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Home My WebLink AboutBuilding Permit #383 - 55 MAIN STREET 11/4/2010 BUILDING•PERMITof p1ORT11 StLED �6"�"Y TOWN OF NORTH ANDOVER 0 APPLICATION FOR PLAN EXAMINATION r Permit NO: Date Received Date Issued: r SSgcHus�� 1 J zIMPORTANT:Applicant must complete all items on this p 'WTVR' •-}ice A.".1 - 2'r`ket i:' .�R-"e-'.'e,..+-•-n{l'.�i`�y=-��r: ..his l•�:c!�-'= - :zrr, - page - -'r€�""_ . ^'`9.' .=!... 3._ V.u "g �_.v_._..�. ..e_.__i-�• r1.�:.. L-}''`i_rc-.Tr'•.e��lr:.+.�_-i:-_c,r._,i.�-. - }^l;�''. ,CGS.,. 'T3'..;:1`- .:�.:=e:.-T,6 T"_,.,•� } .'.1^ g. r�'r' _ �i".:T=w -i"�4 -r:u._a, R•rL s':5=:MON �1014N• ,,, .,._ Y"" �- -+�% '.>.:gvgc�;;- .•, r�- '-a�'r-'t`+'-..�_.:.v'�• 1'=.�' ;�- �' - '�5�� s_:: .frr'',1i� – L i 1 } fir, y S i - _ 1 - Olov :x=�S:� ,7� 5--. �'�. .I\'f'NrrU .!ttt'n'. ,'S.>`�:r.�i:'y'.i`i' iw.�"FirTv_.._�_a•. _ ,.b-. tom}' _ >_u.,!<'�- `_2-s•- .1^-.?' - .s'e,�.;�---�a�.;n>G=F;.-„''--;r' _ :r_y - `,:+:-1-e . - - -",� il;.,. _-•�_•_� a>:' n�:�e'',s4z.-I� z:-. 'b�rJi)I"a•,L�SY !.d1'J." SJtr' ” c YF ,?�• r - -' -cw•` 'S '. ._r!:S'`'1 +�•.` a.ti.ti �_x' ''�.'tgx r,.lk".. ...sN.••'�`yR'. .�> .v.,-,. .row .r•';T:>,�; ...r�•,'•;r%...s!�?� _-:.t'='.',Lca,,.�.m'• -a n' -.Y El � ,� •r-�-� -�'''- g t-r .�h� t. `-•'r �..,1•-...xr. i �✓�� 'v''�• r. r I7 x � F— i...7� .k^ f :Lm - - - r;, 4 mac. X•• - K:� -F 1 sem, *; �: .� �. -�• n5- - ar•F v,am�.`�u3-say P�:.:--'rh -;•�•�.--:.�_Y�vl:d<�'�''•.��`-=t'-�anl �t�-.-:��}=,_.�,t .{y,.:H•.d � � t__rye..�'•e' ' ._�„ .•�;- r:..i�:v--..tz^:,;4.r5--nrT_�".-FdF•�. , __ _ ;,'�,,, rLi, v'rt:•-x'rFtt_e:�.- .:o,,...a"; r;a1.',k.,_s`.'. ._z___r•-1f�._,�_�st_r:. r t� �•�.+_ 'n -�?%u - '^'�'-'r'r1"�L-.f�'�.sF .-.-,t-..��4=+_ '=.:1(Ti:�f•7caa�'i:•T.:£,ir3�-�i..:+,--y`v'a.%;ri��i4�7E�:1re.T� _ Lr ��°.b79 .I: r r- I�..''"J�;'"-,^"�` TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential . New Building One family . Addition we-o more famil y Industrial Alteration • No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other �`•�,-,�- `c ]��-,�'+''.t=�1�s•'s :.'�Arai5i^'- S'. ..L`,k 'n.: srzk, _ ..�,U;.•'v ry�r--�p��--n��?�y'Y��`�ve�•`1,.,'�� .o� { a>L�-'-k..�,'�'Vjq'�r 4,��",,7``.�-rt_ •��5.+''�- =,'ih:>T,°'_ .; ry;9^';•e��rY`._��:�_.:.!?a iiLs.^.�'7=••a:,r.F--.X5'=3 -�� ,�e..a;�t'�`_:"r3' S"„��R�.k"�� iy+��yv"'8'� v��1�e'�' �' f�-.s+�s1L1� a,.:F.t'�.-.y4.� ,'�'^'�•5��ri.��:18�hT7x+%r��tr�-�?��C+'''��+'�^'-'F�u^• .4.,.r._�._�+.+'z�T��r�. �+ <.:F.:�r zf '�r�`��i"��^ ^�r� ''i�e�p"�,� ua �� '"� a>E=��"'e�•; '"t� F� ��' �� _ _a,? G-��Rte,;'4 F_�.L"S�i�'-}x_Yv'��4 �4�,}•'•r.(' ��.� r�'��+"'f,..�,r""' _-�"�-rC T� �-#��4 �x�z�,:��, ' - .. .-a4�.',vz._v-'•...�_....':`s n",'-.f,?4.... S;•;;-U.l�"'ak��. k.�'.k"a�Y_�r_,_c+ DESCRIPTION OF WORK TO BE PREFORMED: DO % IrFrjvv � 01 h is'/_ � 1`� L i jJ�9•-i`�i�• W ! t J-G ��?l�� J G-'� . Identificafion Pleas a or Print CrIy) Cie - OWNER: Name: !�-/`••�_.S'e /,�j� Phone: 92,4' 6 '1,2 /y:V/ Address: '--- 4x0.:,ali..' " ',r.^.•w'��'.'._'`^�ev''.,.'>�F"��.�.-.'x`=SY', ` tom' •e- ,F '�cam_,...-'+��'� c=1'kf�,-5.�}�+^�`� � '.`�,ki' "i,.,•,.i�d" �.�+3'.":"�„ Suu„' i.... „i gN -auk - cNiv` 'r•' m ^ �>` - #:r Ih„ �.� NOR_ ,::_, ._.a--y' ,5�,i a,,'t c•�3j, ,.I2.r+�p��u'��,a F-1-.r..aa z.5�n�1 � � , L z-r .. M. Yr;1 ; 'y �.m{ .. -• =t1 ]IJ�rLi� �0.rw .' � ; +��' '-•-� c."..w FOP 7 _.L- r+-.:, �rm afig.- mi _af �,-„" im Y " �'" '� ';.Gi'y r'4`' ; tYz.su..v• .«--:- _ ;,spa,CIO't�` ,ssi-YF��_ ..- •'4: _ ".--# 'S • 1}..•', 'E H=yLt.�t -`. � �'. f7> -: 1''rw -rr.";,✓s=. _"�''4'.. P t `.Y f. -f. ��.....�„`, �,. 1pi•�w"'t,�`1,.sr:4 `;s" �.}r ��,3' - -,- r` aal"�'�r �14r�r�ii ;' ""FH?f 'rF';`.'_ •.�F. 'L�- '' A' .7 ,^,�Y _+ -f' �.+ ,. ;?fr t .;s,-,fi•"7�ra1 ..s Wiz�,g -^l1 r --••�� I 3i j4" T6 L^-qNIP _• e.lrWi>.F.�,2A fi•4 1 y Y5 ��,,1 A. ! - kip. ,{r�F •_ - i �.;-'�� 7 ��s'ai ve aK ' .v� r � �19L��' �.,- --, a r 7r: �i i•_: i f1 -9 ,y .iw,. � .. w ;�• �r+i4-.. r.Y•: tt"� r` t� 2`' -' s'-. ",arc:' 7..--��'7._>,•--rz: i,�.,=;fir. �:s = '� c r F , ice �'1`.- 6n•'„ 4f 3"s �' :r'ra;r ;,tc^' a ' -�k. y.A:_>s. >��_-- - y: - - ,c:r =z::ee�`j - .>,...l�.•...�.=i�-�`�sY��a!�•- k..r '^'i3o:S{ .;t.� f,. _ - �>hi8,•.�._,�.�.-r- .`1l};I�;`" �;Yi es,. .�'"n'.,�`�aS,._ ��• ar,>r' Yc'• "'i,'ti`Ly.-'r_•"-."�'-.-•�� p,�t�" '3`• - 1�'� c '+. S.tis�'��"4, =-"��•.. �_:+;iz•""�¢''tF"w.-2-...R•�5�', 3_�?=^ _. _r.- `-,,x.>^ ;'i _ N$' .` %F:� ':Y,�. j' -;>-r".ei.�t ,_•v `:3'" C °6=•�:'�•. ^=c--- .n-e.. c .-.?Fu-..' "^ak.,3 T?' 'Slw�-^kr".�•r- y- ?3f>n _ a ..w.�..,.zt - �=AQ �l.l N-'SfS"i :s,:r'4`-`cT-\=z*-t;zs."': ->r..=3.'�• 3r- `z t. PIF=i'...�. a' -. j zGf's1`-.•,'..'r--,e r1,r':ra:2 r S a7�'�G.`�a' g.�1' '�t'1�` _ �wa .tr' 'f~-e=.•.=p-'h, �.>"LI�"y-r��'-•?• -..:i'�sn%lgt4�:.y .rr21f�; -,� er7"�•..••'•"' k+�#sl-ry °kS>:Xw.CF.^`Ju%.- - eL`W^_ ill - _ _fi•._ _ t '� ,��•,J ' +rte a � 1 NE- F ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PSIT:$12.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$923,00 PER S.F. &C Total Project Cost: $ 4. �Od FEE: Check No.: Receipt No.: NOTE: Persons co tracting w' unregistered contractors do not ave access to the bzca ano fund -' n ure L raer F i .I I I Plans Submitted Plans Waived Certified Plot:Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL Public Sewer Tann ing/MassageBody 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 C'#0I 11IVIEI I I S 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: Locate 84 O ood Street ^• - -1• '' y,��.'.y_•+_ -- - H:C' ,..r+ �:t'�'-�hk':ate`^.d� s.t_'/.�.•.�-�y ..:>y'[I:moi=: :�.!'.-'n .h _ _ L'O'CN432- 1 ate:d� ��111ai�J:�ire�� n. -.J�r�-'� =@rte _ -v:�-- - -- i_-'•.-' _ ..z.... ._.r_-.•-+ �. .•�-_. _-.r+s.. ....-,.... .�__.. _.........v' - _�=r:_ _ �{_ >rry u� -s.=1�`�."hw'-.�.'•'ts�:�r:`�sem. u _.....--. -wz.-=•gin ' ..-,:.+:-.•., ie _�:-:may..;:'.r-::',.=.:._r.�-::"/:�s�:_� - �'1'i�'�.,±-. ,amu: _ - - _ %i':vin:�+a�y�.•�,-'�..�',4t;;r�l��:::_`i'F-u��.::.:i.'�-`:£��'i�.�+i"-- :. t 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 2010 i i J 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 o Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ IVI "ass 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 4-New Construction (Single and Two Family) ❑ Building Permit Application /_+ ..t:ti'i r1 i Y v i nl t �t ❑ el i�,.c„ r-roposed Plot P say ❑ 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 Pian 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 Doe:Building Permit Revised 2008 Location �y cs No. � Date NORTh TOWN OF NORTH ANDOVER CiAr. c •,ti0 F � w A Certificate of Occupancy $ ' Building/Frame/Frame Permit Fee s+cmust 9 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # Building Inspector ORTH Towno � � O ov... ... .. . .... er No. h � a tw- LAKE O dower, IVlass., COCMIC HE WICK ADRATED ) P'9 5 `SS BOARD OF HEALTH Food/Kitchen ..PERM IT T D _ Septic System BUILDING INSPECTOR THIS CERTIFIES THAT Foundation has permission to erect........................................ buildings on .. .......I�4. ft.......&....................... Rough to be occupied as............... ....... . 4 Chimney ..................................... ...... ............... provided that the person':Zce 6lj his permit shall in every respe onform 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 6 PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRU ST TS Rough ....... ..................................................................................................... Service BUILDING INSPECTOR Final Occupancy Permit Required to Ocaltpy 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. Page# of pages CS # 022680 978-688-6737 HIC# 103358 A. J. Walsh & Sons - or 55 Pleasant Street 1-866-AJWALSH .North Andover, MA 01845 Proposal Submitted Job Name Job# Address // Job Location testi ( t (1-� 0 �0 �� Date Date of Plans Phone# 414 �, Architect We hereby submit specifications and estimates for:.................... .......................... ...................................... 46 .. _.___....................... ----------- . _-.___- ------...._... _........_ ---------_ _ ...... .................... _ _...._.........__..._....---------_.._._....!. ..... -- -......._.................--..-_.____ � �� _� ---._..................................___..............__ .............._....----.........................._ ----- ___ -----......................------ ._.___..---- - —_ .�._.---- -. -----____ .__ - ....... rte. a �` , a__ ��? _...._._.._..................._._ _.F/ _._.._.-��...............�1UO_...._...._. ��_ti�_; t".... �_ z ' lJ �Li_.__ '_.._ ' c/_._...._......__........_ ..................---._......__ :_...._..._...._ ............. ._. .._........._...... ..__..__._._..._........._.._._......------._.-...._...__._..._..- --------.._..------=----- -._.__..__...._._.._.. _ .._.__.__....__._.._...__..__..__......._._.._. f --....... .........................---....... _........_ .� � ...__.: tl ..._.. ._ ..: .` � --._.....--- . ._.__...._.._..................................___...........__..........._...... We propose hereby to furnish material and labor-\complete in accordance with-the above specifications for the sum of: 4 'V$ ��y +r-- "414%, /tNZ44_4,E, Dollars U with payments to be made as follows: Y Any alteration or deviation from above specifications involving extra costs will be Respectfully executed only upon written order, and will become an extra charge over and -- above the estimate.All agreements contingent upon strikes,accidents,or delays submitted � r beyond our cohtrol. Note—this proposal 7y be withdraw;by us if not accepted tn days. acceptance of j)rOP0 ar The above prices,specifications arid conditions are satisfactory and areSif gnature / hereby accepted.You are authorized to do the work as specified. �!�i" Payments will be made as outlined above. Date of Acceptance-- Signature XIN The Commonwealth of Massachusetts . Department of Industrial Accidents " Office of Investigations :I:•? % 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): �U �/7 .S Q,Ats Address: /14r i JgJY 7— s- /-City/State/Zip: Ad A ,S/Doaeli� /V*Phone #: 97d' —(Jf—6 23 7 Are pirlan employer?Check theappropriate box: Type of project(required): 1. I am a employer with l 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor orP artner- listed on the attached sheet. 7• E] Remodeling 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 required.] officers have exercised their 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.0 Plu ing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12. oof repairs insurance required.] t employees. ' p yees. [No workers 13.❑ Other comp. insurance required.] *Any applicant that checks box#I must also FII 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: l �� / /) Ce Policy#or Self-ins. Lic.#: 6/L��yi�D /�OO Expiration Date: !/ Job Site Address: 5'5— 1'7,4//yJ7— Ad /3�`/�J(JdC/� 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 Inay be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby cert' ,under the pains and penalties of perjury that the information provided above is true and correct. Signature: Date: Phone#: ?, JV;---6237 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#: 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 person erson 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-contractors)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 cavy 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 confinnation 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 pen-nit/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 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 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 Fax#617-727-7749 Revised 5-26-05 www.mass.govldia MASSACHUSETTS HOME IMPROVEMENT CONTRACT This form satisfies all basic rgquitements of the state's Home]mpmvemert Contractor law(MdI:chapter!42A),but:does not include standard language to protect homeowners. Seek legal advice if necessary."Any peison plarmmg homti;mprovements ahouid.5 sf notbbiin l copy a. d Massachusetts,consumer guide to home improvement"before agreeing to any work on yourresidence.You m obtain-a free Office of Consumer;Affairs:and Business Ra copy the gulatioa sConsumer Information at-617-9734787-or 148&283_3757. - Homeowner Information 'Contractor Information arae /.� � /1/7� �' Ps°Y ams -pTf Street A (do not use.a Post Offi. Box address); tractor/Sal �. _ espcson/Owner Name '.. City/town state zip code ass Address(must include a street aeidresg) . Nb )9,A/,D 0 1)e� 1W,4 o&K, 00 4.N T' 4 Daytime Phone Evening Phone. state Zip Code 'Aid Mailing Address(It different from above) 3umness Phone _LEmployer ID or SA Numtier I - . . ta�eageers untmoa homeoo• Hmw c®a,rforaeyar+®ee: -E.pmd;n:dac�- - - =. MOWN=M=ber emtrsotmhsaee I �� / .. . The Contractor agrees to do the following work for the Horueo tier. ✓ (UcKnuc in acuu,.0 W, Roo graWDr=RMrMW,5FMUseG�=2M11 Ro0 /i7e�''io� L . =- G e ?F}T� h i - i�G� Required Permits-The-following building permits are required Proposed Start and Completion Schedule-The fdllowmg schedule will and will be±se curedby the contractor as the'homeownees agent; be adhered to unless circumstances beyond:tbe contractor's'control arise (Owners who secure their own permits will be excluded Irom.the Guaranty Fund'provisions of Date when boiitracturwill begin contracted work. MGL chapter 141A.) Date when contracted .work will be substantially.completed. Total Contract Price and Payment Scbedule a Q� The Contractor.agrees to perform the work,furnish the material and labor specified above for the vital sum of: J`�D� (•) yments will be made according to the following schedule: 0® $ upon,.signingconpact(notaoexceed1/3ofthetotaticontrac t 'ex, the costo£ Im 4i ial order i 1 spec t isms,whichever is greater) by or upon completion of y _ CA by or upon completion of 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 S to be paid for ordered before the contracted work begins in order 5 to be paid for to me d the completion schedule.(**) NOTES:(•)including all finance dunes(••)Law requires that any deposit Or down payment required by the conuaetor before work.begins may not exceed the greater of(a)onethird 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 Exorew Warranty.is an exorese.Warranty bemn provided by dee enntraetor+ No Yet lap q of rh warranh Subcontractors The contractor$ o the coarraere agrees to be solely responsible for completion of the work descabed regardius of the actions of any third party/subcontractor utilized by the contractor. The contractor further agrees to be solely responsible for all payments to sA subcontractors fol materials and labor under this agreement 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 • Don't be pressured into signing ' di ffi l - I� going the contract Take time to lead and fidiq understand it Ask'questions if sornetiring is ttnclear. • Make sure the contractor has a valid Home Immnvement ContracRrr Reaiciraei The i>iwnj most home improvement contractors and. subcontractors to be registered with the Director ofHome Improvement Contractor Registration. You may mgistiati writing Y'm quifie aboutcontractor. on by ting to the Director atone Ashburton Place,Room 1301,.Boston MA 02108 orby.calling 61.7-727-3200,or ]-800-223-0933. - . ,. • Does the contractor have insi mo 7 Check o see that your contractor is properly insured, t • Know your rights and responsibilities. Read the Important Infirmunion the ieverseside of this form and get a copy of the Consumer Guide to the Home Iillprovement Contractor Law: You may cancel this a if it has been signed at a place other than thecomractois'normel lace of bus' contractor in ori' at his/h main ofTice or bran office o p provided you notify the third business d y following signing of this ant.See the aaachedtice obY telegram sent or by delivery,not later thea midnight of the, f cancellation form for an explanation ofthis right DO NO SI S CTIF THERE ARE ANY BLANK SPACESM Two icktak t oapi of the aM.4be d signed Oze copy should so to the .The odw sbmld be .. .. ooPY kept by the contrsUor. Ho sow a s Signature Contractor's Sigmitm Dai. ,Date Contractor Arbitration The Home Improvement,Contractor Law provides-homeowners with.the right-to.initiate an arbitration action(as an alternative i court actton)if they;have a:dispite.with a contractor. The.same:tighf is not automatically afforded to a. e conimcto r would have: resolve any.dispute helshe.lias with a homeowner in court unless • contractor,however. Th � Y sP both parties agree to,the optional•clause provided below:.This clause would give the contractor the same.right to, arbitration as is afforded to the homeowner-by the Home Improvement Contractor Law. The contractor and a om caner hereby ally agree in advance that in the event the contractor has a dispute concerning this contract, contractor ay bmit the dispute to a private arbitration firm which has been approved by the Secretary of the Fac tiv ffice f et Affairs and Business Regulation and the consumer shall be required to liifiit to such arbi do provid Massachusetts General Laws,c l42 omeo�n igni;ture Contractor's Signa O :'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 altenzative•dispute resolution even where this section is not separatel signed-by1he parties Homeowner's Rights A homeowners rights under•the 14me•.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 n sponsible-for completing the work as described,in a timely and;workmanlle manner. Homeowners may be entitled to other specific legal:rights if the contractor guarantees. or provides anexpress warranty for:workmanship oi•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 oonsumer/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 g;riginal contract must be in writing and agreed to by both parties.Contracted work may not begin until both parties have received a fully executed copy of the contract,and the three day recission period has expired. Accelerated Payments A contractor may not demand payments inadvance.of the dates specified on the payment schedule in eases 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 funds not yet due be placed in'a joint escrow account as a prerequisite to.continuing the contracted work. Withdrawal of funds from,.said account would require the signatures of both parties. Additional Information 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 freecopy of "A Consumer Guide to the Home Improvement Contractor Law,"•contact Cgnsumer Information Hotline Office of Consumer Affairs and Business Regulation 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,additional information specifically 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 1-800-223-0933 For assistance with informal mediation of disputes or to register formal complaints against a business,call: Comahier`t:ompiaint'Section Office of the Attorney General (617)727-8400 AND/OR Better Business Bureau (508)652-4800 (508)755-2548 (413)734-3114 S III t � .�fe Uai.zirzaizrve�rlf� cf�.jjt{.,,a �r� Office of Consumer Affairs&Business Regulation _ -•_HOME IMPROVEMENT CONTRACTOR Registration: 103358 Type: Expiration: 7/7/2012 Private Corporatior A.J 'VVALSH&SONS,INC. Arthur Walsh,Jr. 55 Pleasant St N Andover,MA 01845 Undersecretary ar License or registration valid for individul use only before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation i 10 Park Plaza-Suite 5170 Boston,NIA 02116 `\'ot vali without si11're Nlassachuwtt. - Wpartntcilt lit' Public lsafetN ..VVY Bl)a d of Builtlnt, Rc,;iil ttnnn. anti �tandm-ds License: CS 22680 ARTHUR J WALSH JR 159A WAVERLY RD N ANDOVER, MA 01845 �-�- -� Ex sjration: 6/9/2012 t Tr-: 29327 I i