Loading...
HomeMy WebLinkAboutBuilding Permit #602 - 55 HARWOOD STREET 5/11/2009 BUILDING PERMITO� NORT#1 '9 `ttLlO TOWN OF NORTH ANDOVER 0�`4: O� APPLICATION FOR PLAN EXAMINATION Permit NO: 02 Date Received Date Issued: L1110q �SSACHUS�� IMPORTANT:Applicant must complete all items on this page LOCATION S— ����—�,Jc�c� 5t Print PROPERTY OWNER ��'� ts� ToT It— Print MAP NO: PARCEL: 1A ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building a family Addition Two or more family Industrial ter No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other Septic Well Floodplain Wetlands Watershed District Water/Sewer DESCRIPTION OF WORK TO BE PREFORMED: (�c�( ►A2(��.�� - I .J� &= o P tifj c is cf ",o .Z Identification .Please Type or Print Clearly) OWNER: Name: Phone: 9-)P- at-61- laid Address: V S7_ P e, Lc..woua Sr CONTRACTOR Name:-_-_`lZ o13 r P-d'&RUCC 'L Phone: '2 T--- Y6 9, Address: -21 L-icoa Z�fLtyr:� c:1 S S b l ai-! Supervisor's Construction License: 16 Exp. Date: _ I l kat 1Za l 0 Home Improvement License: / 5-61 Exp. Date: 91/4 (A616 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: $ �T� oa FEE: $_ Check No.: Receipt No.: -�2;Z©/7 NOTE: Persons contracting with unregistered contractors do not have access to the guarantyfund signature of Agent/0 Signature of—contractor— i 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 j 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 ❑ 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 ❑ 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 ND Addition Or Decks i ❑ 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:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2008 _G7 _ Location f/ d0 S No. (- 02- Date _ // MORTN TOWN OF NORTH ANDOVER f v " Certificate of Occupancy $ i i # �,SSACMUSES� Building/Frame Permit Fee $ '? Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 220 ` 7 ,, BuAing Inspector f //((££I y � ' F '��. f,; /fjr' /� f 'r��� l //(/��� I J ,^ Y� f ��� � i J y t r ' �, ' 'f J` .r P ,� ' 1� '�; I/ r ,1 �', a .' 1 l d r'� ' � !'" � "� 7+i ic1 t� , � ; � L�` �, �r,'A. ///, : t i �q, �I^A !t 1 �� ttt t Jrt. z Ms - __ — 1{ /:� 'iA�k�.:� �ti... �t "�+n ^;. .. � �, �,� , � " �� , ,> ,.. � r � .. ��., ���� ���. �� �`��,�;: -�= �, �� � �� �� .� �:��. ``'�. IAORTH Town of t 4Andover 0 No. G D 20W X...� ,.. R . W 77 CONdover, Mass., T O — LAKE 1 co KIC KE WICK A04A TE D `S BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR « "©.�_#THISCERTIFIES THAT....... . ..��............ ........ ................................ ......................... ....................................... Foundation /1�t P�L/OF.� has permission to erect........................................ buildings on ...,.ar... .........�7 ...... . .... ��......................... Rough (/ t;G / Chimney to be occupied as.......... ....... ...�#./�..... . '... ..........., 1 ....... .....��.�., �.j ..tio ......-file-in y provided that the arson accepting this peri shall i ve es ect conform to the terms of thea I'ication on file in P P P g P P PP Final this office, and to the provisions of the Codes and By-Law 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 PER.MTT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTIO TARTS Rough ......... . ............... ..�� s .................................... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR 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. SEE REVERSE SIDE Smoke Det. AC RD CERTIFICATE OF LIABILITY INSURANCE DATE(MM/D TM 0 //18/22009009) PRODUCER (97$887-4900 FAX (978)887-2404 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Edward F. Sennott Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 16 South Main Street HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P. 0. Box 457 Topsfield, MA 01983 INSURERS AFFORDING COVERAGE NAIC# INSURED R & R Construction LLC INSURERA: Nautilus Insurance Co. DBA: C/O Robert Repucci INSURER B: 71 Wood Drive INSURER C: Essex, MA 01929 INSURER D: INSURER E: COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. rA DD' TYPE OF INSURANCE POLICY NUMBER P LICY EFFECTIVE POLICY EXPIRATION NSR DATE MM/DD/YY DATE MM/OD/YY LIMITS GENERAL LIABILITY NC730170 11/23/2008 11/23/2009 EACH OCCURRENCE $ 1,000,00 X COMMERCIAL GENERAL LIABILITY DAMAGE RENTED $ CLAIMS MADE OCCUR PREMISES Ea occurence 50,000 MED EXP(Any one person) $ 5,00 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 1,000,000 POLICY PRO- JECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY _ AUTO ONLY-EA ACCIDENT $ ANY AUTO EA ACC $ OTHER THAN AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR a CLAIMS MADE AGGREGATE $ DEDUCTIBLE RETENTION $ $ WORKERS COMPENSATION AND TORY LIMITS OTH- EMPLOYERS'LIABILITY _ER ANY PROPRIETOR/PARTNERIEXECUTIVE E.L.EACH ACCIDENT s $ OFFICER/MEMBER EXCLUDED' E.L.DISEASE-EA EMPLOYE $ If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS E: 37 Harris St CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE To L-j /J 6 P- EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, A BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Q U I►�—GD ��I b D a�'(' Peter Sennott/LA ACORD 25(2001108) FAX: (978)741-4365 ©ACORD CORPORATION 1988 i The Commonwealth of Massachusetts �f l Department of Industrial Accidents #�t Office of Investigations .+� 600 TMashinpton Street b Boston, MA 02111 c; www_muss.gov/dia . Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibiy NaIne (Businessiorganization/individual)•_ (`it C-0.,nj 3T-Q t IC p—r vim✓ (__L(,__ Address: ( wy (���.✓ City/State/Zip:_ S.v - / �� Phone Are you an employer?Check.the appropriate box: 1.Q I am a employer with 4. ❑ 1 am a genera!contractor and I Type of project(required): employees(full and/or part-time).* have hired the sub-contractors 6• Q New construction 2. i am a:sote proprietor or partner- listed on the attached sheet.i 7• ❑Remodeling ship and have no employees These sub-contactors have 8. Q Demolition working for me.in any capacity, workers' comp.insurance. .insurance 5. 9• Q Building addition [No workers'comp. ❑ We are a corporation and its required.] officers have exercised their 10•0 Electrical repairs or additions 3.0 1 am a homeowner doing all work right of exem r•on per MGL I 1 •❑ Plu Plumbing repairs or additions myself. [No-workers'comp. c. 1.52, §1(4),and we have no I2. Roof insurance required.]t ❑ repairs q I. .employees. [No workers' comp. insurance required.] 13.Q.Other *Any applicant that checks boat#l must a1s0 fill out the section below showing theirworkerc'eompensation policy information t Homeowners who submit this affidavit indicating they are doing all work and then hh outside contractors must submit a new affidavit indicating'Ruch. SCarrttactors that check this box most arteched an additional sheet showing.the mum of the sub-contractors and their workers'temp.Policy information. I am an employer that is provrdirrg:workers'compensation insurance for my employees: Below is the policy and job site information. Insurance Company Name: /I 4a--u i ��� ^l,. t; CO Policy#or Self-ins.Lie.#: C—)-z-.01720 Expiration Date:_ Job Site Address: S.(` Ciiy/StatelZip: til -Ant IkI J Attach a copy of the workers' compensation policy decaration Page(showing the poli cy number and expiration date}. Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine Of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct S_i -ure/ Date _ Phone#: -Cr 7tp— FBoard only. Do not write u:this area,to be completed by city or town official n: Permit/License# ority(circle one): Health 2. Building Department 3.City/Town Clerk 4.Electrical Inspector - Plumbing Inspectorson• 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 apaxtments 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)arnd 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 cant'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,notthe 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 Iicense number on the appropriate tine. 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 ofthe affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 TeL #617-7274900 ext 406 or 1-9.77-MASSAFE Revised 5-26-05 Fax#617-727-774 www.mass.gov/dia I 13A. w m egu a Ais`kff ffs License or registratibn valid for individui use-only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: 127156 Board of Building Regulations and Standards _ 'i One Ashburton Place Rm 1301 Expiration .911412010 Tr#.273817 Boston,Ma;02108 T,y'pe Private Corporation. R&R CONSTRUCTION!LLC" ; ROBERT REPUCGI 71 WOOD DRa.,CL��-`, a` �,NotvarjdESSEX,MA 01929Administrator without sign I ature , 9699 :#jl rawr!ssiwuw OLOZ/I,Z/I...l :uollendx 762660 HW 'X3SS3 80 DOOM 1,L 100f1d38 r IN3808 00 :01 Pa4aillsaa 9LL99 SD :asuaarl as1.19311 a0slAladnS u01;:ina;su00 sp.IPptm.I5 Pui'suoi;rins aH ;uiplin8. >paro8 iaa;rs �elgnd.;o IuNtIlLimblU - slla�ny�rssr� ti®tuecewmer itafos�ta street Address(vto trot[r<ca Past offi[:e Sar ) otrlracfas'5alrsk C)a°iru e CityPt'own Slime Zip Code ' nsio�AdQtesslmtmincludeasaoln ) fit- rc.— NLS . �t�5 `7l c--•>cjc>®--��- c 1 stt,te zipcoat Phone litatc g2�?J5 -tom 64-SS6 ( l —. c5l-c��L`� ndailiag Atkkess(i[ditfac+n taunt idtove) - I�ie j78-��"rY61Y 1F�ntdu�cr 4Dor5.S. taa•m�ewt.�rb.r�� risme ratta�rmmber Ed��� xcete¢cogban:. taa•�a.an.m "�� f S �(� f y d w'C� The contractor agrees to do the following work for the Hom ever in t ejejeo,specirying Inc type,orano,aria xr Me or Materials to Be UWM A- tf ((V 0 rl- L_j o, Pegtdmd Permits-The following tmilditg pcimits a a tequirod proposed start and C,ompkaon Scheme-The folowittg s ate will and will be secured by the contractor as the homeowner`s agent, he adhered to unless circuit mitres beyond teecwArW-&,s control Mase (Owners who secure their own petits will be excluded from the Guaranty Fuel prouinions of (� 7t�atc nfien contractor will begirt connected,t-o& MGI,chapter142A.) rr� / W 4/D5oatc when cuntractcd wMkkwiilbcsobstautintlyoompteted. Total contract Price and Payment Schedule 2 The Contractor agrees to perfimn the work,furnisb the material and labor specified above far the total Stan of _a7 2 f / ($C3 Payments v mitt be made accordirig to the fothowing schedule: upon signing contract(not to exceed 1/3 of the twat contract prize ur the r�5t of special dreier items,whitdaens is greatix) $_4,'Tq by ._ _t RZI n C or Ligon etaupietion of S l2 i D cru tun of + (N a CJ Csti .^CO� upon completion ------ ----- ------- $ upon compktion of the contract. (Low t'orhids demanding fisil payment until contract is completed to both party`s s9 istacximt) The Following mattxird/equiparent must be special 3 iU� ...w be paid for u A cT,t_. 'r' S -c7C k— _ _.. cv t S dh T ^^e '2' CtActPd". ;- ordeneSbefore the carpres�e�arkttey�asinmdcr 5_�/ice ttabepaxtfin_._..---5_---__—LS...-._--..-_-._. to meet the completion schedule() NOTES:(a)preluding aB finance charger(•r)Law requires that any deposit or down-paymcat required by ttte contra for txfore work begins may not exceed the Wwtcr of(a)one-third ofihe total eowntet price or(b)the actual cast of any special egnipmeat at custom ttmde ntateriat which must be specie!ordered in advaitce to meet the completion wlmedale. . Eanrrra Warramc-Is an r xiress warrunxv brutal Provided by the contractorg No Yet tall lerttts.ttf!ht warramc Abe ptl rn rYe aantratYt Subcontractors-The contractor agrees to be solely responsible Ybr completion of the wvrk described tegimdless of the actions of any third party/subcontractor utilized by the contractor. The contractor further agrees to he solely nxponsibie for all payments to all subconlyr for materials and labor under this agreement Contract Acceptance-Upon signing,this document becomes a binding contract under law. Unless otherwise noted widrin this tete contract shall not imply that any lies or ad=securing interest has been pbaex:d on the residea[:e_ Review die fotlamag croons'and ices carefidly before signing this contract. Duni be pmsmx-.d into signing the contract.Take time to read and fully understand it. Ask questions itsomething is unclear. • Make sure the contractor has a valid Home ttnomcment Contractor Recistration. The hack requires most hame improvement connacto s and subcontractors to be registered with the Director ofHome Improvement.Contritaor Registration_ You may inquire absut amttactoa registration by writing to the Director at One Ashburton Place,Room t301,Boston,MA 021011 or by calling 617-727-3200 or 1-800-223-W33. a Does the contractor have insurance' Check to see That your contractor is properly insured. s know your rights and responsibilities. Read the important lurormmi[m on the reverse side orthis form and get a copy ofthe Cine inter Guidc to the Home improvement Contractor.L:aw. You may cancel this agreement if it has lacca sigt[ud at a place other than the cotrtratxots tmttnal phoe of bttsiaulss,provided you testify rhe contractor in writing at hislhermain office or branch officer by ordinary mail posted,by telegram settlor by ddivery,not later than midnight o€the third business day following the si ting of this agreement. See the attached notice of cancellation farm for an explanation of this ri t DG N®T SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACESM �Fim identical espies It P"and signed_One copy sbould sa to the hwneurvncr.Tk other owpy shontd bekept by the tminwtm. &S�tr^ �tTnlraCtdar'S�!$IIa41fiE , _---y - - ---- �- -� - Date ---- Dt6r — ----- Contractor Audi fA i as - acts(assn The Home Imgtove t C.a or law provides homeowners with the alternative to court action)if they have adispute with a contractor. The samerw is2gzOWmjfwftnMxdedtua mWiess contractor,however: The coutractorwouldhavetoresolve any dispute h dAc has with a maxrurt both parties agree to the opfional ceruse pnvided below. This clause wind gree f arbitration as is afforded to the homeowner by the Home Improvement Contractor Law The contractor and the homeowner hereby mutually agree in advance that infhe evuant the Chas a dispute this ccmfma�the factor may submit the dispute to a private firm vrhi&bac been approved by concerningthe S of the Executive Office o€Caper Affiirs and Busr� and 4m o "be runout to . �o such provided In Massachusetts Gtm�al Laws, Horn s Signafrae NOT110E:The tag.�ures ofthe parties above apply amly to the agreement of Bbe pates t O a resolifion initiated by the ooh. Tbebumcuwncrmaymtmftabmmatrve&spnftremlaumcvm tlds.sesamn is not separately signed by the psrties- Homeowner's R 1 and lh rner A homeowner's rights under the Home improvement Contractor Law(MGL " Iiovreve 0 homuxer protection laws(i_e.MGL c impter 93A)may not be waived in any way,even by agreement � Ms may be excluded€roar certain rights if the contractor ihey choose is not properly registered by law. o f Homeowners who s�the`¢own building permits are automatically excluded from all.Guaranty Provisions the Home Impr^ovemearf Contractor Law. The contractor is responsible for completing the work as described,in a timely and wogkinaulam man= Homeowners may be entitled to other specific legal rights if the contractor guarantees or provides an express warranty for workmanship or materials. In addition to guargutees or warranties provided by the contractor,all gout sold in lydassachusetts carry an implied warranty of merchantability and fitness for a particu w Of matters on which the homeowner and contract"kwfidly agree may be added to flue Purpose- If ouhave abort terms of the as hag as they do not restrict a homeowner's basic consumer rights y yon� er/hcstneovrnei'ri&%contact Bre Consumer Information Hotline(listed below). Execution of Coarser of all exhibits and refietmmoad The coact must be executed in duplicate and should not be signed until a copy documents have been aftached. Parties are also advised not in sign the document untilallblank sections have bei fiin or madmil as void,delete,or not applicable. One original signed copy of the with attachm s is to lled. be given to the owner and the other kept by the contractor. Any modification to the original contract must be in wrrtmg Of and agreed to by both parties.Contracted work may not begin until both parties have received a fully owcaftd c VY the contract,and the three day recission period has expired. Accelerated Payments A contractor may not demand payments in advance of the dates specified can the payment Schedule in cases where the homeowner deems him/herwlf to be financially insecure. However,m instances where a contracturdeems him/henseif to be finmmcW*insecure,the contractor may require that the balance of fins not yet due be placed in a joint escrow account as a prerequisite to continuing the contracted work. Withdrawal of fimds fiom said account would require the signatures of.both parties. Additional Iaformation If you have general questions or need additional information about the Home loqmoveracrit CanbutOr Law or athfx consumer rights,or if you wish to obtain a free copy of"A Consumer Guide to the Home Impro mumit Contractor Law,"contact: Consumer Information Hotline Office of Consumer Afi'airs and Business fiegulaboa 10 Park Plaza,Room 5170,Boston,MA 02116 (617)973-8787 or 1-(888)2833757 If you want to verify the registration of a contractor or if you have questions or need tonal information Willy about the contractor registration component of the Home Improvement Contractor Law,contact Director of Home Improvement Contractor Registration. Bureau of Building Regulations and Standards One Ashburton Place,Room 1301,Boston,MA 02108 (617)727-3200 or 14800-223-0933 For assistance with informal mediation of disputes or to register formal complaints against a business,calL. Consumer Complaint Section Office ofthe Attorney General (617)727-8400 AMOR Better Business Bureau (508)6524800 (508)755-2548 (413)734-3114 NORTH ANDOVER BUILDING DEPARTMENT Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit at: - sr-- is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c 115 S 150 A. Also, note Permits are required under Fire Prevention laws Chapter 148 Section 10A. The debris will be disposed of in: G . v`'i- cr��c� �tS�b•t-6 cT fio w n� (Location of Facility) F-oG��-� �- • re-�d'�ccL. Signature of Permit Applicant i Date