HomeMy WebLinkAboutBuilding Permit #680 - 15 BEACON HILL BOULEVARD 5/6/2010 �tORTFr
BUILDING PERMIT oFtt,�o ,°qti
TOWN OF NORTH ANDOVER 32 4` '` `-�'.'°
APPLICATION FOR PLAN EXAMINATION
Permit NO: Date ReceivedX44`
0g1TED P�'y�y
�VSNCHU`�Et
Date Issued:
IMPORTANT:Applicant must complete all items on this page
LOCATION 20-klerrrt"f-
�AA Prim
PROPERTY OWNER PVA,-4t &V3�) v%
Print
MAP 210 =PARCEL: S__ ZONING DISTRICT: Historic District yes no
Machine Shop Village yes no
TYPE OF IMPROVEMENT PROPOSED USE
Resid Non- Residential
New Building ne famil
Addition Two or more family Industrial
teration No. of units: Commercial
Repair, replacement Assessory Bldg Others:
Demolition Other
Septic Well Floodplain Wetlands Watershed District
Water/Sewer
DESCRIPTIOq F WORK TO BE PREFORMED:
FiY1lAlfiif UGi`�✓001 �n Q/IG�S'� ��� `
Identificat•on Please Type or Print Clearly)
OWNER: Name: k1k GJGbI n Phone: (A(%q0&4
Address: �_ oyn 4(ALZ.14
CONTRACTOR Name: a '-Ft` Phone
n, x
'Address: 1� jt2
Supervisor's Construction License: 0—) 425" Exp. Date; 2 b
Home Improvement License: { eZ& '�f Exp. Date; Li 1
ARCHITECT/ENGINEER Phone:
Address: Reg. No.
it
FEE SCHEDULE:BOLDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
Total Project Cost: $ 1114b FEE: $
Check No.: q9 Receipt No.: cC�
NOTE: Persons contr cting with unregistered contractors do not have access to the a ty fund
Si nature of Agent/Owner Signature of contractor
Location l� �E'GICO� hI d
No. k 4 Date Jr- 1d
�oRTh TOWN OF NORTH ANDOVER
f �
O� • Ow
16.
Certificate of Occupancy $
Building/Frame Permit Fee $
s�CHusE
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check #
23CUO Building Inspector
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
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/Signature& Date Driveway Permit
DPW Town Engineer: Signature:
Located 384 Osgood Street
.FIRE DEPARTMENT -Temp Oumpster on site yes _ no
Located at 124 Main Street
Fire Department signatureldate
i , -
COMMENTS
�y
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
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
u Building Permit Application
❑ Workers Comp Affidavit
o 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
u 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)
u 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:Building Permit Revised 2008
ORT
Town Of. Andover .
- .::: ;r.0
No.
�o �T
dover, Mass., 10
0 �
0 LAK;
COCHIC EWICH
OOATED
BOARD OF HEALTH
Food/Kitchen
PERM D Septic System
THIS CERTIFIES THAT... ... K ��v BUILDING INSPECTOR
.............................. .................................. 41. Foundation
1� 111��................
has permission to ere qk............. .............. . .. -buildings on.......I T........16.111.4 4.0. .......I.................................. Rough
Chimney
to be Occupied as......8a. .......... ........................................................
64 terms of the application on file in Final
provided that the person accepting this permit shall in every respect rm to
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 CONSTRU S TIn Rough
. 00 Service
BUILDING INSPECTOR Final
.......... ..=....... ........
01
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.
i
OV �ORTh
o s
�6 �o o - Over
C%
dov •
�A �Ew ° er, Mass.,
y
.4S�RATED APaG`
ERM 4
BOARD OF HEALTH
Food/Kitchen
Septic System
'RTIFIES THATft.f. �
..... .
... ....................
nission to
e,r
eBUILDING
.� Q............r..�.............
..... L
DING I S
PECTOR
ubuildings On ..... I � Foundationupied as..,. . .........
Rough
that the person accepting this permit shall in eve respec c
.............................................. ...............................
i, and to the provisions of the it
and B -every orm to the terms of the application on file in chimney
I in the Town of North Andover. Y Laws relating to the Inspection, Alteration and Construction of
in
Final
1 N of the Zoning or Building Regulations Voids this hermit.
PLUMBING INSPECTOR
PERMIT EXPIRES IN 6 Rough
MO Fina]
UNLESS CONSTRU LATHS
ST ELECTRICAL INSPECTOR
CTO
R
........ ............................................. Rough
..... .IN ..INSPECR
........... .......
BUILD
G Service
TO
Occupancy Permit Required to Occicpy Buildin Final
splay in a Conspicuous Place on the g GAS INSPECTOR
Premises — Do Not Remove Rough
No Lathingor D
r Until Inspected and Approved wall To Be Done _ Final
� pp oved by the Building Inspector. FIRE DEPARTMENTBurner
SEE Street N,
54—
The Commonwealth of Massachusetts
Department o f Industrial Accidents
Office of investigations
600 Washing ton Street
Boston., MDQ 0211,
Workers' Compensation Insurance Affi WWW.Mgssgov/dia
An icant Information davit: Builders/Contractors/Electricians/Plumbers
Please Print Legibly
Name(Business/Organization/Individu d):
Address: ol/V,
M/a m,2 t
City/State/zip: q7 9 R&� �jt{
Phone#:
Are you an employer?Check the appropriate boa:
1.❑ I am a employer with 4. ❑ I am a F8. []
project(required):
�Z-
ein construction
lcontract
oyees(full and/or part-time).* have hir d the sub-contraotorsand l2 a sole proprietor orpartner_ listed on the attached sheet t emodelinghip and have no employees These sub-contractors have
working for me in any capacity. workers' com . ' emolition
[No workers'comp.insurance 5. P insurance. 9. ❑Building addition
❑ We are a corporation and its
3.❑ required-] officers have exercised their 10.1]Electrical r
I am a homeowner doing all work rit of ex ��or additionsemption per MGL 1 I. Plumbing repairs or additions
myself.[No workers'comp. c. 152 14
>
insurance required.]t C ),and we have no 12.
employees. ❑Roof repairs
[No workers
comp.into mce required.] 13.❑Other
try Iicnnt that h_� bo::mi mast also fit'out tae Section beion,show iag+�
I�fomeowners who submit this affidavit indicating they are doingdl work and hen woirws'com, -W on
1Contmctors that check this box must attached an additional sheetshowin the then outside contractors must submit a new affidavit indicating such.
8 name of the sub-contractors and their workers'comp.policy information.
I am an employer that is providing workers'compensation insurance for my employees Below is the policy and,job site
information.
Insurance Company Name:
Policy#or Self-ins.Lic.#:
Expiration Date:
Sob Site Address:
Attach R copy of the workers'compensation policy declaration page(Showing City/State/Zip:
Failure to secure coverage as required under Section 25A of MGL C. 152 can 1R ad to the impositionolicy number
ancrir>v�mon date).
fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties of a
of up to$250.00 a day against the violator. Be advised that a co Penalties in the form of a STOP WORK ORDER and a fine
Investigations of the DIA for insurance coverage verification PY of this statement may be forwarded to the Office of
Ido hereby c d th pains andd penalties o er u
.fp ! rJ'that the information provided above is true aha'correct
SiQnatur
Date:.._ Cp _1_d
'i Phone
Official use only. Do not write in this arca, to be completed by city or town officiaL
City or Town:
Permitucense#
Issuing Authority(circle one):
L Board of Health Z.Building Department 3.Ci /Tow
6. Other n Clerk 4.Electrical inspector 5.Plumbing Inspector.
Contact Person:
Phone#:
Information an- d Instructions
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 writt:m"
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 og 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 mainttanance,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 shall withhold 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 coiMpliance 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.perfoanance of public work um-t-il acceptable evidence of compliance with the insurance
requirements of this chapter have been presented to the contr-a.cting authority."
AppIicanfa
Please 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 certificate(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'comp enation insurance. If an LLC or LLP does have
employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial
Accidents for confirmation of insurance coverage. Also be sttre to sign and date the affidavit. The affidavit should
be returned to the city or town that the application for the 4err�ut or license is beingrequeS+wd not the.De-partrnent of
Industrial Accidents. Should you have any questions regarding the law or if you are r..quired to obtain a workers'
compensation policy,please call the Department at the number=listed below. Self-insured companies should enter their
self-insurance license 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 reference 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 may be 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 bum leaves etc.)said person is NOT required to complete this affidavit
The Office ofInvestigations would like to thank you in 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.f a number.
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Inwestieatiions
600 Washmgtan Street
Boston,MA 021.11
Tel. #617-727-4900 cat406 or 1-977-MASSAFE
Fv. #617-727-7749
Revised 5-26-0�
urn�na7.mass._g ov/dia
The Commonwealth of Afassachusetts
Department o f Industrial Accidents
Office of Investigations
600 K`ashinoMn Street
Boston, MA 02,11
wwwmass.gorldia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbe
Applicant Information rs
Please Print Legibly
Name(Business/Organization/Individual):
Address:
City/State/Zip:
Phone#:
Are you an employer?Check the appropriate box;
1.❑ I am a employer with 4. ❑ I am a F7.
pe of project(required):
genera]contractor and 1
2.❑ employees(full and/or part-time).* have hired the sub-contractors ❑New construction
I am a sole proprietor or partner. listed on the attached sheet$ ❑Remodeling
ship and have no employees Thesesub-contractors haveworking for me in any capacity. workers' com .ins Demolition
working
[No workers'com . • P urance. 9. ❑Building addition
p Insurance 5. ❑ We are a corporation and its
3.❑ required] officers have exercised their 10•❑Electrical repairs or additions
I am a homeowner doing all work right of exemption per MGL 11.0 Plumbing repairs or additions
myself.[No workers'comp. c. 152,§1(4),and we have no
insurance required.]t employees. [No workers' 12.❑Roof repairs
COMP insurance.required-]
I3.❑ Other
t A-'JS'-"��`IItCEII:t ut checla hOv. l y f 0{iI!(Stll E¢C SeChQ^_•O��OP.�:.:jOY.^..^.. f' '
Homeowners who submit this affidavitindical th g -heirwori:ers'comp"-,,,c-,;QeY„��•" t ..-
el'are doing an work-and then'hire outside contractors must submit a new affidavit indicating such.
'Contractors that check this box must attacbed an additional sheet showing the
name of the sub-contractors and their workers'comp.policy information.
an employer that is providing workers'compensation
information. insurance for my employees. Below is thepolicy and,job site
Insurance Company Name:
Policy#or Self-ins.Lie.#:
Expiration Date:
Job Site Address:
City/State/Zip:
Attach a copy of the workers'compensation policy declaration cane sho 0
Failure to secure coverage as required under Section 25A ofMGL c.Page
lid to ththe eoimposilicy number
nbof anc dation date).
fine up to$1,500.00 and/or one-year imprisonment,as well as_civil penalties in the form of a STOP WORK ORDER ha of 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 and penalties of perjury that the information f matron provided above is true and correct
Signature:
Phone#: -_-
F[the
only. Do not write in this area, to be completed by city or town 0 ciaL
n: Permit/License#
hority(circle one):
Health 2.Buiialing Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing
b Inspector
son:
Phone
� I
Information ani d Instructions
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 tie legal representatives of a deceased employer,or the
receiver or trustee of an individual,partnership,association ox-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 mainteximce,construction or repair work on such dwelling house
or on the grounds or budding appurtenant thereto shall not because of sucb.employment be deemed to be an employer."
MGL chapter 152,§25C(6)also slates that"every state or 164cal licensing agency shall withhold the issuance or
renewal of a license or permit to operate a business or.to Monstruct buildings in the commonwealth for any
applicant who has not produced acceptable evidence of co-Irnpliance 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 un1t-il acceptable evidence of compliance with the insurance
requirements of this chapter have been presented to the contracting authority."
Applicants
Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if
necessary,supply sub-contractors)name(s),addresses)and phone number(s)along with their certificate(s)of
insurance. Lit sited Liability Companies(LLCM or Limited Liability partnerships(LLP)with no employees other than the
members or partners,.are not required to carry workers'comp enation insurance. If an LLC or LLP does have
employees,a policy is required. Be advised that this affidavit may be 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 retusued to the city or town that the application for the pmt or license is.l,tmg requested not the.Department of
Industrial Accidents. Should you have any questions regarditxg 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 license 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 reference 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 may be 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
(Le,a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit
The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions,
please do not hesitate to give us a call.
The Depar6ment's address,telephone and:fax_number._-..
The Commonwealth of Massa&usetts
Department of Industrial Accidents
Office of Iuvestivations
600 Washington Street
Boston,NLA 02111
Tel. #617-727-4900 ext 4,06 or 1-977-MASSAFE
Revised 5-26-05
Fay;#617-72.7-7749
)ArMrV .mass...--ov/dia
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,the contractor may submit the dispute to a private arbitration firm which has been approved by
the Secretary of the Executive Office of Consumer Affairs and Business Regulation and the consumer shall he required
to submit to such arbitration as provided In Massachusetts General Laws,ch ter 142A.
Homeowner's Signature Con ctor's Signa e
NOTICE:The signatures of the parties above apply only to the agree of the parties to alternative dispute resolution
initiated 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 carry 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 recission 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 himlherself 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 fonds 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 Consumer Guide to the Home Improvement Contractor
Law,"contact
Consumer Information Hotline
Office of Consumer Affairs and Business Regulation
10 Park Plaza,Room 5170,Boston,MA 02116
(617)973-8787 or 1-(888)2833757
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
Bureau of Building Regulations and Standards
One Ashburton Place,Room 1301,Boston,MA 02108
(617)727-3200 or 1-800-223-0933
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)6524800
(508)755-2548
(413)734-3114
REMOVE EXISTING WINDOW
AND IN-FILL OPENING
\,
FIXTURES:
6 -3 V2 SHOWER WALLS SWANSTONE TAHITI DESERT SK326012
TOILET KOHLER DEVONSHIRE K34880
--------------
---------- TUB KOHLER ARCHER K 1123RAO
VANITY TOP SWANSTONE TAHITI DESERT VT152231
Oil
FAUCET KOHLER DEVONSHIRE K3944CP
SHOWER/TUB VALVE DEVONSHIRE K-T39549CP
PAPER HOLDER, TOWEL RING, TOWEL BAR IN DEVOHSIRE
6' POLISHED CHROME FINISH
INTERIOR FINISHES:
2 1/4 PREFINISHED OAK FLOORING
3 5/8 PAINTED CROWN MOULDING
MDF WAINSCOTING AT 46" HEIGHT
NEW INTERIOR TRIM TO MATCH KITCHEN
REPLACE DOOR AND 36wX38h" VANITY AND 18" LINEN CLOSET
LOCATE 3" CLOSER TO
KITCHEN PARTITION
BEAUDOIN RESIDENCE
15 BEACON HILL BLVD
PROPOSED FIRST FLOOR BATH PLAN
s (per
l 8011 1' fYi)LilLp•
Building Re �
HOME i "and St
MPRpy ACTpRrds
Regtstra''t o EMgNT CONTR
152844
Exprration 0/4/2010
}
' MORETTI gUr r Type Li abilityC0IPIr Tr* 275812 j
LRS1t
,IOHfv MORETTI r i�C a'
` CHANDLER ROA_b t
E l?OXFpRD. MA 0192fi "� ;5 a%
AdminiAbb
sh'ator '
°"'NI lssxchu�'eftt
Bo trdL�epartmcpt of p
W,Btrilrlul- Rf.ulation� . rrhlie Saco,
construction S to I St:
upervisor tndur'ds
License: CS 79425 License
Restricted to: 00
JOHN C MORETTI
4 CHANDLER RD
BOXFORD, MA 01921
Expiration:
8/8/2010
Tr#: 1278
i
Massachusetts Home Improvement Sample Contract
This form satisfies all basic requirements of the 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.
Homeowner Information Contractor Information
Name Company Name
AAV\t+ke 12k��Ol1n �Of2t � -2w, Aaas
Street Address(do not use a Post Office Box address) ontractod Salesperson/Owner Nae
(S >14,r k $ Ntjd f& mI
City/Town State Zip Code usiness Address(must include a street address)
(I�A "VOV M 4 CAv „d1e r It
Daytime Phone Evening Phone ity/I'own StateZip Code
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The Contractor agrees to do the following work for the Homed ner:
Tuesi;nuc in Man the wout to completed,sped ymg the pe, ran an e or matenals to ve uuse ton see i necessary. �+
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Required Permits-The f lowing building permits are required Proposed Start and Completion Schedule-The following schedule will
and will be secured by the contractor as the homeowners agent, be adhered to unless circumstances beyond the contractor's control arse
(Owners who secure their own permits will be
excluded from the Guaranty Fund provisions of 41�U Date when contractor will begin contracted work.
MGL chapter 142A.) 1
Date when contracted work will be substantially completed.
Total Contract Price and Payment Schedule (O�
The Contractor agrees to perform the work,furnish the material and labor specified above for the total sum of: (_)
Payments will be made according to the following schedule:
s_2%ODD upon signing contract(not to exceed 1/3 of the total contract price or the cost of special order items,whichever is greater)
$�17 by /_/_or upon completion of ��<t[J0�um%i n )
$ 33—,00 Q
by /_/_or upon completion of t Y 4(�tkl�1 VV� A(45W
$ 2 11 100 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 $ to be paid for /T
ordered before the contracted work begins in order $ to be paid for
to meet the completion schedule.(**)
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 most be special ordered in advance to meet the completion schedule.
Express Warranty-Is an express warranty beine Provided by the contractor? No Yes tell terms of the warramty must be attached to the contractl
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 agreement
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 has a valid Home Improvement Contractor Registration. 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 One Ashburton Place,Room 1301,Boston,MA 02108 or by calling 617-727-3200 or
1-800-223-0933.
• Does the contractor have insurance? Check to see that your contractor is properly insured.
• Know your rights and responsibilities. Read the Important Infomtation 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 of business,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 signing of this agreement. Seethe attached notice of cancellation form for an explanation of this right.
DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACESM
Two identical copies ofthe contract must be wmpleted and signed the copy should go to the h reowner.The other copy should be kept by the couuactor.
Homeowner's Signature Con actor's Signature
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