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HomeMy WebLinkAboutBuilding Permit #406-13 - 78 EDGELAWN AVENUE 11/15/2012 O*NO BUILDING PERMIT DT b gtio TOWN OF NORTH ANDOVER �? h "'- •- ,a 0� 4 ..� APPLICATION FOR PLAN EXAMINATION Permit NO: �0-C/ Date Received �sy°�R,rE, SSACHUS� Date Issued: `� /56R/T-tNT: I Applicant must complete all items on this page .. yr'.._vrr_' ....-.a::c ...�..,..,,,,,.,�..+:.:.: .�...� '.tyii'#"".:•!,.;`j_`"*S "ry" y ��� .:..r`d^ — '^.4'`'S ':v'}xa • t L©GATION' 7� A4E L >+ Feint ., Y �i�ss 1}�v o P.RO.FERTY 0INNERt -_ _ ,2 A LL- So..� ' MAP. NO 'S% PARCEL �7? ZONINGIDISTRICT:, _ HistoncaDistnct yes - ' - '" � MachmeFStiop?Village; yes� _ TYPE OF IMPROVEMENT PROPOSED USE T Re ' Non- Residential New BuildingOne fa ' Addition Two or more family Industrial eration No. of units: Commercial Repair, re I Assessory Bldg Others: emolition Other it _ .. q . µp Septic� ` V11ell� ! Flood lam . V11,etlands Watershed ®isfnct -, - � DESCRIPTION OF WORK TO BE PREFORMED: �C�sJ C.4 e ►v7' L4 4 0u� t�av c2 Identification Please Type or Print Clearly) OWNER: Name: a4SS4No" LussO Phone: 92k � Z�►'ZS"" Address: '79 / 406-&4+L..-, A-(� COIVTRA ?TT®R "Name ma ''Addressz— t'' k; _ Exp Date © �f . r Su ervisors3Construction�Llcense �_� - �, ! ;HomeflmprovementLicense: . .�t7.7 �M1 �� k �EXp, iDate C/I�_.S:'-� ;s.x• ARCHITECT/ENGINEER Phone: Address: Reg. No. s FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ Z®Do- FEE: Check No.: y� 2 Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner Signature of contractorw�� i . Location/� x-- No. Date �l� Z • • TOWN OF NORTH ANDOVER Nk s Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ � Other Permit Fee $ TOTAL $ Check# y, 2, 25956 136ilding Inspector 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 DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments . 4 Water & Sewer Connection/Signature &Date Driveway Permit DPW Town Engineer: Signature: Located 384 Os ood Street FIRE DEPARTMENT. = Temp'Dumpster on site yes., Located at,.124 Main Street` £ fr t Fire{Deparfinent signature1date-- .COMMENTS',, COMMENTS', ti -P 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 i Doc.Building Permit Revised 2008 r 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 o Floor Plan Or Proposed Interior Work o Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks j o 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 VOTE: 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 NORTf-� Town Of o - n+ No. ® * - h ver, Mass,0 L^045 AA COCNICHOWIC' S U BOARD OF HEALTH Food/Kitchen PERMI . T LD Septic System THIS CERTIFIES THAT ...... 14-A......� BUILDING INSPECTOR Foundation has permission to erect .......................... buildings on .;7,:f ZGlf..�a ........................ Rough to be occupied as ........ ...... .`,l� � �r�rt..� .:S E. cad�.... ?t?`'......................................... 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 VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION STARTS Rough Service ...... .......... ... . ' .................................... Final INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Buildinz Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. SEE REVERSE SIDE The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations t a 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: builders/Contractors/Electricians/Plumbers Applicant Information ]Please Print Legibly Naine(Business/Organization/Individual): Le-11-4 Vd t t 10 o iw S i-LZ� Address: i 4!�_ FON►Jr_ I'M City/State/Zip: 4AV r=24,d 1 M4 Phone.#: q 7 e -'A S -'7o1 S— Are you an employer?Check the appropriate box: Type of project(required):. 1.[31 am a employer with Z-5— 4. E] I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.El I am a sole proprietor or partner- ship listed on the attached sheet. 7. [modeling 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 I L E]Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152,§1(4),and we have no employees. [No workers' 13.[1 Other comp.insurance required.] *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 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 employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: F12ED C C-UU9,C.�t — Policy#or Self-ins.Lic.#: QQ 0 0 6 OA G 0 10 a Expiration Date: -]— -f' Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). k ailure.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 certify under the pains and penalties of perjury that the information provided above is true and correct Signature E_ k �� Date Phone#• 1-7 ' Z(,S--`7 J S,( 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#• ATE �� ® CERTIFICATE OF LIABILITY INSURANCE 071D111120122012 IDDIYYYY) ® 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 statelelent on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT DcrothyA.Carleft,CIC,RPLU F978 454.1865 Fred C.Church,Inc. NAME: AX PHONE 978 3227231 ( ) 41 Wellman Street A1C No Ext): Lowell,MAC No 01851 (800)225-1865 ADD E-MAILRIESS: dcorlatl@Iredcchurch.com INSURERS AFFORDING COVERAGE NAIC# INSURERA: Citizens Insurance Company of America 31534 INSURED INSURER El• Hanover Insurance Company 22252 New England Window 8 Door LLC 22306 INSURER C: Massachusetts Bay Insurance 45 Fond!Road New Hampshire Employers Insurance Company 13083 Haverhill,MA 01832.1302 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:22446 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 DR 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. I TR TYPE OF INSURANCE ADDL SUER POLICY NUMBER MWODI EFF MWDI DYE LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X DAMAGE T RENTED 100,000 COMMERCIAL GENERAL LIABILITY PREMISES Ea occunenee $ CLAIMS-MADE a OCCUR MED EXP(Any one person) $ 10,000 A ZBNO161407 7/1/2012 711/2013 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY PRO-JECT LOC S X X (Ea acciiden SINGLE LIMIT S 1,000,000 AUTOMOBILE LIABILITY X ANY AUTO BODILY INJURY(Per person) $ C ALL OWNED SCHEDULED ADN8162169 71112012 71112013 BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE S HIREDAUTOS AUTOS Per accident S X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 9000,000 BEXCESS LIAB CLAIMS-MADE UHN8167305 711/2012 71112013 AGGREGATE S 9,000,000 DED I I RETENTIONS $ WORKERS COMPENSATION X I WCyLIM TATT- J OTH- AND EMPLOYERS'LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE Y/N N 1 A 000082601825 71112012 712013 E.L.EACH ACCIDENT $ER 500,000 D OFFICERIMEMBER EXCLUDED? 11500,000 (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required) Proof of Insurance CERTIFICATE HOLDER CANCELLATION 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# Mst# Cert Holder# ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD 1 Massachusetts - Dema;tmerrt of Public$aie y Board of Building Regulations and Standards Construction Supervisor License: CS-089853 �! WILLIAM R NICIJOLS 57 PEARTREE RD HAVERHILL MA 01830 l \ 1A =xpiraiiorn Commissioner 10/26/2014 .