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HomeMy WebLinkAboutBuilding Permit #458 - 115 LANCASTER ROAD 12/6/2011 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION i Permit NO: Date Received Date Issued: -!D EVIPORTA.NT:Applicant must complete all items on this page LOCATION ICS L n� s',1-;ee, 9—a Print PROPERTY OWNER 9�5� (>' / Print MAP NO: W_PARCEL:l / ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building 'One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial "epair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other (] 5 ep c ®We l +p Floodplaua €OWetlands tershedtDis"fiict ;DWater%Sewer. - DESCRIPTION OF WORK TO BE PERFORMED: r ffi - 41 /qac l g Lvi nn�� 1� v� t`o odd Identification Please Tyor Print Clearly),pe OWNER: Name: kd&cr✓• - M,5111 // Phone: 971-69 ny Address: Z/ CONTRACTOR Name: r,,) Phone: ' n Address: �� �` r_-A, WCJr ' rte. Supervisor's Construction License: 2C) 2 Exp. Date: Home Improvement License: V I(e b/ Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT.$92.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Go Total Project Cost: $ R B3. FEE: $ `3 Check No.: 14 03 2— Receipt No.:a4g- G-:� NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agerit/Owner ' D Signature of contractor ,: 1 _�, u V 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 CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Siqnature 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 DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT - Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date COMMENTS ! i i 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 de artment use ® Notified for pickup - Date Doc:.Building Permit Revised 2008 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 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 Permit Application ❑ Certified Surveyed Plot Plan o Workers Comp Affidavit o Photo Copy of H.I.C. And C.S.L. Licenses o Copy Of Contract E3 Flo or/Crossection/E levation 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) o Building Permit Application ❑ Certified Proposed Plot Plan o Photo of H.I.C. And C.S.L. Licenses o Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic y raullc Calculations (If Applicable) o Copy of Contract o Mass check Energy Compliance Report o Engineering Affidavits for Engineered products MOTE: 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 :hat the appeal period is over. The applicant must then et this recorded at the Registry of Deeds. One co and roof of recording g g Y PY P g nust be submitted with the building application Doc: Doc.Building Permit Revised 2008mi FORTH Town of �� Andover . O "A No. M 4 `7 �� _ o , �` lover, Mass., Ir�-(D•1 Y` Q '-- LAKE COCHICHEWICK AoRArED �P�� "♦C E BOARD OF HEALTH PEnMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THISCERTIFIES THAT............ .. ............ .................. ........ ..................................... .......................................... Foundation has permission to erect...........:.:....... buildings on .....�.�. ........`.� � J ....... Rough ........ h ..........w......................... to be occupied as...........�... ......... T......W` A a.................................................................... Chimney ' e provided that the person accepting this perm d 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 LESS CONS�V d TJ Rough ...................... i............................................................. 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 FIR_ E-DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner - Street No. SEE REVERSE SIDE Smoke Det. Sep 1511 07:44p David Sullivan 19784105478 p.5 104 Otis St.,Northborough,NL;k 01532 J&L WINDOWS,INC.,D/B/A MA Home Improvement Contractor 508j 919-0900•Fax:;774;1987-3013 Renewal Licensc#149601 (Expires 1/24/2012) �: byAndersen Federal Tax ID-#83-0404201/J1 WINDOW REPLACEMENT A,-49�! CUSTOM WINDOW AND DOOR REMODELING AGREEMENT Buyer(s)Nune Date of Agreement Or Bvyerisl Street Address,City,State,and Zip Code i� s— la N r /yo til/Z- A491 o/Sym EA1oil Address cme Telephone Number Work Tek lone Number I Bnyer(s) hereby jointly and severally agrees to purchase the products and/or services of J&L Windows,Inc.d/b/a Renewal by Andetsett ('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. Total Job Amount- 9 33 Est imated Starting Date: Method of PoymentLI�Check ❑Cash ❑Financed Deposit Received(33%lAd_9*-_ Q Balance at Start of Job(33°i)�O�yEstimatae' I Credit Cards are accepted for deposit dGamplefionDatOnly—maximum 1/3 of the project cost. 6alonce on Substantial r _(Tp W k _ i Please see Credit Card Payment Form. Completion of Job(33%) J By signing this agreement,you acknowledge that the Balance at Start ofJob and the Balance on Substantial Completion 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) I)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& Endo ,lnc. Lfeal y Ande en Buyer(s) Buyers) By- �SjiSnaturc of (duct/AlanaFcr nantrr• >ignatun: ,. U;o J t///>lJ�� 0�e, tlf)11Lf�LEr Print lame 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. — — — — — — — — — — — — — — —5<• — — — — — — — — — — — — — — -�<— — — — — — — — — — — — — — —5c NOTICE OF CANCELLATION NOTICE OF CA LLATI N Date of Transaction . You may cancel I Date of Transaction . You may cancel this transaction,without any penalty or obligation,within this transaction,withou n enalty or obligation,within three business days from the above date.If you cancel,any I 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 win I and any security interest arising out of the transaction will be canceled.If you cancel,you must make available to the i 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 as when received,any goods delivered to you under this this Contract or Sale; oryou may, if you wish, comply Contract or Sale;or you may,if you wish,comply with the with the instructions of e Seller regarding the return instructions of the Seller regarding the return shipment of th shipment of the goods at the Seller's expense and risk. the goods at the Seller's expense and risk.If you do make Ifyou do make the goods available to the Seller and the 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 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 you agree goods available to the Seller,or if you agree to return the to return the goods to the Seller and fail to do so,thengoods 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 Inc. d/b/a Renevw by Andersen, 104 Chis Street, Street, Northborough, MA 01532, BY NOT LATER THAN Northo ugh MA 01532,BY NOT LATER THAN MIDNIGHT MIDNIGHT OF .(Date) OP ,J .(Date) I HEREBY CANCEL THIS TRANSACTION. i 1 HER Y CANCEL THIS TRANSACTION. Buyer's 51gnoture Print Name Dole Buyer's Signature Print Name Dote RbA Copy- Whitc Buyer Copy-Yellow Buycr Copy-rink Sep 1511 07:42p David Sullivan 19784105478 p.2 Renewal RENEWAL BY ANDERSEN &M H1C License#t 49co I bY�I1C�2fSeR" Federal Tax IDu(expu83 0404201 Or GREATER lYSassAcl(usLTrs AND Ne��'HAt<aPSIt1Re WINDOW REPLACEMENT 1"nnJnae"C,pv y 104 Otis Street•Northborough,Massachusetts 01532 Phone 503.919.0900•Fax 774.987.3013 SPECIFICATION SHEET Buyer(s)Nam Date of Agreeme 7'he Buyer(s)listed above herebyjointty and severally agree to purchase the goods and/orservices 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 RENIODELING AGREEMENT,of which this Specification Sheet is a pati. PATIO DOOR DETAILS 1. Install total of: Permashield Gliding Patio Doors) ❑ 510"x 6'8" ❑ Other(not available in 8068) Op.panel is❑ left ❑ right(as viewed from exterior) Interior and Exterior Color to be: ❑ White a Canvas ❑ Sandstone ❑Terratone (Color same inside and out on PS) Hardware: Metro: ❑ White ❑ Stone ❑ Bright Brass ❑ Other—Specify ❑ Yes ❑ No Gliding Patio Door to have sidelight? Size: ❑ Yes Q No Grilles? If yes: GBG ❑INTW ❑ FDL(Pattern is standard as viewed in book for all doors) 2. Install total of: Narrowline GlidinZ Patio Door(s) ❑ 6'0"x 6'8" ❑ Other: Op.panel is❑ left❑ right(as viewed from exterior) Exterior Color: ❑ White ❑ Canvas ❑ Sandtone ❑ Terratone (Interior is WOOD and customer must paint or stain) Hardware: Metro: ❑ White ❑ Canvas ❑ Stone ❑ Bright Brass ❑ Other—Specify: ❑ Yes ❑ No Gliding Patio door to have sidelight? Size: ❑ Yes ❑ No Grilles? If yes: GBG ❑ I11UW ❑ FDL (full Divided Light) 3. Install total of: Frenchwood Gliding,Patio Door(s) ❑ GO"x 618" ❑ Other: Op.panel is❑left ❑ right(as viewed from exterior) Exterior Color: ❑White p Canvas ❑ Sandtone ❑ Terratone Interior Wood: ❑ Pine ❑ Oak ❑ Maple Interior finish: ❑ Prefinished White(Available only with white exterior) ❑ Unfinished(Paint/stain done by customer) Hardware: Metro: ❑ White❑ Stone ❑ Bright Brass ❑ Satin Nickel ❑ Yes ❑ No Gliding Patio door to have sidelight? Size. ❑ Yes ❑ No Grilles? if yes: GBG ❑ UVTW ❑ FDL (full Divided Light) 4. Install total of: / Frenehwwd Hinged Patio Door(s) 00"x 68" ❑ Other: ❑ Yes ❑ No Active/Passive Panel?: ❑ Left ❑ Right(viewed from ext.which is active) OR ❑ Yes ❑ No�/Stationary Pmel7: Left Right Door Swing, Insuring ❑ Outswirrg Exterior Color: ❑ Canvas ❑ Sandtone ❑ Terratone Interior Wood: Oak ❑ Maple Interior Finish Prefinished ❑ Unfinished(Paint/stain done by customer) r�� Hardware: Metro: ❑ to Stone ❑ Bright Brass ❑ Satin Nickel `NOTE: Qanvas hins:ed screen frume N/A—must choose white or stone if exterior is canvas` ❑ Yesed Patio door to have sidelight? Size: ❑ 1'c es If yes: GBG ❑ INI'W ❑ FDL (full Divided Light) STORM DOOR DL'TAILS 5. Install total of: Storm Door(s) 6. ❑ Full View❑ Mid View 7. Color to be: ❑ White ❑ Canvas ❑ Sandtone ❑ Bronze❑ Forest Green 8. Size tote: ❑ 32" ❑ 34"(White only) ❑ 36" ❑ Custom(10 week lead time) Size: 9. Hardware to be: ❑ Bright Brass ❑ Nickel 10. .dditionaljobdetail,-< Sem_ Cfis"T, �O/t__ ��j��w,e/lam s'cleeT)oy 4Yes ❑ No Owner agrees to be present on Ilse find]day of installation for final inspection and to deliver Final payment. � o final payment shall be demanded until the contract is completed to the satis6cfion ofall 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 ate no verbal understandings changing or i modifying any of the terms. This Specification Sheet may not be changed or its terms modified or varied in any way unless such c—angea,are in-writing and ri _d by Loth the Buyer(s)and Confrscter_ Buyer(s)hereby acknowledge± t Buyer(s)has read this Specification Sheet. Ren by rs n a and NH Buyer(s)/� Buyer(s) Signa of Pro uct ager Signature Signature �) , LGr7 U/ CJ J Jy �a�? M0IJ C� Print Name of Product Manager Print Name Print Name S' ,1511 07AP David Sullivan 19784105478 p.4 • J u L Windows,Inc.dib/a ret'rcet,Nbrthborcugh,MA 01532 Renewal AIAHICLicense#14960I(expires 1/24,'12) a )5.919.0900 a Fax 774.987.3013 ea Federal Tax][V 83.0404201 bAndersen. WINDOW REPLACEMENT an AndersenCamxny I or GttrA7ER MAssACHusum AMo NEW HA.NPSHLRE WINDOW SPECIFICATION SHEET Buyer(s)Name Date of Agreement The Buyer(s)listed above hereby iointly 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 DMAES 1. Contractor will Instal]a total of windows in Owner's home;using the following individual quantities: 