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Home My WebLink AboutBuilding Permit #190-13 - 38 PHILLIPS COURT 8/25/2013 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit N0: Date Received Date Issued: I PORTANT:Applicant must complete all items on this page LOCATION' ' pS - -- T P.nn T�Y Y. u. {PR:OPEROINNERr t —M Print a 100PYear Old Structure., u nal EMAP{NO:' PARCEG: _ ZONING DISTERICT __ Historic District Frio Machine Shop VJllogoi , yes no. TYPE OF IMPROVEMENT PROPOSED USE Re 'dential Non- Residential El New Building One family ❑Addition Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial Repair, replacement ❑Assessory Bldg ❑ Others: Demolition ❑ Other ❑`Septic E V11e11 .U'Flbodpla n Wetlands, 1 Watershed'District v ❑Water/Sewer.: - ° DESCRIPTION OF WORK TO BE PERFORMED: I P4 RQ ��pi e�is�-+► 4- - U E4"F4 (,far(- 6zl Y ore-* Identific tion Ple se T e or Print Clearly) OWNER: Name: a. arQf �ertt- Phone: q7 -6 Address: '39 i c�4 _ _ r 4. CONTRACTOR dName i4dtlress. b �San�-�5 _ u Supervisor?; Con structlon`Ll cense: 23 Exp Date: - r Home Improvement License o a?d __ '_ _ __ Exp _,R 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: $ yi ��q•3� FEE: $ � Check No.: a 6 �� ' � Receipt No.: NOTE: Persons contracting 't unregistered contractors do not have access t e guaranty fund . --s�--=^�-�-�--- xr. __..,. Signature,.ofAgent/Qvvner;' Slgature.of contractor._ a Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans El Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE-_OF:.SEWERAGE.DISP.OSAL 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 A i CONSERVATION Reviewed on Signature COMMENTS I HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connec$ionisignature& Date Driveway Permit DPW Tow> Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMeNT -Temp bumpster on site yes no Located-at 124,Main Street = . Fire ®eparf'riierit signatureldate ' 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 I I e , I i i B Notified for pickup - Date } Doc.Building Permit Revised 2010 Building Department The foii,,ovving 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 o Workers Comp Affidavit a Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ 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 Addition Or Decks Li Building Permit Application Li Certified Surveyed Plot Plan o Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ 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) Li Building Permit Application ❑ Certified Proposed Plot Plan ❑ 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) o 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 apo,-al period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be subm.tted with the building application Doc: Doc.Builjing Permit Revised 2012 1 i Location'sk IV- - No. Date i e - TOWN OF NORTH ANDOVER e Certificate of Occupancy $ Building/Frame Permit Fee " $-r 4 Foundation Permit Fee $ Other Permit Fee ti $ TOTAL $ Check# k' 26794 Building Inspector is NORTI� Town of O p+ No. % h , ver, Mass, COCHICMEWICM �d -ATE D ►.P S U BOARD OF HEALTH Food/Kitchen . PERMIT T L D Septic System THIS CERTIFIES THAT ..art R-rad-wewc , �,,,,,,,,,,,, BUILDING INSPECTOR . has permission to erect ..........:............... buildings on ....................... .. ,....��,��...., .�w• Foundation Rough tobe occupied as ................. .. . n...J�*.&A....................................................................... Chimney provided that the person accepting this permit shall 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 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 J • .UNLESS CONSTRUCTIgMiTAIRT Rough Service (..(j. ....... ................. Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Buildinz 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. SEE REVERSE SIDE The Commonwealth of Massachusetts T Department of Industrial Accidents Office of Investigations r I Congress Street, Suite 100 Boston, MA 02114-2017 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information �Q Please Print Legibly Name (Business/Organization/Individual): J>a� [�ckn0 Address: 64 t l,eew +. City/State/Zip: Me+haeh -71 MA01 Phone#: f-�9aa2 Are ou an employer? Check the appropriate box: Type of project(required): 1. I am a employer with 3 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑ New construction 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for the in any capacity. employees and have workers' comp.insurance.$ 9. E] Building addition [No workers' comp. insurance p 5. We are 10. Electrical repairs or additions a corporation and its required.] rp ❑ p dttlons q ] ❑ 3_.❑ I am a homeowner doing all work officers have exercised their 11.E] Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] t c. 152, §1(4),and we have no ] employees. [No workers' 13.❑ Other 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. #Contractors 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. Insurance Company Name: Al MUTU0.� 'nSt>mtrxe �An'1104,11�/ Policy#or Self-ins. Lic.#: AWC• yob•70-17 S3Y-A*13A Expiration Date:_ (r//Al l Job Site Address: CJD 1 (� �� City/State/Zip: r waft. & Olf ys 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 cO ify unde tile a pains and penalties of perjury that the informatio�z provided above is true and correct. Si nature: q V1____1--____.__-------- 11--l-11-1-.1._I Date[_, Phone#: 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): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: 1 vassacnusetts 'Department Dt ?uc +c Safety �--� Board of Building Reguiations ina Standards ( „n,trurti.,n .1ulicnn r x i_icense: CS-023365 ,- _, ` ; DAVID RFITA90 56 PLEASANT STREET " METHUEN MA 01844 Commissioner 12/04/2013 M c ri to -----—� N O W F• Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Hoene lrnproveinent Contractor Registration Reqistration: 108782 Type: Private Corporation Expiration: 8/25/2014 Tr# 230264 DAVID REITANO REMODEL & BUILD David Reitano ---------- - 56 Pleasant St -- - -------- ---- . ..-------'- Methuen, MA 01844 - -- -- — - Update Address and return card.Mark reason for cliange. Address C, Renewal L-] Employment j Lost Card SCA 1 .:5 MA-0511 i ]. Office ofCansumcr Affairs 3c Business Regulation License or registration valid for individut use only P;E'FE—h40ME IMPROVEMENT CONTRACTOR before the expiration date. if found return to: l`—th a istratlon: Office of Consumer Affairs and Business Regulation 9 108782 Type: S _ : xpiration: 8/25/2014 Private Corporation 10 Park Plaza-Suite 5171) ) ==.rte`-` Boston,MA 02116 DAVID REITANO REMODEL&BUILD David Reitano 56 Pleasant St � Methuen, MA 01844 - ----- - ----- __ .._. Undersecretary of valid without signature Aco CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 06/11/2013 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 01571.-001 CONTACT NAME: T A Sullivan Ins Agcy Inc AI°NN.Ext: (978)683-4700 a/c.No.: 135 Merrimack St EMAIL Methuen,MA 01844 ADDRESS: INSURER(S) FORDING COVERAGE NAIC INSURER A: A.I.M.Mutual Insurance Company 33758 INSURED David Reitano INSURER B' David Reitano Building&Remodeling INSURER C: 66 Pleasant Street INSURER'D Methuen,MA 01844 INSURER E' INSURER F, COVERAGES 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 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LTR INSR WVD POLICY NUMBER MMIDDIYYYY MMIDD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ PREMISES Ea occurrence CLAIMS-MADE ❑OCCUR MED EXP(Any one person) $ __- PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ EN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ OLICY RCTO- LOC E AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE AUTOS $ Per accident S UMBRELLA LIABOCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS MADE AGGREGATE $ �//pRDEERD MM RETENTION $ $ ANND ERMpPPLRO�E�E�RpBRELpIgABIrILIIETRY�X X TORY LIMITS ER A OFFICER/MEMBER/EXCLUDE/D?ECUTIVE YIN E.L.EACH ACCIDENT $ 100,000 ❑Y N/A AWC400-7027338-2013A 6/12/2013 6/12/2014 (Mandatory in If E.L.DISEASE-EA EMPLOYEE $ 100,000 yeS DESG` and describe under RIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMB $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Workers Compensation Coverage applies to MA employees only.. The workers compensation policy does not provide coverage for David Reitano CERTIFICATE HOLDER CANCELLATION LOWES COMPANIES INC PO BOX 1111 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN N WILKESBORO,NC 28656 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE (2010/05) The ACORD name and logo are registered marks of ACORD ACORD CORPORATION.All rights reserved. ACORD 25 @ 1988-2010 Asti r- CERTIFICATE OF LIABILITYaareluMLI2012 O INSURANCE I,t291r2U,2 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 INSURERISI, AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the poticylles)must be endorsed. If SUBROGATION IS WAIVED,subject to the terns and conditions of the po11Cy,Certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder In Ileu of such endorserns-11 ). PRODUCER Paychex Insurance.Agency; Inc. _ NAMEA 1501 Sawgrass Drnre P"0N o Ex _ Nei* _ E-MAIL WC Rochester,N`( 14620 anoa�ss: _ 877-26"85D INSURER AFFORDINGCOVERAOE NAICN ...................... .•._`_ INSUFMERA:°ntiun FU in:airevr.:.:,nr�*r I INSURED --- _ Davic Rejlano +NsuMtFns: dba DA AD REITANO REMODELING AND BUILDING INSURER C 56 Pl asant St INSURER D: \1ethuen..PAA 01844 —' INSURER E: INSURER F; COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLI--„IES OF INSURANCE LISTED BELOW HAVE BEEN'$SUED 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 IFSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, F XC._LISIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRT—_._ ---'- ..... LTR TYPE OF INSURANCEDbl.SV9RT" - - --- POLMC EFF POL POLICY NUMBER I OENFRAL LIABILITY MMf YY ID N DIY LIMITS I- X EACH OCCURP,EWE S 1 ccc.(-000 C COMMERCIAL GENERAL LIABILITY -PMISESiEao=rrw=1 1;N'(Ep S tin Fon GLAMS-MADE C'CCUR dnePe+sdnl.-_ ,S`'fro — DABP303650 12rn112011 12101,121013MEDEXP(An ot� -- PERSYJPIALS,ADV+NTJRY y INC"I'FT, — --..._...._ GENERALAGGREGATE 5 2t6d'AK, GENL AOC,R=GATE LIMIT APPLIES PER: - -- r PRODUCTS-COMPl)P POLICY LOC ASG 5 z'%(10-K9%(10-K9k PRO- S AU70M061LE LIABIL17y n. U.�I Ea ecdde ......I ANY AUTO -• ALL CVsNED S�NEAULED L-BOD'LY INJURY(Per pm ) S - ---. AUTOS AUTOS !900 LYINJURY(Peraccident) F HIREDAUT� NDN-0'AMEO -S AUTOS PROPER^/DAM.AGE 5 UMBRELLA LIAR EOCCUR I EACH OCCURRENCE ; EXCESS LIAB $•MADE: _-- !AGGREGATE _ $ DED I RVENTI -$ YVORNERS COMPENSATION NC STAT'J• jOTH- AND EMPLOYERS'UASIUTY YIN N AN',PFOP41ETvP.IPARTNERFx-CUTiVE E.L.EACH ACCIDENT 'S UrTI�CEPJMEIABEREXCLUCEO? NfA (Mandatory in NH) —_....... .. Ify-s,dezribd under E.L.UI—SEASE.EA EMPLOYES S _ OESCRIPTIDN(k ERATICNSWow EI L.p13E4SE•PDLCYUMIT:a I I OESCRIP7ION OF OPERATIONS 1 LOCATIONS J VEHICLES(Attach ACORD 101,Addmonat Remarks Schedule,Amore spam M repuked) LOWE'S COMPANIES, INC. AND LOWE'S HIW INC ARE NAMED AS ADDITIONAL INSURED WITH RESPECTS TO GENERAL LIABILITY. CERTIFICATE HOLDER CANCELLATION SHUU_C ANY O:-HE ABOVE DESCR BEG:r)LICIES 8E CANCELLED BEFORE THE LOWE'S COMPANIES, INC. EXPiRATICN DATE THEREOF NCTICEWLL BE DELI V=RE:IN AC:,ORDANCE1biTf-THE PCL(:'r-F.OVISIONS,BUT FAI•JjRE TO MAIL SUCH NOTICE SHA_L IMP;'SE P13,ATTN: IS INSURANCE r�EU,AT ON,OR U.ABILITI G:=AMf KIND UPON THE C 361RANY,ITS.AGEI.TS,CR PO BOX 1111 REPRESENTATIVES. NORTH WILKESBORO, NC 28656 AUTHORIZEDREPRESENTATIVE 01988-201 CORD CORPORATION, All rights reserved. ACORD 25(2010/05) The ACORD nine and logo are registered marks of ACORD STORE COPY t _ INSTALLATION SERVICES CUSTOMER CONTRACT- MWORK- INT/EXT/PATIO DOOR LOWE'S OF SALEM, NH, STORE#2382 STORE PHONE: (603)681-4218 541 SOUTH BROADWAY SALESPERSON:ANTHONY CORNACCHIO SALEM, NH 03079-0000 SALESPERSON ID: 631180 Document Print Date : 08/25/2013 This is only a Quote for the merchandise and services printed below. This becomes an agreement upon payment and issuance of a Lowe's receipt, upon which the entire agree- ment, including the specifically completed pages of this document, the Terms and Conditions included with this document, the applicable portion(s) of Lowe's receipt, and any other addenda or attachments hereto,shall be referred to herein as this"Contract." PLEASE READ THIS ENTIRE DOCUMENT INCLUDING THE "TERMS AND CONDITIONS." BEFORE SIGNING. Lowe's Registration or Contractor License Number/Lowe's Contractor Name Lowe's Home Centers, Inc.'s MA HIC NO.: 148688 Lowe's Home Centers, Inc.'s FEIN: 56-0748358 Customer Name S MARGARET BRODERICK Home Phone 978-688-6228 O Customer Address Other Phone 38 PHILLIPS COURT �— City State/Province Zip/Postal Code � NORTH ANDOVER MA 01845 Installation Address Tr 38 PHILLIPS COURT O Installation City Installation State/Province Installation Zip/Postal Code NORTH ANDOVER MA 01845 MERCHANDISE AND INSTALLATION SUMMARY MERCHANDISE SUMMARY 58593 : TC-M0842Z-SD : SOS : SOS BMTT PRESTAINED FBGLSS TEXTUR : PRE-STAINED WOOD GRAIN SINGLE DOOR UNIT TERRACOURT- ZINC CAMING : TRU LOGISTICS INCORPORATED - QTY 1 58593 : TC-M0842Z-SD : SOS : SOS BMTT PRESTAINED FBGLSS TEXTUR : PRE-STAINED WOOD GRAIN SINGLE DOOR UNIT TERRACOURT- ZINC CAMING : TRU LOGISTICS INCORPORATED - QTY 1 1158 : 1158 : STK : 1X6X8' SELECT PINE : 1X6X8' SELECT PINE : PRECISION LUMBER - QTY 8 3089 : EC100 : STK : PNE COVE 100 11/16 X 11/16 8' : PNE COVE 100 11/16 X 11/16 8' : EAST COAST MILLWORK DISTRIBUTI -QTY 1 3465 : EC164 : STK : PNE BCAP 164 1 1/8 X 11/16 8' : PNE BCAP 164 1 1/8 X 11/16 8' : EAST COAST MILLWORK DISTRIBUTI - QTY 6 238348 : 2828-8 : STK : 3/4X7.25X8 RF EMBOSD PVC TRM BRD : 3/4X7.25X8 RF EMBOSD PVC TRM BRD : ROYAL MOULDINGS LIMITED - QTY 8 Store 2382 Project No. 387854683 for MARGARET BRODERICK Page 1 of 8 c` STORE COPY Materials Price $ 3307.88 INSTALLATION DESCRIPTION Stock or SOS : SOS Door Type : Exterior Select Location : Front Door Select New Door: Single Pre-hung Number of Doors to Install : 2 Side Lights or Transoms : No Hardwood (Mahogany or Oak) Door : No Hidden Damage Description : None Number of additional holes bored for accessories : None Install Specialized Mortise Hardware : No Install Storm Door: No - Lead Safe Practices : Yes Total Linear Feet of Custom Trim to be Installed : 96 Deliver Door : Yes Customer Understands Scope of the Project : Yes Permit Required : Yes Who Will Obtain Permit: Lowe's Permit Fee : No Additional Miles Traveled over 20 : 0 Bring Up To Code Description : None Local Disposal Fee : Yes Describe Other Work Needed : reduce frame opening plaster wall jamb exten- sions Other Work Charge : Yes Comments : center arch benchmark pre finished Labor Charges $ 1606.50 Detail Deduction -$ 35.00 Additional Specifications: Notation: Lowe's will not make structural modifications, paint or stain or remove/reinstall security system equipment. Customer is responsible to advise if prop- erty is governed by Historic District Regulations. Additional Specifications:Federal law requires Lowe's to provide you with the pamphlet Renovate Right., Important Lead Hazard Information for Families, Child Care Providers and Schools. By signing this Contract, Customer acknowledges having received a copy of this pamphlet before w Customer of the potential risk of the lead hazard exposure from renovation activity to be performed in Customer's dwelling unit. ork began informing 7-Tc CHARGES OF ALL MERCHANDISE AND SERVICES *where applicable SUB-TOTAL $4879.3 *TAX $ 0.0 Store 2382 Project No. 387854683 for MARGARET BRODERICK Page 2 of 8 RM 1 i STORE COPY DELIVERY $ 0.0 ORDER TOTAL $4879.3 BALANCE DUE Work is to commence upon reasona le a^ailaf' y Contractor which is anticipated to be C [fill in date]. Estimated completion date is i �' [fill in date]. NOTICE TO CUSTOMER All items listed in this contract and specification sheet(s) are to be installed under conditions agreed upon at time of purchase and at the price appearing on this contract form. This assumes sound existing substructures, superstructure and points of attachments. Extra labor or material incident to installation necessitated by defective substructures, superstructure, points of attachment, or the moving of fixtures or appliances to be billed at extra cost to custom- er. IF THE CONTRACT TOTAL IS $1 000 00 OR LESS Customer must pay in full fC MPLETE THI SECTION ONLY WHEN THE CONTRACT TOTAL EXCEEDS$1,000.00: _wustomer to Pay in Full; OR [_] Customer to use the following payment schedule: (1) Deposit of$ to be paid upon signing contract. Any deposit collected at the time this Contract is signed will not exceed one-third (1/3) of the contract price; and (2) Payment of $ to be collected upon or after the commencement of work. I/We authorize Lowe's to do one of the following (check ap- propriate box below): [_] Charge my/our credit card for the amount of the payment indicated above upon or after the commencement of work; or [_] Deposit my/our check for the amount of the payment indicated above anytime upon or after the commencement of work; and (3) Final payment of$100.00, to be paid upon completion of the installation to both parties' satisfaction. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES AND UNTIL YOU HAVE READ THE TERMS AND CONDITIONS CON- TAINED IN THIS CONTRACT AND WHICH FOLLOW THE SIGNATURE PAGE(s). BY SIGNING BELOW, YOU ARE ACKNOWLEDGING THAT YOU HAVE READ, UNDERSTAND AND AGREE TO THE TERMS AND CONDITIONS SET FORTH IN THIS CONTRACT. YOU ARE ENTITLED TO A COPY OF THIS CONTRACT AT THE TIME OF SIGNATURE. NOTICE REGARDING ARBITRATION AGREEMENT FOR CLAIMS COVERED BY M.G.L. c 142A • Store 2382 Project No. 387854683 for MARGARET BRODERICK Page 3 of 8 �1 STORE COPY LOWE'S AND OWNER HEREBY MUTUALLY AGREE IN ADVANCE THAT IN THE EVENT LOWE'S HAS A DISPUTE CONCERNING THIS CON- TRACT, THAT LOWE'S MAY SUBMIT SUCH DISPUTE TO A PRIVATE ARBITRATION SERVICE WHICH HAS BEEN APPROVED BY THE SECRET- ARY OF THE EXECUTIVE OFFICE OF CONSUMER AFFAIRS AND BUSINESS REGULATIONS AND THE OWNER SHALL BE REQUIRED TO SUB- MIT TO SUCH ARBITRATION AS PROVIDED IN M.G.L. c.142A. By=� .� � Date: �'Z SI 1� Lowe's Home Centers Inc. By:U -�� Date: Owner By: Date: Co-owner or Witness THE SIGNATURES OF THE PARTIES ABOVE APPLY ONLY TO THE AGREEMENT OF THE PARTIES TO ALTERNATIVE DISPUTE RESOLUTION INITIATED BY LOWE'S PURSUANT TO M.G.L. c.142A. THE OWNER MAY BE PERMITTED TO INITIATE ALTERNATIVE DISPUTE RESOLUTION EVEN WHERE THE SECTION ABOVE IS NOT SEPERATELY SI ED BY THE P 'RTIES. WITNESS OUR HAND(S) AND SEAL(S) BELOW THIS DAY OF �,�� (� Lowe's Home Centers, Inc. By: _2 AA r (Seal) Print Name:— 1X`n C_015� \k Address `� "'�"� ��`' (Seal) Owner cz f CL- eel- Cdy State/Province Zip/Postal Code q Print Name Co-Owner or Witness (Seal) Print Name Customer acknowledges receipt of a true copy which was completely filled in prior to Customer's execution hereof. You the customer may cancel this transaction . Store 2382 Project No. 387854683 for MARGARET BRODERICK Page 4 of 8 ,s