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HomeMy WebLinkAboutMiscellaneous - 89 BEAR HILL ROAD 4/30/2018N Location No. /%sem' 0 / Z Date NORTh TOWN OF NORTH ANDOVER 9 Certificate of Occupancy $ J.CMustt� Building/Frame Permit Fee $ A 5' - :E -Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 76 2 4 5 2, 6 wilding Inspector TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: 175—R61 -z, Issued: R/31 11 Date Received IMPORTANT: Applicant must complete all items on this Daae 1 LOCATION Print MAP NO:�PARCEL:5�) 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 ❑ Alter tion No. of units: ❑ Commercial P-ge`pair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition El Other i®S pticWe1;� (DFlooclplau i®°Wetlands3'`0 WatersledlD ict' Water/,Sewer: i DESCRIPTION OF WORK TO BE PERFORMED: IAC° I V oc) Identification Please Type or Print Clearly) G OWNER: Name: K.CC �``� �= C� h lh Phone: Address: ? q &A:Y ti i I � ku�,) CONTRACTOR Name: Address: i nim ISS Phone: Scq-OZ I –O K6 Supervisor's Construction License: U Exp. Date: Home Improvement License: - C 4eol 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: $ �� �`�'. 06 ���. a1`�, Ge FEE: $ o2S�Sr— Check No.:s Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the giLarantyfund �Sin'nafurP Pn a �. Sianafiare of:eorifractor-'. sa_- - C04f4vps-c� 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 VOTE: 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 :hat the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording ]lust be submitted with the building application Doc: Doc.Building Permit Revised 2008mi Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑Swimming Art ❑ Pools El 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 COMMENTS CONSERVATION COMMENTS HEALTH COMMENTS DATE REJECTED u DATE APPROVED 11 Reviewed on Siqnature Reviewed on Signature Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Conservation Decision: Comme Comments Water & Sewer Connection/Signature & Date Driveway Permit DPW Town Engineer: Signature: FIRE DEPARTMENT - Temp Dumpster on site yes. Located at 124 Main Street Fire Department signature/date COMMENTS Located 384 Osgood Street no 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 El Notified for pickup - Date Doc:.Building Permit Revised 2008 O z V O co O O z CL o CO) � C co Om C C V2 G 'a c y c m m CD L- I.- = 3� co C* CD _cc o a CL c< CM CcCOD c C z Q. CD CL Q C.3 y � C C LLI U) U) ceW W it LLIW C4 c y- o m C t�G : o 0 C ` O H ° C c O V C3 CLC W W � L x z _ +• U W W a o a O F' ow CD a 0 0 p m c E � �mm Cc N MI m3 Q' .tic mca O . CAy O O Cr 'E y CD . a w aC.3 m A z Z u COL C o o� m v a Cc: V' .�. O O.O Cf C u OM L m W t •y MD O O �... ac "E h_I Z O O ,cc W �Uy ,1C � a fd G a C y o =*-a,m� I--1 '\O .Z W G 'ono m a a is W �°° C to ro G, o O v O O ..0 q p G p � G O G � �. w U) w C2 U x n: w w U) w w tt� cn cf), V O co O O z CL o CO) � C co Om C C V2 G 'a c y c m m CD L- I.- = 3� co C* CD _cc o a CL c< CM CcCOD c C z Q. CD CL Q C.3 y � C C LLI U) U) ceW W it LLIW C4 c y- o m C : o 0 C ` O H C c O V C3 CLC W W � L _ +• o a ow CD 0 0 p m c E � �mm Cc N MI m3 Q' .tic mca m . CAy O O Cr 'E y CD . a aC.3 m cm COL C o o� m : f0.1 O 'p V' .�. O O.O Cf C m W t •y MD O O �... ac "E CZ C v 43; .y Z O v LLI ,cc Im o ,0 C: N� a :2 CD ; = Q C y o =*-a,m� V O co O O z CL o CO) � C co Om C C V2 G 'a c y c m m CD L- I.- = 3� co C* CD _cc o a CL c< CM CcCOD c C z Q. CD CL Q C.3 y � C C LLI U) U) ceW W it LLIW C4 14 Otis St., Northborough, MA 01532 J&L ININDONIS, INC., D/B/A MA Home Improvement Contractor 508) 919-0900 • Fax: (774) 987-3013 r Renewal��.� License #149601 (Expires 1/24/2012) Andersen. - Federal Tax ID #83-0404201 I WINDOW REPLACEMENT an Md—Company CUSTOM WINDOW AND DOOR REMODELING AGREEMENT yerlsl Name Date of Agreempnt qG yerlsl Street Address, City, State, and Zip Code li�--I /� QA- 1q, I, fid A 40&1e%— (J t k"g Aoil Address Home Telephone Number Work Telephone Number ri --� C--? / nI tyer(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 ecification sheet(s) (collectively, this "Agreement'1. Buyer(s) hereby agrees to sign a completion certificate after Contractor has completed I work under this Agreement. ai Total Job Amount: t; Deposit Received (33%): (6 / q, Balance at Start of Job (33%):K Balance on Substantial G j 1 /. �f Completion of Job (33%): 'r/ aK' Estim fed Starting -Date: Estimated Completion Date: Method of Payment: ❑Check Q�redit Card ❑Cash ❑Financed If payment is by Credit Card, please fill out the Credit Card Receipt of Deposit Form By signing this agreement, you acknowledge that the Balance at Start of Job and the Balance on Substantial Completion of Job cannot be made by credit card and must be made by personal check, bank check, or cash. nyer(s) agrees and understands that this Agreement constitutes the entire understanding between the parties, and that .ere are no verbal understandings changing or modifying any of the terms of this Agreement. No alteration to or deviation am this Agreement will be valid without the signed, written consent of both Buyer(s) and Contractor. Buyer(s) hereby :knowledges that Buyer(s) 1) has read this Agreement, understands the terms of this Agreement, and has received a Impleted, signed, and dated copy of this Agreement, including the two attached Notices of Cancellation, on the date first ritten above and 2) was orally informed of Buyer's right to cancel this Agreement. DO NOT SIGN THIS CONTRACT IF EiER.E ARE ANY BLANK SPACES. & L Windows, Inc. d/b/a Renewal by Andersen Signature 9f rodq Manager �� ��CO.U� Print Name of Product Manager Buyer Signature �0-� r04 Print Name Buyer(s) Signature 1'4%; Arr� Print Name 3U, THE BUYER(S), MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD JSINESS DAY AFTER THE DATE OF THIS TRANSACTION. SEE THE ATTACHED NOTICE OF CANCELLATION FORMS )R AN EXPLANATION OF THIS RIGHT. — — — — — — — — — — — — — — —�c- — — — — — -�1<— — — — — — — — — — — — — — — NOTICE F ANCELL . TION X NOTICE .OF ANCELLATION ate of Transaction l You may cancel I Date of Transaction b You may cancel its transaction, witho a i penalty or obligation, within this transaction, withou an/y' penalor obligation, within ree business days from the above date. If you cancel, any three business days from the above date. If you cancel, any roperty traded in, any payments made by you under the property traded in, any payments made by you under the mtract of Sale, and any negotiable instrument executed I Contract of Sale, and any negotiable instrument executed r you will be resumed within 10 days following receipt I by you will be returned within 10 days following receipt Y the Contractor ("Seller") of your cancellation notice, by the Contractor ("Seller") of your cancellation notice, ad any security interest arising out of the transaction will and any security interest arising out of the transaction will canceled. If you cancel, you must make available to the be canceled. If you cancel, you must make available to the :Iter at your residence, in substantially as good condition Seller at your residence, in substantially as good condition s when received, any goods delivered to you under as when received, any goods delivered to you under this its Contract or Sale; oryou may, if you wish, comply I Contract or Sale; or you may, if you wish, comply with the 'ith the instructions of the Seller regarding the return instructions of the Seller regarding the return shipment of tipment of the goods at the Seller's expense and risk, i the goods at the Seller's expense and risk. If you do make yo_ d7 make the goods available to the Seller and the I the goods aeailah!e tc the Seller ama tl:-- Se!ler does not Aer does not pick them up within 20 days .of the date pick them uta within 20 days of the date of your Notice your Notice of Cancellation, you may retain or dispose of Cancellation, you may retain or dispose of the goods the goods without an further obligation. If you fail to without any further obligation. If you fail to make the lake the goods available to the Seller, or ifou agree I goods available to the Seller, or if you agree to return the return the goods to the Seller and fail to do so, then I clods to the Seller and fail to do so, then you remain liable au remain liable for performance of all obligation under for performance of all obligations under the Contract. to Contract. To cancel this transaction, mail or deliver a I To cancel this transaction, mail or deliver a signed and tned and dated copy of this cancellation notice or any I dated copy of this cancellation notice or any other written er written notice, or send a telegram to Contractor. J notice, or send a telegram to Contractor. J & L Windows, L Windows, Inc. d/b/a Renewal by Andersen, 104 Otis Inc, d/b/a Renewal by Andersen, 104 Otis Street, rest, Northborou h, 01532, BY NOT LATER THAN North ug jMA `3�,�6; NOT LATER THAN MIDNIGHT iIDNIGHT OF - . (Date) OF AEREBY CANCEf TH( TRANSACTION. i I HERE6Y CKWELL EL THIS TRANSACTION. Buyer's Signature Print Name Date Buyer's Signature Print Name Date RbA Copy - White Buyer Copy - Yellow Buyer Copy - Pink I, 104 Otis Street, Northborough, MA 01532 "—'` J & L Windows, Inc. d/b/a � MA HIC License # ] 49601 (expires 1/24/12) Phone 508.919.0900 • Fax 774.957.3013 Renewal Federal Tax ID# 83-0404201 byAndersen. • WINDOW REPLACEMENT —Ando Comp.M OF GREATER MAssAcHusErrs Arm NEw HAn rmw WINDOW SPECIFICATION SHEET (yer(s) Name Date of Asreement l /C 6,014 f d{ The Buyer(s) listed above hereby jointly and severally agree to purchase the goods and/or services listed Belo , in Ycordance 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 quantities: Double Hung (DB) 'N 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 _L 2 Lite GIiding 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. ipa Yes ❑ No Qty of Windows to be Custom Fit Replace m t: % L) 3. 54 Yes El No Qty of Sills to be replaced by Contractor: 4. ❑ Yes Q No Qty of Windows to be New Construction Full frame (includes new interior & exterior casings) and actual Exterior casings: ❑ Pine ❑ Maintenance -free material ❑ Factory applied 908 Fibrex brickmold 5. Glazing to be: M HP Low- E-4 Tm er If other, please specify: 6. Exterior color to be: ❑ White ❑ San Ca ❑ Terratone ocoa Bean 7. Interior color to be: E] White ❑ San d Canvas ❑ Terraton� Maple ❑ Oak Note: Interior co]�on only be white, wood or same color as ex error. Wood interiors need to finished by Owner. S. Hardware: ❑ White Aj Sto ❑ Canvas ❑ Brass ❑Estate Hardware: Style: 9. ❑ Yes Pn-No Install Lifts with Double Hung Windows 10. Screens: windows to have: ❑ Half or E� Full screens Screens to: �Fibergls uminum ❑ TruScene GRMU DEFAIIS 11. Windows have grilles: ❑ Yesg No If yes: ❑ Grille Between Glass (GBG) ❑ Removable Interior Wood (iN w) ❑ Full Divided Light (Fogy) Qty Qt' Qty Qty Qty: Qty Qty: -1 [EDHIE DH CW/Pic¢ire Glider CPW orG Draw grille patterns above `Use additional sheet if needed Owner approved (initials): ( ) ADDITIONAL WORK DETAILS 12. ❑ Yes No 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 P No Contractor will install new paint -ready or stain -ready inside or outside stops qty of openings: Interior stops qty of openings: Exterior stops qty f openings: ❑ Pine ❑ Maintenance -free material 15. Owner is aware that Contractor does not do any painting. Owner Initials 16. ❑ Yes W No Contractor will wrap exterior casings with alummil stock of color. Note: Wrapping may be required with storm window removal; removal of storm windows will leave screw holes in casing. 17. ® Yes ❑ No Contractor will insulate, caulk and seal windows with 3 -point system to prevent water and air infiltration. 18. [j� Yes ❑ No Clean up all job related debris including old windows will be removed. Vacuum nightly. 19. ® Yes ❑ No A limited warranty shall be issued to Owner upon completion of the job and payment in full. 20. �f Yes ❑ No hAflding 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. 21.�f Yes ❑ No All discounts h een applied to this agreement p,e. 22. Additional job details: C V 23. VYes ❑ No Owner agrees to be present on the final day of installation for final inspection and to deliver final payment. V final payment shall be demanded until the contract is completed to the satisfaction ofall partles. 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 m writing and signed by both the Buyer(s) and Contractor. Buyer(s) hereby ackqAofication SheeL Renewal newall by Andersen of Greater MA and NHJu Mes) (� SignatAA ure of Product Manager Signature r,g � � < tii@i �'0 /-"C- i la Print Name of Product Manager Print Name Print Name MA License # 149601 (expires 1/24/12) enewa ` ' � RENEWAL BY ANDERSEN Federal Tax ID# 83-0404201 byAndersenr OF GREATER MASSACHUSETTS AND NEW HAMPSHIRE WINDOW REPLACEMENT m:\edcrvnGanpa:•v 104 Otis Street • Northborou ft, Massachusetts 01532 Phone 508.919.0900 • Fax 774.987.3013 COMMACF AMENDNRNT This Amendment (`Amendment') is to the CUSTOM WINDOW AND DOOR REMODELING AGREEMENT ("Agreement") by and between J&L Windows, Inc. dba Renewal by Andersen of Greater Massachusetts and New Hampshire and PATTI FORD ("buyers"). Contractor and Buyer(s) hereby agree to amend and modify the Agreement as indicated below. Other than as specifically indicated below, all the terms and conditions of the Agreement will remain in full force and effect. This Amendment is subject to the terms and conditions of the Agreement. The following ad- ditions, alterations, or deletions to the products and services Buyer(s) ordered are being made: ADD (1) WINDOW UNIT IN BEDROOM TO EXISTING CONTRACT $1358 As a result of these changes, the following terms of the Agreement are also changing (if there is no change, an item will be left blank or marked as "N/A", indicating that no change applies: Total Job Amount: $21217.00 New Estimated Starting Date: Method of V Cash ✓ Check ❑ Mastercard Payment: New Deposit Received (33%): $6619.00 RECEIVED ❑ Visa ❑ Discover ❑ Financed ,NEW Balance at Start of $7299.00 Job (33%): CUSTOMER New Estimated Completion Date: NEW Balance on Substan- tial $7299.00 Completion of Job (33%): CUSTOMER By signing this contract amendment, you acknowledge that the Balance at Start of Job and the Balance on Substantial Completion of Job cannot be made by credit card and must be made by personal check, bank check, or cash. It is agreed and understood by and between the parties that this Amendment and the original Agreement constitute the entire understanding between the parties, and there are no verbal understandings changing or modifying any of the teens of this Amendment. Buyer(s) hereby acknowledges that Buyer(s) has read this Amendment and has received a completed, signed, and dated copy of this Amendment on the date written below. Renewal by Andersen of Greater MA and NH By: Signature of Product Manager BRIAN JACQUES Print Name of Product Manager Doc ID: 20110623124617746 Sertifi Electronic Signature Buyer(s) E -Signed s V27120I1 8.03:00 p^1 CST Patti Ford rphFaordiaw.net IN 24.147 ?25.230 Signature 6/27/2011 — Date J/ Date D / i L� Y The Commoaweai h ofhfassachusetts Departtmnt of Industrid Accidents Office of Investigations 600 F 411ington Street Boston, MIA 92111 . UT. .. wit".mass.govldia . Workert' Compensation Insl�rznee Affidavit' Buifders'ContractorslLl Pl�s Psr ut�bt _A Iieanf InformafZan ' Led Name (Business/0gmnizada,nRndividuaD: J) e IJ c�'y Anol ars Yl awstate 1p: Ar !A bo r-0, r d dLML PhD= Are you sa employer? Check the appropriate bar. ' 1. Erj am a employer whir �3 D 4. ❑ T am a germ contractor end I employees (fnlf and/or part-time),* haw himd the sub -contractors listed on 60 attached sheet t 2, [] I am a sole proprietor or partner- 7=r.ma -cont =tors havo ship and have no omployees working for me in day capacity. . WML-=' Comp. rBt'iarBace. [No workers' comp. insar oo 5. ❑ We arra a aerporafion and its off>cen bave c=-aisod their. �) , 3:E] I � quirra homeowner doing an work of ezampd# per MGL ' c 152, x.1(4), and we bave no - myself [Na workes8' comp. insuraMD0 t au�ioyeos.. Ro warian' roquired.] ca= las mnee requismd.] Tppe of project (required): 6. ❑ New construction Z: deiiag B. Dcolition 9. BdIding addition 10.[] $loCtrical cepa= or addific . 11.❑ Rlumbing repairs or additions 12.0 Roof ropairs i3.M osier *Amy smIi= ft 6cZ bot iFl mast also fiII ort the section briar sbowiagffiea wodass' compeasafian pn5ey ia%stiois t $omeowaan who submit *a aff davit md'mtMg *4 = d=g ink and fikm hay est submit a nm aindgvk iadicsiiae anrh. oahtetoa that chest tbu bas mnct eCached as addifiamnl sheet sloaRnne $�e acme of ibc cub-ao�ct�s and $ec was' comp Policy infnmudion law art entploper that is pros leMN, workara' compendon imsurartce for my employees Below..ia the policy'znd job site information. insurance Company Name: Policy # orr` F�piratioa Date: lob Site Address: caty/st�erLip: iU Attach a copy of the wrkers' corrtpeasation policy declaration pave (showing the policy mmiber and erpiratiaa date). FWI= to secure covorage as regnimd under Section 25A of MGL c.152 can. lead to tiu imposition W criminal penalties of i fin 5ne up -to $1,500.00 and/or one-year imprisonment, ss well as civil penalties in & fame •of a STOP WORK ORDER and a e -of up to 5250.00 a day against tim violator. Be advised that a copy of this statement may bo forwarded to tbL Qffice of Investigations of toe DIA for imn=0 coverage vmif mtian. I doherby u r the paints and pma:was�f perjury that the information prodded above ' trrc/e.and correct IF) f/�- 0y O{ftcial use only. Do not write in this area, to be completed by city or town official City or Tom Permit2icense # Issuing Axthority (circle one): L Board of Health 2. BmIdiag Dep$rtment 3. elty/Town. Clerk 4. Mectrical Inspector S. Plumbin; Impectnr 6. Other Contact Person: Phone #: Massachusety, - Depai-tment cif' Public SafetN Boardfof Building Re,-,ulations and Stan (l.tr(Is Construction Supervisor License License: CS 95707 BRIAN DENNISON 86 CREST CIRCLE WORCESTER, MA 01603 Expiration: 9/8/2012 ('uumissi„nrr Tr-.-: 2622 ;. Office of Consumer Affairs & Business Regulation Al HOME IM.PROVEEMENT CONTRACTOR T. Regfs&atio $01 EzPi�-12 2 t Card .. RENEWAL BY BRIAN DENNIS ai 104 OTIS STREE NORTHBOROUGH;'MTa32 Undersecretary '4 CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DONY" GENERAL LIABILITY 02/09/2011 .THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING 'INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER Joseph McKeone JP McKeone Insurance Agency, Inc. P.O. Box 333 CONTACT NAME-- FA ! 734-662-8100 AIC No: E-Ma� ADDRESS: _ INSURER(S) AFFORDING COVERAGE NAIC#I Ann Arbor, MI 48106-0333 INSURER A: Hartford Insurance Com an INSURED J&L Windows, Inc. Renewal by Andersen INSURER B: Nautilus 104 Otis St. Northborough, MA 01532 INSURER C-: ' INSURER D: INSURER E: • INSURER F renveo Anew _—_--•— _-- _ -- ---- nnr�.�Ivn nulvloan: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS 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. INSR LTR TYPE OF INSURANCE INSRD SVMD POLICYNUMBERPM/LII Y E MM UCY - LIMITS B GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 COMMERCIAL GENERAL LIABILITY CLAIMS -MADE © OCCUR NC958461 10/01/2010 10/01/2011 DAMAG PREMISES Ea occurrence $ 100.00 MED EXP (Any one person) $ 5 000 PERSONAL & ADV INJURY $ 1.000,000 GENERAL AGGREGATE $ 2,000,000 . GEN'L AGGREGATE LIMIT APPLIES PER POLICY PRO- LOC PRODUCTS -COMP/OP AGG $ 2 OOO DOO S A AUTOMOBILE X LIABILnY ANY AUTO AAU OS NED SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS 35MCCXD6390 10/01/2010 10/01/2011 EO eBBII1NdE�D SINGLE LIMIT (Ea 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per acclde $ UMBRELLA LIA EXCESS LIAB OCCUR CLAIMS -MADE I EACH OCCURRENCE $ AGGREGATE $ DED RETENTION le AND EMPLOYERS' LUU3ILITY WORKERS COMPENSATION Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE EXCLUDED? ❑ Mandatory in NH) If yes, describe under DESCRIPTION OF OPERAi10NS below $ WC STAN OTH- A N / A 35 WECPP1444 02/17/2011 02/17/2012 I EL EACH ACCIDENT $ QQQ E.L.SQQ DISEASE - EA EMPLOYEE S 500,000 EL DISEASE • POLICY LIMIT le 500,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) r1FI7TI9:IPATc unI n=e INSURED COPY 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 �w INCSO-GUIU AL:UKU C:UHPUHA_n0N. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD •L�'�sl� [1� IFF • • —J2 it i� Raw • tS�Qt�,",,e,,��cRr�: -.yam• ��, . iF 4 s • .. r�uu� �•iun�. r.-cts�-u�n��n mai uti�. I • x 4 • - ��+,-��:.�..e•+�+-.��+. rs,r��rrd.-mss.++ r - � • . ^ ' _ — -, �� 'Tri+i.�•...�r..i��:�� • ' . • •�--•� *`� � � �hA A8 5Za est • x..7..1 ©Fi • 7�i , •.e.r .... „rte, �-�m�ca a�.� • • • � • f Do not remove until final code inspection. Save label for future reference. ar ` It Thls proauccmeets Green sears 441�� environmental standards Wgoverning energy efficiency. heavy mecale in me frame ana sash material, packaging. ana materials. 100-00511408-012 100-00511408-012 �� Renewal >. byAndersen� �'�=' 1A.r! N l) 0Yg--R £P LAC Ev iZpb3—«n.�nddrsanC:dmpany . AND -N-34 Composite IF i33�<�i1t i~l�'<YWoodNinyl ............................ Dual Argon Low -E4 SmartSun Product Type:. Glider ENERGY PERFORMANCE RATINGS U -Factor Solar Heat Gain Coefficient � ♦ - --0.19 U.S./I-P Metric/S1 ADDITIONAL PERFORMANCE RATINGS Visible Transmittance 0.,43 Manufacturer stlpulara3 that mesa ratings conform to applicaole NFRC procedures for aetermining whole proauGt performance. NFRC ratings are determined for a Roca set at environmental conditions ana a specific praoutt sire. NFRC doesnot recommend any pracutt anti floes not warrant me sult5alllty at arry pfodutttor arty spectilc use. con^-ur manutocs,eara IItL-rnturotoFamef'�IUEeat pdAa/alaneL in}oTatHJn:- - --. �••. ___. www.nfrc.org Win9dow actndu•000r An ersen -Corporation, I A Glidin Window enurac rar _ pu arse conrorrnanca a ra awing stanaaras Standard Rating NAFS-02 orAAMANDhWCSA101A.SJA440-05 DP psf HS -C35 ar ` It Thls proauccmeets Green sears 441�� environmental standards Wgoverning energy efficiency. heavy mecale in me frame ana sash material, packaging. ana materials. 100-00511408-012 100-00511408-012 Location No. , ' ^ Date -/c1 irr w TOWN OF NORTH ANDOVER I.. G A Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ F Other Permit Fee $ �eAA,r,,Connection Fee $ 161,10 Wat�t��ection Fee $ I�TAL $ 35- ,uo/%, Building Inspectors Div. 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