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Building Permit #790-12 - 185 BRIDGES LANE 5/2/2012
TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: 7�0—I L Date Issued: // z IMPORTANT: Date Received 5- a •„1.01 L must complete all items on this c -s 9 AJ )y 0. p Print PROPERTY OWNER R. Print MAP NO �O� PPARCEL:�/D j 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 CtOne family ❑ Addition ❑ Two or more family ❑ Industrial ❑ Alteration No. of units: ❑ Commercial P� Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ' ®'Se tick ®Well Floodplam 0 W 3• i p ti" *+c_ tg ri®i „ "i is s etlands - x a E atershed�Di'stnct:' ®,,Wafer/Sewer ;. DESCRIPTION OF WORK TO BE PERFORMED: A 414 le. - I,,00w, asi- F.4, V&-;vtE'e1fp i2.ovF A-,glcr A+11e)u Cf ,LeaF 6" - +hFtwo Jox1g )-o put_(.,40L.Jk) S�aInwEU- (Identification Please Type or Print Clearly) OWNER: Name: a �1ZR-y ►13 u p_6 K Phone Y,??, 605 FY -;V. Address: 18S 9rz1d es, 0, N ouc>tO1Yy6' CONTRACTOR Name: d X912 Pis V (a Phone:' 5 ) t 0C - 5) 9 Address: r y g5�, I Y� d 0 U ��t, fi14- Ol 1 0 Supervisor's Construction License: D S Exp. Date: Home Improvement License: 10,E 7, Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE. BULDING PERMIT. $12.00 PER $9000.00 OF THE TOTAL ESTIMATED COST BASED ON $925.00 PER S.F. s Total Project Coat: $ 3aoS* FEE: $ 3� Check No.:_ Receipt No.: NTE: er ons contracting with unregistered contractors do not have access to the guaranty fund Sgnature,o Agent/Cr- _- , , vSipnafure of contractor =: Location �5 ��� C�G' Fs No. � 0 _ � 2 Date Check #/ 25255 TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ � ,DD Foundation Permit Fee $ Other Permit Fee $ TOTAL $ 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 e 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: Conservation Decision: Comments Comments Water & Sewer Connection/Signature Date Driveway Permit DPW Town Engineer: Signature: `Located 384 Osgood Street FIRE DEPARTMENT --Temp Dumpster on site yes no �L eated at 124 Main Street " 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 Doc:.Building Permit Revised 2011 June/mi 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 ❑ Photo Copy of H.I.C. And/Or C.S.L. Licenses o 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 Perr Addition or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses o Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler- Plan And Hydraulic Calculations (If Applicable) o 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) o Building Permit Application o Certified Proposed Plot Plan o 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: Doc.Building Permit Revised 2008mi m m m m y m mm C2 y .O C � a � CA Cl) 10. O CD n Z CL O 0. r c as c O y � o � CD CDCL O c� CD CDo C CD y. CD CZ O CO) OO CO CD CO) 1 Z O O O � CD o O CCD I C W..&= = - m O sc=p Q N 2 EL O CO) ® n m C7 O y ci a n m z =r= N o: CD -yo' T =r m m ... -o �mm m a J -CA p p p p 0 C p vs C-3 o sy� ca oa •.....: m m �*0 m p O �..�.yy a C, dCD CO) C yC Q CL: CL' CA to r^ � m r o V, y W d NCD cm C'1 •\ :� C.) 0 R o CO)CD 3`�'� oma. Cn = ED ca CD o �• cn m Co a'n na p �; C o o ~" E3o d 9 .. :' N fD F o �' o 5 w o x CD o Q o m a1CL o O Z 0 0 O C CD ' le, Office of Consumer Affairs and Business ReguMon 10 Park PIM - Suite 5170 Boston, Massachusetts 02116 Home 1mprovement Con=cuw Registration POLAR BEAR INSULATION CO. Vincent LeBlanc P.O. BOX 958 ANDOVER, MA 01810 Req' hftarr 102M . m TYPW- DBA E*ra1WX 7MM12 TM 298M Update Address and return card. Mark reawn for change. Address Reawal Employment —Lost Curd License orroman vaildfor-indiddid we HOME IMPROVENUNT CONTRACMR before the exVirafign date: If Mmd return 1w P aessswitim 102726 Type: Office of Consumer baud BugmessRe gulafton Snphsfi= 71MID12 DBA 10 Park.Phaa - Suite, -55170 Boston, HA 02116 BF -AR MIAA-170N CO- Wment LAEL-MG 51 $0. CANAL ST.45A LAWRENM MA 01841 Unduseeretam 99352 R*sfrictecf tL' -- WSt 3 VINCEly*`.LEBLAN& 24 LAND143LDRIVE ETH UEN; MA 01844 men .Expiration, I 1�0 1.2. Xmvad without —S SL 105924 OP ID: SS ACVR©� CERTIFICATE OF LIABILITY INSURANCE DATE (MMmDIYYYYj 031126112 'fHISFCERTIFICATE 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 pollcy(les) must be endorsed. if SUBROGATION IS WAIVED, sWed 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 978-688-7000 Durso A Jankowski Ins Agcy LLC - g78 -688-70Q1 198 Massachusetts Avenue North Andover, NIA 01845 Charles S. Randone NAME Moles Fax No No: E-MAIL ADDRE DUCE CUSTOMERID & POLAR4 MU AFFORDING COVERAGE NAIL 0 INSURED Polar Bear Insulation Co. Inc. P O Box 958 Andover, MA 01810 INSURERA:Penn America 32859 INSURER Insurance Co. 33618 INSIuuRC:Guard insurance Group INSURER D : INSURER E : 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 WITH 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 MAYHAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ALIM bUB14 POLICY NUMBER POLICY EFF POLICY EXP MIDO LONffS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY FV --1 CLAIMS -MADE PAC69Q6.385 03124/12 03/24113 PREMISES E,=- MED EXP(Any one person) $ 5,0 PERSONAL & ADV INJURY $ 1,000,0 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE UMIT APPLIES PER: PRODUCTS- COMPIOP AGG $ 1,000,00 POLICY PRO- LOC $ B AUTOMOBILE LIABdrrY ANY AUTO 2100926 01/04112 01/04113 COMBINED SINGLE LIMIT $ 1,000,00 (Ea accident) BODILY INJURY (Per person) $ ALL OWNEDAUTOS X SCHEDULED AUTOS X HIREDAUTOS BODILY INJURY (Per accident) S PROPERTY DAMAGE (Peraccident) $ X NO"WNED AUTOS $ UMBRELLA UAB X OCCUR EACH OCCURRENCE $ 1,000,00 A EXCESS LIAB CLAIMS -MADE PAC6906385 03/24/12 03124113 AGGREGATE $ DEDUCTIBLE $ $ RETENTION $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNB D(E&MVE Y t N OFRCER/Iv1FMBER EXCLUDED? El (Mandatory in NH) N I A POWCW2037 01101112 01/01/13 X jQRY LIMITS ER Et. EACH ACCIDENT $ 1,000,00 EL DISEASE- EA EMPLOYEE $ 1,00%ow If yas, describe under DESCRIPTION OF OPERATIONS below El_ DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) Insulation Work - Mineral CSG, NSTAR and National Grid are additional on General Liability policy CFRTIRCATF HOLDER r_amr:F1 I Amour ©1988-2009 ACORD CORPORATION. All rights reserved ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CSG National Grid Nsfar THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Clocsg 400 Washington St Ste 2000 Westborough, MA 015W4 AUrHORIZEDREPMENTArnE _Pa_ n_ ©1988-2009 ACORD CORPORATION. All rights reserved ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD The Commonwealth of Massachusetts Dcpat7ntettt of lndttstrial Accidents Office of Investigations 600 6Vashingtolt Street Boston, MA 02111 )vmv.ntass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Annlieant Information Please Print Legibly Name (Business/Organization/Individual): l ol,/.l-i 0' 4K)S, y Lk I K Co. tm.. Address: O Qo' 1 SI So CA&jALS fi lya-uvre.twcc, 1w4- City/State/Zip: CA�lu Phorle Are you an employer? Check the -appropriate box: 1. ❑ I am demployer with 4. ❑ I am a general contractor and I employees (full aridlor part-time).* have hired the sub -contractors listed on the attached sheet. t 2. LJI am a sole proprietor or partner-. ship and have no employees working for me in any capacity. [No workers' comp. insurance required.] 3. ❑ I am a homeowner doing all work myself. [No workers' comp. insurance required.] t These sub -contractors have workers' comp. insurance. We are a corporation and its officers have exercised their right of exemption per MGL c. 152, § 1(4), and we have no employees. [No workers' comp. insurance required.] Type of project (required): 6. ❑ New construction ?. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition .10. [:]'Electrical repairs or additions 11.❑ Plumbing repairs or additions 12.❑ Roof repairs l 13.[. Othe,49L XZQL fa im 'Any applicant that checks box # 1 must also Gtl 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 meet showing the nae or sub -contractors and their workers' comm p, policy inforation. tContraclors that check this box must attached an additional sh jam an employer that is providing workers' conrpensation insurance for ►ny employees. Beloit, is the policy artd,job site irrforrttation. /- Insurance Company Name: G� Policy # or Self-ius. Lic. #: Vows— Expiration Date: A013 Job Site Address: SSS 1L1 d fiN i0 A. Uc� City/State/Zip: Of 9 YS 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 e. 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 feilify under the pains and penalties of pe►ju>T that the information provided above is true and correct PhnnP#• 920 �0?— W I s -,� .a nl z Oficial use only. Do riot write in this area, to be completed by city or toren official. City or Town: Issuing Authority (circle one): 1. Board of Health 2. Building Department 6. _Other Contact Person:_ Perrnit/License # Cityrrbwn Clerk 4. Electrical Inspector 5,Plumbingluspector Phone #: Conser ation Services Group 50 Washington St. Suite 3000 Westborough, MA 01581 CONTRACTOR WORK ORDEF Printed: 3/27/2012 Work Order id: S29324P32287C238 - .. _.__...<-... _ . anon.:...... .... ..�._�..._..-...�..: __,_ _ _ - �n .:�usto erl it D. .:.__ _ -- _ - Polar Bear Insulation Barry Burbank Phone (Eve): 978.685-9836 PO Box 958 Description 185 Bridges Ln Phone (Day): 508-574-6547 Andover, MA 01810 North Andover, MA 01845-2220 Site ID: 500002029324 __. ... .. .._. _... , __. Ono - _.:.._;..... �..... _._..:.._:--.-.,__....................:�;.....�.�....s-'.2 _.. _._-_._ ._.. r........ _ _ _ .. _. ,.... _. Location Description Quantity Unit $ Total Damming 24 $1.77 $42.48 Attic Propavent Z or 4` 108 $3.44 $371.52 Attic Vent bath fan to roof flapper 2 $116.10 $232.20 Living Space Therma-Dome (R19) with carpentry (Attic) 1 $209.63 $209.63 Living Space Whole House Fan Box: Polyisocyanurate 2' (At 1 $45.00 $45.00 Living Space Attic Floor Open Blow Cellulose 6' 1,232 $1.26 $1,552.32 Living Space Perform Air Sealing at Estimated 62.5 CFM50 10 $75.25 $752.50 Installed Measures Total $3,205.65 ,_- aypient Incentive Payments Customer Share Air Sealing incentive Weatherization Incentive Total Incentive Payments Total Customer Share Less Deposit Of Customer Share Balance (Due Contractor) $1,007.13 $1,648.89 $2,656.02 $549.63 $183.21 $366.42 Conservation Services Group - 50 Washington Street Suite 3000 -Westborough, MA 01581 - (508) 836-9500 (NG Conser atlon Services Group F5L771� 9e�vA national grid 2 2Q THE POWER OF ACTION L This service is brought to you through support from your local utility This Agreement is made by and among Barry Burbank 185 Bridges Ln North Andover, MA 01845-2220 Customer ID: C00000039338 Contract ID: 20111129 Site ID: S00002029324 and. Conservation Services Group (CSG) 50 Washuigton Street, Stdte 3000 Westborough, MA 01581 Reg. No. 120837 Federal ID No. 222457170 I. DESCRIPTION OF WORK TO BE PERFORMED Contractor willperforin or cause to be performed the folloWing Avork on these "Premises" in a professional manner and in accordance with the terms of this Contract, including the attached reconwlendalionshvork order describing the work in detail (the "Work) which are incorporated herein by reference: Description Vent bath fan to roof flapper P_r_opavent 2' or 4' _Damming Attic Floor Open Blow Cellulose 6" Quantity 2 ---- -- _ 108 24 1.232 -- Location Attic - - -- - $232.20 — _Attic- - — - --- - - - — --- $371.52 NIA $42.48_ L""raring 31,552.32 _ Sub Total: $2,188.52 Energy Efficiency Incentive $1,648.89 Net Sales Tax After Incentive $0.00 Total $549.63 1. CUSTOMER affirms that they have received no incentives during the past 12 months. Initial here 2. The incentive is dependent upon the package purchased and/or prior incentive utilization. Cl=ges to r d al line items andior previous incentives may Increase or decrease the size of the incentive. ��' / �j 3. CUSTOMER affirms that their electric provider is National Grid Electric. Initial here_,g� k,9 �j_ Printed: 11/29/2011 Page 1 of 1 II. PAYMENT Customer agrees to ntrac or for the Work, the Customer Share of the Contract Price as follows: PaNmtent #1: $ .ell as a Deposit payable to CSG upon signing the Contract. (not to exceed 1/3 of tine total retail costs or actual costs of special orders, Whichever is greater). Final Payment. $,,�(� � �e3 as the final payment for the Work shall be due and payable to the Independent Installation Contractor ("I1C") upon satisfactory completion of the Rork. Customer understands that he/she Mill not be required to pay the Utility incentive Share of the Contract price in the annotut_ of. � 9 '17ne Utility incentive Share is dependent upon the package purchased and/or prior incentive utilization. Changes to individual line itenns :and/or previous incentives may increase or decrease the size of tine Utility Incentive. Share. You may cancel this agreement if it has been signed by a party there to at a place other than an address of the seller; which may be his main office or a branch there of, provided you notify the seller in writing at his main office or branch 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. DO T SI N IS ONR I HERE ARE ANY BLANK SPACES. C� omer n ntots) . ue Date hndicat u• s 6 IIC here, if applicable initial here if Cott nt49tnt the Program to assign a Participating Contractor CSC Signahr Date Name of CSG Representative (Printed) _---S IM011 Terms and Conditions appear oil the reverse I V ^' Ill. ASSIGNMENT OF CONTRACT BY CSG Customer acknowledges that CSG will, and Customer hereby requests that CSG, assign this Contract to a specific iiC to undertake the Work on the terms set forth In the Contract. Before such assignment, the term "Contractor" refers to CSG. After such assignment, (a) the term "Contractor" refers to the IIC that assumes the Contract, (b) Customer shall provide CSG with such information regarding Contractor's performance as CSG may reasonably request and access to CSG at a reasonable time and permit CSG to inspect Contractor's work, (c) Customer shall have no recourse against CSG for any of the performance, non-performance or deficient performance of the contract obligations on the part of the IIC, and (d) Customer and the IIC agree to notify CSG of any dispute between them concerning the Contract to provide CSG with such information regarding the dispute as CSG may reasonably request and to consent to CSG's participation, at its sole election, in any arbitration or other dispute resolution proceeding. IV. LIMITED TIME OFFER The terms, prices, and incentive offered in this Contract are valid for only 30 days from the date of CSG presentation to the Customer if this contract has not been executed by the Customer. V. COMMENCEMENT AND COMPLETION IIC will not begin the Work or order the materials before the sixth day after the signing of this Contract by CSG and Customer, whichever signs later. Subjectto the availability of subcontractors/materials and to delays attributable to the weather or "acts of God", the Work will begin as soon as practical after Customer and CSG have both signed this contract and be substantially completed no later than 60 days after that date, barring delay caused by circumstances beyond Contractors control. Contractor reserves the right to advise the Customer of changes in the projected start and completion dates, based upon availability of materials and subcontractors. Upon completion of the Work, IIC will leave the Premises in a neat and orderly condition but shall not be responsible to correct conditions outside the scope of its Work. Vi. MODIFICATION This Contract cannot be changed except by a writing signed by CSG and the Customer. VII. PERMITS Contractor believes that the following permits may be required for this project depending upon the judgment of local inspectors: Electrical, Plumbing/Gas, Mechanical, Building. Contractor certifies that IiC and any subcontractor IIC uses for the Work will obtain any and all necessary work-related permits. Contractor shall inform the Customer of the permits required and any customer co -pay or cost of the required permit acquisitions. If Customer chooses to secure her/his own work-related permits, and/or deal with an unregistered contractor, Customer will be excluded from the Guaranty Fund provisions of M.G.L. c. 142A. VIII. LIMITATION OF LIABILITY Customer acknowledges and agrees that to the fullest extent permitted under Massachusetts law, the sole liability and responsibility of Contractor for any damage or loss will be limited to the purchase price paid by Customer. IX. CUSTOMER'S DUTY Customer must prepare the Premises for the Work. Objects which obstruct areas of Work must be moved before the Work is to commence or Customer may be charged and agrees to pay the cost, time and labor incurred in moving such objects. Customer affirms that they have received no incentives (from the above-named Utility) during the last calendar year. X. NOTICE CONCERNING SPONSORSHIP Customer understands and acknowledges that the IIC is not an agent, vendor or sub -vendor of the Utility with respect to the installation of any energy efficiency measures. In the event of the failure of any energy conservation device to perform as expected, Customer agrees that Customer's sole recourse is to the IIC and not to CSG or the Utility. The Utility and its operating companies shall not maintain, remove or perform any work whatsoever on the energy conservation measures installed. Customer understands and acknowledges that its participation in the Mass Save Home Energy Services Program is voluntary and that it has consented for Contractor to install the proposed energy conservation measures. Customer agrees that it shall not hold CSG, the Utility, their affiliates or operating companies liable for IIC's failure to perform its obligations under this agreement, for failure of the energy conservation measures to function, for any damage to Customer's Premises caused by the IIC or for any and all damages to property or Injury to persons caused by the energy conservation measures. XI. ENERGY BENEFITS The local sponsoring Utility is entitled to 100% of the energy benefits associated with all Energy Conservation Measures, excluding the value of energy cost savings by the Customer, but including all rights to all associated ISO -NE Energy, Capacity and Reserves Products, and the Contractor agrees to provide the Utility with such further documentation as the Utility may request to confirm the Utility's ownership of such benefits and Products. XII. NOTICE 1. All contractors and subcontractors must be registered by the director and any inquiries about a contractor or subcontractor relating to a registration should be directed to. Office of Consumer Affairs and Business Regulation, Home Improvement Contractor Registration, 10 Park Plaza, Room 5170, Boston, Massachusetts 02116, 617-973-8700. 2. Contractor warrants as follows: A. Materials and workmanship will meet or exceed the specifications in CSG's Materials and Installation Standards. B. The Work and the materials furnished by the IIC will conform to the requirements of this Contract. if there be a defect in workmanship or materials, or any damage caused by its subcontractors or employees is discovered within one year after completion of the Work (including cleanup), the IIC will, at its own expense, at its option, remedy, repair, correct, replace, or cause to be remedied, repaired, corrected or replaced such defect or damage. 3. Customer has the following rights under Mass. G.L. c. 142A: A. At the time of signing this Contract, the Customer shall be furnished with a copy of it. No Work shall begin prior to the signing of this Contract. B. Any party may bring an action to enforce any provisions of Mass. G.L. c. 142A. or to seek damages or the Customer may request that a dispute be decided under the terms of a private arbitration program approved by the Secretary of the Executive Office of Consumer Affairs and Business Regulations. C. Customer may have the right to be compensated from the Residential Contractor's Guaranty Fund for actual losses Incurred as a result of a registered contractor's or subcontractor's conduct found by a court to be work performed in a poor or unworkmanlike manner or which violates certain laws for the protection of consumers within 6 months after the Customer has obtained a judgment or arbitration award and has exhausted customary reasonable efforts to collect the judgment or award. D. IIC reserves its right, under Massachusetts law, to file a notice of contract, and to take all other steps provided by statute to perfect and to enforce by lawsuit a mechanic's and/or supplier's lien if the Customer falls to make payment as provide herein. XIII. MISCELLANEOUS Contractor and Customer hereby mutually agree in advance that in the event that Contractor has a dispute concerning this Contract Contractor may submit such dispute to a private arbitration service which has been approved by the Office of Consumer Affairs and Business Regulation and Customer shall be required to submit to such arbitration as provided in M.G.L. c 142A. Customer. Contracte rr: NOTICE: The signatures of the parties above apply only to the agreement of the parties to alternate dispute resolution initiated by the Contractor. The Customer may initiate alternative dispute resolution even where this section is not signed separately by the parties. Conner ation Services Group This service is broui This Agreement is made by and among Barry Burbank 185 Bridges Ln North Andover, MA 01845-2220 Contract ID: 20111129 ASEAL nationalgrid THE POWER OF ACTION ro you through support from your local utility Conservation Services Group (CSG) 50 Was1iington Street, Suite 3000 Westborough, MA 01581 Reg. No. 120837 Federal ID No. 222457170 I. DESCRIPTION OF WORK TO BE PERFORMED Contractor will perforin or cause to be performed the following work on these "Premises' in a professional manner and in accordance with tine ternns of this Contract, hicludung the attached reconuiendatio»s/work order describing (lie work in detail (the "Work") which are incorporated herein by reference: Description Quantity Location Perforin Air Sealing at Estimated 62.5 CFM50 Per Hour 10 Cluing Space $752.50 Thera -Dome (R18) with carpentry_(Attic) 1 Living Space $208.63 Whole House Fan Box: Polyi_socyanurate 2' (Attic) 1 Living Space $45.00 Sub Total: $1,007.13 Energy Efficiency Incentive $1,,007.13 Net Sales Tax After Incentive $0.00 Total $0.00 1. CUSTOMER affirms that they have received no incentives during the past 12 months. Initial 2. The incentive Is dependent upon the package purchased and/or prior incentive util tie . Changes to rid ual line items and/or previous incentives may increase or decrease the size of the incentive. 3. CUSTOMER affirms that their electric provider is National Grid Electric. Initial her II. PAYMENT Customer agrees to pay C rf t r'Or the Work, the Customer Share of the Contract Price as follows: Payment #l: S as a Deposit payable to CSG upon signing the Contract. (not to exceed 113 of tine total retail costs or actual costs of special Ord tetter is greater). Fill. 'd Payment:- as the final payment for the Work shall be due and payable to the Independent Installation Contractor ("IIC") upon satisfactory completion of the Fork. /, Customer understands that lie/she aril) not be requiretl to pay the Utility hicentive Share of the Contract price in the amount of dD&7J J- The Utility Incentive Share is dependent upon the package. purchased and/or prior incentive utilizatioi . Changes to indiit dual Wie items and/or previous incentives may increase or decrease the size of the Utility incentive Share. You may cancel this agreement if it has been signed by a party there to at a place other than an address of the seller, which may be his main office or a branch there of, provided you notify the seller in writing at his main office or branch 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. DO NOT Slgtq THJ5 CONTAAf- F THERE ARE ANY BLANK SPACES. (Olt) initial here if you wvit the Program to assign a Participating Contractor III. ASSIGNMENT OF CONTRACT BY CSG Customer acknowledges that CSG will, and Customer hereby requests that CSG, assign this Contract to a specific IIC to undertake the Work on the terms set forth in the Contract. Before such assignment, the term "Contractor" refers to CSG. After such assignment, (a) the term "Contractor" refers to the IIC that assumes the Contract, (b) Customer shall provide C5G with such information regarding Contractor's performance as CSG may reasonably request and access to CSG at a reasonable time and permit CSG to inspect Contractor's work, (c) Customer shall have no recourse against CSG for any of the performance, non-performance or deficient performance of the contract obligations on the part of the IIC, and (d) Customer and the IiC agree to notify CSG of any dispute between them concerning the Contract, to provide CSG with such information regarding the dispute as CSG may reasonably request and to consent to CSG's participation, at its sole election, in any arbitration or other dispute resolution proceeding. IV. LIMITED TIME OFFER The terms, prices, and incentive offered in this Contract are valid for only 30 days from the date of CSG presentation to the Customer if this contract has not been executed by the Customer. V. COMMENCEMENT AND COMPLETION iIC will not begin the Work or order the materials before the sixth day after the signing of this Contract by CSG and Customer, whichever signs later. Subject to the availability of subcontractorslmaterials and to delays attributable to the weather or "acts of God", the Work will begin as soon as practical after Customer and CSG have both signed this contract and be substantially completed no later than 60 days after that date, barring delay caused by circumstances beyond Contractors control. Contractor reserves the right to advise the Customer of changes in the projected start and completion dates, based upon availability of materials and subcontractors. Upon completion of the Work, IIC will leave the Premises in a neat and orderly condition but shall not be responsible to correct conditions outside the scope of its Work. V). MODIFICATION This Contract cannot be changed except by a writing signed by CSG and the Customer. VII. PERMITS Contractor believes that the following permits may be required for this project depending upon the judgment of local inspectors: Electrical, Plumbing/Gas, Mechanical, Building. Contractor certifies that IIC and any subcontractor IIC uses for the Work will obtain any and all necessary work-related permits. Contractor shall inform the Customer of the permits required and any customer co -pay or cost of the required permit acquisitions. If Customer chooses to secure her/his own work-related permits, and/or deal with an unregistered contractor, Customer will be excluded from the Guaranty Fund provisions of M.G.L. c. 142A. Vill. LIMITATION OF LIABILITY Customer acknowledges and agrees that to the fullest extent permitted under Massachusetts law, the sole liability and responsibility of Contractor for any damage or loss will be limited to the purchase price paid by Customer. IX. CUSTOMER'S DUTY Customer must prepare the Premises for the Work. Objects which obstruct areas of Work must be moved before the Work is to commence or Customer may be charged and agrees to pay the cost, time and labor incurred in moving such objects. Customer affirms that they have received no incentives (from the above-named Utility) during the last calendar year. X. NOTICE CONCERNING SPONSORSHIP Customer understands and acknowledges that the IIC is not an agent vendor or sub -vendor of the Utility with respect to the installation of any energy efficiency measures. In the event of the failure of any energy conservation device to perform as expected, Customer agrees that Customer's sole recourse is to the IIC and not to CSG or the Utility. The Utility and Its operating companies shall not maintain, remove or perform any work whatsoever on the energy conservation measures installed. Customer understands and acknowledges that its participation in the Mass Save Home Energy Services Program is voluntary and that it has consented for Contractor to install the proposed energy conservation measures. Customer agrees that it shall not hold CSG, the Utility, their affiliates or operating companies liable for IlC's failure to perform its obligations under this agreement, for failure of the energy conservation measures to function, for any damage to Customer's Premises caused by the IiC or for any and all damages to property or injury to persons caused by the energy conservation measures. XI. ENERGY BENEFITS The local sponsoring Utility is entitled to 100% of the energy benefits associated with all Energy Conservation Measures, excluding the value of energy cost savings by the Customer, but including all rights to ail associated ISO -NE Energy, Capacity and Reserves Products, and the Contractor agrees to provide the Utility with such further documentation as the Utility may request to confirm the Utility's ownership of such benefits and Products. XII. NOTICE 1. All contractors and subcontractors must be registered by the director and any inquiries about a contractor or subcontractor relating to a registration should be directed to: Office of Consumer Affairs and Business Regulation, Home Improvement Contractor Registration, 10 Park Plaza, Room 5170, Boston, Massachusetts 02116, 617-973-8700. 2. Contractor warrants as follows: A. Materials and workmanship will meet or exceed the specifications in CSG's Materials and Installation Standards. B. The Work and the materials furnished by the IIC will conform to the requirements of this Contract. If there be a defect In workmanship or materials, or any damage caused by its subcontractors or employees Is discovered within one year after completion of the Work (including cleanup), the IiC will, at its own expense, at Its option, remedy, repair, correct, replace, or cause to be remedied, repaired, corrected or replaced such defect or damage. 3. Customer has the following rights under Mass. G.L. c. 142A: A. At the time of signing this Contract the Customer shall be furnished with a copy of it. No Work shall begin prior to the signing of this Contract. B. Any party may bring an action to enforce any provisions of Mass. G.L. c. 142A. or to seek damages or the Customer may request that a dispute be decided under the terms of a private arbitration program approved by the Secretary of the Executive Office of Consumer Affairs and Business Regulations. C. Customer may have the right to be compensated from the Residential Contractor's Guaranty Fund for actual losses Incurred as a result of a registered contractor's or subcontractor's conduct found by a court to be work performed in a poor or unworkmanlike manner or which violates certain laws for the protection of consumers within 6 months after the Customer has obtained a judgment or arbitration award and has exhausted customary reasonable efforts to collect the judgment or award. D. IIC reserves its right, under Massachusetts law, to file a notice of contract, and to take all other steps provided by statute to perfect and to enforce by lawsuit a mechanic's and/or supplier's lien If the Customer fails to make payment as provide herein. ' XIIL MISCELLANEOUS Contractor and Customer hereby mutually agree in advance that in the event that Contractor has a dispute concerning this Contract, Contractor may submit such dispute to a private arbitration service which has been approved by the Office of Consumer Affairs and Business Regulation and Customer shall be required to submit to such arbitration as provided in M.G.L. c 142A. Customer: i Contrac r: NOTICE: The signatures of the parties above apply only to the agreement of the parties to alternate dispute resolution iniiiated by the Contractor. The Customer may initiate alternative dispute resolution even where this section is not signed separately by the pprties.