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Miscellaneous - 173 BERKELEY ROAD 4/30/2018
N j'gw V m �I� � m m g � O o O �_ _ Location /t73 `% JPCO No -,-p S 01` Date .,30 w7 i "SRT" TOWN OF NORTH ANDOVER O��"1e '•,h00 :. Certificate of Occupancy $ 14U t<�' Building/Frame Permit Fee $ D Foundation Permit Fee $ Other Permit Fee $ TOTAL $`— Check # 1 164'18 �/w -� Building Inspector 71, > Cl t z = a ? = C i 71 i r r _ _ = C - 77 - C 7 N � o I � b i or, Z North Andover Building Department Tel: 978-688-9545- DEBRIS 78-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c11,S150A. The debris will be disposed of in: A4 Cr - (Location of f=acility) ignature of Permit Applicant C Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector I I'QC> O.A) i1WO M Q FORM U - LOT RELEASE FORM e p % i -(k, J o P*^a -0 &cK ,51f7/o 3 INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. *************************"APPLICANT FILLS OUT THIS SECTION''**** APPLICANT 2�,� L� �ZZi� PHONE LOCATION: Assessors Map Number 17 PARCEL SUBDIVISION LOT (S) /' STREET 173 /�� �� � � �t-� ST. NUMBER -5 *********************************OFFICIAL USE ONLY*********************************** RECOMMENDATIONS OF TOWN GENTS: 5P CONSERVATION ADMINISTRATOR DATE APPROVED DATE REJECTED COMMENTS TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR -HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR -HEALTH DATE APPROVED DATE REJECTED COMMENTS PUBLIC WORKS - SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR Revised 9197 jm DATE The Commonwealth of Massachusetts Department of Industrial Accidents Office of investigations Boston, Mass. 02111 Workers' Compensation Insurance Afr7dav:t Name - Plesse Pant 11 Name. I cc"ticn- / 7)? L f i 40 IIA14 0 ✓`y 'YZ. 1444- Ch• ire C l'i am a hcmeowner per7crri c al! work myself. L_I am a scle prcprie:or and have no one wcr'king it any c4caci^Y M. I am an employer providing workers' comensaticn for my empievees wor<ing on this job. > . _ 12. 0 Address City 2.727 4IXT IA -15. clic. Insurance Co 1,J4-- omDc ne Y. Insurance Co. Polk/ ' allure to se, -,-,re coverage as required under Se ---,ion ZCA or MGL 52 can Ieac to the imccsiticn cf criminal cenaities cr a rine uc to S1,5CC.OG ancicr one years' Imenscnrnent as well as evil;enalties in the fcrm of a STOP WORK ORDER anc a fine ct (5;00 00) a day acaicst Me. uncorsane that a cepy et nis st2-,ement may 'oe rerwarced the i]rc or Invesacaucris of the CW. �cr cc',erace ventica�:cn. I Cc ,herecr ce ,T✓ unser ,he p rt j c s c" r u .pocn prcvided a0cve is true and cerrcc.' ` signcture Print name ��=Phcne Y At .3k7 Crfical use only do nct write !n :ha area tc be ccmcietee by c:ry cr :cNn crfic:ai C•iv cr l c'Nn LC ,e -x :r immedi�are respcnse is require%' Ccnr�cr -erson. J =hcne T _ EullClnc c- �r c=ns;nc Fc-�r:' Se!ecrmGn's Crica reCBr;rE%t VC"'er r ll r _ ;moi WIND 11 P 10 MS AFFIDAVIT i the undw*n4 bong me °tomer'of the pmpwwae herre�by � t. PW,, the Buil�ng of . Rooms to act as fflp►+rn� in obtain' a Wlong Pwn Signior® of oN►ner: Ad**W of QWW Y dN-&�—Ltalvl 35 Dunham Rd B11 MA 01821 (978) �4 5 r (978)6634880 Customer. City: Job Number: Order Date: PRUE boston 11823 03/18/03 A WALL -r 7/ 47.375 + 0.5 + 47.375 + 4 + 2 sill(s) =102" B WALL 4+71.375+0.5+71.375+0.5+71.375+ 4 +1 sills)=225" ICWALL r ., 4 + 59.375 + 0.5 + 59.375 + 1.5 + 3 sill(s) =128" ROOF PLAN ,s" s" 7,;ts+ 3/?r t WLI {-7 / %,• 7 Ls D D D 4+71.375+0.5+71.375+0.5+71.375+ 4 +1 sills)=225" ICWALL r ., 4 + 59.375 + 0.5 + 59.375 + 1.5 + 3 sill(s) =128" ROOF PLAN ,s" s" 7,;ts+ 3/?r t WLI {-7 / %,• 7 Ls J 780CMR: STATE BOARD OF BUILDLIIG REGULATIONS AND STANDARDS M MASSACHUSETTS STATE BUDALNG CODE CONSUMER NF'ORMAnON FORM • "SUNROOMS" Massachusetts State Building Code (780 CMR, Appeadix J, Section J1.1.3.3.1) The Massachusetts State Building C5dc (780 CMR) includes provisions to am that hooses and house ar81 OD$ mm energy effmieaey standatds.'t w suppj==ta! CONSUMER WFORMATION FORM is to be filed as pact of the building permit applicution when a btWdedconntracca ce homeowner, constcwiartmstallin8 a house addition with very large percentage of glass to opaque wall, setts to utilize aspeaal energy coaservaticn exemption option for "sunroom" additions to an existing house (780 Cwt, Appendix J, Section J1.123.1). This FORM is not intended to prevent a homeowner from selecting a "a mroom" of any size, configuration. orientation, form of oonswction or percent glazing, lut rather is only intended to assist homeowners in becoming aware of some of the impottaat energy conservation and year-round comfort considet Ens involved in selecting and utilizing a "sunroom" addition. The connection of"sunroom" snvcnmes to rmd=ual buildings may create comfort and eeergy consumption issues due to uncontrolled sola.• pm or uncontrolled radiation cooling of the main house. In the selection and construetionrinstallation of"sunmoms", included below is a ton-roowred.open-ended list of product and d� considerations that a homeowner may wish to consider before actually oonsttuuiagitnstalliag a "sunroom". $ is recommended that consumers carsiully rtvicw tree options with their designer, builder, or contractor, m order to mi"izai potential energy consumption and/or bouse discomfort issues In addition, tits qualifications and reputation of the company or individuals to be hired we important consideradoos. PROIDUCT AND D ION CONI_ ERATIOH$ RELATED TO "SUNROOMS" • Solar Orientation and Natural Shading • Type of Glazing • Insulating value ' • Solar beat gain • Frame materials • Glazing to frame sealing and gasketing materials/ seal durability and/or weather tightness of the sunroom • Adequate vent0atim - Operable windows and fans • Applied Shading Systenss • Insulation level in floors, walls, and ceilings • Passible Sunroom isolation from the maim hoose via a wall and/or door or slider • Heating and Cooling Methods: Efficient;, Zoning and Controls Homeowner Acknowledgment The Massachusetts State Building Code, Secuon 11 .1��.1, requires that the actualtfrone, v' 3KY: (no! tine owners agent or representative) admowledge receipt of this CONSUMM])MRMATION FORM prior to issuance of a Building Permit for a project that Wchtdes "sttnroom" additions to an existing residential building. In accordance with this requirement, the undersigned hereby admowledges that sh-./he has read the information m this document concerning suoroom comfort and energy conservation. Date AddrWS of Permitted Project Owner Address Cif differau than project location) Owner's telephone auunber 68? 790 CMR - Sixth Edition I Ix7/98 03/13/2003 14:49 513-782-3903 ENCLOSURE SUPPLIERS PAGE 03 pbdDm jA md. mm* 36 VWJ Mt Rood, BRA MA 01821 • H.6C• 0127172 Q—W ft - 1978 663.14'85 * 1-8774WS4M Siding .o/ AetproBn,eMYwndolrs • aba.s+i9cPeetPFydbRotxRs • wtM 9k�+ • Stda,YYisdeNis+oaeK • tSunerAsBbB COWRACT maps -1 ora To ..� °� C Dare City A,. smce jp p 1� 8u sPh+mcf rdM�i A AEC$ PAMAGE AMUCAMR Cl CU5 QatBt UfMMM+ p AtLZOD6b APlitODL A> _ x — D9CKBuuTBYC)h► d'Xb"4G6't�sBi'IIiCDNCPEi&BP�A7vDliRSf5A3AitYVAPPRBAR,�R.3/Pi0TMD96ANE� OAOOv6 ngRe�t yrs^ TRB,r1l� PL1fR'OOP Stl6Pf.00R SH' FBFAT� PI.AiVXm'I:i AS ta�45ARY SGtat ANi?'t)R RADJNG DFGOLS AS ttQtL'), D6tA�'. EJCI577NG DECA3 O WTArPidc+OL6 BIBTARLW / 1Nti 9pFt11 Y ANA ga47tA/L yt" 7ewcaa Alae caQavB t Pt00p aOsaaPro�T t/Sl A[L8t Q "AM A700A 11AVJ'46ZTAl1LSe CONCRMS1AM (oraaTommhm OotVWrm>Rts lWMMts daCPmWAPPRM502 --x�_ BLABPOUMSy�Y APDR X4'TENa'MVAPORRARRWLSM=Pr-AMNSMLOCALBSlAW(;COD£ F��O'�':[J�-'k'_MpLr PeOTAPIPaG'8)A$ 0C113'lI27d�sA)PP7Wr�1�9rnsG ��Q,Up�,►Plgl®t:LWr.M1R.Pi._-- --. Demi Arra sr��-'RtowcAt.sva�Q cvDs, a � rear a>M*orsseLs � R�a'rn�rt;rooraa►norm ux sr�DCrt,►t� ROpF tiN9tQ.ArFD041511PENi�D RFA), GOYCQFd PP +9ka�PoxrlMotrnfN[4� O� Ae! B.00h iPOrtdVALd" ffiAMn-A ppt.YB[YRPNB R4i0Lti7'$aFVa1N tR-i9) WAH O �.rwrawn�vu►�noc�oassrm►sar�Bo�r.7�uaeem��r�Dr�Ana�awrnt C7 afixSn��PrrdCARTl � armP(co>Vae ) 13 WAVSALPC E3Ew. _• VSi� APaLaG»;1.E OMGP(t70W1R ) Dwvram t;TrLB ❑r,AaLR ROOFCULOk i7 w+un� TAN �1 TRitMt:OLOR pwBa 1r um (MpAROPf WDVN7w SWAM OA#FAmx BowrOZg1momo�1P aynnANG 0samsom SKT GLM M07 A! Lr MI D VMMM _gWAlCZMMMMH0WA5MMA6P0WMX R1�11Q1�68lQSSII-!C pV2AN IRfQLInI pN NEW ROpt)USMWAMMAUZ OUXURM PF "MI. GLAZQABL130RWM AmscAmA 06mumTOTALNP.-.. — APOJRUAPPbxICPM=OATSAPMPA,tM4D CU4ULi1������� QUrnwA$)#oOWNSP0VW tMMVOTAPWNAB6S 0T1.1tAAAPA D%WAN S0.YLPQii (VJPM00W0PLT) rAMACA LZ {JJaacitl0�,evr�S .Os � C:�NOPevEaer� CF WIM m ra07 RXWM4 WA,6 POA P0MWArlOti%=WCrUR)M Of FAM'A46 MOM ROOM, BUYER MM TO CANCEL BUYFJt MAY CANCEL TM CONMACT BY DEWAS NG Toed rAM for above S WR1TCIi7`t Ntr= TO THE SWIM & ANY TUM PMR DM DaYtBel►1 TO MIDHIOB'f OF M TMD RLMO SS DAY AFM M DATE OF TM TRMSACRON, BUYER MAY VSE TMS B�u►et payable upon loft pn1Abk qty cOMRAicr As Tma Nora By OVM'SF r In E CAIVCEI: ATAT THE BOMMAND ADDM B [l FhmcW by: d Cash On Caevlaron � Tffi ATTIN:ADM=SHMMA8DoVL FayomsoiS—Perfmoth An mamrial u gm„� ro b• � �ifieb Alt nodt is se be eoeepincd W a �aaa�{il0e •unRat o�diori ro tq•tdwd pnGgcrw. ThIP amueatx h read aRiy with !� �Raa6•C,mUploe WAi aot be hdd te�st'66 ter Lhne and EAaferia, dUt�e, 61tN�,, s,� OE God df BRy ndlei' OIMds bayood � <4md. owm wm{ that &e e4oky iA"Pewft ie Mau* fm ms �L simm SIH1 aai&i as for wr* b order pm* R In a•t Amim D �RAitlOp HiCEpI ae 11Med 8h61E. 9[tdi W Q 7bR9t ,,,,, MJl�7 frtlfll t,loR daPC. WRQ pfOd117r4. Plll Cillk �� daaeflxe this watraet m ftms the mom of Arc Fwd. and no 001. Mktg, oohlmo4 yaw as 06MWNe. Aw be bad 'mom B�b7 6vtA Putiee. An � iRttd ahts+s. n rettro�e and Tpul amy aH jab teLEed tkb�a.A.D Bain ead dlu+nRNn aflaldd. MA Yox For Your Orderl k4 et 'Ail wAin ya's Sin Cht *Om AuRtnti=d Officer aT.r A'•J aansSaieaninn r1.7Oity—.j rr54flr000 nr ire. rc rCK1C1 I.Inr" r411J, •r . r.n rt ♦n..r 03/19/2003 14:49 513-782-3903 ENCLOSURE SUPPLIERS PAGE 04 r ��tl�i4,�we.dewlroLrune++•xac.nxnla • (MT�1GM1495.1•S7T•9d4M ffll�efTallrtlRllafw ttNpafl��*• • fnMsl�pa • tfwsaeMtaofwri *0"4 nnsff4afsa „•m,. - mft n.r CONTRACT P" of.0� CNAMPMONPAVO WALLSXfiY " DIrD7'zrd4 m'wriawa.a•.o ®MfS[�f'IbMpA•R11lE.MAM1PALt11af3UR4U811Lt�4ANDNafA1.1•�1�'=p�WAit t�rap�•ALLC�� Lvl WAUgpfCiUgSNSDA)UTANDfI'1 MS1r5'rlsda'15Nix vifityA9fiRIRS� yf,igpTBALiA AIwLO 6aysOYMEW. AitnaolLla• xT1E�WLMT010 RXANG 1L.LMROM�SW-tAV tR'MM21MC M'�AIDDOWWCW= 4LOCI@1GNYSi�I AN00� ALTS+>R+f,II,ATi1R�a�, BYNGL4CiC Qi1BRL�CB• ST/4A,LBGt; Ste. 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Poe,nad& in older good k � qf!i iab}oea m t»rlcf W'*h mxepf NOW AM SW inflg11 da on oraWn � - 1. �a* Rm d,me &or- VLAd pvckkm 014GrRge ���CbA oo" d1h 000aaa CmL' faf7a (M a ftila � m of 69 Pg fmdas Mm%ig. 1. vA l 4w NY atEmtiVlie; a�...�1F lfiad� fi aaelprs AU � fWod dmyL t`halvfsn to flafesa MA 6-1 mwq djob reWW ddb All salsa and &w,4fli'ffflatao�,T k YAL For porta Order! X ./Est lr C11tCnpton Ropabvt 'S SignatulC Chfanplon Awdimiod Od'ncer CT .M.'J AF PCt�11A!1Snn rT.7G11S1 •/.1 la•Tnrarmq•c U1 Jrx1 ICT1C1 fiNST .d.a.lu-. •..n .... rT .r++ rw-.�_e+_uu EETE oG A-R�2.is o -o1s0 cy, UCO Maiw P. oolle 3ti ow- su wll..t sane clodsoloti — 436- an ltd 35 Osaka X% 03A21 &so wgs amp IA awe "uurr +AOR vati�� we X SWAM ALamoiomim sommmm A ooWAV= x oprawo�� LWLM r� oommou" aoae• Q�ewoa �. • aooucnoF Els- M : 0 s Lial city C e s ' Am ZT M iNSNcE mr 000 �--- a vw Mm u���1 0 p�mwoiWerar s 2� 1.14 s 1/2002 12/0 3. wR • i on on �pp�.,i��e+► s P!� pllOp CPU" i FJ►lrOC f .-- a' Ara • : 00 s o00 u u�2 3=Je a;°"G • 500000 j ... :�� • 3000 01 • u/o 19;/0u�00� s�c+m�-�► : .1000 01 32/02 u � . • 3o.000.0� L e �oo®aroo°"o�° L°a°�oaw ymmov[11i ,.. �, �ouawraiM�� romti ���.11sMMM M�►�IM1�YOi10M1m". aww�n+� mo aoaw�+aMOLOW �1me �iorMawa�!��noo�wooMa � aFiwv�soeooreunoaaerawn A01��aR `a , w/ �}ZIN- 31e �no�,vmontuea � o��aQacluae� - --_ _ Board of Build^ng Regulations and Standards ROME IMPROVEMENT CONTRACTOR Registration 127172 ' Ex0iratison. 9/15/2004 . "Type Supplement Card CHAMPION WINDOW JW 'gitE 35 DUNHAM RD. / BILLERICA, MA 01821 Administrator t- - — _ i!lR17�ffAZ to . -BOAR- OF #33lILDiNG REG 'L,4T MS k € t CDNST#tt7CTl0iti SllPER1fiOR Lumber ° Bar#ladate Q bfit 22 o: ;939 Facrres ,04109/br nVA i 24 Sz}�€#2WQQ0. dV �Ee+ v �i Jt4J e DI�NV2S,-A�9�3; f�d�an�straf� �. �}ZIN- 31e �no�,vmontuea � o��aQacluae� - --_ _ Board of Build^ng Regulations and Standards ROME IMPROVEMENT CONTRACTOR Registration 127172 ' Ex0iratison. 9/15/2004 . "Type Supplement Card CHAMPION WINDOW JW 'gitE 35 DUNHAM RD. / BILLERICA, MA 01821 Administrator t- C/) M m U) Cl) m m CACD n n Z y CD o =, r c CZ = H o p CD CDCL O Q Er m d CD CCD O C0D w w P. c, CD y CD O y CD S v CA O 'OCD Z o a CD 0 CD C -OM I'll O m _2 0 —•N O Q' N —1 atm C07 � m0CL rn CD Z N �.0 co) o �o,�a No T m �o m m p ti co � O ? m m _ R 7 0 :� CC2 t do r a )1-O' ' �m CL__ o //C1�7 (92o =r =r Q VJ 6N m (/) c Mm l l CDC ^ d o D =: 0 O Ngo m N . z y�12. � o H m :A iD V' /n N NQ i. =r � z =ro� cn z N .-� " m� W N�� �cn cn � y m i O LW �0c- H °^ o�n It *rf w c 4�v aha b OH w oda It OH °� n b aGa O � c ^ 4 0 w y 0 0 c ma REFERENCES ESSEX NORTH DISTRICT REGISTRY OF DEEDS: DEED BOOK 4803, PAGE 286. PLAN NO. 7778 ASSESSOR'S MAP 47 BLOCK LOT 54 ZONING: R-4 TOTAL AREA = 13,019 S.F. 100% AREA OF EXIST. BUILD. = 2,551 S.F. 19.6% AREA OF EXIST. DECK = 253 S.F. 1.9% EXISTING COVERAGE = 2,804 S.F. 21.5% AREA PROP. ADD. = 196 S.F. 1.52% PROPOSED COVERAGE = 2,804 S.F. 21.5% OPEN SPACE = 10,215 S.F. 78.5% N/F DOROTHY M. HAMMOND IPIN — IPIN SET- N65'53'4S'E SET N56 38'53" E 22.00' 86.05' I. I of I< I 01� oo I "I" NI I M �I MI ! tl I 30.5' p(IST.DEC .18.8' :: 7ii ,.PROPOSED::.:.' .. ADDRION'::: - I EXISTiNG:o 5.3' 29.8' DECK... - — 13.5' 19.9' / I I 3 PORCH w I� I oo LOT 8 o EXISTING ui N IN WOOD/B ICK N (V tJ I #17, (n LOT 6 I Z w I w � I I 0 0 I 3 I LOT 7 13,019 S.F. r,! l l I I 73.80'! IPIN R=340.00' DH/Se S 65'38'53" W SET FND i�3 BERKELEY ROAD IPIN SET _at Ar._ PLAN OF LAND IN g w s NORTH ANDOVER., MA. � NO. 173 BERKELEY ROAD JAMES W.L.S. DATE PREPARED FOR: ZONING: _4 FOR PEFRMIT ° D` AHO BRADFORD ENGINEERING CO. SHEET 1 Of 1 DRAWN- A.H.O. IFl°-D. BRM 3 WASHINGTON S Q . REVISIONS BY giECKEI?: WJ S HAVERHILL MA. 01 830 JWB SCALE: 1" = 20' 6 Fax: PHONE (978) 373-239 (978) 373-8021 BRWORD ENGROWORLDNMATT.NET DATE: MARCH 26, 2003 FLE NAmE' PERMIT\ NA032603. DWG FlLE Not 131460S 10 3 0 N 2799 NORTH Ot.�`tD '•��'O � 9 �SS CHUS TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that .................. tC..kS.!. �.�`.. �.....:vt CF S e G has permission to perform .............. 1�.....� ........�.....� ........................................... wiring in the building of ............ -i -...................... ' North Andover,, Mass. Fee .. � . 5.., !.. Lic. No... .. U ......... :....... /....r ..�........... LECTRICAL MpEcmlt Check # � �' WHITE: Applicant CANARY: Building Dept. PINK: Treasurer I Ll Y i (� uiticr Ose 0"ly The Commonwealth of Massachusetts Prr: it N'0. Department of Public Safety - = Occupancy b Fee Oicc keG - $OARD OF FIRE PREVENTION REGULATIONS S27 CMR 7200 3/90 Ota�e bunk) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All wvtk to be performed in accordance with the Massachuserts Electrical Code. 52.7 CMR 1.2.00 1 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date ( r, I I / _ City or Town of NO 1�O,L&Tfz To the Inspector' Lf Wires: The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number) 1 1�IZf:( C Owner or Tenant FRC t� t `�C�t✓ (� n Owner's Address Is this permit in conjunction with a building permit: Yes ❑ No ifs (Check Appropriate Box) Purpose of Building �1 C tl Utility Authorization N0. Existing Service Z0U Amps J? U / Z4IO Volts Overhead ❑ Undgrd ❑ No. of Meters New Service Amps / —Volts OverheadEl❑ No. of Meters Number of Feeders and Ampacity No. of Receptacle Outlets UUnr-dgrd (� Battery£Unittsncy Location and Nature of Proposed Electrical Work No. of Gas Burners FIRE ALARMS No. of Zones No. of Detection and )t c , C) 1-- ^i u n »u1C < No. of Ranges No. of Air Cond. tons OTHER: INSURANCE COVERAGE: -Pursuant to the requirements of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES ❑ NO E] I have submitted valid proof of same to this office. YES E] NO (] If you have checked YES,:please indicate the type of coverage by checkingtheappropriate box. INSURANCE OND ❑ OTHER[:] (Please Specify) �stnsLvV Expi ation Date Estimated Value of Electrical Work S Work £o Start Inspection Date Requested: Rough Final Signed undethe penalties of perjury:';,' FIRM NA[ �C (LvI �I�c7 f_ f41 V lit i n _LIC. NO. % 3�t✓iJiJ Licensee M A-Tc4e L 0'. Y132Cs Signature LIC NO. 5 ii Address[ R Dam S+ 5, �. p� wiZ�iN� e HA— ej*Bus. Tel No. + Vri 5 - Alt. Tel. No. [j- 3' 014NERIS INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its stantiai equivalent as required by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner Agent (Please check one) PERMIT FEE S 2 Telephone No. TKVAI No. of Lighting Outlets No. of Hot Tubs No. of Transformers No. of Lighting Fixtures SwimmingPool Above LM in- grnd. LJ grnd. ❑ Generators KVA No. of Lighting No. of Receptacle Outlets No. of Oil Burners Battery£Unittsncy No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Detection and Total No. of Ranges No. of Air Cond. tons Initiating Devices No. of Sounding Devices No. of Self Contained Detection/Sounding Devices Local ❑ Municipal ❑ Other No. of Disposals No. of pumps TTons Total No. of Dishwashers Space/Area Heating KW KW No. of Dryers Heating Devices Connection No, of o, o Low Voltage No. of Water Heaters KW Si ns Ballasts Wiring No. Hydro Massage Tubs No. of Motors Total HP OTHER: INSURANCE COVERAGE: -Pursuant to the requirements of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES ❑ NO E] I have submitted valid proof of same to this office. YES E] NO (] If you have checked YES,:please indicate the type of coverage by checkingtheappropriate box. INSURANCE OND ❑ OTHER[:] (Please Specify) �stnsLvV Expi ation Date Estimated Value of Electrical Work S Work £o Start Inspection Date Requested: Rough Final Signed undethe penalties of perjury:';,' FIRM NA[ �C (LvI �I�c7 f_ f41 V lit i n _LIC. NO. % 3�t✓iJiJ Licensee M A-Tc4e L 0'. Y132Cs Signature LIC NO. 5 ii Address[ R Dam S+ 5, �. p� wiZ�iN� e HA— ej*Bus. Tel No. + Vri 5 - Alt. Tel. No. [j- 3' 014NERIS INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its stantiai equivalent as required by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner Agent (Please check one) PERMIT FEE S 2 Telephone No. M REMARKS BY ELECTRICIAN: FL ti ��RL aiV Pr iSA dt-ci 03, *-HG Gu, Cj C 4PID Y4&.- lGwNut,,) put,,)20 xv TU GAcA4 )50 H &V O *7 Tv /3' SCew> Ge-) &-y's Wix- �►9��1 Ai�i� ��P? f> 0Fr E-ojTl LZ N L • EEC a c 'u V O L w tU C M REMARKS BY ELECTRICIAN: FL r6"G-'At-j A 1 T Tom)3 ��RL aiV Pr iSA dt-ci 03, *-HG Gu, Cj C 4PID Y4&.- lGwNut,,) put,,)20 xv TU GAcA4 )50 H &V O *7 Tv /3' SCew> Ge-) &-y's Wix- �►9��1 Ai�i� ��P? f> 0Fr E-ojTl LZ 1#67 1�cwT)qc--r-?> ),,s G n Location /?3 4 -,,rt r No. Date NORTH TOWN OF NORTH ANDOVER /*WP7/ T- Certificate of Occupancy $ ,ssAC14USt< Building/Frame Permit Fee $ v 4 _ Foundation Permit Fee $ Other Permit Fee $ > .�,� TOTAL $ O 1 Check # 119"1138 1 t3" Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT WA5RENOVA T OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER: �j, Ll DATE ISSUED: Building Commissioner/Inspector of Bui131ngs Date J SECTION 1- SITE INFORMATION 1.1 Property Address: 31cq,IlUII ,L - rmurEK I T UW14YMtllr/AU'1'IIUXtZED AGENT 1.2 Assessors Map and Parcel Number: l / Map Number Parcel Number 2.1 Owner of Record 1.3 Zoning Information: Zoning District Proposed Use 1.4 Property Dimensions: Lot Area Fronto ft 1.6 BUILDING SETBACKS ft Name (Print) Front Yard Side Yard Rear Yard Reqttired Provide ed Provided red Provided 3! z C3 y 1.7 Water Supply M.CxL.C.40. 54) Public 0 Private ❑ 1.5. Flood Zone Infomiation: 1.8 Sewerage Disposal System: Zone Outside Flood Zone ❑ Municipal On Site Disposal System 0 U0 M X 3 s Z O O v M a 1 t' O Z M O an r v M faaa _r Z a 31cq,IlUII ,L - rmurEK I T UW14YMtllr/AU'1'IIUXtZED AGENT Historic District: Yes _ No _ 2.1 Owner of Record /7,3 Name (Print) Address for Service Y7 - 2 7E Signature Telephone 2.2 Owner of Record: Name Print Address rvice: Signature Tele hone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor. 07 Z 7 7 Z License Number �.� Sl�7�two� �✓� Address t 7e Rb Telephone Expiration Date 3.2 Registered Home Improvement Contractor Not Applicable ❑ J 2 7/; 2 CompanyName''�� Registration Number Address Expiration Date Si Tel hone U0 M X 3 s Z O O v M a 1 t' O Z M O an r v M faaa _r Z a c a SECTION 4 - WORKERS COMPENSATION (M.G.L. C 152 § 2506) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the bIi!dog permit. Signed affidavit Attached Yes ....4.K_No....... ❑ SECTION 5 Description of Proposed Work(check all applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: /YX/ y 77y6— 6DOIs SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to be Completed by permit applicant OFFICIAL USE _ *" 1. Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee (a) X (b) �� ? ems. C� �• �' 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, as Owner/Authorized Agent of subject property Hereby authorize C >7�i '% f to act on My behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date SECTION 7b O/WNER/AUTHORIZED AGENT DECLARATION as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief Print ame Signature er Date NO. O STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TI1vIBERS I 2ND 3KD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE a ltj d y. i .fit 1 QuA W R �1 x W-4 AC7 p; Q� i� v u 8 cn O a z A ,.,� con ` CL 0 U I O a C7 a cd w A�1 U W U ►� W W O a C w GY a O a�' w W A W rA Ei cn O cn r� lw VJ Z 4N O Go C m cm C Im 00 o cm C C N t 0 Z O 5 CD F. M 0 W P-4 M"V CD cm Oca 'D O 0 A O O 'E m m L W O d Co �Q cc C O C a� c z CD V COD O C C C W d H D LLI cl Y/ LLI Y/ W W 19 W to c_ o z �Oc con ` CL 0 � n O m O N C = 'vV Q C ui CL G.. O A 0 N O C m O� G a+ CL O� i 44:= N O :*E. Ea .2 CL.m o_ Z is �. o a N :0= Cr O C07 d mm ,3 H lw VJ Z 4N O Go C m cm C Im 00 o cm C C N t 0 Z O 5 CD F. M 0 W P-4 M"V CD cm Oca 'D O 0 A O O 'E m m L W O d Co �Q cc C O C a� c z CD V COD O C C C W d H D LLI cl Y/ LLI Y/ W W 19 W to z con ` CL 0 � n = m m 3 = W ui G.. O = N dt C o *� w�v� m O� G CLLu CL O i A 2 N O :*E. H .2 CL.m lw VJ Z 4N O Go C m cm C Im 00 o cm C C N t 0 Z O 5 CD F. M 0 W P-4 M"V CD cm Oca 'D O 0 A O O 'E m m L W O d Co �Q cc C O C a� c z CD V COD O C C C W d H D LLI cl Y/ LLI Y/ W W 19 W to NORTH ANDOVER BUILDING DEPARTMENT Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit at: is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c 11, S 150 A. Also, note Permits are required under Fire Prevention laws,, C*hapter 148 Section I 0A. The debris will be disposed of in: A /�,..,r�s.z�2 .L3a 771f.✓ Fire Department Sign off: Dumpster Permit (Location of Facility) S gnature of Permit plicant 11 Date FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. *****************************APPLICANT FILLS OUT THIS SECTION*********************** APPLICANT _C= �j/'Z�zy Gl���o��. �-�ri v PHONE 1 �� �6V 6 Zob _,5 L/ OCATION: Assessor's Map Number ! PARCEL UBDIVISION /� LOT (S) 7 STREET C'�%C��CL G l= }' AI ST. NUMBER � 7J *****************************************OFFICIAL USE ' ONLY*********************************** RECOMMENDATIONS OF TOWN AGENTS: I,,,--60NSERVATION ADMINISTRATOR DATE APPROVED DATE REJECTED COMMENTS TOWN PLANNER COMMENTS FOOD INSPECTOR -HEALTH DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED SEPTIC INSPECTOR -HEALTH DATE APPROVED DATE REJECTED COMMENTS PUBLIC WORKS - SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT DUMPSTER PERMIT RECEIVED BY BUILDING INSPECTOR DATE The Commonwealth of Hassaehusetts Department of Industrial Accidents 41� Office of Investigations 1 600 Washington Street Boston, MA 02111 www.ntnss.-ov/din Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Uraniratiun/lnilivitluull: ���'� %¢' /v Address: A&-- S-f— City/State/Zip: ��%/-��-� /�?1 Phone #: q7�'" t7– ou an employer? Check the appropriate box: IAI am a employer with / Z_ 4• ❑ I am a general contractor and I cmployees (full and/or part -tithe).* have hired the sub -contractors 2. ❑ 1 am a sole proprietor or partner- listed on the attached sheet. # ship and have no employees These sub -contractors have working for me in any capacity. workers' comp. insurance. 5. [1 We are a corporation and its [No workers' comp. insurance required.] officers have exercised their 3. ❑ 1 am a homeowner doing all work right of exemption per MGL myself. [No workers' comp. c. 152,§§' 1(4), and we have no insurance required.] t employees. [No workers' comp. insurance required.] Type of project (required): 6. ❑ New construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10.❑ Electrical repairs or additions I I.❑ Plumbing repairs or additions 12.❑ Roof repairs 13.❑ Other 'Any applicant that checks box N I must also till out the section below showing their workers' compensation policy intbrmation. + Homeowners who submit thisaffidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. >Contractors that check this box must attached an additional sheet showing the name of the sub -contractors and their workers comp policy information. I am an employer that is providing workers' compensation insurance for my employees. Below is lite policy and job site information. Insurance Company Name:__ Policy # or Self -ins. Lic. 9:_ — 2 — `` DJ Expiration Date: / 2 f_ ° 6 Job Site Address:/7�_c=-,- +X o City/State/Zip: 11.,46,,,s`t Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of NIGL c. 152 can lead to the imposition of criminal penalties of a Fine up to $1,500.00 and/or one -,year imprisonment, as well as civil penalties in the forth of a STOP WORK ORDER and a tine of up to 5250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. do hereby certify u► ai► h' er'ury that the information provided above is trite and correct. Siumatttre: Date: PhnnF / 7,,)-- X 0 — Qlfcial use only. Do not write in this area, to be completed by city or town gfflc•ial. City or Town: Permit/License # Issuing Authority (circle one): I. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone #: N/F DOROTHY M. HAMMOND IPIN . .0- ]AIN SET N6553'43" E SfT N 55'38'53" E u w�rwr IZ I I N 1 2 FroRy r/ fir :• W000/8RICK a' ,_� ,.x..:v. -•�.o�-',.Crtvufir,l',°f''��T.�11';F jr� ','f��' � M';-r�"�r� � 31 LOT 6 ' LOT t 13,0 19 S_F. 25.20' IPIN ' -i?0' b�j B S 65.38 ,5x w SET m BERKELEY ROAD PLAN OF' LAND IN NORTH ANDOVER, MA. IP!N SET w 0) IP)N SET t +• N/F DOROTHY M. HAMMOND IPIN . .0- ]AIN SET N6553'43" E SfT N 55'38'53" E u w�rwr IZ I I N 1 2 FroRy r/ fir :• W000/8RICK a' ,_� ,.x..:v. -•�.o�-',.Crtvufir,l',°f''��T.�11';F jr� ','f��' � M';-r�"�r� � 31 LOT 6 ' LOT t 13,0 19 S_F. 25.20' IPIN ' -i?0' b�j B S 65.38 ,5x w SET m BERKELEY ROAD PLAN OF' LAND IN NORTH ANDOVER, MA. IP!N SET w 0) IP)N SET MOV -01-2005 08:17 FROM- , '. T-620 P101/001 F-952 REFERENCES ESSEX NORTH DISTRICT REGISTRY OF DEEDS: DEED BOOK 4803, PAGE 286. TOTAL AREA = 13,019 S.F. 100;; AREA OF EXIST, OU LD. - 2,551 S.F. 19,66 PLAN N0, 7778 AREA OF EXIST. DI:',;K = 253 S.F. 1.9% ASSESSOR'S EXISTING COVERAGE= 2,804 S.F. 21,5R MAP 47 AREA PROP. ADD. = 196 S.F. 1,529. � RA PROPOSED CDVEUE = 2,804 S.F. 21.5:.' LOT S4 OPEN SPACE 10,7.15 S.F, 78.51 20NING: R-4 Q N/F DOROTHY M. HMMOND N 6538'53" E I$ I 1c4 t IPN SEr I LOT 7 I -I 13,019 S_F. —n1 I I R- R=-%4u.vU" pN J Oa+JO JJ w SET no BERKELEY ROAID FLAN OF LAND I�� IN e NORTH ANDOVER, MA. r� NO. 173 BERKE4.EY ROAL) JAMES W. r A IDR FOR PERMIT _ AHO BRADFORD ENGINEERING CO. A.H.O. 8RM 3 WASHINGTON SO. kir We HAVERHILL NIA. 01 830 JWB 1" = 20' (978) 37.3-23961'—(978) 373-8021 1.aloapararn [ARCH 26, 2003 PERMR\NA0328Q3.DWG 131460S T +: o PIN SET LOT 8 Inm 1 of 1 3 III Customer; p' de ' A WALL 77.375 + 0.5 + 77.375 + 4 + 2 sill(s) = 162" B WALL 4 + 77.37Ei + 0.5 + 77.375 + 4 + 4 sill(s) = 168" C WALL 4 + 59.375 + 0.5 + 71.375 + 2 sill(s) = 138" ROOF PLAN City: Job Number: Order Date: boslon 3718 01 /05/06 474 V4 rgj9.�u * ft" MINI Fn T 4 tF �T 'f V,l Tj —Ai'v'oW 41 FACTORY DIRECT SINCE 1953 r '` �• O O �, ; 2;10 Ballardvale St. • Wilmington, MA 01887 978 84-6108.877-846-3699.978-284-6115 Fax .VINDOW • SID ll G PA Roos ® H.I.C. 127172 / T.I.N. 58-244-2642 io_. %cam Dalt Email �����gg,,r�� p Home Phone Business Phone (Mr. / Mrs,) City AIL", State//r//7" zip [_f _4 - - Coul lty/Twnshp Replace, hent Windows a Storm Windows & Doors • Vinyl Siding, Trim & Shatters • Glass & Screen Patio Rooms • Entry & Patio Doors WHOLESALE & RETAIL PATIO ROOM CONTRACT CHAMPION f0 MEASURE, MANUFACTURE, FURNISH AND INSTALLTHE FOLLOWING CU:;TOM MADE PRODUCTS FOR THE AMOUNT STIPULATED BELOW: ❑ AllSeason!iinyl Patio Room From Nominal 6' Components With Outside Dimensions Of Approximately A: X B: X C: X73 Season Aluminum Patio Room From Nominal 4' Components Outside Dimensions Of Approximately A: � X B: � X C: ❑Aluminum S:reen Room From Nominal2' Components With Outside Dimensions Of Approximately A:_ X B:,—_ X C: DECK OR -!"g YES NCI YES N 0 l�/Under Customer's Existing Rolf ❑ Roorr Deck Approximately _ X _ Material ❑ JLr 'Cn Customer's Existing Concrete Slab ❑ Open Deck Approximately _ X _ Malarial O❑ On Customer's Existing Deck 0 @Aleps: Wood 0 Concrete ❑ Approx. Number Of Risers _ Open ❑ Closed O 0,fiear Out Existing: Slab ❑ Deck 0 ❑ QI:Ra,lin llApproximately lin. 11. Material ❑ 'Footers For Existing Slab ❑ 91.61kirtin I Approximately lin. A. Material ❑ Tear Out Existing: Walls ❑ Screens 0 Roof ❑ Rails ❑ Jr5 pour flow Open Concrete Slab Without Footers Approximalety_ X _ ❑ ®'131st Sub Floor �� uj� ?�d, /r Ll 1-4-F Connate Slab With Footers Approximately _ X _ ❑ 6• Ins d Polydeck ❑ nsu]al t I lndor nark WALLS All Champion P;Itio Room wall systems consist of a series of sliding windows on top of approximately 16'1 all knee walls andfor full view sliding doors {{see layout). Windows and doors include locking system, synchiock interlocks, stainless steel wheels and sliding screens. Champion to determ pAxact size of nits al ri I fti lmsasur .I and all walls Ina ude build-0utand leveling system as necessary. y - y ��77 111 $lass is temper@d.salety.glas3, . - • . YES No ` / = r ��) �/*R(- ❑ See Attached Drawing ❑ Super Frame, Wing & Trim Color: While O Tan O BronzegTf J ❑ ❑ 3116' Triple Strength Non-Insulaled Glass ,` tY 0 Double Pane Insulated Glass `tjiti'( O tow -E Insulated Glass ❑ Sitar -Green Insulated Glass 0 0•J. OO Argon Gas Filled I.G. Units (AI] Season aero � Only) ❑ fixed Glass Knee Walls Location: AJ,BC jjj O ❑ it nee Wall w/Aluminum Skin: While an O bronze Jy O U knee Wall Ninyl Skin: White ❑ Tan ❑ : 0 RmldUp Build Down L3 Location: A B CO. y�r`/t/daC .t f ONixed Tr nsom Glass Location: A BO GO e -i !� I! 0 ❑ U Cap Existing Posts{ LAYOUT SKETCH _ OK U ❑ I ay Lock X =ACTIVE =FI O O ;;]filing Screen Room System (No Glass) 0 XED �- =FULLVIEW ROOF KNEEWALLJr Champion's supedoam roof system Is a nominal 4' (R-19) or 6' (R•30) expanded poly -styrene insulated foan panels with an embossed laminated aluminum skin and thermally broken I -Beams. NO ,��,//// NO Q O Studio Roof System Color: While 0 Ta 4'X 6' ❑ O Gutter & Down Spout To Grade 1J�iJ N2 ❑ Gable Roof System Color: While ❑ Ta 4' 6' ❑ O Shingles (To Match As Close As Possible) O 4 -Gable Glass 0 Wing Glass O Number Of Pieces:_ ❑ O Skylighls Vented O Non -Vented O Quantity:_ ❑ Q-6his Tie-in (Includes Shingles On Saddle Only And Vesical Vinyl Fill On Inside Of Saddle) COORS YES NO O Sorm: Outswing Color Style LI ft Hinge ❑ Right Hinge ❑ ISLO Location: A 11B ❑ C O ❑ thy: Inswing O oulswing O Color Style L(h Hinge 0 Right Hinge O ISLO Location: A O B O C 0 O HER YES NO YES NO ❑ HtaUCgol unit: OD ❑ ❑ Blinds: G for Style Height _ Location: A ❑ B O C ❑ O Carpet _ X _ Color —„_ Cut To Fit Loose Laid O Eloarical Package Including: _ Wag Sockets, _Wall Switch(es) & _Hookj�scd Quslort�-Provided Ceiling Fan With Ivory Wira.Moid C r Interior Roof Slope; T rox: the T ous • W II ❑ Gulter Boarri Boa Approx. Height 6' /g CJ a on Is NotRg,'Slimiursti.r Existing Nouse Root Condilion TWO YEARS FREE_ IN HOME SE ;VICE BUYER'S RIGHT TO CANCEL Total price for above $ BUYER MAY CANCEL THIS CONTRACT BY DELIVERING WRITTEN NOTICE TO THE SELLER AT ANY TIME PRIOR TO Down oaymen$ D b MIDNIGHT OF THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION. BUYER MAY USE THIS CONTRACT Balance payable on2 AS THAT NOTICE BY WRITING "I HEREBY CANCEL" AT THE Installr0ion/Delivery $ 1, 7^4 J BOTTOM AND ADDING BUYER'S NAME AND ADDRESS. THE NOTICE MUS';' BE DELIVERED TO THE SELLER AT THE ADDRESS NOWN ABOVE. ❑ Bank Financing 0 Cash on Completion All material is guaranteed to be as specified. All wort is to be completed In a workmanlike manner according to standard a Is contract Is valid only with proper signatures. Champion shall not be responsible for time and material delays, strikes, acts of God or any other matters beyond as control. Buyer and Own I' 1 equity In this property Is securtry for this contract. Since thio contract scans - made to order gnods, It Is not subject to cencallalion except as stated above. Stan Installation on or sop weeks from above date. Estimated date of substantial completion Is . All charges li tied above. Champion to remove and haul away all job related debits. M sales and discounts slotted, All contractors and subcontractors must be registered by the Dowd of u8 ' agulstlons enc' Standards and any Inquiries relating to registration should be directed to this agency, Ch Zion li I obtain any and all necessary permits as the owner's agent unless otherwise directed by Buyer. If Buyer ■source permits, he or she maybe excluded from the guaranty fund previsir L e. If Champion must pursue auger for collection of amounts Deet due, Buyer will be table for Champion's reasonable pfa and caste, Including attornal fees. A flWC htARCE cart ated,�1ha rete of I.1/2 perc r month (te'6 ANNUAL PERCENTAGE RATE) wit Pe added to delinquent accounts. All installation and completion dates aro a rc ximale end au aJY to 'hang& without not e. erbal promises can cause miwnderstandings,the�cajl a this con ct con5"w's the nderstending at the parties, and no other understand' g, c illaleral, verbal o o ee+ curl e, shallq�o� di I signed by bath podia Thank you +�/rp ur er/der, tlo��o n t ^canfr ct 1 there are any blanks spaces./ /� /. /P!%% /J FXIM ! f .5. r� . ' f `e MNDOWS SIDIN FWTIO ROOMS, AFFIDAVIT I, the undersigned, being the owner of the property at Hereby verify that I have authorized Champion Window, Siding and Patio Rooms and its agents to apply to the Building Department of the City of /l j�,.✓Jo�,n� To act as representatives in obtaining building permits. Champion Window, Siding and Patio Rooms will obtain standard Building Permits only. I am responsible for any outside Engineering expenses, variance fees "and Certified Plot Plans required by any Government Agency. I understand that Champion Window, Siding and Patio Rooms may assist me in obtaining these documents but I am responsible for all Printed Name o Owner Street Address of Owner ipop°v-r, bt/tA City & State Champion Window, Siding and Patio Rooms Date Zip Code TEL: (978) 284-6108 FAX. (978) 284-6115 'AC�;)RLih CERTIFICATE OF LIABILITY INSURANCE DAT COMBINED SINGLE LIMIT (Ea accident) S PRODUCER (513)221-1140 FAX (513)872-7519 C A I Insurance Agency, Inc. 3481 Central Parkway, Ste. 300 Cincinnati, OH 45223-3397 12/01/2005 /01/2005) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. PROPERTY DAM4GE $ (Peraccident) Kevin SDhlotman INSURERS AFFORDING COVERAGE NAIC # INSURERA: Firemans Fund Insurance Compan Z1873 INSURED Champion Window Co. of Boston North, LLC 230 Ballardvale Dr Ste B Wilmington, HA 01887 wsURERB: St Paul Fire & Marine Ins. Co 4767 INSURERC: INSURER D: 12/01/2005 INSURER E: Cr)VFRARF:C AGGREGATE S 15,000 THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITH; ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED MAY PER -FAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS C POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCECI BY PAID CLAIMS. MR DD' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION GF'.NERAL LIABILITY LIMITS EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGETO RENTED S CLAIMS MADE OCCUR MED EXP (A -one rson) $ GEN'L AGGREGATE LIMIT APPLIES PER POLICY n fIECT I- IECT I I LOC AUYOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS GARAGE LIABILITY ANY AUTO EX( ESSNMBRELLA LIABILITY X OCCUR C] CLAIMS MADE A DEDUCTIBLE RETENTION S WORKER;' COMPENSATION AND EMPLOYERS' LIABILITY B ANY PROF RIETORlPARTNEF/EXECUTIVE OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below OTHER Pe PERSONAL & ADV INJURY S GENERALAGGR.EGATE S PRODUCTS - COMP/OPAGG IS DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES/ EXCLUSIONS ADDED BY ENDORSFMENTI SPECIAL PROVISIONS Client Copy Sample Wilmington, MA 01887 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVORTOMAIL 30* DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE _,_ A ACORD 25 (2001/08) ©ACORD CORPORATION 1988 COMBINED SINGLE LIMIT (Ea accident) S BODILY INJURY. S (Per person) BODILY INJURY S (Per accident) PROPERTY DAM4GE $ (Peraccident) AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ AUTOONLY: AGG $ XAU8773907114 12/01/2005 12/01/2006 EACH OCCURRENCE S 15,000 AGGREGATE S 15,000 $ S S -281K593-1-05 12/01/2005 12/01/2006 X WCSTATU- OTH- E.L. EACH ACCIDENT $ 1,000 E.L. DISEASE - EA EMPLOYEE $ 1 000 E.I. DISEASE -POLICY LIMIT S 1.000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES/ EXCLUSIONS ADDED BY ENDORSFMENTI SPECIAL PROVISIONS Client Copy Sample Wilmington, MA 01887 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVORTOMAIL 30* DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE _,_ A ACORD 25 (2001/08) ©ACORD CORPORATION 1988 � � r ✓/2( TDM77ry120�IZlIlP.ltLciL O� ///GO.ddlX,C/LUDB�d BOARD OF BUILDING REGULATIONS ,g icense: CONSTRUCTION SUPERVISOR Number: CS 072772 7 9 3irthdate:04107/1962 j p:tTM� Expires: 04107/2006 Tr. no: 24177 Restricted: 00 JEFF C STEELE 24 SHERWOOD AVE DANVERS, MA 01923 Commissioner Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration: 127172 Expiration: 9/15/2006 Type: Supplement Card CHAMPION WINDOW & PATIO RO J ff'ffftLE 230 BALLARDVALE ST WILMINGTON, MA 01887 Administrator 2 F-1 L p 0.75" . ... ............. - I ... ......... ............ ... . . 2.51 I 75 3.29" -------- - l 6,437" /1 11- if 6,210" 11 c) .... . . ................ 6,563" 3.460" 2,228" 6,964" —41 4----� N) po Ln p rl) N) O ...... .......... . 6.21 6 05" co ra RSC C + L) + 77 ZxN o 1.000" .75" 1.000" co 0 0 00 m 1.80" < 5.74" C) 2.51 5.980" r 0 1.80" 00 .......... ... ....... ....... Q 2� 2.51 il') CD (.n 1.600 .............. 6,888 . . .......... ..... ...... . ... .......... .. ... ............... - - -- ----- -- --f=7 0 CCC.. . . ......... .... 16.03C„ E 0.065 O O 0.696 PARTS FOR A CHAMPION WINDOWS SING1 E SLOPF "VINYL CLAD" PATIO ROOM CESI 0,915 0) N� 0 (( . ......... . .. . .... . . . . . ........ ...... . ........... . .......... . CHAMPION ENCLOSURE SUPPLIERS INC. 12111 Chompion Play, Cincinnoti, OH 45241 PH 513 782-3900 FAX : 513 782-3903 5EE WAP I FOP A40WAPU POOF PANNI, 5PM5 I Z „3 z = v � N 73 rn c .d Z O 0 0 O II IIV Z � � Z �4 SCC p 4 Q ....... o Z O g ._......c zc� N N ^ Q 1° g Z Z Q N W Moog_ > 713 I ......__._. n „3 z = v � N 73 rn c .d Z O 0 0 O z Z � � �- ....... ..... O g ._......c zc� N N ^ Q 1° g Z Z Q N W Moog_ C'CC J J v J \ O O O O fl v ZC9 N co ^ b' \34 N .42 m z4l c� Z � � rn rn I O ......__._. n „3 z = v � N 73 rn O � O ......__._. n O z = v � N rn rn � Z O �G O z Z � � �- ....... ..... 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T F, S rn � Q ccc iCESI ENCLOSURE SUPPLIERS INC. 12111 Chornpion Woy, Cincinnati, OH 45241 PH: 513 782-3900 > „X : 513 782-3903 0-, " -O u � # p # .T1 � 6 i1 # n X Q X z X S e� N Z D N O u Oz N � zcNa� O OW Q 71 n WW 70 E # 0 OV'1 [Na� OVA M� M Cts O C) a N � N � Q t1 D # � 6 # -1 �o N X MY. � Z D N O u Oz N � zcNa� O OW f� z0 71 n WW 70 y Z 20 \ OV'1 [Na� OVA M� M Cts 6 .A N � N � Q N � rn r \P � z C r: o>z #� f Q� \ O O X P -A C1 N Cl Q O (l X p 0 O H O z t1 D # � 6 # -1 �o N X MY. � Z D N O u Oz W zcNa� O S� f� z0 n � N n WW 70 y Z 20 \ OV'1 [Na� OVA M� M Cts PW 0 Tn Cv713 g G V Jz 3Z C-) oz N �O QI 71 - � 6 � n C't[ N 7lS Qi Fel O X N O u Oz W g() #z ttz ZO�� f� z0 � v, .A y Z 20 \ OV'1 [Na� OVA M� M 0 Tn Cv713 g G V Jz 3Z C-) oz N �O QI 71 - i> N ia, rdi � 6 � n C't[ N Qi Fel O X N O u Oz W � � 7Z 76 >p a � v, .A y Z 20 \ � M 6 .A N � N � Q N � rn r \P � z C r� X -A C1 N Cl O (l X p 0 O H O z 7Zz i> N ia, rdi � 6 � n C't[ Qi Fel O X N O u y W � � 7Z 76 >p a � v, .A y Z 20 \ � X 6 .A N � N � Q N � rn r \P o a N o 0 f m SECTION DETAILS FOR m SINGLE SLOPE u o O � n CHAMPION VINYL CLAD w g PATIO ENCLOSURE # N Co � X _ W Q 41 � n C't[ Qi Fel O N O u y SS 7Z 76 >p # N Co � X _ W Q 41 � 1 C't[ Qi Fel O N O u y SS 7Z 76 >p .A y Z 20 \ � � 1 C't[ Qi Fel O X SS N � x = 2 9 Z, n D 5 CHAMPION ENCLOSURE SUPPLIERS INC 12111 Chomp on Way, Cincinnoti, OH 45241 PH: 513 782-3900 FAX : 513 782-3903 I 01 ON a Q y� ? 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Qi= 0 3a 'c 3 v\-1 03 lz O 3 `,4\ 1-n \N _ � E z ca ornC�a�n ca � C>) z N G-1 ccC z � Q N ��no�za�a�n O z CCC CCC CCC � T x y � z z z O E N z z� o X �S "FABLES NOTES AND 0 0 � N AND GENERAL O Z 03 � O SPECIFICATIONS FOR SINGLE SLOPE oZ = o "VINYL CLAD" PATIO ROOM Z 0 0 0 0 0 n o Qo C 0 ^ N 0 0 0 °� z v Cz N O N LN O W A O A Ocri O �c Q N W O �0 \N _ � E z ca ornC�a�n ca � C>) z N G-1 ccC z � Q N ��no�za�a�n O z CCC CCC CCC � T x y � z z z O E N z z� o V �S X �S "FABLES NOTES AND 0 0 � N AND GENERAL O Z 03 � O SPECIFICATIONS FOR SINGLE SLOPE oZ = o "VINYL CLAD" PATIO ROOM Z 0 0 0 0 0 n o V �S rmar N �'i '. 4 •: Gfq 0 a CESCHAMPION ENCLOSURE SUPPLIERS INC. 12111 Champion Woy, Cintinnoti, OH 45241 PH: 513 782-3900 N FAX : 513 782-3903 �S 0 0 � N = O \Z 03 � O z Z 0 0 0 0 0 0 h O Qo C 0 ^ N 0 0 0 °� z v Cz N O N LN O W A O A Ocri O �c Q N W O rmar N �'i '. 4 •: Gfq 0 a CESCHAMPION ENCLOSURE SUPPLIERS INC. 12111 Champion Woy, Cintinnoti, OH 45241 PH: 513 782-3900 N FAX : 513 782-3903 � ^Smeg w N = O \Z 03 S v � Z 0 0 0 0 0 0 h O C ^ N 0 0 0 °� z v N O N LN O W A O A Ocri rmar N �'i '. 4 •: Gfq 0 a CESCHAMPION ENCLOSURE SUPPLIERS INC. 12111 Champion Woy, Cintinnoti, OH 45241 PH: 513 782-3900 N FAX : 513 782-3903 C� L O 17- 0.75" 0.75" s I i I i r- I i N 0.75" 2.51 " 07 u CCC r Cl , 3.29" " Ik� 6.437" 11 _...._ 6.210" I G a ............ ... .... ....- ._.--....... ..... 6.563" ....._ ....._..-..._....._... ....._..... 3.460" 2.228" 6.964" t-- 6.21 „ -- 0.05" A I 1.aoa .75 1.000 4----1 Ln Ll� - _ ._.-..... _..-._............... 6.888" _._.-........-_..__._..........._...._..... 1.80" i I 5.74" __.___-----�" z II co * Cl �( o 6.030" 77O 6.190" 2.51" OO '" v Z 5.980" 1.80" Q 0.065 0.91500 ^' Z 60 i O co 0 TnT 2.51 " —� e OO w - .,�`�,,o .....,... y, ., cn 1.600 ti 7"��•i 0.696 ... ...... ...............�.. siy� ..•,� .+ N O o o 2 PARTS FOR A CHAMPION WINDOWS CHAMPION ENCLOSURE SlUPPLIER, INC. ^j SINGI...E S[ OPE "VINYL CLAD" PATI() ROOMI 12111 Chomplon Woy, Cnclnnot, 0H 45241 PH: 513 782-3900 I . p I` FAX_ 513 782_3903C EiB I �y..............__.._..._........_..- 5.99.. -- C-) OO W C7 � � CZTc O Z 6.437" 11 _...._ 6.210" I G a ............ ... .... ....- ._.--....... ..... 6.563" ....._ ....._..-..._....._... ....._..... 3.460" 2.228" 6.964" t-- 6.21 „ -- 0.05" A I 1.aoa .75 1.000 4----1 Ln Ll� - _ ._.-..... _..-._............... 6.888" _._.-........-_..__._..........._...._..... 1.80" i I 5.74" __.___-----�" z II co * Cl �( o 6.030" 77O 6.190" 2.51" OO '" v Z 5.980" 1.80" Q 0.065 0.91500 ^' Z 60 i O co 0 TnT 2.51 " —� e OO w - .,�`�,,o .....,... y, ., cn 1.600 ti 7"��•i 0.696 ... ...... ...............�.. siy� ..•,� .+ N O o o 2 PARTS FOR A CHAMPION WINDOWS CHAMPION ENCLOSURE SlUPPLIER, INC. ^j SINGI...E S[ OPE "VINYL CLAD" PATI() ROOMI 12111 Chomplon Woy, Cnclnnot, 0H 45241 PH: 513 782-3900 I . p I` FAX_ 513 782_3903C EiB I �y..............__.._..._........_..- 5.99.. -- 1% kpt I DOOM PkOJ111101 AND POOP pP,NE, TAN - N d Q 5vP iA13I P I POP ALI.OWMI-E POOF PARI. 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FAX : 513 782-3903_1 s g # �? # # �� �� y0 # z~O O ?� rn Q) 2265 x =O c�. lDix x an # 2 �- 'a S w rn w NC z D\ x rn c1 � 71 cid CC11 n' _ 1 d N�N N-1:: rn cit N 3 d0 -, "t` N Z -, 'A ,1 t713 L, C�Ct •°e ° .e 7a 1+ IN c�c w S �. 11 1 �t 1 rn Z N c4� O a m z< 713 / �s 03 f Z o °o S l lr 1 cR z i i 1 1 y_......- � 1i # # o o000 �c 0 z b x z ° , x x x w �`X TN# D z�=iNn(bSCl Z- # o ,\\w a s on X y x x c (� v X X z ZSZ' 3 z s UUn n y w -iNON-�N zfi "mop i ON caN z $2 Z xz- cerci - rnhZ��� �� > Q\ 00 00 � �zc�z � �� r scwN�s g� €ori` 2`t co c:Q fining QL CR n R #Z�o� aN� opo 8p D� a�4 OCG 1....- `i O _._... _✓ %,�.__, � v Cit � � � p, cit �- � 1 � � i s 1 ; 713 71 %C C" ,. \ r*:.±r-^";1 ... x_.....14'°.. ....... C _ ��CC �?���' ,i€ qA #u# C" z 2i a N ?l0 D Q „ 000 y C') Cl X Cmc \ Tl O 77 1V V� -P Z \ 771 � n- 9-17 O� ao n Q N .-. n ✓ 1 , 1 S O l pp A O N NO ogrz - oK p O X 0 77 1 1 1 Z �, t N n ; _ 1 _ t 21! Q n 1za, ?Cga d 2Z= �Ox izz\ z N Z Q a N p y w d n N T a C') O -� �N D O= p '>J1 N \\ w N D f n a d N N Cl V� O TNN � Z C' - oN O x z � w _ � z ,`,g1111Tt1111117/!p ..............._ r - Q Fct N (7g OCIO � A CQ:41p�14,� �Oza •.. kc • �u ka FZ C) S O v t c� 71N < v, l b N O m SECTION DETAILS FOR 0 0 SINGLE SLOPE u ? CHAMPION VINYL. CLAD w " o PATIO ENCLOSURE CHAMPION ENCLOSURE SUPPLIERS INC 12111 Champion Way, Cincinnati, OH 45241 PH: 513 782-390C' FAX : 513 */82-3903 v I , SAINNON a z. 0 z 7s r h VK� CO C) 77 Z c�cc� O{ O; O�DZO F� Z, CHAMPION ENCLOSURE SUPPLIERS INC. O Q) �? Z �' SPECIFICATIONS FOR SINGLE SLOPE V� I O n z "VINYL CLAD" PATIO ROOM12111 o O r N 0 O 0 °� � S z O O� O C .......... __. . C9 o O O �o O N v C) t a z. 0 z 7s 77 z r C O lossO r h VK� CO C) 77 Z c�cc� O{ O; O�DZO F� Z, CHAMPION ENCLOSURE SUPPLIERS INC. O Q) �? Z �' SPECIFICATIONS FOR SINGLE SLOPE V� I O n z "VINYL CLAD" PATIO ROOM12111 o O r N 0 O 0 °� � S z O O� O C .......... __. . 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O O Z �' SPECIFICATIONS FOR SINGLE SLOPE V� I O n z "VINYL CLAD" PATIO ROOM12111 o O r N 0 W 0 °� � S z FAX : 51,E 782'-3903) O� O C Z O O �o O N v C) I gIZ,1a_oNaN� <OpO� ACC Z cc c =1 O N v DQz ��zc`n, O<O oo �a z�D� Zc c R O 7�CS y z 7�� 0 O z G�7 z 71, O O O a O O z 0 rn az<�z Q o CnCI �_O �n 76a o N z � o a E z o z o o z —z z`J z Q O v A 7Z o a z Z a V S � CHAMPION ENCLOSURE SUPPLIERS INC. �Z o Z �' SPECIFICATIONS FOR SINGLE SLOPE I n z "VINYL CLAD" PATIO ROOM12111 r N 0 0 0 °� � S z FAX : 51,E 782'-3903) O O I gIZ,1a_oNaN� <OpO� ACC Z cc c =1 O N v DQz ��zc`n, O<O oo �a z�D� Zc c R O 7�CS y z 7�� 0 O z G�7 z 71, O O O a O O z 0 rn az<�z Q o CnCI �_O �n 76a o N z � o a E z o z o o z —z z`J z Q O v A 7Z o a z Z IABLES AND GENERAL NOTES AND CHAMPION ENCLOSURE SUPPLIERS INC. �Z o �' SPECIFICATIONS FOR SINGLE SLOPE I z "VINYL CLAD" PATIO ROOM12111 I� Chornplon Woy, C m nno(i, ON 45241 PM: 513 782-3900CES, FAX : 51,E 782'-3903) O F=4 4 4 5 O F. M I M� w I CCM C O.� MI cD — E m m cc CL ~ 3� O CD0 CL cc 0 CL L a cm< ca C o Cc m �z0 CL� c C _cc 0 LLIm 19 0 W U) S o m c o � a c O N C vV GG \4 0 w V) v Vn w b O w _c O a: G � U G w" w � p c� G w ow, W s p rx w" aQ U cG w' W a'i Z cn cn 5 O F. M I M� w I CCM C O.� MI cD — E m m cc CL ~ 3� O CD0 CL cc 0 CL L a cm< ca C o Cc m �z0 CL� c C _cc 0 LLIm 19 0 W U) S o m c o � c O N C vV C C m N co O � m N � CD CF O CD. - 0 0 VCl E S 0 m o r `%CD A m c NL. CDram y CD 3 cm m C C � � � m C y . � y m aU N m y d C = �Z opo C = m :m oo H v y m a j CO) G ZrCR •VNi AD r F ,C CZmC p w+ N u C3 CD CO2 010 _ {y0 m H v C 4 m 5 O F. M I M� w I CCM C O.� MI cD — E m m cc CL ~ 3� O CD0 CL cc 0 CL L a cm< ca C o Cc m �z0 CL� c C _cc 0 LLIm 19 0 W U) Customer; , prue A WALL City: bosion 77.375 + 0.5 + 77.375 + 4 + 2 sill(s) = 162" B WALL ij 4 + 77.375) + 0.5 + 77.375 + 4 + 4 sill(s) = 168" 4 + 59.375 + 0.5 + 71.375 + 2 sill(s) = 138" ROOF PLAN Job- Number: Order Date: 3718 01/05/06 - f Aj sr.s i.! w 1 '� ♦ ,A i.-'t�°' rtta.w� . ^�^rij� "ter" f R 4 `<%�' ,l+Ay�,'�1,,r¢�f„.," •nos , .;;� n:i�i sk { },la,;d, - � � � n � �� •adz , r '�' 4 { � ff((( Yr. � }~ aGj�•+': gy� �mr. .S kv'�.ullusui. w..1„ri 4 sd- t yJim f h �. � f� JY�� FPz•. {A T f r FACTORY DIRECT 0 SINCE 1953 • ' •` + 2;10 Ballardvale St. a Wilmington, MA 01887 w�( 978 84-6108.877-846-3699.978.284-6115 Fax riNcow SIDI G PAA�9Q ROO s D® H.I.C. 127172 / T.I.N. 58-244-2642 To ,. Dat< FE mail 2 "��,'a�/�,,,�� Home Phone Business Phone (Mr. / Mrs.) city AV— ,Stata/{'//7" zip t_i�1�YJ County/Twnshp - Replace-nent windows • Storm Windows & Doors • Vinyl Siding, Trim & Shitters • Glass & Screen Patio Rooms • Entry & Patio Doors WHOLESALE & RETAIL PATIO ROOM CONTRACT CHAMPION 10 MEASURE, MANUFACTURE, FURNISH AND INSTALL THE FOLLOWING CUI;TOM MADE PRODUCTS FOR THE AMOUNT STIPULATED BELOW: �O/ A•II-Season !rinyl Patio Room From Nominal 6' Components With Outside Dimensions 01 Approximalely A: X B: X C: +OS Season Allminum Patio Room From Nominal 4' Components Outside Dimensions Of ApproximatelyA; X B: X C: ❑Aluminum S:reen Room From Nominal 2'Components With Outside Dimensions Of Approximately A: DECK OR -;L" . YES NII YES IN ❑ 'Under Customer's Existing Roel 0' Room Deck Approximately _ X _ Malarial ❑ 1kon Customer's Existing Concrete Slab ❑ Open Deck Approximately _ X _ Material ❑ On Customer's Existing Deck 0 Steps: Wood 0 Concrete ❑ Approx. Number 01 Risers _ Open 0 Closed 0 O glo-Tear Out Existing: Slab ❑ Deck 0 0 Gr Railing Approximately ___ lin. ft. Malarial 0 il),'Fdoters For Existing Slab 0 9�-6kirtin I Approximately fin. ft. Material 0 Tear Out Existing: Walls U/—S_creens ❑ Roo�f/O Rail ❑ 0 Pour New Open Concrete Slab Without Foolers Approximately _ X _ ❑ ®'tA4 Sub Floor R&6 Ab� �4'� ❑ Poy� ew Concrete Slab With Footers Approximately _ X _ ❑ &nsu`lated Polydeck ❑ nsulala Under Deck INALL3 All Champion Pnlio Room wall systems consist of a series of sliding windows on top of approximately 16' fall knee walls and/or full view include loddng system, synchlodc interlocks, stainless steel wheels and sliding screens. Champion to dalarm pAxact size of nits ydI fl and all walls inc ude build -out and leveling system as necessary. r' ' al lirPaV)1 J YES NO O Super Frame, Wing 8 Trim Color. While O Tan ❑ Bronze ❑ ❑ 3/16' Triple Strength Non-Insulaled Glass �I CJS ❑ Double Pane Insulated Glass ❑ tow -E Insulated Glass 0 Solar -Green Insulated Glass 0 J ❑ 4rgon Gas Filled I.G. Units (AII Season oom Only) / U Ixed Glass Knee Walls Location: A B )(C : V t _........#r..l . ,....i. : . ❑ ❑ linea Wall w(Alumindin Skin: While ❑Bronze EI vi y.Q,. " ❑ U IcneeWall IVinyISit' While Tan .--�: 0 I)uildUp Built' in: Location: A O B❑ CO. y2rr/eN� O Irixed Tr nsom Glass Location: A ❑ 80 Co tom. ¢......:... 0 U CapcLAYOUT SKETCH OK s(ing Posts _ j'J U O I:ey Loock s ah U El SGding Screen Room System (No Glass) X =ACTIVE 0 =FIXED ' /dN! ROOF—=KNEEWALL.....<_.g...Vr',�i Champion's supedoam root sysiem is a nom:na14' (R-19) or 6' (R-30) expanded poly -styrene insulated loan panels with an embossed laminated aluminur broken ]-Beams. YES NO NO j 0 Stadio Roof System Color: While O Ta 4'�6. ❑ ❑ Gutter & Down Spout To Grade All) NL ❑ K Goble Roof System Color. While 0 Te 4' 6' O ' a ❑Shingles (To Match As Close As Possible) ible Glass O Wing Glass 0 Number Of Pieces:_ O 0 Skylights: Vented ❑ Non -Vented O Ouantily:_ ❑ :ble Tie-in (Includes Shingles On Saddle Only And Vertical Vinyl Fill On Inside Of Saddle) DOORS YES NO 0 Sorm:Oulswing ❑ cry: Inswing U Ouiswing ❑ layout). Windows and doors ass is tempergd salety.glas;, .....:... . 0 See Attached Drawing skin and thermally 1, ?if a 7100 Color Style Lr fl Hinge 0 Right Hinge ❑ ISLO Location: A ❑ B U CC) Calor Style left Hinge 0 Right Hinge 0 ISLO Location: A 0 B 0 C ❑ O HEq YES NO u s� YES NO ❑ He aVCool Unit /J G ��O 0 0 Blinds: G for Style Height _ Location: A O R CIC ❑ 0 Carpet _ X _ Color �,_ Cut To Fit Loose Laid ❑ nhical Package Including: -Wall Sockets, _Wall Switch(es) & _Ho*gpS C I Customs Provided Ceiling Fan With Ivory Wire.Mofd :L . Interior Roof Slone:; To Approx- h Allacha3 To House Wali ❑ Gullet Board ❑ Fascia oad Approx. Heigh) ti /B Cnamnfn� le nr,a ori.•.,,.,.:,.,., e_. e_....__ � ._�_._ _ _ ,.. _ _ ... —TWO YEARS FREE BUYER'S RIGHT TO CANCEL BUYER MAY CANCEL THIS CONTRACT BY DELIVERING Total rice for above $ WRITTEN NOTICE TO THE SELLER AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY AFTER THE DATE �/%ZI " Down aayment $ d 6 OF THIS TRANSACTION. BUYER MAY USE THIS CONTRACT AS THAT NOTICE BY WRITING "I HEREBY CANCEL" AT THE Balance payable on f ,Gy BOTTOM AND ADDING BUYER'S NAME AND ADDRESS. THE Installation/Delivery $/ NOTICE MUS-•' BE DELIVERED TO THE SELLER AT THE ADDRESS NOWN ABOVE. 1 O Bank Financing ❑ Cash on Completion Aft material is guaranteed to be as specified. All work Is to be completed In a workmanlike manner according to standard-gzapfcsIs contract Is valid only with proper signatures. Champion Shall not be . responsible for time and material decays, slraces, ads of God or any other mailers beyond its control. Buyer end Dam 3� tPequity In this property Is security for this contract. Since this contrail Balis made to ardor goads, h Is not subject to cancellation except as stated above. Stan Installation on or abf weeks from above dale. Estimated date of substantial completion h All charges litied above. Champion to remove and haul away all job related debris. All safes and discamts alotled. All contractors and subcontractors must be registered by the Board of ud ' agulatlons anc Standards and any Inquiries retailing to reglstradon should be directed to this agency. ChimplonsLaJI obtain any and all necessary permits as the Owner's agent unless otherwise directed by Bgyac If Buyer secures permits, he or she may be excluded from the guaranty fund pmvisi.r L e. NJ& If Champion must pursue Buyer for collection of amounts past due, Buyer will be Gable for Champion's reasonable f js and costs, Including attorney's fees. A FINANC NARGE calf: ale a rete of I -t/2 pare month (18°h ANNUAL PERCENTAGE RATE) wifM added to delinquent accounts. AM Installation and completion dates afro a timate end au a 10 change wlthom not e. eNal promises can cause misunderstandings, choral la this con"cl constitutes the nderslanding of the pontes, and no other understand' g, c ulaleral, verbal o o ervA e, shall di I signed by both pante Thank / you f i'l ordrir. a n It contr ct i there are any blanks spaces. lD uce V' a ecudty o. CI pion R a cativo t).� r