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79 VALLEY ST - BUILDING INSPECTION (2) Y The Commonwealth of Massachusetts RE EIV ° Board of Building Regulations and Standards INSPECTI HA QTCES Massachusetts State Building Code, 780 CMR SA EM ' .Revised Mar 201 _ Building Permit Application To Construct,Repair, Renovate Or DemlowMA`( One-or Two-Family Dwelling ,This Section.For Official Use.Only" Building Permit Number - Date Applied: Building Official(Pnnt Name}. - Signature SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map &Parcel NumbersIN - - V l.la Is this -,accvpted street?yeses_ no ivlap Numb Parcel 1 :.-a '1,� ,,ntn� _r [ . . Prope, -. din nsao: lot- Zoning vistrict ProposeJUse Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Prccided Required Provided Required Provided 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: %one: __ Outside Flood Zone? - - Public❑ Private-❑ Check if yes❑ Municipal❑ On site disposal system- Ll . SECTION 2: PROPERTY OWNERSHIP' zOwnert of Record _1 Name(P 't t) City,State,ZIPTdo.and Street J --- -- -�- Telephone Finail Address SECTION 3:DESCRIPTION:OF PROPOSED WORK=(check all that apply)` New G:•mstruc[ioa❑ Existing Building❑ Owner-Occupied ❑ Repairs(s Aheration(s} ❑ • Addition C Demolition ❑ Accessory Bldg. ❑ Number of Units Other ❑ Specify: Brief Description of Proposed Work': -fines-1-a 1 l 1 40 o r i n+O CX I a l Day pi c� SECTION 4:ESTIMATED CONSTRUCTION COSTS " Item Estimated Costs: Labor and Materials Official Use Only 1.Building $ 3{Q p Q O 1. Building Permit Fee:$ Indicate how fee is determined:r' ❑Standard .CityfToivn Apphcahon Fee 2.Electrical $ - ., " p Total Project Cost"(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ - 4.Mechanical (HVAC) $ List: e 5.Mechanical (Fire $ ', Suppression) Total All Fees.$ Check No. Check Amount: Cask Amount < 6.Total Project Cost: $3,f 00 ob 11 Paid in Full ❑Outstanding Balance Due i 1 SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) "09 ci License Number Expiration Date Name of CSL Holder ., List CSL Type(see below) bil `- Q6 c'e.4ar 51 — No.and Street Type Description j gnb Q l0 tll� Q D) __ U Unrestricted(Buildings u to 35,000 cu.ft.) R I -Restricted 1&2 Family Dwelling City/Town,State,ZIP - M Masonry �— RC Roofing Covering _ WS Window and Siding - -�n SF Solid Fuel Burning Appliances _ /� 1� •�{�OZ) X 3,-1 _ T Insulation Telehone Email ad ress (' D Demolition" - 5.2 Registered Home Improvement Ca:„tractor(HIC) _ - , `4 6S2 C _S.-IS Ne.IO Gf I LC HIC Registration Number Expiration Date : 'SIC Con .nv ame of HIC.Registrai Name, - f ctr SF, +z)r,-,4;oX6/-Q N .and Street Email ad -- Wc6i(c), M-A n18oI `7dl G33-�lda City/Town, State,ZIP Telephone SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.1k.§ 15C(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 ...... No........... ❑ - <" r SECTION 7a: OWNER AUTHORIZATION TO CE.COMPLETED.WHEN " OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,as Owner of the subject Property, 3 hereby authorize N tkjp,-a r -hnc3l LLc, to act on my behalf,in all matters relative to work authorized by this building permit application. __Ae s�°M—ZA-�- --- 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. Print Owner's or Authorized Agent's Name ..lectronic Signature to ( - 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. og 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 basementlattics,decks or porch) Gross living area(sq.ft.) Habitable room count 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 I�� N - .® C1t Reg#0605216 Ill's �� Contract# - RI Reg 926463 Fne9lIDvin➢Name uwmwm.no- Federal ID#20-2625129 Corporate Headquarters,26 Cedar St Wobum,MA,(P)800-342-2211 IF)781-933-9626,www.newpro.00m 65599 THIS CONTRACT MADE THE /11, day of y 20%f_between {i A> Vc,.J-W g7l-7y5 fly/' (H Descent,) e� (Name Phone) (Bus/Cell Phone) of 7 7 //�/ ty I r f 4 1 !1 C) /)7\ (Address) (City) (State) (Zip) 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: (Job Address) a-I ElThe job address is a condominium. TOTAL# RO WINDOW OPTIONS . -,frrk-;`. � '- ...f& WINDOWS K, SERIESp Grids: YES NO A CONTOUR 8DL EURO., DIAMOND Window Color CITY Window Colo OBS/TMP:lmcaopn/ ❑TOP []BOTTOM Int: InL screens: color Full Screen Standeret []HALF ❑FULL Ext EXC Vent Latches: ❑YES LJ NO Capping Color: DOORS x ;cinema in 1*MODEL QTY Please initial: PVC Smooth NoMar No Capping Sliding GiasS Door•'i;: [ of i M� ' h10DELNAME `',% .g` . MODEL# - QTY,.: cowl m: asmmer onasrstanast PROS Double Hung 755 Active: ere eemer Riebe noes not do any painting or staining. 2 Lite Slider HDWR: SN B WN BGE (is'.again removing or replacing'riedor 3 Lite Slider der nra.t¢tr°) 757 753 EntryIDoor Style i,' I stopsortam). NEWPR001snotrwpon- 3Lite5lider (In,vs,,In) 75fi 1 color en LJ,S our y sibleforwntliaorearco-cumstancesbe - Casement(HingedRight) 851 Fiberglass '� yondds conbol induamg wneensagon resu¢- Casemenl(HingetlLe%) _852 HDWR: SN B. AGB AS ORB ingfmm or tluo tp preexisting conditions. Twin Casement 853 $idebte S le="" .e (c/rcte one). Stationary Casement 856 c In out: ��Lpt9H. Thple Casement om tl0,,14) 659 $term DOOfSn' Balance padrkos ar at rompiabo,, Triple Casement (in.in,in) 860 Dolor Picture Window 751 Iffri SN Be AGB AB FINANCE Sash Only 752 Leff Hinge RrOM Hinga Bank wmpletion form slices,at installation Hopper _491 EntryDodr`Slyle Awning 351 cmor m: oue ,TOTAL' Garden Window 798 Fiberglass seal Bay Window(Roof/Bona) HDWR: SN Be AGB AB ORB Bow Window(Rocl/Soffit) Other Door s,:..J DEPOSIT Other c l i p Our % i""': /�Up Other HowR: ORDER�. DESCRIBE WORK&PROMOTIONS APPLIED: :'TOTAL°"; I AUE ATI� OIJ ANSTALL' Est.Start Date: Ili 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 transaction 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 unlawfully enter your premises or commit any breach of the peace to repossess goods purchased 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. Owner's initials By` EIN# Signe Product Skx,5.a5iafPdnted Na Owns By: Signed: NEWPRO Operating,LLC(Signature) Owner ' WHITE: Branch Copy YELLOW: Customers Copy PINK: File Copy GOLD: Finance Copy s 6mtz t ^ ;. ;'ur - 1 han OurFl#nce to Yours * JOB#: LEAD PAINT STATUS M!] 7 L Yr Built:LSWP: ONE MUSTWI#dbWcSidingandiMdrb Pageof EXEMPT: BESELECTE I� ` CUSTOMER ,�A.Ucv,j�L. E-MAIL e DATE ` /C. /4 HOME PHONE >� � y- si yr `ADDRESS .� .: GL x�/ f� WORK/CELL PHONE 'CITY STATE 74 LcA t/"„ ZIP BEST DAY TO INSTALL: M T W TH F (circle one) PRODUCT SPECIALIST ESTIMATED START DATE TOTAL#of #OF BOW/BAY/ *EXTERIOR - GRID COLOR WINDOWS GARDEN CLADDING #OF DOORS (inside%outside) CAP COLOR Gay —Bow'— White Storm—r— �MFG: NAPCO / Norantlex / Gartlen Sherc Steel 1 COntouf � Other Rao/ or Soffit Painted Patio Prairie (cire/e one) Diamond Locks&Keepers(circle one): White Almond Bronze Brass Satin Nickel PVC / Smooth (circle one) (circle one) Handles&Night Latches(circle all that apply): White Almond Bronze Satin Nickel Brass No Bottom Handles Night Latches Inside Color: White Natural Oak London Walnut Colonial Cherry Banister Oak Outside Color: White Basic Brown Almond Forest Green Tuxedo Gray Clayslone Mocha Bronze Winterberry Wedgewood Blue Window Model: OPENING SIZE STOPS NO. MODEL WxH U.I. LOCATION GRID SCR IN OUT CONV ADDITIONS �( ENING CUT_ b3De6 261 &3 J3�- x x �{!jt x x x x x x is � I x p x x x x ono A (,// x x x x x x x x x x x x x x Measureman: x x �} Initials Date Crew Size Needed Time Frame to complete job Capping Type r"0: Speciaa nstallation Instructions: LP4Jt 9k' /Lr OLLo r.y�JL�, yw/A. �,��. s PRE-INSTALLATION INSPECTION MATERIAL CHECK LIST CUSTOMER NAME — --- ADDRESS__—�--��``i—� PHONE: DATE: Please Circle TYPE OF HOUSE EXTERIOR OUTSIDE CASING CASINGS 2 Story Aluminum Siding 908 Brick Mold 2 1/2 Clam 3 Story Asbestos 4 Bend 2 1/2 Colonial Camponelli's Brick Blind Stop 3 112 Clam Cape Clap Board Crown Headers 3 1/2 Colonial Raised Ranch Stucco �IaL— Belly R — Narrow Metal Fin Flat Split Entry n f Sidi Permashield Tri Level Wood Shingles CONSTRUCTION TYPE OF INSTALL STOOL STOPS Barn Sash Aluminum Track 2 1/2 1 5/8 Colonial Say Removal Anderson 3.1/2 2 1/2 Colonial Bow Removal Outside Install 4 1/4 1 518 Ranch Enlarge Opening Plastic Track 5 Bull Nose Garden Removal Replacement 6 7/8 Colonial Mullion Removal Steel Frame Clear Silicone Scotia Reduce Opening Thumb Latch Latex Weight Pockets White Silicone Wood Conversion List all other information and Stock Needed - a 1/6/2014 10:02 AM FROM: Fax TO: 17819320860 PAGE: 001 OF 001 DATE IS IMMIDDIYYYY) CERTIFICATE OF LIAI3 UTY INSURANCE 1/T" 014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY 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 certificate holder is an ADDITIONAL INSURED, the Policyles) must be endorsed. If SUBROGATION IS WAIVED, subjecl to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the "- certificate holder in lieu of such endorsement s . PRODUCER I — N Melissa Pflug Mackintire Insurance Agency Inc PHONE (508)366-6161 FAX (508)366-5202 11 West Blain Street16A D Ne: IL ,melissap@mackintire.com INSURER 9 AFFORDING COVERAGE NAIC e Westborough MA 01581-1931 INSURED INSURERA:Peerless Insurance Co. 24198 Neeapro Operating LAC INSURERSA.cadia Insurance Co. NSURER C 26 Cedar St. INSURERO: INSURER E Woburn MR, 01801 1 IN♦BURERf: r I)iIS� UCLKIIHY IHAI IHE YVLIL rES(�.�rrNgUff/(�(t`�LrrI EL'tltLOLP MX06S$EEN ISSUtU IV IHt INSUKOWA,t�l7 I,96VUM IHE POLICY YEKIOU INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO VVIICH 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.LIMITS SHOWN MAY INSR HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE POLICY NlA18ER MMI IOO VEY\N MMI IODIVE1'VP LIMITS GENERAL LIABILITY X EACH OCCURRENCE $ 1,000,000 COMMERCIAL GENERAL LIABILITY EACH 1 o $ 100,000 I A CLAIMS-MADE a]OCCURBP BSB9577 2/31/2013 2/31/2014 MEDEXP(An one Orson) $ 5,000 PERSONAL BADVINJURV $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 X POLICY PR � LOC 4DTOMOBILE LIABILITY 000 , .A ANYAUTD 1 000_ r-. _ - E.;t,ILli " ' �iPer n ALL DWNED X SCHcDULED 0584174 / / ADIOS AUTOS 2/31/201311.2,33.2n1a(BODILY IJJUII (Per o L.entl $ X HI..0 AUTOS X AUTOS ED Of 'L)4 $ unlnsureamolonst Bls I¢Ilmq $ 250,00 X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 5,000,000 A - EXC;SS LIAR - CUIMSMADE AGGREGATE - $ 5,000,000 _ CEO X RETENTION 30�000 V 8562576 2/31/2013 2/31/2010 B WORHERB COMPENSATION $ AND EMPLOYERS'LABILITY Vu9 STATU- OTH- ANY PROPRIETORrPARTNERIE%ECUTIVE YIN T R IT OFFICEWMEMSER EXCLUDED'! ❑ N/A EL EACH ACCIDENT $ SOO O00 (Mandatary in NM) -20-20-003506-01 /1/2013 A/2014 --- Ifyas,desoibeuntler E.L.DISEASE-EA EMPLOYE $ 500,000 DESCRIPTION OFOPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500 000 DESCPoPTIDN OF OPERATIDNS I LOCATIONS I VEHICLES (gtlaeM1 ACORD tat,Addltlonel Remarks SCM1edulq if more Spate Ie required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN To Whom It May Concern ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE T Moynagh/MARTAN ACORD 25(2010105) ©1988.2010 ACORD CORPORATION. All rights reserved. INS025(zolooslDl The ACORD name and logo are registered marks of ACORD - The Contfnonwealth of Massachusetts Department Of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 UV = www.ntassgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le tbly Name (Business/Organization/Individual): Address:, s;2e, C Ja L SST City/State/Zip: (�! r 1-n q (::)l 301 Phone F an employer?Check the appropriate box: m a employer with Type of project(required): 5� 4. ❑ I am a general contractor and I ployees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction m a sole proprietor or partner- listed on the attached sheet. t 7. Remodelingp and have no employees These sub-contractors have 8. ❑Demolitionrking for me in any capacity. workers'comp. insurance. [No workers'comp, 5. 9. ❑Building addition P ❑ We are a corporation and its required.] officers have exercised their 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 1 L❑Plumbing repairs or additions myself [No workers' comp. c. 152, §1(4),and we have no insurance required.] t 12.❑Roof repairs employees. [No workers' comp. insurance required.] 13.❑Other *Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit new affidavit indicating 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 an employer that is providing workers'compensationinffoormastion. insurance for any employees. Below is the policy and job site Insurance Company Name:_h3gr br7 K2, n fit, r. nre �a � Policy#or Self-iris.Lie.#�6� : �t IC . 1 .. o _ Od3So� ) Expiration Date: IS: Job Site Address: �]- City/State/Zip! � B01970 Attach a copyof the wopensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as requued 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 pe11 ties 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 a Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties ofpei jury that the informadotr provided above is true and correct. Si nature: _ Date: Phone#: 7,V— FF,alely. Do not write in this area, to be completed by city or town officialPermit/License# ity(circle one): alth 2. Building Department 3.City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector Contact Person: Phone#i f s W- 9� fice of Consumer Affairs&Business Regulation License or registration valid for individul use only ME IMPROVEMENT CONTRACTOR before the expiration date.If found return to: egistration: �146589 ' Type: Office of Consumer Affairs and Business Regulation Expiration: 5/5/2016 10 Park Plaza-Suite 5170 NEWPRO OPERATING,ILC.� Supplement t:ard Boston,MA 02116 THOMAS FOXON 26 CEDAR ST. WOS URN. MA 01801 / Undersecretary Not valid without sigry tore Massachusetts--Department of Public Safety Board of Building Regulations and Standards Construction Superxisor License CS-029090 THOMASP FOXQN - 230 WALNUT STL, •" r READING MA 03867 iratior. Commissioner 11/19/2015 -