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29 VALLEY ST - BUILDING INSPECTION (6) ' sp, The Commonwealth of Massachusetts n Board of Building Regulations and Standards CITY OF ALEM Massachusetts State Building Code, 780 CMR SdMar 0 Revised Mar 2011 Building Permit Application To Construct, Repair, Renovate Or Demolish a One-or Two-Family Dwelling This Section For Official Use Only. Building Permit Number: ate Applie w y. /V/ Building Official(Print Name) SignatLVe Date SECTION 1: SITE INFORMAT I.J� o e,rty�A Tess: L ��L 1.2 Ass�ssgrs Ma & Parcel Num r 1o(f`1 pV rry t 7 - I ({— p 1.I a Is this an acceptA street?yes no Map Number Parcel Number 1.3 Zo� 9ng Fnfarmati n: ?.l Property Di Teens s -,.. . Ube- Hi mI �11 Zoning District Proposed Use Lo rea(sq ft) Fronta o 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provid Required Prov' ed Required P ided 1.6 W r Supply: (M.G.L c.40,§54) 1.7 Flo one Information: 1.8 wage Disposal System: Zo _ Outside Flood Zone? lic❑ Private❑ Check if yes❑ unicipal ❑ On site disposal system ❑ SECTION 2: PROPERTY OWNERSHIP' Owner of Record: 1 ) rcana-. �Baru_a �Saf��l . Ck - O1G `io Name(Print) City,State,ZIP a9 Malley S ree± 97o0`74s�9� No.and Street Telephone Email Address SECTION 3: DESCRIPTION OF PROPOSED WORK' (check all that apply) New Construction ❑ Existing Building ❑ Owner-Occupied ❑ 1 Repairs(s) Alteration(s) ❑ Addition ❑ Demolition ❑ 1 Accessory Bldg. ❑ Number of Units I Other ❑ Specify: ^^,,'',,ec o_i.,j DC 'p of Drop: edU/ork2. nCl, / S jvr��:S.; ��1/�m ) - SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only Labor and Materials I. Building $ 94S 1. Building Permit Fee: $ Indicate how fee is determined: 2. Electrical $ ❑ Standard City/Town Application Fee 'tip ❑Total Project Costa (Item 6)x multiplier x 3. Plumbing $ 2. Other Fees: $ 4. Mechanical (HVAC) List: 5. Mechanical (Fire Suppression) $ — Total All Fees: $ n�� Check No. Check Amount: Cash Amount: 6. Total Project Cost: $ L� 0 Paid in Full 0 Outstanding Balance Due: / SECTION 5: CONSTRUCTION SERVICES �y p 5.1 Construction Supervisor License(CSL) 9 7S C, C.�Ve(2- - . oa��C� License Number Expira[io Dale Name ot'CSL Holder 0 kY7 f3 S I00 r�va List CSL Type(see below) No.a d Street n Type Description U Unrestricted(Buildings up to 35,000 cu. ft.) t l R Restricted 1&2 Family Dwelling City/T n,S ,ZIP M Masonry _ RC Roofing Covering WS Window and Siding ry ,,eC ��//77p�//����// SF Solid Fuel Burning Appliances l 'Q kS l��,j-oZgp 'IQC . I 1 Insulation Tele hone Email address D I Demolition 5.2 Registered Home ImpTrovementlC,oryJ�tractor IC) Spa,- / // C7/'O ^"1 I_f)ll rS C +•kVi 'A--1 .IOS Vet- HICRegistration Number Expiration Date HIC Com an me or H C Reis nt N e I � cc) tYo.and Street FL _3Z7 �2 R�'� ZS� 04`J/ Email address Cit / n, State, IP Telephone SECTION 6: WORKERS'COMPENSATION INSURANCE AFFIDAVIT (M.G.L. c. 152. § 25C(6)) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the Issuance of the building permit. Signed Affidavit Attached? Yes .........:� No ........... ❑ SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT Ac-n r .. I, as Owner of the subject property,hereby authorize 440 >� (')yy1L° WI/� - US Svc to act on my behalf, in all matters relative to work author' ed by is building per it pplication. 1 n o r c� 7 1 a Print Owner's Name(Electronic Signature ate SECTION 7b: OWNER`OR AUTHORIZED AGENT DECLARATION By entering my name below, I hereby attest under the pains and penalties of perjury that all of the information contained in this aoplica ion;, tru [e to[he best of my knowledge and unde/stfanding. a�lzec- /� ate onic ignature Date NOTES: I. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregi contractor (not registered in the Home Improvement Contractor(HIC)Program), will not have access a arbitration program or guaranty fund under M.G.L. c. 142A.Other important information on th Program can be found at www.mass. ovg /oca Information on the Construction Supervisor License ca ound at www.mass.gov/dps 2. When substantial work is planned,provi ormatton e ow: 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 bathroom Number of half/baths Type of heating sy em Number of decks/porches Type of coolin ystem Enclosed Open 3. "Total Project Square Footage"may be substituted for"Total Project Cost" CITY OF S.U.F.M, N'W&ALCHUSETTS • BuMDMG DEPARTMENT 130 WASHINGTON STREET, 3iO FLOOR TEL (978) 745-9595 FAx(978) 740-9846 Kl.\{BERIEY DRISCOLL MAYOR THo\w ST.PtEmE DIRECTOR OF PUBLIC PROPERTY/BUILDLNG CONMSSIONER Construction Debris Disposal affidavit (required for all demolition and renovation work) In accordance with the sixth edition of the State Building Code, 780 CMR section 111.5 Debris, and the provisions of MGL c 40, S 54; Building Permit # is issued with the condition that the 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 transported by: 1 (name of hauler) The debris will be disposed of in r- iV-)�_ (name of facility) u � _ vev3 u h ; r5 � 07-0ciC) (address of f cility) si nature of ermi[app rc date Jcbrisnll.dN: 4 The.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/Orgaruzatiordindividual): Sears Home Improvement Products Incorporated Address: 1024 Florida Central Parkway City/State/Zip: Longwood, FL 32750 Phone #: 860-753-0452 Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6 ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. I ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working forme 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 l l.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.❑ Roof repairs insurance required.] t employees. [No workers' 13.M Others — 2 7+ comp. insurance required.] Any applicant that checks box#1 must also fill out the section below showing their workers'compensation pot icy information. i t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit anew anidavu indicating such. (Contractors that check this box must attached an additional sheet showing the time 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: Ace American Insurance Company / Phone: 866-283-7122 Policy #or Self-ins. Lic. #: WLRC46482815 Expiration Date: 08/01/2012 Job Site Address: O�q l �� re City/State/Z' '0 197b 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! to 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 DLA for insurance coverage verification. 1 do hereby certi nd the pains an penalties ofperjury that the information provide above ntandeorrect. Si nature (Sears Auth. Agent} Date: Phone #: Home—Fax : 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#: DATEIMMIDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 07I19/011 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 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 c certificate holder in lieu of such endorsement(s). 