47 WHALERS LN - BUILDING INSPECTION The Commonwealth of Massachusetts
1� Board of Building Regulations and Standards Towncif
�'•,Si Massachusetts State Building Code, 780 CMR, 7'"edition
� Building Dept
Building Permit Applic 'on To nstruct, Repair, Renovate Or Demolish a
One- or Tw -Family Dwelling
This Section For Official Use Only
Building Permit 4um1�ber: Date Applied:6"b—G+ Q
Signature: /0 /
Building Com oner/Inspect B .dings Date
S ION l:SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map& Parcel Numbers
t-h Wh0 LCn�
I.1 a Is this an accepted street?yes_ no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
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:
Public❑ Private❑ Zone: _ Outside Flood Zone?Check if yes❑ Municipal❑ On site disposal system ❑
SECTION 2: PROPERTY OWNERSHIP[
2.1 Owner of Record:
Llndo SucaF,no y -7 Whalers Ln .
Name(Print) Address for Service:
A a- ?n 8- -7`--I 5 516 y
Signature Telephone
SECTION 3:DESCRIPTION OF PROPOSED WORK:(check all that apply)
New Construction❑ Existing Building❑ Owner-Occupied ❑ 1 Repairs(s) G]" Alteration(s) ❑ I Addition ❑
Demolition ❑ Accessory Bldg. ❑ Number of Units_ Other ❑ Specify:
Brief Description of Proposed Work':
/l" V 11 L-1 wl✓) <lowi
FRC e I
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
Labor and Materials
I. Building S J�w(o� 1. Building Permit Fee: $ Indicate how fee is determined:
❑Standard City/Town Application Fee
2. Electrical $ ❑Total Project Cost(Item 6)x multiplier x
3. Plumbing $ 2. Other Fees: E 1/
4. Mechanical (HVAC) S List: .J
5. Mechanical (Fire S
Suppression) Total All Fees: S
Check No. Check Amount: Cash Amount:
6. Total Project Cost: S 51D(o r) 0 Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Licensed Construction Supervisor(CSL) 2 q O ci h
r
.,. •�04'Y1GS I" f'Ux on License Number Expiration Date
N.4me of CSL-Helder List CSL Type(see below)
► _ (o C�C�a� St T Description
Addre �u(n U Unrestricted(up to 35.000 Cu. Ft.)
R Restricted 1&2 Family Dwelling
Signature M Masonry Only
7 RC Residential Roofing Covering
Telephone WS Residential Window and Sidin
SF Residential Solid Fuel Burning Appliance Installation
D Residential Demolition
5.2 Registered Home Improvement Contractor(HIC) I (_� (O�j�C)
NPL"uDrb
HIC Company Name or HIC Registrant Name Registration Number
�(n CeC1r S Ereet Wo{7uln 5 (5 � 20i/
Ad�r � - 7 R I .q Sol_R 3C)C) Expiration Date
Signer _T Telephone
SECTION 6: WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152.4 25C(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..... ..... O
SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
1, (,L r\d o- as Owner of the subject property hereby
authorize t\ P t t inv to act on my behalf,in all matters
relative to work authorized by this building permit application.
�(� �v/(�
Si nature of Owner Date
SECTION 7b: OWNEW OR AUTHORIZED AGENT DECLARATION
1, Th UY1'1 QS P FOX Or 1 ,as Owner or Authorized Agent hereby declare
that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and
behalf
col s P Fo�ovl
Print Name
Signature of Owner or Authorized Agent Date O r0
Si ned under the pains and penalties of riu
NOTES:
I. 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 and
Construction Supervisor Licensing(CSL)can be found in 780 CMR Regulations I I0.116 and 110.115, respectively.
2. When substantial work is planned,provide the information below:
Total floors area(Sq. Ft.) (including garage, finished basement/attics,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 5308 13 n FeWWRIG deral ��0-2625129
J O
CT Reg#0605216
RI Reg#26463 window;Siding and More
Corporate Headquarters,26 Cedar St,Woburn,MA,(P)800-34/2-2211 (F)781-933-9626,www.newpro.com
THIS CONTRACT MADE THE— day of A .
i `/ 20 09 between
L,vr� Ser,:Xnio f 7k-7Y-r-5' 6 V /off- WO 419
(Home Owners) (Home Phone) (Bus/ el Phone)
of `f / bl,/L/el-s � �9 4•m A 111 f77}
(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-Mail) r propnetary use only
TOTAL Additional Model TOTAL
Windows Purchased NEWPRO Work Number Qty CASH 1
Window Color In: Out: Sliding Glass Door PRICE
Capping Color r-/� t r/„ _ Steel Securi Door
W f, Door olor In: Out: DEPOSIT
Model Name Model Numbers Qty Sidelites - WITH 56t
Double Hung New Construction Unit ORDER
Picture Window Storm Door BALANCE
Casement — Obscure Glass TOP IBOTTOM DUE AT
2 Lite 13 Lite Slider Screens HALF U INSTALL J L
Ba /Bow Fra — Please Initial., K.
Roof me.' ❑ Soffit: ❑ Customer understands that kEWPROO does not CASH
Garden Window do any painting or staining. lie:when removing Balance paid to installer at installation
Awning or replacing interior stops or trim)
Hopper — NEWPRO®is not responsible for conditions or
Shaped s circumstances beyond its control including con- FINANCE
Other densatlon resulting from or due to pre-existing Bank completion orm signed at installation
conditions.
DESCRIBE WORK: (4e LJi n44Dw Y . r n e n
Est.Start Date: 7 `Z�'d�/ Customer understands this is an"estimated date" iC Est.Comp. Date: 5,
KN?Fa
a e a 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,Room1301,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.
DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES.
. The owner has seen"sample"warranties that will be provided by NEWPRO upon installation. Sample warranties`provided to Owner.
IN WIT ESS WHEREOF,the parties have hereunto signed their names this day of A0'TJ / 20 d
/A �rY/"f 5� EIN# Signed
Marketing Representative Printed Name Owner
Accepted: NE perating,ILL
ey �- Signed,
Owner
CORPORATE OFFICE - SHREWSBURY BRANCH OFFICE WARWICK BRANCH OFFICE
26 Cedar St 151-153 Memorial Drive Business Pk 24 Minnesota Ave
Woburn,MA 01801 - Suite B-C Warwick,RI 02888
(P)800-242-9974(From NE) Shrewsbury,MA 01545 (P)800-356-3312(From NE)
IF)781-933-0717 (P)800-456-0555(From NE) IF)401-732-1371
IF)508-842-9248
WHITE: Branch Copy YELLOW: Customers Copy PINK: File Copy GOLD: Finance Copy
US-15 R0508
Frain Our Hume to 1bws. - '
s JOB# J Wt@dawi dfdmypndMoft Page of
CUSTOMER `n�"-
F-MAILADDRESS -1 lj"LlrsP.r'4 yt YL6 +.�'�YlOfir'k7 il HOME PHONE 179-777J- IS/e i/ -
DATE WORW LL IONE �'S - i�'''�k.4
moo
ADDRESS 4I Like,te s it-.n .
BEST DAY TO INSTALL: M T W TH F
CITY,STATE 5ci tj R (Please circle one)
PRODUCT SPECIALIST 6(e°SS Go BRANCH: ESTIMATED START DATE
TOTAL#OF. #OF DOORS WINDOW COLOR .
WINDOWS #OF BOW/BAY/GARDEN storm,Steel,Pave 'Inslde/Oulslde CAP COLOR
® ��`I
OPENING SIZE I STOPS
NO. -STYLE W x FI U.I. LOCATION IGRIDJ SCR IN OUT ADDITIONS OPENING I CUT
! ) l 36m5o JRG G5J r x x
(07 1 S"T Ci x
103 3&1V50 9 L.r. o x x
to K 8& L o P x x.
A QT�
x x
r
x x
x x .
x x
x x
x x
x x
x x
. x x
x x
x. x
Measureman: - -
Initials Date Crew Size Needed Time Frame 10 complete job Capping Type
Special Installation Instructions:
hou
Directions to site' '
S/7/2009 3:S9 PM FR4Y: Meckin[Sb Ineu[in..Mackin[iTe Inaueance AOen TO: 8.1701,320860 PAGE: 002 OF 003
ACORD CERTIFICATE OF LIABILITY INSURANCE os—77 09
R- (508)366-6161 FAX (508)366-5202 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
4ackintire Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE -
11 West Main Street - HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR
ALTER THE COVERAGE AFFORDED.BY THE POLICIES BELOW. -
Westborough, MA 01581-1931
INSURERS AFFORDING COVERAGE - NAICW
,I..Newpro OPeratiog LLC IIBMBtA Peerless Insurance Co.- 24198 -
26 Cedar St. - INSW W
Woburn, MA 01801 1,o w C
IMIAFRm - -
IMWEAE
OVrRAQFS
-THE POLICIES OF INSURANCE LISTED aELOW WIVE BEEN ISSUED TO THE INSURED N0%MEDA8ENE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING -
ANY REOIIIREMEM,TERM OR CONDITION OF AM COMRACT OR OTHER DOQIMEM WITH RESPECTTO WHICHT,11S CERTIFICATE MAY BE ISSUED OR -
MAY PERTAIN,TIE INSURANCE AFFORDED SY TIE POLICIES DESCRIBED HEREIN IS SUBIECTTOALL INETERMS.EXCLUSIONS AND CON0111=OF SUCH
POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
D TKEDFWSYWWCE POU"NUMEER POYCVEFFECnIW PDLI EIPIRATON DIDIB
"-RALLMBILM P $598370 - MA POLICY 12/31/2008 12/31/2009 EIb10CCWPFHCE s 1,000,
X wMnERCPa aENfRnl LIPDE P 9589577 - RI POLICY - s 300.00 ,yam ✓ v� �'�'a`��`u�
CINAe MINE O DCNR MFD EYP(My uu prsm) s 15,00 Board of B.ildi.g Regulations and Standards
Ilw- PERsoNa•ADV INM+r i 1,000,00(
HOME IMPROVEMENT CONTRACTOR
GEFIERraAooREaore 1 2,000.00
OEIM1PffAEWIE LNIROLPIIES PER: PROp1C15-rA`BAD YF i 2,000,000
- � Registrat0.11:�146589 ,..
nVlRwaeoeuseAlrc BA SS8417a 12/31/zoos 12/31/3009 ,�s,NElEluar EXpiraUOn $%5/2011
ANrwro IEexHawl ` 1 000 000
X nSuC.I EoOvmLLmFD AWrtIoCIsS eIParo lFl�rr mwOu w
plemen
t Card-TtP
f pE A X wPEounas 9mnvwury NEWPRO OPERAtiNz'rul.O Wl
% ea+owemruros - - 91=1 eR1 i -+ter' z.
THOMAS FOXON�".
26 CEDAR ST.
6NIAOELUaRm' ADroolav-EAAcaDEM s WOBURN,MA 01801
Administrator
PNV AIeD �� EAAcc i _ j
AuroolAr: aCC s -
EseEssEnaREwueeam CU 3592571 12/31/20DB 12/31/2OD9 4 s 000 00
x' «ow �awR6MnoE PLGPEfiRE i 5,000.00
A r
DEDucnala s ,
X aElEHnav s 10,00 $
WOMFAP<oNPENunONNID T—OY
T4
eMnorEarueeurtr WC8645974 05/01/2009 05/01/2010 ES.EAMPK'ICENT i .500 00
A Pm FROPRR3IXUPPARt>�CI _
oFrICOLMEMEERExawED9 E.L.DI9EASE-EIEM%D s 500.000 .-
u 9vunw laNa -
ESE°-'cw PRovlsloxs wl.,. Ex.olsPwsE-Pale l.wrz1$ 500.00 �ja
oTHEa - ' Board of Budding Regulations and Standards� I 1
3EecmFToxocoPERAnoasnounoxslvEiECLBsIsscLusmNsaooEoerFNooRssMMnlsPEcuLPROMnoxs I i Construction Supervisor License
Ulc 4s CS 29690
L9/2009 Tr# 8131
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fXOIaOMlIOF1NE190W OESCR06a POL1OF]8G CY10ELlCD aFFONEINO ,-�.� 3b �
' EYPvuTmx wTETNEREoq TNenOuwoneuRERwuU E.mEAwnroNNl 'QFRTIFICATS HOLDER CANCELLATION
THOMASP FOX
/ a
14_oAro wWRWu xonwTO TNEcasmute lmLOEauwEOroTNE LEFT, I 230 WALNUT ST
Taws of Saugus aurFANUREroMsa sucHwoTlo;awu most NOOBDOATmN ORusMury I RF14pING,MA 01867
298 Central Street oPAMNNO NP4NTHe wsuRER,ns AOP3m oRREPREaaRAllVEa ,.- Commissioner
Saugus. MA MRXOw>'IDRFPREiENmTNE I .
Timothy 3. Noynagh �.-
'/aCORD25(200/108) OACOROCORPORATION 798E - - J
ouu rrusrungtunrrtre;w
--
www.mass.gaddia
+8t,.CAutPdlasatl°�InsuxanceAf�davtt: Ouildels/contractors/JE]pleaseRrntLe bl .
Applicant Information "
Name(Business/Organization/Individual): NEWPRO
Address: 26 CEDAR STREET
City/State/Zip: WOBURN,MA 01801 Phone#: 781-932-8300 Eat.251
Are you an employer? Check the appropriate boa:. Type of project(required):
1,X I am a employer with 50+ 4. ❑ I am a general contractor and 1 6. ❑ New construction .
employers(full have hired the sub-contractors _? X Remodeling ,
listed on the'aftached sheet.$
2.❑ I am a sole proprietor or partner- These sub-contractors have a. ❑ Demolition
ship and have no employees workers' comp.insurance. 9, ❑ Building addition
working for me in any capacity. .
[No workers' comp:insurance 5, ❑ We are a corporation and its 10;❑ Electrical repairs or additions
required.) officers have exercised their.
3.LiI am a homeowner doing all work
right of exemption per IvIGL l 1,❑ Plumbing repairs or additions
c. 152, § l(4),and we have no 12,❑ Roof repairs
myself. [No workers'comp.
insurance required.]+ employees.[No workers' 13.❑, Other'
COMP,insurance required.]
spm,"applicentthatchecksbox#lmustalsofill Out the seetionbel all owshkdt�heir Laeko�ldemnh'aCtm�smustsubtlicY anewaffidavltindicattagsuch. -
+Homeowners who submit this'affidavit indicating they are dig
$Coniractora that check this box must attached an additional ehea t showing fits name of the aubcoatradwa endtheu workers'comp.policy infatmatton.
insurance form ent to ees.Below is the policy andJoh site Information..
compensation in Y P Y ,
In worJrers A
1 am an employer thatls provld g -
Insurance Company Name;.
Policy#or Selfins.Lic,#- 90967005
Expiration Date: 05101AM 2oi0
Whaler 5 L•'r) " City/State/Zip:
Job Site Address: u 1 d expiration date).
n policy declaration page(showing the policy number an , p
Attach a copy of the workers- compensation p Y of a
P
secure coverage as required under Section 25A of IvIGL.c•152 can lead to the imposition of criminal penaltiesER and a fine
fine up
to$1,50STOP WOAR OPM
fine up to$1,500.00 and/or otte-year imprisonment,as well as civil penalties in the form of a
ofup 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.'
X do hereby cerll/y under thepains and penalties of perjury the{the Information yrovided above is true rind correct.
FOR NEW-PROData 6 Dom_
Signature ��'•
Phone#: 781-953-8146
Offlcidl use only:Do not wrtie in this area,to be completed by city or town official.
City or Town:
' � - . Permit/License#
Issuing Authority(circle one):'
. Buildin De artrnen 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
1.Board of Health
6.Other
Phone#:
Contact Person:
}
ENERGY S ' rIs . in Highiiglited Regions
=qualified In all zones
r
NEWPRO MANUFACTURING
�rrrac NFWpRO 2000 DOUBLE HUNG
iNAcellular PVC frame,Triple glazed,
Low E coating(en0:034,S2&6),
t net Fene�NeWan ,
Rdnec°undle Krypton/Argoo/air tilled
PRe. M
EV•K-27A0016.00001
ENCE RATINGS
r Heat Gain coefficient
ADDITANCE RATINGS
Vistble Trir Leakage(U.S.A-P)
ON0A
Condensati
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re.NPAC retlnOeemdebmlinedtaeavoeetd dan dae(Mmffimmmu WdMw�IaryaaMa
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