HomeMy WebLinkAboutBuilding Permit #005-2011 - 112 Forest Street 6/8/2010 BUILDING PERMIT VIORTH
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit NO: .2011 Date Received
C14U
Date Issued: Hu
IMPORTANT:Applicant must complete all items on this page
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TYPE OF IMPROVEMENT— PROPOSED USE
-Residential Non- Residential
New Building One fqmil _
Addition Two or more family industrial
Alteration No. of units: Commercial
RepairZreplacemea> Assessory Bldg Others:
Demolition Other
n
DESCRIPTION OF WORK TO BE PREFORMED:
S*('J Cru 06A "r—
Identification Please Type or Print Clearly)
OWNER: Name: f�me_ I e-v\ Phone:
Address: ))a S—k MCA
,COP
' 'TRACT, _,t
Name
.. ......
Su p
V
_!§t6ii on license
koaie vemen�L7icen
License -
,
.Exp. Date
ARCHITECT/ENGINEER Phone:
Address: Reg. No.
FEE SCHEDULE.BOLDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
Total Project Cost: $ FEE: $
Check No.: Receipt No.: ;2 &4
NOTE: Persons contracting with unregistered contractors do not have access to the guar nd
81g,nalure-of
Location/•? /tecll 'S� —�
No. 0�// Date �//
&OWTN TOWN OF NORTH ANDOVER
N 9
a Certificate of Occupancy $
. i .
SSACMUBuilding/Frame Permit Fee $ / 16
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check #
t i
2 3 0 `� Build ng'14pector
Plans Submitted Plans Waived Certified Plot Plan Stamped Plans
TYPE OF SEWERAGE DISPOSAL
Public Sewer Tanning/Massage/Body Art Swimming Pools
Well Tobacco Sales
Food Packaging/Sales
Private(septic tank,etc. Permanent Dumpster on Site
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
DATE REJECTED DATE APPROVED
PLANNING & DEVELOPMENT
COMMENTS
DATE REJECTED DATE APPROVED
CONSERVATION
COMMENTS
DATE REJECTED DATE APPROVED
HEALTH
COMMENTS
Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision: Comments
Conservation Decision: Comments
Water & Sewer Connection/Signature&Date Driveway Permit
Located at 384 Osgood Street
FIRE ;DEPARTMENT TernP Dumpster on site fires no
Located at 124>Main Street
Fire l eparfirnen#s�graature date'
Y
COMMENTS
Dimension
Number of Stories: Total square feet of floor area, based on Exterior dimensions.
Total land area, sq. ft.:
ELECTRICAL: Movement of Meter location, mast or service drop requires approval of
Electrical Inspector Yes No
DANGER ZONE LITERATURE: Yes No
MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine
NOTES and DATA— (For department use
❑ Notified for pickup - Date
Doc.Building Permit Revised 2007
Building Department
The following is a list of the required forms to be filled out for the appropriate permit to be obtained.
Roofing, Siding, Interior Rehabilitation Permits
❑ Building Permit Application
❑ Workers Comp Affidavit
❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses
❑ Copy of Contract
❑ Floor Plan Or Proposed Interior Work
❑ Engineering Affidavits for Engineered products
NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit
Addition Or Decks
❑ Building Permit Application
❑ Certified Surveyed Plot Plan
❑ Workers Comp Affidavit
❑ Photo Copy of H.I.C. And C.S.L. Licenses
❑ Copy Of Contract
❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And
Hydraulic Calculations (If Applicable)
❑ Mass check Energy Compliance Report (If Applicable)
❑ Engineering Affidavits for Engineered products
NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit
New .Construction (Single and Two Family)
❑ Building Permit Application
❑ Certified Proposed Plot Plan
❑ Photo of H.I.C. And C.S.L. Licenses
❑ Workers Comp Affidavit
❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And
Hydraulic Calculations (If Applicable)
❑ Copy of Contract
❑ Mass check Energy Compliance Report
❑ Engineering Affidavits for Engineered products
NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit
In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals
that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording
must be submitted with the building application
Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07
Revised 2.2007
NORTH
0" 0 over
No.
