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30C-029 353 BURTS PIT RD BP-2021-0091 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block:30C-029 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-2021-0091 Proiect# JS-2021-000142 Est.Cost: $6889.00 Fee: $40.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: HOME DEPOT.AT HOME SERVICES 106106 Lot Size(sq.ft.): 37330.92 Owner: NIEMAN ROXANNE M Zoning: SR(100)/ Applicant: HOME DEPOT AT HOME SERVICES AT. 353 BURTS PIT RD Applicant Address: Phone: Insurance: 5 RIVERVIEW DR (401)935-2633 O Workers Compensation NORTH PROVIDENCER102904 ISSUED ON.7/24/2020 0:00:00 TO PERFORM THE FOLLOWING WORK.-INSTALL 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 7/24/2020 0:00:00 $40.00 212 Main Street,Phone(413)587-1240, Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner Jam.. 114 3 �; n Ar e Commonwealth of Massachusetts B � o of Building Regulations and Standards FOR f ti��s" C sachusetts State Building Code,780 CMR' MUNICIPALITY USE t pplication To Construct,Repair;Renovate Or Demolish a Revised Mw-2011 One-or Two-Family,Dwelling This Section For Official Use Only Building Permit Number: -off ( ' A lied: �vl� ( �o5s 7-24-70 Building OfMal(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 PropV Address: 1.2 Assessors Map&Parcel Numbers JD,-eiS ? C, n q LI I a Is this an accepted street?yes no Map Number Parcel Number 1.3 Zoning Information: IA Property Dimensions: Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply:(M.G.L c.40,154) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Zone. Outside Flood Zone? Public 13 Private❑ . Check if yes0 Municipal 13On site disposal system ❑ SECTION 2: PROPERTY OWNERSHIPI- 2J Owner'of Record: tSoxQr,Ae- ie-/vi zi Fle,r4en_,.c— 106 2- Name(Print) !� City,State,ZIP- No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction❑ Existing Building❑ Owner-Occupied ❑ Repairs(s) ❑ Alteration(s) ❑ J Addition 17 Demolition ❑ Accessory Bldg.❑ Number of Units Other 9`Specify Wi1O�f Brief Description of Proposed Workz: ov.c Q a w cl e late e w i�cl v C �✓'" a 14 u.Gfyi 1 SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only CLabor and Materials) 1.Building S l�' �� 1. Building Permit Fee:S Indicate hoar fee is determined: 2.Electrical S ❑Standard City/Town Application Fee ❑Total Project Cost'(Item 6)x multiplier x 3.Plumbing S 2. Other Fees: S 4.Mechanical (HVAC) S List 5.Mechanical (Fire S Suppression) Total All Fees:S Check No4- 74 Check Amount oCash Amount: 6.Total Project Cost: S 6 9 0 d 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) License Number Expiration Date Name of CSL Holder 2 3 List CSL Type(see be)ow) (NS �P� h�� Sf No.and Street Type Description �n 6/-tei e nn rI/� D/ U 4 U Unrestricted(Buildingsu to 35,000 cu.ft. tryCtr wn,S ,ZIP '•I R Restricted l&2 Family Dwelling M Masonry RCI Roofing Covering Window and Siding 2 1 /� Solid fuel Burning Appliances 3 ",3�2- /tit 6 c7�/OSII 6)QM4•d I•(OM I I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) /17r elZ 112 /� --TA C MC Registration Number pna n Date HIC Company Name r C Registrant Name No.a $$text I Eni it dddress � l.A 6A 3033 9 96q gSZ lfu i- Cit /Town,State,ZIP Telephone SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.G 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...........13 SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,as Owner of the subject property,hereby authorize/4,1t to act on my behalf,in all matters relative to work authorized by dis building permit 4plication. Print Owner's Name(Electronic Signature) Date SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION By entering my name below,I hereby attest under the pains and penalties of petjury that all of the information contai in this appli true and accurate to the best of my knowledge and understanding. Print wns or gent N (Electronic Sierra Date er' NOTES: 1. An Owner who obtains a building permit to do his/her oam work,or an ottmer who hires an unregistered contractor (not registered in the Horne Improvement Contractor(HIC)Program),will not have access to the arbitration program or guaranty fund under M.G.L.c. 142A.Other important information on the HIC Program can be found at tv%,w,mass_gov/oca Information ou the Construction Supervisor License can be found at kvwnv.mass.eov/dos 2. When substantial work is planned,provide the information below: Total floor area(sq.fc) (including garage,finished basement/attics,decks or porch) Gross living area(sq.ft.) Habitable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of half/baths Type of beating system Number of decks/porches Type of cooling system Enclosed Open 3. '?otal Project Square Footage"maybe substituted for"Total Project Cost" City of Northampton Massachusetts : s DWAFd2 1dT OF svlLrlrrrG INSPECT.rONS 212 Main Street • Manicipal Building Northampton, Mil 01060 HOMEOWNERS'E)Ga PTIONELIGIBILMAFF7DAWT I, (insert full legal name), born (insert _ month,day,year),hereby depose and state the following: 1. I am seeking a building permit pursuant to the homeowners'exemption to the permit requirements of the Massachusetts State Building Code, codified at 780 CMR 110.85.1.3.1, in connection with a project or work on a parcel of land to which I hold legal title. 2. I am not engaged in, and the project or work for-which I am seeking the aforementioned homeowners'. exemption, does not involve the field erection of manufactured,buildings constructed in accordance with 780 CMR 110.83. 3. I qualify under the State Building Code's definition of"homeowner"as defined at 780 CMR 110.R5.1.2: Person(s) who owns 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 home owner. 4.. I do not hold a valid Massachusetts construction supervision license and, except to the extent that I qualify for and will abide by the Massachusetts State Building Code's requirements for the supervision of the project or work on my parcel, I am not engaged in construction supervision in connection with any project or work involving construction, reconstruction, alteration, repair, removal or demolition involving any activity regulated by any provision of the Massachusetts State Building Code. 5. If I engage any other person or persons for hire in connection with the aforementioned project or work on my parcel,I acknowledge that I am required to and will act as the supervisor for said project or work. Signed under the pains and penalties of perjury on this Z day of 294 20—Z2 (Signature) The Commonwealth of Massachusetts Department oflndustrialAccidents I Con,-,ress Street,Suite 100 Boston,lKA 02114-2017 www.mass gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information '� Please Print Legibly, Name(Business/Organization/Individual): 1(-61Xe Address: Z Y�S� ,tea els fes'/%I �C c✓ 5-ZArCity/State/Zip: �f��� �j ft 3 0 3 39 Phone t S(,O - 95-2- Are e you an employer?Cheri:the appropriate box: Type of project(required): 1.❑I am a employer with employees(full and/or part-time)-* 7, []New construction 2.❑I am a sole proprietoror partnership and have oo employees working for cat in $, El Remodeling any capacity.[No workers'comp.insurance required.) 3.F I am a homeowner doing all work myselL(No workers'comp.insurance requited] 1 9. Demolition [�4.❑]am a homeowner and will be hiring contractors to conduct all work on my property. 1 will 10 Building addition 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 501 am a general contractor and I have hired the sub-contractors listed on the attached sheet These sub-contractors have emplaycrs and have workers'comp.insurance.! 13.❑Roof repairs 6.❑We arca corporation and its officers have exercised their right of exemption per MGL c. 14.®Other rN;/1dD w 152,§1(4),and we have no employees,(No workers'comp_insurance required.] Any applicant that checks box#I must also 511 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 inforniatrom Insurance Company Name: Y` n CCP G,vt AM it 1� Policy#or Self-ins.Lic.#: XwC (1S5 2 9 5n� �QS1� ttt�� Expiration Date. 03 C�l 2 b2 � Job Site Address: S 3 S t'-� 4S P 1'�0�j City/State/Zip: VVI A O 1062— Attach a copy of the workers'compensation policy declaration pace(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 da hereby certify der tyre pacers hies of perjury that the information provided above is true and correct Signature: `� Date: �L 3 - 2-e2- O Phone#: 0- 2-- Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/Liceuse# 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#: Go Permits, LLC 105 Buttonball Lane Glastonbury, CT 06033 l Scott Doughman Phone: 860-952-4112 Fax: 860-430-6719 scottdoughman@gopermits.org Re: Massachusetts Solid Waste Affidavit Good day, Please find attached locations where the installers can bring their debris from the jobs. These are all Home Depot USA, Inc. locations. • 72 Shaker Road, Unit 2 Enfield, CT 06082 • 32 Scotland Boulevard Bridgewater, MA 02324 • 375 Airport Drive Worcester, MA 01602 • 12 Linscott Road Woburn, MA 01801 • 50 Maria Ave Johnston, RI 02919 Thank you, Go Permits I I The City of Northampton P e . Building Department 212 Main Street ice^' Northampton,Massachusetts 01060 Phone(413) 529-1402 Fax (413) 529-1433 CONSTRUCTION DEBRIS AFFIDAVIT (FOR ALL DEMOLITION AND RENOVATION PROJECTS) In accordance with the provisions of MGL c40, s54, a condition of Building Permit Number is that all debris resulting from this work shall be disposed of in a properly licensed waste disposal facility as defined by MGL c 111, S 150A. The debris will be disposed of in: Location of Facility__ Z__sS h a�� `� V'�_ �%A-' _ p& The debris will be transported by: Name of Hauler_ _L IU �� �— 5 - _ — C _ _ _ _ _ _ _ Signature,of Applicant:_ _ _ _ _. _ Date:__ ___ 191 SOLID WASTE DISPOSAL AFFIDAVIT As a result of the provisions of MGL c 40, 554, I acknowledge that as a condition of the building permit issued to (insert address) all debris resulting from the construction activity governed by this Building Permit shall be disposed of in a property licensed solid waste disposal facility, as defined by MGL c I 11, S 150A. - 6elc/41 G_ 4f"W'- 3 -_.. Name of Permit applicant (Please Print) fb0 - 9.SZ- Telephone Number Date Sig'nVaKre t (Print or Type the following information) A4/W- USA e- Com any to Pick-up or facility where disposed 71"Z Address n C-r X60 City, State,Zip Code gbo - 9sz - L1112-- Telephone number 25 West Street, Leominster, MA 01453 0 978-534-7517(phone)0 978-840-0039(fax) www.leominster-ma.gov Home Improvement Agreement: Pagel Home Depot License #'s - For the most current listing www.Homedepot.com/LicenseNumbers MA: 107774, 112785 Ronald Engelbrecht Salesperson Name: Registration No. if applicable): Home Depot U.S.A., Inc. ("Home Depot") or Service Provider named below will furnish, install and/ or service the equipment listed below at the price, terms and conditions as outlined on this form. Nieman I Roxanne New England South 1-19GPK9CG ustomer Last Name Customer First Name Store # / Branch Name Customer Lead/ P # 353 Burts Pit Road Florence MA 01062 Customer Address City State Zi (413) 320-1155 1roxnieman@icloud.com Home Phone# Work 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: 908 Boston Turnpike Unit 1 Shrewsbur IMA 01545 Address City State Zip Or Email: I customercancellationnortheast@homedepot.com Service Provider Email Address 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 PAYMENT(S) 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 THE 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 YOUR RIGLT TO CANCEL. Acknowledged by: 07/16/2020 Customer'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: $ 6889.40 Includes all applicable taxes. Excludes finance charges.* Sales Tax: $ 10.00 (If applicable) *Maximum deposit ONL Y applicable in MD, MA, ME(33%), NJ, Wl(9991"') Dep. 1 25.0 % Deposit Amount $ 1722.35 1 Remaining Balance $ 5167.05 The Home Depot-2455 Paces Ferry Road, N.W. Bldg. B-3,Atlanta, Georgia 30339-Customer Care: 1-800-466-3337 Home Improvement Agreement: Page2 Finance Charges: *Any interest payments or other finance charges will be determined by Customer's separate cardholder or loan agreement, to which The 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 payment(s) made payable to The Home Depot. Insurance proceeds will will not -, be used to pay some or all of the total amount of sale. Description of Work to be Performed: Installation of 1windows A more detailed description of the work to be performed is included in the section entitled Scope of Work which appears on page 0 of this Agreement. Anticipated Delivery Date/Installation Schedule Approximate Start Date: 09/10/2020 Approximate Finish Date: 10/os/2o2o 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. By initialing this paragraph, I consent to receive only electronic records related to this transaction. '® Initial Acceptance and Authorization: By signing below, you authorize Home Depot to (a) arrange for Service Provider to perform Installation and/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/permitting information may need to be provided to You later.) By signing, you acknowledge that you have read, understand, and accept this Agreement in its entirety, including the General Terms and Conditions and State Supplement, if any. You further acknowledge receiving a complete copy of this Agreement. Keep it to protect your legal rights. X I Zk ' 07/16/2020 The Home Depot Customer's Signature Date Service Provider Name X 07/16/2020 908 Boston Turnpike Unit 1 Co-Signer (if applicable) Date Service Provider Address X 07/16/2020 Shrewsbury MA 01545 Signature B half of Home Depot ate i tate Zi HIS 0554523, R-1-073-13-00004 Service Provider Phone Number 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 The Home Depot General Terms & Conditions 1. DEFINITIONS: "Agreement" means the Home Improvement Agreement between You and Home Depot, plus (a) any Change Orders; (b) the State Supplement, if any; (c) these General Terms and Conditions ("General Conditions") and any documents referenced in or attached to any of the foregoing. "Defect" means any Services that are found not to be as warranted. "Home" means the real property, fixtures and any physical improvements where the Services are performed."Services" means (1) the delivery and furnishing of goods, equipment, materials, and hardware; and (11) any related labor and services, including without limitation, construction, consultation, fabrication, erection, installation, inspection, maintenance, repair, and testing. "Service Provider" means an independent contractor, authorized by Home Depot, and its employees, agents, and subcontractors. "Work Area" means any property, buildings, or structures necessary for the staging, temporary storing and performance of the Services. "You"t'Your" means the customer identified in the Agreement. 2. HOME DEPOT'S RESPONSIBILITIES: Home Depot or Service Provider will complete the Services in a workmanlike manner and in accordance with applicable law without causing damage to Your Home, provided, however, that Home Depot or Service Provider will not start or continue with any Services upon discovery of any condition at Your Home that Home Depot or Service Provider deems in its sole discretion to be hazardous or unsafe. Unless specifically contracted to do so, neither Home Depot nor Service Provider is obligated to repair such pre-existing hazardous or unsafe conditions. 3. ASSIGNMENT/SUBCONTRACTING: Home Depot and Service Provider may assign this Agreement, or any right herein, or any monies due or to become due hereunder, and may delegate or subcontract any obligations or Services hereunder without Your consent. This Agreement shall not be assigned by You without first receiving Home Depot's written consent, which may be denied in Home Depot's sole discretion. 4. YOUR RESPONSIBILITIES: (a) Payment: You agree to pay Home Depot in full for the Services pursuant to the terms of this Agreement. (b) Safe Access: You agree to provide Home Depot and Service Provider Safe Access to Your Home. "Safe Access" means safe and complete access to the Work Area, including, without limitation: (1) obtaining in advance of the Services consent, permission, or relief from any covenants, easements, restrictions, or other legal encumbrances affecting the Work Area; (2) providing the location of utilities, whether underground, concealed, overhead or visible, to Home Depot or Service Provider; (3) removing from the Work Area physical impediments, hazards, and building code or zoning violations that affect directly or indirectly the Work Area; (4) removing unsafe working conditions and hazardous materials, including environmental hazards, from the Work Area; (5) providing sanitary facilities to Home Depot or Service Provider convenient to the Work Area (or, alternatively, paying for the rental costs of such facilities); (6) providing all utilities, including without limitation, power, water, ventilation and climate control, in and for the Work Area; (7) removing from and protecting against minors, pets, guests and visitors in the Work Area; (8) keeping permits, if required, visible at all times; (9) disengaging, suspending or terminating any security systems protecting the Work Area; (10) providing adequate temporary storage space as needed for Home Depot's or Service Provider's performance of the Services; and (11) not Interfering, Impeding, impacting or otherwise disrupting the Work Area at any time during Home Depot's or Service Provider's performance of the Services. (c) No Performance: Services are to be performed by Home Depot or Service Provider. If You attempt to perform or assist with the Services in any way, You assume all risk for property damage and for injury to Yourself and others. 5. MODIFICATIONS AND CHANGE ORDERS: Without invalidating this Agreement, You may authorize Home Depot or Service Provider to perform Services beyond the scope of the Agreement ("Chance Order"). A Change Order shall be issued by Home Depot or Service Provider on behalf of Home Depot, which You may accept by signing. Upon Your signing of the Change Order, it shall become part of this Agreement, subject to all of the terms of the Agreement. Change Order may also result from Home Depot or Service Provider encountering conditions at the Work Area that impact, impede or otherwise The Home Depot-2455 Paces Ferry Road, N.W. Bldg. B-3,Atlanta, Georgia 30339-Customer Care. 1-800-466-3337 The Home Depot General Terms & Conditions interfere with the performance of the Services, requiring an increase in cost, time, or both. Following the discovery of any conditions that impact, impede or otherwise cause the Work Area not to have Safe Access, Home Depot may immediately ask for a Change Order or discontinue the Services without further obligation to You. If You decline a Change Order request, You or Home Depot may terminate this Agreement. 6. TITLE AND RISK OF LOSS: The title to and risk of loss for any materials or goods provided to You that originate from Home Depot shall pass to You when paid in full by (1) You or (2) the Service Provider as part of the Services. Title to any other materials or goods provided by Service Provider shall pass to You upon completion of the Services. 7. WARRANTY AND LIMITATION ON WARRANTIES: (a) Warranty: Unless otherwise stated in the Agreement, Home Depot warrants for 1 year from the completion date that all Services shall (i) be performed with good workmanship and (ii) conform to the requirements of the Agreement. During the warranty period and within a reasonable time after receiving notice from You of a warranty claim, Home Depot may, at its sole option (i) correct or replace each Defect, or (ii) remove each Defect and refund the full purchase price thereof to You; provided, however, that all warranties are voided if (1) anyone other than Home Depot or Service Provider performs work upon or otherwise modifies any materials or Services provided under this Agreement, or (2) You fail to pay Home Depot as provided in this Agreement. (b) Limitation on Warranties: THE WARRANTIES PROVIDED IN THIS AGREEMENT ARE STRICTLY LIMITED TO THE FOREGOING EXPRESS WARRANTIES CONTAINED IN PARAGRAPH 7A, IN THE WARRANTY SECTION OF THE AGREEMENT, IF ANY, OR IN THE STATE SUPPLEMENT, IF ANY. YOU ACKNOWLEDGE AND AGREE THAT NO OTHER WARRANTIES ARE MADE OR GIVEN BY HOME DEPOT OR SERVICE PROVIDER, INCLUDING ANY WARRANTY FOR FITNESS OF PURPOSE, WARRANTY OF MERCHANTABILITY, OR ANY OTHER ORAL, EXPRESS OR IMPLIED WARRANTIES. HOME DEPOT'S EXPRESS WARRANTIES ARE VOIDED FOR ANY DEFECT CAUSED BY ABUSE, MISUSE, NEGLECT, ACTS OF GOD, LACK OF PRESCRIBED OR STANDARD MAINTENANCE, OR IMPROPER CARE/CLEANING. ANY MANUFACTURER'S WARRANTIES PROVIDED FOR GOODS, MATERIALS, OR EQUIPMENT WILL BE PASSED THROUGH BY HOME DEPOT TO YOU, AND YOU AGREE TO LOOK SOLELY TO SUCH MANUFACTURER FOR REMEDY OF ANY DEFECT IN SUCH GOODS, MATERIALS, AND EQUIPMENT. HOME DEPOT MAY ASSIST YOU WITH WARRANTY CLAIMS AGAINST MANUFACTURERS. 8. TERMINATION: This Agreement may be terminated by Home Depot for its convenience, and by either party for cause if the other party fails to correct a material breach within ten (10) days after receiving notice from the non-breaching party identifying the breach. In the event Home Depot terminates this Agreement because You fail to provide Safe Access to perform the Services, or if either party terminates the Agreement because You decline a Change Order request resulting from unforeseen or hazardous conditions, then You shall pay Home Depot for Services provided through the date of termination plus any costs or expenses incurred by Home Depot or Service Provider as a result of the termination. 9. CHOICE OF LAW; SEVERABILITY: This Agreement shall be governed by and interpreted in accordance with the laws of the State where the Project is physically located. The parties intend for the terms and conditions in the Agreement to be complementary, consistent, and enforceable under applicable laws. In the event any term or condition in the Agreement violates applicable law, such term or condition shall be severed from the Agreement, but only to the extent necessary to avoid such violation, without invalidating any other terms and conditions of the Agreement. The Home Depot-2455 Paces Ferry Road, N.W. Bldg. B-3,Atlanta, Georgia 30339-Customer Care: 1-800-466-3337 The Home Depot General Terms & Conditions 10. ENTIRE AGREEMENT: This Agreement is the final, integrated, and exclusive expression of the parties' understanding, which supersedes all prior offers, orders, understandings, representations, proposals, confirmations, and negotiations between the parties, whether oral or written. No course of dealing, usage of trade, course of performance, course of conduct, or any other evidence of additional or different terms shall be admissible to contradict or vary any term in the Agreement. 11. SECURITY INTERESTS: LIENS: If You make all payments as required under this Agreement, no security interest will be placed against Your property by Home Depot. If a security interest is placed on Your property, it creates a lien, mortgage, or other claim against Your property to secure payment and may cause a loss of Your property if You fail to pay as requested. After paying on any completed phase of the Services and before making any further payments, You should request from Home Depot or Service Provider a signed, unconditional release from, or waiver of, any right to place any claim against Your property applicable to the work then completed. You may ask an attorney about Your rights to discharge security interests. 12. RETURNS: Custom order merchandise (i.e., goods that are custom made, uniquely altered, colormatched, shaped, sized, or otherwise uniquely designed or fitted to the requirements of a particular space) is non-returnable, and its purchase price cannot be refunded unless Home Depot or Service Provider (1) incorrectly ordered item, or (2) damaged item beyond repair. Special order merchandise may be returned, and a refund for all or part of the purchase price provided, in the discretion of Home Depot. Please contact Your store for additional details concerning returns. 13. AGREEMENT/SERVICE ORDER COMMUNICATION PREFERENCES: You can visit www.homedepot.com > In- Store Special Orders at any time to access Your account for the following: (1) Update Your Agreement/Service Order Communication Preferences (email, text, Auto Call); (2 Contact Home Depot for order assistance; (3) View latest order status; or (4) Take action to schedule pickup for Your Service Orders. To stop any of the following communications You may visit www.homedepot.com > In-Store Special Orders to access Your account to update Your Agreement/ Service Order Communication Preferences, contact The Home Depot, and take action on orders. If You signed up to receive updates about Your Agreement/Service Order(s) via: (a) Text Message Communications, You may receive multiple messages per order (including current and future orders) via automated technology to the mobile phone number You provided. The total number of messages received depends on the number of orders placed and order activity. Standard message and data rates apply. Not all carriers covered. You can text STOP to 97710 to stop (You will be sent a confirmation message). Call 1-877-467-2581 or 1-800-466-3337 for help; (b) Electronic voice communications (Auto Call), You may receive multiple pre-recorded phone calls per order (including current and future orders) via automated technology to the phone number You provided. The total number of calls received depends on the number of orders placed and order activity. You can press 9 during a call to opt out or call 800-HOME-DEPOT for help; or (c) Email Communications, You may receive multiple Emails per order (including current and future orders) via automated technology to the Email address You provided. The total number of Emails received depends on the number of orders placed and order activity. The Home Depot-2455 Paces Ferry Road, N.W. Bldg. B-3,Atlanta,Georgia 30339-Customer Care: 1-800-466-3337 WINDOW SPECIFICATION SHEET - Spec.Sheet#: 1.19GPK9CG Sheet: 1 of 1 Customer: Roxanne Nieman ,lob#:1-19GPK9CG Consultant: Ronald Engelbrecht Date: 07/16/2020 New Window Hinge Locations Existing Window Measurements Grids Product Options Labor Options From outside, Left to Right Bays,Bows Location Color Rough Opening #of bars #of bars Csmnts,1 Pnl, use L,R or S Glass Misc Items Hardware Code Screens For doors use Mull "S"=stationary or W� Style Wraps m y d o o Q o "X" operating t Room Floor Code (Y/N) Style Code Series Code E x F ui U a > x > _ STD,White, GlassPack: WRAP,LSR 1 BONUS 1st SB-DH Y OH 6100 WH WH 28 54 82 F, WH,W C ALL 2 1 ALL 2 1 Standard GBG H STD,White, GlassPack: WRAP,LSR 2 BONUS 1st SB-DH Y DH 6100 WH WH 28 54 82 F, WH,W C ALL 2 1 ALL 2 1 Standard GBG H STD,White, GlassPack: WRAP,LSR 3 BONUS 1st SB-DH Y DH 6100 WH WH 28 54 82 F, WH,W C ALL 2 1 ALL 2 1 Standard GBG H STD,White, GlassPack: WRAP,LSR 4 BONUS 1st SB-C1 Y OH 6100 WH WH 19 34 53 F, WH,W C ALL 1 1 ALL 1 1 Standard GBG H STD,White,TMP:Full, WRAP,LSR 5 BONUS 1st BGDI Y GD-FH 6500 WH WH 71.25 79.25 150.5 F, WH,W C ALL 2 5 ALL 2 5 GlassPack:Standard, X S GBG H Swing: outswing SPECIAL CONSIDERATIONS: 1:White,2:White,3:White,4:White,5:White Wrap Color nterior Casing Type Colonial Bay or Bow window: eatboard material(vinyl only-Birch or Oak) Bay Project Angle(30 or 45) Bay Flanker Type(DH,SH,or Csmnt) Top of window to soffit(inches) If tied to soffit,color of soffit material I have reviewed and agree with all the job specifications above and the Construct Roof(Yes or No)' Special Terms and Conditions on the following page Garden Window: atboard Material(vinyl only-White Pionite,Birch or Oak) • With Grids Style Glass Package Glazing Spacer IG U SHGC U SHGC (all with Argon) Fact Fact . 1 ! .wning 6500 Base ProSolar Supercept 718" 0.26 0.23 • • -1 0.26 0.21 • • • ;asenlent 6500 Base ProSolar Supercept 7/8" 026 0.24 0 o e o 026 0.22 0 0 0 0 ransom 6500 Base ProSolar Superc ept 1' 027 0.32 • • 0.27 0.29 • • rouble-Hung 6500 Base ProSolar Supercept 718" 0.29 0.26 • 0.29 0.24 0 0 • 'icture Casement (NH) 6500 Base ProSolar Superoept 718" 0.26 0.28 • • 0.26 0.25 • • • • icture 6500 Base ProSolar Supercept 718" 0.27 0.29 • • 0.27 0.26 • • Panel Slider 6500 Base ProSolar Superoept 7/8" 0.29 0.26 • 0.29 023 • • e Panel Sliders 6500 Base(s 21 Sglt) Pro Solar Supercept 7/a"1 0.29 0.26 0.28 0.23 Orden Door(CH) 6500 Energy Star ProSolar SUN Super Spacer 1" 0.30 024 • e e o 0.30 0.21 0 • o 0 atio Door INOVO 6500 Base Pro Solar Super Spacer 1" 0.28 0.26 o 0 0.31 0.23 1 0 • • 0 ! Homes located everywhere EXCEPT:Arizona,California,Who.Nevada,New Mexico,Oregon,iltah,and Washington. wning(Inc Hopper) 6100 Base Pro Solar Intercept 718" 0.27 0.24 ejolojol 028 021 o e o 0 'asement 6100 Base Pro Solar Intercept 718" 0.27 024 • • • • 0.27 0.22 • • • • rouble-Hung 6100 EneTy Star Pro Solar Supercept 3/4" 0.30 0.30 • 0.30 027 • • 0 icture Casement pro Boge) 6100 Base Pro Solar Intercept 7/8" 0.27 0.28 • • 0.27 0.25 • • • • 'icture 6100 Base Pro Solar Intercept 3/4' 0.27 0.31 • • 0.27 0.28 e o Panel Slider 6100 Base Pro Solar Intercept 314" 0.30 0.28 • 0.30 0.27 le Panel Slider 6100 Base Pro Solar Intercept 3/4" 0.30 0.29 © 0.30 0.27 0 &E111110 Homes located everywhere EXCEPT:Arizona,Califomia,Idaho,Nevada,New Mexico,Oregon,Utah,and Washington. atio Door(NOVO 6100 Energy Star Pro Solar Super Spacer 1" 1 0.28 026 • -1 1 1 0.28 023 jejol • • atio Door NARROW FRAME 6100(PD05)Base Pro Solar Intercept- 314-10-28 0.30 e • 0.28 0.26 jellell e ! Homes located only in AWowfng markets:Dallas,Denver,Detroit;Phila,Northern NJ,Long Island,NY. wning 6200 Base Pro Solar SHADE Supercept 314' 0.27 0.25 11. 91- • • • 026 023 e e o asement 6200 Base Pro Solar SHADE Supercept 314" 0.26 0.18 • • • • 0.29 0.17 • • • e icture Casement-NH 6200 Base Pro Solar SHADE Supercept 314" 0.25 0.21 o • o • 0.25 0.19 e • • o icture Window 6200 Base Pro Solar SHADE Supercept 314" 0.26 0.24 • • • • 0.26 0.22 • • • • ingle Hung 6200 Base Pro Solar SHADE Supercept 3/4" 0.28 0.23 • • • • 0.28 021 • • • ingle Slider 6200 Base Pro Solar SHADE Supercept 314" 0.28 0.23 • • • 0.28 0.21 • 0 0 Panel Slider 6200 Base Pro Solar SHADE Supercept 314" 0.28 0.23 028 0.21 • 0 0 • IWTMIIIHornes located in coastal areas. wning SB+300VL Energy Star PS SUNNI-ami Superoept 1' 026 023 0 • • • 026 0.21 • • • • asement SB+300VL Base PSA-ami Super Spacer 1' 025 023 • • • • 0.25 0.21 • • • • ouble Hung SB+300VL Base PSA-ami Super Spacer 1' 0.29 0.25 • • • • 0.29 023 • • • • lider SB+300VL Base PS/Lami Intercept V 029 0.25 • e • • 0.29 0.23 0 o e 0 atio Door SB+300VL ETC 366 PS Shade/Lami Super Spacer 1' 0.30 0.19 • • • • .• arden Door(CH) SB+300VL - Base PSA-ami Super Spacer V 0.30 028 • • 0.30 0.25 l°l ` l°1° Dots indicate Energy Star certified for that zone - ----- �--- ---- - -- - - --- Please • • . .. . windows AC-"nR . CERTIFICATE OF LIABILITY INSURANCE u,,, W" THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CODERS 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: it the certificate holder is an ADDITIONAL INSURED,the pobcy(ses)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED.subject to the terms and conditions of dw policy.certain Policies may require an endorsement. A statement on this certificate does not COnfa rights to the certificate holder in Neu of such endorsement(s1 PR ASH USA INC. NAME: PHONE TWO ALLIANCE CENTER - TFEWI—m- 3560 L E NOX ROAD.SUITE 2400 ATLANTA,GA 30326 WKIMOIAFFCIWMCOVBtME Nw• CN101642069-HameD-GAW.-2421 MSuERA:OW Republic km anceCo 2 147 INSURED INSURER 0:Nor Inc Co 23841 THE HOVE DEPOT,INC. HOVE DEPOT USA,INC. INSURER C:Hoffaftk Capta*Wance 2455 PACES PERRY ROAD ISIIIER D: BUILDING C-20 ATLANTA,GA 30339 NAUXER E !INSURER F: COVERAGES CERTIFICATE NUMBER: ATL-OD4353439LM REVISION NUMBER:25 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. MSK TYPE OF NIMOLvNCE POLICY MLMMIErt LIMITSLTR A X CNWM33KcBNBiRLLUOLFFY MWZY314574 03101019 0301r2022 EACHOCCLRRENCE S 1.000,001) DAMAGE TO MEN Ito CUWSMADE rX 1 OCCUR PSS lEaowarence'1 f 1,000.001) X SIR:$1,000,000 MED EXP(Any one esen' f EXCLUDED PERSONAL AtAOVINJURY f I== GENLAGGREGATE LIMIT APPLIES PER GENERALAGGREGATE f Z000,ODO X POLICY❑JPERCOT- ❑LOC PRODUCT'-COAPAOPAGO IS 2AOO,ODO OTHER: I is A AUTOMOBIELVIBLIry I IMWTS314573 031101/2019 03010nf 1.000.000 a'4set X ANYAUTO BODILY KKIRY(Por pesen) f OWNED SCHEDULED SELF INSURED AUTO PHY DVG BODILY INJURY Ter=dot) f AUTOSONLYAUTOS MIED MHIRED ONLY H AUTOSONLY ipff aeridert f f IMBIH.LALMIB OCCUR EACHOCCUb�E f EXCESSLMIB .MADE AG(I;*MTE f DEO I I RETE1r MS f B WDRKEItfcow"isimonWC 023D96004(AKMNJ,VT) ER 0311"rMl X PEAR OTH AND EMPLOYERFLWAIITYWC 023096005 03e01fL020 03M),f202t B ANYPROPRIETORMARTNER1EXECUTWE NIA ) EL EACH ACCIDENT f 5,000,000 FI q EXc>_uDEO? on El DISEASE-EA EMPLOYEEf y5,000,000 DESCRIPTION OFOF OPHiAT10NG blow urdw Carom ed on AddibORal P� EL.DISEASE-POLICY LIMIT f 5,000,000 C Excess AMID 29711MI100M 03e011202D 03001!2021 LImR 4.000,000 A Excess Gfferal babfgi MM2X 314560 03012019 0301tm22 Lot 8.000.001) DESCRIPTION OFOPERATIONS ILOCATIONS/VEHICLES(ACORDM.AddliwdRmayrbeadnd!d%m spaoew 4 EVIDENCE OF INSURANCE CERTIFICATE HOLDER CANCELLATION HOVE DEPOT USA,INC SHOULD ANY OF THE ABOVE DESCRBED POLIGEs BE CANCELLED BEFORE 2455 PACES FERRY ROAD THE EM MtAT10N DATE THEREOF, NOTICE WILL BE DELIVERED N BUILDING G20 ACCORDANCE WITH THE POLICY PROVISIONS- ATLANTA GA 30339 AUn10R®REPRESBMTATI E of Marsh USA be. MumhiMukheYjee J1eCAu�as: ��L.titcna/ er @ 1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER D: C%101642066 LOC#: Atlanta ArY]OR ADDITIONAL REMARKS SCHEDULE Page of a AOENCY NANIM MZURM AAIARSlt tRS0..lIC. THE HOE DEPOT.%C KWE DEPOT US A..RC Roucr NUMBER :455 PACES FEM ROAD ILLDING C-0 ATLANTA,GA 303M CARRER WACCOCE F3187111E DALE: ADDITIONAL REPMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM. FORM NUMBER: 76 FORM TfiLE_ Certificate of Liability Insurance "We Compereahnrr Cwdr%wed.: Cmdw Wwwn eCanp"dNo+Ameroe FAW Reeler WLR C669=716 1ALAR FL lD.W,%S.Y(V,L AAIS)IO,NF N%ND.CK SC,SD,TN„YW;NY Nm*n Oic 0Wt23D bo in Oic A1iiD3!2OJ21 IPJ 0111 M,mm CWWNMINNO cbarenceConpsny Poky Homier WC( DMD0.3:DC,DEJ4[^ID,NN,AIf f/l'X) ENedaeDm TONT-m Eawsimi Die:=1=1 ;ELI Let 55,030.000 Cmr*er ACE Arrre+rsr Mr�rarror Cae*sy Pocky%w-e_WCU0664sT53JQST (AZ CAXX OR,VA.WA 1 EFiesin Dake:03A11020 Bwebon Dela:03101f= (E4 Let 541000,000 Stt51,000AWSIR forte MnofAZCAA AIC„CR;YA,WA Crier.Notcrw LmwwFie a momew Cormeey Fcicr nu-aer XWC 6559156(CWI=,CT„GAWIAM CHAA,UT) 5 chwDah•:03t,11.= Empm Aw Oahe:03131;20!:•1 E`i:.ma 54,33"Wc $1 aXl00,S1R for Fie abrin afCOW NVJAI O",PA,UT SM, =SFR for lu*ie of GA S3 DW SR fm 4e allele aF CT Cs+er Nefurel Ur+m fm hr>wsrce SWTWT %cy%U b”X(#C 655w,AM EFledrve Daly:03 I':'323 Espr+adon Dahe J3rJ1' 1 IEL.'i Let 54,W,M0 SR:5503030 7X E-pc>M XS Inder�r* Cr_ Ones Upon In>taa�u%ommrq Pricy Nuo-ie-TNS C6693ZU5?X;, ElkKbw Dehe:33+31+2' 0 Enw AwDene:3301x.3,:1 I�-:i Let 510:300.003 DR:51,000;300 ACORD 101(2008101) OD 20W ACORD CORPORA71ON_/1N rights reserved The ACORD nanle and toW are registered marks of ACORD Office of Consumer Affairs and Business Regulation 1000 Washington Street- Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration Type. Supplement Card HOME DEPOT USA INC Registration. 112785 P O BOX t D5451 Expiration- 04122/2Q21 ATTN_ LICENSE MGMT TEAM ATLANTA,GA 30348 Update Address and Retum Card_ SCA* O NM-ftt7 .J�i Y.rii✓.vivviiwr//�r�.�,yrNjiN�/' Office of Consuraw Afhirs 8 Suahrese Reyu WiOw HOME IMPROVEM=CONTRACTOR Regk*w6w valid for individual use only TYPE:SuvpiemeM Card before the w0mlion data. If kund return to: FAW1011001 Offita of Consumer Affairs and Busk%em Regulation 112755 04r= 21 1000 waw*wton Street -suite 710 HOME DEPOT USA INC Boston,MA 02115 RICHARD OLMSTEAD i j -- 2455 PACES FERRY RD C-11 HSC �w^ t�•�^"�s ATLANTA.GA 30339 Undersecretary Not valid without signature EXTER-2 OP ID:FC DATE IMWDOrYYYY) .4CORO' CERTIFICATE OF LIABILITY INSURANCE _ 11/19/2019 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,11wpotky(�)must be endorsed. If SUBROGATION IS WANED,sub�ct to the terms and conditions of"policy.certain polkke may n p*o an BndonemarlL A sbd*msnt On this certificate does not confer rights to the certificate holder M Abu of such endoneme ee. nu _�_- PROOU)CER -.. Canary Blomatrom r lets.Agency r +13-7111.1�Y� ,._ . ___._ _.. 1�.w);413-786_-7004 868 Springfield St. s Lstl: - Feeding Hills,61A 01030.2161 ��iss:dmafNlOQ" mstrOm.com epggVERAGE _..--'_------- "=a 34784 ;NSURE A A t CdtilfiwMv kwVt4w*C4- tasuNin Exterior Remodeling Group Inc, --- Eugenht Clubotani 23 Benham St -- Springfield,MA 01109 aswRERoe iR►: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE SEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTW'MITHSTANOW ANY REQUIREMENT,TERM OR CONDITION OF ANY C014TRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,TIlE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, E=LUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE SEEN REDUCED BY PAID CLAIMS. _ No - --- - -F - - ------ ---- AWL - - ---- YEFi --- --------- TTPE aMIM1AlIC[ POLICY Nummx ►O�TCYEItP — Laws Coviveramm Gomm Lwam EACH OCCURRENCE S 1 CLAMSdAADE 0 OCCURAE11 Es soccurenca� S MED EXPone parson S ...._ PERSONAL E ADV INJURY S _'--- GENt AGGREGATE LeNT APPLIES PER POLICY❑ OtBE1NLADtI1rE0ATE a ❑LOC PRODucrs-ODairOPADG s OTHER i AUTOMOBILE UABIUTY COMB pBINED INUa Li 1 s 1.000 im LEAA _AUTO r420 11/08/2019 11IBSI Y0 BODILYINJURYtparpwmq s ALL OWNED -X SCHEOIAED --- AUTOS AUTOS BODILY INJURY 1PsrsorJdllU S V X HRMAUtOS X AUTOSWNEO EsDaldaY DAMAGE nD = S 1 IaMRELLA umEACH OCCURRENCE ! low xasLJAB cLArrs+rAOE -- -- AGOREQATE � DED RETENTIONS WORHERI COMPENSATION S AND EMPWnW LUWKITY ANY PROPRETOR~TNERIMECun% Yr ATUTE B OFFICERMEYaER EXCLUDED) NIA E.L EACH ACCO M i(Mudslsry in NH) s,downee.rWm E.LDISEASE-EA >i D RPTION OF OPERATIONS DMoe EL DISEASE•POlJCl/laat S DESCIa►TION OF OPERATKM r LOCAIM M I VtN CLEM tACORD 101.AAMalnl Runarlp Soho".M"a amcpeN N Leon M r,,beo CERTIFICATE HOLDER CANCELLATION HOMEDE3 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE Home Depot USA,Inc. ACCORDANCE WITH THE POLICY PROVISIONS. WILL BE DELIVERED IN Home Services COmplicance C•11 2455 Paces Ferry Rd AUTNOR¢ED REPRESENTATIVE Atlanta,GA 30339 ACORD 25(2014101) The ACORD name and logo are registered'"arks of of ACORD CORPORATION All Hhts 9 resonred. L 1,:K I If I(.AIC vT• TIAolu IT INOUIIA4iVl..0 - _ E)SIt7n@1S EMS CERTIFICATE 4 ISSUED AS A MATTER OF WFORMATIGN ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 1l01,0ER THts CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND. EXTEND OR ALTER THE COVERAGE AFFORDED OY THE POLICIES SELOW. THIS CERTIFICATE OT INSURANCE DOES NOT CONSTITUTE A CONTRACT K"KEN TK ISSUING IN=UREpit) AUTHORIZED UPRESENtAtIVE OR PRODUCII I.AND THE CERTIFICATE HOLDER. WPORTANT,. it"to cartificaft hotdsr is ss ADDITIONAL INSURED.tfw Peaeyliss)feast hsys ADDITIONAL INSURED ptevisbss of be*•dorsad. M 8UFIROGATIDN 19 WAFVF.O.wt►)sc'I to the/arms and con"iens of Etta Patiry.certain powisa stay,require an ertdsrssstset A statement on this eautificats does not coiner r s to the ceelftsts holder In lieu of such s .r•rtvereStiggs&Starr Inwranta Agy.hx 1%4 Boston Rd Suite 1 �41)•St�6657 is 413443.1137 Ydl:hrahsm MA 01095 _EA<.iIA1. �I tlxlQgll�brlgyrandl,larrklsurarics.ibrtl ittl[�t•Ar r.>tC�3^"aP.'St %AR:. Ae(AeeA WESTE'RNWORLO r.-4n F%TERIOR Rr-.fAODFt ING GROUP INC smArsa 23 BENHAM ST SPRINGFIELD MA 0110.9 °it"reac W.l�tl D- lritaltfl/ AI COVERAGES CERTIFICATE NUMAER: REVISION NUMiER: 11,115 IS 10 CERTIFY THAT THE MICIeS Of 1kSVRAIVCE L(STEb 6ELC44 HAVE kftV rSSLA0 10 THE 04;,fUD NAW0•11014 FOR Tf#E FOOCY PFRIOU I'iDICATtV fxl"VITHSIAAWiG ANY RLOVtALMEN1 MMA C*C&W1t(X.OR AAY CONTRACT CiR OTHER DOCUK1141 W7111 ALSKC1 TO 09"C"1.115 mkTifKAIE fAAY bE ISSUED tilt MAY PERTAIN.HIE IkSt*AVCE *K*E 0 BV Int NA CIES DfS_RIKD HERCik ;S SUBJECT TO ALL THE fFTIL151. EK(;LUSI(Mi1SAN)G-CMIWTIUNSUI bWfk Ak;ts 1101ab-AYAt1MAY#*AVLCLOA 14L'GLVMY$'AgrCWV3 Allft111. vAfuev/It pfte rte► TV"OEM1•IAsatty9Lq ft-2. - r22?Li'ritt2B 3.3_rt. Ia.rTs I/ CDYMteCMteffows"146eerTYuu _f4r." CCLINRCKIF 11040000 U MIM 4+01 ✓Q ocn111S ;t.o..+w+.+ 1190000 #IPMN31Si 01*12019 071334010 Ldu 1 Ai.Ar7 w L.... ,5000 Pt sTF}Aa.!Atyr wr..•. ;1000000 GE hl At9619,041t l 0011 APPI1t l PIR i irallt RaLA�l'.rntr'AI! 100`7400 �`' va�grkrt cawcs+u., .1000000 trarCrQ 1cCt 0 TSG AU1000 tLiu eua411r -- dcaj. AW A4T0 600 La#---,4,;•v,s•.0 ! fiAfifq UTO$ (4 Or�piI RJJ�I �e•.itdw4. 1 AUtirS iNll l A43T4a 1•Ill(f fi]ri SJVrrk f1 P1i01'tRrf GAYA(.F. t S 111N1MtLfwlW 17{r11R tAti'>1 OCtrrat.,tf._. -S it K"ss IIAe 11 AMY UAL* AiJ,N�S1a!t 1 ����.Q.eF.-.�' i SIM•+}....._-._�� ''1 _ 1 P=, LitYLOrfN!'tfAYMitY 1t�r1.Tt �4x A.-404 4"11At1*tJ-'1htM.(M l_Utrrr YrM.yrw (: #A:•w ar-.0 t Lr I 1 fft.f ku Wrf Rf t(A Wft" tomfooYIs104 (.___i f. EfyCASt EAtuntr,-LL T t. C%EAST PCA._v LOA 1 {rt5('A±<•it,Al ff Dlrf RATltitui TlMl. _.._ LJ I.___1 _ QQ of uR r1.Ow of orlRAttNns r Lourryr!rlsustacs:Asc,�f(i wosm.ra.rrw aslt.ew..ws..x.r+.o ea..wo.++w..e HO AT-MOLIE SER VICES.INC ANI)THE HOME DEPOT ARE INCLUM AS ADDITIONAL INSURANCE WITH RESPECTS TO LIABILITY I INSURANCE ♦YW433 FOR 04GOiNG OPERATIOW AND CONPLETCD OPFRATIONS ENDORSEMENTS CERTIFICATE HOLDER CANCELLAT TMD AT HOME SERVICES INC S"OuLDANYOFTNC-ABOYEDISC RAIEDPOLICIES OfCANCti(EDINFOR& Atte:Installer Relations Dept TME 1=4MTI(N DATE THEREOF bOnCE W'tL e£ DFLMERED 1.14 Home ServicesConViianceC-TI ACCOROAIWWTHTIEPOLICYPROvca %s+ ?455 Paces Felty Rd Atlanta Go 30339 .�trpslttssEfhalst.�atrvt THOU"J SRZI CI -�� t!f— C 1968-7015 ACOR F ACORD 25(2016.9)) The ACORA roma and logo 3m registered*%encs of ACORD I' Pr.aac.A>-y fw.a s.csA set 6:�•.:>. �+. n•.5cs.t^,+•[i Mpetaw rleW+wI NF2fa-IfTT OATIE CERTIFICATE OF LIABILITY INSURANCE '"Ill) THIS CERTIFICATE IS *SUED A$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 T>4E PpLIC1ES BELOW. THIS CERTIFICATE OF INSURANCE DOES 1401 CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURERISI AUTHOPALED REPRESENTATIVE OR PRODUCER.AND THE CERTIFICATE 00%OCR � IMPORTANT: b tht ceAdicate holds is an ADDITIONAL IfiSUREO.the poky(its)caval be tndotsed V SMAOOATION 0 WAIVED. subled to the trans and eontftlens of the pommy certain pokcks may teduirt an t1.OtrssnrtM- A slaternenT on t"conWwatr dors not cwdtl nlhls to tftt certificate holder in um of such ardorser"td s). COk-ArwcocrEt• .a T"-vs 5-vp BRIGGS STARR INSURANCE AGENCY INC f p t t4'3:5c35E51 IAA tit L-MVI-1 wst Irl ccm I WA lkys l oh RD teals`AKOtOai6 tort*1tGt aAt. i"it.ORANAM Adis:)ARD f%SL*J A`*XlF+r• 42 ivrf Arwtrlo wynr*• EXTERIOR REMODELING GkOUP INC wwelwc «suMt+L o IJ w NNAT.r ST s.sLatrl I al'RIN(;FI in MA 01 IC*---] r. COVERAGES CERTIFICATE NUMBER 440471 R! 'HIS IS lU CERTW r THAI f1E POL KAES GF i`iS 1r1A'.CL LISTED O(LOA PAVt @It%IsUffn TD'-t 11141 V%kW-)&W-YT-FCA Trlt•Pr-XK,Y P-RCA) *0 ;ATCD. N0lVAtH5tA4D14{i ANY RE0U:f4U1NT_ T[RV C1R COW?K.fr!ts ANY CONTRACT CA 0",R DOCUbEW Y.11I/Al SPEC? Tl All C•t YH,S CEpT10"If MAY BE ISStlEO OR WAY PERTAIN " NSI. C AFFQRfTED eY THE pQIF FS PES I q IIERFM+5 Ct►S,fCT TO A-It THE 1tRsrS f ACLVSICdN5 ANbCOf9XT1DNS W'SUCI4 P0r.ILIES L 1101S SFKYRTA MAYMAI'E dffn R{Qyo(n S'r PASD CIAUS AM SAW 1.MYt �. COMMERCIAL 06604ge 1 t.MKIt craw:,-w��.l c•:r,� �fiiJl/�r.� `-.•1 -.t Yi to t Or l-N'. NA h as2.r11•al>.K x+Ir f l:r V7 a:.oAf[;art tAAT ri'r•tt 9 w w :I+af tell aGIH;aTF I AutoLrwtas ltYRllr i E.1 : 1 Mr.A�.IU HIIl i/AVli;S AJIC, �ti r4?ie'r. IFffiI.YR LSA 1,1G l••:. T� Iwlat:al'F I Of)L Ki.to%1"AI {..._ .. .. alOilrttRSCOMrtFAAt'WM >'•1•Z- •... .,-. 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Tae ctat.s d Lars�rera2e Can re�xrsa�ntit dart rY s°•�essT't9 t^e Proor of Co•.:•ar�r•Car�rPr':ar'F�sT=on Search uxA al w•w*.mast yip.i:.rQ'wrrkrt-C{rYq' rKiL4n s�.•tf:•gi! t.'. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF TWE ABOVE DEtt1tIAED POUC&I f1E CANtEbLEb!E!0lM THE tJL1117tATIOM DATE TWREOF. WOTICt WILL ME OLO MMM 06 HOME DEPOT USA INC HOME SERVICE COLML(ANCE C•T T ACaxnA.tt*01-*t E POLICY►IIOviSlosg i4'-5 PACES FEAR"RD AUT>.o�7 Er11[sE�rATht ATLANTA GA ?,.??9 Da-<•'Ir r�lel Ca:.'_ '.YC2;a!rq C 1N#-"14 ACORD CORPORATION. AM rights reserved. ACORD 2S(2014+Di) The ACORD tame and Ingo are nVwkred marks of ACORD ,4400Rd CERTIFICATE OF LIABILITY INSURANCE °"71 , 12ND°'"'m 02,11al THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HIOLDEft. 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(SL AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER IMPORTANT: It the certificate holder is an ADDITIONAL INSURED,the Po icy(ies)must have ADDITIONAL INSURED It SUBROGATION IS WAIVED,subject to the terms and conditions of thepolicy, provisions A be endorsed. this CefUfWate doe=not Confer to the Certificate Molder in lieu of such endo Cenfenent(s) require A sfatwneTrt on PRODUCM QUKTACT MARSH USA,W ICY f TWO ALLIANCE CENTER PHME FAX 356OLENOXRCAD,SUITE2400 "IA� Wt.Flok_ ATLANTA,GA 3=6 Ess. CNJ0l6&2069+tnweO.GAW-2'P21 _NSUWl[S AFP0Pk alB/bVERAOE KAICd — aMiNaR A 00 PAN LIJa 1 Ms rwE Co _ 24147 a TIE HOME DEPOT,INC. ueultilt 9,:New Hevphm Ins Go., 23MI HOME GEES F U.S.P,INC "will c: r 2455 PACES EFIRY ROAD BUILDING C,4 MUMS"0. --- ATLANTA,GA.30338 tlM111�R E. MEMBER F -_ COVERAGES CERTIFICATE NUMBER: AIL-004353439.33 REVISION NUMBER: 25 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, TELA OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT w1TH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICES DESCRIBED HEREIN IS SUBJECT TO ALL THE TE EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. RMS, --- — TV"oradkovNCE Win 4aaTs A x COMMERCIAL seNERAItJgfaLRY MW7Y31W4 I0301r2019 030Lr2LTr? EAC,oDCURRENCE f 1A00,000 CLAIMS-MADE X .OCCUR I WWAQEfi-RENTED— - -----' x SIR$1,000.00C ?K 1EsooaMtenw f 1,000,OOD E71P(Ani f E%CLUOED L AGGREGATE I PER &ADViKj A f 1,000,000 6ESONAL Ni14RT APPLIES PER. GENERAL AGGREGATE S 2,000,000 X_POLICY' LOC --- PRODUCTS-COMwgPAGG f 2A00,0M OTHER, AIII AUTONOMILEU AIIL r 8314573 D317t, 1 Q3012022 i(Elm SOMI — f 1.000,000 X ANY AUTO I _ --_ ♦...y�r. trer P�nPil i OWED SCHEDULED SELF INSURED AUTO DMG T IMBED ONLY "i! 90DILY NLAIRY(per.00bmgi f AUTOS ONLY i AUT ONLY PROF+E�TY-IS'Ff-rE . S f �4f IEILLAUAe - OCCUR EACHOCCUrtRENCE f ol tine CLAIMS-MADE.RF,TENTIONf B WORMERSCOIPENSATlON 'f 8 AND EMPLOYM'LIABMJTY r f N G X ! M►all W"3230960105 --- --- TW— ANYPROPRIE UTfYE u (W�) D3O1:2ON? .03JQ1(p21 iDFPr-EA IE WNENBERFxCLLt7ED" El Ni A' ELEACH ACCIOENT S 5,000.000 ;J 403CF �Urea t L.o�BEASE-EA EMPL s 5,M0.90D COltbnuedanAd*t*rW - -- AAAA-- SCRIPTU7N OF OPERA-KMUmarC;Oftliaued E L DISEASE-POLICY LIMIT S C Suess App 297110M LOOM 4 00p i A ExomCienuNIjad+q MWZX31458D 0XV2019 03Alr= I" 8000. DESCROMM OF OPERATIONS)LOCATIONS 1 VEHICLES ACORD tel,AOI1IaMI RmmrMA Scbeduk mY W M mltvd a�% **^ply) EVIOENCC CF IN5URANGE - CERTIFICATE HOLDER CANCELLATION HOME DEPOT USA.INC 2455 PACES FERRY ROAD SHOULD ANY OF THE ABOVE EWWRMeo POLICES BE CANCELLED BEFORE SUILDNGC-20 THE EXPIRATION DATE THEREOF. NOTICE MLL BE DELIVERED MI ATLANTA,GA 30339 ACCORDANCE 11RTH THE POLICY PROVISIONS. AUrNORIZED REPRESWTATNE of Marsh USA Inc. MlWM N MLW*qee C 148&2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marcs of ACORD AGENCY CUSTOMER 10: CN101642069 LOC f: Abarlta Accw& ADDITIONAL REMARKS SCHEDULE Page 2 Of 3 AGENCY - NAhED NSURED MARSH US4,INC. THE HOME DEPOT INC. POLICY mums" _ - HOW DEPOT U SA.,INC, 2455 PACES FERRY ROAD BIALDING C•20 CARRIER AIASC CODE ATLANTA,GA 30339 EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance Wafter,Cprrpe wwn Lonem W Career WdMWVtY h Wra+ce Gompatry of North Amerca PO yNumber WLRCGUW715(AL.ARFL,ID,1AKS.KY.LA.MS,NO,N WNDOKSC,SD.TRWVYTY) r%m*We 010'7024 Expira v Dak C30U20?t (EL)Umit SS OOO 000 Camey.Nay Harrtpr #e Insware Corp" Pala Number WC 023D%M(DC.DE.H.III,M1),MN.MT.NY.R1) Efea"Dm 0301r)020 Expmon Do.I7301t2021 (111 Limo 55,000,000 Grrw ACE AntBvAn Insuanpe Comp8w P0J7 4JTdw.WCU C6W&753(Wj(AZ,CAILNC CR.VA,WA) Emepnw Dye:0307.2020 Exwalm Dale M81=1 (ELI Lmt 54,000,000 SIR S 1.00D,CO0 SIR bt 7te styes of AZ.CA.1 NC OR VA WA vane.NAhWW L hw Fye Wwame CwIWy ?dcll NtAtW xW;WM(091(CO.CT GJUE M W,OH,PA.LIT) Efrece.eOate 03,0V2020 Ertpratrn Date.03'0 I11C21 IEL)Wit 54,000070 $1 OV OW SIR br ine Stales of COME,Nd.M1 OH PA,UT Si 50.000 SIR W ft yap a CA M,74 SIR fpr the Stag of CT Caner WWII Union Foe Instraxe Company %ky'it ober XWC 65.59357((SII(MA) :rfaiya Dap aU01r2020 EKp Own Dae D10t12021 fEL)La t$4,500.030 SIR U00000 TX Employers XS Meer nty- Cartel:**$kwon Itsurar4;e Company Poky Numbe TNS C6fi9373t5 fTX} EExfte US&0301+2020 Ehplralm Dale:030 12D21 (EU Lunt s1D.00D.WO SIR Sf,000.000 ACORD 101(200MI) 4D 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo aro registered marks of ACORD w t Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CSSL-106106 Construction Supervisor Specially . EUGENIU CIUBOTARU 23 BENHAM STREET SPRINGFIELD MA 011D9 ! 4 Expiration: Commissioner 09/29/2020 N. MASSc ^t HUSrM ,- DRIV'ER'S LICENSED -rw 091312016 ' 5454316 .' '•:;•.L t:;- 3 X912 2912MI 91198 ,KEUGENIU� 01-.18?3 BENHAM SIR� . �. ;. ' SPRINGFIELD,NA 01109.2301 ?isms M 16 Hct V-02" ' - ;:�_. .,;_ �':.�� scDtertcr,�►�Ww om2r1ct5 _ 9l* � .:rfrce of Consumer Affairs S Business Regulation HOME IMPROVEMENT CONTRACTOR TYPE: Coraoration Reaistrat+ n Emiration 187566 08/09/2021 EXTERIOR REMODEL ih7G%'3%RQUP. INC EUGENIU rlUBOTARU 23 ST !MA 01109 Undersecreta+ Go Permits, LLC • 105 Buttonball Lane Glastonbury, CT 06033 Scott Doughman Phone: 860-952-4112 Fax: 860-430-6719 scottdoughman@gopermits.org Re: Building Permit Application - Licenses Good day. Please find attached permit application, licenses and supporting documents. Home Depot USA, Inc. sold the job and is the G.C. HIC 112785 Exp. 4/22/21 Workers Comp.- Union Fire Insurance Co. Policy XWC 6559357 (QSI) (MA) Exp. 3/1/21 Eugeniu Ciubotaru of Exterior Remodeling is the sub-contractor. CSSL-106106 Exp. 9/29/20 HIC 187666 Exp. 5/9/21 Workers Comp. — Briggs Star Insurance Agency. Policy R2WC081125 Exp. 8/7/20 All licenses and insurances are attached. Once the permit is ready: • Please fax or e-mail a copy of the permit and receipt to the below address and mail the original to the homeowner: Fax: 860-430-6719 Email: permits .gopermits.org • If you unable to mail the permit to the homeowner please send to the below address and we will ensure the permit is at the home posted at the time of installation: Go Permits, LLC 105 Buttonball Lane Glastonbury, CT 06033 If we are required to pick up the permit in at the building department, please call 860-952- 4112 once it's ready and we will come to get it. Thank you. Go Permits