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31A-304 (5) 26 JAMES AVE BP-2020-0356 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 3 1 A- 304 CITY OF NORTHAMPTON Lot: -001 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-2020-0356 Project# JS-2020-000599 Est. Cost: $12000.00 Fee: $40.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: LOWES HOME CENTERS INC 049918 Lot Size(sq. ft.): 13939.20 Owner: KLEIN Zoning: URA(100)/ Applicant: LOWES HOME CENTERS INC AT. 26 JAMES AVE Applicant Address: Phone: Insurance: 22 GRANVILLE RD (413) 272-89310 WC SOUTHWICKMA01077 ISSUED ON:9/19/2019 0:00:00 TO PERFORM THE FOLLOWING WORK.INSTALL 23 REPLACEMENT WINDOWS POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Service: Meter: Footings: Rough: Rough: House# Foundation: Driveway Final: Final: Final: Rough Frame: Gas: Fire Department Fireplace/Chimney: Rough: Oil: Insulation: Final: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occupancy Signature: FeeType: Date Paid: Amount: Building 9/19/2019 0:00:00 $40.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner a�0 J sG C/11,(, Wk1kt- 1j&1y Department use only City of Northampton Status of Permit: Building Department Curb Cut/Driveway Permit 212 Main Street Sewer/Septic Availability Room 100 Water/Well Availability a ' Northampton, MA 01060 Two Sets of Structural Plans iv phone 413-587-1240 Fax 413- REC =ts�� APPLICATION TO CONSTRUCT,ALTER, REPAIR REN VATE OR DEMOLISH A C NE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION SEP 1 7 2019 31 A , -W-( 1.1 Property Address n to a completed by office DEPT.OF BUILDING INSPECTIONS -), yyo A116 N -HAMPTON.MA 01080 It Unit Zone Overlay District Elm St.District CB District SECTION 2 -PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: �IklAI 26 wh&'5 A(/, Name(Print) Current Mailing Address: L•C S 2- - Z-� Telephone 77 Signature 2.2 Authorized Agent: �. �tS f�'' �q[l 7.-, ��OQ CGW lS -�7��'�f� ✓�1�0/� G I I P �C 7 I Name(Print) C_ Current Mailing(Address: '"� l -� - 27"? "? Sign`arU-rE7 Telephone SECTION 3 -ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building I Z (1 (a) Building Permit Fee 2. Electrical (b) Estimated Total Cost of Construction from 6 3. Plumbing Building Permit Fee 4c) OD 4. Mechanical(HVAC) 5. Fire Protection 6. Total= 0 +2 +3+4+5) ( LV v L Check Number This Section For Official Use Only Building Permit Number: Date Issued Q Signature: Building Commissioner/Inspector of Buildings Date EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) 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 tilled 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 We&paved parking) #of Parking Spaces Fill: (volume&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO O DON'T KNOW Q YES Q IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO O DON'T KNOW 0 YES 0 IF YES: enter Book Page and/or Document # B. Does the site contain a brook, body of water or wetlands? NO 0 DON'T KNOW 0 YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained 0 Obtained 0 , 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 0 NO Q 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 0 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 ❑ Addition ❑ Replacement Wi ows Alteration(s) ❑ Roofing ❑ Or Doors Accessory Bldg. ❑ Demolition ❑ New Signs [O] Decks [0 Siding [O] Other[0] Brief Description of Proposed (� '� 0__� PPtU(o'y,pn tb ',J",( 5 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, , as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date I, �w�5 -cuii^P C `" kJ as Owner/Authorized Agent hereby declare that the statements 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. Print Name Signature of Owner/Agent Date SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: AA AAlc �lWN ` �01(� License Number Addres Expiration Date `{ Signat Telephone 9.Renistered Home Improvement Contractor: Not Applicable ❑ C4A-'P5 J-(4,4e ('qA k/S ((4 P N Company Name Registration Number ub C d''vPGi njl u� tMocfei u l I-P, AJ6 (()— I?--t '/ Address Expiration Date Telephone 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....... �3'— No...... ❑ City of Northampton Massachusetts U DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street •Municipal Building 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: -)-Irn0 kp (Please print house number and street name) Is to be disposed of at: VGII�Py 1��c` (� ny 2'14 6ltHr�`�� (Please 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 Applicant 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 Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Bus i ness/Organi zation/I nd ividual): Address: 10 U & LAA1 e� t71u1) City/State/Zip: 0vr-o0hu-11P 1 A16 7 (I) Phone #: ��� 'Z__? Z Are you an employer? Check the appropriate box: Type of project(required): 1.❑ 1 am a employer with 4. [2' i am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑ New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g, ❑ Demolition workingfor me in an capacity. employees and have workers' y P h'• 9. E] Building addition [No workers' comp. insurance comp. insurance.+ required.] 5. ❑ We are a corporation and its 10.E] Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 1 1.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.] t c. 152, §1(4), and we have no employees. [No workers' 13.0 Other comp. insurance required.] *Any applicant that checks box#1 must also fill 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 employees. If the sub-contractors have employees,they must provide 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. QQ �r Insurance Company Name: ^' (�<<jK �� 0,,A (,015 ti IC Policy #or Self-ins. Lic. 17 71) Expiration Date: Job Site Address: 'Z(� 12" Ally City/State/Zip: AV r44m P /Ind 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 MGL c. 152 can lead to the imposition of criminal penalties of 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. Be advised that 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 pains and penalties of perjury that the information provided above is true and correct. I Signature. C' Date: �� Irp �— q Phone#: ' 172 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#: CONTRACT# 0 01 L 0 6 t9 MASSACHUSETTS SERVICES SOLUTIONS INSTALLED SALES CONTRACT LOWE'S AUTHORIZED REPRESENTA71VE NUMBER CUSTOMER STORE NO. STREET ADDRESS STREET ADDRESS CITY STATE zip CITY STATE ZIP TELEPHONE TELEPHONE DATE LOWE S HOME CENTERS,LLC'S MA HIC NO.: 148686 cAsH e�gpp u.c ctR G FEIN 56-0746358 +r This is only a quote for the merchandise and services printed below. This becomes an agreement upon Payment. Upon payment,to entire agreement,Including the spedlicaty completed pages of this document.the Temis and Conditions included with this document and any other addends and attachments hereto,shat be referred to heroin as this'Contract." PLEASE READ ALL TERMS AND CONDITIONS ON THE REVERSE SIDE OF THIS PAGE AND FOLLOWING PAGES BEFORE SIGNING. INSTALLATION STREET ADDRESS CITY STATE ZIP NOTICE TO CUSTOMER-PRICE CALCULATIONS:In order to properly perform the installation of certain Goods,the Contract Price may include more Goods than actually will be installed based on the measured square footage of the Project Area. As a result, the parties agree that the lump-sum Price stated in this Contract is calculated upon both the value of estimated Goods required to fulfill the Contract(including waste),which may exceed the actual square footage of the Project Area,and the labor which may be estimated 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 that the Price includes these costs which may not be refunded once the Installation Services are performed. Are permits required for this installation?: ( ]Yes [ ] No Contract Total *applicable tax included NOTICE TO CUSTOMER: Federal law require! Lowe's to provide you with the pamplet Renovate Right. By signing this Contract, Customer acknowledges having received a copy of this pamphlet before work began informing Customer of the potential risk of the lead hazard exposure from renovation activity to be performed in Customer's dwelling unit. NOTE: If rotted wood is discovered during installation additional charges will apply. You will be given a quote and a change order must be completed and signed by the customer for any additional charges,, ' Customer must Initial. Any work or material not specified is not included in this contract.Any changes or additions will be at /additional charge for the material and labor. PHOTO RELEASE:Customer grants to Lowe's and Lowe's employees and independent contract rs the right to take photographs of the Premises where Installation Services will be performed and all work performed at the Premises related to this Contract,and irrevocably grants to Lowe's all right,title and interest in and to the photographs for use in all markets and media,worldwide,in perpetuity.Customer authorizes Lowe's to copyright,use and publish the photographs in print and/or electronically,and agrees that Lowe's may use such photographs for any lawful purpose,including,but not limited to,marketing, advertising, publicity, illustration,training and Web content. By initialing 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 or customer made Good(s)which is anticipated to be (fill in date).Estimated completion date is 1 -- : ,, (fill in date). Said estimated substantial completion date is not of the essence.A statement of any contingencies that would materially change said estimated substantial completion date is as follows: % ' ' (if applicable,insert a statement of such 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: (1)Deposit S f to be paid upon signing contract.Any deposit collected at the time this Contract is signed will not exceed one-third (1/3)of the contract,price;and 12)Payment of S to be collected upon or after the commencement of work.IfWa authorize Lowe's to do one of the following(check appropriate box below): ]Charge my/our credit card for the amount of the payment indicated above upon or after the commencement of work; or ( ]Deposit my/our check for the amount of the payment indicated above upon or after the commencement of work;and (3)Final payment of$100.00 to be paid upon completion of the installation and both parties'satisfaction. NOTICE REGARDING ARBITRATION AGREEMENT FOR CLAIMS COVERED BY M.G.L.c 142A LOWE'S AND OWNER HEREBY MUTUALLY AGREE IN ADVANCE THAT IN THE EVENT LOWE'S HAS A DISPUTE CONCERNING THIS CONTRACT, THAT LOWE'S MAY SUBMIT SUCH DISPUTE TO A PRIVATE ARBITRATION SERVICE WHICH HAS BEEN APPROVED BY THE SECRETARY OF THE EXECUTIVE OFFICE OF CONSUMER AFFAIRS AND BUSINESS REGULATIONS AND THE OWNER SHALL BE REQUIRED TO SUBMIT TO SUCH ARBITRATION AS PROVIDED IN M.G L c 142A.THE SIGNATURES OF THE PARTIES BELOW APPLY ONLY TO THE AGREEMENT OF THE PARTIES TO ALTE_RNA YE DISPUTE RESOLUTION INITIATED BY LOWES PURSUANT TO M.G.L.c 142A_THE OWNER MAY BE PERMITTED TO INITIATE=ALTERNATIVE DISPUTE RESOLUTION (TION EVEN WHERE THIS SECTION IS NOT SEPARATELY SIGNED BY THE PARTIES. If customer has a complaint which cannot be resolved informally, the home Improvement Contractor Law/M G I r 142A1 may nrnvirip rt tctnmar with tha rim ht in rant tact rhif—tin t+,r.,,tmh�"—f-art;tr rI .. « .........,• A k„-�-n:.".... REM CONTRACT# 00120691 MASSACHUSETTS SERVICES SOLUTIONS INSTALLED SALES CONTRACT LOWE'S AUTHORIZED REPRESENTATIVE NUMBER CUSTOMER STORE NO J rT­RE­ET_AD_0_RESS STREET ADDRESS CITY STATE ZIP CITY STATE ZIP A / 1_ a TELEPHONE TELEPHONE DATE LOWE'S HOME CENTERS,LLC'S MA HIC NO. 148688 GnSHp LOGREG FEIN.56-0748358 CHARGE This is ony a quote for the merchandise and services pnnted below. This becomes an agreement upon payment. Upon payment,the entire agreement,induAng the sped8calty Wrnpleted pages of this document,the Terms and Conditions induded with this document and any other addenda end attachments hereto,stud be referred to herein as this'Contrail" PLEASE READ ALL TERMS AND CONDITIONS ON THE REVERSE SIDE OF THIS PAGE AND FOLLOWING PAGES BEFORE SIGNING. WSTALLATION STREET ADDRESS CITY STATE ZIP PHOTO RELEASE Customer grants to Lowe's and Lowe's employees and independent contractors the right to take photographs of the Premises where Installation Services will be performed and all work performed at the Premises related to this Contract,and irrevocably grants to Lowe's all right,title and interest in and to the photographs for use in all markets and media,worldwide,in perpetuity.Customer authorizes Lowe's to copyright, use and publish the photographs in print and/or electronically,and agrees that Lowe's may use such photographs for any lawful purpose,including,but not limited to,marketing, advertising,publicity, illustration,training and Web content. By initialing here, Customer agrees to the foregoing, [Customer to initial to the left]. Are permits required for this installation?: [ ]Yes [ j No Contract Total applicable tax included NOTICE TO CUSTOMER: Federal law requires Lowe's to provide you with the pamplet Renovate Right. By signing this Contract, Customer acknowledges having received a copy of this pamphlet before work began informing Customer of the potential risk of the lead hazard exposure from renovation activity to be performed in Customer's dwelling unit. NOTE: If rotted wood is discovered during installation additional charges will apply. You will be given a quote and a change order must be completed and signed by the customer for any additional charges. Customer must initial. 'Any work or material not specified is not included in this contract.Any changes or additions will be at an additional charge for the material and labor. WAIVER OF LIEN and ONE YEAR WARRANTY(TO BE SIGNED BY INSTALLER) I,the undersigned Installerllndependent Contractor,having been employed by the Customer who signed the Certificate of Completion below do hereby certify that the work for this project will be or has been completed in a workmanlike manner and to the Customer's satisfaction.In consideration of the receipt of one dollar and other good and valuable consideration,and to the extent permitted by applicable law,I hereby waive and relinquish all liens and all rights and claims of liens which i,the undersigned,now have or may hereafter have for labor or materials furnished,and further certify that all work performed and materials furnished,if any,by any other party or parties upon the order of the undersigned,have been fully paid for.Further,I the undersigned,agree to Cause the prompt release of any mechanic's lien(s)which may be filed against the Customers premises by any subcontractor,laborer,mechanic or material supplier claiming the right to file such a lien through work related to the Customer's Contract with Lowe's.In addition to any warranties provided by law or specified elsewhere,including the Customer's Contract with Lowe's.the undersigned.further warrants that all work furnished for this project shall be free from defects either in material or workmanship.If any defects in material or workmanship shall be discovered in the work furnished or material used during the course of the work or within one year from the date of the Certificate of Completion,the undersigned agrees to replace or correct such defective work or material,free from all expense to Lowe's and the Customer in a manner satisfactory to the Customer. I further represent that I have given Customer the option of retaining some or all of the surplus materials or having some or all of such surplus materials removed from the Customers premises. If applicable to the performance of the work required for this project,I,the undersigned Installer/Independent Contractor,do hereby certify that I have complied with all requirements of the Lead Renovation,Repair,and Painting Program Rule('LRRPP Rule`).40 C.F.R.sec.745.80 et seq.,or any applicable state laws or program regulating lead-based paint safe work practices, including compliance with all information distribution.notice requirements and work practice standards in performing the work required for this project.I certify that I have provided the Customer with all documentation required to be supplied under the LRRPP Rule or stale program,shall retain all records required by law,and have attached to this document copies of all of the records required to be retained by the LRRPP Rule or applicable state program. Signed and delivered this day cf (seal) Installer Print Name CERTIFICATE OF COMPLETION t.1,the Customer,certify that the InstalersAndependent Contractors or their stsrcontractors,have furnished all Goads and/or services,that installation,repairs and alterations or improvements ('the installation serv"S1 have been compieted as set kM f my/our car*ad wb Lowe's,and that I ham been offered the oppattmlty to request that Lowe's allow me to mW some or all of any unused,receipted surplus materials rather dw have stx�su"Is materials remeut the property of Lowe's. Ia �:T,ri'*a%. a^ i S �a ti +r c S . t t S ^, 5 � 5 i < _ , q � � •. � , .rc a 9 -, Y�t " S °* 4 ♦ aTY t x ; ) 4 r tl S 4 s ) 4 4 y 4 i"s '1 0 n 4 5 : 'F h s ', t', i 1 h '' a at �� � EatR # � S44t'! 1ty � � ssSl + il Si4hs `�'k' 45�9"; i a4 � 4l - . ' 1 Installation Proposal - Windows 1 Date: Store# Sales Specialist Customer Name License# 2nd Contact Name Home Phone Job Site Address Work/Cell Phone City,State and ZiptfCustomer Email Preparation: Additional Considerations: OPre-installation inspection El Install new interior casing ©Provide appropriate protection to home during installation ❑Install new exterior trim 00btain and post any necessary permits C3 Install new exterior wrap(trim coil) ODedicated project support staff will be in contact with you OCustom work: every step of the way installation: Clean-up/Final Inspection: EDRemove and haul away existing windows ]Complete final cleanup and haul away all job related debris OCheck existing windows for leaks and evidence of pest qTest product and perform complete inspection with customer infestation 0Install new windows and window accessories,including required caulk,stops,and fasteners J, (� V �i`/ �/ Ct' `�`:. f {' /Grfr�' 'r• -- (�ail ' _ 7A5,�" 5'9 -�fJ � 0d, 54A-(( 5 "5 l C { Total Investment ,/;,/ , All Installation services are guaranteed by Lowe's labor warfrity.Additional charges may apply for permit fees.Professional Installation available through independent contractors licensed and registered where applicable. License numbers and certifications held by or on behalf of Lowe's Home Centers,LLC and/or Lowe's Home Centers,Inc.:AL$8187;AK 039289;AR x0037290514;AZ NROC291645;CA 0991832,Bond x106055877,;CT PHIC0639387,#MCO.0903044;DE 01993102010,EL 00001326824,NCGC1508417,NCRC1327732,#FRO4517;GA#RB00005306;HI OC-33489;IL x104014837;KS-Arkansas City 0R-20104)(1136,Wichita N549S,Johnson County#2012.6366;KY-Lexington 011562;IA NC110383;ID#RCE-38637,IN-Hammond 0017105-02;LA-0LMP2481,CBCN16533,01554408;MA#148688,#35194; MD#91680-22;MI 02102144445;MN 080629859;MS NR17568;MT#161006;NC 070220;NO#30316;NE#23319;NM$382385;NY-New York Cory#1291730,#1291733,#1375178,#1351065,Nassau 0H177789WW,0H177789010D,NH1777890200,Suffolk 043906-H,#48295-ME,$44066-MP,x41444-HF,Buffalo#556853,Putnam xPC2742-A.Tonawanda 0CN0391,Rockland#H-11092-86,00-00, Westchester#WC•23319-H10;NVx0079079;OH-Columbus#65872,#HIC4S65,Lancaster JIM96,Waren x4266;OK N48191,80OW341,002337;OR 0201237;PA-Sunbury 0751,Johnstown 1100467;RI 020575;SC NG116664G319696;TN#64743,#3070;TX NTACLB24674E,NEC-29349;UT$9002087-S501;VA 027010365964);WA SLOWESHC863OH:WV#WV014656;and WI 81133309.License numbers) and certifications may be subject to change In accordance with local or state government processes.For the most current listing of license numbers and certifications held by or on behalf of Lowe's Home Centers,LLC and related entities,please visit http://www.lowes.com/(kDenSenun)bef$ IMPORTANT:This is an estimate only.This estimate is subject to change and does not bind you or Lowe's.This estimate is not a contract nor will it modify any future contract you may sign with Lowe's for the installation services.You may accept this proposalpnly by signing the appropriate Exterior Solutions Installed Sales Contract with Lowe's and making payment according to the terns and conditions therein.!Estimate good for 30 days).Installation feevMll be and additional charges may be based on total product required to futfill order(including waste),which exceeds actual area square footage.If you would like to discuss the measurements or would like a copy of this document,please contact the Lowe's Store Associate.Please review your contract carefully for all charges prior to signing. 55110 REV.7/15 NOTICE OF RIGHT TO CANCEL (enter date of transaction) (Date) You may CANCEL this transaction, without any Penalty or Obligation, within THREE BUSINESS DAYS from the above date. If you cancel, any property traded in, any payments made by you under the contract or sale, and any negotiable instrument executed by you will be returned within TEN BUSINESS DAYS following receipt by the seller of your cancellation notice, and any security interest arising out of the transaction will be cancelled. If you cancel, you must make available to the seller at your residence, in substantially as good condition as when received, any goods delivered to you under this contract or sale, or you may if you wish, comply with the instructions of the seller regarding the return shipment of the goods at the seller's expense and risk. If you do make the gpods available to the seller and the seller does not pick them up within 20 days of the date of your notice of cancellation, you may retain or dispose of the goods without any further obligation. If you fail to make the goods available to the seller, or if you agree to return the goods to the seller and fail to do so, then you remain liable for performance of all obligations under the contract. To cancel this transaction, mail or deliver a signed and dated copy of this cancellation notice or any other written notice, or send a telegram, to [Name of seller] at _ — NOT LATER [Address of seller's place of business] THAN MIDNIGHT OF [Enter date 3 business days after transaction date above(or longer as required [Date] by applicable law);include Saturdays but not Sundays and Federal Holidays.) I HEREBY CANCEL THIS T4NSACTION. (Date) (Buyer's Signature) ACKNOWLEDGMENT OF RECEIPT OF DISCLOSURES AND CERTIFICATION On this day of (year), each of you hereby acknowledges receipt of two (2) copies of the foregoing Notice of Right to Cancel; each of you who is a party to the Contract hereby acknowledges receipt of one (1) copy of the fully executed and dated Contract Number _ (SEAL) (SEAL) (Witness) ---- NOTE: Each Customer who is a party to the Contract must sign above. Item#90993 Rev:12113) ,JOB FOLDER COPY r�epia COfMrnt W/rndow Detail SpeameationsLoaaUon Dat8: Drawlnp — •' 'tt?I+9: -------_— 3 L( x �ustor;ter %oUitamr prone s lns+�1!mr: are»tWW be#Wfm for IrWh tion A#messum7wip must be In Inches Location ' Wick Height W1dUl Height.. &yie Comment 4 -3_ s c (,ol r s r 3 's e pqP, _. s � r r CERTIFICATE OF LIABILITY INSURANCE == 14 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(res)must have ADDITIONAL INSURED provisions or be endorsed.If y SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this c certificate does not confer rights to the Cenificate holder in lieu of such endorsement(s). w a CONk�D.rCE R NAME R A, ., i;k StrviL s ><ruth, Inc. — FAA Sbb) ib3 712e� ,) F3 :":•f m i,::r1 rte NC Office AC r10 CO), ( TJAVC N�) 'R 1411 vet-ipolitan Avenue, Suite 400 EJtA1L p lotte Nc '&04 usA ADOPESS: s INSURER(SI AFFORDING COVERAGE rIa*,d NSI'AC: NSURERA_—_f reat Ark-,i(,.In ASNuratite i ni"InY A.t <,moanieS, Inc. ENSURER B. National Union Fire Ins Co of Pitt Sh;uo)I, 1h44; T (dlsidiat ies S Bouievm'! NStNtERC Nev., Hampshire Ir+stu'ance Company . . .r elle NC. 2FL17 w,A .NSURERD- -NSURCR C _ NSURER F: COVERAGES CERTIFICATE NUMBER:570075483114 REVISION NUMBER: THIS 15 TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED RWED ABOVE FOR THE POLICY PERIOD NOICATE0,NOTWITHSTANDING ANY REOUIREMENT,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 M SUBJECT TO ALL THE TERMS, XCL USIONS AND CONDITIONS OF SUC1l POLICIES LUTS SHOWN MAY HAVE BEEN REDUCED BY PAID CUjM$ Limits stow n are as requested ADOL WIN POLICY Ur POULY LAP TE OF 1N9U#ANCE WV POLICY NUMB€R Yv VY UMTS TYPE COMMERCIAL GENERAL LIABILITY Y Y Self-Insured 04/01/2019 04/01/2020 EF "txC RRfrtiC=_ ktF.D[%P(Any m..Pwxn, PERSONAL 6 AD IN.'_14+ iA GE NEPAL ACdFRCCdTe` � El AUTOMOBILE LIAatUTY CA 4993101 04/0112019 04101/2020 COMzi-00 StWtE tM;T SS.Orx�,004 ADS P ara avTo CA 4993103 04/01/2019 04/01/2020 I,Wty INN-1tlY Z Ca^Ct .l£EF MA e£A_L✓ -a+ 9_.,.,..