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38B-212 (7) t.. STURDY HOME IMPROVEMENT, INC. ACCEPTANCE PAGE MA REG. #151711 CT REG. #0601525 ANY WORK NOT STATED ON PREVIOUS PAGES IS EXCLUDED The following schedule will be adhered to unless circumstances beyond the contractor's control arise: Work scheduled to begin the week of----/----/ . Expected completion date-----/ /----Weather permitting. The cash price for labor and material as described above is: 1st payment 2nd payment 3rd payment 4th payment Contract Total (upon signing) -� Roof $ ��} - - Ventilation $ ►�`` Other work $ Roofing total $ $ $ $ $ Siding $ $ $ $ $ Windows $ $ $ _ $ $ Special orders $ $_ ' $ $ $ ly Other $ $ ��%\� �$ $ $ Totals $ �► ta $�� $ l�,it, $ ' i�;�ti Terms: Cash _Finance Credit Card: #_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Exp. date____ / ____Code_ Payment schedule: Any balance not paid in full within thirty days, will be charged 1.8%interest per 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 the 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 the completion schedule) $ to be paid for $ to be paid for 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 this contract. Additional provisions are stated on reverse side and are part of this contract. In witness whereof Purchaser(s) has/have hereunto signed their names this�t'.'-t` ,s i�- 0, day of T 20 1 s and acknowledge receipt of a true copy of this contract. UNLESS OTHERWISE SPECIFIED, IT IS UNDERSTOOD THAT THE OWNER IS READY FOR THE WORK TO BEGIN. THE PURCHASE PRICE QUOTED ABOVE WILL BE HONORED ONLY UNTIL (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 cancella- 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 contractor may submit such dispute to a private arbitration service which has been approved by the office of Consumer Affairs and Business Regulation and the consumer shall be required to submit to such arbitration as provided in MGL c 142A. Iz Ir Representative OA19r: r Owner: NOTICE. The signatures of the parties above apply only to the agreement of the parties to alternate dispute resolution initiated by the contractor. The owner may initiate alternative dispute resolution even where this section is not signed separately by the parties" Do not sicin this contract if there are anv blanks aces Submitted_, , '" __ ;A�rcepteO ill, by: .- -_ `%y i epresentative Purchaser at - _ Accepted Accepted by: by: Representative Purchaser Date 459 Main Street Toll Free (877)378-8739 Indian Orchard,MA 01151 Worcester (508)797-6600 E-mail: HR @SturdyHome.com Springfield (413)543-5906 STUR www.SturdyHome.com New Haven (203)848-2118 Fax (413)543-3200 HOME IMPROVEMENT, INC. i WINDOWS • SIDING • ROOFING • ADDITIONS MA REG. #151711 CT REG. #0601525 Name `I Home Phone j 4 Business Phone Address Cell Phone Other-_j Aliv Town/City A� � Representative Date 1W 7^ ` fit '��(.l �'►`t �� / _7 I/we the owner(s) of the premises described hereinafter, referred to as Owner, offer to contract with Sturdy Home Improvement, Inc. hereinafter referred to as Contractor,to furnish, deliver and arrange for installation of all materials to improve the premises as described below. Yes No ROOFING SCOPE OF WORK: [ ❑ 1. Contractor to obtain required building permit(see attached permit authorization form) 1 2^ 3_ Family home. ❑ 2. Provide certificate of insurance for workers compensation, general liability. (see attache certificates). ❑ 3. Provide job site dumpster, set on planks,to remove job related debris only. Please Note:dumpster for contractor's use only. (see dumpster clause). A ❑ 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). ❑ 5. Keep job site in a clean and orderly manner. Rake work areas at end of job. Use magnetic sweep to pick up nails. ❑ 6. Provide OSHA approved staging to safely perform work. ❑ 7. Work consecutive days excluding inclement weather. (rain, snow, high winds;high heat, thunder showers, etc). ❑ 8. Staff project with qualifi d mechanics experienced in residential asphalt roofing. ❑ 9. Strip existing 1, 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 .}=' ❑10.Inspect roof deck prior to re-roofing. Renail loose boards: A. Replace rotted or cracked boards at$---LQ-per linear foot. B. Install new plywood at$ Gn per sheet. �'' C. Number of sheets of plywood included into this estimate: Quantity (see unit cost ab�,o,,,Y a for(ddb'oJaW6ets6)�. t�;= ❑11. Furnish and install �`� N i t) L A N�1 A�`.ti shingles. Color- l ❑12. Furnish and install 8"aluminum drip edge around roof perimeter.White Mill Brown 13. Install cedar drip edge at eaves under aluminum drip edge. Linear ft j ❑14. Furnish and install ice/water shield at eaves 3' 6' V other. Three feet in valleys and around all roof penetrations. ❑ og 15.Furnish and install underlayment to entire roof. Roofer select Diamond Deck Jj ❑ 16.Furnish and install starter course shingles, eaves& rake. IZI ❑ 17.Furnish and install hip and ridge cap. ❑ 18. Furnish and install new neoprene roof boots at soil pipes up to 4"in diameter. Quantity Size (boots at electrical mast to be reused). ❑ 1619. Reuse stove pipe flashing kits. (�20. Reuse existing step flashing at roof/wall intersections. ❑ ,]21. Furnish and install new aluminum copper step flashing at roof/wall intersections. Linear feet If siding work is needed, a cost assessment will be made at that time. ❑ ❑22. Reuse existing wall flashing at roof/wall intersection, ❑ 23. 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 that time. ❑24. Furnish and install new aluminum copper step flashing at base of chimney under existing lead counter flashing. �� ❑25. Replace chimney lead counter flashing. 1 flue 2 flues 3 flues other ❑ ,]26. Install new roof hood to vent bathroom(s)with insulated flexible tube. Remove roof deck to gain access into attic. Color: black only. ❑ ( 27. Gutter Helmets to be removed and reinstalled by others. ❑ 28. Remove and dispose of gutters attached with spike and ferrule. }+] 29. Remove and reinstall existing gutters strapped to roof. Install straps under shingle over shingles ❑ r` 30. Remove and reinstall existing gutters with hidden hangers. Linear feet ❑31. Reuse skylight flashing kits Replace skylight flashing kits Quantity (Velux models, stack only). ❑ 32. Remove and dispose of the following:Antenna Snow/Ice Wires Snow Guards/Ice belts . Solar panels ❑ } ]33. Remove Satellite Dish up to 24'in diameter. Alignment and installation by others. : ] ❑34. Page Two= ROOF PLAN. ❑ ]35. Page Three=VENTILATION. ❑ 36. Page Four=VENTILATION PLAN. t ❑ ]37. Addendum (A)=OTHER WORK. ;r j ❑ /U 38. Addendum (B)=LOW SLOPE,ROOFING. ° - ./ (] ❑39. Acceptance Page Initial s;;T�_ Initials' Initials >.. •nom �-. <,,4<-r.-� c..� .� 459 MAIN STRBBT—F.O,BOX 51033—SPRINGFIELD,MA 01151 MA.PEG#151711 ET.REG#601525 877-3STURDY FAX 413-543-3200 11D@bQ� Name: Address: BUG City/State/zip: �•�� :^�c .a (owner), of the property located at: e authorize Sturdy home Improvement,Inc. To act as my agent for the construction project taldng place at the above address, I also, authorize Sturdy Nome ImprovementUno to obtain a building permit for this project. I understand and accept responsibility to comply with all regulations and required inspections. ignatao of Owner Date C lu Signature of Owner Date City of Northampton 212 Main Street,Northampton, MA 01060 Solid Waste Disposal Affidavit In accordance of the provisions of MGL c 40, S54, I acknowledge that as a condition of the building permit all debris resulting from the construction activity governed by this Building Permit shall be disposed of in a properly licensed solid waste disposal facility, as defined by MGL c 111, S 150A. Address of the work: The debris will be transported by: In cko-A l C The debris will be received by: -�s I'1 a (C) Building permit number: Name of Permit Applicant Date Signature of Permit Applicant The Commonwealth of Massachusetts Department of IndustrialAccidents 4 Office of Investigations d I Congress Street, Suite 100 Boston,MA 02114-2017 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print LeLibly Name (Business/Organization/Individual):)fCld N � Mpr� irYt�t`l-�—S Address: q�A M 'in a SU i+e- 1:3 City/State/Zip: ' i Phone#: Are you an employer? Check the appropriate box: Type of project(required): 1.I�Q I am a employer with_1 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. 7. ❑ Remodeling ship and have no employees These sub-contractors have g, ❑ Demolition working for me in any capacity. employees and have workers' 9. ❑ Building addition [No workers' comp. insurance comp. insurance.t required.] 5. ❑ We are a corporation and its 10.❑ 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.❑ 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. (Contractors 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. r�!� Insurance Company Name: 7rolV( f er s -i--ns UfalrX e- — Policy#or Self-ins. Lie. #: 368 SO --I G) Expiration Dater 2 111 'b _ Job Site Address: `D 1 r y i Pw )q)ef)oe_ City/State/Zip: kb t (M A 6 Cbo Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under thepains andpenalties ofperjury that the information provided above is true and correct. Si mature: Date: Phone#: 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#: milli SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: ,v ) J bra 2— `-��—LM License Numbers °-I 6gi V g tr) s,t- s v; (e d7a I- MY 1c1i Sf Z Add Expiratio Date Z% -2 I -73 ,,, Signature Telephone 9.Registered Home Improvement Contractor: Not Applicable ❑ 1511N Company Name Registration Number s-b)fd w t`kmy (,f '-,) 61/ (' Address J Expiration Dale t45c-( rQLQ ( K? S,+— s Lt 1f-e 1:?�, __Telephone A)3-Gi8 160) SECTION 10-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...... ❑ 11. - Home Owner Exemption The current exemption for"homeowners"was extended to include Owner-occupied Dwellings of one(1) or two(2)families and to allow such homeowner to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor.CMR 780, Sixth Edition Section 108.3.5.1. Definition of Homeowner:Person(s)who own a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two family dwelling,attached or detached structures accessory to such use and/or farm structures.A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official,on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. As acting Construction Supervisor your presence on the job site will be required from time to time,during and upon completion of the work for which this permit is issued. Also be