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HomeMy WebLinkAboutBuilding Permit #039-13 - 41 BRUIN HILL ROAD 7/18/2012 BUILDING PERMIT of tAORT#i TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued: IWORTANT:Applicant must complete all items on this page n, om A 3" t_V"7-_t'K__ X96-AT nV.- ' :Net IRPROP WISIR F-2-0 ft—IN IST, ......------ TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building X One family Addition Two or more family Industrial Alteration No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition ..J -Other bodpidir! s ers wr; 41r a D_E1RIPTION OF WORK TO BE PREFORMED: eej 04 of &J_.T Identificatiqu '4lease Type or Print Flearly) OWNER: Name: 4e_ _ --_0 54 "Ikvvi Scm Phone: Address: 'z1_0e==M 24r, ct�a oewe 2V�' X 22 All; IN E on fTiR XN1Avi A H4 IN S 69' K4 A- Y t ,A'd 81 r 9 4 --a "f - -j ", Supervisor s�Chonstyruction`License , Exp ?_-,L`2,6 e. ARCHITECT/ENGINEER Phone: Address: -Reg. No. FEE SCHEDULE:BU I DING PERMIT.,$12.00 P�ER_��000XO OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. I �T Total Project Cost: —FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have ace YssZto the guaranty and , Signature, Aden r L dT Ow'her. -- Sidnature contractor . 0 N Location Lk No. 1 Date , • TOWN OF NORTH ANDOVER • St'13:r.vxng ' . e Certificate of Occupancy. $ Building/Frame Permit Fee $ lZ Foundation Permit Fee $ R rrt)"g Other Permit Fee $ TOTAL $ Check# Z1 25516 Building Inspector i J � t I Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning/Massage/Body Art Swimming Pools Well Tobacco Sales Food Packaging/Sales Private(septic tank,etc. X Permanent Dumpster on Site I 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 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 Town Engineer: Signature: Located 384 Osgood Street .F.IRE:DE-PARTMENT: :=Temp:Dbmpster on site: yes*. ono. ,._.. z `Loc afed �at - 124 ai` S- M n t�eet=• .17.1�p Departmentfsignature/date. 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) ® 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 A114 ❑ Engineering Affidavits for Engineered products X1/.4 N OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or. Decks ❑ BuildingPermit 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) ( PP ) ❑ Mass check Energy Compliance Report (If Applicable) ® Engineering Affidavits for Engineered products d OTE: 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 10TE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then.get this recorded at the Registry of Deeds. One copy and proof of recording ]must be submitted with the building application Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2008 NORTH TO-wn of t ndover No. 3 -- h ver Mass, o LCHE 1, 7 COC NIC N.WICK S V BOARD OF HEALTH Food/Kitchen - PER IT D Septic System THIS CERTIFIES THAT ...... ... .10.. .. ...... ..... ............................................................. BUILDING INSPECTOR % 14 . Foundation has permission to er t .......................... buildings on .. . .....Saw..... I.... ,.. Rough to be occupied as ..94'9' 4'9' ..Sta .. . . . %.,... . , .... .. Chimney provided that the person accepting this permit shall In very respell conform to the terms o 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 MIGNTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTI R = Rough Service .............. ................................................................ Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. SEE REVERSE SIDE ------rte----- .•,� ,. , . . 1t.d:.,.a. u, tts Dc )�i.i-Wier ii of Tul)Hc 51:" Board ot• Buildin- Re-ulutions.and Standar -ts Construction Supervisor License Liceins?, CS 73301 MANUEL M -SOUSA 9 OTIS RD JIMT15. BEVERLY, MA 01.915 t Expiration; 11/25/2012 d', .mita,per Tr#: 7859 Version 8.12 INTEGRITY QUOTE 05/24/12 *** CAUTION: IT IS RECOMMENDED THAT A MINIMUM OF 1/4 INCH BE ADDED *** *** TO THE ROUGH OPENING HEIGHT WHEN USING MARVIN SILLGUARD *** x** UNIT AVAILABILITY AND PRICE SUBJECT TO CHANGE *** *** NET PRICE (in USD) *** PROJECT: BONNIE WILKINSON QUOTE: 00000001 '•`,` QTY: 2 MARK UNIT - TAT fid& 'Bid� b9+ORS I TDH 280.80 561.60 WOOD - ULTREX SERIES CN 3056 Ro 30 1/2" X 56 1/4" IG - 1 LITE LoE-366 W/ARGON 12.96 25.92 WH SASH LOCK 0.00 0.00 SCREEN 15.12 30.24 STONE WHITE SURROUND 0.00 0.00 CHARCOAL FIBERGLASS MESH 0.00 0.00 NAILING FIN 0.00 0.00 4 9/16" JAMBS 0.00 0.00 WHITE INTERIOR 36.72 73.44 STONE WHITE EXTERIOR 0.00 0.00 I TOTAL NET PRICE 345.60 691.20 v v AS VIEWED FROM THE EXTERIOR QUOTE: 00000002 QTY: 3 MARK UNIT -BATHS AND BASEMENT I TDH 236.16 708.48 WOOD - ULTREX SERIES CN 3040 RO 30 1/2" X 40 1/4" IG - 1 LITE LoE-366 W/ARGON 9.36 28.08 WH SASH LOCK 0.00 0.00 SCREEN 12.96 38.88 STONE WHITE SURROUND 0.00 0.00 CHARCOAL FIBERGLASS MESH 0.00 0.00 NAILING FIN 0.00 0.00 4 9/16" JAMBS 0.00 0.00 t+rHITE INTERIOR 36.72 110.16 STONE WHITE EXTERIOR 0.00 0.00 TOTAL NET PRICE 295.20 `� 885.60 QUOTE CONTINUED ON NEXT PAGE. r i Office of Consumer Affairs and Business Regulation k Par <` 10- Plaza_ Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Reqistration: 15 9 i Type: di idua MANUEL SOUSA Expiration: 5/9/2013 Tru 214411 MANUEL SOUSA 9 OTIS ROAD UNIT 15 BEVERLY, MA 01915 Update Address and return card.Mark reason for change. i DPS-CAI Co 50M-04/04-G101216 [ J Address Renewal J._J Employment Lost Card - _j u/f� l�(lOII/ilIIII !•,f ,(j,Jdlll.(flG1P. .t2 Office o �onsumer' a�is 'Biness egu anon License or registration valid for individul use only HOME IMPROVEMENT ONTRACTOR before the expiration date. If found return to: Re9istrationr55795� 1 Type: Office of Consumer Affairs and Business Regulation Expiration: 5/9!2013 Individual 10 Park Plaza-Suite 5170 \ EL SOUSA Boston,MA 02116 MAiVlt MANUEL SOUSA 9 OTIS ROAD UNIT 15 BEVERLY,MA 01915 � `� / ' "�'. �^e 1 .. Undersecretary^ Not valid without signature _ I Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE revised 5-26-05 Fax#617-727-7749 www.mass.gov/dia a *: h� zZ A Moynihan Lumber Co. 1 ' 82 River Rd t Beverly MA 01915 978 927 0032 4.1 j Customer: Project: BONNIE WILKINSON Salesperson: STEVE BLACK PO: Comments: Item: 0001 Reference: Manufacturer: Brosco Exterior Doors Quantity: RO Size=4'6" x 6' 10 1/2" Lead Time: Stock Material Product Category=Entry Doors;Product Configuration=Single Door Unit with Single Sidelight;Door Thickness= 3/4";Door Material=Fiberglass;Product Type=Decorative Glass Doors;Sidelight Product Type=Decorative Glass Doors;Door Family=Smooth Pro;Frame Configuration=Frame With Posts;Handing=Right Hand- +, , Stationary Inswing;Sidelight Position=Sidelight On Knob Side,Door Size=,0"x 6'8"W/=1'2"x 6'8' Sidelight(s);Door Panel Layout=Full Lite;Door Insert Design=Bristol;Door aming options=-atin Nickel; Model Number=SP686BT;Sidelight Panel Layout=Full Lite;Sidelight Insert Design=Bristol;Sidelight Canting Options=Satin Nickel;Sidelight Model Number=SP690BT;Jamb Species=Finger-Jointed Primed;Jamb Type: Framesaver;Jamb Width=49/16";Weatherstrip Option=Bronze Compression;Bore Option=Standard 2 3/8" Double Bore;Deadbolt Jamb Prep=Prep Jamb for Deadbolt;Bore Back Set=2 3/8";Hinge Radius=5/8" Square/Radius;Hinge Option=Plain Bearing;Hinge Prep=3-Hinge Prep;Hinge Size=4"x4";Hinge Finish= I Bright Brass Plated(US-3);Sill=Aluminum Sill Bronze Finish;Exterior Casing Type=No Casing;Sill Hom Lengti =3 112" 21 "Image shown as seen from outside** **All Brosco setup door units have specific overhang requirements to qualify for the manufacturer's warranty.Please see www.brosco.com for more Information.— Comments: Item Total: $ 1825.3: Is's t' Total: $ 18253 Item: 0002 Reference: Manufacturer. Larson Storm Doors by Brosco Quantity: Door Size=36"x 81" Lead Time: Stock Material Product Category=Storm Doors:Product Layout=Full View Storm Doors;Unit Type=Classic View;Door Layout =Full View Door w/Interchangeable Screen;Door Material Type=Aluminum Frame;Door Thickness=1 1/4*; " Frame Color=White;Glass Option=Clear Glass;Hardware Finish=Brushed Nickel;Model Number=350-17; -` Custom Size=No;Door Width=36";Door Height=81" I I 3 1 f Comments: Item Total: $ 236.88 Item Quantity Total: $ 236.88 Quote to: 44 1 Of 2 06/08/2012 Version: 2.9.6.12.0.3 35HIP TICKET � I{II{Iilllllllllllllllllllllllllllllllll OYNIHAN BEVERLY LUMBER Ord#: 161453.0 0 BOX 509 2 RIVER ST Router CITY i EVERLY, MA 01915p' ���®� Page 1 of 2 �yy��,`` hone: (978) 927-0032 O N AN W ax,: (978) 927-8201 Order: 06/11/12 o: COD240 Ship To: Sched: 06/05/12 ASH SALES/STEVE BLACK BONNIE WILKINSON 41 BRUIN HILL AVE - Printed -NORTH ANDOVER Date: 06/27/12 Time: 05:00 PM FOB: DLVD Entd By:. SB56 Via: CUSTOMER PICK UP Contact: Phone: Type: WHSE in: 09 C Out: 56- Terms: CASH 2% Your Order: WILKINSON Customer Instructions Net Line # Item Number Quantity Description Net Price Extended 0001,00 : L 1.00. EA 5/4X6X20 AZEK SQUARE EDGE 128.00 E 128.00 CORNER 0002.00 1818TT 2.00 .EA 1X8-18' TRIM TEC ( AZEK ) 51.27 E 102.54 PVC TRIMBOARD SOLD IN 18' PC 0003.00 1518TT 1.00 EA 1X5-18' TRIM TEC ( AZEK ) 32.90 E 32.90 PVC TRIMBOARD SOLD IN 18' PC. 0004,.00 WSV 5.00 -EA 2"X8' WHITE SOFFIT VENT ALUM 4.53 E 22.65 DOUBLE FLANGE 0005.00 1518TT 4.00 EA, 1X5-18' TRIM TEC ( AZEK ) 32.90. E 131.60 PVC TRIMBOARD SOLD IN 18' PC 0006.00: 11018TT 2.00 EA 1X10-18' TRIM TEC ( AZEK ) 65.10 E 130.20 PVC TRIMBOARD SOLD IN 18' PC 0007.00 1318TT 3.00 EA 1X3-18" TRIM TEC (AZEK) 20.75 E 62.25 SOLD AS 18' LENGTHS ONLY 0008:00 :STRAIGHTFLASH6 1.00 RO TYVEK STRAIGHTFLASH FLASH VF 120.00 E 120.00 TAPE-6" X 125 ROLL 0009,00 '11810WFW ' b.00 PC 1-1/8".220" WINDOW FLASHING 3.66 E 21.96 WHITE 0010:00 : 23WCP 3.00 EA 2X3 WHITE"ALUMINUM. COND PIPE 14.10 E 42.31 10' PS23W STANDARD *HIP TICKET 1111111111111111111 IN OYNIHAN BEVERLY LUMBER Ord#: 164453.0 O BOX 509 2 RIVER ST Route: -CITY EVERLY, MA 01915i�MOM AAp� Page: 2 of 2 MOMM N hone: (978) 927-0032 ax: (978) 927-8201 Order: 06/11/12 o: `COD240 Ship To: Sched: 06/05/12 ASH SALES/STEVE BLACK BONNIE WILKINSON 41 BRUIN HILL AVE Printed NORTH ANDOVER Date: 06/27/12 Time: 05:00 PM FOB.: DLVD Entd By: SB56 Via: CUSTOMER PICK UP Contact: Phone: Type: WHSE In: 09 / Out: 56 Terms: CASH 2% Your Order:: WILKINSON Net Line # Item Number Quantity Description Net Price Extended 0011.00 WCLEAT6,00 EA GUTTER.DOWN PIPE CLEAT 0.7.0 E 4.18 WHITE PCW 0012:00 . 21-012 "35.00 EA HIDDEN HANGER W/SCREW 5" 1.97 E 68.95 BERGER 32-120 0013,.00 23WAELA 3.00 EA 2X3 WHITE ALUM ELBOW. A- 1.63 E 4.90 FRONT BEND 0014.00 5214STSW 1.00 EA 5LB 2-1/4" STAINLESS TRIM 79.08 E 79.08 SCREWS WHITE HEAD HT#5W 0.015.00 046959 2.00 ..EA SWAN COIL WIRE SIDING 2" WHITE 88.87 E 177:.74 STAINLESS RING 6D 120OCT 0016.00. 12231 4.00 EA GE II SILICONE CLEAR .7.49 E 29.96 GE5000 0017.00 WM8710PFJ 256.00 LN 11/16X2-1/2 PFJ COL CAS-8710PJ 0.50 E 128.00 Tally (Qty/Len): 16/16 0018.00 14POP 26.00 LN 1X4 SE POPLAR KD C+BTR 0.99 E 25.74 Tally (Qty/Len): 1112, 1/14 0019.00 54420TT 1.00 EA 5/44- 20' TRIM TEC ( AZEK ) .35.10 E 35.10 PVC TRIMBOARD SOLD IN 20' PC 0020.00 L 170.00 EA CERTAINTEED TEXTURED SIDING. '7.18 E 1:220.60 5 1/4" SILVERPLATE:170/12 0025.00 48547 :.1.00 EA DEFLECTO DRYER VENT KIT 415' 12.99 E 12.99 LOUVERED WHITE HOOD`ACSK5WF *Return Policy:All returns must be accompanied by an invoice: Returns must be made with n 30 days of receipt of goods. There Merchandise.. . : 2.581:.65 : will be no return on special ordered or assembled goods. All returns are subject to a handling charge and must be in saleable condition. Tax.. . . . . . . . ... : 161.35 *TERMS:2/10 net 25. Finance.charge after 30 days on unpaid balance. 1.5%per month or i8%annual percentage rate. Ml SG Charges. . : 0.00 *Customer Acceptance Policy I have verified quantity,description and condition of goods to be acceptable. I understand 1 have 48 hours to report any concealed shortages or damages to Moynihan Lumber byphone or In writing Order Total. . . : .2.743.00 ACCEPTED BY: LeSS. Deposit.. . 0.00. Discount. . . .: . : 51.63 Balance Due. 2 6.91.37 Version 8.12 INTEGRITY QUOTE 05/24/12 *** CAUTION: IT IS RECOMMENDED THAT A MINIMUM OF 1/4 INCH BE ADDED *** ** TO THE ROUGH OPENING HEIGHT WHEN USING MARVIN SILLGUARD *** *** UNIT AVAILABILITY AND PRICE SUBJECT TO CHANGE *** *** NET PRICE tin USD) *** PAGE 3 PROJECT: BONNIE WILKINSON i Lai AS VIEWED FROM THE EXTERIOR QUOTE: 00000005 QTY: 2 MARK UNIT - FIRST FLOOR NEW OPENINGS RO 60" X 56 1/4" - 2W1H 0.00 0.00 "Al I TDH 280.80 561.60 WOOD - ULTREX SERIES CN 3056 IG - 1 LITE LOE-366 W`/ARGON 12.96 25.92 WH SASH LOCK 0.00 0.00 SCREEN 15.12 30.24 STONE WHITE SURROUND 0.00 0.00 CHARCOAL FIBERGLASS MESH 0.00 0.00 **A2 I TDH 280.80 561.60 WOOD - ULTREX SERIES CN 3056 IG - 1 LITE LoE-366 W/ARGON 12.96 25.92 WH SASH LOCK 0.00 0.00 SCREEN 15.12 30.24 STONE WHITE SURROUND 0.00 0.00 CHARCOAL FIBERGLASS MESH 0.00 0.00 NAILING FIN 0.00 0.00 4 9/16" JAMBS 0.00 0.00 WHITE INTERIOR 73.44 146.88 STONE WHITE EXTERIOR 0.00 % 0.00 TOTAL NET PRICE 691.20 ` 1,382.40 v v 0 0 AS VIEWED FROM THE EXTERIOR " SUB TOTAL: 4, 024.80 6.250% SALES TAX: 251.55 j r / �' PROJECT TOTAL NET PRICE: 4,27 6.35 Version 8.12 INTEGRITY QUOTE 05/24/12 *** CAUTION: IT IS RECOMMENDED THAT A MINIMUM OF 1/4 INCH BE ADDED *xx *** TO THE ROUGH OPENING HEIGHT WHEN USING MARVIN SILLGUARD *** *** UNIT AVAILABILITY AND PRICE SUBJECT TO CHANGE *** x** NET PRICE (in USD) *** PAGE 2 PROJECT: BONNIE WILKINSON 0 AS VIEWED FROM THE EXTERIOR QUOTE: 00000003 QTY: 2 MARK UNIT - BATHS AND-BASE-ME-NT I TDH 236.16 472.32 FLOOD - ULTREX SERIES CN 3040 RO 30 1/2" X 40 1/4" IG - 1 LITE TEMP LoE-366 W/ARGON 81.36 162.72 WH SASH LOCK 0.00 0.00 SCREEN 12.96 25.92 STONE WHITE SURROUND 0.00 0.00 CHARCOAL FIBERGLASS MESH 0.00 0.00 NAILING FIN 0.00 0.00 4 9/16" JAMBS 0.00 0.00 WHITE INTERIOR 36.72 73.44 STONE WHITE EXTERIOR 0.00 / 0.00 TOTAL NET PRICE 367.20 '1 734.40 0 AS VIEWED FROM THE EXTERIOR QUOTE: 00000004 QTY: 1 MARK UNIT - KITCHEN I TDH 270.00 WOOD - ULTREX SERIES CN 3840 RO 38 1/2" X 40 1/4" IG - 1 LITE L•oE-366 W/ARGON 11.52 WH SASH LOCK 0.00 SCREEN 12.96 STONE WHITE SURROUND 0.00 CHARCOAL FIBERGLASS MESH 0.00 NAILING FIN 0.00 4 9/16" JAMBS 0.00 WHITE INTERIOR 36.72 STONE WHITE EXTERIOR 0.00 TOTAL NET PRICE 331.20 QUOTE CONTINUED ON NEXT PAGE. Massachusetts Rome Improvement Sam' ple Contract This form satisfies all basic requirements of the state's Home Improvement Contractor Law(MGL chapter 142A),but does not include standard language to protect homeowners. SeeIc legal advice if necessary. Any person planning home improvements should first obtain a copy of"A Massachusetts Consumer Guide to Home Improvement"before agreeing to any work on your residence.You may obtain a free copy by calling the Office of Consumer Affairs and Business Regulation's Consumer information Hotline at 