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HomeMy WebLinkAboutBuilding Permit #116 - 67 KARA DRIVE 8/10/2009 NORTH BUILDING PERMIT oF�t%.aD ,6 TOWN OF NORTH ANDOVER �`4 ., �6 0� APPLICATION FOR PLAN EXAMINATION * ,� Permit NO: Date Received '1740°A TD *Py Date Issued: W110 I PORTANT: Applicant must complete all items on this page LOCATION � C+ -- C1, t Print PROPERTY OWNER \ t,..1€ Print MAP NO: PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition Two or more family Industrial Alteration No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other Septic Well Floodplain Wetlands Watershed District Water/Sewer DESCRIPTION OF WORK TO BE PREFORMED: Identificatio Please Type or Print Clearly) OWNER: Name: Phone: Address: VA �Pt,21 7pt\—��-k , CONTRACTOR Name: ,J iu. Phone: Address: \ Supervisor's Construction License:QS Exp. Date: g Horne lm..,provement License: 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: $ �j'l} � OC-5 FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature o- Agent/(! net�{S (� ature of contract �, 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 CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature $Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT -Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature%late COMMENTS 1 Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— (For department use ❑ Notified for pickup - Date Doc.Building Permit Revised 2008 Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc:Building Permit Application Revised 2.2008 Location C[ �G No. Date NORTh TOWN OF NORTH ANDOVER 40 w } ° Certificate of Occupancy $ ��s'"'°''•<�' CMusBuilding/Frame/Frame Permit Fee $ � sAt 9 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 22611 Btfifding Inspector ,tAORT#q ® o Andover No. dover, Mass.,- Y_6__�z COC "LI�CA.. I CK Pa` ORA T E D BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT.......... ...... ........................................ ... ..... . .. ...........).................................. Foundation has permission to erect........................................ bUlIdjngs on ..........6..7....... i............................ Rough to be occupied as ...... . . ./("//./..1/.. ..................................................................I......... Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTIO ARTS Rough ..........I...... ....... ... ... ....... ..... Service ......... .. . BUILDING INSPECTOR Final Occupancy Permit Required to Owipy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. (ex es Renewal . F ,NEWAL BY ANDERSE' M4 License Felderal Tax ID#r83 4042011 byAndersen. �- WINDOW REPLACEMENT mAn&.-C..p- OF GREATER MASSACHUSETTS AND NEW HAMPSHIRE 104 Otis Street•Northborough,MA 01532 Phone 508.919.0900•Fax 508.919.0903 CUSTOM WINDOW AND DOOR REMODELING AGREEMENT Buyer(s)Name Date of Agreement CGL0%/d1L- LLS�fn Buyer(s)Street Address,City,State,and Zip fode . E-Mail Address Home Telephone Number Work Telephone Number ? -a —61qW Buyer(s)hereby jointly and severally agrees to purchase the products and/or services of J&L Wmdows,Inc.dba Renewal by Andersen of Greater Massachusetts and New Hampshire("Contractor"),in accordance with the terms and conditions described on the front and the reverse of this agreement and on the attached specification sheet(s)(collectively,this`Agreement").Buyer(s)hereby agrees to sign a completion certificate after Contractor has completed all work under this Agreement. p ()b Estimated of Pymnt:O Cash ❑Check (h astercard ❑VISA Total Job Amount: Estimated Starting Date: Deposit Received(33%): � S �. co ❑Discover ❑Financed,App#: W'�C o Name on Credit Card: Balance at Start of Job(33%): 39�° /V� t� Estimated Completion Date: Credit Card#: Y66'Inv I / Balance on Substantial d"i 3_y Dy S Completion oflob(33%) - FCC Exp.Date: CC Security Code: `7L3 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. Renewal by Andersen of Greater MA and NH Buyer(s) Buyer(s) By: Signature of Product Manager Signature Signature iv Print Name of Product Manager Print Name r 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. �— — — - - - - - - - - - - - -� - - - - - - - - - - - - - �c- - - - - — — — — — — — — — — � NOTICE OF CANCELLATION X NOTICE OF CANCELLATION Date of Transaction �`)-o`t .You may cancel I Date of Transaction -ay-a`I ,You'may cancel this transaction,without any penalty or obligation,within I this transaction without any pens ty or obligation,within three business days from the above date.If you cancel,any three business,gays from the above date.If you cancel,any property traded in,any payments made by you under the1 roperty 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 Seller of your cancellation notice,and any security by the Seller of your cancellation notice,and any security interest arising out of the transaction will be canceled. interest arising out of the transaction will be canceled. If you cancel, you must make available to the Seller at If you cancel, you must make available to the Seller at your residence, in substantially as good conditionas your residence, in substantially as good condition as when received, any goods delivered to you under this when received, any goods delivered to you under this Contract or Sale;or you may,if you wish,comply with the I Contract or Sale;or you may,if you wish,comply with the instructions of the Seller regarding the return shipment of instructions of the Seller regarding the return shipment of the goods at the Sellers expense and risk.If you do make 1 the goods at the Sellers expense and risk.If you do make the goods available to the Seller and the Seller does not the goods available to the Seller and the Seller does not pick them up within 20 days of the date of your Notice I pick them up within 20 days of the date of our Notice of Cancellation,you may retain or dispose of the goods I of Cancellation,you may retain or dispose of the goods without any further obligation. If you fail to make the I without any further obligation. If you fail to make the goods available to the Seller,or if you agree to return the 1 goods available to the_Sefler,or if you agree to return the goods to the Seller and fail to do so,then you remain liable I goods to the Seller and fail to do so,then you remain liable for performance of all obligations under the Contract. for performance of all obligations under the Contract. To cancel this transaction, mail or deliver a signed and I To cancel this transaction, mail or deliver a signed and dated copy of this cancellation notice or any other written dated copy of this cancellation notice or any other written notice, or send a telegram to Renewal by Andersen notice, or send a telegram to Renewal by Andersen of Greater Massachusetts and New Hampshire, 104 1 of Greater Massachusetts and New Hampshire, 104 Otis Street,Northborough,MA 01532,NOT LATER THAN I Otis Street,Northborough,MA 01532, NOT LATER THAN MIDNIGHT OF - - —.(Date) MIDNIGHT OF 17-Al-07 .(Date) I HEREBY CANCEL THIS TRANSACTION. X I HEREBY CANCEL THIS TRANSACTION. I Consumers signature Date 1 Consumer's Signature Date RbA Copy- White Customer Copy-Yellow Customer Copy-Pink RteRenewal ;.. RENEWAL BY ANDERSEN MA License#149601(expires l/24/10) n ewal. p�0 MASSACHUSETTS E C ! T iCLTn AND A 1 �r C Federal Tax ID# 83-0404201 WINDOW REPLACEMENT ..Anda C,m y OF UREATER/V1/15JAl.HUJLI IS A1Y✓NEW lla`y1Vlt"`)H11W 104 Otis Street*Northborough,Massachusetts 01532 Phone 508.919.0900*Fax 508.919.0903 SPECIFICATION SHEET Buyer(s)Name Date of Agreement '?2 -o 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. ctor will Install a total of windows in Owner's home,using the following individual quantities: 9a ouble Hung(DB) [�-I?ual sash ❑ Cottage sash(1/3 top,2/3 bottom) ❑ Oriel sash(2/3 top.1/3 bottom) Casement(CW) ❑ Hinge right ❑ Hinge left(as viewed from exterior): ❑ Standard handle ❑ Metro handle Double Casement(CDW) [L}Standard handle ❑ Metro handle — Wdpp :::p 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(FW) Bay or Bow Window Patio Doors(see separate Door Specification Sheet) 2. g 'Yes ❑ No Qty of Windows to be Custom Fit Replacement: 3. D es ❑ No Qty of Sills to be replaced by Contractor: 4. ❑ Yes 5.. Qty of Windows to be New Construction Full frame(includes new interior&exterior casings) Exterior casings: ❑ Pine ❑ Maintenance-free material ❑ Factory applied 908 Fibrex brickmold 5. Glazing to be: RSP Low-E®SmartSunTm (Tax Credit Eligible) ❑ Other If other,please specify: 6. Exterior color to be: [White ❑ Sand ❑ Canvas ❑ Terratone ❑ Cocoa Bean 7. Interior color to be: ❑L-White ❑ Sand E] Canvas ❑Terratone ❑ Pine E]Maple ❑ Oak Jg � E Note: Interior color can only be white,wood or same color as exterior. Wood interiors need to finished by Owner. C>008. Hardware: (White ®"Stone [-] Canvas E] Brass � — 5xo 6 ..) ���i LV 9. ❑ Yes [j]' o Install Lifts with Double Hung Windows 10. Screens: windows to have: ❑ Half or [ 411 screens Screens to be: ❑ Fiberglass ❑ Aluminum ❑ TruScene7 GRILLE DETAILS 11.Windows have grilles: Yes ❑ No If yes:iTGrffle Between Glass(GSG)❑ Removable Interior Wood a rw)❑ Full Divided Light(FDL) Qt':_� Qty: Qty_ Qt': Qt': Qt': Qt': SVV_ DH DH DH DH CW/Picture Glider CPW orG Draw grille patterns above *Use additional sheet if needed Owner approved(initials):( ) ADDITIONAL WORK DETAILS 12.❑ Yes P-9-—contractor will remove metal frames of windows. Qty of Units: 13.❑ Yes Q AIa-eontractor will install new paint-ready or stain-ready casings. Interior casing qty of openings: Exterior casings qty of openings: ❑ Pine ❑ Maintenance-free material 14.❑ Yeso 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 aware that Contractor does not do any painting. ( 1 Owner Initials 16.❑ Yes o Contractor will wrap exterior casings with aluminum coil stock of color. 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. No A limited warranty shall be issued to Owner upon completion of the job and payment in full. 19. es ❑ No Rqgdin Permit—Contractor will secure any and all necessary permits. The fee for the permit(s)is not included in the Contract Price and a separate check is required at the time of sale for this fee. 20. Additional job details: 6 0 46fL 'l'ffZU W:fj�ztl YE iS�nrl� 21.elYes ❑ No Owner agrees to be present on the final day of installation for final inspection and to deliver final payment. No final payment shall be demanded until the contract is completed to the satisfaction ofall parties. It is agreed and understood by and between the parties that this Specification Sheet,along with the CUSTOM WINDOW AND DOOR REMODELING AGREEMENT,constitutes the entire understanding between the parties,and there are no verbal understandings changing or modifying any of the terms. This Specification Sheet may not be changed or its terms modified or varied in any way unless such changes are in writing and signed by both the Buyer(s)and Contractor. Buyer(s)hereby acknowledge that Buyer(s)has read this Specification Sheet. Renewal y Anderse 1 of Greater MA and NH Buyer(s) Buyer(s) By: r. S" tare of Product Manager Signature Signature (2u, ,ILI. Pv Print Name of Product Manager Print Name Print Name RbA Copy- White Customer Copy-Yellow The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 ....uqp� www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/tlectricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organizadon/Individual): AoneJai 4 til E rS e_yi Address: /D Y City/State/Zip: bo ra AM3,2- Phone Are'you an employer?Check the appropriate box: Type of project (required): L&I.am a employer with D 4. ❑ I 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 # ? emodeling ship and have no employees These sub-contractors have 8. Demolition working for me in any capacity. workers'comp.insurance." g• ❑Building addition [No workers' comp.insurance 5. ❑ We are a corporation and its 10. Electrical repairs or additions required.] officers have exercised their 3.❑ 1 am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself. [No workers' comp. c. 152,§,1(4),and we have no 12.❑Roof repairs insurance required.]t employees.[No workers' comp,insurance required.] 13.❑Other *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their 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: . J l 114 Ke_o a-P_ JA s fd h c e_ IX Policy#or Self-ins.Lic. 6 Expiration Date: Job Site Address: �g l 1`�{P�`A— — City/State/Zip: R).. 0.11 (Xh J� M�. 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 WORT{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 cc OF un er the pains and penalties.of perjury that the information provided above is true and correct. Signature:- i' Date ! G�o Phone#: 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 Cleric 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: i~ ��'':'• `'"' ✓die•�asnmranulealC�i a�✓�aaauc�uaeua ' Board of Building Regulations and Standards 'Construction SuperviscrLicense., License;i CS •95707 � Birtii�a�e��'r'g/8/1982 •• ' r_ 95707 JE #iration .97812010 Re`s` Ictio[Mzi- OF:i,, BRIAN DENNISO -?fir J 86 CREST CIRCLE WORCESTER,MA 01603"' . Coplmissioner' er I RENEWAL BY ANDERSON BRIAN' .DENN ISON 104.OTIS STREET •NORTHBOROUGH, MA.01532 . DPS-CAI c, som-ovd7-PC8490 _.a. ..... .. - .... .• ✓�ze.'Pomvmaozmea� G��!l,�Ga.1a¢clzudel�i1 _ ,--- Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR 1.»ot Reglstrafiont, 149601 • _ Er�iiral�o:i_=!?3/2010 . ,yp PPiement Card RENEWAL BY A'D•ERO;N' BRIAN DENNIS 'r"r 104 OTIS STREET` cw =%! .�,` NORTHBOROUGH,MA 01532 Administrator A A CORD CT� CATEF LIAMINSUA ®&TE,1d>F»�D�YYYY, 02/17/2009 PRCOUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Joseph McKeone ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE JP McKeone Insurance Agency, Inc: HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O. Box 333 Ann Arbor, MI 48106-0333. INSURERS AFFORDING COVERAGE MAIC# INSURED Renewal by Anderson INSURERA: Hartford Insurance Com an y. J&L Windows, Inc, INSURERS: Hermita e 104 Ot1S SI INSURERC: Northborough, SRA 01532 INSURER 0: I INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR'OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUB.IECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TY0WSR' DL POUCYE.�CTNE POLICYERFIRATION e c POLICY NUMBER LIMITS B GENERALUABILITY NCP 507 404 09/0712008 09107/2009 EACHOCCURREAiCE I S 1,000,000 COMMERCUL GENERAL LIABILITY E TO 11PREiu1SES Ee ctaan� S 100,0 DO CLAIMS MADE ©OCCUR MED EXP(An one Person) S _ 5,000 PERSONAL BADVINJURY S 1,000,000 GENERAL AG=REGAT—e S 2,000,000 GENLAGGREGATE LIMIT APPLIES PER:. PRODUCTS•CONIPIOPAGO S 2.000000 POLICY n PRa7 LOC A A=141084—m LIABILITY 35 MCC XD 6390 10101/2008 10/01/09 COMBINED SINGLE LIMIT aNYALJTO (Enaccidem) 6 . 1,000,000 X ALL OWNED AUTOS BODILY IWURY S SCHEDULED AUTOS (Per Person) HIRED AUTOS SODILYINJURY . S NON-0WNED AUTOS (Per a�dont) PROP"cRTY DAMAGE S {Perttcidenq GARAGE 71UTY AUTO ONLY,EA ACCIDENT Is ANY ALTO OTHER THAN EA ACC S AUTO ONLY: AGG Is EXCESSIUItBRELLA LIABILITY EACH OCCURRENCE ,S OCCUR . Q CLAIMS MADE AGGREGATE y S DEDUCTIBLE S RETE nON A NIORNERSCOMPENSATION AND 35 WEC PP 1444 02/1712009 02/17/2010 wcsTATu- °TH EMPLOYER$'UABILITY ANY PROPRIETOILPARTNE•a!E XECUTNE E.L.EACH ACCIDENT S 500,000 OFFICER411EMSER EXCLUDED?. E.L.DISEASE.EA EMPLOYEE S 500,000 tf yes,IAL desaiflo PROVISIanderONS below DISEASE-POLICY LIMIT S 500,000 SPEC OTHER DESCRIPTION OF OPERAT10k3!LOCATIONS VEHICLES I EXCLUSIONS ADDED BY ENCORSEf,ENT I SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION INSURED COPY DATE THE?=�F.THE ISSUING INSURER WILL ENDEAVOR TO k9ari 90 Days +vR1TT�I NOTICE TO THE CERTIFICATE HOLDER RUME TO THE LEFT,BUT FAILURE TO DO SO SHALL. IL;POSE NO OSUG✓~'oION OR LIABILITY OF ANY KITED UPON THE INSURER,ITS AGE47S OR REPRESENTATIVES. AUTHOR TLS REPRESENTATIVE ACORD 25(2001108) O ACORD CORPORATION 5986 '01 MA •,�:'*/' .� .. ..._ M..s.. ., ',II�J�NItIRMHi. ''�'.• :.�,':n='":+__'�'.'.- ..f•. .,,y.ti.. ..r•ti+;.�«:.•• ..r'. •• t raiF. :herr' ,Dual'.: -k;on' low; • 'j�Iti Y+'c� bouble Rung .;�:..- .•••1 .:r w,,, . EX ' U. 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( U•Factor(U_S)/I-P Solar Heat Gain Coefficient 09..33 0 s ' ADDITIONaI PERFORMANCE' RATINGS. :. Vis'ibl''li"nSmitl'ance' A 9 14ft4hd(U4r Itlp*tn+l 631 hlkgs eontorm b tppHwbl�MFA pionlu(a=r,15; ARM U�c produol pirlolm�nu,Nac p1(qi it$eelhminre for a food III,it whonm ipeeilleptod'ucltin.Contullmieu(Ieluier'141(p(w0lOoKrp*o fpoofo 6esigri Prtassure(PSi7 F. 1 • � C R3.O 1• �Ir.»egrrtl.q ti/.eeellra-•O� rMYl�l .. .. , � .rL.HL�./1 LtH.7P1rrn t� d�gJ1t1.11..1r111�1.. TIOW T. mails w uuedt M.60••440,4 I,(;p.G_AIrtM111ieboe Mequiri4ieDt1 woMl Higma►K GeRitfeillan►1►OtvP r o r re al. N.FRC BY ANDERSEN, Wood/Vinyl Composite Frame PfatifoaalFei2s7atin Dual Argon. 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