3D FLETCHER WAY - BUILDING INSPECTION (3) The Commonwealth of Massachusetts
Board of Building Regulations and Standards CITY
\ , Massachusetts State Building Code,780 CMR, 7's edition R OF dALevise �ry
Building Permit Application To Construe , Repair, Renovate Or Demolish a 1, 2008
e-or Two-Fa ily Dwelling
This SectionAor Official Use Only
Building Permit Number: Date Applied: �r �• O
Signature: >, ��` !� • ��
Buildin ommissioner/I spector uildings Date
ION 1: SITE INFORMATION
1.1 Property I �L:rtJZ Address: 1.2 Assessors Map&Parcel Numbers
3 � W
1.1 a Is this an accepted street?yes no Map Number Parcel Number
13 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use Lot Area(sq ft) Frontage(ft)
1.5 Building Setbacks(ft)
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 yesO
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record:
M(A-%-j-'hew Cc�ct2V-V*NE 3t� �IeCtt€�
Name(Print) Address for Service:
-7sl - 3vN —Gcf C- Z
Signature Telephone
SECTION 3:DESCRIPTION OF PROPOSED WORIe(check all that apply)
New Construction❑ Existing Building❑ Owner-Occupied ❑ Repairs(s) ❑ Alteration(s) ❑ Addition ❑
Demolition ❑ 'Accessory Bldg. ❑ Number of Units I Other ❑ Specify:
Brief Description of Proposed Work : -+�^� A�tt-Z (1+2flwCxVr e..�,� i�^1-v`f tt�vyY
C. A ck P W'}i O booty
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
Labor and Materials
1.Building $ 3 9 <- 1. Building Permit Fee: $ Indicate how fee is determined:
2.Electrical $ ❑ Standard City/Town Application Fee
❑Total Project Cost (item 6)x multiplier x
3.Plumbing $ 2. Other Fees: $
4.Mechanical (HVAC) $ List:
5.Mechanical (Fire $ Total All Fees: $
Su ression
Check No. Check Amount: Cash Amount:
6.Total Project Cost: $ '3 tp 0 Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Licensed Construction Supervisor(CSL) e 5 q ,�-7-z G
ph t�j✓yy (.J i t t L 0 License Number Expiration Date
Name of CSL-Holder List CSL Type(see below)
Addres Type Description
U Unrestricted(up to 35,000 Cu.Ft.
R Restricted 1&2 Family Dwelling
SignaI6 M Masonry Only
5-6SI 6 3( 101 RC Residential Roofing Covering
Telephone WS Residential Window and Siding
SF Residential Solid Fuel Burning Appliance Installation
- D Residential Demolition
5.2eeggstered Home Improvement Contractor(HIC)
�t a t.. W.tie%it..-3 �� ) l--I
HIC Company Name or HIC Registrant Name Registration Number
Addres SQ1-S-VO'3 11 !j Expiration Date
Sibdlrwc
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 ..........❑ No...........❑
SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
1 , as Owner of the subject property hereby
authorize to act on my behalf,in all matters
relative to work authorized by this building permit application.
Si nature of Owner Date
SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION
I,_�� Gw o z ty "Lr.�o W- 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.
Atv IIWV1 f-ov;el-(, c>
Print Nam /(/5-A 8
Signa o r or JuthorindAgent Date
Si ned under pairs and penalties of a 'u )
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 I I O.R6 and I I O.RS,respectively.
2. When substantial work is planned,provide the information below:
Total floors area(Sq.Ft.) (including garage,finished baserrenUattics,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"maybe substituted for"Total Project Cost"
�� \ 75 Stockwell Drive •Avon, MA 02322
O FACTORY DIRECT SINCE 1953 1� 1
1 508-580-3119 • 877-946-3699 •508-580-6064 Fax �"
HIIC 127179 •TIN 043450124
WINDOWS ttiYS1I,DING,y /PATIO
'A�T1I OpR,gOO M,S�'® Date ''J ' le)
To {��A-UEIA) l.ao'l�l'11-�C1IU E-mail
��)Q-../ e
3 �� Ft�� � -, ` / '7 Home Pho e Zell Phon
City SA�C0 1 State NA— zip 0 11_� Business (Mr./Mrs.)
Patio Doors • Replacement Windows •Vinyl Siding, Trim & Shutters•Glass & Screen Patio Rooms• Entry Doors
WHOLESALE & RETAIL PATIO DOOR CONTRACT
CHAMPION MANUFACTURING AGREES TO MEASURE, MANUFACTURE OR FURNISH AND
INSTALL THE FOLLOWING CUSTOM MADE PATIO DOOR(S) FOR THE AMOUNT STIPULATED BELOW:
CHAMPION PATIO DOORS FEATURE DOUBLE-PANE,ARGON ENHANCED,COMFORT 365®GLASS AND RE-ENFORCED VINYL FRAMES WITH FUSION-WELDED CORNERS.
INTERIOR/EXTERIOR DOOR COLOR 51' White ❑ Tan if choosing ColorBond®option for exterior,you must still select an interior color
HARDWARE OPTION:9111ithite ❑Tan ❑ Nickel ❑ Brass (Multipoint locking system standard)
COLORBOND®OPTION: (exterior only) ❑ Adobe ❑ Brick Red ❑ Bronze ❑ Colonial Blue ❑ Cottage Gray ❑ Emerald Green ❑Tan ❑ White
SLIDING PATIO DOOR- Nominal sizes
❑ 5 =2.5'+2.5' f" 6'=3'+3' ❑ 7'=3'+4' '', �C I S�''..
❑ 8 =4'+4' ❑ 9'=3' +3'+3' ❑ 12'=S+3'+3'+3' i` Ir, ru + -"='nt �` + "'
O
i
❑ 12 =4'+4'+4' 4e E,'tK r 'I"'„+ y 1 g r �":,.a sa-�m
�
X=ACTIVE O= FIXED (ISLO) G'y' - ..� di K �* �; ',�a '��r+;.
- OPTIONS: ❑ TRANSOM ❑ SIDELIGHT ❑ RIGHT ❑LEFT
GRID STYLES ❑ RECTANGLE ❑ CONTOUR
g El INTERNAL BLINDS*
El ❑ hp ❑ r + ❑ (V,6',9'&12'Doors only-Internal mini blinds will be white In color)
COLONIAL DIAMOND" PRAIRIE OPEN
4'ar PRAIRIE El DOG DOOR* Dog doors feature extruded aluminum frames with two
Not available in contour flexible PVC vinyl flaps and impact resistant GE LEXANO security cover.
❑ ETCHED GLASS SIZE OPENING SIZE
DOG DOORS WILL BE PLACED UNDER THE HANDLE OF THE OPERATING
❑ DOUBLE PRAIRIE :J:[_� El TRELLIS DOOR AND CANNOT HAVE BLINDS OR ETCHED GLASS
TOTAL NUMBER OF PATIO DOORS ON THIS ORDER: Was this home built prior
LOCATION(S)OF DOOR(S) IN HOME _ ,1 _ to 1978? ❑YES AND
OTHER: �� pp�� ne /1 Ll S�G�. ,�Ir S U L 1/�i 7TG'iii*�d If es, the undersigned agrees
�Pl L-�=LYE"� �� rxy✓ '1 r �� ` '"l Y 9 9
to the terms and conditions of
1x !� the Champion Lead Safe Work
❑ Customer agrees to allow Champion to display a yard sign until 30 days after completion Practice Addendum.i
tPATIO DOORS WITH BLINDS OR DOG DOOR OPTION WILL NOT HAVE COMFORT 365®GLASS.. 1•`"L
TWO YEARS FREE IN HOME SERVICE Bu11'er's Signature
BUYER'S RIGHT TO CANCEL
BUYER MAY CANCEL THIS CONTRACT BY DELIVERING WRITTEN Total price` $
NOTICE TO THE SELLER AT ANY TIME PRIOR TO MIDNIGHT OF THE Down payment $ �}d0 , o,
THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION.
BUYER MAY USE THIS CONTRACT AS THAT NOTICE BY WRITING Balance payable on
"I HEREBY CANCEL" AT THE BOTTOM AND ADDING BUYER'S NAME Installation/Delivery $ ��`� '
AND ADDRESS. THE NOTICE MUST BE DELIVERED TO THE SELLER AT
THE ADDRESS SHOWN ABOVE. ❑ Bank Financing J�1Cash on Completion
All material is guaranteed to be as specified. All work is to be completed in a workmanlike manner according to standard practices.This contract is valid only with proper signatures. Chem ion shall not be held
responsible for time and material delays,strikes,acts of God or any other matters beyond its control.Buyer od r agrees that the equity in this property is security for this contract. in i conireot calls far
made to order goads,it is not subject to cancellation except as stated above.Stan installation on or about weeks from above date.Estimated date of substantial completion is .All charges listed
above.Champion to remove and haul away all job related debris.All sales and discounts allottetl.All contractors d subcontractors must be registered by the Board of Building Regulation a standards and any
inquiries relating to registration should be directed to this agency.Champion shall obtain any and all necessary permits as the Owner's agent unless otherwise directed by Buyer.If Buyer secures permits,he or she
may be excluded from the guaranty fund provision of G.L.c.142A.If Champion must pursue Buyer for collection of amounts past due,Buyer will be liable for Champion's reasonable fees and costs,including attorney's
fees.A FINANCE CHARGE calculated at the rate of 1-12 percent per month(18%ANNUAL PERCENTAGE RATE)will be added to delinquent accounts.All installation and completion dates are approximate and
subject to c e without notice.Verbal promises can cause misunderstandings,therefore this contract constitutes the entire undemt3nc�no I the parties,a o other und�rst nding,collateral,verbal or otherwise,
shall be b' g,u_*ss si ned by to hh owhe hank you for your order- Do not sign this contract If there are any S (s s.
Oyer's Signa ur `� Champion eprese e
X k
Buyer's Signature Champion Manufacturing Authorized Officer
Form 1t:CW23-0310-AB mChan ion,2010
The Coninronweald, oflllassdcTznsetts
�i ;! 17epar6nent ofbidirsts•ial Accidents
Office oflnvestigations
600 Washington Street
Jam' Boston,PLI02II7
p www-Mass.gov/dia
A )lcant Nforniation tors/Electricians/Plumbers
Workers, .Cora ensation insurance Afi➢davI6 Builders/Contrac
Please Print Legibly
N3ITle(Business/Orgaijzstion/Individual): ��'�Y�"t�,t,,.rB� �ry�. �� �'�
Address: cA.- 4-e r r tJ +'2 V-\f 6YI�-t 140,4q
City/StatelZip: IUU ry Phone#: S
n employers Chec CV 0 - 3 t t g
Are ak the appropriate box-
1•flGf i am a employer with (O 4. I am a general contractor and I Type of project(required):
employees (fill and/orparwima).* have hired the sub-contractors 6- ❑New construction
2.❑ I am a sole proprietor orparwer- listed on the attached sheet 7_
Ship and have no employees These sub-contractors have Remodeling
worhing forme in'any capacity. employees and have workers' $' ❑Demolition
No workers'comp.insurance comp. insurance. g- ❑Building addition
requireH-] 5. We aze a cotpatatioa and its 10.0 Electrical repairs or additions 3.❑,I tun a homeowner doing all work officers have exercised their
myself.'[No workers' comp, right of exemption per MGL 11.0 Plumbing reparrs or additions
insurance required.] t c. 152, §1(4). and we have no 12.0 Roof repairs
employees_[No workers' 13.(p�eer np6V s
comp.insurance required.]
�!Any applicant that checks box#)must also fill out the section below showing their workers'compensation policy information.
Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new DMdavit iadicating such,
•'Contractors that check this box most attached an additional sheet showing the name of the sub•cantractom and state whether or not those entities have
—.mployecs..irthe sub-contractors have employees,:they mostprovide their workers'comp_policy number,
am aix employer that is providing rvorlters'compensation insurance for my employees. 8efo>u is the policy and job site
irfornr anon.
nsurance Company Name:
Policy At or Self-ius.Uc.#: -
Expiration Date:
Job Site Address:
City/State/Zip:
f ittoch a copy of the workers' compensation policy declaration page(showing the policy number and expiration date).
"'Mare 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 WS250.00'a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Livestigations of the'DIA for insurance coverage verification.
I do hereby certify un r t epair� a en lies ofperjrrry that the information provided above is true and correct.
S i ture
Date: . f
Paone#c
OfjfcfaI use only Do not inrite in this area,to be completed by city or to)vrrofftCal
City orTown: Permit/License
ff
Issuing Authority(circle one):
I.Board of Health 2.Building Department 3.City/Town Cleric 4.-Electrical
b.Other Inspector S.Plumbing inspector
Contact Person-
Phone#
FACTORY DIRECT®SINCE 1953
=®
WINDOWS • SIDING PATIO ROOMS
TO Whom It May Concern:
I hereby authorize Antonio (Tony) Dasilva to act on my behalf pertaining to all matters
regarding building permits, and to act as my representative on behalf of our company.
Please feel free to call me with any concerns.
•VINYL REPLACEMENT
Sincerely,
WINDOWS
M
as
s
a
c
h
usetts - 17e1i tftrucnt of Public=Sat'ety"
Board offluildino RLtalations and Standards
,Construction Supervisor License
Anthony , . ov' llo
-.aicense:-CS '97226
Division anager
■ STORM DOORS& Champion of Boston South
WINDOWS CS 97226 ANTHONY C"OVIELLO
I IIC 127179 27 COLONIAL DRIV€
CLINTON, MA=01510
Office (508) 580-3119 Expiration: 5i6i2012
Fax (508) 580-6064 ( mu Ih;„i„I,,.,. Tr~: 28039
■ PATIO&ENTRY DOORS Cell (978) 804-6199 - - - - -
15 VINYL SIDING AND TRIM '
�\ Office of Consumer Affairs&Business Regulation License or registration valid for individul use only
HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to:
Registration:sg<27179 Type: Office of Consumer Affairs and Business Regulation
Expiration: 2012 Ltd Liability Corpor 10 Park Plaza-Suite 5170
Boston,MA 02116
TCPIONVVIN ## Q M SOUTH
0 PATIO Rooms&
PORCH ENCLOSURES ANTHONY CO I -
75 STOCKWELL D
AVON, MA 02322
Undersecretary Not vat' ith t signature "--
,
' F Iria-I I�i
I
75 STOCKWELL DRIVE Is AVON, MA 02322
PH: 508-580-3119 Is 877-946-3699 Is FX: 508-580-6064
7
n' l rl ►I I1111}I� I; I ` l t 11 ,
fit ,I PAcro Y oIR cr , N E l ' k I 75 Stockwell Drive •Avon MA 02322
508-580-3119.877-946 3699,-1508-580-6064 Fax
l l IC 127179•TIN 043450124'
r I VIN6dWSr'•I SIDIW I �P�TIOI OOMS. ® } I', ' I 9 S ' �� I� II��
To _". u.. : �UUI IILQI �� I , r ) Date
I ,ill ill p}
I
�e- l
�N.� - E-mail (�[� f—f /�G}� /��p(�
` ' � � �..� Home Ph e, 1 7 I f02.. ICeif (0 S2L7 4
I� ill j .nl ,1 I V ! 1
Cfry '1 Ik gtate,.a r -ZiP 7o , Business Phone(Mr. Mrs.) II 'n'd 1 ' I t ,Tr
px I # h9llleli �11�rd} Ifl�IIlrl
i Re lacement rick • t rrn oof�s•Vinyl Siding,Trim&Shutters•Glass&Screen Patio Rooms a Entry&Patio Doors
Cl �}'��i'��� :�IV�H LESALE&�RETAIL DOOR CONTRACT{ n 1 ri1
i, j AMPIbN M NUFACT RING AGREES TO MEASURE MANUFACTUR 1 ,G r 0 IF' URNISH AND
9 INSTAL iTHEl�Q OWII�GICUSTOM MADE PRODUCTS'FOR THE AMOUNSf'PUI ATED BELOW:
ENTRY DOO�RI#h i I r`� � I `1 I'll! .' ' ENTRY DOOR #2 {
Locati• n ' , II ;I(I �1I� F'I 9I Yr''Ii 1 Location I' ENTRY DOOR #3
Location 11
Smile b'French I } ".O�Ga` n'view{I It O Single , -U French p Gardenview O Single III OlFrarch 11 . ❑Gardenview
Garde view S reen Oolor d White Gardenview Screen Color U White U Tan U Bronze Gardenview Screen Color O White U Tan U Bronze
Modell
" Nj' hb h'° Irrinodel#
_ Model# i I.d;Ilj: i {
SidelitSldellte Model# .