'E PRODUCER cow CT N L ACT Risk services Central, Inc. NAME:P O (8667 283J122 FAX (84]) 953-5390 N Chicago IL office (MONO.E,ak Ac.No.: y 200 East Randolph E4AIL Chicago IL 60601 USA ADDRESS: _ INSURERIB)AFFORDING COVERAGE NAIC0 INSURED INSURERA: Indemnity Insurance Co of North America 43575 Sears Holdings Corporation INSURER 9: ACE American Insurance Company 22667 dba Sears, Roebuck and Co. Attn: Risk Management E3-219A INSURERC: 3333 Beverly Road INSURER D: Hoffman Estates IL 60179 USA INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:570043294986 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. Limits shown are as requested LTR TYPE OF INSURANCE INSR MD POLICY NUMBER PULIUy /YY MMIDMAGGREGATE LIMITS GENERAL LIABILITY HGOG RENCE $5,000.000 X COMMERCIAL GENERAL LIABILITY ocwnence $5,000.000 CLAIMS-MADE X❑OCCUR one Penon) EXCluded ADV INJURY $50000,006 REGATE $5,000,000 m GEN'LAGGREGATELIMIT APPLIES PER: OMP/OP AGO $5,000,000 m X POLICY PRO- LOC C, n B AUTOMOBILE LIABILITY ISAH08696 3 OS Ol 201108 Ol 012 COMBINED SINGLE LIMIT E5,000,000 m B ISAH08690649 08/01/2011 08/01/2012 Ea accident)_ ANY AUTO BODILY INJURY I Per person) O X ALL OWNED SCHEDULED BODILY INJURY(Per accident) 2AUTOS AUTOS X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE N AUTOS Pe,ecudenl U C Y UMBRELLA LIAR OCCUR EACH OCCURRENCE U EXCESS LIAR CLAIMS-MADE AGGREGATE DED IRETENTiON A WORKERS COMPENSATION AND WLRC46482815 OB O1 2011 08/01/2012 WC STATU- OTH- B EMPLOYERS'LIABILITY YIN WLRC46482803 081011201108/01/2012 X TORY LIMITS ER ANY PROPRIETOR'PART NERIEXECUTIVE EL.EACH ACCIDENT $2,D00,000 A OFFIOER/MEMBER EXCLUDF.D> NIA SCFC46482827 08/01/2011 08/01/2012 (Mandatory in NH) EL.DISEASE-EA EMPLOYEE $2,000,000 II Yea.deso i, ands, DESCRIPTION OF OPERATIONS below E L.UsEASE-POUCY LIMIT 12,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Addaional Remarks Schedule,a more apace 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. Sears Home Improvement Products, Inc. AUTHORIZED REPRESENTATIVE 1024 Florida Central Parkway Longwood FL 32750 USA alGfA'L^V G/C64BL'N f/✓719JLZRG�a/fBGt ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010I05) The ACORD name and logo are registered marks of ACORD � fie Z�a�rrtrr�w�ut'st�tz�i o �.���a�aau�u�aeC� Office of Consumer Affairi§ and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 148607 Type: Supplement Card Expiration: 10/11/2013 SEARS HOME IMPROVEMENT PRODUCTsi LUBOS SVEC 1024 FLORIDA CENTRAL PKWY '� 3 ?r LONGWOOD, FL 32750 {. Update Address and return card.Mark reason for change. .. 1 Address C Renewal- ❑ Employment J Lost Card DPs-CAI 0 50M-04/04-GG�101216 ✓/re '�nnmeonw✓-rs� a�✓�.aalac�euoe(1`a - -. —._ _. - —.- - — -- — J Office of Consumer Affairs&Business Regulation License or registration valid for individul use only IROME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation Registration: .148607 Type: 10 Park Plaza-Suite 5170 Expiration: 10/11/2013 Supplement Card Boston,MA 02116 SEARS HOME IMPROVEMENT PRODUCTS INC. LUBOS SVEC 1024 FLORIDA CENTRAL PKWY 4,'�-,-- e LONGWOOD,FL 32750 llnJersecretan 4alidwithout signature av \ta%s chuwlt+ Department of public Safetl 1 V Board of Buildm Rcguluttonv and Standar(. IJ Cdbstru6on Supervisor License 1 License: CS 97519 c r LUBOS SVEC '.; ;;.. 