advised that with reference to Chapter 152(Workers'Compensation) and Chapter 153 (Liability of Employers to Employees for injuries not resulting in Death)of the Massachusetts General Laws Annotated,you may be liable for person(s) you hire to perform work for you under this permit. The undersigned"homeowner"certifies and assumes responsibility for compliance with the State Building Code,City of Northampton Ordinances,State and Local Zoning Laws and State of Massachusetts General Laws Annotated. Homeowner Signature SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing Or Doors E] Accessory Bldg. ❑ Demolition ❑ New Signs [I--3] Decks [Q Siding[EI] Other[Q Brief Descriptioo of Proposed Work:5fC I D {'k\7A1f1 1 I-I- 4,0 f S d f (-)v 12116LH iP-()C) o n -4 4) 3 M u SC�t'o're-'s vCQi:5h and Iel-&4c-" t C2 ftG�i✓1 G1 LumJma r Sian iCS a�EY �n�e- b Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet 6a.If New house and or addition to existing housing, complete the following: a. Use of building :One Family Two Family Other b. Number of rooms in each family unit: Number of Bathrooms c. Is there a garage attached? d. Proposed Square footage of new construction. Dimensions e. Number of stories? f. Method of heating? Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction i. Is construction within 100 ft.of wetlands? Yes No. Is construction within 100 yr. floodplain Yes No j. Depth of basement or cellar floor below finished grade k. Will building conform to the Building and Zoning regulations? Yes No. I. Septic Tank City Sewer Private well City water Supply SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT i, as Owner of the subject property hereby authorize to act on my behalf, in all matters relatiyb to work authorized b' y this building permit application. Signature of Owner Date c J� n �,/�/�� ,)fJ�\ 1�� as Owner/Authorized Agent hereby declare thJt the statements and informatibn on the foregoing application are true and accurate,to the best of my knowledge and belief. Signed r the pains and penalti of perjury. Pri t / Date Signature of Owner/Agent Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size e� Frontage Setbacks Front r 1 Side L:` R:!. , L:= Rf........J Rear - Building Height f Bldg. Square Footage % ' i Open Space Footage _ % (Lot area minus bldg&paved _parking) #of Parking Spaces Fill: _ volume&Location - - S A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO 0 DON'T KNOW Q YES IF YES, date issued IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DON'T KNOW 0 YES 0 IF YES: enter Book Paged and/or Document#' B. Does the site contain a brook, body of water or wetlands? NO 0 DON'T KNOW Q YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained , Date Issued: C. Do any signs exist on the property? YES Q NO 0 IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property? YES 0 NO Q IF YES, describe size, type and location: e ,�1 i E. Will the construction activity disturb(clearing,grading,excavation,or filling)over 1 acre or is it part of a common plan that will disturb over 1 acre? YES 0 NO 0 IF YES,then a Northampton Storm Water Management Permit from the DPW is required. Department use only E� ityof Northampton Status of Permit: - ilding Department Curb Cut/Driveway Permit 212 Main Street Sewer/Septic Ayaiiability OCT R►5 Room 100 Water/Well Availability No hampton, MA 01060 Two Sets:of StrUbturei F?lar#s oE��7.e�e�, ,, �;ptt:on 13- $7-1240 Fax 413-587-1272 Plot/Site Plans' NQ"=--- Other Specify APPLICATION TO CONSTRUCT,ALTER,REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Property Address: This section to be completed by office Map Lot Unit (fit i`�Qy��}fiiYl, fit R , C'(DC Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: ' ) 0 1k1cd-e Name(Print) Current Mailing Telephone! Signature 2.2 Authorized Agent: Name(Print) Current Mailing Address: Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant 1. Building (a)Building Permit Fee 2. Electrical (b)Estimated Total Cost of Construction from 6 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) 5. Fire Protection 6. Total=(1 +2+3+4+5) Q Q Check Number This Section For Official Use Only Date Building Permit Number: Issued: Signature: Building Commissioner/Inspector of Buildings Date 16 FAIRVIEW AVE BP-2016-0498 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 38B-212 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Cateeorv: ROOF BUILDING PERMIT Permit# BP-2016-0498 Project# JS-2016-000836 Est. Cost: $2600.00 Fee: $40.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: STURDY HOME IMPROVEMENT 093603 Lot Size(sq. ft.): 3615.48 Owner: WATERMAN PAUL D&DONNA L Zoning. URB(100)/ Applicant: STURDY HOME IMPROVEMENT AT. 16 FAIRVIEW AVE Applicant Address: Phone: Insurance: P O BOX 51033 (413) 543-5906 WC INDIAN ORCHARDMA01151 ISSUED ON:1011912015 0:00:00 TO PERFORM THE FOLLOWING WORK.•STRIP & SHINGLE 4 SQ ROOF 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: Driveway Final: Final: Final: Rough Frame: Gas: Fire Department Fireplace/Chimney: Rough: Oil: Insulation: Final: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of OccuRancy Signature: FeeType: Date Paid: Amount: Building 10/14/2015 0:00:00 $40.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner