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17 AURORA LN - BPA-11-627 REFACE CABINETS ,�� The Commonwealth of Massachusetts I Board of Building Regulations and Standards OFSALEM CITY Massachusetts State Building Code, 780 CMR, 7`s edition Revised January Building Permit Application To Construct,Repair,Renovate Or Demolish a I, 2008 or Two-Family Dw lhhg T is Section For tcial Use Only Building Permit Numb Date Applied: 2 Signature: 2 Building Co missioner/ n e or of Buildings Date SECTION 1: SITE INFORMATION 1.1 Property Address: ID: 7-29-841 1.2 Assessors Map&Parcel Numbers 17 Aurora Lane 7 29-841 l.lals this an accepted street? Yes X no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Di asfons: One Family Condo Zoning District _Proposed Use ea(sq ft) P ge(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required rovided Required Provided Requir Provided 1.6 Water Supply: (M.G,L C. 1.7 Flood Zone Informati 1.8 Sewage Disposal System: Public rivate 1i Zone: _ - ood Zone9 k if yes❑ Municipal a disposal system ❑ _ Chec SECTION2: PROPERTY OWNERSHIP' it�Owner ofRecord: Pedro Schiu Wl 17 Aurora Lane Name(Print)- - Address for Service: Attached Contract 978-594-0589 Signature Telephone 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 Other ❑ Specify: Brief Description of Proposed Work': Reface/Laminate Kitchen Cabinets,Non-Structural. SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1.Building $6,500- 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 ($VAC) $0 List: 5. Mechanical (Fire $0 Suppression). Total All Fees: $ Check No. Check Amount: Cash Amount: 6. Total Project Cost: $6,500- 0 Paid in Full 0 Outstanding Balance Due: I / ` 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 List CSL 827 o son C , 06277 .Type(see below) U Type Description A ss U Unrestricted(up to 35,000 Cu.Ft. R Restricted 1&2 Family Dwelling M Masonry Only 860-753-0452 RC Residential Roofing Covering Telephone WS Residential Window and Siding SF Residential Solid Fuel Buming 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 24 lorida entral Parkway/Longwood,FL 32750 Ad s 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 ..........0 No........... ❑ SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, Pedro Schack , 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. L14 , Attached Contract/Authorization Letter r (o I I Signature of Owner Date SECTION 7b: OWNEW OR AUTHORIZED AGENT DECLARATION I, 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. Lubvs Sv c—Sears Hom rovement- Authorized Agent / Cell 860-753-0452 Print i Date (Signed under the pains and penalties of perjury) NOTES: I. 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 1 I0.R6 and I l0.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 balf/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" ,< CITY OF SM EM, N'Lxss kcHUSET s • BUILDL\G DEP ARTJIENT 1 130 WASHNGTON STREET, 3t°FLOOR TEL. (978) 745-9595 FMX(978) 740-9846 IONtBFRr RY DRISCOLL MAYOR THo&w ST.Pwmm DIRECTOR OF PUBLIC PROPERTY/BUIMLNG CO%MSSIONER Construction Debris Disposal Affidavit (required for all demolition and renovation work) In accordance with the sixth edition of the State Building Code, 780 CMR section 111.5 Debris, and the provisions of MGL c 40, S 54; Building Permit# is issued with the condition that the debris resulting from this work shall be disposed of in a properly licensed waste disposal facility as defined by MGL c l 11, S 150A. The debris will be transported by: l ru G� t V1 !�j (name of hauler) The debris will be disposed of in 3P -i r&C (�:� k I k1 (name of facility) t, I V r'S t UCan C.L u r� Mn - O zo 9 U (address of facility) gna applicant 6 _ da e Jcbrivtr.Jce t ' l The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investi2ations 600 Washington Street Boston, MA 02111 www mass.govvdia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electiticians/Plumbers Applicant Information Please Print Ledbly Name (Business/Orgarrtzation/lndividual):_ 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. ElI 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>thwattached•sheet:t--— = T. ❑_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. 