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Home My WebLink AboutBuilding Permit # 12/1/2016 OR`N BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION ', 41 1� w. Permit No#• Date Received • �ssacyus�� Pate Issued: ORTANT:Applicant mast complete all items on this page LOCATION Pant PROPERTY OWNER Pnnf i O�Year 5r[rcture Yes na:. IVIQ,P PARCEL ZONING'DISTRICT H�storEc ®i'str�ct ye iao 1a9e . Yew Maeh�ne Shop Vrl no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building A One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial R-Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other 0 Septic M Well q Floodplain , ❑Wbtlefn-s V1Tate�shed'District - DESCRIPTION OF WORK TO BE PERFORMED: ' m Yea Identification- Please Type or Print Clearly' GINNER: Name: s Phone: -7 -J' i Address: �—>D -u S - - Contracfior. Name. Phone,. �' ?�: �� 7� mss` Supervisor's C:oristrue ion'License ...__ .; ,._ Exp. Date ARCHITECTIENG[NEER Phone: Address: Reg. No. aEli FEE SCHEDULE.BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST B FD ON$125.00 PER S.F. Total ProjeGt Cost: $ & FEE: $ Check No.:—/17Receipt No-: MOTE: -Persons contracting widt unregistered contractor°s do not have:access to the guaranty fund 5igriatiaie of.J�gerlOwnertrre bt coritractar � ""'I Town o 2 . Andover. . ® ti 'y 0 No. 7 Din F h ver, Mass �^ OLAK �. COC hi["g WIC t S U BOARD OF HEALTH Foot[/Kitchen PERMIT Septic System THIS CERTIFIES THAT.. . .......u .. ,......Ift4 ,. 1, `m . .. ... . ..�. . BUILDING INSPECTOR has permission to ere ... buildings On �...... r� .`s Foundation .................. .... ...... ...... ... ..........,..... .......... .. � y Rough tobe occupied as ....... .,. .. ...... ... ... ...... ............................... Chimney provided that the person acceptin his permit shall in every respect con f m to the terms of the application Final on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection,Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUC ST Rough Service ....... ... .. ............................ Final BUILDING INSPECTOR 1 GAS INSPECTOR Occuipancy Permit Required toOccupy BulldlnRough Display in a Conspicuous Place on the Premises - Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. Contract - Detailed Pella Window and Door Showroom of Haverhill Sales Rep Name: McLoughlin, Daniel 45 Fondi Rd Sales Rep Phone: 978-373-2500 Haverhill, MA 01832 Sales Rep Fax: Phone: (978)373-2500 Fax: (978) 373-7274 Sales Rep E-Mail: mcioughlindv@pellaboston.com Customer Information Project/Delivery Address Order Information Tony Ruisanchez Ruisanchez,Tony,1815153 Quote Name: 350 Series Patio Slider 507 Salem St 507 Salem St Order Number: 741 DVO152 NORTH ANDOVER, MA 01845-3109 Lot# Quote Number: 8453783 Primary Phone:(305)7258381 North Andover,MA 01845-3109 Order Type: Installed Sales Mobile Phone: County: Payment Terms: Deposit1C.O.D. Fax Number: Tax Code: MA TAX 6.25 E-Mail: antoni1970@aol.com Quoted Date: 11/8/2016 Great P[ains#: 11272381 Customer Number: 1008157890 Customer Account: 1004087129 Line# Location: Attributes 10 None Assigned Delivery/Setup-Delivery/Setup Item Price Qty Ext'd Price $235.00 1 8235,00 For more information regarding the finishing,maintenance, service and warranty of all Pella4D products, visit the Pella@)website at www.pella.com Printed on 11/9/2016 Contract-Detailed Page 1 of 8 Customer:Tony Ruisanchez Project Name: Ruisanchez,Tony,1815153 Order Number: 741DVO152 Quote Number: 8453783 ::.Line.# Location: Attributes 15 Deck Pella 350 Series, Double Sliding Door Vent Right I Fixed,71.5 X 79.5,White Item Price Qty ExVd Price $4,476.91 1 $4,476.91 1:7280 Vent Right/Fixed Double Sliding Door PK# Frame Size: 71 112 X 79 112 w 824 General Information: Yes,Standard,+1-50,+1-50,Vinyl, Nail Fin,Foam Insulated,6", 1 318",4 518",No Sill Riser Exterior Color 1 Finish: White Interior Color/Finish: White Glass: Insulated Dual Tempered Low E Low-E Insulating Glass With Window Fashions Air Filled Non High Altitude -1rs Hardware Options: Keylock Included,White,White,Steel Viewed From Exterior Screen; Sliding Screen,White,Premium,Conventional Fiberglass Unit Accessories: Blinds-Between-The-Glass,White Performance Information: CPD Not Rated,Performance Class R,PG 50,Calculated Positive DP Rating 50,Calculated Negative DP Rating 50,Year Rated 08 Wrapping Information: No Interior Trim,Pella Recommended Clearance,Perimeter Length=302",Glazing Pressure=175. Frame Size:71.5"X 79.5" Lead Safe Install-Lead Safe Install Qty 1 PD-2 Wide-Install 2-Wide Sliding Patio Door Qty 1 Finish Patio Trim-Finish PaintlStain Patio Door Interior Trim Only Qty 1 Wrap Coil Stock-Full Capping per unit Qty 1 Line.# Location: aAttributes 20 40%Off Installation Item Price Qty Exfd Price ($440.00) 1 ($440.00) For more information regarding the finishing, maintenance, service and warranty of all Pella®products, visit the Pella®website at www_pella,com Printed on 11/9/2016 Contract-Detailed Page 2 of 8 Customer:Tony Ruisanchez Project Name: Ruisanchez,Tony,1815153 Order Number 741 DVO152 Quote Number: 8453783 Line# L6cation. Attributes 25 5%Same Day Decision Item Price Qty I=_xt'd Price ($213.00) 1 ($213,00) 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 Iocal 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 parry.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 along with information on Florida Product Approval System(FPAS)Number and Texas Dept.of Insurance(TDI)number go to 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 11/9/2016 Contract-Detailed Page 3 of 8 Customer:Tony Ruisanchez Project Name: Ruisanchez,Tony,1815153 Order Number. 741DVO152 Quote Number: 8453783 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 Arrange to have any plumbing and electrical repairs or changes made by appropriate licensed contractor Provide a door handle and Iockset for entry door if Pella handle and Iockset is not purchased. Before the Installation Pella agrees to do the following: Obtain Building Permit(When required) Prefinish products when purchased in contract During the Installation the Homeowner agrees to do the following: 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 following: Deliver and unload products purchased per contract Place and remove drop cloths in work area then vacuum, and remove all debris at end of day Remove existing product, 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 exterior primed pine wood trim or Composite. Composite will be unfinished. If Purchased, install interior trim matching wood window finish or White trim for Impervia and Encompass Install non-Pella entry door Iockset provided by you. Pella is not responsible for it's quality or performance After the Installation the Homeowner agrees to do the following_ Be available for completion and sign off to verify all products purchased are in working order Reinstall existing shutters and awnings Re-install existing shades, drapes, window treatments,wall hangings, and reposition furniture 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 Fill nail holes and joints on interior trim if windows are to be stained (after staining) Clean up exterior casing issues due to storm window removal if full wrap or new exterior trim is not purchased For more information regarding the finishing, maintenance, service and warranty of all Pella®products,visit the Pella®website at www.pella.com Printed on 1119/2016 Contract-Detailed Page 4 of 8 Customer:Tony Ruisanchez Project Name: Ruisanchez,Tony,1815153 Order Number: 741DVO152 Quote Number: 8453783 roject Checklist has been reviewed Customer initial Product Only Addendum has been reviewed Customer initial Credit Card Account 4: Last 4 Digits Expiration Date: / Charge final payment to same account (Upon substantial completion) Customer 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 11/912016 Contract-Detailed Page 5 of $ Customer:Tony Ruisanchez Project Name: Ruisanchez,Tony,1815153 Order Dumber: 741DV0152 Quote Number: 8453783 Project Checklist has been reviewed Antonio Ruisanchez Dan McLoughlin Order Totals C om Na (Please print) Pella Safes Rep Name (Please print) Taxable Subtotal $3,191.91 Sales Tax @ 6.25% $199.49 Customer Signature Pella Sales Rep Signature 1 119116 Non-taxable Subtotal $857.00 1119116 Total $4,258.40 Date Date Deposit Received $2,129.20 Amount Due $2,129. 14 Credit Card Approval Signature For more information regarding the finishing, maintenance, service and warranty of all Pella®products, visit the Pella®website at www_pelia.com Printed on 111912016 Contract-Detailed Page 6 of 8 PELLA WINDOWS AND DOORS CONTRACT 7. PAYMENTS 1. TERMS AND CONDITIONS Pella shall be entitled to stop the Work upon written notice to Owner for any material default or failure by Owner,including but not limited to,the Owner's These'Perms and Conditions are an integral part ofthe contract set forth on the failure to pay Pella the amount due within seven days after the date payment is Product Order(the"Contract")between New England Window and Door LLC due. dba Pella Windows&Doors,Inc,("Pella")and the person(s)identified on the Product Order("Owner")to supply the products(the"Products"),and perform S. CORRECTION OF WORK the work(the"Work")described or referred to in such Contract. For Product Only purchases,a signed"Product Only Addendum"is a required part ofthe Pella shall correct installation Work not in conformance with the requirements contract. ofthe Contract,if notified in writing by the Owner within two years after the Completion Date or,if earlier,the date on which the Work is substantially 2 OWNER provided and payment of the Purchase Price made subject to a holdback as provided above.Correction of Work as herein provided shall be Owner's sole Pella is not responsible for any existing security systems.Owner shall remove remedy for defective workmanship,and is provided in lieu of any and all other all shades;verticals,blinds,curtains,drapes or window mounted air remedies.Pella's obligation to correct Work is conditioned on Pella's prior conditioners,prior to the installation of the Products.Pella's installers are not receipt of all payments then due. responsible for the removal or installation of these types of items. Pella is not responsible for pre-existing window coverings fitting on newly installed Pella 9. LIMITED PRODUCT WARRANTX windows. Pella shall warrant all Pella products,but only in accordance with the Pella The Owner shall provide complete access to the work site between the hours Windows&Doors Limited Warranty.THIS LIMITED WARRANTY SHALL of 7:00 a.m.and 6:00 p.m.(Monday through Friday)for Pella's installers to BE THE SOLE WARRANTY WITH RESPECT TO THE PRODUCTS AND deliver the Products and perform the Work. PELLA SPECIFICALLY DISCLAIMS ALI,OTHER WARRANTIES, EXPRESS OR IMPLIED,WRITTEN OR ORAL(INCLUDING WITHOUT 3. PELLA LIMITATION ANY WARRANTY OF MERCHANTABILITY OR FITNESS Pella will be responsible for and have control over construction means, FOR A PARTICULAR PURPOSE). methods,techniques,sequences and procedures and for coordinating all portions of the Work.Pella will be responsible for the Work of its Pella 10. NO CONSEQUENTIAL DAMAGES Contractors who will install the Products. UNDER NO CIRCUMSTANCES SHALL PELLA BE LIABLE FOR Unless provided otherwise in the Work description,Pella will provide and pay CONSEQUENTIAL,INCIDENTAL,INDIRECT,OR SPECIAL DAMAGES, for all labor,materials,equipment,tools and machinery,transportation,and WHETHER FORESEEN OR UNFORESEEN. other facilities and services necessary for the proper execution and completion of the Work. 11. HOME IMPROVEMENT CONTRACTORS The materials and equipment furnished under the Contract will be good quality All home improvement contractors and subcontractors shall be registered with and new unless otherwise required or permitted,the Work will be free from the director ofthe Home Improvement Contractor Registration Program defects not inherent in the quality required ar permitted,and the Work administered by the Board of Building Regulations and Standards. Pella and conform with the requirements of this Contract.Pella shall not be responsible any of its subcontractors identified in this agreement have been registered. for damages or defects caused by abuse,modifications not executed by Pella, Any inquires about Pella or any of its subcontractors relating to registration improper or insufficient maintenance,improper operations or normal wear and should be directed to:Director,home Improvement Contractor Registration, tear. Pella will keep the premises and surrounding area free from 10 Park Plaza,Room 5170,Boston,MA,02116,617-973-8787,888-283-3757 accumulation of waste materials or rubbish caused by performance ofthe or visit the HIC website at ht :/hvww.mass. ov/ocabarl Work. 12. PERMITS(1VIA customers only) 4. CHANGES Pella is obligated to and will obtain the following permits for this project: Buildin Homeowners who secure their own permits will be The Owner may order in writing changes in the Work consisting of additions, excluded from the guaranty fund provisions of Massachusetts General Laws, deletions,or modifications("Change Order"). Any Change Order shall chapter 142A. include an adjustment to the Price and the Substantial Completion Date,as determined by Pella. Pella reserves the right to approve or disapprove any In addition to the rights and warrantics enumerated in this agreement,you may Change Order and any such Change Order must be signed by both Owner and have additional rights under Massachusetts General Laws,chapter 142A and Pella to be effective. 780 Code of Massachusetts Regulations R6. 5. SUBSTANTIAL COMPLETION 13. NOTICE OF CANCELLATION Owner understands and agrees that the Substantial Completion Date is an You may cancel this agreement if it has been signed by a patty estimate only and that the actual date on which the Work is completed may be thereto at a place other than an address ofthe seller,which extended to allow for Change Orders requested by Owner or if the time to may be his main Office or branch thereof,provided you notify complete the Work is affected by conduct of the Owner,weather,labor disputes,availability of subcontractors,acts of God,fire or other causes the seller in writing at his main office or branch by ordinary reasonably beyond Pella's control.If for any reason the Work is not fully mail posted,by telegram sent or by delivery,not later than completed by the Substantial Completion Date(including any extensions midnight ofthe third business day following the signing of this contemplated above),but is substantially completed by such date,i.e.,the agreement. Product has been installed,but minor parts or components are missing or need to be replaced or repaired,a hold back proportionate to the cost of remaining See the attached Notice of Cancel lation for an explanation of parts or work to be completed is acceptable.However,the holdback will not this right. exceed the amount of the completion costs or I0%ofthe remaining unpaid balance of the Price,whichever is less. 6. FINANCING Do not sign this contract if there are any blank spaces. If payment ofthe Price is financed with a financial institution through Pella,all Financing paperwork must be completed upon signing of this Contract and the requisite approvals and authorizations for the full amount of the requested1 financing shall have been received from the financial institution. Customer s. .—. clr., 11g'1 Date DISPUTES THE CONTRACTOR AND THE HOMEOWNER HEREBY MUTUALLY AGREE IN ADVANCE THAT IN THE EVENT PELLA HAS A DISPUTE CONCERNING THIS CONTRACT, PELLA MAY SUBMIT SUCH DISPUTE TO A PRIVATE ARBITRATION SERVICE WHICH HAS BEEN APPROVED BY THE SECRETARY OF THE EXECUTIVE OFFICE OF CONSUMER AFFAIRS AND BUSINESS REGULATIONS AND THE CONSUMER SHALL BE REQUIRED TO SUBMIT TO SUCH ARBITRATION AS PROVIDED IN M.G.L.c. 142A Pella Windows & Doors Contractor Homeowner NOTICE: THE SIGNATURE OF THE PARTIES ABOVE APPLY ONLY TO THE AGREEMENT OF THE PARTIES TO ALTERNATIVE DISPUTE SETTLEMENT INITIATED BY THE CONTRACTOR. THE OWNER MAY INITIATE ALTERNATIVE DISPUTE RESOLUTION EVEN WHERE THIS SECTION IS NOT SEPARATELY SIGNED BY THE PARTIES. NOTICE OF CANCELLATION Date of transaction: 1119116 You may cancel this transaction, without any penalty or obligation, within three business days from the above date. If you cancel, any property traded in, any payments made by you under the agreement, and any negotiable instrument executed by you will be returned within ten business days following receipt by the seller of your cancellation notice, and any security interest arising out of the transaction will be cancelled. If you cancel, you must make available to the seller at your residence, in substantially as good condition as when received, any goods delivered to you under this agreement; or you may if you wish, comply with the instructions of the seller regarding the return shipment of the goods at the seller's expense and risk. If you do make the goods available to the seller and the seller does not pick them up within twenty days of the date of your notice of cancellation, you may retain or dispose of the goods without any further obligation. If you fail to make the goods available to the seller, or if you agree to return the goods to the seller and fail to do so, then you remain liable for performance of all obligations under the contract. To cancel this transaction, mail or deliver a signed and dated copy of this cancellation notice or any other written notice, or send a telegram to Pella Windows and Doors, at 45 Fondi Rd., Haverhill NIA 01832 i not later than midnight of 11/12/16 (three business days from the date of transaction above). I hereby cancel this transaction. 1 (Date) (Buyer's signature) i u ij i i i 6 flae cow-Monwealth ofAfassachusetts DeprrrfFrtent of Indnvtria(Aeciderats ' 1 Congress Street,Suite 100 i BOS&7",MA 02-114-2017 WwMassgov/dia Mrorkers'Compensation Insurance Affidavit:BnUders/Contractozs/Electdcians/Plumbers. TO BE FILED WrrH THE PEIZNg TING AUrEIOR Ty A lieant Information Please Print tae "bl Maine(Businessl0rganiz4,,n&dividval): � M_ Address: City/Stade/Zip: V sn- oC Phone#: Ate you an employer?Check the appropriate box. Type of project(required): I am a employs with employees{full andlorpart time).= 2. I am a sole 7. ❑New construction ❑ p€oprietnrorparinership and have no employees working forme in BUY capacity[No worker,'comp,insurance re<luued] S. RRemodoling 3.❑I am a homeowner doing all work myself[No workers'comp.iomra.,,,,.required,t 9• ❑Demolition 4. lam a homeowner and writ be1 _❑RR*UAg 9ddltian.. ]irnng conhadnrs#q conduct all wn€le an my p€operty I will nsnre ihafall_co ractnr ev e Welit s'-Co insteiance orsre ate T�_��lectnrna[repausoradditions ., ., . pmpnetnrswrthnoemployees.-�.." --___ . . 5.❑I am a general eontractar and I have hired the sub-conracfors listed on the attached sheet. ,12:❑Plumbiug repairs or additions ^ These sub-coatt-actDrs have employees and have workers'comp.iusmmce# I3.❑Roofrepah 6,E]W-are a corpotian and its afficets have exercised their right of exemption per MGL e. 14.❑Other 152,§I(4),and we have no employers.[No wori='comp,fim ranee ntion P *Any applicant that checks box#1 must also fill orf the section below showing their workers'compen&SdOn policy inforruatioa, t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors most snhmit a new a$$davit indicating such tCtrrr#ractors that check this box must attached an additional sheet showing the name ofthe sub-ontractors and sate whether or not those errfities have employees. Uthe sub-ra�act n have employees,they mtzs#provide their wor)mrs'comp.policy number. p am an employer tlrat is providing Workers'compensation haunmce for my employees: Beloty is the policy and job site inforinafiom Insurance Company Name: ��y Policy#or Self-ins.Lie.#l: `d _, Expiration Date:_ lob site Address: City/5tate/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 MGI,c. 152,§25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the OlUce of Investigations of the DIA for insurance coverage verification. I do hereby certify ander the pains acrd penaNes ofpaqury drat the information provided alcove is true acrd correct. Signature: - Date: Phone#: Offrdal use only. Do Trot write in this area,to be completed by city or tmvrr officapL City or Town PeYxnit/IC.iceuse# Issuing Authority(circle ane):. 1.Board of Health 2.Building Department 3.CitYlTown Cleric 4.Electrical Inspector 5.Plnurbirig Inspec#or 6.Other Contact Person: Phone#: T ® DATE(MMIDDIYYYY) A CERTIFICATE OF LIABILITY INSURANCE 971D7f1916 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(les)must be endorsed. It 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). CONTAC Dorothy A.Corlett,CIC,RPLU PRODUCER NAME: Fred C.Church,Inc. PHONE 978 3227231 FAX {078)454-1565 41 Wellman Street JAIC,No Lowell,MA 01651 ADE dcadellAfredcchurch.mm (800)225-1865 INSURER 5 AFFORDING COVERAGE NAIC 1{ INSURER A CNizeAs Insurance Company of Amedca 31534 INSURED INSURER B: New Hampshire Employers Insurance Company 13083 New England Window A Door LLC INSURERC: 45 Forr i Road Haverhill,MA 01 B32-1302 INSURER D INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:58475 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. INSRTYPEOFtNSURANCE ADPL Yvvn SUER POLICYNUMBER MMIDD EFF P,LIM ffDCDYLIMITS LTR GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 GE TO RE TED X 100 0110 COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ CLAIMS-MADE I OCCUR MED EXP(Any one parson) $ 10,000 A X CG0001 7SN8161407 7/112016 71112017 PERSONAL&ADV INJURY $ 1.000,000 GENERAL AGGREGATE $ 2,000,004 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPfOP AGG $ 2000,000 POLICY MPRO X LDC $ COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY a accident ANYAUTO BODILY INJURY(Per person) 8 ALL OWNED SCHEDULED BODILY INJURY(Ear accident)A OS $ ALT UT OS FIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS er acciden $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ i EXCESS LIAR CLAIMS-MADE AGGREGATE - $ DED RETENTIONS $ WORKERS COMPENSATION X 'STATiI OTH AND EMPLOYERS'LIABILITY E ANY PROPRIETORIPARTNERIEXECUTIVE❑ 8007024 71312016 715!2017 E.L.EACH ACCSDENT $ 500,900 OFFICEWMIAWR EXCLUDED? B N!A 500,000 (Mandatory in NH) E1.DISEASE-EA EMPLOYE $ Ifyes,describe underE.L.DISEASE-POLICY LIMIT $ 590,000 DESCRIPTION OF OPERATIONS 6etow i DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 1131,Additional Remarks Schedule,H more space is moluimtl) CERTIFICATE HOLDER CANCELLATION Town o1 North Andover 1600 Osgood Street,Suite 2043 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Nrth Andover,MA 01845 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, AUTHORIZED REPRESENTATIVE CFenta "so Mata 68415 Cert Holder# (9515 D 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 26(2090106) The ACORD name and logo are registered marks of ACORD j Massac�useLis t7piaar rnenF oP Board of Btxiieiin u�iic .5a€eiy egu iatians and Standards License: OS-08g853 7 WILLIAM R NICHOLS 57 PEARTiREE RD HAVERHILL Mot 01s30. �,rr�issiana� L ��Piration: 10/25/2011 lice of Consoaxaer Affairs&Business Regulation UIE 1MPlROVEiIl M!CO License or registration valid,fbr indivic ui use oarly before the exp ' iration date. lid found return to: e9istrattoro. 783279: Office off Consumer Affairs and Business Regulation Type - 912412017 10 Park Plaza-Suite 5170 NEW ENGLAND &';' d()P,, LLC. Supplement C 'rd $ostorr,AiA 02116 PELLA WINDOWS&:DOORS; William Nichols 45 FONDI ROAD HAVERNII_L,)m 0.1832 - --�— fludersecret:ary (s1 1Vot valid without sigaaatrare