•, dy B i aL t g L.SA.v CA 4993102 04/0112019 04/01/2020 PNOf E41 Y t AL1'. � .rec vtor; VA Ivor dccaentl i a umtvrt.aAtlAti x . uma22762 04/01:2019 041 1/ EAG+OCCLRR@r:"E 1q,000,0lx} V SIR applies I:xcas9Per tA+Ticy term% a condi ions LIAe $10,000,000 '".t7 't Hrri�nTlilir. C WORKERS COMPENSATION A140 wC0.2 1 161 4! 1; I 04i0I/20?0 X PER STATU` RT.<, EMPLOYERS'L IA01UTY YIN AOS rR(;eR t:GRrrY.P .:.rt,cxLc..-rte E EACHAC.CI-nENT S2.t)i7{i,tNn rr, ER.acLeetRExc..l3c N,A SIR applies per policy term% 6 condi ions tEA.,.r,tory inNNl E t C71SEASE-tAf:krrLUYE.. S:,000,000 1411171':x:'1F .rEi+At�cir,s,tclaW E L psEA,E•Qoc,cy rlsr;T S?.(w),000-- 11 furls WC 7lwCS 565603 041011201904101/1020 EL Each Accident S; 000.000 AOS EL Disease Policy 53.00;)"100 SIR applies per, policy ter s b cone ions EL Disease - Ea Emp s1,000.wi0 CIE SCRIPIION OF OPERATIONS i LOCATIONS�VEreCLE S(ACORD 1O(,AddoiOMI R,Nmrke SeMdub may W ARaehed d Inde$pact is rpUk*dl ..RNF.•r< I,o Crneral Iia6iI ity 1'.AlI,v is `.. Ir l—,tired. i = CERTIFICATE HOLDER CANCELLATION �Y r SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE El PIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE LMT" THC POLICY PROVISIONS L(Ave's COMI)arlieS, Inc. AUTHORIZED REPRESENTATIVE .Intl its sI,bsidiaries lUtl(I loweS N►vd, veoresviile Nr: M117-85.'0 U5., 1,11988-2015 ACORD CORPORATION-All rights reserved. ACORD 26(2016103) 1tie ACORD name and logo are registered marks of ACORD AcoRo® CERTIFICATE OF LIABILITY INSURANCE DA 0 811 412 0 1 9 Y) 08/14/2019 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(ies) must 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 NAME: Marie Proulx FAX INSURANCE CENTER OF NEW ENGLAND No. , (413)750-7106 A/c No: E-MAIL P ADDRESS: m roulx Icne.com 1070 SUFFIED ST INSURER(S)AFFORDING COVERAGE NAIC# AGAWAM MA 01001 INSURERA: AIM MUTUAL INS CO 33758 INSURED INSURER B: MARK JODOIN INSURERC: JODOIN HOME IMPROVEMENT INSURER D: 15 JONES DRIVE INSURER E: EASTHAMPTON MA 01027 INSURER F: COVERAGES CERTIFICATE NUMBER: 436810 REVISION NUMBER: 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 THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF MWDCY EXP DIYYYY LIMITS LTR COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ MTC CLAIMS-MADE r-1OCCUR PREMISES Ea occurrence $ MED EXP(Any one person) $ N/A PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY❑JE F7 LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINEDSINGLELIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED N/A BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNEDPROPERTY DAMAGE $ ac HIRED AUTOS AUTOS Per cident UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE N/A AGGREGATE $ DED I I RETENTION5 $ WORKERS COMPENSATION X STATUTE ERH AND EMPLOYERS'LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $ 500,000 A OFFICER/MEMBER EXCLUDED? N/A N/A NIA AWC40070296132019A 08/31/2019 08/31/2020 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 N/A DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space Is required) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.gov/lwd/workers-compensation/investigations/. Sole proprietor has not elected coverage. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Lowes Companies Inc and any and all subsidiaries ACCORDANCE WITH THE POLICY PROVISIONS. Mail Code A3ESS 1000 Lowes Blvd AUTHORIZED REPRESENTATIVE Mooresville NC 28117 ` l Daniel M.Crowey,CPCU,Vice President—Residual Market—WCRIBMA ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD Office of Consumer `�� '• ;,// HOME IMP Affalry ausinesa Regulation ROVEMENT CONTRACTOR TYPE:SUAolement Card I � � rr LOWE'S HOME CENTERS LLC 1p/E 2019 CHRISTOPHER MINIE 1000 LOWES 13LVD MOORESVILLE,NC 28117 CS Undersecretary Office of consumerAffF�j:s&Business Regulatior. HOME IM PROVE M EN'I" '',XNTRACTOR TYPE:indivitlual Renistration ExPiratiUn 159137 04/03/2020 MARK JODOIR DIB/AJODOIN HOME IMPROVEMENT MARK.S.JODOIN �- 15 JONES DR EASTHAMPTON.MA 01027 Underserf`C i'Y Commonwealth of Massachusetts Division of Professional Licensure p Board of Building Regulations and Standards Constrttctton Sfa ervisor CS-049918 Expires: 12129/202 MARK S JODOIN 15 JONES DR EASTHAMPTONMA 01027 k . Commissioner