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18D-029 I riot IIfin j!t " C:>J - Roofing, Propozal - "-'t © m I +o OU I CT.REG. No.0621848 T ]���� � ge� of Pages MA REG. No. 162058 v HOME IMPROVEMENT 2003 RIVERDALE STREET WEST SPRINGFIELD,MA 01089 aW �'Ellte" Toll Free:1-888-597-2$23•Local:413-382-0249 FAX:413-382-0241 Proposal Submitted To Homeowner Work To Be Performed At Name r 1 �' A+t CQ 14 1'rl ,0. Name _ Street M« L`. �;���. Stree City 1�p�Cl °mot. DID State Zips City State_Zip_ Date 1 " )q Telephone ��j6L}05ZC� Date Telephone. Vista Home Improvement agrees to do the following: Acquire all permits for roofing work Material Location Shingle Over J Tear Off L l Main House ❑Garage LI Shed OSupply Dumpster-Location_ LJ Inspect Decking for damage L1 Replace Decking @ per sheet LJ Install all New Decking-Type Q– ___--per sheet Roofing MFG Color Style _ White/Brown drip edge U F-8 Lj F-5 L]Deck Underlayment U#15 Felt ❑Rhino Liner Ll L]Ice and water Barrier U 3' LJ 6' L)Full Lj Flash all valleys,penetrations,eaves and chimneys LJ Supply and install pipe boot flashing LJ Supply and install ridge vent U Generic L]Cobra Exhaust L1 Supply and install vent kit L]Supply and install soffit vents- Qty. C l R&R Gutters L]Total Job Clean-Up ❑Supply and install 12 in,lead on chimney WARRMITY vk L]Standard System Plus U Golden Pledge Attention Homeowners:Please cover all personal belongings in the attic,garage,or storage areas due to the possibility of roofing debris or dust coming throught the cracks of the wood.Vista Home improvement will not be responsible for debris or dust In the areas mentioned.Also Vista is not responsible for gaps from siding on home and roof line due to multi layer strips. U Roiled/Rubber Roofing Type _-_ Color Location Other: All material is guaranteed to be as specified.All work to be completed in a workmanlike manner according to standard practices.Any alteration or deviation from the above specifications must be made in writing on an Add-on/Modification of Contract form and may become an extra charge over and above the amount stated herein.This agreement is contingent upon delays beyond our control.Owners to carry fire,tornado and other necessary insurance.Our workers are fully covered by Workmen's Compensation Insurance.Homeowner agrees to pay for all work as set forth below.If the homeowner defaults,homeowner agrees to pay all costs of collection,including reasonable attorneys fees,in addition to other damages incurred by contractor.An 18%per month service charge will be assessed for all payments not made within 10 days of due date per the schedule below: We propose hereby to iurnish material and labor-complete i cordance with,14 above specifications,f rthe surn of: l r Ci — Said amount shall be paid as follows: Note:This proposal may be withdrawn by us if not accepted within days. YOU,THE BUYER,MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY AFTER THE DAY OF THIS TRANSACTION.SEE THE ATTACHED NOTICE OF CANCELLATION FOR AN EXPLANATION OF THIS RIGHT.(SATURDAY IS A LEGAL BUSINESS DAY IN CONNECTICUT.)THIS SALE IS SUBJECT TO THE PROVISIONS OF THE HOME SOLICITATION SALES ACT AND THE HOME IMPROVEMENT ACT.THIS INSTRUMENT IS NOT N IA, Signature of Contractor or authorized representative:_. have read the terms stated herein,they have been explained to(me/us),and(I/We)find them to b factory an c them. Signature of Homeowner(s): HOME IMPROVEMENT August 21,2014 Ron Karakula 10 Damon Road Northampton, Ma Addendum A Strip roof of existing layers of roofing shingles and dispose of debris on home. . Supply and install aluminum drip edge f8 Supply and install ice and water barrier to code Supply synthetic underlayment on remaining decking Supply and install new pipe boots and seal with geocel sealant Supply and install cobra rolled ridge vent. Seal cap nails with geocel Supply and install GAF Timberline High Definition Architectural shingle with lifetime warranty on material and labor REMOVE AND REINSTALL GUTTER SYSTEM Total Job Clean Up LIFETIME WARRANTY ON MATERIAL AND LABOR COMES WITH GAF SYSTEM PLUS WARRANTY Includes labor material disposal(dumpster on site)permits and taxes $7,342.00 Terms are 500 down 1/3 on start and balance on completion. . . . . . . . . . . . . . . . . . . . . . . . . . . . 2003 Riverdale Road,West Springfield MA 010. 89-Phone: (413)382-0249 Fax: (413)382-0241 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations I.1 _-- .1 ;�1 I Congress Street, Suite 100 Boston, MA 02114-2017 - www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/individual):VISTA HOME IMPROVEMENT/BRIAN RUDD Address:2003 RIVERDALE ST. City/State/Zip:WEST SPRINGFIELD, MA 01089 Phone #:413-382-0249 Are you an employer?Check the appropriate box: Type of project(required): 1. ✓❑ I am a employer with 9 4. ❑ I am a general contractor and 1 6 ❑ New construction employees (full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g, ❑ Demolition working for me in any capacity. employees and have workers' [No workers' comp. insurance comp. insurance.: 9. Building addition required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] t c. 152, §1(4), and we have no employees. [No workers' 13.❑ Other comp. insurance required.] "Any applicant that checks box 41 must also fill out the section below showing their workers'compensation policy information. i.Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'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:SOUTHWICK INSURANCE Policy# or Self-ins. Lic.#:JUB2E072183 Expiration Date:03/1212015 Job Site Address: t 0Da..v^.yt City/State/Zip: �N h I, M/� pl-qet) 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$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 the pains and penalties of perjury that the information provided above is true and correct Signature: Date Phone#:413-382-0249 Official use only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone#: SECTION 8-CONSTRUCTION SERVICES 7 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder: A, qa6ca L�A 10 W i�j"-0 License Number Address Expiration Datel Signatur Telephon 9. Registered Home Improvement Contractor:/ Not Applicable Vt5 Vz". tY 1 Y d,— 0 L 0'?,I >t"f( Company Name �— Registration Number 'Zooms C'' -&O-u 5 11 b�of 1 y Address Expira on Ddte . Tfv1 ( (� '�� Telephone(q 3 Y SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152,§25C(S)) 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 build' g permit. Signed Affidavit Attached Yes....... 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 buildine 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 ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ✓❑ Or Doors 171 Accessory Bldg. ❑ Demolition ❑ New Signs [[3] Decks [M Siding[0] Other[a Brief Description of Proposed Work: Strip exisitng shingles and underlying components and replace with new materials. Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet 5a. 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 / I, a•,� ,-�ka� �'CU_t� Y 2a t 1 _ as Owner of the subject property (� hereby authorize _���5�7� IAW" kVr%e(1r%�rirnVA4- to act on my behalf, in all matters relative to work authorized by this build—inj permit application. St-'e CpAk,,uX'A-) Signature of Owner Date "W V1_4 1 ,,, , f� „ as Owner/Authorized Agent hereby declare that the statements and informationlon the foregoing application are true and accurate,to the best of my knowledge and belief. Signed under the pains and penalties of perjury. 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 tilled 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 DON'T KNOW ® YES O IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO ® DONT KNOW O YES IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO G�r DON'T KNOW ® YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained ® Obtained 0 , Date Issued: C. Do any signs exist on the property? YES ® NO IF YES, describe size, type and location: D. Are there any proposed changes to or additions of signs intended for the property ? YES ® NO 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 © NO (� IF YES,then a Northampton Storm Water Management Permit from the DPW is required. Department use only ;City of Northampton Status of Permit: Ruilding Department Curb Cut/Driveway Permit '- AUG 18 2014 1' `212 Main Street Sewer/Septic Availability ' 11 Room 100 Water/Well Availability piurruing&Gds InspEd�t ampton, MA 01060 Two Sets of Structural Plans Electric, Northam ton, _ 7-1240 Fax 413-587-1272 Plot/Site Plans Other Specify APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Properly Address: This section to be completed by office `„vl% (244— Map Lot Unit ty1A ©I c uuo Zone Overlay District Elm St District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Ron Karakula 10 Damon Rd. Northampton,MA 01060 Name(Print) Current Mailing Address: 413-584-0524 C S Q_� Telephone Signature 2.2 Authorized Aaent: \J:s�3. ��P�-1 d mA Name(Print); Current Mailing Address: 'Z--pre W 9 Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by ermit applicant 1. Building 7,342 (a) Building Permit Fee 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) 7,342 Check Number 6b This Section For Official Use Only Building Permit Number: Date Issued: Signature: Building Commissioner/Inspector of Buildings Date 10 DAMON RD BP-2015-0196 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 18D-029 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-2015-0196 Project# JS-2015-000374 Est.Cost: $7342.00 Fee: $35.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: VISTA HOME IMPROVEMENT 106156 Lot Size(sg. ft.): 62290.80 Owner: KARAKULA RONALD Zoning: GB(50)/HB(50)/WP(30)/ Applicant. VISTA HOME IMPROVEMENT AT. 10 DAMON RD Applicant Address: Phone: Insurance: 1346 ELM ST (413) 382-0249 WC WEST SPRINGFIELDMA01089 ISSUED ON.811912014 0:00:00 TO PERFORM THE FOLLOWING WORK:STRI P & SH I NGLE 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 8/19/2014 0:00:00 $35.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner