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HomeMy WebLinkAboutBuilding Permit #155-2016 - 5 SKYVIEW TERRACE 8/4/2015 BUILDING PERMIT o` No DT 6� ti TOWN OF NORTH ANDOVER o APPLICATION FOR PLAN EXAMINATION 70 Permit No#: , Date ReceivedA��� " 79A�R.\7Eo I.PP (5 c� � gSSACH►1`-+�� Date Issued: IMPORTANT: Applicant must complete all items on this page C17� LOCATION OIK yyiew �P/? Print . PROPERTY OWNER J')" Pe-t�ORell, Print 100 Year Structure yes &no MAP OO 988 PARCEL: 00do5' ZONING DISTRICT: Historic District yes Machine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ane 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_ _ DESCRIPTION OF WORK TO BE PERFORMED: �P�A? -- Jdentific n- Please Type or Print Clearly OWNER: Name: J 1vN 1dR-e Phone: Address: z312 Contractor Name: �� 7 �I'�� Phone: Email: Address: d UV' e4 Y Ord Supervisor's Construction License: � 57- Exp. Date: �U 4�i1P Home Improvement License: 76 8/L Exp. Date: 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: $ �7v-014 ,00 FEE: $ Check No.: 9tpu� U72 Receip t No.: � 1 `� NOTE: Persons contracting with unregistered contractors do not have access to guaranty fund PQnature of contractor 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 PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes r Planning Board Decision: Comments Conservation Decision: Comments Wafter& Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: Os_ 'FIREiDEPARdTMENT = T�empDumpster onsite � es y � ` n Located 384 good Street Loca ed j - µ _ bL . FiretDepartment�signature/dafe. _ f 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: lies No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— (For department use) ❑ Notified for pickup Call Email Date Time Contact Name Doc.Building Permit Revised 2014 r 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 4. 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 ;rb Engineering Affidavits for Engineered products OTE: 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 4. Workers Comp Affidavit Photo Copy of H.I.C. And C.S.L. Licenses Copy Of Contract Floor/Cross Section/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 OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) Building Permit Application 46 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 2012 IECC Energy code Engineering Affidavits for Engineered products OTE: 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:Building Permit Revised 2014 Location No. — Vl Date • - TOWN OF NORTH ANDOVER • ���'�LEb I6�6. . • ■ Certificate of Occupancy $ a ,w... Building/Frame Permit Fee $201 Foundation Permit Fee $ r Other Permit Fee $ � TOTAL $ _ Check# r Building Inspector NORTFf Town of EAndover O - to 2,elll(e � Z yX C, h ver, Mass, / COC NIC NlWKK 1• SAO �\\r 4A-rE D O'f S U BOARD OF HEALTH Food/Kitchen - PERMIT T LD Septic System THIS CERTIFIES THAT � '17 BUILDING INSPECTOR Foundation has permission to erect .......................... buildings on . ...... ....................................................... Rough 9 tobe occupied as ............... ......... .....�. ....1 .12 <..1 ............................................... Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application Final on file in 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 CONSTRUCTIO STARTS Rough Service ........ ......... . A7...................................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building 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. Smoke Det. I Renewal MA Home Improvement Contractor ` � License#170810(Expires 12123/2015) 7nl � tlt�etSE'n. Renewal by Andersen Corporation WINDOW NEP"CEYEw wMje c�v Federal Tax ID A41-1918413 30 Forbes Rd. Northborough,MA 01532 (508)351-2200 Fax(508)986-7072 CUS`T'OMER NqN'DOW AND DOOR REMODELING AGREEMENT Buyer(s)Name Date: JIM PETTORELLI - MAY 30, 2015 IBuyer(s)Street Address City State Zip Code---7 f 5 SKYVIEW TERRACE NORTH ANDOVER ;A7] 01815 (Email Address Home Telephone Number Work/Cell Telephone Number KERNAPOP®COMCAST'.N ET 978-208-7198 617-817-8303 ,theyibuyer(s)hereby jointly and severally agrees to purchase the goods acid/or services of Renewal by Andersen Corporation("Contractor"),in accordance with Buyer(s)hereby agrees to sign a completion certificate after Contractor has completed all work under this Agreement. terms and carlditions described on the front and the reverse of this agreement and on the attached specification sheet(s)(collectively,this"Agreement"). Total Job Amount $ 24,426 krnount l-aiariced$ 0 Est.Start Date Method of Payment Deposit deceived(33%)$ 8,142.00 oapoeit at 60-nin9$ 0.00 Check Cash 8-10 weeks Balance Start of Job(33%)$ 8,142.00 chw*a Balance on Substantial At Sutismntiat Est.Install Time Credit Card Completion of Job(33%)$ 8,142.00 Conipkt on$ 0,00 3-4 days It credit card is selected,please NO"I shad bedenteetded uxl�' we eaeaLed see Cradlt Card Payrrrent form 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 Buyers right to cancel this Agreement. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. Renewal by Andersen Corporation er(s) Buyer(s) By: iV1+ /I641,1�-L signature of Consultant Signature Signature X MICHAEL BUTLER JIM PETTORELLI Mated Name of Consuitam Printed Name Pied Nania YOU,THE.BUYER(S),MAY CANCEL INS TRANSACTION AT ANYTIME 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 r3ANCELL1170N NOTICE OF CANCELLATION Date of Tmosacdon 5/70/15 You may came!this t Date of Traysacton 5/30/13 .You may taxied this t transaction,without any penalty p rty tea i ed Witltla three business days from the transaction,Without any penalty er obtigndon,a3thln three business days from t$e the Contract eIf ncu cancel,.any property traded In,any payments made by you under t shove date.if you Cancel,any property traded In,any payments made by you under Sate and any negotiable instrument executed by you will be t the Contract of Sale,and any negotiable Instrument executed by you%-M be returned within 10 days following receipt by the Contractor("Seller")of your t returned within 10 days following receipt by die Contractor("Seller') of your cancellation nodee,and any security Interest arising out of the transaction Will be t cancellation notice,and any security interest arising on of the transaction will be canceled. If you Cancel,you must make available to the Seller at your residence,In t canceled. If you cancel,you must make available to the Seller at your residence,in substantially ns goodcondition as when received,any goods delivered to you under i substantially ns good rendition as when received,any goods delivered to youunder this Contract or Sale or you maSS it you wish,comply With the inswetions of the t this.Contract or Sale;or you may;if you wish,comply with the insirnetiomi of the Seller regarding the return shipment of the goods at the Seller's expense and risk. t Seller regarding the return shipment of the goods at the Seller's expense and risk. If you do make the goods available to the Seller and the Seller does not pick them up t if you do make the goods available to the Setter and die Seller does not pick them up Within 20 days of the date of your Notice of Cancethtisa,you may retara or dispose t within 20 days of the date of your Notice of Cancellation,you may retain or dispose of the goods without any further obligation. If you fail to snake the goods avaiiabte t of the goods withomt say further obligation. If you fail to make the goads avaaable to the Seller,or If you agree to return the goods to the Seller and fall to do so,then to the SeUc a or If you agree to return the goods to the Seller and fail to do so,then you remain liable for performance of all obligations under the Contras.To cancel t you remain liable for performance of all obligations under the Contract.To cancel this transaction,mail or deliver a signed and dated copy of this cauctil"On notice i this transaction,mall or deliver a signed and dated copy of this caaceuadon notice or any otter written nodee,or sent a telegram to Contractor:Renewal by Andersen,t or any other Written notice,or send*telegram to Contractor. Renewal!ry Andersen, 30 Forbes Rd. Northtorough,MA 01532. t 30 Forbes Rd.Nordiborough,MA 01532. I HEREBY CANCEL THIS TRANSACTION. t I IIEREBT CANCELTRLS TRANSACTION. f t a'RaR Pfini Near Arte t atryah soniaA P6M Naaa pUte Renewal Renewal by Andersen Corporation MA Home Improvement Contractor byAndersen, 30 Forbes rd Northborough,MA 01532 License#170810 (Expires 12123/2015) On"DDW REPLACEMENT anArinsm�smm� (508)351-2200 Fax:(508)-986-7072 Federal 1D#41-1918413 Window Specification Sheet Buyer(s)�ez{s)Narrtc Date of Agreenir:nt. JIM PETTORELLI SAT, MAY 30, 2015 The buyer(s)listed above hereby jointly and severally agree to purchase the goods and/or sen ices listed below,in accordance;with the prices and terms described Oil the Specification Sheet and the front.and the reverse of the accompanying CUSTOM AVEXDOV4 AND DOOR REMODELING AGREEMENT,of which the Specification Sheet is part. WINDOW&DOOR DETAi LS - APa exterior/tnte(w Color Hardware Hardware Grille Groo Gleas Room I wilds helpht ul Window/Door Style Detail Casings Ext-Int Color Style Screens Sara tsrn Grilles Sash 1/3 Sash 2 Lifts Options Living 1 32 62 94 DSFcott.so rallxt MF 90SAnt oirm NHIWH White Standard FTS ansur mw 3/3 3/2 No Temiler Uving 2 32 62 94 DBFcott,sq rail,, ExtMF908Ant pin NHAVH White Standard FTS artSu mw 313 3f2 No Temper Office 3 _ 32 62 94 D$F,cott,s raft„ MF 908/Int n HIWH White Standard FTS marts w1W 3/3 3f2 No _Tem r Office 4 32 62 94 DSF,cott,s rail,, MF 908/Int HANH White Standard FTS anS wrte/ 313 3/2 No Tem r Mst Bed 3 32 62 94 DRI, ual, rails sill Ext.MF 908 H White Standard FTS rt5 waw 3/2 312 No No Mst Bed 6 32 62 94 DBI, al rail,sb silt Ext.MF 908 H/VVH White Standard FTS martsu waw 3/2 3/2 No No Bed 1 7 32 62 94 DBI, al, rails sill Fxd.MF 908 ANN White Standard FTS art mw 312 3/2 No No Bed 1 f3 32 fit 94 OBI, ual, rall,s sill Ext.MF 908 HANH White Standard FTS arts INIV 3f2 3!2 No No 9 10 II 12 13 dI 15 16 - 17 18 19 - 20 21 22 23 24 25 BAY&BOW DETAILS pprox Style Detail f vAdw Appro c Number Frame Window End Center LOWE 1 Roof/ HardwarD Room Count S Flankers t c Anole Lhas Interior ExtAnt Cotor Grilles sashes sashes Screens Sma tstat Sa16t Color SPECIALTY WINDOW DETAILS Futl/ A Room ppmx towE/ Specialty BAk/BOW ADDITIONAL WORK NOTES Curet Style Insert W. SmartSun Gd@es Grl➢a Style ExtAnt Calor Uvin 2 Circle Top Full 50 SmartSun No WH/WH Office 2 Circle Top Full 50 SnrertSun No MANH ADDITIONAL WORK DETAILS: iriranc vim t ills nn frtmt of hnnu.�4'est trim,"Can rl I Contractor will wrap exterior casings with ooil stock color of Owner is aware that Contractor does not do any painting/staining or removal/installation of alarm system or window treatments/hardware.It is the responsibility of the homeowner to have the alarm system and window treatmentslhardwara removed prior to installation. We make no guarantee as to whether alarms or window 2 treatments/hardware will fit after replacement. Customer Is also aware In some cases there will be glass loss. H there Is,the amount will be dependent on the type of exists , ng windows, of installation and window style.We make no guarantee as to the amount of glass loss.Customer 1s aware and understands any and all unseen rot Is not included in this contract.Should any rot be found there will bean additional charge for time and materials unless so stated in this contract. 3 Yes Contractor will Insulate,caulk and seal windows with 3-point system to prevent water and air infiltration.Removal and disposal of all Job related debris, windows,doors,storm windows and vacuum nightly included. Upon completion of the Job and payment in full,a limited warranty shall be issued. 4 Yes Building Permft--Contractor will secure any and all necessary permits. The fee for the permit(s)is Included in the total contract price. Yes All discounts have been applied to this agreement. G ✓ 1'es :nd Owner agrees to be present on the final day of installation for final Inspection.and to deliver final payment/finance form(s). isagreed arxd understood between the parijes that dik Specification Shetty along with dre CUSTO\f WI`*DOW AN D DOOR REMODELING AGREEMENT,tonstiwtes the entirr (undemanding hentren the patsies,and diem aft,no verbal understandings duutgiuq or modifyinq any of the terms.TMs Specifuatdott Sheet may not he changed or its terms nmdified or t;uied in any way unless such changt.s are in writing and signed by both the Bu)-vqs)and Contractor. Buyer(s)hereby acLimdedge that diuyer!si has mad dus Specification Slteet Renewal by Andersen Corporation Buyers) Buyers) /14i0� Signature of Consultant Signature Signature MICHAEL BUTLER JIM PETTORELLI Print Name of Consultant Print Name Print Name WINDa WS•00aR5 ,Mdersen. i w Andersen'NERC Certified Total Unit Performance (continued) Andersen'Product Glass Type U-Factor' SHGC' Vf'. - Andersen'Product Glass Type U-Factor' I SHGC' VT, Archftectirral 400 Series HP Low-Ell. 027 035 0.60 HP low-E4 032 018 0.47 HP low-E4 with Grilles 028 031 0.54 }1P lmv-E4 with.Gnlles 032 025 0.42 033 f HP li HP Low-E4 Sun 032 0.17 0.26 aw-E4 Sun 027 021 f" s' Circle Top" Casement window HP Low-E4 Sun with Gilles 0.32 0.16 0.23 ; Casement Window HP Low-E4 Sun with Grilles 0.29 0.19 0.30 ± �' '' HP Imw E4 SmanSun 016 023 0.54 f: HP low-E4 SmanSun 0.31 0.18 0.42 HP Lmv-E4 Smar45un w/Gnlles 028 021 0.49 FS HP Low-E4 SmartSun w/Gdlles 031 0.17 038 HP lmv-E4 017 035 0.60 HP tovrE4 032 018 0.47 "! HP low-E4 with Grilles 0.28 031 0.5M1 - HP L°w-E4 aPoh Grilles 032 025 0.42 I'FA HPU;:5 Sun 027 021 0.33 - ( French Casement HP Imv-E4 Sun 0.32 0.17 026 c , Circle&Oval Whol Window HP Low-E4 Sun with Grilles 032 0.16 023 - H�MG029 D.19 0.30 , _ 026 023 0.54 HP Lor-E4 SmarlSun 031 0-18 0.42Iy HP torr-E4SmartSunw/GrRles 031 0.17 038HPL028 021 0.49 �il _ HP Low-E4 028 0.33 0.58 HP lmv-Eq 032 028 O.M17 I?'. lip Lor-E4 with Gilles 029 0.30 0.52 ' - HP Low-E4 with Gilles 0.32 015 0.42 HP low-E4 Sun 028 020 031 ':_. ., IIP Low-E4 Sun 032 0.1T 026 ; AwningAreh Window [] Awning Window HP Low-E4 Sun with Gilles 032 0.16 023 ; ! HP Low-E4 Sun with Grilles 029 0.18 0.28 HP law-E4 SnhartSun 027 023 0.52 ,i - E r1 HP Low-E4 SmarlSun 031 0.18 0.42 -i.-l '• HP low-E4 Smar}Sun w/Gilles 018 021 0.46 ? ° HP Low-E4 SmarlSun w/Gdltes 031 0.17 038 HP tow-E4 0.27 033 0.58 HP low-E4 031 032 0.55 -{ lip Low-E4 with Gilles 0.31 029 0.49 F r HP Low-E4 with Gilles 028 030 052 . 1, HP Low-E4 Sun 017 010 0.31 V"! casement/Awning HP Low-E4 Sun 0.31 020 031 i FlesHrame Window Picture Window HP Low-E4 Sun with Gillies 0.31 0.18 028 [�9�� HP low-E4 Sun with Gilles 029 0.18 028 HP Low-E4 SmartSun 0.31 021 0.50 HP Low-E4 SmanSun 0.26 023 0.52 ` HP Lmv-E4 SmanSun w/Gdlles 028 021 0.46 [�I lip Lmv-E4 SmarlSun w/GdRes 0.31 0.19 0.44 HP Low-E4 0.31 033 0.58 HP low-E4 030 037 0.64 HP lou-E4 with Grilles 0.32 030 0.52 HP tow-E4 with Grilles 030 033 057 _ HP Low-E4 Sun 031 020 0.31 [' HP Lor-E4 Sun 031 022 0.36 Springtine Window - Specialty Window HP Lor-E4 Sun with Grilles 031 020 032 ,n HP Inw{4 Sun with Grilles 0.33 0.18 018 F - HP Lmv-E4 SmerlSun 030 013 0.52 HP toe-E4 SmadSun 0.30 024 0.58 HP Low-E4 SmartSun w/Gilles 032 021 0.46 - 5 HP Low-154 SmanSun vi/Grilles 0.30 022 0.52 !'i HP Lor-E4 0.30 01T 0.45 (1 HP low-E4 032 022 037 s HP tma-E4 virth Gilles 032 023 0.39 l:l fir, HP Low-E4 math Gilles 033 020 033 - HP Low-E4 Sun 031 0.16 0.25 Hinged hawing HP Low-E4 Sun 0.33 0.14 0.21 - Frenchwood' French Door III?Low-E4 Sun with Gilles 034 0.13 0.18 - gliding Patio Door IIP tow-E4 Sun with Grilles 032 0.14 0.22 ".'• �'' HP Imw-E4 SmartSun 030 0-18 0.41 = '('�".I HP Law-FA Smar!Sun 032 0.15 0.33 I1P I HP Low-E4 SmaitSun w/Grilles 0.31 0.16 035 mv-E4 SmarlSun w/6rBles 0.33 014 030 - NP Lvw-E4 031 024 0.41 [� HP tow-E4 033 025 0.41 HP low-E4 with Grilles 032 021 035 ` : :r, Hp Low-114 with Gilles 034 012 036 - °-�0�°rE W Frcnehwood'Hinged .i HP Low-E4 Sun 0.31 0.15 02HP low-E4 Sun 033 0.16 023 3 ;'� Hinged Ootswing - . Inswing Patio Door or 'I Hp t -Eil Sun with Gilles 032 0.13 0.19 - -. French Door HP Low-E4 Sun with Grilles 035 014 020 _4 HP Low-E4 SmartSun 030 0-16 0.37 MHP Low-E4 SmarLSun 032 0.17 0.37 I =Z HP Low-E4 SmmlSan w/GnTles 034 0.15 032 - E-0 HP Low-E4 SmartSun w/Gnlles 0.31 0.14 031 S o HP Low--E-4 0.31 015 0.41 HP Lvw{4 033 023 0311 - v HP low-E4 with Gn71es 0.32 021 0.35 7�, � HP Low-E4 with Gilles 033 021 0.34 - HP Low-E4 Sun 0.31 0.15 0.23 F'hhed French Door- HP law E4 Sun 033 0.14 021 Frenchwood'Hinged ' Sidelight' HP low-E4 Sun with Grilles 034 0.13 0.19 - Outawing Patio Door HP low-E4 Sun with Grilles 0.32 0.13 0.19 ' �' HP low-E4 SmartSun 030 0-17 0.37 7`1 ` 1 IfP Low-E4 Sm°rtSun 032 D-15 034 - HP Law-E4 SmanSun /Grilles 031 0-15 031 !" HP ton-E4 SmartSun w/Gmles 0.33 0.14 0.30 = HP tow-E4 0.31 022 037 �, HP Lzr-E4 032 025 0.41 033 022 0.37 - HP Low-E4 with Gilles 032 020 033 ;1 HP Low-E44 with Grilles FrenHP Lor-E4 Sun 0.32 0.14 0.21 - - moat Transom HP Low-E4 Son 032 0.15 023 - Ci°Y00� French Door HP Imv-E4 Sun with pines 033 0.14 020 - Patio Door side8ght. IIP Low-154 Sun with Gilles 032 0.13 0.18 - HP tow-E4 SmarlSun 0.31 0.15 0.33 '''Els � HP Low-El SmarlSun 032 0.1 037 HP low-E4 SmanSun w/Grilles 032 0.14 0.29 • ,�i' HP low{4 SmarlSun w/Grilles 0.32 0155 033 = HP Low-E4 0.30 024 0.40 HP Loa-E4 035 026 0.44 HP Low-E4 with Gilles 0.30 021 0.35 HP 1aw{4 with Grilles 0.36 023 038 - .l HP 1ow-E4 Sun 0.35 0.16 014 - Frenchwoud' HP low-E4 Sun 0.30 0-15 0.22 Folding Door - Patio Door Transom lip Low.E4 Sun with Grilles 0.31 0.13 0.20 '( HP Low-E4 Sun vnlh Gilles 036 0.14 011 HP Low-E4 SnonSun 0.29 0.16 0.36 I -` HP Imv-E4 SmartSun 0.34 0.17 039 - HP Low-E4 SmartSun w/Gilles 0.30 0.14 0.32 {1 HP for-E4 SmartSvn w/Gilles 036 0-15 0.34 - mnGnued an nen page •For NFRC certified total unit performance on units with capillary breather tubes for high altitudes,please visit andersemvindows.com. •'High-Performance"Low-E4'"(HP low-E4), -Performance"Lor-E4-SmartSun"'(HP Low-E4 SmartSun)and"High-Performance Low-E4'Sun'(lip Low-E4 Sun)are Andersen trademarks for"Low-E"glass- 11-Factor defines the amount of heat loss through the total unit in BTU/hr sq.ME The lower the value,the less heal is lost through the entire product Window values represent non-tempered glass.Use of tempered glass can Increase U-Factor ratings.See andersellwindows.com for specific performance values.Door values represent tempered glass. 'Solar Heat Gain Coefficient(SHGC)defines the fraction of solar radiation admitted through the glass both directly transmitted and absorbed and subsequently released inward.The lower the value,the less heat is transmitted through the product 'Visible Transmittance(VT)measures how much light comes through a product(glass and frame).The higher the value,from 0 to 1,the more daylight the product lets in over the product's total unit area.Visible Transmittance is measured over the 380 to 760 nonometer portion of the solef spectrum. •NFRC ratings are based on modeling by a third party agency as validated by an independent test lab in compliance with NFRC program and procedural requirements. •This date is accurate as of December 2010.Due to ongoing product changes,updated test results or new industry standards or requirements,this data may change over time.Ratings are for sizes specified by NERC for testing and certification.Ratings may vary depending on use of tempered glass,different grille options,glass for high altitudes,etc. •PassiveSun-glass values are available online at andersenwindows.com. 277 PRODUCT PERFORMANCE s Andersen' NRC lariafied Total Unit Perforriman,e (canlmued) rRE Andersen Product. Glass Type Ll-FactDr' SL-IGC' V13 200 Series. - - • Gear Dual Pane 0.45 0-60 0.63 - Clear Dual Pane wb Grilles 0.45 054 0.56 - TOt-Wash Low-E 030 032 0.55 Dauhle-Hung-Window Lmv-Ewith Galles 030 029 0.49 ] - HP Low-E4 SmartSun 0.30 031 0.49 HP Lmv-E4 SmartSun w/6nlles 031 0_19 0.43 20 Clear Dual Pane 0.45 0-61 0.64 - Narrolihe; Clear Dual Pane with Grilles 0.45 O_!:A 0.57 _ Double-.417t Window tmµ£ 030 0-2 0.56 LomfE vith Grilles 0.31 0..29 0.50 Gear Dual Pane 0.44 0_63 0.66 - NarroOne" _ Gear Dual Pane with Grilles 0.44 0.57 0_% - Transom Window Low-E 027 0_34 0.58 - Lmv-E with Grilles 027 030 0.52 T� Clear Dual Pana 0.45 0.60 0.63 - Clear Dual Pane with Grilles 0.45 0,54 . 0.56 - 6Hding-Wmdow Low-E 0.30 0.32 0.55 Low-E with Grilles 030 029 0.49 Lmv-E SmartSun 030 021 0-49 Low-E SmmnSun with Grilles 0.31 0_19 0.43 Gear Dual Pane 0.43 0_61 0.65 - -- Gear Dual Pane with Grilles 0.43 0_55 058 - Fved;Transom;. Lmv-E 028 0.33 0.56 DMe Tap'Wmdhw '' Low-E with Grilles 028 030 050 Law•E SmartSun 027 022 051 Lmv-E SmartSun with GnUes 027 0.20 0.45 -7121 Gear Dual Pana 0.44 0_61 0.64 - Clear Dual Pane wM Gr01es 0.45 053 056 - Low-E 029 032 0.56 - Naroiine' Low-E with Grilles 030 0..29 0.49 ailing Patio Doors - Lav-E San 029 020 0.31 ... Lmv-ESan withGales 091 0_18 U71 _ Lav E SmartSun 028 021 0-50 M :j R1 Lar.,-E SmartSun with Gnlles 0.30 0_19 0.44 - Clear Dual Pane 0.43 0.61 0.64 - Clear Dual Pane with Grilles 0.43 054 0.56 - Lm,-E 028 052 0.56 - Pemu-Slildd'. Low-E with Grilles 0.30 0.29 0.49 '-'- 60ding Patio Doors - Law-E Sun 029 019 030 -�-�' Lm,-E Sun with Grilles 0.30 0_17 027 Loo E SmartSun 0.27 022 050 '9 Law-E SmartSun with Grilles 0.29 019 0.44 - Gear Dual Pane 0.43 0..15 0.47 - Dear Dual Pane with Grilles 0.43 039 0.40 Lav-E 0.32 024 OAS IM 18nged.lusaving Low-E Willi Galles 0.33 0.21 035 - Patio Doors - law-E Sun 032 0.15 023 Low-E San with Grilles 034 0.13 019 Low-E SmartSun C 32 016 037 Low-E SmartSun with Gnlles 033 114 031 - a Renewal byAndersena .•:• WINDOW' REPLACEMENT anMdetsenComraay Wood/Vinyl Composite IF Dual Argon Low E4 SmartSun Double Hung 100-00473518-010 'ENERGY PERFORMANCE RATINGS U-Factor(U.S)/I-P Solar Heat Gain Coefficient 0n29 0m19 - ADDITIONAL PERFORMANCE RATINGS Visible Transmittance OA2 Manufacturer stipulates that these ratings conform to appl.:ahle NFRC procedures for determining whole product performance.NFRC ratings are determined fora fixed set of environmental condkions and a e. specific product sa NFRC does not recommend any product and does not warrant the suaahBny of any product for any specific use. Consult manufacturer's leerature ler other product performance information. L s www.nfm.org 44;* +f. This product meets Green Sears environmental Mn.Ua 1 Mandardsgoverningenergy • - .'••,-?•r,�,.'•••*,^�'?,�, . eMiciancy,heavy metals in r.e� >v';:•M1�:.: '-Z .. :.:the frame and sash z,5 ^•^•`.'•.<,"•'/ijg�`l t .ntaterel,packaging,and ":y;':�; �`%ti . yr4W YM consumer educational •.•%":;4::..�•:r.;,:. roatedals. f, ........... ........................; . ...n.ein..a..ro� DESIGN PRESSURE(PSS wndow atm Door ' Man`uhLvD-rwdn a.cant� H-LC25 RbA DB Sloped Sill DH IN Tested toliMS-Ma( M,IAAVDMAtCSAIOI/MAW4K Marutac ar stipulates contarmar"to mea litanl9 startaaras. Meets or exceeds M.E.C.,C.E.C.&I.E.C.C.Air laffdration requkements WDMA Hallmark Certification Program. v E The Commonwealth of Massachusetts Department of Industrial Accidents Office oflnvestigadons ir I Congress Street,Suite 100 Boston,MA 02114-2017 www mass gov/dia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print L_ eaibly Name (Business/Organization/Individual): RENEWAL BY ANDERSEN Address:30 FORBES ROAD City/State/Zip:NORTH BORO, MA 01532 Phone#:508-351-2200 Are you an employer?Check the appropriate box: 1.NI am a employer with 30 4. I am a general contractor and I Type of project(required): employees(full and/or part-time).' have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. Q Remodeling ship and have no employees These sub-contractors have 8, E]Demolition working for me in any capacity. employees and have workers' [No workers' comp. insurance comp.insurance.: 4 E]Building addition required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ 1 am a homeowner doing all work officers have exercised their 11.[]Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12,0 Roof repairs insurance required.] i c. 152, §1(4),and we have no employees. [No workers' 13.0 Other comp. insurance required.] 'Any applicant that checks box Ill 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 state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp,policy number. , I am an employer that isproviding workers'compensation insurance for my employees Below is the policy andjob site information. Insurance Company Name:OLD REPUBLIC INS. CO. Policy#or Self-ins. Lic. #:MWC 30293800 Expiration Date: 10/01/15 Job Site Address: 5 Skyview Terr City/State/Zip: North Andover, MA 01845 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. Ido hereby ce fy nder the pains and penalties of perjury that the information provided above is true and correct Signat Date: C/ e 8-351-2200 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/Ucense# Issuing Authority(circle one): -71 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#• ANDECOR41 YADAVYO AiCOrRU CERTIFICATE OF LIABILITY INSURANCE °A `M""°�4 10/1/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: 1f the certificate holder is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION 15 WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Cerdflcates@wlllls.cOm Willis of Minnesota,Inc. PHONE 8� 945-7378 FAXNo):{ ) c/o 26 Century Blvd No Eat:( ) Arc 888 467-2378 P.O.Box 305191 1:-MAIL Nashville,TN 37230-5181 ADDRESS: INSURER($)AFFORDING COVERAGE NAIC 0 .INSURER A:Old Republic Insurance Company 24147 INSURED INSURER B: Renewal by Andersen Corporation INSURER C: 30 Forbes Road INSURER D: Northborough,MA 01532 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. ILTIR NSR TYPE OF INSURANCE A O POLICY NUMBER POLICY E LICY FJ(P MUDDIYYYYI (MMfDDIYYYY1 LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 TO CLAIMS-MADE X OCCUR MWZY302940 10l01/ZOi4 10!01!2015 PREMISES Ea occurrence $ 500,00 MED EXP(Any one person) $ 10,00 PERSONAL&ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,00 X POLICY❑JECT 1-1 LOC PRODUCTS-COMPIOP AGG $ 4,000,00 OTHER: $ AUTOMOBILE LIABILITY COMBINEDdSINGLE LIMITMe $ $,000,00 A X ANY AUTO MWTB302575 10/01/2014 1010112015 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Par accidant) $ NON-OWNED PE DAMAGE— HIRED AUTOS AUTOS Peraccidant $ $ UMBRELLA UAB OCCUR EACH OCCURRENCE $ EXCESS LIAO CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION _ AND EMPLOYERS-LIABILITY Y r N X STATUTE ETH A OFFICER/ME BE EXCLUDED EcuTIVE NIA MwC30293800 40/01/2014 10!0112015 E.LEACH ACCIDENT $ 1,000,00 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,00 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,00 DESCRIPTION OF OPERATIONS U LOCATIONS U VEHICLES(ACORD 101,Addltlonal Remarks Schedule,may be attached M more space E required) I CERTIFICATE HOLDER CANCELLATION 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 Evidence of Insurance ©1988.2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD Massachusetts-Department of public Safety Board of Building Regulations and Standards Construction Supemisor License:CS4)90125 I JABS L MORIN 06 GARDINER S LYNN MA 0190 :' Expiration Commissioner IOMW2016 CN Rice of Consumer Affairs&Susmess Regulation ME IMPROVEMENT CONTRACTOR Registration: 170810 Type:. 8xpiragoo. 12/23!2015 Supplement r t RENEWAL BY ANDERSON CORPORATION F�• JAIME MORIN 104 OTIS STREET � 7 NORTHBOROUGH,MA 01532 Underseeretary -Q { +r � i I