12C-114 (3) BP-2023-1427
95 RICK DR COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
12C-114-001 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-2023-1427 PERMISSION IS HEREBY GRANTED TO:
Project# WINDOWS 2023 Contractor: License:
Est. Cost: 3765 HOME DEPOT USA INC 106106
Const.Class: Exp.Date: 09/29/2024
Use Group: Owner: STAMPA MAURA J
Lot Size (sq.ft.)
Zoning: RI/WSP Applicant: HOME DEPOT USA INC
Applicant Address Phone: Insurance:
2455 PACES FERRY RD NW 860-952-4112 WLRC50668058
ATLANTA, GA 30339
ISSUED ON:10/13/2023
TO PERFORM THE FOLLOWING WORK:
4 REPLACEMENT WINDOWS
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector
Underground: Service: Meter: Footings:
Rough: Rough: House# Foundation:
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 y2
•e, . 3:,&kz5,
Fees Paid: $40.00
•
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner
p e, ,,„,,:,( ea rl/"4'1 feu,.•.¢ Zr
pGf r„YZe 9 o rr"
The Commonwealth of Massachusetts r `c� VE I
Board of Building Regulations and Standa ds R
It
� MUNI IP TY
EMassachusetts State Building Code, 780 C R OCT 2023 SE
Building Permit Application To Construct, Repair, Reno ate r Demolish a Revise Mar 011
One-or Two-Family Dwelling nr DT nFuu,�
,,UgTHA^,4'io I,%.1,, TIOiVS
This Section For Official Use On y �._ ��r.,sA 0106n
Building Permit Number: 30.d, 3- I'{)7 Date Applied:
d„� I Z. //ç7' ID-1BuildingOfficial Si n Date
(PrintName) Signa
1: SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map&Parcel Numbers
qs' 4,ck Moe f`bfcnce Ago/oo6Z
1.la Is this an accepted street?yes ✓ no 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 if yes❑
SECTION 2: PROPERTY OWNERSHIP
2.1 Owner'of Record)
mM rel. S l yot ReteetCC N' D/06 °-
Name(Print) City,State,ZIP
e?c /140 - Pe efts -,SQj- 140 0I0JsictIme".6 qMa;(. cows
No.and Street Telephone Email Adoress
SECTION 3: DESCRIPTION OF PROPOSED WORK2(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 Specify:
Brief Description of Proposed or 2:
0/ jle« w0.er I,kc . peke w
4' S ar . ctur "( , 21
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1. Building $ 3'i.6 S' .90 1. Building Permit Fee: $ Indicate how fee is determined:
❑ Standard City/Town Application Fee
2.Electrical $ ❑Total Project Costa(Item 6)x multiplier x
3. Plumbing $ 2. Other Fees: $
4. Mechanical (HVAC) $ List:
5. Mechanical (Fire $
Suppression) Total All Fe s:n$,� fi
Check No./b Check Amount: Cash Amount:
6. Total Project Cost: $ C',vv 0 Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
/46/a Z9 2f
Ex'}e. C of-AAA. License Number Expiration ate
Name of-CSL Holder
ZS 0044.44 S h List CSL Type(see below) V S
Na and Street Type Description
i L f o�rd 9 U Unrestricted(Buildings up to 35,000 Cu.ft.)
_—_ R Restricted 1&2 Family Dwelling
Ci own, te,ZIP M Masonry
RC Roofmg Covering
— Window and Sidin
SF _Appliances
gQ-95 Z- L p.C/w4413(10 ge tr ik-1.O_(ci I Insulation
Telephone rmail address D Demolition
5.2 Registered Home Improvement Contractor(HIC)
�G vt uSA ,ri,c l Z S L Zte
I►A S /� HIC Registration Number E irati n Date
HIC Company,Namewor HIC Registrant Name
LYE i)accs F�r•> Ra .ci•N:7.5 450 d u 73 ,orJ
No.and StreetI'61,1IAddress
/ e. , 6/1 30339 4o m52 - 'ti[Z
City/T'own, 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? 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: 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,t-st o y knowledge and understanding.
Print Owner's or Authorized Agent's Name(Electronic Signa 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. 142k 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 half/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
TNbM
•" Massachusetts
W;
( DEPARTMENT OF BUILDING INSPECTIONS 7i
yJ
212 Main Street • Municipal Building ,',
Northampton, MA 01060 f� h,^,N
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: /4rr•4t (flee-03 t S*1
Location of Facility: '7-Z S!4at #' gem.' (ern./ Z Eete(ol CT 66012
The debris will be transported by:
Name of Hauler: E e4,1c. 514,60 i— _
Signature of Applicant: Date: l6 '/L " z 5
The Commonwealth of Massachusetts
Department of Industrial Accidents
g) Office of Investigations
_��t�= �j Lafayette City Center
:?=_3. 2 Avenue de Lafayette, Boston,MA 02111-1750
,`' .�` 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 #:1-860-952-4112
Are you an employer? Check the appropriate box: Type of project(required):
1.❑ I am a employer with 4. MI I am a general contractor and I
employees (full and/or part-time).* have hired the sub-contractors 6. ❑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 8. ❑Demolition
workingfor me in anycapacity. employees and have workers'
p n 9. ❑Building addition
[No workers' comp. insurance comp. insurance.:
required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions
3.❑ I am a homeowner doing all work officers have exercised their 11.❑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.I.1 OtherWindow 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.
tContractors 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:3/1/2024
Job Site Address: q4- AA. D, .'.` City/State/Zip: 1 bR'.ge.e /*{4 v/46 Z
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: /D— /Z - "L 3'
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):
10Board of Health 20 Building Department 31:City/Town Clerk 4.0 Electrical Inspector 5.0Plumbing
Inspector 6.0Other
Contact Person: Phone#:
ACREDATE(MM�DD.YYYY1
�_. CERTIFICATE OF LIABILITY INSURANCE 022'.2;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 POUCIES
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 pollcy(ies)must have ADDITIONAL INSURED provisions or be endorsed,—
if SUBROGATION IS WAIVED,subtect 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(sj.
PRODUCER CONTACT
HARSH USA tiC NAME
1 FAX
TWO ALLIANCE CENTER LAY' .F141 j .NH.
3560 LENOx ROAD.SUITE 2400 E-MAIL
ATLANTAGA 30325 ADDRESS
INSURERIS)AFFORDING COVE RAGE MAIL I
CN10•642%9--ia'-eD-GAW-22-25 INSURER A.CHI Rspu'JM'.IrrS,asce Gv 2d14'
ININAEDTFE I1cF E DEPOT,INC INSURER B S.IndMWlty rs Ca Of N'olI Are'to d3575
HaSiE DEPOT U.S A_ INC NSURER C.ACE AMNION Intutertcn G r-c4f t 22667
2455 PACES FERRY ROAD
BUILDING C-20 NBURER D. —
ATLANTA GA 3039 INSURER
I NBURER F.
COVERAGES CERTIFICATE NUMBER: ATL-035 0 7 22 250 1 5 REVISION NUMBER: 7
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
SIR ADOI 5UeR POLICY EFF POUCY EXP
LtN TYPE Of INSURANCE *so two POUCY NUMBER ,0Y117DIYYYY) 1MMOD1'YYY1 LIMITS
A X CCWERCLAL OENIERAL uAad.IfY MWZY 31E645 0'C'i2022 rAT,T{1!2325 EACH OCCURRENCE f 1.0001100
1 CJ.IMS-,MACE ' OCCUR. PREMISES tEaa MGsi f 1�.�
X Ea I'3a3 6]0 MED EXP,Aiy one maw f EXCLUDED
PERSONAL 6 ADM INJURY S I.000000
OENL AGGREGATE LSAT APPLIES PER GENERAL AGGREGATE f 2,00E000
POLICY Ei ❑LOC PRODUCTS-COMP'On AGG f 2.030_000
OTHER. S
A AUTOMOBILEIMBILITY MWT5316649 03X.2322 Dorms CCMISNED SINGLE LILtT f 1,0E9000
ANY AUTO. BJDIL Y INAIRY;Per perwn I
'-'—' GINNED — SCHEDULED SELF 1tSUREDAUTOFlfYOW BJDi 'INJURY,.Fvf aa:.mmp S
AUTOS ONLY ALRO6
~�"N`REO NCN�f7NNEG PXOOPcRTY GANAUE S
,.....,AUTOS ONLY kir OS ONLY e•v`-•r1u'ii
f
A UYBRELLALIAB �X gyp, MWZX315647 Q3rU '20.4 0101!2025 EACHOCCURR_NGE f 13,000.000
X EXCESS LASS CLASS-►FGF AGGREGATE f 10•DCC.NIC
F
DED 1 1 FETE'(T•ONX f
B WORKERS COMPENSATION SCFC50 66 8 1 95 11N11 .:.C`27L '0391.2024 x'PER I IoTH-
AND EMPLOYERS'uAaan'Y STATUTE EG
Ah,'?FJFkF_T OP.Fri.TNERrEXECL'T 'E YrN VILRCSCb58'.50 IMT} :uC'21Z3 03r41.2024 EL EACH ACCIDENT f 5.�.000
CPR GER.10E VEEP EACL,,IOEDT N II I '
IMana'Iiory In NM E L.DISEASE-EA EMPLOYEE f 5,039.000
It Nei.,Mums VAC CINNIVA d an h]Cf)crm Page 5,O30000
DESCRIPTION OF OPERATIONS ba5w E L.DISEASE•POLICY LOST f
i
l
DESCRIPTION Of OPERATIONS,LOCATIONS!VEHICLES(AC ORO 1f1.Aeditianat Ramaetca WNW*,naY Da attached it maw spar*M roqu.nra)
MCC NCE Or riSURA'wa
CERTIFICATE HOLDER CANCELLATION
-+CIE DEPOT USA.NC. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
2455 PACES FERRY ROAD BUILDING C-iO THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN
ATLANTA.GA 30339 ACCORDANCE WITH THE POUCY PROVISIONS.
AUTHORIZED REPRESENTATIVE
l 7/taz4u ZIS. 'Ifrc.
C 1988-2016 ACORD CORPORATION All rights reserved.
ACORD 25(20161031 The ACORD name and logo are registered marks of ACORD
AGENCY CUSTOMER ID: CN 10164206S
LOC#: Atlanta
ACCOREP ADDITIONAL REMARKS SCHEDULE Page 2 of 3
AGENCY NAMED INSURED
AIRR_`•.-USR.D:_ THE HOME DEPOT,PC
HOME DEPOT U SA.NC
POCrCY NUMBER 2155 PACES FERRY ROAD
B+ALDI G C 2D
ATLANTA GA 30339
CARRIER MAKC CODE
EFFECTIVE DATE.
ADDITIONAL REMARKS
THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM.
FORM NUMBER: 25 FORM TITLE Ceritirate of Liability Insurance
'Markers Co^per at._n Cc-sruac..
Comer Smiley hafara Ce9.aty Gnomical
Pdicytietrbr LDS03831D,,ALARAZFL,D.WO KS.0.uAIISPAONC,t4f.M.tfl 0KSC.SD,TNw1 NY Veil
Ef4drOale:03Al2C23
Etonian Da!DwrXC24
(Ell Limit SS EC XE
Came Safety haEr.,Camaty Coravatcr
Pate timber SP1:18859:105I CAOR.'!6'i a
Elleca a Dale:I3/J1,2r,,23
Erproton Om*5Y21,2C21
(ELI Lint S5 DX:CO
SR SI,OX,OCC
Amer ACE Nnercan rsu•ame Cirroary
Pdrr Muerber"No 506c8:05 AOSfi IGAMLNY.Of1,U)
Efkmre Cate.:iUJ1Q323
Erprom Cafe.J3MJ1i21Y24
(ELILar2 KOCC 2a
SR$1.0)0,000
SIR(GA(_S750,O:G
Can MCrmty Irrtanra Cosprty alflsdk Arnim
kit!kalibir-WiRCYAN1051(Alt O,CT.DCDE..HLINANICIAEMN.1.04.1M.PARI.YTI
EBmimaCdt i3/J1i2 3
Eepramn Dow:530112E24
al brit$5.0X:000
TX Enicvols XS howdy.
