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HomeMy WebLinkAboutBuilding Permit #265-13 - 526 WINTER STREET 10/4/2012 1 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION 1� Permit NO: J t Date Received Date Issued IMPORTANT:Applicant must complete all items on this page L,OCATIO.N _. W,,tib'-etr .S . PROPERTY'0 VN L o r c-o�n4C.�t�" _P.H.4. loo' ear'Old,Structure yes' (no MAP"NO? d ARCEL: ZONING DIST .. Historic District yes Machine.Shop Village yes 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 ❑ Septic ❑Well', ❑ Floodplain: 0 Wetlands:. ❑ WatershedT)istrict, N Water/Sewer_._ ` DESCRIPTION OF WORK TO BE PERFORMED: or COP Identification Please Type or Print Clearly) OWNER: Name:()oo�ca, Amk7 CC-)"%Jn((,At 5CPwo7 Phone:' ��3 X59 Address: 526 W ioi �z 5-tl cet N oa-rta ll ow6ye tz. CONTRACTOR Name: � �`� � .._w�.._ �_�,=�e:c ,- - __ Rhone: Address: C, - Su. eCe:� —rvisors; onstruetion Lcens � Exp.. Date: 4P p g _ Exp. Date: (P t Home Im rovement'License: O 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: $ A- ®OCA , 00 FEE: $ I Check No.: Receipt No.: C � NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund 5lgnature aof Agent/Owrier Signature of contractor Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ tamped Plans ❑ Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS f 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-signatiireldate ' 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.$10041000 fine i I NOTES and DATA— (For department use ® Notified for pickup - Date 3 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 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 ❑ Certified Surveyed Plot Plan ❑ 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). ❑ Building Permit Application ❑ Certified 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: Doc.Building Permit Revised 2012 Location c� _lam Na D e s a ' TOWN OF NORTH ANDOVER e �IT01 , e e " Certificate of Occupancy $ Building/Frame Permit Fee $� - Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check ate, 25784 Building Inspector t. r 1F x.10 R T�� ► ,� W. E 1c . . ve" . No. - y ! 1 Z o h ver, Mass, 9 �� COC NICNs WICK ADRgTED ►'P�,��y _ s BOARD OF HEALTH PERMIT T LD Food/Kitchen Septic System . a THIS CERTIFIES THAT .. ........................... � BUILDING INSPECTOR M. NS. ............... ......... ................. ........... . .. .... .... . �. � Foundation has permission to erect .......................... buil din son .... ... .... ..�..1!�.. .. � .�r� Rough to be occupied as ..... .�.. .... .....�1. .1.1!�... ........................................................................ Chimney provided that the person acce tin this permit shall in !+ .respect conform to the terms of the application Final p p p p 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 MQWHS ELECTRICAL INSPECTOR UNLESS CONSTRUCT A Rough Service ........................ .................................................. Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building 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 f F7T Massachusetts -Department of Pudic Safety Board of Building Regulations and Standards Construction Supervisor License: CS-072948 STEPHEN R SEMI__,. r 13 HEIDI LNC o may. Billerica MA,018 1 r Expiration COrdll'tiiSSiC371£r 01/16/2014 Office of Consumer Affairs and Business Regulation, 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 172068 Type: DBA Expiration: 5/16/2014 Tr# 225369 SALEMI EXTERIORSj , STEPHEN SALEMI `n' M ` : -..• `; 13 HEIDI LANE BILLERICA, MA 01821 K . c •-- <-o Update Address and return card.Mark reason for change. ❑ Address ❑ Renewal [:] Employment Lost Card SCA 1 0 20M-05/11 her Affairs &BCli n��a Regulation License or registration valid for individul use only Office of Consumer Affairs&Busihess Regulation g Y ,,OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: , egistration: 1=72068 Type: Office of Consumer Affairs and Business Regulation xpiration: .„5/.1;6%2.0:14„ DBA 10 Park Plaza-Suite 5170 J----- Boston,MA 02116 _= -- SALE I EXTERIORSa= _; _==-=- Wj i STEPHEN SALEMI "y,' r 13 HEIDI LANE BILLERICA, MA 01821 '' ._ V ,r Undersecretary Not valid without signature 4/25/2012 12:11 PM FROM: Foster TO: 1-978-667-7263 PAGE: 001 OF 001 ACCORD® CERTIFICATE OF LIABILITY INSURANCE DATE k.--, 04/25/2012 THIS CERTIFICA`T'E 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(les) 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 endorsements. PRODUCER ACT NAME: NORTH ANDOVER INSU>(ZANCE AGENCY, .INC (AIC,PNONENo, Ext): ( (978) 686-2266 AA:, (970) 686-6410 � NoF M.J. FOSTER INStMANCE SERVICES A DRESS : cfernandez@nafins.com 163 MAIN STREET cus-roa c aSalemi & Ronayne Exteriors - DBA St NORTH ANDOVER MA 01845-2508 INSURERS)AFFORDING COVERAGE MAIC f INSURED INSURER A IMERCHANPS INSURANCE GROUP Steve Salemi Exteriors INSURER a LIBERTY MUTL%L INSURANCE DBA Salemi Exteriors INSURER C 13 Heidi Lane INSURER D INSURER E Billerica MA 01821- 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. NSR - ADDL SUSR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE NSR wVD POLICY NUMBER (MWDDNYYY) (MWDDNYYY) LIMITS A GENERAL LIABILITY Y 3OP1043SS4 0/30/2011 0/30/2012 EACiOCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LLABILITY If / 1 / PREMISES Eeocowrence $ 500,000 q AIMS MADE ❑X OCCUR ! / ! ! MED EXP(Any one person) $ 15,00-0 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: / / ! / PRODUCTS-COMPtOPAGO $ 2,000,000 X POLICY PRO LOC A JWTOMOBILE LIABILITY BOP1043554 0/30/2011 0/30/2012 COMBINED SINGLE LIMIT $ 1,000,000 (Ee accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED AUTOS / / / ! BODILY INJURY(Per accident) $ SCHEDULED ALTOS PROPERTY DAMAGE X HIREDAUTOS / / / / (Perecdderd) $ X NON-OVMEOAUTOS UMBRELLA LIAB OCCUR 1 / 1 / EACH OCCURRENCE HCLAIMS-MADE EXCESS LIAR 1 1 1 I AGGREGATE $ DEDUCTIBLE RETENTION IB WORKERS CONDENSATION C1-31S-376326-012 2/25/2012 2/25/2013 XI TORY VAC STATDTH- AND EMPLOYERS' LIABILITY ANY PROPRIETOWARTNERIDCECUTIVE YIN ! / / / EL EACH ACCIDENT $ 1 OO OQO OFFICEIt"ER EXCWDED7 ❑ NIA (MandetorViq NH) 1 / I / E.L.DISEASE-EA EMPLOYE $ 100,000— If 00 000If yes,describe bRder DESCRIPTION OF ATIONSbelow I / ! I E.L.DISEASE-POLICY LIMIT $ 500,000 l 1 I / DESCRIPTION OF OPERATIONS 7 LOCATIONS I VEHICLES (Attach ACORD 101, Ad40ao1 Remarks; SermUst, Ir "re &pact is IeTk'ed) GEATIFICATE HOLDER CANCELLATION r. SHOULD ANY OF THE ABOVE DESCRIBED POLIC12S BE CACELLED BEFORE `> THE EXPIRATION DATE THEREOF, NOTICE 'ALL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. STEVE sALF.I+.II DBA SALT MI EXTERIORS - AUTHORED REPRESENTATIVE 13 HEIDI LANE BILIZEt CA MA 01ftj.- Rt;ORQ 23(2009149) ©1988-2009 ACORD COI ORATION. All ri hfs reserved. ff3"..015toe1 The ACORD name and logo are registered marks of ACORD x> The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,AM 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): cS G IoM,; 1EXA-e s'o c s Address: I 'S VAe,A, Lvi City/State/Zip: f�); l�k6 (Tk Kc, O 1 e Z I Phone#: �3 S z Are yop an employer?Check the appropriate box: Type of project(required): 1. I am a employer with 1 4. ❑ I am a general contractor and I 6. ❑New construction art-time) employees full and/or .* have hired the sub-contractors ( p listed on the attached sheet. � ?• E]Remodeling 2.El am a sole proprietor or partner- ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers' comp.insurance. 9. []Building addition [No workers' comp.insurance 5. ❑ We are a corporation and its 10.El Electrical repairs or additions required.] officers have exercised their right of exemption per MGL 11.[:]Plumbing repairs or additions 3.El I am a homeowner doing all work g p p myself. [No workers comp. c. 152, §1(4),and we have no 12.❑Roof repairs insurance required.]i employees.[No workers' 13.[KOther _I Ct ✓1 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 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: !M`Jy S�'�' ��-�s�,,,^ C_Q_ Policy#or Self-ins.Lie.#: U 1 C 1 `�J I S` 6 2,0 - 61 Z Expiration Date: 25 '1 Job Site Address: 1P LA-Artk¢.r 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 verification. I do hereby certify under the pains and penalties of perjury that the information provided above is trice and correct. Signature t 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 !`nnfarf PPrcnn• _ Phone#' 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 oVicenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to 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 evised 5-26-05 Fax#617-727-7749 Massachusetts Rome Improvement Sam' We Contract This form satisfies all basic requirements of the slate's Home Improvement Contractor Law(MGL chapter 142A),but does not include standard language to protect homeowners. SeeIc Iegal advice if necessary. Any person planning home improvements should first obtain a copy of"A Massachusetts Consumer Guide to Home Improvement"before agreeing to any work on your residence.You may obtain a free copy by calling the Office of Consumer Affairs and Business Regulation's Consumer Information Hotline at 617-973-8787 or 1-888-283-3757 or on our website. Homeowner Information Contractor Infor>mnation Name Company Name UPJ Street Address(do not use aPost 0 ce Box address) Contractor/Salesperson/OwnerName �' S V`��� -t hax salt"% City/Town State Zip Code Business Address(must include a street address) /U 0 AN d A 0 �� � \ 'b &� �-VA Daytime Phone Evening Phone City/Town State Zip Code Mci C)t 6z 1 Mailing Address at different from above) Business Phoned g. (}i_S qVederal Employer M or S.S.Number d L$-"+Z-43 6-1 Some Improvement ContractorReg.Number Expiration date Law requires that most bome improvement contractors have n valid registration number The Contractor agrees to do the following worIc for the Homeowner: CSV t� t (Describe in detail the work to completed,specifying the type,brand,and grade of materials to be used,use additional sheets ifnecessatv.) comer Requlrecl Permits-The following building permits are required Proposed Start and Completion Schedule-'The following schedule will and will be secured by the contractor as-the homeowner's agent: be adhered to unless circumstances beyond the contractor's control arise (Owners who secure their own permits will be excluded from the Guaranty Fund provisions of 1 l 2 Date when contractor will begin contracted work. MGL chapter 142A.) Date when contracted work will be substantially completed. Total Contract Price and Payment Schedule The Contractor agrees to perform the work,furnish the material and labor specified above for the total sum of: (ti) Payments will be made according to the following schedule: $ 000 upon signing contract(not to exceed 1/3 of the total contract price or the cost of special order items,whichever is greater) $—a OQU by 1/'l o / 17— or upon completion of $ by -L(I_/ /L-,j or upon completion of $ y_ 000 upon completion of the contract. (Law forbids demanding full payment until contract is completed to both party's satisfaction) . The following material/equipment must be special $ to be paid for ordered before the contracted work begins in order to meet the completion schedule.(*) $ to be paid for ` NOM&(4)Inciuding'all finance charges(°i*)Law requires that any deposit or down-payment required by the contractor before work begins may not exceed the greater of(a)one-third of the total contract price or(b)the actual cost of any special equipment or custom made material which must be special ordered in advance to meet the completion schedule. Express Warranty-Is nn express warranty beine provided by the contractor? ❑No❑*Yes(ill terms of the warranty must be attached to the contract) Subcontractors-The contractor agrees to be solely responsible for completion of the work described regardless of the actions of any third party/subcontractor utilized by the contractor. The contractor further agrees to be solely responsible for all payments to all subcontractors for materials and labor under this a Bement Contract Acceptance-Upon signing,this document becomes a binding contract under law. Unless otherwise noted within this document,the contract shall not imply that any lien or other security interest has been placed on the residence. Review the following cautions and notices carefully before signing this contract. o Don't be pressured into signing the contract.Take time to read and fully understand it. Ask questions if something is unclear., 0 Make sure the contractor has a valid Home Improvement Contractor Registration. The law requires most home improvement contractors and subcontractors to be registered with the Director ofHome Improvement Contractor Registration. You may inquire about contractor registration by writing to the Director at 10 Park Plaza,Room 5170,Poston,MA 02116 or by calling 617-973-8787 or 888-283-3757. o Does the contractor have insurance? Ask the Contractor for his insurance company information so that you can confirm coverage,or ask to see a copy of a"proof of insurance"document. o Know your rights and responsibilities. Read the Important Information on the reverse side of this form and get a copy of the Consumer Guide to the Home Improvement Contractor Law. You may cancel this agreement if it has been signed at a place other than the contractor'snormal place of business,provided you notify the contractor in writing at his/her main,office or branch office by ordinary mail posted,by telegram sent or by delivery,not later than midnight of the third business day following the signing of this agreement. See the attached notice of cancellation form for an explanation of this right. DO NOT'SZG'N TMS CONTRACT IF THERE ARE ANY BLANK SpACESr t l Two identical copies of the contract must be completed and signed. One copy should go to the homeowner. The other copy shoOd be Icept by flee contractor. Homeowner's Signature Contracto�Signa��� 'Date Date Contraetor Arbitration The Home Impiovement Contractor Law provides homeowners with the right to initiate an arbitration action(as an alternative to court action)if they have a dispute with a contractor. The same light is not automatically afforded to a contractor,however. The contractor would have to resolve any dispute he/she has with a homeowner in court unless both parties agree to the optional clause provided below. This clause would give the contractor the same right to arbitration as is of forded to the homeowner by the Home Xmprovement Contractor Law. The contractor and the homeowner hereby mutually agree in advance that in the event the contractor has a dispute concerning this contract;the contractor may submit the dispute to a private arbitration f-r which has been approved by the Secretary of the Executive Office of Consumer Affairs and Business Regulation and the consumer shall be required to submit to such arbitration as provided Ind Iassachusetts General Laws, chapter 142A.. Homeo tier's Signature Contractor's Signature, NOTICE:The signatures of the parties above apply only-to the agreement of the parties to alternative dispute resolution initiated by the contractor: The homeowner may initiate alternative dispute resolution even where this section is not separately signed by the parties. Homeowner's Rights A homeowner's rights under the Home Improvement Contractor Law(MGL chapter 142A)and other consumer protection laws(i.e.MGL chapter 93A)may not be waived in any way, even by agreement. However,homeowners may be excluded from certain rights if the contractor they choose is not properly registered as prescribed by law. Homeowners who secure their own building permits are automatically excluded'from all Guaranty Fund provisions of the Home Improvement Contractor Law. The contractor is responsible for completing the work as described,in a timely and workmanlike manner. Homeowners may be entitled to other specific legal rights if the contractor guarantees or provides an express warranty for worlananship or materials. In addition to guarantees or warranties provided by the contractor,all goods sold-in Massachusetts carry an implied warranty of merchantability and fitness for a particular purpose. An enumeration of other matters on which the homeowner and contractor lawfully agree may be > added to the terms of the contract as long as they do not restrict a homeowner's basic consumer rights. If you have questions about your consumer/homeowner rights,contact the Consumer Information Hotline(listed below). Execution of Contract The contract must be executed in duplicate and should not be signed until a copy of all exhibits and referenced documents have been attached. Parties are also advised not to sign the document until all blank sections have been filled in or marked as void,deleted, or not applicable. One original signed copy of the contract with attachments is to be given to the owner and the other kept by the contractor. Any modification to the.original contract must be in writing and agreed to by both parties. Contracted work may not begin until both parities have received a fully executed copy of the contract,and the three day rescission period has expired. Accelerated Payments A contractor may not demand payments in advance of the dates specified on the.payment schedule in cases where the homeowner deems him/herself to be financially insecure. However,in instances where a contractor deems him/herself to be financially insecure,the contractor may require that the balance of fiends not yet due be placed in a j oint escrow account as a prerequisite to continuing the contracted work. Withdrawal of funds from said-account would require the signatures of both parties. :Additional formation t If you have general questions or need additional information about the Home Improvement Contractor Law or other consumer rights,or if you wish to obtain a free copy of "A Massachusetts Consumer Guide to Home Improvement" contact: Consumer Information Hotline Office of Consumer Affairs and Business Regulation 10 Park Plaza,Room 5170,Boston,MA 02116 617-973-8787, 888-283-3757 orvisitthe OCABRwebsite atlhW://www.mass.gov/ocabr/ If you want to verify the registration of a contractor or if you have questions or need additional information specifically about the contractor registration component of the Home Improvement Contractor Law,contact: Director of Home Improvement Contractor Registration Office of Consumer Affairs and Business Regulation 10 Park Plaza,Room 5170,Boston,MA 02116 617-973-8787, 888-283-3757 or visit the BIC website atbttp://www.tnass.gov/ooibr/ Go online to view the status of a Home Improvement Contractor's Registration: I-Lit�://db.state.ma.us/homeimt�rovement/]icenseelist.asp For assistance with informal mediation of disputes or to register formal complaints against a business,call: Consumer Complaint Section Office of the Attorney General 617-727-8400 AND/OR Better Business Bureau 508-652-4800, 508-755-2548 or 413-734-3114• Version 2.1-I V22/2010