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Home My WebLink AboutBuilding Permit #563-13 - 115 LANCASTER ROAD 2/19/2013 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION j Permit NO: Date Received Date Issued: IMPORTANT:A plicant must complete all items on this page LOCATION I\S `-Gtn_('(!k�`l�-cr �CC pmt- ,�n P� PROPERTY OWNER--L� IA0r\. a e_ \ Print 100 Year:Old Structure yes �0)0 I MAP NO'. IOy,7 PARCEL:OIto � ZONING DISTRICT:. Historic District yes Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building X One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑Well ❑ Floodplain, ❑Wetlands ❑ Watershed District,.' ❑Water/Sewer nn DESCRI TION OF WORK TO BE PERFORM D: LV\.I-A Y� a� -- no � G Identification Please Type or Print Clearly) OWNER: Name: ,)\,() I6nr, 'p-« Phone: q�$_�8�- �O(o� Address: 5 , S c� �� l' k31A S� CONTRACTOR Name:,, V2t�f�\S�/1 Phone: ,A�)T-351 - a)UO 4 Address: - Lr►n Supervisor's Construction Licenser 5o Exp. Date:..-- Home ate:__Home Improvement License: Iy I O Exp. Date.: I a`J.3 ;1 _3 ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ u(r), y. FEE: $ Check No.: 0? Receipt No.: o9,6 NOTE: Persons contracting with unregistered contractors do not have access tot uaranty fund `Signatureof Agent/Owner _ v Signatureof_contractor Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ l Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ l 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 4 PLANNING & DEVELOPMENT ❑ ❑ i i COMMENTS CONSERVATION Reviewed on Siqnature COMMENTS i HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments ConFe rvation Decision: Comments R Water & Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT - Temp Dumpster on site yes no Located at'124 Main Street Fire Departinentsignaturdldate I COMMENTS � I Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of fleeter 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.$10041000 fine NOTES and DATA— For department use LJ Notified for pickup - Date i Doc.Building Permit Revised 2010 Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. 1 Roofing, Siding, Interior Rehabilitation Permits o Building Permit Application ❑ Workers Comp Affidavit o Photo Copy Of H.I.C. And/Or C.S.L. Licenses o Copy of Contract o Floor Plan Or Proposed Interior Work o Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks o Building pp Permit Application ❑ Certified Surveyed Plot Plan o Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses o Copy Of Contract o Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) o Mass check Energy Compliance Report (If Applicable) o 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) o Building Permit Application o Certified Proposed Plot Plan o Photo of H.I.C. And C.S.L. Licenses o Workers Comp Affidavit { o Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) o Copy of Contract o Mass check Energy Compliance Report o 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: Doc.Building Permit Revised 2012 NORTH own -of ..A", 6 Andover No. 3 6 1310 IM WWWW 01 LAXI _ ICh ver, Mass, A- cocHicKlWICK 7,9 A0 ArED S U BOARD OF HEALTH Food/Kitchen PERMI'T T LD Septic System THIS CERTIFIES THAT ....... BUILDING 7C.. .....1�70..JV..Y.t�../! BUILDING INSPECTOR . ..... . .. ..................................................................... ` ... Foundation ..................... has permission to erect.......................... buildings on ../:��..... �'/.�,�� °:..... Rough to be occupied as .................. .......................... Chimney provided that the person accepting this permit shall in every respect conform 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 CONSTRUCTIO S ARTS Rough Service ................... .. ..... ......................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building 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. Smoke Det. SEE REVERSE SIDE Renewal - MA Home Improvement Contractor byAndersen. •, License#170810(Expires 12/23/2013) WINDOW REPLACEMENT an Andersen company Renewal by Andersen Corporation Federal Tax ID#41-1918413 104 Otis St.,Northborough,MA 01532 (508)351-2200•Fax:(651)351-4810 CUSTOM /WINDOW AND DOOR REMODELING AGREEMENT r s)Name /t't C!✓l� -Z ��U--'"L`}"I1--r CG+. Date of Agreement s)Street Address,City,Stat,and Zip Code E-Mail Address Home Telephone Number Work Telephone Number ',6 �c 6 r Buyer(s) ereby Jointly and severally agrees to purchase the products and/or services of Renewal by Andersen Corporation ("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. i Total Job Amount: / tt CtG+�� Estimated Starting Date: Method of Payment: J Amount Financed /✓ � -+, _ ❑Check ❑Cash Deposit Received l33%):_/14 t��v _� QVisa/MC ❑Discover ❑Financed AMEX Balance at Start of Job(33%): ZS'new D Estimated Completion Date: p If credit card is selected,please Balance on Substantial / see Credit Card Payment Form. Completion of Job(33%): 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. Renewal b Andersen Corporation f Buyer(s) Buyer(s) By: 1.. Sig" ture of P uct Manager 4 Signature Signature Print N me of Pr6duct Manager Print N e 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. - - - - - - - - - - - - - - -2c- - - - - - - — — — — — — — -X— — — — — — — — — — — — — — — � NOTICE OF CANCELLATION I X NOTICE OF CANCELLATION Date of Transaction - -/7 You may cancel Date of Transaction 2 �-L.T 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 f 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 I 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 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; oryyou may, if you wish, comply 1 Contract or Sale;or you may,if you wish,comp.1y with the with the instructions of le 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 pick them ujp within 20 days of the date ofYour Notice of your Notice of Cancellation,you may retain or dispose I of Cancellation,you may retain or dispose of the goods of the ggoods without any further obligation.If you fail to without any further obligation. If you fail to make the make to goods available to the Seller, or if ou agree I 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, I notice,or send a telegram to Contractor: Renewal by Andersen Corporation, 104 Otis I Renewal by Andersen Corporation, 104 Chis Street, Street, Northbor ugh, MA 01532, BY NOT LATER THAN North orough,MA 01532,BY NOT LATER THAN MIDNIGHT MIDNIGHT OF - t�- ,(Dote) OF -h-/' ,(pate) 1 HEREBY CANCEL THIS TRANSACTION. 1 HEREBY CANCEL THIS TRANSACTION. I Buyer's Signature Print Name Date I Buyer's Signature Print Name Date RbA Copy- White Buyer Copy-Yellow Buyer Copy-Pink QBLLP2009.RBA-Ph.MANH Renewal •� enewal by Andersen Corporath MA Home Improvement Contractor bYAndersena 104 Otis St.,Northborough,MA 01532 License#170810(Expires 12/23/2013) WINDOW REPLACEMENT an Andersen Company (508)3j1-2200•Fax:(651)351-4810 Federal Tax ID#41-1918413 WINDOW SPECIFICATION SHEET Buyer(s)Name Date of Agreement 2 < P _-2_. The Buyer(s)listed abWe hereby jointly 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 DETAILS 1. Contractor will Install a total of 211 windows in Owners home,using the following individual quantities: Double Hung(DB)_X Equal sash_Cottage sash(1/3 top,2/3 bottom)_Oriel sash(2/3 top.1/3 bottom)_Flat sill aware t class f Square Check Rail_Curve Check Rail Casement(CS)_Hinge right_Hinge left(as viewed from exterior) / Double Casement(CD) 2 Lite Gliding Window(GW) Casement/Picture/Casement(CT)_1:1:1 or_1:2:1 Glider/Picture/Glider(GPM_1:1:1 or_1:2:1 o� Picture Window Bay or Bow Awning Window _#Lights Soffit/Roof Shingle/Copper Specialty Window C/ Patio Doors(see separate door spec sheet) Seat to be Primed/Oak/Pine 11 11LJ [LI[LJ E:11::] 2. -.31 Qty of Windows to be Custom Fit Replacement: 3. 'fes Qty of Windows to be Custom Fit Full frame(INCLUDES NEW INTERIOR&EXTERIOR CASINGS) Exterior�asings:_Pine_Mai enance-free material_Factory applied 908 Fibrex bri kmold 4.Glazing to be:_HP Low-E-4 TM _ empered _Other If other,please specify: 5.Exterior color to be: /White_Sand_Canvas_Terratone_Cocoa Bean_Dark Bronze_Forest Green_Black 6.Interior color to be: White_Sand_Canvas_Pine_Maple_Oak_Same as Exterior Note:Wood interiors need to finished by Owner. 7.Hardware: White_Stone—Canvas_Estate Hardware: Style: 8.�Install Lifts with Double Hung Windows 9. Screens:windows to have:_Half or screens Screens to be:_Fiberglass_Aluminum vTruScene GRILLE DEFARS 10. Windows have grilles:_Grille Between Glass(GBG) Removable Interior Wood GNTW)_Full Divided Light(FDL) ( )Owner approved(initials) Draw grille patterns below 'Use additional s t if needed Qty: Qty: Qty: Qtr: Qty: Qty: Qty: ADDITIONAL WORK DETAILS 11. Qty of_Sills_Sill noses to be replaced by Contractor 12. — Contractor will remove metal frames of windows. 13. Contractor will install new_paint-ready or_stain-ready_Interior_Exterior casings in_Pine_Maintenance-free material 14. —Contractor will install new_paint-ready or_stain-ready_Interior_Exterior stops in_Pine_Maintenance-free material 15.( Intls-Owner is aware,contractor does not do any painting or removal installation of alarm system/hardware. It is the responsibility of the homeowner to have the alarm system/hardware removed prior to installation. 16. '> Contractor will wrap exterior casings with coil stock of color. Note:Wrapping may be required with storm window removal;removal of storm windows will leave screw holes in casing. 17.Contractor will insulate,caulk and seal windows with 3-Point system to prevent water and air infiltration. Removal and disposal of all job related debris,win- dows,storm windows and vacuum nightly included. Upon completion of the job and payment in full,a limited warranty shall be issued. 18.J2 Yes❑No Building Permit7—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. Ck# � $ L' 19. Yes❑No All discounts have been applied to this agreement price. 20.Additional job details: �J� <✓- /-7 c'm�L 7Z�JiL e L n %G✓ �C-C'�%LY<ff C 21.RYes El No Owner agrees to be present on the final day of installation for final inspection and to deliver final payment/finance form(s). 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 that Buyer(s)has read this Specification Sheet. Renewal ndersen Corporation Buyer(s) Buyer(s) By G Signature orProduct Manager torture Signature n/ Print Nam of Product Manager Print me Print Name Renewal Renewal by Andersen Corporation CA 104 Otis Street•Northborough,Massachusetts 01532 MA Home Improvement Contractor i byAndersen g MA License#170810(expires • Phone(508)351-2200•Fax(508)986-7072 12/23/2013) WINDOW REPLACEMENT an Andersen Company Federal Tax ID# 41-1918413 CONTRACT AMENDMENT This Amendment("Amendment")is to the CUSTOM WINDOW AND DOOR REMODELING AGREEMENT("Agreement")by and between Renewal by Andersen Corporation and Bob Monstell("buyers"). Contractor and Buyer(s)hereby agree to amend and modify the Agreement as indicated below. Other than as specifically indicated below,all the terms and conditions of the Agreement will remain in full force and effect. This Amendment is subject to the terms and conditions of the Agreement. The following additions,alterations,or deletions to the products and services Buyer(s)ordered are being made: Removing 1 circle top and 1 picture window from original order. As a result of these changes, the following terms of the Agreement are also changing (if there is no change, an item will be left blank or marked as"N/A",indicating that no change applies: NEW Total Job Amount: $42,400.00 Payment Method: New Deposit Received(33%):$15,000.00(Received) Credit Card New Balance at Start of Job(33%):$13,700.00 Check/Credit Card New Balance on Check/Credit Card Substantial Completion of Job(33%):$13,700.00 It is agreed and understood by and between the parties that this Amendment and the original Agreement constitute the entire understanding be- tween the parties,and there are no verbal understandings changing or modifying any of the terms of this Amendment. Buyer(s)hereby acknowl- edges that Buyer(s)has read this Amendment and has received a completed,signed,and dated copy of this Amendment on the date written below. I Renewal by Andersen Corporation Buyer(s) By. Signature of Product Manager Signature Date E-Signed : 02/1812013 11:38 AM DST Carl Bryson Robert Mongell 2/15/2013 hmong12@gmall:c0m I0:96237AQ4 3. Print Name of Product Manager �oeT[�;.3Di�o2i3i4asi259s Date Doc ID: 20130215140612591 I The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information /n� I Please Print Legibly Name (Business/Organization/Individual):_-�e, ,) ,1 �)t Address: City/State/Zip: 1 53a Phone#: SZ)`� Are you an employer?Check the appropriate box: Tape of project(required): 1.0 I am a employer with ,3 04. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. .Q 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. E]Building addition coinP• [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 1 L❑Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 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. t 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-contractors and state whether or not those entities have employees. Ifthe 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 job site information. Insurance Company Name: P tnU�D\� C, �r1 S C Policy#or Self-ins.Lic.#:___M l A\ C_ ` Ll?0'( Expiration Date: Job Site Address: 1�' L a n CSI,� r K t� II �,� City/State/Zip:�llp t^ a�-��M-, 01I 41' . 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 cert d thepains and penalties ofperjury that the information provided above is a and correct+ Signature: Date: 2 / Phone#: S-0 9 Official use only. Do not write in this area,to be completed by cityor 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#: ACOR CERTIFICATE OF LIABILITY INSURANCE DATE 2/2012"' 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(ies) must be endorsed. If 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 endomement(s). PRODUCER 1-612-333-3323 CONTACT g NAME: Jonelle Hargrove or Eric Johnson Hays Companies PHONE 612-333-3323 F' 612-373-7270 AIC No 80 South 8th Street EMAIL ADDRESS: Suite 700 PRODUCER Minneapolis, MN 55402 CUSTOMER INSURERS AFFORDING COVERAGE NAIC p INSURED INSURERA: OLD REPUBLIC INS CO 24147 Renewal By Andersen Corporation INSURER B: NATIONAL UNION FIRE INS CO OF PITTS 19445 104 Otis Street INSURER C: Northborough, MA 01532 INSURER D: INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: 29229436 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. INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE &a Wyn POLICY NUMBER MMIDD MM/DD LIMITS A GENERAL LIABILITY MWZY 59828 10/01/1 10/01/13 EACH OCCURRENCE $ 1,0001000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO NTED PREMISES aEoccu ence $ 500,000 CLAIMS-MADE ril OCCUR MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 3,000,000 X POLICY PRO-iEcT F7 LOC 1 $ A AUTOMOBILE LIABILITY MWTB 21700 10/01 1 10/01/13 COMBINED SINGLE LIMIT $ 3,000,000 X ANY AUTO (Ea accident) BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE X HIRED AUTOS (Per accident) $ X NON-OWNED AUTOS $ $ B X UMBRELLALIAB JX OCCUR 13273355 10/01/1 10/01/13 EACHOCCURRENCE $ 25,000,000 EXCESS LIAR CLAIMS-MADE AGGREGATE $ 25,000,000 DEDUCTIBLE $ X RETENTION $ 25,000 $ A WORKERS COMPENSATION MWC 117948 00 10/01/1 10/01/13 X WCSTATU- OTH- AND EMPLOYERS'LIABILITY Y/NER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFRCER/MEMSER EXCLUDED? N❑ N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 es describe describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,ff more apace Is required) Evidence of Insurance. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Evidence of Insurance THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE erica 01988.2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD 29229436 Massachusetts -Department of Public Safety ! Board of Building Regulations and Standards j Construction Supenisor License: CS-095707 BRIAN D DENM ON , 7 LAMBS POND CIR rs Chariton MA 01517 I J.�rw �✓ w " "``` Expiration Commissioner 09/08/2014 { 1:17/ee� noouue�t// aaeae�zuaeda Office of Consumer Affairs&B siness Regulation HOME IMPROVEMENT CONTRACTORRegistration: 1;470810 `f TY Pe:Exp ration. 12013 Corporation ^v k0,WPRATION ! _ BRIAN DENNISO ' 104 OTIS ST. NORTHBOROUGH, } = Undersecretary Renewal byAndersen, WINDOW' REPLACEMENT ItnAndematCotlryltop WoodMnyl Composite IF "- Coraa Duel Argon Low E4 Smansun Doub100-00473518--010 -ENERGY PERFORMANCE RATINGS U-Factor(U.S)/1-P Solar Heat Gain Coefficient9 i I ADDITIONAL PERFORMANCE RATINGS Visible Transmittance ' I M1nnY pnbm11111nn.1M. prod.0 1p46tlatMetMr atinD4cenferm tenppLa6b NFRC pnx4011ra br dntlrminigwAoY NERC N161yf1A dN4rmMd blfrla wt dlMGnnlrnt11lepWiinnl4rM�spneiSe product nen. NMC dons CanuYlnnros4andry don nq 6.= .rprodowpodMpbiwY aanY p/0d1Ct briny ttp4do s111. - WWWAIOAM T6'sprodletront4Snookco msntd 041111111 . �`• '.aM6eineY.64nvy rnnt11ttb r; ''r � .P IM bu111 sod 11146 j t�'jntur:�pttetayinp 11d f emrsm4rn0.=b—W / DESIGN PRESSURE(PSF) i RbA DB Sloped S ll DH IN I Tr1k1aNN�QrAMAAMp.IMSAt01A4�MIDai Mn6Mrr mnlgtmrolbh 4eMrOn- dataalw:lWe M.E.C.CF.C,i1,E.CA.AtrMflltrati11n r11asiwstlttts WU61A lYMAc CsdR'enifn Wepeam. � I it I • I I I. & H Y w Location No. J/ Date 'r ' TOWN OF NORTH ANDOVER a m Certificate of Occupancy $ Building/Frame Permit Fee $_iDd :. Foundation Permit Fee $ Other Permit Fee rp $ n TOTAL $ Check# � n 26155 B ilding Inspector 1