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HomeMy WebLinkAboutBuilding Permit #111 - 270 FARNUM STREET 8/10/2009 BUILDING PERMIT NORTH q TOWN OF NORTH ANDOVER L _ - - p APPLICATION FOR PLAN EXAMINATION w Permit NO: `(/ Date Received ��SSACHUS���� Date Issued: PORTANT: Applicant must complete all items on this page LOCATION 10 W> �; Print PROPERTY OWNER �5 ) Pent MAP NO:/ 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, replacemen Assessory Bldg Others: Demolition Other Septic Well Floodplain Wetlands Watershed District Water/Sewer DESCRIPTION OF WORK TO BE PREFORMED: 6/vA V\k,-,F Identification Please Type or Print Clearly) OWNER: Name: Phone: Address: 1� (�Uy Vy,, CONTRACTOR Name:� �. LSA Phone: (D ' Address: —?(P- Supervisor's Construction Licenses Exp. Date: Home Improvement"License: Exp. Date: )` ' /-16 ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ �� FEE: $ ' Check No.: 7�`�/ Receipt No.: C) NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund nature of A ent/Owner m .�i g g ���� ��-Signature of contra Location "?70 l—u r/V No. � Date No�TM TOWN OF NORTH ANDOVER Of• .w ,•,4O f 9 Certificate of Occupancy $ 11 •O•+r•o.�' �sswcHusEt� Building/Frame Permit Fee $ � — Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 2231- 6 X/ Building Inspector 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 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 signaturefdate COMMENTS I 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.s100-s1000 fine NOTES and DATA— For department use) ❑ Notified for pickup - Date —._..........._............._.......—._.............................-----_._......._..................._.......---....._................................__.........................__._..—_..__._._...................._.....-----................................-_...._.._............... Doc.Building Permit Revised 2008 i I 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 orspecial permit was required the Town Clerks office must Stam the decision from the Board of Appeals P PP 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 Application Revised 2.2008 NORTH TONM of L over ... NO. �: .� ,. . r`D LA E dover, Mass., ' COC HIC HE WICK AORATED F6k? �C5 S BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT..........-->.u.` -5...............`��-�t ./ .............. .......................................................,............ Foundation • has permission to erect.................................... buildings o .. .7. ... p ......4,, ... ................... Rough �t ' to be occupied as........................................ .......... 1.©/........ � C, ............................................................................ Chimney 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 STARTS Rough IDING Service ........................ ... ...... 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. r SEE REVERSE SIDE Smoke Det. ies Renewal R NEWAL BY ANDERSEN License Federal Tax ID#r83-04042101) byAndersen. ua WINDOW REPLACEMENT mAd—C..ra OF GREATER MASSACHUSETTS AND NEW HAMPSHIRE 104 Otis Street•Northborough,MA 01532 Phone 508.919.0900•Fax 508.919.0903 CUSTOM WINDOW AND DOOR REMODELING AGREEMENT Buyer(s) me Date of Agreement USR nl s )3 0 Buyer(s)Street Address,City,State,and Zip Code QloJ ® A E-Mail Address Home Telephone Number Work Telephone Number 3-f3$ Buyer(s)hereby jointly and severally agrees to purchase the products and/or services of J&L Windows,Inc.dba Renewal by Andersen of Greater Massachusetts and New Hampshire("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: y0 QA Estimated Starting Date: Method of Pymnt:IDCash ❑Check ❑Mastercard ❑VISA ❑Discover C3 Financed,App#: Deposit Received(33%(: I� Name on Credit Card:- "r r�l ��� Balance at Start of Job(33%): .3,q 3� U q/ Estimated Completion Date: Credit Card#: I %p0 / o Q d 0 Balance on Substantial lJ Completion of Job(33%(: CC Exp.Date: Q 1 CC Security Code:'L/0 By initialing here,you acknowledge that the Balance at Start of Job and the Balance on Substantial Completion Buyer Initials Ll_ of 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 e� 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 b dersen of Greater MA and NH Buy e � Buyer(s) By: X ySi ature of Product Manager Signature Signature Print Name of Product Manager Print Name Print Name r 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 t N ELLATION K NOTICE OF CANCELLATION Date of Transaction V6 1A You may cancel I Date of Transaction .You may cancel this transactiowithout a pe y pen Ity or obligation,within I this transaction,without any nalty or obligation,within three business gays from the above date.If you cancel,any three business days from the above date.If you cancel,any �roperty traded in,any payments made by you under the I roperty traded in,any payments made by you under the ontract 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 Seller of your cancellation notice,and any security by the Seller of your cancellation notice,and any security interest arising out of the transaction will be canceled. interest arising out of the transaction will be canceled. If you cancel, you must make available to the Seller at If you cancel, you must make available to the Seller at your residence, in substantially as good condition as 1 your residence, in substantially as good condition as when received, any goods delivered to you under this I when received; any goods delivered to you under this Contract or Sale;or you may,if you wish,comply with the I Contract or Sale,or you may,if you wish,comply with the instructions of the Seller regarding the return shipment of X instructions of tie Seller regarding the return shipment of the goods at the Sellers expense and risk.If you do make I the goods at the Sellers expense and risk.If you do make the goods available to the Seller and the Seller does not the goods available to the Seller and the Seller does not pick them up within 20 days of the date of your Notice pick them up within 20 days of the date of your Notice of Cancellation,you may retain or dispose of the goods of Cancellation,you may retain or dispose of the goods without any further obligation. If you fail to make the I without any further obligation. If you fail to make the goods available to the Seller,or if you agree to return the goods available to the Seller,or if you agree to return the goods to the Seller and fail to do so,thenyou remain liable 1 goods to the Seller and fail to do so,then you remain liable for performance of all obligations under the Contract. for performance of all obligations under the Contract. To cancel this transaction, mail or deliver a signed and I To cancel this transaction, mail or deliver a signed and dated copy of this cancellation notice or any other written 1 dated copy of this cancellation notice or any other written notice, or send a telegram to Renewal by Andersen notice, or send a telegram to Renewal by Andersen of Greater Massachusetts and New Hampshire, 104 I of Greater Massachusetts and New Hampshire, 104 Otis Street,North 'ro gh,MA 01532, NOT LATER THAN 1 Otis Street,Northborough,MA 01532,NOT LATER THAN MIDNIGHT OF .(Date) MIDNIGHT OF .(Date) I HEREBY CANCEL HIS TRANSACTION. X I HEREBY CANCEL THIS TRANSACTION. I Consumer's Signature Date 1 Consumer's Signature Date RbA Copy- White Customer Copy-Yellow Customer Copy-Pink ReneV,/'al ���� Un ��L� MA License#149601(expires 1/24/10) b�YpllldeCSe l RENEWAL BY ANDERSEN Federal Tax ID# 83-0404201 yA REPLACEMENT anAndenmGmpany OF GnATER MASSACHUSETTS AND NEW HAMPSHIRL WINDO104 Otis Street*Northborough,Massachusetts 01532 Phone 508.919.0900*Fax 508.919.0903 SPECIFICATION SHEET Buyer(s)Name Date of Agv1 men! ltkvil d The Buyers)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 AGREEMENT,of which this Specification Sheet is a part. WINDOW DETAILS 1. Contractor will Install a total of windows in Owner's home,using the following individual quantities: Double Hung(DB) ❑ Equal sash ❑ Cottage sash(1/3 top,2/3 bottom) ❑ Oriel sash(2/3 top.1/3 bottom) Casement(CW) ❑ Hinge right ❑ Hinge left(as viewed from exterior): ❑ Standard handle ❑ Metro handle Double Casement(CDW) ❑ Standard handle ❑ Metro handle Casement/Picture/Casement(CPW) ❑ 1:1:1 or ❑ 1:2:1 ❑ Standard handle ❑ Metro handle 2 Lite Gliding Window(GW) Glider/Picture/Glider(GFW) ❑ 1:1:1 or ❑ 1:2:1 Awning Window(AW) Picture Window(PW) Bay or Bow Window Patio Doors(see separate Door Specification Sheet) 2. ❑ YesFNo o Qty of Windows to be Custom Fit Replacement: 3. ❑ Yeso Qty of Sills to be replaced by Contractor: 4. ❑ Yes 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 Czu&tPdgrble) ❑ Other If other,please specify: 6. Exterior color to be:,,White ❑ Sand M Canvas ❑Terratone ❑ Cocoa Bean 7. Interior color to be: ❑ White ❑ Sand ❑ Canvas ❑ Terratone P�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: ❑ White DS Stone ❑ Canvas ❑ Brass Double Hung: 9:❑ YesZ-No Install Lifts with Double Hung Windows 10. Screens: windows to have: ❑ Half or ❑ Full screens Screens to be: ❑ Fiberglass Aluminum ❑ TruScene GRILLE DETAILS 11.Windows have grilles: ❑ Yes- (o If yes:❑ Grille Between Glass(GBG)❑ Removable Interior Wood aNTW)❑ Full Divided Light mw Qty Qty Qty Qty Qty: Qty: Qty: DH DH DH DH CW/Picture Glider CPW Or G Draw grille patterns above *Use additional sheet if needed Owner approved(initials):( ) ADDITIONAL WORK DEI'AI S 12.❑ Yes No Contractor will remove metal frames of windows. Qty of Units: 13.❑ Yes No Contractor will install new paint-ready or stain-ready casings. Interior casing qty of openings: Exterior casings qty of openings: F-1Fine F] Maintenance-freematerial 14.❑ Yes [}No Contractor will install new paint-ready or st ' in ' or outside stops qty of openings: Interior stops qty of openings: Exteriors ps q o ❑ Pine ❑ Maintenance-free material 15. Owner is aware that Contractor does not do any painting. Owner Initials r 16. Yes ❑ No Contractor will wrap exterior casings with aluminum coil stock of L�� 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 paymdnt.in full. 19. Yes ❑ No Buil ' Permit—Contractor will secure any and all necessary permits. The fee for the permit(s)is not included in the Contract Price and a separate check is require at the time of sale for this fee. 20. Additional job details: 1 1 �f�Oa `Y�I'DQI, t wJ'_ c >)� to f i-J t 21. Yes [j No Owner agrees to be present on the final day of installation for final inspection and to deliver final payment. i-N 'nal 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 modifyingany of the This Specification Sheet may not be changed or its terms modified or varied in any way unless such changes are in writing and signed both the Buyer(s)and Contractor. Buyer(s)hereby acknowledge that Buyer(s)has read this Specification Sheet. Renewal by And r en f Greater MA and NH Buyer( Buyer(s) Ey: Sign ef Prodi ct ager Signature Signature � Print Name of Product Manager Print Name Print Name RbA Copy- White Customer Copy-Yellow The Commonwealth 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 Name(Business/Organizadon/Individual): Re11L::,J a I y Q4 ;r3 a n Address: /0.y ay; City/State/Zip: /VOY- bo rof, A4 Phone Are'you an employer?Check the appropriate box: Type of project (required): 1.&I.am a employer with JC) 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. x emodeling 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 10.0 Electrical repairs or additions 3.❑ 1 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.❑Roof repairs insurance required.] t employees.[No workers' 13.❑Other comp.insurance required.] 'Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name.of the sub-contractors and.their workers'comp.policy information. lam an employer that isproviding workers'compensation insurance for my employees Below,is the policy and job site information. Insurance Company Name: J Policy#or Self-ins.Lic.#: � � � � I�'-f� Expiration Date: r- Job Site Address: � I 0,0000 Yx-\ 4--% City/State/Zip: , A AL, -- �er 00 yfi. Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the.imposition of criminal penalties of a fine up to$1;500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy.of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby cer un-ler the pains and penalties.of perjury that the information provided above is ue and correct s' Sienature: %j Date: Phone#: 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#: •.� .....r_-:::Lz�:'::1 YJ JGG��NL�/IG(Y/(GL'GW(����GLUG4W ' Y: Board of Building Regulations and Standards 'Construction Supervisor Licanse•:i,,,•, ,;k. Llcense; CS •95707 .� � Hirafida�e'�-'91811982 • 'i . -` - Tri 95707 1E� I'rat[on^..978'12010 •;'� Viz—r=•ice -- =+••� . n Re`siRibob=4O ! BRIAN DENNISO = _ �" • - 86 CREST CIRCLE�_� =��,� � � . •.�. WORCESTER,MA 01603" Commissioner; IL / RENEWAL BY ANDERSON BRIAN DENNISON 104.OTIS STREET •NORTHBOROUGH, MA.01532 DPS-CAI Ce SOM-07/07-PC8490 p .-�. . ..... - ,• ✓/r.�.-O�omvirtoncaea� �¢c�zudeG�a _ -- Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Reglstr'afiMn 149601 ion—X12-412010 supplement Card RENEWAL BY AI1D;E1 ,.©, �.•, BRIAN DENNIS( ,Iv, 104 OTIS STREET"..,,; NORTHBOROUGH,MA X1532 Administrator ACORD CERTH�IC a TE F LIABILITY IN ®� ( '«/DII/YYYY) 02/17/2009 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Joseph McKsone ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE JP McKeone Insurance Agency, Inc. ALTER THE C©VERAGECAFFORDED BATE DOES Y TPE POLICIES BELLOW P.O. Box 333 Ann Arbor, MI 43106-0333 INSURERS AFFORDING COVERAGE HAIL# INSURED Renewal by Anderson INSURE_RA: Hgltford Insurance Com an J&L Windows,Inc. INSURER e: Hermitage 104 Otis St INSURER C: Northborough,MA 01532 INSURER 0: I 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 CONDI TIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INLTR SR D1 PNSR rePOLJGYECTiIlE ROLNN:YEXFIPATION E POLICY PNUNSER Tc LKITS B• GEJNERALLJASIUTY HCP 507 404 09/07/2008 09/07/2009 EACHOCCURRENCE S 1000000' COMMERCLALA, DAMAGETO GENERLIADJUrY PREMLSE5 Ea E 10Q,OGO CLAIMS MADE ©OCCUR MED EXP(Anyone person) $ _ 5,000 PERSONAL&ADV INJURY S 1,000,000 ZENERAL AG.REGATE S 2,000.000 GENt.AGGREGATE LIMIT APPLIES {PER:. PRODUCTS-COMPIOPAGG $ 2,000000 POLICY I � PcCa I I!OC A AUTOMOSO—c LIAZI1JTY 35 MCC XD 6390 10101/2006 10/01/09 COMBINED SINGLE LIMB ANYAUTO (Eae=denu S 1,000,000 X ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) S RHIRED AUTCS BODILYIf1JURY . S NON-OWNED AUTOS (Per sadenq PROPERTY DAMAGE S (Perecidenq GARAGE LIABILITY AUTO ONLY-EA ACGCENT Is ANY AUTO OTHER THAN EAACC S AUTO ONLY: AGO Is EXCESSIUMBRELLA LIABILITY EACH CCCURRENCE I S OCCUR . a CLAIMSMADE AGGREGATE I S S DEDUCTIBLE I S RETEEMON' S I S A WORKERS COMPENSATION AND 35 WEC PP 1444 02117/2009 02/17/2010 I we staru. I OT H- EMPLOMV.LIASiLETY EB ANY PROPRLETOILAARTNER/ExECUTIVE E.L.EACH ACCIDENT S500,000 OFFICERRNEMBER EXCLUDED?. EL DISEASE-EA EMPLOYEE S 500,000 I yea,AL PR o ISIO EL DIS---ASF-POLICY LIMIT S '5500 000 SPECIAL PROVISIONS hstmv OTHER DESCRIPTION OF OPERATIONS!LOCATIONS I VEHICLES N EXCLUSIONS AODE-D BY ENDORSEMEMTI SPEC9dL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRISEO POLICIES BE CANCELLED BEFORE THE EXPIRATION INSURED COPY DATE TKEREOF,THE ISSUING INSURER WILL ENDEAVOR TO G9AM 10 DAYS WRITTEN @NOTICE TO THE CERTIFICATE HOLDER N=M TO THE LFT,BUT FAILURE TO DO 50 S4NALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHOR=REPRESENTATIVE ACORD 25(2001108) 0 ACORD CORPORATION 1983 400 Frenchwood®Gliding Page 1 of 2 Andersen®400 Series Frenchwood®Gliding Patio Door z 9 , 4; Performance ' i fi k +C , Center of Glass Performance Data ................................................. . sl� I�w �r ',�,� 5 ,, ;� y' '� - y, 1.� ,xj "t'�' "Yst�+. .S �J - ' xx: - Jz ..... ...a•...m...,..:k:..�: .. 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'.+�, a.„f y,�'.K��..S.��i���.,• � f - t ��r�'�i. ,s p t�4, �""f`' 4 Y�rtes � y' ' e- d� iat�M t� Train f} 76 fps n X496 � 1} 51 5 MUM -- --- CA r H - ,"" �' 0.3ZJ 74 �, j r;{ j k �Si Baa P zrt i �' ux: �� a6......�..A....�.y�a, ��`� ; w Top-, �r' 3 }_ 75 ;"E6o96 .Q,-3 ; a7% '" "� Ckw io' L u I 'ti�9 r wsi —�__ °t 11*1 OttC� ! yal r�"� T: x26 yi. �3����7 7� �15�� i � �7�` � -�����, r k' - t t� 'r"r'�km .z-!wt—n,�- --....• �-r Pal?I��Yi` 99a 10�,3+4 � �� � 773{R k� ��+�9�,�' ZZL}u f' .fV �vM� �L.� �FEI✓ ( Lt Mr35 i. 13 1 %M p � .. .. FiPILOFIR i 0 33 r 2 1 I1 '7> 58r#`D Fk a�)± Raaf Chir_ f � 3 0V.54 ��IN T, `�3 [4 !anl3��� ..L:ti� d Ys,p.arm4-��...uN`i- _ �"�e�.�ss.:.i"vd•-1�J . "High-Performance"(HP Low-E)and"High-Performance Sun"(HP Sun)are Andersen trademarks for Lnw_F nlacc