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25C-113 (6) 54 GRANT AVE BP-2020-1090 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 25C- 113 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: FIRE RESTORATION BUILDING PERMIT Permit# BP-2020-1090 Project# JS-2020-001840 Est. Cost: $28000.00 Fee: $182.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: ALEX FILIERE - PDR OF WORCESTER COUNTY 112964 Lot Size(sq. ft.): 4486.68 Owner: CORBO MARIAROSARIA Zoning: URB(100)/ Applicant: ALEX FILIERE - PDR OF WORCESTER COUNTY AT. 54 GRANT AVE Applicant Address: Phone: Insurance: 547 HARTFORD TURNPIKE (778) 278-7541 WC SHREWSBURYMA01545 ISSUED ON.5/1/2020 0:00:00 TO PERFORM THE FOLLOWING WORK.RESTORING SIDE OF HOUSE/GARAGE AFTER FIRE LOSS 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 5/1/2020 0:00:00 $182.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner �'�---� Department use only City of Northampt�n stats of Permit: Building Department MAY - Curd Cut/Driveway Permit 2PO ! 212 Main Street Sel+er/Se, tic Availability Room 100 G7`'"�-- __ W ter,WpIl r--� Availability OFUfCGlAlrr { Northampton,'MA Qt60r+aMr�mN lPIa n� +CJS Sets of Structural Plans phone 413-587-1240 Fax 413-587- - 7nit�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 5qf � Map,� Lot //_3Unit Zone Overlay District Elm St.District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: Name(Print) ` Vol 'Current Mailing Address: 1_1 0 A��1 •f�,Y�', Telephone �( Signature 2.2 Authorized Agent: 10K A It Name(Print) Current Mailing Address: 417 If q - 0 S��l Signature Telephone SECTION 3-t?STIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building0aa (a)Building Permit Fee 2. Electrical j 0 0 (b)Estimated Total Cost of G�I Construction from 6) 3. Plumbing Building Permit Fee �{ y 4. Mechanical(HVAC) 5. Fire Protection / 6. Total=(1 +2 + 3+4+5) o0o Check Number /1� —;o Qgo Date This Section For Official Use Only "�! ' Building Permit Number: Issued: Signature: Building Comm issioner/Inspec of Buildings Date 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 DLpartment Lot Size Frontage Setbacks Front Side L: R. :::::__ L: R: Rear Building Height Bldg.Square Footage Open Space Footage (I,ot arca minus bldg&paved Arkin } #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 Q 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 DONT KNOW 0 YES 0 IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Q Obtained 0 Date Issued: C. Do any signs exist on the property? YES 0 NO 0 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 Q IF YES,then a Northampton Storm Water Management Permit from the DPW is required. SECTIONS-DESCRIPTION OF PROPOSED WORK(check all applicable) New House ❑ Addition ❑ Replacement W'i1dows. I Alteration(s) ❑ Roofing ❑ Or Doors Accessory Bldg. ❑ Demolition ❑ New Signs [®] Decks [© Siding lk] Other[a Brief Des ription of Propos j f Work: rs I O lid Alteration of existing bedroom Yes No Adding new bedroom YesNo ,/" Attached Narrative Renovating unfinished basement Yes ✓ No Plans Attached Roll -Sheet 6a. If New house and or addition to existing housing, complete the follow na: a. Use of building:One Family Two Family / 8 Y y 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 . 1. 