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HomeMy WebLinkAboutBuilding Permit #147-15 - 78 EDGELAWN AVENUE 8/11/2014 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION /I Permit N0: Date Received Q Date Issued: U 4� IMPORTANT:Applicant must complete all items on thisage t�CTFw LOCATION AV�7�' = r- '-C . - - PROPERTY OWNER Print 100 Year o0structure yes no- AP NO MPARCEL:&b71ZONI,NG'DiSTRICT .Historic District yes no : �� Machine:Shop.Village yes: no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building line family 0 Addition 0 Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial C64epair, replacement 0 Assessory Bldg 0 Others: 0 Demolition ❑ Other 0 Septic: El-Well" EIFloodplain 0 Wetlands 0 Watershed=District'_ 0 Water/Sewer__ DESCRIPTION OF WORK TO BE PERFORMED: REFP is z =! a eA'C I!Sbk1oo") Identification Please Type or Print Clearly) OWNER: Name: 0/4-5s4uor_g- mosso Phone:22k.796- 747. Address: '�� � t-�w-v A-c,< .PeiI lel(NM�ws_ I / / tsPhone,�?tr ZLS�a�s =CONTRACTOR' Name � ,.,...t In-�,., �cJr� �.t 'Address: 14,5-- 72– Supervicor's•C,gnstructon License:. Og 9 S 3 _ Exp Date:' ; Home,Improvement License;:. `1Q)353 __- Exp: Dater 41--:-10 :/Z ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BOLDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ — FEE: $ Check No.: ��� �f Receipt No.: 7 7 s NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund SgnateSigi�atureof contractor/ Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ Location No. Date . • TOWN OF NORTH ANDOVER . � Certificate of Occupancy $ � Building/Frame Permit Fee Foundation Permit Fee $ Other Permit Fee $ �, TOTAL $ Check#9L� Building/lns�ector Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE.DISPOSAL Public Sewer ❑ Tanning/MassageBodyArt ❑. . 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 DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes t Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature& Date Driveway Permit DPW Tows! ]Engineer: Signature: Located 384 Osgood Street -FIRE DEPARTMENT - Temp Dumpster on site yes no Located at 124 Main Street Fire Departinei t=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 2010 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 o Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the apt<al period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be subm'ated with the building application Doc: Doc.Bui?ding permit Revised 2012 NORTH own of 0 . 100 No. - ,� oh ver, Mass, COCNIC MIWICK A°R4Teo S u BOARD OF HEALTH PERMIT T. LD Food/Kitchen Septic System THIS CERTIFIES THAT ... .lf`'.^r !Q! .....`.�.v fsa BUILDING INSPECTOR ....................................................................... Foundation has permission to erect buildings on . Rough to be occupied as ...........................(..1 !.!!tP.GL+ ............................................................................. Chimney provided that the person accepting this permit shall in every 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 Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION STARTS Rough ............. .'.fir.IV. .............................. Service 4 Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Display in a Conspicuous Place on the Premises — Do Not Remove . Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. The Coutttionivealth ofMassachnsetts Department of bidustrial Accidents ( Office of Inresti;ations I Congress Street,.Shite 100 Boston,JL4 011.1-201 irwii:ntass goiMia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibl Mile iBusineis•OI'?illi ntionhidividliall. ��/� �f Lg 4-a6ef1 {-)Crd,0, Address: S� I I✓ial�� d{a C'itr:StllteZip: voZ1 "! Are you an employer?Check the appropriate box: Type of project(required): i.'t4I am a emplover will, 4. ❑I am a=eneral contractor and I employees(,hill and-or part-time).^ have hired the sub-coiltriett,rc ❑Nett`ci?i]ii111CI1011 '.❑ I and a.sole proprietor or partner- listed on the attached sheet. 7. 0SIRemodeling shipand have no employees These null-contraciof,havi ` em l 1 cS. ❑Demolition wollchlo. employees and have t'orti e1S .fi surance.; lil t InQ ai li]01! [NO workers, Ct,llill.111511ra11Cc comp. required] 5 ❑ We area corporation and its 10.❑Electrical repairs or additions ❑ I am a homeowner doinz all work officers have elercised t112n I Ln Plumbing repair or additions my"s& [No workers' comp. ri.2ht Of exemption per_%MGiL 1'❑Roof repairs instirance required]t c. 151 y I(4),and we have no employees. [No workers' 1�_❑other compinsurance required] -arty applicant that cliecks box=1,lust also fill out the section below shoaling their r rakers'conlpensaiionpolicy mfonnation. 