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Building Permit #445-11 - 185 BRIDGES LANE 11/24/2000
TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION � Date Received .lf'�.;��;�:3•v t Permit NO: , Date Issued: IMPORTANT:A licant must com Tete all itemson this age _LOCATION S POA til Ee; Print PROPERTY OWNER 9 A<44 6,/ft_d- Print MAP NO:�PARCEL: '-'ZONING DISTRICT: Historic District yes o Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Resigetial Non- Residential ❑ New Building One family ❑Addition ❑Two or more family ❑ Industrial ❑ eration No. of units: ❑ Commercial epair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other j - a-hsrtwa,- p..--- *. :_. ✓ai- •, ". .- -i k N- __,E`'.er_,Y `� ..x,-.a+.3' T �K'x_S; f ®9Flood lain ®Wetlands � ,D WatershedtDlstf - ® Se tic ❑Well _� - per; d� ,� c� � P�. . y. � « �S,.r' tri`1 q 'r" F -ef' ''err 'r tWater/Sewer ,� _ z _ _ _ - DESCRIPTION OF WORK TO BE PERFORMED: Al Identification Please Type or Print Clearly) OWNER: Name: 4 J29 Z A tV Phone:5 8"J"-7 Address g �i�t�C �� Iy• 1�/I/�� 1� � � CONTRACTOR Name: I IIAo 20y__ 41/� C'd enF�A4rr2�4Phone: 201 2-- Y96�5' Address: I Supervisor's Construction License: / 0, 5 q 7 ? Exp. Date: 2-- 15 _ 2-6 1 Home Improvement License: j ( C) Exp. Date: a �-- ARCH ITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT.$12.00 PER$9000.00 OF THE TOTAL ESTIMATED COSTBASED ON$125.00 PER S.F. Total Project Cost/:I$ ` G e d FEE: $ W1 Check No.: 10 Receipt No.: 41— NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner;: - . ;_Signature:ofcontracto -j Location Date Of .MORr" �� . ' - - • °� NOF NORTH SOV AN � .. ;s ertificate of J4CMUSEtr OccVAanc Building/Frame Permit Y Fee Foundation Permit Fee - Other p $ Permit Fee TOTAL $ ji check # I(1 6Q $. 237x8 Building Inspector Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ [Well YPE OF SEWERAGE DISPOSAL blic Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑ ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/signature&Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT -Temp Dumpster on site yes no Located at 124 Main Street Fire Department signatuge/date COAIM ENTS 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 El Notified for pickup - Date Doc:.Building Permit Revised 2008 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 Permi 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 o 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 i 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 se p d 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 40TE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit a all cases if a variance or special permit was required the Town Clerks office must stamp'the decision from the Board of Appeals iat the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording lust be submitted with the building application Doe: Doe-Building permit Revised 2008mi I -arc..-oRa� OP ID' CERTIFICATE `n OF LIABILITY INSURANCE 7DATE(MM/DDfffnrM THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOL ER.I 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: If the certificate holder Is=ADDITIONAL INSURED, th the terms and conditions of the policy,certaie policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to n 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 336-272-7161 NTACT Senn Dunn-GSO NAME: Karen K. Ro stet CIC 3625 N.Elm St. 336-346-1397 P"ONE .336-272-7161 E�nAIL F c Ne:336-346-1397 P O Box 9375 AD kro ter seltndunn-com Greensboro,INC 27429-0375 PRODUC WINDO-2 INSURED Window World of Boston,LLC INSURER 9 AFFORDING COVERAGE NAIC R 118 Shaver Street IN$URERA:HanoVer American Insurance Co 36064 North Wilkesboro,INC 28659 INSURER g; INSURER C: INSURER D: rNeURER E COVERAGES CERTIFICATE NUMBER: THIS IS TO CERTIFY THAT THEPOLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED ENAM O ABO)MBEOR 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 nDC TYPE OF INSURANCEIN-RD-Mmb OLIa