HomeMy WebLinkAboutBuilding Permit #792-11 - 120 SALEM STREET 5/25/2011 BUILDING PERMIToOO DT bq�.
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit NO: Date Received
rim
�gSSACHU5����
Date Issued:
IMPORTANT:Applicant must complete all items on this page
LOCArTION`s= :� � �. ,
?Print * _ 1
PROPER�T°YrOWNER _ 4 . T . y,
;Pnnt
AP 21,'0; .G PARCELa w� . _'�ZONINGDI TSS RICT _H stoic®is nct es, no I
x Y
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
New Building One family
Addition Two or more family Industrial
Alteration No. of units: Commercial
Repair, replacement Assessory Bldg Others:
Demolition Other
Septic fVl/ell L �Floodpla h -Wetlands = } ` 1Natershed�iD st-ict f
q`
;,, Water/Sewel•# � ° �'
.. _ _:.�--.,.w.fir._..y—l'—.._-�.._-�-v..-.-. ..e.-e..sem--_?.. .4•..L.w;c, .ti _ . �._,: .x s:-<.
r(.
DES RIPTION OF WORK TO BE PREFORMED:
Identification Please Type or Print Clearly)
OWNER: Name: Phone:
Address:
• v `
f i
CONTRA$TOR 'Name _ r .T
f �
Acid ress �+ � .. y[S��� -
n
Su,pervisor'sConst�uctio �1Lice a R
I
�Hame;Irnprove.rnent�License � ja} ,,sF:� , r. EX {®ate.:M
R - _. . .�.
ARCHITECT/ENGINEER Phone: p
Address: Reg. No.
FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F.
Total Project Cost: $ G ��� A�0 FEE: $_1,5-41-00
Check No.: IoI6 6'0 Receipt No.:��,� e /
NOTE: Persons contracting with unregistered contractors do not have access to the gu fund
Si nature;ofA ent/Owner -
Signature of`contractor _
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 K.I.C. And C.S.L. Licenses
❑ Copy Of Contract
❑ Floor/Crossection/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.
o 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
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 thea appeal period is over. The applicant must then et this recorded at the Registry pp p pp g g try of Deeds. One copy and proof of recording
must be submitted with the building application
Doc:Building Permit Revised 2008
Plans Submitted Plans Waived Certified Plot Plan Stamped Plans
TYPE OF SEWERAGE DISPOSAL
Public Sewer Tanning/MassageBody 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
DATE REJECTED DATE APPROVED
PLANNING & DEVELOPMENT
COMMENTS
CONSERVATION Reviewed on Signature
COMMENTS
HEALTH Reviewed on Signature
r
COMMENTS
Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision: Comments
tConservation Decision: Comments
Water & Sewer Connection/signature& Date - Driveway Permit
DPW Town Engineer: Signature:
Located 384 Osgood Street
AFIRE xDERTMENT Temp Durnpster on situ yes _z ' no � {�
Located at 12 MainStreet f �-
Fire,kDepartent,s.rgnature/dafe
�� � =• -` „�,�_,....�..,��
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
NOTES and DATA— (For department use)
❑ Notified for pickup - Date
Doc.Building Permit Revised 2010
Location
No. a _�� Date 5 A5
HpRTh -TOWN OF NORTH ANDOVER
o:..so,•'bhp
. 9
}�a Certificate of Occupancy $
CMs<� Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check # d
242U1 /
Building Inspector
ORTH
F '
Town of
oAndover
7 fk
--- -o " dover, Mass.,LAK
S
COCMICMEWICK
BOARD OF HEALTH
PERMIT . T b
Food/Kitchen
Septic System
/ BUILDING INSPECTOR
�Gj .
THIS CERTIFIES THAT..................�i'...............a/M jr,-�
.............................................................................................................................. Foundation
has permission to erect........................................ buildings on ./. .a... 4.l r.yi...r? ................................................... Rough
tobe occupied as............... ................................................................................................... Chimney
provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final
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
VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough
Final
PERMIT EXPIRES IN 6 MONTHS
UNLESS CONSTRUCTION ARTS ELECTRICAL INSPECTOR
Rough
...................................... Service
............................ ..................... ........
BUILDING INSPECTOR
Final
Occupancy Permit Required to Occupy Building GAS INSPECTOR
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.
SEE REVERSE Sa®E Smoke Det.
NOV-30-2010 TUE 04;05 PN ALLAN INS AGNCY FAX NO, 978+745+5483 P. 01
A ORD, CERTIFICATE OF LIABILITY INSURANCE 11/30/2010'
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ALLAN INSURANCE AGPNCY INC. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
63 1/2JGffe.raon Avenue 2nd F IDOES NOT
EATER THE COVERAGE AFFORDED BY THE POLICES BLOW.
Flo. F3QX 511
SALEM MA 01970-0511 E
COMPANY .�COMPANIES AFFORDI...
NGa COVERAGE
.
......... �_—._... _..
A Seneca Insurance Company
INSURED
COMPANY
TGLRC INC dba Lambert Roofing 13 Safety Insurance Group
265 WINTER STREET
COMPANY Landmark Insurance Company
xAv$1tHxLL MA 01830-
COMPANY
p National Union Fire Insurance
COVERAGES
THIS IS TO CERTIFY THAT THE POUCIES OF INSURANCE LISTED BELOW HAVE SEEN ISSUED TO THE INSURED NAMED ABOVE FO:R THE PCLICY 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 6Y THE POLICIES DESCRIBED HEREIN 15 SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LWITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
T TYPE OF INSURANCE I POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION
LTATYPE
DATE(MMIDD/YY) LIMITS
GENERAL LIABILITY -
X� SGL3000422 / / / BODILY INJURY OCC a 1 000,OCO
GO.VIPREHENSIVE FORM / ---
ElODILY IN IN-IIJRY AGG $ - 2 000,000
_ PREMISESICPERAnQNS _ - - - ..-.....-.. _.. _.1.
A UNDERGROUND { { / / PROPERTY DAN.ACE OCC $ 2 0001 000
. ... .. .. ..
- GPERT--Y__...DAMAGE FGG $
X PRODUCT$rCQSAPLETECOLLAPSE HAZARD PkETEOOPER BIBPD COMBINED CCC, $
CONTRACTUAL 11/12/,2DLO 11/12/2011 BI&PD COM$IN=D AGG
lNDEPENDFNT CONTRACTORS •PERSONAL INJURY ACC $ 1,000,QOO
X I PERSBROAD FORM PROPERTY DAMAGE / { / { Medical Payment 5 000
X�PERSONAL INJURY � � �••-•-� ..... - ,
ANY AUTO BODILY INJURY
--� (POr PorsoM 5
X IALL OWNED AUTOS(Priy4oPass; 6203819 07/16/2010 07/16/2011
X-I+ALL OVJNEQ AUTOS BODILY INJURY
_...I(Diner than rrwate Peeanngwl :p6r nq;dpont) $
X HIRED AUTOS
X iNON-OhNED AUTOS / { { / PROPERTY DAMAGE $
GARAGE LWAUTY ------
-"'� BODILY INJURY&
PROPERTY
DAMAGE b 1,000,000
"EXCE5SLIABILITY COMBiN'- -- - _
C X UMBRELLA FORM .EACH OCCURRENCE $ S OOO,000
PGjRE9
FIA054557 11/12/2010 11{ � � �12/2011 AATE
OTHER THAN UMBRELLA FORM ... 5,000,000
WORKERS COMPENSATION AND - �• VJC STA -' -
D EMPLOYERS'LIABILITY 009934145
/ / / { —.TORY LlMfrS.TU• ..i X...STH EB
THE PRO;'RIETORI I X 1SNCL EL EACH ACCIDENT $ 1,000,000
?ARTNERSJEXCCUTIVE M, 46/28/,2010 08 FL DISEASE-POLICY LIMIT $ 1,000,000
OFFICER$ARE; EXCL' /28/2011
OTHEREL DISF_ASE-EA EMPI OYES , 1,OOO,000
DESCRIPTION OF OPERAnONSILOCATIONSMHICLFS7SPECIALITEMS
CERTIFICATE HOLDER
( y SHOULD ANYOFTHE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THk
EXPIRATION DATE 7HEROF,THE ISSUING COMPANY WILL
ENDEAVOR TO MAIL
30 DAYS WRIT(FN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
BUT FAILURE TO ASPJL SUCH NOTICE SMALL IMPOSE NO OBLIGATION OR LIABILITY
OF AN KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES.
ARIZ D PRU NTATIVE
ACORD 25-N(1185) ECOIMO/RPOR�TI'O
(7 N 19x8
e :�
sa r Affiun aad usss Regulation
10 Pak Plaza Suite 5170
t ®sten, l gsetts OL 116
�kite iMprovement R egi�tjo.n
Registration:., 149221
?,.^� -- =
Type: Private Co"afio,
0t a psi�^ ' }iz; iration: 12/6/2013 -rr#
RCHAIDLAMBERT
2 T� i
v ! ; rRSTBEET , -
�,i
HA
VERHILI
UPd:*.Addrtw and returg card_trapIc reaso
Adder �' Ado � ❑ gmn awm nt
sac�au±�ctas- Department ns -wic S;eet_,
:i'{ of BBuildinge8i'eulati;ons and 6,Y<g91dard-.
_ C- onstruc':t8o n SL p2r4J Si}r i;c8i3Se
License: CS 7813D
RICHARD..i LAMBERT
94 PICAUDI i y RD
HAMPSTEAD, NH 03841
Explirecion- 6/212012
T:#: 30062
The Commonwealth of Massachusetts
FOR
Board of Building Regulations and Standards MUNICIPALITY
Massachusetts State Building Code, 780 CMR, 7`'edition USE
Building Permit Application Revised
Januiwy 1,2008 _
This Section For Official Use Only
Building Permit Number: Date Applied:
Signature:
Building Inspector Date
SECTION 1:SITE INFORMATION
Residential ❑ Commercial ❑ Other Description:
j 1.1 Po erty Ad
V Dnq% dress: 1.2 Assessors Map&Parcel Numbers
1.1 a is this an accepted street?yes no 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❑ Private❑ Zone: Outside Flood Zone? Municipal❑ On site disposal system ❑
Commercial- Service Size Check ifyes❑
SECTION 2: PROPERTY OWNERSI3IP1
2.1 Owner'of Record:
Name(Print) Address for Service:
Signature Telephone
SUCTION 3:DESCRIPTION OF PROPOSED WORIO(check all that apply)
New Construction❑ Existing Building❑ Owner-Occupied ❑ Repairs(s) ❑ 1 Alteration(s) ❑ Addition D
Demolition 13 Accessory Bldg. 13 Number of Units Other 13 Specify:
Brief Description of Proposed Work':
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs:
(Labor and Materials) Official Use Only
1.Building $ 1. Building Permit Fee:$
2.EIectrical $ 2. Indicate how fee is determined:
E3 Standard City/Town Application Fee
3.Plumbing $ ❑'Total Project Cos3(Item 6)x multiplier x
4.Mechanical (HVAC) $ 3. Other Fees: $
5.Mechanical $ List:
(Fire Suppression)
Total All Fees:$
6.Total Project Cost: Check No. Check Amount Cash Amount:
�v F,1;;i'vifcWea1t11 O
��---� f 1Vlassac1111setts
Department oflidustrial,4ccidents
�S Office oflnvestigations
600 Washington Street
,, — Boston,AL4 02III
� - )P7vw.mass govldia
Workers' Compensation Insurance Affidavit:Builders/Contractors/E,E lectricians/Plumbers
Applicant Information Please Print Legibly
NaMa(Business/Organization/Individual): A \V�
Address:
City/StatPhone#-GA. �7
Are Y101dan employer? Check the appropriate box:
1. I am a employer with.Q _ 4- ❑ I am a general contractor and 7 Tie of project(required):
employees(frill and/or part-time).* have hired the sub-contractors 6. ❑New construction
2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling
shipan h
d have no employees These sub-contractors have e 8. �Demolition
working for me in any capacity. employees and have workers'
[No workers' comp.insurance comp.insurance_t g- ❑Building addition
required.] 5. 0 We are a corporation and its 10.0 Electrical repairs or additions
3.❑ I am a homeowner doing all work officers have exercised their ILD Plumbing repairs or additions
myself. [No workers' comp. right of exemption per MGL R
insurance required.] t c. 152, §1(4),and we have no 12.E], Joof re pauz
employees.[No workers' 13-LTOthe N`-Ii 1
comp.insurance required.] t�0 j
•Any applicant that checks box i#1 must also fill out the section below showing their workers,co enation policy t Homeowners who submit this affidavit indicating they are doing all work and then hire outside onIIactors mustinf or a new affidavit indicating such
tContractors 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. ]f the sub-contractors have employees,they must provide their workers'camp.policy number.
I ant an employer that isproviding workers'compensation insurance for my employees. Below is thepolicy and job site
information.
Insurance Company Name
Policy#or Self-ins.Lie. Expiration Dater 3 • ` I
rN
Job Site AddressCity/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 Section 25A ofMGL c. 152 can lead to the imposition of criminal penalties of a
fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORD ORDER and a Erne
of up to$250.00 a day against the violator. Be advised that a copy of this statement may forwarded to the Office a
Investigations of the DIA for insurance coverage verification.
I do hereby certify It r tIr pains and penalties ofperjury that the information provided above is true and correct.
Signature: `
Date:
Phone
Oficial use only. Do not write in this area,to be completed by city or town offrciaL
City or Town: Permit/License#
Issuing Authority(circle one):
I.Board of Health 2.Building Department 3.City/Town Cleric 4.Electrical Inspector S.Plumbing Inspector
6.Other
Contact Person_ Phone#-
SECTION 5: CONSTRUCTION SERVICES
5.1 Licensed Construction Supervisor(CSL)
Y License Number ExpirationElate
nme CSL-Hal er . •,
List CSL Type(see below)
Type Description
Address U Unrestricted(u to 35,000 Cu.Ft)
RRestricted 1&2 Family Dwelling
Si tur `
�� M Masonry Only
RC Residential Roofing Covering
Telephone WS Residential Window and Siding
SF Residential Solid Fuel Burning Appliance Installation
D Residential Demolition
.2 Registered Home I ove a Contr Fetor(HIC)
C Ca p N ar HIC g' trap „�^ Registration Number
A dress �n,
Ex alio Date
Signator _ 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.......... No...........❑
SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
as Owner of the subject property hereby
authorize•, to act on my behalf,in all matters
relative to work authorized by this building permit appAcation.
Signature of Owner Date
SECTION 7b: OWNER'OR AUTHORIZED AGENT DECLARATION
as Owner or Authorized Agent hereby declare that
the statements and information on the foregoing application are true and accurate,to the best of my knowledge and behalf
Print Name
Signature of 15ti er Agent Date
(Signed under the pains and penalties of perjury)
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(MC)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 and Construction
Supervisor Licensing(CSL)can be found in 780 CMR Regulations l 10.116 and 110.115,respectively.
2. When substantial work is planned,provide the information below:
Total floors 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
The Commonwealth of Massachusetts
Board of Building Regulations and Standards
Massachusetts State Building Code,780 CMR,7'b Edition
Building Permit Application To Construct,Repair,Renovate Or Demolish a
One-or Two-Family Dwelling
SECTIONS:ADDITIONAL APPROVALS
1. Ballardvale Historic District Commission: Date:
2. Board of Health: Date:
3. Conservation Commission: ; Date:
4. Design Review Board: Date:
5. Electrical Permit Number: Date:
6. Fire Prevention: Date:
7. Planning Board Lot Release: Date:
8. Preservation Commission: Date:
9. Zoning Board of Appeals: Date:
I
I
E
- T.
6i5 ON OF
ambert
EI\ # 51-050-3313 vouaeoaF• Haverhill, MA 978 374.9224
MA Reg. # 149221BBB.
oofing Lawrence MA 978.E 7.7339
MA Lia UCS # 78130 S441,M--2932 Hampton NH 603.92 9224
`- -- Single-Ply License# 1711 �' Hampstead MI 603. ?9.8200
'fol 1 Free 1.888.: S.ROOF
265 Winter Street I
Haverhill SIA 01830
i
*Licensed ;'41nsured *Factory Trained Factory Certified
Name: Performance Building Company Date: 0511/2011.
Telephone: (978) 937-7900 Alt. Telephone: (508) 726-0679 -Mail : jim@cas-ma. c bm
Rlling Address: 50 Tanner Street Lowell, MA 01852
,yob Address: 120 Salem Stre-at North Andover, MA 01845
I
Scope of Work
12 Strip and Re-roof
1 Prepare for re-roofing by ensuring all safety measures in accordal�e with OSHA standa i
regulations and landscape .is properly protected.
1 Remove existing layers of shingles down to roof deck and dispose o� in a legal. fashio from
tole job site. j
F-11 Inspect wood deck, if we discover any rotted wood, replacement wild be performed at * 30 per
sheet or $3. 50 per ft for boards. If chimneys need lead flashing a�d $450. 00 for each
chimney.
[
Install 8" drip edge to all rakes and eaves. Color White.
Apply ice & water shield (UNDERLAYMENT) as per manufacturers' specifications 6' and u all
roofs to walls. All wood siding and carpentry work by PBC.
Apply premium (UNDERLAYMENT) to the balance of the exposed wood de k.
U Re-flash all plumbing stack pipes, and any roof penetrations as re uired and dictated )y good
roof practice to ensure water tightness.
' .; Install a new: Certainteed Landmark Limited Lifetime Architectural Charcoal Black
iJ Furnish and Install a nevi shingle over style ridge vent system or qual
7 All debris generated by Lambert Roofing Co. , Inc. will be cleaned up and disposed of : -om the
Job site in a legal fashion. Under no circumstances will the waterti ht integrity of th
building be compromised.
i
*Denotes potential additional costs above the total job cost.
UPON COMPLETION AND PAYMENT IN FULL, ROOF SHALL HAVE A WORKMANSHIP G�ARANTEE FOR A PERIi ) OF 2
FEARS HONORED AND ISSUED BY THE LAMBERT ROOFING COMPANY AND A LIMITED LIFETIME HONORED ? dD
:ISSUED BY THE SHINGLE h1ANUF'ACTURER (SEE MRRANTI' TERMS AAD CONDITI0A AT IFIFY CERTAINTEE CO,IM).
i
y
y..
TOTAL JOB COIST.- Twelve Thousand Seven Hundred Seventy Five. . . . . $12, 775. 0
TOTAL CONTRACT PRICE AND PAYMENT SCHEDULE
Payment will be made according to the following work schedule:
i
I
$4, 258. 00 upon stock and start.
$8, 517. 00 upon completion of contract.
I
i
(Law forbids demanding full payment until contract is completed tol'both party' s satisf ction)
You may cancel this agreement if it has been signed at a place other than the contra ;or' s
normal place of business, provided you notify the contractor in writing at his/her mai office
or branch office by ordinary mail posted, by telegram or by delive3y, not later than j idnight
of the third business clay following the signing of this agreement. See attached not ;e of
cancellation for an explanation of this riL.
i
TO NOT SIGN THIS CONTRACT IF THERE ANY BLANK SPACES
Acceptance of the Contract Proposal
Owner(s) Signature(s)". — _ Late:
Contractor' s Signature: _ Date:
www. lamb rtroofing. com
Company Insurances
TGLRC Inc. DBA Lambert Roofing Company will provide certification of insurances, demonsi •ating
that we are fully insured for worker' s compensations, general liability, automobile lia[ lity
and an umbrella policy. This documentation will be sent through the 6S mail to the abov( named
party if not already provided.
IMLRC Inc. dba Lambert Roofing Company agrees to:
® Conmience the described work on or about 05-19-2011
® Complete the described work in approximately 2-3 days.
® Not be held liable for delays due to circumstances beyond our control.
® Not be held liable for any damages to landscape and or ixtures due to
circumstances beyond our control.
® Not be held liable and not covered under the workmanshi warranty, for pre-
existing conditions including but not limited to:
e Mold and or wood rot, defective, faulty, rotted or worn building counterpai .s
such as, but no limited to: siding, roofing, masonry, p�umbing and windows, all
of which may jeopardize the watertight integrity of the structure.
e Unless otherwise noted within this document, the contra t shall not imply t tat
any lien or other security interest has been placed onhe residence.
® This contract is the complete contract unless a signed �hange Order has bec .
executed between TGLRC Inc. DBA Lambert Roofing Company and the
Homeowner/Business Owner or Agent.
Permits
i
i
A building permit may be required to remove and replace your roof. It is our obligation o
secure these permits if required as the home owner' s agent. Note: Homeowners who secure heir
own permits or deal with unregistered contractors are excluded from the Guaranty Fund pi visions
of 1MGL c. 142A.
Accelerated Payment
A contractor may not demand payments in advance of the dates .specified on the payment sc :edule
in cases where the homeowner deems him/herself to be financially insecure. However, in i stances
where a contractor deems him/herself to be financially insecure, thelcontractor may reqs re that
the balance of funds not yet due be placed in a joint escrow accountlas a prerequisite t
continuing the contracted work, Withdrawal of funds from said account4 would require the
signatures of both parties.
Payment Terms
i
A finance charge of 1. 5% a :month (18% per year) will be added to all iinvoices on the 315 day.
Al! legal and or collection fees will be paid by the binding holder �f this contract.
® The law requires that any deposit or down payment required by TGLRC Inc. dba Laml !rt
Roofing Company before work begins may not exceed the greater of -
1/3 of the total contract price or:
i
The actual cost of Special or Custom made materials which mdst be special order d in
advance to meet the completion schedule.
Arbitration
Me contractor and the homeowner hereby mutually agree in advance th4t in the event that the
contractor has a dispute concerning this contract, the contractor masubmit such disput to a
private, arbitration service which has been approved by the Office of ,Consumer Affairs an
Business Regulation and the consumer shall be required to submit to �uch arbitration as
orov ided in ft GL c 142A.
i
Owner: �
Date:
I
Contractor: _ llate:_
I
I
i
Contractor Registration
I
i
Ail. home improvement, contractors and subcontractors must be register6d, any inquiries al >ut a
contractor or subcontractor relating to a registration should be dirdcted to:
Contractor Registration:
i
Director of Home Improvement Contr
p actorRegistration
Board of Building Regulations and Standard
One Ashburton Place, Rm. 1301
I
Boston, MA 02108
(617) 727-3200
:.cine linprovenient Contractor Law:
Consumer Information Hotline
Commonwealth of Massachusetts
Office of Consumer Affairs and Business Regula ions
10 Park Plaza, Rm. 5170
Boston, MA 02116
(617) 973-8787
W' assistance. with .rnfoimal Ivedlatlon o.f disputes or to .register foI vital complaints agaj !st a
business, call: 1
Consumer Complaint Section
Office of the Attorney General
(617) 727--8400
AND/OR
Better Business Bureau
(508) 652-4800
(508) 755-2548
(413) 734-3114
Cancellation
You may cancel this agreement if it has been signed by a party thereto at a place other han
an address of the seller, which may be in the main office or branch thereof, provided yo
tie�ify the seller in writing at the main office by ordinary snail posted, by telegram sen or
by delivery, no later than that midnight of the third business day fo',llowing the signing of
she agreement. i
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