HomeMy WebLinkAboutBuilding Permit #53-12 - 33 ELM STREET 7/22/2011BUILDING -PERMIT
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit NO: �� v I y Date Received A 0'
TYPE OF IMPROVEMENT
PROPOSED USE
Residential
Non- Residential
New Building
✓ One family
Addition
Two or more.family
Industrial
Alteration
No. of units:
Commercial
✓Repair, replacement
Assessory Bldg
Others:
Demolition
Other
:
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DESCRIPTION
OF WORK TO BE PREFORMED,
F
Identification PIease Type or Print Clearly)
OWNER: Name: f � hrt s (-oc Phone: 9 -1 8 97 S 5` fO
ARCHITECT/ENGINEER Phone:
Address: Reg. No.
FEE SCHEDULE. BULDING PERMIT: $12.00 PER $9000,00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F.
Total Project Cost: $ r(ag0 . y FEE: $
Check No.: Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have access to the gyaranty fund
Location
r
No. J �- Date
HpRTq TOWN OF NORTH ANDOVEF�'
` Certificate of Occupancy $
CNUsE<�' Building/Frame Permit Fee $ a
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check # /
Building Inspector
Plans Submitted Plans Waived Certified Plot Pian Stamped Plans
TYPEOF 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
PLANNING & DEVELOPMENT
COMME
DATE APPROVED
CONSERVATION Reviewed on Signature
1..�JIV111lIEIYT�7
HEALTH Reviewed on Signature
COMMENTS
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision:
Conservation Decision:
Comments
Comments,
Water & Sewer Connection/Signature & Date Driveway Permit
DPW Town Engineer: Signature:
Dimension
Number of Stories: Total square feet of floor area, based on Exterior dimensions.
Total land area, sq. ft.:
ELECTRICAL: Movement of Meter location, mast or service drop requires approval of
Electrical Inspector Yes No
DANGER ZONE LITERATURE: Yes No
MGL Chapter 166 Section 21A —F and G min.$100-$1000 fine
Doc.Building Permit Revised 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 N.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
❑ 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)
❑ 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
0.0
11Cei uIled 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
Doc: Building Permit Revised 2008
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DATE (MMIDDIYYYY)
ACORD,. CERTIFICATE OF LIABILITY INSURANCE I9-/3-Zpld
PRODUCER S08.651.7700 FAX THIS CERTIFICATE 18 ISSUED AS A MATTER OF INFORMATION
Eastern Insurance Group LLC -Main ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EMNO OR
Z33 West Central Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Natick, MA 01760
INSURERS AFFORDING COVERAGE INAIC #
INsuRED Davi Ca!ft ri Cone TROTinq & Sidi"n-gInc INSURCRA: ASPEN SPECIALTY INS CO
200 Sutton St INSURER a;
Suite 226 INSURER C:
North Andover, MA 01845 INSURER 0:
INSURER E:
COVERAGES
ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWrrHSTANDING
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN
CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
ANY REQUIREMENT, TERM OR CONDITION OF ANY
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERI�AS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR IMMLTR
NSR
rPE OF INSURANCE
POLICY NUMBER
CPT12S310
OA MMIDD
09/06/2010
DATE MMIDD
LIMITS
09/06/2011
EACH OCCURRENCE $ 1 000,0
REPRESENTATIVE4.
GENERAL LIABILITY
PrPAEMire S It E, olxulrence $ 50,01A
0 i - 0 ( N. All rights reserver
X CO.WERCIAL GENERAL LIAeIUYY
MED EXP (Any ene ponen) $ 1,00q
CLAIMS MADE M OCCUR
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PRODUCTS - COMNOP AGG SJECT
GEN'L AGGREGATE LIMIT APPLIES PER;
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COMBINED 91NOLE UMIT S
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BODILY INJURY 3
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SCHEDULED AUTOS
HIRED AUTOS
BODILY INJURY S
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NON.OWNED AUTOS
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GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT S
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E.L DISEASE • EA E'APLO $
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SPECIAL PROVISIONS below
j E.L. DISEASE - POUCY LIMIT $
OTHER
I
DESCRIPTION OF OPERATIONS i LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
CERTIFICATE HOLDER
IiARIoGLLJA I IVN
SHOULD ANY OF THE ABOVE OESCRISED POLICIES BE CANCELLED BEFORE THE EXPIRATIOI
David Castricone Roofing& Siding, Inc.
