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HomeMy WebLinkAboutBuilding Permit #006-2011 - 60 RALEIGH TAVERN LANE 2/1/2010 TOWN OF NORTH ANDOVER 0 . APPLICATION FOR PLAN EXAMINATION e * O 6 �"61/ Date Received Permit N0: �SSACHus�� Date Issued: l� IM ORTANT Applicant must complete all items on this page �.����-'�k ����' '�' ems. � �• ��. -ter � .� �ss �,x;�� • 5� ak t � yy iA o & F .5 •4 ��d. TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building , One family ❑ Addition ❑Two or more family ❑ Industrial ❑ Alteration No. of units: 0 Commercial Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other � a s t � urn ¢ tax D SCRIPTION OF WORK TO BE PREFORMED: �s Identification Please Type or Print Clearly) Phone: OWNER: Name: Wg- y �,. ���O.�e-f� Vic. Address Q (%L� 1 V of �v�e g`�; , .r�x��,��".s+ t°.�k �.r�.-..r.h� -�� � a,�..' ���i. �`'`..^�'. �3.4�r��g�����^��k"v.. ..��;,F_ � .: r� �; .e.ra�..�a•�a-'-" _ 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: $ �a Cog 3 • FEE: $ Check No.: L 0 Receipt No.: 2 3�Y NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund 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 DATE REJECTED DATE APPROVED PLANNING &-DEVELOPMENT ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ . ❑ COMMENTS I DATE REJECTED DATE APPROVED HEALTH ❑ ❑ COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes t Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature & Date Located at 384 Osgood Street Driveway Permit �J. —s"x �5+ ,. A"� ?Na���° ,(iaY4a, z,�, T�, it, ebz , L$=�s u"IAL .���.e� xr ,5 x x ty� * ash wax " < s � s e } y x xr natu'v ly S�',5 s yy ` �?'1 '.9�.��5' "�:.��'r +��`S^a` •� � ��t a`' ..^«�4 ��-d -,s,,ss a�.�r..�=5.. 7a ,:a...;5 i �s�,' "�Y� e r�''a� � a?r ''� �''.,�' �`?` � ��Y ` �r w�"S��C,4°.f �, 3�� k`�''.s7' z � '&.c rk'^''✓Fn3 4 .p aw a..r a' 1 v';...•< t,t. ,�. .. ,. .��s, 3 ,..,aar'�en `5�'4+. t .�ys. ""»�',.e� r .,.�k k 7 s U Kri.�l •:r Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 section 21A—F and G min.$100-$1000 fine NOTES and DATA— For department use ❑ Notified for pickup - Date Doc.Building Permit Revised 2007 Building Department The following is a list of the required forms to.be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2007 Location 0 /r^ i � 6'!TC y��'-46,"A/ f$ No. Date -7 l 2-),v IJ NaRTM TOWN OF NORTH ANDOVER 3? OL 41 wjv,"Nw � 9 Certificate of Occupancy $ CMH Eck' Building/Frame Permit Fee $ fAUs Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # Zfq 2604 4 Building Inspector ORTH Town of And �AK o dover, Mass., � COCHICHEWICK - %p A0RATEO `S U BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT ................ ....................... Foundation has permission to erect........................................ buildings on ...................................... .. ...................... ....... ....e .. Rough 11 � t0 be occupied as ,. ,. /.� ..... Chimney p' ............................ ........................................ ......................................... ............... 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 UNLESS CONSTRUCTION TARTS ELECTRICAL INSPECTOR Rough ,��� ~ ............................. ... ......... ..... ........................................................... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR I Display in a Conspicuous Place on the Premises — Do Not- Remove RoughFinal 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. 104 Otis St.,Northborough,MA 01532 J&L WINDOWS,INC.,D/B/A _ MA Home Improvement Contractor (508)919-0900•Fax:(774)987-3013 Renewal License#149601 (Expires 1/24/2012) byAndersen. Aili Federal Tax ID#83-0404201 WINDOW REPLACEMENT =And—Compaq CUSTOM WINDOW AND DOOR REMODELING AGREEMENT Buyer(s)Name Date of Agreement Buyer(s)Street Address,City,State,and iip Code 162 12 Lr\ loIq E Mail Address Home Tele one Number Work Telephone Number Buyer(s) hereby jointly and severally agrees to purchase the products and/or services of J&L Windows,Inc.d/b/a Renewal by Andersen ("Contractor"),in accordance with the terms and conditions described on the front and the reverse of this agreement and on the attached specification sheet(s) (collectively,this"Agreement').Buyer(s)hereby agrees to sign a completion certificate after Contractor has completed all work under this Agreement. / Method of Pymnt:O Cash 0 Check 0 Mastercard VISA Total Job Amount: (t7�t� Estimated Starting Date: 0 p ( )� /o 0 Discover 0 Financed,App#:� Deposit Received 33%: r d / �^ Name on Credit Card: Balance at Start of Job(33%):-7.5_/P C Estimated Completion Date: Credit Card# Balance on Substantial - Completion Completion of Job(33%):7-547 ,/5CC Exp.Date CC Security Code: ism By initialing here,you acknowledge that the Balance at Start of Job and the Balance on Substantial Completion Buyer Initials of Job cannot be made by credit card and must be made by personal check,bank check,or cash. Buyer(s) agrees and understands that this Agreement constitutes the entire understanding between the parties,and that there are no verbal understandings changing or modifying any of the terms of this Agreement.No alteration to or deviation from this Agreement will be valid without the signed,written consent of both Buyer(s) and Contractor. Buyer(s) hereby acknowledges that Buyer(s) 1) has read this Agreement, understands the terms of this Agreement, and has received a completed,signed,and dated copy of this Agreement,including the two attached Notices of Cancellation,on the date first written above and 2)was orally informed of Buyer's right to cancel this Agreement.DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. J:L Windo ,Inc. a Renewal by Andersen Buyer(s)n Buyer(s) B 2 Signature of Product Maa\n/ager Signature Signature 1 1 1r) Pnnt Name of Product 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— — — — — — — — — — — — — — —� . NOTICE OF CANCELLATION X NOTICE Of CANCELLATION Date of Transaction as-T-10 . You may cancel Date of Transaction g-le . You may cancel this transaction,without any penalty or obligation,within this transaction,without any penalty or obligation,within three business days from the above date.If you cancel,any three business days from the above date.If you cancel,any property traded in,any payments made by you under the property traded in,any payments made by you under the Contract of Sale,and any negotiable instrument executed I Contract of Sale,and any negotiable instrument executed by you will be returned within 10 days following receipt I by you will be returned within 10 days following receipt by the Contractor ("Seller") of your cancellation notice, by the Contractor ("Seller") of your cancellation notice, and any security interest arising out of the transaction will and any security interest arising out of the transaction will be canceled.If you cancel,you must make available to the be canceled.If you cancel,you must make available to the Seller at your residence,in substantially as good condition i Seller at your residence,in substantially as good condition as when received, any goods delivered to you under I as when received,any goods delivered to you under this this Contract or Sale; or you may, if you wish, comply I Contract or Sale;or you may,if You wish,comply with the with the instructions of the Seller regarding the return instructions of the Seller regarding the return shipment of shipment of the goods at the Seller's expense and risk. I the goods at the Seller's expense and risk.If you do make If you do make the goods available to the Seller and the I the goods available to the Seller and the Seller does not Seller does not pick them up within 20 days of the date I pick them up within 20 days of the date ofyour Notice of your Notice of Cancellation,you may retain or dispose I of Cancellation,you may retain or dispose of the goods of the goods without any further obligation.If you fail to without any further obligation. If you fail to make the make.the goods available to the Seller, or if ou agree I Fr ds available to the Seller,or if you agree to return the to returnthe goods to the Seller and fail to do so, thends to the Seller and fail to do so,then you remain liable you remain liable for performance of all obligations underperformance of all obligations under the Contract. the Contract.To cancel this transaction, mail or deliver a To cancel this transaction, mail or deliver a signed and signed and dated copy of this cancellation notice or any I dated copy of this cancellation notice or any other written other written notice,or send a telegram to Contractor.J notice,or send a telegram to Contractor.J&L Windows, &L Windows,Inc.d/b/a Renewal by Andersen, 104 Otis I Inc. d/b/a Renewal by Andersen, 104 Otis Street, Street, Northborough, MA 01532, BY NOT LATER THAN Northborough,MA 01532,BY NOT LATER THAN MIDNIGHT MIDNIGHT OF 6-/(-1 D .(Date) OF j s-//-/!J .(Date) I HEREBY CANCELTHIS TRANSACTION. I HEREBY CANCEL THIS TRANSACTION. Buyer's Signature Dote Buyer's Signature Date RbA Copy- White Buyer Copy-Yellow Buyer Copy-Pink J&L Windows,hic.d/b/a Ph Otis Street,Northborough,MA 01532 - RenewalMA HIC License#149601(expires 1/24/12) Phone 508.919.0900•Fax 774.987.3013 US Federal Tax ID# 83-0404201 byMdersen. WINDOW REPLACEMENT an Ard—C—pany OF GREATER MASSACHUSETTS AND NEW HaMPS M WINDOW SPECIFICATION SHEEP Buyer(s)Name Date of Agreement v The Buyer(s)listed above hereby jointly and severally agree to purchase the goods and/or services listed below,in accordance with the prices and terms described on the Specification Sheet and the front and the reverse of the accompanying CUSTOM WINDOW AND DOOR REMODELING AGREEMENT, of which this Specification Sheet is a part. WINDOW DETAILS 1.ff Contractor will Install a total of windows in Owner's home,using the following individual quantities: Double Hung(DB) X Equal sash ❑ Cottage sash(1/3 top,2/3 bottom) ❑ Oriel sash(2/3 top.1/3 bottom) Casement(CW) ❑ Hinge right ❑ Hinge left(as viewed from exterior): ❑ Standard handle ❑ Metro handle Double Casement(CDW) ❑ Standard handle ❑Metro handle Casement/Picture/Casement(CPW) ❑ 1:1:1 or ❑ 1:2:1 ❑ Standard handle ❑ Metro handle 2 Lite Gliding Window(GW) Glider/Picture/Glider(GPW) ❑ 1:1:1 or ❑ 1:2:1 Awning Window(AW) Picture Window(PW) Bay or Bow Window Patio Doors(see separate Door Specification Sheet) �p Z. �Yes ❑ No Qty of Windows to be Custom Fit Replacement: f.1_ 3. ❑ Yes [ No Qty of Sills to be replaced by Contractor: 4. ❑ Yes 9 No Qty of Windows to be New Construction Pull frame(includes new interior&exterior casings) Exterior casings: ❑ Pine ❑ Maintenance-free material ❑ Factory applied 908 Fibrex brickmold 5. Glazing to be: M-HP Low-E®SmartSunTM (Tex Gfeditffigrble) ❑ Other If other,please specify: 6. Exterior color to be:K White ❑ Sand F] Canvas E] Terratone F-1CocoaBean 7. Interior color to be: White ❑ Sand ❑ Canvas ❑ Terratone ❑ Pine ❑ Maple ❑ Oak Note: Interior color can only be white,wood or same color as exterior. Wood interiors need to finished by Owner. 8. Hardware:X White ❑ Stone ❑ Canvas ❑ Brass ❑ Estate Hardware: Style: 9.*Yes K No Install Lifts with Double Hung Windows 10. Screens: windows to have: ❑ Half or Full screens Screens to be:+Fiberglass ❑ Aluminum ❑ TruScene GRILLE DETAILS 11.Windows have grilles: Z,Yes ❑ No If yes:X Grille Between Glass(GBG)❑ Removable Interior Wood 0»❑ Full Divided Light(FDL) Qty- Qty- Qty- Qty- Qty- Qty Qty- 11 DH DH DH DH CW/PioWre Glider CPW or G Draw grille patterns above `Use additional sheet if needed Owner approved(initials): ADDITIONAL WORK DETAILS 12.❑ Yes$ZNo Contractor will remove metal frames of windows. Qty of Units: 13.❑ Yes No Contractor will install new paint-ready or stain-ready casings. Interi r casing qty of openings: Exterior casings qty of openings: ❑ Pine ❑ Maintenance-free material 14.❑ Yes 1N No Contractor will install new paint-ready or stain-ready inside or outside stops qty of openings: Interior stops qty of openings: Exterior stops qty of openings: ❑ Pine ❑ Maintenance-free material 15. Owner is ware that Contractor does not do any painting. ( )Owner Initials 16.❑ Yes No Contractor will wrap exterior casings with aluminum coil stock of color. Note: Wrapping may be required with storm window removal;removal of storm windows will leave screw holes in casing. 17. Yes ❑ No Contractor will insulate,caulk and seal windows with 3-point system to prevent water and air infiltration. 18. Yes ❑ No A limited warranty shall be issued to Owner upon completion of the job and payment in full. 19.XYes ❑ No Building Permit--Contractor will secure any and all necessary permits. The fee for the permit(s)is not included in the Con act Price and a separate check/Ts required at the time of sale for this fee. 20. Additional job details'e`nS �, T 21. Yes ❑ No Owner agrees to be present on the final day of installation for final inspection and to deliver final payment. No finalpayment 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 signed by both the Buyer(s)and Contractor. Buyer(s)hereby acknowledge that Buyer(s)has read this Specification Sheet. Rener Aadersercaf Gerber MA and NH Buyer(s) Buyer(s) —Umature of Product Manager Signature Signature cam, rt) f 1 T Print Name of Product Manager Print Name Print Name Tlie Coinmonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Wmmass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information' Please Print Legibly Name(Business/Organizadon/Individual): �2nelJ a 1 _3� , e-n .Address:. /0� &&erJ- City/State%Zip: f 1 0 ro Al Phone#: Are you an employer?Check the appropriate box: Type of project (required): 1-aI am a employer with D 4. ❑J am a general contractor and 1 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. t modeling ship and have no employees These-sub-contractors have S. b Demolition working for me in any capacity. workers' comp.insurance. g• ❑Building addition [No workers'comp.insumice 5. ❑ We are a corporation and its required.]. officers have exercised their 10. Electrical repairs or additions 3:❑ I am a homeowner doing all work right of exemption per MGL I1.7 Plumbing repairs or additions myselL[No workers'comp: c.152,§.1(4),and we have no 12.[]Roof repairs insurance required.]t employees ..[No workers' 13.[1 Other . comp.insurance required.] '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 anew On-davit indicating such. =Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees Below.is the policy and job site information. Insurance Company Name: Ke-o»•-_ )n St�ed n C e Policy#or Self-ins,Lic.#: �y/ ln��L�� �`7�` _ Expiration Date: . Job Site Address: V v , C ty/State/Zip:_6j ; PI R J(JJEA_,­' 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 25k 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby cer u er the pains and pena�,ef perjury that t1:e information provided above is true-and correct Simature• ( Date: Phone#• /� .'J U c _ a W. - Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: }. - •-z:c'F,t.�' 1 clJL6 TOd�IYllL69t[IJELZLUG 0 ✓UGQddQCfl yf: Board of Building$egulatious and$tapdards i 'Construction•SuperviscrUcansa•t;%":. A• i Llcen;;e;, •96707 8irttii�atei�-�q1611982 A N50- , ' Trd 95707 JE plratlorl: 7872010 6RIAN DENNISO 86 CREST CIRCLE _ y WORCESTER,MA 01603*";. Colnrrlissioner; . ' • ✓fie Toonanwnweal� o�./f�aaaac/uraes Office of Consumer Affairs&Business Regulation NOME IMPROVEMENT CONTRACTOR Registration &001 Expi - 12 . nt Card RENEWAL BY ti Te "+ BRIAN DENNIS- — J+ c � r 104 OTIS STREE NORTHBOROUGH,'t ai32 Undersecretary , AC()RDry CERTIFICATE OF LIABILITY INSURANCE °0211012 0' PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Joseph McKeone ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR JP McKeone Insurance Agency, Inc. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O. Box 333 Ann Arbor, M1 48106-0333 INSURERS AFFORDING COVERAGE NAIC# INSURED Renewal by Andersen INSURER A: Hartford Insurance Company J and L Windows,Inc. INSURER B: Nautilus 104 Otis St INSURER C: _ Northborough,MA 01532 INSURER O: 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 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED.BY PAID CLAIMS. WSR D'LPOUCYNUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS I TR lmqpb TYPE OF INSURANCE B GENERAL LIABILITY NC958461 10/01/2009 10101/2010 EACH OCCURRENCE S 1000000 DAMAGE TO RENT COMMERCMLGENERAL LMILITY PREMISES a o=ummoe S 100.ODO CLAIMS MADE 0 OCCUR MED EXP(Any on person) S 5,00Q000 PERSONAL&ADV INJURY : _1=0-01 GENERAL AGGREGATE $ 2,000,000 GENL AGGPWATE LIMIT APPLIES PER: PRODUCTS•C.OMPgP AGG S 2,000,000 1 17 POLICY PRO• LOC A I AUTOMOBILE UABILITY 35MCC XD 6390 10/01/2009 10/01/2010 COMBINED SINGLE LIMIT $ 1,000,000 ANYAUTO (Eo ooadent) X ALL OWNED AUTOS BODILY INJURY S (Per person) SCHEDULED AUTOS HIRED AUTOS BODILY INJURY S NON-OWNED AUTOS (par amdem) — i PROPERTY DAMAGE S (Por a=dent) OARAOE LIABILITYAUTO ONLY•EAACCIDENT S _ ANY AUTO OTHER THAN EA ACC S AUTO ONLY: AGG I S EXCESSNMBRELLALIABILITY EACH OCCURRENCE S OCCUR CLAIMS MADE AGGREGATE S S DEDUCTIBLE S RETENTION S' S A WORKERS-COMPENSATION AND 35 WECPP 1444 02/17/2010 02/17/2011 WcsrATu• _FA EMPLOYERS'UAB!Un E.L.EACH ACCIDENT S 50O,OOD ANY PROPRIETORIPARTHER/EXECUTIVE E.L,DISEASE.EA EMPLOYEE S 500 OOO OFFICERIMEMBER EKCLUDED7 - Uyyet.desatbo under E.L.DISEASE-POLICY LIMIT S 500,000 SPECML PROVISIONS below OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLJ_S I EYCWSIONS ADDED BY ENDORSEMENT!SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION INSURED COPY DATE THEREOF,THE 18sUING INSURER NUL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. may. AUTHOR¢EDREPRESENTATNE ACORD 25(2001!08) ©ACORD CORPORATION 1988 i ATM Renewar Arik, .�•�; A MAbyAndersena WINDOW REPLACEMENT a nklderun(:omgioy ' ;,. Wood/Vinyl Composite IF �s :�;mss•;fi;:, Dual Argon Low E4 SmanSun »>.:,<.:.:,:...>:..:>::.,,•>:, Double Hung 100-00473518-010 ENERGY PERFORMANCE RATINGS U-Factor(U.S)/I-P Solar Heat Gain Coefficient 0n29 I 0019 ADDITIONAL PERFORMANCE RATINGS Visible Transmittance OA2 Manufacturerstipulatas that these rix ingsconform toapplizable NFRC procedures for determining whole product performance.NFRC ratings are determined for a fixed sat of environmental conditions and a specific product size. NFRC does not recommend any product and does not warrant the suitability of any product for any specili:use. CiOnsua manuhcturer's literature for other product performance information. Www.nftc.org 'TSe4*k This product manta Graan .� •: •, �A sears environmental caned. •x•.,,,. Qw rdandardsgoverningenergy �''i �•" Y'•`Y;`^''>•+� �+ etfciancy,heavy metals in `... 1 +••, ;�+'�� •:.the frame and sash � a�•.,.i;»;•.,�yr�;,•7,•n`��,,• tt�matarel packaging,and ( f 'r,:; ..'•�i;;ff r <••:;:�: yji consumer educational � •A�}�;. ' t� materials, tw-i 4u ••: �o%%:•''..' {�Y DESIGN PRESSURE(PSF) A a 'Wndow and War www.Whl7nufaCtutrs A49ocillim 111N .,I� LC25 opedma.SRbA DB Sloped Sill DH Manutanarer st tes confarmaroe to thea doable sta .chats of exceeds 1A.E.C.,C.E.C,8 I.E.C.C.Ai Infliltration requirements WOMA Hallmark Cartircation Program.