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25A-066 (2) BP-2022-0637 46 HUBBARD AVE COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 25A-066-001 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-2022-0637 PERMISSION IS HEREBY GRANTED TO: Project# WINDOWS Contractor: License: Est. Cost: 13188 HOME DEPOT USA INC 106106 Const.Class: Exp.Date:09/29/2022 Use Group: Owner: WAGMAN COTE, KEVIN G. &ALISA, M. Lot Size (sq.ft.) Zoning: URB Applicant: HOME DEPOT USA INC Applicant Address Phone: Insurance: 2455 PACES FERRY RD NW 860-952-41 12 WC 06588608(AOS) ATLANTA, GA 30339 ISSUED ON:06/06/2022 TO PERFORM THE FOLLOWING WORK: 16 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: Final: Final: Final: Rough Frame: Gas: Fire Department Driveway Final: Fireplace/Chimney: Rough: Oil: Insulation: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: - • . Fees Paid: $91.00 212 Main Street, Phone(413) 587-1240,Fax:(413)587-1272 Office of the Building Commissioner — Department use only • --RECEIVED City of Northampton Status of Permit: Building Department Curb Cut/Driveway Permit 212 Main Street Sewer/Septic Availability JUN - 3 2022 Room 100 Water/Well Availability Northampton, MA 01060 Two Sets of Structural Plans DFPT. e 13-587-1240 Fax 413-587-1272 Plot/Site Plans OF BUILDING,1NSPECP i°' NORTHAMPTON.MA 01060 Other Specify APPLICATION TO CONSTRUCT,ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION This section to be completed by office 1.1 Property Address: LA. UrAdi, � �� � Map A— Lot 5(( i7 Unit Nor e/olgAn 44 ©J 060 Zone Overlay District Elm St.District CB District SECTION 2 -PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: KGu i n 1(6 71A4,10 b*•-d ,4 vetsN-e• f, Name rint) Current Mailing Address: 0/060 C, " 'i t3 .sue 4/0a z Telephone tur 2.2 Authorized Agent: 6e'a c/ Z. 64/r,*C, j t— /oS At Al 41( La 4 z 6/as4i Cr Name(Print' I Current Mailing Address: Q6 o f 3" 860 - `KZ - V//Z Signat 4 ,r / Telephone SECTION 3 -ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building l/ 3/ ee 4a (a) Building Permit Fee 2. Electrical a (b)Estimated Total Cost of Construction from (6) 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection 6. Total = (1 +2+3+4+5) ( / 3 f ST 00 Check Number ` 20✓a This Section For Official Use Only � Building Permit Number' 'O 37 Date Issued: Signature: /i�/27 G-G-ZOZZ 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 ver been issued for/on the site? NO Q DONT KNOW YES Q IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO Q DON'T KNOW er YES Q IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO Q DON'T KNOW er YES Q IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Q Obtained Q , Date Issued: C. Do any signs exist on the property? YES Q NO Or IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES Q NO l J IF YES, describe size, type and location: E. Will the construction activity disturb(clearing,grading,excav on,or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES Q NO IF YES,then a Northampton Storm Water Management Permit from the DPW is required. SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Wjst�ows Alteration(s) n Roofing n Or Doors [� Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [IL) Siding[0] Other[0] Brief Description of Propos d ,�elac - / /) /-` `' Work: Q„�►� � �{//i► / / // i /f0 ���u�� Alteration of existing bedroom Yes No Adding new bedroom Yes ✓ No U Attached Narrative Renovating unfinished basement Yes ✓No Plans Attached Roll -Sheet o�� • . 