'Hollleotavers who iliblilit this affidavit llldicatias!ihey afe do:Ag all work and then hire our_ide courractors must submit a new affidavit itidicaiLig such. 'COilii'actors that check-this box must attached an additional sheet shod ins the uvne of the siib•coutractors and stair tdlether or nor those curio's 113re :nlpiey s. If the sub-couti ictors h.^.ce eniyloytes.they must piotide their workers'comp.policy multber. I am an employer that is providing irorkers'compensation insarance for nip emploree.s. Below is the police and Job site inform Rion. I11slLrance('011lpai1V Nane:A r,..-.� tt� f /ZE —EM,'O J,�;e4 S XA/S eO Policy:4 or Self-ins.Lic.i!: 74)oo '0 I r Expiration Date: / 5� Job Site Address: Cif?:'State Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy'number and expiration date). Failure to serine coverage as required under Section':A of IIGL c. 152 Call lead to the nnposltion Oi criminal penalties of a line lip it,'S 1.5110.00 and'or one-year ililprisonnielli.as well as civil penalties in the form of a STOP\FORT;ORDER and a tide of up to 5250.00 a day against the violator. Be advised that a cop}-of this statement mai-be forlrarded to the Office of illvesT14at10lls of the DLA for insurance coveme verification. Ido hereby certify ander the pains and penalties of perfarr that the information prorided abowe is tare and correct. Official use oidr. Do not write in this area,to be completed br cit,or town official. City or Town: PermitiZiceirse Issuing Authority(circle one): 1.Board of Health I Building Department 3.Cin./Town Clerk 4,Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: ACERTIFICATE OF LIABILITY INSURANCE 07/02/2014MM/DDIYYYY) 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 CONTACT Dorothy A.Corlett,CIC,RPLU Fred C.Church,Inc. NAME: 41 Wellman Street PHONE 978 3227231 FAX (978)454-1865 E-MAILLowell,MA 01851 C o Ext). A/C No: dcodett@fredcchurch.com (800)225-1865 ADDRESS: INSURERS AFFORDING COVERAGE NAIC# INSURER A: Citizens Insurance Company of America 31534 INSURED INSURER B: New Hampshire Employers Insurance Company 13083 New England Wndow 8 Door LLC INSURER C: 45 Fondi Road Haverhill,MA 01832-1302 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:30382 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MMIDD MMIDD/YYYY GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE ( RENTED 100,000 PREMISESS Ea occurrence $ CLAIMS-MADE a OCCUR MED EXP(Any one person) $ 10,000 A ZBN8161407 7/1/2014 7/1/2015 PERSONAL BADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY X JECT PRO- X LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNEDHIRED AUTOS AUTOS ED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NPROPERTY DAMAGE Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION X I WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N I ER 500,000 ANY PROPRIETOR/PARTNER/EXECUTIVED? N/A 400040101 7/1/2014 7/1/2015 E.L.EACH ACCIDENT $ B OFFICER/MEMBER EXCLUDE (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION low 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 REPRESENTATIVE Client# Mst# Cert Holder# ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD f k"4psachiisetts-=CA pz, rne' t,of Public Safety , 8 aTd or Building Rei qulafitsn_, and Stpndards- q 01n�trtietion SuperNisur ^ ` Licepse: CS-089853'• WILLIAI?RNICH'bLS 57 PEARTREE RD HAVERHILL MA 01830 J�•�+-� �Ji '� i'fs ; F (26/201�rfklratic?rf { 104 ' eoo,rini.a�uuecrl/a��/ll��aJac%c�ee License or registration valid for individul use only Office of Consumer Affairs&Business Regulation before the expiration date. If found return to ME IMPROVEMENT CONTRACTOR Office of Consumer Affairs and Business Regulation egistration: 1:78383 Type: 10 Park Plaza-Suite 5170 xpiration: 4/10/2016_; Corporation Boston,MA 02116 PELLA WINDOWS AND DOOR d WILLIAM NICHOLS 45 FONDE RD HAVERHILL,MA 01832 Undersecretary. Not valid without signature 4 Contract - Detailed • Pella Window and Door Showroom of Haverhill • Sales Rep Name: Griseto, Anthony 45 Fondi Road Sales Rep Phone: 978-373-2500 Haverhill, MA 01832 Sales Rep Fax: Phone: 9783732500 Fax: 9783737274 Sales Rep E-Mail: GRISETOAC@pellaboston.com Customer Information Project/Delivery Address Order Information Cassandra Lusso Lusso,Cassa ndra,NorthAndover,MA,1426521 Quote Name: 12 wide Encompass Window 78 Edgelawn Ave. 78 Edgelawn Ave. Order Number: 741AGO242 NORTH ANDOVER, MA 01845 Lot# Quote Number: 5906148 Primary Phone: (978)7907675 NORTH ANDOVER,MA 01845 Order Type: Installed Sales Mobile Phone: County: ESSEX Payment Terms: Deposit/C.O.D. Fax Number: Tax Code: MA TAX 6.25 E-Mail: Clusso13@gmail.com Quoted Date: 7/18/2014 Great Plains#: 6824356 Customer Number: 1006304603 Customer Account: 1001848712 Customer Notes: MA North Andover $12/1000($30 MIN FEE). Customer paid$30.00 building permit fee with check#170 Line# Location: Attributes 10 Delivery Delivery/Setup- Delivery/Setup Item Price Qty Ext'd Price $235.00 1 $235.00 For more information regarding the finishing, maintenance, service and warranty of all Pella®products, visit the Pella®website at www.pella.com Printed on 7/19/2014 Contract-Detailed Page 1 of 8 Customer: Cassandra Lusso Project Name: Lusso,Cassandra,NorthAndover,MA,1426521 Order Number: 741AGO242 Quote Number: 5906148 Line# Location: Attributes 15 Min Order Minimum Unit Fee- Min. Order Setup Fee 3 or Less Windows Item Price Qty Ext'd Price $200.00 1 $200.00 Line# Location: Attributes 20 Kitchen Vinyl Windows/ Doors By Pella, 2-Wide Double Hung, White Item Price Qty Ext'd Price $1,955.50 1 $1,955.50 a _ 1:Double Hung,Equal PK# General Information: Standard,Vinyl, Nail Fin,4 3/16", 1 5/8",2 9/16" U __ _ — Exterior Color/Finish: White 652 Interior Color/Finish: White Glass: Insulated Low-E Advanced Low-E Insulating Glass Argon Non High Altitude Hardware Options: White Screen: Half Screen Viewed From Exterior Grille: GBG, No Custom Grille,3/4"Contour,Traditional(3W2H/3W2H) Vertical Mull 1: FactoryMull, 1/2"Integral Mullion 2: Double Hung, Equal General Information: Standard,Vinyl,Nail Fin,4 3/16", 1 5/8",2 9/16" Exterior Color/Finish: White Interior Color/Finish: White Glass: Insulated Low-E Advanced Low-E Insulating Glass Argon Non High Altitude Hardware Options: White Screen: Half Screen Grille: GBG, No Custom Grille,3/4"Contour,Traditional(3W2H/3W2H) Vertical Mull 1: FactoryMull, 1/2"Integral Mullion Composite Trim>48-Composite Trim Upgrade>Greater than 48 inches wide Qty 1 Finish FF Trim-Finish Paint/Stain FF Interior Trim Only Qty 1 FF-48-96 wide-Install Full Frame Window_48-96 inches wide 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 7/19/2014 Contract-Detailed Page 2 of 8 Customer: Cassandra Lusso Project Name: Lusso,Cassandra,NorthAndover,MA,1426521 Order Number: 741AGO242 Quote Number: 5906148 Line# Location: Attributes 25 10 PCT OFF July Rebate-July Rebate Item Price Qty Ext'd Price ($239.00) 1 ($239.00) Line# Location: Attributes 30 5 PCT OFF July Rebate-July Rebate Item Price Qty Ext'd Price ($107.00) 1 ($107.00) Thank You For Purchasing Pella® Products PELLA WARRANTY: Pella products are covered by Pella's limited warranties in effect at the time of sale. All applicable product warranties are incorporated into and become a part of this contract. Please see the warranties for complete details,taking special note of the two important notice sections regarding installation of Pella products and proper management of moisture within the wall system.Neither Pella Corporation nor Pella Windows&Doors will be bound by any other warranty unless specifically set out in this contract. However,Pella Corporation will not be liable for branch warranties which create obligations in addition to or obligations which are inconsistent with Pella written warranties. Clear opening(egress) information does not take into consideration the addition of a Rolscreen [or any other accessory] to the product.You should consult your local building code to ensure your Pella products meet local egress requirements. Per the manufacturer's limited warranty,unfinished mahogany exterior windows and doors must be finished upon receipt prior to installing and refinished annually,thereafter. Variations in wood grain, color,texture or natural characteristics are not covered under the limited warranty. For more information regarding the finishing, maintenance, service and warranty of all Pella®products, visit the Pella®website at www.pelia.com Printed on 7/19/2014 Contract-Detailed Page 3 of 8 Customer: Cassandra Lusso Project Name: Lusso,Cassandra,NorthAndover,MA,1426521 Order Number: 741AGO242 Quote Number: 5906148 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 v 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 During the Installation Pella agrees to do the following: 'Deliver and unload products purchased per contract Place and remove drop cloths in work area then vacuum,and remove all debris at end of day: Remove existing product, including storm windows, and dispose of it unless otherwise specified= Install all products using method specified in contract per Pella Installation Instructions! Replace interior and/or exterior trim only if purchased If Purchased, install exterior primed pine wood trim or Composite. Composite will be unfinished.p 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 followinq: Be available for completion and sign off to verify all products purchased are in working order Reinstall existing shutters and awnings Re-install existing shades, drapes, window treatments, wall hangings, and reposition furniture. Arrange to have alarm system and doorbells reinstalled Reinstall air conditioners Remove stickers from product and save for energy rebate and tax purposes; Wash all interior& exterior glass surfaces Fill nail holes and joints on interior trim if windows are to be stained (after staining) Clean up exterior casing issues due to storm window removal if full wrap or new exterior trim is not purchased For more information regarding the finishing, maintenance, service and warranty of all Pella®products, visit the Pella®website at www.pella.com Printed on 7/19/2014 Contract-Detailed Page 4 of 8 LICCor Sandra Lusso Project Name: Lusso,Cassandra,NorthAndover,MA,1426521 Order Number: 741AGO242 Quote Number: 5906148 Project Checklist has been reviewed Customer initial Product Only Addendum has been reviewed Customer initial 8 2 Credit Card Account#: Last 4 Digits 1 3 Expiration Date: 1 0 1 4 Charge final payment to same account (Upon substantial completion) Customer initial For more information regarding the finishing, maintenance, service and warranty of all Pella®products, visit the Pella®website at www.pelia.com Printed on 7/19/2014 Contract-Detailed Page 5 of 8 Customer: Cassandra Lusso Project Name: Lusso,Cassandra,NorthAndover,MA,1426521 Order Number: 741AGO242 Quote Number: 5906148 X oProject Checklist has been reviewed Cassandra Lusso Anthony Griseto Customer Name (Please print) Pella Sales Rep (Please print) Order Totals Taxable Subtotal $614.50 Customer Signature Ulla SalejEep Signature Sales Tax @ 6.25% $38.41 7/19/2014 7/19/70 14 Non-taxable Subtotal $1,430.00 Date Date Total $2,082.91 Deposit Received $1,041.45 Credit Card Approval Signature Amount Due $1,041.46 For more information regarding the finishing, maintenance, service and warranty of all Pella®products, visit the Pella®website at www.pelia.com Printed on 7/19/2014 Contract-Detailed Page 6 of 8 NOTICE OF CANCELLATION Date of transaction: 7/19/2014 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 atour residence, in substantially Y 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 7/23/2014 (three business days from the date of transaction above). I hereby cancel this transaction. (Date) (Buyer's signature) 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 or permitted,the Work will be free from the director of the Home Improvement Contractor Registration Program defects not inherent in the quality required or permitted,and the Work administered by the Board of Building Regulations and Standards. Pella and conform with the requirements of this Contract.Pella shall not be responsible any of its subcontractors identified in this agreement have been registered. for damages or defects caused by abuse,modifications not executed by Pella, Any inquires about Pella or any of its subcontractors relating to registration improper or insufficient maintenance,improper operation or normal wear and should be directed to:Director,Home Improvement Contractor Registration, tear. Pella will keep the premises and surrounding area free from One Ashburton Place,Boston,MA 02108,617-727-8598 accumulation of waste materials or rubbish caused by performance of the 12. PERMITS(MA customers only) Work. Pella is obligated to and will obtain the following permits for this project: 4. CHANGES BUIICIinq . 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 agreement. contemplated above),but is substantially completed by such date,i.e.,the Product has been installed,but minor parts or components are missing or need See the attached Notice of Cancellation for an explanation of to be replaced or repaired,a hold back proportionate to the cost of remaining parts or work to be completed is acceptable.However,the holdback will not this right. exceed the amount of the completion costs or 10%of the remaining unpaid balance of the Price,whichever is less. Do not sign this contract if there are any blank spaces. 6. FINANCING If If payment of the Price is financed with a financial institution through Pella,all A600 financing paperwork must be completed upon signing of this Contract and the G • requisite approvals and authorizations for the full amount of the requested financing shall have been received from the financial institution. CusYyne9191re� Date/ I / 14 D 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 & Doors Contractor Aoe /. 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.