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Building Permit #458-14 - 136 OLD VILLAGE LANE 11/21/2013
TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION �'� '� Permit NO: Date Received Date Issued: r l WIPORTANT: Applicant must complete all items on this page LOCATION /J(. 0Ln Print _ PROPERTY OWNER Print 100 Year Old Structure yes no MAPNO:-2-10 PARCEL: ()`((tZONING DISTRICT:(-bct/ Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building 4<One family ❑Addition ❑i�vo or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District ❑Water/Sewer DESCRIPTION OF,3JVORK TO BE PERFORMED: Z !2 ff SLrpIN� /.�c)p�2S Identification Please Type or Print Clearly) OWNER: Name:_ A2�i (A-100J Phone: Li 7• ''3S V/35�7 Address V CONTRACTOR Name: /0,-_-14 Address: q5 FOLIh �� C-��((l �z tF-l(1 �'t'l�- y/ � 3 Z Supervisor's Construction License: o � `1 K-3 -Exp. Date: / o Home Improvement License: Zc9 7 Exp. Date: l ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDIN ',ERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $V C�o� —' FEE: Check No.: Recei t I SCJ p No::' I NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner i�hZ � Signature of contracto�,c_ 1� Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF.SEWERAGE DISPOSAL Public Sewer ❑ Swimming Pools ❑ Tanning/Massage/Body Art ❑ 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 COMMENTS e Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature& Date Driveway Permit DPW T'o`es Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT - Temp Dumpster on site yes no Located at 124 Mair, Street Fire Department signatureldate COMMENTS I i Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Dieter 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 El Notified for pickup - Date r f - Doc.Building Permit Revised 2010 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 ❑ Workers Comp Affidavit o Photo Copy Of H.I.C. And/Or C.S.L. Licenses Li 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 ❑ 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) o 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) o Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit o 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 apw al period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submAted with the building application Doc: Doc.Buiiding Permit Revised 2012 Location No. 1 v Date . • TOWN OF NORTH ANDOVER'• 40 Certificate of Occupancy $ • Building/Frame Permit Fee $ LAJ - Foundation Permit Fee $ Other Permit Fee $ TOTAL $ G Check#� 3 Building Inspector NORTfy own of s E :.4", . A-ndover No. 469 ,0 * - *Coh ver, Mass, 2 �� A- cocHKHRWICK �1' S U BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System W&O4 BUILDING INSPECTOR THISCERTIFIES THAT,.-.G"......................................................................................................... Foundation .4 has permission to erect .......................... buildings on ..� .�4... I ..X.1�. .Q! �.....�� Rough to be occupied as ... .Y. w .. .t.w.��. .M!!1. . ►. l. �S........................... 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 STARTS Rough Service Apex _ ................. . Final ......:: , ............................... BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Reguired 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. Smoke Det. SEE REVERSE SIDE The Commonwealth of Massachusetts -- Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 _ www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Ledbly Name(Business/Organization/Individual): Address: >j� ty.. - _ i t,. Phone #: `� 7�` gym.. 7e _.Ci_ /State/Z1 P'. _� LtlLi Are you an employer?Check the appropriate box: Type of project(required): 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.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. employees and have workers' 9 ❑Building addition [No workers' comp. insurance comp.insurance.$ required.] 5. ❑ We are a corporation and its 1011 Electrical repairs or additions 3.❑ 1 am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. ?10 workers' corirp. right of exemption per MGL 12.❑Roofrepairs insurance required.]t c. 152, §1(4), and we have no 13.0 Other employees. [No workers' comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. TContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. lain an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. 11 Insurance Company Name: A/d- 6Jd-021-0,yE S -XA1_S C C3 Policy#or Self-ins.Lic.#: � Z `�d.� ! Expiration Date: _7 2.0/ 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 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 true and correct. Signature: l/U/^,, Date: Phone#: Q_ ( _. 7-C -7 J571_ 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#: DATE(MMIDDIYYYY) A!C?Rb CERTIFICATE OF LIABILITY INSURANCE 07/08/2013 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). NTA T Dorothy A.Corlett,CIC,RPLU PRODUCER NAME: Fred C.Church,Inc. PHONE 978 3227231 FAX (978)454 1865 41 Wellman Street AIC W A!C No Lowell,MA 01851 E-MAIL dcorlett@fredcchurch.com (800)2251865 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# • INSURERA: Citizens Insurance Company of America 31534 INSURED INSURER B: Hanover Insurance company 22292 New England Window S Door LLC INSURER C: Massachusetts Bay Insurance 22306 45 Fondi Road New Hampshire Employers Insurance Company 13083 ----- -Hsverhill;-MA-01832-1302- --- _ _..._ . -..._ .. - _... --- .. _. .. - _.. ._.- INSURERE-: -- - - fNSUAERF .- COVERAGES CERTIFICATE NUMBER:26329 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 DDLTYPE OF INSURANCE INSR SUER WVD POLICY NUMBER MWD�Y EFF M Lop YY LIMITS LTR GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X DAMAGETO RENTED 100,000 COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ CLAIMS-MACE a OCCUR MED EXP(Any one person) $ 10,000 A ZBN6161407 7/1/2013 71112014 PERSONAL 8 ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 riPOLICYX PRO- X LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 Ea accident $ X ANY AUTO BODILY INJURY(Per person) $ C ALL OWNED SCHEDULED ADN8162169 711/2013 711/2014 BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIREDAUTOS AUTOS Per accident X UMBRELLA LIAB XOCCUR EACH OCCURRENCE $ 9,000,000 B EXCESS LIAB CLAIMS-MADE UHN8167305 711/2013 7/112014 AGGREGATE $ 9,000,000 F-FOED RETENTION$ $ WORKERS COMPENSATION X WCR STATU- O R AND EMPLOYERS'LIABILITY Y/NLI ANY PROPRIETOR/PARTNFA/EXECU`T 400040101 7/112013 7/112014 E.L.EACH ACCIDENT $ 500,000 D OFFICER/MEMBER EXCLUDED? N/P` 500,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under500,000 DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT 1$ DESCRIPTION OF OPERATIONS I LOCATIONS!VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER 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. AUTHORIZED REPRESENTATIVE Client# Mst# 26329 Cert Holder# ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD i ' �1 f tPlii!iti'i yll l)l'7'13;a71' - _.. ..: CS-089853 �1 WILLIAM R NI 57 PEARTRdt RD HAVERHILL MA 01830.' 10/26/2014 .-,, �J�c`�o»rnrnirr�rcrlf�c�n�la���ic�cr�eri`� Mee of Consumer Affairs&Business Regulation x ME IMPROVEMENT.CONTRACTOR egistration: 129774 Ty Expiration: 1`•1/2/2015 , Supplement c PELL A WINDOWS AND DOORS i WILLIAM NICHOLS 45 FONDI RD. HAVERHILL, MA 01832 Undersecretary i Contract - Detailed Pella Window and Door Showrocim of Haverhill Sales Rep Name: Griseto, Anthony Haverhill, MA 01832 Fondi Road Sales Rep Phone: 978-373-2500 HU� Phone: 9783;32500 Fax; 3 Sales Rep Fax:"83737274 Sales Rep E-Mail: GRISE70AC@pellaboston.com Customer Information _ Project/Delivery Address_ _Order Information Gary Wood Wood,Ga�y,NoOhArndo74er,MA,1310489 Quote Name: 19 Encompass Windows,2 Sliding Doors,3 136 Old Village Ln 136 Old Village Ln Order Number: 741AGO134 NORTH ANDOVER,MA 018454533 Lot# Quote Number: 5124610 Day Phone: (617)3351357 NORTH ANDOVER,MA 01845.4533 Order Type: Installed Sales Mobile Phone: County: ESSEX Payment Temis: Wells Fargo Fax Number: 'Tax Code: MA TAX 6.25 E-Mail: Quoted Date: 10/212013 Great Plains#: 7551962 Customer Number: 1006669301 Customer Account: 1002123604 Customer Notes: MA North Andover $12/1000($30 MIN FEE). Customer Paid permit fee of$247.00 vitt,check#i 4:;5 Line# Location: v _ _ _ Attributes 5 Delivery Delivery/Setup.-CleliverySSetup Item Price Qty Ext'd Price $200.00 1 $200.00 For more information regarding the-5ni•shing, maintenance,sertice and warranty of all Pellae products, visit the Pella(&website at www.pella.com Printed on 10/11/2013 Contract-Detailed Page 1 of 8 Customer: Gary Wood ?rcjeot Name: Wood,G2ry,AorthAnr;over,I.AA,1510489 Order Number: 741Ac30134 Quote Number:5124610 LI ne7 Location: _ Ai rlbutes 25 FAV ROOM Vinyl Windows;Doors By Pella, Double Slicing Door Faxed/Vent Leff White Item Price Qty Ext'd Price $2,958.97 1 $2,958.97 1:Fixed/Vent Left Do-jt le Sliding Door PK# General Information: S:andard,Vinyl,Nail Fin UVith Mullion Groove,4 1/2",1 7/16",3 1/16", 10 Series 587 Exterior Color/Finish: White Interior Color/Finish: White Glass: Insulated,remrvad Low E Advanced Arson Non High Altitudi Hardware Options: VWhice,White :screen: Sliding Scraen,Premium Viewed From Exterior Unit Accessories: No Options Orille: No Grille, Composite Trim>4E,-Compcsite Trim Upgrade>Greater ths.n 18 inches wide Qty 1 Extra Layer INT-Extra Layer Interior Qty 1 PD–2 Wide-In:<ta4;!-Wide Petie Door Qty 1 Qpenint/_Build in of Lower-i-owxr or Build In Opening Qty 1 Line# Location: Attributes —� 28 FAV ROOM sulLoOpening_Build in or Lower-Lower or Build In Opening Item Price Qty Ext'a Price $616.00 1 $616.00 For more irrlormation regarding the fmi bng, maintenan.:e,service and wananty of all PellaO products,visit the Fella®website at www.pella.com Printed on 10/11/2013 Conrract-Detviled Page 2 of 8 Customer: Gary Wood iciest Name: Wood,Gary,NorthAndover,iAA,131C489 Order Number: 741Ac30134 Quote Number: 5124610 Line# Location:� !Attributes 30 TV ROOM Vinyl Windows;Doors By Delle, Double Sliding Door Fixed I Vent Left, White Item Price Qty Ext'd Price $2,499.38 1 $2,429.38 1:Fixed/Vent Left Oout,le Slidinp Door PK# General Information: E-tandard,Vinyl,Nail Fin LVith Mullion Groove,4 /2", 1 7/13",3 1116",10 Series 595 tcxterior Coior/Finish: White Interior Color/Finish: White Glass: Insulated rempered Low E Advanced Amon Non High Altitude Hardware Options: White,White Screen: Sliding Screen,Premium Viewed From EAerior Unit Accessories: No Cptions grille: No Grille, Composite Trim>4£-Composite Trim Upgrade>Greater than 48 inches;wide Qty 1 PD-2 Wide-Install:!-Wide PLitie Door Qty 1 Line# Location:_ _ _ Y_Attributes 40 DOWNSTAIRS Vinyl Windows I Coors By Pelle, Double Hung, White Item Price Qty Ext'd Price $699.95 6 $4,199.70 ii r; I 1:Size Double Hung,Equal i PK# general Information: Standard,Vinyl,Block Frame With:Mull Groovs,3 1!4",3 1l4",20 S-)ries,Sill Adapter Included,Head Expander Included + la 595 Exterior Color/Finish:`White Interior Color/Finish' White t` Glass: Insulated Low? Advanced Argon Non Hijh Altitude Screen: Full Screen Grille; GBG,3/4"Conl.oar,Traditional(3W2H 13Vt2H) Viewed From Exterior PI—Complete-fella Complete Pocket Qty 1 Line# Location Attributes 45 UP STAIRS BED Vinyl Windows I Coors By Pelle, Double Hwig, White Item Price Qty Ext'd Price r i $63723 7 $4,810.61 I n 1:Size Double Hung,Equal i I PK# General Information: Standard,Vinyl,Block Frame With Mull Groove,'4 1/4",3 1/4",20 Series,Sill Adapter Included,Head Expander Included 595 Exterior Color/Finish: White Interior Color/Finish: White {� Glass: Insulated Lcw ti Advanced Argon Non High Aititude I Screen: Full Screen Grille: GBG,.3/4"Contour,Traditional(3W2H 13CV2Hi Viewed From Exterior PI—Complete-Pella Complete Pocket Qty For more information regarding the finishing, maintenance,service and war:-anty of all PellaO products,visit the Pella®website at www.pella.com Printed on 10/11/2013 Contract-Detailed Page 3 of 8 Customer:Gary Wood Project Name: Weo(i,Gary,hiorthAndover,IAA,1310489 Order Number: 741At30134 Quote Number: 5124610 Line# Location: Attributes. 50 MST BATH TUB Vinyl Windows!Doors By f eta, Double Hung, White Item Price Qty Ext'd Price _ $801.05 2 $1,602.10 3 n 6 1:Size Double Hung,Hqual PK# General Information: Standard,Vinyl,Block Frame With Mull Groove,3 1/4",3 114",20 Series,Sill Adapter Included,Head Expander Included ft"ow r 595 Exterior Color/FinisF.: White Interior Color/Finish: '.'Vhite Glass: Insulated Tempe ed Low E Advanced Argon Non High Altitude Screen: Full Screen Grille: GBG,3/4"Coniour,Traditional(3W2H 13W21-1) Viewed From EAerior PI—Complete-Pella Complete Pocket Qty 1 Line# Location: Attributes 55 BATHS Vinyl Windows, Goors By Peila, Double Hung, WhitF Item Price _ Qty Ext'd Price $636.33 2 $1,272.66 1:Size Double Hung,Equal PK# General Information: Standard,Vinyl,Block Frame With Mull Groove,:3 1/4",3 114",20 Series,Sill Adapter Included,Head Expander Included 595 [Exterior Color/Finish: White Interior Color/Finish- White Glass: Insula'ied Low;: Advanced Argon Non High Altitute Screen: Full Screen Grille: GBG,3/4"Con".our,Traditional(3VV2H 13kWH) Viewed From EAerior PI—Complete-Pella Complete Pocket Qty 1 Line# Location: Attributes i 60 Laundry Room Vinyl Windows i Doors By Pella, Double Hung, White Item Price Qty Ext'd Price $1,709.64 1 $1,709.64 1:SizeNon-Standard Siza Double Hung,Equal PK# General Information: Standard,Vinyl,Nail Fin,•i 3/16", 1 50",2 9/16",25 Series S95 l'cxterior Color/Finish: White Interior Color/Finish. tVhite ' Glass: Insulated Lcw Z Advanced Argon Non High Altitude S creen: Full Screen Grille: GBG,3/4"Coni.our,Traditional(3W2H 13VWH) Viewed From Exterior FF<48 wide-Insta'.I Full Frame window 43 inches or less wade Qty 1 Composite Trim<U-Composite Upgrade-48 Inches or Less Wide Qty 1 Trim—Stool and Apron-Add Stool and Apron Trim to P°cture Frame Qty 1 For more information regarding the finish,ng, maintenance,seniice and warranty of all Pella@ products,visit the Pella®website at www.pella.com Printed on 10/11/2013 Contract-Uetsiled Page 4 of 8 Customer: Gary Woad ProjEct Name: Wcod,Gt3ry,hlorthAndover,MA,1�,110489 Order Number: 741AGO134 Quote Number: 5124610 Opening_9uild in or Lower-Lower or Sui`d In opening Qty 1 Line# Location: _ _ Attributes 65 FAV ROOM FRONT Vinyl Windows!Doors By Sella, Sliding Window Vent Flight/Fixed/Vent Lefty White Item Price Qty Ext'd Price $1,732.76 l $1,732.76 1:Size Vent Dight/Fis:ed I Vent Laft Triple Slider PK# General Information: :tandard,Vinyl,Nail Fin,2 11116",1 1/8',1 9/16",10 Series 595 Uxterior Color/Fir.ist4: White interior Color/Finish: './Vhite Glass: Insulated Low= Advanced Argon Non High Altitude Hardware Options: S,a,idard Loci, Screen: Half Screen Viewed From Exterior GrMe: GBG,3/4"Con,ow,Traditional(2MH 14IN4H/M41-1) FF-48-96 wide•Irs:all Full Frame Window_48-96 inches wide Qty 1 Composite Trina>4U-Composite Trim tlpdrade>Greater than 48 inches wide Qty 1 Trim Stool and Axon-Add Stool and Apron Trim to Picture Fame Qty 1 Line# Location: AtMbutes 70 33 PCT OFF INSTALL October Rebate-•:):Aober Rebate Item Price Qty Ext'd Price ($2,400.00) l ($2,400.00) For more information regarding the fni%;hang, mairstenan;.e,service and warranty of all PellaO products,visit the fella®website at www.pelia.com Printed on 10/11/2013 Contract•Detailed Page 5 of 8 Customer:Gary Wood Project Name: Wand,Garj,NorthAndover,MA,13lM89 Order Number: 741AGO134 Quote Number: 5124610 Line# Location: Attributer: 75 5 PCT OFF WF October Rebate-- O:.tober Rebate Item Price Qty Ext'd Price ($953.05) 1 ($983.05) Thank You For Purchasing Fella(& Products PELLA WARRANTY: Pella products are covered by Pella's limited wan•anties i>i affect at the time of sale.All applicable product warranties are incorporated into and become a part 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 Pe!;lr,Nindows& Doocs 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 Pelf;written warranties. Clear opening(egress)information does not take into cons.deration the addition 3f a Rclsereen[or any other accessory]to the product. You should consult your local building code to ensure your Pella products meet local egress requ:rt m:-,r..ts. Per the manufacturer's limited warranty,unfinished mahogany exterior windows and doors must be fmished upon receipt prior to installing and refinished annually,thereafter. Variations in wood grain,color,texture or natural cha•acte.istics are not covered under the limited warranty. Project Checklist Review (tri tallad Orders Only) Before the Installation that Homeowner agrees tc!rlo the fo�IloHrinq; Obtain Condo Association Approval Obtain Historic Approval Remove existing shutters and awnings Remove air conditioners Remove existing shades, drapes, windowtreatmen`s wall hangings, and personal belongings Move furniture at least 3 feat away from work area Tie or cut back trees, bushes and shrubs in the worX area Arrange to have alarm system and doorbelis disconrn:cted Arrange to have any plumbing and electrical repair•or changas made by appropriate licensed contractor Provide a door handle and Iockset for entry door if Pella handle and locks.et is not purchased. For more information regarding the finishing, maintenance,service and warranty of all Pellar.D products,visit the Pella®website at www.pella.com Printed on 10/11/2013 Contract-Detailed Page 6 of 8 Customer:Gary Wood Project Name: Wood,G:.ry,florthAndover,MA,ta1C489 Order Number: 741AG0134 Quote Number: 5124610 Before the Installation Pella agrees to do the folhowincr: Obtain Building Permit(When required) Prefinish products when purchased in contract Durina the Installation the Hom owner aorees.to Bio the foilowinct, 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 ag•ees 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 windov,,s, and dispose of it unless otherwise spec;tied Install all products using method specified in contract per Pella Installe.tioi Instructions Replace interior and/or exterior trim only if purchGsecl If Purchased, install exterior primed pine wood trim of Composite. Composite will be unfinished. If Purchased, install interior trim matching wood window finish or White trim for lmpewia end Encompass Install non-Pella entry door lockset provided by you. Fella is not responsible for it's glaality or performance After the Installation the Hooneowner agrees tI eic the folEovving: 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, drape.;,window treatments, wall hangings, and reposition furniture Arrange to have alarm system and doorbelis rein3taJl,:d Reinstall air conditioners Remove stickers from product and save for energy ebate and tax purposes Wash all interior&exterior glass:surfaces Fil o es an on interior trim if windows are.to be strained(after staining) /F or eosin 'sues due to storm window removal if full wrap or new exterior trim is not r_Iurchased oject C cklist has been review eci _Product Onl}, Addendum has been:reviewed Customer initial Credit Card Account#: Last 4 Digits Expiration Date: For more information regarding the finishing, maintenance,service and waranty of all PellaO products,visit the Pella®website at www.pella.com Printed on 10/1112013 Contract-Detailed Page 7 of 8 Customer: Gary Wood P 'e:°gVtsor, ary,Northkdover,MA,1310489 Order Number: 741AGO134 Quote Number: 5124610 Charge final payment to same account —. = (Upon substantial comp�.etion) stnmer mrtial �troje,&,Checklist has been reviewed Customer Name (Please print) Pella S ' me (Please print �— Order Totals Taxable Subtotal $7,483.77 Customer Signature lJ` ella Saes Re . gnatur, ' Sales Tax @ 6.25% $467.74 d •e> —>0 Non-taxable Subtotal $10,665.00 'Date sate Total $18,E16.51 Deposit Received $9,309.25 C dit Card Approval Si i tune mount Due $9,307.26 For more information regarding the Finishing, maintenance,service and war;anty of all Pellac�products,visit the PellaO m,ebsite at www.pella.com Printed on 10/11/2013 Contract-Detailed Page 8 of 8 NOTICE OF CANCELLATION Customer Name: a- , 4 0,,, alm l - lease print) Date of transaction: ®' 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 ietunied within ten business days following receipt by the seller of your canceliation notice, and any security interest arislzg viii of iLi C.inti saction ill b c.:. cclIe`�,.. e If,you cancel, you must make available to the seller att your residence, in substantially as gcod co ndit.cr as when iec--i ved, `r -ondc &1;vered to you'ander thic --T e 71PPts c-r you may if you wish, comply wAh the instructions of dhe 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 goons avaiiabie 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 G O��`����(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 Terris 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 confonnance with the requirements contract. of the Conti-act,if notified in w,iting by the Owner-within.vo year after the Completion Datc or,if earlier,the&rte 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 resnonsible for pre-existing window coverings fitting on newly installed Pella windows. 9. LIMIT Di?Fiit DUCT vt'ARRAW TY 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 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 Dalz will tic respo^si.l_:le for erd harp cc"t^cl o-er.;nstn nf:i`r means, FOR A PARTICULAR PURPOSE). riltthods,iCX;!1 uquCb, ailii pi-u ctd-wes a,ld fu[CJuiJi.laiilig ail 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 i.inl."�,s paG-Suzil JiYie;wise i;,ti,e r✓Jik dtsa-iption,i'eiln-willp;vv;uv amu pay WHETHER INCIDENTAL,INDIRECT.OR SPECIAL DAMAGES, for all labor,miaterials,equipment,tools and inachinery-,trunspJ.atirn,and WHETHER FORESEEN OR UNFORESEEN. other facibtieq and servires necessary for the proper exerution unci 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 ilio inister of y the Boa;.;of Building Cegulatior s and St ant.ds. P defects not inherent in the quality required or p--:mitted,and the Work administered co the Bound en Building Regulations and Standards. Pella and conform with the regniremeets 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. shoAny inquires about o:Di ec any of its subcontractors relating to registration n improper or insufficient maintenance,improper operation or normal wear and Onc A!i directed Mace, Director,Home Improvement Contractor Registration, C:le!'.s::b•�:o:Flace,3osic:l,:.i s 021 un,�17-',27-E ERS tear. Pella will keep the premises and surrounding area free from accumulation of waste materials or rubbish caused by performance of the 12. PERMITS(MA customers only) Work. eiia', oligaieti to and wiii obtain the following permits for this project: m4. CHANGES Homeowners who secure their own permits will be excluded fro to 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 i iii Code of Massachusetts Reguiadons Ro. Pella to be effective. 13. NOTICE OF CANCELLATION S, SUBSTANTIA-1,COMPLETION You Iia cancel this agreement if it has been sl led b a y ��� � y party Owner lrnderstands and agreas that the Substantial Completion Date is an tllerelc at a pplucv other than.an add,Cs;of dbe stiller,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. Do not sign this contract if there are any blank spaces. 6. FINANCING If payment of the Price is financed with a financial institution through Pella,all 1 financing paperwork must be completed upon signing of this Contract and the /� requisite approvals and authorizations for the full amount of the requested V ) financing shall have been received from the financial institution. X—Cu.-nyb-m si ature Ir\— l�_? I Date DISPUTES Job Damel�� d 4- 44111 — g Date ��V20i 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 ITRATION AS PROVIDED IN M.G.L.c. 142A l6ntractor M 11 ti Homeowner NOTICE: THE SIGNA'C'T TRE OF THE PARTIES TIES A BOO ,APPLY ONLY TO T14-F AGREEMENT OF THE PARTIES TO ALTERNATrVE DISPUTE SET-1TLENIENT INITIATED BY THE CONTRACTOR. THE OWNER MAY INITIATE A-1 TEPNATIVE DISPUTE RESOLUTION EVEN WHERE THIS SECTION IS NOT SEPARATELY SIGNED BY THE PARTIES.