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17A-108 (5) BP-2023-1589 33 CLAIRE AVE COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 17A-108-001 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-2023-1589 PERMISSION IS HEREBY GRANTED TO: Project# WINDOW 2023 Contractor: License: Est. Cost: 3538 RENEWAL BY ANDERSEN 090125 Const.Class: Exp.Date: 10/06/2024 Use Group: Owner: J KOSTEK SARAJANE &LEON Lot Size (sq.ft.) Zoning: RI/URA Applicant: RENEWAL BY ANDERSEN Applicant Address hone: Insurance: 30 FORBES RD 508-351-227 WLRC50668058 NORTHBOROUGH, MA 01532 ISSUED ON: 11/15/2023 TO PERFORM THE FOLLOWING WORK: 1 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 � s ' ar . ),2 . cg''1 • II Fees Paid: $40.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner ttiN 1pe/07"� ' ' • cad j , 4'`' `eincP ! Cer I 4� a Se/s e"CB 5o r�i s .J ieretord The Commonwealth of Massachusetts I Board of Building Regulations and Standards MUNICIOR PALITY PALITY '✓ _ 9 2023 i Massachusetts State Building Code, 780 CMR USE Building Pertiit Application To Construct, Repair, Renovate Or Demolish a Revised Mar 2011 - One-or Two-Family Dwelling -.4;;I roar:►NsPPc U;',= ,,.in TON.MA Ot<'. This Section For Official Use Only Building Permit Number: ✓0 n A 3-JSS79 Date Applied: /i< ZS ,//, - //-/g/'ZetZ3 Building Official(Print Name) Signature Date SECTION 1: SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map& Parcel Numbers 33 C<a/rc 1.l a 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❑ Private 0 Zone: _ Outside Flood Zone? Municipal 0 On site disposal system 0 Check if yes!: SECTION 2: PROPERTY OWNERSHIP1 2.1 Ownerl of Record: Samoa, 7a nc. 14-05-k- it. N0,-/64" .l 1169 0/0 6 2-- Name(Print) City,State,ZIP 33 Otte 2I-r Li(3-SSS- q-23Z sarlc 04 dovt No. and Street Telephone Email Address 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: /y keep,R 1 Brief Description of Proposed Work': t� -N/%/kt4rf t/ `e ono-e. 00w c' A p 42 t-C / .✓i-.4 clivv- !,to 14 r, `P R� 14,A 40 S frt�; O( 1 Z� SECTION 4: ESTUV1A ED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ 3,6 3 S,OD 1. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical $ ❑ Standard City/Town Application Fee ❑Total Project Costa(Item 6)x multiplier x 3. Plumbing $ 2. Other Fees: $ 4. Mechanical (IIVAC) $ List: 5. Mechanical (Fire $ Suppression) Total All Fees: $ f P Check No. t.� eck Amount: ° Cash Amount: 6. Total Project Cost: $ 4 73 0, �0 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction struction Supervisor License(CSL) 0 90 /IX- ,t,' /Ly )At Me- /1''14 License Number Expirationio Date Name of CSL Holder �S 36 ' List CSL Type(see below) No.and Street Type Description &o/ �C°154 ,1"/14 4/4/5-33 2- U Unrestricted(Buildings up to 35,000 Cu.ft.) �'[ /�" R Restricted 1&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering Window and Siding SF Solid Fuel Burning Appliances S2' Y/I2 �fy L2e24 i1 eG�1DG€ .e0 I Insulation Telephone mail address ✓ D Demolition 5.2 Registered Home Improvement Contractor(HIC) 12/ZZ /ZT Reywid 61 4Ackestel HIC Registration Number Expiration Date HIC Company,Namf o> C Resistant Name 30 1'6 i.vs x d ���✓ a�o�G�eil 1 No.and Stet Email address Ree..fiverS4P5 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? Yes .. . V No 0 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 penaltie of perjury that all of the information con .' .' in this application is true and accurate to the best of my knowl dge and understanding. r , 41 / 1' -9- 2-3 Print er'• or A onzed is Name(Electronic Signature) 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.g_rv< /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 Nuniber 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 ?'"0. � Massachusetts � �'<<G - ;,r DEPARTMENT OF BUILDING INSPECTIONS ' ;; ,�, 212 Main Street • Municipal Building yvj OD Northampton, MA 01060 Jslh a,- '' 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: 3o .t4ja -S /d /U'✓`4 4°-O `4-5k M4 o/c32 The debris will be transported by: Name of Hauler: I/004 Alla 4, e,/11'mil Signature of Applicant: A Date: f J -f-z 1 ne L,ommonweatrn of massacnuserrs Department of Industrial Accidents Office of Investigations Lafayette City Center 2 Avenue de Lafayette, Boston,MA 02111-1750 s www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Bus iness/Organization/Individua1): Renewal by Andersen Address: 30 Forbes Rd. City/State/Zip: Northborough, MA 01532 Phone #:508-351-2277 x 6 Are you an employer? Check the appropriate box: 4. I am a general contractor and I Type of project(required): 30 1.NI I am a employer with ❑ 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 working for me in any capacity. employees and have workers' 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 11.0 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 Replacement employees. [No workers' 13.�Other p comp. insurance required.] *Any 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: Old Republic Insurance CO. Policy#or Self-ins. Lic. #: MWC 314158, 23 Expiration Date: 10/01/2024 Job Site Address: 33 Claire Ave City/State/Zip: Northampton MA 01062 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: ��i ?.G/?� Date: ` I — Phone#: 5 -351-2277 x 6 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): 1❑Board of Health 20 Building Department 31:City/Town Clerk 4.0 Electrical Inspector 5.0Plumbing Inspector 6.0Other Contact Person: Phone#: RENEWAL BY ANDERSEN SPECIFICATION Et TECHNICAL MANUAL TECHNICAL INFORMATION PERFORMANCE RATINGS AND TEST DATA NFRC Total Unit Performance U-Factor Renewal by Andersen® High Performance Glass Type (BTUI(hr ft2 oF)) Product Air HP Gas Blend Air HP Gas Blend Without Grilles 0.42 0.41 0.51 0.51 .82 Clear Full Divided Light Grilles 0.43 0.41 0.46 0.46 Without Grilles 0.31 0.28 0.28 0.27 .72 s ... ,I, u.ac u.ca u.co 0.25 Casement Without Grilles 0.32 0.29 0.17 0.17 .40 S Low-E4®Sun Fixed Full Divided Light Grilles 0.33 0.30 0.16 0.15 tk out Grilles ) 0.31 0.28 0.19 0.18 .65 ow-E4®SmartSun -. Full Divided Light Grilles 0.32 0.29 Oil 0.17 Now Low E4®SmartSun -Without Grilles 0.26 0.24 0.18 0.18 .63 with HeatLock"' Full Divided Light Grilles 0.26 0.24 0.17 0.16 Without Grilles 0.43 0.41 0.51 0.51 .82 Clear Full Divided Light Grilles 0A3 0.41 0.46 0.46 Without Grilles 0.31 0.28 0.28 0.27 .72 Low-E4® Full Divided Light Grilles 0.32 0.29 0.25 0.25 Without Grilles 0.32 0.29 0.17 0.17 .40 Awning Low-E4fr Sun Full Divided Light Grilles 0.33 0.30 0.16 0.15 Without Grilles 0.31 0.28 0.19 0.18 .65 Low-E4fr SmartSunn" Full Divided Light Grilles 0.32 0.29 0.17 0.17 low E4®SmartSun Without Grilles 0.27 0.25 0.18 0.18 .63 with HeatLock"' Full Divided Light Grilles 0.27 0.25 0.17 0.16 Without Grilles 0.46 - 0.58 - .82 Clear Full Divided Light Grilles 0.46 - 0.52 - Without Grilles 0.33 0.30 0.31 0.31 .72 Low-E4® Full Divided Light Grilles 0.34 0.31 0.28 0.28 Double Hung DS ® Without Grilles 0.33 0.30 0.20 0.19 .40 (All Frames) Low-E4 Sun Full Divided Light Grilles 0.35 0.31 0.18 0.17 Without Grilles 0.32 0.29 0.21 0.21 .65 Low-E4®SmartSun' Full Divided Light Grilles 0.34 0.30 0.19 0.19 Low E4®SmartSun Without Grilles 0.27 0.25 0.20 0.20 .63 with HeatLockTM Full Divided Light Grilles 0.30 0.27 0.18 0.18 09-9 COMPANY CONFIDENTIAL- REVISION AA-01 9 RENEWAL �4 / byANDERSEN / / FULL SERVICE WINDOW 8 DOOR REPLACEMENT • J • Re: Massachusetts Solid Waste Affidavit Good day, Please find attached location where the installers will bring their debris from the jobs. These are all Renewal by Andersen location. • WASTE MANAGEMENT—30 FORBES RD, NORTHBOROUGH,MA 01532 When filling out any solid waste affidavit, it's the installer whom will be removing the garbage and dumping the trash at the Renewal by Andersen dumpster locations closest to that job. Thank you, Go Permits Go Permits, LLC 105 Buttonball Lane G4131 IR Glastonbury, CT 06033 PERMITS Scott Doughman Phone: 860-952-4112 iiii„ \\NI,441 Fax: 860-430-6719 scottdoughman@gopermits.org Re: Building Permit Application - Licenses Good day, Please find attached permit application, licenses and supporting documents. Renewal by Andersen sold the job and is the G.C. and CSL - CSL #CS-090125 -- Exp. 10/06/24 - HIC #170810 -- Exp 12/22/23 - Workers Comp -#MWC 31415822 — Exp. 10/01/24 Old Republic Insurance Co 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: renewalbyandersen(a gopermits.orq • If you unable to mail the permit to the homeowner please send to the below address and we will ensure the permit is at the home posted at the time of installation: Go Permits, LLC 105 Buttonball Lane Glastonbury, CT 06033 If we are required to pick up the permit in at the building department, please call 860-952- 4112 once it's ready and we will come to get it. Thank you, Go Permits Commonwealth of Massachusetts ,~__ Construction litp.rYisOl Division of Occupational Lrcensure Unrestricted-Btriidings of any use group which contain Board of Building Regulations and Standards less than 35,000 cubic feet(19M cubic meters)of enclosed ,:nst,(tett'�1 1t ISV erviscr space i l CS-090125 • '..i•. • ES,pires: 10/06/2024 JAIME L MO r 64 NOrn RAYMOND Nl! •• ' v `i9 ,t a Faber*to possess a current edition of me Masaach .e ulftc C^—^zissiOzrr i1,3.8G ask.. Sista 9uild1K1 Cods is came lot rrvacabort of this Scans*. v For information about tllis license Cal MITI 727-smo or visit wwwinass.govfdpl THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Im r o etnent Cop tractor Registration ""`. type Suppiertwnt Card Registration, 170810 RENEWAL BY ANDERSI N PLC ttaltifation 121221202:3 NO tTHBOROUGH,MA 01532 ,... ,,i k-', tlsv+' 1.* ' Update Address and Return Card. THE COMMONWEALTH Of MASSACHUSETTS Office of Consumer Affairs&Business Regulation Registration valve for individual use only before:ha •w.pinlet,.riot. 14 found return to. HOME IMPROVEMENTiv%J n (and CTUft Office of Consumer Affairs and Business Regulation TYPE:Sutx nwm tat t000 Washington Strom -Suite 710 Rt;�17l0,tatilAe 2221423 Beaten,MA 02110 17l)Bt0 12�z21�1a in-,NicWfL BY ANDERSEN!LC JAiME MORIN /r/ ._,.1�� :ih FORBES RD ±n.