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HomeMy WebLinkAboutBuilding Permit #641 - 637 JOHNSON STREET 5/11/2009BUILDING PERMIT TOWN OF NORTH ANDOVER /, APPLICATION FOR PLAN EXAMINATION Permit NO:, Date Received ,S--// e,�, Date Issued: IMPORTANT: Applicant must complete all items on this DaSe LOCATION f , % h n so 57�- • A ''45� Print PROPERTY OWNER IDA U Print MAP NO:_PARCEL: Z -K ZONING DISTRICT: Historic District !Machine Shop yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition Two or more family Industrial Alteration No. of units: % Commercial Repair, replacement Assessory Bldg Others: Demolition Other Septic Well: Floodplain Wetlands Watershed District Water/Sewer DESCRIPTION OF WORK TO BE PREFORMED: ,Ja,, _ ave' �, •- r , Identification Please Type or Print Clearly) _ OWNER: Name: Avid . g!,.,417-1-/1 En • Phone:/ - 97k - d 7,S-'74XP? Address: 6&-7. hrsotJ S7- /J�>z /jr�l�=4it%�� CONTRACTOR Name: /)fJ/) `J1STrz� i Phone Address: X90 A Supervisor's Construction License:�a v Exp. Date: `'.x/03 0 ARCHITECT/ENGINEER Phone: Address: Reg. No FEE SCHEDULE: BULDING PERMIT: $1200 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S. F. Total Project Cost: $ Jr47�aG° cti ' FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner Signature of contracto 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 •uu CONSERVATION COMMENTS Y HEALTFF COMMENTS DATE REJECTED DATE APPROVED Reviewed on Signature Reviewed on Signature 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: Sign Located 364 Usg000 Street � FIRE DEPARTMENT - Temp Dumpster on site yes no 1W,0 av-2 rz,-4 IA Located at 124 Main Street — 771-` r 61 � Fire Department signature/date / COMMENTS Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA — (For department use ❑ Notified for pickup - Date Doc.Building Permit Revised 2008 M Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofin , Siding, Interior Rehabilitation Permits Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc: INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2008 Location T66UO)i S+ - No. 6Z!5� Date 1,3 I 40ItT#j TOWN OF NORTH ANDOVER Certificate of Occupancy $ CHU Building/Frame Permit Fee $ Foundation Permit Fee s Other Permit Fee $ TOTAL $ Check # 22bL Ok--Q- Building Insp—ec �Tr— THOMAS WOODS INS AGENCY 20 PARK AVENUE PO BOX 2940 WORCESTER, MA 01613 75G5K INSURED CTBA SIDING & ROOFING LLC: 290 KELLY ROAD NORTHBRIDGE, MA 01534 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE COMPANY A CONTINENTAL CASUALTY COMPANY COMPANY B COMPANY C COMPANY D COVERAGE CANCELLATION TOWN OF SHREWSBURY SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE THIS M TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAWS. AUTHORIZED REPRESENTATIVE CO POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER DATE (MM1001YY) DATE LIMITS GENERAL LIABILITY GENERAL AGGREGATE $ COMMERCIAL GENERAL PRODUCTS-COMP/OP AGG. $ CLAIMS MADE OCCUR. PERSONAL && ADV. INJURY $ OWNER'S && CONTRACTOR'S PROT. EACH OCCURRENCE $ FIRE DAMAGE (Anyone fire) $ MED. EXPENSE (Any one person) $ AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT $ ALL OWNED AUTOS BODILY INJURY (Per Person) $ SCHEDULE AUTOS BODILY INJURY (Per Accident) $ HIRED AUTOS PROPERTY DAMAGE $ NON -OWNED AUTOS GARAGE LIABILITY ANY AUTOS AUTO ONLY - EA ACCIDENT $ OTHER THAN AUTO ONLY: EACH ACCIDENT $ AGREGATE $ EXCESS LIABILITY UMBRELLA FORM EACH OCCURRENCE $ OTHER THAN UMBRELLA FORM AGGREGATE $ WORKER'S COMPENSATION AND A EMPOLYER'S LIABILITY UB -0245N251 -O9 03-13-09 03-13-10 STATUTORY LIMITS X THE PROPRIETOR/ EACH ACCIDENT $ 500,000 PARTNERS/EXECUTIVE X INCL DISEASE - POLICY LIMIT $ 500,000 OFFICERS ARE: EXCL DISEASE - EACH EMPLOYEE $ 500,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLES/RESTRICTIONS/SPECIAL ITEMS THIS REPLACES ANY PRIOR CERTIFICATE fSSUED TO THL• CERT[TqCATF, HOLDER ART-CnNG WORKERS COMP COVERAGE. CERTIFICATE HOLDER CANCELLATION TOWN OF SHREWSBURY SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT 100 MAPLE AVE FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. SHREWSBURY, MA 01545 AUTHORIZED REPRESENTATIVE ACORD 25-5 (3/93) Dennis Chookaszis i 7 oft i iiisL'rr 1.8t1 � The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 *ashington Street Boston, MA 02111 j www mass gov/dia . Workers' Compensation Lnsitranee Affidavit: Builders/Contractors/Electricians/PInmbers NaIIle (Business/Orguization/Individual): Address: City/state/Zip. Phone 7 7 - ole 7 V Are you an employer? Check.the appropriate box• �.,��� 1. ❑ I am a employer 4, -- Type of project (requires: with employees full and/or part-time).* ( part- ' ) l�"I am a general contractor and I have hired the sub -contractors 6. ❑ New construction 2. ❑ I am a:sole proprietor or partner- listed on the attached sheet. i ?• ❑ Remodeling ship and have no employees These sub -contractors have 8. ❑ Demolition working for me .in any capacity, [No workers' comp. insurance workers' comp. insurance. 5. El We are a corporation and its 9. E] Building addition required.) 3. ❑ 1 am a homeowner doing officers have exercised their 10. Electrical ❑ repairs or additions ' all work myself. [No workers' comp. right of exemption per MGL c. 152, § 1(4), and we have no 1117 Plum airs or additions insurance required.] t .employees. [No workers' 12.[j2<of repairs I3.❑.0ther camp. insurance required.] — .•., msv nu our me section below showing their workem' compensation policy information t Homeowner¢ who submit this afffdavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. 4coatmetors that check this box most attached an additional sheet showing. the name of the sub -contractors and their workers' comp. po!icy infomradon I ant an employer that is. provi4ng:workers I compensation insurance for ►rry a ployee s MeV0&7 information Below iP &7 aed job site . Insurance Company Name:_ f' Policy # or Self -ins. Lie. #: V 0 —e) ,Q y/�Q/a.g' / _v � Expiration Date: v3- Job Site Address: Z,3 / .% o A I-) _sexj City/State/Zip: ' Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration dat 4 Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against. the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA fqj insurance coverage verification. I do hereby pains and penalties of perjury that the infnr»wtion provided above is tree and eorred Officfal use only. Do not write is 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 S. Plumbing Inspector 6. Other �� Confiact 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 "...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as "an individual, partnership, association, corporation or other legal entity, or any two or more of the'foreping engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver ortrustee 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 er 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 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 Acciderrts 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, rtot'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 numberlisted below. Self-insured companies should enter their self-insurance license number on tiie'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/Jicense 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 rs on file for fu we permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.) said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Departrnent of industrial Accidents Office of Investigations 600 Washington Street Basfon, MA 02111 TeL # 617-727-4900 6 t 406 or 1-8.77-MASSAFE Fax # 617-727-7749 Revised 5 -26 -US www.mass.gov/dia M M M M M YI M c A, .0 C � CD � d 'O O MZ y a.O nm r c MW O CL. = y 0 CD CD o cr CD CD O CD cm cm a s CD y CD CZ O CA CD am C) CO) O 'o Z CD O CD O C CD cn c J n O WOO 0 cn C c ='a O m 2 Q �• dl OQ H d O � O � y 7 m 0 O C) C2 9 2 d � 23. 177 Z ?� VA -4 -1 �o•..a m O y O y N 0Sm m 2 > > -0 C -� m p3 0 oZy � m aye: a om CLJ2 0 om..: m O m y co 0 CD C CL m .Ort• N ���, • O. d : Q N c CL N CD � mm -•► m y H H O m .dirt H CD FW 0 C, A n ® o :+ G H0IL Al •o o . CD ,� _= m O CD,: CD h ....: o m : � o n � •s o: CAo: c o moo: o z O y 0 9 /# * O 14 po ti OQF 6� D o 1►;. A Z c O m � 7o Z GO 110 M � n m n O rt 14 po w OQF G) y c Z GO z 7o Z GO 110 M � n m n r c :7- x "-a • O -O CTBA Siding & Roofing 508-266-2074 Northbridge, MA PROPOSAL AND CONTRACT CTBA Siding & Roofing 290 Kelly Road Northbridge, MA 01534 MA Lic. 121428 P SER'S NAME. H E PH NE OFFICE NUMBER ADD C �^ TATE 1 ZIP NEAREST CROSS STREET INSTALLATION ADDRESS, IF DIFFEREN I CITY STATE ZIP SALESPERSON TO CHECK ITEMS TO BE , REPARATION A METAL IA ❑CLEAN-UP BID AND SPECIFY ON PROPOSAL .4AR-OFF JGRPNTRY ❑ VENTILATION ❑ GUTTER WORK INSPECTION R L TH OL OWI G _PROBLEM AREAS:` 1 NAIL OVER EXIS7PNG-8ES"(G000v , e Shingles 0 Decking h' FA ing ❑ Shakes, Tiles, Metal Apply over xisting sH' les. ! materials will conform to udIA—e ❑ Vent Pipe Flashirk; ' ❑ Ventilation ❑ Guttering` ALL: t ❑ Valley Flashing ElO erhang n ` ❑ xposed Ceiling , Wind/Water/Ice Underlayment Ln.Ft. ❑ Other w o ol-jbi FL�,SHING: Install or Rework:. ElDormer/Wall Flashing CTBA agrees to arrange. installation of the following pe of fl C` himney Flashing ❑ Step Flashing ❑Vet Flashing ❑ Other Flashing " r ofi g material with limited material warranty by, the nufacturer. s VEIILATION TO BE INSTALL, Q • e �' i Ridge Ventsr4' ❑ Static Vents ❑ Eave Vents at Alte me Years r: ,�41!❑Turbine Veris ❑Power Vents ❑Gable End Vents warranty for details) lF Note: No warranty,is given for leaks caused by backup of nails. STACK COVERS: Replace :# Size: Note: Blends show less variation in shade due to light reflection than DRIP EDGE TO BE INSTALL EQ: solid colors. black normally has some shade variation. Install _ L. F. To be installed on a story house. Rise Per 12" GUTTERING (Color- and Description): ❑ Attached G°arEige ❑ Free -S riding Garage ❑ Low -Slope OVERHANG AND TRIM (Color and Description - Reasonably Match Other: J� ° existing): Z Zhingles OF EXISTING ROOF: CLEAN-UP AND. REMOVAL: Job site will have a neat, clean appearance after the lob is completed ❑Gable ❑Hip ❑Mansard 0 Shakes - ,�.,'" 13 tile ❑Low -Slope 13 Slate ❑ Other ; n 1 Note ' IC 64tis Qtresp9n �b/eforanyasonry; wood 'I Note: ,eT akes o responsibility for iden ' icatioli norfr�mZya1 n�r-�r���or other --ma � fs, nor any:iter s above' roof line. Any hidd�n 11( distuFb c f xi tin a vii np� nal r ems or s. If it is conditions whi h re uire additional worir dr any. requested b 9 rl' PP 4 Y 4 y termd t an of themenl Dr-jobsit s are an environmental purchaser will be bills a rte d purchaser agrees to pay for azard, he purchaser must arrange (at purchaser's sole additional the work as an extra. Initials. 1 t _ ei pense) for,removal haul -away, dumping; and repla _ t o mate- - �- �: �4ddrtional_Layers:_It rspossi_ during the course of.installatio_n that ..- -- ;f rtals'accordmg to'exlstmg focal, state and Federal law. = r Inh tials. additional layers of material could ba found. If additional layers are.. 13 Valley type -Existing New n. Ft. found ,,% r s to pay $ per square per layer as MAIN ROOF has _� layers off �: tP >�. an extra. . Initials.l,�, . ADJACENT ROOF has I y rs of' 13- REMOVE existing roofing to the, deck, cover with a Installation Dates: The current estimated start date should be within new felt and then r ro$$fing materials. the next weeks. Subsequently, based on the estimated DECK: Plywood Mckness T & G x work in this contract. -the current estimated completion date should Other: f be within days of the actual start date. ROTTEN OR DETERIORATED DECKING: CTBA will, install.approved Note: These estimates are subject to the DELAYS IN INSTALLATION sheathing where needed. No charge or estimate has been made for condition on the reverse. replacing such rotten or deter' rated wood. If such conditions are found, purchaser H d separately and agrees to pay for the � J l� rt � c OA • work as an extra. Initials. /"j u"°' t� S S cial Instructions: t 4 %14 C K If there is an unseen j k/, ere will be an addition, char a 7.00per linier_ft. for pre , t` I ft. for ledaer hnard >6 p Yv„l viurrrney neeas re(eaded` ha$550aft ` ==_r- o fr J Zit a �5 bf CASH PRICE: $ K0Q, A oa"' ! C% C METHOD OF PAYMENT: (The credit terms and conditions are provided on a separate document.) Price valid for thirty (30) days. ❑ Cash: payments as follows: $ down, middle, balance due on completion. If'payment by check: BANK REFERENCE: C TACT NAME: PHONE #. �3A f 4.0 C�1� � Z ci . Customer will be responsible for permit fees3,CTBA inital ., If customer choses Wells Fargo custome power of attorney authorization to process with 17 SUBMITTED BY signature when completion is signed. inital - APPROVED BY REPRESENTATIVE MANAGER I/We, the owner(s) of the premises described above (hereinafter referred to as "Purchaser(s)") offer to contract with CTBA to furnish, deliver and arrange for installation of all materials necessary according to the above specifications. THE TERMS AND CONDITIONS OF THIS AGREEMENT ARE CONTAINED ON BOTH SIDES OF THIS FORM. Do not sign this contract if there are any blank spaces. PURCHASER'S SIGNATURE: SPOUSE'S SIGNATURE: DATE: YOU, THE BUYER, MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY AFTER THE DATE OF THE TRANSACTION. SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS' RIGHT. Note: The following construction related permits are necessary before the contracted work begins: It is the Home Improvement Contractor's obligation to obtain such permits as the owner's agent. Owners who secure their own permits or deal with unregistered contractors: will be excluded from the guaranty fund provisions of M.G.L. c. 142A. . TERMS AND CONDITIONS OF THIS PROPOSAL AND CONTRACT DELAYS IN INSTALLATION. Purchaser agrees that CTBA is not responsible for delays in delivery or installation due to weather, fire, strikes, shortages, war, government regulations or any causes beyond its control. ORAL AGREEMENTS AND CHANGES IN PROPOSAL Purchaser understands there are no oral agreements. Everything purchaser expects CTBA to do has been included in writing in this proposal. Nothing can be changed in this proposal unless it is in writing on a separate form accepted by purchaser and CTBA. PAYMENT. Purchaser agrees to pay CTBA the cash price (plus specific interest charges if sales is a credit sale thatspecifies interest charges) that covers the price of materials and installation as shown on the reverse side, including any change orders or extras caused by hidden conditions or requests of the purchaser. Purchaser agrees to pay CTBA the reasonable costs of enforcement or collection in the event it is necessary for CTBA or the installer to retain an attorney to initiate legal proceedings. Purchaser agrees to pay reasonable attorney's fees and costs incurred, whether or not court proceedings are instigated, in addition to other sums. ARBITRATION. The Contractor and the Homeowner hereby mutually agree in advance that in the event the Contractor ha a dispute concerning this contract, the Contractor may sub the dispute to on firm which has been approved by the Secretary of the ecubve Office of Consumer Affairs and Business Regulatio mer shall,be require o submit to such arbitration as provided in Massachuse General , chapter 142A. Homeowner Signature: J ✓y ' Contractor Signature: NOTICE: The signature of the parties above apply to the agreement of the parties to alternative dispute resolution initithe Contractor. The Homeowner may initiate alternative dispute resolution even where this section is not separately signed by both parties. The laws o the State of Massachusetts shall govern any controversy concerning the interpretation of or obligations under this Proposal & Contract. EXCLUSIVE REMEDY. Purchaser agrees that THE LIMITED WARRANTIES PROVIDED BY THE SHINGLE MANUFACTURER AND THE INSTALLER SHALL BE THE PUR- CHASER'S EXCLUSIVE AND SOLE REMEDY WITH RESPECT TO THE SERVICES, SALE, MATERIALS, ROOF, JOB, INSTALLATION OR THE WORK PERFORMED IN CONNECTION WITH THE ROOF. CONTRACT FOR SERVICES. Purchaser agrees that this is a contract for the performance of services and all payments made pursuant to this contract are for servic- es rendered. Purchaser agrees that this contract is not a contract for the sale of goods. In any event THERE ARE NOT WARRANTIES WHICH EXTEND BEYOND THE DESCRIPTION IN THE LIMITED WARRANTIES PROVIDED BY THE SHINGLE MANUFACTURER AND THE INSTALLER (rHE LIMITED WARRANTIES). THE LIMITED WARRANTIES SUPERSEDE AND ARE PROVIDED IN LIEU OF ALL OTHER WARRANTIES OR GUARANTEES WHETHER EXPRESSED OR IMPLIED, INCLUDING, WITHOUT LIMITATION, WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE. CTBA and the installer's agents have no authority to give warranties or guarantees beyond these provided herein. 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 prop- erly registered as prescribed by law. Homeowners who secure their own building permits are automatically excluded from any 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 pro- vided by the Contractor, all goods sold in Massachusetts cant' so implied warranty of merchantability and fitness for a particular purpose. An enumeration of the mat- ters on which the Homeowner and Contractor lawfully agree may be added to the terms of the contract as long as they do not restrict Homeowner's basic consumer's 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, not applicable or n/a. One original signed copy of the contract with attachments is to be given to the Owner and the others 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. 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 Consumer Guide to Home Improvement Contractor Law", contact: Consumer Information Hotline — Executive Office of Consumer Affairs, One Ashburton Place, Room 1411, Boston, MA 02108 — or call — (617) 727-7780. All home improvement contractors must be registered in Massachusetts. If you want to verify the registration of a contractor orf you have additional questions or need additional information 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 — or call — (617) 727-8598 or (617) 727-3200. IN-HOME SALE OR SERVICE NOTICE OF CANCELLATION YOU MAY CANCEL THIS TRANSACTION, WITHOUT ANY PENALTY OR OBLIGATION, WITHIN THREE (3) BUSINESS DAYS FROM THE DATE ON THE REVERSE SIDE. IF YOU CANCEL, ANY PROPERTY TRADED IN, ANY' PAYMENTS MADE BY YOU UNDER' THE CONTRACT OR SALE, AND ANY NEGOTIABLE INSTRUMENT EXECUTED BY YOU WILL BE. RETURNED WITHIN 10 BUSINESS DAYS FOLLOWING RECEIPT BY THE SELLER OF YOUR CANCELLATION NOTICE, AND ANY SECURITY INTEREStARISING OUT OF THE TRANSACTION WILL BE CANCELLED. IF YOU CANCEL, YOU MUST MARE 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 OF THE 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 20 DAYS OF THE DATE OF YOUR NOTICE OF CANCELLATION, YOU MAY RETAIN OR DISPOSE 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. ACKNOWLEDGEMENT OF RECEIPT OF NOTICE OF CANCELLATION: YOU HEREBY ACKNOWLEDGE RECEIPT OF THE COMPLETED NOTICE OF CANCELLATION SET OUT ABOVE AND THAT THE SELLER HAS ORALLY INFORMED YOU OF YOUR RIGHT TO CANCEL. Date: Homeowner Signature: 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 CTBA AT THE ADDRESS ON THE REVERSE SIDE. NOT LATER THAN MIDNIGHT OF 20 I HEREBY CANCEL THIS TRANSACTION DATE PURCHASER'S SIGNATURE /AAA'AA •s.i rw M r"1 Lo- Sof M co .rr 4 O CDti.Jl � f C:) 0 rw M r"1 Lo- Sof .rr O rnr.•. W � f 70 r. � i id D �. I� C 6 i:� O Q C> to r- m in Q O QCD co Uuj- C'3 0 0 cn�,co Qw-eF=--- a mDrnO C-) C,,, z r— G � J � o � y = c C C 6 i:� O Q C> to r- m in Q O QCD co Uuj- C'3 0 0 cn�,co Qw-eF=--- a mDrnO C-) C,,, z 05/30/2008 09:46 5087556412 THOMAS WOODS INSURAN PAGE 01/02 ACORD. CERTIFICATE OF LIABILITY INSURANCE OP ID Bc OATC� PRODUCER CTHAIR 1 05/30/08 THIS CERTIFICATE I9 ISSUED AS A MATTER OF NIFORAFATION DATE MM1DQ ONLY AND CONFERS NO RIGHTS UPON THE CERTWICATE Thomas J Woods Insurance Agcy HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. Box 2940 ALTER THE COVERAGE AFFORDED BY THE Pol. ICIES BELOW. Norceater MA 01613 A Phone:508-755-5944 Fax:508-791-9841 INSURERS AFFORDING COVERAGE NAIC0 04BIIRED IMOURERA woetom world 2neu"aoe Co. INBuRERB• Commerce Insurance Co an1 34754 CTRA Slldlsn i Roofing LLC INSURERC Scottsdale Insurance Co. Nortl biixgeeMM RR 01534-1137 1 '. INs�uRER D INSURER E: •c THE POLICIE3 OF INSVRANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDRION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCAND HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIEC. AGOtICOATC LIMITS OHOWN MAY MAVC BEEN REDUGEU OT WAN Cl/4M3 LTR TYPE OF 04SUPAIRCE I POLICY NUMBER DATE MM1DQ GATE I LI1476 GENERAL UAMITY EACH OCCVRrtGNO[ 31000000 A X .X COMMERCIAL GENERAL LIABILITY CLAIMS MADE 7X OCCUR; NPPIII1819 06/07/07 06/07/08 PREMISEStEeoenrretlC&$50000 MED EXP (Arty err penes) E 50Q0 RENEWAL 06/07/08 � 06/07/09 PERSONALSADVINJURY 31000000 GENERAL AGGREGATE 22000000 WXL AGGREGATE LIMIT APPLIES PER POLICY F I , ECT LOC PRODUOTA .1`HWntP AGG 91000000 X AUTOMOBILE LIABILITY ANYAVTo LM1412 06/27/07 06/27/08 ' COMBINED SINGLE LIMB f 1000000 "iCein1 ALL OWNED AUTOS SCHEOVLED AUTOS LZ1412 06/27/07 I I 06/27/08 BODr<YINJURY (Pa person) f H i X X HIRED AUTOS NON4WNED AUTOS BOORr INJURY (Per A -Mf" f PROPERTY DAMAGE � i (Per eanneMl GARAGE LIABILITY j AUTO ONLY - EA ACCIDENT S ANY AVTO I I OTHER THAN EA'LCIC i AUTO ONLY: AGG f C I X EXCESSAIMMELLALIABILITY rX- OCCUR J CLAIMSwoE I XLS0044184 09/04/07 06/07/09 EACHOCCut:weNCE t 1000000 1 AGGREGATE 91000000 s I pEOVCTIBLE � f X I RETENTION i 2500 f WOMMOSCOMPENSATIONAND AN PROP I TOWPA6ADILY ANY PROPRIE70RIPARTNERIEXECUTNE SEE NOTE BELOW I �TeovLeuTp Ew E.L. EACH ACCIDENT 3 OFFICENMEMER EXGLUDI y yet eeWae unser aCv�w pRt,VIslol.s CCWCPA49 APntEll TO Heti, I! El DISEASE - EA EMPLOYEE $ t ular.AeE - POLICY LIMIT t OTHER OES=pTION OF OF£RABONG I LOCATIONS 1 VEHICLES I EXCLUSiOMS ADDED BY ENODRSiw T I SPECIAL PROVIWONS MORKERS COWMSATION COVERAGE INFORMATION WXLL BE PROVIDED UNDER 8E8ARATE COVER BY TML ASSIGNED RISK CARRIER. AVALON BAY COM MITIES INC IS. LISTED AS ADDITIONAL INSURED ON THE GENERAL LIABILITY POLICY, AUTO LIABSLITY AND EXCESS/Ut48RELLA POLICIES. A WhIVER OF StMAOaATION APPLISS. WOR=R8 COmENSATION APPLIES TO THE STATE OF MASSACHUSETTS. AVALON BAY COM11MITY 611-426-1610 ATTN: MARILYNN 8ELYEA 51 SLEEKER ST. STE 750 BOSTON NA 02210 AVALON2 I SHOULD ANY OF THE ABOVE QeSCRIBED POLICIES BE CANCELLED BEFORQ TME DAT! TMEREOP, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRrTTE4 NOTICC TO TME beN t IPK:ATE MOLDER NAMED TO THE LEFT. BUT FAILURE TO 00 SO SMALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR REPRESENTATIVES.