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Location Q�Z>
No. Date
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8765
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TOWN OF NORTH ANDOVEft
M
Ceitilicate ol Occupancy ,p
Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee - $
Sewer Connection Fee $
Water Connection Fee $
TOTAL & $
Building Inspector
Div. Public Works
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KEEN CONSTiUCTION CO.
21 HEWITT AVENUE
NORTH ANDOVER, MA 01845 NAR10
Tel: (508) 691-5201 M E M B E R
Fax: (508) 682-3231
Submitted
To: IJ
........ ... ...
I L
.. . ......... ........................... .......... . .. . . ............
1) C 1011141.111 . ............ 1410 0 11 Y,��
..........
PHONE DAT
JOB NAME / NO.
We hereby submit specifications and estimates for work to be performed and materials to be used:
PROPOZ"10AL
All home improvement contractors and subcontractors
engaged in home improvement contracting, unless
-specifically exempt from registration by Provisions of
Chapter 142A of the general laws, must be registered with
the Commonwealth of Massachusetts. Inquiries about
registration and status should be made to the Director,
Home Improvement Contract Registration, One Ashburton
Place, Room 1301, Boston, MA 02108 (617): �27_�8598.
Owners who secure their own construction related
permits or deal with unregistered contractors will
be excluded from the Guaranty Fund Provision of
MGL c. 142A.
REGISTRATION NO.
MA. H.I.C. 108383
JOB LOCATION
'Z 1� " A 'e� 0 " �S C,,. I I c_� 0 C , e , S 1c. 0 L, r%- J--- C, 0 1 , Z <� 0 �_o
............. ................. ....................... -1-1111_ ..................... ...................... .............................. ........................... ...................................... ........................
io`
................ Z ............... .......... . . .......................
................................. 111-1 ...................... _ _ 1. .. ......... .... ... .. "... .) .s e I .................
". � fl e-, I.,
I E )1� I - + I I) "
ce Dees r�e�,
... ............. I ................................... ..... ......... - . .............
onstruction related permits:
.. ............
00
WORK SCHEDULE
ContraIr �wil.1,r1t,�egIp,th Contractor will begin the work on or
.fgo the work or order the materials before the third day following the signing of this Agreement, unless specified here in w
(date). Barring delay caused by circumstances beyond Contractor's control, the work will be completed by . q —n !7-S . (date). The Owner hereby
acknowledges and agrees that the scheduling dates are approximate and that such delays that are not avoidable by the Contractor shall nof be considered as violations of this Agreement.
WARRANTY
The Contractor warrants that the work furnished hereunder shall be free from defects in materials and workmanship for a period of following completion and shall
comply with the requirements of this Agreement. In the event any defect in workmanship or materials, or damage caused by the Contractor, h1s; subcontractors, employees or agents, is
discovered within one year after completion of any job, including cleanup, the Contractor shall, at his own expense, forthwith remedy, repair, correct, replace, orcause to be remedied,
repaired, or replaced, such damage or such defect in materials or workmanship.The foregoing warranties shall survive any inspection performed in connection with the agreed-upon work.
We Propose hereby to furnish material and labor - complete in accordance with above specifications, for the sum of
00
L 7 Lo f`1 11 11) dollars ($
Payment to be made as folio
% ($ kf;� ;V6 ntract;CY.* Z 03o KENNETH B. KEEN
Tupon signing co
% ($ upon completion of -r.>E(—
% upon completion of
shall be made forthwith upon
completion of work under this contract.
Notice: No agreement for home improvement contracting work shall require a
> down payment (advance deposit) of more than one-third of the total contract price
or the total amount of all deposits or payments which the contractor must make, in
advance, to order and/or otherwise obtain delivery of special order materials and
equipment, whichever amount is greater.
Name of Contractor / Designated Registrant
21 HEWITT AVE.
Street Address
NO., ANDOVER, MA 01845
City / State
508-691-5201 508-682-3231
Phone Fax
Name of Salesman
ignatu
Note: This proposal may be withdrawn by us if not accepted within - days
Acceptance of Proposal - I have read both sides of this document and all attached documents and accept the. prices, specifications and conditions stated.
I understand that upon signing, this proposal becomes a binding contract. You are authorized to do the work as specified. Payment will be made as outlined above.
You, the Buyer, may c el this transaction at any time prior to midnight of the third business day after the date of
' _:Pp��tt
this transaction. Cancellati must be done in writing.
CIT SIGN THIS CONTRACT.11F THERE ARE ANY BLANK SPACES.
