Modification Request Form
Please read all of the following before competing this request!

After submitting, you will receive an email of this completed form. Attach all supporting pictures, documents, etc. to that email and forward to office@pittsfieldvillage.com.
**!!!** This form is not considered submitted for approval until the supporting materials have been received!!! **!!!**

Please submit at least 3 business days prior to Modification / Maintenance Meeting.

General Criteria used by the Modification/Maintenance
committee to review requested modifications:

Does the requested modification appear to:

1) Use the same kind of doors, windows, building materials, colors, and general
architectural styles that are already in use in Pittsfield Village?

2) Not add additional maintenance burden to the association?

3) Conform to good construction practices?

4) Follow the rules of the association and the city, county and state laws?


Important Agreement

If the requested modifications are approved,
the following agreement shall be understood:

1) The co-owner agrees that they are entirely responsible for all upkeep and maintenance of the
modifications. Further, this responsibility will be passed on to any future co-owner living in this particular
unit. The new owner will be made aware of this condition in writing by the current owner prior to the sale
of the unit. Failure to notify the new owner will not in any way release the new owner of the responsibility
of the upkeep and maintenance for the modifications.

2) All contractors working on the site other than the owner will be able to furnish a workman’s
compensation certificate to the Cooperative prior to work beginning.

3) All applicable permits and approvals from all governmental bodies will be obtained by the
owner.

Email address
Name
Your answer
Current Date
MM
/
DD
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YYYY
Next Committee Meeting (first Tuesday of the month)
MM
/
DD
/
YYYY
Address
Your answer
Home Phone
Your answer
Work Phone
Your answer
Requested Modification
Your answer
Licensed Contaractor
Required
Deadline for Completion
MM
/
DD
/
YYYY
Owner has received specifications and has read and agrees to owner modification agreement.
Required
Date Agreement Reviewed
MM
/
DD
/
YYYY
A copy of your responses will be emailed to the address you provided.
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