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Building Permit #518-14 - 66 JAY ROAD 12/31/2013
TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION �Permit N Date Received Date Issued: ' IMPORTANT: Applicant must complete all items on this page ._ •'!' LOCATIONI'- Prin PROPERTY OWNER Print 100 Year Old Structure MAP NO: DD ILPARCEL: ZONING DISTRICT Historic District _ Machine Shoo Village yes no yes no .TYPE OF IMPROVEMEi�T_ PROPOSED USE Non- Residential Residial ❑ New Building A,6ne family ❑ Two or more family ❑Industrial ❑ it No. of units: ❑Commercial Alteration ❑ Others: ❑ Repair, replacement ❑ Assessory Bldg ❑ Demolition _._. Welt ❑ Other- Ei Floodplain ❑ Wetlands ❑Watershed District D Septic. q El Water/Sewer _ Plfu 662 entific tion Please Type or Print Clearly) OWNER: Name: CCtC At, '(40 Phoi ,� , Phone: 791- CONTRACTOR 'Name:- �9._ SSS.__ -, -, r Supervisor's Construction License: = VY Ex p Date: Exp. Date: Z -H_ % Home Improvement License: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE: BULDING PERMIT: lo' /$►12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. a 0 0 FEE: $ Total Project Cost: $ e Check No.: /e� 70 Receipt No.: o i57 7 NOTE: Persons contracting with unregistered contractors do not have access to the uaranty^ and - .7! t`IQlU1G°VP yyluuvwr,.. •, ,_ ... . Signature of_Agent/OWn6 _ -- � -. Plans Submitted L.Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ `i Building Department "—The fol ?wing is'a>li`st'of the required.forms to be filled out*for the. appropriate -permit to'.be obtained. Roofivg, Siding, Interior Rehabilitation Permits ❑ ` B;bilding 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 o Photo Copy of H.I.C. And C.S.L. Licenses L3 Copy Of Contract .o Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) M1 " o Mdss 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) _ E ❑ Building Permit Application o Certified Proposed Plot Plan o Photo of,H.f.C. And C.S.L. Licenses, ❑ Workers Comp Affidavit j r� o 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 apw-al period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be subm.tted with the building application Doc: Doc.Builtiiing Permit Revised 2012 Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ -�TYPE_OF=-SEWERAGEDiS-PDSAL Public Sewer ❑.Swimming Tanning/MassageBody Art ❑ - Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales El Private (septic tank, etc.- ❑ - _ . -Permanent Du" mpster on Site ❑ THE. FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM ._:---DATE REJECTED DATE:APPROVED PLANNING & DEVELOPMENT' ❑ ❑ COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decisionfreceipt submitted yes Planning Board Decision: Comme f Conservation Decision: Comments Water & Sewer Connection/Signature & Date Driveway Permit DPW Towo Engineer: Signature: Located :364 Us ooa Street FIREDEPARTMf NT �,T:ennp Dumpser on site :yes Ao , Locatedat�124`MainS'treetpp.�y;,�Mf ,� ,� ���. �, P ,n.`�f• �r. � i�'I;R:t � ? •.C;`,r�iFe..s � 4�""�'" .W, iir 4€3 F .r � a K i Fires,Departmer�tYsignature/datelF`x,t,y,a,�"_`'s. t , ,,. COMMENTS#�" tvi??4�t+4a.i�t�r?�3Y1�t.•at i� �:�".3't ;� +..%� ; �7� +i}Y+i�tt+ x?ki.{lXw.: Dimensien Number of Stories: Total land area; sq. ft.: Total square feet of floor area, based on Exterior dimensions 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 LI Notified for pickup - Date Doe.Building Permit Revised 2010 Location'- `y No. Date Check # TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ �P Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Ir 27197 Bp lding nspector Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost $ 20,000.00 m $ - $ ' 240.00 Plumbing Fee $ 30.00 Gas Fee 100 comm. $ 100.00 Electrical Fee $ : 30.00 Total fees collected $ 400.00 66 Jay Road 518-14 on 12/31/13 Remodel Kitchen Hub International New England LLC To:re: Certificate (19786889542) Client#: 256754 DANIELDUSS 09:08 12/31/13 EST Pg 2-2 ACORD,. CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) F 12/31/2013 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 HUB International New England 4 West Mill Street Medfield, MA 02052 508 359-4151 CONTACT NAME: Kim Cornetta AICNE Ext : 508-359-2939 FAX No : 866-599-6962 EMAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC A INSURER A : Safety Insurance Co INSURED INSURER B: Hartford Insurance Co Daniel Dussault 09/1512014 990 Johnson Street INSURER C: COMMERCIAL GENERAL LIABILITY North Andover, MA 01845 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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 CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS; EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF MM/DDIYYYY POLICY EXP MM/DD/YYY LIMITS A GENERAL LIABILITY BMA00121372 911512013 09/1512014 EACH OCCURRENCE 000,000 COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $100,,00 CLAIMS-MADE F OCCUR MED EXP (Any one person) $10000 PERSONAL 8 ADV INJURY $ 300,000 GENERAL AGGREGATE $600,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 600,000 PRO- F POLICY ECT LOC J ECT $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE $ Per accident UMBRELLA LIAB HCLAIMS-MADE OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAR DED RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFiCER/MEMBER EXCLUDED) � N / A 08WECEH1833 D312612013 0312612014 XWC STATU- OTH- ORY MtTS E.L. EACH ACCIDENT $100,000 E.L. DISEASE - EA EMPLOYEE $100,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $500,000 1 -_ L DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) "* Workers Comp Information " Proprietors/Partners/Executive Officers/Members Excluded: Daniel Dussault Town of North Andover Building Department ACORD 25 (2010/05) 1 of 1 #S1049194/M1049192 101.1 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 U 1988-ZUIO ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD KC004 CA m m m y m CA F) M 10 CD 0 Z O CL r Q �. > to �O v CD CL a CD O N 10O U) CD CD U) CD vI v Z a CD O r C) N O Nrr X00 ~m < 0 —9 - �+ m a T N �o � T z CA T 0) 2) x O S m 22 a r M Q T m N U) CD .0 C M T �' , 61 _r 3 7 � --i `°• CD 0 `-° (D L 3 O Q 7z 3 O Z e�•�• rt � c•?�� v, �, c c Cl) o. to CD W N CD 'o CD CD O' N N O CD O. O0•r Q c0 O N _, O O rt c7 C O . \ `o rn � <. 70 C O y (a c_ oo,� Cr S. X O � y n � cn < 0 � Q O — .:� -- Q- O. .� NCD N rn CO) CD CL CD �C D r O .�� �0. Z � Cc r•f O r•F CD W CD fN � C N y OOw aCD CD -0 0 w o CL O r C) N O Nrr X00 ~m (AW (D z O C0 j f�D �+ m a T N �o � T z CA T 0) N (D < f1 N x O S m 22 a r M Q T m N ;o O DO S .0 C M T �' , 61 _r 3 7 � O O 3 � j W C D .70 T .0 (D L 3 O Q 7z 3 W O D ° Q m ._ �I >; - �I Ma!;sachusetts - Department of Public Safety E Board of Building RegGlations and Standards Construction Supervisor License: CS•,09084fi - DANIEL F DUSS PET 990 JOHNSON ST ��°-��� s NO ANDOVER NTA 0184 r \� Expiration a Commissioner 12/26/2014 "{fit*lce o Qnstr�ftairs 0 s�ness RC u atiu MEN i n 1 i i�ME�INiPROVEIIYIENT CONTRACTOR Reqtstraiion l"r--,414,9853� [xpiration: 2/s14•/x014BrA ~ 3- D UL � CARP�ENTR_ DANIEL'rDUSS-AdL' 990 JOHNSON STREET x;Y NORTH ANDOVER; MA 0185 Undersecretary ,. The Commonwealth of Massachusetts - Department ofIndustrigl Accidents Office of Investigations kvi 600 Washington Street Boston, MA 02111 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Name (Business/Organization/Individual): Address: 720 -J-0k1VSV_-,J N, City/State/Zip: Al, AAI PQVe2- 0/t Y *Phone #: q E 5-13` Are you a ployer? Check the appropriate box: 1. am a employer with �-- 4. ❑ I 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. t - 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. ❑ 1 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. ❑ New construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10.❑ Electrical repairs or additions I L ❑ Plumbing repairs or additions 12. ❑ Roof repairs 13. ❑ Other YAny applicant tbat checks box #1 must also fill out the section below showing their workers' compensation policy information. Homeowners who submit this affidavit indicating they sire doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub -contractors and their workers' comp. policy information. Yam an employer that is providing workers' compensation insurance for my employees Below is the policy and job site information. 1 j 1 n I Insurance Company Name:. / t+t - Policy # or Self -ins. Lic. #: Expiration Date: fo Job Site Address: City/State/Zip: N,�y 1 Attach a copy of the workers' compe sationpolicy declaration page (showing the policy number and expiration date). Failure to secure coverage as required.under Section 25A of MGL c.152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one=year imprisonment, as well as civil penalties in the form of a STOP. WORK ORDER and a fine of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. Y do Here Signature: certify de the ins and p n Ities of ' ry that the information provided abo a is fru Date: and correct. Phone #: Official use only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other - - - Contact Person: Phone #: Information and Instruction's Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, express or implied, oral or written." An employer'is defined as "an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the owner of a dwelling"house having notmore than three apartnkr is 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 orbuilding n1F iurte ant thereto shall not bo'cause of such employment be deemed Yb be an employes." MGL chapter 152, §25C(6) also states that "every state or loeal'licensfng agency_ shall withhold the issuance or renewal oTa 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 maybe 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 retained 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 - t t m 1 5 t 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 tie pp&mit/license number which will be used as a refereprce number..I. addition, an applicant that must submit multiple permit/license applications in any given year, need -only submit `ohne affdavftindicating 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 cooperationland should you haff any questions, please do not hesitate to give us a call. 1 The Department's address; f'ele�hoiletand fax number: The Commonwealth of,Massac,,b is ;'S Department of Industrial .Accidents Office Of Investigations 600 Wasbungton. Street Boston, MA 021 It Tox. # 617-727 4900 ext 406 or 1-877,7MASS.AJFB Revised 5-26-05 Fax # 617-727-7740 wvv—masa,govldia 781-858-5134 C , M This form satisfies all bmc row& eats of the states Home lmpmvem®t Contmctorl.aw (MGL craptee 142A),.Imt does not include standard I dffim a to protect hommwnem .Smk tMd advice if ooces-U. Any person.planning home improvements should first obtain a copy of "A Massa�tsetts Consumer Guide to Home Improve.meat" before agreeing to any work on your residence. You may obtain a free copy by calling the Office of Consume Affairs and Business Regulation's Consumer Information Hotline at 617-973-8787 or 1-888-283-3757 or on our website. ``` HomggOO►�ner Information Contractor Information Kvi lex A l r% '0 r -+n N= a d� Company DV SS O tf C�t2 ► Street Address (do not Past OfficeBox address) Salesperson/ Name r o li5 UP Al � frown State 11 r4NS--s a0S-18-(0131 B ess ddres (must ivclud a sbrct address) S Jr. MUJN of A , DaytmePhone E Phone CAPrown State Tap Code t Ani 0WIR? MA 0191S� Mmbng Address ($ different from above) Business Phone Federal Employer ID or S.S_ Number - Ell— C.W..b ft-NomhQ -3 am ZINN The Contractor agrees to do the following work for the Homeowner. (Desmbe in detail the work to completed, specifying the type, brand, and of materials to be used, use additional sheets if necessary.) Ivf/ t)em-o 0-r CWSTIA G 4d c V Re/ -o ►tel 12-owL, -(Cla #Velj ©v - All Pb�,, �r C7/e(--F. A V d- rind (61 O'D2t tS9 Regained Permits- The following btnlding permits ate &quuJ Proposed Start and Completion Schedule - The following schedule will and will be secured by the contractor as the homeownees agent be adhered to unless circumstances beyond the contractor's control arise (Owners who secure their own permits will be excluded from the Guaranty Fund provisions of 4 e when contractor will begin contracted wortr. MGL chapter 142A.) I - WyDclewhen contracted work will be substantially completed Total Contract Price and Payment Schedule Q 7 �►j J�()rj The Contractor agrees to perform the work, famish the material and tabor specified above for the total sum o�+ Payments will be made according to the following schedule: $'''���/ upon signing contract (not to exceed 1/3 of the total contract price or the cost of special order items, whichever is greater) $ t�O Iby L /ji/A or upon completion of $10400 by / /_ or upon completion of /A/ $ upon completion of the contract (Law forbids demanding full payment until contract is completed to beth 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 (**) Lew requires that any depositor down-paymern r veil by the contractor before work begins may not exceed the greater of (a) one-third of the total conk ct price or (b) the of arty special equipment or custom made material which must be special ordered in advance to meet the completion schedule. 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 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 hnprovement Contractor Reastration. The law requires most home*provement'oontrattors:and subcontractors to be registered with the Director of Home Improvement Contractor Registration You may inquireab(141tRou -or - 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 con conftrm 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 pjjmch office by ordinary mait;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 canadlation.forut .for an explanation of this right DO NOT SIGN THIS CONTRACT IF THERE ARE ANYAWANK SPACESM 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 R 'o a consumer all be required to suX�1-2� arbitration as provided In Massachusetts General ws, 42A. Homeowne?s Si Con azure 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 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 lawfiilly 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 Information 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 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 617973-8787, 888-283-3757 or visit the HIC website at Go online to view the status of a Home Improvement Contractor's Registration: 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 - 11/2212010 .. 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 I - I (date). I HEREBY CANCEL THIS TRANSACTION. Date: 3 Buyer's Signature: