HomeMy WebLinkAboutPlans - 5 GREEN HILL AVENUE 3/7/2016Permit No#: /C
Date Issued: 311
BUILDING PERMIT
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Date Received
IMPORTANT: Applicant must complete all items on this page
TYPE OF IMPROVEMENT
PROPOSED'USE
`'
Residential
Non- Residential
❑ New Building
❑ Addition
❑ Alteration
KOne family
❑ Two or more family
No. of units:
❑ Industrial
❑ Commercial
Repair, replacement
❑ Demolition
❑ Assessory Bldg
❑ Others:
❑ Other
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DESCRIPTION OF WORK TO BE PERFORMED:
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Identification - Please Type or Print Clearly
OWNER: Name: t't)S
Address: S.— ' -am Wet,/ .
ARCHITECT/ENGINEER
Phone:
Phone:
Address: Reg. No.
FEE SCHEDULE: BULDING PEI IIT: $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F.
Total Project Cost: $ /, — FEE: $
Receipt No.: bbCi
Check No.:
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty ffund
Signature of. Agent/Owner: Signature of;eoritractor
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THIS CERTIFIES THAT
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Project Name: Ellis,Scott,1679110
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Amount Due $0.01
'Deposit Received $1,910.28
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Non-taxable Subtotal $1,098.67
Sales Tax @ 6.25% $47.74
'Taxable Subtotal $763.88
Order Totals
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PELLA WINDOWS AND DOORS CONTRACT
1. TERMS AND CONDITIONS
These Terms and Conditions are an integral part of the contract set forth on the
Product Order (the "Contract") between New England Window and Door LLC
dba Pella Windows & Doors, Inc. ("Pella") and the person(s) identified on the
Product Order ("Owner") to supply the products (the "Products"), and perform
the work (the "Work") described or referred to in such Contract. For Product
Only purchases, a signed "Product Only Addendum" is a required part of the
contract.
2. OWNER
Pella is not responsible for any existing security systems. Owner shall remove
all shades; verticals, blinds, curtains, drapes or window mounted air
conditioners, prior to the installation of the Products. Pella's installers are not
responsible for the removal or installation of these types of items. Pella is not
responsible for pre-existing window coverings fitting on newly installed Pella
windows.
The Owner shall provide complete access to the work site between the hours
of 7:00 a.m. and 6:00 p.m. (Monday through Friday) for Pella's installers to
deliver the Products and perform the Work.
3. PELLA
Pella will be responsible for and have control over construction means,
methods, techniques, sequences and procedures and for coordinating all
portions of the Work. Pella will be responsible for the.Work of its Pella
Contractors who will install the Products.
Unless provided otherwise in the Work description, Pella will provide and pay
for all labor, materials, equipment, tools and machinery, transportation, and
other facilities and services necessary for the proper execution and completion
of the Work.
The materials and equipment furnished under the Contract will be good quality
and new unless otherwise required or permitted, the Work will be free from
defects not inherent in the quality required or permitted, and the Work
conform with the requirements of this Contract. Pella shall not be responsible
for damages or defects caused by abuse. modifications not executed by Pella,
improper or insufficient maintenance, improper operation or normal wear and
tear. Pella will keep the premises and surrounding area free from
accumulation of waste materials or rubbish caused by performance of the
Work.
4. CHANGES
The Owner may order in writing changes in the Work consisting of additions,
deletions, or modifications ("Change Order"). Any Change Order shall
include an adjustment to the Price and the Substantial Completion Date, as
determined by Pella. Pella reserves the right to approve or disapprove any
Change Order and any such Change Order must be signed by both Owner and
Pella to be effective.
5. SUBSTANTIAL COMPLETION
Owner understands and agrees that the Substantial Completion Date is an
estimate only and that the actual date on which the Work is completed may be
extended to allow for Change Orders requested by Owner or if the time to
complete the Work is affected by conduct of the Owner, weather, labor
disputes, availability of subcontractors, acts of God, fire or other causes
reasonably beyond Pella's control. If for any reason the Work is not fully
completed by the Substantial Completion Date (including any extensions
contemplated above), but is substantially completed by such date, i.e., the
Product has been installed, but minor parts or components are missing or need
to be replaced or repaired, a hold back proportionate to the cost of remaining
parts or work to be completed is acceptable. However, the holdback will not
exceed the amount of the completion costs or 10 % of the remaining unpaid
balance of the Price, whichever is less.
6. FINANCING
If payment of the Price is financed with a financial institution through Pella, all
financing paperwork must be completed upon signing of this Contract and the
requisite approvals and authorizations for the full amount of the requested
financing shall have been received from the financial institution.
7. PAYMENTS
Pella shall be entitled to stop the Work upon written notice to Owner for any
material default or failure by Owner, including but not limited to, the Owner's
failure to pay Pella the amount due within seven days after the date payment is
due.
8. CORRECTION OF WORK
Pella shall correct installation Work not in conformance with the requirements
of the Contract, if notified in writing by the Owner within two years after the
Completion Date or, if earlier, the date on which the Work is substantially
completed and payment of the Purchase Price made subject to a holdback as
provided above. Correction of Work as herein provided shall be Owner's sole
remedy for defective workmanship, and is provided in lieu of any and all other
remedies. Pella's obligation to correct Work is conditioned on Pella's prior
receipt of all payments then due.
9. LIMITED PRODUCT WARRANTY
Pella shall warrant all Pella products, but only in accordance with the Pella
Windows & Doors Limited Warranty. THIS LIMITED WARRANTY SHALL
BE THE SOLE WARRANTY WITH RESPECT TO THE PRODUCTS AND
PELLA SPECIFICALLY DISCLAIMS ALL OTHER WARRANTIES,
EXPRESS OR IMPLIED, WRITTEN OR ORAL (INCLUDING WITHOUT
LIMITATION ANY WARRANTY OF MERCHANTABILITY OR FITNESS
FOR A PARTICULAR PURPOSE).
10. NO CONSEQUENTIAL DAMAGES
UNDER NO CIRCUMSTANCES SHALL PELLA BE LIABLE FOR
CONSEQUENTIAL, INCIDENTAL, INDIRECT, OR SPECIAL DAMAGES,
WHETHER FORESEEN OR UNFORESEEN.
11. HOME IMPROVEMENT CONTRACTORS
All home improvement contractors and subcontractors shall be registered with
the director of the Home Improvement Contractor Registration Program
administered by the Board of Building Regulations and Standards. Pella and
any of its subcontractors identified in this agreement have been registered.
Any inquires about Pella or any of its subcontractors relating to registration
should be directed to: Director, Home Improvement Contractor Registration,
10 Park Plaza, Room 5170, Boston, MA, 02116, 617-973-8787, 888-283-3757
or visit the H1C website at Jii!n cv, c.m:1,N 1101 •acuhar
12. PERMITS (MA customers only)
Pella is obligated to and will obtain the following permits for this project:
Building . Homeowners who secure their own permits will be
excluded from the guaranty fund provisions of Massachusetts General Laws,
chapter 142A.
In addition to the rights and warranties enumerated in this agreement, you may
have additional rights under Massachusetts General Laws, chapter I42A and
780 Code of Massachusetts Regulations R6.
13. NOTICE OF CANCELLATION
You may cancel this agreement if it has been signed by a party
thereto at a place other than an address of the seller, which
may be his main office or branch thereof, provided you notify
the seller 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 the attached Notice of Cancellation for an explanation of
this right.
Do not sign this contract if there are any blank spaces.
(�ti�n
Customer signature 2/26/16
Date
DISPUTES
THE CONTRACTOR AND THE HOMEOWNER HEREBY MUTUALLY AGREE IN
ADVANCE THAT IN THE EVENT PELLA HAS A DISPUTE CONCERNING THIS
CONTRACT, PELLA MAY SUBMIT SUCH DISPUTE TO A PRIVATE
ARBITRATION SERVICE WHICH HAS BEEN APPROVED BY THE SECRETARY
OF THE EXECUTIVE OFFICE OF CONSUMER AFFAIRS AND BUSINESS
REGULATIONS AND THE CONSUMER SHALL BE REQUIRED TO SUBMIT TO
SUCH ARBITRATION AS PROVIDED IN M.G.L.c. 142A
Pella Windows & Doors
Contractor
.7(-"Ar qZ-1;
omeowner
NOTICE: THE SIGNATURE OF THE PARTIES ABOVE APPLY ONLY TO THE
AGREEMENT OF THE PARTIES TO ALTERNATIVE DISPUTE SETTLEMENT
INITIATED BY THE CONTRACTOR. THE OWNER MAY INITIATE
ALTERNATIVE DISPUTE RESOLUTION EVEN WHERE THIS SECTION IS NOT
SEPARATELY SIGNED BY THE PARTIES.
Are you an employer? Check the appropriate box:
,cE
The Commonwealth ofthssa►a?dt►G.s'ea'rs
Department of 'Mask' Accidents
Office ofIna'estggations
1 Congress Street, Suite 100
Boston, MA O2114 2Ol7
wmat, aaaaass.govfdie
Workers' Compensation Insurance Affidavit: B ders/Contraetora9eetriduans/Pivaatabea°s
A►��&antt lfotl•oaaltaatu Please Pra�>t Let�biv
Name(Business/Organization/Individual): - , r jar ; a b LL:
Address: S = i >
City/State/Zip: 14-44041 t I 041- g'? Phone #: 9 7 Z -77 A, '
am. a employer with zs 4. 0 lam a general contractor and I
have hired the sub -contractors
listed on the attached sheet.
These sub -contractors have
employees and have workers'
comp. insurance.+
5. ® We are a corporation and its
officers have exercised their
tight of exemption per MGL
c. 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 worker compensation policy information.
r
Type of project (required):6. ® New construction
7. ' enrodeling
S. ® Demolition
9. 0 Building addition
10.0 Electrical repairs or additions
11.0 Plumbing repairs or additions
12.® Roof repairs
13.l Other
1
17.
employees (flail and/or part-time).*
2.0 I am a sole proprietor or partner-
ship and have no employees
working forme in any capacity.
[No workers' comp. insurance
required.]
® I ani a homeowner doing all work
myself. [No workers' comp.
insurance required.] 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 oat those entities have
employees. tf the sub -contactors have employees, they must provide their workers' camp. 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: d4 ! ti [ r , 'e 17 - S e Q
Policy # or Self -ins. Lic. ##: 1-1060 (40 I a
fob Site Address: City/Stale/Zip:
Attach a copy of the workers' compensation policy declaration page (showing the policy number and erpiratuoua date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition ofcriminal penalties of a
tine 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 ofthe-DIA for insurance coverage verification.
Expiration Date:
I do hereby certify under the pains and penalties of perkily that the information[ provided above is true and correct.
Signature: Date
Phone #:
Official use only. Do not write ha this area, to be completed by city or town official
City ow Town: Permit/License it
C:C
Atem.=--- ME CERTIFICATE OF UA ; Y INISLP ' NCE
YYy
06/2912E(MMIDDN)
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BET1NUEEN THE ISSUING INSURER(S),
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
HOLDER.
BY THE
AUTHORIZED
THIS
POLICIES
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must 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
Fred C. Church, Inc.
41 Wellman Sheet
Lowell, MA 01851
(800)225.1005
CONTACT Dorothy A. Corlett, CIC, RPLU
NAME:
PHONE (910) 454-1865
INC. No. Eat); 970 3227231 (NC, Na);
E-MAIL dcodellgredcchurch.com
ADDRESS:
INSURER(S) AFFORDING COVERAGE
NAIL ff
INSURER A: Cilizens(nsuranceCompany ofAmerica
31534
INSURED
New England Window & Door LLC
45 Fondi Road
Haverhill, MA 01832-1302
nrn m.•...-.,-., _---'------- C..,"
INSURERS: New Hampshlre Employers Insurance Company
13083
INSURER C
INSURER D :
INSURER E :
INSURER F :
IMGVI, lVrtl rtlUIVlDCR.
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
LTR
TYPE OF INSURANCE
ADDL
JNSR
SUBR
WW1
POLICY NUMBER
EFF
(MMJODI
IWLDDIY EXP
(MY
LIMITS
GENERAL
X•
LIABILITY
EACH OCCURRENCE
$ 1,000,000
COMMERCIAL GENERAL LIABILITY
DAMAGE TO RENTED
S 100,000
PREMISES (Ea occurrences
CLAIMS -MADE I X I OCCUR
$ 10,000
X
CG0001
MED EXP (Any one parson)
A
ZBN8161407
7/1/2015
711/2016
PERSONAL
1,W0.000
$
& ADV INJURY
GENERAL
S 2.000,000
AGGREGATE
GEN'L AGGREGATE
-1
X
LIMIT APPLIES PER:
PRODUCTS -COMP/OP AGO
$ 2,000,000
POLICY
Pta 1 1 LOC
S
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
(Ea accident)
$
A
ANY AUTO
ALL OWNED
—
SCHEDULED
BODILY INJURY (Per person)
$
A
AUTOS
_AUTOS
BODILY INJURY (Per accident)
$
H
HIRED AUTOS
gpgED
PROPERTY DAMAGE
(Per accident)
$
S
UMBRELLA LIAR
OCCUR
EACH OCCURRENCE
S
EXCESS LIAR
CLAIMS -MADE
AGGREGATE
S
DED
RETENTION $
$
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y/ N
I(
WC STATU-
TORY LIMITS
OTH-
ER
B
ANY PROPRIETORIPARTNERIEXECUTIVE
OFFICER/MEMBER EXCLUDED?
N I A
400040101
7/1/2015
7/1/2016
EL EACH ACCIDENT
500,000
$
(Mandatary In NH)
If yes, describe under
E.L. DISEASE - EA EMPLOYEE
$ 500,000
DESCRIPTION OF OPERATIONS below
EL DISEASE - POLICY LIMIT
500,000
$
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if morn space i required)
nEenv,Purn Q� a,`., n,aA
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
Clianl fl L95�
AUTHORIZED REPRESENTATIVE
Msift rm.; wrrr 3548
(rl d4100 nn.c,n it .r-c nna., -a-a,..na n ea• ._.
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William Nichols
45 FONDI ROAD
s.
ar
k
HAVERHI.LL, MA• 01832