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18C-093 (11)
28 GLEASON RD BP-2017-1439 GIS n: COMMONWEALTH OF MASSACHUSETTS Man B ock: I8C-093 CITY OF NORTHAMPTON Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: Bath reno BUILDING PERMIT Permit ft BP-2017-1439 Project# JS-2017-002394 Est.Cost:$9500.00 Fee:$65.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: STURDY HOME IMPROVEMENT 093603 Lot Size(sq,ft.): 21126.60 Owner: LESLEY DANIEL&NAOMI Zoning:URB(l00,k' Applicant: STURDY HOME IMPROVEMENT AT: 28 GLEASON RD Applicant Address: Phone: Insurance: P O BOX 51033 (413) 543-5906 WC INDIAN ORCHAR DMA01151 ISSUED ON:6/9/2077 0:00:00 TO PERFORM THE FOLLOWING WORK:REMODEL EXISTING 1ST FLOOR HALF BATH 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/I 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: FeeTvpe: Date Paid: Amount: Building 6/9/2017 0:00:00 $65.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner File#BP-2017-1439 APPLICANT/CONTACT PERSON STURDY HOME IMPROVEMENT ADDRESS/PHONE P O BOX 51033 INDIAN ORCHARD (413)543.5906 PROPERTY LOCATION 28 GLEASON RD MAP 18C PARCEL 093 001 ZONE URB(100# THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATI N CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Pee Paid re— ]}undine Permit Filled out Fee Paid - TvpeofConstruction: REMODEL EXISTING 1ST F, OUR HALFBATH r+ New Construction 4 u/ k Non tion to Ex interior renovations us- Addition Addition to Existing Rr// _ Accessory Structure Building Plans Included: �,t1 Owner/Statement or License 093603 VV'' �3 sets of Plans t Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION PRESENTED: pti p ed 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 Storm Water Management r. a 2�/wf1 Signature ui Mg II c':i Date 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 Status of Permit Building Department Curb CutDriveway Permit 6 212 Main Street Sewer/Septic Availability I L I Room 100 Watermell Availability - lorthampton, MA 01060 Two Sets of Structural Plans ----- —phone 413-587-1240 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 oProperty Address: � ``�� This section to be comp{r< by office G12nScn Kms' Map IT,/ t� Unit Nb(4hamD-ic m(} Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: D:ur 1 tis ley is ltettscn fled 1 c-A-crrktt71 �1t� ame(Print) 04;ept i ailing Address:) 19 Telephone Signature 2.2 Authorized Agent: Notvrtdbla2\s+u 4i kkITOata+xwe nen+ 45-6ircamasyN*et3 l�anbiCh�td,mnat5( Name(Pript7 yCurrent Mailing Address: Jr � _� s� [/ 416- 21Z- 1392_ Signature 0 Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit 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 p Le �1 //o�r�i/1 6. Total=(1 +2+3+4+5) 1yq, _00 Check Number —/A/J`-' V J This Section For Official Use Only —7 1VVV�""" Building Permit Number: Date Issued: Signature: Building Commissioner/Inspector of Buildings Date SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) Roofing ❑ Or Doors ID Accessory Bldg. ❑ Demolition ❑ New Signs [o] Decks [Cl Siding[0] Other[I7] Brief Descripfion of Proposed Work: mtdel e c s4 i no) to Ctecr )'yl) Alteration of existing bedroom Yes )C No Adding new bedroom Yes X No Attached Narrative Renovating unfinished basement Yes 7C No Plans Attached Roll -Sheet ea.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 L7/.A e V-S1 Qxr as Owner of the subject property `, f 1 hereby authorize l U-v\ci 110.7 j ,'SIL c1j4k�rc -TIMID 1))0MQ(}{ - to act on my behalf,in all matters relative t work authorize by this building per it application. Signature of Owner \, [' t '1 �rv� ` I/�h Date I, �d bin? Sku Ci1i"1'U ple011l(� ,as Owner/Authorized Agent hereby declare that the statemerks and inffrmation orlthe foregoing application are true and accurate,to the best of my knowledge and belief. Signed under the pains and penalties of perjury. Print Na e Signature of Owner/Agent Date cir oeq SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor:( lDY-17 /� Not Applicable ❑ � Name of License Holder: p 1a `J1t {a License Number 14SC (Xu.(r SUN-cI3Slx\((u, cfchLA1d fhflh,i(SI Mdress. Expiration Date ` y(eph 1L 3g Signature Telephone 9.Registered Home Improvement Contractor: Not Applicable 0 W a y WSNL.J'm pn)ii f Company N me Registration Number 4sq Minn suRe (3illAckin (ICc iel MR Oils] Address �1 1 Expiration Date Telephane1113'psc(p'1NA 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 buil ng 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 City of Northampton 212 Main Street, Northampton, MA 01060 Solid Waste 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. Address of the work: 2S- C1\ oR n Q0c4 The debris will be transported by: A 4-IQl k(I, at-Ad Q,PClCu(n The debris will be received by: LLSAF i Alland I 4c I r Building permit number: J Name of Permit Applicant 1 )pr( \c . d icv Date Signature of PeirKit Applicant The Commonwealth of Massachusetts �-�= Department of Industrial Accidents )6= '1�" 1= t Office of Investigations e. s'1 _i = 0 1 Congress Street, Suite 100 =ti�-i= Boston, MA 02114-2017 M,r www.mass.gov/dia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information 1Please Print Legibly Name (Business/Organization/hdividual): Sud ck *-\cc o. iLc ?.1\-,)Qt f) {. Address: q{ q Mean 5} Su ISP 12 T City/State/ZipTMICU v (\(hOj IY1R (f lc- I Phone #: ILO OAZ— WC..i Are u an employer? Checktheappropriate box: Type of project(required): 1. I am a employer with p 4. ❑ lam a general contractor and I employees (full and/or part-time).* have hired die sub-contractors 6. ❑ New construction listed on the attached sheet. 7. ❑ Remodeling 2.ID I am a sole proprietor or partner- 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 II.❑ Plumbing repairs or additions myself. [No workers' com right of exemption per MGL y / p c. 152, 1and we have no 12.,❑-{, Roof repairs insurance required.] c (4), 13.✓0 OtherlbaTh throat 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. t 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. 1 am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. ,f ' ( Insurance Company Name:''(QU P,AQ s_ Torkerf\f it\ CD CJI- }4-11101( L -/ Policy#orSelf-in(s. Lic. #: Ufb-CJ ye.)2)j(,p ticl 0c— f0 Expiration Date: p�119.I (90 1yy,� Job Site Address: (/t5 �1'�sfl It-l� City/State/Zip: 1141k0,Th ik Iltt! 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. 1 do hereby certify under the�painnss and penalties of perjury that the information provided above is true and correct. a1O, /Signature: I �'JDate: (DI I 117 �f Phone#: lb—C11 —ILAI Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License ft 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#: DocuSign Envelope ID:COA4BC1B-0955-40D7-AE6D-4E4761BC9C48 s�URt�1r HOME IMPROVEMENT "No Substitute for Quality" 459 Main Street Indian Orchard, MA 01151 • (413) 543-5906 (508)-797-6600 OWNER PERMIT AUTHORIZATION Daniel Lesley Name: Address: �.� ClUCq n City/State/Zip (t)-1-4-ha ji ' in,rV ,N \ Daniel Lesley I (owner), of the property located at: authorize Sturdy Home Improvement,Inc. to act as my agent for the construction project taking place at the above address. I also authorize Sturdy Home Improdement, Inc. to obtain a building permit for this project. I understand and accept responsibility to comply with all regulations and required inspections. ,-DeeuSlgnetl by: 5/19/2017 Signatureo ner Date Signature of Owner Date 4 CERTIFICATE OF LIABILITY INSURANCE 8/8/2`0 ° 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 policy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER NAMEACT : Nadine West Orchard-Dowd Insurance Agency LLC PHONE FAX 14 Rchala Road (AIC.NO Exfl 911-419-LOD0 (AIc.No):411-417-150 Holyoke MA 01040 E-MAILDESS: nwest®lewd.Com PRODUCER;D#:STURHOM-02 INSURER(S)AFFORDING COVERAGE NAIL t/ INSURED INSURFAA:AtlantiC Casualty Insurance Company 42814 Sturdy Home Improvement, Inc. P.O. Box 51033 INSURERS: Indian Orchard MA D1151 INSURER c: INSURERO: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:397345024 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR 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. ILTR TYPE OF INSURANCE INSR W VUADULT BREFF POCYEXP POLICY NUMBER I UEFFI IMMNOMIYPI LIMITS A GENERALDABIDtt M1a5000199 0/7/3016 a/7/2017 EACH OCCURRENCE $1,000,000 DED COMMERCIAL GENERAL LIABILITY PPREMSES(Ea GE TO o Ixurrence) 850,000 CLAIMS-MADE OCCUR MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE n,000,o00 GE AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $2,000,000 POLICY 7 PRP LOG AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OVrNEDAUTOS BODILY INJURY(Per accident) S SCHEDULED AUTOS • PROPERTY DAMAGE HIRED AMPS (Per aoddenq NONDWNEDAUI'OS $ UMBRELLA LIAR OCCUR EACH OCCURRENCE EXCESS LIAR CINMS-MADE AGGREGATE $ DEDUCTIBLE 8 RETENTION $ _ $ WORKERSCOMPENSATION7 COATS 0TH- ANDEMPLOYERS'LIABIDtt TORY I T9 H ANY PROPRIETORPARTNEWEXEC°INE I YIN EL EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? NIA (Mandatory In Na) E.L.DISEASE-EA EMPLOYEE $ DESCRIPTION OF OPERATIONS below DEL.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD DI,Additional Remarks Schedule,if more space Is required) Workers' Compensation Certificate of Insurance to follow separately from the carrier. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©19862009 ACORD CORPORATION. All rights reserved. ACORD 25(2009109) The ACORD name and logo are registered marks of ACORD aC 0]/99(/90167016 CERTIFICATE OF LIABILITY INSURANCE (DATE(MMTh TNLYCER IFICATE IS ISSUED ASA 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 policy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require and endorsement. Astatement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: ORCHARD INS AGCY INC PHONE FAX 485 MAIN STREET plc,No,Ext): (AIC,No): E-MAIL INDIAN ORCHARD,MA 01151-1241 ADDRESS: 281/CR INSURER(S)AFFORDING COVERAGE NAICe INSURED INSURER A: TRAVELERS INDEMNITY COMPANY OF AMERICA STURDY HOME IMPROVEMENT,INC INSURER BI INSURER C: PO BOX 51033 INSURER 0: INSURER E: INDIAN ORCHARD,MA 01151 INSURER F: COVERAGES CERTIFICATE NUMSER: REVISION NUMBER: THIS IS TO CERTIFY THAT REPULSES OFINSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FORTHE PCUCYPERIOD INDICATES NOIVNTHSTANDING ANT REQUIREMENT,TERM OR CONDITION OF ANYCONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE NAY BE ISSUED OR MAY PERTAIN.THE INSURANCE AFFORDED BY TN INGLES DESCRIEED HEREIN IS SUBJECT TO ALLTHETERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD SUB POLICY EVE DATE POLICY INP DATE LTR TYPE OFINSURANOE L R POUCYNUMBER (MMIDDIYYYYI (MMNDIYYYY) LIMBS GENERAL LIABILITY EACH OCCURRENCE $ 1COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED CLAIMS CLAIMSMAOE nOCCUR. °REMISES(Ea occurrence) IMED EXP WWSGIS perso0) $ DERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT AP PLIES PER: GENERAL AGGREGATE $ —1 POLICY n PROJECT LOC PRODUCTS-COMP:0PAGG $ AUTOMOBILE LIABILITY COMBINED SINGLE $ ANY AUTO LEERIER accident) — ALL OWNED AUTOS BODILY INJURY $ SCHEDULE AUTOS (Per person) — HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROE ERN DAMAGE $ (Per accident) 1 UMBRELLA NABI I OCCUR EACH OCCURRENCE $ EXCESS LIAB ^I CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION$ I$ A WORKERS COMPENSATION ANDWC STATUTORY OTHER EMPLOYER'S LIABILITY YIN US59388505-1a 0721/2016 07121/2017 X WAITS ANY PROPEAITOR WEpiXECIRIVE I WA E.L EACH ACCIDENT $ 1.000,000 EXCLUDED? :Mandator/In NH) EL DISEASE-EA EMPLOYEE $ 1,000,000 IfDybUdIP11ONe OF E.L.DISEASE-POLICY LIMB $ 1,000,000 Dsw desoibN OF OPEAgTI0N5 Eelav DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLESIRESTRICTIONSISPECIAL ITEMS THIS REPLACES ANY PRIOR CER IINICATE ISSUED TO TIM CERTIFICAT&HOLDER AFFECTING-WORKERS COMP COVERAGE CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL SE DELIVERED IN ACCORDANCE WITH THE POLICYPROVISIONS. AUTHORIZED REPRESENT E -( ACORD 25(2010/05) The AGGRO name and logo are registered marks of ACORD 1988.2010 ACORD CORPORATION. All rights reserved. Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-093603 Construction Supervisor DAVID DIAZ , 270TREMONTST SPRINGFIELD M%101 t - - • rs.-1.. nn Expiration: Commissioner 08107/2017 PTS. 1c o onsumer Affairs end Business Regulation' 10 Park Playa - Suite 5170 �`0.0 Boston, Massachusetts 02116 Home ImprovemeA' 4ontractor Registration Registration: 151711 -iti--- 177.? 7 -�rl /A Type: Supplement Card s — ( Expiration: 626/2018 STURDY HOME IMPROVEMENT, I T #� t, ` I. DAVID DIAZ '`I 1� / ,Is J I 459 MAIN STREET tr INDIAN ORCHARD, MA 01151 %'/Update Address and return card.Mark reason for change. sca, 20M-05/11fl Address U Renewal D Employment El Lost Card cn Wometeon,zea/tA/'e2/IUrur cA,„ern . . Office of Consumer Affairs&Business Regulation License or registration valid for individual use only Ya ME IMPROVEMENT CONTRACTOR ' before the expiration date. If found return to: n {5173x ?Registration; Type: Office ofConsumSer Affairs and Business Regulation 9 ` 10 Park Plaza-Suite 5170 ' „„„e Expiration $21fi] cik _ Supplement Card Boston,MA 02116 STURDY HOME IMPROVMENTFINC DAVID NIS 459 MAIN STREET ' j„c.<rws,4_ `—f)/) c /\ INDIAN ORCHARD,MA 01151 Undersecretary Not valid without signal DocuSign Envelope ID:COA4BC1 B-0955-4001-AE6D-4E4761 BC9C49 srURbv HOME IMPROVEMENT WORCESTER SPRINGFIELD HARTFORD 459 MAIN STREET-P.O.BOX 51033-SPRINGFIELD,MA 01151 MA.REG,/151711 CT.REG./601525 1-877-3-STURDY 508-797-6600 413-543-5906 FAX413-543-3200 CONTRACT FOR: DATE:May 19,20177 NAME:Daniel Lesley PHONE: (301)501-1779 STREET:28 Gleason Rd. TOWN:Northampton,MA STURDY HOME IMPROVEMENT INC("Contractor")PROPOSES TO: Remodel existing i"floor half bath per the following specifications: Section 1:Plans and Permits 1.1 Plans and Engineering Provide design/build plans-None 1.2 Permits Provide building permit from Municipality Section 2:Site and Foundation 2.1 Site Work-None 2.2 Demolition Demo bathroom down to studs and sub-floor Save louvered built in cabinet Dispose of debris 2.3 Excavation-None 2.4 Concrete-None 2.5 Masonry-None Section 3:Framing 3.1 Floor framing-None 3.2 Wall Framing-None 3.3 Roof Framing,Ceiling Framing-None Section 4:Exterior 4.1 Roofing-None 4.251dIng-None 4.3 Gutters•None 4.4 Shutters-None 4.5 Exterior Doors-None 4.6 Windows-None 4.7 Decks-None os Page 1 of 6 INITIALS INITIAI5 Dacusign Envelope 10:COA4BC1 B-0955-0007-AE60-0E4161BC9C48 Section 5:Mechanical 5.1 Plumbing Rough and finish plumbing for the following fixtures: Toilet Pedestal sink and faucet Allowance for plumbing fixtures$700.00 5.2 Heating,Cooling,Ventilation Keep existing baseboard heat 5.3 Electrical New GFI outlet by sink Install light over pedestal(Customer to supply) 5.4 Insulation Batt insulation In exterior walls Section 6 interior 6.1 Plaster or Drywall 1/2 drywall on walls and ceiling 6.1 Interior Doors Keep existing 6.2 Door Trim 2 1/2"primed colonial casing 6.3 Window him 2 1/2"primed colonial casing 64 Baseboard and Wainscot 3 1/4"primed colonial baseboard 6.5 Stairways and Handrails-None 6.6 Cabinetry Install customer supplied medicine cabinet 6.7 Closet Interiors-None Section 7 Specialties 7.1 Countertops-None 7.2 Interior Stone Work-None 7.3 Tile Work Tile on bath floor.Customer to supply tile,Contractor to supply thin-set and grout 7.4 Wood,Vinyl,or Laminate Floors-None 7.5 Carpet-None 7.6 Glass and Mirrors-none 7.7 Bath Specialties Install bath specialties i.e.robe hook,towel bar etc.(Customer to supply) Section 8 Paint 8.1 Interior Paint Walls,ceiling and trim �os Page 2 of 6 INmnts` mmALS INITIALS DocuSlgn Envelope ID:COA4BC1 B-0955-40D7-AE6D-4E4761BC9C48 8.2 Exterior Paint-Nona Section 9 Landscape,Paving,Walkways 9.1 Topsoil,Seeding,Sodding-None 9.2 Plantings-None 9.3 Walkways-None 9.4 Hardscape-None 9.5 Driveways-None Section 10 Clean and Close 10.1 Punchlist Items 10.2 Final Clean Payment Schedule Total Price of Investment $10,300.00 Repeat Customer&Veteran Discount -$800.00 New Total $9,500.00 Acceptance of contract $1,000.00 Start of demo $3,500.00 Start of plumbing $4,000.00 Completion $1,000.00 Payment schedule is based on project milestones, not the cost of ant particular phase Any balance not paid in full within thirty days will be charged t.5%interest per month. Additional work orders are to be paid for once accepted and approved by purchaser. os Page 3 of 6 INITIALS INUAIS INITIALS DocuSign Envelope ID:COA4BC1 B-0955-40D7-AE6D-4E4761 BC9C48 GENERAL CONDITIONS 1. UNFORSEEN SITE CONDITIONS: Site conditions that hinder excavation, foundation, or concrete work that incur additional expense shall be billed to the customer. 2. UNFORSEEN STRUCTURAL CONDITIONS: Any unforeseen or pre-existing framing and structural conditions that create a hazard or danger, or that do not meet state building code, shall be upgraded at the customer's expense. 3. UNFORSEEN MECHANICAL CONDITIONS: Any unforeseen deficiencies in the electrical, plumbing, or HVAC systems, or pre-existing work that creates a hazard or danger, discovered dining demolition or construction,shall be upgraded to applicable building codes at customer's expense. Moving of wires, ducts, or plumbing pipes that are discovered during demolition or construction may incur additional charges. 4. MATCHING EXISTING FINISHES AND MATERIALS: Where Contractor's work involves the 'matching of existing finishes or materials," Contractor will use his best efforts to match existing finishes and materials 5. START DATE/COMPLETION TIME Tentative start date is week of 2017. Work will progress on consecutive work days until completion,with the exception of inclement weather, inspections,etc.The estimated time for completion is weeks from the start. 6. CHANGE ORDERS The contract amount and payment terms as shown in this contract will be changed if needed only by written change order,agreed to and signed by both parties. 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 2017 and acknowledges receipt of a true copy of this contract. UNLESS OTHERWISE SPECIFIED,IT IS UNDERSTOOD THAT THE OWNER IS READY FOR THIS WORK TO BEGIN.THE PURCHASE PRICE QUO PED ABOVE WILL BE HONORED ONLY UNTIL .2017. 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 cancellation form for an explanation of this right. Signature affixed below also acts as receipt that Purchaser(s)received separate cancellation forms. e9 Page 4 of 6 mmus � !"Inas INMAIs Docusign Envelope ID:COA4BC1B-095540D7-AE6D-4E4761BC9C48 The following is a requirement by Massachusetts General Law, Home Improvement Contractor Law MOL, e 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 meltdarbitratMn as provided in MGL a 142A. Owner: a— • `Aece4ADeDF7F4CA • _. Contractor: 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 sign this contract if there are any blank spaces. Representative of Contractor: Submitted By Date: Accepted By Date: Representative of Owner: e—ooasisnee by: Accepted By Date: `Aeoe4Aosovm4CA, Accepted By Date: os Page 5 of 6 INIPA� INITAtS INITIALS DocuSign Envelope ID:COA4BCI B-0955-4007-AE6D-4E4761BC9C48 ACCtiFFANCS Thiscnaha¢aad the agreement for oredi,if any,shall constitute the entireagreement&Green thepatis,wvhidtthcenlhe agreement andapedlications shall not bealteredor modified ex-raptly written agreement between thepalnbereb Otvee(a)undelghMa that lb'V dominent does nutconatiwtea valid andbincRogCo tsdfrcm:y purpose until andudess it is sty:ed aedmptedby Sturdyllom¢Improvement,Inc. INTHE EVENT TNIS OFFBRTO comma IS NOT ACCEPTED BY COMINCTOR.ANSPAYMENYMADE HtRSIINDERSIIAI.LHRRFFUNDED TO'1HE ONMBWS)AND THIS PROPOSAL SHALL BB NULL AND VOID AND OP NO EFFECT.THE CONTRACTOR IS NOT RESPONSIBLE FOR RUSTING STRUCTURAL DEFECTS,DRY ROT OR CODE VIOLATIONS. NO REPAIRING, PLASTERWG,GARPENTRYOR DECORATING d INCLUDED IIMLSSSPECIFICALLY CHARGEDTORAND SPECIFIED TN WRRNO HEREIN. AccessrmyroOwner agremla allow Conlmdor access Netlike perimeter sfbvMingtope:fenm wort Contractor shall attempt topmtedlandscaping,shrubs,driveways and lawn.Acer to perimeter of structure is ntldedto inSallpcWutt,autilnedin this agreement.Contractor shall not be responsible for any damage that mayoral.tolandampingwhi!eattain work areal. ADDITIONAL PROTECTIONS:Protection of Inside areas of attic and livbg spaces the responstlity of homeowner. Contractor will pnfde tarp(s)at•metarenurab Contractor Is not respmulUefordustaad/ordebds Inside Gradate as a result ofwork performed on Hleprolery. ADDITIONALWARRANTY INFORMATION:All for goods supplledbyceranctormder this Agreement sballbe thosegivenby NemenuDgmerafsndtgoads,whiels shall be and are hereby passed through&ere to Owner.Under schmnufacurersamntl Ownermay berequiredregisteror mall inn warranty card or other evidence of at ershiP and use of suds yuipm ti order a such to Iwo.otme'u(ilu Collin regirte such documentation,whist failurevohe,manufacture,tnlmnty,shall notrespavibillyfor Contractor equipment wanany such goods.Thewanay gives Owner-specific legal tights and Owner may also hate other rights mayyhiehfrom state to state.Under Massachusetts law sales fgoods< an Implied warranty of merchantability and fn for aery air purpose Al material sill be specified.All work to be tnpleted in a worbnan like manner.Any allmdanr or dedatlon from the Noce specifications requested byOwner Involving extra eons will be=rated onlyupontmtten orders,and%Gibe®e an extra ehageever the original estimate. ARBITRATION:TIN parties he:ehyagree that the Masuel:usettrArbitradon Act shall apply to all disputes aaddaims arising outaf,or relating to this agreement,including the breach thereof. The parties agree to follow the npedited procedural of the Commercial Arbitration Rotes of the American Arbitration Association ata hearing only to be held in Springfield,Massachusetts.The commencement of arbitration proceedings by en aggrieved Y a condition precedent In the commencement of legal action by either parye except,mandatory arbitration procedures required in this Agreement shall not be applicable to any daim by Sandy Home Improvement,Inc.,wherdn it seeks a prejudgment remedy numb as a real estate attachment,for eases where Owner has not paid a hill which iadneto StnmyHonelmprovement In ATrORNErSFEEs/COSTS:Owneragree.to pay all costs of collection,including reasonable attorneys fees,cost and expensen Piirthermore,interest shalL be charged at the hlghe lawful rate ofime:dstdnany andel avwnepaymeeta. DELAYS:'nutshell be no llabiliyfordelaysIn,or failure to complete&Evelyne Installation elan or any oftheheein mentioned merchandise,If due to any cause beyond Contracteh control, including but not limited to fire,sNke,war,terrorism,go < regulations,actor God orlabor or materials shortages DELAYS IN COMPLETION DOE TO CONCRALEO CONDITIONS:owner herebyocknmwledgee[Latin certain remodeling work,the demolition ofpaNans ofthe Franseen on structure may reveal additional defects,conditions or the need foradditjonal wod<ebids must be repaired,abpedarcnrN out in beorder to complete the work described under die contract.In such case(s),owner agreeses thettheduration of the work and thescheduleddate of completion may differ from the date stated on this front,and that such variation shalt not be considered to be violation orOilS<emma DINEPSrEn(s)t Domyars delivered to the rite tvlh be doneby olsen,tm4gs stated on the contract.Sturdy Home Improvement Inc.will not he held'responsible for any damage to driveway, Iawns,londmPng curbing,fg.eat The edging drifrewaymustb bl to nithatand thecapacibmt a truckith a hlryloaded container.Sturdyllome ImprovementIna cannot beheld responsible for Previous d gip eristing driveways( els dip scratches or unforeseend Cao).TheOuntracter will not hheld 161fr any dag that mayacur fromthecurbInto thepropeny with the delvery/mmoval of trasheontelners by therttf ub aromploYeeMSutly Monte InINovement.Inc HAZARDOUS WASTE/ASBESTOS/CONTAMINANTS/MOLD:Olmerrepresents and warrants that the project area and baeeae free from ham-dour.vane,lead paint,asbestos and/or other contaminants. nrer In Ida f thia representetlim and warranty,1 "d that by accepting this Cot C dosM1reby release and Indemnify and hold laimkas the Contractor from andgu ll elaimh damages,NaNlitlei,lossesexpenses,direct and/or Ithrea including hut notl ted to. tteris fees andd! arising out of,or mulling front the performance°cony of11 M by Contractor laims against contractor relating to,involving f hrd lead paint, besw and/or other contaminants Owner is hereby advised that mofdtlo grow end beprehent in concealed areas of Me home.Contractor to neither Imade an analysis Verification endessumes no liabilityliabilityfor the detemnohnn ofmoldewmng in oven nid owners renm Otvneheceby gees that therahall not be responsible forthedetection,containment,orremediationmf O y casting mold nerfur further waivesagrees ntl claims and to hold Contractor harmless against any clap Cor based In whole invert on the release epeadel mold that deer notodginateodtb Contractor's negligence INSTAULnONn It Is understood that the contractor may sot natal sold material but that by your signature you authgme the Contractor to arrange for the petomance of installation by a qualified Installer.You also authorize the Contactor,ill to terve on Installation taoriord&widi lie specifications shown herein.fo)To pay thelnueller upon yaw execution of u completion certificate establishing that the installation hasbem ntitfactolymnpleted,You egreeto pay to the Contratlmlbeamount apmfiedhcein,whhlndlleover Umpires Gadd materials end the installation charge. MODIPIGnOR 1Ns agreement,except as to cdnealed renditions or delays oecisioned thereby fir by restarts,rennet change except by twltten statement signed by both Contractor and Owner.Homer,cancellation by Owner is not allowed in accordance with the Notice of Cancellation.Omer hereby pants Contractor limited Pout,of Attorney mcomplete incomplete documents on Oeners behalf.All ebangmdersoradditional trod:orders must be In writing,regardless oftheanmunla additional time.All edddonal work orders acMngeordersteill be paid(or in fell oneear¢pted so as to net artist payment schedule.ltdceipt&cheek and amount within star and finish dates,unless Nedfied in meow°(cher,will constitute en agreement to Mange order or additional workorder work performed.Du the responsibility ofhomeowner to rteeive written edRlioen]work order or change order for documentation. ORAL REPRESENTATIONS:ANY AGREEMENTS OR REPRESENTATIONS STATED ORALLY ORN WRITING EY TIM CONTRACTOR'S REPRESENTATIVE PPl0A T01111.9 AGREEMENT SMALLER SUPERSEDED BYTNLS.CONTRACT:1NR CONTENTS Or THIS CONTRACT,NPPIM,NDwVRRMO,CONS'fflUTESTHBENIIEBAGREEMFMR EFDVEPN BOTHPAR'I'IRS.UNIrsS STATED IN THIS CONTRICC,TNERE ARRNOGOARANTELS ONWAIMANIIRS,EXPRESSED MAGNUM),h1ADE BYTHE CONTRACTOR PAYMENT IDEFAULT Ov tR topay, II Av h thwritten terms end eeWihrn;provided,however,fContractor, Id grants Owner merit,(len Owner shall sign Carl C prhatksory note for IF credit to granted.The terms of the promissory note shell be incorporated hby reference andmade LSgirt hereof.if Owner falls to make all payments strictly In accordance with the!ems of this contract,and/or othenrIse defaults hereunder or on the promissory nthe eudre unpaldbal of the contract and note shall be Immediately due and payable,without further protest,notice or demand,end Contractor shall be free lo exercise its mnd neuve rights and remedies,which may l eWShut not be limited to,salt,attachment and debts pursuant to various applicable lien-laws.Owner also agreestasign a completion ceN(leupon completion of work.Owner egrets to pay all Mats of collectio:Jncluding reasonable attorney's lees,costs and expungesFurthermore,interval shall be paged at the highest lawful rate of interest on any and all overdue payments.If Owner cancels this contract at any time subsequent to midnight of the third business day after the date ofthecontmq Owner will be responsible for all ofContmdefs damages,whlehwia Include,but are not limited to,the difference between the contract price and the cost of matedal and labor which wenuid constitute pmt prole In addition to any and all other damages suffered and/or sustained by Contractor.Contractor reserves the tight to cancel this oar tract at any time within thirty daays of the dare nfthls contract lithe Contractor cancels,Omer will be promptly haired In writing by al:aurhorked officer.IfConlmcor cane*,Contractor Mumoill promptly return any WMentW rboa made PAYMENTS:robe Owner fails atony time tomakea payment of heprie as finallydetermMMand egrsd,the Contractor than be entitled to Nepworkwithout beinginbeach of contract. Own&egret to pay the contractor the reasonable costa of enforcement or collection,and/or if in the event it Is weaselly for the Contractor to retain an attorney end/<F to Institute legal Proceedings,Owner agrees!coney reaeobleattomeya tees and costs Incurred,vehUberor not mint proceedings are Initiated,In addition to oiler sums. RESTARTS;If theinfect issmppcdbytlloowner Neatly paradef fiche,a rested fee Nlenpemnt(GM ofthecoehirtedpri e will be required to compensate the Contractor for thenreevnry Ilme and re-main/alien of staff and materials.Depending on Ne duration of the stoppage,an additional equitable adjustment maybe nezessary forever wage inerwu a M general escalation. SFRN@WARRANTY,to addtim teeny wamn y extended to mase on the produrl(s)used In a service,should the workmoroWp(or application)of this service prove fart'within ONR YRatR, Sturdy Home Improvement,ac trill uponnotice from yon,cause such faults tobe corrected by repair at no additional cat la pw Sbdce'Ada this warranty is avaaablebyclling(RT/)SsfURDy.Thhwamn4gives yon speci&Igai dghteandyenta.also leveotlerrights wbW very from stele to state START DATES*Unless othww(a,stated In Maned,the start date shall fallow the completion of presiousb'scheduled projects.Completion of prefect shell follow Ina wmkmanbie manner consistent with ecabtihedmnsta<dmatandards SuBCONTRACtING5 Ontra orhes the right to subcontract any pat,,or an..att xk agreed fern to beperfomnedAU permits,license requirements,workmen'awmpensation and/or other job rryWrememwAall belle sole reapnnwoflee subcontractor.GMnctmoyeo eaneanrithstandhng any agreement fa materials aha abetween m n Conhatland a third psryta , mlector is apeablem!Coeswrcompletion!failwork delated In limelysdinrtmanlbbe manner. SUBSTANTIAL COMPLETION: Owner agrees that upon the stMuntialCompletion of project that final balance minis double lit value of the product yet to be install will be doe upon coMmaor polnwaureto twmakepayment will wmconuGsmrerestart e proJctesnetdaboe.My failure or delay in payments win cold onySUNy Home lmprovcmeet Newamny for wNmanehip SURPLUS MATHUAL:Any remaining saplusmamWs afammpletfon efNlapb ricri.=tab the property oftwContractorltocrediti dueon returns Ds LPage 6 of 6 INITIALS INITIALS INITIALS_