827 THOMPSON F )AD THOMPSON, CT 06277 Expiration: 8/31/2012 'x (onnni�ionrr Trg: 2442 - � i f Office Location. Ii Date S 7 -1 q vac x 1 i S am Home Improvement Products,Inc. guslCmer Name O0. P .Box—522290 � l� P'C Y�10/rtlN 1 24 Floridaida Genital Parkway Customers Home Phone Customer's work Phone Home Impfovement Pro L ngwood,FL 32752-2290 ducts P one (800)469-4663 Street Address ESTIMATE AND PROPOSAL 0 ourfor Licens JPCgiSlratgn Nummr Windows C (HIC.06071i Do(50006423T, rily �— State zip Code (46542.87854)I PA(PA005491 o(g70 Is ni on within city limits? R (27281)�WV(WV025882) Installation Address County &6 ki Wives_ ❑No none Address(if different from above) city State I Zip Cotle Picked Consultant Name a License No Of midtahle) ben, Z DeacrlpUon of the Project and Descdpllan of the Significant Malerlala to be Used and Equipment to be Installed 1. Remove existing units to be replaced.(PLEASE NOTE:The removed units are likely to Wit d.) 2. Prepare openings as necessary to receive replacement units.(No finish work other than normal peculator is to be done unless otherwise noted below.) 3. Installation includes the clean uAaj all ioQdelated debris upon completion of the job. 4. Install Sears Weathemeater _Y L..L1L _Windows in the openings of scribed below according to the following specdications'. - COLOR: N(Nhde ❑Tan ❑Clay ❑WOitr igfu`Wirodgraimhoiri . ❑Wlate/Dark.Woodgraln laterior. TYPE: )QDH Dry DPW Ory__ ❑Casement Ory_ Type DISH Ory_ ❑ED Oty__ ❑Bay ❑1-LR Cry ❑Garden Door Ctg_ ❑Bow: ❑3lite 114 lite ❑5 lite M-LR Ob, ❑Garden Window W-LR Of= ❑Other Oty GLASS: ❑Tempered• BY__ ❑OBS Half Dry._ SC EENS:Check if other than FIBERGLASS 'PLEASE NOTE Tempered glass will be installed to ❑CBS Full Oty._ (on sashes only) ❑Aluminum meet building codes. ❑Laminated Dry. I GRIDS: Type Color Placement: &isri g units NOT to be replaced. ❑Yes OGol Flat -__-- - - 0alit a ❑W6odgram ❑Top LA4ao ❑CoI SCulp/ContourA El ❑Full ❑Other(Specify 1 Brass ❑Bottom Clay ❑Flankers Only 5. (If applicable)After the completion of the project,the Customer will be responsible for the apt icalion and removal(storage)of shutter panels. In the event that the project requires the installation of storm shutters or egress windc vs,Sears Home Improvement Products, Inc.('Si 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 1 nor to the Commencement of any work, Sears will refund any previous payment and this contract will be automatically cancelled. 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 e. Custormeds)mice APPROXIMATE START DATE and APPROXIMATE COMPLETION DATE: The work will start approximate) "G (Approximate Stan Oate)and will he substantially completed by approximately��Z l Appmximate Completio Date).These dates are subject to change at the time the contend is accepted br Sears Horne l nymveni Products,I I"Sears")or or any other ti a by mutual written agreement Customer understands that me Approximate Stan Date is only an estimated dale and the Customer will be contacted prior o this date to schedule the actual start date. lne TOTAL PRICE irMluding all labor,material,taxes and any applicable discount is Contract Price $ Initial Payment(not to exceed 30%of Total Price unless Special Order) late Sales Tax Final Payment(balance payable upon completion of job) $ ocl Sales Tax The InBiat Payment is due prior to Sears ordering produces. Te al Amount Due $ The forth and method by which the Lustomer(s)Will pay is described in a separate fash/Credil Card Faymed Addendum made a pad of and incorporated into this contract by re erence. Cusiomer(s)milli NOTICE TO BUYER:YOU,THE BUYER,MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO If IDNIGHT OF THE THIRD BUSINESS DAY (FIFTH BUSINESS DAY IN ALASKA,FIFTEENTH BUSINESS DAY IN NORTH DAKOTA IF YOU ARE AGE 15 OR OLDER)AFTER THE DATE OF THIS TRANSACTION.SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THII RIGHT. Addilianal provisions of this ..h.ertare stated I.the pages Iollo img. n� �—1 o.n..or,aa Components)initials 5 y IIIIIII I II 01111 ADDITIONAL PROVISIONS Job Number. _ Electoral and Aoorovai. Sears offers to furnish the materials and arrange for their delivery and instr lation as specified on the first page archer the attached Sketches and specification Sheets for the TOTAL PRICE shown.This offer must be appr rved by the Installation Department.It this is a credit sale or a payment on completion sale,it must be approved by the Credit Sales Departm or If this proposal is nut approved or the installation cannot be made in accordance with the law,this offer will be withdrawn and any paymen is you have made will be refunded to you. Any materials left over after the installation has been completed are Sears property and will be rem reed by Sears. Installptlig . I understand that Sears will not install The materials but will arrange for the ers atlatio 1,Sears is not responsible for materials or installation NOT furnished or arranged by Sears.Sears agrees to procure all permits required by to at law. Author ration. I authorize Sears to (1)arrange for a contractor(licensed where required by law)to nake the installation of materials(2)issue a work order for this installation W a contractor:(3)inspect the installation'.Intl 14)pay the pooh ictof when the installation is complete if I have signed a certificate that the installation has been completed to my satisfaction. Delays IS Installation. I agree that Sears is not responsible for delays in delivery or installation on to weather.fire.strikes,war,government regulations or any causes beyond Sears'control. Dart Agreement add Changing in Contra,. I understand that there are no oral agreements betwin n 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 t is in writing on a separate form accepted by me and Sears. Reoonc'hllity gl Buvdr. 1 agree that any information or measurements that I give to Sears are car act and complete.I am responsible for any special work described in this contract. ElmArical A plumbing Service. I will provide adequate electrical anill plcm5ingi servica(s)tomr,any newly instated appliances or other. - furnislengs.If the electrical and/or plumbing services)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, pavemon. I will pay Sears the Cash price that Covers the price of material and Installation a5 shoal on the first page. Warranty Information. Appropriate product warranty documents will be given to me by Sears.Sei is Warranty on Installation is: SEARS'LIMITED WARRANTY ON INSTALLATION In addition to any manufacturer warranty extended to you on the produchs)used(which warranty be humes effective the date the merchandise is installed),If the workmanship(or application)of any Sears'arranged installation proves faulty within( one year for Weathermaler Value Line.(it) two years for Weatherbeater Plus,or(111)three years for Weatherbeaier Max,and Weatherbeater StiXambeaher,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 Top air is not commercially practicable or cannot be timely made,then,at Sears'sole discretion,Sears may elect to provide replacement or rathe .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 tram State to State. NOTICE TO BUYER 1. DO NOT SIGN THE AGREEMENT IF ANY OF THE SPACES INTENDED FOR THE AGREED TEI MS 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 I D PROTECT YOUR LEGAL RIGHTS. 3. YOU MAY PAY OFF THE FULL UNPAID BALANCE DUE UNDER THE AGREEMENT AT ANY IME,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 USINESS DAY(FIFTH BUSINESS DAY IN 4 ALASKA,FIFTEENTH BUSINESS DAY IN NORTH DAKOTA IF YOU ARE AGE 65 OR OLDER) ER THE DATE OF THIS TRANSACTION. SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIG T.FAILURE TO EXERCISE THIS OPTION, HOWEVER,WILL NOT INTERFERE WITH ANY OTHER REMEDIES AGAINST THE RETAIL BELLE 1 YOU MAY POSSESS.IF YOU WISH,YOU MAY USE THIS PAGE AS NOTIFICATION BY WRITING"I HEREBY RESCIND"AND ADDING YOIL I 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 OMMIT ANY BREACH OF THE PEACE TO REPOSSESS GOODS PURCHASED UNDER THIS AGREEMENT — NOTICE TO MARYLAND RESIDENTS ONLY Notice'.AI home improvement contmcmrs and subcontractors must be licensed by the Maryland Home mprovement Commission.Inquiries regard- ing a contractor or suhconlracmt should be bimcled to the Home Improvement Commission,telephone: 10-230 6309 or(in-state)1-888-218-5925. NOTICE TO NEW HANES IRE CUSTOMERS NEW HAMPSHIRE LAW,RSA 359-G.CONTAINS IMPORTANT REOUIREMENTS YOU MUST FOLLOI V BEFORE YOU MAY FILE A LAWSUIT OR OTHER ACTION FOR DEFECTIVE CONSTRUCTION AGAINST THE CONTRACTOR WHO CONSTRILK TED,REMODELED.OR REPAIRED YOUR HOME.SIXTY DAYS BEFORE YOU FILE A LAWSUIT OR OTHER ACTION,YOU MUST SERVE ON T flE CONTRACTOR A WRITTEN NOTICE OF ANY CONSTRUCTION CONDITIONS YOU ALLEGE ARE DEFECTIVE.UNDER THE LAW,A CONTRAC FOR HAS THE OPPORTUNITY TO REPAIR AND/OR PAY FOR THE DEFECTS,THERE ARE STRICT DEADLINES AND PROCEDURES UNDER STA E LAW,AND FAILURE TO FOLLOW THEM MAY AFFECT YOUR ABILITY TO FILE A LAWSUIT OR OTHER ACTION. a 5.37-I`� Customer'ss to Dale Customers sio ature Date Accepted by Sears Home Improvement Products.Inc.p'Sears")on 'xg27=�-_ Date Management Representative ' »r}y" +." `a NFRC �t1u�11� �ussr� t 1ixx' sssa�a tl� clssk;?+a r�c:i W 1� .��xe� a F.� fi t:?wI'ili Q 1 ar—r, National Fenestration 1 xcrtats '° � + sg 1 3..18 1-14i ILxi-s Mrratad Rating Councile Rq 6'?eifx•4 K0 ENERGY PERFORMANCE RATINGS EVALUAGION DE RENE"ME M ENERGEr1Co U-Factor Solar Heat Gain Coefficient Factor-1.) eoefldente:Ganancia de Energia Solar WSA-P) Wetrico/Sa ADDITIONAL.. PERFORMANCE RATINGS EVALUAGION SUPLEMEWARIA DE RENDIMIENTO Visible Transmittance Transmision de i.uzVisible Manufacturer stipulates that these ratings conform to applicable NFRC procedures for determining whole product performance.NFRC ratings are determined for a fired set of environmental conditions and a specific product size.NFRC does not recommend any product and does not warrant the sultabi ily of any product for any specific use.Consult manufacturer's literature for rather product performance information.wvnv.ntrc.org - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Este fabricante estipula que estos vafores cumplen con fos procedlmientos aplicables de NFRC para determinar at rendimfento total del producto.Los vafores usados par NFRC son determinados por un conjunto fiio de condiciones amblentales y un tamana de producto aspecffico.NFRC no recomienda ningun producto y no garantiza que at producto sea adecuado pare un use especifico.Consulte con at ill folletbdel fabricante pars el use aproplado de esta producto.wvuw.rdm.org •3`aiIr he X'Yl;.. W ,e .L..aatYG4'Siz. J ! "`I .i /ems�f° „„, :`. f- +.`• RY.d3 'J C"K?;:3C?. += ;. "1"i .rC f,i %PI 8 �--.`.';15�}2'.i'01 110007 P9 .rsz:4 e,/Tj09LOYa Keep this label fay possible ENERGY STARO rebates.To learn more visit www.energymr.gov Guarde esta etiqueta poro posibles reemboisos ENERGY STARP Para coaacermbs acerce do esto,visite%vwiv.energysfor gov.