R POLI EFF PO EKP GENERAL LIAUILnY LIMITS A X COMMERCIAL GENERAL�wBILfIY X EACH OCCURRENCE: $ 1,000,00 OZR7902527 04/07/10 04/01/11 pREM15 E sacunrnc S 300,00 CLAIMS-MADE OCCUR MED EXP(Any one a yp�) $ 5,00 PERSONAL&ADV INJURY $ 1,000,00 GENERALAGGREGATE $ 2,000,00 GENT_AGGREGATE LIMIT APPLIES PER: POLICY PRO- LOC PRODUCTS-COMP/OPAGG $ 2,000,00 AUTOMOBILE LIABILITY $ AhIYAIJTO COMBINED SINGLE LIMIT $ (Ea accidM ALLOWNEDAUTOS BODILYI $ SCHEDULED AUTOS BODILYI $HIREDAUTOS PROPER(Peraccid $NONdWNEDAE,f1'OSUMBRELLAUAB X OCCURA XEXCESSLIABCLAIM8-MADEEACH OC1,000,00 DEDucnsLE OZR7902527 04/01/10 04/01/11 AGGREGATE $ 11000100 RE tMON S WORKERS COMPENSATION $ AND EMPLOYERS,LIABILITY Y N WCS A OTIq- ANY PROPRIE70R/PARTNER/EXECthnrE RY IM q ON/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCI.UDED? (Mandatory In NM rbIRS-GRIPTION sdescribe under E.L DISEASE•EA EMPLOYE $ CRIPTIONOF PERATIONEL.DISEASE-POLICY LIMP(OP OPERATIONS/LOCA71ONS I VEHICLES(Attach ACORD 101,Additional Remake Sthedula,ti'more Space Is roqulrotl) CERT FICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEPORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN North Andover Town Hall ACCORDANCE WITH THE POLICY PROVISION& 120 Main Street 'I North Andover,MA 01845 AUTHORIZED REPRESENTATIVE ACORD 25(2009/09) 83-2009 ACORD CORPORATION. All rights reserved. The ACORD name and 1090 are registered marks Of ACORD i NO Id Wb 88 :80 03M 01H-VZ-AON TM - Window World of Boston MA HIC Registration 24 Cummings Park, Suite 15A Number: Woburn, MA 01801 166025 V\6 (781) 932-4805 • Fax: (781) 932-4828 Federal ID# www.windowworldofboston.com 27-1481665 "Simply the Best for Less .. c Customer: d �'odi �Ovfs �V(j 8 A-(\ Phone (h) 6-6 C ` Install Address: �� l,3 /� C rT�s y's Phone (w) Bill Address: (_ A/�J=>G VZEY- Ma 01? E-mail WINDOW WORLD GLASS OPTIONS 1000 Series DH Mech i $180 1 1 Stimulus Energy Package* $79 l�b 2000 Series DH Mech--Weld $190 Includes Solarzone ETC Package Solarzone Glass $45 4000 Series DH All-Weld $2003 ao Argon Gas $15 6000 Series DH All-Weld $235 Triple Glazed TG2** (Argon Filled) $155 2 Lite Slider $329 Triple Glazed TK2** (Krypton Filled) $196 2 Lite Slider Swing&Clean $389 (*Series 4000&6000 Only-Qualifies for Federal Tax Credit) i **( Series 6000 Only-Qualifies for Federal Tax Credit) 3 Lite Slider (1/3,1/3,1/3) (1/4,1/2,1/4); $520 3 Lite Slider Swing&Clean (1/3,1/3,1/3) 1(1/4,1/2,1/4)$595 WINDOW OPTIONS '�1/2 Screens $gam Picture/Fixed Lite $329 Awning $255 i, foam Insulation on Jambs and Head $11 r1AX . uble Strength Glass $15 Casement $285 Double Locks (> 26") $5 � 2 Lite Casement $570 Full Screens $22 3 Lite Casement (1/3,1/3,1/3) (1/4,1/2,,/4) $855 Colonial Grids (Cont Flat) $38/10 Basement Hopper i $200 Prairie Grids $44 Diamond Grids $69 Bay Window $2350 Simulated Divided Lite $182 Bow Window $2475 Tempered DH Sash (BSO) (TSO) $65 Garden Window ; $1875 Obscure Glass (BSO) (TSO) $35 Specialty Window $ Oriel Style (40/60 or 60/40) $30 Beige ; $35 Foam Enhanced Frame (Series 6000 Only) $25 Wood Grain Interior(Series 4000116000 only) $95 PRE 1978 BUILT HOMES (Federal Lead Containment Law) (Light Oak/Dark Oak/Cherry/White/Fox Wood)% With Custom Premium Exterior Trim $50 Brown Exterior(Series 6000 Only)'1 $95 Without Custom Premium Exterior Trim $70 MY HOME WAS BUILT IN THE YEAR 76 Initial Window Color MISCELLANEOUS Inside I outside Custom Exterior Trim/Wrap Wood Out DOORS extured $60 ❑Smooth G-8 $75 $/� Vinyl Rolling Patio Door 6ft. $895 `Facing Color Vinyl Rolling Patio Door 8ft. $995 Custom Exterior rim/Wrap Metal Out Vinyl Rolling Patio Door 9ft. $1095 ❑Textured $75 Ll Smooth G-8$90 $Facing Color Includes Exterior vinyl Trim Special Custom Exterior Trim/Wrap $ FacingColor $30 � Mull to Form Multi Unit Specialty Door ; Install Exterior Stops $45 Grids Patio Door $100 Install Interior Casing $45 Solarzone Glass for Patio Door $125 Fir Out Window $45Insulate Weight Boxes $20 Solarzone Elite Glass for Patio