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B-19-768 - 0049 BRITTANIA CIRCLE - Building Permit �aqz Zg The Commonwealth of Massachusetts t� Board of Building Regulations and Standards ;�s 1~M t Massachusetts State Building Code,780 CMRt ' Revrsed mar 2011 Building Permit Application To Construct,Repair,Renovate Or Deugish One-or Two-Family Dwelling � ••;r_ , `�1E. TW$eA ,or 64 IJse Only 11din1;Permit Nai�nber Date P h®d }lhrltling Oci it(I'rmt I3ate) igaatriFO. 1Q, 1.1 Property Address: 1.2 Assessors Map&Parcel lumbers 1.1 Is this an accepted street9 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 I9isposal System: Public❑ Private❑ Zone: _ Outside Flood Zone? Municipal❑ On site disposal system ❑ Check if yes❑ SECTIONZi P t l dT�'� '1►iI�RSI P' wne 'of Record: ame(Pu rrl nft� City,State,ZIP aq Y-/ ZO 2_S No.and Street Telephone Email Address SECTION&DESCRIPTION OF PRo1PO m 0*(ohecR an that apply) New Construction❑ Existing 1uilding❑ Owner-Occupied• ❑ Repairs(s) Alterafion�s� ❑ Addition u Demolition ❑ Accessory Bldg.❑ Number of Units Other ❑ Specify: Brief Description of Proposed Worle: _ 'n SC'PIOPT 4: T ILA'I' ID CONSTRUCTION COSTS Estimated Costs: Item Official Use Only (Labor and Materials 1.Building $ 1. Btuliling Perarttt Ftee $ . , Itid oate hove fee is determined: 2.Electrical $ C.I Standard Citj�/Tov+ai ApOicatia Fee 'Total Project Costs(Itern 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ . 4.Mechpical (HVAC) $ { List: = / "I r� 5.Mechutical (Fire $ Total All Fees:$ Suppression) Cheok No. Check Amount: Cash Amount: 6.Total Project Cost: $ ( a -_ I]Paid in Full0 Outstanding Balance Dtie: SEMOl+d 5; t~ T1 UC'I'I l IC1 5.1 Construction Supervisor License(CSL) s License Number Expiration Date Name of CSL kloljCr, List CSL Type(see below) ;:. .. D....:..::fion. o.and Street ��( U Unrestricted(Buildings u to 35,000 cu.ft. AJAq+ N Restricted ldf2 FamilyDwelling City/Pown,State M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances ' I Insulation Telephone Email address D Demolition 5. a 'stered ome Improvement Contractor(HIC) C Re ' tion Number Exp —kation Date HIC Com an ame or HIC Registrant Name t; —(Str to eet �0 r— > v Email address o Gam- �3 �' Ci PTown,State, Tele hone S)MMON 6t W a C4T1t I~1 SA3 V 5k 1�1�C t Ff�AYIII'.(1i.fg'.L.e:l'J2.§25C(i6�) 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...........❑ TC fDI►I 7as tt AU11101MAT. T.Ct$E C� L)E lY C1d3.!'�$�—CTOR.4A'a:.:M` .0. 4Rll D.: ' '. 31'4:4'3 ": $',H 1,as Owner of the subject property,hereby authorize ' LAW to act on my behalf,in all matters relative to work authorized by this building permit application. 92-j4 C. LLA Print Owner's Name(Elec me ignature) Date SECT:QN 71� ®!�(+1 It'Olft AU`I d D x1G N ) .4RA IION By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information contained in this application is true and accurate to the best of my knowledge and understanding. PrintOwner's or Authorized Agent's Name(Electronic Signature) Date _ 1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(MC)Program),will not have access to the arbitration program or guaranty fund under M.G.L.c. 142A.Other important information on the MC-Program can be found at www.ni s. ov/oca Information on the Construction Supervisor License can be found at www.mass.g_ov/das 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) (including garage,finished basement/attics,decks or porch) Gross