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31A-034 WORK SCHEDULE on r c r wil not begin the work or order the materials before the third day following the signing of this Agreement, unless specified ' .. ontractor will begin the work on or about (date). Barring delay caused by circumstances beyond Contractors control, the work will be completed by ate). The Owner hereby acknowledges and a ees that the scheduling dates are approximate and that such delays that are not .avoidable by the Contractor including, ut no limited to strikes, Acts of God, shortages of materials, accidents, and all other delays beyond its control, shall not be considered as violations of this A reeme �i () WARRANTY ml The Contractor warrants that the work furnished hereunder shall be free from defects in materials and workmanship for a period of following completion and shall co y with the requirements of this Agreement. In the event any defect in workmanship or materials, or damage caused by the Contractor, its sub nt tors, employees or agents, is discovered after completion of any job, Including cleanup, the Contractor shall, at its own expense, forthwith remedy, repair, correct, replace, or cause to be remedied, repaired or replaced, such damage or such defect in materials and workmanship. The foregoing warranties shall survive any inspection performed in connection with the agreed -upon work. YHI agrees to perform the work, furnish the material and labor specified above for the total sum of:) i Lt Ci U % ($ Lt ('; 0 ) upon signing contract; Name of Representative 91Z ivt ,. Authorized Signature 44 11L4'V-fral ($ ) upon completion of f / 173 G �� %($ 4' k _ L' 3 e ) upon completion of __ (�, /4, Notice: No agreement for home improvement contracting work shall require a down payment (advance / ✓✓✓ V Y /3 deposit) of more than one -third of the total contract price or the total amount of all deposits or payments ($ 000 V ) Shall be made forthwith upon which the contractor must make, in advance, to order and/or otherwise obtain delivery of special order completion of work under this contract. materials and equipment, whichever amount is greater. Acceptance of Proposal I have read both sides of this document and accept the prices, specifications and conditions stated. I understand that upon signing, this proposal becomes a binding contract. You are authorized to do the work as specified. Payment will be made as outlined above. 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 refer to the Notice of Cancellation below contents of which are referred to above and incorporated herein by reference. DO OT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. A 3 Signature A T , I _ //I _ h ; 5° Date Signature Date or 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 CONTRACT OR SALE, 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. 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: YANKEE HOME IMPROVEMENT, INC., 82 INDUSTRIAL DR., NORTHAMPTON, MA 01060 NOT LATER THAN MIDNIGHT OF ' h / 1 3 I HEREBY CANCEL THIS TRANSACTION (Date. Su ays and lidays excluded) BUYERS SIGNATURE DATE Buyer(s) acknowledge receipt of two comple -1 filled in copies of this notice on the date first above written hereof. Buyer's Signature A / / - .l 1 /, L _____ Buyer's Signature ( o3 utters/Attic Barrier Agreement 1 I t 1 Thousands of Satisfied YANKEE 82 Industrial Drive MA Lic# 160584 225 Cedar Hill St, Suite 200 N orthampton, MA 01060 CT Lic# 0673924 Marlborough, MA 01752 HOME 1 M, P R Q V Q E T 413 341 -5259 RI Lic # 33382 877 88- YANKEE The MOST Referred Contractor All home improvement contractors and subcontractors must be registered and any inquiries in New England about a contractor or subcontractor relating to a registration should be directed to: Office of Consumer Affairs and Business Regulation Ten Park Plaza, Suite 5170 www.YankeeHomelnc.com Boston, MA 02116 Phone: (617) 973 -8700 i Date i / ) / i3 ,, J Homeowner Information �� Name f -141 ` L./WHOA Street Address 7 QKLj J 1 Cit 0b1111 14 /y�A t tatefl4 Home Phone £Work Phone Cell Phones. , 0 E -Mail rig Lear nior) e Mailing Address (If different) C'I'Ah -P The Contractor agrees to do the following work for the Homeowner Construction Texts Nes ❑No I ROOFING T pe �/ I y(C? Color /Lep Style C;at-l$�D Pot ?C1 Removal of Existing Roofing es No 3 imy6t2r5 Ice and Water Barrier 'Full ❑ Partial Removal of Garage Roofing Yes M O Ridge Vents ❑No Dumpster Wes ❑No Replace Sheathing Wes es ❑No Sheets Incl. A L'L' 111 Main House Roof Yes ❑No Price per sheet (a as needed ) Garage Roof ■Yes L fio Rolled /Low Slope OYes �lo Front Porch Roof %''' Jo Location Rear Porch Roof ❑Yes No . / Fleshings 1Yes ❑No Drip Edge XYes ❑No Color i+,6}•1117G Location _ ' Li, W PO iii -- (Gf rni) y At." 5 Alf_ GUTTERS Color Downspouts Col - Layout Attached ❑Yes ❑N • ❑ Residential 5in ❑ Commercial 6in Gutter Protection ❑ ❑No Downspout ❑ - -sidential ❑ Commercial Type Garage ■ es ❑No Location Porch ❑Yes ❑No Color ATTIC ENERGY B - - RIER BLOWN -IN INSULATION ❑ Rafter Install ❑ Floor Install ❑ •.en Attic Blow Kneewall It es ❑No • Net Blow Walls • ' es ❑No Area to be c - - red by homeowner ❑Yes ❑No Kneewall ❑Yes ❑No Type exterior Cladding Special Instructions / T .5 a al Le '*.: 44 - 41 -_. _ J!_ ' -, 'f _ S nfilWillP ' .) I= gir [ . it ',tit__ ie S WORK SCHEDULE Cony.° r begin the work or order the materials before the third day following the signing of this Agreement, unless specified ,. - ;. f ontractor will begin the work on or about g / L � (date). Barring delay caused by circumstances beyond Contractors control, the work will be completed by _ £ lal •ate). The Owner hereby acknowledges and a ees that the scheduling dates are approximate and that such delays that are not avoidable by the Contractor including, eut nor limited to strikes, Acts of God, shortages of materials, accidents, and at other delays beyond its control, shall not be considered as violations of this Agreeme p /. v� WARRANTY W i C' i 6 `/ �L� ��l�.u ' ° ' - i The Contractor warrants that the work fumished hereunder shall be free from defects in materials and workmanship for a perio of following completion and shall co . y with the requirements of this Agreement. In the event any defect in workmanship or materials, or damage caused by the Contractor, its sub nt ors, employees or agents, is discovered after completion of any job, Including cleanup, the Contractor shall, at its own expense, forthwith remedy, repair, correct, replace, or cause to be remedied, repaired or replaced, such damage or such defect in materials and workmanship. The foregoing warranties shall survive any inspection performed in connection with the agreed -upon work. YHI agrees to perform the work, furnish the material and labor specified above for the total sum of: I 1 14 t - 0 l � o Name of Representative 6( V �A t iii t l A.l Z _/7 / ($ � 'T a� � � 1 upon sionina con P S : , i. , , inueicHuwa nrE nerello Waste 5 rice .,:,„,p, 1 Service ,1,,i,, eva CALL: • ,b0 ' roalnor:, em sERv'EE 612 • (c,-unta Loi R FAS • C Us __er Lo‘41 • Cust°"' Waste . st!R FO3) T453 2, Reliab • " II: ii". ::', ''' (4 Fast 4.x.7 - .-----'- It'' R . ‘9,- ---,..'—a-"L----'-" ---''''' 4 : ' ' ' ...„, , ,. ,.,„ ,......,......_ .1( ''''''' --"—.7 r-----7 i , .17 , . ; ....., ;,..,,,,_...7...,--i.„.„.:.:;,K ; 2. ,--1 i .. , . f. is" i -__7-7, , . f., R-.6 -=T',-;-...::.if.:,..-,.._: i , . I • ft ' E A , 21.: ,ir's,,„..:.:.• . , ,,,,,-... 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''''.7' . - • ''' . , - " '..‘: . , , „ ' • rt-,54.Ft' ' , V ' '-' "' ak respo . 1119 .,,_ '.•.' ,.,..';,i,--.....:,°,4'''. •' .. 21- V Quic e_titive pric V comP . =.-. .„'-'-' ,,,.''. .. ., „ . . -- - -- FNCE _.„ ' . , ., „.„.. .., -1 :.v...'.. •'''''''' ''' PXPE1-' ld' ' ''''''''' "' RS - --ie Isla/. _ <,4Area! 0 y EA7 s.n,inctiek. te.cmrt__m _ . ....sk 1 ...; orine,,,,rtu Ar I ,..... VIVIEN nere111:1 vvvli 4.rt"m in „ „, 1 ,..,at • ), 1 , rO, ' h er , Weat Local " °F ( °F) Or-- A ddress T,UPIP L g 4 1.Vealbc■ dma I Our n — :‘,..,z..4 `, ' ,-,,, : 'T.,: . - - )012 9:48 AM j. Tin -e reit° Waste street i 1-- L3‘--. - -. ..,$ - centurY 0 1 00 1 e'') 1 3 2 ,,m mA A o aw ''' Phone p & Local 3 j? 1 / ( 413 ) 455-1"2 The Commonwealth oflMlassachusetts Department of Industrial Accidents !'�f Office of � a _,ilfl= '� 6110 Washington Street iii:= � Boston, MA 02111 7 .., www.mass gov /dfa Workers' Compensation Insurance Affidavit: Builders/ Contractors /Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization /individual): 'S 4&JKEE 1 l‘21MS .rMPQCNE..A/1 &" Ill T • Address: 8 2 2 ALT) ii5 T 2 t A. L .2o Q./ V ii City / State /Zip: i\ORT1- 141MI PT© hi , PiA . 01060 Phone .#•: 4 4-/3 -13'-ii- i - 5 2 S 9 Are you an employer? Check the appropriate box: Type of project (required): 1. I am a employer with �a contractor 4. 0 I am a general conctor and I have hired the sub - contractors 6 . 0 New construction employees (fidi and/or pant - time). * 2.0 I am a sole proprietor or partner- on the attached sheet 7. Remodeling ship and have no employees These sub - contractors have g. 0 Demolition working for me in any capacity. employees and have workers' [No workers' comp. insurance COn insurance.: 9. 0 Banding addition required] 5. 0 We are a corporation and its 10.0 Electrical repairs or additions 3.0 1 am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.] t c. 152, § 1(4), and we have no employees. [No workers' 13.0 Other comp. insurance required.) 'Any applicant that checks box #1 mist also fill out the section below showing their worker' compensation poky information. 1. 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 subcontractors and state whether ornot those entities have employees. if the sub - contractors have employers, they must provide their workes' comp. policy number. Jam an employer that is providing workers' compensation insurance for my employees .Below is the policy and fob site information. Insurance Company Name: th 'A h1 / Ti= 5 TZ9 TN' 3!u SOli2.QA!L Z 0.131 9 ,411Y Policy # or Self -ins. Lic. #: 6 16 /B - SBSiJ 7' —14--i2 Expiration Date: /D- 2 - 2 i.3 Joh Site Address: 7 FR AAJKL I N STxZEE' T City / State /Zip: NDRTTAMPFDAt, MA, 01060 Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and /or one -year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to 5250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. s do hereby certify u the pains and penalties o_fperjury-thatihrinformittiO n-provided above is true and correct Signature: Date- Phone #: i-[3 341 - 52_59 - 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 l 6. Other .f Contact Person: Phone #: J j SECTION 8 - CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder : �"�`�' 'VAN C 5 eF3' 4- Z License Number Z IILWD115TR(AL IV R774WMPTCJAJ AfA ., U /U6, U 5--(9- 20th Address �j7 - -_ Expiration Date ' /1' �Y / // 13 3'+1 -52 59 Signa re Telephone 9. Registered Home Improvement Contractor: Not Applicable ❑ Y,4Rl KEE' 140 ME .Z:MPRO V E /V /EAl 7" / GO -5 Company Name • Registration Number £ 2 TAUT J5 TRIAL-7 2 . A MT?l?T ,.4PrZ)111 MH - GJ /0 F D 8 - 7- ZO/ 4t- Address Expiration Date Telephone N l3 °3t/ -5 2 59 SECTION 10- WORKERS' COMPENSATION INSURANCE AFFIDAVIT (M.G.L. c. 152, § 25C(6)) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed Affidavit Attached Yes lli No ❑ 11. - Home Owner Exemption The current exemption for "homeowners" was extended to include Owner- occupied Dwellings of one (1) or two(2) families and to allow such homeowner to engage an individual for hire who does not possess a license, provided that the owner acts as supervisor. CMR 780, Sixth Edition Section 108.3.5.1. Definition of Homeowner: Person (s) who own a parcel of land on which he /she resides or intends to reside, on which there is, or is intended to be, a one or two family dwelling, attached or detached structures accessory to such use and/ or farm structures. A person who constructs more than one home in a two -year period shall not be considered a homeowner. Such "homeowner" shall submit to the Building Official, on a form acceptable to the Building Official. that he /she shall be responsible for all such work performed under the building permit. As acting Construction Supervisor your presence on the job site will be required from time to time, during and upon completion of the work for which this permit is issued. Also be advised that with reference to Chapter 152 (Workers' Compensation) and Chapter 153 (Liability of Employers to Employees for injuries not resulting in Death) of the Massachusetts General Laws Annotated, you may be liable for person(s) you hire to perform work for you under this permit. The undersigned "homeowner" certifies and assumes responsibility for compliance with the State Building Code, City of Northampton Ordinances, State and Local Zoning Laws and State of Massachusetts General Laws Annotated. Homeowner Signature SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable) New House El Addition ❑ Replacement Windows Alteration(s) ED Roofing MI Or Doors 0 Accessory Bldg. 0 Demolition El New Signs [r] Decks [I] Siding [0] Other [❑] Brief Description of Proposed Work: 5 AND 7tEPLACC ? D S 4 // I r oLE' Alteration of existing bedroom Yes No Adding new bedroom Yes X No Attached Narrative Renovating unfinished basement Yes )C No Plans Attached Roll - Sheet sa. If New house and or addition to existing housing, complete the following: a. Use of building : One Family Two Family Other b. Number of rooms in each family unit: Number of Bathrooms c. Is there a garage attached? d. Proposed Square footage of new construction. Dimensions e. Number of stories? f. Method of heating? Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction i. Is construction within 100 ft. of wetlands? Yes No. Is construction within 100 yr. floodplain Yes No j. Depth of basement or cellar floor below finished grade k. Will building conform to the Building and Zoning regulations? Yes No . I. Septic Tank City Sewer Private well City water Supply SECTION 7a - OWNER AUTHORIZATION - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT l �tA iZC Y LRIZNl Ok/ , as Owner of the subject property hereby authorize YA1dKEE 1 Is Z 4RROVE'MCNL T to act on my behalf, in all matters relative to work authorized by this building permit application. OA/ A TIZ.AC T Signature of Owner Date GE 7ZOAJAM - Aip M!2 TJ'/ PROYEI'/E■f T , as Owner /Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief. Signed under the pains and penalties of perjury. CE:e_i4/ D KnA/AAl -- Print Name Signature of Owner /Agent 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 Size Frontage Setbacks Front Side L: R: L: R: Rear Building Height Bldg. Square Footage Open Space Footage (Lot area minus bldg & paved parking) # of Parking Spaces Fill: (volume & Location) A. Has a Special Permit /Variance /Finding ever been issued for /on the site? NO 0 DONT KNOW YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO ® DONT KNOW J YES 0 IF YES: enter Book Page and /or Document # B. Does the site contain a brook, body of water or wetlands? NO 0 DON'T KNOW tif,t, YES O IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Q Obtained ® , Date Issued: C. Do any signs exist on the property? YES Q 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 cEc) 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 Q NO tit IF YES, then a Northampton Storm Water Management Perrnit from the DPW is required. --- ---`�� Department use only Fliiid City of Northampton of'Pemtit Building Department Curb etrdPrbieway : atm 42 u - 212 Main Street -Sewer/SeptioAvailability Room 100 , Water/Well Avakbility DEPT. OF BUILDING INSPECTIONS orthampton, MA 01060 Two Sets of Structural Plans NORTHAMPTON MA 01 3- 587 -1240 Fax 413 - 587 -1272 Plot/Site Othef Spetgj+ APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 - SITE INFORMATION 1.1 Property Address: This section to be completed by office 7 F - kiA(k.lkL/JV 57 T Map Lot Unit /C1Q1PTHAA7F ILI , An • O /0/v© Zone Overlay District Elm St. District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: MAFZC Y LA l./ 7F724AJ /ZL /4J ST M2R77- 1AMPTOM . MA Name (Print) Current Mailing Address: '-H 3 5 F_:i `i `j tF ( /)A/ C1JA/Ti A.0 T Telephone Signature 2.2 Authorized Agent: 7AW(.F'F (-LOME EMS DVEME4.[T CaERA/QD 1JUUAL/- R2.2 JDUSTRIC3L eV627T44P" /P/ZXJ, MQ Name (P _ — - - -Currant Mailing Address: /3- _' AL/ —5 Sig ature Telephone SECTION 3 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only completed by permit applicant 1. Building r 1 -- t -9 (a) Building Permit Fee K 3 5 . CEO 2. Electrical (b) Estimated Total Cost of Construction from (6) 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection 6. Total = (1 + 2 + 3 + 4 + 5) 14- , H-90 Check Number 949, This Section For Official Use Only Date Building Permit Number: Issued: Signature: Building Commissioner /Inspector of Buildings Date 7 FRANKLIN ST BP- 2013 -0732 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 31A - 034 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: ROOF BUILDING PERMIT Permit # BP- 2013 -0732 Project # JS- 2013- 001246 Est. Cost: $14490.00 Fee: $35.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: YANKEE HOME IMPROVEMENT INC 89442 Lot Size(sq. ft.): 10018.80 Owner: LARMON MARCY JANE Zoning: URB(100)/ Applicant: YANKEE HOME IMPROVEMENT INC AT: 7 FRANKLIN ST Applicant Address: Phone: Insurance: 82 INDUSTRIAL DR, UNIT 2 (413) 584 -8318 WC NORTHAMPTONMA01060 ISSUED ON:1/30/2013 0:00:00 TO PERFORM THE FOLLOWING WORK:STRIP & SHINGLE ROOF POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Service: Meter: Footings: Rough: Rough: House # Foundation: Driveway Final: Final: Final: Rough Frame: Gas: Fire Department Fireplace /Chimney: Rough: Oil: Insulation: Final: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occupancy Signature: FeeType: Date Paid: Amount: Building 1/30/2013 0:00:00 $35.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Louis Hasbrouck — Building Commissioner