HomeMy WebLinkAboutBuilding Permit # 6/9/2015 BU1E IN IT o� �oRry
�.c L@O /6 -Y
TOWN OF NORTH ANDOVER $'2 •b °
APPLICATION FOR PLAN EXAMINATION _
Permit No#: fl Date Received ?,q°�RArED
ssacwuse
Date Issued:
IMPORTANT: Applicant must complete all items on this page
LOCATION �"
PROPERTY OWNER
IF Print 100 Year Structure yesno
MAP �'� PARCEL: c>�ZONING DISTRICT: Historic District yes no
Machine Shop Village yes no
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
❑ New Building ne family
❑Addition ❑ Two or more family
❑ Industrial
❑Alteration No. of units: ❑ Commercial
epair, replacement ❑Assessory Bldg ❑ Others:
❑ Demolition ❑ Other
riworal���yl 'yrff s�uvurrl�.wp IFJd/"r`r.r,.-ri,r,�r,! r,�r„,, ,� ,� iwia �,.vnyohrl��,nIN"1WJJfi,"'�k'!;�?fr'YNIIf(10 1fJ a�rrrr �p�rwr'r�,�YHi,�4llfn�y0!'I<f��ll/! f� U V21i�(�',.IdFa�wlAf(�'�ffUGJ,�"k (I%� rn�IdPf11 111/ �1'.
r
DESCRIPTION OF WORK TO BE PERFORMED:
l_ •��7 tc-)`Alta dAJ5
Identification- Plfalse T ape Print Clearly / 7 �� 9
OWNER: Name:( o r�•@ do e� Phone:
Address:
Contractor Name: A/ Phone:
( ' -7 W-
Email
Address: 36 k--
IVdy�
Supervisor's Construction License: d 9,0 / Exp. Date: � —//P
Home Improvement License: G �a Exp. Date:
ARCHITECT/ENGINEER Phone:
Ad Reg. No.
Address: 9
FEE SCHEDULE:BOLDING PERMIT:$12.00 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 with unregistered contractors do not have access to e guaranty fund
ttoRTH
Town ofndove
2 _E. ....��. r
® {A
®
h ver, Mass
O LANE
COC NICNl WICK
Q�aWTE® P?P�,�S
S V
BOARD OF HEALTH
PER T T Food/Kitchen
Septic System
THIS CERTIFIES THAT .............. ... ..i�. ............ ........ ..� ,. ..,,.,,.,.. ,. ,, , BUILDING INSPECTOR
.. .... .. . . .. .... ....... .
has permission to erect .......................... buildings on .......... ... .......................................Z4.•............. Foundation
on a 411100A
Rough
to be occupied asV ).............................. Chimney
............ .. . .......ce....................4, x'11.. ....
provided that the person accepting thisipermit 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
VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough
Final
EXPIRESPERMIT S ELECTRICAL INSPECTOR
UNLESS CONS-TRU7N STARTS Rough
0 /E--! Service
................................................................................ 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 Approvedy the Building Inspector. Burner
Street No.
Smoke Det.
Renewal MAHo€ne improvement Contractor,
Y License,!/170810(Expires 1212X2015)
byAndersen. Renewal by Andersen Corporation Federal Tax ID#41-1918413'.
l:itS e�Jt# REPiACE stEMT '.n 1 E , '
30 Forbes Rd. Northborough,MA 01532
(508)351.2200 Fax(508)-986-7072
CUSTOMER WINDOW AND DOOR REMODELING AGREEMENT
Buyers)Name Date.
GEORGE WHITEHEAD - APRIL 20, 2015
Buyer(s)Street Address city State Zip Code
74 BELMONT STREET (NORTH ANDOVER MA 0184S
Email Address Home Telephone Number Work/Cell Telephone Number
GWHITE 8937pAoL.eom 978-685-0295 603-685-5549
Buyer(s)hereby jointly and severalty 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).
Buyers)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 $ 11,868 sinont FinancedS 6,868
!Deposit Received(33%)$ 5,000.00 $ 3,434.00 V ChecktCash
8-10 weeks
Balance Start of Job(3340$ 0.00 Check 195
Balance on SubstantialAI su€sts al Est.InsWf Time Credit Card
Completion of Job(33%)$ 0.00 comfAetico S 3,434.00
1.2 days If credit cane i3 selected,Please
r3o fins[ ,,,st+a oe aemsnaeil u M M iea see astis.:ed sere Credit Card Paymerit faun
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 Andersen Corporation Buyers) Buyer(s)
( ��
Jeerff' Hell
Signature of Consultant ignature Signature
X GEORGE HOLT GEORGE WHITEHEAD
Printed Name of Con-truant Printed Name Printed Name '..
YOU,THE BUYERtS),MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO M€DNIGW OF THE THIRD BUSINESS DAY AFTER THE DATE OF TIAs TRANSACTION.
SEE THE ATTACHED NOTICE OF CANCELLATION FORMS FOR AN EXPLANATION OF THIS RIGHT:
':"------------------------------------ ------------------------------------- F
NOTICE OF C1ANCE ATION NOTICE OFCANCELLATION I
Bate of Transaction z%'ti:;1, .Xan may cancel tk[s I Date of'Itanaaedoa I-;1111'1 Yottmayeauselthis
'transartlon,without any penalty or obligation,within three business da}*from the 1 transaction,without any penalty or obugatton,within three huslness day* From the
ahos*date.If you cancel,aaypraperly traded in,.any payments made Ess you under alum date.If you cancer,any property traded In,any paynsents made by you under
the Contract of Sate,and any negotiable Instrmitent executed by you will be 1 the Coatrart of Sale,and any negodxble instrument executed by you".01 be
returned taithin ID da}'s to€loN4.ag rereSpt by the Coniractar("3eiler"i of}Y.nr I returned within 10 days f.t owbig receipt by the Contractor("Setter") of your
cancellation natter,and any security Interest aristttg out of the transaction will he I cancellation notice,and any security iatrrrsi arising out of the transaction♦cili be
canceled. If}'oa cancel,yrsn const make available to the Seller at your residence,in 1 canceled. Ir you cancel,you must nuke available to dhr Seller at your residence,In
suhstantlalty as good condition as when received,any goods delivered us you under 1 su1soroulany as good randidon as when receltvd,any goods delivered to you under !.
this Contract or Sale;or you mav,If you wish,comply with the instructions of the 1 this Contract or Sale/or you tnaK H you wish,comply veitlt.ihr instructions of the
Seller regarding the return shipment of the goods at the Seller's expense and risk. I Seller regarding the return sbiprneot of the goads at the Seller's expense and rigk.
If you do make the goods available to the Seller and the Seller does at pick them up I IF you do snake the goods available to the Seller and the Seller does not pick/kern up
aith€n 20 days of the date of your Notice of Cancellation,you may,retain ar dispose 1 within 20 days of the date of your Notice of Cancelhaloa,you sway retain or dispose
of the,goods without any further nh0gatim. If you fail to asakr the goads avat'labte 1 of the goods without any Ast-ther ohligad— If you Fait to snake the goods available
to the Seller,or If you agree to return the goods to the Seller and fail to do so,then to the Seiler,or if you agree to return the goods to the Seller and tail to do so,then
.)va remain liable for performance of all obligations nailer the Contract.To cancel 1 you rrtnaia tlable,for performaucr of all oldigations under the eontract.To rant,*/
this trausaetiva,mail or .deliver a slgaed and dated copy of this raarrlLatioa Holier 1 this transaction,sua€I or dcllver a sigard and dated c»py of this raaceITatian notice
or any other written nosier,or send a Wegratn to Contractor;Renewal by Andersen,I or any nther written notice,or send a telegram to Coatrattort Renewal by Andersen,
3I€Forbes Rd, Nurthborough MA 01532. 1 30 Forbes Rd.Northborough,AIA 01332.
'.l HFSiFaIY C:AtVCEL THtS TRAhSACT10N, 1 1 HEREBY CANCEL THIS TRANSACTION.
1
'', D4,eim Sig:.c::+x PEkt ttaz-re Ltatn I rt ivy c9-arae FEaA p1-s-Ec t)�t
.enewa lRenewal by Andersen Corporation MA Noma Improvement Contractor
byAndersens 30 Forbes rd Northborough,ASA 01532 License#170810 (Expires 12/2312015)
wrnoow REPLACEMENT <,,.e: ,-a.i:.,,;;.a+, (508)351-2200 Fax:(508)-985-7072 Federai iD#41-1918413
Window Specification Sheet
l3utrr:'s;Vaux Da€e.ol` 1s{i tncnt
GEORGE WHITEHEAD MON, APR 20, 2015
hht intttrr s Iistr(l abov'herch ,lo`tutt}^attd severally agree to pulrll sec 111t.goo s atxihir sc[zieers 611A below,ill accordance with tliv ptices and fonts dcscrihcd
on nti t1w S})c�cili4xttian Sheol athe.linut and the rtwcow of the.accoatipanying (iL"10,0M WINM(')'11':-N)DOOR REMODE1,11A10 AG1ZV lA11 N'l;cif whicti
the spvcilication Sheet is part.
WINDOW tic DOOR DETAILS
Extersovintettar Color Hardwaro Hardwwo Loy,,Et r Grills Grier Glass
Room # N�idih h.wa u.{. Window/Door$ le Detail Cosi s Ext'int color style Saaens Smart.. Grille$ Sash M Sash 1 Lifts Options
p
Lied 1 201 :3:3 4 7 80 Da sg rail ftgual Insert sloped$lll Ext.V*ap WH&N Stone Standard FFG '4nansur uerxe No No
Bed 2 2()1 :t i 47 80 DB sq rat€equal insert stoped sal-ilExt.Wryr t» WWPN Stone Standard FFG arts. t ort No No
». »
Mancave 203 3:3 4.7 80 DB sq rail Squal insert E!2 ed eiii Ext.Wrap WHIPN Stone standard FFG sats.r ncnn No No
Mancave 20-1 :33 47 80 DB sq mLtqyal insert stoped s 11 Ext.WrapWH/PN Stone Standard FFG tvtsw Ilona No No
Bed 3205 33 4 i 80 DB s ra l uaI insast sto il€ Ex#.WrWH1
ap pN Stone Standard FFG 31nartsu, Norio No No
Bed 3 _ 206 33 1 T 80 DB sq rail equal insert sloped sil€ Ext.Wra WHIM T Stone Standard FFG snsu, None No � No
Bath 2 `07 21 37 50 DB sq rail 29val insert sto ed sill ExL Wrap WH/PN Stone Standard FFG mut,,. t No Temper
Total 7 BAY BOW&RVILD OUT DETAILS
Approx
StyloDetait! yridihj Apptax. Nrunbcr Framo Window I I End Centor LowEI Roof! Harchvrue
Rooth courts style Ftankers ht Casing. Angle €.lies lnteiiar INVInt Cosmo Qnl?os Mhos sashes Screens Smattsatt Soffit Cobr
SPECIALTY WINDOW DETAILS
Full i Approx. LowE r specialty DAY/BOW ADDITIONAL WORK NOTES
Roam Count Style fnseR U.I. Smartsun Grine Gr€lo Tyle Extant co'or t:tr•i,i r .+c.ui�t ;n t.scE:€'c,wfi ,:,,{<m-.+i a&•,�:?i+u h«-
tl.<rv.tdl tw•sigrtifii r;a Gl,t�a lar.
ADDITIONAL WORK DETAILS:
No Contractor will wrap exterior casings with coil stock color of
Owner is aware that Contractor does not do any paintinglstaining orremavaifinstaiiation of alarm system or window treatments/hardware.It is the responsibility of
the homeowner to have the alarm System and window treatmentslhardware removed prior to installation. I%make no guarantee as to whether alarms or window
treatmentsihardware will fit after replacement, Customer is also aware in soma cases them will be glass loss, if there is,the armounf 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 toss.Customer is aware and understands any and all
unseen rpt is not included in this contract.Should any rot be found there will be an additional charge for time 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 job and payment in full,a limited warranty shall be issued.
l Yes Building Parmti--Contractor will secure any and all necessary permits. The fee for the permit(s)Is included in the total contract price.
Yes All discounts have been applied to this agreement.
r., Ica No Owner agrees to be present on the final day of installation for final inspection and to deliver final payment t finance form(s).
is k"
gn-cdand undr•r,iwKf Ih and Lrnwell di r partite that 111St.crilicntion lusrt,Am",kid)the CUSTOM WIND(M'AID DOOR RI:MOD111XV;A01tLt\iE 1',cou"14mrs dw etnin,
n!#lit rVl.niilliE tM'llt4`t'n t}ii'p nnE"V);cnd€)[[YY`dnY'nLt wrhal in d 1:t.m,ling f 1t.mgijlg of 111"dil}illi;.{in\nt tltr wi ni, 1€SIV`ijw6f amain sh'C'f nlit"51iit I'm rhe}ril'-d€lr ltl 4.1 In,w",lif"I(+r Nuti d ifr
:.`Hilt 1t7t1'niil(:S)1liE tl('It;nYrir'S:Yri'!tt 1tBYEli :,nil ;nt'Sf IK'Will all,lin),'rs alld Cowr o-iii; ttnvo4 .'V ll�A.hl'a['I.nnlVl;'ilia'tIl it Buyt1-'i1 Ji'44".id stn;+1(N'f'4�11'3C36!i.l ift14\^!.
:RenewalbyAndersen Corporation 33u r�t;51 i3ub<rsi
f eel y c:lett
Signature of Consultant jgna are Signature
GEORGE HOLT GEORGE WHITEHEAr)
Print Name of Consultant Print Name Print Name
Renewal Renewal by Andersen Corporation - - -
111 It'd, " 1 "mlr, Impyo�'Iamtc€ €,.!'tAr. or
Ander '
i""lti ik C`°� f' z( tl�{{) 1514 fhv t fi t{. • A:I",%k.,z3r ..4 170 I,�t�xl'ivo
121110�201 Ill
11Ei gG:P4� _�MAifi m e <r�:�ae{<xi,r,q ,�„.
^r to 5
'xliv,,Atwt1r:imomi i`"Af:te'nd11'vif9")is 1 2{iiv 11�AOR h1:, 9ti t 1 N.I s r. sk{:7::fit.}',w{”I<tr t�v.rl�«t1{:"t 1 °'heal
k`{iwell Rxk.`em';il[A,Amkreen C.orl''oral{c%Imcf,r lr'l!p whac ea I'"E'rtib`c°Es"14 ca``.mill'>lk,bc'r alai 1ktly('r(%j h-a-dfy agree to:hili'Id e3ttt tt okli}t'
{11e,'�glo.`liia'14 m Eli€'ltytl[M l%iln 4v4 Other lluut Lvlomr ,alt{ltr` t.r,PiN"Nomti&�4 file Ag.rcot lit WLIJ z°omAll ill
6,411 fcwro�Xjkfoli'€o- `{•lu'Al€ie1`€klmol{1: xtd'+« t t't 13ir'vo:'f•il'1N "(1:1101'6 i'c:.ii><`.11{_ {h
y%o I'l:'} �;41'e 1r•,`in" a ul6o:
Windows in single family attachod home to Gusto r(#205,206 and 267)will now be white art both exterior and
inUriar,
<v f�4€sly X71 Olartges,.Ill,, follii€t`in l:rviLi if Ila€` s€ta tti`,t,t?o%( t� f'l at t(1 tl iii?,� Wlla>Tt Sti 3l6! ilf t�f4a, E�1't Ixt 114 44'{�i l*i W1 i?liull�ti's'
ioark€tl pis''+d/A',it'd almg,lit,tl llkt clt.lvtg'o tai pfie�"
i'sMOOAD(`hamck
New tju{.m.c+ it matt of bels:
NoA, lkii4rt�x,;,It Givol Skv 1'il°tame
It is Wt4d wA undaomdby tadi Wwt,the pamlia ihat 06 Ameadmuf orA dw m a" S{9mto the•+Gt1g1w undumandim be-
Irl 1ho p.�,and*mv vabal undorlftmftigs c-h or nWdft sM At t>fc of fts ±1c < Pt ) hatty 1-b
lllict l»zvoA this Amcndmc*snd rvpOvWx QmvVla ,Opv d,md d*W PM a tfds Anwmlmml on 4WlPvp6*nWcrw,
lrtal by AndersmCotrrltt tO
CV34?2W�Ci,-31 AM rST
George E. Whitehead
• �hitlk�ll�;1F47•�tii.�lfti�
-
=
The Commonwealth of Massachusetts
Department oflndustrialAccidents
Office ofInvestigadons
' I Congress Street,Suite 100
Boston,MA 02114-2017
www.mass gov/lila
Workers'Compensation Insurance Affidavit: builders/Contractors/Electricians/Plumbers
Applicant Information Please Print LeL7ibl
Name (Business/Organization/individual)'--RENEWAL BY ANDERSEN
Address:30 FORBES ROAD
City/State/Zip:NORTH BORO, MA 01532 Phone#:508-351-2200
Are you an employer?Check the appropriate boa: Type of project(required):
1.FMI am a employer with 30 4. EJI am a general contractor and I
employees(full and/or part-time).
have hired the sub-contractors 6. ❑New construction
2.❑ l am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling
ship and have no employees These sub-contractors have 8. ❑Demolition
working for me in any capacity, employees and have workers'
insurance.: 9 El Building addition
cors
[No workers' comp. insurance p•
required.] 5. ❑ We are a corporation and its 10.El Electrical repairs or additions
3.❑ I am a homeowner doing all work officers have exercised their 1 l.❑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.[]Other
comp.insurance required.]
*Any applicant that checks hox ill 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.
fContractors 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. #.MWC 30293800 Expiration Date:
Job Site Address: 10/01115
7� �Yy ��� sol—' City/StatelZin• /C4 /9Nfd"
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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereb c �thland penalties of perjury that the information provided above is true and carrecd
Simature: Date: 05/19/15
Phone#* 6-351-220+0
Official use only. Do not write in this area,to be completed by city or town official.
City or Town: Permit/License#
Issuing Authority(circle one):
1.Board of health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector LPIumbingspector
6.Other
Contact Person: Phone#:
ANDECOR-01 YADAVYO
CER�°lFI `F OF LIABILITY INSURANCE DATE(MMIDINYYYY)
1011/2014
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to
the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsement(s).
PRODUCER NAAMIE: T CertNlcate$ i{il$.com
Willis of Minnesota Inc. PHONM Er:(877)945-7378 No):(888)467-2378
c/o 26 Century BQ E-MAIL
P.O.Box 305191 ADDRESS:
Nashville,TN 372305191 -"----""-- —� — ---�-
_INSURERi$)AFFORDING COVERAGE NAIL M
INSURER A:Old Republic Insurance Company 24147
INSURED INSURER 0:
Renewal by Andersen Corporation INSURER C:
30 Forbes Road INSURER D:
Northborough,MA 01582 INSURERE:
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 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.
