32C-082 STURDY HOME IMPROVEMENT, INC. ACCEPTANCE PAGE MA REG. #151711
" CT REG. #601525
ANY WORK NOT STATED ON PREVIOUS PAGES IS EXCLUDED
The following schedule will be adhered to unless circumstances beyond the contractor's control arise:
Work scheduled to begin the week of jL_ /_2-U /_i L Expected completion date 11. 1 /jL_Weather permitting.
The cash price for labor and material as described above is:
1st payment 2nd payment 3rd payment 4th payment
Contract Total (upon signing)
Roof $ lit, 00 C> PLer, s' I -1).."-j t /4 , 517-4 C ( i` 41 on
Ventilation $
n rR3: Other work $ O�
Roofing total $ 41,2. 0 $ 1 12-a $ 1 7/2 $ /7/2 rca $ 4.114 O tt
Siding $ $ .- $ $ $ ,,.
Windows $ $ $ qe....,,. $ r• ......... $
Special orders $ ""` $ "`"�" $ $ `"� $
?C' e) 0 a V " �
if ,r ,5fa Other $ 2 $ .2.oO $ $oC • $ '800 . $
v
Totals $ t Z i•0 ' 0 $ ` $ r ' , ��c' -' $ to / $ j
Terms: Cash Finance
M t.. Credit Card: 'p. dE . Codf
Payment schedule:
Any balance not paid in full within thirty days, will be charged 1.8% interest per month.
In order to meet the completion schedule, the following material /equipment must be SPECIAL ORDERED before the contracted work begins.
(Law requires that any deposit or down - payment required by the contractor before work begins, may not exceed the greater of (a.) one -third of the
total contract price or (b.) the actual cost of any special equipment or custom made material which must be special ordered in advance to meet the
completion schedule)
$ to be paid for
$ to be paid for
Any additional work orders are to be paid for once accepted and approved by purchaser.
Verbal understandings and agreements with representatives shall not be binding. All understandings and agreements must be set forth in writing in this
contract. Additional provisions are stated on reverse side and are part of this contract. In witness whereof Purchaser(s) has /have hereunto signed their names
this 19 " ` day of Nov& t 20 11 and acknowledge receipt of a true copy of this contract.
UNLESS OTHERWISE SPECIFIED, IT IS UNDERSTOOD THAT THE OWNER IS READY FOR THE WORK TO BEGIN. THE PURCHASE PRICE QUOTED
ABOVE WILL BE HONORED ONLY UNTIL -fV% I 1! (Date).
You the Purchaser(s) may cancel this transaction at any time prior to midnight of the third business day after the date of this transaction. See notice of cancella-
tion form for an explanation of this right. Signature affixed below also acts as receipt that Purchaser(s) received separate cancellation forms.
The following Is a requirement by Massachusetts General Law, Home Improvement Contractor Law MGL c 142A:
"The contractor and the homeowner hereby mutually agree in advance that in the event that the contractor has a dispute concerning this contract, the contractor
may submit such dispute to a private arbitration service which has been approved by the office of Consumer Affairs and Business Regulation and the consumer
shall be required to submit to such arbitration as provided in MGL c 142A.
Representativ �... - Ow er.
}
Owner:
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
Submitted _..__ AaCep�Cbd .; /1
/
Representative PUrctiaserf ( , Date
Accepted Accepted
by: by:
Representative Purchaser Date
STURDY HOME IMPROVEMENT, INC. MA REG. #151711
CT REG. #601525
" •
Addendum (A) OTHER WORK
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Irutials Initial-. ' itials
STURDY HOME IMPROVEMENT INC. MA REG. #151711 Legend:
PAGE 2 - ROOF PLAN CT REG. #601525
, \.... Valley
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.4 D u I-A c2,5 it... 0,,, -7,..v.-A vca--1 0.1\.) - 1 --- k-vvs
7_,Nic, / Ridge vent
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Gutters
C. it i A4 oci..5
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so •
Chimney
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e
•-• ac:ti / / m .:.., "7 , Pv' Roof Boots
/
/
0
t Satellite Dish
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EI
, 10 Skylights
iy --17-iLs f-i.otts„4 6 01-4 sir
t_____,..........
(... . Step Flashing
t ‘24,1N.,51 .. ' 1
IM
if-- Material
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1 ivoTe': ciArt. t-N Nii g-i- - .1.-i-V3t
i
Q ...oz,r,. n Dumpster
L,...).A.4e4;L.. 5\;‘,..2..\ 1/4. „Dv Q-Lcs, ,.\,...- 4,1 colis41,35 At.-5 & e6
Dumpster
p pp - 0, - - -ruc.,14-- - ecot rk .-c
FRONT OF HOUSE
INC = Area to be done NIC = Area not included
Please Note: Any area not shown on this plan are not included Initials f---6".'"' Initia1Q-Zat—aorn,
)II Free (8,77) 378 -8739 459 Main Street
Indian Orchard, MA 01151
rorcester (508) 797 - 6600 E -mail: HR@SturdyHome.com
pringfield (413) 543 -5906 www.SturdyHome.com
ew Haven (203) 848-2118 HOME IMPROVEMENT, INC.
ax (413) 543-3200
WINDOWS • SIDING • ROOFING • ADDITIONS MA REG. #151711 CT REG. #601525
ame may, Home Phone Business Phone
ddress 2. 44 .� 2..40 ` j Cell Phone Other
t �. �'. to Lt ¢ ( Zt 5
own /City Representative Date
1U t ke p - k - Co , AA A • c91 0490 13 , 1/ f / c1 / /1
/we the owner(s) of the premises described hereinafter, referred to as Owner, offer to contract with Sturdy Home Improvement, Inc. hereinafter
eferred to as Contractor, to furnish, deliver and arrange for installation of all materials to improve the premises as described below,
Yes No ROOFING SCOPE OF WORK:
4 ❑ 1. Contractor to obtain required building permit (see attached permit authorization form) 1_ 2_ 3_ Family home.
❑ 2. Provide certificate of insurance for workers compensation, general liability. (see attached certificates).
❑ 3. Provide job site dumpster, set on planks, to remove job related debris only. Please Note: dumpster for contractor's use only.
(see dumpster clause).
„" ❑ 4. Prior to stripping roof, tarp sides of house beneath work area, from roof edge to bottom of wall.
(see additional protection clause on back).
❑ 5. Keep job site in a clean and orderly manner. Rake work areas at end of job. Use magnetic sweep to pick up nails.
❑ 6. Provide OSHA approved staging to safely perform work.
1 ' ❑ 7. Work consecutive days excluding inclement weather. (rain, snow, high winds, high heat, thunder showers, etc).
• ❑ 8. Staff project with qualifiedJnechanics experienced in residential asphalt roofing.
,� ❑ 9. Strip existing 1 ./ 3 layers of asphalt roofing (see roof plan, page 2). Number of squares
A. - one layer cedar removal. Number of squares -
B. -- one layer slate removal. Number of squares ---
• ❑ 10. Inspect roof deck prior to re- roofing. Renail loose boards:
A. Replace rotted or cracked boards at $ 5 • ° " per linear foot.
B. Replace delaminated plywood at $ 22.0 per square foot.
C. Number of sheets of plywood included into this estimate: Quantity C) (see unit cost above for additional sheets).
air Li L-
11. Furnish and install 0+nd -s LL-- ' t -firms ca- shingles. Color CAAreou/ /24 k
Air ❑ 12. Furnish and install 8" aluminum drip edge around roof perimeter. White Mill Brown ✓�.
❑
.4/13. Install cedar drip edge at eaves under aluminum drip edge. Linear ft
.g Li 14. Furnish and install ice /water shield at eaves 3' *✓ 6' other. Three feet in valleys and around all roof penetrations.
❑ 15. Furnish and install underlayment to entire roof. Roofer select V Diamond Deck
-it' ❑ 16. Furnish and install starter course shingles, eaves & rake.
❑ 17. Furnish and install hip and ridge.
❑ 18. Furnish and install new neoprene roof boots at soil pipes up to 4" in diameter. Quantity 1 Size (boots at electrical
mast to be reused).
❑ i 9. Reuse stove pipe flashing kits.
❑ .s❑'20. Reuse existing step flashing at roof /wall intersections.
❑ 4'21. Furnish and install new aluminum copper step flashing at roof /wall intersections. Linear feet . If siding
work is needed, a cost assessment will be made at that time.
❑ 22. Reuse existing wall flashing at roof /wall intersection.
❑ ..423. Furnish and install new aluminum wall flashing at roof /wall intersections. Linear feet . If siding work is needed, a cost
assessment will be made at thit time.
❑ 24. Furnish and install new No aluminum copper step flashing at base of chimney under existing lead counter flashing.
.i ❑ 25. Replace chimney lead counter flashing. 1 flue ✓ 2 flues 3 flues other ,
❑ 4'26. Install new roof hood to vent bathroom(s) with insulated flexible tube. Remove roof deck to gain access into attic. Color: black
only.
❑ er27. Gutter Helmets to be removed and reinstalled by others.
❑
Jar 28. Remove and dispose of gutters attached with spike and ferrule.
❑
e29. Remove and reinstall existing gutters strapped to roof. Install straps under shingle over shingles .
❑ -S30. Remove and reinstall existing gutters with hidden hangers. Linear feet
❑
.at 31. Reuse skylight flashing kits Replace skylight flashing kits Quantity (Velux models, stock only).
❑ 11'32. Remove and dispose of the following: Antenna Snow /Ice Wires Snow Guards /Ice belts Solar panels .
❑ 4133. Remove Satellite Dish up to 24' in diameter. Alignment and installation by others.
,,,W ❑ 34. Page Two = ROOF PLAN.
Li 405. Page Three = VENTILATION.
Li 1 Page Four = VENTILATION PLAN.
❑ 37. Addendum (A) = OTHER WORK.
❑ 4/'38. Addendum (B) = LOW SLOPE ROOFING.
-Isi' El 39. Acceptance Page Initials Initials Initials
The Commonwealth of Massachusetts
* = c Department of Industrial Accidents 1 Office of Investigations
tel: G 600 Washington Street
Boston, MA 02111
\ www.mass.gov /dia
Workers' Compensation Insurance Affidavit: Builders / Contractors /Electricians/Plumbers
Applicant Information ,,/ y e J m Please Print Legibly
Name ( Business /Organization/Individual): i 5 4J'(/1 H d m pro Vet vt / I &n'�
I
Address: 4 Main (.5"i
Cit t rchai'd, M4 1/5 / Phone It: 4/,3 - 5 l /
Are you an employer? Check the box: Type of project (required):
1. Q" I am a employer with O 4. ❑ I am a general contractor and I 6
❑New construction
employees (full and/or part - time).* have hired the sub - contractors
2. ❑ 1 am a sole proprietor or partner- listed on the attached sheet 1 7. ❑ Remodeling
ship and have no employees These sub - contractors have 8. (1 Demolition
working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition
[No workers' comp. insurance 5. ❑ We are a corporation and its .
officers have exercised their 10.0 Electrical repairs or additions
required.]
3.0 I am a homeowner doing all work right of exemption per MGL 11.0 Plumbing repairs or additions
myself. [No workers' comp, c. 152, §1(4), and we have no 12. 2.R - Roof repairs
insurance required.] t employees. [No workers'
13.0 Other
comp. insurance required.] -
*My applicant that checks box 111 must also fill out the section below showing their workers' compensation policy information:
I Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
1 Contractors that check this box must attached an additional sheet showing the name of the subcontractors and their workers' comp. policy information.
I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name: 6 lnsu-rCe_
Policy # or Self -ins. Lic. #: C - 00 / - 7 O i 51' Expiration Date: 7/2--111 A
Job Site Address: d / b kV/ / S0 I/ /4 ✓e_ City /State/Zip: O r l /7 a/li i nda )/D6c
Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to $1,500.00 and/or one -year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby certify under the ,pains and penalties ofperjury that the infornmation provided above is true and correct.
Si :nature: 402111, - # 041U/wial; Date: /
Phone #: 1 7 1 / 3 - 5
Official use only. Do not write in this area, to be completed by city or town official.
City or Town: _ P ermit/l..icense #
Issuing Authority (circle one):
1. Board of Health 2. Building Department 3. City/Towtt Clerk 4. Electrical Inspector 5. Plumbing Inspector
6. Other
Contact Person: Phone #:
ECTION 8 - CONSTRUCTION SERVICES
.1 Licensed Construction Supervisor: Not Applicable / ❑
lame of License Holder : D a V i cI Pia 2 9366 3
License Number
0'70 - rrrmonrt Sf S p ring-Fie/C/ ,MA D j I o 817113
Address Expiration Date
C ✓ P -- LI/3 - 5y 3 "5
Signature Telephone
9. Registered Home Improvement Contractor: rc Not Applicable ❑
Sturdy Horne. improvement 151711
Company Name/ Registration Number
i f5 6 1 Main St. 6107‘11.02.
Address r o p Expiration Date
cJion Orchard, MA 01151 Telephoner' «)5
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 l!! No ❑
11. Home Owner Exemption
The current exemption for "homeowners" was extended to include Owner - occupied Dwellings of one (1) or two(2) families
and to allow such homeowner to engage an individual for hire who does not possess a license, provided that the owner acts
as supervisor. CMR 780, Sixth Edition Section 108.3.5.1.
Definition of Homeowner: Person (s) who own a parcel of land on which he /she resides or intends to reside, on which there
is, or is intended to be, a one or two family dwelling, attached or detached structures accessory to such use and/ or farm
structures. A person who constructs more than one home in a two -year period shall not be considered a homeowner.
Such "homeowner" shall submit to the Building Official, on a form acceptable to the Building Official, that he /she shall be
responsible for all such work performed under the building permit.
As acting Construction Supervisor your presence on the job site will be required from time to time, during and upon
completion of the work for which this permit is issued.
Also be advised that with reference to Chapter 152 (Workers' Compensation) and Chapter 153 (Liability of Employers to
Employees for injuries not resulting in Death) of the Massachusetts General Laws Annotated, you may be liable for person(s)
you hire to perform work for you under this permit.
The undersigned "homeowner" certifies and assumes responsibility for compliance with the State Building Code, City of
Northampton Ordinances, State and Local Zoning Laws and State of Massachusetts General Laws Annotated.
Homeowner Signature
SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable)
New House ❑ Addition ❑ Replacement Windows Alteration(s) I I Roofing
Or Doors 0
Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [p Siding [0] Other [0]
Brief Description of Proposed
Work: remove and rtp(ace roof.(par+ial roof
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 PERMIT
, as Owner of the subject
property
hereby authorize
to act on my behalf, in all matters relative to work authorized by this building permit application.
Signature of Owner Date
S+urc!v Nome i mpro V mei 11 , as Owner /Authorized
Agent hereby declare t t the statements and i formation on the foregoing application are true and accurate, to the best of my knowledge
and belief.
Signed under the pains and penalties of perjury. Print Name
/ /r/.. 1 1.
Signature /1 -ner/ • gent Date
Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information
Existing Proposed Required by Zoning
This column to be filled in by
Building Department
Lot Size
Frontage
Setbacks Front
Side L:._ + R: L: R:
Rear
Building Height
Bldg. Square Footage
Open Space Footage
f r
(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 0 YES 0
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DON'T KNOW 0 YES 0
IF YES: enter Book Page and /or Document #'
B. Does the site contain a brook, body of water or wetlands? NO 0 DON'T KNOW 0 YES 0
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained 0 Obtained , 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 0 NO 0
IF YES, describe size, type and location:
E. Will the construction activity disturb (clearing, grading, excavation, or filling) over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES 0 NO 0
IF YES, then a Northampton Storm Water Management Permit from the DPW is required.
f
Department use only ,
RECEIVED City of Northampton Status of Permit
Building Department Curb Cut/Driveway permit;
212 Main Street Sewer /Septicl Availability
Room 100 WaterMteli Availability•
Northampton, MA 01060 Two Sets of Structural Plans
D OF BUILDING INSPE n e 413- 587 -1240 Fax 413- 587 -1272 Plot/Site Plans
NORTHAMPTON, MA01060 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
ail * aZ to W , old ,4V e - Map Lot Unit
No rfh atn pfon M'4 01 0 la o Zone Overlay District
Elm St, District GB District
SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT ' / 1
7
2.1 Owner of Record: /v or1 air2.7ph_
Ellzabefh G'eor9e _ig0 a 6 A),'/ /4/e.1114 0/060
Name (Print) Current Mailin Address:
���- 31 -a
Telephone
Signature
2.2 Authorized Agent:
S r o rn )mpro Vemenf X69 1Y1a -i n SL Indian Drchar of /s/
Name (Print) Current Mailing Address:
*13 -5 *3-- /t R
Signature Telephone
SECTION 3 - ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost (Dollars) to be Official Use Only
completed by permit applicant
1. Building 4 7 A80, o o (a) Building Permit Fee
2. Electrical (b) Estimated Total Cost of
Construction from (6)
3. Plumbing Building Permit Fee
4. Mechanical (HVAC)
5. Fire Protection
6. Total= (1 +2 +3 +4 +5) 4 6j.,"0, 00 Check Number g/915 35
This Section For Official Use Only
Building Permit Number: Date
Issued:
Signature:
Building Commissioner /Inspector of Buildings Date
24 WILSON AVE BP- 2012 -0634
GIS #: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 32C - 082 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- 2012 -0634
Project # JS-2012-001090
Est. Cost: $6280.00
Fee: $35.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: STURDY HOME IMPROVEMENT 093603
Lot Size(sq. ft.): 5096.52 Owner: GEORGE ELIZABETH M
Zoning: URC(100)/ Applicant: STURDY HOME IMPROVEMENT
AT: 24 WILSON AVE
Applicant Address: Phone: Insurance:
P O BOX 51033 (413) 543 - 5906 WC
INDIAN ORCHARDMA01151 ISSUED ON :1/6/2012 0 :00 :00
TO PERFORM THE FOLLOWING WORK :STRIP & SHINGLE PARTIAL 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 1/6/2012 0:00:00 $35.00
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Louis Hasbrouck — Building Commissioner