Loading...
06-010 (11) BP-2023-0794 595 HAYDENVILLE RD COMMONWEALTH OF ASSACHUSETTS Map:Block:Lot: 06-010-001 CITY OF NORTH MPTON Permit: Exterior Res PERSONS CONTRACTING WITH UNREG STERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUA NTY FUND (MGL c.142A) BUILDING ERMIT Permit# BP-2023-0794 PERMISSIO IS HEREBY GRANTED TO: Project# 2023 WINDOWS Contractor: License: Est. Cost: LOWES HOME CE ERS INC 117055 Const.Class: Exp.Date: 08/02/20 5 Use Group: Owner: J GRE I RY, SETH H&ANGELA Lot Size (sq.ft.) Zoning: RR Applicant: LOWE. HOME CENTERS INC Applicant Address Phone: Insurance: 282 RUSSELL ST (413)588-0270 WA565D294595013 (AOS) HADLEY, MA 01035 ISSUED ON: 06/21/2023 TO PERFORM THE FOLLOWING WORK: REPLACE 9 WINDOWS -NO STRUCTURAL CHANGES 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 NO THAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: 14 • ci0 Fees Paid: $40.00 212 Main Street,Phone(413)587-1240,Fax (413)587-1272 Office of the Building Commissi trier l ji0L00 .frmtd, a 14,414,044uo t, n_' relkekA .Sap@/i,v4. The Commonwealth of Massachusetts Board of Building Regulations and Standards FOR z ' _ Xi Massachusetts State Building Code, 780 CMR MUNICIPALITY o , {'j� USE 4 Bu g Permit Application To Construct,Repair,Renovate Or Demolish a Revised Mar 2011 I m One-or Two-Family Dwelling , _4 i remlb WI — This Section For Official Use Only iilitldm ermit er:8P-2o 23 - D7 q `lam Date Applied: Illi m . �� i \--4111 6/a i/9 3 • ' _ _• •Pit Name) Signature Date SECTION 1:SITE INFORMATION 1.1 PropertyAddr s,_.. 5-511. /� / 1.2 Assessors Map&Parcel Numbers � �7�/LE'J /`� f,tr, —0/0 — t,0 / 1.1 a Is this an accepted street?yes no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: 112 /2,6acre_ 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 if yes0 2: PROPERTY OWNERSHIP' 2.1 Owner'of ecord: c_....->""th /4. ' ')/7"9/Vg-- Liii_C --eiA D/153 Name(Print) C. State,ZIP J • .39 /day/le) st- /i-3 P io l� 1e r/ 6- a , , No.and Street Telephone Ema ddress SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s)W Alteration(s) ❑ Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify: Brief Description of Proposed Work': SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ 9, i_l��p.bro I. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical $ ❑Standard City/Town Application Fee 9 ❑Total Project Cost (Item 6)x multiplier 3.Plumbing $ 2. Other Fees: $ 4. Mechanical (HVAC) $ List: 5.Mechanical (Fire Suppression) $ Total ` I up $ vo Check N6. / heck Amount: ID.—Cash Amount: 6.Total Project Cost: $ 9/41Q A, ir a 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor LicensesSL) /J 10 L c II 1e, le a/9 License Number Expiration Date Name of CSL Holde<r� j // ,%. e ae /f e i _iti A.,List CSL Type(see below) No.and Street /�L /� (J �`/ / Type Description -. i �- �� /T O/. '2 2 U Unrestricted(Buildings up to 35,000 cu.fl.) T�/� L�%(,/ / (�/ (n / R Restricted 1&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding \�O�. SF Solid Fuel Burning Appliances — '►Ei /--`yJ / a� Q�l�/ I Insulation Telephone � Email address D Demolition 5.2 RegisteredAd ovement Contractor(HIC) l 2/r Rr /d t/�6,7IC I HIC Registration Number Expirati Date HIC Com/py y�(am�pr HIC Nanje r� lit d 1.6 //I e- No.and Stye �" q'06 j- 1.3i 7 Email address 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 with this application. Failure to provide this affidavit will result in the denial of the Issuance of the building permit. Signed Affidavit Attached? YesLFFNo ❑ SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1,as Owner of the subject property,hereby authorize . ,e000z,. to act on my behalf,in all matters relative�la to work authorized by this building permit application. Print Owner's N (Electronic/ ,v1 ' o a- e// �gnat r ) ate SECTION 7b:OWNER' 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 of my knowledge and understanding. ip( Jrz) (/4 3 Print Owner's or Aut orizdelAgent's Name(Electronic Signature) ate g ) 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.gov/dps 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 room count Number of fireplaces Number of bedrooms Number of bathrooms Number of halfbaths 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 � wc .. ti 2s�" r �ci Massachusetts �4, �.. ( p * C. a 3. it i < t' A , DEPARTMENT OF BUILDING INSPECTIONS y ' ,�'14 1' 212 Main Stramt • Municipal Building Jb D Northampton, Nit 01060 '�sph 3,j�$' 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: Location of Facility: Ea (l©td✓6 //i /'I/ i?t 'z (gx-z-- iU� 0 o7/c -° The debris will be transported by: Name of Hauler: 4/., r. & i &- Signaturec , -) of Applicant: Date: (//43 `›AThe Commonwealth of Massachusetts Department of IndustrialAccidents • I Congress Street,Suite 100 Boston.MA 0211 4-2017 :w worm mass gotlditr %%others'Compensation Insurance Affidavit:BuildersiContractors/Eleetricians!!Plumbers. ` 1)BE FILED WITH'THE PERMI lTlrt:AITHOitl'Tl. Anniicant Information Please Print Leeds's Name t>3us,tte_.:oratat>fzanon I min:idustl_ LOWES HOME CENTERS -Address: 1000 LOWES BLVD City:State Zip: MOORESVILLE, NC 28117 Phone . 860-505-9314 Are boa an taprlwrr?t beck the appropriate boa: Type of project(required): 101 sin a employer tth . .._ employed(lull marts pat-haw[.• 7 3 New construction 20 I as a sole prupnetda or pant ralup and tore no employed working fur rn:an 8. 0 Remodeling any valued!,No workers-comp.ammo: n quired.] .30 I am a horneowan doing all uottt a works'ry3c1 .iNo conc_imnrsmY romarol.l" y_ !�'(Demolitiondl t ma a huracvwrw.a and w ill be humpc�crrunwirs u to candied all wank un tm property. 1 will 10 Building addition damn that all evacra-Lus wilier haw workers'cunspert.alaon iasm.mcl w axe sole 11.0Electrical repairs or additions prvyuxcturs with no employed. I I-0 Plumbing Mira or additions lag 1 am a pennant contractor and I hoe hared the sunkutanleiara Wien on the enaebcd'beet. 30 Roof repairs ibcse nib-contracture hoc emplaned and lea c worlds'comp.msurunce) I#_[NOther 6.0 sve in:a terporaiiva and ab utficcra have demised then rsghl of exemption per Att&L e. 1 S i*1141.and we hake no smplayecS.[Vo wuikcal'etntp.Uxrtnamee required.] 'Aar applicant that ehcele bw.=1 must alio Cell out the cactus bah.*:howrwr then workers.-eoupcmatiun pulley tnfonuatistn. *lkuncow dun.ado aulmit this atla6ad uteheatmu the are donta all work and then lure maxid4 caatraeiezr area autxmt a new atid:oo it xadaeatang sts,:h ;Cuntracttns that clerk an"boat anted atta f:ed en adahtianal chant ahowms the nmtac of the sub-eunttacton and sia€c w hciher or not those candid kti c caraploy.tcs If the sub-cdmtrackr>haVe exrpluyeess_they meet provide their worker.sump.policy ntmm ba_ lam an employer that is providing workers'compensation insurance for My employees. Below is the policy and job site information. Insurance Company Name: LM INSURANCE CORP police or Self=ins.Lic.a: WA565Q29459501)3 (AOS) ,/ Etptration nib.,/ 4/2/2024 Jib Site Address: 5951\kit GZ l4 1e1 . City.StutefZip: / `�l�.r,�/-14 ache Attach a copy of the,tuckers'compen scion policy declaration page(showing the pokey number and expiration date). Failure to secure coverage as reyuued under MGL e. 152§25A is a cnminal violation punishable by a line up to SI 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 5250.0I)a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. l do hereby certify under the pains and and penalties of perjury that the information presided above is true and correct Signature: 4V.2 ' 5:9t# Date. /.57' Phone : 860-505-9314 ' Official use only. Do not write in this area.to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): I.Board of Health 2.Building Department 3.CitytToin Clerk 4.Electreai Inspector S.Plumbing inspector 6.Other Contact Person: Phone#: THE COMMONWEALTH OF MASSAHUSETTS Office of Consumer Affairs and Business Regulation 1000 Washington Street- Suite 710 Boston,,Massachusetts 02118 Home Improvement_Ccntractor,Registration T Supplement Card ' ' Registration: 148688 LOWES HOME CENTERS.LLC w r` Expiration- 10:1712023 1000 LOWES BLVDf. _ SERVICES COMPLIANCE il .� ,t"' MOORESVILLE,NC 28117 Update Address and Return Card. THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs 8 Business Regulation Registration valid for individual use only before the HOME IMPROVEMENT CONTRACTOR expiration date. If found return to: TYPE:Supplement Card Office of Consumer Affairs and Business Regulation Resistratton Expiration 1000 Washington Street -Suite 710 1-18688 10417/2023 Boston,MA 02118 LOWE'S HOME CENTERS,LLC NEXEDES SOTO 1000 LOWES BLVD .Ek /V� �2e 54+ o. SERVIMOORESVILLE. COMPLIANCE UndersecretaryNot valid without signature NC 28117 � ` ACORO® DATE(MWDOIYYYY) �, CERTIFICATE OF LIABILITY INSURANCE 03/172023 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW_ THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION(S WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Marsh USA Inc. NAME: PHONE FAX 100 North Tr yon Skeet,Stile 3600 (A/C,Na Eat): (A/C,No): Charlotte,NC 28202 EMAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC• CN102776519-Loaves-Si-23-24 Y INSURER A:Liberty MlAual Fie Insurance Company 23035 INSUREnLowe s Carpanies,Inc. INSURER 6:Interstate Fre&Casualty Co 22829 and subsidaries INSURER C:LM Insurance Corporation 33600 1000 Lowe's Boulevard Mooresville,NC 28117 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: ATL-004934190-29 REVISION NUMBER: 27 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTRINSR TYPE OF INSURANCE ADM SUER POLICY EFF POUCY EXP INSD YWD POUCY NUMBER (MMIDD/YYYY) (MMIDD/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S CLAIMS-MADE OCCUR Sett Insured belowDAMAGEPREM� O RENTED S(Ea occurrence) S MED EXP(Any one person) S PERSONAL&ADV INJURY S GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE S PRO- POLICY JECT LOC PRODUCTS-COMP/OP AGG S OTHER S A AUTOMOBILELIABRnY AS2651294595103 04l0t(1023 0410 2024 CO SINGLE LIMIT S 5,003,000 (Ea accident) X ANY AUTO BODILY INJURY(Per person) S — OWNED SCHEDULED BODILY INJURY(Per accident) S _ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY — AUTOS ONLY (Per accident) S S B X UMBRELLA LAB X USZ000210200 (OrYUR 040012023 04012024 EACHrIG1JIRRENCE S 10,0O0,000 EXCESS UAB CLAIMS-MADE AGGREGATE S 10,000,000 DED RETENTION S S C WORKERS COMPENSATION -WA5650294595013(AOS) 041012023 041012024 X PER OTH- AND EMPLOYERS'LIABILITY WC.5651294595�3 STATUTE ER C ANYPROPRIETOR/PARTNER/EXECUTNE Y/N (WI,MN) 041012023 04I012024 EL EACH ACCIDENT S 2.000.� OFFICER/MEMBEREXCLUDED? N NIA (Mandatory in NH) EL DISEASE-EA EMPLOYEE S 2,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below EL 1>LRFCRF-POLICY ltlrtrT S 2• � C Excess Workers'Colrpensahon EW565N294595063(FL) 041012023 04/01/2024 (WC per statute) 3,000,000 A Excess Workers'Compensation EW265N294595033(AOS) 04/012023 04/01/2024 (WC per statute) 3,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is reignited) Commercial General liability pdicy is Sett-Insured,effective 4/12023 to 4/112024. SEE SECOND PAGE FOR ADDITIONAL WORDING CERTIFICATE HOLDER CANCELLATION Loaves Companies,Inc. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE arid its subsidaries THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1000 Lowes Boulevard ACCORDANCE WITH THE POLICY PROVISIONS. Mooresville,NC 28117 AUTHORIZED REPRESENTATIVE 1co! ZLS�f 9�c. ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD II* ‘. ., IP' Commonwealth of Massachusetts Division of Occupational Licensure Board of Budding Regulations and Standards -II fsiutp"rv.LI StOr Constictititort CS-117055 ,, 6,plres: 08102/2025 KYLE R SEAOLES 7; 14R PEACH ORCHARD ROAD , . PROSPECT CJ 06712 .. . ....: • • ,-.V' '''.:- .:ommtsstoner y-',,,,„i -, f e 6-mitx..., A� CERTIFICATE OF LIABILITY INSURANCE DATE A E(M4/20/DD 2rr) 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: lithe certificate holder is an ADDITIONAL INSURED,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(s). PRODUCER CONTACT Diane Gendreau,CISR NAME: Nicholson Associates,Inc. PH N ): (203)877-2741 FAX c,No): (203)877-9004 395 New Haven Ave. ADDORESS: d.gendreau@nicholsonassoc.com P.O.Box 5189 INSURER(S)AFFORDING COVERAGE NAIC# Milford CT 06460 INSURER A: Selective Insurance Co of S.C. 19259 INSURED INSURER B EAST COAST MILLWORK,LLC INSURER C: 14R PEACH ORCHARD RD INSURER D: INSURER E: PROSPECT CT 06712-6001 INSURER F: COVERAGES CERTIFICATE NUMBER: 9/22-23 GLAuto Umb REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL I c- POUCY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POUCY NUMBER (MM/DD/YYYY) (MM!DD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1'000 000 DAMAGE ED CLAIMS-MADE X1 OCCUR PREMISESO(EaEoccurrence) $ 500'000 MED EXP(Any one person) $ 15,000 A Y S 2040386 09/2 09/22/2023 PERSONAL&ADV INJURY $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 3.000,000 POLICY JECT LOC PRODUCTS-COMP/OP AGG $ 3•B00•B00 OTHER. $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) X ANY AUTO BODILY INJURY(Per person) $ A OWNED SCHEDULED Y S 2040386 09/22/2022 09/22/2023 BODILY INJURY(Peracddent) $ AUTOS ONLY _ AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) Medical payments $ 5,000 X)UMBRELLAUAB OCCUR EACH OCCURRENCE $ 2,000,000 A EXCESS LIAR CLAIMS-MADE S 2040386 09/22/2022 09/22/2023 AGGREGATE $ 2,000,000 DED RETENTION$ $ WORKERS COMPENSATION XI PER OTH- AND EMPLOYERS'LIABILITY Y/N /�)STATUTE ER A ANY PROPRIETOR/PARTNER/EXECUTIVE Y NIA WC 9084546 06/04/2022 06/04/2023 E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 50U,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Lowe's Companies,Inc.and Lowe's Home Centers,LLC are named as additional insureds as respects general liability and auto liability. This insurance is primary over any other available insurance coverage.10 Day Notice of Cancellation for Non-Payment of Premium. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Lowe's Companies,Inc.and any and all subsidiaries ACCORDANCE WITH THE POLICY PROVISIONS. 1000 Lowe's Blvd AUTHORIZED REPRESENTATIVE Mooresville NC 28117 tt52 I ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Lowe's Custom Order Quote LOWE'S Quote# 783065623 Quote Name: Gregory_windows_2 Date Printed: 6/15/2023 Customer: Angie Gregory Store: (1916)LOWE'S OF HADLEY,MA Item Total: 9 PreSavings Total: $4,883.38 Email: angiejgregory@gmail.com Associate: STEVEN LOCKWOOD(3070929) Freight Total: $0.00 Address: 595 HAYDENVILLE RD Address: 282 RUSSELL STREET Labor Total: $0.00 LEEDS,MA 01053 HADLEY,MA 01035-0000 Pre Tax Total: $4,150.90 Phone: (413)522-1029 Phone: (413)588-0270 Savings Total: ($732.48) I I ReliaBilt Glass Warranty Labor Warranty Product Warranty 24-in x 37 1/2-in I Series 3900 IHC Double Hung i c it I ❑`r44, 0 0 `,•�-,Ii'❑ ❑- •I❑ ;. Equal Sash I White pi 3,* ry'' l�•,_l { or/ I I Triple Pane I Low-E w/Argon I Clear �.�•.i{ l �y'i Tempered ~_ - i1 J Color Matched Hardware • o •• � � o El ^raml o a4an114-in Full Screen Clear View Mesh RO-� Room Location:bath line* Item Summary Production lime Was Price Now Price Quantity Total Savings Pre-Tax Total 100-1 'Product'••' 22 days $701.86 $596.58 1 ($105.28) $596.58 3900 INC,Double Hung,Double Hung,24 x 37.5 Valid thru:06/09/2023 Begin Line 100 Description —Line 100-1— ReliaBilt I Double Hung 124-in x 37 1/2-in I Complete Unit I White I Triple Pane I Low-E In-Store Pick-Up 3900 IHC I Double Hung I Equal Energy Star w/Argon I Clear I Tempered I No Grids I Multi Northern I 24-in I 37 1/2-in I -Cavity Foam Filled Frame I Color Matched Hardware I Standard Night Latch I Full Screen I Clear View Mesh I Installed in Window I Head Expander I Lifetime Glass Breakage& Labor-Discounted Package I ADW-M-388- 00061-00009 10.21 10.23 172 10.39 I FL20473 I WIN-1654 I DP60:Size Tested 36-in x 74-in I End Line 100 Description Page 1 Of 3 1 I ReliaBilt Glass Warranty Labor Warranty Product Warranty 40-in x 49 1/2-in I Series 3900 IHC Double Hung Ag . El 1:1 .!••-.,1.:1:1 12- ..S. :II. 1:1 - - Equal Sash 1 White .r*1•r• i • h1_1_14 o'rTriple Pane Low E w/Argon Clear Single �i - .: • rrli� • • . Strength •. .'A. `' ( � _ 1 1 Color Matched Hardware ❑ o • ❑ o ' ❑ _• .I o — Ro 2:1/4-in Full Screen I Clear View Mesh Room Location:bedroom 1 Line l Item Summary Production Time Was Price Now Price Quantity Total Savings Pre-Tax Total 200-1 ***Product`•' 15 days $522.69 $444.29 1 ($78.40) $444.29 3900 IHC,Double Hung,Double Hung,40 x 49.5 Valid thru:06/09/2023 Begin Line 200 Description —Line 200-1— ReliaBilt I Double Hung I 40-in x 49 1/2-in I Complete Unit I White I Triple Pane I Low-E In-Store Pick-Up 3900 IHC I Double Hung I Equal Energy Star w/Argon I Clear I Single Strength I No Grids I Northern I 40-in 149 1/2-in I Multi-Cavity Foam Filled Frame I Color Matched Hardware I Double Sash Lock I Standard Night Latch I Full Screen I Clear View Mesh I Installed in Window I Head Expander Lifetime Labor Warranty-INCLUDES FREE GBW ADW-M-388-00055-00009 10.21 10.23 172 I 0.4 I FL20473 I WIN-1654 I DP60:Size Tested 36-in x 74-in I End Line 200 Description 1 ReliaBilt Glass Warranty Labor Warranty Product Warranty 32 in x 49 in Series 3900 IHC Double Hung ac I ❑ •` +' ; ❑ ❑ J =❑ ❑■ • ;,ii�❑ ...._ Equal Sash White r ry• h ..:l { �� �` y Triple Pane Low E w/Argon Clear Single �i � •; 1. l• . Strength `' k �.• `� I1 = : Color Matched Hardware 0 o • ❑ � � o ' ❑ c . — RO 3 211/4-m — Full Screen I Clear View Mesh Room Location:bedroom 1 Line C Item Summary Production Time Was Price Now Price Quantity Total Savings Pre-Tax Total 300-1 `•'Product"• 15 days $522.69 $444.29 5 ($392.00) $2,221.45 3900 IHC,Double Hung,Double Hung,32 x 49.5 Valid thru:06/09/2023 Begin Line 300 Description —Line 300-1— ReliaBilt I Double Hung I 32-in x 49 1/2-in I Complete Unit I White I Triple Pane ( Low-E In-Store Pick-Up 3900 IHC I Double Hung I Equal Energy Star w/Argon I Clear I Single Strength I No Grids I Northern I 32-in 149 1/2-in I Multi-Cavity Foam Filled Frame I Color Matched Hardware I Double Sash Lock I Standard Night Latch I Full Screen I Clear View Mesh I Installed in Window I Head Expander 1 Lifetime Labor Warranty-INCLUDES FREE GBW I ADW-M-388-00055-00009 10.21 10.23 172 I 0.4 I FL20473 I WIN-1654 I DP60:Size Tested 36-in x 74-in End Line 300 Description Page 2 Of 3 II ReliaBilt 32 in x 49 1/2 in Series 3900 IHC Double Hung Glass Warranty Labor Warranty Product Warranty 0 7.11 El o� Equal Sash I White rr•,. c �' "• IX Triple Pane I Low-E w/Argon I Clear I Single �i , .: . • . • I Strength • .' r ti Color Matched Hardware o D • " o � I•• . o -Ro 32i'/4-m -. Full Screen I Clear View Mesh Room Location:kitchen Line Si Item Summary Production Time Was Price Now Price Quantity Total Savings Pre-Tax Total 400-1 ***Product*** 15 days $522.69 $444.29 2 ($156.80) $888.58 3900 INC,Double Hung,Double Hung,32 x 49.5 Valid thru:06/09/2023 Begin Line 400 Description —Line 400-1-- ReliaBilt I Double Hung I 32-in x 49 1/2-in I Complete Unit I White I Triple Pane I Low-E In-Store Pick-Up I 3900 IHC I Double Hung I Equal Energy Star w/Argon I Clear I Single Strength I No Grids I Northern I 32-in I 49 1/2-in I Multi-Cavity Foam Filled Frame I Color Matched Hardware I Double Sash Lock I Standard Night Latch I Full Screen I Clear View Mesh I Installed in Window I Head Expander I Lifetime labor Warranty-INCLUDES FREE GBW I ADW-M-388-00055-00009 10.21 10.23 172 10.4 I FL20473 I WIN-1654 I DP60:Size Tested 36-in x 74-in I End Line 400 Description Accepted by: Date: 6/15/2023 Pre-Tax Total I $4,150.90 This quote is an estimate only and valid for 30 days on all regularly priced items.For promotional items please refer to the dates listed above. This estimate does not include tax or delivery charges.Estimated arrival will be determined at the time of purchase.All of the above quantities,dimensions,specifications and accessories have been verified and accepted by the customer. ****Special order configured products returned or canceled after 72 hours from purchase are subject to a 20%restocking fee.**** Page 3 Of 3 V Store 1916 LOWE'S OF HADLEY, MA 282 RUSSELL STREET HADLEY, Massachusetts 01035 Low E IS ' Contract Prepared for: Angie Gregory 595 Haydenville Rd Leeds, Massachusetts 01053 4135221029 Prepared by: Steven Lockwood (413)588-0270 steven.lockwood@lowes.com Store 1916 LOWS S OF HADLEY_MA-Contract- 1038455-Page 1 of 27 LOWE'S MASSACHUSETTS SERVICES SOLUTIONS INSTALLED SALES CONTRACT LOWE'S AUTHORIZED REPRESENTATIVE SALES ID DATE CUSTOMER NAME Steven Lockwood 3070929 06/05/2023 Angie Gregory SIORE NO. STREET ADDRESS STREET ADDRESS 1916 282 RUSSELL STREET 595 Haydenville Rd CITY STATE ZIP CITY STATE ZIP HADLEY MASSACHUSETTS 01035 Leeds Massachusetts 01053 TELEPHONE TELEPHONE (413)588-0270 4135221029 EMAIL EMAIL steven.lockwood@lowes.com angiejgregory r@gmail.com LOWE'S CONTRACTOR LICENSE# LOWE'S REPRESENTATIVE LICENSE# CREDIT/DEBIT CHECK LCC CARD GIFT CARD #CSL-081810;HIC#148688; 3070929 This is only a quote for the merchandise and services printed below. Lowe's does not offer services to paint,seal or stain fences. This becomes an agreement upon payment and issuance of a Lowe's receipt,upon pay-ment,the entire agreement,including the specifically completed pages of this document,the Terms and Conditions included with this document and any other addenda and attachments hereto,shall be referred to herein as this"Contract."PLEASE READ THIS ENTIRE DOCUMENT, INCLUDING THE "NOTICES,""TERMS AND CONDITIONS,"AND"ADDENDUM"CONTAINED WITHIN THIS CONTRACT ON THE FOLLOWING PAGES BEFORE SIGNING. INSTALLATION STREET ADDRESS CITY STATE ZIP 595 Haydenville Rd Leeds Massachusetts 01053 MERCHANDISE AND INSTALLATION SUMMARY:(I.E.ITEM NUMBERS,COLORS,DIMENSIONS, CONSIDERATIONS): Windows Product Windows Project Pocket installation of 9 windows. Bathroom window to have tempered(safety)glass. All windows to be double hung white vinyl, no grids,full screen clear view mesh, lifetime accidental glass breakage and labor warranty, Foam filled frame. All windows are triple pane, argon gas. (spec sheet at bottom of proposal) Proposal and pricing dependent on installer second measure to ensure suitability, sizing, and estimated installation costs. Installation Process • Remove&haul away existing windows • Check existing windows for leaks and evidence of pest infestation • Install new windows&accessories, including caulk, stops, and fasteneirs • Follow Lead Safe Practices(if required) • Follow Health and Safety Guidelines Store 1916 LOWE_S OF HADLEY_MA-Contract-1038455-Page 2 of 27 n-up!Final Inspection • Complete final clean-up and haul away all job-related debris • Test product&perform complete inspection with customer • Review warranty information Project Preparation Process • Dedicated project support staff keeps you up-to-date through every process • Installer conducts Pre-Installation Inspection • Provides appropriate protection to home during installation • Obtain & post any necessary permits • Perform Lead Assessment(if applicable) Work is to commence upon reasonable availability of Contractor and/or any special order or customer made Good(s)which is anticipated to be 06120/2023.Estimated completion date is 07129/2023. CONTRACT TOTAL $9,496.00 Paid upon signature of Installed Sales Contract(33%) $3,100.68 Paid upon or after commencement of work(67%) $6,295.32 Paid upon completion of Installed Services to both parties satisfaction $100.00 Store 1916 LOWE_S OF HADLEY_MA-Contract-1038455-Page 3 of 27 FE INFORMATION. Federal and applicable state laws require that You be provided with a lead hazard information hlet such as the Renovate Right: Important Lead Hazard Information for Families, Child Care Providers and Schools. By igning this Contract, You acknowledge having received a copy of this information pamphlet before work began informing You of the potential risk of the lead hazard exposure from renovation activity performed in Your dwelling unit or facility. A copy of the pamphlet is available at the following website: www.lowes.com/EPARRP For more information see: https://www.epa.gov/lead/lead-renovation-repair-and-paintinq-program. NOTICE OF ARBITRATION AGREEMENT: This Contract provides that all claims by Customer or Lowe's will be resolved by BINDING ARBITRATION. Customer and Lowe's GIVE UP THE RIGHT TO GO TO COURT to enforce this Contract (EXCEPT for matters that may be taken to SMALL CLAIMS COURT). Lowe's and Customer's rights will be determined by a NEUTRAL ARBITRATOR and NOT a judge or jury. Lowe's and Customer are entitled to a FAIR HEARING. But the arbitration procedures are SIMPLER AND MORE LIMITED THAN RULES APPLICABLE IN COURT. Arbitrator decisions are as enforceable as any court order and are subject to VERY LIMITED REVIEW BY A COURT. FOR MORE DETAILS: Review the section titled ARBITRATION AGREEMENT, WAIVER OF JURY TRIAL AND WAIVER OF CLASS ACTION ADJUDICATION found in the Terms and Conditions of this Contract. NOTICE REGARDING ARBITRATION AGREEMENT FOR CLAIMS COVERED BY M.G.L. c. 142A: LOWE'S AND OWNER HEREBY MUTUALLY AGREE IN ADVANCE THAT IN THE EVENT LOWE'S HAS A DISPUTE CONCERNING THIS CONTRACT, THAT LOWE'S MAY SUBMIT SUCH DISPUTE TO A PRIVATE ARBITRATION SERVICE WHICH HAS BEEN APPROVED BY THE SECRETARY OF THE EXECUTIVE OFFICE OF CONSUMER AFFAIRS AND BUSINESS REGULATIONS AND THE OWNER SHALL BE REQUIRED TO SUBMIT TO SUCH ARBITRATION AS PROVIDED IN M.G.L. c.142A. THE SIGNATURES OF THE PARTIES BELOW APPLY ONLY TO THE AGREEMENT OF THE PARTIES TO ALTERNATIVE DISPUTE RESOLUTION INITIATED BY LOWES, PURSUANT TO M.G.L. c. 142A. THE OWNER MAY BE PERMITTED TO INITIATE ALTERNATIVE DISPUTE RESOLUTION EVEN WHERE THIS SECTION IS NOT SEPARATELY SIGNED BY THE PARTIES. If customer has a complaint which cannot be resolved informally, the home Improvement Contractor Law (M.G.L. c. 142A) may provide Customer with the right to request arbitration through a private arbitration program approved by the Director of the Office of Consumer Affairs and Business Regulation, as an alternative to court action. The same right is not afforded to Lowe's unless this Notice is signed and dated by Lowe's and Customer. All claims by Customer or Lowe's concerning this Contract which cannot be resolved informally, and which are not covered by M.G.L. c142A or subject to the jurisdiction of a small claims court, shall be resolved by binding arbitration as set forth in the Terms and Conditions. By: "Atwell, cre-r4�ve-er Date: Lowe's Authorized Representative By: �r.---/ - Date: 06/05/23 Customer PRICE CALCULATIONS. If this Contract includes Goods and related Installation Services sold by unit of measurement, such as per square foot, the Price may include more Goods than the actual measurements of Your project area. The Price includes the total amount of Goods required by Lowe's to fulfill the Contract (including surplus materials and overages) (together the "Estimated Product")and the Installation Services required based upon this total amount of Goods. For instance, a 120 square foot room may require 140 square feet of carpet to properly match the carpet seams, pattern, or unique room characteristics, and the Price would include Installation Services based upon the 140 square feet of carpet. The total amount of Estimated Product is based upon the total Goods recommended by the Installer, based on the Installer's assessment of unique characteristics of Your project. If any usable Goods are left over, Lowe's may, at its discretion, initiate a Price adjustment. Lowe's will not adjust the Contract Price for the related Installation Services. By signing this Contract, You acknowledge You are aware of Your project area measurements and the amount of Estimated Product, and that the Estimated Product may exceed Your actual project area. If Your project includes the installation of flooring materials, by signing this Contract You further acknowledge having received a completed Flooring Detail Diagram (the "Diagram") prior to execution of this Contract. Upon request, Lowe's can provide You with additional copies of the Diagram, which identifies the square footage of Your project area and the square footage of the Estimated Goods. PHOTO RELEASE. By signing this Contract, You grant to Lowe's, its representatives, and Installer the right to take and use photographs, videos, or other representations of the Premises before and after the Installation Services and all work performed at the Premises related to this Contract (the "Content"). Lowe's irrevocably keeps all rights (including the copyright), title, and interest in the Content for use in all markets and media, worldwide, in perpetuity. Lowe's can use the Content, in any form or medium, internally for any purpose (e.g., customer service, planning, and claims. NOTICE REGARDING PAYMENT SCHEDULE. If the Contract Price is$1,000 or less, payment of the Price by Customer to Lowe's is due in full upon execution of this Contract. If the Contract Price exceeds $1,000, Customer shall use the following payment schedule: (1) Deposit of $ 3100.68 [enter 1/3 of the contract Price] to be paid upon signing this Contact. Any deposit collected at the time this Contract is signed will not exceed one-third (1/3)of the Contract Price; Store 1916 LOWE_S OF HADLEY MA-Contract-1038455-Page 4 of 27 Rev.03/02/2021 yment of $ 6295.32 [enter 2/3 of the contract Price minus $100] to be collected upon or after the commencement of work. Customer authorizes Lowe's to charge Customer's credit card. or deposit Customer's check, for the amount of the payment indicated in this section anytime upon or after the commencement of the work; and (3) Final payment of$100 to be paid upon completion of the Installation Services to both parties' satisfaction. NOTICE OF CUSTOMER'S RIGHT TO CANCEL. If this is a "door-to-door sale" as defined by 16 C.F.R. §429.0(a), or if this Contract is signed by Customer at a place other than the address of the seller as set forth in M.G.L. c. 93 § 48, You, the Customer, may cancel this Contract at any time prior to midnight of the third business day after the date of this transaction. See the notice of cancellation form sent as an attachment to this Contract for an explanation of this right. By executing this Contract, Customer acknowledges receipt of two(2) completed copies of the Notice of Right to Cancel form and certifies Lowe's has informed Customer orally of his or her right to cancel. NOTICE TO CUSTOMER. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. Lowe's Home Centers, LLC EXECUTION DATE: 06/05/23 LOWE'S AUTHORIZED REPRESENTATIVE SIGNATURt OWNER'S SIGNATURE CO-OWNER SIGNATURE )& n. cY O'Cik.w-o-art - Customer acknowledges receipt of a true copy of this contract which was completely filled in prior to Customer's execution hereof. Store 1916 LOWE_S OF HADLEY_MA-Contract-1038455-Page 5 of 27 Rev.03/02/2021