Loading...
30C-010 ($ 7000 )upon signing contract; Name of Representative i j� C-( Authorized Signature I %($ )upon completion or le#:- '%o(8 )upon completion of To . Notice:Na 4groo of for home improvement contracting work ahall require a down payment(advance depoelt)of more then one-third of the total contract mice or the total amount of at deposits or payment's (8 !!! }shall be made forthwith Upon rrl whioh the contractor must make,In advance,to order endlor otherwise obtain delivery of special order completion of work under this contract, materials and equipment,)tbicltwyr amvypt is greeter, 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 ou uutliried 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 NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. Signature . ., . 2 . - ,/. . . Pr--7G S-43 Signature Date NOTICE OF CANCEL LATION 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 NOME IMPROVEMENT, INC., 82 INDUSTRIAL DR., NORTMAMPTO MA n, N()T I ATFR THAN MIMIC:NT O �df ` �rr�`f I HEREBY CANCEL THIS TRANSACTION (D■te.Sunday and hd a> utled) BUYERS SIGNATURE DATE Buyer(s)acknowledge receipt of two completely filled in copies of this notice on the date first above written hereof. 41 ii Buyer's Signature f . w AL-ma. ' . 4.� Buyer's Signature ........... • Roofing/Gutters/Attic Barrier Agreement I III ', Thousands of Satisfied Clients! YANKEE t \ ! 82 Industrial Drive MA Lic#1605$4 225 Cedar Hill St, Suite 200 Northampton, MA 01080 CT Lic#0673924 Marlborough, MA 01752 NOME ! M P R O V E= M E N T 413 341-5259 RI Lic#33382 $77 88-YANKEE The MOS I Referred Contractor All home improvement contractors and subcontractors must be registered and any inquiries ill 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 Hur t uwttetr Inf rmation Name tti bulk/ke 4(‘reet Address V3 f "Aibreifiel, City •' 4Rt ' ' Sta Zip (11/660 Home Phone `1' /7i7 Work Phone- Cell Phone E-Mail Mailing Address (If different) The Contnirtor agrees to do the folloislnj Ivor*for the Homeowner LROOFINO Type *L// Color t Style„___Ad `f1"/l a L., Removal of Existing Roofing Plea ❑No Ice and Water Barrier ('Full El Partial Removal of Garage Roofing s ❑No Ridge Vents IRfes ❑No Dumpster es ❑No Replace Sheathing ❑Yes p(9.- Sheets Incl. -""r Main House Roof es ❑Ne Pricy per sheet 2S (as needed) Garage Roof es ❑No Rolled/Low Slope ❑Yes ❑No Front Porch Roof es ❑No Location �,�/ Rear Porch Roof s ❑No Fleshings pies ❑No Drip Edge gRes ❑No Color lAjkill Location itifrAte /�10CCo [GUTTERS Color Downspouts Color Layout Attached ❑Yes ONo 01 Residential Sin ❑ Commercial bin Gutter Protection ❑Yes OW Downspout ❑ Residential ❑ Commercial Type Garage ❑Yes ©No Location Porch • ❑Yes ❑No Color [ATTIC ENERGY BARRIER BLOWN-IN INSULATION © Rafter Install ❑ Floor Install ❑ Open Attic Blow Kneewall Dives ❑No ❑ Net Blow Walls ❑Yes ❑No Area to be cleared by homeowner ❑Yes ONO Kneewall ❑Yes ❑No Type of exterior Cladding Special Instructions •T i SC DULE - . . Ill not begin the work or order the materials before the third day following the signing of this Agreement, unless Spa hkt .Contractor will begin the work on or about ji (date).Barring delay CauSed by Circumstances beyond Contractor's control,the work will be Completed b +',J (date).The Owner hereby acknowledges and a• 'e at the scheduling dates are approximate and that such delays that are not avoidable by the Contractor Includng, b load to strikes, Acts of God, shortages of mate als,accidents,and all other delays beyond Its control,shall not be considered as violations of this Agreement, WARRANTY ff��� The Contractor warrants that the Work furnished hereunder shall be free from defects in materials and workmanship for a period of L7(/ /S—following completion and shall comply with the requirements of this Agreement,to the event any defect to workmanship or materials,or damage caused by the Contractor,its Subtontractors.employees or agents,is discovered after completion of any job, Including cleanup,the Contractor shell,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 te greed-upon work. YHI agrees to perform the work,furnish the material and labor specified above for the total sum of: 1 r3671 .,. ti 54 7 ,1 / • ���z ,z;rrc Net i�S1 Tit,�q5, 1Th LAW o CITY O F A rril. BUILDING INSPECTION DEPARTMENT Construction Debris Affidavit In accordance with the provisions of MG.L. c. 40 § 54, all debris resulting from any work covered by a Building Permit shall be disposed of in a properly licensed disposal facility, as defined by M.G.L. c. 111 § 150A. Address of Work: 4- p ' The debris will be transported by: T T i /T 1 ) % 'i;_-> The debris will be received at: D / Is d i ,c1 ' ' I AM FAMILIAR WITH THE REQUIREMENTS OF 310 CMR 7.09, AND I HAVE MADE PROPER NOTIFICATION TO ALL FEDERAL, STATE, AND MUNICIPAL AUTHORITIES HAVING JURISDICTION. :.nature of Permit Applicant P--7153 -t J Date Building Permit Number: CITY HALL, 70 ALLEN STREET, PITTSFIELD, MA 01201 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): 7 tn/fGL "T;E►RUv J-/r, Address: `d.. 2 cA City/State/Zip: do) ..* & I c, 1 Phone# Are you an employer? Check the appropriate box: Type of project(required): I. am an employer with 4.—I am a general contractor and I 6. _New Construction employees(full and/or part-time)* have hired the sub-contractors Remodeling 2. I am a sole proprietor or partner- listed on the attached sheet. I — ship and have no employees These sub-contractors have • 8. _Demolition working for me in any capacity. employees and have workers' 9. _Building Addition [No workers' comp.insurance comp. insurance. 10. Electrical repairs or additions required.] 5. -- We are a corporation and its 11 Plumbing repairs or additions 3. _I am a homeowner doing all work officers have exercised their myself. [No workers' comp. right of exemption per MGL 12. _Roof repairs insurance required.]t C. 152, ' 1(4),and we have no 13. _Other employees. [No workers' comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. H Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. I Contractors that check this box must attach an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees.If the sub- contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: oNii 'F 1--.4-4,5t4 rrn. •.x; Z c Policy#or Self-ins. Lic. #: 61, j4j .`j 501 951 Expiration Date: 10-2-13 Job Site Address: 9 _ (1.04L.,40_ City/State/Zip: iJa 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 S1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under th' 'dins and penalties of perjury that the information provided above is true and correct Signature: - "`°-° =_.,- Date: 7_) _1L3 Phone#: Official use only. Do not write in this area,to be completed by city of town official. City or Town: _— 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#: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) C 5 S 9 4,4 2 3-P3- 2014 GE RATRD MA I Atli License Number Expiration Date Name of CSL Holder List CSL Type(see below) 410 E12. IN.D[15 TR/ft L 2D/'iVt. No.and Street Type Description lOA?!'HA I�9 PTD�1/.MASS. O/Ofo 0 U Unrestricted(Buildings up to 35,000 cu.ft.) R Restricted 1&2 Family Dwelling 667PRY 0/2 City/Town,State,ZIP M Maso NA Ili CYr f a RC Roon Covering /G/4./AZURE WS Window and Siding SF Solid Fuel Burning Appliances 44/3-34/-5259 I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) F p58 8-7-26/4 YANKEE" - ME Zit/IPeOVEMEAi r HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name 82. NDiJS 7-XI . .Zo 2/t/E No.and Street Email address Not2THf+MPTD MA55 06.6 W3-34/--5ZS5 y/Town,State,ZIP Telephone SECTION 6:WORKERS' COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152.§ 25C(6)) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the Issuance of the building permit. Signed Affidavit Attached? Yes �( No .❑ SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1,as Owner of the subject property,hereby authorize YA NKEE- /-bDME =I•ME VE-AdrEtki'T to act on my behalf,in all matters tel ive to work authorized by this building permit application. nN CCMJ TIZACT .7-- ) Print Owner's Name(Electroni attire) Dat SECTION 7b:OWNER' OR AUTHORIZED AGENT DECLARATION By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information ;ERRY OR co in this application is true and accurate to the best of my knowledge and understanding. �f/killt'/'5 /VATURE� int Owner's or Authorized Agent's Name(Electronic Signature) Date NOTES: 1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration program or guaranty fund under M.G.L.c. 142A.Other important information on the HIC Program can be found at www.mass.gov/oca Information on the Construction Supervisor License can be found at wwvw.mass.gov.r/dps 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) (including garage,finished basement/attics,decks or porch) Gross living area(sq.ft.) Habitable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of half/baths Type of heating system Number of decks/porches Type of cooling system Enclosed Open 3. "Total Project Square Footage"may be substituted for"Total Project Cost" • 1 = ECEIVED .� at( tc)ST r JUL 1 P 2013 9.,/ /', G�.....„,_ d DEPT.0,Lla.. ::0id5 NonitiA:�:= o.:, ++1,.0,060 The Commonwealth of Massachusetts FOR —I Board of Building Regulations and Standards MUNICIIPALITY 1,'\.I 'f! Massachusetts State Building Code, 780 CMR :1. USE Building Permit Application To Construct, Repair, Renovate Or Demolish a Revised Mar 2011 One-or Two-Family Dwelling This Section For Official Use Only Building Permit Number: Date Applied: Ale 4,0'1:7- m- 7-1875 Building Official Print Name) ' Sib-r ure Date y.g.- 6,0a44ut. SECTION 1:SITE INFORMATION 1.1 Propert Address: 1.2 Assessors Map&Parcel Numbers Li 53-- .49, , . 1.1a Is this an accepted street?yes ono Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public CI Private CI Zone: Outside Flood Zone? Municipal❑ On site disposal system ❑ Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: _C O u'.\.■ 1,-e. tt. 1 R j LL, S 14}ANC,,Al\-a. INVA Name(Print) City,State,ZIP - 5-5 !Le&ec. ' .t i ': 17'/ffifficc No.and Street Telephone Email Address SECTION 3: DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction❑ Existing Building❑ Owner-Occupied ❑ Repairs(s) ❑ Alteration(s) ❑ Addition ❑ Demolition ❑ Accessory Bldg.❑ Number of Units Other ❑ Specify: Brief Description o Proposed Work': M - R*K--1 - SECTION 4: ESTIMATED CONSTRUCTION COSTS Estimated Costs: Item Official Use Only (Labor and Materials) 1. Building $ 9,5";3 d D 1. Building Permit Fee:$ Indicate how fee is determined: ❑Standard City/Town Application Fee 2. Electrical $ ❑Total Project Cost'(Item 6)x multiplier x 3. Plumbing $ _ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5. Mechanical (Fire $ Total All Fees:$ Suppression) Check No. Check Amount: Cash Amount: 6.Total Project Cost: $ �t (`7 b ❑Paid in Full ❑Outstanding Balance Due: 455 FLORENCE RD BP-2014-0054 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 30C-010 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-2014-0054 Project# JS-2014-000123 Est.Cost: $25300.00 Fee: $35.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: YANKEE HOME IMPROVEMENT INC 89442 Lot Size(sq. ft.): 47175.48 Owner: BOUTHILETTE PHYLLIS R Zoning: SR(100)/WSP(52)/ Applicant: YANKEE HOME IMPROVEMENT INC AT: 455 FLORENCE RD Applicant Address: Phone: Insurance: 82 INDUSTRIAL DR, UNIT 2 (413) 341-5259 () WC NORTHAMPTONMA01060 ISSUED ON:7/18/2013 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 7/18/2013 0:00:00 $35.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner