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CITY OF SALEM
'! jA ,e PUBLIC PROPRERTY
DEPARTMENT
Constrtiction Debris Disposal Affidavit
(reLluired Iiu all demolition and renovation work)
In accordance ith the sixth edition of the State Building Code, 780 CAIR section 1 1 1 5
Dcbris• 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 lacility as defined by MOL c
111, S 150A.
The debris will be transported by:
E L l l 0-'(
I name of hauler)
I he debris will be disposed of in :
Imm�e of faulily)
13 Whec �lna Rve
u�,t,lre,. ,�rl���hlyt WObrvlvrti
f� agnatutc of piiiun .ipp cant
ale
from dur fbme to Yours...
MA Reg#146589 Federal 6 2 2625129
CT Reg#060605216
RI Reg#26463 Window,Siding and More
Corporate Headquarters,26 Cedar St,Woburn,.MA,(P)800-342-2211 (F)781-933-9626,www.newpro.com
THfS CONTRACT MADE THE day of ' 20_0�between
(Home Owners) (Home Phone) (Bu a Phone)
of .. S S Q
(Address) (City) (state) (zip)
the"Owner"and NEWPRO Operating, LLC, "NEWPRO". ❑ The job address is a condominium.
NEWPRO hereby agrees that it will for the consideration hereinafter mentioned,furnish all labor and material necessary to install the following
described work at the premises located at
(Job Address E-Maill for propnetary use only
TOTAL Additional Model TOTAL ��
"
Windows Purchased NEWPRO20W Work Number Q CASH
Window Color In: Out: SlidingGlass Door "�� PRICE r
Capping Color W ,� Steel SecurityDoor I
Door color n: Out: krT DEPOSIT
Model Name Model Numbers City Sidelites WITH
Double Hung New Construction Unit ORDER
Picture Window Storm Door W BALANCE ! '
Casement Obscure Glass BO^OM DUE AT
2 Lite/3 Lite Slider IScreens HALF F ILL INSTALL tr `
Bay I Bow Frame IPlease Initial:
Roof.' ❑ Soffit: ❑ lCustomer understands that NEWPROO does not - CASH
Garden Window do any painting or staining. (ie:when removing Balance p er at installation `
Awning or replacing interior stops or trim)
Hopper NEWPROO is not responsible for conditions or
Shaped ^ circumstances beyond its control including con- FINANCE
Other densation resulting from or due to pre-existing Bank completion form signed at installation
GRIDS Colonial 1,69L -Lero con itions.
DESCRIBE WORK: 2. , h
Est. Start Date: Customer understands this is an"estimated date" 7.5]r Est.Comp. Date: 1-21& 61
ni is s
Initials Customer understands all steel security doors will have a 3/4"aluminum threshold installed over existing threshold.
It shall be the obligation of NEWPRO to obtain any and all permits necessary under this agreement,as the Owner's Agent. The Owners who secure their
own construction-related permits,or deal with unregistered Contractors will be excluded from the guaranty fund provisions of MGLC,142A. All Home
Improvement Contractors and Subcontractors shall be registered by the Director and any inquiries about a Contractor or Subcontractor relating to a registration
should be directed to: Director,Home Improvement Contractor Registration,One Ashburton PI,Room 1301,Boston,MA 02108,(617)727-8598. If the
Owner is obtaining financing by way of a Retail Installment Sales Agreement,such Agreement shall include a time schedule of payments to be made under
said contract and the amount of each payment stated in dollars,including all finance charges. The Retail Installment Sales Agreement shall be incorporated
herein by reference. If the Owner is obtaining a revolving credit line to pay,in whole or in part,for the contract amount herein,the terms of the revolving
line of credit including interest rate and payment terms,shall be clearly set out on the credit application. The portion of the credit-application referencing
a time schedule of payment,to be made under this contract,and the amount of each payment stated in dollars,including all finance charges,shall be
incorporated herein by reference.
NEWPRO represents that it carries Workmen's Compensation and Public Liability Insurance in the amount of$100,000-$300,000.
If the Owner refuses to permit NEWPRO to proceed with the work herein,or in the event of any breach of the Owner of this agreement,for any reason
whatsoever shall cause the owner to pay NEWPRO a sum of money equal to thirty-three and one-third percent of the price agreed to be paid,as fixed,
liquidated and ascertained damages,and not as a penalty,without further proof of loss or damage.
- NEWPRO shall not be held liable in damages for delays in the performance of this contract due to causes beyond its reasonable control.
Owner warrants that he is the owner of the property on which the work is to be performed or that he is otherwise authorized on behalf of the owners to enter
into this agreement.This contract represents the entire agreement between Owner and NEWPRO and cannot be changed except in writing signed by both the Owner and
NEWPRO.
You are entitled to a copy of the Contract at the time you sign. Keep it to protect your legal rights. We, the
aforesaid owners,certify that immediately after the signing of the aforesaid agreement,a copy was furnished to us.
You may cancel this agreement if it has been signed by a party thereto at a place other than an address of the
seller,which may be his main office, or branch thereof, provided you notify seller in writing at his main office or
branch by ordinary mail posted, by telegram sent or by delivery, not later than midnight of the third business day
following the signing of this agreement. (Saturday is a legal business day). See the attached notice of cancellation
form for an explanation of this right.
y
DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES.
j E�fhe owner has seen"sample"warranties that will be provided by NEWPRO upon installation. sample warranties provided Owner.
j IN WITNESS WHEREOF,the parties have hereunto signed their names this-day ofV -20
13 ,,,�����^ddd(((���rrr�����^ `
(�epr nt EIN# Signed
Marketing Representative Printed N me Owner
Accept EWP O L -
By Signed
Owner
7 (ORPORATE OFFIC SHREWSBURY BRANCH OFFICE WARWICK BRANCH OFFICE
6 Cedar St 151-153 Memorial Drive Business Pk 24 Minnesota Ave
rn,MA 01 1 Suite B-C Warwick,RI 02888
2-997 rom NE) Shrewsbury,MA 01545 (P)800-356-3312(From NE)
8 3-0717 (P)800-456-0555(From NE) (F)401-732-1371
ii (F)508-842-9248
rti WHITE: Branch Copy YELLOW: Customer's Copy - PINK: File Copy GOLD: Finance Copy
�' uenc R0508
W-21,1111
page_of_
JOB# windows,Sung and More tl
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CUSTOMER \M 1 l/� I'G�QQ' &Ae-S
- E-MAILA�DRESS
HOME PHONE 1 0 V
'•' Mrs
DATE 1'®� WORK/ ELL HONE
ADDRESS BEST DAY TO INSTALL: M T W TH F
CITY, STATE (Please circle one)
PRODUCT SPECIALIST RANCH: Wd� ESTIMATED START DATE
TOTAL#OF #OF DOORS WINDOW COLOR
WINDOWS #OF BOW/BAY/GARDEN to a Patio
[��insiderOWsioe CAP COLOR
OPENING SIZE STOPS CUT
NO. STYLE W x H U.I. LOCATION GROEI SCR IN OUT ADDITIONS OPENING
G3W� l3 k 13 x X
a Z 'y U 15 x x
x x
x xn
x x
x x
x x
x x
z x
x x
x x —
.. x" x
x x
x x
x x
x x
Measuremam - - -
Initials. Date Crew Size Needed Time Frame to complete job Cappin F� -�
Special Installation Instructions:
Do al e�
Directions to site:
.RavhaE 1101
5/7/2009 3:59 PM PAQM: Macklncice Insurance Mackintire Insurance A e0 TO: 6,17819320860 PAGE: 002 OF 003
ACORD CERTIFICATE OF LIABILITY INSURANCE o/0/2009
'"°PUCE° (508)366-6161 ' FAX (S08)366-S202 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Mackintire Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE -
11 West Main Street HOLDER.THISCERTIFICATEOOESNOTAMEND,EXTEND OR -
ALTER THE COVERAGE AFFORDED.BY THE POLICIES BELOW.
Westborough, MA OIS81-1931
INSURERS AFFORDING COVERAGE NAICB
NsuRso Newpro Operating LLC wnaaLA Peerless Insurance Co. 24199
26 Cedar St. woPeae:
Woburn. MA 01801 wswPRc:
-
' IxSwipiE
OVrRAGES
-THE POLICIES OF INSURANCE LISTED BELOW HAVE SEEN 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 COMMONS OF SUCH
POLICIES.AOGREOATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
180. P°LICYEFPECrNE PO4cr QaPwAT°x
TYPE°F we11MNCE PRIG M"M LLNRB
OEwake-lueenv Cap 8588370 - MA POLICY 12/31/2009 12/31/2009 ErnloccuwFHCE a 1,000,00(
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uAIMSMmE X❑acun MFD E%P(o.Iy wewRenl $ 15 0 B g
LA PERsowLArwlxuRr a 100000 HOME IMPROVEMENT CONTRACTOR
POIERAL AOoPEwre a 2,000.00
cOn AccREwTE UMIr APPLIES PE¢ Paowns-mvP�Anc a 2 000 0 i
POLICY zu LOc R¢QlStrallA¢ 146589
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Avlaxoellelwawrr BA 8584174 1 //31/20DB 12/31/2009 coMalrgn slNsucuMa a El(plydGOD 5/5/2011
Axr Auro IEsscoaa,o 1,0000 - '�-.� Tpe Supplement Card
,W.owmED affoS (PP4vwMr
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IPxP.an)A NEWPRO OPEBmer Ar* arexovmm,uaos tPerecaaxo THOMAS FOXON
kk.
ryx.eva.al - 26 CEDAR ST. - -�j''3/
oeaAaeluee.m Amoow.v-eaA .Su a WOBURN,MA 01801 Administrator
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x occvR �aAINS Mane AGGaEse s a 5,000.00
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WOHIwRB CPMPENBATONANO w'C 6TAN 0114 ..
EUPIovMlrlueRm VX8645974 05/01/2009 OS/01/2010 El.e AICOEW a S00 00
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nvo.rermw wex E.L.D19E/SE-Pale Luna 1 500.00 {^�` p T
s+ecus PnowNPxs enw ✓ "(Ob'!)i9/ygn{ 8a �.�aaags.Gemsld
u Board Of Building
,Regulations;and Standards `
-' ConstructiOo;Superviscr License -
P unueerinNw OrsMTIONV Launrua I.CLEe l EYaufloNS ADDED er ExP0a9EuEATI 1 sa.PaOwsroN9 i
u BDs, cs 29o90
4 �1IM09 Tr9i 8131
CERTIFICATE HOLDER CANCELI-ATION
' sHPwn unaFTxE ABOVEOEscawEovoLloEe Be uxcsLLQo ePFoaETNs I THOMASP FOXIF� ZOO
O.o^wAnoxwTETHsasoF,THE laewxoweuaEavml ExoEAvoaTo uAA I 1 1 ;
y/�wYa YA9T1EN xvncero rHe rawm¢An[NOLnea NAxEoro eHe lEFr, 230 WALNUT ST
eur PAeua6 ra NAN ova xorcE aMw.wPose xot9euwTn9x wvwnm - �-.- y /"
Town of Saugus - REgpING,MA,01867 �'
298 Central Street oP AxrxlNowaxTxe lxauAER na ACExre OwREPREasrrtAmEn s t.Ommis$iJiner }
Saugus, MA AUlxoamnarPasesxrArxe i
Tialoth J. Mo a h ,--- y �
ACOR023(2001108) ®ACORD CORPORATION 088
W01.1alif e
in Highlighted a ,la
f`F
P
•qualified In all zones
L NRWPRO MANUFACTURING
�rrrac t4EWPRO 2000 DOUBLE HUNG
cellular PVC frame,Triple glazed,
Low E coating(e-0.034,S2&5),
.Krypton/Argon/air tilled
DEV.K•27.00018.00001
ENERGY PERFORMANCE RATINGS
i U-Factor(U.S.II•P) Solar Heat Gain Coefficient
ON19 0 .27
ADDITIONAL PERFORMANCE RATINGS
Visible Transmittance AV Leakage(U.SJI-P)
0,40 0.1
Condensation Resistance
70
Manwatworetlpulaws taateaeaem0a0a wmemetoaPPl de NFAC pmeadumhrdetemunina
pmdudP ^^+nw.NPRCeadopeeredelane ed(ara useend deesnotNmettuntl aumllebtllry oleM
aPwNle ectelu,NFNC aoeena�*eomm V6V=-im oNerowducl Peda'menae fidomla0on.
pmdsol�srenr�pecNo uw. dd mmuNaenerdalm,ory
The Commonwealth of Massachusetts
pepartment of Industrial Accidents
in Office of Investigations
600 Washington Street
Boston, MA 02111
wwTV.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plunabers
Applicant Information Please Print Legibly
Name (Business/oreanizatiorigndividual): NEWPP-O
Address: 2Lo CEDAk- ST
City/State.-Zip: Wo13u2n/ M� DI SOI Phone r: 781 93�-83op ExT �5/
Are you an employer' Check the appropriate box: Type of project (required):
r� t 4. ❑ I am a genera] contractor and I
I.t79 I am a employer with 5d 6 ❑ 1,ew construction
employees (full and/or part-time).* have hired the sub-contractors
listed an the attached sheet * � � Remodeling
B a
2.
prG p'
❑ I Bari G.0 Gwr GI partneI-
ship and have no employees These sub-contractors have 8. ❑ Demolition
working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition
[..No workers' comp. insurance 5. ❑ We area corporation and its I0.❑ Electrical repairs or additions
required.] officers have exercised their
ri t of exemption per MGL 11.❑ Plumbing repairs or additions
3.❑ 1 am a homeowner doing all work , ! p
myself [No workers' comp. c. 152, §I(4), and we have no 12.❑ Roof repairs
insurance required.] t employees. [No workers' 13.❑ Other
comp. insurance required.]
-Any applicant that checks box a must also fill out the section below showing their workers'wmprnsation policy infomtation -
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit in such.
:Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name: HQCkin+ire Tnscironce Aqe-r)ci.l
Policy=or Self-ins. Lic. W C 8 to tl 5 q`)L4 Expiration Date: 5- 1 . 2 0 1 U
Job Site Address: a--I P I Ct l 1-ECrS Sl City/State/Zip: Sa lic m
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 S1.500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up to S250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigarions of the DI A for insurance coverage verification.
I do hereby certify under the pains and penalties ofperjury that the information provided above is true and correct
Simatre FOR NLW PP n Date- ye/ o9
Phone 9 $ I-q53 81L4IP
Official use only. Do not write in this area, to be completed by city or town official.
City or Town: Permit/License#
Issuing Authority (circle one):
1. Board of Health 2. Building Department 3. City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector
6. Other
Contact Person: Phone#: