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31B-155 (6) BP-2024-0514 11 TRUMBULL RD COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 31B-155-001 CITY OF NORTHAMPTON Permit: Exterior Res PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit# BP-2024-0514 PERMISSION IS HEREBY GRANTED TO: Project# ROOF 2024 Contractor: License: ERIE CONSTRUCTION MID WEST Est.Cost: 13740 LLC 106394 Const.Class: Exp.Date: 05/11/2024 Use Group: Owner: STUBBS SUSAN L& BARRY GOLDSTEIN Lot Size (sq.ft.) Zoning: URC Applicant: ERIE CONSTRUCTION MID WEST LLC Applicant Address Phone: Insurance: 3516 GRANITE CIRCLE 717-255-0595 WC6-Z5 1-293 745 TOLEDO, OH 43617 ISSUED ON: 04/29/2024 TO PERFORM THE FOLLOWING WORK: STRIP AND REROOF 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: Final: Final: Final: Rough Frame: Gas: Fire Department Driveway Final: Fireplace/Chimney: Rough: Oil: Insulation: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: 14/2. Fees Paid: $40.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner I . APR e 6 c i � The Commonwealth of Massacfiuthetts.��,,; ��p, �,. � /t Board of Building Regulations and Standards r4a 0E�oONs 1_UNIC PALITY FOR ~ 1 Massachusetts State Building Code,780 CMR USE Building Permit Application To Construct,Repair,Renovate Or Demolish a Revised Mar 2011 One-or Two-Family Dwelling This Section For Official Use Only Building PP rmit Number:0200• 4 57 CI Date Applied: /Sew,.) (255 / : Li Z(, 2UZy Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Pro e ty Addres 1.2 Assessors Map&Parcel Numbers I '[[ A \A v l.la Is this an accepted street?yes no K Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public 0 Private 0 Zone: _ Outside Flood Zone? Municipal 0 On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 wne�r'Yof Rec o II T1 k Y b k I I laoad �v� y � idlS�t�un Name(Print) City,State,ZIP NOy 'm o ", rna . bl a ►3.3�D nn�,Jiui No.an tree Telephone E it Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s)N,' Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg.0 Number of Units Other 0 Specify: Brief Description of Proposed Work2: TCour(Vi� 5 f Ojici r l SV t vl I ee . SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building s 1 ,lob 1. Building Permit Fee:$ Indicate how fee is determined: ❑Standard City/Town Application Fee 2.Electrical $ ❑Total Project Costa(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire $ Suppression) Total All F s� 41 Check No heck Amount: q Qash Amount: 6.Total Project Cost: S (3 I-- ( O ❑Paid in Full 0 Outstanding Balance Due: 4 SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) 166 2q/L C 1„ G Cldeer S License Numbcr Expiration Datc Name of CSL qn Oak I 'a'I ty na01 List CSL Type(see below) No. d Street `/ V Type Description Ho land i 0 1� .rj Zg U Unrestricted(Buildings up to 35,000 Cu.ft.) �ty/Tlo IwnV,LS/ta`[te%1 (J l ( ✓ Restricted 1&2 Family Dwelling Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances 'l l•255•D595 Dle r>A e.(Ue i hs gtriehdyre 1 Insulation Telephone Email address •CON/ D Demolition 5.2 Registered Home Improvement Contractor(HIC) Is q90 5 6-6-2 S rc- r(L (v tyAG}Ito� 1 r A & -vvif si- (/tom/ HIC Registrationtr Number Ixpiration Date rCpmpany Name orRegistrant t rlame tp G kit. CA rat. CUM(. WC! hieevrthorp_o No.and Street Email address Tp1edo, ON 1 (-Miti/ iI7-zssorgs . COrn City/Town,State,ZIP Telephone SECTION 6: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 Iff No 0 SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR �A LV CPPLIESIF/O'RpBUILDING PERMIT I ?I,as Owner of the subject property,hereby authorize tLt A hS to act on my behalf,in all matters relative to work authorized by this building permit application. [30\ GO1dSkt r 1-4I15I2J-4 Print Owner's Nanke(Electronic Signature) Date SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information con ' ' this application is a andaccurate to the best of my knowledge and understanding. el /5/zq 'nt Owner's or Authorized Agent's Name(Electronic Signature) / Date NOTES: 1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration program or guaranty fund under M.G.L.c. 142A.Other important information on the HIC Program can be found at www.mass.gov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dps 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) (including garage,finished basement/attics,decks or porch) Gross living area(sq.ft.) Habitable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of half/baths Type of heating system Number of decks/porches Type of cooling system Enclosed Open 3. "Total Project Square Footage"may be substituted for"Total Project Cost" CITY OF NORTHAMPTON SETBACK PLAN MAP: LOT: LOT SIZE: REAR LOT DIMENSION: REAR YARD SIDE YARD SIDE YARD FRONT SETBACK FRONTAGE City of Northampton YH3pIj Massachusetts * wi S 4-, i-E-;t DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building .o3Y�r si Northampton, MA 01060 sY _" ° CONSTRUCTION DEBRIS AFFIDAVIT (FOR ALL DEMOLITION AND RENOVATION PROJECTS) In accordance of the provisions of MGL c 40, S54, a condition of Building Permit Number is that all debris resulting from this work shall be disposed of in a properly licensed waste disposal facility, as defined by MGL c 111, S 150A. The debris will be disposed of in: Location of Facility: /9(4 1 I 1 c}c r The debris will be transported by: Name of Hauler: QYoI� ►✓ (� OiptXS Signature of Applicant: Date: / -- -- The Commonwealth of Massachusetts i- '‘44,,r, Deportment of 1ndustritrl:Accidents l II1 Congress Street,Suite 100 Boston, . /.4 02114-201? www.ntass.gov/dia 1%orkers'Compensation Insurance AITidasit:BuildersI'(:ontractory Electricians,Pluutbers. it)BE FILED W i"TH I IIE PERMIT!I G At II1UItl Il. Applicant Information Please Print Leeibis • Name t Business,Organizatiotlndtv!dual 1: YI1. CO S /vtc-yi Or L Der1y ("Of I V15 1942^ ) Address: 31 )L, &ra y►i le C►'ire 1 - City/Stateizip: T1 0/0,c I1, �-l3Le l7 Phone#: "1-7- 2 5 5-05-9 5 Are you an easphner?Cheek the appropriate boa: Type of project(required): 1.❑1 am a.•rnpluv s with _,_ employees(full and:or part-tonic' 7. Q New construction 20 I am a sole proprietor or partnership and have no employees working fur rise to K. CI Remodeling any capacity.[Nu workers'cutup.insurance mourned.] 30 I am a h uuwrer thing all%Wit myself. No wak oaz ma s•Co .insurance required.)' 9. ❑Demolition um 10® Building addition 421,1 am a larmeowtrcr and will he hums omit:tours to cuttdud all work on my piupenty. I will crosu re that all nimtra tun either hate workers'compensation insurance it are sole I I.0 Electrical repairs or additions prupnetors w oh no employees. 12.0 Plumbing repairs or addil ions 50 I am a mama)runtraetor and I have hued the sub-contractors listed on the attached sheet. These sob-.umum:tors base empluyees and(save worker comp.unurunee.^ I3. Roof repairs 6.0 We are a corporation aril its officers have-exercised their right of exemption pet Wit_e. I4.0Otber 151 11f41.and we Irate no employees.[No workers'etmtp.insurance required.( 'Any win-minima cheeks bus al must also till out the seetum below show tng their workers'eumpensaliun policy udartrmtton +Ilunteuwoscrs who submit this affulst it indicating they are doing all work and then bin outside couilr.w tors must submit a nevi affidavit it initicating such. Itunleactors that check thus but must attached an additional sheet showing the name of the suhrcwttracturs and,tale w hethtx or nut thaw entities Lase employees if the sub-contractors hit e.employee?.they must pros ide their workers'comp.policy number f ant on employer that is prorirlint, ,eort era'compensation insurance,for tut'employees. 8e1uw is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lie. Expiration Date: Job Site Address: City"State.'Zip: 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 e. 152,Z;25A is a criminal violation punishable by a fine up to 51.500.00 and-or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a tine of up to 5250.00 a day against the violator.A copy of this statement may be forwarded to the Oflice of investigations of the DiA for insurance coverage verification. I do hereby certif'under the pains andApenalties of perjury that the injormruion provided abore is true and correct. !/Signature: V` Date: L//51 2, Phone 4: 7 17 - Z 55-05 9 Official use only. Do not write in this area,to be completed by city or town official ('its or Town: Permit license# Issuing Authority (circle one): I. Board of Health 2.Building Department 3.City,'"ussn Clerk -I.Electrical Inspector 5. Plumbing Inspector h.Other Contact Person: Phone#: City of Northampton Massachusetts �?s ,{ = I. • DEPARTMENT OF BUILDING INSPECTIONS ® m ' 212 Main Street • Municipal Building Northampton, MA 01060 sS'Nyy 3,7`1� HOMEOWNERS'EXEMPTION ELIGIBILITY AFFIDAVIT /�(/gyp/ /te flt(Cp UV l S (insert fish legal name), born I/zi/�i (insert month, day,year),hereby depose and state the following: 1. I am seeking a building permit pursuant to the homeowners' exemption to the permit requirements of the Massachusetts State Building Code, codified at 780 CMR 110.R5.1.3.1, in connection with a project or work on a parcel of land to which I hold legal title. 2. 1 am not engaged in, and the project or work for which I am seeking the aforementioned homeowners'exemption, does not involve the field erection of manufactured buildings constructed in accordance with 780 CMR 110.R3. 3. I qualify under the State Building Code's definition of"homeowner"as defined at 780 CMR 110.R5.1.2: Person(s)who owns 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 home owner. 4. I do not hold a valid Massachusetts construction supervision license and, except to the extent that I qualify for and will abide by the Massachusetts State Building Code's requirements for the supervision of the project or work on my parcel, I am not engaged in construction supervision in connection with any project or work involving construction, reconstruction, alteration, repair, removal or demolition involving any activity regulated by any provision of the Massachusetts State Building Code. 5. If I engage any other person or persons for hire in connection with the aforementioned project or work on my parcel,I acknowledge that I am required to and will act as the supervisor407 for said project or work. Signed under the pains and penalties of perjury on this /y day of f ,20_,ZL/ Ik///761 Z/41 (Signature) ACORO CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 4/25/2024 4/21,2023 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). CONTACT PRODUCER LUCkton Companies NAME: 1185 Avenue of the Americas,Suite 2010 PHONE FAX New York NY 10036 E-MAIL exc)- iNc No): 646-572-7300 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIL• INSURER A:The Cincinnati Insurance Company 10677 INSURED Erie Construction Mid-West,LLC INSURER B:Navigators Specialty Insurance Company 36056 1500420 3516 Granite Circle INSURER C:The First Liberty Insurance Corporation 33588 Toledo OH 43617 INSURER D:Homesite Insurance Company of Florida 11156 INSURER E: INSURER F: COVERAGES Ist CERTIFICATE NUMBER: 18402199 REVISION NUMBER: XXXXXXX 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 TYPE OF INSURANCE ,ADDL SUER POLICY EFF POLICY EXP LIMITS INSD WVD POUCY NUMBER (MMIDD/YYYY) (MMIDDIYYYY) A X COMMERCIAL GENERAL LIABILITY N N EPP0534782 4/25/2023 4/25/2024 EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE x 1 OCCUR DAMAGE S l RENTED PREMISES(Ea occurrence) S 100,000 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEM_AGGREGATE UMR APPLES PER: GENERAL AGGREGATE $ 2,000,000 PRO PRODUCTS-COMP/OP AGG $ 2,000,000 PRO- POUCY LOC OTHER: $ A AUTOMOBILE LIABILITY N N EBA0534782 4/25/2023 4/25/2024 COMBINED NGLE LIMIT $ CO accident)SI 1,000,000 x ANY AUTO BODILY INJURY(Per person) $ XXXXXXX OWNED_ AUTOS ONLY AUTOSULED BODILY INJURY(Per atxltlenl) $ XXXXXXX HIRED NON-OWNED PROPERTY DAMAGE $ XXXXXXX AUTOS ONLY _AUTOS ONLY (Per accident) $ XXXXXXX B X UMBRELLA UAB X OCCUR N N NY23EXCZOE0551C 4/25/2023 4/25/2024 EACH OCCURRENCE $ 3,000,000 EXCESS UAB CLAIMS-MADE AGGREGATE $ 3,000,000 DED RETENTION$ $ XXXXXXX WORKERS COMPENSATION OTH- C AND EMPLOYERS'LIABILITY YIN N WC6-Z51-293745-023 4/25/4 /20LX TUTE ERANY PROPRIETOR/PARTNER/EXECUTIVE E. H ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? n N/A (Mandatoryy in NH) .L.DISEASE-EA EMPLOYEE $ 1,000,000 DESCRIPTION OF OPERATIONS below EL DISEASE-POUCY LIMIT $ 1,000,000 D Excess$2M X S3M N N CXP-018308-00 4/25/2023 4/25/2024 Occ:$2,000,000 Agg:$2,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space is required) CERTIFICATE HOLDER CANCELLATION See Attachment SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 18402199 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN For Your InformationACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRE,,SCI:mATIVE 01988-2015 ACORD CORPORATION. I rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Attachment Code:D607603 Master ID: I500420,Certificate ID: 18402199 LOCKTOK For Your Information Dear Erie Construction Mid-West,LLC certificate holder: In an effort to meet demand for instant electronic delivery of certificates,Lockton Companies now provides paperless delivery of Certificates of Insurance. Thank you for your patience and willingness to help us lessen our environmental footprint. To fulfill your certificate delivery,we need your email address.Please contact us via one of the methods below with your Holder ID number,email address,and phone number in the event we have any questions. Your Holder 1D number is 18402199. Email: EriecertrequestsaIockton.com • Toll-free automated phone service: 866-218-4018 If this certificate is no longer needed or valid,please notify us. Thank you, Lockton Companies Lockton Companies 1185 Avenue of the Americas,Suite 2010 New York,NY 10036 lockton.com Commonwealth of Massachusetts Division of Occupational Licensure Board of Budding Regulations and Standards Constructiotz4 vt �1 &2 Family Y«. •s CSFA-106394 * %pires:05/11/2024 CMADLEY L MI A� p 8935 OAK VALLEY ipi HOLLAND OF , • 1, 4vird i "i• 4'nf.LVd:133 Commissio.. . fi C7""` THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement tractor Registration +'+ Type: Out of State Corporation v T Registration: 159905 ERIE CONSTRUCTION MID-WEST, LLC Expiration: 06/18/2025 3516 GRANITE CIRCLE TOLEDO,OH 43617 44 Update Address and Return Card. THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs&Business Regulation Registration valid for individual use only before the HOME IMPROVEMENT CONTRACTOR expiration date. If found return to: TYPE:Out of State Corporation Office of Consumer Affairs and Business Regulation Registration Expiration 1000 Washington Street -Suite 710 159905 06/18/2025 Boston,MA 02118 ERIE CONSTRUCTION MID-WEST,LLC s7 r4, KEVIN WARD 3516 GRANITE CIRCLE ✓ia f,{ ,e7a /zGh+4. TOLEDO,OH 43617 = 'r Undersecretary Not valid without signature THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement Centractor Registration n, = Type: Supplement Card w "� P Registration: 159905 ERIE CONSTRUCTION MID-WEST, LLC rirr 0,10Expiration: 06/18/2025 3516 GRANITE CIRCLEor or or,r TOLEDO,OH 43617 ,,,, w'x irl1 i,R�� Update Address and Return Card. THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs&Business Regulation Registration valid for individual use only before the HOME IMPROVEMENT CONTRACTOR expiration date. If found return to: TYPE:Supplement Card Office of Consumer Affairs and Business Regulation Registration Expiration 1000 Washington Street -Suite 710 159905 06/18/2025 Boston,MA 02118 ERIE CONSTRUCTION MID-WEST,LLC- CHADLEY SMITH t-- 3516 GRANITE CIRCLE' � / ' TOLEDO,OH 43617 $-t ^?` Undersecretary Not valid without signature THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affair§ and Business Regulation 1000 Washingtq{.Srjt- Suite 710 Boston Massachusetts--0118 Home Improvement tractor-Reg stration t j I{ � }: E Type: Supplement Card -a ..,+.....'a rsttation: 159905 ERIE CONSTRUCTION MID-WEST,EEC 's, Ei pitation: 06/18/2025 3516 GRANITE CIRCLE .4 ,w, 1 TOLEDO,OH 43617 SONIIMI• *w r vs- Ja1'44 v �t`I. Update Address and Return Card. THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs&Business Regulation Registration valid for individual use only before the HOME IMPROVEMENT CONTRACTOR expiration date. If found return to: TYPE:Supprernent Card Office of Consumer Affairs and Business Regulation Registration ff Expiration 1000 Washington Street -Suite 710 1 9905 ;4.4.06/18/2025 Boston,MA 02118 ERIE CONSTRUCTION MIDW ES C }y. t h,,T s, .sa.,., ' i PATRICK TROMPETE / �� 3516 GRANITE CIRCLE r. ��,4,,' i,Gr,,,,Ka. 'Gfi#di TOLEDO,OH 43617 `� .. Undersecretary Not valid without signature DocuSign Envelope ID:8DCB8738-7847-472B-A0F2-DAF9C2AC13A9 Massachusetts Only: DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. 3516 Granite Circle, Toledo, OH 43617 Customer Care: 1-800-684-4628 E131E H O M E eriehome.combers: Contractor License Numbers: 159905, CSFA-106394 Custom Remodeling Agreement Buyer Name: Barry Goldstein Co-Buyer Name: Sue Stubbs Address: 11 Trumbull Road, Northampton, MA, 01060 Phone Number:4133203009 Email: barrysg@gmail.com Reference: R043-044957 Buyer(s)hereby jointly and severally agrees to purchase the products and/or services of Erie Construction Mid-West, LLC.("Contractor")as listed herein and on the accompanying Specification Sheet(s)in accordance with the terms and conditions described on each page of this Agreement and on each page of the attached Specification Sheet(s) (collectively,"Agreement").Buyer(s)agrees to sign a Completion Certificate after Contractor has completed all work under this Agreement. Date of Contract: 4/4/2024 Purchase Price: $13,740.00 O5 u5 Estimated Start Date: 4/5/2024 Down Payment: $1,374 k7 G� Estimated Completion Date: 6/5/2024 Balance Due Upon Completion: $12,366.00 Method of Payment: Cash Buyer(s)agrees and understands that this Agreement constitutes the entire understanding between the parties, and that there are no verbal understandings,changing,or modifying any of the terms of this Agreement. No alteration to or deviation from this Agreement will be valid without the signed,written consent of both Buyer(s)and Contractor. Buyer(s) hereby acknowledges that Buyer(s)has read this entire Agreement, understands the terms of this Agreement, and has received a completed, signed,and dated copy of this Agreement, including the two attached Notices of Cancellation,on the date first written above. Buyer(s)also acknowledges that Buyer(s)was orally informed of Buyer's right to cancel this Agreement. Buyer Information Co-Buyer Information Name: Barry Goldstein Name:Sue Stubbs a a by: fsisapatigai by: (1'2, ale)da4-1n6C24 ua(ieeds f'4 24 Erie Representative Erie Representative Name: Christopher Malloy Name: Daniel Casper l'giMs'' by: ��� aai by: Da e 9949F 24 e."1 4 bI24 DocuSign Envelope ID:8DCB8738-7847-472B-A0F2-DAF9C2AC13A9 Specification Sheet Buyer Name: Barry Goldstein Co-Buyer Name: Sue Stubbs Address: 11 Trumbull Road, Northampton, MA, 01060 Date of Contract: 4/4/2024 Phone Number:4133203009 Reference Number: R043-044957 Buyer(s) listed above hereby jointly and severally agrees to purchase the goods and/or services listed below, in accordance with the prices and terms described on this Specification Sheet and the Custom Remodeling Agreement, of which this Specification Sheet is a part. Additional terms and conditions are listed below. Shingle Profile: Fiberglass Shingle Color: Summit Grey Product(s) Fiberglass Roofing - Band 3 Standard Removal (1 -2 Layers of Asphalt, Cedar, Metal, Slate) Erie to remove existing roofing and properly dispose. Erie to furnish and install fiberglass dimensional shingle. Erie to furnish and install Premium Synthetic Underlayment. Erie to furnish and install all accessories that may include drip edge, pipe boots, and flashing. Erie to vent roof properly. Erie to furnish and install ice and water shield where applicable. Garage only Price includes all labor, material,warranty, and 100%job cleanup. It is agreed and understood by and between the parties that this Specification Sheet, along with the Custom Remodeling Agreement, constitutes the entire understanding between the parties, and there no verbal understandings, changing, or modifying any of the terms.This Specification Sheet may not be changed or its terms modified or varied in any way unless such changes are in writing and signed by both Buyer(s)and Contractor. Buyer(s) hereby acknowledge that Buyer(s) has read the entirety of this Specification Sheet. Buyer Information Co-Buyer Information Name: Barry Goldstein Name: ��Sue Stubbs Await%by: � g p gt f gp j qF� Ta 3B94 44 traL 8B4674f'LU24 HOVER Roof Measurements 11 Trumbull Road NORTHAMPTON, MA 01060 - .k\ir ,' '' ; ili,.* --g--. -'tki , --4te . of --• ' - - 4 . , ... . , .. .,.. -,- i : ,,, ---, - • �a i .,. ate' n ' ill . - : 9,�. a , ' 3 , I.. a� . c . : , t , ', Anima: ' i Art- VIEW 3D MODEL R.2024 HOVER Inc.All rights reserved.This document and the images,measurement data,format and contents are the exclusive property of HOVER.HOVER is the registered trademark PROPERTY ID:11720880 of Hover Inc.All other brands,products and company names mentioned herein may be trademarks or registered trademarks of their respective holders. a3aQr000000utMnlAl BARRY GOLDSTEIN- Use of this document is subject to HOVER's Terms of Use and is provided"as is."HOVER makes no guarantees,representations or warranties of any kind,express or implied,arising by law 4 APR 2024 or otherwise relating to this document or its contents or use,including but not limited to,quality,accuracy,completeness,reliability.or fitness for a particular purpose. HOVER Roof Measurements 11 Trumbull Road, Northampton, MA ROOF SUMMARY Roof Area Total Length Roof Facets 924 ft2 2 - Ridges/Hips - 1 37'6" Valleys - 0 - Rakes - 4 49' 3" Eaves - 2 75' Flashing - 0 - Step Flashing - 0 - Drip Edge/Perimeter - - 124' 3" Roof Pitch* Area Percentage 4/12 924 ft2 100% Example Waste Factor Calculations Zero Waste +5% +10% +15% +20% Area 924 ft2 970 ft2 1016 ft2 1063 ft2 1109 ft2 Squares 91/2 10 10'/3 102/3 111/3 The table above provides the total roof area of a given property using waste percentages as noted.Please consider that area values and specific waste factors can be influenced by the size and complexity of the property,captured image quality,specific roofing techniques,and your own level of expertise.Additional square footage for Hip,Ridge,and Starter shingles are not included in this waste factor and will require additional materials.This table is only intended to make common waste calculations easier and should not be interpreted as recommendations. 0 2024 HOVER Inc.All rights reserved.This document and the Images,measurement data,format and contents are the exclusive property of HOVER.HOVER is the registered trademark PROPERTY ID:11720860 of Hover Inc.All other brands.products and company names mentioned herein may be trademarks or registered trademarks of their respective holders. a3aQr000000utMnl Al Powered by HOVER BARRY GOLDSTEIN- Use of this document is subject to HOVER's Terms of Use and is provided"as is."HOVER makes no guarantees,representations or warranties of any kind,express or implied,arising 4 APR 2024 Page 2 by law or otherwise relating to this document or its contents or use,including but not limited to,Quality,accuracy.completeness,reliability,or fitness for a particular purpose. 9 11110 HOVER Roof Measurements 11 Trumbull Road, Northampton, MA FOOTPRINT BACK 36'4" 36'4" E N S W N N N Number of Stories:1 0 0 0 Footprint Perimeter:116' 5" Footprint Area: 795 ft2 36'4" - FRONT 2024 MOVER Inc.All rights reserved.This document and the images,measurement data,format and contents are the exclusive property of HOVER.HOVER is the registered trademark PROPERTY ID:11720860 of Hover Inc.All other brands,products and company names mentioned herein may be trademarks or registered trademarks of their respective holders. a3aQr000000UtMnIAI Powered by HOVER BARRY GOLDSTEIN- Vse of this document is subject to HOVERS Terms of Use and Is provided"as is."HOVER makes no guarantees,representations or warranties of any kind,express or implied,arising by law or otherwise relating to this document or its contents or use,including but not limited to,quality,accuracy,completeness,reliability,or fitness for a particular purpose. 4 APR 2024 Page 3 H OVER Roof Measurements 11 Trumbull Road, Northampton, MA SOFFIT 3 2 4 Soffit Summary Depth Type Count Total Length Total Area 6" -12" rakes 4 49'3" 28 ft2 eaves 2 72' 9" 55 ft2 Totals 121'11" 83 ft2 1 5 6 43 2024 HOVER Inc.All rights reserved.This document and the images,measurement data,format and contents are the exclusive property of HOVER.HOVER is the registered trademark PROPERTY ID:11720860 of Hover Inc.All other brands.products and company names mentioned herein may be trademarks or registered trademarks of their respective holders. a3aOr000000utMnlAl Powered by a H OV E R BARRY GOLDSTEIN- Use of this document Is subject to HOVER's Terms of Use and is provided"as is."HOVER makes no guarantees,representations or warranties of any kind,express or Implied,arising 4 APR 2024 Page 4 by law or otherwise relating to this document or its contents or use.including but not limited to.quality.accuracy.completeness,reliability,or fitness for a particular purpose. 9 III Roof Measurements 11 Trumbull Road, Northampton, MA V 1 ` SOFFIT Soffit Breakdown num Type Depth Length Area Pitch 1 rake 7" 12' 4" 7 ft2 4/12 2 rake 7" 12' 4" 7 ft' 4/12 3 eave 9" 36' 4" 27 ft' 1 4/12 4 rake 7" 12' 4" 7 ft' 4/12 5 rake 7" 12' 4" 7 ft2 4/12 6 eave 9" 36' 4" 27 ft2 4/12 0 Feature is too small to label on the plan diagram 0 2024 HOVER Inc.All rights reserved.This document and the images,measurement data,format and contents are the exclusive property of HOVER.HOVER is the registered trademark PROPERTY ID:11720860 of Hover Inc.All other brands.products and company names mentioned herein may be trademarks or registered trademarks of their respective holders. a3aOr000000utM nl Al Dowered by HOVER BARRY GOLDSTEIN- Use of this document is subject to HOVER's Terms of Use and is provided"as is."HOVER makes no guarantees,representations or warranties of any kind,express or implied,arising by law or otherwise relating to this document or its contents or use,including but not limited to,quality,accuracy,completeness,reliability,or fitness for a particular purpose. 4 APR 2024 Page 5 • HOVER Roof Measurements 11 Trumbull Road, Northampton, MA ROOF MEASUREMENTS -j (E)37 6" (— Roof Length Ridges(RI) 37'6" N N Hips (H) - A Valleys (V) - Rakes (RA) 49' 3" Eaves (E) 75' T (RI)37'6" Flashing (Fr Step - Step Flashing (SF)' Transition Line (TL) - N at a Please view the 3D model for more detail(e.g.flashing,step flashing and some other roof lines may be difficult to see on the PDF) (E)3T6" r0 2024 HOVER Inc.All rights reserved.This document and the images,measurement data,format and contents are the exclusive property of HOVER.HOVER is the registered trademark PROPERTY ID:11720860 of Hover Inc.All other brands,products and company names mentioned herein may be trademarks or registered trademarks of their respective holders. a3a0r000000UtMnIAI Powered by a HOVER BARRY GOLDSTEIN- Use of this document is subject to HOVER's Terms of Use and is provided"as is."HOVER makes no guarantees,representations or warranties of any kind,express or implied,arising by law or otherwise relating to this document or its contents or use,including but not limited to,quality,accuracy,completeness,reliability,or fitness for a particular purpose. 4 APR 2024 Page 6 HOVER 11111$ Roof Measurements 11 Trumbull Road, Northampton, MA ROOF FACETS RF-2 Roof Facets Facet Area Pitch RF-1 462 ft' 4/12 RF-2 462 ft' 4/12 RF-1 0 2024 HOVER Inc.All rights reserved.This document and the images,measurement data,format and contents are the exclusive property of HOVER.HOVER is the registered trademark PROPERTY ID:11720860 of Hover Inc.All other brands,products and company names mentioned herein may be trademarks or registered trademarks of their respective holders. a3a0r000000UtMnIAI Powered by a HOVER Use of this document is subject to HOVER's Terms of Use and is provided"as is."HOVER makes no guarantees,representations or warranties of any kind,express or implied,arising BARRY GOLDSTEIN- by law or otherwise relating to this document or its contents or use,Including but not limited to,quality,accuracy,completeness,reliability,or fitness for a particular purpose. 4 APR 2024 Page 7 11 Roof Measurements 11 Trumbull Road, Northampton, MA r ROOF AREA 462 Roof Facets Total Total 2 924 ft7 462 0 2024 HOVER Inc.All rights reserved.This document and the images,measurement data,format and contents are the exclusive property of HOVER.HOVER is the registered trademark PROPERTY ID:11720860 of Hover Inc.All other brands,products and company names mentioned herein may be trademarks or registered trademarks of their respective holders. a3a0r000000UtMn1A1 Powered by a HOVER BARRY GOLDSTEIN- Use of this document is subject to HOVER's Terms of Use and is provided"as is."HOVER makes no guarantees,representations or warranties of any kind,express or implied,arising by law or otherwise relating to this document or its contents or use,including but not limited to,quality,accuracy,completeness,reliability,or fitness for a particular purpose. 4 APR 2024 Page 8 ACc CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) �..i" 4/25/2025 4/24/2024 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). CONT PRODUCER Lockton Companies NAMEACT 1185 Avenue of the Americas,Suite 2010 PHONE FAX New York NY 10036 INC.No.Ext): (A/C,No): 646-572-7300 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:The Cincinnati Insurance Company 10677 INSURED Erie Construction Mid-West,LLC INSURER B:Navigators Specialty Insurance Company 36056 1500420 3516 Granite Circle INSURER C:The First Liberty Insurance Corporation 33588 Toledo OH 43617 INSURER D:Homesite Insurance Company of Florida 11156 INSURER E: INSURER F: COVERAGES 1st CERTIFICATE NUMBER: 18402199 REVISION NUMBER: XXXXXXX 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 TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSR WVD (MM/DD/YYYY) (MM/DD/YYYY) A X COMMERCIAL GENERAL LIABILITY N N EPP0534782 4/25/2024 4/25/2025 EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR DAMAGE TO RENTED PREMISES(Ea occurrence) $ 100,000 MED EXP(Any one person) $ 10,000 PERSONAL 8 ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY PRO- JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ A AUTOMOBILE LIABILITY N N EPP0534782 4/25/2024 4/25/2025 COMBINED NGLE LIMIT $ (Ea accident)SI 1,000,000 x ANY AUTO BODILY INJURY(Per person) $ XXXXXXX OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS XXXXXXX HIRED NON-OWNED PROPERTY DAMAGE $ XXXXXXX AUTOS ONLY AUTOS ONLY (Per accident) $ XXXXXXX B X UMBRELLA LIAB X OCCUR N N NY24EXCZOE055IC 4/25/2024 4/25/2025 EACH OCCURRENCE $ 3,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 3,000,000 DED RETENTION$ $ XXXXXXX WORKERS COMPENSATION PER OTH- C AND EMPLOYERS'LIABILITY N WA6-65D-293745-024 4/25/2024 4/25/2025 X STATUTE ER ANYIPRR/MEY PROPRIETO R EXCLUDED?ECUTIVE YN N/A E.L.EACH ACCIDENT $ 1,000,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under --- " DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 D Excess$2M X$3M N N CXP-018308-01 4/25/2024 4/25/2025 Occ:$2,000,000 Agg:$2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION See Attachment SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 18402199 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN For Your Information ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRr Seri t ATIVE ! `� E 11 ©1988-2015 ACORD CORPORATION. I rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Attachment Code:D607603 Master ID: 1500420,Certificate ID: 18402199 w For Your Information Dear Erie Construction Mid-West, LLC certificate holder: In an effort to meet demand for instant electronic delivery of certificates, Lockton Companies now provides paperless delivery of Certificates of Insurance. Thank you for your patience and willingness to help us lessen our environmental footprint. To fulfill your certificate delivery,we need your email address. Please contact us via one of the methods below with your Holder ID number, email address, and phone number in the event we have any questions. Your Holder ID number is 18402199. Email: Eriecertrequests(a�Iockton.com • Toll-free automated phone service: 866-218-4018 If this certificate is no longer needed or valid,please notify us. Thank you, Lockton Companies Lockton Companies 1185 Avenue of the.Americas, Suite 2010 New York, NY 10036 lockton.com