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HomeMy WebLinkAboutMiscellaneous - 1401 GREAT POND ROAD 4/30/2018 (10) � �� �� 0� �� � `\� � � I _ — s BUILDING PERMIT NORTHAti TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION # Permit NO: 001/ �Q�� Date Received a,4°oq "r �y* �SSACHL7`+�� Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION �J . 4 <� Q `A S i Pri�t PROPERTY OWNERN-etc,_,r .C � e ���;&� c� Print MAP NO: PARCEL;�3 ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building X One family Addition Two or more family Industrial Alteration No. of units: Commercial XRepair, replacement Assessory Bldg Others: Demolition Other Septic Well Floodplain Wetlands Watershed District Water/Sewer DESCRIPTION OF WORK TO BE PREFORMED: _ Identification Please Type or Print Clearly) OWNER: Name: y,v> e -� Phone: AddressN-k b \ Co(-e6A CONTRACTOR 'Name: Phone: SbT-%r-©moi aj c- Address:,Sko e ire rc 5\cc N(0 6 3 Supervisor's Construction License: 5 Exp. Date: S -10 Home Improvement License: M(oU( Exp. Date: ARCHITECT/ENGINEER N 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: $ FEE: $ J 7 Check No.: &12!� Receipt No.:_;Z?ro�� NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund ignature of Agenture of contractor_ ... Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2008 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 21 A—F and G min.$100-$1000 fine NOTES and DATA— For department use 0 Notified for pickup - Date Doc.Building Permit Revised 2008 Plans Submitted Plans Waived Certified Plot Plan Stamped Plans i 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 I 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 a 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 Location 47, ,/ �`�� / o'er No. - Date NaRTM TOWN OF NORTH ANDOVER 0 • • p ' Certificate of Occupancy $ Building/Frame Permit Fee $ S� swCHus Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # Y 230q �, I j uf1ding Inspector F NpRTH Town of And TO No. Y__ _ /Vo o dover, Mass., LAKE COCMICMEWICK 7,4 ADRATED SS BOARD OF HEALTH Food/Kitchen .PERMIT T D Septic System • BUILDING INSPECTOR THIS CERTIFIES THAT �.y. ............................... ......... .................................................................. ............ ........... ............... Foundation /z1o/ 6 /pc-e� �/V has permission to erect........................................ buildings on .................................................. .......r� .................... Rough to be occupied as................................�J.`...........!!`.�1. .0l'�................................................................................................... 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 CONSTRUCTION ARTS Rough ARTS 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. 104 Diis St.,Northhr mugh,MA 01.532 I&J,WINDOWS,ING.,D/H/A MA Home.Improvement Contractor. (508)919-0900•Fax:(774)9117-:3013 renewal license#148601 (f xpire,ti 1/24/Z01 2) byAndersen. Federal Tax ID#53-0404201 WINDOW R57LAGEMENT nn n+kranG'mpnny CUSTOM WINDOW AND DOOR REMODELING AGREEMENT 3uyer(5(Namn Bale of ApreemRnl Lia Ba er(sl SfroM Addrem,_City,Stah+,end Zip Cad,, E-Mail Address Home Tela hong Number Work inlnphon r --- Buyer(s) hereby jointly and severally ngrecs to purchase thc,products and/or, services of (Fc L Windows,Inc.d/b/a 1 enewal by Andersen ("Contractor"),in accordance with the terms a.nd.conditions described on the front and the reverse of this agreement and on the Aianhed Specificatiq.n shect(s) (collectively,this"Agreement").Buye (s)hereby agrees to signa completion cerl:i0cate after Contraclor has completed all work under this Agreement. ,`/y Method of Pymnt:U Cash U Check O Mastercard UVISA Total Jab Amount, F. 6.'. Fsfimoted Storting DowMethod Discover U Financed,App#: De osif Received 33%:_--.. �' """' p ( ) ---- "" Name on Credit Card. Bdldrice at Start of Job 133%): Estimated Completion Datct Credit Card#: Balance on Substantial Completion,of Job 'e:-_..____.. CC Exp.Date: CC Security Code: F initialingherr,you acknowledge.thatthe Balance nt Startrrf,)ob and the Ralancc on Substantial Cnmrletion Buyer Tniti ,lnnnt: ,:ac, by credit card And mast bo trade.by personal check,bank chock,or cash, Buyer(s) agrees and understands that this Agreement constituter the entiurr understanding between the parties, and that there are no verbal understandings changing or modifying any of the terms o.£this Agreement.No alteration to or deviation from this Agreement"U be valid without the signed,written consetat of both Buyers) 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 Cst.ncenation,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&i,W wq, e.d/b/a Renewal by Andersen Buyer(5) Buyer(s) By: L� � i tantrc of Prnrlint Manager Si)nnt'ar•.` SiBnaturlt Piint Namn of Product N!lan:Lgcr Print Namt•. Print Name YOU,.THE BUYER(S), MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OE THE THIRD BUS1N£SSMAY AFTER TETE DATE OF THIS TRANSACTION.SEE THE ATTACKED NOTICE OF CANCELLATION FORMS FOR AN EXPLANATION OF THIS RIGHT. NOTICE�-C�l��I��1C�Et�L,, 1�ON NOTICEuOF W1 Cts. Date..of Transoction __S:)_-n •You may cancel. .Date of Transaction. )- You may cancel this transaction,without any penalty or obligation,within I this transaction,wither any penalty or obligation,within three business days from the above date.If you cancel,any I three business dot's from the above date.If you cancel;any property traded in,any payments made by you under the I property traded in,any payments made by you under the Contract of Sale,and any negotiable-instroment executed Contrail of Sale,and any negotiable instrument executed byyou will be returned within 10 days following receipti by you will be returned within 10 days following receipty the Contractor ("Seller") of your.cancellation notice, by the.Contractor ("Seller") of your cancellation notice, and any security interest arising out of th9 transaction will I and any security interest arising out of the transaction will be canceled.If you cancel,you must make 4j in to the be canceled.If you cancel,you must make available to the Seller at your residence,in substantially as good condition Seller at your-residence,in substantially as good condition as when received, any goods delivered to you under i' as when received,any goods delivered to you under this this Contract or Sale; oryyoou may, if you wish, on h,'comply. I Contract or Sale;or you may,if You wish,comply with the with the instructions' of the Seller regarding the return instructions of the Seller regarding the.retum shipment of shipment of the goods at the Seller's expense.and.Ask. I the-goods at-.the Seller's.expense and risk.If you_do make If you do make the goods available to the Seller and the the goods available to the Seller and the Seller does not Seller does,not pick them up within 20'days of the date I pick them up within 20 days of the date of your Notice of your Notice of Cancellation,you may retain or dispose I of Cancellation,you may retain or dispose of the goods of the goods without any further obligation.If you fail to without any further obligation. If you lata to make the make the goods available to the Seller, or if u agree goods available to the Seller,or if you agree to return the to return.te 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 performance 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 ciny i dated copy of this cancellation lnotice or any other written other written notice, or send a telegram to Contractor:J I notice,or send a tolegrom to Contractor.J&L Windows, &L Windows,Inc.d/b/a Renewal by Andersen, 104 Otis l Inc. d/b/a 'RenewalAndersen, 104 Otis Street, Street, Northborough, �01,5�3�2,.BY NOT LATER THAN Northbojyvg , A 0.153,BY NOT.LATERTHAN MIDNIGHT MIDNIGHT OF t�- cci.(Date} O) i/..Date) I HEREBY CANCEL HIS TRANSACTION. I,HFRES CANCEL THIS TRANSACTION. Buyer's Signarurc — pare I Buyer's SigoahLre Data ~Y ^— oL.n r'.,•.+._ AA/114n RT—Ir CII,Tp_Yellomr T31.1vcr Conv-Fink J�L Windows,inc.d/b/a 104 Otis Street,tvorthboirough,M,1 01.532 MAtI1ldCCsC t 149601 (expirs 1/24/12) Fhone 508919.0900-Fax 774,987.30 11 renewal Federal Tax IV##83.0404201. byAndersen. '� WINDOW RePLAC4M5Nr vn Mdl hGH 1l Y ^Zz 9Z, �G{ OF CI%AAnR MAacncttuserrs AND New HAMMIrme WINDOW SPECIFICATION SHEET 13uycr(s)Name Date,of Agreement The Buyer(s)listed above hercbyieintly and severally agree to purchase the goods and/or services listed below,in accordance with the prices and terms described on the specification Shcct and the front and the reverse of the accompanyir4q CUSTOM WINi)OW AND DOOR RFMODF.LING AGR£EMTNT, 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 quantities; —4——Double Hung(DB) tial sash ❑ Cottagc sash(1/3 top,2/3 bottom) ❑ Oriel sash(2/3 top.1/3 bottom) C.Asettlent(CW) ❑ 11irlgc right 0 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 ❑ L'2:1 ❑ Standard handle ❑ Metro handle 2 Lite,Gliding Window(GW) Glider/Picturc/Glider(GPW) ❑ 1:1 1 or ❑ 1:2:1 Awning Window(AW) Picture Window(FW) Ray or Bow Window ho Doors(see separate Door Specification Sheet) 2. gKes ❑ No Qty of Windows to be Custom Fit Replacement: 3. © Yes � o Ql:y of Sills to be replaced by Contractor: 4. ❑ Yes No Qty of Windows to be New Construction Full frame(includes new interior Fc exterior.casings) Exterior cast s: ❑ pine❑ Maintenance-free material ❑ Factory applied 908 Fibrex brickmold $. Glazing to be,: 1P 1,0%, SmartSunT. (Tax C editL6gx7tle) 0 Other if other,please spocify: 6. Exterior color to be:, rW_hitc❑ Sand ❑ Canvas ❑ Terratone ❑ Cocoa Bean. 7. Interior color to be: il:e ❑ Sand ❑ Canvas ❑ Terratonc ❑ Pine ❑ Maple ❑ Oak Note: Interior color can only be white,wood or same,color as exterior. Wood interiors need to finished,by Owner. 8. Hardware: >hite ❑ Stonc ❑ Canvas ❑ Brass ❑ Estate Hardware; Style: 9. 0 Yes o Install Lifts with Dovble Hung Windows 10. Screens: windows to have: ❑ Half o/' 2'1;ii11 Screens Screens to be: ❑ fiberglass [e.}-it>'uminum ❑ TruScene GRILLE)77AIL,S 11,Windows have grilles: ❑ Yes E" ISO I yes:(2 Gripe Betwccn Glass(coca❑ Removable Interior Wood(IN'rw)❑ Full Divided Light tFnla Qty, Qty: Qty . Qty: Qty: Qty: Qty: X1.1 DH DH OH DH dw/Pldore Glider CPW or Draw grille patterns above "Use additional Sheet if needed Owner approved(initial ADDITIONAL WORK DETAILS 12.❑ Ycs QlNo Contractor will remove metal frames of windows. Qty of Units: I3.❑ yes Contractor will install now paint-ready or stain-ready casings. interior cos g qty of openings: F.xter.ior casings qty of openings: ❑ Pine, [] Maintenance-free material 14.❑ Yes o Contractor will install new pairi:-ready or stain,-ready inside or outside stops qty of openings: interior amps qty of openings: Exterio e ❑ Pine ❑ Maintenance-free material 15. Owner is aware that Contractor docs not do any pain' Initials 16.❑ Ycs g�Contractor will wrap exterior casings wit of color. _,Note: Wrapping may be required with storm.window removal;removal of storm windows will leave screw holes in casins. 17.FT Yes-0 No Contractor will insulate,caulk and seal windows with 3-point.system to prevent water and air infiltration. I$. No A limited warranty shall be issued to Owner upon completion of the job and payment in full. 19, Ycs ❑ No Auil, ' 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: iul!� _z3 21. Fycs (] No Owner agrees to be present on the final day of installation for final inspection and to deliver stinal payment. Np final pay7nentshR11 b�demaridcd until the cents Hot.iv completed to the satisfaction of All panties. 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 inany way unless such changes are in writing And signed by both the Buyer(s)and ContrwtAr. Buye(s)hereby acknowledge that Buyer(s)has read this Specification Sheet, Renewal erse f Greater MA And NH Buyer(s) �� Buyer(s) Sy: _ Sisna fpro uctMankker Signafttre Signature Print Name of Product Manager Print Name Print Name The Commonwealth of Massachusetts Department of Industrial Accidents Office of InvestigqtIons 600 Washington Street Boston,MA 02111 uv� www.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electriciaris/Plumbers Applicant Information Please Print Legibly Name(Business/Organizadon/Individual): j et lew o .Address: 10,/ Qf r S ��-Yer✓�" ' P: A1ari�boo, A4 Dl.��� Phone#: Ci /State%Zi • Are you an employer?Check the appropriate box: Type of project (required): 1-&1 am a employer with�D 4. ❑ 1 am a general contractor and I 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. # modeling Vag 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 S. ❑ We are a corporation and its required.]. � officers have exercised their '10.11 Electrical repairs or additions . . 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' 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 allwork 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 isproviding workers'compensation insurance for my employees Below,is the policy and job site information. Insurance Company Name: . ' /1/C 1�fin» lit Sty✓0 Yl C - Policy#or Self-ins,Lic.#: �v/ ln��� /`�`f - Expiration Date: a AlWIL. Job Site Address: (� ��� fd A,5 /�City/State/Zip: 1y, /l/.JCPE/ th 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 23A 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(77r the pains and penalties.of perjury that the information provided above/%true fi�d�correct Sienature: Date. ��V Phone# % �U ��`✓- t7 f�LY/ 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#: . i • I :,,;;�-a,�.-�.. .:;r•.+•��, ' YJfze wa�ryma�uuea��i a��acfi 1 yt: Board of Bundin;fiegulations and Standards 'Construction•SuperviscrLicensa•t;,,;, A.,; ' 'f•e':CS -95707 N.U. Biethiatet=Jl0982 Tri 95707 ' t iE p►ratio-WQ2010 BRIAN DENNISO 86CREST CIRCLE . ' i fly WORCESTER,' 01603 Colanlissiongr; . f. 7226 TOO�tYlft0721lJ6d �O�a/I�GQQd¢C/tl1Q�l6 ' Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registratior<n6Z�s"'L4 X01 Expira —=-:.- .12 . T`Ie nt Card RENEWAL BY '+ BRIAN DENNIS- 104 OTIS STREE — 9= NORTHBOROUGH,Mt?�a0� 32 Undersecretary ACORDy CERTIFICATi E OF LIABILITY INSURANCE °0211012 0l 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 INSURER A-. Hartford Insurance Company 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 A.DVLPOLICYEFFECTNE POLtCYEICPIRATION LIMITS i TR NqRQ1 TYPE OF INSURANCE B GENERAL LIABILITY NC958461 10/01/2009 10101/2010 EACH OCCURRENCE s 1,000,000 72 COMMERCIAL GENERAL LIABILITY PREMISES Ea omurenoeI S 100.000 CLAIMS MADE FIOCCUR MED EXP(Any OM pamn) $ 5,.000 PERSONAL i AOV INJURY $ 1,000,000 GENERAL AGGREGATE S 2,000,000 GENL AGGPWATE LIMIT APPLIES PER: PRODUCTS.COMP/OP AGG S 2 000 0000_ POLICY PRO, LOC A I AUTOMOBILE LIABILITY 35MCC XD 6390 10/01/2009 10/01/2010 COMBINED SINGLE LIMIT S 1,000,000_ ANY AUTO (Eo nladenl) X ALL OWNED ALTOS BODILY INJURY S (Per Person) SCHEDULEDAUTOS HIRED AUTOS BODILY INJURY S (Per a„-ddenq NON-OWNED AUTO$ I PROPERTY DAMAGE S (Per at:adenq GARAGE LIABILITY AUTO ONLY•EEA ACCIDENT S ANY AUTO OTHER THAN EA ACC S AUTOONLY: AGO S EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE S OCCUR CLAIMS MADE AGGREGATE S • 5 DEDUCTIBLE S RETENTION S' S A WORKERs.cOMPENSAnONAND 35 WECPP 1444 02/17/2010 02/17/2011 wR LI ITS 1 0TH• EMPLOYERS•LIAB!U Y E.L.EACH ACCIDENT S 500,00.0 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERAAEMBER EXCLUDED? I E.L.DISEASE-EA EMPLOYEE S 500.000 Urs desaf under E.L.DISEASE-POLICY LIMIT S 500,000 SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION INSURED COPY DATE THEREOF,THE ISSUING INSURER HALL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATNES. AUTNORD:EDREPRESENTATNE ACORD 25(2001108) `©cACORD CORPORATION 1988 Renewa ` byAndersena WINDOW REPLACEMENT anAnderun(otnpany ' ;. ;�,e.i+r •�r, Wood/Vinyl Composite IF Dual Argon Low E4 StnartSun Double Hung 100-00473518-010 ENERGY PERFORMANCE RATINGS U-Factor(U.S)/I-P Solar Heat Gain Coefficient Ox ,29 0 . 19 ADDITIONAL PERFORMANCE RATINGS Visible Transmittance 0 . 42 Manulaeturar stipulates that these ratinas contorm to applicable NFRC procedures for datermuting whole product paAomtance.NFRC ratings are determined for a luted sat of environmental conditions and a specic product size. NFRC does not recommend any product and does not warrant the sulabaity of any product for any specific usa. Consul manulacturar's literature for other product performance information. Www.nitc.otg 10 This product meats Graen .� > ' Sears environmental r standards governing anergy '.7".n".Y�'-'o:'.°. r):.."%".�...rr•.,t,'%';_r,,ti� efficiency,heavy metals in •'.the fnma and eash ® •Z.:r. ..ci•• Jnr!. l+d^material,Packaging,and reit- ^Y:.;•r..,..JM:r�:"tttr .,,tri.., t.v;•3 ro, �consumaraducationalr materials. os.rRu '.a;:$iy.•.;�.'•'%d'firi� YY •. s DESIGN PRESSURE(PSS /'/�� r � l 'Wt100YYWld 00f ' �L Cit!5 hYnulacssers A490Cbtlon www.wdma.com RbA DB Sloped Sill DH 1N Testid to lUFS-02 arAA91MWMA/CSn 1QIA3lAe/0Ui MSMamue st lat9e eoMormance to thea 11021319 starnaaras. rNaata of axcaeds M.E.C.,C.E.C,81.E.C.C.Air Intlihretion requirements WOMA Hallmark Cartilication Program. l