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HomeMy WebLinkAboutBuilding Permit #274-2012 - 29 BUCKINGHAM ROAD 10/3/2011 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Z Date Received Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION �29 1 1 h Ct PROPERTY OWNERQVL -*In VY1 6 Unit# Print MAP NO: PARCEL: G ZONING DISTRICT: RA- Historic District yes no Machine Shop Village yes no 100 year-old structure yeso TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building gone family ❑Addition ❑Two or more family ❑ Industrial Iteration No. of units: 11 Corn rcial ❑ Repair, replacement ❑Assessory Bldg ❑ hers: ❑ Demolition ❑ Other ! a- -rca�.� q $ � yam ' pticWell ❑Floodplain' { Wetlands � � Wat shed,Dtrict,F .� ., ®'Water/Sewer a � �, a 3 � �� -;� £; t :>- ±�rrLx�.:Yv...ez r+ti��> .r.�.,.,.�.as�:ii4 -w.a.. _ ..3'L�a`K DESCRIPTION OF WORK TO BE PERFORMED: sidt" S k)q /f )(�w r ✓ i (Iden ifica ' n Plealefrype or Print Clearly) Z OWNER: Name: I Vrl Phone:03•6 l oZ 9. Address: R(.t, la q a k" Rn C. CX CONTRACTOR Nam : , tA4Y15 hone: -7S,3 • 014-S Z— Address: Sc k-" 1-1-7-A SI CT-06277 Supervisor's Construction License: q Exp. Date: 08 A3 IIdO/c;2 Home Improvement License: /4 Exp. Date: / /� ARCHITECT/ENGINEER tiA Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT.$12.00 PER$11000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ 1 4 4-- FEE: $ ,�7 Check No.: �/ Receipt No.: -'�y & Y NOTE: Persons contracting wi nregis eyed contraors d not have access t h guaran fund - 'i Signature o �4 wn` Signature°_of contra T `_ � - Location Date No. NORTH TOWN OF NORTH ANDOVER _ of�« o •. tie ' N 9 Certificate of Occupancy $ iib •'' �' Building/Frame Permit Fee $ ss�cMusa Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 61 0 4 - B � a � �� di� ing Inspector (� 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 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 4 Planning Board Decision: Comments --- Conservation Decision: Comments Water & Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT - Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date COMMENTS I Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— For department use ❑ Notified for pickup - Date Doc:.Building Permit Revised 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 4 uilding Permit Application �hotoorkers Comp Affidavit Copy of H.I.C. And/Or C.S.L. Licenses Nd of Contract NA Floor Plan Or Proposed Interior Work NA, Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Pel Addition or Decks ❑ Building Permit App ' ation ❑ Certified Survey Plot Plan o Workers Affidavit ❑ Photo p f H.I.C. And C.S.L. Licenses ❑ Copy O ontraci ❑ Floor/C ssection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydr lic Calculations (If Applicable) ❑ Mas check Energy Compliance Report (If Applicable) ❑ E ineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Pern New Construction (Single and Two Fa ) ❑ Building Permit Applicati ❑ Certified Props P Plan ❑ Photo of Ml C C.S.L. Licenses ❑ Workers Affidavit ❑ Two Sets Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydra c Calculations (If Applicable) ❑ Co of Contract -- ❑ ss check Energy Compliance Report ❑ ngineering Affidavits for Engineered products NOTE: Il dumpster, permits require sign off from Fire Department prior to issuance of Bldg .Pert 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 recordin must be submitted with the building application Doc: Doc.Building Permit Revised 2008mi NORTH 0 of over 0 .1 Y C% L LAKE 0111. . Mass.,--- -over, ass., �� `••J /� COCKICMEWICK 1� DRATED P'?YL BOARD OF HEALTH PERMIT T Food/Kitchen Septic System / BUILDING INSPECTOR THIS CERTIFIES THAT..............`.. ...�%.�� �� . . �7 .............. ....................................................................... ...................................... . Foundation 4 f'LS...XO4; ..... i ........ Rough has permission to erect........................................ buildings on a.. ...... ... .. .� ... ..i...tC .. to be occupied as.. . . . . .. . G /....v r'u Chimney provided that the person accepting this permit shall irf every respect cofiform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION S ARTS Rough ...0 . ............................................................ Service / BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building Inspector. Burn erFlRE_DEPARTMENT Street No. SEE REVERSE SIDE Smoke Det. r {� i � r The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 w ,w.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Orgarrization/Individual): Sears Home Improvement Products Incorporated Address: 1024 Florida Central Parkway City/State/Zip: Longwood, FL 32750 Phone #: 860-753-0452 Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. t 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working forme in any capacity. workers' comp. insurance. 9. ❑Building addition [No workers' comp. insurance 5. We are a corporation and its 10.❑Electrical repairs or additions required.] officers have exercised their 3.❑ 1 am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.0 Roof repairs insurance required.]t employees. [No workers' 13.� Other /� ' comp. insurance required.] Sill *My 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 anew affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Ace American Insurance Company / Phone:866-283-7122 Policy#or Self-ins. Lic. #: WLRC46482815 Expiration Date 08/01/2012 /I/or Job Site Address i City/State/ZiA er, Attach a copy of the workers' compensate n 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 certi un r the pains penalties of perjury that the information provided above is true and correct. Sigriatur . (Sears Auth.Agent} 'f" Date Phone#: Home—Fax: 860-315-7468 / Cell: 860-753-0452 Official use only. Do not write in this area, to be completed by city or town official. i City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2.Building Department 3.Cityffown Clerk 4. Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: 10 CERTIFICATE OF LIABILITY INSURANCE DATE(MM07119//20112011 i THIS CERTIFICATE 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 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 t°..' certificate holder in lieu of such endorsement(s). PRODUCER CONTACT '(D NAME: Aon Risk Services Central, Inc. PHONE (866) 283-7122 FAX (847) 953-5390 y Chicago IL Office (AIC.No.Ext): (AIC.No.): .a 200 East Randolph E-MAIL C Chicago IL 60601 USA ADDRESS: _ INSURER(S)AFFORDING COVERAGE NAIC A INSURED INSURER A: Indemnity Insurance CO Of North America 43575 Sears Holdings Corporation INSURER B: ACE American Insurance Company 22667 dba Sears, Roebuck and Co. Attn: Risk Management E3-219A INSURER C: 3333 Beverly Road INSURER D: Hoffman Estates IL 60179 USA INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:570043294986 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 MAY HAVE BEEN REDUCED BY PAID CLAIMS. Limits shown are as requested LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER IMMIDD (MM1DDfYYYYl LIMITS B GENERAL LIABILITY HGF' 530962 "6X71= EACH OCCURRENCE $S'000'000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $S'000'000 CLAIMS-MADE X❑OCCUR MED EXP(Any one person) EXCI uded PERSONAL BADV INJURY $5,000,000 C GENERAL AGGREGATE $5,000,000 g GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $5,000,000 v X POLICY PRO- JECTLOC o t` B AUTOMOBILE LIABILITY ISAH08696637 08 O1 2011 08/01/2012 COMBINED SINGLE LIMIT $S'000'000 B ISAH08690649 08/01/2011 08/01/2012 Ea accident ANY AUTO BODILY INJURY(Per person) 0 X ALL OWNED SCHEDULED BODILY INJURY(Per accident) y AUTOS AUTOS PROPERTY DAMAGE V X HIRED AUTOS X NON-OWNED AUTOS (Per accident) t Ot UMBRELLA LIAR HOCCUR EACH OCCURRENCE V EXCESS LJAB CLAIMS-MADE AGGREGATE DED RETENTION A WORKERS COMPENSATION AND WLRC46482815 O8/O1 2011_08F01_/_20_12 X WC STATU- OTH- S EMPLOYERS'LIABILITY YIN WLRC46482803 08/01/2011 08/01/2012 TORY LIMITS ER ANY PROPRIETOR I PARTNER I EXECl1TIVE E.L.EACH ACCIDENT $2,000,000 A OFFICER/MEMBEREXCLUDED? N NIA SCFC46482827 08/01/2011 08/01/2012 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $2,000,000 It es,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $2,000,000- DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) aft- CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Sears Home Improvement Products, Inc. AUTHORIZED REPRESENTATIVE 1024 Florida Central Parkway Longwood FL 32750 USA c�4'a�a i✓��rJiftutxr0 F �yss�G�na ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD i; �- Ice 0onsunela7n useless lei` n ice-�`. • � o 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvelnent Contractor Re�istrat o�� Y,. Registration: 148607 Type: Supplement Card SEARS HOME IMPROVEMENT PRODUCT expiration: 110/11/2011 LUSOS SVEC 1024 FLORIDA CENTZAI_ PKWY LONGWOOD, FL 32750 11pdate Address and return card-dart;reason for Chang e. "1- Address Renewal ` " Employment Lost Gard �IPS•C.n, Ct 50+n•e,Vg4•Qr0i2l6 1/� l•G'JtPJiI.A^7tf�L�i2�(!l t� �lf7i�FlC�ffu'P��r _ Ofllcc of Concuurcr affaus&dtt curs%Itr< ulaiion License or registration valid for individul use onit EIRF-7. HOMEIMPROVEMENT CONTRACTOR before the expiration date. if found return to: Office of C:onsumer:lffairs and Business Regulation Registration: 148607- 10 Park Plaza-Suite 5170 `. " Expiration: 10/11!2011 Boston,MA 02116 t- Type: Suopiement Card SEARS HOME IiVIPROVEMENT PRODUCTS INC. LU6OS SVEC 1024 FLORIDA(CENTRAL PKVVY LONGWOOD,FL 32759 t aulreseerei:rr� \ol Valid without sr-anature .3 - Massachusetts- Dcprailment of Public Sat'co - Board of Building Rculations and Standards Construction Supervisor License License: CS 97519 I r LUBOS SVEC 827 THOMPSON F')AD .> THOMPSON, CT 06277 Expiration: 8/31/2012 t'onuni••imrcr' Tr#: 2442 1111111111III III Office Location: Proposal Date QQ 07 Job k 3 Sears Home Improvement Products,Inc. o ' Customer Nar Sea P.O.Box 522290 tJ ,8V D V ^!/T/l_ 1024 Florida Central Parkway Customer's Home Phone Customers Work Phone Home Improvement Products Longwood.FL 32752-2290 q7&-483-C12 '779-a67-•_a_6_7- 3Saf Phone (800)469-4663 Street Address ESTIMATE AND PROPOSAL Contractor License/Registration Number -")1 8 C9 I^tUxfog'-1.1 Siding HIC#148607;all plumbing and electrical City IState zip code services performed by licensed subcontractors �( 7-W A^_A p d rg t/J installs thin City Ijtnils? FEIN 25-1698591 Installation Address County ^_ '_es_ L7 No Billing Address(it different Irom above) City State Zip Code Project Consultant Name&L se Na(if applicable) 6d Description of the Project and Description of the Significant Materials to be Used and Equipment to be installed The work to be done under this contract includes the following(where checked): Not Included Included SImiticalions Preparation: 1. ❑ Obtain all necessary permits and insurance. 2. Q ❑ Inspect surfaces in work area,re-nail loose wood,and replace rotten surface wood where necessary in work area (excluding roof,decking,rafters and structural members). 3. ❑ [ig Remove existing siding. Type: 4. ❑ IIK Fr out walls on brick,block,metal or stucco areas. Location: 5. Caulk and seal around all windows and doors in the work area as necessary. 6. Install approved non-corrosive starter strip. Insulation: 7. [ " ❑ Install insulation of flatwall areas that are to be sided with _]1/4" extruded polystyrene insulation. Custom Trim: 8. C4--' ❑ Install custom Vyna-Klad aluminum fascia system. Color: W/7-.,r-- 9. 9. ❑ Remove existing gunering. After removal,existing guttering will be: ❑re-attached []•dispoSMd of to. ❑ CW Install new guttering and downspouts. 11. 0/ ❑ Cover soffit areas of home with vinyl soffit system(except where noted below in"Work NOT to be done")using: [_YG5_Max ❑WB Plus ❑Weatherbeater ❑Value Line ❑Other: Color: 7� Pallern: 12. ❑ Qy Install custom Vyna-Klad aluminum fneze rdo�a s. Size: Location: Color: 13. L9'� ❑ Jump butt clow trim. Location: ,• / 14. S;i� [] Custom wrap Windows r sills./mulls;headers with Vyna-Klad alu num. 11-lenE 15. [�' ❑ Remove and re-install existing storm windows I awnings!shutters. 16. Install new shutters ❑Panel ❑Louver Color: G• 1,1,10 17. Custom wrap door facings with Vyna•Klad aluminum. Color: 18. ❑ Custom wrap garage door facings single/double with Vyna-Klad aluminum. Color: 19. ❑ Remove and re-install storm doors. 20. 0/' ❑ Install deluxe comer posts. Color: Siding: 21. 6J,— ❑ Install EQ WB-Max❑WB Plus❑Weatherbeater[]Value Line ❑Other: Solid vinyl siding. TYPE:Q.H zontal ❑Vertical Color: Porch 22. [ ❑ Porch ceilings: Location:_� 7C Cola T Systems: 23. ❑ Porch posts: COIOC 24. ❑ Porch beams: Color: Clean up: 25. ❑ [_ Clean up and removal of all job-related debris. 26. E ❑ Remove excess materials and re-stock(each job is over-shipped to avoid delays). Additional work to be done: Work NOT to be done: No drip edge covered;no paint applied. SPECIAL INSTRUCTIONS: r,��� Ej NCt r &-YC �Dc S�I.'�' (y�N—� �v�e Y C� • //klfi//TFi All of the above check boxes and the"Work NOT to be done"section have been reviewed and explained to me. Customer(s)initials• . APPROXIMATE START DATE and APPROXIMATE COMPLETION DATE: The work will start approximately S f..XQ.fiG.S (Approximate Start Date)and will be substantially completed by approximately&p,•g .__(Approximate Completion Date).These dates are subject to change at the time the contract is accepted by Sears Home Improvement Products.Inc.("Sears")or at any other time by mutual written agreement.Customer understands that the Approximate Start Date is only an estimated date and th;Customer will be contacted prior to this date to schedule the actual start date. The TOTAL PRICE including all labor,material,taxes and any applicable discount is L Contract Price $ Initial Payment(not to exceed 30%of Total Price unless Special Order) $ State Sales Tax( %) $ Final Payment(balance payable upon completion of job) $ Local Sales Tax(�%a) $ Total Amount Duel$ The form and method by which the Customer(s)will pay is described in a separate Cash/Credit Card Payment Addendum made a part of and incorporated into this contract by reference. Customer(s)initials fa✓.I NOTICE TO BUYER:YOU,THE BUYER, MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY (FIFTH BUSINESS DAY IN ALASKA,FIFTEENTH BUSINESS DAY IN NORTH DAKOTA IF YOU ARE AGE 65 OR OLDER)AFTER THE DATE OF THIS TRANSACTION.SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. Additional provisions of this contract are stated on the pages 1011awing. Customer(s)initials rw,) sSr MA Aev OVOG I i IIIIIIIIII 111111 ADDED ONAL P OVISI,ONS Job Number:-- Proposal and 9pprov . Sears offers to furnish the materials and arrange for their delivery and installation as specified on the first page and/or h the attached sketches and specification sheets for the TOTAL PRICE shown.This offer must be approved by the Installation Department.If this e is a credit sale or a payment on completion sale,it must be approved by the Credit Sales Department. If this proposal is not approved or the installation cannot be made in accordance with the law,this offer will be withdrawn and any payments you have made will be refunded to you. Any materials left over after the installation has been completed are Sears property and will be removed by Sears- Installatiola. I understand that Seaas will not install the materials but will arrange for the installation.Sears is not responsible for materials or installation NOT furnished or arranged by Sears.Sears agrees to procure all permits required by local law. Authorization. I authorize Sears to:(1)arrange for a contractor(licensed where required by law)to make the installation of materials;(2)issue a work order for this installation to a contractor; (3)inspect the installation;and(4) pay the contractor when the installation is complete if I have signed a certificate that the installation has been completed to my satisfaction. Delays in Installation. I agree that Sears is not responsible for delays in delivery or installation due to weather,fire,strikes,war,government regulations or any causes beyond Sears'control. OTA-1 Weements and Changes in Centrad. I understand that there are no oral agreements between Sears and me.Everything I expect Sears to do has been included in writing in this contract.Nothing can be changed in this contract unless it is in writing on a separate form accepted by me and Sears. Hesponsibifity of Buyer. I agree that any information or measurements that I give to Sears are correct and complete.I am responsible for any special work described in this contract. Ele;trical& Plumbin Service. I will provide adequate electrical and/or plumbing service(s)to run any newly installed appliances or other furnishings.If the electrical and/or plumbing service(s)do not meet the standards of the utility company or electrical and/or plumbing codes, I will make the necessary changes at my expense unless Sears has agreed in this contract to make the changes. Payme . I will pay Sears the cash price that covers the price of material and installation as shown on the first page. Warrant Information. Appropriate product warranty documents will be given to me by Sears.Sears'Warranty on Installation is: SEARS'LIMITED WARRANTY ON INSTALLATION In addition to any manufacturer warranty extended to you on the product(s)used(which warranty becomes effective the date the merchandise is installed),if the workmanship(or application)of any Sears'arranged installation proves faulty within (i)one year for Weatherbeater or other brand,(ii)two years for Weatherbeater Plus.or(iii)three years for Weatherbeater Max,then upon notice from you Sears will cause such faults to be corrected by repair at no additional cost to you. If Sears determines that repair is not commercially practicable or cannot be timely made, then,at Sears'sole discretion,Sears may elect to provide replacement or refund.Service under this Limited Warranty is available by calling Sears Home Improvement Products at 1-800-222-5030,Option 4.This warranty gives you specific legal rights,and you may also have other rights that vary from State to State. NOTICE TO BUYER 1. DO NOT SIGN THE AGREEMENT IF ANY OF THE SPACES INTENDED FOR THE AGREED TERMS TO THE EXTENT OF THE AVAILABLE INFORMATION ARE LEFT BLANK. 2. YOU ARE ENTITLED TO A COPY OF THIS AGREEMENT AT THE TIME YOU SIGN IT.KEEP IT TO PROTECT YOUR LEGAL RIGHTS. 3. YOU MAY PAY OFF THE FULL UNPAID BALANCE DUE UNDER THE AGREEMENT AT ANY TIME, AND IN SO DOING YOU SHALL BE ENTITLED TO A FULL REBATE OF THE UNEARNED FINANCE AND INSURANCE CHARGES. 4. YOU MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY[FIFTH BUSINESS DAY IN ALASKA, FIFTEENTH BUSINESS DAY IN NORTH DAKOTA IF YOU ARE AGE 65 OR OLDER]AFTER THE DATE OF THIS TRANSACTION. SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. FAILURE TO EXERCISE THIS OPTION, HOWEVER,WILL NOT INTERFERE WITH ANY OTHER REMEDIES AGAINST THE RETAIL SELLER YOU MAY POSSESS.IF YOU WISH,YOU MAY USE THIS PAGE AS NOTIFICATION BY WRITING"I HEREBY RESCIND"AND ADDING YOUR NAME AND ADDRESS.A DUPLICATE OF THIS RECEIPT IS PROVIDED BY THE SELLER FOR YOUR RECORDS. 5. IT SHALL NOT BE LEGAL FOR THE SELLER TO ENTER YOUR PREMISES UNLAWFULLY OR COMMIT ANY BREACH OF THE PEACE TO REPOSSESS GOODS PURCHASED UNDER THIS AGREEMENT. NQ11- E TO MASSSACHUSETTS RESIWITS ONLY In addition to the Notice to Buyer shown above, Massachusetts law requires that contracts for home improvement work state that all home improvement contractors and subcontractors shall be registered and that any inquiries about a contractor or subcontractor relating to a registration should be directed to. Director,Home Improvement Contractor Registration P.O.Box 871 Taunton,MA 02780-0871 Telephone:(508)821-9375 Please note that owners who secure their own construction-related permits or deal with unregistered contractors shall be excluded from access to the Guarantee Fund. Notwithstanding any other language in the contract or associated documents, Sears will not remove, replace, or install any heating or air conditioning system, or any portion thereof, if asbestos or asbestos-containing material is known or likely to be present in that heating or air conditioning system, or any portion thereof. If it is determined or reasonably suspected that asbestos is present,either before commencement or during performance of the work,it shall be the cus- tomer's responsibility to select, retain and pay all costs of a Division of Occupational Safety("DOS") licensed Asbestos Contractor to remove all asbestos or verity that none is present in the components involved in the job. If the determina- tion or reasonable suspicion of the presence of asbestos arises after Sears has started the work,Sears will immediately cease performing the work until a DOS licensed Asbestos Contractor, hired by the customer. removes all asbestos from the components scheduled for repair or replacement in accordance with 310 C.M.R. 7.00 and 453 C-M.R 6.00 or veri- fies that none is present. By signing the contract the customer agrees that it understands the above. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES Customer's signature Date Customer's si n Date Accepted by Sears Home Improvement Products,Inc.("Sears")on �� by:_ t Rep sen ative Date n SSI-MA Rev 071oo