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8 OAKLAND ST - BUILDING INSPECTION U/ The Commonwealth of Massachusetts Board of Building Regulations and Standards CITY Massachusetts State Building Code, 780 CMR, 7`"edition OFSALEM Revised Jan Mry 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 Number: Date A ted: Signature: noUft Building Commissioner/Ins ctor of Buil Vs Date SECTIO 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 Di tons: R2 One Family Zoning District Proposed Use L ea(sq ft) Fronta ) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required rovided 1.6 Water Supply: (M.G.L 1.7 Flood Zone Informatio 1.8 Sewage Disposal System: Public rivate❑ Zone: _ end Zone? Municipal a isposal system ❑ Check if yes❑ SECTION 2: PROPERTY OWNERSHIP` 2.1 Owner of Record: Anne Marie Sirois 8 Oakland Street Name(Print) Address for Service: Attached Contract 978-745-8423 Signature Telephone SECTION 3:DESCRIPTION OF PROPOSED WORK'(check all that apply) New Construction❑ Existing Building❑ Owner-Occupied ❑ Repairs(s) Q Alteration(s) ❑ Addition ❑ Demolition ❑ Accessory Bldg. ❑ Number of Units Other ❑ Specify: Brief Description of Proposed Workz: Install Vinyl Siding SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $17,756- 1. Building Permit Fee: $ Indicate how fee is determined: ❑ Standard City/Town Application Fee 2. Electrical $0 ❑Total Project Cost'(Item 6)x multiplier x 3. Plumbing $0 2. Other Fees: $ 4. Mechanical (HVAC) $0 List: 5. Mechanical (Fire $0 Suppression) Total All Fees: $ Check No. Check Amount: Cash Amount: 6. Total Project Cost: $17,756- 0 Paid in Full 0 Outstanding Balance Due: 1 SECTION 5: CONSTRUCTION SERVICES 5.1 Licensed Construction Supervisor(CSL) 97519 08/31/2012 Lubos Svec—Sears Authorized Agent License Number Expiration Date Name of CSL-Holder 827 Romgson,CT 06277 List CSL Type(see below) U Type Description Ad s — U Unrestricted u to 35,000 Cu. Ft. R Restricted 1&2 Family Dwelling S nature 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 454 Florit Central Parkwa /Longwood,FL 32750 A s 10/11/2011 860-753-0452 Expiration Date Sig Lure 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 ..........0 No........... ❑ SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1, 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 f G y 41 J0 Signature of Owner Date SECTION 7b:OWNER' 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 Sv Se Home Im ovement- Authorized Agent / Cell: 860-753-0452 Print Name Ma 4, J0 Sigrikefe ofDviner o ooze g Dates (Signed under the pains and penalties ofpee du 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(HIC)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 110.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" 1� t CITY OF SALEM ' I PUBLIC PROPRERTY DEPARTMENT \I I_'C W'.0 IA,..ON til1+l1"T # SAT I S1.\IA,;.0 I It .I Ii .a'1 _ I-rt:97$..'4+7p95 0 1'.\S:7rN:74�-TiIb Construction Debris Disposal Affidavit (required fur all demolition and renovation work) In accordance with life sixth edition of tlrc Stale Ouilding Code, 780 CMR secliun 1 1 1.5 Debris, and the provisions of MGL a 40, S 54; Ouilding Permit tt is issued with the condition that the debris resulting front this work shall htr disposes! of in it properly licensed waste disposal facility as defined by MGL c 111. S 150A. The debris will /bye transported by: 1 nomc of houkrl lie debris will be disposed ofin : ,Bp _ fr Lo 5 (name - facility) � (O Ave V(A c- 53G .S (.Cr1 /v rs IaJJTesS ul'I'acil w) iWliluru n p� ant �1 ��� Jatc .—— The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ky 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Orgarumtiot✓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(fall 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 8. ❑Demolition working forme in any capacity. workers' comp. insurance. 9. ❑Building addition [No workers' comp. insurance 5. M 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 repairs t.o'� insurance required.]t employees. [No workers' 13.0 Other / r comp. insurance required.] 'My applicant that chedcs box#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 atdavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contradors and their workers'comp.policy information. lam an employer that is providing 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. #: WLRC461 8211 Expiration Date: 08/01/2011 Job Site Address: 8 Oa �I q n �Str1?tCity/State/Z 019—to 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 DIA for insurance coverage verification. I do herebZen u�s.the pains penalties ofperjury that the information providded/°4ove is true anddcorrect. l -z {Sears Auth. Agent) Date, / � ci�z 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#: 1 y 08/06/2010 08:14 4077676536 SHIP PERMITS&LICENSE PAGE 01/02 a CERTIFICATE OF LIABILITY INSURANCE BATE(08��D12010> R A000 Risk Services Central, Inc. TRIS CERTIFICATE I6 ISSUED AS A MATTER OF INFORMATION ONLY Chicago IL Office AND CONFERS NO RIGHTS UPON THE CE.R7'IFICATE HOLDER TNIS 200 East Randolph CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER TRR Chicago TL 60601 USA CDVERACE A"ORDED BY THE POLICIES BELOW. Mo98. 866 283-7122 -- 847 953-5390 DISURER6 AEFORIILNG COVERAGE NAICO utsuatn R15VRVl4 A. National Union Fire Ins CO of pittsburgh IS"S Sears Moldings Corporation INSURER e: ACE American InyTtrante company 22667 °h dba sears NDme Improqvement products, xoc Al.tn- Risk Managemeht,E3-219A MIME11e indemnity insurance Co of North America 43575 3333 Beverly Road —- Hoffman Estates 11, 90179 USA MUReO D; i v rttarimR m o COVERAGES - THE PaFIGIE3 OF MSURANCBUSTRO FWtAW FMW BEFN TSSL'ED TO nW INSURm NAMEDAROVEMRTRB POUCY PERIOD MOICATED.NOTWITWSTANUING ANY RFQUReMETSI',TEAM OR CMZMON OP ANY CONYRACT DROTHtR OCCUNIENr WCM RESPeCriO WHICH THIS CERTDTCATR MAY 6EISSUEO OR MAY PERTAIN.17H6010URANCE AFFORDED HYTRE MLICIFS DESCRIB80 FWARM ISS, MCTTOAIL THETERMS,E.xC3XTRONS AND CO,WMONS OF SUW PoucIri AGGKWAT'EIJIdOSSHOWN MAY HAVE BEEN REDUCED av PAID CIARehS. LmaTB SNOWN ARL- AS REOUE6TED 0a cm s 'Ivan OP1MDRAIiR P91tCYN[Rnt@nn roLCY tlnE vPVGY sav,RAYN)N L*Rirn A tATP pATC mON a IMa11.T' M 2S5]9826 Oa/ollwin 08/01/7011 HAOI DLT;DRgpiLF. $5,900.000 X C0.1IMP�QAr-nmEBU Lv.01LITY UA AGJ!". M $5,000,000 MARMMAoE OM IM NMI 5 <t Pmaro'uxa c u e TEasoFlALanOV INRmv I5,000.000 0R ' DENPIALAItgeeD.11r 55,000.000 m GFNLACDR66ATE IIMI'AvvitF:4 veil ,, m` Q ❑ � © wonUcrf:•CO4T.Dr AOc 55,000.000 0 0 AUTOMonnsUA0u1T' ESAFd18625505 U8/01/2010 08/01/2011 mMenaEomNGIa NMn o tin.AUio 15AN08625499 08/01/2010 09/0/7021 0[Ias ) S5.000,000 Z AL.oNNED nUTe1S BODR.Y aMm, N SCNEUVLRo nomtR � (bid x wREOADms ' aDmty ntrvaY U NpN ownsnADTDs � meKmm? vAtmnTY DnMAUE Otr+aalml GAPAGRUw81tAT1• AUTDONIY-aAACCDIEAT AHYAVTO O AVH N E,ACC AY"�D ONLI' Aao A exc¢ssfVMm[m.uluenArY sE2747375 08/01/2009 BACHOCCURItBNLE aCPtR ❑ CTAIMS MADE ( Aq<mWATE S2.000.000 o�VCTmat aBIBNriM a WORKERS CGWeNSATION AnD CLAM vq R erpN- OTH• - GMttAl2RS'LNBafry yfp S[SC CA MA [ IN I :C46138259 08/01/2010 08/Ol/207.1 et 6nCN A0c.TR+AT Sz.aDO.aW ANY PROTR�TOpR/YAIRNflifrYPrvlIMR LI W1 EL DL4aA56 Ep6A*•'CPYER S2.000.000 C �i:P �iWj8XC4ua�nl WLRC46138211 08/0l/2o10 08/01./2011 eLO1ZEAS¢FOLItY 11Mit R.000,000 it gamatemdv m'rARAi eBOvmtpNR Mvd All Other States A OI71ER DES¢IPnM10P pP6RAT10?FSaAGATIi.�'&eDnrlb�llfl[t11i510N5 ADnSn RYFL90RE8l.IEttrhPKTALPRDVL4fONS - CERTIFICATE HOLDER CANCELLATION Sears Nome Improvement products, InC. SHOUI.O ANY ternto ADDvane3¢I6eocolanee en UNtnu.fm eeeoaE me nxrmAriON 1024 Florida Central Parkway DATE WHERGET10{v}g a P.SURER Pm.(.@.DEAVoatti ptKi Longwood FL 32750 USA aw.vswarF+Ta+NOncOronmrsRTmurexowmNAMsomnr¢I.m-c. ' OFTA�INiD OVON TRi[DE RGULRHt if$ACLNRIPR nF�v�YF QUTnTI�vES AVINOniSDREVRaSENTAlIVE � Jw.�r4 ACORD LS(3009/01) (51988-2009 ACORD CORPORATION.A0 right;Mrerted-'— The ACORD mums and logo arc regLthumd MATES of ACORD Received on 8/6/2010 0:16:28 AM y , - QCE OO11SUll1E1. HII'i111.5 d(1 LlSlrie55 ell attOn 10 Park.Plaza - Suite 5170 Boston, Massachusetts 02116 Home JlTiprovement Contractor Registration Y. Registration: 148607 Tvpe: Supplement Card Expiration: 10/11/2011 SEARS HOME IMPROVEMENT PRODUCT LUBOS SVEC 1024 FLORIDA CENTRAL PKWY -- - LONGWOOD, FL 32750 update Address and return card-Nlark reason for change. —1 Address Renmal Emplocment Lost Card IW&CA: i, 60a011omc:01210 - Offire of(:unumuer:V'Gtirs l Rumncs Itleolatina license or registration valid for individul use only t+ HOME IMPROVEMENT CONTRACTOR before the expiration date. if found return tn: Office of Consumer affairs and Business Regulation 1--p!' Registration: 148607. 10 Park t'la>a-Suite 5 t70 Expiration: 101111201) Boston,NIA 02116 Type: Supplement Card SEARS HOME IMPROVEMENT PRODUCTS INC.FLORIDALUB 024 SVEC W241' CENTRAL PKN!Y LONGWOOD.FL32750 t'nderserrenvy \'nt valiJ without si=na -i J - -- - '-' Massachusetts - Department of Public Safer 4 Board of Buildin-, Re-ulations and Standards > tiIP Construction Supervisor License License: CS 97519 - LUBOS SVEC 827 THOMPSON F "SAD - c, THOMPSON, CT Ob277 Expiration: 8/31/2012 .. ('.nnmissiuttrr Tr#: 2442 J y 1119111111Nl9 Proposal oats 1-30-6NI 1 Job At .(1619019- Bears Home Improvement Pmduels,Inc. Cusrorrer Name P.O.Box 522290 "e. oa 1024 Florida Central Parkway cu amens Nome Poore eusrolrertwork Phone Longwood.FL 32752-2290 Home Improvement Pro-ducts Phone 80O)469-4503 _ SholAddribyi V ESTIMATE AND PROPOSAL unnlracAor LlcenSPliegistration 10,1110ol 'S+' Siding HIC►148607:all plumbing and electrical - pry 51210 zip;;[de services performed by lirernnd suhcomractors Q Is in lation within city limits? FEIN 25-1698591 Installation Address County Yes _ ❑No eilfing Addrm(it dillereal from abov I City $late 210 Code Pr ' nmsnn em a tlr 0go,(if aaa:iuhW! Description of the ProjeN and Description all the SignMcaif Materials M be used and Equal meM to Ine ituntalled_ The work to be done under this contract inductee the tolleing(where checl ed): NO hkeludad hlo> 1 SYlecift[alions Hepaatton: 1. ] Obtain all necessary perndis and irsarsrre. 2. ElInspectsurfaces in wok area,re-nail rose wood,anplace rotten surface wood where necessary in work area J (excluding root,dedong.181Ie, and structural mentions). 3. l5d I�].,/i lArrym exieting sidi gt. Type; ViAily 4. vJ Fr out wags On brdr,block metal or stucco areas. LOcadm: 5. ❑ Caulk and seal around allwindows and doors in the work arm as necessary. 6- I--I Install approved rmnuMrnskw urter strip. hmuleNon: 7. ❑ Install insuladoil of 0atvsll areas that are to be sided with 64.014- exWdedpoysyreneirrsWatim. Custom Trim; 8. ❑ Install datam Yyna40ad atunWnlm fasaa system. C"i9. { // ❑ Remove extsanlp gu0ern i After remov)il.,existirg ryreaJvq wa11 be re-a chod I�dspoeetl of to. �j L.I Well new guaedng and downspeuts. t }( bu{k7 CFRO T-) 11. [✓✓jj '.] Cover soffit areas of Mine Wth ArrA srdfit s tern lo�rcept xfiem roled below m'Wodc NOT to be dorm-)long ❑WO Max ❑WB Plus Weamerbeater ❑Va6ta Imp ( Other: / Color. f}DQTti ( .(�1�M Paharn: 12. ] LN Instal datum VynalOad alumnMnfrleze Size: �/ Location: cow 13. N JIWI bull w4rdow aim. Location: - Goon 14. N_ C7. Custom wrap vmrows/sills I mulls I headers with Vyna-IG d alurmrwm. Color: 15, LI/Remove and reinstall"brgatom windows l awnings!shoots. 16. [� �v Install newshuders ❑Panel ]Lower Cdor. 17. E7]/ ❑ Ct6tom", door facings Winn Vyna-load alurrenum. Odor 0 is ❑ Cr tomwrapgwr pftkmfmnrgssingle/dolmlewihVyna-t0adalumnum. 19. ❑/Remove and re"Insiall storm doors. Odor: 20. OJ Install deluxe comer posts. calm:__ 9aNr5: 21'. LEI O Instep C WE Max O WH wus weathernb��aater IJ Value Line❑Other: lid vinyl siding. _J TYPE:[vJHorizontal ❑Vertical Coon Porch 22. C Porch callings: Location: Color: Systems: 23. chuaLs: C.Npt: _.. 24 (14 Porch(b.'ana: COW.Clean up: 21 Fl Clem up and removal M all p related dears. 26. ❑ RenoMe exlxa]materials and re-sock(each Job is paler-snipped to avoid delays). Ad itional work tube one: - War to— hk-RiT 10ne: No drip edge covered no paint plied- . . . . .. .. ... .. ... .. ., .... SPECIAL INSTRUCTIONS: — All of the above check boxes and the"Work NOT to be lone"section have been reviewed and explained to me. Cusomer(s) - APPROXIMATESTART DATE and APPROXIMATE COMPLETION DATE: The work will start approximately 1-21,VP�P.k1 (Approximate Start l Date)and will he substantially completed by approximately (Approximit a Completion Datei.These dates are Subject to change at the rime the Contract is accepted by Sears Home Improvement Products nc.("Sears")of at any other tine by mural wrillcn agreement.Customer understands that the Approximate Stan Date is only an N.timated date and the Customer will be contacted prior to this date to schedule the actual sod date. The TOTAL PRICE including all labor,material,taxes and any applicable dtaaount is $ commct Price $ Initial Payment(not to exceed 30%or Total Price unless Special Order) $ State Sales Tax( %a) $ Final Payment(balance pdyabb upon completion of lob) $ Lu l SrIR Tax(_%) $ ToUI Amount DUe $ Tho form and mmhod fe whirr me Customers)hill pay is Ueac'n11ed in a separate easWGreon Card Payment Addendum 11ade a pan of and iceorponted into Ulis olm(ract ply inference. NOTICE TO BUYER:YOU,THE BUYER,MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THP THIRD BUSINESS DAY (FIFTH BUSINESS'DAY IN ALASKA,FIFTEENTH BUSINESS DAY IN NORTH DAXOTA IF YOU ARE AGE 65 OR OLDER)AFTER THE DATE OF THIS TRANSACTION.SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. JJ,,ll..���. �_[]/�' / n Addhional provieiom of Nita contract arc stated on the pages lollawmg' GustoHlar(5)ini'`(��J�f MI-MA Rp Mp1 V '- 2•d S909 TSB 8L6 dSb e82:80 22 2D Few - WK 7p�t£�5 iiP7 ;'!; "re panTo_oy Ilillll I II III111 ADRITIBN&UROVISIM PmooN{and A roe I. Sears offers to furnish the materials and arrange for their delivery and installation as specified on the first page and/or the attached sketches and specification shears for the TOTAL PRICE shown.This offer must be approved by the Installation Oepanment.II this Is a credit sale or a payment on completion sale,it must be approved by the Credit Sales Department.If this proposal is Fiat approval or the installation caeuut be made in accordance wen the law,this offer will be withdrawn and any payments you have made will be refunded to you. Any materials left over after the irstanation has been completed are Sears property and will be removed by Sears. Installation. I understand that Sears will not install the materials but will arrange for the installation.Sears is not responsible for materials or amialldtiun NOT furnished or arranged by Seers.Sears agrees to procure all permits required by local law. And-ggZyllpo. I authorize Sears to:(1)arange for a contractor(licensed where required by law)to make the installation of materials:(2)Issue a work order for this installation to a contractor;(3)inspect the installation;and (4)pay the contractor when the installation is complete if I Imve signed a certificate trial the installation nas been completed to my satisfaction. Delays In IoA]ailailga. I agree that Scors is not responsible for delays in delivery or installation due to weather,fire,strikes,war,governm ant regulations or any causes beyond Sears control. Oral Bgreemems poll Channeg jnfiant Tact I understand that[here are no oral agreements between Sears and are.Everything I expect Seats to do has been included in writing in this contract.Nothing can be changed in this contract unless it is in writing on a separate form accepted by me and Sears. &—sponslblllty of Buffif I agree that any information or measurements that I give to Sears arc correct and complete.I am responsible for any special work described in this contract. Electrical&Phoublha Service- I will provide adequate electrical and/or plumbing ceroicets)to run any newly installed appliances or other lurnishings.If the electrical and/or plumbing service(s)do not meet the standards of the utility company or electrical andor plumbing critics, I will make the necessary changes at my expense unless Sears has agreed in this contract to make the changes PdBmNaf. I will pay Sears flip.cash price that covers the price of material and installation as*hewn on the final nine. WattA0ly information. Appropriate product warranty documents will be given to me by Sears.Sears'Warranty on Installation Is: SEARS'LIMITED WARRANTY ON INSTALLATION In addition to any manufacturer varranfy extended to you on the producl(s)used(which warranty becomes effective the date the merchandise is installed),if the workmanship(or applicatmn)of any Sears'arranged installation proves faulty wilhin(i)one year for Weatherbeater or other brand, lit)two years for Weatherbeater Plus.ar fili)three years for Weatherbeater Max.then upon notice from you Sears will ranee such faults in he corrected by repair at no additional cost to you If Sears determines that repair is not commercially practicable or cannot be timely/•.lade, then,at Sears'sale discretion,Sears may elect to provide replacement or refund.Service under this Limited Warranty is available by calling Sears Home Improvement Products at 1-800-222-5030.Option 4.This warranty gives you sper;hc legal rights,and you may also have other rights that vary boar State lu Slots NOTICETO BUYER 1. 00 NOT SIGN THE AGnEEMEHT IF ANY OF THE SPACES INTENDED FOR THE AGREED TERMS TO 111E EXTENT OF THE AVAILABLE INFORMATION 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 OFF THE FULL UNPAID BALANCE DUE UNDER THE AGREEMENT AT ANY TIME,AND IN SO DOING YOU SHALL BE ENTITLED TO A FULL REBATE OF THE UNEARNED FINANCE AND INSURANCE CHARGES. 4. YOU MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY[FIFTH BUSINESS DAY IN ALASKA,FIFTEENTH BUSINESS DAY IN NORTH DAKOTA IF YOU ARE AGE 65 OR OLDER)AFTER THE DATE OF THIS TRANSACTION. SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT.FAILURE TO EXERCISE THIS OPTION, HOWEVER,WILL NOT INTERFERE VIM ANY OTHER REMEDIESAGAINST THE RETAIL SELLER YOU MAY POSSESS.IF YOU WISH,YOU MAY USE THIS PAGE AS NOnFICATNIN BY WRITING"1 HEREBY RESCIND"AND ADDING YOUR NAME AND ADDRESS.A DUPLICATE OF THIS RECEIPT IS PROVIDED BY THE SELLER FOR YOURAECORDS. ' 5. 1T SHALL NOT BE LEGAL FOR THE SELLER TO ENTER YOUR PREMISES UNLAWFULLY OR COMMIT ANY BREACH OF THE PEACE TO REPOSSESS GOODS PURCHASED UNDER THIS AGREEMF.RT. NOTICE TO MASSIICHUSEHI RESIDENTS ONLY FaddlUono the Notice to Buyer shown above,Massachusetts law requires that contracts for home improvement work state that all home t contractors and subcontractors shall be registered and that any inquiries about a contractor or subcontractor relating to a should be directed in: ector,Home Impruvenie it Contractor Registration .Box 871 nton,MA 02780-0871 phone:(508)821-9375 hat Owners who secure their own construction-related permits or deal with unregistered contractors shall be excluded from access to Ilia Guarantee Fund, Notwithstanding any other language in the contract or associated documents, Seats will not remove, replace, or install any heating or air conditioning system, or any portion thereof, if asbestos or Ashestos-containing material is known or likely to be present in that heating or air conditioning system, or any portion thereof. If it is determined or reasonably Suspected that asbestos is present,either before commencement or during performance of the work, it shalt be the cos tamer's responsibility to select, retain and pay all costs of a Division of Occupational Safety("DOS') licensed Asbestos -Contractorto remove all asbestos or verify that none Is present in the rnmpnnents involved in the job. If the determina- tIon or reasonable Suspicion of the pmsenotofasbestos arises after Sears has started the work, Sears will immediately cease performing the work until a DOS licensed Asbestos Contractor, hired by the customer,removes all asbestos from the components scheduled for repair or replacement in accordance with 310 C.M.R 7.00 and 453 C.M.R. 6.00 or veri- Nc ss that none is present. By signing the contract the Customer agrees that it understands the above. 00 NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES 23A Cus�Igna-tll Date Customer's,signay,pe n, Dale ars; Accepted by Sears Home Improvement Products,Ina.("Se on_ •e�Q--obi) by;_ 1'� Date Man merit Representative nun,fin Pros G'cl 9909 19B BLG '9ul 'sm30-lInH d9al iii ad do Few -