HomeMy WebLinkAboutBuilding Permit #925-14 - 54 MILLPOND 6/19/2014Permit
Date Issued: Y 11
BUILDING PERMIT
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Date Received
IMPORTANT: AoDlicant must comD]ete all items on this
LOCATION -S*q M *k \1 IT,
i�'. t
Print
PROPERTY OWNER 'RobtA 2 v 2- A C- ��
Print
MAP NO09S. A PARCE9-11Z,1,-A,-4V ZONING DISTRICT: Historic District yes no
0
—2) 76—o q-5� A o 0 5 Oc o 0. d4achine Shop Villaqe ves rn
TYPE OF IMPROVEMENT
PROPOSED USE
Residential
Non- Residential
New Building
WO—ne family
0 Addition
El Two or more family
11 Industrial
No. of units:
11 Commercial
_yAlteration
)? Repair, replacement
11 Assessory Bldg
11 Others:
Demolition
Dr OtherRV ?j, p, c e ry\ -e A) -T
—0
0 Septic 11 Well
0 Floodplain C1 Wetlands
11 Watershed District
0 Water/Sewer
I
-e I A oOC-5 - '(\ 0 5 -�C L) (-+o rct I C k Cz f) el -e-
Identification Please Type or Print Clearly)
OWNER: Name:.- Q6�3er+ Phone:93F-697-40P
Address:
CONTRACTOR Name: Phone: 351 - ZZ CJ'
Address: 1A �L
Supervisor's Construction
Home Improvement License:
A ka ro, A 0 t53'1
Exp. Date:
Exp. Date:
ARCH ITECT/ENGI NEER Phone:
Address: Reg. No.
FEE SCHEDULE: BULDING PERMIT. MOO PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F.
Total Project Cost: $ q 3--7(to, tj j> FEE: $ � k '�) .
Check No.:. (,A C) b -al ReceiptNo.:
I
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
r" — k
BUILDING PERMIT
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit No#: Date Received
Date Issued:
IMPORTANT: A-POicant must comWete all items on this
LOCATION
Print
PROPERTY OWNER
Print 1 00 - Year 8t(u6tyre
MAP PARCEL:.- ZONING DISTRICT: —Historic District
Machine 8hop V1
,of,
yes no
yes no
yes no
TYPE OF IMPROVEMENT
PROPOSED USE
Residential
Non- Residential
D New Building
El One family
0 Addition
El Two or more family
0 Industrial
El Alteration
No. of units:
0 Commercial
0 Repair, replacement
D Assessory Bldg
11 Others:
0 Demolition
El Other
El Septic 0 Well
El FloQdpl.ain El Wetlands
El Watershed' District
El Water/Sewer
DESCRIPTION OF WORK TO BE PERFORMED:
Identification - Please Type or Print Clearly
OWNER: Name: Phone:
Address -
ARCH ITECT/ENGI NEER
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.: Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have access to the guarantyfund
LSigna , eofAgent/Owner Sianatureof contractor
f
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
c3 Floor Plan Or Proposed Interior Work
u 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
ci Certified Surveyed Plot Plan
u Workers Comp Affidavit
Ei Photo Copy of H.I.C. And C.S.L. Licenses
ci Copy Of Contract
o Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And
Hydraulic Calculations (if Applicable)
13 Mass check Energy Compliance Report (If Applicable)
o 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)
Lj 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
Doe: Building Permit Revised 2014
Plans Submitted El Plans Waived [I Certified Plot Plan El Stamped Plans El
TYPE OF SEWERAGE DISPOSAL
Public Sewer
Tanning/Massage/Body Art E]
Swinuning Pools
Well
Tobacco Sales 11
Food Packaging/Sales 11
Private (septic tank, etc. El
Pennanent Dumpster on Site F1
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
PLANNING & DEVELOPMENT Reviewed On
COMMENTS
CONSERVATION
COMMENTS
HEALTH
COMMENTS
Signature.
Reviewed on Signature
Reviewed on Signature
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
FIR-EbEPAkTMENT -Tem-0'Qumpsteron-i,---
site yes
Located at 124 MaimStreet
Fire Department signature/dI.Ate
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
MGL Chapter 166 Section 21 A —F and G min.$100-$1000 fine
NU 11--5 ana LJA I A — (1 -or cievartment use
LI Notified for pickup Call Email
Date Time Contact Name
Doc.Building Perinit Revised 2014
No
tag.
Check #
27692
Date
TOWN OF NORTH ANDOVER
Certificate of Occupancy $-
Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee
TOTAL
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TOWN OF NORTH ANDOVER
AFFIDAVIT
Home Improvement Contractor Law
Supplement to Permit Application
MGL c. 142 A requires that the "reconstruction, alteration, renovation, repair, modernization,
conversion, improvement, removal, demolition, or construction of an addition to any pre-existing
owner occupied building containing at least one but not more than four dwelling units ... or to
structures which are adjacent to such residence or building" be done by registered contractors,
with certain exception, along with other requirements.
Type of Work: REPLACE 2 DOORS - NO STRUCTURAL CHANGE
Address of Work 54 MILL POND
Owner Name: ROBERT ZUZACK
Date of Permit Application: 6/11/14
I hereby certify that:
Est. Cost 9376-00
Registration is not required for the following reason(s): For office Use Only
Work excluded by law Permit No.
Job under $1,000 Date
Building not owner -occupied
Owner pulling own permit
Other (specify)
Notice is hereby given that:
OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS
FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION
PROGRAM OR GUARANTY FIND LINER MGL c. 142A.
Signed under penalties of perjury:
I hereby apply for a permit as the agent of the owner:
6/11/14 JAIME MORIN/RENEWAL BY ANDERSEN 170810
Date actor Name Registration No.
OR:
v r)e
Notwithstanding the above notice,�l erebyy apply for a permit as the owner of the above property:
Date
Owner Name
- - - ------------------------
MA Home Improvement Contractor
newa
License #170810 (Expires 12/23/2015)
byZdersenl. Renewal by Andersen Corporation
Federal Tax ID #41-1918413
104 Otis St. Northborouah. MA 01532
(508) 351-2200 Fax (5081-986-7072
CUSTOMER WINDOW AND DOOR REMODELING AGREEMENT
Buyer(s) Name Date:
ROBERT ZUZACK
MAY 9, 2014
Buyer(s) Street Address city State Zip Code
54 MILL POND
N ANDOVER
MA
01845
Email Address Home Telephone Number Work/Cell Telephone Number
BZED@YAHOO.COM
978-687-6698
978-337-S271
Buyer(s) hereby jointly and severally agrees to purchase the goods and/or services of Renewal by Andersen Corporation ("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.
Est. Start Date
Method of Pgyment
Total Job Amount $ 9,376.00
Amount Financed $ 0.00
P--,, Check/Cash
Deposit Received (33%) $ 3,125.00
10- 12 weeks
Balance Start of Job (33%) $ 3,125.50
Deposit at signi�g $ 0.00
Check# 2879
Balance on Substantial
At S�bstantiai
Est. Install Time
D Credit Card
Completion of Job (33%) $ 3,125.50
completion $ 0.00
TB.D.
If credit card Is selected, please
Me. =Cvredl
I
I
Card Payment 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 Buyer's right to cancel this Agreement. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES.
Renewal by Andersen Corporation Buyer(s) Buyer(s)
S&Pew, D"a,, T-� 18
By:
Signature of Project Manager Signature Signature
STEVEN DANA ROBERT ZLIZACK
Printed Name of Project Manager Printed Name Printed 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
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 7
NOTICE OF CANCELLATION NOTICE OF CANCELLATION
Date of Transaction 5/9/14 . You may cancel this Data of Transaction 5/9/14 You may cancel this
..
transaction, without any penalty or obligation, within three business days fmm the transaction, without any penalty or obligation, within three business days from the
above date. If you cancel, any property traded in, any payments made by you under above date. If you cancel, any property traded in, any payments made by you under
the Contract of Sale, and any negotiable instrument executed by you will be the Contract of Sale, and any negotiable instrument executed by you will be
returned within 10 days following receipt by the Contractor ("Seller") of your returned within 10 days following receipt by the Contractor ("Seller") of yew
ci—cenation notice, and any security interest arising out of the transaction will be I cancellation notice, and any security interest arising out of the transaction will be
canceled. If you cancel, you most make available to the Seller atyour residence, in I canceled. If you cancel, you most make available to the Seller at yew residence, in
substantially as good condition se when received, any goods delivered to you under I substantially as good condition as when received, any goods delivered to you under
this Contract or Sale; or you may, if you wish, comply with the instructions of the this Contract or Sale; or you may, if you wish, comply with the instructions of the
Seller regarding the return shipment of the goods at the Seller's expense and risk. Seller regarding the reture 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 If you do make the goods available to the Seller and the Seller does not pick them up
within 20 days of the date of your Notice of Cancellation, you may retain or dispose within 20 days of the date of yaw Notice of Cancellation, you may reWn or dispose
of the goods without any further obligation. If you fail to make the goods available of the goods without any further obligation. If you foU to make the goods available
to the Seller, or if you agree to return the goods to the Seller and fail to do so, then to the Seller, or if you agree to remrn the goods to the Seller and fil to do so, then
you remain liable for performance of all obligations under the Contract. To cancel you remain Hable for perfortnance of all obligations under the Contract. To cancel
this transaction, mail or deliver a signed and dated copy of this cancellation notice this transaction, mail or deliver a signed and dated copy of this cancellation notice
or any other written notice, or send a telegrano to Contractor: Renewal by Andersen, 1 or any other written notice, or send a telegrarn to Contractor; Renewal by Andersen,
1040tisSt. Northbomugh,MA01532, BY NOT LATER THAN MIDNIGHT OF 1 104 Otis St. Nothbo—gh, MA 01532, BY NOT ]LATER THAN MIDNIGHT OF
5/12/14 (Date) I HEREBY CANCEL THIS TRANSACTION. 5/12/14 (Date) I HEREBY CANCEL THIS TRANSACTION.
I�yeM Sig -t— Nnt Nam cote swe� sig-- N. Nam Dale
en Renewal by Andersen Corporation MA Home Improvement Contractor
!ZAnde n. 104 Otis St. Northborough, MA 01532 License #170810 (Expires 12/23/2015)
INOWW REPLACEMENT 1,A,.1 -C, V (508) 351-2200 Fax: (508)-986-7072 Federal ID #41-1918413
Window Specification Sheet
Buyer(s) Name Date of Agreement
ROBERT ZUZACK
FRI, MAY 9, 2014
The buyer(s) listed above herebyjointly 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 the Specification Sheet is part.
WINDOW DETAILS
Approx. Ext=Hor Color Hardware I Hardware s_ LowE4/ Gril G,l ]a Glass
Room U.I. Window/Door Style Detail Ext -Int Color style Smartaunj Grilles SWh'l'/3 Sash 2 Uft Optlons
Living 2 175 IND ExtJInt. Pine DZIPN Dist.Bronzi Encino FFG SmsrtSuJ No- ----- ----- I ----- No
Total 2 BAY & BOW DETAILS *See Bay/Bow Measure Sheet
Styl Detail Approx. Approx. Number Frame Window End Center LowE Roof/ Hardwe
Room Count Style Flankers U.I. CaNings I Angle Lites Interior Ext(Int Color Grilles sastres I sashes screens Smartson soffit colorre
SPECIALTY WINDOW DETAILS
Full / Approx. LOWE Specialty BAY/BOW ADDITIONAL WORK NOTES
Room Count Style Insert U.I. Smar'S- Grilles GrIllestyle ExtAnt Color Cmtomer is — thm ith by/b� i,d� —der 72 inches
th— ill la� �igifi—t gl.. I. -
ADDITIONAL WORK DETAILS:
I No Contractor will wrap exterior casings with coil stock color of
2 r
Owner is aware that Contractor does not do any painting1staining or removalfinstallation of alarm system or window freatments1hardware. it is the
responsibility of the homeowner to have the alarm system and window treatmentslhardware removed prior to installation. We make no guarantee as to
whether alarms or window treatments1hardware will fit after replacement. Customer is also aware in some cases them will be glass loss. Ifthereisthe
amount will be dependent on the type of existing windows, type of installation and window sVe. We make no guarantee as to the amount of glass loss.
Customer is aware and understands any and aft unseen rot is not included in this contract. Should any rot be found there will be an 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 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. Check # 2880 $ 110.00
5 yes All discounts have been applied to this agreement.
6 f� Yes 0 No Owner agrees to be present on the final day of installation for final inspection and to deliver final payment / finance form(s).
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 them are no verbal understandings changing or modifying say of the terms. This Specification Sheet may not be Changed or its terms
modified or —ied in any way unless such changes are in writing and signed by both the Buyc�s) aad Contractor. Buyer(s) hereby acknowledge that Buyer(s) has mad this Specification
Sheet.
Renewal by Andersen Corporation Buyer(s) Buyer(s)
By S&Pm - -- ----------
Signature of Project Manager— _�ignatu - re S!9.natur.e
STEVEN DANA ROBERT ZUZACK
Print Name of Project Manager Print Name Print Name
The Commonwealth ofMassachuseUs
DeParhn�#t dfl#dustrial Accidents
Office of Invesdgations
600 Washington Street.
Boston, MA 02111
wwwmass.gov1dia
AP Workers' Compensation Insurance Affidavit: Bugders/Contractors/Electricians/,plumbers
-plicant Information
Please Print Legibly
Name (13usiness/Organization/Individual): �(,.P�ne"Jck
Address:lbt4
City/State/Zip: Aor-�Q�,
Are you an employer? Check the appropriate box:
1,2'1 am a employer with 3J 4. E] I am a general contractor and I -
Type Of Proitet (required):
employees (full and/or part-time).* have hired the sub-contractoTs
6. 0 New construction
2.[3 1 am a sole . proprietor or partner- listed on the attached sheet.
7. Q-iGnodeling
ship and have no employees These sub -contractors have
8. Demolition
working for me in any capacity, employees and have workers'
[No workers' comp. insurance comp. insurance.:
9. Building addition
required.] 5. Ej We are a corporation and its
3. El 1, am a homeowner doing all work officers have exercised their
10. Electrical repairs or additions
I I - El Plumbi'g repairs
myself. [No w9rkers'comp. right of exemption' per MGL
insurance t
or additions
12 Roof repairs
requiredJ c. 152, § 1(4)9 and we have no
employees, [No Workers"
13. E] Other
comp. insuna nee required-]
*Any applicant that 6ecks box #I niust a] so fill out tfic section Ve"18w showing their workers' cc6 pentation policy information.
t Homeowners who submit this affidavit indicating ihey are.doing all work and then him oitside coInfii6tors,
must
$Contractors that check this box must attached an additional sheet showing the name ofthe sub -contractors and
employees. Ifthe sub -contractors have employees, they ist their ,
suVinit a n g such.
aw affidavit mi* d catin
state whether or not those entities have
provide work ers licy umbe
ppmp, po n r.
lam an mrJoyer that isproviding workers, compensation msuranceforMY MV10yees. Bdowlsthe
infoymadom O�&Y and)ob site
Insurance Company Name TV-\ A
Policy # or Self -ins. Lic. #: Expiration Date:
Job Site Address: C ity/S tate/Z ip haq 1"�r fl�c 1 gqS-
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 dffice of
Investigations of the DIA for insurance coverage verification.
ldoherebwc rhyun thepains andpenaitks ofperjury that the informatloniroii&dabove is true and correct.
S i I U � - % !! f! �
1p,
Phone #: Jaz2 o
Ofricial use only. Do not wrfte in this area, to be conrleted by cityor town offmiaL
City or Town:
Permit/License #
Issuing Authority (circle one):
I. Board of Health 2. Building Department 3. CitY/Town Clerk '4. Electrical Inspector'
6., Other 5. Plumbing Inspector
Contact Person: Phone M
"TEOWN"YM
JE4�!� CERT IFICATE OF LIABILITY INSURANCE 20/01/2013
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLOElt. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND. EXTEND OR ALTER THE COVERAGE AFFORDED 13Y THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORM
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the pol[CAIOS) must be endorsed. If SUBRO
the terms and conditions of the policy, certain policies may require an endorsement. A statement an this certificate does not confer rights . to the
certificate holder In Ileu of such ondonsern
PRODUCER TIVS, 3 3 3 - 3 3 2 3 —
says Ccovanies PHONE Efl: 612-333-3323 FAX
80 South Sth Street E41AL M&N.1, 12-373-7270
quite 100 AGsRF.S:
Kinneavolis, NK S5402
INSURED
Renewel By Anderson Corporation
104 Otis street
lForthborough, INA 01532
OLD RZPMLXC INS CO 24147
RLTIONAL UNION FIRR INS CO OF PITTS 19443
IJVZ:KA0C* CERTIFICATE NUMBER: 36122490 REVISION NUMBER.
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED AS OR THE POLICY PERIDD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT to WHICH THIS
UVV F
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 CLANS.
'i I
!L T"E OF INSURANCE POLICY Nu . USER POLICYEFF ITS
GENERAL LIABILITY X"Y 300362 10/02/1 10/01/14 EACH
�X COMMERCIAL GENERAL LIABnnY . S 1,000,000
-- --� CLAIMS -MADE Fil OCCUR 7 Is $S00,000
A I A'=LZ;;;ffLM*^;M YIN I NIA1 JKWC 300359 00 1 10/��
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Aftoch ACORD IC1. AddWWW pMmr" Sd"Ub. ff MM Wow k
2S.000,oa
i7,00—o.000
2.000,000
To whcft It Kay Concern SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CAWCEI I BEFORE
Yor insurance Purposes only THE EXPIRATION DATE THEREOF, NOTICE WILL 13E DEUVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUMRIZED REPRESENTATIVE
0 1988-2010 ACORD e0—R—P0—R—A—Tj-0`N. All —dghtr .. rVad.
ACORD 25 (2010105) The ACORD name and logo are registered morks of AcoRD
jh—grove
36222490
am Pson $ 20,000
MAL& ADVo j $ 2,000,000
GE AGGREGATE $4,00o,000
GENT AGGREGATE LNIT APPLIES PEk
M PRO- F-1
PRODUCTS - COMPIOP AGG 114100010oo
p. Loc
AUTOWBAX LIABILITY
am 300026
20/0x/14-
ED 61 $
ANYAUTO
(Em nn 3,000,000
ALL O*'NEI) SCHEDULED
BODILY INJURY (Parpemm) $
AUTOS AUTOS
BOMVKU`IY(PW20dcWnQ $
'MrNEO
HIRED AUTOS Id
11
PROPERTY
$
OCCUR
1�
20562235
I
20/02/1
20/01/24'
EACH OCCURRENCE
EUX"CU""U"
EBB LIAR
I
. $ 2S. 000, oaC
A I A'=LZ;;;ffLM*^;M YIN I NIA1 JKWC 300359 00 1 10/��
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Aftoch ACORD IC1. AddWWW pMmr" Sd"Ub. ff MM Wow k
2S.000,oa
i7,00—o.000
2.000,000
To whcft It Kay Concern SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CAWCEI I BEFORE
Yor insurance Purposes only THE EXPIRATION DATE THEREOF, NOTICE WILL 13E DEUVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUMRIZED REPRESENTATIVE
0 1988-2010 ACORD e0—R—P0—R—A—Tj-0`N. All —dghtr .. rVad.
ACORD 25 (2010105) The ACORD name and logo are registered morks of AcoRD
jh—grove
36222490
M 0 s s z ft I v _i�,
13� eb OfPublit S - Afg
'Board of Buildin kedulati j
ons and S`t�
Constructii(�n SuFtnisor
License: C$490125
JAM L MdRW
86 �5RARItpWINER S -f
. -4j.
12- —i IEX15iration'.
f�pmmissjo6ef 10/06/2 014,
SCA I Co 20M-05/11
free Of COnsumer Affairs & Business Regul,t,"
OME IMPROVEMENT CONTRACTOR
Registratift,
Expi
Type:
RENEWAL BY AN 61E�j. Supplement C.
PORATION
JAIME MORIN
104 OTIS STREET
NORTHBOROUGH, MA 01532
Undersecretary
C
PRODUCT PERFORMANCE
13
AnderSeW NRC Ceriffied Total Unit Performance (mn*nd)
GI=Type U-Factol':
SHW
VP.
am DuW Pane
0.45'
QM
0.63
Clear Dual Pam wft Whes
OAS
(154
0.56
Lv�E
030
032
D.55
bovi-Eiftrailles
030
1129
0-49-�
HP Into-& SmartSun
030
a2i,
0.49' -
Hp L.& -u Smallsm VIGOP
031
CLIS
IL43
Clear Deal Pane
0.45
0-61,
0.64,
Clearoml pwrelft roes,
CL45
0-54
0-57,
'wwb*41uwwWdGw,-
L9*E
0-30'
012
ILSS
ANF -E With GfflaS .
0.31
(UV,
V*'� A �,r
Clear Duall Parie vfM GOes
DA4
am
Qm'�
tow -E-
0.27
034.--..,
0-Spow
lmkp.E wM CAes
0.27
am,:
uearDuilPme
OAS
0-0;. OM4,ii�,.,,.
ClearDuilPaireviltbCaBlest OAS,'�
-4
0-
OM,-,�
L8w4E 0.30.-
Oil,
0.55,,�4N.�
41
0.30,
029,-
0.49,'_q. -,9.
�AvwLESWOW,
030
421,
IL49. �;,ffi
Lja6-E SmartSun vift Gages.
0.31
Q-19
0.43
Clearnwpane,
0.43.
OA1
0.65.1. -
Clear Dual Paili VM G does 0.43
0M
OS8,;.."
&A
633
036�� 13
CL27
OM
0.51�o,,Z .,ntrjW
L Sanallstm ift willes
(L27
d=
&45
i�' ChwDual Pan
a.",
0m,
—7�
-
DWl?aiiew0Gffies.-
0.45—
053-
111.56,
Lff�E
0.29
am
0,56,
fbmVwftGfille&,
0-30�j
029,.,
Law -E San
0.29
020
031
law -E Sin vft tones
031,
d2ll� !-3 2
Ifia-E S..dsun
028
0-n
om-
io�E SmartSwi iddi -Sbas
0.30
U-19
OA4.
Clear Dual �im
OA
QM
ILS4
Clear iwl pane'm rin
0,Q
(1.54.
QM.
lbv�E
0.28
am
0.56'
La*f VWGMM
030..
0-18
OA
-t witsita
029
am
w*E SLm vnih GOes
00
0-17
027 12
!LvwESiuwIS=
11.27.
0-22
0M, -
In. -E SisASW vft 90es
0-n
0M
0.4
�'Ciw Deal Pane
OA3
OAS
OA7--';'.
Clearowpauelsimsm
0.43
1139
1140,_-.
'L6*E
032
L24
IIAI
hym-E vM GOes
0.33
0M
am
?.66 ie;�;7
IMES= QMN
0.34
0-13
019
-----------
Low-ESmarlSo
032
0.16
1237
saillitsm Ift rij.
L". dim
am
0.14
031
W I No a wz - D a a RS
.Andersen.
Andersen"' NFRC Certified Total Unit Performance (icenlunuaq
conbow 0 Dal Pao!
For NMC clintified total unit PBFIO"na nce On Units with capillary bma ther tubes for high altitudes, please Visit anderstenwindows-com.
'High-Perlormance I.Low-15C (HP LBW -154), -High-performance Low -EV SmartSuh- (HP Low -E4 SmartSun) and 'High -Performance- Law-EVSue (mp Low -154 Sun) am Andaman brademorlis for 'tcrw�V ghm&
U-11actor defines the amount of beat loss through the total unit in BTU/hrsq- ME The ' Idwerthe value, the less heat Is lust1hrough the entire product Window values represent non-iltemperad glass. Use ciftempered AWS can
increase D -Factor rartings. See andemennindowit-com for speCilic Peftmance values- Doorvalues mpreseritizarpered gitim
SolarMeet Gain Coefficient (SHGQ defines the fraction ofsolar radiation admitted through the glatis both doefttransitifted and absorbed and subsequently released b.mard. The lowerthe value, Me less bliatis bloomildid
through the product.
3 11hribleTransraftintce (VT) measures bow much light comes thmugh 0 product. Ighms and frame). The higher Ilie value, from 0 to 2. the more dayflglftt�e product lets In Car the FrioduLlis totall uAltarea. Visiblelfinumothilance
Is measured over the 390 to M nanometer portion of the solBf spectrum.
• NFRC ratings are based an modeling by a third party agency as vallilated by an Indep endentliest lob in complitance with NMC progra in and procedural requirements.
• WN data Is a ccurnne as of December 2010- Due to ongoing product changes, updated test results or new industry standards or requirements, this data may change car time. Ratings are for sizes, specified by NrRC for
testing and certnimutin- Ratings may wiry depending on use of tempered glass, different grille options, glass for high altitudes, etc.
• PassfreSue glass values am anniflable online at andersemirtridows-com-
a
HP tom,1511 �, 0.27
033
OBB
Aiodamari! Produd" GhmsIypa
AndersW Pioduct.
GfMTYP 0
0 -Factor'
SHW
VP
-77-
Hitow,-Mtm
7. 77.
0.20
031
O -V
HP tow -154 Sun taMpff"
0.29
1111' Laiii-M.
027.
035
0.60. PIJ�
-HP Lo.M SmiulSain
0.26
HP low -E4 with GYMCS
028
oat
0-54
0-28
Ch" Tsiy�
HP Low -M Son
027
0.21
O.M
0,31
ftsimaint Mouly
Rp Lma sun with rsaves
D.29
Dig
0.3o
Ej
0-30
HP Loa -M SmartSun
026
0.23
054
Fi
HP tow -154 SmariStat w/GnIles
Ole
021
OA9
JfP Low -0 Son 016Gflei'
0.33
HIP Low -154
0.27
0-35
0.60,
HP �� rlStA
0.30
HP Low -154 wb Grilles
0.28
031
0.54
021
OA6
HP Lur44 Suit
0.27
0.21,
0.33
0.21
arcle & end Modiiii.
HP Law,& Sun with Grilles
029
0.19
030
0.23
0.39--�' W. -!NAM
HP low -E4 SmwtSun
0.26
GM
0.54 �ik
P]
Gibiling PAO ocitir
HP Low -E4 SmartSun w/Gffln
0.28
021
0.49,
026
HP Low -E4
o2s
o3a
o.5s
�a' M
HIP Lori -154 SmerlSim V�Qrflles ,
HP Low -154 with.GiMes .
0-29
03D
OS2 F -I
J
#T tow� Suh'4 0.28
020
031,
NR
Arch *Ihdbw
HP Low -154 Sun vifth Grilles
0.29
Q.Is
028, �71
-i 11M
j
HPLOw-E4Sm?!tS-
OIT
023
0.52 - -P�Ap.
conbow 0 Dal Pao!
For NMC clintified total unit PBFIO"na nce On Units with capillary bma ther tubes for high altitudes, please Visit anderstenwindows-com.
'High-Perlormance I.Low-15C (HP LBW -154), -High-performance Low -EV SmartSuh- (HP Low -E4 SmartSun) and 'High -Performance- Law-EVSue (mp Low -154 Sun) am Andaman brademorlis for 'tcrw�V ghm&
U-11actor defines the amount of beat loss through the total unit in BTU/hrsq- ME The ' Idwerthe value, the less heat Is lust1hrough the entire product Window values represent non-iltemperad glass. Use ciftempered AWS can
increase D -Factor rartings. See andemennindowit-com for speCilic Peftmance values- Doorvalues mpreseritizarpered gitim
SolarMeet Gain Coefficient (SHGQ defines the fraction ofsolar radiation admitted through the glatis both doefttransitifted and absorbed and subsequently released b.mard. The lowerthe value, Me less bliatis bloomildid
through the product.
3 11hribleTransraftintce (VT) measures bow much light comes thmugh 0 product. Ighms and frame). The higher Ilie value, from 0 to 2. the more dayflglftt�e product lets In Car the FrioduLlis totall uAltarea. Visiblelfinumothilance
Is measured over the 390 to M nanometer portion of the solBf spectrum.
• NFRC ratings are based an modeling by a third party agency as vallilated by an Indep endentliest lob in complitance with NMC progra in and procedural requirements.
• WN data Is a ccurnne as of December 2010- Due to ongoing product changes, updated test results or new industry standards or requirements, this data may change car time. Ratings are for sizes, specified by NrRC for
testing and certnimutin- Ratings may wiry depending on use of tempered glass, different grille options, glass for high altitudes, etc.
• PassfreSue glass values am anniflable online at andersemirtridows-com-
a
HP tom,1511 �, 0.27
033
OBB
Aiodamari! Produd" GhmsIypa
HP Low-Mvith QVIes-',
028
0-30
OM, F3-
A�
-77-
Hitow,-Mtm
0-27 -
0.20
031
O -V
HP tow -154 Sun taMpff"
0.29
0.111
028-R
032
0.25
-HP Lo.M SmiulSain
0.26
0-23
GM- -4 !N IP
Q17
HP Law -M ShmintSun wfWleS
0-28
0.21
DAG
0.16
0.23
HPIL.-154
0,31
033
GM
M
i
HP IRv#-E4 With GAIlles
032
0-30
0.52
JN -
HP LUN -164
HP LO-154,�!iim
031-
020
0.31-
HIP, Low'.0 vM Gan
032
JfP Low -0 Son 016Gflei'
0.33
GAS
0.281 ---
0.32
i.-1-7026
HP �� rlStA
0.30
OM
0.52,,' im i
1
HP tow4M SmioiSun.�/Gffles 0M.
021
OA6
031
a."
UP Low -154
030
0.21
4D -45 V
eu
038
HIP towa WM Mai
0M
0.23
0.39--�' W. -!NAM
OAT
HI'Low-,164flurn
031
0-16'
02510 Fq-
Gibiling PAO ocitir
HIP Lo*464 Sun vft Gffles
0-32
0-14
. 0.22.-
026
HPLO*aSrhaoISuri%�
030
PAS"-"
0.41 -1, F -I
�a' M
HIP Lori -154 SmerlSim V�Qrflles ,
031,
0.16
0-35
�'i� HP Low -0 SmarGun w/QMn
HP Lint,464
0.31.-
024
0.41
HP law -154
0-91
HP Low -154 %M Grilles
0-32
11210.35
HP Low4FA vft Gilles
031
FmnWmooa* glogiad
Hp towF4 Sim
031
0-16.
0-23
020
.b.w.goaftoo.-
HP Law4E4 Sun with Giflies
032
0.13
0.19
028
FAM
HIP Low -154 SmootSuo
0.30.
(UG
_0137
j HPLow-E4SmvrlStmw/GMm,
-v
031
0-14
0-11
IM
UP tow -M
- HPLaw-E4
0-31
Q25
OAI--� r-
-
0.30
HIP LuirC4 111111111 Goa
0M
P�.!
1110 ly ftniaw HIP Low -154 Sun
-AtE
an
HIP LOMLa Sim
031
015
.021 ITT.
020
GuWft F�1119 llloa�
HILowTASun-withlilifft
0.32
0.13
0.19
01%
HP Low -M SftftS=
030
OAT
037,
!16r'
R".:Q19
HP law -M SmartSun winGrilles
0.31
015
031 M
P"M
HP Wail% MM GIVIes
HP W.4E4
0.31
OM
0.37 "t P$
Wood bwft'. HPLOPF-Mon
CM
HP Lo..E4 with Gan
0.32
020
0.33
F1
F,6,-' k mr
HP tow -M Son
0.32
0.14
021
0.15
M. Dooi S11ilelligiii. I
KP Low -EA Suit wo Gifiles
0-32
am
0.18
030
HP LOW -M Smad&m
'031
OAS
033 M
PAR
RP Lowa on GMN
HP Lotv-154 ShuntSuo vilMes
am
0.14
029
"bowing MY, Lowa SIM
0.33--
Up LOW -154
030
024
0.40
025
0-14
HIP to"a Willi Gioles
030
0.21
03S
0.17
0-37
HIP Low -E4 Sun
030
0-15
0-22
0.32
ratio bour Tralisain
KP Low -B Sun wilh GMes
0.31
0.13
0.20
HIP tow -M OM Gfilles
HP Low -154 SmartSua
0.29
0-16
036
R.4 Onimick bb* WILOW-154SIM
"PLuiv-154SmanSunw/Grilles,
030
0.14
032 r,
HPILwaSontifilhOlDes
conbow 0 Dal Pao!
For NMC clintified total unit PBFIO"na nce On Units with capillary bma ther tubes for high altitudes, please Visit anderstenwindows-com.
'High-Perlormance I.Low-15C (HP LBW -154), -High-performance Low -EV SmartSuh- (HP Low -E4 SmartSun) and 'High -Performance- Law-EVSue (mp Low -154 Sun) am Andaman brademorlis for 'tcrw�V ghm&
U-11actor defines the amount of beat loss through the total unit in BTU/hrsq- ME The ' Idwerthe value, the less heat Is lust1hrough the entire product Window values represent non-iltemperad glass. Use ciftempered AWS can
increase D -Factor rartings. See andemennindowit-com for speCilic Peftmance values- Doorvalues mpreseritizarpered gitim
SolarMeet Gain Coefficient (SHGQ defines the fraction ofsolar radiation admitted through the glatis both doefttransitifted and absorbed and subsequently released b.mard. The lowerthe value, Me less bliatis bloomildid
through the product.
3 11hribleTransraftintce (VT) measures bow much light comes thmugh 0 product. Ighms and frame). The higher Ilie value, from 0 to 2. the more dayflglftt�e product lets In Car the FrioduLlis totall uAltarea. Visiblelfinumothilance
Is measured over the 390 to M nanometer portion of the solBf spectrum.
• NFRC ratings are based an modeling by a third party agency as vallilated by an Indep endentliest lob in complitance with NMC progra in and procedural requirements.
• WN data Is a ccurnne as of December 2010- Due to ongoing product changes, updated test results or new industry standards or requirements, this data may change car time. Ratings are for sizes, specified by NrRC for
testing and certnimutin- Ratings may wiry depending on use of tempered glass, different grille options, glass for high altitudes, etc.
• PassfreSue glass values am anniflable online at andersemirtridows-com-
a
I
Aiodamari! Produd" GhmsIypa
U-Nme
SHW
YP
-77-
HIP, LVN-&
O -V
U."
0.4T
OR
HP Low -154 whh.Gfflles
032
0.25
0.42
HP too -154 Sun
O..Om Window
0.32
Q17
0.26
FIN
HP Low -E4 Sun wfth GnIles
0-32
0.16
0.23
FM
HIP Lowa Smrdkm
031
GAS
M
i
HP Law -154 SmadSun w(Giffles
031
0.17
38
HP LUN -164
032
020
CA7
HIP, Low'.0 vM Gan
032
0.25
DA2
F7 IM
UP Low -154 Sun
0.32
i.-1-7026
Window HP Low -E4 Sam with Grilles
032
0.16
0.23
ffP tow -154 SmadSun
031
a."
CA2
Fy E
HP EMU Smarratin W/Gfts
0.31
0.17
038
UP LVNE4
032
026
OAT
F1
HP tow -164 vd& GdRes
0.32
025
OA2
rq F3
HP towa sun
032
all
026
HP Lowa San tin
-M QMN
032
1116
023
tip LON-154 SMMSW
031
0.18
0A2
�'i� HP Low -0 SmarGun w/QMn
031
0-17
038
HP law -154
0-91
0M
03S
HP Low4FA vft Gilles
031
029
OA9
C.A.h/A.MV4 HP Lawa Sun
-ML-MS--MQVl.
11111
020
031
0.31
0.1111
028
FAM
HIP tabIE4 Solution
031
021
0.50--
ffp smadsmw/QEN
031
039
0,44
IM
UP tow -M
030
Q3?
0.64
Eli
HIP tow," With (Mas
0.30
0-33
OS7
P�.!
1110 ly ftniaw HIP Low -154 Sun
031
an
036
FE IM
eal�
I, HP tow -154 Sun wo Gilles
031
020
0.32
UP Lux -E4 SnordSon
0.30
024
01%
ET II L
HP tow -154 SmadtSun w(Gfilles
0.30
0.22
0M
R".:Q19
HP towa
032
022
03T
HP Wail% MM GIVIes
033
020
033
Wood bwft'. HPLOPF-Mon
CM
014
Oil
""Mb Poor HP Low -M Son UM GiRles
0,34
0.13
M
HP Lava SmWtSm
032
0.15
033
HIP low -M StrumSunw/lin
Vles
033
(114
030
#11' Lo* -E4
0.33
0.25
OAI
RP Lowa on GMN
034
0.22
036
"bowing MY, Lowa SIM
0.33--
0-16
023
UP tu.M Skin vft Gfilles
025
0-14
020
HP tow -154 SMUISIM
032
0.17
0-37
HP Low -154 Smarftn w/011hes
034
111.13
0.32
NP to*"
am
0.23
038
HIP tow -M OM Gfilles
0M
021
034
R.4 Onimick bb* WILOW-154SIM
0M
0.14
021
HPILwaSontifilhOlDes
034
OM
OJ9
UP Low -164 SmodSon
032
GAS
0.34
HP Iowa smartson WIGOM
0-33
OA4
030
IW Lux -154
OM
025.
OAI
I HP Low -154 vft Met
0.33
022
037
Roedubrumno HP Low -164 Son
032
0-15
023
Fission fter HP Low -E4 Sim with, Goa
0-33
(k14
020
IW Low -M SInarlSun
IDM
016
037
HP twa smarlson W/Goes
0M
015
0M
HP IVINFITA
'r -IIP
035
026
M"
Lini,154 M GO.
036
023
038
HIR Low -194 Sun
035
�76-024
-7
HP Low -154 So %ft Gdges
036
014
021
-
t HP tu*& Smart5un
034
0.17
039
-
- HP Low -154 SmartSun w/GyMes
0.36
OAS
034
-
conbow 0 Dal Pao!
For NMC clintified total unit PBFIO"na nce On Units with capillary bma ther tubes for high altitudes, please Visit anderstenwindows-com.
'High-Perlormance I.Low-15C (HP LBW -154), -High-performance Low -EV SmartSuh- (HP Low -E4 SmartSun) and 'High -Performance- Law-EVSue (mp Low -154 Sun) am Andaman brademorlis for 'tcrw�V ghm&
U-11actor defines the amount of beat loss through the total unit in BTU/hrsq- ME The ' Idwerthe value, the less heat Is lust1hrough the entire product Window values represent non-iltemperad glass. Use ciftempered AWS can
increase D -Factor rartings. See andemennindowit-com for speCilic Peftmance values- Doorvalues mpreseritizarpered gitim
SolarMeet Gain Coefficient (SHGQ defines the fraction ofsolar radiation admitted through the glatis both doefttransitifted and absorbed and subsequently released b.mard. The lowerthe value, Me less bliatis bloomildid
through the product.
3 11hribleTransraftintce (VT) measures bow much light comes thmugh 0 product. Ighms and frame). The higher Ilie value, from 0 to 2. the more dayflglftt�e product lets In Car the FrioduLlis totall uAltarea. Visiblelfinumothilance
Is measured over the 390 to M nanometer portion of the solBf spectrum.
• NFRC ratings are based an modeling by a third party agency as vallilated by an Indep endentliest lob in complitance with NMC progra in and procedural requirements.
• WN data Is a ccurnne as of December 2010- Due to ongoing product changes, updated test results or new industry standards or requirements, this data may change car time. Ratings are for sizes, specified by NrRC for
testing and certnimutin- Ratings may wiry depending on use of tempered glass, different grille options, glass for high altitudes, etc.
• PassfreSue glass values am anniflable online at andersemirtridows-com-
a
0
White, Megan
From: Steve Dana <stevedanal 01 @gmail.com>
Sent: Thursday, June 12, 2014 11:05 AM
To: White, Megan
Subject: Fwd: Summary document with'approval note zuzack pd n Andover
Sent from my Wad
Begin forwarded message:
From: Bob Zuzack <bzedgyahoo.com>
Date: June 12, 2014 at 10:20:18 AM EDT
To: Steve Dana <stevedanal 0 1 ggmail.com>
Subject: Fw:'Summary document with approval note
Reply -To: Bob Zuzack <bzed@yahoo.co >
Steve here is email from Design Review Committee approving installation\. You have to
read all the way the to the last line. Let me know if this satisfies the need.
71. 1 Me
On Wednesday, June 11, 2014 4:58 PM, Richard Nawrocki < r. nawrocki(�q mail. com > wrote:
Bob,
Both Pella and Anderson produce quality sliders and I'm sure if properly
installed will provide years of good service for your unit. Two principal
concerns exist, based on sliders being installed here in other units at Millpond.
One relating to the structure of the building in that we have found in that the
structure that the slider resets on, especially at ground level can have severe
decay and rot that is not decreeable unless the slider is removed. In one
recent incident a replacement slider was installed without taking care of the
rotted wood, shortly after installation the unit owner had problems with the
operation of the slider, requiring its removal and reinstallation after replacing
the rotted wood that should have been corrected the first time. We, Millpond
will repair any rotted wooden structure found during inspection after the
old slider's removal. When the slider is taken out, if rot is found, notify us and
we will have Maintenance repair structural damage.
The second concern is assuring that the slider is installed in a way to
assure it's sealed to the weather, sliders come with tabs attached to be sealed
and fastened to the building to assure they don't leak during rain and snow
(especially wind driven rain) which can lead to future structural damage.
As indicated earlier, the slider frame needs to be of the same external
color (brown / terra tone) as the current units throughout the complex have,
and they should be clear with no crosspieces at attached or inside the
glass. Millpond will provide external siding material (the same as what is used
on the rest of the condo siding) to use to enclose the new sliders. Be aware
that your contractor should not "picture frame" the sliders. Should that take
place we will require that it be removed and replaced.
Per the DR application we, Millpond may opt to inspect the work during or
after it's completion.
I will attempt to send you an approval to top ahead, on the DR form, but
since i have had some difficulty with that in the past you may use this
as ago ahead. All conditions identified on the form apply ..... For The Design
Review Team ...... Dick Nawrocki