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17A-280 (5)
BP-2024-0112 389 BRIDGE RD COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 17A-280-001 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-2024-0112 PERMISSION IS HEREBY GRANTED TO: Project# WINDOWS 2024 Contractor: License: Est. Cost: 15802 HOME DEPOT USA INC CSSL098785 Const.Class: Exp.Date: 04/27/2024 Use Group: Owner: WAGMAN, ALISA M.& COTE, KEVIN G. Lot Size (sq.ft.) Zoning: URA Applicant: HOME DEPOT USA INC Applicant Address Phone: Insurance:. 2455 PACES FERRY RD NW 860-952-4112 WLRC50668058 ATLANTA, GA 30339 ISSUED ON: 02/05/2024 TO PERFORM THE FOLLOWING WORK: 16 REPLACEMENT WINDOWS POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Service: Meter: Footings: Rough: Rough: House # Foundation: Final: Final: Final: Rough Frame: Gas: Fire Department Driveway Final: Fireplace/Chimney: Rough: Oil: Insulation: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: Fees Paid: $40.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner PIeA.S4 e~t.a,4'1 * perms GJ g Itc 4 A"t o rrc �o� r.✓ is et,o1ptAL-J . '9 r The Commonwealth of Massachsetts „ V Board of Building Regulations and tan ds tie pALITY ;� Massachusetts State Building Cod , 78g MR c7 �� E Building Permit Application To Construct, Repair, ea e emolish a evisar 2011 One-or Two-Family Dwelling tig1tim°./ivr; ,i ' 14'This Section For Official Use Only �4 7 6,�ioA4 / Building Permit Number: 47.)el Oil 2_ Date Applied: / ii / c=vi+-.) (145 // z-z 20zy Building Official(Print Name) Signature Date SECTION 1: SITE INFORMATION 1.1 Prop rty Address: 1.2 Assessors Map&Parcel Numbers 384 Dr,dd0g. diCs nor e/Ice MA 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 Ow ner'of Record: ill i sa•►d ic�.4n w guy,a►0% Cote. Flo 44Ce 44 A a (O 6 L Name(Print) City,State,ZIP 3 81 6 r,ei.y. f,o.,a 4 3. 586• *IL 0•10.5k�wa.9s a n-1 ous;k.c o" No.and Street Telephone Email Address SECTION 3: DESCRIPTION OF PROPOSED WORK(check all that apply) New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units Other DoSpecify:aele4,ceme4t ,,,i pletaus Brief Description of Proposed Work': i e4t L dirofrel ittelaK. / , w l Aili...j /.'' g tche G4r€ .-, /Po s AAoked r,.t d cs /, A—t r . Z6 . SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $ /5- Fa it o 1. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical $ ❑ Standard City/Town Application Fee 0 Total Project Costa(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire $ Suppression) Total All Fees: $ ii Check No(lgigTheck Amount: 40 Cash Amount: 6.Total Project Cost: $ ,, 'pi .op 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor� License(CSL) Og g � yi Z 9/A 1 'va.� k s SO6"'t ik,, License Number Expiration Date Name of CSL Holder �/ ��r Si J4' u R�Jet List CSL Type(see below) No.and Street Type Description D�oS�- Unrestricted(Buildings up to 35,000 Cu.ft.) M•a R:�nsit A R Restricted 1842 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering Window and Siding SF Solid Fuel Burning Appliances �/3•Z2I-4:6_4_ P err%, Ojopert .o r I Insulation Telephone "Erllail address D Demolition 5.2 Registered Home Improvement Contractor(HIC) /I2 *85 2z2 104 Deg of TA C. HIC Registration Number iration Date HIC CompanyNIame or HIC Registrant Name 2Y ?SS ces Fer;) 640...1 Ptrr�tS ggo up+' .or No.pnd dStrcet ro A 30339 6o•952- eI 2 "l m it 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? Yes MK. 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 of my knowledge and understanding. Cee4 i 1 C. Cfgt •a. i,1.- Print Owner's or Authorized Agent's 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.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" The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Lafayette City Center 'n:MEM = 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 (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 l © 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 capacity. employees and have workers' any ap h 9. El Building addition [No workers' comp. insurance comp. insurance.: 10.0Electrical repairs or additions required.] 