living area(sq.ft.) Habitable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of half/baths Type of heating system Number of decks/porches Type of cooling system Enclosed Open 3. "Total Project Square Footage"maybe substituted for"Total Project Cost" ..: Hie C hihiorrwe- afti, f luiissirclilrset s ;Departsent of;Tiz�i�;Frauf4ccrclereis: _z Co rgr ess Stree4; Srrrte 1,00. B x:NIA 021 4 2 1, .ww.mass g0v1dI qI - 'S�Urlters'�ampensat>on Insurance.A[Iidavit,B� filers/Go."nt3ctors/Electricia�n�/Plunrbe.fs:; 'TO I3E FILLED 1 ITH THE I'EI21ti1:I f 1 I)\G AUTHt)Rll 1:: An;1i.464 tlnforuia"io-ii: Pfeii eWFrint Ueitily. . Na[71e (Bgstnzss traiuzationlintliidaal) �� � �$ F � °Additssi� O IL &n City/State/Zip :.. LI 'li . e# Aee�uu an Implore ChecttitIteappro�riate boY.; g} .0 Of' iO eCt rf uirQ(. _ p p...I ( .q ) 1.. n aainplo��i i�fli_.�.��mplo}ets(Eul:1'at�ci'ar;pan tope) viztor of partitershtp aii Itaea.na:empiovee§�vorkmforme in $. Rt tiigdeitn. 'an} capantt [�o,vvorl.ets ;rump msuranc.e requuzd] 3.�[arnaliontco�4nerdotn�a7Cs4orl myself \o}_�orke>' camp insuranresequiredf dcHk��1amte 'Will im zo eoaa . --- 1011 W.10ig.addition.: _-.---- ensure:thatall c onEractors yttber hake ti�orlers:camp�psaix�n insurance or are sole 11_ E1LCirtcI repairs or dddltiDils pt:oprietots vYttli:'no empio}•ers: ' Plurnbtn�xe. atrs csr adtttons �. J am a zneral�ontrac for and 1 have}brad j4&e?ub conLaGtors listed,op iha dtidchad s�teet: T[iese,:}ttb contra toe hase.em�lo)re�s;:and hac;e l�otf ers comp,insuran�e 4 I�: TLpof repairs bDVrearzacorpoattdnand tso£ficarsha�2e�erctsedtl�etrsi tit o?,e.ertzpttoiapzrMG c: I4`.❑O#11�i r. �?. t(J} and Ey°e:{7ate,nq ztnpld}zes:["q workers co ed. 'rAnt apphcanthat chEil;s box rtJ-must also•�Jlsout Eh�,seceton bei"ova shovv�u�*thaicY�.orAzr, eompens?ttgn po[tc.t.information: ,T�eowners.arito submi are doGG114 xuoi ;and then J ire outside„conuactor�must.submit:a nary aflidavik indi tm rsuch: tCorit"actors:ibat.ctteck ifi s box tiaiist.air acJa�d:an acid.it oital,sheei;sho�tioa ha nama Uthe:sub bntraciors and sidEe tihether o'rnot those zntitaea tiav en}plo}•ens tftliesub cpntractorsbavQempioye�s t(ie3_;mustprov detliatr-itiOagrs camp po)c}nugaber. I am arr eniploGer that prof•adirtg*.6ike6',C0ntpe►zstrtran rresarralice fvr :y t]�f e m &elaw s the�sol It"anal/ b s e rrt fvrrnaiioir:: insurance Goinp�ny;;Narne � � e Policy or pelf LI ins.Ltc :.... �. �_t ..._ ....... .. .... fob`Sate address= rutijt h/Set atael/Zip:; m bn��.. a.. tion �Att4 f� o . m h. : e c 6w pg so c . Fa litre tip secure coveragesas required ttnde. r'MGL is werttninat a to7ation punishable byr a fiirtc up to SI, O(10 aiid or`one year tniprisontttent as vtiell as GiI'i]penal€ies in it e fori..,ol a STg'1�'O ORD'ER and a fine of up to ?�0.00 a day aQa>nst the v xitat.or a c opy of this staieitient mai be fors aided to the Q ce oI Tily c stt�ations of the Did for insurance`" c©�ecage tieificattou: I rlv.,:hereb.t:cerlrf t ztnrier l e.paitz..s anrf p��ria'I�Pies of per�rrr3rtTinfthe fvrtnalrart prvt,t�lerl abas a cs:true and correct;, S} CtCfI iLSe Oi1.Tj D0:srotJ i.te s this-aregl to be corrrpleteri b; tity vr'toivi riff cicrf pity o Toov.ai: Perzii`it/t i`eiase#. Issii 6 A itflinr to(cis Ile°one): y;.Boacci of ups til . Bpiiirling74 �g�artat� nt. 3::pity/ oesn Cietit El etrtcal:�iis�eetor s �lumbqu iris ee:tor. '.6.Other contact I'�rsii.tii.; d'iiiine#: ® DATE(MM/DD/YYYY) ® CERTIFICATE OF LIABILITY INSURANCE 4/16/2019 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 policy(ies)must have ADDITIONAL INSURED provisions or 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 endorsement(s). PRODUCER - - - CONTACT N J fl cFred C. Church Insurance AME: ueline Normandin HON FAX 4541865 A/c Noll:97841 Wellman Street c Na 8 8 Lowell MA 01851 ADDRESS: inonnandin fredcchurch.com INSURER S AFFORDING COVERAGE NAIC# INSURERA:Hanover Insurance Company 22292 INSURED BOSTWIN-01 INSURERB:A.I.M.Mutual Insurance CO 33758 Boston Window&Door, LI_C DBA Pella Boston Windows&Doors INSURERC: 45 FOndl Road INSURERD: Haverhill MA 01832 INSURERE: INSURER F: 'COVERAGES CERTIFICATE NUMBER:1603875097 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. INSR I TYPE OF INSURAPICE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSD D POLICYNUMBER MM/DD MM/DD/YYYY A X COMMERCIAL GENERAL LIABILITY ZBND79634 1/1/2019 1/1/2020 EACH OCCURRENCE $1,000,000 CLAIMS-MADE C,OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $100,000 MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: I GENERAL AGGREGATE $2,000,000 POLICY�JECT []LOC PRODUCTS-COMP/OPAGG $2,000,000 OTHER: $ A AUTOMOBILE LIABILITY AWND796284 1/1/2019 1/1/2020 COMBINED SINGLE LIMIT $1,000,000 Ea accident X ANY AUTO BODILY INJURY(Per person) $ OWNED X SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED I X NON-OWNED PROPERT.YDAMAGE $ AUTOS ONLY AUTOS ONLY Per accident $ A. X UMBRELLA LIAB X OCCUR UHND797278 1/1/2019 1/1/2020 EACH OCCURRENCE $9,000,000 EXCESSLIAB CLAIMS-MADE AGGREGATE $9,000,000 DED I X I RETENTION$n $ PER B WORKERS COMPENSATION 11007414 1/1/2019 1/1/2020 X STATUTE EERH I MA&ME AND EMPLOYERS'LIABILITY Y/N ANYPROPRIETOR/PARTNER/EXECUTIVE M E.L.EACH ACCIDENT $500,000 OFFICER/MEMBEREXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Pella Boston Window&Doors 45 Fondi Road Haverhill MA 01830 AUTHORIZED REPRESENTATIVE � I ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD ,J; GOIYIn10f1Wealth oF; a8sa�chuiots, -D- onal Li ens ae: a C0ara>.ot't3uildirtg RegU➢'atoons:.�n st`ndards td i ' v . c:v N.ci Constrtn� 1'fi4� rvisos' ) N r; 0, a CS''089853 {' o >r i is 1,fib 417441i 7, XpIreS 0/26/Z020 9 cci 0 H r >. $ l..' 3 kgm', Srs9r,+k It � ; t ip- t` c ,F t " N.w+_cu O "LLIAM:R NB FBOd:�i " ' a 1 Hy 9r r ' 3 9 N ,i rtl. y ,w ��{ y y of 3, 'CAR �R AV�Nd9E v ��`7yif sy? Y{E � u r" p o $ ti SALISRIURV M F®,0`952 y 1C7` ., �r, '`4 0 o'�,w . !bir � c .t�• r�� ,S f � �� is 3 �=7 V O L..��✓:.. 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P�LLA .>I..,. ..//�' ,.._. ._ ✓ Q.��1/5`& OOR , ._,,:. . , >~r..r ��,` � � ,,�r�r =u�...>;", k. ,„. LLiAnn„,. nl"_._ -^,,.•- 't x -t. .:ur„:k; #!, it :l d, t St, 'ri: 'i'7i r. :pk. ._..., ,.,.,:,.. ,.:..... .. .:::.. ,....�.. .. .. .. -...,...li ,, 4rJ -�v. � ,f.,*,,.tY. .:,...,. t :;�. r $.,. .,,,.a •. ..L,. '�`�..> ;J:. [.. ,!1 r - s'� � 1' . ., - •: ,.. - : ;.1 ,,�'� L? irs. ,Y''s..ya;. q. r'L,. :.., k '^'•.,,t r j .�i �i ✓ S 8 1�.bra,:- k> ( HA�(,ERHtLL :4.01832,, :r>, �, -.._, ...:'•: --''._... .. �. �.<. :..,,n ;a. + .! f7 .:,� §. � - f i �Iti - 1. Contract - Detailed Pella Windows and Doors Sales Rep Name: LeClair,Alex ® HIC#183279/Tax ID#26-1413183 45 Fondi Road Sales Rep Phone: 978-802-8892 Haverhill, MA 01832 Sales Rep Fax: Phone: (978) 373-2500 Fax: Sales Rep E-Mail: leclairaj@pellaboston.com �::; x: :. __ � ate,. ,; � �h :.. 7- '...• IA Customer Information Project/Delwery.¢Address . Order.lnfarmation Pat Bergstrom Bergstrom,Pat,49 Brittania Cir,Salem,MA,US,01970, Quote Name: 3 250 Windows 49 Brittania Cir 49 Brittania Cir Order Number: 741AL0213 SALEM, MA 01970-6848 Lot# Quote Number: 11452536 Primary Phone:(978)7292025 SALEM,MA 01970-6848 Order Type: Installed Sales Mobile Phone: County: ESSEX Payment Terms: Fax Number: Tax Code: MA TAX 6.25 E-Mail: pmrbergstrom1986@gmail.com Quoted Date: 6/7/2019 Great Plains#: 17239904 Customer Number: 1009191454 Customer Account: 1005263855 - 10 None Assigned Delivery/Setup- Delivery/Setup Item Price Qty Ext'd Price $181.50 1 $181.50 I For more information regarding the finishing, maintenance, service and warranty of all Pella®products, visit the Pella®website at www.pella.com Printed on 6/7/2019 Contract-Detailed Page 1 of 7 Customer: Pat Bergstrom Project Name: Bergstrom,Pat,49 Brittania Cir,Salem,MA,US,01970, Order Number: 741AL0213 Quote Number: 11452536 Lme# cation ` Attributes - `. �r �> 6w-f 15 Fixed Stairs Pella 250 Series, Direct Set Fixed Frame, White Item Price Qty ExVd Price $1,237.10 2 $2,474.20 1:SizeNon-Standard Size Fixed Frame Direct Set PK# General Information: Standard,Vinyl,Block,No Foam Insulated,3 1/4",3 1/4",Sill Adapter Included,Head Expander Included 2037 Exterior Color/Finish: White Interior Color/Finish: White Glass: Insulated Dual Tempered Low-E Advanced Low-E Insulating Glass Argon Non High Altitude _.._..."__ Performance Information: U-Factor 0.27,SHGC 0.31,VLT 0.58,CPD PEL-N-209-00056-00001,Performance Class CW,PG 30,Calculated Positive DP Rating 30,Calculated Negative DP Rating 30,Year Rated 08111 Viewed From Exterior Grille: No Grille, Remove/Reinstall Blinds-Remove/Reinstall Blinds Qty 1 Window Installation-Window Installation Qty 1 Material—Jamb Pocket<60-Upgrade to Jamb Pocket<60 Qty 1 Material—Jamb Pocket-Upgrade Jamb Pocket Qty 1 Une# Location41 = Attributes 25 Fixed Above Doors Pella 250 Series, Direct Set Fixed Frame, White Item Price Qty Ex1rd Price $1,237.10 1 $1,237.10 1:SizeNon-Standard Size Fixed Frame Direct Set 1 PK# General Information: Standard,Vinyl,Block,No Foam Insulated,3 1/4",3 1/4",Sill Adapter Included,Head Expander Included 2037 Exterior Color/Finish: White Interior Color/Finish: White Glass: Insulated Dual Tempered Low-E Advanced Low-E Insulating Glass Argon Non High Altitude Performance Information: U-Factor 0.27,SHGC 0.31,VLT 0.58,CPD PEL-N-209-00056-00001,Performance Class CW,PG 30,Calculated Positive DP Rating 30,Calculated Negative DP Rating 30,Year Rated 08111 Viewed From Exterior Grille: No Grille, Remove/Reinstall Blinds-Remove/Reinstall Blinds Qty 1 Window Installation-Window Installation Qty 1 Material—Jamb Pocket<60-Upgrade to Jamb Pocket<60 Qty 1 Material—Jamb Pocket-Upgrade Jamb Pocket 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 6/7/2019 Contract-Detailed Page 2 of 7 Customer: Pat Bergstrom Project Name: Bergstrom,Pat,49 Bd tania Cir,Salem,MA,US,01970, Order Number: 741AL0213 Quote Number: 11452536 Attributes 30 None Assigned Min.Order Quantity- Min.Order Under 3 FF or 5 PF Item Price aty Ext'd Price $268.00 1 $268.00 Thank You For Purchasing Pella® Products For more information regarding the finishing, maintenance,service and warranty of all Pella®products,visit the Pella®website at www.pella.com Printed on 6/7/2019 Contract-Detailed Page 3 of 7 Customer: Pat Bergstrom Project Name: Bergstrom,Pat,49 Brittania