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HomeMy WebLinkAbout0055 CHASE STREET l 1 Town of Barnstable Permit# ,y Expires 6 months from issue date -P O�egulatory Services Feeq� 6'�, 0'3 P� 16 < U 90 P Thomas F.Geiler,Director RFD MA'I �� Building Division TOWN OF NOTABLE v. Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number Property Address Residential Value of Wor G 1,F7 ,5S fee-of$25.00-for ork under-$6000 00�- Owner's Name&Address L(A v vex— GF�vT Contractor's Name per, r 5 7-4^yam ,o __T—L4_, /�( W 2ve±Telephone Number 8C-L,�r_Z;3 0 4S� Home Improvement Contractor License#(if applicable) / 4 8 6 O 77 ex p _ / 0 ' o9 0ol Construction Supervisor's License#(if applicable) 97 g'3 1 ' ,2 XWorkman's Compensation Insurance Check one: El I am a sole proprietor ❑ I am the Homeowner I have Worker's Compensation Insurance Insurance Company Name knnRsx �S?C V 1 C e S Workman's Comp.Policy# W L RC, A J �70 1 0 0 �7 Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to RC-niove ,A RWac e- 03�W❑Re-roof(not stripping. Going over existing layers of roof) t rtJow5 W e1S t ze f A)O�7—S�rC,�G�U c. ❑ Re-side $�L ki 5 CA fo r w. Replacement Windows/doors/sliders.U-Value 0i 3 a (maximum.44) 'Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A opy o the Home I rovement Contractors License is required. SIGNATURE: T eC�r S C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Interne iles\Content.Oudook\MY7NB4IL\EXPRESS.doc Revised 100608 snxxsTnsM 639. Town of Barnstable Regulatory Services Thomas F.Geiler,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, r � I ,as Owner of the subject property u oS vecr — _qen- hereby authorize__n2 r 5 P V"o to act on my behalf, in all matters relative to work authorized by this building permit application for: Ise C h as C-� S+r-ee (Address of Job) le7 X1 Signature of Owner D4e Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Intemet Files\Content.Outlook\MY7NB4IL\EXPRESS.doc Revised 100608 ' They Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/organizatiowindividual): Sears Home Improvement Products Incorporated Address: 1024 Florida Central Parkway City/State/Zip: Longwood,FL. 32750 Phone #: 407-551-5402 Are you an employer?Check_the apQropriate box: Type of project(required): 1.❑ I am`a:employer with-- 4: ❑ I_am a-general-e'ont-mctor-and I" 6. ❑New constructiorr- employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. t 7. ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition - working for me in any capacity. workers'comp..insurance. 9. ❑Building addition [No workers'comp. insurance 5. We are a corporation and its required:] officers have exercised their 10:❑Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs.or additions myself. [No workers' comp. c: 152,§1(4),and we have no 12.❑Roof rcpa;.ss insurance required.]t employees. [No workers' comp. insurance.required.] 13.� Other ,_ Q E *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. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Aon Risk Services Central,Inc. / Phone:(866)283-7122 Policy#or Self-ins.Lic. #: WLRC45701207 Expiration Date: 08/01/2010 Job Site Address: �C�`� i < w�j+l^��� City/State/Zip op6O Attach a copy of the workers'_compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage asspquired under Section 25A of,MGL c..152'ean lead to the imposition of criminal penalties of a fine up to$1,500M 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 der e,pains a penalties of perjury that the information provided Bove is true and correct. Si afore: {Sears Auth.Agent) Date: Jr Phone#: Home:860-315-7468 / Cell:860-753-0452 Official use only. Do not write in this area,to be completed by city or town official. City or Town: _ Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: DATE(MM/DD/YYYY) -`` CERTIFICATE OF LIABILITY INSURANCE 07/17/2009 , PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY Aon Risk Services Central, Inc. Chicago IL Office AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS 200 East Randolph CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE Chicago IL 60601 USA COVERAGE AFFORDED BY THE POLICIES BELOW. _ ( PHONE- 866 283-7122 FAx 847 953-5390 INSURERS AFFORDING.COVERAGE NAIC# INSURED INSURER A: ACE American Insurance Company 22667 Sears Holdings Corporation INSURER : Indemnity Insurance Co of North America 43575 w dba Sears Home Improvement. Products; Inc Attn: Risk Management E3-219A INSIJRERc: d 3333 Beverly,Road Hoffman Estates IL60179 USA INSURERD: •o I INSURER E: p COVERAGES SIR applies per terms and conditions of the policy x 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LIMITS SHOWN ARE AS REQUESTED INSR ADD' LTR INS INSRD TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS DATE D DATE D/YYYY A ENERALLIABHrrY HDOG24933398 08/01/2009 08/01/2010 EACH OCCURRENCE $5,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $5,000,000 CLAIMS MADE ®,OCCUR PREMISES occurrence) MED EXP(Any one person) EXC U e O PERSONAL&ADV INJURY $5,000,000 n GENERAL AGGREGATE $5,000,000 LA GEN'L AGGREGATE LIMIT APPLIES PER m PRODUCTS-COMP/OPAGG $5,000,000 ❑X POLICY ❑ PRO- ❑ LOC O IECT Ln A AUTOMOBILE LIABILITY ISAH0857957A 08/01/2009 08/01/2010 COMBINED SINGLE LIMIT O A ANY AUTO ISAH08579568 08/01/2009 08/01/2010 (Ea accident) $S,000,000 Z ALL OWNED AUTOS - BODILY INJURY - u SCHEDULED AUTOS (Per person) X HIRED AUTOS BODILY INJURY U )( NON OWNED AUTOS (Per accident) PROPERTY DAMAGE (Per accident) GARAGE LIABHRrY AUTO ONLY-EA ACCIDENT ANY AUTO I OTHER THAN EA ACC AUTO ONLY: AGG EXCESS/UMBRELLA LIABILITY ' EACH OCCURRENCE ❑OCCUR ❑ CLAIMS MADE AGGREGATE H DEDUCTIBLE RETENTION A WORKERS COMPENSATION AND WLRC 01219 08/01/2009 X WC STATU- OTH- EMPLOYERS'LIABILITY CA T R LIMIT ER E.L.EACH ACCIDENT $1,000,000 A ❑ SCFC45701220 08/01/2009 08/01/2010 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MFMBER EXCLUDED? WI E.L.DISEASE-EA EMPLOYEE $1,000,000 B (Mandatory in NH) WLRC45701207 08/01/2009 08/01/2010 If yes,describe under SPECIAL PROVISIONS below All Other States EL.DISEASE-POLICY LIMIT $1,000,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEIUCLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS - bI CERTIFICAT E HOLDER CANCELLATION Sears Home Improvement Products, Inc SHOULD ANY OF THE ABOVE DESCRIBED PoiICIESBE CANCELLED BEFORE THEEXPIRATION 1024 Florida central Parkway DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL Longwood FL 32750 USA 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE a ��� � ACORD 25(2009/01) ©1988-2009 ACORD CORPORATION.All ri¢hts reservedi A / - y. Board of Building Regulations and Standards One Ashburton Place.- Room 1301 1 Boston. Massachusetts 0210.8 Construction Supervisor License _ .. _. ..... __._ License- CS:, .9751'9 Restriction: Birthdate: 8/31/1963 Expiration: 8/31/2010 Tr# 97519 827 THOMPSON ROAD THOMPSON, CT 06277 — -- -- --- Update Address and return card.Mark reason for change. oPs cni a Sohn oslos-PCeaso Address —j Renewal 1-1 Lost Card �ri A �4 �� ,:�,.�.,w-.�,� � �/ze�omv»zoruuea�n�'./� uf�tlb�•r::, � a ` ,Board of Building Regulations and Standards yi t Y - Construction Supervisor License t) itsstr8 License: CS 97519 B�ithdate: 8/31/1963 UV 8t :6.02 [yes:HAZ t ,,08.29-2007 " ` . Expiraton:,8/31/2010 Tr# 97519 T0SHO�IPSi3Fl `" Restriction: 00 - 9' �TNOmAbil CT "" r r LUBOS SVEC 827THOMPSON ROAD - -- —�`� THOMPSON CT 06277 Commissioner t -";an*ffii;Vatr":I!isoe& a � � . s One Ashburton Place -- Room 1301 Boston,MassN s� 02I08 fi e p1 �Vel��IlllJ actor Registratiox , � Registration: 148607. T"ype: Public Corporation Expiration: 1011112009 Trii 259552 _SEARS HOME IMPROVEMENT 1 ALFRED .NYMAN SIR. fbj sY R1 1024 FLORIDA CENTRAL PKWY�;,, _ � - (j --- - LO�lC�1lUOOD, FL 32750 �,' �` ' Update Address'and ireturn earl.Mark mason for change. _ 0 Address .0 Renewal Fr Employment- 0`boost Card DtPS.CA1 a 50M4Y 7/07 PCMD ✓h8 ti731tY0tfU6CE► t7�s/LLcrl6�ete9�$ Board of t3uudang][tegntatto s aadscoudards Lieenscoir►tgistradon valid for individul tine only HOME IMPROVEMENT CONTRACTOR before ft expiratlon date. Xf)Found return to: t Beard of]Building Regulatiow And Standards z Regi9tra t0 148607 r One Ashbuoon Place o 1301 3 .�. 15(c'F' t�t7�- !'1'tl�o _SM 118._e F i i (�itlfptl411 - .l$OStt3EA,Ia,����� , SMS HOME IN r O ODUCTS INC. " ALFRED NYMAiV` i 1024 FLORIDA Cfi =� LONGWOOD.FL 327 Admingstrator riot valid�,vmut atare Boar mt a ula0f oats an an�ar�s � ' One Ashburton Place Room 1301 Boston. Massachusetts 02108 Home Improvement Contractor Registration Registration: 148607 _ Type: Supplement Card Expiration: 10/11/2009 SEARS HOME IMPROVEMENT PRODUCT Sears Authorized Agent LUBOS SVEC Home- 860-792-8106 . 1024 FLORIDA CENTRAL PKW`r' Cel>! -860-753-0452 LONGWOOD, FL 32750 Update Address and return cant.!•lark reason fur change. (".1 Address ❑ Renewal Fj' Employment Lost Card DPS C.As 0 sera-07rnr-F••:,04.9c r, �1'e 'a1i 2;r»rr;'uik��,(l1-of t'rr sa t�3alli . Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. tf found return to: Board of BuildingRegulations and Standards Expiration: 10/1112009%-V" Registration: 148607 One Ashburton Place Rm 1301 :Typaai Supplement Card Boston,Ala.02108 SEARS HOME IMPROVEMENT PR cur46 "SVEC 1024 FLORIDA CENTRAL PKWY LONGWOOD,FL 32750 AdministratorKot valid without signsa J 0 0' ho 1 1 7 8 One Ashton Place Room 1301 Bost . M se 420 Home veme tractor Re stradox Reg!-tratior:: 4I 6fl7 Type: Public Corooration irvitier):- SEARS HOME AN MP'RO` MEt1` ALFRED NYM JR. 1024 FLORIDA CENTRAL PKWY !'- w LONGWOOD, FL 327-50 Up&U Adfim and roara card.9Nirk sremou for change:. r. Addrm 0 Rewwsd [7,, mploytttene (' Lost Caril s+aRPd at 8n1hl1rtg f;e tetlo s neat tun ds 3:;,.q a ae mglgmi au valid for i ndiiWdW aft 01 y HOME IMPROVEMENT CONMCTOR bc£om Ow t*melon date. If Eoxtatd m txtrrt tau.- e%. rd of BoUding RegWiftow rind 3tnndards Regis 1Wja,0rtc, 148807 t d bm>!tsi 1Platye 1�d1 f3tll. E _ /14t20f 1`e 26t,2 !s = 02108 . Z---- c GO 4rti ' Tt SMS HOME 11 � �:rfJDIJCTS INC. ' ALFRED NYMAN 1024 FLORIDAC LONGWOOD.FL 32 Admintstatur IVtitva�d t�t:�&gr3otnaar NFRC ? Rid veritana de doble guillotinaa National Fenestration Rating Council$ asLt € DC NI; f r } girl Q43111a ENERGY (PERFORMANCE RATINGS WALUAOION DE RENDIMIMM ENEROETi O U-Factor Solar Meat Gain Coefficient. Factor-U Coefciente:Gananeia de Energia Solar 0 . s . 3", {UM-Pi We icofsi) ADDITIONAL (PERFORMANCE RATINGS EVALUACION SUPLEMEWARIA DE RENDIMIEWO Visible Transmittance Transmision de luzWiible a_) Manufacturer stipulates that these ratings conform to applicable NFRC procedures for determining whole product performance.NFRC ratings are.determined for a fixed set of environmental conditions and a specific product size.NFRC does not recommend any product and does not warrant the suitability of any product for any specific use.Consult manufacturer's iiterature for other product performance information.vAvw.nfrc.org - - - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - - - - - - - Este fabricante estipula quo estos valores cumpien con los procedimientos aplicables de NFRC pars determinar el rendirniento total del product.tips valores usadr s por NFRC son determinados por un conjunto fijo de condiciones ambientales y un tamano de producto especifico.NFRC no recomienda ningun'producto y no gamntixa que el producto sea adecuado pima un use especifico.Consulte con el folleto del fabricatte Para el use apropiado de este producto.www.nffc.org STAR for °y. � � a La vn4&ad rya? f i-°a para ` w elm Ni r' € P m_3b� o r '9 vv 164 cif Keep this label for possible ENERGY STARO rebates.To loam more visit,vynv.energystar.gov Guarde esta etiqueto pam posihles reembokos ENERGY STARP Para conoter mds acerca de esto,visile wmv.energystargov. I • ;� � IIIIIIIIII III III '� - Proposal Date Sears Home Improvement Products,Inc. Job S P.O.Box 522290 Customer Name 1024 Florida Central Parkway Customer's Home Phone Customers work Phone Longwood,FL 32752-2290 L �.g� �—rr Home Improvement Products Phone (800)469-4663 y� !! contractor I irense/Registration Number Street Address ESTIMATE AND PROPOSAL 5-5- L K RSE S Windows M (465 2,878);DC (2 281); ); c;y State Zip Code MD(46542,87854);RI(27281); �t �y �„�� � a�0 Is installation within city limits? WV(WV025882) Installation Address County ❑Yes_ ❑No Billing Address(if different Irom above) Ci[y T te Zip Code Project Consultant Name 8 License No.(if applicable) Description of the Project and Description of the Significant Materials to be Used and Equipment to be installed 1. Remove existing units to be replaced.(PLEASE NOTE:The removed units are likely to be damaged.) 2. Prepare openings as necessary to receive replacement units.(No finish work other than normal installation is to be done unless otherwise noted below.) 3. Installation includes the clean up gfvl lob-related debris upon completion of the job. 4. Install Sears Weatherbeater �` 5 Windows in the openings described below according to the following specifications: COLOR: White ❑Tan ❑Clay ❑White/Light Woodgrain Interior ❑White/Dark Woodgrain Interior TYPE: ;KDH Oty ❑PW Qty__ — ❑Casement Qry_ Type ❑SH Qty_ ❑PO Oty-- ❑Bay ❑1-LR Oly ❑Garden Door Oty—_ ❑Bow: ❑3 lite ❑4 lite ❑5 lite ❑2-LR Oty_ ❑Garden Window ❑3-LR Oty_ ❑Other _ _ _ —Qty GLASS: ❑Tempered' Ory. ❑OBS Half Oty.— SCREENS:Check if other than FIBERGLASS 'PLEASE NOTE.:Tempered glass will be installed to ❑OBS Full Oty. (on sashes only) ❑Aluminum meet building codes. ❑Laminated City. GRIDS: Type Color. Placement: Existing units NOT to be replaced. - - ---------------------------- g ❑Yes ❑Col Flat ❑White ❑Wood rain Top KNo ❑Col Sculp/Contour ❑Tan ❑Full ❑Other(Specify:) ❑Brass ❑Bottom ❑Clay ❑Flankers Only 5. (If applicable)After the completion of the project,the customer will be responsible for the application and removal(storage)of shutter panels.In the event that the project requires the installation of storm shutters or egress windows,Sears Home Improvement Products, Inc.("Sears')will not re-install any affected security bars. 6. (If applicable)In the event Sears is unable for whatever reason to obtain the proper permits prior to the commencement of any work, Sears will refund any previous payment and this contract will be automatically cancelled. Additional work to be done: i— Work NOT to be d—one Wo SPECIAL INSTRUCTIONS: 6 nFV7� R t L"+� NW>C-#r�.�O All of the above check boxes and the"Work NOT to be done"section have been reviewed and explained to me. Customer(s)inibaP APPROXIMATE START DATE and APPROXIMATE COMPLETION DATE: The work will start approximately ZO xb zrb ximate Start Date)and will be substantially completed by approximately Fr?-?- ximate Completion Date).These dates are subject to change at the time the contract is accepted by Sears Home Improvement Products,Inc..1"Sears")or at any other time by mutual written agreement.Customer understands that the Approximate Start Date is only an estimated date and the Customer will be contacted prior to this date to schedule the actual start date. The TOTAL PRICE including all labor,material,taxes and any applicable discount is $ Contract Price $ Initial Payment(not to exceed 30%of Total Price unless Special Order) $ l State Sales Tax(�%) $ Final Payment(balance payable upon completion of job) $ Local Sales Tax( %) $ The Initial Payment is due prior to Sears ordering products. Total Amount Due S The form and method by which the Customers)will pay is described in a separate Cash/Cred—, CCard Payment Addendum made a part off amid incorporated into this contract by reference. Customers)inibaleAl NOTICE TO BUYER:YOU,THE BUYER,MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY (FIFTH BUSINESS DAY IN ALASKA,FIFTEENTH BUSINESS DAY IN NORTH DAKOTA IF YOU ARE AGE 65 OR OLDER)AFTER THE DATE OF THIS TRANSACTION.SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. Additional provisions of this contract are stated on the pages fallowing. Customer(s)initials i swt-ca Rey o4ioo ttUtll►l►fl►lit ADDITIONAL PROVISIONS Proposal and Aoorov_a]. Sears offers to furnish the materials and arrange`or their delivery and installation as specified on the first page and/or the attached sketches and specification sheets for the TOTAL PRICE shown.This offer must be approved by the Installation Department.If this is a