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14 FOSTER ST - BUILDING INSPECTION (2) The Commonwealth of Massachusetts o Board of Building Regulations and Standards CITY OF Massachusetts State Building Code, 780 CMR SALEM Revised Mar 201l Building Permit Application To Construct, Repair, Renovate Or Demolish a One- or Two-Family Dwelling This Section For Official Use Only Building Permit Number: TDate Applied - - LO 1 3 Building Official(Print Name) tgnature Date SECTION 1: SITE INF MATION I.I Property Address: 1.2 Assessors Map& Parcel Numbers 1 yoke r S6 _ I.I a Is this an accepted street?yes no Map Number Parcel Number .-- -- ---L 3—Zoning Information: - - 1.4 Property Dimensians: Zoning District Proposed Use Lot Area(sq ft) Frontage(tt) 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? Check if yes❑ Municipal ❑ On site disposal system ❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: r clue one-, So.Iepm, ITO 01g7o Name(Pont) City,State.ZIP 14 lrot,4er e,4. 97$-g43-y699 No. and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK'(check all that apply) New Construction ❑ Existing Building ❑ Owner-Occupied ❑ Repairs(s) Alteration(s) ❑ Addition ❑ Demolition ❑ Accessory Bldg. ❑ Number of Units Other ❑ Specily: Brief Description of Proposed Work'-: v f rV fbelhy om SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials I. Building $ i o 24. qT I. Building Permit Fee: $ Indicate how fee is determined: 2. Electrical $ ❑ Standard City/Town Application Fee ❑Total Project Cost'(Item 6)x multiplier x 4. Plumbing S 2. Other Fees: $�� ca \ 4. Mechanical (HVAC) $ � List: v {�JL 5. Mechanical (Fire $ i Su ression) Total All Fees: $ Check No. Check Amount: Cash Amount: 6. Total Project Cost: $ 1f pub• 9q ❑ Paid in Full ❑Outstanding Balance Due: ,�� 4 hc)►occhl, SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) 7 1 1 8 - &fxta Wp Lrl License Number Exp rat Name of CSL Holder j 2 List CSL Type(see below) No.and Street Type Description U Unrestricted(Buildings up to 35.000 cu. It.) Pt tIT R Restricted 1&2 Family Dwelling Citv/town,Staid. 1IP M Masonry RC Root in Covering WS Window and Siding SF Solid Fuel Burning Appliances —T► � -bt� I Insulation Tel, hone Email address D Demolition f 5.2 Registered HomeImprovement Contractor(HIC) l�l P6?� to / /S ` d {ram Ca4e HIC Registrations Number Expiration Date (IIC Company Nam or HI , Registrant Name �U, —ryrn tl a rlc6A.chalone @ More.lDweS•Corr, No.and S eet Email address ry 1't 111A orr 611`3S4`oqw City/Town,State, I '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 Issu Fce 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 to act on my behalf, in all matters relative to work authorized by this building permit application. 6he7 &n4rtJ Iz z / Print Owner's Name IFIectronic Signature) Date SECTION 7b: OWNEW OR AUTHORIZED AGENT DECLARATION By entering my name below, I hereby attest under the pains and penalties of perjury that all of the information contained in this application is true and accurate to the best of my knowledge and understanding. R« 0 � `Z � z 13 Print O wners or Authorized Agent' nd s Name(Electronic ggnature) Date 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 can be found at www.inass.gov/oca Information on the Construction Supervisor License can be found at yvww.mass.sov/dps 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" l ne UUMMan weunn Of [Hussucnusells Maw.,e7.>:w;F�:�,,;, . ., Department oflndustrial Accidents Office of Investigations I Congress Street, Suite 100 Boston, MA 02114-2017 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): 7&nttW 1I)QGklIY) Address: City/State/Zip: Phone #: q7�' '53;-035X Are you an employer? Check the appropriate box: Type of project(required): 1. I am a employer with 1 4. ❑ I am a general contractor and 1 employees (full and/or part-time).* have hired the sub-contractors 6. New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling shipand have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. employees and have workers' comp. insurance.1 9. ❑ Building addition [No workers' comp. insurance P• required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] '1 c. 1.52, §1(4), and we have no employees. [No workers' 13.0 Other comp, insurance required.] *Any applicant that checks box#] must also fill out the section below showing their workers'compensation policy information. r 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-contactors 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 jab site information. Insurance Company Name: A'p Arhe.rkm Tn omce C,"MIDMV Policy#or Self-ins. Lic. #: U B"y g Ots' Cal;L'13 Expiration Date: [d �9 1 Job Site Address: ly f**trkr SSA. City/State/Zip: Uew �} 01170 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 hereb certi r the Cains and enalties ofivedury that the in ormation provided above is true and correct. Signature:L `Date Phone#: - 3 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#: Massachusetts - Department of Public Safety Board of Building Regulations and Standards C.mstrucnon Supcn i.nr -. License CS-071187 _I F RONALD E WACOUN 12 TUCKERS CT,3RD FL FEARODY MA 61960 Expiration Commissioner 08104120115 i �/!flij•nnrrrer. r<Hv.:/ e+ lreira< �rvnC/, ;! Qfillr Uf(IPaYalael'Affair's�t n1lFl�d(ess nc�ulefion License or registration valid far individul use only ME IMPROVEMENT CONTRACTOR llefore the expiration date, if found return to: eglstration7 133n14 Type: Off7ec of Consumer Affairs and Business Regulation Piratlom. 6W12.015 DBA 10 Park Plaza--Suite 5170 Boston,MA 02116 RONCO CONSTRUc r.lotk RONALD WACHLIN 12 TUCKERS CT. •� - - �� ./ _, G-G•-�,'. PEABODY,MA 019e0 t!odarsaermAry Not valid without signature l CERTIFICATE OF LIABILITY INSURANCE ( TIFIGATE 131SSUE0 AS A MATTER OF INFORMATION ONLY AND CONFERS 1 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 p D E N CE - IF T O E IMPORTANT:If the certificate holder Is an ADDITIONAL INSURED,the pelicy(ies)must be endorsed. It SUBROGATION 15 WAIVED,subject to the terms and conditions of the policy,certain policies may require and endorsement. A statement on this certificate does not confer rights to the certificate holder 1n lieu of such endorsements . EADDRESS: PRODUCER PATRICK J WOODS INS AOCY Fax I�G,�)= s0 MAIN SI REIII pEABOL)Y,A4A 01960 T25YY INSURER(S)AFFORDING COVERAGE NAIC# ------•- --"�Y� INSURER A: ACI:ANMRIc AN MStMANCr,COMaANY INSURED W ACHLIN.RONALD DBA RONCO CONSTRUCTION INsuRER B: INSURER C: INSURER O: 12'rUCKER S CT INSURER E: PEABODY,MA 01960 INSURER F! REVISION NUMBER: COVERAGES CERTIFICATE NUMBER: ISIS CE FY TT L SO INSURANCEAV T L TED BELOW HEBEEN ISSUED TO THE INSURED NAMED ABOVE FOR OLICY PERIOD INDICATED. NOM7THSTAHUNG TANY REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OR O i HER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN ISSUBJECT TO ALL THE TERMS.EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED By PAID CL.NMS. pDD SUR POLICYEFFDATE POLICY EXP DATE UR TYPE OF INSURANCEUNITSI NSR L R POLICY NUMBER (MMOD%YYW) (MMIODIYYYYI -ACH OCCURRENCE g GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY AMAGE TO RENTED $ CLAIMS MADE OCCUR. REMISES(Ea Occurrence) 7ED EXP(Any dna person) S PERSONAL B,ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: ENERAL AGGREGATE $ POLICY 0 PROJECT a LOC RODUCTS-COMP/OP AGG S AUTOMOBILE LIABILITY OMBINED SINGLE $ ANY AUTO LIMIT(Ea accdenq BODILY INJURY $ ALL SCHEDU E AUTOS (Per BODILY INparson) SCHEDULE AUTOS � 1300ELV INJURY $ HIRED AUTOS (Per accident) NON-OWNED AUTOS PROPERTY DAMAGE $ (Per accloent) EACH OCCURRENCE $ UMBRELLA UAS OCCUR AGGREGATE $ EXCESS UAB CLAIMS,MADE $ DEDUCTIBLE S RETENTION $ ___ .--- WG STATUTORY OTHER A WORKERR'S LIABILITY ON AND YIN UBAUGSPOIZ-13 10/20/2013 t0/29/7.Ot4 EACH NrOr EMPLOYER'S DAB[Llri ANY PROPERITORIPARTNERIFXECUTNE � NfA E.L EACH ACCIDENT $ fOO DOD OFFICERVEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE S 100,000 (Mandatory In NH) deeulbe E.L.DISEASE-POLICY LIMIT $ 500,000 If yes, odder DESCRIPTION OF OPERATIONS U6IOw DESCRIPTION OF OPERATIONSIL.DCATIDNSNEHICLESIRESTRICTIONS!SPECIAL ITEMS JUS REPLACES ANY PRIOR CERftI'IFICAI E ISSUED TO'I"f�CERTIFI('ATE HOLDER An;F.CTMC'[WORKERS Co,SIP COVSRAGE. 'rHE INS[1RED'S MA.WORKERS COMPENSATION POLICY AND I1S LMII TIED OTHER STATIC•:$ENDORSEMENT AUTHORIZES 1-HE PAYMENT Of BENEVITS FOR CLAIMS MADE DY THE INSURGIYS NIA EMPLU t'EES IN STA'1'k$O'fllliR THAN MA. NO AUTI IORIZA 11ON IS CIVEN TO PAY CLAIMS FOR RENEPITS IN STATES OTIIF.R 'HiAN MA U'THE IPISLRED HIRES,OR HAS HIRL'U EMPLOYEES OUTSIDE OF MA. THIS Pi)LICY ODES NOT PROVIDE COVIiRAGE POR ANY STATE 01'HER THAN MA. THE vIORKERR COMPENSATION POLICY LIOES NOT PROVIDE COVERAGE FOR WACIiUN,RONALD. _ CERTIFICATE HOLDER CANCELLATION LOyygS COMPANIES INC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL B DELIV ED AfTN:IS INSURANCE IN ACCORDANCE WITH THE POLICY PROV PO BOX I I I AUTHORIZED REPRESENTATIVE N 1O W ILKESBORU,NC 26656 _ ACORD 25(2010/05) The ACORD name and 1090 are registered marks Df ACDRD 1588-2010 ACORD COR R IS r erred. Otlice OCusumeq j y ✓ y &Business Reuod .OM' 'PROVEMENTCONTRACTOR Registration: Expfra;;'B TYPe .. LOWERS HOME p13 ' . Supplement RICHARD CHALOf 136 TURNPIKE R13 SFJ@TE 10p _ SOUTHBOROUGH'MAOi 77 -- Underse_ er- a' Office of Consumer Affairs & Business Regulation- Mass.Gov Page 1 of 1 The Official Website of the Office of Consumer Affairs&Business Regulation(OCABR) Consumer Affairs and Business ReguOation ' ,-_.... ._..- -.._ ,- ,_ ,-. -___ -_ -..w.-..,_- Home Consumer Home Improvement Contracting HIC Registration Complaints rZo Registratidp,�4-8 Home Improvement Contractor Registrant LOWE'S HOMES CENTERS INC Registration Home Page Name KEVIN BECKER Address 136TURNPIKE RD. SUITE 100 City, State Zip SOUTHBOROUGH, MA 01772 Expiration Date11;9/96/20� T5---% Complaints Details COMPLAINT NO DATE RECEIVED 2005-051-HU 09/16/2005 2009-083 03/04/2009 2012-108 08/28/2012 You can also view arbitration and Guaranty Fund history. Back To Search http://services.oca.state.ma.us/hic/liedetails.aspx?txtSearchLN=49486 11/4/2013 STORE COPY INSTALLATION SERVICES CUSTOMER CONTRACT- MWORK - INT/EXT/PATIO DOOR LOWE'S OF DANVERS, MA., STORE# 1094 STORE PHONE: (978)646-9099 153 ANDOVER STREET SALESPERSON: GARY EVANS DANVERS, MA 01923 SALESPERSON ID: 135952 Document Print Date: 11/19/2013 This is only a Quote for the merchandise and services printed below.This becomes an agreement upon payment and issuance of a Lowe's receipt, upon which the entire agree- ment, including the specifically completed pages of this document, the Terms and Conditions included with this document, the applicable portion(s) of Lowe's receipt, and any other addenda or attachments hereto,shall be referred to herein as this"Contract." PLEASE READ THIS ENTIRE DOCUMENT INCLUDING THE "TERMS AND CONDITIONS-" BEFORE SIGNING Lowe's Registration or Contractor License Number/Lowe's Contractor Name Lowe's Home Centers, LLC's MA HIC NO.: 148688 Lowe's Home Centers, LLC's FEIN: 56-0748358 Customer Name Home Phone S CARLOS NUNEZ 978-943-4699 O Customer Address Other Phone 14 FOSTER ST L City State/Province Zip/Postal Code D SALEM MA 01970 Installation Address T 14 FOSTER ST O Installation City Installation State/Province Installation Zip/Postal Code SALEM MA 01970 MERCHANDISE AND INSTALLATION SUMMARY MERCHANDISE SUMMARY 1049 : 87548 : STK : 1X4X8 RED OAK BOARD : 1X4X8 RED OAK BOARD : BABCOCK LUMBER -QTY 1 1161 : 1161 : STK : 1X8X8FT SELECT PINE : 1X8X8FT SELECT PINE : PRECISION LUMBER -QTY 1 18302 : STK : FINE CASE 351 2-1/2X1 1/16X8' : PNE CASE 351 2-1/2X1 1/1 6X8' - CITY 1 115253 : 37081032 : STK : CB 36-IN CONCORD WHT MV : CB 36-IN CONCORD WHT MV : COMFORT-BILT WINDOWS AND DOORS - CITY 1 131207 : 131207 : STK : 1X8X16 PRIMED FNGR JNT(+333358) : 1X8X16 PRIMED FNGR JNT.(+333358) : IRVING FOREST PRODUCTS (MAINE) - QTY 1 Materials Price Store 1094 Project No. 396632374 for CARLOS NUNEZ Page 1 of 8 STORE COPY INSTALLATION DESCRIPTION Stock or SOS : SOS Door Type : Exterior Select Location : Front Door Select New Door : Single Pre-hung Number of Doors to Install : 1 Side Lights or Transoms :Yes Total Number of Side Lights and Transoms : 1 Hardwood (Mahogany or Oak) Door : No Hidden Damage Description : None Number of additional holes bored for accessories : None Install Specialized Mortise Hardware : No Install Storm Door : Replace existing storm door Lead Safe Practices : No Total Linear Feet of Custom Trim to be Installed : 0 Deliver Door: Yes Customer Understands Scope of the Project : Yes Permit Required : No Additional Miles Traveled over 20 : 0 Bring Up To Code Description : None Local Disposal Fee : Yes Describe Other Work Needed : B/O JAMB. CUSTOM WORK. BASIC STORM Other Work Charge : Yes DOOR INSTALL. Comments : No Comment Labor Charges $ 793.00 Detail Deduction $ 35.00 Additional Specifications: Notation: Lowe's will not make structural modifications, paint or stain or remove/reinstall security system equipment. Customer is responsible to advise if prop- erty is governed by Historic District Regulations. Additional Specifications:Federal law requires Lowe's to provide you with the pamphlet Renovate Right: Important Lead Hazard Information for Families, Child Care Providers and Schools. By signing this Contract, Customer acknowledges having received a copy of this pamphlet before work began informing Customer of the potential risk of the lead hazard exposure from renovation activity to be performed in Customer's dwelling unit. PHOTO RELEASE: Customer grants to Lowe's and Lowe's employees and independent contractors the right to take photograghs of the Premises where In- stallation Services will be performed and all work performed at the Premises related to this Contract, and irrevocably grants to Lowe's all right, title, interest in and to the photographs for use in all markets and media, worldwide, in perpetuity. Customer authorizes Lowe's to copyright, use and publish the photographs in print and/or electronically, and agrees that Lowe's may use such photographs for any lawful purpose, including, but not limited to, marketing, advertising, publi- city, illustration, training and Web content. By initialing here, Customer agrees to the foregoing. [Customer to initial to the left]. NOTICE TO CUSTOMER-PRICE CALCULATIONS: In order to properly perform the installation of certain Goods, the Contract Price may include more Goods than actually will be installed based on the measured square footage of the Project Area. As a result, the parties agree that the lump-sum Price stated in this Contract is calculated upon both the value of the estimated Goods required to fulfill the Contract (including`waste), which may exceed the actual square footage of the Project Area, and the labor which may be estimated based on the amount of Goods required to fulfill the contract (including waste). By signing this Con- Store 1094 Project No. 396632374 for CARLOS NUNEZ Page 2 of 8 STORE COPY tract below, Customer acknowledges receipt of this notice and agrees and understands that the Price includes these costs which may not be refunded once the Installation Services are performed.. TOTAL CHARGES OF ALL MERCHANDISE AND SERVICES 'where applicable SUB-TOTAL $ 1026.9 *TAX $ 0.0 DELIVERY $ 0.0 ORDER TOTAL $ 1026.9 BALANCE DUE Work is to commence upon reasonabllle/v/ail blitl of Contractor which is anticipated to be [fill in date]. Estimated completion date is y�l�� 7 [fill in date]. NOTICE TO CUSTOMER All items listed in this contract and specification sheet(s) are to be installed under conditions agreed upon at time of purchase and at the price appearing on this contract form. This assumes sound existing substructures, superstructure and points of attachments. Extra labor or material incident to installation necessitated by defective substructures, superstructure, points of attachment, or the moving of fixtures or appliances to be billed at extra cost to custom- er. IF THE CONTRACT TOTAL IS$1 000 00 OR LESS Customer must pay in full COMPLETE THIS SECTION ONLY WHEN THE CONTRACT TOTAL EXCEEDS$1,000.00: [_] Customer to Pay in Full; OR (_]Customer to use the following payment schedule: (1) Deposit of $ to be paid upon signing contract. Any deposit collected at the time this Contract is signed will not exceed one-third (1/3) of the contract price; and (2) Payment of $_ to be collected upon or after the commencement of work. I/We authorize Lowe's to do one of the following (check ap- propriate box below): [a Charge my/our credit card for the amount of the payment indicated above upon or after the commencement of work; or Store 1094 Project No. 396632374 for CARLOS NUNEZ Page 3 of 8 STORE COPY (_] Deposit my/our check for the amount of the payment indicated above anytime upon or after the commencement of work; and (3) Final payment of$100.00, to be paid upon completion of the installation to both parties' satisfaction. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES AND UNTIL YOU HAVE READ THE TERMS AND CONDITIONS CON- TAINED IN THIS CONTRACT AND WHICH FOLLOW THE SIGNATURE PAGE(s). BY SIGNING BELOW, YOU ARE ACKNOWLEDGING THAT YOU HAVE READ, UNDERSTAND AND AGREE TO THE TERMS AND CONDITIONS SET FORTH IN THIS CONTRACT. YOU ARE ENTITLED TO A COPY OF THIS CONTRACT AT THE TIME OF SIGNATURE. NOTICE REGARDING ARBITRATION AGREEMENT FOR CLAIMS COVERED BY M.G.L. c 142A LOWE'S AND OWNER HEREBY MUTUALLY AGREE IN ADVANCE THAT IN THE EVENT LOWE'S HAS A DISPUTE CONCERNING THIS CON- TRACT, THAT LOWE'S MAY SUBMIT SUCH DISPUTE TO A PRIVATE ARBITRATION SERVICE WHICH HAS BEEN APPROVED BY THE SECRET- ARY OF THE EXECUTIVE OFFICE OF CONSUMER AFFAIRS AND BUSINESS REGULATIONS AND THE OWNER SHALL BE REQUIRED TO SUB- MIT TO 9fir H// ,iB/I/TIR I AS PROVIDED IN M.G.L. c.142A. By: ! . (///(L Date: l( l! Lowe's Ho e Ce ters LL BY: Dater h 3 Owner By: Date: Co-owner or Witness THE SIGNATURES OF THE PARTIES ABOVE APPLY ONLY TO THE AGREEMENT OF THE PARTIES TO ALTERNATIVE DISPUTE RESOLUTION INITIATED BY LOWE'S PURSUANT TO M.G.L. c 142A THE OWNER MAY BE PERMITTED TO INITIATE ALTERNATIVE DISPUTE RESOLUTION EVEN WHERE THE SECTION ABOVE IS NOT SEPERATELY,51GNED BY THE PARTIES. zz WITNESS OUR HAND(S)AND SEAL(S) BELOW THIS DAY OF D; , , fI l. Lowe'zz;z& s Home Centers, Inc. By:By: (Seal) Print Name: �/ y A ess (Seal) Owner Store 1094 Project No. 396632374 for CARLOS NUNEZ Page 4 of 8