5. ❑ We are a corporation and its 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 13.®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: 381 gri`Ay. Qom J City/State/Zip: $'1srcnet M? 8(042 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 fme 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 fme 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& Date: Z- Z- Z. h 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 2❑BuildingDepartment 3tJCity/Town Clerk 4.0 Electrical Inspector 5E:Plumbing Inspector 6.0Other Contact Person: Phone#: City of Northampton S Massachusetts tit44 Y ' ` DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building Northampton, MA 01060 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: 4f/1e reel< usiti .cc?2 .914 LC, nit 2 e46a ei CT 060$2 The debris will be transported by: Name of Hauler: 3',ra,. g - / t454 Mt$4/ #'S Signature of Applicant: Date: 2 Page 1 of 7 P L)I GEM PRO SERIES WIV k l u /r`,,c' R E P A C L M L N T WINDOWS N D O W S Energy SW 1 � Ou•seed NFRC Certified Values g . U•Faclor i R•valuo Total NFRC Total (Center of'(Center ol Unit CPD Unit n o EE Product Typo/Popular Glazing Options Glass) Glass) R•value Number U•Factor SHGC VT CR z z w to pouble Hung Warm Edge Spacer Clear IGU 0.49 2.0 2.1 0.47 0.60 0.83 43 Gnites(NSdth<1`) 0.49 2,0 2.1 0.47 0.53 t 0.58 43 _!_, Sculptured Gni.es dtlV 1") 0A9 2.0 2.1 0.47 0.48 0.49 43 HP(Low E Argon IGU) 3.8 3.2 0.31 0.28 0.53 53 • • Gr9tes(Wfdthat) 0.28 3.8 3.2 0.31 0.25 0.47• 53 • • • Sculptured Griles(W+dth>1") nog 3.8 3.2 0,31 0.22 0.41 53 • • • HPSe(Solar Cooling Low E Argon IGU) 5 4.0 3.2 0.31 0.21 0.41 53 • • • Grlles(N5d!h<i`)_ 0.25 4.0 3.2 0.31 0.19 0.37 r53 • • • Sculptured Grilles(Width>1") 0.25 4.0 3.2 0.31 0.17 0.33 53 • • • HP2(Double Low E Argon IGU) 0.25 4.0 3.2 0.31 0.28 0.45 54 • • • Grilles(Width<1') 0.25 4.0 3.2 _ 0.31 0.23 0.40 54 -, • • • Sculptured Grilles(Width>1") 0,25 4.0 3.2 0.31 0.21 0.35 54 • • • HP2*(Double Low E Argon IGU) 0.21 4.8 3.7 0.27 ) 0.27 0.51 44 • • • • GAeesSWtdth<1') 0.21 4.8 3,7 i 0.27 0.24 0.45 44 • • • • Sculptured Grilles(Width>I") 0.21 4.6 3.7 0.27 0.22 r 0.40 44 '• • • • HP2Max(Triple Pane Double Low E Argon IOU) 0.18 5.8 CO 3.8 N 0.26 0.23 0.39 82 • • • • Grilles(Wldlh<1") 0.18 5.6 3.7 r 0.27 0.21 0.35 62 • • • • Sculptured Grilles(Width>li - N/A 14/A N/A =,' N/A N/A , N/A N/A - HP3Mex(Nate Pane Triple Low E Argon IGU) 0.18 6.3 4.3 (' 0.23 0.21 0A0 t 53 • •,• • Grille dth<1") 0.18 6.3 4.3 0.23 0.19 0.35 53 • • • • Sculptured Grilles(Width>t") N/A N/A WA N/A N/A N/A N/A - - - - Warm Edge Plus+Spacer Clear IGU N/A WA N/A WA WA N/A N/A • - - - Grilles(rMdth<1") N/A N/A N/A WA N/A N/A N/A - • - - SCulptured Grilles(W•dth>1") N/A N/A N/A WA WA N/A , WA - - - - HP(Low E Argon IGU) 0.26 3.8 3.3 0.30 0.28 0.53 56 • • • Odes(Width<t") 0.26 3.8 3.3 0.30 0.25 '0.47 58 • a • • Sculptured Grilles(Width>1) 0.26 3.8 3.3 0.30 0.22 0.41 58 • • • • HPSC(Solar Coding Law E A gon IGU) 0.25 4.0 3.3_ 0.30 0.21 0.41 58 -• • • • Grilles(N1dth<1") 0.25 4.0 3.3 0.30 0.19 r 0.37 58 • • • • Sculptured Grilles(Wdlh'l) 0.25 4.0 3.3 0.30 0.17 , 0.33 58 • • • • HP2(Double Low E Argon IGU) 0.25 4.0 3.3 0.30 0.26 0.45 57 •'• • • Gnlles(Width<1") 0.25 4.0 3.3 0.30 0,23 0.40 57 • • • • Sculptured Grilles(Wdth>t") 0.25 4.0 3.3 0.30 0.21 0.35 57 . • • • HP2+(Double Low E Argon IOU) 0.21 4.8 3.8 0.26 0.27 0.51 46 • •'• • Grilles(Wrdth<1") 0.21 4.8 3.8 0.28 0.24 0.45 46 • • • • Sculptured Grilles(Width'l") 0.21 4.8 3A 0.26 0.22 0.40 40 • • • • Frame R•Core Ug•Grade WannEdge Spacer Clear IGU 0.49 2,0 2.2 0.46 0.58 0.61 43 Grilles(Width<11 - 0.49 2.0 2.2 0.46 0.52 0.54 43 Sculptured Grilles(Width>1") 0.49 2.0 2.2 0.46 0.48 0.48, 43 HP(Low E Argon IGU) 0.28 • 3.8 3.2 0.31 0.27 ( 0,51 52 • • • Gnles(Wtdth<1") 0.28 3.8 3.2 0.31 0.24 0.45 52 • • •. Sculptured Grilles(WidthaID 0.26 3.8 3.2 0.31 0.22 0.40 52 • • • HPtc(Solar Cooling Low E Argon IGU) 0.26 4.0 3.2 0.31 ' 0.20 (0.40 62 '•r• • Grilles(<1') 0.25 4.0 3.2_ 0.31 0.18 0.38 52 • • • Sculptured Grilles(Wid8t51) 0.25 ' 4.0 3.2 0.31 0.16 0.31 52 • •i• HP2(Double Low E Argon IOU) 0.25 4.0 3.3 0.30 0.25 0.43 52 • • • • Grilles(N1dth<1) 0.25 4.0 3.3 0.30 0.22 0.39 52 •;• • • Sculptured Grilles(Width>t) 0.25 4.0 3.3 0.30 0.20 0.34 52 ,••• • • HP2+(Double Low E Argon IOU) 0.21 4.8 3.7 0.27 0.28 0.50 44 • •r• • Grilles(Width<1") 0.21 4.8 , 3.7 0.27 0.24 0.44 44 • • • • Sculptured Grilles(Width>1") 0.21 4.8 3.7 I0.27 0.21 0.39 44 • • • • HP2Max(Triple Pane Double law E Argon IGUL 0.18 6.8 N 0.25 0.23 0.40 84 • • • • Grilles(1Aidth<V) 0.18 5.8 4.0 r 0.25 0.21 0.35 84 ••,•,• • Sculptured Grilses(Width>1) N/A N/A N/A a* N/A , N/A N/A WA - - - - HP3Max(Triple Pane Triple Low E Argon IGU) 0.16 6.3 4.5 (3 0.22 0.21 0.38 53 • • • • Grilles(Nidth<1") 0.16 6.3 , 4.3 t 0.23 0.19 0.34 53 • • • • Sculptured Grilles(Widthat") WA WA WA E N/A N/A N/A N/A • • - - WarmEdge Plus*Spacer Clear IGU 0.49 2.0 2.2 0.45 0.58 0.61 44 Grilles(Nidth<t") 0.49 2.0 , 2.2 0.45 0,52 10.54 44 __- Sculptured Grilles(1Mdth>1") 0.49 2.0 • 2,2_ 0.45 0,46 0.48 44 HP(Low E Argon IGU) 0.28 3,8 3.3 0.30 0,27 0.51 56 • • • • Grilles(NSdth<1") 0.28 3.8 3.3 0.30 0.24 0,45 58 .• • • • Sculptured Grilles(Width>1•') 0.28 3.8 3.3 0.30 0.22 0.40 56 •• • • • HPro(Solar Cooling Low E Argon IGU) 0.25 4.0 3.4 0.29 0.20 0.40 57 • • • • Grilles(<1') 0.25 4.0 3.4 0.29 0.18 0.38 57 • • • • Sculptured Grilles(N1dth>1") ' 0.25 4.0 , 3.4 0.29 0.18 0,31 " 57 • • • • HP2(Double Low E Argon IGU) 0.25 4.0 3.4 0.29 0.25 0A3 57 • • • • Grlles(Width<1) 0.25 4.0 3.4 0.29 0.22 0.39 57 • • • • Sculptured Grilles(Width>t") 0.25 4.0 3.4 0.29 0.20 0.31 57 • • • • HP2+(Double Low E Argon IGU) 0.21 4.8 3.8 0.26 0.26 0.50 44 1 • • • • Grilles(WOO(?) 0.21 4.8 3.8 0.28 0.24 0A4 44 • • • •i Sculptured Grilles(Wsitha ") 0.21 4.8 3.8 0.26 0.21 0.39 44 • • • • R•S Option HP4an(True Pane Triple Low E Argon IGU) 0.16 6.3 4.6 i 0.22 0.21 0.36 53 • • • • Grilles(YYdth<1) 0,18 6.3 4.6 0.22 0.19 0.34 53 • • • • Sculptured Grilles(WlGh>t) WA WA WA N/A N/A WA N/A - - - Printed:8!6/2011 ALo, CERTIFICATE OF LIABILITY INSURANCE °"TE"B°°mw' 11/08/2023 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 poticy(iies)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 li COACT Mary Beni,nw, ---- GREYLOCK INSURANCE AGENCY 1IdA�Fat (413) 729-6090 1, wooRE; mbenjamurN greylock.org 5 Court St INSURERS!)NF ORONO COVERAGE NAIC a Westfield MA 01085 NSURERA: ATLANTIC CHARTER INS CO 44326 mum INSURERS IVAN KOSOBUTSKYY NSUREM INSURER D T2 STAFFORD ROAD NalnreaE: MONSON MA 01057 INEURERF: COVERAGES CERTIFICATE NUMBER: 948976 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 ANOCONOITIONS OF SUCH POE ICIE S LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. NSR ADO_SUER POLICY EPE POUCY EXP LTR TYPE OF INSURANCE NSO ►VO POLICYNUMSER IMM O,YYYYI INNNOOOIYYYYI LBWS COMMERCIALe81ERAL LIABILITY EACH OCCURRENCE 3 CLA#ISWDE i i OCCUR PREMISES F,aEoccummoel $ ( Use EXP tAry an*paean) 3 _ N'A PERSONAL i AOV INJURY $ Gen ADORE-GATE LIMIT APR.IES PER GENERAL AGGREGATE S RPOLICY n y -r UDC PRODUCTS•COMPOP AGG $ OTHER AUTOMOBILE UNWEPT COMBINED SINGLE UNIT $ _ 1E4 aaadenil ANY AUTO BOOZY/*JURY pa paean) 3 AUTOBOON.Y OS scrietkeeD N A 8000.Y INJURY 'e*cadent) 3 AU OS CAR Y AIRED NO NT SO LY War acadeenti 3 URIE ELLAUAB OCCUR EACH OCCURRBNCE 3 _ excesD s uaa CiAM(SMAOk_ N A AGOREGA TE $ ^---WORKERS Co M� --— XI:UT UTE 1 1 Ht"` ANOEMPLOYERS'UABIL TY A OFFICERAADABREXCLtDED', WA NAN.'A VA.;V01468904 11113/2023 11/1312024 E.t EACH ACCIDENT $ 100,000 planaletwyinlNq —' EL DISEASE-EAEMPLOYE $ 100,000 aya s,dssar0a undsr OESC$t I'TION OP OPERATIONS below E L.DISEASE•POLICY LIMIT $ 500,000 N/A DESCRIPTION OF OPERATIONS!LOCATIONS/YOWLS.(ACORD E1•Odd Waal Remote$Medic,may be attached s roar*sweets required) Miters Camperaaean benehc wd1 be pad Si Meemarntaees eny oyves(Ay Persian*to Enddnemenl WC 200300a.no authors aeon is gown to pal dams br benefits In empbyaes in Nabs nOa than Messadrures dada enured hews.a hes hied lime a pldyees abide d Macwdrueea* Tire ceslaale d ensvawe*Rows tie potol micros online dies Mai Ih~s oe bolus was issued Neese Re erseaeon dale on Inc above poecy precedes Me awe date of Tie oee/tcnaot nwwnce) The stake d as coverage can be mmuowd daily by ecceseng Re I5oo.I d Courage-Coverage Vertical/on Seadh bdt at wewrnala govAwdhma ees•aanpansaWnMwstpatms/ Sob praprnbr Nis not*laded cnwage. Cmlruakcn of atuve Named insured t61 REMOOELP1G CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN THD At-Home Services Inc ACCORDANCE WITH THE POUCY PROVISIONS. 2590 Cumberland Parkway#300 AUTHORIZED REPRESENTATIVE Atlanta GA 30339 Dia1rM'I M Crowley,CPC11,Vick: Prusidernl-Residual 14talket-WCRIBMA <1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo aro registered marks of ACORD AC ROB CERTIFICATE OF LIABILITY INSURANCE DATE IMM,VO.YVYY1 02'21 02J 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 endorsomont(s). PRODUCER I CONI ACT MARSH USA.INC HAWHH E IWO ALLIANC CENTER A No F�11 1NC,N �� 3560 LENOX ROAD,SUITE 2403 AL • ATLANTA,GA 30326 ADORERS I N uRERAI Off ORoN O COVERAGE RAC e CN101612069-143neD-GAW-2225 BRA:ON Reeutik heuanoe Co 24147 Nf1aMoT}E HOME DEPOT,NC. ME RtER11:HldaTrlllr lisCo OI LAMA Monts 43575 HOME DEPOTU.S.A,INC. _NS.MERC:ICE Amman YISISOYCornoaeY 2Z67 2455 PACES FERRY ROAD BUILDING C-20 NeuRERo ATLANTA.GA 30332 INSURER a: _INSURE IIF COVERAGES CERTIFICATE NUMBER: ATL•0050 7 22 2 5.15 REVISION NUMBER: 7 THIS IS TO CERTFY 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 POLICES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTRR TYPE OF INSURANCE 11330 END POLICY NUMBER ifillaNDBYvYY1 MMIDQTYYW1 LINTS A x COMMERCIAL GENERALUAaa.aTY MIYZY316848 03'Ot!2022 0310112025 EACHoccuees ce s 1,000,000 CLAMS MADE D OCCUR PRELp3 TORN vwrl S 1000.000 X SR:$1 AOOA03 MEO EXP(Ass one palm) $ EXCLUDED — PERSONAL a ADV INJURY $ I A90 A0 GEWt AGGREGATE WAIT APR ES PER'. GENERAL AGGREGATE S 21300.000 POLICY❑78- 1 1 IOC . PRODIFCTS•COMPX)PAGG $ 2.000.030 OTHER S A AUTOMOBILE Lamar/ Mf1T8316640 03/01/2022 03/0112025 COWERED SINGLE LIMIT $ 1 A00.000 _ 4£s a ad.I) X ANY AUTO BODILY N.AIRY rev poem) S '—' owNEo —"'9CNEOU*E0 SB.F INSURED AUTO 11fY DMG eooLY INJURY(Pa amd.+II $ AUTOS ONLY _ AUTOS - HIRED NONCNIFIED PROPERTY MANGE S AUTOSS ONLY AUTOS ONLY Seer Hcodenil $ A uI$REUAUA$ F./......1 (xrAIR VAZX 31E647 0AIf2071 A1/2025 EACH occuP.aENcE s 10E00,030 X ExcessUAs _ CLAMS-MADE AGGREGATE S 10.000.000 DED I PE TT/Mow$ 3 B WORKERS COMPENSATION SCFC50668196(WO 0310172023 03/01/2024 x r PER 1 1 oTH- C ANOEMfIorlits LIABILITYYIN 1NLRC50368150(Mu 03701/2023 0301/2024 t STATUTE 1 1 ER ANYPROPRIE IMPAIR TNERIEXECUTNE E.L EACH ACCIDENT S 5,000,000 OFFICERMEMEEREXCLUDEAT NIA MANNIsby in NN) E.L DISEASE-EAEMFLOYE£ S 5.100• 030 M yss deurbe undw Conbned on Addtional Fags EL DISEASE-POLICY LW a 5000.000 DESCRIPTION OF OPERATK)NS below IZ$CRIPT1pa OF OPERATIONS/LOCATIONS I VENICLIS(ACORO lot,A MMAN Remote sdheltu s,nay be altachsa a mot specs Y raqund) DE/BCE OF NSURANCE CERTIFICATE HOLDER CANCELLATION HOME DEPOT USA,INC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 2455 PACES FERRY ROAD BUL01NGC20 THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN ATLANTA.GA 30339 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE r t ?/laz.tls '7 5:4r 7,sc. d 1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) Tho ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: CN`C 15420ED1 LOC k. Atlanta ACOR Go ADDITIONAL REMARKS SCHEDULE Page 2 of 3 AGENCY •NAMED INSURED LMRSN USA INC. THE HONE DEPOT,NC NOME DEPOT USA.ING POLICY NOMBER 2455 PACES FERRY ROAD 84.ILDING C.23 __. ATLANTA GA 3:.339 CARRIER NAIC COOE EFFECTWE DATE ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM. FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance '/eaters Co verse cn Ca-n'usa. Cemer Safety Yaer.t:m.sty Capomfat POI ILy N.rtter LDSs068389 t eLARAZFL.CY,IAbL.i(S:KY LA104)AO.WC,NE,141,1E}.00(SC,SD,TW'AVel W Y1 ENeco.e Cat.33612iS23 EeyuaLon Car 03+31(2024 ,,ELI tort 15.UJ1':3176 Canter Wily Natcra•Cas a9y Com:17 n Pcitcy Fainter,s s:'8:4)OSII!CA OR'WAS Effete*Det:33a'.2C2 Eipatan Doe OY3ta 21 ELI tin $5,0X,300 SIR S1,Qa0.ex Cn'nnr ACE Amexan rsi'rce Gamer", Narter'WSUCSOOSTErt5;0'SJ3:GAM tiV CH,LIM Etfeo a Cele.OV41,2t23 Eepraeon Cet:'alI012024 DEL, t 51,01C,000 SIR sum 3c0 SIR K AI S753,0:XC Carrier Inde e*I sirance Curnpary of No71 Amara PricySmarr.WLRC50E68?:8f/.ACC,CT DCCE MAMA MDl1E.M{114,KI,(VY.IAKRI.VTI Maio Ds*030/2G23 EepraioaDitt0301i21`2t (ELI LierR$50:01,3a0 TX Enptlen 9lS hamrity Cane 2undi Are can neuirce CarrArro Plc?.timber.NSL 11383191TXI elective Oft.33r.112023 Eyre en Oar 3Ya1 l Ell tar[S6.0CCAXI SIR$5,000.000 ACORD 101 (2008101I _2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affaip6 and Business Regulation 1000 Washing/451 rogt-Suite 710 Bosto -Massachusetts.-f 118 Home 1m• �iMtb E tTiaatiti-_.iStratian i ==........J.... ,.. ===___ ,,,,;(i " -- =-„_ _ Typo Corporatwn HOME DEPOT USA INC to • SEEM I, ." • utinn: 112705 P O BOX 105451 -` ss E , etion 01l27t2025 ATTN; LICEN 5 SE MGMT TEAM ; rl "'"'ATLANTA,GA 30348 ^1.:L F. Ai Y�-«d7 y A#rTt tr"•-- i 1 UpdaM Addis**and Ronan Card. THE COMMONWEAI.TN OF MASSACHr)SETTS Office of Const ;* AN tFs A Business Regt af4on Regtehalron valid for Indtvldual use only before the HOME fMPROVE1ilENT CONTRACTOR esyWat ton oat.. If found'Hum 10 TYPE'r4Tptratbart Office of Constmar Affairs and Business Requbtlon RCmalLallof1 0 Laaastaiin 1000 Washington Street•State 710 17245 1)olineo.zb Bmlon,INA 02118 HOW pt POI USA tl4cr. r 1 ;it i f COURI NEYA MOM 111 --; ... 2455 PACES FERRY RIK f l 1#SC,' fiAwM.G/44.4 ATI.ANTA,GA 30390 • UndgrT.rKrnL r� Not valid without signature HIC Registration Complaints Registration # 152379 Registrant Ivan Kosobutskyy DBA I & I Remodeling Name IVAN KOSOBUTSHYY Address 72 STAFFORD ROAD City, State Zip MONSON, MA 01057 Expiration Date 08/22/2024 Complaints Details No complaints found for this registrant. The Official Website of the Executive Office of EOHED,the Divsion of Professional Licensure,and the Division of Standards * , , IOW Public Safety Mass GeMe State A.- • - it Mass. Licensee Details Demographic Information Full Name: IVAN KOSOBUTSKYY Owner Name: License Address Information City: MONSON State: MA Zipcode: 01057 Country: United States License Information License No: Profession: License Status: CSSL-098785 License Type: Building Licenses Date of Last Renewal: 4C/S2S21/ 0W2S2 issue Date: 4/10/2008 Active tatus Change Reason: License Renewal Expiration Date: Today's Date: 4/27/2024 9/19/2022 Secondary License Type:oing Business As: -Windows and Siding Prerequisite Information Licensee: KOSOBUTSKYY, IVAN Relationship: Attribute Of License No: CSSL-098785 No Available Documents w IS• :'"',:N7� J '� �^*'i l q N.' y= Commonwealth of Massachusetts IF} Division of Occupational Licensure Board of Building Regulations and Standards Construct upe �Specialty CSSL-098785 ' '; �'' Eicpires: 04/27/2024 IVAN ROSOB)iTSKYY i 72 STAFFORB ROAD4i l' ' > lki :;" MONSON MA:01057 ,. 'g; '1 dil (II J, ' ,' Commissioner C1i f;. �`i Eve7i ik, , I ___I'vals4..___K0so6Ht4k __.. authorize Go Perwwlit4 1 t (' !o purl taro t-,using nIti CS License#_ pg _2,g ___.,..._.. and my HIC Registration # is g._.". $ _ ..__._._, . • i a R: 1 - 2 _CA.,; Installer Signature /_ s 1 Company Name "r$ S"' 1 _4!'H�!ri_ .i.IrLr Ei' 'i 3`,. A d ; ,,,J1 = : till iiiii0..th 7'Bin2� i.h.,-rx + 1llr that < ( !� 'S (U �i i : '''' A r 3 Ivan.Kosobutskyy _4 j . 5„r,,.,d ad.v ws„n MA 0tns, n a Q ��! { r E i5, !we , i has s�cce l+dtr uury�leied toe 4•oeu.,curse r i !:,tact-Safe Renovator-Supervl t ` ' - ? . ;� p u, ,4na tda.A54 4%IR 4 O°dna 40 C F R n to '`. 5 :we y a cw+o+,«wn ,.., i Ni i i t F I¢ Z n Si U , AMlhgy V+Ww.v .Ma C WY * gi if 11 * is N �. p E 1j11340374-4o17g4 MaY_101423 ._.i_ ___.....__ i wi Q EDUCATION INSTITUTE FOR ENVIRONMENTAL 14 `1 Home Improvement Agreement: Page 1 Home Depot License#'s -For the most current listing visit www.Homedepot.com/LicenseNumbers MA: 107774, 112785 Ronald Engelbrecht Salesperson Name Registration #(Req. in CA,CT,ME,MD,MI,NJ,DC) Home Depot U.S.A.,Inc.("Home Depot") or Authorized Service Provider named below will furnish, install and/or service the equipment listed below at the price, terms and conditions as outlined on this form. 1. Service Provider Contact Information The Home Depot l [The Home Depot Service Provider Contact Name Service Provider Company Name (203) 265-7037 ffcancellationnortheast@hom LMA: 107774, 112785 Phone# r'�vider Email Address Service Provider License#(s) 2. Customer Information wagmam cote talisa and Kevin New England West F40388742 Customer Last Name Customer First Name Store#/Branch Name Customer Lead/PO# 389 Bridge Road Florence MA 01062 Customer Address City State Zip (413) 586-4032 (413) 695-7697 mosleywags@gmail.com Home Phone# Work Phone# Cell Phone# Customer Email Address 3. NOTICE OF RIGHT TO CANCEL YOU MAY CANCEL THIS AGREEMENT WITHOUT PENALTY OR OBLIGATION BY CONTACTING THE SERVICE PROVIDER OR STORE DIRECTLY; EMAILING SERVICE PROVIDER AT: customercancellationnortheast@homedepot.com OR DELIVERING WRITTEN NOTICE TO HOME DEPOT AT: 1070 N. Farms Road, Unit 3 Wallingford Wallingford CT 06492 Address City State Zip BY MIDNIGHT ON THE THIRD BUSINESS DAY AFTER SIGNING, UNLESS THE STATE SUPPLEMENT PROVIDES A DIFFERENT CANCELLATION PERIOD. THE STATE SUPPLEMENT CONTAINS A FORM TO USE IF ONE IS SPECIFICALLY PRESCRIBED BY LAW IN YOUR STATE. YOUR PAYMENT(S) WILL BE RETURNED WITHIN TEN (10) BUSINESS DAYS AFTER HOME DEPOT'S RECEIPT OF YOUR NOTICE. YOU MUST MAKE AVAILABLE FOR PICKUP BY HOME DEPOT OR SERVICE PROVIDER, AT YOUR SERVICE ADDRESS, AND IN SUBSTANTIALLY THE SAME CONDITION AS WHEN DELIVERED, ANY MERCHANDISE OR MATERIALS DELIVERED TO YOU. OR YOU MAY CONTACT HOME DEPOT FOR INSTRUCTIONS REGARDING RETURN SHIPMENT AT HOME DEPOT'S EXPENSE. THE LAW REQUIRES THAT THE HOME DEPOT GIVE YOU A NOTICE EXPLAINING YOUR RIGHT TO CANCEL. PLEASE SIGN BELOW TO ACKNOWLEDGE THAT YOU HAVE BEEN GIVEN ORAL AND WRITTEN NOTICE OF YOUR RIGHT TO CANCEL. Acknowledged by: 01/27/2024 Customer's Signature Date 460 Standard Form HlA(21 Jul.21)(E) Generated Date nl/77/2024 Lead/PO# F403887a2 v 0.1.12 400 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: 07/25/2024 Approximate Finish Date: 08/24/2024 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: $ 15802.56 Includes all applicable taxes. Excludes finance charges.* Sales Tax: $ 0.00 (If applicable, total amount of taxes included in Contract Price) *Ma.v.itnutn deposit ONLY applicable in still), MA, ME (33%), NJ, WI (99%) Deposit % 25.0 Deposit Amount $ 3950.65 Remaining Balance $ [11851.91 8. Finance Charges Any interest payments or other finance charges will be determined by Customer's separate cardholder or loan agreement, to which Home Depot is NOT a party, and will be in addition to Customer's payment under this Agreement. Customer is subject to the terms and conditions of the cardholder or loan agreement, as applicable. No funds should be made payable to Service Provider; however, Service Provider may collect Customer's payments made payable to Home Depot. 