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Building Permit #271-14 - 1260 SALEM STREET 9/24/2013
r%ORTk BUILDING PERMIT OF�t�eo TOWN OF NORTH ANDOVER io APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received . SacHus Date Issued: MPORTANT:Applicant must complete all items on this page LOCATION, I� a 'Print _. PROPERTY QINNER _ _ C Z.e.rf¢. IDAK MAP N® �A ERARCEL: 41� ZbNING`DISTRICT' Historic District yes no _._ . MachinerShop Village yes no 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 Well ❑ Floodplain Wetlands ©: VVatershediQstrict DESCRIPTION OF W RK TO BE PREFORMED: CV n i ct- Identification Please Type or Print Clearly) OWNER: Name: 1l CPhone: y-75 Address: CONTRACTOR .Name: LL C.- Phone: a 51 ,, Address: 0 71(r-4 So 3,777. Nd Supervisor s�Construction License Exp; Date,:, f�*o Ex Home#Improvement License: �. -733 p. ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$92.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ 19.30 FEE: $��_�I Check No.: Receipt No.: NOTE: Persons contracti g 't g tered contractors do not have access to the guaranty fund - - Ca Signature;of AgentLQvvne f. _ Signature of cont!ac _ _._ 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 i DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS CONSERVATIONReviewed 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/Signature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE;DEPARTMENT -Temp'DoMpsteron site yes. -Locatedtat 124 MairitStreet Fire Department signatureldate ._- GQIVIMENTSa- _, n 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.$10041000 fine NOTES and DATA— For department use ❑ Notified for pickup - Date I Doc.Building Permit Revised 2008 i Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Skiing, 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 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:INSPECTIONAL SERVICES DEPARTMENTMFORM07 Revised 2.2008 Location�Q b n Sa 1 No. � Date . - TOWN OF NORTH ANDOVER S TLED r646, • • ne. ee Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee R $ TOTAL $ Check# 1 - Building Inspector NORTH own of EAndover 0 '.•. -on No. 2-1Lf o * _ t o T 2 o h , ver, Mass, CI A- GOC NIC Ml wKK y7' 7�A�R�lTEO I'p '�5 S V BOARD OF HEALTH Food/Kitchen Septic System lC. .� THIS CERTIFIES THAT PERRJIT ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, BUILDING INSPECTOR Foundation has permission to erect .......... buildings on � .0 �a. ........................ Rough tobe occupied as ............ .... .............!! -.......9.40-&.4.0 . ......A............................................ Chimney provided that the person accepting is permit shall in every respect c orm 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 VIOLATION of the Zoning or Building Regulations Voids this Permit. . Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTI ST TS Rough Service .............. ..... ....................................................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Buildinz 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. SEE REVERSE SIDE t%ORTH own of ? �. s EAndover 0 No. Z1 1,+ � - s y T O - LAME h , ver, Mass, CI �J- fOCHICHIWICK �1. Jd A�'#A'r S U BOARD OF HEALTH Food/Kitchen rr Septic System THIS CERTIFIES THATPER41T,,, T . .......... BUILDING INSPECTOR .............t�.� ................. ................................... has permission to erect � 4,p,,,,,,,, gc, Foundation p .............�........... buildings on ..... . Rough to be occupied as O ...... ............................................ Chimney ............ ........... ....... ....... . provided that the person accepting is permit shall in every respect c orm 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 VIOLATION of the Zoning or Building Regulations Voids this Permit. . Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTI ST TS Rough Service .............. ..... ....................................................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Buildinz 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. SEE REVERSE SIDE The Commonwealth ofMassachusetts Department oflnilustrialAccitlents Office of Investigationy 600 Washington Street Boston,MA 02111 S-f www.massgovIdia Workers' Compensation Insurance AffitdavitdBuiis/Contractors/Electricians/Plumbers A licant Information UVa 00Iing, LLC please Print Le X ><bl Name(Business/Organization9ndividual): No, Reading, MA 01 Address: City/State/Zip: Phone#: _V w y Erequir an employer?Check the appropriate box: a employer with 1() 4. general Type ofproject(required): loyees(full and/or part-time).