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Home My WebLink AboutBuilding Permit # 4/27/2016 BUILDING PERMIT �oRTa TOWN OF NORTH ANDOVER �� heti`- APPLICATION FOR PLAN EXAMINATION ® '_ Permit No#: 1 Date Received �9RA°Rareo PP0.'�� SS�4CFOU`��R Date Issued: f w IMPORTANT: Applicant must complete all items on this page LOCATIONS EVF-b2 6/Le-= b�-Z- Print PROPERTY OWNER R ct4°2-0 VA-6(f Print 100 Year Structure yesZno MAP r' a 7 PARCEL:ddZONING DISTRICT: Historic District yeso Machine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building Cine family ❑Addition ❑ Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial C7-Fze'pair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ' Q Septrc ❑Well, d c ❑ Floo plain ❑Wetlands ❑ Watershed D�stn t Q 1lVater/Sealer f 'F DESCRIPTION OF WORK TO BE PERFORMED: Identification- Please Type or Print Clearly OWNER: Name: c ; Phone 706 Address: F—g _ r Contractor Name:Pe�Jl iAf /j, tj, �Lehone: L _L� Email: Address: 4 Pcd\jo v,, d c C crtJ- Supervisor's Construction License: ` `is Exp. Date: /o ,ate Home Improvement License: 1 &3 Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING t�RMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ ,C60 FEE: $ Check No.: ` Receipt No.: 6 6 DOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund — - -- F t%ORTH Town of2 Anctover ® f . ® Y h Ver' as C' 44 �p OR coc"IC IWICK �1' 7 AORATEO PPS` '9S U BOARD OF HEALTH Food/Kitchen PtR I LD Septic System BUILDING INSPECTOR THIS CERTIFIES THAT . •••• •• . kg.................................... ............................ ................................ Foundation ........................ has permission to erect ............. ............. buildings on ..... ....... ... .... Rough to be occupied as ......... .. . . .. •• ;04.. a—? . .................................. Chimney on provided that the person accepting t is permit shall in every respect conform to the'terms of the Altepat Alteration and Final on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection, PLUMBING INSPECTOR Construction of Buildings in the Town of North Andover. Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final ELECTRICAL INSPECTOR PERMIT EXPIRES IN.6 MONTHS ST Rough UNLESS CONSTRUCT7, Service ...... �.......................... Final ......... ...... ....... BUILDING INSPECTOR GAS INSPECTOR CCt �qulred t® Occupy Bulldllll Rough Final Y is la in a Conspicuous lace the Premises '� Do of Remove FIRE DEPARTMENT No Lathing or Dry Wall To Be Done Burner Until Inspected and Approvedthe Building Inspector. Street No. Smoke Det. I '-- i2_0 Detailed Contract _ filed `" Sales Rep Name: Gless, Benjamin Pella VVindow and Door Showroom of Haverhill Sales Rep Phone: 978-360-0818 45 Fondi Rd Sales Rep Fax: ® ellaboston.com Haverhill, MA 01832 Sales Rep E-Mail: glessba@pellaboston.com 373-7274 Phone: (978)373-2500 Fax: ) c7� waek, CI res 3 �� P ofeCtlp@�lul� =,a 350 Series FULL FRAM Custom erIr►forrClat�Orlk Valle,Richard,1705973 Richard Valle 58 Evergreen Dr741 BG0105 Order Number: 58 Evergreen Dr Quote Number: 773633 NORTH ANDOVER,MA 01845-6002 Lot# Order Type: Installed Sales NORTH ANDOVER,MA 01845-6002 payment Terms: Deposit/C.O.D. Primary Phone:(978)6851022 County: ESSEX Tax Code: MA TAX 6.25 Mobile Phone: Quoted Date: 411012016 Fax Number: E-Mail: valle.r@verizon.net Great Plains* 10571750 Customer Number: 1007863449 customer Account: 1003713493 Customer Notes: Predeliver all interior trim to HIO to be stained. 2112 colonial for casings and apro 1 x4 flat for extension jambs. 