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HomeMy WebLinkAboutBuilding Permit #788 - 80 LACONIA CIRCLE 5/1/2012Permit NO:'—) OWNER: Address: P T ZA TOFZj _, I BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received OFWORK TO BE PREFORMED: <. I J &I A A I ' \." C' -1 Dfy)( -s Please Type or Print Clearly) 6 x WA- ii! Phon'0-3, k - ..... �Qwd--- E-) 0-_i, C0e - -a t -! ...... Y-7 , 7 1W11- q Phone:_ZcrS - 4�4 - 43 ARCHITECT/ENGINEER 7EW—�4,e— L.54,tAVJA� Address: &g1t,4e-1 + 6M Reg. No.-P)I5� FEE SCHEDULE: BOLDING PERMIT.- $12-00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. $ FEE: $ 0 Total Project Cost: Check No.: Receipt No.: -2 unregistered contractors do not h NOTE: Persons contractin 11th ri. uunfreggIs have accfsto the guarantyfund� . r 0 c0 Fr 46 A NO Plans Submitted 11 Plans Waived 11 Certified Plot Plan D Stamped Plans 11 TYPE OF SEWERAGE DISPOSAL Public Sewer El Tanning/Massage/Body Art El Swimming Pools El Well El Tobacco Sales El Food Packaging/Sales El Private (septic tank, etc. El Permanent Dumpster on Site El THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT n [I — COMMENTS CONSERVATION COMMENTS Reviewed on I --( / / a Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decisi Comments Water & Sewer Connection/Signature & Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street ribh-siffi- 7- '­j 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: lies 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 40TE: 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 VOTE: 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 Li 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 M OTE: 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 DEPARTM ENTMFORM07 Revised 2.2008 Location0y l �law-,14 l //l No 7" O Date Check 41-0 iJ —3 25253 TOWN OF NORTH ANDOVER Certificate of Occupancy * $ Building/Frame Permit Fee $_07 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Building Inspector i Ch o c t e- 'O a1 C! ��„ Q n' 1 .x /A Q �+s � iJ ODi ti- G SA d 1 ap N g a o a cn U t4� �. r CL10 ci ea C •' Q � Q. � Lt. S7 r ` \ / 6 ���' / it : • � `••7•• a � +L I q m f D u � 'ti3 � � �• j M f L � `� a io cO x aj r l4 i m _ � m � L y x' � • �, � cz. S • � � a C'l ¢ L a� 01 0 x a �p o c SQL CK, ! + L sr *O co O , • �� i1 a l of . \� CO c� U ti�.< +• 416 r O G M. + 6' • �.. 0., Permit NO: Date Issued BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received IMPORTANT: Applic �wl _Zl "tA @ _5 E PARCELS Z@NIN J must complete all items on this page twf"" a1J fa rC1 t V 'rine tit '- �Y:Z, 3 .-ves TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building 0 One family 0 Addition 11 Two or more family 11 Industrial 0 Alteration No. of units: D Commercial 0 Repair, replacement D Assessory Bldg 11 Others: D Demolition 11 Other —W ❑ Septic, M j, 61 d6do MiWetldiids' 'E ... Mt-mlibal i8tribt DESUKIP I 1UN Ul- VVUKM I u r5c rmcrunivirmu. Identification Please Type or Print Clearly) 6R_5C13 OWNER: Name:— P;�Ap__ Phone: . I J.- - - _. / -As g,"111 N r _l fT �n n rl &AAz uee-, (n I t A Tnt R(IN M 04� (,f A6 - A, 's W oi! i pej��flsoris ��O P. Exp q C 1.4 ILV ur 9 4<;;4 ARCHITECT/ENGINEER L'44) Phone:WS- -3/�(S4lIC Address: Reg. NoAP_)B rcell) FEE SCHEDULE., BULDING PERMIT. $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost: $ FEE: $ 00 — Check No.: Receipt No.: NOTE: Persons contracti7111th unregistered'unregistered'contractors do not have aco s /to the guarantyfund V W, Plans Submitted ❑ Plans Waived 11 Certified Plot Plan D Stamped Plans 11 TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Sw'mming Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales El Private (septic tank, etc. El Permanent Dumpster on Site El THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT El El COMMENT CONSERVATION Reviewed on � )•�O) )9- Signature q-1 COMMENTS ?-� � - [ 1-(q 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 RTKE-Dum NTft T IL ti, 4'-N F men Wgn6tQ"rd1d9t-" -J4 L -fir s 6tr. 'zhi V -14V CERTIF/ED FOUNDATION PLAN LOCATED IN ► SCALE.7 11- 4-01 DATE' Li)u6 S.L.G/LES R.L.S. LAWRENCE a NORTH ANDOIER „ sa � l � `i • • D CSA (rJ ,�?,. • 11;0ol 1� / CERT/FY THAT THE OFFSETS SHOWN ARE FOR THE USE OF OFFSETS SHOWN THE BU/LD/NG INSPECTOR ONL Y 8 SUCH CONFORM TO THE USE /S FOR DETERMINATION OFZON/NG;; a 912 a ♦ y ZONING B Y L A W OF CONFORM/7y OR NON CONFORM/T Y WHEN CONS TRUCTEO t .4`o!eo® CERTIFICATE OF LIABILITY INSURANCE 4/251 oil ' 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(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terns 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 FIAT/Cross Ins -Manchester 1100 Elm Street Manchester NH 03101 NAONMEACT Sandra Gargano PHONE (603) 669-3218 FAX o. (603)645-4331 E AIL :sgargano@crossagency.com INSURER(S) AFFORDING COVERAGE NAIC A INSURERANational Fire Ins CO of INSURED South Shore Gunite Pools and Spas Inc 7 Progress Avenue Chelmsford MA 01824-3606 INSURER B :American Alternative Ins. Corp INSURERC: INSURER 0: INSURER E : INSURER F: COVERAGES CERTIFICATE NUMBER:SSG Master 12-13 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 AWL SUBR POLICY NUMBER POLICY EFF M POLICY EXP MMIDD LIMITS GENERAL UABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE RE TED PREMISES Ea occurrence $ 100,000 A CLAIMS -MADE OCCUR 1 NS4013391907 /1/2012 /1/2013 MED EXP (Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 X CG0001 12/07 GENERAL AGGREGATE $ 2,000,000 _ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 $ RO LOC POLICYFX] PIFCT AUTOMOBILE LIABILITY COMED SINGLE LIMIT Ea aBINent 1,000,000 BODILY INJURY (Per person) $ A X ANY AUTO BODILY INJURY (Per accident) $ ALLOWNED SCHEDULED SAP4013391888 /1/2012 /1/2013 AUTOS NUTOS PROPERTY DAMAGE $ (par. t) ON -OWNED SAP4015536568 /1/2012 /1/2013 HIRED AUTOS AUTOS limit $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 B EXCESS LJAB CLAIMS -MADE DED I X I RETENTION$ 10,OOC $ 82A2UB0000865-00 /1/2012 /1/2013 • WORKERS COMPENSATIONX WC STAT%- OTI AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNERIEXECUTIVE E.L. EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N I A KC4013391891 /1/2012 /1/2013 E.L. DISEASE- EA EMPLOYE $ 11000,000 If yes, describe under DESCRIPTION OF OPERATIONS below $), , CT, RI , ME , VT E.L. DISEASE - POLICY LIMIT S 1,000,000 A Limited Pollution INS4013391907 /1/2012 /1/2013 Occurrence $1,000,000 Worksites Liability DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If mon space is required) Covering swimming pool construction/related operations of the named isnured during policy term. Ia The Jenkins Residence 80 Laconia Circle North Andover, MA 01845 25(20101051 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 Sandra Gargano/SG5 ©1988-2010 ACORD CORPORATION. All rights reserved. INS025 nnlnns) nt Tho Arnpn mama Anel Innn gra ranie4arari mnrira of A('npn t9—* L"' a x p m O0 L2 V)b J) U � A C x o w a bo w w w v U) w" x p cn p a4 G u. z � a w c w cn z �i cn v Q O cn c o � c N � � C "~ O v V CLC CD r O CD 4,OYfd,xy V m i w m Y= O 0 CL m 10" E E O L �Q O m corA O o c CL= N � CD m O �: N N CD 3 m � �m ;s c N O N mo > acs - N m m CMO Q /ate_ 4 C0.1cc 'J v 0 O O . C. Q i t m c CD m=3 CL. H 0 N m Z. W C �yL..'flt O c r � •fNA da O c LU , — 4- ui E ca IS N C.3 m p ® C Vi d O 'O 0:8 Z W . 2 y �0 t— L w CL m N W W N The Commonwealth of Massachusetts Department of Industrial Accidents ;17,Office of Investigations 600 Washington Street 4i r Boston, MA 02111 is www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers nolicant Information Please Print Le2ibl, Name (Business/Organization/Individual): Address: f OCA t_Q2 City/State/Zip: LA8L L:L5- Are you an employer? Check the appr 1. KI am a employer with 1-3c) employees (full and/or part-time).* ?. ❑ I am a sole proprietor or partner- ship and have no employees working for me in any capacity. [No workers' comp. insurance required.] 3. ❑ I am a homeowner doing all work myself. [No workers' comp. insurance required.] t Phone #: (Z63" iate box: 4. ❑ I am a general contractor and I have hired the sub -contractors listed on the attached sheet. These sub -contractors have employees and have workers' comp. insurance.$ 5. ❑ We are a corporation and its officers have exercised their right of exemption per MGL c. 152, §1(4), and we have no employees. [No workers' comp. insurance required.] Type of project (required): 6. ❑ New construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10.❑ Electrical repairs or aciclitions 11.❑ Plumbing repairs or additions 12.❑ Roof repairs 1V .3.Other (r (U(44 -(A `Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. ' 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 and state whether or not those entities have employees. If the sub -contractors have employees, they must provide their workers' comp. policy number. 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.#: W L ' O" S39 L1u 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 51,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a tine of up to 5250.00 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 and penalties of perjury that the information provided above is true and correct. =LftA%JO 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 #: [] ❑ c V > °• a� n-4(nU) =r C) O CD �0O2 CD OU)arj) D= DZO > Dm O AO IM N Z IM O O r- m m m x a. o v o 7 � 7 C J -4 N C coo N CD 7 n A) CL o, s cn OO C H `d O CD cn H� O LA O S .m cD- O � Q M x m Y M L3. N cA °, C Baa oy N Z o -u > > r+� m U � 0 m 10 0 3 O 3 , > A O 13 01) m Z m r o to 0 1?0 1 j (i >c _ Z r n o n (" o h m O � QI K d a [] ❑ c V > °• a� n-4(nU) =r C) O CD �0O2 CD OU)arj) D= DZO > Dm O AO IM N Z IM O O r- m m m x a. o v o 7 � 7 C J -4 N C coo N CD 7 n A) CL o, OO C H `d O CD M 0 Ew 0 H� O LA lO: tnt CL En CD • Q� N cA CD �t O • 10 O• I) Iuu9alvilt -pt Public satco 1 board cif Buildin,Rr_ulations ;mil 4cuulanl% Construction Supervisor L+cense License: CS 56070 Restricted to: 00 ROBERT € GUARINO 7 PROGRESS AVE CHELMSFORD, MA 01824 Expirelwn_ 511312dt2 t omei.aHnrt Tr'4: 25" :Iouth Shore Gunite Pool & Spa, Inc, 2 of Progress Avenue • Chelmsford, MA 01824 1-800-649-8080 THE GENERAL TERMS AND CONDITIONS ON THE REVERSE SIDE ARE PART OF THIS AGREEMENT EXHIBIT A SWIMMING POOL CONSTRUCTION AGREEMENT (BETWEEN "CONTRACTOR" AND "BUYER") NAME (Buyer) MAIL ADDRESS '� Q t-- A -O rJ ( A �G� e-C'I �i CITY JOB ADDRESS HOME PHONE E-MAIL POOL SIZE CITY BUS. PHONE CELLPHONE Ca STATE_ ZIP STATE ZIP DEPTH �3� -� SURFACE AREA + PERIMETER 1) Engineered structural plans and working drawings..............................................................Included 2) Swimming pool construction permits, as required by state and local code ....................*** o 3) Established shape, location and elevation prior to excavation of swimming pool ..............................Included 4) Normal excavation of pool, removal of soil, and placement of wood frame work (up to 8 hours) ..........Included Additional Excavation $200.00 per hour 4 hour minimum. 5) Engineered steel reinforcing throughout pool ....................Included 6) Engineered concrete, gunite structure to meet or exceed state local codes..................................................................Included 7) Water cure gunite shell twice daily for 7 days ................By Owner 8) One set of shallow end steps with 4 ft. bench ................ .InI dT 9) Swimout deep end �l L1 � 10) Stumps, concrete, or other debris removal ..............111 -T,ACldb� 11) One 6" band waterline, frostproof tile .................. �t+ 12) Coping .................. ( , 12A) Coping Material �" �✓ 12B) Coping Color .................. 12C) ............... 13) Interior finish to be water proof 13A) Interior finish material AA4! r ,iX............ �J 13B) Interior finish color WkstKe, C&0--1 ......... 13C) .................. 14) Filling of pool within 24 hrs ..........................By Owner FILTER SPECIFICATIONS l 15) Filter manufacturer .4–' - . .............. 15A) Filter size 2>0 0 S� .................. L11- 16) Pump manufacturer S�A . 16A) Pump Size S Ov \Is, - SSS .................. l(, 17) U.L. listed exterior timing control....................................*Included 18) Complete hookup of all pool lines to filter ........................Included HEATER SPECIFICATIONS 19) Approved Heater type Fuel 19A) Heater BTU ratinb ------ Indoor -----Outdoor---- 20) Water lines to heater connected by contractor ....................Included 21) Fuel connections, venting and fuel permits ....................By Qwner 22) Heater other: AC)A �;N Ak - - S .......... � C� JKA, PLUMBING SPECIFICATIONS 23) Non corrosive plumbing and fittings throughout ............*Included 24) Self adjusting surface skimmer........................................*Included 25) Pressure return outlets to pool..........................................*Included 26) Main drain receptacle with grate ........................................Included 27) Max. piping between filter and pool, 25 ft ........................Inclu ed�j( �j, 28) Additional piping @ 35� per ft ........ (y,S�{�_�tL�`' ik AUTOMATIC POOL CLEANER AND CIRCULATION 29) Floor recirculation --------- ................ 30) Deluxe PCC2000 W/leaf canister ................* =i,i r 31) Pool Cleaner, other -:5:Z au DISINFECTION SYSTEM / I I ' 32) TypeTj4M-T W\/ W�/ AAa.................*lo( i t; 1 -rP 15 1) (,J A-Ary?G, W 1 h MISCELLANEOUS SPECIFICATIONS 33) U.L. Approved marine u derwater light 50' cord 120 Volt ..Q).. k . ............... 34) U.L. Approved deck box and conduit for light .......... 35) Diving board size Color .......... 36) Ladder type-- -- .......... 37) Stainless steel step rail, figure 4 ................................ 38) Electrical................................................................... 39) Pool motors, clocks & switches ................................. 39A) Bonding of steel reinforcement ................................. 40) Bonding of deck wire ................................................. 40A) ; ;Li c kA Cl� �` ���"p ................. 41) Safety rope and floats ................................................ 42) Property damage negligence insurance during construction .................................... 43) Public liability and workmen's .....*Included .....*Included * �-L�-1� LC l, ; .Included .......Included compensation insurance ......................................................Included 44) State and federal sales tax ..................................................Included 45) Written lifetime structural guarantee ..................................Included 46) Attac e Separate. .................. 46A) Size .... .......... 46B) Spa light 120 volt w/50' cor .. ............ 46C) Spa control .................. 46................ TV P% A JUIAX, LL' LVL' Vl\ Vl\JV11L-1LLL` 0"Iu %-"I I"111"1\J r rLyulATi 47) —tons of crushed stone @ $ ..................�c.�_ 47A) Additional stone at $- Per 18 ton load ........"iti+C� _c4c 47B) Water or unsuitable soil conditions, 18 to 20 tons of crushed stone at $ per load�S� .................. /U94'"�l C� Additional stone at $ per load GRADING 48) Rough backfill to pipe grade 1p �C`.v. Li►:... 49) Gravel for under deck (if necessary) ..................By Owner 50) Grading & compacting of deck area up to hours.... P) L START UP MAINTENANCE 51) Deluxe cleaning tools (wall brush, leaf skimmer, pole, vacuum head and hose, test kit, thermometer) ..................Included 52) Start up and operations instructions....................................Included 53) Start up and balance chemicals ..........................................Included 54) Daily testing & adjustment of ph level ............................By owner 55) Brushing of interior surface after pool is filled with water....................................................By owner - Depending on interior finish , brushing will be 1 to 2 times daily * 5 year parts and labor warranty ** Filter has a 5 year warranty - Filter tank has a 10 year warranty *** Refer to exhibit B on back of contract THIS CONTRACT PRICE IN VALID FOR 45 DAYS Contractor Renrecentative Dnh, ArrPntPrl � '7 )I �•�" l� Homeowner Information SOUTH SHORE GUN- : POOL & SPA, INC. SWIMMING POOL - Horne Improvement Contract Contractor Information I of 2 Company Name South Shore Gunite Pool & Spa, Inc. Name v Contractor/Owner Name Street Address (Not Post Office Box) City/Torn State Zip Code Mailing Address (If Different from above) City,'Town State Daytime Phone Evening Phone 04-3146507 Cell Phone C \/\ �J, s Fax Number c,v�m E-mail Address Contractor Information I of 2 Company Name South Shore Gunite Pool & Spa, Inc. Contractor/Owner Name 7 Progress Avenue Business Street Address Chelmsford MA 0 182 4 City,'Town State Zip Code 800-649-8080 04-3146507 Business Phone Federal Employer ID Contractor is also referred to as "Seller" herein for some purposes Salesperson(s):Contractor Registration #: 105485 Exp. Date WORK TO BE PERFORMED AND MATERIALS TO BE USED Contractor Agrees To Do the Following Work for Homeowner: Contractor will build an inground swimming pool to be located at in accordance with the drawinl?s and specifications which are or shall be attached hereto as Exhibit A, and in accordance with the provisions of Exhibit B Materials Expected To Be Used: The Contractor expects to use the materials which are or shall be specified in Exhibit A and those which may be needed under the provisions of Exhibit B. The rollon•ing schedrde will be adhered to unless circumstances beyond the contractor's control arise: Work Scheduled to Begin:_/_��/ '2�'L Expected Date Of Completion: (Date Contractor will begin contracted work) (Date when contracted work will be si—stantial'IyRo:;m�pleted) TOTAL CONTRACT PRICE AND PAYMENT SCHEDULE The Contractor agrees to perform the work, famish the material and labor specified above for the SUM of: S `)40 (*Include all finance charges in this amount Payments will be made according to the following SCHEDULE: S 7,_P- upon signing contract (*Not to exceed 1/3 of the total contract price OR the cost of special order items, whichever is greater*) 400'0 OF CONTRACT DUE DAY OF EXCAVATION S/_ 7 — 1500 OF CONTRACT DUE DAY OF TILE $ lJ r - In order to meet the completion schedule, the following material/equipment must be special 40% OF CONTRACT DUE DAY OF GUNITE S 1__,2) 40% Ct-/ ;5% OF CONTRACT DUE DAY OF FILTER & PUMP START UP:1 1(�7c( to be paid for the contracted work begins DO NOT S GN THIS CONTRACT IF THERE ARE ANY BLANK SPACES Identical copies of the contract should go to the home rand e contVffN Homeowner's Signature C o`atractor tgnature . - -- ate Date / � You may cancel this agreement if it has been signed by a party thereto at a place other than an address of the seller, (the contractor) which may be his main office or branch thereof, provided you notif\ the seller in writing at his main office or branch by ordinary mail posted, by telegram sent or by delivery, not later than midnight of the third business day following the signing of the agreement j See attached notice of cancellation for an explanation of this right. REQUIRED PERMITS The following building permits are required. It is the obligation of the contractor to secure such permits as the homeonwer's agent: PLEASE REFER TO EXHIBIT B AGREED CONDITIONS PARAGRAPH 3 NOTE: Owners who secure their own permits or deal with unregistered contractors are excluded from the Guaranty Fund provisions of MGL c. 142A. Is an EXPRESS WARRANTY being provided by the contractor? NO ES **AII terms o he rranty must be attached to the contract** NOTE: All home improvement contractors and subcontractors shall be registered and any inquiries about a contractor or subcontractor relating to a registration should be directed to: Director, Home Improvement Contractor Registration One Ashburton Place, Room 1301 Boston, MA 02108 617-727-8598 ARBITRATION 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 such dispute to a private arbitration service which has been approved by the Secretary of the Executive Office of Consumer Affairs and Bu�i�tess Regulations and the consumer shall be required to sub- mit to such arbitration as Provided.i&M.G.L.c. 142A. / , Contractor: �`�+ Homeowner: Date: `. + % V5 17,Q I -L, (This clause is optional, cross o t if nota plicable) Date: Lt I Contractor's Financial Insecurity — In instances where a contractor deems him/herself to be financially insecure, that is the contractor believes the payment of funds due him may be in jeopardy, 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 from said account would require the signatures of both parties. THE CONTRACT MUST ALSO CONTAIN: 1) A Complete Description of any other documents which are part of the agreement; 2) A List and Description of other matters upon which the contractor and homeowner lawfully agree; 3) Any Other Provisions otherwise required by applicable laws of the Commonwealth.