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11C-032 (4) 9 STOWELL ST BP-2020-1256 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: I IC-032 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 P E RM I T Permit# BP-2020-1256 Project# JS-2020-002114 Est.Cost: $19405.00 Fee:$40.00 PERMISS fON IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: SAMBRICO I BRIAN RUDD 111478 Lot Size(sg. ft.): 13416.48 Owner: ELLI T PAULA Zoning: URA(100)/HB(0)/ Applicant. S MBRICO - BRIAN RUDD AT: 9 STO ELL ST Applicant Address: Phone: Insurance: 2003 RIVERDALE ST (413)382-0249 WEST SPRINGFIELDMA01089 ISSUED ON:6/18/2020 0:00:00 TO PERFORM THE FOLLOWINGORK:STRIP & SHINGLE ROOF POST THIS CARD SO IT IS VISIBLE FRO 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 Si«nature: FeeTvve: Date Paid: Amount: Building 6/18/2020 0:00:00 $40.00 212 Main Street, Phone(413)587-1240,Fax:(413)587-1272 Louis Hasbrouck—Building Commissioner r-- �JI (2 Z n' ul- --,CnF 0 — Department use only - City of Northampton Status of Permit: 54 Building Department Curb Cut/Driveway Permit 212 Main Street Sewer/Septic Availability Room 100 Water/Well Availability r Northampton, MA 01060 Two Sets of Structural Plans phone 413-587-1240 Fax 413-5587-1272 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 n �w p ,�L.J� i S" Map Lot D3� Unit l � ` A u!` ` u C Zone Overlay District (� 1 J Elm St. District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 24 Owner of Record: VG U � 0 6 116 A j et C'I ?-O(—WVA '�Vbvit\k 1� I VLdS MA IW5 �> e(Print) 0 (renotM Add s:lep ne Signature 2. uthorized A ent: lei ikzda -e ws a rint) Si re urrrent Mail�ing Address: NV I 6 �// 6elephone/3) )Q / v SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building ,`� �Q (a)Building Permit Fee (, I �J!l 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) O Check Number This Section For Official Use Only 5 Building Permit Number: �/�J V~ Date Issued: Signature: Building Commissioner/Inspector of Buildings Date �. @ Ulm EMAIL ADDRESS (REQUIRED; EITHER HOMEOWNER OR CONTRACTOR) SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing Or Doors D I A, Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [0 Siding[O] Other[dJ Brief De n o f Prf�pose `n p n ^ 1 Work: 1 lJ `1 1���`1 �i w lJLSV l�.ll \CUU C - Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes 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. 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 PERMITS I, 1 `, ' �1�—� as Owner of the subject property hereby authorize vmcw to act y behalf, in a I matters relative to work authorized by this building perm appliation. Signature of Owner Date I, 7 ( IJLs^ as Owner/Authorized Agent he declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief. Sign er the pains and pena s of perjury Print Name � � as Sig re o Owner Agent e SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: l A / Not AApplic`able 11n Name of License Holder: ' v\ /` �i_? 1 ' License Number � v t rd��� plA Addre �� Expiration Date Tel hone 9-Registered Home Improvement Contractor: Not Applicable ❑ a VvS ►�v t �� US^X om an N e Registration Number e. S' i - c-- - ( d�dryess t Expiration Date �1 cis Telephone I ! 7 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 build ng permit. Signed Affidavit Attached Yes....... No...... ❑ City of Northampton r 'F Massachusetts i ,A H DEPARTMENT OF BUILDING INSPECTIONS ti 212 Main Street • Municipal Building `• Northampton, MA 01060 AFFIDAVIT Home Improvement Contractor Law Supplement to Permit Application The Office of Consumer Affairs and Business Re agulation("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 mut be registered as a Home Improvement Contractor("HIC"). M.G.L.Chapter 142A requires that the"reconst ction, 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.... r to structures which are adjacent to such residence or building"be done by registered contractors. Note:If the homeo ner has contracted with a corporation or LLC, that entity must be registered Type of Work. 04 Est.Cost: —) U/05 Address of Work: Date of Permit Application: 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 FOE 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 i LLSO 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 for a building permit as the agent of the owner: c� %ffibn c,) vt t � S D to Contractor Nam j��l�C, ;mI�C.I�e ig stratign No. OR: �-ll (Jr USI fY � Notwithstanding the above notice, I hereby apply for a building permit as the owner of the above property: Date Owner Name an J Signature City of Northampton Massachusetts DEPARTMENT OF BUILDING INSPECTIONS \ 212 Main Street •Municipal Building ti Northampton, MA 01060 SNyY11 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: G awP,jl "�ait- (Please print house number and street name) Is to be disposed of at: (Please print name and loca 'on of facile y Or will be disposed of in a dumpster onsite rented or leased from: (Company Name and Agdr s) S' ature otreYmft Applicant or Owndr Da 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 = Department of Industrial Accidents I Con rress Street,Suite 100 Bos n, MA 02114-2017 r ji ww mass.gov/dia urkers'Compensation Insurance ffidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information A I I Please Print Le ibl Name(Busin s/Organization/Individual): 'C Address: I City/State/Zip lq W�A Phone#: Are you an employer?Ch a appropriate box: Type of project(required): IgI,'m a employer with employees(full and/or part-time).* 7. ❑ New construction m a sole proprietor or partnership and have no employees orking for me in 8. E] Remodeling any capacity.[No workers'comp.insurance required.] 9. ❑Demolition 3.F I am a homeowner doing all work myself.[No workers'com 3.insurance required.]' 10E] Building addition 4.❑1 am a homeowner and will be hiring contractors to conduct ill work on my property. I will ensure that all contractors either have workers'compensatior insurance or are sole 11.❑Electrical repairs or additions proprietors with no employees. 12.Fl Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑ROof r airs These sub-contractors have employees and have workers'comp.insurance. Kl 6.[:]We are a corporation and its officers have exercised their rig]t of exemption per MGL c. 14.q�ther 152,§1(4),and we have no employees.[No workers'comp. insurance required.] 'Any applicant that checks box#1 must also fill out the section belo showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing al work and then hire outside contractors must submit a new affidavit indicating such. -Contractors that check this box must attached an additional sheet sh wing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provid their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. \ n ,� �j'��� Insurance Company Name. W� 1 NS QUI , \ l�L� 5 Policy#or Self-ins.Lic.#: (� xpiration Date: 3 Job Site Address: City/State/Zip:(t2,&s o/a'J Attach a copy of the workers'compensation policy leclaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 1 2,1251 is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penaltie 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 a forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do irerehl•certijj, the pains a d p nalties ffpirjuty that the information provided above is true and correct Sian Dater Phone#: Official use only. Do not write in this area,to be citnipleted by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.Ci /Town Clerk 4.Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone#: Page 1 of 7 2097 Riverdale Street MA Lic# 162058 West Springfield, MA CT Lic# 0621848 01089 Vista. G '(O'HOME IMPROVEMENT vistahomeimprovement.com , Phone: 888.597.2323 Fax: 413.382.0241 ROOFING CONTRACT All home improvement contractors and subcontractors must be registered and 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 Phone: 617.973.8700 Customer Information Paula Elliott yellowturtle21@gmail.com Date: 06/09/2020 Terri Buckley Yellowturtle21@gmail.com Rep: David Lauzon 9 Stowell St buggles1960@outlook.com Leeds MA 01053 (413)336-2447 (413)230-6064 Roof Specifications Owens Corning Roof Systems Preferred Roof System Color Harbor Blue Drip Edge Color white Number of Layers 1 Attic plywood Tear Off/Shingle Over tear off Location Full house and garage Underlayment Pro Armor Ice & Water Shield 6feet Supply and Install Ridge Vent yes Vista Home Improvements agrees to do the following: Supply Dumpster Included Dumpster location Driveway Inspect Decking for damage Yes Replacement decking price per sq ft 2.75 Replacement decking price per sq ft Ice and Water all valleys, penetrations, eaves and chimneys Yes Supply and install pipe boot flashing Yes Total Job Clean-Up Yes 12" Chimney Relead 1 I, Paula Elliott,Terri Buckley have read the terms stated herein, they have been explained to (me/us), and (I/We) find them to be satisfactory and hereby accept them. This spade intentionally left blank Page 2 of 7 Roof Sketch / Photos I ----------- r Y r David Lauzon, Authorized Representative Paula Elliott 06/09/2020 06/09/2020 Date Date —Z��/ nl4� Terri Buckley 06/09/2020 Date This space intent+onaiiy ier� Dunk Page 3 of 7 Homeowner's Association NO WORK SCHEDULE Contractor will not begin the work or order the materials before the third day following the signing of this Agreement, unless specified herein. Contractor will begin the work on or about 07/09/2020 Barring delay caused by circumstances beyond Contractors control, the work will be completed by 08/09/2020 WARRANTY The Contractor warrants that the work furnished hereunder shall be free from defects in materials and workmanship for the period stated below following completion and shall comply with the requirements of this Agreement. In the event any defect in workmanship or materials, or damage caused by the Contractor, its subcontractors, employees or agents, is discovered after completion of any job, Including cleanup, the Contractor shall, at its own expense, forthwith remedy, repair, correct, replace, or cause to be remedied, repaired or replaced, such damage or such defect in materials and workmanship. The foregoing warranties shall survive any inspection performed in connection with the agreed-upon work. Warranty Period 25 Year Measure Section Measure Set With -- Marc Date Measure Is set for 06/11/2020 Time Measure is set for Between 12-3 Total Contract Amount (All Discounts Applied) $191405.00 Payment Deposit $5,000.00 Last 4 of SS# 6566 Green Sky Application ID# Amount Financed $14,405.00 Form of Payment For Deposit Check Check# 5966 Check Date 06/09/2020 Acceptance of Proposal I have read both sides of this document and accept the prices, specifications and conditions stated. I understand that upon signing, this proposal becomes a binding contract. You are authorized to do the work as specified. Payment will be made as outlined above. You may cancel this agreement if it has been signed by a party thereto at a place other than an address of the Seller, which may be his main office or branch thereof, provided you notify the Seller in writing at his main office or branch by ordinary mail posted, by telegram sent or by delivery, not later than midnight of the third business day following the signing of this agreement. Please refer to the Notice of Cancellation below contents of which are referred to above and incorporated herein by reference. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. This space intentionally left blank Page 4 of 7 NOTICE OF CANCELLATION YOU MAY CANCEL THIS TRANSACTION, WITHOUT ANY YOU MAY CANCEL THIS TRANSACTION, WITHOUT ANY PENALTY OR OBLIGATION; WITHIN THREE BUSINESS DAYS PENALTY OR OBLIGATION; WITHIN THREE BUSINESS DAYS FROM THE ABOVE DATE. FROM THE ABOVE DATE. IF YOU CANCEL, ANY PROPERTY TRADED IN, ANY PAYMENTS IF YOU CANCEL, ANY PROPERTY TRADED IN, ANY PAYMENTS MADE BY YOU UNDER THE CONTRACT OR SALE, AND ANY MADE BY YOU UNDER THE CONTRACT OR SALE, AND ANY NEGOTIABLE INSTRUMENT EXECUTED BY YOU WILL BE NEGOTIABLE INSTRUMENT EXECUTED BY YOU WILL BE RETURNED WITHIN TEN BUSINESS DAYS FOLLOWING RETURNED WITHIN TEN BUSINESS DAYS FOLLOWING RECEIPT BY THE SELLER OF YOUR CANCELLATION NOTICE, RECEIPT BY THE SELLER OF YOUR CANCELLATION NOTICE, AND ANY SECURITY INTEREST ARISING OUT OF THE AND ANY SECURITY INTEREST ARISING OUT OF THE TRANSACTION WILL BE CANCELLED. TRANSACTION WILL BE CANCELLED. TO CANCEL THIS TRANSACTION, MAIL OR DELIVER A SIGNED TO CANCEL THIS TRANSACTION, MAIL OR DELIVER A SIGNED AND DATED COPY OF THIS CANCELLATION NOTICE OR ANY AND DATED COPY OF THIS CANCELLATION NOTICE OR ANY OTHER WRITTEN NOTICE, OR SEND A TELEGRAM TO: VISTA OTHER WRITTEN NOTICE, OR SEND A TELEGRAM TO: VISTA HOME IMPROVEMENT, 2097 RIVERDALE STREET WEST HOME IMPROVEMENT, 2097 RIVERDALE STREET WEST SPRINGFIELD, MA 01089 NOT LATER THAN MIDNIGHT OF SPRINGFIELD, MA 01089 NOT LATER THAN MIDNIGHT OF THE THIRD BUSINESS DAY FROM 06/09/2020 THE THIRD BUSINESS DAY FROM 06/09/2020 Vista Home Improvement Vista Home Improvement 2097 Riverdale Street 2097 Riverdale Street West Springfield, MA 01089 West Springfield, MA 01089 NO LATER THAN MIDNIGHT OF THE THIRD BUSINESS DAY NO LATER THAN MIDNIGHT OF THE THIRD BUSINESS DAY FROM THE DATE OF THIS CONTRACT. FROM THE DATE OF THIS CONTRACT. I HEREBY CANCEL THIS CONTRACT. I HEREBY CANCEL THIS CONTRACT. BUYER'S SIGNATURE DATE: BUYER'S SIGNATURE DATE: Buyer(s) Acknowledge Receipt of the Cancellation Notice Paula Elliott Terri Buckley 06/09/2020 06/09/2020 Date Date This spa e intentionally left blank Page 5 of 7 Ownership of Property: The undersigned warrants that he/she is Owner of the property on which the work is to be performed or that he/she is otherwise authorized on behalf of Owner(s) to enter into this Contract. Notice of Scheduling Changes: Contractor agrees to provide Owner with notice when delays become known to the Contractor. Concealed Conditions: Should concealed conditions encountered in the performance of the contract be at variance with the conditions indicated by the contract and/or Owner or should unknown conditions of an unusual nature, differ from those ordinarily encountered and generally recognized as inherent in the work of the character provided for in this contract be encountered, the contract shall be equitably increased. Furthermore, if unknown and/or concealed conditions prevent Contractor from completing the contract, the contract shall be equitably increased or decreased, as the case maybe. Delays in Completion Due to Concealed Conditions: Owner hereby acknowledges that in certain remodeling work, the demolition of portions of the pre-existing structure may reveal additional defects & conditions or the need for additional work, which must be repaired, altered or carried out in order to complete the work described under the contract. In such case(s), Owner agrees that the duration of the work and the scheduled date of completion may differ from the date stated on the front, and that such variation shall not be considered to be a violation of this contract. Restarts: If the project is stopped by Owner for a period of greater than ten (10) days, a restart fee of ten percent (10%) of the contract price will be required to compensate Contractor for the necessary time and remobilization of staff and materials. Depending on the duration of the stoppage, an additional equitable adjustment may be necessary to cover wage increases and general escalation. Product Substitution: Without Owner's consent and at the discretion of Contractor, Contractor may use materials and articles of quality and merit equal to those designated in the contract, where the materials described in the contract are unavailable or their use in impractical, provided however, the material must be of equal or greater value than those specified in the contract and there shall be no additional charge to Owner. Hazardous Waste/Asbestos/Contaminants/Mold: Owner represents and warrants that the project area and house are free from hazardous waste, lead paint, asbestos and/or other contaminants. Therefore, in consideration of this representation and warranty, it is agreed that by accepting this contract, Owner does hereby release and indemnify and hold harmless Contractor from and against all claims, damages, liabilities, losses, expenses, direct and/or indirect, including but not limited to, attorney's fees and defense costs arising out of or resulting from the performance of any of the services by Contractor or claims against Contractor relating to, involving or arising out of hazardous waste, lead paint, asbestos, and/or other contaminants unless such damages or claims are caused solely by Contractor's negligence. Owner is hereby advised that mold can grow and be present in concealed areas of the home, Contractor has neither made an analysis nor verification, and assumes no liability for the determination of mold existing in or on Owner's residence. Owner hereby agrees that Contractor shall not be responsible for the detection, containment, or remediation of and existing mold. Owner further waives all claims and agrees to hold Contractor harmless against any claim based in whole or in part on the release of spread of mold that does not originate with Contractor negligence. Additional Warranty Information: This spa e intentionally left blank Page 6 of 7 All warranties for goods supplied by Contractor under this Agreement shall be those given by the manufacturer of such goods, which shall be and are hereby passed through directly to Owner. Under such manufacturer's warranties, Owner may be required to register or mail in warranty card or other evidence of ownership and use of such equipment in order to activate such warranties. Owner's failure to mail in or register such documentation, which failure voids the manufacturer's warranty, shall not create any responsibility for Contractor to warranty such goods. The warranty gives Owner specific legal rights and Owner may also have other rights which may vary from state to state. Under Massachusetts law, sales of goods carry an implied warranty of merchantability and fitness for a particular purpose. All material is guaranteed to be specified. All work to be completed in a workman like manner. Any alterations or deviation form the above specifications requested by Owner involving extra costs will be executed only upon written orders, and will become an extra charge over the estimate. Arbitration: The parties hereby agree that the Massachusetts Arbitration Act shall apply to all disputes and claims arising out of, or relating to this Agreement, including the breach thereof. The parties agree to follow the expedited procedures of the Commercial Arbitration Rules of the American Arbitration Association at a hearing only to be held in Springfield, Massachusetts. The commencement of arbitration proceedings by an aggrieved is a condition precedent to the commencement of legal action by either party except, mandatory arbitration procedures required in this Agreement shall not be applicable to any claim by V.H.I., wherein it seeks a prejudgment remedy such as a real estate attachment, for cases where Owner has not paid a bill which is due to V.H.I., Subcontracting: Contractor has the right to subcontract any part, or all, of the work agreed herein to be performed. All permits, license requirements, workmen's compensation and/or other job requirements shall be the sole responsibility of the subcontractor. Contractor agrees that, notwithstanding any agreement for materials and/or labor between Contractor and a third party, Contractor is responsible to Owner for completion of all work described in a timely and workmanlike manner. No Acceleration of Payments but Escrowing Allowed: The Contractor may not require payments to be made in advance of the times specified in Payment Section (front), provided, however, if it deems itself to be insecure, it may require, as a prerequisite to continuing the work described herein, that the balance of the payments under this contract that are in control of Owner, shall be placed in a joint escrow account that requires the signature of both Contractor and Owner for withdrawal. Insurance: Contractor will be responsible to Owner or any third party for any property damage or bodily injury caused by itself, its employees or its subcontractors in the performance of, or as a result of, work under this Agreement. Contractor agrees to carry insurance to cover such damage or injury. Construction Related Permit Acquisition: Contractor, under provisions of Chapter 142A of the Massachusetts General Laws, is required to apply for and obtain all construction related permits. Contractor shall not be deemed responsible for delays in the work described in this agreement caused by regulator, permit granting or inspectional agencies, authorities or individuals. NOTICE: If Owner obtains his/her own construction related-permits for the work described under this Agreement, Owner is hereby advised that in the event of a dispute, judgment and non payment of Contractor, Owner will not be entitled to make claim to or collection from the guaranty fund established in M.G.L. c. 142A. Modification: This Agreement, except as to concealed conditions or delays occasioned thereby or by restarts, cannot be changed except by a written statement signed by both Contractor and Owner. However, cancellation by Owner is allowed in accordance with the Notice of Cancellation. Owner hereby grants Contractor a limited Power of Attorney to complete incomplete documents on Owners behalf. Page 7 of 7 Completeness of Contract for Execution: Owner is hereby advised not to sign this Agreement unless and until all blank sections have been filled in or marked as void, deleted or not applicable, and until all exhibits and related or referenced documents that are incorporated herein are attached hereto. Attorney's Fees/Costs Owner agrees to pay all costs of collection, including reasonable attorney's fees, cost and expenses. Furthermore, interest shall be charged at the highest lawful rate of interest on any and all overdue payments. Copy of Agreement to be given to Owner: This Agreement is governed by the laws of the Commonwealth of Massachusetts. It must be executed in duplicate, and an original, signed copy hereof given to the Owner at the time of execution. No work under the Agreement shall begin prior to the signing of the Agreement and transmittal to the Owner of a copy therefor. Paula Elliott Terri Buckley 06/09/2020 06/09/2020 Date Date David Lauzon Authorized Representative 06/09/2020 Date This spa e intentionally left blank Comrnonwealth of Massachusetts Division of Professional Licensure Board of Building Regulations and Standards Construction Supervisor CS-111478 Expires:01/2112021 BRIAN RUDD 175 COYOTE CIRCLE FEEDING HILLS MA 01030 i Commissioner CERTIFICATE OF LIABILITY INSURANCE DATE(MMI12020 Y) T TIFICATE 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 be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require and endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: SOUTHWICK INS AGENCY INC PHONE FAX P O BOX 100 (A/C,No,Ext): (A/C,No): E-MAIL SOUTHWICK,MA 01077 ADDRESS: 28TKC INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A: TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA SAMBRICO LLC DBA VISTA HOME IMPROVEMENT INSURER B: INSURER C: INSURER D: 2097 RIVERDALE STREET INSURER E: WEST SPRINGFIELD,MA 01089 INSURER F: COVERAGES CERTIFICATE NUMBER: 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 CONTRACT OR 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. INSR %DDL5UBR POLICY EFF DATE POLICY EXP DATE LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MMIDDIYYYY) (MWDDWYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY AMAGE TO RENTED $ CLAIMS MADE ❑OCCUR DREMISES(Ea occurrence) ED EXP(Any one person) $ ERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER ENERAL AGGREGATE $ POLICY D PROJECT LOC RODUCTS-COMPIOP AGG $ AUTOMOBILE LIABILITY COMBINED SINGLE $ ANY AUTO LIMIT(Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULE AUTOS (Per person) HIRED AUTOS BODILY INJURY $ (Per accident) NON OWNED AUTOS PROPERTY DAMAGE $ (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKER'S COMPENSATION AND X I WC STATUTORY OTHER EMPLOYER'S LIABILITY YIN UB-2E072183-20 03/12/2020 03/12/2021 LIMITS ANY PROPERITOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLES/RESTRICTIONSISIIECIAL ITEMS THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE. CERTIFICATE HOLDER CANCELLATION TOWN OF WEST SPRINGFIELD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 26 CENTRAL STREET BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENT VE !� / WEST SPRINGFIELD-MA 01089 � � ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD 1988-2010 ACORD CORPORATION. All rights reserved. Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Mail'kachusetts 02118 Home Improvement-Contractor Registration Type: LLC Registration: 162058 VISTA HOME IMPROVEMENT Expiration: 01/02/2021 2097 RIVERDALE ST WEST SPRINGFIELD,MA 01089 Update Address and Return Card. SCA 1 c7 20M-05117 %l,. '/.,-,,.•,ri.,vWA/11,a1-ie„ Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:LLC before the expiration date. If found return to: Reaistration Expiration Office of Consumer Affairs and Business Regulation 162058 01/02/2021 1000 Washington Street-Suite 710 VISTA HOME IMPROVEMENT Boston,MA 02118 BRIAN RUDD ML�Sa ficti� 2097 RIVERDALE ST \;�_k:(;,r�-- W EST SPRINGFIELD, MA 01089 Not valid without Signature Undersecretary DATE(MMIDDIYYYY) AC7"R" CERTIFICATE OF LIABILITY INSURANCE `� 07/12/2019 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 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). PEER C NTACT ) MISNAME: WILLIAM J MIS INSURANCE PHONE Exty-- 413-568-6111 FAX �1: 413-572-9191 156 ELM STREET -MAIL ADDRESS: "BILL@BILLMISINSURANCE.COM WESTFIELD MA 01085 _ INSURE S)AFFORDING COVERAGE NAIL# INSt,mA: NAUTILAS INS CO INSURED INSURER B: SAMBRICO LLC/VISTA HOME IMPROVEMENT INSURER C: 2097 RIVERDALE RD INSURER D: WEST SPRINGFIELD MA 01089 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 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 CONTRACT OR 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. L�R --- - TR TYPE OF INSURANCE POLICY NUMBER P� Y EFF POLI EXP LIMITS X COMMERCIAL GENERALLIABILITY EACHOCCURRENCE S 1,000.000 K/ RENTED SUR PREMISES Ea occurrence $ 100,000 MED EXP oneperson) $ 5000 Y G3679203 08/01/2019 08/01/2020 PERSONAL 8 AoV IFUURY $ 1.000.0W GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY E JJCT 71 LOC PRODUCTS-COMPIOP AGG $ 2.000.000 OTHER: $ ----- _ - AUTOMOBILE LUMLrrY JC acrj EDSINGLE LIMIT $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS NON-OAUTOS PROPERTY DAMAGE $ HIRED AUTOS AUTOS gD acddent $ i UMBRELLA LIAB OCCUR EACH OCCURRENCE S rEXCESS LIAB CIAIMS4AADE AGGREGATE $ DED RETENTION $ WORKERS COMPENSATION TH- AND EMPLOYERS'LIABILITY YIN STATUTE ER__- ANYPROPRIETORIPARTNEIVFJO=CUTIVEE.L.EACH ACCIDENT $ OFFICER/MEMBEREXCLUDED? ❑NIA (Mandatory In NH) EL DISEASE-EA EMPLOY $ 6 Yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached H more space is required) 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. SAMBRICO LLCNISTA HOME IMPROVEMENT 2097 RIVERDALE RD AUTHORIZED REPRESENTATIV" WEST SPRINGFIELD MA 01089 / ';J/1 ©1 8/014 A ORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD