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Building Permit #462-15 - 55 VEST WAY 11/12/2015
BUILDING PERMIT TOWN OF NORTH ANDOVER 2,_ 1 APPLICATION FOR PLAN EXAMINATION Permit No#: 1� L _ t Date Received Date Issued: A /12,111 IMPORTANT: Applicant must all items on this LOCATION"- Pnnt' `PROPERTYOWNER A2,-r's • i � /' t/. —_ - - -- _ 'MAP%U PARCEL: ZONING DISTFRICT _ H y2s'. TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family 0 Addition ❑ Two or more family ❑ Industrial ❑ AI ion No. of units: ❑ Commercial p,Ffepair, replacement ❑ Assessory Bldg ❑ Others: 0 Demolition ❑ Other ❑ Septic'r Well,7 ❑fmoodpla n ❑ Wetlands .b'l Watershed District ❑ Water /Sewer (� DESCRIP N O UKK U tit�ld rtrcr nth:, Identification - Please Type or Print Clearly OWNER: Name: W . Phone: �� 6 ?37. 3Y64 Address: Contactor.N'ame: __-'Phon -e .Address . t� oil � �� 1 c� � �e �) O &4,1- LL . - N �_ _ Supervisor—'S Construction License._Dc'��,- Exp®ate Home lm �rovernent 'ucense-__7©—___-- Exp Date r_ p 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: $ C5Af ys® • Q'�D FEE: $ y 13, yy Check No.: �� Receipt No.: C NOTE: Persons contracting with unregistered contractors do not have access to the a fund 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 PLANNING & DEVELOPMENT Reviewed On COMMENTS Signature CONSERVATION Reviewed on Signature COMMENTS HEALTH COMMENTS Reviewed on Signature Zoning Board of Appeals: Variance, Petition N Planning Board Decision: Conservation Decision: Comments Comments Zoning Decision/receipt submitted yes Water & Sewer Connection/Signature & Date Driveway Permit DPW Town Engineer: Signature: 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 Call Email Date Time Contact Name Doc.Building Permit Revised 2014 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 o Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H. I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Cross Section/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 N(>TE: 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: Building Permit Revised 2014 TOWN OF NORTH ANDOVER Certificate of Occupancy Building/Frame Permit Fee Foundation Permit Fee Other Permit Fee TOTAL L. Check 4t 28256 o W U CNQ z z 1-4 xW� 0wUJ 0� r (.) z = WW xW aWta .jH tum Z Q �..... 'z z o Z U� WU a�a z a W W H H 0 w P W z�MC3 o�00 �> wH LLJ t�!>0 0�_ z u z(DW uL -- W P 8 Lu W U wouw h- z= � LU > z < uL W U. O u U. UJ U. W d<0 w 0 � c� cow0 i.- o F< C P to �aPz u - n U- W �F:ow X LU X1.1 W �- L) a) w 1Y . r � Q O O i+ U a� w •� cr C z J E z a? F — �[ c d b�E ow N a CD y� O G 7 U z�� 0 a.L E L V N in to � M w 6L W 0 0. D 0 LL d z U u i� C T- C) W D Ix fL N U CD Q � CD N t d Q c: E o zWD O aa- ro m 0 C U W m U D Lu u HUJ UJZ J f WUl �' UJ w 0: 0 zx z o as > Ln Ln Oct uZ �� CLQ �a Lud W ? (A (A z (A U T- C) W D Ix fL N U CD Q � CD N t d Q c: E o zWD O aa- ro m 0 C G O U) ir W z t� U- P w w w 0 u w z z W z W ©c_ W O ❑ Z) �u Ww0 mwoo 0< j CL ❑<J� 0 0 Cly Q LIJ 0 U 2 W }" H uj z LU LL w < 0 co _zxW 00> o Q= D WXQ 0 cr ce Z LJ C..� Lu W � 'r D l j J z2 w _u}Q_ 0 W V)gaa wjr>- T 0<�LL W 0 _�� <QU� T W Z r.._ m Q W Z < WLf) 1-z LLJ c� V)L �- Q =wX �-Z.L) W Y �' LU U� 0• S w D CL W z z W CL 9 r� .� td cv A Ln Ln ry- Rf r_ D rl CD ro 0 rduo 0 ti N C. CrJ qJ .Ci W : 4 ill > co 'i f-+ V co a G� z 4 -4 En .� G O U) ir W z t� U- P w w w 0 u w z z W z W ©c_ W O ❑ Z) �u Ww0 mwoo 0< j CL ❑<J� 0 0 Cly Q LIJ 0 U 2 W }" H uj z LU LL w < 0 co _zxW 00> o Q= D WXQ 0 cr ce Z LJ C..� Lu W � 'r D l j J z2 w _u}Q_ 0 W V)gaa wjr>- T 0<�LL W 0 _�� <QU� T W Z r.._ m Q W Z < WLf) 1-z LLJ c� V)L �- Q =wX �-Z.L) W Y �' LU U� 0• S w D CL W z z W CL 9 r� A � n O V O C @)0) ++ �i ry)O > U U R O 0 V ON UU 'C .. C N O rl - > vi 'C W U v -0 v U z v 0 Zco W v a > Z -00 � a _ O W O Ccd U p W • Q p U�. N Z UcdW � CJN N V V] dj d> yL' 'Aun G� U N .1 0 bA Q U -cs NO m OO�C CIA N Oa O O z N W O " �+ cC -� _ O N OHO cd U H a bA� 00 o o �o� o 40.44 0 bb �H1� dna 00 oUw3v� as ACORp' CERTIFICATE OF LIABILITY INSURANCEri DATE(MMIDDIYYYY) �.-�' 1 /03/2014 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 NONTAME�CT Daniella Franca PHONE 508 485-1926 FAc No), 508 485-8519 Stephen W. Gersh Ins Agency Inc IL . df franca ershinsurance. A'MAFir 9 Monument Avenue INSURERS AFFORDING COVERAGE NAIC # Marlboro MA 01752 _ INSURER A : GENERAL AGGREGATE $2,000,000 INSURED INSURER B : INSURERC: Advanced Remodeling & Renovation INSURER D : 488 Boston Post Rd INSURER E: Suite D1 INSURER F : Marlborough MA 01752 COVERAGES CERTIFICATE NIIMRFR- RFVISION NIIMRFR- 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL SUB POLICY NUMBER POLICY EFF M/DDIYYYY MMI DYLICY EXP LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ❑ OCCUR WS187527 11115/2013 11/15/2014 EACH OCCURRENCE $1,000,000 PRPMISFS ( Fn nrrtirren,p) RENTED $100,000 MED EXP An one person)$1,000 PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ AUTOMOBILE LIABILITY ANY AUTO ALL OW NED SCHEDULED AUTOS AUTOS HIREDAUTOS NON -OWNED AUTOS - - COMBINED SINGLE LIMIT BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ UMBRELLA LIAB EXCESS LIAB HOCCUR CLAIMS -MADE - - EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY - Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE❑ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A _ _ _ . - WC STATU- OTH- E.L. EACH ACCIDENT $ E.L. DISEASE -.EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) The Worker's Compensation Certificate has been ordered, and will be sent directly from the Insurance Company. l.rK I IrIt.A I r MULUCK t.ANt.rLLA I IUN Town of North Andover 1600 Osgood St Building 20 Suite 2035 North Andover, MA 01845 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD 0 ENO Q LU LU ,,• . o m C N u \ o LL N ? U a In 0 W N z z J m C O m 'O O tC °�° K v U LL 0 LU U N z (� m D J d .0 °�° or LL 0 W N Z Q U u LU W - L °�° d' U i {n 5 LL oc O U Wa z LA L- °�° K .. LL z LU a W 0 . LU 25 LL .. N.. i ca O Z �'' L1 {% N � Y 0 (n O **wwn Vl OO r O v o � LU •Q L � o O O OO r LU Z z m ti N •� CO r Q O v, c, Do O L W Q rV N l— V W • Al Z o L I O w W J v G- Z m � V o a� c O 0 N O • t O Z O a � J J W S O m _ O O O LL Ln U- O_ N . Ln OF LLJ d N z C9 J + -O O O LL L =3 O Q C L U - ro O LL O LN z z .. t a00 O '2' co -C LL O d z Q U LU ui LU nO� CC O N �o C. LL oC O LU Z D O O LL Z LU a W LU U. O O CO N N .. .. O N Y O N O W O O Z �. O W CL cn Q z c� i ,4J 0 O O a �Q � m OM �CL Cl) 'Ayd O W i cnCL r O &0O E Vco 4� tLA LLI •� 0 •0 `�` r Q W Cz ujw a� (D N a, uj ? Z m � o V a� c 0 0 N G1 • t O z O Q � J W O Z �. O _ Q i ,4J O O a �Q � OM �CL O Z 'Ayd O W U cnCL Y./�✓dV�I��.Y ���V�Ld VI��� PREPARED FOR: Mr. and Mrs. McElhineey 55 Vest Way North Andover, MA 01845 Phone: (978) 687.3866 PREPARED BY: Leonardo Parreira Dasilva Advanced Remodeling and Renovation 488 Boston Post Rd.- Suite D1 Marlborough, MA 01752 Phone: 978.440.5020 H.I.C. Reg. Number 170814 Expiration 12/23/2015 C.S.L. Number 084348 Expiration 02/14/2015 Lead -Safe Contractor License Number LR001737 Exp. 02/04/2019 r ADVANCED Job Number# 2014-063 Page 2 ADVANCED 6 . @E) October 20, 2014 Dear Mr. and Mrs. McElhiney, I would briefly like to tell you about Advanced Remodeling and Renovation and why you will want to choose us for your Home Improvement project. Advanced Remodeling and Renovation provides $2,000,000.00 of liability insurance. All of our employees are covered by Workers Compensation Insurance so that you will not be exposed to any liability should any of our employees be injured while on your job. We are licensed with Massachusetts Contractors Association (License #170814), for your protection. ■ We are members of Certified Contractors Network (CCN) ■ We are members of Better Business Bureau (BBB) ■ Lead -Safe Contractor License ■ James Hardie Associate Contractor ■ Master Shingle Applicator (Certainteed) ■ Master Shingle Company (Certainteed) ■ Angie's List 2012 Super Service Award • Angie's List 2013 Super Service Award As a legitimate and dependable remodeling company, we maintain these affiliations and credentials to provide you with the highest level of confidence and customer service. We are registered, licensed and approved with many manufacturers for the installations of premium products. ■ Our estimators are knowledgeable in product differences and quality. -!.Our-mechanics are qualified-qand attend pre. approved ;on=going- r trainingkto keep them'Yup to date on the; latest technological advances the remodeling industry`:ulcluding the local bu milding codes. = { 4 Your home ... Our reputation. Very Truly Yours, Leonardo Parreira Dasilva Advanced R. & R. ADVANCED Initialed by: Contractor , I..e.—J Job Number# 2014-063 OERT I ,p ® ADVANCED NOTICE NOTICE TO TO EMPLOYEES • res EMPLOYEES eyy V The Commonwealth of Massachusetts DEPARTMENT OF INDUSTRIAL ACCIDENTS 600 Washington Street, Boston, Massachusetts 02111 617-727-4900 As required by Massachusetts General Law, Chapter 152, Sections 21, 22, & 30, this will give you notice that I (we) have provided payment to our injured employees under the above mentioned chapter by insuring with: A.I.M. Mutual Insurance Company NAME OF INSURANCE COMPANY P.O. Box 4070 Burlington, MA 01803-0970 ADDRESS OF INSURANCE COMPANY A W C -400-7030056-2013A POLICY NUMBER 11/16/2013-11/16/2014 EFFECTIVE DATES Agency Stephen W Gersh Ins A Inc 9 Monument Avenue g Y Marlboro, MA 01752 (508)485-1926 NAME OF INSURANCE AGENT ADDRESS Advanced Remodeling and Renovation 488 Boston Post Road Suite D1 Marlborough, MA 01752 PHONE EMPLOYER ADDRESS 11/20/2013 MEDICAL TREATMENT The above named insurer is required in cases of personal injuries arising out of and in the course of employment to furnish adequate and reasonable hospital and medical services in accordance with the provisions of the Workers Compensation Act. A copy of the First Report of Injury must be given to the injured employee. The employee may select his or her own physician. The reasonable cost of the services provided by the treating physician will be paid by the insurer, if the treatment is necessary and reasonably connected to the work related injury. In cases requiring hospital attention, employees are hereby notified that the insurer has arranged for such attention at the NEAREST AND BEST MEDICAL FACILITY EMPLOYER ADDRESS TO BE POSTED BY EMPLOYER �a ADVANCED Initialed by: Contractor rtn C%Ck Job Number# 2014-063 Page 4 So,Y�t ,S,Ea ADVANCED Lead Renovation, Repair and Painting Rule (RRP Rule) Lead poisoning is a major, preventable environmental health problem for both children and adults. In children, it may cause developmental problems, lower IQ, behavioral problems, language delay, anemia, damage to the nervous system and other problems. High lead levels in adults can cause high blood pressure, headaches, memory problems, kidney damage, irritability, difficulty sleeping, nerve disorders, muscle or joint pain and damage to the reproductive system. Public health problems related to lead poisoning results in billions of dollars in health care costs to taxpayers and the government. Although bans on leaded gasoline and paint have greatly reduced the incidence of dangerous lead levels in children, many children are still at risk for damaging lead exposure. Lead paint and the related dust and chips are the leading cause of high lead levels in U.S. children. Effective July 9, 2010, the Massachusetts Department of Labor Standards ("DLS") (then Division of Occupational Safety "DOS") promulgated amendments to its Deleading and Lead -Safe Renovation Regulation, 454 CMR 22.00. These amendments establish safety standards for renovation, repair and painting work that disturbs lead paint in target housing and child -occupied facilities built before 1978, which parallel similar federal EPA requirements that became effective in April 2010 under the 'Renovation, Repair and Painting Rule" (RRP Rule) intended to increase awareness of lead hazards that occur as a result of renovations. DLS received authorization from EPA to administer and enforce the lead safety standards for renovation, repair and painting work set forth in 454 CMR 22.00, in lieu of the federal standard being enforced by EPA in Massachusetts. This regulation applies to residential houses, apartments, and child -occupied facilities such as schools and day-care centers built before 1978. IT'S THE LAW! Federal law requires contractors that disturb painted surfaces in homes, child care facilities and schools built before 1978 to be certified and follow specific work practices to prevent lead contamination. Always ask to see your contractor's certification. Federal law requires that individuals receive certain information before renovating more than six square feet of painted surfaces in a room for interior projects or more than twenty square feet of painted surfaces for exterior projects or window replacement or demolition in housing, child pre facilities and schools built before 1978. Homeowners and tenants: renovators must give you this pamphlet before starting work. Child care facilities, including preschools and kindergarten classrooms, and the families of children under six years of age that attend those facilities: renovators must provide a copy of this pamphlet to child pre facilities and general renovation information to families whose children attend those facilities. /ADVANCED Initialed by: Contractor • Homeowner Job Number# 2014-063 Page 5 ADVANCED - $flIYGEE$LISiCfl „ oeuxc . , mo a enox.n ox BBB_ r. S i -r rqw-94.1 00 THE COMMONWEALTH OF MASSACHUSETTS - EXECUTiVL-, OFFICL- OF LABOR AND WORKFORCE DEVELOPMENT DEPARTMENT OF LABOR STANDARDS 19 STAMFORD STREET, BOSTON, MASSACHUSETTS 02114 LEAD -SAFE RENOVATION CONTRACTOR LICENSE ADVANCED_ REMODELING AND RENOVATION 488 BOSTON POST ROA_ D` SUITED i MARLBOROUGH MA'01752 LICENSE: LR001737 EXPIRES: Monday ,.February 04, 2019 w,. IN ACCORDANCE WITH.NLG.L. C. 111, § 197B(b) AND 454 CMR 22.04; THIS LICENSE IS ISSUED BY THE DEPARTMENT OF LABOR STANDARDS TO THE CONTRACTOR ABOVE FOR THE PURPOSE OF ENGAGING IN LEAD -SAFE RENOVATION AND/OR MODERATERISK DELEADING WORK. THIS LICENSE IS VALID FOR A PERIOD OF FIVE (5) YEARS. THIS LICENSE MUST BE MAINTAINED BY THE CONTRACTOR IN ACCORDANCE WITH M.G.L. C. 711; § 19713(b)(2) AND 454 CMR 22.04 WHEN ENGAGED IN LEAD -SAFE RENOVATION AND/OR MODERATE -RISK DELEADING WORK. LEAD SAFE RENOVATION CONTRACTORS MAY NOT , .- PERFORM MODERATE RISK DELEADING WORK UNLESS THEY EMPLOY. A rSUPERVISOR, WHO HAS. TAKEN THE REQUISITE TRAINING AS REQUIRED BY 454 CMR 22.00; TO OVERSEE THE WORK. `HEATTwR E. ROWS, DIRECTOR' ., Please detach this mailing fab and keep your license certificate in an accessible location. A copy Of this license must be maintained at each. worksite. ADVANCED REMODELING AND RENOVATION 488 BOSTON POST ROAD - SUITE DI f MARLBOROUGH, MA 01752 /ADVANCED Initialed by: Contractor Homeowner rL��� Job Number# 2014-063 ..- . at `• F �,f`1': „`iih ` /.M�c�a Ilei. ADVANCED EXTERIOR EVALUATION: (Siding) The existing siding is made of an organic material (Cedar/Spruce) and is currently rotting on the bottom of a good portion of the walls that meet the roofing. It is also a breading ground for mold and mildew since there is no moisture release. The moi e is being trapped between the house and the siding. The absence of weather barrier cause e paint does not stick on existing sidingj Advanced R&R suggest that a new maintenance e siding be installed. / EXTERIOR EVALUATION: (Soffit/Fascia) Futhermore the soffit and fascia area are seeing damage from the elements and are harboring moisture. To protect these area a fascia wrap (or replaced) and a vented soffit panel is recommended to be installed. These installations will ensure no more bothersome painting. ADVANCEDInitialed by: ContractorHomeowner Job Number# 2014-063 Page 7 SH[H61E6L1Si6H , jr ADVANCED BB EXTERIOR EVALUATION (Gutter Pollution): Guttertopper is recommended and can be installed over the new gutters to keep leaves and debris out. Overall, this will keep the gutter and downspouts running more effectively. As well this will take the danger of climbing ladders and the hassle of cleaning the gutters out of the yearly schedule for good. This project has been specified°in accordance with local building codes, industry standards and manufacturer specification requirements. All work will be installed by certified craftsmen to assure qualification for James Hardie Building Products warranty. We at Advanced R. & R. understand that for most people this may be your first experience with siding your home. With that in mind, we want to offer you this list of "what to expect" during your siding project. We hope this will help to avoid any confusion or problems before, during and after we arrive to complete your project. Scope of Work to be Performed: COMPLETE TEAR OFF OF SIDING AND TRIM. RE SIDE HOUSES WITH JAMES HARDIE FIBER CEMENT 5".'� (Owners who secure their' own permits will ' be eiMuded from the Guaranty Fund; '' roAsions MGL f } chapter 142A.) Required Permits: Siding (105 CMR 460.000: Lead Poisoning Prevention and Control) Homes Built Before 1978 No (1982) I A .,,, qq ADVANCED Initialed by: Contractor HomeownerF l� \ 6� Job Number# 2014-063 Page 8 �� Sn��ctsS[abtee ADVANCED to General Specifications: 1. At the end of each day, the working area will be made watertight to protect the building from normal weather conditions. 2. The work area will be cleaned of all siding debris during and broom cleaned after job completion. 3. The work area will be magnetically swept to pick-up any left over nails after job completion. 4. All gutters pertaining to the work area will be cleaned of all debris after job completion. 5. All work performed by Advanced R. & R. will be in accordance with manufacturer's recommendations and guidelines and the local building codes. 6. Advanced R. & R. extends to its customers a (5) year workmanship warranty to supplement any applicable manufacturer's warranty program. Job Site Preparation: Advanced R. & R. "Property Protection Measures" will b ' 1 2 3. M 5. M 7. 8. V imp emented throughout the fob. Upon the start of the job, we will place a job site yard sign on your property and request that it stay for the duration and completion of your project. This is our best form of advertising as we are proud to display the quality workmanship we instill in every siding project we complete. Advanced R. & R. will provide a container for the disposal of siding materials. We will need to locate and prepare a convenient place for the container. Advanced R. & R. may require the full use of your driveway during the course ',of your siding project. It will also be necessary to have access to an external electrical power. source. Advanced R. & R. will make every attempt to protect the roofing, windows, doorways, porches, decks, patios, and surrounding grounds and shrubbery with tarps. Due to the large amount of debris being removed, there are times when damage may occur. If there is a particular tree or bush that you wish to protect, please note below under "special requests" prior to the start of your project. However. Advanced R. & R. will not be held responsible for damage to landscaping .5.z Advanced1R. & Rhkreco'mmends that prior to start„of the job1fiat you remove or s cure all fragile or irreplaceable items on wallsjan&ceilings that could be disturbed or damaged during j, the job. AdvancAe, 4 ed.R. & R cannot '"'hold responsible for damage to said items -1, � Advanced.R-:-& R�_will make everyattempt to protect the guttef§,-downspouts, awniings�-fr m damage by removal of the old materials. Please be aware that there may be times when minor damage or marring may occur, as we cannot guarantee it will not. Advanced R. & R. will remove and/or replace antennas, cables, satellite dishes, cupolas, and any other electronic devices to accommodate continuation of the scope of work contracted. We cannot be held responsible for operating condition or damage to said items after replacement. Television or satellite reception, all cabling, wiring and hardware are the responsibility of the homeowner. Advanced R. & R. will not be held responsible for poor appearance or damage due to a pre- existing condition. zr_p ADV” NCED Initialed by: Contractor Homeowner ) l BE Job Number# 2014-063 .g- Siding and Trim Removal: Advanced R. & R. will remove and dispose of existing (1) Layers of siding material to the substrate: Substrate Preparation: • Inspect all substrate for stability and ability to install new siding. • Replace rotten wood at the request of the homeowner at the rates below 1. Replace rotted or damaged plywood or OSB at $79.00 per 4' X 8' sheeting. 2. Any replacement of rotted or damaged framing or finishing lumber charged at a time & material basis. Labor will be charged at a rate of $45 per man-hour plus materials. Advanced R. & R. will notify the customer prior to proceeding with the above additional work: Fights cold, snow, ice and worry. The HZ5® product line lets you sleep easy in climates with freezing temperatures, extreme seasonal temperature variations, and snow and ice. To ensure its beauty matches its durability, we've engineered the surface for higher performance, giving it superior paint adhesion and moisture resistance. So you aren't getting an exterior that performs well in cold, nasty climates. You're getting an exterior engineered just for it. • Resists damage from freezing temperatures. • Resists damage from snow and ice. • Resists damage from moisture. • Maintains dimensional stability under challenging weather conditions. • Noncombustible* • Complete exterior available in lap, shingle, panel, fascia, trim and soffit. ij{ Unprecedented Peace of Mind!!! (We're so confident The HardieZoneO System siding can withstand the rigors of the North American climate, we're offering our strongest warranty. This outstanding 30 -year** limited, transferable warranty offers nonprorated product coverage for the entire 30 years.) ADVANCEDInitialed by: ContractorHomeowner Job Number# 2014-063 Page 10 ADVANCED � ,F SHIYHLL61AbTCH BBB. James Hardie House Wrap What is HardieWrap? HardieWrap weather barrier is an innovative, higher performing weather barrier that is engineered for climate so you get the right wrap as your second line of defense no matter where your project is located. From James Hardie, maker of America's #1 brand of siding. HardieWrap weather barrier provides a balance of water resistance and breathability, allowing moisture (water vapor) from inside your building to escape so the area within the wall stays dry. What is Hardie Wrap Weather Barrier? HardieWrap weather barrier is an innovative, higher performing weather barrier made by James Hardie, maker of America's #1 brand of siding. HardieWrap weather barrier provides a balance of water resistance and water vapor permeability, reducing water intrusion from the outside while releasing water vapor from inside the home to dry out the wall cavity James Hardie Seam Tape What is HardieWrap Seam Tape? HardieWrap Seam Tape is designed to seal vertical and horizontal seams and small holes in the weather barrier to prevent air and water infiltration. HardieWrap Seam Tape adheres to most surfaces and continues to perform even in low temperatures. It contains no asphalts, VOCs (volatile organic compounds) or solvents, which can reduce adhesion over time. Fasteners -8i w rye � Staples°`are the preferredIand recommended .fastening method. '�4' t Fasten HardieWrap weather barrier in:4 , such away_ _ that ensures the wrap is secured to the wall with staples a maximum of 18" O.C. (on center) in the vertical and horizontal direction. Staples should be construction -grade and must be galvanized. gig.¢ 5� wN r ADVANCED Initialed by: Contractor Homeowner K Job Number# 2014-063 .g- 11 a iADVANCED James Hardie Soffit Panel: James Hardie Soffit panels are available in a vented and non -vented in a range of pre-cut sizes. As with all James Hardie siding products, HardieSoffit panels are Engineered for Climate®, so you can have peace of mind that your siding products will stand up to the harshest elements no matter where you live. HardieSoffit panels are noncombustible and come with a 30 -year non prorated, transferable, limited warranty. Non -Vented Smooth: Beaded Porch Panel: Vented Smooth: Board & Batten: HardiePlank Lap 4din� HardiePlankS.Alap siding is the popular brand of siding in America can be found on over 5.5 million he With its strength, beauty and dural HardiePlank® siding enhances protects homes in all kinds of I Hardie provides siding with spe performance attributes relative to climate where the product is being i James Hardie now gives you /ADVANCED Initialed by: Contractore'.Homeowner Job Number# 2014-063 .g- 12 �gAO'SAF�. !a. :�... � Ia `ADVANCED cERr�Fi...�}�R :w�u optimum siding for your home and climate, regardless of location. All HardiePlank® lap siding comes in a variety of looks and textures, all of which are engineered for climate. We are so sure about how well the HardieZone system will perform, HardiePlank® lap siding comes with a 30 -year non -prorated, transferable, limited warranty—our strongest warranty ever. Hardie Trim Boards Our ,fiber cement trim adds the finishing touches to a beautiful, lasting James Hardie homes, and are all engineered for climate, so you get the right siding for your home no matter how harsh the weather is where you live. HardieTrim® boards provide unmatched durability and allow you to create a variety of design possibilities for trim, gables, corners, fascia, windows, doors, column wraps, rakes, friezes, decorative trim and other non-structural architectural elements. HardieTrim boards come with a 15 - year transferable, limited warranty. Hardie Crown HardieTrim Crown Moulding is a highly durable and dimensionally stable trim accessory that can be used as window ornamental and to enhance the design of the roof line. James Hardie_. Colo&Ius,Technology, r ,: James ,Hardie® �siding productg,,with ColorPlus® technology,g -!a unified composition of (advanced fiber -cement and baked -on pigment - combines thea highest qua 1q,,�raw, mater, proprietary manufacturing process and equipment, revolutionary paint technology and innovative color process that give homeowners a superior siding solution for their homes. • Specially formulated paint stands up to UV levels in a way few field -applied paints can, offering up to 30% more fade resistance. • ColorPlus Technology finish comes with a 15 -year limited warranty that covers both paint and labor and protects against peeling, cracking, and chipping ADVANCED Initialed by: Contracto • Homeowners QN, Job Number# 2014-063 Page 13 5of�����„�eo ADVANCED Maall General Installation Requirements ry via UM La ` N� n n Vl L N eO Ol h 4WEm O n C O .E '% C v m a10i m xmx at 48 C Eo % t c m mC E cD L cL ,„.•I.i m 3 `m _ m u) LCL c 'j � : •ww.. LL o 3 rn � a '� m E L° PON vw- o o m o 'fit c ill m \\ O C Ir _ d. � i3I m g O 2 L 2 m 2E o & v aoaaio 1 m N tL C C O) YG N n O) C (p O ca tr m L `m ro3 m m Ems o c �n m i aoo cEv n 2mEFo m cm 2 m �v�n-mo N oLm. `o m ani Eos 3 m - L6 P m v rn m m rn �. iq •. N r•a'-r — 'a t i m Lrn c c a °° m m E co m c m ma'-coo`mb'i V4 7E3 zr � .n y n 1 ADVANCEDInitialed by: Contractor Homeowner Job Number# 2014-063 Page 14 ADVANCED 941 7SWOjPVE 111A OVA [ASTENEF1 REOUIREMENTS corigh"ed Uln-InOW Offift 10 be can VM 10�rtede 1* aft irobIlillim, of dech coww fugGAfte pmducft Vftm Wt ftAM b0% Obft fft& W fd,Wftth Oda 9 INW& &W F&WM num be'WoLt-or lim. "AM&* GN&SWUffig bqfi&MftWd (*WMtdff 17- T*& I& Huffiffide LAP ffft. GEN MAL FA STENINS REQUIREMENTS Famws rrwL be mr-mina =Avt gamv&w, or amilm aKc ElddMagalVOMM are a=*ft but May a=ff premaWra onw.b& Jams Haftlia mmmmenas ff*. used qahy, hot= ell gAarl'ad Wis. James IWO isiro vesponstle 1& Me wmam m961wn d 1zleciem Sbirdess sled llasftffin are nmommandod when lasullft James Hafda* peft-ts; new the awan, large Wdies of tateK w in very hinid dWMg& MaFMIMMIfeft of O0 and CA pfaffir"m4raMed WAM reanmend spam imabuft of Mo physicali harriers Do pual Wed =w of ACO & CA pma-valk-MM wad and alum marl pmduchLl FaMmm used to, apse!! Hardieftm Tes On pfawralve4eakd woad mad he of wa dwell Ane -co" 00w1w OBM of gatless mea and In a=wance ID MM (PC H317.3 of 2M 813 2334.9.5. PNEUMATIC FASTENING James Hudeprodufts CM be 1121W nA110d Of ItSWW with a pnewyWic teal_ pneuwic w"ning Is riq*1 rommunded. SO air OrWSLO SO UML IM (leOgner is d&o Snug VAII the WON Of ft -siding.A Mish anint allarAwit on The powmak teal is Feco-in- IT*ftm. Mg W1 ho WIM lift dap& the MI is dfiven. it sfitsig ft nail depth pmvn dfifkuit choose a seng that tm&t dyhos Ute nal pfia under dritm trails m@ *a a smwlh faced hannet - ,Dm not apply 1w insWaWn -to sim MaTdrg- WWI appikmw pmftt evaluagan or k&q for canct famnas We and plammerd 10 acpkw spedied desol Wfi-d baft. NOTF- Published wind bad& may rat he aWitob io all am toafe Wal Buililing ODORS hW Sp9dic jL11sWbL Cansult Affes. Hardie DOrkal sffvim ff you are tulsLn d applicable M*W109 documatMafini. • DOM WOWS "ndlaft to SidMg 20 framing. • FaMmar Imads shcold ft o4 against siding Oo air sp". Olq.A) • Do not ow-Mve, trail neads of drive nalls X an angle- • 9 nail is CNfdffgft, (211 nail 11016, and add a nah. ft. S) • far wad ftaiffifg. wof men rites stmuld be hft flush inu pial* Wah a hammer of sw kalft remove am "am rmlo. NOIL ftewwar a Mutual membec is OrWWL flaram& 6-M& he trAW WD even spacing to u shii-dwo mmbef. !Tie tablet MWiV direct to OM OF.PIPWd Shauld OWy he used when Itask"'fim1hig Is nal availablie. Do not am Wominum, b0amrs, Maples, or clipped head rWI&- 24. - Figum 14 F'Oultali.5 0 NORIUMM GvQrLv AW faf BOM FAM SAUg flush and aw Rafflne DO NOT FPVTOA -TTIL tinder drive n Matta -L4P Uln-InOW Offift 10 be can VM 10�rtede 1* aft irobIlillim, of dech coww fugGAfte pmducft Vftm Wt ftAM b0% Obft fft& W fd,Wftth Oda 9 INW& &W F&WM num be'WoLt-or lim. "AM&* GN&SWUffig bqfi&MftWd (*WMtdff 17- T*& I& Huffiffide LAP ffft. GEN MAL FA STENINS REQUIREMENTS Famws rrwL be mr-mina =Avt gamv&w, or amilm aKc ElddMagalVOMM are a=*ft but May a=ff premaWra onw.b& Jams Haftlia mmmmenas ff*. used qahy, hot= ell gAarl'ad Wis. James IWO isiro vesponstle 1& Me wmam m961wn d 1zleciem Sbirdess sled llasftffin are nmommandod when lasullft James Hafda* peft-ts; new the awan, large Wdies of tateK w in very hinid dWMg& MaFMIMMIfeft of O0 and CA pfaffir"m4raMed WAM reanmend spam imabuft of Mo physicali harriers Do pual Wed =w of ACO & CA pma-valk-MM wad and alum marl pmduchLl FaMmm used to, apse!! Hardieftm Tes On pfawralve4eakd woad mad he of wa dwell Ane -co" 00w1w OBM of gatless mea and In a=wance ID MM (PC H317.3 of 2M 813 2334.9.5. PNEUMATIC FASTENING James Hudeprodufts CM be 1121W nA110d Of ItSWW with a pnewyWic teal_ pneuwic w"ning Is riq*1 rommunded. SO air OrWSLO SO UML IM (leOgner is d&o Snug VAII the WON Of ft -siding.A Mish anint allarAwit on The powmak teal is Feco-in- IT*ftm. Mg W1 ho WIM lift dap& the MI is dfiven. it sfitsig ft nail depth pmvn dfifkuit choose a seng that tm&t dyhos Ute nal pfia under dritm trails m@ *a a smwlh faced hannet - ,Dm not apply 1w insWaWn -to sim MaTdrg- WWI appikmw pmftt evaluagan or k&q for canct famnas We and plammerd 10 acpkw spedied desol Wfi-d baft. NOTF- Published wind bad& may rat he aWitob io all am toafe Wal Buililing ODORS hW Sp9dic jL11sWbL Cansult Affes. Hardie DOrkal sffvim ff you are tulsLn d applicable M*W109 documatMafini. • DOM WOWS "ndlaft to SidMg 20 framing. • FaMmar Imads shcold ft o4 against siding Oo air sp". Olq.A) • Do not ow-Mve, trail neads of drive nalls X an angle- • 9 nail is CNfdffgft, (211 nail 11016, and add a nah. ft. S) • far wad ftaiffifg. wof men rites stmuld be hft flush inu pial* Wah a hammer of sw kalft remove am "am rmlo. NOIL ftewwar a Mutual membec is OrWWL flaram& 6-M& he trAW WD even spacing to u shii-dwo mmbef. !Tie tablet MWiV direct to OM OF.PIPWd Shauld OWy he used when Itask"'fim1hig Is nal availablie. Do not am Wominum, b0amrs, Maples, or clipped head rWI&- Hsufll�•m im 1pl�� L/'ADVANCEDInitialed by: Contractor A:�1. 1...owner BE 0 FO U& Nail SAUg flush DOWT DO NOT FPVTOA Figure B tinder drive n Matta Hsufll�•m im 1pl�� L/'ADVANCEDInitialed by: Contractor A:�1. 1...owner BE Job Number# 2014-063 Page 15 &ADVANCED 7RiM APPLICATION FOR 1VWNDOWS, DOORS WckeO 9i�fdad the 44alilf & Oi`HER OPMINGS reaJs�et anti over ooroe oeta�eenthe Trim tike opeiri9tg prier to the instablimat the sliding (kuru 16)_ the Flal Tau& e' ng add ft oastring. Bafrlee Florae a Flat lab at the end of eeachtrim boardrg d and one tab e 1 �' QC. Nt%tei".reea ive 114' 9$p Aftaeh the trim boar aid fllal;T21tis around fhe opening as stem In Figares 16 acid 17_ We 16 ga_ gahrenimd 2" long fiirdsh nafs to enswe � proper fastening it needed, Fkpre 16 Side trim pieces go to The lo-, of the window. Figure 17 HaaftieP piece spam the sviiWefAi aitlucfrdig ftte awe ffiffi t3orusim apiece is the Ytk M lir life window. NOTE Follw ymrr vdnduWdoor rnanuiwturers instaftlon irmftetions. BAND BOARDS, FRIEZE BOARDS, HAKE TRIM & FASCIA HardleTdmP PM hoards may also be used as band boards, frieze boards; rake trim off fascia (Figure 19)Aba 16 ga. galvanized 2' long finish nafs to ensure pfoper fastening if needed. Figure 19 Smorlit panel 2a sub I6seia 111MdieTr;tYP NT3V HafdieY6de NT3- board HaraleT&&Nr3TM Band Board FRIEZE BOARD yr board .f Of 1 Leave s irfi7imufm cies,. 1/E' their caulL d� w. stfaattr�fg ' Wffter-res Swe rad HardlePwo sktaag Terarrfiale fie Burd Ifmn HardieeTtirIP NT3n' Board Fasten 6ie2e board b rfarning tAi2ing tri ga" `Pled 2` long finish dais. Ensure proper fastening. t iardieTrin'f NdT3TM Baard Figure 20 U9' caaaced gap is left between Figure 19 sidirea and the side IrM piiems. FASCIA & RAKE Far iascia and rake applicadons, a fl2sh4 is required over top of the fawk (Figure 21). Figura 21 Rear stteatPirfg Fkure 22 Birdhouse LietatT Ensure thai all birdhouse tf M is adfflp&ly faswned to a surd mbshaie. 1�9of tism¢�g' Drip edge Ilasning HerdieTrirrrf ttr31° board (ensure adequate, famening} finiaNKM nam tCififn` tdT3'` k+:sfirl IWrnI ;rW%,isi. M TR1`110—PM 6113 Job Number# 2014-063 Page 16 ADVANCED - SEL1E6Ca.{y}E8 BBB, Hardie Trim X PVC Trim En.-giin a ered for climate A,.{:ajla tete with = n l❑ rP,Iu 4a:.1ecls-nolog Dime;n.iona.l staNlity ftld°%pint longer r , lnst•a lis wit(i finish ns -its or concealed f'acsten.ingtsystern :nsii2te=nt. fma.in;t&,na nc.e. eydes lnsta Its the --ame. retg a:rdle ,a f time of year or to mpe.=nature Proven du a l�ilil ®f cement #1 Bra idl of trim,, Builder Ua:g;azin a 2 OS— 200'R One prow ct fits ,all es on "Iff Ex a ns -ion -a ni: centre cfio.n varies friars ma nu 4ctu Per to ma:n u b ctw rer, h.,ow evae r ,must call fn:r.rninirnuM..'11 ." gaps O�t,ja•intS, in stall requ irements vary, hy temp}eratu:rle Requires, full headFedi nail Requires ; r ia:l �adh a iVesi fb:r' la.int treat m. ent . Req irea special paint Edges, and joints titwn, iends: to discolor over time; /1DY/`1NCD Initialed by: Contracto Homeowner CO Job Number# 2014-063 Page 17 . e 4 USSECe ADVANCEDBBg. � ceMmuixe a uxav,nox Gutter Svstem Installation: Gutter and Downspout Preparation: Remove and haul away existing gutters and downspouts from following areas: Install new seamlessgutters on house with proper slope for drainage; Roof Drainage: The roof is one of the most essential parts of a building as it protects occupants, contents, and the interior of the structure from the elements. The roof drainage system is equally important. Factors that must be considered in the design of roof drainage systems are the area to be drained, size of the gutters, downspouts, outlets, slope of the roof, type of building, and appearance. Roof Area to be considered: The design capacity for a roof drainage system depends on the quantity of water to be handled. The quantity of water in turn depends on the roof area, slope and rainfall intensity. Rainfall Intensity Rainfall intensity is given in inches per hour for a five minute duration based on U.S. Weather Bureau records. Gutter Installation: Install new gutters and downspouts to the following areas: Install new downspouts on to assist in proper drainage. Install 5" seamless Aluminum gutters to replace the existing gutters. Materials to be factory - finished on both the inside and outside. All inside and outside corners shall be factory -mitered and riveted for a more attractive appearance. ■ All seams will be riveted and sealed with aluminum gutter seal caulking. ■ Gutters to be attached with heavy-duty screw hangers placed at approximately 24" centers. Hangtite Gutter screw hangers provide greater holding power than any other hanging system and more importantly allow for expansion and contraction. ■ Gutters will be sloped for positive drainage. Downspout Installation j k �i'--•y '" I., Install;"x4j' Alumiinum downspouts as located,on the attached drawing,.,. _ ,. '. . •. w _ 2. All downspouts shall be installed using pre -finished aluminum bands, secured to the exterior wall. 3. All elbows for angles will be factory -formed for a more attractive appearance, and installed as necessary to accommodate water flow. 4. Because of the design of the soffit overhangs, molding work, etc., the kickbacks and elbows for angles will be field -formed and installed as necessary to accommodate water flow. 5. Workmanship Warranty on Complete Gutter Systems: 2 year on ioint leaks only from completion date. ADVANCED Initialed by: Contractor Homeowner (C rVA Job Number# 2014-063 _ Page 18 ADVANCED � Sn�stt�srta �'"" Leaf Relief Gutter Shield Installation: Leaf Relief Gsystem-. utter Shield over gutters Leaf Relief Gutter Shield is designed to keep gutter pollution out and have the drainage system working a peak level throughout the year. It will also in assisting ice off the roofing system and pesky birds from nesting inside the gutters. Leaf Relief Gutter Shield Installation: 1. Clean all gutters and downspouts of all leaves, pine needles, and debris. 2. Run water over the roofing system to ensure the gutter system is working properly. 3. Make any adjustments to the gutter for proper drainage and caulk any leaking seams. 4. Install Leaf Relief Gutter Shield system to the gutter using zinc -plated screws. i ADVANCEDInitialed by: Contractor�_Homeowner �� Job Number# 2014-063 Page 19 So�Y��eK{�eA ADVANCED BBs. 7111) GOOD James Hardie ColorPlus Siding, Trims and Roof Lines With Aluminum Wrap ■ Remove and dispose of the existing (01) layers of siding, and wood trims. ■ Cover the exposed base wood walls with J.H. House Wrap wind/moisture barrier and seam tape. ■ Cover the underlying fascia boards and rake boards with Mastic aluminum. ■ Install vinyl soffit panels with hidden vents. ■ Install J.H. 5.5" corners boards and 7.25" water table. ■ Install J.H. 4.5" windows/door, 2.5" frieze board and 7.25" water table. ■ Install James Hardie lap siding 5" exposure ColorPlus Technology. ■ Install new mounting blocks under the fixtures. ■ Install new seamless aluminum .032 gutters and downspouts at all roof overhangs. ■ Install Leaf Relief Gutter Shield over gutters system. $30,280.00 Accepted _---_ _ Initial BETTER James Hardie ColorPlus ■ Remove and dispose of the existing (0 1) layers of siding, wood trims, fascia and soffit. ■ Cover the exposed base wood walls with J.H. House Wrap wind/moisture barrier and seam tape. ■ Install J.H. 7.25" fascia, 5.5" corners boards and soffits (vented/no-vented). ■ Install J.H. 4.5" windows/door, 2.5" frieze board and 7.25" water table. ■ Install James Hardie lap siding 4" exposure ColorPlus Technology. ■ Install new mounting blocks under the fixtures. ■ Install new seamless aluminum .032 gutters and downspouts at all roof overhangs. ■ Install Leaf Relief Gutter Shield over gutters system. .{ BEST $340, 6Q,00 Accepted Initial James Hardie ColorPlus 7" Single Siding and Trims ■ Remove and dispose of the existing (1) layers of siding, wood trims, fascia and soffit. ■ Cover the exposed base wood walls with J.H. House Wrap wind/moisture barrier and seam tape. ■ Install J.H. 7.25" fascia, 5.5" corners boards and soffits (vented/no-vented). ■ Install J.H. 4.5" windows/door, 2.5" frieze board and 7.25" water table. ■ Install James Hardie shingles siding 7" exposure ColorPlus Technology. ■ Install new mounting blocks under the fixtures. ■ Install new seamless aluminum .032 gutters and downspouts at all roof overhangs. Install Leaf Relief Gutter Shield over gutters system. $45,420.00 Accepted Initial ADVANCED Initialed by: Contractor �Homeownera a. Job Number# 2014-063 Page 1 i,EpO' ARF gyEL�. � ya,eieai�r.: ADVANCED ' t What is not included on this propose: 1. PERMIT FEE (Advanced R. & R. will file all paper work for the permit and apply for it). 2. REMOVAL OF EXISTING ASBESTOS (licensed removal contractor). 3. INTERIOR PAINT WORK. 4. EXTERIOR PAINT WORK. OPTIONS (in addition to price below): These options are in addition/subtraction to/f om the total price. ❑ utters: New vinyl shutters are optional at $125.00 per pair installed. Front and back Doors Installation: New door installation at $160.00 per door (Door y by owners). Picture Window Installation.: New window installation (Window supply by owners). Please add $230.00 for this option. This Proposal is based upon current material and labor cost. This Proposal may be withdrawn if not accepted within Sixty (60) days. ACCEPTED AND AGREED: The prices, specifications and conditions contained herein this Agreement are satisfactory and hereby accepted. You are authorized to perform the work as specified. (MUST BE SIGNED BY ALL OWNERS) DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACESM Two identical cadies of the contract must be completed and signed. One copy should go to the homeowner. The other copy should be kept by the contractor. OWNE OWNER: &�Q DATE: (' 3 i AGREEMENT IS>90r FULLY EXECUTED UNTIL SIGNED BY A LICENSED BY ADVANCED REMODELING AND RENOVATIOK,dl Leonarmo ar eira asilva'A'dvan&d R. & R. ; jp? • , � 1 f s, l . � �` w 0 DATE �} f� ,a f YOU, HE1OWNER-MAY CANCEL THIS(.TRANSACTION AT ANY TIME, PRIOR�T;O MIDNIGHT,,:fOF THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION. SEE THE NOTICE OF CANCELLATION CLAUSE BELOW FOR AN EXPLANATION OF THIS RIGHT We at Advanced R. & R. would like to thank you in advance for this opportunity to review and prepare this proposal for your home. We are totally committed to providing "100% Customer Satisfaction" before, during and after your r project. We have taken pains to make sure this proposal is suited to meet your needs for now and in the future. Please call me at your convenience if you have any questions at all. We look forward to working with you. Yours truly, Leonardo Parreira Dasilva Advanced Remodeling and Renovation AD A VCED Initialed by: Contractor/10Homeowner 1 .Job Number# 2014-063 Page ��AD'SAFF. I�'.•". ma��mc. cF a E k0110 Contractor Arbitration The Home Improvement 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 right 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 afforded to the homeowner by the Home Improvement 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 firm which has been approved by the Secretary of the Executive Office of Consumer Affairs and Bu ' ess Regulation and the consumer shall be required to submit to such azbi ati provided In Massachusetts General Laws, chapt 2A. /)((ter%\ (.! Homeowner's Signature Contractor's Signature NOTICE: The signatures o 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 workmanship 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 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 parties 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 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 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 Bosion, MA 02116 617-973,-8787 888-283=3757 or visit il'e OCABR we6site,at http://www.mass.gov/ocabr/; yl s + a & If you want to verify the registration of a contractor or if you have questions or need_., additional information specifically. about the contractor registration componenfof the Home Improvement Contractor>Law; contact: s" Y r v• <t Director of Home Improvement Contractor Registration: Office of CoA'sumer Affairs and Business Regulation ' 10 Park Plaza, Room 5170, Boston, MA 02116 617-973-8787, 888-283-3757 or visit the HIC website at littp://www.mass.gov/ocabr/ Go online to view the status of a Home Improvement Contractor's Registration: http://db.state.ma.us/lionieimproveinent/iicenseelist.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 508-6524800, 508-755-2548 or 413-734-3114 Version 2.1 - 11/22/2010 ADVANCEDInitialed by: Contractor , Homeowner / ` .lob Number# 2014-063 Page 22 sew Pp : u uu 4 P SOLY61[N{gEB ADVANCED e J. H. SIDING COLOR: . Cedarmill - Smooth JAMES HARDIE TRIM COLOR: FASCIA COLOR: WINDOW TRIM COLOR: SOFFIT PANEL COLOR: GUTTER COLOR: DOWNSPOUT COLOR: GUTTERTOPPER COLOR: LOCATION OF TRASH CONTAINER: LOCATION OF MATERIALS: LOCATIONS OF ELECTRIC SERVICE: ADDITIONAL PHONE NUMBERS: (work) (cell) AUTHORIZED CONTACT WHILE AWAY: (name) SPECIAL CONCERNS OR REQUESTS: (items listed are not part of the proposal) Terms and Conditions: (phone) Agreement: This, Agreement is between Advanced R. & R — Mr. and.Mrs. McElhiney and/or their agents The Company agrees 3'., .,, j �,. _... k .. � "ter q e. t'}. to do the work house're side contained herein for the O"er. The Workshall not,inelude`i` itimony in.court—' any reason?% u g .. t �n L Time of Completion:{Contrai for shall commeuce,the work under this agreement on or before,Monday,, a O/' 2014 and the work shall be completed on or befo e Friday �� /q � , 20;14 s '� f ,2. Your Total Investment items ',q A.'il�i7 '' t). £° io 3. Payment:of,Fund and Deposit: Owner`hereby agrees to,.pay Company for the..Work in cash,equivalents, unless otherwise agreed upon in writing. Owner agrees to pay Company: a) $ �� 0%) at the time of the execution of this Agreement i/ /2014 b) $ %) due 3 weeks prior to start of work Z/ l,O /2014 c) $ A q 4 O • Olffb%) due upon completion of the left side / /05/2014 d) $ X Ot (9 • Cl00/6) due upon completion of the back /02 / 0/2014 e) $ -t- /6) due upon completion of the right side ZZ/ / 52014 f) $ Y . oo (10%) balance due upon either the Completion Date as defined herein or upon Sub antial Completion as defined herein. Substantial Completion shall mean if only certain minor items of Work are incomplete; the cost of those items may be withheld from the final payment at the Owner's option until such items are completed. No jobs will be scheduled or started without a deposit without management approval. All payments made pursuant to this Agreement shall only be made to Company. ADVANCED Initialed by: Contractor Homeowner vjv Job Number# 2014-063 .g- 23 79ME 4. Change Orders: Neither this Agreement nor any term hereof may be amended, waived, discharged or terminated, except by a writing signed by both the Contractor and Homeowner. 5. Late Payment / Service Charge: Any funds owed greater than 30 days beyond the Completion Date are subject to a service charge of one and one-half percent (1'/z °/a) per month on the unpaid balance. 6. Materials: Company shall provide necessary labor, materials, and sales tax on materials to complete the Work as specified. Company shall not be responsible for an exact match of any materials, including but not limited to, roofing, siding, metal work, and shingle shading. All materials shall remain the property and title of the Company until fully paid by Owner. All surplus materials shall remain the property of the Company unless, at Company's option, turned over to the Owner upon the completion of the Work. Company is not responsible for replacement of any lumber, sheathing, trim or rotted wood, or replacement parts in excess of the agreed amount unless specified in this Agreement. The Company may, in its own discretion, substitute materials to be used in the Work. If determined by Company, during the performance of the Work, that additional labor and materials are required beyond what is specified in this Agreement in order to complete the Work, the cost for the additional labor and materials will be borne by Owner. 7. Changes in Contract: The Owner hereby expressly authorizes any of his joint signatories, if there be any, or any of his agents, servants, employees, attorneys -in -fact, or personal representatives to execute and deliver to the Company any written additional change order (hereinafter the Change Order) and any other documents necessary to consummate this Agreement, which shall be binding and conclusive on said Owner. Owner hereby acknowledges that any Change Orders, requested b Oand approved by Company pursuant to this section of this Agreement, shall be paid as per the terms of the Company's Change Order policy. Any changes made to this Agreement as required by regulatory agencies will be at additional cost to the Owner, unless such changes or additions are cited in this Agreement. Furthermore, by signing below, Owner acknowledges that no change has been made to this Agreement by any salesperson or. other agent of Company on behalf of Owner. 8. Owner Responsibilities: Owner warrants to Company that he is the legal owner of the Property. Owner agrees to provide to Company at no charge, electric power and water for construction purposes. Owner acknowledges that the removal of permanently attached building materials often disturbs and vibrates the existing Property. The debris generated from this Work and related procedures may cause inconvenience or discomfort which is normal construction wear and tear conditions, and not Company negligence and may include, but is not limited to, interior wall cracks, flaking of wall paint, debris falling into an attic, disturbance to shrubbery and lawns, small divots in the driveway from equipment such as roll -off trash containers and dump truck. As a precaution, Owner shall remove from walls or ceilings, items such as, but not limited to, chandeliers, paintings, and plates. Owner shall lock away or secure other items of value in or on the Property. Owner.shall make himself available during construction for clarification. of specifications, approval of additional Work and to provide adequate access to the Property as may be required. 9. Cancellation of Agreement: Should Owner cancel this Agreement for any reason prior to the Rescission Date of this Agreement, Company shall return to Owner all payments made under this Agreement within ten (10) days of receipt of the Notice of Cancellation of this Agreement which is incorporated herein and made a part hereof. If the Agreement is breached thereafter without consent of the Company, liquidated damages of 20% of the cash price of the Work, plus a proportionate share of all Work already performed will be due the Company. To cancel this Agreement, mail or deliver a signed and dated copy of the Cancellation Notice or other written notice to the Company at its address noted on this Agreement no later than midnight of the third business day from the date of this Agreement. 10. Default: Owner shall be in default of this Agreement at any time if he does not tender payments as listed in section 2 & 6 of this Agreement. Upon Owner's default, the Company may immediately discontinue Work and the, entire balance shall be immediately due and payables Waiver,or indulgerce of any default shall'not operates a warverlof ariy`othr default on future occasions. �� _ _ 11. Attorneys Fees: In; the eveni that=legal proceedings are instituted=for the recovery of the unpaid Agreement price and any additional charges due, the er agrees to reimburse all actual c'os, expenses and attorneys' fees incurred bye 12. Company Warranty: In order for any warranty to'be effective against Company or any other party, Owner must: (1) have paid all sums owed to Company under this Agreement and any applicable Change Orders: (2) provide by immediate (or 10 days) written notice, by certified mail, to Company upon discovering any defect or failure of the Work performed and: (3) not allowed any third party to, in any way, alter or repair any of the Work performed by Company. Company shall provide Owner with a (5 years) warranty against defects in workmanship for a period contained herein from the Completion Date. Material warranty shall be limited to manufacturer's warranty of materials. Company does not warrant the material or labor of items such as, but not limited to; caulking materials, sealant, reflective coatings, painted surfaces, metal materials, or the possible failure of these items. Company's warranty is only effective if properly cleaned and maintained at least twice a year. Normal maintenance and care of Work installed is the Owner's responsibility. If damage occurs to roof or interior of house, which is a result of clogged gutters, then any warranty stated herein is void. Company's warranties as stated in this section of this Agreement shall be null and void for any water ponding beyond forty-eight (48) hours, except as set forth in this Agreement. ADVANCEDInitialed by: Contractor ` Homeowner_LM Job Number# 2014-063 ..- 24 GAD' -SAF feZ: � � ��"�,..� riv, ADVANCED �'TIFIED.�- 13. Company Not Liable: Owner acknowledges that at no time shall Company's liability exceed the total amount charged for the Work performed under this Agreement. Company shall not be liable for any defects which are characteristic to the particular materials such as cracks, splits, and shrinkage or warping of wood or lumber etc. Due to the nature of the Work, damages to the property sometimes occur. Therefore, the Company is not responsible for nail pops, cracks to wails or ceilings of existing structures. Company assumes no liability for damages, including but not limited, to existing landscaping, trees or shrubs. Company is not liable for common occurrence weather related problems such as ice dam, gutter back up or Acts of God. Company is not liable for any ponding of water or improper drainage due to incorrect sloping of existing roof structure or roof structure problems that could cause sagging or unevenness in existing roof deck. Owner acknowledges that the Company is only responsible for damages to the property and the contents therein under Company's liability insurance, if Company, or its employees or servants are held or found to be negligent and, if Owner notified Company within forty-eight (48) hours of the occurrence. 14. Insurance: Owner agrees to carry homeowner's insurance covering fire, theft, storm, and damage to the property including, but not limited to, landscaping, trees, shrubs, driveways and walkways in sufficient amounts to cover the Work and materials under construction by the Company and agrees to compensate the Company for losses sustained by these conditions. Company shall, in amounts and with carriers subject to Company's sole discretion, provide workers' compensation, public liability and property damage for the Work, unless a general contractor, sub -contractor, or Owner, in whole or in part, supplies such insurance. The Company's maximum liability is limited to the coverage provided. 15. Outside Financing: If the Work is financed through an outside lending agency, the Owner agrees to execute and deliver necessary finance papers, mortgage, or other forms required by the lending agency in advance of commencement of the Work. Upon notice of Substantial Completion of the Work, the Owner will execute a certificate of completion, if required. 16. Binding Contract: This Agreement, until approved by Company, is subject to change or revocation by Company, without notice. Upon approval by Company, this Agreement shall constitute a binding agreement between the Company and the Owner. In the event such approval is not granted within thirty (30) days of the date of this Agreement, the deposit paid by the Owner will be refunded without interest and this Agreement shall be deemed not approved and neither the Company nor the Owner shall be liable to each other for costs or damages. Notwithstanding anything contained herein to the contrary, Company reserves the right to reject or cancel all or part of this Agreement due to unacceptable payment performance or credit rating of the Owner. Any change approved by Company shall be communicated to Owner and be subject to acceptance within ten (10) days. If such change is not accepted in writing by Owner within such time, the deposit shall be refunded without interest to Owner in full termination of this Agreement. 17. Service Calls: Service calls requested by the Owner shall be included in the written workmanship warranty only if the call for service is a warranted service call. On service calls where it is deemed by the Company to be a non -warranted item, the Owner will be charged for the service call or work performed at Company's established rates. 18. Entire Agreement: This Agreement constitutes the entire agreement between the Parties. Company is not liable for nor bound in any manner by any statements; representations, warranties, collateral or otherwise, or promises made by any person representing or proposing to represent Company unless such statements, representations, or promises are set forth in this Agreement. Any modification of this Agreement must be in writing and signed by the both parties. 19. Severability: If any provisions, paragraphs or sub -paragraphs of this Agreement are adjudged by any court to be void or unenforceable in whole or in part, this adjudication shall not affect the validity of the remainder of this Agreement. Each provision of this Agreement is severable from every other provision, and constitutes a separate and distinct covenant.i '" r i, _ _.., it,,,. a ,.i • .;�.. -w 1 �: 20. No Waiver: The Company may accept late payments or partial'payment checks, bank drafts or money orders marked "Paid in Full" wrthotifivaiving any of its rights related to this`Agreement� 1 •21. Gender: Wherever,- this Agreement reference is made tofthe masculine gender, it shall be construed to include the feminine gender andivice versa unless the context clean indicates otherwise. If 22. Copy of Contract: By signing below, Owner acknowledges receipt of a copy of this Agreement which has been signed by the Company. f)l q l `�'s� r) ADV/p "ANCED Initialed by: Contractor Homeowner . .. Job Number# 2014-063 Page 25 , is .,,mow R M9 dirt. ADVANCED cFR71.lE0 iF 4 CZE :3E3di: NOTICE OF CANCELLATION YOU MAY CANCEL THIS TRANSACTION, WITHOUT PENALTY OR OBLIGATION, WITHIN THREE BUSINESS DAYS FROM THE ABOVE DATE. IF YOU CANCEL, ANY PROPERTY TRADED IN, ANY PAYMENTS MADE BY YOU UNDER THE CONTRACT OR SALE, AND ANY NEGOTIABLE INSTRUMENTS EXECUTED BY YOU WILL BE RETURNED WITHIN TEN BUSINESS DAYS FOLLOWING RECEIPT BY THE SELLER OF YOU CANCELLATION NOTICE, AND ANY SECURITY INTEREST ARISING OUT OF THE TRANSACTION WILL BE CANCELLED. IF YOU CANCEL, YOU MUST MAKE AVAILABLE TO THE SELLER AT YOUR RESIDENCE, IN SUBSTANTIALLY AS GOOD CONDITION AS WHEN RECEIVED, ANY GOODS DELIVERED TO YOU UNDER THIS CONTRACT OR SALE; OR YOU MAY, IF YOU WISH, COMPLY WITH THE INSTRUCTIONS OF THE SELLER REGARDING THE RETURN SHIPMENT OF THE GOODS AT THE SELLER'S EXPENSE AND RISK. IF YOU DO MAKE THE GOODS AVAILABLE TO THE SELLER AND THE SELLER DOES NOT PICK THEM UP WITHIN TWENTY DAYS OF THE DATE OF CANCELLATION, YOU MAY RETAIN OR DESPOSE OF THE GOODS WITHOUT ANY FURTHER OBLIGATION. IF YOU FAIL TO MAKE THE GOODS AVAILABLE TO THE SELLER, OR IF YOU AGREE TO RETURN THE GOODS TO THE SELLER AND FAIL TO DO SO, THEN YOU REMAIN LIABLE FOR PERFORMANCE OF ALL OBLIGATIONS UNDER THE CONTRACT. TO CANCEL THIS TRANSACTION, MAIL, OR DELIVER A SIGNED AND DATED COPY OF THIS CANCELLATION NOTICE OR ANY OTHER WRITTEN NOTICE, OR SEND A TELEGRAM -TO ADVANCED REMODELING AND RENOVATION, AT "488 -BOSTON POST ROAD ?SUITE D1 GH, MASSACHUSSETTS 01752 NOT; LATER THAN MIDNIGHT OFA, ys Date: I HEREBY CANCEL THIS TRANSACTION. Buyer's Signature: ADVANCED Initialed by: Contracto • Homeowner_i � The Commonwealth of Massachusetts Department of IndustrialAccidints Office of Investigations 600 Washington Street Boston, MA. 02111 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): tP(/1,q1vci c) klemoleellw& Gi�1 fC Fl3e 0 Address: --K City/State/Zip: lNwodS4/® 11W4 0« hone #: e 7 Are you ployer? Check the appropriate box: 1.am a employer with c_ -Z,4. F1 am a general contractor and I employees (full and/or part-time).* have hired the sub -contractors 2. ❑ I am a sole proprietor or partner- listed on the attached sheet. ship and'have no employees These sub -contractors have working for me in any capacity. workers' comp. insurance. [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 3. ❑ I am a homeowner doing all work right of exemption per MGL myself. [No workers' comp. C. 152, § 1(4), and we have no insurance required.] employees. [No workers' comp. insurance required.] Type of project (required): 6. 0 New co straction F 7. emodeling 8. 0 Demolition 9. 0 Building addition 10.0 Electrical repairs or additions 11.0 Plumbing. repairs or additions 12.0 Roof repairs 13. ❑ Other 'Any applicant that checks box#1 must also fill out the section below showing their workers' compensation policy information. i -Homeowners who submit this affidavit indicating they ft're 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 and their workers' comp. policy information. X 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. Lie. #: —,4/00' 70,;RD5 Expiration Date: �� f Job Site Address: 575- s2 �� City/State/Zip: 414izalee ev 0%,4,./sz j S Attach a copy of the workers' compensationpolicy declaration page (showing the policy number and expiration date). Failure to secure coverage as requiredunder 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 the DIA for insurance coverage verification. I do hereby certify under the.41 vSrpW and penalties of perjury tliat the information provided above true any correct. 0 Phone #: Official use only. Do not write in this area, to he 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. EIectrical Inspector 5. PIumbing Inspector 6. Other - - - Contact Phone #: 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 ofhire,- 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 employes." 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 producedacceptable 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 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 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 Ma ssa.,chusetts Department of WuMal.Accidents Office ofInvestigation', 6.00 Wasbiugtou. Street Boston MA. 021.1.1, TO. # 617-7-27_4900 oxt 406 ox 1-8,77-M. Revised 5-26-05 Fax # 617-727-7749 www.mass,g ... . Ja Oceof L+ PR NT � ` ALatrs m »a�rroar OME IM 0VE AiT CAc� ejistra#ioh RAOTpR �. 770814 - ,, xpiradon: X2015 AD;..DBA VgNr ED REMODECJN . ELEVZA bgSlLVA D 488 BOSTON RD SUI MARLBORO, MA 01752'"P ` =' r Under- - � secretary ' Massachusetts Department of Public Safety , Board of $ui cling Regulation- and'Standards Camtruction Supen•isor Lcen;e: CS -084348 f LEONARDO P DAk'n 0 "% fx 33 Nadine Road..'' Framingham MA%0170 Expiration. " -C ommissioner 02/14/2015