617-973-8787 or 1-888-283-3157 or on our website. Homeowner Information Contractor Information Name - Company Name t ee- V, �� Rd 0�(W . . Street Address(do not use a Post Office Box a ress) Contractor/Salesperson/Owner Name c( S Ci /1'own �- n' State Zip Code Usines;Address(must include a street address) /Z v� /•�/j,4 0/L? 0__14;s dep /16 a� ay ime shone Evening Phone City own State Zip Code Mailing Address(It different from above) Business Phone Federal Employer ID or S.S.Number Law requires that most home Home Improvement Contractor Reg:Number Expiration date improvement contractors have n valid registration number ^ The Contractor agrees to do the following work for the Homeowner: / J ✓[ (Describe in detail the work to completed,specifying the type,brand,and grade of materials to be used,use additional sheets if necessary,) Required Permits-The following building permits are required Proposed Start and Completion Schedule-The following schedule will and will be secured by the.contractor as-the homeowner's agent: be adhered to unless circumstances beyond the contractor's control arise (Owners who secure their oven permits will be excluded from the Guaranty Fund provisions of X Date when contractor will begin contracted work. MGL chapter 142A.) ALU Date when contracted work will be substantially completed. Total Contract Price and Payment Schedule Gil_�The Contractor agrees to perform the work,furnish the material and labor specified above for the total sum of: // Ale o,s rnc� n6G����tolh, r►Z.a�G�G.��(S j Blo �D,L6 o.0 AS . �Xaymems will be m 'ae accorllowing schedule: rw� F, °7a $ upon signing contract(not to exceed 1/3 of the total contract price or the cost of special order items,whichever is greater) $ by _/ / or upon completion of $ by or upon completion of 00, upon completion of the contract. (Law forbids demanding full payment until contract is completed to both party's satisfaction) . The following material/equipment must be special $ to beaid for ordered before the contracted work begins in order p to meet the completion schedule.(**) $ to be paid for NOTES:(*)laacluding ail finance charges('r*)Law requires that any deposit or down-payment required by the contractor before work begins may not exceed the greater of (a)one-third of the total contract price or(b)the actual cost of any special equipment or custom made material which must be special ordered in advance to meet the completion schedule. E% ress warranty-Is an express warranty bein rovided by the contractor? ❑No 'Yes all terms of the warranty must be attached to the contract Subcontractors-The contractor agrees to be solely responsible for completion of the work described regardless of the actions of any third party/subcontractor utilized by the contractor The contractor further agrees to be solely responsible for all payments to all subcontractors for materials and labor under this agreement Z 4,_4XW Contract Acceptance-Upon signing,p p this docu ent becomes� g, b omes a ' _ binding contract oder law. Unless otherwise noted within ' contrac,shall not imply that any lien or other securitythis document,the interest has been placed on the residence. Review carefullybefore signing ew the following cautions and notices going this contract. 0 Don't be pressured into signing the contract.Take time to read and fully understand it. Ask questions if something is unclear., e Make sure the contractor has a valid Home Improvement Contractor Re 'stration. The law requires most home improvement contractors and subcontractors to be registered with the Director of Home Improvement Contractor Registration. You may inquire about contractor registration by writing to the Director at 10 Park Plaza,Room 5170,Boston,Na 02116 or by calling 617-973-8787 or 888-283-3757. o Does the ccn:'actor have insuraBCe? Asir the Contractor for l:is ins'urante Company information so that you can confirm coverage,or ask to see a copy of a"proof of insurance"document. O Know your rights and responsibilities. Read the Important Information on the reverse side of this form and Guide a co Guide to the Home Improvement Contractor Law. g py of the Consumer You may cancel this agreement if it has been signed at a place other than the contractor's normal place of business,provided you notify the contractor in writing at his/her main office or branch office b ordinary third business da following the signing agreement. m�'y mail posted,by telegram sent or by deliver,not later than midnight of the Y g gnin of this a eement. See the attached notice of cancellation form for an explanation of this right. DO IiNOYSfCN THIS CONTRACT IF TB ERE ARE ANY BLANK SPACES!!! o identical copies of the contract must be completed and signed. One copy should go to the homeowner. The o r copy should be kept by the contractor. omeowner's Signature ntractor's ignature rr's q 'Date / la� Dae Contractor Arbitration The Home Improvement Contractor Law provides homeowners with the right to initiate an arbitration action(as an alternative to court action)if they have a dispute with a contractor. The same right is not automatically afforded to a contractor,however. The contractor would have to resolve any dispute he/she has with a homeownerin court unless both parties agree to the optional clause provided below. This clause would give the contractor the same right to arbitration as is afforded to the homeowner by the Home Improvement Contractor Law. The contractor and the homeowner hereby mutually agree in advance that in the event the contractor has a dispute concerning this contract,the contractor may submit the dispute to a private arbitration firm which has been approved by the Secretary of the Executive Office of Consumer Affairs and Business Regulation and the consumer shall be required to submit to such arbitration as provided In Massachusetts General Laws, chapter 142A.. Homeowner's Signat<zre Contractor's Signature NOTICE: The signatures of the parties above apply only-to the agreement of the parties to alternative dispute resolution initiated by the contractor: The homeowner may initiate alternative dispute resolution even where this section is not separately signed by the parties. Homeowner's Rights A homeowner's rights under the Home Improvement Contractor Law(MGL chapter 142A) and other consumer protection laws (i.e.MGL chapter 93A)may not be waived in any way, even by agreement. However,homeowners may be excluded from certain rights if the contractor they choose is not properly registered as prescribed by law. Homeowners who secure their own building permits are automatically excluded from all Guaranty Fund provisions of the Home Improvement Contractor Law. The contractor is responsible for completing the work as described, in a timely and workmanlike manner. Homeowners may be entitled to other specific legal rights if the contractor guarantees or provides an express warranty for workmanship or materials. In addition to guarantees or warranties provided by the contractor, all goods sold in Massachusetts carry an implied warranty of merchantability and fitness for a particular purpose. An enumeration of other matters on which the homeowner and contractor lawfully agree may be added to the terms of the contract as long as they do not restrict a homeowner's basic consumer rights. If you have questions about your consumer/homeowner rights, contact the Consumer Information Hotline(listed below). • 1 Execution of Contract The contract must be executed in duplicate and should not be signed until a copy of all exhibits and referenced doc-uments have been attached. Parties are also advised not to sign the document until all blank sections have been filled in or marked as void, deleted, or not applicable. One original signed copy of the contract with attachments is to be given to the owner and the other kept by the contractor. Any modification to the original contract must be in writing and agreed to by both parties. Contracted work may not begin until both parties have received a fully executed copy of the contract, and the three day rescission period has expired. Accelerated Payments A contractor may not demand payments in advance of the dates specified on the payment schedule in cases where the homeowner deems him/herself to be financially insecure. However,in instances where a contractor deems him/herself to be financially insecure,the contractor may require that the balance of funds not yet due be placed in a joint escrow account as a prerequisite to continuing the contracted work. Withdrawal of Rinds from said account would require the signatures of both parties. , Additional Information If you have general questions or need additional information about the Home Imp rovement Contractor Law or other consiuner rights, or if you wish t 11 g y sl o obtain a free co of A Massachusetts Consumer Guide to Home Izn •ove e t copy Improvement" n contact: p Consumer Information Hotline Office of Consumer Affairs and Business Regulation 10 Park Plaza,Room 5170,Boston,MA 02116 617-973-8787, 888-283-3757 or visit the OCABR website at hitt.://vmNv.mass.gov/ocabr/ If you want to verify the registration of a contractor or if you have questions or need additional information specifically about the contractor registration component of the Home Improvement Contractor Law, contact: Director of Home Improvement Contractor Registration Office of Consumer Affairs and Business Regulation 10 Park Plaza,Room 5170,Boston,MA 02116 617-973-8787, 888-283-3757 or visit the HIC website at litt-o://www.mass.gov/ocabr/ Go online to view the status of a Home Improvement Contractor's Registration: hll)://db.state.ma.us/tiomei=rovement/licenseelist asp For assistance with informal mediation of disputes or to register formal complaints against a business, call: Consumer Complaint Section Office of the Attorney General 617-727-8400 AND/OR Better Business Bureau 508-652;4800, 508-755-2548 or 413-734-3114 Version 2.1-11/22/2010 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 M Name(Business/Organization/Individual): GL6� li�G/�_ '50(e &_ Address: D Q City/State/Zip: U aej V 4 j Phone#: //7— 6 v?:f Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction p1loyees(full and/or part-time).* have hired the sub-contractors emodeling 2. I am a sole proprietor or partner- listed on the attached sheet. ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers'comp.insurance. 9. ❑Building addition [No workers' comp.insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself. [No workers'comp. c. 152,§1(4),and we have no 12.❑Roof repairs insurance required.]t employees. [No workers' 13.❑ Other comp.insurance required.] `Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. 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 their workers'comp,policy information. am an employer that isproviding workers'compensation insurance for my employees. Below is thepo/icy and job site nformation. e nsurance Company Name: 'olicy#or Self-ins.Lic.#: �� �i0 Q l Z2 Sr!p L:2 9 Expiration Date: ob Site Address: 7/ F/LCL c'►il c City/State/Zip: !„nd G. �cJ ti-e-lC! `(/t kttach a copy of the workers'compensation policy declaration page(showing the policy number -and texpiration date). Iailure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a ine 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 f up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of ivestigations of the DIA for insurance coverage verification. do hereby certify under the pains andp nalties ofperjuty that the information provided above is true and correct. i na a D te: hone#: 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#: vui. e..r4.V♦v 141V11 a 64niL. .JIVI I I�IJc!'Y LJOL60. II LU/ GV1G 1V . L± HPl YGLr2C. G V1 J SOUSMA1 OP ID: SR A.ICORO" DIYYYY) (MMID E CERTIFICATE OF LIABILITY INSURANCE DAT (MMID12 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER 978-777-9394 CONTACT Steve RICK Dan Hurley Insurance Agency PHONE X Chestnut Green, Suite 24 978-777-3306 Arc No Ext):978-777-9394 Alc No: 978-777-3306 Seven Federal Street a oRlE Danvers,MA 01923-3620 ss:srich@hurleyinsurance.com Daniel J Hurley INSURER(S)AFFORDING COVERAGE NAIC q INSURER A:Preferred Mutual 15024 INSURED Manuel Sousa INSURER B:Atlantic Charter 9 Otis Road -Unit 15 Beverly, MA 01915 INSURER C: INSURER D: INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: 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. ILTR TYPE OF INSURANCEAIJULISUbil POLICY FF POLICY EX NSR WVD POLICY NUMBER MMIDDIYYY MMIDDIYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CPP0100604459 09/07/11 09/07/12AMA TO RE PREMISES Ile occurrence $ 100,000 CLAIMS-MADE Fx__1 OCCUR MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY PRO- CT LOC $ AUTOMOBILE LIABILITY Ea COMBLIMIT $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY Per accident $ AUTOS AUTOS ( ) HIRED AUTOS NON-OWNED PROPERTY DAMAGE AUTOS Per accident $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION X I WCSTATU- OTH- AND EMPLOYERS'LIABILITY TS E B ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N CV00990500 02/23/12 02/23/13 E.L.EACH ACCIDENT $ 100,000 OFFICER/MEMBER EXCLUDED? N I A (Mandatory in NH) SEE NOTES E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS 1 VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) As per policies. Re: Bonnie Wilkerson 41 Bruin Hill Road CERTIFICATE HOLDER CANCELLATION TOWNNOA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of North Andover ACCORDANCE WITH THE POLICY PROVISIONS. 1600 Osgood Street N.Andover, MA 01845 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD VILL• VVV♦V LY1VL1 LW(11✓ •VIVIIIVVV ✓WVV• 1 / 1V/ LV1L 1V • 1Z l-LL1 �WtjV • V V1 V SOUSMA1 PAGE 2 .NOTEPAD INSURED•SNAME Manuel Sousa OP ID: SR DATE 07/18/12 1 s required by Massachusetts Workers Compensation Rating and Inspection Bureau: All requests for (workers' compensation) Certificates of Insurance must be submitted to the servicing carrier or voluntary direct assignment carrier. A request has been faxed to Insurer B named on page 1. nits Deh:i.rfnsicit'tit' "ulilic Board of Building Re!"lations..ind Stanch, Is Construction Supervisor L"icense Licens? cs 73301 MANUEL M •SOUSA.' 9 OTIS RD jNIT15; 13EVERLY, MA 01-915 F Expiration:. 11/25/2012 <'. ,roii�si per Tr#: 7859 SUBMITTED BY: SUBTOTAL: $ 2062.2, ACCEPTED BY: Lt C_ TAXES( 6.25 %): $ 128.85 DATE: t j�: - M GRAND TOTAL: $ 2191.1E Please verify all product specifications prior to ordering. This quote is valid for 30 days. I understand that this order will be placed according to these specifications and is non-refundable. ADDITIONAL INFORMATION: Quote ID: 44 2 Of 2 06/0812012 Version: 2.9.8.12.0.3