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Miscellaneous - 90 COVENTRY LANE 4/30/2018
Form of Notice of Casualty Loss to Building Under MASS. GEN. LAWS, Ch. 139, Sec. 3B To: Building Inspector Building 20, Suite 2035 1600 Osgood Street North Andover, MA 01845 RE: Insured: Nathaniel & Colleen Smith Property Address: 90 Coventry Lane Company: Vermont Mutual Insurance Company Policy/Claim Number: H017101815, HC218552 Date/Cause of Loss: 2/13/2016, Fire and/or Smoke Our File Number: 33058-C Claim has been made involving loss, damage or destruction of the above captioned property, which may either exceed $1,000.00 or cause MASSACHUSETTS GENERAL LAWS, CHAPTER 143, SECTION 6, to be applicable. If any notice under MASSACHUSETTS GENERAL LAWS, CHAPTER 139, SECTION 3B is appropriate, please direct it to the attention of the writer and include a reference to the captioned insured, location, policy number, date of loss and claim or file number. Chris Town, Ext. 114 On this date, I caused copies of this Notice to be sent to the persons named above at the addresses indicated above by First Class Mail. 21WI Signature and Date 7 ANDERSON ADJUSTMENT CO., INC. 50 Nashua Road, Suite 303 PO Box 1098 Londonderry, NH 03053 Cc: North Andover Health Department Building 20, Suite 2035 1600 Osgood Street North Andover, MA 01845 North Andover Fire Department 795 Chickering Road North Andover, MA 01845 n ac O .Z„1 O z O Z mm 4 -1 m i > Z 0 W 0 W ,v r A i m m Z > i t 0 o > °� c A m m f O f o c z 0 4 m 0 0 J 1 t .A O 0 m A 0 z 1 t ! _ t D W A C- r ( 0 Z 0 Z 'n r > o m n m A m n -! y c 0 � 0 > i S 0 ' f1 Z z 0 0 O Z > _ > O 0; z- > A � m > 0 n N p p ! i; m ;>m m I M J m � o O I N ZA > m ! 0 '� A z m f I n ac O .Z„1 O z O Z mm 4 -1 m i > Z 0 W 0 W f7 r r 0 O ' 0 L z °� '° i 0 ae o c 91) ON V` 4 m 0 0 J 1 vl P cr Z r s z z O D W 00 I u I A a i 4 -1 m i > Z 0 W 0 W 0 W m > A 0 O ' 0 L z °� '° i 0 ae o c c 4 m 0 0 A x M A Z r s z z O D 0 C- r 0 z W 0 Z 0 Z 'n r n M I u I mf O to m to > A 0 W 0 W 0 W m > A 0 ,.) * 6 O N +O 3 >U z ° r m o c c c> i Z i> Z Z r s z z 0 Z m 0 C- r 0 z W 0 Z 0 Z 'n r n M o m n m A m n -! y y 0 0 > i z>> 0 0 f1 Z z 0 z 0 O Z > rri > O 0; z- > Z m > 0 n r p p m i; ;>m m m O N ZA > •1 z 0 '� A m W ; 0 Z rn -4 1 c_ [ O 0 o m W _ r ° O > m ° (Ai J Z 0j 10)-4 0 _z m Lh 0 m f� . 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Z � b I I I m Z K U W � � 3,�a Z F► m JZ a p Z Or- w Z LL oO U ' N p h> f ZZ LO V= p S U d laxio� Ol O<<0 u�-�- �� I T�7 ���� u I l z 0 0 U Z � Z Y � W N 2 O cW G W � Z W v oV� Q ► Q m O O NO N N z Z W V �< W «W �� WWOfyQ�0yd0 J p= vf000 ZotZ 000 W li o[ N V V 0 0 Y y m N f O p p Q a d f p g ol W mv� U U Y = O a Q > V Z Z 6 O Q W M p O 1 KO_�� r, O ° oe �Z�-ufi _VQ i;0uf �x W ~oc Ei j y 0 Q< ZS o< O W Z f O OU O -0 r l O m � �m K Qp y C � � d � O az ca 06 � C2• O d = y nto _:2 =s INV � 0 o o p CD o Q� =:r "C CD CD O C O H� �O CO) O �= CD � v CA O 'CD co z� o � C Cp < c O m S _a�cr ca es mm = N Em N sa,,.a o 00 m t o y C) --c. " m c a 0C.m 0.0 cc C =r C m ar a m cro n C a, � J l•� m H �. O d y z� y a CR .C. y cop) '\ I� O O Rt CA o Zr ca W 03 CD10.900. cC/3 K° tri � o pGn W o p�q � z w x ro W z 0 9 p x III C O d 'O '7.. d 0° y 0 O C � � C4NiRAE�OR N4HE INPR�VE�'E 12359 Re9istrat�on '.'° iYPe . 48A 43112j99 1 , ExPi� ation 1 +� Kew pgauline pools � al G. Gooch Gi e 5t L ApMW�STR�T• Stonehas MA 02184 U L661 9 SupepPUMP@ High Performance Pump Series Exclusive, Swing' Aside Hand Knobs make strainer cover removal easy. No tools required... no loose parts... no clamps. Super -Size Housing has extra air handling capacity to assure rapid priming. Totally Balanced, Corrosion -Proof Noryl® Impeller has smooth, wide openings to prevent fouling or clogging. Energy-efficient design produces more flow at equivalent horsepower. Lexan® See-Thru Strainer Cover lets you see when basket needs cleaning and eliminates guesswork. Special self- adjusting seal assures dependable sealing. I 1 III{. �—nu.n•1 1 �Itp ul� rI4}w m 1 ln.. 41M p-� —1161 FIT 1!1141 M ft. 30 100 27--90 24--80 2, 70 W 18--60 J 15--5 0 12--40 ~ 9 30 6 20 3 10 0 0 26-93 All Components Molded of Corrosion - Proof PermaGlassXLTM for extra durability and long life. Heavy -Duty, High - Performance Motor with air -flow ventilation for quieter, cooler operation. Heat Resistant, Industrial Size Ceramic Seal. Long wearing, and 100% drip proof. For fresh or salt water use. Mounting Base provides stable, stress -free support, plus versatility for any installation requirement. Adapts 48 and 56 frame motors. Service -Ease Design gives simple access to all internal parts. Motor and entire drive group assembly can be removed, with- out disturbing pipe or mounting connections, by disengaging just four bolts. N MMM '. Mmmmm M� wmmm �09%a no mmmm 36 .21 MMMMMM! Im MMS I 10 20 30 40 50 60 70 80 90 100 110 120 130 1 CAPACITY PER MINUTE M SUPER -SIZE 110 CUBIC INCH BASKET has extra leaf -holding capacity and extends time between cleanings. Rigid construction with load -extender ribbing assures free flowing oper- ation for heavy debris loads. Super Pump® Series Pumps are listed by: 0 GPM 0 LPM * NSF® CIP 0 HAYWARD POOL PRODUCTS, INC. Hayward Pool Products, Inc. Hayward Pool Products, Inc. Hayward Pool Products Canada Hayward S. A. 900 Fairmount Avenue 2875 Pomona Boulevard 2880 Plymouth Drive Zone Industrielle de Jumet Elizabeth, NJ 07207 Pomona, CA 91768 Oakville, Ontario L6H 5R4 B-6040 Charleroi, Belgium nI ov W ,d a,i„md i}, n c e Star-Clearly" Cartridge Filters Single Locking Knob securely fastens filter head to tank, eliminatir- clamps or bolts. Filter Head provides easy access to cartridge element. Attractive and durable, the head may be rotated to conveniently position pressure gauge and manual air relief valve. Heavy -Duty Filter Tank injection molded of high strength Duralon' for dependable, corrosion -free performance. Automatic Air Relief purges any trapped air during filter operation. Cartridge Element is engineered of high-quality reinforced polyester with gasketed molded end caps for maximum efficiency, easier cleani and longer life. Molded Center Core incorporating unique "Waffle -Pattern Design" allows for maximum flow and provides extra strength. Elevated Filtered Water Collector and Debris Sump prevents accidental by-pass of heavy debris to pool or spa when cartridge is removed for cleaning. 17? or Z' FIP, or Z' Socket Connections for plumbing versatility. W1111) Filter Drain Valve provides fast draining for elevated spas a tubs. Also accepts standard spigot valve. FILTER TYPE: Cartridge element: 75,100 and 150 sq. ft. FILTER TANK: Injection molded DuralonT"I FILTER ELEMENTS: Reinforced Polyester PERFORMANCE RANGE: 1/2 TO 3 HP (75 to 150 GPM) DIMENSIONS: C-800-291/2" H x 13" W (749 mm x 330 mm) C-1100-351/2" H x 13" W (902 mm x 330 mm) C-1500-47" H x 13° W (1194 mm x 330 mm) 'Determined by pump size and piping system hydraulics. 2' piping is recommended for flow rates of 90 GPM or more. Flow rates above 120 GPM are not usually required for residential pools. NSF. EASY TO CLEAN CARTRIDGE ELEMENTS. Hayward cartridges have extra dirt -holding capacity and are engineered of durable, high- quality materials to last for years with only minimal care. Simply remove the cartridge element and hose off with Hayward's EC -2024 Jet -Action Cleaning Wand to restore to clean operating condition. PiAYWARD POOL PRODUCTS, INC. Hayward Pool Products, Inc. Hayward Pool Products, Inc. Hayward Pool Products Canada Hayward S.A. 0 900 Fairmount Avenue 2875 Pomona Boulevard 2880 Plymouth Drive Zoning de Jumet Elizabeth, NJ 07207 Pomona, CA 91768 Oakville, Ontario L6H 5R4 B6040 Jumet, Belgium 19B-92 01 N7 Hayward Printari in 1I S G Performance MODEL NUMBER Data EFFECTIVE FILTRATION AREA DESIGN FLOW RATE TURNOVER (GALS.) 8 Hr. 10 Hr. C-800 C-1100 C-1500 75 sq. ft. 100 sq. ft. 150 sq. ft. 75 GPM 100 GPM 150 GPM' 36,000 48,000 72,000 45,000 60,000 90,000 'Determined by pump size and piping system hydraulics. 2' piping is recommended for flow rates of 90 GPM or more. Flow rates above 120 GPM are not usually required for residential pools. NSF. EASY TO CLEAN CARTRIDGE ELEMENTS. Hayward cartridges have extra dirt -holding capacity and are engineered of durable, high- quality materials to last for years with only minimal care. Simply remove the cartridge element and hose off with Hayward's EC -2024 Jet -Action Cleaning Wand to restore to clean operating condition. PiAYWARD POOL PRODUCTS, INC. Hayward Pool Products, Inc. Hayward Pool Products, Inc. Hayward Pool Products Canada Hayward S.A. 0 900 Fairmount Avenue 2875 Pomona Boulevard 2880 Plymouth Drive Zoning de Jumet Elizabeth, NJ 07207 Pomona, CA 91768 Oakville, Ontario L6H 5R4 B6040 Jumet, Belgium 19B-92 01 N7 Hayward Printari in 1I S G 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 local or state law, regulations or requirements. ****************Applicant fills out this section***************** APPLICANT: Kj Phone LOCATION: Assessor's Map Number Parcel Subdivision Lots) _ Street St. Number �0 ************************Official Use Only************************ RE _DATIONS OF T WN AGENTS: Date A d Co servation Admi is Approved rator Date Rejected Comments A)_WMd s `7 /00 Town Planner Comments Food Inspector -Health Septic Inspector -Health Comments Public Works - sewer/water connections - driveway permit Fire Department Received by Building Inspector ~� qy . Date Approved Date Rejected Date Approved Date Rejected Date Approved Date Rejected Date ~ m --__-__-- ^ ` ^ . ' � ~ '~-- '- -'�--- '- -.---' .-_ - � \ � |\ ` ) ' - / ' ' + . ` \ � � ' ` \ / \ \ . . - ` ^^ / . / / ~ m --__-__-- ^ ` ^ . ' � ~ '~-- '- m r r C 3 Locution + No, �>77 Date Q:N°RTM TOWN OF NORTH ANDOVER ffLO ;�,MO 3? ... • o� A Certificate of Occupancy $ Building/Frame Permit Fee $ S1C MUUS Eta' Foundation Permit Fee $ -9ftr Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOIAL !vv j 97 11:12 eilding Inspector 1>>1fi0. Q4 - 3.v Div. Public Works PERMIT NO. y , 4.: . APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. PAGE 1 KBO. 1 LOT NO. I 30 RECORDMAP 2 RECORD OF OWNERSHIP DATE BOOK ;PAGE ZONE SUB DIV. LOT NO. LOCATION 570 am� 'M PURPOSE OF BUILDING G X TO �JW MYKJ OWNER'S NAME ,�J,44NftVM)t4Q NO. OF STORIES SIZE I OWNER'S ADDRESS at, n „ l _ n BASEMENT OR SLAB ARCHITECT'S NAME _ SIZE OF FLOOR TIMBERS IST 2ND ]RD BUILDER'S NAME Oaw t1�^,%� /1�� SPAN DISTANCE TO NEAREST BUiLDlfrG (1 -- DIMENSIONS OF SILLS DISTANCE FROM STREET r L)T POSTS DISTANCE FROM LOT LINES - SIDES( _, lf/(�I�J /Gq REAR A/� l L UV GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING X 18 BUILDING ADDITION S�ll/11VYi1�� MATERIAL OF CHIMNEY IS BUILDING ALTERATION �© IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE (�QC J IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS SEE BOTH SIDES PAGE 1 FILL OUT SECTIONS 1 - 8 PAGE 2 FILL OUT SECTIONS 1 - 12 ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING . ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FILED ta SIGNATURE OF OW ER OR AUTHbRIlfE0 AGENT , A FEE PERMIT GRANTED r nY # — X997 s PROPERTY INFORMATION LAND COST EST. BLDG. COST EST. BLDG. COST PER SQ. FT. EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. 4 APPROVED BY ?tt BUILDING INSPKCTOR OWNERTEL./ CONTR. TEL.+ CONTR. LIC. # H.I.C. # 1 3 59 , v , t f + BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY 11SIOPIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY _ OFFICES _ LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA - APARTMENTS I RAGES, ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. Ifl CONSTRUCTION 2 FOUNDATION _ 8 INTERIOR FINISH CONCRETE _ 3 1 2 13 CONCRETE 81. K. PINE BRICK OR STONE HARDW'D PIERS PLASTER DRY WALL _ UNFIN. 3 BASEMENT AREA FULL FIN. B'M'T' AREA 1/4 1/1 % FIN. ATTIC AREA _ N_O am T FIRE PLACES _ _ HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS DROP SIDING WOOD SHINGLES ASPHALT SIDING ASBESTOS SIDING VERT. SIDING B I _ 2 1_ 3 _ _ CONCRETE EARTH HARDNV*0 COMIACN ASPH. TILE STUCCO' ON MASONRY STUCCO ON FRAME I Y ATTIC STRS. b FLOOR BRICK ON FRAME I_ CONC, OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME SUPERIORI J POOR _ ADEQUATE 1 NONE 5 ROOF 9 10 PLUMBING CaABIE HIP MANSARD BATH QFIX GAMBREL TOILET RM. FIX.) FLAT SHED WATER CLOSET ASPHALT SHINGLES LAVATORY _ WOOD SHINGES KITCHEN SINK $LATE NO PLUMBING TAR R GRAVEL STALL SHOWER _ ROU—XTFIN8 MODERN FIXTURES _ _ TILE FLOOR TILE DADO 8 l I G 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. b COLS. STEAM STEEL BMS. 6 COLS. HOT W'T'R OR VAPOR WOOD RAFTERS AIR CONDITIONING _ RADIANT H'T'G UNIT HEATERS GAS 7 NO. OF ROOMS OIL B'M'T 2nd ELECTRIC _ 3rd NO HEATING Ifl veter, Lanell Vice President i '. Concentra Corporation 21 North Avenue Burlington, MA CONCENT R A 01803-3301 OOCaq Tel: (617)229-4635 Fax: (617)229-4700PTLanell@aol.com SXa/,,Q ;;, P H 0 N r • TO r T� DATE �J . 5 I FRO - AREA CODE NO. M E s s A G E --' i SIGNED PHONED BACK CALL RETURNED SEE YOUO AGAIN ALL E] WAS IN URGENT ANDOVER COUNTRY CLUB ANDOVER, MASSACHUSETTS 01810 TELEPHONE 508-475-1263 1 7 i O O � m > � OIo o m = > 0 0 m N; N r 0 F W c 1 � --1i > 1 > 1 � F Z_ Z n Z r O o° c c N n o q ; nqi nqi o 1 M x 7n .4 A. n a O 0 � � 1 > O 0 r r 1 I 2 V 2 0 N ,> 1 m _ Z r O In -col1 i I" - I ' r 0 A � b o � r a A 1 0 O 2 > i --4 N � 1 1 1 7 i O O � m > � OIo o � r r 0 0 m N; N r 0 F W c 1 � --1i > 1 > 1 � F Z_ Z n Z r O o° c c N n o q ; 1 7 i u z m i f i m > � OIo o O m> 0 0 m N; N r 0 F c c C> --1i > 1 > I rr'- F Z_ Z n Z r O o° c c N n o q ; nqi nqi o 1 M x 7n .4 A. n a O 0 0 > O G7 r r 1 I 2 V 2 0 N ,> Z m _ Z r O In i I" - C 0 m O =+ f o r a A a 0 2 > i --4 u z m i f i m m> OIo O m> 0 0 N; F c c C> --1i > 1 > -4 > rr'- = Z_ Z n Z >y o o° n n n o ; o „ o M x 7n i A. n a a 0 > O G7 p p 1 I 2 0 2 0 O ,> Z m 230 0 r O In i I" - > 0 m O =+ f o r a A a > i --4 N n z 0 0 ; o Z A C i q r C _ Q D 0 C p Z n0i 0 M � Z n � m Z A P o i M i i; 0 s 0; 1! .m Z C 1 p m o m m a w A Z 2 w w 700 ������-4 0 w�*a. � 2 Z Z Z r 0 w Z r -4 -qi O n 0 o p p 0 o* q $ o° w 0 ZO N 2 Z 2 q= 0 p m Ir i O n n n _ c .4 m m = -� -1i o O z a m q ^ a p 0 f c o o s I 2 0 0 0 * m > o i o r a '� m 70p Z = r � O a0 n' > M p x N �. r i x -1 i o > m A A. 2 N _ q u O � � 0 to v, y d C � d � O CA CM3 CD ,% z CO) C26 U C2 go ? 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Q= ZIW xl r VO�aQiwwm..UNN �:O��;an�o0c V W V 3 < u1 1-N� V < r m� ■ i 1 q6 ,O J W S I- 2 v' O ju Y IL 2 ta 3 s o0 o. s a .• ,v m r• . { m �• m it Q ' , SENT BY'[NTERN'[ TAX SERVICF-�', : 4-23-97 / IDINST&YOUNG K X P ° ° FRYS7 & YU[N& 617 438 6971;*-;--\/ 2 ° |nLMImmo,11�n . 2�O.arcml4xi strec, Uoswn,nAVl||6 � MnNw"5ifc (017)859-0�'0| fm.__- Com _ From: Datw Phone: Pages: ` . . ^ . , ^ ^ , , ,, ^ . . . .. , ° SENT BY.-fNTER\'L TAX SERVICES : 4-23-97 8:44AM ERNST & YUL\GJ 617 438 6071:'4121 2 f"', V�tlo �G cvvj�N / 9-7 L Al 1c)a 7f /twigj rl rC (fq fop C Pp (a e7 P.5-2 NEW AQUALINE POOLS 8 GILMORE ST. STONEHAM, MA 02180 (617) 438-8557 May 14, 1997 Dear Mr. & Mrs. Lanell On Friday, May 9, 1997 my company, New Aqualine Pools, mistakenly excavated a portion of your property and removed several trees and damaged others. From the beginning we admitted our mistake and I am eager to rectify the situation as soon as practical. On Saturday, May 10, 1997 we met to discuss the issue. You asked for a letter from me containing certain items. This letter is intended to satisfy your request as best I can. I have set up deadlines to comfort you and at the same time been careful not to overpromise something I cannot deliver. First, we agree to immediately (within 48 hours of your approval to do so, of course weather permitting) fill in the affected area to your reasonable satisfaction. Second, we agree to plant trees to reasonably re -landscape the affected area of 15 x 30 feet. Due to construction on the pool, if it is acceptable to you, we would agree to complete this work no later than June 15, 1997. Third, we agree to meet to identify the quantity, size, and condition of the trees removed. These trees will then be appraised. We understand that you desire to obtain your own appraisal. We are insured by Scottsdale Insurance Company and will need to have our insurance company also perform an appraisal. We understand your desire to be reasonable and so we are sure that any difference in the appraisals can be quickly reconciled. Fourth, you have asked us to post a bond large enough to cover the repair. We are fully insured and have attached a binder and letter from our insurance agent. We believe this is sufficient guarantee of work to be performed. Sincerely ours, ea MAY 16 1997 k ' INSURANCE 7,1 Home • Auto * Life -, Vuainrss Aft, Lariell 92 Coven fryLane No. Andove4 AM 01810 i14r, Dwell, Mau 15,1997 6 Al DeLucia 274 Main Street, Suite 304 • Reading, M4 0190 S1'7-844-$$3� HAVE, ENCLOSED A BINDER AS PROOF OF COVERAGE FOR SVA, AQUALINE POOLS, 71his Jerter represents our acknowledgment on S19197 dstmmage sustained at 92 Coventry Lane, No. Andover, SIA, I have .not&cd Scottsdale Ins. Co, of your loss and filed a clan. Wv wiu work with underaW&g to exped1ty ms's matrer to your satisfaction. The damage teauhing In the remof-al of soils trees and related damage 19 coFrcd under NctwAt, o affne `s Contractors .Liability policy. Scottsdale Ins, Co. Is tesponslhle for any x»anitary restitution the . Glalmax�tYs et�tltled to. A campar y appy ltser u W contact you to access the damage to your property. Sincerely, 4 Aa;an Delucia MAY 16 199T _a FRO14:ERNST & YOUNG LLP ID:6176596205 '44:0: PAGE 54'5 LATE (MKVD YY) 5i ; 5/97 THIS SN'DER iS A T1=UGPORARY INSURMCE CONTRACT, SUWF-CT TO THE CONDITIMS SHOWN ON TI- it1= U$E &*F. OF THiS FORM. P1 , ,CEF+ 'A'l !k :, 617-544-53 >3 lCOMPARY V 'BINDER ! ' E N4. CO. X36'.8 I . ARK tI�SliRAiiCE AGENCYSCOTTSCAL DAT2 E+ECTTVE TtwE TE EX"VZAT" TUC 274 MAIN STREET SUITE 304 X AM i IZ-O+ ATS+ READING, Nle. 01867 15i97 12;01 PfaST.. r:c HIS ENDER 15 ISSUEO TO EJ,; EtC CCw r-RAlpE 0J TKE AS^VE NAMEDSiOhPANY _.� ...�._ r_ _ GFR FyYkPiN,C- Pn%IC f EFtCY DESCMPTION OF OPSnON%VEKCLMPRGF'ERTY{bnOodi iS urmr.pn) INSURED NEW AQ' ALINE POQLS S1101AMING POOL CONTRACTOR. 8 GiLMORE STREET ST0NEWAM, MA C2 i60 TYPE QF lKWRQd= i COVERAGEIFORMS I jdMUaJNT ; DEDUCTELE: COM % PF.OPSf2Y1' CAUSES OF LOJ,�'S„ ' BASIC L>� $RtaPJGt SPEC SVlw.NMING POOL CONTFACTORS rX;Go#r*-F_LtC4AL GENERAL L'ASiLl Y'GENERA LM x,000 DEDUCTIBLE aaC;nt.ts-C^�14c,tFaia � � CLAIMSMADE ! X t�CCtln ; mss'. ear_ a !� v x Ute' ! t IO>i�RiER'S & COKTR;ti C T OR PROT 1 ;Fc_- TR"' :'P.TEFOR CLAWSWADE ACED SW VnI c --d P.V=l i t+ Auromoau LIAsulTl 0.1MeuE 04aLMr1Yi ` :ANYA:!'C EOL+tYItalURYt•`arparaxa 5 a :,LL DY►etGO SOS GL4 IN:UR`! "Per e -_aider I SCHEDULED A1)TOS 111 PACvFRTy WAVA is K:Rc:t AUTOS NECCDALPAYAiW$ ! �Oi:-0`�NED AUTOS Pf N& P, ttL � PROT -s ::YrfNStY•�p M:iTOttlr E ALfEv^ PfiY.5iC�1L. tiJU11/4C�E CFD ALL irHlf`i:S `SCtiEDI!l.6O VE}i;CL=.c AC'Upl C.0.cHVALUF a'TFo NAwr is ce�LlsgK _..- . !OTHERT4AN CGL: 0`etcR ' GARA(m Lb1 CTY AUTODN�Y-CtA.ACCfCEhT S AM' At T O OTHS2 TKAk ATO MY: ISI F! ACCfDEAT 9 AGGREGATE S F,REW LiABif—Ty 1ntCy dxuRFYN'� I x UMERELLAFORA, :Armxic �4TE I S 01-F,LR -rm UmapE.LA FOW . -797MO DATEr ►4 C', AWAS WDE SELF-Nl.Xv£D Ftrn% m t STATLIT0AY LWTS WORKERS GO CATIONAND F1,CeiRCCID�J' s eeLOYER$ I.L 8iL17Y i Ias> - POUCr IaM!T S i 15 sa - ala+ iatoYf ' s SPECIAL covcrrous GT4ER OOVERAGES 'M TGA3E£ i Abl)'VOWAL l wlkED LOSS PAYE. WAS t - MAY 1 6 1997 ' AUTHopu`•o FSE A THE Date.. ...... 3? '` TOWN OF NORTH ANDOVER' ' PERMIT FOR GAS INSTALLATION • o� � i .� si X0,,..0 ✓• q`i ,SSACHUSEt - '� `'Phis certifies that ...� .�.. ... .. .............. . has permission for, gas installation ...f S in the buildings of ...T t ti ................................ at North Andover, Mass, Fee. ,2a� .'.. Lic. No. -/F:�.�. N. n .... . G INSPECTOR Check # C 7328 G (Print or Type) City, Town Building AT: Location qt-) New ❑ Renovation ❑ Plans Submitted Yes ❑ No ❑ Date V �'`� 19 Permit N L� Owner's 1� Name Type of Occupancy: Replacement ❑ (Pnnt or Type)\ Check One: Certificate Installing Company Namc L l A Corp. Address t C3 Partnership T �_ ❑ Firm/Company Business Telephone Name of Licensed Plumber or Gasfittcr I hereby ccndy that all of the details and information I have submitted (or entered) in above application arc true and accurate to the bat of my sno-lcd jc and thatall plumbing wort and installatioru performed under Permit issued for this application will be in compliance with all pertinent prohaons of the Massachusctu State Gu Code and Chapter 142 of the General Laiws. I ha�c irtformcd the owner or his agent that I do not have liability insuranoc including completed operations coverage. Sgrri uri or 0—ii/ Apim I have a current liability insunncq policy to include completed opcntions coverage. 4— By . Title City/ Town APPROVED (OFFICE USE ONLY) C moo.• •SAI W—C . %1.00— ..•, '000 TYPE LICENSE: ,5,Plumbcr ❑ Gasfittcr J aster ❑ loumcyman Signature of Liccnscd Plumber or Gasfittcr rva4� License Number ■■■■■■■■■■■■■■■■■■■■■■■■■■■■ (Pnnt or Type)\ Check One: Certificate Installing Company Namc L l A Corp. Address t C3 Partnership T �_ ❑ Firm/Company Business Telephone Name of Licensed Plumber or Gasfittcr I hereby ccndy that all of the details and information I have submitted (or entered) in above application arc true and accurate to the bat of my sno-lcd jc and thatall plumbing wort and installatioru performed under Permit issued for this application will be in compliance with all pertinent prohaons of the Massachusctu State Gu Code and Chapter 142 of the General Laiws. I ha�c irtformcd the owner or his agent that I do not have liability insuranoc including completed operations coverage. Sgrri uri or 0—ii/ Apim I have a current liability insunncq policy to include completed opcntions coverage. 4— By . Title City/ Town APPROVED (OFFICE USE ONLY) C moo.• •SAI W—C . %1.00— ..•, '000 TYPE LICENSE: ,5,Plumbcr ❑ Gasfittcr J aster ❑ loumcyman Signature of Liccnscd Plumber or Gasfittcr rva4� License Number Location !� Uva No. Date NGRTH TOWN OF NORTH ANDOVER 41 F 9 Certificate of Occupancy $ �'�s "•^° Eta Building/Frame Permit Fee $ V sACHUs Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # Building Inspector Permit NO:� / Date Issued:. 4 - / - / v TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received IMPORTANT: Applicant must complete all items on this nage LOCATION 10 &ue �Iy " ' Print PROPERTY OWNER 61611rF'v��/-� Print MAP NO: PARCEL: _ ZONING DISTRICT: Historic District ye< Machine Shop Villaae ves TYPE OF IMPROVEMENT PROPOSED USE Resid_eab4--T—�. Non- Residential New Building 'One famil Addition Two or more family Industrial teratiota No. of units: Commercial Others: Re air re lacement Assessory Bldg Demolition Other Septic Well Floodplain Wetlands Watershed District Water/Sewer DE5GRIPTION—OF WORK TO BE PERFORMED: Identification Please Type or Print Clearly) OWNER: Name: Phone Address: CONTRACTOR Name:rm(,�rnr�akJ t 1L�r tl.",, ,,moi IS Phone: q-7 k • 2.-S• -)asp Address: 4:s, Fo+ oT te,o q4,veoz4, tj kAA- o r Y3 I, Supervisor's Construction License: Exp. Date: /b • Z6 - rL7 Home License: I �)t -1'2 Date: 1 /-o d -i ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE. BULDING�rP/ERMIT. $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost: $1!>6 , oo& — FEE: $ Check No.: s 7 Receipt No.: 9L pZ-OO-Q"- NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund �ignature of Agent/Owner �2�t- ,, ._ 9 _ �, . ___� �-�_ Si nature of contractorA����;�G._ Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning/Massage/Body Art 1 Swimming Pools Well Tobacco Sales Food Packaging/Sales Private (septic tank, etc. Permanent Dumpster on Site THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Conservation Decision: Comments Comments Water & Sewer Connection/Signature & Date Driveway Permit DPW Town Engineer: Signature: FIRE DEPARTMENT - Temp Dumpster on site yes. Located at 124 Main Street Fire Department signature/date COMMENTS Locatea J64 Usgooa Street no 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 NU I t5 and UA I A - (I -or department use ❑ Notified for pickup - Date Doc:.Building Permit Revised 2008 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 o Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products 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: Doc.Building Permit Revised 2008 O z S� x� F+ w x u 41 o w v cn 0 w A a or. o w o a; U a w 0 a o. n°G w O w U w W moo u w AG d w w �' w � A W a w r aq o Z ci, v Q v cn C C . 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TERYIS AND CONDITIONS These Teens and Conditions arc an integral part of the contract set forth on the Product Order (the "Contract") between New England Window and Door LLC dba Pella Windows & Dours, Inc. ("Pella') and the persons) identified on the Product Order ("Owner") to supply the products (the "Products"), and perform the work (the "Work") described or referred to in such Contract. For Product Only purchases, a signed "Product Only Addendum" is a required part of the contract, 2. OWNER Pella is not responsible for any existing security systems. Owner shall remove all shades: verticals, blinds, curtains. drapes or window mounted air conditioners, prior to the installation of the Products. Pella's installers are not responsible for the removal or installation of these types of items. Pella is not responsible for pre-existing window coverings filling on newly installed Pella windows. The Owner shall provide complete access to the work site between the hours of 7:00 a.m. and 6:00 p.m. (Monday through Friday) for POWs installers to deliver the Products and perform the Work. 3. PELLA Pella will be responsible for and have control over construction means, methods; techniques, sequences and procedures and for coordinating all portions of the Work. Pella will be responsible for the Work of its Pella Contractors who will install the Products. Unless provided otherwise in the Work description. Pella will provide and pay for all labor, materials, equipment, tools and machinery. transportation, and other facilities and services necessary for the proper execution and completion of the Work. The materials and equipment furnished under the Contract will be good quality and new unless otherwise requited or permitted, the Work will he free from defects not inherent in the quality required or permitted, and the Work conform with the requirements of this Contract. Pella shall not be responsible for damages or defects caused by abuse, modifications not executed by Pella, improper or insufficient maintenance, improper operation or normal wear and tear. Pella will keep the premises and surrounding area free from accumulation of waste materials or rubbish caused by performance of the Work. 4. CHANGES The Owner may order in writing changes in the Work consisting of additions, deletions, or modifications ("Change Orrler"). Any Change Order shall include an adjustment to the Price and the Substantial Completion Date. as determined by Pella. Pella reserves the right to approve or disapprove any Change Order and any such Change Order must be signed by both Owner and Pella to be effective. SUBSTANTIAI. COMPLETION Owner understands and agrees that the Substantial Completion Date is an estimate only and that the actual date on which the Work is completed may be extended to allow for Change Orders requested by Owner or if tie time to complete the Work is affected by conduct of the Owner. weather, labor disputes, availability of subcontractors, acts of Clod, fire or other causes reasonably beyond Pella's control. If for any reason the Work is not fully completed by the Substantial Completion nate (including any extensions contemplated above), but is substantially completed by such date, i.e., the Product has been installed, but minor parts or components are missing or need to be replaced or repaired, a hold back proportionate to The cost of remaining parts or work to be completed is acceptable. However, the holdback will not exceed the amount of the completion costs or 10 `rc of the remaining unpaid balance of the Price, whichever is less, 6. FINANCING if payment of the Price is financed with a financial institution through Pella, at financing paperwork must be completed upon signing of this Contract and the requisite approvals and authorizations for the full amount of the requested financing shall have been received from the financial institution. PAYMENTS Pella shall be entitled to stop the Work upon written notice to Owner for any material default or failure by Owner, including but not limited to, the Owner's failure to pay Pella the amount due within seven days after the date payment is due. CORRECTION OF WORK Pella shall cornet installation Work not in conformance with the mquirernents of the Contract. if notified in writing by the Owner within two years after the Completion Date or, if earlier, the date on which the Work is substantially completed and payment of tiro Purchase Price nude subject to a holdback as provided above. Correction of Work as herein provided shall be Owner's sole remedy for defective workmanship, and is provided in lieu of any and all other remedies. Pella's obligation to correct Work is conditioned on Pella's prior receipt of all payments then due. LirviiTN:i) PRODUCT WARRANTY Pella shall warrant all Pella products, but only in accordance with the Pella Windows & Doors Limited Warranty. THiS LIMITED WARRANTY SHALL BE THE SOLE WARRANTY WITH RESPECT TO THE PRODUCTS AND PELLA SPECIFICALLY DISCLAIMS ALL OTHER WARRANTIES, EXPRESS OR IMPLIED, WRITTEN OR ORAL (INCLUDING WiTHOUT LIMITATION ANY WARRANTY OF MERCHANTABILITY OR F'ITNFSS FOR A PARTICULAR PURPOSE). 10. NO CONSEQUENTIAL DAMAGES UNDER NO CIRCIIVISTANCES SHALL PELLA BE LIABLE FOR CONSEQUENTIAL. INCIDENTAL, INDIRECT, OR SPECIAL DAMAGES, WHETHER FORESEEN OR UNFORESEEN. 11. HOME fNIPROVENIENT CONTRACTORS All home improvement contractors and subcontractors shall be registered with the director of the Home improvement Contractor Registration Program administered by the Board of Building Regulations and Standards. Pelta and any of its subcontractors identified in this agreement have been registered. Any inquires abo t Pella or any of its subcontractors relating to registration should be directed to: Director. Home Improvement Contractor Registration, One Ashburton Place. Boston, MA 02108,617-727-8599 12. PERMITS (MA customers only) Pdi5iotrligalc o and will obtain the following permits for this project: '-� . Homeowners who secure their own permits will be excluded Tont the guaranty fund provisions of Massachusetts General Laws, chapter 142A. In addition to the rights and warranties enumerated in this agreement, you may have additional rights under Massachusetts General Laws, chapter 142A and 780 Code of Massachusetts Regulations R6- 13. NOTICE OF CANCELLATION You may cancel this agreement if it has been signed by a party thereto at a place other than an address of the seller, which may be his main office or branch thereof, provided you notify the seller in writing at his main office or branch 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, See the attached Notice of Cancellation for an explanation of this right. Do not sign this contract if there are any blank spaces. -1 A Customer `ignature Date D DISPUTES Job Named-= Date THE CONTRACTOR AND THE HOMEOWNER HEREBY MUTUALLY AGREE IN ADVANCE THAT IN THE EVENT PELLA HAS A DISPUTE CONCERNING THIS CONTRACT, PELLA MAY SUBMIT SUCH DISPUTE TO A PRIVATE ARBITRATION SERVICE WHICH HAS BEEN APPROVED BY THE SECRETARY OF THE EXECUTIVE OFFICE OF CONSUMER AFFAIRS AND BUSINESS REGULATIONS AND THE CONSUMER SHALL BE REQUIRED TO SUBMIT TO SUCH ARBITRAT AS PROVIDED IN M.G.L.c. 142A Contractor �.,. Homeowner NOTICE: THE SIGNATURE OF THE PARTIES ABOVE APPLY ONLY TO THE AGREEMENT OF THE PARTIES TO ALTERNATIVE DISPUTE SETTLEMENT INITIATED BY THE CONTRACTOR. THE OWNER MAY INITIATE ALTERNATIVE DISPUTE RESOLUTION EVEN WHERE THIS SECTION IS NOT SEPARATELY SIGNED BY THE PARTIES. NOTICE OF CANCELLATION Customer Name: (Please print) Date of transaction: 141( & t You may cancel this transaction, without any penalty or obligation, within three business days from the above date. If you cancel, any property traded in, any payments made by you under the agreement, and any negotiable instrument executed by you will be returned within ten business days following receipt by the seller of your cancellation notice, and any security interest arising out of the transaction will be cancelled. If you cancel, you must make available to the seller at your residence, in substantially as good condition as when received, any goods delivered to you under this agreement; or you may if you wish, comply with the instructions of the seller regarding the return shipment of the goods at the seller's expense and risk. If you do make the goods available to the seller and the seller does not pick them up within twenty days of the date of your notice of cancellation, you may retain or dispose of the goods without any further obligation. If you fail to make the goods available to the seller, or if you agree to return the goods to the seller and fail to do so, then you remain liable for performance of all obligations under the contract. To cancel this transaction, mail or deliver a signed and dated copy of this cancellation notice or any other written notice, or send a telegram to Pella Windows and Doors, at 45 Fondi Rd., Haverhill, MA 01832 not later than midnight of 142-111 1�) (three business days from the date of transaction above). I hereby cancel this transaction. (Date) (Buyer's signature)