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Home My WebLink AboutBuilding Permit #643 - 479 SALEM STREET 4/22/2010BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued: IMPORTANT: Applicant must complete all items on this page ii DE CRIPTION OF WORK TO BE PREFORMED: ll Q,0r'\1rc r 0 I 1.5 c/1 i1c J .S — N v S` (-(Jctuo,C. C \,4-,-\G £ . Please Type or Print Clearly) OWNER: Name: 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: $ S ,o o `� FEE: $ Iwo Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner _ 5i �N�� o Signature of contractor cw�v2 Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT ❑ COMMENTS CONSERVATION COMMENTS HEALTH COMMENTS ■❑ DATE REJECTED DATE APPROVED El DATE REJECTED DATE APPROVED DATE REJECTED DATE APPROVED FRI 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 ❑ 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 Located at 384 Osgood Street Dimension , , Number of Stories: Total square feet of floor area, based on Exterior dimensions. i 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 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 hoto Copy Of H.I.C. And/Or C.S.L. Licenses ❑l Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products 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 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 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 DEPARTMENTMITORM07 Revised 2.2007 Location No. Date C. TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame P ermit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL. $ Check # I -� / r 22959 Building Inspector O F=4 0 xP-4 A as c u a4 v, u w a IS O ,c.7 G U `°:3 w w a a a a°G w AG o a �' � w w c�° v chi w x p a o aG w z w a c� �+ Mcn 2 v Q o cn Cd _ c c m c c C N O C :vV •O. cc c : d C ev ON �t s ai 3 C,u QW �+ m CL E c Q1.2 O CM "D me E o co 2 - CA M (� h cmcc O N •O O H O O SCAcm W - V :.Lo) m O C H Q � /•W^ � O O � m 1•x-1 cvv•�Z `o cm , _c � m H m C •C Z WW C: = 'y .= =5 ca = ._.SS •. o y O�Z LU O V O p ® CLC , CO) • 06 0,-5 - _ to `ti = c H r $ c.=.m 0 COz O U Cl) v O r•+•r a� O v Z a O G H C C C CO2co 0 '� h .co) E m m o as 3� 0CO CD o t. Cc O d CL. CMa CO2 c ccc Li J .� CO2 Z c C-7 y c C C c CO2 D LLI 0 LLI U) W W I% W U) ACORD,. CERTIFICATE OF LIABILITY INSURANCE Do2iia2 0) PRODUCER Joseph MCKeone JP ArlcKeone Insurance Agency, Inc. P.O. "Box -333 Ann Arbo, MI 48106-0333 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURED Renewal by Andersen, J and L Windows, Inc. 104 Otis St Northborough, MA 01532 INSURERA: Hartford Insurance Company INSURER B: Nautilus INSURER C: _ INSURER D: INSURER E: CnVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. .-..--- INSR D'L POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION DATE IMMfDDfYY) LIMITS B GENERALu4sturY NC958461 10/01/2009 10/01/2010EACH.00CURRENCE S 1000000 PREMISES Es of mf= S 100.000 COMMERCIAL GENERAL LIABILITY CLAIMS MADE' ❑ OCCUR MED EXP (Any one parson) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENT AGGPC,;ATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG S 2.000.0000 17 POLICY PRO- LOC jECr A I AUTOMOBILE LIABILITY 35MCC XD 6390 10/01/2009 10/0172010 COMBINED SINGLE LIMIT I S 1,000,000 ANYAUTO (Eoa=idenq BODILY INJURY X ALL OWNED AUTOS SCHEDULED AUTOS (Per person) S BODILY INJURY S HIRED AUTOS NON -OWNED AUTO (Par axidant) - — PROPERTY DAMAGE S I JPor A=denl) I'S LIABILITY AUTO ONLY.EAACCIDE14T S __ OTHER THAN EAACC S 'ANYAUTO AUTO ONLY: AGG S EXCESSMMBRE.LLALIABILITY EACHOCCURRENCE S OCCUR CLAIMS MADE AGGREGATE S S DEDUCTIBLE S RETENTION S' S A w(IRr.ETesCOMPENSATION AND 35 WECPP 1444 02/17/2010 02/17/2011 wCSTATu. orH. EMPLOYERS' LJAB!L i rY E.L. EACH ACCIDENT S 500,000 ANY PROPRIETOR/PARTNERrEXECUTNE OFFICER/MEMBER.EXCLUDED? E.L. DISEASE - EA EMPLOYEE S 500,000 1( yOt, desaibo Under SPECIAL PROVISIONS below E.L. DISEASE- POLICY LIMIT $ 500.000 OTHER DESCRIPTION OF OPERATIONS f LOCATtoms / VEHtCLES t EXCUIStONS ADDED BY ENDORSEMENT I SPEC" PROVISIONS INSURED COPY CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILMY`OF AgY KIND UPON THE INSURER, ITS AGENTS OR AUTHORIZED ACORD 25 (2001106) @ ACORD CORPORATION 1088 te al Woo dNinyi Cotrposlte •H'ame LowE i � Dual Pane Arpv _ Casement . pES�I Solar Feat Gain Coefficient U -Factor (U• ) SE ADDI �. I�. I r, �1 �� . Visible T�ansmittancelu` . . ' �taaufiotDrer sttpula4s teal thine talirpa copforifl. � aPPl�b10 jJr�C •p�a8u� es, lot• 0cp�minhrj �ho6a ' product parlortnariu.,krRC tatlagz att baNrt11h9d (oF a fize6 set dt e�•Gonm'ntai ppd�iicna and a ' � ti •. tP:ciliapfoductsfra.Consattmanulac(uitr'slllatatuto;tototherprndwlpyrforrc�ri:ainloffi9llan:' . F+eOReG IpS•Oaf rN"lgl 'W" � Gr�I W I f 11r1r. • . R3.0"' we..n1Av�ir Au asa e.r{n Nrr� rrtWlr re..M('/r� Moels tE,D, i LEG.G_AIrInllltrsUon Re®UI(oment: WDrfle Halimasw GeRitie�llan PtoDsam ."m N,uuua ma--s V 5sal's environrrtrmal F•- , } standards goveming . e)' ane ,y efficient}; h= metals in the tame an a pacivigin;, and consu —= education materiah x�l to°�..�,� , • — ;�` DESIGN PRESSURE (PSF)' E -l �■ry�qp _..L C iwnv.wvmfl.evm lu lFl RbA QB Sloped Sill M Tatdm NP.FS.O?mAAMgIryDN,pf�AIOI/151A440.p.L Mnvafeetvre•5tlavintes emt� ! Maals afa%eoe1; � e'mnnmt f5 umrArn61 �r —•C+C•—•C, E LB—C.C. AV InflWratmn requlteman7s N9Mh hulhmr; CertlfleaOon Program. v p a a Massachusetts - Department of Public Safety Board of Building Re- .0 and Standards MW Construction. Supervisor License License: CS 101952 Restricted to: 00, DAVID BANCROFT 5 JOHNSTON AVENUE WHITINSVILLE, MA 01588 Expiration: 3/19/2012 ('o min issiq)ner Tr#: 101952 ✓/ie 1J00?7/1i7.d/uuP,alt/z a�'./Glaaeoriu�aellb Office of Consumer Affairs & Business Regulation IOUOME IMPROVEMENT CONTRACTOR Registration: 601 Expirat—to�-4Z M 12 it, _ i' y-piearEent Card 1. RENEWAL BY ANDERSCI DAVE BANCRO�j�--�` 104 OTIS STREEf,-.. NORTHBOROUGH, iVl% 12 Undersecretary Fps. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations a 600 Washington Street Boston, MA 02111 . ' www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Address: /0 // /U i 4 C1.�.3� C �� %�% 000 City/State/Zip: pf��i d_ a i aPhone #: T 1 Are you an employer? Check the appropriate box: LaI am a employer with 00 4. ❑ I am a general contractor and I employees (full and/or part-time).* 2. ❑ I am a soleproprietor or partner- have hired the sub -contractors listed on the attached sheet. t ship and have no employees These sub -contractors have working for me in any capacity. workers' comp. insurance. 5. ❑ We are a corporation and its [No workers' comp. insurance required.] officers have exercised their 3. ❑ 1 am a homeowner doing all work right of exemption per MGL myself. [No workers' comp. c. 152, § 1(4), and we have no insurance required.] t employees. [No workers' comp. insurance required.] Type of project (required): 6. ❑ New construction 7. emodeling S. Demolition 9. ❑ Building addition 10.❑ Electrical repairs or additions 11.❑ Plumbing repairs or additions 12.❑ Roof repairs 13.❑ Other *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 their workers' comp. policy information. I am an employer that is providing workers' compensation insurance for my employees. Below. is the policy and job site information. Insurance Company Name: ! l'/ G 1) 2 0 >7 I/7 Sty Y� h Policy # or Self -ins. Lic. #: J/ Inl � � /YyJExpiration Date: 2 Job Site Address: 4ci City/State/Zip: t l�E fl y Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby cer un4er the pains and penalties.of perjury that the information provided abore is true and correct F) I/ �- o /;(V 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 104 Otis Si., NOrlhburungln, MA (115.)2 508) 919-0000 • Filx; ;771 i 987 -:it) H kuycr(s) Nano .J&L 1CtNuntu'S, 1.\(:... II/B/:\ Renewal byAndersen. ra ..aew ...,.�.M.ar ,,..................„ WINDOW SPECIFICATION SHEET no k I [011ie lntproveaucnl Contractor Isc4149601 (expires 1/24/"201 Z) FCLICI'al 'I:tx Il) #83.. 0404201 '111c: Buyar(s) lisled allow Ierohy joinlly and severally n;,rrr to ptu•clmsr tram 1 & 1. Windows, ttc'. d/b/a mdwal by Andel:ua ("Cont•aclor'1 IDC :cxnlx ;nal/er .services lislcd h clow. iu accordance wills the pairs ulld Irnov dc'sertbed on the Slnciite:dion SI ret nal the Iroal and the reverx OI' the (litislwtiaiivin:{ Cl6ti i.)Xi WIN00W AND POOK KIA40Vl ,ING AG0,FA1I;NT, of which IN., Sped(icatlon Sheet is a part. WINDOW DEfAIIS I. Contractor will hlsloll ;t local of _9/i winclowN ill 111IVCI`S hon1C, a>il the f(1llowilIg individtitil q ilnlilieS! I)ollble Iluny; (1)11) P97til tial sastt ❑ Cot Ia.,i'stlSll ( I/3 Itill, 'L/3 botton)) ❑ Oriel Sash ('L/ 5 lop. I/3 bot tont) Casement (CW) ❑ Hinge lt4llt ❑ I Iin;;a 1,1't (as viewed from exIcriov): ❑ SkIlldard hand C ❑ MCII'J handle _ DOnble Casement (C'DW)'Standard h,uuile ❑ Metro handle Casement / Picture / C ascf11Cn1 (CI'W) ❑ 1:1:1 Or ❑ 1:2:1 ❑ Slan)(lard h;uu1L: ❑ Nidl_ 1 handlC I _ Z hllc' 4lidiin; WindOw (GW) I Glider / Picture / Glider (GI'W) ❑ 1:1:1 or ❑ 1:2:1 Awning Window (AW) _ Piton Window (1'W) Nay or Bow Window Patio Poors (sce xparale Door SpcCihCil10II SIWQ0 2. N 1'es ❑ NO Qty OI Windows 10 he Clis10111 Ill KC111MCeille111: .zG 3. ❑ 1'es �j No Qly of Sills 10 Ik raplaccd by COnlractor: C 4. ❑ Yes Rf'No Qlv tic Windows to L,l New Construction Full frame fintludO new interim' X Cstcri r CtlSings) Extcrior casings: ❑ Pine ❑ MaittlCtuulCa-frac'I'Mcriul ❑ I'actory applied 90R ribrcx brick hold 5. Gl,uillYtobc: a'lit'LOw-E;It:Su«t'15un',I (Tse Qtxli'IE!(gib1e) ❑ Otlwr I(011let',I)ICItSCSpccil'}•: (i. I:xterior Color to IV: t'While• ❑ $;Ind ❑ C'anvas ❑ TerN itonr ❑ Cocoa Nc:ul I 7. 1111CHN' Color IO be: ;R--Whitc ❑ Sana ❑ Catn'as ❑ Terratow. ❑ Pine ❑ MaplC ❑ Oak Note: Inleriur color i tut Only Ile tvlljte, woo11 lir s;nnn, rOlnr :u Cxkrinr. WCxld interiors meed tet f llittlwd by Buyer. S, E,ally I Itt'dw;u'c; Style-d!ZZ'-4C- 4). ❑ 1'os O Install Lifts with Double l lump /indows 111 10. Sc:recns: windows to have: ❑ Ihalf yrLV roll selcens kivens to hC Pibcrwla.ss ❑ Aluntinirnl [] Truscene. GRILLE DETAILS I I. Windows have grillCs:,K_Yas [1 No ll yes: ❑ 6611v Nelwcen Gkas ?Iv: / .I Olv: _.._ I-Ny: QI y: ] KCnlova/ble Interior t Qtv:.... "l QI uN w ❑ Full DIVIt1ed Light QVIJ Qty: Draw grille pkulerns above *1 INC uddiliOnal shCCt it lteedcef Buyer approved ADDITIONAL WORK DETAIIS 12. ❑ Yes E� NO Cont'nc'IOr will rctllove metal trances of windows. Qly Of L'nihs: 13. ❑ 1'O Q-A'o ('onn•detnr will install now paint -read}' or still II4eady Casings. httt1.HOrcasingilly nfolxnilixS: tatCH01'Casin•s gtvotopahillgs: ❑ Pinc ❑ Aiairrtanane.c-I'rcenlatcrinl 14. ❑ Cee P •NO C'Onu'tICI V will install new paint -ready or Stain-x;u1y inside Or Outside stops qty of openings:.--. Interior slops ally of olvlliit<Qs: Exic -ir r stop. ?:B.��y ❑ I'inr ❑ Maintrnancc-IiTC material 15. Buyer is aware that Contractor does not do any p ming. (� Initials 1 (i. ❑ Yes ' No COnit't1CIOC will wrap extcrinr Casink. i8t xluntintutOf Color'. Note: Wr;tl>piu; may be required with 9101111 window ITIIIOVJI1 removal M..arnrnl windows will IC uvc screw holes in casirnq. 17,8 -'Ws ❑ No Conlracor will insulate, caulk kind seal windows with 3-1x,int system to prevent water altd at, inl'ilwiltion. I8.,E�rYes ❑ NO A lintiled warranty shall bx issued to Buyer upon Completion of IDC job and paynlCnt in lull. 19. ❑ NO Building Perms Contractor will sccurc anv arnl all accessary permit's. The fee for the permil(S) is not inclrlded in the Contract Price turd a separate check is required tit the little of salC far this fee. 2p• Addilional jobdetails: 21. Yes ❑ No Buyer agrees to be presetsI on Ilse final day of installation lite Twill inspection and to deliver final pklylliol t. No final pa vin, wl d1111YIV d<'1MIAY01f 111W] rho• c•un1111cY L4 reins/I/c'1c•d h1 the salisl.IWlhvr 11':1/! ft Mitts. It is agreed and understood by and between the parties that this Spcciftcation Sheet, along with the CUSTOM WINDOW ANA DOOR REMODELING AGREEMENT, constitutes the entire understanding between the parties, and there are no verbal understandings changing or modifying any of the terms. This Specification Sheet may not be changed or its terms modified or varied in any way unless such changes are in writing and signed by both the Buyer(s) and Contractor. Buyer(s) hereby acknowledge that Buyer(s) has tread this Specification Sheet. J & L Wi �l�c. /• Renewal by Andersen yeC(9) Buyers) liy,c- ignature of Product Manager Signature Signature Print Name of Product Manager Print Name B/Z d E10EL861,LL1 « Print Name lE;60 BZ -0-010Z Oman!®i NMI iMEMOI amino Draw grille pkulerns above *1 INC uddiliOnal shCCt it lteedcef Buyer approved ADDITIONAL WORK DETAIIS 12. ❑ Yes E� NO Cont'nc'IOr will rctllove metal trances of windows. Qly Of L'nihs: 13. ❑ 1'O Q-A'o ('onn•detnr will install now paint -read}' or still II4eady Casings. httt1.HOrcasingilly nfolxnilixS: tatCH01'Casin•s gtvotopahillgs: ❑ Pinc ❑ Aiairrtanane.c-I'rcenlatcrinl 14. ❑ Cee P •NO C'Onu'tICI V will install new paint -ready or Stain-x;u1y inside Or Outside stops qty of openings:.--. Interior slops ally of olvlliit<Qs: Exic -ir r stop. ?:B.��y ❑ I'inr ❑ Maintrnancc-IiTC material 15. Buyer is aware that Contractor does not do any p ming. (� Initials 1 (i. ❑ Yes ' No COnit't1CIOC will wrap extcrinr Casink. i8t xluntintutOf Color'. Note: Wr;tl>piu; may be required with 9101111 window ITIIIOVJI1 removal M..arnrnl windows will IC uvc screw holes in casirnq. 17,8 -'Ws ❑ No Conlracor will insulate, caulk kind seal windows with 3-1x,int system to prevent water altd at, inl'ilwiltion. I8.,E�rYes ❑ NO A lintiled warranty shall bx issued to Buyer upon Completion of IDC job and paynlCnt in lull. 19. ❑ NO Building Perms Contractor will sccurc anv arnl all accessary permit's. The fee for the permil(S) is not inclrlded in the Contract Price turd a separate check is required tit the little of salC far this fee. 2p• Addilional jobdetails: 21. Yes ❑ No Buyer agrees to be presetsI on Ilse final day of installation lite Twill inspection and to deliver final pklylliol t. No final pa vin, wl d1111YIV d<'1MIAY01f 111W] rho• c•un1111cY L4 reins/I/c'1c•d h1 the salisl.IWlhvr 11':1/! ft Mitts. It is agreed and understood by and between the parties that this Spcciftcation Sheet, along with the CUSTOM WINDOW ANA DOOR REMODELING AGREEMENT, constitutes the entire understanding between the parties, and there are no verbal understandings changing or modifying any of the terms. This Specification Sheet may not be changed or its terms modified or varied in any way unless such changes are in writing and signed by both the Buyer(s) and Contractor. Buyer(s) hereby acknowledge that Buyer(s) has tread this Specification Sheet. J & L Wi �l�c. /• Renewal by Andersen yeC(9) Buyers) liy,c- ignature of Product Manager Signature Signature Print Name of Product Manager Print Name B/Z d E10EL861,LL1 « Print Name lE;60 BZ -0-010Z 101 Oli, St- Norlhborougl. NIA 01352 j&..1.11't.\u(ms, 1"(:., U/II/.\ MA I Tome In,lvvvctn it Contractor 508; 0 19-0900 - V; I X: i77 bl)t,-:inial Renewal *7 Licow#14',1(,01 (Expires 1/24/'2012) byo Andersen. her+c.ral lax In #830,1 -0120 WINUGW REPLACEMENT -Ain0.kii(:ii.iir CUSTOM WINDOW AND DOOR REMODELING AGREEMENT Buyer(s) Nome _ Date of Aoreomont .. ..._PPPPPP _._...._ . .. eff B�yo, Stiller Address, City, State, and Lip Code Z 9 k 4,, wv St /y• /-� " ,)o i,6-.._.., 'Kn,-L G / iyS— ((E-Mail Address Home Tele2ho,Te Nymber Work Telephone Number L_��SS>vl( r�Hol,co,-•, �/0�(7 �F777) 7�'.._.._ �i71�7�7� 7� Iitryer(s) h12rchy jointly and NOM -ally .k4l-wN to pill -chum: the productz :uut/or service, 01'.) & I, WindOWq, 111C. d/b/a >;UMil. by Anderson ("i'onbactur'7, in acuu-dancC with 0112 ICITIS and CandiliOnS dcscribcd ou the front and te reverse of this a2rccnienl and Ott Ille allachCd spccificalion sleel(s) (Collectively, I1iS "A�Wolltenl'). Buyer(S) hCreby agrees to sign it conrplctiou cerlific;uc ;eller l'rnlruclur' bus comploted all Work under Ibis AQtITC 1112111. Buyer(s) agrees and understands that this Agreement constitutes the entire understanding between the parties, and that there are no verbal understandings changing or modifying any of the terms of this .Agree-ment. No alteration to or deviation from this Agreement will be valid without the signed, written consent of both Buyer(s) and Contractor. Buyer(s) hereby acknr,wlcdgek that Buyers) 1) hoc read this Agreement, understands the terms of this Agreement, and has received a completed, signed, and dated copy of this Agreement, including the two attached Notices of Cancellation, on the date first written above and 2) was orally informed of Buyer's right to cancel this Agreement. DO NOT SIGN THIS CONTRACT IF THERE. ARE ANY BLANK SPACES. J & L Window,,, Inc. d/ u Renewal by Andersen Buyye 5. Sign;unre nl' I'l-WILI'I 1l:utagc•r Si rTliur 4—%�/_✓� frim Nuur of ]Yudurt \I:uutgcr Print Nanu Buycr(s) Si�„alurr Prins Nilt YOU, THE BUYER(S), MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION. SEE THE ATTACHED NOTICE OF CANCELLATION FORMS FOR AN EXPLANATION OF THIS RIGHT. 4 _ _ — — — _ _ — _ — — — ._. ;i.S _ _ _ _ _ _ _ _ _ _ _ _ _ — — — — —':K NOTICE OF CANCELLATION X NOTICE OF CANCELLATION Date of Transaction 3 - Z-) I& . You may cancel Date of Transaction 'Z -2 ? - I u . You may cancel this transaction, without any penalty or obligation, within this transaction, without any penalty or obligation, within three business days from the above date. ti you cancel, any three business days from the above date. ff you cancel, any property traded in, any payments made by you under the property traded in, any payments made by you under the Control of Sale, and any negotiable instrument executed 1 Contract of Sale, and any negotiable instrument executed by you will be returned within 10 days following receipt I by you will be returned within 10 days following receipt by the Contractor ("Seller") of your cancellation notice, I by the Contractor ("Seller") of your cancellation notice, and any security interest arising out of the transaction will and any security interest arising out of the transaction will be canceled. If you cancel, you must make available to the be canceled. If you cancel, you must make available to the Seiler at your residence, in substantially as good condition Seller at your residence, in substantially as good condition as when received, any goods delivered to you under as when received, any goods delivered to you under this this Contract or Sale; oryyou may, if you wish, comply Contract or Sale; or you may, if --you wish, comply with the with the instructions of the Seller regarding the return instructions of the Seller r'egarcriing the return shipment of shipment of the goods at the Seller's expense and risk. I the goods at the Seller's expense and risk. If you do make If you do make the goods available to the Seller and the I the goods available to the Seller and the Seller does not Seller does not pick them up within 20 days of the date pick them up within 20 days of the date of your Notice of your Notice of Cancellation, you may retain or dispose of Cancellation, you may retain or dispose of the goods of the goods without an �r further obl' ati a. If you fail to without an further obligation. If you fail to make the make the goods available to tine Seer, or if yyou agree I goods available to the Seller, or if you agree to return the o return the goods to the Seller and fail to do so, then clods to the Seller and fail to cl so, then you remain liable you remain liable for performance of all obl'�gations under I for performance of all obligations under the Contract. the Contract. To cancel this transaction, mail or deliver a I To cancel this transaction, mail or deriver a signed and signed and dated copy of this cancellation notice or any I dated copy of this cancellation notice or any other written other written notice, or send a telegram to Contractor: J notice, or send a telegram to Contractor: J & L Windows, & L Windows, Inc. d/b/a Renewal by Andersen, 104 Chis Inc. d/b/o Renewal by Andersen, 104 Otis Street, Street, Northborough, MA 01532, BY NOT LATER THAN Northborough, MA 01532, BY NOT LATER THAN MIDNIGHT MIDNIGHT OF 1- 71 tri _. (Date) OF (Dare) I HEREBY CANCEL THIS TRANSACTION, I HEREBY CANCEL THIS TRANSACTION. Buyer's Signature — Date - I Buyer's Signature Orate 84d EIOfL861LLt « W60 SZ -0-01,0Z Method of Pymnt: 'J Cash "f,eck U Mastercard U VISA , 11 Total Job Amount: �,/ W L � Estimnted Storting Date: J Discover J Financed, App#: Dcposil Roceived (33%): f 3� c ) 3 yV Name on Credit Card: Balance at Start of Job (3391.): 21333 d 1 3 3) Eslimated Completion Dale: P Credit Card #: Balance on Substantial �, • F - e,,e.i.0 }' Completion of Job (33%1: j) I CC Exp. Date: CC Security Code: --- _ BN roil aling him• not ac knnsclr(lp, that Ihr Iiidanrr at Surd tdjoh and Ihc Balanrs ern stthstantiol (:smgrlA tiuu Buyer Initials „I',)„b r:u,nnt Iu mads 11L '.1,4 dil c aryl and mu,i hr moist by pvr.oiial chock, bank chock. or va h. Buyer(s) agrees and understands that this Agreement constitutes the entire understanding between the parties, and that there are no verbal understandings changing or modifying any of the terms of this .Agree-ment. No alteration to or deviation from this Agreement will be valid without the signed, written consent of both Buyer(s) and Contractor. Buyer(s) hereby acknr,wlcdgek that Buyers) 1) hoc read this Agreement, understands the terms of this Agreement, and has received a completed, signed, and dated copy of this Agreement, including the two attached Notices of Cancellation, on the date first written above and 2) was orally informed of Buyer's right to cancel this Agreement. DO NOT SIGN THIS CONTRACT IF THERE. ARE ANY BLANK SPACES. J & L Window,,, Inc. d/ u Renewal by Andersen Buyye 5. Sign;unre nl' I'l-WILI'I 1l:utagc•r Si rTliur 4—%�/_✓� frim Nuur of ]Yudurt \I:uutgcr Print Nanu Buycr(s) Si�„alurr Prins Nilt YOU, THE BUYER(S), MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION. SEE THE ATTACHED NOTICE OF CANCELLATION FORMS FOR AN EXPLANATION OF THIS RIGHT. 4 _ _ — — — _ _ — _ — — — ._. ;i.S _ _ _ _ _ _ _ _ _ _ _ _ _ — — — — —':K NOTICE OF CANCELLATION X NOTICE OF CANCELLATION Date of Transaction 3 - Z-) I& . You may cancel Date of Transaction 'Z -2 ? - I u . You may cancel this transaction, without any penalty or obligation, within this transaction, without any penalty or obligation, within three business days from the above date. ti you cancel, any three business days from the above date. ff you cancel, any property traded in, any payments made by you under the property traded in, any payments made by you under the Control of Sale, and any negotiable instrument executed 1 Contract of Sale, and any negotiable instrument executed by you will be returned within 10 days following receipt I by you will be returned within 10 days following receipt by the Contractor ("Seller") of your cancellation notice, I by the Contractor ("Seller") of your cancellation notice, and any security interest arising out of the transaction will and any security interest arising out of the transaction will be canceled. If you cancel, you must make available to the be canceled. If you cancel, you must make available to the Seiler at your residence, in substantially as good condition Seller at your residence, in substantially as good condition as when received, any goods delivered to you under as when received, any goods delivered to you under this this Contract or Sale; oryyou may, if you wish, comply Contract or Sale; or you may, if --you wish, comply with the with the instructions of the Seller regarding the return instructions of the Seller r'egarcriing the return shipment of shipment of the goods at the Seller's expense and risk. I the goods at the Seller's expense and risk. If you do make If you do make the goods available to the Seller and the I the goods available to the Seller and the Seller does not Seller does not pick them up within 20 days of the date pick them up within 20 days of the date of your Notice of your Notice of Cancellation, you may retain or dispose of Cancellation, you may retain or dispose of the goods of the goods without an �r further obl' ati a. If you fail to without an further obligation. If you fail to make the make the goods available to tine Seer, or if yyou agree I goods available to the Seller, or if you agree to return the o return the goods to the Seller and fail to do so, then clods to the Seller and fail to cl so, then you remain liable you remain liable for performance of all obl'�gations under I for performance of all obligations under the Contract. the Contract. To cancel this transaction, mail or deliver a I To cancel this transaction, mail or deriver a signed and signed and dated copy of this cancellation notice or any I dated copy of this cancellation notice or any other written other written notice, or send a telegram to Contractor: J notice, or send a telegram to Contractor: J & L Windows, & L Windows, Inc. d/b/a Renewal by Andersen, 104 Chis Inc. d/b/o Renewal by Andersen, 104 Otis Street, Street, Northborough, MA 01532, BY NOT LATER THAN Northborough, MA 01532, BY NOT LATER THAN MIDNIGHT MIDNIGHT OF 1- 71 tri _. (Date) OF (Dare) I HEREBY CANCEL THIS TRANSACTION, I HEREBY CANCEL THIS TRANSACTION. Buyer's Signature — Date - I Buyer's Signature Orate 84d EIOfL861LLt « W60 SZ -0-01,0Z