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HomeMy WebLinkAboutBuilding Permit #132-2017 - 759 GREAT POND ROAD 8/10/2016 4q4ad BUILDING PERMIT o�No DTH � TOWN OF NORTH ANDOVER 3� yy,,,` _'a°46 0 APPLICATION FOR PLAN EXAMINATION Permit No#: — �d .f 1 Date Received �0 7 lrED nea �5 � H Date Issued: �SAC US�� IMP RTANT: Applicant must complete all items on this page LOCATION re.J Pa o l �r7��h ulrlo err/V`A(?I $ys cc Print PROPERTY OWNER Print 100 Year Structure yes no MAP PARCEL _ZONING DISTRICT: (R14 Historic District yes no [61 " I Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building VOne family ❑ Addition ❑ Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial �0 Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other Septic ❑1Nell ! ❑ Floodplain ❑Wetlands. ❑ WatershedDistnctµ , ❑Water/SewerSC - DERIPTION OF WORK TO BE PERFORMED: Reo6 o w tjoos- rucaurc, ( l -t Identification- Please Type or Print Clearly OWNER: Name: Z�r yb S f Phone .e Address: -759 o j �� Andoo-,er, A41- 61�- �S Contractor Name: �G,.t w �Iortv) Phone: vc�-3�1 oZc�I L4Email: _ Address: ry /14,J 015-3 -z— Supervisor's Construction License: Exp. Date: Home Improvement License: t,70 SS16 Exp. Date: Z 2 3- 1"7 F ARCHITECT/ENGINEER Phone: , ' Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BED ON$925.00 PER S.F. Total Project Cost: $ 00 FEE: $ �� Check No.: ��� 0 Receipt No.: �J l� NOTE: Persons contracting with unregistered contractors do not have acces uaranty fund ture of - nee: ig i Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ `lmmmg.Pools Well ❑ Tobacco Sales ❑ Food Packaging/Sales D Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF e U FORM PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS CONSERVATION Reviewed on Siqnature COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes I �?lanning Board Decision: Comments Conservation Decision: Comments Nater& Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE' DEP�RT�MIENT Temp Dumpster on�site )yes�=.. .��� � . L a'ed a1�24 Main Str etF' Fire' Depament" signature/dates = - - " �.��yrt r Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Metter 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 fl' NOTES and DATA— (For department use) I i y i ® Notified for pickup Call Email Date Time Contact Name Doe.Building Permit Revised 2014 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 ®TE: 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/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) i6 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 2012 I ECC Energy code Engineering Affidavits for Engineered products OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg. Permit l 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 7 J)l No. �i r.!