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Building Permit #537-2011 - Permits #537-2011 - 386 SUTTON STREET 1/13/2010
TOWN OF NORTH DOVER APPLICATION FOR PLAN EXAMINATION Permit NO: a Date Received Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION Print PROPERTY OWNERl P NO:67�OPARCEL: Print MA ZONING DISTRICT: Historic District yesa. Machine Shop Village yes (''ho, _-________.__........___.._-_-- TYPE OF IMPROVEMENT _�,RR POSq?,USE Residential Non- Residential 0 New Building U-Ohe family 0 Addition [I Two or more family 0 Industrial 11 Alteration No. of units: n Commercial FCT-Repair, replacement 0 Assessory Bldg 11 Others: 11 Demolition 11 Other F] S 0 Floodplain FJ Wetlands U Watershed District EJ Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED:. le77 tt,-71 Z'-k,,I IS Identification Please Type or Print Clearly) OWNER: Name: I C Phone: /'-73m, 4S' Id Address: c i,�j S T- CONTRACTOR Name: Phone: Address: Supervisor's Construction License: 6,` ')'s 5' 1) Exp. Date: /0, 174 Home Improvement License: Date: - ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT.'$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COSTB Sq DON$125.00 PER S.F. Total Project Cost: $ 4 FEE: 0 1&Check No.: ?:� Receipt No.: &- NOTE: Persons contracting with unregistered contractors do not have access to the guaranty Signature of AgonOwner Si nature -qp-htracto ---- -...- ...... NORTH, c . JF Town of R Andover' ' , 0 (0) . dover, Mass., /3 �9 A0R4TE0 �ls� BOARD OF HEALTH Food/Kitchen 'PER �M� I.T I D Septic System . ® �® BUILDING INSPECTOR ffj A THIS CERTIFIES THAT------------ - t ----.--.----..-.-.--.-- -.--I�. - ............................... ..................................................... Foundation has ermissiorr to erect........................................ buildings on �....-� .... Rough to be-occupied.as Meg64 0'P...-M? -.AA* Ld*WS.---------.- y Chimne provided that the person acclapting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of-the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT ESP S IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUC ® S �I'S Rough ........ i ----- ................................... Service BUILD G INSPECTOR Final Occupancy Pmn.it Required to Occupy wilding GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove, Fine No Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT" Burner. Street No. SEE REVERSE SIDE smoke Det. Contract ~ Detailed Pella Windows& Doors Sales Rep Name: Keating, Linda HIC#129774/Tax|D#26-1413183 45 Fondi Road Sales Rep Phone: (970423-6987 Haverhill, MAU1832 Sales Rep Fax: Phone: (978373-2500 Fax: (978)373-7274 Sales Rep E-Mait: |keedng@pe||obooton.00m ress _Cwstornier Information Pr6jectirDellivery,Add Order Information Will Connors WLK Connors,Will&Katie North Andover Quote Name: 15 windows&2 doors 386 Sutton Street 386 Sutton Street Order Number: 741LK0292 Day Phone: NORTH ANDOVER,MA 01845 Order Type: Installed Sales Mobile Phone: County: ESSEX Payment Terms: Deposit/C.O.D. Fax Number: Tax Code: MA TAX 6.25 Great Plains#: Attributes Line# Location: 10 spare bedroom Vinyl Windows I Doors by Pella, Double Hung,28.25 X 49.75,White,None Qty | 1'Non-Standard Size Double Hung,Equal Split Frame Size: zo1wx*onw General Information: manumd.wmo.Bmc*�amav�nmuUanxne��w^Vf�O.unaenon.xuap�,mmuu=u.����exp�rmormmu�m Exterior Color/Finish: White Interior Color/Finish: White Interior | Glass: Insulated Low E Advanced Argon Gas ormvn: Full Screen Viewed From Exteho, Grille: wnnr, m�anninn|nmnnpuou: pe�mo�r�on �=1oer.Exvdnop��mn~1zs. Fnyno����28.25^K49.75" ^ Final Wall Depth:None mosxte,m,vvrap-mvvxrap Qty I wvo_pp integrated-Install mxv Integrated Stop pp QtY I ' For more "information regarding the finishing,maintenance,service—and warranty—all-P--- products,visit—the Pellao website at www.pelia.com Printed on 12/6120 0 Contract'Detailed Page 1 Of 8 Customer:Will Connors Project Name: WLK Connors,Will&Katie North Andover Order Number: 741 LK0292 Quote Number: 2293702 ='._Line# Locdtibn. Attributes : .. 15 bath Vinyl Windows 1 Doors by Pella;Double Hung,28.25 X 45.75,White, None Qty 1 I 1:Non-Standard Size Double Hung,Equal Split Frame Size: 28 114 X 45 314 General Information: Standard,Vinyl,Block Frame with Mull Groove(3-114"OAW),20 Series,Adapter Included,Head Expander Included Exterior Color Finish: White Interior Color!Finish: White Interior Glass: Insulated Low E Advanced Argon Gas Screen: Full Screen Viewed From Exterior G Ile: None, Frame Size:28.25"X 45.75" Wapping Information: Perimeter Length=148",Glazing Pressure=130. Final Wall Depth:None No Exterior Wrap-No Wrap Qty 1 NW PF integrated-Install NW Integrated Stop PF Qty 1 Line.#' Location: Attributes' 20 master Vinyl Windows f Doors by Pella,Double Hung,28.25 X 49.75,White, None Qty 2 1:Non-Standard Size Double Hung,Equal Split Frame Size: 28114 X 49 314 General Information: Standard,Vinyl,Block Frame with Mull Groove(3 114"QAW),20 Series,Adapter Included,Head Expander Included Exterior Color I Finish: White I Interior Color I Finish: White Interior Glass: Insulated Low E Advanced Argon Gas Screen: Full Screen viewed From Exterior Grille: None, Frame Size:28.25"X 49.75" Wrapping Information: Perimeter Length=156",Glazing Pressure=125. Final Wall Depth:None No Exterior Wrap-No Wrap QtY 1 NW_PF integrated-Install NW Integrated Stop PF Qty 1 I i I ]i I For more informafion regarding the finishing,maintenance,service and warranty of all Pella®products,visit the Pella®website at www.pe[la.com i Printed on 121612010 Contract-Detailed Page 2 of 8 ii Customer:Will Connors Project Name: WLK Connors,Will&Katie North Andover Order Number: 741LK0292 Quote Number: 2293702 A Line'# Location: ttrrbus7771 25 ironing board room Vinyl Windows 1 Doors by Pella, Double Hung,28.25 X 49.75,White, None Qtr 1 1:Non-Standard Size Double Hung,Equal Split Frame Size: 28 114 X 49 3A General Information: Standard,Vinyl,Block Frame with Mull Groove(3-1/4"OAW),20 Series,Adapter Included,Head Expander Included Exterior Color/Finish: White Interior Color/Finish: White lnterior ., Glass: Insulated Low E Advanced Argon Gas Screen: Full Screen Viewed From 6)terior Grille: None, Frame Size:28.26"X 49.75" Wrapping Information: Perimeter Length=156",Glazing Pressure=125. Final Wall Depth:None No Exterior Wrap-No Wrap Qty 1 NW PF integrated-install NW Integrated Stop PF Qty 1 Line#` Location: At tributes 30 ironing board room Vinyl Windows!Doors by Pella, Double Hung,28.25 X 49.75,White, None Qty 2 1:Non-Standard Size Double Hung,Equal Split Frame Size: 28 114 X 49 314 General Information: Standard,Vinyl,Block Frame wilh Mull Groove(3-114"OAW),20 Series,Adapter Included,Head Expander Included Exterior Color/Finish: White Interior Color!Finish: White Interior Glass: Insulated Low E Advanced Argon Gas Screen: Full Screen Viewed From Exterior Grille: None, Frame Size:28.25"X 49.75" Wrapping Information: Perimeter Length=156",Glazing Pressure=125. Final Wall Depth:None No Exterior wrap-No Wrap QtY 1 NW PF STD-Install NW Standard PF Qty 1 For more information regarding the finishing,maintenance,service and warranty of all Pella®products,visit the Pella@ website at wvwr.pelia.com Printed on 121612010 Contract-Detailed Page 3 of 8 i I , Customer:Will Connors Project Name: WLK Connors,Will&Katie North Andover Order Number: 741LK0292 Quote Number: 2293702 :Line# Ldcatian. Afitrif�utes:: 35 tiving room Vinyl Windows 1 Doors by Pella,Double Hung,36.25 X 49.75,White, None Qty 4 1:Non-Standard Size Double Hung,Equal Split Frame Size: 36 114 X 49 314 =r' Genera[Information: Standard,Vinyl,Block Frame with Mull Groove(3-114"OAVV),20 Series,Adapter Included,Head Expander Included ;> Exterior Cvlvr 1 Finish: White W Interior Color I Finish: White Interior Glass: Insulated Low E Advanced Argon Gas J Screen: Full Screen Viewed From Exterior Griiie: None, Frame Size:36.25"X 49.75" wrapping Information: Perimeter Length=172".Glazing Pressure=95. Final Wall Depth:None No Exterior Wrap-No Wrap Qty 1 NW_PF integrated-Install NW Integrated Stop PF Qty 1 Line# Location: Attributes;: . 40 lstfloorbath Vinyl Windows f Doors by Pella, Double Hung,25 X 39.75,White, None MY 1 I 1:Non-Standard Size Double Hung,Equal Split V _ Frame Size: 25 X 32 314 r General Information: Standard,Vinyl,Block Frame with Mull Groove(3-114"OAVtr),20 Series,Adapter Included,Head Expander Included 'F Exterior Color!Finish: White Interior Color I Finish: White Interior Glass: Insulated Low E Advanced Argon Gas -- = Screen: Full Screen Viewed From Exterior Grille: None, Frame Size:25"X 39.75" Wrapping Information: Perimeter Length=130",Glazing Pressure=165. Final Wall Depth:None No Exterior Wrap-No Wrap Qty 1 NW PF STD-Install NW Standard PF Qty 1 For more information regarding the finishing,maintenance,service and warranty of all Pella®products,visit the Pella®website at www.pelia.com Printed on 121612010 Contract-Detailed Page 4 of 8 Customer:Will Connors Project Name: WLK Connors,Will&Katie North Andover Order Number. 74ILKC292 Quote Number, 2293702 =rLine# Lbcatibn , A#trihutes-. - 45 dining room Vinyl Windows I Doors by Fella, Double Hung,36.25 X 49.75,White, None Qty 2 1:Non-Standard Size Double Hung,Equal Split Frame Size: 36 114 X 49 314 .n General Information: Standard,Vinyl,131ack Frame with Mull Groove(3-1/4"OAUV),20 Series,Adapter Included,Head Expander Included Exterior Color J Finish: White Interior Color 1 Finish: White Interior Glass: Insulated Low E Advanced Argon Gas Screen: Full Screen Viewed From Exterior Grille: None, Frame Size:36,25"X 49,75" wrapping Information: Perimeter Length=172",Glazing Pressure=95. Final Wall Depth:None No Exterior wrap-No Wrap Qty 1 NW PF integrated-Install NW Integrated Stop PF Qty 1 Attributes "L'acatinn: 50 backdoor Entry Systems, Inswing Door Left,33.5 X$1.5,White,5.3116" Qty l 1:3284 Left Inswing Door Frame Size: 33112 X 81 112 " r General Information: Clad,Standard Sill,Nickel Anodized,Glazed,112 Light,Smooth Fiberglass i' „,I Exterior Color 1 Finish: Standard EnduraClad,White,Painted,White ] *L Interior Color I Finish: Painted,White,Match Interior Panel Interior Sash I Panel: Include Panel Protective Face Sheet a Glass: Tempered Low E Argon Gas Viewed From Exterior Hardware Options: Latch Bore with Deadbolt,2-318",Knob,No Handle Set,Chatham,Widham Single Cylinder,Standard Hinge,Satin Nickel,Satin Nickel Frame Size:33.5"X 81.5" Unit Accessories: No Options,None Grilles: Simulated Divided Lite(SOL),718",Traditional,3,3 Final Wall Depth:5-3/16" Wrapping Information: Foldout Fins,5-3116"Factory Applied,Perimeter Length=230". Trim-Exterior-Standard Exterior Trim Qty 1 Trim-interior-Picture Frame-Interior trim Qty 1 ED Single-Install Single ED Qty 1 Composite Trim a 48-Composite Upgrade-Greater than 48 inches wide Qty 1 For more information regarding the finishing,maintenance,service and warranty of all Pella®products,visit the Pella®website at www.pella.com Printed on 1216010 Contract-Detailed Page 5 of 8 Customer:Will Connors Project Name: WLK Connors,Will&Katie North Andover Order Number: 741 LK0292 Quote Number: 2293702 Line# Cacation. . ::. Attributes 55 front door Entry Systems,Inswing Door Left,37.5 X 85.5,White,5.3116" Qty 1 ^ i 1:3684 Left Inswing Door Frame Size: 37 112 X 85 112 General Information: Clad,Standard Sill,Nickel Anodized,Glazed,Arch Head 112 Light,Primed Steel 4 Exterior Color I Finish: Standard EnduraClad,White,Painted,White Interior Color I Finish: Painted,White,Match Interior Panel Interior ;„ y Sash 1 Panel: Include Panel Protective Face Sheet 1 Glass: Tempered Decorative Glass-Castile Black Viewed From Exterior Hardware options: Latch Bore-With Deadbolt,2-3/8",Knob,Millbrook Handle Set Single Cylinder,Chatham,Standard Hinge,Satin Nickel,Satin Nickel rame Size:37.5"X$5.5" Unit Accessories: None E Wrapping Information: Foldout Fins,5-3116"FactoryApplied,Perimeter Length=246". Final Wall Depth:5-3116" Trim-Exterior-Standard Exterior Trim Qty 1 Trim-Interior-Picture Frame-Interior trim Qty, 1 ED Single-Install Single ED Qty 1 Composite Trim n 48-Composite Upgrade-Greater than 48 inches wide Qty 1 Thank You For Purchasing PellaO Products PELLA WARRANTY: Pella products are covered by PelWs limited