HomeMy WebLinkAboutBuilding Permit #114 - 461 SUMMER STREET 8/10/2009 BUILDING PERMIT o` No RT" qti
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
�yPermit NO: Date Received
gSSACHUSEt
Date Issued:
IMPORTANT: Applicant must complete all items on this page
LOCATION o� ctiMyv�f '
Print
j PROPERTY OWNER
Print
MAP NO: PARCEL. ZONING DISTRICT: Historic District - yes no
Machine Shop Village yes no
i
I .
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
New Building One family ✓'"
Addition Two or more family Industrial
Alteration No. of units: Commercial
Repair, replacement Assessory Bldg Others:
Demolition Other
Septic Well Floodplain Wetlands Watershed District.
Water/Sewer ,m
DESCRIPTION OF WORK TO BE PREFORMED:
� L
Identification PI e se Type or Print Clearly)
OWNER: Name: Phone:
Address:
CONTRACTOR Name: P�-U, 1� aLU�d` Phone: S�-'
C;.k'l
Supervisor's Construction License: 95�)O'J Exp. Date: 6 ,
Horne Improvement License: I fCed 'Exp. Date:____Lt D
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.: S� Receipt No.: 2
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
ignature of Agen#/Ownet4 ;r` Signature of contrac —
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
i
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 124Main Street
fire Department signature/date _
COMMENTS
Dimension
Number of Stories: Total square feet of floor area, based on Exterior dimensions.
Total land area, sq. ft.:
ELECTRICAL: Movement of Meter location, mast or service drop requires approval of
Electrical Inspector Yes No
DANGER ZONE LITERATURE: Yes No
MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine
NOTES and DATA— (For department use
i
I
I
s
❑ Notified for pickup - Date
--..._....._........._._...__..._._......_ ........._......._................_.._-...._....._...........__................----......................._.....................-...._...........----._......__-._..........................--..__... --._..........................................
Doc.Building Permit Revised 2008
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
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
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
I
Doc:Building Permit Application
Revised 2.2008
Location
No. ��� Date
NORTH TOWN OF NORTH ANDOVER
00
Certificate of Occupancy $
;�s"'•'°'t<� Building/Frame Permit Fee $ _
s�CHus
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check # / (
22509 ,fes
E iu IIng Inspector
ORT#i
TONM o Andover
0
No.
over, Mass.,_9/1o/"
0 LA E
COCHICHEWICK
IT oj�'ArE D P'*1 BOARD OF HEALTH
Food/Kitchen
PERMIT T D Septic System
THIS CERTIFIES THAT............ ............................( BUILDING INSPECTOR
...... /..... Foundation
has permission to erect........................................ buildings on ..../ 1c),I.V'r ... .........................................
A T(� Rough
tobe occupied as........................................f7...... ..................................................................................... 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 CONSTRU=O -$TART Rough
...... ........... ... ............
....................... ..........................
............... BUILDING INSPECTOR Service
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.
Renewal MA License#149601 (expires 1/24/10)
o00 E E y AL B i A DERS�' Federal Tax ID#83-0404201
byAndersen
WINDOW REPLACEMENT u,A°dv nCo p,,y OF GREATER MASSACHUSETTS AND NEW HAMPSHIRE
104 Otis Street<Northborough,MA 01532
Phone 508.919.0900•Fax 508.919.0903
CUSTOM WINDOW ARID DOOR REMODELING AGREEMENT
Buyerlsl, o e - Date of Agreement
KL�M' 14
1� , (-11,WA Z��a h2e
Buyerisl.Street Addre ity,State,and Zip Code r
E-Mail AddressHome Tele hone Num/bfr Work Telephoone Number
bo
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.
) Method of Pymnt:0 Cash 0 Check 0 Mastercard 0 VISA
Total Job Amount: I Estimated Starring ate: El Discover F' cad,App#:
i
Deposit Received(33%):
Name on Credit Card:
Balance at Start of Job(33%):/ Est' ote mpletio Date: Credit Card#:
Balance on Substantial
Completion of Job 33%): / EE�� CC Exp.Date: CC Security Code:
By initialing here,you acknowledge that the Balance at Start of job and the Balance on Substantial Completion
Buyer Ini ' s 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 enddre 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 BLAND SPACES.
Renewal bi AncLersenreateIMA and NH Buyer(s) Buyer(s)
. }
1 ��
Sigtaature oyProduct Ma Qer _ Siaiuiei ��� Signature
rint Name of Pro uct Manager Print Name 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.
— — — — — — — — — — — — — — —X- — — — — — — — — — — — — -�<— — — — — — — — — — — — —
NC9TICE OF CANC L IONX NOTICE OF-CANCELLA70ON
Date of Transoction . You
may cancel I Date of Transaction . You may Cancel
this transaction,withoeb ny p lea or obligation,within I this transoetion,without any ena or obligation,within
three business days frothe above date.If you cancel,any three business days from the above ate.If you cancel,any
property traded in,any payments made by you under thei pr®perty traded in,any payments anode by you under the
Contract of Sale,and any negotiable instrument executed I Contract of Sale,and any neeotiable instrument executed
by you will be returned within 10 days following receipt I by you will be returned within I0 days following receipt
by the Seller of your Cancellation notice,and any security I by the Seller of your Cancellation notice,and any securi[[�
interest arising out of the transaction will be canceled. 1 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 your residence, in substantially as good condition as .
when received, any goods delivered to-you under this 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 Xinstructions of the Seller regarding the return shipment of
the goods at the Sellers expense and risk.If you do make the goods at the Sellers expense and risk.Ifyou do make
the goods available to the Seller and the Seller does not the goods available to the Seller and the Sealer does not
pick them up within 20 days of the date of your Notice I pick them up within 20 days of the date of our Notice
I Cancellation,you seen retain or dispose of the goods I ofr Cancellation,you ma retain or dispose o�the goods
without any further obb11c�ation. If you fail to make the I without any further obi.g�ation. If you fail to make the
goods available to the Seller,or if you agree to return the I goods available to the SeIer,or if you agree to return the
goods to the Seller and fail fro do so,thenyou remain liable oods to the Seller and fail to do so,then yyou remain Liable
For performance of oil obligations under the Contract. For performance of all obligations undler the Contract.
To cancel this transaction, mail or deliver a signed and To cancel this transaction, mail or deliver a signed and
dated copy of this cancellation notice or any other written dated Copy of this Cancellation notice or any other written
notice, or send o telegram to Renewal by Andersen I notice, or send a telegram to Renewal by Andersen
of Greater Massachusetts and New Hampshire, 104 1 of Greater Massachusetts and New Hampshire, 1104
Otis Street, Noct bo:oatgh6
Kutp1532,NOT LATER THAN Otis Street,Noou lx, 1532, N07 LATER'THAN
91MIDNIG'HT OF .(Date) MIDNIGHT OF 2b0 � .(Date)
I HEREBY CANCEL TkS T h9S CTICEN. X I EIERE�y CANCEL' I-0IS TRANS CTION.
I
Consumer's Signature Date I Consumer's Signature Date
RbA Copy- White Customer Copy-Yellow Customer Copy-Pink
Renewal RENEWAL BY ANDERSEN MA License#149601(expires 1/24/10)
Andersen. Di ART MASSACHUSETTS
CC C2T c ♦w ISI HAMPSHIRE c DL Federal Tax ID# 53-0404201
WINDOW REPLACEMENT .n dasm'o,p , OF GREATER MASSACHUSETTS AND NEW HAMPSHIRE
104 Otis Street•Northborough,Massachusetts 01532
Phone 508.919.0900•Fax 508.919.0903
SPECIFICATION SHEET
Buyer(s Tame Date of Agree rat
V j
The Buyers)listed 4 ove 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. tractor will Install a total of windows in Owner's home,using the following individual quantities:
Double Hung(DB) [&<Ual sash A'(ttage sash(1/3 top,2/3 bottom) ❑ Oriel sash(2/3 top.1/3 bottom)
Casement(CW) /g>hnge 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 '3
Awning Window(AW)
Picture Window(PW)
Bay or Bow Window
Pdio Doors(see separate Door Specification Sheet)
2. �-., �N�o Qty of Windows to be Custom Fit Replacement: -
LCJ�o
3. ❑ Yes Qty of Sills to be replaced by Contractor:
4. E14es ❑ No Qty of Windows to be New Construction Full frame(includes new interior&exterior casings)
Exterior casin • ❑ Pine ❑ Maintenance-free material ❑ Factory applied 908 Fibrex brickmold
5. Glazing to be: P Low;P&SmartSunTM (Tex CreditEkole) ❑ Other If other,please specify:
6. Exterior color to be: [ hite ❑ Sand ❑ Canvas ❑ Terratone ❑ Cocoa Bean
7. Interioncolor to be: 5—shite ❑ Sand ❑ Canvas ❑ Terratone ❑ Pine ❑ Maple ❑ Oak
Note: Irate r color can only be white,wood or same color as exterior. Wood interiors need to finished by Owner.
8. Hardware: ite ❑ Stone ❑ Canvas ❑ Brass Double Hung:
9. ❑ Yes Install Lifts with Double Hung dows
10. Screens: windows to have: E] Half or ulI screens Screens to be: fiberglass ❑ Aluminum ❑ TruScene
/ GRILLE DEME S
i
11.Windows ve grilles: ® Yes ❑ No If yes:P Grille Between GI s(GSG)❑ Removable Interior Wood oxrW)❑ Full Divided Light(FDL)
QtT Qty:— Qty:J— Qty: Qty: Qty: I Qty: I
d t If C'
H DH CH DH ictu ide, CPW I
Draw grille patterns above "Use additional sheet if need; Own approved(inti
ADDITIONAL WORK DETAILS
12.❑ Yes Contractor will remove metal frames of windows. Qty of Units:
13.F-1Yes Er No Contractor will install new paint-ready or stain-ready casings.
Interiorasmg qty of openings: Exterior casings qty of openings: ❑ Pine ❑ Maintenance-free material
14.EJ Yes oContractor will install new paint-ready or stain-ready inside or outside stops qty of openings:
Interior stops qty of openings: Exterior stcV-P�um—EC-0ii!St�Ock
❑ Pine ❑ Maintenance-free material
15. Owner is aw that Contractor does not do any painwner Initials
16.❑ Yes o Contractor will wrap exterior casings wit 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. Y s ❑ No A limited warranty shall be issued to Owner upon completion of the job and payment in full.
19. P ❑ 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:
21. Yes ❑ No Owner agrees to be present on the final day of installation for final inspection and to deliver final payment.
No final payment shall be demanded until the contract is completed to the satisfaction of all parties.
It is agreed and understood by and between the parties that this Specification Sheet,along with the CUSTOM WINDOW AND DOOR
REMODELING AGREEMENT,constitutes the entire understanding between the parties,and there are no verbal understandings changing or
modifying any of the terms. This Specification Sheet may not be changed or its terms modified or varied in any way unless such changes are
in writing and igned by both the Buyer(s)and Contractor. Buyer(s)hereby acknowledge that Buyer(s)has read this Specification Sheet.
Renewal b de. of an Buyer(s) Buyer(s) )
v
S' fire p�f Pro !ct Manager Signature X) Signature
X/7:-;
Print Name Product Manager Print Name Print Name
RbA Copy- White Customer Copy-Yellow
The Commonwealth of 3fassachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston,MA 02111
Y www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Colitractors/Electriciains/Plumbers
Applicant Information Please Print Legibly
Name(Business/Organization/Individual): Rer)e0r.) / �nder-Se,4
Address: /D q Ui
City/State/Zip —A f jo ro f Phone#: o 00
Are'you an employer?Check the appropriate box: Type of project (required):
L aI.am a employer with J C) 4. El am a general contractor and I
have hired the sub-contractors 6. ❑New construction
employees(full and/or part-time).* '7.• emodelin
2.❑ I am a sole proprietor or partner- listed on the attached sheet. x g
ship and have no employees These sub-contractors have 8. Demolition
working. for me in an capacity. workers'comp.insurance:
g Y P h'• 9. E]Building addition
[No workers' comp.insurance 5. ❑ We are a corporation and its
10. Electrical repairs or additions
required.] officers have exercised their
3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions
myself. [No workers' comp. c. 152, §1(4),and we have no 12.❑Roof repairs
insurance required.]t employees.[No workers'
comp.insurance required.] 13.7 Other
*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 worker;'comp.policy information.
I am an employer that is providing workers'compensation insurance for my employees Below.is thepolicy and job site
information. ))
Insurance Company Name: . ' �C Ke-0 r)-P— /n n
Policy#or Self-ins.Lic..#: J `�� ��� l'�`} _ Expiration Date: »�,f
Job Site Address:_ 5� -� City/State/Zip:
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration ate).
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��rtlepains and penalties.of perjury that the information provided above is true and correct
Sienature: I Date: Q/�)5
Phone#: % - d CYJ
Official use only. Do not write in this area,to be completed by city or town officiaG
City or Town: PermitUcense#
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#:
�'�'�;. ::` ��ie�joy�ym4�uaea��i a�✓4Lcraaac�
Board of Building Itegulatipns and Standards .
A. _ 'Construction Supervisor License
License;,CS 95707
6i trate ;91a/1982 i
E, ration-928/2010 Tri 95707
Rests
_ •l;t r•�; •(`_r_7 tri
BRIAN DENNISOIx � _ l+
86 CREST CIRCLE
WORCESTER-,MA 01603 Commissioner;
RENEWAL BY ANDERSON
ON
BRIAN .DENN1S.
104.OTIS STREET
NORTHBOROUGH, MA 01532
DPS•CA1 C, SOM-07167•PC8490 O
__F. ✓/ie [Doawnwouaeai ✓�GaJa¢c�zube�la
Board of Building Regulations and Standards
HOME IMPROVEMENT CONTRACTOR
Registrafi.011, 149601
rE_x_Qira i^:o124/2010
Upplement Card
RENEWAL BY P[lI7.E�f�QN_:tc�
BRIAN DENNIS r.;J
104 OTIS STREET` S;;
`NORTHBOROUGH,MA 01532 Administrator
���RD � � °� F UABILI INSURANCE DATE(mmpluff �
02/17/2009
PRODUCERTHIS CERTIFICATE IS ISSUED AS A'MATTER OF INFORMATION
Joseph McKeone ONLY AND COFFERS NO RIGHTS UPON THE CERTIFICATE
JP McKeone Insurance Agency, Inca HOLDER. THIS CERTIFICATE DOES MOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES.BELOW.
P.O. Box 333
Ann Arbor, MI 46105-0333. INSURERS AFFORDING COVERAGE MAIC#
`D Renewal by Anderson
INSURER A: Hartford Insurance Comps iy
J&L Windows,Inc, INSURER B: 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 ETHER 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.
INSR D L POLICY EFrECTME POLJCY ERPIPATION
LTR NSR e F POUCYNUMBER LIH{TS
B: GENERAL LIABILITY HCP 507 404 09/07/2006 09/07/2009 EACH OCCURRENCE I S 1 Z0,000
COMM
ERCU+L GENERaAL UABILIIY _ DAWGE To PREMISES Me a=saen� S 10Q 00Q
CLAIMS MADE ®OCCUR OMED EXP(Anyone person) S 5 000
PERSONALBADV INJURY s 1000 000
GENERALAG'REGATE S 2.000 000
GENLAGGRE(GA�TELIMIT APPLIES PER:.
PRODUCTS•COmP/OPAGO S 2,000000
POLICY I P F"COT LOC
A AUTOMOBILE uABtury 35 MCC XD 6390 10101/2008 10/01/09 COMBINED SINGLE LIMIT
ANYAUTO (EBeWdenl) a 1,000,000
X ALL OWNED AUTOS
SODILYINJURY
SCHEDULED AUTOS (Per person) S
HIRED AUTOS
NON•OWNEDAUTOS p0er$L�ntjRY S
PROPERTY DAMAGE
(Peracidenq S•
GARAGE LABILITY AUTO ONLY,EA ACCIDENT I S
ANY AUTO OTHER THAN EA ACC S
AUTO ONLY: AGG S
EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE Is
OCCUR . a CLAIMS,MADE AGGREGATE
$
S
DEDUCTIBLE S
RETENTION
A WORKERS coMPENSAnoNAND 35 VVEC PP 1444 02/17/2009 0211"!/2010JTS
WesrArU. IoTH.I
FR
EMPLOYERr UABJLCTY
ANY PROPRIETORLPARTNERIE:ECUTWE E.L.EACH ACCIDEPIT S 500,000
OFFICERIMEMSER EXCLUDED?. E.L.DISEASE.EA EMPLOYEE S 500,000
Uea,AL PROVISIONS polow o under
s�EDwL PREL DISEASP.POLICY LIMIT S 500,000
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I ErCLUSIONS ADDED BY ENCORS&.1111T I SPECIAL PROVISIONS
CERTIFICATE HOLDER CANCELLATION
plc SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPUdAT{ON
INSURED COPY DATE THEREOF,THE ISSUING INSURER WALL ENDEAVOR TO MAIL 10 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER I'MED TO THE LEFT,BUT FAILURE TO DO SO SHALL
IMPOSE NO 013UGATION OR LIABILITY OF AIN KNO UPON THE INSURER,ITS AGENTS OR
REPRESENTATPrr.S.
AU'IHORMEO REPRESENTATIVE
ACORD 25(2001108) 0 ACORD CORPORATION 1993
�pRC re al
NMv�t1.1;v" pn INoodNioyl Composite'Frame
Rump GixricAA DUAI, k9on low E
Piclure
ENERGY PERFORMANCE:RATINGS
U-Factor(U;S)ll.P" Solar Neat Gain Coefficient
- 0- -3-2
ADDITIONAL PERFORMANCE RATINGS I
visible.Transmittance ;
' hNn�►c+YnrO�yV+•,MIN•'••I•tMP••nh�n•N.hl•�t,t,jq^0 rt•r fr � ., ,
rrr•�rNM•. Ih'r� Mhr'441nE 7Mih�I�IMt . . •
NMC AIM/►M I•bOMy1 air•k•I!•t N MWNII►MJsiM�n.�A•}q•NII•M!y!"t 1h., .
Nf�c�t:•nt♦Ih��,,,Ml iA+1•alN/I»t�»I+rwn)M••.W�1/1/:/rY/holy""Ffn vpwoll•.
. - �O•q►uRT•nuq•tur1r,11•MiwhrN�.r I.tM., 'hM11M1•Ib . ) �' .
DESIGN.PRESSURE'(PSF)
.50 -021
0 4
ukl V k '
M•,u��••q/•KEA.0,EC.It WC,0-/IrIeMN�•n w�Ylh+f.RK WOMA II•Mrk CwV,c,E.y�nMT ••
r •
o
RJre al
BY ANDAAM'
WoodNinyl Composite FrameLow E
tjajbrial F0e*GVa M' Dual Argon.
Rating Catmcitt:�l Glider
ENERGY PERFORMANCE RATINGS -
U-Factor(U-S)4-P Solar Heat Gain Coefficient
030
111.34 . .
�.
ADDITIONAL PERFORMANCE RATINGS -
Visible Transmittance
00. 49 ,.:.
manufacturer sdpuletes that loose ardjrnil9ncd lora Axed satlol envlron�mental condltio sandtee rmIpeNAe produc size.
performance.NERC.tgtln944[!!d_.........,.,„•
NFRC does not recommend any productand does oo"Artant'Iho'sulfab111ty otanypraduct{oteny epoeltic uae...
ConsultmanufocturorsaterajuratorotherproduetperfomuneaLlnt6mmtl n•
www.nfte:o '
n •
DESIGN PRESSURE(PSS
ndoa aor
s Do0
Menu pssodeTim
-WW.ww.w�dmn:com '
HS L C 2 5 100-00296313-006
Toledm ANSIIMMArNet'WDA 101 .52.91orNAF9-01. Meau[Murer sti" letumntomucrz to theaexNe dnndxrd+. i
Meets or exceeds M.E.C.;C.E.C.S I.E.C.C.Nr lnflatmtlon requlnments WDMA Haltrnerk Cartlflceaon Pm9rem• .
Y
is .. . ..
••� .' r Nriaiilfbif� Wood,Ninyl,Gornpgs(lr�+'zm� :•
i third Dual Pane Mppn• Cow E
Ca men
i sa [
..
Jim
i { ENERGY PERFORMANCE RATINGS
zr(U-VICoefficient '
•, U•Facto ( ,)1. Solarjieat Gain
30-
AD.Dftl.ONAL'PERF.QRMANCE"RATINGS.
VisiVe•T•ransmitVance.' `
M+nV�orUnr itlputalµc hl,l Nri�i htkgs conro�b rppHwbb M;bi dores,la a q knoll
. � Dfoducl pdrfoml,nu,,lrt�{C nlMpi,tr aeth�l+►re for r ru�O,nL er rpr6on!n�pu1 Wnd�tionru+e� •
' '. ipecil(cp►od'ud�Irt.Con:�lrmi�Ul,oluier'ltillnru��{oro ►,rptoeuofpiAanlano�inloligdlon:• .
•�'vr.NrCrO'. '
1
• --� .. . . ate'. - - '.. '� , . ... • .-�x`.:-�'�="-'x••
Design Pressure(PSS r �
• ■■w-,- V.'A(7 y• �M.il►.pr1Lq lir•Merr���0t .,orut�r
Y f��.nllral..b�brh.
.. .. � OArlo NfN rA Lr.r g11.w+rn t. .
Meil�or t2cudi M.EO;,�tA,1 I,E;O G AirInllllishm AtgUITti ienti WOMA Haim"le GeNfkillan►IMful'
j
k
r
re at,
gC
BY ANDERSEN'
wood/Vinyl composite Frame
pleta�at Feriesbabvn Dual Argon. Low E
Ratigg Cmc7® Glider
"'E
NERGY PERFORMANCE RATINGS -
U-Factor(U.$)/I-P Sofas Heat Gain Coefficient
0.
30
ADDITIONAL PERFORMANCE RATINGS -
A
Visible Transmittance
0049
Manufeeturerstlpulates thatngs those
retlngs wnform to applicable NFRC procedures for dotermintng whole product
performance•ryFutst0RO sthattho.delagnined lora Axed set of environmental condillm and a specift product size.
NFRC.does not recommend any product end does notwiertahl'tho'ii ltablAty of eny product for MY Specific uae..
Consult manufacturer's literature for other product perfomtaeeaintormatlort. '
DESIGN PRESSURE(PSS
YMtlea end Do¢
audacsueS Aaradedon
M www.wcmn:eom ' .
H S - LI. 106. .0206313-006
• 7ated to ANSUMMAINWH'DA101 +-e7orNAFS-02 Mmu[Murer st'ulmcs mnfomNeento the Gcehle anndnrds
CEA&M.C.C.AIrtnMbatlon requirements WDMA Hallmark Certlficatlon Program• ,.
a
` Meets or exceeds M.EC„, '
y