Loading...
HomeMy WebLinkAboutBuilding Permit #001-2011 - 80 LACONIA CIRCLE 5/1/2018 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: alyd/� Date Received Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION Y(!1G1 /'r- 0&,( ---- Print PROPERTY OWNER'! � 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, replacem Assessory Bldg Others: Demoli ion Other Septic Well Floodplain Wetlands Watershed District Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: ,D�Ac�.r �/ C,cJ c`�•,yoc,.1S NO � Identification, Please Type or Print Clearly) OWNER: Name: �_ �r�.kr i n!-2) Phone: ��—(QSS Address:--s, ( `Cv 1 i cAJ CONTRACTOR Name: 10c t,iv`1 Phone: Address: Ti (0... � }� ,�� �,.}C,�.S C€.�� 'r l Ior-- Supervisor's Construction License: 55770? Exp. Date: !r U Home ImprovementLicense: Nq(,001 Exp. Date: 11,441 & ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BOLDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. / GU Total Project Cost: $ -36�� FEE: $ 6S'0e-> Check No.: ! / 7C�, Receipt No.: �✓�©y� NOTE: Persons contracting with unregistered contractors do not have access to the uaranty fund Signature of Agent/Owner C+n-Cvwrrcf Signature of contractor Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning/Massage/Body Art Swimming Pools Well Tobacco Sales Food Packaging/Sales Private(septic tank,etc. Permanent Dumpster on Site THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM 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/date COMMENTS i 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: Doc.Building Permit Revised 2008 Location 1?0 No. 00/ — 2011 Date 7X,1'11110 NOR,h TOWN OF NORTH ANDOVER + s Certificate of Occupancy $ �'�S'••° '�<� Building/Frame/Frame Permit Fee $ "� S cMusa 9 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # /aV ;7 ` 23G << L Building Inspector NORTH own of _ Andover 13 v T O v.M^Nur y�`:•F..r•_",'.vK•�..:q.. ..... No. DD/-moo/�• -_ _ __ -o dover, Mass., 20 T O t- LAK 2COCMICMEWICK Vt DRATED U BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT.......\ ...��.`.E...����'ate.. t. .................................................................................................... Foundation Gil has permission to erect........................................ buildings on ..:_.�©......................."�!.�.............` . E............................ Rough .... ti - Chimney l � ............ ........rto be occupied as....... ! ... .................................................................................................................. 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 CONSTRUCTION STARTS Rough �� Service ........................................................'.::-:.. .. ... ...... .... ..... .... .......... ... . . BUILDING INSPECTOR Final Occupancy Permit Required to Occupy 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. J&L L WINDOWS,INC.,D/B/A MA Home Improvement Contractor 104 Otis St.,Northborough,MA 01532 J ' p (508)919-0900•Fax:(774)987-3013 Renews' License#149601 (Expires 1/24/2012) A Federal Tax ID#83-0404201 ZAndersen. WINDOW REPLACEMENT an Mde Company CUSTOM WINDOW AND DOOR REMODELING AGREEMENT Buyer(s)Name Date of Agreement Buyerrllsl Street Addres,City,State,and Zip Code OD s.Cbry �t CirV NIJJ �� h�d(/�1i✓ f /"` /1 oil E-Mail Address Home Telephone Number Work Telephone Number fi`rv. kn• s t l �uid GdIM 7 9 &55- 5S `l 6,1?Y3 0916 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. J f Method of Pymnt:O Cash eck ❑Mastercard ❑VISA Total Job Amount: —(+p J Estimated Starting Date: p Discover nanced,App#: 3-31 -ry Deposit Received(33%):. Od Name on Credit Card: Balance at Start of Job(33%' Z f €st mated Completion Date: Credit Card#: Balance on Substantial Jr lv 4,v��GC Q Completion of Job(33%. CC Exp.Date: CC Security Code: 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 Windows c.d/b Renewal by Andersen Buyers) Buyer(s) / l By: V Signature of Product Manager Signature re �I '� Print Name of Product Manager Print Name P n 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. NOTICE OF CANCELLATION 1 NOTICE OF CANCELLATION Date of Transaction 7/ -((2 . You may cancel I Date of Transaction I • 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 1 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, I by the Contractor ("Seller") of your cancellation notice, and any security interest arising out of the transaction will I and any security interest arising out of the transaction will be canceled.If you cancel,you must make available to the I be canceled.If you cancel,you must make available to the Seller at your residence,in substantially as good condition 1 Seller at your residence,in substantially as good condition as when received, any goods delivered to you under as when received,any goods delivered to you under this this Contract or Sale; or you may, if you wish, comply 1 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 ou do make the goods available to the Seller and the I the goods available to the Seller and the Seller does not Mer does not pick them up within 20 days of the date pick them ujp within 20 days of the date of our Notice of your Notice of Cancellation,you may retain or dispose of Cancellation,you m retain or dispose of the goods t ation. If you fail to make the of the goods without an further obligation.If you fail to without an further ob g make the goods available to the Seller, or if you agree I oods available to the Seller,or if you agree to return the to return the goods to the Seller and fail to do so, then goods to the Seller and fail to do so,then you remain liable you remain liable for performance of all obligations under I for to of all obligations under the Contract. the Contract.To cancel this transaction, mail or deliver a I 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 1 notice,or send a telegram to Contractor.J&L Windows, &L Windows,Inc.d/b/a Renewal by Andersen,104 Otis 1 Inc. d/b/a Renewal by Andersen, 104 Otis Street Street, Northborough, MA 01532, BY NOT LATER THAN Northborough,MA 01532,)NOT LATER THAN MIDNIGHT MIDNIGHT OF �%-�- /J .(Date) OF- t'/ . Date 1 HEREBY CANCEL THIS TRANSACTION. I HEREBY CANCEL THIS TRANSACTION. Buyer's Signature Date I Buyer's Signature Date RbA Copy- White Buyer Copy-Yellow Buyer Copy-Pink J&L WINDOwiS INC. D/B/A MA Home Improvement 104 Otis St.,Northborough,MA 01532 J Contractor (508)919-0900•Fax:(774)987-3013Renewal License#149601 (Expires 1/24/2012) .��' Federal Tax ID#83-0404201 byAndersen. WINDOW REPLACEMENT "n AMd C—Wy WINDOW SPECIFICATION SHEEP Buyer(s)Name Date of Agreement The Buyer(s) listed above hereby jointly and severally agree to purchase from J&L Windows,Inc.d/b/a Renewal by Andersen ("Contractor") 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 DEfAIIS 1. Contractor will Install a total of windows in Buyer's home,using the following individual quantities: 'f Double Hung(DB)J'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) 2. J Yes ❑ No Qty of Windows to be Custom Fit Replacement: 3. ❑ Yes Jjj No Qty of Sills to be replaced by Contractor: 4. ❑ Yes &-No 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: R'HP Low-E®SmartSunTM (Tax Crr&EkOle) ❑ Other If other,please specify: 6. Exterior color to be. White ❑ Sand ❑ Canvas ❑ Terratone ❑ Cocoa Bean 7. Interior color to be:.JZ 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 Buyer. 8. Estate Hardware:Style L-0 H�I-L 9. ❑ Yes P§:No Install Lifts with Double Hung Windows 10. Screens: windows to have: E] �Half or ull screens Screens to be:4&fiberglass Aluminum E]TruScene GRILLE DETAILS 11.Windows have grilles:7E3,Y es ❑ No If yes:Er GriIle Between Glass(GBG)❑ Removable Interior Wood ctrl❑ Full Divided Light(roc) Qty: Qty: Qty: Qty: Qty: Qt': Qt': pF1 pFi pH pH CW/Picture Glider CPW or Ll I 1 11 Draw grille patterns above 'Use additional sheet if needed Buyer approved(initials): ADDITIONAL WORK DETAIIS 12.❑ Yes 15JNo Contractor will remove metal frames of windows. Qty of Units: 13.❑ Yes &No Contractor will install new paint-ready or stain-ready casings. Interior casing qty of openings: Exterior casings qty of openings: ❑ Pine ❑ Maintenance-free material 14.❑ Yes �N No Contractor will install new paint-ready or stai eady inside or outside stops qty of openings: Interior stops qty of openings: Exterior st o F1 Pine ❑ Maintenance-free material 15. Buyer is aware that Contractor does not do any pain Bu er Initials 16.❑ Yes 5J-No Contractor will wrap exterior casings alumi in c ' ock of color. Note: Wrapping may be required with storm window removal;removal of storm windows will leave screw holes in casing. 17,o-Ves ❑ 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 Buyer upon completion of the job and payment in full. 19.f�g'Yes ❑ No 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. 20. Additional job details: 21.12J5Yes ❑ No Buyer agrees to be present on the final day of installation for final inspection and to deliver final payment. No final pawnent 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 S cation Sheet. J&L Win c.d/ enewal by Andersen Buyer(s) Bu e ) By: . Signature of Product Manager Signature S Print Name of Product Manager Print Name t Name RbA Copy- White Buyer Copy-Yellow The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Y www mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Annlicant Information' Please Print Legibly Name(Business/Organizadonllndividual): wen eu)G 1 Z V N/1 r�1 erS eY) Address: /DSI 41V S �eeJ_ City/Sfate%Zip: Nf4, bo,-, ,,� �1.���_ Phone#: (��F) Are you an employer?Check the appropriate box: Type of project (required): 1-al am a employer with ti30 4• []'1 am a general contractor and I 6• ❑New construction employees(full and/or part-time).* have hired the sub-contractors listed on the attached sheet x 7• modeling 2.❑ I am a sole proprietor or partner- • ship and have no employees These.sub-contractors have S. Demolition working for me in any capacity. workers' comp.insurance. g• ❑Building addition [No workers'comp.insurance 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 11. Plumbing repairs or additions myself[No workers'comp. c.152,'§.1(4),and we have no 12•0 Roof repairs insurance required.]t employees..[No workers' 13.❑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 a new affidavit indicating such lContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp-policy information• lam an employer that is providing workers'compensation insurance for my employees Below.is the policy and job site information. nn Insurance Company Name: 1 'T" A)(` &-o Li r-d n C e Policy#or Self-ins.Lie.#: �tJ ���� �`�`� _ Expiration Date: Job Site Address: 2nl acs;; vj i P- ,( City/State/Zip: Aj _l'!n boJc�w � v Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c.152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby cer u7- erJthe pains and pen alties•of perjury that the information provided above is true-and true-and correct Simature w, Date: �V Phone# Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: . '�,j!,�n"'..c f.'.5v� �Jle 1lJ6rlYhidltlOEIZLGIL 4�✓l�LQddaC�c'w.."', � ' Board of Buildingltegulations and$tapdords i Constriction•SupervisorLlcansa•t;,,,,, A•,;�,: License CS •95707 i BirthiVafe1:'9l8.11982 p afia as_g 8i?Q10 Tri 95707 ' BRIAN,DENNIS OIC• �_ 1 86 CREST CIRCLE A 01 03""L Foims ion r .ORCESTER"M , •. 72.e...a Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Reg istratiorgg�01 Expira 12 . t Card RENEWAL BY ++ BRIAN DENNIS — J 104 OTIS STREE ,c'.w NORTHBOROUGH YiA. 2 Undersecretary ACORD,. CERTIFICATE OF LIABILITY INSURANCE °02110120' 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, MI 48106-0333 INSURERS AFFORDING COVERAGE NAIL# INSURED Renewal by Andersen INSURERA: Hgqford Insurance an J and L Windows,Inc. INSURER B: Nautilus 104 Otis St INSURER C: _ Northborough,MA 01532 INSURER D: 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 DL POLICYNUMBER POUCYEFFECTIVE POUCYEXPIRATION LIMITS I TR mqPQ TYPE OF INSURANCE B GENERALUABILm NC958461 10101/2009 10/01/2010 EACH OCCURRENCE S 1.000.000 COMMERCIAL GENERAL LIABILITY PREMISES Ea o=jrenw S 100.000 CLAIMS MADE F�OCCUR MED EXP(Any Orn Person) $ 5,000 PERSONAL&AOV INJURY $ 1000 00 GENERAL AGGREGATE S 2.000,000 GENA AGGPE.iATEUMRAPPLIES PER: PRODUCTS-COMPIOPAGG S 20000000 POLICY PRO• 7LOC A AUTOMOBILE LIABILITY 35MCC XD 6390 10101/2009 10/01/2010 COMBINED SINGLE LIMIT I S 1,000,000 (ED accident) ANY AUTO X ALLOWNEOAUTOS BODILY INJURY S (Per person) SCHEDULED AUTOS HIRED AUTOS BODILY INJURY S (Por aeodent) NON OWNED AUTOS PROPERTYDAMAGE S (Par ewdanq OAt;IAGE LIABILITY AUTO ONLY-EA ACCIDENT S _ ANY AUTO OTHER THAN EA ACC S AUTO ONLY: AGO S EXCESSIUMBRELLAUABILITY EACH OCCURRENCE S OCCUR CLAIMS MADE AGGREGATE S S DEDUCTIBLE S RETENTION S' WC STA-TU- OTH. A WORKERs.cOmm"ATIONAND 35 WECPP 1444 02/17/2010 02/17/2011 EfL EMPLOYERS'UAB!UrY E.L.EACH ACCIDENT S 500,000 ANY PROPRIETOR/PARTHER/EXECUTNE •E.L.DISEASE-FA EMPLOYEE S 500.000 OFFICER/MEMBER EXCLUDED? 1I eI.desalt under E.l.DtSEASE-POLICY LIMB S 500,000 SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES 1 EXCLUSIONS ADDED BY ENDDRSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN INSURED COPY 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. AUTHORIZED REPRESENTATIVE Q Q Cl 0 ACORD CORPORATION 1988 ACORD 25(2001108) i Renewaje�( YAl byAndersena WINDOW REPLACEMENT anMdecunC ompany ' wood/Vinyl Composite IF Dual Argo I • r-.�.••i�, i n Low E4 SmartSun � Double Hung 100-00473518-010 ENERGY PERFORMANCE RATINGS U-Factor(U.S)/I-P Solar Heat Gain Coefficient 1 019 0v19 ADDITIONAL PERFORMANCE RATINGS Visible Transmittance OA2 Manufacturer stipuletes that these ratings conform to applicable NFRC procedures for determining whole product performance.NFRC ratings are determined for a sited 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 specific use. Cc...a manufacturer's literature for*that product performance information. Www.nfrn.oig ,g�tc This product masts Green .� DRi• 9earsenvsonmantal tensa •+r ••• ;standards governingenergy '�� ?•�">,`'�'?+• efficiency,heavy metals in � `•; , '•'Ilia frame and sash f'^.,�muerial,packaging,and t ?':�'•••,:.^"rr;`•::'a:Y". • eonaumar educational :��'�=���•' ' m•:rn.....a....... ':+wawWl.4wwN.M:. DESIGN PRESSURE(PSF) f wntow ens fbor ' M+nufacawars aamcatbn H LC25 RbA DB Sloped can d Sill DH IN Te.t:afotUfs�2ar�auunwmucSAtMnsrAaaaS Marmacvrran nTecaxxormarnceroanaa akmmeaurnaras. ' `Deana or axcaads M.E:C.,C.E.C,t I.E.C.C.A's InlYttration raquiramanta WDMA Hallmark Ceni(cation Program.