17 JAPONICA ST - BUILDING INSPECTION EITyOF
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PUBLIC PROPERTY
DEPARTMENT
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1.e SITS INFORMATION
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9.0 OWNERS w INFORMATION
8.i Owner ofLoW Narr Wessel
marm I HOrr WtsSe1
Addnsst 17 Japon,co- St
Telephone. I qr)9 -594. 53(�p
&A COMPLETE THIS SECTWN FOR WORK IN wymmum BUILDINGS ONLY
Addition Exl"
Renovadw Number of storks Renovated
Change U Use New
Demouftn ,tip
Approximate year of Arms per Aoor(st) Renovated M
constructlan or renovation
of existing building New
Brie!Description of Proposed Work:
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info 'exishrng Op-enings
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Date
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CITY OF SALEM9 MASSACHtlSETTS
PUBLIC PROPERTY DEPARTMENT
120 WASHINOTON STREET. 3R0 FLOOR-
SALEM. MASEACHU3ETTE 0I970
STAMLEr J. USMICZ, JR. TELEPHONE: 9711-745-9399 ExT. 300
MAVOR FAX: 970-740-94544
Salem Buflftnij-Departinenj
Debris Dlsoosal Form
In 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:
durnps+er (L.ocationofFacility) �3 wheei(r�g Qve
�-
Signature of Applicadt
Date
ACORD CERTIFICATE OF LIABILITY INSURANCE OR ID HJ DATE(MM/DD/Y""`')
NEWPR-1 05/01/08
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
American First Ins Agency Inc HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR
122 Quincy 'Share Drive ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
North Quincy MA 02171
Phones 617-770-9000 INSURERS AFFORDING COVERAGE NAICN
INSURED INSURER A: Arbella Protection Ins. Cc
INSURER B:
Ne ro Operating LLC INSURER C:
P0 w0b11ZII 2 901B01 INSU: ERD:
INSURER E:
COVERAGES
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,AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
LTR INBRI TVPEOFINSURANCE POLICY NUMBER DATE MMIDON DATE MMIDDIYY LIMITS
GENERAL LIABILITY EACH OCCURRENCE $ 1,000.000
A X COMMERCIAL GENERAL LIABILITY 850000010649 - 01/01/09 01/01/09 PREMISES Ea=arence) $ 50,000
CLAIMS MADE ®OCCUR MED EXP(Any ana Parson) S 5 e 000
PERSONAL S ADV INJURY $ 1,000.000
GENERAL AGGREGATE $2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $2,000,000
1 POUCV P�I,aT LOG '
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
ANY AUTO 81037400001 12/31/07 12/31/08 (Ea-cilen0 $ 1,000,000
ALL OWNED AUTOS BODILY INJURY
X SCHEDULED AUTOS (Par Perean) S
X HIRED AUTOS BODILY INJURY
X NON-OWNED AUTOS (Per azdaen0 S
PROPERTY DAMAGE $
(ParaeNaen)
GARAGE LUUIIUTY AUTO ONLY-EA ACCIDENT $
ANY AUTO OTHER THAN EA ACC S
AUTO ONLY: AGO $
ERCESSIUMBRELLALIABILITY EACH OCCURRENCE $ 5.000,000
A X OCCUR EICLAIMSMADE 4600010709 01/01/08 01/01/09 AGGREGATE $ 5,000,000
S
DEDUCTIBLE $
1 , RETENTION $ All
( WORKERS COMPENSATION'AND X ITO&YTIMITS
ER
S 'EMPLOYERS LIABILITY
A'. ANY PROPRIETOR/PARTNER/EXECUTIVE 90967005 05/01/08 05/01/09 E.L. II EACACCIDENT $500,000
OFFICER/MEMBER,EXCLUOEOT E.LDISEASE-EAEMPLOY $500.000
ndw
SMICIALPRO PROVISIONS
E.L.DISEASE-POLICY LIMIT 5 500,000
SPECIAL PROVISIONS 4elmv
OTHER
DESCRIPTION OF OPERATIONS/.LOCATIONS/VEHICLES I EXCLUSIONS ADDED BV ENDORSEMENT/SPECIAL PROVISIONS
OPERATIONS OF INSURED
CERTIFICATE HOLDER CANCELLATION
SPECINE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATH
DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO 00 SO:SHAL
SP847 ID'!EN IMPOSE NO OBLIGATION OR ILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR
SENTA 8.
