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HomeMy WebLinkAboutBuilding Permit #798-13 - 106 ROCKY BROOK ROAD 5/21/2013 14ORTH BUILDING PERMIT o�tt,�o 6�ti TOWN OF NORTH ANDOVER _ APPLICATION FOR PLAN EXAMINATION * ,� Permit NO: I Date Received,P"0 rEo a 'S �SSACHUS�� Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION /O!o Rocr �. Rrint PROPERTYOWNER.r►Z-,.' t :MAP NO: _ _ PARCEL: ZONING DISTRICT Histonc,District yes_ - ',shop.Village , .yes. .; . Machi _ TYPE OF IMPROVEMENT PROPOSED USE Reside ' Non- Residential New BuildingOne famil Addition Two or more family Industrial Alterati No. of units: Commercial Re air re la Assessory Bldg Others: Demolition Other "Septic. Well . - Flood Iain 1Netlands +5 Watershedbist ict° P Water/Sewers: DESCRIPTION OF WORK TO BE PREFORMED: �E/JC�CE/�lEi�fT� F_.•ct� �y-n2 v2 it Identification Please Type or Print Clearly) OWNER: Name:Tlegm- ����G Phone: 4,-)+-clY.7• 6114 Address: /01. 2a bkf-oK 11b CONTRACTOR Name / 11A- kAV e A.,,,ll«��Gl .Address: L1,5- Su pervi§ors.Construction tsSupervisor's.Construction License a 1 i-5 3 _ _ :Exp .Date: //�O ZZ,- Horn Z.Home Im rove:ment License. __.. ,� ` :� ` ._. __, Exp ,Date: - ,P - -- F ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ © FEE: $�Q Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/OwnerSignature of contractor L,. - Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application o Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit I Addition Or Decks I ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2008 Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning/Massage/Body Art Swimming Pools Well Tobacco Sales Food Packaging/Sales Private(septic tank,etc. Permanent Dumpster on Site THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on_ Signature J COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes PlanningBoard Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature&Date Driveway Permit i DPW Town Engineer: Signature: Located 384 Osgood Street FIRE.--D'EPARTMENT': Dumpster on site yes Locatedat 124 Main Street r .� 'Fire-Department signature/date z. COMMENTS E Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— (For department use i 4 ❑ Notified for pickup - Date Doc.Building Permit Revised 2008 Location No. 1 t Date •Z s - TOWN OF NORTH ANDOVER "" Certificate of Occupancy $ . :: Buildings Frame Permit Fee $ d z Foundation Permit Fee $ Permit Fee Other $ TOTAL $ Check#q �U 26426 Building Inspector NORT1j Town of over IE No. *Ah ver, Mass, COCNIC N1WICN A�RATIE S u BOARD OF HEALTH - T T LD Food/Kitchen PERMI Septic System THIS CERTIFIES THAT �� P_• c;�f BUILDING INSPECTOR ....................................................::`. .....�............................................................ ' 'oC)CJL _a�a� Foundation has permission to erect ... .. buildings on Rough to be occupied as .......... ...... ....... ... � :?: .. 94 a(�?Z. ..{ :�,-; c?�.-r7 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 CONSTRUCTIO Rough Service .................. ............................................................. Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building 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. SEE REVERSE SIDE Smoke Det. The Commonwealth of Massachusetts Department of industrial Accidents z W Off ce of bnvestigations d 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation insurance Affidavit: Builders/Contractors/E1 bers Please Print m bl Applicant Information - Name (Business/Organization/Individual). a s,i " r §✓ Address: ;_i',. City/State/Zip: Hnv r s.b a _ Phone.#: ' a 1 Are you an employer? Check the appropriate box: Type of project(required): y ,= 4. ❑ I am a general contractor and I 6 [J New construction 1.[�^I am a employer with -- * have hired the sub-contractors employees(full and/or part-time)• Q 7. ;�' Remodeling listed on the attached sheet. , 2.❑ I am a'sole proprietor or partner- These sub-contractors have g, ❑Demolition ship and have no employees employees and have workers' working for me m any capacity, comp,.msurance.t ' aci 9. E]Building addition P No workers' comp.insurance 10.E]Electrical repairs or additions 5. E] We area-corporation and its required.] officers have exercised their 11.❑Plumbing repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 12.❑Roof repairs myself. [No workers' comp. c. 152, §1(4),and we have no insurance required.] t 13.❑ Other employees. [No workers' comp.insurance required.] irwoTkers'cotion- *Any applicant that checks box#1 must also fill out the section belowall war and hen hire outside ontractoors mulst submt't a new affidavit indicating such. t Homeowners who submit this affidavit indicating they are doing nal sheet showing the name of the sub contractors and state whether or not those entities have $Contractors that check this box must attached an additio 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 job site. information. -- av',S t_rr — Insurance Company Name: ' d.. Expiration Date: -_..i; J Policy#or Self-ins. Lic # ( _ b 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 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 Investi ations of the DIA for insurance cover a e verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature: . �_. Date: Z!- Phone 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#: page 3 of 4 • ® DATE(MMIDD/YYYY) ACCPR® CERTIFICATE OF LIABILITY INSURANCE 08/01/2012 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(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). CONTACT PRODUCER NAME: Dorothy A.Corlett,CIC,RPLU Fred C.Church,Inc. PHONE 978 3227231 FAX (976)454-1865 41 Wellman Street A/C No Ext): A1C No Lowell,MA 01851 E-MAIL dcorlett@fredcchurch.com (800)225-1865 ADDRESS: . INSURER(S)AFFORDING COVERAGE NAIC# INSURER A; Citizens Insurance Company of America 31534 INSURED INSURER 8: Hanover Insurance Company 22292 New England Window&Door LLC 22306 INSURER C; Massachusetts Bay Insurance 45 Fondl Road New Hampshire Employers Insurance Company 13082 Haverhill,MA 01832-1302 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:22446 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 REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL UBR POLICY EFF POLICY LIMITS LTR INSR WVD POLICY NUMBER MM/DDIYYYY MMIDD/YEXP GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X DAMAGE TO RENTED 100,000 COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ CLAIMS-MADE M OCCUR MED EXP(Any one person) $ 10,000 A ZBN8181407 7/1/2012 7/1/2013 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY MPE 0- M LOC $ AUTOMOBILE LIABILITY Ea aco NEdeDtSINGLE LIMIT 1,000,000 X ANY AUTO BODILY INJURY(Per person) $ C ALLOWNED SCHEDULED ADN8162169 7/1/2012 7/1/2013 BODILY INJURY(Per accident) $ AUTOS AUTOS NDN-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident $ X UMBRELLA LIAR rlOCCUR EACH OCCURRENCE $ 9,000,000 13 EXCESS LIAR CLAIMS-MADE UHNS167305 7/1/2012 7/112013 AGGREGATE $ 9,000,000 OED RETENTION$ $ WORKERS COMPENSATION X WC STATU- OTH- AND EMPLOYERS'LIABILITYY L IT ANY PROPRIETOR/PARTNER/EXECUTIVE Y 1 N E.L.EACH ACCIDENT $I ER 500,000 D OFFICER/MEMBER EXCLUDED? N/A 000082601825 711/2012 7/1/2013 500,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Evidence of Insurance for Building Permit for the Town of Walpole . CERTIFICATE HOLDER CANCELLATION Town of Walpole Building Department SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Walpole,MA 02081 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Client# Mst# 22446 Cert Holder# @ 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD a =.,) (•�??._- ' i v,nst1-11 chi I3 sAh 1'�kor a;, 6 ,:s=: CS-089853 s� W ILLUM R NICHOLS;_;. 57 PEARTRAJ RD HAVERHILL MA 01836::.'.. 10/26/2014 Office of.Consemer Eiffa;;; • �us;iiesRegula6on ' Oh'IE IMPROVEMENT CONTRACTOR ?r- Registratf6r., g6�_g774. Exp-a, q 0 Supplement rc,� j �2C�13,r' TY e: RELLP LVINDOVII A _ WILLIAM "NICHOL 45 FONDI RD. - ==' HAVERHILL, P4A 01832 Undersecretary Contract - Detailed Pella Window and Door Showroom of Haverhill Sales Rep Name: Whelan, Kevin 45 Fondi Road Sales Rep Phone: 978-373-2500 Haverhill, MA 01832 Sales Rep Fax: Phone: 9783732500 Fax: 9783737274 Sales Rep E-Mail: WHELANKM@pellaboston.com r. E„......:.�i _,x:E . Ec€.: r a E.. nss.:e-•r.::.t."t. ., y. w..,..,f� _.�. ........_an E,.a�:.... .x.. $.__k.f.,x,.:d.t .:::•.. :4Ehs :. °i i..0 8�.. Orc�er�inform ..::..:._-.fl Irina Shneydennan Shneyderman,Irina,North Andover,Ma1232346 Quote Name: Front Entry 106 Rocky Brook Rd 106 Rocky Brook Rd Order Number: 741 KWO018 NORTH ANDOVER,MA 01845-1463 Lot# Quote Number: 4634206 Day Phone: (978)4820166 North Andover,MA 01845-1463 Order Type: Installed Sales Mobile Phone: County: Payment Terms: Fax Number: Tax Code: MA TAX 6.25 E-Mail: Quoted Date: 4/26/2013 Great Plains#: Customer Number: 1006482894 Customer Account: 1001970132 <:, .. a :s:: s u.'. ..>. '.':_£.�<'H f..�:.}s.'.• �Y< R.<;x .::..t Yt;+ '_k ,,.Pre.. �,.e...;.., _. ... 0� _� e E � x Ef r ._a. .. � �;., h►ttrlb _ �? :: � _....; ,4 .�;m- 10 None Assigned Delivery/Setup-Delivery/Setup Item Price Qty Ext'd Price $200.00 1 $200.00 For more information regarding the finishing,maintenance,service and warranty of all Pella®products,visit the Pella®website at www.pelia.com Printed on 4/30/2013 Contract-Detailed Paoe 1 of 6 ,Customer: Irina Shneyderman Project Name: Shney derman Irina North Andover,Ma1232346 Order Number: 741KWO018Quote Number: 4634206 e77, ._� 15 Front Entry Pella Brand, 3-Wide Inswing Entry Door Sidelight,66.5 X 81.75,White,5 9/16" Item Price Qty Ext'd Price 1:1480 Fixed Inswing Entry Door Sidelight $5,170.56 1 $5,170.56 PK# Frame Size: 15 1/2 X 813/4 559 General Information: Clad,Wood,Pine,6 7/8",15/16",5 9/16",Standard Sill,Nickel Finish Sill,Oak Threshold Entry Door Panel: Glazed,Fiberglass,Oak,Oak,1/2 Light Exterior Color/Finish: Standard Enduraclad,Painted,White,White _ Interior Color/Finish: Painted,White,White Glass: Tempered Low E Viewed From Exterior Grilles: No Grille Frame Size:66.5"X 81.75" Vertical Mull 1: FactoryMull,Reinforcing Plate,Frame To Frame Width: 0" 2:3480 Right Inswing Entry Door Frame Size: 351/2 X 813/4 Entry Door Panel Solid,Fiberglass,Oak,Oa General Information: Clad,Wood,Pine,6 7/8",15/16",5 9/16",Standard Sill;Nickel Finish Sill,Oak Threshold 4 Panel Oak, Exterior Color/Finish: Standard Painted,riled White ,White Interior Color/Finish: Painted,White,White Hardware Options: Latch Bore 2 3/8",2,1/8",No.Handle Set,Standard Steel,Brass Unit Accessories: No Bang Panel Vertical Mull 2: FactoryMull,Reinforcing Plate,Frame To Frame Width: 0" 3:1480 Fixed Inswing Entry Door Sidelight Frame Size: 15 1/2 X 813/4 General Information: Clad,Wood,Pine,6 7/8", 15/16",5 9/16",Standard Sill,Nickel Finish Sill,Oak Threshold Entry Door Panel: Glazed,Fiberglass,Oak,Oak,1/2 Light Exterior Color/Finish: Standard Enduraclad,Painted,White,White Interior Color Jr Finish: Painted,White,White Glass: Tempered Low E Grilles: No Grille Vertical Mull 1: FactoryMull,Reinforcing Plate,Frame To Frame Width: 0" Wrapping Information: L Receptor,No Exterior Trim,No Interior Trim,5 9/16",6 7/8",Factory Applied,Pella Recommended Clearance,Perimeter Length=297". ES—Single with SIT Install Single Entry Door with Sidelight and/or Transom Qty, 1 Composite Trim>48-Composite Trim Upgrade>Greater than 48 incheswide Qty 1 e � -j"-1, dvx`M,��. .r" » 5F 20 Bathroom Vinyl -_; Windows/Doors By Pella, Double Hung,27 X 45.5,White Item Price Qty Ext'd Price 1:Nonstandard SizeNon-Standard Size Double Hung,Equal $507.91 2 $1,015.82 .a PK# Frame Size: 27 X 45 1/2 559 General Information: Standard,Vinyl,Block Frame With Mull Groove,3 1/4',3 1/4",20 Series,Sill Adapter Included,No Head Expander Exterior Color/Finish: White Interior Color/Finish: White _ Glass: Insulated Low E Advanced Argon Non High Altitude Screen: Full Screen Viewed From Exterior Grille: GBG,3/4"Contour,Traditional(2W2H/2W2H) Frame Size:27"X 45.5" Wrapping Information: No Exterior Trim,No Interior Trim,Pella Recommended Clearance,Perimeter Length=145",Glazing Pressure=55. No Ext Wrap/Cap-No Exterior Wrap/Cap 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 4/30/2013 Contract-Detailed Pace 2 of R Cfastomer: Irina Shneyderman Project Name: Shneyderman,ldna,North Andover,Mal 232346 Order Number: 741KW0018 Quote Number: 4634206 PI—Express-Express Pocket Qty 1 �. .!. A y� i. 25 10 PCT Off April Promo-April Promotion Item Price Qty Exrd Price ($587.04) 1 ($587.04) .�.. A _ . . . .» ,.. ..._<: z.r..-a �?E» 30 5 PCT off April Promo-April Promotion Item Price Qty Exrd Price ($289.56) 1 ($289.56) 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,taldng 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. For more information regarding the finishing, maintenance,service and warranty of all Pella®products,visit the Pella®website at www.pella.com Printed on 4/30/2013 Contract-Detailed Paqe 3 of 6 C+Jstomer: Irina Shneyderman Project Name: Shneyderman,Irina,North Andover,Ma1232346 Order Number. 741KWO018 Quote Number: 4634206 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 an plumbing g y p b g and electrical repairs or changes made by appropriate licensed contractor � Provide a door handle and lockset for entry door if Pella handle and lockset is not purchased. Before the Installation Pella agrees to do the following: Obtain'Building Permit(When required) Prefinish products when purchased in contract During 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 to do 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 lockset provided by you. Pella is not responsible for its 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 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 For more information regarding the finishing,maintenance,service and warranty of all Pella®products,visit the Pella®website at www.pella.com Printed on 4/30/2013 Contract-Detailed Page 4 of 6 �.�Y sob Customer: Project Name: Irina Sheyderman,North Andover Ma Order Number. 741KWO018 Quote Number: 463F6 4 ag Project Checklist has been reviewed Customer initial Product Only Addendum has been reviewed Customer initial Credit Card Account#: Last 4 Digits Expiration Date: / Charge final payment to same account j (Upon substantial completion) Customer initial i For more information regarding the finishing,maintenance,service and warranty of all Pella®products,visit the Pella®website at www.pella.com n.4-6-4 a 1n7inn4 70i"Fig Vi Customer: Project Name: Irina Sheyderman,North Andover Ma Order Number: 741KWO018 Quote Number:49g719R Orroject Checklist has been reviewed 6t.vz 1_ V Lo1 wi- Custome ame (Please print) P4§lla Sales Rep Name (Please print) Order Totals Taxable Subtotal $3,857.30 CuVomer Si ture PelFa Sales Rep Signature Sales Tax @ 6.25% $241.0 L9_ 7/zo r .jX7 / 20 Non-taxable Subtotal $1,652.48 Date Date Toil $5,750.86 Deposit Received Credit Card Approval Signature Amount Due $5,750.86 1 For more information regarding the finishing,maintenance,service and warranty of all Pella®products,visit the Pella®website at www.pella.com DrinfnA nn A/7710MI 0—fm,4 Iln4oilnA Dann R n4 R NOTICE OF CANCELLATION Customer Name: I r i 110. S h n e u de a n (Please print) Date of transaction: �f A;P/-;L Q 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 under 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 6-1 J AZV 1 (three business days from the date of transaction above). I hereby cancel this transaction. (Date) (Buyer's signature) PELLA WINDOWS AND DOORS CONTRACT ' 7. PAYMENTS 1. TERMS AND CONDITIONS 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 Terms 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 payment 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("Owner")to supply the products(the"Products"),and perform 8 CORRECTION OF WORK 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 defective 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 of these types of items. Pella is not responsible for pre-existing window coverings fitting on newly installed Pella windows. y LIMITED PRODUCT WARRANTY Pella shall wan-ant 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 through Friday)for Pella's installers to BE THE SOLE WARRANTY WITH 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. UNDER NO CIRCUMSTANCES SHALL PELLA BE LIABLE FOR Unless provided otherwise in the Work description,Pella will provide and pay CONSEQUENTIAL,INCIDENTAL,INDIRECT,OR SPECIAL DAMAGES, for all labor,materials,equipment,tools and machinery,transportation,and WHETHER FORESEEN OR UNFORESEEN. other facilities and services necessary for the proper execution and completion of the Work. 11. HOME IMPROVEMENT CONTRACTORS The materials and equipment furnished under the Contract will be good quality All home improvement contractors and subcontractors shall be registered with and new unless otherwise required or permitted,the Work will be free from the director of the Home Improvement Contractor Registration Program defects not inherent in the quality required or permitted,and the Work administered by the Board of Building Regulations and Standards. Pella and conform with the requirements of this Contract.Pella shall not be responsible any of its subcontractors identified in this agreement have been registered. for damages or defects caused by abuse,modifications not executed by Pella, Any inquires about Pella or any of its subcontractors relating to registration improper or insufficient maintenance,improper operation or normal wear and should be directed to:Director,Home Improvement Contractor Registration, tear. Pella will keep the premises and surrounding area free from One Ashburton Place,Boston,MA 02108,617-727-8598 accumulation of waste materials or rubbish caused by performance of the 12. PERMITS(MA customers only) Work Pella is obligated to and will obtain the following permits for this project: 4. CHANGES . Homeowners who secure their own permits will be excluded=e guaranty fund provisions of Massachusetts General Laws, The Owner may order in writing changes in the Work consisting of additions, chapter 142A. deletions,or modifications("Change Order"). Any Change Order shall include an adjustment to the Price and the Substantial Completion Date,as In addition to the rights and warranties enumerated in this agreement,you may determined by Pella. Pella reserves the right to approve or disapprove any have additional rights under Massachusetts General Laws,chapter 142A and Change Order and any such Change Order must be signed by both Owner and 780 Code of Massachusetts Regulations R6. Pella to be effective. 13. NOTICE OF CANCELLATION 5. SUBSTANTIAL COMPLETION You may cancel this agreement if it has been signed by a party Owner understands and agrees that the Substantial Completion Date is an thereto at a place other than an address of the seller,which estimate only and that the actual date on which the Work is completed may be may be his main office or branch thereof,provided you notify 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 the seller in writing at his main office or branch by ordinary disputes,availability of subcontractors,acts of God,fire or other causes mail posted,by telegram sent or by delivery,not later than reasonably beyond Pella's control.If for any reason the Work is not fully midnight Of the third business day following the signing Of this completed by the Substantial Completion Date(including any extensions agreement. 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 See the attached Notice of Cancellation for an explanation of 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 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 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. Customer signatlA a7 Aol � Date 0 DISPUTES Job Name SI1 e r m A h Date y/a��a0 3 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 T Q O SUCH ARBITRATION AS PROVIDED IN M.G.L.c. 142A w 2 Con ctor Ho caner NOTICE: THE SIGNATURE OF THETARTIES 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.