0 We are a corporation and its required.] officers have exercised their ]0. 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 re^ ra"s insurance required.] t employees. [No workers' .� ]3 Other - comp. insurance required.] , Any applicant that checks box#1 must also fill out the section below sliming their workers'compensation policy infoninafion. �5 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 time of the sub-contractors and their workers'comp.policy information. I 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 Job Site Address: 17 A(A r0 M 4Z�/ e, City/State/ ip I R -7 0 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 hereby c ' un the pains an nalties ofperjury that the information provided a is true and correct. S {Sears Auth.Agent) Date: 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#: 08/06/2010 08:14 4077678536 SHIP PERMITSELICENSE PAGE 01/02 ! CERTMCATE OF LIABILITY INSURANCE OATE08/4/2010 mn Aar Tm IM S CERTCATE IS TSSURD AS A MATTER OF T.NPORMATION ONLV Chicago cago IL Office Risk Services Central, Inc. AND CONFERS NO RIG)TTS UPON TIME CER'rTPICATE HOLDER THIS C Chi East Randolph CERIYF[G A DOES NOT AMEND,EXTEND GLACIER THE Chicago IL 50601 USA oDVERACE AFFORDED DY77TR POLICIES BELOW. nt .(856) 253-7122 PAX- 847 953-5390 INSU'RERS APFORDRNG COVERAGE NAIL IHquxw Rmum6 National Union Fire Ins CO of Pittsburgh 19445 Se dba Sears Home Tmprars Holdings corporation neuvam ACE American insurance Company 22657 ez gqvepent Products, 2ne Attn: Risk mangemeht,E3-219A oaoRmrc Indemnity insurance Co of North America 43575 5 3333 OeYerly Road - HOffman EStaves ZL M179 USA mSU�R P. y RE mmRa: 2 COVERACES THE POI.RDIl40F nmURM'CB IASTPJ)AH(JW nAVa BFIIS ESL'FJ)TOi1R Q1SGR®NAM®AROVEFOR TAB POOCY PeIGOD IND7CATFD.NOTWITHSIA MT ANY REQUWUO 2Gf,TERM OR CONDITION OF ANY CONTRACT MOTHER OOCUARIFr WFM REScmCCTO WHICH THIS CERTMCATBAUY Be MuEDOR MAY P TA[N,THE INSURANCE AFR31UM EYTHE PDUCIES DESCRIBED HEREONISSUBJECT 10 ALL THE TERMS,BxI=us;c Ns AND C"MoN3 of SUCK PDI.iC AGGREG.4TT;JJMi1S SHORN MAY HAVEBEEN)LEOUCEDBY PAIDL MdVI. LRgia SHOWN ARE AS REOUEBTED m D I.T11 WSRE TYP60PrmNhnNCt PDytYN{mrnmr W"eC 41 gL £ YION mrmwoI LBtI'IY AROm1m9 DATAP IV,V a LlABB.(IY rmOG25519R26 08/01(2010 08/01J2011 BACNOCCVPamnE kS,OOD.ODD t1]M®pALaP29ALLrA89.m Mf1AQE To aavrLD 55.000,000 CCAJMSRA08 � nccuR ratAosav I Tom eu e _ PmLfanALaADY a+nmY s5.000,000 0 OENEPs[P154agO.ttt n 55,000,000 m GF]11.AOGREOAT84neT ArruTa pe0. ,_ T O �� ❑ ��©LOC PPODllRP-CONI'DP ACC S5.000,000 pQ D AUTOMOtliIBWllSdn• ISAMOB62550S 08/01/2010 08/01/2011 rnmaareDsurctalmOT o ANY AUTO 2sa 08625449 OB(D3.(2010 OB/01/205I a, s5.000.000 Z AU.OxT'EDABTOS BOOBY OOLRY _ sLI+EDulco Auras troPmw) x waOu,u ^ 600ILYBUOPY U Pr0.V Oa%em AuIDS I Dcm�ataA) miDTOITT DAMAGE OTr+flaom) LAMA to,hJlV AMOONLY-EAA[LV mvl, O DTHERTNA% EA ACC AU10 ONLV: A00 0. 6%C®9IUMPRmla tmailtrr 8E27471375 08/O1/2009 (:ACHO(YTmEaNLTi X owua LJA wub I AOCRROATE 52.000.000 o�rznmz DBIL'NJ10N H WOet®LSGOAttQ49ATrONA. CA0.t A X PTATL-5c so LYN.ISYFAS'GJAmN Y/h sc W [ irJ 1FC46138259 OB/01/2010 OB/O1/2011 a'-RAdlncc�i 12400,000 AF:TROM1TOIs ORfvPIR`+rrtJ if@tl)IRR u � DymQrp ,�gq BXCtJJOEai R.L DISEASE.W 6NmAVtE 52.000.000 C L^P•nP•m,Tm nHr 1tlLRC46130211 O8/01/2010 08/03/2031 U A¢Pl mtle gpgT/a,rBBVrt1ON4 Mev All Other States e.L DISRAS(!-fVDLV IIGOr 52,000.000 Om1Q ptgrserrrtBA OPOPGRATIO!SIIACATRR'�SVEM265IIX(]LSIOtm ABOfiD flT FATOR59MPArTSPECTALrYnVD10N5 - CERTIFICATE HOLDER CANCELLATION Sears Home 1mpmwIsaent Products, Inc. gNBBUPANYrB PBR AOOV8Dt90C6eoeOLrFl6ae GNCLIJ.fA BEroaET%E axVmAi50N 1024 Florida Central Parka y mTE YB@eOP,TIm IATmnn MSVPUMHBLWRIRAVORTOu•, - LOngw d FL 32750 USA OUT,PiLV�HaaI TO O0505NALL ImPa4RehOGOB)]rdS�fM.