16D-016 wu SIM i9MM%tWM IflfAffMM
459 MAIN STREET-P.O.BOY 51033-SPRINGFIELD,MA 01151
MA,REG#151711 CT.REG#601525
877-38TUPDY M413-543-3200
Name:
Address: i 's-
City/State/Zip: Ia�;j
i v^\ ^gAIA�A C (owner), of the,property
located at: n sl_ authorize Sturdy Home
Improvement,Inc. To act as my agent for the construction project taping
place at the above address. I also, authorize Sturdy home Improvement,Ine
to obtain a building permit for this protect.I understand and accept
responsibility to comply with all regulations and required inspections.
4=0 wner ate
Signature of Owner Date
STURDY HOME IMPROVEMENT, INC, ACCEPTANCE PAGE MA REG.415171
CT REG.#060152
ANY WORK NOT STATED ON PREVIOUS PAGES iS EXCLUDED
The following schedule will be adhered to unless circumstances beyond the contractor's control arise:
Work scheduled to begin the week of____/----/__ Expected completion date___/____!----Weather permitting. f�S)b
The cash price for labor and material as described above is:
1st payment 2nd payment 3rd payment 4th payment
Contract Total {u/pgn signing) k 4.rrK 1 A1. G.J%AT rt-- CLAAA-!
Roof <G�yfhrGf' R_ V-l 1 T a h-C-,=�6
(�1ovLlLK�
Ventilation $
(m,,
Other work $� K
Roofing total $ $ l $ q t $ ZI& $ Mw,
$ $"Dea.1I i311vs" $ $ $
Siding r-
.t
Windows � �_ � _ $ $
Special orders .�� $_ $ $ $ --°
r
Other $ $ $ $ $
Totals
Terms: Cash —Finance
Credit Card:#_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Exp.date____ / ____Code_,
Payment schedule:
Any balance not paid in full within thirty days, will be charged 1.8%interest per month.
In order to meet the completion schedule,the following material/equipment must be SPECIAL ORDERED before the contracted work begins.
(Law requires that any deposit or down=payment required by the contractor before work begins,may not exceed the greater of(a.)one-third of the
total contract price or(b.)the actual cost of any special equipment or custom made material which must be special ordered in advance to meet the
completion schedule)
$---q—to be paid for
$ � to be paid for
Any additional work orders are to be paid for once accepted and approved by purchaser.
Verbal understandings and agreements with representatives shall not be binding. All understandings and agreements must be set forth in writing in this
contract. Additional provisions are stated on reverse side and are part of this contract. In witness whereof Purchaser(s)has/have hereunto signed their names
this day of LJ 20–,(5 and acknowledge receipt of a true copy of this contract.
UNLESS OTHERWISE SPECIFIED,IT IS ONDERSTOOD THAT THE OWNER IS READY FOR THE WORK TO BEGIN. THE PURCHASE PRICE QUOTED
ABOVE WILL BE HONORED ONLY UNTIL (Date).
You the Purchaser(s)may cancel this transaction at any time prior to midnight of the third business day after the date of this transaction.See notice of cancella-
tion form for an explanation of this right. Signature affixed below also acts as receipt that Purchaser(s)received separate cancellation forms.
The following is a requirement by Massachusetts General Law,Home Improvement Contractor Law MGL c 142A:
`The contractor and the homeowner hereby mutually agree in advance that in the event that the contractor has a dispute concerning this contract,the contractor
may submit such dispute to a private arbitration service which has been approved by the office of Consumer Affairs and Business Regulation and the consumer
shall be required to submit to such/arbitration as provided in MGL c 142A.
Representative: "^° Owner:
Owner. `` Pi. /` V
NOTICE:The signatures of the parties above apply only to the agreement of the parties to alternate dispute resolution initiated by the contractor. The owner
may initiate alternative dispute resolution even where this section is not signed separately by the parties"
Do not sin this contract it there are any blank spaces
Submitted x Accepted t ,A\ lc
Representative urc er Date
Accepted Accepted
by: by:
......■■■..rr..//! ■..KimII�I...r....■■..r...■■■.■■ ■■■
No ON ■..■■.r■�rl/r■�1 ■■■■■■■■■■■■ ■ ■■ ■■�■ ■■MIN mom . ...■■.■.CCr. .r C..
...a■.■..n■��.a�■./ .r■,..Ci.r■r.r■ .....■ ■ ■r..■ ,s .
mom IN.■■.. .rr ■MEN■■.■ .■■.■ ■■
..�..�..■. min �ff mom mom 0 ON
ME Iff ■rr■■�ri.�■r■ �a_...� /..0
.■■.■■■■■■■ ■■a�■■.C■■fir■■ ,,... ME
■.r r��rrrr•�■�■�.r�rC�i
Cr ■�I1C■■�i�'� ■Cr■I. . �C■ .
.. ■■■ ...r ■ter■r�■■■�■■.r.....■ ■�■■■��u■■.r■r.�r■.. . . . .
.■■r.■■r■■■■■■ /■■ ■■l■r■r■■�■: s .■...,,�■■■■■■■r� ■■
....r■�.rril■r■■ MINN 0
r■■r.r ■■■!/•• rl■�■■■.�1C■rC.■■•r■■ ri■.r r Ii�/a■■ - ;• •
■r�
r.■�1■r��i���tr1�Iir ..C. I.t7. .
■.rrr■rr.r ..■��..■ .�CCr.■■.rr■ ■�■■■■��_ ■■ ■qtr.■■■ .
■.■C■o■■r ■ ■�CC■C��■■■
r. ..0■C..... .r.(��( r■ ■■ ....r■.r ..
.r■ r�r�i�r.0 ..■ r ■.■C■.■■■■
.rCr.■r.rr■ rCr.
� .■tCC■ r�i r�■C�r■.■.rr■.r■
■.■.....■■.C..r■r.. ■�..rl■.
■■■r.C.■.■r.■.■.■ ■■■.... ■■■■.■■.■
MEMO MEN..■■.■■■■..■■■■.■.... .■....■t■. ...■.■.■■ ■■.■■..■
■.rrrrr.MEN rr■r ■C � �CCiCC■�■■i i C i ■
NOON No C.r■ ■ i •Cr r■r•CrC.C
��r�CCr■■r■�■CrCr■■■■ ■■■■■■r■■■■■r■■■■■■■■■■■■■■■■
459 Main Street
Tall Frees (877)378-8739 Indian Orchard,MA 01151
Worcestser (508)797-6600 E-mail:HROSturdyHome,corn '
Springfield (413)543-5906 STURDY www.SturdyHome.com
New aven 203 848- 1
w ( ) 2118 .
Fax (413)543-3200 HOME IMPROVEMENT, MA REG.#151711 CT REG.#0601525
WINDOWS • SIDING • ROOFING • ADDITIONS
Name Horne Pho e Business Phone
Address �)', Cell Phone Other ST
M Town/City , W Representative q Date�� Hle� AQAJ
I/we the owners)of the premises described hereinafter, referred to as Owner,offer to contract with Sturdy Home Improvement, Inc.hereinafter
referred to as Contractor,to furnish,deliver and arrange for installation of all materials to improve the premises as described below.
Yes No ROOFING SCOPE OF WORK:
0" ❑ 1. Contractor to obtain required building permit(see attached permit authorization form) 'F? 2_e 3 0 Family home.
❑ 2. Provide certificate of insurance for workers compensation,general liability.(see attached certificates).
( ❑ 3. Provide job site dumpster,set on planks,to remove job related debris only. Please Note:dumpster for contractor's use only.
(see dumpster clause).
l ❑ 4. Prior to stripping roof,tarp sides of house beneath work area,from roof edge to bottom of wall.
(see additional protection clause on back).
❑°' ❑ 5. Keep job site in a clean.and orderly manner.Rake work areas at end of job. Use magnetic sweep to pick up nails.
Q," ❑ 6. Provide OSHA approved staging to safely perform work.
❑ 7. Work consecutive days excluding inclement weather.(rain,snow,high winds,high heat,thundershowers,etc).
❑ S. Staff project with qualified mechanics experienced in'residential asphalt roofing.
❑ 9. Strip existing 1 4'�` 2 fO- 3Ld-D 3 d-D layers of asphalt roofing(see roof plan,page 2). Number of squares /fit
A. !;�? one layer cedar removal. Number of squares d
B. rf one layer slate removal. Number of squares °
�❑10,inspect roof deck prior to re-roofing. Renail loose boards:
A.Replace rotted or cracked boards at$ ��ao per linear foot.
