Loading...
HomeMy WebLinkAboutBuilding Permit #470 - 701 WAVERLY ROAD 12/17/2012BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: /Date Received ��ssgrEv Pv "J Date Issued: I - / -z— IMPORTANT: Applicant must complete all items on this page L'OCAT TION 77nI CF-�� Print PROPERTY'OWNER?�Qo1V�}�-0 Print {MARNQ; PARCEL- ZONING DISTRICT,. Histonc:District yes-(.no Machine,,Shop;Village,.,..yes, TYPE OF IMPROVEMENT PROPOSED USE Reside Non- Residential New Building ne family Addie --Two or more family Industrial Altera ' No. of units: Commercial Repair, replacem Assessory Bldg Others: emo i ion Septic = Well Other Floodplain . Wetlands; Watershed0istriff Water/Sewer,. DESCRIPTION OF VVUMM I U tat r-Ktl'UM1v1tu: k ttA16t,Re) Identification Please Type or Print Clearly) OWNER: Name: k9DU1+ o blw"F Phone: 27E 4E�9- Z_ioi Address: -7ol CONTRACTOR: Name: l� E�rnt�akl5 )plc /I%t,� Phone COY Z �� • 7�� 'Address: 4<.S -jq),Vd Supervisor's}Construction License: Exp Date: /,0 a = Ex Date• `l - o 7-/ 3 Home Impr'_ovement,Lacense: !:. ; 77Y., .: P._r....., 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: $ 30 Check No.: h- Receipt No.: Qv d NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of -A, gent/Owner �% Signature :of contractor livv� I 9 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 - U FORM PLANNING & DEVELOPMENT COMMENTS CONSERVATION COMMENTS HEALTH COMMENTS DATE REJECTED DATE APPROVED Reviewed on Signature Reviewed on Signature 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: Locatea ;564 Us ood Street FIRE'DEPARTMENT ,- Temp`Dumpster on site.. 'yes .,no. Located at 1244Mam Street p Fire'Department`signatu're/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 ❑ Notified for pickup - Date Doc.Building Permit Revised 2008 Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products MOTE: 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 ALocation 1 /J V V4 4,, l - No. Datef�------ ®' TOWN OF NORTH ANDOVER • Certificate of Occupancy $ Building/Frame Permit Fee Foundation Permit Fee $ r�ra ����• Other Permit Fee $ �t TOTAL $ Check # ,d 26039 Building Inspector N� r 0 Q x LL c m O .� i O LL D AO N 'a+C Q. Ln cl: o w N Z z C J D m O a' 7 LL b0 D w ? O E U LL 0 a Z Z m J d bD O c cc 0 a Z 2 H W W bA 7 c' u N LL a Z N bA 7 LL' LL z 2 a a W G w LL O m O 41 41 v N r-3 v Y O N C • i � o 'Q•a cc 4a O= C. L N d � �O+ O O C w C ea • 0- 0 i " 3 �Cc V o > ' n`:eao ac _� s V Q N O• •c o `m O z CL U) •0 O .o c c0 • L Q Q .Y d 0 cc •N - V O C •� Q L L _ CD •.m Q to 4+ N m W O 'a O O uj CL= 0 li •� T N C V V LJJ ON U N 0-0 d �, co Q. d •> w C H M O F- .� � "0=-I.-CL0 O O O a W Z 0 m Cl) Cl) O E Z V. w� U) CL z O LJJ O � U W CL z_ m O C O N d s O O Q J 0 .t2 ti E CD o o CD z �. I = a E , •Am W v D O O CL ELCL a� Q t cc M v_ J '0 .'C O }D l!(V+ O CL V CL N a r' M 0 r uj = c 0 m6L v ,au_+ O O LL v ? O_ N N 0 Z z m c O C O LL 7 O Q' E t U r9 = LL o u LLI CL z Z CmC G J d j O O.' c0 C LL 0 u CL z U U J L LU O U N N O LL OC 0 ? Q (� 0p O OC LL z Q W W 25 7 CD O l j .. cu Y E N 0 Cc o CL a) �a 0 o U E Q L N w � �C O i = � . 0 (i L CL " 3 . m M M > _ 0 = 0 (n 0 o d > o� O• .a o Coz U) 0O An ;�•3 � o~ • L 4+ Q 0 Q. Y 0 0�.i Fr = 0 .N rt+ _ 0) I— v 0 = E- 12 V ea m 2 m (_ I- O vs CL v 0 W='O +�+ O O LL '� d N = .Q t O W •E el v 0 -0 CO CL w> 0 N -0 O H t - c. 0 U O W :a Z Z 0 m Cf) r O E — A N W a o W O U c_ ^W J z 0 _ N 0 t O Q Q a J O O w L N c c O O CL CL EF)Q c � J W Zv CL c The Commonwealth of Massachacsetts Department ofIndustrial Accidents ®face of Investigations J 600 Washington ,street Boston, M -A 02111 y www.mass.gov1d1a Workers' Compensation Insurance Affidavit: Bannllde>rs/Comtractoirs/Electricnan§/Phambers Name (Business/Orgmdntion/Individual): .f - Address: 4 FDN rJr- ID employees (full and/or part-time).* Citv/State/Zin: jr�AVEJ2M-. tj Mrd 01 �3 y Phone.#: Are you an employer? Check the appropriate box: 1. ETI am a employer with Z -S— 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub -contractors 2. ❑ i am a sole proprietor or partner- listed on the attached sheet. ship and have no employees These sub -contractors have working for me in any capacity. employees and have workers' (No workers' comp. insurance comp. insurance -1 5. ❑ We are a corporation and its required.] 3. ❑ I am a homeowner doing all work officers have exercised their myself. [No workers' comp. right 6f exemption per MGL insurance required.] t c. 152, § 1(4), and we have no employees. (No workers' comm. insurance required.] Type of project (required): 6. ❑ New construction 7. 9 -remodeling 8. ❑ 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. t Homeowners who submit this affidavit indicating they ate 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 employer that is providing workerscompensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy # or SeIf-ins. Lic. #: ''' R O O 8 a % 0 16 a S Expiration Date: 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 NIG-, c. 152 can leadto the imposition of criminal penalties of a fine tip 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 Investieations of the DIA for insurance coves a verification. I do hereby certify under the pains -and penalties of perjury that the information provided above is true and correct Signature: [ �pJ, ��� c We: 2 - /? Z _ Phone #: Of use only. Do not write in this area, tb be completed by city or town official City or Town: Fermit/License # Issuing Authority (circle one): I. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person. Phone #: 0 ¢V. f6 � 1t d+ L � to -0 r N O X O LU � Z'1 R 7 4 M \L} \La \ f O � w N C O c G, fiS .•`. 00- 000QR CO- 9 ci m c U _o u x 4 Cr u O �� tll ro , o 0 A 7 � w L ci - �� tll IWtT,m� o o Uci�._ Z ! Q Q. J J O t L > W >>_J o CL 7. V S 0 '&i }. j 1 ,�� EP CERTIFICATE OF LIABILITY INSURANCE DATE 071111112012MMIDDIYYYY) 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 BElMEEN 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 Fe 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 Fred C. Church, Inc. 41 Wellman Street Lowell, MA 01851 (800) 225.1865 NAME: ONTA T DorothyA.CorleO, CIC, RPLU PHONE 976 3227211 FAX ( 976 ) 454.1865 A1C No Ext : A1C No E-MAIL ADDRESS: dcorletl�iredcchurch.com INSURER S AFFORDING COVERAGE NAIC q GENERAL LIABILITY Citizens Insurance Company of America 31534 INSURER A INSUREDHanover New England Window & Door LLC 45 Fondi Road Haverhill, MA 01832.1302 insurance Company 22282 INSURER B : INSURER C: Massachulells Bay Insurance 22306 New Hampshire Employers Insurance Company 13083 INSURER D: DAMA ETORENTED 100,000 PREMISES Ea acc.mmce $ INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: ' " RevlZwre MUMUC c: 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 CONTRACTOR 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 INSURANCE ADSL SUER POLICY NUMBER MMIO�Y� MhU0DIIYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMA ETORENTED 100,000 PREMISES Ea acc.mmce $ X COMMERCIAL GENERAL LIABILITY MED EXP (Any one person) $ 10,000 CLAIMS -MADE � OCCUR PERSONAL & ADV INJURY $ 1,000,000 A ZBN8161407 71112012 711/2013 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $ 2.000,000 $ POLICY X PRO- X LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 Ea accident S BODILY INJURY (Per person) $ X ANY AUTO BODILY INJURY (Per accident) I s C ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIREDAUTOS AUTOS ADN8162169 71112012 71112013 PROPERTY DAMAGE $ (Per accident) S X UMBRELLA LIAR X OCCUR EACH OCCURRENCE Is 9,000,000 AGGREGATE 5 9,000,000 B EXCESS LIAB CLAIMS -MADE UHNS167305 71112012 71112013 DED I I RETENTIONS $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECU 1lvc YIN OFFICERIMEMBER EXCLUDED? (Mandatory In NH) N 1 A 000082601625 7/112012 71112013 X WCyTA �T• OTH- S ER 500,000 E.L. EACH ACCIDENT Is 500,000 E.L. DISEASE - EA EMPLOYE $ 500,000 E.L. DISEASE - POLICY LIMIT 1 $ If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) Proof of Insurance New England Window 8 Door LLC 45 Fondi Road SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Haverhill, MA 01830 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE P Client n 29buMst a 22446 Cert Holder # ©19118-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD w = CD m o N W TF < WRxm ti r? Z O `2 su N d jli 0 M o # O CCD a � r Q N W v ' ' `� M d 3 C,7 0 `'' 3: m 3 w Z +C n r o Z N m 0) Q TI 0 Q `n m0 `< m T rr xCD 3 CD L) N CD fQ W _OD as � CD o Cil CD 0 x O 'O � � ID A Q_ G)amG) n+ n�= ��z — A, �N yF•@CD33 N 3O m N 00 S Oii�N CD > > N O -e.m 7 :3 -69 O 3 n Nd m CO Q C 0 O v = CD m 7 O N N o o 3t t 33 WRxm ti r? Z O C c 0 M o as 0 y CCD � r Q N m o � m m c `� M d 3 .eta Z +C css li m 0) Q IV 7V G Cn Q rn C `< 1 T rr 3 CD L) N CD fQ ? � � N o Cil II 0 x O � � A D N O CD CD N Q ID v n C Q CDQ Q m x v d 7 Q N 7 A CD Q 0 0 0 M M M o Z w u m M x o .� C PD it 41 ,= 3 � CD 0 a Z O as c 3 o _< 3 CD rn(< z __ rr coo m 0 a O_ � A O W OO W6 N 4O G_ Z. C) 3 jo a a o o 3t t GD ti r? Z O C Z' 0 M o y CCD _ v CD k „ .eta Z +C css iZ3 co N IV�$� C) xn-CD- IV 7V G Cn 1 r jo a a :� o x 2<1 a a ..C,3 o c r? Z Z' D O iZ3 co M IV�$� C) xn-CD- IV 7V G Cn 1 s.r `< 1 i e v 3 s.r 1 3 o = 47 -n < W : m Fu m : o m CM 1, a o kq n 3 ut n z. � ,O 00 0 1� _. V... m;i�m� < X , — Ca E 0 MNW O O1 O H D1 � o v C m m m — m 0 alw R1 0 T 1 C d N <D C c N o � X w m 0 A 0 3 I v O W m S �p G) 2L y 0 A 9 fl Z C 'DCD v5 w Ate- ' m. n m = a� o 3V 2' �� �m CD � am � rn j o O (p O � f3� G G_) w N. CC) _ .IIS i c a � co Ln m;i�m� < X , — Ca E 0 MNW O O1 O H D1 � o v C m m m — m 0 alw R1 0 T 1 C d N <D C c N o � X w m 0 A 0 3 Z c) O 3 CD 0 O 0 CL 0 6 —0. a Z v 3 CD O m O a 00 W co O z 0 c n 0 R W 0 - CD Z i` c CD A O O £J 0 O CD C 3 0 - CD z -P N CO v v co cn 10 n v5 w Ate- zZV, o T ID0 - n m Q S w Z c) O 3 CD 0 O 0 CL 0 6 —0. a Z v 3 CD O m O a 00 W co O z 0 c n 0 R W 0 - CD Z i` c CD A O O £J 0 O CD C 3 0 - CD z -P N CO v v co cn D i 3 rn 3 O C Ol CD # 53 551 O i Ct CD dti �? W 0 CD 0 . Cl A CO) m s p p m r N O vi+ O IY ♦ < S ID 3 u -n ? CD — Zj m 1 Z .Sa In a — O cfl nWi O OCD 0 CD _ > = X un a 4h. w w R _ z I v G iL �f- I Iz 0 0 0 5 X o' i C) 'n W N 0 m m m 3 N NcGO�ID 9 0 - Q 0 .. C1 -n M Q- C °: r— co)— — zt O NN 7 N X W min fA (n O 53 r o Q. cr 3 U) m 0 m aS m o c a5 'C Cl) o m m \ � 3 '1 O N K i5 G? N m 3 � N C @ O x 11 m JO m - �-� rc4 Cal O G K z m 3 CD 0 LV O N d co CSl co O z O O Q O CD d CD z c C 7i I V II O CT S�..J C O CD z C 3 cr CD A IV CO v v co US C) 'n i 3 min 53 r o 0 CD- { 3 o n n m m - �-� rc4 c o — — CD7: V i S Gi — I U Cw C g CD 1 D p O _ II < > co O 6x3 D • � r' 1 S 1 Cal O G K z m 3 CD 0 LV O N d co CSl co O z O O Q O CD d CD z c C 7i I V II O CT S�..J C O CD z C 3 cr CD A IV CO v v co US � r _ o ZE _ 0 — _ Yom• m O- " to ZziO r O m4 O) Z3 � O v— s0 Zx PE CD = - CI) 3 7 `= O CD x ? Q V O = W ;R O y. G d �wX Z<Gi(nx03 mph �•' C C 03 'n 'a8_ N R rL y G�� W 3 d m u ® z m 3 zC 6 Q.'ems► A 3 z..8f y Od N N W_ 34t 0O (fl cn m m 3 E3 C C Cl) o - O 0nm con -0=202 0 o ag c O �.m O 0 m , m __ C cn- 0 NO m m O O N0 O CD 2.O m m 3 -F WM W 0.00 tD 3 G?t�.m. W ■ 3 j N O . 7. 3 A(D cmi 7 N 0- 3 0? N D A N 3 G7 �.N Xm O �� Spy = x m.. �tn�o �CO-4 4 cQ � G o °�° D.. 3 -nm MCL=r y 3c QQC�py Q CD D 0 o m < _ = v s c 3 g�mmm 0 ��m�m A) � CA II1 Q. 'ft m O 7 d N 3 m N m m tQ Q Cr y 0 3 r am < 3@ nm CD 'p (D rF eM O m m Q 0 7 m C 0 7 3 N K K N G +* (P C tQa Q Z C Q m CD D m gT! M 5 a oo p p 5 a Q. CD p 3 s A'S 07 m W m W d N W N W O W m (P i A N O m p O O CDD : m o CP C m - CA LTI c w w m m m y 0 n co u m W N X ¢j O K m 3 `� cD 0 _ e9 ZE _ 0 — _ Yom• J .i m 3 `G a) S CD T CD CrC CD CU ov 0 0 3 n w < - o n n z - - - _ - -. cr C; n _ ZA2 C6 D cD CD �� s �0 J 0 CD CD C O P) r? fD 0 vOi O rL CD o0sb �- co co �. D. O A NroCD , CD A 0 4.CD N N O 0 a m 0 0 CA o:3 < rL 0 O f a a 0.-- CD -O�r. n .. - G C g — _ L Y: — i Cr. A v A r :f •--� `� � -• Cil J• _ O CD 3 0 73 G Q 4 O CCD 0. O = 2 a A in -s O Y T il CD CCD 0 CD A O r CD Z G <D >S cD 3 O cu S M O a >5 a- CD Z W a' co <D a K CD CD z m —w 0 m:� CD cam = w T -0o w° U m e CD rD c am fD'0 (P (P N crcr MU � v � o =� N <� m � � 0) v 3 CD �zos oa= =v <� =° c 33 3 0)m"''09 ny <to cn0 * 03 3 ? 0 03 << fl1 n 3 �' O A CC] f0 C1 �, O O O 3 :3 —@ — O v (ll 0= O 7 rt CD Cp rt 3 W rt O O 0 0 (D CD C<D S n .► �■ C D ° v i] 0 (D C r 7 Cn Cn �' -0 tD C L 7 S Q (n S C 41 r' 3 yr—i — CD �{ Q CD CD .. � X C L CD Cl) , coa O O O II7 CD y' O \ V o C 3• X CD -0 C2 0- CD O Fn CD O (D N 0 f2 _ 0 — .s m = x -, X• 0 CL O z .3 O© O< O (D n. O. r Q N 7 �, S C1 7 O M Li 0 Q W O� ='. O Pis Q' 3 Q 3 O 3 -s — 7 O 0 O O CD CCD rt << n 3 A 4� c CL Ci c4 tQ 0 N �: C!1 —Co < O n; `< Cy n -p ty 3 CD �F CO C2 CQ D N to N O — 3 41 fl1 3 '0 O C L — (D CD Cll = Cn CD 7 v m fl to to Cn x x c ern ° O � `� Q`c � ° =-a n 4 w C2 CD CD rt O(D N (D tf] 0 C2 ° "�'' C Q` Q C J �'' `T 0 n o= rCF. 3 ° Cn ) Cn O ° O =• rxi• �-., n `G O rt .o G -p 3 31< Cr3. ° j C2 CS C L 3 "_ O (D (D 7 O C! (D O� 3: C 3 CD a- K= CD Q :] J O u �-� 3 m C2 = Q O 3, -0 3. 3 0 = 0 O = (D — O m 3W O C � : z to C L C2 to 7 Q (D 3 (D 3. (o j T � ' tp 3 3 O � O P� a �° m Q3 a� 0 e9 mom ac CD OL CL =-�"ni O �to=3 �0-C3OtD�°N CD �.x(DO �lD --ft CD J = O i�3 < O ED O O _7- 3 0 (D N CD M CU tD to 0 O J O�CQ O CD 0Q Ort N S p O Q O 0 (D C Cn N Cn p<j N Q `2 Q CD .3-' 'Q C1 O 0 0 N 0~ 3 O -a ua � CD c Q m 0 � � t3 Q C Q 0 O CD ° C D= ° 3 - 3 Q m- { °m - 0 x;33 -0yZ rt Q N a 3� O CD 0 a --k 0 -to =�• 3 c o O v Cn O A = 3 n OCN CD N �'tn C1 C3 CQ N O C N O 30 3 3 m 00 7 II_ O N (D Q a W 3(n Q� O fl 3 Cn (D N ? En CD •..,...0 CD 3 'o 3 p O tD K O 0 - to CD -0 fD (D O (D _ M. C= 3 N 3 c CD _ m 0 (° at 2- NCD OL n — — ul n,< � m CD O = 0CD :3 L2 n n 0 0 ° o 3 cn ED m N CD Q 0 CD z v m �^ 7 2 CD\ / [ o CD \ CA � k $0 � \ ® \ � CD - § t E | - § CD n . _ § / 7 § � C \ � ®. CD % � ® ƒ , 9 i 7 { %PL ! % , ,CD, / ' § { g / ! 0 3 § » k / ¥ m \ k k \ o f CD _ / / -0 ° n CD k -4 \ � \ � K O E § f \ ƒ , § m (D \ � & Change Order CUSTOMER: Ron vola DATE: 1#/29/2012 Changing order from 8 windows to 1 window in the kitchen. No moiney has been deposited yet Will get new deposit check and permit fee check Project job number is 741 BB0166 &JlD1.ri rNl o ggrlo W6.) - The Original Contract Sum Was: The Contract Sum Will Be Changed In The Amount Of: The New Contract Sum Including This Change Order Is: 1c � e"A-0 Deposit (WA Of Total Contract): Change Order Deposit (50% Of Change Order Amount): Amount Due Upon Substantial Completion: Company Bruce Badalaty Representative: Signature: Date: — 11/29/2012 MA Ma Ron Viola Customer Name: Signature: Date: 11/29/2012 Pella Windows & Doors. 45 Fondi Road Haverhill, MA 01832 Phone: (800) 866-9886 Fax: (978) 373-7274 Revised W32006 M cc �• 3 Q 0 m n CD n IDx m a Q z (D CL D af Z' w_ ` 4 Z 1 O �! _ — X a r Ci X - v 5c :� 1 1 1 I i., 0 Cu Z v 3 rn 15 0 ni 0 O 7 fv a 00 CJI CT Cb O Z O 7 Q O C O CD Z C a m N CO v v CO Ch NOTICE OF CANCELLATION Customer Name: (Please print) Date of transaction: �-- 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 f -.;L— (three business days from the date of transaction above). I hereby cancel this transaction. (Date) (Buyer's signature) WINDOWS AND DOORS CONTRACT TEPOIS ?-ND CONDITIONS zm,: e e and Conditions are an integral part of the contract set forth on the 07ler (the `contract") between New England Window and Door LLC u .H2 Windows & Doors, Inc. ("Pella') and the person(s) identified on the ..a Order ("Owner') to supply the products (the "Products"), and perform ii-- wod, (the "Work") described or referred to in such Contract. For Product O3'ty purchases, a signed "Product Only Addendum" is a required part of the oantracL 2. OWNER Pella is not responsible for any existing security systems. Owner shall remove all shades; verticals, blinds, curtains, drapes or window mounted air conditioners, prior to the installation of the Products. Pella's installers are not responsible for the removal or installation of these types of items. Pella is not responsible for pre-existing window coverings fitting on newly installed Pella windows. The Owner shall provide complete access to the work site between the hours of 7:00 a.m. and 6:00 p.m. (Monday through Friday) for Pella's installers to deliver the Products and perform the Work. 3. PELLA Pella will be responsible for and have control over construction means, methods, techniques, sequences and procedures and for coordinating all portions of the Work Pella will be responsible for the Work of its Pella Contractors who will install the Products. Unless provided otherwise in the Work description, Pella will provide and pay for all labor, materials, equipment, tools and machinery, transportation, and other facilities and services necessary for the proper execution and completion of the Work. The materials and equipment furnished under the Contract will be good quality and new unless otherwise required or permitted, the Work will be free from defects not inherent in the quality required or permitted, and the Work conform with the requirements of this Contract. Pella shall not be responsible for damages or defects caused by abuse, modifications not executed by Pella, improper or insufficient maintenance, improper operation or normal wear and tear. Pella will keep the premises and surrounding area free from accumulation of waste materials or rubbish caused by performance of the Work. CHANGES The Owner may order in writing changes in the Work consisting of additions, deletions, or modifications ("Change Order"). Any Change Order shall include an adjustment to the Price and the Substantial Completion Date, as determined by Pella. Pella reserves the right to approve or disapprove any Change Order and any such Change Order must be signed by both Owner and Pella to be effective. SUBSTANTIAL COMPLETION Owner understands and agrees that the Substantial Completion Date is an estimate only and that the actual date on which the Work is completed may be extended to allow for Change Orders requested by Owner or if the time to complete the Work is affected by conduct of the Owner, weather, labor disputes, availability of subcontractors, acts of God, fire or other causes reasonably beyond Pella's control. If for any reason the Work is not fully completed by the Substantial Completion Date (including any extensions contemplated above), but is substantially completed by such date, i.e., the Product has been installed, but minor parts or components are missing or need to be replaced or repaired, a hold back proportionate to the cost of remaining parts or work to be completed is acceptable. However, the holdback will not exceed the amount of the completion costs or 10 % of the remaining unpaid balance of the Price, whichever is less. FINANCING If payment of the Price is financed with a financial institution through Pella, all financing paperwork must be completed upon signing of this Contract and the requisite approvals and authorizations for the full amount of the requested financing shall have been received from the financial institution. PA 1- I s Pella shall beer—`< r -for''' material def ruh e- failure to pay Pe1L due. CORRECTION OF VI#Z : Pella shall correct installation We-krr_ ==f====r---�-R-= of the Contract, if notified in writi. Completion Date or, if earlier, the d,-- T = �+--�- completed and payment of the Pu�� e 7- s= -s r = =-:L= provided above. Correction of remedy for defective workmanship, andis . - r -�- remedies. Pella's obligation to correct Td ek is ==- == receipt of all payments then due. LIMITED PRODUCT WARRANTY Pella shall warrant all Pella products, but only in acoxm=. - Windows & Doors Limited Warranty. THIS LIMITED�r�'� � -_"�: 5___' BE THE SOLE WARRANTY WITH RESPECT TO THE PROs: PELLA SPECIFICALLY DISCLAIMS ALL OTHER W-APUR '_'+ =S - EXPRESS OR IMPLIED, WRITTEN OR ORAL (IN,CLU DIL C � d—,u ` LIMITATION ANY WARRANTY OF MERCHANTABILIT2 C? FOR A PARTICULAR PURPOSE). 10. NO CONSEQUENTIAL DAMAGES UNDER NO CIRCUMSTANCES SHALL PELLA BE LIABLE FOR CONSEQUENTIAL, INCIDENTAL, INDIRECT, OR SPECIAL DAKNGES. WHETHER FORESEEN OR UNFORESEEN. 11. HOME IMPROVEMENT CONTRACTORS All home improvement contractors and subcontractors shall be registered with the director of the Home Improvement Contractor Registration Program administered by the Board of Building Regulations and Standards. Pella and any of its subcontractors identified in this agreement have been registered. Any inquires about Pella or any of its subcontractors relating to registration should be directed to: Director, Home Improvement Contractor Registration. One Ashburton Place, Boston, MA 02108, 617-727-8598 12. PERMITS (MA customers only) Pel is obloqted to and will obtain the following permits for this project: Homeowners who secure their own permits will be exc uded from the g ty fund provisions of Massachusetts General .Laws. chapter 142A In addition to the rights and warranties enumerated in this agreemeaL cuu mat have additional rights under Massachusetts General Laws, chapter 14,11k aim 780 Code of Massachusetts Regulations R6. 13. NOTICE OF CANCELLATION You may cancel this agreement if it has been signed by a party thereto at a place other than an address of the seller, which may be his main office or branch thereof_ provided you notify the seller in writing at his main office or branch by ordinary mail posted, by telegram sent or by delivery-, not later than midnight of the third business day following the signing of this agreement. See the attached Notice of Cancellation for an explanation of this right. Do not sign this contract if there are any blank spaces. (4,A "'Z. Customer tgnat e 11 A h �-- Date DISPUTES Job Name ` of DateZ- THE CONTRACTOR AND THE HOMEOWNER HEREBY MUTUALLY AGRL= ADVANCE THAT IN THE EVENT PELLA HAS A DISPUTE CONCERNT4G T-�IC 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 SUB -\-IIT TO SUCH ARBITRATION AS PROVIDED IN M.G.L.c. 142A Contractor � V Homeowner 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.