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HomeMy WebLinkAboutBuilding Permit #263-15 - 11 PHILLIPS COMMON 9/18/2014 BUILDING PERMIT of NORTH qti TOWN OF NORTH ANDOVER 0 O - L APPLICATION FOR PLAN EXAMINATION Permit No#: S� Date Received � -- QDAA7ED 0, �5 Date Issued: �SSACHUS I P TANT:Applicant must complete all items on this page LOCATIONk ' � i( t IP'ROPERT,Y'OUVNER' 4 A MAP P"rant 1bbT,?Qr Struc_t re, e, - PARC:ELL/ _ N TiR sto c nn w ING S� CT yes t' �Hi ri ®istrictyes. MachnekShop;Villages eyes ono —� — - a—, TYPE OF IMPROVEMENT PROPOSED USE Resid tial Non- Residential ❑ New Building ne family ❑Addition ❑ Two or more family ❑ Industrial ❑64eration No. of units: ❑ Commercial Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑:Septics ❑INelll _ ❑ Floodplain �Wetl ntls "` v> - ❑Wat�r/S ❑ VSlaters�hed distnct,� DESCRIPTION OF WORK TO BE PERFORMED. A'6 how Identification- Please T pe or Print Clearly OWNER: Name: &- L Phone: Address: ContractoName l'► on � 'Phe -� Address��3 �f�i`�� �t Supervisot'sMConstructi©n.LFicense _r w a { Hon%Improvement Licehi's l ZO§1 = a rExp D to /AZ �! f ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT.•$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ l��- ' FEE: $ Check No.: L Receipt No.: 0 NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund LSign_ature of A ent/Owner:: g agnature of contractor__ I Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS I - Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes i Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street :FIRE,DEPARTMENfT =Temp ®umpster�on�ste yes – -a ono d afi 1244Main Streef 4 s— T F 'Locate_ Fire' epartment`signatureldate� — _ a . a r I Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine i NOTES and DATA— (For department use) ❑ Notified for pickup Call Email Date Time Contact Name Doc.Building Permit Revised 2014 Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ? ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products j NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg. Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc:Building Permit Revised 2014 Location k om. r .lam COMMA" i No. +' Date 1 r r �i o - TOWN OF NORTH_ ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee s, tJ j r Foundation Permit Fee $ , Other Permit Fee $. t?, TOTAL $ . ( Check28015 It. Building Inspector. V i NORTH Town of _ AndoveT fid ver Mass - T O I.AKII ' ' CoCKICMl WICK X11,9 AERATED r'PP�.�S s ll BOARD OF HEALTH PERMIT T L O Food/Kitchen Septic System J/\ BUILDING INSPECTOR THIS CERTIFIES THAT �G.. ........... �..�.....�..�'� , has permission to erect ......... buildings on ... ' ... l (. .06. ".Y. Foundation � Rough to be occupied as ...mvq ............ ..... .. . .... ... .af...1 ............................................... Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application Final on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR I Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final IN PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCT TARTS Rough Service ......... .. ................................................................ Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the-Building Inspector. Burner Street No. Smoke Det. 9 Massachusetts-DepartmentLof Public Safety Board of Building Regulations and Standards Construction Supervisor License: C"87977 ERIC VII PALM , 3 BMTON ST - ' YA Salem MA 01970= .ter M« t4. Expiration Commissioner 04123/2016 =i 601AFOR117ealt/.01-ArJJnC/'r1Jefj 4 0mcc of Consumer Affairs&Business Regulation ME IMPROVEMENT CONTRACTOR gistration: 142U89 Type piration: 311ti2016- Ltd Liability Corpo. ATLANTIC WEATHERIZATION 1.L:G. x ERIC PALM 61R JEFFERSON AVE SALEM,MA 01970. Undersecretary AC�® DATE(MM/DOM"II%. � CERTIFICATE OF LIABILITY INSURANCE 3/10/2014 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). PRODUCER CONTACT C NAME: llOIIStrCtiOn Eastern Insurance Group LLC PHONE (508)651-7700 FAX No: 233 West Central Street EDRF INSURERS AFFORDING COVERAGE NAIC 9 Natick MA 01760 INSURER AArbella Protection Ins. Co. 41360 INSURED INSURER 8 Arbella Indemnity Ins Co. 10017 Atlantic Weatherization INSURERCNautilus Insurance CO 61 Rear Jefferson Avenue INSURER 0. INSURER E; Salem MA 01970 INSURER F: COVERAGES CERTIFICATE NUMBERidaster 2014 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. lNSR POUCY EFF POLICY EXP LTR TYPE OF INSURANCE Im wV0 POUCY NUMBER M MM/D LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE To -PREMISES Ea occurrence $ 50,000 A CLAIMS-MADE Fx-1 OCCUR 8500042816 /20/2014 /20/2015 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY X PRO LOC $ AUTOMOBILE LIABILITY COMBIINdED SINGLE LIMIT E 1,000,000 B ANY AUTO BODILY INJURY(Per person) $ ALL OWNED XSCHEDULED 1020015871 /20/2014 /20/2015 AUTOS AUTOS BODILY INJURY(Per accident) $ X HIRED AUTOS X AUTOS NO AWNED PROPERTY DAMAGE $ Per accident PIP-Basic $ 8,000 X UMBRELLA UAB X OCCUR EACH OCCURRENCE $ 1,000,000 A ��LtAe CLAIMS-MADE AGGREGATE $ 1,000,000 DEO RETENTION$ 600058654 /20/2014 /20/2015 $ WORKERS COMPENSATION WC STATU- DTH AND EMPLOYERS'UABIUTY IN I FR OFRCER/MEMBEANY R�EXC EXCLUDED?ECUTNE Y❑ NIA E.L.EACH ACCIDENT $ (Mandatory In NH) . E.L.DISEASE-EA EMPLOYE $ if yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ C POLLUTION LIABILITYPL200378602^ 0/1/2013 0/1/2014 GENERAL AGGREGATE $1,000,000 EA POLLUTION CONDITION $1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(Attach AdORD 101,Additional Remarks Schedule,If 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 TOWN OF NORTH ANDOVER ACCORDANCE WITH THE POLICY PROVISIONS. 16010 OSGOOD STREET NORTH ANDOVER, MA 01845 AUTHORIZED REPRESENTATNE Ronald Cleaves/SME , "-�-- ACORD 25(2010105) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025 rgninrLsi m Tho Anewn nnma*nd Innn nro ranicfarnd n%2rka of ACnpn Rightfax N3-2 4/18/2014 7:54 :21 AM PAGE 2/002 Fax Server CERTIFICATE OF LIABILITY INSURANCE FDATEi(MM/DD1YYYY) T. IFI CATE 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 O ODUCAND THE CERTIFICATE HO IMPORTANT:if the certificate holder is an ADDITIONAL INSURED,the policy(les)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: EASTERN INS GROUP LLC PHONE FAX 233 WEST CENTRAL STREET (A1C,No,Ext): (A1C,No): NATICK,MA 01760 E-MAIL ADDRESS: 22ML W INSURER(S)AFFORDING COVERAGE NAIC 8 INSURED INSURER A: AMERICAN ZURICH INSURANCE COMPANY ATLANTIC WEATHERIZATION LLC INSURER e: INSURER C: INSURER D: 61 REAR JEFFERSON AVE INSURER.E: SALEM,MA 01970 INSURER F. COVERAGES CERT)FICATE NUMBER: REVISION NUMBER: T LS T FY THAT THE POLICES OF INSURANCE US-FED 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 MAYBE ISSUED OR MAY PERTAIN.THE INSURANCE AFFORDED BY THE POLICIES'DESCRIBED HEREIN LS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAD CLAIMS. INSR ADD SUB POLICY EFF DATE POLICY EXP DATE LTR TYPE OF INSURANCE L R POLICY NUMBER (MMIDDIYYYY) (MNWmYYYV) LIMITS GENERAL LIABILITY ACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY — CLAIMS MADE [D OCCUR. AMAGE TO RENTED $ REMISES(Ea occurrence) I KRODUCTS XP(Any one person) $ GEN'L AGGREGATE LIMIT APPLIES PER: NAL&ADV INJURY $ ALAGGREGATE $ POLICY PROJECT❑LOC COMP/OP AGG $ AUTOMOBILE LIABILITY COMBINED SINGLE $ ANY AUTO LIMIT(Ea accident) ALL OWNED AUTOS BODILY INJURY SCHEDULE AUTOS (Perarson P HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE " AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ A WORKER'S COMPENSATION AND WC STATUTORY OTHER EMPLOYER'S LIABILITY YIN UB-5B270121-14 03/20/2014 03/20/2015 X LIMITS i ANY PROPERITORIPARTNERIEXECUTIVE OFFICERWEMBER EXCLUDED? N/A E.L.EACH ACCIDENT $ 500,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 It yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERAMONSILOCATIONSNEHICLES!RESTRICTIONS/SPECIAL ITEMS THIS REPLACES ANY PRIOR CHRT[FICATE ISSUED TO THE CERTTFTCATE HOLDER AFFECTING WORKERS COMP COVERAGE. CERTIFICATE HOLDER CANCELLATION TOWN OF NORTH ANDOVER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 1600 OSGOOD ST BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPR A VE N ANDOVER,MA 01845 >;7 ;;=r ;_•,: ACORD 25(2010!05) The ACORD name and logo are registered marks of ACORD 19882010 ACORD CORPORATION. All rights reserved. - The Commonwealth ofMassacliusetts _ DepartFnent of Industrial Accidents Office oflnvestigations 1 Congress Street,Suite 100 Boston,MA 02114-2017 Workers' Compensation Insurance Affidavit;sgudd s/Contractors { A licant Information /Electricians/Plumbers / Please Print Le bly ; Name (Businessforganiration/Individual): Address: City/State/Zip: -e`f-, Q/017 U Phone#: 0/7 7W- klq Are employer?Check the appropriate box: 1•t Type of project(required); 1 am a employer with 4• Q I am a general contractor and I employees(full and/or p .* have hired the sub-contractors 6• ❑New construction 2•Q I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have working for me in any capacity. employees and have workers' g' 0 Demolition [No workers'comp.insurance comp.insurance J g• []Building addition i 3.Qrequired.] 5. Q We are a corporation and its 10.Q Electrical repairs or additions I am a homeowner doing all work officers have exercised their 11.❑ myself. [No workers' comp. right of exemption per MGL Plumbing repairs or additions insurance required.]t c. 152,§1(4),and we have no 12.,-.0_, Roof repairs employees. [No workers' 13.[; ' ther_ comp. insurance required.] `Any applicant that cbecks box 41 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-contracmrs and state whether or not those entities employees. If the sub-contractors have employees,they must provide their workers'comp,policy number. have 1 am an employer that is providing workers'compensation insurance for my information. employees Below is thepolicy and job site Insurance Company Name:�7u, Policy#or Self-ins.Lic.#: -70 /-7 f Expiration Date: 3/a o II5-- 92 Job Site Address: / ,' I Attach a copy of the workers'compensate n policy declaration page City/State/Zip: Al A-dmr-el Failure to secure coverage as required and P g (showing the policy number and expiration date). �1 under Section 25A of MGL c. 152 can lead to t ) fine up to si,5oo.00 and/or one-year imprisonment,as well as civil penalties in the form imof position STOP of criminal penalties of a Of up to$250A0 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office and a fine Investigations of the DIA for insurance coverage verification. Ido hereby certi der theins anAvenaldes of er ury that the in ormation rovided abo77 AM" ve ove is true and correct. Si afore: -----_ __ Date: ___ 4Q Phone#: 7 9- 741y, � y 3 I Official use only. Do not write in this area,to be completed by cif,or town official City or'gown: Permit/License# Issuing Authority(circle one): 1.$oard of Health 2.BuildingDepartment 3,Ci /Town Clerk 4.Electrical In Inspector 5.Plumbing Ins ti.Other P ' P g pectar Contact Person: Phone#- Massachusetts Yoffie Iffi rovemennt Sam �e tC®ntfratct T hisits all basic raiuirements of the ale's Home Improvement Contractor Law(1v1GL chs ter l42 A) but of tect homeowners• Seek legal'a vice if n Consumer Guide to Home Im eeessary'A°Y person planning home improvements hotild first obtain Oes Out l cop stn ^q�mero cel"before agreeing to any tt�d on Affairs and Susinca:Retsina'on'_s Consumer Inform H°Uinc at G7 urresidceCc-You may obtain a free co b Homeowner Information s?s-8?a?or 1-888 Py )calling the 283 3?57 or on our website- Name Contractor.inforfnation Company Name Ad 2 � r Street Address(do nRt use a ost' ice Box address) antic-ewwizafi(3nt L,LC UL , Can uactoi/Sal S NI' Vei!!ie Citvlrtrim, rate irp Cods � f . Business Address(must inc u j.2-- Phone aPhoneEvcnittg one StState/-/ .. CiRr�rOt1T tV7 0 b Zip Cade lafaili Ad rtS dress (It different from above) Business Phone Federal fdn I p oyer ID or SS.Number . L-m—rdrsautmosi bmm. nom 1¢po°pQ��o m:,'torRs,TLm6e .;;Eg3rtianLtc 1 mnrmm�eart TheContrn _. - as�dn?n4onacnhcr" (Describe in detail 8u workto-odo the e[f ollowing po for the Homeowner. -+ P. ed specifying eh type,brand,and [Fade of materiatt to be usett,lice additional cheek ifn +• - 041 - tom•. � ,. .. # 7reits-The follownigbuildingpetmi are red by the contractor as the homed els Sedje required Start and Completian Scheilale secure their ow' aled to unless circumstances The follmvi9schedule will the Guaranty Fad its ill bbE}oad the contractorscontrolarise r 142A.) pro{inionDate cited conuaccor trill I begin can Work Date when contracted wall;will be substantially completed. total Coatraa Price and Payment Schedule The Contractor agrees to perform the work,famish be material and labor ,�/� specified above for the total sum of: `�J VQ, Payments will be made according to the following hedule: S- ZV upon signing contract:not to ee ( 1/3 of the total contract price pr the cost ofspecial order items,tvinchever is greater) b} /�or upon com letion of S vvV�i by / /— or upon conal letion of_ S-'== C upon Completion ofthe contract, ( wforbids demandm g full p ent until contract is completed to both The foltonin.materraVequipment must be special PanY's satisfaction) ordered h S 'r efore the contracted wart begins in order 1n .. d for r to meet the completion schedule(••) . S .d f NOTES:(')Gtelodin9 all finance choses(„)Law not ecceed the pester of(a)one La o quitthe that a%,deposit or down-payment required by the con whiff must be special ordered in ad�arrce to t t Ne reel price s(b)the actual cost oftmy specie] nactor txfare swrl:bins may completion schedule equipment or custom made material ETD Subcontractors-The contractor r rov' h can era or? ❑ o Yes all t PaMAubcontractor utilized b•the ca own to be solely r ponsible.for of lheic "ached to th n rnct tractor. The r agme ti c) of the work described re r a!s and tractor further agrees to be solei• Loess of the actions of any third Contract rices tunce- r 3 responsible for all actions to all subcontractors for contract shall notimply ffiat any 1 orr othersetarri gaing,this documentecemes a binding contract under law. -security littlest has been laced on the iesidenbe-Review thUnless otherwise {to ted cautious and document, the 1 carefully before signing this contract V notices Dont be Pressured into signing the contract.Tal. time to read and fol[ and t t ° ales sure th contra orb a veli Name I E22. n } erstand it Ask questions ifsomelhirig is unclCc'' svbcongactors to be n ctarR The late registered with the Directorme Imp requires in home' registration by writing to the Direct 10 ParkProvemcet Contractor Registration- You st in improvement contractors and Does the contractor hinstuaoce7 Room 5170,Boston,MA 02116 or b Y quire about Contractor . see a copy of a Ask the Ca tractor for his insuran,i:onl•an Y calling 617 973-8787 or 888-283-3757. proof of insurance”docament. P Y u►formation so that you can Confit[coverage,or ask to Know your rights and sponsibilities.Read the re Guide to the Home Improvement Contractor Law Portant hlfOlmutlOn on the reverse side of this In and get a copy of the Consumer You may cancel this agreement if it has been signed $ contractor in writing Y>n at place other than the contractor's normal place of business, third business g at his/her main office or branch o ice by ordinary mail Posted,by tele f day following the si@n ff a this a Proi+ided you notify the Stem t.See-the attached notice ofcaneelgriaaumo rm Pbordeefivety not later than midnight ofihe DO NOT SIGN HIS Cp CTIF �A�� a cP'no'notation ofthis right- j Toa idtal'Kal copies oftbe eoatraa const be e°mP1et sad sisaed p'� ``��' TsbouldgotofthomcrosTa 7Lcother o ,SPACESM `vJ eoPS should be ixpr h_s. tom r. Homeoener's Si lure t n - Con hattor s Signature I �1 Date 10 Date t Contractor Arbitration f The Home improvement Contractor Law provides homeowners with the right to initiate an arbitration action-(as as alternative to court action)if they have a'dispute with a contractor. The same Til ht is not automatically affordedto a contractor,however. The contractor would have to resolve any dispute he/she h Ls with a homeowner in court unless,- both parties agree to the optional clause provided below. This clause would gh the contractor the same right to arbitration as is afforded to the homeowner by the Home improvement Contractor Law. The contractor and the liorhebivnef tieretiy fiiitiiatly agree in advance that in the vent the contractor has a dispute concerning ibis contract-the coatractoF:rgaytsubmit the dispute to a private arbi tion firm which has been approved by the Secretary of the)executive Office of Consumer Affairs and Business Regula ion and the consumer be required. j to submit to such arbitration as provrded Iii iulassachusetts General Laws:ch 1424. Homeowner's Signature Contract is Signature NOTICE:The,signatures of the parties above apply only to the agreement of th patties to alternative dispute resolution initiated by the'contractor. The homeonmer may initiate alternative d ispute resolution even where this section is not separately signed by the parties. Hoineo mere Rights er A homeowner's rights under the Home-Improvement Contractor Law(MGL ch ter 142A)and other consurn protection laws(i.e.MGL chapter 93A)may not be waived in any way.even by agreement Howevert homeowners may be excluded from certain rights if the contractor they choose is not properl r registered as prescribed by law. E Homeoner who secure their own building permits are automatically&clude from all Guaranty Fund provisions of w ctor is responsible for com leting the work as described.in a . the Home Improvement Contractor Law. The contra.. timely and workmanlike tnannen Homeowners may be entitled.to other specifi legal rights if the contractor-. guarantees or provides' express warranty for wrorkmanship or materials: In a dition to guarantees or%warranties provided by the contractor:all goods sold in Massachusetts carry an implied w ty:ofinerchantabilityand fitness for, a particular purpose. An enumeration of other matters on ivhich the homeowne and contractor lawfully agree may.be added to the terms of the contract as long.as they do not restrict a homeowner's basic consumer rights. If you have questions about your consume.r/homeowrner rights,contact the Consumer Info ation Hotline(listed below). - Execution of Contract The contract must be executed in du urate and should not be signed until a copy of all exhibits and referenced sed not to sign the docume t until all blank sections have been documents have been attached. Parties are also advi filled in or marked as void.deleted or not applicable. One original signed cop of the contract with attachments is to be given to the owner and the other kept by the contractor. Any modification t the original contract must he in writing and agreed to by both parties.Contracted work may not begin until both parties have received a fully executed copy of the contract and the three day rescission period has expired. _ Accelerated Pavments A contractor may not demand payments in advance of the dates specified on the payment schedule in cases%.fiere the homeowner deems him/herself to be financially insecure.However,in instance where a contractor deems him/herself to be financially insecure.the contractor may require that the balance of funds of yet due be placed in a joint escrow account as a prerequisite to continuing the contracted work. Withdrawal of s from said account would require the signatures ofboth parties. Additional information If you have general questions'or need additional information about the Home provement Contractor Law or other consumer rights;or ifyou wish to.obtain"a free copy of "A Massachusetts Con er Guide to Home Improvement" contact: Consumer information Hotline Office of.Consumer Affairs and Business Re lation 10 Park Plaza,Room 5170,Boston.MA 0 116 617-973-8787;888.283-3757 orvisitthe OCABRwebsite-aI i_ii If you want to verify the registration of a contractor or if you have_questions or need additional information specifically, about the contractor registration component of the Home Improvement Contra for Law.contact: ' Director of Home Improvement Contractor Re tion Office of Consumer Affairs and Business Re 106 10 Park Plaza.Room 5170,Boston.MA G 116 " � : t.z=ia au afr: "617-973=8781,888-X83-377 orvisit the RIC«ebsite at ;.��.. .,, L, Go online to view the status.of a Home Improvement Contractor's Regstrati ?'tEi3:;'Clti.Ei ii:.:3Tei.u�'iSOs;t2l �t?CQC"�leic'3i;l;l�t3nc2Ei�i.?=t7 for assistance with informal mediation of disputes or to register formal compl 'nts against a business.call: Consumer Complaint Section Office of the Attorney General. 617-727-8400 AND/OR Better Business Bureau :nsz-A;ijiRnn ;f1R-755-2548 or 41373 114 -------