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31A-179 (2) 19 WASHINGTON AVE BP-2017-0699 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Btock: 31A- 179 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: REPAIR BUILDING PERMIT Permit# BP-2017-0699 Project# JS-2017-001154 Est.Cost: $19500.00 Fee: $127.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: use Group COMPLETE RESTORATION SOLUTIONS 103014 Lot Size(sq.ft.): 11282.04 Owner: LOCKWOOD ALLISON Zoning: URB(100)/ Applicant: COMPLETE RESTORATION SOLUTIONS AT: 19 WASHINGTON AVE Applicant Address: Phone: Insurance: 30 HAYES CIRC (413) 592-2772 WC C H I C O P E E MA01020 ISSUED ON:11/28/2016 0:00:00 TO PERFORM THE FOLLOWING WORK:REPAIRS DUE TO WATER DAMAGE - CABINETS, DRYWALL, FLOORING, ELECTRIC & PLUMBING 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 11/28/20160:00:00 $127.00 212 Main Street, Phone(413)587-1240, Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner File#BP-2017-0699 APPLICANT/CONTACT PERSON COMPLETE RESTORATION SOLUTIONS ADDRESS/PHONE 30 HAYES CIRC CHICOPEE (413)592-2772 PROPERTY LOCATION 19 WASHINGTON AVE MAP 3 IA PARCEL 179 001 ZONE URB(3001i THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Fee Paid rr ,�� BPgildin mnj Filled out �I Feu Paid Iypeof Constructions REPAIRS DUE TO WATER DAMAGE-CABINETS,DRYWALL_FLOORING ELECTRIC&PLUMBING New Construction Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: C wn,r/State ent r Licens 10.014 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION PRESENTED: ✓_/{gproved Additional permits required(see below) PLANNING BOARD PERMIT REQUIRED UNDER:§ Intermediate Project: Site Plan AND/OR Special Permit With Site Plan Major Project Site Nan AND/OR Special Permit With Site Plan ZONING BOARD PERMIT REQUIRED UNDER: ?i 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 // t/d Signature of Building 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 MGI.,40A.Contact Office of Planning&Development for more information. . $a ' City of Northampton Yt1iEC > a '"""'t' ` `""'- - "' - r ' .\% Building Department cfi,ft(e-r,l! ,'", rfq° #,,,! . ,."'eelO� ,v 212 Main Street ' r" 777- 2'4-I • ' -'yt. r4`r 4, s Room 10O �� " the I rr,xnr,-ma a ,a,1.07.a„w,.aw, ���\\\y % Northampton, MA 01060 744-4.;,,..44.4 �if:h'r"�a�1.;,;:,a...=H= /phone 413-587-1240 Fax 413-587-1272 r / �.!5 "'j APP ‘ TION TO CONSTRUCT,ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 314 a 1761 1.1 Property Address: This section to be completed by office 0 brash.., c,.) A Vtnvc Map Lot Unit. Uo.*n, e.o,4 MA 01occ Zone Overlay District Elm St.District CB District SECTION 2•PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: t46soi.i 3 501,1,0 I oc.40emni r'O Wr,i(,rn yt--(k.61 A(L }Joi'biter,hv. hA 0L Name(Print) Current Matting Address _ ti D3 - 515 - 44v0 Telephone Signature P-AYIIli/: 2.2Authorized Agent: �`± h VOSCN� t'1 l ttla' _.._ n 1+"IrjrJCS CI& 0, ",r" PA bo Th Name(Print) Current Mailing Address- gel - SnC '27'7'2_ Signature Telephone SECTIONS-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 G t So 0 Construction from(6) 3. Plumbing }7 O b 0Building Permit Fee 4. Mechanical(HVAC) 5 Fire Protection 6. 7/A31=0 +2+3+4+5) 47, j(rg Check Number i /7 SC /i21 1�r This Section For Official Use Only Building Permit Number: I IIsssued: Signature: Building Commissioner/Inspector of Buildings Date 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 Six r _ 11 L— -_'__ 11 1 Frontage [ — 1— -- — 1 Setbacks Front 1—. I r.., 1 L._. Side LLIR'L LI I R1 _ 1 i�. 7 _- Rear L � L_J L1 Building Height 1 r _ i [__—I I Bldg. Square Footage --'- I Lill (--i Open Space Footage _ % __.— r_ - Rot arca minus bldg&paved L____ C._ L._—J L_. parkii) #of Parking Spaces nisi L_—_L Fill: 1 (volume&Location) ^_ --. — ---- — ` -- —'— A. I-las a Special Permit/Variance/Finding ever been issued for/on the site? NO 0 DON'T KNOW O YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO O DON'T KNOW O YES 0 IF YES: enter Book _ l Pagel _____I and/or Document S B. Does the site contain a brook, body of water or wetlands? NO Q DONT KNOW 0 YES Q IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained 0 Obtained Q , Date Issued ` _.,_ __,� C. Do any signs exist on the property? YES Q NO O IF YES, describe size, type and Location: i D. Are there any proposed changes to or additions of signs intended for the property? YES © NO 0 IF YES, describe size, type and location: E. Will the construction activity disturb(clearing,grading,excavation,or fining)over'I acre or is it part of a common plan that will disturb over I acre? YES © NO O IF YES,then a Northampton Storm Water Management Permit from the DPW is required. 11/22/2016 11:56 2026627512 BRN2282E9 PAGE 03/58 SECTION S.DESCRIPTION OF PROPOSED WORK(check MI aDPI)cabj New House n Addition ❑ Replacement Windows TAlmrationls) ❑ Roofing 0 Or Doors 0 Accessory Bldg. LI Demolition 0 New Signs IDI Decks ID Siding 10I Other(01 Brief Description of Proposed Work. Alteration of existing bedroom`Yes^No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet fia,if New Nouse and at addition to existIne housing,.compfete the fdltowinq. 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 stones? f Method of heating? Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Messcheck Energy Compliance form attached? h Type of construction i. Is construction within 100 ftof wetlands? Yes No. is construction within 100 yr. floodplain Yes NO 6 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 -,0141 Lock W0c.13, ,as Owner of the sublet property ITI) rip p hereby authorize BR(1) 1 ' c `+ ^r 17H, to act on my behalf, in al metters relative to wor authorized by this building permit application.tErnedi WOVEM3E'rkt 2z 2.o IL, Signature or Owner Date I. 701-IN Lo GkWOO) , ,as Owner/Authorized VP— 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 -.014N Luckwo61 , Print Name /a .I y,,,v A/d6W r IV OVE 1'I,D�. 2'z. 20_I C,, signewre or Ownedngem Date 2 SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House in Addition C Replacement Windows Alteration(s) t i Roofing C Or Doors 0 Accessory Bldg ❑ Demolition ❑ New Signs EDI Decks tO Siding to) Other(co Brief Description of Proposed 9.,oPwt'n dUt-Orn. flaMzeae Work: ( , t ¶r kn. ch- c : Ele- ( . R .k 4toA. r ft-,�t 33,-.11Pc,r.iA^'r %A- AAd cyAl. irloonn.„ r Plp.,.vy D/A/X.3 Alteration of existing bedroom Yes x No Adding new bedroom Yes de, Itt it Attached Narrative Renovating unfinished basement _Yes , _ No Plans Attached Roll -Sheet 0:if New house a id,oraddition to existing housing;complete.tne 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 f stories? f. Method of heating? Fireplaces or Woodstoves Number of each 9. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction i. Is construction within 700 ft.of wetlands? Yes No. Is construction within 700 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 1, ` ee C pahr,,k ) __. ,as Owner of the subject properly hereby authorize .. to act on my behalf, in all matters relative to work authorized by this building permit application. .-- Signature of Owner Date _ I, J<,«af. VI CjiNz4.F .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 penaltiesof perjury. —3—Clic P%., ti‘ Lilk eV\C Print Name li/ie/i6 Signature of 0,. t` ADate SECTION 8 -CONSTRUCTION SERVICES 8.1 Lieeneed Construction—Supervisor: Not Applicable ❑ fu Name opense Holder: .1(15CC)1 M C rSI C&VC - i License Number N' a. We Or r O.i, I S 30120 Address I, Expiration Date (- )3- alt Sign ure Telephone email J occitv,.o Cr s 4!1C .LC'2M 98 Re ilstored-Home Improvement;Contractor: J Not Applicable 0 COrnplaAe OA,S1-acslirl,. 30ltiki1(,492) Company Name Registration Number C) 1-1c L) (xAt_ On,cOrrc N\a. Qin=-O /7 oa- 0i7 . Address Expiration Date Telephone '/13- ?It "_31 L SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.0.152,§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 buildin. permit. Signed Affidavit Attached Yes._...- AS No 0 ome' ® ner•Exemption The current exemption for"homeowners'was extended to include Qwner-occupied Dwellings of one(I) or two(2)families and to allow such homeowner to engage an indirtdual 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 accertable to the Building Official that hetshe 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,duringand 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 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 150k Address of the work: i 6vG H , �-oa (\,c 1vA-1c,0 , f 61006 The debris will be transported by: Cpwptevr Rc s'c cc u J 5olvt\u p The debris will be received by: (NG AC flw ol frxn - Building permit number: Name of Permit Applicant Dnv'D c $tt\ti lvvv iY 10I C c Date Signature of Permit Applicant The Commonwealth of Massachusetts Department of Industrial Accidents 1 S= R Office of Investigations it I Congress Street,Suite 100 Boston,MA 027[4-20(7 » _ www.mass.gov/dia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organivasionllmlividual)_ i eh.,ple�C I _ Or., a.. _ •• Address: 3(3 i rjs _ . . . - 20 .... City/State/Zip:.... - .: _.+t n i. —...._ Phone#:_...1.3 ' 'L - : l i L Are you an employer?Check the appropriate box: Type of project(required): 1.[.i am a employer with [ 4. Q I am a general contractor and I 4 have hired the sub-contractors 6. ❑New construction employees(full and/or part-time)." 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. Q Remodeling ship and have no employees These sub-contractors have g, ❑Demolition working for me in any capacity. employees and have workers' deco insurance.t 9. ID Building addition [No workers' comp. insurance comp. 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions e officers have exercised their 1 I. Plumbingrepairs or additions ..❑ Z am a homeowner doing all work P myself [No workers' comp. right of exemption per MGL 12.]Roof repairs insurance required.]t c. I52, §l(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`campemation 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. tCone'Uors that cheek 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 tam an employer that is providing workers'compensation insurance for my employees. Below iv the policy and job site information. 'r Insurance Company Name: L.4 Tl cl.. TnYu o. cq )e.0;cc Policy#or Self-ins. Lie. #: (}nc rxi 4.35(3' ' 6- if- Expiration Date: `i` I - I7 Job Site Address: I', W cash,ag cora 1^'�t ...... City/State/Zip: kl ataja zj Nn AI0 b O 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 line 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 daft against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations oflh DIr hia age verification. - I do hereby cerci n r ns �. • l thaw perjury e information provided above is true and correct. Signature: 1 ^_ Date: IV-.16 - IL _____ Phone IS ti/3 - 9t2 -Zl1i_ Official use only. Do not write in this area,to be completed by city or town official. City or Town: ,i Permit/License#_ _ _ Issuing Authority(circle one): I.Board of Health 2.Building Department 3. City/Town Clerk 4,Electrical Inspector 5.Plumbing Inspector 6.Other __ Contact Person: Phone#:,, ...... TE AC R e CERTIFICATE OF LIABILITY INSURANCE 8/29/2016° " IY r THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS MO RIGHTS UPON THE CERTIFICATE HOLDER THIS s CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POUCIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S). AUTHORIZED REPRESENTATIVE OR PRODUCER AND THE CERTIFICATE HOLDER. - IMPORTANT: It the certificate holder M an ADDITIONAL INSURED,the policy(es)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 certificate holder in lieu of such endorsement5). PnOWCER Gall CS aka Bora%Ski Insurance ceo^'E (413)586-5011 FA Ny 88 ling Street, Suite a enuiyT 9croake@bo skivns,iia ca cote _MSUREWSJ AFFORDCoVERAGE .w_ NAC a Northampton !A 01060-3257 WLPERA Capitol Specialty Ina Com 10328 MSUREa --- INSURER e Zurich insurance Services ZVft001 Complete Restoration Solutions Inc. INSURER C.Bffinove 2 292 3O Haynes Circle F ineMenD� fi USER E: I Chicopee MA 01020 WE Surat COVERAGES CERTIFICATE NUMBER:18-18 REVISION NUMBER: 1—THLS IS TO CERTIFY THAT THE POLICI S OF INSURANCE LISTED BELOW HAVE BEEN rSSUED TQ THY INSCRED NAMED ABOVE FOR THE PO E_ C •CEC USOTE MAY BE ISSUED STUNS OR AYER AE, L E IN S RANCMAFNAVE HE POLICE OR SCRIS D NI YUH ECTPTO t LI. V 4 4 C NC LATEO. NO?MTN ANDING ANY REQUIREMENT.TERM OR CONDITION Of ANY CON D C CLUSIONS MAY O OITNOR MAY POICIE'IME INSURANCE AFFORDEDAVEBEENBY THE CED BY DESCRIBED HEREIN IS SUBJECT TOPLI E TER'AU SUCHE-0BYPAIO CLAIMS NeN -.... . WcEcY),, PotP4 ) -'. VMRS MEQ EUWWGE ince in POLICY NVMBEk X COMNERGI,LGENERAL IJABLtt I I I EACH OCCURRENCE_ 9 1,000,000h E fCX GrYd MINAE-b A CLAN.MA0 X OCCUR .ypFaq Ft reM5L6 300.0'10 X Profession 1 Liability IMp15052$-02 fl126(201fi 6/2A/ > MINE 1 rneWwni6 5,000 Im I PERSONAL8 ANINNRY 5 1.000.000. • N' GAREGATE LAO APPAESR.R t GENERALA06REGATE S 2,000,000 ac ;l«1 II PRODUCTS CDMP1OP AGG a 2,000.000 L'MR tggav uVaNlry ,1 1,000,000 AUIOuoaLE LwWury : I COMmuMMi.SINGLE MY FLTO [LEA 16OMI Y+Rv tPrpe&W 4 ]`AYcC - SCHEOULEO YINJURV Met=Aden° 5 ▪ JS U -6R sw EC/,rn,.,C" . ..6 uo. 1. IPtl4#t'CE] _. 1 X UMBRELLA LAB I X I occ 1 EACH OCCURRENCE I$ 5,000,000 A EXCESS A.UB CLAIMS M60k AGGREGATE E 5000,COO. OED X RETENTIONS 10,000 EV00015119-02 '. e/28(2016 8/25/2017 ,i WORNERSGO6PENSASION . PER_. ATure OM- N4Pen!DYERS.'Wani Eft ROMq W E IEFECUTM12 A A El E K00CMT 6 nn n.v^ B I Gmory - M306,2638(4.6-16 9/1/2016 9(1/2017 EL.DISEASE•E EMPLOYE2 4 1,000.0001 urn DEC. id:6 CP Mf0NS bo-Cc I EL MSE:SE-POLLS 31.A S 1,020.000 • C Baalment Coverage ABN965954 02 8/28/2016 S/2912017 '$SLOG OP heir A CPL 8V20150525-02 0/28/2016 A/20/2017 $TMCoar Ea Oa: ( ornerier°.OFCPEVATIONS I LOCAIIONSI VFIICLES(ACM/101,Adenoma Rnwts SalmauYR may W.naoMd XMOM alum 6 ngJnal • CERTIFICATE HOLDER CANCPI I ATION - 51+04)10 ANY OP THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE TEE EXPIRATION DATE THEREOF, NOTICE WALL BE DELIVERED IN ACCORDANCE 1MTH THE POLICY PROVISIONS, AUTHORED REPRESENTATIVE I 1 _ �. IR BOYIDWSkI/BORGCA o` -' aA' a-C.: I 0198s-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD INSO26 omen �i a l; a s El;n; t-' ri i% x,17 e t rC:.N ,to,, I!. Office of Con.un:er Affair, and Business ReJu,a;,ac 10 Park Plaza - Suite 51 70 Boston, Massachusetts 02116 Home Improvement Contractor Registration Regls:rat:on 154927 Type: Private Corso-ation COMPLETE RESTORATION SOLUTIONS, ; Exp's-a5c 2„``17 -ry 277402JOSEPH GILLETTE 30 HAYNES CIRCLE CHICOPEE, MA 01020 - - - Cpoat td res and r „i. %lar .i. _. .. _- Address = Renew ai —_ Employ _// 4./// /4(.....//f//WV. - -7---,_Office of Consumer kffairs&e Regulation Licenseoregistrationvalid forlivid use only mm - -expiration a 1 t returnto_r = Registration 164 r Type: Office of Consumer Affairs and BusinessR.ouiarinnIO Park Hasa c,:rtepl-dExpiration: '222047 P. ;e Corporation _ -DMOLcc RESTORATION SOLUTIONS, INC. Boston.N:1 074-3.5 1 /iwi MII 32 InevNES CIRCLE - �°ei L. - Undersecretary -- totar dwithouts,rlature Massachusetts-Department of Public Safety Board of Building Regulations and Standards Cnn:rructinn Sinn icor License: 'CS-101r4L JOSgpg M GILI.g';'E 6 SHADY an ' �LSgppy"c W6S7 Sr s n Expiration Commissioner 00/302017 COMPLETE $#CRSRESTOItATION SOLUTIOLUTI so nCircle,Cniropee,MA 01020 SOLUTIONS FID# 80-0453943 MA HIC#164927 MA CSL#103014 CT CSL#556236 CONTRACT & PAYMENT AUTHORIZATION Agreement made this 25 day of October_, 2016 by and between Complete Restoration Solutions, Inc.,at 30 Haynes Circle, Chicopee, Massachusetts,01020 (hereinafter referred to as"CRS") and Allison&John Lockwood of 19 Washington Avenue _Northampton, MA 01060 (hereinafter referred to as"You"). Article 1: Nature of Work and Contract Price. CRS agrees to commence work on Your property and coordinate matters with You and Your insurance company in order to effect repairs quickly and professionally. CRS shall supply itemized specifications to You and Your insurance company showing the work specified and its cost, and accept payment in the amount agreed to by CRS. All proposed work is subject to approval by appropriate building officials and You. The total amount agreed to be paid for the work specified and the time schedule of payments is set forth in the attached payment schedule. The specifications, payment schedule, any addenda and any change orders shall become a part of and incorporated into this Contract. Article 2: Permission to Start Work. You agree to allow CRS to commence work on the above described property, to pay CRS the amount agreed to by CRS and Your insurance company for work performed by CRS, and to direct Your insurance company to include the name of CRS on any settlement drafts or checks. Article 3: Additional Changes to Work. You may, from time to time, in writing, make changes in or additions to the work to be performed by CRS and CRS shall make such changes or additions at Your sole cost and expense, at such prices as You and CRS may agree to in writing ("Change Orders"). CRS will obtain Your written permission before doing any work not covered by Your insurance carrier. Article 4: Insurance and Delays in Work Performance. CRS may not be liable to begin work or continue the work due to weather conditions, strikes, accidents, unavailability of material, or delays beyond CRS's control. You must carry fire, general liability, tornado, and other necessary insurance. CRS and its subcontractors shall provide all insurance required to fully protect their employees and subcontractors. If payments are not made by You within three(3) days after the date as applicable on the payment schedule, CRS may elect to terminate performance and cancel this contract. If CRS elects to terminate performance and cancel this contract, CRS shall do so by notifying You in writing. Performance by CRS is conditioned upon payment by You. If CRS is delayed at any time in the progress of the work by an act or neglect of Yours or by any employee or agent of You, or by any separate contractor employed by You or by changes ordered in the work, or by labor disputes, conditions not reasonably anticipated, unavoidable casualties, or any causes beyond CRS's control. or by delay authorized by You, then the contract time shall be extended by change order for such reasonable items as You and CRS may determine. Article 5: Workmanship. CRS shall cause the work to be done in a good and workmanlike manner according to the standard practices of the trade. CRS will provide a one(I)year limited warranty as set forth in the attached document,which is incorporated into this Contract. CRS may, at its discretion, engage subcontractors to perform work hereunder. In that event, all such subcontractors shall be adequately insured for any injury to its employees or others incurring loss or injury, whether personal or property, as a result of the acts of the subcontractor or its employees. In the event CRS inadvertently causes any damage to Your property during the performance of this Contract, CRS shall remain fully responsible to repair said property to its original condition, or replace said property,at the discretion of CRS. Article 6: Default. In the event of default in payment or in any other manner by You, You agree to pay all costs of collection including reasonable attorney's fees, in addition to other damages incurred by CRS. You further agree to pay the maximum interest permissible by the laws of the State of Massachusetts on any sum in default. Article 7: Concealed Conditions. Should CRS discover concealed conditions or unknown conditions in an existing structure different from normal conditions customarily found or unknown conditions below the ground, then the contract amount may be increased by a change order upon the request of CRS or You within five (5) days after the condition is first observed. CRS and You and/or Your insurance representative shall agree on the work to be performed and its cost prior to the work being completed. Both parties agree that any work to be performed shall be stated in writing and signed by both parties,which shall become a part of this Contract. Article 8: Binding Obligations. The obligations of this Agreement are binding upon CRS and its successors and assigns and upon You and Your heirs,successors,executors,administrators,and assigns. Article 9: Starting and Completion Dates. Work to commence on or before November 14, 2016 and be substantially completed in accordance with the terms of this contract on or before December 31 ,2016, which may be extended for delays beyond the control of CRS. Any change orders signed after this Agreement date may affect completion dates. Article 10: Permits It is the responsibility of CRS to obtain all necessary and applicable permits before beginning the Work. In the event You secure Your own permit, You will be excluded from the Residential Contractor's Guaranty Fund. All contractors and subcontractors must be registered by the State. Any inquiries relating to CRS's registration should be directed to the administrator of the Board of Regulations and Standards. Your rights are set forth in iN.G.L.c.142A. YOU ARE ENTITLED TO A COPY OF THIS CONTRACT AT THE TIME YOU SIGN IT. NO WORK SHALL BEGIN PRIOR TO THE SIGNING OF THIS CONTRACT. YOU, THE BUYER, MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD (3°°) BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION. SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. Complete Restoration Solutions,Inc. Date BY: 9p,A0 SW_t:LpF- Print Owner(s): ,Gjy1r1C-14 /1"/L0' By: Date Duly Authorized By: Date Duly Authorized NOTICE OF CANCELLATION You may cancel this transaction, without any penalty or obligation, within three (3) business days from the above date, provided You submit written notice to CRS within the time set forth herein. If You cancel, any property traded in, any payments made by You under the contract or sale, any negotiable instrument executed by You will be returned within ten (10) business days following receipt by CRS of Your cancellation notice, and any security interest arising out of the transaction will be cancelled. If You cancel, You must make available to CRS, at Your residence, any goods delivered to You under this contract of sale; or You may, if You wish, comply with the instructions of CRS regarding the return shipment of the goods at CRS's expense and risk. If You do make the goods available to CRS and CRS does not pick them up within twenty (20) days of the date of cancellation, You may retain or dispose of the goods without further obligation If You fail to make the goods available to CRS or if You agree to return the goods to CRS and fail to do so, then You remain liable for performance of all obligations under the contract. To cancel this transaction, mail or deliver a signed and dated copy of this cancellation notice or any other written notice,or send a telegram to CRS at the following address: Complete Restoration Solutions, Inc. 30 Haynes Circle Chicopee, MA 01020 No later than midnight of the third business day following the signing of the Contract I (We) hereby cancel this transaction. Owner's Signature Date Owner's Signature Date I(We) hereby acknowledge receipt of a fully completed Contract& Payment Authorization and Notice of Cancellation. Owner's Signature Date Owner's Signature Date Complete Restoration Solutions, Inc. LIMITED WARRANTY Complete Restoration Solutions, Inc.("CRS")guarantees that the Work will be constructed in a good and workmanlike manner and it will guarantee the Work against defects in workmanship and materials for a period of one(I)year from the date of its completion. Warranty work will be completed within sixty(60)days from the date of receipt of written request from the owner("You"'). Please note that this Limited Warranty specifically excludes consequential damages.This warranty is extended to You.CRS shalt provide and assign to You any and all manufacturers' warranties on all appliances and equipment supplied by CRS at the premises, if any. CRS specifically does not assume responsibility for any of the following items,each of which is specifically excluded from this Limited Warranty: I. Defects in appliances covered by the manufacturers' warranties which are hereby assigned directly to You. Each manufacturer's warranty claim procedure must be followed where a defect appears in any of those items. 2. Damage due to ordinary wear and tear,abusive use, misuse,or lack of proper maintenance of the home or its component parts or systems. 3. Defects which are not caused by the negligence of CRS and/or its subcontractors, but the result of characteristics common to the materials used such as, but not limited to; (a)warping or deflection of wood: (b)fading,chalking and checking of paint or stain due to sunlight; (c)cracks in concrete due to drying and curing of concrete plaster,brick or masonry; and (d)drying, shrinking and cracking of caulking and weather stripping. Where CRS's work involves the matching of existing finishes or materials. CRS will use its best efforts to match existing finishes and materials. However,CRS does not guarantee an exact match due to such factors as discoloration due to the aging process,difference in dye lots,and difficulty of exactly matching certain finishes, colors,and planes. 4. Defects in items installed by You or anyone other than CRS or its subcontractors at CRS's order. 5. Labor performed by You or anyone other than CRS or its subcontractors at CRS's order. 6. Defects in items supplied by You. 7. Loss or injury due to the elements not caused by the negligence of CRS and its subcontractors. 8. Conditions not caused by CRS andlor its subcontractors resulting from condensation on,or contraction of materials. 9. Paint applied over newly plastered walls unless applied by CRS or its subcontractors. W. Consequential damages. All implied warranties including, but not limited to warranties of merchantability and fitness for a particular purpose, are limited to the one(I)year warranty period as set forth above. This Limited Warranty is the only expressed warranty given. In the event that any of the provisions of the Limited Warranty shall be held invalid, the remainder of the provisions of the Limited Warranty shall remain M full force and effect. CRS is not an architect,engineer, or designer. CRS is not being hired to perform any of these services. To the extent that(:RS makes any suggestions in these areas, it is acknowledged CRS's suggestions are not a substitute for professional engineering,architectural,or design services,and are not to be relied on as such by You. CRS is not responsible for the cost of correcting errors and omissions by Your design professionals and separate contractors.