<OR rUn%H�T OPANT lfam DqH THEaL411Pm1,IS§A(a?NfT OR aPYRF9EATnmVtit AVraO .PTaSENTATNB -5e— ACORD 25(3U09(O1) IDIM-2009 ACORD CORPORATION.AU righft M--d— The ACORO name and logo am rtgl,%mv d met Rs OTACORD Received on 816/2010 8: 16:28 AM r. -- of ICe usmessean - 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 - Home Improvement Contractor Re=istrat'ion Registration. 148607 _ Type: Supplement Card Expiration: 1011 112 01 1 SEARS HOME IMPROVEMENT PRODUCT LUBOS SVEC 1024 FLORIDA CENTRAL PKWY -- - LONGWOOD, FL 32750 lipdale.\ddres5 and rehl rn caM.block rc:uan fw dlangf. -_-_ l Address Rfnewal _Empioymfnt_ Lost Card LWSCAI P SbMpCbbGlal'+I6 0(Rre o(Cmisfmcr Affairs 8'Ii,Umcss R sala ltOl LICL'p$e or 1'L•fliltralim!Vltld for 111d1Vldnl use only HOME IMPROVEMENT CONTRACTOR Office ehe expiration date. o found return in: p before of Consumer Affairs Ind Business return V4a—;' Registration: 1486D7- 10 Park Plant Suite 5170Expirat-on: 10l1112011 Boston.b1A02H6 1 Type: Supplement Card SEARS HOME IMPROVEMENT PRODUCTS INC. LU6O5 SVEC 1024 FLORIDA CENTRAL PKWY LONGWOOD.FL 32750 i'ndrrurremrr _ Nat valid withouttare - -*- Nr Issechusetls- Department of Public S:d'et. - 9 •-Board of Buildin' Rvr_ulations and Standards - Construction Supervisor License - License: CS 97519 I LUBOS SVEC 827 THOMPSON F')AD THOMPSON. CT 06277 ��- -�"�,�•� Expiration: 8f3l/2012, t unnnisginacr Tr#: 2442 i IIIIIIIIII III111 Office Location: -7 O Sears Home Improvement Products,Inc. Pruposal Late (( Job YEA .� 522290 C tamer Name Scars P.O.Box rids Central - Cb1VC. 1024 Florida Central Parkway -2290 Customer's Hame Phorn: Customer's Work Phane Home Improvement Products PhneLongwood,FL 3275 69-46 Phone (800)469-4663 Street Address ESTIMATE AND PROP65AL Gontmcour LicensdRegistration Number r ln Cabinet Refacing CT(HIC.0607669);DC(500015423); Ci State Zip Cotle MD(46542,87854);PA(PA005499); ljl Is installation within city limits? RI(27281),WV(WV025882) Installation Address County ❑Yes ❑No Billing Address(it dinerent rmm above) uny State Zip Code Protect Consultant Name 8 License No.(it applicable) Description of the Project and Description of the Significant Materials to be Used and Equipment to he installed The work to be done under this contract includes the following: 1. Remove and discard existing door/drawer fronts and prepare all appropriate cabinet surfaces for refacing. 2. Alter stiles/rails and repair cabinets as needed. 3. Laminate all appropriate cabinet surfaces with DecoLam Laminate;color to be (K Wood Grain !'1 ❑Solid color 4. Furnish and install custom-rpady�door and drawer fronts;style to be: K'CY\CD,&T=XP CA_ — Door hardware A A Drawer hardware t f� Hinges: Qr�'tx Traditional(Color) ❑Finger Pulls(Only available if not purchasing hardware) FlEufopean 5- a.All Installation includes: New drawer and glides,tilt out tray,matching molding and clean up and haul away of all job-related debris. b.Premium Refacing Installation includes: Fully laminated wall-cabinet bottoms and painted/stained returns on face frames. c.Good Installation includes: Backs of doors and drawer fronts manufactured with a special white laminate. NOTE: Good does DM include painted or shined returns an face frames. This installation will be(check one): .Premium ❑Goad Installation also includes the fallowing OPTIONAL features(where checked): Valance(Specify) n Countertops ❑Solid Surface ❑Laminate ❑None Clear Glass Door Quantity Brand Backsplash(up to 4 1/2'included) ❑French Lite Door Quantity Color Color ❑Knick/Knack Shelves/Units Quantity Edge Profile ❑Corbels Quantity Baeksplash - (Check all that appal ❑Internal Adjustable Shelves Quantity ❑Nane ❑Over 4-1/2'- ❑Over W-20' ❑20'. LRall-Out Shelves Quantity ❑Coved ❑Butt-Jointed ❑Tile I J New Additional Wall Cabinet Lineal Feet Sink ❑New ❑ 8R ❑Customer Providing ❑New Additional Base Cabinet Lineal Feet Color M del t a Holes . ❑New Additional 4-Drawer Disposal Model# El Lotion Soap Dispenser Base Cabinet Lineal Feet Temporary Sink: ❑Yes ❑No ❑New Additional Pantry Cabinet Lineal Feet Faucet ❑New ❑ 8R ❑Customer Providing ❑lazy Susan Tray Quantity Color Model d ❑Frame-Out Metal(Frameless Tear-ore Counterto asks lash Cabinets) Quantity Soon ailid-oil Yes No (No Soldt Removal) [Special Flat Laminate 2 n Square Feet I I ❑Wall-Oven to Pantry Conversion Lighting 0 Low Voltage endant ❑Dishwasher Frame-Out ❑Other(Specify) ❑Wine/Bottle Rack Inches Flooring Yes No If"Yes":Flooring Addendum is part of and incorporated into this contract by reference. Customers inbals PLEASE NOTE:No electrical or plumbing work is included on new appliances. Additional work to be done: Work NOT to be done: Removal or moving of any walls;flooring,painting,wallpaper work; repairs of water or termite damage to sub- floors or walls;electrical or olumbing work outside of this kitchen or bath project. SPECIAL INSTRUCTIONS: All of the above check boxes and the"Work NOT to be done"section have been reviewed and explained to me. Customers)initials APPROXIMATE START DATE and APPROXIMATE COMPLETION DATE: The work will start approximately A-,3 w'eCl_S (Approximate tars Date)and will be substantially completed by approximately t-aW-"YS (Approximate Completion Date)-These dates are subject to cha at the time the contract is accepted by Sears Home Improvement Products, Inc.("Sears")or at any other time by mutual written agreement.Customer understands that the Approximate Start Date is only an estimated date and the Customer will be contacted prior to this date to schedule the actual start date. The TOTAL PRICE including all labor,material,taxes and any applicable discount is $ Contract Price $ _C7_X3 Initial Payment(rot to exceed 30%of Total Price unless Special Order) $ State Sales Tax( %) $ Final Payment(balance payable upon completion of job) $ - Local Sales Tax(_%) $ The Initial Payment is due prior to Sears ordering products. Total Amount Due S The form and method by which the Customer(s)will pay is deBicTib-i in a separate Cash/Credit Card Payment Addendum made a part of and incorporated into this contract by reference. Customer(s)initials NOTICE TO BUYER:YOU,THE BUYER, MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS AT (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. \ / Additional provisions of this contract are slated an the pages fallowing. Customer(s)initials ` 7 SC1Sd Rm09/04 �unmumm ADDITIONAL PROVISIONS Job Number I1 Proposal pALA"royaL Sears otters to furnish the materials and arrange for their delivery and installation as specified on the first page and/or the attached sketches and specification sheets for the TOTAL PRICE shown.This offer must be approved by the Installation Department.If this is a credit safe or a payment on completion sale,it must be approved by the Credit Sales Department. If this proposal is not approved or the installation cannot be made in accordance with the law,this offer will be withdrawn and any payments you have made will be refunded to you. Any materials left over after the installation has been completed are Sears property and will be removed by Sears. Ins.1aflation. I understand that Sears will not install the materials but will arrange for the installation.Sears is not responsible for materials or installation NOT,furnished or arranged by Sears.Sears agrees to procure all permits required by local law. Aothorizatinn. I authorize Sears to:(1)arrange for a contractor(licensed where required by law)to make the installation of materials; (2)issue a w^ry order for this installation to a contractor; (3) inspect the installation; and (4) pay the contractor when the installation is complete if I have signed a certificate that the installation has been completed to my satisfaction. Delays in Installation. I agree that Sears is not responsible for delays in delivery or installation due to weather,tire,strikes,war,government regulations or any causes beyond Sears'control. Oral Agreements and Changes in Contract. I understand that there are no oral agreements between Sears and me.Everything I expect Sears to do has been included in writing in this contract.Nothing can he chapged in this contract unless it is in writing on a separate form accepted by me and Sears. Responsibility of Beyer. I agree that any information or measurements that I give to Sears are correct and complete.I am responsible for any special work described in this contract. Electrical A Plumhing Service I will provide adequate electrical andlor plumbing service(s)to run any newly installed appliances or other furnishings. If the electrical and/or plumbing service(s)do not meet the standards of the utility company or electrical and/or plumbing codes, I will make the necessary changes at my expense unless Sears has agreed in this contract to make the changes. Payment. I will pay Sears the cash price that covers the price of material and installation as shown on the first page. Warranty Information Appropriate product warranty documents will he given to me by Sears.Sears'Warranty on Installation is: SEARS'LIMITED WARRANTY ON INSTALLATION In addition to any manufacturer warranty extended to you on the product(s)used(which warranty becomes effective the date the merchandise is installed),if the workmanship(or application)of any Sears arranged installation proves faulty within two years(Premium)or one year(Goad)after products are installed then, upon notice from you,Sears will cause such faults to be corrected by repair at no additional cost to you. If Sears determines that repair is not commercially practicable or cannot be timely made,then,at Sears'sole 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 specific legal rights,and you may also have other rights that vary from State to State. NOTICE TO BUYER 1. 00 NOT SIGN THE AGREEMENT IF ANY OF THE SPACES INTENDED FOR THE AGREED TERMS TO THE 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 WITH ANY OTHER REMEDIES AGAINST THE RETAIL SELLER YOU MAY POSSESS.IF YOU WISH,YOU MAY USE THIS PAGE AS NOTIFICATION BY WRITING"I HEREBY RESCIND"AND ADDING 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 UNLAWFULLY OR COMMIT ANY BREACH OF THE PEACE TO REPOSSESS GOODS PURCHASED UNDER THIS AGREEMENT. NOTICE TO MARYLAND RESIDENTS ONLY Notice:All home improvement contractors and subcontractors must be licensed by the Maryland Home Improvement Commission.Inquiries regard- ing a contractor or subcontractor should be directed to the Home Improvement Commission,telephone:410-230-6309 or(in-state)1-888-218-5925. NOTICE TO NEW HAMPSHIRE CUSTOMERS NEW HAMPSHIRE LAW, RSA 359-6,CONTAINS IMPORTANT REQUIREMENTS YOU MUST FOLLOW BEFORE YOU MAY FILE A LAWSUIT OR OTHER ACTION FOR DEFECTIVE CONSTRUCTION AGAINST THE CONTRACTOR WHO CONSTRUCTED, REMODELED, OR REPAIRED YOUR HOME.SIXTY DAYS BEFORE YOU FILE A LAWSUIT OR OTHER ACTION,YOU MUST SERVE ON THE CONTRACTOR A WRITTEN NOTICE OF ANY CONSTRUCTION CONDITIONS YOU ALLEGE ARE DEFECTIVE.UNDER THE LAW,A CONTRACTOR HAS THE OPPORTUNITY TO REPAIR AND/OR PAY FOR THE DEFECTS.THERE ARE STRICT DEADLINES AND PROCEDURES UNDER STATE LAW,AND FAILURE TO FOLLOW THEM MAY AFFECT YOUR ABILITY TO FILE A LAWSUIT OR OTHER ACTION. �'I1s�nl Customer's signature Date Customers signature Date r �Home Improvement Products.Inc.("Stars")on - - \ Date Management Representative � � uStnnuurNa/ne� _ �/\Ccopi ' | Address:- _ Dnym/o`| ^ Tr-|ephVM8: �---� _ _--� ' -----_--___--'_-_'-_�__- HM*N�� r��H�� --'---_---_--`---�--_-_-----_--_-_'-- - -__-:[�eriSic.