HomeMy WebLinkAboutBuilding Permit #290-15 - 174 INGALLS STREET 9/22/2015 ORTH
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BUILDING PERMIT 3? g '6"
TOWN OF NORTH ANDOVER ° t o
��u-I� APPLICATION FOR PLAN EXAMINATION i b
Permit NO: Date Received41,40
Q� � �9SSACHUS t
Date Issued: I �`7
IMPORTANT:Applicant must complete all items on this page
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TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
❑ New Building -�J One family
❑ Addition ❑ Two or more family ❑ Industrial
❑Alteration No. of units: ❑ Commercial
N Repair, replacement ❑Assessory Bldg ❑ Others:
❑ Demolition ❑ Other
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REPLACE 7 WINDOWS AND 1 DOOR- NO STRUCTURAL CHANGE
Identification Please Type or Print Clearly)
OWNER: Name: DAVID &JOYCE MACLARY Phone: 978-686-0528
Address: 174 INGALLS ST NORTH ANDOVER,MA 01845
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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 ost: $ 12,902.00 FEE: $ 1195.b-D
Check No.: Receipt No.: - U4 -
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
O
BUILDING PERMIT ' a o`"L oT 6
TOWN OF NORTH ANDOVERoL
o " . a
APPLICATION FOR PLAN EXAMINATION
�o
Permit No#: Date Received
gSSACHUS
Date Issued:
IMPORTANT: Applicant must complete all items on this page
, � u
LOO ION
s
Prot,
{PROPERTY OWNER , ..�. -- _-- --- - ---- -
Pnn3 1.OQ Year St uetae yes, ng
EMAP-- _ PARCEL ZONING:DISTRICi-: 1Historic ®{strict yes ino,
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
❑ New Building ❑ One family
❑Addition ❑ Two or more family ❑ Industrial
❑Alteration No. of units: ❑ Commercial
❑ Repair, replacement ❑Assessory Bldg ❑ Others:
❑ Demolition ❑ Other
❑ Septic 01Ne41OFloodplam ❑Wetlands p.` Wate_rshed'�District
0 Watertao- r
DESCRIPTION OF WORK TO BE PERFORMED:
Identification- Please Type or Print Clearly
OWNER: Name: Phone:
Address:
ContractorENarne -� Phone _
_ --
Address.
Supervisor's Construction License: -_ � __ Exp: Date __ = g
Horne,lm pro
ve qe
- _
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. 4
Total Project Cost: $ FEE: $
Check No.: Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
s
Signature ofaAgent%Owner - Signature of contr, ;tor
Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
TYPE'OF SEWERAGE DISPOSAL
Public Sewer ❑ Tanning/Massage/Body Art ❑ Swinnming 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
PLANNING & DEVELOPMENT Reviewed On Signature_
COMMENTS
CONSERVATION Reviewed on Signature
COMMENTS
HEALTH Reviewed on Signature
COMMENTS
{
a
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:
FLocated 384 Osgood Street
E#DEPARTMENT - T rernp ®umpsterryested,at124+Me EDepartment signatureLd:ate
COMMENTS —__m
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
MGL Chapter 166 Section 21A—F and G min.$1oo-$1000 fine NO
NOTES and DATA - (For department use)
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❑ Notified for pickup Call Email
I I 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
❑ Workers Comp Affidavit
❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses
o 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
a Floor/Cross Section/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
o 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 a
❑ Engineering Affidavits for Engineered products
NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg. Permit
+ In all_cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals
that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording
must be submitted with the building application
Doc:Building Permit Revised 2014
Location � 1tS
Date
e - TOWN OF NORTH ANDOVER
o Certificate of Occupancy $
Building/Frame Permit Fee
Foundation Permit Fee $
Other Permit Fee $ "
. xr �a '
TOTAL $
Check# �
28042
Building Inspector
t%ORTH
Town of t E : 1� Andover
No. L IE
h ver, Mass,
COC NIC MI WICK
�dS0RAr PPP,i�(5
U BOARD OF HEALTH
Food/Kitchen
PERMIT T LD n I Q Septic System
• ��C6! ��
THIS CERTIFIES THAT ...... BUILDING INSPECTOR
... .I a....k..�jc�:....... . ......... ... .... ...... ..............................
�LL �� I J-I�j Foundation
has permission to ere ..... .................... buildings on ..� ':f............. . ..I.y...... . .r �........................
