13C GRISWOLD DR - BUILDING INSPECTION (3) F . : , C°n _. a' ,Xkl :. ).!` rer' +�-.
Commonwea.alth of Massachusetts
\ t Department of Public Safety
::\lessaclusrtts Stair Building Curia(i811 C NIB)
Building Permit Application for any Building otherthan rOne-orTwtrFamily Dwelling
("(his Section For Official Use Only)
Building Permit Number: Dale Applied: "_ Building Official:
SECr1ON 1: LOCeCIION(Please indicate Block k and Lot`N fur liications for which a street address is not available)
No.and Street City /Town Zip Code Name of Building(if applicable)
SECTION 2:PROPOSED WORK
Edition ut NIA Stale Code used If New Construction check here,O or check all that apply in the two rows below --
Esislinf; Building Cl Rupair \Itaratiun ❑ Addition❑ Demolition (Please fill out,iihd submit:Cj+pi nilix I)
Change tit Use` ❑ Changauf Occupancy ', ❑ Other ❑ Specify:___ _
Are building pl ms and/or construction documents being supplied as part of this permit application? Yes ❑ No ❑-
Is an Independent Structural Engineering Peer Review required? Ycs ❑ No ❑
Brief Description of Proposed Work:,.__
( O( — _—
SECTION 3:COMPLETE Fills SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDI'riON,OR
CHANGE IN USE OR OCCUPANCY °
Check here if Ili Existing Building investigation and Evaluation is enclosed (See 780 CNIR 34) ❑
Existing Use Group(s): _ Proposed Use Group(s):
SECTION 4:BUILDING HEIGHT AND AREA
Existing proposed
No.of Flours/Stories(include basement levels)& Area Per Fluor(sq. ft.)
Total Area(sq. ft.)end Total Height(ft.)
4
SECTION 5:USE GROUP(Check as applicable)
A: Assembly A-1 ❑ A-3❑ Nightclub ❑ A-1 ❑ A4❑ A-i❑ 1 B: Business Cl E: Educational ❑
F: Fads F-I ❑ F2❑ FI: Ili h F I a z m d H-I ❑ H-2❑: 11.3 ❑ (1--4❑ H-i❑
L Institutional 1-1 ❑ 1-2❑ 1-3❑ 14❑ �. %lercantile❑ R: Residential R-10 R-'_❑ R-1❑ 1140
S: Storage S-1 ❑ 5.2❑ Uo Utility❑ Special Use O end please describe below:
Special Use
SECTION 6:CONSTRUCTION TYPE(Check as applicable)
IA ❑ IB ❑ r IIA ❑ IIB ❑ IIIA ❑ IIIB.❑ IV,❑ I VA ❑ VB ❑
SEC"rION 7: SITE INFORMATION(refer to 780 CNIR 111.0 for details on each item)
Water Supply: Flood Zone Information: Sewage Disposal: Trench Permit: Debris Removal:
Public❑ ❑u•rk if outside Road /_unc❑ hulicata municipal❑
:\ trrnCh will nut hu Licensed Dispos,d Situ❑
rrquinvl ❑ur trench. or specify:,!_ -
Private❑ or indentik, Zone oron site system ❑ pt rindis roc laird ❑ h'
Railroad right-of-way: hazards to Air Navigation: •.i , -ri
Not Applitable❑ r Is Stmrture within airpurl appn n-1i area?,� Is the it n:v n++ + ntpich d•.
or l on,rirt to Build cm InsrJ \❑ lcs ❑ or o❑ �� I Yes❑ \o ❑ i
S ECI ION 8:CON"I"ENT OF CER HFICA IT OI'OCCUIlA NCY
Ldilion a l Code, L'ae Grt op(s). _. I\'pool Comm rut son: tht upant Load per hl,",f'
Pot.Ihv luilthng t+mlain en Sprin kltr sy stem' �ptcial sniulttioll's
r
SECIIONYl PROPERTY OWNER AU'HIORIZA"IION
N,unc,uxl AdJ n•ss ul Proprrl}'Uwncr _ —
C,co -e > Gkw 1, t 3 C Grisl,sa ld LY Z— .\t m m 3 6 I 70
Name(Print) ----- No.and Street City/Town Zip
Properly Otuner Contact Information:
plyrrw� b)4- 353- 1361
I isle --- reephone No. (business) Telephone No. (cull) a-mail address
If apphc,lble, the�p_r�operty owner hereby authorizes
—j]I U10.Lu_ Ulohe _13G TurnPI KQ ' — — MA cW/7,R
Name Street Address City/Town State Zip
to act on the property owner's behalf, in all matters relative to work authorized by this building permit a 1 plication.-
SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 2)
if bu ildin•is leas than 33,0W cu.ft.of endowed s+ace and/or not under Construction Control then check here 0 and ski Section 10.1
10.1 Re istered Professional Res onsible for Construction Control
Lo�✓CJ Q �n�erS L(7- 3�° odd iYX0
More(Re•ist ant) k "relepht I e NO. a-mail address Registration Nurn g Z�j/f3
_136 m 1 �6 DOq/{Y fl1/1- 0177,E C
Street Address City/Town 1I .. State Zip Discipline Expiration Date
10.2 General Contractor
Company Name
g a 1 9 3
Mune of Person ResTinstble fur Construction License No. and Type if Applic.ble
5 Wi6ifd 51- ISM /h A (n✓i or 9 P
Street Address City/Town State Zip
G"7f- 534--717 - -
Tcle +hone No. business Telephone No. cell e-mail address
SECTION 11:is,( F.hla, c t wrl who I ION 1..1dI1tANt'I auto"W1I M.G.L.c.152.§ ZSC 6
A Workers'Compensation Insurance Affidavit from the MA Department of Industrial Accidents must be completed and
submitted with this application. Failure to provide this affidavit will result in the denial of he ''suantt of the building permit.
Is a signed Affidavit submitted with this a lication? Yes No ❑
SECTION 12-CONSTRUCTION COSTS AND PERMIT FEE
Item Estimated Costs:(Labor
and Materials) Total Construction Cost(from Item 6)-S_ .
1. Building 1S .5 Building Permit Fee-Total Construction Cost x (Insert here
_. Electrical 5 i appropriate municipal factor) -5
t. Plumbing 5 /
J. Mechanical (HVAC) 5 i Note: klinivo un fee=5 (contact music i�Ale y)
3. MuChaoical Other) 5 / +—
Fndase check payable hl
t,. Tidal Cost 5 37�•�5 (contact numicip,llih•)and write check number here
SECTION 13 SIGNATURE OF BUILDING PERMIT APPLICANT
By entering nn• n.une below, I herebv attest under the pains and penalties of perjury that all of the inhumation Contained in this
application is Inue and accurate t thnu�+rst to m � �%vleklfeanddemanding.
UI St0
Please print and aiR4n low /�, ,,[�J,,,,rf��,�,, ,,l'iitle 1'Iephane No. flue
_ �36_ Tufn�l . . -- -- --c7v `'1fJ��I- -- -- --- -in/_} Q 177a
tilrvet :Wdras Lll\'i rn ro Stale Lip
Municipal Inspector to fill out this section upon application approval:
Warne Dale
The Commonwealth of Massachusetts (]
Department of Industrial Accidents
Office of Investigations
I Congress Street, Suite 100
Boston,MA 02114-2017
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information- Please Print Legibly Name (Business/Or¢1�mtiizzation/Indiv�iiddnlal): Mithae I -}�e t'�/tl I le
Address: J -MIS+I I�Q•
City/State/Zip: D I D Phone #: JIB— 530--717Y
Are's you an employer? Check the appropriate box:„ Type of project(required):
1.❑ 1 am a employer with 4. ❑ I am a general contractor and I
employees(full and/or part-time).` have hired the sub-contractors 6. ❑New construction
2. 1 am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling
ship and have no employees These sub-contractors have g, ❑Demolition _
working for me in any capacity. employees and have workers'
insurance? 9. ❑Building addition
comp. -
[No workers' comp. insurance P�
required.] 5. ❑ We are a corporation and its 10.❑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.] t C. 152, §1(4),and we have no
employees. [No workers' 13.0 Other
comp. insurance required.]
'Any applicant that checks lox#1 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 affidavit indicating such.
'Contractors that check this box must attached an additional sheet showing the name of the subcontractors and state whether or not those entities have
employees. If the sub-contractors have employees.they must provide their workers'comp.policy number.
I anf an employer that is providing workers'compensation insurance for my employees- Below is the policy and job site
information.
Insurance Company Name:
Policy#or Self-ins.Lie.#: Expiration Date:
Job Site Address: G (-,PrlStts6 Dr. City/State/Lip: &Aer 1 r MA Ol re7d
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required tinder 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 he forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby certi ruder the sins enalties o e "u that the in ormation provided above is true and correct.
ignahtre: Date
Phone#: _ 4?
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#:
Y
Office of Consumer Affairs&Business Regulation
w
OME IMPROVEMENT CONTRACTOR
Registretiona ¢88 Type
Expire Supplement
. . LOWE'S HOME°
RICHARD CHAL �� '
136 TURNPIKE RS3>�EY
SOUTH BOROUGH,� Undersecretary -
3 1 t [
d
1
A
411 1
82193
mcHAEL OEM1LLE
S.SkfSTO ST '
M, MA 019701002013
a 6892 ,
-% ✓f' I/1 yI;f-ll-tUCCC/XX L f l'L✓JJt4f.'1(// (' 1
Offi c of onsumer Affairs and Business Regulation
10 Park Plaza - Suite 51.70
Boston, Massacuseits 02;. 16
'dale linpro-vement Contractor Registration
- Registration: 162-22
Tvre: Individuai
xpration: 4/612015 Trk 238965
'.E -140MAS DEMILLE
=- �-3-"QTOL ,-.
E, MA Cog TC1
`!ipdate Addrass and return c rd.Mari.reason for change.
"1 Address - Renewal F, Employment -" Lost Surd
' < �,Gl3iupf i f Irs"I I n pe.ti 3cgnla.I"sup License or registration;aid far indioidul use only
N C'r IF-FDVEMENT CCIH—RACTCR before the expiration date. If found return to:
L,eg; --F-tic r: 162722 Type: Office of E:oasumei Affairs and Business Regulation
1i6120,5 Ind ridual 10 Park Plaza-Suite 5fi70
- Bostan,NIA 02 i 16
_. ✓� .J...L>.
n
:zde:srrcet r.� Nr ;valir,'welnaut signature
gyp.
PRRENTE INgURRNCE Fax:9785315587 Jan 14 2013 16:38 F.01
iy
C TIFICATE OF LIABILITY INSURANCE ;14/20 114:�013
THIS CERTIFICATE IS ISSPED AlOF INFORMATION ONLYAND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
CERTIFICATE DOES NOTp1FFIR ELY OR NEGATIVELY AMEND.EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW,THIS C`ERTIFICA)'E OF URANCE DOES NOT CONSTITUTE CONTRACT BETWEEN THE ISSUING 1NSURER(S),AUTHORIZED
REPRESENTATIVE R PRODUC • AND THE CER71MCA-M HOLDER.
IMPORTANT.it the certlfl;ato hio • Is an ADDITIONAL INSURED,the Polley(Ie3)must be endorsed.It SUBROGATION IS WAIVED,subject to the
terms an e conditions of -e poll rtain policies may require an endorsement.A statement on this certificate does pot confer rights to the
or in lieu o such ` rsemord s.
EAICo ells ICI coNrAcr Brenda Cozzolino .
M7 709-8338 F (800)370.2924
ey
450 Veterans Memorial Parkwory s brmdac@,wkellV.com
Building 5 ° PReODCER
16SS01
f. East Proeitlence - A,l 024.
'INsuR® •e a 1'I MURMA: AlanBe CasuaB Ins Co 42546AI
MO Construction I T-' --(
NsuREae: _
5 Bristol Rd
9' INsuRERo:
Salern I t: ._._'
MA 01970 INSURHt E: 1 ..
i euURERF: '
-COVERAGES Gt TIFICATE NUMBER: NUMBER:
THIS 16 TO CERTIFY T14ATTH IOLICI OF INSURANCE LISTED BEL(MNWE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
NOICATEO.NOTWITMSTANOI,gyJG ANY lUIRSMIENT,TERM OR CONDITION OFANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO~CH THIS
CERTIFICATE MAY BE 1SSUED?OR MA f RTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
FXGLUSIONS 1 LIMITS SHOWN Y HAVE BEEN REDUCED BY DCLAIMS
IAI
NNE TYPE OF INSURANCE i :j AD MUCY WF
l PW1Cf NIlMOER LIMITS
CEN L UA6ILITY I.I
EACH OCCURRENCE $ 300,000
A C04M6.'CIAL GENERALLM'BM1ITY LI! evawlRrrea) s 50,000
CLArNSMADE MME (ArryemP w) s 5,000
A ) i
Y L118000742 08729/2012 OW912013 FstsoNALaaov iNJIRY i 300,000
ENLAOGREGATE UMriAPFU $PER. GENFRN„AC-GREFATE $
"A FROCTICTS-COMPIGFhri6 i Svc _'^
X POLICY t LOC ! R;
AUiOlA�01ELIA'aILYr1' COMBINED 5NOLE LIWr
XN AUTU i ��.Y. (Ea Wr are) f
ALL OriNmPirT03 ��p BODILYNJJRY(Parpa ) t
SCficDUL�gl1YCf• ; i}ti� 0001YNJURY(F rms"V; T
HIREDADTOG (.„' (PBfQeP FZtYYCIAMAGE t
I
N0M1-0NNEDAVr0S 6
it s
UMBREU.A LAO &,OUR EAI71 OCCURRETIrE f
.'
EJICESS UABpLMMS4AGGREGAIE 8
L�DUCiNt-E I
f f
RET NT )N S
YA7rtIQ415 fAJAS ATIDNAND
EMPLOYERS'LIAea.nY fN T -
M�FyP�ROt/PIyR�ErATBOEFRRIXTN EC d TN!I` N NIA E.L.EAOIACCIOEsIT $
(MarNRonY In UHF +1�[f adly tlor 1 EL U&SkSE FA ETNLOYff 5
E.L.DIFFiISE-POLICY LIMT.. $
DESCmtpTfONOFOPERATKMILo6xno1s CLES Witxn ACWrD iOl,AeeMwW Ramvrlla 9ehedrk,a mme epwaofrWUln�
loMA2's{omt>dniesdnc.dtd any and al idiaries are named as additional insured,
as respecttd the liability Polity)
CERTIFICATE MOLDER j. CANCELLATION
is
1; Lme's Compar)les Inc 4 WOULD ANY OF THE ABOVE DESCRIDm POLICIES BE CANCELLED BEFORE
THE EVRAT10N DATE THEREOF,NOTICE WILL BE DELIVERED IN '
Attn:Is Insurance s - ACCORDANCE PORN THE POLICY PROVItMONU.
PO BOX 11i1 '(g� AUn10PoZEe REPPoa3f?frAITVE '
r. - North ViO)kesbDro :} NC 28656
Katherine M. Kelley, AAI, CIC
if 0ISMZ009ACORD CORPORATION.All rights reserved
ACORO 25(2099/09) .): The ACORD name and loge are msistered mart of ACORD
STORE COPY
INSTALLATION SERVICES CUSTOMER CONTRACT- MWORK - INT/EXT/PATIO DOOR
i LOWE'S OF DANVERS, MAC, STORE # 1094 STORE PHONE: (978)646-909%
" 153 ANDOVER STREET SALESPERSON: DENNIS GLENNON
� La
DANVERS, MA 01923 SALESPERSON ID: 1227928
Document Print Date : 08/01/2013
This is only a Qucre 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, Inc.'s MA HIC NO.: 148688 Lowe's Home Centers, Inc.'s FEIN: 56-0748358
Customer Name Home Phone
S GEORGE CHAN 516-353-1851
® Customer Address Other Phone
13 C GRIISWOLD DR
L City State/Province Zip/Postal Code
D SALEM MA 01970
Installation Address
13 C GRISWOLD DR
Installation City Installation State/Province Installation Zip/Postal Code
® SALEM MA 01970
MERCHANDISE AND INSTALLATION SUMMARY
MERCHANDISE SUMMARY
231054 : 70 3/4"X 79 1/2" : SOS : SOS VYL THERMASTAR PATIO DR : 70 3/4" X 79 1/2"/XO/ACCESSORIES/PARTS/OTHER : PELLA VINYL PATIO
DOORS EAST -QTY 1
326404 : 7481 7 1 61 3369 : STK : 6' TS TAR DR CLR XO(LH) BBG NO SCR : 6 TSTAR DR CLR XO(LH) BBG NO SCR : PELLA VINYL PATIO DOORS EAST-
QTY 1
Materials Price $ 833.85
,r �inrc. 1094 P1oJ�x�t hl�;. i'17z: 1 fn ;EOM d:' Ci9 dV Page i of 7 'i
STORE.COPY
Stock or!SOS : Stock Door Type : Patio
Select Location : Back Dour Select New Door : Sliding
Number of Doors to Install : 1 Side Lights or Transoms : No
Hidden Damage Description : None Number of additional holes bored for accessories : None
Install Specialized Mortise Hardware : No 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-out jamb
Other Work Charge : Yes Comments : No Comment
Labor Charges $ 574.00
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 governedby Historic District Regulations.
Additional Speeitications: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 thepotential risk of the lead hazard exposure from renovation activity to be performed in Customer's dwelling unit.
TOTAL CHARGES OF ALL MERCHANDISE AND SERVICES where applicable
SUB-TOTAL $ 1372.8E
*TAX $ 0.0c
DELIVERY $ 0.0c
ORDER TOTAL $ 1372.8E
BALANCE DUE
VNork is to coinrm ne e npni i io eson able avail ahlity of Contractor which is anticip deal to be_ , _ [fill in date].
5
:fore iO4 Projec:i h:io. loll?i5?1 i for GI='OAGE GI-1APd Page 2 of 7
STORE COPY
Estimated completion date is [fill in date].
NO7110E TO CUSTOMER
All items listed inthis 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 merit pay in full.
COMPLETE THUS 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 pfice; 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):
[_] Charge my/our credit card for the amount of the payment indicated above upon or after the commencement of work; or
L] 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 EKF_CUTIVE OFFICE OF CONSUMER AFFAIRS AND BUSINESS REGULATIONS AND THE OWNER SHALT_ BE REQUIRED TO SUB-
MIT TO SUCH ARBITRATION AS PROVIDED IN M.G.L. c.142A.
1,7�--`_'-
s
f \ !lr_'73"" for li!I'::Lt!'i=p'_ CHr" 1:.•-7.C;<, i of 7
3tcre 1094 i rojec; No. 318
!
STORE COP)
By Date: 4�1�' ----
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 iOWE'S PURSUANT TO M.G.L. c.142A. THE OWNER MAY BE PERMITTED TO INITIATE ALTERNATIVE_ DISPUTE RESOLUTION
EVEN WHERE 7HE SECTION ABOVE IS NOT SEPERATELY SIGNED BY THE PARTIES.
WITNESS OUR HAND(S) AND SEAL(S) BELOW THIS DAY OF
Lowe's Home C enters, Inc.
By: (Seal)
Print Name:
�.
Address n (Seal;
l
City1 Vstate/Province Zip/Postal Code Print Name
Co-Owner or Witness (Seal'
Print Name
Customer acknowledges receipt of a true copy which was completely filled in prior to Customer's execution hereof. You the customer may cancel this transaction
at any time prior t a rnidnight on the third business day after the date of this transaction. See the attached Notice of Right to Cancel for an explanation of
this right.
lore '•')` 4 'rolect k3 ). M7727311 for GECRGE (tilt Ni page 4 of 7