Loading...
18C-100 (3) BP-2023-0770 23 GLEASON RD COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 18C-100-001 CITY OF NORTHAIVIPTON Permit: Alts Renovations Repair PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit # BP-2023-0770 PERMISSIO IS HEREBY GRANTED TO: Project# WINDOWS 2023 Contractor: License: Est. Cost: 1081 HOME DEPOT USA NC 106106 Const.Class: Exp.Date: 09/29/202 Use Group: Owner: R GORDON JOHN H&AUTUMN Lot Size (sq.ft.) Zoning: URB applicant: R GOR N JOHN H& AUTUMN Applicant Address Phone: Insurance: 23 GLEASON RD NORTHAMPTON, MA 01060 ISSUED ON: 06/12/2023 TO PERFORM THE FOLLOWING WORK: REPLACEMENT WINDOW 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: ' • I Fees Paid: $65.00 212 Main Street,Phone(413)587-1240,Fax (413)587-1272 Office of the Building Commiss ner E C EIVET---) The Commonwealth of Massa use s J N 1 2 2023 tf Board of Building Regulations an Sta rds 'OR Massachusetts State Building Cod , 78 w1UN IPALITY N.Or EUll DINrz INSPECTION USE Building Permit Application To Construct,Repa , T Demob*k'bso l�evis d Mar 2011 One-or Two-Family Dwelling This Section For Official Use Only Buildin Permit Number�I ..3-+ 7 0 L' Date Applied: f / UIL ' 1`O�s //�/G_ V"/zzoz3 Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 PropertyAddress: 1.2 Assessors Map&Parcel Numbers 2-3 6 I CQ.Soal ted 1.1a Is this an accepted street?yes ono Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public 0 Private 0 Zone: _ Outside Flood Zone? Municipal 0 On site disposal system 0 Check ifyes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 wnerIA 41f #1 ord: G D rcid✓. it4,4#tysV..7 4A AM D l 66 O Name(Print) City,State,ZIP 23 61c4a0.1 Ad c43- -59i a F el on e,NI4•).w., No.and Street Telephone Email Address/ SECTION 3:DESCRIPTION OF PROPOSED WORK'(check all that apply) New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units__ Other I]I.Specify: Bri f Description of"posed ork': Is".144 //e I 6,.. a.6., 1;0' .• Z 7. SECTION 4:EST ESTIM ED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ to k40 1. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical $ 0 Standard City/Town Application Fee . ❑Total Project Costa (Item 6)x multiplier x 3. Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ 'List: 5.Mechanical (Fire 4 Suppression) $ Total All Fees: r ' p Check No. 41 heck Amount. 1.) Cash Amount: 6.Total Project Cost: $ (d 0 /,1U 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) /•106/p 6 Z j Z y Cj I44• C l u Ivo biro.. License Number Expiration ate t Name of CSL Holder w 2 3 �CnhaM s�Gt List CSL Type(see below) No.and Street �j J /�/J Type Description (J rl n l/ /C /'l Q /O f� U Unrestricted(Buildings up to 35,000 Cu.ft.) C! ! / R restricted 1&2 Family Dwelling City/TIwn,Stat ,ZIP M asonry RC oofing Covering rS , Window and Siding �7 SF Solid Fuel Burning Appliances Yi3.33e-�ai pool a.5,0iper045.0, I Insulation Telephone Email afldrells D emolition 5.2 Registered Hope I�rgvement Contractor(HIC) r 5 Zz 2�` ys/1►G_p •t. ,ur.CX'11 J.d�[._ HIC egistration Number E iration Date HI Com Name or PIIC Registrant Name Co_ P's fir K o,,4 .errt•h C� ,Ko75. 00 No.and t eeet .Z Email dress �c 6� 3dsf9 go)-5S2 '`111 City/Town,State,ZIP Telephone SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152.§ 25C(6)) Workers Compensation Insurance affidavit must be completed and submitted wiflt this application. Failure to provide this affidavit will result in the denial of the Issuance of the building permit. Signed Affidavit Attached? Yes ❑✓ No ❑ SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,as Owner of the subject property,hereby authorize to act on my behalf,in all matters relative to work authorized by this building permit application. Print Owner's Name(Electronic Signature) Date SECTION 7b:OWNER1 OR AUTHORIZED AGENT DECLARATION By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information contained in this application is true and accurate to the best y knowledge and understanding. gercLa C4 e - - 6 — ° z-3 Print Owner's or Authorized Agent's Name(Electronic ig e) Date NOTES: 1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration program or guaranty fund under M.G.L.c. 142A.Other important information on the HIC Program can be found at www.mass.gov/oca Information on the Construction Supervisor License can be found at www.mass.govidps 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) (including garage,finished basement/attics,decks or porch) Gross living area(sq.ft.) Habitable ro¢m count Number of fireplaces Number of bedrooms Number of bathrooms Number of balf/baths Type of heating system Number of decks/porches Type of cooling system Enclosed_ Open 3. "Total Project Square Footage"may be substituted for"Total Project Cost" City of Northampton NG Si Massachusetts k DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building Northampton, MA 01060 .p3N,+. ).°� CONSTRUCTION DEBRIS AFFIDAVIT (FOR ALL DEMOLITION AND RENOVATION PROJECTS) In accordance of the provisions of MGL c 40, S54, a condition of Building Permit Number is that all debris resulting from this work shall be disposed of in a properly licensed waste disposal facility, as defined by MGL c 111, S 150A. The debris will be disposed of in: /AL ` Location of Facility: 2- Sh4&e-i' R00'd G � 6a� Z The debris will be transported by: Qrt,i"-, Cif(A, oJ "- Name of Hauler: E?► ioroE I12cfrL- C4 t k7 Signature of Applicant: Date: ��� t 3 The Commonwealth of Massachusetts Department of Industrial Accidents ' Office of Investigations Lafayette City Center 2 Avenue de Lafayette, Boston,MA 0 111-1750 www mass.gov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual):Home Depot USA, Inc. Address:2455 Paces Ferry Road City/State/Zip:Atlanta GA 30339 Phone#:860-952-4112 Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. © I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have 8. 0 Demolition working for me in any capacity. employees and have worke 9. ❑Building addition [No workers' comp.insurance comp.insurance.: required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised the' 11.0 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152,§1(4),and we have no 13 ®OtberWindow Replacement employees. [No workers' comp.insurance required.] *My applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:Indemnity Insurance Company of North America Policy#or Self-ins.Lic.#:WLRC50668058 Expiration Date:3/1/2�0ja�24 Job Site Address: 2-3 1/1.4�5 0 ^ lie "t/ p //TL' � City/State/Zip:: f d 0 40 Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature: Date: � to ' t3 Phone#: 860-952-4112 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(check one): 1112Board of Health 20 Building Department 3,OCit /Town Clerk 4.0 Electrical Inspector 50Plumbing Inspector 6.0Other Contact Person: Phone#: 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. • 72 Shaker Road, Unit 2 Enfield, CT 06082 • 32 Scotland Boulevard Bridgewater, MA 02324 Gallant Moving & Storage • 375 Airport Drive Worcester, MA 01602 Euro-American Worldwide Logistics • 12 Linscott Road Woburn, MA 01801 Silvas Transport Inc • 50 Maria Ave Johnston, RI 02919 Vito's Express Thank you, Go Perm its ■Ita i 101IITa Pl- • • 1=I04W-F-1 av l itr'•3 i iii•T[1Tg iviFT ITT ENOTZ 161W • i • )ated: 5130/2: J 1 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 Ile" 0.26 0.23 • • Q 0.26 0.21 II • • 0 :asement 6500 Base ProSolar Supercept 7/8" 0.26 0.24 • • 0 0 0.26 0.22 0 • • ransom 6500 Base ProSolar Supercept 1' 027 0.32 • • 0.27 0.29 • • Iouble-Hung 6500 Base ProSolar Supercept 7/8" 0.29 0.26 • 0.29 0.24 0 • • 'icture Casement (NH) 6500 Base ProSolar Supercept 7/8" 0.26 0.28 • • 0.26 0.25 • • • m 'icture 6500 Base ProSolar Supercept 7l8" 0.27 0.29 • • 0.27 0.26 • • Panel Slider 6500 Base ProSotar Supercept 7/8" 0.29 0.26 • 0.29 0.23 0 0 0 Panel Sliders 6500 Base(s 21 Sgtt) Pro Solar Supercept 7/8" 0.29 0.26 •I 0.28 0.23 • 0 • 500 DOORS larden Door(CH) 6500 Energy Star ProSolar SUN Super Spacer 1" 10.30 0.24 I•I•I 0 I •10.30 0.21 I•I•I •I • 'atio Door INOVO 6500 Base Pro Solar Super Spacer 1" 0.28 0.26 • • 0.31 0.23 0 • 0 0 r 1 00 Homes located everywhere EXCEPT:Arizona,California,Idaho,Nevada,New Mexico,Oregon,Utah,and Washington. ,wning_(Inc Hopper) 6100 Base Pro Solar Intercept 7/8" 0.27 0.24 0 • • • 0.28 0.21 • • 0 • :asement • 6100 Base Pro Solar Intercept 7/8" 0.27)024 • • • • 0.27 0.22 • • • • ouble-Hung 6100 Energy Star Pro Solar Supercept 3/4" 0.30 0.30 • 0.30 0.27 • e • 'icture Casement(No lingo) 6100 Base Pro Solar Intercept 7/8" 027 0.28 • • 0.27 0.25 • • • • 'icture 6100 Base Pro Solar Intercept 314" 0.27 0.31 • • 0.27 0.28 0 • Panel Slider 6100 Base Pro Solar Intercept 3/4" 0.30 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. 