Cir,Salem,MA,US,01970, Order Number: 741AL0213 Quote Number: 11452536 PELLA WARRANTY: Pella products are covered by Pella's limited warranties in effect at the time of sale.All applicable product warranties are incorporated into and become apart of this contract. Please see the warranties for complete details,taking special note of the two important notice sections regarding installation of Pella products and proper management of moisture within the wall system.Neither Pella Corporation nor the Seller 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 obligations 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 Rolscreen[or 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 characteristics are not covered under the limited warranty. INSYNCTIVE 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 Insynctive Software Agreement and Privacy Policy are part of the terns of sale. ARBITRATION AND CLASS ACTION WAIVER("ARBITRATION AGREEMENT") YOU and Pella and its subsidiaries and the Pella Branded Distributor AGREE TO ARBITRATE DISPUTES ARISING OUT OF OR RELATING TO YOUR PELLA PRODUCTS(INCLUDES PELLA GOODS AND PELLA SERVICES)AND WAIVE THE RIGHT TO HAVE A COURT OR JURY DECIDE DISPUTES.YOU WAIVE ALL RIGHTS TO PROCEED AS A MEMBER OR REPRESENTATIVE OF A CLASS ACTION,INCLUDING CLASS ARBITRATION,REGARDING DISPUTES ARISING OUT OF OR RELATING TO YOUR PELLA PRODUCTS.You may opt out of this Arbitration Agreement by providing notice to Pella no later than ninety(90)calendar days from the date You purchased or otherwise took ownership of Your Pella Goods.To opt out,You must send notice by e-mail to pellawebsupportp_pella.com,with the subject line:"Arbitration Opt Out"or by calling(877)473-5527.Opting out of the Arbitration Agreement will not affect the coverage provided by any applicable limited warranty pertaining to Your Pella Products.For complete information,including the full terms and conditions of this Arbitration Agreement, which are incorporated herein by reference,please visit www.pella.com/arbitration or e-mail to pellawebsup"port@pella.com,with the subject line:"Arbitration Details"or call (877)473-5527.D'ARBITRAGE ET RENONCIATION AU RECOURS COLLECTIF("convention d'arbitrage")EN FRANCAIS SEE PELLA.COM/ARBITRATION. DE ARBITRATE Y RENUNCIA COLECTIVA("acuerdo de arbitraje")EN ESPANOL VER PELLA.COM/ARBITRATION. Product Performance Information: U-Factor,Solar Heat Gain Coefficient(SHGC),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 suitability of any product for any specific use. Design Pressure(DP),Performance Class,and Performance Grade(PG)are certified by a third party organization,in many cases the Window and Door Manufacturers Association (WDMA).The certification requires the performance of at least one product of the product line to be tested in accordance with the applicable performance standards and verified by an independent party.The certification indicates that the product(s)of the product line passed the applicable tests.The certification does not apply to mulled and/or product combinations unless noted.Actual product results will vary and change over the products life. For more performance information aiong with information on Florida Product Approval-Syste,.F-PAS)N,.n ber and Texas,afie"t.of s'urance'Tui` bG go F www.pella.com/performance. For more information regarding the finishing, maintenance, service and warranty of all Pella®products,visit the Pella®website at www.pella.com Printed on 6/7/2019 Contract-Detailed Page 4 of 7 Customer: Pat Bergstrom Project Name: Bergstrom,Pat,49 Brittania Cir,Salem,MA,US,01 970, Order Number: 741AL0213 Quote Number: 11452536 v T✓> Project Checklist has been reviewed Customer initial Product Only Addendum has been reviewed Customer initial P /�' Final payment is due upon Substantial Completion per the Terms and Conditions Customer Initial Removal and reinstallation of blinds are the responsibility of the homeowner. If for any reason blinds are not removed,you will be charged to remove the blinds and we are not responsible for any damage that might occur to the existing blinds. Pella will not reinstall blinds and does not guaranty.existing blinds will fit in to the new windows. Customer Initial A 1.5%FINANCE CHARGE PER MONTH WILL BE ASSESSED TO ALL BALANCES OLDER THAN 30 DAYS Credit Card Accou #: Last 4 Digits Expiration Date: / Charge final payment to sa a account (Upon substantial comp tion) ustomer initial For more information regarding the finishing, maintenance,service and warranty of all Pella®products,visit the Pella®website at www.pella.com Printed on 6/7/2019 Contract-Detailed Page 6 of 7 Customer: Pat Bergstrom Project Name: Bergstrom,Pat,49 Brittania Cir,Salem,MA,US,01970, Order Number: 741AL0213 ,Quote Number: 11452536 �oject Checklist has been reviewed Pat Bergstrom Alex LeClair Order Totals E s }` _ Customer Name (Please print) e a s Rep Name (Please print) Taxable Subtotal $2,226.87 O Sales Tax @ 6.25% $139.18 Customer Signature Pella Sales Rep Signature 6/7/2019 6/7/2019 Non-taxable Subtotal $1,933.93 Total $4,299.98 Date Date Deposit Received $2,150.00 J Amount Due $2,149.98 The cardholder authorizes Pella Boston Windows&Doors to charge the(circle one)VISA,MASTERCARD, DISCOVER,or AMERICAN EXPRESS for the full amount of this order. The cardholder agrees to the card issuer's terms and conditions and is legally authorized to use this card.The cardholder can request an electronic receipt of this transaction.The cardholder's signature further acknowledges use of this card for this purchase and gives permission to have this card used for transactions associated with this order. Last 4 is of Cred' Card Condo Info Card Expirat' n Da (MMNYYY) Jill Fama, CMCA Crownshield Management Corp. Card hers signature 18 Crowninshield St., Peabody, MA, 01960 978-532-4800 ext. 232 Email: jfama@crowninshield.com Date of Signature For more information regarding the finishing, maintenance, service and warranty of all Pella®products, visit the Pella®website at www.pella.com Printed on 6/7/2019 Contract-Detailed Page 7 of 7 CITY OF SALEM MASSA a-IU5 ETI'S S BUILDING DEPARTMENT 120 WASHINGTON STREET,3RDFLOOR 'AL.(978)745-9595 RAMERLEYDRISOOLL FAX(978)740-9846 MAYOR THOMM ST.PIERRE DIRECTOR OF PUBLIC PROPERTY/BUILDING OOAWSSIONBR Construction Debris Disposal Affidavit (required for all demolition & renovation work In accordance with the sixth edition of the State Building Code, 780 CMR,Section 111.5 Debris, and the provisions of MGL c40,S54;Building Permit# —is issued with the conditio'n that the debris resulting from this work shall be disposed of in a properly licenses waste deposit facility as defined by MGL c 111,S150A. The debris will be transported by: (name of ha r) The debris;will be disposed of in: (name of facility) (address of facility) A � Signature of applicant (today's date) a