S
Appro i.�Size Door 1k:: ,u I t !'i'lI 'i III 4�@ I;ta�„ t+ �IApprox.'Size Door Sidelite Madel#
Approx. SizeUoor
Appro,.=S_iz, a 9rdelf e t o f r '�F haul ICI "'.ilf,i �I '!�Appfox,.Size Sidelite
l� l _ Approx.Slie'Sitlelite
Jamb ize t it III! 11 +^ III I,11 If111 il,fl l I:Jamb Size Jamb�Size
Jamb Jype Wood I1O Ste II LIF�anie,"''d Ic ; ;Jamb Type .O Wood El Steel L Frame Jamb Type' 'h O Wood El Steel L Frame
Sltlelil;iLocatigmlSLO p(Left's[ijRlgh Ib Botfil `i, IiSidelite Location ISLO U Left U Right ❑Both Sidelite LocatlonlSLO a Left O Right U Both
Hinge ISLO yfs, 1 ❑).'eft,lURlgh I (� `� I IH{nge ISLO _ Cl Left J Right HingeI ISLO l I j, ❑Left J Right '
Swing Style It =I ❑Inewinj}'IIO ii;i 'u't win` g`1 �ISwing Style ❑Inswin Q Outswin Swin S le, 4 ° I. i, J Inswing U Outswing
9 9 g ty I dTl'
Door I finish +Smooth Steel i Wood ram Sfeel I,tr IlDoor Finish U Smooth Steel ❑Woodgrain Steer (Door Fi fsn l ❑Smooth Steel ❑Woodgrain Steel
r, i I;..*1d t)rq t F ,,1, {IIsII r I ' ydb I f1 I V! - ' 9 g �. ''�� f �l ro l
U Woodgrain Fiber IaSsII (
I 1 t sl! I r U Wootl rain Fiber lass ❑Woodgrain Fiberglass
Glass >tyfe D ' r„ I',; I I'rllt f II 19 i I~ 10 In Glass Style Door Glass'S IeI'D ty . oor
Glass style Sidelite C(J ;llhiw lj I';�t r{ Glass Style Sidelite
ty Glass Style Sidelite
®� rN I I¢ she: II 1 I
Door'I lutsfde odr Insfde I{L' I DdomOutside: Door Inside: _. Door Outside l; l iDoor Inside:
Jamb Ju fide Jam1 i l sidle} l '' r�IJamb Outside: Jamb Inside: Jamb 0lutsidei' {i I ' r' 'Jamb Inside:
Sidelitei 0utsid8�, f6tild ite GlnaI' ; t ',� , ISitlelite Outside: Sidelite Inside: Sidelite Outside;,i 1 '
4 ptI11, N i Sidelite Inside:
Transl m Outside , Al"' r•, T}ans m lost l 11y I 'Transom Outside: Transom inside: Trarisolli 0utsi,tle l l ;Transom inside:
Hardware Pacllage k 1 p�J{ IIIy}I�i ( �IHardware Package
.r 9 . HardwarePacka�gei '
Hardwire Finish k O'AnbquelBrass�f Bn jtit�Bras II t Hardware Finish U Antique Brass U Bright Brass Hardware Finishl"i U Antique Brass J Bright Brass
fo U Satin lfVickelf `ill i� �7� F' �� 1 �� j� I C Satin Nickel l �I �� p Satin Nickel
If External Gnds 9;:Ill ' (�' �k If External Grids If External Grids
In:Ide Color Outside C rI �� i t nside Color. .':Outside Color; Inside Color.�lli I
b : Outside Color:
If IntelplihGndii J White O Tan o$ronz 1 W' I IIf;Intalmai Grids .J White J Tan J Bronze.J,Brass If internal Grids:O White❑Tan U Bronze U Brass
If Intemai Min(Blinds ,I P (p White 14 r I l lifiinternal Mini Blinds, LI Whde . _ If Internal Mini Blinds 'i U White
Upgrade#i 3"'G'�fLl; 'll L� }�{il��� �ll d�} 1 : Upgrade#tr
Upgrade�#2 � 1r{,r a . I' y olvlh P9
II .�3 }��" A:�C Upgrade'#21 - U' rade#2. iisl; .�.
'Jamt relnforcing:plates stars aid;' iall,sf gee do0 i(Jamb reinforcing plates standard on all single doors Jamb reinforcing plates'standard on all single doors
*Adjustable threshold stan'6 Fd bn Iall do isb rsh �'p Adjustable threshold standard on all doors
} 4 Adjustable,tfireshold standard on all doors
I l t l i FNN I l lid mitt lr 41 l l 1 1, 1 ,
TO tAL NOMBER'OF I 1Si0 HIS ORDER: Was this home Wit1prior to 1978?J YES)III
�@i r
' 1p,E' t'��Ii 11 � �I rb1 � - Y1 �h�. 1 1 rsig 9 I'a
I/ Ts unde sl ned a lees to the terms and
OT! IER t si u" tar ed. conditions orlthe Champion Lead Safe Work
'Pr'a�ic I Ad"e'n'd nil d� '
�y lytti �lI {l {' qk �11 i61 i I�IIIit�I�i� e pr p.
(fir (/�(!
"` .I>''• li Ili, IIll1�I L i h IyEARSfREE.SERVICE TO ORIGINAL PURCHASER B y'er s$Ignature
IIXIIJII 1 la'r I e,110 I
BUYEi 'SI IGH �tOi�ANGELI '
= n 4 f r Ili *
1 I l Total price
BUYER MAY CANCEL 1 H1 11 ONl 011 i }8Y,DELIVERING
1 I ' C
WRTTfNi1VOTICETOl ,HRSE �I:R�A 'ANYhTIMEPRI0RT0
MIDNIGHTOFTHEI`HIRDIU INE 'DAYIAFTERTHEDATE Down payment
air" fHaS TRANS Z ION•�;B'U"Y� ER'; )MA 111iISE THIS CON_ t`11 ! �� Ill' !, �� 'I
Balance payable)o 1 I ,
TRPCTASTHATNOTICE Y'u�RITIN .'sI,IHEREBYCANCEL'. III
Installation/Delivery $ '��c��y /yam 2�
II ill t U.
AT;THE r BOTTOM.iAIC AD ING 1 UYERLS NAME SAND l3 I ' i " Ili "
ADURIESSl ,THE' NOTiC� MU TII'B 'DELIVERED TO THE O Bank Financing . II �': Cash on Completion
SEL_ER A1f+THE ADORES IPSHQWN` BOVE'
r .Ifile hll1 p
i'. { II +aII: Il+nlr lit , :Ifl! I ' I. .
JI miter al is;gue eed,toihe es fed,i Aliitill s to,bla4opleled In lai,iorkmenlike manner awarding to standard praclims.Thisconiract Is valid poly wiUi proper signatures. Cha pion shall not be hem sspansi Ae fdr lime end material tleleys�mdkes,lada God bdatiy,oftier ma ters beyondlits control.Buyer d r agrees that the equity in this property is security for this contract: in s contract rills for
rade to frdergood,it III subled,to barrcelllidon a pt a4 arat4q aboYei Start Instellatlon on or about eks from above dale.Esliand date of substantial,00mpletan is All charges listed
bove 6 eemmpplont�removeentl haul e,4ay,¢II joq reiAt �Uebde;All sales eM discounts allotted.All coot amors d subcontractors must be registered by the Bmrd of Building Regulation a d Standards and any
,gwnes%latlng to registration shohlrf be direiie to to gancy;, hlplon idaeq abtaln an and all necessary y ry permits as the Owner's agent unless otherwipe ddocledlb'y Buyer,If Buyer secures permits,he or she -
leybeeeduijedfrom(heiguaramytunQ rovislonlrun 1�142Ai,1 lidl�plo8 must pursue Buyerlormilectlonot amounts pastdus,-Buyerwlll be liable for ampion'a reasonable fees and costs,including attorneys
aes A F NANC I1AaGE kaloulaied a I the 9 of ti /2 parceht� r rrtontr 18%,ANNUAL PERCENTAi ATE)will be added to delinquentecgdu Il in�lalletion and complotion'dates are approximate end
haled U ch a ilhouthotice VertlSs ro s.¢Fan hat mlaJr{tle ndings,'therefarethis contradcon es a entire underst ng of a paN d no btherunderstanding.collateral,verbal or otherwise,
hall be yin mass signed y )h�p e:. anN � hd ur y�Itl� I?�o not sign this con e" if are any en sp s. P; 11' Ill
uyie s I slur f 4rp{{11, l ,l k� ]girl l wi i i1 C at ve
X i l�� �
users fgnature, I a
{ � � ��1� f6, ,I 1ett Champion MarrUllcturingAuthorized utticer, 11