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79 VALLEY ST - BUILDING INSPECTION -Iq G< G3S© The Commonwealth of Massachusetts Board of Building Regulations and Standards CITY OF �f Massachusetts State Building Code,780 CMR SALEM Revised Mar 2011 - Building Permit Application To Construct,Repair,Renovate Or Demolish a i One-or Two-Family Dwelling This Section For Official Use-Only . `+ Building Permit Number. f Dat plied - ^ :• i- Building Official(Print Name) . Si afore. —.. - 8n . . '" Date�.J:" r� SECTION I:.SITE INFORMATION ,„ CP0 1.1 Property Address 1.2 Assessors Map &Parcel Numbers L1,-)L r! —4 q_J N l.la Is this an acted street?yeses no Map Number Parcel Number y/ N 1.3 Zoning Informatior:' 1.4 Property Dimensions: I' l I� 0,:�& A c r� Zoning District Propose •e 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: - Public❑ Private❑ - Zone: _ Outside Flood Zone?Check if yes❑ Municipal❑ On site disposal system- d " SECTION 2: PROPERTY OWNERSHIP' `. 2.1 Owner'of Record: "(Print �ndcr�7in �a,k,n, Il7-A d ) 971� . Name(Prinnt City,State,ZIP No.and Stieet .J Telephone Email Address SECT16N 3:DESCRIPTION OF PROPOSED WORK=(check all that apply] New Construction❑ Existing Building❑ Gwner-Oecupied ❑ Repairs(s) Alterations) El Aduition ❑ Demolition ❑ 1 Accessory Bldg. ❑ Number of Units Other ❑ Specify: Brief Description of Proposed Work': �r�6-j„ Il 5 4Jin�,lnu7r Ir�tz� �k.t`Si�n,� SECTION 4:EST[MATED'CONSTRUCTION COSTS4`. Estimated Costs: Item Labor and Materials Official Use Daly 1.Building $ I Building Permit Fee:',$ =Indicate how fee rs determined:,' �S.Da ❑standard„,city/Town:Apphcabon Fee 2.Electrical $ ElTotal Project Cost'(Item 6)x multiplier x 3.Plumbing $ 2. 'Other Fees: $ 4.Mechanical (HVAC) $ List 5.Mechanical (Fire Suppression) $ Total All Fees $ Cheek No. Check Amount: Cash Amount. 6.Total Project Cost: $ g qZ)a 0 o ❑Paid in Full 0 Outstanding Balance Due 1 SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) , 0�i-9090 - I -( , —FhO(r-)nS �-? FO Xnr) License Number Expiration Date Name of CSL Holder I 1 List CSL Type(see below) V -;�/6 Cedar S+ No.and Street Type Description W O�U/t� fl I�'U I- U Unrestricted(Buildings u to 35,000 cu.ft.) -- t _ Restricted 1&2 Family Dwelling City/Town,State,ZIP M Masonry -- RC Roofing Covering _ WS Window and Siding - - - '�JSs-LJ p L t� SF Solid Fuel Burning Appliances _ _-7`e1 —rp rr'S7-D XZjr'1@i-�C,i,rypri�,[:�.M I Insulation - - Telephone Email address D Demolition _ 5.2 Registered Home Improvement Cirntractor(HIC) _ � a , HI Registration Number Expiration Date HIC om�any Name or C.R4I egistrara&me No. d Street Email ad ess — i)a6L rro, n-A 012o1 7�1J-g33 q1,co City/Town,State,ZIP Telephone SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152.§ 25C(6))'4 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........... ❑ - - SECTION 79:OWNER'AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,as Owner of the subject property,hereby authorize ✓IWCO to act on my behalf,in all matters relative to work authorized by this building permit ap [cation. MG1P�lI 11 Anolv,r�r�------ ------- Print Own 's e(Electronic Signature) Date SECTION 1b: O`A'NEW 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 gent' ame(Electrmic Signature) � D t - 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.eov/oca Information on the Construction Supervisor License can be found at www.mass. ove /dns 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# 5 �� ® - CT Reg# 6051 6 Contract# RI 'RI Reg#2646646{I '� T^we/HHn9xwneMWamm�b Federal 1011120-2625129 Corporate Headquarters,26 Cedar St,Woburn MA,(P)800-42-2211(F)781-9I3133--'9F626,www.newpm.com 66 C 00 3 THIS CONTRACT MADE THE l day of AL) 20 1 I between ll 1'—,1:gec\ l `-4U 51�� (H unfourl (Name Ph ne) (Bus/Cell Phone) of V llev S} Sa��1� MA nia1r) ineptness) (CrtY) .(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 precBises lace at: at: /U eafYle > ❑ The job address is a condominium. (Job Address) DOTAL#S r, NEWPRO WINOOW, PTIONS aJa#R'ShYkt„ I7 w^.>x'r-;.v.r sr " WINDOWS ':'. eERIES# � �., Grids: YES NO ONTOUR SDL EURO pIAMOND Window Color pry ,Window Color CITY OBS/TMP:(Losear) []TOP []BOTTOM Inl: Int: Screens:(Exterior color Full Screen Sttendartl) 1ALF []FULL -- Ext Ext El Vent Latches: []YES 0 Capping Color: DOORS -` *r•,;;.MODEL QT/Please lnldal. PVC Smooth LJ Norman No Capping I !ding Glass Door (v)•�• YODEL NAME ':.MODEL#. -CITY a or In out: cuelomerunderslan Brat NEwPROPJ Double Hung Asti Lan center Right does notdo any painting.,stern,. 2 Lite Slider 757 HDM SN Be wH BE (ie:when remwrg ar repiaung inledor 3 Lite Slider pre,.cunt 753 Entr D TStyle:',V steps or trim).NEWPROOis not respon- 3 Lite Slider (vs,In,tn) 756 Color I Out: able forcand'dionsnrclmumstencesbe- Casement(Hinged Right) 851 Flee lass a'. yonditsruntrnlincludingcondensationresmt- CasemeOl(HingetlLefl) _852 HDWR: SN Be AGB AS ORB Ia.loom or due to preeusting conditions. Twin Casement 853 -- Sid lite S Is ° — ferrete one). Stationary Casement 856 color In: m: CASH g59 c Triple Casement Na,ta,vat Storm Door S e m Balance pai las omplen.n Triple Casement (in,in,tot 860 Color Picture Window 751 HDWR: SN a AGB AS FINANCE Sash Only 752 Left Hln tat Hinge Bank wmplefi.n mom signed a.nswilalion Hopper 491 Entry Door is Awning 351 c ou TOTAL, / 'Garden Window 798 F arglass Ste „CA$H; R )� 2 Bay Window(Roof l Soffit) -_ HDWR aN BB AGB a oae .:,RICE 11) VV Bow Window(aopv some Other oor u - d DEPOSIT Other t 1 In out: WITH�y' Other -� WR: ORDER DESCRIBE WORKS PROMO IONSAPP IED: ;TOTAL" _ r, k m DUE AT", /I_ I� r )N/ rr - .INSTALL V Est Start Date: -S.Ih Est.Comp.Date: Customer understands this is an"estimated dale" 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 pertormed;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. ^f9 - ---- - -- (Rhode Island Sales Only): Owner acknowledges receipt of required Contractor's Registration and Licensing Board consumer educ ation materials. \ �Owner's initials - By:_ UCAA EIN# Signed: x/ 9 � LCM.�.AJLdp�J Product Specialist One, Ow r By: Signed:NEWPRO Operatl Owner WHITE: Branch Capy YELLOW: Customers Copy PINK: File Copy GOLD: Finance Copy US." NEWPRO WINDOWS, SIDING AND MORE 26 CEDAR STREET, WOBURN, MA01801 SERVICE DEPARTMENTS WOBURN (800)242-9974 RHODE ISLAND(800)356-3312 SERVICE REQ ID: M-67423 ORIGIN DATE: 8/1/2014 CUSTOMER: Anderson, Margery ADDRESS: 79 Valley St CITY STATE: Salem, MA 01970 TELEPHONE: 978-744-5145 BUSINESS: CELL: L ORIGINAL OWNER: YES NO YEAR INSTALLED: VENDOR: r CUSTOMER SERVICE REPRESENTATIVE: asullivan SERVICE TECHNICIAN(S): Tom Foxon APPOINTMENT DATE: Wednesday,August 06 2014 TIME: PM - SERVICE REQUIRED: new sale measure. Meausre five windows. Set for Wednesday, 8/6 Pm between 12:00-2:00"'HOME 1 BUILT 1965' YJ C ADDITIONAL SERVICE REQUI3 R`D P X 5 ) SERVICE RESULTS: r TIME IN: TIME OUT: --- LABOR Cb''I4RGES: WARRANTIED _ PAYABLE. ,,r,9.00 HOURS: X $ _ $ PARTS CHARGES: WARRANTIED: PAYABLE: $0.00 COST: $0.00 TOTAL PAID: CLIENTS SIGNATURE: Printed: 81512014 Page: 5 of 6 From Our Home to yours.., JOB#: - LEAD PA1�I((N,�T/� SSTATUS EABUSE TECr ONLY a Yr Built: t-I t�S ' 'esU1t_sm LSWP: :>< ONE MUST Windows,Siding and More Page 7o11ff� EXEMPT: BESELECTE P.,e r( , CUSTOMER e,h� r JOCl11 3 SDYI E-MAIL (� Q [' DATE O� HOMEPHON� L1 � 1��1\ I\ 1HS � ADDRESS �t9C 1/al�rlVeMS�A\ WORK/CELL PHONE 1 V Ik CITY,STATE lCller' 1 , `N ZIP 1 O�`O BEST DAY TO INSTALL: M T W TH CIF (circle one) PRODUCT SPECIALIST 1T 11UYVVV)�n 1 ESTIMATED START DATE -(�l- S-)4 a. TOTAL#OF #OF BOW/BAY/ 'EXTERIOR GRID COLOR - WINDOWS GARDEN CLADDING #OF DOORS (Inside/Outside) CAP COLOR ' Bay'_ Baw'_ While Storm SDL n MFG: NAPCO / Norandex / Garden_Shelf_ � Steel gParrour `.��1 �ZOther Roof arSoffit Patio ra)ne (circle one) Diamond VC / Smooth Locks&Keepers(circle one): White Almond Bronze Brass Satin Nickel (circle one) (cirole one) Handles&Night Latches(circle all that apply): White Almond Bronze Satin Nickel Brass No Bottom Handles Night Latches Inside Color: kite Natural Oak Colonial Cherry Barrister Oak Outside Color:EDBasic Brown CT Beige �h\\Foo/rest Green Tuxedo Gray Claystone Terra Brown Bronze Winterberry Wedgewood Blue Window Model: V l \r(� t 11"T" OPENING SIZE STOPS NO. MODEL W x H U.I. LOCATION GRIDS SCR IN OUT CONV ADDITIONS OPENING CUT IN 5 3ax l ��� z �C �s� 3 x 53 3t sa x ys ` P U l0 5 S2X46 1 l3 I 2 X 3*7 x ' 51F x ys ' K 03 logs a x l4 �o j2 2 �� x -Y x N 1095 a�Xlift � Rj 2 V2 a� x � ' 75 x 2 $ x .17 ? x , 9.7a r_ VV ��C4 x x 014 / x x ,►d i X D' l x x x x x x gg x x �J x x x x - - -- - _- x x x x Measurema nitials L DlaOte Crew Size Needed Time Frame to complete job Capping Type Special Installation Instructions: 10 J� pp „t`, '�jf✓ Ln 33 ' C��C� pack R �� �� Oy\ �e-1�� SJQ -oy 't� CL4�ew�e�1� 1�1S1C�� cR cam, ©AA \ ✓'In( oy S/2/2014 11:16 AM FROM: Fax Mackintire Ins Agcy Inc TO: 17919320960 PAGE: 002 OF 002 .aco CERTIFICATE OF LIABILITY INSURANCE Sit/2014""' 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 INSURERS), AUTHORIZED s REPRESENTAIIVE_OR PRODUCER.-AND D THE,CER. IFICAJE_HOLDER..-e,�._ ._.,,._.w,�. .,.,,.. - =. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policyiies)must be endorsed. If SUBROGATION IS WAIVED, subject 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 endorsements . PRODUCER CONTACT NONE: Melissa Pflug , Mackintire Insurance Agency Inc P (508)366-6161 FAX Ne: (908)366-5202 11 West Main Street .melissa @mackintire.com -- INSURER(3)AFFOROINGCOVERAGE NAICa i- Westborough MA 01581-1931 INSURERA Libert Mutual/Peerless 24198 INSURED - INSURERBAeadia Insurance Co. - Newpro Operating LLC - - INSURERC: - - 26 Cedar St. INSURER D: INSURER E: Woburn - MA 01801 INSURER F: COVERAGES CERTIFICATE NUMBER:13 - 14 Master - REVISION NUMBER: THIS IS TO CERTIFY THAT 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE POLICY NUMBER MI W MMIDDIY LIMITS - GENERAL LIABILITY EACH OCCURRENCE $ 1,000,006 X COMMERCIAL GENERAL LIABILITY PREMISES Es occunence $ 100,000 A CLAIMS-NIADE ®OCCUR BP $589577 2/31/2013 2/31/2014 MED Erie(My oneperson) 5,00 PERSONAL 6 ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGO $ 2,000,000 -FCT X POLICY PR0 LOG $ AUTOMOBILE LIABILITY Ed.coiLIJtxstlent LIMIT 1,000,000 A MY AUTO BODILY INJURY(per person) $ ALL OMED X SCHEDULED 8584174 2/31/2013 2/31/2014 BODILY INJURY(Per.. dent $ X AUTOS HIRED AUTOS X U ED e cadnt"AGE AUTOS P . e $ Uninsuretl motorist Bls lit limit $ 250.000 X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 5,000,000 A EXCESS LIAB CLAIMSWADE AGGREGATE $ 5,000,000 DED I X I RETENTION CU 8592578 2/31/2013 2/31/2014 $ B WORKERS COMPENSATION VrCSTATT- O IE TH- AND EMPLOYERS'LIABILITY ANY PROPRIEfORIPARTNERXECUTIVE� NIA E L.EACH ACCIDENT $ 500,00 OFRCERIMEMBER EXCLUDED? -20-20-003506-01 /1/2019 /1/2015 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,00 If yyne.,da scribe under fre IPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONSI LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule.It more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES:-!'CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. To Whom It Kay Concern AUTHORIZED REPRESENTATIVE T Moynagh/MARIAN ACORD 25(2010/05) ®1988.2010 ACORD CORPORATION. All rights reserved. INS025(201005)01 The ACORD name and logo are registered marks of ACORD 1 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gorldia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual):�1zt�.:-era Address:�t� City/State/Zip: l 2nhum t MAl y/ c?ot Phone#: 3. /Inu Are you an employer?Check the appropriate box: Type of project(required): 1.0 I am a employer with SO 4. ❑ I am a general contractor and 1 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 10.❑ 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#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 anew affidavit indicating such. 3Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am air employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: ,bQQ Is),-)h i-e J-L.S,I ro»c c j,nc Policy#or Self-ins.Lie. #: (,t��; - Q c" -moo ' Od3SoE-. - �.ti J Expiration Date:y` Job Site Address: �� 67-- City/State/Zip: Q Attach a copy of the workers'comp cation 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 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 the pains and penalties ofpeijury that the information provided above is true and correct. Sixmatum �L%y rf%?l Dafe g1o_77Z` Phone#: Official use only. Do Out write in this area,to be completed by city or town Official. `A 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,��r 1(nUr Nlnurrrrn���r/r`��rrJinr�[OC��J 4!five of Consumer Affairs&Business Regulation License or registration valid for individul use only I ME IMPROVEMENT CONTRACTOR before the expiration date.If found return to: Registration: 146589 Office of Consumer Affairs and Business Regulation - Type: 10 Park Plaza-Suite 5170 *�' Expiration: 5/5/2015 Supplement -:ard PG Boston,MA 02116 NEWPRO OPERATING, LLC. THOMAS FOXON 26 CEDAR ST. WOBURN, MA 01801 it Undersecretary Not valid without 5i¢ry lure 4 Massachusetts - Department 0t Public Safety Board Of Building Regulations and Standards Construction Supervisor icense CS-029090 MOMASPFOXQN ' 230 WALNUT ST READING MA Oi86T , - Commissioner 11 ill 9/2015 P ® = Qualed In all zones NEWPRO MANUFACTURING SERIES G NEWPRO 200V La"`R DOUBLE HUNG Cellular PVC frame,Triple glazed, �= National Fenesl atlon Low E coating(e-0.027,S2&5), Reling 0oundlm Krypton/air filled ® DEV•K•27•0003"0001 ENERGY PERFORMANCE RATINGS U-Factor(U.S.A-P) Solar Heat Gain Coeffident 0,17 0,24 ADDITIONAL PERFORMANCE RATINGS Visible Transmittance Air Leakage(U.S./I-P) 0.40 0a Condensation Resistance 70 - Menuiecfurer ellpUld961hetaleep imalpe canhmrla epplkable NFNOprpnntlaeefatletetmlaNAalide pretluclPertamenae.NFlIO retlnpe se tlelermaadfarenetvn eMa�rowNaal7M NuN M-ki ppnduq Yxe.NFPC deee notrocammendWmbd enee pdannagan. protluclloran epxlaaup.Cmeuttmenulepdnhaarg tordNarpretlud pertain a F