- � Rough
tobe occupied as ...........P.G ...I.... .4 .........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 CONSTRUCTION/
T TS Rough
V 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.
Renewal MA Home Improvement Contractor
License#170810(Expires 12/23/2015)
WY�10Eer Renewal by Andersen Corporation Federal Tax ID#41-1918413
- WINDOW REPLACEMENT EMENT EMT an A,deao,Gn,gam. '
104 Otis St. Northborough.MA 01532
(508)351-2200 Fax(508)-986-7072
CUSTOMER WINDOW AND DOOR REMODELING AGREEMENT
Buyer(s)Name Date:
JOYCE MACLARY - DAVID MACLARY AUGUST 20,2014
Buyer(s)Street Address city State Zip Code
174 INGALLS ST NORTH ANDOVER MA 01845
Email Address Home Telephone Number Work/Cell Telephone Number
978-686-0528 978-973-3285
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 $ 12,902.00 Amount Financed$ 12,902.00 Est.Start Date Method of Payment
Deposit Received(33%)$ 0.00 12 weeks ® Check/Cash
Balance Start of Job(33%)$ 0.00 Deposit at signing$ 6,451.00 Check#
Balance on Substantial At Substantial Est.Install Time ® Credit Card
Completion of Job(33%)$ 0.00 completion$ 6,451.00
2-3 days If credit cab is selected,please
see Credit Card Payment form
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 Andersen Corporatti�on/� Buyer(s) Buyer(s) n //
By: �PC•6C/LC�L eI CPtLC/ ,y f2�(At dl '��(�.�o�-.y
Signature of Project Manager Signature Signature /
ROLAND PELLETIER JOYCE MACLARY DAVID MACLARY
Printed Name of Project Manager Printed Name Printed Name
YOU,THE BUYER(S),MAY CANCEL THIS TRANSACTION AT ANYTIME 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.
____________________________________
--------------------------------------
NOTICE
_______________________NOTICE OF CANCELLATION NOTICE OF CANCELLATION
Date of Transaction 8/20/14 You may cancel this I Date of Transaction 8/20/14 You may cancel this
transaction,without any penalty or obligation,within three business days from the transaction,without any penalty or obligation,within three business days from the
above date.If you cancel,any property traded in,any payments made by you under I above date.If you cancel,any property traded in,any payments made by you under
the Contract of Sale,and any negotiable instrument executed by you win be I the Contract of Sale,and any negotiable instrument executed by you will be
returned within 10 days following receipt by the Contractor("Seller")of your I returned within 10 days following receipt by the Contractor("Seller")of your
cancellation notice,and any security interest arising out of the transaction will be I cancellation notice,and my security interest arising out of the transaction will be
canceled. If you cancel,you most make available to the Seller at your residence,in I canceled. If you cancel,you must make available to the Seller at your residence,in
substantially as good condition as when received,any goods delivered to you under I substantially as good condition as when received,any goods delivered to you under
this Contract or Sale;or you may,if you wish,Comply with the instructions of the I this Contract or Sale;or you may,if you wish,comply with the instructions of the
Seller regarding the return shipment of the goods at the Seller's expense and risk. I Seller regarding the return shipment of the goods at the Seder's expense and risk.
If you do make the goods available to the Seller and the Seller does not pick them up I If you do make the goods available to the Seller and the Seller does not pick them up
within 20 days of the date of your Notice of Cancellation,you may retain or dispose I within 20 days of the date of your Notice of Cancellation,you may retain or dispose
of the goods without any further obligation. If you fail to make the goods available of the goods without any further obligation. If you fail to make the goods available
to the Seller,or if you agree to return the goods to the Seller and fail to do so,then I to the Seller,or if you agree to return the goods to the Seller and fail to do so,then
you remain liable for performance of all obligations under the Contract.To cancel I you remain liable for performance of all obligations under the Contract.To Cancel
this transaction,mail or deliver a signed and dated copy of this cancellation notice I this transaction,mail or deliver a signed and dated Copy of this Cancellation notice
or any other written notice,or send a telegram to Contractor:Renewal by Andersen,I or any other written notice,or send a telegram to Contractor: Renewal by Andersen,
104 Otis St. Northborough,MA 01532,BY NOT LATER THAN MIDNIGHT OF I 104 Otis St.Northborough,MA 01532,BY NOT LATER THAN MIDNIGHT OF
8/23/14 .(Date) 1 HEREBY CANCEL THIS TRANSACTION. 8/23/14 .(Date) I HEREBY CANCEL THIS TRANSACTION.