✓� l�2GCit bf�/I�CQ.OGac�lcldP.k6 Office of:ConsuinerAffa ,L iiasiraess Regulation ;. OME IMPR6VF_MENTCONTRACTOR Registration;Ax'21774 Type, Expiration 1y12L2Q1,3 Supplement r: h _ A j 7. i, ri.. PELLA WINDOWSAAXD DOORS-` WILLIAM NICHOLS =}a 45 FONDI RD g � -- HAVERHILL, .MA 01.832 L`n&cs:cretary Contract - Detailed LOW"" F'elll�a'Windows E&Doors � / lgale�s.Rep Naimo: Badaalat!y, Bruce ,1111 dt ,r I-IICk'12> '%7�t /Tax I;IJ#Std-111318. 4:5 Faortd Road �\ �"Y gales hep Plyao�nm. 978-422-451 Haverhill, MA 01832 1 SaUt>;Flop Fax: p'Il►pne: (g716);373 i!5pi3 Fs��t: (S78)373-7274 lgalos Rep E411ad: BadaalatyBPQpella�lbosytoni.coim wuuarr l,,`Iustomer Inforimrattioln PrrOjl:eclMe lliyery Atldress OrOar linfforiTiation Cassandra Lusso Lu,sso,Cassandra,11176105,INorth Andover Quote Name: 1 Encompass Slider 78 Ed5lelawn Ave. 78 Edgelawn Ave, Order Number: 741 NORTH ANDOVER:,MA 01845 Lot# Quote Number,: 4225452 Day Phone: (978)7907675 North Andover, MIA 01845. Ordler Type: Installed Sales Mobile Phone: County: Payment Terms: DeposlK.O.D. Fax Number: Tax Code: MA TAX 6.25. l E-Flail: Clusso13Ggmail.com Quoted Date: 10/27/2012 Creat Plains#: 6824356 Customer Number: 1006304603 Customer Account: 1001 EA8712 Line# Location: Attrilbutes 10 Back Patio Door VNnyl Windows 1 Doors by Pella, Sliding Patio door Fixed if Vent,94.75 X 79.5,White oty _ 1 11:9680 Fixed/Vent SlidingPatio Door PK d Frame Size: 943/4X791/2 r� y�4 General Information: Standard,Vinyl, Nail;Fin Wth Mullion Groove(4.1/2"CAW),10 Series Exterior Color/Finish: White Interior Color!Finish: Whits Interior Glass: insulated Tempered Lovr E Advanced Hardware Options,: Brass:Interior/Color Matched Exterior Viewed From Exterior Screen: Sliding Screen,Premium Fraime Size,;94.75")(79.5" Unit Accessories: No Options Grille. None; Wrapping Information: Perimeter Length::3U9"„Glazing Pressure=4205. PDL2 Wide-install 2.Widle Patio Door Qty 1 Composites Trina>48-Composite Trim Upgradle>Greater than 48 inches wide Qty 1 i For more information regarding the finishing,maintenance,service and warranty of all Pella*products,visit the Pella@ website at vrnniw.pella.com n.i..a...r.,., ahrn�,r�rv�•ry r,.,..•r.,�..i �..�..,:r.,,� r�.,..., a ..c c Customer: Cassandra Lus.so ProijectNarne: t,usso,.Cassandra,1176106,North Andover CirderNu:mbe:r: 741 Quote,Nurnber:4225452 Line# Location: 15 None Assigned Premium Delivery-Premium Delivery-Two(men on a truck MY 1 Line# Location: N,ttrrbutes 20 10 pct door rebate October Promo-October Promotion, aty 1 Line# Location: � Attrlibutes 25 urgency October(Promo-October Promotion MY 1 For more information regarding the finishing,maintenance,_service and warranty of all Pelta®products,visit the Fella®website at www.pella,com -4 c Customer.:Cassandra Lusso PrdjectNante: iLusso,Cassandra,117610w,Nodh Andover Ord'erNumbe;r 741 Quote Number:4225452 Line fl Location 30 None Assigned OBL.T2001 - Keyloak,Stailnless Steel, Random (3ty 1 Thank YOU For Purchasing Pella®R Products PELLA WAR13AhlT1Pi Pella products are covered by Pe U's limited warranties in,effect at the time of sale.All applicable product warranties acre 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 yo+ur local building code to ensure your Della products nneet local egress requirements. Per the manufacturer's limited warranty,unfinished mahogany exterior windows and doors nnust 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. Project Checklist Review (installed Orders Orly) Before the Installation the H meowner agrees to do th®fQ Iom mcg: 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 out 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 l ockset for entry door if Pella handle and lockset is not purchased. For more.information regarding the finishing,maintenance,service and warranty of all Pella@ products,visit the Pella®website at www.loella,com 0.4..1...1.... 4 nt,)7 Mn4 11 !`,....i.,.,..F P1..3.�:1...1 0.,.... 7 ..1 C Customer:Cassandra Lusso Projact Name: Lusso,Cassandra,1176105,North Andover Order Number: 741 Quote Number: 4225452 Wore tile�stal-�-I�utN�rN� Pt�WNa�t�� �!l�2 li�ll5 Obtain Building Permit(When mecluired) Prefinish products when purchased)in contract lE1UN"a tbe 11"MaNation tho (cgme.bwrNnsr agE2oig to dg thiefMIoyyin Keep,pets saibly away from work.area. Keep children safely away from work area Allow Pella Installer room to work safely within your home During the ,egLges.tt>da thehoillowiqg; 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 usinig method specified in contract per:Pella Installation linstructions Replace interior and/or exterior trim only if purchased If Purchased, install exterior primed pine wood tdim or Composite.Composiite will be unfinished. If Purchased, install interior trim matchinig 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 r_the Instailli�.qn the H meow net a9rgs tx)dg tho following: Be available for completion andl sign off to vetiify.all products purchased are in working order Reinstall existing shutters and awnings Re-Install existing shades, drapers, window treatments,wall hangings, and reposition furniture- Arrange urnitureArrange to have alarm system and doorlbells reinstalled' Reinstall air conditioner's Remove stickers from(product and save for energy rebate and tax purposes Wash all interior&exterior glass surfaces (pill nail holes,and joints on interior trim if windows are to be stained (after sitaining) Clean up exterior casing issues;due to storm window removal if full wrap or new exterior trim is not purchased ��_��'` Project Checklist has been revie`ved Customer initiid Product Only Adldendurn has been reviewed Customer initial l Credit Card,Accotmt:#: Last 4 Digits L/Expiration Date: C J For more information regarding the finishing,maintenance, service and warranty of all PellaO products,visit the Pella0wehsite atwww.pella.com Customer:Cassandra Lusso Project Name: LUSso,.Cassandra,1176105,North Andover Order Number: 741 Quote Number: 4225452 Chin-ge irti 1.payment to sa ne account (` C,4i tC_ (Upon subitslntial Completion) Custoaierinitial Project,Clheckllat lhas been revierwod J ���.:.�...�,...�,.�.....�...�.- i� o C s {-1 Order - Totals ey -1.0... Customer Name (Pleaua Prot) P,7 a. bs Rol �JGIEkU�rlli()w� O r�60er 1�otals A "L _Taxable_Subtotal $1,2:03.57 Customer S nature � � ql o`ale ti op, in urp Sales Tax @ 6.25% $75.22 ;; ) Non-taxable Subtotal $1,016!00 Zd.-- Z Z /_-• �� / / Total $2,2:94.79 Date Date Deposit Received $1,147.40 kQWj Z !rnount Duey $1,147.39 Credit Card approval Signature ---®---- For more information regarding thefrnishing,maintenance, service and warranty of•alll Pella®products,visit the Pella0website at www.pella.com n.:.44..w 4A)')'7 vin 4n I`—{...,.N n-4.,11..A n..,... r .f tl NOTICE OF CANCELLATION Customer Name: V SS-0 (Please print) Date of transaction: �' 1 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 1 0 ?I / hree business days from the date of transaction above). I hereby cancel this transaction. (Date) (Buyer's signature) DISPUTES Job Namey Date �- THE CONTRACTOR AND THE HOMEOWNER HEREBY MUTUALLY AGREE 111 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 ARBITRATI N AS PROVIDED IN M.G.L.c. 142A Contractor 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. PELLA WINDOWS AND DOORS CONTRACT i. TERMS AND CONDITIONS XE----r These Terms and Conditions are an integral part of the contract set foith L,-- Product Order(the"Contract")between New England Window and Drs LLAC dba Pella Windows&Doors,Inc.