27 NORTHEY ST - BUILDING INSPECTION The Cwealth of Massachusetts
onmwn IOIt
Board of Building Regulations and Standards
4 Mt Nll'IP \I I„
c MaSSaChLISetIS State 1uilding Code, 7SU C'MR. ',°i edition
`.r. Rrri,wd Ammn_r
Building Permit Application To CunsuucL Repair. Rrnoeatr Or Drnuilish a �
One- or Tit o-FoIlndv Duelling _rnri
t� This Section or Official Use Only _--_-_
Building Permit Nut ec Date Applied:
Signature: t��-------
BuilJing Cununis.ion Inspector of Bt it rags Date
SECTION 1: SITE INFORMATION
1.1 Property .Yddress: S 1.2 Assessors Map & Parcel Numbers
is 7` •- v no Map Number Pal r N r,--- ------
I.la Is this an accepted street? yes— ".0 rl �m�m.-
1.4 Property Dimensions:
1.3 Zoning Information: i Y
Zoning District` Proposed Use Lot Area(sy it) Frontage tit)
5 Building Setbacks (ft)
Front Yard Side Yards Rear Yard
�—
Required Provided Required Pnrvided Required Pru eiJrd
i
1.6 Water Supply: tM.G.L c. 40, §54) 1.7 Flood Zone Information: LS Sewage Disposal System:
Zone: _ Outside Flood Zone? Municipal ❑ On site disposal system ❑
Public ❑ Private ❑ Check if yes❑
SECTION 2: PROPERTY OWNERSHIP'
2511 2 1 Owner'or Record:L yP /-o No nN a 7 Mni��V
Name (Print) Address for Service.
Telephone
Signature
P
SECTION 3: DESCRIPTION OF PROPOSED WORK(check all that apply)
New Construction ❑ Existing Building ❑ Owner-Occupied ❑ Repairs(s) .A.lterutionlrU O l \ddifiun ❑
I :ernolition ❑ Accessory Bldg. ❑ Number of Units I Other ❑ Specify:
�----- -Proposed-- WorkZ: --I Rricf Description of _ —
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
I. Building ( 6�' - 1. Building Permit Fee: $ Indicate how fee is determined
a ❑ Standard City/Town Application Fee
3. Electrical $ t_ O Total Project Cost' (Item 6) x multiplier x
1. Plumbing $_ _. Other Fees: .$
4. Mechanical (HVAC) $ List::
5. Mechanical (Fire
Total All Fees: S
Suppression)
Check No. Check Amount: cash :\mOunt
b. Total Project Cost: of6 0 Paid in Full 0 Outstanding Balance
SECTION 5: CONSTRUCTION SERVICES
5.1 Licensed Construction Supervisor (CSL) R 3 _J-D_Z6 a8 r
" GtJ IS/kz i &4A4 Ah c,df S License Numher EXIIHation Dale
Name of CSL-
ho
List CSI_ fypc(see helo%s')4 � � Descri riion
\ddrrss
_
�L Unresu'irtedttl to i5.(X)OCu. Ft.r
R Restricted 1&2 Famik Dsselling
Si nuure ��`�1 ,bf Masonn Only
Z S RC Rrside_nlial Routine Coscrme
Telephone \VS Residrnuul VV'i nduw;uid Sldlne
SF Rrsidrnlial Soli) Purl liurnin_ :\ >>liunrr Ina,d Luum
D Re.identi:d Demolition
egistered Hume 1 rprove�ment Contractor (HIC)
�tl �rl�A(4n—jg /✓.r L.ttZ - -/a-q 7-7-4
- -' ------
HI Con any Name or HIC Re istranl Nat a Registration NU!6her
Iz / - a
Address on
f _? _�� Expiration r Dalc
Signature Telephone
SECTION 6: WORKERS' COMPENSATION INSURANCE AFFIDAVIT (M.G.L. c. 152. § 25C(6))
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to powde
this affidavit will result in the denial of the Issuance of the building permit.
Signed Affidavit Attached? Yes ......... No ......... . ❑ -
SECTION 7a: OWNER AUTHORIZATION TO BE COMPLrTE:: WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR B_ U_tLDING PERMIT _
L &1-/ _, as Owne: of the subject property hereby
❑uthorize A- L1LOOV-s- to act on my behalf, in all naticis
relative to work authorized by this buildmL,permit application. _
Signature of Owner _ Date
SECTION 7b: OWNER' OR AUTi'ttORILED AGENT DECLARATION
L F I kwt Ali 6tt� �S ______ ._.—_. as Owner or Authorized Agent hereby declare
that the statements and information on the foregoing application are true and accuraie, to the best of my knowledge and
behalf
Print Name
Signature of Owner or Authorized Agent Date
(Signed under the pains and penalties of perjury)
NOTES:
1. An Owner who obtains a building permit to do his/her own work, or an owner who hires an unregistered contrncur
(not registered in the Home Improvement Contractor {HIC) Program). will not, have access to the arbitration
program or guaranty fund under M.G.L. c. 142A. Other important information on the HIC Program Lind
Construction Supervisor Licensing (CSI) can be found in 780 CMR Regulations 1 10.116 and I I0.R5. respectively.
_'. When substantial work is planned, provide the information below:
Total floors area(Sq. Ft.) (including garage, finished base mendatt ics,decks or porchl
Gross living area tSq. Ft.) Habitable room count _
Number of fireplaces Number of bedrooms -_
Number of bathrooms Number of h;l Ub:uhs
'rope of heating system Number of decks/ porches
Type of cooling system Enclosed Open --- __--
3. "Total Project Square Footage- may be substituted for "Total Project Cost"
. ` CITY OF SALEM
=1 �^ PUBLIC PROPRERTY
`4s �f..
DEPAIZT'�IENT
Construction Debris Disposal .affidavit
(rcyuired liir all demolition iutd rawvation \vork)
In accordance ��ith the sixth edition ofthe State Building Code, 780 ChIR scclion 1 11.5
Dcbiis, and the provisions of MGL c 40, S 54;
Building Permit it is issued with the condition that the debris resulting from
this work shall he disposed of in a properly licensed waste disposal facility as defined by MGL c
111. S 150A.
The debris will be transported by:
In❑ a (it hauler)
I he debris will be disposed of in
name of facility)
45_FaiV0T; ho d g-i-e&J42.11
laddres, of facility) 6CJU��
.Ignatwe of permit .applicant
q-/S-Ok
,late.
T/te Commonwealth of Massaebuseus
Department oflndustrial Accidents
OJfrce•of Investigations
600 Washington Street
Boston,MA 02111
www nwssgov/tia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
ADDlicant Information r r Please Print Legibly
Name(Business/otgaa;ratiowFlmlividualy_ Re l(4 W,,*,A Dw 3 ctl DOOI'3 nC
Address: q$' F6h4 s aak .
City/state/Zip: {+Ol �►i�� MIS �Ig3Z rrplKil�iU#"�r 'R78 -fZ?."•72ss
Are you as employer!Check the appropriate box: Type'of project(required):
1. I am'a employer with 'Z-S • 4. 0 I am a general contraytor and I 6 New conshuction
employees(fidl and/or part-time).• have hired ftcub=contractors
2.0 I am a sole proprietor or pMwr- listed on the'auaclKd.*Aa t 7.' Remodeling:
ship and.have no employees. These sbb-onractors have 8: 0 Demolition
working for me in any capacity. workers'comp. insurance. ' 9: ❑Building addition
(No workers`comp. insurance. 5. 0 We arc a corporation and its.
required.] officers have exercised their 10.0 Electrical tepairs or-additions
3.0 I am.a homeowner doing ail.work . right of exemption perMGI 11:0 Plumbing repairs or additions
Myself (No-workers' comp: ' cl 152, §1(4),and we have no 12.0 Roof repairs
irsa nce required.)'r employees. [No workers' 13 0 Other
comp.inswer6ce required:] .
�woy applicant Wat ehala twx/1 moat ayo fill tiutthe faction bflow ahowing ' J6igayt'•bo�pe3uti4nPuGcy, bta5atiw ,.
t Homeowners who aabiYgt tlui ffidevlt mAleadna dieg.ue doing al wok cad then h madd& � mdRedina MWL.
eox4ilXo"s,mwt Whpit i'aew atrdivit'
tCortrarxass that cbeci ode box most.attarhed an addltiooal atieetsbowing the name af4c adb-con aaars.aod Ibeir wotkew coop•policy h fmossim.
Ion an eurployel:t9tat.ls providieg workers'cons ensarion bvurance for my emplo etc—Bdoiv is fkr o '
brjortrration y p bry:and job site
Insurance Company Name: Ftd G, ' '.ektJra�1
Policy#or Self-ins.Lic. #:_0$'W SAIL-$7142 Exp."tion Date:7 a 00
Job Site Address
tp:
Attach*copy of the workers' competwation policy declaration page.(showing the policy number and expiration date).
Failure to wqure eovt:tage as required under Sectidn.25A of MGL e.•152 can lead Ito the ik.iposition of criminal penalties of I.a
fine up to 51,500.00 and/or onayear imprisonment,as well as•civtil penalties inthe form of a STOP WORK.ORDEit"a fir
of up to$250.00 a day against the violator. Be advised that a cony o'f A-U—statement may be fotwarded to the Office of
Investigations of the.DtA fa insurance coverage verification. ,
!do hereby certify under dte pabss and penatt&s ofpedury that the infomwffora provided above is true and correct. -
Simtature• 6iL w ZiC 6i_ �/.�--- — Date 9/ O
Phone#: ( 7g� 2�5•. f 2 �5
6,&i d use only. Do not writs be.this area,to be conrided by city or town offs Pal.
City or Town: —PC rmit/ilcease#
Issniag Authority(circle oaq)c
I: Board of Iieait'h'2.$nilding Wpartment 3.Cityrrown Clerk '4.Electrical Inspector S Plumbing Inspector
6 lMer
ACORD.. CERTIFICATE OF LIABILITY INSURANCE 07/D=11081`�"11:42 " .
Fred '•k800)225-IS65 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
41 Wellm=Shed _ HOLDER. THIS CERTIFICATE DOES NOT-AMEND, EXTEND OR
L.omILMA01851 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
BOD-225-1865 .. -
INSURERS AFFORDING COVERAGE- NAIC 0.
INSURED ,
NewEaglmdWmdov&.DoorLLC INSURER A.' Ltiliuoslamlmce Company ofAmaiHa
45 Fondi Road INSURER a: HanoverlBMBance ComFeay
HaverhilLMA 01832-1302 INSURER C: MaMdMSega BaY 110000MOs
wwRERD: Twin City Fire ln311[eoee Co. 29459
sISURERE
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.
Pisa ADWI
roLICYNUMBER POLICY EFFECTIVE ro ffMO%RAl10N UAaT8
GENERAL LIABILITY EACH OCCURRENCE j 1.OD0,000
X COMMERCIAL GENERAL LIABILITY $500.000
CWNSMADE a OCCUR NED EXP a $10,000
A ZBN8161407 7/l2008 7W2009 PEIMONALaADVINIURY $1,000.000
GENERALLAGGREGATE S%OOD,000
GEHL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/.OPAGG $ 2,000,000
Pouw tea- ElLac
AVTOMOOILELUSIUIY COMSINEDSINGLELMR
XANYAUTO (Ea erdaee0 $1,000,000
ALL OWNED AUTOS .. BODILY INJURY .$ .
C �oOS ADN8162169 7/12008 7/12009 PePH )
X S �
BODILY INJURY $
X HON-OWNED AUTOS lvr amMeeO
PROPERTYDAMAGE•.' S
GARAGE LIABILITY- AUTOONLV-EA ACCIDENT 5 •.
ANY AM OTHER THAN EA PLC S
. AUTO ONLr: . AGO S .
EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE f 9000,000
.X OCCUR ❑CLAIMS MADE AGGREGATE _ 9,000,OW
B UHN8167305 7/12008 7/12009 :
OEOLCTBLE $
X RETENTION , S S .
WORKERS COMPENSATIONAN4 - X L"/CSTATU- OTI-
VIER
EMPLOVEIM LIABILITY
D AwPROmETmpARrmEmExEcunvE 08WBM5742 7112008 7112009 EJ_EACH ACCIDENT $500.000
oFyysFlaaCERIMEMBEa ExCLUDE07 E.L.DISEASE,EA EMPLOYEE $500,000
` SPECIAL PROVISIONS ee ` ? .... .._ .. .. E.L.o1SFA5E-POLICY LIMB I S $00.000 . . . ..
OTHER .
DESCRIPTION OF OPERATUM I LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENOORSEME W/SPECYIL PROVL4MNS .
Proof oflnsmance
CERTIFICATE HOLDER CANCELLATION '
New England Window Bc Door LL C SHOULD ANTOFTHEABOVEDESCRIBEC POLICIES BE CANCELLFABEFORE TNEEIIPDiATOH
5 Fondi Road DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
Haverhill,MA 01830 NOTICE To THE CERTIFICATE HOLDER NAMED TO THE LEFT.BUT FAILURE TO DO Im SHALL
MOOSE NO OBLIGATION OR LIABILITY OF ANY NMD,UPON THE INSURER.US AGENTS OR
REPRESENTATIVES .
�. AVTNORO'ED REPRESENTATNE:,':'::::::::::::::.::: ':... •..
ACORD 25(2001108) Client# 296D Mt 0 Auto GL,UMB.WC, cut# Q ACORD CORPORATION 1988
4, �..
OT
BOARD 00 BUILDING REGULATIONS
License: CONSTRUCTION SUPERVISOR
+' d Number: CS 4089853
Birthdatei 70126/1960
Expires: 10/26/2008 Tr.no 89853
Restricted. 00 ,
WILLIAM R NICHOLS
57EH A
HAVERHILLILL, MA 01830 , Commissioner,
'
✓fie lOammaarerue� n�✓��akuu.�euoeCCa
.SI-11 Board of Building Regulations and Standards
HOME IMPROVEMENT CONTRACTOR
Registration: 129774
Expiration: 11/2/2009
Type: Supplement Card
PELLA WINDOWS AND DOORS
WILLIAM NICHOLS
45 FONDI RD.
HAVERHILL,MA 01832 Administrator
Contract (��
U Pella Windows &Doors, Inc. r
45 FONDI ROAD
HAVERHILL MA 01832
HIC # 129774 /TAX ID 26-1413183
Phone: 800-866-9886 Fax: 978-373-7274
Customer Project/Ship-To Order
LONDON,PHILIP LONDON wme salem Date 00/00/00 / r�_
27 NORTHEY ST 27 NORTHEY ST No.
Need Date 00/00/00
SALEM, MA 01971 SALEM, MA 01970 Sales Rep. Name McLellan,Mike/WME
ESSEX ESSEX Prepared by MM
Payment Terms Deposit/C.O.D.
Owner: Mr.PHILIP LONDON I Architect
Bus. Phone:( ) - Bus. Phone: Dist.Order No.
Bus. Fax: ( ) - Home Phone: (617)447-3459 i
Cellular:
Home Phone: ( ) -
FComments: DEPOSIT$4084.
IBAL DUE$40.84.
PERMITS
Outside View Item Qty. Description
--r - —.- _
Item#5 Qty: I Vent Double-Hung, Frame:31-1/2 X 56-1/2: Pella Impervia, Alternative
Location: BATH Material, Model I , Half Vent/match Half Vent, White, 11/16" Obscure Temp
R.O: 2' 8" X 4'9" IG Glazing,Half Screen, White Hardware,3/4" Standard Colonial GBG
WaIlCond: 1 11/16" (Fin to Roomside) (muntin pattern: 3Wx2H/3Wx2H), White, Precision Fit Frame-3 1/4"
J Value Added Items: Disposal per Unit-Qty 1
Impervia DH P-Fit-Qty I
Notes: — - - - --
Item# 10 Qty: 4 Vent Double-Hung, Frame:31-1/2 X 56-1/2: Pella Impervia, Alternative
Location: Material, Model I , Half Vent!match Half Vent. White, 11/16" lnsulShld IG
R.O: 2'8" X 4'9" Glazing,Half Screen, White Hardware,3/4" Standard Colonial GBG (muntin
WaIlCond: 1 11/16" (Fin to Roomside) pattern: 3Wx2H/3Wx2H). White, Precision Fit Frame-3 1/4"
IValue Added Items: Disposal per Unit-Qty I
Impervia DH P-Fit-Qty I
Notes: ---- — -- ... - - - - ------
_— --.--_----__--____—_—__- -._—_--------___.___- ------ -- --- Contract-Pagel oft
h
a
Contract for Customer LONDON, Project: LONDON wme salem Order No:
S
Outside View Item Qty. Description
Item# 11 Qty: I Vent Double-Hung,Frame:31-1/2 X 56-1/2: Pella Impervia,Alternative
❑ Location: KIT Material, Model 1 , Half Vent/match Half Vent, White, 11/16" InsulShld IG
R.O: 2' 8" X 4'9" Glazing,Half Screen,White Hardware, 3/4" Standard Colonial GBG(muntin
WaIlCond: I I I/16" (Fin to Roomside) pattern: 3 Wx2H/3 Wx2H), White, Precision Fit Frame-3 1/4"
Value Added Items: Disposal per Unit-Qty 1
Impervia DH P-Fit-Qty I
Notes:
Item# 15 Qty: 5 Vent Double-Hung, Frame:31-1/2 X 56: Pella Impervia,Alternative
Location: Material, Model I , Half Vent/match Half Vent,White, 11/16" InsulShld IG
R.O: 2' 8" X 4' 8-1/2" Glazing, Half Screen, White Hardware,3/4" Standard Colonial GBG (muntin
WaIlCond: 1 11/16" (Fin to Roomside) pattern: 3Wx2H/3 Wx2H), White, Precision Fit Frame-3 1/4"
Value Added Items: Disposal per Unit-Qty I
Impervia DH P-Fit-Qty I
Notes:
Thank You For Purchas' g Pella Products
o -
rTaxable Subtotal $6,060.79
1 — _.__ — - - :- — — -- — - -
Customer Signature ells Sales Representative ignatme
MA 2000 at 5.6VX 303.04:
-- --- F--- - ---- -- -
None_ _ at0.00% i 0.00,
None at 0.00% 0.00
Y Z iNon-taxable Subtotal _1, 00 j
C)
—G`� total 8,167.I67.83
Date Date Deposit Received $0.00
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 branch 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.
— _-
----— - Contract-Page 2 of 2
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 DAMAGES
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. it. HOME IMPROVEMENT CONTRACTORS
improvement contractors and subcontractors shall be registered with
The materials and equipment furnished under the Contract will be good quality All home im p
and new unless otherwise required or permitted,the Work will be free from the director of the Home Improvement Contractor Registration Program
administered by the Board of Building Regulations and Standards. Pella and
defects not inherent in the quality required or permitted,and the Work any of its subcontractors identified in this agreement have been registered.
for
with the requirements y this e,modifications
Contract.Pella shall not ut 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 insufficient maintenance,improper operation normal wear and One Ashburton Place,Boston,MA 02108,617-727-8598
[ear. Pellaa will keep the premises and surrounding area freea from
accumulation of waste materials or rubbish caused by performance of the 12. PERMITS(MA customers only)
Work.
Pella is ob igated and will obtain the following permits for this project;
4. CHANGES Homeowners who secure their own permits will be
excluded fro 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 he 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 of the 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 fully 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 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
parts or work to be completed is acceptable.However,the holdback will not this right.
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 a lank 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 full amount of the requested X
financing shall have been received from the financial institution. ust�ignature ,
Date
NOTICE OF CANCELLATION
Date of transaction: ") ``-�,6
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, nat R 45 Fondi Rd., Haverhill, MA 01832
not later than midnight of 7 'O d (three business days from the date of
transaction above).
I hereby cancel this transaction.
(Date) (Buyer's signature)
F
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
�. � �
Contrac or
il'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.
a