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Building Permit #287-16 - 458 WAVERLY ROAD 9/4/2015
seraww,c � �S� BUILDING PERMIT of NORTy q TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION ` Permit No#: O �Q Date Received r / .SSgCHt15B Date Issued: I RTANT Applicant must complete all items on this page -. r a,.-J -i `l rl " s ' '•�5 t f, �;�.yr 1'r„aiy rj '� .�J} k �r � G r�1 ,+ �a� > },1i�! q •� e A ' ''t, i w�7��t ,1ti'n w}i.�`� I {:;, {.�i A S` /►J :lit a 1..: '. .s+rrdY t.,r i ui {a,s i.r ( - r t [4 �-.„ �`R,. `�.,k.�a ! L i"`'r°�•` E sa'2 Z %,+'�•C ra-S.7rY fr}*rT`51'x.'^s'+N-i--e!y^-•.e.�^.tJ' ^•�.�w C'±"?, f �. r �n{•a +°XveyS�'+�:�r�+y>>.<�� J'r:�s ye tr J .. F A' R8 J�a's frr�. n'-� Lr' tt rrti,�� �•`,+?"'s�E�. ,,xraw,+-..� r.{ r .�� ,! � ��,.��ST{ 'fir ,,r� x' rtY [`'ti 4A#a^��r . . PROlI?ERrT�Y�®1NNERj r r S i tAA �s F I t ry1 .os 2 �Qo Year tfUCt e y{ r W,75 M,AP yr til .r a4 � �. � xRARCEL �ZONING,.DISTRI'CT �rHistoncDistnct � r =F.ye�s� o / 7 ! t ', P ! �5p } 1 r ;FM �=,C.�� F e�-•.R �� [.fi. 'NT.. -�agd t S_pp�yVillagp yes '' n TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building One family ❑Addition I wo or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial repair, replacement 0 Assessory Bldg ❑ Others: ❑ Demolition ❑,Other d Septic' dWell� E 04FLoodplani ”"efl"ands� � 0 V�latersfie�d4Dts 4 �� _.i. r hr_ Y r DESCRIPTION OF WORK TO BE PERFORMED: L,1 �aNydw S � �IIdentification- Please Type or Print Clearly OWNER: Name: C6<-,S L.-,,©c>io Phone: 1"ZS-•74'.&S5 S' Address: SS WAyeki.€ ` � �-.�o ?-a` � r.• a �s.- � 'f Oji .1 ,.,.� '! �� r t 3n 6/ A yi ,-e I '�w _A X.YL� n r ContraNfame r rr r 1 :Phones 7 cto . � � h' �r .c.', i'"'+..:? y ,� M ,t-?z^' r r F 4; h•t4 r �T R+.'iy t # �N i x.. .'.. _f. %'- mt"��_ .,y�,'- �--,rl•n�.�,a - r -•• r n. �•p . g/� � g. r�7 ]tV_ga4 m {-'L"rr�}��ti« "•mss.-..j Rrt^ T.r..re. -,� .� ;: rAdtlress7 ] 7 rVIVA Es3�Za9 Ff%1� 4�WHr �`O G $wlt+iFA. 'r< r+''< � i F !•:. a .fir,r A l:C',' k _ f •.., f;•}. aF 7 .Y r �r � � {t � r 1 •^ w xii r Y X r.r i t a c a � 'd.,;e-✓*S!i f+'i":}1j.� 1X`L+iy�''"t`�{�' -. "�r r�f<i -�.�,,+i �1 s I f' a - A` p.•+� i y - �; E�Supervisor�s onstructionLicense� '° ptt� -:� r x:r` '�� .r �•r r`t 1 �� ,may �_. '�I r V.A t� _ F f�� F ➢� t �. .ry .''R�'*it � fif z�r� ��, it'r,.' �. t-. (e ,� t � ;,}•a t x � � t ! 1 ,._,y : 1 :. t C tY-. r d f + f � t r Ik`x iHome Improvem`entLicense ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ FEE: $_ Check No.: tom Receipt No.: CQJ NOTE: Persons contracts g with unregistered contractors do not have access to the guaranty fund -�[. Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF m U FORM PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS CONSERVATION Reviewed on Signature � I COMMENTS t HEALTH Reviewed on Signature s 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 FIRE DEPARfTMENT -Temp Dempster on sit- yes no Located at 1x24 Main Street Fire Departmen RR . ature/date 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) El Notified for pickup Call Email Date Time Contact Name Doc.Buildinb Permit Revised 2014 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 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 OTE: 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 46 Photo Copy of H.I.C. And C.S.L. Licenses Copy Of Contract Floor/Cross Section/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 OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New ConstructionSin le and Two Family) � g Y) 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 2012 IECC Energy code Engineering Affidavits for Engineered products OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg. Permit I 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:Building Permit Revised 2014 Location No. r / Date . - TOWN OF NORTH ANDOVER. . 9 i& . Certificate of Occupancy $� Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee TOTAL $ Check# r `. °� (1 Building Inspector 3- 2'9301. ....- NORTH - . w: .. . � E ver a tit h ti ver, Mass, COCMICHI'WICK A0R�reo S U . .. BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System THIS CERTIFIES THAT C . //�,�. , BUILDING INSPECTOR ........... ...... ......... .. ........................................ .......Ai Foundation has permission to erect .......................... buildings on ......... ,�...... ......... ... .... .... . • Rough to be occupied as .....Pna)pting ..... ... ......... .. ...... � ... ................. Chimney provided that the pers this permit shall in eve 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 p ONTHS ELECTRICAL INSPECTOR UNLESS. CONSTRUCTI Rough Service .............. ........ ........................................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Reguired to Occupy Building Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. Contract - Detailed Pella Window and Door Showroom of Haverhill S�ZS Sales Rep Name: Clancy, Ryan 45 Fondi Road Sales Rep Phone: 978-373-2500 Haverhill, MA 01832 Sales Rep Fax: Sales Rep E-Mail: clancyrp@pellaboston.com Customer Information Project/Delivery Address Order Information Chris Wood Wood,Chris,NorthAndover,MA,1608225 Quote Name: 2 Windows, 3 Doors 458 Waverley Rd 458 Waverley Rd Order Number: 741RCO215 NORTH ANDOVER, MA 01845-4213 Lot# Quote Number: 7056994 Primary Phone: (978)7643519 NORTH ANDOVER,MA 01845-4213 Order Type: Installed Sales Mobile Phone: County: ESSEX Payment Terms: Deposit/C.O.D. Fax Number: Tax Code: MATAXHOL 0 E-Mail: chrisjwood@verizon.net Quoted Date: 8/14/2015 Great Plains#: 9580187 Customer Number: 1007296108 Customer Account: 1003013833 Customer Notes: Permit fee of$96 paid on 8/15/15 Line# Location: Attributes 10 None Assigned Delivery/Setup- Delivery/Setup Item Price Qty Ext'd Price $184.20 1 $184.20 For more information regarding the finishing, maintenance, service and warranty of all Pella®products, visit the Pella®website at www.pelia.com Printed on 8/15/2015 Contract-Detailed Page 1 of 8 Customer: Chris Wood Project Name: Wood,Chds,NorthAndover,MA,1608225 Order Number: 741RCO215 Quote Number: 7056994 Line# Location: Attributes 15 Front Door Pella Brand, Inswing Entry Door Left, 31.5 X 79.75, Poplar White, 4 9/16" Item Price Qty Ext'd Price $2,414.81 1 $2,414.81 1:Non-Standard Size Left Inswing Entry Door #' rr. PK# Frame Size: 31 1/2 X 79 3/4 ",� 722 General Information: No Fire Rating, No Fire Rating,Clad,Wood,Pine, 5 7/8", 1 5/16",4 9/16", Standard Sill, Mill Finish Sill,Oak Threshold ,� Entry Door Panel: Glazed, Fiberglass,Smooth,Smooth,Twin Colonial Light Exterior Color/Finish: Standard Enduraclad,Painted,Poplar White, Poplar White I J'' Interior Color/Finish: Painted,Poplar White, Linen White 1773Y.a . Glass: Tempered Low-E Viewed From Exterior Hardware Options: Latch Bore with Deadbolt, No Deadbolt Sensor,2 3/8",2 1/8",No Handle Set,Aluminum Adjustable,Satin Nickel Frame Size:31.5"X 79.75' Unit Accessories: No Bang Panel Grilles: No Grille Wrapping Information: Nail Fin, Factory Applied,No Exterior Trim,No Interior Trim,4 9/16",5 7/8",Pella Recommended Clearance, Perimeter Length= 223". ES_Single-Install Single Entry Door Qty 1 Entry Trim Finish-Finish Paint/Stain Entry Interior Trim Only Qty 1 Comp Trim>48-Composite Trim Upgrade>Greater than 48 inches wide Qty 1 Extra Layer EXT-Extra Layer Exterior Trim Qty 1 Line# Location: Attributes 20 Back Door Pella Brand, Inswing Entry Door Right, 31.5 X 79.75, Poplar White, 4 9/16" Item Price Qty Ext'd Price z $2,414.81 1 $2,414.81 1:Nonstandard Size Right Inswing Entry Door r * PK# Frame Size: 31 1/2 X 79 3/4 General Information: No Fire Rating, No Fire Rating,Clad,Wood, Pine,5 7/8", 1 5/16",4 9/16",Standard Sill,Mill Finish Sill,Oak Threshold SOP. 722 Entry Door Panel: Glazed, Fiberglass, Smooth,Smooth,Twin Colonial Light Exterior Color/Finish: Standard Enduraclad,Painted, Poplar White, Poplar White Interior Color/Finish: Painted,Poplar White, Linen White on,S: Glass: Tempered Low-E Viewed From Exterior Hardware Options: Latch Bore with Deadbolt, No Deadbolt Sensor,2 3/8",2 1/8",No Handle Set,Aluminum Adjustable,Satin Nickel Frame Size:31.5'X 79.75' Unit Accessories: No Bang Panel Grilles: No Grille Wrapping Information: Nail Fin, Factory Applied,No Exterior Trim, No Interior Trim,4 9/16", 5 7/8", Pella Recommended Clearance, Perimeter Length= 223". ES—Single-Install Single Entry Door Qty 1 Entry Trim Finish-Finish Paint/Stain Entry Interior Trim Only Qty 1 Comp Trim>48-Composite Trim Upgrade>Greater than 48 inches wide Qty 1 Extra Layer EXT-Extra Layer Exterior Trim 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 8/15/2015 Contract-Detailed Page 2 of 8 Customer: Chris Wood Project Name: Wood,Ch ris,NorthAndover,MA,1608225 Order Number: 741 RCO215 Quote Number: 7056994 Line# Location: Attributes 25 Middle Door Encompass By Pella, Inswing Entry Door Right, 33.5 X 81.5 Item Price Qty Ext'd Price $1,863.17 1 $1,863.17 1:3280 Right Inswing Entry Door - PK# Frame Size: 33 1/2 X 81 1/2 General Information: No Fire Rating,Wood,Wood, Pine,Standard Sill,Mill Finish Sill,Composite Threshold 722 Entry Door Panel: Glazed,Fiberglass,Smooth,Smooth, 1/2 Light Exterior Color/Finish: Painted,Poplar White, Primed Interior Color/Finish: Painted,Poplar White, Primed Glass: Tempered Low-E Viewed From Exterior Hardware Options: Latch Bore with Deadbolt,2 3/8",Standard Steel,Satin Nickel Frame Size:33.5"X 81.5' Grilles: No Grille Wrapping Information: Without Brickmould, No Interior Trim,4 9/16",4 9/16",Pella Recommended Clearance, Perimeter Length=230". ES-Single-Install Single Entry Door Qty 1 Entry Trim Finish-Finish Paint/Stain Entry Interior Trim Only Qty 1 Comp Trim>48-Composite Trim Upgrade>Greater than 48 inches wide Qty 1 Line# Location: Attributes 30 Mudroom Vinyl Windows/Doors By Pella, Double Hung, 33.5 X 48.5, White Item Price Qty Ext'd Price $498.36 2 $996.72 1: Nonstandard SizeNon-Standard Size Double Hung,Equal ua PK# Frame Size: 33 1/2 X 48 1/2 3' 722 General Information: Standard,Vinyl, Block Frame With Mull Groove, 3 1/4",3 1/4",Sill Adapter Included, Head Expander Included Exterior Color/Finish: White Interior Color/Finish: White I Glass: Insulated Low-E Advanced Low-E Insulating Glass Argon Non High Altitude Hardware Options: White,Standard Vent Stop Viewed From Exterior Screen: Full Screen Grille: No Grille, Frame Size:33.5"X 48.5" Wrapping Information: No Exterior Trim, No Interior Trim, Pella Recommended Clearance, Perimeter Length=164",Glazing Pressure= 105. PI_Exp Wrap-Pocket Express W/Wrap 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. For more information regarding the finishing, maintenance, service and warranty of all Pella@ products, visit the Pella@ website at www.pella.com Printed on 8/15/2015 Contract-Detailed Page 3 of 8 Customer: Chris Wood Project Name: Wood,Ch ris,NorthAndover,MA,1608225 Order Number: 741RCO215 Quote Number: 7056994 Per Variations in wood grain,color,texture or natural characteristics are not covered under the limited warranty. 1NSYNCTIVE PRODUCTS: In addition,Pella Insynctive Products are covered by the Pella Insynctive Products Software License Agreement and Pella Insynctive Products Privacy Policy in effect at the time of sale,which can be found at Insynctive.pella.com. By installing or using Your Insynctive Products you are acknowledging the Insynctive Software Agreement and Privacy Policy are part of the terms of sale. 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: 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 Durinq the Installation Pella agrees to do the following: Deliver and unload products purchased per contract Place and remove drop cloths in work area then vacuum, and remove all debris at end of day Remove existing product, including storm windows, and dispose of it unless otherwise specified Install all products using method specified in contract per Pella Installation Instructions Replace interior and/or exterior trim only if purchased If Purchased, install exterior primed pine wood trim or Composite. Composite will be unfinished. If Purchased, install interior trim matching wood window finish or White trim for Impervia and Encompass Install non-Pella entry door lockset provided by you. Pella is not responsible for 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 For more information regarding the finishing, maintenance, service and warranty of all Pella@ products, visit the Pella@ website at www.pella.com Printed on 8/15/2015 Contract-Detailed Page 4 of 8 Customer: Chris Wood Project Name: Wood,Chris,NorthAndover,MA,1608225 Order Number: 741 RCO215 Quote Number: 7056994 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 P ject Checklist has been reviewed t r� iti Product Only Addendum has been reviewed Customer initial Credit Card Account#: Last 4 Digits Expiration