wN W UNT a v � � FULL OH v a FRAM NSE11i1 ALN ^2bt�. ". .y ;:: .•,7 .$OI.S ip; MEASURETECHIStZE ONLY g1LY TOTAL MT/ISM Interio TW SC UI Standard #Bars #Bars #Bars #Bars Pattern MIS" Location Existin Series Wlntl Exterb Finis Jam Stantlar (WID7 Size Grid Exterior Interior Vert Hodz vertE' 8 Labor Wlndo Type Style Color Color Liner S"- AW CODE WAL SILL Sash Hing Temp Screen Type Grid Grid Pattern (per (per Locati (Per (Per Location Obscur Finish Finis Finish Item R. Floo Coda CODE COD CODE GOD Colo Code Wid Height HEIGH Width Height DEPT ANGL Split Venting/Handing Style CODE Options COD Cdor Color CODE sash) sash) CODE Sash) Sash) CODE CODE CODE Type COD Type CODE CODES 1 DINE 3rd C2 [110 C2-1 11 WH 55.0 7.00 102 L IR I [S-N H I none WH To WH STD H WRAP I IT I 2 BED 3rd C2 400 C2-1 TR WH 55.0 7.00 102 L IR I [S-N H none WH STD [11 STID WH WRAP 3ED 3rd C2 00 C2- R H 55.0 7.00 102 L Rs-N H none WH STD WH STD WH WRAP 2 ►�vmArrr+aRir ;-; seiar+ra .wouc�rywesaetusrron +rm+ri.. +lnao..nod y P gecr nMgM:(B I ITop of Wintl.w to Bofln(inches) rap Color(1) TErratore,Wrap Color(2) Terratone,Wrap Color(3):Terratone Bay W nEow FleMera(pl/Casemein) W i0lh o1 Overhang(intoes) Conswm Roof 1(Yes I No) If nen m Soon,wbr of Solfii material 1 hem is no guarantee t at rrew shingles will match-no color. NEW DOOR UNIT MEASURE FULL FRAME ip TECH SIZE ONLY PD Non rem Assembl ESI TOTAL (200 Nate: Location Interio UI RO/ Inswing PD PD Gliding Hingetl 400,& S,ne�sun Existing Seri Exterio Finish Standar (WIDTH TIP Ext Extensio Grid Exterio Interb #Bar #B Door Door A-Ser Lock Lock Options an Diner C uery Door Type Style Color Color Size AW to Jamb Jamb Type Grid Grid Patter ert( fiz( bscur Scree INor # Venting Venting gliding HRDW HROW Keyed Mulled/ Special fBg1O"al wbe7 T Code COD COD CODE CODE Code Width Heigh HEIGHTWidth Heigh TIP Size Location COD Color Color CODE Sash Sash CODE CODE OUT Panel Handing Hardin only) Type Finish Lock Stacked Notes MISC Labor Item CODES veseor No Pmnle Yes Width es #of boxes es Color Approval Print Nam.KAREN A TARLOW T.ne Home Owner The Coitltnoirivea th ofli assrtchzisetts Depa trnettt of Industrirtlticcidents (% I Cotagress-Street,$Trite 100 Bastai.AYA 02114-2017 ti_ y wur n2ass.oYfflla Work Compensation Insurance Stfidavii:ranileers/ContrnctorslElecfricians/1'Iumbcrs. TO BE Ii:I,ED 111ITII T ITE PEFIMITPING AUTHORITY. Aouliennt Information Ple.se Print LeoibF Name(BusinesJOrganiralierjlndividual): :address: L) City/Stateizi 'Ghotic , Areynt;nn employe:?Check t(seappropriate boa: Type of project(required): t (.�(am a esTptOytr t4fd1 empioyc�(Full and:ur p:rt•[i nc).` 7. ,lett,construction j 3 I am a sol: ire rieturur pannctsh( and Kaye no cm to•e3 parkin. ror me m ; ren ca tv.(leo w r P P S S. Relnodelin� I +' F==� ork�rs'cpm?.instat,awa:ehiu)red.j 3Q t am a hanicowwr doing all work myseFE INN t:a :cr'camp.insurance«;ter d j t 9 ❑Demolition ►.•'.�I sm a homcotraa and will behiring canlrutters to rondurdall wart:un my property_ 1 will 10 C3 Building addition ensuredratallcomperdationinsurmua_urzre..rie I L[]Electrical repairs or additions Proprietors wish no cmplayccs 12.[]Plumbing repairs or additions 5 I am a genera)conuaetar and I have(tired the su4 can!ramors listed on the aluched sheat, 13_Q R f repflirs 1-hese soh-centmvors have enpWITes and have wortrers-comp.insurancc.- Nl 14. ti.�we are a carpemion and its of;icers bare exercised their right of excinptien per N401-c. t y 52.§1(4).and twee have no eniployee3.iNo trortcrs'comp.ttt5ttt3nce T;a:r.1.j 1 IIII i `:Env applicant that cha:is Fwx=l mast also fill out d:_section lieloty shuPrin;L;:it fret:xrs'contpeisatinn po)icy inrorn)tion. 'Honeowners who submit this affidavit indicating they at,-doing all ttioi:,and t.er:hha outside conuuetois must sub-nit a new artidavil indicating such. Y r anaretors=.hat check this box trust auaehciaa additional shwashowing the name u the sub-comm eors and state tvhcthe..ornat:hose entities have I" einpluyees. ly the sub-contactors have empl-y'ees.they tut=_st xiwede their:yore)eracamp policy number. 1 ant reran errplo�er t?rat is providiri�zt.•ariters'co�npeasiytivrr i:ra'Itroltcejvr my euptoyees. ?3etarvist?re po:icp mtd jobsire _ injornirt?on. Insurance Company N,-,m.e. U `) Policy:'.or Self-ins.Lie..:).4lr✓ Expiration Dste: Jnb Site Address: CityiState/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiry ' n date), Failure to secure coverage as required tinder 1IGL c.I5§25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORM:ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement may be fonvarded to the Ofce of Investigations of the DIA for insurance coverage verrcation. 1 da kerebil certif i 111YYr1he inrn?MrRVf per tliai fh ornra1 an provided ubmie is true and correct. Signature: Dote: r r i'tt fie€• a,ficial Ilse on!}. Do not write in this area,to be cor3lpteteff by efrp or town o�ciui City or Town: Permit/License - issuing Authority(circle one): ?' I.Board of S nith 2.Building Department 3.CitylTown Cierk 4_Electrical Inspector 5.Plumbing Inspector l 6.Other i Contact Person: Phone'M Office of Consumer Affairs and Business Regulation 10 Park Plaza- Suite 5170 Boston, Massachusetts 02116 Home Improvemerit Contractor Registration Type: Supplement Card HOME DEPOT USA INC Registration: 112785 Expiration: 04/22/2019 2455 PACES FERRY RD C-11 HSC _ ATLANTA,GA 30339 - w Update Address and return card. Mark reason for change. :a 1 0 zonn-oe;!+ ❑ Address ❑ Renewal ❑ Employment ❑ Lost Card � �//n lro-rrrieoerereerl(f nf`2,`��c:e«eLulel/: --- Office of Consumer Affairs&Business Regulation — HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:SUDDlemeni Card before the expiration date. If found return to: Reaistration Ex-alration Office of Consumer Affairs and Business Regulation _= 112785 04/22/2019 10 Park Plaza-Suite 5170 HOME DEPOT USA INC Boston,MA 02116 RICHARD TROIA ,Q �- 2455 PACES FERRY RD C-11 HSC ATLANTA,GA 30339 Undersecretary Not valid withou signature ACO® DATE(MMIDD/YYYY► �.% � CERTIFICATE OF LIABILITY INSURANCE 02/22/2018 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(les)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 MARSH USA,INC. NAME: FAX TWO ALLIANCE CENTER PHOc N Ext: [AIC.No): 3560 LENOX ROAD,SUITE 2400 E-MAILS: ATLANTA,GA 30326 INSURER(S)AFFORDING COVERAGE NAIL# CN101642069-HomeD-GAW-18-19 INSURER A:Old Re utilic Insurance Co 24147 INSURED THE HOME DEPOT,INC. INSURER B:Nen Hampshire Ins Co 23841 HOME DEPOT U.S.A.,INC. INSURER C:HomeRisk Captive Insurance Com an 2455 PACES FERRY ROAD INSURER 0: BUILDING C-20 ATLANTA,GA 30339 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: ATL-004353439-16 REVISION NUMBER: 3 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 1"E TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRTVPE OF INSURANCE ADDL S R POLICY EFF POLICY EXP LIMITS IABILITY I% LTR INS WV POLICY NUMBER MMIDO MMIOD A X COMMERCIAL GENERAL Lr1WZY 312717 03/01/2018 03/01/2019 EACH OCCURRENCE $ 9,000,000 'AMAGE TO RENTED CLAIMS-MADE a OCCUR 'PREMISES(Ea occurrence) $ 1,000,000 LIMITS OF POLICY XS MED EXP(Any one person) $ EXCLUDED OF SIR:S1M PER OCC PERSONAL&ADV INJURY $ 9,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 9,000,000 X POLICY❑jECT M LOC 9,000,000 PRODUCTS-COMP/OP AGG $ OTHER: $ A AUTOMOBILE LIABILITY M1NTB312718 03101018 03/01/2019 COMBINED SINGLE LIMIT $ 1,000,000 Ea accident X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED SELF INSURED AUTO PHY D.MG BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE s DED RETENTIONS I $ B WORKERS COMPENSATION WC 014122577 (AK,NH,NJ,VT) 03/01/2018 03i0112019 X I PER OTH- AND EMPLOYERS'LIABILITY YIN WC014122578"1) 0310112018 03101/2019 STATUTE ER 