Loading...
B-19-1031 - 0031 APPLEBY ROAD - Building Permit The Commonwealth of Massachusetts °F Board of Building Regulations and Standards CITY Massachusetts State Building Code,780 CMR SALEM Revised Mar 2011 Building Permit Application To Construct,Repair,Renovate Or Demolish a l'n One-or Two-Family Dwelling Q This Section For Official Use Only Building Permit Number: Date Applied: 5 EVE V ✓<-, S . Building Official(Print Name) Signature Date ;r I r--3. SECTION 1:SITE INFORMATION r.(1 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers rn -+ 1.1 a Is this aV accepted stree?yes no Map Number Parcel Number 1.3 Zoning Information: 1.4 lProperty Dimensions: Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) "f FJ Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public❑ Private❑ Zone: _ Outside Flood Zone? Municipal❑ On site disposal system ❑ Check if yes❑ SECTION 2: PROPERTY WNERSHIP' .1 Owner'of Record Name.(P - t) City,State,ZIP 3 ,6 6z• 6V No.and SAIt elephone Email Add ss SECTION 3:DESCRIPTION OF PROPOSED WORKZ(checkA that apply) New Construction❑ Existing Building❑ Owner-Occupied ❑ Repairs(s) Alteration(s) ❑ Addition ❑ Demolition ❑ Accessory Bldg. um r f Units Rther ❑ Spec' B 'ef Description of Propos Work2:7C SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only Labor and Materials 1.Building $ 1. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical $ ❑Standard City/Town Application Fee ❑Total Project Costa(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire $ Suppression) Total All Fees: $ I D � Check No. Check Amount: Cash Amount:� 6. Total Project Cost: $ ❑Paid in Full ❑Outstanding Balance Due: �11°\ c .F SECTION 5: CONSTRUCTION SERVICES 5.1 onstruction Supervi o icense(CSL) �7110�- J License Number Exp ation Pfate Name of CSL Holder ^ List CSL Type(see below) q - No.and Street Type Description I U U estricted(Buildings lip to 35,000 cu.ft. R Restricted 1&2 Family Dwelling City/Town,4tate,ZIP M Masonry RC Roofing Covering WS Window and Siding 'I SF Solid Fuel Burning Appliances I Insulation Telephone a U Email address D Demolition 5.2 egistered Ho a Imp vement Contractor(HIC) 5 109y3a 7 2-/&�40 HI Cp,pnMyN HIl 4 is t N e HIC Ryegistration Number E' iratio Date N�. dd �/ � r'� p/� q �q el a +��q rSSe rV Gom 1 U m V/�(l f�2 7.�S 7 /b ' �� / Email address City/Town,State,ZIP Telephone SECTION 6:WORKERS COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152.§ 25C 6 Workers Compensation Insurance affidavit must be ompleted and submitted with this application. Failure to provide this affidavit will result in the denial of the Issuan of the building permit. Signed Affidavit Attached? Yes .......... No...........❑ SECTION 7a:'OWNER'AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,as Owner of the subject property;hereby authorize S to act on my behalf,in all matters relative to work authorized by this building permit application. Print Owner's Name(Electronic Signature) Date SECTION 7b: OWNER'OR AUTHORIZED AGENT DECLARATION By entering my nam5/AR-5 I hereby attest under the pains and penalties of perjury that all of the information c tamed in this ap s true and accurate t the b st of my knowledge and understanding. r 9 6 Print Owner's or Authorized A nt's Name(Electronic Signature) Date 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 can be found at www.mqELgov/oca v�Information on the Construction Supervisor License can be found at www.mass.gov/dts 2. When substantial work is planned,provide the information below: Total floor 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" k S .Y RACIINT-02 GHOUGHTON DATE(MM/DDIYYYY) ram/ CERTIFICATE OF 8AB9fl�9 INSURANCE 01/02/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER LICenSe#1760862 NAMEACT Gretchen Houghton HUB International New England PHONE r ,EXt): jA No):FAX 600 Longwater Drive Norwell,MA 02061-9146 Ao RLEss:gretchen.houghton@hubinternational.com INSURERS AFFORDING COVERAGE NAIC# INSURERA:Tokio Marine Specialty Insurance Company- 23850 INSURED A.R.S Services LLC INSURER B:Philadelphia