�`V Date ibluw j r • - TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $3S2- Foundation 3S2Foundation Permit Fee Other Permit Fee TOTAL $ i - - Check# -76 3071 9 Building Inspector/ r NORT1{ q Town of 2 6 ndover O - to Ao �^�, h ver, Mass, )61 1. C CIC Nlc N@wlcK ��• /.PS S U BOARD OF HEALTH Food/Kitchen PERMIT T LD 0.—j) LSeptic System THIS CERTIFIES THAT .......... .�. .ke.e.k ... BUILDING INSPECTOR ..... .... ... ........... ......... .. ..... ........... IFoundation has permission to erect ... buildings on .� .. f� . Rough to be occupied as ............ ........ �.� ,1rK .. �.!4l ................................... Chimney provided that the person accepting this per rfiit 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 CONST TIO R S Rough Service ... ... ... ... ...... ............ Final B NG IN PECTOR 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. RMIeWall, Agreement Document and! Payment Terms- tyArdem.en dEw Remr-wA bT•Alifirmll Of FlrNIV® 11 .Shcsip�n tow.1 rte:FswwpI be!<rsk stir_ x-53 brew Pond FA 1 1 i Y I ,ftd0,W lA 0 i W: Ff43w. 51-?7COIFBA:MORE-TOR I� roGRCr<1�E�4 Ef3llfiJ?5 1 i75�#("nIU f Jtl C mAet ,;i Nair& jorsh;Shheah,an Coikceaer Date DIVI'1,r I CvAia mtu,(.r)�'uut Ad 759 Grmat Pond IRdI Nom Andover, M.01 piisist#apelcilrusa�l•iat:rlt � `i 11 '11iartll;II�liara E4'iittlt 8?� r I t dai1 Fe'd E drb r3 6I� a . vrixhwj,Rad balwij)hereby yr-i.nr_l;)• Ryvwrs idA pia-mch rtry p.rrAucts arad'ior semim er"ReDmial by Andemen LLC&Wa Rein wa[1 by 1iawreF to l�•L ta,�ar`d 7r3�s�2��aic� , iih �t�til ids tir�5: E tius;iii a34,n idtofts aa�"IneJ�ici:6�i.i .fS Cuht t.C tt�,�t7c�ltEiFi® 9oi� 'I.% iR rt `C`r�trn �`+micx OF 01m xi mom.fimmi=_ ,v Cliraf rr ii eipss ext a nr; Sq_ks C rE s rens sE ��+n J? S'Am.,,T�'-pd-S. atm SFr Buil r w3 ma,y*n,=dozw tararcaf-he to ahk AeMment Mimmm the wa is 4w luch aur X11 c��.Ltiyrfx.F ac ie jad. cryo ratted hencin by ref.�s:awm u11reL �#��.h" 'i"i en�'�_P�u�ear��� h� u;a�xi�n a�rari��er iii nc�.�Etev 4.Qe�trat�a� C.DZ �l..ai1 x�ak stmsfrx ibis rirretent.. a� i��e� :° isieruitii: i S E� nu.a rLnen4 ;4��_' 3+ � ' "�[E�+t tl�r Tiq &lZ'S>;`j�[Ah_itr api AnnDuA(+, iFn amm? i Sewall. Itemized Order IRjecie�_pt. I emen 1.ew-1 Fri Re7Wval bw Arrkrsen ttIC ,3 Grew:Nnd A.d 1708io 0indri5 MA"a1;,14E ■a• " �taa rib ?FO ' i'i�irthl7r3r4a�h,.F 4{Nq . 2 [ 'a X66 1 i 1�r i °%': ;.1-22W1F1 5 t Wk-TO P,2 1,Fbf'z cr.ancvffair134soatk r,r_0ITa,cam jam mm Rou.m. Held Mise "Add New, bdra w fid' taundre npdcw.-' Double-flung. Esqual, Full-Frame, Traditiomal hCL rail. E TEflr R ►f ..1> 7ER R Llfhitl?alas','�aS1'4.Al l; High Performance SmartSun Glass, No Pattwn, RardW31ra. While, $erog. Fil rc i gg., ��;11 Sere M. e� l 3IIF.Grille$ Bette-Glass(GBGI. GAile Patterm Sash 1: Marlified Prairie, Sash 2: Modified Nairie. IFtJJJis<c rJon 102 Office Wfrrdaw:: Double-Hung. Equal, Slops Sill Inserts Traditional VieGic.rail, EXTERIOR Whii%ie, INTERIOR Whitt,Olrsv- 5a5h SII;. aligh Rerfonmance SariasiSrrrs Glass, No Pattern, Kairrdwaarel Il . arc".' Filserglas, , Full Screjo, Gf��i'* 'St,�St11w arltle5 Begg E lass(GBGI. Grille Paverm Sash 4: 1ADdified Prairie„ Sash 2: Modified Prairie; Misc Mn VR-Wow. D-:?utile-.*wV: Equal, Slope Sill Insert;,TradilJonal (:hechrail, EXTERIOR'± e , ItIrT'FRtQR White, 04tig-_ 5�Sh All; High Perlorwriancet SrrrartSim Mass, No Patrer%'Klwxdvv•are. While, Fee-n, Flbeifa Fvl1 5rx", a, G,rj1:[* 5.tyjv 15rllies Betti een Glass(GBG}e Grills-Pattern: Sash 't: t4ladified Prairie, Sash : Modified ftaww. Mise t'tcn 104 Mice `k _ridavc, Double-thin. Equal., Slope Sill Insert,Traditional d.he(k.rall, ErtY RIOR'4OiLe, INTERIOR White, GIS Usti All: High Performance Smar:Srsn G.la.ss, No Pattern. flwdwarao While; 51cratm Fibeiglax5. FulI 5rr'W.,15,H]It 5"W:rrillec, Betwe�m Glass(GBG).Grille Patterm Sash is l aillilied Prairie,.. Sash .2: Modified Pirairiie. MIsc: r n ReneWal Itemized Order Reei Ci 'IPpt T 'byAn,demen n.:•—iaaXacmom r W,Rf Us 9oad 1 Wurr.h ttw. ugh,NIA,0 Sm 101 "'ooe:553-r-51-2200 I Faig:15W 96&-Q;2 Me.rrA1r-,c a ni Lmg alms 105 Kitchen YXI nodow,Casement Single., Casement, Left.1-1 Frame, EXTERIUR While, INTEMOR Whitc'. WASf 545111 AU, H 19 h 1%_errwrnance SmartSun'Glass, No Pattern, HaFdmrarre: White, 50ay.,fv Fll�rgtm, I;tjll 5,creen, io Hilt - f- -e Grass tGOG), Grille,Palterm.ash 1: Modified Praise,Sash 2: Modified Prairie, Milav,Man Window.Double-Hung. Equal, Slope Sill ruse t.Traditional Cht(Ar011, EXTERIOR White, INTERIOR White.Of-aw I ah All-, Etigh PedorTnance SmartSun Glass, No Faltem.Ti?mpered Glass, Na.Fd%varet Wh'A)P_ Screen- Fiberglass., Full'Screen, -Grille Style, Grilles Between Glass GBG), Grille ftnern- Sash is Modified Pra&ie.Sash 2: Modified Frairie, misc- Non Kitc4en W.—indow. Picture,Fuff-ftam, 1XIEF111011 Whiff,,WTERIOR VOhite, Glass. Sas4 AD:High Peilormance STrwill5un Glass, No P4tte.rn, iarlflo styte-OWfrs 11etw"..a %Ia5s, 60111M Poterm Sash 1,; kloddied Prairie, Sash 2 Modified Prairie, Misc, Non 1 Q61--en Wlndow-CTaserrvent- SEni gk-., Casement Lef-48ase-Frarrke, I EXTERIOR White, IWEWOR'%Ohite, GLOSS,- Sash All;High Perf ocniFince 5marlSva 5-Lgs. No PMIef n, F# me'�Vhlte. Sixeerv, TruScene vAlh tweriGr Color Match,GAIle Style, Grilles Bet-ween Glaiss (GBG), G 61IN PAttern.,Sash 1, Modified Prairie, Sash 2: Modified Pralne, Mist: Non Rikille Wall. Itemized Order Re�e"P NA Mderssen dbu icmv---albT Wmfimmof I ortwostmcftiwn ° teaot RrAw.8190Ya I b W,41nCki-An LK 759 weat Porid Its 170910 WiltiApdaver,MA.01 drVz cox M. 'LILCM nc 3'Vis'R;[Ed l'wkshbrar€Ugh,f .f P : E UVa 56-1'10 P 11I DIN Window. Dryuhle-114un% Equat Slope Sill Inse ,Traditional Cbe.Ck rail, EXTERIOR Mite, INTERIOf;White, 1514V°$ajh All, Nigh Peribrmance Smart'an Glass, No Patteraq, 'Hudware: While, mere' Fibefgla%s €UII 5(10,ea, 15AI :l'e Style �5rllles Between Glass(GBG). Grille,frattrerm Sash 1: fAodfif:ied Prairie,. Sash .2: Modified P€airie, Mise- Non !LlltleWi ndow; Douh le-Hwvg, Equal, Slope Sill Inswi>Traditional Check rail, CXTER[OR White,I?ITER*R trNtc-6 ellbSC.Ush All: High Performance Smam%n,Glass, No Patlem,KaMware, Nhigk, 5vte : Flic1 , Full Ser, t3;r 'lle 5ile; Rllles Between Glass tGRG-L Grille Pattern: Sash I.: C dified Prairie, Sash 1- Modified Pralrig, Milsv Non 2011 Bedl WIr+d+aw. Dj2uhle-Hwi , Equal, Slave Sill Insert.Traditional C;heckrail, UXTERIOR White,IWERFf, R White,, 0. 1mv, 540h All: High Performance 5rror`.Sun Mass, No Patter,,Illard. ware. VV 01e, Rree -, hbefglam, FulI Scwa, Grille Si as.Gillies Bt,tyween-Glass(GBG). Grille Pattern., Sash 1:: thadified (prairie, Sash 2: Modified Prairie.fAlsc: Non 2 !Beal WJndvwr Double-Hung. Equal, Slade Sill insefL,Traditional C.heckrail, EXTERIOR Whine.KFEWR White. Sa5h All: High Peribrmance Srnay%Sun Glass.. No Patt'erna'KaYx ware, 4tUlM1i4k, cr eel; Fi erc l' ,Full SC + # , Gnllle -yfe,irliles Between Glass(GBS;). Grille Pattern: 53s4 9: Uodified Prairie, Sash 2: Modified l0vasrte. Misr- tson QV I'll IS pa'De 6 if 'I S Rene l Itemized zed Order Re e' p T dbw�•"la. Amdtma of lies to ass ::rr al he f'rKwsenuc �9 Great mriri Pd `. 1170910 0910 ! ��a�r,a lei A 13'�hr Ea I 3D Fvbn"Zad i'hk11tltbi:roiigh,.4%01562 �3w9 2aC�G+I f%_ &5Q4QZ2I's L��p514114. +idflC r° �i Sftrtf_`�IF�gam 2133 8ed2 Wlndvw:r Double Hung. equal, Slope Sill In ext:.,Traditional C4htCkrail, JXTERIQR Whitt, INTE'i�tghA'14Nte. GIB SVUSh til; : i}h Perfurmance Smar Sun Glass., No Pattern,14w9ware: Vdhile, Crtieni: Fibc4glaes5y Full 1�$�."4�i5 ,kill St!¢tlt:;Grille Between Mass(GBG).Grille,Pattern; Sash 4: Modified Prairie, Sash 2: Modified Prairiie. Mist!Nan ,204 ':Bed2 Wfndow,. Double-Hung. equal, Slope Sill Insert, Traditional Che('kfail. 1)(TERIOR W%te, ItITERIOR VVhite', Gjapi;tUsh .ill; Nigh Performance SmanStm Glass., No Pattern,?Hardwaree Mile, UVIOM: FIRM 914%. Grill 5(jfet4l. GAIle Grilles Setween Glass{GRGX Grille PatternT Sash 1: hlDffified Prairie, Sash 2': Modified Ftra'ifi . Misc: Pfn Z05 !Bath WJridevir: Double-Hung, Equal. Slope Sill Nnsert,Ttaditionai Chec*rail, EXTERICIR While, INTERIOR'Nhiie. Us-a-,Sash All- High Performance Srnar6un Glass, No FatCem,Tempered Glass, Fla dware.White. 'Seen! Fiberglass„ Ftdl Screen, Grille Styles Grilles Between Glass�GRG), Ga lle!E5a'it xn; Sash 1: Modif led PraC .'Sash Modified Praiai,e. Misc. Nan nd+aw- [rouble-Hung. Equal, Slope Sill Insert, Traditional Cbmtkraiil, EXTERIOR.While, INTERIOR Wh4e, Ghtsv Sa All: High F'erformbrxe Sc aaSr rn Glass, mo Ft31�r�s:;ttr��lr�ir,e:c: White, Screena Fibe4ass. Full Screen, Grille Sees Grilles RiAweet 431355i'GOG). Grillo-IF�a rr; Sash T R edified Prairie, Sash 2: Modified Faure, Miss rfn tl�'ta rx tax padre�t 't:� eWal ItemizedOrder eceipt LOW lrm :FWK- l bw,6r#Jffw LK P,913ret Pond NA 1708.10 Fie krk1ave3.ala,0 rrI S -I IMT Lm axyLacamunr 3tr:Fvdxis Swd I wiftm gh,N%015.32 fa'L M [s 1'I v 20.7 fi4er M.n+dowr. Double--lung, Equal, Slope Sill Insert,TraditinDal Qht.CPfoil, UgERIQIR White, IPZT'EF'IQR White, �_-�elfssi;— a All: High Peri'unnance Smar`kSan Glass No PattE n E�ar�daraare� whiie, ite r; Fibef9141, , Full Y �, Qri1.le 5t 1 Ori11eS Between glass{GB(3- ,Grille Pattern: Sash 1: Ntodif edf Prairie, Sash 2: Modified Ptairie. fd sc. r4an ill" ter WJ re ow Drvuhle-(dung, Equal, SlopE Silt lnsert,.Traditional ChipcPrail. JXTERFOR Bite.IHTERRW hi.te,: qlm :Sri a All; High Performance SmanSun Glass, No PatW% HwAware, MO, Urce ,: Fibeig1a:m, FulI SU'4+:+rr, 15ARt. Styl L-':f-oilleS Between,G lass(G86 , Grille-Pattern; Sash 1: WjOffifiea Prairie, Sash 2: Modified Prairie. Mist Pin 209, Nursery Wlndo-w: Double-Hung. Equal, SIovE Sill Inser6;,Traditional Cheekr$Il, UgERIOA V itt, W'i-ER R White, lzsv 5006 All: Nigh Performance Sman.'Ssrn Glass., No Pattern„ Karelwarm. Between Mass tGBG). Grille Pattern: lash 1: IAodifiedl Prairie, Sash 1Modified P'rai+ie, FA1!-c. Mn .29II0 N ur-sery Wffindom Double-Hung. Equal, Slope Sill Insei Traditional Q• e(kfall. iLgER[Oft Mkke,, IHTERFUR White. --1 :' Sath All; Nigh Performance Sm.-MSun,Glass, No Pat'Efk:Harillware- Xfixksi9 , ec o. [r115t,ra�f t, Full Scyton., i5,Ig'Ilt Styllea t tle$ Bmweep Glass(GBG), Grille Pamm; Sash I.: h4Ddifie+d Prairie, Sash 1: Modified Praire, follsc. rftn QUI 00 T. 'Paye �a Remi I! Itemized__ rde r Receipt t g 7iewmal by xjrklmsm.[PC bg,area,Mnd hi 170810 tr,AnrlMr.Nit;Oiiia aRcn�e ni ��.,rr .NSGwusFksad9'NoTthhm'tigh fmgW.? Ian 14'•4r as 9 e�G�J i= 4;I1 a ?� FyD510!11P�!Ef�ciirit54l ". &!mt'�R�€Ct!T1 jam mm .211 BLAS WW Mom. Double-hung; Equal, Slope Sill tnsea,.Traditional CheCkfo)i1, EeNTERIOR Mite,INTEP D9 White+,6Ig ° W#h Al I: Higrhi Perfunman.ce Smardun Glass, No Pattefri, KmAi rare; 'Rimm, Urmen,: Flbefglaz, Fu11 Scirtim, i5rillle 5ty1g� O illes Between-G lass(GBG.). Grille,Pattern; Sash, I: Modified Paairie, Sash L Modified Prairie. Mise, %n ,212 !Bed3 Wrtdowe Duuhle-Hurq, equal, :Slope.Sill lmseat� Traditional Chet-k►.sil, ErtTfFliOR While, IFITERIOR Wh Itea WaSS Sa5h Al I; High Pericorrnance 5mmkSun Glass, No Pattern, Kardware. mile, Rmaii;' Fibeeg.la%, FwlI Steed. 15 .lt. Sty.f c. odlll(n Between Glass i GOGL Grille Patterm Sash. I: t4cidified F`rairie,. Sash 2: h+lodified Prabie. Ism mn WINDOWS:22 PATIO,COORS.10 SPE O''a"�0 IMISt=:`f TOT61 UPDATED: 0611106 by:. t•em!pl�dje,:aL*h ,t,-mIra and b-aJ safir by the E 4. Renewal -- - Renewal - Andersen Corporation 3��aT]C�. #re 6.1532 R�1a�mIe nderse : PhrneS3S 12_ 0- (508't Fax 92;6.'707n 1 T�(tSa�7rim:a 4kit r`47=rerlr:lt en1 PAlmeiWnv—,mm'0 Jl to tllc CL!1'''T 0M%NL1iND0W Mi.v 0R RU�A W1;1,UNG t).'C; Ul UNI JX�4i C 0 ikg 1w m tv,n 47)1by aFjcI IscLWth W-mewal[*y Amek-Mem + pcteluf�rFn.rttikiAt.c la f lnsiat d•'ilral r "Ed. 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'no In•terl r, casIngs ou Il eeaiera;alntl.lttunrdrk +slrralnm, to naw be pre-printed white.Talk thetino,windo5aNIn the d(riin ,airmgout 6f conf il-et. ililn4:re,:rirre no other ebinigm:to original co.n- tract: ctiivl c xSator thev F 3^ �5� :7d cylpl d 11�,L rib l �n Wm 1 ( tl c �4 ;i t triraai'' tire also cl ta.in l:t (it If yr e 3 a nc�cEr guga.. fkn ite�r� wilt Imo* 1�� 131itrhl. or NEWToWilldbAmmil., $33,496P100 Pay. Nm rlv 11;Rtwtiwed:$C I X 1.00 d,:rt r1'S17 F:ina.t e Nk-m"r lLwircv at Sarin of ju !$1 ,2841,Oti Or i-Sk-;Facim e. It b gpftd and a nkrid o byr sand .Ow Wks 1tc Mh AmeAdnwnt md,-kit a dSLml AS.maw.nt onwitute Lha rtTdm a ndenfanding bc- tween lam.mW1*=am no Irl th_�mr trli�l,�r 'i71 t�l0# 'C(' iFn; r , p 1 Eh y an i' CAS - .- "- - - ill�.t'�p�a°���hits a'[rsd t'Ilis�iirrsrndrrltzrnk�d 1!�3erea4� 1 �1t�1cr3 uund.dried E �A! _.p /�d�iN d�MCEw��®lCaLt aprl;, � C"w' dn IfolSiMA'; f1�i�wal,l�, ai� fair ;13tt �m�� t r' . tele 5sfir#r: �rr�aaflrEr+Favw7Laea3 tn,tCO 9it.aDa '�aiiun_ kiea~lnesn 31A3V r1dl;d2t`'1A, Ptlati,Mum c4 C'9'CZdu t NUmapper Wile by WINDOW' REPLACEMENT An Mdetaenf;nlnpanp a t pi rg g WoodMnyl Composite IF Dual Argon Low E4 StnartSun > Double Hung 100-00473518-010 -E HERGY PERFOR KE WHIGS U-Factor(U.S)/!_p Solar Heat Gain Coefficient 'y AODtrto uAL PERFORMAR E RVINGS Visible Transmittance MenuLeturarplputetq tAal SAeee miAp aeMerm IeappioaA19 NFPC preeaderee for deernninigwlpN pladum pedemlaace.NFPC MOVO of daterre6�ee(era t9rad set o1 enVironmeMel eondeieaa and a specx product ake. NffiC does not reeoelmepd airy PeodYot and doer net NafPrd-!uAlDVtV*f auy pMdaet for wWapecilic use. ceneott mtntufaatonh fiteratun!er ether pmdocf perhrmanes fetorymtiee. WWWAmeig This pfedactmlete6nen t" 6safs eeYlfgltMMlll *Ij etfioeneK Aeavit mefairBythe haele and 0.0 43 males(Putegfn8.and ,1� �. .•.. •' ' Cene4mef e4ugt6roel �``r' 'r -- �b nmui& as i' ;1 ' a, "ZZ d3"w.�n..vwwNww DESIGN PRESSURE(PSF) ka r° t�1d91.lA90do �l A1tmN�A9mdntpt , Rb- DB Sloped Sill pH IN TetlBGfoI1MSQ2erAlJ�fArVNMIvNSA10lA&ArIbLS Ma7AiC11a's oe oolrMtlaloeb tlls! Bm1110af9110Wde. HeeM or MGGOeM M.E.C.,C.E.C.BLEC.C.AY lallillratigt regeirementa WCMA MallmtkCertiL.scion Program. ' t Do nd remora m M Ind coda laeped0an- San li6al tgun iakre a h slam I i Rfriewal byAn&rsm I • .uu,aN ev�.nser ,.a,rv.o.�n. AND 4-102 t Duelwo "An Camp. Lava-E4 ! Produ Type: Cm ment ENEPOY PEAFOAMANOE WNCS U-Fwtor Pacer:Pied Gwn ccom fent 0'.29, 1.655 0.28 . (U-8 ADOMMAL fEAPOM"CE nATrNGs VWlbla TrammittHn08' � . . ._ � • '• 0.48 � • • • " bMc�foPfat��Pl�11lOMF�.M lIR:}srlbpr�011dpw�Y�C s 1i►pQallstl�Irp R��lf1MM1l�7�iCd�t��7�s1�T1�.�. tl r • 1 1, v: _ wsamRA+rvFXWPJMteuaaWao DP par DM rrarwrr - �....w admrmp.�. 1 4 r • ! 10 $l�! V fCf� fuel ite � •en1«rtt.� >L•i9^.+IerpA:tsw7 �n+astP� h r. &,YItvvood�r..o�,,N T hr ' f ��i on`aw"nisi Product Type; Piclvra binaeiun UNMR Yr PWRFt0MdANCV aa7tntcys U-fi�ctor U014r Hest Gain Coefftclent Liz. iz e}�� I1.5 -P gm I ;2 ADDITIONAL Pwlw0f &-Wcrm ft^-n c—g YsEbfe Tra+�smnlan°�a "°"—� 'I FRO mom "'r.r.m.n.�uey+�.>Atte rr.ew r�mm � m r.�pxre�rn��enforec..pws y�uwtatl° ', t"•"" !°0q^A1��YProdYc411m16ns rt[xw�ae�W aneee�r. gat>w+t,•,l..elcsw.r:..rs,,.r,aaurylw,.,,aard��:,t�lrwlc''t�"rapt wos�tmr>�ly�m Irra. rlrrntw.au 'L trdopr w,�m��nu�n�on,ursa,n.�,saw;.u.as � t)Ppsr F-e�a V• ar i 'r,�*,�'�O� MfOtl1,q�,R mete a mnufat ' Q 7D0-0f151 BOOB-001 ,strna..wmmcae reirvsar,errsvk t f I I The Comwnivealth of Mawachmats Depa:fl"Itt of lid- h1w.feddelef M. r -affu�e of lin-estigatiotir it'll!4*n1ng'Wn:greet Boston,M 02111 wsm.maitgoit1dia Worktrs' wompens0urns fasurafce Af lda-,it; t uRdt.-s/Cu>st:arta,-sl' :'ectr c?ansfi tu.a e s ri►��`i1 11-`. 'n iurnt$t;art Megat.Print Lapd., nt.am4e RENEWAL BY ANDERSEN AdiresS' 30 FORGES ROAD Gty/State,`T.ip';NORTHBORO,MA 01532 — photte ij.: 508-351-2200 Are you an employer?C teck the appropriate bo,: - �'iw of project 4"uiredj. 1.'Vl am a atnployar with 30 �4. 13 1 am a general vntractor and I employees(fu;l and;'or past time:)" nave hired the ttb-contrawors f'' d i�ew deli ruc4iort ' 10 1 am a sole proprietor or partner- i stud ern the attached sheet Remodeling ng ship acid have ne,employat,s l)t.eft sub-eerttwtors have S. 0 I)emolititm working. for me.in any tmwity. workeW comp-insuranLv. 4, Building addition (No worker`s'4omp.it wmnce 5, 0 'We are a corporation and it: y required.] officerx have cxzat s-d their 10.10. Ele trlcai repairs or additions I.am a hunteowner doing all v:ork riggt of exe'niption pet,MG1. 11: Plumbing repairs or additions tuyself:1 No workers"comp,, c.. 152,i 10),and wt have mi 12,�Roof repairs insurance requ"- .1`t employees..[.Vo aorkars' i comp.insmancemquire3 1� 3 - __-.____ *ARF".tp�+;Mi that OrtA',bcx:� must 4t1k;till ottt tit w. titn W.tier�a;ng ties a►vr�:?s at�;d Sdti:i:t^ s. 1 t 1�4To 'tit� - w�::btnit th it.affiugrtt rAdicBttaE:N-1,vdoing si!uort 4nu d"'Mit must iuhtntt amu-affidavit tthtii;attug u:h � .:wtU�tnrs t�citec4;thK Ik7:a rtuabi t+dtar.t `au� r'" a aJd,ta era, rrw��W.te. e a W.nmi�nt tr.c.nub-titer ra�7ns.and riser worker:'a,0>Ti�t.pntiry rnfamxtan lam an eaplover tkar is prvvidiag worters'rotay pr wdon imurenee Jor n r emplo3'ew& helot,is ahe pWicy awd jub she .4#Ormadon: lnsurance Cotnt»y tiarre: OLD REPUBLIC INS. CO. l'ulir .or'Seli-ins. Li,:. :- .!v�y�ir Q,54�IQ0. _ . 1?xpiraton Vete; 10-0116 Job SiteAddcess% 759 GREAT POND ROAD --� ci istawzi NORTH_ANDOVER,MA 01845 Attach a copy of the workers'compensation policy deciarntaton page(shoving the pot e}'number and elpiration+dare). .Failure to secure coverage as:equirxA. -un de- Section 2 5 A of NMGL cl 1511 can lead to the knposition of criminal p��tta a ,;n afine up to$1,500.00 andior one-year.imprisonment,as well as Ov�il peuait;r in thz fu.�tn��f a STt)1'Vkt�R[�r,aRDERarx1 a fitta a of up to"59.00 a day against the violator. He advisee that a copy of this statetnelit mavn be fiardad to the Office of Inv"A ations,of the IMA for insurance coverage vefificarion. E I dd hereb eeW rt r the pains andpenaWrs df perlurj,,that the inj?►r,.Md t provided crbvta A'~and eorrett Phone a:__ 1-2200 t#icial uve oidy. Do not write ht floe area,to be rvrarlrlrted by r; or town iii a let City or Town: PeriaMLiceuse� Issuing Authority(elicit one): 77 I.Board of Health Z.Building Department 3.Cit)!Town Clerk 4.Electrical Inspector.5.Plumbing hmpector 6.Other m:o ntaet Person; 11hooe M ANDECOR-01 YADAVYO f'i�tlA® DATE(MMIDDNWY) CERTIFICATE OF LIABILITY INSURANCE 1 10!1!2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the , certificate holder in lieu of such endorsement(s). s. PRODUCER CONTACT NAME: Willis tierbf{Cate Cient@r Willis of Minnesota,Inc. PHONEFAX c/o 26 Century Blvd INC,No.E .(877 945_7378 Arc Nol:(888)467-2378 P.O.Box 305191 ADM ISS;Certificates willis.com Nashville,TN 37230-5191 INSURER(S)AFFORDING COVERAGE NAIC$ IN3URERA:01d Republic Insurance Company 24147 INSURED INSURER B: Renewal by Andersen LLC INSURERC: 30 Forbes Road INSURERD: 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 CER11FICATE 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. INSR ADOLSUBR TYPE OF INSURANCE POLICY EFF POLIC EXP LTR INSD WVD POLICYNUMBER MMIDDIYYYY MM/DD/YYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 11000,00 CLAIMS-MADE T OCCUR MW,ZY 305440 10/01/2015 10/01/2016 PREMISES(Ea occurre-RTEDAce $ 500,000 MED EXP(Any one person) $ 10,00 PERSONAL&ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ ..4,000,000 X POLICY E]PRO ❑LOC PRODUCTS-COMP/OP AGG $ 4,000,00 PRO- OTHER: AUTOMOBILE LIABILITYCOMBINED SINGLE LIMIT $ 51000,000 _ a accident) A X ANY AUTO MWTB305438 10/01/2015 10/01/2016 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ NON-OAUTOS PROPERTY DAMAG $ HIRED AUTOS Per accident $ UMBRELLAI.IABOCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAfMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION _ AND EMPLOYERS'LIABILITY YIN X STATUTE ERH A ANY PROPRIETORIPARTNERIEXECUTIVE MWC30543700 10/01/2015 1010112016 E.L.EACH ACCIDENT $ 1,000,0 I OFFICER/MEMBER EXCLUDED? N NIA 3 (Mandatory d ory In NH) be and E,L.DISEASE-EA EMPLOYE $ 11000,00 I If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 110001000 i DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) rrr 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 J- �'✓� ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD Ma.;t huuette-Department of Pubke safety Soard of Ekdlding Regutationa and Standards Construrtton Supen-hor - :.teena� Vw ,r Expiratloa Ca€i�sa3on�.a 1Q/�11l�fi cTle T".-I xo1a.Pad 111/(c-�aeaaa�uJe a ice of Consumer Affairs&Business Regulation ME IMPROVEMENT CONTRACTOR Registration;:. xt0 Type. Explratiq _ Supplement Gard RENEWAL BY ANQgR •LtZ. JAIME MORIN 30 FORBES RD •,,=--- NORTHBOROUGH,MA 01532 Undersecretary 1 f i 1. I