* ❑a e hired the ub c ntrac ocontractor s 6. ❑New construction a sole proprietor or partner- listed on the attached shgget.t 7. ❑Remodeling and have no employees These sub-contractors have ing for me in any capacity. workers,comp.insurance. 8' ❑Demolition workers'comp.insurance 5. ❑ We are a corporation and its 9• ❑Building addition red.] .officers have exercised their 10.❑Electrical repairs or additions a homeowner doing all work right of exemption per MGL 1 L❑Plumbing repairs or additions lf.[No workers'comp. c.152, §1(4),and we have no , ,�nce required.]t em to ees. , 12•�ofrepairs P Y [No workers comp,insurance required.] 13.0 Other *Any applicant that checks box#1 must also fill out the section below showing their workers'compensationpolicy information. Homeowners who submitthis affidavit indicatingthey are doing all work and then hire outside contractors must submit a new affidavit.indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. am an employer that is providing workerscomp information. ensation insurance for my employees Below is the policy and job site Insurance Company Name: Policy#or Self-ins.Lic.#: ` () 13 Q 101 R �, Expiration Date: Job Site Address: J o?G 0 .SCJc W J.;1— 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 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 of the DIA,for insurance coverage verification. I'do hereby certify under the pains andpenadties ofperjury that the information provided above is true anrd correct. ` >i nature: `.hone#: —7S-! 5"J. 9 Offacial use ondy. .bo not Write in this area,to be completed by city or town offcial. 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 6.Other g Inspector Contact Person: Phone#: Information and Instructions uctlons Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more Of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shallwithhold the issuance*or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants PIease fill out the workers',compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their eerocate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If au LLC or LLP does have employees,a policy is required. Be advised that this affidavit maybe submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy;please call the Department at the number listed below. Self-insured companies should enter their self-insurance Iicense number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a referencd number. In addition,an applicant that must submit multiple Permit/license applications in any given year;need only submit one affidavit indicating current Policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)"A copy of the affidavit that has been officially stamped or marked by the city or town maybe provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not-related to,any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOTrequired to complete this affidavit. The Office of Investigations would like to thank yo-din advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: T e Co��MOzowcalth of Massa ni?setts Department of Zndustrlal A.ccideats Office Of InVestigatxons 600 Washingi:on Stireet Boston;MA- 02111 Tel.#617=-727-4.900 ext 406 or 1-877-MASS,AFE Revised 5-26-05 Fax#617-727-7749 Www.mass,gov/dia NOTICE Z W NOTICE TO o TO EMPLOYEES EMPLOYEES AV The Commonwealth of Massachusetts DEPARTMENT OF INDUSTRIAL ACCIDENTS 600 Washington Street, Boston, Massachusetts 02111 617-7274900 — http://www.mass.gov/dia As required by Massachusetts General Law, Chapter 152,Sections 21, 22&30, this will give you notice that I (we) have provided for payment to our injured employees under the above mentioned chapter by insuring with: THE TRAVELERS INSURANCE COMPANIES NAME OF INSURANCE COMPANY P.O. BOX 1450 MIDDLEBORO MA 02344-1450 ADDRESS OF INSURANCE COMPANY (7POUB-023ON9i -9-1 3) 03-11-13 TO 03-11 -14 POLICY NUMBER EFFECTIVE DATES GILBERT INS AGCY 137 MAIN ST n� READING MA 01867 NAME OF INSURANCE AGENT ADDRESS PHONE# o� DUVAL ROOFING LLC 184 PARK STREET NORTH READING MA 01 864 EMPLOYER ADDRESS EMPLOYER'S WORKERS COMPENSATION OFFICER (IF ANY) DATE MEDICAL TREATMENT The above named insurer is required in cases of personal injuries arising out of and in the course of employment to furnish adequate and reasonable hospital and medical services in accordance with the provisions of the Workers' Compensation Act. A copy of the First Report of Injury must be given to the injured employee. The employee may select his or her own physician. The reasonable cost of the services provided by the treating physician will be paid by the insurer, if the treatment is necessary and reasonably '— connected to the work related injury. In cases requiring hospital attention, employees are hereby notified that the insurer has arranged for such attention at the NAME OF HOSPITAL ADDRESS 001907 W20P1G02 TO BE POSTED BY EMPLOYER VAH4111 /2013 09:19 FAX 781 942 2226 GILBERT 0 001 DATE(MM/DD1YYYT) jzbFCERTIFICATE QF LIABILITY INSURANCE ; 9/10/2013 ERTIFICATE 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). CONTME: PRODUCER ACT Barbara McDonough Gilbert Insurance Ager►cy, Inc. PNONa - (701)942-2225 FAQ NGI(791►94a-2226 137 Main Street EMAIL ,bmedonough@gilbertinsurance.com INSURERS AFFORDING COVERAGE I NAIC S Readi=g mA 01867-3922 IN3URERA;HARLEYSVjZ1M ORCESTER INS CO. 26182 INSURED INSURER @;Travelers Ins. CO. 0031 Duval Roofing, LLC. INSURER C; p.o. Box 637 INSURER 0: INSURER E North Reading MA 01864 INSURER F: COVERAGES CERTIFICATE NUMBER:CL1331300142 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 IO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIE=S.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. R POLICY EFF POLICY EXP LIMUS L NTR TYPE OF INSURANCE POLICY NUMBER M1oD GENERALLIABILITY EACH OCCURRENCE S 1.,000,000 DAMAG TED $ 100,000 X COMMERCIAL GENERAL LIABILITY PREMI ES E A CLAIMS-MADE Q OCCUR LG4158G 10/23/2012 0/29/2013 MED EXP(An vne arson) S 5,000 PERSONAL&ADV INJURY 5 1,000,000 GENERAL AGGREGATE S 2,000,000 QEN't ACaGREGATE LIMIT PER; PRODUCTS-COMPIOP AGG 3 2,000,000 X POLICY pirgmoi 17 LOC $ 0 131NED SINGLE LIMIT 50(),000 AUTOMOBILE LIABILITY BODILY INJURY(Per person) $ ANY AUTO ALL O6 60 X SCH SCHEDULED 94456G 10/23/2012 0/23/2013 BODILY INJURY(Pereccldenl► S X . NON-OWNED PROfprPHRTY DAMAGE g HIRED AUTOS AUTOS Idont Uninsured rngvrlsl ej s lit limit S 100,000 UMBRELLA LIAR H OCCUR EACH OCCURRENCE 5 EXCESS LIAB CLAIMS-ME AGGREGATE 5 DED RETENTIONS WC STATU- OTN- B WORKHRSCOMPENSATION To be provided directly TQEXJWlTr EIC AND EMPLOYFIRS'LlABILITYYIN is Travelere Insurance E.L.EACH ACCIDENT S 100,000 ANY PROPRIETOR/PARTNERIEXECUTtVE( N/A OPFICER/MEMBER EXCLUDED? u /11/2013 /11/2014 E.L DISEASE-EA EMPLOYE 100,000 (Mandatory In NN) Ifry8e deeClDe under E.L DISEASE-POLICY LIMIT 3 500,000 DESCRIPTION OF OPERATIONS balmw DESCRIPTION OF OPERATIONS/LOCATIONS!VEHICLES (Attach ACORD 101,Addl(1Onal RGmarlrs Schedule,if mote space is raqulmd) EvidanCA of Coverage CERTIFICATE HOLDER. CANCELLATION (978) 688-9542 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL I BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Town of North Andover 1600 Oagood Street AUTNORIZED REPRESENTATIVE North Andover, MA bd Gilbert, CIC/BARBAR ACORD 25(2010105) ®1988-2010 ACORD CORPORATION.i All rights reserved. ..�. Tr,s AtInan nnrne.anti Innn ara raaimered marks of ACORD Page No. of Pages Builders License # 58443 Home Construction Reg. # 167338 DuvaIAL RoofingLLC (781)944-1994 (978)664-2557 READING NORTH READING P.O. Box 637, North Reading, MA 01864 Please visit us at www.duvalroofing.com PROPOU' I ED C { / P NEO _ I DATE / 1K` STREET Q9,STATE AND We hereby submit specifications and estimates for: O'Rip& Remove all existing roof related debris from roof as well as job site with our own disposal truck. NO DRIVEWAY DUMPSTERS Ld1 layer of existing roof shingles ❑2 layers of existing roof shingles ❑3 layers or more of existing roof shingles 0 Replace any damaged roof decking; not to exceed 32sq.ft. (additional at$1.70 per sq.ft.) ©"Install 8"Aluminum Drip-edge/Rake-edge along entire perimeter(Choicehite Brown or Mill) G�Install ICE&WATER UNDERLAYMENT on all horizontal eaves, sidewalls, skylights and chimney flashing 0•Install a premium base sheet underlayment(felt)that is in compliance with the asphalt shingle manufacturer chosen by the homeowner YInstall The Homeowner's Choice of the selected Tamko/IKO or GAF Limited Lifetime Architectural Roof Shingles `See individual manufacturer's warranty for specific details 0 Replace all existing bathroom louver and/or exhaust pipe(s)with new aluminum flanges 0 Chimney(s)-counter-flash and re-step existing flashing ❑Cut& Install new lead flashing O'Install a continuous low profile Ridge-Vent on all ridge lines Soffit-Vents D�Roof Louver-Vents c / Seamless Aluminum Gutters-Custom fabricated'on/site with our own gutter machine LJU Downspouts at additional .Ce/af Guards L3 Other r / r f `Please Note:All items in roof attic should be removed or covered due to falling roof particles, at time of roof tear-off Price includes all items above that are checked only/others may be priced separately upon request. Pe 1drupose hereby to furnish material and labor-complete in accordance with above specifications,for the sum of: Total price not including options. dollars($ ,--7; ). Payment to be made as follows: 30%deposit required before ordering materials.Balance due in full upon day of completion. Please make all payments out to Kenneth Duval, mailed to: P.O. Box 637, No. Reading, MA 01864 Final Payment is due upon day of completion and is subject to the Authorized supplemented Terms&Condition.sheet when scheduling. Signature r At t ' THIS PROPOSAL IS VALID FOR - ) DAYS DUE TO FLUCTUATIONS IN MATERIAL&DISPOSAL PRICES. ` Massachusetts Home Improvement Sample Contract This form satisfies all basic requirements ofthe state's Home Improvement Contractor Law(MGL chapter 142A),but does not include standard language to protect homeowners. Seek legal advice if necessary. Any person planning home improvements should first obtain a copy of"A Massachusetts Consumer Guide to Home Improvement"before agreeing to any work on your residence.You may obtain a free copy by calling the Office of Consumer Affairs and Business Regulation's Consumer Information Hotline at 617-973-8787 or 1-888-283-3757 or on our website. Homeowner Information Contractor Information Company Name arae Street Address(do not use a Post Office Box address) Con mctor/Salesperson/Owner Name 7b0 Si4Ler, City/Town State Zip Code Busmess Address(must include a, s) No. ANoo N— 0)595 0 - Pa s Daytime Phone Evening Phone City/f State Zip Code 973474-W4 979 -208-A96S oaf Mailing Address(It diff=ut from above) Business Phone Federal Employer ID or S.S.Number Home Impravmem Comnaw Reg.Number &xpimrion aae �..rr�.�atbxtmaatb.me lamvpW reghtrtexa....manbebr•ve (,o -7339 The Contractor agrees to do the following work for the Homeowner: (Describe in detail the work to completed,specifying the type,brand,and grade of materials to be used,use additional sbeets if necessary.) & -.1, m -n4 4 - kw_A-� AtSo RgfLn,_Th-DvA,�RooF;*. 06 D#M W7113 # SZGK*V /'�Oate�1�.Prtdvt ► S Q�1 tPgray 11 t to 1 7}/ Z ftoTL pA6is� Required Permits-The following building permits are required Proposed Start aAd Completion Schedule-The following schedule will and will be secured by the contractor as the homeowner's agent: be adhered to unless circumstances beyond the contractor's control arise (Owners who secure their own permits will be 3 ( 4t*D excluded from the Guaranty Fund provisions of Date when contractor will b ' contracted work. MGL chapter 142A.) Date when contracted work 71 be substantially completed. Total Contract Price and Payment Schedule The Contractor agrees to perform the work,furnish the material and labor specified above for the total sum of: M Payments will be made according to the following schedule: $ upon signing contract(not to exceed 1/3 of the total contract price pr the cost of special order items,whichever is greater) $ by / /_or upon completion of $/ by_/ /_or upon completion of $ 055 ✓ upon completion of the contract. (Law forbids demanding full payment until contract is completed to both party's satisfaction) The following material/equipment must be special s to be paid for ordered before the contracted work begins in order to meet the completion schedule.(**) $ to be paid for 4A_ NOTES:(*)Including all finance charges(**)Law requires that any deposit or down-payment required by the contractor before work begins may not exceed the greater of(a)one-third of the total contract price or(b)the actual cost of any special equipment or custom made material which twist be special ordered in advance to meet the completion schedule. Express Warrantv-h an express warranty beine provided by the contractor? ❑No Yes fall terms of the warranty must be attached to the contract) Subcontractors-The contractor agrees to be solely responsible for completion of the work described regardless of the actions of any third party/subcontractor utilized by the contractor. The contractor further agrees to be solely responsible for all payments to all subcontractors for materials and labor under this aucement Contract Acceptance-Upon signing,this document becomes a binding contract under law. Unless otherwise noted within this document,the contract shall not imply that any lien or other security interest has been placed on the residence. Review the following cautions and notices carefully,before signing this contract. • Don't be pressured into signing the contract.Take time to read and fully understand it. Ask questions if something is unclear. • Make sure the contractor bas a valid Home Improvement Contractor Re6stration. The law requires most home improvement contractors and subcontractors to be registered with the Director of Home Improvement Contractor Registration.You may inquire about contractor registration by writing to the Director at 10 Park Plaza,Room 5170,Boston,MA 02116 or by calling 617-973-8787 or 888-283-3757. • Does the contractor have insurance? Ask the Contractor for his insurance company information so that you can confirm coverage,or ask to see a copy of a"proof of insurance"document. • Know your rights and responsibilities. Read the Important Information on the reverse side of this form and get a copy of the Consumer Guide to the Home Improvement Contractor Law. You may cancel this agreement if it has been signed at a place other than the contractor's normal place ofbusiness,provided you notify the contractor in writing at his/her main office or branch office by ordinary mail posted,by telegram sent or by delivery,not later than midnight of the third business day following the s' ' g of this agreement. Seethe attached notice of cancellation form for an explanation of this right. O N. THIS CONTRACT IF THERE ARE ANY BLANK SPACES!!! o d 1 epptes o mist be completed and signed-One copy should go to the homeowner.The other copy should be kept by ttu co»pactor. Homeowner' Signa a ontractor's Signature I Date Date D Vt i 1 ✓ Contractor Arbitration The Home Improvement Contractor Law provides homeowners with the right to initiate an arbitration action(as an alternative to court action)if they have a dispute with a contractor. The same right is not automatically afforded to a contractor,however. The contractor would have to resolve any dispute he/she has with a homeowner in court unless both parties agree to the optional clause provided below. This clause would give the contractor the same right to arbitration as is afforded to the homeowner by the Home Improvement Contractor Law. The contractor and the homeowner hereby mutually agree in advance that in the event the contractor has a dispute concerning this contract,A contractor may submit the dispute to a private arbitration firm which has been approved by the Secret of the Exe t e Office of Consumer Affairs and Business Regulation and the consumer shall be required to ubmit t h ttr ti p vided In Massachusetts General Laws,chapter 142A. �l Q Homeowner's Signa ontractor's Signature ` NOTICE:The si tures of the parties above apply only to the agreement of the parties to alternative dispute resolution initiate by the contractor. The homeowner may initiate alternative dispute resolution even where this section is not separately signed by the parties. Homeowner's Rights A homeowner's rights under the Home Improvement Contractor Law(MGL chapter 142A)and other consumer protection laws(i.e.MGL chapter 93A)may not be waived in any way,even by agreement. However,homeowners may be excluded from certain rights if the contractor they choose is not properly registered as prescribed by law. Homeowners who secure their own building permits are automatically excluded from all Guaranty Fund provisions of the Home Improvement Contractor Law. The contractor is responsible for completing the work as described,in a timely and workmanlike manner. Homeowners may be entitled to other specific legal rights if the contractor guarantees or provides an express warranty for workmanship or materials. In addition to guarantees or warranties provided by the contractor,all goods sold in Massachusetts cavy an implied warranty of merchantability and fitness for a particular purpose. An enumeration of other matters on which the homeowner 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 consumer/homeowner rights,contact the Consumer Information Hotline(listed below). Execution of Contract The contract must be executed in duplicate and should not be signed until a copy of all exhibits and referenced documents have been attached. Parties are also advised not to sign the document until all blank sections have been filled in or marked as void,deleted,or not applicable. One original signed copy of the contract with attachments is to be given to the owner and the other kept by the contractor. Any modification to the original contract must be 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 Payments A contractor may not demand payments in advance of the dates specified on the payment schedule in cases where the homeowner deems him/herself to be financially insecure. However,in instances where a contractor deems him/herself to be financially insecure,the contractor may require that the balance of funds not yet due be placed in a joint escrow account as a prerequisite to continuing the contracted work. Withdrawal of funds from said account would require the signatures of both parties. Additional Information If you have general questions or need additional information about the Home Improvement Contractor Law or other consumer rights,or if you wish to obtain a free copy of "A Massachusetts Consumer Guide to Home Improvement" contact: Consumer Information Hotline Office of Consumer Affairs and Business Regulation 10 Park Plaza,Room 5170,Boston,MA 02116 617-973-8787,888-283-3757 or visit the OCABR website at http://www.mass.gpv/ocabr/ 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 Contractor Law,contact: Director of Home Improvement Contractor Registration Office of Consumer Affairs and Business Regulation 10 Park Plaza,Room 5170,Boston,MA 02116 617-973-8787,888-283-3757 or visit the HIC website at http://www.mass.eov/ocabr/ Go online to view the status of a Home Improvement Contractor's Registration: http://db.state.ma.us/homeimprovement/licenseelist.asp For assistance with informal mediation of disputes or to register formal complaints against a business,call: Consumer Complaint Section Office of the Attorney General 617-727-8400 AND/OR Better Business Bureau 508-652-4800,508-755-2548 or 413-734-3114 Version 2.1-11/22/2010 1160 Ske_•6t'. 11b ��~ ` HOME IMPROVEMENT CONTRACT TERMS AND CONDITIONS(M.G.L..142A) 1. WORK:Provided the Homeowner performs under this agreement,the Contractor shall perform the work on the Property as specified Proposal,attached and incorporated herein.The work does not include extraordinary conditions of which the Contractor could not reasonably be aware.If such conditions are encountered,this shall be an additional cost to the Homeowner.Materials selected by Homeowner may have to be ordered or custom made,which items are specified in the Proposal.The Contractor is not obligated to agree to any modifications,extras or change orders unless such items are agreed to in writing by the Contractor.All extras and changes shall be at an additional cost to the Homeowner.Contractor shall perform the work in a good and workmanlike manner using materials consistent with this contract.Due to Material shortages Contractor may substitute material of equivalent grade. Rp,wc:� SAYiu-e Grvktiv i qG�mo Ita 2. PERMITS: If a building permit is required for the work,the Contractor shall obtain same as Homeowner's agent.Contractor is not responsible for any 3 ry other permits that may be required for the Work,and Homeowner is responsible.to determine whether any zoning,planning or wetland related permits or N,y�rG approvals are necessary.Homeowners who secure their own permits or deal with unregistered contractors will not have access to the Guaranty Fund. 4 3. COMMENCEMENT AND COMPLETION: Homeowner acknowledges the commencement date of the work is fluid,and is subject to numerous factors such as scheduling other contractors,delivery of materials and weather.Contractor and Homeowner shall determine the commencement date of the Work when a more definite determination can be made and shall execute a written acknowledgement of same.The Work shall be substantially completed within 48 hours of commencement,except for longer periods as may apply to particular projects as Contractor shall notify Homeowner in the Proposal,and subject to delays for circumstances beyond Contractor's control.Notwithstanding,the commencement date and substantial completion date may be extended,and the Contractor will not be liable for delays caused by,labor or material shortages,delays in delivery of items selected by the Homeowner,governmental action, and unforseen events beyond the Contractor's control,'including but not limited to weather,strikes,war,the acts of third persons or the acts of the Homeowner.The Homeowner recognizes that the commencement date may be delayed due to scheduling or the completion of Contractor's other jobs. 4. PAYMENTS: Contractor agrees to perform the Work and to furnish the materials and labor specified in the Proposal for the amount as stated in the Proposal. Thirty percent (30%) of the total is to be paid as a deposit with the signing of this contract. Upon cancellation prior to commencement of the Work,any remaining deposit will be returned less the costs for materials ordered for which Contractor was unable to cancel:Final payment shall be due upon completion day of the Work and Homeowner agrees it may not hold any retainage.Late fees may be applied for late payments.Homeowner shall pay Contractor's reasonable costs of collection,including attorney's fees and costs.Time is of the essence hereof. 5. WARRANTY: For a period of ten(10)years after substantioal completeion of the Work the roof will be free of leaks caused by defects in workmanship, but not those caused by ice backing-up or extraordinary weather events,including blizzards,tornadoes,hurricanes or storms of greater than a twenty-five year duration or intensity.Contractor gives no warranties with reference to any materials or equipoment installed in the Premises,passes any such warranties directly to the Homeowner,and Homeowner agrees to look only to the manufacturer with reference thereto.This limited warranty extends to the Homeowner only and is not transferable to succeeding Homeowners.This Limited Warranty specifically excludes(i)all consequential and incidental damages;(ii) damage due to ordinary wear and tear,abusive use,misuse,or lack of proper maintenance;(iii)defects which are the result of characteristics common to materials used;(iv)defects in items installed or supplied by anyone other than Contractor;(v)work done by anyone other than by Contractor;and(vi)loss or injury due to the elements.There are no other expressed or implied warranties or representations made or given. 6. ENTIRE AGREEMENT: This contract and all documents referenced herein constitute the complete and final agreement between the parties.In the event that any of the provisions of this contract shall be held to be invalid,the remainder of the provisions of this contract shall remain in full force and effect.Two identical copies of this contract have been completed and signed.Homeowner acknowledeges receipt of a completed work proposal signed by the Contractor. 7. HOME IMPROVEMENT REGISTRATION: In accordance with M.G.L.c. 142 A.§ 9,Contractor is registered with the Bureau of Building Regulations and Standards Registration No:167338. Homeowner may verify by contacting the Director at(617)727-3200,ext. 25205.A Homeowner's rights under the Home Improvement Law(M.G.L.c..142A)and other consumer protection laVWmapWt.be,vtaivedJ ova) p� Wner acknowledges receipt of a copy of 780 CMR R6 and Massachusetts.Gemneral Laws chapter 142A,and which are available online at www.mass.gov.Questions may be directed to the Consumer Information Hotline,(617)727-7780. 8 ARBT1 R 4i ION: Contractor and the-Homeowner hereby mutually agree-in advarrce7that in the event the-(Co'ntractor has--a dispute cont:eming this contract,the Contractor may submit such dispute to a private arbitration service which has been approved by the secretary of Executive Office of Consumer Affairs and Business Regulations and the consumer shall be required to submit to such arbitration as provided in M.G.L.c. 142A.No lein or security interest is imposed on the Property as a consequence of this contract,but Contractor has the right to record this contract or a notice of this contract, or seek a lien if the Homeowner breaches this Contract. 9. HOMEOWNER COVENANTS: The Homeowner agrees,represnts and warrants that(a)the Homeowner grants permission to the Contractor to enter the Property to perform the work as covered by this contract;(b)the Homeowner has.funds available to make full payment under this contract to the Contractor upon day of completion;(c)the Homeowner understands that construcTon as contemplated by this agreement creates a dangerous condition, and agrees not to enter portions of the Property under construction until the Contractor advises the Homeowner that the consatruction is completed;and(d) that code requirements may result in roofing nails penetrating through roof decking and will be visible on the underside of some surfaces.The Homeowner indemnifies,exonerates and holds harmless the Contractor from any loss,damage,claim,liability or expense(including reasonable attorney's fees,deposi- tion costs and court costs)resulting from a breach of this provision.Contractor is not resposible for damage to landscaping that will grow back during the next growing season. 10. CANCELLATION: Homeowner may cel i a ment provided Homeowner notifies the Contractor in wrifrn at the address listed in the Proposal not later than midnight of the third b sines f I n e signing of this agreement. HOMEOWNER'S SIGNATURE: TODAY'S DATE: � 1 SHINGLE SELECTION: &lJM4}!I� ` CR't1N APPROX.1/3 DEPOSIT: 2 ��( �OU il JL 6 5 PROPOSAL DATE: Page No. of Pages Builders License 9 58443 I Home Construction Reg. # 167338 DuvaJAL RoofingLL, (781)944-1994 (978)664-2557 READING NORTH READING P.O. Box 637, North Reading, MA 01864 Please visit us at www.duvalroofing.com 4 Zee PROPOSAL SUBMITTED TO I W 13-L 7_�Z9 STREET ( O 57a+-1 e rV )•` CrR STATE AND(ZIP�CODE o r An L v e r We hereb submit specificatio sande rimates for. r dy Rip& Remove all existing roof related debris from roof as well as job site with our own disposal truck. NO DRIVEWAY DUMPSTERS 1 lJ 1 layer of existing roof shingles ❑2 layers of existing root shingles 0 3 layers or more of existing roof shingles Replace any damaged roof decking; not to exceed 32sq.ft. (additional at$1.70 per sq.ft.) Install 8"Aluminum Drip-edge/Rake-edge along entire perimeter(Choice hit?)Brown or Mill) Install ICE&WATER UNDERLAYMENT on all horizontal eaves,sidewalls, skylights and chimney flashing Install a premium base sheet underlayment(felt)that is in compliance with the asphalt shingle manufacturer chosen by the homeowner Install The Homeowner's Choice of the selected Tamko/IKO or GAF Limited Lifetime Architectural Roof Shingles See individual manufacturer's warranty for specific details lM712,7eD LANvmtavc Replace all existing bathroom louver and/or exhaust pipe(s)with new aluminum flanges O—Owa Chimney(s)-counter-flash and re-step existing flashing v✓rntu-n►;�Nrt3 �✓ ❑Cut& Install new lead flashing Install a continuous low profile Ridge-Vent on all ridge lines Soffit-Vents 03 Roof Louver-Vents Ce /t x'11.4 �e Seamless Aluminum Gutters-Custom fabricated on site with our own gutter machine �Gwo ❑ Downspouts at additional y ❑Leaf Guards Other e 1 C e 41/ e 174 -ra sc r rale - ,b 0a,-J rq�le - 4r,q cjo ✓ c �- ° Z►CU =-i56 De,, e LO 79 vF ls> O,.r L� aF 1/DuS -i6 P w ADZ — I�S Ccf�SC��T "Please Note:All items in roof attic should be removed or covered due to falling roof particles, at time of roof tear-off Price includes all items above that are checked only/others may be priced separately upon request. We Frapaze.. hereby to furnish material and labor-complete in accordance with above specifications,for the sum of: Total price not including options. dollars($ Payment to be made as follows: 4 30%deposit required before ordering materials.Balance due in full upon day of completion.v $ll 00 70 .Please make all payments out to Kenneth Duval, mailed to: P.O. Box 637, No. Reading, MA 01864 Final Payment is due upon day of completion and is subject to the Authorized supplemented Terms&Condition sheet when scheduling. Signature ✓ tp THIS PROPOSAL IS VALID FOR DAYS DUE TO FLUCTUATIONS IN MATERIAL&DISPOSAL PRICES.