' AUT NOR REDR RESEN AT
J r
ACORD 26(2001M) a ACORD CORPORATION 191
e
e e • e ea
.® = Qualified In all zones
Lo NEWPRO MANUFACTURING
krxc 2000 DOUBLE HUNG
Cellular PVC frame, Triple glazed,
National Fenestration - Low E coating (e=0.034, 32-& 5),
_Rating Council® Krypton/air.filled
I
® oEV-K�20-00001
ENERGY PERFORMANCE RATINGS
U-Factor(U.S./I-P) Solar Heat Gain Coefficient
OAT 0 . 27
ADDITIONAL PERFORMANCE RATINGS
Visible Transmittance Condensation Resistance
3
: 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
specific product size.NFRC does not recommend any product and does not warrant the suilabllily of any
-or for any specific use.Consult manufacturer's literature for other product performance information.
www.nfrc.or
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T:hiCitvlAS-P FOX
23g WALNUT�uT
REPoO:ING;MA.01867 CommissFoner
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i \ Board of Building Regulations and Standards
HOME IMPROVEMENT CONTRACTOR
� Registration •1t16589
EXpuaf�o_b.�, �/.5/2009
Type Supplement Card
NEWPRO OPERRTING -
THOMAS FOXON
26 CEDAR ST - ...�.
WOBURN, MA 01801 Administrator
' Department oflndustrial Accidents
Office oflnvestigations
600 Washington Street
Boston, MA 02111
www.mass.gov/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 M 781-932-8300 Ext.251
Are you an employer? Check the appropriate box:. Type of project(required): _
1.X I am a employer with 50+ 4. ❑ I am a general contractor and 1 6. ❑ New construction
employees(full and/or part-time).* have hired the sub-contractors
listed on the attached sheet.
2. ❑ I am a sole proprietor or partner- listed 7. X Remodeling
ship and have no employees These sub-contractors have 8. ❑ Demolition
working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition
[No workers' comp. insurance 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions
required.] officers have exercised their
3. ❑ I am a homeowner doing all work right of exemption per MGL l 1.❑ 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 time of the sub-contractors and their workers'comp.policy information.
I 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.Lic. #- 90967005 Expiration Date: 05/01/20OR
Job Site Address: 11 JapUni Cn -'J . So(em , AAA City/State/Zip:
Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby certify under the pains and penalties ofper'ury lit the information provided above is true and correct.
Signature: 77 FOR NEWPRO Date: 6 .3O
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 . Bui ding De artmen 3. City/Town Clerk 4. Electrical Inspector S.Plumbing Inspector
6. Other
Contact Person: Phone#:
MA Reg. #146589 5458
6
CT Reg. #0605216
RI Reg. #16463 THE REPLACEMENrwlNDOW PE® Federal ID#20-2625129
Corporate Headquarters:26 Cedar St.,P.O.Box 2696 Woburn,MA 01ga8- (781)933-4100 1-80P 2211
THIS CO;TRACT MADE THE . . . . . . . . . � . , day of. �!. . . . . 200. between. . . . . . . . . . . .
Sc' . . . . . . . . . . . T -: K. , . . (�
. . . . . .
(Home Owners) (Home Pone) Bus./Cell Phone Mr./Mrs.
Of. . . . .� . . . . . S�00. G�. . . s.'�. . . . . . . . . 5 �2 /1/I / . . .� . . . . . G S�E!. . . . .
(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 described work at the premises located at
. . . . . . . . �s.rlvY'. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(Job address) E-Mail Address
TOTAL NEWPRO Additional Style Oty TOTAL CASH
Windows Purchased Work PRICE
Window Color Specify Sliding Glass Door DEPOSIT
Capping Color Specify W O Steel Securi Door WITH ORDER �C
Double Hun
Picture Window bscure Glass BOTTOM BALANCE
StationaryCasement Screens ALF' FULL DUE AT J> ��
Casement- Model # INSTALLATION
2 Lite 13 Lite Slider NEWPRO" does not do any painting or
Bay/ Bow Frame staining. CASH
Garden Window NEWPRO* la not responsible for conditions Balance Paid to
r circumstances beyond its control Including nstaller at Installation
Awningondensatlon resulting from or due to pre
Other existing conditions. INANCE Bank Completion
GRIDS NI 0 1 Xonial I mond Form Signed at Installation
DESCRIBE WORK: -f-
4 f �
All steel security doors will have a 3/4"aluminum threshold installed over existing threshold.-0 Customer Initials
Est.Start Date: - -p�r Est. Comp. Date: - 6
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 be incorporated herein by reference.
NEWPRO represents that it carries Workmen's Compensation and Public Liability Insurance in the amount of$100,0004300,000.
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 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 Ow r has seen "sample" warranties that will be provided by NEWPRO upon installation.
Sample warranties provided to Owner. `7
IN WITNESS WHERE F, the parties have hereunto signed their names this 4 day of Orin
EIN# Signe0xi �a � I
Marketing Representative Printed Name rwner
Acc R sting, ---
By r Signed
M keting py s t ignat Owner
WOBURN BRANCH OFFICE SHREWSBURY BRANCH OFFICE - WARWICK BRANCH OFFICE
26 Cedar Street 151-153 Memorial I)M BusinessPark 45 Glibame Street
Wubum,MA 01801 Suite B-C Warwick,RI 02886
TEL:781-932.83000M.330 Shrewsbury,MA 01545 TEL:401-732-2407
800-242-9974(FROM NE) TEL:508-842-6876 800356-3312(FROM NE) _
FAX 781-933-0717 800.456-0555(FROM NE) FAX:401-732-1371
FAX:508-842-9248
WHITE: Branch Copy YELLOW: Customer's Copy PINK: File
File Copy GOLD: Finance Copy
US-15 100/PKG. 11105 'Jr�/y OQ`J
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JOB# Windows,Siding and More ' � Page_of_
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CUSTOMF,R
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E-MAIL ADDRESS ✓ HOME PHONE
DATE _ C�"— '"'� ' �! b WORK/CELL PHONE
ADDRESS
"�- —� `S (Circle one)
I _ � �7
II BEST DAY TO INSTALL: M T W TH F
CITY,STATE AM (Please circle one)
PRODUCT SPECIALIST BRANCH: _C}�b ESTIMATED START DATE -7-v r
TOTAL#OF #OFDOORS WINDOW COLOR
WINDOWS OF BOW/BAY/GARDEN storm.Steel Patio inside/Outside CAP COLOR
0I �J Ic�
OPENING SIZE STOPS
NO. STYLE W x H U.I. I LOCATION GRIDJ SCR IN OUT ADDITIONS OPENING CUT
i t S 3 .k. 9V' 114, 1( ':�' t/a I x x
5y v yd Ix x
A SS - L+'rb ,t 0 j/a I x x
355" Kly` 9 L- a `lz x x
/v4' 3 S �2 X �2 v jI x x
o 7 25� 311�3 'H �laz.rc C) ya x x
O 3 �)� ,31 x�� `I 3r LT\ tJa x x
x x
x x
x x
x x
x x
x x
x x
Measureman:
Initials Date Crew.Size Needed Time Frame to complete job Capping Type
Special Installation Instructions:
Directions to site., -
Remed IM1
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