HomeMy WebLinkAboutBuilding Permit #646 - 4 Wood Avenue 5/2/2008BUILDING PERMIT
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TOWN OF NORTH ANDOVER o?
APPLICATION FOR PLAN EXAMINATION ~
* s h
Permit NO: /^ Av// Date Received 116"`9°"
PP��S
SSACHUSE
Date Issued. J �/
IMPORTANT: Applicant must complete all items on this pate
LOCATION Anort--
PROPERTY OWNER-�O'S-eeh A tJlSnntt T. bzk-k-o
Print
MAP NO: '4(.0 PARCEL: _ZONING DISTRICT: 41) Historic District yes
Machine Shop Village ves
TYPE OF IMPROVEMENT
PROPOSED USE
Residential
Non- Residential
Naw Building
One family
Ad d ition
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
OWNER: Name:
Address:
CONTRACTOR Na
Address:
DESCRIPTION OF WORK TO BE PREFORMED:
"o P- , )( . t a ` �Yv�i IA V--2--)0vv1
fication Please T,or Print Clearly)
Phone:q'2d 19,5 -1S 3
o1kk 0't IJvU V"— Phone:
Supervisor's Construction License:
Home Improvement Lice
Exp. Date:
Date:
ARCHITECT/ENGINEER Phone:
Address:
Reg. No.
FEE SCHEDULE. BOLDING PERMIT: $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F.
1-1
Total Project Cost: $ `,ate FEE:
Check No.: Receipt No.:1 iJ
NOTE: Persons contracting with unregistered contractors do not have acces to the guaranty fund
Signature of Agent/Owne U ture of contractor
Plans Submitted Plans Waived Certified Plot Plan Stamped Plans
TYPE OF SEWERAGE DISPOSAL
Public Sewer
Tanning/Massage/Body Art
Swimming Pools
Well
Tobacco Sales
Food Packaging/Sales
Private (septic tank, etc.
Permanent Dumpster on Site
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
DATE REJECTED DATE APPROVED
PLANNING & DEVELOPMENT
COMMENTS
CONSERVATION Reviewed on �% 13 0/ d 1S Signature
COMMENTS 1y ,7* W` 1A
100' ofr. "CUJvw,.
HEALTH Reviewed on Signature
COMMENTS�-
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision:
Comments
Conservation Decision: Comments
Water & Sewer Connection/Signature & Date Driveway Permit
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
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
❑ Notified for pickup - Date
Doc.Building Permit Revised 2008
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
o 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
Location v" ��"r '
4--1-
No. Date
NORTH
TOWN OF NORTH ANDOVER
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TOWN OF NORTH ANDOVER
OFFICE OF
BUILDING DEPARTMENT
* to • 1600 Osgood Strut Building 20 Suite 2-36
North Andover, Massachusetts 01845
1ss�c��t
Gerald A Brown Telephone (978) 688-9545
Inspector of Buildings Fax (978) 688-9542
HOMEOWNER LICENSE EXEMPTION
Please p
DATE: D - % o
JOB LOCATION: `t 1. 4
Number Street Address
HOMEOWNER SW&Lh .d— j 9 7P-- &P6 " 1 73 -q3,-)5
Name Some Phone work Phoft
PRESENT MAILING ADDRESS `t �oo_
City Town State Zip Code
The current exemption for "homeowners" was extended to include owner -occupied dwellings to two units or less
and to allow snch homeowners to engage an individual for hire who does not possess a license, provided that the
owner acts as supervisor). State Building (Code $ection 108.3.5.1)
DEFINMON OF HOMEOWNER
Person(s) who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended
to be, a one or two family structures. A person who constructs more that one home in a two-year period shall not
be considered a homeowner.
The undersigned "homeowner" assumes responsibility for compliances with the State Building Code and other
Applicable codes, by laws, rules and regulations.
The undersigned "homeowner" certifies that he/she understands the Town of North Andover Building Department
minimum inspection procedures and regnirs and that he/she will comply with said procedures and
requirements.
APPROVAL OF BURDING OFFICIAL
Revised 10.2005
Farm Homm ma E=mptim
BOARD OF �,PPE.ULS 699-9531 CONSERVATION E88-9530 HEALTH 698-9540 PLANNING on -9535
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
tV Boston, MA 02111 ,.
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
pplicant Information Please Print Leibl,
Name(Business/Organization/Individual): 1�>Lk_3 1. -4 Jo
Address:
City/State/Zip: 0.
0 (.4S Phone .#: g e7k —b91S7 15-k3
Are you an employer? Check the appropriate box:
1. ❑ I am a employer with
4• ❑ I am a general contractor and I
employees (full and/or part-time).*
have hired the sub -contractors
2. ❑ J am a sole proprietor or partner-
listed on the attached sheet.
ship and have no employees
These sub -contractors have
working for me in any capacity.
employees and have workers'
[No workers' comp. insurance
comp. insurance.$
quired.]
5. ❑ We are a corporation and its
3. I am a homeowner doing all work
officers have exercised their
myself. [No workers' comp.
right of exemption per MGL
insurance required.] t
c. 152, §1(4), and we have no
employees. [No workers'
comp. insurance required.]
Type of project (required):.,
6. ❑ New construction
7. ❑ Remodeling
& ❑ Demolition
9. ❑ Building addition
10.❑ Electrical repairs or additions
11.❑ Plumbing repairs or additions
12.❑ Roof repairs
13. ❑ Other
"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 N
Policy # or Self -ins. Lic. #:' Expiration Date:
Job Site Address:
City/State/Zip:
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 fie
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"rtit& under the pains and penalties of perjury that the information provided above is true and correct
one #: -7 - �9
Official use only. Do not write in this area, to
City or Town:
Issuing Authority (circle one):
1. Board of Health 2. Building Department
6. Other
Contact Person:
O
or town official.