Signature
I Date
Signature
Date
.IVIV - I M11 I MINI W" IWIM I IWIN WIN LJM%.,r% li
-T
............ ..........
ir 1
<
4 IL
........................ ..........
................. . ...........................
.....................................
(Q/ .......................
................... ....................
". � fl e-, I.,
I E )1� I - + I I) "
ce Dees r�e�,
... ............. I ................................... ..... ......... - . .............
onstruction related permits:
.. ............
00
WORK SCHEDULE
ContraIr �wil.1,r1t,�egIp,th Contractor will begin the work on or
.fgo the work or order the materials before the third day following the signing of this Agreement, unless specified here in w
(date). Barring delay caused by circumstances beyond Contractor's control, the work will be completed by . q —n !7-S . (date). The Owner hereby
acknowledges and agrees that the scheduling dates are approximate and that such delays that are not avoidable by the Contractor shall nof be considered as violations of this Agreement.
WARRANTY
The Contractor warrants that the work furnished hereunder shall be free from defects in materials and workmanship for a period of following completion and shall
comply with the requirements of this Agreement. In the event any defect in workmanship or materials, or damage caused by the Contractor, h1s; subcontractors, employees or agents, is
discovered within one year after completion of any job, including cleanup, the Contractor shall, at his own expense, forthwith remedy, repair, correct, replace, orcause to be remedied,
repaired, or replaced, such damage or such defect in materials or workmanship.The foregoing warranties shall survive any inspection performed in connection with the agreed-upon work.
We Propose hereby to furnish material and labor - complete in accordance with above specifications, for the sum of
00
L 7 Lo f`1 11 11) dollars ($
Payment to be made as folio
% ($ kf;� ;V6 ntract;CY.* Z 03o KENNETH B. KEEN
Tupon signing co
% ($ upon completion of -r.>E(—
% upon completion of
shall be made forthwith upon
completion of work under this contract.
Notice: No agreement for home improvement contracting work shall require a
> down payment (advance deposit) of more than one-third of the total contract price
or the total amount of all deposits or payments which the contractor must make, in
advance, to order and/or otherwise obtain delivery of special order materials and
equipment, whichever amount is greater.
Name of Contractor / Designated Registrant
21 HEWITT AVE.
Street Address
NO., ANDOVER, MA 01845
City / State
508-691-5201 508-682-3231
Phone Fax
Name of Salesman
ignatu
Note: This proposal may be withdrawn by us if not accepted within - days
Acceptance of Proposal - I have read both sides of this document and all attached documents and accept the. prices, specifications and conditions stated.
I understand that upon signing, this proposal becomes a binding contract. You are authorized to do the work as specified. Payment will be made as outlined above.
You, the Buyer, may c el this transaction at any time prior to midnight of the third business day after the date of
' _:Pp��tt
this transaction. Cancellati must be done in writing.
CIT SIGN THIS CONTRACT.11F THERE ARE ANY BLANK SPACES.
Signature
I Date
Signature
Date
.IVIV - I M11 I MINI W" IWIM I IWIN WIN LJM%.,r% li
4 1 . ,
I . -
NOT ICE OF SCHEDULE CHANGES
The Contractor agrees that when delays become krown to the Contractor. the Contractor wil'i advisp the Ow-,er as soon as
is reasonable,
DELAYS IN COMPLETION DUE TO HIDDEN CONDITIONS
The Owner hereby acknowledges at d ag ees that in cefla:rt rc-iocic�fng t,',c Ctlrl
Structure may reveal additional defects, condit'ons or the need for adcIftiof"Ji wark IMWK ML:�t b� r-oal�j.o, itere
u or car -
'led Out in order to commence or to cor-pletn, "he aork desm,bed inde, the contracl il, casek--) t!L(- owner agrees
'that the prce, ddration of t1,e work and t -c sched�jlo(,, ciate of corilp�etior -r.aY dIt'c- 4,11 � 11 thc �-e-c z�t:i:uo ji, ihe front, a -d
that such variation which is iot avo�dab C b) 'he Cor,l,actor -i ali not bf, cc.,-!�.�dcrcri it, cor-ii ,ct
ADDITIONAL WARHANTY INFORMATION
Atli warranties for eqOpmen� F�i;pr)cd by the UiX;ei lji-b Agreernorit! shj I 91VV` DY IfIC; 'Pa'-JIFJOU�er-,- rjf
:such equ pniprit Wnl& Sll-,i I CC h( r'J'y -0 VC L y t� 5 t0o Ov.,ne, CIL r Sdf�r" rfl�l I i I aCt J,erS war
-anties. ti -,e Owne( -ia� be 'ecu -o"4 �,� 't ( , f�J,'d or Ot;,��- ct ' 1,J us�� �:)f 'S"C' k
cqu�pr;-.ent in order lo activ�:.tp s--" � -i -,f- doc - -icr-,[a1,: �;, %',r�)JLJ; ,,
voids tie rian,ifacturx � warnirty. tof to -�,var rr�,ty ;ixf e (..oner.t
The wwranty gives t�-e DAnei rf e G vary f--� !, slate to state.
