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HomeMy WebLinkAboutBuilding Permit #369 - 174 JOHNSON STREET 11/5/2012 i TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued, IMPORTANT:Applicant must complete all items on this page LOCATION % 7S/ -o6,*.$-0,1 .,r7- - Print PROPERTY OWNER I OAAict4 e 04 ✓,'S -`i 7 t C -da o i Print 100 Year Old Structure yes no MAP NO: PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop 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 A Repair, replacement ❑Assessory Bldg ❑ Others: ❑ E'emolition ❑ Other ❑ Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District ❑NVater/Sewer DESCRIPTION OF WORK TO BE PERFORMED: 1'4sT// r/ew $" /,3/c-fc /44vlleeeleT1,01/1 Identification Please Type or Print Clearly) OWNER: Name: l -„<R;44e /_2'ry,-.s” Phone: 7r�Yr7- -o Z--'? Address: /7y ,ia��sE•z sr N ,�.� v�� CONTRACTOR Name: c-.G AIAK 41" Phone: Address: 1g,i� sT. P/1,�7w ��t` o-?���`.. Supervisor's Construction License: C-s'"o ���/6 Exp. Date: Home Improvement License: �/Z Exp. Date: -2 S -f y ARCHITECT/ENGINEER Phone: i Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BAS DON$125.00 PER S.F. Total Project Cost: $ 7Seo FEE: $ A C/ Check No.: 1'n Il Receipt No.: -Iqo NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner_4 ASignature of contractor ..�a�,�j', ��1 Plans Submitted ❑ Plans Waived 0 Certified Plot Plan ❑ Stamped Plans ❑ i 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 APPROVE PLANNING & DEVELOPMENT ❑ ❑ J` /� i COMMENTS Ih 111einerer l z,,,,.- CONSERVATION aheCONSERVATION Reviewed on "_ASignature '_klti J COMMENTS.NU D vje_A�C ,_L 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 Towi., Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT - Temp Dumpster on site yes no Located at 124 Main Street Fire Department-signattireldate 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 t El Notified for pickup - Date i Doc.Building Permit Revised 2010 Building Department The fohowing is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit , ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy 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 appal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc: Doc.Building permit Revised 2012 Location No. Date ' • - TOWN OF NORTH ANDOVER • Certificate of Occupancy $^ =� Building/Frame Permit Fee $ � R Foundation Permit Fee Other Permit Fee $ TOTAL $ Check# 25909 Bui ding Inspector 0ORTH Town of t 1,' \ Andove- 0 to No. _ SAF h " ver, Mass, w GOCKICHf WICK A. . S U BOARD OF HEALTH Food/Kitchen PE R�_ Septic System IT T LD THIS CERTIFIES THAT . ....... . . . .............................................. BUILDING INSPECTOR has permission to erect ......... buildin s on I . ...... .. .. ... . M`... Foundation p ... ...... ... .... ... r .. . .A ....... .. .... Rough to be occupied as .. .�.1.1 .......... .. .. .. ... . r` Chimney provided that the person acce ting this permit shall in every respect conform 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 CONSTRUC SrL.J.z Rough Service ....... .................. ................NOMMOV.................. Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building 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 Foundation Supportworks of NM LLC. f nr(}ilir.e Use Only Jack Bowen We solve Foundation Issues www.bsnh.com [ �491A cn (603) 382-6098 (877) DRY-4-YOU i 10238 Main St,Plaistow NH 03865,. Jack Bowen,Jack@bsnh.com,(603)2344007 03923 rl FAX:(603)382-2403 FS-7154 #146119 PROPOSAL DATE: 08/10/2012 EMAIL: mail SUBMITTED TO: Lorriane Davis HOME: 978-6.87-0628 ADDRESS: 174 Johnson St N.Andover MA 01845 WORK: -- JOB LOCATION: 174 Johnson St N.Andover MA 01845 CELL: -- FAX: -- System Features Geo-Lock Anchors 12"x18"Wall Plate Concrete R&R Square Feet INSTALLATION DATE: 6'Extension Wall Excavation 0-5' -- Hide-A-Way Anchor Cover Pier Excavation 0-5' Tightening Kit-GL Expansion Joint Helical Anchor 12"x18"Wall Plate Permits&Engineering Helical Extension 3' Waterproofing Membrane PowerBrace 8' Exterior Drainage Joist Reinforcement LawnScape Outlet Cross Beam Support Lift.lMoJe Barn 1 " Tightening Kit-PB Full Wall Foundation Block 90 3"Push Pier Standard Bracket Excavation 1 3.5"Push Pier Entry Door 1 3"Helical Pier Standard Bracket Permit 1 ` 3.5"Helical Pier Custom 6 Slab Pier Push Custom 7 DETAILED DRAWING ATTACHED Void Fill Custom 8 Type of wall: Block SmartJack 14 Foundation Crack Repair t Cast-in-Place Footing Foundation Grading Existing wall finish: Supplemental Beam Foundation Pointing Existing floor finish: dirt Drywall Removal Custom 12 Total depth per pier included in price: Each add'i foot at add'I cost of: We Propose To finish material 8 labor-complete in accordance with above- specifications,for the sum of "� Total Contract Price $ g�5g gg Deposit Required 30 % $ 6565:98 Deposit Paid $ 0.00 Due Upon Installation $ 18550.00 Any alteration from the above specifications and corresponding price adjustment(if necessary)will be made only at the Customer's request or approval.Completing the work in this Proposal at the time scheduled is contingent upon accidents or delays beyond our control.This Proposal is based primarily on the Customer's description of the problem.This Proposal may be withdrawn if not accepted by the Customer within 120 days. / Authorized signature: Date Acceptance of ContrZe- m/we are5aware of and agree to the contents of this Proposal,the attached Job Detail sheet(s),and the attached Acceptance of Contr /,e are Limited Warranty,(together,the"Contract").You are authorized to do the work as specified in the Contract.I/we will make the payment set forth in this Contract at the time it is due.I/we will pay your service charge of 1-1/3%per month(16%per annum)if my/our account is 30 days or more past due,plus your ttorney's fees and costs to collect and enforce this Contract. r Signature X:, J Y�i ' Q i ,j �J pate4-,-Il ! f1 - Customer has read and understood the X l_ /, ,CATION: 174 Johnson St N. Andover, IIIA 0185 2=77""7777 ! j � ! li i 'A i I l,✓e 6�`"9 2�f jga N AX �1 I =- 7, s ,x,•F °� >e. �. O I LABELS: A:direction of floor joist. SPECIFICATIONS: CONTRACTOR WILL: CUSTOMER WILL: ADDITIONAL NOTES: 1.Contractor will raise structure and relocate over raa footings,install 8'block foundation walls with 1 entry door.Seal foundation,backfill and grade for proper drainage,rough grade and seed work area.Contractor is responsible for permit.Contractor will install windows if required at no extra cost. CERTIFICATE OF LIABILITY INSURANCEDATE(MM/DDIYM) -./12/12 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTORDED BY THE POLICIES HOLDER THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFF BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE I RDED , AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. ISSUING (S) 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). PRODUCER CONT T NAME M.P. Roberts Insurance Agency PHONE 1060 Osgood Street IAIC N • (9 8) 683-8073 �x No, (978) 683-3147 North Andover, MA 01845 ADDRESS: INSURE S AFFORDING COVERAGE NAIC# INSURER A:NATIONAL FIRE & MARINE INS.CO. INSURED INSURER 8:Zurich FOUNDATION SWORKS OF INSURER C:Merchants Mutual Insurance Co NEW HAMPSHIRE, LLCLLC 238 MAIN STREET INSURER DINSURER E: PLAISTOW, NH 03865 INSURER F: COVERAGES CERTIFICATE NUMBER: 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 WrrH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF-SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. !DML SUBR -�---- ---- POLIC`!EFF "POLICY EXP " LTR TYPE OF INSURANCE 1 POLICY NUMBER MIDDIY MM/DDYYYY� -— LIMITS — -- — A GENERALLIABILITY (72LPS015250 3/18/121 3/18/13 EACH OCCURRENCE $ 1 CDD DDC X COMMERCIAL GENERAL LIABILITY ! DAMAGECTOU Un NEO REM le, Is 100,000 CLAIMS-MADE Fx_1 OCCUR MED EXP(Anyone person) 1$ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 1,0 0 000 GENT AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OPAGG 1$ 2,000,000 POLICY PRCT F7 O_ LOC I$ •C AUTOMOBILELIABIUTY CAPI056726 11/2/11 11/2/12 COf 'N'd.D�SINGLELIMIT $ 1,000,000 r ANYAUTO BODILY INJURY(Per person) S ALLOWNED SCHEDULED AUTOS X AUTOS BODILY INJURY(Per accident) $ X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE AUTOS I Peraccident $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE Is EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ I Is B WORKERS COMPENSATION WC04766848 5/23/12 5/23/13 WC STATU- OTH-1 AND EMPLOYERS'LIABILITY YIN ANY PROPRIEMR/PARTNERIEXECUTIVE E.L.EACHACGOEM $ 500 000 OFFICERIMEMBER EXCLUDED? N/A (Mandatory in H sdcribe under aE.L.DISEASE.EA EMPLOYEE $ 500,000 e, under OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of North Andover ACCORDANCE WITH THE POLICY PROVISIONS. 1600 Osgood Street AUTHORIZED REPRESENTATIVE North Andover, MA 01845 I ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD Phone: Fax: E-Mail: The Commonwealth of Massachusetts —� Department of Industrial Accidents Office of Investigations 1 Congress Street, Suite 100 Boston,MA 02114-2017 www.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers ApIRUcant Information Please Print Legibly Name(Business/Organization/Individual): �Y''L- n, ■1 1. ,� �' �t4- / Address: 239 Ci /State/Zip: P/.s r",- y./ o3?4 5" Phone#: 6'03- Are you an employer?Check the appropriate box: Type of project(required): 1.® I am a employer with //✓� 4. 1 am a general contractor and 1 6. [❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g. Demolition working for me in any capacity. employees and have workers' insurance.$ 9. ❑Building addition comp.[No workers' comp.insurance P• required.] 5. [] We are a corporation and its 10.0 Electrical repairs or additions 3.0 I am a homeowner doing all work officers have exercised their 11.[]Plumbing repairs or additions myself [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.®Other,Ne c✓ �°ods comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: /YI/° A 0 6&ArS �il.Sv A Q/J c e q G e,,7 c. )/ Policy#or Self-ins.Lic.#: (f✓C a y 74 62' /,F Expiration Date: J_=-23-13 Job Site Address:—,/731 Jo/,n,S'oA .f'T. City/State/Zip:/'V.q�deve ��. 0/XY,.4" 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. I do hereby certify under the ains and eenaftks o er'uy that thein ormation provided above is true and correct Si Date nature: -- /-7 Phone#: Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#• Required Contract Terms Page 1 of 2 The Official Website of the Office of Consumer Affairs&Business Regulation(OCABR) Mass.Gov Consumer Affairs and Business Regulation Home>Consumer>Home Improvement Contracting> ... ....... ............................................................................................................................................................................................................. ................. Required Contract Terms ''�Contracts-all contracts over$1,000(One Thousand Dollars)must be in writing. NEWS&UPDATES The law requires the following FOURTEEN items to be included in any contract between a homeowner and a registered home improvement contractor for home improvement work subject to MGL c.142A: OCA Survey Finds One in Five Home Improvement Contractor 1. The complete agreement between the contractor and the owner and a clear description of any other documents Advertisements Placed by which are part of the agreement. Unregistered Entity 2. The full names,federal I.D.number(if applicable),addresses(NOT P.O.Box numbers),of the parties,the More... contractors registration number,the name(s)of the salesperson(s)in volved if an and the y date the contract was Subscribe Lean more executed by the parties. ' 3. The date on which the work is scheduled to begin and the date the work is scheduled to be substantially completed. . RELATED LINKS 4. A detailed description of the work to be done and the materials to be used. " Yon Gid Konsomate 5. The total amount agreed to be paid for the work to be performed under the contract Massachusetts you Reparasyon 6. A time schedule of payments to be made under the contract and the amount of each payment stated in dollars, nan Kay -including any finance charges.Any deposit required to be paid in advance of the start of the work SHALL NOT 0"0 G 0❑❑f]G 0 G❑❑0 exceed one-third of the total contract price or the actual cost of any material or equipment of a special order or custom made nature,which must be ordered in advance of the start of the work to assure that the project will proceed on Guia para el Consumidor de Massach schedule. No final payment shall be demanded until the contract is completed to the satisfaction of all parties. e]Hooarusetts para Mejoras en 7. All parties must sign the contract. Gufa para el Consumidor de 8. A clear and conspicuous notice stating: ! Massachusetts para Mejoras en a.That all home improvement contractors and subcontractors shall be registered and that any inquiries about a el Hogar contractor or subcontractor relating to a registration should be directed to: i Office of Consumer Affairs and Business Regulation Ten Park Plaza,Suite 5170 Boston,MA 02116 Phone:(617)973-8700 b.The contractor's registration number must be on the first page of the contract. c.The homeowner's three day cancellation rights under MGL c 93 s 48; MGL c 140D s 10 or MGL c 255D s 14 as may be applicable. d.All warranties on the owner's rights under the provisions of and MGL c.142A. e.In ten point bold type or larger,directly above the space provided for the signature,the following statement: DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. f. Whether any lien or security interest is on the residence as a consequence of the contract. 9. An enumeration of such other matters upon which the owner and contractor may lawfully agree. 10. Any other provisions otherwise required by the applicable laws of the Commonwealth. 11. Permit Notice:Every contract shall contain a clause informing the owner of the following: a.any and all necessary construction-related permits; b.that it shall be the obligation of the contractor to obtain such permits. c.that owners who secure their own construction-related permits or deal with unregistered contractors shall be excluded from access to the Guarantee Fund. Massachusetts Home Improvement Sample Contract This form satisfies all basic requirements of the s'tate'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 Name Company Name /7'Y �n/id:Sci'I .S'T iso 6�/I�G;t fics� _S�Pj�rRT,f�e i2FCS" ®�` /p//l 44 C Street Address(do not use a Post Office Box address) Contractor/Salesperson/Owner Name -z37' -Iff%,7 .$-7- City/Town State Zip Code Business Address(mast include a street address) %77-697 c746-2? D'aytimePhonc BveningPhonc City/Town State Zip Code Ce-3 372 41e y.y- Mailing Address at different from above) Business PhoneFederal Employer M or S.S.Number Law requires that most home Home improvementcontmctorReg:Number Expiration date . improvement contractors have a vnlid registrntion number The Contractor agrees to do the following work for the Homeowner: f6 (Describe in detail the worlcto completed,specifying the type,brand,and grade of materials to be used,use additional sheets if necessary.) ..z'�,rTQi� /leer ��' .t�'/ac� ,�C�•rr��:7;c,, �� Required Permits-The following building permits are r'equired 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 t . y the contractor's control arise (Owners who secure their owls permits will be excluded from the Guaranty Fund provisions of �/S�� Date when contractor will begin contracted work. MGL chapter 142A.) fa S—,2 Date when contracted work will be substantially completed. Total Contract Price and Payment Schedule The Contractor agrees to perform the work,£urnishthe material and labor specified above for the total sum of: /7 Bao i Payments will be made according to the following schedule: S3�e upon signing contract(not to exceed 1/3 of the total contract price or the cost of special order items,whichever is greater) by / / or upon completion of $ by / / or upon completion of upon completion of the contract. (Law forbids demanding full payment until contract is completed to both party's satisfaction) . The followingmaterial/equipment must be special $ to be paid for ordered before the contracted work begins in order to meet the completion schedule.(121) $ to be paid for NOTES;(*)Including all finance charges('i"i')Law requires that any deposit or down-payment p yment 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 must be special ordered in advance to meet the completion schedule. Express Warranty-is an express warranty being provided by the contractor ? ❑No Yes(all 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 anthird party/subcontractor utilized by the contractor. The contractor further agrees to be solely responsible for all a y materials and labor un p payments to all subcontractors der this a gement tractors for Contract Acceptance-Upon signing,this document becomes a binding contract under law. Unless otherwise contract shall not' se noted within imply that any lien or other sec thin this document,the unity interest has been placed on the residence. Review the following cautions and notices carefully before signing this contract. o Don`t be pressured into signing the contract.Take time to read and fully understand it. Ask questions if something is unclear, o Malce sure the contractor has a valid Home Im rovement Contractor Re istration. The law requires most home improvement contractors and subcontractors to be registered with the Director ofHome 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 aslc to see a copy of a"proof of insurance"document. o 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 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'SZGN TMS CONTRACT IF THERE ARE ANy ELAM<SJPACESM Two identical copies of the contract must be completed and signed. One copy should go to the Homeowner. The other copy shotdd be kept by the contractor. om wner's Signature _'� d e A Contractorignature 'Date' Date Required Contract Terms Page 2 of 2 12. Acceleration of payment: No contract shall contain an acceleration clause under which any part or all of the balance not yet due maybe declared due and payable because the holder deems himself to be insecure. However, where the contractor deems himself to be insecure he may require as a prerequisite to continuing said work that the balance of funds due under the contract,which are in possession of the owner,shall be placed in a joint escrow account requiring the signatures of the home improvement contractor and the owner for withdrawal. 13. No work shall begin prior to the signing of the contract and transmittal to the owner of a copy of such contract. 14. Arbitration: If the contractor determines that in the event of a dispute,the contractor wishes the dispute to be settled by arbitration,this fact must be signified on the contract and both the contractor and owner shall sign this clause separately. The following format is acceptable(in 10 point type or larger); "The contractor andthe homeowner hereby mutually agree in advance that in the event that the contractor has a dispute concerning this contract,the contractor may submit such dispute to a private arbitration service which has been approved by the Office of Consumer Affairs and Business Regulation and the consumer shall be required to submit to h arbitration as provided j CL c I92A. Owner: l�C/ Contractor:— NOTICE: The signatures of the parties above apply only to the agreement of theparties to alternate dispute resolution initiated by the contractor. The owner may initiate alternative dispute resolution even where this section is Lot si ed separately by the parties." ©2011 Commonwealth of Massachusetts r Contractor Arbitration The Home Impiovement 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 Elm which has been approved by the Secretary of the Executive Office of Consumer Affairs and Business Regulation and the consumer shall be required to sub 't to such arbitration s provided-In/Massachusetts General Laws,chapter 142A.. Ho eowner's Signature Con actor's Signature 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 worlonanship or materials. In addition to guarantees or warranties provided by the contractor, all goods sold-in Massachusetts tarty 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 Lentil 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 Wormation .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 11t ://v v.mass.gov/oc,-Lbl•/ 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 HLC website at lim://www..tnass.gov/oclbr/ Go online to view the status of a Home Improvement Contractor's Registration: hair.//db.state.ma.us/llomeimproveir.i ent/l icenseelist.m 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