`' r ,<.'4.."t i. NoHTHBOR0061-f,MA 01532 Uniler3!cretafy Not lid without signature 1/4.1,45 RENEWAL bYANDERSEEN N nociws cox murmur To Whom It May Concern: This letter will authorize the following personls) to act as agent(s) on behalf of Renewal by Andersen ILL 9900 Jamaica Ave South, Cottage Grove MN 5S016 to pull for per-slits and inspections with respect to the installation, maintenance and repair of windows and entry tinort tmdPr Mascarhusetts State Home tmprcw ment Contractor license niimher 170810 and Construction Supervisor license number CS-090125. It you have any questions, please call me at 508 351 2277 ext & Authanzed person(sl: Go Permits LLC Sarah Hammad David Anderson Maureen Kivel Scott Doughman Ryan 8-onda Sor,annara Kuy Mark Foster Glynn Norgan tennller winke went y mold en Gerald Cramer Nick Rago Danel Vickerman Stephen Wilder Katie Grocott Bonnie Myers Carrie Fol gno Michael Rogers Rachel Orloff amie Mo'In Renewal by anderser 1LC HIC 170810 CSL—C5090!25 Local District Office Address 30 Forbes Rd Northborough, MA 01532 er;rwal Iw Andersen ItC 9 00lamaw Awe South,Cottage Grave Mk 55016 Page 1 of 1 (to DATE(MM/DD/YYYY) QC�RO A.. CERTIFICATE OF LIABILITY INSURANCE 09/21/2023 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 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 Willis Towers Watson Certificate Center NAME: Willis Towers Watson Midwest, Inc. c/o 26 century Blvd (NC.No.Ext): 1-877-945-7378 FAX No): 1-888-467-2378 E-MAIL c P.O. Box 305191 ADDRESS: ertificates@willis.corn Nashville, TN 372305191 USA INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: Old Republic Insurance Coepany 24147 INSURED INSURER B: Renewal by Andersen LLC 30 Forbes Road INSURER C: Northborough, t 01532 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:W30224860 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER (MMIDD/YYYY) (MMIDDIYYYY) X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 3,000,000 DAMAGE RENTED CLAIMS-MADE X OCCUR PREMISESO(Ea occurrence) $ _ 500,000 A MED EXP(Any one person) $ 10,000 MWZY 314161 23 10/01/2023 10/01/2024 PERSONAL BADVINJURY $ 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 6,000,000 X POLICY JPERCOT- LOC PRODUCTS-COMP/OPAGG $ 6,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 5,000,000 (Ea accident) X ANY AUTO BODILY INJURY(Per person) $ A OWNED SCHEDULED Mt4TB 314159 23 10/01/2023 10/01/2024 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER YIN A ANYPROPRIETOR/PARTNER/EXECUTIVE EL.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBEREXCLUDED? No NIA MWC 314158 23 !,10/01/2023 10/01/2024 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED „REPRESENTATIVE I Evidence of Insurance egnirUL K• /�^ 4J ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD sp. ID: 24694639 BATCH: 3138744 Agreement Document and Payment Terms NW- DBA:RENEWAL BY ANDERSEN OF BOSTON Sara Jane&Leon Kostek •RENEWAL Legal Name: Renewal by Andersen LLC 33 Claire Ave HIC#170810 Northampton,MA 01062 byANDERSEN 30 Forbes Road I Northborough,MA 01532 H:(413)335-7232 Rl1 YIW11Y1.&000,IIItX[WP Phone:(508)351-2200 I Fax:(508)986-7072 I rbaboston@gmail.com Sara Jane & Leon Kostek 10/25/23 BUYER(S)NAME CONTRACT DATE 33 Claire Ave ,Northampton , MA 01062 (413)335-7232 BUYER(S)STREET ADDRESS PRIMARY NUMBER SECONDARY NUMBER sarle72@yahoo.corn PRIMARY EMAIL SECONDARY EMAIL NOTES: Buyer(s) hereby jointly and severally agrees to purchase the products and/or services of Renewal by Andersen LLC d/b/a Renewal By Andersen of Boston("Contractor"),in accordance with the terms and conditions described in this Agreement Document and Payment Terms,any documents listed in the Table of Contents,and any other document attached to this Agreement Document,the terms of which are all agreed to by the parties and incorporated herein by reference(collectively,this"Agreement"). Buyer(s)hereby agrees to sign a completion certificate after Contractor has completed all work