Under MLa,;sacl-uscIts iaw sXe-, f f1f,
wss for a ra l�cu,ar purpose.
All malori,i is guay-, -'.eco t- �%,:-ner ctr
tj standard
prac'ices A-� a :f-,!ition or J(-,
be execi�,!ud f. Wy upor vov6lfler
D r 0 W, I t�ecci—'F- af, Cx! upon strkes, t, 'I, Lients cr delays
L,--,(�nd out cont,c�
SUBC0'q'TH/.'NCT1 N 0-
Cont:,,(;tj� is resjuns-Lic tj L)l,%-
LW[Vwx� ",CwfacL, ..-�i a 'Ih-o Dar-ly,
e�y , I -[ V�o k: rd - 11, K�' - C'
NO ACCELE RATION 0 F PAY Vk F N I S 13 U I' I PC v �'i \ 0 A L L OW E D
The Contractor rnay not oqu�re pa�`U-!,, '�' )C �- 11A � J\, "'CC' 1 — .'s sr oi,' P�jyrne -,t c; for
reazion that he cleerrs hirm.,cif ur �hc pa�r,�e�,�'s 1- Uc -,cc �-A'CUle, U ' T1,a y
require. asa prerequisite tocontiiit,ir.1 rhp V.Of-t t�al u,( ti"e L,1y1qC1-1l�; .'Irj� I !f, ; C'� "I"ic, l!'�at
are in the control of the Owner. st�a I �m� -.1 ir,, a �),, , , r -
(V C �JW Q (4, "-c 'S�( tm,� rl,�j
and the Owner for withdrawal
INSURANCE
Contractor will be responsible to Owner or any thud 'or any rroper!y 61�,.m;4qe or bodily nlu(y ca -sed by himself, his
employees or his subcor.tractors in the performance of or is a of, the �,t.)rk Grider th,s Ayreernent. Contractor agrees
lo carry insurance to cover such damage or tnlury
CONSTRUCTION RELATED PERMIT ACQUISITION
The Contractor under provisions of Ch,ipte( 142A of the Genera! i awq is required to apply for and obta,n all construction -
,,elated permits. The Contractor sha!i not be deemed respunsib;e or delays in the worK described in this agreement caused
by regulatory, permit granting or inspectioral agencPs. agencies. a0thOrities or !nd'Niduals
Notice: If the Owner obtains his own construction-relatud permits for the tviciric describL-d under
this agreement or deals with unregistered contractors, the Owner is hereby advir.:!d
that In the event of a dispute, judgment and nonpayment of the Contracior, the Owncr
will not be entitlM to make a claim to or collection from the guaranty �und ctstablished
by Chapter 142P., r.�'-.G.L.