Came-Zurich Amman Hearn:Ceue
Palm Mmbr.NSL.1138919(fXI
Etireue Cate'J3)tic1123
Erpraten Ns:OY0112024
EL:Lr+c$5.000.0oC
3IR 1.500CXO
ACORD 101 (2008f01► 2008 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
THE COMMONWEALTH OF MASSACHUSETTS
Office of Consumer Affai 3 anq Business Regulation
1000 Washing jra t-Surge 710
Bosto t44assacttusetts.N118
Home Ima • t e•- treCCor-r istration
m --. e ,Type: Corporation
✓ $$ ,=5."'t .�,anon. 1127e5
HOAR DEPOT USA INC :. anon: O4I27J2025
PO BOX 105451 :▪ . > -R z
ATLANTA.TN: LICENSE MGMT TEAM # _ = ! —
x v
L. }= Update Address and Rattan Card.�
THE COMMONWEALTH OF MASSACHUSETTS
Othse of Constants;ANce A Sv4M.aa RegJaffoa Reolatribnn valki fa indiWd,rAt vas only before the
es wn data. 1f found return to
HOME IMPROV ENT CONTRACTOR *spiral
YPE rdlwrt Office of Constarser Affairs and business Regulatioo
gp 4 1000 Washington Street •Stolle T10
11 fi}_
_ Boston,.MA 02115
HOME DEPOT USA} ;;
3!
COURTNEY A HOVrt,'lr
2465 Pat Es FERRY Rb it fMf't"'r`1',`
r. a''var"t
ATIANTA,6A 3933♦i "r llndrxrecretary Not valid without signature
.ttcomb CERTIFICATE OF LIABILITY INSURANCE DATE WARDD,YYYY1
1/31/2023
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 IS WAIVED, subject to the terms and conditions of the policy,certain pdicles may require en endorsement. A statement on
this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER AizeCT Deborah Marino
Canary Blomstrom Insurance Agency P1.OfeE T FAx
868 Springfield Street Ar.1so Eal.(413 50�022 >;AG No(413)786-7004
Feeding Hills,MA 01030 E :dmarinocana blomstrom.com
INSURER'S'Af f UN INu LovENAGE MAX
NSURER A.NGM Insurance Co. 14788
INSuREU Ns&Rre B•Arbella Protection Insur9nce Gomnanv 41360
Exterior Remodeling Group Inc. INSURER c.AIM Mutual Insurance Co.
23 Benham St NSURERD:
Springfield,MA 01109
Nx4RERE
INSURER F
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES Of INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NASD 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 8E ISSUED OR MAY PERTAIN THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS.
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.. TS SHOV.`,HAY HAVE BEEN REDUCED BY PAD CLAIMS.
!NSA-
MCA.OF INSURANCE (ADOI.SUER PDUC Y NUMER mucr EFF POKY EIIP
LTR n W411 1MilDEVYYYY, IMMDOJYYYYI LAM
A X COMMERCIAL GENERAL LIABILITY EACH Tri uRRENCE di 1,000,000
CL IMs4AMOt: [ J uccu' MPP3376W 7/27t2022 7/27/2023 pasu'L°scEioRENTED $ 500,000
MED EXP AMv oft bcrsoN I
10,000
HENSEXIALSADvtNA tY 1 1,000.000
^fn:AG 7E LOAF APa IE9 PER GENERAL FA:.RELATE f
2,000,000
pp��,,�� VROPLKITH•CN MPaPA0O I 2,000.000
Ti r,ICv �"Uf �1 Csf:
X THE Ft
p 131.xA1➢r 0•aNGN.E..Irair 1,600,000
AU TomouLEIwUTr twa ar,,,Irnt,
at,•.AUT° 1020110392 8/17/2022 8/17/2023 U:IUE Y pNJUHY G••• )
M NE0 SCHEDULED
.S.J'Y.CYrE. AUTOS FOOL.Y INJURY,E.,,,xxisrif 1
PROPERTY QAMAiFX 'Al C Ira X ';',.an ow?V t'm arattcil I
r A
UMBRELLA CMS UCL UA EACH OCCURRENCE I
EXCESS LIA6 r_AIMSJAADE #iUREGATL .� ......,
DEE I 1 RETENTIONS t
C AWRO KERB C MP N*ATLem R X l221U TH
IE I f -
WCC-500-5028443-2023A 10512023 1;2512024 500,000
ANN PROFfgf-ra.PART+ERESECUTNE EA.EACH AOODEitt ,1
I� FI,VER EXCLUDED, Y N,A
In NM] E...DISEASE-EA EMPLOYEE S 500,000
(:t u�Nlc•)tJN OF C'Leh 1loss t+Y.TY L.t LIISEASL. Sx,ICYLIMI1 I 500,000
DESCRIPTOR OF OPERATIONS!LOCATIONS!VEHICLES ACORD 101 ASOLo.vl Remarbe SQ„edule.may be atleched x more space Is required?
Home Depot ULSA.Inc.is named as Additional Nfsured with respects to General Liability. Eugenio Ciuboteru is excluded from the Workers'Compensation
Policy.
CERTIFICATE HOLDER CANCELLATION`
SHOULD ANY OF THE ABOVE DESCRIBED POi ICIES BE CANCELLED BEFORE
Home Depot U.S.A.Inc THE EXPIRATION DATE THEREOF, NOTICE WLL BE DELIVERED IN
P ACCORDANCE VATH THE POLICY PROVISIONS.
2455 Paces Ferry Rd C-11
Atlanta,GA 30339
AUTHORIZED REPRESENTATIVE
ACORD 25(2016/03) ®1988.2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
t Put Clototail Viii4Ouit of It*kroculve Ohm of t-r.;+4L- tte,:Anon of Pvilemsorval licansare and tQ3,6166o1 Stardar
11111116 6 11.410
PuZiliff?„="istits,
()Mass.
Licensee Details
Demographic Information
Ft Name EUGENIU CIUBOTARti
wrer
License Address Information
Snr4og'eld
te MA
ipcode 01109
ounfr) United States
License Information
Lcense 4o CSSL-106106 Lcense Type Construction Supervisor Spec,"
Profession Bulldog Licenses Date ot Last Renewal 10131022
Issue Date 4,12/2017 Er oval=Date 9v292024
'Lcense Status Active Today s Date 10.14/2022
,SeCOndaty License T,pe
fDcong Business As
'Status Change Reason Lcense Renewa,
Prerequisite Information
kicensee -CIU0OTAITO,EUGENtU
Attnbute Of
License Na CSSL-I06106
Io kv a raiYe 60cuments.
I -
Commonwealth ot Massachusetts
Division of Occupational Licensure
Board of Building Regulations and Standards
t7I f41?„
Constructigsr5upe4, r Specialty
CSSL-106106 Opires: 09/29/2024
Air
EUGENIU CIVBOTA.
23 BENHAM ItTRE zr'"
SPRINGFIELtM
.00 ,
4161.1,VAA33
/-1 • •
r•...an..4nnoie.e.;••• "
94.0 0000000 1,6. (.1174.4. I 1. L,
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 of this license.
For information about this license
Call (617) 727-3200 or visit www.massgovdpl
Off#cq of Consumer Affairs and Business Regulation
1000 Washington Street.State 71U
Boston,Mass tusetts 02118
Home improvsr*tent Contractor Registration
1P0 COMA(Y+eY;
EX' t `t up. ` t !MOWOfice ofConsumer 266FP RW.S?
SPm t,n,u4 et * Etionv, QS.C9•K1:s
Affairs and
Business �'�""�'�'.
MAWS*mom o zoom. avow*
rx#:CML01WYti no»gs^•X ion tour Yx ortavl4WI uu nnit
awa a tM*+ Mot,XeM a N....e my 10.
Regulation (OCABR) tow .n�o M otal g tl. ,.
TX"114B"re»hKfl:lli FAPi4 NC :»„orsa.,.M„Or't4
H1C Registration Complaintsa1304``ffi°x"" ` - a
sX»t1Wr'a11 ata 0at;L .y.s.
Registration e 187664
Registrant EXTERIOR REMODELING GROUP INC
Name EUGENIU CIUBOTARU
Address 23 BENHAM ST
City.State Zip SPRINGFIELD MA 01109 CIAD&Ru
Expiration Date 05109/2025 i epu -
autnori' Go Permits i_Lc to pull pcnntts using my
Complaints Details LL
No complaints found for this registrant l.J License Ti r !O 6 __T_ aria my
BIC Registration N I$$ 66 6 ___.
'.^:cc:ions:please call me at: t Li, 3 l J 3 3 5=3 7 O a
installer Diu....
t-OMpany tvai,.,. __ Ey ttiti o_ R,P Me 0IF 1 G ROU f>
Go Permits, LLC
0011111 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 Permits
e -ome B epo - erma T a ue o a ro• uc s T anu acture• •y imonton
Dated: 5I3
Without Grids With Grids
Style Glass Package Glazing Spacer (G U SHGC U SHGC
(al!with Argon) Fact Fact
6500
kwning 6500 Base ProSolar Supercept lie" 0.26 0.23 •�� 0.26 0.21 •j•T• •
3asement 6500 Base ProSolar Supercept 7/8" 0.26 0.24 • • • • 0.26 0.22 • • • •
transom 6500 Base ProSolar Supercept 1' 0.27 0.32 • • 0.27 0.29 • • _
)ouble-Hung 6500 Base ProSolar Supercept 7/8"_ 0.29 0.26 • 0.29 0.24 • •
'icture Casement (NH) 6500 Base ProSolar Supercept 7/8" 0.26 0.28 • • 0.26 0.25 • • • •
'icture 6500 Base ProSolar Supercept 7/8" 0.27 0.29 • • 0.27 0.26 • •
?Panel Slider 6500 Base ProSolar Supercept 7/8" 0.29 0.26 • 0.29 0.23 • • •
3 Panel Sliders 6500 Base(s 2t Sqft) Pro Solar Supercept 7/8" 0.29 0.26 a 0.28 0.23 e C •
•500 DOORS
3arden Door(CH) 6500 Energy Star ProSolar SUN Super Spacer 1" 0.30 0.24 I 0 I •I•I 0 10.30 0.21 l•I•I •I •
'atio Door INOVO 6500 Base Pro Solar Super Spacer 1" 0.28 0.26 • • 0_31 Q.23 • • • •
• 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 • • • • 0.28 0.21 • • • •
3asement • 6100 Base Pro Solar Intercept 7/8" 0.27 0.24 • • • • 0.27 0.22 • • • •
le.. ".FIUT 6100 Energy Star Pro Solar Supercept 3/4" .30 0.30 • 0.30 0.27 • • •
't asement(No Hinge) 6100 Base Pro Solar Intercept 7/8" 0.28 • • 0.27 0.25 • • • •
'icture 6100 Base Pro Solar Intercept 3/4" 0.27 0.31 • • 0.27 0.28 • •
Panel Slider 6100 Base Pro Solar Intercept 3/4" 0.30 0.28 • 0.30 0.27 •
3 Panel Slider 6100 Base Pro Solar Intercept 3/4" 0.30 0.29 • 0.30 0.27 0
• 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 • • 0.28 0.23 •' • • •
'atio Door NARROW FRAME 6100(PD05)Base Pro Solar Intercept 3/4" 0.28 0.30 0 0 0.28 0.26 0 •
6200 Homes located only in following markets:Dallas,Denver,Detroit Phila,Northern NJ,Long Island,NY.
\wring 6200 Base Pro Solar SHADE Supercept 3/4" 0.27 0.25 ' • • 0 : 0.26 0.23 • a 1 0 0
3asement 6200 Base Pro Solar SHADE Supercept 3/4" 0.26 0.18 • • • 0 0.29 0.17 • • • •
'icture Casement-NH 6200 Base Pro Solar SHADE Supercept 3/4" 0.25 0.21 • • • 0 0.25 0.19 • • • •
'icture Window 6200 Base Pro Solar SHADE Supercept 3/4" 0.26 0.24 • • • • 0.26 0.22 • • • •
Single Hung 6200 Base Pro Solar SHADE Supercept 3/4" 0.28 0.23 • • • • 0.28 0.21 • • •
Single Slider 6200 Base Pro Solar SHADE Supercept 3/4" 0.28 0.23 • • • 0.28 0.21 - • • •
3 Panel Slider 6200 Base Pro Solar SHADE Supercept 3/4" _ 0.28 0.23 • • • 0.28 0.21 0 •_0
•tormBreaker Plus 300VL Homes located in coastal areas.
\wring SB+300VL Energy Star PS SUN/Lami Supercept 1' 0.26 0.23 0 0 0 c- 0.26 0.21 0 0 0 0
3asement SB+300VL Base PS/Lami Super Spacer 1" 0.25 0.23 ••.0 0.25 0.21 • • • •
)ouble Hung SB+300VL Base PS/Lami Super Spacer 1" 0.29 0.25 • • • • 0.29 0.23 • • • •
Slider SB+300VL Base PS/Lami Intercept 1' 0.29 0.25 • • • • 0.29 0.23 • • • •
'atio Door SB+300VL ETC 366 PS Shade l Lami Super Spacer 1" 0.30 0.19 • • • • No Grids Allowed
3arden Door(CH) SB+300VL Base PS/Lami Super Spacer 1" 0.30 0.28 •• • 0.30 0.25 •• •• • •
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#: F37747426 Sheet: 1 of 1
Customer: MUARA STAMPA Job#: F37747426 Consultant: Chad Minton Date: 09/26/2023
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,RorS
Glass Misc Items
Hardware Code
Screens For doors use
c_7 O Mull "S"=stationary or
Style Wraps ° 15 t LL ra 5 ,2 N m u N "X"=operating
UJ Room Floor Code (YN) Style Code Series Code g w 3 i co' U 0. > xo .1 > _
-
STD,White, GlassPack: WRAP,LSR
1 BSMT Basem DH- Y DH 6100 WH WH 34 49 83 Standard
ent ALDER
STD,White, GlassPack: WRAP,LSR
2 KITCH 1st DH- Y DH 6100 WH WH 29 33 62 Standard
ALDER
STD,White, GlassPack: WRAP,LSR
3 KITCH 1st DH- Y DH 6100 WH WH 33 49 82 Standard
ALDER
STD,White,TMP:Full, WRAP,LSR
4 BATH 1st DH- Y OH 6100 WH WH 25 37 62 GlassPack:Standard
ALDER
SPECIAL CONSIDERATIONS:
1:White,2:White,3:White,4: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(OH,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)
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 _ 1The Home Depot
Service Provider Contact Name Service Provider Company Name
(203) 265-7037 customercancellationnorthe ast@hom MA: 107774, 112785
Phone # gg vp°cec$'vider Email Address Service Provider License#(s)
2. Customer Information
rS TAM PA MUARA 1 New England West F37747426
Customer Last Name Customer First Name Store#/Branch Name Customer Lead/PO#
195 Rick Drive Florence MA 01062 j
Customer Address City State Zip
4135887429 (413) 584-2876 mojstampa@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 H ME DEPOT GIVE YOU A NOTICE EXPLAINING YOUR RIGHT
TO CANCEL. PLEASE SIGN BELO TO AC OWLEDGE THAT YOU HAVE BEEN GIVEN ORAL
AND WRITTEN N TICE OF YOUR GHT NCEL.
Acknowledged by• I 09/26/2023
Customer's Signature Date
460 Standard Form HIA(21JuL21)(E) Generated Date 0Q/2R/2023 Lead/P0# F'Ma7426 v 0.1.12
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: 03/24/2024 Approximate Finish Date: 04/23/2024 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: $ 3765.80 Includes all applicable taxes. Excludes finance charges.*
Sales Tax: $ 0.00 (If applicable, total amount of taxes included in Contract Price)
Y lrrxiinuin deposit ONLY applicable in MD. MA, ME (33%), NJ, WI (99%)
Deposit% 25.0 Deposit Amount $ 941.46 Remaining Balance $ [2824.34
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.
09/26/2023
Customer's Signature Date
X /s/The Home Depot 09/26/2023
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 1b5-iu3/
460 Standard Form H1A(21 Jul.21)(E) Generated Date OA/2F/2023 Lead/PO# F377474.26 v 0.1.12
" 1 Scope of Work
STAMPA MUARA New England West F37747426
Customer Last Name Customer First Name Store#/Branch Name Lead #
Job #: (Internal
Reference) Products: Spec Sheet(s) #: Project Amount
Reference)
F37747426 Windows Entry Doors F37747426 3765.80
Windows Entry Doors
Windows Entry Doors
Windows Entry Doors
Windows Entry Doors
Sales Tax 0.00
Total Contract Amount 3765.80
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):
wo Standard Form HIA(21 Jul.21)(E) Generated Date 0O/2c i2073 Lead/PO# Fq77d7d26 v 0112
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.
460 Standard FamH1A(21 Jul 21)(E) Generated Date 09/26/2023 Lead/PO# F377L17a96 v 0.1.12
�1
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.
460 Standard Form HIA(2IJuL21)(E) Generated Date 1)9/96/2023 Lead/PO# 77a761.96 v 0.1.12
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.govilead/renovation-repair-and-painting-program.
460 Standard Form HlA(21 Sul.2t)(E) Generated Date Og/2R/2023 Lead/PO# F'177d7a26 v 0.1.12
Go Permits, LLC
105 Buttonball Lane
GPO IR 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. 4/22/2025.
Workers' Comp: Indemnity Insurance Company of North America
Policy: WLRC50668058 Expires 3/1/2024
Eugeniu Ciubotaru of Exterior Remodeling is the sub-contractor.
CSSL-106106 Exp. 9/29/2024 / HIC 187666 Exp. 5/9/2025
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: permits(a ciopermits.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