19 SABLE RD W - BUILDING INSPECTION -7 2) '
)OF Ias
The Commonwealth of Massachusetts
° Board of Building Regulations and Standards CITY OF
Massachusetts State Building Code, 780 CMR SALEM
Revised Mar 2011 - -
Building Permit Application To Construct,Repair,Renovate Or Demolish a
One-or Two-Family Dwelling
This Section For Official Use..Only. ,
Building Peiinit Number: ' but Applied:, '_ 1
Building Official(Print Name)
SECTION 4:SITE INFORMATION "
_ 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers
1.la Is this an_.;depted street?ys,f - no_ �lapNumber Parcel N. ::er
1.3 oning Information:�, - 1.5 Property Ilimensions: - -
—1 - vary--ei
Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) `-
1.5 Building Setbacks(ft)
Front Yard Side Yards. Rear Yard
Required Provided Required Provided Required Provided
1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
- Zon.: Outside Flood Zone? ^e3 y
Public❑ Private❑ Municipal❑ On site disposal system -
--� Check if yes❑ i - posa rrl
SECTION 2: PROPERTY OWNERSHIP' a n
2.1 Owner of Record: prrn
a r �.lem mfl �19-7a c .' >17"
Name(Print) CiTy,State,ZIP r—e
r*t
No.and Street Telephone - Email Address y .
SECTION 3 DESCRIPTION OF PROPOSED WORK'. (check all that apply) m
New Construction❑ Existing Building❑ Owner-Occupied-❑ Repairs(s) AI[eration(s) ❑ Addition�❑ y
Demolition ❑ Accessory Bldg.❑ Number of Units_ Other ❑ Specify:
Brief Description of Proposed WorkZ:'�'n S-1-irll CJ
D �
SECTION 4.ESTIMATED CONSTRUCTION COSTS ,
Estimated Costs:
Item Official Use Only
Labor and Materials
1.Building $ jtJe) do Budding Permit Fee:$,; Indicate how fee is determined:;
L]Standard City/Town ApphcattonFee
2.Electrical $ p Total Project Cost- (I o 6)x multiplier x
3.Plumbing $ 2. O r Fees: $
4.Mechanical (HVAC) $ List
5.Mechanical (Fire $
Suppress Total All Fees:$
1 ' da Check No. Check Amount: Cash Amount:
6. Total Project Cost: $ 5 SY� O Paid in Full JI Outstanding Balance Due.
ot
�� ��
1
e" SECTION 5: CONSTRUCTION SERVICES
" 5.1 Construction Supervisor License(CSL) -
Th�� ��.� �? �oxoo� baS°�c2
License Number Expiration Date
Name of CSL Holder
ay CGf(' List CSL Type(see below)
No.and Street Type Description r
w Ubl)�67 y�'l� Q� �'a) U Unrestricted(Buildin su to35,000cu. ft.)
t + t Restricted 1&2 Family Dwelling
City/Town,State,Z M Masonry
RC
Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
(D, (ZDCV1 ` I Insulation
Tele hone Email address D Demolition _
5.2 Registered Home Improvement OuiAractor(HIC)
ew r �A n L _ __ HIC Registration, umber Expiration Tate
1-IICCom a�ry��xNameor:ic.Registrant ame
No.and Street Email address —
b)Q6ofo r>� bJBDI 7k1'933-�JOd
City/Town,State,ZIP Telephone ;
SECTION 6:WORKERS',COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c,152.§ 25G(6))
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide -
this affidavit will result in the denial of the Issuance of the building permit.
Signed Affidavit Attached? Yes .........4 No...........❑ -
SECTION 79:OWNER AUTHORIZATION TO EE.COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
�,. t,as Owner of the subject Froperty,hereby authorize_ I CLO Pr
( h' La
to act on my behalf,in all matters relative to work authorized b this buildng permit a lication.
a6hn -4- Re-6cc22a ,-- 3 ao If--
Print Owner's Name(Electronic Signature) Date'
SECTION 7b:OWNER'OR`AUTHORIZED AGENT DECLARATION
By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information
contained in this application is true and accurate to the best of my knowledge and understanding.
QWji
Print 7 er's ovrt�r Authortzed Ag t s Name( le trunie Signature) Dat -
NOTES:
1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor
(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 can be found at
www.mass. oa v/oca Information on the Construction Supervisor License can be found at www.mass.gov/dps
2. When substantial work is planned,provide the information below:
Total floor area(sq.ft.) (including garage,finished basement/attics,decks or porch)
Gross living area(sq, I,) Habitable room court
Number of fireplaces_. Number of bedrooms
Number of bathrooms Number of half/baths
Type 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"
MA Reg#146589
CT Reg#0605216HiWolow
Contract#
RI Reg#26463 Energy Saving Home lmpravements Federal ID#20-2625129
1 Corporate Headquarters,26 Cedar St,Woburn,MA,(P)800-342-2211 IF)781-933-9626,www riewpro.com 65523
THIS CONTRACT MADE THE ( day of 20 J% between
-(Home Owners) (Home Phone) (BusrCell Phone)
of
(Address) (City) (State) -(zip)
�.-.r
the "Owner"and NEWPRO Operating, LLC, "NEWPRO". (E-Mail) for proprietary use only
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:
The job address is a condominium.
(Job Address)
TOTAL# °,a NEWPRO WINDOW OPTIONS
WINDOWS SERIES Grids:DYES LJ NO LJCONTOUR LJSDL LJEUROLJDIAMOND
Window Color QTY Window Color CITY OBS/TMP: (Location) ❑TOP ❑BOTTOM
Int: Int: Screens:(Exterior color Full Screen Standard) ❑HALF ❑FULL'
Ext Ext: Vent Latches: ❑YES ❑-NO
Capping Color: DOOR$ MODEL. CITY Please Initial:
PVC Smooth NoMar No Capping ., .Sliding Glass Door, •.,
MODELNAME MODEL# 9107Y, Color In: Out: Customer understands that NEWPRO®
Double Hung 755 Active: Left Center Right does not do any painting or staining.
2 Lite Slider 757 HDWR: SN Be WH BGE lie:when removing or replacing interior
3 Lite Slider (1/4:-1/2;v4) t FC 753 It Entry DoorSWe-ttNitf5lict I stops ortrim). NEWPROCas not respon-
3 Lite Slider (1/3.1/3,1/3) _. 756 Color In: Out: sible for conditions or circumstances be-
Casement(Hinged Right) 851 Fiberglass Steel yond its control including condensation result-
Casement(Hinged Left) 852 HDWR: SN BB AGB AB ORB ing from or due to pre-existing conditions.
Twin Casement 853 Sidelite S e�.;°�' 1.tyI (circle one):
Stationary Casement _856 color In: Out CASH
Triple Casement om,is im 859 Ston Door$ Ie :' Balance paid to installer at completion
Triple Casement (113,113.v3) 860 Color
Picture Window 751 HDWR: : SN t BB AGB AS 1 FINANCE,
Sash Only ----'' -
y 7$2 Left Hinge Right Hinge Bank completion form signetl at installation
Hopper 491 Entry Door Style r
Awning 351 Color In: Out: TOTAL
Garden Window 798 Fiberglass Steel CA_SHk f✓ r
Bay Window(Roof/Soffit) HDWR: SN BB AGB AS ORB ;r!. RK;E:vc ^'
Bow Window(Roof/Soffit) Other Door r°,,p`" DEPOSIT
Other Color In: Out: WITH
Other HDWR: ORDER..,:..
DESCRIBE WORK&PROMOTIONS APPLIED: TOTAL
-.
INSTALL
Est. Start Date: p. Est. Comp. Date: " - Customer understands this is an"estimated date"
Owner has read and agrees to the terms and conditions on the front and the reverse of this Agreement. Owner
specifically agrees to the(1)Total Cash Price; (2)work being performed; and (3)work not being performed. Owner
understands that this Agreement and any attachments contain all of the promises made by NEWPRO. Owner has been
orally advised of his right to cancel this'transactiod at any time prior to midnight of the third business day after the
date of this transaction and Owner was provided with two (2)copies of a cancellation form explaining this right.
DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES.
(Rhode Island Sales Only): Notice to buyer: (1) Do not sign this Agreement if any of the spaces intended for the
agreed terms to the extent of then available information are left blank. (2)You are entitled to a copy of this
Agreement at the time you sign it. (3)You may at any time pay off the full unpaid balance due under this Agreement,
and in so doing you may be entitled to receive a partial rebate of the finance and insurance charges. (4)The seller
has no right to unlawfullyenter your premises or commit any breach of the peace to repossess goods pprchasel)
under this Agreement. (5)You may cancel this Agreement if it has not been at the main office or branch office of
the seller in the Agreement by registered or certified mail, which shall be posted not later than midnight of the third
calendar day after the day on which the buyer signs the Agreement, excluding Sunday and any holiday on which
regular mail deliveries are not made. See the accompanying notice of cancellation form for an explanation of
buyer's rights.
(Rhode Island Sales Only): Owner acknowledges receipt of required Contractor's Registration and Licensing
Board consumer education materials. El Owner's initials
Fy . lT By: - EIN#_ Signed:
Product Specialist(Printed Name) Owner
r f4
By: Signed: t 4
NEWPRO Operating,LLC(Signature)' T Owner
r
WHITE: Branch Copy YELLOW: Customer's Copy PINK: File Copy GOLD: Finance Copy
us-1s R1m2
ADDITIONAL TERNIS AND CONDITIONS
Walitianhes: A product warranties are provided by the manufacturers of the products that Owner is purchasing. NEWPRO is also
providing Owner with a labor warranty, which covers NEWPRO's labor. Owner understands that Owner should read all the written
warranties for complete details of warranty coverage and that warranties are available for complete review before signing this Agreement.
Late Cancellation: Owner understands that Owner has three (3) business days to cancel this Agreement. Owner understands that if
Owner wants to cancel this Agreement after those three (3) days, NEWPRO does not have to allow that. Owner understands that if
NEWPRO does let Owner cancel, however, that Owner will have to pay to NEVVPRO a late cancellation fee equal to 33.3% of the
purchase price in order to cover NEWPRO's labor,administrative,and material costs,so long as that is legally allowed.
Delay/Unknown Conditions/Damages: Owner understands that if NEWPRO determines within thirty(30)days of the date of this
Agreement that it cannot perform the work according to NEWPRO's professional standards,NEWPRO can cancel this Agreement,notify
Owner of cancellation, and promptly return Owner's money. Owner understands that issues that may cause NEWPRO to cancel this
Agreement include incorrect pricing or unknown pre-existing conditions to the property. Owner understands that NEWPRO is not
responsible for structural or other defects in the property,and that NEWPRO's products do not cure these problems. Owner understands
that the work could be delayed by events that NEWPRO does not control. Owner understands that NEWPRO is not responsible for(a)
damages due to causes beyond NEWPRO's control,(b)damages arising from a delay in NEWPRO performing under this Agreement,or
(c)unintentional damage to Owner's personal property, it being understood that it is Owner's responsibility to remove/secure his personal
property prior to commencement of work.
When Money Is Due: Owner agrees that when the work is"substantially complete", Owner will pay the balance due on this Agreement.
Owner understands that "substantially complete" means the work has-been materially foished, functional as intended, and a final
inspection,permit, or occupancy certificate, if required, has been obtained. Owner agrees that once Owner has paid the purchase price, if
Owner believes any of the work performed by NEWPRO is defective or incomplete, NEWPRO will inspect the work and perform any
service Owner is entitled to under this Agreement and/or any warranty. Owner agrees that if Owner does not pay any of the money when
it is due,Owner can be charged a late fee of 1.5%on the amount owed for each month the money is not paid. Owner agrees that if Owner
defaults on any promises under this Agreement, and NEWPRO hires an attorney to enforce this Agreement,Owner will pay NEWPRO its
reasonable legal fees and related costs or expenses,as long as it is legal for Owner to do that.
Other Understandings: Owner agrees that Owner will assert a dispute, claim,or controversy(hereafter referred to as a "Claim")
arising under or relating to this Agreement only on behalf of Owner's own self and that Owner will not assert a Claim on behalf
of,or as a member of,a class or group in either an arbitration proceeding,a private attorney general action or in any other forum
or action. If a court determines that this specific paragraph is not fully enforceable, the court's determination shall be subject to appeal.
This paragraph does not apply to any lawsuit or administrative proceeding filed against NEWPRO by a state or federal government
agency even when such agency is seeking relief on behalf of a class of buyers. Owner agrees and understand that if Owner finances the
work, Owner's separately provided financing documents will include the number of monthly payments and the amount of each payment,
including any finance charge. Owner promises that he will provide NEWPRO with access To the work area, including access to electrical
outlets. Owner understands that this Agreement and any attachments make tip the entire understanding between the parties. Owner agrees
that any change to this Agreement must be in writing and signed by both parties.
(Massachusetts Sales Only):All contractors and subcontractors must be registered by the administrator of the Board of Building
Regulations and Standards and any inquiries about a contractor or subcontractor relating to a registration should be directed to: Office of
Consumer Affairs and Business Regulation,Ten Park Plaza,Suite 5170,Boston,Massachusetts 02116 Telephone: (617)973-8700.
It shall be the obligation of NEWPRO to obtain any and a1I permits necessary under this agreement,as the Owner's Agent.NEWPRO
shall advise Owner of any necessary permits.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.
Any deposit required wider this Agreement to be paid in advance of the commencement of work shall not exceed the greater of one-third of
the total contract price or the actual cost of any materials or equipment of a special order or custom-made nature,which must be ordered in
advance of the commencement of work,in order to assure that the project will proceed our schedule.No final payment shall be demanded
until the contract is completed to the satisfaction of the patties.
(Rhode Island Sales Only): THIS IS A NON-NEGOTIABLE CONSUMER NOTE.During the term of this Agreement,NEWPRO shall
maintain public liability and property damage insurance covering the work of not less than$500,000 combined single limit, bodily injury
and property damage and workers' compensation insurance as required under chapter 29 of title 28. NEWPRO and/or subcontractors or
material persons may file a lien in accordance with Rhode Island Mechanics Lien Act,chapter 28 of title 34,
(Maine Sales Only): Consumers are strongly advised to visit the Attorney General's publicly accessible website
(www.maine.gov/ag) to gather current information on how to enforce their rights when constructing or repairing their homes.
The Attorney General can be contacted by telephone at 207-626-8800.
Anv alteration or deviation from the above contractual specifications that results in a revision of the contract price will be executed only
upon the parties entering into a written change order.
In addition to any additional warranties agreed to by the parties, NEWPRO warrants that the work will be free from faulty materials,
constructed according to the standards of the building code applicable for this location, constructed in a skillful manner, and In for
habitation or appropriate use.The warranty rights and set forth is the Maine Uniform Commercial Code apply to this Agreement.
If a dispute arises concerning the provisions of this contract or the performance by the parties that may not be resolved through a small
claims action, then the parties agree to settle this dispute by jointly paying for one of the following: ❑ Binding arbitration as regulated by
the Maine Uniform Arbitration Act, with the parties agreeing to accept as final the arbitrator's decision; ❑ Nonbinding arbitration, with
the parties free to not accept the arbitrator's decision and to seek satisfaction through other means, including a lawsuit; or ❑x Mediation,
with the patties agreeing to enter into good faith negotiations through a neutral mediator in order to attempt to resolve their differences.
(Connecticut Sales Only): THIS INSTRUMENT IS BASED UPON A HOME SOLICITATION SALE, WHICH SALE IS SUBJECT
TO THE PROVISIONS OF THE HOME SOLICITATION SALES ACT.THIS INSTRUMENT IS NOT NEGOTIABLE.
The owner(s) of NEWPRO is or has been a shareholder, member, partner, or owner of the following corporations, limited liability
companies, partnerships, sole proprietorships or other legal entities that have been a home improvement contractor during the previous
five years:NONE
From Our Home to Yours... Job#: LEAD PAINT STATUS - t>iRE NLY'=n'I'.
570538 Yr Built: 1986
LSWP: ONE MUST
CUSTOMER GIRARD
E-MAIL
DATE 1-3-14 HOME PHONE 781-248-9037
ADDRESS 19 SABLE RD W
WORK/CELL PHONE
CITY,STATE,ZIP SALEM MA BEST DAY TO INSTALL: M T W TH F (circle one)
PRODUCT SPECIALIST PANES KASSIOTIS
ESTIMATED START DATE
TOTAL#OF #OF BOW/BAY/ GRID COLOR y4 G��Y
WINDOWS GARDEN #OF DOORS (inside/Outside) CAP COLOR
BaY ^Bow Sto TSOL tom.DMFG: NAPCO / NorandexGamen�Shelf� Steel Contour tOther
Roo( v Soffit Patio Prairie (circle one)
Diamond PVC I Smooth
Locks&Keepers(circle one)'•' White ' Almond Bronze Brass (circle one) (circle one)
Handles&Night Latches(circle all that apply): hite Almond Bronze No Bottom Handles Night Latches(Night Latches are Nora standard feature)
Inside Color(circle one):LWhite )Natural Oak London Walnut Colonial Cherry Muskoka Oak Barrister Oak
"". �.tICC
Outside Color(circle one): White .Brown Wicker Forest Green Wedge Blue Sandstone Burgandy Bronze Custom
OPENING SIZE STOPS
N0. STYLE W x H U.I. LOCATION GRID SCR IN OUT CONV ADDITIONS OPENING CUT
1 1065 71x48 119 LIV F .7
2 10 71X48 119 LIV F / - _7 J . ) -73 1, 5
3 x x
4 x x
5 .' 'r`�L; `'� u'.�" x x
6 x x
7 { x x
8 /J x x
9 / p
L x x
v
10 x x
x x
12
13 x x
14 x x
15 z x
16 -- x x
Initials Dale Crew rze Needed Tme It am9 two complet •job_._ , pping Type
Special Installation Instructions: "?
The Commonwealth ofMassachusetts
Department oflndustrial 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
NamC (Business/Organization/Individual): Ale.("� lr ) l ) ra f M Ll_
I
Address:
City/State/Zip: urn MY q c13of Phone
Are you an employer?Check the appropriate box: Type of project(required):
1. ] I am a employer with `SO 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. t 7 Remodeling
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 are a corporation and its
required.] officers have exercised their M❑ Electrical repairs or additions
3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions
myself. [No workers' comp. c. 152, §1(4), and we have no 12.❑ Roof repairs
insurance required.]t employees. [No workers' 13.❑ Other
comp. insurance required.]
*Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
f Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information
I air an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information. n
Insurance Company Name: Log c J<w)K ,?, f n t r-o nce.
Policy#or S elf-ins.Lie. #: ( )C - -,�c" -aC, - (00 �E _ J Expiration Date: ,
Job Site Address: I I S IQ, RA .t City/State/Zip"SlIer r) rl'j A dl 97 a
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 hnprisonment,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 thepains and penalties o perjury that the information provided above is true and correct.
Signature: Date: .0 4"
lly
Phone#: L t
Offrcial 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#:
C��p r(true/blrogneYlAG r/n.��nlJn('�aJ���J
ffice of Consumer Affairs&Business Regulation License or registration valid for individul use only
"3
ME IMPROVEMENT CONTRACTOR before the expiration date.If found return to:
.-kryRegistration: 146589 - Office of Consumer Affairs and Business Regulation
M Type: 10 Park Plaza-Suite 5170
Expiration: 5/5/2015 Supplement Card Boston,NIA 02116
NEWPRO OPERATING, LLC.
THOMAS FOXON
26 CEDAR ST. cz— �
WOBURN, MA 01801 - /f r
Undersecretary Not valid without sigq lure
Massachusetts- Department Of Public Safety
Board of Building Regulations and Standards
Construction Super,'isor, _
License: CS-029090
TT3051ASPFOXQ1u s
230 WALNUT ST�
READING MA 0186T e -
,.plration
Commissioner 11/19/2015
r ."
RegionsENERGY STAR"' 01.1alified
in Highlighted
1
®=Quellfled In all zones
NEWPRO MANUFACTURING
CNFJ SERIES G NEWPRO 2000
HORIZONTAL SLIDER
Cellular PVC frame,Triple glazed,
Ralln NeO CowrL® �Feneahellan Low E coating( 'e 0 027,$2&5),
),
® Krypton/air filled _
OEV•K•20•00030.00001
ENERGY PERFORMANCE RATINGS
U-Factor(U.S.A-P) Solar Heat Gain Coefficient
0 . 17 0.24
ADDITIONAL PERFORMANCE RATINGS
Visible Transmittance Condensation Resistance
0.40 70
prod.ac arere0palefes metf0ese manpa eonlorm to applicable NFAC pmcetlureamr tldIll lj
_
protluct pertonnence.N1410.11.98.ro tlea:nnlned fore Netlsetafemlmnmemal condltlons
specl0c product size.NFHC does not recommend eny pprotluc[and does not warrsmthe sullablarty specific use Consult manufacWrer'e lNemmm for other product performance i
w .nfrc.or