HomeMy WebLinkAboutBuilding Permit #533 - 429 ABBOTT STREET 1/10/2012X14 ,�
BUILDING PERMIT
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit NO: Date Received
Date Issued:
IMPORTANT: Applicant must complete all items on this page
LOCAT
PROFE
MAP NO: PARCEL: 20NING'DISTRICT: ,Historic District
- - -�,--
e
yes
no
no
TYPE OF IMPROVEMENT
PROPOSED USE
Residential
Non- Residential
❑ New Building
AB- he family
❑ Addition
❑ Two or more family
11 Industrial
❑ Alteration
No. of units:
❑ Commercial
epair, replacement
❑ Assessory Bldg
❑ Others:
❑ Demolition
❑ Other
C Septic<1N61
Cl -Floodplain ❑Wetlands
U. Watershed<pistrict
0`Water1Sewer ..
DESGKIF I IUN UI- VVUMtt t u mr- rmr-rumivir-u.
i
C A
Identification Please Type or Print Clearly)
OWNER: Name ict.�.�v.v.c.� 4-r�vr�►4^ s Phone: Q4
Address: VN Cha II
CONTRACTOR Name: SAN Phone: US '_`I ('7 'c.� Y�
Address:
Supervisor's Construction License. X15 7U-7 -Exp:
Horime `Improvement Licens
ARCH ITECT/ENGINEE
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.
0o Od
Total Project Cost: $_� �� i FEE: $ /q/.
p
Recei t No.: 13�qqq
Check No.:
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
ire, of Agent/Ow.ner_ _ 5 .. C) -1-- SI" nature of;confractOr
g _� . u �_ �__�
Location I � /' / S�-C
No. 3 Date
TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee $ ' G'
TOTAL $ I C I
Check # �'G / (V
24947
Building Inspector
Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
TYPE OF SEWERAGE DISPOSAL
Swimming Pools ElPublic Sewer ElTanningTanning/Massage/Body Art ❑
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 Snature
COMMENTS
HEALTH Reviewed on Signature
/i
COMMENTS
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision:
Comm
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. .
LOcato&zit 124: Main ,Street
Fire'Departnient;sigtiature/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
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: INSPECTIONAL SERVICES DEPARTMENTMFORM07
Revised 2.2008
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104 Otis St.,.Northborough, MA 01532 ' J&L WINDOWS, INC., D/B/A ( 'IA Home Improvement Contractor
(508) 919-0900 • Fax: (774) 987-3013Rvenewal - s cense #149601 (Expires 1/24/2012)
lbyAndersen. Federal Tax ID #83-0404201
WINDOW REPLACEMENT an And,—C11,,my
CUSTOM WINDOW AND DOOR REMODELING AGREEMENT
Name i Date of
Buyer(s) Sheet Address, City, State, and Zip Code '
E -Mail Address Home Telephone Number Work Telephone Number
Buyer(s) hereby jointly and s(berally agrees to purchase the products and/or services of J & L Windows, Inc. d/h/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.
Total Job Amount _�
Estimate rcrtin Date:
Method of Payment: OCheck ❑Cash ' nced
Deposit Received (33%):�
Balance at Start of Job (33%):
Balance on Substantial
Completion of Job (33%):-/:��y�
Estimated Comp9plefl Date:
_ G
z
Credit Cards are accepted for deposit
only — maximum 1/3 of the project cost.
Please see Credit Card Payment Form.
By signing this agreement, you acknowledge that the Balance at Start of Job and the Balance on Substantial Completion
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
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 W. Inc. d/b/a newal by Andersen Bu O "
Bv- 'U4✓
Si ture ofodu Manager i ure
Print Name of Product Manager Print Name
Buyer(s) '
Signature
Print Name
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.
— — — — — — — — — — — — — — —�<- — — — — — — — — — --- — — --- — — — — — — — — — —
NOTICE OF CANCELLATION NOTICE OF CANCELLATION
Date of Transaction . You may cancel Date of Transaction . You may cancel
this transaction, without any penalty or obligation, within I this transaction, without any penalty or obligation, within
three business days from the above date. If you cancel, any I three business days from the above date. If you cancel, any
property traded in, 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 1.0 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 as when received, any goods delivered to you under this
this Contract or Sale; or you may, if you wish, comply 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 you do make the goods available to the Seller and the I the goods available to the Seller and the Seller does not
Seller does not pick them up within 20 days of the date pick them up within 20 days of the date of your Notice
of your Notice of Cancellation, you may retain or dispose of Cancellation, you mZ
retain or dispose of the goods
of the goods without any further obligation. If you fail to without anf further ogation: If you fail to make the
make the goods available to the Seller, or if you agree goods avai able to the er, or if you agree to return the
to return the goods to the Seller and fail to dso, then goods to the Seller and fail to do so, then You remain liable
you remain liable for performance of all obligations under for performance of all obligations under the Contract.
the Contract. To cancel this transaction, mail or deliver a To cancel this transaction, mail or deliver a signed and
signed and dated copy of this cancellation notice or any I 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 Chis I Inc. d/b/a Renewal by Andersen, 104 Otis Street,
Street, Northborough, MA 01532, BY NOT LATER THAN Northborough, MA01532, BY NOT LATER THAN MIDNIGHT
MIDNIGHT OF . (Date) OF . (Date)
1 HEREBY CANCEL THIS TRANSACTION. I I HEREBY CANCEL THIS TRANSACTION.
Buyer's Signature Print Name _ Date Buyer's Signature Print Name Date
RbA Copy - White Buyer Copy - Yellow Buyer Copy - Pink
104 Otis Street, Northborough, MA 01532
Phone 508.919.0900 • Fax 774.987.3013
Buyer(s) Name
J & L Windows, Inc. d/b/a
rRenewal
byAndersen.
WINDOW REPLACEMENT -Arid
OF G—Tix MA$SAMSE!M AND NEW HAMPS M
WINDOW SPECIFICATION SHEET
_ MA HIC License # 149601 (expires 1/24/ 12)
Federal Tax ID# 83-0404201
Date of Agreement
The Buyer(s) listed above herdby 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 DETAIIS
1. Co gactor will Install a total of windows in Owner's home, using the following individual quantities:
Double Hung (DB) ual 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 (GPW) ❑ 1:1:1 or ❑ 1:2:1
Awning Window (AW) Picture Window (PW)
llay�or Bow Window Patio Doors (see separate Door Specification Sheet)
2• Yes ❑ N3,Qty
of Windows to be Custom Fit Replacement:
3. El Yes o of Sills to be replaced by Contractor:
4. ❑ Yes o Qty of Windows to be New Construction Full frame (includes new interior & exterior casings) and actual
Exterior casings: LJ Pine ❑ Maintenance -free material ❑ Factory applied 908 Fibrex brickmold
5. Glazing to be: Low- E-4 TM " ❑ Other If other, please specify:
6. Exterior color to be: ❑ White ❑ Sand14,C-an—vas ❑ Terratone ^❑ ^C�oc�oa Bean
7. Interior color to be: ❑ White ❑ Sand ❑ Canvas El Terratone L�-E L Maple ❑ Oak
Note: Interior color ca y be white, wood or same color as exterior. Wood interiors need to finished by Owner.
8. Hardware : ❑ White Stone ❑ Canvas ❑ Brass ❑ Estate Hardware: Style:
9. ❑ Yes ❑ No Install Lifts with Double Hung Windows
10. Screens: windows to have: ❑ Half or ❑ Full screens Screens to be:fiberglass ❑ Aluminum ❑ TruScene
11. Windows have grilles:
Qty: __/ Qty:
GRUIX DETAIIS
❑ No If yes: ❑ Grille Between Glass (GBG)
Interior Wood t mv) ❑ Full Divided Light (FDW
Qty Qty Qty: Qty: Otv:
DH DH DH DH CW/ wre Glitler CF'W orG
Draw grille patterns above
`Use additional sheet if needed
ADDITIONAL WORK DETAILS
Owner approved (initials):
12. ❑ Yes ontractor will remove metal frames of windows. Qty of Units:
13. ❑ Yes o Contractor will install new paint -ready or stain -ready casings.
Interior c . g qty of openings: Exterior casings qty of openings: ❑ Pine ❑ Maintenance -free material
14. ❑ Yes o Contractor will install new paint -ready or stain -ready inside or outside stops qty of openings:
Interior stops qty of openings: Exterior stops c1tv o @ gs: - ❑ Pine ❑ Maintenance -free material
15. Owner is a�e that Contractor does not do any paintingg. G Owner Initials
16. ❑ Yes 2No Contractor will wrap exterior casings with alum' oll stock of color.
ote: Wrapping may be required with storm window removal; removal of storm windows will leave screw holes in casing.
] 7. s ❑ No Contractor will insulate, caulk and seal windows with 3 -point system to prevent water and air infiltration.
18.'/es ❑ No Cleanup all job related debris including old windows will be removed. Vacuum nightly.
19. fes ❑, No A limited warranty shall be issued to Owner upon completion of the job and payment in full.
20.Wdditional
No B Permit�ontractor will secure any and all necessary permits. The fee for the permit(s) is not
ded in the Contract Price and a separate check is required at the time of sale for this fee.
21. No All discounts have been applied to this agreement price.
22.jobdetails:
23. VYes ❑ No Owner agrees to be present on the final day of installation for final inspection and to deliver final payment.
No final payment shall he demanded until the contract is completed to the satisfaction ofall 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 SheeL
Renewal n of ter MA and NH Buyer Buyer(s)
By:
S' tore of o tract ager Signature
Print Name of Product Manager Print Name Print Name
'e Camrnan�eaitis of hfars¢chusett�
' Departrneaf ofircdusiricQlticcidenfs
pec of fnt'esfigaiians
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'a easafian �,srrrsnee A�.�� $vild.ers/Cantr'ae�r�l�I� � tLaWffil
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Are you am ean*yefi Chock$ie &pPro pri � confracinr andI 6, �] New constrncfion
L -I an a mnpSoyorVq%fi� D 4. Q'iam a i�
at-fimc), haw �ircd the sub-coatactnrs
cmployDcs (fallandlor p Nh d an tbz aftaabcd shrct t
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Tnese sub-co�cton have
ship Bid hm I1D cmplapees valk Lq' DO=, III6lILSIlC0. S, � Btr di g addrfiaa
rvaridng for ma is say eapaartF. S. ❑'wp are a GMpM7 aril its 1a.�] Elad m! rmpeira or addt6onr
o tivarkcra' comp msyssaca Boa ar additions
offie�n havo czaizisad thniL EI Plumbing rep
inquir°d.),' rlgint of ==iptip par MCsL Ll
am a lmmeov = doing an WO& a LEI, and wa hsva art t2.Q RDof sopHs�
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tAay �firxntt� elm bat t�1 nw+$ nioo f 11 orfi fag scefirm b deo � �� �aese s�ihsYlt indieafiaE znr.�, .
t gnmeax�ua wha cubmlt tiro dndm m irsfmE moi' ece bning eltRad e� fam buc ocdsi mi
t w��, °°rap p°ti�y mfnr 1°a
ua sddifinasl r�eetdwn'inE the aa� of 9u �r-onntacln<s
as ton S ehecYthis hazm � ers, 'Belup'Ir the poh* and jab cite
I am ant ctrtploj�rr thatia praYu{Tng xnrkers' corxpeasadan u,,sra-ansce fc�r my cmplvy •
ircfarraa�fors. .. ' ) — •
Insma, ma Company 2�amc;
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Job On Address: nsmiber En3 es�Bfinn date).
deelsraf%au para (sh.awiag Elia poky
ktLCE a copy of the VMrimrr' enrzzpcnsEtinn policy c; LSZ can lnad to imposifion of aaminal pcna$scs of a
Fang to sCCarc covamge ea rogaired tm$rr SeDfinn 25A of r �n 1 'nfi in 6D fi�'of a 5rop Wdk� QRI��ER snd a f�
fine upon $L,SDQ.QO snd/ar ono-ycBr imprisonrnmt as melt a s of l p ha fnrwardn6 to fba Dffmr of
-afvp to S2511,00 a day against I= violatnr, Br, a$visod 6 9 a acpy.of tisis st�mLnt
Invmajq Elam of tba Mk fnr fns a=t onmmgo
vmffimfim
I da hereby c a the pains and prnaffica erjury flint the k farm¢tian prmlided rt6vPe u irae¢na corra��
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are to be mmplefed by city ar torn a tciul
Dicta! rtsi nnfy. Dn not write in this a,
City Dr Tomm!
. ' PermitlLi�B �
nncAt horiEy (circta ane : ectnr 5 Piam3. . LnSP�tnr
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Cmrtlkct Peron=
Massachusetts - Dc 1partment of Public Sala.
'Boartllof Buildin_r RcniiLtinns and Standai-ds '
Construction Supervisor License
License: GS 35707
BRIAN DENNISON r.
86 CREST CIRCLE
WORCESTER, MA 01603
Expiration: 8/3/2012
Unnint ksiuncr TrR: 2672
II .ii`• , �' .✓OLEy lIJGyTR//7!.{1'KIrJE�G(AY O�✓!'W�QCIiU6EGf0 Yt.
. Office of Consumer Alla@ra & Business Regula -tion �.
J. H0ME fgI ROVEMENT CONTRACTOR
Registiationn '
Expi _ 12
f Card
�h
RENEWAL BY qC�l
"BRIAN. DENNIS
1D4 OTIS STREE
NORTHBOROUGH, ' ' �2 Undersecretary
A�LYCERTIFICATE.OF LIABILITY INSURANCE
DATE
021'
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(%, AUTHORIZED
REPRESENTATIVE DR 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
J.P. McKeone Insurance Agency Inc
JP McKeone Insurance Agency, Inc.
P.O. Box 333
CON ACT
NAME:
PRONE FAX
ac No Ext, (734) 662-8100 (A)C,No:
ADDRESS:
INSURER( AFFORDING COVERAGE NAIC#
Ann Arbor, MI 481060333
INSURER A.. Nautilus 19662
INSURED J&L Windows, Inc. Renewal by Andersen
INSURER B; Hartford 37478
INSURER C:
104 Otis St.
Northborough, MA 01532
•
INSURER D:
INSURER E:
INSURER F:
DAM"GE TO RENTED 1 00,000
l
noQrrorero All IRAQ CQ. KF V[till IN Nr IMMMM,
vTHIS 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 W FH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
LTR
TYPE OF INSURANCE
ADDL
SUER
POLICY NUMBER
POLICE
MM! C LIMITS
A
GENERAL LIABILITY
NC958461
10/01/2011
10/01/2012 EACH OCCURRENCE $ 1,000,000
DAM"GE TO RENTED 1 00,000
l
COMMERCIAL GENERAL LIABILITY
ES Ea ocrrence$
PREM Scu
CLAIMS -MADE V OCCUR
MED EXP (Any one person) $ 5,000
PERSONAL & ADV INJURY $ 1 ,000,000
_
_
I GENERAL AGGREGATE $ 2,000,000
- -
` PRODUCTS -COMPIOPAGG 5 2,000,0DO
GEN'LAGGREGATE LIMIT APPLIES PER:
POLICY PRO- LOC
-
I $
AUTOMOBILE LIABILITY
35 MCCXD6390
10/01/2011
10/01/2012 COMBINED SINGLE LIMB 1,000,000
• Ea acciden
ANY AUTO
I BODILY INJURY (Per person) $
ALL OWNED SCHEDULED
I BODILY INJURY (Per accident) $
AUTOS AUTOS
NON -OWNED
DAMAGE $
I
HIRED AUTOS AUTOS
PePROPERTY'
$
UMBRELLA LIAR
OCCUR
EACH OCCURRENCE $
EXCESS UAB -
CLAIMS -MADE
I
-
-
AGGREGATE $
DED RETENTION
A
WORKERS COMPENSATION35
WECPP1444
02/17/2011
02/17/2012 WCSTALIMTU=TSI O R-
1
AND EMPLOYERS' LIABILITY
500,000
ANY PROPRIETOR/PARTNER/EXECUTIVE
E.L EACH ACCIDENT $
OFFICER/MEMSER EXCLUDED?
(Mandatory in NH)
N / A
E.L DISEASE - EA EMPLOYEE $ 5OD,000
It yes, describe under
500,000
DESCRIPTION OF OPERATIONS below
E.L DISEASE -POLICY LIMIT $
B
PEDOH555DO 0507
09/27/2011
09/27/2012 i
i
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, it more space is required) -
GtK I It-IGA 1 t HL)LUtH L:ANL t:LLA I ILAN
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 - -
Ud 19136-ZUI U AGUKU GUKt'IJKA I IUM. AN ngnrs reserves
ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD
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Renewal
byAndersenn ----'
WINDOW REPLACEMENT an AntittsenC:omp+ny
WoodNinyl Composite IF
Dual Argon Low E4 SmartSun
civ
Double Hung
100-00473518-010
PERFORMANCE
RATINGS
ENERGY
U -Factor (U.S)/I-P
Solar Heat Gain Coefficient
0.29
0A 9
ADDITIONAL PERFORMANCE RATINGS
Visible Transmittance
Om42-
an.f..t_ stipulates that Masa .tinge eonlerm to applicable NFRC procedures for datamrnimg what product
NFRC ratings gra ddtarmi .d for a tb[ed set of envbonmantal Bond§ions and a specific product sea.
performance. use.
NFRC does not recommend any product and does not warrant the suitabiNly of any product for any specific
information.
Consult manufacturer's 1h.,atara for that product performance
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