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Home My WebLink AboutBuilding Permit #369-14 - 80 OLD FARM ROAD 10/21/2013 TOWN OF NORTH ANDOVER �PPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued: \ ��I,MPOR ANT:Applicant must complete all items on this page LOCATION 01A 4h,vv -'�_ - [_ Print PROPERTY OWNER De,6O1�a"A TU1VA_aA f Print 100 Year Old Structure yes no MAP N031,�^ PARCEL:&— ZONING DISTRICT: Historic District y no Machine Shop Village ye no TYPE OF IMPROVEMENT. PROPOSED USE Residential Non- Residential ❑ New Building )40ne family ❑Addition ❑Two or more family ❑ Industrial Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District ❑Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: Id n ification Please Type or Print Clearly) OWNER: Name: +D�c -ZAP;\� f Phone: Address: CONTRACTOR Name: , UgypLA Phone: 7 �F/ Address: Supervisor's Construction License:_D y q Cy C0 Exp. Date: Home Improvement License: Z 3 Exp. Date: �3 ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BULD/NG PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ FEE: $ Check No.: Receipt No.:��` Q 14 NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner Signature of contractor Plans Submitted Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ r Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ .-TYPE:OYSEWERAGE DiSP.OSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑ Well ❑ Tobacco.Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc.. ❑ - Permanent Dumpster on Site ❑ THE.FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE.APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS 1 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 To-,,v;! Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT - Temp Dumpster on site yes no Located'at 124 Mair Street-Fire-06parthnerit signature/date COMMENTS Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions._ .Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A-F and G min.$100-$1000.fine NOTES and DATA— For department use ® Notified for pickup - Date { I Doc.Building Permit Revised 2010 c Building Department The foi?owing is=aii'st of the required forms to be"filled out for the appropriate permit to be obtained. Roofivg, 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 o Workers Comp Affidavit ❑ Two Sets of Building PlansReturned To Be One ( ) 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 cans 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.+.ted with the building application Doc: Doc.Building permit Revised 2012 . I Location No. � ' Date /0 . - TOWN OF NORTH ANDOVER • • Certificate of Occupancy $ Building/Frame Permit Fqe $ � Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check# � Building Inspector Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost $ 35,270.00 m $ - $ 423.24 Plumbing Fee $ 52.91 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 52.91 Total fees collected $ 629.05 80 Old Farm Road 369-14 on 10/21/2013 Master and 1/2 Bath Reno CERTIFICATE OF LIABILITY INSURANCE 0/2;/2013°"YYY' ACOl2/7' 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 CONTACT Paychex Insurance.Agency Inc PAYCHEX INSURANCE AGENCY,INC. PHONE 877-266 6$50 FAX 585 389-7426 150 SAWGRASS DRIVE ROCHESTER,NY 14620 E-MAIL Certs@paychex.com INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A: Wesco Insurance Company WESC JEFF L VEGLIA INSURER B: JEFFREY VEGLIA CONTRACTING 33 EDWARD AVE INSURER C: LYNNFIELD,MA 01940 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. NS TYPE OF INSURANCE DDL SR U p POLICY NUMBER POLICY EFF POLICY EXP LIMITS TR N (MMIDD/YYYY) MMIDD/YYYY) GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITYES 1. DAMAGE TO RENTED $ CLAIMS-MADE[:: MED FRCP(Any one person) $ -- PERSONAL 8 ADV INJURY $ GENERAL AGGREGATE $ ENL AGGREGATE LIMIT APPLIES PER: POLICY =PROJECT=LOC PRODUCTS-COMP/OP AGG $ $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY nuro (En accident) $ BODILY INJURY ALL OWNED SCHEDULED Person) AUTOS AVTOS (Per $ NDN-OWNED BODILY INJURY $ HIRED AVTOS AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) $ _UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS-MAUE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION AND WC STAN- 071/- EMPLOY—LUB,urY WWC3070084 10/26/2013 10/26/2014 X H_ E.L.EACH ACCIDENT $ 100,000.00 ANY PROPRIETOFLIPARTNER/EXEGUTIVE — — OFFICEWMEMBER EXCLUDED? JN E.L.DISEASE-EA EMPLOYEE $ 100,000.00 (Mandatory In NR) Y N/A