under this Agreement. TOTAL JOB AMOUNT: $3,538 By signing this Agreement,you acknowledge that the Balance Due,and the Amount Financed must be made by personal check,bank check,credit card,or cash. DEPOSIT RECEIVED: $1,179 BALANCE DUE: $2,359 Estimated Start: Estimated Completion: 10 weeks 1 AMOUNT FINANCED: $0 We schedule installations based on the date of the signed contract and secondarily on the date METHOD OF PAYMENT: Check in which we complete the technical measurements.The installation date that we are providing at this time is only an estimate.We will communicate an official date and time at a later date. Rain and extreme weather are the most common causes for delay. NOTES: Buyer(s)agrees and understands that this Agreement constitutes the entire understandings between the parties and that there are no verbal understandings changing or modifying any of the terms of this Agreement. No alterations to or deviations from this Agreement will be valid without the signed,written consent of both the Buyer(s)and Contractor. Buyer(s)hereby acknowledges that Buyer(s) 1)has read this Agreement,understands the terms of this Agreement,and has received a completed,signed,and dated copy of this Agreement,including the two attached Notices of Cancellation,on the date first written above and 2)was orally informed of Buyer's right to cancel this Agreement. NOTICE TO BUYER: Do not sign this contract if blank.You are entitled to a copy of the contract at the time you sign. YOU,THE BUYER, MAY CANCEL THIS TRANSACTION AT ANY TIME NOT LATER THAN MIDNIGHT OF 10/28/2023 OR THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION,WHICHEVER DATE IS LATER. SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. SIGNATURE OF SALES PERSON SIGNATURE SIGNATURE William Abdelnour Sara Jane Kostek Leon Kostek PRINT NAME OF SALES PERSON PRINT NAME PRINT NAME 10/25/23 Page 2/ 37 Itemized Order Receipt 4 DBA:RENEWAL BY ANDERSEN OF BOSTON Sara Jane&Leon Kosfok Legal Name: Renewal by Andersen LLC 33 Claire Ave RENEWAL HIC#170810 Northampton,MA 01062 brANDERSEN 30 Forbes Road I Northborough,MA 01532 H:(413)335-7232 Phone:(508)351-2200 I Fax:(508)986-7072 I rbaboston@gmail.com ID#: ROOM: SIZE: DETAILS: PRICE: 101 Kitchen Window Casement Single Left, Base Frame, Exterior Sandtone, Interior Canvas, Performance Calculator PG Rating: 40 j DP Rating: + 40 / - 40 Glass, All Sash: High Performance SmartSun Glass, No Pattern, Hardware, Canvas, Screen, Fiberglass, Full Screen, Grille Style, No Grille, Misc, Aluminum Wrap Casing,Aluminum wrap of exterior casing., WINDOWS: 1 PATIO DOORS: 0 ENTRY DOORS: 0 SPECIALTY: 0 MISC: 0 TOTAL $3,538 Renewal by Andersen is committed to our customers'safety by complying with the rules and lead-safe work practices specified by the EPA. 10/25/23 Page 3/ 37 `4 Jim Payment Authorization Form DBA:RENEWAL BY ANDERSEN OF BOSTON Sara Jane&Leon Radek Legal Name: Renewal by Andersen LLC 33 Claire Ave RENEWAL HIC#170810 Northampton,MA 01062 byANDERSEN 30 Forbes Road I Northborough,MA 01532 H: (413)335-7232 MUM MOW*a 0001101.4011W Phone:(508)351-2200 I Fax:(508)986-7072 I rbaboston@gmail.com Sara Jane Kostek Leon Kostek BUYER NAME CO-BUYER NAME 33 Claire Ave Northampton ADDRESS CITY MA 01062 (413)335-7232 STATE ZIP CODE PHONE NUMBER 1 PHONE NUMBER 2 William Abdelnour $3,538 SALES REP CONTRACT BALANCE PAYMENT SCHEDULE ($3,538) CASH DEPOSIT(1) FINANCED DEPOSIT(2) SUBSTANTIAL COMPLETION(3) CHECK $1,179 $0 $2.359 (1)CASH DEPOSIT: Renewal by Andersen requires thirty-three percent(33%)of the purchase price paid at Agreement Signing. Buyer(s)may pay through the following payment methods:cash,check,debit card,or credit card("Cash Deposit"). (2) FINANCED DEPOSIT: Renewal by Andersen requires fifty percent(33%)of the purchase price advanced at Agreement Signing. For Buyer(s) that receive approved financing through a Renewal by Andersen lender("Lender"),the Lender will advance this required amount directly to Renewal by Andersen ("Financed Deposit").For open-end credit loans,the Lender will not extend credit to the Buyer(s). For all financings,the Buyer(s)will not owe any payments until Substantial Completion(as defined in item 3 below)and the Lender has advanced or otherwise delivered the remaining balance to Renewal by Andersen. (3) SUBSTANTIAL COMPLETION: Renewal by Andersen requires the final payment(which shall be delivered by the Lender in the case of projects financed through Lenders)on the day of installation when all windows and/or doors included in this Agreement have been installed into their openings and any interior and exterior trims have been applied("Substantial Completion"). If there are Change Orders associated with the project covered by this Agreement,the difference in the Job Amount will be reconciled in the final payment requested from the Buyer(or the Lender in the case of a project financed by a Lender)upon Substantial Completion. BY SIGNING BELOW, I/WE,THE BUYER(S): 1.Authorization for Direct Payment Via ACH: The Buyer(s) acknowledges providing Renewal by Anderson a check or designating a checking or savings bank account at a depository financial institution by providing Buyer(s)' account and routing number information for the payments listed above at Agreement Signing and Renewal by Andersen entered the account information into its payment system. Buyer(s) authorizes Renewal by Andersen to electronically debit the designated account(and, if necessary,electronically credit the account to correct any erroneous debit) based on the amount(s),form of payment(s),and timing as specified in the Payment Authorization Schedule above. Buyer(s) acknowledges that Renewal by Andersen may reattempt any payment that is returned unpaid. 2. Authorization for Card Payment: The Buyer(s) acknowledges authorizing Renewal by Anderson to apply the payments listed above to Buyer(s)' credit or debit card that Buyer provided at Agreement Signing and Renewal by Andersen entered the card information into its payment system. Buyer(s)authorizes Renewal by Andersen to charge the Buyer(s)' credit or debit card based on the amount(s), form of payment(s),and timing as specified in the Payment Authorization Schedule above. Buyer(s)acknowledges that Renewal by Andersen may reattempt any payment that is declined. 3. Buyer(s) agrees that any payment transactions that Buyer(s)authorizes comply with all applicable laws. 4. Buyer(s) acknowledges that this payment authorization will remain in full-force and effect until Renewal by Andersen has received written notification from Buyer(s)that Buyer(s)wish to revoke this authorization at least three (3) business days' prior to the scheduled payment date. For any change orders that affect the payment amount set forth above, Renewal by Anderson will notify Buyer(s) of the payment amount that will be debited or charged at least ten (10) calendar days prior to the transaction date. Sara Jane Kostek /C� 10/25/23 BUYER NAME SIGNATURE DATE 1Caostek � S A. 10/25/23 Page 4/ 37 CO-BUYER NAME SIGNATURE DATE