5,000,000 B ANYPROPRIETORIPARTNERIEXECUTIVEOFFICERIMEMBEREXCLUDED? � NIA E.L.E.L.EACH ACCIDENT $ (Mandatory in NH) E.L DISEASE-EA EMPLOYEE $ 5,000.000 If yes,describe under Continued on Additional Page 5.000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ C Excess Auto 297-1-10011-00-2018 03/01/2018 0310112019 Limit: 4,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) EVIDENCE OF INSURANCE CERTIFICATE HOLDER CANCELLATION HOME DEPOT USA,INC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 2455 PACES FERRY ROAD THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN BUILDING C-20 ACCORDANCE WITH THE POLICY PROVISIONS. ATLANIA,GA 30339 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi Mukherlee0.�n� ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: CN101642069 LOC# Atlanta A�V ADDITIONAL REMARKS SCHEDULE Page 2 of 3 AGENCY NAMED INSURED MARSH USA,INC. THE HOME DEPOT,INC. HOME DEPOT U.S.A.,INC. POLICY NUMBER 2455 PACES FERRY ROAD BUILDING C-20 ATLANTA,GA 30339 CARRIER NAIC CODE EFFECTIVE DATE:- ADDITIONAL ATEADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance Workers Compensation Continued: Carrier:Indemnity Insurance Company of North America Policy Number.WLR C64783191(AL,AR,FL,ID,IA,KS,KY,LA.MS,MO.NE,NM,ND,OK,SC,SD,TN,EYV tVY) Effective Dale:03101/2018 Expiration Date:0310112019 (FL)Limit:51,000,000 Carrier:New Hampshire Insurance Company Policy Number:WC 014122576 (DC,DE,HI,IN,MD,MN,MT,NY,RQ Effective Dale:0310112018 Expiration Date:03101/2019 (EL)Limit:$1,000,000 Carrier:ACE American Insurance Company Policy Number:WCU C64783221(QSI)(AZ,CA,IL,NC,OR,VA VJA) Efieclive Date:0310112018 Expiration Date:03/0112019 (EU Umil:$1,000,000 SIR:S1,DD0,000 SIR for the states of AZ,CA,IL,NC,OR,VA,4VA Carrier:National Union Fire Insurance Company Policy Number:XWC 4595580(OSI)(CO,CT,GA,ME,MI,NV,OH,PA,UT) Effeclive Dale:0310112018 Expiration Date:0310112019 (EL)Limit:S1,000,000 S1,O0,000 SIR for the stales of CO,ME,NV,MI,OH,PA,UT S750000 SIR fa the sla(e of GA 5350,000 SIR for the state of CT Carrier:National Union Fire Insurance Company Policy Number:XWC 4595561(QSp(MA) M ^ � Eff2clive Date:03/011201 6 Expiration Dale:03/0112019 (EL)Limit:$1,000,000 TX Ernptoyers XS Indemnity: Carriedifinios Union Insurance Company Policy Number:TNS C4916693A(TX) Effective Date:0310112018 Expiration Date:03/0112019 (EL)Limit:$10,000,000 SIR:51,000,000 ACORD 101 (2008101) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Do not remove until final code inspection. .5ave label for future reference. ENERGY 1Highlighted Certili� ENERGY STAR dans r , surbrillance Canada EURE f6 energystargc.ca X. energystar,gov „NOT REMOVE UNTIL FINAL NSPFCTIDWIJE , FINALE Renewal ^� byAndersen. eNFP-C WINDOW REPLACEMENT a::Pa�3eese::Ce,mp a; AND-N-28-04330-00001 �atl�latFenestad Vinyl/blood Composite Material RaurgDual-Pane with Argon Product Type: Double Hung ENERGY PERFORMANCE RATINGS U-Factor - Solar Heat Gain Coefficient 0 . 2811 . 59 0 . 21 U- .l } (MriI ADDITIONAL PERFORMANCE RATINGS ,i;si bles{/ ta Transmittance V . —i 8 s 'Fac-u,p a e meta.. -'0: _- -FA:=c t r2COf.Y C m,]fr-0J:-1ra Jif:. -ar'_ct:.Le._.- `a';:rC=t'of 3rx "c .try pr=,:wtarw:2 0 C­4­., Vt/DMA LiCensee: 129-H-835.25 129-H-835.24 Hallmark Certified Andersen Corporation trilw.wd9B-CON PbA Double-Hung STANDARD RATING 01 Ag9AHDYR CSP 101 T.S.':9380-08 Class LC-PG25:Size Tested:32.0 m 63. OP-35 -35 RAWN011A'CSA 101 1 S.3 A3A0-11 LC-POS;32.0,nz 63.O,n-35:•35 AAAA WD." CSA IN LS.?A436-08 Class LC-PG25: Size TcsIed'812m z1600or, 937051-09 Positive Negative Owen Pressure(OP):680 Pa Hater Penetration Resistance Test Pressure:180 Pa Canadian Air Inti t trap an:fill ltra n on:A3 i I FL# FL14564 _K ..:. i� �� '�.�yy.. !d a.Yl _ p „��. ... 1Yi� .fua�+M� 't< T' fes`� ..• r.. fes•' ._jF N4 Kt.'s,✓ y{4 �.�y .Ow'aY.- v..� 1R+4� } y+# ..f. 'a`/ � i rte.