HomeMy WebLinkAboutBuilding Permit #572-12 - 1500 SALEM STREET 1/27/2012 TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit NO: �� 2 Date Received
Date Issued: 2? 2—
RTANT:Applicant must complete all items on this page
LOCATION /-:3_66 S /
�.
PROPERTY OWNER t/G�}r�/ ll� Print Unit#
Print
MAP NO: ""6 PARCEL: ZONING DISTRICT: Historic District yes no
Machine Shop Village yes no
100 year-old structure 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
0 Repair, replacement ❑Assessory Bldg ❑ Others:
❑ Demolition ❑ Other
oodplain ®Wetlands =i0 Wa is G
❑ mater/.Sewer • '• _�
I -
DESCRIPTION OF WORK TO BE PERFORMED:
-Ly%)ST/�VL NFtiv
I
(Identification Please Type or Print Clearly)
OWNER: Name: y �'�i/� Phone �!7Sr- �Z 7��Ue/
Address: /fie a I'1`/ ST /y 11LIV19OXC,C
CONTRACTOR Name: Phone:
Address: /:3 S/G/Yj=I/�// LL y �/�%�/�c /-l_7A-,1A( S6A /(04-.
Supervisor's Construction License: .53.5-0 6 Exp. Date: 30 2p/
Home Improvement License: //Z of J� Exp. Date- � 20/3
ARCHITECT/ENGINEER Phone:
a
Address: Reg. No.
FEE SCHEDULE:BULDING PERMIT: 92.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F.
Total Project Cost: $ FEE: $_
Check No.. Receipt No.: o?Y
NOTE: Persons contracting with unregistered contractors do not
have access to the ran
t1'.fand
,�ignaref�Agent/Owner
to _go ' ;� „' '` SignatureAoficontract x _A
": I
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
o 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 Departmentrior to issuance of Bldg Permit
p g
Addition or Decks
❑ Building Pp Permit Application
❑ Certified Surveyed Plot Plan
❑ Workers Comp Affidavit
o Photo Copy of H.I.C. And C.S.L. Licenses
E, Copy Of Contract
o Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And
Hydraulic Calculations (If Applicable)
o Mass check Energy Compliance Report (If Applicable)
o Engineering Affidavits for Engineered products
NOTE: All idumpster permits require sign off from Fire Department prior to issuance of Bldg Permit
New Construction (Single and Two Family)
❑ Building Permit Application
Ei Certified Proposed Plot Plan .
Photo of H.I.C. And C.S.L. Licenses
o Workers Comp Affidavit
❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And
Hydraulic Calculations (If Applicable) -
o Copy of Contract
o 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
i
Doc: Doc.Building Permit Revised 2008mi
f
Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
TYPE OF SEWERAGE DISPOSAL
Public Sewer El' Tanning/MassageBody Art ❑ Swimming Pools ❑
Well ❑ Tobacco Sales ❑
Food Packaging/Sales ❑
Private(septic tank,etc. ❑ permanent Dumpster on Site ❑
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
DATE REJECTED DATE APPROVED
PLANNING & DEVELOPMENT ❑ ❑
COMMENTS
CONSERVATION Reviewed on Signature
COMMENTS
HEALTH Reviewed on Signature
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 Dumpster on site yes - =rio-
Located at 124 Main Street I
Fire Department signature/date
COMMENTS
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
I
® Notified for pickup - Date
Doc:.Building Permit Revised 2011 June/mi
Locations/
No. r 2 2 Date � 7//
NpRTN TOWN OF NORTH ANDOVER
A
♦ s
Certificate of Occupancy $
�'s�cMusEt� Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check #rIA&
24L5Building Inspector
NORTH
Town of
0
L o '� dover, Mass.,_/ "2
Q - LAKE
COC MIC ME WICK ti
SRATED P �C2
U BOARD OF HEALTH
Food/Kitchen
Septic System
PERMIT
BUILDING INSPECTOR
THIS CERTIFIES THAT................................... .... 9� '
...................................................................................................... Foundation
6 5a��^ S�
has permission to erect........................................ buildings on..&�.............2..............................,............................................... Rough
�77f 6 ! E Chimney
to be occupied as..........................F.......a�I..,,l.... ...I............... ...�1.'................................................................................... y
provided that the person accepting this permit shall in every respect conform to the terms of the.application on file in Final
this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of
Buildings in the Town of North Andover. PLUMBING INSPECTOR
VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough
Final
PERMIT EXPIRES IN 6 MONTHS
ELECTRICAL INSPECTOR
UNLESS CONSTRUCTIONTS Rough
...................... ........ ..d:�'.f.�... .............................................. 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 (Nall To Be Done FIRE-DEPARTMENT
Until Inspected and Approved by the Building Inspector. Burner
Street No.
SEE REVERSE SIDE Smoke Det.
The Commonwealth of Massachusetts
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
1 V J ���, i i7iw.��ulu�i�tu 11T,T,wilui�.�iarl..ili
Name (Business/Organization/individual): L
Address: 13 S7ME E WALL TE 1Z PW E
City/State/Zip- AT /AI S 0,41 14A- d 3b'11 Phone#:
Are you an employer?Check the appropriate box: Type of project(required):
1. 1 am a employer with Z 4. ❑ I am a general contractor and 1 6. ❑New traction
employees(full and/or part-time).* have hired the sub-contractors
2.❑ I am a sole proprietor or partner- listed on the attached sheet t 7• emodeling
ship and have no employees 'These sub-contractors have 8. ❑Demolition
working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition
[No workers'comp.insurance 5. ❑ We are a corporation and its
10.F-1 Electrical repairs or additions
required.] officers have exercised their
3.❑ I am a homeowner doing all work right of exemption per MGL 1 l.❑ Plumbing repairs or additions
myself. [No workers'comp. c. 152, §1(4),and we have no 12.❑ Roof repairs
insurance required.]t employees. [No workers' 131-1 Other
comp. insurance required.]
'Any applicant that checks boz#t 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 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: Al o r C UTA IZ 0 --MS. co,
Policy#or Self-ins. Lic.#: G, k/C—Z I T 91 G Expiration Date: j�— 16--.201z
Job Site Address:1 �� 5;we�;1VI ST City/State/Zi p:Ly��i�G��.��_
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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
Ido hereby certify un the d penalties of perjury that the information provided above is true and""
.
correct
Signature: r Date: 1-23— /Z
Phone#: e c 3— —;l2
Ojllcial use only. Do not write in this area,to be completed by city or town official
City or Town: Permit/License#
Issuing Authority(circle one):
1. Board of Health 2. Building Department 3.City/Town Clerk 4. Electrical Inspector S. Plumbing Inspector
6.Other
Contact Person: Phone#:
7j 7e, �
Office:o onsumer airs mess +egu a on
HOME IMPROVEMENT CONTRACTOR
Registration: �A112595 Type:
-,Expiration:, 4/9/2013 VG ' ISS z
GARY LISS T{
13 STONEWALL TER 7 .j
ATKINSON,NH 03811 „ ' Undersecretary
°c.,..
Nlassachusetts - Department of Public Safety
Board of Building, Rel-ulations and Standard!
Construction Supervisor License
License: CS 53506
GARY E LISS
13 STONEWALL TERR
ATKINSON, NH 03811
--�— �` Expiration: 3/30/2013
('onunisiuncr Tr#: 13129
I
DATE IreNVDDIYy"
CERTIFICATED�1> ►81LITY INSU ROCE. 1�.23/201
THIS
CERTIFICATE IS ISSUED AS-A MATTER OF INFORMATION ONLY AND"NF'ER3 NO RIGHTS UPON THE CERTIFICATE fiOLDER. TH19
GF12T1FICATE DOES IV01 AI FIRMAT11tELY'()R M GATtYELY AMEND, EXTENC3 OR ALTER jHE.CUVERAOE AFFORDED SY.THE PQUCIES
THIS CERT.iFICATE,PF INSURANCE DOES NOT CONSTITUTE A-CONTRACT"BETWEEN THE ISSUING INSURERS}, AUTHORIZE�3
REPMF.NTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER:
IIVIP.ORTANT: If the Certificate bolder:it an .ADDITIONAL INSURED,the policy(ies)must be andersed. Ifi SUBROGATION!S YIIAIVED,subject to
the.teams and.00ndltio=.Of the poiicY,certei •Policies maY require are endowment, A statement on than carhficate does.not conferdghts to the
Cerliflcat:e holder!n lieu of surh endorsement($) C ACT
PRODUCER .
PHONE . {Og-382.8600 R27 FA .609'.3ttR.:2a3Il
Insurance Splut:jons Corporation E-MAIL
6t} Weatvil3 a Rd ROD
PRDDUCF.ft
Plaistow., NR. 038155
IN $ AFFORDING COypRAGE "
Macialana Costa
INSURED. . INSURER A�'N Insurance COm .
aN RER>'..N ArGVA1W Ins, aLncE� 'C6
Gary Liss I ba Gary' hiss Geneka.CflntKactor INSURER G;
10 Stonewall .Terrace. INSURERD: "
- arsi;rxEii f� -
At1cj-nson NH 038 12148 tN RERF:
COVERAGES I~ERTIF1CATE NUfI�DER>rRp
;ras 2/20/2412 REVISION NUNN-3ER:
THIS IS TO CERTIFY THAT THE.POLICIES OF INSURANCI L}$TE0 BELOW HAVVE BEEIa ISSUED TO THE INSURED NAAIIFD ABOWE F{9R THE POLICY PERIOD
IN))I iATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO VVHICH TH1$
CERTII KATE MAY''B£ISSUED OR 1piAY'PBRTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN is SUBJECT IO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
POLICY EFP PouCY EXP UMAlIl3
POLIGYNUMBER MMIDU iAMIG!
TYPE OF R18URANGE IN -'
GENAL VAHaATY SCU317B91 2/20/2011 2120'/2.012 EArµOCCUIiRENCE'• $ 110001000
T ED
P ES
x :
CONNERC r>ENERAI wIHILITX 5 6 000
`CCAIM64aAD2'�OCCUR Mn EXP sonl S
' pER50hIAL`&A[7Y IhIJUfIY.'
:GENERAL'AGGREGATE 3 2;00.U. 000.'
PRODUCTS-DDiAFi0P ACG.
.peN'L'AG6R1:(iATElIMiTWPP'UF-$'PER; .... .
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� S .POLaCY
PRO-: RSrIyX�FSXIMIT..
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'HODILjI-INJIJR''t'IPalp�dtlJ
ACC CICMNED AUTOS .. .• .
BODILY9�IJURY.IPor*dlQrrt)' $
SCIIO)iaEgAUTOS
IPer Iaaadela) '
ItREO RITl'Og _ g: ' ' -
NON43WNEUrApTP3'
ul�ienEwl UA$' OCCUR
EACH OCCURRENCE '. •�_
f7ICEgg UFL& ,GLAIM& AOE - .. .. AbGREGATE .t°' . . ...
DEDUG'r�LE.
ItEtEpITION S gJ15/2DS1 5/I5J241� Y STAR - Ot1F
.B• WORKOMCOMPENSATION � 21997t} , • ..
:'AND altililt.1 6:L:VACH A6CiDENT. 3 • lOQ "040
.A9y-PI IiTXIWPkR UTTvE7i'I NIA'
ASH{R E7SG UDED7 Lj 'EL:DISEASE
-EA ENIFCOY7 .$ zap—()
IEIy in•ttalp::, .
Nyes;clasaIDe ISlder:'' E.L DISEASE PQUC:Y LIMfT S :X00. 4 0
DESCRIFTION OF OPERATIONS hakaw
-DESCRiIrII31lI 4p-'gPERATIONS}L;}QCCATHIN9 J YgH4CLES IAUAch ACORN 191,Ad.dMona)13emetk$9Gh�du)�HlP10le space a8 ragaimd) __ .
GERTIFICATE 14OLDEf2 QAi�ICELLATIOW
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES.BE CANCELLED BEFORE
THE EXI2fRATt0N BATE THEREOF,' NOTICE WILL BE DEWERF0'IN
ACCORDANCE WITH THr;POLICY PROASIONiS..
Mr. & Mrs John, g,uid
1500 Salem.sat: AUTHPREEDR9PRUENTAYNF
N Ps�dover.r NA .(31845
ltSla� >vastaJMI�I 'y ' { '
..ACIORD 25('1809109)' _.. . .. .. ..... a 1 $-
98 .2009 ACORD CORPORATION All right reserved
WSa25•t2oosr�) The and,loga,are registared r+Iarks of ACDT2D
Wd t1V:ZL ZLOZ f'7 USP
Home Improvement Contract * Gary Liss, General Contractor
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 an work on your residence. You may obtain a free
copy by call the Office of Consumer Affairs and Business Regulation's Consumer Information Hotline at 617-973-8787 or 1-888-282-
Homeowner Information Contractor Information
Name Company Name
Mr.and Mrs.John Reid Gary Liss General Contractor
Street Address Contractor/Salesperson/Owner Name
1500 Salem St. Gary Liss
City/Town Business Address(must include a street address)
North Andover 13 Stonewall Terrace
Daytime Phone Evening Phone City/Town State zip code
978-794-1716 Atkinson N.H. 03811
Mailing Address(If different from above) Business Phone Federal Employer ID Number
603-362-5185 02-0386673
Law requires that most home Home Improvement Contractor Reg.Number Construction Supervisor
improvement contractors License Number
have a valid registration 112595 53506
number
The Contractor agrees to do the following work for the Homeowner: See Attached
(Describe in detail the work to be completed,specifying the type,brand,and grade of materials to be used,use additional sheets if necessary)
Required Permits-The following building permits are Proposed Start and Completion Schedule-The following schedule will be
required and will be secured by the contractor as the adhered to unless circumstances beyond the contractor's control arise
homeowner's agent:(Owners who secure their own permits
1/23/12 Date when contactor will begin contacted work
will be,excluded from the Guaranty Fund provisions of MGL . _2/23/12 Date when contacted work will be substantially completed
chaptr 142A.)
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
Payments will be made according to the following schedule:
$5,000.00_upon signing contract(not to exceed 1/3 of the total contact price pr.the cost of special order items,whichever is greater)
$5,000.00 _by 1 /23/12 •or work begins
$10,000.00by 1/31/12 or upon completion of
$ 10,000.00_by 1/9/12 / or upon completion of
$5,000.00_ upon completion of the contract(Law forbids demanding full payment until contract is completed to both party's satisfaction)
The following matenal/Nriprne nt must be special $ to be paid for
ordered before the contracted work begins in order
to meet the completion schedule(**) $ to be paid for
NOTES:(*)Including all finance charges(**)Law requires that any deposit or down-payment required by the contractor before work begins may
not exceed the greaterof(a)one-thud ofthe total contract price or(b)the actual cost ofany special equipment or custom made material
which must be special ordered in advance to meet the completion schedule.
Express Warranty-Is an express warranty being Provided by the contractor? ONO DYes(All tem>s of the warranty must he attached to the contractl
Subcontractors-The contactor agrees to be solely responsible for completion of the work described regardless of the actions of any third party/
subcontractor utilized by the contactor.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 contact 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 Contactor 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 contactor 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 Contactor 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 contactor 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.See the attached notice of cancellation form for an explanation of this right
DO NOT SIGN THIS CONTRACT IF THERE ARE Y BLANK SPACES!
. entical copies of the contract must be completed and signed.One copy should go to the homeowner o her copy should be kept by the"contractor. t
Homeowners Signature ature _.__.._._..
7
Date Date
r�
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 ved by the Secretary of the Executive
Office of Consumer Affairs and Business Regulation and the consumer shall be required t mit to such arbitration as provided In
M usetts General Laws,chap 142A.
- eo, er's Signature Con ctor's gnature
NOTICE:The signatures of the parties above apply only to the agreement 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 rescission period has expired.
Accelerated Payments
A contractor may not demand payments in advance of the dates specified on the payment schedule hi cases where the homeowner
deems Mm/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 fiords 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 Hotlin
Office of Consumer Affairs, 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.gov/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.pov/ocabr/
Go online to view the status of a Home Improvement Contractor's Registration:
hitp:Hdb.state.ma.us/homeimDrovement/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
508-6524800,508-755-2548 or 413-734-3114
Version 2.1-11/22/2010
PROP OS AL (3-ary Uss
Gen ' ar
Ml/12 13 Stonewall zeaace
Mp.and Mm John I MA Lie.#0553546 A 03811
603-362-5185
1500 Salem street HIC Reg.# 112595 www.garylissbuilders.com
N.Andove.,MA
Quote hnchHles labor and material, unless otherwise sued, to r ovate and histall
flooring,which entail:
• Install 9 solid six-panel primed Masonite doors
• Install prelnbIed Wkkharn 21a'red oak flooring in hallway,kitchen,dining room,TV room,Janet's
r
Install new primed baseboard in affected areas
• Tape and finish existing sheetrock in entry
e Constma archway in 1d as
e Install new Edtehen inets{owner to su }
Building permit
$35,000.00
I
Payment Schedule:
$ 51000.00 Deposit
$ 5,000.00 Work begins
$ 10 .00 On or around Jan 31st
$10,000.€10 On or around Feb 9
$5,000.00 Upon completion
Warranty:Ali labor and materials supplied by contraetorto be warranted for one year.
Acceptance of Proposal
TIS above pries.speeMcations and conditions are sa"etory and are hereby acted.You are authorized to
do thl e work as€ ified.Payments will be made as outlined above.
_Z4-
&bnl bed W. Gary Lss '