_=- LAKE o dover, Mass.,T �
o
COCKICMEWICK y1.
7�SRATED PP� �
S BOARD OF HEALTH
Food/Kitchen
.PERM 'IT T Septic System
BUILDING INSPECTOR
THIS CERTIFIES THAT......................... Ec�Ei`�!.......X0..��'.l09 ..........................
.... .......................................................... Foundation
has permission to erect........................................ buildings on../../,/�......z— :....... '.........5...�................................... Rough
(�
Chimney
to be occu ied as y
p . ........ ..................................................................................................................................
provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final
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 CONSTRUCTION ST TS Rough
...................................... 95,.tl�-'
Service
BUILDING INSPECTOR
Final
Occupancy Permit Required to Occupy Building GAS INSPECTOR
Rough
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.
SEE REVERSE SIDE Smoke Det.
104 Otis St.,Northborough,MA 01532 J&L WINDOWS,INC.,D/B/A - MA Home Improvement Contractor
(508)919-0900•Fax:(774)987-3013 113e ' License#149601 (Expires 1/24/2012)
Renewal. Federal Tax ID 983-0404201
.,
WINDOW REPLACEMENT •n And—.C—N y
CUSTOM WINDOW AND DOOR REMODELING AGREEMENT
Buyer(s)Name - Date of Agreement
Buyer(s)Street Address,City,State,and Zip Code -
Z %2 r I-,,- n olo tJ��
E-Mail Address Home Telephone Number Work Telep one Number
Buyer(s)hereby jointly and severally agrees to purchase the products and/or services of J&L Windows,Inc.d/b/a Renewal by Andersen
("Contractor"),in accordance with the terms and conditions described on the front and the reverse of this agreement and on the attached
specification sheet(s) (collectively,this"Agreement").Buyer(s)hereby agrees to sign a completion certificate after Contractor has completed
all work under this Agreement.
�( 7%4 Method of Pymnt:O Cash Check L1 Mastercard 0 VISA
Total Job Amount:I_\_�_G < Estimated Starting Date:
-_1 _ ❑Discover ❑Financed,App#: a�'Z
Deposit Received(33%): 75�
75� Name on Credit Card:
Balance at Start of Job(33%): Estimated Completion Date:
P Credit Card#:
Balance on Substantial if1°
Completion of Job(33%): p CC Exp.Date: CC Security Code:
By initialing here,you acknowledge that the Balance at Start of Job and the Balance on Substantial Completion
Buyer Initials of Job cannot be made by credit card and must be made by personal check,bank check,or cash.
Buyer(s) agrees and understands that this Agreement constitutes the entire understanding between the parties,and that
there are no verbal understandings changing or modifying any of the terms of this Agreement.No alteration to or deviation
from this Agreement will be valid without the signed,written consent of both Buyer(s) and Contractor.Buyer(s) hereby
acknowledges that Buyer(s) 1) has read this Agreement, understands the terms of this Agreement, and has received a
completed,signed,and dated copy of this Agreement,including the two attached Notices of Cancellation,on the date first
written above and 2)was orally informed of Buyer's right to cancel this Agreement.DO NOT SIGN THIS CONTRACT IF
THERE ARE ANY BLANK SPACES.
�J&L Win , d/b/a Renewal by Andersen er(s) Buyer(s)
Signature of Product Manager Signature Signature
Print Name of Product Manager Print Name Print Name
YOU, THE BUYER(S), MAY CANCEL THIS TRANSACTION AT.ANY TIME PRIOR TO MIDNIGHT OF THE THIRD
BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION.SEE THE ATTACHED NOTICE OF CANCELLATION FORMS
FOR AN EXPLANATION OF THIS RIGHT.
�— — — — — — — — — — — —_— — —�,<- — — — — — —
NOTICE OF CANCELLATION X NOTICE OF CANCELLATION
Date of Transaction 421-10 . You may cancel Date of Transaction — —td You may cancel
this transaction,without any penalty or obligation,within I this transaction,without any penalty or obligation,within
three business days from the above date.If you cancel,any 1 three business days from the above date.If you cancel,any
property traded in,any payments made by you under the property traded in,any payments made by you under the
Contract of Sale,and any negotiable instrument executed Contract of Sale,and any negotiable instrument executed
by you will be returned within 10 days following receipt I by you will be returned within 10 days following receipt
by the Contractor ("Seller") of your cancellation notice, I by the Contractor ("Seller") of your cancellation notice,
and any security interest arising out of the transaction will 1 and any security interest arising out of the transaction will
be canceled.If you cancel,you must make available to the be canceled.If you cancel,you must make available to the
Seller at your residence,in substantially as good condition I Seller at your residence,in substantially as good condition
as when received, any goods delivered to you under I as when received,any goods delivered to you under this
this Contract or Sale; or you may, if you wish, comply I Contract or Sale;or you may,if You wish,comply with the
with the instructions of the Seller regarding the return instructions of the Seller regarding the return shipment of
shipment of the goods at the Seller's expense and risk. I the goods at the Seller's expense and risk.If you do make
If you do make the goods available to the Seller and the I the goods available to the Seller and the Seller does not
Seller does not pick them up within 20 days of the date I pick them ulp within 20 days of the date of your Notice
of your Notice of Cancellation,you may retain or dispose of Cancellation,you may retain or dispose of the goods
of the goods without any further obligation.If you fail to without any further obligation. If you fail to make the
make the goods available to the Seller, or if, ou.a ree goods available to the Seller,or if you agree to return the
to return the goods to the.Seller and fail to do so,then I cods to the Seller and fail to do so,then you remain liable
you remain liable for performance of all obligations under i for performance of all obligations under the Contract.
the Contract.To cancel this transaction, mail or deliver a I To cancel this transaction, mail or deliver a signed and
signed and dated copy of this cancellation notice or any I dated copy of this cancellation notice or any other written
other written notice,or send a telegram to Contractor.J I notice,or send a telegram to Contractor.J&L Windows,
&L Windows,Inc.d/b/a Renewal by Andersen, 104 Otis I Inc. d/b/a Renewal by Andersen, 104 Otis Street,
Street, Northborou h, MA 01532, BY NOT LATER THAN Northborough,Mq 01532,BY NOT LATER THAN MIDNIGHT
MIDNIGHT OF _ — .(Date) OF�=Z'J l0 .(Date)
1 HEREBY CANCEL THIS TRANSACTION. I HEREBY CANCEL THIS TRANSACTION.
Buyer's Signature Date I Buyer's Signature Date
RbA Copy- White Buyer Copy-Yellow Buyer Copy-Pink
_ J&L Windows,Inc.d/b/a _
104 Otis Street,Northborough,MA 01532Renewa■ MA HIC License#149601(expires 1/24/12)
Phone 508.919.0900•Fax 774.987.3013 K 1111 Federal Tax ID# 83-0404201
�i�
byAndersen.
WINDOW REPLACEMENT an And-Company
Or GREATER MAssacxusrm AND Nrw HAMPsHim
WINDOW SPECIFICATION SHEEP
Buyer(s)Name Date of Agreement
The Buyer(s)listed abovg4ierebyiatly and severally agree to purchase the goods and/or services listed below,in accordance with the prices and terms
described on the Specification Sheet and the front and the reverse of the accompanying CUSTOM WINDOW AND DOOR REMODELING AGREEMENT,
of which this Specification Sheet is a part.
WINDOW DETAI S
1. Contractor will Install a total of windows in Owner's home,using the following individual quantities:
Double Hung(DB) ❑ Equal sash ❑ Cottage sash(1/3 top,2/3 bottom) ❑.Oriel sash(2/3 top.1/3 bottom)
Casement(CW) ❑ Hinge right ❑ Hinge left(as viewed from exterior): ❑ Standard handle ❑ Metro handle
Double Casement(CDW) ❑ Standard handle ❑Metro handle
Casement/Picture/Casement(CPW) ❑ 1:1:1 or ❑ 1:2:1 ❑ Standard handle ❑ Metro handle
2 Lite Gliding Window(GW)
Glider/Picture/Glider(GPW) ❑ 1:1:1 or ❑ 1:2:1
Awning Window(AW)
Picture Window(PW)
Bay or Bow Window
Patio Doors(see separate Door Specification Sheet)
2. Yes ❑ No Qty of Windows to be Custom Fit Replacement:
3. ❑ Yes No Qty of Sills to be replaced by Contractor:
4. [[K'Yes ❑ No Qty of Windows to be New Construction Full frame(includes new interior&exterior casings) _
Exterior casings: ❑ Pine ❑ Maintenance-free material Factory applied 908 Fibrex brickmold
p
5. Glazing to be: I!-HP Low-E®SmartSunTM (Tex Caro it Eligible) [] Other If other,please specify:
6. Exterior color to be: ❑ White ❑ Sand Rg Canvas ❑ Terratone ❑ Cocoa Bean
7. Interior color to be: ❑ White ❑ Sand 0!�Canvas ❑Terratone ❑ Pine ❑ Maple ❑ Oak
Note: Interior color can only be white,wood or same color as exterior. Wood interiors need to finished by Owner.
8. Hardware: ❑ White ❑ Stone rg Canvas ❑ Brass ❑ Estate Hardware: Style:
9. ❑ Yes J.No Install Lifts with Double Hung Windows
10. Screens: windows to have: ❑ Half or XFull screens Screens to be: Fiberglass ❑ Aluminum ❑ TruScene
GRILLE DETAILS
11.Windows have grilles: Yes ❑ No If yes:X Grille Between Glass(GaG)❑ Removable Interior Wood aisrrm❑ Full Divided Light(FOL)
Qt': Qty. S QtyQtyQ Qty :
11
I'[
H H DH DH CW/Piclure Glider CPW or GJ
Draw grille patterns above 'Use additional sheet if needed Owner approved(initials):( )
ADDITIONAL WORK DETAILS
12.❑ Yes MNo Contractor will remove metal frames of windows. Qty of Units:
13.❑ Yes No Contractor will install new paint-ready or stain-ready casings.
Interior casing qty of openings: Exterior casings qty of openings: ❑ Pine ❑ Maintenance-free material
14.❑ Yes Z[No Contractor will install new paint-ready or stain-ready inside or outside stops qty of openings:
Interior stops qty of openings: Exterior stops qty of openings: ❑ Pine ❑ Maintenance-free material
15. Owner is aware that Contractor does not do any painting. ( )Owner Initials
16.❑ Yes 6 No Contractor will wrap exterior casings with aluminum coil stock of color.
Note: Wrapping may be required with storm window removal;removal of storm windows will leave screw holes in casing.
17. Yes F-1NoContractor will insulate,caulk and seal windows with 3-point system to prevent water and air infiltration.
18. Yes ❑ No A limited warranty shall be issued to Owner upon completion of the job and payment in full.
19.X Yes ❑ No Building Permit--Contractor will secure any and all necessary permits. The fee for the permit(s)is not
included in the Contract Price and a separate check is required at the time of sale for this fee.
20. Additional job details:
21.r Yes ❑ No Owner agrees to be present on the final day of installation for final inspection and to deliver final payment.
No final payment shall be demanded until the contract is completed to the satisfaction of ell parties.
It is agreed and understood by and between the parties that this Specification Sheet,along with the CUSTOM WINDOW AND DOOR REMODELING
AGREEMENT,constitutes the entire understanding between the parties,and there are no verbal understandings changing or modifying any of the
terms. This Specification Sheet may not be changed or its terms modified or varied in any way unless such changes are in writing and signed by both
the Buyer(s)and Contractor. Buyer(s)hereby acknowledge� uye(s)has read this Specification Sheet.
Ren of 0 tQp MA and NH Buyer(s Buyer(s)
��o>��tCManager Signature Signature
Print Name of Product Manager Print Name Print Name
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investiptions
600 Washington Street
Boston,MA 02111
U1, www.mass gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
k olicant Information Please Print Legibly
Name(Business/Organizadon/Individual): l)eiOel4)G 1 lUV H)'lr�ieY'SeY)
.Address: /DSI Qj� S WrerJ-
City/State%Zip: /V Oro d o re, yU Phone#: 6, ) m-000
Are you an employer?Check the appropriate box: Type of project (required):
1-E'I am a employer with tO p 4. []'1 am a general contractor and I 6. 0 New construction
employees(full and/or part-time).* have hired the sub-contractors
2.0 I am a sole proprietor or partner- .listed on the attached sheet.; modeling
ship and have no employees These.sub-contractors have S. Demolition
working for me in any capacity. workers' comp.insurance. 9• Building addition
[No workers'comp.insurance 5. ❑ We are a corporation and its
required.].
officers have exercised their 10.❑Electrical repairs or additions
3: I am a homeowner doing all work right of exemption per MGL 11.0 Plumbing repairs or additions
myself[No workers'comp. c.152,§.1(4),and we have no 12.0 Roof repairs
insurance required.]t employees..[No workers' 13.0 Other .
comp.insurance required.]
*Any applicant that checks box#I must also fill out the section below showing-their workers'compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit anew of davit indicating such
IGontractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information.
Tarn an employer that isproviding workers'compensation insurance for my employees Belowls thepolicy and job site
information.
Insurance Company Name: �' 1� l rl(' &I fa n C e
Policy#or Self-ins,Lie.#: �y/ W�L�� ��`f` _ Expiration Date: .
Job Site Address: VCl�t", City/State/Zip: t\ P�
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 cer un• er the pains and penaltiaspnfperjury that the information provided above is true and correct
Sitrnature' Date:
Phone# % U�� ��✓l- O�Cl�
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 M
. i
I ^y+ tF'• =�;fi.'4� az; rQp�1141Z67u��N� '
;. .:• y': Beard niBuildingltegulatlons and Standards .
_ Constrl�ction•SupervisorLicense.{;,,,, A.; '
,.e`•CS •95707
I.cont
;
SIrttiZMkg1971982
85707
IE lratipr!^78 "
:* ; • 12010 I•
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6RI6N,DENNISON
86 CREST CIRCLE
issiongr I '
WORCESTER;MA 01603Colrtm .
°Tk&..../d
./d a�✓�craaac/weell3
Office of Consumer Affairs&Business Regulation
HOME IMPROVEMENT CONTRACTOR
Reglstratlor 4 X01
Expire
T�1e nt Card
RENEWAL BY
�1 -
�+ BRIAN DENNIS- `
104 OTIS STREE a. �.
NORTHBOROUGH�M '015$2 Undersecretary
ACORD. CERTIFICATi E OF LIABILITY INSURANCE °02/10/2 0l
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Joseph McKeone ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
JP McKeone Insurance Agency, Inc. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P.O. Box 333
Ann Arbor, M( 48106-0333 INSURERS AFFORDING COVERAGE NAIC#
INSURED Renewal by Andersen INSURER A: Ha Ord Insurance Company
J and L Windows,Inc. INSURER 0: Nautilus
104 Otis St INSURER C: _
Northborough,MA 01532 INSURER D:
INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING
ANY REOUIREMENT,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.SY PAID CLAIMS.
WSR DL POLICYNUMBER POLICYEFFECTNE POUCYEXPIRA710H LIMITS
TYPE OF INSURANCE DATE IMM/D2=B
GENERAL LIABILITY NC958461 10/01/2009 10/01/2010 EACHOCCU c,E S 1,000,000
COMMERCIAL GENERAL LIABILITY PREMISES a ooa+rence S 100,000
CLAIMS MADE F-1 OCCUR MED EXP(Any ort.parson) S 5,000
PERSONAL 6 ADV INJURY S 1,000,000
GENERAL AGGREGATE S 2,000,000
GENL AGGPWATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ 2,000,000
POLICY PROJECT LOC
A I AUTOMOBILE LIABILITY 35MCCXD6390 10/01/2009 10/01/2010 COMBINED SINGLE LIMIT S 1,000,000
(Ea neddenq
ANY AUTO
X ALLOWNEDAUTOS BODILY INJURY S
(Per Person)
SCHEDULED AUTOS
HIRED AUTOS BODILY INJURY S
(Paracodenq
NON-0WNED AUTOS —
' I PROPERTY DAMAGE S
(Par A=den)
GARAGE LIABILITY AUTO ONLY•EEA ACCIDENT S
ANY AUTO OTHER THAN EA ACC S
AUTO ONLY: AGO S
EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE S
OCCUR CLAIMS MADE AGGREGATE S
S
DEDUCTIBLE S
RETENTION S' S
A VIORKERS-COMPENSATIONAND 35 WECPP 1444 02/17/2010 02/17/2011 wCSTATU• DTH•
EMPLOYERS LLAB!U rY E.L.EACH ACCIDENT S 500-0
ANY PRDPRIETORIPARTNER/EXECUTNE
OFFICERMEMBER EXCLUDED? IE.L.DISEASE-EA EMPLOYEE S 500 000
[fps desalbo under E.L.DISEASE-POLICY LIMIT S 500.000
SPECIAL PROVISIONS below
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT SPECIAL PROVISIONS
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
INSURED COPY DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,tTS AGENTS OR
REPRESENTATIVES.
AUTHORED RttPRESEHTATNE
ACORD 25(2001108) /Y�/[/ 0 ACORD CORPORATION 1988
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ENERGY PERFORMANCE RATINGS
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ADDITIONAL PERFORMANCE.RATINGS
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Manufacturer stipulates that these ratings conform to applicable hFK procedures for determining whole
product perfo�mence,NERC rafts.are determined for a fined set of environmental conditions and a
specific product size.Consult manufacturer's literature for other product performance information.
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Design Pr sure.(PSF)
Meets or exceeds.WEC.,,UC.,S I.EC.C.Atr Infiltration Requirements.WbNR Hallmark Cerufication Program
Renewal
byAndersena
WINDOW REPLACEMENT anAnder=Cnmjnny
Wood�nyl Composite IF
�k1:;�;vrr.;.� Dual Argon Low E4 SmartSun
Double Hung
100-00473518-010
ENERGY PERFORMANCE RATINGS
- U-Factor(U.S)/I-P Solar Heat Gain Coefficient
i
019
0019 . 1
ADDITIONAL PERFORMANCE RATINGS
Visible Transmittance
0 . 42
Manufatturar atiputatas that Masa rmings conform to appf.-able NFHC procedures lot determining whole product
panormance.NFHC ratings era datarmutad bra limed sat o1 environmental conditions and a specdc product sae.
NFHC does not recommend any product and does not warrant the suitability of any product for any apacAi:use.
Consult manufacturer's laaatura for other product performance information. .
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Te616atoliMS-02orAAMAA'ODMAICSA101ASfA40-M M"XilaChte stipulatee aantormar"to Ina
1004=16 standards.
4'10.1.or emca0ds M.E:C.,C.E.C.A LE.C.C.Air Infharallcn requirements WOMA hallmark Cenfcation Program.