Indemnity Insurance Company 18058 A.R.S Restoration Specialists LLC INSURERC:Zurich American Insurance Company 16535 AIRS Restoration Specialists LLC INSURERD: 38 Crafts Street Newton,MA 02458 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY EXP LTR INSD WVD /DD MM DD LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 CLAIMS-MADE [�]OCCUR X X PPK1921786 01101/2019 01/01/2020 DAMAGE TO RENToccuED $ 100,000 -PREMISMED EXP(Any oneperson) $ 5,000 PERSONAL&ADV INJURY $ 2,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 POLICY�PECT LOC PRODUCTS-COMP/OPAGG $ 3,000,000 OTHER: B AUTOMOBILE LIABILITY COMBINEDSINGLELIMIT 1,000,000 Ea accident $_ X ANY AUTO X X PHPK1921689 01/01/2019 01/01/2020 BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ AUTOS ONLY AUOTNOS ONL� PeDacEctlenDAMAGE $ A X UMBRELLA L1AB X OCCUR EACH OCCURRENCE $ 5,000,000 TDED CESSLUIB CLAIMS-MADE X X PUB659070 01/01/2019 01/01/2020 AGGREGATE $ 6,000,000 I X I RETENTION$ 0 $ C WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE YIN X WCO27450801' 01/01/2019 01/07/2020 1,000,000 OFFICERIMEMBER EXCLUDED? NIA E.L.EACH ACCIDENT $ (Mandatory in NH) 1,000,000 E.LDISEASE-EAEMPLOYE $ yes, O under D E.L.DISEASE-POLICY LIMIT $ DESCRIPTION N OF OPERATIONS below 1,000,000 A CPL X X PPK1921792 01/01/2019 01/01/2020 Cont.Poll Liability 2,000,000 B Bailment Coverage X X PHPK1921689 01/01/2019 01/01/2020 Customers Property 250,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) A.R.S Services LLC,AIRS Restoration Specialists LLC,A.R.S Restoration Specialists LLC,Blaine Oney Construction Company LLC dba Emergency Services& Reconstruction,South River Restoration-Texas,LLC,and South River Restoration,LLC are wholly-owned subsidiaries of RACI Intermediate Holdings LLC. Policy Named Insureds: A.R.S Services LLC A.R.S Restoration Specialists LLC AIRS Restoration Specialists LLC SEE ATTACHED ACORD 101 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE A.R.S.Services LLC THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Evidence of Coverage ACCORDANCE WITH THE POLICY PROVISIONS. 38 Crafts Street Newton,MA 02458 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD f AGENCY CUSTOMER ID:rcra1.11iiv 1-vs unuuun I uIM LOC#: 0 ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY License#1780862 NAMED INSURED HUB International New England A.R.S Services LLC g A.R.S Restoration Specialists LLC POLICY NUMBER ARS Restoration Specialists LLC 38 Crafts Street EE PAGE 1 Newton,MA 02458 CARRIER NAIC CODE USA EE PAGE 1 SEE P 1 EFFECTIVE DATE:SEE PAGE 1 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: &CORD 25 FORM TITLE: Certificate of Liability Insurance Description of Operations/Locations/Vehicles: Insured Locations: 38 Crafts Street Newton MA 02458 480 St.James Ave Springfield,MA 01109 110 Old Townhouse Road South Yarmouth MA 02664 181 Putnam Pike Johnston RI02919 1 Rebel Road#3 Hudson NH 03051 2 A Street Auburn MA 01605 355 Sacket Point Road North Haven,CT 06473 ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Commonwealth of Massachusetts Division of Professional Licensure Board of Building Regulations and Standards ''PP Constr�a7jE�RT� ¢e�rvisor Cs-.M909r pires: 10/22/2022 ag THOMAS J G&AGWI'. 29 BIGELOW-STI2,tET ,_•A t BRIGHTON MA 02 135 `. Z�c 0CD , i g�'M yF.�'i a_ m o I Commissioner CD In zCD y o m Rom Construction Supervisor NR-i m 4 f Unrestricted -Buildings of any use group which contain ro a 70 H less than 35,000 cubic feet(991 cubic meters)of enclosed C o D� space. a O& % ` (D M W Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. _ For information about this license Call(617)727•t200 or visit www.mass.gov/dpi. I r The Commonwealth of Massachusetts Department of Industrial Accidents I Congress Street, Suite 100 Boston,MA 02114-2017 www.mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Lesibly Name (Business/Organization/Individual):A.R.S. Restoration Address:38 Crafts St. City/State/Zip:Newton Mass, 02458 Phone#:(617)-969-1119 Are you an employer?Check the appropriate box: Type of project(required): I.E I am a employer with 125 employees(full and/or part-time).* 7. ❑New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in 8, ❑Remodeling any capacity.[No workers'comp.insurance required.] 9. ❑Demolition 3.❑I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 10 ❑Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.0 Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.Q I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑ Of 14. the re airs These sub-contractors have employees and have workers'comp.insurance.t 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. r 152,§1(4),and we have no employees.[No workers'comp.insurance required.] Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:Zurich American Insurance Policy#or Self-ins.Lie.#:WCO27450801 Expiration Date- 1/01/2020 7 L:��Job Site Address: City/State/Zip: D /d Attach a copy of the workers ompen ion policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do her r e pai s and pe tie of perjury that the information provideF71,g ve is true and correct. Signature: Date: Phone#: (617)-969-1119 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#: i OTY OF SALEK MASSACHUSE M fig . BUILDING DEPARTWNT 120 WASHINGTON STREET,31D FLOOR 'ILL.(978)745-9595 K MBERLEYDRISODLL FAX(978)740-9846 MAYOR THOMAS ST.PM E DIRECTOR OF PUBLICPROPER7YAU11DING 00!1vWSSI0NER Construction Debris Disposal Affidavit (required for all demolition & renovation work In accordance with the sixth edition of the State Building Code, 780 CMR,Section 111.5 Debris, and the provisions of MGL c40,S54;Building Permit# condition that the debris resulting from this work shall be disposed of in a properly I censes ued with the waste deposit facility as defined by MGL c 111,S150A. The debris will be transported by: ` (name of hauler) The debris will be disposed of in: -1 (name of facility) 34ss(ad 02 �5 8 cility) Sign 64 :applicant (to y's da A.R.S. Services,Inc. 38 Crafts Street Newton,MA 02458-1449 Phone: (617)969-1119 Fax: (617)244-1115 MAPFRE SELECT PROGRAM-RESIDENTIAL CONTRACTING AGREEMENT Read this agreement and make sure you understand it before signing it. This agreement has legal force and effect and binds those who sign it. A.R.S. Services, Inc. Notice: 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 State of Massachusetts. Designated Registrant's Name: A.R.S Services,Inc. Registration Number: 106438 Salesperson's Name: Ross Ebanez This Agreement is made on 08/27/2019 between A.R.S. Services,Inc. (DATE) (CONTRACTOR) of 38 Crafts Street,Newton,MA 02458 (617)969-1119 (ADDRESS) (PHONE NUMBER) hereinafter called"Contractor"and Francis Malik (OWNER) of 31 Appleby Rd Salem,MA 01970 (617)962-9637 (ADDRESS) (PHONE NUMBER) hereinafter called"Owner". I. DETAILED DESCRIPTION OF WORK TO BE PERFORMED Contractor agrees to perform in a good and workmanlike manner all work detailed below. Such work consists of the following: See attached Scope of Work. A more detailed description of the work to be performed is contained in the Scope of Work attached hereto as Exhibit 1. DETAILED DESCRIPTION OF MATERIALS TO BE USED Materials to be used in performing the above-described work consist of the following: See attached Selection Sheet. A more detailed description of the materials to be used in performing the work is contained in the Scope of Work attached hereto as Exhibit I. 571557 v2 Receptionist\C\MS Office\Winword\Forms\ResidentalContractAgreement.doc II. PRICE Contractor agrees to do all work described in Section I for the amount agreed upon with MAPFRE; with supplemental items to be determined at a later date. III. PAYMENT Payment will be made as follows: Payment 1: $500-Deductible to be collected prior to work beginning. Payment 2: $9,861.50-Remainder of balance to be paid by MAPFRE to ARS directly once Certificate of Satisfaction(COS)is signed by insured. **In the event the insured is paid directly by MAPFRE,the above payment terms are subject to change** Contractor reserves the right to bill each line item in the contract that has a price associated with it independently from all other line items. Payment for each line item, which has been satisfactorily completed, is due upon receipt of invoice from Contractor. More specifically, Owner agrees to not withhold payment on any item, which has been satisfactorily completed due to his/her complaint(s) with any other item(s). IV.COMMENCEMENT AND COMPLETION OF WORK Contractor will not begin the work or order the materials before the third day following the signing of this Agreement,unless specified here in writing. Contractor will begin the work on or about two weeks after receipt of contract and selections,barring delay caused by circumstances beyond Contractor's control.The Owner hereby acknowledges and agrees that the scheduling dates are approximate and that such delays that are not avoidable by the Contractor shall not be considered as violations of this Agreement. V. NO ACCELERATION OF PAYMENTS BUT ESCROWING ALLOWED The Contractor may not require payments to be made in advance of the times specified in Section III (Payment) above for the reason that Contractor deems itself or the payments to be insecure. If, however, Contractor deems itself to be insecure, Contractor may require, as a prerequisite to continuing the work described herein, that the balance of the payments under this contract that are in the control of the Owner, shall be placed in a joint escrow account that requires the signature of both the Contractor and the Owner for withdrawal. VI.INSURANCE Contractor will be responsible to Owner or any third party for any property damage or bodily injury caused by Contractor, its employees or its subcontractors in the performance of, or as a result of, the work under this Agreement. Contractor agrees to carry insurance to cover such damage or injury. VIL SUBCONTRACTING Contractor agrees that, notwithstanding any agreement for materials and/or labor between Contractor and a third party, Contractor is responsible to Owner for completion of all work described in this Agreement in a timely and workmanlike manner. VIIL CONSTRUCTION-RELATED PERMITS The following construction-related permits will be necessary in order to complete the scope of work included in the Agreement: YES The Contractor under provisions of Chapter 142A of the General Laws is required to apply for and obtain all construction-related permits. The Contractor shall not be deemed responsible for delays in the work described in this Agreement caused by regulatory, permit granting or inspectional agencies,authorities or individuals. 571557 v2 Receptionist\C\MS Office\Winword\Forms\ResidentalContractAgreement.doc l IX.MODIFICATION This Agreement,including the provisions relating to price(Section II)and payment schedule(Section III)cannot be changed except by a written statement signed by both Contractor and Owner. However, cancellation by Owner is allowed in accordance with the Notice s of Cancellation(annexed). s 4 X. CHANGE ORDER Change orders are additional items contracted subsequent to the signing of this Agreement, the cost of which is not included in the i original design and specifications stated on the original scope of work(see Exhibit I). Upon agreement of a change in scope to the original scope of work,a change order form(see Exhibit 111)shall be signed by both parties. Any additional charge established by the f change order shall be due upon signing of the change order form. Each change order shall be treated as a separate contract and completion of those items specified in any change order shall not be grounds for withholding any other payments specified in this Agreement. All change orders are subject to an administrative fee of$75.00 per change order. XI.COLLECTION FEES AND FILINGS Interest of 1.5% per month will be charged on past due accounts over 30 days. Should collection proceedings be instituted for payment, Owner agrees to pay reasonable attorney's fees,court costs,and other costs incurred. There will be a$25.00 charge for any 3 returned checks. While no security interest is created by this Agreement,the Contractor shall have the right to file a notice of contract and a statement of account in order to create such a security interest to ensure that payment is made as required hereunder. 3 t XII.SETTLEMENT OF DISPUTES Any controversy or claim arising out of or relating to this Agreement, or the breach thereof,shall be settled by arbitration before one arbitrator administered by the American Arbitration Association (AAA) under its Construction Industry Arbitration Rules and judgment on the award rendered by the arbitrator may be entered in any court having jurisdiction thereof. In all other cases,the fees will be split evenly by both parties. l l As an alternative to arbitration,both parties may voluntarily agree to have the matter settled in the appropriate Small Claims Session of the Trial Court of Massachusetts. Such an agreement must be put in writing and signed by both parties.. If either party does not agree to submit the action to Small Claims,the arbitration clause contained herein shall be in full force and effect. wner's Signature Contractor's Signature } . i 's l i i t i t , s i s 3 F�F 1 l k l 571551 v2 ReceptionisMMS Ofticclw mvord\FormslRcsidentatContractAgrecment.doe # t RIGHTS TO CANCEL The Owner may cancel this agreement if it has been signed by the Owner at a place other than an address of the Contractor which may be his main office or a branch thereof, provided that the Owner notifies the contractor in writing at his main office or branch rd ordinary mail posted, by telegram sent or by delivery,not later than midnight of the third I business day following the signing of this agreement. See attached Notice of i Cancellation. a HOMEOWNER: 1 DO NOT SIGN THIS CONTRACT IF THERE AREANY BLANI[SPACES. � i # x Owner's Signatur6 Date Signed s # Contractor's Signature Date Signed s i # Y f { F F F t # F # # { 5715s7 Q Receptionist\cm Office\Wimvord\Forms\ResidentatContractAgrecment.doc XIII. WARRANTIES The Contractor warrants that the work furnished here under shall be free from defects in materials and workmanship for a period of three years 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, its subcontractors, employees or agents, is discovered within one year after completion of any job, including cleanup, the Contractor shall, at its own expense, forthwith remedy, repair, correct, replace, or cause to be remedied, repaired, or replaced, such damage or such defect in materials or workmanship based on Commercial Construction Performance Guidelines for Professional Builders and Remodelers. The foregoing warranties shall survive any inspection performed in connection with the agreed-upon work. All warranties for equipment supplied by the Contractor under this Agreement shall be those given by the manufacturers of such equipment, which shall be and are hereby passed through directly to the Owner. Under such manufacturers' warranties, the Owner may be required to register or mail in a warranty card or other evidence of ownership and use of such equipment in order to activate such warranties. The Owner's failure to mail in or register such documentation, which failure voids the manufacturer's warranty, shall not create any responsibility for the Contractor to warranty such equipment. This warranty gives the Owner specific legal rights, and Owner may also have other rights, which vary from state to state. Under Massachusetts law,sales of goods carry an implied warranty of merchantability and fitness for a particular purpose. XIV.COMPLETENESS OF AGREEMENT FOR EXECUTION The Owner is hereby advised that the Owner should not sign this Agreement unless and until all blank sections have been filled in or marked as void, deleted or not applicable, and until all exhibits and related or referenced documents that are incorporated herein are attached hereto. XV. COPY OF AGREEMENT TO BE GIVEN TO OWNER This Agreement is governed by the laws of Massachusetts. It must be executed in duplicate, and an original signed copy hereof given to the Owner at the time of execution. No work under the Agreement shall begin prior to the signing of the Agreement and transmittal to the Owner of a copy thereof. This Agreement, including the Exhibits attached hereto, constitutes the entire agreement of the parties with respect to the subject matter hereof. 571557 Q Receptionist\C\MS Office\Winword\Forms\ResidentalContractAgreement.doc 7 RIGHTS TO CANCEL The Owner may cancel this agreement if it has been signed by the Owner at a place other than an address of the Contractor which may be his main office or a branch thereof, provided that the Owner notifies the contractor in writing at his main office or branch by ordinary mail posted,by telegram sent or by delivery,not later than midnight of the third business day following the signing of this agreement. See attached Notice of Cancellation. HOMEOWNER: DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. Owner's Signature Date Signed Contractor's Signature Date Signed 571557 Q Receptionist\C\MS Office\winword\Forms\ResidentalContractAgreement.doc ENTER DATE OF TRANSACTION NOTICE OF CANCELLATION You may cancel this transaction,without any penalty or obligation,within three business days from the above date. If you cancel,any property traded in,any payments made by you under the agreement,and the Contractor of your cancellation notice will return with any negotiable instrument executed by you,in ten business days following receipt,and any security interest arising out of the transaction will be canceled. If you cancel,you must make available to the Contractor at your residence,in substantially as good condition as when received,any goods delivered to you under this agreement;or you may,if you wish,comply with the instructions of the Contractor,regarding the return shipment of the goods at the Contractor's expense and risk. If you do make the goods available to the Contractor and the Contractor does not pick them up within twenty days of the date of your notice of cancellation,you may retain or dispose of the goods without any further obligation. If you fail to make goods available to the contractor,or if you agree to return the goods to the Contractor and fail to do so,then you remain liable for performance of all obligations under the agreement. To cancel this transaction,mail or deliver a signed and dated copy of this Notice of Cancellation or any other written notice,or send a telegram to (NAME OF CONTRACTOR) at (ADDRESS OF CONTRACTOR'S PLACE OF BUSINESS) NO LATER THAN MIDNIGHT OF I HEREBY CANCEL THIS TRANSACTION. (DATE) (OWNER'S SIGNATURE) (OWNER'S ADDRESS) (Two copies of this form to be attached to the Residential Contracting Agreement) 571557 Q Receptionist\C\MS Office\Winword\Forms\ResidentalContractAgreement.doc ENTER DATE OF TRANSACTION NOTICE OF CANCELLATION You may cancel this transaction,without any penalty or obligation,within three business days from the above date. If you cancel,any property traded in,any payments made by you under the agreement,and the Contractor of your cancellation notice will return any negotiable instrument executed by you with ten business days following receipt,and any security interest arising out of the transaction will be canceled. If you cancel,you must make available to the Contractor at your residence,in substantially as good condition as when received,any goods delivered to you under this agreement;or you may,if you wish,comply with the instructions of the Contractor,regarding the return shipment of the goods at the Contractor's expense and risk. If you do make the goods available to the Contractor and the Contractor does not pick them up within twenty days of the date of your notice of cancellation,you may retain or dispose of the goods without any further obligation. If you fail to make goods available to the contractor,or if you agree to return the goods to the Contractor and fail to do so,then you remain liable for performance of all obligations under the agreement. To cancel this transaction,mail or deliver a signed and dated copy of this Notice of Cancellation or any other written notice,or send a telegram to (NAME OF CONTRACTOR) at (ADDRESS OF CONTRACTOR'S PLACE OF BUSINESS) NO LATER THAN MIDNIGHT OF I HEREBY CANCEL THIS TRANSACTION. (DATE) (OWNER'S SIGNATURE) (OWNER'S ADDRESS) (Two copies of this form to be attached to the Residential Contracting Agreement) 571557 Q Receptionist\C\MS Office\Winword\Forms\ResidentalContractAgreement.doc A.R.S. SERVICES, INC. Restoration &Renovation 38 Crafts Street Newton,MA 02458-1449 Phone: (617)969-1119 Fax: (617)244-1115 Exhibit I (Scope of Work) 571557 Q Receptionist\C\MS Office\Winword\Forms\ResidentalContractAgreement.doc <(� ARS Restoration Specialists 38 Crafts Street Newton MA 02458 sPt sTs Tax ID:35-2602161 Insured: FRANCIS V MALIK Home: (617)962-9637 Property: 31 APPLEBY RD SALEM,MA 01970 Home: 31 APPLEBY RD SALEM,MA 01970 Claim Rep.: unknown Estimator: Jeffrey Galatis Business: (617)969-1119 x 0823 Business: 38 Crafts St. E-mail: jgalatis@arsserv.com Newton MA Claim Number: RTWT03 Policy Number: M38128 Type of Loss: Water Date Contacted: 8/5/2019 Date of Loss: 8/2/2019 Date Received: 8/5/2019 Date Inspected: 8/18/2019 Date Entered: 8/8/2019 1:31 PM Date Est.Completed: 8/20/2019 1:19 PM Price List: MABOBX -AUG19 Restoration/Service/Remodel Estimate: FRANCIS V MALIK This estimate is the combined total for repairs. �( ARS Restoration Specialists 38 Crafts Street Newton MA 02458 sPEcuisisTs Tax ID:35-2602161 �owra�vcas"q ,« FRANCIS_V_MALIK General conditions DESCRIPTION QTy 1. Taxes,insurance,permits&fees(Bid Item) 1.00 EA Open item 2. Haul debris-per pickup truck load-including dump fees 1.00 EA NOTES: Living Room Height:8' 2'6' 0'11"-12'7"—� —12's" 652.31 SF Walls 295.44 SF Ceiling M ,a, za a = = 947.75 SF Walls&Ceiling295.44 SF Floor 6„ 1' Living Room s 1) j 32.83 SY Flooring 80.72 LF Floor Perimeter � 9'7"tea' 1 ,4'5", .a's". 85.64 LF Ceil.Perimeter Missing Wall-Goes to Floor 4' 11"X 6'8" Opens into Exterior r 10". - Subroom: Stairs(1) Height: 13' M148.91 SF Walls 19.80 SF Ceiling 168.72 SF Walls&Ceiling 34.79 SF Floor 3.87 SY Flooring 16.49 LF Floor Perimeter 14.14 LF Ceil.Perimeter Missing Wall 2' 10"X 12' 11 15/16" Opens into Exterior Missing Wall 2' 10"X 12' 11 15/16" Opens into LIVING_ROOM DESCRIPTION QTY 3. Floor protection-heavy paper and tape 330.23 SF 4. Dust control barrier per square foot 66.00 SF 5. Peel&seal zipper-heavy duty 2.00 EA 6. Detach&Reset Light fixture 1.00 EA FRANCIS_V_MALIK 8/27/2019 Page:2 ARS Restoration Specialists 38 Crafts Street Newton MA 02458 sGEcu;i'Wf' Tax ID:35-2602161 CONTINUED-Living Room DESCRIPTION QTY 7. Heat/AC register-Mechanically attached-Detach&reset 3.00 EA 8. Detach&Reset Window drapery-hardware-Large 1.00 EA 9. Batt insulation- 10"-R30-paper faced 315.24 SF 10. Two coat plaster over 1/2"gypsum core blueboard 196.00 SF 11. Texture drywall-smooth/skim coat 119.24 SF Smooth coat ceiling texture to allow for texture to be redone so it all matches. 12. Texture drywall-heavy hand texture 1116.46 SF 13. R&R Wallpaper-High grade 801.22 SF 14. Remove Additional charge to remove non-strippable wallpaper 801.22 SF 15. Prep wall for wallpaper 801.22 SF 16. Seal the walls w/PVA primer-one coat 801.22 SF 17. Seal/prime then paint the ceiling(2 coats) 315.24 SF NOTES: Grand Total Areas: 1,602.44 SF Walls 630.48 SF Ceiling 2,232.92 SF Walls and Ceiling 660.46 SF Floor 73.38 SY Flooring 97.21 LF Floor Perimeter 0.00 SF Long Wall 0.00 SF Short Wall 99.78 LF Ceil.Perimeter 330.23 Floor Area 346.56 Total Area 597.73 Interior Wall Area 697.54 Exterior Wall Area 81.15 Exterior Perimeter of Walls 0.00 Surface Area 0.00 Number of Squares 0.00 Total Perimeter Length 0.00 Total Ridge Length 0.00 Total Hip Length Thank you for choosing ARS Services,we appreciate the opportunity to serve you. FRANCIS_V_MALIK 8/27/2019 Page:3 Main Level 291211 281611 3' 4" N � � n N 1 2' 10"—+ —41 Living Room `n -" cn � 0 iT 0 Stairs (1� P 18' 18' 8" a Main Level FRANCIS_V_MALIK 8/27/2019 Page: 4 i A.R.S. SERVICES, INC. Restoration &Renovation 38 Crafts Street Newton,MA 02458-1449 Phone: (617)969-1119 Fax: (617)244-1115 EXHIBIT II Date: Upon completion of the following punch list items listed, (the Job) will be considered complete and the final payment due in full. Balance due upon completion: $ Agreement to completion list Date: (Owner's signature) Agreement to completion list Date: (Contractor's signature) Punch list items completed in full Date: (Owner's signature) 571557 v2 Receptionist\C\MS Office\Winword\Forms\ResidentalContractAgreement.doc A.R.S. SERVICES, INC. Restoration&Renovation f 38 Crafts Street Newton,MA 02458-1449 Phone:(617)969-1119 Fm(617)M-1115 . R R EXHIBIT III Date: 3 Project#: R R Change.Order# Contractor is directed to increase the scope of the work to include: K 1e ix H d- �q V►r�q[.L.� L. oto'y"x N ?�G rt �� 5.�eP wa LLt�/FP!eR R a OF Met9u R t Total: $ 1 In acceptance of this Change Order,the undersigned Owner shall pay Contractor the sum of$ for the additional items not included in the original scope of work. Such amount shall be due and payable upon the signing.of this change order. j i If the foregoing correctly sets forth our understanding.and agreement,please sign where indicated. R i Accepted and Agreed To: Owner's Signature R p1 { Contractor's Signature i R i 571ss7 v2 R Receptionist\WS Offce\Wimvord\FormslResidentalContractAgreement.doe t .. A.R.S. SERVICES, INC. Restoration&Renovation. 38 Crafts Street Newton,MA 02458-1449 Phone:(617)969-1119 Fax:(617)244-1115 EXHIBIT II Date: t i Upon completion of the following punch list items listed, (the Job) will be considered complete and the final payment due in M. � E L JV 1. S A-104-K 11 if2^0-S S 1f/N( (10s47 RN .vdert Z,_�v v MdD%xt f iN i s�• E _ t C 1 Balance due upon completion: $ t Agreement to completion list , 4z—e�X Date: (Owner's signature) Agreement to completion list Dater (Contractor's signature) { 9 t Punch list items completed in full ��� ����'f-'� Date: ` �� /o (Owner's signature) r 1 s f 5715,57 v2 Receptionist\CWS ofrice\wimvord\Forms\ResidentalContractAgreementdoc s i i }.` Fire, Flood , Smoke , Mold , RCC01IStruCtlon o In R EST OR A T I ON SPECIALISTS i i WORK AUTHORIZATIONICONTRACT&DIRECTION OF PAYMENT The undersigned,as the owner/representative of the PROPERTY, hereby authorizes and instructs ARS v ices due to loss submitted on orl{and services August 5,2019. Services Inc.to perform� n f JOB NUMBER: NEW 190978R CUSTOMER NAME: Francis Malik # STREET NAME: 31 Appleby Rd CITY: Salem STATE: MA ZIP CODE: 01970 INSURANCE COMPANY: MAPFRE Insurance INSURANCE ADJUSTER: CUSTOMER CLAIM#: RTWT03 ' DATE OF LOSS: August 5,2019 r 1. I hereby authorize ARS Services,Inc.to perform the necessary work at the above property and I give the above Insurance Carrier permission to directly pay ARS Services,"Ine.for any&all work required to restore the structure within the premises to as near pre-loss condition. i 2.) In the event that any part or whole of the authorized work is not covered by my property insurance,I accept ; full responsibility for payment.I understand that 1.5%interest per month will be charged on past due i accounts over 30 days. Should collection proceedings be instituted for payment,customer agrees to pay reasonable attorney fees,court costs,and other costs incurred.There will be a$25.00 charge for returned checks. 3.) The undersigned agrees to pay ARS Services,Inc.the deductible amount of the policy before the work begins unless it has been deferred to other areas of the policy for said claim by the insurance adjuster. l i V, Name(Print) Authorized Signature Date 3 6 i t i t t i ARS: Always Reach to Serve Throughout New.England i 24/7/365 Emergency Service 1-877-461-1111 www.arsserve.com a � Fire . Flood Smoke, Mold , Reconstruction RESTORATION &PEC64LIST ► I Francis Malik 31 Appleby Rd .Salem, MA 01970 ROOM: LIVING ROOM Store Manufacturer Color Finish (ex.,flat,eggshell,gloss.:. Paint Selection sw75S'� ; Wails i I i i i Selections authorized by: � l Signature Date i s i I i i i } ARS Always Ready to Serve Throughout New England 24/9/365 Emergency Service.1=877-461-1111 www.arsserve:com b