Loading...
HomeMy WebLinkAboutMiscellaneous - 256 MASSACHUSETTS AVENUE 4/30/2018N CTI 0 J CD D Qc- O S O C A m 6--' o cn 0 o m z m � R, 3713 Date. �... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that �— . fl C j ............................... has permission to perform �. 1�e wiring in the building of..........I�` � p(� ......................................................" at.............................................................. ... .North ov Fee.5----12!�.. Lic. No .............. ................< �......... ............... ELECTRICAL SPECTOR Check # A • i Date. �... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that �— . fl C j ............................... has permission to perform �. 1�e wiring in the building of..........I�` � p(� ......................................................" at.............................................................. ... .North ov Fee.5----12!�.. Lic. No .............. ................< �......... ............... ELECTRICAL SPECTOR Check # ti s Office Use Only The Commonwealth of Massachusetts ,�� N; Permit No. r� Department of Public Safety Occupancy & Fee Checked BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 3/90 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date f l L a. Ioioo or- A] o9vos✓E-1'Z To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number) cc 6 rnASS AIr Owner or Tenant AJ Owner's Address �}�f►�( Is this permit in conjunction with a building permit: Yes No ❑ (Check Appropriate Box) Purpose of Building RV I DEAIC& Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work SF/R d/ C E. -FOQ VIA1 1 G 5101 No. of Lighting Outlets No. of Hot Tubs Total No. of Transformers KVA No. of Lighting Fixtures In - Swimming Pool Ab nd. ❑ grnd. ❑ Generators KVA No. of Receptacle Outlets No. of Oil Burners No. of Emergency Lighting Battery Units No. of Switch Outlets No. of Gas burners FIRE ALARMS No. of Zones No. of Detection and Initiating Devices No. of Sounding Devices No. of Self Contained Detection/Sounding Devices Municipal Local ❑ Connection ❑Other No. of Ranges Total No. of Air Cond. tons No. of Disposals Heat Total Total No. of pumps Tons KW No. of Dishwashers Space/Area Heating KW No. of Dryers Heating Devices KW No. of Water Heaters KW No. of No. of Signs Ballasts Low Voltage 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 Comp Operations Coverage or its substantial equivalent. I have submitted valid proof of same to this office. YES gr NO ❑. If you have ch ed YES, please indicate the type of coverage by checking the appropriate box. INSURANCE BOND ❑ OTHER ❑ (Please Specify) Estimated Value o rical Work $ Work to Start y 9 Signed under the penalties of perjury: FIRM Ni Licensee Address ( xpiration Date) LIC. NO. A1521VI Ir. tin 3Z�Z� OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage or its substantial equivalent as required by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner ❑ Agent ❑ (Please check one) Telephone No. PERMIT FEE $ (Signature of Owner or Agent) ;r Offi The Commonwealth of Massachusetts use Only -7 Permit No. Department of Public Safety Occupancy & Fee Checked BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 3/90 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00 (PLEASE PRINT IN INK OR1,TYPE ALL INFORMATION) Date— IyRet L Off. 7—,oWN of AJ AlwouE/Z To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number) �^a�56 IN5,5 - At/r Owner or. Tenant -�7( �% a e N e C,o Owner's- Address _TAAr i_ Is this permit in conjunction with a building permit: Yes j No ❑ (Check Appropriate Box) Purpose of Building I?�9/.��NC� Utility Authorization No. Existing Service Amps _ / Volts Overhead ❑ Undgrd ❑ No. of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work SERV/c J01ti No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total . KVA No. of Lighting Fixtures Swimming Pool AboveIn - md. ❑ gmd. ❑ Generators KVA No. of Receptacle Outlets No. of Oil Burners No. Battof Emergency Lighting Bery Units No. of Switch Outlets No. of Gas burners FIRE ALARMS No. of Zones No. of Detection and Initiating Devices No. of Ranges Total No. of Air Cond. tons Heat Total Total No. of Disposals No. of Pumps Tons KW No. of Sounding Devices No. of Self Contained Detection/Sounding Devices Local' Municipal `❑ Connection ❑ Other No. of Dishwashers Space/Area Heating KW No. of Dryers Heating Devices KW No. of Water Heaters KW No. of No. of Signs Ballasts Low Voltage Wiring No. Hydro Massage Tubs No. of Motors Total HP INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws I have a current Liability Insurance Policy including Compl Operations Coverage or its substantial equivalent. I have submitted valid proof of same to this office. YES WI NO ❑. If you have cheo ed YES, please indicate the type of coverage by checking the appropriate box. INSURANCE BOND ❑ OTHER ❑ (Please Specify) Estimated Value o rical Work $ ��t7 •y Work to Start Signed under the penalties of perjury: FIRM N) Licensee Address YES gD NO ❑ (Expiration Date) LIC. NO. 15'02'11 ir No C 3ZNZ4 OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage or its substantial equivalent as required by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner ❑ Agent ❑ (Please check one) Telephone No. (Signature of Owner or Agent) PERMIT FEE $ Z / (_ ` Location c> 0 A SS No. 'A Q 1) Date ",. TOWN OF NORTH ANDOVER _ A Certificate of Occupancy $ �It':���<;s <�' Building/Frame Permit Fee $ d Foundation Permit Fee $ Other Permit Fee $ TOTAL $ co Ct Check # o,1 193 to 15432 �M ( 62 -- Building Inspector s 1.1 Property Address: ,2S(o MASS AVS 1.2 Assessors Map and Parcel (U Map Number Number: l (f Parcel Num er Signature Telephone 1.3 Zoning Information: Zoning Distrid Proposed Use Address for Service: 1.4 Property Dimensions: Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft 3.1 Licensed Construction Supervisor: Licensed Construction Supervisor: Address Signature Telephone Front Yard Side Yard License Number Rear Yard Required Provide Required Provided Required Provided Registration Number z— A ress 1.7 Water Supply M.G.L.C.40. 54) Public ❑ Private ❑ Zone 1.5. Flood Zone Information: Outside Flood Zone ❑ 1.8 Municipal Sewerage Disposal System: ❑ On Site Disposal System ❑ NEU I1Uiv 2 - FKUPERI Y UWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record STC Name (Print) Address for Service: Signature Telephone 2.2 Owner of Record: Name Print \6 Address for Service: Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Licensed Construction Supervisor: Address Signature Telephone Not Applicable ❑ License Number Expiration Date 3.2 Registered Home Improvement Contractor 6 F-rTeR- bj/Av0or✓ VlA/wG Not Applicable ❑ / 2 Company Name /f3 �Ai�s l2� l9✓E2Ni�c. Registration Number z— A ress Expiration Date Signature Telephone OU M M z O z M 90 O 0 M _r ^/Z Y Q cF.CTinN 4 - WORKERS COMPENSATION (M.G.L. C 152 6 25c(6) 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 building permit. Signed affidavit Attached Yes .......0 No ....... 0 SECTION 5 Descri tion of Proposed Work(check all applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition 11 Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: )U\I�L s, V9t "'>o ID �4o0,� e SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to be Completed by permit applicant OFFICIAL USE ONLY 1. Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee (a) X (b) 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 as Owner/Authorized Agent of subject property Hereby authorize Cl1A-C 1 `4,—) to act on My, b in al matters relative or authorized by this building permit application.. nature of Owner Date 16, SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION �n n I, I �' 1 1 \, "c� At,-� ,as Owner/Authorized Agent of subject property ff Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowleflge andbelliief n Y �' I 1 e 4 -CL. Print N e Sir4ature of Owner/Agent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 2 ND 3 SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS DIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE BETTER HOMES WINDOW ANIS SIDING THE EXCLUSIVE WINDOW AND SIDING CONTRACTOR 978-372-6385 TOLL FREE 1-800-668-3505 MASS REGISTRATION # 122318 DATE 1014 I0% N SOURCE CONSULTANT HOME TEL. GBS-- 5_L8' A WORK TEL. MRJMRS. THIS AGREEMENT, made and entered into between BETTER HOMES WINDOWS AND SIDING hereafter referred to as a contractor AND S-A'E PN L=w iPP, r %-c`z` ADDRESS/STREET •Z,, Ca M,4<.0 AQ Or CITY IN orTK raa.I v-6TATE� Zip hereafter referred to as owner. 4 THE SAID CONTRACTOR hereby agrees that it will furnish all labor and materials necessary to install the following described work at premises located at: JOB ADDRESS AV-, L CONTRACTOR agrees to start described work on/or about weeks after final measure and complete described work in about working days. WkN T SP 121%'1lc In addition to manufacturers warranty, Better Homes Window and Siding guarantees our workmanship for five years. ALL HOME IMPROVEMENT CONTRACTORS AND SUBCONTRACTORS SHALL BE REGISTERED IN MA. INQUIRIES RELATING TO A REGISTRATION SHOULD BE MADE TO: DIRECTOR, HOME IMPROVEMENT CONTRACTOR REGISTRATION, ONE ASHBURTON PLACE, ROOM 1301, BOSTON, MA 02108, TEL. 617-727-8598. We hereby submit specifications and estimates for: -tb �-lazts r A -.j o 4rA,-6 'C- 1) 1) ( C E M O 3 Q; t! -Y l S Tl h►(AP v \ t 134 -Z Av F, R- 3. Gvi-r L1-��. iYt�n^ t...A-TK 4V<- C_caAPr't-N0 �4rt.�.�nctvvM I�S�`f►-�` IIV cSA - v��� v�N S�f=f�� S c�-w� . 5' 1►�sz�l. v -(w)( s"\js T -o trrJtj'�_ 1_1-;7 STEL,' , RC- C -dg -A P't1'E0 1W A -C<-6 Dq,1.c< (01tA Pro PaSA1 Lt rrty— „ WE PROPOSE HEREBY TO FURNISH TOTALINVESTMENT w MATERIAL AND LABOR (IF SPECIFIED) - c COMPLETE IN FULL ACCORDANCE WITH .5-3')6gA/r3 DEPOSIT ABOVE SPECIFICATIONS FOR THE SUM OF: BALANCE UPON COMPLETION ANY WORK NOT LISTED ON THIS CONTRACT WILL BE AT ADDITIONAL CHARGE. BEITER HOMES WINDOW AND SIDING DOES NOT INCLUDE PAINTING OR STAINING ON ANY PROJECT UNLESS SPECIFIED ON THIS CONTRACT. You may cancel this agreement if it has been signed by a party thereto at a place other than the address of the seller, provided that you notify the seller in writing at 18 Bates Road, Haverhill, MA 01832, by ordinary mail posted, by telegram sent, or by delivery, not later than midnight of the third business day following the signing of this agreement. ALL MATERIAL IS GUARANTEED TO BE AS SPECIFIED. ALL WORK TO BE COMPLETED IN A WORKMANLIKE MANNER ACCORDING TO STANDARD PRACTICES. ANY ALTERATIONS OR DEVIATION FROM THE ABOVE SPECIFICATIONS INVOLVING EXTRA q STS WILL BE EXECUTED ONLY UPON WRITTEN WORK ORDER AND WILL BECOME AN EXTRA CHARGE OVER AND ABOVE THE ESTIMATE. THIS IS TO INCLUDE, BU IS NOT LIMITED TO, HIDDEN DAMAGES THAT ARE UNCOVERED DURING THE COURSE of THE JOB AND ADDITIONAL WORK REQUIRED BY LOCAL BUILDING INS CTORS. ALL ELEMENTS OF THIS AGREEMENT ARE C TINGENT UPON STRIKES, ACCIDENTS, OR DELAYS BEYOND OUR CONTROL. NOTE, THIS PROPOSAL MAY BE WITHDRAWN BY CONTRACTOR O IF NOT ACCEPTED WITHIN DAYS. AUTHORIZED SIGNATURE DATE ACCEPTANCE: THE ABOVE PRICES, SPECIFICATIONS, AND CONDITIONS ARE SATISFACTORY AND ARE HEREBY ACCEPTED. YOU ARE AUTHORIZED TO DO THE WORK AS SPECIFIED. PAYMENT WILL BE MADE AS OUTLINED ABOVE. AN INTEREST CHARGE OF I-1 /2% PER MONTH (18% PER YEAR) WILL BE ADDED TO ANY AMOUNT UNPAID AFTER 30 DAYS FROM INVOICE DATE. DO NOT S_ �T1 HIS CONTRAC ;F IF THERE ARE ANY BLANK SPACES SIGNATURE > ����"' �'/ DATE SIGNATURE DATE d B. EMPLOYERS LIABILITY INSURANCE: Part Two of the policy applies to work in each state listed In Item 3.A. The limits of our liability under Part Two are: Bodily Injury by Accident: $ 500000 Each Accident Bodily Injury by Disease: $ 500000 Policy Limit Bodily injury by Disease: $ 500000 Each Employee C. OTHER STATES INSURANCE: Part Three of the policy applies to the states, if any, listed here: SEE ENDORSEMENT WC 20 03.06 D. This policy includes these endorsements and schedules: SEE LISTING OF ENDORSEMENTS - EXTENSION OF INFO PAGE 4. The premium for this policy will be determined by our Manuals of Rules, Classifications, Plans. All required information Is subject to verification and change by audit madeRates and Rating DATE OF ISSUE: 10-0-2-01 RM OFFICE: CNA 04LJ ST ASSIGN: MA OVA i AV Ali fM Cemwyfm�wt, Tbv Ms4o- f WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLIC TYPE AR INFORMATION PAGE WC 00 00 01 ( Al POLICY NUMBER: ( ES59UB-794X687-3-01) RENEWAL OF (ES59UB-495X700-9-01) s, jk INSURER: CONTINEN-AL CASUALTY COMPANY I I �i NCCI CO CODE: 80381. INSURED: , LAW, MICHAEL DBA BETTER HOMES PRODUCER: $! WINDOWS & SIDING ANTHONY & MALCOLM INS 18 BATES RD 3 S CENTRAL ST HAVERHILL MA 01830 PO BOX 5128 BRADFORD MA 01835 F� Insured is AN INDIVIDUAL is Other work places and identification numbers are A shown In the 2. The policy period Is from schedule(s) attached. 09-25-01 to 04-30-02 12:01 A.M. at the insured's mailing addresss. 3. A. WORKERS COMPENSATION INSURANCE: Compensation Law of the Part One of thelic applies to the Workers i y pp state(s) listed here: = MA z. B. EMPLOYERS LIABILITY INSURANCE: Part Two of the policy applies to work in each state listed In Item 3.A. The limits of our liability under Part Two are: Bodily Injury by Accident: $ 500000 Each Accident Bodily Injury by Disease: $ 500000 Policy Limit Bodily injury by Disease: $ 500000 Each Employee C. OTHER STATES INSURANCE: Part Three of the policy applies to the states, if any, listed here: SEE ENDORSEMENT WC 20 03.06 D. This policy includes these endorsements and schedules: SEE LISTING OF ENDORSEMENTS - EXTENSION OF INFO PAGE 4. The premium for this policy will be determined by our Manuals of Rules, Classifications, Plans. All required information Is subject to verification and change by audit madeRates and Rating DATE OF ISSUE: 10-0-2-01 RM OFFICE: CNA 04LJ ST ASSIGN: MA C/) m m C/) O C 0 Q H aoSa m CO) F C o m !7 mF CL CC7 '+ ZH CD .�-O to w ca =rdd 0 FFC o Homy c y i .fl O 0 Zy n CO) o c:0) - d ? ti :� : z CO) $4 r :4- p O =CL400 0 -&,4: oCn m0 CD CL CL CO) n CA p C�7 > CO) � O d t..9, c � coo'=' �C -1 C� 7C1 C/)c = S.CD M CIOa 4 O (f n�] .. � m CO CL = �� r r cr CD -v .. C-1 � o O � CD o co 0:� Z =r _ CS v a� O CD y C3 CD 4 CO)CD 'O Z pq�+7 • o+ co CD . Cy " v O O: CD C -) o: 0 W • 0 C C� CD c'17 0 pi b 0 r- b O m n pc Cc: ro O c cp O O 1 0 fi 0 0 c CD04 d I� Z Location r9S-b N A �S A U -e-_ ._ No. Date hpRTq TOWN OF NORTH ANDOVER dL 3? •. p F s Certificate of Occupancy $ �' b'"•°''t�' Building/Frame Permit Fee $ � S ,SSACNUSE Foundation Permit Fee $ Other Permit Fee $ TOTAL $S Check #� 156:0 Building Inspector I ` w TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT"" REPAIR, RENOVATE, OR DEMOpLISH A ONE OR TWO FAMILY DWELLING ,RASM,5%s°�v•e+ �u. BUILDING PERMIT NUMBER: 626 6 / DATE ISSUED: y �' SIGNATURE: Building Commissioner/12EL=tor of Buildings Date SECTION 1- SITE INFORMATION 1.1 PropertyJA��d�/drr�esss:C :2 W s"//iJS c Aysr / 1.2 Assessors Map and Parcel 110 Map Number Number: Parcel Number ri 1.3 Zoning Information: Zoning District Proposed Use G 1.4 Property Dimensions: Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft 2.2 Owner of Record: Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided Not Applicable ❑ Licensed Construction Supervisor: 1.7 Water Supply M.GL.C.40. 54) Public ❑ Private ❑ 1.5. Flood Zone Information: Zone Outside Flood Zone ❑ 1.8 Municipal Sewerage Disposal System: ❑ On Site Disposal System ❑ SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record Name (Print) Address for Service: G Signature Telephone 2.2 Owner of Record: Name Print Address for Service: // --tom St nature Tele hone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: License Number i Address Expiration Date Signature Telephone 3.2 Registered Homle Improvement Contractor Not Applicable ❑ ,&CiiGR. 1-00(-S W�NiJo� SI�iItj6 22J Company Name 2 n T F S I b2F41 /�/� f1V��� . 9 Registration Number Addres p l 7 p •'372'�j 3 �� Expiration Date Signature Telephone M M X Z O J SECTION 4 - WORKERS COMPENSATION (NLG.L. C 152 § 25c(6) 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 building permit. Signed affidavit Attached Yes .......❑ No ....... 0 SECTION 5 Description of Proposed Work cher applicable New Construction ❑ Existing Building Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to be Com leted by permit applicant OFFICM USE ONLY I . Building ©C1 Cl (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction G d� 3 Plumbing Building Permit fee (e) X (b) �-- // 6 4 Mechanical (HVAC)f� 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 �Ac s7'�_ c:U as Owner/Authorized Agent of subject property Hereby authorize [ . i CCt- kdrn C S W t"oi,.l to act on M bel lf, in all matters dative t work authorized by this building permit application. Si nature Owner C- Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, 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 Name Signature of Owner/Agent Date FEMME_.. NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR T1IvIBERS 1 2ND 3 RD SPAN DIMENSIONS OF SILLS 1: M ENSIONS OF POSTS DRvIENSIONS 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 01 Q OVA Mr All MAr C0__jlm&,rb J'ou M�4o' INSURER: CONTINEN-AL CASUALTY COMPANY 1. INSURED: LAW, MICHAEL DBA BETTER HOMES WINDOWS & SIDING 18 BATES RD HAVERHILL MA 01630 Insured is AN INDIVIDUAL 'r WORKERS COMPENSATION AND i EMPLOYERS LIABILITY POLICt TYPE AR INFORMATION PAGE WC 00 00 01 ( POLICY NUMBER: (6S59UB-794X687-3-01 ) RENEWAL OF (6S59UB-495X700-9-01) NCCI CO CODE: 80381 PRODUCER: ANTHONY & MALCOLM INS 3 S CENTRAL ST PO BOX 5128 BRADFORD MA 01835 Other work places and identification numbers are shown In the schedule(s) attached. 2. The policy period is from 09-25-01 to 04-30-02 12:01 A.M. at the insured's mailing addresss. 3- A. WORKERS COMPENSATION INSURANCE: Part One of the policy applies to the Workers Compensation Law of the state(s) listed here; MA B. EMPLOYERS LIABILITY INSURANCE: Part Two of the policy applies to work in each state listed In Item 3.A. The limits of our liability under Part Two are: Bodily Injury by Accident: $ 500000 Each Accident Bodily Injury by Disease: $ 500000 Policy Limit Bodily Injury by Disease: $ 500000 Each Employee C. OTHER STATES INSURANCE: Part Three of the policy applies to the sta#es, If any, listed here: SEE ENDORSEMENT WC 20 03.06 D. This policy Includes these endorsements and schedules: SEE LISTING OF ENDORSEMENTS - EXTENSION OF INFO PAGE 4. The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating Plans. All required information Is subject to verification and change by audit to be made ANNUALLY. DATE OF ISSUE: 10-02-01 RM OFFICE: CNA 04LI ST ASSIGN: MA BETTER HOMES WINDOW AND SIDING THE EXCLUSIVE WINDOW AND SIDING CONTRACTOR 978-37276385 TOLL FREE 1-800-668-3505 MASS REGISTRATION #122318 DATE 22 0/9y 0vG 2-- SOURCE CONSULTANT J HOME TEL. &e8 --528y WORK TEL. MRJMRS. THIS AGREEMENT, made and entered iA �o between BETTER HOMES WINDOWS AND SIDING hereafter referred to as a contractor AND TEi'iq�,� Acdgco ADDRESS/STREET hereafter referred to as owner. CITY P, /'4AJ1)Q fZ STATE M/; ZIP _ 018 qS- THE SAID CONTRACTOR hereby agrees that it will furnish all labor and materials necessary to install the following described work at premises located at: JOB ADDRESS. CONTRACTOR agrees to start described work on/or about weeks after final measure and complete described work in about working days. In addition to manufacturers warranty, Better Homes Window and Siding guarantees our workmanship for five years. ALL HOME IMPROVEMENT CONTRACTORS AND SUBCONTRACTORS SHALL BE REGISTERED IN MA. INQUIRIES RELATING TO A REGISTRATION SHOULD BE MADE TO: DIRECTOR, HOME IMPROVEMENT CONTRACTOR REGISTRATION, ONE ASHBURTON PLACE, ROOM 1301, BOSTON, MA 02108, TEL. 617-727-8598. We hereby submit specifications and estimates for: I<%m i✓ <S'rn� rnl�L 1 Elm ALL i200F EN � X25 ._ n.L<? °2oQ F 'D EC F 'bi=cl_I / _ `2c -?Lac - y� ER_ ll= i FF A)C-S:D1:b ?Pt fC,K ; eZ 51+1E 51 =\Zorn L- P11LIV, F_VN�Es Arv'b iLou�v t_1.. `PEOC i "i2F9Tt®nJS. (:�VE[L zC_M6IAj rR tai t 3o d rr_- .d n� 577AL X11 F IZ ►�' Dc A'tZQ0xj D Cry i I RS " is-12AvY1� i E2 L c. % ; K C �/� -Y73 R! 0G. EL ,5' R j'17C1a ,rr ._ .. S ` * r t�Uc� r//tlG �. S'�r► 'EEma`,c bEBRi S Ajo 7-E- Q ru C, :r-'0U1ISE_ 0+'- LoCtZV- - ALS- Siff` UjA LL S 0rz lair A)D 'PU11u i 1 -"j6 -S' W i LL WE PROPOSE HEREBY TO FURNISH TOTAL INVESTMENT MATERIAL AND LABOR (IF SPECIFIED) - DEPOSIT COMPLETE IN FULL ACCORDANCE WITH ABOVE SPECIFICATIONS FOR THE SUM OF: BALANCE UPON COMPLETION ANY WORK NOT LISTED ON THIS CONTRACT WILL BE AT ADDITIONAL CHARGE. BETTER HOMES WINDOW AND SIDING DOES NOT INCLUDE PAINTING OR STAINING ON ANY PROJECT UNLESS SPECIFIED ON THIS CONTRACT. You. may cancel this agreement if it has been signed by a party thereto at a place other than the address of the seller, provided that you notify the seller in writing at 18 Bates Road, Haverhill, MA 01832, by ordinary mail posted, by telegram sent, or by delivery, not later than midnight of the third business day following the signing of this agreement. ALL MATERIAL IS GUARANTEED TO BE AS SPECIFIED. ALL WORK TO BE COMPLETED IN A WORKMANLIKE MANNER ACCORDING TO STANDARD PRACTICES. ANY ALTERATIONS OR DEVIATION FROM THE ABOVE SPECIFICATIONS INVOLVING EXTRA COSTS WILL BE EXECUTED ONLY UPON WRITTEN WORK ORDER AND WILL BECOME AN EXTRA CHARGE OVER AND ABOVE THE ESTIMATE. THIS IS TO INCLUDE, BUT 1S NOT LIMITED TO, HIDDEN DAMAGES THAT ARE UNCOVERED DURING THE COURSE OF THEJOB AND ADDITIONAL WORK REQUIRED BY LOCAL BUILDING INSPECTORS. ALL ELEMENTS OF THIS AGREEMENT ARE—CONTINGENT UPON STRIKES, ACCIDENTS, OR DELAYS BEYOND OUR CONTROL. NOTE, THIS PROPOSAL MAY BE WITHDRAWN BY CONTRACTOR IF NOT ACCEPTED WITHIN DAYS. AUTHORIZED SIGNATURE DATE ACCEPTANCE: THE ABOVE PRICES, SPECIFICATIONS, AND CONDITIONS ARE SATISFACTORY AND ARE HEREBY ACCEPTED. YOU ARE AUTHORIZED TO DO THE WORK AS SPECIFIED. PAYMENT WILL BE MADE AS OUTLINED ABOVE. AN INTEREST CHARGE OF 1-1 /2% PER MONTH (I8% PER YEAR) WILL BE ADDED TO ANY AMOUNT UNPAID AFTER 30 DAYS FROM INVOICE DATE. DONO G THIS CONTRACT IF THERE ARE ANY BLANK SPACES SIGNAT J> ' 1 7� ' DATE -="� SIGNATURE DATE v North Andover Building Department Tel: 978-688-g DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permi Number is that the debris resulting from this work shall be i disposed of in a properly licensed solid• waste disposal facility as defined b c11,S150A. yMGL The debris will be disposed of in: ,-6 - AL (Location of Facility) Sign re o�Perm�itAp�p icant Date NOTE: Demolition permit from tl?e Town of North Andover must be obtained for this project through the Office of the Building Inspector Cl) M m Cl) 0 m CO) CD az O O CL r. d d CDa Op CL c CCD O .... a v CD Cif 10 CD O LTJ CO) d O CO) F O CO) LTJ O rh CD CD a. y CD CIS ft IL O I cn n O z cn C� 2 0 cn rr�^ VJ 4c C ?100 = _ O �• y 0 Q N dC S. CD y CL m to !9 G� T Z N �� ca O� = wO H T =r CL,,. a o CD -40m d G y N O_ OD h f � tC �. p sm C aCD CL ..« ^► m o =ra:0 m m H r m 0 CD ;r c CL y s C i C. r� o��=Q H�co o t0 SD VJ y ,J�r yQ V 'CA ON �m CD Af: CD c oCD .s . .� CO cn W H CD CW cn olv-d d (r pC) d O � z y O � O - r� Z b � v ` a :7, a O zi 5y r z � b•a O.r x - o M �i r� Ou �J z 0 )nq 0 9 O C CD O �X S