I
Bayer's Signature Flint Name pate i Buyer§Signature RIM N— Dale
(Renewal Renewal by Andersen Corporation MA Home Improvement contractor
bAndersen. 104 Otis St. Northborough,MA 01532 License#170810 (Expires 12/23/2015)
WINDOW REPLACEMENT —And—G—Mnr (508)351-2200 Fax:(508)-986-7072 Federal ID#41-1918413
Window Specification Sheet
Buyer(s)Name Date of Agreement
JOYCE MACLARY DAVID MACLARY WED, AUG 20, 2014
The buyer(s)listed 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
AGREL'MENT,of which die Specification Sheet is part.
WINDOW DETAILS
Approx. ExteriorAntenor Color Hardware Hardware LowE4/ Grille Grllle Glass
Room # U.I. Window/Door Style Detail Casings
EM-lat Color Ste Screens Smartsun Grilles Sash 1/3 Sash 2 Lifts O Ions
Porch 1 104 New GW insert lafo NoWH/WH White Standard FFG 3martsur GBG 2/5 2/5 No No
Porch 4 116 New GW insert lafo NoWH/WH White Standard FFG 3martSur GBG 3/5 3/5 No No
Porch 2 93 New GW insert lafo No WHIM White Standard FFG 3martsur GBG 2/5 2/5 No No
Porch 1 32/80 FWH No WH/WH White Standard None ISmartSur None I ----- I ----- No No
Total 8 BAY&BOW DETAILS *See Ba /Bow Measure Sheet
Style Detail/ Approx.- Approx. Number Frame Window End Center LowE/ Roof/ Hardware
Room Count a Flankers U.I. Call s An le Lites Interior ExtAnt Color Grilles sashes sashes Screens Smartsun Soffit Color
SPECIALTY WINDOW DETAILS
Full/ Approx. LowE/ Specialty BAY/BOW ADDITIONAL WORK NOTES
Room Count a Insert U.I. Smartsun Grilles GrilleStyle Ext/bH Color Customer is aware that with bay/b—windows under 72 inches
there gill be si ifi—a glass lose.
ADDITIONAL WORK DETAILS:
I No Contractor will wrap exterior casings with coil stock color of
Owner is aware that Contractor does not do any painting/staining or removal/installation of alarm system or window treatments/hardware.It is the
responsibility of the homeowner to have the alarm system and window treatments/hardware removed prior to installation. We make no guarantee as to
2 whether alarms or window treatments/hardware will fit after replacement. Customer is also aware in some cases there will be glass loss. H 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 all unseen rot is not included in this contract.Should any rot be found there will be an additional charge for
time and materials unless so stated in this contract.
3 yes 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.
4 Yes Building Permit--Contractor will secure any and all necessary permits. The fee for the permft(s)is not included in the Contract Price and a separate
check is required at the time of sale for this fee. Check# 1651 $ 156
5 yes All discounts have been applied to this agreement.
5 (✓,. 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 REMODE.IJNG AGREEMENT constitutes the
entire understanding between the parties,and there are no verbal understandings changing or modifying any of the terms.This Specification Sheet may not be changed or its terms
modified or varied in any way unless such changes are in writing and signed by both the Buyer(s)and Contractor. Buyer(s)hereby acknowledge that Buyer(s)has read this Specification
Sheet.
Renewal by Andersen Corporation Buyer(s) I Buyer(s)
By
Signature of Project Manager Signature Signature
ROLAND PELLETIER JOYCE MACLARY DAVID MACLARY
Print Name of Project Manager Print Name Print Name
The Commonwealth of Massachusetts
4�-
Departme "of Industrial Accidents v
Office of Invesdgadons
' . +600 Washington Street
Bosion;'MA 02111
www massgov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
AppUcant In Please Print,Legibly
Mwe(Business/organintion/Individual): RGA(1 9—w C,\ j
Address:_ 3C-�) �or6s a�--
City/State/Zip: hone#: ,'�-R -
Are you an employer?Check the appropriate box:
Type°of project{required):
i..LJ'1 am a employer with 3J 4.'Q I am a general contractor and I
employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction,
2.Q I am a sole propri`e'tor or partner- listed on the attached sheet. 7. remodeling ..
ship and have no employees These sub-contractors have 8. Q Demolition
working forme in any capacity. employees and have workers'
comp.insurance.: 9. ❑Building addition
[No workers'comp.insurance p ,, „ .. 1.
required.] 5. Q We are a corporation and its 10.❑Electrical repairs or additions
3.[) 'I am a homeowner do'ili all work officer`s`have exercised their
g 11:Q Plumbing repairs or additions
myself [No workers'comp. rtgof exempio - eGL .< ,
insurance required.]t c 152, §1(4),and we have no 12.❑Roof repairs
einployees'[No workers' 13.[]Other.
' comp:insurance required.] Z -
*Any applicant that checks box#1 must also fill
out the sectio'n'below sho�vinn the�workers'`co' mak'
$ mpensation polrcy mfomtation.
t Homeowners who submit this affidavitindieatmg i6y are.doing all work and then hire outside contractors must-submit'a new affidavit indicating such.
(Contractors that check this boz must attached an additional sheet"showingthe°nauie of the sub-contractors and state whether of not those entities%ave
employees. If the sub-contractors have employees,they.must provide their,;workers'comp_policy.npmber
lam an employer that is providing workers'compensation insurance for my employees Below"`ir the policy and job site
information. (�
dlj\
Insurance Company Name: _ ,lc. ,n S ()
Policy#or Self-ins.Lic.#:_ tjs
..Expiration Date: 1 .
Job Site4Address: _ �S City/State/Zip: A 11.Jo j/ o--r,
Attach s 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.c'timinal 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. lie 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 cern i er palns and penalties of perjury`that the information p'r'ovided above is true and correct:
Si aturc. 1i�
Date:
Phone#:
Official use Wly. Do not Write in this area,to be Completed by city or town ofcial
City or Town: Permit/License#
Issuing Authority(circle one):
L Board of Health 2.Building(Department 3-City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone#:
A CERTIFICATE OF LIABILITY INSURANCE Deo 0/2013" '
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: N the certificate holder is an ADDITIONAL INSURED,the policy(les)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 1-612-333-3323 CONTACT
Hays Companies PHONE FAX,AIC No: 612-373-7270
80 South 8th Street EMAIL (
Suite 700 ADDRESS:
Minneapolis, MN 55402 INSURERS AFFORDING COVERAGE NAIC0
INSURERA:OLD REPUBLIC INS CO 24147
INSURED
Renewal By Andersen Corporation INSURER B:NAT3ONAL UNION FIRE INS CO OF PITTS 19445
INSURER C:
104 Otis Street INSURER D:
Northborough, MA 01532 INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: 36122490 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
LTR TYPE OF INSURANCE -Ab—DE 5 R POLICY EFF POLICY EXP
POLICY NUMBER MMIDD MMIDDYYI LIMBS
A GENERAL LIABILITY MNZY 300361 10/01/1 10/01/14 EACH OCCURRENCE $1,000,000
X COMMERCIAL GENERAL LIABILITY 500,000
PREMISES oxuce. $
CLAIMS-MADE O OCCUR Ea nen
MED EXP(Any onerson 10,000
Pe $
PERSONAL 8 ADV INJURY $1,000,000
GENERAL AGGREGATE $4,000,000
GENL AGGREGATE LIMIT APPLIES PER: . PRODUCTS-COMPIOP AGG $4,000,000
J,CTX POLICYF71 PRO- LOC
$
A AUTOMOBILE LIABILITY MWTB 300026 '10/01/11 07G1 14 COMBINED SINGLE LIMIT
(Ea.1dent 5,000,000
X ANY AUTO BODILY INJURY(Per person) $
ALL OWNED SCHEDULED
AUTOS AUTOS BODILY INJURY(Per accident) $NON-OWNED
111
HIRED AUTOS X AUTOS Pe�aaideMDAMAGE $
B X UMBRELLA UAB X $
OCCUR 20562235
10/01/1 10/01/14 EACH OCCURRENCE
EXCESS LU1B
E25,000,000
CLAIMS-MADE AGGREGATE $25,000,000
DED X RETEN1ION$25,000
WORKERS COMPENSATION $
A AND EMPLOYERS,LIABILITY YIN MNC 300359 00 10/O1/1 10/01/14 X WC STAITORY IMTII- OTH-
ANY CERMEETORIPARTNDEDXECUTNE E.L.EACH ACCIDENT $ 11000,000
(Mandatory
InN R EXCLUDED? a N/A
(Mandatory In NH) E.L.DISEASE-EA EMPLOYE $1,000,000
H d
s, scribe under
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000
i
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,N more space is required)
i
CERTIFICATE HOLDER CANCELLATION
I
i
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
To Whom It May Concern THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
For Insurance Purposes Only ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
C 1988-2010 ACORD CORPORATION. All rights reserved.
ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD
jhargrove
36122490
45.VM 'Matsachusefts Detpart '6ht'6f Public S fdty
;Board of 86iidi.ng Regulations and Stani7ard'f
Ccrnst:ruction Sti"n-isor
License: C8490125 = 'I
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JAIME L MQRW:`
a.
86 GARDINIIt S t e--
e
LYNN MA 019Q
Expiration
'toinmissioner 70/0672014
1
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SCA 1 % 20M-05/11
7/e�arivrn�.izu�ea�i o�C��uaeC�a
!rice of Consumer Affairs&Business Regulation
OME IMPROVEMENT CONTRACTOR
Registration 1T0810:
Expiration Type:
,12/23f�015 Supplement:
RENEWAL BY ANIJ ON° Q
s Ac RPORATION
,. :.:
JAIME MORIN
r 104 OTIS STREET
d NORTHBOROUGH,MA 01532
Undersecretary
I ecretary
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Andersen' NFRC Certified Total Unit Performance (conOtiteti)
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Andersen,Predict Class Type I U factor' l SHGCv VT` Andersen'ry " Glass Type U-factor' I SI1GCv V1' R3i
400 Series Architectural .
I IP Lmv E4 0.32 0.7.8 0.47
HP Low E4 U t• 0.35 • 0.60 _ .-- - "
HP Low-E4 will,Galles---0.28 0.31 0.54
H-P Irnv-E4 wittGrilles 0.32 015 0.42
r,' ,y.
HP Law-E4 Sun U.27 021 - 0.33 ;1 HP Lmv-E4 Sun 0.32 0.17 0.26 ala W
Circle Top _ casement Window LIP low-EM1 Sun with Grilles 0.32 0.16 0.23 ``)
Casement Window IlhLow-F4 Sun with Grilles U.7.9 0.19 0.30 - HP Low-Ell SmariSun. 0.31 0.18 042 ''
IIP 1nw;F4 SmartSun 0.26 0.23 0.54 'r k:1
•I HP Imo-E4 SmarlSun w/Grilles 0.28 0.21 .0.49 'I. HP Low-E4 Smar[Sun w/Grilles 0.2R 0.47
0.31 0.17 0.38 ?!
v
HP Lmv-E4 17.32 .
lip Low-E4 0.27 0.35 Wit) P'
- HP Invr-E4 with Grilles 0.32 025 0.42
IIP Low-F4 with Grilles) 0.28 0.31 0.54 K9
ITP Low- Sun 0.32 0.17 0.26
E4 ?.
IIP Law-E4 Sun 0.77 021 0.33 Fm i French Casement - -
Circle&Oval Window Window IIP Low-Ell Sun with Grilles 0.32 0.16 0.23 f s'
I IIP Low-E4 Sun with Grilles 0.29 0.19 0.30 ° ITP Low-E4 SmartSun 0.31 0.18 0.47. Vit!
till lore-F4 SmadSun 0.76 0_13 0 54 )!� '
HP Law-[4 SmarlSun vi/Grilles U.280.71 0.49 [? ,¢i� till Lmrr-E4 SmartSun w/Grilles 0.31 D.17 0.38 Q n
- tip Luv-E4 0.32 0.28 0.47
IIPLow-E4 0.28 0.33 0.58 R - Lj
a�+7 ITP Low-E4 with Grilles 0.32 015 0.42
IIP InwV Willi Grilles 0.29 0.30
lip Low-114 Sun 0.32 0.17 0.26
LIP Lbw-E4 Sim 0.28 0.20 0.31 hr.+i,( `? Awning Window
Arch Window { HP Lmrr-E4 Sun wit)Grilles 0.32 0.16 0.7.3 " ?
HP Lav-E4 Sun with Grilles 0.29 0.18 0.28
!IP Low-E4 SmarlSun 0.27 _ 0.7.3 0.52 a til i b HP Lmx-14 SmaHSun 0.31 0.18 0.42
ITP low-E4 SmartSun w/Crites 0.2R 021 0 46 F11 �'? - IIP Lmv-E4 SmatlSun tv/Grilles 0.31 0.17 -0.36 tit
flP Lmv-E4 0.31 0.32 0.55 �.c.
tip Law-E4 0.27 033 0.56 [e$
;,�� IIP lmw-E4 with Grilles 0.31 029 0.49
IIP Low-E4 with Grilles 0.28 0.30 0.57 _
till Low-E4 Sun 0.27 010 0.31 F l- Casemenl/Awning IIP Low-E4 Sun 0.31 020 U.31 i
- c Picture Windom ITP lmr-E4 Sun with Grilles 0.31 0.18 0.78
Flextrame"Wlodow '-- I„ _
IIP Lour-F4 Sun with Grilles U.29 O.1A 0.28 Hp Lmx-E4 SmartSnn 0.31 011 0.50 'M
--- ftp Low-E4 SanartSun 0.26 013 0.57 u ''' ? _ -
I-
HP Low-E4 SmartSun w/Galles 0.28 021 0.46 ,.T HP Low-E4 SnmftSun w/Grilles 0.31 U.19
IIP Low-E4 0_.31 0.33 0.58 HP Lavr-F4 0 64
0.30 0.37
IIP Low-F4 with Grilles 0.32 030 0.57 lip Lour-E4 wilh Grilles 0.30 0.33 _o.r,7 E
-IIP Law-E4 Sun 0.31. 02U 0.3 `� _ IIP Lmv-114 Sun 0.31 022 0 36
Specialty Window. IIP Law-E4 Sun wit)Grilles 0.31 0.20 0.32 r�
Springline Window -- - -
IIP Lmv-L4'.Sun with Grilles 0.33 0.18: 028 k HP Lin-FM1 SmarlSun 0.30 024 U.58 M)
IIP Low-E4 SmaaSun 0.30 0.23 0.52 t f ?;+�
P Law-E4 SmartSun yr/Grilles 0.32 011 U.46 B,;i;? s 1 Q3 tip Imr-E4 Smartsun w/Grilhs 0.30 0.72 o.52 DR In
II
HP Unv-E4 U.30 0.27 0.45 F� 4 IIP I.m'7-EM1 0.32 022 0 37 .F-'r)
Ivry ITP Law-E4 with Grilles 0.33 01.0 0.33
IIP Luw-E4 with Galles 0.37. 023 U.39 � - ILP Low-E4 Sun 0.33 0.14 0.21 -
Frencihwood' HP Law-E4 Sun 0.31 0.16_0.25 Pdhi 1.•i Hinged Inswing -
French Door IIP lmr-E4 Sun vath Grilles 0.34 0.13 0.18
Gliding Patio Door IIP Law-E4 Sun wittGrilles 0.32 0.14 0.22 M F`1 - fIP Lmv-E4 SmariSun 0.32
IIP Low-E4 SmadSun 0.30 0.18 U.41 &)y 4''I M _
I1P Lmn-E4 SmaaSun vi/Galles. 0.31 0.16 0.35 r'! HP Low-E4 SmartSun w/Grilles 0.33 0.14 0.30 g
tipimv-E4 0.33 025 0.41 me
tip Lew-F4 0.31 U.24 0.41. 1<i EI -
IIP Low-114 will Grilles 0.32 0.71 0.35 19� it>? I IT,Low-E4 with Galles 0.34 0.72 0.36
tip Lmw-F4 Sun 0.33 0.16 0.23 a
Frenclhureod'!tinged ! - lip Lmv-EM1 S_un 0.31 0.15 0.23 k'.i� F1 rF dinged Outswing _
O
InswingPatio Door e' ? - FrencliDoor
ITP Law-E4 Sun with Grilles 0.35 0.14 0.20 -:ce+a
I ITP Low-E4 Sun with Grilles 0.32 0.13 0.19 i IIP Low-E4 SmartSun 0.37 0.17 0.37 ) ;Tj Q1 f6+'
c�
IIP low-E4 SmartSun 0.30 0.16 0.37 § (•6�u? _
tip Law-E4 SrnortSun w/Galles 0.31 0.14 0.31 HP Lour-E4 SmadSun w/Grilles 0.34 0.15 0.32 - o
HP Low-E4 0.31 01.5 0.41. E I in,Low-E4 0.33 023 0.38 - ��
HP Low-E4 with Grilles 0.33 021 0.34
IIP Law-E4 with Grilles 0.32 021 0.35 I'M fl 1' -- -
_
'� Fixed, Door- lip Low-E4 Sun 0.33 0.14 0.21
Frenchwaod'Hingoit- I IIP Loi-Ell Shin 0.31 0.15 -E
U.23 RIs - - _
eutswing Pelfc Door.' UP Lme-F4 Sun with Grilles 0.37 0.13 0.19--0111 li Fla Sidelight HP Lmn-E4 Sun with Grilles 0.34 0.13 0.19 0.15 0.34 -
ITP Lmrr-E4 SmartSun 0.37.
HP Low-E4 SmarlSun 0.30 0.17 0.37 M T P1_
HP Lmn-E4 SrnmLSun w/Grilles 0.33 0.14 0.30 -
lip Low-E4 SlnarlSun w/Galles 0.31 0.15 0.31 (' L"� HP Irnv-E4 0.32 025 0.41 -
lip Low-E4 0.31 0.72 0.37
lip Lour-E4 with Grilles 0.33 0.72 0.37 -
HP Low-E4 with Grilles 0.37. 0.20 0.330 _
t;,, IIP Low-E4 0.32 0.15 0.23
Frenchwood':''
tip Lavr-E4 Sun 0.32 0.14 0.71 Uri Fixed ch Door
: .
French Door IIP low-E4 Sun with Guiles 0.33 0.14 0.20
Patio Door Sidelight HP Low-E4 Sun with Grilles 0.32 0.13 0.18-Mill _
.. - � pfis ITP Law
SmartSun 0:37 0.16 0.37
lipLnw-E4 SmartSun 0.31 0.15 0.33 �l� _
Ti: HP Lmw-E4 SmdSun w/Gfilles 0.32 0.15 0.33
IIP Lavr FA Smartsun w/Grilles 0.32 0.14 0.79 ?M 0 016 0.44 -
i'I i - till Low-E4 0.35
HP Lmv-F4 0.30 0.74 U 40 -
tip Low-E4 with Grilles 036 013 0.38 -
IIP Law-E4 with Grilles 0.30 0.21 0.35 (' "'t 01 �_ --
lip
-
------ r{i s"( - ITP Low-E4Sun 0.35 0.16_014 -
Frenchwood• !Tp Low-E4 Sun 0.30 015_0.7.7 {+• Folding Door- -
-' - �?.0 tIP Lmrr-F4 Sun wish Grilles 0.36 0.14 0.21
Patio Door Transom I It,Low-E4 Sun with Grilles 0.31 0.13 0.7.D )x"9
HP Low-E4 SmartSun 0.29 0.16 0.3 6 id7(` `' 11P Inty-E4 SnmrlSmh 0.34 0.17 0.39 -
IIP Lov+-E4 SmartSun w/Grilles 0.3U 0.14 0.32 aV1.l x9`� - HP Lnw-E4 SmarlSun w/Grilles 0.36 0.15 0.34 -
congmred on next page
Far NFRC certified total unit performance on units with capillary breather tubes for high altitudes,please visit andersemvindows.cul
••Iligh-Performance'Law-F4-"(IIP Law-E4),'fligh-Perfannance"Levi-E?SmartSun""(HP Low-F4 SmartSun)and•Iligh-Performance"Law-FM1•Sun"(Hp Low-F4 Sun)are Andersen trademarks for'Low-E'glass.
' U-Factor defines the amount or heat less through the total unit in RIH/hr sq.f[.°F.Tire lovrerffie value,the less boat is lust through the entire product Window values represent novo-tempered glass.Use of tempered glass can
increase 11-Factor ratings.See andersenwindows.cnm for specific perrormanre values.Doorvalues representtempered glass.
the lass both directly transmitted and absorbed and subsequently released inward_The lower the value,the less heat is transmitted
'Solar IteaLGain Coefficient(SHGC)rlefines the fraction of solar radiation admitted through g
through the product-
'Visible Transmittance(VT)measures haw much light comes through a product(glass and fmme).The higher the value,from 0 to 1,the more daylightthe product lets fn aver the product's total unit area.Visible Transmittance
is measurer)over file 380 to 760 m r meter portion of tine snlaf speclmm.
•NFRC ratings are based an modeling by a third party agency as validated by an hidependent test lab in compliance with NFRC program and procedure[requirements.
•This data is aucmhate as aF December 7.010.Due to ongoing product changes,updated test results or new industry standards or requirements,this dam may change over time.Ratings are for sizes specified by NFRC for
testing and certification.Ratings shay vary depending on use of tempered glass,different grille aptons,glass far high altitudes,ate.
Pas'Nesun"glass values are available online at andersenwindows.com.
277
PRODUCT PERFORMANCE
Andersen*NRC Certified iorei Unit Performance (continuer,)
JI.
' Andersen'3roduct Glass Type 1-1-Factor' SHGC' VP
200 Series.
1 Clear Dual Pane 10.45 -0-60 0.53 -
Clear Dual Pane,.ft Grilles 0.45 0-54 0.56 -
Tilt,wnsh Law-E 0.30 0.32 0.55
Dauble-HungrWindow- Lnw-E with Grilles 0.30 029 0.49
HP Lav-E4 SmartSun 0.30 021 0.49 1
HP Lav R SmartSun w/Grilles 0.31 019 0.43 ;
Clear Dual Pane 0.45 0.61 0.64 -
Narralihe"- .. Clear Dual Pane with Grilles 0.45 054 0.57 -
Double-Hung"Window Low-E 0.30 0.32 0.56
Lmv-E with Grilles 0.31 029 0.50
Clear Dual Pane 0.44 OM 0.66 -
Narration' Clear Dual Pane with Galles 0.44 0.57 0.59 -
Traosom Window Low-E 0.27 034 058
Law-E with Grilles 027 030 0.52 5 'J'
- Clear Dual Pane 0.45 0.60 0.63 -
Clear Dual Pane wlh Grilles 0.45 0.54 . 0.56 -
'" - Law{ 0.30 032 0.55
Gliding Window
Low-E wilb Grilles 0.30 029 0.49
'-
Low-E SmartSun 0.30 021 0.49
Lrn-E SmartSun with Grilles 0.31 0.19 0.43
Clear Dual Pane 0.43 0.61 0.65 -
._ Clear Dual Pane vath Galles 0.43 0.55 0.58 -
P&ed;Transom;, Lnw-E 028 0.33 0.56 5
Chale Tap"Wind'ow Low-E with Grilles 0.28 0.30 0.50 EZI `1
Lmv-E SmartSun 027 022 0.51 El 3
Low-E SmartSun with Grilles 027 020 0.45
Clear Dual Pane 0.44 0.61 0.64 -
Clear Dual Pane%,AM Galles 0.45 0.53 0.56 -
Low-E 0.29 032 0.56 -
Narrutine' Low-Ewith Galles 0.30 029 0.49
Gliding Patio Doars Law-E Son 029 020 0.31 ��'
Low-E Sun with Grilles 0.31 0.18 027, a3
law-E SmartSun 0.28 021 0.50 J
Lm,tiE SmartSun with Galles 0.30 0.19 0.44
.-- - Clear Dual Pane 0.43 0.61 0.64 -
Clear Dual Pane with Grilles 0.43 054 0.56 -
Lnw-E 02.8 0.32 0.56 -
Perma-Shield'. Luxv-E with Galles 0.30 029 0.49 :tri
Gliding Patio Doors. Lmy-E Sun 0.29 0.19 030
Law£Sun with Galles 0.30 0.17 027
Lmv-E SmartSun 027 022 0.50 '��•
Lmv-E SmanSun with Grilles 029 0-19 0.44
Clear Dual Pane 0.43 0.45 0.47 -
- Clear Dual Pane with Grilles 0.43 0.39 0.40 -
Lmv-E 0.32 024 0.41
Hinged.lnswing Low-E with Grilles 0.33 021 0.35 -
;Patio DonrsLaw-E Sun 0.32 0.15 023
Lmv-E Sun with Grilles 0.34 0.13 0.19 -
Low-E SmartSun 032 0.16 0.371-.,J'
- - Low-E SmarlSun wish Galles 0.33 0-14 0.31 -
GLF
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