Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
Building Permit #309-12 - 79 KARA DRIVE 10/12/2011
BUILDING-PERMIT NORTy 16f �O TOWN OF NORTH ANDOVER or APPLICATION FOR PLAN EXAMINATION Permit NO: 01-/2 Date Received �4pDRATED Date Issued: /0 2 �/ �SSgcHus�� IMPORTANT:Applicant must complete all items on this page 7r gS=z� ':.Tia: :.;t•_ _ - •,�w:sr ?-79^� -ice_ - - �" .S�,sv. .„a.' .s•rrz X41 _ -;�<'�.•`` -<:1_ - 4 .:-s"'i.'::._..:. �. 'e�G' �4 - -v{.• - - _ ,5 .1iv >nsrat - -.e,. _..�,^ =:..c. - � '•=tom"4- �:;1_ _ I...x:.:-'�- - - -,P::�, - •`�n .-..±ass"aF�s'. - - •:�'.:"-�- : - '( r.''X•:E�c.'• .r''-:-' air" _Jam" �`}_.:,i ti<:^y;:'^:, .--. .� f. ='�•.i F•rF.. ::��.>_..., - �..i.. r:4`S'S:I_.+.1. ::.n>-_ , �y:C4+ '•1':..F?'�,a_- .ry.,. :r`.tir>'`.:,n .�.:7.• :'.. 'l-:ar ^ice yam_ _ �4 .R1 - _ i I •V>-' yr'-4�.^_-,_... 3:f•.�+:n'i. �'-�:.F•I.r..�yvn::Y..:.:`1-�1'}�V�= Nr-t;.. aa��._4 L�%i�•s: t'�� - : :cy;(t;. •�0.;e ,:� r'- Y L'�7-, �':r:�:;5.�:�a.u.:•rp s.L"-(";:%-,�il'•>:,+,»._�`,�.E 4-�e-ziY+^a..eL�e._TM S �•t _4= �,3��tr. - ,�i' r : - ..^:• _ '`' ^�'.-3.;.-.-^r,. YTs�� .t .Z ala_a._� �H. L`- ry PS`i •,..+s._.;, Y T•.1:'4}1 _ 1��, k� �,'"r.�T T".`!Aa`•'ir �.v?ti�.�.5�.e-�..r�hi 4 ..1 n .N� �yIL Irl-'C-.�"L".'ii i1��fY ,-o:_+7,- I . +.l>•i � - _ .(.. >_r: ?iC-•1 i�.f��'�1LJ' �:W`�_.._. •�:_1.(-. _ .ia'1....'�iy'}._.. EV._r^!.?l.^..�. -•a Sr q r r.. ;"fv".;,•,-,•c=a��"'=....,f•-;. :af._v. -_��+'�_r e- _ - _ - - �_1'.` __ _Y� -.w-!>r...'\t_.wl=J!,;_ -1 �:r,r _S�.n ,"i�:y ,a.s<�_��� Siv --�@.e:,.e.:a.:•�e:�&saw _ __ _ - .-r.`.`2i �.:. _. ..._ ._..^,:_.�r .s Fr.�.rcz .. .>,..ss•�ti s�°^. ,-•'. _ ..1=v-. �o- _ -;:r..;-::c,-- �,l T.•_a:.,I "�L< S:a;.�S. .--'y,,,�}.c..r eak 'P_. .ae _(,:'-ei'a„ +,•�a }+..__ �..].'.p� .�It :2 i!,t��: ��'::�,'�.'>'�-•:��..y. "L1 �FA'ih.-�•�l•..e^^��>�>�''.�• �n-.+�• 'a �1� �j-:�a.lhi✓r'\:"i.e� "{ - l�'.. 77T,•�( - _'�G.:�_ _ _.•`-� _ ..y.'S.�.:_,��• sFF[.;JY.:-•�1.--1��J�'���.... >..�..__.P,'.-:�:F�r�.y,1..1� +)•.�� � =rs�..st-i"E," hN�•+� . ju. >�k+Y.:I�l.��'i1+.y�r.'„i_-�' - _..�">-:�,f-;�+-._. :S''�L'-".'.'_,.. '..�hl� i Li. dr. _ - drrtt„ {>:el: s..'.SIfM. � _ - .52r� rte T. l� r.+ .L - ,� 11; _ -_ iti'•.... T'GJ;-�_�..utlw..Z�t,`-�-�,n'I`= �..a`:�:.�1 i ___ - __ "�'_-•-s•' r i a 5t ,-Y �,�:.�.-^_`�°.i-�:;�z,'"^d�-,�_ ..-a} _:zi=.�•�.i--..�•--`ti.�"'^•:..._ "' n y ti`•��. - '-,.:•r,� � .•�c •i`R.-4•`zr_,..;4.. ,..g.'2 -�.l'�. �:'"- �' '=:�+ei:_ �, - = ..� � �• F Y Oil' ��,,ff -P,_ -'�rf�•ti3.a �•ra 1S^ J rr' ,�.r•F sl.•.r-.n .7_ .u- r - s 1 •.3.: l��:ti � - ��' �'�•3.'� wit.:Y-'...>- �r:•'-�. F �....-S --.1..rl.i - - .a� x..F,' :.� .:�. - "tGvv''•••F 5n3•. ��: Tz r$��_.�:`-�+r=�"'.. , `�'i� s�-��s�2�.:-r ut .k.. ,M��^> - ..F"• E?; r'. .1A ..5. - �y,� .f G%V.,•.ti...j.• ^,.� y��'.^.:1 ':[^ .'1'cF,Z--.'• .1• r�f x.5:31: I...'r .i't"`r•^.(L .`�:= rcc- i _yn,'y.lt - - - _� 1�� �Tu:-.c-,»,d� ',��,a�!L'���Ls+�t�;�'..,'L•r�' r.�-y,_.'",�,Y_3 _ _ "::� '�" •"ti•.: '-'.T';;.-+ _ _ _ Y .:7uri�-X1'1• >�'t .,'Ss• .,E,:�� .rhe,-=.-.r!� .,,.rr- .T'Fu..Lv;:"a;�-•r - .- '^_ti^` ;v.-�-_r'•,�-�,.� - - .-4, "� -���'iFh-, cr,.r. lC�s. ..:ti. "�;orL�c•�4�, _ �.;''Vur: .s< .!-a x5s' tr..-=w:,���.:�.vrd�i._!•c..tt y-.rte„ `•.rs - -r7=F.`•j.�•`-''"..:': �1_.+r �..,> fi��'� ;�. �;? ,:,�a>r�.#=r•.'.'L ;.33+.ti•}� .:�51 �t�.�. '''�"� '�r'-4'sra:-�7�i. :�-_: -F,i�. s'-'�-��,n•ir' ;��;�§• .gin-r s::�.__;w.tir0._,,,__?;. x-� lx,, r .-...asmr ';:.11r=`;ice: ...3 - �,r, .$,=iee °ti_�€r"--r 1 n=L•rt10?.?,;, - .?, =" _ _^7` :.a-r.> „'' _ 4.._ , =..,•=:ki4.�?,r.,>,t^.•y. _c to-,w~Hr�-.;t.m.;:.,. :::•ra`=s=:a'.i.�i�r�'-'�.as'�:vL.-a�_.ts1.�s;r.,>st... .t -,Ik. ��.rt��7.1�-u�ryl. -^,ti�'i,`3•:�:�:i:�. .fi ,t��'•_ .:i-=v:c�z•..k�F:• ,.� - 3� ^%i�£• '*y`��!M1}- ,'�Ti�-:' -. .. _. _._.riva.:�:rr`,.:,._r___..-r• `Gii:�•.,��n..:..:;'r.,`7�c_..•r,�_.r,;.r••�k:2•�i�c ___-�_'�i ��� NJ.t�,:�'y{�iy�.�„C.V'�'e�.�.n Q� f`-_-. s , TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building -6h-e family Addition Two or more.family Industrial ration No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other '-_�-s2`s'�y "� 'K r�-.-..t:�y. ?Sa?�:5`�.r,`.,.rt�,%>i,>.�.. tn..;.��,.�-"•� �'titi�__w-...., >;i.-. _ 1 '� �`�'�,�,y�:T�� �7 r.o.>_ `=:- �, 5 y�';�-:ti" _.-.<"2�1L Y' 'i• 7P a,, w-.y :'�,n `�;._ ��r'[.r�� _ ^fie.;i �� _ F "1' �3 .e :� a � !meq r'� -Erb ,pyr:t1+� {�J7 y�.�'b..wry :��:(n�. S..��74�p d"„taa���•x .:.'T��a.' a��.c�,,� �. 't^L�.;� `�.n�ta E''' rz`.°•g� k:s �. m.,�N,4ix" 3 s. t�..L;-.�_'._�. >"�� �� � t��:L•�i.�,7'L�'r'a*..�-u.��-'. a� 'r�_ _ I _�' ��_�$'' .�,.3..-,_ �,�'l:;ri;7�'�r�, .. �z d,, ..r• � s r���n '"�� h���. '�L u ,��.�. '�7�, DESCRIPTION OF WORK TO BE PREFORMED: • d� .mac'-E-�. 1 (� .n �� Identification PIease Type or Print CI.early) OWNER: Name: (.,.A; Phone Address: A r ii- •ai .,:a°` -�3•� ,..�.. ;ham,:�ia✓`3„i`k�.`e.-•L•�:' - _ .k. ,..-�;y.:�;..:riv::��,:�_ :_,,..,.,,� 1ti�.� .. _ _ _ _ �e'w..- .ti' (k-- �,I;.;fa.._ .ao.. ,z �.',--- 2•'rsi-..19:" 7'r."-''a«7=�9, ',:• 'i::'"rr,N,,,Tt.'}t"�``I:"eti- 't�-�.ti;�.wua.5,_y - �tuu:e:._:-e _„ ...a_ate_ "��%rr •- -•'-E -ern. -s��'�.:a_,�•�.r�`0,^�-... I.....r'll:�r ->�-..,. ..,.-.r...:�.��:=-F!� - „��_�{-".:; ,v �_a 5"s� =,adrti;�..�.� a�!'�� "±•�:�` •=.;a•-�s::v� � -,�,s„se=lic"J'�-Et�•,�-� '�"h�. �•a1,..=..^z;?„••, Vr -�e�,�'sL f�5'S_;�-`'�_.al.`4.��r'�F ��i_ -�'(E.'Z' :s"�:aC�"=��-� •5..��Ti2f�ai°> ..3f.="�7r,.4°�.'f 'S'ry._..;, '�:^u.''f�t'�'G.m�.C''�',.�-_ua1_:. r�3 rte.,Jt'�jr.Er,.a`Sf,�--r f...� �7.e. ,.,y��_ }g•�:'f' �n N r'�:7:: u- - 'r�y"•G.�, r _.y>, 5 .� .,y_r .,�. . k^c�,r�w.. ? :K;, '.+x., " '4F,".t. �. y. i _ �' •`.'y .' 1"� .r"Y�sA a' �,�ir�r'�y�' ff_�'' - - a'v-.nSi .w^�xa :•� t� :_ c[ "' ., r- •y-m.s, 5. k�,'"1f ;xy;., w,:"at•.'• •,Ty•-• r•> r,-.,:r... �.' e' s.t��b.-, nr�� S. •r.•.•, k-1 all 1�;��� a �. !� � :r' - �"�_ v. �`'�s� � -.t ?���3s�}} ���7r.- '� • �i,i.:Grr�N��"3,'p.,"J(i�x.�z���''a(rr•S.F�c{� � ,�:••n ������ ,�,Q( r..�it ,r.,l�=��lil�r��v��'„fvf'('��(�•'"n�,f�Rr "-�^ f,,�}a rns ls*-.� ers- 7. ,+Y•;�•rr.-+-� ams !n,:�6 .i •Y'� 'Q� an.,.�� � IS;G`a�'x,P r$�>h'Yr r`F,Q�'�`;�,�'+LTi,`n�`�'"''�.'--{r�1$�+�.x.. �5.1.�.-.x]',"r: .�-4+'�tis,�^`µr r.,itrmcib,;�� � F'3�t�,j� "` �a °k. .g5 -' "�'�>a '''i� "�• -. �r!�( dr `+r s t Y i.- oma ys.».., r..� `�41* .^.h•r a„S' j�, a w. r'A'•v .l*,''�, cL y�'t,•'•i?=r��.•'-� $� �-���'•���-,'�3b �M1xL���",� ,�•�•,� �� ��)� Ir/�'a����+ ��,1�,r�_�•� •�,5'4,� a , " r�..r;��r- #.r •.Y ,�, 7,,. ADR I:vwl IN41 YI�iAir+7 e ,a�'..F^nJ r+ 'zu."r:'.. .� `�s ti�4u �a..'f 4 '- i`c{�T•`,_ ? p A'.. y E:-r* �•J �:+"'+-''�.•.'�:'n9�'Y'w'.�.sir ti� _ _ _ _ � �.-.�r'C-=" �Cv���r i•�.rrT �� :r�4_j}t�.v�'m%VFs;'J'�'' „i, �.,,,�`-- ,-,r:�-',y'- <t�c- .w,.- ~3a a's,,. .�>`"-�,�i.��sl;>5,5;•a��.i=�.v�a :5,.,.�.� y�`_:.:N� _ -?Y;.tom _ u....�.. -,.r �:'.' ��-. r����'•rcx��a'-; '�z:�=�.� > .a:K,. ., .•cx:�fe3'=,2" y;�;r> ^t.,y.+ 1� - - ':,,,. ,.>�,,r..x-;rr:• 's'?l=_'�'".,- .-?..a - =•,yE-�:� "t-k*S.'r Y�r ,: _ 'C�S�''p>•::,'7�•_ '�' �,°rr". }-o'r-4., r.r.� • ^�^: �':..f:: :,tyl;.:.,,f'`.y':,tY,L rT,,, n'-• r"' ,` �. 3q^-'•t„?ir'':rF;> :tc�i k .. s.rv,1: 7�nlcva ,-. ! ;t F.s^prc �^(k-is, , •; 6`_ .-."r,-�.9; Q;. .'S,�•�''4'�i •y7'c isYv; x'._. -_><'.3'ri"•._ T r., ';u1r`�r`�TEve*:,.u.3.� -.�'�1-:7<,..•-�+.,sn,.nc���,3 x.�fl'�'•.. MEN� cs�-' •..i'^.- _y �` 'f .tGef•'4,,,rim,�ir f.. �•.��'.+`tk��> -'�'� �.�. ����", .(•`J �D'����7�;T�N'N''��]�� � ll��T�lrS�"�`'rrz�'• '-, x-0 �at-��(�.rr!;,` ,� ,�;�y � 4s� rF� ^� Y�...a--. -.ar>*.,,.�„<::re,....,e ew^r_,«�,.._.r.1f��J, .. n>(r �i�- �3.tx a ^���.E'�.��qtr, �•t ��>'r�:..�r.� ..f"�-�.L���'�i$ ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BOLDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. Total Project Cost: $ "3� C.�� b. FEE: $ yet 9. O-' Check No.: Receipt No.: h/ NOTE: Persons contracting with unrebaistered contractors do not have access to the --zsaranty fund �1�a�. --e erg 0a�vner`t '= - gna`tur w _. _.. - _ contor �x< 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 Siariature COViM1EN T S HEALTH Reviewed on Sianature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments t Conservation Decision: Comments i Water & Sewer Connection/signature Date - Drivewav Permit DPW Town Engineer: Signature: :... :...:_r it - Located 384 Osgood Street t y = - F )� rPus - : r. ate. :.._..:. � _ ...._.. _ d�f•����fain:Sfre�I.� .r:...�: .�,.. _--, _r.�.. _ �r:�::__ _ _ ,,r�_�..�_•� I .•....__....__....__..,...�-. _ _._ ._ ... .. -_.. .�:..��_ ..,--:=.��::-_. - _ - - - +_1. - r_ _ _ ryf _ _,IF _ - ark= - ._...-x..¢:.v.':�ya r4 .e.......J.1_1._..�......_...a..._..+ .-x..� .F - :F�_- - - _ -.—::'1''�i'r`if'���ti"4j�'::�='••:ice - i 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 o Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ IVI "ass 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 ❑ Ceified Proposed Plot Pian. ❑ 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 appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc:Building Permit Revised 2008 Location No. �� �" Date MORTh TOWN OF NORTH ANDOVER O' .•o .•'�+ 9 �a Certificate of Occupancy $ 9 MuBuilding/Frame/Frame Permit Fee $ yy� s,usE Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 3 '13 24691 /Building Inspector NORTH own o over O11A No. � /.� if o , over, Mass., Y Q LAKE �. COCMICMEWICK 7�AQRATED S BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR --, 61 , THIS CERTIFIES THAT......... ...............�../ S� ........................................................................................................................... Foundation has permission to erect........................................ buildings on ............................................... Rough cr. ........................................................... to be occupied as.............................. ... I tG..�!� .... :'e'��� Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application on file in. Final 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 CONSTRUC'T'ION ST.RTS Rough : .J`i.. Service ........ . .... . . .. .......... .................. . . BUILDING INSPECTOR Final Occupancy Permit Required to Occltpy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry (Mall To Be Done FIRE•DEPARTMENT Until Inspected and Approved by the Building Inspector. IBurner, Street No. SEE REVERSE SIDE Smoke Det. 104 Otis St.,Northborou h,'\'L L 01532 J& WINDOWS INC.,D/A/A g ' } MA Home Improvement Contractor (508)919.0900•Fm;(774)':)8'-3013 Renewal License#149601 (Expires 1/24/2012) byAndersen. Federal Tax IT)#S3-0404201 II, WINDOW ntPUOaNIMNr .n Mdnr<bmpmry CUSTOM WINDOW AND DOOR REMODELING AGREEMENT Buyor(sl Name _ bate of A ranmont P Buyr..r(,l Str9et Address,City,Stare,ai,l Z Code E-Mail Address _ Home Tale h�ojne�N7umber C 4As4&Tale herrn Number .., U tr! Buyers).hereby jointly and:icv.rally agrv—st to purchase the products and/or services of J&L Windows,tnc,d/b/a Renewal by Andersen ("Contractor"),in accordan;e'rith the terms and conditions described on the front and the reverse of this agreement and on the attached specification shect(s) (collcclive y,this"Agreement").13uyer(s)hereby agrees to sign a completion certificate after Contractor.has completed all work under this Agreemt.nl:. Total Job Amoiink Estimated Starting bate: Method of Payment-,%checl< ❑Cash Winanced Deposit Received(34'%):rte'!—� t3 �✓�� Balance of Start of lob(3,'.'%),/ Credit Cards are accepted for deposit Estimated Completion Dote: only-maximum 1/3 of the project cost. Balance on.Substareial _� Please see Credit Card Payment Form. Completion of Job(33'ol:a-91 Q l' By signing this agreenl onr,you acknowledge that theBalanee at Stan of Job and the Balance on Substantial Completion of Job cannot 1be made by credit card and must be made by personal Check,bank check,or cash. Buyer(s) agrees and and ms tands that this Agreement constitutes the entire understanding between the parties, and that there are afro verbal undet rata tidings changing or modi6ring any of the terms of this Agreement.No alteration to or deviation £rano this Agreement will b!valid without the signed,written consent of both Buyer(s) and Contractor.Buyer(s) hereby acknowledges that Buye��(sj i'I) has read this Agreement, understands the terms of thiw A$rcement, and horn received a completed,signed,and �tl d copy of this Agreement;including the two attached Notices of Cancellation,on the date Burst written above and 2)wav of silly informed of Buyer's tight to cancel this Agreement.AO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANf11,S1'ACES. J&L Wind v,Inc.d/b/a Iter ewal by Andersen Buyer(s Buyer(s) Byetj � anatirF of inatrSignature.uE - y/ Print Name of Pr duct k-rnager Print Name � Print Name YOU, THE BUYER(S), I IIA!' CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY AFTER 11,41 IDATE OF THIS TRANSACTION.SEETHE ATTACHED NOTICE OF CANCELLATION FORMS FOR AN EXPLANATIONI 01THIS RIGHT. -- - - - - - - - -- - _ - -�.<• - - - - - - - --� -- - - - - - - --- - - - - - - - - - - -,< NOTICE OF, ANCELLATiON x �lOICE OF CANCELLATION Date of Transaction . You may cancel Date of Transaction . You may cancel this transaction,withoou'1'or y penalty or obligation,vAthin i this transaction,without any penalty or obligation,within three business days froWi th a above date.If you'eancel,any 1 three business days from the above date.If you cancel,any property traded in,any 1:w±rments made by you under the I property traded in,any payments made by you under the Contract of Sale,and anlr r egotiable instrument executed I Contract of We,and any negotiable instrument executed by you will be returned w thin 10 days following receipt I by you will be returned within 10 days following receipt by the Contractor ("Sol ler') of your cancellation notice, I. by the Contractor ("Seller") of your cancellation notice, and any sUh interesi al(sing out of the transaction will I and any security interest arising out of the transaction will be canceled.If you canail,I roti must make available to the be canceled.if you eoneel,you must'make available to the Seller at your residence4 iin ubstantially as good condition I Seller at your residance,in substantially as good condition as when received, ani i s delivered'to you under as when received,any goods delivered to you under this this Carttrvct or Sale;`d yr7 ` may, if �t-wish, aTmpFy i Contractor Sale;or you may,if ou wish,comply►with the with the itlstrvctions. Seller ."a.ding the lahlrn ' inshvction5 of the Seller regard7mg the return shipment of shipment of the Seller's;1ex" ;attc�risk. I fhe goods at firm Sellers expense and rish.iF you do make If�tsb°do tilakt� tlldlsle t6ihe'-Sellew ane!the I the goods available to-th+e'Wlnr t ild'tha Seller does net Seller does not pick thel!h II p within 20 days of"I date I pick them up within 20 days of the date of dour Notice Of your Notice of Cancel lk �n,you may retain or dispose I of Cancellation,you may retain or dispose of the goods Of the goods without ig other obligation.If you fail to without any further obligation. If you fail to make the make rite Dods avail I Ito the Seller,or if u 6 ree I goods available to the Seller,or if you agree to return the to return goods goods to the;Seller and,fail to o so,g en I goods to the Seller and fail to do so,then you remain liable you remain liable for p jFa mance of all obligations under I for performance of all.obligations under the Contract. the Contract.To concel Iiia transaction,mail or deliver a I To cancel this transaction, mad or deliver a signed and signed and dated copy!jbf'this cancellation notice or any i dated copy of this cancellation notice or any either written other written notice,orl4el Id a telegram to Contractor:J I notice,or send a telegram to Contractor':J&1 Windows, &L windows,Inc.d/b/(I`-ft�tnewa)by Andersen, 104 Otis I Inc. d/b/a Renewal Andersen, '104 Otis Street, Street, Northborough, rlA j0153�, BY NOT LATER THAN Northborough,MAO 1532,BY NOT LATER THAN MIDNIGHT MIDNIGHT OF .(Date) OF .(Date) i HEREBY CANCEL THIS t ILA gsACTION. I HEREBY CANCEL THIS TRANSACTION. buyer':Sienare.e f'r'rnr Vame Dalo .. ..., I Moyer',Sigwvre Mm N.— Dotn RbA Copy- White Buyer Copy-Yellow Buyer Copy-rink rod ntis Slrect,NorthbOtvuKtl,M 1 O).)3'L J X`L Wuldowo,ltte,d/bin F11Dnc"CS..9'ID•OFJOO•Fax 7'4.'37.301$ Renewal HIC I,jeensc#14D601(gxpires 1/24/1'2: MFcdersl Tax 1n# 8s-0404201 byAmdersen. •- WINDOW REPLACEMENT nn And--C Mp,,y Or C.LtPATM MMtACHUSMS ANO NEW HmMl.uRE Buyer(s)Name WINDOW SPECIFICATION SHyxr Date of Agreement 1170 Buyer.(s)listed above hcreb%jointly and severally agree to purchase the goods and/or services listed below,in with the prices and terms of which on the ifi cit'i n Sli :seer and the.front and the reverse of the accompanying CUSTOM WINDOW AND DOOR RF,MODEUNG ACTi;F,EMENT, of which this Specification Shea is apart, WINDOW DETAILS 1.3 S_Contractor will Install al to PJ.of.."1 U windows in Ow.ner's home,using the following individual quantic es: Double Hung(111.3) U F,qual sash ❑ Cottage sash(:I/3 top,213 bottom) ❑ Oriel sash(213 top.I/3 bottom) Casement(CW) [ I-iingc-ra,¢ht ❑ Hinge left(as viewed from exterior): 0 Standard handle ❑ Metro handle Double Casement(,'UW) ❑ Standard handle❑ Metro handle Casement/Picture I Casement(CPW) )•;1;1 Or❑ 1 2:1 [] Standard handle ❑ Metro handle 2 rite Cdidt.nq Wind)w(GW) Glider/P cttu-e/G ider(GPW) ❑ 1;1:1 or M 1:2:1 Awning Windov•(A W) Picture Wusdow(FW) Bay Or Bow Win i.ov Patio Doors(sec separate Door Specification Sheet) 2. Yes ❑ No Qty of Wi tdows to be Custom Fit Rcplacemcnt: _ [1 3. ❑ yes ® No Qty Of;fill 1-0 be replaced by Contractor: 4. ❑ Yes �'No Qty of'JVi Idows to be New Construction Full frame(includes new interior Fc exterior casings)and actual Exterior casin;s: [,� 'inC ❑ Maintenance-free.matcria.l ❑ Factory applied 908 Fibrex brickmold 5. Glazing to be: 0 FTP Lew- :-4 TM Q Other if other,please specify: 6. Exterior color to be: �T'Wl lie ❑ Sand ❑ Canvas ❑Terratone ❑ Cocoa Scan 7. Interior color to tic; 2'Wh.te ❑ Sand ❑ Canvas ❑Terraton.e ❑ fine ❑ Maple ❑ Oak Note: Interior cone r c,n only be white,wood,Or Mme color as exterior, Wood interiors need to finished by Owner, 8. Hardware; IXI White P "One ❑ Canvas ❑ Brass ❑ Fstatc Hardware: Style: 9. ❑ Yes X No Install Li Its-vith Doublc Hung Windows /c=t'p���S�� C1^ 1.0. Screens; windows tc h,lve: ❑ Half or k Full screens Screens to be: ❑ Fiberglass ❑ Aluminum Tru Scene _ GRU LE DETAILS 11-Windows have grilles: [] fes RArO if yes:❑ Grille Between chms(wc,)❑ Removable interior Wood(irrrw)❑ Full pivided light WUL) Qty' Qty = Qty' Qty; Qty i rte, Q y: Qty: DH 01 DH CWIPIrture faltler CPW a D Draw grille patterns above _ "Use additional sheet if needed Owner approved(initials):( ) _ ADDITIONAL WOU DEFAIIS 12.❑ Yeso NO Contract ar.1 rill remove metal frames of windows. Qty of Units: 13.❑ Yes JN No Cori[racl:Ir+Fill install n.ewpaint-ready or stain-ready casir4gs. hTterior casing qty Of o lenitlks; Exterior casings qty of openings: [3 Pine ❑ Ma.intenariec-free material 14.❑ Yes X No Contract:Ir y rill install new paint-ready or stain-ready inside or outside stops qty of openings: Interior stops qty a,gip nings: Exterior stops qty ningx ❑ Pine ❑ Maintenance-free material 1.S. Owner is aware that Col ltn,tor does not do any painting. • Owner Initials 16,❑ Yes'Z No C ontri ctc;^w ill wrap exterior Gassings with alurnincoil stock of _color, Note: Wrapping inrly k:required withstorm window romova i removal of storm windows will leave screw holes in casing. 17. Yes ❑ No Contracu)r vill insulate,caulk and seal windows with.3-point system to prevent wafer and air infiltration. 18. Yes ❑No Clean UP al jnl)edatcd debris including old windvws will be,removed.Vacuum nightly. 19-E Yes ❑ No A limiter l w.rranty shall be issued to Owner upon completion of the job and payment in full. 20,[9] Yes ❑ No Buil N put--Contractor will secure any and all necessary permits. The fee for the pertnit(s)is not included in the Con:rac Price and a separate check is required at the time Of stile for this fee. 21.t Yes ❑No All disr;vunt have her..n applied to this agreement price, 22, Additional job details; _,- - 23. [ f Yes ❑ No Owner N-r:es to be present on the final d,cy of installation for,final inspection and to deliver final payment. n final pv)!mwrt shell(T:do rfrvrdeci until flic confrant is conrplefed to the satisfaction of all pnrfii'ec. It is agreed and understood by rut between the parties that this Specification Sheet,a]p. with the CUSTOM WINDOW AND DOOR REMODI LTNG AGREEMENT,consritutos the a ttix understanding betweon the parties,and there are no verbal understandings charging or modifying arty of the terms This Specification sheet Ira-not be changed or its torus mocUed or varied in any way unless such changes are in writing and signed by both the Buyer�(s)�and Contractor, Iit I yrw(s)hereby acknowle ge that Buyers)has read this Specification Sheet R7oh �Y An ersen of Gres(or\L4 and NEI Buyer Buy�(s) H y ignature o Product l i lm,ager S ature Signature Prost Name of Product IvU,lager 'Print Name Phrit Name The Cornrnoawealtft of Massachu.�efts ' dustrial Accidents Departmenf of In office df Inveragattons 600 Irgistne n Street Bnstoa,MA 62111 t s►.inass.gevidia . Qr�ere' Compensation Fnsirr$ace Mda�$ddere/Contractarsl Ply se Print e 1 A:t3rjjkmt Wormafion' Vi onllndtduail: a er• NHnle($tuinea+l0rgdnizefi . City�S�eteJZtp: � .. Type of project (0#r'4: Are you an employer?Check tiie appropriate ban fi. 2�ew construction �. [].I M A gancael nanimctor and I 1.E-I am a rmpioyor with'2 D * ; •m bind the sub-cont=tnrs odcFing employees(full and)or part-time), Z� Iistod oa tba attnahed sheet Deffi Mnn 2.[] I am a sole prcprit for orperineu- Thesasub-con1wtm have _ ship and have w Moploypes j ..�I camp.iIIa1II9nCG. g, []BuMing a ddition WCOIwod* for me is aay capac,ty. r. own and its or addifioaa [No vaarkcra'com .hwraaco S. ❑ We are a cup 10,[]Eleciriaal rapaiza p o$ier�have==-Med tlmit. airs or addifiaas regmraIL].' riga of csonipfiom per MGL, 11.[]Plumbing rep 3,-[3 I am m homeowaQ doing all aaork and wo hava no I2.[]Rflaf i-epa iss Zarb"[No vaorkere'comp: employes.-ENO woli=' I9.(]Dir insurance r�equimd-]t .o�y a r•equirGd.] r Lt101L Amy appiies�tbar eheol�hoz#1 mud Kbo fa Mt the r M&M befor gbowiag1h wow'compo n PovcY mrmm ere doiaY and thm bice eclsidc oonim tacw�davlt iedieaonF mch t g0mcownan whc=bmtt 6M 6fdav� a ��pf the mb-cowndm ad&*vmi=�comp•Pobc}'id DL • �Gcnttaetoa that 0hrr,Y this bc=�atb0bed as����7°i� . ettsatton utsrvance far my ampinyet:s. 'BeIow.'k the policy and job site I trrn art cmplvj�er'thatis pr�►Id'frtg.workea'a'comp. • irtfarrnatian. �'•� � r Y1 C °l, — — . Insurance Cc mpany Nsmt:' n•� If1 r�r�r ��� 1���,��•r��_. g�girafinnDatc' . Policy for Self-ins;Lit.* `a . pity/Stat�Z�.p:.�._L•T"f1.�d c���; n'1- Job 5b Address: and et, iratian cktz). declaration para(shovemg the policy number AftuJi a copy of the•~corkers to.MP nsatinn.policy osifion of adminal penalfibB of a FwI=to smaure covmge as rmg=d undar SGDb'L 25L of MM a.152 can lead to&D imp D endlor neo- ar kqm ism mmt,ns wrll as ciril pcnaltirs in fiu f of a$TC3P WORD ORDER and a fine fink tip-ta S1,501D Ye Pp be forwarded to the Office of -Dfup to$250.00 a day against ft violator, Br,advised 69 a co of this statement may Invesfigafiona of$u DIA fnr inenrant:e cov=go vacificaf>� vrmatfon P ricTided abate is trtu'¢nd correct I do hereby cc u r the pains and pcnaltiet crjttry at the ircf ( � Data' Phone# ! •CYJ officialorgy,'Do not write in this area,to be completed by city or toK+n ocial Ciy or Tow= . • PermitlLieense# . �s g A runty(circle one): ect or S.Plumhfng Inspector L Board of Health 2.Building Department 3,C tyflown Clerk 4,Plectricel p , • 6.Ofiser . Phone P Cantact Person Y NIassachusctt� - Department of Public Safety Boardlof BuildinRe,-,ulations and Standards Construction Supervisor License License: CS 95707 BRIAN DENNISON 86 CREST CIRCLE • - WORCESTER, MA 01603 Expiration: 9/8/2012 ( �nunissilit]el. Tru: 2622 . Office of Consumer Affaita&Business Regulation A. HOME IMPROVEMENT CONTRACTOR ,Registratio 501' Exp! 12 . (Ti t Card , RENEWAL BY 1. BR1AN DE NNIS� ; 104 OTIS STRE NORTHBOROUGt2 Undersecretary AC VCEDATE(MM/Do/YYY1� CERTIFICATE OF LIABILITY INSURANCE 02/0g/2011 .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 N��ACT Joseph McKeone PHONE JP McKeone Insurance Agency, Inc. AN 734-662-6100 aC Na: P.O.BOX 333 ADDRESE4 Ann Arbor, 'MI 46106-0333 INSURER AFFORDING COVERAGE NAIC# INSURED INSURER A.: Hartford Insurance Company J&L Windows, Inc. Renewal by Andersen Lwsuggiip.Nautilus 104 Otis St. INSURER c.: Northborough,MA 01532 INSURER D: INSURER E: COVERAGES INsuRER F CERTIFICATE NUMBER: 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, IXCLt1SIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LLTR TYPE OF INSURANCE L POLICY EFF POLICY EXP LIMITS POLICY'NUMaER B GENERAL LIABILITY EACH OCCURRENCE S ' 1 DOD ODD COMMERCIAL GENERAL LIABILITY NC958461• 10/01/2016 10/0' 011 PREMISES Eeoceunenoel i 100.000 CLAIMS-MADE ©OCCURS ODO MED EXP Arty one person i PERSONAL&ADV INJURY $ 1 ODD ODD ' S GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 2.000,000 POLICY PRQ- LOC PRODUCTS-COMP/OP AGG s 2,000,000 AUTOMOBILE UABILRY i A 35MCCXD6390 1 D/01/2010 10/01/2011 COMBINED SINGLE LIMIT 1 000 000 ANT•AUTO ecclde ALL OWNED SCHEDULED BODILY INJURY(Perperson) $ X AUTOS BODILY INJURY(Per ecoldenQ 5 AUTOS HIRED AUTOS NON OWNED AUTOS PROPERTY DAMAGE or aocldenl UMBRELLA LIAR $ OCCUR I EACH OCCURRENCE _ EXCESS LJAB CLAIMS-MADE AGGREGATE s DED RETENTION s A WOR IO Rc COMPENSATION 5 AND EMPLOYERS'LIABILI YY/N 35 WECPPI444 02Ji 7/2011 02/17/2012 WC STATU OTH ANY OFFICEXCLUDED?OPRIETORIPACLLUUDED�� N/A ILL EACH ACCIDENT S 5DO DDD (Mandi fry In NH) If yes desadbe under DESCRIPTION E.L.DISEASE-EA EMPLOYEE 500.000 OF OPERATIONS below EJ DISEASE-POLICY LIMIT s 500.0001 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD ID1,Additional Remarks Schedule,If more space Is required) CERTIFICATE HOLDER CANCELLATION INSURED DOPY SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHOROM REPRESENTATIVE %CORD 25(2010/0 01968-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ' +iV "'�'L"r.•P"�'1�^7Sa7T'•�37Z3A'4"� +�.�'R� , i�L Rd rL �aZS ' i •,��.�,i 4�r�s0.1�e��u�[�7id 1 1�LLI�Q Y .6 L PF . 0 LC-41.�L''N7►7-CQ L ' i3 min �T 4 VIMt� Do not remove until final code inspection. Save label for future reference. Qualified for area indicated, 19ions indiqu6es.Admissible pour les Canada r R � aW / %/ atM U c E fy�1'Ji'aipii�l • W ID ertergysWrgoV Qualified/Admissible Renewal byAindei all WINDOW REPLACEMENT �'+�•���* AND-N-3 LA VinylANood Composite Material 3i3L's �` Dual Argon Low-E4 SmarlSun Product Type: Picture ENERGY PERFORMANCE RATINGS LI-Factor Solar Heat Gain Coefficient 0.27 1 . 53 0e22 U.S.A-P (Metric/S.1) ADDITIONAL PERFORMANCE RATINGS Visible Transmittance • 0 . 51 '_ • Manufarwrer stlputatea mat these ratings conform to applicable NFRC procedures for de[arminlnp wnola product performance.NFRC ratings are determined Por a fbao set at emAronmentel cononone and a specnc prdductshe. NFRc does not consum menutacturers tltedany product nd does not warrant me rsture tar omen product performance Information.ddry Product for any specttic use. wwwmtm.org a .raw.•m aai a , - • � wawa..wwr 779TT72 Andersen Co oration:RbA Picture Window Anders ren pus s conrormence a ro oMnD n'IFFTE. Standard Rating NAF5•04orAAMAA' WJCSAtotes.vaaaMs DP psf F-050 �V g"-t The product masts Green Seats 4 Environmental standards � goveminoinp energy a Efficiency,neavymetats .4•t'In me frame end seen material,pacld,ging,and ��� cnnssumereducational 100-00511006-001 MeeC dr eixeeds MP.C.,CE.C,61E.C.C.Air Irflildatlon requirements WDMANaomarK cerdEstion Program"