'atio Door INOVO 6100 Energy Star Pro Solar Super Spacer 1" 0.28 0.26 0 • 028 0.23 Q Q C • 'atio Door NARROW FRAME 6100(P005)Base Pro Solar Intercept 3/4" 0.28 0.30 0 • 0.28 0.26 0 0 6200 Homes located only in following markets:Dallas,Denver,Detroit,Phila,Northern NJ,Long Island,NY. ,wning 6200 Base Pro Solar SHADE Supercept 3/4" 0.27 0.25 • 0 I a 0.26 0.23 m 0 I :asement 6200 Base Pro Solar SHADE Supercept3/4" 0.26 0.18 • 0 1 • I 1 � 0.29 0.17 • o I c: c 'icture Casement-NH 6200 Base Pro Solar SHADE Supercept 3/4" 0.25 0.21 • 0 • 025 0.19 • 0 0 0 'icture Window 6200 Base Pro Solar SHADE Supercept 314" 0.26 0.24 • • • • 0.26 0.22 • • • • ingle Hung 6200 Base Pro Solar SHADE Supercept 3/4" 0.28 0.23 _ • • _ • • 0.28 0.21 • • • angle Slider 6200 Base Pro Solar SHADE Supercept 3/4" 0.28 0.23 _ a a • 0.28 0.21 • • 0 Panel Slider 6200 Base Pro Solar SHADE Supercept 3/4" 0.28 0.23 0 • a 0.28 0.21 0 0 0 tormBreaker Plus 300VL Homes located in coastal areas. ,wning SB+300VL Energy Star PS SUN/Lami Supercept 1' 0.26 023 • • • • 0.26 0.21 •1• • • :asement SB+300VL Base PS/Lami Super Spacer 1' 0.25 0.23 • • • • 0.25 0.21 0 0 • m louble Hung SB+300VL Base PS/Lami Super Spacer 1" 0.29 0.25 • • • • 0.29 0.23 • 0 • 0 lider SB+300VL Base PS/Lami 1" 0.29 0.25 • • • • _.-- _____..-......__ Intercept 0.29 0.23 0 • 0 m 'atio Door SB+300VL ETC 366 PS Shade/Lami Super Spacer 1" 0.30 0.19 CI • • • N o G n a s A,I wed _ iarden Door(CH) SB+300VL Base PS/Lami Super Spacer 1' 0.30 0.28 Q Q 0.30 0.25 01 0 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. WINDOW SPECIFICATION SHEET - Spec.Sheet#: 134529581 Sheet: 1 of 1 Customer: AUTUMN GORDON Job#: 134529581 Consultant: Chad Minton Date: 06/03/2023 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 # V = c Mull "S"=stationary or m Style Wraps d d rn nco `o `-�' .t "X"=operating Li, X O T O c0 O - O O N O (= Room Floor Code (Y/N) Style Code Series Code E w 3 x 5 1—ai U o- > x _, > x STD,White, GlassPack: WRAP,LSR 1 BSMT Basem AWN- Y BH 6100 WH WH 32 15 47 Standard ent ALDER SPECIAL CONSIDERATIONS: 1:White 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) 1 Home Improvement Agreement: Page 1 Home Depot License#'s-For the most current listing visit www.Homedepot.com/LicenseNumbers MA: 107774, 112785 Chad Minton 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# §gam c�ctSvider Email Address Service Provider License #(s) 2.Customer Information GORDON AUTUMN New England West F34529581 Customer Last Name Customer First Name Store #/Branch Name Customer Lead/PO# 23 GLEASON RD Northampton MA 01060 Customer Address City State Zip (413) 896-5989 ahrgordon@gmail.com Home Phone# Work Phone# Ccli 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 —I 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 UR RIGHT/if�CANC Acknowledged by: 06/03/2023 Custo is Signature Date 460 Standard Form MA(21 Jul.21)(E) Generated Date 06/08/2023 Lead PO F34.529581 v 0112 , 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: 11/30/2023 Approximate Finish Date: 12/30/2023 All dates are approximate and subject to change based on unforeseen events including incleme t 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 c mmunications related to this Agreement. By contacting your Service Provider,you may update your email address, ithdraw your consent,or obtain a paper copy of the Agreement or related documents at no charge. By providing y ur consent and verifying your email address above, you confirm that you have access to a computer that can receiv 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: $ 1081.00 Includes all applicable tax s. Excludes finance charges.* Sales Tax: $ 0.00 (If applicable,total amoun of taxes included in Contract Price) *Maximum deposit ONLY applicable in MD,MA, E(33%), NJ, WI(99%) Deposit % 25.0 Deposit Amount S 270.25 Remaining Balance S [810.75 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 Se ice Provider to perform any Services or (b) order and arrange for the delivery of special order merchandise, incl ding special order merchandise that may be custom made, as specified in this Agreement. Do not sign if blank or ' complete. (Service Provider's or permitting information may need to be provided to You later.)By signing,you ac owledge that:(i)You have read,understand, and accept this Agreement in its entirety, including the General Cond tions and State Supplement, if any; (ii) You are receiving a complete copy of this Agreement; (iii)all rights and int rests under this Agreement are solely vested in the person listed as"Customer"above; and(iv)Electronic signatur will be deemed originals for all purposes. X 06/03/2023 Cust er's Signature Date X /s/The Home Depot 06/03/2023 The Home Depot Digital Signature Date For questions related to your installation,contact Sery ce Provider at (203) For any other concerns, contact The Home Der of at 1-800-466-3337 265 'o,57 460 Standard Farm FHA(21 Jul.21)(E) Generated Date $• $C I Leam" F 34 529 581 Scope of Work ► K GORDON AUTUMN New England West F34529581 Customer Last Namc Customer First Name Store#/Branch Name Lead # .lob #: Products: Spec Sheet(s)#: Project Amount Rclerrncel F34529581 Windows Entry Doors F34529581 1081.00 Windows Entry Doors Windows Entry Doors Windows Entry