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29-251 (2) f S HOME I M P R O V E M E N T "No Substitute for Quality" 459 Main Street Indian Orchard, MA 01151 (413) 543 -5906 (508)- 797 -6600 OWNER PERMIT AUTHORIZATION Name : c��i i /n, /fi gNr /A - 2 ci 4,j 0. h1 i lla ma Address: C / Daerlool t d City /State /Zip Pv re0 ( e //4 0/06 ' I 5h M. MC/11(114 ' d, y✓1 / V 1 )1(114,114 ''' (owner), of the property located at: authorize Sturdy Home Improvement, Inc. to act as my agent for the construction project taking place at the above address. I also authorize Sturdy Home Improvement, Inc. to obtain a building permit for this project. I understand and accept responsibility to comply with all regulations and required inspections. -r.-Y /7 7 / YA ignature of Owner Date ,Leil.l , 1 7 /1- Sig ..Lure of II wne Date 6----- •STURDY HOME IMPROVEMENT, INC. ACCEPTANCE PAGE MA REG. #1 CT REG. #61 - ANY WORK NOT STATED ON PREVIOUS PAGES IS EXCLUDED ! The following scheduldwill be adhered to unless circumstances beyond the contractor's control arise: Work scheduled to begin the week of a #y/ Dq. Expected completion date of /OLJBf Weather permitting. The cash price for labor and material as described above is: ' Contract Total 1st payment grid payment 3rd payment 4th paym (upon signing) complet of: Roof $ completion o eiu completior Jc'= i c I-Fu cis,. Ventilation $ Other work $ Roofing total 8o40'I $ 2 (] 4 (0. $ 2-(O(• (o. $ ) L. ii. 9, $ Siding $ /2--0 $ 1- /U 00 $ 1 7/0 00 ; $ 1 7 / (>00, ,..4„ $ Windows $ $ S'rqk' 4 5A.; 5-,4, c.40 -, r"-'''' $ Ifr 460C,6, Special orders $ f W $ $ / r©C (A.A R Totals $224, $ . C4 L 4 G. i s6g $ PO C$�6 $ $ /> Z ', Terms: Cash Finance / Credit Card: # - _ _ I I I / 6 f ( di Exp. date____ / ____ Code_ Payment schedule: Any balance not paid in full within thirty days, will be charged 1.8% interest / er month. In order to meet the completion schedule, the following material /equipment must be SPECIAL ORDERED before the contracted work begins. (Law requires that any deposit or down - payment required by the contractor before work begins, may not exceed the greater of (a.) one -third of 1 total contract price or (b.) the actual cost of any special equipment or custom made material which must be special ordered in advance to meet completion schedule) $ 0 to be paid for $ 0 to be paid for 0 Any additional work orders are to be paid for once accepted and approved by purchaser. Verbal understandings and agreements with representatives shall not be binding. All understandings and agreements must be set forth in writing in contract. Ad ition provisions are stated on reverse side and are part of this contract. In witness whereof Purchaser(s) has /have hereunto signed their ni this D day of 0 7 20 r")9 and acknowledge receipt of a true copy of this contract. UNLESS TH RWISE SPECIFIED, IT IS UNDERSTOOD THAT THE OWNER IS READY FOR THE WORK TO BEGIN. THE PURCHASE PRICE QUOT ABOVE WILL BE HONORED ONLY UNTIL ) -7// j'a 0 7 (Date). '` You the Purchaser(s) may cancel this transaction at any time prior to midnight of the third business day after the date of this transaction. See notice of car tion form for an explanation of this right. Signature affixed below also acts as receipt that Purchaser(s) received separate cancellation forms. The following is a requirement by Massachusetts General Law, Home Improvement Contractor Law MGL c 142A: The contractor and the homeowner hereby mutually agree in advance that in the event that the contractor has a dispute concerning this contract, the con may submit such dispute to a private arbitration service which has been approved by the office of Consumer Affairs and Business Regulation and the con; shall be required to submit to such arbitration as provided in MGL c 142A. Representative: \,.. f L 1 � \ (i_, i IL- Owner: /4 �'� NOTICE: The signatures of the parties above apply only to the agreement of the parties to alternhfe diispiute, resolution \initiated by the contractor. The owl may initiate alternative dispute resolution even where this section is not signed separately by theiprties" f ------ / Do not sign this contract if there are any blank spaces Submitted ti , 11 ,f 8 1... . , — Accepted , by: 77/ y ` by: � : .; -- Repre Purc e I 1 Dat? Accepted Accepted id i , l 1 1 l Vikil...--.- \ Ill I b y: by: l Representative ,` " Prchaser 1 Date t t STURDY HOME IMPROVEMENT, INC. S-A,-,- MA REG. #151711 Legend: CT REG. #601525 I PAGE 4 - .- VT ENION PLAN i 1 '~ t Ridge vent 1 0 kvcl 2 /8\ = 8 x 16 '1 t3 39 /6\ = 6 x 16 7 IIIIMINI 1".; }� �. Q- --- (1 4 =4x16 1 Soffit Vent Proper Vents S +F Vented soffit k Panel + Alum Facia Wrap mi '" C, „ 0 0 so n� 0 �� tz t- Vented soffit �� only 'f t-( - Z a r\! _ 5 Z 1 { i `� { 1 4 F.0 F ascia only ct i iv‘jc Q 2,2,02 U 1 1 ,L c)c , - U 0 0 °,4-titt,., 0 Gutters H C Roof Hood \ O H Kitchen Hood . FRONT OF HOUSE C G Close Gable ' • MA REG. #11711 www.SturdyHome.com CT R0.601525 34 Front St. • Springfield, MA 011 S 1- 877- 3- STURDI . H OME IMPROVEMENT Office: 413.543.59 WINDOWS • SIDING • ROOFING • DECKS Fax.: 413.543.32 Name - -- p� / / Home Phone Business Phone Address Cell Phone Other Co/ 6v�t cL(..,ak pif4.-C Town/City 1 . 4 Repre Date / ! f 4 1 /we the owner(s) of the premises described hereinafter, referred to as Purchaser, offer to contract with Sturdy Home Improvement, Inc. hereinafter referred t Contractor, to furnish, deliver and arrange for installation of all materials to improve the premises as described below. Yes No SIDING SCOPE OF WORK: ,. -.°` [� ❑ 1 . Contractor to obtain required building permit (see attached permit authorization form) 1_ 2_ 3_ Family home. lid' ❑ 2. Provide certificate of insurance for workers compensation, general liability. (see attached certificates) Q' ❑ 3. Keep job site in a clean and orderly manner. Er' ,❑ 4. Provide OSHA approved staging to safley perform work. 0-' ❑ 5. Customer to remove all ornamental and personal items away from house, yard and walls outside, etc. II ❑ 6. Strip / layers of siding_,Qff existing house. Wood clapboards '- Vinyl Cedar Shakes Stucco Aluminum EIFS Other ❑ . Gutter helmets to be removed and reinstalled by others. (2 ❑ 8. Remove and dispose of gutters attached with spike ferrule. ❑ 3'9. Remove and reinstall existing gutters strapped to roof. Install straps under shingle over shingles . ❑ pri0. Remove and reinstall texisting gutters with hidden n ers. Linear feet I , A... ,/ ) ! �~ ❑ 11. Furnish and install new gutters ear feet, and downspouts t ' ' C_Nked4(10' Iengt . Color AZ•er 4f11 ❑ l r 12. Remove Satellite Dish up to 24" in diameter. Alig ment and installation by others. S 4 1" ©" ❑ 13. Remov, and reinstall the following items: �,,,,"+- � 1, Shutters. (see number 16) V. ❑ Doorbell -. ED Storm door. ❑ Street numbers d meter (power lines to remain, wrap around anchors) 3 Lights (see number 15) Q lblephone a `Hater meter ,,� table TV lines 0 Dryer vents 0 ❑ 14. Install insulati siding. 1/8 inch fan fold 3/8 tongue and grooved Tyvek Polar Board Jig High density poly styrene/ Green Board . Total Squares II. ❑ 15. Install customer provided light fixture on house. Please note additional wiring ,s not included, Quantity f, � Li 16. Install c mterner.pre*Med shutters on house.. Quantity "Ii VG .1. \ rT "emik - C..Lim,, X. Lt. V V c/Lo 01 ❑ 17. Extensions of water facets on the exterior of home are not included. Pleaseipte if n deis will be an additional $85.00 each. Q ❑ 8. Furnish and install ) w " f j t, fi 4 `1 i, • siding. Color H urn }' f O� Total number of squares / cp El U:19. Install Super Corners. Color 6 Style 0 Linear feet 0 ❑ 111`20. Porch ceiling to be covered with soffit siding. Total squares 0 u'. ❑ 21. Install J channels around windows and doors. Color /41/4K-K. S111 Style C- O tMw/ . nriv ❑ ❑ 22. Install finish trim under windowsills. Color 17e Tt • ✓ j) ❑ 6 23. Install vinyl soffit on overhangs. Vent soffit boards prior to installing vented soffit materials. C L/l ( 1 ) Linear feet a ❑ 4. Install aluminum coil stock on fascias on front, rear and si s of house. Color1J4' OAT ' I Pat") , Linear feet (,4'r't C Ak"P . ED &25. Install aluminum wraps around f .iT l (' °window and e ►(T 'TW Please note: Garage doors will not be wraped and Sturdy He Improvement also recommends a - one - boor of the house mrsrmabad with aluminum materials. Composite materials can be added by spec orders only (see addendum A) ❑ 26. Cover gables end vents with siding to prevent air -flow. (if the roof is vented with soffit and ridge vents, then gable end vents must be closed in / order to qualify for warranty coverage) 2- / 2-Y ) 1 6 A. a.t.• -- Q ❑ 27. Homeowner agrees not to hire directly any employee /representative /sub contractor of Sturdy Home Improvement, Inc. for any side additional work in relation to this contract or any future work. Homeowner also agrees not to make payments in any other name other than SI Home Improvement, Inc. unless Sturdy Home Improvement, Inc. gives prior authorization. If so, the employee /representative /subcontractor w f terminated immediatley ❑ 28. Homeowner agrees to cut back or remove any landscaping 18" from house in order for contractor to gain access around perimeter of founds ❑ 29. Addendum (A) = OTHER WORK. 1 ,,. k S \ p4, ( V%1 C ' (.)0 L (� U vF L 0� �-a ` R z r� uJ t., -I ❑ 30. Acceptance Page a ❑ 31. Work not included: 1. Final cleaning of windows 2. Any rotted wood (other: � 4, _...." ��� �`` f / Initials Initials b/ InitiaJar t 1 MA REG. #151711 www.SturdyHome.com CT REa. #601525 TURb F 459 Main St. • Springfield, MA 0 Worcester: 508 -797 -6600 HOME I M P R O V E M E N T , INC. Springfield: 413.543.5 1- 877 -3- STURDY WINDOWS • SIDING • ROOFING • ADDITIONS Fax.: 413.543.3: WORCESTER SPRINGFIELD HARTFORD Name - . i f - L 1 Home Pj�o� e / Business Phone Address �� U � �� J) Cell Phone Other 0 U �L Town /City Repiesen five Date. I /we the owner(s) of the premises described hereinafter, referred to as Owner, offer to contract with Sturdy Home Improvement, Inc. hereinafter eferred to I Contractor, to furnish, deliver and arrange for installation of all materials to improve the premises as described below. Ye No ROOFING SCOPE OF WORK:_ �./ V • 1. Contractor to obtain required building permit (see attached permit authorization form) 1 2 3_ Family home. T' 2. Provide certificate of insurance for workers compensation, general liability. (see attached certificates). [ ❑ L 3. Provide job site dumpster, set on planks, to remove job related debris only. Please Note: dumpster for contractor's use only. (see dumpster c ,� E Li 4. Prior to stripping roof, tarp sides of house beneath work area, from roof edge to bottom of wall. (see additional protection clause on back). UV ❑ 5. Keep job site in a clean and orderly manner. Rake work areas at end of job. Use magnetic sweep to pick up nails. Vl •❑ 6. Provide OSHA approved staging to safely perform work. U z ❑ 7. Work consecutive days excluding inclement weather. (rain, snow, high winds, high heat, thunder showers, etc). ❑ 8. Staff project with qualified mm chanics experienced in residential asphalt roofing. / lair ❑ 9. Strip existing 1 v _ 2 3- layers of asphalt roofing (see roof plan, page 2). Number of squares +, . A. one layer cedar removal. Number of squares . B. °' one layer slate removal. Number of squares ` . C. u number of layers vary by section (see roof plan, page 2). ❑ 10. Inspect roof deck prior to re- roofing. Renail loose boards: [ A. Replace rotted or cracked boards at $ ' per linear foot. B. Replace boards with same thickness plywood at $ per square foot. C. Replace delaminated plywood at $ per square foot. D. Plywood layover with 1/2 inch CDX at $ 3.7 I per square foot. E. Number of sheets / of plywood include51 into this a timate: Quantity (see unit cost above for dition sheets). er. ❑ 11. Furnish and install t e'W //_t s ''e" . u. /1. ,.. : .. Gt.