HomeMy WebLinkAboutBuilding Permit #360-11 - 261 WAVERLY ROAD 10/29/2010 R..
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit NO: V Date Received
Date Issued:
IMPORTANT:Applicant must complete all items on this page
LOCATION t L4 12h
Print,
PROPERTY OWNER 'Soa..j-t o s
Print
MAP NOZOPARCEZONING DISTRICT: Historic District yes
Machine Shop Village yes no
TYPE OF IMPROVEMENT PROPOSED USE
Resi Non- Residential
New Building famil
Addition Two or more family Industrial
ation No. of units: Commercial
e lacemen Assessory Bldg Others:
Demolition Other
Septic Well Floodplain Wetlands _ Watershed District
Water/Sewer
DESCRIPTION OF WORK TO BE PERFORMED:
cl /C�DC�rdtil�i�r� I,e.1�..r.oati.sz
Identification Please Type or Print Clearly)
OWNER: Name: Z—oA — �,o o,,(s Phone:9-2&-16%-7-3tgo
Address:
CONTRACTOR A)IELts Phone 97 7 5- xss
Address: q,!� - rAn r g--2(4cc( ,A- otA-3-A --
Supervisor's Construction License: t ��SS SR3 _ Exp. Date: 14)
Home Improvement License: to �7` Exp. Date:
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: $ 'I Qlobo FEE: $
Check No.: Receipt No.:4�3 Z V
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
ignnature of Agent/Owner P Signature of contractor , '
Plans Submitted Plans Waived Certified Plot Plan Stamped Plans
I
TYPE OF SEWERAGE DISPOSAL
Public Sewer Tanning/Massage/Body Art Swimming Pool
Well , '
Tobacco Sales Food Pang/Sal ps ,� �p�
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
a COMMENTS j
f
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
I
DPW Town Engineer: Signature:
Located 384 Osgood Street
FIRE DEPARTMENT -tewmDumpster on site yes no
Located at 924 Mai 1AZE"ate
Fire Departil ,
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 ❑ Notified for pickup - Date
Doc:.Building Permit Revised 2008
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
❑ 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
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)
❑ 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: Doc.Building Permit Revised 2008
Location ?,gz lvGyGl l ��•
No. t! "I� Date
NORT1y TOWN OF NORTH ANDOVER
O
F s
D
♦ y �
Certificate of Occupancy $
Building/Frame Permit Fee $ U
�cNus
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check #
236U
Building Inspector
NORTH
TO" of
0
No. 3 Go ao a
CN
o _ -o dover, Mass., 0 ' e7c1. •
co HIC ME WICK ^
RATED
BOARD OF HEALTH
PERMIT T D Food/Kitchen
Septic System
BUILDING INSPECTOR
op."'"� (/�
THIS CERTIFIES THAT \� .�.... `_ �M`..................................................... Foundation
has permission to erect..... ......... buildings on .......Z.`.l........;,!;Au..... ........�! Rough
.... ...................
to be occupied as....... ....... ..... ............ ........... .............. 1.x"1 .......... Chimney
provided that the pers c e ing this permit shall in every respect conform to the terms of the application on file in Final
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 CONSTRUC N TS Rough
Service
........... ..........................................................................
BUILDING INSPECTOR
Final
Occupancy Permit Required to Ocmpy Building GAS INSPECTOR
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 S 1 D E Smoke Det.
✓ �/%/I//
irs a.GlltttcJe .6
$ Dtit+�lr�nsNmera &B' tueSs 4iegutation
Aq
�'{'. HQ �iLp�b1�EM1=PIT�OI�TRACTOR, t ;,:
r
TJ15n9774
pira6on_11/2/2011
i 3Eypec�SupplerrielhtCard
PELLAW.INDOWS:AND DOQR$.{
WIt, lAM 1VICHOLS -
�IAVERWIL�,;MA 01t1`�' r �a••
.. J _p n[J�derseer�tary° .
Massachusetts- Department of Public Safeh
Board of Buildim- Reulations and Standards
Construction Supervisor License
License: CS 89853
WILLIAM R NICHOLS
57 PEARTREE RD
HAVERHILL, MA 01830
Expiration: 10/26/2012
Commissioner Tr#: 4529
ACORD,M CERTIFICATE OF LIABILITY INSURANCE01DATE
( IWIDDI0)
PRODUCER (800)225-1865 THIS CERTIFICATE 15 ISSUED A5 A MATTER OF INFORMATION
Fred C.Church,Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Wellman Street HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
41
41 ell, an 01851 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
800.225-1865
INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A: Citizens Insurance Company of America
New England Window&Door LLC INSURERS: Wausau Underwriters Insurance Company
45 Fondi Road
Haverhill,MA 01832.1302 INSIJRERQ
INSURER D:
INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FORTHE 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
ILSR OL POLICY NUMBER pOLTCYEFFEOCTIVE 00LII YEMPIR TION MJ- LIMITS
TYPIR OF INSURANCEGENERAL LIABILITY EACH OCCURRENCE $1,000,000
DA AGE TO RENTED 100,000
X COMMERCIAL GENERAL LIABILITY PREMISES Eaaraurance $
CLAIMS MADE a OCCUR MED EXP(Anyone arson) $10,000
A ZBN8161407 7/1/2010 7/112011 PERSONAL B,ADVINJURY $1,000,000
GENERALAGGREGATE $2,000,000
GEN-L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOPAGG $2.000,000
POLICY PxSER&
LOC
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000
X ANY AUTO (Ee aooldenl)
ALL OWNED AUTOS BODILY INJURY
SCHEDULED AUTOS (Perparsanl $
A ADN8162169 7/1120(0 1/(/2011
X HIRED AUTOS (Peva eId INJURY $
X NON-OWNED AUTOS
PROPERTYDAMAOE $
(Per aeoldent)
GARAGE LIABILITY AUTO ONLY•EA ACCIDENT $
ANY AUTO OTHER THAN EA ACC S
AUTO ONLY: AGG S
EXCESSIUMBRELLALIABILITY EACH OCCURRENCE $9,000,000
_R]OCCUR CLAIMS MADE AGGREGATE $9,000,000
A UHN8167305 7/1/2010 7ll/2011 g
DEDUCTIBLE S
X RETENTION $ S
WORKERS COMPENSATION AND )( WC ST TU• 0TH-
EMPLOYERS'LIABILITY E.L.EACHACCIDENT $500,000
B ANY PROPRIETORIPARTNEMEXECUTIVE WCCZ11259957010 7/1/2010 71112011
OFFICERIMEMBEREXCLUDED? E.L.DISEASE-EA EMPLOYEE $500,000
If yes,desadbeunder
SPECIAL PROVISIONS below E.L.OISEASE-POLICY LIMIT 1$ 5001000
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
Proof of Insurance
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
New England Window&Door LLC NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL
5 Fondi Road IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR
Haverhill,MA 01830 REPRESENTATIVES.
AUTHOREEEOREPRESENTATIVE p
ACORD 25(2001!08) Client# -)can Mst# 10-1 I GL,UMB,WC, Cert# 0 ACORD CORPORATION 1988
Auto
Office of.Investigations
600 Washington Street
Boston,MA 02111
www.massgov/dia
ion Insurance Affidavit:Builders/Contractors/Electricians/Plumbers
Workers Compensat Please Print Le ibl
A licant Information
/ �o •�' I300� Lip
Name(Business/Orm diatiowbdividual): t:�(
Address: °-ES Fo 4 ��
City/State/zip:
d l�?a:- Phone#; 8' Z(�S dSs
Type of pro]ed(required):
Are you an employer?'Check the.appropriate boa:mp with y 6 New const(� ruction
a e to er �S 4• � I am a general contractor and I
l:[�am have, the sub-contractors 7. 13 Remodeling
employees(full and/or part-time). listed ou the atiached sheet.$ B Demolition
2.0 I am a sole proprietor orpartner- These sub-contractors have
ship and have no employees workers' comp.insurance. 9• []Building addifian.
working for me in any capacity. 10.C]Electrical repairs or additions
5, [] We are a corporation and its
(No workers'comp.insurance•' airs or.additions
_.. _...... ........ .. ..._....,:. •,.: .... � . ..::.......•o a '� . . .
rs have exerc ed their
„1,1.,0..plum,bmgreP
-required.] tofexemptionperl►ilGL
3•❑ I am a homeowner doing all work c••152,'§10),and'we have no 12:0 Raof rep&
myself.[No workers' comp• ' employees.[iso workers' 13,(]Other
insurance required.]f' crimp.insurance required.]
at cheotcs box#1 must also fill out the seotion below showing their viorkel s'cOmpensatton policy 9nfo t anew:
•p ny applicant th do g ell work end then bite outside coutradors•most submit a new eifiila of c information
t Hcmeownas who submit this ef�dAt$tdicating they •
tCantractots that check this box must attached an•additional sheet showing the name of the•sutrcontraetots end then wotkais'Damp P
avidin workers'donepensatioi:insurance fer•my employees:'Below h the policy and job site
[dig an employer that ispr g
information.
CompanyName: e
Insurance
Expiration Date:_
Policy#
or Self-ins.Lic.
' Cityl5taterzip.: _ .
Job Site Address: expiration date).
'cam eusatiou policy d'ecla'ration page(9howingtke Policy number and
Attach a COPY-Of tie workeis p osidou of cri &d.penalties of a
11 as civil.penaldes in the'formof a STOP WORI{'OltDER and a ane
Failure to secure coy erage as requued under Section 25ji W of MGL.c. 152can lead to the imp DE of'
fine up to$1,500.00 and/oi one-year imprisonment;
to$250.00 a day against the!violator. Be advised that a copy of this statemmtmay be forwarded to the
of up . -
investigations of the DIA for insurance coverage verification.
airs and ¢nutrias of perjury that the information provided above is true and correct
I do hereby certify•under'the p p Date:
Si afore:
Phone* or town o iciaL
Offciai use only. Do not write in this area,•to be completed by ccty.
Yermit/License#
City or Town:
y p Ins ector
Issuing Authority(circle one): .
1
•gourd of-Health 2.Building Department 3:Cit 1Town clerk 4.Electrical Ins �actor 5.plumb ng;
6'Other Phone#•
Contact Person:
i
Contract Detailed
Pella Windows& Doors ����� Sales Rep Name: Keating, Linda
® HIC#129774/Tax ID#26-1413183 45 Fondi Road Sales Rep Phone: 978 423-6987
Haverhill, MA 01832 Sales Rep Fax:Phone: (
)
Phone: (978)373-2500 Fax: (978)373-7274 Sales Rep E-Mail: Ikeatinq(a).pellaboston.con
Customer.lnformatioin Project/pOvery Address Order Informat>lon
Joanne Gibbons WLK Gibbons,Joanne North Andover Quote Name: upstairs w/small living rm windows
261 Waverly Rd 261 Waverly Rd
Order Number: 741 LK0245
NORTH ANDOVER,MA 01845 Lot# Quote Number: 2018930
Day Phone: (978)6873190 NORTH ANDOVER,MA 01845 Order Type: Installed Sales
Mobile Phone: County: ESSEX Payment Terms: Deposit/C.O.D.
Fax Number: Tax Code: MA TAX 6.25
E-Mail: Quoted Date: 9/18/2010
Great Plains M
Line# Location: Atdibutes
10 master Architect, Precision Hung Double Hung,33.5 X 49.25,White Qty
2
1:Non-Standard Size Double Hung,Equal Split
Frame Size: 33 1/2 X 49 1/4
General Information: Style Edition,Clad, None
Exterior Color/Finish: Standard EnduraClad,White
Interior Color/Finish: Unfinished Interior
Glass: Insulated Low E Advanced Argon Gas
Hardware Options: Spoon Lock,None,White,No Sash Lift
Viewed From Exterior Screen: Full Screen,InView
Frame Size:33.5"X 49.25" Grille: RMB,No,3/4",Traditional(3W2H/3W2H),Unfinished Wood,Unfinished Wood,Shipped In Unit
Wrapping Information: Perimeter Length=166",Glazing Pressure=100.