1x6 round over stool. 514 x 5 flat for field mull in David's BR. �1 ti N ALL EXTERIOR CASINGS TO BE CAPPED in POPLAR WHIT 7 77 77T fi } 4, L-a-..14 c� " fil �w ".y`^'a`c '', c�''1R (" 4e4 �' .P";Ar�.Mute$"i.3-,-a,s:a ` a.. .,:aa.... < ti..z�� _., ..�,, wh..>e Ext'd Price ��b . F,�G�i-. Item Price Qty Lme#� L ocat�onti, w ,_.K $176.25 1 $176.25 10 None Assigned DeliverylSetup-DeliverylSetup maintenance,service and warranty of all Pella®products,visit the Pella®website at www.pella.com Page 1 of 10 For more information regarding the finishing, Contract-Detailed Printed on 4114!2016 Customer: Richard Valle Protect Name: Valle,Richard,1705973 Order Number: 741BG0105 Quote Number:7736338 4�M 01 Exed Price tate# Lacato � � k .U. Item Price Qty ond $1,266.22 3o Dining Room Back Pella 350 Series,Double Hung,33.75 X 47.5,Alm $1 6 2 1 1:33.7547.5 Double Hung,Equal Frame Size: 33 3/4 X 47 1/2 _ PK# General Information: Yes,Standard,Vinyl,Nail Fin,Foam Insulated,4 1/2",13/8",3 1/8" 779 Exterior Color/Finish: Almond Interior Color/Finish: Almond ' Glass: Insulated Dual Low-E Advanced Low-E Insulating Glass Argon Non High Altitude .•-,: sic_ ^` Hardware Options: Cam-Action Lock,Almond,Standard Vent Stop,No Limited Opening Hardware,No Maximum Opening Hardware,Integrated Vinyl Viewed From Exterior Sash Lift Screen: Full Screen,InView'T" ,No Custom Grille,3/4"Contour,Traditional(3W2H/3W2H),Almond,Almon lazing Pressure Wrapping Information: No Interior Trim,Pella Recommended Clearance,Perimeter Length=163",G =105. Frame Size:33.75"X 47.5" Grille: GBG Customer Notes: Try and keep the interior stool intact. Qty 1 Trim Stool and Apron-Add Stool and Apron Trim to Picture Frame Qty 1 Wrap Coil Stock-Full Capping per unit Qty 1 FF<48 wide-Install Full Frame Window 48 inches or less wide Qty 1 Lead Safe Install-Lead Safe Install Y 11 -MIR ft ME ^;a, '�ca,. CFi, 3� ''`"'u 4*Attrlbaw ues � .��} tt�t' ..`; �'�',.�,� '�v �N, Une#��Locatlo t 11 r 4 1h� M . b m«k_. «. n. .t. , Ite P- MY Ext'd Price ...., .. � d $1,243.83 $— 1243 83 33.75 X 39.5,Almon 31 bath back Pella 350 Series,Double Hung, 1 1:33.7539.5 Double Hung,Equal FFRPK# Frame Size: 33 314 X 39 112 General Information: Yes,Standard,Vinyl,Nail Fin,Foam Insulated,4 1/2",1318" 3 118" 779 Exterior Color/Finish: Almond Interior Color/Finish: Almond i Glass: In Dual Low-E Advanced Low-E Insulating Glass Argon Non High Altitude ;. Hardware Options: Cam-Action Lock,Almond,Standard Vent Stop,No Limited Opening Hardware,No Maximum Opening Hardware,Integrated Vinyl Viewed From Exterior Sash Lift Screen: Full Screen,InViewTM' Frame Size:33.75 X 39.5 Grille: GBG,No Custom Grille,3/4"Contour,Traditional(3W2H l 3W2H),Almond,Almon Wrapping Information: No Interior Trim,Pella Recommended Clearance,Perimeter Length=147",Glazi�g Pressure=110. Trim Stool and Apron-Add Stool and Apron Trim to Picture Frame Qty 1 Wrap Coil Stock-Full Capping per unit Qty 1 FF<48 wide-Install Full Frame Window 48 inches or less wide Qty 1 Lead Safe Install-Lead Safe Install com For more information regarding the finishing,maintenance,service and warranty of all Pella®products,visit the Pelia®website at www.pell Page 2 of 10 Contract-Detailed Printed on 411412016 ' Valle Project Name: Valle,Richard,1705973 Order Number: 741BG0105 Quote Number: 7736338 Customer:Richard �... . ,. Attr�butes� w a_ . Item Price 4h/ �" Ext'd Price �. , $2 93 1 $2,284.93 35 David's BR front Pella 350 Series,2-Wide Double Hung,69.5 X 47.5,Almond 1:33.7547.5 Double Hung,Equal 1 PK# Frame Size: 33 3/4 X 47 1/2 General Information: Yes,Standard,Vinyl,Nail Fin,Foam Insulated,41/2",13/8" 3 1/8" 779 Exterior Color/Finish: Almond Interior Color 1 Finish: Almond Altitude nsulating Glass W Hardwareoptions*Dual Cam Action Lock,Almond,(Standard Vent Stop,No Limited hopen ng Hardware,No Maximum Opening Hardware, Integrated Vinyl Viewed From Exterior Sash Lift Screen: Full Screen,InVewTM' Almond,Almond Frame Size:69.5"X 47.5" Grille: GBG,No Custom Grille,3/4"Contour,Traditional(3W2H/3W2H), Vertical Mull 1: AlignedWith,2" 2:33.7547.5 Double Hung,Equal Frame Size: 33 3/4 X 47 1/2 ndard,Vinyl,Nail Fin,Foam Insulated,4 112",13/8",3 1/ General Information: Yes,Sta Exterior Color/Finish: Almond Interior Color 1 Finish: Almond Glass: Insulated Dual Low-E Advanced Low-E Insulating Glass Argon Non High Altitude Hardware options: Cam-Action Lock,Almond,Standard Vent Stop,No Limited Opening Hardware,No Maximum Opening Hardware,Integrated Vinyl Sash Lift Screen: Full Screen,InVewTm Grille: GBG,No Custom Grille,3/4"Contour,Traditional(3W2H/3W2H),Almond,Almon Vertical Mull 1: AlignedWith,2" ecommended Clearance,Perimeter Length=234",Glazing Pressure=10 Wrapping Information: No Interior Trim,Pella R . Customer Notes: Add field mull on site to match existing. Qty 1 Trim Stool and Apron-Add Stool and Apron Trim to Picture Frame Qty 1 Wrap Coil Stock-Full Capping per unit Qty 1 FF 48-96 wide-Install Full Frame Window_48-96 inches wide Qty 1 Lead Safe Install-Lead Safe Install Qty 1 Field Mull Win/Dr-Mull Window or Door in Field For more information regarding the finishing,maintenance,service and warranty of all Pella®products,visit the Pella®website at www.pell Page 3 of 10 Contract-Detailed Printed on 411412016 Customer: Richard Valle Project Name: Valle,Richard,1705973 Order Number. 741BG0105 Quote Number: 7736338 40 Susan's BR front/sid Pella 350 Series, Double Hung,33.75 X 47.5,Almond Item Price Qty Exfd Price $1,266.22 2 $2,532.44 1:33.7547.5 Double Hung,Equal PK# Frame Size: 33 3/4 X 47 1/2 General Information: Yes,Standard,Vinyl,Nail Fin,Foam Insulated,4 1/2",1 3/8",3 1/8" 779 Exterior Color/Finish: Almond Interior Color/Finish: Almond Glass: Insulated Dual Low-E Advanced Low-E Insulating Glass Argon Non High Altitude Hardware Options: Cam-Action Lock,Almond,Standard Vent Stop,No Limited Opening Hardware,No Maximum Opening Hardware,Integrated Vinyl V 'From Ext6iiior iewed Sash Lift Screen: Full Screen,InVewTm Frame Size:33.75"X 47.5" Grille: GBG,No Custom Grille,3/4"Contour,Traditional(3W2H/3W2H),Almond,Almond Wrapping Information: No Interior Trim,Pella Recommended Clearance,Perimeter Length=163",Glazing Pressure=105. Trim—Stool and Apron-Add Stool and Apron Trim to Picture Frame Qty 1 Wrap Coil Stock-Full Capping per unit Qty 1 FF<48 wide-Install Full Frame Window 48 inches or less wide Qty 1 Lead Safe Install-Lead Safe Install Qty 1 1IR 45 master side/back Pella 350 Series, Double Hung,33.75 X 47.5,Almond Item Price Qty Exrd Price $1,266.22 2 $2,532.44 1:33.7547.5 Double Hung,Equal PK# Frame Size: 33 3/4 X 47 1/2 General Information: Yes,Standard,Vinyl,Nail Fin,Foam Insulated,4 1/2",13/8",3 1/8" 779 Exterior Color/Finish: Almond Interior Color/Finish: Almond Glass: Insulated Dual Low E Advanced Low-E Insulating Glass Argon Non High Altitude Hardware Options: Cam-Action Lock,Almond,Standard Vent Stop,No Limited Opening Hardware,No Maximum Opening Hardware,Integrated Vinyl Viewed From Exterior Sash Lift Frame Size:33.75"X 47.5" Screen: Full Screen,InVewTm Grille: GBG,No Custom Grille,3/4"Contour,Traditional(3W2H/3W2H),Almond,Almond Wrapping Information: No Interior Trim,Pella Recommended Clearance,Perimeter Length=163",Glazing Pressure=105. Trim—Stool and Apron-Add Stool and Apron Trim to Picture Frame Qty 1 Wrap Coil Stock-Full Capping per unit Qty 1 FF<48 wide-Install Full Frame Window 48 inches or less wide Qty 1 Lead Safe Install-Lead Safe Install Qty 1 For more information regarding the finishing, maintenance,service and warranty of all Pella®products,visit the Pella®website at www.pelia.com Printed on 4/14/2016 Contract-Detailed Page 4 of 10 Customer: Richard Valle Project Name: Valle,Richard,1705973 Order Number. 741 BG0105 Quote Number: 7736338 iLlne _ Location: ` �� 50 master bath back Pella 350 Series, Double Hung,33.75 X 39.5,Almond Item Price Qty Ext'd Price $1,243.83 1 $1,243.83 1:33.7539.5 Double Hung,Equal PK# Frame Size: 33 3/4 X 39 1/2 779 General Information: Yes,Standard,Vinyl,Nail Fin,Foam Insulated,4 1/2",13/8",3 1/8" Exterior Color/Finish: Almond Interior Color/Finish: Almond Glass: Insulated Dual Low-E Advanced Low-E Insulating Glass Argon Non High Altitude c Hardware Options: Cam-Action Lock,Almond,Standard Vent Stop,No Limited Opening Hardware,No Maximum Opening Hardware,Integrated Vinyl Viewed From Exterior Sash Lift Frame Size:33.75"X 39.5" Screen: Full Screen,InViewTm Grille: GBG,No Custom Grille,3/4"Contour,Traditional(3W2H/3W2H),Almond,Almond Wrapping Information: No Interior Trim,Pella Recommended Clearance,Perimeter Length=147",Glazing Pressure=110. Trim—Stool and Apron-Add Stool and Apron Trim to Picture Frame Qty 1 Wrap Coil Stock-Full Capping per unit Qty 1 FF<48 wide-Install Full Frame Window 48 inches or less wide Qty 1 Lead Safe Install-Lead Safe Install Qty 1 Thank You For Purchasing Pella® Products 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 a part 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 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 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 terms of sale. 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 For more information regarding the finishing, maintenance,service and warranty of all Pella®products,visit the Pella®website at www.pelia.com Printed on 4/14/2016 Contract-Detailed Page 5 of 10 Customer: Richard Valle Project Name: Valle,Richard,1705973 Order Number: 741BG0105 Quote Number: 7736338 combinations unless noted.Actual product results will vary and change over the products life. number go to www pella.com For more erformance information along with information on Florida Product Approval System(FPAS)Number and Texas Dept.of Insurance(TDI)P /perfo_�ce- Project Checklist Review (Installed Orders Only) Before the Installation the Homeowner agrees to do the following: Obtain Condo Association Approval Obtain Historic Approval Remove existing shutters and awnings 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 g appropriate licensed contractor Arrange to have any plumbing and electrical repairs or changes made by app p Provide a door handle and lockset for entry door if Pella handle and lockset is not purchased. Before the Installation Pella agrees to do the following: Obtain Building Permit(When required Prefinish products when purchased in contract Durina the Installation the Homeowner agrees to do the followin : Keep pets safely away from work area 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 followin Deliver and unload products purchased per contract See HO about Storm windows Remove existing product,Place and remove oducloths 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 exteriortprrrmrnatching woine odrwindow fin sh oor r White trriiimtforlmpervia and Encompass If Purchased, install interior Install non-Pella entry door lockset provided by you. Pella is not responsible for its quality or performance After the Installation the Homeowner agrees to do the followin : Be available for completion and sign off to verify all product5 purchased are in working order Reinstall existing shutters and awnings Re-install existing shades,drapes,window treatments,wall hangings, and reposition furniture For more information regarding the finishing,maintenance,service and warranty of all Pella®products,visit the Pella®website at www.pell Page 6 of 10 Contract-Detailed Printed on 411412016 Customer. Richard Valle Project Name: Valle,Richard,1705973 Order Number. 741BG0105 Quote Number: 7736338 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 ows are to be stained(after staining) Fill nail holes and joints on interior trim if wind I val if full wrap or new exterior trim is not purchased r casing issues due to storm window remo ect Checklist has been reviewed J •Customer initial Product Only Addendum has been reviewed customer initial 1061 Credit Card Account#: Last 4 Digits / 9/2017 Expiration Date: Charge final payment to same account (Upon substantial completion) Customer initial bsite at www.pell For more information regarding the finishing,maintenance,service and warranty of all Pella®products,visit the Pella®wePage 7 of 10 Contract-Detailed Printed on 4/14/2016 Customer: Richard Valle Project Name: Valle,Richard,1705973 Order Number. 741BG0105 Quote Number: 7736338 10 Wroject Checklist has been reviewed Richard Valle Benjamin Gless � T�� . ., Customer N me ease print) Pella S Rep Na a (Please print) der FO _ Taxable Subtotal $5,681.19 Customer Signature Pella ales ep Signature Sales Tax @ 6.25% $355.07 4/14/2016 4/14/9n1 F Non-taxable Subtotal $5,598.75 Date Date Total $11,635.01 Deposit Received $5,817.51 Credit Card Approval Signature Amount Due $5,817.50 For more information regarding the finishing, maintenance,service and warranty of all Pella®products,visit the Pella®website at www.pelia.com Printed on 4/14/2016 Contract-Detailed Page 8 of 10 The Commonweralth of Mrj,ssacletasetts Department of Industrial Aecidents Office of Invesdgations 1 Congress Street, Suite 100 Boston,MA 02114-2017 41 niwv.inassogov/dia Workers' Collnpensation Insurance Affidavits Bniiders/Contractors/Plectricians/Plumbers Agpflcant Information Please Print Legibly Name(Business/organization/Individttal): 11A Address: 4-5 1--b N a r— e,r) City/State/Zip: ate: ;t: , ' - Phone#: Are you an employer?Check the appropriate box: 1.[5.,1am a employer with GS— 4. ❑ I am a general contractor and I Type of project(required): employees(full and/or part-time). have hued the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. (&Remodeling ship and have no employees These sub-contractors have g, ❑Demolition working for me in any capacity. employees and have workers' insurance.# 9. ®Building addition comp.[No workers' comp.insurance required.] 5. ❑ We are a corporation and its 10,❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.f-1 Phunbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.E]Roof repairs insurance required.]; a 152, §1(4),and we have no 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. tConu actors that check this box must attached an additional sheet showing the name of the stub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and joh site information. Insurance Company Name: Policy#or Self-ins.Lie.#: Ll ( Expiration Date:__7 ® � Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(sho-vvvtg 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 ofperjury that the information provided above is true atad correct. Signature: - - - - — Dated_/ Phone#: . - . 9-7 Of ficial use only. leo not evrite in this area,to be completed by city or town official. City or Town: Permit/License# CERTIFICATE E F LIABILITY INSURANCE Bfi/DATE� DlyyyU} 19MN0D 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, EKTENO OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT®ETWjEN THE ISSUING INSURER{S),AUTLIORI�ED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL the terms and conditions of the pokey;certain INSURED,the 11 (1111 10s)must be endorsed. If SUBROGATION IS WAIVED, subject to policies may require an endotsemenL A statement on this certificate does not confer rights to PRODUCER the certificate holder in lieu of such endDraement{s}. CONTACT Rad C.Cl Inc 91 WellmanSlreet NA MIb Ou0yA Codes,CIC,RPLU Lowell,MA 01851 PHONE 9703127231 FAM 1918}959—IBIS (000}225.1085 EMAIL AIC No: ADDRESS: dc�el�O]Iredcchurrh.com its R 5 AFFORDING COVERAGE MAIC 8 INSURED INSURER A: Ciflunsi ranceCompanyoFAmadca 31539 New England Window A Door LLC INSURER E: New HaarpsNra EmPtayars Ii Company 13083 45 Fondl Road INSURER G: Haverh0l,MA 01832.1302 INSURER D: INSURER E: COVERAGES54457 INSURER F: CERTIFICATE NUMBER: THIS IS TO CERTIFY THAT THE POLICIES DF INSURANCE LISTEp BELOW HAVE BEEN ISSUED TO THE INSUR NAMED ABOVE FOR THE POLICY PERIOD SION NUMBER: INDICATED. PJO7IMTHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR 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 BYPAID CLAIMS. INSR ADDLSUBR LTR PEOFINSURANCE POLICY EFF POUDGGYEXP LIMITS GENERAL LIABILITY POLICYNUPABER MIND D X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 DAMAGE TO REll 100,000 CLAIMS•MADE , OCCUR PREMISES - occunanee S A X COOOUiMEDEXP(Anyonepa 7rson} g 10,000 BNO161407 7/1/2015 71112016 PERSONALSADVINJURY 15 1,000,000 GENi.AGGREGATE LIMIT APPLIES PER: GENERALAGGP,EGATE S 2.111DD POLICY X ARCO M LOC PRODUCTS-COMP/OPAGO S 2,000,000 AUTOMOBILE LIABILITY S COMBINED SINGLE LIMIT ANY AUTO Es accidanl ALL OWNED M SCHEDULED BODILY INJURY(Perparaan) S AUTOS AUTOS NON-OWNED BODILY INJURY(Peraccidenl} S HIREDAUi05 AUTOS PROPERTY DAMAGE Pe accidanl $ UMBRELLA LIAD S OCCUR EXCESS LWB CLAIMS•MADE EACH OCCURRENCE S DED RETENTIONS AGGREGATE S WORKERS COMPENSATION S AND EMPLOYERS,LIABILITY 31 K�Si Mfg El B ANYPROPRIETORIPARTNERIEXECUIVE YIN OFFICER/MEMBER DELUDED? NIA 400040101 T/1/2015 i/112016 EL EACHACGIOENT 8 500,000 (Mandato in NH) IlyeCRIP beunderE.L.DISEASE-EAEMPLOY g 500,000 OE5CRIPTION DF OPERATIONS below E.L.DISEASE-POLICY LIMIT g 500,000 OESCRIPi7DNOFOPERATIONS ILOCATIONS IVEHICLES(AtiacIaACOROIIAddiOonalRan,arhsSchedule,ifmore space brgtisad) CERTIFICATE HOLDER CANCELLATION F7 7!101J�t)ANY OF TOE ABOVE DESCRIBED POLICIES BE CANCELLErS Rprinwa I J = CS-089853 WILLUM R NICHOLS $,7 PEAIYTREE Rbr c ftAVFRH[LL MA 91830 /26/2®16 r�c nninrcn�r�+a�/� '1/- lljjar%�i.ic/l� ce of Consumer Affairs&Business Regulation License or registration valid for individul use only before the expiration date. If found return to: l �IE IMPROVEMENT to: office of Consumer Affairs and Business Regulation 3279 Type: 10 Park Plaza-Suite 5170 egistration: 18 ~ " Expiration: 9/24/2017 Supplement C`nrd Boston,MA 02116 NEW ENGLAND WINDOW&DOOR,LLC. PELLA WINDOWS&DOORS William Nichols r 1 P 45 FONDI ROAD Sotvalid.without signature HAVERHIL.L,llAA 01832 Undersecretary