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Miscellaneous - 306 HILLSIDE ROAD 4/30/2018 (3)
1� ^✓� NORTH 9 BUILDING PERMIT do TOWN OF NORTH ANDOVER �� APPLICATION FOR PLAN EXAMINATION * _ Permit No#: -? Date Received 7 ��RATED f'f gSSACHU`��� Date Issued: y IMPORTANT: Applicant must complete all items on this page LOCATION (,,� (f� l�cSf�ir / P1�rin ��roti%P PROPERTY OWNER - - Print 100 Year Structure yes no MAP��—S PARCEL: 4,91911 ZONING DISTRICT`� Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District ❑Water/Sewer DESCRIPTION OF WORK T BE PERFORMED: W1/vbd w -3 Identificatio Please Type or Print Clearly OWNER: Name: �il7�✓� L •cGliv�v� Phone: Address: 3,o e. �' //5i be Contractor Name: JAia*P ' Phone: �' 9!a G d S'`l --- Email: Address: dr p S ) dr Supervisor's ConstructionLicense: 90 �'�"� Exp. Date: Home Improvement License: l7l) a'�D Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ .19, ZIV7 �b FEE: $ , 00 Check No.: 940 2167 Receipt No.: NOTE: Persons contracting with unregistered contractors do not have acce,��)the guaranty fund ignature of Agent/Owner Signature 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 o 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 o Photo Copy of H.I.C. And C.S.L. Licenses a 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) o 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 o Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg. Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc:Building Permit Revised 2014 i L 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 I or department use NOTES and DATA— (F p ) I I ❑ Notified for pickup Call Email Date Time Contact Name Doc.Building Pennit Revised 2014 Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/MassageBody 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 Reviewed On Signature_ COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes . s Planning Board Decision: Comments N Conservation Decision: Comments Water & Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street a FIRE DEPARTMENT Temp D.umpster on site no, Located at 124.Main Street Fire Department signatureld'ate COMMENTS Location ILA k 0-11 JS°'3 No. 116-1 Date 0 . . TOWN OF NORTH ANDOVER aW Certificate of Occupancy $ Building/Frame Permit Fee $ d .OD Foundation Permit Fee $ Other Permit Fee $ r TOTAL $ r Check# J ;� Buildin�Inspector NORTH own of E ndover o - ..�. 96 w� V soh ver, Mass, /o COCHIC"IWICK y�• S V BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System ^ �j BUILDING INSPECTOR THIS CERTIFIES THAT .!1.�G� F.... .1.................... ........................................................................ �o6 ///-`/� �G/� Al Foundation has permission to erect .......................... buildi/ngs) on ..........................{ . .................. ......................... Rough to be occupied as U 1 1 ce .. x.................��................................................................................................................ Chimney provided that the person accepting this permit 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 Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION T RTS Rough Service ............... .... ........ .�ae,,.................................. Final BUILDING INSPECTOR 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. MA Horne Improvement Contractor N;:�newal Lkense#170810(Expires 102312015). by'Andersen, Renewal by Andersen Corporation Federal Tax ID#41-1918411 30Forbes Rd, Northborough,AMA 01532 (508)351-2200 Fax(508)-986-7072 CUSTOMER WINDOW AND DOOR REMODEUNG AGREEMENT Buyerr(s)Name Date: DIANE SULLIVAN MARCH 15. 2015 .Buyer(s)Street Address city State Zip Code 306 HILLSIDE RD NORTH ANDOVER MA 0184S Email Address Home Telephone Number Work/Cell Telephone Number = ©IAN ESOMSLAW.EDU 978-725-5980 978-382-5674 Buyer(s)hereby jointly and severally agrees to purchase the goods 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 Est.Start Date Method of Payment Total Job Amount $ 19,447 kmount Financed 19447 Deposit Received(33%)$ 0.00 DeRwelt at siglf'r% 9,72150 CheckfCash 10-12weeks Balance Start of Job(331,6)$ O-OD Check 4 Balance an SubstantialAiSUbSte-l" Est,Install rime Credit Card completion of Job(33%)$ 0.00 Ct mp wua S 9,723,50 3-4 days Ifuttcard isselected,please Cao Basi _+x shat¢ emantsad arAt t:arcet gra seri,.::vtsee edit Card Par-fent form Buyerfs)agrees and understands that this Agreement constitutes the entire understanding between the parties,and that them 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 Bttyer(s)and Contractor. Buyer(s)hereby acknowledges that Buyer(s)1)has read this Agreement,understands the term of this Agreement,and has received a completed signed and dated copy of tits Agreement,including the two attached Notices of Cancellation,on the date first written above and 2)was orally informed of Buyers right to cancel this Agreement. 00 NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. Renewal by Andaman Corporation Buyer(s) Buyer(s) Ch'i 7' lir[E' Signature of Consultant Signature Signature X CHRIS SWEET DIANE SULLIVAN Printed Name of Comullant Printed Name Phinted Nam YOU,THE BUYERIS),MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY AFTER THE DATE OFTHIS TRANSACTION. SEE THE ATTACHED NOTICE OF CANCELLATION FORMS FDA AN EXPLANATION OF THIS RIGHT ----------------------------------------------------------------------------I NOTICE OFCAKCEILLATION NOTICL OFCANCELLATION Date of Tr*o%_t1oa L" A'o.may cancel this Dole of Traivgactioia You may carrel this transaction,without.any penalty or Obligation,*dthiu three business days from the transaction,without any penalty or obligation,W"in three business day. from the ab�date.If you coure.1,any property traded In,any payments— abw.*date.If you ttimmll,my Property traded in,any Payments made by you tinder de,by you under the Contract of Site,and any negotiable htrumem executed by you wall he I she Cam"es of Sale,and any—gatialdeiwaramedt executed hyyou WWbe fotlo%iiig r"*4pt by the Contractor("sell"") of),our I returned withl.10 day.raloiog receipt.by the Contractor I"S*Ber"i of your canavilation notitV.,and any security interest arising out of the tra,miaction,.1ll be I cancellation nad—,and any security interest arising out of the I mati action%M be .-AMeted. If yon varveI,you mastm*&**vailable to tbe'3rllcr at your residence,in I caotclr& if you raucel,, available to cf-Seller at your residemein substantially as good condition as when rre.elved,any goods delivered to you under I snitstantially as good raadititm as when rc<;eiwrd,.say goods delivered en ynau nasdcr :thio ComraclorSale;ar you ms,if you wish.,comply'with.the instrurtioas of the I thisContract oi-Sale;or you may,U you wish,comply with the istrurdou%of the Seller reg"Ing the"turatihip.nem of the good.at the Seller's—pe...andristi. I SAW.regarding the remr-shipment of the goods at the Si,_Um Seller espee and risk. Ifyou de,reg"Ing the goods available to the SUer And the.Seller does not pick them up I It you do mase the goods aiailallAe to the Sa.Rer and the S.Re,do*.s not pia them up within 20 days of the date of your Notireof Canceilatiouyou mag retain at dispose I svithi.20days*f the date of your Nasiciof Cancellation,you may retain.rditposc of the gaaads widtout arra further olditTatian. Ify—railtto-h the goods a"aillithle If yeti fad tamak the ltodsavailable to,the.Seller,or if you agree to mturs the goods to the s*,.Urr and fail to An so,then I to the Sell—,or it you agree to".to—the goods to the Sell—and Cia to do so,them. you remain liable for performance of all dbUgatious under the Contract. To cancel y.0 remain liable for ri—formattee of all obfigadtins audrr die Contracg.To caaml this transaction,mast or deliver.signed and dated copy of this—itcollatiou sititic. d"transaction,mail or deN—r a signed"d dated copy of this cancellation notice or � any other Art&A notice,or—ad.telegram to Contractor:Renewal.by And�.rsea,1 or ear taker written notice,�send a itirgran,to Conttattar. Renewal by An d.erse.d 30►*Ar Rd. NortlibootughMA01332. i 30 It'"s Rd.Northborough,MA 01532. I HEMEBY CIAN CTA.TWS TRANSACTION. I 1 HEREBY CANCEL TMS TRANSMYnON. W'_ SgJ'S>.'eR"'U No— tAmtc Renewal Renewa16 Y Andersen Co'rporatioIn MA Home Improvement Contractor byAndersen.,` 30 Forbes rd Northborough:MA 01532 License#170810 (Expires 12/2312015) wrnaow REPLACEMENT , A..a,,c..,:,%%,"• (608)351.2200 Fax:(508)-986-7072 Fedarai ID#41-1918413 Window Specification Sheet BIINr,It"s NaniI, 1)atr.of Agreement. DIANE SULLIVAN SUN, MAR 15, 2015 1 he taupe((, lisrei)a1>r,��hrrrtir jtrittti}"anti*c ticra)IS�,tit€�e ttr Ixun€hu c�q.it<r ruc)s auttl t st rcttss listrxi heritsty,in atttcardanca trith dw pricc,.tutd wrens tit-scribcd Otk(lit•Spevilication Shirt and the:rmm ane)thr rt;-errsv of Ili, :tErr,rintiatFttiltt~ CUS'I'MI WINDOW AND DOOR RVA10DEI,ANG,1f:RI^.L 1I,,,N ,of whidt the Sitccifte:ititin Sheet is)aal t. WINDOW&DOOR DETAILS _ RrR r!up. Appy' ExtariUrflnirsraUr Cuter Hardv.�are i4alowlirt, LovrE4> G,ilio Grille Glass Room N .0h ne1gM U,i. WindowiDoor Style Detail Cas: Ext-Int color &t'le SE—is 5r..ar un 1111" Snste,?.!'3 Snt;h 2 Life Options Kitchen I Oil fit) 80 140 FWH INSWING DUAL PANEL Ext,MF Flat NHNJH Brt.Brass Nharnore None s nortsu 3sG 3/5 a s No Tome2r Kitchen 102 ;12 32 fi4 GW insert late L-Trim WKlWH White standard FTS smartsur cer 2'3 213 No No Total 3 w RAY O &RMIM OUT DMAILS ».».» APprox ..,... ....�....»» ._ ..... Style Detail 1 width., i Approx. Number Frame window Fad Center LewE�' Root 1 Hardware Room Count Style Ffan€wi it`ll ht Casinqu Anllse Utes listener Ex41nt Gclor Grnlos sashes sasixas Screws Srraatsun Soffit Color Dining 110 baa 1:2:1 DS.PW.013 sq 86 1 til 1 Wrap 20.28 3 Birch WHr'WH GBG 212 4/4 FTS I SmartSUn Hoof White SPECIALTY WINDOW DP.TMI S Full Approx. Lr✓v+E.' SpeClalty SAY/BOW ADDITIONAL WORK NOTES Rofinl Count Btyla ,w- inswi U.I. Srmr1Sun Gnilas. Gnila Style Extra t color ,nl 1,;,,/1,.,- i xl<n,x u,h ?i.rn 4r+ tic,%wli rv,.iRurirasas ti;Vao-tl:�'.. ADDITIONAL WORK DETAILSs No Contractor will wrap exterior casin s with coil stock color of Owner is aware that Contractor does not do any paintinq/staininq or ramavallrnstaflation of alarm system or window treatments/hardware.It is the responsihility of the homeowner to have the alarm system and window treatments/hardware removed prior to Installation. We make no guarantee as to whether alarms or window treatmentslhardwane will tit after replacement. Customer is also aware in same cases there will be glass loss. if there is,the amount will be dependent on the type of existing windows,type of installation and window style.We make no guarantee as to the amount of glass loss.Customer is aware and understands any and alt unseen rot is not included in this contract.Should any rot be found there vvdl be an additional charge for trate and materials unless so stated in this contract. Yes Contractor will insulate,caulk and seal windows with 3-point system to prevent water and air infiltration.Removal and disposal of all job related debris, windows,doors,storm windows and vacuum nightly included. Upon completion of the jib and payment in full,a limited warranty shall be issued. I Yeti Building Permit--Contractor will secure any and all necessary permits. The fee for the parmit(s)is included in the total contract price. Yes All discounts have been applied to this agreement. }c �„ Owner agrees to be present an the final day of installation for final inspection and to deliver final payment/finance form(s). �i Et is a}trc<vt rut41 tdudra•aue�d 6n Gull in�t'�+��t:ehe I)+u^lac�Iiaai dil.,;TPv�c ifec�tin;t�h,�!.,atm t:itl9 9}xe Xwt.1117\{tt`l\CtQ1C'ALU 1)Of70.`111.,AlfttthJ.1AC.AfClci I„}(ti.A h.rF mtra,tu<thr eulim �ilnitt"rsl.tl{J{Sly.',I»'F{'iV"i'.1 illi'Il:tl fn`v..krl(I Illt'3't',JiM1'Illi A4'ilwl IL^t�i£Y i Ili iikiiti f'11 Yl ti 111y,!.�7i'hSl (1tr1:IL',�tii4 t1i 911'`Lf n F. Thi, Sill vl Iml,mo 6,di;,3gs'd m Iia tA'Cii i�ti1(YI IItN.`<I flE'l'tlrlt'St 9n illlY 1t.11!1111!'*�l'.4#2 it IIY.iliit'�.il'tit"1111n�t!1(i vt.�ilt`Fl;ill"I'NI,131 lfd4 III tS C�i st13,t{-itl�t T.N.d:it. 1t1t 11;��It�Sii M:11'ki Yt'le tr•'fy"1'9I'Itf f{I+r E W ilA, iY,i<I tf kl::.`int,v'Allt.11i6tt7 zftll'Y`I. :Renewal by Andersen Corporation Buvcrc /r; 13tttaCn. Signature of Consultant Signature Signature CHRIS SWEET DIANE SULLIVAN Print Name of Consultant Print Name Print Name ........... ............. .......... -.1 1............................... 11111"..'...... Renewal by Andersen Corporation MA Home Improvement Contractor 30 Forbes rd Northborough,MA 01532 License#170810 (Expires 12123r2015) (5081,351-2200 Fax:(508)-986-7072 Federal ID#41-1918413 Provia Door Specification Sheet 11tivUr,'s)Naint, Dair(if Agrc-nwnt FDIANE SULLIVAN March I St 2015 'I'he bklycri'."'rk'lryi of lit'.ft4)Vj0iul1%:'MI(I M Wrath agwe I'A purchai't,the g(X)(h and/or sk n i(v,liwii lirlr w.lit au,.'mianov,V'iJI 010 all(l 1crill,fleo ibcd oil the Sperifit,ailon Stwer and ilie ftoni and the nAvlwof'the af,comparvyint OM WEND()!tAND D()OR RFAR)DLLING AGREEME.N 1:of whi,It the sperifivaliml Sh"e4 k tiara_ ENTRYDOOR DETAILS Width 3W, lVight fi(rl ImIal,&pth 49116 49/16 49/16 49/16 49/16 49/16 Leg 206 Oqatm'de SKI'! '106 inside Colo, CJiiitrcita OuistdcCololr isircsidelitu (')utsidv GAor Cla.%s stylv Cl(-ar Girling Nolit- MuIrAin Sintooth oixTation HRF0 Add Grille No Grille options Nolle Inside.cotor -N,mv Oiitsid,,Color None Int lock�L G,o Int rini�h Ext.kwksct G(10rkiMl EM ri.ih lbre"llold Kickplize No Matt Sot No Claddingcnlm No STORM DOORS Illoiar!;Lyle �;_(g 1 1 1 Stone Color Nl"I"Nfw I-landle.5tvie li,ndle Col.r Additional Storm wilt have glass sash also included Job Notes:, Owner is aware that Contractor does not do anypainfingistaWng orremovallinstall9tion ofalarm system and door tteatments1hardwarer.it is the responsibility of the homeowner to have the alarm systern and door treatments1hardware removed prior to installatrof r. ft make no guarantee as to whether alarms,door treatments or hardware will fit after replacement. Customer is also aware in some cases there will be glass loss. If there is,the amount will be dependent on the type of existing do=,type of installation and window style.V&make no guarantee as to the amount of glass loss.Customer is aware and understands any and all unseen not is not included in this contract.Should any rot be found them will be an additional charge for time and materials unless so stated in this contract, yc-4 Contractor will insulate,caulk and seal windows with 3-point system to prevent water and air infiltration. Removal and disposal of all 0 related debris,doom, storm doom and vacuum nightly included, Upon completion of the job and payment in full,a limited warranty shall be issued. 'i Yes Building Permit--Contractor will secure any and all necessary permits. The fee for the permiqs)is included in the total contract price. sl Yes All discounts have been applied to this agreement. N6" So (,Mint i'agrv't�lo be oil dic I'Llial day of irtstallalion for fulal irlspecdoll and to ddiver fillaf jxxgllem/fitian(;e .V)Fit tri p(qiwnOW1 be,&wwMed untif Af ro'dwel i"t(i'vj.rh Iq N thtlatpfivheal 0 eft pay ins. 11 izag"_ia.l luwlrnvgi In.Ertl lw'va'rI'thr pa'tk that Sl Mt vi,h the CUS'l 0XI t%INDON'"%N71)i)0.)R REMODIAINC'Ar,JMEMEN 1:,,wuw it, iwntwndw panix,,d flun-hCG,m imdci,oznditlp i f,tier tern- J hi, shirt n;"."o 1,�1,41"z"'d...i"'r'r mn"!in an"tm unj��+arh Changesand Cwn-aoor. ltki%rrs)wn4,y.,ckww1Mg,iax huwrs�has am it,wfitineawl�wnl"[1w math IN-Ik, thi,",p�ii%xio.Sh,,t Renewal by Andersen Corporation ffilyvrfs Buyer S� Signature of Consultant Signaft-ire Signature CHRIS SWEET DIANE SULLIVAN Print Name of Consultant Print Name Print Name PRODUCT PERFORMANCE Andersen'NFRC Cariatised Total UnPa.PerfofMaraee (canllnDed) � Mdeisea.Rroduct. Glass Type U-Factor' SHGCz VP 200 Series. Gear Dual Pane 0.45 0.60 0.63 - Gear Dual Pane with Gnlles 0.45 0.54 0.56 - TiD-Waslr - Lam-E 0.30 0.32 a55 Double-Hung-Madow- Low-E w@h Galles 030 029 0.49 m HP Lo*-E4 SmartSun 030 am 0.49 HP Law-E4 SmartSun w/Gnlles 031 0.19 0.43 Lam, Gear Dual Pane 0.45 1161 0.64 - Narmrrbe'. - Gear Dual Para:with Galles 0.45 0.54 0-57 - Doubie-Hung"Window Low-E 030 032 0.56 Lov-EwithGi les 0.31 029 0.50 7 .. Grdr Dual Pane 0.44 0-M 0.66 - . NarroGne` _ - Gear Dual Pane wish Grilles 0.44 057 0.59 - Ttansom Window Lmv_E 027 D.34 0.58 Limy-E with Grilles 027 030 0.52 Gear Dual Pane 0.45 0.60 0.63 - - Gear Dual Pane wHh Grilles 0.45 054 056 - - Low-E 0.30 0-32 0.55 Gliding Window Law-E with Gniles 0.30 0-29 0.49 Lmv-E SmartSan 030 021 0.49 + Lawes SmanSun with Grilles 0.31 019 0.43 Gear Dual Pane 0.43 0.61 0.65 - Gear Dual Pane with Grilles 0.43 O.S. '' 056 Fa ad Tratmum;.� Law-E 028 033 0.56 CiM.Top'Wlnd'm Low-E with Grilles 028 030 050 Law-E Smattsun 027 022 0.51 Low{SmartSun with Groes 027 020 0.45 Gear Dual Pane 0,44 0.61 0.64 - Gear Dual Pane wrlh Grilles 0.45 0.53 056 - - Low-E 029 C 32 0.56 - NarmGm' _ LmwE adhQ les 0.30 029 0.49 arudmg Patio Boars Lmv-E San 029 020 031 Low-E Sun wdh Gilles 0.31 0.18 027, y low-E SmartSun 028 02.1 0.50 Low-E SmartSun vft Grilles 030 0.19 0.44 Gear Dual Pane 0.43 0.61 0.64 - Clew Dual Pane with Galles 0.43 054 0.56 - Lmv-E 028 0.32 0.56 - :.Perms-Shield'..-. Low-E whh Grilles 030 029 0.49 .y Grtd'mg Patio Doors Low-E Sun 029 0.19 0.30 - Law-E Sun with Gi ies 030 0.17 027 .. , Low-ESmartsun 027 012 050 Law-E SmartSun with Grilles 029 019 0.44 " Gear Dual Pane 0.43 0.45 0.47 - Gear Dual Pane with Gnlles 0.43 039 0-40 - Law-E 0.32 C 24 0.41 .M,"Jaswing Low-E with Grilles 033 021 035 - M-8 Boom 1 Low-E Sun 032 015 023 M M 0 Lm-E Sun with Grilles 034 0.13 0.19 - Low-ESr®rtsun 032 016 0.37 Low-E SmartSun with Gnites 0.33 0-14 0.31 - ve t erW INDO WS•DO ONS - � And sem } Andersen'NFRC Certified Total Unit Performance (continued) ( . Andersen'Product ' Glass Type U-Factor' i SHGCz V1' i- r a Andersen'Product Glass Type U-Factor' SHGCz VP I r a� ' 'Architectural. ; 400 Series HP low-E4 032 028 0.47 HP Low-E4. 0.27 035 0.60 HP low-E4 wdih Grilles 028 031 0.54 HP law-E4 enth-Galles 0.32 025 0.42 'i -E Low-E4 G Sun 027 021 0.33 �� HP Low-E4 Sun 032 0.17 026 !�� �•�; Circle Top Casemern Window HP lmv-E4 Sun with Galles 032 0.16 0.23 Casement Window HP Low-E4 Sun with Grilles 0.29 0.19 030 Hp tnv-E4 SmartSun 031 0-18 0.42 '.i >:•r HP law-E4 SmartSun 0.26 023 0.54 !"? F11 HP Low-E4 SmartSun w/Grilles 0.31 0.17 0.38 HP low-E4 SmadSun w/Grilles 028 021 0.49 : HP Law-E4 032 028 0.47 HP law-E4 021 035 0.60 - HPLow-E4whth Gnlies 0.28 031 0.54 HP Low-E4 with Grilles 032 025 0.42 HP Law-E4 Sun 032 0.17 026 HP law-E4 Sun 0.27 021 0.33 T,. - Frenum Casementk Circle&Oval Window9 0.30 .� Wmdm r HP Low-E4 Sun with Grilles 032 0.16 023 HP Imr-EM1 Sun with Grilles 029 0.1 HP 4 Sun SmanSe026 023 0.54 �''. �`S HP Law-E4 SmarlSuo 031 0.18 0.42 ' F1_ ? a IIP Low-E4 SmartSim w/Galles .031 0.17 0.38 HP tux-E4 SmartSun w/Galles 0.28 0.21 0.49 - HP Low-114 032 028 0.47 r'I HP Low-E4 028 0-33 0.58 t.1 HP law-E4 with Grilles 0-29 030 0.52law-E4 with Gnks 032 025 0.42 '1,7' HP Law-E4 Sun 0.28 020 031 (: � HP Low-E4 Sun 032 0.17 026 Arch Window Arming Window HP Low-E4 Sun with Galles 032 0.16 0.23 HP Low-E4 Sun with Grilles 029 0.18 028 -i HP Low{4 Sorenson 031 0.18 OA2 HP Low-E4 SmartSun 027 023 0.52 HP Law-E4 SmartSun w/Galles 028 021 0.46 -.;[; HP Low-E4 SmartSun w/Gnlles 031 0.17 0.38 E' HP law{4 031 032 0.55 i HP Low-1140.27 033 0.58 !.3 029 0.49 !.,I - HP law-E4 with Galles 0.31 tip law-E4 with Galles 028 0.30 0.52 s HP law-E4 Sun 031 020 031 r� HP law-E4 Sun 027 020 0.31 t� i' Casemert/Awaft FlexHrame Window HP lour-E4 Sun with Grilles 029 0.18 0.28 i Window HP Low-E4 Sun with Grilles 031 0.18 HP low-E4 Smart4un 031 021 HP law-E4 simetSun 0.26 023 0.52 FA Hp Low-E4 SmanSun w/Gnlies 031 0-19 0.44 fes. HP Law-E4 SmadSun w/Grilles 028 021 0.46 �'1 HP Low-E4 03D HP Law-E4 0-31 033 0.58 HP low-E4 with Galles 0.30 033 0.57 .i HP law-E4 with Grilles 032 030 0.52 Low-E4 Sun 031 020 031F _ HP Low-E4 Sun 0.31 022 038 lip Low `.�i E a Specialty window Hp Low-154 Sun vffih Galles 031 020 0.32 Spangline Window Hp�v{4 Sun with Ghilies 033 0.18 028 ' HP Low-E4 Smar[Sun 030 023 052 :'� F)'; HP tow{4 SmarlSun 0.30 024 0.58 �'�. %:.L1 , lip Low-E4 SmartSun Low-E n vi/Grilles 032 021 0.46 C �C'3 HP low-E4 SmartSun w/Galles 030 022 052 E !'•' HP Law-E4 0.32 022 037 F i Ell HP taw-E4 0.30 027 0.45r^i - _ 0 HP Imr{4 with Grilles 33 020 0.33 .1 HP Low-E4 with Galles 0.32 023 0.39 s•� - HP�f{4 Sun 033 0-14 0.21 re d - HP low-E4 Sun 031 0.16 02Reach 5 !�'l. '' eMooring hwoo � renhih pow HP taw-E4 Sun with 6nlles 034 0.13 0.18 Olihting Patio Door HP luw-E4 Sun with Galles 0.32 0.14 022 lip Low-FA SmanSun 032 0-15 0.33 i-;� i ELI tip low-E4 SmartSun 0.30 0.18 0.41 Vl HP law-E4 Sorenson w/Wes 0.33 0-14 0.30 - i HP low-E4 SmartSun w/Gilles 0.31 016 0.35 -' HP law-E4 033 025 0.41 HP Imr-E4 0.31 024 0.41 „r.;� 'i �a HP lmv-C4 with 6nlles 034 022 03 _6 m j HP low-E4 wGalles 0.32 021 0.35 with HP Low-E4 Sun 0.33 0.16 0.23 o HP luw-E4 Sun 031 0.15 023 ,.K j +� Hinged Outming _ da Frenchwood'Hinged m. r" French Door HP Law-E4 Sun with Galles 035 0.14 020 Inswing Patio Dow HP Low-E4 Sun with Grilles 0.32 0.13 0.19 ! lip luw-E4 SmartSun 032 017 037 i' HP Law-E4 SmartSun 030 0.16 0.37 t - r - - HP low-E4 SmarlSuo w/Gnlles 0.34 0.15 0.32 E'�o HP Low-E4 SmartSun w/Gif ies 0.31 0.14 0.31 F HP tow-E4 033 023 HP law-E4 031 025 0.41 - Hp�v{4 with 6d9� 0.33 021 034 - HP taw-E4 with Galles 0.32 021 0350 ' - HP�v{4 Sun 033 0.14 021 - Frencrawd'Hinged'. ' HP low-E4 Sun 0.31 0.15 023 iia Foxed French.Dow- _ ,, SMetigM HP law-E4 Sun vnth Grilles 0.34 0-13 0.19 oulswing Patio Door I HP Law-E4 Sun with Galles 0.32 0.13 0.19 ''w lip Low-E4 SmaitSun 032 0-15 034 - HP low-E4 SmadSun 030 0.17----6.37 Hp Low-E4 sman Sun w/Gdlles 033 0.14 030 - HP torr{4 SmartSun w/Grilles 031 015 0.31 'a ! ?1 HP Iaw-E4 032 025 0.41 - HP Law-Ell 0.31 022 037 - HP Low-E4 with Galles 033 0?2 0.37 HP Low-E4 with Grilles 0.32 020 0.33 Hp 1pa{4 Sun 032 0.15 0.23 - HP low-E4 Sun 0.32 0-14 021 r^''• Feed Transom Ff _ enchwooT: t French Door HP Low-E4 Sun with Galles 033 0-14 020 Patio Door$idefight HP Lmw-E4 Sun with Galles 0.32 0.13 0.18 ; ` '� i Hp Lmv{4 Sorenson 032 0.16 037 - HP Low-E4 SmartSun 0.31 0.15 0.33 r1 `-F7 - HP Imo-E4 SmadSun w/Grilles 032 0.15 033 _ HP i.mr-E4 SmartSun w/Galles 0.3Z 014 029 HP Low-E4 035 026 0.44 - HP Low-E4 0.30 024 0.40 ' HP Low-E4 with Galles 036 0.23 038 - HP law-E4 withGdlles 030 021 0.35 -')`' HP LavtE4 Sun 0.35 0-16 024 - Frenchwautr HP lmv-E4 Sun 030 0.15 0.22 '� Folding Dow r� F? HP tun-E4 Sun vnth Galles 036 0.14 021 - Low-E4 Patio Door Transom IIP Sun with Galles 0.31 0.13 0.20 Hp lmr-E4 SmartSun 034 0-17 0.39 - HP Low-E4 Small&- 0.29 0-16 0-36 �� `F Hp lmr_E4 Smartshm w/Galles 036 0.15 034 - HP tmr-E4 Snu ZS,w/Galles 030 0.14 0.32 '-1 F3 continued on net page • For NFRC certified total unit performance on units with capillary breather tubes for high altitudes,please visit andersenwinduws.com. "High-Performance"Low-E4"(HP Low-E4) -Performance"Low-E4'smartSun"`(HP Low-E4 SmartSun)and'High-Performance Low-E4'Sun'(tip Low-E4 Sun)are Andersen trademarks for'Low-E"glass. ' 11-Factor defines the amount of heat loss through the total unit in 8TU/hr sq-MIR The lower the value,the less heat is lost through the entre product Window values represent non-tempered glass.Use of tempered glass can increase U-Factor ratings.See andersenwindows.com for specific performance values.Doarvalues represent glass- 'Solar HeatGain Coefficient(SHGC)defines the fraction of solar radiation admitted Uhmugh the glass both directly transmitted and absorbed and subsequently released inward_The lower the value,the tens heat is transmitted through the product 'Visible Transmittance(VT)measures how much light comes thmugh a product(glass and frame).The higher the value,from 0 to 1,the more daylightthe product lets in over the produM's total unit area.VisileTransmhltance is measured over the 380 to 760 nanometer porton of the solaf spectrum. •NFRC ratings are based on modeling by a third party agency as validated by an independent test tab in compliances aria ds or requirements procedural data unayrchange over time.Ratings are for sizes specified by NFRC for •This data is accurate as of December 2010.Due to ongoing product changes,updated test results or new industry , testing and certification.Ratings may vary depending on use of tempered glass,different grille options,glass for high altitudes,etc •PassiveSun glass values are available online at andersenwindows.com. 277 a ' On old remove opt➢fnd code hgadm.soup lehd terrine Idemm aI c I � ti...eva e •a I ul �' `e � fpr E � i 4 ''1LS,-f#� .—P -� fa�oi.nMar�amr� i l i Renewal. AND-N-35 WoodMnyl Ca %FF Dud Argon Low-E4 SmarfSun j ' PmductType, Glider ENERGY PERFORMANCE RATINGS U Fader Solar Heat Gain Cwffldent 0:29 : 1.65 0.21 .S.&P etrlrAl ADDRIONAL PERFORMANCE RATINGS Vlelble.T.nemittanee 0.49 MUMI on: 3mfldert! Rem �' NlPf eirANMVNeMYd1MUt]!MO ••DP psi}iEIM- , I t ' tao•ao51aD3s-a16 � � - I i ' II L 11 The Commonwealth of Massachusetts Department of Industrial Accidents b Office of Investigations d 1 Congress Street, Suite 100 ,= Boston,MA 02114-2017 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): RENEWAL BY ANDERSEN Address:30 FORBES ROAD City/State/Zip: NORTHBORO, MA 01532 Phone #:508-351-2200 Are you an employer? Check the appropriate box: Type of project(required): 1.9 I am a employer with 30 4. ❑ 1 am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6 E]New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. R Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. employees and have workers' insurance.$ 9• ❑ Building addition comp.[No workers' comp. insurance P• required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3. I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.0 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. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees Below is the policy and job site information. Insurance Company Name:OLD REPUBLIC INS. CO. Policy#or Self-ins. Lic. #:MWC11111,514, 3�,00293800 Expiration Date: 10/01/15 Job Site Address:_�& `J// s1�2 l�j� City/State/Zip:WO �>d lie'? 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 rtify der the pains andpenalties ofperjury that the information provided above is true and correct: Si ature Date: _w "/0�1 Pho #• 08-351-2200 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#: ANDECOR-01 YADAVYO CERTIFICATE OF LIABILITY INSURANCE ffDATEIMMIDIN"M ,011/20 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE OLDER.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 pollcy(les)must be endorsed. N 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). PRODUCER Wily of Minnesota,Inc. cT c�ertificatos@willls.com CID 26 Century Blvd IM a :(877)946.7378 P.O.Box 305191 AIC No:(888)467-2378 Nashville,TN 37230-5191 AODREss: INSU S --DING COVERAGE NAZCA INSURERA:OId Republic Insurance Compan 24147 INSURED INSURER B: Renewal by Andersen Corporation INSURER c 30 Forbes Road INSURER D Northborough,MA 01532 NSURER 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 NTH 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE POLICY NUMBER — A X COMMERCIAL GENERAL UAWLnY LIMITS EACH OCCURRENCE E 1,000,00 CLAIMS-MADE 0 OCCUR 302940 10/01/2014 10/01/2015 PREMISES Ea $ 500, MED EXP(Any one person $ 10,00 --— PERSONAL&ADV INJURY S 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: JECTT LOC X POLICY F-1GENERALAGGREGATE S 4,000,00 PRODUCTS-COMP/OPAGG $ 4,000,00 OTHER: AUTOMOBILE LIABILITY S a accMerDit I G S 5,000,00 A X ANY AUTO 302575 10/01/2014 10/01/2015 BODILY INJURY(Per person) $ AL AUTOS ED SSCHEDULED AUTOS BODILY INJURY(Per embW) S HIREDAUTOS AUTOS ED 7- ROAM MAGE $ UMBRELLA A LIABJOCCUR $ EACH OCCURRENCE $ EXCESS UAB CLAIMS�AADE AGGREGATE $ DED RETENTION WORKERS COMPENSATION ER OT $ A PRE OPRIEETTOR ARTNERIEXECUT VE YIN C30293800 10/01/2014 10/01/2015 IABILITY X STATI>rE ER OFFICEP AEMBER EXCLUDED? N❑N I A E.L.EACH ACCIDENT $ 1,000, My�ea desaRrendalayMNnd under E.L.DISEASE-EA EMPLOYE $ 1,000, DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,AddWDml Remarks Schedule,may be attached K moee apace b:repulred) 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 ACORD 25(2014101) The ACORD name and I ©1988-2014 ACORD CORPORATION. All rights reserved, ogo are registered marks of ACORD } Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supen-isor License: CS4MI25 JAIME L MORIN ' 86 GARDINER ST sz I LYNN MA 01901-F Expiration Commissioner 10/06/2016 — (92- ipairvmo--- o�C�/�ataaofivael � i ffice of Consumer Affairs&Business Regulation OME IMPROVEMENT CONTRACTOR Registration: .170810 Type. fxplration: 12123!2015 ' Supplement�. ., RENEWAL BY ANDERSONCORPORATION r JAIME MORIN 104 OTIS STREET NORTHBOROUGH,MA 01532 Undersecretary ` Z1, I �.