Doors Windows Entry Doors Sales Tax 0.00 Total Contract Amount 1081.00 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): 460 Standard tarn HL\(21 Jul.21)(E) Generated Date I. • a Lead/PON F3a52958.1 v 0.1.12 4" '` The Home Depot General Terms& Conditions A. 1. DEFINITIONS: "Agreement" means (1) 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 w anty documents, if any; and (e) the Scope of Work. "Defect" means any Services that are found to be no -compliant with manufacturer's installation instructions. "Home"means the real property, fixtures and any p sical improvements where the Services are performed. "Services"means(i)the delivery and furnishing of go ds,equipment,materials,and hardware; and (ii)any related labor and services,including without limitation,co struction,consultation,fabrication,erection, installation,inspection,maintenance,repair,and testing."Scope o Work"means a detailed description of work or Services to be performed, including,but not limited to, any quo es, 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. " ork Area"means any property,buildings,or structures necessary for the staging, temporary storing and perfo ance 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 with.ut causing damage to Your Home,provided, however, that Home Depot or Service Provider will not start or c•ntinue 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 specific.I ly contracted to do so, neither Home Depot nor Service Provider is obligated to repair such pre-existing bazar•sus 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 m=y delegate or subcontract any obligations or Services hereunder without Your consent. This Agreement will n.t be assigned by You without first receiving Home Depot's written consent,which may be denied in Home De•ot's sole discretion. 4. YOUR RESPONSIBILITIES:(a)Payment:You agree to pay Hom Depot in full for the Services pursuant to the terms of this Agreement. (b) Safe Access: You agree to provide H•me 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)provi ing all utilities,including without limitation, power,water,ventilation and climate control,in and for the Work A ea;(7)removing from and protecting against minors, pets, guests and visitors in the Work Area; (8) keeping ermits, if required, visible at all times; (9) disengaging,suspending or terminating any security systems prote ting the Work Area;(10)providing adequate temporary storage space as needed for Home Depot's or Service Pr ider'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. 460 Standard hand tttn(21 Jul.21)(E) Generated Date •. •e 1 Lead/PO# F34.5,9581 V 0.t.12 Oti ,S The Home Depot General Terms&Conditions 5. MODIFICATIONS AND CHANGE ORDERS: Without invalidati g this Agreement,You may authorize Home Depot or Service Provider to perform Services beyond the scope of he Agreement("Change Order").A Change Order will be issued by Home Depot or Service Provider on beha f of Home Depot, which You may accept by signing.Upon Your signing of the Change Order,it will become pa 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 con•'tions that impact, impede or otherwise cause the Work Area not to have Safe Access, Home Depot may immed ately ask for a Change Order or discontinue the Services without further obligation to You. Home Depot may al o ask for a change order in the event of errors or omissions in measurements or quantities used to determine the I ontract 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 y 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 Servic- Provider will pass to You upon completion of the Services. 7. WARRANTY LIMITATION ON WARRANTIES AND DAMA I ES: (a) Warranty: Unless otherwise stated in the Agreement, Home Depot warrants for 1 year from the ompletion date (the "Warranty Period") that all Services will: (i) be performed with good workmanship .nd (ii) conform to the requirements of the Agreement. During the Warranty Period and within a reasonabl• time after receiving notice from You of a warranty claim, Home Depot may, at its sole discretion (I) co ect or replace each Defect, (II) authorize the correction or replacement of each Defect; or (III) remove e;ch Defect and refund all or a proportional amount of the Contract Price thereof to You;provided, however, that all warranties are voided if(I) anyone other than Home Depot or Service Provider performs work u.•n or otherwise modifies any materials or Services provided under this Agreement; or (2) You fail to p• Home Depot in full as provided in this Agreement. Any warrantable corrections, replacements or repai . made in accordance with this Agreement will not extend the Warranty Period. (b) Limitation on War anties: THE WARRANTIES PROVIDED IN THIS AGREEMENT ARE STRICTLY LIMITED TO TH FOREGOING EXPRESS WARRANTIES CONTAINED IN THIS PARAGRAPH IN THE WARRANTY S CTION OF THE AGREEMENT, IF ANY. YOU ACKNOWLEDGE AND AGREE THAT NO OTHER W•.RRANTIES ARE MADE OR GIVEN BY HOME DEPOT OR SERVICE PROVIDER,INCLUDING ANY ARRANTY FOR FITNESS OF PURPOSE, WARRANTY OF MERCHANTABILITY,OR ANY OTHER ORA ,EXPRESS OR IMPLIED WARRANTIES. HOME DEPOT'S EXPRESS WARRANTIES ARE VOIDED F o R ANY DEFECT CAUSED BY ABUSE, MISUSE, NEGLECT, ACTS OF GOD, LACK OF PRESCRIB;I OR STANDARD MAINTENANCE, OR IMPROPER CARE/CLEANING. ANY MANUFACTURER'S ARRANTIES PROVIDED FOR GOODS, MATERIALS, OR EQUIPMENT WILL BE PASSED THROUG BY HOME DEPOT TO YOU, AND YOU AGREE TO LOOK SOLELY TO SUCH MANUFACTURER F•R REMEDY OF ANY DEFECT IN SUCH GOODS, MATERIALS, AND EQUIPMENT. HOME DEPOT AY 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 Dep a t terminates this Agreement because You fail to provide Safe Access to perform the Services,or if either party to inates the Agreement because You decline a Change Order request resulting from unforeseen,hazardous,or safe conditions or conditions that materially changes the Scope of Work,then You will pay Home Depot for Se ices provided through the date of termination plus any costs or expenses incurred by Home Depot or Service Pre ider as a result of the termination. 460 Standard Faun 111A(21 Jul.21)(E) Generated Date I I LeadiPOst F34529581 v o.1.12 1 �4 The Home Depot General Terms& Conditions 16. 9. CHOICE OF LAW; SEVERABILITY: This Agreement will be go erned by and interpreted in accordance with the laws of the State where the Project is physically located. The arties intend for the terms and conditions in the Agreement to be complementary,consistent,and enforceable u der applicable laws. In the event any term or condition in the Agreement violates applicable law, such term or c ndition will be severed from the Agreement, but only to the extent necessary to avoid such violation,without i validating 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 ora or written. No course of dealing, usage of trade, course of performance, course of conduct, or any other evi ence 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 ecurity interest is placed on Your property, it creates a lien, mortgage, or other claim against Your property to s cure payment and may cause a loss of Your property if You fail to pay as requested.After paying on any compl ted phase of the Services and before making any further payments,You should request from Home Depot or Se ice Provider a signed,unconditional release from, or waiver of, any right to place any claim against Your pro erty applicable to the work then completed. You may ask an attorney about Your rights to discharge security in erests. 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 require ents of a particular space)is non-returnable, and its Contract Price cannot be refunded unless Home Depot or `ervice Provider(1) incorrectly ordered item, or(2) damaged item beyond repair. Special or custom order merc andise 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 PREFE NCES: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 pick p for Your Service Orders. To stop any of the following communications You may visit www.homedepot.c e > In-Store Special Orders to access Your account to update Your Agreement/Service Order Communicatio Preferences, contact The Home Depot, and take action on orders. If You signed up to receive updates abou Your Agreement/Service Order(s) via: (a) Text Message Communications, You may receive multiple mes'•ges per order (including current and future orders) via automated technology to the mobile phone number su provided. The total number of messages received depends on the number of orders placed and order acti ity. Standard message and data rates apply. Not all carriers covered. You can text STOP to 97710 to stop I ou will be sent a confirmation message). Call 1-877-467-2581 or 1-800-466-3337 for help; (b) Electroni 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 o• out or call 800-HOME-DEPOT for help;or (c) Email Communications, You may receive multiple Emails p= 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 to.ting to determine if lead paint is present,and additional precautions if lead paint is present. You will be informe' 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. 460 Standard Form H[A(21 Jul 21)(E) Generated Date s s, I Lead(POtt F 3a529581 v 0.1.12 Go Permits, LLC 1130 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. 