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HomeMy WebLinkAboutBuilding Permit #535-11 - 740 FOREST STREET 1/10/2011TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: 63 S'--11 Date Issued: / � // IMPORTANT: Date Received must complete all items on this LOCATION -7atO Fot-e e.4 S+ Print PROPERTY OWNER �v° a.�- w► a s ° -- ` Print MAP NO: DS 4 PARCEL:ZONING DISTRICT: Historic District yes ye no IL Machine Shop Village no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ Addition ❑ Alteration ❑ One family ❑ Two or more family No. of units: ❑ Industrial ❑ Commercial CKRepair, replacement ❑ Demolition a'r"ii"°F"js , • 0 e U, t ®Well A 10Water_/Sewed_ ❑ Assessory Bldg ❑ Other ❑ Others: ' ®Wa Fershed Di firic_jt a, tt , t 'Dglq . Floodplain ®VJ�etlandsj Zr DESCRIPTION OF WORK TO BE PERFORMED: 61 + cJ� a c t- o� i� i� ayi c)► V a•�.: ,- ; � Identification Please Type or Print Clearly) OWNER: Name: S ay -fir o... -,d J e-,% 1 Ino --7 p so V1 Phone: q75? 33'7 S q cab Address: `14O o�z �4-. �7. A.,,&ovMQ. CONTRACTOR Name: Phone: Address: 3 s d�&-c.... 2-� S i r �c.► M b /4 a► t Supervisor's Construction License: -05' "1 -1,4t3 Exp. Date: Home Improvement License: ISD b0%,Z- NO Z- Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No ►-z..l 6-7 l L z FEE SCHEDULE. BULDING PERMIT. $92.00 PER $9000.00 OF THE TOTAL ESTIMATED COST BASED ON $925.00 PER S.F. Total Project Cost: $ 2 c o o 0 FEE: $ f9-- 0 Check No.: �r7 Receipt No.: V-5-2— NOTE: _ Per -sons Yacting with unregistered contractors do not have access to the guaranty fund _ YSgnature of contractor' x- Location No. �•� �/ Date ,/—"Ad— TOWN OF NORTH ANDOVER F s 9 �o ; . Certificate of Occupancy $ ' ssCNUsE<�' Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL Check # -/-7 23852 Building Inspector Building Department The following is a Iist of the required forms to be furred out for the appropriate permit to be Roofing, Siding, Interior Rehabilitation Permits ° Building Permit A Q ° Workers Com Application ° Photo Cop Of Affidavit Y H. I. C. And/Or C. S. L. e ° Copy of Contract Licenses ° Floor Plan Or Proposed Interior Work All Engineering Affidavits for Engineer r'X NOTE: ' Aster permits require sign off fr"� �`��ede �4 s�1s Addition Or Decks Ge s�; so ° Building Permit Applir. ° Certified Surveyed at ° Workers Comp: ❑ Photo COPY ' \610 O Fe�G p�� Pee 4s� ,' e`a�s " ° COPY Of r' eos �s ❑ Floor1r, 4 ® G� H r'" op O ❑ L 0 00 NOTE: All d, S��.Gs�i �• �O��Q 4 Nei/ c®ns#6', 4 0 1p' ° Building Pe, oe� ° Certified Prop, Q Photo of H. I. C ` a Gg�O� ate - kers Com ���� ❑ Two Sets of gu ldin\ rldrng� 5 d ❑ Hydraulic Calculations,,, 14��� Py of Contract \ O0 ° Mass check Ener G ° En gineerin Energy COmPi,\ VOTE: All darn g Affidavits for Eny Aster permits re d �` eG\yo� quire sign ofi ��'� ° n all cases • GO ` �e O if a variance ors \Own �5 �eJ�Z tiot``��bat the aPPeal period is ovepeCial permit was re !lust be sub thea st then the T:, A(i miffed with the build' applicant must then get this re\ ' mg application GO Doc: Doc.Building Permit Revised 2008mi Y �5 msz ; e, e� X00 Ad Qa (No Q`a� Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ElTanning/MassageBody Art ElSwimming Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private (septic tank, etc. ❑ Permanent Dumpster on Site - ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS CONSERVATION Reviewed on Signature COMMENTS • HEALTH Reviewed on ' - Signature' .COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature & Date Driveway Permit DPW Town Engineer: Signature: ' Located _ 384 Osgood Street FIRE DEPARTMENT - Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date = ' COMMENTS 384 Osgood street no Dimension Total square feet of floor area, based on Exterior dimensions.---- Number of stories:----- Total land area, sq- ft.: requires approval of vement of Meter location, mast or service rop q ELECTRICAL: M° Yes Electrical Inspector No DANGER ZONE LITERATURE: Yes MGL chapter 166 Section 21A -F and G min.$100-$1000 fine I)oc:.Bui1din9 Permit Revised 2008 @Cep qs�O 4o0 „�� `� QL •. soo ��c ^,• PQM' � AFP Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA — For department use ® Notified for pickup - Date Doc:.Building Permit Revised 2008 Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan - ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ 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 40TE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit n all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals hat the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording lust be submitted with the building application Doe: Doc.Building permit Revised 2008mi ERS m c C* i O C •+ O CJ C') d'O CL C m G 0 rD CCD CD CCA L Z f. Q� o co �r `NG�� wQO O 2.,ro: s c E \O :ate U ca l oo cc Cn N CO Z : N G G O �; N O w Em U :ate` m CC/)) H O m cr. .G p cm O Q :�_ W ►--� ^ � d G Z m h-1 V N O C.3 :1,:2 Z o CD CL. C Q i' m G •a m *- c.Liu COD N J ~ .N CL=A G Z V W E C0.1 COD •VJ O O y a o� C2:55 .. - CL N p = - O_ Z cc O Z O Cl co L C3 0 Z CD CL O CO) � C co cm CO)I0 -0 CO — •� m m G3 CD CD CD CL-) CD CD o cc o a C ,Ca ca CD CcCc •C Z CD Q CL V y CO C .0 C CO2 CG O w v cn O w O w U u. a O p w G i a O Fzi p w y cn iw O w G w cn cn cn m c C* i O C •+ O CJ C') d'O CL C m G 0 rD CCD CD CCA L Z f. Q� o co �r `NG�� wQO O 2.,ro: s c E \O :ate U ca l oo cc Cn N CO Z : N G G O �; N O w Em U :ate` m CC/)) H O m cr. .G p cm O Q :�_ W ►--� ^ � d G Z m h-1 V N O C.3 :1,:2 Z o CD CL. C Q i' m G •a m *- c.Liu COD N J ~ .N CL=A G Z V W E C0.1 COD •VJ O O y a o� C2:55 .. - CL N p = - O_ Z cc O Z O Cl co L C3 0 Z CD CL O CO) � C co cm CO)I0 -0 CO — •� m m G3 CD CD CD CL-) CD CD o cc o a C ,Ca ca CD CcCc •C Z CD Q CL V y CO C .0 C CO2 UA U) W W 19 W U) f °#J « �2' .g. . L § 2 { f °#J « �2' \\t q 07c \/ It 4j g / � f T ® DATE (MM/DDNYYY) ACORO CERTIFICATE OF LIABILITY INSURANCE 11/30/2010 PRODUCER 978.425.9595, Fax978.425.9160 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION W. E. Noyes & Son Ins Agcy, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 73 Front Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O. Bax 1248 Shirley MA 01464 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: National Grange Mutual IIIc ALLAN AHOLA Et JOHN HUDLIN INSURER B: PO BOX 471 INSURER C: INSURER 0: AYER MA 01432 INSURER E: vv v �rvrvc..� 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL INSR ADD'L—, POLICY EFFECTIVE LTR INSIRD TYPE OF INSURANCE POLICY NUMBER POLICY EXPIRATION I LIMITS GENERAL LIABILITY 035699 11/07/2010 - 11/07/2011 I EACH OCCURRENCE $ 1,000,000 RENTED DAMAGE TO $ 500,000 COMMERCIAL GENERAL LIABILITY ,. PREMISES (Ea occurrence) A CLAIMS MADE X OCCUR - MED EXP (Any one person) $ 10,000 X PERSONAL&ADV INJURY $ 1,000,000 j I GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE_ LIMIT APPLIES PER:. PRODUCTS - COMPIOP AGG : $ 2,000,000 POLICY PRO- � LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS j BODILY INJURY $ NON -OWNED AUTOS (Per accident) PROPERTY DAMAGE $ . (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ _ - _ ANY AUTOi 'OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS /UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR 171 CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY YIN i TORY LIMITS ER . . ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? E.L. EACH ACCIDENT $ - (Mandatory In NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under - -" SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ OTHER i DESCRIPTION OF OPERATIONS 1 LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CFRTIFICATF HAI nFR CANCFI 1 ATIAN AGORD 25 (2009101) ©1988-2009 AC RO CORPORATION. All rights reserved. INS025 (200801) The ACORD name and logo are registered marks of ACOR SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Stuart Thompson DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN 740 Fourth St. NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL North Andover, MA 01845 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Ted Noyes AGORD 25 (2009101) ©1988-2009 AC RO CORPORATION. All rights reserved. INS025 (200801) The ACORD name and logo are registered marks of ACOR The Commonwealth of Massachusetts I Department of Industrial Accidents j„P�w '� Office of Investigations .s 600 Washington Street w e4 f Boston, MA 02111 *.� www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please PrinfLejZib1Y Name (Business/Organization/Individual): Address: _S kA City/State/Zip: S\ Phone #: q 72 >�tq o A 0! Are you an employer? Check the appropriate box: 1. ❑ I am a employer with 4. ❑ I am a general contractor and I (full and/or part-time).* have hired the sub -contractors �,�employees 2. I� 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. ❑ I am a homeowner doing all work right of exemption per MGL myself. [No workers' comp. c. 152, § 1(4), and we have no insurance required.] employees. [No workers' comp. insurance required.] Type of project (required): 6. ❑ New construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10.0 Electrical repairs or additions 11.0 Plumbing repairs or additions 12. E] Roof repairs 13.❑ Other *Any applicant that checks box # 1 must also fill out the section below showing their workers' compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub -contractors acid their workers' comp. policy information. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy # or Self -ins. Lic. #: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the fonn 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. I do hereby certify under the pains andpenalties ofpeijury that the information provided above is true and correct.' Signature: 11 � Date: 1/ I&/'/ 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 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 foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the owner,of a,dwelling house having not more.than three aparhrienis 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 452, §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 perfonnance 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-contractor(s) name(s), address(es) and phone numbers) along with their certificate(s) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you Have any questions regarding the law or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Deparhnent has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the pen-nit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in.any given year, need only submit one affidavit indicating current policy information (if necessary) and under "Job Site Address" the applicant should write "all locations in (city or town)." A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future pen -nits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or pen -nit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.) said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax # 617-727-7749 Revised 5-26-05 www.mass.gov/dia Massachusetts Rome IniDrovement Sample Contract This (form satisfies all basic 'requirements of the state's Home Imps 'vemeuit Coniractor Law MGL chapter ° ( pt r 14_A), but does not include standard language to protect homeowners. Seek legal advice If i I g necessary. An} person planning home improvements should first obtain a co of"a lviussachosetts consumer guide to home improvement" before agreeing to any work on your residence. You may obtain a free co b PY . Office of Consumer Affairs and Business Regulation's Consumer copy y calling the Information Hotline at Information Romeowne Information r- l,,,� prI . ams ' omp;3ny ams . -7 0 ' S eel -Address (do not use a Post Office Box address) Contntctorl Salesperson/ OwnerNtime 474- 0 Cityrl awn State Zit Code usiMss Address (must include a street address) Daytime Pbone Evening Phone i rrown n' State - -•-Zip Code ' Mailing Address (It different from above)Kir M Business Phan 0 al Employer ID or S.S. Number , . isW- Wre°that most homdw- Home provemeatconhactorReg.Nmaber pvrmeot cont8spmtiandste • , contractors have s and re&tmtion mamber ' The Contractor agrees in do the "following wort: for the Homeo ner: crt e m a Woric o comp e e specs g e e, ran ,Wu glaut: ul mat n s o e on ece s Regaired.'Eermits - The followinj"buildiirg permits are required Proposed Start nod Completion Schedule - The fpllowing schedule will and ��yyil1 be secured by the contractor as the homeowner's agent, be adhered to unless circumstances beyond the contractoYs control arise (0 ners who secure their own permits wiU be exelpded from, the Guarant}i Fund provisions' of t 2. t t Date when contractorwill begin contracted work. MGL chapter 142A.) ' Z !%, !! Date when contracted work will be substantially completed. Total Contract Price and Payment Schedule ' The Contractor agrees'to perform the work, furnish the material and labor specifiedabove for itis total sum of: ZOO , O O O M Payrrieirts 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) ao UO d by - -/�/� or upon compledon-'of R. c+c� 5 .00 Oa • by `/_I_ • or upon completion of r' y t,� n n ..0 �6 �•� o $ D D ° upon completion of the contract (Law forbids demanding full payment until contract is completed to both parry's satisfaction) The following material/equipment must be special $ to be paid for ordered before the contracted worl'begins in order S to be paid for to meet the completion schedule.(**) 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. - -- - , es tut terms of the warrnn . s be attached o the contract Subebntractars - Tlie coritractor agrees to be solely responsible for completion of the work described regardless of the actions of any third paity{subcontractor utilized by the contractor. The contractor further agree$ to be solely'resp materials and labor under this- agreement hnsible 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 carefully before signing this contrack contract shall not imply that any lien or other security inter esthas 'been placed on the residence. Review the following cautions and notices • Don't be pressured into signing the contract Take time to read and fully understand it. Ask questions if something is unclear. • ' 1_Iake sure the contractor hoc a valid Home improvement Contractor .ertistmtion The law requires most home improvement contractors and subcontractors to be registered with the Director of Home It iprovement Contractor Registration. You may inquire about contractor registration bywriting to the Director at One Ashburton Place, Room 1301, Boston, MA 02108 or by calling 617-727-3200 or I�800-223-0933. • Does the contractor have insurance? Check to see that your contractor is properly insured. • Know your rights and responsibilities. Read the Important Inforiantion on the reverse side of this form and g Guide to the Home- Improvement Contractor Law. . • •et a copy of the Consumer > You may cancel this agreement if it has been signed at i placc other• than the contractor'& 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 delidery, 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!!! Two idcrincat copi of the•contract must be completed and signed. One cagy should go to• thb hoincowncr. The other copy should be kept by tha contractor. Homeowner's Signature Contractor's Signature Date / l t Dat -0 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 affordeq 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 h6meowuer 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 f, , 'which has been apprpved, by the Secretary. of the- Executive offlce. of Consumer Affairs and Business Regulation and the consumer shall. be.required to submit wto such arb' ation.as provided In Massachusetts General Laws,,chapter 142A. ome;�oGee ...s Signature Co tractor'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 signed by the parties. 'Homeowner!s Rights ' A homeowner's rights under the Home Improvement Contractor Law (MGLchapter 142A) and other consumer ' Protection laws (i.e, lVl!'iL chapter 93A).may not be waived in any way, may be excluded. from certain rights if the contractor they choos, is not properly registered' dent'-as p� es ribed by law: homeowners Homeowners who secure their own building permits are automatically excluded from all Guarantylyund 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 fi iplieii warranty of merchantability and fitness for a particdlar Purpose; An enumeration of other matters -on whichthe homeowner and contractor lawfully agree maybe added to the term's 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 Iinformatiori Hotline (listed below). Execution of 'Contract t. The contract must be executed in dulicate 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 tie given to the owner,'and the other kep(by the contractor: Anyjmodificationto the original contract must be in writing and agreed to by both parties. Contracted work may notbegin until both parties have received a fully executed copy of the contract; and the three day. recissiou period has expired. Accelerated Payinents 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 liimR erself -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 wor1L• Withdrawal of funds from said account -would require the signatures ofbothparties, Additional Information If you have general questions or need additional information about the Home Improvement Contractor Law or other consumer rights, or iiyou wish to obtain a free copy .of "A Consumer Guide to the Home Improvement Contractor Law," contact: Guide. Consumer Information Hotline Office of Consumer Affairs and Bus iness'Regulation .10 Park Plaza, Room 5170, Boston, MA 02116 (617) 973-8787'oa• 1,(8'88) 2833757 If you want to verify the registration of a contractor or if you have questions or need about the contractor registration component of the Home' Improvement Con ed additional information specifyally Contractor Law, contact: Director of Home Improvement Contractor Registration Bureau ofBuilding Regulations and Standards ! One -Ashburton Place, koom•1301, Boston, MA 02108 (617) 727-3200 or 1-800-223-0933. For assistance with informal mediation of disputes or to register formal complaints against g rest a business, call: Consumer Complaint Section Office of the Attorirey General r (617) 727-8400 ^ AND/OR -Better Business Bureau (508) 652-4800 .(508) 755-2548 (413) 734-3114