HomeMy WebLinkAboutBuilding Permit #041-14 - 1607 SALEM STREET 7/11/2013 TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit NO: Date Received
Date Issued: lit 1
IMPORTANT:Applicant must complete all items on this page
LOCATION' -
_
PROPERTY OWRERA -
- Print, 100 YearOld'Structure yes no
MAF AE2C.ELZQNLNG DISTRICT: HistoricDistrict yes
- -
Machine:Shop,Village, yes.
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
❑ New Building ne family
❑Addition ❑ I wo or more family ❑ Industrial
❑Alteration No. of units: ❑ Commercial
G4tepair, replacement ❑Assessory Bldg ❑ Others:
❑ Demolition ❑ Other
❑ Sep tic, We11= ❑ Floodplain: D Wetlands ❑ V1/atersliedlDistricta .
❑Water/Sewer, .
DESCRIPTION OF WORK-TO BE PERFORMED:
f�•
Identification Please Tyre or Print Clearly)
OWNER: Name: 4\ A J!SdA4�-XA Phone:
Address: /6 a`7 SAtZ P-t 9
CONTRACTOR' Name:.11, Phone::. ?Y
- - - _ --
Address: 4 -5i- k.5 c �
5 Cl e LY3
Supervisor's.Construction.License: Q kCI k Emi, [ate: 6�-Lc y
Home.,Improvement License; / 5 775 ' - Exp: Date: ''-3-
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: $ �`7 FEE: $
Check No.: Receipt No.: aQ01 t
NOTE: Persons con ratting with unregistered contractors do not have access to the guaranty fund
Signature�ofAgent/OwneSignature of contractor `
Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan 11 Stamped Plans ❑
Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
TYPE OF SEWERAGE.DISPOSAL
Public Sewer ❑ Tanning/MassageBodyArt ❑. Swimming Pools ❑
Well ❑ Tobacco Sales ❑
Food Packaging/Sales ❑
Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑
I
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
i I
DATE REJECTED DATE APPROVED
PLANNING & DEVELOPMENT ❑ ❑
COMMENTS
CONSERVATION Reviewed onSignature
CCMfMENTS "
I�
HEALTH Reviewed on Signature
COMMENTS
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 Tow;! Engineer: Signature:
Located 384 Osgood Street
FIRE DEPARTRFNT - Temp Dumpster on site yes no
Located at 124 Main.'Street
Fire Department signatureldate 4
COMMENTS
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,
I
® Notified for pickup - Date
I
Doe.Building Permit Revised 2010
J I
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
o Copy of Contract
❑ Floor Plan Or Proposed Interior Work
❑ Engineering Affidavits for Engineered products
i NOTE: All dumpster.permits require sign off from Fire Department prior to issuance of Bldg Permit
Addition Or Decks
❑ Building Permit Application
❑ Certified Surveyed Plot Plan
o Workers Comp Affidavit
❑ Photo Copy of H.I.C. And C.S.L. Licenses
o 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)
o Engineering Affidavits for Engineered products
(VOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit
New Construction (Single and Two Family)
❑ Building Permit Application
o Certified Proposed Plot Plan
o Photo of H.I.C. And C.S.L. Licenses
o 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
i NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit
1 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 apn.al period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording
must be subm:ated with the building application
Doc: Doc.Building permit Revised 2012
Location
NaDate
• - TOWN OF NORTH ANDOVER
Certificate of Occupancy $fir.
. Building/Frame Permit Fee $
' r Foundation Permit Fee $
Other Permit Fee $
TOTAL
Check#S�{
K 4te��
26611 Building Inspector
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 Legibly
Name(Business/Organization/Individual):FLI I A i Al i r<t,D a �-
Address:
City/State/Zip: Pmt EPA,E I i'll 0Vk 3 2- Phone #: _741_
Are you an employer?Check the appropriate box: Type of project(required):
1.C&am a with
employer er 4. E] I am a general contractor and I
6. E]New construction
employees(full and/or part-time).* have hired the sub-contractors
2.F1 am a sole proprietor or partner- listed on the attached sheet. 7. Remodeling
ship and have no employees These sub-contractors have g. ❑Demolition
working for me in any capacity. employees and have workers' g ❑Building addition
[Nu workers' comp. insurance comp. insurance.$
required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions
3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions
myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs
insurance required.]t c. 152, §1(4),and we have no
employees. [No workers' 13.❑ Other
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.
$Contractors 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.
I ant an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name: Alfa- Et4l2 .c;"t_l_/Z s JW S (in-
i
Policy#or Self-ins.Lic.#: q( f e Expiration Date: '-7'_/` 2-0 j
i
Job Site Address: City/State/Zip:
Attach a copy of the workerscompensation 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.
Sit?nature• Date:
Phone M �r e�
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(MM/DD/YYYY)
,a�n CERTIFICATE OF LIABILITY INSURANCE [1710
812013
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 Dorothy A.Corlett,CIC,RPLU
PRODUCER NAME:
Fred C.Church,Inc. PHONE 978 3227231 FAX (978)454 1865
41 Wellman Street A1C No Ext: A1C No:
Lowell,MA 01851 E-MAIL doorlett@fredcchurch.com
(800)225-1865 ADDRESS:
INSURERS AFFORDING COVERAGE NAIC#
INSURER A:
Citizens Insurance Company of America 31534
INSURED Hanover Insurance Company 22292
INSURERB:
New England Window&Door LLC - INSURER C: Massachusetts Bay Insurance 22306
i
45 Fondi Road New Hampshire Employers Insurance Company 13083
Haverhill,MA 01832-1302 INSURERD:
INSURER E:
INSURER F
COVERAGES CERTIFICATE NUMBER:2632e 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 SUBR POLICY NUMBER MM/DD EFF MMIDDf EXP LIMITS
LTR
GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
X
DAMAGE T RENTED 100,000
COMMERCIAL GENERAL LIABILITY PREMISES Es occurrence $
CLAIMS-MADE a OCCUR MED EXP(Any one person) $ 10,000
A ZBN8161407 7/1/2013 7/1/2014 PERSONAL&ADV INJURY $ 1,000,000
GENERAL AGGREGATE $ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000
PRO- X LOC $
POLICY X JFrT
COMBINED SINGLE LIMIT 1,000,000
AUTOMOBILE LIABILITY Ea accident
X ANY AUTO BODILY INJURY(Per person) $
C ALL OWNED SCHEDULED ADN8162169 7/1/2013 711/2014 BODI LY I NJURY(Per accident) $
AUTOS AUTOS
NON-OWNED PROPERTY DAMAGE $
HIRED AUTOS AUTOS Per accident
X UMBRELLA LIAR OCCUR X EACH OCCURRENCE $ 9,000,000
B EXCESS LIAR CLAIMS-MADE UHN8187305 7/1/2013 7/1/2014 AGGREGATE $ 9.000,000
DED RETENTION$ $
WORKERS COMPENSATION X WC STATU- O R
AND EMPLOYERS'LIABILITY Y/N
ANY PROPRIETOR/PARTNER/EXECUTIVE 400040101 7/1/2013 7/1/2014 E.L.EACH ACCIDENT $ 500,000
D OFFICERIMEMBER EXCLUDED? N 1 p` 500,000
ISEASE-EA EMPLOYE
(Mandatory in NH) E.L.D $
If yes,describe under 500,000
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
DESCRIPTION OF OPERATIONS/LOCATIONS I 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
Pl .
Client# 29bU Mst# 26329Cert Holder# @ 1988-2010 ACORD CORPORATION. All rights reserved.
ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD
��G:eF88'd t f d:,wlsx�d +Vyl � Lt�,i-2V�s ;.94'sa a pa•;r-0 +s'C1E5
CS-089853 �r
WII,LIAM R NICHOLS
57 PEART kt RD
HAVERFIILL MA 01830`t -
10/26/2014 .
Office of.Consu __.cess Regulation
a 0mt iMPR0VEMENT CONTRACTOR .
Recgistratior 1129.774, TY
pes
Expi.ratiun jl [201.3 Supplement
F 4 ,
FELLA WINDOW S.AND,DQOR8- `'
. 1.
WILLIAM NICHGLS` c ,
45 FONDI RD. _
HAVERHILL,.MA 01832" Underscretary
Contract - Detailed
Pella Window and Door Showroom of Haverhill Sales Rep Name: Griseto, Anthony
45 Fondi Road 7 Sales Rep Phone: 978-373-2500
Haverhill, MA 01832 Sales Rep Fax:
Phone: 9783732500 Fax: 9783737274 Sales Re E-Mail: GRISETOAC@pellaboston.com
@pellaboston.com
Customer Information Project/Delivery Address Order Information
Ted and Lucyna Mateja Mateja,Ted and Lucyna,NorthAndover,MA,1263922 Quote Name: Mateja,Ted and Lucyna,1263922
1607 Salem St. 1607 Salem St.
Order Number: 741AGO074
NORTH ANDOVER,MA 01845 Lot# Quote Number: 4821534
Day Phone: NORTH ANDOVER,MA 01845 Order T
Mobile Phone: ESSEX
Installed Sales
County: ESSEX Payment Terms: Deposit/C.O.D.
Fax Number: Tax Code: MA TAX 6.25
E-Mail: Quoted Date: 6/25/2013
Great Plains#: 4763703
Customer Number: 1004690915
Customer Account: 1001139015
Customer Notes: Permit Fee Paid with check#5598
Line# Location: Attributes
10 Delivery Delivery/Setup-Delivery/Setup Item Price Qty Extd Price
$200A0 1 $200.00
For more information regarding the finishing,maintenance,service and warranty of all Pe[Ia®products,visitthe Pella®website at www.polla.com
Printed on 6/26/2013 Contract-Detailed Page 1 of 5
Customer.Ted and Lucyna Mateja Project Name: Mateja,Ted and Lucyna,NorthAndover,MA,1263922 Order Number: 741AGO074 Quote Number:4821534
Line# Location: Attributes
15 Gameroom Impervia, Double Hung, Brown Item Price Qty Ext'd Price
$968.92 3 $2,906.76
1:SizeNonStandard Size Double Hung,Equal
PK# General Information: Standard,DuracasM,Block,Foam Insulated,3",3"
Exterior Color/Finish: Brown
574 Interior Color/Finish: Brown
f V �I Glass: Insulated Low E Advanced Argon Non High Altitude
Hardware Options: Standard Lock,Brown
Screen: Full Screen,InView"
Viewed From Exterior Grille: No Grille,
PI Ext Trim Pocket w/Exterior Trim dty
No Ext.Wrap/Cap-No Exterior Wrap/Cap Qty 1
Composite Trim<48-Composite Upgrade-48 Inches or Less Wide Qty 1
Line# Location: Attributes
20 10 PCT OFF June Rebate-June Rebate Item Price Qty Ext'd Price
($319.11} 1 ($319.11)
Line# Location: Attributes
f 25 5 PCT OFF FTC June Rebate-June Rebate Item Price Qty Ext'd Price
($142.72) 1 ($142.72)
For more information regarding the finishing,maintenance,service and warranty of all Pella®products,visit the Pella®website at www.pelle.com
Printed on 6/26/2013 Contract-Detailed Page 2 of 5
Customer.Ted and Lucyna Mateja Project Name: Mateja,Ted and Lucyna,NorthAndover,MA,1263922 Order Number: 741AGO074 Quote Number:4821534
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 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 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,
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 lockset for entry door if Pella handle and lockset is not purchased.
Before the Installation Pella agrees to do the following:
'i Obtain Building Permit(When required)
Prefinish products when purchased in contract
During the Installation the Homeowner agrees to do the following
I Keep pets safely away from work area
Keep children safely away from work area
Allow Pella Installer room to work safely within your home
Durina 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
For more information regarding the finishing,maintenance,service and warranty of all Pella®products, visit the Pella®website at www.pella.com
Printed on 6/26/2013 Contract-Detailed Page 3 of 5
0
4
Customer:Ted and Lucyna Mateja Project Name: Mateja,Ted and Lucyna,NorthAndover,MA,1263922 Order Number: 741AGO074 Quote Number:4821534
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 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
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)
Cleanup exterior casing issues due to storm window remo al if full wrap or new exterior trim is not purchased
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
(Upon substantial completion) Customer initial
I
I
For more information regarding the finishing,maintenance,service and warranty of all Pella®products,visit the PellaO website at www.pelia.com
Printed on 6/26/2013 Contract-Detailed Page 4 of 5
• Customer.Ted and Luc na Mate�a
Y J Project Name: Matejajed and Lucyna,NorthAndover,MA,1263922 Order Number: 741AGO074 Quote Number:4821534
Project Checklist has been reviewed
HAIMCCIf M137TLT4 10
C mtomer Name (Please pr Pella4Sales (Please pr, Order Totals
Taxable Subtotal $1,235.39
Cu s mer S' nature Sales Tax @ 6.25% $77.21
tElla— Dae Non-taxable Subtotal $1,409,54
Total $2,722.14
Deposit Received $1,361.07
Credit Card Approval Signature Amount Due $1,361.0
711
For more information regarding the finishing,maintenance,service and warranty of all Pella®products,visit the Pella®website at www.Pella.com
46 Printed on 6/26/2013 Contract-Detailed
Page 5 of 5
r
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 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 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
Pella isnot responsible for any existing security systems.Owner shall remove provided above.Correction of Work as herein provided shall be Owner's sole
remedy for defective workmanship,and is provided in lieu of any and all other
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. 9. LIMITED PRODUCT WARRANTY
The Owner shall provide complete access to rite work site between the hours Pella shall warrant all Pella products,but only in accordance with the Pella
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
confomr 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.
Pea i� i atedto and will obtain the following permits for this project:
4• CHANGES Homeowners who secure their own permits will be
consisting of additions, excluded fro[ a guaranty fund provisions of Massachusetts General Laws,
The Owner may order in writing changes in the Work co
chapter 142A.
deletions,ormodifications("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
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 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
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 financed with a financial institution through Pella,all _
financing -I
g 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. u r sig ire
VC
Date
`� �J / DISPUTES
Job Name leAPI L(,{ WGA
Date Z
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 BITRA ION AS PROVID IN G.L.c. 142A
i
ontractor
omeowner
NOTICE: THE SIGNATURE OF THE PARTIES ABOVE APPLY ONLY TO THE
AGREEMENT OF THE PARTIES TO ALTERNATIVE DISPUTE SETTLEMENT
INITIATED BY THE CONTRACTOR. THE OWNER MAY INITIATE
ALTERNATIVE DISPUTE RESOLUTION EVEN WHERE THIS SECTION IS NOT
SEPARATELY SIGNED BY THE PARTIES.
NOTICE OF CANCELLATION
Customer Name: I-e-y vc-4uc v, Rte`- .r
(Please print)
Date of transaction: Z(1 ZO
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 Doors,and Dat 45 Fon
_ �, di Rd.,Haverhill.Mei 01 832
not later than midnight of � Zv d 1j (three business days from the date of
transaction above).
I hereby cancel this transaction.
(Date) (Buyer's signature)
Y g ) i
NORTH
Town of t : �� . Andover
O
No. Q� * _-
Z
ver, Mass,
COC MIC MI W.CM *1_1.
p�gATEO APPERMIT T �,`'�5
S u
LDBOARD OF HEALTH
Food/Kitchen
Septic System
THIS CERTIFIES THAT ...........1.�i�. 40 ... .................................................. BUILDING INSPECTOR
t.&..0i.W
4. Foundation
has permission to erect.......................... buildings on .... .. ........ ............. ...........
Rough
to be occupied as . ........ .. ......... .. ....... .. .. �...am................................ chimney
provided that the pe on accep Ing 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 ONTHS ELECTRICAL INSPECTOR
. UNLESS CONSTRUCT TA Rough
Service
............. .. ........ ......46�
.. 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.
Smoke Det.
SEE REVERSE SIDE