credit sale or a payment on completion sale,it must be approved by he Credit Sales Department.If this proposal is not approved or the installation cannot be made in accordance with the law,this offer will be%ithdrawn and any payments you have made will be refunded to you. Any materials left over after the installation has been completed are Sears property and will be removed by Sears. Installation. I understand that Sears will not install the materials but will trrange for the installation.Sears is not responsible for materials or installation NOT furnished or arranged by Sears.Sears agrees to procure;ill permits required by local law. Authorization. I authorize Sears to:(1)arrange for a contractor(licensed where required by law)to make the installation of materials;(2)issue a work order for this installatior to a contractor;(3)inspect the installation;and(4)pay the contractor when the installation is complete if I have signed a certificate that the installation has been completed to my satisfaction. 011ays in Installation. I agree that Sears is not responsible for delays in]elivery or installation due to weather,fire,strikes.war,government regulations or any causes beyond Sears'control. Oral Agreements md Channes in Contract. I understand that there are na oral agreements between Sears and me.Everything I expect Sears to do has been included in writing in this contract.Nothing can be changed in this contract unless it is in writing on a separate form accepted by me and Sears. Resoonsiblllty g(Buver. I agree that any information or measurements that I give to Sears are correct and complete.I am responsible for any special work described in this contract. Electrical$t Plumbino Service. I will provide adequate electrical and/or plumbing service(s)to run any newly installed appliances or other furnishings. If the electrical and/or plumbing service(s)do not meet the s-andards of the utility company or electrical and/or plumbing codes, I will make the necessary changes at my expense unless Sears has agreeo in this contract to make the changes. Payment. I will pay Sears the cash price that covers the price of material and installation as shown on the first page. Warranty Information. Appropriate product warranty documents will be given to me by Sears.Sears'Warranty on Installation is: SEARS'LIMITED WARRANTY ON INSTALLATION In addition to.any manufacturer warranty extended to you on the product(s)used(which warranty becomes effective the date the merchandise is installed),if the workmanship(or application)of any Sears'arranged installation proves faulty within(i)one year for Weatherbeater Value Line,(ii) two years for Weatherbeater Plus,or(iii)three years for Weatherbeater Max.and Weatherbeater Slormbeater,then upon notice from you Sears will cause such faults to be corrected by repair at no additional cost to you.If Sears determines that repair is not commercially practicable or cannot be timely made,then,at Sears'sole discretion,Sears may elect to provide replacement or refund.Service under this Limited Warranty is available by calling Sears Home Improvement Products at 1-800-222-5030,Option 4.This warranty gives you specific legal rights,and you may also have other rights that vary f-om State to State. NOTICE TO BUYER I. DO NOT SIGN THE AGREEMENT IF ANY OF THE SPACES INTENDED FOR THE AGREED TERMS TO THE EXTENT OF THE AVAILABLE INFORMATION ARE LEFT BLANK. 2. YOU ARE ENTITLED TO A COPY OF THIS AGREEMENT AT THE TIME YOU SIGN IT.KEEP IT TO PROTECT YOUR LEGAL RIGHTS. 3. YOU MAY PAY OFF THE FULL UNPAID BALANCE DUE UNDER THE AGREEMENT AT ANY TIME,AND IN SO DOING YOU SHALL BE ENTITLED TO A FULL REBATE OF THE UNEARNED FINANCE AND INSURANCE CHARGES. 4. YOU MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY[FIFTH BUSINESS DAY IN ALASKA, FIFTEENTH BUSINESS DAY IN NORTH DAKOTA IF YOU ARE AGE 65 OR OLDER]AFTER THE DATE OF THIS TRANSACTION. SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT.FAILURE TO EXERCISE THIS OPTION, HOWEVER,WILL NOT INTERFERE WITH ANY OTHER REMEDIES AGAINST THE RETAIL SELLER YOU MAY POSSESS.IF YOU WISH,YOU MAY USE THIS PAGE AS NOTIFICATION BY WRITING"I HEREBY RESCIND"AND ADDING YOUR NAME AND ADDRESS.A DUPLICATE OF THIS RECEIPT IS PROVIDED BY THE SELLER FOR YOUR RECORDS. 5. IT SHALL NOT BE LEGAL FOR THE SELLER TO ENTER YOUR PREMISES UNLAWFULLY OR COMMIT ANY BREACH OF THE PEACE TO REPOSSESS GOODS PURCHASED UNDER THIS AGREEMENT. NOTICE TO MARYLAND RESIDENTS ONLY Notice:All home improvement contractors and subcontractors must be licensed by the Maryland Home Improvement Commission.Inquiries regard- ing a contractor or subcontractor should be directed to the Home Improvement Commission,telephone:410-230-6309 or(in-state)1-888-218-5925. NOTICE TO NEW HAMPSHIRE CUSTOMERS NEW HAMPSHIRE LAW,RSA 359-G,CONTAINS IMPORTANT REOUIREMENTS YOU MUST FOLLOW BEFORE YOU MAY FILE A LAWSUIT OR OTHER ACTION FOR DEFECTIVE CONSTRUCTION AGAINST THE CONTRACTOR WHO CONSTRUCTED, REMODELED, OR REPAIRED YOUR HOME.SIXTY DAYS BEFORE YOU FILE A LAWSUIT OR OTHER ACTION.YOU MUST SERVE ON THE CONTRACTOR A WRITTEN NOTICE OF ANY CONSTRUCTION CONDITIONS YOU ALLEGE ARE DEFECTIVE.UNDER THE LAW,A CONTRACTOR HAS THE OPPORTUNITY TO REPAIR AND/OR PAY FOR THE DEFECTS.THERE ARE STRICT DEADLINES AND PROCEDURES UNDER STATE LAW,AND FAILURE TO FOLLOW THEM MAY AFFECT YOUR ABILITY TO FILE A LAWSUIT OR OTHER ACTION. _ 3 0 Customer's signature Date Customer's signature ° ate Accepted by Sears Home Improvement Products,Inc.("Sears")on o� by: 4 1/ x c Tarr. rie_ DMte Management 54resentative t SWl-G4 R-04/0£ , I I - � , .b IIIIIIIIII III III Proposal Date 3 e Job d 3 O Sears Home Improvement Products,Inc. Customer Name P.O.Box 599290 L 1024 Florida Central Parkway Customers Home Phone I Custarner's work Phone Longwood,FL 32752-2290 Z%3 D Home Improvement Products Phone (800)469-4663 Street Address ESTIMATE AND PROPOSAL Contractor License/Registration Number 53— 's� Doors HIC#148607;all plumbing and electrical city State Zip Code I services performed by licensed subcontractors 14, OV ,� 02.6o Is installation within city limits? FEIN 25-1698591 Insta atjon Address County El El Nn Billing Address(if different from above) City (Stale Zio Cade Project Consuftant Name 8 License No.(if applicable) Description of the Project and Description of the Significant Materials to be Used and Equipment to he installed Entry Door 1 Location: Entry Door 2 Location: Style: Style: ❑Full Jamb ❑L Frame ❑Double ❑Heritage ❑Patic ❑Fu•I Jamb ❑L Framc ❑Double ❑Heritage ❑Patio ❑CC Grained [:]CC Smooth ❑VL Smooth ❑CC Grained ❑CC Smooth ❑VL Smooth Colors Ext Int Colors Ext Int Grid/Blind Colors Grid/Blind Colors Ext Int Ext Int ❑Glass Style ❑Glass Style Finish: []Bright Brass❑Antique Brass ID Satin Nickel ❑Aged Bronze Finish: ❑Bright Brass❑Antique Brass ❑Satin Nickel ❑Aged Bronze El Standard Hardware Package El Standard Hardware Package Additional Options: Additional Options: INSWING: ❑LH ❑RH ❑ OUTSWING: ❑LH ❑RH❑INSWING: ❑LH ❑RH ❑ OUTSWING: ❑LH ❑RH Casing: ❑2.5 Modern ❑2.5 Colonial ❑3.5 Colonial Casing: ❑2.5 Modern ❑2.5 Colonial ❑3.5 Colonial Casing Color: Casing Color: ❑Door Cutdown Patio Door Screen Color ❑Door Cutdown Patio Door Screen Color ❑Standard Jamb ❑Extended Jamb [:]Standard Jamb ❑Extended Jamb Jamb Cladding Color: Jamb Cladding Color: Door 1 SIDELITES STORM DOORS Location:Aga Poo fZ. Model Number: Model Number: ❑Ful I Jamb ❑L Frame []Double ❑Heritage ❑Patio Colors Ext ----—Int ❑CC Grained ❑CC Smooth ❑VL Smooth ❑Tinted Glass: ❑Bronze ❑Gray ❑ reen ❑Low'E' Colors Ext Int ntandard Hardware Package lack ❑White GridlBlind Colors ❑Specialty Hardware: Ext Int ❑Glass Style Door 1 TRANSOMS Finish: El Bright Brass❑Antique Brass ❑Satin Nickel ❑Aged Bronze Model Number: PLEASE NOTE: Contractor is not liable for the condition or Grid Color Ext Int operation of rehung storm doors. ❑Glass Style Additional work to be done: Work NOT to be done: SPECIAL INSTRUCTIONS: All of the above check boxes and the"Work NOT to be done"section have been reviewed and explained to me. Customer(s)initials APPROXIMATE START DATE and APPROXIMATE COMPLETION DATE: The work will start approximately 2.*76 Z-S2 roximate Start Date)and will be substantially completed by approximately STo?-,��r.AApproximate Completion Date).These dates are subject to change at the time the contract is accepted by Sears Home Improvement Products,Inc.('Sears")or at any other time by mutual written agreement.Customer un- derstands that the Approximate Start Date is only an estimated date and the Customer will be contacted prior to this date to schedule the actual start date. The TOTAL PRICE including all labor,material,taxes and any applicable discount is Contract Price $ Initial Payment(not to exceed 30%of Total Price unless Special Order) $ ,'L State Sales Tax(_%) — Final Payment(balance payable upon completion of job) $ LO Local Sales Tax( %) $ The Initial Payment is due prior to Sears ordering products. _ Total Amount Due S The form and method by which the Customer(s)will pay is described in a separate Cash/Credit Card Payment Addendum made a part of and incorporated into this contract by reference. Customer(s)initialp- NOTICE TO BUYER:YOU,THE BUYER,MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY (FIFTH BUSINESS DAY IN ALASKA,FIFTEENTH BUSINESS DAY IN NORTH DAKOTA IF YOU ARE AGE 55 OR OLDER)AFTER THE DATE OF THIS TRANSACTION.SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. Additional provisions of this contract are stated on the pages following Customer(s)initial SDI-MA R-04/09 r t s ADDITIONAL PROVISIONS Proposal and Approval. Sears offers to furnish the materials and arrange for their delivery and installation as specified on the first page and/or the attached sketches and specification sheets for the TOTAL PRICE shown.This offer must be approved by the Installation Department.If this is a credit sale or a payment on completion sale,it must be approved by the Credit Sales Department.If this proposal is not approved or the in- stallation cannot be made in accordance with the law,this offer will be withdrawn and any payments you have made will be refunded to you.Any materials left over after the installation has been completed are Sears property and will be removed by Sears. Installation. I understand that Sears will not install the materials but will arrange for the installation.Sears is not responsible for materials or installation NOT furnished or arranged by Sears.Sears agrees to procure all permits required by local law. Authorization. I authorize Sears to:(1)arrange for a contractor(licensed where required by law)to make the installation of materials;(2)issue a work order for this installation to a contractor;(3)inspect the installation;and(4)pay the contractor when the installation is complete if I have signed a certificate that the installation has been completed to my satisfaction. Delays iii Installation. I agree that Sears is not responsible for delays in 6livery or installation due to weather,fire,strikes,war,government regulations or any causes beyond Sears'control. Oral Agreements AnA Changes in Co rl ac. I understand that there are no oral agreements between Sears and me.Everything I expect Sears to do has been included in writing in this contract.Nothing can be changed in this contract unless it is in writing on a separate form accepted by me and Sears. s that I gave to Sears are correct and complete.I am responsible for any Responsibility At Buyer. I agree that any information or measurement special work described in this contract. Electrical&Plumbing Service. I will provide adequate electrical and/or plumbing service(s)to run any newly installed appliances or other fur- nishings.If the electrical and/or plumbing service(s)do not meet the standards of the utility company or electrical and/or plumbing codes,I will make the necessary changes at my expense unless Sears has agreed in this contract to make the changes. payment. I will pay Sears the cash price that covers the price of material and installation as shown on the first page. Warranty Information. Appropriate product warranty documents will be given to me by Sears.Sears'Warranty on Installation is: SEARS'LIMITED