31A-099 73 VERNON ST BP-2018-1010
GIS#: COMMONWEALTH OF MASSACHUSETTS
M=Block: 31A-099 CITY OF NORTHAMPTON
Lot: .001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL 042A)
Category: WATER DAMAGE BUILDING PERMIT
Permit# BP-2018-1010
Proiect# JS-2018-001833
Est.Cost: $27909.00
Fee: $182.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: ANTHONY STOKES DBA S & L CONSTRUCTION 094609
Lot Size(sq. ft.): 26136.00 Owner: CUTLER WILLIAM
Zoning:URB(i00)/ Applicant: ANTHONY STOKES DBA S & L CONSTRUCTION
AT: 73 VERNON ST
Applicant Address: Phone: Insurance:
79 MONTAGUE CITY RD (413) 824-1040 WC
GREEN FIELDMA01301 ISSUED ON:4/6/20I8 0:00.00
TO PERFORM THE FOLLOWING WORK:BATHROOM AND 1ST FLOOR RENO DUE TO
WATER DAMAGE
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 4/6/20180:00:00 $182.00
212 Main Street, Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
File#BP-2018-1010
APPLICANT/CONTACT PERSON ANTHONY STOKES DBA S&L CONSTRUCTION
ADDRESS/PHONE 79 MONTAGUE CITY RD GREENFIELD (413)824-1040
PROPERTY LOCATION 73 VERNON ST
MAP 3 1 A PARCEL 099 001 ZONE URB(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
SED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid
Typeof Construction, BATHROOM AND IST FLOM RENO DUE TO WATER DAMAGE
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 094609
3 Sets of Plans/Plot Plan
THE F LLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFqRMATION 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 Stoma Water Management
D olition Delay
D
Sa eo Builditg Oflic' Dat
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.
Department use only
City of Northampton slaws OfPermit
- .✓' Building Department Curb CWDnvcway Permit
212 Main Street Sevaer/Septic Avahsbility
Room 100 Water/Well Availability
r Northampton, MA 01060 Two Sets of Structural Plans
phone 413-587-1240 Fax 413-587-1272 PkAlSite Plans
APPLICATION TO CONSTRUCT,ALT R, vVATE O OEM IOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION AM 5
1.1 Prooerly Address- o-PT ev nar>;u= cioms This Section to be compl-led by office
mwnc,-
Map Lot �7 Unit
73 Vernon Street Zone Overlay District
Elm SL District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record: L
William Cutler 31 �.ybdt 6rt,r. tiofrAyrot �q
Name(Prin�t) Current Mailing Address: 413-320-2421
L -y.1n �irAT? Telephone
Signature `
2.2 Authorized Anent;
1r�+tlp r<� S-iu KPS Ji4 e i 6'r eVtM1L L� IMAOI JI
Name(Pont) CurrentCurrent Mailing Addiacs�
z _ y.3 - 8av - /oio
Signature Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed bpermit applicant
1. Building �a lr,LCA u° (a)Building Permit Fee
2. Electrical (b)Estimated Total Cost of
Construction from 6
3. Plumbing Building Permit Fee
4. Mechanical(HVAC) l U
5. Fire Protection 1
6. Total=(1 +2+3+4+5) a7 qOq ` j Check Number dQ
This Section For Official Use Only
Building Permit Number: Date
Issued:
Signature:
Building Commissioner/Inspector of Buildings Date
EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR)
Section 4. ZONING AU Information Must Ile Completed.Permit Can M Denied Due To Incomplete Information
Existing Proposed Required by Zoning
This column to be tiller in by
Building Department
Lot Size
Frontage
Setbacks Front
Side L: R: L: R:
Rear
Building Height
Bldg. Square Footage %
Open Space Footage
(Lot arca minus bldg&pavd
kin
#of Parking Spaces
Fill:
(volume&Location)
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO O DONT KNOW O YES O
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO O DONT KNOW O YES O
IF YES: enter Book Page and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO O DONT KNOW O YES O
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained O Obtained O , Date Issued:
C. Do any signs exist on the property? YES O NO O
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property? YES O NO O
IF YES, describe size, type and location:
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 O NO O
IF YES,then a Northampton Storm Water Management Pemut from the DPW is required.
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all aooliceble)
New House ❑ Addition ❑ Replacement Windows Akeration(s)� Roofing 0
Or Doors D
Accessory Bldg. ❑ Demolition ❑ New Signs ([3] Decks [q Siding PJ Other[E:A
Brief Description of Proposed (�Q,lir �R b
mC`S y' 2 _ a, 4roy7A, ajyd- Sf !- PBC
Work: $¢p i}}iD-L�.tc� — l �� L'
Alternation of existing bedroom_Yes ,Z No Adding new bedroom Yes IC No
Attached Narrative Renovating unfinished basement Yes �No
Plans Attached Roll -Sheet
ea.If New house and or addition to existing housing, complete the following:
a. Use of building One Family OC Two Farri Other
b. Number of rooms in each family unit: I O Number of Bathrooms 2
c. Is there a garage attached? h7()
d. Proposed Square footage of new construction. Dimensions
e. Number of stories?
f Method of heating? Ain CkA Q0} .a CK+(5' Fireplaces or Woodstoves UI:2 _Number of each
g. Energy Conservation Compliance. Masscheck Energy Compliance form attached?
h. Type of construction k 3Aiocy—
i. Is construction within 100 R.of wetlands? Yes No. Is construction within 100 yr. floodplain_Yes No
j. Depth of basement or cellar floor below finished grade
k. Will building conform to the Building and Zoning regulations? Yes No.
I. Septic Tank_ City Sewer Private well City water Supply,
SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
r`�- �'`/ iI � l✓-"� C"1'� ,as Owner of the subject
property ,/� 1
hereby authorize 4-1-ytO" gor. ) / S}D�.j LIPS wI ic0ly7 I*Nw\ InL
to act on my beh i all matters�al a to work authorized y this building permit application.
Signature of Owlnelr ` 1, ,, Date
I._ �y�l�y`�-f J W as Owner/Authorized
Agent hereby declare that t e statements and information on the foregoing application are true and accurate, to the best of my knowledge
and belief.
Signed under the pains and penalties of perjury.
T ti S
Pnnt Name
3/�� ado/Sl
Signature of Owner/Agent Date
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction/Supervisor: Not Applicable ❑ p
Name of Licame,H /
older: r7rt �-l.� F7 StD CIS
License Number
-7G mo+rlag,re c e1 Gre ,,4 J ma ot30) 5/1? Idol
Address Expiration Date
go?✓- 10 vu
Signature Telephone
9.Repiaterod Home Improvement Contractor. Not Applicable ❑
S 00,0 1$ IOt-L
Company Name Registration Number
d35 (�(�F✓j/v rRero/ O/3>'3 4 /-0 ) 2019
Address Expiration Date
Telephone Z/M - WV-/0Y0
SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.153,§25C)8))
Workers Compensation Insurance affidavit must be completed and submitted with this application.Failure to provide this affitlavtt will result
in the denial of the issuance of the building permit.
Signed Affidavit Attached Yes__. No...... ❑
_ City of Northampton
Massachusetts
® c
1 ;
m2A811MEnT OF HUZLD)XO ZRSPSCTZOA`S �
212 Hain Street • Municipal Building
Northampton, NA 01060 rYh. YJI�,Cb
AFFIDAVIT
Home Improvement Contractor Law
Supplement to Permit Application
The Office of Consumer Affairs and Business Regulation("OCABR")regulates the registration of contractors and
subcontractors performing improvements or renovations on detached one to four family homes. Prior to
perfortning work on such homes,a contractor must be registered as a Home Improvement Contractor("HIC").
M.G.L.Chapter 142A requires that the"reconstruction, alteration, renovation, repair, modernization, conversion,
improvement, removal, demolition, or construction of an addition to any pre-existing ownerbccupied building containing
at least one but not mom than four dwelling units....or to structures which am adjacent to such residence or building'be
done by registered contractors.
Note:If the homeowner has contracted with a corporation or LLC,that entity mast be registered
MGye o✓
Type of Work: t iVtl'y4 f,,,) t. Q-¢ wtAc�L' �� Est. Z`ost �p9-? Qo(
Address of Work: 7_'�, U Q(no o 5{ r�f a—_I tk)0(4 wavyl o- 001. a0 a1
Z
Date of Permit Application:
1 hereby certify that:
Registration is not required for the following reason(s):
Work excluded by law(explain):
Job under$1,000.00
Owner obtaining own permit(explain):
_Building not owner-occupied
_Other(specify):
OWNERS OBTAINING THEIR OWN PERMIT OR ENTERING INTO CONTRACTS WITH UNREGISTERED
CONTRACTORS OR SUBCONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK ARE NOT
ELIGIBLE FOR AND DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND
UNDER M.G.L.Chapter 142A.SUCH OWNERS ALSO ASSUME THE RESPONSIBILITES FOR ALL WORK
PERFORMED UNDER THE BUILDING PERMIT.SEE NEXT PAGE FOR MORE INFORMATION.
Signed under the penalties of perjury:
I hereby apply for a building permit as the agent of the owner:
3/a-)ldoi9 r? c} lv�w 19 StCM
Date Contractor Name HIC Registration No.
OR:
Notwithstanding the above notice, I hereby apply for a building permit as the owner of the above property:
Date Owner Name and Signature
City of Northampton
Massachusetts
c
4
DEPARTMENT OF BUILDING INSPECTIONS �
212 . Ln Street • l ICI pel Building
Q
g
NorNa ton, NA 01060 rah,-Y'll'aCT
Massachusetts Residential Building Code
Section 110.R5.1.2
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.
Section 110.85.1.3.1
Any homeowner performing work for which a building permit is required shall be exempt from
the licensing provisions of 780 CMR i 10.R5, provided that if a homeowner engages a persons)
for hire to do such work, then such homeowner shall act as supervisor.
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.
Q
City of Northampton
Massachusetts DEPAAIMENT OF BUILDING RISPECTZOlPS232 Main Street •Municipal Huiltling
C`
MorifiidpT9n, !A 01060
Debris 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.
The debris from construction work being performed at:
73 V2(RuA Slree--r
(Please print house number and street name)
Is to be disposed of at:
Ic 'c _ttc II.
(Please print name nd low n of facility)
Or will be disposed of in a dumpster onsite rented or leased from:
(Company Name and Address)
Signat �Iew6lAlpplicant or Owner Date
If, for any reason, the debris will not be disposed of as indicated,the Applicant or Owner shall notify the
Building Department as to the location where the debris will be disposed.
�\ The Commonwealth of Massachusetts
Department of Industrial Accidents
I Congress Street, Suite 100
7
Boston,MA 02114-2017
www.mass.gov/dia
Workers'Compensation Insurance Affidavit:General Businesses.
TO BE FILED WITH THE PERMITTING AUTHORITY.
Applicant Information Please Print Legibly
Business/Organization Name: :iia gel d E,pSCk coAi, vI_h ,. 114(
Address: 33S (7Tagk,Aetsaj 466
City/State/Zip: S. ck.,6-e ij 0,14 01371 Phone#: 413- 981f -loyo
Are you an employer?Check the appropriate box: Business Type(required):
1.91 1 am a employer with (r employees(full and/ 5. ❑Retail
or pan-time).' 6. ❑RestauroduBar/Eating Establishment
2.❑ 1 am a sole proprietor or partnership and have no 7. ❑Office and/or Sales(incl.real estate,auto,etc.)
employees working for me in any capacity.
[No workers' comp.insurance required] 9. ❑ Non-profit
3.❑ We are a corporation and its officers have exercised 9. ❑Entertainment
their right of exemption per a 152,§I(4),and we have 10.❑ Mani facmring
no employees. [No workers'comp, insurance required]`
4.❑ We are a non-profit organizafioq staffed by volunteers,
❑
IL He
alth Care
with no employees. [No workers' comp.insurance req.] 120Dther
'Any applicem that checks box BI most also fill out the section below showing their workers compensation policy information,
'9Rhecorpmate officers have--,.it themselves,but this corporation has other employee ,a workers compensation policy is required and such an
organization should check box 41.
I am an employer that is providing workers'compensation insurancefor my employees. Below is the policy information.
Insurance Company Name: (�iOn)Pvcu.AaA( (&JUcalll
Insurer's Address 23 i/Q/Anr>1 ,�{'1` Z /
City/State/Zip: PUO/ r IQ 1910 9_'�
Policy#or Self-ins.Lie.# tin S 5 q R 7 q �g 5_-2`1 19 Expiration Date: O 2,/0-3/11
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 S 1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of STOP WORK ORDER and a fine
of up to$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby certify,under the pains and penanies oteperjury that the information provided above is true and correct.
Signature - D t ' 31d71d0/
Phone#: Y/3 AadV -
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.Licensing Board S.Selectmen's Office
6.Other
Contact Person: Phone#:
cow rageo gm,dm
Information and Instructions
Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees.
Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire,
express or implied,oral or written"
An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more
of the foregoing engaged in ajoint enterprise,and including the legal representatives of deceased employer,or the
receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However,the
owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the
dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house
or on the grounds or building appurtenant thereto shall not because of such employment be deemed to he an employer."
MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or
renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any
applicant who has not produced acceptable evidence of compliance with the insurance coverage required"
Additionally,MGL chapter 152,§25C(7)states`Neither the commonwealth nor any of its political subdivisions shall
enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance
requirements of this chapter have been presented to the contracting authority."
Applicants
Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if
necessary,supply yew insurance company's name,address and phone number along with a certificate of insurance.
Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members
or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy
is required.Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of
insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town
that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you
have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the
Department at the number listed below. Self-insured companies should enter their self-insurance license number on the
appropriate line.
City or Town Officials
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom
of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant.
Please be sure to fill in the permit/license number which will he used as a reference number. In addition,an applicant that
must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current
policy information(if necessary). A copy of the affidavit that has been officially stamped or marked by the city or town
may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit
most be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business
or commercial venture(i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this
affidavit.
The Department's address,telephone and fax number:
The Commonwealth of Massachusetts
Department of Industrial Accidents
1 Congress Street
Boston, MA 02114-2017
Tel. # 617-727-4900 ext. 7406 or 1-877-MASSAFE
Fax# 617-727-7749
www.mass.gov/dia
Faem Revisal 02-2315
® S&L Construction Inc. Invoice
CUNSiRUCiI0N235GreenfiieldRd
Suite 5 Date j Invoice R
South Deerfield MA. 3272018 281
MA 01373
i
Bill To
William Caller
73 Vernon Strect
Northampton MA 01027
wcot1er57(ngmail.com
413-320-2421
I
i
Job Description Price
173 Vernon Street
1
Labor to hang drywall tape 3 coats,prepare areas in living room,dining room,and pantry 7,48800
�for paint.
Labor to remove wallpaper, and prepare walls for paint(includes skimming walls, 1,872.00
sanding,etc.)Remove window between front bedroom and hall.
Labor remove shower,sink,toilet,sabnoor etc, 1,24800
Labor to remove and replace damaged sub0oor in front bedroom 329.00
Labor to prime and paint 2nd Floor,stairwell,livingroom,diningroom,and pantry walls, 7,680.00
ceilings,and trim.
Labor and materials to remove and replace livingromn,diningroom,and pantry hardwood. 4,308.00
�Elecriral: Install new lighting in livingroom and pantry,update wiring in livining mom, 1,214.00
pantry,and 2nd floor bathroom
Materials to complete the above projects. Includes insulation,drywall,paint,firring, 3,188.00
fasteners,trim, hangers,framing,plywood,etc.
Dumpster 400.00
Total
Payments/Credits
Balance Due
Page t
®® S&L Construction Inc. Invoice
CONSTRUCT ION 235 Greenfield Rd
Suite 5 Date Invoice#
South Deerfield MA, 3/27/2018 281
MA 01373
Bill To
i William Cutler
73 Vernon Street
Northampton MA 01027
wcutler57rrygnail.com
X413-320-2421
Job Description Price
rpennit fee: 182.00
This estimate does not include carpet for the 2nd Floor or Flooring for the 2nd Floor bath 0.00
I
I
i
I
I
I,
�I
Total $27,909.00
Payments/Credits $0A
Balance Due $27,909.00
Page 2
Rill
CONSTRUCTION
CONTRACT FOR SERVICES
This Contract for Services ("Contract") is entered into on this 27 day of March, 2018 ("Effective Date") by and
between Stokes&Lipski Construction,Inc.(License#181012)of 235 Greenfield Rd,Ste 5,S.Deerfield, MA 01373
("S&L"),and William Cutler oQ vP 4 /— _ A),-A w'K("Property Owner")(collectively"Parties"),
for certain construction and/or renovation work at the property located at 73 Vernon Street Northampton MA
01027 ("Worksite").
WHEREFORE, in consideration of the mutual promises set forth below, the sufficiency of which is hereby
acknowledged,the Parties hereby agree as follows:
1. SERVICES AND TERM OF CONTRACT
Beginning on or about 16 April ("Commencement Date"), S&L shall provide to Property Owner the services
described in the attached Exhibit A ("Services" or"Work"),which is herein incorporated as though fully set forth,
verbatim.
S&L anticipates that the Work will be completed on or about 7 May 2018, ("Completion Date"), though there
may be unanticipated variables that could expedite or delay the Commencement Date and/or Completion Date,
including without limitation inclement weather, delivery of materials, scheduling issues, acts of god, boycotts,
accidents, permit issues, forces majeure, and other such unforeseen circumstances. S&L will use reasonable
efforts to commence and complete the work on or by the stated dates, but bears no liability for delays unless
there is clear and convincing evidence that S&L failed to act reasonably under the circumstances.
2. PAYMENT/S FOR WORK, LABOR, MATERIALS,AND SERVICES
The total cost to the Property Owner for the work,labor,services,and materials called for hereunder is$27,909.00
("Contract Price"),which shall be due and payable as follows:
$9,303.00 Due upon execution of this Contract (this deposit does not exceed the
greater of one-third of the total price or the cost of custom materials)
$4,651.50 Due upon/by 16 April 2018
$4,651.50 Due upon/by 23 April 2018
$4,651.50 Due upon/by 30 April 2018
$4,651.50 Due upon completion of the work called for herein
All payments shall be made by Property Owner within ten (10) calendar days of the above-noted triggering
events, by way of checks made out to Stokes& Lipski Construction, Inc., delivered to 235 Greenfield Road,Suite
5, South Deerfield, MA 01373.
In the event that any payment called for hereunder is late in any respect, S&L, in its sole election and discretion,
may immediately suspend any and all Work unless and until Property Owner comes current on all payments
owed.If Property Owner comes current on all payments owed within thirty(30) calendar days of the applicable
due date set forth above, then S&L shall resume the work. If the Property Owner fails to come current within
thirty(30) days of the applicable due date set forth above, S&L may treat the failure to timely pay as a material
breach of this Contract, may terminate the Contract without liability, may immediately begin applying interest at
the rate of twelve percent(12%) per annum, and may seek any and all legal remedies available to S&L.
Page 1 of 5
Payments shall not be contingent upon acceptance of any work done by third-parties, and S&L shall have no
responsibility or liability for any work performed or materials provided by third-parties.
3. MATERIALS
S&L has provided Property Owner with a list of anticipated materials needed for the Work, as well as the
associated costs.These anticipated costs are set forth in Exhibit B hereto, and are included in the Contract Price
set forth above. S&L may make reasonable substitutions of materials without penalty, offset, or credit, so long
as such substitutions, in S&L's business judgment, are similar in quality to those listed in Exhibit B
4. CHANGE ORDERS
The work, labor, materials,and services called for in this Contract shall be strictly limited to that which is expressly
set forth in Exhibit A, attached hereto. S&L shall have no obligation whatsoever to perform or provide any
additional work,labor,materials,or services beyond that what is specifically detailed in Exhibit A,absent a written
Change Order that is signed by all Parties, and details said additional work and the additional payment/s for the
same. Such fully executed Change Orders shall become part of this Contract, subject to all of the terms,
limitations, and conditions set forth herein.
Notwithstanding the foregoing,this Contract is based on a visual inspection of the Worksite;therefore there may
be unforeseen conditions that cannot reasonably be recognized by visual inspection alone. If any such
unforeseen conditions become apparent after S&L commences the work, then S&L shall provide written Notice
to the Property Owner regarding the unforeseen condition and the anticipated costs to assess, cure, rectify, or
otherwise address the same. If Property Owner does not object to said Notice in writing within five (5)calendar
days of receipt, the Parties agree that S&L may presume that the Property Owner agrees to pay any and all
additional costs set forth in S&L's Notice,and the work detailed in said Notice shall become part of this Contract,
subject to all of the terms, limitations, and conditions set forth herein, and the additional costs shall be paid by
Property Owner on or before the next installment payment due date.
S. WORK SITE
Property Owner warrants and represents that he/she/they is/are the legal owners of the Property herein
described, that he/she/they is/are authorized to enter Into this Contract, that the Worksite meets all zoning
requirements,that the Worksite is safe,that there are no latent or patent hazards,and that the Worksite is secure
for S&L's equipment, materials,and the like.
Property Owner shall provide to S&L,without cost to S&L,a sufficiently sized and wholly secure room or area on
the Property for S&L to store materials and equipment for the Work. Property Owner shall assure that this room
or area is safe from theft,vandalism,weather, mold,third-party access, unauthorized use, deterioration,or other
risks. In addition to providing S&L keys to said secured area, Property Owner shall provide all necessary heat,
light, electricity,water, and other necessities.
6. PERMITS,APPROVALS,AND LICENSING
S&L has informed the Property Owner of any and all necessary permits,which S&L shall obtain in accord with
governing law. If the Property Owner obtains permits directly, Property Owner will be excluded from the
guaranty fund provisions of Mass. Gen. Laws,ch. 142A.
S&L shall comply with all state and local licensing and registration requirements for the type of work involved,
and hereby states that S&L holds the following: Massachusetts Unrestricted Construction Supervisors license
#094609; Massachusetts Home Improvement Contractor Registration #181012; and Massachusetts Lead Safe
Renovator Supervisors license# NAT-RV-1-966-15-05166,
7. NOTICE OF COMPLETION
Page 2 of S
Within ten (10)calendar days of the date the work called for hereunder is complete, Property Owner shall sign
a Notice of Completion.If the Property Owner fails to sign said Notice of Completion,and also fails to
document, within that same ten (10) day period,the reasons for its failure to sign said Notice,then the Parties
agree that S&L may presume that the Work was completed to Property Owner's full satisfaction,and S&L may
sign the Notice of Completion on the Property Owner's behalf.
8. COMPLIANCE Be INSURANCE
S&L shall provide the Services in a professional manner, and in compliance with all applicable federal, state and
local laws and regulations. S&L shall also maintain adequate insurance to cover the Work.
9. WARRANTY
S&L shall perform the work called for hereunder in a professional and workmanlike manner, and in accord with
generally acceptable standards in the community. S&L guarantees work against defects in workmanship and
materials for a period of one(1)year from the date the Work is completed, provided that Property Owner notifies
S&L in writing of such defects within thirty (30) calendar days after the date that the Property Owner knew or
should have known of the alleged defect. In such an event, S&L shall be afforded a reasonable opportunity to
assess and cure the defect.
10. INDEMNIFICATION&WAIVER OF CONSEQUENTIAL DAMAGES
Property Owner shall indemnify and hold S&L harmless for and against any and all claims, losses, liabilities, and
expenses, including actual attorneys' fees,that arise out of, In connection with, or because of(a) hazards at the
Worksite that S&L did not affirmatively create; (b) Property Owner's failure to secure the Worksite so it is
inaccessible to third-parties; (c) defects at the Property or Worksite; (d) inaccuracies in the plans, drawings, or
blueprints Property Owner provides to S&L; (e) Property Owner's failure to act with due care in preparing or
maintaining the Worksite and/or surrounding areas; and/or (f) Property Owner's negligence, gross negligence,
or willful misconduct.In no event shall S&L be liable for consequential damages.