7 Double Hung(DB)3U Equal sash ❑ Cottage sash(1/3 top,2/3 bottom) ❑ Oriel sash(2/3 top.1/3 bottom) Casement(CVV ❑ Hinge right ❑ Hinge left(as viewed from exterior): ❑ Standard handle ❑ Metro handle Double Casement(CD1\I ❑ 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(A\k0 _�Picture Window(PW) Bay or Dow Window Patio Doors(see sep f e Door Specification Sheet) 2. Yes ❑ No Qty of Windows to be Custom Fit Replacement: A. ❑ Yes No Qty of Sills to be replaced by Contractor: 4. ❑ Yes No Qtv of Windows to be New Construction Full frame(includes new Interior&exterior casings)and actual Exterior(, sings: ❑ Pine E] Maintenance-free material F1Pactory applied 908 Fibrex bricknteld 5. Glazing to be 'HP Lou--EA— ❑ Other If ether,please specify: G. Exterior color to be:Wo Sand ❑ Canvas ❑ Terratone [_1Cocoa Bean 7. Interior color to bc. Sand ❑ Canvas ❑ Terratone ❑ Fine ❑ Maple❑ Oak Note: r color fait only be white,wood or same color as exterior. Wood interiors need to finished by Owner. S. Hardware Stone ❑ Canvas ❑ Brass ❑ Estate Hardwasc: Style: 9. ❑ Y"es g No Instal]Lifts with Dauj&Bung Windows 10. Screens: windows to huveHalf r ❑ Full screens &crcons to bc: ❑ Fiberglass ❑ Aluminum TruScc GRILLE DEFAIIS 11.\Vindows lave grlllc No If yes:❑ Grille Between Glass(GH_ Fctnovable Interior Wood a na) Full Divided Light(roll Qty: Qty: Qty:Lam.! Qty: Qty: Qty:— Qty: IL DFI DH OH off El Glder CPA?cr GP. Draw grille patterns above 'Use additional sheet if needed Owner approved(initials) ADDITIONAL WORK DEFAU 12.❑ Yes No Contractor will remove metal frames of windows. Qty of Units: I S.❑ Yc 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 No Contractor will install new paint-ready or stain- aside or outside stops qty of openings: Interior stops qty of openings: Ext erio ops qt�of opening, ❑ Pine ❑ Maintenance-free material 15. Owner aware that Contractor does not do any pain mer IG.❑ Yes No Contractor will wrap exterior casings with a stock of color. Note: Wrapping may be required with storm window removal.removal of storm%vindows will leave screw holes in casing. 17� Yes ❑ No Contractor will insulate,caulk and seal windows with 3-point sysiem to prevent water and air infiltration. Yes []No Clean up all job related debris including old windows w611 be removed.Vacuum nightly: 1. Yes ❑ No A limited warranty sluil!be issued to Owner upon completion of thejob and payment in full. Yes ❑ No Building PCrtrtit—COn"clor will secure any and all necessary permits. The fee for lite permits)is not included in the Contract Price and a separate check is requited at the time of sale for this fee. 2 Yes ❑_No ,Idl discounts have been ap lied to this agreement rice. / 'Kdditional jol;details: Z :ru � /Nry --"g X ham/ff yC P/1Sr//�• SNv(>✓ / IJV Oit�.v f t�ST 4/ AJO ­'�/.Lj -/ ti k p .iv.s T TO /-t is-%re.,A 4,--QS 23. Yes E] No Ow m cr agrees to be present on the final of installation for final inspection and to deliver final payment. rho fin l paymertJ sh�r!be demanded until the contract is completed to the satisfaction ofall parties. It is agreed and understood by wad 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. llnis Specification S not be c ed or its terms modified or varied in any way unless such changes are in writing and signed by both the Buyers)end Contract r. u e-s)he acb.wledge that Buyer(s)has read this Specification Sreet. en f yer(s) Buyers) Signature of duct ger Signa a Signafi e Print Name of Product Manager Print Name Print Name Tke Comrnmcweaftls of hsassackrr�e� •. o fndustrx tr1 tit;csde Dep�e� f . Office of Inge dpfftaffs 600 FlOd sgtaa Etreef Bnstan,X4 02111 afion fnctrrsnce Affidavit;Builders/Contractors `,IettricZaas1P{IImbe rr Workers Compens Plasse Priv A Iicsnt Fuformstian' n/lnvJ—D?ael' Nmno(Businmdc)rged=fto ss;. D �` ( PhD= Cify�StiatedZig; D f�h bn�D � � .. . hype ofprtijt3tt (rr;t}uired); • Are an an=plvpet`7 Check fine apprapriste ban . Y 'ad 23cw canstxnction . oneual GDntraGtOr fi B Ism ❑ Hm a cmployarwifit�3 —.� ;' 4' ❑Ow bhrd the sub-conixaotnra �� odcFing omploymis(fnlf Mm Vclr part-�). m the attacbGd shad t Z,ElI am a solo proprietor arpnt3w- ase sal. ronhwtara have B. Doalolition ship and hMve M maplCros i .Z�' Dome.iny'tIMW& 9, 0 BmIding � working for m4 In�°v��' 5WC Hie IL G omt�a and its clip '10.C]l�ctrical ceptors or addifians• No oanrkcte'comp.insurldoe S. ❑ mem have=oisised thou. His or 1106013rz4=d-);' vght of csampfion Por MOIL, Rlumhing rep 3:❑ I am a homGowncr doing an work i52 4 and we have no I2.❑pmof ropB n; a ,@1( )� tnysGlt[Na vaor�' Camp. Map�ycot:,•(No warmers' 13-ElOar ' insuranco mqui it t any o rrq=d-I •their WML"='oamp�donn p°Ley mfarm *Aay applie�at that cid hes tt'1 m1 euo f 110,E the�eeFi�beL:r chevtia� in iaew efndavit indioe6nE�vrh t gomeowne n whn tubmtt thu affidacnth�dir t;they�' 6."DI ar>d cath w�mss'D=P.Pot1G7 �1°a �Coatneetna t*hchrr.Y 6h bot molt clucked on edam and job fife trnrkrra'campc=don inszv'anee far my eatplayecs �elmv.is the pvFscy I am as cmplvper that fa prayid"mg. . ' infarrnatian. , ' •�•� �,/ �/ J - 1 Y1� °t. Insurance Companp No= J It .SOS lJ� . t� ir�tia�Datc; Police#ar ScIf-ins,Lia.#; nmm lob Rite Address: / p� ,er and ezpira&n dstEl. Aftaccli a espy of the vmrkare'oompenssfianpolmY der a�Dn pgtre(shavrmg P c, 152 can 1Lad in the impot;iflan of Grimsnal penalfios of e ccfian25A afMGL and a run ae re d nndcr S 5T1DP01 DRD� to qr,=CDv p � c�•of a 19611 a6 elvl m lbt5IIl til im ' onnitni;Hs p fbe Dfficc of . DDD and/or ona-Yc4 o iDrwardcd to D . b ' u •tn$1 5 m8 p visod9lat a ropy this stsiamcnt e -of Up to S250.00 a dHy against file vials tar. Fc ad avrmfigafi=of file DIA for insar :cOvCrago • ecG d carr Ido hereby ce rc er the pains tzrtd pertafties' ,�I�3'that the iazfarmatean praYided u6vYe is tut.en , . • Data; . �tPnatIIrc. � , o .CY1 D�icial use aI Da YW wry in this area,tv he enmplefed by city ar tarn o tciQi J Cgty or Tovtn '. • PermitlLictnBe# g A-uthmtj(Cgrck ane); ectar 5.Plumhin;Inspector L Saard of Health 2.S Department 3.C �ITown c3wk 4.Mwbim lWP ,. • fi,Other - . Cantact Person V • Massachusetts - Department of Public Safety Boar(liof• Building- Reuulation's and Standards Construction's u pervisor License License: CS 95707 BRIAN DENNISON 86 CREST CIRCLE WORCESTER, MA 01603 Expiration: 9/8/2012 ('ununissiuncr TrR: 2622 4. Office of Consumer Affairs&Business Regniafion HOME IMPROVEMENT CONTRACTOR ' RegistiaEiot���01' . api 12 t Card RENEWAL BY q�J BRIAN DE NIS '104 OTiS SIRE T: '��!° 4�7 NORTHBOR0 H. Undersecretary ACC® CERTIFICATE.OF LIABILITY INSURANCE DATE o�o�0'11 Y' 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 endorsement(s). PRODUCER CONTACT J.P. McKeone Insurance Agency Inc NAME: PHONE FAX JP McKeone Insurance Agency, Inc. ac-No . (734)662-8100 A/c No: P.O.Box 333 AIL ADDRESS: Ann Arbor, MI 481060333 INSURER(s)AFFORDING COVERAGE NAIC p .INSURER A: Nautilus 19682 INSURED J&L Windows,Inc.Renewal by Andersen INSURER B: Hartford 37478 104 Otis St. Northborough,MA 01532 INSURER c INSURER D: INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: 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. TYPE OF INSURANCE ADDL SUBR _ POLICY NUMBER MM/ID� MMIDDY EXP I LIMITS LTR A GENERAL LIABILITY NC956461 10/01/2011 10/01/2012!. EACH OCCURRENCE $ 1,000,000 COMMERCIAL GENERAL LIABILITY RENTED PRE'M SES Ea occurrence $ 100'000 CLAIMS-MADE IV OCCUR MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEWL AGGREGATE LIMIT APPLIES PER: `PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY JECT PRO- LOC I $ AUTOMOBILE LIABILITY 35MCCXD6390 10/01/2011 10/01/2012 COMBINED SINGLE LIMIT 1,000,000 Ea accident ANY AUTO j BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS BODILY INJURY(Per accident) $ AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS _ ' Per accident $ UMBRELLA LIAB OCCUR i EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE I AGGREGATE $ DED RETENTION$ ---------- I --- $ A WORKERS COMPENSATION 35 WECPP1444 02/17/2011 02/17/2012WCSTATU- oTH- OR IM, ER AND EMPLOYERS'LIABILITY ANY PROPRIETORMARTNEWEXECUTIVE N/A E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? 500,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,descdbe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ B PEOOH55500 0507 09/27/2011 09/27/2012 i DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,it more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 4*41 clean' ©1988.2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD Do not remove until final code inspection. Save label for future reference. Qualified for area indicated� 19 ; : r Canada 7 enwVysto mean- crj rncan.gc.cn ! I Tri�• •: • N c m. ' �;��.h•• •x o ar ,w w. o� c U - E s�x�wrwrrrn' h d eisetgystargoY ®<puardied/AdmissF6le Renewal ,, r alp byAnderseri. �.ri`" WINDOW REPLACEMENT u�f n.lmuaiC%umP+�Y AND-N-37 f ^sEf�tsir :; Vinyl/Wood Composite.Material 3—W�gd'6-o"4 Dual Argon Low-E4 SmartSun Product Type: Picture ENERGY PERFORMANCE RATINGS U-Factor Solar Heat Gain Coefficient 0.27 1 . 53 0e22 U.S.A-P Met ic/SI ADDITIONAL PERFORMANCE RATINGS Visible Transmittance 0 . 51 Manuta=rar stipulates msttnese retlngs corlm,m sppllcaole NFRC proceaures tareeterminhg whole praeutt pertohnance.NFRC ratings are aetermmea tar aroma set of environmental conditions ana a specmc proautt stre. NFRc was nut recommena any proautt ano don notwanenr me suaaomry of arty proauttmr any specmc uss. Consua manum=mrs merawre tar other proautt pertannance Intormstion. . www.mrcarg s . -/ -02 dens en Co oration:RbA Picture Window anume rer pua s conformance to me following standards Standard Rating NAFS-02orAkAkWMA;CSAt0terarA44M5 DP psf F-050 'AL g t This proautt meats Green Seams enNronmamal atantlaras gaveming energy emciancy,heavy metals In me frame ana seen �w matartai,pacl®ging,ana consumermaterials.raucational 100-00511006-001 Ween or NOR ME.e.,c7c,8 LECA.Air Innaaation m4ulrements WDMA NallmsrK carecadan Pmgram. - WINDOWS-DOORS Is4•t Andersen. GlassT e' tl FactDr' SHGC' Vf' Ioduet- Glasslype' lL-NClnr' SHGC' VP i +, - ••�!- - - `rx,"' �1. P_V.•.-rt. _ - �.Y:4�. ^�, ''.: .l.L. i :_ ....r - !, y^sr... � n Li-Yit-' �Ahdeisen.400 Se -�:-•,•:,:..��::R"'" �s- - -._=, nrietsen Anihificfutai rhr :�.y-, ._ 6es..,�_•,.-. �.. -u'k,"•+-.`^y;.:'.:."���ir _ ..-:�.. _ 'A �;,�..�;v�.,.`�3.��`��,rx�_�.;li��,'L�__., - - G. s_ :. 12 Ism: i �... HP Ln*-E4 028 033•` 058 � 1 hL�w�;���n �i4 •. HP Low-E4 032 0.28 0.47 ' ,�•� .`+ y _ •'kw..;-t�+,,,`b-,�t: HP Lnw-E4 with Galles" 029 •030 '0.52 �;�'� � k ��"��.��'`.�` HP Low-E4 w(fh Grilles 032 025 0.42 'Q�"�-:� M ".HPLaw-E45un G32. 017 0.26' 3;2 :? HP Low-E4 Sun 028 020 031 =Asch�llindoie.,- }: p AwDGr wlRauw iw{� ::;" Ja'=> HP Lnw-E4 Sun wlth Gr01rs 029 0.18 02e �l _ R*� HP Inw E4 Sun with Galles 032 016 n2s HP Low-E4 SmartSun 027 023 0.52 '�_!] r,4 HP Lw-E4 SmanSun 031 0.18 0.42 in g s i e` HP Low-E4 SmartSun w/Gnllas 028 021 0.46 _] tai t"`. ..... HP Law-E4 SmartSun w/Gnlles 0.31 017 0.38 r y: HP Lo*-E4 027 033 '0.58 p�._i ''�.'•` �`c'�'" HP Law-E4 031 0.32 0.55 - y,�•', •� HP Low-E4 with Galles 028 - 0.30 052 'RM 't. �•rrryet:• HP law-E4 with Gnles 031 029 0.49 ].]5 HPLaw-E4Sun 027 020 031 �.=; ®. �TCasmu i6C` HPlnwE4Sun 031 020 031 Flea7kame4.Wlodow.': I':.-•-•' r.:.- �' - �'-:.=• dRlchrts�YYfndoa--�.;•�c. HP Low-E4 Sun wb Galles.; 031 0.18 028a�� k�r�ry�.�}4•,�-rtw_*�^,h�.=; HP taw-E4 Sun wRtl Gnllef 029 01B ...028 �_�® e„ .... �- "Q tc }},_�,,� `�; HP Low-E4 SmartSun 026 .� 023 052 ���� � � .i'. •',�?`��:�• HP Low-E4 SmartSun� 031 021 0.50 I :et�5�.'�=;�;+'•?� HP Lnw-E4 SmaaSun w/Grilles"- 0.28 021 0.46 M -4,', ®� �F�"�;a ,,. �"- NP law-E45martSun w/Grilles� 031 0.19 0.44 I HP Low-E4 .0.31 033 0.58 4_^` • , •�' _ HP Law-E4 030 0.37 0.64 'f '"'"f-+= HP Law-E4 with Galles 032 030 052 ^�] r t - HP Lnw-E4 wbGr01es 030 033 057 50 3 HP Low-E4 Sun . 031 020 0.31 3.2 '""�• HP Law-E4 Sun 031 022 036 S napthe�'Wladow. :. , p ally daw i`j HP Low-E4 Sun with Grilles 0.33- "0.18 028 .r]' ® til`"<��jyc 4 =•,rr,- HP Low-E4 Sun wRhGr01e� 031 020 0.32 HP Law-E4 SmartSun 030 023 052 -�L ® �ri x `• HP Law E4 SmartSun. 030 024 0.58 ® y HP Law-E4 SmartSun w/Grilses 032 021 0.46 �"i_�� ;;,X'x? e a HP law E45martSun w/Gr01es 030 022 0.52 _I Ilk, r r °-"* HP Law-E4. 030 -027 0.45 '_t ® 'y _ s"' HP Lmv-E4 032 022 037 n " `. HP Low-E4 with Gallen 032 023 039 '�•'=.i3 - "`CA ^' HP Law,E4 with Galles 033 020 033 - IFrenchwood.�r'+:� HP Law-Edson 031 0.16 025 -:,;.�7®: 8ed'Fr"e0e1f0oor.,• HP law-E45un 033 Q14 021 4?- - �- GQ' paB`o•Ooa r 0.14 0 HP Lnw-E4 Sun wb Galles 032 - 22 ,�. �® HP law-E4 Sun with Gtlllr's 034 0.13 0.18 - .;•: HPv-E45mart3un 030. 0.18 0.41 4,.T.z': HP La*-E4 SmartSun 0.32 0.15 033 - Lm � ':��.. �-' ��••- sr.T4�y�n� HP law E4 SmartSun w/Galles 031 0.16 035 S�:c_a® I = yk a?. HP Low-E4 SmaaSun w/Gnlles 033 0.14 030 - ,�-• HP Low-E4 032 022 037 t E a. HP Low-E4 031 024 D.41 t" it � -T_ HP Low-E4 with GaOes. 031 021 035 _ � "`''� `ter t ` HP Lo*E4 with Grilles033 020 033 '�,FrdnrJrwoad•Hmded' HP Law-E4 Sun 031 0.15 023. ��`^� Fr-e*t-0,000 a HP Lo%44 Sun, 032 0:14 021 T� 'Ratio•Door"'eswiar'' HP Law�4 Sun with Gr01es 0.32 0.13 019 - {.:' D °fL.-; HP Low-E4 Sun with Grilles 033 0.13 0.18 - y� 'rte*'• 4,-' S._:r 8 w e. '�g, `HP Low-E4 SmartSun 032 0.15 0.33 M 22-3 Is HP lrnv�4 SmartSun" 030 0.16 037 _;�® 7'3 HP Law-E4 SmartSun w Galles 035 0.14 030 HP Low-E4 SmartSun w/Grilles -.- 031 0.14._" 031 .: 'ice' / - IK:+. HP law-E4 031 025- 0.41 �';;,:y��®-:.- : ''�.' "r" : .. .HP Low-E4 035 015 024 h' 1~ ; HP Lom-E4 wOh Galles 035 0.16 025 got HP law-E4 wlth Grilles 032 021 035 = n`•�Ys1_ . ;Fie d!_NID HPLow-E4Sun 031 015. 0.73 N :! E arJl;Door HP LawE45un 035 010 0.14 i8a pn�011f n -- HP Law-E4 Sun wb Galles 035 0.10 0.14 - d HP Low-E4 Sun with Gn11es 032 0.13 0.19 =s,®- •` •�:�' HP Low-E4 SmartSun 030 � 0.17 037 $i-�® s •;��„_ � -� HPaaw�45martSdn 035 0.11 022 .� �. NP Law-E4 SmartSun w/Gdlles� 031 _ 0.15 �� 031 �.: ;;:�®� -�'.:.�"�'�' HP Low-E4 SmenSun w/Gr01es 035• QSO 020 - ¢LL �rty s HP Low-E4 031 022 037 �.. ° n HP Lwi-�E4 034 0.15 0.18 - �S•- HP Lmw-E4 vi th Galles 032... 020.,: 033 4 HP Low-E4 with Galles 034 0.16 026 - 'Fre'ehwaD ha0o::, HP Low-E4 Sun 032 0.14 021 R. ;,Erer�dj UDoc,�r a HP lmv-Ed Sun 034 0.10 0.14 0 at-SfeeB t-2' .f. Ch HP Law-E4SunwOh Gr01es 034 0.10 14 . Eh HP Law-E4 Sun wRh GaOes 032 0.13 0.18 ._y N i - � '"`=.c�.•v.w HP Law-E4 SmartSun 031 0.15 033 �=;�� .+�*' = HP Law-E4 SmartSun 034 0.10 022 - sem+ - :^ =r �• &� HP Low-E4 Smart.Sun w/Gillies 032 0.14 029 ; 'r �.•�_-.b.:�•-s.-r'` HP Low-E4 SmartSun w/Gdllrs 034 0.10 021 - ''4 '. HP Low-E4 030 024 0.40 _ ® "" Yy''�=%�'-';n`'r HP Law-E4 032 022 037 }� 4 'Wr -;t§4 HP Lnw-E4 wlth Grilles 030 021 035 .':.� I T` -_ "--• HP Low-E4 with Grilles D33 0211 033 - ren ad�� 7jo;•: HP'law-E4 Sun 030 015 022 _:3� CammemlalDuar HPLovr-E4Sun 032 0.14 021 J-• LET, W„•'a` 'ODDr7ralraom:•.,_> HP Low-E4 Sun wlth Grilles 031 0.13 020 - OvtswiD pry'- HP Low-E4 Sun with Grilles 033 0.13 0.18 - •P,D... ,.. �_�� !:' ter NP'Law-E4 SmartSun 029 0.16 036 11„i:"ir®� t~�� .�';- HP law-E4 SmartSun D32 0.15 033 HP Law-E4 SmartSun w/Gnlles 0300.14 032 _;M® '.,epi:spp; "`` HP Law-E4 SmartSun w/Grilles 0.35 014 0.30 - ..:. ... . .. ... .,�,•-,_. - fir.'„ ,r �,Andersm• - i ,.. .::__, „ .;,>!?,s� :fir: _ _ - II ,a.+F.=1rA'7--t:� h" �"�,�r� �'.�.4+,:�art:,-�ki_`��-•cr•..:i .�' a ca 'I ,'A►efihe4rral'4:�..�r.'+t��`�'-� `�'fir•���"-%=F�'_rwkt: �1'''.��."�� ?i'And'eraeri!200:Se Fs;r:�Ai����:�.` .•-`..-_.'-�•� w.,.r"y.' - -"`�`,`.�1c. MEMO ^L= = HP Low-E4f• 032• D28 Q47 •;' y„ Clear Dual Pane 0.45 0.60 0.53 iso= c "` HP Law-E4 with Grilles 032 . 025 0.42 1 71t311as1( .`• Clear Dual Pane with Grilles 0.45 0.54 0 51t a :: m l .<.,r _.r; e1: '"ami 2 Double yuDBNOndow, lnw E 030 032 0.55 rN HP Low-E4 Sun 032 0.17 026 _ ® i, n t:.raemeot`.1�ndow• x ,f??;�",'`. Law-EwOh Galles 030 029 0.49 HP Low-E4 Sun with Grilles 032 0.16. 023 i�® r HP Lnw-E4 SmartSun 031 0.18 0.42 I' •,_._'-•"te`�•y? Clear Dual Pane 0.45 0.61 0.64 `'`$LL��• E o- - ff N HP Law-E4 SmartSun w/Grilles 031 0.17 038 ±J aN_ago jhe': •v, Clear Duel Pane with Grilles 0.45 0.54 QS/ - outile D r 9Vln w-E 030 032 0.56 !s HP Law-E4 032 02B 0.47 L�. w H las HP Low-E4 with Gdlles 032 0.25 0.42 �. ® - 1::.' a>._ Law-E with Galles D31 D29 0.50 =1 HP 032 0.17 026 " Clear Dual Pane 0.44 0.63 0.66 - �,Jr+endi-tiiamenl:,� =;•�® �•• e,,:,, 1MhdanL `r HP Lee-E4 Sun wb Grilles 032 0.16 D23 lfac' .bv` Clear Dual Pane with Gdlles 0.44 0.57 0.59 - 't'`4r:, `.� WW? t',Tiaioomi�Yfnilciw"!; LawrE am 034 0.58 !-;�:,,"y�:,�• .�- HP Low-E4 SmartSun 031 � 0.18 0.42 _l:�® r}�'•:5• -�;:;1'_. %fMj;•-r'..,--o, HP Low-E4 SmaaSun w/Grilles 031 0.17 038 ?® •rAr"s; i� -_ Low-E with Grilles .0.28 030 05230 J�§ eoadnaed an next pale PRODUCT PERFORMANCE Andersen•. NFRC Certified Total Unit Performance (continued) ) = � I V? I ' GlassT e I U-Facine I SHGC du � Clear Dual Pane 0.45 0.60 0.53 .. - - _� Clear.Dual Pane with Grilles 0.45 0.54 0.56 Gllpin YYihdonr°yF .. Law E 0.30 0.32 0.55 J Lnw E.with Grilles 0 30 029 0.49 " Clear Dual Pane 0.43 0.81 0.65 - ti r, - � �" Clear Dual Pane with Grilles 0.43 0.55 0.58 .� 'Window'- CI e1e-sTu_ ,. Lowy 0.28. 0.33 0.56 --� Low-E with Gnlles 0.28 0.30 0.50 2 Clear Dual Pane 0.48 0.59 0.53 ;i Clear Dual Pane with Grilles 0.45 0.52 0.55 = a a," Lowy 029 0.32 0.55 028 0.48 a file!G6dIng;Ss. Low-E with Grilles 091 Low-E sun oss 020 0.30 ' Low-E Sun with Grilles 0.31 0.17 026 Low-E SmartSun 028 0.22 0.50 nes Low-E SmartSun wlth Grilles 0.30: 0.19 0.44 Clear Dual Pane 0.44 0.61 0.64 - 2° i _ - �� Clear Dual Pane whit Grilles: 0.44 0.54 0.56: z �. _ 028 0.32 0.56 j Low-E with Grilles 090 029 0.49 rma:=shield . Low-E Sun... 019 0.19 . 090 J GUdli�git?:do-foo �, Low-E Sun with Grilles 0.30 0.17 027 c Low-ESmartSun 028 0.22 0.50` i =: Low-E SmartSun with Grilles 029 0.19 0.44 :5z ;. Clear Dual Pane 0.43 0.45 0.47 - k . Clear Dual Pane with Grilles 0.44 0.39 0.40 - �Vv§ Law-E 0.32 0.24 0.41 ®. a .21 0.35 -- Ninged-8''qu; .0e Low E with Grilles 0.33 0 x "�=�E 7n•"•=� Low-E Sun 092 0.15 0.23 Sun wb Gnlles 0.34 0.13 " .'�� Law E SmartSun 0 31 0.16 0.37 Low-E SmartSun with Grilles 0.33 .0.14. 0.31 I II . • PSI • rrmkil umv .Y . U—Fzeo�at'�U..�S�f--P , • lir-l��-C3a� Co�Ezi�lerat • x29 - ' •' ' ale Tr���n� - ,. _ ..o X'42 "Oil INSP Ir i� .. ❑E�IE�•i PF�1FiE�P'`SSP =. . . 1�•�e�CYe���r".rte+P 2 ISMO Location,// h�lctle No. d" Date HORTry TOWN OF NORTH ANDOVER O F R 9 Certificate of Occupancy $ s,CMuSBuilding/Frame Permit Fee $ g Foundation Permit Fee $ Other Permit Fee $ TOTAL $ ' Check # Y V 3 24663 Building Inspector