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HomeMy WebLinkAboutBuilding Permit #272-14 - 92 COLONIAL AVENUE 9/24/2013 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued: c I OR ANT:Applicant must complete all items on this page t � LOCATION Cwt ► Print` PROPERTY OWNER 1 �� 2I-� ►'1 Print 100 Year Old Structure yes MAP NO: RCEfT ZONING DISTRICT: Historic District yes /no no Machine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building One family ❑Addition ❑Two or more family ❑ Industrial Iteration No. of units: ❑ Commercial ,&Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic 0 Well ❑ Floodplain ❑Wetlands ❑ Watershed District 0 Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: c Identificaatigfi P e y o riot Clearly) ��� OWNER: Name: G�r�/ Phone. Address: ' ���eK A bl e7" CONTRACTOR Name: cJ►1v►J kv S.o--,r,&J� Phone: q'I2er'—$i f Y9W Address: 165- Supervisor's bSSupervisor's Construction Licenser D3 Exp. Date: W074///60 Home Improvement License: 1 L/9 L/ Exp. Date: c3L,,;2l � ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 P Total Project Cost: $ C FEE: $ Check No.: Receipt No.:� 0 NOTE: Persons ontract ng with unregistered contractors do not have access to ae guaran fund Signature of Ag. Signature of contractor. Plans Submitted ❑ Plans Waived 0 Certified Plot Plan ❑ Stamped Plans ❑ Location `�'1 C C7 ec,� N :�- `q Date y 1� • '- TOWN OF NORTH ANDr . Certificate of Occupancy w Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check# � Building 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 'OTE: +LTH Reviewed on Signature L 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 Todvaa Engineer: Signature: 7 Located 384 Osgood Street FIRE DEPARTM—Ehif T -Temp Dumpster on site yes no Located at 124 Mair Street Fire Department signatureldate 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 I I ® Notified for pickup - Date Doc.Building Permit Revised 2010 r Building Department The foh0wing is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits o Building Permit Application ❑ Workers Comp Affidavit o Photo Copy Of H.I.C. And/Or C.S.L. Licenses o Copy of Contract o Floor Plan Or Proposed Interior Work o Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks o Building Permit Application o Certified Surveyed Plot Plan o Workers Comp Affidavit a Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract o Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) o Mass check Energy Compliance Report (If Applicable) o 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) o Building Permit Application a Certified Proposed Plot Plan o Photo of H.I.C. And C.S.L. Licenses o Workers Comp Affidavit a Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract o Mass check Energy Compliance Report o Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit In all cas�S if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the app%,al period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be subm.tted with the building application Doc: Doc.Buiiding Permit Revised 2012 NORTH Town of tAndover 0 46�z� 2-iz. iZ h ver, Mass, > o COCMICK.WICK S U BOARD OF HEALTH Food/Kitchen PERMIT LD Septic System THIS CERTIFIES THAT .......................�. .... .............. ....I._.. . ...................................................... BUILDING INSPECTOR has permission to erect.......................... buildings on ...q.L..........�&.I..p.IIRW. ................. Foundation �. _ Rough to be occupied as ....... :�..... .. ... ...��►� .I.... ................................................ Chimney provided that the person accepting this permit shall 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 VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR T1 UNLESS CONSTRU Rough g TARTS Service rD .... .............. .................................. BUILDING INSPECTOR Final 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 Z;7 D 2 Fajnik sense CSFA-106031 SHAWN ARSENAULT 10-5 HAMILTON STREET Leominster MA 01413 08124/2016 II k. Office of Consumer Affairs&B siness Reg,:—don HOME IMPROVEMENT CONTRACTOR Registration: 171474 Type: Expiration: 3/21/2014 individual ARSENAULT. E HAWN ARSENAULT 105 HAMILTON L-..:DtAINSTER, MA 01453- UndcrSeerctiry ARSEN-2 OP ID:NB �R� CERTIFICATE OF LIABILITY INSURANCE °ATE`MMf°°'YYYY' 08/07/13 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 endomement(s). CONTACT PRODUCER 978-534-5133 NAME: Anderson,Bagley 8r Mayo 978-534-9385 HON. E,d: AX No Insurance Agency,Inc. 44 Main Street,P.0.Box 360 E-MAIL ADDRESS: Leominster,MA 01453 Richard M.Bagley INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Charter Oak Fire Ins Company 25615 INSURED Shawn Arsenault& INSURER B:Travelers Indemnity of America 25666 Eric Arsenault dba Arsenault INSURER C:Travelers Brothers Construction 105 Hamilton St 1st FL INSURER D: Leominster,MA 01453 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. L90W POLICY EFF POLICY EXP rB TYPE OF INSURANCE POLICY NUMBER MMIDD MMIDD LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1 r000�00 X COMMERCIAL GENERAL LIABILITY 16805583MS46ACJ13 08101112 08101/14 DAMAGPREMISES Ea occurrence $ 300,00 CLAIMS-MADE rx-1 OCCUR MED EXP(Any one parson) $ 5,00 PERSONAL&ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,00 POLICY PROECj LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 500,00 Ea accident $ A ANY AUTO BA-8672A67842-SEL 08126112 08126113 BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS PROPERTY DAMAGE NON-OWNED Per..".n') ccident $ HIREDAUTOS AUTOS $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DED RETENTION$ WORKERS COMPENSATION C STATUS OTH- TWORY LIMITS I I ER AND EMPLOYERS'LIABILITY YIN C ANY PROPRIETORIPARTNER/EXECUTIVE❑ 1HUB6B90875713 04/02113 04102I14 E.L.EACH ACCIDENT S 100,00 OFFICERIMEMBER EXCLUDED? N I A (Mandatory in NH) E.L.DISEASE-EP,EMPLOYE $ 1()0,000 If yes,describe under E.L.DISEASE-POLICY LIMIT $ 500,00 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Moynihan Lumber Co. ACCORDANCE WITH THE POLICY PROVISIONS. 164 Chestnut Street North Reading,MA 01864 AUTHORIZED REPRESENTATIVE Richard M.Bagley ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD �` Department of Industrial Accidents l�f' i7v �t k l Ofji-ce of Investigations 600 Waslzingtorz Street Boston, AM 02111 Www.mass.gov1dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le M3: Name (Business/Organization/Individual): -S /'1 r1 k,-" 7-- Address: /015- ("if-Y/CtatP/lin e(?}Y/en0C't�yl Phone 4: Are you an employer? Check the appropriate box: — -- 1.ElI am a employer with 4. Fj I am a general contractor and I Type of project(required): �tnployees(full and/or part-time).* have hired the sub-contractors 6. F1 New construction 2. I am a sole proprietor or partner- listed on the attached sheet. 7. 0 Remodeling ship and have no employees These sub-contractors have g, E]Demolition working for me in any capacity: employees and have workers' [No workers' comp. insurance comp. insurance.$ 9. ❑ Building addition required.] 5. [J We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.] t c. 152, §1(4), and we have no employees. [No workers' 13.0 Other comp. insurance required.] x A-qv app!;,­f thaf r1, L- 1, x#I 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 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 pr•ovidine workers'compensation insurancefor 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 form of a STOP WORD 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 certify it der the pains id penalties ofpeijiuy that the information provided above is trete and correct. Si ature: C - Date: Phone#: Official arse only. Do not write in this area, to be comp[eied by city or town official City or'Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2e