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2D HART WAY - BUILDING INSPECTION CM-OF-1 LOW PUBLIC PROPERTY DEPARTm&NT (�J 13DWA84ML"�itYr. a/A.AO�a{„701YT. AtPl.ICATION FOR TM RUAElL RRNNOYAIM CONSMUMOPI DE.r[OLRI N.OR CHANGR OF USZ OR OCCU! Nrv_ Folk •Ny F>icr_va NG mmcrum 1.0 SfTt INFORMATION ..iC ! o'r�D Loealton Nauru Buildtr� F�opsny ------ -- D Hart" WGt SQ-lean . MA F *M 1p b bated in a;CorawvM n Am YM HW"io oiwm YM 9.0 OWNEROW INFORMATION 2.1 Owner of La" 3-Ohr) Ka r)e Mantis Addruw a D Kart- vv Gy Tom~. Q-18 - -7 Ll I- zq 1-7 ff THIS SECTION FOR WORK IN E><IiaNp 9LMLDI lag ONLY Existing Number of Storks Renovated Change h Use Now OemoGtkxt E)"yrg Approximate ear of per n constructIon or renovation Area Raw s F enovated of existing building ew add Description of Proposed Work: �/G�Axit-�i�az 3 zx�d i�����2o�eeyc�c --- - ----Mail Permit to; _ ._ Ulm of that&Ak**? d w e � � n mate is Ma ourrent It dwea4l.tow�IM As9 M,�eanw of euidinq? WS"&&*I Conform 10 L&W? - Aab""? Ardftca Nara Addrw and Paena wdmda'e Noma N� AddnMs and Pea» IZ — Cao.imcdon SupOvims Ucwwo# 2 Gl O G 0 HIC ReplstaUon d EsWnard � 3. pows F«Calaial m Permit FN S EslYnalad Con X$7161000 RsskM dd --- --- — Esdmabd Cost X=41/:1000 Conenandal, --—An Addltlonal S&OO Is added as an AdmkistnWa dwye. Make tun Mat an fields are prop" and tog"man to avold delays in prodssln4. The WMmWad do"hereby aPPly tbn a Bu*"Permit tom bold to Me above atstad apad0atlom Sipnod under pwuft of PWJIO • `� Date c,' 06 CITY OF SALEMq MASSACHUSKTTS PUBLIC PROPERTY DEPARTMENT 120 WASMIMOTON STMK9T, 3s0 FLOOR---- SALLM. MAfswcNUsarrs 01970 STANUM J. U30YICX, JO. T[LtrMONE: 978-745-9595 H%T. 390 MATOA FAX: 978a40.9444 Salem Buildlna Demrtment Debris Dlsoasal Form fn accordance with the provisions of MGL c40 S 54, a condition of your Building Permit is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL Chapter III, S 150 A. The debris will be disposed of in: f C Y2 (Location of Facility) 13 vI . Wobuln , MA Signature of Applicant Date AC0RD- -,CERTIFICATE OF LIABILITY INSURANCE R-i �.12i31/0 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Y AND CONFERS NO RIGHTS UPON THE CERTIFICATE PRODUCER ONLY S CERTIFICATE DOES - ONLY AND CI NOT AMEND,EXTEND ORHO - American First Ins Agency Inc ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 122 Quincy Shore Drive NAIC# North Quincy NA 02171 INSURERS AFFORDING COVERAGE Phone: 617-770-9000 INSUREfl A: Arbella Protection Ina. Co INSURED INSURER B: INSURER C: ewprO Op N erating LLC INSURER D: PO Hox 2696 Woburn NA 01801 - INSUREfl E: COVERAGESSSUED TO THE INSURED THE POLICIES OF INSI,RRAICE M OR CIONDITIIONOOF ANY CONTRIACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THISCERTIFICATE MAYBE ISSUED OR DING ANY REQUIREMENT,MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED DV PAID CLAIMS. - POL C EF E 1 E PI A LIMITS LTfl NSR TYPE OF INSURANCE POLICYNUMBER 0 TE(MMJ ONY) DATE(MNI/OO/YY EACH OCCURRENCE 51,000,000 GENERAL LIABILITY D1/01/08 01/01/09 PREMISES(Eaaccurenca) $ 50,ODD A X COMMERCIAL GENERAL LIABILITY 850000010649 - MEDEXP(Anyoneperson) $ 5,000 CLAIMS MADE OCCUR - PERSONAL&ADV INJURY $ 1,DO0,000 GENEFlALAGGREGATE 52,000,000 PRODUCTS-COMP/OPAGG S . 00 0,000 — — GEN'L AGGREGATE LIMIT APPLIES PEP: PRO- POLICY JECT LOC COMBINED SINGLE LIMIT $ 1,000,000 AUTOMOBILE LIABILITY 12/31/07 12/31/08 IEa accldenl) ' A ANY AUTO - 81037400001 BODILY INJURY $ ALL OWNED AUTOS (Per Parson) X• SCHEDULED.AUTOS - BODILY INJURY S X. HIREDAUTOS (Per accldent) X NON-OWNED AUTOS - pROPERTY DAMAGE S (Per amidwl) AUTO OINLY-EA ACCIOENT $ ' GARAGE LIABILITY OTHER THAN EA ACC $ ANY AUTO - AUTO ONLY: AGG S EACH OCCURRENCE 5 5,COO,DDD EXCESSIUMBRELLA LIABILITY 01/O1/08 01/01/09 AGGREGATE SS,DDD,DDD A X OCCUR CLAIMSMADE 4600010709 $ $ DEDUCTIBLE - - - S RETENTION S - X TORY LIMITS ER WORKERS COMPENSATION AND 05/01/07 05/01/08 E,L.EACH ACCIDENT $ 500,000 EMPLOYERS'LIABILITY 90967005 A ANY PROPRIETOR'PARTNER/EXECUTIVE C-.I_CISEASEEAG�dPLOYEE $ 500sD00 OFFIGER/MEMGER EXCLUDED? - - El.DISEASE POLICY LPAIr $$ 500_ oj� SPECIAL PROVISIONS below OTHER OESCRIPTI NOF OPERA710N31 LOCATIONS/VEHICLES/EXCLUSIONS ADDED BV ENOOflSEMENT/SPECIAL PROVISIONS OPERATIONS OF INSURED CANCELLATION CERTIFICATE HOLDER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION _ SPECINE GATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3 O DAYS WRITTEN N07IC E TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL _ SPECIMEN POSENO BLIGATIONORL ITV OF ANY KING UPON THE INSURER,ITS AGENTS OR REPRESENT TIVES A IZE REP S NTA IVE J Farre CP 0 ACORD CORPORATION 199e amllll.d'ualxa0ls a DEVCO PRODUCTS, INC. drac Nawpro/Denalf 7000 Double Hung. - Vinyl frai ,.Triplo ylztad, . wlkr+i Fwrtraa+n Low E c*.Iing I.—o.034,5265J, - wryceaa krypton/Argon/alr tilted,nlvldsrs e ENERGY PERFORMANCE RATINGS Uractor(U.S,/I-P)' Solar Heat Gain Coefficient ' 0a19 0.25 ADDITIONAL PERFORMANCE RATINGS Visible Transmittance Air leakage(U.SA-P) , ®a60V. a . Condensation Resistance 7 . MVManacsOWhlo CratOrenWgs aMamblppNaEk NgiLpxed�n frdet?nMrgside ' sycifKpoducl .'r,.i.,r Mumarca GFACwtln�mde4.mirdlaaMdufofmtt5av,rznW�n41'asmds . sm.lomAmavtactirNtMmLa haNerpWti pabmara4Srmrfidi . ' www.nfm.cam - . GTk / az Board oEBuilding Regulations and Standards H Construction Supervisor License Liote, CS 29090 -Tr# 8131 ita sum io tiff THOMALN FOX©�ce_t, _ 230 WALNUT$'E - ' READING,MA 01867 � Commissioner' . �,\ JJze �a�rrrri�wmu:ea�C.�e a�✓�rxnvac,�u..o-teC� - Board of Building Regulations and Standards - HOME IMPROVEMENT CONTRACTOR Registraticui. 146589 - . Expv6666 .; 6(5/2009 Typei Supplement Card NEWPRO OPERATING LLCi - - THOMAS FOXON - 26 CEDAR ST. ( ,,...�. WOBURN,MA 01801 Administrator f . Department oflndustrial Accidents Of ice oflnvestigations 600 Washington Street � . Boston, MA 02111 www.mass. o�v/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): NEWPRO Address: 26 CEDAR STREET City/State/Zip: WOBURN,MA 01801 Phone#: 781-932-8300 Ext. 251 Are you anemployer? Check the appropriate box: - Type of project(required): 1.X I am a employer with 50+ 4. ❑ I am a general contractor and I 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. $ 7. X Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition workingfor me in an capacity. workers' comp. insurance. 9 Y P tY ❑ Building addition No workers' coo insurance 5. ❑ We are a corporation and its [ P 10.❑ Electrical repairs or additions required.] officers have exercised their 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.] + employees. [No workers' 13.❑ Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. +Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. t am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: ARBELLA PROTECTION INSURANCE Policy#or Self-ins.Lie.#- 90967005 Expiration Date: 05/01/2008 Job Site Address: 9P 1 bI City/State/Zip: Attach a copy of the workers' compensation p icy 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 thepains and penalties ofper'ury that the information provided above is true and correct Signature: FOR NEWPRO Date: � // 0� Phone#: 781-953-8146 Official use only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health . Building Department]3. City/Town Clerk 4. Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: MA Reg. #146589 ! ' 56014 CT Reg. #0605216 O RI Reg. #26463 �EREPLACEMENrwINDOW Federal ID#20-2625129 Corporate Headquarters:26 Ceder St,P.O.51,2696 Woburn,MA 0188e (781)9334/00 1-800342-2211 THIS CONTRACT MADE THE . `\y :�!�i `7day of. ff 200.9. . between . . . . . ant . ... .. . . . . . . . . . . . . . F7T— 74;q :c?y7-7 of. (Home Owners ,c, (yy,,�, ) (Ho evPhone) (Bus. ell hone) � (McRvtrs.) / Dl. : V . (Address) (State) (Zip Code) the "Owner and NEWPRO Operating, LLC, "NEWPRO". NEWPRO hereby agrees that it will for the consideration hereinafter mentioned, furnish all labor and material necessary to install the following describedd Ork at the premises located at (Job address) . . . '(E-Mail Address) TOTAL NEWPRO Additional Style le Q TOTAL CASH Windows Purchased Work PRICE Window Color Specify Sliding Glass Door DEPOSIT Capping Color Specify Oty Staa Seas oor 4. —y I WITH ORDER Double Hung f Picture Window Obscure Glass TOP BOTTOM BALANCE Stationary Casement Screens HALF FULL DUE AT Casement - Model# INSTALLATION 2 Lite / 3 Lite Slider NEWPRO® does not do any painting or b Bay/ Bow Frame staining. CASH Garden Window NEWPRO` is not responsible for conditions Balance Paid to or circumstances beyond its control Including Installer at Installation Awningcondensation resulting from or due to pre- Other existing conditions. FINANCE Bank Completion GRIDS Colonial Diamond Form Signed at Installation DESCRIBE WORK: ' ,vYaI U ram- i 5 r kJt Ins A 1;Ikl ab CPJr �Jc f " , 0 c:t_ LA I r.P,t .1-f. t l SCouw — tPv7c� All steel security doors will have a 3/4"aluminum threshold installed over exis'ng threshold.0 Customer Initials Est. Start Date: ,,,) to g Est. Comp. Date: t 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 Place, Room 1301, 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 to 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 cf 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 that entire agreement between the Owner and NEWPRO and cannot be changed except by a 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 �—O-wnne has seen "sample" warranties that will be provided by NEWPRO upon installation. LLn Sample warranties provided to Owner. IN WITNESS WHEREOF, the parties have hereunto signed their names is day of.,2&� 200L Gb� EIN# Signed Marketing Representative Printed Name Owner Accepted: NEWPRO Operating, LLC By Signed Marketing Representative Signature Owner WOBURN BRANCH OFFICE SHREWSBURY BRANCH OFFICE WARWICK BRANCH OFFICE. 26 Cedar Street 151-153 Memorial Drive Business Park - 24 Minnesota Avenue Woburn,MA 01801 Suite B-C Warwick,RI 02888 TEL:781-932-8300/EXT:330 Shrewsbury,MA 01545- - TEL:401-732-2407 800-242-9974(FROM NE) TEL:508-842-6876 800-356-3312(FROM NE) FAX:781-933-0717 800456-0555(FROM NE) FAX:401-732-1371 FAX:506-842-9248 WHITE: Branch Copy YELLOW: Customer's Copy PINK: File Copy GOLD: Finance Copy US-15 100/PKG. (Rev8/07) N L07 LI�"�� wrndoivs/�eora rn THE R JOB# EPLACEMENT WINOOW PEOPLE IArt t -? Page Of CUSTOMER joli E-MAIL ADDRESS HOME PHONE_! ^/� DATE /C�u-rC� WORK/CELL PHONE'/�_ lPy� — (066 _ (Circle one) - `ADDRESS _ 'J �rll�l �u-`'� _ BEST DAY TO INSTALL: M T W TH F CITY,STATE - ��Z--�NVI - (Please circle one) �\ - PRODUCT SPECIALIST BRANCH: ESTIMATED START DATE TOTAL#OF #OF DOORS WINDOW COLOR - - WINDOWS � #OF BOW/BAY/GARDEN stor steei. tiu insi� CAP COLOR OPENING SIZE STOPS N STYLE W x H U.I. LOCATION GRID SCR IN I OUT ADDITIONS OPENING CUT LU-� Sax YO J x x J (Z X- O vYL`I x x T. x x t x x x x x x x x x x x x .. / x x x x x x x x x x x x If x x Measureman: - Initials Date Crew Size Needed Time Frame to complete job Capping Type Special Installation Inslr do - ��e i/Y/t7cLUi' ��- L�USGcyJ� C�i¢iiv� Directions to site: Revised 1101