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 ��OAIX l L-01 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 r � as Owner/Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief. Signed under the pains and penalties of perjury. Print Name Signa re of er/A t Date SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable ❑ � rJ� t Q Name of License Holder:� / ,�� tom/ "' C['"i(d it 1 / / j License Number zj Address (�f Expiration Date 44-2w/ Sigliature Telephone Registered Home Improvement Contractor: Not Applicable ❑ 1?38 oq Company Name Registration Number Address Expirat n Date ph&C SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152,§25C(8)) 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....... B No...... ❑ �4 City of Northampton w Massachusetts Y � DEPARTMENT OF BUILDING INSPECTSONS a t 212 Main Street •Municipal Buildings n� ' 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: L7q r),vy 11,,e (Please print house number and street name) Is to be disposed of at: �P.119W& C r sr r+R•� 7ftC (Please print name and location of facility) Or will be disposed of in a dumpster onsite rented or leased from: &2V—C'(0x4Ve aj /U (Company Name and Address) ignature of rmit Applicant or Owner Date 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 Congress Street,Suite 100 1` Boston,MA 02114-2017 www mass.gov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Le ibl Dame (Business/Ort*an�iizztion/IInfdividual): ffe i Address: _J q qi t7d44,(Z JL t„X1-k_ City/State/ZipAf 0,. Ii' M4 3Y5 Phone#: pj` y ` 6�• �`� Are you as employer?Check the apolp.,priate box: Type of project(required): 1. (um a employer with—A _employees(full and/or part-time)-* 7. ❑New construction 2. 1 am a sole proprietor or urtnershi and have no employees working for me in ❑ p p p p' p � 8. ❑ Remodeling any capacity.[No workers'comp.insurance required.] 9. Demolition 3.n 1 am a homeowner doing all work myself.[No workers'comp.insurance required.]r ❑ 10('1 Byilding addition 4,[]1 am a homeowner and will be hiring contractors to conduct all work an my properly. 1 will ensure that all contractors either have workers'compensation insurance or aresole I l. Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5,0 1 am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑R repairs These sub contractors have employees and have workers comp.insurance.t ,(. 6,[:]We are a corporation and its officers have exercised their right of exemption per MGt.c. 14. Other rC Xq 1z 44K- 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 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 worker,'comp.policy number. I am an employer that is providing workers'compensation insurance for my eni ployees. Below is the policy and jab site information. gyp^ Insurance Company Name:J441 Il✓Avi 6"t? Policy 4 or Self-ins.Lic.#I („/C � P.J C qk O ZYQ 1 g Expiration Date:_ IOZI-4/16 Job Site Address: fAve City/State./Lip: f Attach a copy of the workers' compensation policy declaration page(showing the policy number and 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. I do hereby certify under the pains and veiw1des of perjury that the information provided above is true and correct Sip-nature: / Date: Phone 4: 0� Official use only. Do not write in this area,to be completed by city or town ofcial 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#: 10� Liberty Liberty Mutual Insurance Mutual.. PO Box 515097 INSURANCE Los Angeles,CA 90051-5097 Fax:(888)268-8840 Insured: DANIELE GIRARDI&MARIAROSARIA CORBO Cell: (929)250-9621 Property: 54 GRANT AVE E-mail: dgirardi@umass.edu NORTHAMPTON,MA 01060-2322 Home. 54 GRANT AVE NORTHAMPTON,MA 01060-2322 Claim Number: 042287538-01 Policy Number: H3121842103240 Type of Loss: Fire-Electrical Date Contacted: 4/7/2020 10:00 PM Date of Loss: 3/27/2020 Date Received: 3/27/2020 Date Inspected: 4/9/2020 11:00 AM Date Entered: 4/7/2020 12:03 PM Date Est.Completed: 4/10/2020 1:19 PM Price List: MASP8X_APR20 Restoration/Service/Remodel Estimate: DANIELE GIRA ACT 1 In the following pages,you will find the estimated cost of covered repairs to your property. For Dwelling and/or Other Structure items:The estimated cost of covered repairs to your home is calculated using current local prices that are usual and customary.This estimate is based on the replacement cost of the damaged property,less your policy deductible and any applicable depreciation. Your current mortgage company may be listed as the payee on payment(s)for the covered repairs to your home.If so,you will need to contact your mortgage company to determine their procedures for processing claims payments.The mortgage company will not be listed on payments for your personal property. We encourage you to work with a contractor of your choice in completing the repairs to your home.If you or your contractor has any questions or concerns about this estimate,please contact me at the number shown above.It is important to call us with questions prior to beginning repairs,as any changes in the scope of damages or pricing must be pre-approve y Li erty Mutual surance. For Personal Property items:Prices are calculated utilizing like,kind and quality goods,less any applicable depreciation,policy limits,or other adjustments as outlined in the estimate.For your convenience,we can refer you to vendors who may be able to directly replace many of your lost and/or damaged items. If you have any questions about this estimate,please do not hesitate to contact us at the numbers provided above. Thank you for insuring with Liberty Mutual Insurance.We appreciate your business. Liberty Liberty Mutual Insurance Mutual. PO Box 515097 INSURANCE Los Angeles,CA 90051-5097 Fax:(888)268-8840 DANIELE_GIRA_ACT_1 Demolition DESCRIPTION QTY UNIT PRICE TOTAL 1. General Demolition-per hour 16.00 HR @ 55.00= 880.00 3 men one day to demo roof on garage and siding. 2. Dumpster load-Approx.30 yards,5-7 tons of debris 1.00 EA @ 868.94= 868.94 The payment for this item has not yet been incurred. Source-Eagle View Mechanical DESCRIPTION QTY UNIT PRICE TOTAL 3. Duct-free split system-2 zone-High efficiency 1.00 EA @ 3,972.24= 3,972.24 4. Central air-condenser unit-3 ton-up to 13 SEER 1.00 EA @ 1,784.64= 1,784.64 5. 220 volt commercial wiring/conduit,box,outlet,switch 1.00 EA @ 405.25= 405.25 6. Electrician-per hour 16.00 HR @ 90.21 = 1,443.36 Additional labor to install equipment and new runs to exterior. Exterior Exterior DESCRIPTION QTY UNIT PRICE TOTAL 7. Material Only Stud wall-2"x 4"load bearing- 16"oc 32.00 SF @ 0.77= 24.64 8. Material Only Sheathing system w/built-in barrier&taped seams- 480.90 SF @ 1.57= 755.01 5/8" 9. Furring strip-1"x 3" 480.90 SF @ 0.88= 423.19 10. Carpenter-General Framer-per hour 32.00 HR @ 60.90= 1,948.80 2 Men 2 days to repair framing and install strapping. 11. Wet spray cellulose insulation-4"-R13 480.90 SF @ 1.23= 591.51 12. Rigid foam insulation board-2" 480.90 SF @ 1.72= 827.15 13. Siding-vinyl 480.90 SF @ 3.58= 1,721.62 14. Vinyl outside corner post 50.00 LF @ 5.13= 256.50 15. Detach&Reset Siding-vinyl 176.00 SF @ 1.93= 339.68 Detach siding on the sides to reinstall corner post 16. Soffit&fascia-metal- F overhang 26.00 LF @ 10.25= 266.50 17. Detach&Reset Gutter/downspout-aluminum-up to 5" 44.00 LF @ 3.78= 166.32 18. Vinyl window-double hung, 13-19 sf 2.00 EA @ 338.50= 677.00 19. Scaff=old-per section(per week) 6.00 WK @ 49.28= 295.68 DANIELE GIRA ACT_1 4/17/2020 Page:2 Liberty Liberty Mutual Insurance Mutual. PO Box 515097 INSURANCE Los Angeles,CA 90051-5097 Fax: (888)268-8840 CONTINUED-Exterior DESCRIPTION QTY UNIT PRICE TOTAL 20. Labor to set up and take down scaffold-per section 6.00 EA @ 28.60= 171.60 21. Clean with pressure/chemical spray 2,400.88 SF @ 0.29= 696.26 22. Carpenter-General Framer-per hour 4.00 HR @ 60.90= 243.60 To reassemble clothes hanging structure. 23. FRAMING&ROUGH CARPENTRY 1.00 EA @ 50.00= 50.00 Material for clothes hanging structure. Garage Garage DESCRIPTION QTY UNIT PRICE TOTAL 24. Siding-vinyl 261.42 SF @ 3.58= 935.88 25. Soffit&fascia-metal- l'overhang 25.00 LF @ 10.25= 256.25 26. Wood window-picture(fixed),24-32 sf 1.00 EA @ 850.65= 850.65 27.. Clean with pressure/chemical spray 506.92 SF @ 0.29= 147.01 Level 2 Nursery Height:8' Window 2'6"X 4' Opens into Exterior Window 21611 X 4' Opens into Exterior Window 2'6"X 4' Opens into Exterior Window 2'6"X 4' Opens into Exterior Door 2'6"X 6'8" Opens into ROOM2 Subroom: Nursery Closet(1) Height:8' Door Y 10"X 6'8" Opens into NURSERY Door 3' 10"X 6'8" Opens into NURSERY Door 3' 10" X 6'8" Opens into NURSERY DESCRIPTION QTY UNIT PRICE TOTAL 32. Window trim set(casing&stop) 26.00 LF @ 4.37= 113.62 33. Paint door/window trim&jamb-2 coats(per side) 5.00 EA @ 31.60= 158.00 DANIELE GIRA ACT_1 4/17/2020 Page:3 Liberty Liberty Mutual Insurance Mutual. PO Box 515097 INSURANCE Los Angeles,CA 90051-5097 Fax:(888)268-8840 CONTINUED-Nursery DESCRIPTION QTY UNIT PRICE TOTAL 34. Seal/prime then paint the walls and ceiling(2 coats) 758.00 SF @ 0.97= 735.26 35. Paint door slab only-2 coats(per side) 3.00 EA @ 37.22= 111.66 General DESCRIPTION QTY UNIT PRICE TOTAL 36. Taxes,insurance,permits&fees(Bid Item) 1.00 EA @ 250.00= 250.00 Initial allowance for permit processing.Actual cost will be supplemented. 37. Residential Supervision/Project Management-per hour 24.00 HR @ 65.19= 1,564.56 3 hours a week for 8 weeks Grand Total Areas: 6,659.85 SF Walls 2,419.67 SF Ceiling 9,079.52 SF Walls and Ceiling 2,439.56 SF Floor 271.06 SY Flooring 796.84 LF Floor Perimeter 0.00 SF Long Wall 0.00 SF Short Wall 830.17 LF Ceil.Perimeter 2,439.56 Floor Area 2,628.99 Total Area 6,216.09 Interior Wall Area 7,011.47 Exterior Wall Area 421.29 Exterior Perimeter of Walls 1,663.30 Surface Area 16.63 Number of Squares 261.31 Total Perimeter Length 66.03 Total Ridge Length 0.00 Total Hip Length Coverage Item Total % ACV Total % Dwelling 20,873.65 90.51% 23,649.25 90.35% Contents 0.00 0.00% 0.00 0.000/0 Other Structures 2,189.79 9.49% 2,527.05 9.65% Loss of Use 0.00 0.00% 0.00 0.00% Total 23,063.44 100.00% 26,176.30 100.00% DANIELE GIRA ACT 1 4/17/2020 Page:4 Liberty Liberty Mutual Insurance Mutual. PO Box 515097 INSURANCE Los Angeles,CA 90051-5097 Fax:(888)268-8840 Summary for Dwelling Line Item Total 20,873.65 Material Sales Tax 534.72 Subtotal 21,408.37 Overhead 2,140.84 Profit 2,140.84 Replacement Cost Value $25,690.05 Less Depreciation (2,040.80) Actual Cash Value $23,649.25 Net Claim $23,649.25 Total Recoverable Depreciation 2,040.80 Total Paid When Incurred 1,042.72 Net Claim if Additional Amounts are Recovered $26,732.77 Additional Amounts include depreciation that has been recovered and Paid When Incurred(PWI)items.Paid When Incurred(PWI) items refer to items,which may not be necessary in the repair of your property damaged by a covered loss.if incurred,or completed, reimbursement of reasonable costs will be made up to the maximum amounts identified as eligible for PWI in the estimate. Dwelling Paid When Incurred Line Item Total 868.94 Overhead 86.89 Profit 86.89 Replacement Cost Value $1,042.72 Total Paid When Incurred $1,042.72 DANIELE G1RA ACT 1 4/17/2020 Page: 5 Lib�rtiy Liberty Mutual Insurance Mutual. PO Box 515097 INSURANCE Los Angeles,CA 90051-5097 Fax:(888)268-8840 Summary for Other Structures Line Item Total 2,189.79 Material Sales Tax 79.30 Subtotal 2,269-09 Overhead 226.92 Profit 226.92 Replacement Cost Value $2,722.93 Less Depreciation (195.88) Actual Cash Value $2,527.05 Net Claim $2,527.05 Total Recoverable Depreciation 195.88 Net Claim if Depreciation is Recovered $2,722.93 DANIELE GIRA ACT_1 4/17/2020 Page: 6 l�ibcrty Liberty Mutual Insurance Mutual. PO Box 515097 INSURANCE Los Angeles,CA 90051-5097 Fax:(888)268-8840 Recap of Taxes,Overhead and Profit Overhead(10%) Profit(10%) Material Sales Tax Clothing Sales Tax Storage Tax(6.25%) (6.25%) (6.25%) Line Items 2,367.76 2,367.76 614.02 0.00 0.00 Total 2,367.76 2,367.76 614.02 0.00 0.00 DANIELE GIRA ACT 1 4/17/2020 Page:7 Liberty Liberty Mutual Insurance Mutual. p0 Box 515097 INSURANCE Los Angeles,CA 90051-5097 Fax: (888)268-8840 Recap by Room Estimate:DANIELE_GIRA_ACT_1 Demolition 880.00 3.82% Coverage:Dwelling 100.00% = 880.00 Area: Source-Eagle View Mechanical 7,605.49 32.98% Coverage:Dwelling 100.00% = 7,605.49 Area:Exterior 9,455.06 41.00% Coverage: Dwelling 100.00% = 9,455.06 Area Subtotal: Exterior 9,455.06 41.00% Coverage:Dwelling 100.00% = 9,455.06 Area:Garage 2,189.79 9.49% Coverage: Other Structures 100.00% = 2,189.79 Area Subtotal: Garage 2,189.79 9.49% Coverage:Other Structures 100.00% = 2,189.79 Area:Level 2 Nursery 1,118.54 4.85% Coverage:Dwelling 100,00% = 1,118.54 Area Subtotal: Level 2 1,118.54 4.85% Coverage:Dwelling 100.00% = 1,118.54 Area Subtotal: Source-Eagle View 20,368.88 8832% Coverage:Dwelling 89.25% = 18,179.09 Coverage: Other Structures 10.75% = 2,189.79 General 1,814.56 7.87% Coverage: Dwelling 100.00% = 1,814.56 Subtotal of Areas 23,063.44 100.00% Coverage: Dwelling 90.51% = 20,873.65 Coverage: Other Structures 9.49% = 2,189.79 Total 23,063.44 100.00% DANIELE GIRA ACT_1 4/17/2020 Page: 8 Liberty Liberty Mutual Insurance Mutual. PO Box 515097 INSURANCE Los Angeles,CA 90051-5097 Fax: (888)268-8840 Recap by Category with Depreciation O&P Items RCV Deprec. ACV CLEANING 843.27 843.27 Coverage:Dwelling @ 82.57% = 696.26 Coverage:Other Structures @ 17.43% = 147.01 GENERAL DEMOLITION 880.00 880.00 Coverage:Dwelling @ 100.00% = 880.00 ELECTRICAL 1,848.61 12.16 1,836.45 Coverage:Dwelling @ 100.00% = 1,848.61 PERMITS AND FEES 250.00 250.00 Coverage: Dwelling @ 100.00% = 250.00 FINISH CARPENTRY/TRIMWORK 113.62 2.27 111.35 Coverage:Dwelling @ 100.00% = 113.62 FRAMING&ROUGH CARPENTRY 3,445.24 24.05 3,421.19 Coverage:Dwelling @ 100.00% = 3,445.24 HEAT, VENT&AIR CONDITIONING 5,756.88 1,151.38 4,605.50 Coverage:Dwelling @ 100.00% = 5,756.88 INSULATION 1,418.66 34.29 1,384.37 Coverage:Dwelling @ 100.00% = 1,418.66 LABOR ONLY 1,564.56 1,564.56 Coverage:Dwelling @ 100.00% = 1,564.56 PAINTING 1,004.92 200.98 803.94 Coverage:Dwelling @ 100.00% = 1,004.92 SCAFFOLDING 467.28 467.28 Coverage:Dwelling @ 100.00% = 467.28 SIDING 3,253.68 174.84 3,078.84 Coverage:Dwelling @ 71.24% = 2,317.80 Coverage:Other Structures @ 28.76% = 935.88 SOFFIT,FASCIA,&GUTTER 689.07 31.37 657.70 Coverage:Dwelling @ 62.81% = 432.82 Coverage: Other Structures @ 37.19% = 256.25 WINDOWS-VINYL 677.00 67.70 609.30 Coverage:Dwelling @ 100.00% = 677.00 WINDOWS-WOOD 850.65 85.07 765.58 Coverage:Other Structures @ 100.00% = 850.65 O&P Items Subtotal 23,063.44 1,784.11 21,279.33 Material Sales Tax 614.02 79.85 534.17 Coverage:Dwelling @ 87.09% = 534.72 Coverage: Other Structures @ 12.91% = 79.30 Overhead 2,367.76 186.36 2,181.40 Coverage:Dwelling @ 90.42% = 2,140.84 Coverage:Other Structures @ 9.58% = 226.92 Profit 2,367.76 186.36 2,181.40 Coverage:Dwelling @ 90.42% = 2,140.84 DANIELE GIRA ACT_1 4/17/2020 Page: 9 LibeLiberty Mutual Insurance Mutual. PO Box 515097 INSURANCE Los Angeles,CA 90051-5097 Fax:(888)268-8840 Coverage:Other Structures @ 9.58% = 226.92 Total 28,412.98 2,236.68 26,176.30 Any person who knowingly,and with the intent to injure,defraud or deceive,submits information to an insurer that is false, incomplete or misleading,may be guilty of a crime. DANIELE G1RA ACT_1 4/17/2020 Page: 10 Source-Eagle View-Basement 231- 2219" 221411 22' 1 It M M Do 1 _ ^, O N 12' 6111 Basement ' -)417" 241711 Basement DANIELE_GIRA_ACT 1 4/17/2020 Page: 11 Source-Eagle View-First Floor 8' l 1 " 12' 11 " 3' 10"4-6? 4"------+31 1 "X10' 2' 6111 8' it 12' 7" - - 9' 8" n T �34 �v ai '� - 3, 4" 6 M Bathroom _ _ 1 �Officc 6. 2"—� I 91 111 _ M 1 T 0„`-i 91 9' 3���� Kitchen N i=ce °O M M 1 81911 ' 9” �91 711Room 3 Living Room '— �o 9' 3" 0 Rear Entry 121911 1 1 3 11 �o 12' 8" c�1 24' 8.. - 1 22' 11" W First Floor DANIELE_G]RA_ACT 1 4/17/2020 Page: 12 Source-Eagle View-Level 2 -121611 91 l„ �31 611 1 11 811� 791 T T = 1 n � urscry1C21osc rl 113 ase Office �� �t rn ' �6' � 6'— �` � �� ,�6' _n X311111 Hallway 101 o 1011-1Master Bedroom Nursery _ Play Area/Room o Bathroom o 13' V- 1711 7" 12' 11J- L---C 61411 1 1 11 a Level 2 DANIELE_GIRA_ACT_1 4/17/2020 Page: 13 Source-Eagle View-Exterior 271211 24' 11" M� 14 N �.-. F4( `A) N 2 _ F8(A) 8(A Y 25' 8" Exterior DANIELE_GIRA_ACT 1 4/17/2020 Page: 14 Source-Eagle View-Garage 1516" F7(B) Garage Roof 0 N F6(A) Garage DANIELE_GIRA ACT I 4/17/2020 Page: 15 RECOVER • RECONSTRUCT - RESTORE [I%!. I, I7;%N IS R :S..1.,0R ',,'I 10N 0T_11`(?R('ES T 1 R ( (:xt,,N-FY Boyne River Companies,Inc. dba Paul Davis Restoration of Worcester County 547 Hartford Turnpike Shrewsbury,MA 01545 (508)841-PAUL worcester.pauldavis.com WORK AUTHORIZATION We authorize Boyne River Companies,Inc dba Paul Davis Restoration of Worcester County,herein-after referred to as Contractor,to make repairs to our property at the address below,damaged by Fire on or about . The"Terms and Conditions"attached to this page are a part of this authorization. We agree that the total cost of the work will be in accordance with the original estimate and any supplemental estimates prepared by Contractor and approved by the adjuster for your insurance company,if applicable,plus any change orders approved by Owner(s)and Contractor. This work authorization,along with all approved estimates,supplemental estimates and change orders shall constitute the contractual obligations of the Owner(s)and Contractor. We understand that Contractor is not an agent or representative of your insurance company or its adjuster and that we alone have the authority to authorize Contractor to make said repairs. We understand that this does not bind the insurance company and in the event that there is no coverage then we agree to pay the invoice(s)submitted for the work done by the contractor. We agree that any portion of work,such as deductibles,betterment,depreciation,or additional work requested by us,not covered by insurance,must be paid by us on commencement or as per payment schedule. Our mortgage payments are made to and we request them to protect the interest of Contractor in handling the loss draft or check. Our insurance company is and we authorize them to pay all proceeds due to Contractor payable under our policy directly to Contractor and any Mortgage Company named. If our names are included on the payment(s);we agree to promptly endorse said payment to Mortgage Company or into an escrow account in a bank acceptable to Contractor. Payments to be as follows: 50%, Initial Payment(Due before work start) 50%, Final Payment(Due at signing of Certificate of Satisfaction) We agree that any payments not made in accordance with this schedule shall be considered delinquent after ten days and agree to pay interest thereon at 1 %%per month or 18%per annum until paid. By signing this document you are providing consent for us to collect and store your personal information.It will only be used or shared in connection with the completion of work under this contract.Information may be shared with a third-party for the purposes of quality surveys and service improvements on the work performed.No information is used or shared with any outside parties for the purposes of marketing to you. Due to the nature of the work,no completion date is specked. No verbal agreements are binding on Contractor. Owner's Name:Daniele Girard! Owner: V710� Loss Address:54 Grant Ave.Northampton.MA.USA.01060 Phone:1-929-250-9621 Boyne River Companies,Inc.dba Paul Davis Restoration of Worcester County TERMS AND CONDITIONS 1. The repairs,replacement,or additions authorized herein relate to the specifications on the front page of this contract,or those attached hereto,do not cover pre-existing deficiencies unless specifically stated. 2. Items which will not clean,which shrink or discolor as a result of cleaning,or are damaged by dry-rot or sun fading are not guaranteed,and Contractor shall not bear any responsibility for their loss or damage. 3. All materials used will be standard stock materials,unless otherwise specified,and will match existing materials within reasonable tolerance as to color,texture,design,etc. 4. All painting is estimated to return existing paint to same color. Any changes in color or type of material will be done at extra cost to the Owner(s). 5. The contract price is based on completion during normal working hours and Owner(s)agree to provide access to the job site as required for completion of the work. Owner's telephone,electricity,water and toilet are to be made available to Contractor's personnel during the course of the work. 6. Any work deleted from this Work Authorization,original approved estimates,supplemental estimates and/or change orders must be agreed to by both the Owner(s)and Contractor in writing and the Owner(s)will be reimbursed for such work in an amount equal to Contractor's projected cost on said work. 7. Contractor is not responsible for the theft,disappearance of or damage to jewelry,art objects,silver,gold,antiques or personal items and Owner(s) agrees to remove,store,or protect such items,unless those items are removed and inventoried by Contractor personnel and stored in Contractor facilities. 8. Contractor is not responsible for any cracks or damage to Owner's driveway that may result from the use of a trash dumpster. 9. Contractor guarantees all workmanship covered by this work authorization for a period of one(1)year from date of use by Owner(s). All materials used are covered by the normal guarantees,if any,provided by the manufacturers or suppliers. 10. In the event it becomes necessary for Contractor to turn this matter over to its attorney for collection,Owner(s)agrees to pay attorney's fees and court cost as incurred for such collection. 11. Contractor has no responsibility for additional work or services performed under any agreement between the Owner(s)and the workmen or subcontractors or Contractor. 12. Guarantee void if payment(s)are not made as to the terms of the contract. 13. If repairs or alterations have been made or attempted on any guaranteed items by anyone other than Contractor,this guarantee shall become void. 14.A Lien may be placed on this property for non-payment,for which a$300.00 charge will be made to defray the cost of filing