9. Acceptance and Authorization By signing below, you authorize Home Depot to: (a) arrange for Service Provider to perform any Services or (b) order and arrange for the delivery of special order merchandise, including special order merchandise that may be custom made, as specified in this Agreement. Do not sign if blank or incomplete. (Service Provider's or permitting information may need to be provided to You later.)By signing, you acknowledge that: (i)You have read,understand, and accept this Agreement in its entirety, including the General Conditions and State Supplement, if any; (ii) You are receiving a complete copy of this Agreement; (iii) all rights and interests under this Agreement are solely vested in the person listed as "Customer" above; and (iv) Electronic signatures will be deemed originals for all purposes. X , i- 01/27/2024 Customer's Signature Date X /s/The Home Depot 01/27/2024 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 'u 6i 4d0 Standard Form HIA(2 Jul.21)(E) Generated Date A1/27/202A Lead/PO# Fa0388742 v o.1.12 4* 0 Scope of Work wagmam cote alisa and Kevin —1 New England West F40388742 Customer Last Name Customer First Name Store #/Branch Name Lead # Job #: (Internal Products: Spec Sheet(s) #: Project Amount Reference) F40388742 + Windows Entry Doors F40388742 15802.56 Windows Entry Doors Windows Entry Doors Windows Entry Doors _ Windows Entry Doors Sales Tax 0.00 Total Contract Amount 15802.56 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: GLW East-Replacement-Series-Warranty , WIN17 1500SeriesWarranty Warranty Name(s): 460 Standard Form HIA(21 Jul.21)(E) Generated Date 0 /77/202a Lead/PO# Fa 03887a2 v 0.1.12 ��4• 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 FamHIA(21 Jul 21)(E) Generated Date 01/27/2D2a ``"ip" F6.03887a2 V o.1.12 The Home Depot General Terms & Conditions 16. 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 WARRAN 11ES 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(21 JuL 21)(E) Generated Date n 1/7 7/2 0 2.1 Lead" Fn o 3 R R 7d2 v 0.1.12 ` 6 The Home Depot General Terms & Conditions 9. CHOICE OF LAW: SEVERABILITY: This Agreement will be governed by and interpreted in accordance with the laws of the State where the Project is physically located. The parties intend for the terms and conditions in the Agreement to be complementary, consistent, and enforceable under applicable laws. In the event any term or condition in the Agreement violates applicable law, such term or condition will be severed from the Agreement, but only to the extent necessary to avoid such violation, without invalidating any other terms and conditions of the Agreement. 10. ENTIRE AGREEMENT: This Agreement is the final, integrated, and exclusive expression of the parties' understanding, which supersedes all prior offers, orders, understandings, representations, proposals, confirmations, and negotiations between the parties, whether oral or written. No course of dealing, usage of trade, course of performance, course of conduct, or any other evidence of additional or different terms will be admissible to contradict or vary any term in the Agreement. 11. SECURITY INTERESTS: LIENS: If You make all payments as required under this Agreement, no security interest will be placed against Your property by Home Depot. If a security interest is placed on Your property, it creates a lien, mortgage, or other claim against Your property to secure payment and may cause a loss of Your property if You fail to pay as requested. After paying on any completed phase of the Services and before making any further payments, You should request from Home Depot or Service Provider a signed, unconditional release from, or waiver of, any right to place any claim against Your property applicable to the work then completed. You may ask an attorney about Your rights to discharge security interests. 12. RETURNS: Custom order merchandise (i.e., goods that are custom made, uniquely altered, colormatched, shaped,sized,or otherwise uniquely designed or fitted to the requirements of a particular space)is non-returnable, and its Contract Price cannot be refunded unless Home Depot or Service Provider(1)incorrectly ordered item, or (2) damaged item beyond repair. Special or custom order merchandise may be returned, and a refund for all or part of the Contract Price provided, in the discretion of Home Depot. Please contact The Home Depot for additional details concerning returns. 13. AGREEMENT/SERVICE ORDER COMMUNICATION PREFERENCES: You can visit www.homedepot.com > In-Store Special Orders at any time to access Your account for the following: (1) Update Your Agreement/ Service Order Communication Preferences(email,text,Auto Call);(2)Contact Home Depot for order assistance; (3) View latest order status; or (4) Take action to schedule pickup for Your Service Orders. To stop any of the following communications You may visit www.homedepot.com > In-Store Special Orders to access Your account to update Your Agreement/Service Order Communication Preferences, contact The Home Depot, and take action on orders. If You signed up to receive updates about Your Agreement/Service Order(s) via: (a) Text Message Communications, You may receive multiple messages per order (including current and future orders) via automated technology to the mobile phone number You provided. The total number of messages received depends on the number of orders placed and order activity. Standard message and data rates apply. Not all carriers covered. You can text STOP to 97710 to stop (You will be sent a confirmation message). Call 1-877-467-2581 or 1-800-466-3337 for help; (b) Electronic voice communications (Auto Call), You may receive multiple pre-recorded phone calls per order (including current and future orders) via automated technology to the phone number You provided. The total number of calls received depends on the number of orders placed and order activity. You can press 9 during a call to opt out or call 800-HOME-DEPOT for help; or (c) Email Communications, You may receive multiple Emails per order (including current and future orders) via automated technology to the Email address You provided. The total number of Emails received depends on the number of orders placed and order activity. 14. LEAD PAINT:Homes built prior to 1978 may require additional testing to determine if lead paint is present, and additional precautions if lead paint is present. You will be informed by Your Service Provider of any additional costs resulting from lead paint requirements prior to performing the Work. For additional information, visit www.epa.gov/lead/renovation-repair-and-painting-program. 460 Standard Form ILIA(21Ju121)(E) Generated Date n1/771202d Lead/PO# Fa03887a2 v 0.1.12 Go Permits, LLC G0_ 105 Buttonball Lane Glastonbury, CT 06033 I PERMITS Scott Doughman \Stase00. -01/1 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 — Ace American Insurance Co. Policy WLRC50668150 (MT) Exp. 3/1/24 Ivan Kosobutskyy, D/B/A I & I Remodeling is the sub-contractor. #CSSL-098785 Exp. 4/27/2024 / HIC#152379 Exp. 8/22/2024 Workers Comp. —Atlantic Charter Insurance Company # WCV01468904 Exp. 11/13/2024 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@clopermits.orcl • 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 Go Permits, LLC 105 Buttonball Lane ������� Glastonbury, CT 06033 Scott Doughman Phone: 860-952-4112 Fax: 860-430-6719 scottdoughman@gopermits.org To Whom It May Concern, If you have any questions or require any further information for this building permit application, feel free to call us at your convenience and we would be happy to assist you. Once the permit is ready, please mail it in the provided envelope to the following address: Go Permits, LLC 105 Buttonball Ln Glastonbury, CT 06033 Thank you! David Anderson, Permit Expediter Go Permits, LLC Phone: 860-402-3293 Email: davidanderson@gopermits.org Go Permits, LLC 105 Buttonball Lane, Glastonbury CT 06033 www.gopermits.org Go Permits, LLC 105 Buttonball Lane 60'In Glastonbury, CT 06033 PERMU I Scott Doughman `l` 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