-4..4,41 f'c`A � mgles. Color '' ALa J\ c I -1A Vc [' ❑� 1�2. Furnish and install 8" aluminum drip edge around roof perimeter. White c�' Mill Brown . ❑ 1 3. Install cedar drip edge at eaves under aluminum dcip edge. Linear ft 0 . r / 7 ❑ 14. Furnish and install ice /water shield at eaves 3' 6' other. Three feet in valleys and around all roof penetrations. ❑ 15. Furnish and install fiberglass reinforced roof underlayment to remainder of roof above the ice /water Vield. ❑ 1§(� urnish and install new neoprene roof boots at soil pipes up to 4" in diameter. Quantity i Size 1 (boots at electrical mast to be reused). 1:1 7. Reuse stove pipe flashing kits. ❑ [E Reuse existing step flashing at rpof /wall intersections. ❑ 19. Furnish and install new ✓ aluminum () ,cwpperstep flashing at roof /wall intersections. Linear feet . If siding work is needed, a cost assessment will be made at that time. ❑ _.r 20. Reuse existing wall flashing at roof /wall intersection. , ' • l�� / ❑ 21. Furnish and install new aluminum wall flashing at roof /wall intersections. Linear feet . If siding work is needed, a cost assessment will be made at th Ime. ❑ 22. Furnish and install new aluminum opper step flashing at base of chimney under existing lead counter flashing. Il' ❑ 23, Replace chimney lead counter flashing. 1 flue 2 flues 2-^3 flues other . ❑ A4,, Install new roof hood vent bathroom(s) with insulated flexible tube. Remove roof deck to gain access into attic. Color: black only. ❑ 25. Gutter Helmets to be removed and reinstalled by others. ❑ ❑ 26. Remove and dispose of gutters attached with spike and ferrule. ❑ 11 Remove and reinstall existing gutters strapped to roof. Install straps under shingle over shingles_. 13 [2 Remove and reinstall existing gutters with hidden hangers. Linear feet Ur ❑29. Reuse skylight flashing kits ✓` Replace skylight flashing kits Quantity (Velux models, stock only). V4 I o 8r.,., S r ❑ [2'30. Remove and dispose of the following: Antenna_ Snow /Ice Wires Snow Guards /Ice belts Solar panels 1? C' I CI 131. Remove Satellite Dish up to 24' in diameter. Alignment and installation by others. r'K id ❑ 2. Page Two = ROOF PLAN. 0 ❑ H Page Three = VENTILATION. ❑ �V Page Four = VENTILATION PLAN. ❑ Addendum (A) = OTHER WORK. ( Addendum (B) = LOW SLOPE ROOFING. 37. Acceptance Page �f 13 38. Owner agrees not to hire directly any employee /representative /subcontractor of Sturdy Home'Improvement, Inc. for any side work, additional wo relation to this contract or any future work. Owner also agrees not to make payments in any other name other than Sturdy Home Improvement, unless Sturdy Home Improvement, Inc. gives prior authorization. If so, the employee /representative /subs'• tr:ctor will be terminated immediatel■ Initial- : Initials - a,.i Initialsy1.f Ji , , , - / 4 f Office of Consumer Affai a nd Business Regulation = - 10 Park Plaza - Suite 5170 _ Boston, Massachusetts 02116 Home Improvement Contractor Registration ,- Registration: 151711 Type: Supplement Card STURDY HOME IMPROVEMENT, INC n ; !,= 4 ` Expiration: 6/26/2014 DAVID DIAZ - M r — — — 459 MAIN STREET SUITE 13 = == INDIAN ORCHARD, MA 01151 _ - 1 c ..r...�. $' ?ar - ) Update Address and return card. Mark reason for change. DPS -CA1 0 50M-04/04-G101216 [_1 Address D Renewal D Employment H Lost Card fie iaomvmonweaid al✓gaaaac%€14el5 Office of Consumer Affairs & Business Regulation License or registration valid for individul use only 1K fi OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: C =.IZ 4 Office of Consumer Affairs and Business Regulation Re gistra ti on: 151711 Type: = 1- _ l 10 ParkPlaza- Suite5170 - Expiration: 6/26/2014 Supplement Card Boston, MA 02116 STURDY HOME IMPROVEMENT, INC DAVID DIAZ cz........e„,/ PO BOX 51033 g --,63 — INDIAN ORCHARD, MA 01151 Undersecretary Not valid without signat )7 Massachusetts - Department of Public Safet) 1 Board of Building. Regulations and Standards Construction Supervisor License License: CS 93603 DAVID DIAZ 270 TREMONT ST . — SPRINGFIELD, MA 01104 ., Expiration: 8/7/2013 ('uniii�issiuner Tr#: 20303 4 , The Commonwealth of Massachusetts I Print Form I Department of Industrial Accidents —,1t - Office of Investigations el „i 1 Congress Street, Suite 100 t. _. Boston, MA 02114 -2017 "- =:.1 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders / Contractors /Electricians/Plumbers Applicant Information Please Print Legibly Name ( Business /Organization/Individual): t 1* 1 g 0 "C true. -% Address: )I5c1 mat n St City /State /Zip: AA (t 0 rC *YL • f}' -4 011 ■ Phone #: -Li 1 ' - - c'O • Are ou an employer? Check the appropriate box: Type of project (required): 1. I am a employer with 73 4. ❑ I am a general contractor and I employees (full and/or part- time).* have hired the sub - contractors 6. ['New construction listed on the attached sheet. 7. ❑ Remodeling 2. III I am a sole proprietor or partner- ship and have no employees These sub - contractors have 8. ❑ Demolition working for me in any capacity. employees and have workers' 9. ❑ Building addition [No workers' comp. insurance comp. insurance. required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3. ❑ I am a homeowner doing all work officers have exercised their 11.❑ 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 employees. [No workers' 13.0 Other comp. insurance required.] *Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub - contractors and state whether or not those entities have employees. If the sub - contractors have employees, they must provide their workers' comp. policy number. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: - If a.A.K,f P ir--S l y rC(n C Policy # or Self -ins. Lic. #: °'S�3(O' St y S Expiration Date: -7 / 1 ) / 1 3 Job Site Address: (p( OVtt' (y — 0rty' .. City /State /Zip: (lcj t.net i (}rt_ 0102 Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). r Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one -year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature:! ( Date] (� / 2 - / 12- C Phone #: C t ( ?, 5 - I( - )L0 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 #: Q 1 Version 1.7 Commercial Building Permit May 15, 2000 SECTION 10- STRUCTURAL PEER REVIEW (780 CMR 110.11) Independent Structural Engineering Structural Peer Review Required Yes 0 No 0 SECTION 11 - OWNER AUTHORIZATION - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, as Owner of the subject property hereby authorize L .._ _ , to act on my behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date I, m,., , as Owner /Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief. Signed under the pains and penalties of perjury. Print Name Signature of Owner /Agent Date SECTION 12 - CONSTRUCTION SERVICES 10.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder : David Diaz 93603 License Number 459 Main St. Indian Orchard MA 01151 08/07/2013 Address - Expiration Date ___ d,. / / , (413) 218 -7392 Signature Telephone SECTION 13 - 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 0 No 0 •