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HomeMy WebLinkAboutBuilding Permit #205-14 - 20 BRIDGES LANE 9/5/2013 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit N0: i Date Received Date Issued: " IMPORTANT:Applicant must complete all items on this page 'vim '�' �e�' :�" *�"=R� � � UP ng P11 TYPE OF IMPROVEMENT PROPOSED USE Resicintial Non- Residential ❑ New Building Riiii family ❑Addition 0 Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other N d a ',"5"' 'v'° rF�'ls3.. x�+t ux+ac. ®���/�pttc C7i�Jll/ell F f loodp in ala ds � ate herd D stric .� ,r.. ��e. ', •,`'�. `h a..1•.;.>.r'kA«c.,.......:s_n .w sx r'n,... .;u, 'rq'.. '.�f& ..tkM #' w" £.r �. ....1 �• .;i, �'.as.�. '.w . y ,tt�.S._ . DESCRIPTION OF WORK TO BE PERFORMED: l�70 liw4 i Go*'►2Y �CI Q4 012 Identifica 'on Please Type or Print Clearly) _ OWNER: Name: nf0 Phone: Address: i �.Cft1� PI-16 IC5a c f a3 b �Fa, r �° a Oil � tV'i 'g" sir�"R+ '"``�. G �Y 3'i`"6'".+k i V.'+`$ 11 k'' F .. Z xa „; C®NTR�ACT®R Nam�e� y r, � Phon� � `° 'a '+ ' I � ��� � �1`nT a' 'ry:.;•5 ��� ':. G��, f 1� ��v`,C�it���Js'4�✓N Jt�+�"���ij o V^ `" ,ars+ — ' '.r � .'�t- '7' "'_MRS..<. EEO s� ha'i s g t - ' � u tea.. �Su e sons Cons icy ice se �_' ��� p ��, r � �EScp ate � � '�.A� -'�}L .�- �c.{5„�s��ik n�.�!x �e�� ��T"'� E.. .��."N�t:� .k t.��.�`"�• � .���aF.�ss '�v �: �• a�`+`�� � p � '” * ��-` '� '� � ��� ""� p-�•.�imp-e: �� �: ` r i�5�#;.� 't'�'' ARCHITECT/ENGINEER Phone: Address: Ref li FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ �`�`Lo, �n FEE: $ i Check No.: Receipt No.: ��Q NOTE: Persons con acting w' -unre ' ter contrnrtors do not have access to the guarantyf nd 4igr�'atureof ggent/OweSignat re o�corifracforY, ,;; __., s Plans Submitted ❑ Plans Waived Certified Plot Plan 11 Stamped Plans ❑ BUILDING PERMITNORTH Qf SSLED 16 AA. TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION 70 Date Received �,9"`ATEP Permit No#: q °q^reo►ePSg9 SSAC14US Date Issued: IMPORTANT:Applicant must complete all items on this page t Print is 1Pnnt r1YearStructure yes. tno PARCELDISTRICTHistoriclDistnct �yest "� ` kMachine Sho".pVillage. yes; tno } TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Sept c rWelld i ®F -Odd p9 Iain ❑i`Wetla ds ❑ WatFE D strict 1V1later//Sewer �-- _ DESCRIPTION OF WORK TO BE PERFORMED: Identification- Please Type or Print Clearly OWNER: Name: Phone: Address: Cont�,acton,N m .� iP_hone r -77 e ' f 7 .... �Addres�s . r. Supervisor sConsructio ,lLic. -� I4HorY a Imp V.e.menRNc-e,se< � � R � �ExpeDate� -� ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of AgeriJOwner _ _ _ Signature of contractor y ,: y :r Locatio 19(L,� CCA - No. Date 3 • - TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee 1 $ � -J Foundation Permit Fee $ Other Permit Fee $ ok�rrTOTAL $ Check#� , 2G8U; Building Inspector Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ .•TIrPE OF--,SEW-ERAGEDISPOSAL Public Sewer ❑ Tanning/MassageBodyArt El. . ..Sw'nun'ng 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- . DATEAPPR_OVED PLANNING & DEVELOPMENT ❑ COMMENTS .CONSERVATION Reviewed on Siqnature COMMENTS HEALTH Reviewed on Siqnature COMMENTS Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes . Planning Board Decision: Comments Conservation Decision: Comments Nater& Sewer Connection'/Signature&Date Driveway Permit DPW'Toes:Engineer: Signature: Located 384 Osgood Street FIRE DEP�4RTi191�=[VT -Temp Dumpster on site yes.. . no .Located at 124 Mair Street Fire Departnier�tsignatureidate` 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) ® Notified for pickup Call Email Date Time Contact Name Doc.Bniiding Pennit Revised 2014 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 a Workers Comp Affidavit o Photo Copy Of H.I.C. And/Or C.S.L. Licenses o Copy of Contract o Floor Plan Or Proposed Interior Work a Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks o Building Permit Application u Certified Surveyed Plot Plan ❑ Workers Comp Affidavit Li Photo Copy of H.I.C. And C.S.L. Licenses o Copy Of Contract o Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) a 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 ❑ 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) 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 Doc:Building Permit Revised 2014 NORTHTownof _ 0 , . , No. ® g5-- * - Q h ver, Mass, ) 12 coc"Ic"o WIC. V x.95 RArEo P-P�,�'C5 U BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System THIS CERTIFIES THAT ................. 4w.rA._...6. ............ BUILDING INSPECTOR has permission to erect.. ...... buildings on .. Foundation ..... ...... ..�1�........ Rough to be occupied as ......... .' I / ....... ��i......... *T-..w................................. Chimney provided that the person accepting 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 AgO PERMIT EXPIRES IN 6 THS ELECTRICAL INSPECTOR 0% PERMIT UNLESS CONSTRUCTI Rough Service .................... ... ....................................... .......... 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 'J nu Aug 19 ue: 30:oo [UJ..D YLOfeI. V1W11d1LU1I,ALUU.ILCY J.V. V.LWiWI r I&=yv + ..+ .- P11.,WML�„ vr.1% e 11 Iwrs I ` wI I..Irim III Ins I a IIVW%01 08/13/2013 / PRODUCER 978,887.4900 FAX 978.887.2404 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION r Edward F. Sennott Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 16 South Main Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P. 0. Box 457 Topsfield, MA 01983 _ _IIINSURERS AFFORDING COVERAGE NAIL# iNsuHEo Aqua Terra-Property Management, Inc. r�11' LR-R.a:_Acadia Insurance 31325 DBA Warn Traditions Stove Shoppe LR-RB Union Insurance Co. _ P 0 Box 4:081 Danvers, MA 01923 �INSLRERD: IIJSLR=R't: COVERAGES THE POLICIES OF IN:URANCE 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 IP SURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMSTNSR , LTR NS TYPE OF INSURANCE POLICYNLNBER DATE MIDD DATE MMlD-YPID 1 LIMITS GENERAL LIABILITY CPA033SS87 04/14/2013 04/14/2014 EACHOCCUFRENCE _ £ 1,000,00 �'JFNA�E�iTREIV�ELr X COMtv1E'RCIAL GENERAL-LABILITY PPEMISES(Ea occ�.;r-me) _�£ __ 100,000 CLAIMS MADE LX]OCCUR MEC EXP(Anv one pers7r) _LS___ 5,000 A PERSONAL&A77 NJLURY I£ 1,000,000 GFNERALAG.-,REGATE s 2,000,000 GEN"L AGGREGnTE LIMIT APPLIES PER PRODUCTS-COMP/OF AGG £ 2,000,000 � � PCLICY I JECryT _OC AUTOMOBILE LIABILITY MAA0335589-121 04/14/2013 04/14/2014 OL,fdB!1-1D;NGLELtWT £ AWAUTO (Ee accidanf �_ 1,000,000 AL_O'.NNE-AUTIOS BODILY INJURY I£ I ('er person) B Ix SCHEDULE:UAUTOS _ X HIRED AUTOS BODILY NJURY ('era ciden:) £ X NCN-CV\N:D AUTOS __—-------_—_-- _-- — _ PROPERTY DAMAGE £ GARAGE LIASILIT' r ALTO ONLY. AW AUTO OTHER-HAV EA ACC $ .ALTO ONLY A,,� £ EXCESS IUMBFSLLALIABIUTY CUA03357641 04/14/2013 04/14/2014 EACH OCCURRENCE £ 1,000,000 X OCCUR 171 CLAIMS MADE AGGREGATE £ 1,000,000 A -- -—Ts — DECUCTIB= £ � RETENTCdI $-WOfUr — £ --- AND EERS COMPERS IONLTY YIN WCA0335590-13104/14/2013 04/14/2014ToarLiMlrs X ER ANY FROPRIETOR,'PAF'T.�ER/EXECUTIVE r—) W E.L.EACH ACCIDENT s 500,00 A OFFICERNEMBER EYf LUD=-D9 LJ (MandetorylnNH) I E1 DISEASE-EAEMFLOYEE $ __500,00 I`Ws,describ?ender SPECA_PROJISICNStalrw E.L.U6EASE-FOLICYIIMT $ 50010-0-0- OTHER OO OOOTHER I I I i DESCRIPTION OF OPERATIO V$I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT!SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORETHE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL lO DAYS WRITTEN NoncE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Greg C rorby IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR 20 Bridges Lane REPRESENTATIVES. North Andover, MA 01845 AUTHORIZED REPRESENTATIVE Peter Sennott AAM ACORD 25(2009/01 j @ 1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD The Commonwealth of Massachusetts Department of Industrial Accidents Office oflnvestigadons 600 Washington Street Boston,MA 02111 www.ntassgov/dia Workers'Compensation Insurance Affidavit:BuildersiContractorslElectricians/Plumbers Applicant Information Please Print Legibly .tlnimt- . int . Natne(Business/Organixationilndividual):_ ;:1j..._ Address; 1 `t'a�1�'. �`1;1 Y 1 `�• o. ?ll c C City/Statei'Zip; 'L-lir\\/e( Nt' iClr",� Phone Are you an employer?Check the appropriate box: Type of project(required): 1.® Jam a employer with !J _ 4. ❑ 1 am a general contractor and 1 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.[1 I am a sole proprietor or partner- listed on the attached sheet.t 7• E]Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers'comp.insurance. g, ❑Building addition [No workers'comp.insurance 5. Elwe are a corporation and its required.] officers have exercised their 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGI, 17.❑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' 13.®Other Vi s; I')� i�tt lilt COMP.insurance required.] — — Any applicant that checks box#1 must also fill out the section below showing their workers'cumpeusalion policy information. +Homeowners who submit this affidavit indicating they arc doing all work and then hire outside contractors must submit a new affidavit indicating such. lContractorsthat check this box must attached an additional sheet showing the name of the subcontractorsand their workers'comp.policy inForivation. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:_ _A('.ctCTt'A. 1.-1)5��5(Zt1t P� Policy#or Self-ins.Lie.#_ iA)C_A C'5'. 151SeJQ 13 _ Expiration Date:_ Job Site Address: Niches City/State/Zip: Attach a copy of the workers'compteilsation 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 imprisomnent,as well as civil penalties in the fonn 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 car fin, rider the p 'nsa enalties of pet jury that the information provided above is true anti correct. Signature: Date: �,� Phone#: '1)F) Official ase only. Do not write in this area,to be completed by city or tonin official City or Town: PermitfLicense# 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#: Department of Code Enforcement Debris Disposal Affidavit In accordance with the provisions of GL,c.40,sec.564,a condition of permit# is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by GL,c. 111,se:, 150A. The debris will,or has been disposed ofat- Location of Facility ,de., clo, �,��(Y' � ► 0�0 �' f w i P (+ l I C r Location of action/jobsite (Street Add ess) Signature of contractot) Date V VU4=94 P PELLET INSERT SPECIFICATIONS Technical Data see Performance Wtdth Wiiftll 1ielght Heigh# ;Dapth Weight Hea#ink* Btu/hour Burn Rafe .Hopper r Particpfafe Outside Freptace Insid6fireplay; Outside Fveplaae jnside Firnplate Inside fireplace F hbsl,y...% Capacity; `Ca�attt :1 EHSissions,` .Input Iths/t,ourl• t y ft 1'� �ar1 I-.:, #lbsl 19/hoUrt 'Mt.Vernon. n 36-5/8" 32" 29-3/4" 23-7/8" 15" 425 up to 3,100 14,620 to 17 7t 56 EPA 60,200 Compliant 8,000 to Castile'lnsert- 32-5/16" 28-1/16" 24-3/4" 19" 13-1/16" 260 up to 1,500 1.5-4 45 .7 30,000 Classic Bay 28-1/2" 29-1/4" 25-1/2" 22" 13" 243 up to 2,500 14,000 to 2.0-5.5 60 to 9 12001 40,00075 °Santa Fe rt- 8000 to Inse21-i/2" 28-7/B" 25-3/8" 23" 12-3/4" 214 up to 1,500 1.5-4 45 .7 30,000 Maximum square feet of Energy Star efficient home with 8-ft.ceiling and framed insulated floors in heating zone 4.••BTUs calculated using premiumwood pellets at 8,600 btu/lh t Softwood ' - wood pellets with flame height adjusted+5: PELLET INSERT CLEARANCES Mt.Vernon AE Tri InsertAC 0Q1/' EV..d Serlhn end Fam 7r1rn MASONRY&ZERO CLEARANCE BUILT-IN INSTALLATION INSTALLATIONS p e ',:lupvarrt -'rear'be`ni: a Masonry 24' 15' 23-7/8" 34' 6" 12" 0" 1 0" 6" 1 6" 1 3" 2" 17-1/2-12-3A-I 3" 6" I ZC 24' 15" 23-7/8" 34' Castile ® " a Insert ta r ® -A F— E MASONRY&ZERO CLEARANCE BUILT-IN INSTALLATION INSTALLATIONS AmpAawn ftush)h22nhi � e Masonr 23-7/16"1 14" 19-1/4" 21-1/4' 28-1/4" "0" 12" 0" 0" 6" 6" 0- 0" 2-1/2" 0" 1ZC I 23-7/16" 18" 19-1/4" 21-1/4" 28-1/4" Classic Bay 1200; A B C B 1 g c ➢ C A -^ D U, p 10 - — E MASONRY&ZERO CLEARANCE eai'vani, +io eni:.:3 BUILT-IN INSTALLATION losing rear shrouel INSTALLATIONS Masonr 22"1 13" 119-1/2' -29-1/4 ZC 22" 15-1/2- 25-1/2" 22-1/2" 29-1/4' � redrvent topwerii rdSY�ent topvarct> - 6" 12" 3" 1 6" 1 B" 1 0" 3" 0" 0" 2-1/2' 3" 0" •sizemnoorprnraodonraustneaaaedtotnisaimen:ion. It using 811-0730.attow i-vr Max.hu. oeprh:i2in. — Santa Fe a.� 1 Insert rA C ➢ B A B C E A i e'geerence TO EV=d Sedbn AW Face Trh D MASONRY&ZERO CLEARANCE BUILT-IN INSTALLATION INSTALLATIONS MEMEM= — ant"' - 16' 12" 4-3/4" 10" 6- 6" 2 2-1/2" 2' 2-1/2" 3' Masonr 24" 16" 23-1 4" 29-1/4" ZC 1 24" 1 16" 123-1/4"129-/4'. 23-1/4" 29.1/4" CB1�00 FPeNet laser# SeA� Ci �7C'�oZt?l �UAflAE Listin-g-and Code Approvals A. Appliance Certification E. BTU & Efficiency Specifications MODEL: 1200-I Pellet Insert Emissions Rating" .9 grams/hr LABORATORY: -OMNI.Test Laboratories, Inc *BTU Output: 14,000-40,000/hr REPORT NO. 061-S-13-2 Heating Capacity: up to 2;500 sq.ft.depending on:climate:zone TYPE: Solid Fuel Room'Heater/Pellet Fuel erCapacity; 60-75 lbs Ho - Burning Type Insert pp ' STANDARD: ASTM E1509-95, UL:C:S628-93, ULC Fuel: Wood-Pellets-or Shelled Corn S610-M87, ULC S628=M93 and ULC/ Shipping Weight; 243 lbs ORD-C1482-M1990 Room Heater Pellet Fuel Burning Type and (UM)84-HUD, *BTU output will vary, depending on the brand of fuel you Mobile Home Approved use in your appliance. Consult your Quadra Fire-dealer for best results. B. Mobile Home Approved This appliance is approved for mobile home installations WARNING!Risk of Firel Hearth&--Home Technologies dis- when not installed in a sleeping room-,and when an outside claims any responsibility for, and the warranty and agency combustion air inlet is provided. The structural integrity of the listing will be voided by the above actions. mobile home floor, ceiling,and walls must be maintained. DO NOT. The appliance must be properly grounded to the frame of Install or operate damaged..ppliance the mobile home and use onlylisted pellet vent;Class"L"or Modify appliance "PL"connector pipe. A Quadra-Fire Outside Air Kit must be install offer.than as instructed by Hearth & Home installed in a mobile home installation. Technologies 5t Note: This appliance is also approved forinstallation Operate the appliance°.without fully, assembling all into a shop. components> . Overfire Install any co riponent;not approved`by Hearth & Home Technologies • Install'parts or components not Listed or approved. C. Glass,Specifications Improper installation,.adjustment, alteration, service or This appliance is equipped with 5mm ceramic glass. Replace. maintenance.can cause injury or property damage: glass only with,5mm ceramic glass Please contact your For assistance or additional information, consult a qualified nt lass. installer, service agency or your dealer. i dealer for replacement g 1 NOTE: This installation must conformwith.local codes. In the absence of local codes you must_comply with the ASTM NOTE: Hearth:&'HomeTechnologes; nianufacturerof E1509-95, ULC S628-93, ULC S610-M87, ULCIORD-C- this appliance, reserves the right to alter its products, 1482-M1990,(UM)84-HUD. their specifications and/or.:price.without-notice. D. Electrical Rating Quadra-Fire is a registered trademark 115 VAC,60 Hz, Start 4.1 Amps, Run 1.1 Amps of Hearth&Home Technologies. m horlR Anna' ^.A 7014-188 September WARM TRADITIONS S TO VE SHOPPE A Division of AQUA TERRA PROPERTY MANAGEMENT, INC Contractors License #105711 Robert Raucci Board o I B t I i I d i I I anI till]thl rd, -ne a n j Licensp: CS 105711 ROBERT RAUCCI 123 NORTH BROADWAY HAVERHILL, MA 01832 oat t Expirmw!) 2/1312014 105711 Home Improvement Contractors License #170349 Aqua Terra Property Management, Inc. SCA1 is 2OM-05/11 Office of Consumer Affairs&Business Regulation OME IMPROVEMENT CONTRACTOR egistration: 1'70349 Type: Expirat1on:,-----�_*,- :5 Corporation AQUA TERRA PRO E-MENT INC. ROBERT RAUCCI 144 PINE STREET DANVERS,MA 01923 Undersecretary 144 Pine Street, P.O. Box 2081 Danvers, MA 01923 978-777-5562 WARMTRADITIONS STOVE SHOPPE 144 Pine Street P O Box 2081 Danvers, MA 01923 978-777-5562 _ 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 agrceing 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 CompanyName f/ ) cn,e Ci~©S abt�'ts`,�n fl& c i� lora , 1►c.>, Street Address eo notuse aPost Office Box address) Contractor/Salesperson/Owner Name ow bftd es lane,, Robe+ •Raaccl City•own I State Zip Code Bpsiness Address(must include a street address) �� nd��e� Mfr of g � ��n�2 �t �- irvers. ©IRa D'aytimePhone 8veningPhone City(Town state Zip Code 9_8 -qW- So Q q-)e�` )- ss4� * Mailing Address(It different from above) Business Phone I Federal Employer M or S.S.Number • Horne improvementcontractorrteg:Number Expirationdnte Lnw regniros flint mosthome ' Impomncontrantors have nvnttdregtstrationnumber ya The Contractor agrees to do the following work for the Homeowner: (Describe in detail the wodcto completed,specifying the type,brand,and grade of materials to be used,use additional sheets ifnecessatv.) Required Permits-The following building permits are required Proposed Start and Completion Schedule-The following schedule will and will be secured by the contractor as-the homeowner's agent: be adhered to unless circumstances beyond the contractors control arise (®wners who secure their own permits will be excluded from the Guaranty Fund provisions of -6;43 Date when contractor will begin contractedwork MGL chapter 1.42A.) Date when contracted work will be substantially completed. Total Contract Price and Payment Schedule t$`� �•� O® The Contractor agrees to perform the work,fuxnish the material and labor specified above for the total sum.of: ti. Payments will be made according to the following schedule: 0®, upon signing contract(not to exceed 1/3 of the total contract price or the cost of special order items,whichever is greater) $ Vod YIP.P. by / I or upon completion of U )9f' $ 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 following materiaUequipmentmust be special $ to be paid for ordered before the contracted work begins in order to meetthe completion schedule.(**) $ to be paid for at NOT1;S:($)Including all finance charges( )Lazy to that atry deposit or dawn payment required by the contractor before work begins may not exceed the greater of(a)one third of the total contract price or(b)the actual cost of any special equipment or custom made material which must be special ordered in advance to meet the completion sohedule- * ❑-yes(11l terms of the warranty must be nttached 4o the contra ress Warranty Ts an express warranty begne provided by the contrletor? [j No Subcontractors-The contractor agrees to be solely responsible for completion of the work described regardless of the actions of any tbird party/subcontractor .utilized by the contractor. The contractor further agrees to be solely responsible for all payments to all subcontractors for materials and Iaborunder this asreement Couiract Acceptance-Upon signing,this document becomes a binding contract under law. Unless otherwise noted within this document,the contract shall not imply that any lien or other security interest has been placed on the residence. Review the following cautions and notices carefully before signing this contract. e 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 Improvement Contractor Reeistration, 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 ask 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 Crui.de to the):dome Improvemml Contractor Law, Xou may cancel this agreement if it has been signed at a place other than the contractor's normal place of business, y the provided you notif 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 dap following the signing of this agreement. See the attached notice of cancellation forth for an explanation of this right. SIGN T i- S CONTRACT IF TB ERE ARE ANY B LAN'<SPACE, !! jow�y wntract must be completed and signed, one copy should go to Ute homeovmer.The other copy shotddbe kept by the contractor. O 42--� O Contractor's Signature Homeowner's Sign tore D 3 3 Date 'Date Cbntraefor Arbifrataion The Home Ixuprovement Contractor Law provides homeowners With the right to initiate alternati7e to court action,)if they have a g an arbitration action(as an contractor,however. dispute with a contractor. The same right�not automatieall both parties agree to the options cIatitse Provided Below. T1.1is clause resolve an y afforded to a y dispute would she has with a homeowner.in court arbitration as is afforded to the homeowner by the Rome Improvement Contragive ctor he contractor the same right unless The contractor and the homeowner hereby mutually agree in advance that in the eventw. concerning the contractor has a y this contract,the contractor may submit the dispute to a private arbitration firm which has bee dispute the Secretary of the Executive Office of Consumer Affairs and Business Regulation and the co to submit to such arbitration as provided In.Massachusetts General Laws,chapter 142A., n approved by nsiuner shall be required Homeowner's Signature ®7L'ICJCl:The signatures of the parties above a 1 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-z4 gned 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 rile work as described,in a timely and workmard lce manner. Homeowners may be entitled to other specific legal rights if the contractor guarantees or provides an express warranty for worlananship or materials, In addition to antees 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 law.fnlly agree may be added to the terms of the contract as long as they do not restdot a homeowner's basic consumer rights. If yQtl have questions about your consumer/homeowner rights,contact the Consumer Information Hotline(listed below). Execution of Contract The contract must be executed in du licate and should not be signed until a copy of all exhibits and referenced doctunents 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 mo dif cation 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 fiends from,said account would require the signatures of both parties. Additional Information If you have general questions or need additional information about the Home Improvement Contractor Law or other consumer rights,or if you wish to obtain a free copy of "A.Massachusetts Consumer Guide to Home improvement" contact: Consumer Information Hotline Office of Consumer Affairs and Business Regulation, 10 Parlc Plaza,Room 5170,Boston,MA 02116 617-973-8787, 888-283-3757 or visit the OCA33Rwebsite atl1ttp://www.mass.gov/ocabr/ If you want to verify the registration of a contractor or if you have questions or need additional information speci6 Gaily about the contractor registration component of the Home Improvement Contractor Law,contact: Director ofHome 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 EIC website at lrttp://vrWW..tnass.gov/ocabr/ Go online to view the status of a Home Ixoprovement Contractor's Registration: hLp://db.state.ma.tris/liomeimprovement/licenseelist asv For assistance with informal mediation of disputes or to register formal complaints against a business,can: 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 2.1-1 U22no10