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HomeMy WebLinkAboutBuilding Permit #375-15 - 35 WRIGHT AVENUE 10/20/2014 NORTH BUILDING PERMIT °* TOWN OF NORTH ANDOVER o� APPLICATION FOR PLAN EXAMINATION 'yy' l+ O Permit No#. Date Received s O?A SACHUS� Date Issued: v" 1 IMPORTANT: Applicant must complete all items on this page LOCATION Print PROPERTY OWNS Print 100 Year Structure yesno MAP PARCEL: ZONING DISTRICT: Historic District ye no '7�z_ Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building k1 One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other El Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: I' rJa0Q,IfI Identification- Please Type or Print Clearly OWNER: Name:(AL--aPhone: Address: - lav Contractor Name hone: kz;g Address:0( _f O Supervisor's Cons ruction License: / 1 Exp. Date: 3b,, Home Improvement License: Ao// Exp. Date: //`2 I5 ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BOLDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. $ Total Project Cost: �,��� FEE: ` Check No.: y Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the n Signature of Agent/OwneFq &4 O Signature of contractor r Plans Submitted ❑ Plans Waived El Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL ' Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools El Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑ I I 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 Signature COMMENTS i 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 Locate, at 124 Main Street AFi - ertment signature/date { COMME :� 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 j NOTES and DATA— (For department use) I ❑ Notified for pickup Call Email 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 o Building Permit Application o Workers Comp Affidavit o Photo Copy Of H.I.C. And/Or C.S.L. Licenses o Copy of Contract o Floor Plan Or Proposed Interior Work o Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit I Addition Or Decks o Building Permit Application o Certified Surveyed Plot Plan o Workers Comp Affidavit o Photo Copy of H.I.C. And C.S.L. Licenses o Copy Of Contract o Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) o Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction ct on (Sin le and Two Family) Y) o Building Permit Application o Certified Proposed Plot Plan o Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit o Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract o Mass check Energy Compliance Report o 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 R Location No. ` Date 2t) t`9 • - TOWN OF NORTH ANDOVER • Certificate of Occupancy $ Building/Frame Permit Fee $ � Foundation Permit Fee $ Other Permit Fee TOTAL $ Check# ol 2 ( "1 63 Building Inspector r NORTH Town of 2Andover p :., 0 0�-�.Dh ver, Mass, A_ COCHICHewrcu �'► 7�pD4ATED S V BOARD OF HEALTH Food/Kitchen PERMIT L D Septic System THIS CERTIFIES THAT .... &SIM................. � . ............ .......... .....,............... BUILDING INSPECTOR Foundation has permission to erect .......................... buildings on ...�.. ..... ... ......... ..�,............. Rough to be occupied as .......... . .......................................... Chimney p' �R...................... ...... .. .�,. provided that the person accepting this permit hall in every respect conform to the terms of the application Final on file in this office, and to the provisions.of the Codes and By-Laws relating to the Inspection, Alteration and 1 Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR 1 Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONS T O Rough i Service ..... �. ..... ........ ....... Final BUI INSP TOR { GAS INSPECTOR li Occupancy Permit Required to Occupy Building Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final 11 No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. I Office of Consumer Affairs-an d Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 162111 Type: Supplement Carel NEXT STEP LIVING INC. Expiration: 1/14/2015 ROGER OUELLETTE 21 DRYDOCK AVE. 2TH FL BOSTON, MA 02211 Update Addressand return card.Mark e•¢asOa for change. Address U II�enna^�aI n Employment F-] Lost(Carl office Of cC®msnean¢n Affairs Business Il8¢ganlatu®a ]License Or registration valid 1b.tntdlMd ul nese oLm ,r bOME IMPROVEMENT CONTRACTOR beef o e the exp Arataon drtre:. ff found return to. Reglstration. 162111T e, ®ice of Consumev-AA�ffff Ars and Business Regulation Expiration: 1/14/2015 �� 10]Park Plaza a Sate SR70 Supplement':card Boston,NA`01�'i6 NEXT LI T STEP 3/IE�G INC. �° ROGER OUELLETTE g 21 DRVTJOCE<AVE.2TIa FL 4 BOSTON,MA 02210 - Undersecretary (y` of valid wiithout siignnattammn, — 1 l� 1 R � r Massachusetts Department of Public Safety Board of Building Regulations and Standards t'onatruction Supvri iwr Spe talo ~ I rcense GSK_1028 1 ROGE,R A®Vi LLETTL 35 STAMMI ORE ROAD', txprrat,or, Reza ctsd o: CSSL OC e ffisukition Contra(mor Failure to possess a current edition ou`the MloossachusWs S ae Building Cade is vause for revoc Con 01 this license. For OPS LicenAng Worm-atioo visk- The Commonwealth of Massachusetts Department of Industrial Accidents W Office of Investigations a d I Congress Street, Suite 100 � W Boston,MA 021142017 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le ibl Name (Business/Organization/Individual): Next Step Living Address: 21 ®rydock Ave City/State/Zip: Boston, (V6A 02210 Phone#:(666)667-6729 Are you an employer?Check the appropriate bozo Type of project(required). �'P p J � q � 1,[[� I am a employer with 650 4. ® I am a general contractor and 1 6. ®New construction ployees (fall and/or part-time).' have hired the sub-contractors 2.0 I am a sole proprietor or partner- lasted on the attached sheet. 7. ®Remodeling ship and have no employees These sub-contractors have 8. c]Demolition working for axle in any capacity. employees and have workers' 9 ®Building addition o workers' com insurance comp. insurance.l quwork p 5. [� We are a corporation and its 10.n Electrical repairs or additions � 3.® I am a homeowner doing all work officers have exercised their 1 LE]Plumbing repairs or additions myself. [No workers' cornp. right of exemption per have n 12.®Roof repairs insurance required.] t c. 152, §1(4),and we have no Insulation employees. [No workers' 13.01 Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Iiomeowners 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 vot those entities have employees. If the sub-contractors have employees,they must provide their workerscomp.policy number. [am an employer that is providing workers'compensation insurance for my employees. Below is the policy and fob site information, ! Insurance Company Marne: A-I-M Mutual Insurance Company Policy#or Self-ins. Lic.#:AVC-400-7030025-2014A Expiration bate: 9/30/15 Job Site Address: City/State/Zip: 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage v fi tion. Ido hereby certify under the pains anden es perjury that the information provided above is trace and correct Si ature: Date: 10/ 1 / Phone#: Official use only. Do not write in this area,to be completed by city or town official. City or Towne Permit/License.# Issuing Authority(circle one): 1°Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector S°Plumbing Inspector 6°Other Contact Person: Phone#: I NESTS-1 OP ID.EL CERTIFICATE OF LIABILITY INSURANCE r DATE(MMIDDIYYY`t) �,..� 1 10/0112014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION O%y AND CONFER$ N® RIGHTS UPON TH9 Q911TIFIGATF HOLDER,THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POL1CIES BELL Vy. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), 4PTH09I990 RgP FSENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMP I-TANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION IS WA,IV%OB4Ig6j tq the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to Bhp certificate holder in lien of such endorsements. PRODUCER CONTACT M6Laughliry Ipsurance Agency PHONE Erin Lyons FAX 626 Lynn fells ParkWpy AI No Erg,:781-605-2 AIc No:781-665.02 Melrose,MA 02176 E-MAIL John E.McLaughlin Jr. -ADDRESS: INSURERS AFFORDING COVERAGE NAIL 0 INSURER A:Nautilus Insurance INSURED Mext Step I lving,Inc. INSURER B:Commerce Insurance Company 3475 21 Drydock Avenue,2nd Floor INSURERC:A.LM.Mutual Insurance Co. Boston,MA 02210 INsuReRD:AXIS Insurance Company 15610 INSURER E: INSURER F C®VEBtAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY P�R(I0 INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THI2 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, ILTR TYPE OF INSURANCE POLICY NUMBER MMONYYYD,Y (MM/DR=LICY EFF EXP LIMITS A X COMMERCIAL GENEPAL LIABILITY EACH OCCURRENCE $ 1,0®0,00® CLAIMS-MADE FV_ OCCUR ECP2010196=12 09/20/2014 09130!2015 PREM SES Ea occurrence $AMAGE TO RENTED 151®,®®® MED EXP(Any one person) $ 0,000 PERSONAL✓tADV INJURY $ 11 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ ?49149 POLICY ElJE°T LOC PRODUCTS-COMPIOPAGG $ 1vq�4,p�11 OTHER: NG $ MBNS AUTOMOBILE LIABI6ITY COIED—IN L MII Ea accident) B ANY AUTO 14MMBOKKOM 09/30/2014 09130/2015 BODILY INJURY(Per person) $ � ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS Per accident $ $ UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 5,000106 ® EXCESS UAB CLAIMS-MADE Ep U763547012014 09/30/2014 09130/2015 AGGREGATE $ 5,0%006 011 DED I I RETENTION$ $ WORKERS COMPENSATION STATUTE ERR AND EMPLOYERS'LIABILITY C ANY PROPRIETORIPARTNERIEXECUTIVE YIN TO BE ISSUED BY CARRIER 09/30/2014 00/30/2015 E.L.EACH ACCIDENT $ 500,000 OFFICERIMEMBER EXCLUDED' ElN/A (Mandatory In NN) E.L.DISEASE-EA EMPLOYEE $ 500,000 Ifs describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) FOR jRqF0pA&Tj0jq oNLy I CERTIFICATE HOLDER CANCELLATION INFO-01 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN For Information Only ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED DRRE.PRESENTTA71VE ©19662014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/91) Tho ApgRA 90MIn loop,are rgq!s,t�ry 4f ACOR 10119h F0 n e-Ovcf t S t pit U Vi n g . This agreement Is made by and among Next Step Living, Inc.("NSL") Sue and Steve Hansen 21 Drydock Avenue,2nd floor 35 Wright Ave Boston,MA 02210 phone: (866)867-8729 North Andover, MA 01845 Site ID: A296101 18-Sep-14 1. DESCRIPTION OF WORK TO BE PERFORMED NSL will perform or cause to be performed the following work on the customer's address above,in a professional manner and in accordance with the terms of this Contract,including the attached recommendations/work order describing the work in detail(the"Work")which are incorporated herein by reference: , e , 1,Vork Location: Attic Flat Propavent 2'or 4' 69 Each $138.00 Vent bath fan to roof flapper 1 Each $118.75 Damming 157 Lnft $321.85 Attic Floor Open Blow Cellulose 6" 1,242 sgft $1,490.40 Perform Air Sealing at Estimated 62.5 CFM50 Per Hour 10 Hr $750.00 MA Save CMA Weatherization Incentive $2,264,25 Estimated Annual Energy Savings from the Above Improvements $116.00 I 2. PAYMENT. CUSTOMER agrees to pay NSL for the work as follows: Payment#1: $100.00 -Credit Card or E-check deposit is due at the time the Work is scheduled. Required payment information will be collected over the phone by a customer service representative at the time of scheduling. Deposit is not to exceed 1l3 of the total retail costs. (Note:Mastercard,Visa,and Discover accepted) Additional Payments and Final Invoice: $454.75 -Additional payments for the Work shall be due upon completion of the Work. If the final invoice is being paid by check,credit card information will still be required at the time of scheduling. Notify the customer service representative that you are paying by check and your card will not be charged unless we fail to receive payment within 5 days of invoice. I I Sep 23 2014 .Ctr aer4.*W,e%oi<; Date .�.sar a K•�CeTo 18 Sep 2014 Sulsan 909hkemulder susN8LArSfd?jdt4 68 2014; Date Name of NSL Representative i The Terms of this Agreement are contained on both sides of this page Next Step Living o 21 Drydock Avenue 2nd floor Boston,MA 02210-(866)867-8729 1 inquiry@nextsteplivinginc.com www.nextstepliving.com I TERMS OF AGREEMENT 3.PROPOSED START DATE AND COMPLETION SCHEDULE NSL will contact customer io schedule the'tvom at a mutually agreeable t me,SUniect to this a,' 'ah lity cf subcc^trac.tors or materials,Or to c.,ays aftnhutable to the weather or other events beyono NSL's control. 4.CONTRACTOR REGISTRATION Massachusetts taw requires home irrp evefrerctraosG d stconacars is bereg€ treatfite Director Nomnproveme^t Contractor Reyistra:sur. You r ayi1 os d !:n:quire about contractor registration by writing to:Office of Consumer Affairs and Business Regulation,Ten Park Plaza,Suite 5170,Boston,MA 02116.617-973-8700 5.PERMITS NSI-will obtain any necessary permits as the Customer's exert. Cusm-merswho secure the o vi' pe ni is or deal wit':an unregistered ccs tracto-oil be exc uded from.the Guaranty Fund provisions of the Home Improverrier:.t Contractor Law. 6.PERFORMANCE OF THE WORK AND CHANGES. 6.1 NSL will net con-,me ice the Work,,trier to signir;g:his Agreernen:and trans•t iita!of a copy e'Agreement to tie 0,isto Mer 6 This Arrecment may be supple rented,amended.n•moained cr:v y the miiitual agreement a t me oplies.No supple rent;amenomem,or rodr,icatio:-of tris Agreement shall be hindino unless it is in:siting and signed by all parlies, G.3 At times ou,weat`lerizatior team discovers s':ust ons in::e structure during the course of the Work that indicates a risk for A health or safety concern for residents. Such concerns can include'nut are not limited tovent.l.ation,potentially hazardous materials such as mold or asbestos,or sirs lura:co,ceras. In the case rif heall'i or safety concerns being identified.NSL reserves the fight,per section 9.2 of this ccr;tragi,co .Dmrrunlcaie concernsto the C s crier and!salt v+.pork,until such concerns nave been addressed. 8.1 The rebates and incentives available'rom the Mass Save"i",Home Energy Services Program and arnounts due from the Cuslorle,are based or,the best estimate of Ili'e situation in I'e structure by the NSL home energy adviser. However,at t res our weatlienzation tears discovers situations in ine home during the course of the Werk toot impact the availabi'iiy of rebates and ilio .dives.`torr tl e Mass Save Program. Ins such s tuations;NSL will cornu^late such chatges to the Cuslumer mdudi.^g any mpact on amount the Customer would be expected to pay for the work. 1 he Customer.t itnaJe the opt!gn to remove from the Contract the work,elements that need adjustment,or set up a separate contract for performing the adiusted work. 6.5 NSL represents and warrants to:t e Customer that;a)the materials and equipment furrfsheo wider this Acre rne-t>xJi be o-`good quality and new;(b1 that ttie Werk I : H lye free from defects and(-I that the!;'ort w'I cor r0m w to the description Of the 1"voik des nbec:n Paragrapt 1, i 7.INSURANCE AND REGISTRATION NSrepresents arid warrants 101r'e CuslomFn, . tit"as ii VAi:d Home improvement Iert rcntr?.C1c:reg s ria ion(N0:'62111)a ld the necessary i'!Stlfr."°Cull re•:t';Iif`C by aoNficau e law and nor nahv inaintairied by pr dent contractors in NS-'s field,includino,but not:;mite w.,ycrkers Cgmpens tori Insurance for all employees who will Der:"orm the Work, 8,QUALITY OF WORK. NSA agrees that the Work will be oerxo-nod in a good and t:grkriarlike manner,aro that NSI will repair and replace,at its c-r expense,and promptly upon Customer's eruest,an d ;, o cis in workmanship and mater,s provided by NSL which appear up to(1)year after complelor,ofthe Work D !^lith n nmy longer pe:led as permitted or ec;uired under apolioable toot.provided NSL has receive'final payment as provided herein. 9.PRE-EXISTING CONDITIONS&PROPERTY PROTECTION .1 NSL shall not be respor sl^le to,any tonnages as?consequence,^'the,,','arkerfo me .h the mune:rue:o,>.re-exist ng conditio, s. These conditions include but are r t limited to poorly fastened or broken drywall,moisture damage,rot-code conshdion cracked or t agile s:ding or shingles.old pines aril Fitt rigs,°otiinq iuood.etc. 9. NSL rese .es the rr kit not to perform Work upon the discovery o ass esms,mold,or any otner potent':at health risk to'he Cuslomer. In this event,Tie Customer is reSpO:sible for Yemedv ng the a!-"ask sitia.lon in::Uding anV lecossary remcvG . nazaroc's materials and all b lls for services to da..,shall he paid '"tmediate:y. ' or,, cannot resu-n e,until remediation is complete. 9.3 Wt i!e NSL Vdii'€*lake best eflc;its..y protea cry prior ,rt,Of fine t l a_Jrner, ,t IS the i1StOr1'6(S rcS,,.i S�bility i0 rem(i�'e Or prCtP.Ct nc;uding Gist protection,any De sorra'..property'ncludlnu the home,itself. RSL will''.0 he:espOnsibie for damages toor osses Of any Of t"e above mentioned Dripent` not prgDefy prOteCted prior to the commencement o'f the'rVdrk. 10.GENERAL PROVISIONS. 10,1 NSL reserves the right, the extent perm fled by app cable fa :to :ave,tilt or maintain a mechanic's d'rraieriai men s ben.or is c notr..e or in tenion to lien;old to take any other steps to per'ct and enforce such a lien,I-Customer fails to pay NSL as Drovideo herein. 1G.2 Tili.S Agreement shall t e consiru.,ti in a cardanc;e,ifh file laws of the Cornmcnwealt.i or Massach setts. 0.3 This Agreementiorrils t e complete integrated agreement.Detween NSL arid Customer. The pa:les re;,resant and warren'that;n executing this Agreement,they are nut relying on any representations,warranties or tears other than as expressly contained hereiri. This Agreernen:supersedes a 1 prior agreements betwee i the Cutumer and Contraclor and may not be altered absent a subsequent written agreement signed by both parries. You may cancel this Agreement if ii Ilan been signed at a place other t an the NSL's normal pia e Of,,. s1r.01-5,plovi ed yo:nc:ry NSI.in writinq at its main office or branch offi e by ordinary mail posted.by telegram sent o-by delivery,n;:later har mi n!c t of the tri d Lu.,neap ay talc ling tite s gni g c'this Agreement. See the attached nolcn� canceliatic;farm'or art.explairatipn of;fills right. � 11,ENERGY BENEFITS. The Sponsoring Utility Company(the Uf.li y)is eratled to 100%Of the enerV benefits associated tvith rill Energy Go-Set'atlon M-,a-ureS,eXglUdirg th,°Valise Of one fgV cess savings by the Customer,butt including all rights to all associated ISO IFErile cy.Ca pa;tv and Reserves Products.NS_agrees to provide the UPJiy with such further docurnentatiur as the Ut.Ii y may r 4aest to cDnr.nn the Utility's cwrership of such benefit,arc Products. 12.NOTICE CONCERNING SPONSORSHIP. Customer understands and acknowledges that NSL is not an agent vendor or sDb-vendor of the Sponsoring Utility Compaey(the Utility)with respect to the installation o.' an energy ofFlciercy Treasures.In the even-,of the fallufe of an energy conser4atlo':device to perform as expected.Customer's Sole cour e is t0 Cortravtor and not t0 Co lse nation Services Grout;(CSG)or to the Utility.The ut lity and is operating compan c sinall not inalntain,Ye^:love or perform any work i0aisoever on the energy conservation measures installed. Cuatomer uncerstands<ld acknowledges that their par-cep tion it,,rue Miiass Save Home Energy Serv'ces Progr,iri is voluntary and that they nave consented fur CO:.1tracto'to install fide p oposed energy gonseiva.iort measures. C.istdmer ag.ees:halt s:ali not hold CSG,the Utility.t ef�affi;iMes r, operating companies liable for Contractor s to perform s onligatlons under:his agreement,for failure of fir e')('rcy COnservaiion measures TO function,for any damage to Customers Premises cause[oy Contractor or for any and all damages to property or injury to 13.LIMITED TIME OFFER. The pr,^.,es and incentive offe ed in this Contract are suhfec:to :ingc it acco dan..e..t"7he S:^,onso inu Utility Company Mass Save Home Energy Services Program offers. 14.CONTRACT CANCELLATION Under Massachusetts law,you may cancel this agreement if it has been signed by a party thereto at a place other than an address of the seller,which may be his main office or a branch thereof,provided you notify the seller in writing at his main office or branch 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. gliSlILt Planview Diagram Team 1 2 Customer v� e-� Advisor Name: ( CA I _ - Address -7 �` A �`t Advisor Phone #: Town VVd'�� Any limitations to access by truck? Site ID 4146 1 U ( NOTES Any work scoped outside of Best Practice? Approved by: rv� CJ k� I C% 46