MODIFICATION
This Agreement, ncludaig the provk3iofifi if� ',It -q C a. id pay ut , sclilf-u-- o.innot t;e ci- except oy a written
sta"lementsgneciby both Conlrac,ora-dCW-r-'( b, i0d. 11 � I
I - i Owner S alto" !n acco,(-,—ce. with 1')e Notice
Df Cancellat'ion
-qS r,c f 7 \J 1- I -OR PXFC�;-1 10'
C 0 P L. E T E N
T'he 0,*.!na� it; ;izrc ro, Viiis A(
IrEar,-ziii unlvizi �--�d i,-idi vil b�larl` s-zcdcns have bazint
illed in m- M&r'.;&--; -07t, LL-� oi ilo: rpil,c�.:bIlEt �..nr; L:i-ti: elj a,.Xilb�is e -x: �-Ic'k2d or rz;z,-:ric-d clocurnents
thEl erz Jnccr'?OLT� a��, -_,, I,: --alo�
COPY 0FA3'-1E-:F4'viFJ1':1
This Agreement;,., L V.1-, r-,
11 --s* C;�CcutL;rj 0 rjuui,caie LIM! aj� cxqrna, t;gred copy,
dc: �c 0 - nut V i-, bo%t;:�', P !c ifle signirg 01 t;le
�efeoi given to t -)f-. u, f� (7,:, u�
karce-nor't Lind LJ
-A
Location
No. Date
HU
% C-.0—
TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee
TOTAL
Check #
17766
6iii—di-ng ��tor
9 Ar . .1
TOWN OF NORTH ANDOVER
BUILDING DEPARTMENT
APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING
&r a,
BUELDING PERNUT NUMBER: DATE ISSUED:
SIGNATURE: Aa44 I
Building Commissioner/IE�REtor of Buildings Date —0
SECTION I- SITE INFORMATION I
1.1 Property Address:
C(�(
1.2 Assessors Map and Parcel Number:
%lap Number Parcel Number
1.3 Zoning Information:
Zoning Di�tr ict Proposed Use
1.4 Property Dimensions:
Lot Area (sf) Frontage (ft)
1.6 BULDING SETBACKS (ft)
Front Yard Side Yard
Rear Yard
Required Provide Regifired Provi&d
Rapired Provicw
1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information:
Public 0 Private 0 Zone Outside Flood ZAMe 0
1.8 Sewerage Disposal System:
Municipal 0 On Site Disposal System 0
SECTION 2 - PROPERTY OWNERSHIPJAUTHORIZED AGENT
1-listuric [District: 'MS NQ
2.1 Owner of Record
MAR-nt\,j Lov--,)Pic 9)Wii1LL- P --L)
Name (Print) Address for Service:
q,-,,%^.( I
Signature Telephone
2.2 Owner of Record:
Name Print Address for Service:
Signature Telephone
SECTION 3 - CONSTRUCTION SERVICES
3.1 Licensed Construction Supervisor:
Licensed Construction Supervisor:
Address
Signature Telephone
Not Applicable 0
License Number
Expiration Date
3.2 Registered Home Improvement Contractor
H01'AE b-ET>o1-
Not Applicable 0
Company Name
-z->L4z;- GPIFIEFI�Oob ST -1 vjo-,;�Cc--,T�-r,
Registration Number
8/-2,/0(,
A ress
X,CIJA.e�) CO� 5&!� - 5' &2 (
Expirafion Date
§,Tn-a-t u r e — Telephone
T
M
z
0
0
z
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90
0
ic
M
1%
SECTION 4 - WORIURS COMPENSATION (NLG.L C 152 § 25c(6) I
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result
in the denial of the issuance of the building permit.
Signed affidavit Attached Yes ........ Z No ....... El
SECTION5 Descriptiono Proposed Work (check applicable)
New Construction 0 Existing Building 0 Repair(s)- terations(s) Addition 0
Accessory Bldg. [I Demolition 0 Other 11 Specify,
Brief Description of Proposed Work:
FGFIACE
I SECTION 6 - ESTIMATVI) CONSTRUCTION MRTR I
Item
k C� /-Z--7 Lo
Date
Estimated Cost (Dollar) to be
Completed y permit applicant
OMCIAL USE ONLY
I .
Building
000
(a) Building Permit Fee
Multiplier
to
2
Electrical
(b) Estimated Total Cost of
Construction
DIMENSIONS OF GIRDERS
Plumbing
HEIGHT OF FOUNDATION
Building Permit fee (a) x (b)
SIZE OF FOOTING
4 Mechanical (HVAC)
5 Fire Protection
.6
Total (1+2+3+4+5
0
Check Number
0M%-JL1%J1'N /0 %JW1'NrJK AulnUMLLAHVIN 1U BE UUMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
1, 1 as Owner/Authorized Agent of subject property
Hereby authorize to act on
My behalf, in all matters relative to work authorized by this building permit application.
Signature of Owner Date
SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION
I I V%
� N—% C as Owner/Authorized Age of subject
property
Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge
and belief
�'� N �.
Print N
Signature of Owner/Agent
k C� /-Z--7 Lo
Date
-NO. OF STORIES
SIZE N
BASEMENT OR SLAB
SIZE OF FLOOR TIMBERS I Sri
2 ND 3Ku
SPAN
DMENSIONS OF SELLS
DIMENSIONS OF POSTS
DIMENSIONS OF GIRDERS
HEIGHT OF FOUNDATION
THICKNESS
SIZE OF FOOTING
X
MATERIAL OF CHRvINEY
IS BUILDING ON SOLID OR FILLED LAND
IS BUILDING CONNECTED TO NATURAL GAS LINE
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1 .1.11 . 6
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
c 11, S 150 A.
The debris will be disposed of in:
Y's 5 �-—, —5x 6 S -
(Location of Fracility)
�A—pplicant
Signature of
�Z-7 /OL-(
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 ofMassachusetts
Department of Industrial Accidents
met
600 Washington Street
Boston, Mass. 02111
Workers' Compensation Insurance Affidavit - General Businesses
parric:
address: "�:FT-
0-(--,C C-7
%%ork site locati,,ln (full address): e;tg 4
1 arn a sole proprietor and have no one
Working in any capacity.
I am an ernplover with eninlave. e
Ur= -4-9-J4 t LL— 'R
Business Type: El Retail E]
EJ Office
(full & part time). E] other
M
'45&9 - 5`7 LP
Restaurant/Bar/Eating Establisun—ent
Sales (ificluding Real Estate, Autos etc.)
I ani an einployer providing workers' compensa ion for m . v c , niployees workiag on this job.
coulpa"N' name.- --r, 0
address: C� 6-5—
YVI — I r, / V < 0 /V
/LL /�- "I �
cit%-: a7 , /Y
phone ii:
insurance,,.. Alne�r-1441A) OWUC, A"-WO.WCR,
v N 1�;2
: `77,
F] I am a sole proprietor and have hired the independent contrac ors listed below A-h'o have the 1501lowing workers'
couipenSatiOD polices:
companv name:
address:
citv:
insurance co.
cornpittiv narne:
address:
insurance co.
Failure to -secure coverage as . . . . . . . . . . . . . . . . . . . .............
ction 25A of NIGL 152- can lead to the impo3ition of c -r inalpenalt of
one years' iruprisenment as well as cjvU penalties nalties fine UP to $1,S00-00 and/or
coll� of this stalemen(may be forivairded to in the form ofa STOP WOFJ� ORDER and a fine ofS 00-00 a day against me. I understand that a
the Office Of Investigations of the DIA for coverage vitrilication.
I do hereby certib, under thepains andpenallies ofperiury that the information . provided above is true and correct.
Print riame
official we oull do not write In this area to be completed by city or town official
cit� or town:
Building I)CPartment
0 chcvktr unindiate response Is required 01-k—Wig 13—d
Selectmen's OMe.
c tontact person: DHealth Department
1revncdScpt 200)) phone #; ClOther
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O;t-26 04 07:27p
FRON'. KIMBLY
Michael Bedard
FAX NO. ; 6033629679
1-401-246-2868
Sep. 14 2004 11:05PM P4
HOME IMPROVENIENT CONTRACT
Sold, Fumished and Installed by:
Branch Narne: &7111) Date: THD At -Home Services. Inc.
d/b/a Ilie Homc Depot. At-flotine Services
345A Greenwood Street, Worcester, MA 01607
BranchNumber: Job Tull Free (800.) 657-5182; Fax: 508-756-2859
Federal 11)1175-2698460 Nih'13c.1 C 02439 PTC,,.L. [.1.# 16427
('I'Lic#565523; \AAticsniclmprovententCt)nLnieLtirgc.L-,.012(,N93
InMallation Address:
KV
Eyp. fin to:
—('S I I
City
Work Phnnei
77�\;--c 7F-
state Zip
lb—phone:
I crio,\., F 5 li,
Horric Address,
(If different from Installation Address) city
state zip
Proweethiformation; I/We,'You ("Purchaser"), the owners of the property located at the above histallation address, offer to
wlthiiont 'Depot") to flurinish. deliverand arrange for the installation of all materials ad
Conti -act Depot U.S.A., Inc. ("Horn
described on the aLtachitel Spec Sheer incorporated herein by rcfcren : ce and niade It pnrt hereof
Home Depot reserves the right to'cancel this contract if, upon re -inspection of the job, Home Depot determines that it
cannot perform JIB abligntions due to a structural problem with the home or becamw work required to eornpletc the job
was not included in the cantract.
Ll
CONTRACT*A MOUNT S J� / I
*0.SS DEPOSIT S
BALANCE DUE
ON COMPLETION S_
'Mininnim 25% of Cunirnct Amo --t due upon execution
of this contract.
Indicate Payment Method For
BALANCE DUE ON !COMPLETION'.
DEPOSIT PAYMENT OPTIONS
(Subject to rund vefirication Andlort—lit opproval.)
1. Check. Cashicri (Aleck or US PoAlulqerv;c� Money Order
Q16de payabl. tu I he Home Depot).
2. Credit Qud* und/ornthcrpAyritent updun.s, Circle Orte Below
c 1 llacov�
r(.: -,d Discov� A—r1cAnExp
Ch---- Home I)cvot Home Improvenall I An, The lionie Ocpor Credit Cird
.')Cp 'tlo'
Awitwble Credit'. $ 0 KM & IMCC ONLY)
A4ctftfcoi��? 15—io— Fp.
marw.Name as it appeirs on card:_
6By my/ayr signature bdow, )h*e I ec i uILo H orne 1) cpot to ct-crut the nbovo
"C' 4, '"'o
on' 4 1 0
r.fer.nCed Credit ctird rur Zh�e dcp. 111dic"re
'htc
Da.
rtJho)d-T'K.1iGn:rIutc
HIL or.IIDCC Authorization Codes
Deposit Final Payment
HZS .-I# � 1-300
Purchaser agrees that, irtmiodildtCly upon satisfactory completion of1he Work, Purchaser will execute a Completion Certificitte
ar.d pay any balance due. PuTchaser also agrees to beJoindy undseverally obligaicd and liable hereunder.
Entire—,, -1,�pent: This agreement and its attachrrients, including any I! , nanoin,, ngreement, criniiin the complete apreement
I, 'it
bel.wee . qtig es and can not be amended
,.�w p
�,dy;i M. wiless in fin Me gmei titAigntel by hoth pirtles.
�Jz parao- A 4 C y
TICE TO PURCHWAS
Do not sign this contract before you read it. Vau are enlitittl to a compiciely filled -In copy or the con2t., at the time you sign. Keep
it to protect your rights. Do not sign an Icmte or ogreenscot stating that you are Shtisfied with the entire project
,g Completion Cerlif - - from requefifirlyrnr occepting, I Completion Certificate Ogned
be�rnre this project Is complete. Law pro ibits honte reptair contractais
by the owner priar tothe actual completion of Cie work to bv performed undtir the, con Ott.
You may cAucelLhis trpusaction at may time prior to Initial ht or the third business day after the date of this contirrict. See Notice of
Canceligtion for an explanatiou, of thi� righ(. There williv. #I service chm-gv. equal in 25% of the contract Amount If the job Is
cancelled by Purctimer AFTER the third buAness day.
BY MY/OUR SIGNATLIPE BELOW, I/WR AGREE'IX) OF BOUND M—l-HETERMS OF THIS CONTRA(77. IIWE ACKNOViLEUGE
RFC'r)lPTOFA (X)PYOrTHIS CONTRACTAND TWO COMPLETED COVILS Or TBE-NOTIC;COF CAi\,LEIXAT1ON..,
11Y My,'OUk SIUNATURE RCLOW, l,`Wh UNDERSTANn THXF TIM AGREEMI--NT IS SuHin(7 TO REVIrW OF MY/01JR
CREDIT HISTORY AND VWL AUTHORIZE IIOME DEVOT AlUTHORIZRI) CONTRM-TOR, TO VETUrY AND ItiWIJ1W MY/01.111
CREDITREXORD WITH A'N/JINQP..VM.9NY C.RF,r)JVREPORTTNG AUENCY AND RELFASS THEM rROM ALL LIAMLITY
INCURREDFROMIN Vr. ISAIqWSORF.RRORS. .
5(JBlvlIMD.UY: Date:
U1 t,
ACCEPTED BY: D2te:
Dutc;
NI)TIMADDITIONALTEXILMS, CONDITIONS ANDWARRAKIWNARE STAIM)ON THE VIVVICIISE SIDE ANo ARE PART 0111:1115 CON-rICAUT
Mire- 8�h Mile YcIld— cumor- Pink-RnIeS COT -11—
5A8-04 C -SC
N
N
I
L-01
S
Location
No. Date
TOWN OF NORTH ANDOVER
0
Certificate of Occupancy $
Building/Frame Permit Fee $
lot
Foundation Permit Fee $
Other Permit Fee $
Sewer Connection Fee $
Water Connection Fee $
$ -fV
TOTAL
Building Instedor
12814 Div. Public Works
Location
No. I -� Date
-0
TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee $
Sewer Connection Fee $ MN
Water Connection Fee $
TOTAL $
Building lns�ecfor
Div. Public Works
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