E.L.DISEASE-POLICY LIMIT $ 500,000.00 If yes,dnsMM under DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION JEFF L VEGLIA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION JEFFREY VEGLIA CONTRACTING DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY 33 EDWARD AVE PROVISIONS,BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LYNNFIELD,MA 01940 LIABILITY OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE I ACORD 25(2010/05) / 01988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD The Commonwealth of Massachusetts Department of IndustrialAccidihts Office of Investigations 600 Washington Street Boston,MA.02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): 0 Address: ffi-,(e City/State/Zip: 4L t Phone#: Are you an employer?Check the appropriate box: Type of project(required): 1.W am a employer with 1 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have Hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. E]Remodeling ship and'have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers' comp.insurance. 9. ❑Building addition [No workers' comp.insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.F1 Electrical repairs or additions 3.❑ 1 am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself. [No workers' comp. c. 152,§1(4),and we have no 12.0 Roof repairs insurance required.]t employees.[No workers' comp.insurance required.] 13.❑ Other *Any applicant that checks box 01 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they time doing all work and then hire outside contractors must submit a new affidavit indicating such. TContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. lam an employer that is providing workers'compensation insurance for my employees. Below is thepolicy anal job site information. Insurance Company Name:. Policy#or Self-ins.Lie.9-.") w Expiration Date: C) Job Site Address: �2 Old 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 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. Ido hereby certo uncle t1 a arns and penalties ofperjury that the information provided above is true and correct. Si ature: Date: A/ J 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 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)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 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 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 bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA.02111 Tel,#617-727_4900 ext 406 or 1-877 MMASSAFE Revised 5-26-05 Fax#617-727-7749 www.mass,gov1dia SEE ATTACHED ADDENDUM—SCOPE OF WORK Article 3. Limited Warranties Contractor will complete the specified work in a substantial and workmanlike manner according to standard practices prevalent in Contractor's trade. Contractor warrants,that the specified work will comply with all applicable building codes and regulations. Contractor warrants that the labor and materials provided as part of the specified work will be free from defects for 365 days from the date of completion. Article 4. Price $35,270.00 Any unforeseen problems or conditions could result in a price adjustment. All abutted walls to bathrooms should be inspected before work begins. Work from start to finish should be around 6-8 weeks with no unforeseen problems. Payment schedule : • Deposit to start $12,000.00 Plus materials if requested. • After plaster $12,000.00 • Final $11,270.00 Materials bought through Jeff Veglia Remodeling suppliers are to be paid upon ordering. A check for$3,500 is due as Jeff Veglia Remodeling put deposit down mid September to Republic Plumbing to order materials for 80 Old Farm Rd,N. Andover project. Please make all checks payable to Jeff Veglia Remodeling. I HAVE READ AND ACCEPTED THIS CONTRACT INCLUDING ADDENDUM: SCOPE OF WORK (ATTACHED) X Q n DATE /v p Deborah W. James X ` DATE U 16/13 Jeff Ve is 2 NO R T!� Town of o . 0 No. - ti s h ver Mass � COCNIC.,.'CN y7• p°RATED �PP •cy s � BOARD OF HEALTH PERMI T D Food/Kitchen Septic System THIS CERTIFIES THAT ..... T� l �iw�...,.... .... . .,�..� .... BUILDING INSPECTOR ....... .Z .. ............................... ... \�. �.� Foundation has permission to erect .......................... buildings on .. .... ..... ..................... / e Rough to be occupied as .�.1....... �. ...... �... ......... .. ...... .. ...•............................ Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application Final on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection,Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final PERMIT EXPIRES IN 6 MONTHS T ELECTRICAL INSPECTOR UNLESS CONSTRUKIDN ST Rough Service ......... ........ ........... .............. Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. SEE REVERSE SIDE ACORD CERTIFICATE OF LIABILITY INSURANCE 110/05/121DD/YY) 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 COMPANIES AFFORDING COVERAGE PAYCHEX INSURANCE AGENCY,INC. CO AAM 150 SAWGRASS DRIVE Technology Insurance Company ROCHESTER,NY 14620 COMPANY 877-266-6850 INSURED COMPANY JEFF L VEGLIA C 33 EDWARD AVE LYNNFIELD,MA 01940 COMPANY D 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. O TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS DATE(MM/DD/YY) DATE(MM/DD/YY) GENERAL LIABILITY GENERAL AGGREGATE $ COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG $ CLAIMS MADE OCCUR PERSONAL&ADV INJURY $ OWNER'S&CONTRACTOR'S PROT EACH OCCURRENCE $ FIRE DAMAGE(Any one fire) $ MED EXP(Any one person) $ AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT $ ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN AUTO ONLY: EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ UMBRELLA FORM AGGREGATE $ OTHER THAN UMBRELLA FORM $ WC TATU- WORKER'S COMPENSATION AND XTORSI oER EMPLOYERS'LIABILITY TWC3329696 10/26/12 10/26/13 EL EACH ACCIDENT $ 100,000.00 THE PROPRIETOR/ INCL EL DISEASE-POLICY LIMIT $ 500,000.00 PARTNERSIEXECUTIVE OFFICERS ARE: X�EXCL EL DISEASE-EA EMPLOYEEI$ 100,000.00 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION JEFFREY L VEGLIA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS,BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE _ d Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 129331 Type: Individual Expiration: 8/13/2015 Tr# 241461 Jeffrey L. Veglia Jeffrey Veglia 33 EDWARD AVE. LYNNFIELD, MA 01940 Update Address and return card.Mark reason for change. SCA 1 is 20M-05/11 Address ❑ Renewal ❑ Employment Lost Card � �j ie t0aar�i��ruaea;l(,l o�C�/j/�,cr�Jac�u�eCG.1 _ _ _ Office of Consumer Affairs&Business Regulation License or registration valid for individul use only - �OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: — _ egistration: 1.29331 Type: Office of Consumer Affairs and Business Regulation Expiration: 8/13/2015 Individual 10 Park Plaza-Suite 5170 Boston,MA 02116 Jeffrey L.Veglia Jeffrey Veglia 33 EDWARD AVE. g , LYNNFIELD, MA 01940 Undersecretary o v lid with t signature utyiic Safety a meat a1 PU Standards` sachusetts-CRegulations an Maatd 01 guild�n9 superN r ? �j Soa uct""' g6 CoutitC CS_0'C. License' LVE fit.. JEF�AgD Ate' 0940 `�` LYLDNip` Exp�tat0�5 J��, �J�.-�OmmL55%,off CONTRACT TITLE: MASTER AND HALF BATHROOM CONTRACT CONTRACT DATE: 10/17/2013 Contractor: Jeff Veglia Contracting 33 Edward Avenue Lynnfield,MA 01940 617-905-7581 MA-License#129331 Customer: Deborah W. James 80 Old Farm Rd North Andover,Ma Article 1. General Provisions 1. Contractor may at its discretion engage subcontractors to perform work hereunder,provide contractor shall full pay said subcontractor and in all instances remain responsible for the quality. 2. All change orders shall be in writing and signed by both the Customer and the Contractor. 3. During construction, Contractor agrees to remove all debris and leave the premises in broom clean condition each night. 4. In the event that the Customer fails to pay any periodic or installment payment due hereunder,Contractor may cease work without breach pending payment or resolution of any dispute. 5. It is agreed that the contractor shall perform the specified work as an independent contractor. Contractor maintains his own independent business. 6. Contractor shall comply with all state and local licensing and registration requirements for this type of activity involved in the specified work. Contractor is a MA licensed Home Improvement Contractor carrying the following license number: 129331. 7. Contractor shall be responsible for determining which permits are necessary and for obtaining the permits. Contractor shall pay for all state and local permits necessary for performing the specific work. 8. All materials shall be new, in compliance with all applicable laws and codes,and shall be covered by a manufacturer's warranty. 9. Contractor carries the following insurance worker's comp(America Trust)and general liability through Waterstreet Insurance Agency, Article 2. Scope of Work i °iY