Loading...
HomeMy WebLinkAboutBuilding Permit #474-13 - 130 HEATH ROAD 12/19/2012 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit N0:q1 Date Received 1 Date Issued: I2 1 \1/ IMPORTANT:Applicant must complete all items on this page LOCATION 13 0 4e 6L Print. PROPERTY OWNER Prinf. 10o Year Old structure yesC)no MAP NO: �?q-PARCEL: _ZONING DISTRICT: `�3 Historic•District yes Machine Shop Village. yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ne family ❑Addition El Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial P-<epair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic. ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District El Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED, TJ Identific ion Please Type or Print Clearly) OWNER: Name: �o.ro� r��� Phone: Address: �� �� I-�n Cave CONTRACTOR Name: (k V\ A/V 5 A Phone' 5253 Address: )asp :_ �- Supervisors Construction License. Ex , Date: , p Home Improvement 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: $ l� o� FEE: $ 3 0Z Check No.: ,9- ad 6 k Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund 5ignatureof Agert/Owner Signature of contractor Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ l TYPE OF SEWERAGE DISPOSAL ❑ Swimming Pools Public Sewer ❑ Tanning/Massage/Body Art ❑ i Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ f Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑ I` THE FOLLOWING SECTIONS FOR OFFICE USE ONLY 1 INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ j COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments 4 Conservation Decision: Comments Water & Sewer Connection/Signature& Date Driveway Permit DPW Tow ]Engineer: Signature: Located 384 Os ood Street FIRE DEPARTMENT - Temp Dumpster on site yes no Located at-124 Main Street Fire Departinent-signatbre/date 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.$10041000 fine NOTES and DATA— (For department use ® Notified for pickup - Date Doc.Building Permit Revised 2010 I Building Department I� The foltowing is a list of the required forms to be filled out for the appropriate permit to be obtained. L 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 submi4ted with the building application Doc: Doc.Building Permit Revised 2012 Location 1 �' No. i1H Date s - TOWN OF NORTH ANDOVER • Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ �� r} Other Permit Fee $ TOTAL $ � Check#, 'I Z� 26043 Building Inspector NORTH oven -of - t _E 6 ndover O No. 41 t T LAK, h ver, Mass, ,1 eC . I 2,o 12- COC HICHEW1CM ��• A�RATEO S u BOARD OF HEALTH PERM -1-T T D Food/Kitchen Septic System ftes----6o THIS CERTIFIES THAT A �:..:.. BUILDING INSPECTOR has permission to erect .. buildings ......�, Q; '� 20 Foundation ........................ buildin son ..... ........................................... I ?.� ,.lRough to be occupied as ........:'. . ..1�!�. ...... .......!`�Iti..'.1.lAd.!!...I............................................................ 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 CONSTRUCT Rough rw .�+ 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. ..,cense#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 Buyer(s)Name Date of Agreement Buyer(s)Street Address,City,State,and Zip Code 43U i. � �9�vo i1cT,-L J E-Mail Address Home Telephone Numbbe?rr / Work Telephone Number l O — 60 Buyer(s) hereby 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. Estimated Starting Date: Method of Payment: Total Job Amount: Amount Financed i]Check ❑Cash C) 6ik-s Deposit Received(33%): ��7`s' OV'sa/MC ❑Discover Financed pAMEX Balance at Start of Job(33%): Estimated Completion Date: If credit card is selected,please Balance on Substantial ` (j�� l — 3�� 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 by A ndCorpor 'on $u Buyer(s) j '-15ignature of Product Manager Signatu e Signature ( Print Name of Prod t 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. - - - - - - - - - - - - - - -9-< - - - - - - - - -- - - - - - - - - - - - - - -2c NOTICEPJ CANCELLATION X NOTICE OF CANCELLATION Date of Transaction - /—L—You may cancel Date of Transaction V -.3a--./ :2— 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 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 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 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 I pick them u,p 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 thegoods 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 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 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: I 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,MA 01532,BY NOT LATER THAN MIDNIGHT MIDNIGHT OF 1-0- 3 -/ .(Date) OF_ 10--T- Jam-,(Date) 1 HEREBY CANCEL THIS TRANSACTION. I I HEREBY CANCEL THIS TRANSACTION. I Buyer's Signature Print Name Dote Buyer's Signature Print Name Data RbA Copy- White Buyer Copy-Yellow Buyer Copy-Pink ©JBLLP2009.RBA-Ph.MANH Renewal newal by Andersen COrpOratic MA Home Improvement Contractor byAndersen.LAM4 104 Otis St.,Northborough,MA 01532 License#170810(Expires 12/23/2013) WINDOW REPLACEMENT an Andersen Company (508)351-2200•Fax:(651)351-4810 Federal Tax ID#41-1918413 WINDOW SPECIFICATION SHEET Buyer(s)Name Date of Agreement 2STO // -.?b -- / The Buyer(s)fisted above 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 DEMOS 1. Conrractor will Install a total of windows in Owner's home,using the following individual quantities: Double Hung(DB),Y Equal sash_Cottage sash(1/3 top,2/3 bottom)_Oriel sash(2/3 top.1/3 bottom)_Flat sill awa a or class i ss) 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 Picture Window Bay or Bow Awning Window _#Lights Soffit/Roof Shingle/Copper Specialty Window Patio Doors(see separate door spec sheet) Seat to be Primed/Oak/Pine 2. <—Qty of Windows to be Custom Fit Replacement: 3. A)C)_Qty of Windows to be Custom Fit Full frame(INCLUDES NEW INTERIOR&EXTERIOR CASINGS) Exterio�r.caa, s:_Pine_Maintenance-free material_Factory applied 908 Fibrex brickmold 4.Glazing tc be: YHP Low-E-4 TM _Tempered _Other If other,please specify: 5.Exterior color to be: _Sand_Canvas_Terratone_Cocoa Bean_Dark Bronze_Forest Green_Black 6.Interior color to • �'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;Win s ' '/ 9. Screens:windows to have:_I.M.or_Full screens Screens to be:_Fiberglass_Aluminum_TruScene GRHU MARS 10. IVO Windows have grilles:_Grille Between Glass(GBG)_Removable Interior Wood(INTW)_Full Divided Light(FDL) ( y )Owner approved(initials) Draw grille patterns below `Use additional sheet if needed QtyQty- Qty: Qty Qty-. Qty: Qty: ADDITIONAL WORK DEFAOS I. Qty of_Sills_Sill noses to be replaced by Contractor 12.—Contractor will remove metal frames of windows. 13. /\ LO Contractor will install new_paint-ready or_stain-ready_Interior_Exterior casings in_Pine_Maintenance-free material 14. N ontractor will install new_paint-ready or_stain-ready_Interior_Exterior stops in_Pine_Maintenance-free material 15.( )Int(s Owner is aware that Contractor does not do any painting. 16. CQ0 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,windows,storm windows and vacuum nightly included. Upon completion of the job and payment in full,a limited warranty shall be issued. 18. Yes❑No Building Permit—Contractor will secure any and all necessary permits.The fee for the permits)is not included in the Contract Price and a separate check is required at the time of sale for this fee. Ck# $ 19. Yes❑No All discounts have been applied to this agreement price. 20.Additional job details: 21. Yes❑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. RenewaI_WAnders Cor on Buyer(s) Buyer(s) signature aua�`er J Signa Signature N Print Name of Prod ct Manager Print Name Print Name of ' • Dcht.of�re'rluslriul�4ccrd8irrts . O,flu of bm►es#gaf o& ADD Washmgtan Street .' 'Boom,AM 0111 Workers' Compeneution Imurance Affidavit: B fidera/Conb=tnr&Mectirisne/Pb mbers Please Priest Lea—IT A..p. Iicant Iafermafian {� t • Addres �-' 1y Phtsne#: Sd�' ' SI_ 6120JCX Are you ap eu plopexl Check&e uppropdala'b= Type of project(regdr d): "1 pt I am a emploprg with D T 4• ❑ I em a general comt<sebr®d I fi ❑Newcamsvc6m asuUor lzmz,� bave hied the sib-eo u �oY= (full Pte' listed on the att$phad sheat I❑ I em a sole proprietor arpa t=- Demolition W*and have no=ployaess Tlsesb sob-aa oars ka�+e s• ❑ working fm me in gmy capacsfy, wad=- cosap'msttsmmce g, [3 BnzEmg addition ' [No wadmm'comp 5. ❑ We ace a earpaaaiiom and ata 10,❑E[eotrieal=pain or RAASCM officers]save=Mciscd� cess ndditians 3,❑ I am a homeowner doing aIl want �of��Pff MGL ' • 1 L❑P»iag M MYBaf D40 variosrr+ =MRa, 152, §1(4),and vm hirw n.o 120 Roof� insaranec recluifO&I t =300YO• [No worim 13-❑Other 40010P.iasaranco=Pi"43 `Any ep�fi®t these,&a box#1=mot ileo fm ant the eat below*M*z their w�a'aoo�®pab-y 4 t 13nmaoxnas who cod�mit ltrir aSrLadt i tbey res vt rvok cad thol hese aaztidc smmd eohmlt a nor affidavit mdnfn g cath ZCamt<acs'tha!chat tbdr ba=mat dbabal ai adddiaral i8 fie==ofthc' their w�r�ms'Damp P�6?mea I®n oar mwivesr Scat is providing workers'coarPtata+Mfon irsarcranest flog my WPTVera Below is At POIL7 acrd job azar Name;;_ C) e C) � C �r. Insaz�ce City n � � bat, Policy W or Set€iia.Ut.# �J � 0� Sob bite Adiittss' b .T V` � ' C Y"`�`�h '�'l Jet ,lel• ���y .Arch a copy of the pwodmrr'wugP sftion Policy drr'rI"%M PAP(Shuw8 the Poficy mmobw and eqW-atmn&te). Faihm'ta Rocrire coVerap as reapired tinder•Section 25A ofMGL c, 152'can lead to the iazposiliom of caimmal pma2ties of e fine-Up to$1,500.00 and/or ame-peter ia�ent,ac well as ci-4 penatfiea is tbt form of a SLOP WORK ORDER.and a 5ne of ug to 5250.00 a day a ping the violator Be advised•that a copy o'f�is stat=wmf maybe fmwm'&d,ta tare Office of ins of the DIA foes'M=N=coverage v=ffioabon .I dm by.arr�sfj��v+ ;'tlfie p of Pa�m7'Brat dee u#bFM�provida-above rs rW mrd cnh.rct :•S•i�R+,.,� . Dem, •� I 1.�- . D, crQl use arrZj►6 Do nor writ in dcismva;to-be eoerPdded�p city or iaM,Oiidd . C4 ar Tvwx P # IMnc Ayrfhn {cr-c3e.tuae�: s. of s z.a DgMr6W s, C�ip/Ttrvrrt c� 4; �btspedar Pizmebdunf �.•mer. - , •• ' . ' CERTIFICATE OF LIABILITY INSURANCE F 09/25/2012 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THI: CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIE! BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHOMME REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER IMPORTANT:_ If the certificate holder is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION IS WAIVED,subject tc 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 endomemen s. PRODUCER 1-612-333-3323 Jonelle Hargrove or Eric Johnson Hays Companies PHONE . 612-333-3323 FAx 73-7270 80 80 South 8th Street '� Suite 700 PRODUCER Ifinneapolis, ler? 55402 CUSTOMER B., INS S AFFORDING COVERAGE NAIC I INSURED Renewal 8y Andersen Corporation INSURER A: OLD REPUBLIC IHS CO 24147 INSURER 8: NATIO)IAL UNION FIRE INS CO OF pMS 19445 104 Otis Street INSURER C: Northborough, Kh 01532 INSURERD: 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 ADDTYPE OF INSURANCE L UBR POLICY NUMBER POLICY EFF POLICY EXP- LTR LIMITS A GENERAL LIABILITY UNZY 59828 10/01/1 10/01/13 EACH OCCURRENCE E 11000,000 X COMMERCIAL GENERAL LIABILITYPREMISES oxurrence E 500,000 CLAIMS-MADE OCCUR MED EXP are person)' $ 10,000 PERSONAL R ADV INJURY S 1,000,000 GENERAL AGGREGATE S 4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 3,000,000 X1 POLICY PRO LOC = A AUTOMOBILE LIABILITY MRTB 21700 20/01/14 10/02/13 COMBINED SINGLE LIMIT E 3,000,000 X ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY(Per person) : SCHEDULED AUTOS BODILY INJURY(Per moddent) _ a HIRED AUTOS PROPERTY DAMAGE : (Per madded) X NON-OWNEDAUTOS $ f 8 x UMBRELLALWB x OCCUR 1327335510/Ol/1 10/01/13 EACH OCCURRENCE $ 25,000,000 EXCESS LIAR CLNMS4mmr: AGGREGATE $ 25,000,000 DEDUCTIBLE $ IX RETENTION i 25,000 $ 1► WORMISCOMPENSATIO01 IANC 117948 00 10/Ol/1 10/01/13 x WCSTATAI 0&ANY AND EMPLOYERS'LIABILITY Y/N �� FOFRCCEERM EMBER EXCLUDED?RADECUTIVE NIA E.L.EACH ACCIDENT $ 1,00;-,-000 (Mandat°ry1n and E.L.DISEASE-EAEMPLO f 1,000,000 M =under DESCRIPTION OF OPERATIONS bebw E.L.DISEASE-POLICY LIMIT $ 2,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (Attach ACORD ,Ad,AddlSoml Ranmb Sdadate,K mon space b nqutnsd) Evidence of Insurance. CERTIFICATE HOLDER CANCELLATION Evidence of ineurance SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AVTNDRIM REPRESENTATIVE Massachusetts-Department of Public Safety i Board of Building Regulations and Standards j Construction Supen icor I License: CS-095707 BRIAN D DENNIS.6N 7 LAMBS POND CIRCLIE Chariton MA 015117W r * �. 11 ilk Expiration Commissioner 09/08/2014 o�.�aaea�i+,caella Office of Consumer Affairs&Business Regulation VHOME IMPROVEMENT CONTRACTOR Registration: ..ti 170810 Type: j Expiration: .123/2013 Corporation RWALL BY ANpEftSENICORPORATION t .z BRIAN DENNISOb, 104 OTIS ST. NORTHBOROUGH,MA 01532 Undersecretary i 1 r 1 s 1 i Renewal - .. byAndersene WINDOW' REPLACEMENT AnMdermCompany ,.;,.. woodNirryl Composite IF 9 Dual Argon Low E4 SmarlSun tt:gC::.stx�t'� >,:,....�.�. >..... Double Hung I 100-00473518-010 ENERGY PERFORMANCE RATINGS U-Factor(U.S)/I-P Solar Heat Gain Coefficient OM- 29 0n19 ADDITIONAL PERFORMANCE RATINGS Visible Transmittance OA2 Manufacturer stipulates that these ratings conform to applicable NFAC procedures for determiniig whole product performance.NFAC ratioge aro determined for a feed set of environmental cooddions and a specific pmducl eke. NFAC does not recommend any product and does not warrant the svinhdly of any product for any specili:use. Consul manufacturer's literature for other product pedormance information. www.rdlt:.otg This product meets Green Searsanvronmantal sheen •>'•�y {w >standards govemingenergy 4 „• pe, r>.., .'{...,,.,>,• p,•� . efficiency,heavy"lab in .' 'r'•the frame and sun �,•q.:.,o>y�.�-"' . fe.,a'•nntare�Pactoging,end ,:3;<� .�.F✓" consumer educational F.iiS i+<i coo- : materials. as.it.a ;t >•r•:ci......l`� 'S i DESIGN PRESSURE(PSF) i r a FlelMl sea , - e www�w sm..eom H-LC25 RbA DB Sloped Sill DH IN YftWNIUFShcaAMdM%A(A l0l!VMIUOS Mambelyer st tot.&VftManoe W ns a hG.—aros. leets at exceeds M.E.C.,C.E.C.A I.E.C.C.Air InfWration requirements WMA Hallmark Cedir"tion program. I ' I i I