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HomeMy WebLinkAboutBuilding Permit # 9/4/2015 II BUILDING IT Of t&O ya0i3Ty D ,a Igo TOWN F T �2 APPLICATION FOR PLAN EXAMINATION Permit No#: ,,, Date Received//—�' & �q AD�ATED PPp`i �wSsgcHus`` R Date Issued: 1VIPORTANT: Applicant must complete all items on this page LOCATION t � L� a '.. Av Print PROPERTY OWNER SAMESL � Print 100 Year Structure yes 0 MAP / PARCEL: ZONING DISTRICT: Historic District yes no AV p �- Machine Shop Village yes no ter, TYPE Or IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building A,One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial epair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other t//�1 II1!���1 1.S.I�e(fJa�/�,,,.t�!e,..t�dcr"�1I/,lSa..,letfw,/rfr W,e/r�l/..(e/,l/,r.lly/�/////i///i!�/i///,�//////���/✓,r/��/r//�//�//r,,�rfr//!///❑////�l.F/rl6/l/!///l o�/l////d C/1,l/.r r/,.llr,IUa////(i.�!1n////�/////rl///r/r/��I//,//,/,I./❑/ai,/i/,,ri,/,,W�G//l��e///rr.//.l///l.y/„al/�//�///,!✓/dl.„s.r.Y!v//�1/f r/s,/////lr/,/i,d/r/f,../.,>/�f d�„ MIN ,J J rr,s oJe./r o/d .FDtI sr// /r'r rr..; � �l DESCRIPTION OF WORK TO BE PERFORMED: Identification- Please Type or Print Clearly OWNER: Name: Phone6n /q. 36s-/ Address: - Contractor Name: WAi I &�, % �d Phone: .7 Email: Address: t 3'2 Supervisor's Construction License: _ Exp. Date: Home Improvement License: 7 Y Exp. Date: - ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$9000,00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ FEE: $ � Check No.: "`7/ `� Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund ID 'Town ofSORT H ,. � �. ....gyp ndover 0 . No. - h ver, Mass, L , COC NICC"t NC-ICK �'?ATEO S u BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System THIS CERTIFIES THAT • BUILDING INSPECTOR .. has permission to erect .......................... buildings on ..... ......... .. ..�. x.��O�wr...... .... , ....... Foundation 10h 1 Rough to be occupied as ................4ing ......... ....... .... ... ......... ............. ...... ....................................... Chimney - provided that the person accethis permi shall in every respect conform to the terms of the application Final on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES I NTH ELECTRICAL INSPECTOR ® LESS C S CTI A Rough Service ............. ....... ....... ..... ........ Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. Contract - Detailed Pella Window and Door Showroom of Haverhill Sales Rep Name: Clancy, Ryan ® 45 Fondi Road Sales Rep Phone: 978-373-2500 Haverhill, MA 01832 C>�, Sales Rep Fax: �_l ic-0 _ , Sales Rep E-Mail: clancyrp@pellaboston.com Customer Information Project/Delivery Address Order Information James Hashem Hashem,James,NorthAndover,MA,1600048 Quote Name: 4 Windows 4 Holbrook Rd 4 Holbrook Rd Order Number: 741 RCO203 NORTH ANDOVER,MA 01845-3706 Lot# Quote Number: 6999920 Primary Phone:(978)3143051 NORTH ANDOVER,MA 01845-3706 Order Type: Installed Sales Mobile Phone: County: ESSEX Payment Terms: Deposit/C.O.D. Fax Number: Tax Code: MA TAX 6.25 E-Mail: jdhashem@gmail.com Quoted Date: 7/29/2015 Great Plains#: 9535605 Customer Number: 1007279706 Customer Account: 1002991683 Customer Notes: Permit fee of$108 paid on 7/30/15 Line# Location: Attributes 10 None Assigned Delivery/Setup-Delivery/Setup Item Price Qty ExVd Price $180.76 1 $180.76 For more information regarding the finishing, maintenance, service and warranty of all Pella®products,visit the Pella®website at www.pella.com Printed on 7/30/2015 Contract-Detailed Page 1 of 10 Customer:James Hashem Project Name: Hashem,James,NorthAndover,MA,1600048 Order Number: 741RCO203 Quote Number: 6999920 Line# Location: Attributes 15 Kitchen Vinyl Windows I Doors By Pella, 3-Wide Double Hung, 99 X 40,White Item Price Qty Ext'd Price $1,887.53 1 $1,887.53 1:Non-Standard SizeNon-Standard Size Double Hung,Equal 4 q p PK# Frame Size: 19 1/2 X 40 718 General Information: Standard,Vinyl,Nail Fin,4 3/16", 1 5/8",2 9/16" Exterior Color/Finish: White Interior Color/Finish: White Glass: Insulated Low-E Advanced Low-E Insulating Glass Argon Non High Altitude Hardware Options: White,Standard Vent Stop Viewed From Exterior Screen: Full Screen Frame Size:99"X 40" Grille: No Grille, Vertical Mull 1: FactoryMull, 1/2"Standard Mullion,Frame To Frame Width: 0.5" 2:Non-Standard Size Non-Stand ard Size Fixed Direct Set Frame Size: 59 X 40 General Information: Standard,Vinyl,Nail Fin,4 3/16",1 5/8",2 9/16" Exterior Color/Finish: White Interior Color/Finish: White Glass: Insulated Low-E Advanced Low-E Insulating Glass Argon Non High Altitude Grille: No Grille, Vertical Mull 2: FactoryMull,1/2"Standard Mullion,Frame To Frame Width: 0.5" 3:Non-Standard SizeNon-Standard Size Double Hung,Equal Frame Size: 19 1/2 X 40 General Information: Standard,Vinyl,Nail Fin,4 3/16", 1 5/8",2 9/16" Exterior Color/Finish: White Interior Color/Finish: White Glass: Insulated Low-E Advanced Low-E Insulating Glass Argon Non High Altitude Hardware Options: White,Standard Vent Stop Screen: Full Screen Grille: No Grille, Vertical Mull 1: FactoryMull,1/2"Standard Mullion,Frame To Frame Width: 0.5" Wrapping Information: No Exterior Trim,No Interior Trim,Pella Recommended Clearance,Perimeter Length=278",Glazing Pressure=55. FF>96 wide-Install Full Frame Window>96 inches wide Qty 1 Finish FF Trim-Finish Paint/Stain FF Interior Trim Only Qty 1 Comp Trim>48-Composite Trim Upgrade>Greater than 48 inches wide Qty 1 Trim—Stool and Apron-Add Stool and Apron Trim to Picture Frame 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 7/30/2015 Contract-Detailed Page 2 of 10 Customer:James Hashem Project Name: Hash em,James,NorthAndover,MA,1600048 Order Number: 741 RCO203 Quote Number: 6999920 Line# Location: Attributes 20 Master Bedroom Vinyl Windows/Doors By Pella, 3-Wide Double Hung, 99 X 64,White Item Price Qty ExVd Price $2,193.88 1 $2,193.88 C 1:Non-Standard SizeNon-Standard Size Double Hung,Equal PK# Frame Size: 19 1/2 X 64 718 General Information: Standard,Vinyl,Nail Fin,4 3/16", 1 5/8",2 9/16" Exterior Color/Finish: White Interior Color/Finish: White Glass: Insulated Low-E Advanced Low-E Insulating Glass Argon Non High Altitude Hardware Options: White,Standard Vent Stop Viewed From Exterior Screen: Full Screen Frame Size:99"X 64" Grille: No Grille, Vertical Mull 1: FactoryMull, 1/2"Standard Mullion,Frame To Frame Width: 0.5" 2:Non-Standard SizeNon-Standard Size Fixed Direct Set Frame Size: 59 X 64 General Information: Standard,Vinyl,Nail Fin,4 3/16",1 5/8",2 9/16" Exterior Color/Finish: White Interior Color/Finish: White Glass: Insulated Low-E Advanced Low-E Insulating Glass Argon Non High Altitude Grille: No Grille, Vertical Mull 2: FactoryMull,1/2"Standard Mullion,Frame To Frame Width: 0.5" 3:Non-Standard SizeNon-Standard Size Double Hung,Equal Frame Size: 19 1/2 X 64 General Information: Standard,Vinyl,Nail Fin,4 3/16",1 5/8",2 9/16" Exterior Color/Finish: White Interior Color/Finish: White Glass: Insulated Low-E Advanced Low-E Insulating Glass Argon Non High Altitude Hardware Options: White,Standard Vent Stop Screen: Full Screen Grille: No Grille, Vertical Mull 1: FactoryMull,1/2"Standard Mullion,Frame To Frame Width: 0.5" Wrapping Information: No Exterior Trim,No Interior Trim,Pella Recommended Clearance,Perimeter Length=326",Glazing Pressure=65. FF>96 wide-Install Full Frame Window>96 inches wide Qty 1 FF>60 Height-Install Full Frame Window>60 inches Unit/Composite Height Qty 1 Finish FF Trim-Finish Paint/Stain FF Interior Trim Only Qty 1 Comp Trim>48-Composite Trim Upgrade>Greater than 48 inches wide Qty 1 Trim—Stool and Apron-Add Stool and Apron Trim to Picture Frame 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 7/30/2015 Contract-Detailed Page 3 of 10 Customer: James Hashem Project Name: Hashem,James,NorthAndover,MA,1600048 Order Number: 741RCO203 Quote Number: 6999920 Line# Location: Attributes 25 Living Room Front Vinyl Windows I Doors By Pella, 3-Wide Double Hung, 80 X 64,White Item Price Qty ExVd Price $2,042.07 1 $2,042.07 r 1:Non-Standard SizeNon-Standard Size Double Hung,Equal PK# Frame Size: 19 1/2 X 64 718 General Information: Standard,Vinyl,Nail Fin,4 3/16", 1 5/8",2 9/16" -I Exterior Color/Finish: White Interior Color/Finish: White Glass: Insulated Low-E Advanced Low-E Insulating Glass Argon Non High Altitude Hardware Options: White,Standard Vent Stop Viewed From Exterior Screen: Full Screen Frame Size:80"X 64" Grille: No Grille, Vertical Mull 1: FactoryMull,1/2"Standard Mullion,Frame To Frame Width: 0.5" 2:Non-Standard Size Non-Stand ard Size Fixed Direct Set Frame Size: 40 X 64 General Information: Standard,Vinyl,Nail Fin,4 3/16",1 5/8",2 9/16" Exterior Color/Finish: White Interior Color/Finish: White Glass: Insulated Low-E Advanced Low-E Insulating Glass Argon Non High Altitude Grille: No Grille, Vertical Mull 2: FactoryMull,1/2"Standard Mullion,Frame To Frame Width: 0.5" 3:Non-Standard SizeNon-Standard Size Double Hung,Equal Frame Size: 19 1/2 X 64 General Information: Standard,Vinyl,Nail Fin,4 3/16", 1 5/8",2 9/16" Exterior Color/Finish: White Interior Color/Finish: White Glass: Insulated Low-E Advanced Low-E Insulating Glass Argon Non High Altitude Hardware Options: White,Standard Vent Stop Screen: Full Screen Grille: No Grille, Vertical Mull 1: FactoryMull,1/2"Standard Mullion,Frame To Frame Width: 0.5" Wrapping Information: No Exterior Trim,No Interior Trim,Pella Recommended Clearance,Perimeter Length=288",Glazing Pressure=50. FF>60 Height-Install Full Frame Window>60 inches Unit/Composite Height Qty 1 FF-48-96 wide-Install Full Frame Window_48-96 inches wide Qty 1 Finish FF Trim-Finish Paint/Stain FF Interior Trim Only Qty 1 Comp Trim>48-Composite Trim Upgrade>Greater than 48 inches wide Qty 1 Trim—Stool and Apron-Add Stool and Apron Trim to Picture Frame 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 7/30/2015 Contract-Detailed Page 4 of 10 Customer:James Hashem Project Name: Hashem,James,NorthAndover,MA,1600048 Order Number: 741RCO203 Quote Number: 6999920 Line# location: Attributes 30 Living Room side Vinyl Windows/Doors By Pella, 3-Wide Double Hung, 99 X 64,White Item Price Qty Ext'd Price $2,193.88 1 $2,193.88 C 1:Non-Standard SizeNon-Standard Size Double Hung,Equal PK# Frame Size: 19 1/2 X 64 General Information: Standard,Vinyl,Nail Fin,4 3/16", 1 5/8",2 9/16" a 718 Exterior Color/Finish: White Interior Color/Finish: White Glass: Insulated Low-E Advanced Low-E Insulating Glass Argon Non High Altitude Hardware Options: White,Standard Vent Stop Viewed From Exterior Screen: Full Screen Frame Size:99"X 64" Grille: No Grille, Vertical Mull 1: FactoryMull, 1/2"Standard Mullion,Frame To Frame Width: 0.5" 2:Non-Standard SizeNon-Standard Size Fixed Direct Set Frame Size: 59 X 64 General Information: Standard,Vinyl,Nail Fin,4 3/16",1 5/8",2 9/16" Exterior Color/Finish: White Interior Color/Finish: White Glass: Insulated Low-E Advanced Low-E Insulating Glass Argon Non High Altitude Grille: No Grille, Vertical Mull 2: FactoryMull,1/2"Standard Mullion,Frame To Frame Width: 0.5" 3:Non-Standard SizeNon-Standard Size Double Hung,Equal Frame Size: 19 1/2 X 64 General Information: Standard,Vinyl,Nail Fin,4 3/16", 1 5/8",2 9/16" Exterior Color/Finish: White Interior Color/Finish: White Glass: Insulated Low-E Advanced Low-E Insulating Glass Argon Non High Altitude Hardware Options: White,Standard Vent Stop Screen: Full Screen Grille: No Grille, Vertical Mull 1: FactoryMull,1/2"Standard Mullion,Frame To Frame Width: 0.5" Wrapping Information: No Exterior Trim,No Interior Trim,Pella Recommended Clearance,Perimeter Length=326",Glazing Pressure=65. FF>96 wide-Install Full Frame Window>96 inches wide Qty 1 FF>60 Height-Install Full Frame Window>60 inches Unit/Composite Height Qty 1 Finish FF Trim-Finish Paint/Stain FF Interior Trim Only Qty 1 Comp Trim>48-Composite Trim Upgrade>Greater than 48 inches wide Qty 1 Trim—Stool and Apron-Add Stool and Apron Trim to Picture Frame Qty 1 Thank You For Purchasing Pella® Products PELLA WARRANTY: Pella products are covered by Pella's 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. For more information regarding the finishing, maintenance, service and warranty of all Pella®products, visit the Pella®website at www.pelia.com Printed on 7/30/2015 Contract-Detailed Page 5 of 10 Customer:James Hashem Project Name: Hash em,James,NorthAndover,MA,1600048 Order Number: 741 RCO203 Quote Number: 6999920 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. INSYNCTIVE PRODUCTS:In addition,Pella Insynctive Products are covered by the Pella Insynctive Products Software License Agreement and Pella Insynctive Products Privacy Policy in effect at the time of sale,which can be found at Insynctive.pella.com. By installing or using Your Insynctive Products you are acknowledging the Insynctive Software Agreement and Privacy Policy are part of the terms of sale. Project 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 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 agrees to do the following: 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 During the Installation Pella agrees 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 Composite. Composite 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: For more information regarding the finishing, maintenance,service and warranty of all Pella@ products, visit the Pella@ website at www.pelia.com Printed on 7/30/2015 Contract-Detailed Page 6 of 10 Customer:James Hashem Project Name: Hashem,James,NorthAndover,MA,1600048 Order Number: 741 RCO203 Quote Number: 6999920 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 II interior&exterior glass surfaces Fill holes nd joints on interior trim if windows are to be stained (after staining) t i casing issues due to storm window removal if full wrap or new exterior trim is not purchased oject Checklist has been reviewed Customer initial Product Only Addendum has been reviewed Customer initial Credit Card Account#: Last 4 Digits Expiration Date: / Charge final payment to same account (Upon substantial completion) Customer initial For more information regarding the finishing, maintenance, service and warranty of all Pella®products, visit the Pella@ website at www.pella.com Printed on 7/30/2015 Contract-Detailed Page 7 of 10 Customer:James Hashem Project Name: Hashem,James,Nor hAndover,MA,1600048 Order Number: 741RCO203 Quote Number: 6999920 roject Checklist has been reviewed Ja es Hashem VRyanI ncy mer N e (Please print) e ep Name (Please print) Order Totals Taxable Subtotal $4,201.49 Customer Signature es Rep Signature Sales Tax @ 6.25% $262.59 7/30/15 7/30/15 Non-taxable Subtotal $4,296.63 Date Date Total $8,760.71 Deposit Received $8,760.71 Credit Card Approval Signature Amount Due $0.00 For more information regarding the finishing, maintenance, service and warranty of all Pella®products,visit the Pella®website at www.pella.com Printed on 7/30/2015 Contract-Detailed Page 8 of 10 NOTICE OF CANCELLATION Date of transaction: 7/30/15 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 8/3/15 (three business days from the date of transaction above). I hereby cancel this transaction. (Date) (Buyer's signature) PELLA WINDOWS AND DOORS CONTRACT 7 PAYMENTS 1. TERMS AND CONDITIONS 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 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 person(s)identified on the Product Order("Owner")to supply the products(the"Products"),and perform 8 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 shall 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 2. OWNER completed and payment of the Purchase Price made subject to a holdback as provided above.Correction of Work as herein 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 types of items. Pella is not responsible for pre-existing window coverings fitting on newly installed Pella 9. LIMITED PRODUCT WARRANTY 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 portions of the Work.Pella will be responsible for the Work of its Pella 10. NO CONSEQUENTIAL DAIVIAGES Contractors who will install the Products. UNDER NO CIRCUMSTANCES SHALL PELLA BE LIABLE FOR Unless provided otherwise in the Work description,Pella will provide and pay CONSEQUENTIAL,INCIDENTAL,INDIRECT,OR SPECIAL DAMAGES, for all labor,materials,equipment,tools and machinery,transportation,and WHETHER FORESEEN OR UNFORESEEN. other facilities and services necessary for the proper execution and completion of the Work. 11. HOME IMPROVEMENT CONTRACTORS The materials and equipment famished under the Contract will be good quality All home improvement contractors and subcontractors shall be registered with and new unless otherwise required or permitted,the Work will be free from the director of the Home Improvement Contractor Registration Program defects not inherent in the quality required or permitted,and the Work administered by the Board of Building Regulations and Standards. Pella and conform with the requirements of this Contract.Pella shall not be responsible any of its subcontractors identified in this agreement have been registered. for damages or defects caused by abuse,modifications not executed by Pella, Any inquires about Pella or any of its subcontractors relating to registration improper or insufficient maintenance,improper operation or normal wear and should be directed to:Director,Home Improvement Contractor Registration, tear. Pella will keep the premises and surrounding area free from One Ashburton Place,Boston,MA 02108,617-727-8598 accumulation of waste materials or rubbish caused by performance of the 12. PERMITS(MA customers only) Work. Pella is obligated to and will obtain the following permits for this project: 4. CHANGES Building . Homeowners who secure their own permits will be 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 additional rights under Massachusetts General Laws,chapter 142A and Change Order and any such Change Order must be signed by both Owner and 780 Code of Massachusetts Regulations R6. Pella to be effective. 13. NOTICE OF CANCELLATION 5. SUBSTANTIAL COMPLETION You may cancel this agreement if it has been signed by a party Owner understands and agrees that the 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 branch thereof,provided you notify extended to allow for Change Orders requested by Owner or if the time to complete the Work is affected by conduct ofthe Owner,weather,labor the seller in writing at his main office or branch by ordinary 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 filly midnight of the third business day following the signing of this completed by the Substantial Completion Date(including any extensions agreement. contemplated above),but is substantially completed by such date,i.e.,the Product has been installed,but ininor 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 parts or work to be completed is acceptable.However,the holdback will not this fight. 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 requisite approvals and authorizations for the fill amount of the requested financing shall have been received from the financial institution. Customer signature 7/30/15 Date DISPUTES 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. 142A Pella Windows and Doors Contractor omeowner 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. The Commonwealth of Massachusetts 1'�tr t F�rtn Department of Industrial Accidents Office of Investigations ' I Congress,Street, ,Suite 100 ' Boston, MA 02114-2017 11MM,nass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individttal): o,mt) Y2 L-LQ Address: 45- City/State/Zip: 5City/State/Zip: t4miepzd.l ) Phone #: Are you an employer? Check the appropriate box: Type of project(required): 1.[2.,l am a employer with ---7S 4. ❑ I am a general contractor and I 6. ❑ New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. 7. E&Retriodeling ship and have no employees Mese sub-contractors have g. ❑ Demolition working for me in any capacity. employees and have workers' 9. Building addition [No workers' comp. insurance comp. insurance. required.] 5. corporation We are a oration and its 10.❑ Electrical repairs or additions ❑ P 3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions p.No workers myself. ' com right of exemption per MGL y [ 12.E]Roof repairs insurance required.] c. 152, §1(4), and we have no employees. [No workers' 13.0 Other comp, insurance required.] *Any applicant that checks box#1 must also lilt out the section below showing their workers'compensation policy information. Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contactors have employees,they must provide their workers'comp,policy number. I amn an emplover that is pf•oviding workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: ( f1,q ,N S Policy#or Self-ins. Lic.#: 4l060 Lf C; d C: ( Expiration Date: 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 $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature: -- -` 7777777777, -- - - --- Date -- ----- Phone#; Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1. Board of health 2. Building Department 3.City/Town Cleric 4. Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone#: ACGWO� CERTIFICATE OF LIABILITY INSURANCE 06129/0iSMNODDIYYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: if the certificate holder is an ADDITIONAL INSURED, the policy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER C NTACT Dom1Ay A-Corlall,CIC,RPLU Fred C.Church,Inc. NAME. 41 Wellman Street PHONE 9783227231 FAX Lowell,MA 01851 C o AIC :No (978)454-1865 (800)225-1865 E-MAIL ADDRESS: dcaletf@fredcchurch.com INSURER(S)AFFORDING COVERAGE NAIL 8 INSURERA: Citizens Insurance Company of America 31534 INSURED New England Window 6 Door LLC INSURER B; New Hampshire Employers Insurance Company 13083 45 Fnndl Road INSURER C: Haverhill,MA91832-1302 INSURER D: INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER:54457 REVISION NUMBER: ElEE1 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUDR POUCY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBERMMIDD MM10D LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED s 100,000 PREMISES Ea occurrence CLAIMS-MADE M OCCUR MED EXP(Any one person) s 10,000 A X C00001 ZBN8161407 7/1/2015 71112016 1,000,W0 PERSONAL&ADV INJURY S GENERAL AGGREGATE s 2.000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOPAGG s 2.000,000 POLICY X PRO- X LOC s AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident _ $ ANY AUTO BODILY INJURY(Per person) s ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) s HIREDAUTOS NON-OWNED OAUTSWNED PROPERTY DAMAGE § Per ecc dent S EACH OCCURRENCE s UMBRELLA LIAB OCCUR EXCESS LIAR CLAIMS-MADE AGGREGATE s DED RETENTIONS s WORKERS COMPENSATION X WCSTATU- 0TH- AND EMPLOYERS'LIABILITY YIN I IT E B ANY PROPRIErORIPARTNER/EXECUTIVEEL EACH ACCIDENT s 500,000 OFFICERIMEMBER EXCLUDED? NIA 400040101 71112015 7/112016 (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ 500,000 If yes,describe under E.L. DESCRIPTION OF OPERATIONS below IEL DISEASE-POLICY LIMIT I$ 5001000 DESCRIPTION OF OPERATIONS I LOCATIONS[VEHICLES(Attach ACORD 101,Additional Remarics Schedule,If more space isrequired) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ,f i Client It - Mst it Cert Holder ft 384117 ©1908-2010 ACORD CORPORATION. All rights reserved. ACORD 26(2010105) The ACORD name and logo are registered marks of ACORD m CS-089853 „ WILLIAM R NICHOLS 57 PEARTREE RID' HAVERHILL MA; 01830 26/2016 ;. ���enur�nnruoef<�l n n �QJJ�ICIrrreLY1 ;_ License or regSstration*alid for individul use only r Office.of Consumer Affairs&BBnsi ess Regulation before the expiration date. If found return to ME IMPROVEMENT CONTRACTOR Office of Consumer Affairs and Business Regulation _ egistration: 178383 Type: 10 Park Plaza-Suite.5170 xpiration 4/10f2016 Corporation Boston,MA 02116 kQ „Y PELLA WINDOWS AND DOOR WILLIAM NICHOLS Y .45 FONDE RD ���.� ,�, �•f::: _ ... HAVERHILL,MA 01832 Undersecretary Not valid without signature