No preview available
HomeMy WebLinkAboutBuilding Permit #Exception - 129 CARLTON LANE 5/1/2018 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATIO Permit NO: O� —I Date Received Date Issued: 1 Fm� �-� IMP RTANT:Applicant must complete all items on this page s ,y. ,,,t, ,,.:.r -°* a..�,x--. ••^ c- 77 cw7:777"51"", !"R LL til B r PR©PERT3Y ®1NNER�Ia �� Its v t�,ti �' $100 YJ"M Id Structure yes to pNl�A}PNO? �7�0 1PARC=E1_: Mn,O ING DI TRR ICT Histone District lyes t no P.V I age��YeS ►< ` achine Sh I f TYPE OF IMPROVEMENT PROPOSED USE Resid tial Non- Residential ❑New Building ne family ❑Addition ❑Two or more family ❑Industrial ❑6Veration No. of units: ❑Commercial epair, replacement ❑Assessory Bldg ❑ Others: ❑Demolition ❑Other - s@ F;r :gaxat r ❑Septicl [E 1W i �� "' . , a�Floodpla �rWetlandstry � n�:l © UNatershed�}Dlstrict woX 4 'r`7 p + T'7 'S� + DESCRIPTION OF WORKT BE PERFORMED: l,� A c,is 1 dentification Please Type or Print Clearly) OWNER: Name: )����G✓" SQVAonl�-_ Phone:9 W-'LFA-00'.(e Address: I oZ C&f-(�Z^ L�.r� _�Jd•� -�. v.C�c,�7 e r r (1ti<� l �l S s � , w i �st ij •I s - i .� i � J � r t C®NIF,Z','CT®R(Name> �5 .r�n' �e Phone 15�� -� lA�dtl ess : � fit`S 4 � ' ,d 1/ J�/�c� ` y f•� .6 « �Suen/ o13-fib nLw�ce. risd f Date omeImprove -�l txr ��-_ r {. ,. .''' fr 4"S_` a tti .''. c r'a. ti i r♦ �H tmenLeen � 3(H n ARCHITECT/ENGINEER Phone: c Address: Reg. No. FEE SCHEDULE:BOLDING PERMIT:$92.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. Total Project Cost: $ �� U 3�r v� FEE: $ (OcQ o ZZ Check No.: ��� Receipt No.: Z6�� NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund !Si natute.of.A ent/.Owner.., _. ;.. ::`: Si in4d�e of contractor ; E)i- ,,, 0­1­44­4 4 n r)t--, %A[-G,. A n r1,, ;-F;—A 01-4. DL,.-. n i—i Building Department The fol owing 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 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 10TE: All dumpster.permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building pp Permit Application o Certified Surveyed Plot Plan ❑ Workers Comp Affidavit o 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) o Mass check Energy Compliance Report (If Applicable) u Engineering Atiiidavits for Engineered products OTE: 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 Q 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 COTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit fn 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 app.al 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 i i Plans Submitted ❑ Plans Waived,[] Certified Plot Plan ❑ Stamped Plans ❑ TYPE OFSEWERAGEDISPOSAL Public Sewer ❑ Tanning/MassageBodyArt ❑. . 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 Signature COMMENTS Zoning Board of Appeals:Variance, Petition No: Zoning Decisionlreceipt submitted yes .. f,Planning Board Decision: Comments Conservation Decision: Comments Water&Sewer Connection/Signature&Date Driveway Permit DPW Toivn]Engineer: Signature: Located 384 Osgood Street FIDE*DEP�i"TMthT -Temp Dumpster on site yes no I located at'924 MainStreet Fire Depart.merit sigiiattir®/date COMIMENP9 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 OGL Chapter 166 Section 21A-F and G min.$100-$1000 fine 140TES and DATA—(For department use i U Notified for pickup - Date E )oc,Building Permit Revised 2010 Location i-2�9 o ckto 4vj LJ. No. t I Date III-) 1 • • TOWN OF NORTH ANDOVER Certificate of Occupancy $ o a0 , Building/Frame Permit Fee $ �- a; Foundation Permit Fee $ fly ;ny„ ` � Other Permit Fee $ fJ ATrI)Nvv: TOTAL $ Check# 2g %2- 2665 22ra5% Building Inspector r 7 t►ORTH - E ve. . No. (AS-0- 1 h ver, Mass (J1rI 2� Ali . I.^ CoCNICMl M.K.[ 1' RAtEo U BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System wSo. BUILDING INSPECTOR THIS CERTIFIES THAT ..............t........... ..... .............,...... .......... . ............ .............................. ' .�a Foundation has permission to erect.......................... buildings on ... .. .... .... . .......................................... p o►� ,u cQ�w s Rough tobe occupied as ........ .....� ..�..............�......t.................................................................... 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 I ONTHS ELECTRICAL INSPECTOR UNLESS CONSTRU T ST SRough 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 RenewalMA Home Improvement Contractor ,,,• — License#170810(Expires 12/23/2013) ♦�i byi f�n u Edersen. V Federal Tax ID#41-1918413 WINDOW REPLACEMENT an And—m Company Renewal by Andersen Corporation 104 Otis St.,Northborough,MA 01532 (508)351-2200•Fax:(651)351-4810 CUSTOM WINDOW AND DOOR REMODELING AGREEMENT Buyer(sl Name Dote of Agreement - S oil Buyers)Street Address,City,State,and Zip Code Z c� awe — o E,'vMail Address Home Tele hone Number Work Telephone Number Buyer(s) hereby jointly and se orally 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 sheets)(collectively,this"Agreement').Buyer(s)hereby agrees to sign a completion certificate after Contractor has completed all work under this Agreement. Estimated Starting Date: Method of Payment: Total Job Amount: �3 Amount Financed []Check ❑ Check Cash Deposit Received(33%): � 7 OlVsa//MM ❑CIAMEXDiscover aF need Balance at Start of Job(33%): ✓�t 0 5 ,/ Estimated Com Tion Date: If credit Lard is selected,please Balance on Substantial I I �j� see Credit Card Payment Form. Completion of Joh(33%): /J L/ 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 dersen Co oration Buyers Buyer(s) r 1 By: Si t re of 11roductIvIanager i turc 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. - - — — — — — — — — — — — :1- - - - - — - - - - - - - - - -:,<- - - - - - — - - - -t' — — — � NOTICE OF CANCELLATION h NOTICE OF CANCELLATION Date of Transaction k —/3 �/?, ,,You may cancel Date of Transaction .You may cancel this transaction,without any penalty or obligation,within this transaction,without any penalty 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 I property traded in,any payments made by you under the Contract of Sale,and any negotiable instrument executed I 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 I 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; or you may, if you wish, comply I Contractor 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 Sellers expense and risk. I the goods at the Seller's expense and risk.If you do make If fou 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 of Your Notice of your Notice of Cancellation,you may retain or dispose I of Cancellation,you may retain or dispose of the goods of the goods without any further obligation.If you fail to without an further obligation. If you fail to make the make the goods available to the Seller,or if ou a roe 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 goods 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. notice,or send a telegram to Contractor. Renewal by Andersen Corporation,104 Otis I Renewal by Andersen Corporation, 104 Otis Street, Street, Northborough,MA 01532, BY NOT LATER THAN Northborough,MA01532,BY NOT LATERTHAN MIDNIGHT MIDNIGHT OF .(Date) OF (Date) I HEREBY CANCEL THIS TRANSACTION. 1 HEREBY CANCEL THIS TRANSACTION. Buyer's Signature Print Name Data I Buyer's Signature Print Name Date RbA Copy- White Buyer Copy-Yellow Buyer Copy-Pink @JBLLP2009.RBAPh.MANH Renewal Aenewal by Andersen COrporah__ MA Home Improvement Contractor 104 Otis St.,Northborough,MA 01532 License#170810(Expires 12/23/2013) bYAndersen. (508)351-2200•Fax:(508)9867072 Federal Tax ID#41-1918413 WINDOW REPLACEMENT an Anderaen Company _ WINDOW SPECIFICATION SHEET Buyer(s)Name Date of Agreement 1 4 - / 3- 1 The Buyer(s i lis cd above hereby jointly and severally agree to purchase the goods and/or services listed below,in accordance with the prices and terms described on;iic 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 DEFAQS 1. Cor}ttaCor will Install a total of windows in Owner's home,using the following individual quantities: Double Aung(DB) ual mer is of sas (customer h_Cottage sash(1/3 top,2/3 bottom)_Oriel sash(2/3 top.1/3 bottom)_Flat sill toto awareclass _xluare 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(GFW)_1:1:1 or 1:2:1 Pidur:r Window Bay or Sow Awning Window _#Lites Soffit/Roof Shingle/Copper Specialty Window Patio Doors(see separate door spec sheet) Seat to be Primed/Oak/Pine 1E:1 I I _1E:1 I I'l I'Ll 2. Windows Qty of to be Custom Fit Replacement: 3. 1/16 Qty of Windows to be Custom Fit Full frame(INCLUDES NEW INTERIOR&EXTERIOR CASINGS) Exterior rags:_Pine_Maintenance-free material_Factory applied 908 Fibrex brickmold 4.Glazing to be:__V HP LoyiE4c'SmartsunTM _Tempered _Other If other,please specify: 5.Exterior color to be:_� ite_Sand—Canvas_Terratone_Cocoa Bean_Dark Bronze_Forest Green_Black_Red Rock 6.Interior color to . White_Canvas_Pine_Maple_Oak_Same as Exterior Note:Wood interiors need to finished by Owner. 7.HardwareWhite_Stone_Canvas_Estate Hardware: Style: 8. /�J Install lifts with Doubl ung Windows 9. Screens:windows to have: Half or Full eens Screens to be:-lelfiberglass_Aluminum_TruScene GRILLE DEFARS 10. claws have grilles: Grille Between Glass(GBG)_Removable Interior Wood(INTW)_Full Divided I_ight(FDI) ( / Owner approved(initials) Draw grille patterns below Use additional sheet if needed / Qty Qty-. QtY QtY QtY Qtyl l0r_ DDEjEl S� e7 ADDITIONAL WORK DEFARS 11. 2 L Qty of_Sills—Sill noses to be replaced by Contractor 12. no Contractor will remove metal frames of windows. 13. a C ntractcr will install new_paint-ready or_stain-ready_Interior_Exterior casings in_Pine_Maintenance-free material �14. ntractor will install new_paint-ready or_stain-ready_Interior_Exterior stops in_Pine_Maintenance-free material Inds-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/harclware removed prior to installation. 16. 0 Contractor will wrap exterior easings 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, windows,storm windows and vacuum nightly included Upon completion of the job and payment in full,a limited warranty shall be issued Customer is aware in so a cases there will be glass loss If there is glass loss,the amount will be dependent on the type of existing window,type of installation,insert or full fra and window style. We make no guarantee as to the amount of glass loss Customer is also aware and understands that any and all unseen rot is not h ude ' this contract.Should any rot be found there will bean additional charge for time and materials unless so stated in this contract. 18. es No Building Permit—Contractor will secure any and all necessary permits.The fee for the permit(s)is not neluded in the Contract Price and a separate check is required at the time of sale for this fee. Ck# $ 19. es❑No All discounts have been applied to this agreement price. 20.Additional j /details: 21. es❑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 mo ed 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 B r(s)has rea his Specification Sheet. Rene 1 ZA,nders Corporation Buyers) Buyer(s) By: lWat4e of Product Manager Sig t6m Signature Print Name of Product Manager Print Name Print Name The Conanonweaft of VesswAuseja DepwVxent oflndastriai-4ecide#w Office oflnvestigations . 600 Washington Sdeet. Boston,JL4 02111 www-Hoss gov/din Workers'Compensation insurance Aifidevit: Bulders/Contra�ctors/Eiectricixns/Plumbers A licant Infot�ation Please Print L 'b IV Name(BusinessfiOwnization/lndivi"): p,e i,Jci 1 . Q A rL , Address:-I o� ;s S City/State/Zip r 1533 Phone#: S� S t Are you an employer?Check the Appropriate box: 1. I am a employer with_,a() 4. Q I am a general contractor and I Type of project(required): employees(full and/or pat-time).• have hired the sub-contractors 6• ❑New construction 2.❑ I am a sole'proprietor or partner- listed on the attached sheet. 7. odes ship and have no employees These sub-contractors have S. (]pemolle working for me in any capacity, employees and have workers' ition [No workers'comp.insurance comp.insurance; - 9. ❑Building addition 3.❑ required.] 5. We are a corporation and its 10.❑Electrical repairs or additions I am a homeowner doing all work officers have exercised their myself.[No woiicers'comp. right of exemption per MGL 11.(]Phtmbiing repays or additions Roof❑Roo . insurancerequited.]t - c. 152,§1(4),and we have no 12. repairs employees.[No workers' 13.(]Other come•insurance requited.] `Any apph'eant that ibecks box#1 must also 511 out ffie eectioa below Showing their worloers'�rnpensation li t Homeowners s who submit6A affidavit indicating they M dnimg all work and d=h6e autaido oohtraetors � m =Contractors that check this box meat attached an additional heet submit a no aMdavit indicating such. showing the name eftbe a d Oft why or not those entities have employees. tithe sub-contactors have.emocyees,they.must Favids their workers•comp.Policy number. Ion an anploy"that h prwldlntg.workm l compatsadon � lnstatrnce or lnfor�matfon, f ' +lP�Y Below k&e popsy,=d job sure Insurance Company Name: �, b�i G �n S C Policy#or Self-ins.Lic.#: C it Expiration late:_ Job Site Address.-las- LA City/State/Zip: 4A / kc, Attach a copy of the workers'compensation policy declaration �d 6(�y Page(showing the policy number and Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the.imposition of criminal penalties of a expiration fine up to$1,500.00 and/or -imposition imprisomnent,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 cxrt/fy the pelts and pexmh*ofped Z7 that rhe infonnadon rovlded p above is true and conreft S - hone#: E only. Do not write fit!Itis ere&,to be Completed by city*or town off k&L n• Permit/Licese# hority(circle one): Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 3.Plumbing Inspector son: Phone#• CERTIFICATE OF LIABILITY INSURANCE 09/25/2012 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: H the COMI'irate holder Is an ADDITIONAL INSURED,the policy(ies)must be endore®d. if SUBROGATION IS WAIVED,subject io the terms and cendidons of the policy,certain policies may require an endorsement. A statement on this artlficate doss not cooter certificate holder In lieu of such endoraeme s rights to the PRODUCE 1-612-333-3323 elle 8a Hays Companies rgrove or Eric Johnson PHONE . 612-333-3323 FAx 80 South 8th Street pa:612-373-7270 Suite 700 Minneapolis, NK 55402ER 10 9- NSURED I"Su s AFFORDING COVERAGE NAILS ERA: OLD REPUBLIC INS CO Renewal BY Andersen Corporation NsuR 24147 Nits: NATIONAL UNION PIKE Zips CO OF PITTS 104 otic street 19445 INSURER C: ilorthborough, KA 01532 NSURERD: NBURER 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, LTR TYPE OF INSURANCE PW ICY NUMBER POIICYEFF PpyGYEII► A OENERALLMeILm 1] MNZY 59828 10/01 10/0I 13 Lem COMMERCIAL GENERAL LIABILITY 3 , S ae S 500,000 CLAIM54AADE �OCCUR PREMMED E)Q' rcmeperson $10,000 PERSONAL a ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 4,000,000 GEN L AGGREGATE LR AIT APPLIES DER; PRODUCTS-COMPlOP AGG S 3,000.00c POLICY PRT Loc >► AIrrOMOBaELIABIM KW= 2170010 O1 1 3-0101/13 COMBINED SINGLE LIMB S 3,000,000 X ANY AUTO Oa s=VuR) ALL OWNED AUTOS BODILY INJURY(Pp Parson) S SCHEDULED AUTOS BODILY INJURY(Per eoddeM I Y HIREDAUTOS PROPERTYDAMAGE (Pa►eceldent) _ x NON-0WNEDAUTOS s B x UMBRELLA UAs Y = OCCUR 13273355 EXCE58LuB CLAIMS�IADE 10/02/1 10/01/13 EACH OCCURRENCE $25,000,000 . DEDUCTIBLE ANTE S 25,000,000 Z RETENTION 25,000 $ >\ 110DIUMRSCOMPENSATION ANDEMPLOYEWIJABILnY YIN 10fC 117948 00 10/Ol/1 10/01/13 Z WICSTATU 0TH ANY PROPRIMBERIEXCLUDED?Q CUIIVE E.L.EACH ACCIDENT $1,000,000 OFFICT3tMEMBER EXCLUDED? N I A (Maedetay in NH) DESERIP yyeess TI OFOF�ERATTONS below E-LDI ASE-EAEMPLOYE1j$ 1,000,000 F_L.DWAsE-POUCYUMIT IS 1,0001000 IDEBCNPTMVVC--M--A-IM—SIW"MO=IMMASS(AMach ACORD 101,AddlGo�ul Ramarka SeMdWa,Knan aPaa k Ruled) Evidence of insurance. CERTIFICATE HOLDER CANCELLATION Evidence of insurance SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELNERED IN ACCORDANCE WITH(THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ericj ecnon eje rewwemm ........,_ 01958.2009 ACORD CORPARATMu wan _�.a. CCl��pom�mia�uaecz��i a�Cac�ivaelYa. i fficc of Consumer Affairs&Business Regulation 1: ME IMPROVEMENT CONTRACTOR j egistration: 1708'10 Type: Expiration: '12/23/2013 Supplement RENEWAL BY ANDERSON CORPORATION JOSEPH REZZA 104 OTIS STREET NORTHBOROUGH,MA 01532 Undersecretary i JIM Massachusetts -Department of Public Safety Board of Building Regulations and Standards ,�. Construction Super icor License: CS-065272 JOSEPH P REZW _ 168 KELLEY BLVD N ATTLEBORO MA Expiration Commissioner 04/25/2014 i I enew, Irycsen 1b�kCQY� REPMCEacrar �oAnaewncrtoiw,m woomas T1s ff Dual Oaf tow E4 SftwMt ' 100.00473618-01 O ENERGY PERFORKMCE UTIGGS i U-Factor(U.S)/1-P Soler Heat Gain Coefficient umigr 091TIOUL PERFORPICE WINGS Visible Transmittance Oct- tv 4z wahM+Arwi�Bucod Hiro wMYot�duwr f gyfaYb NfllCf���Mweriwwi�y�Miel pOw I i owtnrro.NAIC w7Fp tac Mr�wiM 10tlf WOwt1 dwMvMmle�ICrNbMYM��priC MAradoe. I MpC�er�at weewwreanypAert tidde�oMl wriwwlM�Ltiyd�eypelw/aLy�e�r. crsnwrrae�reolsbmnsa«M..1ACiw�sArw�aidawV>a. - 1 SlUe Ttb�we.awru6�ere - -P, F'^+,r I wrArdepr.wip�wHpy i"•;• y, '�{p � '- ..,� DESIGN PRESSURE(P$Fl MW 25 ERMOBI ped Sill OH IN o � �wnurrw�OaMf+C.Cif.�C.61FS+C.At1�ew�M�rsri0M11MMrIwd�Gil�rlb�ltipia I i 1 I I I i