Door* $168 Repair Sill or Jamb $50 (*Qualifies for Federal TaxCredit) Remove Wood Mull $30 $ Remove Storm Window $15 Remove Bay/Bow $250 $ Roof for Bay/Bow $500 Storm Door $ Insulated Sent Board for Bay/Bow $110 Remove and Install A/C $50 Door Color / WINDOW WORLD CARES Inside i Outside St.Judes Children's Research Hospital $ DISCLAIMER: The information!herein related to the Federal Stimulus Package is for informational purposes ONLY. This information is not intended to be legal or tax advice. You should contact your accountant or other tax professional for advice related to specific tax benefits of purchasing energy efficient windows. NO EXTRA WORK-IF NOT IN'WRITING! Customer agrees to the terms of payment as follows: Extra Labor& Materials $ a Green Environmental Disposal Fee $ $175.00 Total Amount $ 77 f I Custom Order Deposit 50% .j C7 0-&#• 1 1 Balance Paid to Installer upon Completion $ F' 11 ,,6-S Amount Financed $ / Window World of Boston anticipates starting this work qrl��N and being substantially completed in�` yFs.Security Interest:Yes No v Any deposit required in advance of the start of the work SHA L NOT exceed 331/3%of the total contract price or the actual cost of any material or equipment'of special order or custom made nature,which must be ordered in advance of the start of the work to assure that the project will proceed on schedule.No final payment shall be demanded until the contract is completed to the satisfaction on all parties. All home improvement contractors and subcontractors shall be registered and that any inquires about a contract or subcontractor relating to a registration should.be directed to:Office of Consumer Affairs and Business Regulation,Ten Park Plaza,Suite 5170 Boston,MA 02116.Phone:(617)973-8700 No work shall begin prior to the signing.of the contract and transmittal to the owner of a copy of such contract. Window World of Boston under provision.of Chapte"r 142A of the general laws is required to apply for and obtain all construction-related permits.Window World of Boston shall not be deemed responsible for delays in the work described in this agreement caused by regulatory,permit granting agencies,authorities or individuals. Notice:If the PURCHASER(S)obtains his own construction related permits for the work described under this agreement or deals with unregistered contractors, the PURCHASER(S) is hereby advised that in the event of a dispute,judgement and nonpayment,the PURCHASER(S)will not be entitled to make a claim or collection from the guaranty fund established by chapter 142A,M.G.L. You the buyer may Kncef this transaction at any time prior to midnight of the third business day after the date of this transaction. Notice can Illationm belin writing postmarked no later than midnight of the following third business day. THIS IS A CUSTOM ORDER NOT FOR RESALE! 4- en r• o no ign if there are any blank spaces. Date S s o not si n if there a �I I 9 y blank,spaces. Date Owner:Do not sign if there are any blank spaces. Date Wob n 4-19-1 0 White Copy-Original Yellow Copy-File Pink Copy-Customer PREPARING FOR YOUR NEW WINDOWSAND DOORS Congratulations on your decision to increase the-comfort level, value and appearance of your home.To maximize your investment and enable the installation to take place as smoothly as possible, we Have created this handout to acquaint you with what to expect when our installers arrive.l. Expected Delivery Time.All of our windows are custom made at one of our manufacturing plants located around the country and shipped to any of our over 200 Window World locations.The time between when your order is placed and when the windows are ready to be installed,though not guaranteed is typically 6 to 8 weeks.At that point we will call you to set an installation date. If for some reason you need to delay your installation for more than a couple of weeks after notification that we are ready to install your order we will be happy to work with you.We will need to collect the remaining balance before installation if the delay you request is more than three weeks. 2. Access to the Windows and Doors. We will need approximately 2 feet in front of each window, inside your home, so we can place our drop cloths and tools necessary to perform our work.When the old windows are removed, gusts of wind typically flow through your home. It is advisable to gather together important papers,and other small items that can be disturbed by the wind and relocate them. Computers and other electronic equipment should be covered or relocated temporarily. Please move aside any furnishings that are in the way of our work. If any furniture items are too heavy to move easily,we will gladly assist you. 3.Window Coverings.To gain access to the interior of the windows,we need all mini blinds,vertical blinds, roll-up shades,shutters, drapes and any other window covering removed prior to our installation. We are not responsible for removing or reinstallation of these items and are.not responsible for damage resulting in the removal and reinstallation.We also are not responsible for any window covering alterations-that may be required to reinstall them. 4. Plants and Bushes.Occasionally we need to work in planters and other landscaped areas of your home that are adjacent to the windows and doors. Please survey your yard prior to us arriving and look for potential problems. Some trees and vigorous bushes need to be pruned back to give us access to your windows. Delicate plants and shrubs in areas right below a window should be temporarily relocated if they cannot survive being stepped on and you want to preserve them.We strive to be careful when working around vegetation, but our priorities are to focus on our work,your windows and our safety while working on your property.We are not responsible for any damage to plants,shrubs or landscaped areas. 5.Arrival and Departure Times.We will advise you of the expected arrival time for our crew at the time we set up the installation date with you.We generally stay till the job is done, unless it will be a 2 or 3-day job, in which case we may work as long as there is daylight. It is our policy that our installers get a sign-off form and collect the outstanding balance at the completion of the job. We ask that you be available to approve the job and make final payment at the time of completion. If this is not convenient for you, we need to know before we start the job. Inclement weather and other unforeseen hindrances are a fact of life and as such we ask that you understand if the weather,traffic,etc.cause a delay or cancellation of an installation appointment.We typically do not schedule more than a day or two in advance to try to avoid such issues. 6.Our Worksite.We like to set up our worksite as close to your windows and doors as possible and generally your driveway is the best spot. If using the driveway will block a garaged car, please be ready to pull it out upon arrival. 7. Alarm Systems. For those of you who have alarm systems, the alarm company should be notified and advised of our job. They will be responsible for the disconnection and reconnection of your alarm system. 8. Where do we start? Upon arrival, the crew leader will survey the job and determine where to begin. If you have a preference, feel free to advise us and we will accommodate to the best of our ability. Because we�work in stages (i.e., removal of old windows, setting the new window,wrapping of exterior,etc.),we don't complete the job one window at a time.The job moves along in a rolling progression where each operation is done on all windows at the same time.This produces a,quality job. 9. If the job takes more than a day,will there be any openings in my house?Of course not.We only remove that which can be reinstalled in the same day.Although there may not be a complete window, it will be weather-tight and secure for overnight. (Please no critiquing at this time). 10.Pets.We love furry,four-legged creatures;however,we need your help in supervising them.We are not always able to close a gate or door behind us when carrying a window, so please keep them in a safe place. Our job description does not include scampering down the street after Fido with new found freedom.Many people say,don't worry,he doesn't bite,but many installers have been bitten.So please secure dogs that have an aggressive bark towards strangers. 11.Expect-some dust, noise and general disruption of your living space. Construction work:can sometimes be messy depending upon the scope of your job. It's an unfortunate reality of remodeling, but we do our best to keep things under control.We appreciate your patience and understanding during the job and until everything is finished. Even after we have cleaned up, it is advisable to surrey the areas for something we may have overlooked (i.e., kids rooms, baby's room). 12. *Damage to walls and old trim stops. For those of you who have old aluminum and steel windows and are replacing them due to sweating and damaging of the walls be advised that all water damage plaster will most likely fall out. In addition,all the patch work you have done over the years will fall out also.This is normal; however,we are not plaster experts,so the repair to those walls would best be left to the experts. In some cases due to out of square openings, new trim is required to make the window look good. *Unless noted on the contract i new trim will not be provided or installed by us.You can expect to do some touch up painting-on the trim after the installation of your new windows.This is not always necessary and is usually minor if it occurs. If your trim stops around your sashes are very old,dry,and brittle,they I may snap and crack upon removal. If this happens, we can leave them off if you please, or for a small up charge, replace them with newer ones. Many of the old style stops are no longer available so we would replace the entire window with newer style stops. Should we discover any hidden damage to the frame or wall area we will advise you before we proceed.Should you decide to replace or repair anything,the price will be added to your balance. 13. Relax and enjoy the show. After we've been introduced to your home, feel free to run errands, take a walk, or just relax. If a question should arise; by all mean k the crew leader for clarification.We enjoy people who are interested in what we do, and most customers are intrigued with the proce e d get nervous, however,when a customer constantly hovers over our shoulder. Like any professional,we're always happy to ans r es i ns, but we appreciate being able to concentrate on our work without interruptions and distractions. This ensures a safe and q ali i allation. 14. Past Due Bala e a subject to a service charge of 1.5% per month. In the event that this.amount•is,placed-in-the hands-of an attorney for collecti ;th urchaser a s to pay all costs of collection, including easonable attorney fee. Return check fee is$50(fifty dollars). F Salesperson wner P.S. Now would be a good time to review contract with the salesman to be sur of your order options and work to be done. Only the items and services on the contract will be done. If you have any questions whatsoever, now is the time to ask. Window World-of Boston may not require an acceleration of payments as specified in the payment section (front)for the reason that he deems himself or'the payments to be insecure. However, where the contractor deems himself to be insecure he may require as a prerequisite to continu' said work that the balance of funds due under the contract, which are in possession of the owner,shall be placed in a joi a crow account requiring the signatures of the home improvement contractor and the owner for withdrawal. Arbitration: Window World, st and the PURCHASER(S) hereby mutually agree in advance that in the event Win- dow World of Boston has , ' concer g the contract, Window World of Boston may submit such dispute to a EZ private arbitration ser is as been proved by the Secretary of the Executive Office of Consumer Affairs and Business Regulations onsumer all be required to submit to such arbitra 'on in M.G.L. c 142A. gam- Window World Owner Date t Dat d-n NOTICE. The signatures of the p rties above apply only to the agreement of the parties to alternate dispute resolution initiated by the contractor. The owner may initiate dispute resolution even "where this section is not`signed separately by the parties" Woburn 4-19-10 OP 1D. CERTIFICATEKY OF LIABILITY INSURANCE DATE(MM/DDn'Y1fY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS1 No RIGHTS UPON THE CERTIFICATE HOLDERTHIS 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: If 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 336-272-7161 CONT1i4T Senn Dunn-GSO NAME! Karen K. Ro stet CIC 336-346-1397 PkONE .336-272-7161 3625 N.Elm St. E nnAIL F C N.i:336-346-1397 P O Box 9375 AD kro ter senndunn-Com Greensboro,NC 27429-0375 PR DU WINDO-2 INSURED Window World of Boston,LLC INSURER S AFFORDING COVERAGE NAIL A 118 Shaver Street INSURER A:HanoverAmerican Insurance Cc 36064 North Wilkesboro,NC 26659 INSURER B: INSURER C: INSURER D: INSURER F: 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 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 BYPAID CLAIMS. INSR aDD LTR TYPE OF INSURANCE POLI EFF PO EXP GENERAL UABIIIiY Ouc ER LIMITS WT A X COMMERCIAL GENERALLWBILRY X EACHOCCURRENCI $ 1,000,00 OZIt7902527 04/07/10 04101/11 PREMIS 9occurrenc S 300,00 CLAIMS-MADE a OCCUR MED EXP(qny cne a son) $ 5,00 PERSONAL&ADV INJURY S '1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMB APPLIES PER: POLICY PRO LOC PRODUCTS-OOMP/OP AGO S 2,000,00 AUTOMOMLE LIABILITY $ COMBINED SINGLE LIMIT $ ANYAU70 (Ea occIdenl) ALL OWNEDAUTOS BODILY INJURY(Per pmon) $ SCHEDULED AUTOS BODILY INJURY(Peraocidpnt) $ HIRED A.UjW PROPERTY DAMAGE $ (Per accident) NON-OWNEDAUTOS UMBRELLA UAB $ X OCCUR A X EXCESS LIA I CLAIMS-MADE EACH OCCURRENCE $ 1,000,00 DEDUCTI9LE OZR7902527 04/01/10 04/01/11 AGGREGATE $ 1,000,00 RE NTION $ WOWMRS COMPENSATION $ AND EMPLOYERS'UABILITY W C SLA O R ANY PROPRIETOR/PARTNERtEXECU'r Ya RY IM OFFICERIMEMBER EXCLUDED? (Mandatory in NN) N/A E.L.EACH ACCIDENT $ M yea,describe under E.L.DISEASE-EA EMPLOYE $ DEE CRIPTION OF PERATION E.L.DISEASE-POLICY LIMR $ DESCRIPTION OP OPERATIONS/LOCATIONS I VEHICLES(Attach ACORD 101,Additional Ramarks Schedule,If more epace Is required) - - ___7 CERTIFICATE HOLDER CANCANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN North Andover Town Hall ACCORDANCE WITH THE POLICY PROVISIONS. 120 Main Street North Andover,MA 01845 AUTHORIZED REPRESENTATIVE ACORD 25 2009/09 ®1988-2009 ACORD CORPORATION. All rights reserved. ( ) The ACORD name and 1090 are registered marks of ACORD Z00 'd Wd 88 :50 03M 01R-VZ-AON f " i Elk, Office of Collsunler Affairs and Ifusiness Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registretlon: 166025 Type: LLC Expiration: 411212012 Tr# 295878 WINDOW WORLD OF BOSTON, LLC. - HOWARD INGLE 118 SHAVER ST N, WILKESBORO, NC 28659 --- Update Address and return card.Mark reason for change. Address '_ Renewal ^_i Employment (" ] Lost Card OPS-CAI 0 sore-04104-aio1216 i ORTH oVM of over 0 LAKE -O lover, Mass., COCHICHEWICK AORATED `S BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT........&.r r.. . .11..�a1.!!1.. - �........... .... ..................... .............................. .................................... Foundation has permission to erect............................ ........... buildings on ....Lac.....� �........�1�-..................... Rough .....I. T.....lc�o ............................................................. to be occupied as Chimney provided that t e person accepting this per it 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 j Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUC O TAR S Rough ................................................... 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. Office of Consumer Affairs.&Business;Regulation I GME IM'PROVEM'ENT CONTRACTOR Registration x16taQ25 Expirafit �1g'12 Type•(; WINOOW WOR B� j7 x%tC. S�pplernent'Cs HUGH MACOONA, 118 8H1�VER 5T i f N V�IIIL ,-i1n��er'sec%etaTy;.N f<_ S J l 2 \ Massachusetts- ilmimaPWm &R Bird « Building Regulations a and Standard's \ n A ,�� S p R�J License ]:cns: c 1,0342 » �lUe > \` 70� ) ) UGH M%C//NAL} . . ? ] 4 F LES/LAb$` � gXBORd/§&kAfl AS } Expiration: 2/1512013 Tq: @»A . � I � TM • "Simply the Best for Less"' Window World of Boston 24 Cummings Park, Suite 15A Woburn, MA 01801 (781) 932-4800 • Fax: (781) 932-4828 www.windowworldofboston.com ]���034839 �_�_es III�'�IIIIIII��I�IIIIIIII'I'I� 1 � RMI NFRC 'I � -is 4000 Doub I e Hung Jational Fene tration CPD:* ASO—A-11-00816-00001 Rating Cou icll@ SOLID UIVYL — UELOEO — DOUBLE GLZO 13/1F IG, DS LOE ETC, ARGON i erirrrm�imn� mr•�riurrim�rtui� � ENERGY PERFORMANCE RATINGS U-Factor Solar Heat Gain Coefficient 0 . 30 1 . 701 0 . 30 (U.S./I-F') (Metric/SI) ADDITION ALL PERFORMANCE RATINGS Visible Transmittance Air Leakage 0 . 56 -- e�ui>.amnnrirmrrumouo•rir�i�®n�rmn�o•� anufacturer stipulates that thase ratings can fxrn to applicable NFRC procedures for determinin whole oduct nr.rf,., z.r ce.NFRC ratings are detern ined for a fixed set of environmental conditions an&a ecitic product size.NFRC does.not recommend an/product and does not warrant the suitability of any oduct for any spe6lic use.Consult manufacI tre!r's literature for other product performance information. 1vwv0.ufrc.org i! I `i r• 1 i i /'�w C�4o/R CERTIFICATE OF LIABILITY INSURANCE OP ID xo DATE(MMIDDIYYYY) WINDO-2 03/31/10 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Senn Dunn - GSO ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 3625 N. Elm St. HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR P O Box 9315 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Greensboro NC 27429-0375 Phone: 336-272-7161 Fax:336-346-1397 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A'. 3 6 0 6 4 emov�z An�ricin Znauranc� Co INSURER B: Window World of Boston, LLC INSURER C: 118 Shaver Street INSURER D: North Wilkesboro NC 28659 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. LTR INSRC TYPE OF INSURANCE POLICY NUMBER DATE(MMIDDIYYYY) DATE(MWDDIYYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1000000 A X COMMERCIAL GENERAL LIABILITY OZR7902521 04/01/10 04/01/11 PREMISES Eaoccurence $ 300000 CLAIMS MADE OCCUR MED EXP(Any one person) $5000 PERSONAL 8 ADV INJURY $ 1000000 GENERAL AGGREGATE s2000000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $200000 0 POLICY PRO LOC JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accident) $ PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY ALTO ONLY-EA ACCIDENT $ ANY AUTO EA ACC $ OTHER THAN AUTO ONLY: AGG $ EXCESS I UMBRELLA LIABILITY EACH OCCURRENCE $ 1000000 A X OCCUR ❑CLAIMS MADE OZR7902527 04/01/10 04/01/11 AGGREGATE $ 1000000 DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN TORY LIMITS ER ANY PROPRIETOR/PARTNERJEXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E L.DISEASE-EA EMPLOYEE $ If yes.describe under SPECIAL PROVISIONS below El DISEASE-POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Certificate holder is additional insured Policy is primary and non-contributory CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 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 Cummings Properties, LLC Attn: Robert Yacobian REPRESENTATIVES. 200 West Cummings Park AUTHORIZEDRESENTATIVE oburn MA 01801-6396 ACORD 25(2009101) ©1988-2009 A RD CORPORATION. All rights reserved. The.ACORD name and logo are registered marks of ACORD The Commonwealth of Massachusetts . Department of Industrial Accidents Off of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): AZ,( /U t)dam, (/I�ULc_0C� �T� S91 Address: 15 n 1,i[41 ar City/State/Zip: 141d 1::L' ),7 Phone#: 7�3r U 5 Are you an employer?Check the appropriate bo Type of project(required): '1.❑ I am a employer with 4. I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet.z 7. ❑Remodeling . ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers' comp.insurance. 9. ❑Building addition [No workers' comp.insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.0 Plumbing repairs or additions myself. [No workers'comp. c. 152,§1(4),and we have no 12.F1 Roof repairs insurance required.]t employees.[No workers' 13.❑-Other comp.insurance require _J d.] *Any applicant that checks box 41 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 hue 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 their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: O z 7R0 Expiration Date: Job Site Address: L g l J; �19� Z-12 City/State/Zip: -Al 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 fins of up to$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains andpenaldes ofperjury that the information provided above is true and correct. Signature: �,e L/ Date: — f� Phone#: Official use only. Do not write in this area,to be completed by city or town of Mal City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town CIerk 4.EIectrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: 04/12/2010 13:24 15087529303 UNIVERSAL INS AGENCY PAGE 01 {i i TE(MWODNYYY) ACt� D,� CERTIFICATE OF LIABILITY INSURANCE DA4/1z/Za, FRooucER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Universal Ins,Agency Inc. ONLY AND CONFERS NO RIGHTS UPON 11HE CERTIFICATE 374 Belmont Street HOLDER. THIS CERTIFICATE DOES NOT AMEND EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Route 9 Worcester, MA 01604 INSUREDS AFFORDING COVERAGE NAIC# INSURED MaSJID;Drrll�m Hom�:lmprou+?m�nts, Ina: INSURERA; SENTNCLINS _RANGE CQ.I.T�,. 22403 34 C.rfxtre�Lina INSURER Q: H TFORD CASUALTY INS CO 28424 Leominater4 MA 01493 INSURER p; _ { INSURER 0: INSURER E, COVERAGE$ THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR TI;E POLICY PERIOD INDICATED,NOTwrm$TANDINO ANY RBQUIREMQNT,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 9Y PAID CLAIMS, INSW A POIJCY EFFEC POLICY EXPIRATK)N POLICY NUMBER UMI A GENERAL LIABILITY OSS BMFO3134 02!02110 Q2l02/11 Fncn°C�uRRfNce S .1,OOO.000 GOMMERCU1t GENERAL LIABILITY EMI R $F$(EE ocaurencol__ CLAIMBIAaDE OCCUR MED EXP(Ary a.Person) a 10,000 PERSONAL m ADV INJURY { AMR OQQ — GENRRALAGGREGAT@ S iOOO OQO GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS•COMP/OP AGO a,OQ0,000 POLICY I XPRO LOC AUTOMOBILE LIABILITY ANY AUTO COMBINED ac derrd)INGI,E LIMIT { ALL OWNED AUTOS BODILY INJURY f SCHEOULED AUTOS (Pet Pef-1) HIRED AUTOS LIODILY IN1URy E NON-OWNED AUTOS (Per eccIdertl) —' PROPERTY DAMAGE, { (Nnf mcident) . ¢AItA6ELIABILITY AUTOONLY.6AACCIDENT ANY AUTO KA AGO S ' OTHER THAN AUTO ONLY: AC4 S EXCIS"MBRELLA LIABILITY EACH OCCURRENCE { OCCUR FICLAIM6 MAD[ AGGREGATE { 9 DIZDUC7IBL.6 : RETENTION { + B WORKERS COMPENSATION AND 08 WEC LE3025 x3/21/10 03/21/11. r"o ueuis_ ° EMPLOYER!)'LIABILITY ANY PROPRIETOMPARTNERIEXSCUJIVE NO E.L,EACH ACCIDENT S _QOQ OQQ OFFICERAAEMBER 4=061" E,I.,DISEASE-EA OMPLOYES { 1 OOQi(� I'M doalxYM undgf PER;AL PR VI f N8 Ealav 121 DISCASE•POLICY LIMIT { ) QOO OTHER i DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADD@D BY ENOORSIWIENT I SPIRCIAL PROVISIONS i CERTIFICATE OLDER CANCELLATION SHOIA,D ANY OF THIS A80vIE DESCRIBED POUG149 BE CANCELLED REFORM THE EXPIRATION WINDOW WORLD OF BOSTON DATE WEREOF,THE ISSUING INSURER WILL ENbEAvOR TO MAIL_20 DAY{ I"MEN NOTICE TO TNA CERTIR:ATA HOLDER NAmW TO THE LEFT,BUT FAILUR$TO DO EQ SHALL 24 CUMMINt�3.F�AFt!<Sl E 168 IMPOSE NO o IOATION OR LIAAIV Y KIND UPON THE INSURER,ITS AGENTS OR U1 OURN;MA 01601-2122 RCM!MENTA �, AUTHORED RE NTATAIE FAX: 888-72.2-4952 ACORN 25(2001108) 0 ACORD CORPORATION,1988