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Home My WebLink AboutBuilding Permit #684-14 - 657 SALEM STREET 4/7/2014TOWN OF NORTH ANDOVER y APPLICATION FOR PLAN EXAMINATION I Permit NO: Date Received Date Issued: IMPORTANT: A licant must complete all items on thisage � � --- LOCATION? . 4 -_� —. /ii-- Print PROPERTY OWNER�?_G�tl�\/ Print MAP NO: PARCEL ZQNNG DLS<<�RICT: 1'00iYear Old Structure yeso IHistonc District yes rz1,i,,o_,L, E�Aar'Kina Chrnn.\/illaria VPc,nn TYPE OF IMPROVEMENT. PROPOSED USE Reside tial Non- Residential ❑ New Building ne family ❑ Addition ❑ Two or more family ❑ Industrial ❑ AI eration No. of units: ❑ Commercial °pair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other Septic- ❑ jEFloodplain ,DrlNetlands ❑Watershed'®istneY ` EW _ ,+ ,Water/Sewer, OWNER: Name: Phone: 1MMt V 44 Supervisor's Construction: License U-0 _' � `�7 �tV! Exp Date: Home Improvement License. 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: $ 2VZ FEE: $ Check No.: �� I Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Sighatur64_ t,— gent/®�wnert�', r - a_`: w..: _ 51gpature or --_c Plans Submitted r.J Plans Waived ❑ Certified Plot Plan ❑ Plans ❑ 109 Building Department The fo1:-3wing is'a=list of -the required forms to be filled out for :the appropriate -permit to -be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ ' Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or"C.S.L Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) a__Engineering_Affidavlts 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 apu•�al period is over. The applicant must then get this recorded at the Registry of Deeds. one copy and proof of recording must be submated with the building application Doc: Doe.Building Permit Revised 2012 Plans Submitted ❑ Plans Waived ❑.: ..-;-Certified Plot Plan ❑ Stamped Plans ❑ l -TYPE-OF SEWERAGEDISP-WAL Public Sewer ❑ Tanning/Massage/Body Art ❑ .. Swimming Pools ❑ Well ❑ Tobacco.Sales E •Food Packaging/Sales El.. Private (septic tank, etc.: - -•- _ . =permanent Duinpster on Site El =THE. FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED: - DATE:APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS :CONSERVATION COMMENTS HEALTH I COMM�NTS Reviewed on Signature Reviewed on Signature Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes . Planning Board Decision: Comme Conservation Decision: :Comments Nater & Sewer Connection/Sicgnature & Date Driveway Permit DPW Tow;! Engineer: Signature: Located 384 Osgood Street 'FIRE DEPARTM!!IE NT Temp Dumpster on site yes - no Located i ill 4AMair `Street `E' Fire DeOartme►rt'signature/date COMMENTS r --I — -.Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. .Totat land -area; sq. ft.: ELECTRICAL: Movement of Meter Iocatiron, rust-or service drop requires approval of Electrical Inspector Yes No DANGER.Z®NE LITERATURE: Yes No MGL-Chapter- 166. Section 21A -F and G min.$100-$1000.fine Doe.Building Permit Revised 2010 Location li ,_�%7 No. Date Caw Check # t 27412 k TOWN OF NORTH ANDOVER Certificate of Occupancy Building/Frame Permit Fee Foundation Permit Fee Other Permit Fee $ TOTAL $ I Bui ding Inspector Gelina5 Structural �ngineering SLC Daniel L. Gelinas, P.E. 579A North End Blvd. Salisbury, MA 01.952-1738 May 12, 2014 Ryan Rourke 66 Regency Drive Dracut MA 01816 cell 978.996.4747 Phone 978.465.6436 Fax 978.465.5160 email danlgelinas@comcast.net SUBJECT: Header, 657 Salem St, North Andover MA Dear Mr. Rourke: Gelinas Structural Engineering LLC (GSE) meet with Buddy Landers on site today to determine if the existing three ply 11 7/8" LVL header spanning 12'-6" satisfies Code. You indicted this is the only issue the Town has; as such we limited our scope to the LVL Header only. After site observations, measurements, office analysis the following is GSE's opinion Executive Summary: 1. Office analysis indicates the three ply 117/8" LVL is capable to support the loading form the 2nd floor, see attached 2. Design basis for this is the IRC 2009 as amended by the Massachusetts Residential Code 8 t Edition amendment, 40 psf Live Load floor loading Please call with any questions. Very Truly Yours, Daniel L. Gelin, G Letter for Header 657 Salem St N A job 14074 Copy Buddy Landers, 24 Colgate Drive, North Andover MA 01845 buddy(a,Buddyelectricinc.com Copy Mike McDowell mikemcd59@comcast.net Boise Cascade Triple 1-3/4" x 11-7/8" VERSA -LAM@ 2.0 3100 SP Floor Beam\Header Dry 11 span I No cantilevers 10/12 slope Monday, May 12, 2014 BC CALC@ Design Report - US Build 2627 File Name: BC CALC Project Job Name: Description: Designs\Header Address: 657 Salem St Specifier: Dan L Gelinas, PE City, State, Zip: North Andover, MA Designer: Gelinas Structural Engineering LLC, 579A North End BIS Customer: Ryan Rourke 66 Regency Dr. Dracut Ma cell 978.996.4 Company: Salisbury MA 01952 [phone 978.360.2562] Code reports: ESR -1040 Misc: danlgelinas@comcast.net BO 12-06-00 Total Horizontal Product Length = 12-06-00 Reaction Summary (Down / Uplift) ( Ibs ) Bearing Live Dead Snow Wind Roof Live BO, 3-1/2" 3,250/0 1,169/0 B1, 3-1/2" 3,250/0 1,169/0 B1 Live Dead Snow Wind Roof Live Trib. Load Summary Tag Description Load Type Ref. Start End 100% 90% 115% 160% 125% 1 Standard Load Unf. Area (Ib/ft^2) L 00-00-00 12-06-00 40 13 13-00-00 Controls Summary Value %Allowable Duration Case Location Pos. Moment 12,816 ft -lbs 40.2% 100% 1 06-03-00 End Shear 3,513 lbs 29.7% 100% 1 01-03-06 Total Load Defl. L/633 (0.228") 37.9% n/a 1 06-03-00 Live Load Defl. L/861 (0.168") 41.8% n/a 2 06-03-00 Max Defl. 0.228" 22.8% n/a 1 06-03-00 Span / Depth 12.2 n/a n/a 0 00-00-00 % Allow % Allow Bearing Supports Dim. (L x W) Value Support Member Material BO Post 3-1/2" x 5-1/4" 4,419 lbs n/a 32.1% Unspecified B1 Post 3-1/2" x 5-1/4" 4,419 lbs n/a 32.1% Unspecified Notes Design meets Code minimum (L/240) Total load deflection criteria. Design meets Code minimum (L/360) Live load deflection criteria. Design meets arbitrary (1") Maximum total load deflection criteria. Calculations assume Member is Fully Braced. Design based on Dry Service Condition. Deflections less than 1/8" were ignored in the results. Fastener Manufacturer: Simpson Strong -Tie, Inc. Page 1 of 2 4�tA OF r Cyt Ur�h EL. L GEL I NAS UO S T RUC: i jRAL. No 3.3994 Job 14074 May 12, 2014 Disclosure Completeness and accuracy of input must be verified by anyone who would rely on output as evidence of suitability for particular application. Output here based on building code -accepted design properties and analysis methods. Installation of BOISE engineered wood products must be in accordance with current Installation Guide and applicable building codes. To obtain Installation Guide or ask questions, please call (800)232-0788 before installation.\n\nBC CALC®, BC FRAMER®, AJS-, ALLJOIST@ , BC RIM BOARDTM' BCI®, BOISE GLULAM rm, SIMPLE FRAMING SYSTEM@ , VERSA -LAM@, VERSA -RIM PLUS@ , VERSA -RIM@, VERSA -STRAND@, VERSA -STUD@ are trademarks of Boise Cascade Wood Products L.L.C. Boise Cascade Triple 1-3/4" x 11-7/8" VERSA -LAM@ 2.0 3100 SP Floor Beam\Header Dry 11 span I No cantilevers 10/12 slope Monday, May 12, 2014 BC CALCO Design Report - US Build 2627 File Name: BC CALC Project Job Name: Description: Designs\Header Address: 657 Salem St Specifier: Dan L Gelinas, PE City, State, Zip: North Andover, MA Designer: Gelinas Structural Engineering LLC, 579A North End BI) Customer: Ryan Rourke 66 Regency Dr. Dracut Ma cell 978.996.4 Company: Salisbury MA 01952 [phone 978.360.25621 Code reports: ESR -1040 Misc: danlgelinas@comcast.net Connection Diagram b a d a minimum = 1-1/2% = 8-7/8" b minimum = 6" d = 24" e minimum = 1" Calculated Side Load = 344.5 Ib/ft Install Screws with screw heads in the loaded ply. Connectors are: SDW22500 Job 14074 May 12, 2014 Page 2 of 2 C O O U) CD 0 Z O CD Cr C. > c. � O 00 CD C� Cr CD O W � CL O 5. O cQ CD U) CD n O Ewk Cl) �G n U) su n CD rt CD CD N� CD N v Z CD O CD B N * C T 7 A O O (D d O � �p z O m N T_ G) m 0 M v '^ Z m M D Z N •� m P'1 ami 55 Z O ;om �• Z Cl) � Z 0 O � O D C r Z G7 z cnW. m O un N * co C T 7 A O O (D d O � �p z O T_ G) m D v '^ m M D Z N •� m P'1 m O Z � L O '6 O 0 N x -S O cr N =' < N rCL O CD 0 <D O 0 m o O_ U) --� N 0 0 CL 0m W0 CO) 0 CD C x o� n Co CL N o D) �• 1••f n =r C <D S O CD 0 0 O C to N' S c o.v, 0 J7 z N D �. ;h _ 'C D c3D nLik 0-Q . / N CD�<� .� C,CL �• . W F O I r• N .a CD IGA 0 o " o co � 0 0 rt CD s ca I O O <D n N D� 0 ZD w o I o_ • Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost 32,000.00 m $ - $ 384.00 Plumbing Fee $ 48.00 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 48.00 Total fees collected $ 580.00 657 Salem Street 684-14 on 4/7/2014 Ktchen and 2 bath Remodel RYANO-1 OP ID: MH CERTIFICATE OF LIABILITY INSURANCEDATE(MMIDD/YYYY) THIS CERTIFICATE 1:9 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 Oft 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 Pollcy(ie9) 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 righty to the certificate holder In 111,NU Of such etldorsementAti- PRODUCER 878-975-1300 CONT CT 978-"6-4747 3e revs 8 Hall Insur.AslloD.lnc 305 North Main St. 978-975-7596 PHONE No, Ext • FA7( ) Andover, MA 01810 E.Ma1 —� Lawrence J. Hall ADDRESS: INSURERLSJ AFFORDING COVERAGE NAIL 4 _ INSURERA:XS Brokers INsuRED Ryan Rourke INSURER e : AEIC 11104 40 Acton ;St. Lowell, MA 01852 INSURER C - INSURER D: A B THIS IS TO CERTIFY THAT THE POLII,'IES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE: POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SLICH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, R TYPE OF INSURANCE POLICYEFF LICY EX POLICY NUMBER MMMOIYYYY M/D LIMITS GENERAL LIABILITY I I EACH OCCURRENCE 1.000.0 JACOINIMERCIAL GENERAL LIABILITY ER71789749 03/18/14 03/18/15 DAMAGE_ KM I LU oeeurronon) _� CLAIMS -MADE OCCUR MED EXP (Any one ersen) $ -- PERSONAL a ADV INJURY $ GENERALAGGREGATF- 9 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS • COMP/OP AGO 3 POLICY I� PFO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT a s>scldern� ANYAUTO BODILY INJURY (Parpaman) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) S HIRED AUTOS NON -OWNED PROPERTY DA S Par accldeJ.11)„ a UMBRELLA LIAR OCCUR EACH OCCURRENCE S EXCESS LIAN T. CLAIMS -MADE AGGREGATE S DED RETENTIONS $ WORKERS1COMPENSATION WCSTATU• OTH- AND EMPLOYERS' LIABILITY _ X E ANY PROPRIETOR/PARTNER/EXECUTIVE YIN WCC -500-5012692-201A 11/11/13 11/11/14 E. L EACH ACCIDENT $ OFPCER/MEMBER EXCLUDED? �] N / A If (Mandatory In NN) E.L. DISEASE - EA EMPLOYEE $ It yS , daacriba under DESCRIPTION OF OPERATIONS holow E.L. DISEASE - POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS / VE 11CLES (Attach ACORD 101, Additional Remarks Sotradula, If more space Is required) NORTHAN Town of North Andover Main Street North Andover, MA 011145 1 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 AQ/ ®1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD a Office of Consumer Affairs and Business Regulation 10 Park Plaza -Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration ROURKE PROPERTY MANAGEM RYAN ROURKE 159 PARKVIEW AVE. LOWELL, MA 01852 SCA 1 % 20M-05/11 ��c �o��rmw�ruoecrlCfo�U/itaQd�ucgeC�Q �. Office of Consumer Affairs & Business Regulation OME IMPROVEMENT CONTRACTOR egistration jj7873 Type: ,. Expiration 2/18/20.16; DBA ROURKE PROPERTYWANAGEMENT Registration: 177873 Type: DBA Expiration: 2/18/2016 Tr# 249134 to Address and return card. Mark reason for change. Ur ress L_j Renewal L_j Employment ❑ Lost Card License or registration valid for individul use only before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation 10 Park Plaza -Suite 5170 ; Boston, MA 02116 RYAN ROURKE`t._ 159 PARKVIEW AVE LOWELL, MA 01852 UndersecretaryV`1 N valid without signature I" t The Commonwealth of Massachusetts - Department of Industrial Accidints Office of Investigations 600 Washington Street Boston, MA. 02111 www.mass gov/dia Workers' Compensation Ymsurance Affidavit: Builders/Contractors/Electricians/Plumbers Address: 46 "N ' City/State/Zip: (err v'' C Phone #• `7 �� < �O 7 �`� Are you an employer? Check the appropriate box: 1. ❑ 1 am a employer with 4• ❑ 1 am a general contractor and I employees (full and/or part tinge).* have Hired the sub -contractors 2. ❑ 1 am a sole proprietor or partner- listed on the attached sheet, t ship and'have no employees These sub -contractors have working for mein any capacity. workers' comp. insurance. [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 3. ❑ 1 am a homeowner doing all work right of exemption per MGL myself. [No workers' comp. c. 152, §I(4), and we have no insurancerequired.] i employees. [No workers' comp. insurance required.] Type of project (required): 6. ❑ New construction f 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10. F1 Electrical repairs or additions 11. F1 Plumbing repairs or additions 12.❑ Roofrepairs 13.❑ Other *Any applicantthat checks box#1 must also fill out the section below showingtheir wbrkers' compensation policy information. i 'Homeowners who submit this affidavit indicating thele s're doing all work and then hire outside contractors must submit a new affidavit indicating such. l'Contractors 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 employe/• that isproviding workers' compensation insurance for my employees Below is thepolicy and job site information. r. 7 ,/ d Insurance Company 0 Policy # or Self- ks.Lic. #: Expiration Date: // I f Job Site Address: 6u - & Lem ,f City/State/Zip: 41- /-4u/*V_ Z Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as requireclunder Section 25A of MGL o.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 rine of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. X do Hereby cert& ulagr Amp . afty andp n lties ofp Yu that the infOYmatlDn provided above TS tY elan/d correct. Si ature: Date: Phone #• Official use only. Do not write in this area, to be completed by city or town offlelal. City or Town: Permit/License # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. EIectrical Inspector 5. Plumbing Inspector 6. Other - - - Contact Person: _ Phone Information and Instro.ctions 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 employes is defined as "an individual, partnership, association, corporation or other legal entity, or any two or more ofthe 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 notmore than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6) also states that "every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced.acceptable evidence of compliance with the insurance coverage required." Additionally, MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary, supply sub -contractors) name(s), address(es) andphonenumber(s) along withtheir 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 maybe 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 acid fax number: ThoCommoawoaMof assachvsPtEs Department ofIndustdal .Accidenta Office ofluvestigatiom 6bG Washhigo a. S1ireet Boston, MA, 02111 Tel, # 61.7-727_4900 e 406 or 1-877,MASS.AaFB Revised 5-26-05 Fay ,# 617-727-7749 www.mass pv1dia I OR -M 11-7 m ,)2j 3_ 4 :3a Massachusetts Home Improvement Sample Contract This form satisfies all basic requirements of the state's Home Improvement Contractor Law (MGL chapter 142A), but does not include standard language to protect homeowners. Seek legal advice if necessary. Any person planning home improvements should first obtain a copy of "A Massachusetts Consumer Guide to Home Improvement" before agreeing to any work on your residence. You may obtain a free copy by calling the Office of Consumer Affairs and Business Regulation's Consumer Information Hotline at 617-973-8787 or 1-888-283-3757 or on our website. Homeowner Information Contractor Information NameV� �Q / �•yg'� 5g4 Company Name Street Address (do not use a Post Office Box address) Contractor/ Salesperson/ Owner Name &5-7 sa lew� .�3j—" lq ly City/fown State Zip Code A- Business Address (must include a street addres ) �� S7L N t fctv�A- p 1, ) Daytime Phone Evening Phone Sod 46a• lai?� City/fown State Zip Code l.0w.Cd 40/ Mailing Address (It different from above) Business Phone Federal Employer 1D or S.S. Number Ian requires that mast home Home Improvement Contractor Reg. Number Exphadon date imam�emeatroaoo�bare ud registsatio a ber� , i� The Contractor agrees to do the following work for the Homeowner: (Describe in detail the work to completed, specifying the type, brand, and grade of materials to be used, use additional sheets if necessary.) L11 AA -0 /444 as /5kf ;Nd 4/xX *1/4 &�4 a/&/ &,W 4 16 Required Permits - The following building permits are required Proposed Start and Completion Schedule - The following schedule will and will be secured by the contractor as the homeowner's agent: be adhered to unless circumstances beyond the contractor's control arise (Owners who secure their own permits will be lq ly excluded from the Guaranty Fund provisions of Date when contractor will begin contracted work. MGL chapter 142A.) 1, ) , Date when contracted work will be substantially completed. Total Contract Price and Payment Schedule The Contractor agrees to perform the work, fumish the material and labor specified above for the total sum of: Payments will be made according to the following schedule: $ c).+ V t/ upon signing contract (not to exceed 1/3 of the total contract ppriice� or the cost of special order items, whicheverriisgreater) $—�d by I Z�A or upon completion of /� /F!i/l f% $� /� by _Y/ 1 V/J�or upon completion of 1 $ upon completion of the contract. (Law forbids demanding full payment until contract is completed to both party's satisfaction) The following material/equipment must be special $ to be paid for ordered before the contracted work begins in order to meet the completion schedule.(**) $ to be paid for NOTES: (*) Including all finance charges (**) Law requires that any deposit or down -payment required by the contractor before work begins may not exceed the greater of (a) one-third of the total contract price or (b) the actual cost of any special equipment or custom made material which must be special ordered in advance to meet the completion schedule. Express Warranty -Is an express warranty being provided by the contractor? ❑ No ❑ Yes fall terms of the warranty must be attached to the contract) Subcontractors -The contractor agrees to be solely responsible for completion of the work described regardless of the actions of any third party/subcontractor utilized by the contractor. The contractor further agrees to be solely responsible for all payments to all subcontractors for materials and labor under this affeement Contract Acceptance - Upon signing, this document becomes a binding contract under law. Unless otherwise noted within this document, the contract shall not imply that any lien or other security interest has been placed on the residence. Review the following cautions and notices carefully before signing this contract. • Don't be pressured into signing the contract. Take time to read and fully understand it. Ask questions if something is unclear. • Make sure the contractor has a valid Home Improvement Contractor Registration. The law requires most home improvement contractors and subcontractors to be registered with the Director of Home Improvement Contractor Registration. You may inquire about contractor registration by writing to the Director at 10 Park Plaza, Room 5170, Boston, MA 02116 or by calling 617-973-8787 or 888-283-3757. • Does the contractor have insurance? Ask the Contractor for his insurance company information so that you can confirm coverage, or ask to see a copy of a "proof of insurance" document. • Know your rights and responsibilities. Read the Important Information on the reverse side of this form and get a copy of the Consumer Guide to the Home Improvement Contractor Law. You may cancel this agreement if it has been signed at a place other than the contractor's normal place of business, provided you notify the contractor in writing at his/her main office or branch office by ordinary mail posted, by telegram sent or by delivery, not later than midnight of the third business day following the signing of this agreement. See the attached notice of cancellation form for an explanation of this right. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES!!! identical copies of the contract must be completed and signed. One copy should go to the homeowner. The other copy sho ntractor. ITwAo Homeowne s Signature Wkptby Contra tor's gnature IN Date Date 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 Business Regulation and the consumer shall be required to submit to such arbitration as provided In Massachusetts General Laws apter 142 . Homeowner's Signature on ctor's Signature NOTICE: The signatures of the parties above apply only to the agreement of the parties to alternative dispute resolution initiated by the contractor. The homeowner may initiate alternative dispute resolution even where this section is not separately siened by the narties. 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 be added to the terms of the contract as long as they do not restrict a homeowner's basic consumer rights. If you have questions about your consumer/homeowner rights, contact the Consumer Information Hotline (listed below). Execution of Contract The contract must be executed in duplicate and should not be signed until a copy of all exhibits and referenced documents have been attached. Parties are also advised not to sign the document until all blank sections have been filled in or marked as void, deleted, or not applicable. One original signed copy of the contract with attachments is to be given to the owner and the other kept by the contractor. Any modification to the original contract must be in writing and agreed to by both parties. Contracted work may not begin until both 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 Informatioa Hotline Office of Consumer Affairs and Business Regulation 10 Park Plaza, Room 5170, Boston, MA 02116 617-973-8787, 888-283-3757 or visit the OCABR website at http://www.mass.gov/ocabr/ If you want to verify the registration of a contractor or if you have questions or need additional information specifically about the contractor registration component of the Home Improvement Contractor Law, contact: Director of Home Improvement Contractor Registration Office of Consumer Affairs and Business Regulation 10 Park Plaza, Room 5170, Boston, MA 02116 617-973-8787, 888-283-3757 or visit the HIC website at http://www.mass.gov/ocabr/ Go online to view the status of a Home Improvement Contractor's Registration: http://db.state.ma.us/homeimprovement/licenseelist.gM For assistance with informal mediation of disputes or to register formal complaints against a business, call: Consumer Complaint Section Office of the Attorney General 617-727-8400 AND/OR Better Business Bureau 508-652-4800, 508-755-2548 or 413-734-3114 Version 2.1 - 11/27/2010 A 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 [Name of Seller], AT [Address of Seller's Place of Business] NOT LATER THAN MIDNIGHT OF Date: I HEREBY CANCEL THIS TRANSACTION. Buyer's Signature: (date). ,5�Rtt+ Estimate for work at 657 Salem kftd, North Andover Ma. Demo Work will include Kitchen cabinets Kitchen floor 1 st floor bath to studs 2nd floor bath to studs Living room stair area Demo wall into living room near front door Remove all doors first floor Remove doors and casings 2nd floor Demo wall from kitchen into dining Total 3500.00 Kitchen - Prep walls for new cabinets that will include skim walls with mud and sand, prep for paint $600.00 Install new kitchen cabinets allowance $3500 Install Granite on kitchen counters $1750 Install granite on new island into dining area $2000 Cost to install cabinets $850 Cost for new floors 150sgft Allowance 3.00ft would be 450.00 for tile 900.00 for install or 1350.00 Total Refinish hardwood floors $3000 Dumpster $650.00 40 yard Purchase 6 new doors for first floor Purchase 3 new prehung doors 2nd floor New door knobs/hardware Bought and installed $1500.00 2nd floor bath complete Includes all fixtures and toilet $5000 plumbing/elec not included New tile 3.00ft for tile 1 st floor bath Includes all fixtures $4000 plumbing/elect not included 3.00 ft for tile included Living room stairs Treds New railing Spindles Installed/finish work Door/frame into dining area $1900.00 Cost for any patch and plaster Stock/material $800 Finish work Stock and material 650.00 Paint Prep walls $4190941M Caulk Stock and material 4500.00 for whole house Permit fee 650.00 Travel 2 trucks 4wks $ 500.00 Total 36,700 " g50O i' A I'A f � a) o'ZdV Payable in 4 installments of $9175.00 6-8 wks to complete depending on elec/plumbing inspections btft S;50 ti tan z:(r — �,&U Ravi(k