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23A-050 (2) 24 WEST CENTER ST BP-2017-0337 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block:23A-050 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: Siding BUILDING PERMIT Permit BP-2017-0337 Project JS-2017-000551 Est. Cost: $20000.00 Fee: $100.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Grouo SERGIY SUPRUNCHUK 104327 Lot Size(so.tt.): 5575.68 Owner: HARRISON HELEN Zoning:URB(l00)/ Applicant: SERGIY SUPRUNCHUK AT: 24 WEST CENTER ST Applicant Address: Phone: Insurance: 536 EAST MAIN ST (413) 883-3802 WC CHICOPEEMA01020 ISSUED ON:9/12/2016 0:00:00 TO PERFORM THE FOLLOWING WORK:VI NYL SIDING & WINDOWS POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Service: Meter: Footings: Rough: Rough: House# Foundation: 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 Occupancy Signature: FeeType: Date Paid: Amount: Building 9/12/2016 0:00:00 $100.00 212 Main Street, Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner File#BP-2017-0337 APPLICANT/CONTACT PERSON SERGIY SUPRUNCHUK ADDRESS/PHONE 536 EAST MAIN ST CHICOPEE (413)883-3802 PROPERTY LOCATION 24 WEST CENTER ST MAP 23A PARCEL 050 001 ZONE URB(100)/ THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLER OUT Fee Paid L JL W 10c9 A /170. LYf Building Permit Filled out Fee Paid T peofConstruction: VINYL SIDING&WINDOWS New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 104327 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON 1NF9RMYIATION PRESENTED: Approved Additional permits required(see below) PLANNING BOARD PERMIT REQUIRED UNDER:§ Intermediate Project: Site Plan AND/OR Special Permit With Site Plan Major Project: Site Plan AND/OR Special Permit With Site Plan ZONING BOARD PERMIT REQUIRED UNDER: § Finding Special Permit Variance" Received&Recorded at Registry of Deeds Proof Enclosed Other Permits Required: Curb Cut from DPW Water Availability Sewer Availability Septic Approval Board of Health Well Water Potability Board of Health Permit from Conservation Commission Permit from CB Architecture Committee Permit from Elm Street Commission Permit DPW Storm Water Management Demolition Signa re of ui ding Official Date Note: Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning requirements and obtain all required permits from Board of Health,Conservation Commission,Department of public works and other applicable permit granting authorities. *Variances are granted only to those applicants who meet the strict standards of MGL 40A. Contact Office of Planning&Development for more information. Deparimentusa6nl v !`,. City of Northampton Status'tof Peimiv E'l 1 « _ " `"- \e ; Building Department Curb Cut/DM/ewe Parmlt /. / %S - X00 z5 212 Main Street Sewer/See-tt4Avaifabik� ly \`L _ Room 100 watg e111Qvatlabilrty - - <C ct `;' Northampton, MA 01060 Twa-Set'sot'StmDfuralPla`ns row' `phone 413-587-1240 Fax 413-587-1272 Ftot/Stte Piens 04 ,e Other Specify-- - - A'PLe� r ATION TO CONSTRUCT,ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION'' / 1.1 Property Address. 