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HomeMy WebLinkAboutMiscellaneous - 12 FARNUM STREET 4/30/2018 (2) 12 FARNUM STREET , + JB 210/107.A-00440000.0 I + 2012 Massachusetts Electrical Code Amendments 527 CMR 12.00§Rule 8: In accordance-with the provisions of M.G.L.c.143,§3L,the 1 permit application form to provide notice of installation of wiring shall be uniform throughout the Commonwealth,and applications shall be filed on the prescribed form.After a permit application has been accepted by an Inspector of Wires appointed pursuant to M.G.L c. 166,§32,an electrical permit shall be issued to the person,fur or corporation stated on the permit application. Such entity shall be responsible for the notification of completion of the work as required in M.G.L.c.143,§3L. Permits shall-be limited as to the time of ongoing construction activity,and may be-deemed-by.the.Inspector_of_Wires abandoned_and_inyalidafhe—. ._ or she has determined that the authorized work has not commenced or has not progressed during the preceding 12-month period.Upon written application,an extension of time for completion of work shall be permitted for reasonable cause.A permit shall be terminated upon the written request of either the owner or-the installing entity stated on the permit application. The Permit Extension Act was created by Section 173 of Chapter 240 of the Acts of 2010 and extended by Sections.74 and 75 of Chapter 238 of the Acts of 2012.The purpose of this act is to promote job P PrP p j growth and long-term economic recovery and the Permit Extension Act furthers this . purpose by establishing an automatic four-year extension to certain permits and licenses concerning the use or development of real property.With limited exceptions,the Act automatically extends,for four years beyond its otherwise applicable expiration date,any permit or approval that was "in effect or existence"during the qualifying period beginning on August 15,2008 and extending1hrough August 15,2012. P4:RuI e —Permit/Date Closed: ***Note:Reapply for new pert ermit Extension Act—Permit/Date Closed: 5�,�'j—/ C... Date.....v�.:..l ��..........'�... �2 f AORTIf, ` ° :••"� TOWN OF NORTH ANDOVER i PERMIT FOR WIRING ♦ o ti� ,Ss4CMU'+� . This certifies that ....:...... ............. r.; ha&permission to perform .......... ................................................ wrong in the building of............... . .:................... 'r at..........LZ..... Ul l........ ../........... ,North Andover,Mass. 1701 t Fee. P� ."... Lic.No. 3 ,..............•• .:! . .....:. `i` L"I.EGTRICAL INSPECTOR Check # �` 8645 Commonwealth of Massachusetts Official Use Only } Department of Fire Services Permit No. C --- Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 11/99] leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(NEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: ,, II 131 of City or Town of: �, )C) h PynrA/P/1 To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street& Number) IJ Er cnu.Lro s4 Owner or Tenant ` S� �a�j C Iu i Telephone No.� (� Owner's Address Is this permit in conjunction with a building permit? Yes No (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters i New Service Ams / Volts Overhead Amps ❑ Undgrd ❑ No. of Meters _ Number of Feeders and Ampacity r Location and Nature of Proposed Electrical Work: F,D t� ( I �,. P h cu n4 l'-psud Completion of the ollowin table M4 be waived by the Inspector of Wires. No. of Recessed Fixtures No. of Ceil.-Susp. (Paddle)Fans No. of Total Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators , KVA No. of Lighting Fixtures Swimming Pool Above ❑ In- E] No. o mergency Lighting- rind. grnd. Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS I No. of Zones No. of Switches No.of Gas Burners No. o Detection and InitiatingDevices No. of Ranges No. of Air Cond. Total No. of Alerting Devices Tons g �+ Heat Pump I.Nu Tons KW No. of Self-Contained • No. of Waste Disposers Totals: Detection/ Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances KW Security Systems: No.of Devices or Equivalent No. of Watero. of o. of � KW Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent by No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: i Allaeh additional detail if desired or as required by the Inspector of Wires. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such covers a is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE Lam' BOND ❑ OTHER ❑ (Specify:) Estimated Value of Electrical Work: Lo,�O -''(Wh (Expiration Date) en required by municipal policy.) Work to Start: / Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify,under the pains an penalties of perjury, that lite information on this application is true and complete. FIRM NAME: A ' hCl L t- j C LIC. NO.: 0JUA A Licensee: i�CbP(4 (Y('.t l J, Signature itz LIC. NO. ' S^ - (If applicable, enter "exempt"in the license number line.) f ' Bus.Tel. No.; 74 Address: a� r ICS Y. ed 1 7 (U \�� to f M7 f (Jf ` �/J Alt. Tel. No.Y r4 ,S3947 OWNERS INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the(check one)❑ owner ❑ owner's agent. Owner/Agent r Signature Telephone No. PERMIT FEE: $ ✓S , i i i Y N J Y Date f NORTH 1 �o TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING `3 SA HU5 This certifies that . . . . . . . . . . . . . . . . . . . l.V . . . . . ... . . . has permission to perform`:� . . . . . . . . . . . . . . . . . . . plumbing in a buildings of . . 2.-�... . . . . . . . . . . . ? -'`��' / Nort Andover, Mass. t; at . . .`. . . . . . . . . . Fe4 . �. .Lic. No%,c?,-ll . �. . . . . . �PLUMBIvG INSPECTOR t Check # ��. , 8015 `. MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMB (Type or print) ING NORTH ANDOVER,MASSACHUSETTS Building Location I G�f V��• Owners N 6) ame Permit# T e of Occu anc \ Amount New Renovation Replacement ' Plans Submitted Yes � o FTX'i'URES c� U � U O Q .a P U Z'Q EIJM 3MELaR 4IH E[JDM SIH Elm 6IH E CM 7]HK _ 9MMOCiR (Print or type) Installing.Company Name ..� ,S � II/1 II�aaD�� Check ne: Certificate p. Address b f Cor ��\r+ e Partner. Business I elephone _ a Firm/Co. i Name of Licensed Plumber Insurance Coverage: Indicate the of insurance coverage by ch In ropriate Liability insurance policy Other type of indemni appbox: ty Bond ❑ Insurance Waiver. I the undersigned,have been made aware that the lice three insurance nsee of this application does not have any one of the above Signature Owner . 10 Agent ❑ I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of m31 knowledge and that all plumbing wort and installations performed underrJOueyman compliance with all Pertinent rovisions of the Massachusetts State plumbin, lication will be in p p o Code By: eneral Laws. rgnature of l:acense um er Title Type of Plumbing License �AN wn OVED coFFtcE vsE orrr r rcense vumoer Mases ❑ Date. . . . . . . ....Z ;r <4 .0R':�+ TOWN OF NORTH ANDOVER « ^ PERMIT FOR PLUMBING ,SSAC14USE� This certifies that i�, .'. .. .'. . . . . . . . . . . . . . . has permission to perform . .. t. S.. . . . . . . . .`.` plumbing in the buildings of . . t. .� ` . . . . . . . . . . . . . . . . . . . . . . . . . at . .