The URL can be used to link to this page

10 LINDEN AVE - BUILDING INSPECTION i� The Commonwealth of Massachusetts Town of Board of Budding Regulations and Standards �� eIG� tJ Massachusetts State Building Code, 780 CMR. T"e'itwn Building Dept Budding Permit Application To Construct. Repair. Renovate r Demolish a okoolowkwo One. or rico-Fans r ivelh Amos This Section For OR ial U Onl Building Permit Number Signature: Building Commisswner/Inspector ofuil ngs Is SECTION 1:SITE I�Jo ATION 1.1 Property Address: 1.2 Assessors MAP& Parcel Numbers 1.1 a Is this an acce led street?yes no Map Number Parcel Number IJ Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use La Area(sq R) Frontage(it) 1.5 Building Setbacks(fl) Front Yard Side Yards ReAr Yard Required Provided Required Provided Required Provided 1.6 Water Supply:( c.40,s34) IJ Flood Zone Information: 1.8 Sewage Disposal System: Zone: _ Outside Flood Zone? Municipal O On site disposal system O Public O Private O Check if s0 P Y SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Recor Name(Print) Address for Service: Signature Telephone SECTION J: DESCRIPTION OF PROPOSED WORK'(c=Specify: New Construction O Existing Building❑ Owner-Occupied Repairs(sAddition O Demolition O Accessory Bldg.O Number of Units_ OtherBrief Description of Proposed Work': SECTION 4: ESTIMATED CONSTRUCTION ; =, p Item Estimated Costs: Omcial Use Only Labor and Materials I. Building f 1. Building Perron Fee: f Indicate how fee is determined: 0 Standard Ciry,Town Application Fee 2 Electrical s 0 Total Project Costs(Item 6)a multiplier x ) Plumbing f 2. Other Fees: f 4. Mechanical (HVAC) f List: s Mrchanical iFire S Total All Fees: f Su ression Check No. _Check Amount: Cash Amount:_ 6 Total Project Cost: S p Paid in Full 0 Ouwandmg Balance Due: SECTION 3: CONSTRUCTION SERVICES 5.1 Licensed Construction Super%isor(CSL► ©*�9jO/ 0 /l 4 Ljccn.. Number E.ptntion ute Lni CSL T ,n Ype IxY hit-low) Tvoc I Description Address— U Unrestricted(up to 33,000 Cu. Ft R Restricted IA2 Family D%ellm S nature —� y M Mason Only 'n RC LResidennal Roofing Covering Telephone I WS Residential Window and Sidinja SF I Residential Solid Fuel Suminal Appliance Installation D I Residential Demolition 3.2 RcItisigr d Vic Improvement Contractor(HIC) /y� ,red �Y� HIC(company Name or HIC Registrant N e Regtstiauon Number A ress 2YLg p—g3 DH �¢apiration Date Si ture Telephone SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 132.1 23C(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. Signal Affidavit Attached? Yea.......... No...........O SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT L 2��E� 64Z �;jj�?i'�.// as Owner of the subject property hereby authorize to act on my behalf,in all matters relative to work authorized by this building permit application. Signature of Owner Date SECTION 7b:OWN ERt OR AUTHORIZED AGENT DECLARATION 1 aster or Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and behalf. D �^ S O ) Print NNW �/ O= Signature of Owner or Auifforized 14ent Date (Signed under the gains and penalli6s of perjury NOTES: I. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor - (not registered in the Home Improvement Contractor(HIC)Program),will gg have access to the arbitration program or guaranty fund under M.G.L. c. I42A. Other important information on the HIC Program and Construction Supervisor Licensing(CSL)can be found in 780 CMR Regulations I 10 R6 and 110 115.respectively. 2. When substantial work is planned, provide the information below: Total Goon area(Sq. Ft.) (including garage, finished basemenVanics,decks or porch) Gross living arcs(Sq. Ft.) Habitable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of half.baths Tvpe of healing system Number of decks/porches TYpeofcoolmgsyslem Enclo.ed Open 1 "Total Project Square Footage"may he.uh,limed for 'Total Project Cost" MA Reg #146589 Fitt III0 Reg. #0605216 56205 RI Reg. #26463 �ucEMENrwwoowPEotxE Federal ID #20-2625129 Corporate Headquarters:26 Cedar St.,P.O.BOX 2696 Wobum,MA 01888 (781)933 100 1-800- 2-2211 THIS CONTRACT MADE THE . . . . . . . . . day of. . .��, . . . . 21 � between. . . . . . . . . . . . ii �/ / I 1. �ITGhr:w 5t1. . �t Home Owners) Horha Phone Of . ' v. ( ) (Bus./Cell Phone) MrJMrs. ( j (Address) (State . 6.077L> (3 . the "Owner" and NEWPRO Operating, LLC, 'NEWPROI (zip Code) NEWPRO hereby agrees that it will for the consideration hereinafter mentioned fur to install the following described work at the premises located at Wish all labor and material necessary (Job address) . . . . .JX '`:` . . . . . . . . . . . . . . . . . . . . . . . . (E-Mail Address) TOTAL NEWPRO Additional Style Qty TOTAL CASH Windows Purchased Work PRICE ( ( Window Color S act lAJ Slidin Glass Door Ca in Color S eci l u O Steel Securi Door DEPOSIT / Double Hun — WITH ORDER �]U ' Picture Window ^ ( Obscure Glass TO Stationary Casement. TiOM BALANCE Screens L DUE AT Casement - Model # 2 Lite/3 Lite Slider INSTALLATION IL� NEWPRO* does not do any painting or Ba / Bow Frame staining. Garden Window NEWPRO* is not responsible for conditions CAS Balance Paid to or circumstances beyond Its control Including Awningcondensation resulting from or due to pre- Installer at Installation GRIDS her DESCRIBE WORK: existing conditions. FINANCE Bank Completion Diamond Form Signed at Installation r J. J II steel security doors will have a 314"aluminum threshold installed over existing threshold. Customer Initials Est. Start Date: Ck ( ' Est. Comp. Date: R - 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 MI 142A. All Home Improvement Contractors and Subcontractors shall be registered by the Director and any inquidea 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 shall be made under said contract and the amount of each payment stated in dollars, including all finance charges. The Retail Installment Sales Agreement ,the terms of therrrevolving line of credit reference. neg�terest rate wner is andpayment)terms,shall iallline be tcl arly, set out in whole on the credit for a appl catio th ccnnr The portionh6 the credit application referencing a time schedule of payment,to be made under this contract, and the amount of each payment stated in dollars, including all finance charges, shall be incorporated herein by reference. NEWPRO represents that it carries Workmen's Compensation and Public Liability Insurance in the amount of$100,000-$300,000. Iwhatsoever f 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 liquidated and es ascertained damages,and notsNEWPRO a Sum penalty,owithout further)to proof of lossand r damage percent of the price agreed to be paid,as fixed, 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 to enter into this agreement. se authoriz ed on behalf of the owner s 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 will at his main ordinary mail posted, by telegram sent or by delivery, not later than midnight of the third business day or following by signing of this agreement. (Saturday is a le al busines Y owing the See the attached notice of cancellation form for an explanation of this right. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. The Owner has seen "sample" warranties that will be provided by NEWPR0 upon installation. Sample warranties provided to Owner. IN WITNESS WHEREOF, the parties have hereunto signed their names this ' day of r 200 S Marketing Representative Printed NameN# Zt Signed Owner Accepted: NEWP perating, LLC By Signed Marketing Repre nt ti Sig re Owner u WOBURN BRANCH OFFICE SHREWSBURY BRANCH OFFICE 26 Cedar Street 151-153 Memorial Drive Business Park WA24 Min BRANCH OFFICE Woburn,MA 01801 Suite B-0 24 Minnesota Avenue TEL:-242-9 74(F/F](T:E) Shrewsbury,MA 01545 Warwick,RI 02888 80 FAX:9974(FROM NE) TEL:508-842-6876 TEL:401-732-2407 FAX:781-933-0717 800456-OW(FROM NE) BOD-3563312(FROM NE) FAX:508-842-9248 FAX:401-732-1371 WHITE: Branch Copy YELLOW: Customer's Copy PINK: File Copy GOLD: Finance Copy - US-15 100/PKG. 1Rev RAI "•"' Page of JOP,# � Wmdotn,Slding and More ' ' - ,CUSTOMER E-MAIL ADDRESS ..HOME PHONE DATE . \ It i WORK/CELL PHONE . ff (Circle one) 1. _ ADDRESS !U —iNte 6IG BEST DAYTO INSTALL: M T W TH F CITY, STATE S( 411-1 �� (715"Z J (Please circle one) PRODUCT SPECIALIST 1 ! H' �1" '��>"*� SRANCH: /ti/� (L ESTIMATED START DATE V TOTAL#OF #OF DOORS WINDOW COLOR WINDOWS #OF BOW/BAY/GARDEN Storm,Steel,PaEo InsideWside CAP COLOR ® ✓ f ��ik OPENING SIZE STOPS NO. STYLE W x H U.I. LOCATION GRIDc SCR IN OUT ADDITIONS OPENING CUT x x /U2 u 1 x x x x x7 is I u-vtLx l+/ X x 4 V � X X x a 1 ! Kx{}t; ,GJ� x x Mx Flo lad i rw\ G x x �YLiv Z b ll0 S J x X�l m owJ 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: - - 1 ,1 Directions to site: R V d 1101 -•••--•• -•-� ••• a..•.+. •+.=n.nuaa �naurance nuceinci[e rnvu[ance n ¢pry '1'°: tl.......lOB6U PAGE: 002 OP 00] I ACORD CERTIFICATE OF LIABILITY INSURANCE os/oii:ot MackPRMU n (508)3surance FAX (508)366-5202 THIS ONLY AND CONFEIS ISSUED RIG TSUPONS A TTHE CERTIFICATE - MetWetlre.Insureet Agency, Inc. HOLDER.THIS CERTIFICATE NOTED OE NOTA END FX END We West Main Street HOLDER.THE AFFO DE NOT AMEND POLICIES BE OR O ALTER THE COVERAGE AFFORDED, THE POLICIES BELOW. ' Westborough, MA 01581-1931 . INSURERS AFFORDING COVERAGE NAICM wsuRev Nevpro Operating LLC - ws . Peerless Insurance Co. 24198 : +� 26 Cedar St. INIARSA e: 1 I' Woburn, NA 01801 INEMeR C. INsuREav: w6LrERE: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD MOICATED.NOTWITHSTANDING ANY REWIREMENT,TERM OR CONDmON 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. M9R POLI EFFECINE POLICYEFPIfIATION TY wiaivMNCE PttICYNYMBER UMn6 - aENERLLLMBILm P 8588370 - MA POLICY 12/31/2008 12/31/2009 EnalocclmrFNCE s1.000 - V X COMn-acuLGEHEIYLLWIL P 8589577 - RI POLICY ° i 300 00 CU¢MSNA[E Xomm NmDT 1Aq R.wxml s 15,00 � Board of Building Regulations and Standards A PUISOw aADV INARY s 1 000.00( vo¢enrtADwewTE $ 2 000 HOME IMPROVEMENT CONTRACTOR CErrtmcREVATE UNRPPPIJEs oER: PRmuers-cawiroxD $ 2 000 PR IstrartiO"L, 89 a Re/r li 1465 POLI°Y ,ApF L. - a i A=IMOeAe uAeAm BA SS94174 12/3 //2002 12/31/2009 coNBwLD SINDLeLNnrt i ., EXplratlPR_S1512011 anAuro IE¢arawW 1.000.000 Type r 501pPlement Card A % swewllE°an°s IPw Prnen) i ;'}_ 3 }_ -1 % HIaE°A'>r°s Baouv wnur NEWPRO OPEF7,�74NiiL :"4.i'1 % NGOONNEDNR09 IPveetiv¢N i -� ]� THOMAS FOXONu - ry.«Naxl 26 CEDAR ST. wwve Lueam ADrovrar-EAAccuxm s WOBURN,MA 01801 `"' - Administrator 1 Nn PNID onER mry EAACC s AUFOaµv: ALE i eXceaavxreRELULUMLm CU 8582578 12/31/2008 12/31/2009 FACHOCGnPerae 1 5,000,000 % ocam �nWNS IeonE AGOIewTE a 5 000 00 A i OEMICDBIE i % RETDRMN s 10,DO $ WONIERe<DI@ENEAIMNAND �•¢N' °M' A "ai c�� WC864S974 OS/01/2OD9 05/01/2010 Ei.EoalxClcon s 500.00 I oFFICEM/fMBE(t EY.4WEM E4 oLSFASE-EAELaLO i 500.00 ,.<• .. n a.FFnw,.iw - s�'ErCv+PRDvlslDxswle„ El.asFASE-PaICY uxrt i 500 0 r-/k p t l✓ �� OTHER i` Bpa✓✓rd ofBOuilding RegulAautitonsand Standards I OESCRUMM°F WERATONBI LO EXCLUSIONS ADDED IVEMMES I EXCLUSIO ADDED BYENDORYENEW1 SPECILL PR VIMIP 'CORStrUCtIOT-SUpervi$Or LICeDSD 1 CS 29090 IZS kl-- ?�/2009 Tr# 8131 i i 1 CERTIFICATE HOLDER CANCELLATION - axolaO AN/oFTHEAeovE VEaweEormmke es uxcELLEv msoRSTRE vipcY-� _1 ` .TH WASP FOXO�ZL� 1 eewunvxwre mwevP,mElaeuwv wwaERwu.aoEAvonroMUL i 1,0_vAra wmrmx xonceroTNe CERIIFIGTPN°LDEA xIBIev Ta Txe LEFtZ 230 WALNUT ST Sur FAawEry NAa MrcH N°TILE muLLvoms xo DaueAnvNwLMMLm READING,MA 01867 298 en Saugus } 298 Central Street aF ANvawowaNTRE IxamMRmADExm oR PEPRE6ExrAT1VEG Commissioner 5au9us, MA AvrHowtev RePREaExrwme ( ..�• ,. '. '. . , : � ', Timothy J. Maynagh _i_ ,_,• I ACORD 25(2001J0a) OACORD CORPORATION/868 - ICI I - u ENE GySTARI�,'Oliailfied in Highlighted Regions .a =qudlfled In all%ones - NEWPRO MANUFACTURING NEWPRO 2000 DOUBLE HUNG Cellular PVC frame,Triple glazed, nd FenedUe,'a Low E coating(e'0:034,S2&5), polAgcoundie Krypton/Argon/air filled - DEV-K-27-00015-00001 - ENERGY PERFORMANCE RATINGS U-Factor(U.S.A-P) Solar Heat Galncoefficient 0.19 0.27 ADDITIONAL. PERFORMANCE RATINGS Visible Transmittance Alr Leakage(U.SJI-P) 0.,40 0.1 Condensation Resistance 70 MwuheWfefaODWslseMdlnesereOnAs Mfsimb spPlWeMeNFRC Prseed txde0omilnin9 e - snw.NMa no e sre delsrmAudfaafiumvtdn^a do iwl Mv°mdme dalsm,oAlH Wash - 'pNduGIP enY eepCaiMN otlOeeaalatammeNlenY.tld . CnneuNmenaMOMawwe.anffrgon; for Where uWpeNnrmeiwe Alfnn1114U0M1 The Commonwealth of Massachusetts Department of Industrial Accidents l _ fLce ofL ves tigations ._ 600 Washington StreetI r Boston, MA 02111 www.massgov/dia R'orkers' Compensation Insurance Affidavit: Builders/Contractors.Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Oreanizationtlndividual): NEWPAO Address: 2Co CEDA2 ST _ City/State.Zip: Wo8L1P_n( W O190) Phone r: 781 . 93,E-8300 EXT a5/ Are you an employer? Check the appropriate box: Type of project (required): I.('� I am a employer with 50 t 4. ❑ I am a general contractor and I 6 ❑ New construction employees (full and/or part-time).* have hired the sub-contractors _.❑ J art, a Sole pr0'yi.0t0r or partner- listed on the attached sheet t I Remodeling ' ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. g. ❑ 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 Tight of er MGL I LEI Plumbing repairs or additions - exemption per myself. [No workers' comp. c. 152, §1(4), and we have no 12.0 Roof repairs insurance required.] t 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- ntracton 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 ?nformation. [nsurance Company Name: HaCkin+ire 1.nsuronce- A9enCL1 _ Policy#or Self-ins. Lic. =: w/G � �y 5 9 `14 Expiration Date: 5- [ - Z 0 ,I�t)� Job Site Address: /!J 4f/7A)''��1/ � City/State/ZipS,��1y1_ 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 S1.500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to S250.00 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 cerrify rider the pains and enalues ofperjury that the information provided above is tr a and co rest Signarint =�L�i�fl Z�Q, FOR NEyj PP, 0 Date Phone" rI 81-g53- 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 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone #: