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HomeMy WebLinkAboutBuilding Permit #847-13 - 92 BONNY LANE 6/5/2013Permit NO: Date Issued: ✓` . BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received IMPORTANT:A nt must comp. all items on this E. N TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑�r-w"family ❑ Addition ❑ Two or more family ❑ Industrial ❑ Al -tion No. of units: ❑ Commercial epair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic D Well D Floodplain D Wetlands ftliershod,011strict ❑ waterisewer _ DESCRIPTION OF WORK TO BE PREFORMED: 14 11)tA .1,1. . Ir Identification Please Type or Print Clearly) 11 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. Total Project Cost: $ 3 a , ��� �� FEE: $ ` cl 4 , e) J Check No.: 7( 1 7 Receipt No.: NOTE: Persons contract' g wiunregistered contractors do not have access to the guaranty fund r ignature of Anent/' Lr,-); Sianature of contractwi''� Location12— No. 941-(� Date Check # A I Y 26487 TOWN OF NORTH ANDOVER Certificate of Occupancy $—.— Building/Frame Permit Fee $ 6D Foundation Permit Fee $ Other Permit Fee TOTAL Building Inspector 1 s Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan n 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 PLANNING & DEVELOPMENT CQ MENTS DATE REJECTED DATE APPROVED ❑ ❑ DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ -El- COMMENTS 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 Located at 384 Osgood Street Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions Total land area, sq. ft.: ELECTRICAL: Movement of rioter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 966 Section 21A -F and G min.$10o-$1000 fine NOTES and DATA — (For department use Q Notified for pickup - Date Doc.Building Permit Revised 2010 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 10TE: 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 produe'is OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application o 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 03TE: 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 apPal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be subni'tted with the building application Doe: Doc.Bui?ding permit Revised 2012 TOWN OF NORT" ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued: Non- Residential 0 New Building 0 One family IMPORTANT: Applicant must complete all items on this page El Two or more family El Industrial El Alteration No. of units: El Commercial 0 Repair, replacement D Assessory Bldg 11 Others: Lt®CATION 0 Other 'W 1' I an [ON, &t;�nd�- R ririt W M mv We RTM VOWyz rE,P P 100YLL-eater OldTra plu J yqA 300 BARGEE '11-'. NO P_ T, oji Dc- M �s L(i LctJ yft fho _M qp i TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential 0 New Building 0 One family D Addition El Two or more family El Industrial El Alteration No. of units: El Commercial 0 Repair, replacement D Assessory Bldg 11 Others: El Demolition 0 Other 'W 1' I an [ON, &t;�nd�- WW .1 iWV'' M mv We DESCRIPTION OF WORK TO BE PERFORMED: Identification Please Type or Print Clearly) OWNER: Name: Phone: • GO N, JTJ R AG ITO IN m bon Ad S'o P�Ni§of�q" -,ti ntL ic nsg-Exp! m e- nLicense pro o�! PTovqffi Date.._ ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE. BOLDING PERMIT.• MOO PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. 'Total Project Cost:$ FEE: $ Check No.: Receipt No.: NOTE: Persons contracting v-* ­;jgistered contractors do not have access to the gUarantyfund signature 8ianeiie.' of e r':o contractor,. ,.. . Pians .qijhmittPrI F1 Plan!' Af;qivpri F1 (t-rfifipri Pint Plan n qt;;mnpri PI;3n.-, F] Plans Submitted ❑ Plans Waived 11 Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF-SEWERAAEDISPOSAL Public Sewer ❑ Tanning/MassageBodyArt ❑.. .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 PLANNING & DEVELOPMENT11 COMME CONSERVATION COMMENTS HEALTH t COMMENTS DATE REJECTED DATE APPROVED Reviewed on Signature Reviewed on Signature Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sevver Connection/Signagure &Date Driveway Permit DPW Town ]Engineer: Signature: Located 384 Os FIRE 'DEPAIRtM .WT - Temp Dumpster on site yes nc� Located at'124 Maui Strdet Fire ®eparniert sigriaturelclate COMMENTS )d Street r� m m m m m m < 0 'a 0cn c�i = U CD -a y O CD, C O CDon, 0 • �+ = 0 m z c � 3 C N. 0. N � CD o m o o CD N CD oo C.) 91) O —I N . " CD CD y �• Q- a1 y <D CL to ' N O co. c as vs a p 0 CD t Do � m O 'a z Z 0 CL —n' n rm �� CL a cn cm z CD n CL Z < Qc fl, c �DO �p CD CL m vi cD CL CinCL o� Cr _U' Z L- CD CD 01 a% W � O o •ao' .d Sl 0 co CL CD CD b yCC CD `D <D 9 N Z0 CD c s J p c c c �I O ;o. C co -a CD �- O CD oCL N LA W T ;a T V1 :I T 0 N T O N 0 C 3 T m D 3 O' O y Ln HO_ m 3 N O m m Z -0 m 0 O E O V C W Z "a m 0 :3 d S < O C OzrD p' =3 C r Z m m O 'O Ln < m 3 O m 3 W D O m D x IM RenewalMA Home Improvement Contractor bYAtldersen. _ cense #170810 (Expires 12/23/2013) �� Renewal by Andersen Corporation Federal Tax ID #41-1918413 WINDOW REPLACEMENT an Andersen Company 104 Otis St., Northborough, MA 01532 (508) 351-2200 • Fax: (651) 351-4810 CUSTOM WINDOW AND DOOR REMODELING AGREEMENT Buyer(s) Name Date of Agreement Je.r f-4 S- / 3 Buyer(s) Street Address, City, State, and Zip Code E -Mail Address Address Home Telephone Number kSbrk-Telephone Number ell -1 --2-tl F- r %7 —76 6 Buyer(s) hereby jointly and severally agrees to purchase the products and/or services of Renewal by Andersen Corporation ("Contractor"), in accordance with the terms and conditions described on the front and the reverse of this agreement and on the attached specification sheet(s) (collectively, this "Agreement'). Buyer(s) hereby agrees to sign a completion certificate after Contractor has completed all work under this Agreement. Total Job Amount: % gq/ Estimated Starting Date: Method of Payment: --� Amount Financed &— 169 t -e 6 b s ❑Check ❑Cash Deposit Received j 3 r). -7afj . l S p00 CI ISO/MC ❑Discover Balance at Start of Job.(2`3%): 0 tEFinanced RAMEX Estimated Completion Date: If credit card is selected, please Balance on Substantial Completion of Job (a33% -r 1 0051 V 5--7 CG / { see Credit Card Payment Form. • Buyer(s) agrees and understands that this Agreement constitutes the entire understanding between the parties, and that there are no verbal understandings changing or modifying any of the terms of this Agreement. No alteration to or deviation from this Agreement will be valid without the signed, written consent of both Buyer(s) and Contractor. Buyer(s) hereby acknowledges that Buyer(s) 1) has read this Agreement, understands the terms of this Agreement, and has received a completed, signed, and dated copy of this Agreement, including the two attached Notices of Cancellation, on the date first written above and 2) was orally informed of Buyer's right to cancel this Agreement. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. Renewal by An ersen orp �,ration B' Signature of Product Manager Print Name of Product Manager B er(s) Signature V /� % 44- e r !�� e ed Print Name Buyer(s) Signature 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. — — — — — — — — — — — — — — —�<- — — — — — — NOTICE OF CANCELLATION Date of Transaction S- 15- / 3 . You may cancel this transaction, without any pens1ty or obligation, within three business days from the above date. If you cancel, any property traded in, any payments made by you under the Contract of Sale, and any negotiable instrument executed by you will be returned within 10 days following receipt by the Contractor ("Seller") of your cancellation notice, and any security interest arising out of the transaction will be canceled. If you cancel, you must make available to the Seller at your residence, in substantially as good condition as when received, any goods delivered to you under this Contract or Sale; or you may, if you wish, comply with the instructions of the Seller regarding the retum shipment of the goods at the Seller's expense and risk. If you do make the goods available to the Seller and the Seller does not pick them up within 20 days of the date of your Notice of Cancellation, you may retain or dispose of the goods without any further obligation. If you fail to make the goods available to the Seller, or ifou agree to return the goods to the Seller and fail to do so, then you remain liable for performance of all obligations under the Contract. To cancel this transaction, mail or deliver a signed and dated copy of this cancellation notice or any other written notice, or send a telegram to Contractor. Renewal by Andersen Corporation, 104 Otis Street, Northborough, MA 01532, BY NOT LATER THAN MIDNIGHT OF 1�- 1 HEREBY CANCEL THIS TRANSACTION. Buyer's Signature Print Name Date RbA Copy - White -------- 91< — — — — — — — — — — — — — — — NOTICE OF CANCELLATION Date of Transaction - - r . You may cancel this transaction, without any penalty or obligation, within three business days from the above date. If you cancel, any property traded in, any payments made by you under the Contract of Sale, and any negotiable instrument executed I by you will be returned within 10 days following receipt by the Contractor ("Seller") of your cancellation notice, and any security interest arising out of the transaction will be canceled. If you cancel, you must make available to the Seller at your residence, in substantially as good condition as when received, any goods delivered to you under this Contractor Sale; or you may, if You wish, comply with the instructions of the Seller regarding the return shipment of I the goods at the Seller's expense and risk. if you do make I the goods available to the Seller and the Seller does not pick them u.p within 20 days of the date ofyour Notice of Cancellation, you may retain or dispose of the goods without any further obligation. If you fail to make the goods available to the Seller, or if you agree to return the Dods to the Seller and fail to do so, then you remain liable for performance of all obligations under the Contract. I To cancel this transaction, mail or deliver a signed and I dated copy of this cancellation notice or any other written notice, or send a telegram to Contractor. Renewal by Andersen Corporation, 104 Otis Street, Northborough, MA 01532, BY NOT LATER THAN MIDNIGHT OF (Date) 1 HEREBY CANCEL THIS TRANSACTION. Bu er's Signature Print Name Date Y Buyer Copy - Yellow Buyer Copy - Pink 01BLLP2009.RBA-Ph.MANH Renewalmewal by Andersen COrporatiC v MA Home Improvement Contractor .:i�� 104 Otis St., Northborough, MA 01532 License #170810 (Expires 12/23/2013) byAndersen. m (508) 351-2200 • Fax: (651) 351-4810 Federal Tax ID #41-1918413 WINDOW REPLACEMENT an Andersen Company WINDOW SPECIFICATION SHEET Buyer(s) Name Date of Agreement )fie >i " k/ R e l S- ( S— 1 3 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. Contractor will Install a total of windows in Owner's home, using the following individual quantifies: Double Hung (DB) _ Equal sash _ Cottage sash (1 /3 top, 2/3 bottom) _ Oriel sash (2/3 top. 1/3 bottom) _ Flat sill (customer is of aware of Glass Ions) Square Check Rail _ Curve Check Rail Casement (CS) _ Hinge right _ Hinge left (as viewed from exterior) Double Casement (CD) 1 2 Lite Gliding Window (GW) Casement / Picture / Casement (CT) _ 1:1:1 or _ 1:2:1 Glider / Picture / Glider (GFW) or _ 1:2:1 Picture Window Bay or Bow Awning Window _ # Lights Soffit / Roof Shingle / Copper Specialty Window Patio Doors (see separate door spec sheet) Seat to be Primed / Oak / Pine LI'DE] E:I'l 1'E1 D'1:1 2: Q Qty of Windows to be Custom Fit Replacement: 3. 1 Qty of Windows to be Custom Fit Full frame (INCLUDES NEW INTERIOR & EXTERIOR CASINGS) Exterior casings: —Pine _ Maintenance -free material ✓actory applied 908 Fibrex bniclanold 4. Glazing to be: _ HP Low- E-4 TM _ Tem Other If other, please specifyc-5j±!�- 5. Exterior color to be: _ White _ S v _ Terratone _ Cocoa Bean _ Dark Bronze _ Forest Green _ Black 6. Interior color to be: _ White _ v e _ Maple _ Oak _ Same as Exterior Note: Wood interiors need to finished by Owner. 7. Hardware: _ White _ Stone anv _ Estate Hardware: Style: 8. Install Lifts with Double Hung indows 9. Screens: windows to have: _ Half or ✓Full screens Screens to be: _ Fiberglass _ AluminumTn- TruScene GAII.i.E DEFAE S 10. Windows have grilles: _ Grille Between Glass (GBG) _ Removable Interior Wood (INTW) _ Full Divided Light (FDL) ( Owner approved (initials) Draw grille patterns below 'Use additional sheet if needed ty. ON: Otv:. ON: ON: Otu• nr.,• ADDITIONAL WORK MARS 11. Qty of _ Sills _ Sill noses to be replaced by Contractor 12. z� Contractor will remove metal frames of windows. 13. Contractor will install new _ paint -ready or _ stain -ready _ Interior —Exterior casings in —Pine _ Maintenance -free material 14. Af�n_ Contractor will install new _ paint -ready or _ stain -ready _ Interior _ Exterior stops in _ Pine _ Maintenance -free material 15.( !ala✓ ) hills - Owner is aware, contractor does not do any painting or removal/installation of alarm system/hardware. It is the lresponsibility of the homeowner to have the alarm system/hardware removed prior to installation. 16. _ Contractor will wrap exterior casings with coil stock of color. Note: Wrapping may be required with storm window removal; removal of storm windows will leave screw holes in casing. 17. Contractor will insulate, caulk and seal windows with 3 -Point system to prevent water and air infiltration. Removal and disposal of alljob related debris, win- d storm windows and vacuum nightly included. Upon completion of the job and payment in full, a limited warranty shall be issued. 18. ['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. Ck # (6 l % $ 3 / 19. Yes ❑ No All discounts have been applied to this agreement price. 20. Additional job details: 21.y 6,es ❑ No Owner agrees to be present on the final day of installation for frnal inspection and to deliver final payment/finance form(s). It is agreed and understood by and between the parties that this Specification Sheet, along with the CUSTOM WINDOW AND DOOR REMODELING AGREEMENT, constitutes the entire understanding between the parties, and 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. Renewaln rsen C rporation rgnature of Product Manager Buyers) /,Z/ Signature Print Naine of Product Manager Print NamZJ e Buyer(s) Signature Print Name The COMMOnweaft ofMassaehusetts Depar"ent of1ndW*ig1 Accidents Of ace of Investigations .600 Washington Street Boston, MA 02111 www.niass gov/din Workers' Compensation Insurance Affidavit: Binders/Contractors/Electricians/Plnmbers Aaplicant Information � Blease print Lt` Name (Business✓Orgynization&divl").—L.dl-tjci,� \n., Address: 1 D S't . Are you an employer? Check the appr 1. T— I am a employer with 3 0 employees (full and/or part-time). 2.0 I am a sole proprietor or partner- ship and have no employees working for me in any capacity. [No workers' comp. insurance required.] 3. ❑ I am a homeowner doing all work myself. [No workers'comp. insurance required.] t Phone #: SbW, riate box: 4. I am a general contractor and I have hired the sub -contractors listed on the attached sheet. These sub -contractors have employees and have workers' comp. insurance.: 5. [] We are a corporation and its officers have exercised their right of exemption per MGL c. 152, §1(4), and we have no employees, [No workers' comp. insurance reauired.l Type of project (required): 6. 0 New construction 7. Remodeling 8. [-]Demolition 9. 0 Building addition 10.0 Electrical repairs or additions 11.0 Plumbing repairs or additions 12.0 Roof repairs 13.0 Other ----------- *Any applicant that checks box #1 muff also fill out the section below showing their workers, compensation policy intbrnytiion. Homeowners who submit this affidavit indicating they are -doing all work and thea hue wide cwatractors must submit a new =Contractors that check this boot must attached an additional sheet affidavit indicating such. employees. Ifthe sub -contractors have 1 showing the name o comp subcontractors and state whether or not those entities have emp o3' s, tom' must provide thea worlcas' comp• policy number. I ams an efaployer that is providing workers' eompenswun Inswunce for my wrloyeex Below Is the o information. _ p licy and fob site Insurance Company 3. Policy # or Self -ins. Lie. #: fid j C // i C- LA co . EXpindon Date Job Site Address: 'n � nytS4 City/State/Zip: Aa os r1t 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 a of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office a Investigations of the DIA for insurance coverage verification. I do hereby certifythe pains and penek les ofp��t' that the in onmadom rovi&d l- f P above is true avid correct -q-1 �) OJf ieia/ use only. Do not write in this area, to be completed by city or town ojykial City or Town: Permit/License # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspecto 6: Other r S. plumbing Inspector Contact Person: Phone #: ✓ CERTIFICATE OF LIABILITY INSURANCE 09/25/2012 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: N the certiNCate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. K SUBROGATION IS WANED, subject to the terns and conditions of the policy, certain policies may require an endorsement. A statement on this CertMicate does not confer rights to the certificate holder in lieu of such endomems s . PRODUCER 1-612-333-3323 CONTACTJ0320116 Hargrove or Eric Johnson Hays Cosrpanies PHONE 612-333-3323 FAX No: 80 South 8th Street 612-373-7270 Suite 700 pROp�ER Minneapolis, MR 55402 CUSTOMER ID I: INSu S AFFORDING COVERAGE MAIC 0 INSURED INSURERA: OLD REPUBLIC IHS CO 24147 Renewal By Andersen Corporation INSURERS: NATIONAL UNION FIRE IHS CO OF pITTS 19445 104 Otis Street INSURERC: Northborough, MA 01532 aMURERO: N_nVPRAGFC PCOTfev►�Te' unue�s• een..n.n� - — — -- - n=VIDIUM NUMtlER: HIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD DICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS ERTIFICATE 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 Y PAID CLAIMS.IN INS TYPE OF INSURANCE ADDL R POLICY NUMBER POLICYE MI�OD EXP YM LNINTS A GENERAL LIABILITY E COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR MNZY 59828 10/01/1 10/01/13 EACHOCCURRENCE S 11000,000 D PREMISES Eaowimmoe S 500,000 MED EXP Any one person S 10,000 PERSONAL 6 ADV INJURY $ 2,000,000 GENERAL AGGREGATE f 41000,000 GENT AGGREGATE LIMIT APPLIES PER:PRODUCTS- X POLICY PRO. LOC COMP/OP AOG f 3.000, 000 S A AUTOMOBILE Z LIABILITY AM,AUTO MNTB 21700 10/01/1: 10/01/f3- COMBINED SINGLE LIMB (Esaodd-d) $ 3,000,000 BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per eodderd) $ SCHEDULED AUTOS X HIRED AUTOS NON -OWNED AUTOS PR PERTYaoddefDAMAGEI�PeS E f i EACH OCCURRENCE f 25, 000, 000 B ]I UMBRELLA UAB S OCCUR EXCESS JAA CLAIMS MADE 13273355 10/01/1 10/01/13 AGGREGATE S 25,000,000 DEDUCTIBLE X RETENTION $ 25,000 S >, WORKERS �VE� LIABILITY ANY PROPRIETORIPARTHERIEXECUTIVE OFFICERANEMBER EXCLUDED? PUndetoy ti) I desgibe under DESCRIPTION OF OPERATIONS belay NIA 117948 00 10/O1/1 10OWENSATION /01/1' 10/01/13 E WCSTATu OTH- f E.L. EACH ACCIDENT f 2,000,000 E L DISEASE -EA EMPLOYEES 1,000,000 E.L. DISEASE -POLICY LIMIT S 1-000,000 DESCRIPTION OF OPERATIONS I LOCATIONS ! VENK:LES (AtlaNr ACORD 4 of Addkbnsl Remade Sslndule. I mom space is requlmd) Evidence of insurance. CERT'IFICAT'E Mnt nFR .....,,�.. __.__. of insurance 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 ericj ©1988-2009 ACORD CORPORATION. All rights r.:...,..N ACORD 25 120D9/091 The ecnon —8 �___ _� ------ fficc of Consumer Affairs &Bus oe sRegulationuaelza ME IMPROVEMENT CONTRACTOR egistration; 1713$10 ExPiratioii g2'j2S 2013 TYpe' 71, RENEWAL By ANDEF2SOly CORPORATION Supplement r JOSEPH REZZA # 104 OTIS STREET t NORTHBOROUGH, MA 01532 ��— Undersecretary j r} t s Massachusetts - Department of Public Safety Board of Building Regulations and Standards . Construction Supervisor License: CS -065272 JOSEPH P REZW �•;. 168 ]KELLEY BLVD w� s N ATTLEBORO RA Expiration Commissioner 04/25/2014 ~ . � uoommmv� « ' --- ) 13, Dual Argon Lvw-E4 SmdSun A0.29 1.65 L - (MOMCISI) 0.49 ails Rn Shwxhtrd Ra" DP psMS-Mr,: NOM o evv "narses.�� 5by, adn1 aL/w� ANC6N-37 � i p cad Compos Material Product mon Piahira SrnariSun ENERGY P6Rf:ORMM CE RATIM S - 1-1-Factor Solar Heat Gain Coeff c4ent 0.2-7 0.2? U. M ADDITIONAL PERURoAMANCE RA"PICA visible Tranerniflanos 0.51 ._� ism °rAwplu„tj i2U.$.jpj .E OP;mf F-C60 dais .� s IwaMrM�Mrwyyrrra �ti11r�11�tsiam 100.00611006-001