3 a 6a. If New house and or addition to existing housing, complete the following: a. Use of building : One Family Two Family Other b. Number of rooms in each family unit: Number of Bathrooms c. Is there a garage attached? d. Proposed Square footage of new construction. Dimensions e. Number of stories? f. Method of heating? Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction i. Is construction within 100 ft.of wetlands? Yes No. Is construction within 100 yr. floodplain Yes No j. Depth of basement or cellar floor below finished grade k. Will building conform to the Building and Zoning regulations? Yes No. I. Septic Tank City Sewer Private well City water Supply SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1, �I//4 , as Owner of the subject property hereby aut •rize "4 ,I.1 LS /eria/ �JC�tsev�i!/IZ� to act on /beha in all matters relative/to war thorized by th(({s building permit application. V�� - . ' ` " 4 � 6 - t- - �vv� Signa-e of• er Date I, VC/k /v C/• ( /'�!i✓ � ,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. Gns L, ("ramie 274— Print Name Signatu of Owne t C / Date SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: L , �'mfr�'/tr✓"/ Not Applicable 0 Name of License Holder: e'^�G/i S i C. 44 h4,T�' /1�44/0� C s S L- — a6/o G License Number z3 /jtnha., .% Strod- Sir, ,ud r oI/aq g_ 29— 2z Addre Expiration Date aturf tle:9(7,-"di Telephone 9.Reaistered Home Improvement Contractor: Not Applicable 0 *me. Dro/ us4 /!2 9 Company Name // Registration Number 2YSc , acs ICi� ,' i �14'% 64 7033i co— 22-z3 Address v� Expiration Date Telephone 64O -95.1-502. SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152,§25C(6)) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building ermit. Signed Affidavit Attached Yes C� No ❑ 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 Massachusetts 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./ ocal on'.• Laws and State of Massachuse General Laws Annotated. Homeowner Signature r 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. Y b /.46 ha.J Address of the work: /tor N / A- /060 The debris will be transported by: I.,vr Lstoefrk)---7 The debris will be received by: .u-4er.9 ( Gfs��•�—� Building permit number: Name of Permit Applicant 6e,iv /1 C, ��.r�ri' ✓� Date Signature of Permit Applicant The Commonwealth of:ilassaehusetts i c D portment c f Industrial Accidents i��;,�., Office of Investigations ; 7 • Lafayette City Center 2 Avenue de Lafayette. Boston, MA 02111-!750 wwyt:mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/('ontractorsiEleetricians/Plumbers Applicant Information Please Print Legibly Name 4liusinessiOrganttation Individual': Home Depot USA Address: 2455 Paces Ferry Road (_ icy/State L:p: Atlanta, GA 30339 f'Ii,>n. 860-952-4112 %re s.ou an employer? ( heck the appropriate box: l ype of project(required): t. . I am a employer with_ •4 )0X lam a general contractor and 1 employees(full and.;or part-time).* have hired the sub contractors h. New construction 2 . I am a sole proprietor or partner- listed on the attached sheet. 7. , Remodeling ship and have no employees These sub-contractors have S. Demolition workingfor me in any capacity. employees and have worker, 9. Building addition [No workers' comp. insurance comp. insurance.: required.] 5 We are a corporation and its 10 , Electrical repairs or addition:, , . I am a homeowner doing all work officers have exercised their 11. Plumbing repairs or addition, myself [No workers' comp, right of exemption per MGL Roof repairs insurance required.] ' c. 152, v 1(4).and we have no employees. [No workers' 13.XX Other window replacement comp. insurance required.] 'Arty applicant that checks lox 41 must also fill out the section below showing their workers'compensation pol icy information. t Homeowners who submit this affidavit indicating they arc doing all work and then hire outside contractors must submit a new aflidas it indicating such. Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not these entities hay e employees. lithe sub-contractors have employees.they must provide their ssurkcrs'comp.policy number. I aver an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance company Name: AIU Insurance Company Policy#or Self-ins. tic. WC 065886028 (AOS] Expiration Date:_. 3/1/2023 Job Site Address: 7‘ t�ihd/d Atm C'ity-State Zip: /( 41 a 244 /1"14" O/0 c U Attach a copy of the workers' compensation police declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1.500.00 and-'or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature. Phone • 860-952-4112 Official use only. Do not write in this area. to be completed by city or town official City or Tow n: Permit/License # Issuing; Authorits (check one): ILJBoard of Health 2❑Building Department 3fCitv1`Tow n Clerk 4.0 Electrical Inspector 5r iiumbin Inspector 6.QOther Contact Person: Phone#: City of Northampton r yj',�',r,irJ. S,S._. , V ., Massachusetts �4, �' t\,_, '.C. • DEPARTMENT OF BUILDING INSPECTIONS 1 F p� ► P 4 ,. .. ot �..-� 212 Main Street • Munici al Buildin -)ti � Northampton, MA 01060 �J'FW 3':,\\,` 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 ins%ctions are made I, w/ 4e understand the above. ( ome o / ident's sig requesting exemption) I will call to schedule all required building inspections necessary for the building permit issued to me. Date ‘ -Z - 2v2. 2 Address of work location W 440?-e/ J '-e--- /i/°�&2rap ,1 f4/19" Dlo 6 o Go Permits, LLC 105 Buttonball Lane 60'_ 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. • 72 Shaker Road, Unit 2 Enfield, CT 06082 • - ' : • = • 1 -var• 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 Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and,if necessary, supply sub-contractor(s) name(s), address(es) and phone number(s) along with their certificate(s) of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary) and under"Job Site Address"the applicant should write "all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 1 Congress Street, Suite 100 Boston, MA 02114-2017 Tel. # 617-727-4900 ext 7406 or 1-877-MASSAFE Revised 7-2013 Fax# 617-727-7749 www.mass.gov/dia WINDOW SPECIFICATION SHEET - Spec.Sheet#: 1-1Y4ZP69H Sheet: 1 of 2 Customer: KEVIN COTE Job#:1-1Y4ZP69H Consultant: Ronald Engelbrecht Date: 04/11/2022 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 c To =° c 1e Mull "S"=stationary or 4. Style Wraps g o, u_ m `o m o g H o To E Y N "X"=operating H ap m t7 c r r Room Floor Code (V/N) Style Code Series Code P. w 3 xm 5 H of _ U 0 -J > I -J > x STD,White,TMP:Full, WRAP,LSR 1 KITCH 1st SB-DH Y DH 6100 WH WH 24 38 62 S, WH,W C TOP 2 1 GlassPack:Standard GBG H STD,White, GlassPack: WRAP,LSR 2 KITCH 1st SB-DH Y DH 6100 WH WH 24 38 62 S, WH,W C TOP 2 1 Standard GBG H STD,White, GlassPack: WRAP,LSR 3 KITCH 1st SB-DH Y DH 6100 WH WH 24 38 62 S, WH,W C TOP 2 1 Standard GBG H STD,White, GlassPack: WRAP,LSR 4 LIV 1st SB-DH Y OH 6100 WH WH 32 54 86 S, WH,W C TOP 2 1 Standard GBG H STD,White, GlassPack: WRAP,LSR 5 LIV 1st SB-DH Y DH 6100 WH WH 32 54 86 S, WH,W C TOP 2 1 Standard GBG H STD,White, GlassPack: WRAP,LSR 6 LIV 1st SB-DH Y DH 6100 WH WH 32 54 86 S, WH,W C TOP 2 1 Standard GBG H STD,White, GlassPack: WRAP,LSR 7 BED 1st SB-DH Y OH 6100 WH WH 32 54 86 S, WH,W C TOP 2 1 Standard GBG H STD,White, GlassPack: WRAP,LSR 8 BED 1st SB-DH Y OH 6100 WH WH 32 54 86 S, WH,W C TOP 2 1 Standard GBG H SPECIAL CONSIDERATIONS: 1:Everest,2:Everest,3:Everest,4:Everest,5:Everest,6:Everest,7:Everest,8: Everest Wrap Color Interior Casing Type Bay or Bow window: Seatboard 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: Seatboard Material(vinyl only-White Pionite,Birch or Oak) WINDOW SPECIFICATION SHEET - Spec.Sheet#: 1-1Y4ZP69H Sheet: 2 of 2 Customer: KEVIN COTE Job#: 1-1Y4ZP69H Consultant: Ronald Engelbrecht Date: 04/11/2022 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,R or S - Glass Misc Items Hardware Code Screens For doors use x - = c Mull "S"=stationary or w Style Wraps 'm .� co `o z id c�q r • "X"=operating H Room Floor Code (YIN) Style Code Series Code = ui 3 = 5 -ai 8 o. x > x� > _ STD,White, GlassPack: WRAP,LSR 9 MBED 1st SB-DH Y DH 6100 WH WH 32 54 86 S, WH,W C TOP 2 1 Standard GBG H STD,White, GlassPack: WRAP,LSR 10 MBED 1st SB-DH Y DH 6100 WH WH 32 54 86 S, WH,W C TOP 2 1 Standard GBG H STD,White, GlassPack: WRAP,LSR 11 UTIL 1st SB-DH Y DH 6100 WH WH 32 50 82 S, WH,W C TOP 2 1 Standard GBG H STD,White, GlassPack: WRAP,LSR 12 UTIL 1st SB-DH Y DH 6100 WH WH 32 50 82 S, WH,W C TOP 2 1 Standard GBG H STD,White, GlassPack: WRAP,LSR 13 UTIL 1st SB-OH Y DH 6100 WH WH 36 46 82 S, WH,W C TOP 2 1 Standard GBG H STD,White,TMP: WRAP,LSR 1 BATH 1st SB-DH Y DH 6100 WH WH 24 38 62 S, WH,W C TOP 2 1 Bottom, GlassPack: 4 GBG H Standard STD,White, GlassPack: WRAP,LSR 15 BSMT Basem BH Y BH 6100 WH WH 31 13 44 Standard ent STD,White, GlassPack: WRAP,LSR 16 BSMT Basem BH Y BH 6100 WH WH 31 13 44 Standard ent SPECIAL CONSIDERATIONS: 9:Everest,10:Everest,11:Everest,12:Everest,13:Everest,14:Everest,15:Everest, 16:Everest Wrap Color Interior Casing Type Bay or Bow window: Seatboard 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: Seatboard Material(vinyl only-White Pionite,Birch or Oak) The Home Depo hermal Value of Products Manu '. ured by Simonton Without Grids With Grids Style Glass Package Glazing Spacer IG U SHGC U SHGC (all with Argon) Fact Fact 6500 Awning 6500 Base ProSolar Supercept 7/8" 0.26 0.23 , 0 0 0.26 0.21 II 0 011 Casement 6500 Base ProSolar Supercept 7/8" 0.26 0.24 c c c 0.26 0.22 ©u �• R-gyp _ _ . _ __ _ _-,n Transom 6500 Base ProSolar Supercept 1' 0.27 0.32 c 0.27 0.29 a Double-Hung 6500 Base ProSolar Supercept 7/8" 0.29 0.26 = I 0.29 0.24 Picture Casement (NH) 6500 Base ProSolar Supercept 7/8" 0.26 0.28 0 c r 0.26 0.25 0 0 0 Picture 6500 Base ProSolar Supercept 7/8" 0.27 0.29 c ^ 0.27 0.26 0 0 0.26 �'°�1 '°L 2 Panel Slider 6500 Base ProSolar Supercept 7/8' 0.29 0.29 0.23 o c 0 3 Panel Sliders 6500 Base(_21 Sqft) ffi Pro Solar Supercept 7/8" 0.29 0.26 _ I 0.28 0.23 0 0 0 6500 DOORS Garden Door(CH) 6500 Energy Star ProSolar SUN Super Spacer 1" I 0.30 0.24 1 0 I 0 I 0 I C 0.30 0.21 Patio Door INOVO 6500 Base Pro Solar Super Spacer 1" 0.28 0.26 0 c 0.31 0.23 ' c 6100 Homes located everywhere EXCEPT:Arizona,California,Idaho,Nevada,New Mexico,Oregon,Utah,and Washington. Awning(Inc Hopper) 6100 Base Pro Solar Intercept 7/8" 0.27 0.24 0 0 0 0 0.28 0.21 �:=,a._ Case It . _ ^t Base Pro Solar Intercept 7/8" 0.27 0.24 ii 0 MD 0.27 0.22 c ouble-Hung .6100 Energy Star Pro Solar Supercept 3/4' -0.30 r 30 ^ 0.30 0 27 Bement(No Hinge) 6100 Base Pro Solar Intercept 7/8" 0.27 0.28 0 0 0.27 0.25 0 _ 0 Picture 6100 Base Pro Solar Intercept 3/4" r ' 0 c 0.27 0.28 -I ^I 2 Panel Slider 6100 Base Pro Solar Intercept 3/4" 0.30 0.28 0 0.30 0.27 1 L . 