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HomeMy WebLinkAboutBuilding Permit #154-2016 - 148 MAIN STREET 8/4/2015 l� I� NORTH BUILDING PERMIT oF�t,ED "tio TOWN OF NORTH ANDOVER 32 y�..' Y. •a APPLICATION FOR PLAN EXAMINATION h 1� Permit No#: � r Date Received ��A O.K. °RATEND Date Issued: W 41 / SSACHUSE IM9PORTANT: Applicant must complete all items on this page LOCATION Print PROPERTY OWNER ,�tiCe o,R.fal-i a Print 100 Year Structure yes no MAP OV-P-0 PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residen 'al Non- Residential ❑ New Building ne family ❑Addition ❑ Two or more family 0 Industrial ❑Alt ion No. of units: ❑ Commercial epair, replacement ❑Assessory Bldg ❑ Others: 0 Demolition ❑ Other 0 Septic 0 Well ❑ Floodplain 0 Wetlands 0 Watershed District 0 Water/Sewer DESCRIPTION OF WORK TO BV PERFORMED: ,F," :�i— U, �� t✓� 2 dd r Identification- Please Type or Print Clearly OWNER: Name:__ J d Yo Q �64tiSoA/ Phone: X39-877!�"�v� Address: A6411V 5'4 64u. Contractor Name: 14 1 wy - Phone: 6a l 7 '4'6 6- US/i 2-, Email: Address: 36 Supervisor's Construction License: D!b S Exp. Date: Home Improvement License: /`7D �� 4 Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED O $125.00 PER S.F. Total Project Cost: $_ FEE: $ Check No.: -© � �� j Receipt No.: 1 NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund &L�—natu[e of Agent/Owner -ee eSiqnature of contractor I Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ f TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanuing/Massage/Body Art ❑ Swiumning Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Pennanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS I CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed wed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes k � C. Planning Board Decision: Comments Conservation Decision: Comments Water& Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIREDERAR+TME iNT Temppumpster,agnAsite ,yes _ ►noa_ _ _ r I Fri',GdPepar�tment-,pk n tu:re/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 i DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine I NOTES and DATA— (For department use) i ❑ Notified for pickup Call Email Date Time Contact Name Doc.Building Pennit Revised 2014 Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits Building Permit Application M �. 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 OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks 4 Building Permit Application .4. Certified Surveyed Plot Plan 4 Workers Comp Affidavit � Photo Copy of H.I.C. And C.S.L. Licenses 4. Copy Of Contract 4. Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) 4, Mass check Energy Compliance Report (If Applicable) Engineering Affidavits 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) 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 2012 IECC Energy code Engineering Affidavits for Engineered products OTE: 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:Building Permit Revised 2014 Location No. (;-1 Date • - TOWN OF NORTH ANDOVER • S� LEU, . bo` Certificate of Occupancy $ 4 Building/Frame Permit Fee $ Foundation Permit Fee $�� Other Permit Fee $ TOTAL $ 1 Check# t[��� U r Building Inspector 2S, ^ 'S ..1 c10RTH � s e Town of : It . Andover o ; - . .. to h ver, Mass, C0C"1C"1WICK V1. �,9 A°R�reo ►�PP,��S S U BOARD OF HEALTH PERMIT L D Food/Kitchen Septic System . THIS CERTIFIES THAT ...................... . .... ..... ......... ........................................ BUILDING INSPECTOR Foundation has permission to erect ........................ buildings on � .�.. ... .. .•...... XN............ Rough to be occupied as .... .. .. .... ...... ...,~. .. �........ .t........ .. ........ ................... Chimney provided that the person a cepting 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 CONSTRUCTION STARTS Rough .... . .......... ...... ... `,,,,....... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Buildinz 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. Renewal byAndersenc'm I WINDOW REFLAGEMEN'T RE 1 3 ve Johnson 148 Main Vit. Unit 234 Bradstrett FOO �North A nr owr MA 01645 *w:� 'Y A*-V cwov�Orem f k&Ori Wtu M*be, iv- l stat fatilif0nR yo i t-�ts to a tx1plaretnent,praject apfriv al for joyfr j(hps;un Fie the aftdreFm lj r,41 akigme. l ha-'ve im l Weil with this letter our ccrtllicavar ofl-PSsurar ,yrodut'i.;73e C�i`t��i ,c���.��i'It�reque-sr wri t to ptm approval witmt be geed,d 4ted and taxied tack to me at 5OU-906-70TZ ar�F mnncd and cmml:d toapri i.as�re isa� am �e� at�Z�t�rrt The m6trmot d orderand specifications for t�1 ��iw��A�,�ia�11). y at , tt��tre:�, l t tt i ratty c or)rt a rawest.and tet me kn. ow an expected ap mvaa djut-,to wemaykeepw,oust�nwt l rOffit-d It wou,id be appreciated. UY011 deed please cant-ac eat SOB-M-2233 'fhARk You fut Your prompt respa nsc. F:w^f?kc"trih*7; Un minismatom: Renmal by Andwssen, PC Ix,588:K'72 30 Fna Pbmje(50,81 35J22rx) Fax(softy 996.1071 Renewal lyyAndersen. n +`. -14Y M979 bC4,-+,j f'jj,,,y4,r ef.E) Viiuw%zrd,r 5- r& p,., ei�V,44,� sem,, 149 Al i•v f. U -. 4 8► U*844 iV"fO,,,A•Aowr MA,, 0184sowftt-4- 6y q O)A Flute[•50M).15 1,1233 Renewal Renewal by Anderson Corporation PAA Home improvement Contractor byAndersen,", 30 Forbes rd Northborough,MA 01532 License#17081D (Expires 12123/2015) 'Welogow REMAGEMENT (508)351-2200 Fax:(508)-986-7072 Federal ID#41.1918413 Window Specification Sheet N iver,;sNanw Dail-ofAgrecmem JOYCE JOHNSON MON, APR 20, 2015 1,11v lillvcr(slistt-d alxwe heltby joilltiv and s,(,vvnilIv agree to pun-lia!w the goods and/or sen,iccs liswd below.in at,cordallcv.Willi the piticcstuid tcrims ckscribM div spr6ficMioll Sheet alld the fmill.alld dir rvtenw of d1c:a(Tompanvilig CUSTOM M-NDOW AM)DOOR RE-MODEUNG,AGREEMEN' of hieli ,tile,Sprcilit-ation Slivet i,;part. WINDOW&DOOR DETAUS .app. AS,;,. 4,pr 00101 Hartkiare Hwd%,Wv Glik Grille Glass Room 9 mdlh Wgt'l U,L Window/Door Style Detail Cast s. Ext.Int Color S 1e Saaeris Sranaton Grilles Sash V3 Swoo 2 Lifts Options Lavin g _It)L ,i'1 15 79 08 so tali equal insert sloped sill Ext.Wrap WHiwiri White standard FFG Low-E4 GeG 312 3P2 No No ving 101 34 45 rail equ 79 DB — —_M --qua WWWH White Standard FFG LMV-E4 CW 3,12 3.12 No No Livia g 102 30 44) 70 D8 sq rail equal insert sloeed sill Ext,Wrap AltiMH White Standard FFG Low-E4 GBG 3/2 312 No No Bed 1 10,35 30 4:) 75 1 DB so rail equal insert sloped sill Ext.Wrap iIVWWH White IStandard FFG I ww,E4 Gee 312 3!2 No No Bad 1 101: 30 T5 75 DB so r±L!Buai insert sio ed sill Ext.Wrap WWWH White Standard FFG Low-E4 GoG 3/2 312 No No Lwin g 10,91 A+WH C Ext.Wrap WH/WH Brt.8rass vintatp FFG smartsjr (,.w3i5 Na Temper Mst Bed 106 080 A-FWN C lafo Ext Wrap WIFIMI-I Brt.Brass vin to FFG 3rnartswi cirm i's 316 No Temper ............................. Total 7 1 RAY.BOW&RUIM OUT DETAILS Style obtail I Approx width, Apprrox. Number Frame Wirdow Ertl Ctattor 1 Luv� 0 Roorn Count &114 Rankers heiciht Cizirqu Angle LIlM Irileow ExVlrotOalor GnIfes s vst art sashes Scowls Smartsun soffit Color SPECIALTY WINDOW DETAILS Futif Approx. LowElspecialty RAY/BOW ADDITIONAL WORK NOM Room Count Style in." U.I. Smarlsul Grilles Grille Style ExOnt Color lliut twil .,aA, u to,, ADDITIONAL WORK DETAILS: I No Contractor will wrap exterior casings with coil stock color of White Owner is aware that Contractor does not do any painting1sraining of alarm system or window treatments/hardware. !tis the responsibility pf the homeowner tohave the alarm system and window freatmentsftiardware removed prior to installation. We make no guarantee as to whether alarms or window 2 treatments/hardware will tit after replacement. Customer is also Mara in some cases them will be glass loss. If there is,the amount will be dependent on the type of existing windows,type of installation and window style.We make no guarantee as to the amount of glass loss.Customer is aware and understands any and aft unseen rot is not included in this contract.Should any rot be found there wftl be an additional charge for time and materials unless so stated in this contract 3 lin 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,doors,storm windows and vacuum nightly included. Upon completion of the job and payment in full,a limited warranty shall be issued. Yes Building Permit--Contractor will secure any and all necessary permits. The fee for the permits)Is Included In the total contract price, flee. 5 Ye., All discounts have been applied to this agreement. N',-, No Owner agrees to be present on the final day of installation for final inspection and to deliver final payment/finance form(s), 'b k agreed and till.lvvsl,xA In:nutb"meen di,r I trlit z tlLat 16,SIX-61iotlimi slw:i:it idolov tvith dw Ct STOM l%T\J)ow AND I)OOR REXIM1,1ING! MIA11 t(otmitwo the calve iuntivtstaiuliltg I.-tk-en the pani-tand lit"n.an,it—erly."Itrrnts. slievi"un rwt I"di;mg,1141'it,f"Alois +dificd m k;.6,d in it)""ifilig:trid iigllvri by Nlio "illovi. now has mad dii,SIR :Renewal by Andersen Corporation /11 114' 3& Signature of Consultant Siiah,re Signature MIKE BUTLER JOYCE JOHNSON Print Name of Consultant —pont Name Print Name _______.___...._.,__,,,. .. ._____._.._...�._ __.._.____ ....... ._.__._...____„__.,__ ._........._... Wnewal. MA Home Improvement Contractor; ' b)( License#170810(Expires 1212342015) Andetsen. Renewal by Andersen Corporation Federal Tax Ig#41-1918413 ' lw£itDOW RFPtArr:yt(life .rids E < > eo 30 Forbes Rd. Northborough,MA 01532 (508)351-2200 Fax(508}-986-7472 CUSTOMER WLNDOW AND DOOR REMODEL FNG AGREEMENT Buyer(s)Name [late: JOYCE JOHNSON - APRIL 20, 2015 Bu r(s)Street Address City State Zip Cade 1148 MAIN ST TWIT 234 BRADSTREET BLO NORTH ANDOVER MA 01$45 Err€ai[Address Home Telephone Number Work/Cell Telephone Number JORO47GE M BARQMAI L.COM 239-877-2805 Buyer#s)hereby jointly and severally agrees to purchase the goods 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. Total Job Amount $ 18,975 kmount financed 0 Est.Start Date Method of Payment Nposit Received(33%)$ 6,325.00 rrDrsrslt at pis S 0.00 Cheek/Cash 12.76/weeks Balance Start of Job(33`x)$ 6,325.00 Check# Balance on Substantial At Substa,tsal Est.instal[Time Credit Card Completion of Job(33'x)$ 6,325.00 cofrlpteta3 S 0.00 1-2 daystt =C=ard isselWed,please CJo tine/ ,st,'I Da Demanded urs/3€: :.res ora sa5srd s�Credtt Card P erA form Buyers)agrees and understands that this Agreement constitutes tho 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 boot Buyar(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 Andersen Corporation Buyer(s) Buyers) 4 " Signature of Consultant S laturere Signature X MIKE I3t1TLEft .JOYCE JOHNSON Printed Name of Gonsuitant Printed Name Pnnted Name YOU,THE BUYER(S),MAY CANCEL THIS TRANSACTtON.AT ANY TIME PRIOR TO MMGHr OF THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACT#ON. SEE THE ATTACHED NOTICE OF CANCELLATION FORMS FOR AN EXPLANATION OF THIS RIGHT. --------------------------------------------------------------------------- 1 NQTiCE OF f:ANCELLAT€O!i NOTICE 6f CANCELL 17ION' t E Bate of Transaction #,ti:ri.� You may cancel this r Slate of Transaction You mayeawaeelthis trousaadon,without soy penalty or Obligation,within three business day%from the transaction,Without any penalty dr obligation,within Il rcr business days from the abot*date.If you taocel,any property traded in,any Payments made In you under I above date.If you rancel,any property traded in,any payments made by you under the Coutes t of Sale,and any negotiable instrument eaecuted by you will be the/`centrad of Sale,and any negotiable instrument executed by yvu/yin tae returned within 14 days following receipt by the C:ontranor¢"Seller"1 of your t returntd within€0 da;-s fotlo-ing receipt by the comractar("Selkrr"g of your camenation notice,and any security interest orisittg out oY the tranaattion will be I rsneellation notice,and any security interest arising out of the transartion will be raamled. V}roe eartt:el,+syn must maoke ava0ab€e to the Setter at your residtw,v,in i c-r coned. If you eaucel,you must make available to the Seller at?*—residence,in substantially as good condition as when tr,eeivrd,any goods delivered to yvu under i sohstantially as flood et ndillon as when received,any goads dell orrd to you ander this Contract ar Sale;or you may,if you wish,aximply with the instructions of the i this Contract or Sale;or yvu may;if yvn wish,eompiy with the incuEw=etions of the Seller regarding the return shipment of the goods at the Seller's expense and risk. Seller regard*the return shipment of the goodo at the Seller's expense and risk. If"do make the goads avanabie to the Seller and the' does not pica them up if you do make the goods available to the Seller and the Setter doea.atot pirla them up j within 20 days of the date of yoga^Notice of Caarellation,you may retain or dispose within 20 days of the data of your Notice of C*m Uatim%.you may retain or dispose :. of the goods without any further Obligation. if you fail to make the goods available 1 of the goods without ant'furtkec obF€tlatitsn. Sf yrou fail to matlae for goads:vatlable m the Seller,or if yvau agtr,e ro return the,goods to the Seller and All in do an,thin to the Seller,Orif you agree to return the goods to the Seller and fail to do so,then yvu remain liable for performance of all obligations under the Contract.To cane) � you retrain liable for perfarmaace of an obligations ns ondrr the Contract.11D camel this transaction,mail ar deliver a signed and dated copy of this cancellation rwtiee this transaction,mall or deliver a signed and dated copy of this cancellation notice or any other written notice,or send a telegram to Cantrarttat:Renewal by Andersen, or nay/nice tvriften ootice,or send a teleg,raat to Cmntractnra Renews!M,•Andersen, 30 Forbes Rd. Nndhbotvugh,MA 01332. 1 38 Forbes Rd.Northborough,NIA 01532. I ItERMY CANCEL T1 S TRANSACTION, I xEMSY CANCEL TWS TRANSM:rION, I I a vers Sigaere rriN ttercx eua i Dyers sq,a� P-00/'Jame pyo . Renewal a byAndersene �- wiNDOW• REPLACEMENT anAndetstrxCompni Wood/Vinyl Composite IF �`:a:•f'n ': v:4 Dual Argon Low E4 SmartSun Double Hung 100-00473518-010 ENERGY PERFORMANCE RATINGS U-Factor(U.S)/I-P Solar Heat Gain Coefficient 00- 29 r ADDITIONAL PERFORMANCE RATINGS Visible Transmittance OA2 Manufacturer miputates that these ratings conform to applicable NFRC procedures for deWrmining whola product performance.NFRC ratings are determined for a fixed set of environmental conditions and a specific product sae. NFRC does not recommend any product and does not warrant the suitability of any product for any specific use. Consult manufacturer's laerat're for other product performance information. www.nfrc.org 'e�lr "SEAL This product meats Green + Seats environmental c.mes .•.,t. :•x�.;•;x.�_, jstandards governingenergy a,t;;;�y;,+o�,•�_,. tj: rr'••r Vii•••. t"'�•. eHicianey.heavy metals in rp;r "• ,.:the trams and sash y.:;•yi:••••' ry? g C•� material,packaging,and :; '^``••r �Y�consumer educational {: materials. a rR.a S;Z: c<•i •'s -------------- DESIGN PRESSURE(PSF) t t l Witoow and 000r ' hlanufar:nMAMdatian H LC25RbA DB Sloped Sill DH IN TeslWtollAFS420f AAMA4'AIdAtCSAt0IAS'AW4& Mafa11ar:1Far s1' tales oontomiance to M appficable standards. Jests or exceeds M.E.C.,C.E.C,81.E.C.C.Air Infbltration requirements WOMA Natlmark Unification program. v dWINDOWS-DOORS areae. Andersen RFRG Certified Total Unit Performance (confined) t�rilh� Andersen'Product Glass Type ; U-Fartor' SHGCT Andersen'Product Glass Type U-factor' SHGC' VP e 400 Series Arcliitectuwl _ � ��' HP Cm-.T4. 0.27 035 0.60 HP law-E4 032 028 0.47 LIP Imv-E4 with Grilles 032 025 0.42 HP Low-E4 with Grilles 028 031 0.54 i:. HP LHP Sun 027 021 033 HP Low-Ell Sun 032 0.17 0.26 [ Circle lap" Casement Window ' Casement Window HP Lmr-E4 Sun with Grilles 0.29 0.19 0.30 ) �'.e NP Low-E4 Sun with G.R. 0.32 0.16 0.23 HP taw E4 SmartSun 026 023 0.54 �' HP Law-E4 SmartSun 0.31 0.18 0.42 F1 i^. HP law-E4 SmartSun w/Gn-Aes 028 021 0.49 '. HP Low-E4 SmartSun w/GyMes 031 0.17 038 HP Lor-E4 027 035 0.60 HP Low-E4 032 028 0.47 HP Lor-E4 vrith Grilles 032 025 0.42 28 I�'• HP Low{4 with Grilles 0 031 0.54 t.. HP Lmr{4 Sun 027 021 0.33 f French Casement HP Law-E4 Sun 0.32 0.17 026 Circle&Oval Window Window lip LoE4 Sun with Grilles 0.32 0.16 023 �. HP Lbw-E4 Sun with Griaes 029 0.19 0.30 G', _ w- �3 HP taw{4 SmartSun 026 023 0.54 ' HP taw-E4 SmaaSun 0.31 0.18 0.42 0.17 038 HP Low-E4 SmadSun w/Grilles 028 0.21 0.49 E!i LIP lux-E4 SmarlSun w/Grilles 031 ' HP Low-E4 028 0.33 0.58 HP Low-E4 032 028 0.47IT'. '. LIP Low-E4 with Grilles 029 0.30 0.52 HP Low{4 with Grilles 0.32 025 0.42 r: HP low-E4 Sun 028 020 031 ' .' IIP Low-E4 Sun 032 0.17 026 Arch Window HP Law{4 Sun with Gnlfes 029 0.18 bait Awning tYmdow LLP Low-E4 Sun with Grilles 0.32 0.16 023 :^I HP law E4 SmarlSun 027 023 0.52 4 HP Low-E4 SmartSun 031 0.18 0.42 HP low-E4 SmanSun w/Grilles 028 021 0.46HP low-E4 SmanSun w/GrOfes 031 0.17 038 HP Low-E4 0.27 033 D.58 HP taw-E4 031 032 0.55 { HP Low-E4 with Grilles 0.31 029 0.49 f t HP Low-E4 with Gnlles 028 _0.30 052x. HP for-E4 Sun 027 020 0.31 Casement/Awning HP lmv-E4 Sun 031 020 031 ':E FleaHrame Wiodoiv Picture Wlndvir HP law{4 Sun with Grilles 031 0.18 028 �� HP tow{4 Sun with Gnlles 029 0.18 0.28 HP Low-E4 SmartSun 026 023 0.52 HP law-E4 SmarLSun 0.31 021 0.50 f� HP low-E4 SmartSun w/GNles 028 021 0.46 [j HP Low-E4 SmarlSun w/Grilles 0.31 0.19 0.44 HP low-Ell 031 033 0.58 HP law-E4 0.30 037 0.64 HP Low-E4 with Grilles 0.32 030 0.52 HP Low-E4 with Grilles 030 033 0.57 HP low-E4 Sun 0.31 020 031 LIP Low-E4 Sun 0.31 022 0.36 Springilne Window Specially Window HP Low-E4 Sun wllh Grilles 031 020 0.32 , tIP Wv{4 Sun with Gnlles 0.33 0.18 028 HP low-E4Sure rtSun 030 D23 0.52 HPImr{4SmanSim 030 024 0.58 HP Lax-E4 S,, r on w/Gnlles 032 021 0.46 HP low-E4 SmartSum w/Grilles 0.30 0-22 0.52 HP Low-E4 030 027 0.45 �"1 HP low-E4 032 022 037 "� `: rJ HP Imv{4 with Grilles 032 023 0.39 t�I �r; HP Imv{4 with Grilles 033 020 033 - HP Low-E4 Sun 031 0.16 0.25 ? Hinged Inswing LLP tow-E4 Sun 033 0.14 0.21 - Frenchwood' French Daor NP Lary{4 Sun with Grilles 034 0.13 0.18 - Gliding Pain poor LIP Lax-Et Sun with Grilles 0.32 0.14 0.22 . HP Lnvr{4 SmartSun 0.3D 0.18 0.41 HP Lmr-EA SmarlSun 032 0-15 033 HP Iow{4 SmartSon w/Grilles 0.31 0.16 0.35 F� HP Lmv-E4 Simonson w/Gdiles 0.33 0.14 030 - „a HP torr-E4 033 025 0.41 an 40 HP taw 0.31 024 0.41 f? -- HPlow E4 wrlh Gn9as 032 021 0.35 r HP Low HP with Grilles 034 022 036 - m HP lax-E4 Sun 0.33 0.16 023 0 nelmmod'Hinged .I HP Low-E4 Sun 0.31 0.15 023 �i Hinged Outswlng - . Inswing Patio Dox I HP low{4 Sun with Grilles 0.32 0.13 0.19 7 'E's French Door HP lax-LA Sun with Grilles 035 014 020 04 HP Low-E4 SmartSun 030 0.16 037 7 F"3 HP Lax-E4 SmaFtSun 032 0.17 0.37 t I era HP Low-154 Smar15un n/Colles 031 0.14 031 z:1 HP lmv-E4 SmartSun w/Grilles 034 0.15 032 - E HP Lmv-E4 031 025 0.41 i HP Low-E4 033 023 HP law-E4 with Grilles 032 021 0.35 7", F'N HP tow-E4 vnlh Grilles 033 021 034 - HP Low-64 Sun 0.31 0.15 023 Fined French Door- HP Low-114 Sun 033 0.14 021 - Freochwood Hinged.. Sidelight HP low-E4 Sun with Grilles 034 0.13 0.19 fluttering Priori Priori DoorLIP low-F4 Sun with Gilles 0.32 0.13 0.19 HP Low-E4 SmartSun 030 0.17 0.37 "1 11P Low-E4 SmartSun 0.32 0.15 034 - nq HP low-E4 SmartSun w/Grilles 033 0-14 0.30 - HP Lor-E4 SmertSun w/Gnlles 0.31 015 031 k:, HP Low-E4 0.31 0-22 037 F? HP Low-E4 032 025 0.41 - HP Low-E4 with Grilles 0.32 020 0.33 i P F':. HP Law-E4 with Grilles 033 022 0.37 - HP low-C4 Sun 0.32 0.14 0.21 Fixed Transom lip low-E4 Sun 032 0.15 023 - Firmchwo°d' French over HP torr{4 Sun with Grilles 033 0.14 020 - Patio Door Side.vii IIP low-E4 Sun with Grilles 032 0.13 0.18 ' ' - HP law-E4 Smarts. 031 0.15 0.33 HP low-E4 SmanSun 032 0.16 037 HP law{4 SmartSun yr/Grilles 0.32 0.14 029 HP law-E4 SmertSun w/Gdfles 032 0.15 033 - HP Low-124 0.30 024 0.40 HP Low-E4 035 026 0.44 - HP low-E4 with Grilles 030 021 035 '.:(qi HP Law-E4 with Grilles 0.36 023 038 Folding Door - Frenchwood' NP low-E4 Sun 0.30 0.15 0.22 ,'• HP law-E4 Sun 0.35 0.16 024 - _ Patio Door Transom IIP Lmr{4 Sun with Grilles 0.31 0.13 0.20 1A .�! HP lax-E4 Sun with Of S 036 D.14 021 HP Low-E4 SmartSun 0-29 0.16 036 ��� �' HP Low-154 SmartSun 0.34 0.17 039 - HP tmf{4 SmanSun w/Gnlles 0.30 0.14 032 HP Low-E4 SmartSun w/Gnlles 036 015 0.34 - Conlinued on nut page -For NERC certified total unit performance on units with capillary breather tubes for high altitudes,please visit andeisemiindows.com. •'High-Performance"Lor-E4-(HP Low-E4),'High-Performance"Low-E4'SmanSun-'(HP low-E4 SmartSun)and'liigh-Performance low-E4'Sun'(HP Low-E4 Sun)are Andersen trademarks for'Low-E"glass. 'U-Factor defines the amount of heat loss through the total unit in BTU/hr sq-ME The lower the value,the less heat is lost through the entire product Window values represent non-tempered glass.Use of tempered glass can Increase 11-Factor ratings.See andersenwindbws.com for specific performance values.Door values representtempered glass. 'Solar Heat Gain Coefficient(SHGC)defines the fraction of solar radiation admitted through the glass both directly transmitted and absorbed and subsequently released inward.The lower the value,the less heat is transmitted through the product 'visible Transmittance(VT)measures how much light comes through a product(glass and frame).The higher the value,from 0 to 1,the more deylightthe product lets In over the product's total unit area.Visible Transmittance is measured over the 380 to 760 nanometer portion of the salaf spectrum. •NFRC ratings are based on modeling by a third party agency as validated by an independent test lab in compliance with NERC program and procedural requirements. •This data is accurate as of December 2010.Due to ongoing product changes,updated test results or new industry standards or requirements,this data may change over time.Ratings are far sizes specified by NERC for testing and certification.Ratings may vary depending on use of tempered glass,liferent grille options,glass for high altitudes,etc •Passive5un-glass values are available online at andersenwindows-com. 277 PRODUCT PERFORMANCE Andersen'NRC Certified Total Unj-Performance (crontinueri) Andersen Product. Glass Type 1.1-Factor' SHGC' VP 200 Series. Gear Dual Pane 0.45 0_60 0.63 - - Gear Dual Pane with Grilles 0.45 0-54 0.56 - T83-wash - Low-E 0.30 032 0.55 Davble-Hung Window tmr-E with Galles 0.30 0.,29 0.49 HP taw-E4 SmartSun 0.30 0.,21 0.49 HP Low-E4 SmarSun w/Gnlles 031 0-19 0.43 �I Gear Dual Pane 0.45 0_61 0.64 - Narrulibe: Clear Dual Pane witb Galles 0.45 0-54 0.57 - DoublrHung'Window ID*-E 030 032 0-56 " Law{-14 Galles 0.31 0.29 050 Gear Dual Pane 0.44 0_63 0.66 - NorroDns: _ Gear Dual Pane with Gnlles 0.44 0.57 0.59 - Transom Via dew Low-E 027 034 0.58 !aw E with 6nbes 027 030 052 Gear Dual Pam: 0.45 0.60 0.63 - Clear Dual Pane w@h Galles 0.45 054 0.56 - Low-E 0.30 032 0.55 Gliding Window Low-E with Gri11es 030 039 0.49 lav-ESmarlSun 0.30 0.21 0.49 .E Low-E SmanSun with Grilles 0.31 0_19 0.43 Clear Dual Pane 0.43 0.61 0.65 - Clear Dual Pane with Galles 0.43 0-5- 058 - Fued;Transom;. Iaw-E 028 033 0.56 Cirefe Top''Wmdow LOWE with Gnbes 028 030 0.50 `! . ... Lu*Z SmarlSun 027 0.22 0.51 .71 32 Lan-E SmatSun whh Galles 027 0.20 0.45 J Clear Dual Pana 0.44 0.61 0.64 Clear Oval Pane wrlh Gres 0.45 053 056 - Lmr-E 029 032 056 - Narn6ne Lew-EwBh Gilles 0.30 029 0.49 60ding Patin Doors Lmv-E San 0-29 020 031 .. Lmr-ESun wn Galles 031 0-18 027, E Law{SmartSun 028 0-.21 0.50 Law,-E SmartSan with Galles 030 0-19 0.44 Clear Dual Pane 0.43 0.61 0.64 - Clear Dual Pane with Gnlles 0.43 054 0.56 - LmwE 028 032 0.56 - Puma-Shleld'. Law-E with Galles 030 0-29 0.49 ' }� Gliding Patio Doors Law{Sun 029 0-19 030 Law{Sun with Gnbes 030 0_17 027 -3 . - Law-ESmanSun 027 022 050 M p29 Law-E SmartSun with Grilles 029 019 0.44 3 " Gear Dual Pane 0.43 145 0.47 - Clear Dual Pane with Galles 0.43 039 0.40 - Law-E D32 024 0.41 s Hbrged"laswing Low-E withGnlles 0.33 021 035 - PatiaDoors Low-E Sun 0.32 0.15 023 Low-E Sun with Gabes 034 013 019 - law-E smartsun 092 0.16 0.37 Low-E Smartsun with Galles 0.33 0.14 031 - V- ga The Commonwealth of Massachusetts Department of IndustrialAccidents Office of Investigations ' I Congress Street, Suite 100 M Boston, MA 02114-2017 www mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): RENEWAL BY ANDERSEN Address:30 FORBES ROAD City/State/Zip:NORTHBORO, MA 01532 Phone #:508-351-2200 Are you an employer? Check the appropriate box: Type of project(required): 1.© I am a employer with 30 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6. ❑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 8. ❑ Demolition working for me in any capacity. employees and have workers' comp. insurance.: 9 E] Building addition [No workers' comp. insurance P• required.] 5. ❑ We are a corporation and its 10.El 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. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that isproviding workers'compensation insurance for my employees Below is the policy and job site information. Insurance Company Name:OLD REPUBLIC INS. CO. Policy#or Self-ins. Lic. #:MWC 30293800 Expiration Date: 10/01/15 Job Site Address: /TO v )d/N' s� �"� City/State/Zip: "dmpexiev A14 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 hereb certify der the pains and penalties ofperjury that the information provided above is true and correct Signature: Date: Phone 8-351-220 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#• ANDECOR-01 YADAVYO A�ORl� CERTIFICATE OF LIABILITY INSURANCE OATS(MNYDOIyYyy) 10/1/2014 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: 9 the certificate holder is an ADDITIONAL INSURED,the policy([")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). pRODL1CM OUNTAUT NAME: certIficphmQMIIls.COm Willis Inc. nNo" 26 Century Blvd N Ee 48�945-7378 60r-.,(888)(888)487'2378 P.O.Box 305181 r.-M Nashville,TN 37230.5181 INSURERS)AFFORDING COVERAGE NAIC M SURERA:Old Republic Insurance Company 24147 INSURED e INSURER B Renewal by Andersen Corporation INSURER C: 30 Forbes Road INSURER D: Northborough,MA 01632 INSURER[ WaUREiF: 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 CONTRACTOR OTHER DOCUMENT NTH 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 I TYPE OF eNiURANCE POUCY NUMBER 11MMIDWYM IMMIDwrym LOTS A X COMMERCIAL OENERAL LIABILITY EACH OCCURRENCE S 1,000,0 CLAIMS41AM T OCCUR MWZY302940 10!01/201, 10/01/2015 PREMISES Ra ocasrarloe SA4,000,00 MED EXP("per person) $ PERSONAL&ADVINJURY $ GERL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ X POLICY❑SPM ❑LOC PRODUCTS-COMPIOPAGG 1 OTHER: 1 AUTOMOBILE LIABILITY -MI1 5,000,00 A X my AUTO MWTB302575 10101/2M4 1010112015 BODar INJURY(Per Poarl) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(ParaaWart) S HIREDAUTOS �0S� Ono PE E 1 S UMBRELLA LJA6 � EACH OCCURRENCE $ EXCESS LUUI OCCURCLAJMa+IADE AGGREGATE S DED RETENTI MIORKERS COMPENSATION 1 AND OTH- EWLO V ERS LJABILM YIN X STATUTE ER NIA A ANY PROPRIETORIPARTNEROEXECUTTVE MWC30293M 1=112014 10/01/2015 E.L EACH ACCIDENT 1 1,000, OFFICERIMEMBEREXCLUDED?punadoryN❑ MMSNO der E.L DISEASE-EA EMPLOYE 1 11000, DESCRIP SNO OF OPERAI IONS below E.L DISEASE-POLICY LIMIT 1 1100010 DESCRFTION OF OPERATIONS I LOCATIONS I YENXI ES(ACORD 1N1,Addtloml Ramada Scluduk,may be dbeNrd t mon spans b Iaqu4ad) i CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE NRTH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ftidence of Insurance ®1988.2014 ACORD CORPORATION. All rights reserved. ACORD 26(2014101) The ACORD name and logo ars registered marks of ACORD Massachusetts-Department of Public Safety Board of Building Regulations and Standards Construction Supenisor License:CS-=125 '! JAM LMORM 86 GARDINSR ST r-"�,:,"tr{r LYNN MA 0190.E .�-�„�► � ��ass Expiration Commissioner t0/08RQ18 3 Mce of COUSYNer Affairs&Snaaeas 1eplatioo iMPROVMNT CONTRACTOR f istnation: 170611) E*Iration:.12123/2!!15 Q' RENEWAL BY ANDERS'O'N CORPORATION Supplement r s 11 JAIME MORIN .s• 104 OTIS STREET g� r MORTHBOROuGH,MA 01532 M. UederKcrefary ` V. f• I i r