Aluminum Wrap-Full Wrap Windows or Doors Qty 1
PF_STD-Install Standard P-fit Qty 1
PAINT-WINDOW DW-Paint Window Dove White 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 9/30/2010 Contract-Detailed Paoe 1 of 8
Customer:Joanne Gibbons Project Name: WLK Gibbons,Joanne North Andover Order Number: 741 LK0245 Quote Number: 2018930
Atte
.Line# Location: ;
"butes
15 office Architect, Precision Hung Double Hung,33.5 X 49.25,White MY
1
1:Non-Standard Size Double Hung,Equal Split
Frame Size: 33 1/2 X 49 1/4
General Information: Style Edition,Clad,None
Exterior Color/Finish: Standard EnduraClad,White
Interior Color/Finish: Unfinished Interior
Glass: Insulated Low E Advanced Argon Gas
-- -- Hardware Options: Spoon Lock,None,White,No Sash Lift
Viewed From Exterior Screen: Full Screen,Inview
Frame Size:33.5"X 49.25" Grille: RMB,No,3/4",Traditional(3W2H/3W2H),Unfinished Wood,Unfinished Wood,Shipped In Unit
Wrapping Information: Perimeter Length=166",Glazing Pressure=100.
Aluminum Wrap-Full Wrap Windows or Doors Qty 1
PF—STD-Install Standard P-fit Qty 1
PAINT-WINDOW DW-Paint Window Dove White Qty 1
;Line# Location: Attributes -.177771
20 hail Architect, Precision Hung Double Hung, 33.5 X 49.25,White Qty
1
1:Nonstandard Size Double Hung,Equal Split
Frame Size: 33 1/2 X 49 1/4
General Information: Style Edition,Chad,None
Exterior Color/Finish: Standard EnduraClad,White
Interior Color/Finish: Unfinished Interior
Glass: Insulated Low E Advanced Argon Gas
-- M.5 ^— Hardware Options: Spoon Lock,None,White,No Sash Lift
Viewed From Exterior Screen: Full Screen,InView
Frame Size:33.5"X 49.25" Grille: RMB,No,3/4",Traditional(3W2H/3W2H),Unfinished Wood,Unfinished Wood,Shipped In Unit
Wrapping Information: Perimeter Length=166",Glazing Pressure=100.
Aluminum Wrap-Full Wrap Windows or Doors Qty 1
PF—STD-Install Standard P-fit Qty 1
PAINT-WINDOW DW-Paint Window Dove White QtY 1
For more information regarding the finishing,maintenance,service and warranty of all Pella®products,visit the Peila®website at www.pella.com
Printed on 9/30/2010 Contract-Detailed Page 2 of 8
Customer:Joanne Gibbons Project Name: WLK Gibbons,Joanne North Andover Order Number: 741 LK0245 Quote Number: 2018930
Attributes
Line.# Location:,
25 bath Architect, Precision Hung Double Hung,27.25 X 41.25,White Qty
1
1:Non-Standard Size Double Hung,Equal Split
Frame Size: 27 1/4 X 41 1/4
General Information: Style Edition,Clad,None
Exterior Color/Finish: Standard EnduraClad,White
Interior Color/Finish: Unfinished Interior
Glass: Insulated Tempered Low E Advanced Argon Gas
4 Hardware Options: Spoon Lock,None,White,No Sash Lift
Viewed From Exterior Screen: Full Screen,Inview
Frame Size:27.25"X 41.25" Grille: RMB,No,3/4",Traditional(3W2H/3W2H),Unfinished Wood,Unfinished Wood,Shipped In Unit
Wrapping Information: Perimeter Length=137',Glazing Pressure=205.
Aluminum Wrap-Full Wrap Windows or Doors Qty, 1
PF—STD-Install Standard 13-fit Qty 1
PAINT-WINDOW DW-Paint Window Dove White Qty, 1
Line# locatlon: .
Attributes
30 Jack's room Architect, Precision Hung Double Hung,33.5 X 49.25,White city
2
1:Nonstandard Size Double Hung,Equal Split
Frame Size: 33 1/2 X 49 1/4
General Information: Style Edition,Clad,None
Exterior Color/Finish: Standard EnduraClad,White
Interior Color/Finish: Unfinished Interior
Glass: Insulated Low E Advanced Argon Gas
-- -- Hardware Options: Spoon Lock,None,White,No Sash Lift
Viewed From Exterior Screen: Full Screen,Inview
Frame Size:33.5"X 49.25" Grille: RMB,No,3/4",Traditional(3W2H/3W2H),Unfinished Wood,Unfinished Wood,Shipped In Unit
Wrapping Information: Perimeter Length=166",Glazing Pressure=100.
Aluminum Wrap-Full Wrap Windows or Doors Qty 1
PF—STD-Install Standard P-fit Qty 1
PAINT-WINDOW DW-Paint Window Dove White 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 9/30/2010 Contract-Detailed Paae 3 of 8
Customer:Joanne Gibbons Project Name: WLK Gibbons,Joanne North Andover Order Number. 741LK0245 Quote Number: 2018930
' Une# Location: -:;
Attributes
35 living room Architect, Casement Fixed, 12.5 X 30.25,White,3-11/16" Qty
12
1:Nonstandard Size Fixed Casement
Frame Size: 12 1/2 X 30 1/4
General Information: Standard,Clad,Pine,None
Exterior Color/Finish: Standard EnduraClad,White
Interior Color/Finish: Unfinished Interior
Glass: Insulated Obscure Low E Advanced Argon Gas
Grille: ILT,No,7/8",Traditional(1W3H)
Viewed From Exterior Wrapping Information: 3-11/16"Factory Applied,Perimeter Length=86",Glazing Pressure=205.
Frame Size:12.5"X 30.25"
Final Wall Depth:3-11/16"
No Exterior Wrap-No Wrap Qty 1
PF Full Frame-Install Full Frame P-Fit Qty 1
Aluminum Wrap-Full Wrap Windows or Doors Qty 1
Thank You For Purchasing Pella® Products
PELLA WARRANTY:
Pella products are covered by Pella's limited warranties in effect at the time of sale.All applicable product warranties are incorporated into and become 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
For more information regarding the finishing,maintenance,service and warranty of all Pella®products,visit the Pella®website at www.pelia.com
Printed on 9/30/2010 Contract-Detailed Paoe 4 of 8
Customer:Joanne Gibbons Project Name: WLK Gibbons,Joanne North Andover Order Number: 741 LK0245 Quote Number: 2018930
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 followina:
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 Azek.Azek 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)
Clean up exterior casing issues due to storm window removal if full wrap or new exterior trim is not purchased
Product only addendum has been reviewed
For more information regarding the finishing,maintenance,service and warranty of all Pella®products,visit the Pella®website at www.pelia.com
Printed on 9/30/2010 Contract-Detailed Paae 5 of 8
Customer:Joanne Gibbons Project Name: WLK Gibbons,Joanne North Andover Order Number: 741 LK0245 Quote Number: 2018930
Project Checklist has been reviewed
Order Totals
k Taxable Subtotal $6,826.94
ret dard Approval Signature Sales Tax @ 6.25% $426.68
Non-taxable Subtotal $2,581.74
X IF 4 "lam Total $9,835.36
Customer Name (please print) Pella Sal s Rep Name (please print)
Deposit Received $4,917.68
Amount Due $4,917.68
e'ustotner Signature ales Rerp�Signat
i5L OU'C 2 �l O Iy ^Z — 0
Date Date
For more information regarding the finishing,maintenance,service and warranty of all Pella®products,visit the Pella®website at www.pella.com
Printed on 9/30/2010 Contract-Detailed Paae 6 of 8
Customer:Joanne Gibbons Project Name: WLK Gibbons,Joanne North Andover Order Number: 741 LK0245 Quote Number: 2018930
Lead Safe Installation Customer Performance Expectations
In order to ensure a proper Lead Safe Installation, it is essential that we have you complete the below tasks prior to your installation:
❑ ALL furniture needs to be moved at least 8 feet away from any window or door being replaced
❑ ALL personal items,wall hangings, and collectibles must be removed prior to your installation date
❑ All blinds and any interior window treatments need to be removed prior to your installation date
❑ Any non-movable furniture(for example: pianos, entertainment centers, built in cabinets, etc) must be cleared of items and be surface dusted prior
to installation
❑ You will be responsible for replacing all furniture and personal items after your installation
❑ Other items:
What to Expect the Containment/Work Area to Look Like
❑ In order to ensure your safety, we will be taking measures to minimize dust/debris does not spread beyond our work area. This may include the
use of plastic sheeting on the floors and/or walls, caution signs, sealing of heating and cooling air vents, and asking that you turn off your HVAC
system during our work.
❑ During your Lead Safe Installation, you may also see your installation professional wearing Personal Protection Equipment.
❑ For your own safety, we are not permitted to allow you inside the work area during the removal of your current product or the installation of your new
windows/doors.
By signing the form below, I am affirming that I understand all the expectations noted above and that I have agreed to have all items completed prior to
my installation commencing. I understand that failure to have these items completed will result in the re-scheduling of my installation and that my
installation date will be scheduled for the next available date.
)C pZ o cx -2x o
sto er Signature Date
For more information regarding the finishing,maintenance,service and warranty of all Pella®products,visit the Pella®website at www.pelia.com
Printed on 9/30/2010 Contract-Detailed Paae 7 of 8
Customer:Joanne Gibbons Project Name: WLK Gibbons,Joanne North Andover Order Number: 741 LK0245 Quote Number: 2018930
Pre-Renovation Form
Occupant Confirmation
Pamphlet Receipt
I have received a copy of the lead hazard information pamphlet informing me of the potential risk of lead hazard exposure from renovation activity to be
performed in my dwelling unit. I received this pamphlet before the work began.
Printed Name of Owner-occupant
Cat OcTQBM .1x o
nat re of Owner-occupant Signature Date
Renovator's Self Certification Option (for tenant-occupied dwellings only)
Instructions to Renovator-If the lead hazard information pamphlet was delivered but a tenant signature was not obtainable,you may check the appropriate box
below.
Declined - I certify that I have made a good faith effort to deliver the lead hazard information pamphlet to the rental dwelling unit listed below at the date
and time indicated and that the occupant declined to sign the confirmation of receipt. I further certify that I have left a copy of the pamphlet at the unit with
the occupant.
Unavailable for signature - I certify that I have made a good faith effort to deliver the lead hazard information pamphlet to the rental dwelling unit listed
below and that the occupant was unavailable to sign the confirmation of receipt. I further certify that I have left a copy of the pamphlet at the unit by
sliding it under the door or by:
(Fill in how pamphlet was left)
Printed Name of Person Certifying Delivery Attempted Delivery Date
Signature of Person Certifying Delivery
Unit Address
Note Regarding Mailing Option --As an alternative to delivery in person, you may mail the lead hazard information pamphlet to the owner and/or tenant.
Pamphlet must be mailed at least 7 days before renovation. Mailing must be documented by a certificate of mailing from the post office.
For more information regarding the finishing, maintenance,service and warranty of all Pella®products,visit the Pella®website at www.pella.com
Printed on 9/30/2010 Contract-Detailed Paoe 8 of 8
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 9. LIMITED PRODUCT WARRANTY
windows.
Pella shall warrant all Pella products,but only in accordance with the Pella
The Owner shall provide complete access to the work site between the hours Windows&Doors Limited Warranty.THIS LIMITED WARRANTY SHALL
of 7:00 a.m.and 6:00 p.m.(Monday 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 I& NO CONSEQUENTIAL DAMAGES
Contractors who will install the Products. R
Unless provided otherwise in the Work description,Pella will provide and pay IN DUCEU "OR SPE '
for all labor,materials,equipment,tools and machinery,transportation,and
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.
Pobld�igited to and will obtain the following permits for this project:
4. CHANGES t . Homeowners who secure their own permits will be
excluded from the 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
S. 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.
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
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. Cu 02 r signs re
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DISPUTES
Job Name[
Date ( ) -2-
THE
ZTHE CONTRACTOR AND THE HOMEOWNER HEREBY MUTUALLY AGREE IN
ADVANCE THAT IN THE EVENT PELLA HAS A DISPUTE CONCERNING THIS
CONTRACT, PELLA MAY SUBMIT SUCH DISPUTE TO A PRIVATE
ARBITRATION SERVICE WHICH HAS BEEN APPROVED BY THE SECRETARY
OF THE EXECUTIVE OFFICE OF CONSUMER AFFAIRS AND BUSINESS
REGULATIONS AND THE CONSUMER SHALL BE REQUIRED TO SUBMIT TO
SUCH ARBITRATION AS PROVIDED IN M.G.L.c. 142A
ractor
ome w er
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: y I A06Uy.,0
(Please print)
Date of transaction: _
r
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 (O (three business days from the date of
transaction above).
I hereby cancel this transaction.
(Date) (Buyer's signature)
i