WARRANTY ON INSTALLATION In addition to any manufacturer warranty extended to you on the producVs)used(which warranty becomes effective the date the merchandise is installed),if the workmanship(or application)of any Sears'arranged installation proves faulty within three years on Custom Craft products and one year on all other products,then upon notice from you Sears will cause such faults to be corrected by repair at no additional cost to you.If Sears de- termines that repair is nut commercially practicable or cannot be timely made then.at Sears'sole discretion,Sears may elect to provide replace- ment or refund.Service under this Limited Warranty is available by calling Sears Home Improvement Products at 1-800-222-5030,Option 4. This warranty gives you specific legal rights,and you may also have other rights that vary from State to State. NOTICE TO BUYER 1. DO NOT SIGN THE AGREEMENT IF ANY OF THE SPACES INTENDED FOR THE AGREED TERMS TO THE EXTENT OF THE AVAILABLE IN- FORMATION ARE LEFT BLANK. 2. YOU ARE ENTITLED TO A COPY OF THIS AGREEMENT AT THE TIME YOU SIGN IT.KEEP IT TO PROTECT YOUR LEGAL RIGHTS. 3. YOU MAY PAY OFF THE FULL UNPAID BALANCE DUE UNDER THE AGREEMENT AT ANY TIME,AND IN SO DOING YOU SHALL BE EN- TITLED TO A FULL REBATE OF THE UNEARNED FINANCE AND INSURANCE CHARGES. l 4. YOU MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY[FIFTH BUSINESS DAY IN ALASKA,FIFTEENTH BUSINESS DAY IN NORTH DAKOTA IF YOU ARE AGE 55 OR OLDER]AFTER THE DATE OF THIS TRANSACTION.SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT.FAILURE TO EXERCISE THIS OPTION,HOW- EVER,WILL NOT INTERFERE WITH ANY OTHER REMEDIES AGAINST THE RETAIL SELLER YOU MAY POSSESS.IF YOU WISH,YOU MAY [ USE THIS PAGE AS NOTIFICATION BY WRITING"I HEREBY RESCIND"AND ADDING YOUR NAME AND ADDRESS-A DUPLICATE OF THIS RECEIPT IS PROVIDED BY THE SELLER FOR YOUR RECORDS. 5. IT SHALL NOT BE LEGAL FOR THE SELLER TO ENTER YOUR PREMISES UNLAWFULLY OR COMMIT ANY BREACH OF THE PEACE TO RE- POSSESS GOODS PURCHASED UNDER THIS AGREEMENT. I NOTICE TO MASSACHUSETMOLUI ENTS ONLY I In addition to the Notice to Buyer shown above,Massachusetts law requir:s that contracts for home improvement work state that all home im- provement contractors and subcontractors shall be registered and that any inquiries about a contractor or subcontractor relating to a reg- istration should be directed to: Director,Horne Improvement Contractor Registration P.O.Box 871 Taunton.MA 02780-0871 Telephone:(508)821-9375 Please note that owners who secure their own construction-related permits or[teal with unregistered contractors shall be excluded from access to the Guarantee Fund. _ __ _ _ _ _ _ Notwithstanding any other language in the contract or associat!cl documents,Sears will not remove,replace,or install any heating or air conditioning system.or any portion thereof,if asbestos or asbestos-containing material is known or likely +o be present in that heating or air conditioning system.or any portion thereof.If it is determined or reasonably suspected ,hat asbestos is present,either before commencement or during performance of the work,it shall be the customer's re-r sponsibility to select,retain and pay all costs of a Division of Occupational Safety("DOS")licensed Asbestos Contractor to remove all asbestos or verify that none is present in the components involved in the job. If the determination or rea- sonable suspicion of the presence of asbestos arises after Sears has started the work,Sears will immediately cease per- forming the work until a DOS licensed Asbestos Contractor. hired by the customer, removes all asbestos from the components scheduled for repair or replacement in accordance with 310 C.M.R.7.00 and 453 C.M,R.6.00 or verifies that, none Is present.By signing the contract the customer agrees-hat it understands the above. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES _ � 3 1-i7og Customer's signature Date !!� Customer's signature , „ Date Accepted by Sears Home Improvement Products,Inc.(`Sears")on Date y Management Reprysentative SDI-MA R-04109