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HomeMy WebLinkAboutBuilding Permit #003-2011 - 180 MARBLERIDGE ROAD 7/1/2011 I TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit N0: 00-3— Date Received Date Issued: ?k(61 IMPORTANT:Applicant must complete all items on this page fl LOCATION 0 (� f-r( D A i�nnt .' PROPERTY OWNER t (�� O- 0 ,P?r t Print- MAP NO:—3�-PARCEL. ZONING DISTRICT: Historic District yes no !Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition Two or more family Industrial Alteration No. of units: Commercial Repair place Assessory Bldg Others: Demo Other Septic Well Floodplain Wetlands Watershed District Water/Sewer DESCRIPTION OF WO K TO BE PERFORMED: e4G i n 0 t�./ Identification Please Type or Print Clearly) OWNER: Name: !D Phone: s-0 - 0 Address: r CONTRACTOR Name; ( /1-i-j � r 11�C� Phone: J46,F: ( S -C276 Address Supervisor's Construction License: Exp. Date: t Home Improvement License: J -(�(,G( Exp. Date; ! �- ARCH ITECT/ENGINEER Phone: f Address: Reg. No. FEE SCHEDULE:BOLDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. O� Total Project Cost: $ 71 FEE: $ Check No.: LO 1-73 Receipt No.: a �l NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fun Signature of Agent/Owner Signature of contractor 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 ❑ 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 submitted with the building application Doc: Doc.Building Permit Revised 2008 Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL Public.Sewer Tanning/Massage/Body Art Swimming Pools Well Tobacco Sales Food Packaging/Sales Private(septic tank,etc. Permanent Dumpster on Site THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM t 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 Decision/receipt submitted yes -� Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature& Date Driveway Permit ,1 DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT --Temp Dumpster on site 'yes - no Located at 124 Main Street Fire Department signature/date COMMENTS .° Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— (For department use i i i i ❑ Notified for pickup - Date i Doc:.Building Permit Revised 2008 / r � Location No. 0 0 3 - a 6 Date NORTH TOWN OF NORTH ANDOVER F 9 Certificate of Occupancy $ ,SSA�HUSEt Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 7.3 23041 Building Inspector � ORTH T0 0 _- 5Andover 0 71Im No.-##,3 q /® _Rt -oLAKE dower, Mass., / COCKICKEWICK 7�SDRATED PP�,`�� BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR �Cl THISCERTIFIES THAT............................✓`1............ . ........................1.5 Af.................................................................................... Foundation has permission to erect......................................... buildings on ...Z?d..... 1.�i.f. .�'v �� ...` .............. Rough �,� 4G �.° Chimney to be occupied as......................... ...��...�......./Y�.......�.^�.���s�..............................:..................................... provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations-Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION S ARTS Rough / -s-e— Service ............................................... ................................... BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the- Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner. Street No. SEE REVERSE SIDE Smoke Det. 104 Otis St.,Northborough,NRA 01532 JU WINDOWS,INC.,D/B/A MA Home Improvement Contractor (308)919-0900•Fax:(774)987-3013 RenewalLicense#149601 (Expires 1/24/2012) Was,- Federal Tax ID#83-0404201 byAndelsen. WINDOW REPLACEMENT a Andra Company CUSTOM WINDOW AND DOOR REMODELING AGREEMENT Buyer(s)Name Date of AgreqAert Buyer(s)Street Address,City,Stat,and Zip Code E-Mail Address v Home Telephone Number Work Telephone Number Buyer(s)hereby jointly and severally agrees to purchase the products and/or services of J&L Windows,Inc.d/b/a Renewal by Andersen ("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. / Method of Pymnt:0 Cash 0 Check Mastercard ❑VISA Total Job Amount:lfj � Estimated Staving Date: - ❑Discover ❑Financed,App#: Deposit Received(33%): t= . / Nto Name on Credit Card: ,�P' `f f��r f��n l(,•('�•�. Balance at Start of Job(33%): r' Estimated Com letion Date: f/ Credit Card#: Balance on Substantial Completion of Job(33%): `�1 J' CC Exp.Date: CC Security Code: By initialing here,you acknowledge that the Balance at Start of Job and the Balance on Substantial Completion Buyer Initialt� M6of Job cannot be made by credit card and must be made by personal check,bank check,or cash. Buyer(s) agrees and understands that this Agreement constitutes the entire understanding between the parties,and that there are no verbal understandings changing or modifying any of the terms of this Agreement.No alteration to or deviation from this Agreement will be valid without the signed,written consent of both Buyer(s) and Contractor.Buyer(s) hereby acknowledges that Buyer(s) 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. J&L Windows,Inc.d/b/a Renewal by Andersen Buyer(s) Buyer(s) r By: Siggnat of Pr ct Manager w Signature J�n Signature �I`r/'��. �/� ���� 1 i e�� �i ����{.;ir�"1�✓// `i�'���jl�i�/u 1. �C��'s''r� Print Name of Product Manager Print Name Print Name T 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. -— — — — — — — — — — — —. — —�<- — — — — — — — — — — — — — -:,c— — — — — — — — — — — — — — NOTICE OF/CA CELLATION I NOTICE F N"ELLATION Date of Transaction '� u�+TE . You may cancel Date of Transaction Y . You may cancel this transaction,with any penalty or obligation,within 1 this transaction,witho t" y penalty or obligation,within If ou cancel an 1 three business days from the above date.If you cancel,any from the above date. ay three business days Y Y property traded,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 Seller at your residence,in substantially as good condition as when received, any goods delivered to you under 1 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 1 the goods available to the Seller-and the Seller does not Seller does not ick them u within 20 days of the date pick them u within 20 days of the date of our Notice P P � y of your Notice of Cancellation,you may retain or dispose 1 of Cancellation,you may retain or dispose of the goods of the goods without any further obligation.If you fail to without any further obligation. If you fail to make the make the goods available to the Seller, or if you agree Fds available to the Seller,or if you agree to return the to.return the goods to the Seller and fail to do so, then ds to the Seller and fail to do so,then you remain liable you remain liable for performance of all obligations under 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 srgtied and dated copy of this cancellation notice or any 1 dated copy of this-cancellation notice or any other written other written notice,or send a telegram to Contractor:J I notice,or send a telegram to Contractor.J&L Windows, &L Windows,Inc.d/b/a Renewal by Andersen,104 Otis 1 Inc. d/b/a Renews by Andersen, 104 Otis Street, Street, Northborou h, 01532, BY NOT LATER THAN NorHrjborbugh MA 01532,BY NOT LATER THAN MIDNIGHT MIDNIGHT OF �- .r *�!/. .(Date) OF .5 G ?% .(Date) I HEREBY CANCE THI TRANSACTION. i 1 HERE Y CANCEL THIS TRANSACTION. Buyer's Signature Date I Buyer's Signature Date RbA Copy- White Buyer Copy-Yellow Buyer Copy-Pink I -- 104 Otis Street,Northborough,MA 01532 MA HIC License#149601(expires 1/24/12) J&L Windows,Inc.d/b/a Phone 508.919.0900•Fax 774.987.3013 Renewal I - Federal Tax ID# 83-0404201 byAndersen. WINDOW REPLACEMENT an Andersen Company OF GREATER MAssACHUs=AND NEw HAMPSHIRE WINDOW SPECIFICATION SHEEP Buyer(s)Name Date o Agreement 176,77 The Buyer(s)listed dbove herebyjointly and severally agree to purchase the goods and/or services listed low m 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 DETAILS 1. Co tractor will Install a total of windows in Owner's home,using the following individual quantities: a Double Hung(DB) Equal sash ❑ Cottage sash(1/3 top,2/3 bottom) ❑ Oriel sash(2/3 top.1/3 bottom) _—L, Casement(CW) ❑ Hinge right ❑ Hinge left(as viewed from exterior): ❑ Standard handle❑ Metro handle �— Double Casement(CDW) ❑ Standard handle ❑ Metro handle Casement/Picture/Casement(CFW) ❑ 1:1:1 or ❑ 1:2:1 ❑ Standard handle ❑ Metro handle d 2 Lite Gliding Window(GW) Glider/Picture/Glider(GFW) ❑ 1:1:1 or ❑ 1:2:1 i Awning Window(AW) Picture Window(FW) Bay or Bow Window Patio Doors(see separate Door Specification Sheet) 2. [ff Yes ❑ No Qty of Windows to be Custom Fit Replacement: 3. ❑ Yes [A No Qty of Sills to be replaced by Contractor: 4. ❑ Yes ©No Qty of Windows to be New Construction Full frame(includes new interior&exterior casings) Exterior casings: ❑ Pine ❑ Maintenance-free material ❑ Factory applied 908 Fibrex brickmold 5. Glazing to be: [] HP Low-E®SmartSunTM (Tax(aeditE!/grble) ❑ Other If other,please specify: 6. Exterior color to be: EZ White ❑ Sand ❑ Canvas ❑ Terratone ❑ Cocoa Bean 7. Interior color to be: R White ❑ Sand ❑ Canvas ❑ Terratone ❑ Pine ❑ Maple ❑ Oak Note: Interior color can only be white,wood or same color as exterior. Wood interiors need to finished by Owner. 8. Hardware: E� White ❑ Stone ❑ Canvas ❑ Brass ❑ Estate Hardware: Style: 9. ❑ Yes [?No Install Lifts with Double Hung Windows 10. Screens: windows to have: ❑ Half or [a Full screens Screens to be: Fiberglass PIAluminum ❑ TruScene DETAIIS 11.Windows have grilles: 0,Yes ❑ No If ye GrilleBetween _ Removable Interior Wood aNrw)❑ Full Divided Light(FDL) 117 Qty: Qty: Qty: Qty: Qty: Qty: Qty: ME DH DH DH 11:1 - er CPW or G PIA Draw grille patterns above 'Use additional sheet if needed Owner approved(initials. c� ADDMONAL WORK DLTAIIS 12.❑ Yes allo Contractor will remove metal frames of windows. Qty of Units: 13.❑ Yes No Contractor will install new paint-ready or stain-ready casings. Intenor casing qty of openings: Exterior casings qty of openings: ❑ Pine ❑ Maintenance-free material 14.❑ Yes [Z No Contractor will install new paint-ready or stain-ready inside or outside stops qty of openings: Interior stops qty of openings: Exterior stops qty of�o}�enings: F-1 Pine E] Maintenance-free material 15. Owner is aware that Contractor does not do any paintitlg, mm 1 Owner Initials 16.❑ Yes,V No Contractor will wrap exterior casings with aluminum coil stock of color. Note: Wrapping may be required with storm window removal;removal of storm windows will leave screw holes in casing. 17. Yes ❑ No Contractor will insulate,caulk and seal windows with 3-point system to prevent water and air infiltration. 18. Yes ❑ No A limited warranty shall be issued to Owner upon completion of the job and payment in full. 196? Yes ❑ No Building Permit--Contractor will secure any and all necessary permits..The fee for the permit(s)is not qq included in the Contract Price and a separ chQ�k is req)ure I t th tim�of sale for tl�Wee. k 20, dditional job details v' /n! d 21.0 Yes ❑ No Owner agrees to be present on the final day of installation for final inspection and to deliver final payment. No final payment shall be demanded until the contract is completed to the satisfaction of all parties. It is agreed and understood by and between the parties that this Specification Sheet,along with the CUSTOM WINDOW AND DOOR REMODELING AGREEMENT,constitutes the entire understanding between the parties,and there 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 of Greater MA and NH Buy r(s) Buyer(s) 1W V Signaft of Product Manager Signature , Signature r sli-/ l a"'r- Print Name of Product Manager Print Name Print Name Tlie C'oinmonlvealtli of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Y www.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Naive(Business/Organizadon/Individual): l 1 ChG�lJ&I �By�11 r�1 ers eY1 .Address: 10,q Qjt` S City/Sfa.&Zip: /Vo � bo l'o�, Phone#: ('�) qv-000 Are you an employer?Check the appropriate box: Type of project (required): 1.Ek am a employer with 0 4• ❑'1 am a general contractor and I 6• []New construction employees(full and/or part-time).* have hired the sub-contractors listed on the attached sheet # ? modeling 2.0 I am a sole proprietor or partner- . ship and have no employees These-sub-contractors have S. Demolition working for me in any capacity. workers' comp.insurance. 9• Building addition [No workers'comp,insurance 5. ❑ Weare a corporation and its 10.❑Electrical repairs or additions. required.]. officers have exercised their 3:❑ I am a homeowner doing all work right of exemption per MGL _ 11.❑Plumbing repairs or additions myself[No workers'comp. c.152,§.1(4),and we have no 12.0 Roof repairs insurance required.]t employees..[No workers' HE Other . comp.insurance required.] *Any applicant that checks boz .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. 1Contractors that check this box must attached an additional sheet showing the name of the sub-contactors and their workers'comp.policy information. I a►n an employer that is providing workers'compensation insurance for my employees Below.is the policy and job site information. nnnn Insurance Company Name: � ' ? /rl(' f),--o r,-p— LS l�c Policy#or Self-ins,Lic.#: �v/ (������'�`1'`f 7(� Expiration Date: � . Job Site Address: L-35a City/State/Zip: � NQCklII:;i� - Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration da e). 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby cer u er the pains and penalties of perjury that the information provided Boyce i true\and correct e• Date: b��V Stanatur . Phone#• /� �'J U F - Official use only. Do not write in this area,to be completed by city or town officiaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5•Plumbing Inspector 6.Other Contact Person: Phone M . i ' I •;�:�n•.ax;ct�;�}•�,q•, xlfLB'f001fYyltdltClIECLLUL nt�/l�(,ad6� _ . Board of Bmlding$egulatipm and Standards _ Construction•supervisarLicense.t-,,, 4. LIcEn. "se;'CS •95707 • i •. �• . Birtliii�ae��31871982 '� . Trd 95707 it. •:= f • �. p�raii'on`:=7812Q�0 �• f.01 ENRON BRIAN DENNISO . �Tr 1 86 CREST CIRCLE :i ^uyr WORCESTER,MA 0 OT— . Coln4ssioner; . '.. .....,•t1.c1 �lu'�onrmca�u�edl!!o�.�aeaar/uaeti~a ' Olree of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registratior>�49001 Expira 12 Tie nt Card RENEWAL BY - i �+ BRIAN DENNIS � � 104 OTIS STREE'[ , /o . NORTHBOROUGH,"�tV `0_� 2 Undersecretary ACC)RD. CERTIFICATE 01= LIABILITY INSURANCE °0ii0/2 01 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Joseph McKeone ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR JP McKeone Insurance Agency, Inc. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O. Box 333 Ann Arbor, MI 46106-0333 INSURERS AFFORDING COVERAGE NAIC# ENSURED Renewal by Andersen INSURERA: Hartford Insurance an J and L Windows,Inc. INSURER 0: Nautilus 104 Otis St INSURER C: _ Northborough,MA 01532 INSURERD: INSURER E: COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED.BY PAID CLAIMS. WSR DL POLICYNUMBER POLICY EFFECTIVE POLICYEXPIRATON OMITS I TR NqRQ TYPE OF INSURANCE B GENERALUASIIJTY NC958461 10/01/2009 10/01/2010 EACH OCCURRENCE S 1.000.000 COMMERCIAL GENERAL LIABILITY PREMISES So"1 S 100.000 CLAIMS MADE FJ OCCUR MED EXP(Any one parson) S 5,0. 00 PERSONAL&ADV INJURY S 1,000,000 GENERAL AGGREGATE S 2,000,000 VGE?rLCPL.iATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG S 2.000.0000 _ POLICY PRO LOC A I AUTOMOBILELIABILITY 35MCC XD 6390 10/01/2009 10/01/2010 COMBINED SINGLE LIMIT S 1,000,000_ (Eo acadent) ANY AUTO X ALL OWNED AUTOS BODILY INJURY S (Per Person) SCHEDULED AUTOS HIRED AUTOS BODILY INJURY S (Por amdenq NON-OWNED AUTO — ' I PROPERTY DAMAGE S (Par Sedan/ OARAOE LIABILITY ALTO ONLY-E:AACCIDENT S _ ANY AUTO OTHER THAN EA ACC S AUTOONLY: AGO S EXCESSNMBRELLALABILITY EACH OCCURRENCE S OCCUR CLAIMS MADE AGGREGATE i ' S DEDUCTIBLE S RETENTION S' 0TH• A WORKERS-COMPENSAnONAND 35 WECPP 1444 02/17/2010 02/17/2011 wCSTATU• EMPLOYERS'LJAMUTY E.L.EACH ACCIDENT S 500.00.0 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFtCERUdEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE S 500,000 It yyet.destxtbo under E.L.DISEASE-POLICY LIMB S 500.000 SPECLAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION INSURED COPY DATE THEREOF,THE ISSUING INSURER MnLL ENDEAVOR TO MAIL 1D DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESE NTAT VES. AUTHORIZED REPRESENTATIVE C/j1', ACORD CORPORATION 1908 w�. ACORD 25(2001108) 7/7/i�/�/L/ © j I Renewal byAndersena WINDOW REPLACEMENT AnMdersanCompany Wood/Vinyl Composite IF iksi st��s;x>:; Dual Argon Low E4 StnartSun Double Hung 100-00473518-010 ENERGY PERFORMANCE RATINGS U-Factor(U.S)/I-P Solar Heat Gain Coefficient 019 0 . 19 . 1 I ADDITIONAL PERFORMANCE RATINGS Visible Transmittance 0 . 42 Manufacturerstipulates that these ratingsconform to app"ble NFRC procedures for determining whole product performance.NFNC ratings are determined for a feed set of environmental conditions and a speci c product size. NFAC does not recommend any product and does not warrant the sulandey of any product for any Specilir,use. Consul manufacturer's literature for other product pedomance information. - www.nfre.org -P- This product meats Green y seal's environmental casae 7 'x '�"•'AA 3 standards goveming energy +mow ��,"*••..;' r"�'i,'"''.t�S*� efrciancy,heavy metals in r"`•-••i r �..,�••,. 1r, •� •',the trams and sash ® k"'%�':'i '.crs•••,*%+� r L'amatareA packaging,and t::;iri,.f•},:v f.�y..,: (> consumer educational V, Gtr matar6ls. usrR.0 .. r. ......•..... DESIGN PRESSURE(PSF) , ,e wnaaw aia or ' _LC25 nnnufacsuers pasocatnn www.wdma.coro RbA DB Sloped Sill DH TN ` TeslaalolMFsfl2ar AAMAAWMAICSAlOIAsfAat00S klwxftclrrr Alt tes mnfermance to tnea licahfa snn0ards. chats or exceeds M.E.C.,C.E.C,H I.E.C.C.Air InNitration requirements WCMA Hapmark Cenircation Program. I