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24B-073 72 BARRETT #318 72 BARRETT ST#318 COMMONWEALTH OF MASSACHUSETTS BP-2021-1815 Map:Block:Lot:24B-073- 045 CITY OF NORTHAMPTON Permit: Exterior Res PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit# BP-2021-1815 PERMISSION IS HEREBY GRANTED TO: Project# Contractor: License: HOME DEPOT USA INCHOME Est.Cost: 4057 DEPOT USA INC 106106 Const.Class: Exp.Date:09/29/2022 Use Group: Owner: URBAN KIMBERLY A Lot Size(sq.ft.) Zoning: URC Applicant: HOME DEPOT USA INC Applicant Address Phone: Insurance: 2455 PACES FERRY RD NW (413)335-3702() ATLANTA, GA 30339 ISSUED ON:08/31/2021 TO PERFORM THE FOLLOWING WORK: 4 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. Signature: Fees Paid: $65.00 212Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner 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 Northampton, MA 01060 Two Sets of Structural Plans phone 413-587-1240 Fa1. 587-1272 Plot/Site Plans / rj�„�� Other Specify APPLICATION TO CONSTRUCT, ALT , RE Al EE OR DEMOLISH A ONE OR TWO FAMILY DWELLING ,r Y\_ SECTION 1 -SITE INFORMATION 4GG } � `'�U This section to be completed byoffice 1.1 Property Address: } o,�G �Q� p 4z Tfc_tt Sr' t-f U 36 9Ttiay�o,,4 Map 7/ Lot Unit /t/ a"^P fil'Ao/060 • 1go,6oio^s a Overlay District St:District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Kini (rl.r bet n 4-1 TSok-rrctt S1rcc k Alai-A ei-+'r+ A14- Name(Pri Current Mailing Address: t7/06o 6,,,,...y) Telephonec(/ 3. 3Zo, igCY Signature 2.2 Authorized Agent: ‘' -d /d L. (tame, ,%t_ /oS /3K(Aft J7411-( La..‘ . Ij/a.sfa^ 13.14- 1 Name(Pri Current Mailing Address: C-1. v 6 0;3 &o - 95z - v /I2_ Signature Telephone SECTION 3 -ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building K (a) Building Permit Fee yoS?- , 00 2. Electrical (b) Estimated Total Cost of Construction from (6) 3. Plumbing Building Permit Fee Ye 0c 4. Mechanical(HVAC) 5. Fire Protection 6. Total =(1 +2 + 3 +4 +5) Ck 4(03 F.Ov Check Number a 7 ge This Section For Official Use Only �,-. f - /,f/� Date Building Permit Number: Issued: Signature: 6 ✓/'2Zj Building Commissioner/Inspector of Buildings Date Section 4. ZONING All Information Must Be Completed.Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size Frontage Setbacks Front Side L: R: L: R:, Rear Building Height Bldg. Square Footage Open Space Footage (Lot area minus bldg&paved parking) #of Parking Spaces Fill: (volume&Location) A. Has a Special Permit/Variance/Finding e er been issued for/on the site? NO 0 DONT KNOW YES IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW (X. YES 0 IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO O DONT KNOW YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained © Obtained Q , Date Issued: C. Do any signs exist on the property? YES © NO Gy- IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES © NO IF YES, describe size, type and location: E. Will the construction activity disturb(clearing, grading,excavation, or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES © NO (;) -- IF YES,then a Northampton Storm Water Management Permit from the DPW is required. SECTION 5-DESCRIPTION OF PROPOSED WORK (check all applicable) New House n Addition ❑ Replacement Wi ows Alteration(s) n Roofing n Or Doors Accessory Bldg. ❑ Demolition El New Signs (DI Decks [D Siding [0] Other[D] Brief De pgcription of Proposed ! 1L, Work: 6 eelov-t aAel i?e f(RCG yw,i4vAir ii.ke F+i ),4(t_ •✓'seees, S' c •„Q . Alteration of existing bedroom Yes ✓No Adding new bedroom Yes o 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 1t Two Family Other rwire GC^' b. Number of rooms in each family unit: ?f' Number of Bathrooms c. Is there a garage attached? ND d. Proposed Square footage of new construction. ,4/4- Dimensions //f e. Number of stories? 3 f. Method of heating? e1ee,fn C- Fireplaces or Woodstoves �`''4 Number of each N14 g. Energy Conservation Compliance. 7(5 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 Ki n1 Lk" q✓1 , as Owner of the subject property p hereby authorize W0 Ve-,)s+ (it TA, e. / E�k � /4-e-1.