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Building Permit #180-2011 - 32 MEADOW LANE 8/31/2010
BUILDING-PERMIT of &ORTy �ttLED �6s ti0 TOWN OF NORTH ANDOVER �2 sit'• y_': ;° o APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued: 3��a ACHUSE��� IMPORTANT:Applicant must complete all items on this page r;�.:;�',4�3:s's",�-`-_:s�em..�= _-:.��•`.t,'�.• .:��+-�'=.if=Ta=' - -d'� = -- - - _ _ 55 . - rr.�.. . r_ :mss+7^=•`- r - -a. mac:, •:ES^ ri`:4 - �./.-.a✓.... t n .c.-.S>.r:::fY, i.r- kt"�...� Gc.r:. r ,. ;..-,r.. .:_ _ — t ..i_ *r_ - - '---"'�.:x... �'$uon3 v.: <'P--,<t.:x"=�:M??-' .,,,..�4°`'_er _ r'�°,�_'1"�,,:,.:4Srs��-,y] 'i�''rr ,,i„ v- 1 3f+i., 71e _-cam _.^-t..iv..�, i.Y��. .w•.i4.�.'r-��tY:•:���.5�y+.��v.Tef,.v .+; .4 li` r r.•. Y'r.� '•,:.Y.n;.: sadr. "' '=1r^',uC'_-.tf_..r_r-AM+r-C��/ nJF.i.-�� v.•F�.iFti� _ -..1� ..-_.-,..�..,.;.._..__. _ ..... _... - _ i_�_9 �.,�?:_ _••'{»C+:*ri.-_'F�..arY.--iS.��_- __ `-, -s. 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("r"�� h��i�-..rk-�rn' ?t.;y:-.,��F��;`i;.y-; °•� ' tr?'�'�n•i>..- �"�t'�r�r�ar :. 4�s;s- r,xY-'� �r �",lv'�r,�,r fir. _rf�•, r:.h -,y s�:?�{X:r�;r���.7•�.�...xt:^f�?�t�1•-4Rs-.�:���'�} 'cat,rr.�d� i5,s;¢��rxT:M',,,� �� q�,ty��-�"ust� Iz^,a.,.�71/,'y��/� �.�y�\�jQ?�-/� ,�:�?Iv�'*r'�[]w+.�L�"}�-�+^-ftYwz(7, Mr/-���;o���' •.X �� ._�::n[3�..1-2s}S-�11�:,'ur3Nlr1.��•�rt^_ __:,-r-y-t--ter,:F,�f4�:.:�Fi'I(ii:�1=i...,,w�4-,,��L��''�,4��t'u1�"+.2,�-ll_!'r+v�+:4'M'IUU���✓AJIlY ��rli.7 :li�L5�4 lia7„�i';`F��1:I�1•���{.,�='� TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One famil Addition wo or more.family Industrial Alteration No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other ^r e #� '�-'�y'��,,r���-a-�•�f rq lY ryj�r 5•s? KK'fa �-r-,a- r:<Syu t- _�•4T�> _ _ � _ �•fZ 9"T.cr" iY� s;ti, F � �_ ��� tall �.L� �I'�r L� r ) '"�t."sS4j:=td � "�'. ;} ate' r y ,�..'4s-a' K ,'e-_s."�'°.`.� ee��rI�,y^�__;.,+.:�1�� �3ir�`�,"'��=�,�a,n .ea•r���`,c'�s:,''��.�f .rrr��„Pve r�3�;�w ���'�'-'k<i :m ��iL�,�s ,y��';�7,���sr�;�i��'1:1-'rJiyi�e�.r",,m .e Fc'•'��4[��r.YY:Pi' `{_ a iii,(`+�..,+,�. "Gr�`cc�� .rr�i����7s���„�k.�,�i,?±•,��a�,�•���':L..e. �ier�l�'��i,�,' ^r-£'.r'-�`�.'�6ri4�;�ydr-�s.� �' ��-"�.Tl•3".��s,�'.�-�y,•?+r�FL�q r-,y �,��,: ' - .��__,��:.:'� �.a,..�cre'U"�n_f f`.,8'c�t:r`.•.e..;.k;i=.:�..4�'.Y:c:_�!f� „__�y,Y.. ��.-•. '�:ra. �^',�: �9 , �.�h»'��r'a ,r"'7�. '_'`� '�' ,,�'r�',�e.-'” ,:.�, � DESCRIPTION OF WORK TO BE PREFORMED: O y1',n � Identification PIease Type or Print CI.earIy) OWNER: Name: lJ ln. Co o Phone: Address: zaf+„'5.,�•wfi o�c, "°�. 'ft i'GY M1oL��•L -�Yrti:i:,, ..,a�,e..sr- S 1`St = t `5r-.. 7� Fc�a;.:.ii J.m,�:T-d'�'��:4•;`i. �_r�'� en A�a .�1,��'...•!Vl}J .�iFa ]-� le`.� y��^ -y�y'� �•� f y1�+.,-kF ,�'l' :TI'+'�in ..f"'v'n 1 S -p�-�'�����-'eiiy fl: Y Fr'^• A" Yy " `a" sm (� .a+ '�.�' �;�. � �{� "7 ,� 2 laic' :r. o-'sY'i�-> •5i4���y-dvsryr.,.,,. ,F•' "s #"�,a.r--.7•a' '. '*:c "S ¢N 1-4.r,rwr�.��1-�� §�E't}-x ,'; MM � L ,} `3d�-""�'U�_-- -+.•,.�. WIN ' - M` '�"�i.'e, -F't .-"r-r" x.1'11°£:'� _ r r.--(•1' - q``tea ''�7` . 3. WE „ wn' ft J'-�,4�i »' •”^ - y_gf.�` .'i,' + _ _'-..n't 't m � �. r.�Y,ti''A`:�;�a. ,'-¢.',Y;`� 'S,� �i���Z" ..'�" •' r'�,'',v- �t'�i�lr�,.'.L F. ,�.Fie_ •'-<<•'sa'�a.-7t'T N�+.qtiz�Y�J r�r,'`y-+��'y-tI«v:;'.'��;::��-'><;�y?R�i"t'.k�'•_--'s��' : 4 r -,�1ak-:�...''-;{?,. i.i..�eu�,:°�a9�`.a•_.., '�•`a tic .-(� vy uTc3a•t'tiSk4s tY "J?.�6�3`� �31-r �gr.4l4r i_l.��r5s.r. !A 'g t ig.'' i� "r .}.' ' ro;l ,�,�:5�fi:r.c 's-'� Cr.:�i.��'��',:�i _ - tx� �1�;�i'y-•,;"T,, a 'r •�_� :�"^r• ;�':-'' .w��-' J" eL,V,„ _Y,..�'- :r(-'C�t - - fir, - _:.cu._.. _ -&•.�..:ri-. N�... �.�b r.•:µ rc- .;, _h.,_ x;9'+_ s'v<;r`:�-�'l�,.'.+.'.'�:�St:..xfl"�:i"`,'•� -'�-, I Y-,iT`.'A...�.Y�: _`,rfZ�_Aa. nt:('�, _ ..u,,.�'"Y.�lr'F...-"_�_✓�r �cSfL..-.aG: - -S.T "r';ilG7!4 _ �ry,;�,•_*2.a-`;y _ — _ .....5�'. - '"''inS: :rk•:a1^,r..-t� :'151+- .,, %qx.._„ y;- ,H•� -_ - �, a�� �--k -4 - �. ce�=e�•Q ,tk-.+... .`,�'..4:c�r.'h;�'' .,.,z� r:�ya1:�,...:ems "��_�`.- 3;�� 21c-,�•p.�lx. -4.S,,,m. ,��' _ ..m�„F:','•'_'�, -3c�..siar,.,.a: ..Lr %•.-'ue ,�;.:,r- ,:J"7..�p.C� Y :t,+, _s ,.2 c:r:x,_ •rF«.. F-.v !•N.a„,fsr,' ::t:.,:� _ 5S';"" -,$�r-vT'i:t;� -�F'%,< [r<_-•fn -,.`�.T'1'' �czr ,•.,.-siAaek„u a:r�.:r,; 7,::'M"�-'rr!- .M`•ty,_.�_<I'- �~y.--Y. G.e'er ,r:,r. .ttj y'> '00-5 x 'n p_.+ s!•- .-s . r '2..a,; r _ 'in _ - - .�:,�� ;•�;� - _ .Vii,^ _ �3?.�x'�•�.. `�. ARCHITECT/ENGINEER Phone: f Address: Reg. No. ` FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Tota[ Project Cost: $ /U, So FEE: $ ,�� O Check No.: 02ePO,6 Receipt No.: �U?d� NOTE: Persons contracting with unregistered contractors do not have a• cess tot a guaranty fund r/�-+�•5-�. .�nr•-rte }` ' VJ�;4i:Ql� r• �'' -�� -u In -`z�r - � `�=.,,r.j ,xh'rz^ + 4.. - riauunsry=_�'agnatu x 5'a re ofacon_cad ;� , 1 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 Sigriature 'iMIRViEN t S i I HEALTH Reviewed on Signature j COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes ° Planning Board Decision: Comments i 'Conservation Decision: Comments Walter& Sewer Connection/Signature&Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street $ e .'S ::x-Y .... �"7;, ''L°li3°:r vr_•.'�Y.a'.:=.i.^.=ii,t-. nor__�_. ..��:....:�..---.�::,:,�_..�:: w�_; F - -: :.: - SIV:_ - ":•§:. �A"= -ocafe:d_� t'�2��fla_�- .:i 1. .: :.,...t .. _?.. •:.�•v rte.:. 1_ 7- T. ', - - - 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) i l i i ❑ Notified for pickup - Date i Doe.Building Permit Revised 2010 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 ❑ 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 j ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract o Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ IVI "'ass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products NOTE.: All dumpster permits. p p s require sign off from Fire Department prior to issuance of Bldg Permit _-New Construction (Single and Two Family) ❑ Building Permit Application r% __V.C:_r n i i ❑ •el tt::-u r-roposed Piot Plan. (a 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:Building Permit Revised 2008 I Location No. /f ' �° Date Of NORTN TOWN OF NORTH ANDOVER .•o ;•,M 0 ,jismid& Certificate of Occupancy $ w *Ar.o IE<� Building/Frame Permit Fee $ --22 0 sic Hus Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 235z � Building Inspector NORTH 06Andover O :vim -ti;4: ;�:�,:... V" No. _ - o dover, Mass., X91 I� LAKE COCHICHEWICK 7� 0 RATED 74, BOARD OF HEALTR Food/Kitchen IT T Septic System BUILDING INSPECTOR THIS CERTIFIES THAT t....... ►..... ...... I�j4l bC.......................................... ............................... Foundation has permission to erect........................................ buildings on ..., d... .. / .....f .. Rough ��i c� Chimney to be occupied as............5....... �J.. ....�°���°� ... ............... /�!a ..... �.. ..�. ...................... y provided that the person accepting this permit shall in every respect conform to the terms of the a lication 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 STARTS Rough .. . ..................... .. .... . .... . . Service UILDING INSPECTOR 7 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 (Nall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner, Street No. SEE REVERSE SIDE Smoke Det. { - The Cominonweizlth of Massachusetts Department o f Iradustrial Accidents id Office of Lnvesz�o atwns 600 Washington Street .Boston, M4 02111 JWorkers' Compensation Insurance Aff da WWW.Mgsse ov/din An licant Informniion �t: BuiiderslContractors/Electricians/Plumbers Please Print Legibly Name (Business/Organization/Individual): �o Address: /Y5- City/State/Zip: 6f-Pbone#: Are you an employer?Check the appropriate boa: I•L I--am a employer with 4. ❑ I am a 7DRemodlehg (required): .e:rt l contractor and I 2.❑ employees(full and/or part-time).* have hired the sub-contractors ruction I am a sole proprietor or partner- listed on the attached sheet I ship and have no employees Thesemob-contractors haveworking for me in any capacity. workers' com . ' on p insurance. [No workers'comp. insurance 5. ❑ We are a c o 9. ❑Building addition required.] orp ration and its b of myself [N �semployees ficers have exercised their 10-[1 Electrical r 3.EDI am a homeowner doing all work right of ex epairs or additi°ns emption per MGL .1 1. ;-Plumbing repairs or additions insurance comp. c. 152,§I(4):and we have no 1� mo quu�dt em to ees. , L d' Koof repairs P Y o [NO workers Pomp.insurance required,] 13•D-6ther I#om o �:ham boxt!" mt s!also M uut ffic sectio,c-a�'shore.;. . was s who submit this affidavit indica -'u a'or==s'cam i c �� P-dc•;—ali l'JVS a11Q Y.......�.....r,..u..� ..uV Contractors that chwl;tls ho.*.W ; IDrn hireoutside eontxacto y acus;sabmit a new affidavit indicating such. ••s'attached an additional sheet showing the name of fhe sub-c omraetors and their workers'comp•policy information. I am an employer that is providing workers'compensaSon insurance or m employees. ircformaSon. � f yBelow,is the policy and job site Insurance Company Name: ._. t—6)44 4--i $ / Policy#or Self-ins.Lic.#: t<.' _ g S`7/ Expiration Date: /�� Job Site Address: yy� - , _ City/State/Z" Attach a copy of the workers' compensation policy declarafion pane(sho ���� Failure to se^ure coverage as required under Section 25A ofMGL c. 152 can lead to theoimposicy tionbof er andexpirationiration date), fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties of a Of up to$200.00 a day against the violator. Be advised that a c pees in the form of a STOP WORK ORDER and a fine Investigations of the DIA for insurance coverage verification. PY of statement maybe forwarded to the Office of I do hereby certify u der the pains realties o er .fP .%ury th4rt the informaiion.provided above is true and correct Sifmature: Phone#: ff Official use 7Dote irz this area, to be completed by cit),or town officiaL c ity or Tow P ermit/License# suiug Auth ): 1. Board of g Department 3. Citv/Town p6. Other Clerk 4.Electrical Ins ector 5.Plumbing InspectorContact Pers ��� Yhone'n:-L 76 //og�, r Information an_ d Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,associaLtion, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association ox-other legal entity,employing employees. However the owner of a dwelling house having not more than three apartnz ents and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not be cause of such,employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to Ctenstruct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the.performance of public work un-t:g acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and if necessary,supply sub-contractors)name(s), address(es) and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC) or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' comp ensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be svire to sign and date the affidavit The affidavit should be mtuiued to the city or tmrn that the application•for the perlait or license is being rea=s*.ed not fh, D epar�Wit.of Industrial Accidents. Should von have.any questions regardib the law or ii you are rek^tiired to obtair,a workers' compensation policy,please call the Department at the number=listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. Cit},or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary) and under`.`Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future perimits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would like to than you in Vance for your cooperation and should you have any questions, please do not hesitate to give us a call The Department'.s address,telephone.and..faxm=ber:... T ie Corn-aonwealth cif Massachusetts. DeParrtmmt of l tdushial Accidents Office of I>Etvestiaatons 600 Wigton Street Boston,M-A 0.2111. Tel. 617-72.7-4900 enxt 4406 or 1-8 77-MASSAFE Revised 5-26-05 Fai #617-72.7-7749 MMM"-mass.-gov/dia sample home Improvement Contract Page 2 of 2 12. Acceleration of payment: No contract shall contain an acceleration clause under which any part or all of the balance not yet due maybe declared due and payable because the holder deems himself to be insecure. However, where the contractor deems himself to be insecure he may require as a prerequisite to continuing said work that the balance of funds due under the contract,which are in possession of the owner,shall be placed in a joint escrow account requiring the signatures of the home improvement contractor and the owner for withdrawal. 13. No work shall begin prior to the signing of the contract and transmittal to the owner of a copy of such contract. 14. Arbitration: If the contractor determines that in the event of a dispute,the contractor wishes the dispute to be settled by arbitration,this fact must be signified on the contract and both the contractor and owner shall sign this clause separately. The following format is acceptable(in 10 point type or larger); "The contractor and the homeowner hereby mutually agree in advance that in the event that the contractor has a dispute concerning this contract,the contractor may submit such dispute to aprivate arbitration service which has been approved by the Office of Consumer Affairs and Business Regulation and the consumer shall be required to submit to such arbitration as provided in MGL c 142,L Ot [-do owner: Contractor. NOTICE: 76 signatures of the parties above apply only to the agreement of the parties to alternate dispute resolution initiated by the contractor. The owner may initiate alternative dispute resolution even where this section is not si rr� ed separately by the parties." ©2010 Commonwealth of Massachusetts http://wmm7.mass.c,ov/?pageID=ocater ninal&L=3&LO=Home&L1=Consumer&L2=Home... 1/27/2010 6arnPle Home Improvement Contract Page I of 2 The Official Website of the Office of Consumer Affairs&Business Regulation(OCABR) Mass.Gov Consumer Affairs and Business Regulation Home>Consumer>Home Improvement Contractinc,> .....................-................. ................ Sample Home Improvement-_C'ont'ra*ct_ Contracts-all contracts over$1,000(One Thousand Dollars)must be in writing. RELATED LINKS The law requires the following FOURTEEN items to be included in any contract between a homeowner and a Yon Gid Konsomat& registered home improvement contractor for home improvement work subject to MGL c.142A: Massachusetts you Reparasyou 1. The complete agreement between the contractor and the owner and a clear description of any other documentsnan Kay which are part of the agreement Ll�"7 G 1L 2. The full names,federal I.D.number(if applicable),address (NOT P.O.Box numbers),of t p es, e eshe parties,the i Guia para el Consumidor de contractors registration number,the name(s)of the salesperson(s)involved,if any and the date the contract was Massachusetts para Mejor&s en executed by the parties. el Hogar 3. The date on which the work is scheduled to begin and the date the work is scheduled to be substantially completed- Guia para el Cons umidor de 4. A detailed description of the work to be done and the materials to be used. Massachusetts pana Mejoras en el Hoear 5. The total amount agreed to be paid for the work to be per-formed under the contract. 6. A time schedule of payments to be made under the contra stated contract and the amount of each payment s ted in dollars, including any finance charges.Any deposit required to be paid in advance of the start of the work SHALL NOT exceed one-third of the total contract price or the actual cost of any material.or equipment of a special order or custom made nature,which must be ordered in advance of the start of the work to assure that the project will proceed on schedule. No final payment shall be demanded until the contract. is completed to the satisfaction of all parties, 7. All parties must sign the contract. 8. A clear and conspicuous notice stating: a.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: Office of Consumer Affairs and Business Regulation Ten Park Plaza,Suite 5170 Boston,AIA 02116 Phone.(617)073-8700 b.The contractor's registration number must be on the first page of the contract. c.The homeowner's three day cancellation rights under MGL c'93 s 48; MGL c 140D s 10 or MGL c 255D s 14 may be applicable. as d.All warranties on the owner's rights under the provisions of and MGL c.142A. e.In ten point bold type or larger,directly above the space provided for the signature,the following statement: DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. f. Whether any lien or security interest is on the residence as a consequence of the contract. 9. An*enumeration of such other matters upon which the owner and contractor may lawfully agree. 10. Any other provisions otherwise required by the applicable laws of the Commonwealth. 11. Permit Notice:Every contract shall contain a clause informing the owner of the following: a.any and all necessary construction-related permits; b.that it shall be the obligation of the contractor to obtain such permits. c.that owners who secure their own construction-related permits or deal with unregistered contractors shall b excluded from access to the Guarantee Fund. http://v.m,w.mass.o ov/?page1D=ocatermlna1&L=3&LO=Home&L I=Consumer&L2=Home... 1/27/2010 t Y Massachusetts Home Impi'Ovement Sample Contract This Form satisfies all basic requirements of the state's Home Improvement Contractor Law(MGL chapter 142A),but does not include standard langtiage 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 617-973-8797 or 1488-283-3757. Homeowner Information Contractor Information Name ompi y Pr Street Ad ess(do not use a Inst Office Bc x address) Contractor/Salesperson/Owner Name J&A Cityfrovm d4ate Zip Code usiness Address(must include a street address) -717 Daytime Phone Evening Phone 1 ityrrown State Zip Code Mailing Address(li different from above) Business Phone ederel Employer ID or S.S.Number taw requim'thal most home ha- Home tvovemeat cotmaetar Ree.Number Hxpaation date pmvrmmt contractor'have a ' n ¢aiatratiao aumF�c /' .� a `,, I The Contractor agrees to do the following work for the Homeowner: /V G V /e_1cj �a e m neurit too mp e e g me e, r e t n s o e e on ace /'Z `syr a✓s' �.x<S l!� fL o o�/s•�q pwt c7d 5 7/7 �f E�/.1 /tet S liYGf /(lam-t✓. V�`� Required.Permits-The following buildiirg permits are required Proposed Start and Completion:Schedule-The following schedule will and Nyill 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 0 Date when contractor will begin contracted work. MGL chapter 142A.) Date when contracted work will be substantially completed. Total Contract Price and Payment Schedule (� 1 The Contractor agrees to perform the work,furnish the material and labor specified above for the total sum of: _ p- 3p0• J d (s) Payttjents will be made according to the following schedule: $ //__, .,10&9444P on signing contract(not to exceed 1/3 of the'total contract price or the cost of special order items,whichever is greater) Fs•Iwo.vt6y / //�t� or upon completion-of 114 Ir $ ODd IBJ by .or upon completion of P,4/✓) S 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 connected work begins in order $ to be paid for to meet the completion schedule.(**) 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 otderedin advance to meet the completion schedule. Express Warreatr.Is an express warranty heloe provided by the contractar7 tum Yes fall terms of the warran must be attached to the ca tractl Subcontractors-Thelcontractor agrees to be solely responsible for completion of the work described regardless of the actions of any third paity/subcontractor utilized by the contractor. The contractor further agrees to be solely responsible for all payments to all subcontractors for materials and labor under this a eement Contract 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. • 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 R eThe 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 One Ashburton Place,Room 1301,Boston,MA 02108 or by calling 617-727-3200 or 1-800-223-0933. • Does the contractor have insurance? Check to see that your contractor is properly insured. • Know your rights and responsibilities. Read the Important Information on the reverse side of this form and get it copy of the Consumer Guide to the Home Improvement Contractor Law. You may cancel this agreement if it has been signed at a plaee other than the contractor's.normal place of business,provided you notify the contractor in writing at his/her main office or branch office by ordinary mail posted,by telegram sent or by delivery,not later than midnight of the third business day following.the signing of this agreement Seethe attached notice of cancellation form for an explanation of this right. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES!!! -,__�rwo identical cops be.contract ust be completed and signed One copy should so to.the homeowner. The other copy should be kept by the contractor. Homeowner's Signature actor's Signature k /3a3v l Date Date 4 36 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 ual.ess 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 ficin which has been approved.by the Secretary,of the Executive Office.of Consumer Affairs and Business Regulation and the consumer shall.be required to submit to such arbitration as provided In Massachusetts General Laws, chapter 142A. U 0,o tj�e h Homeowner's Signature actor's Signa re NOTICE:The signatures of the parties above apply only to the agreem t 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 ft documents have beenicate and should not be signed until.a copy of all exhibits and referenced .attached. Parties are-also advised not to sign the document until all blank sections have been filled in or marked as'yoid,deleted,or not applicable. One original signed copy of the contract with attachments is to be given to the ownerand 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 co the contract,.and the three day recission period has expired. py of 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,orlf you wish to obtain a free copy of "A Cons Law,"contact: umer Guide to the Home Improvement Contractor Consumer Information Hotline Office of Consumer Affairs and Business Regulation .10 Park Plaza,Room 5170,Boston,MA 02116 (6I7)973-8787'or 1-(888)2833757 If you want to verify the registration of a contractor or if you have gU6St101i5 Or Ilet',d additional 1. about the contractor registration component of the Home Improvement Contractor Law,contact:Ilforlrlatlon specifically Director of Home Improvement Contractor Registration Bureau of Building Regulations and Standards One Ashburton Place, Roorn.130I,Boston, MA 02108 (617) 727-3200 or 1-800-223-0933 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 (413)7.34-3114 TT / wor(anJoy lagIan 6iwd 800£-9£8 (80S) ' l89 10 vw'Ob081S3M L t0£-9£8 (80g) # Io!a+Dana i CIN NOlNIAdOH 89 L00£-lL£-008-t #Auodwg:) f' 'IAC19IW .S 2 911d JNIID)\:)] J 2]IdVd IVAOWIN IiSd/V, IPLI\S1 %ek - 3 PLO 1.t unvt h U (}y ® t t DATE(MM/DD/YYYY) �Rv CERTIFICATE OF LIABILITY INSURANCE OP ID BW JPR00-1 08/27/10 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Francis Provencher Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Agency, Inc. HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 530 Rogers Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Lowell MA 01852 Phone: 978-459-8681 Fax:978-454-9343 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Northland insurance companies INSURER B: Commerce Insurance Company 34754 JP and Sons Roofing Inc. INSURER C: National Union Fire Ins. Co. PO BOX 1482 INSURER D: Lowell MA 01853 INSURER E: COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR NSR TYPE OF INSURANCE DATE MM/DD/YYYY DATE MM/DD/YYYY GENERAL LIABILITY EACH OCCURRENCE $ 1000000 A X COMMERCIAL GENERAL LIABILITY WS061991 04/12/10 04/12/11 PREMISES(Ea occurence) $ 50000 CLAIMS MADE X❑ OCCUR MED EXP(Any one person) $ 1000 PERSONAL&ADV INJURY $ 1000000 GENERAL AGGREGATE $2 0 0 0 0 0 0 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2 0 0 0 0 0 0 POLICY PRO ECT LOC J AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1000000 B ANY AUTO BBGS09 12/04/09 12/04/10 (Ea accident) ALL OWNED AUTOS BODILY INJURY X SCHEDULED AUTOS (Per person) $ HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR F-1 CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION - - AND EMPLOYERS'LIABILITY X TORY LIMITS ER C OFFICER/MEMBEROPRIETPJPARTNERJE ECUTIVF� WC3795711 04/12/10 04/12/11 E.L.EACH ACCIDENT $ 100000 EXCLUDE (Mandatory in NH) U E.L.DISEASE-EA EMPLOYEE $100000 If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 500000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Job location: 32 Meadow Lane, N. Andover, MA CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION NANDOVE DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR Town of North Andover REPRESENTATIVES. 120 Main Street AUTHORIZED REPR ATIVE N. Andover MA 01845 C'—T ACORD 25(2009/01) ©1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD PROPOSAL (978) 667-1775 No Job Too Small Proposal No, JP ROOFING Sheet No. P.O. Box 1482 • Lowell, MA 01853 Daft "Rubber Is Our Speciality" Proposal Submitted To Work To Be Performed At Name ,qvl 1 e e n2' z rd l f( ,-" eormMAIPM Street Street v City State City Date of Plans State Architect Telephone Number We hereby propose to furnish the materials and perform the labor necessary for the completion of 1'LgW o ✓� ,gve o 0i5 pOSa v' IWO 2770".P1 4*1� �X�s inn e-Z`a1,4� sl�i e/iJ" vn €000€5 s9" 0 t/.Q!/ter s _' �yc f L 9 sfl G�/�f/�-►m •-►c 109.7 0 1/'ch %S '17 �C�77r✓�2 '1' 4 4 Y F-*k v-1 to Imre°/u j vdt / -714/1 �t7�.tz. Ta /o G(✓0 /-7 � OW-5 Na,%,, A 'J' vcY1'�5 f/ All material is guaranteed to be as specified, and the above work to be performed in accordance with the drawings and specifications submitted for above work and completed in a substantial workmanlike manner for the sum of ;:- .S r4.'r,`T Dollars IS I ff.300 0d ). with payments to be made as follows: �N«-�J �A/f- L✓AY PA19 « iW/ vr' 60'4'm f r�-:'irrA✓ Any alteration or deviation from above Wmifiatiom involvin a Respectfully submitted zi/ extra colts, will be executed only upon written orders, and will become an extra ehe g over end above the stinMe. All agreements contingent upon strikes,soei'm I or delays beyond Per our control. Owner to carry fire,tornado and other necusery insurance upon above work. Workmen's CompenistIon and Note—This proposal may be withdrawn Public Liability Insurance on above work to be taken out by by us if not accepted within days ACCEPTANCE OF PROPOSAL The above prices, specifications and conditions are satisfactory and are hereb accepted. You are authorized to do the work as specified.Payment will be made as outlined above. 1 ¢ 1 I Signature Date s b ' / Signature �� B��O��L1071Sti�I1!ll J[d.Ill��'Ir(IS 4`� HOME IMPROVEMENT CONTRACTOR Registration: 127343 Expiration: 1-0/13/2010 Tr#: 275096 Type: Individual DAVID J. ROPER DAVID ROPER 6 BRISTOL WAY LITCHFIELD,.NH 03052, Administrator •'-' Jlassachusetts- Department of Public Safety Board of Building Re!-ulations and Standards Construction Supervisor License License: CS 68670 Restricted to: 00 i DAVID J ROPER 6 BRISTOL WAY LITCHFIELD, NH 03052 '^sr Jam- �� Expiration: 12/29/2010 ('unnnissiuO/" Tr#: 8676 i I I