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL _ DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO 00 SO SHALL
200 Sutton Street, Suite 226
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, KS AGENTS OR
North Andover, MA 01845
REPRESENTATIVE4.
AUTHO RREDD 75
ACORD 25 (2009101)
0 i - 0 ( N. All rights reserver
The ACORD name and logo are registered marks of A
ACORDDATE(MM/OD/YYYY)
Tw CERTIFICATE OF LIABILITY INSURANCE
i/24!2010
PRODUCER Phone: 508-651-7700 Fax: 508-653-8089
Eastern Insurance Group LLC -Commercial Lines
233 West Central Street
Natick MA 01760
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INS
ADO'L
:NSRn
INSURERS AFFORDING COVERAGE NAIC #
INSURED
David Castricone Roofing & Siding Inc
200 Sutton St
INSURERA:Citation Insurance 74
INSURERB:CHARTIS
LIMITS
Suite 226
INSURER C:
INSURER D:
N::rth Andover hLk 01845
_
INSURER E:
. t
COVERAGES
THE POLICIES OF INSURANCE LISTED BELO`',,' AVE 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
C_ER.TIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN I.S SUBJECT TO ALL THE
TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INS
ADO'L
:NSRn
POLICY NUMBER
POLICYEFFECTIVE
POLICY EXPIRATIONLTR
LIMITS
GENERALLIABIUTV
EACHOCCURRENCE $
COMMERCIAL GENERAL LIABILITYANI
CLAIMSMADE 7OCCUR
PREMISES--9waTeelwel =
MEDEXP(Anyoreperson) S
PERS014AL & ADV 114JURY $
GENERALAGGREGA'TE S
GEN'L AGGREGATE LIMIT APPLIES PER:
PHODUCI'S•COMPIOPAGG $
POLICY 7 PRO
E T LOC
A
AUTOMOBILE
LIABILITY
ANY AUTO
BCNCCV
8/1,y2010
8/1/2011
COMBINED SINGLE LIMIT
(Eaacciderv) S 1, 000, 000
BODILY INJURY
S
Y,
ALL OWNEOAUTUS
SCHEDULEDAUTOS
X
HIREDAUTOS
X
NON-OWNEDAUTOS
BODILY INJURY $
(Per acckbrn)
PROPERTYDAMAGE S
(Per accideln)
GAR AGE LIABILITY
AUTOONLY-EAACCIDENT S
—
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ANY AUTO
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EXCESSIUMBRELLALIABILITY
OCCUR 7 CLAIMSNIADE
EACH OCCURRENCE $
AGGREGATE S
S
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$
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S
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WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
WC003989723
9/213/2010
9!23/2011
X I WCSTATU- OTH-
E_LEACHACCIDENT $ GO
AN'(PROPRIETOR/PARTIJEFL'EXECUTIVE
OFFICER!MEMBEREXCLUDED9
E.L. DISEASE EA EMPLOYEE $ 100,000
IIyyeS,dLscribewitler
SPEC:IALPROSIONSbelow
OTHER
E.L. DISEASE - POUCYLIMIT $ �00, 000
DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES/ EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
CERTIFICATP We)l nFa
David Castricone Roofing & Siding Inc
200 Sutton St
Suite 226
North Andover MA 01845
25(2001108)
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
BEFORE THE EXPIRATION 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 FIND UPON
THE INSURER, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
oACORD CORPORATION 1ARA
0cl1al-0 plillfic S.Jfc(�
Buill-d ul, fillildill..: KC. -.11 lilt imis 1111(1
Construction Swpervisor Specialty License
License: CS SL 99358
Restricted to: RF,WS
. N�j
DAVID CASTRICONE
31 COURT STREET
NORTH ANDOVER, MA 01845
----------- Expirallol): 12116/2011
I'm: 99358
office 01'Cullsomer Affuirs & jil'ilicss 11cguilitioll
-,-,,.HOME IMPROVEMENT CONTRACTOR
Registration: 104569 Type:
Expiration: 711412012 Private Cotporatio
DA
DA D CAST ICONS ROOFING, SIDING &
David Castricone
200 SUTTON ST SUITE 2.26
NORTH ANDOVER, MA 01845 Undersecretary
Town of North Andover
Building Department
27 Charles Street
North Andover, Massachusetts 01845
(978) 688-9545 Fax (978) 688-9542
DEBRIS DISPOSAL FORM
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SS/1 C H Lis
In accordance with the provisions of MGL c 40 s 54, and a condition of
Building permit # the debris resulting from the work shall be disposed
of in a properly licensed solid waste disposal facility as defined by MGL c,l 1, s15Oa.
The debris will be disposed of in /at:
/- � -- E l/(f� �5"' 9 A) AJ
Facility location
Signature of Applicant
Date
NOTE: A demolition permit from the Town of North Andover must be obtained for this
project through the Office of the Building Inspector,
The Commonwealth of Massachusetts
Department of Industrial Accidents
LV Office of Investigations
600 Washington Street
Boston, MA 02111
kvi www. mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Organization/Individual): �ASTR I L 0 AJ E ROO F l K Lr
Address: `_00 J5u h0 n 64-rce-,+, 601 te, ZZ(Q
City/State/Zip: N D. A n d d Ve_/
PA 61 H S Phone #: 99E
(0 M 3Y Z C)
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).*
2. ❑ 1 am a sole proprietor or partner-
have hired the sub -contractors
listed on the attached sheet.
7. EJ Remodeling
ship and have no employees
These sub -contractors have
g, ❑ Demolition
working for me in any capacity.
employees and have workers'
insurance.1
g ❑ Building addition
[No workers' comp. insurance
comp.
5. ❑ We are a corporation and its
10.❑ Electrical repairs or additions
required.]
3. ❑ I am a homeowner doing all work
officers have exercised their
11. El Plumbing repairs or additions
myself. [No workers' comp.
right of exemption per MGL
12.M Roof repairs
insurance required.] t
c. 152, §1(4), and we have no
13.❑ Other
employees. [No workers'
comp. insurance required.]
*Any 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 a new affidavit indicating such.
tContractors that check this box must attached an additional sheet showing the name of the sub -contractors and state whether or not those entities have
employees. If the sub -contractors have employees, they must provide their workers' comp. policy number.
I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site
information. I
Insurance Company Name:
Policy # or Self -ins. Lic. #: Y Y �� Q I s I I Expiration Date: 9-a3-011
Job Site Address: 3,3 �, ( M S�-rec { City/State/Zip: 06, 1' Y O6(1 -r M19-
Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL 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 certify under the pains and penalties of perjury that the information provided above is true and correct.
Sip -nature:. Date:
Phone #: `I l u,5 3 uu
Official use only. Do not write in this area, to be completed by city or town official
City or Town: Permit/License #
Issuing Authority (circle one): 111
1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector
6. Other
Contact Person: Phone M
Information and 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, association, 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 or other legal entity, employing employees. However the
owner of a dwelling house having not more than three apartments 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 because 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 construct 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 until 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-contractor(s) 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' compensation 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 sure to sign and date the affidavit. The affidavit should
be returned to the city or town that the application for the permit or license is being requested, not the Department of
Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain 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.
City 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 permits 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 bum leaves etc.) said person is NOT required to complete this affidavit.
The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions,
please do not hesitate to give us a call.
The Department's address, telephone and fax number:
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston, MA. 02111
Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE
Fax # 617-727-7749
Revised 4-24-07
www.mass.gov/dia
. DAVID CASTRICONE `�t, /�?, /�
CASTRICONE ROOFING & SIDING INC.
ROOFING, SIDING & REMODELING REPLACEMENT WINDOWS
HOME IMPROVEMENT CONTRACTOR REGISTRATION NUMBER 104569
200 SUTTON STREET, SUITE 226, NO. ANDOVER, MA 01845
In North Andover 978-683-3420 In Boxford 978-887-6147 In Haverhill 978-371-7314
Uwe the owner(s) of the premises mentioned below, hereby contract with and authorize you as contractor, to furnish all necessary
materials, labor and workmanship, to install, construct and place the improvements according to the following specifications, terms and
conditions, on premises below described:
LOwner's Name...... . .l`l.,S�......Y.t?.4s1 1 ......................................................... . ..Telca one # ..................................................
�Job Address ....... .�.. .... ..hit_:..... .....r..................................City................ State ..... XIA ....
Specifications:
,....................
✓trip existing shingles.iJy� t/Apply new drip edge to all edges. ldlr�z. �' �
...............................................................................................................................................................................................................
j,A..pply _feet ice and water shield membrane to bottom edges of house. 3 feet ice and water shield membrane
in valleys and bottom edges of any unheated areas of house.
...............................................................................................
14p1y felt paper underlayment. Ws*tall ridge vent to , YJ
.............................................................. .
ill eroof using shingles with a year warranty.
.................................................................................dv�...3...� - �?:.
........................................................................................
--Counterflash chimney. New vent pipe flashing. Legal disposal of all debris.
......................................................:3. ...`..'.:..................... /l//loi2E &pct,
......................
"Area(s) to be worked on:
...............h
..............:.........................................................................................
... ............... . .. .
.............
..............
1.....z......ts...rh.�.....a.r.....� .........�. ...........
........................ _........................ ....................................,1..���.=.9'.g o..
_..� ,/
.... .�...... .......rt�.�- . .::.... .........................R R. -4-- .....�s7 �...
Roof board replacement if necessary @ i 0 /sheet or :�-6°/foot.
........................................................................................................................................................................ ........
... ...........
Two Year Workmanship Warranty (Not Transferable) IV):anufacturer's Warranty as specift y manufacturer
Thera,
for agrees,t9 perform the work d i h the materials specified above fothe SUM o a....... ..%!lo...........
zs'c c% �. s r
able ...... ,2 s ............. on ,.,5� ...............7 fr
Payable....... I ..................... on.................................. stance awe on completion of lob �.�idTti
Owner or Owners are not responsible for Property Damage or Liability whirjob rs m operation. Ghee V # 33,7 -Z
Contractor is not responsible for any damage to the interior of property, including pre-existing conditions (i.e. water stains, crumbling plaster, exposed nails) or
conditions resulting from application of materials specified above (i.e. objects coming loose from walls, crumbling plaster, exposed nails, dust in snit or other living
spaces). Items in attic may need to be covered by homeowner. All materials are property of contractor. Any dumpster placed by contractor is for his use only. Upon
completion of above work, all undersigned agree to execute and deliver to contractor, their joint note in accordance with his (their) above obligation as requested by
contractor. Upon refusal to do so, contractor may at its option declare the entire contract price or so much as then remains unpaid, immediately due and payable. It is
agreed that, if Permitted by law, contractor shall be paid by the owner(s) all reasonable costs, attorney fees and expenses, in addition to the amount due and unpaid, that
shall be incurred in enforcing the terms and conditions of the contract and/or any lien in connection herewith. It is further agreed that this contract may be assigned by
contractor, and also that the obligations hereof shall bind and apply to their heirs, successors or estates of the parties. The undersigned warrant(s) that he is (they are)
the owners(s) of the above mentioned premises and that legal title thereto stands of record in his (their) names(s). There are no representations,, guaranties or
warranties, except such as may be herein incorporated, if any, nor any agreements collateral hereto, nor is the contract dependent upon or subject to any conditions not
herein stated. Any subsequent agreement in reference hereto shall be binding only if in writing and signed by all parties.
All Home Improvement Contractors shall be registered and any inquiries about a contractor or subcontractor relating to a registration
should be directed to: Director, Home Improvement Contractor Registration, One Ashburton Place, Room 1301, Boston, MA 02108
Tel: 617-727-8598
Any and all necessary construction -related permits shall be obtained by the Contractor. Any Owner who secures his own construction -
related permit or deals with unregistered contractors is excluded from the Guaranty Fund provisions of MGL c. 142A.
Approximate starting date of work ................................................ Completion date .........................................................
Receipt of a copy of this contact is hereby acknowledged, and it is further acknowledged by the undersigned that the foregoing
provisions have been read and the contents thereof understood and that no representation or agreement not herein contained shall be
binding upon the parties and that all of the agreements and understandings of said parties are contained herein.
DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES
Owner has three business days to cancel this contract and incur no penalty (see notice of cancellation).
IN WITNESS WHEREOF, the parties have hereunto signed their najnes .................. day of ............................ 20...........
Accepted: -
Sig» ...... ........................................... ......... r r
J, Coe..r Signed ......................................... ............................ Owner
...................................................................
David Castricone, President