-t. Le-t� to act on my behalf, in all matters relative to work authorized by this ilding permit application. Signature of er Date , 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 Nam na of Ow A Date SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable 0 Name of License Holder: &vgeit /�uA C 1'...)So+a..r..... Cr7SL ^ C'DC /0 6 License Number e s k,i d. XerSe ode 6t w q - a g Z.0 Z.Z. Address v Expiration Datel 1-3 gC,i l o - Strec4 Ser4e(c1 ► v/r09 Signa re Telephone CC-).7 y/; _ 33c - 3qcb2- 9. Registered Home Improvement Contractor: Not Applicable 0 /6/$44 .deee f USiI ...c it 2_4t3P s Cornoanv Name Registration Number 1?.S3- I?as Gs {w,/ r2 1 f�-11.4- 6 A 3017 I of z z-�L 3 Address Expiration Date Telephone no-9s-2-cit t 2 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 buildin permit. Signed Affidavit Attached Yes No 0 11. — Home Owner Exemption The current exemption for"homeowners"was extended to include Owner-occupied Dwellings of one(1) or two(2)families and to allow such homeowner to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor.CMR 780, Sixth Edition Section 108.3.5.1. Definition of Homeowner:Person(s)who own a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official,on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. As acting Construction Supervisor your presence on the job site will be required from time to time,during and upon completion of the work for which this permit is issued. Also be advised that with reference to Chapter 152(Workers' Compensation) and Chapter 153 (Liability of Employers to Employees for injuries not resulting in Death)of the Mazsarhusetts General Laws Annotated,you may be liable for person(s) you hire to perform work for you under this permit. The undersigned"homeowner"certifies and assumes responsibility for compliance with the State Building Code,City of Northampton Ordinances,State an'iocal Zoning g Laws and State of Massachusetts General Laws Annotated. Homeowner Signature The Commonwealth of Massachusetts s Department of Industrial Accidents t‘L';--41 Office of Investigations Lafayette City Center } • 2 Avenue de Lafayette. Boston, MA 02111-1750 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Annlicant information Please Print Let'iblv Name 113ustness Organization individual):Home Depot USA. Inc. `T _ Address:2455 Paces Ferry Rd City/State/Zip:Atlanta r, a r Phone#:860-952.4112 Are you an employ rr'' ('heck the appropriate hot: Type of project(required): 1.0 1 am a employer with 4. I:un a t enend contractor and 1 b- j New construction employees(MI and.or part-time t."' have hired the sub-contractors 2,Q 1 am a sole proprietor or partner- These on the attached sheet. 7. Remodeling ship and have no employ These sub-contractors have 8. —I Demolition working for me in anyi employees and have workers' �' 9. 1 Building addition Veto workers' coop_insurance comp. insurance.: required.) 5. NI We axe a corporation and its 10.J Electrical repairs or additions 3.0 1 am a homeowner doing all work officers have exercised their i 1.j Plumabing repairs or additions myself [No workers' comp. right of exemption per MGL 12. Roof ors insurance required.] ' r. 152,*1(4),and we have no repairs o workers' 13-®Other Windows employees. [ comp. insurance required] •Any applicant that checks box#i must also fill out the section below showing their workers'connpeitsatiiun policy information. floetxoyners wlto submit this affidavit indicating they are doing all work and then hire outside ountractu s must submit a new affidavit indicating such. :Contractors that check this box mist attached an additional sheet'Smythe the name of the sub-contractors and state whether ur nut those entities have ertq'lo..tixs. If the sub-contractors hie empk. x,, they must pr<.vidie their c or$.cr, comp.pules number. I am an employer that is proi•idint►corAers'compensation insurance for my e'mplot'e=es. Below is the policy and job site taformation. Insurance Company Name:National Union Fire insurance Co. -- —^— Policy#or Sell-ins. Lie.#:X1NC 1647259 (OSI) (MA) Expiration Date:3/1/22 Job Site Address: q-2 130^rreit 5IY I city/State/zip:44/ l A /4/1 v t o E,t7 Attach a copy of the workers' compensation policy declaration page(showing the policy number and lrstion 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 tine 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. 1 do hereby cents•under the pains and penalties of-perjury that the information provided above is true and correct. Stbnature `` �" Date: (- e t — Ze L/ Phone#: 860-952-4112 . Official use only. Do not write in this area,to be completed by city or town official (etc or Town: Permit/License# Issuing Authority [check one): I LJBoard of Health 2J Building Department 3 ]Cityrrown Clerk 4.0Electrical inspector 5.[)lumbing, Inspector 6.0Other __.