3 Panel Slider 6100 Base Pro Solar Intercept 3/4" 0.30 0.29 I 0.30 0.27 I I I 6100 Doors Homes located ever where 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 0.28 0.23Hof,' - . 0.26 0 f0.28 ._ Patio Door NARROW FRAME 6100(PD05)Base Pro Solar Intercept 3/4•' 0.28 0.30 0 0 0 26 6200 Homes located on/yin following markets:Dallas,Denver,Detroit Phila,Northern NJ,Long Island,NY. Awning 6200 Base Pro Solar SHADE Supercept 3/4" 0.27 0.25 I© 0 I 0 0 0.26 0.23 c 0 0 I 0 Casement 6200 Base Pro Solar SHADE Supercept 3/4" 0.26 0.18 0 0 0 0 0.29 0.17 0 c 0 0 Picture Casement-NH 6200 Base Pro Solar SHADE Supercept 3/4" 0.25 0.21 0 01 - 0 0.25 0.19 0 0 0 0 1 Picture Window 6200 Base Pro Solar SHADE Supercept 3/4" 0.26 0.24 0 otil 0 0 0.26 0.22 0 0 0 0 Single Hung 6200 Base Pro Solar SHADE Supercept 3/4" 0.28 0.23 0 0 ' 0 0.28 0.21 o n o Single Slider 6200 Base Pro Solar SHADE Supercept 3/4" 0.28 0.23 II MI 0 0.28 0.21 I 0 c 0 3 Panel Slider 6200 Base Pro Solar SHADE Supercept 3/4" 0.28 0.23 • 0 I a 0.28 0.21 I 0 0 0 Storm Breaker Plus 300VL Homes located in coastal areas. Awning SB+300VL Energy Star PS SUN/Lami Supercept 1' 0.26 0.23 o 0 c• 0 0.26 _0.21 1 0 0 0 t c Casement SB+300VL Base PS/Lami Super Spacer 1' 0.25 0.23 0 011 0 0 0.25 0.21 0 0 -" 0 Double HungSB+300VL Base PS/Lami S 0 0 Super Spacer 1" 0.29 0�25 0 0 0.29 0.23 °.�.�Ls::. .°_ Slider SB+300VL Base PS/Lami Intercept 1" 0.29 0.25 0 0 2 - 0.29 0.23 c> ' Patio Door SB+300VL ETC 366 PS Shade/Lami Super Spacer 1" 0.30 0.19 0 0 c 0 No Grids Allowed Garden Door(CH) SB+300VL Base PS/Lami Super Spacer 1" 0.30 0.28 10171 1 10.30 0.25 I - I I -.I •Dots indicate Energy Star certified for that zone Please Note:Simonton Windows may substitute East&West windows given the requirements of each order. 1 Home Improvement Agreement: Page 1 Home Depot License#'s -For the most current listing visit www.Homcdcpot.com/LiccnscNumbers MA: 107774, 112785 [Ronald Engelbrecht 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 customercancellationnortheast@hom MA: 107774, 112785 Phone # gem cecrrovider Email Address Service Provider License#(s) 2. Customer Information COTE KEVIN New England West 1-1Y4ZP69H Customer Last Name • Customer First Name Store#% Branch Name Customer Lead/ PO# 46 Hubbard Avenue Northampton MA 01060 Customer Address City State Zip (413) 586-4032 mosleywags@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 Wallingford 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 OF YOUR RIGHT TO CANCEL. Acknowledged by: 04/11/2022 Customer's Signature Date 460 Standard Form HIA(21 Jul.21)(E) Generated Date D4./11/2022 Lead'POi 1-1 YaZ P691-1 ` D 1 12 Home Improvement Agreement: Page 2 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: 10/08/2022 Approximate Finish Date: 11/07/2022 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: $ L3188.31 Includes all applicable taxes. Excludes finance charges.* Sales Tax: $ o.00 (If applicable,total amount of taxes included in Contract Price) '`ila imum deposit ONLY applicable in MD, MA, ME(33%), NJ, WI(99%) Deposit% 25.0 Deposit Amount$ 3297.08 Remaining Balance $ 9891.23 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 04/11/2022 Customer's Signature Date X /s/The Home Depot 04/11/2022 The Home Depot Digital Signature Date For questions related to your installation,contact Service Provider at (203) For any other concerns, contact The Home Depot at 1-800-466-3337 Lbb-/Vd/ 460 Standard Joan t11A(21 Jul.21)(El Generated Date na,11/2022 Lead It 1=1Y4Z269H.. " - � Scope of Work .'..,V•. COTE KEVIN I New England West 1-1Y4ZP69H Customer Last Name Customer First Name Store#/Branch Name Lead Job #: (Internal Products: Spec Sheet(s)#: Project Amount Reference) 1-1Y4ZP69H Windows Entry Doors 1-1Y4ZP69H 13188.31 Windows Entry Doors Windows Entry Doors Windows Entry Doors Windows Entry Doors Sales Tax o.00 Total Contract Amount 13188.31 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: !Simonton 6100 Warranty Name(s): .0/ 46O Standard Form 111A(21 Jul.21)(E) Generated Date 71r2022 Lead,TO" 1-1Y1.7P6.9H_.. 40,� 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. 440 Standard Form IIIA(21 Jul.21)(E) Generated Date fl1� �2022 11 Lead'PO 1-1Y4ZP69H ` 01'2 L., ~ The Home Depot General Terms & Conditions 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 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.(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. 460Stand dFormNA(21Jul21)(El Generated Date fd/11/2022 Lead'PDu 1-1Yd7P69H _ "" 12 •" ,,� 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_ na/11 4(O Standard Form 111A(21 Jul.21)(E) Generated Date /2Q72 Lead'POtt 1-1YAZ p69H 1`1.12 Go Permits, LGC) L..0 105 Buttonball Lane _ Glastonbury, CT 06033 PERMITS 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.- AIU Insurance Co. Policy WC 065886028 (AOS) (MA) Exp. 3/1/23 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-500-5021510-2022A Exp. 1/17/23 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(c�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 ACORON DATE iMMI COY'YYY. CERTIFICATE OF LIABILITY INSURANCE C_232J 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 POUCIES 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 INSURED,the policyfies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsenent(s1. PRODUCER ;CONTACT MARSH USA INC PHONE TWO ALLIANCE UNITY HrP �ay_Ful aA.L•N;l. 3552 LENOX ROAD SUITE 24EE EMA%L ATLANTA GA 30326 ADDRESS INSURERS:AFFOROi4G COVERAGE NAIC a CNIC'6/2:1V9*i9r�cC_GAA 2225 NSURERA.Oa I i:,Jc Ir..:a at�.1 21147 INSURED INSURER B.New hens j l re Its Ca 23'A ' HOAE DEPOT,INC HOME DEPOT U.SA.INC. NSu75ER C.ACE An!e•rarr I'rwse eurym,H 2266- 2455 PACES FERRY ROAD NS IAER D. BUILDINGC-2C ATLANTA,GA 30339 NSURER E. s INSURER F COVERAGES CERTIFICATE NUMBER: ATL Cc'-"'::_s REVISION NUMBER: S THIS IS TO CERTIFY THAT THE POLICES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FLIR THE POLICY FERIOD 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 PCLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, M IR TYPE OF INSURANCE DL 1UBH POUCY EFF POUCY EXP LTRMNBD WYD, POLICY NUMBER IN11payYYY5,IMMrgp1YYYYL. UNNTS A X COMMERCIAL.OBIERAL I LARA fry MSTI 3166.19 03,E.2322 C3E122 5 Ec4`H oCCJP--.SNCE s 'Sr '• CLAIMS-MACET>rt'4.Nt D +AL"iE iJ�iENTE P MISES Ma•XLSOINICti I X SR.61,000 OIX NEC EXP Ary cnaj*:avoni I .. •--, PERSONA:S AEA INAIRY I r GEHL AGGREGATE LVIT 4=*h,E PE F, { GENERAL ACICAEGA E I :r- �X a'COCY a -Cr:: FiOD�._z ::,__ 23, OTI4FJR A AUTOMOBIEEMIIUTY MW16316649 D3E.It= 03151t23325 CeM6.C:.'tt',aLE,,,,,- �i, 1 D}?CC'- IEa a:wan s ..,....,,.. X ANY ALTO BODILY IN-UR"'',Kr or sx, $ ^OWNED -SeiNEDLj.--L SELF NSURED A_'TC PHY:NG _ . AUTOS ONLY , AUTOS B7DI,' V-t F-. .,,. MRED NON-OWILE'_• INIOPCATY CAVAJ.E --.. - AUTOS ONLY AUTOS OILY IPar•i.c.Iottr i A UMBRELLA AJAR A O MWZX 3166+4T EACHOCCURRENC.I DTCt'iJ22 LYIrT112a2o X EXCESS LUIS „LA'NS..M4DE 4.3:3RE:r.1•7 - B WORKERBCOINPENBATION NE16E486029 W'i C3A"2 372 D3,31'2Q23 X I STATUTE I W RY AND EMPLOYERS'UABlLnY C. M ipDFREICR NFTNER•ECECUT'E Y/N WLR C�16439.Ai.IL 0 VR23V 03(01'2723 EL EACH*CCIDE',^ S 5"J: CC CFFICEPS.