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Building Permit #715 - 81 COTUIT STREET 5/12/2010
Permit NO: BUILDING PERMIT TOWN OF NORTH ANDOVER ICATION FOR PLAN EXAMINATION Date Received Date Issued•' V IMPORTANT: Applicant must complete all items on this LOCATION Jic? -� Cp `e 4 ,,,/ E7 /� A�'� P;or Ali Print PROPERTY OWNER tarn /0 c ,Poe J Print 11 MAP 210 Q PARCEL:_ ZONING DISTRICT: r, Historic District yes Machine Shop Village yes rno TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition Two or more family Industrial Alteration No. of units: 2 Commercial Repair, replacement Assessory Bldg Others: Demolition Other Septic Well Floodplain Wetlands Watershed District Water/Sewer on! q1 S-/G/H OWNER: Name: Address:16 8Z CONTRACTOR Name: Address: /-3 ,4 Supervisor's Construction License: JY 9f X23 Exp Home Improvement License: 15?c03 Exp DE5GKI1' I IUN/ yr VVUMM IV OF- -9 c rr�crvr�m�a+. 9 ii'1.-19/1Gi //',p /! 1?'*' 1/v/- 1' / 4 �9��4 0/"o'7 Identification Please Type or Print Clear l4 ,W/ rk-t�.syk la6p 1 ARCHITECT/ENGINEER Dater V-2 6/fzd/2 . Date: S'1290 20/D Phone: Address: Reg. No. FEE SCHEDULE: BOLDING PERMIT $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PERS.F. Total Project Cost: $ l% SOD FEE: $ Check No.:-/ Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner Signature of contracto Location g r.),1 S "r No. D I Date }� v NORT1y ,� TOWN OF NORTH ANDOVER A Certificate of Occupancy $ S cMusE Building/Frame /Frame Permit Fee 9 $ Foundation Permit Fee $ +� Other Permit Fee $ , TOTAL $ it Check # �► 1 23�b1 wilding Inspector Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL 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 CONSERVATION Reviewed on Signature COMMENTS HEALTH COMMENTS Reviewed on Signature Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Conservation Decision: Comments 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 Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL 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 CONSERVATION Reviewed on Signature COMMENTS HEALTH COMMENTS Reviewed on Signature Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Conservation Decision: Comments 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 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 Doc.Building Permit Revised 2010 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 o Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the 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 !)m Building Permit -Revised 2008 ¢ -C 2 ¢ k00 CO (0 .» 0 k �O I \\- Z 1I// ƒ/D 02 \\ lower\L@ \/ / of / * / I \�\< 0LLI L �E \2 2 00F L� LLI Dix O- \ ;t- \LL/ x /\z �(rk\LL dU. \IL . . .. . Lu , z\ %0 ]. 0 t =]- / \ CO 0 rl- coi Wcq \ 0) jLO / � / �.0\..: �....)..... 2 W \ Q�&Zu 2 /0 /W ;�k %/ \\kU ER \. _ . � % . . ._. @ A / 2 ° m =3 \ £ j// ��M :_ � r L- c `:_ r@ 2© (06-0 $ 6 a) CUk/0k k\ ..: 9� t: »m,� @ . yz ... ....6...\ . . ^ q � E « z ) k \ 0 �� iE >_ E ° / \\ \ j k 1 k y, §L m ,« . . \. . .. q. . . . \. U) �Q . .. / �2 \U) \w k / ± O �D z .\......... ......� \� j/#$ . \ f ...........� f R ,y ,: U o \ \... �._. co . \. . ... \ �\ , k \ L\G....:: . '/ ¢ -C 2 ¢ k00 CO (0 Invoice MD Exterior Home Improvement Inc 511 Springbrook Cir Portsmouth NH 03801 (617)830-1040 (603)205-2420 exterior.h.i@gmaii.com Wicone tuit St Andover MA 13 24 May 2010 ynil siding 31.0 $105.0 0.00% 0.00% $3,255.00 indow/Door wrap 21.0 $25.0 0.00% 0.00% $525.00 Ingle garage door wrap 2.0 $30.00 0.00% 0.00% $60.00 Wood siding removal 31.00 $30.00 0.00% 0.00% $930.00 umpster 2.0 $450.00 0.00% 0.00% $900.00 Gutters and downspouts (including materials) 140.00 $10.00 0.00% 0.000/6 $1,400.00 offit&fascia 140.00 $4.00 0.00% 0.00% $560.00 Fascia only 146.00 $3.00 0.00% 0.00% $438.00 ynil fence 1.0 $1,350.00 0.00% 0.00% $1,350.00 Page 1 of 2 Materials - $5386,80 Total -$15154.80 Discount - $654.80 Grand Total - $14500 Page 2 of 2 Subtotal $9,768.00 Tax $0.00 Total $9,768.00 Paid $9,768.00 Balance Due $0.00 Estimate MD Exterior Home Improvement Inc 511 Springbrook Cir Portsmouth NH 03801 (617)830-1040 (603)205-2420 exterior.h.i@gmail.com • Pam Picone 83 Cotuit St North Andover MA P-14 MM--_ DO Decking Correct Deck CX 1X6 12 ft 46.00 $20.00 0.00% 0.00% $920.00 abor 1.0c $1,700.00 0.00% 0.00% $1,700.00 PT 2X8 20 ft 12.00 $20.00 0.00% 0.00% $240.00 PT 2X8 12 ft 5.0 $10.00 0.00% 0.00% $50.00 Brackets 20.00 $2.00 0.00% 0.00% $40.00 oice hangers 20.00 $2.00 0.00% 0.00% $40.00 Screws 2.0 $30.00 0.00% 0.00% $60.00 Concrete mix 2.0 $40.00 0.00% 0.00% $80.00 PT 4X4 posts 5.0 $15.00 0.00% 0.00% $75.00 Pagel of 2 Subtotal $4,365.00 Tax $0.00 Total $4,365.00 Page 2 of 2 irny. U. Lviv i i.vimill F[iCh okonVLER � I CERTIFICATE OF INSUUCE ETA FARM FIRE AND CASUALTY COMPANY, Sloomingtion, Illincle ` " i ` `n STA FARM GENERAL INSURANCE COMPANY, Bloomington, Illinois ❑ STA FARM FIRE AND CASUALTY COMPANY, Scarborough, Onlari0 4ft �tisu�,►Ne 0 STA FARM FLORIDA INSURANCE COMPANY, Winter haven, Florida ❑ STA FARM LLOYDS, Dallas, Tons insures the following policyholder f0 the aoveraMas Indicated below. Name of polOftider Dzmitry Hrytsuk Address of pofigholder j13A ftittier Dr Seabrook, HE 03874 Locetron of operations I same Description of operations cons NV. 411 r. I The policies Meted below have issusd to the pd*ohler for the policy periods sham. The inswrartoe described In these gooses is sub'red to all the germs oduslons, tW c mditions of those policies. The limits of Wbifrty slum may have been reduced by any pald daims. - - POLICY PERIOD LIMITS OF LIABILITY POLICY NUMBER TYPE F INSURANCE Eftorma Date S E>Iiratoe+ tzata a4 OWinning of polig N A Com hensive BODILY INJURY AND 94 -HV -3438-4 F PROPERTY DAMAGE �Thia insurance includes: .05/01/2010..,_05/02/2011.. C] � - Completed Operetions ❑ Co UabilKy ❑ Und rground Hazard Coverege Each Occurrence $500,000 Pe f " ❑ . injury General Aggregate 11110001000 C1 n Hazard Coverage ❑ Col Hazard Coverage Product — Compteted $ N/A ❑ OpwWons Aggregate POLICY PERIOD BODILY INJURY AND PROPERTY DAMAGE EXC ESS LIABILITY Effecthm Da% Em i+Miart )tale (Combined Single Lund) N/A ❑ Um Fda Each O=rronoe $N/A - N/A ❑ r Aggregate $N/A Pert 1 STATUTORY Part 2 BODILY INJURY 6IttIB-0715n136-09 Worb W Compensaft 05/01/2010 05/01/2011 and E mployers Llabilhy Each A COrd $100.000 Disease Each Employee $100,000 Disease Policy Limlt $500,000 POLICY PERIOD LIMITS OF LIABILITY POLICY NUMBER OF INSURANCE gfkcM Date ;ew ME Date (at bepinnlerg of policy Od 29-2009-F51 01 F d X350 04/24/2010 10/27/2010 0100,000/5300,000/00,000 THE CERInFICATE P! L IS NOT A CONTRACT OF INSURANCE AND NEITHER AFFIRMATIVELY NOR NEGATIVELY Ampunft- 01wi mnE! nR eLTR TWF CAVI AnF- APPROV90 BY ANY POLICY DESCRIBED NE'IZEIN. TND At 8 rvicea, zno additional insured with r insurance 717117'r -T17 THD at H=e Services Inc 2690 Cumberline Park Way Suite 300 Atlanta, GA 30339 55o4m as o4+r m Peded in u sA. and the H=e Depot are included as pests to general liability of Ceoftu a Holder If any of the described pdoles are cermled before Its 4lXp Wmn date, State Farm witi try to maD a wrItIm notice to the oertillcate holder 30 days before cancelladon. If however, we fay to mail such nottoo, no oblIgaton or Mbtiity Will be imposed on Stott Farm or its r rep 80mWitfAuthafted Agent 05/12/2010 TM Oft Aierift Cob A AFo Cod p. Sch* 2M ` ' ".� Hampshire Fti?'8 SILVER SCROLL The Commonwealth of Massachusetts Department o f fizdustrial Accidents Office of 1y1Vesz�e aiions ..600 Washington Street Boston, X4 02111 www.nzass-gov/dia Workers' Compensation Insurance Affidavit: guilders/Contractors/Electricians/Plumbers Mlicant Information Name (Business/Organization/Individual): / j`vi_j'Ve/ Address: 1-3 . , //,� City/State/Zip: f'C2gZloo /J/y p `�Tc� Phone Are you an employer? Check the appropriate boa: I . [R -I am a employer with l 4. ❑ I am a general contractor and I 2. ❑employees (full and/or part-time).* have hired the sub -contractors I am a sole proprietor or partner- listed on the attached sheet I ship and have no employees These subcontractors have working forme in any capacity, workers' comp, insurance. [No workers' comp. insurance 5. ❑ We are a corporation and its required] ❑ I am a homeowner doing all work myself. [No workers' comp. insurance required.] f officers have exercised their right of exemption per MGL c. 152, § I (4), and we have no employees_ [No workers' comp. insurance required ] �-n�,' applicant thst checkbox 41 must a?so fir. oat the sejoa beioa, shed^.. ' FIomeowaers who submit th' -,filo � - � wark-ms, con Type of project (required): 6. ❑ New construction 7. ❑ Remodeling 8• ❑ Demolition 9. [] Building addition 10.0 Electrical repairs oradditioms 1 I.[] Plumbing repairs or additions 12.❑ Roof repairs 13.0 Other u vtt mdacatmg they are doing _ : e.