� Contact Person: Phone#: City of Northampton 212 Main Street, Northampton, MA 01060 Solid Waste Disposal Affidavit In accordance of the provisions of MGL c 40, S54, I acknowledge that as a condition of the building permit all debris resulting from the construction activity governed by this Building Permit shall be disposed of in a properly licensed solid waste disposal facility, as defined by MGL c 111 , S 150A. Address of the work: /54,,,e7y ciped, -?fin /if o/c6 The debris will be transported by: r ‘" The debris will be received by: M. - fir° USA- Building permit number: Name of Permit Applicant , C-Q 7/(- -Zfl- 24,z I Date Signature of Permit Applicant City of Northampton Massachusetts 4„s DEPARTMENT OF BUILDING INSPECTIONS � 212 Main Street . Municipal Building ,� Northampton, MA 01060 f• ,n. .{. ��`` INSPECTOR Louis Hasbrouck Chuck Miller Building Commissioner Assistant Commissioner HOME OWNER EXEMPTION ACKNOWLEDGEMENT The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to act as his/her construction supervisor. The state defines "Homeowner" as, " Person(s) who owns a parcel on which he/she resides or intends 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." The building department for the City of Northampton wants any person(s) who seek to use the home owner exemption, to act as their own construction supervisor, to be aware that by doing so you become responsible for compliance with state building codes and regulations. The inspection process requires that the building department be called to inspect work at various stages, which include foundation/footings (before backfill), sonotube holes (before pour), a rough building inspection (before work is concealed). insulation inspection (if required) and a final building inspection. The building department requires these inspections before the work is concealed, failure to secure these inspections can result in failure to obtain a certificate of occupancy until the work can be inspected. If the homeowner hires other trades to perform work(electrical, plumbing &gas) the homeowner will be responsible to make sure that the trades hired secure their proper permits in conjunction to the building permit issued, and that they get their required inspections. Failure of the individual trades to secure the permits and inspections as required can DELAY the project until such time as the proper permits and inspections are made I, 6 ci /4") understand the above. (Home owner/resident's signature sting exemption) I will call to schedule all required building inspections necessary for the building permit issued to me. Date - 2g - - - Address of work location 2-2, ,3a.rie J -7' /4/0/ t4dAcr4 444 /P / Go Permits, LLC 105 Buttonball Lane Glastonbury, CT 06033 PERMITS 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. Contact is Jason Timm 203-265-7037 • 72 Shaker Road, Unit 2 Enfield, CT 06082 (USA Hauling) • 32 Scotland Boulevard Bridgewater, MA 02324 (South Shore Disposal) • 12 Linscott Road Woburn, MA 01801 (ACME Waste Systems) • 535 Grand Army of the Republic Hwy, Somerset, MA 02726 (EZ Disposal) When filling out any solid waste affidavit, it's the installer whom will be removing the garbage and dumping the trash at one of the above Home Depot dumpster locations closest to that job. Thank you, Go Permits WINDOW SPECIFICATION SHEET - Spec.Sheet#: 1-1WL3OZEG Sheet: 1 of 1 Customer: Kim Urban Job#: 1-1WL3OZEG ConSUftarlt: Kyle Harmon Date: 08/20/2021 New Window — Existing Window Hinge Locations 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,A or S Glass Misc Items Hardware Code Screens For doors use E c c mp oP Mull "S"=stationary or t f E a) •13 1 a e "X"=operating 2 Style Wraps k 0 s tS d p o Room Floor Code _ (YIN) Style Coda Series Code_ $ _ x I—ai 8 > , _, > _ x STD,White, GlassPack: METAL, 1 BED1 1st 1 PNL Y 2 PNL 6100 WH WH 71 46 117 Standard WRAP,LSR X S STD,White, GlassPack: METAL, ' 2 BED2 1st 1 PNL Y 2 PNL 6100 WH WH 71 48 117 Standard WRAP,LSR X S STD,White, GlassPack: METAL, 3 LIV 1st 1 PNL Y 2 PNL 6100 WH WH 47 48 93 Standard WRAP,LSR X S STD,White, GlassPack: METAL, 4 LIV 1st SB-3P Y 3 PNL1/4 6100 WH WH 95 46 141 Standard WRAP,LSR NL SPECIAL CONSIDERATIONS: 1:White,2:White,3:White,4:White Wrap Color Interior Casing Type Bay or Bow window: Seatboard material(vinyl any-Birch or Oak) Bay Project Angie(30 or 45) Bay Flanker Type(DH,SH,or Camnt) 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: Seatboard Material(vinyl ony-White Plonite,Birch or Oak) e ' ome P epo - erma T a ue o •ro• ucts T anu actured by Simonton elm 4 Without Grids With Grids Style Glass Package Glazing Spacer 1G !1 SHGC ll 0.SHGC S S (all with Argon) Fact Fact C. 6500 ,wring 6500 Base ProSolar Supercept 7/8" 0.26 0.23 , • • • 0.26 0.21 • • • :asement 6500 Base ProSolar Supercept 7/8" 0.26 0.24 • • • • 0.26 0.22 • • • • ransom 6500 Base ProSolar Supercept 1' 0.27 0.32 • • 0.27 0.29 • • rouble-Hung 6500 Base ProSolar Supercept 7/8" 0.29 0.26 • 0.29 0.24 • • • Picture Casement (NH) 6500 Base ProSolar Supercept 7/8" 0.26 0.28 • • 0.26 0.25 • • • • Picture 6500 Base ProSolar Supercept 7/8", 0.27 0.29 • • 0.27 0.26 • • Panel Slider 6500 Base ProSolar Supercept 7/8" 0.29 0.26 • 0.29 023 • • • Panel Sliders 6500 Base(s 21 sglt) Pro Solar Supercept 7/8" 0.29 0.26 t, 0.28 0.23 e e a 500 DOORS Iarden Door(CH) 6500 Energy Star ProSolar SUN Super Spacer 1" 0.30 0.24 • • • • 0.30 0.21 • • • • Patio Door INOVO 6500 Base Pro Solar Super Spacer 1" 10.28 0.26 I•I el 10.31 0-23 I•I•I•I • r 1 00 Homes located everywhere EXCEPT:Arizona,California,Idaho,Nevada,New Mexico,Oregon,Utah,and Washington. wring(Inc Hopper) 6100 Base Pro Solar Intercept 7/8" 0.27 0.24 • • • • 0.28 0.21 • • • • :asement 6100 Base Pro Solar Intercept 7/8" 0.27 0.24 • • • • 0.27 0.22 • • • • rouble-Hung 6100 Energy Star Pro Solar Supercept 3/4" 0.30 0.30 • 0.30 0.27 k• • • Picture Casement(No Hinge) 6100 Base Pro Solar Intercept 7/8" 0.27 0.28 • • 0.27 0.25 • • • • Picture 6100 Base Pro Solar Intercept 3/4" 0.27 0.31 • • 0.27 0.28 • • Carrel Slider_..) •100 : Pro Solar intercept 3/4"S,•Q,30_)0.28 • 0.30 0.27 • Panel Slider 6100 Base Pro Solar Intercept 3/4" 0.30 0.29 • 0.30 0.27 • 100 Doors Homes located everywhere EXCEPT:Arizona,California,Idaho,Nevada,New Mexico,Oregon,Utah,and Washington. Patio Door INOVO 6100 Energy Star Pro Solar Super Spacer 1" 0.28 0.26 o a 0.28 0.23 • • •Patio Door NARROW FRAME 6100(PD05)Base Pro Solar Intercept 3/4"t 0.28 0.30 {o e 10.28 0.26 I •1 • •I } 6200 Homes located only In following markets:Dallas,Denver,Detroit;Phila,Northern NJ,Long Island,NY. ,wring 6200 Base Pro Solar SHADE Supercept 3/4" 0.27 0.25 • • •1• 0.26 0.23 • • • • :asement 6200 Base Pro Solar SHADE Supercept 3/4" 0.26 0.18 • • • • 0.29 0.17 • • • • Picture Casement-NH 6200 Base Pro Solar SHADE Supercept 3/4" 0.25 0.21 • • • • 025 0.19 • • • • Picture Window 6200 Base Pro Solar SHADE Supercept 3/4" 0.26 0.24 • • • • 0.26 0.22 • • • • jingle Hung 6200 Base Pro Solar SHADE Supercept 3/4" 0.28 0.23 _ • • • • 0.28 0.21 • • • ingle Slider 6200 Base Pro Solar SHADE Supercept 3/4" 0.28 0.23 _ _ • • • 0.28 021 •_ • • Panel Slider 6200 Base Pro Solar SHADE Supercept 3/4" 0.28 0.23 • • • 0.28 0.21 • • • -tormBreaker Plus 300VL Homes located in coastal areas. ,wning SB+300VL Energy Star PS SUN/Lami Supercept 1" 0.26 0.23 • • • • 0.26 0.21 • o •- o asement SB+300VL Base PS/Lami Super Spacer 1' 0.25 0.23 • • • • 0.25 0.21 • • • • ►ouble Hung SB+300VL Base PS/Lami Super Spacer 1" 0.29 0.25 • • • • 0.29 0.23 • • • • lider SB+300VL Base PS/Lami Intercept 1' 0.29 0.25 • • • _• 0.29 0.23 • • • • Patio Door SB+300VL ETC 366 PS Shade/Lami Super Spacer 1" 0.30 0.19 • • • • No Grids Allowed larder Door(CH) SB+300VL Base PS/Lami Super Spacer 1" 0.30 0.28 • • 0.30 0.25 el c 1`' 0 Dots indicate Energy Star certified for that zone Please Note: Simonton Windows may substitute East&West windows given the requirements of each order. rrr:4b; Home Improvement Agreement: Page 1 Home Depot License#'s -For the most current listing visit www.Homedepot.com/LicenseNumbers MA: 107774, 112785 Kyle Harmon Salesperson Name Registration#(Req. in CA,CT,ME,MD,MI,NJ,DC) Home Depot U.S.A.,Inc.("Home Depot") or Authorized 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. 1. Service Provider Contact Information The Home Depot The Home Depot Service Provider Contact Name Service Provider Company Name (203) 265-7037 Jcustomercanceilationnortheast@hom MA: 107774, 112785 Phone# Sg i°ceenvider Email Address Service Provider License#(s) 2. Customer Information Urban Kim New England West 1-1WL3OZEG Customer Last Name Customer First Name Store#/Branch Name Customer Lead/PO# 172 Barrett Street Northampton —1 MA 01060 Customer Address City State Zip I (413) 320-1864 ( brokerkimurban@gmail_com Home Phone# Work Phone# Cell Phone# Customer Email Address 3.NOTICE OF RIGHT TO CANCEL YOU MAY CANCEL THIS AGREEMENT WITHOUT PENALTY OR OBLIGATION BY CONTACTING THE SERVICE PROVIDER OR STORE DIRECTLY; EMAILING SERVICE PROVIDER AT: customercancellationnortheast@homedepot.com OR DELIVERING WRITTEN NOTICE TO HOME DEPOT AT: 1070 N. Farms Road, Unit 3 Wallingford (allingford CT 06492 Address City State Zip 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 0 OUR RIGHT TO CANCEL. Acknowledged by: 08/20/202 Cust er's Signature Date N' '�� 1 Home Improvement Agreement: Page 2 11, 4.Description of Work to be Performed A detailed description of the work to be performed is included in the paragraph entitled Scope of Work, Specification, Customer Summary Sheet, Quote Form, Estimate, Invoice or Measure which is included in this Agreement. 5. Anticipated Delivery Date/Installation Schedule Approximate Start Date: 02/16/2022 Approximate Finish Date: 03/18/2022 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. 6. 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. 7. 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: $ 4057.45 Includes all applicable taxes. Excludes finance charges.* Sales Tax: $ 0.00 (If applicable unt of taxes included in Contract Price) 1Iaxinaunt deposit ONLY a ieable in < iTJ, , 'VIE(33%), >4:I, RI(99%) Deposit% 125.0 I Deposit Amount 11014.37 I emaining Balance $ 13043.08 1 8.Finance Charges Any interest payments or other finance charges will be determined by Customer's separate cardholder or loan agreement, to which Home Depot is NOT a party, and will be in addition to Customer's payment under this Agreement. Customer is subject to the terms and conditions of the cardholder or loan agreement, as applicable. No funds should be made payable to Service Provider; however, Service Provider may collect Customer's payments made payable to Home Depot. 9.Acceptance and Authorization By signing below, you authorize Home Depot to: (a) arrange for Service Provider to perform any Services or (b) order and arrange for the delivery of special order merchandise, including special order merchandise that may be custom made, as specified in this Agreement. Do not sign if blank or incomplete. (Service Provider's or permitting information may need to be provided to You later.)By signing,you acknowledge that: (i)You have read,understand, and accept this Agreement in its entirety, including the General Conditions and State Supplement, if any; (ii) You are receiving a complete copy of this Agreement; (iii)all rights and interests under this Agreement are solely vested in the person listed as"Customer" above; and (iv)Electronic signatures will be deemed originals for all purposes. X 08/20/2021 Cu omer's Signature Date X /s/The Home Depot 08/20/2021 The Home Depot Digital Signature Date For questions related to your installation, contact Service Provider at (203) lb5-/Ud For any other concerns, contact The Home Depot at 1-800-466-3337 Scope of Work Urban Kim New England West 1-1WL3OZEG Customer Last Name Customer First Name Store#/Branch Name Lead# Job#: aster nc Products: Spec Sheet(s)#: Project Amount Reference) 1-1WL3OZEG s, Windows Entry Doors 1-1WL3OZEG 4057.45 Windows Entry Doors Windows Entry Doors Windows Entry Doors Windows Entry Doors Sales Tax 0.00 Total Contract Amount 4057.45 Notes: Warranty: The warranty on the work identified above is listed in the General Terms and Conditions, or if applicable, specified in the following documents: VantagePointe 6500-6100-6060 Warranty Warranty Name(s): • SO'44 The Home Depot General Terms & Conditions 1. DEFINITIONS: "Agreement" means (I) the Home Improvement Agreement between You and Home Depot, (II) the following listed documents, and (III) any documents referenced in or attached to any of the following listed documents: (a) any Change Orders; (b) the State Supplement, if any; (c) these General Terms and Conditions ("General Conditions"); (d) extended installation warranty documents, if any; and (e) the Scope of Work. "Defect" means any Services that are found to be non-compliant with manufacturer's installation instructions. "Home" means the real property, fixtures and any physical improvements where the Services are performed. "Services" means(i)the delivery and furnishing of goods, equipment, materials, and hardware; and (ii)any related labor and services, including without limitation, construction,consultation,fabrication, erection, installation, inspection, maintenance, repair, and testing. "Scope of Work" means a detailed description of work or Services to be performed, including, but not limited to, any quotes, schedules, invoices, specification sheets, proposals, confirmation emails or otherwise. "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"/"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, unsafe or, materially changes the Scope of Work. 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 will 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. The Home Depot General Terms& Conditions ..40. ,: 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("Change Order").A Change Order will 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 will 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 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.Home Depot may also ask for a change order in the event of errors or omissions in measurements or quantities used to determine the Contract Price. 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 will 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 will pass to You upon completion of the Services. 7. WARRANTY LIMITATION ON WARRANTIES AND DAMAGES: (a) Warranty: Unless otherwise stated in the Agreement, Home Depot warrants for 1 year from the completion date (the "Warranty Period") that all Services will: (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 discretion (I) correct or replace each Defect, (II) authorize the correction or replacement of each Defect; or (III) remove each Defect and refund all or a proportional amount of the Contract 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 in full as provided in this Agreement. Any warrantable corrections, replacements or repairs made in accordance with this Agreement will not extend the Warranty Period. (b) Limitation on Warranties: THE WARRANTIES PROVIDED IN THIS AGREEMENT ARE STRICTLY LIMITED TO THE FOREGOING EXPRESS WARRANTIES CONTAINED IN THIS PARAGRAPH IN THE WARRANTY SECTION OF THE AGREEMENT, 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 DEPOTS EXPRESS WARRANTIES ARE VOIDED FOR ANY DEFECT CAUSED BY ABUSE, MISUSE, NEGLECT, ACTS OF GOD, LACK OF PRESCRIBED OR STANDARD MAINTENANCE, OR IMPROPER CARF/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.(c)Limitation on Damages.Home Depot will not be liable to YOU for indirect, incidental, special, punitive or consequential damages RESULTING FROM PERFORMANCE OF THE SERVICES, including, BUT NOT LIMITED TO, damages for lost opportunities, OR lost profits. 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, hazardous, or unsafe conditions or conditions that materially changes the Scope of Work,then You will 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. The Home Depot General Terms & Conditions 9. CHOICE OF LAW: SEVERABILITY: This Agreement will 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 will 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. 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 will 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 Contract Price cannot be refunded unless Home Depot or Service Provider(1)incorrectly ordered item, or (2) damaged item beyond repair. Special or custom order merchandise may be returned, and a refund for all or part of the Contract Price provided, in the discretion of Home Depot. Please contact The Home Depot 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. 14. LEAD PAINT:Homes built prior to 1978 may require additional testing to determine if lead paint is present, and additional precautions if lead paint is present. You will be informed by Your Service Provider of any additional costs resulting from lead paint requirements prior to performing the Work. For additional information, visit www.epa.gov/lead/renovation-repair-and-painting-program, Go Permits, LLC 105 Buttonball Lane MM Glastonbury, CT 06033 rl�ERINIT 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. 4/22/23 Workers Comp.- Union Fire Insurance Co. Policy XWC 1647259 (QSI) (MA) Exp. 3/1/22 Eugeniu Ciubotaru of Exterior Remodeling is the sub-contractor. CSSL-106106 Exp. 9/29/22 HIC 187666 Exp. 5/9/23 Workers Comp.Associated Employers Ins. Policy WCC-500-5021510-2021A Exp. 1/17/22 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.orq • 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 A C)121, CERTIFICATE OF LIABILITY INSURANCE DATE PAINCI.YYYYy 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 INSURERIS), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL U1SURED,the policyties)must have ADDITIONAL INSURED provisions or be endorsed If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on thts certificate does not confer rights to the certificate holder in keu of such endorsements). PRODUCER CONTACT MARSH USA AC PHONAIL_ :1d0 ALLIANCE LAC ac N I FAX Na rns LAIC_NM 3560 LENOX ROAD SLI`E_53L EAMX. AT.MTA GA DDIM. ADDPPaa- TATUPEF.Z}AFFORDING COVERAGE NMC S 041C1 TEE-GOVis. q..r tN5..5EPA. OICIREFa e:;rsr Cc 25147 INSURED T M"JLLE T'£PL, 4fit'. INS-PER 8'.ACtI+Y emtcE Co 'i-'': HCJME DEPCT L.SA NC ttolL ER C ieR.4..-n e!rs_-rre f rea't 4 A 3135 PACES FEhRY RC1A3 INSURER D BU4.DHD C-20 ATLA TA.GA 31"9 INSURER E INSURER P COVERAGES CERTIFICATE MJYN3ER: A asse,2saa REVISION NUMBER: THIS IS TO CERTIFY THAT THE PO-IC.EC•OF INSURANCE LMTED BELOW HAVE BEEN 7D LIED TO THE INSURED NAMED ABOVE FOR THE DO..SCY PERIOD 'NDICATEO. NOTWITHSTANDING ANY REOJIREMENT,TERM OR CONDITION Of ANY CONTRACT OR OTHER DOCJMENT WITH RESPECT TO WHICH THIS' CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFDRDEC BY THE PCISCIES DECCRIBED HEREIN IS SUBJECT TO AU.THE TERMS. 5 _USIONSAND CONDITSCOND DR SUCH POL7CIE5.-iilRTS SHOWN MA`-tA.':E.-BEEN REDUCED BY PAID C._AIWS HSS TYPEr1F INSURANCEADD SCA9r1/ POUCT EFF POLICY EXP UNITS LTA r^ PIXY Nq,MeEP IMNara'reen 4Sf10Cefe YI A .SOMIERAAL OEN®FA,.LSABIL TY IA/ZY 31434 S5C 1:2059 0501 M,.,'^. EMI.O C.AREENCE 5 I.000.0:10 CL4ML4A&CE ri FREEVISE55 Ea ac_uTV:CS 5 1.000,000 - SR.St MC,GOa SRED ExP ORS one Sena, 5 EXCLUDED PERSONAL INN MLA:F,' S 1.00D_tOO GEHL AGGREGATE LSAT APFUES PER GENERN.A0ORSGATE 5 2,D00,000 .. ❑LAC PRODUCTS-COaRbPHOG 5 2.11X000 :WIER AUTCNIONIELNASRRY ►ANTB3145 3 0391t20I9 0.C'7. 2 WFASIFSED.s. SINGLEs 1DGc.000 ,,NY AUTO SELF mum Aura PHYCMG SCDIL";AUURYFercerse 5 —r OWNED c.HEA'JLEC WTi,5 ONLY AT'OS SCCILY,AtA4RY PerSacnent F -RED NON CANED FROPEW Y DAMAGE 5 , AJTD-s COW — A T-DE CNLT =sr Scud, ..MBIEL.A USE }>:tA FLAG.ODG-FIRENGE 5 �— E:•CEab LISS CLANG-/MCI AGGREGATE 5 ) )n_EN''. f 5 B WOOFERS CONWEI•SSTAIN WC 5$:40D5361l;, 330L2021 05±0'I= x ` 'JTF. AND EYPLD",E71 S UABL.,TY 5-tw �- e .A.cFxRIETORPNirEREXECu-.- '1✓JtCS"9F3.^53r'NC,'.A 130tD321 0 01 2 fEACiwAGCOENr S $A00,000 .c:GER/.E16ERFttf.;rec" I .•I N A 1Maneakey In*A Ca3rUec Dr AJID31Li Pile EL.DISEASE-EAEmPLOYEE S 5r0),0130 r m casette awe, SODOOOD DESCRIPT•3N CF Orisuir:aa OM1s ELAN SEASE-PCIICY.INR S C E>cestlatt: 23-11,101tGC202t 03R1,M2I a°sG',^7.2C 4,000,OOD A Eeess Genera_Late.. '.+.,Zi 9145B0 03/0t.2019 0,C.." .,-rl: &OOO I CESCRIPTON OF cieelATIoNs LOCATIONS VEMC LE I IACoCt 1St AaaRicra,Pafrareo SornW/IF,eMMaillaMMra more cps.a roc.,•ta1 E. _ACE OF ASLITANCE CERTIFICATE HOLDER CANCELLATION I-CIIE DEPOT USA,eiC SHOULD ANY Of THE ABOVE DESCRIBED POLICIES 8E CANCELLED BEFORE :455 PACES FEAR(ROPC THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED N BUIL)NG C-20 ACCORDANCE WITH THE POLICY PROVISIONS. ATLANTA,GIt30399 AUTHORIZEDPEARE5ENTATRE or Vann USA in; U3r Xor VJShe'C= MA'S ~ `- '-_ t r51988-2016 ACORD CORPORATION. AN rights reserved. ACORD 25(2016103) The ACORN name and logo are registered marks of ACORD AGENCY CUSTOMER D: CN101642066 LOC!: Atlanta AC-17)RD ADDITIONAL REMARKS SCHEDULE Page 2 of 3 AGENCY MAD INSURED NC CARRER "WC CCOE ERE:TyEDATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 2t, FORM TITLE: Certificate of Liabitty Insurance ATM,Cenaemet err C:rt-aec enter teamed,inwewcc Corpery of%at.le,Ema Dai+ev 4,mrber ALR C6'E25211'iA:.`R r,c,W,lG xriA.Alb.Y imer ILPan,ca,sc,so,m,wv.wv Sfiecc.e:Mt t3 1'0: Espaian ae:0io Ta Oilier AIL elswen r Ca Petty Number NC 023096002 IAA,.1x /IAND,HN e, Jmr 417} Eerestc r Gk 0301,22 EL;.24:SS CODDW :axe 145 A-,eeieenireeweeCempeq Y.mur*CU C6760S331 PM PA,LAWN Feu tie 2e4e 03S1t2821 Espeeten:oft 03U1,'2D2: ura SS O3 DX 3}R S13:C 0O: amt.4erre U-Fo-fie newarce Cyrwer. 4.roer WK.'SA S6iCSJ;ZCC.C7,14,iE,G1,Va`,OtiPitin) r_-+fem.e:fee DAI'1'C: pretax Cnt 03cii:Dz 1:1:....it Sl000DSC 3IR.$1 OW DCC Lane- :Eto-vicar;mare ce Server. Pmi y Wmber 111..R CE S'S'0 iAT EFecirveGk DIUr,' 3± Eweetem Gide 03UG?D Lj it t SSAODDOC Cater Ileneee Linen Fre Yrnrerce'Craen. oim 4e.meer RWC 164 ;CC iMO . Erectiwe Doe.03,O1ZD2t &peek;tie 0341 a.!in-it 14.500 DOC SIR SS00000 7X bmt eyees XS boles rty: CwrierlF+m i eq I WOMOR r Otrepeny PacyllnnYee T14S 05684s1172{TlC! Eifm m tame:0301 4 Empaloe t)ele-D3t11 YS (Eu imet s10 OX.:0D sat 1/POO,DDL; ACORD 101(2000101) ®2000 ACORD CORPORATION_ Al rights reserved. The ACORD name and boo 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 Registration. 112 78s HOME DEPOT USA INC Expiration• 04;2212021 P O BOX 105451 ATTN: LICENSE MGMT TEAM ATLANTA,GA 30348 Update Address and Return Card. tICA t 0 tern-03ri7 Office of Consusser Affairs b Puslneaa Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:S,ppferre-A Gard before the expiration date. If found return to: Registration Exz lretion Office of Consumer Affairs and Business Regulation 112785 r1&`<2!2C21 1000 Washington Street •Suite 710 HOME DEPOT USA INC Boston,MA 02118 Rh^,fiA320 OLMSTEAQ 2455 PACES FERRY RO C-11 MSC ATLANTA,GA 30339 Undersecretary Not valid without signature Office of Consumer Affairs and Business Regulation 1000 Washington Street- Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration 1 ype Carporabon Registration. HOME DEPOT USA INC 112785 Expiration. 0 P O BOX 105451 4;221023 ATTN: LICENSE MGMT TEAM ATLANTA_GA 30348 Update Address and Return Card. Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE. :.;urpera*r,n before the expiration date. If found return to: Registration Expiration Office of Consumer Affairs and Business Regulation ";I r E 5 a 22r2023 1000 Washington Street -Suite 710 HOME DEPOT USA INC Boston.MA 02118 COURTNEY A.HOWE 2456 PACES FERRY RD C-1 I ttSC 4/4004 ATLANTA GA. 30339 Undersecretary Not valid without striatum .�-""1 EXTER-2 OP ID:DM 4C )Ro Yrro CERTIFICATE OF LIABILITY INSURANCE DATE 21 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 INSURERS), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(les)must be endorsed. It SUBROGATION IS WANED.subject to the terms and condttions of the policy,certain policies may require an endorsement. A statement on this certificate does not Confer rights to the certificate holder In Neu of such endorsernent(s). PRODUCER "ACT Debbie Marino Canary Blomstrom Ins.Agency FAIL 8ti8 Springfield SC EaYI-413-769-399:i 1 IArc,Not 413-758-7004 Feeding hills,MA 01030-2151 E ms.dmarinoecartarybkanstrom.com , auISRERtII AFFORCRIO COVERAGE AMC a siguRER A.Associated Employers Ina.Co. INSURED Exterior Remodeling Group Inc. usmut a:Main Street America Group 29939 Eupeniu Ciubofaru 23 Benham St INSURER C. Springfield,MA 01109 usuRER 0: MEURERE. 1fSGRER f.. COVERAGES CERTIFICATE NUMBER: 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 WHlf>1 THIS CERTIFICATE MAY BE MCI IED CR MAY PERTAIN.THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LASTS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS LTRR TYPE OF*DURANCE AISSO AM. POLICY NUS LINTS B OORINERCIM GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 I CLAMS-MACE a cLA. X tIPP337Sw 07r27/2020 07YLT12021 DAAWGE roRET{rEU 1 500,000 X Business Owners PREMSES,Eau TrucaH LIEDEtY iI+Y� ao�Pr i 1 10,000 --- PERSONAL A AD,NARY 1 1,000,000 GENT AGGREGATE LAOT APPLIES PER. GENERAL,AGGREGATE s 2,000,000 �� PROOUC'TS-COPJPOP LOG l 2,000,000 x POUCY©IE T OTHER 1 /AROrDaLE t IAauf► -CCIAR E I SINGLE UMR t 1,000 000 IEi acuORK r B ANY AUTO NPP33T$W 071272020 BODILY INJURY.Pr WNW, 1 ALL DANED V�.$'.EDUCE❑ ' autos AUTOS BODILY DAIRY XGdOMi S hkiED AUTOS AvyasI1NEL� PROPERTY 61LAGE t J AUTDS 1Par actalarti V UMBRELLA LAB OCcUta r1 EACH OCCURRENCE I E]ICES113{AB J S-MMLDE AGGREGATE S .7ED 1 1 RETENTION; - S WORKERS MIDEMPLOYERS'UA!nY I STATUTE 1 X 1 ER A FAYPR7PRfETCR,FIPTIVEREXECUTFSE ElmiA WCC•500-1021510,2021A 01H712021 01/17/2022 Ei,Lev;ACCIDE►IT { 500.000 OFFICER.A,ENEERExCLUCEOT L.._�' Qland.Hore in sop E 1.DISEASE-EA ELIPLOYE'F1 1 300.,000 D ktoC RCPT'IIH'rO PERATTpS OYHa EL Ot.EABE-PODGY WAIT f 500,000� DESCRIPTION OF OPERATIONS I LOCATIONS!VEHICLES IACOaO Let,Adeaaoatl RrnrLs SdrdNtr,ray La NurMd I rra span Y ntfWtll Home Depot U.S.A.Inc is named as Additional Insured respects to General Liability. CERTIFICATE HOLDER CANCELLATION HOMEDE4 SHOULD ANY OF THE ABOVE DESCRIBED POLICES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELNERED IN Home Depot U.S.A Inc ACCORDANCE VON THE POLICY PROVISIONS. 2455 Paces Ferry Rd C-11 Atlanta,GA 30339 AUTHORIZE()REPRESENTATIVE ,tbv L rY)t LA.a 1 . C 111/8-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marls of ACORD Thr(Moil Webs*of She Clrecrame Ofroce of EOHED the tin or Pirefelmormft pore NM NNe rpveitorr of Manama:Is 1.111raill Iftw,v10 Public Safety Mass. . . Licettsee Details DenwAiraPhie Information Full Name: EUGENtil CIUBOTARU Owner Name: License Address Information . City. Springfle10 Slate. MA Z.V.403e. 01109 Country, United Stales License Information .Kense No Profession issue Date Secondary License Type Doing Business As. CSSL-106106 Status Change Reason License Issuance License Type 4BAdciti2Iclivt2eingoitiscerises Date of Last Renewal 9C/r4,2struch020°D Supervisor Specialty Expiration Dale Today's Date 9/29,2022 License Status: 9/16,2020 -- Prerequisite Information Licensee CIUSOTARU EUGENIU Relationship Attribute Of License No CSSL-106106 NO Avallattle Documents Close 4Modow 1.4.!.`i;. • ' .' • . . , . MASSACHUSrTTS 'Li Ditli,61% '..ri.. • •- ,,, ,—- ....mom., LICENSE 4nt- • ,. 1......1 • -•.; .. . * is f'•-.',- , - • . - . ' ' • t. - tile,,,.4.1.:—,);..1.,,,,*, - ....-- .- . ,• . ....- . k r., .4,!....—„1-7, •44.4 _ ‘ JOUNEER 'le 4114 Zip' y;.--..... 09/1512016 . -s4543160 - ‘,..-rz. ....,v1r,k. „k.' _„..•. '" 'isosatms, sa.int- -7 sa Euzi s I-1 ‘.4 1 ' ".",;•.• •••%•!..4• 41'' ':: r • -' 1 '•'i4 •4-, :. N: . ' - '''' r—.:15.......e,t—, ..,-. -• - . ‘,.....,,,- • - : 1 i 5 , , .1zEUGNII) '•• - i i ,•I ••,t, • II • .: = •.,• --;, ,.. -;,=:a 23 BENHAM STREET ' -',•-• i % - .,.. , . -..,2;r:-..-1. SPRINGFIELD,MA 01109-2301 • --,,,--A. - ;:349.e715---7-7---"HsSEx M 14 tiGT 6'-02" 1 - _ . ' - 09/2 : _-:-,•...i.::::,_._—_ 51:0 091612016 Rev 02/2320i6 S _ .... Ottite 0/Consume,iMfairs and Business Regulation 1000 Washington Street State 710 Boston Massachusetts 071/8 Home irorove*-ienlContraktor FlegtStr Kt #14,0 -4 r E‘ Pie,TE.40.114 REMJCELNOtAouP 414314,, A .0vcs 2J Elf.V.INA SPROX*Cli MA 01 444.4 inroddla,Address and fl444444n Cad. 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