11. FORCE MAJEURE
If performance of this Contract or any obligation hereunder is prevented, restricted, or interfered with by causes
beyond either Parry's reasonable control ("Force Majeure"), and if the party unable to carry out its obligations
gives the other party prompt written notice of such event, then the obligations of the party invoking this
provision shall be suspended to the extent necessary by such event. The term "Force Majeure" shall include
without limitation acts of God, fire, explosion,vandalism, storm, casualty, illness, injury, general unavailability of
materials or other similar occurrence, orders or acts of military or civil authority, or by national emergencies,
insurrections, riots, or wars, or strikes, lock-outs, work stoppages,other labor disputes, supplier failures, etc.The
excused party shall use reasonable efforts to avoid or remove such causes of non-performance and shall proceed
to perform with reasonable dispatch whenever such causes are removed or ceased.
12. NOTICE PER M.G.L.CHAPTER 142A
All contractors and subcontractors must be registered by the director and any inquiries about a contractor or
subcontractor relating to a registration should be directed to the director. For ease of reference, S&L's License
number is 181012. Further, the Property Owner may have a three-day cancellation right pursuant to Mass.Gen.
Laws,ch. 93 §48, ch.255D § 14,and/or ch. 140D § 10.The Property Owner also has the warranties and rights
provided for under Mass. Gen. Laws ch. 142A
13. MISCELLANEOUS PROVISIONS
Page 3 of 5
(a) Integration: This Contract contains the entire agreement between the Parties supersedes any and all
prior written or oral discussions and/or agreements.
(b) Severability: If any provision of this Contract are deemed invalid or unenforceable for any reason
whatsoever, all remaining provisions shall continue to be valid and fully enforceable.
(c) Amendment:This Contract may only be modified by a written instrument signed by all Parties hereto,
whether titled Change Order,Addendum, or otherwise.
(d) Governing Law and Venue:This Contract shall be construed in accordance with, and governed by the
laws of the Commonwealth of Massachusetts, and the venue shall be Franklin County, Massachusetts
(e) Notice: Any notice or communication required or permitted under this Contract shall be sufficiently
given if delivered in person, or by certified mail, return receipt requested,to the address set forth in the opening
paragraph or to such other address as one party may have furnished to the other in writing.
(f) Non-Waiver of Rights:The failure of either party to enforce any provision of this Contract shall not be
construed as a waiver or limitation of that parry's right to subsequently enforce strict compliance.
(g) Headings: The headings in this document are not intended to hold legal significance, but instead are
for organizational purposes only.
YOU MAY CANCEL THIS AGREEMENT IF IT HAS BEEN SIGNED BY A PARTY THERETO AT
A PLACE OTHER THAN AN ADDRESS OF THE SELLER, WHICH MAY BE HIS MAIN OFFICE
OR BRANCH THEREOF, PROVIDED YOU NOTIFY THE SELLER IN WRITING AT HIS MAIN
OFFICE OR BRANCH BY ORDINARY MAIL POSTED, BY TELEGRAM SENT OR BY
DELIVERY, NOT LATER THAN MIDNIGHT OF THE THIRD BUSINESS DAY FOLLOWING
THE SIGNING OF THIS AGREEMENT. PLEASE SEE THE ATTACHED NOTICE OF
CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT.
By signing below, I affirm that I (i) have read this agreement, (ii) understand every term, (iii) agree to be bound
by the same, (iv)have sought the advice of legal counsel or have knowingly declined to do so, (v)am authorized
to enter into this contract;and (vi)do so willingly and without any pressure or influence.
DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES
Property Owner's Signature Date
Printed Name:
Stokes& Lipski Construction,Inc. Date
By and through Anthony A.Stokes
Property Owner hereby acknowledges receiving a copy of this contract,fully executed by all parties.
Page 4 of 5
114
Property Owner's Signature Date
NOTICE OF CANCELLATION
Date of Transaction:
You may cancel this transaction, without any penalty or obligation, within three business
days from the above date.
If you cancel, any property traded in, any payments made by you under the agreement, and
any negotiable instrument executed by you will be returned within ten business days
following receipt by the seller of your cancellation notice, and any security interest arising
out of the transaction will be cancelled.
If you cancel, you must make available to the seller at your residence, in substantially as
good condition as when received, any goods delivered to you under this agreement; or you
may if you wish, comply with the instructions of the seller regarding the return shipment of
the goods at the seller's expense and risk.
If you do make the goods available to the seller and the seller does not pick them up within
twenty days of the date of your notice of cancellation, you may retain or dispose of the
goods without any further obligation. If you fail to make the goods available to the seller, or
if you agree to return the goods to the seller 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 Anthony Stokes, S&L Construction, 235
Greenfield Rd, Ste 5, South Deerfield, MA 01373, not later than midnight of the third day
after this contract.
I hereby cancel this transaction.
(Property Owner's signature) Date
Page 5 of 5
ACiI CERTIFICATE OF LIABILITY INSURANCE
93123/29,0.
THIS CERTIFICATE IS ISSUED ASA MATTER OF INFORMATION ONLYAND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EIITEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURERS),AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT. If the certificate holder Is an ADDITIONAL INSURED,the Polk,(Ies)must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED,subject to the burls and conditions of the polity,certain pollchis mi require an endorsement A sb Mon
this certlRcata does not confer rights to the corllRcats holder in lieu of such endorsement's).
PROWLER CONTACT Jovn TaYlIX,CIC
Blackmer Insurance Agern IInc RIoxE (413)625.852) °A 413 25-0210
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INSURED MSURER B. The COmmUU`BBSUUUARGc 34754
STOKES B LIPSKI CONSTRUCTION INC, WSURERC.
WSURER D:
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SOUTH DEERFIELD Ni 01373 IxsuRERF
COVERAGES CERTIFICATE NUMBER: Master 17-10 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEOABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT 411TH RESPECT TO WHICH THIS
CERTIFICATE MAYBE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
L. TYPE OFINBUMNCE INSDIBINAIDI POLICY NUMBER MM �iLp/IY�YY LIMnS
X COMMFRCNLGENEPALUABIHTY EACH OCCURRENCE S 1,W0WD
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CERTIFICATE HOLDER CANCELLATION
SHOULDANYOF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF NOTICE WILL BE DELIVERED IN
Wiliam Culler ACCORDANCE WITH THE POLICY PROVISIONS.
73 Vernon St
AUTHDRUEDREPRIESENTAUVE
NOBhampton MA 01060 ESP 0-I
9)1M--20155 ACORD CORPORATION. All rights reserved.
ACORD 25(20181p3) The ACORD name and logo are registered marks of ACORD
AC RO oe CERTIFICATE OF LIABILITY INSURANCE --(aNG.—
lh� 1 03/23/2018
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the pollGy(ies) must be endorsed. If SUBROGATION IS WANED,subject to
the terms and conditions of the policy,certain policies may require an endorsement. A statement on this cartificate does not colder rights to the
certificate holder in lieu of such endorsements.
PRODUCER SONTACT
NAME John Taylor
BLACKMER INSURANCE AGENCY INC
MIL
AGDaFss: john@blackmers.com
1147 MOHAWK TRAIL INSURERSAFFORDING COVERAGE
SHELBURNE _ .MA 01370 INSURERA: CONTINENTAL CASUALTY CO 1 .20413
WwREG -
INSURERS)_ _
STOKES & LIPSKI CONSTRUCTION INC InwNEac:
INSURER D:
235 GREENFIELD RD INSURER
S DEERFIELD MA 01373 1 MSURERR:
COVERAGES CERTIFICATE NUMBER: 250,432 REVISION NUMBER:
THIS Is TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED MOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS.
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
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Workers'COmponsation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authoduation is given to pay
claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts.
This certificate Of insurance shows the policy in force on Me date that this certificate was issued(unless the expiration date on the above policy predooles the
issue date Of this LarrEcate of insurance). The status Of this coverage can be monitored daily by accessing Me Proof of Coverage-Coverage Verification
Seamh tool at www.mass.govllw Mor em compensation/investiga6onsl.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
William Cutler ACCORDANCE WITH THE POLICY PROVISIONS.
73 Vernon St
AUTRORESDREMESE"TATIvE
Northampton MA 01060 Daniel M.Crawley,CPCU,Uce President-Residual Market-WCRIBMA
®1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD