HomeMy WebLinkAboutBuilding Permit #89-11 - 124 BLUEBERRY HILL LANE 7/28/2010 TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit NO: I Date Received
Date Issued: d
IMPORTANT:Applicant must complete all items on this page
LOCATIONc . C �tl.ec✓�c iGun¢�
Print
PROPERTY OWNER_ t,�G /t`�c (J!Wo
Print
MAP NO: ...PARCEL: ZONING DISTRICT: Historic District yes no
F Machine Shap Village yes no
,g
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
New Building rlOne family
Addition Two or more family Industrial
Alter 'on No. of units: Commercial
Re air, re lacement Assessory Bldg Others:
Demolition Other
Septic Well Floodplain Wetlands Watershed District
Water/Sewer
11
DESCRIPTION OF WORK TO BE PERFORMED:
Identification Please Type or Print Clearly)
OWNER: Name: _ (9;,,G /7tti(�Ort,�t Phone:
Address:_ _/)� Uoco Itih e-
CONTRACTOR Name: Sf"en- kd U Phone: ( 3cb - L34�-
Address: �v G� 4k ALI. ori, fim 0331 t
Supervisor's Construction License: Va t-n-s- Exp. Date: 7 I1t5
Home Improvement License: 03 7 Y� Exp. Date:
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: $ 1, y3�• FEE: $
Check No.: Receipt No.: a
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
Lignature of Agent/Owner-' Signature of contractor
Location
No. Date
�ORT� TOWN OF NORTH ANDOVER
3? ' OL
F p
Certificate of Occupancy $
Building/Frame Permit Fee $
s�CHus
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check # /1 & C-5 J
232 / 5
Building Inspector
f
Plans Submitted Plans Waived Certified Plot Plan Stamped Plans
TYPE OF SEWERAGE DISPOSAL
Public Sewer Tanning/N4assage/Body Art Swimming Pools
Well Tobacco Sales Food Packaging/Sales
i
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
COMMENTS
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision: Comments
Conservation Decision: Comments
Water & Sewer Connection/Sinature & Date Driveway Permit
DPW Town Engineer: Signature:
Located 384 Osgood Street
FIRE DEPARTMENT -Temp Dumpster on site yes no
Located at 124 Main Street
Fire Department slignature/date
COMMENTS
i
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
NOTES and DATA— For department use
❑ Notified for pickup - Date
Doc:.Building Permit Revised 2008
Building Department
artment
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/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
❑ 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 P P 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 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: Doc.Building Permit Revised 2008
ORTH
Tovm of Andover . ,
0
.....
No. - _
o A K E O dover, 1VMass.,
COC MIC HE WICK
lei
DRATED PP�,`��
`SS BOARD OF HEALTH
PERMIT T D Food/Kitchen
Septic System
/ J%//J BUILDING INSPECTOR
THIS CERTIFIES THAT / I
1.. ��i....... C�.� . .........r..................................... .............................................. Foundation
has permission to erect..............:......................... buildings on Via.. ......... ..Z�.. ....... ..... ................................. Rough
to be occupied as........0 r7 Chimney
.......... . ...... ................................................................................... ....................................
provided that the person accepting is permit shall in every respect conform to the terms of the app 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
ELECTRICAL INSPECTOR
UNLESS CONSTR TI IN S ARTS 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 SIDE Smoke Det.
ST0REZ0PY
INSTALLATION:SERVICES CUSTOMIr R CONTRACT - MWORk - INT/EXT/PATIO � � � O
DOOR
LOWE'S OF DANVERS, MA.,.STORE# 1094 STORE PHONE; (978)646-9099
153 ANDOVER STREET SALESPERSON:_ EDWIN VELAZQUEZ
DANVERS, MA 01,923 SALESPERSON JD: 794346
Document Print Date 07/03/2010
This is only a Quote for the merchandise and services printed below. This becomes an,agreement upon payment and
an endorsement by a Lowe's register validation.,, Upon such payment and'endorsement, the entire agreement,i including
the Specifically completed pages of this document, the Terms and Conditions.included.with1his document and any other.
addenda.or attachments hereto, shall be referred to herein'as this"Contract."
PLEASE READ THIS ENTIRE DOCUMENT INCLUDING THE "TERMS AND CONDITIONS." BEFORE SIGNING
Lowe's Registration or Contractor License Number../Lowe'sContractor Name
Lowe's Home Centers, Inc.'s MA HIC NO.: 148688 Lowe's Home Centers, Inc.'sFEIN:
56-0748358
Customer Name Home Phone
S GINA MULDOON 978-688-2760
0 Customer.Address Other Phone
124 BLUEBURY LN
L City State/Province Zip./Postal Code
D NORTH ANDOVER MA 01845
Installation Address
'T . 124,$LUEBURY LN
0 Installation City Installation State/Province; Installation Zip/Postal
Code
NORTH ANDOVER MA 01845
MERCHANDISE AND INSTALLATION SUMMARY
MERCHANDISE SUMMARY
39683 PRODUCTCODE :'SOS SOS RB COMMODITY FBRGLS-DORFAB TC ENTRY/EXTERIOR SINGLE UNIT W2:SIDELITES, HALF,LITE.CLEAR < „
WITH GRILLE : DOOR FABRICATION SERVICES, INC - QTY 1
Materials Pace $ >782 00
Store 1.094 Project No.298277194 for GINA'MULDOON Page 1 of 7,
STbRE "OP
INSTALLATION DESCRIPTION
Stock or SOS SOS Door Type`: Exterior
Select Location : Front DoorSelect New Door.: Single Pre-hung
Number of Doors to Install : 1 Side;Lights or ransoms:Yes
Total Number of Side Lights and Transoms,: 2 Hardwood (Mahogany or Oak) Door : No
HiddenDamage Description : None Number of additional holes bored for accessories : None
Install Specialized Mortise Hardware : No Install Storm:Door ,No
Lead Safety Practices : No. Total Linear'Feef of,Custom Trim to be Installed : 0
Deliver Door Yes Customer Understands Scope of the Project : Yes
Permit Required : No Additional Miles Traveled over 20 : 0
Bring Up To Code Description None Local`Disposal.Fee.: Yes
Describe Other Work Needed 69.00 to raise the door. Other Work Charge Yes
Comments ENTRY DOOR AND SIDELIGHT WILL BE SOLD IN 3.
UNITS.MUST BE PUT TOGETHER.
Labor Charges $. 685.00
Detail`Deduction $ 35:00
Additional Specifications:
Notation: Lowe's will:not make structural modifications, paint or stain or remove/reinstall security system equipment. Customer is responsible to.advise.if prop-
erty is governed by Historic District Regulations.
Additional Specifications: The Environmental Protection Agency(EPA) has requested that Lowe's notify installation customers that a.lead based paint hazard
may exist in dwellings,built prior to 1978. See pamphlet EPA 747-K-99-001 for details.
TOTAL CHARGES OF'ALL MERCHANDISE ANDSERVICES
where applicable labor is taxable,check local tax restrictions.
SUB-TOTAL 432.0
''SALES TAX $ 0.0 .
DELIVERY. $ . . .'0
ORDER TOTAL $ 1432 0 .
BALANCE bUE
Store 1.094 Project No, 298277194 for GINA MULDOON Page
2'of 7
77 77,
ST
F
is to commence uponreasonable availablity of Contractor which is anticipated to be. [fill in date].
ated completion date is -�\ — [fill in date]1..
13
NOTICE TO CUSTOMER
All items listed in this contract and specification sheet(s),are to be installed under conditions agreed upon at time,of purchase and at the price appearing on
this contract form;This assumessound existing substructures, superstructure.and points of attachments. Extra labor or material incident to installation ne
cessitated by defective substructures,superstructure, points of attachment, or the moving of fixtures or appfiancesto be billed of extra cost to customer.
IF THE CONTRACT TOTAL IS $1,000-00 OR LESS Customer must pay in full
COMPLETE THIS SECTION ONLY WHEN THE CONTRACT TOTAL EXCEEDS$1,000.00: . .
;krbustomer to Pay in Full; OR
L) Customer to use the following payment:scheduler
(1) Deposit to.be paid,upon signing contract. Deposit should be 1/3 the total contract price; and
(2) Payment of$ to be paid anytime after this Contract"is signed and before"commencement of installation, I/We authorize Lowe's to do one
of the following (check appropriate box below):
[_J Charge my/our credit card for the amount of the payment indicated above.anytime after the date this Contract is signed; or
[_] Deposit'my/our check.for the amount of the payment indicated above,anytime after the date this Contract is signed; and
(3) Final payment of$100.00%t.o be paid upon completion of the installation and both parties' satisfaction.
DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK,SPACES AND UNTIL YOU HAVE READ THE TERMS AND CONDITIONS CONTAINED IN
THIS CONTRACT AND WHICKFOLLOW THE SIGNATURE PAGE(s). BY SIGNING BELOW, YOU ARE ACKNOWLEDGING THAT YOU HAVE READ,
UND,ERSTANDAND AGREE TO THE TERMS.AND GON,DITIONS'SET.FORTH IN THIS CONTRACT. YOU ARE;ENTITLED TO A COPY OF THIS CON
TRACT AT THE TIME OF SIGNATURE:
NOTICE REGARDING ARBITRATION AGREEMENT FOR:CLAIMS COVERED BY MGL c 142A
LOWE'S AND OWNER HEREBY MUTUALLY AGREE IN,ADVANCE THAT'IN THE EVENT LOWE'S HAS A DISPUTE CONCERNING THIS,CONTR. ACT,
THAT.'LOWE'S MAY SUBMIT SUCH,DISPUTE TO A PRIVATE ARBITRATION SERVICE WHICH HAS BEEN APPROVED.BY TWE.SECRETARY O.F THE "
EXECUTIVE OFFICE OF CONSUMER AFFAIRS AND"BUSI;NESS'..
REGULATIONS AND THE";OWNER SWALL BE`REQU;IRED TO,SURMIT,TO SUCH AR=
'BITRATION A R ED IN MiG.L. c142A:
Store 109. roject No.'298277194 for GINA MULDOON Page
STOR COPY:.
Lol.Aje'l Home Centers, inc.
By:l< - --:Date:
Own r
BY
S Ouse — -----
THE SIGNATURESOF`THE PARTIES ABOVE APPLY ONLY TO THE AGREEMENT- OF THE PARTIES TO ALTERNATIVE DISPUTE RESOLUTION INk
TIATED BY LOWE'S PURSUANT TO M.G L c.1 42ATHE OWNER MAY BE PERMITTED TOJNITIATE ALTERNATIVE DISPUTE RESOLUTION EVEN
WHERE THE SECTION ABOVE IS NOT SEPERATELY SIGNED BY THE PARTIES
WITNESS OUR HAND(S)'AND'SEAL(S) BELOW THIS DAY OF
Lowe's Home Centers; Inc.
By. �--• � ,�.,----- (Seal)
Print Name:
- I . . L,
JC�d J
(Seal) .
Address
09 er
City State/Province Zip/Postal Code Print Name
(Seal)
Spouse .
Print Name
Customer acknowledges receipt of a true copy.which was completely filled in prior to:Customer's execution hereof. You the customer may'cancel this;transaction
at anytime prior to.midnight on the third business day after the date of this transaction.:See the attached Not+ce of Right to Cancei for arrexpianation of,
this right.
Store 1094 Project No.298277194 for GINA MULDOON Page 4 of 7
:STORE. COPY
TEP148AND CONDITIONS
1,"LOWE'S" DEFINED. Within this Contract(as defined on page 1):the term"'Lo+ae s' shaft refer to Lowe's`Home Centers, Inc.,a North Carolina corporation.
2.GENERAL DESCRIPTION. By this Contract, Customer and Lowe's agree that(1) Custome`r.shall purchase and Lowe's shall.seli the goods and/or materiais.;the.'Goods".); and (2) Lowe's shall procure on
Customer's behalf,'and Customer shalt pay for, the services to install the Goods.(the "Installation:.Services") in or on the premises identified on'the;ace of this'Contract(the"Premises"')for the Order Total
stated on the face of this Contract(the "Price")and according to the provisions of the Contract documents.The Contract documents shall consist of(1).the.face of this Contract,titled"Installed Sales Contract:"
(2)these Terms and Conditions.and(3) any attached sketches, materials lists, floor plans, and/or specification sheets and other addenda or attachments hereto:The Contractdocuments do not:inclucle any
correspondence,advertisements.estimates or other documents that are:not attached..
3. INSTALLATION SERVICES.Customer authorizes Lowe's on Customer's behalf to(a)arrange for the Installation Services.to be performed by an independent contractor(the."Installer".)(licensed when leg-
ally required), (b) issue a work order to the Installer to perform the Installation Services; (c)have the installer's workinspected,should Lowe's in its discretion choose to do so(it being agreed that Lowe's has
no obligation,to do so), and(d) pay the Installer after completion of the work and after.receipt of a certificate,signed and dated by Customer,that the work:has been satisfactorily completed(the"Certificate of
Completion"). Customer understands that Lowe's will rely upon the Certificate of Completion in paying the Installer for the Installation::Services.CUSTOMER AGREES THAT THE INSTALLER WILL PER-
FORM THE INSTALLATION SERVICES ACTING.AS AN INDEPENDENT CONTRACTOR FOR CUSTOMER AND NOT UNDER THE'SUPERVISION OR CONTROL OF LOWE'S`>Customer agrees that the
Installation Services'do not include architectural/engineering services Or'structual.changes to the Premises or any other services`beyond the ordinary and routine installation of the Goods as specifically
provided in the Contract. Customer is responsible,at Customer's cost,for providing any:necessary architectural/engineering services or structuaf changes to the Premises or any other services not specifically
identified in this Contract.
4.GOODS.Lowe's.will arrange for delivery of the.Goods to the Premises'.Any surplus materials upon completion of the Installation.Services shall be the property of Customer.
5. PRICE,The Price covers the Goods, installation Services,and applicable taxes.The Price assumes sound existing substructures,superstructure and points of attachments.The Price shall be increased by
the cost and reasonable profit to Lowe's of having to provide additional Goods and/or Installation Services as a result of defective"substructures, superstructures, or points of attachments or the existence of
any other Undisclosed Condition(as defined in section 9 of these Terms and Conditions).In the event of an Undisclosed Condition orthe foregoing, Customer will execute a change order or a new replace-
ment contract upon Lowe's request. -
6.PAYMENT.If the Price is$1,000.00 or less,.payment of the Price by Customer to Lowe's is,due in full upon;execution of this Contract. If the Price is over$1,000.00 Customer m0-choose to pay in full upon
execution of this contract,but Lowe's may not require Customer.to do so. If the.Price is over$.1;000.00 and.Customer does not pay in full at the time of sale, Customer agrees to pay Lowe's according to the
payment schedule set forth in this Contract. Customer agrees to pay a deposit upon execution:of this Contract equal to one-third of the Price.Customer agrees to make a:payment for the balance of the Price
less.the final payment at least one day after the date this Contract is executed and prior to the commencement of the Installation Services: Customer agrees to make the final payment upon completion of the
Installation Services and Customer's satisfaction. Payment for a new replacement contract is payable according to these Terms and Conditions. Payment for any change order is due at.the time of that change
order.
7. LICENSES, PERMITS,SAFETY RULES,BUILDING CODES,ZONING ORDINANCES,AND OTHER LAWS.The Installer shall be solely responsible to Customer for`obtaining any and all licenses which
are legally required to perform the Installation Services.The Installer-shall also be.solely responsible to Customer for the Installation.Services being performed in compliance with all applicable safety rules and
all existing buidling codes,zoning ordinances and other laws.Lowe's shall be responsible to Customer for.obtaining building permits which arelegally required to perform the Installation Services where Lowe's
is legally required to obtain such permits.Where Installer is required to obtain such permits then Installer will be responsible to Customer for obtaining such permits.Customers who secure their own building
permits will be precluded from claiming against certain state guaranty funds relating to home improvements. Neither the Installer.nor Lowe's shall-be responsible for any pre-existing violations of safety rules,
building codes, zoning ordinances or other laws and shall not be required to address or correct same. If prior to the completion:of work a change.occurs to any applicable'safety`rule;building code,,zoning or-
dinance or other law which requires additional Goods and/or installation Services to perform this Contract,Customer agrees to pay Lowe's the:cost and reasonable profit for such additional Goods and Installa-
tion
rule'bulidin Services and to code zoning
utordinesulting change order or new.replacement contract as requested by Lowe's.No additional work will be,'erformed under this Contract due to any change o any applicable safety
g ante or other law that occurs after the completion of work.
8.CUSTOMER'S WARRANTY AGAINST VIOLATIONS OF,EASEMENTS,COVENANTS,AND THIRD PARTY RIGHTS.Customer warrants that performance of Installation Services will not violate any exist-
ing real property easements;covenants,homeowner's association rules or rights of third parties holding an interest in the real property being improved.
9.UNDISCLOSED CONDITIONS IN PREMISES. If Installer discovers any defect,weakness Or dangerous condition including; but.in no.way limited to, mold,mildew, rot,asbestos or infestation ("Undisclosed
Condition')in the Premises structure,substructure; super-structure or points of attachment,Customer.must remedy the Undisclosed Condition at Customer's sole cost and expense and fo Lowe's sole satis-
faction. If Customer refuses to permit inspection of the Premises as set-:forth below„Lowe's may.terminate or`rescind this Contract without remedy.or recourse,by,.or further:obligation to, Customer, except as
expressly.provided below..if Customer.and Lowe's disagree as to whether an Undisclosed Condition exists,Lowe's may in its sole discretion obtain the services:of an inspector.to inspect the Premises,at
Lowe's sole cost and expense,and if Lowe's chooses:to do so,such inspector's report shall be final and conclusive as to whether.an Undisclosed Condition exists. In the eventof any Undisclosed Condition
that Customer does not remedy to.Lowe's sole satisfaction;or any failure by Customer to perform any otherobligation of Customer,undertfiis Contract„then at Lowe'soption (1)Lowe's may rescind this Con-
tract and return the Price to Customer without further cost,or obligation by either Customer or Lowe's if Lowe's notifies Customer of its election to rescind'#his.Contract prior to the earlier of delivery of the
Goods and the Installer beginning performance of the Installation.Services, or (2) Lowe's may terminate this Contract without remedy-or:recourse.by,or further obligation to Customer, except as expressly,
provided below if Lowe's.notifies Customer of its election to terminate this Contract after the earlier of delivery of the Goods and the installer beginning performance of the Installation Services. In the event that
Lowe's terminates the Contract as provided in this Section,then Customer may return the Goods'(otherthan Goods that have been "custom-made")in their original;unopened condition,'to.Lowe's,for a refund
or credit.Any such return must be made within 30 days after Lowe's terminates this Contract.Customer will be charged a 15%restocking fee on any such returns:Goods not in their original, unopened condi-
tion,and custom-made goods, may not be returned."Custom-made”goods include goods that have been uniquely altered,color-matched,shaped,sized,cut or otherwize designed or fitted to accomodate the
requirements of particular space or environment. Examples of custom-made goods include;but are not limited to,cabinets,countertops,floor and wall.coverings,and window treatments. If.Lowe's terminates
this Contract as provided herein, Lowe's shall have no obligation to refund any portion of the Price (except'as,expressly provided herein),and_shall have no.obligation t0..restore. Premises to their original
condition: . .._ ,
..:
10.CUSTOMER'S RESPONSIBILITIES: Customer agrees to pay Lowe's according to.these Terms,and:Conditions.Customer agrees.to:facilitate_the location of utility Imes.CtistoMer is responsible.for identi-
Eying property lines:Customer.agrees to ensure that work area are free of vermin And pre existing physical or environmental hazards;and`bulding/zoning code violations:.Customer agrees to provide the.ln=
stalfer with access to.work areas during working hours and to provide access to sanitary facilities of,to.pay th.e._rental costs for.such.facilities::Customer agrees to ensure-thatany;security system at-the.
Premises will not interfere with performance of the Installation.Services.Customer agrees to providepower to,as'applicable,climate control in,the°work'areas.Customer a rees not to allow unattended minors `
at the Premises while the Installer is present. Customer agres to control and keep pets:away from wo,rk'areas:Customer.a re-es`to kee ;'osted.'permits on:display at all imes. Custornera reesAhat.if%Cus-
9 P,.P.. -p P. Y _. 9
tomer or anyone Customer controls interferes with or delays performace of:theahstallatiom Services,.Customer may be s.ubfect to:transportation/stores e•Charges:or oth.erxesultln ,char es: Customer a. rees -.
.not to assign.or transferthis.Contract.Customer agrees that any.claim against_Lowe's or the Installer urider this Contract should:b'e-made_`,to.L'ow6°s Withinthi 30 caiendar'days:of the date Customer:fIrst
"
becomes aware of a problem:-(Lowe's will attempt resolution of an claims within sixt -60 carendar da s of receiVm"':Cus m" i `, ER'ASSUME ) Y OF
to ers notce) CUSTOM S THE RISK'A FULL LIABILITY
PHYSICALLY ASSISTING WITH.DEOVERY OFT HE'GOODS OR WITH PERFOMANCE OF:THE INSTALLATfON SERV..ICES
Store 1094 Project No. 298277194 for GINA MULbooN Fuge 5 of'.7 ``.
11. MANUFACTURER WARRANTY FOR GOODS/LOWE'S WARRANTY'FOR INSTALLATION SERVICES/LIIIIIITATIONS OF-LIABILITY.Customer is.e6titled to any warranty nro ir: a by a rnanufacturerof
the Goods sold under this Contract. The Installer will provide Customer with any manufacturer consurner%varranty information accompanying_the.Goods' an d..Customer:may also obtain.such information by
contacting Lowe's: Lowe's dioes not warrant the GoodS.AND EXPRESSLY DISCLAIMS ALL.WARRANTiES,EXPRESS OR IMPLIED,TO THE FULLEST EXTENT PERMITTED BY LAW. "
Lowe's does,warrant that the Instaiition Services will be performed by the installer in a good and workmanlike manner .Lowe's warranty for installation services shall extend fora period of one year from the
earlier of(1) the date the Certificate of Completion,is signed by Customer or(2) the,date that'Lowe's'determines that the Installation Services;ha've'been compaeted,or for such realer period,as may be re-
gUired byapplicableaaw governing consumer warranties for workmanship(the"Warranty Period'). LOWE'S WARRANTY THAT:THE INSTALLATION SERVICES WILL BE PERFORMED BY THE.INST,ALLER
IN A GOOD AND WORKMANLIKE'mANNER DOES NOT COVER, AND LOWE'S WILL NOT BE RESPONSIBLE FOR, ANY DEFECT IN SUCH INSTALLATION SERVICES.DUE TO (1) ANY DEFECT,
WEAKNESS OR DANGEROUS CONDITION,INCLUDING BUT NOT.LIMITED TO, MOLD;:ROT;ASBESTOS OR INFESTATION IN THE PREMISES'STRUCTURE SUBSTRUCTURE, SUPERSTRUCTURE
OR POINTSOFATTACHMENT,OR OTHER PRE-EXISTING PHYSICAL.OR ENVIRONMENTAL HAZARD,OR (2)ABUSE;-MISUSE,NEGLECT,OR IMPROPER CLEANING: LOWE'S WARRANTY FOR IN-
STALLATION SERVICES.SHALL BE IN LIEU OF ANY OTHER WARRANTY TO THE:FULLEST EXTENT,PERMITTED;BY.LAW.
:
Customer acknowledges and agrees that Customer shall be limited to seeking recourse or remedy exclusively from:Lowe's-or the Installer (as applicable)_and that no affiliate of'Lowe's shall have any liability
under this Contract. Customer must give Lowe's written notice within the Warranty Period of any warranty claim relating to Installation Services..Customer agrees that its sote'and'exeiusive.rernedy against'
Lowe's for warranty claim is reinstallation in a good an workmanlike manner, including the repair or replacement of any Goods if and to the extent,resonably necessary to correct the defective I'nstailation Ser-
vices. CUSTOMER SHALL HAVE NO OTHER REMEDY FOR A WARRANTY CLAIM,`INCLUDING WITHOUT..LIMITATION:REMEDY FOR LOSS:OR,DAMAGE CAUSED BY NORMAL WEAR AND TEAR,
LOSS OR DAMAGE WHICH HAS NOT BEEN REASONABLY MITIGATED,"OR LOSS OR`DAMAGE CAUSED.BY ACTS OF GOD;IN NO,EVENT SHALL LOWE'S BE LIABLE.FOR.INDIRECT; PUNITIVE,
CONSEQUENTIAL OR INCIDENTAL DAMAGES(SUCH AS, WITHOUT LIMITATION,'LOST PROFITS; LOST SALES,:AND INJURIES TO PERSONS OR PROPERTY), EVEN WHERE LOWE'S HAS BEEN
ADVISED OF THE POSSIBILITY OF SUCH DAMAGES:WHERE_ DUE TO OPERATION OF LAW; SUCH`DAMAGES CANNOT BE`EXCLUDED, THEY ARE EXPRESSLY LIMITED.IN'AMOUNT TO THE
PURCHASE PRICE: in connection with any warranty claim;Customer agrees,at no cost to Lowe's or,the Installer,to,prepare the Premises and the reinstallation area in the manner described in Section 10 of
these Terms andsConditions.
12. DISPUTE RESOLUTION FAR CLAIMS COVERED BY M.G.L. c.1 42A. Most questions or.complaints are resolved informally: If Customer has a question or complaint; Customeragrees to contact the
Lowe's salesperson whose name appears on this Contract and the manager of the Lowe's store where Customer'entered into this Contract.If Customer has a complaint which cannot be resolved informally,.
The Home Impovement Contractor Law(M.G.L,'c.142A)'may provide Customer with the.right to request arbitration through a private arbitration program approved by the Director of the Office of.Consumer Af-
fairs and Business Regulation,-as an alternative to court action. The same right is not afforded to Lowe's unless the"Notice Regarding Arbitration Agreement for'Claims Covered by M.G.L. c.142A"above is
signed and:dated by.Lowe's and the owner.If allowed bystatute or applicable law;the arbitrator may award statutory damages and/or reasonable attorneys'fees and expenses: If Customer fails to pay Lowe's
in accordance with this Contract, Lowe's shall be entitled to recover its reasonable attorney's fees as provided by N.C.Gen.Stat: Section 6-21.2 or other applicable law.To the fullest extent permitted by law,
Lowe's and Customer agree that no class action arbitration of any type may be ordered by a Court or arbitrator(s).under this Contract and,-in addition,that there shall be no joinder of parties, except for joinder
of parties to the transaction covered by this Contract.If a court or arbitrator determines the waiver of the right to class,action arbitration or.the prohibition of joinder of parties (other than parties to the transac-
tion covered by this,Contract)to be unenforceable,then the party bringing such.action will be requiredto'bring such action in a court of law.
13.ARBITRATION AGREEMENT AND WAIVER OF JURY TRIAL FOR CLAIMS NOT COVERED BY M.G.L.c.142A.All claims by Customer or Lowe's concerning this Contract which cannot be resolved in-
formally,and which are not covered by M.G.L.c.142A or subject to the.jurisdiction of a small claims court, shall be resolved by binding arbitration conducted by single arbitrator under the current applicable
rules,procedures and protocols of the American Arbitration Association(as amended)..If the dispute falls within the jurisdiction of a small claims court the claimant may,at its option,choose to arbitrate or file a
small claims action.Any appeal of a judgment from a small claims court shall be resolved.by arbitration as.provided herein. Claims to be resolved by binding arbitration include;but are not limited to (1) all
claims directly or indirectly related to the signing of this arbitrationagreement,the validity or.scope of this arbitration agreement,or any attempt to set aside this arbitration.agreement,(2)all federal or state law
claims relating directly or indirectly to this Contract:(including this arbitration agreement),the information Customer,gave,Lowe's before entering into this Contract and/or any past agreement or agreements
between Customer and Lowe's, (3)all counterciaims,.cross-claims and third-party claims,(4)all common law claims of any kind including common law claims based upon contract,tort,fraud,or other intention-
al
ntention.-
al torts, (5) all claims based upon-a violation of any state.or federal constitution, statute or regulation; (6) all claims asserted by Lowe's against Customer, including claims for money:damages to collect any
sum Lowe's claims Customer owes Lowe's, (7)all claims asserted by Customer individually against Lowe's and/or any of Lowe's employees,.agents,directors,officers,shareholders, managers,members,par-
ent company or affiliated entities(herein collectively referred to as"related third parties")or the Installer,,ihIduding.claims for money damages and/or equitable or,injunctive.relief„(8)all claims asserted on Cus-
tomer'sbehalf by another.person, (9)all claims asserted by Customer as a private attorney general against Lowe's,related third'parties'and the Installer, (10)all claims arising"from or relating directly or in-
directly to the disclosure by Lowe's, related third parties or the installer of any.non public personal information about”Customer,and/or(1.1)alF other claims arising under or'related to this Contract whether or
not set forth above.
Binding arbitration means that Customer waives: (1)any right to a jury.trial;.(2)any right to bring a lawsuit in a court(other than'a small claims court as described.above); and(3)any right to
seek relief in any other forum or from any other.agency.Any claim not decided:by a small.claims court will be decided by an arbitrator,selected by the,American Arbitration,Association.;Lowe's
and Customer agree that binding arbitration provides a simple, cost efficient method_ to resolve disputes,quickly. Lowe's and:Customer therefore agree that no class action'arbitration of any type may be
ordered by a Court or arbitrator(s) under this Contract and,in addition,that there shall be no joinder of parties,except for joinder of parties to the transaction covered by'this Contract. If a court or arbitrator de-
termines the waiver of the right to class action arbitration or the prohibition of.joinder of parties (other than parties to the transaction covered bythis Contract).to be unenforceable then this entire arbitration
agreement shall be rendered null and void,and the party bringing such action will be required to;brinIg such,action in a courtof law:
By agreeing to.binding arbitration Customer and:Lowe's-waive any right'to bringor Pa
How Arbitration Works: rticipate in a Class Action lawsuitregarding any.claim.
Lowe's may demand arbitration by sending written notice to Customer at the address listed ihthis Contract.Customer may demand,arbitration b sendingwritten-notice to Lowe's atthe,following address:Mail
code 2ELG, P.O:'Box 1000,Mooresville, NC 28115.The arbitration shall be held in the,city or county where the Premise's.&616cated"or in such other convenient location aisthe Customer and Lowe's may mu
tually agree:: :
Lowe's shall pay the filing, administrative, hearing and arbitrator's fees associated with the arbitration..Customer;shall not be required to:reimburse Lowe's for these expenses.even,if Lowe's wins the arbitra-
tion: Unlessthe arbitrator's award specifically provides otherwise, Lowe's and Customer will each..:be responsible`for its"own attorneys'fees,and other expenses,:such as.witness and expert witness fees Atahe
timely request of Customer or Lowe's,the arbitrator will provide.a written explanation of:the award so tong as such.requirement is consisentwith the rules, procedures and protocols of the American-Arbitration .
Association.their in effect.
The arbitrator's award,may be filed with and enforced by any court having jurisdiction.
If allowed by statute or applicable law.the arbitrator.mayaward.statuto .dama es and/or resonable attorne s'fees and expenses 11 Customer fails to a .,Lowe s in accordance with this Contract, Lowe s shail
be entitled to,,recover its reasonable attorneys'fees.as'provided,by N:C Gen Stat,Section 6 2;1.2-or other applicable law: -p P Y
The parties:a r..:ee That this 8rbitration.a reemenf is made in connection
with'a transaction Inv Lvin :in erstate.commerce and shalt b sonahe-Fetleral
g _. 9 o._..9 t e governed bythe,Fecl&al Arbitration A"ct but if.for.any,rea
Arbitration Actcioes not apply,then this°arbitration agreement shall be goverened by the,aws of'the'State of Norttti;'Carollna. ,
14.GOVERNING LAW.AND SEVERABILITY.This Contract shall be'inter retell;under and overned b" the laws of the'State'of North Carotin ex r}' Waiver of Ju T1
14.
P g y, a sept that the A bltratlon Agreement and ry.
Store 1094 Project.No. 298277194f GINA MULDOON Page
T.
�i E �,1 P Y
paragraph 13 above is governed cid the Federal Arbitration'Ac. J _�.'..:. Sections:!!- If an provision� he t �` .,- c � ; i
+ s y y p. v t Contract is contrary to ani is v v• . n-t s subject, such unlav4:ui,prov provision snail be ineffective
without invalidating the.other provisions,which shall remain in full, force and effect;except that,as stated in paragraph t3. if the.waiver of c'ass action arbitration,or the rohibition cf consolidation.or joinder, is
determined unenforceable:then the entire arbitration agreement in paragraph 13 will be'rendered nulland void;`
p._ . 1 ..
15. CREDIT CARD/FINANCED TRANSACTiONS. If Custom t uses a credit card or obtaiwfinancing to pay some or ail.of the Price,then CListorner acknowledges that the terms of his or her cardholder
agreement or financing documents may change the total amount of money Customer must.pay to the credit card provider or lender, including any interest"charges and fees.Customer acknowledges that his or
her cardholder agreement or financing documents may have other terms and conditions to which Customer will be subject.Customer also acknowledges that Lowe's is not a party to any such cardholder or fin-`
anciny agreement.
16.WAIVER OF LIENS.Because responsibility for paying the Installer on Customer's behalf belongs;to Lowe's. Lowe''s will require the installer,on behalf of itself and any of the Instal(er'ssubcontractors ma-
terialmen or suppliers,as a condition precedent to payment by Lowe's on Customer's behalf,to fully and.unconditionaiiy relinquish,waive and release any and all mechanic's lie ns;;materiaiman's lien and other
liens in the Premises which the Installer or its subcontractors,materialmen or.suppliers might haveor acquire in the future,by operation of law or otherwise;as a result of this Contract
17.'UNAVOIDABLE DELAY OR FAILURE IN PERFORMANCE EXCUSED.Any delay failure by Lowe's or the Installer in performing this Contract because of stike,fire, flood,-epidemic, acts of terrorism,
acts of God; inability to obtain Goods.in a timely or commercially feasible.man ner;.or any other causes beyond the reasonable control of Lowe's or the Installer shall beexcused and`shal1 not be breaches of
this Contract.
18. ENTIRE AGREEMENT/CHANGES IN WRITING.Customer and.Lowe's agree that this Contract.accurately states the entire agreement between Customer and Lowe's.:concerning the Goods and Installa-
tion Services and replaces and supersedes all prior agreements and understandings relating thereto, both.oral and written,and all oral agreements and understandings entered into at the same time as this
Contract..Anyadditions or changes to this Contract,or any waiver of rights under this Contract,must.be in writing,signed by Customer and Lowe's:'
19.CAPTIONS:Titles or captions of sections contained in this Contract have been inserted only as a matter of convenience and in no way define,limit,extend,describe or.otherwise affect the scope or mean-
ing of this Contractor the intent of any provisions hereof: -
20.ADDITIONAL INFORMATION:All contractors and.subcontractors must be registered by the.Administator of the,Board of Building Regulations and Standards. Inquiries about a contractor or
subcontractor relating to a registration should be directed to the Administrator of the Board at One Ashburton Place,Room 1301,Boston;MA 2108,(617)727-8598.
21.QUESTIONS OR CONCERNS.Customer should speak with the Lowe's salesperson whose name appears on this Contract and the manager of the L0owe's store where Customer entered this`Contract re-
garding routine matters such as scheduling,any requested changes to Customer's order,or any concerns Customer may have about this Contract:the Goods or the Installation Services,at the address and/or
phone number noted on the front page of this Contract.
Store 1094 Project No.298277,194 for GINA MULDOON. Page 7 of7
The Commonwealth of Massachusetts i
Department of Industrial Accidents i
Office'of Investigations
' 600 Washington Street
Boston;MA 02111
www.mass.gov/dia
Workers'.Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information` Please Print Legibly
(� J
Name (Business/Organization/Individual):
Address. 3 c o
Cit P- k� �I 03 1 Phone#;
Are you an employer?Check the appropriate box:
Type of project(required):
1,❑ I am a employer with 4. 0 I am a general contractor and I
employees(full and/or part-time).: ..
have hired the sub-contractors 6. 0 New.construction
2,2rI am a sole proprietor or partner- ` listed on the attached sheet. 7. Remodeling
ship and have no employees These sub-contractors have g, Q Demolition
working I for.me in any capacity, employees and have workers'
[No workers' comp. insurance comp.msurance.t 9. O Building addition
required:] 5. ❑ We are a corporation and its 10.0 Electrical repairs.or additions
officers have exercised their
3: I,am a,homeowner doing all work 11. Plumbing repairs or additions
myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs -
insurance t c. 152,'§1(4),and we have no
employees. [No workers' 13.0 Other
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 workers'comp.policy number.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job Site
information.
Insurance Cy
om'an Name::
P :
Policy#or Self-ins.Lic #: 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 Section 25A of MGL 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 WORK ORDER and a fine
of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations o e DIA for insurance.coverage verification:
I do:hereby cerfl un er the airs and p alti o p jury that the information provided above is true and correct.
Si```ature: Dater b 9
Phone#
Official use only. Do not write in this area,to be completed by city or town official
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.
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