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8 OAKLAND ST - BUILDING INSPECTION (2) The Commonwealth of Massachusetts ® Board of Building Regulations and Standards OF SALEM CITY Massachusetts State Building Code, 780 CMR, 7"edition Rev ed January Building Permit Application To Construct, Repair,Renovate Or Demolish a 1, 2008 One-or Two-Family Dwelling This Section For Official Use Only Building Permit Numb :- Date Applied:I Signature: 4k1+^ 5P511 Building Commissioner/Inspector of Buildings Date SECTION 1: SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map& Parcel Numbers 8 Oakland Street 17 232 1.1 a Is this an accepted street?Yes X no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dim s: R2 One Family Zoning District Proposed Use L a(sq ft) Fron 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required mvided Required Provided Required Provided 1.6 Water Supply: (M. . ,§54) 1.7 Flood Zone Informs . . 1.8 Sewage Disposal S s Zone: _ e Flood Zone? Public Private❑ Check if yes❑ Munic' n site disposal system ❑ ! SECTION 2: PROPERTY OWNERSHIP' i 2.1 Owner l of Record: Anne Marie Sirois 8 Oakland Street Name(Print) Address for Service: Attached Contract 978-745-8423 Signature Telephone .r SECTION 3:DESCRIPTION OF PROPOSED WORK (check all that apply) New Construction❑ Existing Building❑ Owner-Occupied ❑ Repairs(s) H Alteration(s) ❑ Addition ❑ Demolition ❑ Accessory Bldg. ❑ Number of Units I Other ❑ Specify: Brief Description of Proposed Work-2: Replace 1-Entry Door, Same Size,Non-Structural,and Install 1-Storm Door SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $6,035- 1. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical $0 ❑ Standard City/Town Application Fee s ❑Total Project Cost (Item 6)x multiplier x 3. Plumbing $0 2. Other Fees: $ 4. Mechanical (HVAC) $0 List: 5. Mechanical (Fire $0 Su ression Total All Fees: $ Check No. Check Amount: Cash Amount: 6. Total Project Cost: $6,035- 0 Paid in Full 0 Outstanding Balance Due: • SECTION 5: CONSTRUCTION SERVICES 5.1 Licensed Construction Supervisor(CSL) 97519 08/31/2012 Lubos Svbc—Sears Authorized Agent License Number Expiration Date Name of CSL-Holder 827 T m son CT 0 77 List CSL Type(see below) U Type Description Add C�C✓I' U Unrestricted u to 35,000 Cu.Ft. R Restricted 1&2 Family Dwelling e M Masonry Only 860-753-0452 RC Residential Roofing Covering Telephone WS Residential Window and Siding SF Residential Solid Fuel Burning Appliance Installation D Residential Demolition 5.2 Registered Home Improvement Contractor(HIC) Sears Home Imp—Lubos Svec—Sears Agent 148607 HIC Company Name or HIC Registrant Name Registration Number 1 loridaCge traI Parkway/Longwood,FL 32750 Addr W, eCrS 10/11/2011 ` 860-753-0452 Expiration Date Telephone SECTION 6: WORKERS' COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152.§ 25C(6)) 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 ..........❑Q No........... ❑ SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT �r I, Anne Marie Sirois , as Owner of the subject property hereby - authorize Sears Home Improvement—Lubos Svec—Auth.Agent to act on my behalf, in all matters relative to work authorized by this building permit application. Attached Contract /✓Lay /Cgl ?01 11 Signature of Owner Dates SECTION 7b:OWNEW OR AUTHORIZED AGENT DECLARATION 1, Lubos Svec—Sears Auth.Agent ,as Owner or Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and behalf. Lubos SvSears Home Improvement- Authorized Agent / Cell: 860-753-0452 Print Name Sign re of r t onze ge Dates Si ed under the ains an ena ties of per'u NOTES: 1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIQ Program),will not have access to the arbitration program or guaranty fund under M.G.L.c. 142A. Other important information on the HIC Program and Construction Supervisor Licensing(CSL)can be found in 780 CMR Regulations i 10.R6 and 110.R5,respectively. 2. When substantial work is planned,provide the information below: Total floors area(Sq. Ft.) (including garage,finished basement/attics,decks or porch) Gross living area(Sq. Ft.) Habitable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of half/baths Type of heating system Number of decks/porches Type of cooling system Enclosed Open 3. "Total Project Square Footage"may be substituted for"Total Project Cost" r The Commonwealth ofMassachuseus Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www mass.gov/dia Workers' Compensation Insurance AlTidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/orgwiimtion/Individual): Sears Home Improvement Products Incorporated Address: 1024 Florida Central Parkway City/State/Zip: Longwood, FL 32750 Phone #: 860-753-0452 Are you an employer?Check the appropriate box. Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. t 7. ❑Remodeling ship and have no employees These sub-contractors have K ❑Demolition working for me in any capacity. workers' comp. insurance. 9. ❑Building addition [No workers' comp. insurance 5. We are a corporation and its required.] officers have exercised their 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions myself [No workers' comp. c. 152, §1(4),and we have no 12.❑ Roof.epan—s insurance required.] t employees. [No workers' 13.M Other �G C I E comp. insurance required.] 17PP `Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. I— t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. 2Contmctors that check this box must attached an additional sheet showing the time of the sub-contractors and their workers'comp.policy information. 1 am an employer that isproviding workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Ace American Insurance Company / Phone:866-283-7122 Policy#or Self-ins.Lic. #: WLRC46138211 Expiration Date: 08/01/2011 '/ll Job Site Address: <�I�4,1 I City/State/Zi { V Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DLA for insurance coverage verification. I do hereby certify i r to pains and patties ofperprry that the information provided ove is true and correct. Simgmature AZ2 {Sears Auth. Agent} �. Phone#: Home—Fax : 860-315-7468 / Cell: 860-753-0452 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2.Building Department 3.City/Town Clerk 4. Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: N 08/06/2010 08:14 4077678536 SHIP PERMITSKICENSE PAGE 01/02 ACORLtIf' DATE( DD/YYYY) ��. CERTIFICATE OF LIABILITY INSURANCE DalDa/zalo P°OOA S CERTIFICATE IS 7SRMD AS A MATTER OF INPOMAT10N ONLY Chicago IL Office Assn Risk services Central. Inc. AND CONFERS NO RIGH"UPONRE.CER'M+ICATE HOLDER-ITt15 Cce i Chi East Randolph COVERAG1TE DOES NOT AM END,FEIIES OR BELOW.ALTERTfIF, Chicago Is. 60601 USA COXERAGE AFFORDED 9XTRE POLICIES DEI.Op'. NIONE. 666 283-7122 PAA- 847 953-5390 INSURERS AE-BOIIDLNG COVERAGE NAIC2 INSURM - iNSUR6RW National Union Fire Tn5 Co of Pitt5bueyl+ 19445 Sears Moldings Corporation RSUFR O:R ACE American Insurance Company22667 vy dba Sears Home Imprgqvelnent Products, Inc t Attn_ Risk MM2Remeht E3-219A Den Q Indemnity Insurance Co of North America 43S75 5 3333 Beverly Road - -- Hoffman Estates 11, 0179 USA NSUmm D: y v CISl11mR@ o COVERAGES THE rOilCif30F nVSUBANCEUSTP.ORi+lAW iwW etEH TSSL'FA TO TfIR D18UR�NAM6DA00VE➢DR TFC PpuCY Paltloo MDIGTSD. VOT0.71HSLAn'O1/:G ANY AeDlI1RRMENi',TERM OR COND177ON OF ANY CONTRACT DAOTHIlk DOLUMENTWrMRES=TO WEDCH THIS CEATRICATR MAYBE ISSUED OR MAY FERTAM.TT NSURANCEAFSORDEDEY' �D UCIESU SadMOEWAEMIS8Ual TOALLTHETERM,q. RC MI A101CONDDIONSOFBUCBPOI.I=R AGG%VGATefAV1%SHOWN MAY HAVEBEFV REDVCBVUV FAIDcs-m la. UMSSHOWN ARE AS REOUESTEO wva Ra I,Tn iSAD or nCleGNti POVC'V MmimtA roLCY L'NICTrv4 VOLiCY EXnINltON Linen ten MTR mDW g 13ABniiT' NOOG2551.9826 08J01/2010 OB/01/2071 6AC110LLY/PAAaT f5.000.000 % eOMAPlC1AL(IEndaALLW1ILITY OAMAOETORENfen ff,DBDr ODD N rAg DSev ccuMSMwa oecvR I TonoptorvB Lxc u e PSASONALa AOV INrtalY ff.OD0.000 � ' OT:T9iAAl An9BBDAYE °e 5f.000,000 n GDlLACOREOAT6LiMTi MPIh3 TeR : T eaoavcr6.coMrmr AM 55.000,000 nX MUCY El nm,©LOC o 0 AUTOMOOnR 1UAXU1 ISAMU62530S 08/01.non 08/01,201, caMamT;oawclBlm.Irt a o ,MN AU" ISAR08625499 08/03/2010 0 /01/2021 a:+.aBol S5.000.000 Z ALLOA%tSb AUKS BDDMY MAA seffm3 ED AUTOS (h'RMOa] % anum Aurve BODILY WARY U rnTa OtvnRO AUTOS � ryerc�1 eBsrmTv DAMAGE (itr+nid[ml CAAALM1:GiA01LIN AUTOONLY-eAARD nNv ALTO oTHTnTNAN� r,.Act ALTO ONLV A00 A Mccm?VMnccv.ALM®urP BE2747:373 OB/O1/2009 UsiolIzolo R EACH Qe5 CIAD'S mmu; AOOaTAATiP S2.000.000 aErnxnaN � g WIRE46LM17A % 9T4N- 4T14 YlORI®L4 COATECmATtON Anv YID CA N4 C RMNAYENS I4naoJry IN I SC:C46138259 08/0212010 06/01/2017 EL SAM AL=o 52.000.000 A VROI'RMIt RIPAaTATa 1T%ttlIDVE LI E.L DIdEA566ABMPLP-/BEE S2.800.000 e °M uLAC4613821i 08/0112010 os/ol/ioil eL DLtBATe-roucY urnrr sz.000.aw deoEem MECIN.PROVAVYNa b9ow All Other States OTIIE0. Dr,3eK 0AOPOTEGTIO?B4ACATf(9�SAtEiRtl.6518)[CILSSONS ADOBDBY ENDOR89MENlhT'6LTA1.P0.1YVmIDNS CERTIFICATE HOLDER CANCELLATION Sears Home Improvement Products, Inc. SHOUTA wNvwnm AOOVBDeSpua®TovnBe EECANCC11.R0 af50REn1E e%Pmni(ON 1024 Florida central Parkway DATE THMUs0F,TMR TgTUtan o%s8UR SIM BNOBAMM=mA:I Lon9°v od FL 32750 USA 4DAV5 WRTITT)t NRTeg MSliarliRTnIGTExOtOwtMAMb'OTO TNBLm"t. OUTF0.¢UAdtO W dOSHALL IMPOatN0 OR12rdTIOti aR UA9nliY OF ANY IOND IaOH DiE lN.^.V 0.ER./IT ACPNI$O4 a59¢FHPTAYI V ES AVTHOBRFD BdHrdBBNTATivB �� �� �y.�p��wA ACORD 22%(2009101) The ACORD mwe anA logo a"raBlTtcrad Marks atACORD 9R8 IU09 ACORD CORPORATION.All TiKhR reTeraM= Received on 8/6/2010 B; 16:28 AN 0 iice o niee, air, an46slness egu atxin l 10 Park Plaza - Suite 5170 . s! Boston, MflssachUSetts 02116 Home Improvement Contractor Registration Registration: 148607 _ Type: .Supplement Card SEARS HOME,IMPROVEMENT PRODUCT Expiration: 10/11 f 2011 LUBOS SVEC d, — 1024 FLORIDA CENTI<2AI_ PKWY ----- LONGWOOD. FL 32750 lipdale Addrrx5 and return card.Mark reason fur change. —'1 Address ReneHal '"EmploFment Lost Card LWSCA� Fi SCMpV'i9G-my%fC _ Offiee of Cun>mncr Affairs l ltn,i nrss Iltguhdinn License or registration valid(m ind ividul use onh• rPYHOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation ;; Il�- �i Registration: 148607. 10 Park Plaza Suite 5170 - N Expiration: 10111I201i Boston,NIA 02116 Type: Supplement Card n SEARS HOME IMPROVEMENT PRODUCTS INC. LUBOS SVEC 1024 FLURIDA CENTRAL PKWY LONG`NOOD.FL 32750 rudcrscrreta rr Not valid without signature"--` I - += \l:usxhusctts - Dcparnncnt of Public $afrtc 7S Buard pl' Builditl_ Re_ulations and Scuul:u•ds ` Construction Supervisor License _. License: CS 9T519-. x LUBOS SVEC ' 827 THOMPSON F 'SAD THOMPSON, CT 06277 - --- - - - -�- jr'` •• Expiration: 8/31/2012 Couun km-owr Tr#: 2442 . r 1,JV 0Z:EO'B TiOZ;'c/S 'ro CoA-e_.+yy II11lIQIIIAIQ N pnul oats S-- 01 Jobs I 14JO( Seam Home 1Mprovemerl Products,Inc. Customer Name P.D.Baz 522290 1024 Florida Gen list Par kwdy Guainmers Home Pnme cvswmerswnA Phme Home Improvement Union Longwood,FL 32252-2290 E- _ t Phone (800)469A 3 _ soon Addmu EsnUATEANDPAC IOSnu. Gomraelor'Lrcnweriepmraaon liumoer Doors III C#14861 all plumbing and electrical Ci Susie�Lp Code setViCes performed by Ilcensod snhenntradnr5 ' I /1 Is ins adon within city I its? FEIN 25-1698591 Installation Atldress County UdTfies ❑No solute Address(mdiflerem rmmabmB) —IG - State zia C6L !P xuMnt 'den No(itappleamel B Demi Ion of the P ' q antl 0 n of the SI and Maleria as Be Used end ui melt to be Instilled Entry Dear 1 Loeellon' Ba Ermy Door Laeetion: Style: Style: ®Fun Jamb LFrame Double ❑Homage ❑Patio ❑Full Jamb LFrame Double ❑Heritage ❑Patio ❑CC Grained r6 Smooth ❑VL Smooth ❑CC Gruen d ❑CC San" ❑VL SmcoU Colors Ezt -rl)142 -30W Ira Z0DQR &%VAJ colors lId rat_ GddlBlind Colors GfkVBliM C dors; ,.,.� Exl Int t Int Lbti ,9hle ❑Glass S e Frnyy��Fh� Bright Brass❑A e ass Satin Nldtel Aged&ooze Finish: ❑ N Brass❑Antique Brass ❑Satin Nickel❑Aged Brava QStandard Hardware Package ❑Standard rdware Package Additional Options: Additional Up ions: ❑INSWING: IV LH EI RH OUTSWING: �cl{ RH INSWING LH RH OUISWING: ❑LH O RH Casing: ❑2.5 tAc(iern ❑2.5 Colonial 35 Colonial Casing: ❑ .S Modem ❑25 Colonial ❑3.5 Colonial Casing Color: Casing Cc i ❑➢der Cutdam Patio E)oor Saeen Color ❑L)wrC Patio Door Screen Color StarWard Jamb ❑Extended Jamb ❑Standard amb ❑Extended Jamb Jamb CloNlirg Color: Uld Jmnb Dladdi Cola: Door 1 SIDELITES STORM 5 Location: odcl Number: �,3 Cj Model N t/Q Fun Jamb L. be L Frame Dou Heritage Patio Colas d let QCC Grained Smoclh ❑VL BmoWh ❑�intedG s: &ooze dG.yx- ❑Green Low'E' Colors Ext'— /t�mt BSlandarci rdware Package SXWack ❑White Grid/Blind Colors OSpecialty ardware: Ext Int Glass Style ,- Door 1 TRANSOMS Finish: O Br iht Brass O Ankque Brass ❑Sakn Nickel O Aged Bronze Model Number:_ Grid Color FA Int PLEAS NOTE: Contractor Is not liable for the condition or ❑Glass Style operation ofmhung storm doors. Additional work to be done: Work NUI to its done: - SPECIAL OISTRUCTIDNS: Aloof the above check braces and the'Work NOT ao be done-section have gads mewed a It explained to ma. CustomIe�rI(Ms)into I _ APPROXIMATE START DATE and APPROXIMATE COMPLETION DATE:The work wills approximately o7-3 Ga.NT�\ (Approximate Stan Data)and will be substantially completed by approximately !-� D .(ADuruxii Ic Completion Date).These cares are sublaat to change at the can the contract s 2CCapted by Sears Home Improvement Products,Inc.('Seam")0l any other time by mutual waiden agaemem.Customer un- daslaMLsghattheApproximateStanDateisonlyanestimateddateandtheCustomerwillbe enacted poor to this date tosdledule the arnualsmrt date. The TOTAL PRICE indu[lirg all labor,maternl,bax ndany applicable discount i5$ Contract Pare $ Initial Payment(not to exceed 30%or Total Price unless Special Order) $ State Sales Tax(_%) Final Payment(balance payable upon completion of job) Local Sales Tax( %,) -$ The humal Payment is due Porto Sears ordering products. Tolm AMeum one : Tlw term antl method by whits thr CnStomer(s)wile pay Is descrieed in a separate CosKIM Caftl Payment Addndum matle a pail of anJ irwrpamte0 Into this Wnbact by reference. _ - Custo s)col NOTICE TO BUYER:YOU,THE BUYER.MAY CANCEL THIS TRANSACTION AT ANY TI E PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY (FIFTH BUSINESS DAY IN ALASKA,FIFTEENTH BUSINESS DAY IN NORTH DAKOTA IF DU ARE AGE K OR OLDER)AFTER THE Dll F THIS TRANSACTION.DEC THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLAI ATION OF THIS RIGHT. Aadmoml provisions of this continua are dated on the pages following. Costomet(s)' M,.v x.. 2•d GROS TSB GLG 'QUI 'SNEi line dsa e20:00 22 GO Rew i 0;`z0:R TTO?/5/S „r. 1-�ATeD,-J pllllllll tlllll AODIIRQNAL PROVISIO Proposal aad AAALeTal. Sears offers to furnish the materials and arrange forthi it Or ivery and installation as specified on the first page and/or the attached sketches and specs icaturt sheets for the TOTAL PRICE shown.This ON must be approved by the Installation Department.If this is a crpait sale or a payment an completion sale,it must be approved by the Credit Sz as Department.if this proposal is not approved or the in- 'stellat on cannot he made in accordance with the law,this offer will be withdrawn and my payments you have made will be refunded to you.Any materials left over after the installation has been ccmpleted are Sears property and w I be removed by Sears. Ituaid Al@D. I understand that Sears will not install the materials but will arrange to the installation.Sears is not responsible too materals or installation NOT furnished or arranged by Sears.Sears agrees to direction all permits iquired by local law. AA�QriAaOgG. I authorize Sears to:(1)arrange for a contractor(licensed where requ ad by law)to make the installation of materials;(2)issue a work uWar for Ibis itu tallaliun Lu a cur ill act m:(3)inspect the insicili I dim (4} lbe uuuUnulur when Ism hrslalNlimr is cw npinle it I leave signed a Certificate that the installation has been Completed to my Satisfaction. U&M it Installation. I agree that Sears is not responsible for delays in delivery or dStallation due to weather,tire,strikes,war,government regulations or any causes b iyund Sear'control. lltel Aamomentc ADA Changes in CoARBgt• I understand that there are no chat agre meets between Sears and me.Everything I expect Sears to do has been included in writing in this contract.Nothing can be changed in this ci Tract unless it is in writing on a separate form accepted By me and Sears. - NBsoansibility Mlipuir. I agree that any informal on or measurements that I give it Sears are correct and complete.I am responsible for any special work described in this contract. Electrical A Plumbing a9 idita. I will provide adequate electrical and/or plumbing se ices)to run any newly installed appliances of other fur- nishings.If the electrical ands plumbing servicels)do not meet the standards of the dully rompany or eteclrirat and/or plumbing nodes.I will make the necessary changes at my expense unless Sears has agreed in this contract o make the changes. Payment. I will pay Sears the cash price that covers the 36ce of material and instal ion as shown on the first page. Warren Information.Information. Appropriate proll warranty nonvoters will be given to me Sears.Sears'warranty on Installation is: SEARS'LIMITED WARRANTY ON INS ILLATION In adNlion to any manufacturer warranty extended to you on the producgs)used(whi h warranty becomes effective the date the merchandise is Installed),H the workmanship(or application)of any Sears'arranged installation proves aulty within three years on Custom Craft products and one year on all otner products,than upon nonce from you Sears will cause such faults in be orrected by mean at no additional rasl to you.It Sears de- termines that repair is not commercially predicable or cannot be limey made,then.at ears'sole discretion.Sears may elect to provide Stlace- menl or refund.Service under this Limited Warranty is available by wiling Sears H e Improvement Products at 1-800-222-5030,Option 4. This warranty gives you spceigc legal rights,and you may also have other rights that In from arms to State. NOTICE TO BUYER 1, DO 1401 SIGN THE AGREEMENT IF ANY OF THE SPACES INTENDED FOR THE J GREED TERMS TO THE EXTENT OF THE AVAILABLE IW FORMATmN ARE LEFT BLANK- 2- YOU ARE ENTITLED TO A COPY OF THIS AGREEMENT AT THE TIME YOU SIGN IT KEEP IT TO PROTECT YOUR LEGAL RIGHTS. 3. YOU MAY PAY flFF ME FULL UNPAID BALANCE DUE UNDER THE AGREEME T AT ANY TIME,AND IN$0 LIVING YOU SMALL BE EN- TITLED TO A FULL REBATE Or THE UNEARNED FINANCE AND INSURANCE HARGES. " 4. YOU MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT THE THIRD BUSINESS DAY IrIFTH BUSINESS DAY IN ALASKA,FIFTEENTH BUSINESS DAY IN NORTH DAKOTA IF YOU ARE AGE 85 D OLDER]AFTER THE DATE OF THIS TRANSACTION_SEE THE ATTACHED NOTICE OF CANCELLATION FORM FORAM EXPLANATION OF 41S RIGHT.FAILURE TO EXERCISE THIS OPTION,HOW- EVER.WILL NOT INTERFERE WITH ANY OTHER REMEDIES AGAINST THE FILTJ L SELLER YOU MAY POSSESS.IF YOU WISH,YOU MAY USE THIS PAGE AS NOTIFICATION BY WRRINO"I HEREBY RE3C1N0"AND ADi ING YOUR NAME AND ADDRESS,A DUPLICATE OF This RECEIPT IS PROVIDED BY THE SELLER FOR YOUR RECORDS. ' 5. IT SHALL NOT BE LEGAL FOR THE SELLER TO ENTER YOUR PREMISES UNLAFULLY OR COMMIT ANY BREACH OF THE PEACE TO RE - I POSSESS GOODS PURCHASED UNDER THIS AIigEEMENT. 7Regislmfion ASSAC S S E ITS ON In addition to the Notice to Buyer shown abovetts law requires that con) cts for home improvement work slate that all home ire- provement contractors and subcontractors sred and that any tnquiri about a ronbaemr or subcontractor relating to a reg- istration should be directed to: Director,Home Improvement ContracnP.O.Box 871 Taunton.MA 02780-0871 TGepnane:150a)371-9375 Please note that owners who Secure their own elaled permits or deal wH unregistered contractors shall be excluded from access) to the Guarantee Fund. Notwithstanding any other language in the contract or associated doCum Its,Sears will not remove,replace,or install any heating ar air conditloning system,or any portion thereat,if asbestos o sbestos-containing material is known or likely to be present In that heating or air condtttoning system,or any portion th 001.It It is determined or reasonably suspected that asbestos Is present,either Uefpre commencement or during perfor ante of the work, it shall be the Customer's re- sponsibility to select,retain and pay all costs of a Division of OccupatI I Safety("DOS")licensed Asbestos Contractor to remove all asbestos or verity that gone Is present in the components nvolved in the job_ If the determination or rea- sonable suspicion of the presence of asbestos asses after Sears has sta Ed the work,Sears will immediately cease per- tractor, hired by he customer, removes all asbestos from the components scheduled for repairor replacement m accordance with 310 .M.R.7.00 and 453 C.M.R.0.00 or verities that none Is present.By signing the contract the customer agrees that it unde stands the above. --._ -._..._ ---BO NOT SIGN 71119 CONTRACT IF THERE AREA Y BLANB SPA- CESCE$ y �J �/, Cusm er idnarure mate t¢lomers a k f0atg� Accepted by Sears Home Improvement products.Inc.("Sears'}an - -,S L=-&Q J - Orr- Date Management Representative rorarw e..cum - 9'd 5509 ISO FILE; •,,I ,S83EI [(tfl dSN BbO:BO i:2 60 RVN