2 y 14 .ai/ e S j. This section to be completed by office G re. LQ. (4 / A Map Lot Unit I 1-1 oioe z Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 /' ne Ford: \ J 4 / [6<I Name(Print) Current Mailing Address: Telephone i 17/H g ,7 Signature iAt✓dd(2).! : A 2.2 4uthorized Anent: 2—r ` S _N, Fac; rg_ k VII' Name(Pn - Current Mailing Address: Signa I e Telephone SECTION 3 -ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1, Building (a) Building Permit Fee 2. Electrical (b)Estimated Total Cost of 2 O Cl r a Construction from(6) 3. Plumbing Building Permit Fee 4. Mechanical(HVAC) 5. Fire Protection 6. Total=(1 +2 +3+4+5) Check Number /0 V/ 041) This Section For Official Use Only Building Permit Number'. Date Issued: Signature: Building Commissioner/Inspector of Buildings Date Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomptete Information Existing Proposed . Requiredby Zoning This column to k filled in try Building Department Cot Size C--._,�_ ____I ._..._. ____.. Frontage _.. _...� Setbacks Front :..._ I- ----. Side L:' I R:�L.__. L R:I� �, — ----, Rear t I ' Building Height Bldg.Square Footage _.� % _.. Open Space Footage % (Lot area minus bldg&paved I —.. parking) #of Parking Spaces t , L____! Fill: LI &ohms&Location) — —. —.. A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO p' DON'T KNOW O YES O IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO ' DONT KNOW O YES IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO DON'T KNOW 0 YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained O ,,Date Issued: i fYJ C. Do any signs exist on the property? YES O NO 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 ' 1 IF YES, describe size, type and location: Ycc E. Will the construction activity disturb(clearing, gradin a cavation,or filling)over 1 acre or is it par of a common plan that will disturb over 1 acre? YES 0 NO IF YES, then a Northampton Storm Water Manage ent Permit from the DPW is required. SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement WUrdows Alteration(s) ❑ Roofing ❑ Or Doors Accessory Bldg. ❑ Demolition ❑ New Signs [fl] Decks [I Siding[ -r Other[DIj Brief Desctigtiqn of Prppos ` \ Work'. 1/ t +`^-9 \ " t w t .na9r ) W I\ ct vl o V(/ Alteration of existing bedroom Yes No Adding new bedroom Yes <Ca Attached Narrative Renovating unfinished basement Yes Plans Attached Roll -Sheet 6a.If New house an. - edition to existing housing, complete the following: a. Use of building : • e Famil 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. s construction within 100 yr. floodplain Yes S j. Depth of basement or cellar floor below finished grade k. Will building conform to the Building and Zoning regulations? Yes 49 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 relative to work authorized by this building permit application. Signature of Owner Date cl.� 1 1 / I LA kA , as Owner/Authorized Agent hereby clotirdire thet the statemem+ and information on the foregoing application are true and accurate,to the best of my knowledge and belief, \ Signed under the..• •- erjury. 7 g Print - / I / ice ' al 2 Signatures owner/Ag:f Date SECTION 8-CONSTRUCTION SERVICES §.1-LicensedC-onstruetion u.ervisor: - -- ... . •. __ ..Not Ap • able. O , , e,n Name of License Riskierder o ` 0k C -- /0 el 3 2 r / / license umber, e S * c-o ez. S + cG//(//�''� HAL II 12o i 7 Add : - ry /^r Expiration Date i Lir3gg3 3 (s(� o Sig Mie , Telephone S.Reais`ered Home[moron ent Contractor. Not Applicable D fid ;0„,,,, P�2. I t to ,. R. Ol�&4...� 162 L' f S 1'/2 1 K • Company Name 7 s Registration Number 3 -7-5 C -,c 0 ..e- c+ 2 /20/ / • AddressExpiration Date CA �^Clic() Telephone i j3 8i (9 3 02 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 or the issuance of the building permit. iSigned Affidavit Attached Yes._.... No....,. ❑ 11. -Home Owner-Exemption The current exemption for"horneavners"was extended to include Owner-occupied Dwellings of one(I) 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-vear 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 he 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,von may he liable for person(s) you hire to perform work for you under this permit. The undersigned"homeowner"certifies and.assumes responsibility for compliance with tie State Building Code,City of Northampton Ordinances,State and Local Zoning Laws and State of Massachusetts General Laws Annotated. Homeowner Signature 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: 2C/ W (/2I l e r (/] The debris will be transported by: S t The debris will be received by: l� c A Building permit number: O1 Name of Permit Applicant 1-1 I II s ^" I-(61 I714a� 05 / 2 1 � Are Date Signa re o Permit Applicant The Commonwealth of Massachusetts SWDepartment of lndustrialAccidents - — �= l Office of Investigations -- - 1 Congress Street, Suite 100 Boston,MA 02114-201 7 'es_' www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information // / _ {'// ��Prleeaysee Print Legibly Name (Business/Organization/Individual): (/6�)`'�L_//_� // oN� /"- 7/ot O(/ Ac Address:375 �C42ecf �_ /, ['`J r/ City/State/Zip: L.4,,,,e0 eL2- /-I R Phone#: El/ 3 es 23e O Are you an employer? ChecJ[,(he propriate box: �r` `� Type of project(required): 1.}+y I am a employer with 4. ❑ I am a general contractor and 1 employees(full and/or part-time).* have hired the sub-contractors 6. ❑ New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g. ❑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.❑ 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.DRoofrepyi s insurance required.] t c. 152, §I(4),and we have no ((�� employees. [No workers' 1 O�thper J ! 1 ti comp.insurance required.] i,[/ I14 14(Ci *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'comppolicy number. I am an employer that is providing workers' r(mpensation insurance for my employees. Below is the policy and job site information. q Insurance Company Name: ea IQ I V c/' 2�7 1��'AQ Q / _/p Policy#or Self-ins. Lic.#: M l�T'I A P 30 ©b 5 Expiration Date: /2 /0.S.- / /• CJ i. Job Site Address: 2 / t'VP'r c-f- City/State/Zip: ft re-""-Ge H l t 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 e. 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insuraI e coverage verification. I do hereby c�'. , der •m penalties of perjury that the information provided abovdfs t e and c� c 0 >-- o Signature: / ''// gr-'Q i�� 7 Date'. Phone#: t Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License # Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: iI.1xbot All home improvement contrMorsand subronrtKtom engaged m YY�' '^9 home improvement contracting,unless specitacd)y extmpt from ��Ly��L registration by Provisions of Chapter 142A of the general laws, II atytopo at must be registered with the Commonwealth of Massachusetts �y! �JY 4�L Inquiries about registration and status should be made to the a Director. Home Improvement Contract Regbtration, One sweie �fif \�\�� Ashburton Place,Room 1301,Bolton.MA 02108(617)727-859S 536 East Main St Chicopee MA DZD20 Phones:(413)883-3802 i Fax:{413)3314358(41 )331-4357fou can pay more,but you can't buybett '�Y MA LicR1z4218 CI'LicNOfi3564? www.MBanceHomeincwm SUBMTTe TO:-----��yyT��CPhone: 413.977- 6/St Cell: M . .M [I.L c St. Emaii: jn?{Be 41 We hereby submit specM adons and estbnatn/s for work)to be performed and materials to be used: �t Oi±Ss d i ,o Wilt i?sq Ilho(Lz4 f at?gie . 4...2 . Luketbt o4S . acs A Y2/) ju4k His, tiiiiiiiiii3 4y Aisv 'o.iii ,,,,h-da..,k /4// f)/i' 2 r/hQ. /ev-e U f ((.u' i a rv?ovc 4:,,,;10,21 rye path{, (iztikaj Men." y'ea° Al/. /IJ.tire ) • n.'4 tmiF4l, e-+ i6kiffir-k. dr Y1 )sJsfao$ els rim Ckd✓t.Q6 '/ St# Ab•. ❑Alumiribm Trim ❑C)gAlliance Tri Flat Coil ❑PVC Coil G8 Coll Color: 0 Corners Color: ,WINDOWS Grids:❑YES. }WO :Plat ❑Contour ❑Colonial ❑Diamond ❑Other: arrow many? Z) 2D/H_ ❑PIC_ 0 24 0 3h3_ ❑Csmt_ 02WCsmt_ 03Lttcsrnt El AWN 0 HOP ❑BOW(4 or 5 lines) 0 Bay Full Screen:❑YES gid) 0 Wood grain Interior: Color: Exterior Color:0 YES gNO Color: Mull:❑YES 0 NO 0 How many? ❑Glass Option: Type: ❑ClimaTech ❑ClimaTech TK2 ❑ClimaTech TG2 ❑ENTRY DOOR:❑YES ONO ❑Type: ❑Style: ❑STORM DOOR:❑YESNO, 0 Type: ❑Style: ��,��� �„� []'Material Location: Oink/ BB waste Disposal:—ieie"a WORICSOIEDULE isw�LaSmrtgtcww 5d1 Mefdbwig"theta will teMlerttltouWSSa� n� abrym osi4egt:ac vFl sndMs: �t t t r +i. awwmmussu-b.dn manes(wet. ALJ L r t&+ oue.an rmn.wwart vie bPmeeitedymestiw. Contracted weekmry net begin i Goth Wmmkm ea[[Med a hat yams coPf of Ike kunst,and the Oka d&a5csbn period has expired.The Owner hereby acktreretter and area tart the,dedWbr arts art mpmimaw aSNal such delaystletart net avoidable by the contractor Mowing.tut net limited tri Mem,Acts WGA,thorium ofmete es,acdtlems,are allother neiaysbeymM As control Flull net be considered u vbltoln ohne earevilant WARRANTYt1, All mbeavn.4 We mannern etheervls.rlemmingtinundRM benierM1emrtntaMraM amten fiship romthe e a MewwnivWcn.futlwnkomamet el be metered All been,*anti NnNrtr—.banlll:eTannnare. neMtmmYadPmNeG,MYibmtiendM'uYanfrtmthevknalpmlfn<6+clnwMyMYa emewfllb®eeuNon,YuponxinenaMen.aMwlY PAYMENTS TS ttWaewe[eMstart NF 4tlmR. PAYAAENTS we propose hereby mFamish material and labor-.a.V.... m.. . .snob With tote Mete esfollows fZ Ch1 .( ase specification for the sum. 1 II: • S 1/3 ,.$ rea 66 hm<nsenl,emntmn: � l445/#- 1)..s7' . )at�A w1 a 7 - )nz, t A& -'4Wlsrs I ? Nd laa)- B 6 ).PoetlaN.„..aerdm r5 k 743 40 L. ws -atwee mbmm .. Name of Salesman ta.1 /22 nt.sA A 94 WS JMi.c 'siva bem.de ferthwM upon / Wnpmlon won unekrrob contract. Authorized Signature �� d .. fie customer MRty uMeunds ad aneto pay finance eine steeper ratite ex 4Awe 1peranryse r.teW11%)on FM emmMlR balance Mt Wie wihi 30drys Noir completion ce woo.mi permeate waked Ener 3adrysalter completion ofwah their be appMrtflMia unaW9Ntreednes and them outstanding Nbnu.lathe went Weefautcstmrerberets v4*mmnds weaves in WY.'le atltlabntoits outrtareing IM.Nedeem elswoo woe Wed with cc.Melee NCWewawmWeemitt✓s fes. Acceptance of Pmgeal:lhave read both hada ofthis dwmen.M acceptthe prns,specttmtion and conditions cured.I understand that upon Prmm.Mb proposal b.mmaa binding contract You we EmMbedm do work usreccfed.Namenb will be made as outlined.Mm,Vow the Buyer,maymMel thistransactbnn alt time prior tomldnkM of the 320 WYneu my after the dee Wthis nanmttbn.Wnemtlon melee demi ie writing. DO NOT SIGN MS IF THERE ARE ANT SIAM SPACES y Siimatn ,[[jam Mei? 1 f(p y signature Pate NOTICE Of CANCELLATION:MA)MAY CANCEL THI51RANSAC11oN WITHOUT ANY PENALTY DR DBUGAnIXE,WENN THREE BUSINESS DAYS FROM THE ABOVE DATE IF YOU CANCEL,ANY PROPERTY TRADED IN,ANY PAYMENTS MADE BY VDU UNDER THE COMPACT OR SALE,ANO ANY NEGOTIABLE INSTRUMEMDOCUTEDBYYOU WILL BE RENRNE°WITHIN TEN BUSINESS DAYS FOLLOWING RECEIPT BY THE 5EumR OEYWOR CANCEUAnON NOTICE,AND ANYSECUROY INTEREST AMINO OUTOfTHETMNSACNON MUSE COM 1 rO.TO CANCEL THIS'IMNSACTION,MNL OR D€UWR APIANED AND DATED COPY OF TH15 CmCHUTgN NOTICE ON ANY OTHER WRITTENNOTCE,OR SEND A TELEGRAM 10:mueria HOME IMPROVEMENT,INC.,536 NST MAIN ST.,CHICPEE,MA 03020 Maas.Swear sed Meda a RAMS'S i mrsermerrtred TnaIACRVN tBuWM1 eiens e) it I {/a A11 home tmprovement contractors and sW%nMracto engaged in l7�" home improvement contraaleg,unless spettBSally exempt from ']yt�� .A registration by Provisions of Chapter 142A of the general laws, yq Nopoat,a1 must be registered with the Commonwealth of Massachusetts. �IJL VlJ 4Li Inquiries about registration and status should be made to the " " I Director. Home Improvement Contract Aagidbatiory One ,•—.�y� ar ���r. Ashburton Place,Room 1301,Boston,MA02108(617)7 27859 8 536iopen,MA 0t we ft/, .7'44, f, ) ChPhicopee,MA 01020 • • or(413) (413)893 3802 5 ,,.,- ' Y' Fax:13)3)3314358 MoD Can pay more,but you can't buy betel' MA udM1s423a CT Licp063584J w wtABianceHometnc Com ,,FE ��/�,�, SUBMITTED TO: Phone:"1/.}"�1��'661 Cell:„.4d.:58.4:_.• ) t.9 WCu Na CLW- 1 u ( is Email:roar!. `i 106 2 We hereby submit specifications and estimates for WOA to be performed and materials to be used: a r ts .1.Taitlfli !►�/Alpinr/1s ,,S„*/1Sa1 ayr 57 111 I.✓.. .. alJIJaia 'Arta 5rI 21t. i7J..+a+J1:/"iJSTIOWAIWMS!INNS ` IDIiiVfirellif .a l'6T1..4PIR'!�!! UAMI .1171111.; !!'►ri,71'vpJ�ll,;►1. !NG Type:/tSh,i,/smAib.. 7" ,Sint, Colon Cum &{b spect WaR5heeting: Q"/'}'. udlc4, CO.I044 tkci ❑insulation [3f(omeWrap 0 Strip �IOCks&Dryer Vents Color: ry /J rsQtit(ocks Color: ?.S. ❑Shutters Color: ❑Gable Vents(Louvers)Color: OR&R Gutters 0 New Gutters Color: ❑Soffit ❑Fascia Vented:DYES ONO Type Color: Location: J ❑Aluminum Trim ❑Alliance Trim ❑Flat Coil ❑PVC Coil 0 G Coll Color: QCorners Color: C. 5 •r .2clumpster toedtion: d itot/ []i9�erui Location: j�dy3i:tLri/ �'aste Disposal:_74 r'.� /// G�s?K:Te WORK SCHEDULE t Praire -Tin fallowingschedule will be adhered W wins Gr GMGa beypnd;h. ry oii larise: t I aeF(/ Mb.M emuavwi b. I .aavMwm i / t OMwwanmmra"Wwvawlb..S tNMNw.Mwd Contracted work rumor umil bra Parties Mn referred a deb mewled ESM of the comae,as ow three day nscS.on attics nus waked lie O veer hereby aknowlagmand went Oat thrinlulb,gdates rt arprmlmam*Sem surAYMYa mat art notawMabM byNwContactor Nolo*.lot net IMM1edum0N,hta N 6W,*hapset matertaN idiom.andallaenr*lays beg'Mnammrot shall em be ctndnd es Notatbro of fr:wnem. all inutenalsiuve WARRANTY IITLH,Hr& Warranty or as au.ndw smelted W mmulanwer.Labor and wrvmans iphave a wammy none wu war nom the date al uwlman. All work to be Nrinpleted in a wwtmaNNM manner awarding to nar.LN practices Any alteration or devour from the abbe specifications lrwoFFke Nana costs will be executed only upon written orders,and will become an ere One ova and above ON otimate. PAYMENTS We propose hereby to fumah material and Oboe.Mn ete in accord ace with PrmenpmbemadNasMlkawa: specification fqr the con TIC _#k—%u ern cc }ap,nwmmCOMMm: .ltxu MAWAtd 4;_ —Lei el 9 l4.sy."Ian 4wr7 ws .