HomeMy WebLinkAboutBuilding Permit #577-11 - 52 ESSEX STREET 2/23/2011 TOWN OF NORTH ANDOVER
r APPLICATION FOR PLAN EXAMINATION
Permit NO: 1 Date Received
Date Issued: — '—
IMPORTANT:Applicant must complete all items on this page
LOCATION JAZ 655-6?y Si
Print
PROPERTY OWNER M*zr 6ngkYoA-r14h;'
Print
MAP NO: PARCEL:ZONING DISTRICT: Historic District yes no
Machine Shop Village yes
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
❑ New Building ❑One family
❑Addition El Two or more family 0 Industrial
Iteration No. of units: ❑ Commercial
❑ Repair, replacement ❑Assessory Bldg ❑ Others:
❑ Demolition ❑ Other
11Septic ❑We11 UTloodplain O Wetlands 0 WatershediDistrict
DESCRIPTION OF WORK TO BE PERFORMED:
r-i nr 1M &C606jr us�NG�d! ,cs�Die�i�16 L� »�r�rFiiy�.sVia6 7?,3 Safr ZX Z- Dl&dr.
6r1VaG tqugs c bWjaw-r 7 ' $61)44 nV 65-
Identification Please Type or Print Clearly)
OWNER: Name: Mtm&i4kI7' Phone: Goa Pq 614'
Address: 5Z fir•
CONTRACTOR Name: &r&,S Cbevzog ie;u7 Sysrt�, Phone: -)S-1R21-
Address:
/gL/--Address: /o,0 SaW*&r-/ems r^ MA3 A?g
Supervisor's Construction License: 79M Exp. Date: /Q s—W
Home Improvement License: 137 9{43 Exp. Date:
ARCHITECT/ENGINEER Phone:
Address: Reg. No.
FEE SCHEDULE:BULDING PERMIT:$12.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F.
Total Project Cost: $ 30���. FEE:
Check No.: ceipt No.: '
NOT . e ons cti with unregistered contrac do no cess to the guaranty fund
------ --- ------- - - --
Sig a#u : g=_ Owner - -'Sign -e of:contractor r .,
Location 'r;Z- -S
No. 6 — 1 ( Date "a3
Na^TM TOWN OF NORTH ANDOVER
•. p r
F R
9
�o Certificate of Occupancy $ _
s�CMUsE<�' Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check #
239 Building Inspector
Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
TYPE OF SEWERAGE DISPOSAL
Public Sewer ❑ Swimming Pools ❑
Tanning/MassageBody Art ❑
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 Siqnature
COMMENTS
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 Connection/Signature& Date Driveway Permit
DPW Town Engineer: Signature:
Located 384 Osgood Street
FIRE DEPARTMENT - Temp Dumpster on site yes no
Located at 124 Main Street
Fire Department signature/date
COMMENTS
Dimension
Number of Stories: Total square feet of floor area, based on Exterior dimensions.
Total land area, sq. ft.:
ELECTRICAL: Movement of Meter location, mast or service drop requires approval of
Electrical Inspector Yes No
DANGER ZONE LITERATURE: Yes No
MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine
NOTES and DATA— For department use
Ll Notified for pickup - Date
Doc:.Building Permit Revised 2008
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
❑ 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
o Certified Surveyed Plot Plan
❑ Workers Comp Affidavit
❑ Photo Copy of H.I.C. And C.S.L. Licenses
❑ Copy Of Contract
o Flo or/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)
o Building Permit Application
o 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
VOTE: 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
:hat the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording
oust be submitted with the building application
Doc: Doc.Building Permit Revised 2008mi
UG/LJ/LU11 14:13 rAA 1010OU4/LO iNVXhW(aUXVU1V1(V(1 Lg. UU1
CCW0ll� ® CERTIFICATE OF LIABILITY INSURANCE 2/23/UDDIY1
/23/2011
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to
the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsement(s).
PRODUCER CONTACT -F. Cordaro
NAME: .... .............
Andrew G. Gordon, Inc. 4&LNEc_EX0' (781)659-2262 _( _C,rlo); (781)659-4725
660 Main Street F-MAA.GRIL bi11@agordon.com _
P. o. sox ass PRODUCER AADDD44a0 -
Norwell MA 02061 - INSURER(9)AF_FORDINGCOVERAGE NAIC#
INSURED INSURER A YBEIr1es8 Insuranc® 4198
INSURERB:Pilgrlm Insurance Company 21750
Bay State Basement Systems, LLC, DBA: Owens INSURERC:Star Insurance Company
60 Shawmut Road
INSURER D:
Cantron MA 02021 INSURERF;
COVERAGES CERTIFICATE NUMBER Town of Andover 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,
EXCLUSIONSAND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
ADDLSUOR ILTR TYPE OF INSURANCE 'Wk POLICY NUMBER PO/L1pY AFP MPMLDI�Y EXPLIMITS -
MM
GENERALLIABILITY EACH OCCURRENCE $ 11000,000
X COMMERCIAL GENERAL LIABPREMISES
ILITY G B CCIl�occu'�'~
LErfenCe $ 100,000
A CLAIMS-MADE FX_1 OCCUR HP8512651 9/5/2010 9/5/2011 MED EXP(Any one reon) $ 51000
_
PERSONAL&ADV INJURY $ 1,000,000
_ GENERAL AGGREGATE $ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS•COMP/OP AGG $ 2,000,000
X POLICY PRO- LOC - $
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S 1,000,000
(Ea aocldaM)
ANY AUTO
BODILY INJURY(Per person) $
B ALL OWNEDAUTOs GC10007161409 1/17/2011 1/17/2012 _ __.._......__._...
X BODILY INJURY(Per accident) 9
_ SCHEDULED AUTOS PROPERTY DAMAGE
X HIRED AUTOS (Per accident) $
X NON-OWNED AUTOS Unlnsurad motorist BI split limit S - 250,000
Medical payments $ 5,000
X UMBRELLA LIAB OCCUR F11CH OCCURRENCE $ 1 Mill EO
EXCESS LIAR X CLAIMS-MADE AGGREGATE $ - 1 Mill Agg
DEDUCTIBLE $
A X RETENTION $ 10,000 08511953 9/5/2010 9/5/2011 $
C WORKERS COMPENSATION WC STATU- IOTH-
AND EMPLOYERS'LIABILITY YIN TORY,lIM1T$-.__LER_
ANY PROPRIETORIFARTNERIEXECUTIVE= E.L.EACH ACCIDENT 9 11000,000
OFFICER/MEMBER EXCLUDED? N/A
(Mandatory In NH) 0428715 /24/2010 /24/2011 E.L.DISEASE.EA EMPLOYE $ 1,000,000
If Yes,describe under ----- •... _..._.-—
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 8 1,000,000
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required)
CERTIFICATE HOLDER CANCELLATION
(978)688-9S42 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Town of North Andover ACCORDANCE WITH THE POLICY PROVISIONS.
1600 Osgood Street
North Andover, MA 01845 AUTHORIZED REPRESENTAmE
F. Cordaro/CORWIL ,
ACORD 25(2009/09) ®1988-2009 ACORD CORPORATION. All rights reserved.
INS026(200909) The ACORD name and logo are registered marks of ACORD
ORTH
Town of O Andover
Q LAKE o dover, Mass.,
COCHICHEWICK �t
%p ADRATED PPat'`C7
SS ` BOARD OF HEALTH
PERMIT T D Food/Kitchen
Septic System
BUILDING INSPECTOR
THIS CERTIFIES THAT.......{n'1e- ......! .—��..p - ^'!' ............................................................
"'""""""""""" Foundation
.............. buildings on SZ � t�
has permission to erect......................... ...........................................................................:................... Rough
to be occu led as nt.S.h...........e�+^"'�T ,4-- -pl, vlS' Chimney.
. .. . .. . . . .
provided that the person accepting this permit shall in every respect conform to the terms of the application 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 CONS CTI N ARTS
Rough
...... ......................................................................................................... Service
BUILDING INSPECTOR
Final
Occupancy Permit Required to Occupy Building GAS INSPECTOR
Display in a Conspicuous Place on the Premises — Do Not Remove Rough
Final
No Lathing or Dry Wall To Be Done
Until Inspected and Approved by the Building Inspector. Burner
FlRE DEPARTMENT
Street No.
SEE REVERSE SIDE Smoke Det.
CONTRACT TO INSTALL OWENS CORNING BASEMENT WALL FINISHING SYSTEM
Owens Corning Basement Finishing Division (the contractor) hereby submits this proposal to sell and install the Owens Corning Basement
Wall Finishing System and related items as described herein at the residential premises set forth below.This proposal shall not become a
binding commitment unless and until it has been signed by the Contractor and the Customer.
Contractor:
Owens Corning Basement Finishing Systems
a division of Bay State Basement Systems, LLC. L �,� /✓1 i S�
60 Shawmut Road,Canton, MA 02021
Telephone#(781)821-0060 co er 1E i - jrs t��'/%�•t
Facsimile#(781)821-8552
Federal Tax ID# 14-1855297 )l �l ��U✓l/
Mass. Home Improvement Contractor Reg.# 137943
Date 5 ��
Customer:
Customer Namet, t t'g✓
Street Address s .) e e,-
City,
City, State,Zip J f/r! `f��!r �r DG�1 A .
Telephone( 4" D 3
This is a contract between the Contractor and the above named Customer to sell and install the Owens Corning Basement Wall Finishing
System and related items specified herein at the Customer's residential premises identified below:
Installation Premises: �• �/
Street Address J Ei Vit%C�
City, State,Zip
Scope of Work: L✓y f-rrkc — /✓tom G-/,
Are Sketches and/or specification sheets attached? b^ieS* ❑ No
'All attachments are incorporated into and become a part of this contract
Description of Work/Specifications: ,�!r C �l�- �� felt/7 S r ,',> ,'r f '�• ��%�i �_—J�
�411 01r
��li'� l:.✓l 1//f �^�i�J� �(J f�J�/F'����� �^ /I�� f f J �J- r ,+ r STs' I C l p r
ti.i•f/7/Gf ���fr'l _ � -moi• �l �f r,�f; .ice ,/� %•�j Lel ^�'/,.rte ✓�%• i� r ( r'��'�� �
/�� r /�Dr•' F�''_-�J /1r/�/-i'��i' !( �/I� 'T" r � �?' ie'-i � r�,f'l!✓fir �
Work Schedule** �O/`' ,.'r `'t ��r� � rI
Approximate Commencement Date: } /
Approximate Completion Date:
**The proposed work schedule is approximate and subject to change
Contract Price:
Total Contract Price:
Deposit with order: $ !_ r� f (� ❑ Cash Ef-Check# ('
Balance Due:
Terms: ❑ Cash frinance
(Cash terms are 10%deposit,50%on commencement,40%on completion)
$ Due on Commencement
$ Due on Completion
DO NOT SIGN THIS CONTRACT UNTIL ALL APPLICABLE BLANKS ARE COMPLETELY FILLED IN AND UNTIL YOU FIRST READ
AND UNDERSTAND THE ENTIRE CONTRACT, INCLUDING ANY ADDENDUM ATTACHED HERETO,AS WELL AS ANY ATTACHED
SKETCHES, MATERIAL LISTS OR THE LIKE,AND THE TERMS AND CONDITIONS ON THE BACK OF THIS CONTRACT DOCUMENT.
YOU ARE ENTITLED TO A COMPLETE, FULLY EXECUTED COPY OF THIS CONTRACT AT THE TIME OF EXECUTION.
Witness our hand(s)and seal(s) below on this day of
Bay State Bp-s`ement S at�LLCJA rizedRepresentative:
Sign�1e and Titl
1 e' ,,I /�- J7V
Print Name
DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES
Customer***:
Customer Signature ig
Print Name
Customer Signature
lrL.ce,vt AAr 41 le" J
Print Name
Contractor may have certain lien rights in the premises until the price is paid in full.You have the right to cancel this contract,without any
penalty or obligation, at any time prior to midnight of the third business day after the date you signed this contract. See the notice of cancellation
below for an explanation of this right.
***Customer acknowledges receipt of a true copy of this contract which was completely filled in prior to customer's execution hereof.
NOTICE OF CANCELLATION
Date
You may cancel this transaction,without any penalty or obligation,within three(3) business days from the above date.
If you cancel,you will not be liable for any finance or other charges,and any security interest given by you, including any such interest arising by
operation of law, becomes void upon such cancellation. In addition,any property traded in,any payments made by you under the contract of
sale,and any negotiable instrument executed by you will be returned within twenty(20) business days following receipt by the Contractor of
your cancellation notice. If you cancel,you must make available to the Contractor at your residence, in substantially as good condition as when
you received, any goods delivered to you under this contract or sale or you may, if you wish,comply with the instructions of the Contractor
regarding the return shipment of the goods at the Contractor's expense and risk.
If you do make the goods available to the Contractor and the Contractor does not pick them up within twenty(20)days of the date of your notice
of cancellation,you may retain or dispose of the goods without any further obligation.
To cancel this transaction, mail or deliver a signed and dated copy of this cancellation notice or any other written notice to:
Owens Corning Basement Finishing Division
60 Shawmut Road, Canton, MA 02021
Phone: 781-821-0060
Fax:781-821-8552
1 hereby cancel this transaction.
Date Customer's Signature
I hereby acknowledge receipt of two copies of this Notice of Cancellation advising me of my right to cancel.
Date Customer's Signature
C � �
Date Co- ustomer's Signature
TERMS and CONDITIONS
GENERAL DESCRIPTION: By this contract, Customer agrees to purchase and Contractor agrees to sell and install the Owens Corning Base-
ment Wall Finishing System and related items identified on the first page of this contract in the above identified premises,for the stated total
contract price and according to the specifications and other provisions of the contract documents including (a)this contract form, (b)the
Addendum, if and to the extent applicable, (c)any attached sketches, materials lists,floor plans,and/or specifications sheets.
SCOPE OF WORK.Contractor shall be responsible to Customer to supply the Basement Wall Finishing System and related products and for
the performance of the installation services,as required by the contract.All drywall,wood or other paintable surfaces shall be primed and ready
for final touch up and paint. Painting, staining or decorating are not a part of this contract.
PRICE.The Price owed by Customer is a lump-sum,turn key price,covering the Basement System and the labor necessary to install it.The
Price assumes sound existing substructures,superstructures and points of attachments.The Price shall not include the cost and reasonable
profit, as determined by contractor, of having to provide(i)additional products or installation services as a result of defective substructures,
superstructures, or points of attachments, and(ii)any additional goods or installation services beyond those originally specified in the contract
which are requested or approved by the Customer and reflected in a change order signed by the customer and the contractor.
PAYMENT. Payment of the price by Customer is due in full upon the terms set forth in this contract, but in no event later than completion of the
work. In the event that the Contractor declares the project completed but the customer still has some reasonable"punch-list"items, it is agreed
that the Customer may be entitled to withhold 5%of the total contract price until such items are completed.
ENTIRE AGREEMENT/CHANGES.This contract accurately states the entire agreement between Customer and Contractor concerning the
Basement System and the work and replaces and supersedes all prior agreements and understandings relating thereto, both oral and written.
Any additions or changes to this contract must be in writing signed by the Customer and the Contractor.
WARRANTY.Customer is entitled to the product warranty provided by Owens Corning for the Basement Wall Finishing System as well as any
other product warranty provided by a manufacturer of other goods or products comprising part of the Basement System installed under this
contract. Contractor will provide Customer with any such manufacturer consumer warranty information. Contractor warrants that the work will
be performed by Contractor in a good and workmanlike manner. Contractor's warranty for the work shall extend for a period of two(2)years
from the date the work is completed or for such greater period as may be required by applicable law governing consumer warranties for
workmanship. Customer must give Contractor written notice within the warranty period of any warranty claim relating to the work. Customer
agrees that its sole and exclusive remedy against Contractor for a warranty claim is reinstallation in a good and workmanlike manner, including
the repair or replacement of any goods or product if and to the extent reasonably necessary to correct the defective work. Customer shall
have no other remedy against Contractor for a Warranty claim, including without limitation remedy for loss or damage caused by normal wear
and tear, loss or damage which has not been reasonably mitigated, loss or damage caused by intentional or negligent acts, loss or damage
caused by acts of God, incidental or consequential damages for lost profits, sales, injuries to persons or property, or any other incidental or
consequential damages.
CONTRACTOR'S WARRANTY FOR THE WORK SHALL BE IN LIEU OF ANY OTHER WARRANTY EXPRESSED OR IMPLIED, INCLUDING
WITHOUT LIMITATION ANY IMPLIED WARRANTY OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE. IN CON-
NECTION WITH ANY WARRANTY CLAIM, CUSTOMER AGREES,AT NO COST TO THE CONTRACTOR,TO PREPARE THE PREMISES,
INCLUDING THE REMOVAL AND REPLACEMENT OF FIXTURES INCIDENT TO THE REPAIR AREA, SO THAT CONTRACTOR CAN
CORRECT THE DEFECTIVE WORK WITHOUT UNDUE DELAY.
LICENSES, PERMITS,SAFETY RULES, BUILDING CODES,ZONING ORDINANCES,AND OTHER LAWS.Contractor shall be responsible
to Customer for assuring that any and all licenses and/or building permits are obtained. If Customer obtains permits on his own, Customer will
be precluded from claiming against certain state guaranty funds relating to home improvements. Contractor shall also be responsible to
Customer that the contract shall be performed in compliance with all applicable safety rules and all existing building codes,zoning ordinances
and other laws. If a change occurs to any applicable safety rule, building code, zoning ordinance or other law which required additional goods,
products or installation services to perform the contract, Customer agrees to pay the cost and reasonable profit for such additional items and to
execute a resulting change order or new replacement Contract as requested by Contractor.
CUSTOMER'S WARRANTY AGAINST VIOLATION OF EASEMENTS,COVENANTS,AND THIRD PARTY RIGHTS.Customer warrants that
performance of this contract by Contractor will not violate any existing real property easements,covenants, or rights of third parties holding an
interest in the real property being improved.
UNDISCLOSED CONDITIONS IN PREMISES: Customer represents and warrants that any defect or weakness in the Premises'structure,
substructure,superstructure or points of attachment that might affect performance by Contractor has been specifically and fully disclosed and
described in this contract. If any undisclosed defect or weakness is later discovered after performance of this contract has commenced and such
defect or weakness makes additional goods, products,or installation services necessary, Customer agrees to pay the cost and reasonable profit
for such additional items and to execute a resulting change order or new replacement contract as requested by Contractor.
ARBITRATION. If Customer has any questions or complaints regarding the contract, Customer may contact the Contractor whose name and
telephone number appear at the top to this contract.All disputes and claims between Customer and Contractor concerning this contract which
any party believes cannot be resolved informally, including without limitation any warranty claims, shall be resolved by binding arbitration
conducted by a single arbitrator under the auspices, rules and procedures of the American Arbitration Association and in accordance with
applicable federal and state arbitration statutes.The arbitration shall be held in the city or county where the premises are located or in such
other location as the parties may mutually agree. No discovery shall be allowed except as may be agreed to in writing by the parties. Either
party may demand arbitration,and the arbitrators final award shall be issued within ninety(90)days after the service of the arbitration demand
on the other party. It is agreed that all arbitration costs shall be borne by the party that does not prevail.
REMEDY FOR BREACH. If Customer breaches this contract, Contractor shall be entitled to recover the greater of liquidated damages in the
amount of 20%of the total contract price or such actual damages as the contractor may prove.Also, if Customer fails to pay the Price in
accordance with this contract, Contractor shall be entitled to recover its legal costs, including reasonable attorney's fees, in connection with
arbitrating, obtaining judgment on an arbitration award, or otherwise pursuing Customer for collection. In the event that the Contractor cancels
this contract,a written notice will be sent within 30 days of contract date and all deposits or monies on account will be promptly refunded to the
Customer.
UNAVOIDABLE DELAY OR FAILURE IN PERFORMANCE EXCUSED.Any delay or failure by Contractor in performing this contract because
of strike,fire,floods,acts of God, inability to obtain goods,or any other causes beyond the reasonable control of the Contractor shall be
excused and shall not be breaches of this contract.
MISCELLANEOUS.The contract shall be interpreted under and governed by the law of the state where the premises are located,without
reference to its choice of law provisions. If any provision of this contract is contrary to any law to which it is subject, such lawful provision shall
be ineffective without invalidating the other provisions which shall remain in full force and effect.
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
MOLD RESISTANCE.Customer acknowledges that although the Owens Corning Basement Finishing Components are designed to resist the
development of mold,they are not capable of preventing mold if the conditions for mold growth otherwise exist in the basement. Customer
further understands that virtually all basements require dehumidification in order to maintain an appropriate humidity level, and that a failure to
dehumidify could result in mold or mildew development in the completed area and upon the contents.
By initialing here customer acknowledges that they have reviewed and understand the terms and conditions of this contract:
Customer Customer
JI -� avaa
Office of Consumer Affair and Businesulati
s egon
10 Park Plaza - Suite 5170
w~ Boston, Massachusetts 02116
Home ImproveenContractor Registration
Reqistration: 137943
_ Type: Supplement Card
` Y Expiration: 1/29/2013
OWENS CORNING BASEMENT FINtSH1N,G� 1,
DANIEL WALSH
60 SHAWMUT RD -
CANTON, MA 02021 %-
V, Update Address and return card.Mark reason for change.
DPS-CAl Co 50M-04/04-G101216 Address E] Renewal E] Employment Lost Card
✓/ae i�a�nmwozuiec a�,/�aaaac`euaella
Office of Consumer Affairs&Business Regulation License or registration valid for individul use only
OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to:
Office of Consumer Affairs and Business Regulation
Registration: 137943 Type: 10 Park Plaza-Suite 5170
f,.•' Expiration: 1/29/2013 Supplement Card Boston,MA 02116
OWENS CORNING BASEMENT FINISHING SYS
DANIEL WALSH
60 SHAWMUT RD � --
CANTON,MA 02021 Undersecretary Not valid without signature
Massachusetts- Department of Public Safeh
Board of Building Regulations and Standards
Construction Supervisor License
License: CS 79893
Restricted to: 00
DANIEL F WALSH
488 KENDALL RD
TEWKSBURY, MA 01876
Expiration: 10/5/2011
('onunissi„ner Tr#: 7109
The Commonwealth of Massachusetts
wF i Department oflndustrial Accidents
= ¢¢ce 1. ji Office of Investigations
i
600 Washington Street
iiiir'sr s
ug« Boston,DIA 02111
www.mass.gov/dia
Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers
Applicant Information . Please Prinf l,eaibly
Name (Business/Organization/Individual): OW&4 C6ZA a 4 &0"47 s7T541
Address: %W M47- 4YAQ
City/State/Zip:
c4amij . /�/l9 jQZ4Z/ Phone i#: ?6 )r /
Are 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-hme).* have hired the sub-contractors R5
2.El ain a sole proprietor or partner- listed on the attached sheet. t l[d'��Gii odeling
ship and have no employees These sub-contractors have 8. ❑Demolition
working for mein any capacity. workers'comp.insurance. 9. ❑Building addition
[No workers' comp.insurance 5. ❑ We are a corporation and its
required.] officers have exercised their ME]Electrical repairs or additions
3.❑ I ain a hom6owner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions
myself.[No workers'comp. c. 152,§1(4),and we have no 12.0 Roofrepairs
insurance required.] employees.[No workers' 13.❑Other
comp.insurance required.]
*Any applicant that checks box#l 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 anew affidavit indicating such.
TContractors that check this box must attached an additional sheet showing the name of the sub-contractors acid their workers'comp.policy information.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name:
Policy#or Self-ins.Lic.#: Wim(' onX 7 Expiration Date: N '
Job Site Address: ST- 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 maybe forwarded to the Office of
Investigations of A for insurance coverage verification.
Ido hereby er 'y un r tl n nd penalties ofperjury that the information provided above is true and correct
Si at e: Date: rZ3
Phone#• —
Official use only. Do not write in this area,to be completed by city or town offrcial.
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#:
CONTRACT CustomerName �u.-� �,z /u• Customer Signature 4
SKETCH Contract Date- Sales Representative Signature
ATTACHMENT Customer Phone Go =5 z z -O Contract Price 3y 7 E- 7
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NOTES' �i.�,lLyhrt,7 — iYrv, L✓aletia h<e,,lor7 Each box equals one fool unless otherwise noted.This sketch Is a good faith
�OOY!%hci representation of the work to be done,it is understood that all dimensions
derived from this sketch are approximate,and that all locations of outlets,light
fixtures,plugs,jacks and/or switches are subject to change if necessary.
Qa� o��ilfs�cf�i� License or registration valid for individul use only
HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: .
Registration: 144681 Board of Building Regulations and Standards
Expiration: 10/27/2010 Tr# 277171 One Ashburton Place Rm 1301
Boston,Ma.02�A
f Type: DBA � /
R&M CONSTRUCTION -
PATRICK GODFREY
19 WOODLAWN AVE.
ATKINSON, NH 03811 Administrator Not valid without si at re
i
�• . !Massachusetts- Department of Public Safety
'Board of Building Re(Fulations and Standards
Construction Supervisor License
I
License: CS 89347
PATRICK T GODFREY r �D�
19 WOODLAWN AVE <G�y
ATKINSON, NH 03811'
Expiration: 6/23/2012 -
f'ununi..ioncr Tr#: 1488
rl.. ..
I ® Godfrey Innovative Construction Co. i
Rick Godfrey, General Contractor
19 Woodlawn Ave. •Atkinson,NH 03811 rick_godfrey@hotmail.com(781)405-6006
MA Lic. 89347,HIC Lic. 144681
Quality And Integrity Makes All The Difference!
This Agreement, made and entered into between Godfrey Innovative Construction hereafter referred to as
contractor and Stephen and Josephine Rossello of 52 Essex St.,N. Andover MA. ph. 603-609-8117 hereafter
referred to as owner.
The Contractor hereby agrees that it will furnish all labor necessary to install the following described work
located at: 52 Essex St. North Andover. The Contractor agrees to start described work on/or about 1-2 weeks
after final measure, and complete work in about 1-2 working days.
ALL HOME IMPROVEMENET CONTRACTORS AND SUBCONTRACTORS SHALL BE REGISTERED IN MA..INQUIRIES RELATING TO A
REGISTRATION SHOULD BE MADE TO:DIRECTOR,HOME IMPROVEMENT CONTRACTOR REGISTRATION,ONE ASHBURTON PALCE,ROOM 1301,
BOSTON MA 02128,TEL.617-727-8598
o Remove and Install a New Roof
o Remove existing layers of shingles down to roof deck and dispose of. Inspect wood deck, if rotted wood
is discovered, replacement will be performed @ $3.75 per L.F. or$75.00 per sheet of plywood.
o Install 8" drip edge. Color-White
o Apply ice&water shield as per manufacturers' specifications
o Apply 15 #felt paper to balance of exposed wood deck.
o Reflash all stack pipes, and roof penetrations
o If upon inspection, we discover chimney lead to be deteriorated,replacement will performed at
$325.00*, additional.
o Install a new 30 year Architectural Shingle, Color- Black
o All debris will be cleaned up and disposed of from job site.
We propose hereby to furnish labor to remove and install a new roof, disposal fees and any costs associated
with the required permits from the town in full accordance with above specifications for the sum of$3680.00
Owner to purchase all materials and deliver to job site at a cost to owner of$2320.00
Balance due upon completion $3680.00
You may cancel this agreement if it has been signed by a party thereto at a place other than the address of the
seller,provided that you notify the seller in writing at 19 Woodlawn Ave, Atkinson,NH 03811, 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.
All material is guaranteed to be as specified. All work to be completed in a workmanlike manner according to standard practices.Any
alterations or deviation from the above specifications involving extra costs will be executed only upon written work order and will
become an extra charge over and above the estimate.This is to include but limited to,hidden damages that are uncovered during the
course of the job and additional work required by local building i pectors.All elements of this agreement are contingent upon strikes,
accidents,or delays beyond our control.
NOTE,this proposal may be withdra by c r or Pa ck Godfrey 10/1/10 If not accepted within 15 days.
Authorized Signature Date_10/1/10_
ACCEPTANCE: THE ABOVE PRICES,SPEC CATIONS, ND CONDITIONS ARE SATISFACTORY AND ARE HEREBY ACCEPTED.YOU ARE
AUTHORIZED TO DO THE WORK AS SPECIFIED.PAYMENT WIL BE MADE AS OUTLINED ABOVE.
AN INTEREST CHARGE OF 1-1/2%PER MONTH(18%PER YEAR)WILL BE ADDED TO ANY AMOUNT UNPAID AFTER 30 DAYS FROM INVOICE
DATE.
DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES
SIGNADate 10/l/10