("Pella")and the person(s)identified c ziit Product Order("Owner")to supply the products(the"Products"),and rE4' the V GZK the work(the"Work")described or referred to in such Contract For Only purchases,a signed"Product Only Addendum"is a required part of th.- F ea zz= wa:i � contract. Cf zhf cc --XC 2.=- CL -t6 luzli 2. OWNER Pella is not responsible for any existing security systems.Owner shall remove 17r i-N:;-_ all shades;verticals,blinds,curtains,drapes or window mounted air adi R- -n--- -W=i is---r--7r yz-m--5 conditioners,prior to the installation of the Products-Pella's installers are not vtzzz-of 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. LLQ g-11AD V--9"DWECT WARR-1-N-tr` windows. Pella S��-o r. _-7 FZa Cr:-1 The Owner shall provide complete access to the work site between the hours VV`indo„sl&Daz_- RYCLA-11�-,1 5 H i LL of 7:00 a.m.and 6:00 p.m.(Monday through Friday)for Pella's installers to BE THE SOLE WA:- ---i--W i—ia P y:0-REE PROD t-i-5-1N-D deliver the Products and perform the Work- FELLA,SP:EC-ff7K-i-LL#y DV:-:CLi-1XE-A_;-- 617=11 EXPRESS ORE�--Nfie 3. PELLA Pella will be responsible for and have control over construction means, FOR A P ALR-1TC-t-7!-AR-rt-R?Q1 S!:DL 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 CONSEE-QUL-NTLAL DA-NIAGES Contractors who will install the Products. UNDER R N 0 CIRCLMST z!7-NC-Es SK-kLL P ELL-k BE U-AB LE FOR Unless provided otherwise in the Work description,Pella will provide and pay CON SEQUENMA L1 EIICCEDFN T-AL P\rDIRE CT.OR SPECIAL DAMAGES, for all labor,materials,equipment,tools and machinery,transportation,and WHETHER FORESEEN OR UNTORESEEK other facilities and services necessary for the proper execution and completion of the Work. 11. HO'%i-'E 1!NfPRO%T-NIENTT 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 ofth-.Home Improvement Contractor Registration Program defects not inherent in the quality required or permitted,and the Work administered by the Board of Buildmg Regulations and Standards. Pella and conform with the requirements of this Contract Pella shall not be responsible any of its subcontracto-s 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,& PER)t1[[TS QVIA customers only) Work Pe , obli-A t will obtain the following permits for this project: 4. CHANGES Homeowners who secure their own permits will be I excluded from the ty 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. contemplatedabove),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 this right. 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. Do not sign this contract if there are any blank spaces. 6. 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 X financing shall have been received from the financial institution. Custom 10 )--2- Date • s 4 4 A_ Cl) .. _.. ---'�.� ..... :��: :,yam-t�,+.%e•..^. .�... �,r',. " } 1, tQ • l' a f q NOTES COA'T'ED COPPER . I / DECK,A1VD DRIP FI-ASMgG TO 2 PLASHING bL)Ci813RAKED I» �BELOW THE gALCON ., PI-AAC�3D TURN-UP IS TO EE T j BET'QyEp�I GHT TO THB.Ra�O OP THE DOOR IAMB,AND y ByTHEFLAp AND T�NRi�UP IS TO BE SEALED 3• 'POP EDGE 1 S To gE Y�NGG THS FLA���SRALANI'OR MASTIC TO 4. X70 SUP. t? • ENTMZE ARP ARB TO BE SdLDF TO S �7F �TTM COPPER FLASHING. MANCJFACTORED BY S NE�MHRANE•ORP n'4SH TI73? ,. BRMA-BA S FLASHING IS WR GRACE CO. RKII'R TAPE A 7L7 BE SET rT-USH WI7T-I - REPLACEDOVER THE FLAS TTM FLOOR. AND THE CONCRETE prL FROM THE EDGE O.F CON ATE FILL IS TO BE HELD,4» THE BALCONY TOP ALLOW WATER DRAM DO$ .BACF I 1