B. Install new plywood at$ '1 b�`rper sheet.
C.Number of sheets of plywood included into this estimate:Quantity (see unit cost above for additional sh ets).
[ ❑11.Furnish and install C.e wTf ,v�T,e r&- LvAv K Wt n vi k shingles. Color P �--�x"�r
Iff" ❑12,Furnish and install 8"aluminum drip edge around roof perimeter.White Iff Mill Brown
❑ W3.Install cedar drip edge at eaves under aluminum drip edge.Linear.fl
❑14,Furnish and install ice/water shield at eaves C3 3' Three feet in valleys and around all roof penetrations.
❑15,Furnish and install underlayment to entire roof.-0 Roofer select Diamond Deck
12' ❑16.Furnish and install starter course shingles,eaves&rake,
UJI❑17.Furnish and install.hip and ridge cap. 3°y
❑18.Furnish and install new neoprene roof boots at soil pipes up to 4"in diameter. Quantify Size 3. (boots at electrical
mast to be reused).
❑ 119.Reuse stove pipe flashing kits.
13' ❑20.Reuse existing step flashing at roof/wall intersections.
❑ 1&21.Furnish and install new aluminum copper step flashing at roof/wall intersections.Linear feet . If siding
work is needed,a cost assessment will be made at that time.
[� ❑22.Reuse existing wall flashing at roof/wall intersection.
❑ er23.Furnish and install new aluminum wall flashing at roof/wall intersections. Linear feet . If siding work is needed,a cost
assessment will be made at that time.
@I C]24.Furnish and install new r/' aluminum ct:2 copper step flashing at base of chimney under existing lead counter flashing.
&171J 25,Replace chimney lead counter flashing. 1 flue /-- 2 flues 3 flues other
❑ LiP 26.Install new roof hood to vent bathroom(s)with insulated flexible tube. Remove roof deck to gain access into attic.Color:black
only.
❑ [x`27.Gutter Helmets to be'removed and reinstalled by others.
❑ [&n.Remove and dispose of gutters attached with spike and ferrule.
l ❑29.Remove and reinstall existing gutters strapped to roof. Install straps under shingle mover shingles ®.
• W0.Remove and reinstall existing gutters with hidden hangers. Linear feet
❑ Er31.Reuse skylight flashing kits Replace skylight flashing kits Quantity (Velux models,stock only).
❑ U2.Remove and dispose of the following:Antenna Snow/Ice Wires Snow Guards/ice belts Solar panels
❑ U33.Remove Satellite Dish up to 24'in diameter. Alignment and installation by others.
( ❑34.Page Two=ROOF PLAN.
Wr ❑35.Page Three=VENTILATION. S q'i e'•e
❑ EI136.Page Four=VENTILATION PLAN.
❑ M7.Addendum(A)=OTHER WORK.
❑_.-F"38.Addendum(B)=LOW SLOPE ROOFING.
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
VV I Congress Street, Suite 100
Boston, MA 021142017
www mass.gov1dia
Workers' Compensation Insurance Affidavit: Builders/Cont ractors/Electricians/Plumbe>rs
Applicant Information Please Print Legibly
Name (Business/Organization/lndividual):-, J�A Me-
r
Address: "459 ;fY)C ,
City/State/Zip: IoCC 6t Gr oll`5j Phone#: qI,� c f Coal
Are y n employer? Check the appropriate box: Type of project(required):
1. I am a employer with U 4. 0 I am a general contractor and I
employees (full and/or part-time).'`
have hired the sub-contractors 6. E]New construction
2.E3 1 am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling
ship and have no employees These sub-contractors have g. [J Demolition
working for me in any capacity. employees and have workers'
[No workers' comp. insurance comp. insurance.* 9. E]Building addition
required.] S. E] We are a corporation and its 10.0 Electrical repairs or additions
3.❑ 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. woof repairs
insurance required.] 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 teen an employer that isproviding worker's' compensation insurance for my employees. Below is thepolicy andjob site
information. ff
Insurance Company Name: r �.r� t n )-ran CA
Policy#or Self-ins. Lie. #: Q C (j(j']- f`/2 - { `j!2 Expiration Date: -7/Z o S'
�( l en CO Job Site Address: 1'&3 tqo r:�Eh (06 ` 5�� City/State/Zip: Nbt4A t 011)(02
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:
LJ
Phone#: q)3 5413 10'8 1
Official use only. Do not write in this area, to be completed by city or town official.
City or Town: PermitMeense #
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
8.1 Licensed Construction'Sup,�ervisor: Not Applicable ❑
Name of License Holder: , J �Su-J A.t (�� l.J\G Z 13(y o-3
f License Number
zA q ��E k 3 r) , , 1,10 L(L.0 � e kl(a rC7S' (1 I✓T C�I I - 7/1 ,5—'1 ,5—_
Address P _ Expiration Date
i 212 235-2-
S ature Telephone
9.Registered Home Improvement Contractor; Not Applicable ❑
L--t::g aAk 1 5 f '-) 1 l
Company Na Registration Number
15r) nun �-3 k lac t a f) &-ayi „�G � G1 i 5-I (,o /Z(c/1('0
Address Expiration Date
Telephone
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 buildin 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 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 ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing
Or Doors 0
Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [Q Siding [O] Other[DJ
Brief Description of Proposed
Work: �7 e) f�Y1e CD hla 64 a—. iyl:;� 71 ,�,.. 0 C64(Li g_Fex ��htnG(�e�
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement Yes 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
I, as Owner of the subject
property
hereby authorize
to act on my behalf, in all matters relative to work authorized by this building permit application.
Signature of Owner Date
I, I )0 w 10'� as Owner/Authorized
Ayp.mi-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.
D C.v i n.p"D i c_-z
Print e
r
s-
Signature of Owner/Agent tZI Date
R
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 m _.�.
t a e
Frontage ---- .
Setbacks Front '
Side L.. } R:E
Rear
Building Height -
Bldg. Square Footage l % t
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
IF YES, date issued:F
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DON'T KNOW YES 0
IF YES: enter Book I Page= and/or Document #1 ;
B. Does the site contain a brook, body of water or wetlands? NO 0 DON'T KNOW 0 YES 0
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained , Date Issued:
C. Do any signs exist on the property? YES 0 NO
IF YES, describe size, type and location: i - �
D. Are there any proposed changes to or additions of signs intended for the property? YES 0 NO 0
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 0 NO 0
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
Department use only
City of Northampton Status of Permit:
Building Department Curb Cut/Driveway,Permit
���� 212 Main Street Sewer/Septic Availability
S,oNRoom 100 WaterNVell ASratlabllify
rthampton, MA 01060 Two,Sets of Structural Mans
-587-1240 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 Property Address: This section to be completed by office
Map Lot Unit
Zone Overlay District
Elm St.District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
.Au- to h-&4 n 5 I�Iems-,c cnA of 0c,o2
Name(Print) Current Mailing Address:
tii3
Telephone
Signature
2.2 Authorized Accent:
�Cw �GF (D i c, Z- ,y n� YY1Ci; n t?�. ►l0(r c c n�7'G�a-�)h'1� GI r S')
Nam riit) Current Mailing Address:
'ql 3 219 _230, Z
Signature Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by ermit applicant
1. Building (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= 0 +2+ 3+4+ 5) C-1_7 U Check Number j�-
This Section For Official Use Only
Building ermit Number: Date
g Issued:
Signature:
Building Commissioner/Inspector of Buildings Date
185 NORTH MAIN ST BP-2016-0073
GIs#: COMMONWEALTH OF MASSACHUSETTS
MaQBlock: 16D-016 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-2016-0073
Project# JS-2016-000125
Est.Cost: $10000.00
Fee: $40.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: STURDY HOME IMPROVEMENT 093603
Lot Size(sq, ft.): 18164.52 Owner: FEINSTEIN ALEX
Zoning.URB(100)/ Applicant. STURDY HOME IMPROVEMENT
AT. 185 NORTH MAIN ST
Applicant Address: Phone: Insurance:
P O BOX 51033 (413) 543-5906 WC
INDIAN ORCHARDMA01151 ISSUED ON:711712015 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 Occupang/ Signature:
FeeType: Date Paid: Amount:
Building 7/17/2015 0:00:00 $40.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner