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HomeMy WebLinkAboutBuilding Permit #300-15 - 31 LACY STREET 9/18/2014 pORTH BUILDING PERMIT o��t �� "tio TOWN OF NORTH ANDOVER 0 - APPLICATION FOR PLAN EXAMINATION 1 Date Received I 7�QO'V o Pp` Permit No#: q SSgC S Date Issued:—Cal I%I I"i IMPORTANT: Applicant must complete all items on this page LOCATION '31 4A(,Y 57 NmTd I mA Print PROPERTY OWNER :3c44s4 cLA-(zY i Print 100 Year Structure yes 49) MAP Id PARCEL: �� ZONING DISTRICT:`Historic District yes CO Machine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial J(Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District ❑Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: 9,Lme4f. Gy-(g1W(,1 h5y4kLT 1�VT-yJl1 A-NJ S•�Sr[� -tea 2av€' (�'SPN.A-i.L� Identification- Please Type or Print Clearly OWNER: Name: Jd'yktv o y Phone: 97S-79&t-19311Lo Address: '51 4A-C-( 57 6 Contractor Name:l`fzAt 6 6\4 Phone Address: y2 CZG�L�3 t- 6(&L,L SAr. tan-7! Supervisor's Construction License: Exp. Date: oi, I,1 Zu l_t_r, Home Improvement License: _ lH9511-Ah Exp. Date: 1clZr-1 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: $ 10 foSS.�, .0 C) FEE: $ r Check No.: Receipt No.: 3 NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner Signature of contractor 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 PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Siqnature COMMENTS F Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water& Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT - Temp Dumpster on site yes no Located 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 NOTES and DATA— (For department use) i I ❑ Notified for pickup Call Email 3 Date Time Contact Name Doc.Building Permit 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 ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work o Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg. Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the 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 Doe:Building Permit Revised 2014 3 Location l L-4SN-(e e No.70-16 Date 1 � P ti • - TOWN OF NORTH ANDOVER n Certificate of Occupancy $ Building/Frame Permit Fee $ �2 Foundation Permit Fee $ Other Permit Fee $ TOTALaw $ Check#alp `� `t Building Inspector NORTH own of sAndover o - ..�: . � o�hh ver, Mass, COC MIG MI�� ICK ^0 Pay,p R�1 S U BOARD OF HEALTH PERMIT T Food/Kitchen LD Septic System THIS CERTIFIES THAT ..... .... BUILDING INSPECTOR ..., ... Foundation has permission to erect .......................... buildings on .! ...... ...... . ...................... ��, � ' � � Rough tobe occupied as .................. ........ ...... .................. ........................ ................................... Chimney provided that the person accepting this permit shall in every respect conform to th rms 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 Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTI TS 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. Licensed B Insured Member of Boston Better Business BureauVrjo oal Page No of Pages BROOKLINE MALDEN (617) 734-9100COH N (781) 322.0822 ANDOVER TOLL FREE (978) 475.1145 % W% -646-91 11 FULLY LICENSED HOME IMPROVEMENT SPECIALISTS FULLY INSURED 405 WALTHAM,ST.#336,LEXINGTON,MA 02421 PROPOSAL SUBMITTED TO: PHONE DATE O9 STREET JOB NAME t lac ST CITY,STATE AND ZIP CODE JOB LOCATION t23 - -\Z . r A141',t't s 's^mc ARCHITECT DATE OF PLANS JOB PHONE I I T Cohen Construction,Inc.hereby submits specifications and estimates. -All Permits&Fees Included -All work to be completed by Cohen Construction,Inc will comply with Certainteed's strict standards for roof practices. -Strip roofing materials down to the roof decking. -Replace up to 75ft of Boards and up to 3 sheets of plywood at no additional charge. -An additional charge of—� per sheet of plywood will be added to price if exceeds allowance. -An additional charge of !1/aS per board will be added to price if exceeds allowance. -Install six feet(two rows)of Certainteed'Weather Watch'Ice and Water Shield to all eaves of roof. -Install Certainteed's'Diamond Deck'Synthetic Roofing Underlayment on remaining of roof. -Install eight inch aluminum drip edge('Wylt'rf_ color)to all edges of roof. -Install new aluminum pipe flanges to all plumbing exhaust pipes. /_N)_Install new lead counter flashing to base of Chimney(s) -Install a t Fyear Certainteed Shingle of roof. -Shingles will be fastened with appropriate sized nails to meet Certainteed's Warranty minimum. LY/_N)_for roof to be hand nailed. Cohen Construction,Inc.recommends all Boarded Roof Decks to be hand nailed. -LYLN)_hurricane nailing. -Install an'Air Vent'baffled ridge vent to all ridges of house to allow for proper exhaust ventilation. ALL DEBRIS WILL BE REMOVED BY COHEN CONSTRUCTION,INC -Cohen Construction,Inc.practices proper techniques while removing old shingles from roof. -A magnetic sweep of premises will be completed. -All gutters and down spouts will be cleaned 12 YEAR GUARANTEE ON WORKMANSHIP icfE'rinS" YEAR GUARANTEE ON MATERIALS Designing the Balance System for Attic Ventilation Research has shown that the best way to ventilate an attic is with a system that provides continuous airflow along the entire underside of the roof sheathing.Achieving this desired airflow requires a balanced system of intake ventilation low at the roof's edge or in the soffit/eaves and exhaust ventilation at the ridge.Cohen Construction,Inc.hereby submits additional work to be performed to the soffit area of the house,to meet/exceed necessary warranties by Certainteed. Acceptance_(_Y_N)_ y Cohen Construction will perform such work to soffit area: yD12 ,00 XK'(LUot S G U'^ 0'11 I2^K E t3cn+tiZ S Ve i31'opO55e hereby to furnish material and labor-complete in accordance with above specifications for the sum of: Alln►£ T}6iAa� F#VZ A v,-^A E)Ct r--t1 J �� �/fes� dollars Pa ment to be made as follows. 2n f�f PoSrT _ #lA�ab or,l �4TsrftT Ar''� �3tn�vc G� 'L o y�t Tom)L All material is guaranteedto beasspecified.Allworkto be completed in a workmanlike manner according to standard practices.Any alteration or deviation from above specifications involving Authorized extra costs will be executed only upon written orders,and will become an extra charge over and Signature above the estimate.All agreements contingent upon strikes accidents or delays beyond our control. Owner to carry fire,tornado and other necessary insurance.Our workers are fully covered by Note:This�ra�osa maybe Q/`� Workman's Compensation Insurance. withdrawn by us if not accepted within -/�J days. Arreptance Of Propofsaf — The above prices specifications / and conditions are satisfactory and are hereby accepted.You are authorizes to do the work ` as specified.Payment%ill be madetasl ut med above. signatuT" �/ r _ 2r �� S Date of Accept, Z YI F+ €�f Signa re Massachusetts.-Department of Public Safety Board of Building Regulations and Standards ,Construction Supen-isor 1 License: CS-096405 Is CRAIG RCOHEN:` 42 ROYAL CIRCLE Salem NH 03079% i J� Expiration Commissioner 06/14/2016 ,per _ ��e �Doo?vi�aMaus�a�C�aac�catetl� \ ,Office bf Consumer Affairs.'&Buslaess Regulation 0i41E IMP ROVEMENT.CONTRACTOR registration: `148746 TYPE': 4.� ;7 Expiration: _ 10/20/2015 Individual P(7' t' CRAIG COHEN n P t,RA1G COHEN 42 ROYAL CIRCLE SALEfl1;NH 03079. 4Jnd6rsecretary • Massachusetts Home Improvement Sample Contract This form satisfies all basic requirements ofthe state's Home Improvement Contractor Law(MGL chapter 142A),but does not include standard language to protect homeowners. Seek legal advice if necessary. Any person planning home improvements should first obtain a copy of"A Massachusetts Consumer Guide to Home Improvement"before agreeing to any work on your residence.You may obtain a free copy by calling the Office of Consumer Affairs and Business Regulation's Consumer Information Hotline at 617-973-8787 or 1-888-283-3757 or on our website. Homeowner Information Contractor Information Name Company Name S of N &6kA--`/ 'l- Street Address(do not use a Post Office Box address) Contractor/Salesperson/Owner Name • 31 LR[.-t S N, rJOVK " 10,y5 swat. Sr #3;LV City/Town State Zip Code Business Address(must include a street address) q7g-7qH- v4tp "A I"(1TO NJ Zl Daytime Phone Evening Phone Cityfrown State Zip Code W7-33 -3S4 —497-9ltpg Mailing Address(It different from above) Business Phone I Federal Employer ID or S.S.Number Home Improvement Contractor Reg.Number E phation date Law requires that mast home Improvement eontmdors have -lid, Dumber {jig 74 The Contractor agrees to do the following work for the Homeowner: (� (Describe in detail the work to completed,specifying the type,brand,and grade of materials to be used,use additional sheets if necessary.) Rtm6" f%iiTW,J %of, 'Lj 6Nr--, LJ 5ITLL 4- !JC-,J 1.1 FVr 4t CC►2TirWT�Z,IJ /tSPrk�iT A«trtE-TE-c�tvn-L. ROC), SY41_6'A TO i240K Required Permits-The following building pennits 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 contractor's control arise (Owners who secure their own permits will be excluded from the Guaranty Fund provisions of C)I11$I I q Date when contractor will begin contracted work. MGL chapter 142A.) Date when contracted work will be substantially completed. Total Contract Price and Payment Schedule �{ The Contractor agrees to perform the work,fiunish the material and labor specified above for the total sum of #iy,(p50 (*) Payments will be made according to the following schedule: $ upon signing contract(not to exceed 1/3 of the total contract price or the cost of special order items,whichever is greater) $ ��tl V by V_W/_M or upon completion of $ by / /_or upon completion of $ upon completion of the contract. (Law forbids demanding full payment until contract is completed to both party's satisfaction) The following material/equipment must be special $ to be paid for ordered before the contracted work begins in order to meet the completion schedule.(**) $ to be paid for NOTES:(*)Including all finance charges(**)Law requires that any deposit or down-payment required by the contractor before work begins may not exceed the greater of(a)one-third of the total contract price or(b)the actual cost of any special equipment or custom made material which must be special ordered in advance to meet the completion schedule. Express Warranty-Is an express warranty being provided by the contractor?lCo❑Yes(all terms of the warranty must be attached to the contract) Subcontractors-The contractor agrees to be solely responsible for completion of the work described regardless of die actions of any third party/subcontractor utilized by the contractor. The contractor fiuther agrees to be solely responsible for all payments to all subcontractors for materials and labor tinder this agreement Contract Acceptance-Upon signing,this document becomes a binding contract under law. Unless otherwise noted within this document,the contract shall not hnply that any lien or oilier security interest has been placed on the residence. Review the following cautions and notices carefully before signing this contract. • Don't be pressured into signing the contract.Take time to read and fully understand it. Ask questions if something is unclear. • Make sure the contractor has a valid Home Improvement Contractor Registration. The law requires most home improvement contractors and subcontractors to be registered with the Director of Home Improvement 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. • Know your rights and responsibilities. Read the Important Information on the reverse side of this form and get a copy of the Consumer Guide to the Home Improvement Contractor Law. You may cancel this agreement if it has been signed at a place other than the contractor's normal place of business,provided you notify the contractor in writing at his/her main office or branch office by ordinary mail posted,by telegram sent or by delivery,not later than midnight of the third business day following the signing of this agreement. See the attached notice of cancellation form for an explanation of this right. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES!!! Trvo identical copies of the contract must be completed and signed.One copy should go to t:Z;�� tor. X i Homeow er's ignature Contractor' r og�ISS�►I-1 Date Date De CommonwealtA oft1'assaehaseffs Offlee ofbV-08tigateoas 600Washzagton Xi'reet Woston,MA 02.111 -t�w�:mas�.govfc�za ' wQrkexlq'compengatio;aYmsuranceAffil vit:J ni c arc f�Co ac ox /J Xtw� re c n lT"a Xis , A.Upzeaxox�aa-do PXtuaseniX� y Name:(Businesslorgadzation&divzdaal):_ Co&NJ Addrass: N o s *331, - Lt-rcw4UN ha31a (pi-7-331- 3Sfl�O xnpex with A- eaale yorz an aloyez'?CheektTit;e0ropxiate ox: 'type of project(reguirecl): to 4. X am.a general contractor and 1 6. f]New cdnstraction 1.� I am a e � ---- have liixedthe suTi-contractors employees(�and(oxpar�tiw0)T I. El RamodeTing 2.E1 1 ave a sale proprietor ox o artneX• New d on tf a attached sheet sh7o and`liaveno•emoloyees These suis contraetoxsbavo S. Demolition woxlfing forme in any oapacity, workers'compo.insurance. 9. Buff ft addition PTO workers'eomp.insurance �. a We are a avoCorexerciseagond and its 1011 Electricalrep*s ox addiflons xecltzixed.� officers .ave exexeised.their - ri ht of exem Boaz exSY MOL 21 mbingxepairs or additions 3.E x am a h-omeowrler doing all work g o 0 myse . lowoxkers°comp. c.152,§1(4),andwehaven.o 12.KI"oofx6pais in�nraazc�xecluixed.� employees.ENO workers, 13,n Other cornu.imwanca regdre fl e-Anyapplzcaniihatdiecksbox#Z musEalso�Tlonithese�fronbeldv�'shovlingt7ieirwbzkers'com�ensatiogpolicyinfozmafion. '� iX�omeowners hasubmifthisa£tdavitmdicatingihey edgPngatZ�sorkandthenh?reoutsideconiiacforsmvs�suT�m anewaf�dapitindioa�ngsize&. xCon-hacfors illa�clxeclstbis bo�zn>zstaifached z�z additional sheetshovazngtfieuame o�the su1�:eoniracfors andthei�vtorkers'comb.policy infozmation. -'apztenemvfoyeratc gprovdingwo'dars.,eompe�a�atianznsr��c�eefox�.�ye��royees; Belowi��(2e�ralieyta2r�fad�Zt'e ir2�n�mutiorz. . LnsuxanceCompanyTame; RISK 5 ���i1�S 'o1{cy ox elr"-ins. ic.#' UyJ GSn3��d(� ExpixationD2 01 S Sob Sfio ddxess: 31 Lifc`1 51 C%ty/State/Zip:, N, A-jJ)0 L--JZ NA 0.1%4 5 Each a copy o t tewoxke s'coxrt aexisatzoa� aoncydeclaration page(sttowinggaelaoNcynTmhOrand exRkaffoax date). Yallmato seGUM coverageasreq►1z'edundexSection25Aof1U M,0.152 can.le,ad totheinp0SNOnofothainalVmaltiasofa i"tne up to$1,500.00 and/or ones-Yeax.3npxiso�nentx as well.as cWJpenatties is the form of a SWOP lr�!ORT ORDER and a fmo ofup to$250.00 a day againsttb violator. Be advised that a copy oftbis staternentmay be foxwardedto the Offlce-of Investigations ofthe VA.fox hisurance coverage vex cation. tto areby ee zcricret'trieliain� ctpe12a7tie o�pe �ctry t�ia tree i o �ta�iox�p�ovir�ec alioY1e iI ftzra ant�co reed Si atizre• Data: �lione# UPI o�czaZ u.sg o�2ry, Do not wive in trim area,lobe eoxnpreW ry city or town 0 Waf. +Cityor Town.: �ermztl�iceazse# bsulugAuthority PCle Z.Board of7�eaTtTi ?.BuiTdi>zg�e artment 3.CziyIT. o"Clerk 4.ElechicallIngectox 6 RIambinghgector f.Other - - information and instructions Massachusetts General saws cha. ter 152 re s p quires an employers to provide workers compensation fox them employees< Pursuant to this statute,an elm,proyee is defined as"_ovaryperson id the service o£anothex under any coxitract o biro,• express ox implied,oral oxwxitien" .�.0 e�r�e�'�is defined as"anindividual,paxinership,association,coxpoxatiort ax othexlegalentity,or anytvza orxnoxe, . oftbeforegoin engagedinapointenfexpxise and inch ctingthe legalxepresentatzvesofWdec0asedgpiylver,.ort e xe�eiver o fxrzsfee o�an andi�lzdtta�paz exsh%p,association or otherlegal entity,employing employees. 16evex the owner ofa dvte7ling7xor[sehav:ingnotnzaxethauibxee apat-Emenfs andv�l�a resides�•exein,oxthe oceupauto�`tlte dwelling'_eMe of another who employs pexsons to do mainte,nauce,constzuctiozz oxrepaix wox1C on such dwelling house ox axethegxounds oxbding appuxtenantthe xeto shatlnotbecause ofsuch employ mexitbe deexuedta be an employer" 1 GL chapter 152,§25C(6)alsostatesthat"every-state or local Ile-ensfug,agene shall With-hold she issuance or renewal 09a license OXperanit to operate a business or to constxtxet buildiugs ft the coxnntoxlwealtSx fox any pplzcut who leas not pro duced.acceptable evidence of Compliance with the hisuz mice coverage rerluixed;' Additionally,MGL cha)atex 152,§25C(7)slates"Neztberthe commonwealthnox any of!to political subdivisions shall enter into any contractfortheperformanceofpublicworkuntilacceptableevidenceofcompliancewith,thek=m e xeczdreanents ofihis chapter.avebeenpresentedtathecgntractingatathority„” .�ppitcarits PlOaSoffl out the walkers'comp ensation affidavit completely,by c-hecicing the boxes that apply to pour siiaa on and,if iiecessaxy,supply sub-contractox(s)name(s),addresses)andphonenumbex(s)alangwitlz their cextificaie(s)of insttxance< iraiiedLiabilityComyanies(LLC)oxLimitedLiabili P exshfps(LLl')withno o employeeh hat the t members axpaitners,aronotxequireclto caxryws t orl£exs'compensationinsuxance, Han LLC orLLP daeshave exnployees,apolieyisxecluired. Beadvisedthattbisa,MdavitmaybesnbmitiedtotlieDepaxfinentoal f rncjustri Accidents for confit anon of insurance covexage. .Also be sure to sign and date the 2Mdav1i !RE)affi davit should be xetuanedto the city or town thatthe applicaiionfoxihepermst oxlicense isbeingxecliie�ted,no�theDe�ariment of industrial Acoideni. ,Bhouldyou'.ave any cF6sRous xegaxding the law or if you are xoquit ed to obtain a*orkom, compensa oapolicy,please calltheDepaltmentatthgmunberItedbelow. Selfinsurerlcom selPantos sbouZdentextbexx f xnsttra-ace Rcense number on tha appxopxiate line. City or Tom 0MCials �'Zeasebesuxethat'thear,.zdav%tiscompXeieanclpxinieclXegibly, T$eDaparmentb.�.spxovicledaspaeeattTiehotLonz ofihe a£ff davitfox you to ill out lu the event ehe Of Ofxvestigavons has to coni6tyouxegarding th.e applicant; Pleaso be-sure to nil iu he permit/license number which vrill be used as a xezoxence number, Th addition,an applicant thee-16stsubmitmultiplepexoait/licenseagRoadonsin•any givenyeax,neadon[ysubmitoneazftdavitzn(heatln dent p olxcy anToxmaizon.(i rnOcessaxy)and imder'eTA Me Address"the applicant sho�u.'d tvxife"all Zocatio�s in g(city or town):'A copyo t�eaifidavitthathasbeono,�, dally ainpedoxmaike,dbythecityortownxnaybepxovldedtotlie appllcautasploofthataValid afctda t•rsan le ori�tvxepemszisorizcenses. A ewazddavitmistbotllledonteaclt Year'Where ab.omu ovmex or cztzzenxs obtaining alicense oxpe�notxelatedto anybusiness ox comtnereiaZ u"ac e (x,e.a dog license orpiexmit to bwm leaves etc,)saidpersov,is NOT xecpakadto complete this affidavit. The OfEtce of l'nves9gatzona woaald JAG to thank you in advance fox your coop oration and shquld yo-a have any cxixestlons, please do xxo t hesitate to give us a call. The.l7epax-tm.ent's address,telephone aiidfaxnumbex. . CQMMvn:wealth of�?"asa dAwe 1?aPa (,'AtQfTUCT-Wal�!cc a t Ofte 6.QG agbingtW ROVIsed 526-05 Fax#617-W-7749 Contractor Arbitration The Home Improvement Contractor Law provides homeowners with the right to initiate an arbitration action(as an alternative to court action)if they have a dispute with a contractor. The same right is not automatically afforded to a contractor,however. The contractor would have to resolve any dispute he/she has with a homeowner in court unless both parties agree to the optional clause provided below. This clause would give the contractor the same right to arbitration as is afforded to the homeowner by the Home Improvement Contractor Law. The contractor and the homeowner hereby mutually agree in advance that in the event the contractor has a dispute concerning this contract,the contractor may submit the dispute to a private arbitration firm which has been approved by the Secretary of the Executive Office of Consumer Affairs and Business Regulation and the consumer shall be required to sub 't to such arbitration as provided In Massachusetts General Laws,, 42A. Home er's Signature ontracto' ature NOTICE:The signatures of the parti above apply only to the agreement of the parties to alternative dispute resolution initiated by the contractor. The homeowner may initiate alternative dispute resolution even where this section is not separately signed by the parties. Homeowner's Rights A homeowner's rights under the Home Improvement Contractor Law(MGL chapter 142A)and other consumer protection laws(i.e.MGL chapter 93A)may not be waived in any way,even by agreement. However,homeowners may be excluded from certain rights if the contractor they choose is not properly registered as prescribed by law. Homeowners who secure their own building permits are automatically excluded from all Guaranty Fund provisions of the Home Improvement Contractor Law. The contractor is responsible for completing the work as described,in a timely and workmanlike manner. Homeowners may be entitled to other specific legal rights if the contractor guarantees or provides an express warranty for workmanship or materials. In addition to guarantees or warranties provided by the contractor,all goods sold in Massachusetts carry an implied warranty of merchantability and fitness for a particular purpose. An enumeration of other matters on which the homeowner and contractor lawfully agree may be added to the terms of the contract as long as they do not restrict a homeowner's basic consumer rights. If you have questions about your consumer/homeowner rights,contact the Consumer Information Hotline(listed below). Execution of Contract The contract must be executed in duplicate and should not be signed until a copy of all exhibits and referenced documents have been attached. Parties are also advised not to sign the document until all blank sections have been filled in or marked as void,deleted,or not applicable. One original signed copy of the contract with attachments is to be given to the owner and the other kept by the contractor. Any modification to the original contract must be in writing and agreed to by both parties.Contracted work may not begin until both parties have received a fully executed copy of the contract,and the three day rescission period has expired. Accelerated Payments A contractor may not demand payments in advance of the dates specified on the payment schedule in cases where the homeowner deems him/herself to be financially insecure. However,in instances where a contractor deems him/herself to be financially insecure,the contractor may require that the balance of funds not yet due be placed in a joint escrow account as a prerequisite to continuing the contracted work. Withdrawal of funds from said account would require the signatures of both parties. Additional 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 Park Plaza,Room 5170,Boston,MA 02116 617-973-8787,888-283-3757 or visit the OCABR website at http://www.mass.Rov/ocabr/ If you want to verify the registration of a contractor or if you have questions or need additional information specifically about the contractor registration component of the Home Improvement Contractor Law,contact: Director of Home Improvement Contractor Registration Office of Consumer Affairs and Business Regulation 10 Park Plaza,Room 5170,Boston,MA 02116 617-973-8787,888-283-3757 or visit the HIC website at http:/hvww.mass.gov/ocabr/ Go online to view the status of a Home Improvement Contractor's Registration: http://db.state.ma.us/hoiiieiinprovement/licenseelist.4m For assistance with informal mediation of disputes or to register formal complaints against a business,call: Consumer Complaint Section Office of the Attorney General 617-727-8400 AND/OR Better Business Bureau 508-652-4800,508-755-2548 or 413-734-3114 Version 2.1-11/27/2010 ACC> e CERTIFICATE OF LIABILITY INSURANCEDATE(MM/DD/YYYY) `..� 4/17/2014 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 certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Colleen Crowley NAME:Risk Strategies Company PHONE (781)986-4400 F4XNol, (781)963-4420 Ale 15 Pacella Park Drive E-MAILDDRE,s.ccrowley@risk-stratagies.com Suite 240 INSURERS AFFORDING COVERAGE NAIC# Randolph MA 02368 INSURERA:Guard Insurance Group INSURED INSURER 8: Quindi Luis Ramiro, DBA: Speedy Gonsales INSURER C: 748 Lakeview Ave INSURER D: INSURER E: Lowell MA 01850 INSURER F: COVERAGES CERTIFICATE NUMBER:CL1441475258 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. iNSR LTR TYPE OF INSURANCE ADDL S R POLICY NUMBER POLICY EFF MM DDY YYY)EXP - LIMITS GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTEff- COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ CLAIMS-MADE 0 OCCUR MED EXP(An one person $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: - PRODUCTS-COMP/OP AGG $ POLICY ircTPRO LOC. $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURYPer accident $ AUTOS AUTOS ( ) NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS Per accident $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ A WORKERS COMPENSATIONfficer included for X WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/NTORY LIMITS FR ANY PROPRIETOR/PARTNER/EXECUTIVE coverage. OFFICERIMEMBER EXCLUDED? a N/A E.L.EACH ACCIDENT $ 1,000,000 (Mandatory In NH) UWC503986 /17/2014 /17/2015 E.L.DISEASE-EA EMPLOYEd$ 1,000,000 If yes,desaibe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) Evidence of insurance only. CERTIFICATE HOLDER CANCELLATION CRARGCOHEN4242@GMAIL.COM SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Cohen Contruction ACCORDANCE WITH THE POLICY PROVISIONS. 405 Waltham St. Lexington, MA 02421 AUTHORIZED REPRESENTATIVE i Michael Christian/CLC ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025(201005).01 The ACORD name and logo are registered marks of ACORD