WLTR SR TYPE OF INSURANCE 1=WyD POLICY NUMBER IMMID M DfYYWI LIMITS
A X COMMERCIAL GENERAL LIABILITY EACHOCCURRENCE $ 1,000,00
CLAIMS-MADE XI OCCUR MWZY302940 1010112014 10/01/2015 PREMISES(Es occurrence) S 500,00
MED EXP(Any one person) S 10,0
PERSONAL SADV INJURY $ 1,000,00
GERLAGGREGATE UMIT APPLIESPER: GENERAL AGGREGATE $ 4,000,00
X POLICY E1JE T a LOC PRODUCTS-COMPIOPAGG $ 4,000,00
OTHER: S
AUTOMOBILE LIABILITY COMBBII dEeD S E MIT $ 5,000,Oti
A X ANY AUTO MWT8302676 10101/2014 10/01/2015 BODILY INJURY(Per person) $
ALLOWNNED SCHEDULED BODILY INJURY(Par aoddenl) S
AUTOS
NON-OWNED acd �A A E
HR DAUIOS AUTOSP de S
s
UMBRELLA LIAR H OCCUR EACH OCCURRENCE $
EXCESS LIAS CLAIMS-MADE AGGREGATE $
DED I I RETENTIONS $
WORKERS COMPENSATION x
ANO EMPLOYERS'LIABILITYSTATUTE I JER
A ANY PROPRIETORIPARTNERIEXECUTNE YIN RN
10/01/2014 10/01/2015 E.L.EACH ACCIDENT $ 1,000,00
OFFICERIMEMBEREXCLUDED? � NIA
(Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,00
If yea,dear ribe under
DESCRIPTION OFOPERATIONS below E.LDISEASE-POLICY LIMIT $ 1,000,00
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schadula,maybe attached If more apace M requbsd)
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 REPRESENTATNE
Evidence of Insurance
01988.2014 ACORD CORPORATION. All rights reserved.
ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD
Massachusetts -Department of Public Safety
Board of Building Regulations and Standards
Construction supemitor
License:CS-09025 ,
Nvlj*
JAIME L MORIN` }.,
96 GARDINER S
LYNN 14iA 0190 � ` ; �ir
* ♦4;+ Lam`
�- Fj`' 'r w'*' Expiration
Commissioner 10108/2016
M# cc of Coasamer Affairs&8usiness Regutadon
OME IMPROVEMENT CONTRACTOR
Registration: 170810Typv
Expiration: 1212=015 Supplement�
RENEWAL BY ANDERSON CORPORATIOM
JAIME MORIN
104 OTIS STREET
NORTHBOROUGH,MA 01532
Undersecretary � ,
4
3
i
I
Renewal
byAndersene ,,
WINDOW* REPLACEMENT an AndecaertCompaoy
Wood/Vinyl Composite IF
Dual Argon Low E4 SmartSun
Double Hung
.y
100-00473518-010
-ENERGY PERFORMANCE RATINGS
U-Factor(U.Syl-P Solar Heat Gain Coefficient
0
A n29
19
OM
"
ADDITIONAL PERFORMANCE RATINGS
Visible Transmittance
ON42
manufacturer wiputates that theca ratings conform to applicable NFRC procedures for determining Whole product
podomtance.NFRC ratings are detennined for a fixed set of environmental conditions and a specie:product sae.
NFRC does not recommend any product and does not warrant the sueabilly of any product for any specific use.
Consuh manufacturer's literature for other product performance it formation. '
www.nfm.org
�afk -4)f. This product meats Green • it
j sears environmental Cenaea r.,,t• y'•:coc•e,r.,
,yjZn )standards governing energy °• r"*-,
� eKrciancy,heavy metals in �y.
J•% .'
. ::.the frame and sash f.;; y` �*.nj?,;�q•5�y
f,,.b^•matere4 packaging,and �' :,2•{,•`. ::%�;2:•;ar�
consumer educational �'�"tr'fifi;••:•%"o'
t; materials.
s- ------
IS'� P $�PwJ.ns.na„rv.Jew
DESIGN PRESSURE(PSF)
rMi .,
a Wnaow ane Boot '
hlenufacWrers Asmciatbn
VNA4.WdmaAonl
® RbA DB Sloped Sill DH IN
TaStidtolUFS-020fA7J:DV1'AIAAlCSAlOIASAM04S k4mrfa(U"stipulates otnforfnarYa1.)Ma IicaDlastaMards.
Nears or exceeds h11.E.C.,C.E.C.A,1.E.QC.Air InnZlion requirements WDAIA Hallmark Cert&ation Program.