��?. . ./._ . . . . . . . . . , North Andover, Mass. FeeXr. .Lic. No.. 3 � .. . . . . . . . i �PUMBING INSPECTOR Check # 5308 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Printf or Type) l V i L C1i'ele", Mass. .Date 200 2 Permit # S"3 Building Location Z a ,r04(10 L!5� ,Owner's Nam Type of OccupancyAt".S+ z)E.Q TI A(.., New ❑ Renovation ❑ R`plac ment 1K' Plans Submitted: Yes ❑ No ❑ FIXTURES _Z 2 N Q Z Y O Z W W Y LU J W Y V Q N (5 ¢ ¢ N Z N Q ¢ Q ' ~ _Z O _Z H a O O W F- W ¢ S ¢ N y, Z J N N W = N ~ V W N Y Q N a x ¢ m ¢ Q Z ¢ a C9 Q C (� Z ¢ N W F- fA C Q H Z .¢ a ¢ O W W S W 3 O D J N C' i- Q Y G ¢ G W x W k N N Y W t FO- E� O O H ~ Z O p N Z _Z W O V X Q Q S Q Q O Q J J Q ¢ ¢ Q O Q F- i X J (a a Q S ¢ in O I I l` SUB—BSMT. BASEMENT IST FLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR STH FLOOR 6TH FLOOR 7TH FLOOR STH FLOOR Installing.Company Name_ P50r3EeT Q S3P(rmA7'r4e ) Check one: Certificate Address '��n C 4(N m An) "e,Pj ❑ Corporation IY) E TN r.' , Yo A U I ff V./ ❑ Partnership Business Telephone c17 7 perm/Co. ^ Name of Licensed Plumber 7- i�r� �A,�►�or►��1 regee"% INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes No ❑ If you have checked yes, please indicate the type coverage by checking the appropriate box. A liability insurance policy Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner El Agent ❑ 1 hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit issu for this application will be in compliance with all pertinent provisions of the Massachusetts State Plum ' g e andr?7 of the eral Laws. Title 0afire of Ucensed Plum er City/Town Type of License: Master % Journeymah E]_ APPFiONED OFFICE USE-ONLY) License Number_ 3,_,I___ BELOW FOR OFFICE USE ONLY FINAL INSPECTIONS SKETCHES PROGRESS INSPECTIONS FEE NO. APPLICATION FOR PERMIT TO DO PLUMBING NAME &TYPE OF BUILDING LOCATION OF BUILDING PLUMBER b� PERMIT GRANTED DATE 19 • r� PLUMBING INSPECTOR . ri . TV Location '' -�- - No. /ill Date I" pf NpRTq TOWN OF NORTH ANDOVER 41 Certificate of Occupancy $ Building/Frame/Frame Permit Fee $ s,k�,st 9 F' Foundation Permit Fee $ Other Permit Fee $ TOTAL $ °� Check # / v 567 - --"' /� '--Building In ctor TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCTREP RENOVAT OR DEMOUSA A ONE OR TWO FAMILY DWELLING i. B JM,DrNG PERMIT NUNMER __ DATE ISSUED: F1 pq SIGNATURE: Builth hJ5 Date Z SECTION.1-SITE INFORMATION 1.1 Property.Addresc: 1.2 Map and Parcel Number. Map Number e Parcel Numb© i ,1.3 Zoning Information: 1.4 Property Mute cions: Zmin Diatriat Use IA Ames Prprta f 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide ed Provided Rufflired Provided 1.3. Flood zone tnfomatim: i:8' 3 t.�waror sapptyMctcCao. saT sot i Pobik ❑ Priyaw ❑ Zone o4uibeFt0odzone ❑ Muaioipal ❑ Oa SiteDupoaat Sgstonf I1' SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT rn 2.1 Owner of Record r Ta Q��4 �� eid Qc- ► � Name(Print) t� Address for Service: Signature Telephone 2.2 Owner of Accord: y Name Print Address for Service: z . Z M Signature Telephone k SECTION 3 CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable Licensed Construction Supervisor: License Number Address a Expiration Date Signature Telephone. r.. , 3.2 Registered Home Improvement Contractor Not Applicable D u y-64-ezk Paiir>-h� e Comppany�Name Registration1 3 ( © Number Address l*m6oj(Dee 'Signature. Telephone SECTION 4-WORKERS COMPENSATION(KQL C 152 § 25c(6) Workers Compeosalion Insurance affidavit must be completed and submitted withihis,applicatioo.r I ailure to provide dtis affidavit will result in the denial of the issuance of the building Sig*affidavit Attached Yes.......0 No....:.A SECTION 5 DOcii tion otI'M`"sed Work dredtall ' ucaNe'. New Construction,0 Existing Building 0 Repairs) Alterations(s) 0 Addition '0 Accessory Bldg. 0 Demolition 0 1 Other 0 Specify Brief Description of Proposed Work., 1`1(� g� f`e-��� .('.�j fit' I Y1 G r • SECTION 6-ESTIRATED CONSTRUCTION COSTS Item Estimated Coat(Dollar)to be Co leted by applicant: I: Building (a) Building Permit Fee Multi Her 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(a)x(b) 4 Mechanical HVAC° _ v 5 Fire Protection . 6 Total 1+2+3+4+5. S' q I 01b Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUHDING PERMIT I; as OwnerlAuthoriaed.Agent of subject property Herebyauthorize to act on My behalf,in all matters relative to work authorized by this building permit application Signature of Owner Date SECTION7bOl'NNEWAUTHORIZED-AGENTDECI.ARRATION pr C' as Owner/Authorized Agent of subject ply Hereby declare that the statements and information on the foregoing application are true and accutute,.to the bestof my knowledge and belief - Print Nath SipaYure of Owner/Agent Date—� NO.OF STORIES SIZE .BASEMENT OR SLAB SIZE OF FLOOR TIMBERS fir 2 3RD SPAN DD&NSIONS OF SILLS DIMENSIONS OF POSTS DAdENSIONS.OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING. x MATERIAL OF CHII`�Y IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LM i � NpRT►y Town of Andover No. /OQ z _ = L dover, Mass., 9 COC NIC NE WICK AERATED P'P�\ �C `S BOARD OF HEALTH Food/Kitchen PER Septic System BUILDING INSPECTOR T D THIS CERTIFIES THAT................................ ................................................... ...................................... """"""' Foundation has permission to erect............... ... buildings odl� ..�......... Rough to be occupied as.. Chimney provided that the arson acce is permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisi of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of No h Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTIONS — Rough ..................................... ....................................... ....................... ce INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous -Place on the Premises — Do Not Remove Final No Lathing or Dry Wail To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. I I I , North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c11, S150A. The debris will be disposed of in: AA (Location of Facility) Signature of Permit Applicant Lt S Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector • The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers'Compensation Insurance Affidavit Please Print Name: i k_y OL 1 C b s 6V S L<N Location: 0,(-"off S T Cit, N O`� Avgye f- , MA Phone Y)A, �o�� • �o��� 0 am a homeowner performing all work myself. aI am a sole proprietor and have no one working in any capacity EI am an employer providing workers'compensation for my employees working on this job. Company name: y y\kA&A `QQ j►1-j Vic, VD Address a(Do City.. MA Phone#: Insurance Co. UICGVV-(-'Z Policy# Company name' Address City: Phone#: Insurance Co. Policy# Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of($100.00)a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do herby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature �v L Date Print name 5 oywl CAS Ula U Phone# Official use only do not write in this area to be completed by city or town official' E] Building Dept ❑Check if immediate response is required Building Dept p Licensing Board E] Selectman's Office Contact person: Phone#: Health Department Other FORM WORKMAN'S COMPENSATION a Fjxw' ' Standards i3oard of Building R0941 orm O� Boston. Massachusetts 02108 Improvementcontrootor Registration TZ P �Cry UNITED PAINTING OOMPANY INC FRAMINGHAM, MA 01520 �ggL g� �y��„ �y y Upigo k rdan and C0f�9M 0 094�°�'�tib ����!�`�t�'►►t9�� CIn Lost CardJ- 020 02 0 wl?r�3f �PrPt✓ fu"AAi' Iddri► } � � � be the v9phtlad t �e6�ax tat board Of 69116180 Iftesubtfaft Bud standewl ?` tt t 130w one A.aubo ?ISO no 1301 :Erupmant imims 901ftat Me.Oko$ Types pmb 4pwa4 URITED PAINTING COMPANY W JOHN DUOLMY 9 00NAN° Rid►GUITS A A p CERTIFICATE - - - O LIABILITY INSURANUL � 48►1670b THIS CERTIFICATE ISISSUED.AS A MATTER OF IN FORMATION aRODUCFR ONLY AND CONir ERs NO RIGHTS UPON TNIE CERTIFICATE Herlihy Insurance,Agency,Inc. HOLDER TICS CERTIFICATE DOES NOT,AMEND,EXTEND t3R 65 EieT�Street ALTER THE COVERAGE AFFORDED 13Y THE POLICIES BELOW. _ Worcester,MA 01609 AiAIC# 508756-5159 INSURFRS AFFORDING E:OVERAGE INSURER A A+cad4E�I sUranee tSA pang United tailTtng CoEragsat>Y,iasc-end INSURER 8: AEETIegirY iestlE>3tiaTaal tsrtaaEg� United Painting CtaMPanY,t.t_C. INSUE - , RER C: 200 Butterfield Drive,Unit I INSURER D; .Ashland,MA 01721 buSURERE: COVERA€zErs THE POLICIES OF ICIStERAA10E LESTED.fJf3 E3lN HAlrCBEEid ESSUWTOTiiEEtSStJ4 SdA EC3 FL]E�€HEPL3E ICY AEREOt)iND1GAI E17.N JT tTHSTAND�iE'' ANY FtEQU1REMENT.TERM OP.CONDITIW OF ANY CONTRACT OR43THERD(9 LVVE�i'E'V4I Ei RESI�ELLCT THET ERMS,CH YC USIO S ANDTE CO D ISSUED F S MAY PERTAiEV,iHE INSURAE+iCE AFFC3ROEi38YTHEPQ3€CIES BE HEREIN jS SLBJEGTTO ALLTiiETER€1�5,EXCi U5�ONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LWITS SHOW MAY RAVE BEEN REDUCED By PAID COWS. pOLICVEfFECTlVE p�LYEXPYRA 43s:tT& LTR S TYPE OF INSU3'.ANCE Pt]LICY NL6t�lt EACH OCCURRENCE 51 000(Ian A GENERAL LIABILITY CPAD-Ii338710 {get11511Ls� 04115106QAAAAG'ETQRENTED _5250 000 X a COMMERCIAL GENFJ2AL LEA6ILFIY 1100� DG.,�� 4dEG'aXP(Any ai,e perso„) S ctacaseaAT36 3t PERSONAL BADV INJURY s1 IDOQ 1100 i GENERAL..—GR GATE S M.0ou t PRODUCTS.GQmFgOP AUG S 000 000 G-VNY AGGRSGATELIF4IT APPLiSPER: LOCPDttCY � .. t A AtfrOMO tLELIABILITY MAA011338810 1241951115 fl�145fQ6 (Ea,9Waw,i)EDStt6Gi LZrnrf S1,000,001) (Eaaca "'tet ANY AUTO ( [ ALL OWNED AUTOS I BDflp.Y ig . (P�r person-)1 X SCHEDULED AUTOS X HIRED AUTOS HODm dwi) S (Pry orcide;a) � NO 4VVNED AUTOS i X Drive Other Car eRoarR,r nAnaAc� s } --- AUTOONLY-EAACCID T �5 GARAGE UABXVY aTHERTHAN FAA+�C S ?WY AUTO AUTO LNSLY: AczG S A EX-CESaUMBRELL�A-L�raury OIP,4�F#r!S 111 t 1J41951€€s 941`i5106 EACH 0--WRREtve_=` s1 040 006 AGGREGATE Si £100 OOQ X OCCUR L_.l CLAWS MADE � - s s DEDUCTWL£ 5 X RETENTION so WGSTATU- O'tTi- E3 YWRIMRS COMPBNSATEII a AND W C93fli883 �Daisies 08115106 ER2Ptt)}ERS'LIA�4iETY i E.L.EACH ACCIDENT 080000 ANY PROPRIErORPARTWRIEXECUTI"i E ELOISEASE•-EAE 1,--O--`EE s'��UygDD OFFICERIME-MBER EXCLUDED'! it yes,desvibcvn�r E.L.DISE.44E-PDLICY L4l11T X044000 SPECIAL PROVLSIONSbelow OTHER DESCREPTEbt� C3PERATEQRSiCLZi:AS1C�ISIlE digESFEXCCUMMADM Bye"DflRSEAURTISPECIALPROWSiONS l v CERTIRCATE HOLDER CANCELLATION SHOULD ANV DF THE ABMFE DESCRIBED PC,LILYES BE CABti.£LLED BEFORE THE EXPIRAnDN r DATE TFIEREtYr,.THE ISSUMG I1dSURE141A9LLEIRDEAVORRiAFI- — ( DAYS WRITTEN fibTIG£TO THE�CMTISCATE HOLUM NAA9EU TOTE,E LEFT,8UT FAVttiFs To nD GO e" L }pifPOSF%D 4JELIGATS9i:�ORL.4. til°EiFANY 5C44dDUPO2ITHE[RS:s�IRER,FTSFttiENTSOP f REPRESENTATIVE& Au"ORTLEI7 Stg,4MMUTATAM F �}� '�I10�"I�Il Y4iY\f'VS\tll lOt� 18 ACORD 25(2001109)1 Of 2 allM23225 5 R` United Home Experts & 10 6 RnUNITED HOME United Painting Co., Inc. � E X P E R T S'" c 200 Butterfield Dr. Suite I 'tr Ashland, MA 01721 Full worker's Compensation Coverage 508-881.-8555 FAX 5,08-881-5584 MA HIC License#130101 $2,000,000 Liability InsM-ance Coverage www.unitedpaintiing.net RI REG#22948 watranteed work d 7 { q$3- t'1 l� PROPOSAL PACE 1 Project: Bid Date: Attn: Phone#: work#:Company: wo �'ca.P— l Address: Fax#: r Email: City, St.Zip: G/ Heard of us by: • 14 �-^- U V Base proposal,as per attached scope of work: Alt tes: An y additional customer requested carpentry work will be billed at U� o Xc. per:hour+materials. ' Oi^r �dU — Of ices good for 30 days ro ALI • � PAYMENT: Anon-refundable deposit of 1f3 of the accepted proposal item (s) T amotmt is due tft in the amount of with 1/3 due upon half of completion in the amount of and the balance due upon completion in the amount of$ _ +any customer options DISCLOSURE: State law requires us to inform you of contract liens. Any contractor,supplier,or subcontractor may lien your heal property if you or the general contractor fail to pay for goals or services delivered or installed at the work location. Some contractors and suppliers automatically send letters of notification similar to this notice. At your request,we will provide original lien release documents from anyone who provides said materials or service. Please call if you have any questions regarding liens. ACCEPTANCE: The signature on this proposal reflects acceptance of the proposal as per the attached scope of work, authorizes commencement of the work,and hereby guarantees payinent as outlined above.Any amounts not paid within thirty days of invoice are subject to service charges of 1 'h a er month(18%APR).All costs of collection,including reasonable attorney fees are to be paid by the sus er. Ec" Date Date BBB VISA i 1 Pitject,Name: Id f7ru PAGE 2 SCOPE OF WORK he base proposal reflects furnishing labor and material to complete the roofing,remodeling,carpentry and/or siding work following -ofessional.standards as follows: urface preparation/Demolition: Areas for work to be performed:. . .' . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .� . . . . . . . . . . . . . . . . . . .. . . . . . . . ubbish removal es/afi If dum ster, location: . 4 r_R f , Item Included Not Included l)Removal of existing roofing. #of layers(- ) .f more layers,priced when seen 2)Necessary Permitting 3) Inspection of all sheathing and roof penetration flashings. No charge for re-nailing ._ oose roof boards 1) All sheathing rot repair will be priced when seen: priced at$, per 4x8' sheet 1-4 i) Install Ice and water shield under shingles abo e all guttei;edges, in valleys,and tround roof penetrations i} Install 30 lb. felt underlayment under shingles �) Install new aluminum flashing around roof edges(color: Brown,whi , aluminum] j- ;) Install niw pipe vent boots ` ►) Install new ridge vent. Cut new ridge vent if needed. .0) Protect house and bushes with tarps. Clean and remove all debrit when finished Lam% 1) Certainteed SureStart Plus Coverage Warrantee .. Lingle Type 3-Tab:shingles CertainTeed XT Seal King AR 25 yr or Tamko Elite Glass Seal 25 yr Architectural/Laminate shingles CertainTeed Woodscape 30yr or CertainTeed Landmark 30yr or Tamko Heritage 30yr CertainTeed Landmark TL lifetime or CertainTeed Carriage House lifetime or Certainteed Grand Manor lifetime PECIFIC EXCLUSIONS: We understand the following surfaces are to receive no work: ♦Chimney repair work(inspection is included) ® All areas not mentioned above 'larifieations: Basic clean up will be observed at the end of each working day, thorough at end of job. le understanding that if needed, landscaping will be cut back away from the house by others prior to starting the work. ee Definitions and Conditions on the hack of this contract cct for Pyninnntinne Af t,:-mc