Building Department 3. City/'Town Clerk 4.Electrical Inspector S. Plumbing Inspector 6. Other �kanvaa ff• i I Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration r Registration: 136860 x Type: .Private Corporation Expiration: 9/6/2014 Tr# 229034 MOYNIHAN NORTH READING LUMBER,`IN it JOHN MILLER JR. -- - PO BOX 128 N. READING, MA 01864 S tie' /7 P `Update Address and return card.Mark reason for change. ~ SCA 1 i5 20M-05/11 ❑ Address Renewal 0 Employment ❑ Lost Card I i I I I I I MOYNIHAN-NORTH READING LUMBER, INC. "QUALITY BACKED BYA DESIRE TO PLEASE" 164 Chestnut Street /� FEIN:04-2261995 North Reading, MA 01861 Con s tractor Reg No.: 978-864-3310/781-944-8500 9g Exp. Date:—//— Salesperson(s): HOMEOWNER INFORMATION f Name( Daytime Phone 15� Ve Street Address(Not P.O.Box) Evening Phone tt City/Town State Zip Code Mailing Address(f different from Street Address) WORK TO BE PERFORMED AND MATERIALS TO BE USED Moynihan-North Reading Lumber, Inc. agrees to perform the work set forth in Exhibit A for Homeowner and to use such materials in connection therewith as set forth also in Exhibit A,attached hereto and made a part hereof. The following schedule shall be adhered to unless circumstances arise beyond Moynihan-North Reading Lumber, Inc.'s control:Work scheduled to begin:1 /L/4,3- Expected date of completion: May be based upon arrival of special order material TOTAL CONTRACT PRICE AND PAYMENT SCHEDULE Moynihan- North Reading Lumber, Inc. agrees to perform the work,and furnish the material and labor set forth in Exhibit A for the Total Contract Price of: $ r," 2 2. `'� -, (which amount includes all finance charges). Payments shall be made by Homeowner according to the following payment schedule: $ ► 14 *, 2 2 Initial deposit upon signing this Contract(the initial deposit shall not exceed the greater of one-third (1/3)of the Total Contract Price as set forth above; OR the Total Cost of Special/Custom Orders as set forth below). $ '^2 , a I by—/—L-or upon completion of delivery of materials $ by_/ / or upon completion of install $ r`"'"' ""� upon completion of the Contract In order to meet the completion schedule set forth above,the following materials/equipment.must be special ordered before the Contract work begins, for a Total Cost of Special/Custom Orders of$ $ �--�--�'�- tojbe paid for building permit �$ r ,to be paid for 1? 'l- $.._ to be paid for -44 '✓ « 11 DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES - Moynihan-North Reading Lumber Inc. Homeowner's Signature Date Contractor Date By:Dale Fuller Homeowner's Name(Printed) Installed Sales Coordinator You may cancel this Contract if it has been signed by a party thereto at a place other than an address of Contractor,which may be its main office or branch thereof,provided you notify Contractor in writing at its main office or branch by ordinary mail posted,by telegram sent or by delivery,no later than midnight of the third business day following the signing of this Contract. See attached notice of cancellation for an explanation of this right. See reverse side for additional Homeowner Terms and Conditions 1057-NR 1/11 White-Office Yellow-Sales/Service Pink-Customer Page 1 of 5 ' a HOMEOWNER TERMS AND CONDITIONS The following terms and conditions are an integral part of this Contract between Moynihan-North Reading Lumber,Inc.("Contractor l and Homeowner. 1. All payments are due upon presentation of billing,and a late charge of one and one-half percent(11/2%)per moth will be applied to past due charges. Homeowner shall pay Contractor court costs,attorneys'and paralegals'fees,and any other expenses incurred in the collection of past due accounts. 2. If Homeowner is borrowing money from a construction lender to perform the work,Homeowner represents that the construction loan fund is sufficient to pay Contractor and any other contractors performing work on Homeowner's property. Homeowner irrevocably authorizes Contactor to communicate directly with the construction lender regarding payments and loan balances,and authorizes the construction lender to make payments directly to Contactor. 3. Homeowner shall be in default if it breaches any provision of this Contract;if any warranty or statement to Contractor in connection with this Contract or Contractor's extension of credit to Homeowner is false or misleading when made;if any statement to a lending institution in connection with financing for this Contract is false or misleading when made;or if Homeowner becomes insolvent,makes and assignment for the benefit of its creditors,or files or has filed a petition for bankruptcy. 4. If the Total Contract Price includes allowances,and the cost of performing the work covered by an allowance is either greater or less than the allowance,then the Total Contract Price shall be increased or decreased accordingly without the need for a signed Change Order. Unless otherwise requested by Homeowner,Contractor shall use its judgment in accomplishing work covered by an allowance. 5. If Contractor agrees to do any installation work,Homeowner will procure at its expense and before the commencement of work hereunder"all risk"insurance with construction,theft,vandalism,and mischief endorsements attached,the insurance to be in a sum at least equal to the Total Contract Price. The insurance will name Contactor and any subcontractors as additional insured. If the project is destroyed or damaged by accident,disaster or calamity such as fire,flood or storms,Homeowner shall pay for work done by Contractor in rebuilding of restoring the project as extra work. 6. If Homeowner defaults under any of its obligations under this Contract,Contractor may: a. Stop work until any payments are received or defaults are otherwise cured. b. Terminate work upon seven(n days written notice and recover as damages,at its option,either the reasonable value of the work performed through termination,or the balance of the Total Contract Price plus any other damages including reasonable attorneys'and paralegals'fees Contractor suffers as a result of the default. 7. Contractor shall be excused for delay in completion of the Contract caused by contingencies out of its control,including acts or delays of Homeowner or other contractors,acts of God,labor trouble,acts of public agencies or inspectors or public utilities,extra work,breaches of this Contract by Homeowner,problems obtaining materials from suppliers,or other contingencies unforeseen by Contractor. Under no circumstances will Contractor be liable for monetary damages caused by delays as set forth above. g. If Contractor encounters unforeseen conditions that were not reasonably anticipated by Contractor,Contactor shall call the conditions to the attention of Homeowner and the Total Contact Price and schedule will be adjusted by the extra work necessitated thereby. No installation, plumbing,electrical,flooring,decorating or other construction work is to be provided unless specifically set forth herein. In the event Contactor is to perform the installation,it is understood that the price agreed upon herein does not include possible expenses incurred in addressing hidden or unknown contingencies found at the jobsite. In the event such contingencies arise and Contractor is required to furnish labor or materials or otherwise perform work not provided for or contemplated by Contractor,the actual cost of such additional unexpected work plus fifteen percent(15%)thereof will be paid by Homeowner. Contingencies include but are not limited to:inability to reuse existing on of presence of which t and ter canpipes,air shafts,not be determined uuntilgthe work has started;or mperfectioes,louvers and registers;the ns,s,t'rottng or decay in he structure or arts thereof pipes,riser,wiring or conduits,the necessitating replacement. g. Homeowner shall be responsible for the coordination of any work performed by itself or other contactors,and shall be responsible to have the work site ready for contractor to proceed. If installation is involved,with its work through the completion date.Any work performed by Homeowner or other contractors shall not hinder Contractor's schedule. Contractor does not warrant any work performed by Homeowner or other contractors not working for Contractor as its subcontractor. 10. Homeowner understands that some products described in this Contract may be specially designed and custom built,and as such Contractor will take immediate steps upon execution of this Contract to design,order and construct those items as set forth herein. Except as provided on page one of this Contract,this Contract is not subject to cancellation by Homeowner. 11. The delivery date,when given,shall be deemed approximate and performance is subject to delays caused by strikes,fires,weather conditions,acts of God or other reasons not under the control of Contractor,as well as the availability of the product at the time of delivery. Once the delivery date is determined,Homeowner agrees to accept delivery of the product(s)within one(1)week. very and the uct. If Homeowner is not 12 accept he iproduct,the delivery payment hwlll by de as agreed upon and al be upon Homeowner upon then extra storage receipt eoffF Fifty Dollars ready to The risk of oss,damage or destruction, lars($5)per week will be charged. 13. Title to the items sold pursuant to this Contract shall not pass to Homeowner until the full price as set forth in this Contact is paid to Contractor. 14. Contractor agrees that it will perform this Contract in conformity with customary industry practices. Homeowner agrees that any claim for adjustment shall not be reason or cause for failure to make payment of the purchase price in full. 15. This Contract sets forth the entire understanding of the parties. Any and all prior contracts,agreements,warranties or representations made by either party are suseded by this Contract. TANDING DESCRIBED R TO H E CONTRACT PRICE N ESS IND UNTIL HOMEOWNER AND CHANGESCCONTRACTOR SIGN A WRITTEN CHANGE 1057-NR 1/11 White-Office Yellow-Sales/Service Pink-Customer Page 2 of 5 ORDER. No agent of Contractor,unless authorized in writing by Contractor,has any authority to waive or amend this Contract,or to make any new or substituted agreements,warranties and/or representations. 16. Contractor warrants that the work will be free from faulty materials,constructed according to the standards of the building code applicable to the jobsite location,constructed in a skillful manner and fit for habitation or other appropriate use. The warranty rights and remedies set forth in the Massachusetts Uniform Commercial Code apply to the Contract. Contractor does not make any express warranties regarding the work,except for those which may be attached to this Contract as an exhibit. 17. REQUIRED PERMITS.The following building permits are required.It is the obligation of Contractor to secure such permits as Homeowner's agent,unless Homeowner wishes to procure such building permits:(List any and all necessary construction-related permits) NOTE:Homeowners who secure their own permits or deal with unregistered contractors are excluded from the Guaranty Fund provisions of MGL c.142A. 18. 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. 19. Unless otherwise noted in this Contract,this Contract shall not imply that any lien or other security interest has been placed on the residence. 20. ACCELERATION OF PAYMENT.Homeowner's Financial Insecurity-A contractor may not demand payments in advance of the dates specified on the payment schedule in cases where Homeowner deems him/herself to be financially insecure. Contractor's Financial Insecurity--In instances where a contractor deems itself to be financially insecure,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. ARE PLANS ATTACHED AS AN EXHIBIT: YES/,NO (Circle Response) ARE EXPRESS WARRANTIES ATTACHED AS AN EXHIBIT. YES/NO (Circle Response) DOES HOMEOWNER ELECT TO PURCHASE PRODUCTS ONLY FROM CONTRACTOR. DOES HOMEOWNER UNDERSTAND THAT CONTRACTOR IS NOT RESPONSIBLE FOR THE INSTALLATION QUALITY OF PRODUCTS WHEN NOT INSTALLED BY CONTRACTOR. DOES HOMEOWNER UNDERSTANDS THAT IMPROPER INSTALLATION MAY NEGATE PRODUCT WARRANTY: YES/ NO (Circle Response) ARBITRATION Contractor and Homeowner hereby mutually agree in advance that in the event Contractor has a dispute concerning this Contract, 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 Business Regulations and the consumer shall be required to submit to such arbitration as provided in M.G.L.,cs. 142A. Moynihan-North Reading Lumber, Inc. Homeowner's Signature Date 'Date By: Dale Fuller Homeowner's Name(Printed) Installed Sales Coordinator NOTICE:THE SIGNATURES OF THE PARTIES ABOVE APPLY ONLY TO THE AGREEMENT OF THE PARTIES TO ALTERNATIVE DISPUTE RESOLUTION INITIATED BY CONTRACTOR. THE OWNER MAY INITIATE ALTERNATIVE DISPUTE RESOLUTION EVEN WHERE THIS SECTION IS NOT SEPARATELY SIGNED BY THE PARTIES. 1057-NR 1/11 White-Office Yellow-Sales/Service Pink-Customer Page 3 of 5 HOME IMPROVEMENT CONTRACT EXHIBIT A OTHER MATERIALS 1. MERCHANDISE ORDERED FROM FACTORY CANNOT BE RETURNED FOR CREDIT 2. NOT INCLUDED IN INSTALL-PAINTING, STANDING OR FILLING NAIL HOLES 3. MOYNIHAN LUMBER CONTRACTOR WILL REMOVE ALL WASTE MATERIALS FROM JOB SITE 4. ALL WORKMANSHIP GUARANTEED FOR 1 YEAR FROM DATE OF JOB COMPLETION PER MASSACHUSETTS LAW 5. IF WE ARE TO REHANG CURTAINS IT WILL BE DONE NO LATER THAN LAST SCHEDULED DAY AT SITE 6. ANY UNFORSEEN PROBLEMS OR EXTRA WORK WILL BE BROUGHT TO YOUR ATTENTION BEFORE WORK IS PERFORMED 1057-NR 1/11 White-Office Yellow-Sales/Service Pink-Customer Page 4 of 5 You may cancel this Contract if it has been signed by a party thereto at a place other than an address of Contractor, which may be its main office or branch thereof, provided you.notify Contractor in writing at its 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 Contract. NOTICE OF CANCELLATION Date of Contract: YOU MAY CANCEL THIS TRANSACTION, WITHOUT PENALTY OR OBLIGATION, WITHIIN THREE (3) BUSINESS DAYS FROM THE ABOVE DATE. IF YOU CANCEL, ANY PROPERTY TRADED IN, ANY PAYMENTS MADE BY YOU UNDER THE CONTRACT OR SALE, AND ANY NEGOTIABLE INSTRUMENTS EXECUTED BY YOU WILL BE RETURNED WITHIN TEN (10) BUSINESS DAYS FOLLOWING RECEIPT BY CONTRACTOR OF YOUR CANCELLATION NOTICE, AND ANY SECURITY INTEREST ARISING OUT OF THE TRANSACTION WILL BE CANCELLED. IF YOU CANCEL, YOU MUST MAKE AVAILABLE TO CONTRACTOR AT YOUR RESIDENCE, IN SUBSTANTIALLY AS GOOD CONDITION AS WHEN RECEIVED, ANY GOODS DELIVERED TO YOU UNDER THIS CONTRACT OR SALE; OR YOU MAY, IF YOU WISH, COMPLY WITH THE INSTRUCTIONS OF CONTRACTOR REGARDING THE RETURN SHIPMENT OF THE GOODS AT CONTRACTOR'S EXPENSE AND RISK. IF YOU DO MAKE THE GOODS AVAILABLE TO CONTRACTOR AND CONTRACTOR DOES NOT PICK THEM UP WITHIN TWENTY (20) DAYS OF THE DATE OF CANCELLATION, YOU MAY RETAIN OR DISPOSE OF THE GOODS WITHOUT ANY FURTHER OBLIGATION. IF YOU FAIL TO MAKE THE GOODS AVAILABLE TO CONTRACTOR, OR IF YOU AGREE TO RETURN THE GOODS TO CONTRACTOR AND FAIL TO DO SO, THEN YOU REMAIN LIABLE FOR PERFORMANCE OF ALL OBLIGATIONS UNDER THE CONTRACT. TO CANCEL THIS TRANSACTION, MAIL OR DELIVER A SIGNED AND DATED COPY OF THIS CANCELLATION NOTICE OR ANY OTHER WRITTEN NOTICE, OR SEND A TELEGRAM, TO MOYNIHAN-NORTH READING LUMBER, INC. AT 164 CHESTNUT ST, EET, NORTH READING, MASSACHUSETTS 01861, NO LATER THEN MIDNIGHT OF � f77��r"" (date). I HEREBY CANCEL THIS TRANSACTION. Homeowner's Signature Date Homeowner's Name (Printed) 1057-NR 1/11 White-Office Yellow-Sales/Service Pink-Customer Page 5 of 5