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HomeMy WebLinkAboutBuilding Permit #572-11 - 316 RALEIGH TAVERN LANE 2/22/2011 BUILDING PERMIT NORTH qti TOWN OF NORTH ANDOVER to? APPLICATION FOR PLAN EXAMINATION � 9 Permit NO: Z� Date Received SSACHIU)`�E Date Issued: �-�- — IMPORTANT: Applicant must complete all items on this page LOCATION PROPERTY OWNER l 0 Print MAP NO: PARCEL:LZONING DISTRICT: Historic District yesdn Machine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition Two or more family Industrial Alt ration No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other Septic Well Floodplain Wetlands Watershed District Water/Sewer DESCRIPTION OF WORK TO BE PREFORMED: Ide tification Please ype or Print Clearly) lD OWNER: Name: Phone: Address L CONTRACTOR Narne: '� � � Phone: _ e Address: Supervisor's Construction License: Asn Exp. Date:— L I Home Improvement License: 1 t —Exp, Date: bL//(2 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: $ ,szlq FEE: $ o� 7- Check Check No.:ZJJ1r) -1 Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the uaranty fund Si nature of Agent/Owner =moi nature of contractor f 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 ' b 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 oh situ yes no Located at 1.24 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 ❑ Notified for pickup - Date Doc.Building Permit Revised 2008 I Building Department f 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:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2008 c NORTH '9 Andlover 7a d_o�� x_ ®ver, Mass., COCHICHEWICK ^t DRATED P? -`� R M IT �µ ' BOARD OF HEALTH a Food/Kitchen Septic System �PE . T BUILDING INSPECTOR THIS CERTIFIES THAT........`.�.c�, ....... .. (�..� ................................................................ Foundation has permission to erect. g �.. 1r�.....1...W. .............................. Rough to be occupied as......17........ a. .��!!"!�.1..........��'.�Y..�.`1...........:..................................................................... Chimney provided that the person accepting is.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 PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTnTAIRRT S ELECTRICAL INSPECTOR 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 (Nall 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,MA 01532 J&L WINDOWS,INC.,D/B/A MA Home Improvement Contractor 508 919-0900•Fax: 774 987-3013 - License#149601 (Expires 1/24/2012) ( ) ( ) Renewal .,-. Federal Tax ID#83-0404201 byAndersen. WINDOW REPLACEMENT =Md—C,m M CUSTOM WINDOW AND DOOR REMODELING AGREEMENT Buyer(s)Name - Date of Agreement Buyer(s)Street Address,City,State,and Zip Code E-Mail Address Home Telephone Number Wve Telephone Number Cimob/ . eOP-MS(e CCMCRS)"•ref Buyer(s)hereby jointly and severally agrees to purchase the products and/or services of J&L Windows,Inc.d/b/a Renewal by Anderse ("Contractor"),in accordance with the terms and conditions described on the front and the reverse of this agreement and on the attache specification sheet(s) (collectively,this"Agreement').Buyer(s)hereby agrees to sign a completion certificate after Contractor has complete all work under this Agreement. Method of Pymnt:❑Cash ❑Check ❑Mastercard ❑VISA Total Job Amount: /v�`i^'�/ Estimated Starting Date: ❑Discover ❑Financed,App#: Deposit Received(33%D): (F^W" ��rC, Name on Credit Card:C,f 44" 79y �pr� a, Balance at Start of Job(33%):to U Estimated Completion Date: P Credit Card#: Ce4- ?y4JV ;)3- y - On'" Balance on Substantial �CJVt Q Completion of °D): CC Exp.Date: CC Security Code: By initialing here,you acknowledge that the Balance at Start of Job and the Balance on Substantial Completior Buyer Initials 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 the there are no verbal understandings changing or modifying any of the terms of this Agreement.No alteration to or deviatio from this Agreement will be valid without the signed,written consent of both Buyer(s) and Contractor. Buyer(s) hereb acknowledges that Buyer(s) 1) has read this Agreement, understands the terms of this Agreement, and has received completed,signed,and dated copy of this Agreement,including the two attached Notices of Cancellation,on the date fir! written above and 2)was orally informed of Buyer's right to cancel this Agreement.DO NOT SIGN THIS CONTRACT I THERE ARE ANY BLANK SPACES. J&L Windows, c.d/b/a Renewal by Andersen Buyer(s) Buyer(s) By. �- Signat re of Product ager Signature/ Signa re (-wo) ,� i�G (�Natit `— L7-1ti/ 7�`t9Tff2yn/ ,L• Print Name of Product Manager. Print Name Print Name YOU, THE BUYER(S), MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THI BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION.SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. — — — — — --- — —— — — — — —�-<- — — — — — — — — — — — -:-- — — — — — — — — — — — — — — NOTICE OF CANCELLATION X NOTICE OF CANCELLATION Date.of Transaction. . You may cancel Date of Transaction .You may cans this transaction,without any penalty or obligation,within I this transaction,without any penalty or obligation,withi three business days from the above date.If you cancel,any I three business days from the above date.If you cancel,an property traded in,any payments made by you under the I property traded in,any payments made by you under th Contract of Sale,and any negotiable instrument executed Contract of Sale,and any negotiable instrument execute by you will be returned within 10 days following receipt I by you will be returned within 10 days following receil by the Contractor ("Seller") of your cancellation notice, I by the Contractor ("Seller") of your cancellation notia and any security interest arising out of the transaction will I and any security interest arising out of the transaction wi be canceled.If you cancel,you must make available to the be canceled.If you cancel,you must make available to th Seller at your residence,in substantially as good condition I Seller at your residence,in substantially as good conditia as when received, any goods delivered to you under I as when received,any goods delivered to you under th this Contract or Sale, or you may, if you wish, comply I Contract or Sale;or you may,if You wish,comply with th with the instructions of the Seller regarding the return instructions of the Seller regarding the return shipment c shipment of the goods at the Seller's expense and risk. I the goods at the Seller's expense and risk.If you do mak If you do make the goods available to the Seller and the I the goods available to the Seller and the Seller does nc Seller does not pick them up within 20 days of the date I pick them up within 20 days of the date of your Notic of your Notice of Cancellation,you may retain or dispose of Cancellation,you may retain or dispose of the gooc of the goods without any further obligation.If you fail to without any further obligation. If you fail to make th make the goods available to the Seller, or iflou agree goods available to the Seller,or if you agree to return th to return the goods to the Seller and fail to do so, then goods to the Seller and fail to do so,then You remain liabl you remain liable for performance of all obligations under I for performance of-all obligations under the Contrac the Contract. To cancel this transaction, mail or deliver a I To cancel this transaction, mail or deliver a signed an signed and dated copy of this cancellation notice or any dated copy of this cancellation notice or any other writte other written notice,or send a telegram to Contractor.J I notice,or send a telegram to Contractor.J&L Window &L Windows,Inc.d/b/a Renewal by Andersen, 104 Otis Inc. d/b/o Renewal by Andersen, 104 Otis Stree Street, Northborough, MA 01532, BY NOT LATER THAN Northborough,MA 01532,BY NOT LATER THAN MIDNIGF MIDNIGHT OF .(Dote) OF .(Date) I HEREBY CANCEL THIS TRANSACTION. I HEREBY CANCEL THIS TRANSACTION. Buyer's Signature Date I Buyer's Signature Date RbA Copy- White Buyer Copy-Yellow Buyer Copy-Pink 104 Otis Street,Northborough MA 01532 J&L V endows,Inc.d/b/a is Renewal ., MA HIC License#149601(expires 1/24/12) Phone 508.919.0900•Fax 774.987.3013 K Federal Tax ID# 83-0404201 byAndersen. WINDOW REPLACEMENT un Ande C..P..Y OF GREATER MAssACHusrrrs AND NEw HAwsHiRE 'V 1 v n ct u) 3 WINDOW SPECIFICATION SHEEP Buyer(s)Name Date of Agreement ,r,tQ 1 �;Y]2� LZ I T1 A N-7av _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 rever(f oNh,accompanyings,USTOM WINDOW AND DOOR REMODELING'AGREEMENT, of which this Specification Sheet is a part. t Jrl�\ :S_-0 Q 6P-06W DEFAIIS 1. Contractor will Install a total of doves wner's home,using the following individual quantities: �1Double Hung(DB) Equals X ttage 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(GPW) ❑ 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. s ❑ No Qty of Windows to be Custom Fit Replacement: 3. 2-yes ❑ No Qty of Sills to be replaced by Contractor:_6_ si�� 4. ❑ Yes R�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:t] P Low-E®SmartSun— (Tae Crrd&Zb:gtble) ❑ Other If other,please specify: 6. Exterior color to be:4White ❑ Sand ❑ Canvas ❑ Terratone ❑ Cocoa 7. Interior color to be: White ❑ Sand ❑ Canvas ❑ Terratone Pine Maple ❑ Oak Naty.<57te'y19r color can only be white,wood or same color as exterior. Wood interiors need to finished by Owner. 8. Hardw a-.CgVAiite t j_Stone ❑ Canvas ❑ Brass ❑ Estate Hardware: Style: 9. ❑ Yes dgrNo Install Lifts with Double Hung Windows 10. Screens: windows to have: Half or ❑ Fall screens Screens to beCK Fiberglass ❑ Aluminum ❑TruScene GRILLE DETAILS 11.Windows have grilles:9/f Yes ❑ No If ye%�_'Grille Between Glass(GBG)❑ Removable Interior Wood amen❑ Full Divided Light(tDL) Qty: Qty- Qty: Qh'- Qty: Qty: Qty: DH E:1 CW/PictureGlider PW.,G Draw grill patterns above `Use additional sheet if needed Owner approved(initials):( ) ADDITIONAL WORK:DETAILS 12.❑ YesINO Contractor will remove metal frames of windows. Qty of Units: 13.❑ YesNo Contractor will install new paint-ready or stain-ready casings. r casin of openings: Exterior casin s of o enin s: Pine Maintenance-free material In 8 qty $ 4h P g ❑ ❑ 14.❑ Yes No Contractor will install new paint-ready or stain-ready inside or outside stops qty of openings: Interior stops qty of openings: Exterior stops99t�of openings: ❑ Pine ❑ Maintenance-free material 15. Owner i_s.(aware that Contractor does not do any painting. (�f oiT owner Initials ,I,II 16An Yes 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. 19. Yes ❑ No Building_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 required at the time of sale for this fee. 20. Additional job details: G�t NC t 4 c t/ crc S , , 21lYes ❑ 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 unfit 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 m writing and signed by both the Buyer(s)and Contractor. Buyer(s)hereby acknowledge that Buyer(s)has read this Specification Sheet. Renewal Tdersen of Greater MA and NH Buyer(s) Buyer(s) By tare of Product Mataer Signature Signatfim (�, S �,�/� j�dN� euL7/N 3aliN�YN CJo�7in Print Name of Product Manager Print Name Print Name a I The Co=mrweaUA of Marsadiusetfs ' d 'al Aaddents . •Depaxtmt:ni of fn ustrc office of Invesfigations 600 Washington Street + Barton,MA 02111 • .. www.massgovldia Workers' FnSUranCe AffidsPit� $1u�ders/Caniractorsl Iectnciaz�slPllzmbers A lieant Fnformafian' Please.Print Le�bty Name(swine i6pain donbdividnalj• J)en�iJ ay N erS Y1 City/Sfate,�Z1p, IVDP bo 1D r�� d 1��� P40ne Are you m employer?Check the Sppropriste barn Type of project (re#rr ); L E9-I am a employes W h• V?D 4. ❑'I am a general contractor and INew constxnctina employees(fall eadlor part tuna).*' leave himd the sub-contractors []I am a sole proprietor or partner- listed an the attached sheet t ship and have no employees These.sab-contractm have B, Demolifioa working for mein tiny capacity, waimm' camp.bsm=r- g, []Bolding a ddifion [No workers' comp:insuzsuce 5. ❑ Weare a oorpomti and its 2D.[]Electrical repairs or additions rmg R=iL�' . _ of6c o have Bran poo coir �or addifions of ez titin OrI�lGL il.❑Rlumbing nP 3rQ I am a homeowner douag CII work � � P - mysed[Newad=' comp: c.152,j1(4),end we have no 12.0 R.00frcpmin in neo mquimd.]t employees.•[No 7or1=, 13.0 Other • comg.insureace r�gnisod.] . *Any applieaat tht e6mrb bui 91=ut aloo fm oat the smtkm ban showkIlhair worl='comp-m ion poliq mfntmsnon• t Homeowaen veha cabmit thu afndavit indic�me�•}'acz�aIlwach and.thm hhe outside eoatcaetas amst sobm�a new s�devit � . ' �onttactosi that:Chert;thu hoz moat attaabed an addifional sbeets6a�eiag tba name of��°��and thea worl�s amp.P�!�7'' I am an=ploj?er that is prarzdmg VVkdracorrrpensation iR=a=for my employees �eiow.ia the po&7 and job site ' ircforrrtation. •r . Inmreace Company Name, 30 Esgiration Dater policy#or Self-ins.Lin.#; GV Rib Rita Addrass; l� K� y stag; /l) >9 nL)0 ci . 6 Attach a Copy of the workers'compensation policy declsratinn pave(sh.avring the policy umber End erpirofion data:). Fail=to sv. mo ommmgo as requimd under Section 25A of MGL a.L52 cm load to tha imposiiiaa of criminal pt:naliics of a iiac up'to$1,$DD.OD and/or ono-yaar imprisanmcn, . wmU as civil pGnaltics in th0 f�•of a STIP WORK ORDER and a fine -of W to$250.00 a day against fm violatnr. Be advised$int a copy of this stsinmmt may bo fniwarcted to the Qffica of Investigations of the DIA fur ftM= nao coverap VCIIfICatlon• I do hereby c r It pal=and penddea cqury that the inf mmation provided ab is trtu and correct ere •� Date, � �� . 5iaaeizu•eJ �•• p - Phone#' 0,f, cial um only. Do not write in this area,to be Completed by city or tmrn qfcial City or Tom permitlLicOnse# Fssu Autharity(circk one)t Inspector.5,Plumbing Inspector L Bozrd of Health 2.Dodding Depgr{meut 3,( ty/Ta�n Clerk 4,E�Iectru ceI hasp , Caataet Person: Phone#' i i NIaSsachasetts - Department of Public Safety -Board of Building Regulations and Standards -Construction Supervisor License License: CS 55707 BRIAN DENNISON . 86 CREST CIRCLE �''�'� WORCESTER, MA.Q1603. Expiration: GMC12 C'nmmimioner Tr#: 2522 . � �o.�sno�ea�s o�.�a�ar�usetYd omee of Csn=mer Affairs &A $tgut;tiaa . iffiff OME llidPRO ECONTRACTOR • Regls�afioR�� M'p1 Ezptra •12 . e t Card RENEWAL BY BRLkN DENNlS _ 104 OTZS 5TRE •f�•.76�• ' NORTHBOROUGH, _ t3ndersoeretuy ACORO® DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE L.� 02/09/2011 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: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) 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 CONTACT NAME: Joseph McKeone PHONE FAX JP McKeone Insurance Agency, Inc. E-MAIL Exti: 734-662-8100 ac No: P.O. Box 333 ADDRESS: _ INSURERS AFFORDING COVERAGE NAIC# Ann Arbor, MI 48106-0333 INSURER A: Hartford Insurance Company INSURED J&L Windows, Inc. Renewal by Andersen INSURER B:Nautilus 104 Otis St. INSURER C: Northborough,MA 01 532 INSURER D: INSURER E: 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 BY PAID CLAIMS. POLICY EFF POLICY EXP INTR TYPE OF INSURANCE A L S POLICY NUMBER MM/DWYYYY MM/DDr YY LIMITS B GENERAL LIABILITY EACH OCCURRENCE $ 1.000,000 AMA O RENT COMMERCIAL GENERAL LIABILITY NC958461 10/01/2010 10/01/2011 PREMISES Ea occurrence $ 100,000 CLAIMS-MADE ®OCCUR MED EXP(Any one person $ 5,000 PERSONAL&ADV INJURY $ 1,000000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY 17PRO- LOC $ A AUTOMOBILE LIABILITY 35MCCXD6390 10/01/2010 10/01/2011 Ea MBINEDe..U.n SINGLE LIMIT 1,000,000 ANY AUTO BODILY INJURY(Per person) $ ALL X AUTOS OWNED SCHEDAUTOS BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident I $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION 35 WECPP1444 02/17/2011 02/17/2012 WC STATU- OTH- A AND EMPLOYERS'LIABILITY Y/NTORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. ACH ACCIDENT $ 5OO 000' OFFICER/MEMBER EXCLUDED? ❑ N/A L (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below !E.L.DISEASE-POLICY LIMIT $ 500.000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space Is required) CERTIFICATE HOLDER CANCELLATION INSURED COPY SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE �` ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD r . Renewal byAndersen. WINDOW REPLACEMENT anMdeTunClompnny ' wood/Vinyl Composite IF Dual . Argon Low E4 SinartSun �.., .. �, Double Hung 100-00473518-010 -ENERGY PERFORMANCE RATINGS U-Factor(U.S)/I-P Solar Heat Gain Coefficient 0x290n19 . 1 ADDITIONAL PERFORMANCE RATINGS Visible Transmittance 0 . 42 Manufacturer etipufates that them ratings conform to apprsahla NFNC procedures for determining whole prodwY padormaneiL NFRC ratings are determined for afaad all of environmental Coadsions and aspeePn product s¢a. NFNC do's not recommend arty product and does not warrent the suitability of any product for any&peeifc um. Conauh manutantumfs rsemtum for other product porfomonee information. ' .. a www.nim.org This product moats Green - .. Sears environmental hMe4 smndardsgovaming emrQy .;.!s... .. )�`••..;.Y'..t.w:'�;% . a efficiency,heavy mareli n mryy14y.}J A; f J••�_( 't••� ie.the framed sash 4::;"}.y ,�+ •r':(`ytyw • C}matariaL P�bBSA and I� +c•;;1`i.�Fvr.•' . Coasumaraducatinnal � C�?�a`Y ..Sy�f:r:=%� 0"*+ Materials. DESIGN PRESSURE(PSF) fA—'aausenmoC:um H LC25 ' www-wdmacom RbA DB Sloped Sill DH IN r TWW 10IM-M arAA M'0 W=10MSfMtOdS MondacLra stl mrIformarcs to ore a knots enncYd[. Beats or exceeds MIM,C.F-C.i LF-C.C.Air Infharation requirements WDMA Haamarx Cartifiation Program. ' ' I Location C�:C33 No. Date NORTq TOWN OF NORTH ANDOVER poll 9 Certificate of Occupancy $ Building/Frame Permit Fee $ r � Foundation Permit Fee $ Other Permit Fee $ i TOTAL $ Check # 2390 Building Inspector