warranties in effect at the time of sale.All applicable product warranties are incorporated into and become a part of this contract. Please see the warranties for complete details,taking special note of the two important notice sections regarding installation of Pella products and proper management of moisture within the wall system.Neither Pella Corporation nor Pella Windows&Doors will be bound by any other warranty unless specifically set out in this contract. However,Pella Corporation will not be liable for branch warranties which create obligations in addition to or obligations which are inconsistent with Pella written warranties. Clear opening(egress)information does not take into consideration the addition of a Rolscreen[or any other accessory]to the product.You should consult your local building code to ensure your Pella products meet local egress requirements. Per the manufacturer's limited warranty,unfinished mahogany exterior windows and doors must be finished upon receipt prior to installing and refinished annually,thereafter_ Variations in wood grain,color,texture or natural characteristics are not covered under the limited warranty. _...... . . .............._....... . r^,ect Checklist Review (Installed Orders Only) Before the Installation the Homeowner agrees to do the following: Obtain Condo Association Approval Obtain Historic Approval Remove existing shutters and awnings Remove air conditioners Remove existing shades,drapes,window treatments,wall hangings,and personal belongings For more information regarding the finishing,maintenance,service and warranty.of all Pella®products,visit the Pella@ website at www.pella.com Printed on 12/6/2010 Contract-Detailed Page 6 of $ Customer:Will Connors Project Name: WLK Connors,Will&Katie North Andover Order Number: 741 LK0292 Quote Number: 2293702 Move furniture at least 3 feet away from work area Tie or cut back trees, bushes and shrubs in the work area Arrange to have alarm system and doorbells disconnected Arrange to have any plumbing and electrical repairs or changes made by appropriate licensed contractor Provide a door handle and lockset for entry door if Pella handle and lockset is not purchased. Before the Installation Pella acirees to do the followin : Obtain Building Permit(When required) Prefinish products when purchased in contract During the Installation the Homeowner agrees to do the following: Keep pets safely away from work area Keep children safely away from work area Allow Pella Installer room to work safely within your home Durinq the Installation fella acirees.to do the following: Deliver and unload products purchased per contract Place and remove drop cloths in work area then vacuum, and remove all debris at end of day Remove existing product, including storm windows, and dispose of it unless otherwise specified Install all products using method specified in contract per Pella Installation Instructions Replace interior and/or exterior trim only if purchased If Purchased,install exterior primed pine wood trim or Azek.Azek will be unfinished. If Purchased, install interior trim matching wood window finish or White trim for Impervia and Encompass Install non-Pella entry door lockset provided by you. Pella is not responsible for it's quality or performance After the Installation the Homeowner agrees to do the following Be available for completion and sign off to verify all products purchased are in working order Reinstall existing shutters and awnings Re-install existing shades, drapes,window treatments,wall hangings, and reposition furniture Arrange to have alarm system and doorbells reinstalled Reinstall air conditioners Remove stickers from product and save for energy rebate and tax purposes Wash all interior&exterior glass surfaces Fill nail holes and joints on interior trim if windows are to be stained (after staining) Clean up exterior casing issues due to storm window removal if full wrap or new exterior trim is not purchased '�MG Project Checklist has been reviewed Customer initial Product Only Addendum has been reviewed Customer initial Credit Card Account#: Last 4 Digits For more information regarding the finishing,maintenance,service and warranty of all Pella@ products,visit the Pella@ websiie at www.pe[la.com Printed on 1 2/6120 1 0 Contract-Detailed Page 7 of 8 Customer:Will Connors Project Name: WLK Connors,Will&Katie North Andover Order Number. 741LK0292 Quote Number: 2293702 Expiration Date: 0 Cl Charge final payment to same account V-M G (Upon substantial completion) Customer initial Project Checklist has been reviewed (��� Y Order Totals � � Taxable Subtotal $7,826.01 Credit Card Approval Signature Sales Tax @ 6.25% $489.13 f��1 l(�YL1 0� co�r'o 1-3 l D ANon-taxable Subtotal $4,301.05 Total $12,616.19 Customer Name (Please print) Pella Sa s Rep Name (pleas print) Deposit Received $6,308.10 t,l 1• ` Amount Due $6,308.09 Customer Signature 1pe.ug ies.Rep Signatu f a2ltoll� fa1L9l1_� I Date gate For more information regarding the finishing,maintenance,service and warranty of all Pella@ products,visit the Pella®website at www.pella.com Printed on 12/612010 Contract-Detailed Page 8 of 8 NOTICE OF CANCELLATION (75 9_ Customer Name: IX0 (Please Plint) Date of transaction: �C_ C You may cancel this transaction, without any penalty or obligation, within three business days from the above date. If you cancel, any property traded in, any payments made by you under the agreement, and any negotiable instrument executed by you will be returned within ten business days following receipt by the seller of your cancellation notice, and any security interest arising out of the transaction will be cancelled. If you cancel, you must make available to the seller at your residence, in substantially as good condition as when received, any goods delivered to you under this agreement; or you may if you wish, comply with the instructions of the seller regarding the return shipment of the goods at the seller's expense and risk. If you do make the goods available to the seller and the seller does not pick them up within twenty days of the date of your notice of cancellation, you may retain or dispose of the goods without any further obligation. If you fail to make the goods available to the seller, or if you agree to return the goods to the seller and fail to do so, then you remain liable for performance of all obligations under the contract. To cancel this transaction, mail or deliver a signed and dated copy of this cancellation notice or any other written notice, or send a telegram to Pella Windows and Doors, at 45 Fondi Rd., Haverhill MA 01832 1 u a not later than midnight of C (three business days from the date of transaction above). I hereby cancel this transaction. 3 (Date) (Buyer's signature) PELLA WINDOWS AND DOORS CONTRACT7. PAYMENTS 1. TERM$AND CONDITION5 Pella shall be entitled to stop the Work upon written notice to Owner for any material default or failure by Owner,including hot not limited to,the Owner's These Terms and Conditions are an integral part of the contract set forth on the failure to pay Pella the amount due within seven days after the date payment is Product Order(the"Contract")between New England Window and Door LLC due. dba Pella Windows&Doors,Inc.("Pella")and the persons)identified on the Product Order("Owner")to supply the products(the"Products"),and perform & CORRECTION OF WORK 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 Pella stroll correct installation Work not in conformance with the requirements contract. 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 the Purchase Price made subject to a holdback as provided above.Correction of Work as hetrein provided shall be Owner's sole Pella is not responsible for any existing security systems.Owner shall remove remedy for defective workmanship,and is provided in lieu of any and all other all shades;verticals,blinds,curtains,drapes or window mounted air remedies.Pella's obligation to correct Work is conditioned on Pella's prior conditioners,prior to the installation of the Products.Pella's installers are not receipt of all payments then due. responsible for the removal or installation of these tapes of items. Pella is not responsible for pre-existing window coverings fitting on newly installed Pella 9 LIMITED PRODUCT VIrA1tIiANTY windows. Pella shall warrant all Pella products,but only in accordance with the Pella The Owner shall provide complete access to the work site between the hours Windows&Doors Limited Warranty.THIS LIMITED WARRANTY SHALL of 7:00 a.m.and 6:00 p.m,(Monday through Friday)for Pella's installers to BE THE SOLE WARRANTY WITH RESPECT TO THE PRODUCTS AND deliver the Products and perform the Work. PELLA SPECIFICALLY DISCLAIMS ALL OTHER WARRANTIES, EXPRESS OR IMPLIED, WRITTEN OR ORAL(INCLUDING WITHOUT 3. PELLA LIMITATION ANY WARRANTY OF MERCHANTABILITY OR FITNESS Pella will be responsible for and have control over construction means, FOR A PARTICULAR PURPOSE), methods,techniques,sequences and procedures and for coordinating all 10. NO CONSEQUENTIAL DAMAGE,portions of the Work.Pella will be responsible for the Work of its Pella Contractors who will install the Products. UNDER NO CIRCUMSTANCES SHALL PELLA BE LIABLE FOR provided otherwise in the Work description,Pella will provide and pay CONSEQUENTIAL,INCIDENTAL,INDIRECT,OR SPECIAL DAMAGES, Unless P WHETHER FORESEEN OR UNFORESEEN, for all labor,materials,equipment,tools and machinery,transportation,and other facilities and services necessary for the proper execution and completion it. HOME LNIPROVEMENT CONTRACTORS of the Work. All home improvement compactors and subcontractors shall be registered with The materials and equipment furnished under the Contract will be good quality the director of the Home Improvement Contractor Registration Program and new unless otherwise required or permitted,the Work will be free from administered by the Board of Building Regulations and Standards. Pella and defects not inherent in tine quality required or permitted,and the Work any of its subcontractors identified in this agreement have been registered. conform with the requirements of this Contract.Pella shall not be responsible Any inquires about Pella or any of its subcontractors relating to registration for damages or defects caused by abuse,modifications not executed by Pella, should be directed to:Director,Home Improvement Contractor Registration, improper or insufficient maintenance,improper operation or normal wear and One Ashburton Place,Boston,MA 02108,617-727-9598 tear. Pella will keep the premises and surrounding area free from accumulation of waste materials or rubbish caused by performance of the 12. PERMITS(MA customers only) Work. Pella is n li �ted to and will obtain the following permits for this project: -1 d Homeowners who secure their own permits will be 4. CHANGES excluded from the guaranty fund provisions of Massachusetts General Laws, The Owner may order in writing changes in the Work consisting of additions, chapter 142A. deletions,or modifications("Change Order"), Any Change Order shall include an adjustment to the Price and the Substantial Completion Date,as In addition to the rights and warranties enumerated in this agreement,you may determined by Pella. Pella reserves the right to approve or disapprove any have addi€ional rights under Massachusetts General Laws,chapter 142A and Change Order and any such Change Order must be signed by Will Owner and 780 Cade of Massachusetts Regulations R6. Pella to be effective. 13. NOTICE OF CANCELLATION i1 5. SUBSTANTIAL,COMPLETION You may cancel this agreement if it has been signed by a party 9 Owner understands and agrees that€lie Substantial Completion Date is an thereto at a place other than an address of the seller,which estimate only and that the actual date on which the Work is completed may be may be his main office or blanch thereof,provided you notify extended to allow for Change Orders requested by Owner or if the time to the Seller in Writing at his main office Or branch by Ordinary complete the Work is affected by conduct of the Owner,weather,labor disputes,availability of subcontractors,acts of God,fire or other causes mail posted,by telegram sent or by delivery,not later than reasonably beyond Pella's control.If for any reason the Work is not fully midnight of the third business day following the signing of this completed by the Substantial Completion Date(including any extensions agreenletlt, 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 See the attached Notice of Cancellation for an explanation of to be replaced or repaired,a hold back proportionate to the cost of remaining this right. parts or work to be completed is acceptable.However,the holdback will not exceed the amount of the completion costs or 10%of the remaining unpaid balance of the Price,whichever is less. Do not sign this contract if there are any blank spaces. 6. FINANCING If payment of the Price is financed with a financial institution through Pella,all financing paperwork must be completed upon signing of this Contract and the Il requisite approvals and authorizations for the full amount of the requested financing shall have been received from the financial institution. Customer signature .v bi 1 O Date „ I The Commonwealth of Massachusetts r` Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,AM 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers 1 Applicant,lnformation Please Print.Le ibl Tame(Business/Organization/Individual): Address: t1 F0,01LO`: K0 --- City/State/Zip: itm F.q i�c(( IAA+ Ql'k 32. Phone , —1 -Z/,OS---"7J 5S_ Are you an employer?Check the appropriate box: Type of project(required): 1.E�t`I am a employer with 7-S_ 4. ❑ I am a general contractor and I . have hired the sub-contractors employees (full and/or part-time) * 6. Q New construction 2.0 I am a sale proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g, (J Demolition working for me in any capacity. employees and have workers' 9. Building addition [No workers' comp,insurance comp. insurance,l required,] 5. ❑ We are a corporation and its 10. Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself, [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.)t c. 152, §1(4), and we have no employees. [No workers' 13,❑ Other comp, insurance required.] *Any applicant that checks box#!must also fill out the section below showing their workers'compensation policy information. t homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such, tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site Information. Insurance Company Name: F '. Policy#or Self-ins.Lic,#: Expiration iration Date:—__'7-'" Job Site Address: City/State/Zip: _._ 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 MGL c, 152 can lead to the imposition of criminal penalties of a Fine up to$1,500,00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature t )A e��. .. ..,._. _. _.. .rye __.. _.._. . Date: ,. .3 - Phone#: Z Z-evS --70i�,S_ Official use only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: _ Phone#: A-C.00. CERTIFICATE OF LIA131LITY IINSURANC� gATB1L4NIEEhIYYYI 47raaraataa�Isa PACauCEA (aa0)2�S•1854 �iill C �IFICAY�'IS 4S tiED A A AfYER I3P 1NF� (�A-[ION D)IILY ��� C�NF6R5 Ha Rl0 9�P81� �iiE CER�l@tcAG� FTed C,Churah,Inc. 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Fnadl koad IMpCSE HO COUGATIQOR NASR.IrY OF ANY 00 0H THE INSURER,ITS AGENTS OR averhill,MA 01930 gEPs>:sENrATtuEs. ` Al1THGfliEt:f}IiEPAESENIATNE� � ���� , ACBE$©Z5(2004IOfl> Ctient f! i4fin Mst N I(}-r f GL, Cerr�' ©A,CGRID CCRPCRAY10K 19A9 UMB,WC, Aura 731. �.�/ he 6 - .+�t �i �,��ousytmer•�t'�'�iu's&Su i'ue5sy2eguTahvit . - : it - ,�tip�r3�un-y�/2720'!1 i `- y�e_-Supplemei5f Card.- • -PELLA'WlNb011l S A 1Q 0_QRS', V,11li�tA7� .P!lEHbGS� , _, fAV{~F2 Il lvj MA( f = F 3udorseie-V46 ry, M.issachusetts- De1)artmei€t i)f Put€lic Saret+ Soy€rcl of Building Re-r l<t#ions anti .Standai ds Construction Supervisor License License: CS $9853 WILLIAM R NiC-HOLS r� 57 PEARTREE IUD' Fci Y HAVERHILL, MA 01830 Expiration: 10126/2012 (u�nntivsiEnrr Tr#• 4529 FS DISPUTES Job Name Gm 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 ARBITRATION AS PROVIDED IN M.G.L.c. I42A o � for 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. i