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Building Permit # 10/29/2015
01 NORTH qN BUILDING PERMIT TOWN OF NORTH ANDOVER =- APPLICATION FOR PLAN EXAMINATION Permit No# �`�1 Date Received / F Date Issued D Z�'l 1 IMPORTANT Applicant must complete all mems on thisp age r _ TYPE OF IMPROVEMENT_ PROPOSED USE Non-Residential Residential - - ❑New Building "ne family ❑Industrial ❑Addition ❑Two or more family ❑Commercial ❑ _ _Alteration No.of units: -- �Repair,replacement ❑Assessory Bldg 11 Others: ❑Demolition ❑Other av s t ,„ f1 d{fit u�aljao �ln aIxWe}la dsta' P r, saw M t gv` aY.gf(5' Y�Sr.`,n.r' r. kfr`^a,.m DESCRIPTION OF WORK TO BE PERFORMED: Identification-Please Type or Print Clearly Phone:C4' OWNER: Name l !k r , Address 2c 5h-L a a t '�t I t'��v,' �e�a' "�.f.m^IIW�+" al�r`+�``.��2' .,� ��+'S."-° � i q�'� � ''✓ sG-�,� i ARCH ITECTIENGINEER Phone: Address: Reg.No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost:$ c��= FEE:$ '- 2i Check No.: ���' Receipt No.: NOTE: Persons contracting With unregistered contractors do not have access to the guaranty fund c .af��rAs,f.Aderij/Owi3�r �e...�h,a� �=`' .Signaturgofcontrac`tor+ _�,�_r Town o 2 "°fir" Andover No. —x ` h ver,Mass, *Yi,9 pOgnre°�eP�45 RMIT ® $ U I � BOARD OF HEALTH Food/Kitchen , Sept"sy-n THIS CERTIFIES THAT......................IJ Or..............I�.:..GL1G/....................................................... BUILDING INSPECTOR i 3 �a2Pw, �2¢. °ndation has permission to erect..........................buildings on..Y..V:�.........................................�.................... I 1 \ p Rough to be occupied as...........�..... .IGC.wY�p_„7f....�!�?.S.^:.SXR...................................................... cn�mney provided that the person accepting this permit shall in every respect conform to the terms of the application Finai 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. R-gh Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR .UNLESS CONSTRUCTIr STARTS S S..h ................... ....................................................... Final .. BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Display in a Conspicuous Place on the Premises—Do Not Remove Fml No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Bumex Street No. Smoke Det. Contract-Detailed Pella Window and Door Showroom of Haverhill Sales Rep Name: Gonya,Nathan 45 Fanelli Rd HIC#1832791 Tax ID#26-1413183 Sales Rep Phone: 978-360-1287 Haverhill,MA 01832 ��7 ?,:5 Sales Rep Fax: Phone: (978)373-2500 Fax: (978)373-7274 G Sales Rep E-Mail: gonyanb@pellaboston.com Customer lhformation- `Project/Delivery Address 'Order lrrformation Cleon Richards Rchards,Cleon,1636612 Quote Name: RichardcCleen,1636612 2053 Salem St 2053 Salem St Order Number: 741 NG0048 NORTH ANDOVER,MA 01845-3332 Lot# Quote Number: 7229817 Primary Phone:(978)6853872 North Andover,MA 01845-3332 Order Type: Installed Sales Mobile Phone: County: Payment Terms: Dapos YOO.D. Fax Number: Tax Code: MA TAX 6.25 E.Mail: Quoted Date: 10/5/2015 Great Plains#: Customer Number:1007386266 Customer Account: 1003127883 Lne#. �1,ocatgonx Attributes 10 Garage Pella Brand,Inswing Entry Door Right,35.5 X 81.75,White,5 7116" Item Price Qty Ext'd Price 52,849.11 1 $2,849.17 1 3480 Right mewng Entry Door PKk Frame Sae 351/2X813/4 727 General Information No F'm Rafng No F re Rat ng Clatl Wood Pins,6 3/4 1 5/16',5 7/1a,Standard Sill,Mill Finish Sill,Oak Threshold Entry Door Pane 1.Glazed Fberglate Smooth�.� Smooth Craftsman Light' Exterior Color/Finish:Standard Endu ded Panted Vvhts,Vvhte interior Color/Finish.Unfnshed,Wlite Glass:Tempered Low-E Vewed From Exterior Hardware Options:Latch Bore with Deadbelt,No Deatlboll Sensor,2 3/8',21/8',Chatham Knob,Wndham Exterior Keyed Cylinder,Chatham Knob, Frame Sire:35.5"X81,75" satin Ni.kel,Awminum Adjjnstable,satin Nickel U iEAocessories:No Dentil Shelf,No Bang Panel Grilles:No Grille Wrapping Information:Net Fin,Factory Applied,No Exterior Trim,No Interior Trim,5 7/16",6 3/4",Factory Applied,Pe11a Recommended Clearance, Perimeter Length-235'. ES_Single-Install Single Entry Door Qty 1 Entry Trim Finish-Finish Paimsam n Entry Interior Trim Only Qty 1 Comp Trim>48-Composite Trim Upgrade>Greater than 48 inches wide Qty 1 For more information regarding the finishing,maintenance,service and warranty of all Pella®produels,visit the Pella®website at www.pella.com Printed on 10/6/2015 Contraot-Detailed Page 1 of 4 Customer:Clean Richards Project Name: Richards,Clson,1636612 Order Number:74ING0048 Quote Number:7229817 Line# .:Location: Attributes 15 None Assigned Delivery/Setup-Delivery/Setup Item Price Qty exrd Price $197.40 1 $197.49 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 fthis contract. Please to the wanwhics for complete details,taking special note ofthe two important notice sections negarding installation of Pella products and proper management ofmoistme 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 Corpomtion 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 ofa Rolscreen[or any other accessory]to the product.Yen should consult your local building code m ensure your Pella products meet local egress requirements. Per the manufacturer's limited waaanty,unfinished mahogany exice-mr windows and doors must be finished upon receipt prior to installing and refinished annually,thereafter. Variations in wood grain,color,texture or vamral chameteristies are not covered under the limited warranty. IN SYNCTI VE 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 htsynctive.pella.com.By installing or using Yom 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 Removeexisting 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 For more information regarding the finishing,maintenance,service and warranty of all Pella®products,visitthe Pella®website at www.pella.com Printed on 1 01612 01 5 Contract-Detailed Page 2 of 4 Customer:Clean Richards Project Name: Richards,Cleon,1636612 Order Number:741NG0048 Quote Number:7229817 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 Pellarte'to do the fol lowi no: Obtain Building Permit(When required) Prefimsh products when purchased in contract During the Installation the Homeowner agrees to do the following: Keep pets safely we,fr.70Farea 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 aarees to do the follON no: 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 tohave 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 ®� Project Checklist has been reviewed r,�er�arcial Product Only Addendum has been reviewed comma���nal Credit Card Account 4:Last 4 Digits For more information regarding the finishing,maintenance,service and warranty of all Pella®products,visit the Pellas)website at www.pella.com Printed on 10/6/2015 Contract-Detailed Page 3 of 4 Customer:Clean Richards Project Name: Richards,Cleon,1636612 Order Number:741NG0048 Quote Number:7229817 Expiration Dates / Charge final payment to same account ((Upon substantial completion) c��mmn�i��r�at M Project Checklist has been reviewed Cleon Richards Nathan Gonya Customer Nam. FI.— Pana sale,Rep Name (Please an) Order Totals P� Taxable Subtotal $1,925.11 ustomer Signature Pella Sales Rep Signature Sales Tax @ 6.259% $120.32 10/6/15 10/6/15 Non-taxable Subtotal $1,121.40 Date Date Total $3,166.83 Deposit Received $3,166.83 Credit Card Approval signature Amount Due $0.00 For more information regarding the finishing,maintenance,service and warranty of all Pella®products,visit the Pella®website at www.pella.com Printed on 10/6/2015 Contract-Detailed Page 4 of 4 va FIS A lot _= 3 s,oValpeo _ - 3 F - -a C Y r c '8 A s .0. . a 3 - .'g n 8 3 �F'&ZIPIRO R A.gfR 129.6 0 -433 (3� - �W-v- ^ fp MHz El ERI-7. c - 3 c iNg n O s" •� 0 4 _ o RK19 1 gM AsiaI a� u lot3C - c _- -E m y _ 1'- a °HIMI; lit n SPq Appal' ASM UM Fo3 3p _ oSoM _ _ .552 A HE PHO �a � - oAlp � _ 33.". _ ¢ ori -- i _ 3 593 k a I 49P 11 WE '' jig i °'a te �" UM pp =1 pv- z MOR MOs a s x o a? 3 ,6 zQ zR SWNTY 4 All 4 c� _ aa? �� as6 n3 = WAP o n«y _=oo_�$ .� DISPUTES THE CONTRACTOR AND THE HOMEOWNER HEREBY MUTUALLY AGREE IN ADVANCE THAT IN THE EVENT PELLA HAS A DISPUTE CONCERNING THIS CONT1tACT,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&Doors Contractor meowner NOTICE:THE SIGNATURE OF THE PARTIES ABOVE APPLY ONLY TO THE AGREEMENT OF THE PARTIES"f0 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 Date of transaction: 10/6/15 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 tett 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 snake 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 fait 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 10/9/15 (three business days from the date of transaction above). I hereby cancel this transaction. (Date) (Buyer's signature) The Commonwealth of massaclu sedss ---- �^- Department of Industrial Accidents Office of Iasvestigadons 1 Congress street,state 100 Boston,M9 02114-2011 "Woo-rerasa.gov/dia Workers'Compensation Insurance Affidavit:Builders/Coasts actors/Electricians/Piumbess A plicant information Please Print Iv--ihh, Name �E1IA lV � c a b,,r, LLC Address: 4� fm City/State/Zip: _g ,( t Phone#: 975-ZE i � Are you an employer?Check the appropriate boa: Type opproject(required): L E,lam a employer with --zJ 4-❑1 am a general contractor and I employees(fall and/or part-time).= have hu ed the sub-contractors 6.❑New consonetion 2.El am a sole proprietor or partner- listed on the attached sheet. 7.&carodeling ship and have no employees These sub-contractors have 8.❑Demolition working for mein any caPacit. employes and have E] 9,®Building addition req workers'comp.insurance comp.is corral required.] 5.❑We are a corporation and its lo.❑Electrical repairs or additions 3.❑1 am a homeowner doing all work officers have exercised the¢ I I,❑Plumbing repairs or additions myself[No workers'comp. tight of exemption per MGL 12❑Roof repairs insomace required.]i c.152,§1(4),and we have no employees.[No workers' 13.❑Other comp.insurance required.] 'Any applicant tin[cheeks box#1 mus[also❑II au[ata sermon balmy sb—mg theirwodcers'eompnsetianpolicy mfatmation. t Hom ars who snbmittM1isamdavit iitdicaringthey ore Mgsll woth,nd thenhimo idewahac o,,,twbmiravew amdcAtindicating such. =Ceatrdetots that check lbishox must attached an addiriavvl sheet showing the tome orthe suhcoMuctms end surra whether or not those amities hnve employees.If the sub-connsetatx hove emplopecs,they must provide their wod<ers comp.poliry mimbec Pam an employer Shat is providing workers'compensation insurance furan,enrp1q ves.Below is the polky and job site '... information. 1 Insurance Company Name: [t `,d�r�� s a Policy#or Self-ins.Lie.M qot'o H o I o( Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(shoving the policy mother and expiration date). Failure to segue coverage as required under Section 25A of MGL c.152 ran lead to the imposition of erimival 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 herekv cerci•under floe gins and atonies of erpny that the information provided above is true and correct Signature Phone# Dffrcial use ortlp.Do not euriie in this area,to be completed by city or)own nf`km, City or 1fowMe Ee•mit/L'ecense# issuing Aouthority,(circle one): L Board of ileaith 2.dnildeng Department 3.City/Town Clerk 4.Electrical inspector 6.Plumhing 9Hxpeetcw 6.Othes CERTIFICATE OF LIABILITY INSURANCE egTe NWan Y) THIS CERTIFICATE IS ISSUED AS A MATTER" INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS NE CERTIFICATE DOES NOT AFFIRMATIVELY OR GATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER IMPORTANT:If the certiOOate holder IS en ADDITIONAL INSURED,the p,licy)ies)must be endowed.If SUBROGATION IS WAIVED,subject to the term,and conditions of the policy,certain policies may require an endowemem.A statement on this certificate does not confer rights to the certificate hold,,in Neu of,BOh endorsement(,). PRODUCER <Fiw°Jm"n soa�o. Ss rA.cee Aoee ioi5,ss� a,)° 62eB � jmD INSURENA INSURER I COVERAGES CERTIFICATE NUMBER:5°° REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAVEO ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT NTH RESPECT TO WHICH THIS CERTIFICATE MAX BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRISED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. UNITS 1A11 OCCURNED EXP(Anym""") E .N6,C— "I'S' A'GYI6ACV INJURYE,,6 CUU 11111 17'1ER ITT A IL I 1,1.1Cft. _PRODUCTSCO-OPAGG 8 2AD III UNIULUDY ANY P— BODILY INJURY UP.,penan) E o RY IPeramaeU$ EDgUTO TOS rameerU S AGGREGATE STI 9 M-RI NR —ND, eT6Eo N °me°mm 6,6 1,.e,6 _EL EACH ACCIDENT P s 66 �PTIDNOFOPaRATIDN„LO6ATIDN,,ea,le 6IAh NAenRn,6,,Ae616asII——G,.,e,1, P.�1ne,R6) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE E EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. TNON2E0 nEPnESEVu `' cen �, Ced Holtler 11 ©1908-2010 ACORD CORPORATION.All rights reserved. ACORD 25)2010105) The ACORD name and logo are registered marks of ACORD r�r't...... .bird/a G rG,rir consumer'Mm&Busivess Rvgaladoa Li cense or registratio dat, forindi vadum to: before the eapirationdf.i,PFfopnd returvta:l tion ,r EIMPROVEMENT CONTRACTOR Once of Consumer Afaairs and Baseness Regua tion:183279 TYpo' 10 Yark Plaza-Suite 5170 egist rz on: Supplement Cam Boston,MA 02E16 �' Expiration:.9124/2017 NEW ENGLAND WINDOW&DOOR,LLC, PELLA WINDOWS&DOORS W 0iam Nichols 1 � 95 FONDI ROAD / '.t valid bout SI$vatore HAVERHILL,MA 01832 [inderseer-1 u Ley _ 57 PLARTREE RV ggpplERAPIILL P9A,01830 • � -'�' 90126/2016 :