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Home My WebLink AboutBuilding Permit # 9/7/2016 BUILDING PERMIT No�T� OF A.ti .6 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit No#: � Date Received 7 �AArev 4SSRCNU`�� Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION 4,Ul,-4-�E C Print PROPERTY OWNER Print 100 Year Structure yes no MAP J e, PARCEL: 6)!26 ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ; One family ❑Addition ❑ wo or more family ❑ Industrial ❑ Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other �V Watelti DtSrf �� ,' ,e' �r �Wei c � �� .v;��p<Iv[oodplaln,� ��❑�Ietlands�urn ��n�� b.� �w� L r ^s," ','r,., ",^ :e.`',, r h "'�,✓r'sem.; , ; „, �.M; fi,y fE� �-e. ,..s,, �"�,a " z'�';" ,. n �Rr.�� :�1lU`ater.�Sew,er"�f �`+r�'..r✓' �� '�r. ' �,..X�/,.�-�''3' ��`,"/�,,,:."ria.t'��z�F'co-:,��o.�. ••'�-',.. �.�.,:.'.�e:.;ra �._._,.r:Ay'., � r ,.0*;., �`,.�"':? DESCRIPTION OF YVORK TO BE PERFORMED: C , Identification- Please Type or Print Clearly OWNER: Name: -5 A- C S Phone: " Address.- Contractor Name q hone: 2 g Email. Addiess: Z I Supervisor's Construction License: 3 Exp.. Date: l. p Ex Home Improvement License: p- Date: ARCH ITECTIENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BUILDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ ' FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund f oORTft q Town of S .ar: 6 ndover O = - ;' M T h 6 ver, MaSS, ZD � COCNIC Ml w1CM V s � BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System THIS CERTIFIES THAT ............... r-,•r.� ........�,/ ..O�t.... ................................... BUILDING INSPECTOR has permission to erect.......................... buildings on 553*Ac,...?`. ..W........... Foundation 4 .� Y4T�R.a ......up Rough to be occupied as .... ........�.. T� ................................. Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application Final on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection,Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONST TION S Rough Service .......... .... ...... ........ ...... Final BUILDING I PE TOR GAS INSPECTOR Oceupancy Permit Required to Occupy By Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector, Burner Street No. Smoke Det. Contract - Detailed Pella Window and Door Showroom of Haverhill Sales Rep Name: Duff, Stephen 45 Fondi Rd / Sales Rep Phone: 978-373-2500 Haverhill, MA 01832 1 �� Sales Rep Fax: Phone: (978) 373-2500 Fax: (978) 373-7274 Sales Rep E-Mail: DuffS@pellaboston.com Customer Information Project/Deliv6v Address Order Information Lisa Banacos Banacos,Lisa,North Andover,MA 1777488 Quote Name: WINDOWS PROJECT 53 White Birch Lane 53 White Birch Ln Order Number: 741 SDO461 NORTH ANDOVER,MA 01845 Lot# Quote Number: 8192298 Primary Phone:(978)3146280 North Andover,MA 01845-1112 Order Type: Installed Sales Mobile Phone: County: Payment Terms: Deposit/C.O.D. Fax Number: Tax Code: MA TAX 6.25 E-Mail: swind3322@comcast.net Quoted Date: 8/2312016 Great Plains#: 4651057 Customer Number: 1004578269 Customer Account: 1001099167 Line t .:;Location:. Attributes 10 None Assigned Delivery/Setup-Delivery/Setup Qty 1 For more information regarding the finishing, maintenance, service and warranty of all Pella®products,visit the Pella®website at www.pella.com Printed on 812412016 Contract-Detailed Page 1 of 8 Customer: Lisa Banacos Project Name: Ban acos,Lisa,North Andover,MA 1777488 Order Number: 741SD0461 Quote Number: 8192298 Line# Location: _ Attributes .; 15 MASTER Impervia, Double Hung,31,5 X 49.5,White Qty 2 1:Non-Standard SizeNon-Standard Size Double Hung,Equal PK# Frame Size: 31 112 X 49 112 General Information: -Standard,Duracast�3,Block,Foam Insulated,3",3" 816 Exterior Color/Finish: White j Interior Color!Finish: White It Glass: Insulated Low-E Advanced Low-E Insulating Glass Argon Non High Altitude 3 LZ Hardware Options: Cam-Action Lock,White Viewed From Exterior Screen: Full Screen,Conventional Fiberglass Performance Information: U-Factor 0.29,SHGC 0.25,VLT 0.47,CPD PEL-N-126-00556-00001,Performance Class LC,PG 30,Calculated Positive DP Rating 30,Calculated Negative DP Rating 30,Year Rated 08 Grille: GBG,No Custom Grille,3/4"Contour,Traditional(3W2H 13W2H),White,White Wrapping Information: Replacement Precision Fit Kit,No Exterior Trim,No Interior Trim,Pella Recommended Clearance,Perimeter Length=162". Frame Size:31.5"X 49.5" Material—Integrated-Upgrade Pocket Integrated Qty 1 Pocket Installation-Pocket Installation Qty 1 Line#: Location.:. Attributes 17 SPARE Impervia, Double Hung,31.5 X 49.5,White Qt' 2 1:Non-Standard SizeNon-Standard Size Double Hung,Equal =a PK# Frame Size: 31 112 X 49 112 816 General Information: Standard,buracast®,Block,Foam Insulated,3",3" Exterior Color 1 Finish: White Interior Color/Finish: White Glass: Insulated Low-E Advanced Low-E Insulating Glass Argon Non High Altitude �t= Hardware Options: Cam-Action Lock,White Viewed From Exterior Screen: Full Screen,Conventional Fiberglass Performance Information: U-Factor 0.29,SHGC 0.25,VLT 0.47,GPD PEL-N-126-00556-00001,Performance Class LC,PG 30,Calculated Positive DP Rating 30,Calculated.Negative DP Rating 30,Year Rated 08 Grille: GBG,No Custom Grille,314"Contour,Traditional(3W2H!3W2H),White,White Wrapping Information: Replacement Precision Fit Kit,No Exterior Trim,No Interior Trim,Pella Recommended Clearance,Perimeter Length=162". Frame Size:31.5"X 49.5° Material—Integrated-Upgrade Pocket Integrated Qty 1 Pocket Installation-Pocket Installation Qty 1 For more information regarding the finishing, maintenance, service and warranty of all Pella®products, visit the PellaQD website at www.pelia.com Printed on 8124/2016 Contract-Detailed Page 2 of 8 Customer: Lisa Banacos Project Name: Banacos,Lisa,North Andover,MA 1777488 Order Number: 741SDO461 Quote Number: 8192298 Line# :: .: Location: Attributes 20 DINING Impervia, Double Hung, 31.5 X 53.5,White Qty 2 1:Nonstandard SizeNonStandard Size Double Hung,Equal PK# Frame Size: 31 112 X 53 112 816 General Information: Standard,DUracastO,Block,Foam Insulated,3",3" h Exterior Color/Finish: White Interior Color I Finish: White Glass: Insulated Low-E Advanced Low-E Insulating Glass Argon Non High Altitude �i Hardware Options:'Cam-Action Lock,White Viewed From Exterior Screen: Full Screen,Conventional Fiberglass Performance Information: U-Factor 0.29,SHGC 0.25,VLT 0.47,CPD PEL-N-126-00556-00001,Performance Class LC,PG 30,Calculated Positive DP Rating 30,Calculated Negative DP Rating 30,Year Rated 08 Grille: GBG, No Custom Grille,314"Contour,Traditional(3W2H!3W2H),White,White Wrapping information: Replacement Precision Fit Kit,No Exterior Trim,No Interior Trim,Pella Recommended Clearance,Perimeter Length=170". Frame Size:31.5"X 53.5" Material—integrated-Upgrade Pocket Integrated Qty 1 Pocket Installation-Pocket Installation Qty 1 Line#. Location: Attributes 23 MUSIC Impervia, Double Hung,31.5 X 53.5,White Qty 3 I' 1: Non-Standard SizeNonStandard Size Double Hung,Equal PK# Frame Size: 31 112 X 53 112 L!' 816 General Information: Standard, Duracast®,Block,Foam Insulated,3",3" Exterior Color/Finish: White Interior Calor I Finish: White Glass: Insulated Low-E Advanced Law-E Insulating Glass Argon Non High Altitude Hardware Options: Cam-Action Lock,White Viewed From Exterior Screen: Full Screen,Conventional Fiberglass Performance Information: U-Factor 0.29,SHGC 0.25,VLT 0.47,CPD PEL-N-126-00556-00001,Performance Class LC,PG 30,Calculated Positive DP Rating 30,Calculated Negative DP Rating 30,Year Rated 08 Grille: GBG,No Custom Grille,314"Contour,Traditional(3W2H 13W2H),White,White Wrapping Information: Replacement Precision Fit Kit,No Exterior Trim,No Interior Trim,Pella Recommended Clearance,Perimeter Length=170". Frame Size:31.5"X 53.5" Material—Integrated-Upgrade Pocket Integrated Qty 1 Pocket Installation-Pocket Installation Qty 1 For more information regarding the finishing, maintenance,service and warranty of all Pella®products,visit the Pella®website at www.pella.com Printed on 8124/2016 Contract-Detailed Page 3 of 8 Customer: Lisa Banacos Project Name: Banacos,Lisa,North Andover,MA 1777488 Order Number, 741 SDO461 Quote Number: 8192298 Line#:- ; Location: Attributes 24 FAMILY ROOM SIDE Impervia, Double Hung, 31.5 X 53.5,White Qt' 1 1:Nonstandard SlzeNon-Standard Size Double Hung,Equal PK# Frame Size: 31 112 X 53 112 816 General Information: Standard,Duracast@,Block,Foam Insulated,3",3" Exterior Color!Finish: White Interior Color/Finish: White Glass: Insulated Low-E Advanced Low E Insulating Glass Argon Non High Altitude •• 31A Hardware Options: Cam-Action Lock,White Viewed From Exterior Screen: Full Screen,Conventional Fiberglass Performance Information: U-Factor 0.29,SHGC 0.25,VLT 0.47,CPQ PEL-N-1 26-00556-0000 1,Performance Class LC,PG 30,Calculated Positive DP Rating 30,Calculated Negative DP Rating 30,Year Rated 08 Grille: GBG,No Custom Grille,314"Contour,Traditional(3W2H/3W2H),White,White Wrapping Information: Replacement Precision Fit Kit,No Exterior Trim,No Interior Trim,Pella Recommended Clearance,Perimeter Length=170". Frame Size:31.5'X 53.5' Material—integrated-Upgrade Pocket Integrated Qty 1 Pocket Installation-Pocket Installation Qty 1 Line#.; Location... Attributes 25 FAMILY ROOM BACK Impervia, Double Bung, 31.5 X 61.5,White Qty 2 1:Nonstandard SizeNon-Standard Size Double Hung,Equal PK# Frame Size: 31 112 X 61 1/2 General Information: Standard, Duracastfl,Block,Foam Insulated,3",3" EF 816 Exterior Calor!Finish: White j Interior Color/Finish: White 1 Glass: Insulated Low-E Advanced Low-E Insulating Glass Argon Non High Altitude zi • Hardware Options: Cam-Action Lock,White Viewed From Exterior Screen: Full Screen,Conventional Fiberglass Performance Information: U-Factor 0.29,SHGC 0.25,VLT 0.47,CPD PEL-N-126-00556-00001,Performance Class LC,PG 30,Calculated Positive DP Rating 30,Calculated Negative DP Rating 30,Year Rated 08 Grille: GBG,No Custom Grille,314"Contour,Traditional(3W2H 13W2H),White,White Wrapping Information: Replacement Precision Fit Kit,No Exterior Trim,No Interior Trim,Pella Recommended Clearance,Perimeter Length=186". Frame Size:31.5°X 61.5' Material integrated-Upgrade Pocket Integrated Qty 1 Pocket Installation-Pocket Installation Qty 1 For more information regarding the finishing, maintenance, service and warranty of all Pella®products, visit the Pella@ website at www.pelia.com Printed on 812412016 Contract-Detailed Page 4 of 8 Customer: Lisa Banacos Project Name: Ban acos,Lisa,North Andover,MA 1777488 Order Number: 741SDO461 Quote Number: 8192298 Line#-i: 'Location. .Attributes ;. 30 BASEMENT Impervia, Double Bung, 31,5 X 38.5,White Qty 1 1:Nonstandard SizeNonStandard Size Double Hung,Equal rF PK# Frame Size: 31 112 X 38 1I2 816 General Information; Standard,Duracast@, Block,Foam Insulated,3",3" Exterior Color I Finish: White 1 „ Interior Color I Finish: White Glass: Insulated Low-E Advanced Low-E Insulating Glass Argon Non High Attitude a •� —^ Hardware Options: Cam-Action Lock,White Viewed From Exterior Screen: Full Screen,Conventional Fiberglass Performance Information: ll-Factor 0.29,SHGC 0.25,VLT 0.47,CPD PEL-N-126-00556-00001,Performance Class LC,PG 30,Calculated Positive DP Rating 30,Calculated Negative DP Rating 30,Year Rated 08 Grille: GBG,No Custom Grille,314"Contour,Traditional(3W2H 13W2H),White,White Wrapping Information: Replacement Precision Fit Kit,No Exterior Trim,No Interior Trim,Pella Recommended Clearance,Perimeter Length=140". Frame Size:31.5'X 38.5" Material–Ext-Upgrade Exterior Pocket Qty 1 PVC Upgrade a 48 -PVC Upgrade less than 48 inches Qty 1 Pocket Installation-Pocket Installation Qty 1 Thank You For Purchasing Pella® Products PELLA WARRANTY: Pella products are covered by Pella's limited warranties in effect at the time of sale.All applicable product warranties are incorporated into and become apart of this contract. Please see the warranties for complete details,taking special note of the two important notice sections regarding installation of Pella products and proper management of moisture within the wall system.Neither Pella Corporation nor Pella Windows&Doors will be bound by any other warranty unless specifically set out in this contract. However,Pella Corporation will not be liable for branch warranties which create obligations in addition to or obligations which are inconsistent with Pella written warranties. Clear opening(egress)information does not take into consideration the addition of a Rolscreen [or any other accessory]to the product.You should consult your local building code to ensure your Pella products meet local egress requirements. Per the manufacturer's limited warranty,unfinished mahogany exterior windows and doors must be finished upon receipt prior to installing and refinished annually,thereafter. Variations in wood grain,color,texture or natural characteristics are not covered under the limited warranty. INSYNCTIVE PRODUCTS:In addition,Pella Insynctive Products are covered by the Pella Insynctive Products Software License Agreement and Pella Insynctive Products Privacy Policy in effect at the time of sale,which can be found at Insynctive.pella.com. By installing or using Your Insynctive Products you are acknowledging the Insynctive Software Agreement and Privacy Policy are part of the terms of sale. Product Performance Information: U-Factor,Solar Heat Gain Coefficient(SHGC),and Visible Light Transmittance(VLT)are certified by the National Fenestration Rating Council(NFRC).Manufacturer stipulates that these ratings conform to applicable NFRC procedures for determining whole product performance.NFRC ratings are determined for a fixed set of environmental conditions and a specific product size.NFRC does not recommend any products and does not warrant the suitability of any product for any specific use. Design Pressure(DP),Performance Class,and Performance Grade(PG)are certified by a third party organization,in many cases the Window and Door Manufacturers Association For more information regarding the finishing, maintenance, service and warranty of all Pella®products, visit the Pella®website at www.pelia.com Printed on 812412916 Contract-Detailed Page 5 of 8 Customer: Lisa Banacos Project Name: Banacos,Lisa,North Andover,MA 1777488 Order Number: 741SDO461 Quote Number: 8192298 (WDNIA).The certification requires the performance of at least one product of the product line to be tested in accordance with the applicable performance standards and verified by an independent party.The certification indicates that the product(s)of the product line passed the applicable tests.The certification does not apply to mulled and/or product combinations unless noted.Actual product results will vary and change over the products life. For more performance information along with information on Florida Product Approval System(FPAS)Number and Texas Dept.of Insurance(TDI)number go to www.pella.com /performance. Project Checklist Review (installed Orders Only) Before the Installation the Homeowner agrees to do the following: Obtain Condo Association Approval Obtain Historic Approval Remove existing shutters and awnings Remove air conditioners Remove existing shades, drapes, window treatments, wall hangings, and personal belongings Move furniture at least 3 feet away from work area Tie or cut back trees, bushes and shrubs in the work area Arrange to have alarm system and doorbells disconnected Arrange to have any plumbing and electrical repairs or changes made by appropriate licensed contractor Provide a door handle and Iockset for entry door if Pella handle and Iockset is not purchased. Before the Installation Pella agrees to do the following: Obtain Building Permit(When required) Prefinish products when purchased in contract Durinq the Installation the Homeowner agrees to do the following.--.. Keep pets safely away from work area Keep children safely away from work area Allow Pella Installer room to work safely within your home During the Installation Pella agrees_todo the following: Deliver and unload products purchased per contract Place and remove drop cloths in work area then vacuum, and remove all debris at end of day Remove existing product, including storm windows, and dispose of it unless otherwise specified Install all products using method specified in contract per Pella Installation Instructions Replace interior and/or exterior trim only if purchased If Purchased, install exterior primed pine wood trim or Composite. Composite will be unfinished. If Purchased, install interior trim matching wood window finish or White trim for Impervia and Encompass Install non-Pella entry door Iockset provided by you. Pella is not responsible for it's quality or performance After the Installation the Homeowner agrees to do the following: Be available for completion and sign off to verify all products purchased are in working order For more information regarding the finishing, maintenance, service and warranty of all Pella®products, visit the Pella®website at www_pelia.com Printed on 812412016 Contract-Detailed Page 6 of 8 . Customer: Lisa Banacos Project Name: Banacos,Lisa,North Andover,MA 1777488 Order Number: 7418DO461 Quote Number: 8192298 Reinstall existing shutters and awnings Re-install existing shades, drapes, window treatments, wall hangings, and reposition furniture Arrange to have alarm system and doorbells reinstalled Reinstall air conditioners Remove stickers from product and save for energy rebate and tax purposes Wash all interior&exterior glass surfaces Fill nail holes and joints on interior trim if windows are to be stained (after staining) Clean up exterior casing issues due to storm window removal if full wrap or new exterior trim is not purchased _- (0 �? Project Checklist has been reviewed Customer initial Product Only Addendum has been reviewed Customer initial Credit Card Account 4: Last 4 Digits Expiration Date: I Charge final payment to same account (Upon substantial completion) Customer initial For more information regarding the finishing, maintenance, service and warranty of all Pella@ products,visit the Pella®website at www.pellacom Printed on 8/2412016 Contract-Detailed Page 7 of 8 Customer: Lisa Banacos Project Name: Banacos,Lisa,North Andover,MA 1777488 Order Number: 741SDO461 Quote Number: 8192298 ❑Project Checklist has been reviewed Lisa Banacos Steve Duff Order Totals:: Customer Name (Please print) Pella Sales Rep Name tai as print) Taxable Subtotal $7,562.06 �- — Sales Tax @ 6.25% $472.63 Customer Signature Pella Sales Rep Signature 8 / 24 / 16 8 /2 4 / 16 Non-taxable Subtotal $3,790.42 Total $11,825.11 Date date Deposit Received $5,912.56 ``— Amount Due $5,912,55 Credit Card Approval Signature For more information regarding the finishing, maintenance,service and warranty of all Pella®products,visit the Pella®website at www.pe[la.com Printed on 8/2412016 Contract-Detailed Page 8 of 8 i PELLA WINDOWS AND DOORS CONTRACT 7. PAYMENTS I. TERMS AND CONDTTION5 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 These Terns and Conditions are an integral part of the contract set forth on the failure to pay Pella the amount due within seven days after the date paymtent is Product Order(the"Contract")between New England Window and Door LLC due. dba Pella Windows&Doors,Inc.("Pella")and the person(s)identified on the Product Order C"Owner')to supply the products(the"Products"),and perform $ CORRECTION OF tVt71 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 Pella shall correct installation Work not in conformance with the requirements contract. 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 2 OWNER 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 Pella is not responsible for any existing security systems.Owner shall remove remedy for defeetivo workmanship,and is provided in lieu of any and all other all shades;verticals,blinds,curtains,drapes or window mounted air remedies.Pella's obligation to correct Work is conditioned on Pella's prior conditioners,prior to the installation of the Products.Pella's installers are not receipt of all payments then due• responsible for the removal or installation ofthese types of items. Pella is not responsible for pre-existing window coverings fitting on newly installed Pella 9 LIMITED PRODUCT WARRAN'T'Y windows. Pella shall warrant all Pella products,but only in accordance with the Pella The Owner shall provide complete access to the work site between the hours Windows&Doors Limited Warranty,THIS LIMITED WARRANTY SHALL of 7:00 a.m.and 6:00 p.m.(Monday tkough Friday)for Pella's installers to BE THE SOLE WARRANTY W1TH RESPECT TO THE PRODUCTS AND deliver the Products and perform the Work. PELLA SPECIFICALLY DISCLAIMS ALL OTHER WARRANTIES, EXPRESS OR IMPLIED, WRITTEN OR ORAL(INCLUDING WITHOUT 3. PELLA LIMITATION ANY WARRANTY OF MERCHANTABILITY OR FITNESS Pella will be responsible for and have control over construction means, FOR A PARTICULAR PURPOSE). methods,techniques,sequences and procedures and for coordinating all portions of the Work.Pella will be responsible for the Work of its Pella 10. NO CONSEQUENTIAL DAMAGES Contractors who will install the Products. UNDERNO CIRCUMSTANCES SHALL PELLA 13E LIABLE FOR Unless provided otherwise in the Work description,Pella will provide and a CONSEQUENTIAL,INCIDENTAL,INDIRECT,OR SPECIAL,DAMAGES, P P P pay for all lobar,materials,equipment,tools and machinery,transportation,and u<rpm'fHERFORESEEN ORUNFORESEEN, i other facilities and services necessary for the proper execution and completion of the Work. 11. ROME1RV1P1toYEMEI!1T CONTRACTORS The materials and equipment famished under the Contract will he good quality All home improvement contractors and subcontractors shall be registered with the director of the Home Improvement Contractor Registration Program and new unless otherwise required or permitted,the Work will be free from administered by the Board of Building Regulations and Standards. Pella and defects not inherent in the quality required or permitted,and the Work any of its subcontractors identified in this agreement have been registered. I conform with the requirements of this Contract Pella shall not be responsible Any inquires about Pella or any of its subcontractors relating to registration for damages or defects caused by abuse,modifications not executed by Pella, should be directed to:Director,Home Improvement Contractor Registration, or insufficient maintenance,improper ngoperationarea or normal wear and 10 Park Plaza,Room 5170,Boston,MA 02116,617-973-8787,888-283-3757 tear. Pella will keep the premises and surrounding areea free from or visit the HIC Website at http:/htnvw.mass,gov/ocabr! accumulation of waste materials or rubbish caused by performance of the Work 12. PERMITS(MA customers only) 4 CHANGES Pella is obligated to and will obtain the following permits for this project: Bu i I ding Homeowners who secure their own permits will be The Owner may order in writing changes in the Work consisting of additions, excluded from the guaranty fund provisions of Massachusetts General Laws, deletions,or modifications("Change Order"). Any Change Order shall chapter 142A• include an adjustment to the Price and the Substantial Completion Date,as detennined by Pella. Pella reserves the right to approve or disapprove any In addition to the rights and warranties enumerated in this agreement,you may Change Order and any such Change Order must be signed by both Owner and have additional rights under Massachusetts General Laws,chapter 142A and Pella to be effective. 780 Code of Massachusetts Regulations R6• 13. NOTICE OF CANCELLATION 5. SUBSTANTIAL COMPLETION Owner understands and agrees that the Substantial Completion Dale is an You may cancel this agreement if it has been signed by a party estimate only and that the actual date on which the Work is completed may be thereto at a place other than an address of the seller,Which ! extended to allow for Change Orders requested by Owner or if the time to may be his main office or branch thereof,provided you notify complete the Work is affected by conduct of the Owner,weather,labor disputes,availability of subcontractors,acts of God,fire or other causes the seller in writing at his main office or branch by ordinary reasonably beyond Pella's control.If for any reason the Work is not fully mail posted,by telegram sent or by delivery,not later than completed by the Substantial Completion Date(including any extensions midnight of the third business day following the signing of this contemplated above),but is substantially completed by such date,i.e.,the agreement. 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 see the attached Notice of Cancellation for an explanation of parts or work to be completed is acceptable.however,the holdback will not this right. exceed the amount of the completion costs or 10%of the remaining unpaid balance of the Price,whichever is less. 6, FINANCING Do not sign this contract if there are any blank spaces. If payment of the Price is Enanced with a financial institution through Pella,all 'n financing paperwork must be completed upon signing of this Contract and the L}/ requisite approvals and authorizations for the full amount of the requested financing sball have been received from the financial institution. Customer signature 8124/16 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 PROV D DIN M,G.L,c. 142A Contractor "" Homeowner 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. NOTICE OF CANCELLATION Date of transaction: 8/24/16 You may cancel this transaction, without any penalty or obligation, within three business days from the above date. If you cancel, any property traded in, any payments made by you under the agreement, and any negotiable instrument executed by you will be returned within ten business days following receipt by the seller of your cancellation notice, and any security interest arising out of the transaction will be cancelled. If you cancel, you must make available to the seller at your residence, in substantially as good condition as when received, any goods delivered to you under this agreement; or you may if you wish, comply with the instructions of the seller regarding the return shipment of the goods at the seller's expense and risk. If you do make the goods available to the seller and the seller does not pick them up within twenty days of the date of your notice of cancellation, you may retain or dispose of the goods without any further obligation. If you fail to make the goods available to the seller, or if you agree to return the goods to the seller and fail to do so, then you remain liable for performance of all obligations tinder the contract. To cancel this transaction, mail or deliver a signed and dated copy of this cancellation notice or any other written notice, or send a telegram to Pella Windows and Doors, at 45 Fondi Rd., Haverhill, MA 01832 not later than midnight of 8/27/16 (three business days from the date of transaction above). I hereby cancel this transaction. (Date) (Buyer's signature) The Commonwealth of Massachusetts Department of IndustrialAe dents I Congress Street,Suite 100 Boston,MA 02114-2017 kip— www..mass gov/dia orkers'Compensation Insurance Affidavit:Builders/Contractors/LIectricians/Plumbers. TO BE FMED WITH THE.rKPdMTTING AUM0RTTY. Applicant Information Please Print Legibly Name(Business/Drganizafion/ludividual): Address: Aub bwn- City/S / ip: 9 Al P(1oi e#: Are you an employer?Check the appropriate box: Type of project(required): am a employer with empinyees(full.andlnrpwt-time).* 7, ❑New construction 2.Q I am a sole proprietor or partnership and have no employees working for me in 8. Weinodoling any capacity.[No workers'comp.in--rclaired-I 9. 3.F1 am a homeowner doing all work myself[No workers'comp.insurance required•]t El Demolition 4.❑I am a homeowner and wa71 he hiring contractors to conduct alt work on my properly. I will 10❑Building addition ensure that all contractors either have wodcers'compensaiioa insurancz or are sole- 11. Electrical repairs or additions proprietors with no employees. Plumbing repairs or additions S.❑I am a general contractor and I have hired the sob-contractors listed on the attached sheet. 13. Roof repairs 'These sub-contractors have employees andhave workuran 'comp.insr-e.t ❑ P 6.❑We are a corporation and its officers have exercised their right of exemption per MGL C. 14.❑Other 152,§1(4),and we have no employees.[No work rs'comp.incnrance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy infonnatiou. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside mriftacinrs must submit a new affidavit indicating such. tCo&actnrs that check this box must attached an additional shtd showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contnactars have employees,they must provide their workers'comp.policy number. I am an employer that is providing workerscompensation insurance for my employees Below is the policy and job sife btformadom Insurance Company Name: d • �� . " t Policy#or Self-ins.Lia-#: aq Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL a 152,§25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I-do hereby certify under the pains and penalties of perjury that the information provided above is truce and correct ._ Sim._ - Date.:-----._ ...._ Phone#: Q IS 165 a official use only. Do not write in this area,to be completed by city or town official City or Town: PerrnitlLicense# Issuing Authority(circle one):. 1.Board of Health 2.Brtilding Department 3.City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person, Phone#: A� CERTIFICATE OF LIABILITY INSURANCE 0710712016MMlapnYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO 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 OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(les)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), PRODUCERCT Domihy A-GodeB,CIC,RP1.0 Fred C,Church,Inc. NAME: 41 411i11man Sheet PHONE 9783227231 FAX (970)454-1065 Exo; A!C NoIi Lowell,MA 01851 E-MAIL dm0i1@fredcchnreh.com (800€225.1865 ADDRESS: INSURERS AFFOROMG COVERAGE NAIC# INSURERA: Cnizenslnsuranee Companyol'Amedca 31534 INSURED INSURER B: New Hampshire Employers Insurance Company _ 13083 New England Window G Door LLC INSURER C: 45 Fondl Road HaverhM MA 01832-1302 INSURER D: INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER:58475 REVISION NUMBER: 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 REOUCED BY PAID CLAIMS. INTPOLICYEXP RR TYPE OF INSURANCE IN A SR DLSUBR POLICY NUMBER RIIOAILpI pYlYYYY IMMIDUNYYYI LIMITS GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 X COMMERCIAL GENERAL LIABILEFI PREM SES Ea occou'a iCe S 104,000 -71 CLAIMS-MADE IT]OCCUR MED EXP(Any one person) Is 10,004 A X C00001 ZBNB1B14D7 71112016 71112017 PERSONAL&ADV INJURY S 1'000'000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE OMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ 2,000,000 POLICY MPRT X LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE L€MIT a acc dent ANYAUTO BODILY INJURY(Per person) $ ALLOWNEOSCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS HIRED AUTOS NPN-AWNED PROPERTY DAMAGE S AUTOS (Per acdtlen S UMBRELLA LIAR OCCUR EACH OCCURRENCE § EXCESS L. CtAIMS-MAOE AGGREGATE $ DEO RETENTION $ WORKERS COMPENSATIONX IAC STATU- 0711 AND EMPLOYERS'LIABILITY 500000 B ANY PROPRIETORIPARTNERIEXECUTIVE❑ N 1 A 8007D24 7118016 71112017 E,L,EACH ACCIDENT $ OFFICERIMEMBER fXCLUDED7 500,000 iMandatory in NH) E.L.DISEASE•EA EMPLOYE $ Ifyes,describe under500 000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY L€MIT $ DESCRIPTION OF OPERATIONS 1 LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,B more space Is required) CERTIFICATE HOLDER CANCELLATION Town of North Andover Osgood100 Street,suns 2043 NrthAndoverr SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Nrth ,NA 01845 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZEG REPRESENTATIVE Caentu Ns1# 58475 Cert Holder# 79515 C 1988.2010 ACORD CORPORATION. All rights reserved. ACORD 26(2010105) The ACORD name and logo are registered marks of ACORD k i r � ■ , „^.lid} - fr. CS-089853 ^ '. WILL IAN!R NICHOLS 57-PEARTREE RD'+ HAVERHILL MA 01830 < 101261261t f - ce of Consumer Affairs&Business Regulation' License or registration valid for individul use only VIE IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation egistration: -183279.. Type. 10 Park Plaza-Suite 5170 Expiration: 9/2412.3'37 Supplement C ird Boston,MA 02115 NEW ENC,LANDWINDOW&DOOR,LLC. PELLA 1VINDOWS&DOORS Wihram Nichols 45 FOND1 ROAD -- HAVERHILL,MA 01832 Undersecretary Not valid.without signature