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5 MAYFLOWER LN - BUILDING INSPECTIONppppp� E— Contract Pella Windows&Doors,Inc. 120 ANDOVER STREET a DANVERS,MA 01923 Te1978-774-5444 Phone: Cell 978-360-9325 Fax: Fax 978-739-9300 '\ Customer Project/Ship-To Order REARDON,JOHN REARDON-WME-SALEM Date 10/02/2007 Quote No. REARDON 6 HERSEY STREET 6 HERSEY STREET Order No. Need Date 00/00/00 SALEM,MA 01970 salem,MA 01970 Sales Rep.Name Havens,Lou/WME ESSEX ESSEX Prepared by LOU HAVENS Payment Terms Deposit/C.O.D. Owner: JOHN REARDON Architect Bus.Phone:( ) - Bus. Phone: Jamb Depth Bus,Fax:( - Home Phone: P.O.No. Cellular:( ) - Branch Order No. Home Phone:O - Order Type Installed Sales Order Glazing Design 20.00 psf, Pressure Branch Name Pella Windows&Doors,Inc. Branch Address 120 ANDOVER STREET Phone Cell 978-360-9325 City DANVERS,MA 01923 Fax Fax 978-739-9300 State Tel 978-774-5444 Comments: CUSTOMER HASD PAID$443.02 DEPOSIT, (50%OF THE CONTRACT) CUSTOMER HAS PAID USING A CREDIT CARD THE REMAINING$443.02 (FINAL 50%)WILL BE PAID UPON SUBSTANTIAL COMPLETION OF THE INSTALLATION. FINAL PAYMENT WILL BE MADE USING A CREDIT CARD. CUSTOMER HAS GIVEN PELLA CHECK FOR$25 MADE PAYABLE TO PELLA,TO COVER THE COST OF THE BUILDING PERMIT For information regarding the finishing,maintenance,service,and warranty for all Pella products,visit the Pella Website it Printed 10/02/07 Contract-Page 1 of 4 Contract for Customer REARDON,JOHN Project: REARDON-WME-SALEM Or Outside View Item No. Olv. Unit Price Extended Price Item#10 Qty: 1 Fixed/Vent OX Sliding Window,Frame:31-1/2 X 18-1/2:Pella 843.85 843.85 Location:BATH Impervia,Alternative Material,Model 1 ,White, 11/1V InsulShld IG RO: 2'8" X FT' Glazing,Half Screen,White Hardware,Block Frame w/Std Fin WallCond: 1 11/16"(Fin to Roomside) Value Added Items:Impervia Full Frame Replacement-Qty I Disposal per Unit-Qty I Notes: PELLA WINDOWS AND DOORS TERMS AND CONDITIONS 1. OWNER Pella is not responsible for any existing security systems.Please remove all shades;verticals,blinds,curtains,drapes or window mounted air conditioners,prior to the installation of your new windows.Installens are not responsible for the removal or installation of these types of items. The Owner shall provide complete access and full ability to work at the site between the hours of 7:00 am.and 6:00 p.m. 2. 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 Certified Pella Contractors. 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. Them are no liens on the property now as a consequence of this Contract.Provided the Owner pays Pella for the Work in accordance with this Contract,Pella shall keep title to the Owner's property free of liens. The materials and equipment furnished under the Contract will be good quality and new unless otherwise required or permitted,the Work will be five 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 operation under the Contract. 3. CHANGES The Owner,without invalidating the Contract,may order in writing changes in the Work consisting of additions,deletions,or modifications,the Price and the Substantial Completion Date being adjusted,as Pella shall determine.Such changes in the Work shall be authorized only in writing and Pella shall not be required to proceed with changed work unless so authorized. Contract-Page 2 of 4 Contract for Customer REARDON,JOHN 09 Project: REARDON-WME-SALEM Order No.: Zi _ (4� Taxable Subtotal $ 843.85 stomer Signature Pella S sentative Signature Sales Tax at 5.00001/o 42.19 9 Non-taxable Subtotal 0.00 /o A47 Total $ 886.04 Date Daze Deposit Received $ 443.02 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,Inc. 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. Contract-Page 4 of 4 CITY OF SALEM - - -- PUBLIC PROPRERTY - DEPARTNOM >L�u• l'1'7.�eN::.L�i'i 7sR�i�l:fl.Tiwlr<»w u�1s::9 'ht:97Ft��11!�f.�9iiJ�6'!iN Con:crucdos Debris Dispo»f Affidavit (regaiMd for all demolition and rrnovatiaa wont) (a aoeocdanee with the aids edition of dw Stm Building cod@,7110 Chit socdm 111.5 Debris,and dw provisions o(M. GL s 40#g 54 8uiidiad Pon • _ is issnad with dw cood dom drat the debris mstd tg hoax this war shall be disposed of in a property licensed waste disposal fbcitity as dented by%IGL a t 11.! 15" The debris will be tratrsported by: _ (name of haa.d rho&-bds will be disposed of in : Nam a (unity) 4� �o<„z �2- -t�►.�..e�c�--t( a-�r- ....Iwa,I,.�i ia.:6fy� o IF 3i . �...IL J II •.4W t The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Leeibly / �� I . Name (Business/Organization/Individual): �elle� W t��DW S A�•td PC) '\G Address: qS F,4 (LA . City/State/Zip: 4ye('ki11 M/E ol�3Z :;Pbtii l#:: , g78�26 72S5 Are you an employer? Check the appropriate box: Type of project(required): I. I am a employer with 2.S 4. ❑ I am a general contractor and I .. , , • 6. ❑New construction employees(full and/or part-time).' have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the'attached sheet. �• ❑ Remodeling. ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers' comp. insurance. ' 9, ❑ Building addition o workers' comp. i 5. ❑ We are a corporation and its insurance 10.❑ Electrical repairs or additions required.] officers have exercised their 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions myself. [No workers' comp. c1 152, §1(4), and we have no 12.❑Roof repairs insurance required.] t employees.[No workers' 13.0 Other comp. insurance required.] -Any applicant that checks box#1 must also fill out the section below showing diel#:*iirlbiist:compensation policy information- I Homeowners who submit this affidavit indicating they ace doing all work and then lure outside contractors must submit a new affidavit indicating such. y . :contractors that check this box must attached an additional sheet showing the name of the subcontractors and their workers'comp.polity information. - I am an employer that is providing workers'compensation insurance formy employees. Below is the policy and job site information r �" Insurance Company Nameo ��Cd /� C�Vr� rl Policy#or Self-ins. Lie. #: O g W S Al L 57 Al 2 Expiration Date: � Z 00 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'forin of a STOP WORK ORDER and a fine of up to$2511.00 a day against the violator. Be advised that a copyof this:statement maybe 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: Date: 265 ZS 7 S Phone#• (q 70G Official use only. Do not write.in this,area, to be eonrleted 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 hl: ACORD. CERTIFICATE OF LIABILITY INSURANCE 1 IfJ00 07"T 07/112007 09:56 PRODUCER —.— (800)225-1865 -- _ THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Fred C.Church ONLY AND CONFERSNO RIGHTS- UPON THE CERTIFICATE _ HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 41 Wellman Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Lowell,MA 01851 800-225-1965 NAIC# INSURERS AFFORDING COVERAGE INSURED INSURERA: Hanovct Insurance COMPany Pella Windows&Doors,Inc. INSURERS: Twin City Fire losnrB"Ce Co. 45 Fondi Road INSURER CC Haverhill,MA 01932-1302 INSURER 0: NSURER E COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN&0. POLICY NUMBER POLICY EFFECTIVE POLICYE%PIRATION LIMITS EACHOCCURRENCE $1,000,000 GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY E f500000 CLAIMS MADE a OCWR MED E%P one $10,000 A ZBN6161407 7/12007 7/1/2008 PERsonALaaovINJURY f 1.000,000 GENERALAGGREGATE f 2,000,000 PRODUCTS.COMP/OP AGO i 2,000,OW GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- WCT X LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT f 1,000,000 (Fe accident) ANY AUTO X ALL OWNED AUTOS - BODILY INJURY f (Per Parso") A SCHEDULED AUTOS ADN8162169 7/12007 7/1/2008 X HIRED AUTOS BODILY INJURY f (Par emden) X NON-OWNED AUTOS PROPERTY DAMAGE f (Par eccie ) AUTO ONLY-EAACCIOENT f GARAGE LIABILITY EA ACC S ANY AUTO OTHER THAN AUTO ONLY: - AGG f FACHOCCURRENGE f 9,000,lX10 EXCESSAIMBRELLA LIABILITY" 9 000 000 . X OCCUR El CLAIMS MADE AGGREGATE S A UHN6167305 7/12007 7/12006 f f DEDUCTIBLE i X RETENTION S WC STATV- OTH- WORNERS COMPENSATION AND EMPLOYERS'LUUNIUTY EL.EACH ACCIDENT $500,000.00 B ANY OFFICER/MEMBE '/IPARTUDEOECUTIVE 08WBNL5742 7/1/2007 7/1/2008 _ E.L.DISEASE-EA EMROYEE f 500,000.00 N yea Weraiba ul - EL-DISEASE-POL16Y LIMIT S 500,000.00 ' SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS I LOCATIONS IVEHICLES I EXCLUSIONS ADDED BY ENDORSEMENTI SPECIAL PROVISIONS - CERTIFICATE HOLDERCANCELLATION ells Windows&Doors,Inc. SHOULD ANY OF THEXPIR ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EATION S FODddiRoad - DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTENLD Haverhill,Road OI83O NOTICE TO THE CERTIFICATE HOER NAMED TO THE LEFT,BUT FAILURE TO Do W SHALL Fon IMPOSE NO OBLIGATION OR LIABILITY OF ANY IGND UPON THE INSURER,ITS AGENTS OR UMOR REPRESENTATIVES. .. :' # ' AUTOO W zED REPRE SENTATIVE ©ACORD CORPORATION 1988 ACORD 25(2001/08) Client# 2960 Mat# 07-08 GL.Auto,WC& Cert# Umb ✓/. lJOj/ggll2 O� q, ,u08�d �q Board of Building Regulations and Standards HOMEIMPROVEMENTCONTRACTOR Registratl0dy 129774 `} I fl—PV,/�"-' -I 2009 Tr# 260785 �s t _ PELLA WINDOWS AT7l�DOORS SCOTT HOUSE r{ . HAVERHILL, MA 01832 Administrator µ dMIMOE TRO OF *6'11M1 Elcerfse 'C9NSTRUCTI6NSUP.ERISOR. �'. 60LAW OB r;�o 9853 � s T V L ' WILLIAM R NIC i 57 PEA,RTREE R , A Mrf� F cHAYERH itMA 01 �sic �� �� � k�'ax6Ay� c.�'� +k, �x��� �..mla91gf1eP�•,¢`s ,rvy . OF y P P ROPERTY FARTME,�1T WrO 130 WAUWS=M st■M s S AM4 NAMACHUSM 019M IVU M746-IsN•PAN sre 74"M A_*PLCATI M FOR THE RUAM ��OVATiON �nx_arQtr[�rrnnr DYr[OGITION.OR CHMG)L Ot IJ3Z OR OCCII!_ nrCy gOR A_ rV ZxMrrr G SMUCTURE 1.0 UM INFORMATION Location Namw &Adnr. Pro*"Is located h a;Coimnadon Am@ Y&V HWn a-DkMd Y 2.8 OWNER&W INFORMATION 2.1 Owner of Laid Names AA14- It=•-v Addresw Jf wlA-Y F L, w C 2 L,Al SALES n TIMIO . ffS SECTION FOR WORK IN E]It1 XWG BUILDINGS ONLY c�/, Number of 3WMW Renovated rada(Descripdon se Neu► year of Area per floor (st) Renovated calls or renovation ildup New of Proposed Work: --- - ---Mail Permit W „%C-i(VIs /fie Ili} U,),60wk q-(-Foa/cJ r 1?D Y21 1ARtat ie the urrrw t up d the sui dinp? MaWial at9w7dMg4 it d�wovkv&how many tr>ib9� We Yn amid Q Combos to Lml Aspastos9 bo Ard*lds Name Add1rM and Phon* -- madmwe Name c r*Wudion SuPwviaae� °�q_�sr3 HIC RapMMatlon/ is� ' y EsWnsYd Caat iT. Pam*FN CWUABdorr permit FM i Esibnetad Cast X 1171111000 Reeldendal _-- - - --- - - - Eslrnelad Coat X 511f1111006 ConwneretaLAn Add ilond is.00 Is added as an AdimhlstraWe ehrEa. Make sure that all fields are property and wo*written to avoid do**In prodsNn0. The wWmWed do"hereby apply for a ttuil UV pwn*to hM to"above estated sped1cmdor , 8lpned under penattY of pwr wy Datfa /i— 7-07 �I 9 e � A r 1