4/22/25 Workers Comp —Ace American Insurance Co. Policy WLRC50668150 (MT) Exp. 3/1/24 Eugeniu Ciubotaru of Exterior Remodeling is the sub-contractor. CSSL-106106 Exp. 9/29/2024 / HIC 187666 Exp. 5/9/23 Workers Comp-Associated Employers Ins. Policy WCC-500-5028443-2023A Exp. 1/25/24 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: permitsgopermits.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 ..--•'''''Sts 8 ACOREP CERTIFICATE OF LIABILITY INSURANCE DATE(1111CDO.TYVY) 0221t2923 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 PROOUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,Me po licyliesImust 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 lisle certificate does not confer rights to the certificate mower tn lieu of such endorsernentIs I- PRODUCER °CONTACT 1 NAME MA- II USA NC PHONE CAI TWY3 ALLIANCE atiTER I LAC..OWE 3569 LENOX ROAD SUITE 240G ADDRESS_ ATLANTA GA 30325 INEWREENEA AFFORDENG COVERAGE MAE S i..".4/IC'642359-dicreddO-GAVV-2.225 INSURER A.Oil EICK341.'I°.'..1.1,+-r.7.,-, 24147 iNSURED 43575 THE HOME DEPOT,INC OWNER B-.IMSYSEHVIVis Cu CO Nant oerem. HOME DEPOT USA,INC. liellURERC ACE Arne') r iiwre Covent 2455 PACES FERRY ROAD INSURER 0. BUILDING C-2C — ATLANTA GA 36339 wiStPRERE ., 1111BuSIER F - - COVERAGES CERTIFICATE NUMBER: AT L-005372226'6. REVISION NUMBER: ? THIS IS TO OERTIFY THAT THE POLICES OF NSJI7LANCE 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 DR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCUJSIONS AND CONDITIONS or SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED SY PAID CLAIMS, NOR ,ADDL1SUBSP POuCV UP POUCY EXP ,T., TYPE OF INSURANCE WAD SSW POUCY NURSER LISIMIGITXrI2 IMIIDDITYYTi Laris A x COIASIERCAL GENERAL LASK.ITY . MVIZ`r 316549 C`l'C 2D22 olt I 2:,25 EA Ov OCC URR,NCE S 1100 NC Dx.V.A...LE§C-L'EN 1E-, CLAIMS-MALE El OCCUR ' PREMISES tEa s_-_,.1,IX,'L.,' S I 00C,200 I S.R S.,1111.i:1KC MEC E*P,A-,.L.,E,...•,...vi, 5 EXCLUDED .—— I,ow OCO PERSONA-5.I.O,'IKLURV 5 GENT ACCAEC.A.TE LEM T APR IE E PER CZNE EA.ACC.RE f-41,I' ,I 2 300 000 S EO_I Cr E.7ff,-, El...._- ,,,,,,,,,,,,s_COVP OP A,OC 1 2=OM s OTHER A ALITOUMWE udadird IiINT1131S649 :::,.1,',2112.7 ruir.,y1,5 ccAtoiNED,zrA HOLE u*,1 X ANY AUTO BODIL*IN;LIR*,PEI pvio con I —OWNED —AUTCG ONLY , t-EDI.11E0 SELF INSURED AUTO PHY DV..- BODE.*IH UR t.'(Fro.xu.vwnz' S -...a. ,_, Aar cs AWED NOThED Pg0P.,R ,r173..P/TGE 5 AUTOS OHL* • a, IJ JIX,CCC UMBRELLA LAS X c„,,,,,„, MWZX 31664T C IS C'2322 1'31E1'2325 EAGH,DccuR,,,INcE S --. X EXCESS LAB CL AME-MADE AGGREGATE S 13:CC C0C S ,3 WORKERS CCOSPENSATICN ' CFC506681S6 iyn, ',lu trzi.., -733,31.9524 4 I PER I I NH' STATUTE . AND EMPLOYERS'LABILITY WLRCKE6E1 7 53 i MT) '7".3'.il.'2'323 °ICI'2M4 E L EACH ACCIDENT 5.D:O CID: 1-R,OFRE T CR PLR T NEREXE CLIT'VE El S v I I v::E RAE I/BER E*C_ OE ) ildaaNnety In ION •E L DISEASE-EA EMPLOYEE ; 5,9CID CDC. 44s,x4144..34, G,ovsme4 or,Act Fscr41 P/1.4x. 5 3:0 CSC E L DISEASE-PCL IC'(L 11,4, S DESCRIPTOR Of GEER TON !MVO% INSCRIPTION OF OPERATIONS LOCATIONS VEHICLES WORSHAM,NadIXNAN Rune*.SO.odEle.Awry tw alinachad II II N.KNA H..Que.& EVIL ICE OF r.,-..7,.uPAski CERTIFICATE HOLDER CANCELLATION HOME a•Pca.USA.Pic SHOULD AN','OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 2455 PACES FERRY ROAD BUILDING D2O THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ATLANTA,GA 3FI339 ,ACCORDANCE WITH THE POLICY PROVISIONS, AU T H 0 R 1Z E D 4EFRE5ENTATIVE I 1,/...ZI.44( 145>1 9,te ::,...1888-2016 ACORD CORPORAIION. Al rights reserved_ ACORD 25 t201603) The ACORD name and logo are registered ma rAs of ACORD AttNer CUSTOMER lb, CN10164206 LOC a. Atlanta Accmc, ADDITIONAL REMARKS SCHEDULE Page 2 of 3 XGENCY osSuREO THE MCKIE DEPOT NC HDRE DEPOT u.SA.NO POC MuhIBEIR :455 PACES FERRY R34..0 RAISING 0,20 ATLANTA G6 30339 CARRIER EFFECTIVE DATE ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM. FORM NUMBER - FORM TITLE_ Certificate of Liability insurance *Mous Carcanatco Cu,5-ute Camer SOH/Raw Crmaty Lam,sky. Palley Nintw,4.354.736 X10,A_AR AZ FLO,OILILKS KY LASISMO,AC,NEJAIND OK SC,S0 WILVATIV WTI EHNEN,Dale nell2C23 Expank,,at*avlIa2,4 (ELI urt$5.1:03 330 Ciurgr Sikty SiMenw Caa.aly Casmoilat Role"Haim SP431809:1.3541 ICAOR,VM4 Elledroe Doty 11401C2C33 Eoproto,Nw S901(2021 ELI LI—r.ss.oxmo SIR SI 0,E6t00 Cam ACE Amon='Ivarame Careparre Poor-,IArtte7'AI0IC5IRGER6.0511'CAN v.'ORME) Ellecow Cotr 11.013123 Empraor Deft(3*012024 ELI tort HIDE X0 SIR 11000 XO SIR(CAI 1750 OX CamIrrn IllSaffICA Cra' ihorn Amer.! Pr F flirter YARC930680514AKCOCI DC DEH1 14ANEU41EMPLIROUNTPARLVTI Beata elm 71401=3 (.pot, Nne 11,012C24 (ELI U.'S SS WO X0 TO Empoyen AS 1.4311-yr1 Carney Zurich Arnenrar nsurmoe Conwany otIE4Alffbe,NS_'1183.5/7X1 Eliecve 0-341h7123 Liman',Ca*01.01,7024 ELII.2ext IS OX X0 SIR$5,0E31DX ACORD 101 (2008/01) 02008 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 Registration: 112785 HOME DEPOT USA INC Expiration: 04t2212023 P 0 BOX 105451 ATTN: LICENSE MGMT TEAM ATLANTA.GA 30348 Update Address and Return Card, Os of Consurnitr Alines 1.Busin guarton HOME IMPROVEMENT CONTRACTOR Registration valid for individual us•only TYPE:SJouiernent Caro before the expiration date. If found return to: fitalataBRO bigiU0112.0 Office of Consumer Affairs and Business Regulation 112765 04/22/2023 1000 Washington Street -Sults 710 HOME DEPOT USA INC Boston,MA 02116 - - --- i --) RICHARD OLMS , TEAD ; 2465 PACES FERRY RD C-11 hsc :...,...,‘,:( .4'4,4 ATLANTA,GA 30339 ot valid Mined signature undersecretary . .. . .... . . . ... Office of Consumer Affairs d Business Regulation (OCABR! .,. MC Registration Complaints Newsltatioti OS 112 ittO Registrant HOME DEPU I USA INC Name Courtney Howe Address 2455 PACES FERRY RD C-11 HSC City,State Zip ATLANTA,GA 30339 Expiration Date 04/22/2025 Complaints Details No complaints found for this registrant. ."%C.IrptiFf CERTIFICATE OF LIABILITY INSURANCE aAxeleee00ErYYr' �.....-- 1 t3112023 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the polcy)ies)must have ADDITIONAL INSURED provisions or be endorsed. I SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PROOUCEri CT Deborah Marino Canary Blornstrum Insurance Agency Pu 888 Springfield Street ,A,r:Nu E..1 (413)750-9022 ,FAY �gg .>,A�c NA(�413}78ti-7004 Feeding Hite,MA 01030 Auk.dmarino canarybI rnstrorrl.com eM,AERISI AFFORDING cuvr ri,c.r NAIL M INSURER A.NGM Insurance Co. 14788 INSURED _MEWS l;m8.A,r,ella r i uran n 1 Bll Exterior Remodeling Group Inc, NEARER C AIM Mutual Insurance CO. 23 Benham St INSURER D Springfield•MA 11109 — N9UNre r cQ.VERA' E8„,.,._ T NY _fitY1519N NUMPgf THIS IS TO ..ERTIF.' WHAT THE POLICIES OF INSJ9At'C, ..isrFD BELOW HAVE SEEN ISSUED TO THE INSURED NAMED ABOVE-COR THE PCE.ICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT -EMI OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT 1NITH RESPECT TO WHICH THIS CERTIFICATE MAY 9E ISSUED OR MAY PERTAIN THE INSL RANCF ;,FF0 DFD BY THE POLICIES DESCRIBED HEREIN IS SfISJECT TO ALL THE TERMS EXCLUSIONS AND CONDITIONS OF SUCH POI IL IES.::INS-IS SHOWN MAY AVE BEEN REDUCED BY PAID CLAIMS. INSIe ... ATXIl 8U8R pour:),FFF POLES`EXP LTR- TYPE OF NEiNNANCE JNSO YYY4 POUGY HOUSER iM1UtiOtYYYYE iMIMIOITYYY1 mere A X cr.ErNERC1ALGNNER�AL LI ABILITY .S. :M_XGIIRt� I 1,000,000 L I a°.+:-owUE rig CUUUF MPP3376W 7,271022 7127.f2023 IMEZTE°a av s 500,000 10,000 MEG EAR tArs me omen! 3 ,---, . 1,000,000 PLEROL6AiVINANt+ 5. _ � 2,000,000 RttaS1CRE ELIM AP❑ur ,w 1 FNEfAL AGGREGATE 2.000,000 _ Prt.t0 '1.5-G frFUEPrir, 1 X S„ el iia - I sit':e t irelC.. t 1,000,000 B MeaL Au 0E LIAMOUTY TOO''AUTO 1020110392 8117/2022 WI 7t'2023 _; I,r!TWO IR.,Frump) OWNED X SCHEDULED ALTOS ONLY •AUTOS S,CI.Y MAIM'rPui+a :urrri ErO r7AA4GEX A edY XAU Coe :Pe'a:d/s . 6 , ........ `� tWSRELLA LEAS -^ :i1.;`::UEi EACH U CURRENCE E_.. EXCESS LIAR Li AIMA-MATT AOL,eLCLAT€ I DEC 1 i I:ETENTIDNS I C wORtUreS CONPSNSATSN1 X 1 MUTE !!:1 I t„t,_ ANO EMPLOYER:IV LNaRITY WCC-500-5028443-2023A 112512023 12512024 500,001 ANY pRopmE�a�R�RARPAREXECLITIVE r s suss;4'GL t awl ynNEII rXCA UDFD> Y HIS .. NMI 500.000 ..__..._. 300.000 HP .-,,a,,012?ailmai +e. ..._ .. DESCRIPTION OF OPERATIONS 1 LOCATIONS t VE IGLES IAGORD II Aediedra)Rs'arns SE"9NWe,Nay be aE.aeEod it more space Is',squired, Horne Depot U.S.* inc.is named as Additional Insured with respects to General Liability. Eugenie CEuhotaru os excluded from the Mortars'Compensation Policy, CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEOF, NOTICE Home Depot U.S.A..Inc ACCORDANCE Mill HE.POLICY PROVISIONS, WLL BE DELIVERED N 2455 Paces Ferry Rd C-11 Atlanta,GA 30339 AUTHONZED REPRESENTATIVE ACORD 25(2018d03) CD 1908-2015 ACORD CORPORATION. All rights reserved. The ACORD name prod logo are roglxtoted mark.%of ACORD Thd Cdtanal Wenraid,at ars kanduned Ohm ca FORM,nal amain of Nalesnonal tasonuni and tin Noicalo Standiamas NW Public Safety an, . AOCA,et Mass. Licensee Details Orm,earaphic Information FUR Nein@ EuGENTirelUtie5TA.RU !Ovine!'Name License i.ddreas Information t.6 Springteld !State MA Zitacode 01109 !Country United States License Information License No CSSL-.4 06106 License Type onstructiun Supervisor Speciatti :Profession Building Licenses Date of Last Renewal: 1441,2022 :Issue Date 4122017 E,piraton Date 9(292024 License Status Active Today s Date 10142022 Secondary license Type Doing Busmess As Status Change Reason License Renews Prerequisite information ticeisee C.U607AP,I.J EUGENIU Retator.,:x.,0 Aretute(it Ucense CSSL "06106 kailatile I "7,1 ^oew Commonwealth of Massachusetts Division of Occupational Licensure Board of Building Relulations and Standards Constructipijr409r Specialty ,f- CSSL-106106 eft,pires: 09/29/2024 EUGENIU CIVBOTARU 23 BENHAM tTREET SPRINGFIEL6..-,MA 01109 / • ,t) 40, 400`• I, 4: - 4-V /.1,Vrttl- ^ 0 1.2 ,....,..01*.stiLsa,a) ttj L/174-4 4-0, Construction Supervisor Specialty Restricted to. CSSL-WS -Windows and Siding Failure to possess a current edition of the Massachusetts State 8uitdiny Code is cause for revocation of this license For information about this license Call (617) 727-3200 of visit www,niass,goVdpl or of Consume,Affairs and Business utalion 1000 Washington Street Se 710 &won,Massachusetts 02118 Hoi itnornverrrent Creel*tor newer( iort 4,11 Ca.,pi.f Ars, akits01eVAI:ZeiNciteees fuNre= gr tr6fst7 ?..4 Et Osamu ST ",,e SPANCif fLD MA oi 4.4wwW6 41411nE•14 im/4 RW141,11 C411,0 01•161 cisliwWWwW1•616111.116,11106111WWSOWS 1113fic WISRADVEWelli,CORTRUTOW /11.614111,11110trw veM1 St104.14Wf saw smsto AWE CIN`WW,Www, WOW.11M tqw6364411 WAS ,eeee war,, megistriglem taboo 411Csmouftwe MUSK and 11•04.4s,Sisssisuss.wors 'VW C45..V*2444 1,4•6144•Wart Ntww"1 5411st t146 ILYT.EPRY,RE11.6044li 114.10,111511P locs,s4K, za SE1111,1114,117 "'"`'` s.Arrevertto MR WOW tlO valid vordanat re 1'1,111,"WWWW,Y, • &z,o1 en to a 0-6:c ip..1.A authonzeiio ilemnis 1,14k, 10 pun perirms using my C License ff /0(006 ana my HIC Registration it I143 666 • 1-cstions please call me at: (4/ 3 3 3 53 709% IILS Lai ter .N __ t-ompany • 0 oup .""lio EXTEREfJI-01 MIt $DE1. AC$ RL CERTIFICATE OF LIABILITY INSURANCE DATE+hWIDCFYY YY1 Ihry- 8/1/2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER'S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, IMPORTANT: I the certificate holier is an ADDITIONAL WSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED. subject to the terms and conditions of the policy.certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(si. PFFLANJCER NAYIEACT Deborah Marino Canary Blomstrom Insurance Agency °woNr FAA 786-7004 068 Springfield Street A c.No E.11 (413)750-9022 i Ati.Nol(413) Feeding Hills,MA 0103051 iec dmarinoanaryblomstram.com N4tiRERfS1 Alf I:mot a t:u`.'ERAaE RAIC P N&JRE;A NGM Insurance Co. 14t04 INSUNEU „Ii;+LIRER 9 Arbetla Protection Insurance Company 41360 Exterior Remodeling Group Inc. rl&a NER C. 23 Benham St NSUREa o-__-- Springfield,MA 01109 N-,..ine 4 r cOVERAG$ ceBillEI ,AT .N,►4.1,P . THIS is TO CERTIFY THAT THE PULL I_5 OF INSJRAi CE ,ISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAVZD ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING AN, REQUIREMENT. "ERA1 OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT'WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN THE INSURANCE AFFORDED BY T14E POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMIT S S,,C1.'.'v VAY,,AVE BEE%REDUCED BY RAID CLAIMS. INIR TYPE Or NSUIMNCE A00LtIyeR a:)UCr NI.. Pt ICY ENF EItP LIMITSLTR_ _MiO MO IMMIDOIYYYY 1 A A COMMERCIAL GENERAL LMRILJTY 1 AGt1 Gc:CURNENCL 1 1,000.000 --,Uiaraz+uuE Q T cuu MPPTTTEW 7/27/2022 1127/2023 MANAGE T{t RENTED 500,000 f ANAP-k'ei,-u fll(feO[iLl S ...... 1 }x1 .,r;:,e amain 1 10,000 ,<:.,{.,, n?L:Itt,6ZRY s 1,000.000 GENL AGGRETE LW APPLIES PER i:c.NERA,.AGGT.IECATE 1 2,000,000 X „..ic ❑LOC ,,, OnLCu•COMPAQ('Aco 2,000,000 s,MI:AIOKEOrSINGt 1,000,000.B LIMIT B --.1hUr6"r51061.G�.M[#tJTY a n t- :fldenlY ANY AUTO 1020110392 11/17/2022 $/1712023 1,„t;JtAt1JRYire- mem) 43 ~ OWNED SCNECXAEO AUTOS ONLY X AUTOS pp 1 ,l' Fin IN,At,: r#L I X M CAW X strati? ALLALV -.. uweacLii.ii use OCCUR E.CN OCCURREh+..E .f —~ EXCESS USE CLADASAWL7E A:JLIRLIAT[ t DEE I i PETENTFTNS 1 $ WORwERS COMPCNSA ISM TL 1 1 Ll"1.1 AND EMPLOYERS'LMAIITY in tttt MMMM - ANY PROF'RIE'CQFARTNEREXECUTNE in I,,,tAY:n A I N 1 T .FU.' IC.1; InaHER EXCLUDED, U 111 A (sYnaNe,Y NNI E.,DISE.AEF--A-1i.1 c,F= _ I c :r _ '+t 11N LA-OPERATIONS eetak L -pEA .p«'.s f`1 1 nr SCXP11nN OF OPERATIONS'LOCATkONS'VEAELES IACORD 101.AOORxnai RMaarEf 0CF eds N,-tut?be Atiadsed II more spece Is regd.-ea) N-,rnr.I)rpl:U.SA.Inc.is named as Additional Insured with respects to General Liability CERTIFICATE HOLDER CANCELLATION SHOULD ANY Of THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Home Depot U.S.A.Inc THE EXPIRATION DATE THEREOF, NOTICE WLL BE DELIVERED I1 PACCORDANCE WITH THE POLICY VROYLSION% 2455 Paces Ferry Rd C-11 Atlanta,GA 30339 AUTHORIZED REPRESENTATIVE 1 i/ /19 t' A i(r.' ),,t' ACORD 25 i2016/03) C 1088-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered moults of ACORO