*VEER EXCL,-UEC-' ElNIA Mandstoryhlllll r.EL DISEASE-EAE'.'F,.:.v. i ---`-'-C. Ir a ,1N4C I uilfler Lr't _re il`i A6CR•Clul'Pairy ' DESCRIPTON OF OPERATIONS ANON E OIS AYE ' , -- I DESCRIPTION OF OPERATIONS LOCATIONS,VEHICLES(ACORD 101.AaiEK+na R••nu 4..x SCNaaulo.nay Do nracOad I more opacN it.►gdnA EVIDENCE•CS NSURANCE CERTIFICATE HOLDER CANCELLATION -10 4E DEPOT JSA NC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 2455 PACES FERRY ROAD THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN BUILDING C-20 ACCORDANCE WITH THE POLICY PROVISIONS. ATLANTA GA 30339 AUTHORIZE D REPRESENTATIVE I7itaz..14 ZtS:,4 lore. C.1988-2016 ACORD CORPORATION. All nghts reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: CN101642069 LOC N. Atlanta AC+C7RLf ADDITIONAL REMARKS SCHEDULE Page 2 of 3 AGENCY VAR°,-USA ,tAIEDE=c _54. ha_ aovKYNtlalaEA 2155?ADESrERRY ROAD E..ILpIM3 c 23 AT_ANT_A GA CAAAIEW NAK COOS 33339 EFFECTNE DATE ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM. FORM NUMBER: t5 FORM TITLE: Certificate al Liability Insurance '031.ers Core Crrrruc Cam"-it 2m my Inatome Company of hullo Mora %HU Nano WLR 0689164$3 IALAR.FLID,MKS,I(Y!AMMO NO NE NM ND 015SC.SD TN YAWA14..6Y3 Eltevs.e Date 3361 2022 Eepraior.Sete 3t 2D23 ;EL;Lot 5503C.300 Came.AU ew:once Co Poky%atar WC 065896328 ADS, IM 03 DCDE Ni N MA M POMPOM'PAA1.VT E1Yehm Dab 01012C22 Espralon tote 0361,2023 tELI lane S5000.300 Corner ACE Meson iwlmoe Conaar% Pdq Itntar.WOJ C68916te8 rOSIl ICAOR N'A: Enloe Derr 034012C22 Emotion Oak:O11112021 {ELI Umt{4.OE0.000 SIR 61.03C30 Caner Manna ikon gym:°rou,r,oe CanWwN Pallor N.nter%*C 1617323 t i;,:CT_GA.►9.NV OMUT; Platte Da*630311022 Erpralon Cate:0.1312C23 ELI Irk 64.O30.31 S1R31.000.000 SIR ICTk$16D 000 SIR IGAl:S75O000 Tx Employers XS Indeeeetr Canter Shwa Univ.lrevanm Calmly %Icy Natter TNSC66691036 ;Txe Eiisceee SHE 2SA12O22 Swaim Oar.01011C23 ELF Lime 56.000.300 jIF 07c..3C6 ACORD 101 f 2008'01► E)2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo 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 0 BOX 105451 Expiration. 04/222023 ATTN: LICENSE MGMT TEAM ATLANTA.GA 30348 Update Address and Return Card- Mice of Consumer Affairs&eus4»ss%Oyuietion HOME IMPROVEMENT CONTRACTOR Registration valid for Individual use only TYPE:Supplement Cara before the expiration date. If found return to: jtddlon Exaltation Office of Consumer Affairs and Business Regulation 112785 04122J2023 1000 Washington Street -Suite 710 HOME DEPOT USA INC Boston,MA 02118 RICHARD OLMAS''EAD 2455 PACES FERRY RD C-11 HSC ATLANTA,GA 30339 Undersecretary Ot valid wtthou signature --....—ris EXTEREM-Oi MARGIE' "A C.t7R,fl CERTIFICATE OF LIABILITY INSURANCE ATE 1�19120 9/20•Y;Y �--^y 22 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 INSURERISI,AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,me potkyiles)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements PRODUCER T Deborah Marino Canary BIDRrlstrom PHONE Emi 7504022 $ r FAx Ac,"61(413 786-7004 Hills. 030 diOarin canrblomtrom.com INSURERISI AFFORDING COVERAGE NAIL* NeURERA.NGM Insurance Co. . INSURED HADRE.RII Associated Employers Insurance Company 11104 Exterior Remodeling Group Inc- INSURER C 23 Benham St 6 NSufiEli;I.,_ ._... Springfield,MA 01109 ._.. .. .__..._.. .._..._._ ...._.____....---_—_. ...... INSURER E. INSURER 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 WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFTOROED BY THE POLICES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS NMIR ADM_PISURANCE BUM POLICY NUTABER POLICY EFF POLICY EXP Laws NBD IMNO _amp.•. aYt]D+,rryn A I X cotemacUL GENERAL LIABILUTY _ 1,000.000 Fa I. +-CUPRENCE �S �___. CLAIMS-MADE ocrx rt MPP3376W 7(2712021 71712022 HI E:I AIN'T"F . L 500.000 ,µEG EAT' ,.+1c.41 a.,1: 10.D00 PERSON .&AD' m1_'RY _ 1,000,000 CARL ADDREC.ATE LsVIT A.PIASPER GENETIAL AGGREGATE S 2,000.000 X PO-ICY 0 7,AF4. ❑:)= PRODU TS,-ccr/r 9x. ,..i..._.. 2,000.000 DTHEE t I A AUTOMOBILE Luaa,Tr I CCfaeNED SrNCLE_SPIT 1.000.000 AN,'Auto — MPP33TSW 7r27,12021 7127i2022 Fr3DiLY t4+CRY=e'i,+•'.. _ -- OWNED S:nEDULSO AUTOS ONLY ,Y`TOS BDDIL Y INJURY.=c<4.,, _ , X..�.�y��� pCINy....��yyi��F� AUT�Da CNLY X At:ITD TOR P4;DPERTY„XMAG.,. S UMBRELLA LAB OCC,R EACH:.CURREtA4E ,4 ^EXCESS LAB CLAANS•MADE ASCIRE.CATE_ S ZED I I RETENTION S S B -WOPIIERE COMPENSATE* g OTHm AND EMPLOYERS LIABILITY X STAT}jjg ER - AA.a�+-1FRIEiI:R,�PaFTNEE1tECUTh,E YIN WCC-500-5021510-2022A 1i1712022 1117/2023 E E I:14..A-CIDEsT s S00.000 IIYRa R11 MI+MI EISCLLOE:3" N'A 500.000 E. LE4:IL c:.E..4,1 C..E� IeCRIP+LOt O OPERATIONS beo. E DISEASE 6JICY JAR, S 500.000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES AGGRO let.AddlhAne Ramrh►E *odd ma.be ambIha mom*WV if mo space rip .Iulw-,,an Horne Depot U.S.A.Inc.is named es Additional Insured With respects to General Liability CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPiRATIOR THEREOF, Home Depot U_S.A.Inc ACCORDANCE WITH TTHE POLICY PROVISIONSGE WILL BE DELIVERED IN 2455 Paces Ferry Rd C-11 Atlanta.GA 30339 ___ --------- AUTHORIZED REPRESENTATIVE ACORD 25(2016/031 II 1908-2015 ACORD CORPORATION. All rights reserved. The ACORO name and logo are registered marks of ACORD . .._... - - -- • MASSACHUSETTS `- ,- DRIVER'S _.---, ....--.--., - LICENSE --152217:4-71 ---7-`ne •:. --, •• ,.. • %- S4543160 t4t134,9ER ,,,,,„,,, , 091291198 ,-... I . ‘. ---- . TU RU:-L'' .,:: : . 4 . .-, - • .i - ' ;'_EUGENILI' , , .,', -.. , 23 BENHAM STREET - .-- •-' -., i -• -; ....-'' ,, SPRINGFIELD,MA 01109.2301 . _ '.'SEX M 1 A T 6'412" 1-. . . .. - ... . - wisr2im Rev 02i72'7216 09/2,c gin c om mo()wealth of Massactiusen$ 19 Division of Professional Licensure Board of Building Regulations and Standards ,Construction SuperViSor Specialty CSSL -106106 Expires. 09q292022 EUGENIU CIUBOTARU 23 BENHAM STREET SPRINGFIELD MA 01109 1 ti 6 0 ' • • .-,, •.; Commissioner IIP 4 Construction Supervisor Specialty Restricted to: CSSL-WS -Windows and Siding Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation ot this license. For information about this license Call (6171 727-3200 or visit www.rriass,govidpi Of frce o'Consu.gor Afars and Bosoess Regulator tatxt Washasiton Strreu Stark-,/to Boston Massactrusens t.,21ttt Homo rtrry-.vorient Contra tor rierp;ir Itsa, EA riAQP FIEMOCELA,AI.X'LP N, SPC.114..iFiinkle:f•-)9 ... -__ IMAM Menem XT1 R4.11110 CAA. SAPoe 4,crummy MIMI 4 Illierfear Ileguaesef MOW 1110010iMMOIT CoomtAcTo4 moswara.velli M.Marodurt um MN T14.1 Cettereferl 404.e th**30.4041110V14 0 iNSINd moot,41 /44114/144048 Lialcallan c.",ve 0 0:10...0,AitINti 4.14 6.4on44•1%velour, WOK ...44.4.41514 'Kla reMamMem Sin.ei x'E MiC1R FiiiKt,t,thirs7.4100P 04," 1624101 MA Mill "..,, E f,'.4,1,111,0-6RA ',V1,1X i ttt,1 NO4 v4061,rerthote sidinatur4 • i etz.,,eq n to acuzi,...6„,„ authortze(io Fermits ILLl., topmi permits using my C6 License ii I 0( I 0 6 aria my HIC Registration# I 3 66 6 . A ry lucstions please call me at: (Li I 3 ) 3 ...._3 57.3 7 0 9 InStaller ;31w....... t-ompany Nail', ,R,_ - ok. 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