> .°0 )upwden.nofmnewx: I$ 9, 7570 L -445 ,Ns 3876 )upon iabmmpl.NomName of Salesman ii . AT/ J. ' yI r) +Ms 91?. 00 )04.,4,-,,,-„,„,,,„,,,m,pn wad wwmmmranaec . Authorized S%nature . n s.•-�.s.. '�c.Ku The customer henalpy undesunds ad area to pay finance dyne of 13%per month ON annual WIN-NNW NN of]a%)on d.0091ndlry NS a MtIOM within 30 yry aM+completion of work.All payment' received inter Mdayf after=option M work shall be applied Oram unpidflnrm story and then,outtanding balnc*s In the event ouf g4tamer hereby uNMraunds aidapentn p%.in addition to the Qumran..ineebmdnxs,all eons a Wvlatee with mllwtlon iMWtllrc reasonable atmmNs Ms. Acceptance of Prod:neve read ben Adm of thisdocumenlioNaccept the;Nam sptlrotbneMcMbInns Mated.I uoMnun4Tatuponssiaa ON propoosalhtgnes a ANding canna YouaRauto.1zMm tNaworkassisab4.paymn6 vela Mcope Si MONSDME You,eN fryer,may Nowt*a tranaba,0 anytime Mar a mgoaht of the 3rd buYMs dry Not the one ofVda nannc.t C ncd.cn must be done INNatINN DO NOT SIGN 5 CONTRACT IF THERE ARE ANY BLANK SPACES. y` Signatu 1, dy Data //�//�d r.,-Signature Date 17!!111NOTICE OF CAWELIAT1ON YOU WAY WAS,1 5TION ON,WITHOUTANY PDALWOR OBWA11ON,WPM TREE MAIMS DAYS FROM THE ABOVE DATE If TM LANCED,ART PROPERLY MOWN,ANY PAYMENTS MADE BY YOU I(NOERTNE CONTRACT OR SALE,AND ANYNEGOTANEYMSTRUMENT E%KIREDBY YOU VALISE WOWED WPNIN TEN BUSINESS DAYS fD LOWING RECEIPT BY THE SEt1ER OF YOUR CANCEUTATON NOTICE,AND ANY SECURITY INTEREST ARISING OUT OF THE 111(NSACIION WILL BE CANCELED TO MLR THIS TRANSAC110N,MML Oft DELIVER A SIGNED AND DATED COPY Of THIS CANCEIIATION NOTICE 08 ANY OTHER WRITTEN NO110E OA SEND A TELEGRAM 101 AoIANR NOME IMNmWMENT,INC.,534 EAST MAIN ST.,mKOPEF,MA 01020 (Date Soday and Slaws enloded) I HEMSYCANaLTrea TRANSACTION 1&Mtsegatunl ek W0 4 01WHOZeliaaktedein Office of Consumer Affairs and Business Regulation 10 Park Plaza- Suite 5170 Boston,Massachusetts 02116 Home Improvement Contractor Registration . Registration: 154218 Type: Private Corporation • Eapiratorr 2/202017 rs 261497 ALLIANCE HOME IMPROVEMENT, INC SERGIY SUPRUNCHUK - - - 536 MAIN ST CHICOPEE, MA 01020 - Update Address and return cad.Mark reason for thane Address El El Renewal (' Employment fl Lost Card ...----- ''e Y,nanrn.ww/H,q '/fa a rbn dr. • orco.n erAflibs&Busbies xegala6oa License or regis:rationvald for md'widul use only YPROVEa1HfTCON1RACiOR before the expiration date. If Nand newt to: - • • ' 154218 Type Office ofConsumer Affairs and Easiness Regulation •e 72N201T PdeateCmpmarnn TO Park Plaza-Suite 5I70 / Boston,MA 02116 / AUTANCE HOME IMPROVEMENT,INC SERGIY SUPRUNCHUK 536 FAST MAIN ST /!«_ a.n._ CHICOPEE.MA 01020 �Uadasetrttarry Not i;. ', sigoatare ® Massachusetts Department of Public Beaty Board of Building Regulations and Standards License:CS-104327 SERGIWSUPRUNCHUK 696 EASTMAN STREET � . CHICOPEE MA 01020 1r% I.Za lAj_ Expiration: Commissioner 11/26/2017 I ' Will 111 Ill II 1 11 ill II I 1 , , . . 1 il ! 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