20 FEDERAL ST UNIT 5 - BUILDING INSPECTION r 2- -Z
The Commonwealth of Massachusetts
Board of Building Regulations and Standards 7
SAli l w
Massachusetts State Building Code,780 CMR
Revised Mar 201
Building Permit Application To Construct,Repair,Renovate Or Demolish a AUG 3 A
6, One-or Two-Family Dwelling 9- 47
This Section For Official Use Only
Building Permit Number; Date Apppe
Building Official(Print Name) Signature Date
1$_1 SECTION 1:SITE INFORMATION
1.1 rope ddress: �- 1.2 Assessors Map&Parcel Numbers
l.la Is this an accepted street?yes no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use Lot Area(sq ft) Frontage(it)
1.5 Building Setbacks(ft)
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
1.6 Water Supply:(M.G.L e.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public❑ Private❑ Zone: _ Outside Flood Zone? Municipal❑ On site disposal system ❑
Check if yes❑
SEC7ION2: PR0PFRTYOWNERSHIP'
2.1 weer'9f Record:
I ' ewi*PA/ z- MP-4 fp-;PL�
Name(Print) City,State,ZIP
'2-0 f�elnr- z &T- �;- &LIT �1' - ate!
No.and Street Tel Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORIO(check all that apply)
New Construction❑ Existing Building❑ Owner-Occupied ❑ I Repairs(s))" Alteration(s) ❑ 1 Addition ❑
Demolition ❑ Accessory Bldg.❑ Number of Units_ Other ❑ Specify:
Brief Description of Proposed World: 2 < Ei�A-VAR�t
2.i
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Estimated Costs:
Item (Labor and Materials Official Use Only
1.Building o pp — 1. Building Permit Fee:$ Indicate how fee is determined:
2.Electrical $ ❑Standard Cityfrown Application Fee
❑Total Project Cost'(Item 6)x multiplier x
3.Plumbing $ 2: Other Fees: $
4.Mechanical (HVAC) $ .i List:
5.Mechanical (Five $ Total All Fees:$
r6uTotal
ression
Check No. Check Amount: Cash Amount:
Project Cost: f ybbU ❑Paid in Full ❑Outstanding Balance Due: .
00 mAtl ltJ S¢zNS£
C.ON�o L-i 2 t.Jl r"Y�_lto—`I (o�
t SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL) 12EJ F-53
Lrcense Number Expiration Date
.Name of CSI,Holder
rDN�e'1, List CSL Type(see below)_1J —
No.and Street Description
rte. I't _ U UnrestrictedFamily
(Buildings u to35,000w.ft.
I F Q Restricted I&2Famil Dwelling
Cityfrown,State,ZIP — M I Masonry
RC Roofing Covering
WS Window and Siding
q ,. _ SF Solid Fuel Burning Appliances
1�Q2.]1,C9�lCr� I Insulation
Telephone Email address D Demolition
S.�Reglstered Home Improvement Contractor(IIIc) G
if�/^If,I 01 AM 1.� CdRegistration Number Expiration Date
HIC Cowan ame or HIC Registrant Name
Street `� U� ��!�Z y s 7 Email address
Ci /Town,State GIP 6 Telephone
SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152.¢ 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...........❑
SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETER WHEN
OWNER'S AGENT OR CON1TtAGT R APPLIES F4OR BUILDING PERMIT
I,as Owner of the subject property,hereby authorize J? f11 K�t qo i J� S
to act on my behalf,in all matters relative to work authorized by this building permit application.
�_OJ-7-A_t (,— 4:&L 1 09 .3a -�
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(Electronic Signature) Date
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
inny.mass.gov/oca Information on the Construction Supervisor License can be found at MyAMass.gov/dM
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.ft.) Habitable room count
Number of fireplaces Number of bedrooms
Number of bathrooms Number of halfibaths
Type of heating system - Number of decks/porches
Type of cooling system Enclosed Open
3. "Total Project Square Footage"maybe substituted for"Total Project Cost"
CrTY OF S JA ALMSAaim
BULMGDEFAMW
BZD W S7xE�,3�
9kL(97)745.9595:
DRiSt'JOd�.
PAX(97)7*9846
MAY
CR 7tX�ns$T.P�
DnEcrcaoppuaucprxmay/Buwmammomnt
C°®nstruct®®n Debris ®isp®sa/Afdav®t
(required for all demolition and,l'enovati®n work)
in accordance with the sbxth edition of the State Building Code, 7BO CMR, Section 111.5 Debris,
and the provisions of D4GL coo,S 54; Building Permit R is issued with the
condition that the debris resulting from this work shall be disposed of in a property licensed
waste deposit facility as defined by MGL c 111,S 1soA
The debris will be transported by:
a c
(name of h uler)
The debris will be disposed of in:
(mane of facility)
(address of facility) °'-tX— ®t S 3 Z
Signature of applicant
®ate
77ic Commonwealth ofYassachusedt
Department of$ndustrtafAccidents
Z Congress Street,Suite 100
Boston,M4 02114-2017
www.massgovIdia
Workers'Compensation hrsaranceAffidavit.Builders(Contractors/Electxicims/Phmber_
TO BE FILED WITH THE PERIV FIMG AIITHORnY
AlptolicantInformation Please Print Lepib,l
Name n.
Address: C Potm a r
City/Stale/Zip: Phone 9: -2 q0
Are you an employer?Checkk thea 2pprop`mte box: _ Type of project(required).
*41 am a employawffi— e—ployees(lhl.aod/or13-ttime).° 7. E]New construction
2.r]I am a sole proprietor orparmmship end have an employees woddng for me in 8. wemodeling
my capacity.[No wo&—'comp,insmaore mgmred]
3.❑ m I aa homeowner doing all workmyself[No works'comp.inMnMCe required]t 1 Demolition
❑
10❑Building addition
4.❑I am a homeownerand will be hiding cantr-�to wnduct all vrork on my praperiy. I wdl
ensure thatell eoenabxs mtl=have workers'compensation iaemance m are sole- 11.❑Electrical repairs or additions
proprietors with no employees.
12:❑Plumbing repairs or additions
5.❑I am a geaeml contractor end I have hired the sob-cmmactors listed on the attached sheet 13. Roofretors
These sub-coutractors have employees and have worms'comp.immam c l ❑ P
6.❑We are acorpmudon and its officers have cmT sed their right of exemption per MGL c. 14.❑Other
152.41(4).and we have no emplayxc[No wodras'comp.im macere*rd-]
FAnyapplicantthatehecl5 box 91 must alsoffi out the section below showing theirv=k s'compeasmionpolicyinfomatiox
t Homeowners who submit this afFi kv3 indicating they me domg0 work and then hire outside commcbm must submit a new a$davAiwimeong sunt.
tContachms that cbwkft box must etmehed ea additimol sheet showing the n®e ofthe sub-contractors and stale whetter orrethose entities have
employees. If the sub-conlowtom have employees,they must provide the¢wmJxm'comp.policy number.
I am an emptayer Md is providingworkers'compeusaton tnsurmcefor my employees. Below is the policy mrd job site
infornmton.
Insurance Company Name: Na QM hLoq
i—°. ZM S 0
Policy#oExpiration Date:'.!1 1
Job Site Address: Citylstskmp:
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under MGL c.152,§25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance
coverage verification.
Ido hereby certify under thepains and permtan ofperjury that the information provided above is true and correct
Sieg *e-�/ ...'.."J�— Date:
Phone# !?
Oft"use only. Do not write in this area,to be completed by city or town offidol.
City or Town' PermitJdicense#
Issuing Authority(circle one):.
1.Board of B:ealta 2.Bmlding Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
b Other
Contact Person: Phone#:
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 j:
the must be entlorsetl. If SUBROGATION IS WAIVED,subject to
the terms holandder
er In lieu
ons of Me policy,certain Policies may require an endorsement. A statement oa this c,rUflute does not confer rights to the
certificate holtler in Ileu of such entlorsemen s.
PacoucER
Fed c.Chnlm,Inc AV DmNM1YACmietl,GIC,RPLU
0 Waomn SVBe1 PHONE
LmTe6NM01651 C Exl 9]9333831. (971D44-18565
(60612'6-1665 ENNL 0-019ftm lnyl.
pe6RE89:
MUM AFFURDmG COVERAGE NA1C'd
INSURE6 INSURER A: Gan, Anna—CSSWElYaAnnk 31531
New England 4Ymdow 600or LLC;PHIa Yfmd0ws 6Co05 INSURER e: Hamvminsman@Cmllpmy 2 2
95 Fandi Rind INSUnist C: NINESONsOUs Say I.... 22306
HaVmAII,NIA 01032-1302 New Ham Aire
INSURER D: R EllgOyers Insurance Cvmmny 13083
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER:56593 REVISION NUMBER:
THIS IB 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 NTH 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.
Was
LTR TYPE 0FIN5UnANtf S POLICY NUMBpt POULYEFF PoucYEXP
MAD am LmRS
OENEItAL LM®LT'
8 (,060,666
% COMMERGALGENF3ULL LMR PREMISES S 166.660
cuMSMAOE rxcuR
1 m,66o
A % CG6001 2aM61610m T/12e16 1/12011 PERSQVILryDV eRR E
_ PERSONN-6 AOVIWURY y 1.666662-
GEIYERpLAOGREGgTE E ;000,000
GEN'L AGGREGATELMIrgPPLIES PER: PRWLCTS COL&IOP AGG 5 ;600,000
POLICY % PRO, H La
AUTGNeeILE 11ABILITY
E
CS8 SIN S 1,000A60
H ANYAUIO 9-91
6001LY INJURYV'm Persml S
C ALLOWNED SCHEDULED ADN9162169
AUT0.9 AU106 L12016 1/12011 EODILYINAmYIPmemden0 S
HIREDAWOS NON.UANED
AUTOS PROPERTYDgpNGE 5
% cA0W1
UMMEL _ S
% EXCESS1AL619 R 9.006666
9 E%cE55llA6 CIJMSMpDE MM107WS ]/12616 1118011 AGGRECCURRFNCE S
gGL3tEGAiE E 9,OW,PoO
MUNERSDEO COMPENSATION
ARE
EMPLOYERS'
5
ANO ENPLOVERS'LMRILRY YIN � % WC mAIIF 011t
C PNYPRDPPoEIOnNgq}NEmIXECIInVE wgWo
OFFICER0.IEMSER E%CLIHEDi � NIR 606106 1112016 ]11201) EL EACH ACCIDENT 5
IMmdnlnry IN N
ddl 900mo
RIPfmN OF D
Ifyyeesa mmlM OF0 E.LOISEA.SE.EAEIfPLO 8
DESCPEMTIDNS BeNm EL OIGE/SE.P000V L1Mi f 560.001)
6ERCmPIIOH of OPERARDN9ILDGpTIDN9I VF]OELE9(gnacpgLGft6161,pdd"dlun0l Remaps SCM1xdu@,Ilmon apace'¢rspuiwtl)
CERTIFICATE HOLDER CANCELLATION
New England VUPomP a BOm Ut
15 Fund Rand
Havmn6l,MA 01®6 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE. EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WIIS THE POLICY PROVISIONS
AUTHORESS)RFPRBEMAmE
clHld6 - Ntl1° CertHolder# - 019803010 ACORD CORPORATION. All rights reserved.
ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD
--
:+= CS-089853! n
w W ELLIAM R NICHOLS
57 PEARTREE RD
IHAVERHILL MA 01830
A, !
10{28/3018
•,.....,
c
c of Consumer Affairs&Business Regulation License or[egistration valid for found
indi return
uruse only sy
before the expiration date. Iffound return to:
E IMPROVEMENT CONTRACTOR Office of Consumer Affairs and Business Regulation
183279 Type: - 10 Park Plaza-Suite 5170
Expiration: 9/24/2017 - Supplement C'.5rd Boston,MA 02116
NEW ENGLAND WINDOW-&DOOR,LLC.
PELLA WINDOWS&DOORS - -
William Nichols
45 FONDI ROAD -- .(
HAVERHILL,MA 01832 `Undersecretnry - Not validwithout signature
Contract - Detailed
Fella Window and Door Showroom of Haverhill W Sales Rep Name: Duff, Stephen
45 Fondi Rd Sales Rep Phone: 978-373-2500
Haverhill, MA 01832 Sales Rep Fax:
Phone: (978)373-2500 Fax:. (978)373-7274 Sales Rep E-Mail: DuffS@pellaboston.com
derinfotmatlon
tu§6� In6r,1111,36 wti
Stephen Immerman lmmerman,Stephen,1766135 Quote Name: IMPERVIA WINDOWS FIBERGLASS
20 Federal St Unit 6 20 Federal St Unit 5 Order Number. 741SD0454
SALEM,MA 01970-3866 Lot# Quote Number: 8133322
Primary Phone:(617)6949391 Salem,MA 01970-3866 Order Type: Installed Sales
Mobile Phone: County: Payment Terms: Deposit/C.O.D.
Fax Number: Tax Code: MA TAX 6.25
E-Mail: steve.immeman@montserratedu Quoted Date: SS20116
Great Plains#: 10988086
Customer Number., 1008041696
Customer Account: 1003949197
5 DELIVERY SET UP City
For more info rmation regarding the finishing,maintenance,service and warranty of all Pella®products,visa the ellagwebsiteatwww.pelia.ccm
Page I of 6
Printedon 8/1512016 Contract-Detailed
Customer:Stephen Immerman Project Name: Immerman,Stephen.1766135 Order Number. 741500454 Quote Nuntler:8133322
AtM butes 'r„' , s•"' ` ` F y5 ',
s NOT INSTALLING INT MOLDING City
3
Att_ribUtes F <'
20 None Assigned Impervia, Single Hung,22.5 X 71.5,Brown ot
t
-_� 1:Non-Standard SlzeNon-Standard S Ize Single Hung,24"Lower Sash
PK 9 Frame Size: 221/2 X 71 12
General Informatian: Standard,Duracaste,Block,Foam Insulated,3",15/16',1 11/ie'
811 Exterior Color/Finish: Brown
9 Interior Color/Finish: White,Two Color
Glass: Insulated Low-E Advanced Low-E Insulating Glass Argon Non High Altitude
:,a Hardware Options; Cam-Action Lock,White
Viewed From Exterior Screen: Half Screen,Inview^
Performance Information: U-Factor 0.28,SHGC 0.29,VLT 0.53,CPD PEL-N-102-00620-00001,Performance Class LC,PG 40,Calculated Positive OP
Rating 40,Calculated Negative OP Rating 40,Year Rated 08111
Grille: No Grille,
Wrapping Informallon: Standard Fm,No Exterior Trim,No Interior Trim,Pella Recommended Clearance,Perimeter Length=186".
Frame Size:22.9'X 71.5'
PVC Upgrade<48 -PVC Upgrade less than 48 inches Qry 1
FF<48 wide-Install Full Frame Window 48 inches or less wide Qty 1
FF>60 Height-Install Full Frame Window>60 inches UnitfComposite Height Qty 1
For more information regarding the finishing,maintenance,service and warranty of all Pella®products,visit the Pella®website at www.pella.com
Printed on 8/152016 Contract-Detailed Page 2 of 6
Customer:Stephen Immenman ProjectName: Immennan,Stephen,1766135 Order Number. 741SDO454- Quote Number:8133322
25 OFFICE Impervia, Double Hung,34.5 X 44.5, Brown City
1
1:Nonstandard SlzeNonStandard Slze Double Hung,Equal
n FKB Frame Size: 341@X4412
General Information: Standard,Dureaast®,Block,Foam Insulated.3",15116".1 11/16'
811 Exterior Color/Finish: Brown
-�' Interior Color l Finish: White,Two Color
Glass: Insulated Low-E Advanced Low-E Insulating Glass Argon Non High Altitude
Hardware Options: Cam-Action lock,White
Viewed From Exterior Screen: Half Screen,Conventional Fiberglass
Performance Information: U-Factor 0.29,SHGC 0.28,VLTO.52,CPD PEL-N-126-00555-00001,Performance Class LC,PG 30,Calculated Positive DP
Rating 30,Calculated Negative CP Rating 30,Year Rated 08
Grille: No Grille,
Wrapping Information: Standard Fin,No Exterior Trim.No Interior Trim,Pella Recommended Clearance,Perimeter Length=158".
Frame Size:34.5'X 44.5'
PVC Upgrade<48 -PVC Upgrade lase than 48 inches Qty 1
FF<48 wide-Install Full Frame Window 481nches or less wide Oty 1
L neffi `Eocation. " ti. - , 'i'•.I AttritiuTeS -
30 LMNG Roos+ Impervia,Double Hung, 34.5 X 41.5, Brown Cty
1
1:Non-Standard SlzeNon-Standard Size Double Hung,Equal
PK A Frame Size: 34 12 X 41 112
811 General Information: Standard,Duracast®,Block,Foam Insulated,3",15116".1 11116'
Exterior Cclor/Flnlsh: Brown
Interior Color/Finish: White,Two Color
Glass: Insulated Low-E Advanced Low-E Insulating Glass Argon Non High Altitude
Hardware Options: Cam-Action Lock,White
Viewed Fran Extenor Screen: Half Screen,Conventional Fiberglass
Performance information: U-Factor 0.29,SHGC 0.28,VLT 0.52,CPD PEL-N-126-00555-000D1,Performance Class LC,PG 30,Calculated Positive OP
Rating 30,Calculated Negative OR Rating 30,Year Rated 08
Grille: No Grille,
Wrapping Wormation: Standard Fin,No Exterior Trim,No Interior Trim,Pella Recommended Clearance,Perimeter Length=152".
Frame Size:34.5'X 41.5'
PVC Upgrade<48 -PVC Upgrade less than 48 inches City I
FF<48 wide-install Full Frame Window 48 Inches or less wide city 1
Thank You For Purchasing Pella® Products
PELLA WARRANTY:
Pella products arc coverod by Pella's limited warranties in effect at the time of sale.All applicable product warranties are incorporated into and become a partof this contract
Please see the warranties for complete dclails,taking special note of the two important notice sections regarding installation of Pella products and proper management of moisture
For more information regarding the finishing,maintenance,service and warranty of all Pella®products,visit the Pella®website at www:pella com
Printedon 81152016 Contract-Detailed Page 3 of 6
i
Customer: Stephenlmmerman Pro}ectName: Immerman,Stephen,1766135 Order Number741SO0454 Quote Nurrber: 8133322
within the wall system.Neither Pella Corporation nor Pella Windows&Doors will be bound by any other warranty unless specifically set out in this contract. However,Pella
Corporation will not be liable for branch warranties which create obli gations in addition to or obligations which are inconsistent with Pella written warranties.
Clear opening(egress)information does not take into consideration the addition of a Rolscmen for any other accessory]to the product.You should consult your local building code
to ensure your Pella products meet local egress requirements.
Per the manufacturer's limited warranty,unfinished mahogany exterior windows and doors must be finished upon receipt prior to installing and refinished annually,thereafter.
Variations in wood grain,color,texture or natural characuxistics are not covered under the limited warranty.
INSYNCTI VE PRODUCTS: In addition,Pella Insynctive Products are covered by the Pella Insynctive Products Software License Agreement and Pella Insynctive Products
Privacy Policy in effect at the time of sale,which can be found at Insynctive.pella.com. By installing or using Your Insynctive Products you are acknowledging the Insynetivc
Software Agreement and Privacy Policy are part of the terms of sale.
Product Performance laformation:
U-Factor,Solar Hcat Gain Coefficient(Sl1GC),and Visible Light Transmittance(VLT)are certified by the National Fenestration Rating Council(NFRC).Manufacturer stipulates
that these ratings conform to applicable NFRC procedures for determining whole product performance.NFRC ratings are determined for a fixed set of environmental conditions
and a specific product size. NFRC does not recommend any products and does not warrant the suitabiliy of any product for any specific use.
Design Pressure(DP),PerformanceClass,and Performance Grade(PG)are certified by a third party organization,in many cases the Window and Door Adanufacturers Association
(WDNhA).The certification requires the performance of at least one product of the product line to be tested in accordance with the applicable perfomrance standards and verified
not I
by an independent party.The certification indicates that the product(s)of the product lint passed the applicable tests.The certification does apply to mulled and/or product
combinations unless noted. Actual product results will vary and change over the products life.
For more performance information along with information on Florida Product Approval System(FPAS)Number and Texas Dept of Insurance(TDI)number go to neva'Pella.con'
ioerformance.
Project Checklist Review (Installed Orders Only)
Before the Installation the Homeowner agrees to do the following:
j Obtain Condo Association Approval
Obtain Historic Approval
Remove existing shutters and awnings
j Remove air conditioners
Remove existing shades, drapes,window treatments,wall hangings, and personal belongings
Move furniture at least 3 feet away from work area
Tie or cut back trees, bushes and shrubs in the work area
Arrange to have alarm system and doorbells disconnected
Arrange to have any plumbing and electrical repairs or changes made by appropriate licensed contractor
Provide a door handle and lockset forentry door if Pella handle and lockset is not purchased.
Before the Installation Pella agrees to do the following:
Obtain Building Permit(When required)
For more information regarding the finishing,maintenance,service and warranty of all Pella®products,visit the Pellae website at www.pena.com
Page 4 of 6
Printed on 611 512 01 6 Contract-Detailed
Customer: Stephenlmmerman Project Name; ImmennanStephen,1766135 Order .Number. 741SDO454 Quote Number:8133322
Prefinish products when purchased in contract
During the Installation the Homeowner agrees to do the following: /
Keep pets safely away from work area 1
Keep children safely away from work area
Allow Pella Installer room to work safely within your home
During the Installation Pella agrees to do the following:
Deliver and unload products purchased per contract
Place and remove drop cloths in work area then vacuum, and remove all debris at end of day
Remove existing product, including storm windows, and dispose of it unless otherwise specified
Install all products using method specified in contract per Pella Installation Instructions
Replace interior and/or exterior trim only if purchased
If Purchased,install exterior primed pine wood trim or Composite. Composite will be unfinished.
If Purchased,install interior trim matching wood window finish or White trim for Impervia and Encompass
Install non-Pella entry door lockset provided by you. Pella is not responsible for it's quality or performance
After the Installation the Homeowner agrees to do the following:
Be available for completion and sign off to verity all products purchased are in working order
Reinstall existing shutters and awnings
Re-install existing shades, drapes,window treatments,wall hangings, and reposition furniture
Arrange to have alarm system and doorbells reinstalled
Reinstall air conditioners
Remove stickers from product and save for energy rebate and tax purposes
Wash all interior&exterior glass surfaces
Fill nail holes and joints on interior trim if windows are to be stained(after staining)
Clean up exterior casing issues due to storm window removal if full wrap or new exterior trim is not purchased
Project Checklist has been reviewed
Cu3t meriMiil
X159i Product Only Addendum has been reviewed
Customer iNtial
Credit Card Account#: Last 4 Digits D O O Z
Expiration Date: O
Charge final payment to same account Y /
(Upon substantial completion) Hammer aaVar
For more information regarding the finishing,maintenance,service and warranty of all Pella®products,visit the Pella®.website at www.pella.rom
'� Printedon 8/152016 Contract-Detailed Page 5 of 6
Customer. Stephenlmmernan Project Name: Immerman,Stephen,1766135 Order Number 741SD0454 Quote Number:8133322
roject Checklist has been reviewed
Stephen Immerman Steve Duff ��?errotaisx
Customer a e P .0 'np Pella Solas Rep Name (P P""p LNon-taxable
le Subtotal $2,237 96
X Tax @ 6.25% $139.87
Cu ori 5 tur Pella Sales Rep Signature Subtotal $1,794.95
8/15/16 t9/15/16 $4,172.78
Date pate sit Received $2,086.39
Xunt Due $2,086.39
Cre ftCard proval g
i
I
I
For more information regarding the finishing,maintenance,service and warranty of all Pella®products,visit the Pella®website at www.pella.com
Detailed Page 6 of 6
-
1 2016
Contract
", Primed on 815
PELLA WINDOWS AND DOORS CONTRACT 7 PAYMENTS
1 TERMS AND CONDiTTONs'S Pella shall be entitle]to stop the Work upon written notice to Owner for any
materiel default m Pailuro by Owner.including but not limited in,the Owncr'e
Thow Toms and Conditions test an iutegnl part of the contract sort north onthe failum to pay Pella the mount due within seven days after the data payment is
Product Order(the"Cmtrat")between Now England Window and Door LLC due.
dbaPella Windows&.Doom.Inc.C'Pella")and the persm(s)identified ren the
Product Order("Ownee)to supply the products(the'Troducts"),and perform g CORREMON OF WORK
the work(the"Work')described orefetrcd to in such Contract. Fm Product
Only purchases,a signed"Product Only Addendum"is a required part of the Pella shall correct inundation Work not In conformance with the requirements
urate of the Comr mi,if notified in writing by the Owner within two years after the
Completion Date or,if earlier,the date on which the Worlds substantially
2 OWNER completed and payment of the Purchase Price made subject m aholdbank n
provided above.Correction of Work as hereby provided shall be Owner's Ede
Pella is narespmsible for my twisting security systema.Owner shall remove monody for defective wodunnuship,and is provided in Jim of my and all other
all shades;verticals,blinds,comains,drapes or window mounted air remedies.Pella's obligation to coned Work is conditioned at Fella's prior
mad'ulonem,prim wthe installation of the Products.Pella's iuslallas are not receipt ofallpayinots than due.
responsible far the removal or installation of these types of items. Pena is tot
responsible for pre-existing window coverings facing an newly Installed Pella 9. LIMITED PRODUCT WARRANTY
windows
Pella shall warrant all Pella products,but only in aceadmce with ere Pella
The Owner shall provide complete access to the work site between the flours WindAw&Doors Limited Warranty.THIS LIMITED WARRANTY SHALT.
of7:00 a.m.and 6:00 pm.(Monday through Friday)for Pella's installers to BE THE SOLE WARRANTY WITH RESPECT TO THE PRODUCTS AND
deliver the Products and perform the Work. PELLA SPECIFICALLY DISCLAIMS ALL OTHER WARRANTIES,
EXPRESSORIMPLIED, WRITTEN OR ORAL(INCLUDINGWITROUT
3. PELLA LIMITATION ANY WARRANTY OF MERCS1A TTAB£LITY OR FIT:4ESS
Pena will be responsible for and have control over construction means, FOR A PARTICULAR PURPOSE).
methods,techniques,sequences and procedures and for coordinating all
portitmsof the Work.Pella will be responsible for the Wok ofgs;Pella 10. NO CONSEQl1EN'liAl,DAMAGES j
Cmtram,,who wilt install the Products. UNDER NO CIRCUMSTANCES SHALL PELLA BE LIABLE FOR
CONSEQUENTIAL,INCIDENTAL,INDIRECT,OR SPECIAL DAMAGES,
Unless provided otherwise in the Wait description,Pella will provide and pay WHED.jFA FORESEEN OR UNFORESEEN.
r materials,equipment,emir end machinery,transportation.and
for all labor, a eq p 4 erY
otlav facilities and services necessary for the proper execution and eanpbdm
of the Work 11. HF.OM0£PAOVED7ENT CONTRACTORS
Theme[eriati and equipment furnished under the Contract will be good quality the All dame mctor oftheRomsseld improvemeontractors nt subcontractors Rulssmidhall be registeredwith
and new unless otherwise required or permitted,the Work will be free from administered by
t the
improvement Contractor Ragi Standards.
Program 1
administered subcontractors
era DomdofBuildin t is Regulations haStandards. Polls and
_ defetls not inherent is the quality required o permitted,and the ante !
confmn with the m umrems of this Contract.Pena shall not be responsible unY of its res about
identified in this agreement have been registered
q° Any inquires about Pella or any of its subcontractors relating wRogiva nm
for damages or detects mused by abuse,p open o ionseras nes r nor al by Pella, Should be duetted w:Director,tm.MA pmvContractor-977,888-283.75
hopmpvmlaufficient maintenance,improper opvatlon or normal weer and {O Park Plass,Room 5170,Bmtm,MA 02116,617-973-g787,.88g-283.3757 ,
tom. Pella will keep the premises and surrounding area free San or visit the HIC website at httpJ/wrnv,mass.gov(ocabr/
accumulation of waste materials or mbbtsb mused by perfommnce of the
Work. 12. PERMITS(MA customers only)
4. CHANGES Pella is obligated to and will obtain the following permits for this project:
AujldlnO .Homeowaera who secure their own permits win be
'the Owner may ceder in writing changes in The Work consisting of additions, excluded from the guaranty fund provisions of Massachusetts General Laws,
deledone,or modifications("Change Order ). Any Change Order shall chapter 142A.
hmcludc an adjustment to.the Price and the Substaotial Completion Data,as
detmnined by Pena Pella reserves the right to approve or disnppmvc any In addition w the rights and wanaatles enumerated in this assessment.you may
_Change Order and any such Change Order must be signed by both Owner and have additional rights under Massachusetts Oentral Laws,chapter 142A and
Peilaw be effective. 780 Code of Massachssms Regulations R6.
13, NOTICE OR CANCELLATION
S. SUBSTANTIAL COMPLETION
Owner understands and agrees gist the Substantial Completion Data is an You may cancel this agreement if it has been signed by a party
estimate only and that the&=at date on which the Wok is completed may be thereto at a place other than an address of the seller,which
Wended to allow for Change Orders roqucated by Owner or if the time to Duty be his main office or branch thereof,provided you notify !
cmnpimo the Work is affected by conduct ofthe Owner,weather,labor the seller in writing at his main office or branch by ordinary
disputes,availability of subcontractors,not of God,fire a other casts
reaamably beyond Pella's control.If for any meson the Work is not fully trail posted,by telegram sent Or by delivery,not later than
completed by the Substantial Completion Date(mchuling any e#eaions midnight of the third business day following the signing of this
contemplated above),but Is substantially completed by such date,Le.,the agreement.
Product lms been installed,but minor porta or components nye missing or need
to be repiacul or repaired,a hold batty proportionate to the coat of remaining See the attached Notice of Cancellation for an explanation of
ports or work to be completed is acceptable.However,the holdback will not this right
exceed the moat of the completion costs a 10%of the remaining unpaid
balance ofdae Price,whichever is less.
6. FINANCING Do not sign this contract if there are any blank spaccc.
If payment of the Price is£,netted with a financial institution through Pella.an
financing papeovork must he completed upon signing of this Contract and the x -
requisite approval,and authorization for the full amount of the requested
financing shall have been received from the financial institution.
Ctutomvsigneture 8/15/16
Date
DISPUTES
THE CONTRACTOR AND THE HOMEOWNER HEREBY MUTUALLY AGREE IN
ADVANCE THAT IN THE EVENT PELLA HAS A DISPUTE CONCERNING THIS
CONTRACT, PELLA MAY SUBMIT SUCH DISPUTE TO A PRIVATE
ARBITRATION SERVICE WHICH HAS BEEN APPROVED BY THE SECRETARY
OF THE EXECUTIVE OFFICE OF CONSUMER AFFAIRS AND BUSINESS
REGULATIONS AND THE CONSUMER SHALL BE REQUIRED TO SUBMIT TO
SUCH ARBITRATIO PROVIDED IN M.G.L.c. 142A
Contractor
AmIll
NOTICE: THE SIGNATURE OF THE PARTIES ABOVE APPLY ONLY TO THE
AGREEMENT OF THE PARTIES TO ALTERNATIVE DISPUTE SETTLEMENT
INITIATED BY THE CONTRACTOR THE OWNER MAY INITIATE
ALTERNATIVE DISPUTE RESOLUTION EVEN WHERE THIS SECTION IS NOT
SEPARATELY SIGNED BY THE PARTIES.
NOTICE OF CANCELLATION
Date of transaction: 8/15/16
You may cancel this transaction,without any penalty or obligation, within three business
days from the above date.
If you cancel, any property traded in, any payments made by you under the agreement,
and any negotiable instrument executed by you will be returned within ten business days
following receipt by the seller of your cancellation notice, and any security interest
arising out of the transaction will be cancelled.
If you cancel,you must make available to the seller at your residence, in substantially as
good condition as when received,any goods delivered to you under this agreement;or
you may if you wish, comply with the instructions of the seller regarding the return
shipment of the goods at the sellers expense and risk.
If you do make the goods available to the seller and the seller does not pick them up
within twenty days of the date of your notice of cancellation,you may retain or dispose
of the goods without any further obligation. If you fail to make the goods available to the
seller,or if you agree to return the goods to the seller and fail to do so,then you remain
liable for performance of all obligations under the contract.
To cancel this transaction,mail or deliver a signed and dated copy of this cancellation
notice or any other written notice,or send a telegram to
Pella Windows and Doors, at 45 Fondi Rd.. Haverhill.MA 01832
not later than midnight of 8/18/16 (three business days from the date of
transaction above).
I hereby cancel this transaction.
(Date) (Buyer's signature)
PELLA WINDOWS AND DOORS CONTRACT
7. PAYMENTS
1. TERMS AND CONDITIONS Pella shall be enfilled to stop the Work upon written notice to Owner for any
material default or failure by Owner,including but not limited to,the Owner's
These Terns and Conditions are on integral part of the contract set forth on the failure to pay Pella the amount due within seven days after the date payment is
Product Order(tile"Contract")between New England Window and Door LLC due.
dba Pella Windows&Doors,Inc.("Pella")and the person(s)identified on the
Product Order("Owner")to supply the products(the"Products'),and perfomi 8. CORRECTION OF WORK
the work(the"Work")described or referred to in such Contract. For Product
Only purchases,a signed"Product Only Addendum"is a required part of the Pella shall correct installalion Work not in conformance with the requireniens
contract. of the Contract,if notified in writing by the Owner within two years after Ole
Complelioo Date or,if earlier,the date on which the Work is substantially
2. OWNER completed mid payment of the Purchase Price made subject to a holdback as
provided above.Correction of Work as herein provided shall be Owner's sole
Pella is not responsible for any existing security systems.Owner shall remove remedy for defective workmanship,mrd is provided in lieu of any and all other
all shades;verticals,blinds,curtains,drapes or window mounted air remedies.Pella's obligation to correct Work is conditioned on Pella's prior
conditioners,prior to the installation of the Products.Pella's installers are not receipt of all payments that due.
responsible for the ranovnl or installation of these types of iters. Pella is not
responsible for pre-existing window coverings filling an newly installed Pel In 9. LIMITED PRODUCT WARRANTY
windows.
Pella shall wmrant all Pella products,but only in accordance with the Pella
The Owner shall provide complete access to the work site between the hours Windows @ Doors limited Warranty.THIS LIMITED WARRANTY SHALL
of 7:00 a.m.and 6:00 p.m.(Monday through Friday)for Pella's installers to BE THE SOLE WARRANTY WITH RESPECT TO THE PRODUCTS AND
deliver the Products and perform the Work. PELLA SPECIFICALLY DISCLAIMS ALL OTHER WARRANTIES,
EXPRESS OR IMPLIED, WRITTEN OR ORAL(INCLUDING WITHOUT
3. PELLA LIMITATION ANY WARRANTY OF MERCHANTABILITY OR FITNESS
Pella will be responsible for and have control over construction means, FOR A PARTICULAR PURPOSE).
methods,techniques,sequences and procedures and for coordinating all
portions of the Wok.Pella will be responsible for the Work of its Pella 10. NO CONSEQUENTIAL DAMAGES
- Contractors win will install the Products. UNDER NO CIRCUMSTANCES SHALL PELLA BE LIABLE FOR
Unless provided otherwise in file Work description,Pella willrovide and pay CONSEQUENTIAL,INCIDENTAL,INDIRECT,OR SPECIAL DAMAGES,
P p
for
all labor,materials,equipment,tools and machinery,transportation,and WHETHER FORESEEN OR UNFORESEEN.
other facilities and services necessary for the proper execution mid completion
of file Work. 11 HOME IMPROVE\IENT CONTRACTORS
The materials mid equipment furnished under the Contract will be good quality All hone inprovenent contractors and subcontractors shall be registered with
and new unless otherwise required cr pemnitted,the Work will be free Pram the director of tine Homo bnprovement Contractor Registration Program
defects not inherent in the quality required or permitted,and the Work administered by the Board of Building Regulations and Standards. Pella and
conforin with the requirements of this Contract.Pella shall not be responsible any of its subcontractors identified in This ogreanent have been registered.
for damages or defects caused by abuse,modifications not executed by Pella, Any inquires about Pella or any of its subcontractors relating to registration
improper or insufficient nnaintatmice,improper operation or normal wear and should be directed to:Director,Herne hnprovenent Connector Registration,
tear. Pella will keep the prernises and surrounding area free from One Ashburton Place,Boston,MA 02108,617-727-8598
aceunulation of waste nnmeriniS or rubbish caused by performance of the 12. PERMITS(\IA customers only)
Work.
i ¢lied to and will obtain the following pemnits for this project:
Palle
4. CHANCES U11V Cjgnt . Homeowners who secure their own pemtits will be
excluded front the guaranty fiord provisions of Massachusetts General Laws,
Tine Owner may order in writing changes in the Work consisting of additions, chapter 142A.
deletions,or modifications("Change Order"). Any Change Order shall
include an adjushnent to the Price and the Substantial Completion Date,as ht addition to the rights mid warranties enumerated in this agreenme t,you any
determined by Pella. Pella reserves the right to approve or disapprove any have additional rights under Massachusetts General Laws,chapter 142A and
Change Order and mry such Change Order nmst be signed by both Owner and 780 Code of Massachusetts Regulations R6.
Pella to be effective. 13. NOTICE OF CANCELLATION
5. SUBSTANTIAL COMPLETION You may cancel this agreement if it has been signed by a party
Owner understands and agreas that the Substantial Completion Date is mi thereto at a place other than an address of the seller, Which
estimate only and that the actual date on which the Work is completed may be may be his main office Or brawl thereof,provided you notify
extended to allow for Change Orders requested by Owner or if the time to
cornplete lime Work is affected by conduct of the Owner,weather,labor the seller in Writing at his main office or branch by ordinary
disputes,availability of subcontractors,acts of God,fire or other causes mail posted,by telegram sent or by delivery,not later than
reasonablybeyond Pella's control.If for any reason the Work is not fully midnight of the third business day following the sigiiing of this
completed by the Substantial Completion Date(including any extensions agreement.
contemplated above),but is substantially completed by such date,i.e.,the
Product has been installed,but minor parts or components are missing or need See die attached Notice of Cancellation for an explanation of
to be replaced or repaired,a hold back proportionate to the cost of remaining
parts or work to be completed is acceptable.However,the holdback will not this right.
exceed the annount of the completion costs o 10%of the remaining unpaid
balance of the Price,whichever is less.
Do not sign this contract if there are any blank spaces.
6. FINANCING
If payment of the Price is financed with a financial institution through Pella,all X
financing paperwork nest be completed upon signing of this Contract and the /�
requisite approvals and authorizations for the full amount of the requested
financing shall have been received front the financial institution. Custcn?o si nahi
ZZ ZO/6
Dole
III