Date: / I 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 Pella@ website at www.pelia.com Printed on 8/15/2015 Contract-Detailed Page 5 of 8 Customer: Chris Wood Project Name: Wood,Chris,NorthAndover,MA,1608225 Order Number: 741 RCO215 Quote Number: 7056994 "2051r,o,ject Checklist has been reviewed Chris Wood 5ir Clanc 49Wmme Please print) Sales R me (Please print) Order Totals Taxable Subtotal $4,499.37 igna Pell ales Rep glignature Sales Tax @ 0% $0.00 8/15/15 8/15/15 Non-taxable Subtotal $3,374.34 Date Date Total $7,873.71 Deposit Received $7,873.71 Credit Card Approval Signature jArnount Due $0.00 For more information regarding the finishing, maintenance, service and warranty of all Pella(D products, visit the Pella®website at www.pella.com Printed on 8/15/2015 Contract-Detailed Page 6 of 8 NOTICE OF CANCELLATION Date of transaction: 8/15/15 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 8/19/15 (three business days from the date of transaction above). I hereby cancel this transaction. (Date) (Buyer's signature) i r i 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 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 h permitted,the Work will be free from the director of the Home Improvement Contractor Registration Program defects not inherent in the quality required or permitted,and the Work administered by the Board of Building Regulations and Standards. Pella and conform with the requirements of this Contract.Pella shall not be responsible any of its subcontractors identified in this agreement have been registered. for damages or defects caused by abuse,modifications not executed by Pella, Any inquires about Pella or any of its subcontractors relating to registration improper or insufficient maintenance,improper operation or normal wear and should be directed to:Director,Home Improvement Contractor Registration, tear. Pella will keep the premises and surrounding area free from One Ashburton Place,Boston,MA 02108,617-727-8598 accumulation of waste materials or rubbish caused by performance of the 12. PERMITS(MA customers only) Work. Pella is obligated to and will obtain the following permits for this project: 4. CHANGES Building . 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 5. SUBSTANTIAL COMPLETION You may cancel this agreement if it has been signed by a party Owner understands and agrees that the Substantial Completion Date is an thereto at a place other than an address of the seller,which estimate only and that the actual date on which the Work is completed may be may be his main office or branch thereof,provided you notify extended to allow for Change Orders requested by Owner or if the time to complete the Work is affected by conduct of the Owner,weather,labor the seller in writing at his main office or branch by ordinary disputes,availability of subcontractors,acts of God,fire or other causes mail posted,by telegram sent or by delivery,not later than reasonably beyond Pella's control.If for any reason the Work is not fully midnight of the third business day following the signing of this completed by the Substantial Completion Date(including any extensions 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 See the attached Notice of Cancellation for an explanation of to be replaced or repaired,a hold back proportionate to the cost of remaining this right. parts or work to be completed is acceptable.However,the holdback will not g exceed the amount of the completion costs or 10%of the remaining unpaid balance of the Price,whichever is less. 6. FINANCING Do not sign this contract if there are any blank spaces. If payment of the Price is financed with a financial institution through Pella,all financing paperwork must be completed upon signing of this Contract and the requisite approvals and authorizations for the full amount of the requested financing shall have been received from the financial institution. 0/15/15 nature Date DISPUTES 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 ARBITRATION AS PROVIDED IN M.G.L.c. 142A Pella Windows and Doors Contractor I Ho eowner i 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. r i The Commogzwealth of Massaehusetts Pl�n�l�rtn Department of Industrial Accidents Office of Investigations ' 1 Congress Street, Suite 100 ' Boston, .MA 02114-20.17 www.mass.govI iia Workers' Compensation Insurance Affidavit: Builders/Con tractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): AcIlA Address: 45- [-7e,,,n r__ p� City/State/Zip: , j6j& 1)J .7 Phone #: `�7�- Z65_-7�;j,� Are you an employer? Check the appropriate box: 1.Nq am a employer with —,7S 4. Ell am a generalcontractor and.I Type of project(required): employees(full and/or part-time).* have hired the sub-contractors 6. ❑ New construction 2.❑ .I am a sole proprietor or partner- listed on the attached sheet. 7. E&Remodeling ship and have no employees These sub-contractors have g, ❑ Demolition working for me in any capacity. employees and have workers' 9. Building addition [No workers' comp. insurance comp. insurance.; ❑ required.] 5. ❑ We are a corporation and.its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 1.1.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL c. 152, '1 4 12.❑Roof repairs insurance required.] �'• § O,and we have no employees. [No workers' 13.0 Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. i 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 am an entplover that is providing workers'compensatiota insurance for my employees. Below is the poliq'and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: 4 )6, L4 C: 10 Expiration Date: 77 —J" Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investivations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties gteLrjury that the information provided above is true and correct. i —lam attire: - _ __ Date �' —/i5' Phone#: 9 � '.. ,�—"7a - 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#: i ACOR& CERTIFICATE OF LIABILITY GAS FTE (MNODDIYYYY)ZO 5 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). PRODUCER NA E. T DomOry A.Codeti,CIC,RPLU Fred C.Church,Inc. 41 Wellman Street PHONE 9783223AALow ,MA 01851 1X (80)225-1865 d et@fedcrhureh.com C. Not: (978)454-1865 ADORESS. INSURER(S)AFFORDING COVERAGE NAIC✓I INSURER A: GlnPns Insurance Company of America 31534 INSURED NewHar�h sireEmpfoyersinmuranceCampany 13083 New England Window&Door LLC INSURER B 45 Fondi Road INSURER C- Haverh8l,MA 01832-1302 INSURER D: INSURER E: COVERAGES CERTIFICATE NUMBER:54457 INSURER F: SION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAIMED 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 AODL SUB LTR TYPE OF INSURANCE POUCY NUMBER mwPo EFF MM1DO� LIMITS GENERAL LIABILITY EACH OCCURRENCE 8 1.000.000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $ 100,000 CLAIMS-MADE a OCCUR MED ECP(Any one person) $ 10,000 A X CG0001 ZBNO161407 7112015 71112016 1,000,000 PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ 2.000,000 GEN'L AGGREGATE LIMIT APPLIES PEP.: PRODUCTS-COMPIOP AGG $ 2.000,000 POLICY X PRO- X LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMB Ea accident $ ANY AUTO BODILY INJURY(Per pemon) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE AUTOS Per accident $ $ UMBRELLA UAB OCCUR EXCESS LIAR EACH OCCURRENCE $ CLAIMS-MADE AGGREGATE $ DED RETENTION$ WORKERS COMPENSATION $ AND EMPLOYERS'LIABILITY X I WC STATT- OTH I ANY PROPRIETOR/PARTNER/ECECUTIVE N 500,000 B OFFICER/MEMBER EXCLUDED? ❑ NIA 400040101 7112015 7112016 E.L.EACH ACCIDENT $ (Mandatory In NH) 500,000 If yes,describe under EL DISEASE-EA EMPLOY $ DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT $ 500.000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,IF mare space isrequired) 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 REPRESE NTATWE r; Client s Met tl Cert Holder 9 ©1988-2010 ACORD CORPORATION. All r8cghts reserved. ACORD 26 42010106) The ACORD name and lono are recuistered madcs of ACORD P J { CS-089853 WILLIAM R NICH©LS 57 PEARTREE RI) HAVER-BILL Nlk 01830;`" 10/26/2016 f7P ((OY/f-77TO7LLOQfLfl"f1,h,r?•r'[-IXJJCI'C!7!/JG'�1 � ::.a, y: License or r4stration jalid for individul use onl 1. �" Office of Consumer Affairs&,$usiness Regulation before the expiration date. If f6dnd return to:` ME IMPROVEMENT CONTRACTOR Office of Consumer Affairs and Business-Regulation egistration 178383 TYPe 10 Park Plaza-Suite 5170 xpiration: 4/10/2016; Corporation Boston,MA 02116 PELLA WINDOWS AND DOOR WILLIAM NICHOLS 45 FONDE RD Not valid without signature HAVERHILL,MA 01832 Undersecretary .