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15-003 (6) 478 CHESTERFIELD RD BP-2020-0307 GIs#: COMMONWEALTH OF MASSACHUSETTS Map-Block: 15- 003 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-2020-0307 Project# JS-2020-000523 Est. Cost: $13917.00 Fee: $40.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: SEARS HOME IMPROVEMENT PRODUCT 097519 Lot Size(sq. ft.): Owner: SCANLAN JOHN B& Zoning: Applicant: SEARS HOME IMPROVEMENT PRODUCT AT. 478 CHESTERFIELD RD Applicant Address: Phone: Insurance: 827 THOMPSON RD (860) 753-0452 O WC THOMPSONCT06277 ISSUED ON:9/10/2019 0:00:00 TO PERFORM THE FOLLOWING WORKSTRIP & 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 9/10/2019 0:00:00 $40.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner _ (Z Department use only City of No ham ton St tus o Permit: -�' Building D part er>&EP 10 2019 C rb C /Driveway Permit,--_- 212 Mai Str et S wer/ eptiCAvailability r ' ROO 10 EPr ater/ ell Availability Northampt MA s� M�rNGiNSFECTi g'o S is of Structural Plans - phone 413-587-1240 Fax 4 - 01060 plot/Si a Plans Other APPLICATION TO CONSTRUCT,ALTER,REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION '&P cl�o —60 7 1.1 Property Address: This section to be completed by office Map Ma s � f - ( Lot v`�' Unit 472 C�EsT�rt r,� Zone Overlay District Elm St. District CB District_ SECTION 2 -PROPERTY OWNERSHIP/AUTHORIZED AGENT 2...1 Ow�n1rr of Record: -1 an p Na a(Print n Curr it M�ng Addr 94/� - V4��� Telepho e O"t Signature 2.2 Authorized A ent: 82`7 o V"Psor) 1'uhos- "l -'Cie;4 _-�(44SDy), C-r 06-Z-77 Nam Pri — Current Mailing Xddress. JIF 60 - 753 -04S-2- 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) O 5. Fire Protection 6. Total =0 +2+3+4+5) Check Number This Section For Official Use Only Building Permit Number: DateIssued: Signature:t P Building Commissioner/Inspector of Buildings Date ,iLSVF.CO`831 @ Cwy i1 cc)w, EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning This column to be filled in by Building Department Lot Size Frontage Setbacks I-ron t Side I : IZ: 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 W YES 0 IF YES, date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO Q DON'T KNOW YES IF YES: enter Book Page and/or Document# B. Does the site contain a brook, body of water or wetlands? NO 0 DONT KNOW /91% YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained 0 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 O 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 O NO /�Qp IF YES,then a Northampton Storm Water Management Permit from the DPW is required. 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 [O] Decks [M Siding 10] Other[01 Brief De scr of Rro oscd Sh-I /) -- --- 1 S u�r�s - `il Work: ► 1 /�-� Alteration of existing bedroom Yes /` _No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement _Yes X No Plans Attached Roll -Sheet 6a. 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..____ —`__-___, imensions e. Number of stories? f. Method of heating? _ Fireplaces or Woodstoves Number of each----.---- g. ach______g. Energy Conservation Compliance. _Masscheck Energy Compliance form attached? h. Type of constriction _ i. Is construction within 100 ft. etlands? Yes No. Is construction within 100 yr. floodplain Yes No j. Depth of basement or ar floor below finished grade k. Will building con m to the Building and Zoning regulations? Yes No. I. Septic Ta City Sewer Private well City water Supply SECTION 7a-OWNER AUTHORIZATION -TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT a1 —as Owner of the subject property hereby authorize-Aqm to act on my be alf,in qII matters relative to work authorized ry this building permit application. V Signature of Owner Date I, S V �(� _ E%`vl as Own �Authorized Agent hereby declare that the statements and information on the foroing application are true and accurate,to the best of my knowledge and belief. Signed and r the pains and penalties of perjury. /—U A3ignature — (,c j • �t Cl I ,�Bate SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Su rvisor: Nott�App�iclicablle El Name of License Holder CJ V V W`� , Z77 I / V 1 L License Number Vol D SDSd� _ DmO�,C OD 08 31 ZOZO Addr s Expir ion Dat _ _ - tY6D-7-93-0A-SZ ature Tel phone 9. Re istered Home Improvement Contracr: Not Applicable El q6ars HOWe �p -4.0 _ s_&__-. X00-7 Company Name / Registration N tuber C111Wy ;.. t_3275b Z0 I`'1 Addr s Expi ation to . TelephonoW SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152,§25C(6)) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed Affidavit Attached Yes....... No...... ❑ City of Northampton Massachusetts 1 R i / y DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building .= Northampton, MA 01060 AFFIDAVIT Home Improvement Contractor Law Supplement to Permit Application The Office of Consumer Affairs and Business Regulation("OCABR")regulates the registration of contractors and subcontractors performing improvements or renovations on detached one to four family homes. Prior to performing work on such homes, a contractor must be registered as a Home Improvement Contractor("H1C"). M.G.L.Chapter 142A requires that the"reconstruction, alteration, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units....or to structures which are adjacent to such residence or building"be done by registered contractors. Note:ff the homeowner has contracted with a corporation or LLC,that entity must be registered. Type of Work – ` �_Est. Cost: Q 11 -R Address of Work: �-� V—C r _ ` a– D Date of Pen-nit Application: C� I hereby certify that: Registration is not required for the following reason(s): _Work excluded by law(explain): _Job under$1,000.00 Owner obtaining own permit(explain): Building not owner-occupied _Other(specify):____ OWNERS OBTAINING THEIR OWN PERMIT OR ENTERING INTO CONTRACTS WITH UNREGISTERED CONTRACTORS OR SUBCONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK ARE NOT ELIGIBLE FOR AND DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER M.G.L.Chapter 142A.SUCH OWNERS ALSO ASSUME THE RESPONSIBILITES FOR ALL WORK PERFORMED UNDER THE BUILDING PERMIT.SEE NEXT PAGE FOR MORE INFORMATION. Signed under the penalties of perjury: I hereby apply fora uil ing p rmit as the t of the owner: 14 Ltl� �l to �� �u 10 o s v e� 1 9 �8 CO I)Itc Contractor Name HIC Registration No. OR: Notwithstanding the above notice, I hereby apply for a building permit as the owner of the above property: A) A Date Owner Name and Signature City of Northampton Massachusetts DEPARTMENT OF BUILDING INSPECTIONS W r 212 Main Street •Municipal Building Northampton, MA 01060 Debris 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. The debris from construction work being performed at: 4`7 S C��s�e►�-�i -Road (Please print house number and street name) Is to be dis osed of a f �3 .) ispC CL l 6�c3 V-W olwGt /4a Idav_I I /L4 (Please print name and location of facility) Or will be disposed of in a dumpster onsite rented or leased from: (Company Name and Address) u7i. - ------- ----------- e o ermit p cant or ner Dat If, for any reason, the debris will not be disposed of as indicated, the Applicant or Owner shall notify the Building Department as to the location where the debris will be disposed. The Commonwealth of Massachusetts W Department of Industrial Accidents I Congress Street, Suite 100 Boston, MA 02114-2017 M www mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name (Business/Organization/Individual): Sears Home Improvement Products Incorporated Address: 1024 Florida Central Parkway City/State/Zip: Longwood, FL 32750 Phone#: 860-753-0452 Are you an employer?Check the appropriate box: Type Of project(required): I.❑I am a employer with employees(full and/or part-time).* 7. ❑ New construction 2.E]I am a sole proprietor or partnership and have no employees working for me in 8. [:]Remodeling any capacity.[No workers'comp.insurance required.] 9. El Demolition 3.E]I am a homeowner doing all work myself.[No workers'comp.insurance required.]' Q4.4.[]I am a homeowner and will be hiring contractors to conduct all work on my property. I will 10 Building addition ensure that all contractors either have workers'compensation insurance or arc sole 11.[]Electrical repairs or additions proprietors with no employees. 12. Plumbing repairs or additions 5.Q 1 am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.�Roof repairs These sub-contractors have employees and have workers'comp.insurance.: 'R� _ G.PJ We are a corporation and its officers have exercised their right of exemption per MGL c. 14.P4 Other IV` 152,§1(4),and we have no employees.[No workers'comp.insurance required.] ti ' a S *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.police number. /ar»an employer that isproviding workers'compensation insurance fin mr employees. Below is the policy and job site infirrnration. ►nsurance Company Name: JLT Specialty USA / Phone : 866-283-7122 Policy#or Self-ins.Lic.#: 012717069 Expiration Date: 01/01/2020 Job Site Address City/State/Zi C Is IWA 010S3 Attach a copy of the workers' compensation policy declaration page(showing the policy number an expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. /do hereby ger y u er the pains rd penalt�ojfpetrjtn that tlrc i,�rinon provided above is true and correct. Si Hatt *r Date: / //a> �1 Phone#: 860-753-0452 OJliriol use onll•. 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#: RESET FORM AL ORO® DATE(MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 6/27/2019 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(ies) must have ADDITIONAL INSURED provisions or 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 JLT S eclalt USA CONTACT y NAME: Elizabeth Stackowitz 350 Madison Avenue, 7th Floor PHC NE No E a No: New York, NY 10017 IA/E-MAIL ADDRESS: elizabeth.stackowitz@jltus.com INSURERS AFFORDING COVERAGE NAIC 0 www.jltus.com INSURER A: National Union Fire Ins Co Pittsburgh PA 19445 INSURED INSURER B: New Hampshire Insurance Company 23841 Sears Holdings Corporation INSURER ACE Property 8 Casual Insurance Co 20699 dba Sears Home Improvement Products, Inc. - Attn: Risk Management E3-219A INSURERD: American Home Assurance Company 19380 3333 Beverly Road INSURER E: Ins Co State Of Penn 19429 Hoffman Estates IL 60179 INSURER F COVERAGES CERTIFICATE NUMBER: 49633239 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 INDICAT-ED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED HY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POI(CIES.LIMITS SHOWN MAY HAVE 131 I N RI DUCF.D BY POLICY EFF_PAID CLAIMS. ( XP LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER _ _ MM/DDIYYYY MMIDPOLIDnYYY LIMITS A �/ COMMERCIAL GENERAL LIABILITY 5425885 !1/1/2019 1/1/2020 EACH OCCURRENCE $5,000,000 CLAIMS-MADE L.11 OCCUR PREMISES EaEoccu en.e $5,000,000 MED EXP(Any one person) $0 PERSONAL&ADV INJURY $5,000,000 _ GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $5,000,000 POLICY[�JECT �LOC PRODUCTS-COMP/OP AGG $5,000,000 OTHER: $ A AUTOMOBILE LIABILITY 9767458 7/1/2019 1/1/2020 EaaccdeDISINGLELIMIT $5000000 A � ANY AUTO 9767459 7/1/2019 1/1/2020 BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS �— HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident F I I Medical Payment $10,000 L /JUMBRELLA LIAB OCCUR XOO G28144799 003 1/1/2019 8/1/2019 EACH OCCURRENCE $25,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $25,000,000 DED RETENTION$ $ D WORKERS COMPENSATION 012717069 7/1/2019 1/1/2020 ✓ STATUTE ERH AND EMPLOYERS'LIABILITY F YIN 012717070 7/1/2019 1/1/2020 ANYPROPRIETORIPARTNER/EXECUTIVE E.L.EACH ACCIDENT $2000,000 B (OFFICER/MEMBEREXCLUC ] NIA 012717071/012717072 7/1/2019 1/1/2020 B (Mandatory In NH) 012717073/012717074 7/1/2019 1/1/2020 E.L.DISEASE-EA EMPLOYEE1$ If yes,describe under E. DESCRIPTION OF OPERATIONS below 1 1012717075 7/1/2019 1 1/1/2020 1 E.L.DISEASE-POLICY LIMIT ; $2,000,000 i DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Evidence of Coverage. CERTIFICATE HOLDER CANCELLATION Sears Home Improvement PfOdUCtS Inc. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Sear Florida Central meetPTHE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Longwood FL 32750 Parkway ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Andre Eichenholtz ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD (_-LALN"C - Sears Home Improvement I Elizabeth Stackowitz 1 6/27/2019 2:09:32 PH (EDT) I Page - or `l I Office of Consumer Affairs and Business Regi.lation One Ast-ibu:-ton Pla-le - Suite 130'c Boston, Massachusels 02108 Horne ;fllprove!'nent Cont'ractor Registration 11 ypc'.. Registration, 1 486", -,""PUICT S Nc Expir�ition, 10:10?C'1 PK,A ......................... Uprate Ad(jessa� Return rar-' ReSistration vali for incliviluai ose only before file expiration dale, if*OUnd fetLrr,tO� Corlsurnr Aftiwki.o t Park P�:U So Stun, -7S Commonwealth of Massachusetts Division of Professional Ucensure Board of Building Regulations and Staindards suoction 'Supervtsor CS-097519 Expires 0831;2020 LUBOS SVEC 827 THOMPSON ROAD THOMPSON CT 06277 Commissioner Job:26337903 Page 1 of 5 IIII11IIIII'll 1111 Off ce Location: HARTFORD Proposal Date 09/06/2019 lJob Number 26337903 TRANSFORM SR HOME IMPROVEMENT Customer NamePRODUCTS LLC D/B/A SEARS HOME JOHN SCANLAN ESTIMATE 1IMPROVEMENT PRODUCTS NTRA T R" P.O BOX 522290 Customer's Home Phone Customer's Work Phone 1024 FLORIDA CENTRAL PARKWAY (413) 584-5905 AND LONGWOOD,FL 32750-7579 PHONE(800)469-4663 Street Address Contractor License/Registration Number PROPOSAL 478 CHESTERFIELD RD 195903 City State Zip Code LEEDS MA 01053 Is installation within city limits? Installation Address County HAMPSHIRE (Yes/No): YES Billing Address(if different from above) City State Zip Code Project Consultant Name&License No.(if applicable) STEPHEN PRESZ HIS.0557733 Description of the Project and Description of the Significant Materials to be Used and Equipment to be installed Interior Products / Exterior Products Home Warranty QVinyl Siding ✓&oofing E]HVAC ❑Kitchen Remodeling [:]Countertop Whole House [-]Coating QWindows ❑Attic Insulation ❑Cabinet Refacing ❑Flooring System [—]Painting ODoors []Garage Doors ❑Bathroom Appliance SPECIAL INSTRUCTIONS: 2 NO LAYER TEAR OFF MOLD REMEDIATION: This Estimate and Proposal assumes that no mold remediation will be needed during installation work. If, upon inspection by the contractor or others, it is learned that mold remediation is necessary then Customer must arrange and pay for such remediation by a qualified person prior to the start or continuation of work.If Customer fails to arrange for necessary mold remediation within thirty(30)days,Contractor may cancel this contract upon written notice to Customer. ASBESTOS ABATEMENT:This Estimate and Proposal assumes that there are no asbestos containing materials("ACMs")that would be disturbed in the performance of the installation work. If upon further inspection by the contractor or others it is learned that ACMs have to be disturbed to perform work, then Customer must arrange and pay for abatement of asbestos by a qualified person prior to the start or continuation of work. If Customer fails to arrange for necessary asbestos abatement within thirty(30)days,Contractor may cancel this contract upon written notice to Customer. The TOTAL PRICE including all labor,material,taxes and any applicable discount is $ 13,917.36 Contract Price $13,917-36 Earnest Money $ 5oo.oo State Sales Tax $ 0.00 *INITIAL PAYMENT(Not to exceed 30%of TOTAL PRICE;payment is due prior to Local Sales Tax $ 0.00 ordering of product;excludes HVAC in which the INITIAL PAYMENT is 100%.) $3,675.21 Initial Payment Subtotal $41175*21 FINAL PAYMENT(balance payable upon completion of job) $9,742-15 Total Amount Due $ 13,917.36 'The Initial Payment is due prior to Contractor ordering products.A Cancellation Fee of 500.00 plus any incurred materials costs,up to 30% up to$ of the Total Price,may be assessed. Financing: The form and method by which the Customer(s)will pay is described in a separate Cash/Credit Card Payment Addendum made a part of and incorporated into this contract by reference. All of the above check boxes(and associated Product Addendum(s)),"Work NOT to be done:","Additional work to be done:","Special Instructions:", "Mold Remediation","Asbestos Abatement,"and"Financing:"sections have been reviewed by and explained to me.Product Addendum(s)is/are made a part of and incorporated into this contract by reference. Customer(s)initials NOTICE TO BUYER: YOU,THE BUYER, MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD(3) BUSINESS DAY, FIVE (5) BUSINESS DAYS IN MARYLAND, (FIVE (5) BUSINESS DAYS IN ALASKA, SEVEN (7) BUSINESS DAYS IN MARYLAND, FIFTEEN(15) BUSINESS DAYS IN NORTH DAKOTA IF YOU ARE 65 OR OLDER) AFTER THE DATE OF THIS TRANSACTION. SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. SKI-(Dig.) Rev 10/16/17 Job:2633'/903 Nage 7 of 5 Roofing Addendum Consultation Info Lead Number: 26337903 Date: 09/06/207.9 Sales Rep: STEPHEN PRESZ Customer Name: JOHN SCANLAN Phone: 4135845905 Address: 478 CHESTERFIELD RD City: I LEEDS State: MA Description of • and Description of • to be The work to be done under this contract includes the following (where checked): Specs ( 0 included 0 not included) Preparation 1. 0 Tear off existing root shingles down to wood deck on entire house. 2. 0 Inspect wood deck for rotten wood. 3. 0 Replace any rotten wood found in the deck area at a rate of $ 4.00 per square foot. PLEASE NOTE: this amount is not included in the TOTAL PRICE shown below. Installation. 4. 0 Furnish and install PROARMOR underlayment over roof decking. 5. 0 Furnish and install shingles, ice &water cave & valley protector, starter shingles on all eaves, replace any deteriorated "L"flashing, metal drip edge along rake edges and eaves, new vent covers on all vent pipes. 6. 0 Skylight system (See proposal item) 7. 0 Furnish and install attic ventilation system (check all applicable): 0 Turbines Power vents Shingle-over ridge vents 0 Off-ridge vents 0 Soffit vents 8. F—] Furnish and install new flat roof Exterior Protection System: COLOR: Clean-up 9. 0 Clean-up and removal of all job-related debris including excess materials. (Extra materials are shipped with each job to avoid delays). Manufacturer warranty will be sent upon completion of installation. Contractor recommends that Customers have their chimney siding or mortar between brick, stone, or blocks inspected periodically by a professional and tuck pointed and/or waterproofed as needed. Contractor shall not be responsible for chimney integrity other than replacing the flashing in conjunction with the installation of the roofing materials described above. Job:26337903 Page 3 of 5 APPROXIMATE START DATE and APPROXIMATE COMPLETION DATE: The work will start approximately TSD 2 TO 3 WEEKS (Approximate Start Date) It will be substantially completed by approximately TSD (Approximate Completion Date) These dates are subject to change at the time the contract is accepted by Contractor or at any other time by mutual written agreement. Customer understands that the Approximate Start Date is only an estimated date and the Customer will be contacted prior to this date to schedule the actual start date. The TOTAL PRICE including all labor,material, taxes and any discount is $ 13, 91 1•=u Contract Price $ 13,917.36 Initial Payment(not to exceed 30%of Total Price unless Special Order) $ a 17 5 State Sales Tax ( 0.00 oyo)$ 0.00 Final Payment(balance payable upon completion of job) $ 9, —7 4 .1- Local Sales Tax ( 0.00 %)$ 0.00 The Initial Payment is due prior to Contractor ordering products. Total Amount Due $ 13,917.36 Additional work to be done: 2ND LAYER TEAROFF Work NOT to be done: Repairs and replacement of any damaged existing structural members. Interior repair to walls or ceilings including sealing, painting, and/or drywall repair. Removal and/or re-installation of items that may otherwise impede Contractor's ability to install a new roofing system prior to installation. Examples include, but are not limited to,satellite dishes, solor panels, pool heating panels, gutter protection systems, TV antennas, HVAC systems, and weather equipment. ,HED CONTRACTOR'S LIMITED WARRANTY ON INSTALLATION In addition to any manufacturer warranty extended to you on the product(s)used (which warranty becomes effective the date the merchandise is installed),if the workmanship(or application)of any Contractor's arranged installation proves faulty within five years(Best),three years(Better),two years(Good)or one year(Limited)after products are installed,then upon notice from you Contractor will cause such faults to be corrected by repair at no additional cost to you. If Contractor determines that repair is not commercially practicable or cannot be timely made then,at Contractor's sole discretion,Contractor may elect to provide replacement or refund.Service under this Limited Warranty is available by calling Contractor at 1-800-222-5030,Option 4.This warranty gives you specific legal rights,and you may also have other rights that vary from State to State. Proposal Code Description Unit of Measure Units R001M-11 Shingles-Better. OC OakRidge-Brownwood Square 17.50 R010A Steep. Pitch 8 to 9112 Square 17.50 IR014A Underlayment. Weather lock-Eaves/Valley Per Linear Ft. 163.00 R021A Ventilation. Shingle over ridge vents Per Linear Ft. 48.00 R030A Flashing. Chimney Each 1.00 �R036A Extra labor. Extra layer tear off Square 17.50 Job:26337903 Page 4 of 5 ADDITIONAL PROVISIONS Proposal and Approval.Sears offers to furnish the materials and arrange for their delivery and installation as specified on the first page and/or the attached sketches and specif cation sheets for the TOTAL PRICE shown. This offer must be approved by the Installation Department. If this is a credit sale or a payment on completion sale, it must be approved by the Credit Sales Department. If this proposal is not approved or the installation cannot be made in accordance with the law,this offer will be withdrawn and any payments you have made will be refunded to you.Any materials left over after the installation has been completed are Sears property and will be removed by Sears. Installation. I understand that Sears will not install the materials but will arrange for the installation. Sears is not responsible for materials or installation NOT furnished or arranged by Sears. Sears'installation contractor(s)will obtain all building permits required by local law. For homes located in historic or landmark zoning districts, Customer will be responsible for obtaining required approvals and related permits prior to the commencement of work on this contract. Authorization. I authorize Sears to: (1) arrange for a contractor(licensed where required by law) to make the installation of materials; (2) issue a work order for this installation to a contractor; (3)inspect the installation;and(4)pay the contractor when the installation is complete if I have signed a certificate that the installation has been completed to my satisfaction. Delays in Installation. I agree that Sears is not responsible for delays in delivery or installation due to weather,fire,strikes,war,government regulations or any causes beyond Sears'control. Oral Agreements and Changes in Contract. I understand that there are no oral agreements between Sears and me. Everything I expect Sears to do has been included in writing in this contract.Nothing can be changed in this contract unless it is in writing on a separate form accepted by me and Sears. Responsibility of Buyer. I agree that any information or measurements that I give to Sears are correct and complete. I am responsible for any special work described in this contract. Electrical & Plumbing Service. I will provide adequate electrical and/or plumbing service(s) to run any newly installed appliances or other furnishings. If the electrical and/or plumbing service(s) do not meet the standards of the utility company or electrical and/or plumbing codes, I will make the necessary changes at my expense unless Sears has agreed in this contract to make the changes. Payment.I will pay Sears the cash price that covers the price of material and installation as shown on the first page. Warranty Information.Appropriate product warranty documents will be given to me by Sears.Sears'Warranty on Installation is displayed in the Product Addendum. (Dig.) Rev 06/07/17 Job:26337903 Page 5 of 5 NOTICE TO MASSACHUSETTS RESIDENTS ONLY In addition to the Notice to Buyer shown below, Massachusetts law requires that contracts for home improvement work state that all home improvement contractors and subcontractors shall be registered and that any inquiries 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 Boston, MA. 02116 Telephone: (617)973-8700 Please note that owners who secure their own construction-related permits or deal with unregistered contractors shall be excluded from access to the Guarantee Fund. ----------------------------------------------------------------------------------------------------- Notwithstanding any other language in the contract or associated documents, Contractor will not remove, replace, or install any heating or air conditioning system, or any portion thereof, if asbestos or asbestos-containing material is known or likely to be present in that heating or air conditioning system, or any portion thereof. If it is determined or reasonably suspected that asbestos is present, either before commencement or during performance of the work, it shall be the customer's responsibility to select, retain and pay all costs of a Division of Occupational Safety("DOS")licensed Asbestos Contractor to remove all asbestos or verify that none is present in the components involved in the job. If the determination or reasonable suspicion of the presence of asbestos arises after Contractor has started the work, Contractor will immediately cease performing the work until a DOS licensed Asbestos Contractor, hired by the customer, removes all asbestos from the components scheduled for repair or replacement in accordance with 310 C.M.R. 7.00 and 453 C.M.R. 6.00 or verifies that none is present. By signing the contract the customer agrees that it understands the above. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES NOTICE TO BUYER 1. DO NOT SIGN THE AGREEMENT IF ANY OF THE SPACES INTENDED FOR THE AGREED TERMS TO THE EXTENT OF THE AVAILABLE INFORMATION ARE LEFT BLANK. YOU ARE ENTITLED TO A COPY OF THIS AGREEMENT AT THE TIME YOU SIGN IT. KEEP IT TO PROTECT YOUR LEGAL RIGHTS. 3 YOU MAY PAY OFF THE FULL UNPAID BALANCE DUE UNDER THE AGREEMENT AT ANY TIME, AND IN SO DOING YOU SHALL BE ENTITLED TO A FULL REBATE OF THE UNEARNED FINANCE AND INSURANCE CHARGES. l YOU MAY CANCEL THIS TRANSACTION, WITHOUT ANY PENALTY OR OBLIGATION, WITHIN THREE (3) BUSINESS DAYS, FIVE(5) BUSINESS DAYS IN MARYLAND, (FIVE (5) BUSINESS DAYS IN ALASKA, SEVEN (7) BUSINESS DAYS IN MARYLAND, FIFTEEN(15) BUSINESS DAYS IN NORTH DAKOTA IF YOU ARE 65 OR OLDER) FROM THE ABOVE DATE. SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. FAILURE TO EXERCISE THIS OPTION, HOWEVER, WILL NOT INTERFERE WITH ANY OTHER REMEDIES AGAINST THE RETAIL SELLER YOU MAY POSSESS. IF YOU WISH, YOU MAY USE THIS PAGE AS NOTIFICATION BY WRITING "I HEREBY RESCIND" AND ADDING YOUR NAME AND ADDRESS. A DUPLICATE OF THIS RECEIPT IS PROVIDED BY THE SELLER FOR YOUR RECORDS. 5. CANCELLATION FEE. I UNDERSTAND THAT CONTRACTOR, UPON ENTERING INTO THIS AGREEMENT, WILL PROMPTLY INCUR SIGNIFICANT COSTS TO START MY PROJECT. FOR THIS REASON, I AGREE THAT CONTRACTOR WILL RETAIN AS A CANCELLATION FEE THE "EARNEST MONEY" AMOUNT SHOWN AS PART OF THE TOTAL PRICE IN THE EVENT THAT I ELECT TO CANCEL THE AGREEMENT AT ANY TIME AFTER THE EXPIRATION OF ANY LEGAL RIGHT OF RECISION. THIS CANCELLATION FEE WILL BE IN ADDITION TO ANY AMOUNTS I MAY OWE, AND WHICH I AGREE TRANSFORM MAY RECOVER DIRECTLY FROM MY INITIAL PAYMENT, FOR MATERIALS ALREADY ORDERED BY TRANSFORM PRIOR TO CANCELLATION. 6. IT SHALL_ NOT BE LEGAL FOR THE SELLER TO ENTER YOUR PREMISES UNLAWFULLY OR COMMIT ANY BREACH OF THE PEACE TO REPOSSESS GOODS PURCHASED UNDER THIS AGREEMENT. 09/07/2019 09/07/2019 Customer Signature Date Customer Signature Date Accepted by Contractor on 09/07/2019 by Date Management Representative