-... - r,:c:cY � :, tion. ' 1, l,:_ t h "ark and risen hire outside conuact-'s Host submit a new affidavit indicating such. Coatrzctors that cher., this box must attached an additional sheet showing the name of the sub-coatcactors and their worker:' urnp ` an ion. er znax is providing workers' compensationinform¢tsoninsurance for my employees. Below is the policy and job site Insurance Company Name: .S r�q Policy # or Self -ins: Lic. O7 Expiration Date: Job Site Address: (T3 LE)d�ii,l City/State/Zip: , �hdO vP� 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 fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties imposition of criminal penalties of a 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 I do hereby certify under the pains and penalties of perjury th¢t the i"formation provided above is true and correct, sone #: 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. Ci 6. Other ty/Town Clerk 4. Electrical Inspector S. Plumbing Inspector Contact Person: Phone #: Information an- d 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 apartri3Lentr and who resides therein, or the occupant of the dwelling house of another who employs persons to do mainte:3nnnce, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not be cause of such, employment be deemed to be an employer." MGL chapter 152, §25C(6) also states that "every state or local licensing gency shall withhold ibe 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' comp enation 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 store to sign and date the affidavit. The affidavit should be returned to the vitt' or tGCvTi that the BvvuGauGn for the pe tit or license is being r equ'ested, not the Dmart meat. of Industrial Accidents. Should you have any questions regarding +ire taw or if you are r:.rired 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/liceme 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 than you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call- The allThe Department's address, telephone and :f m. number. The Commonwealth of Massachusetts 1}epartmeat of Industrial Accidents Office of lnvestic, 600 Washington Street Boston, IIIA 0.2111. Tel. 4 617-72.7-4900 ea. -t406 or 1-977-MASSAFE Revised 5-26-05 Fai � 617-72.7-7749 U rvrAAi1.InaSS.. °ov/dia, 11assuchusetls - Department of Public Safeh Bourd of Building; Regulations and Standards Construction Supervisor Specialty License License: CS SL 9di823 Restricted to: RF,WS OZMITRY HRYTSUK 13A WHITTIER OR. SEABROOK NH 03874 4n�e-- ►"'` Expiration: &26012 t unmd.aanrr Tr#: 99873 �IEir �srra�rsa�alQi ��G�� Board of Building Regn4lions and Standards T HOME IMPROVEMENT CONTRACTOR Registr"ofr: 159803 EnplmWn: 529/2010 Trll 269023 Type: Private Cotpomflon TRUSTED INSTALLERS INC. DZMITRY HRYTSUK 13 A WHITTIER DRQ„„` SEABROOK, NH 03874 Administrator License or rtgh t don valid for Individul use only before the expiration data If found return to: Board of Building Regulations and Standards One Ashburton Place Rm 1.301 Boston, Ms. 02108 Massachusetts Home Improvement Contract This form satisfies all basic requirements of the state's Home Improvement Contractor Law (MGL chapter 142A), but does not include standard language to protect homeowners. Seek legal advice if necessary. Any person planning home improvements should first obtain a copy of "a Massachusetts consumer guide to home improvement" before agreeing to any work on your residence. You may obtain a free copy by calling the Office of Consumer Affairs and Business Regulation's Consumer Information Hotline at 617-973-8787 or 1-888-283-3757. Homeowner Information Contractor Information Name Pam Picone 83 Cotuit st Company Name Trusted Installers me Dzmitry Hrytsuk Street Address (do not use a Post Office Box address) I Contractor/ Salesperson/ Owner Name North Andover MA 01845 13 A Whittier dr City/Town State Zip Code I Business Address (must include a street address) (978) 886-1720 Seabrook NH 03874 1 Daytime Phone Evening Phone I City/ own State Zip Code (617) 830-1040 208611447 Mailing Address (It different from above) I Business Phone Federal Employer ID or S. S. Number Law requires that most home improvement contractors have a valid registration number Home Improvement Contractor Reg. Number 159803 Expiration date 05/29/2010 The Contractor agrees to do the following work for the Homeowner: (Describe in detail the work to completed, specifying the type, brand, and grade of materials to be used, use additional sheets if necessary.) Removal and installation of vinyl siding (Charter Oak) Removal and installation ofug tters Required Permits - The following building permits are required and will be secured by the contractor as the homeowner's agent, (Owners who secure their own permits will be excluded from the Guaranty Fund provisions of MGL chapter 142A.) Proposed Start and Completion Schedule - The following schedule will be adhered to unless circumstances beyond the contractor's control arise when contractor will begin contracted work. Date when contracted work will be substantially Total Contract Price and Payment Schedule The Contractor agrees to perform the work, furnish the material and labor specified above for the total sum of: 7,250 (*) Payments will be made according to the following schedule: $ 2416.50 upon signing contract (not to exceed 1/3 of the total contract price or the cost of special order items, whichever is greater) $ 2416.50 by 05/21/2010 or upon completion of u $ 2417.00 upon completion of the contract. (Law forbids demanding full payment until contract is completed to both party's satisfaction) Ora' h The following material/equipment must be special $ oo to be paid for 1401 ordered before the contracted work begins in order $ to be paid for to meet the completion schedule.(**) Contractor Arbitration The Home Improvement Contractor Law provides homeowners with the right to initiate an arbitration action (as an alternative to court action) if they have a dispute with a contractor. The same right is not automatically afforded to a contractor, however. The contractor would have to resolve any dispute he/she has with a homeowner in court unless both parties agree to the optional clause provided below. This clause would give the contractor the same right to arbitration as is afforded to the homeowner by the Home Improvement Contractor Law. The contractor and the homeowner hereby mutually agree in advance that in the event the contractor has a dispute concerning this contract, the contractor may submit the dispute to a private arbitration firm which has been approved by the Secretary of the Executive Office of Consumer Affairs and Business Regulation and the consumer shall be required to submit to such arbitration as provided In Massachusetts General Laws, chapter 142A. Homeowner's Signature Si ature Contract Si ature 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 lawfully agree may be added to the terms of the contract as long as they do not restrict a homeowner's basic consumer rights. If you have questions about your consumer/homeowner rights, contact the Consumer Information Hotline (listed below). Execution ofContract 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 recission 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 Consumer Guide to the Home Improvement Contractor Law," contact: Consumer Information Hotline Office of Consumer Affairs and Business Regulation 10 Park Plaza, Room 5170, Boston, MA 02116 (617) 973-8787 or 1-(888) 2833757 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 Bureau of Building Regulations and Standards One Ashburton Place, Room 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 a business, call: Consumer Complaint Section Office of the Attorney General (617) 727-8400 AND/OR Better Business Bureau (508) 652-4800 (508) 755-2548 (413) 734-3114 NOTES: (*) Including all finance charges (**) Law requires that any deposit or down -payment required by the contractor before work begins may not exceed the greater of (a) one-third of the total contract price or (b) the actual cost of any special equipment or custom made material which must be special ordered in advance to meet the completion schedule. Express Warranty -Is an express warranty being provided by the contractor? No Yes (alt terms of the warranty must be attached to the contract) Subcontractors - The contractor agrees to be solely responsible for completion of the work described regardless of the actions of any third party/subcontractor utilized by the contractor. The contractor further agrees to be solely responsible for all payments to all subcontractors for materials and labor under this agreement. 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 uncicar. • Make sure the contractor has a valid Home Improvement Contractor Registration. The law requires most home improvement contractors and subcontractors to be registered with the Director of Home Improvement Contractor Registration. You may inquire about contractor registration by writing to the Director at One Ashburton Place, Room 1301, Boston, MA 02108 or by calling 617-727-3200 or 1-800-223-0933. • Does the contractor have insurance? Check to see that your contractor is properly insured. • Know your rights and responsibilities. Read the Important Information on the reverse side of this form and get a copy of the Consumer Guide to the Home Improvement Contractor Law. You may cancel this agreement if it has been signed at a place other than the contractor's normal place of business, provided you notify the contractor in writing at his/her main office or branch office by ordinary mail posted, by telegram sent or by delivery, not later than midnight of the third business day following the signing of this agreement. See the attached notice of cancellation form for an explanation of this right. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES!!! Two identical copies of the contract must be completed and signed. One copy should go to the homeowner. The other copy should be kept by the contractor. s Signature Con tractor'st5lgnature S114 /2-0/0 ar// y /0,,v Date 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 Consumer Guide to the Home Improvement Contractor Law," contact: Consumer Information Hotline Office of Consumer Affairs and Business Regulation 10 Park Plaza, Room 5170, Boston, MA 02116 (617) 973-8787 or 1-(888) 2833757 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 Bureau of Building Regulations and Standards One Ashburton Place, Room 1301, Boston, MA 02108 (617)727-3200 ort -800-223-0933 For assistance with informal mediation of disputes or to register formal complaints against a business, call: Consumer Complaint Section Office of the Attorney General (617) 727-8400 AND/OR Better Business Bureau (508) 652-4800 (508) 755-2548 (413) 734-3114 Contractor Arbitration The Home Improvement Contractor Law provides homeowners with the right to initiate an arbitration action (as an alternative to court action) if they have a dispute with a contractor. The same right is not automatically afforded to a contractor, however. The contractor would have to resolve any dispute he/she has with a homeowner in court unless both parties agree to the optional clause provided below. This clause would give the contractor the same right to arbitration as is afforded to the homeowner by the Home Improvement Contractor Law. The contractor and the homeowner hereby mutually agree in advance that in the event the contractor has a dispute concerning this contract, the contractor may submit the dispute to a private arbitration firm which has been approved by the Secretary of the Executive Office of Consumer Affairs and Business Regulation and the consumer shall be required to submit to such arbitration as provided In Massachusetts General Laws, chapter 142A. Homeowner's Signature Co ctor's Signature NOTICE: The signatures of the parties above apply only to the agreement of the parties to alternative dispute resolution initiated by the contractor. The homeowner may initiate alternative dispute resolution even where this section is not separately 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 Horne Improvement Contractor Law. The contractor is responsible for completing the work as described, in a timely and workmanlike manner. Homeowners may be entitled to other specific legal rights if the contractor guarantees or provides an express warranty for workmanship or materials. In addition to guarantees or warranties provided by the contractor, all goods sold in Massachusetts carry an implied warranty of merchantability and fitness for a particular purpose. An enumeration of other matters on which the homeowner and contractor lawfully agree may be added to the terms of the contract as long as they do not restrict a homeowner's basic consumer rights. If you have questions about your consumer/homeowner rights, contact the Consumer Information Hotline (listed below). Execution of Contract The contract must be executed in duplicate and should not be signed until a copy of all exhibits and referenced documents have been attached. Parties are also advised not to sign the document until all blank sections have been filled in or marked as void, deleted, or not applicable. One original signed copy of the contract with attachments is to be given to the owner and the other kept by the contractor. Any modification to the original contract must be in writing and agreed to by both parties. Contracted work may not begin until both parties have received a fully executed copy of the contract, and the three day recission 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 NOTES: (*) Including all finance charges (**) Law requires that any deposit or down -payment required by the contractor before work begins may not exceed the greater of (a) one-third of the total contract price or (b) the actual cost of any special equipment or custom made material which must be special ordered in advance to meet the completion schedule. Express Warranty - Is an express warranty being provided by the contractor? No Yes (all terms of the warranty must be attached to the contract) Subcontractors - The contractor agrees to be solely responsible for completion of the work described regardless of the actions of any third party/subcontractor utilized by the contractor. The contractor further agrees to be solely responsible for all payments to all subcontractors for materials and labor under this agreement. Contract Acceptance - Upon signing, this document becomes a binding contract under law. Unless otherwise noted within this document, the contract shall not imply that any lien or other security interest has been placed on the residence. Review the following cautions and notices carefully before signing this contract. • Don't be pressured into signing the contract. Take time to read and fully understand it. Ask questions if something is unclear. • Make sure the contractor has a valid Home Improvement Contractor Registration. The law requires most home improvement contractors and subcontractors to be registered with the Director of Home Improvement Contractor Registration. You may inquire about contractor registration by writing to the Director at One Ashburton Place, Room 1301, Boston, MA 02108 or by calling 617-727-3200 or 1-800-223-0933. • Does the contractor have insurance? Check to see that your contractor is properly insured. • Know your rights and responsibilities. Read the Important Information on the reverse side of this form and get a copy of the Consumer Guide to the Home Improvement Contractor Law. You may cancel this agreement if it has been signed at a place other than the contractor's normal place of business, provided you notify the contractor in writing at his/her main office or branch office by ordinary mail posted, by telegram sent or by delivery, not later than midnight of the third business day following the signing of this agreement. See the attached notice of cancellation form for an explanation of this right. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES!!! Two identical copies of the contract must be completed and signed. One copy should go to the homeowner. The other copy should be kept by the contractor. lke� � �1, 4 Homeowner's Signature Contractor' ignature ©r�f�l��o Date Date Massachusetts Home Improvement Contract This form satisfies all basic requirements of the state's Home Improvement Contractor Law (MGL chapter 142A), but does not include standard language to protect homeowners. Seek legal advice if necessary. Any person planning home improvements should first obtain a copy of "a Massachusetts consumer guide to home improvement" before agreeing to any work on your residence. You may obtain a free copy by calling the Office of Consumer Affairs and Business Regulation's Consumer Information Hotline at 617-973-8787 or 1-888-283-3757. Homeowner Information Contractor Information Name lgory Perchuk 81 Cotuit st Company Name Trusted Installers me Dzmitry Hrytsuk Sheet Address (do not use a Post Office Box address) Contractor/ Salesperson/ Owner Name North Andover MA 01845 13 A Whittier dr �I City/ own State Zip Code Business Address (must include a street address) (978)828-7611 Seabrook NH 03874 Daytime Phone Evening Phone City/Town State Zip Code (617) 830-1040 208611447 I Mailing Address at different from above) I Business Phone Federal Employer ID or S.S. Number Law requires that most home improvement contractors have a valid registration number Home Improvement Contractor Reg. Number 159803 Expiration date 05/29/2010 The Contractor agrees to do the following work for the Homeowner: (Describe in detail the work to completed, specifying the type, brand, and grade of materials to be used, use additional sheets if necessary.) Removal and installation of vinyl siding (Charter Oak) Removal and installation ofug tters Required Permits - The following building permits are required and will be secured by the contractor as the homeowner's agent, (Owners who secure their own permits will be excluded from the Guaranty Fund provisions of MGL chapter 142A.) Proposed Start and Completion Schedule - The following schedule will be adhered to unless circumstances beyond the contractor's control arise /ODate when contractor will begin contracted work. S 2% /t9 Date when contracted work will be substantially Total Contract Price and Payment Schedule The Contractor agrees to perform the work, furnish the material and labor specified above for the total sum of: 7.250 (*) Payments will be made according to the following schedule: $ 2416.50 upon signing contract (not to exceed 1/3 of the total contract price or the cost of special order items, whichever is greater) $ 2416.50 by 05/21/2010 or upon completion of r $ 2417.00 upon completion of the contract. 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