Permit/License #
3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector
Phone #:
Information and Instructions
Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees.
Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire,
express or implied, oral or written." 1. 11 '.
An employer is defined as "an individual, partnership, association, corporation or other legal entity, or any two or more
of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the
receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the
owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the
dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house
or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer."
MGL chapter 152, §25C(6) also states that "every state or local licensing agency shall withhold the issuance or
renewal of a license or permit to, operate �a business or to construct buildings in the commonwealth for any
applicant who has not produced acceptable evidence of compliance with the insurance coverage required."
Additionally, MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall
enter into any contract for. the performance of public work until acceptable evidence of compliance with the insurance
requirements of this chapter have been presented to the contracting authority."
Applicants
Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if
necessary, supply sub-contractor(s) name(s), address(es) and phone number(s) along with their certificate(s) of
insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the
members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have
employees, a policy is required. Be advised that ibis affidavit may submitted to the Department of Industrial
Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should
be returned to the city or town that the application for the permit or license is being requested, not the Department of
Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers'
compensation policy, please call the Department at the number listed below. Self-insured companies should enter their
self-insurance license number on the appropriate line.
City or Town Officials
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom
of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant.
Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant
that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current
policy information (if necessary) and under "Job Site Address" the applicant should write "all locations in (city or
town)." A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the
applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each
year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture
(i.e. a dog license or permit to burn leaves etc.) said person is NOT required to complete this affidavit.
The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions,
please do not hesitate to give us a call.
The Department's address, telephone and fax number:
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston, MA 02111
Tel. # 6.17-727-4900 ext 406 or 1-877-MASSAFE
Revised 11-.22-06 Fax # 617-727-7749
www.mass,.gov/dia
04/18/2008 10:48 FAX 19786833147 M.P.ROBERTS INSURANCE
Q001
ACORD - CERTIFICATE OF LIABILITY INSURANCE 4/1 % 008P
RODUCFR THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
M. P, ROBERTS INS AGCY INC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
1060 Osgood Street HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED SY THE POLICIES $CLOW.
North Andover, MA 01$45
(978) 6$3-8073 INSURERS AFFORDING COVERAGE NAIC#
ISUR90 VISION BUILDERSINSURER A: PROVIDENCE MUTUAL FIRE INS CO
JOSE LOPEZ DHA NauRER e: HANOVER INSURANCE CO
257 CH.Ea`2'RUT ST'.R.k"M INSURER C;
NORTH ANDOVER, MA 018455 UWUYlCRO; ASSOCIATED EtdPLQYERS INSURANCE CO
'OVERAGES
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 WIT14 RESP[CT 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 PAIU GLAIMS.
m
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AroRo
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
OATS
POLICY EXPIRATION
pgTE AMIpD
LIMITS
GENERAL UABIUfY
EACH OCGURRENCS 5 la0 4QQ
p CQWAF,RCIALQENERAL LIABILRI'
CLAIMBMAOE LXJ OCCUR
PpEMI6C6 Ea acculenca 100,000
MEDEXP(Allrmm"on) 3 5,000
A
CPP0059662
08/16/07
08/16/08
PERBONALSADVINJURY ;s y1 000,000
GENERAL AGCREGATE j S 2 00,000
QENLAGGREGATE LIMITAPPLIEBPEP!
PRODUCTS -COMPIOPAGO 1 S 2,000,000
1-1 POLICY � T LOC
AUTOROOBILLELJADI
LMY
COMBINEOSINBLE LIMIT S
ANYAUTO
SEa xeltlanq
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ALLOWNEDAUTOB
60HEDULFDAUTOS
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Parpa I ) pY I S 100,000
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HIRED AUTOS
ADN -8688831-01
4/29/07
14/29/08
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°Per �a,RY $ 300,000
PROPEWN DAMAGE
�i Brand„A,> s lOp,000
GARAGE UAIMUTY
AUTO ONLY, EAACCOENT $
EAACC j
OTHERTHAN _
ANYAUTO
AUTOONLY: qGG S
EXCFRRIUMBRELLA LLABILITY
EACH OCCURRENCE E
AGGREGATE 5 –^•. .
OCCUR ' GLAWSMAOE
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DEDUCTIBLE
RETENTION 5
D
WORKIJYSGONJIENSATIONAND
EMPLOYERS LIABLITY
AIMwCCS004957012008
Pno1'AlCtorvMnAYrcCWE%EWTIYE
I lfy , =mlbau aXCdAlaLlO'1 ndar
EPEC L PROVf810N8tmIm
03/19/08
03/19/09
.X CSTA U•
TQRYLIMITS PTH -
ER
E.L.EACHACCIB�
ENY S 500 000
EA, 01$EAEE - EA EMPLOYEE 5 500,000
E.L. INSEAEE • POLICY LIMIT 5 500,000
OTHER
_w.... „-r.”--1 I-- —,..,..+,.c,,,u.—. c....wunn.a---CdWJvnaC lI.1—LrnwlalVNa
FAX: 978-686-0700
ERTIFICATE HOLDER CANCELLATION
TOWN OF NORTH ANDOVER SHOULD ANY OF THE ABOVE DESCRIBED POLICIft, DE CANCELLED BEFORE THE 9XXPIRATJQN
SUILAING INSPECTOR
DATE THEREOF. THE MOVING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN
---
120 HAIN STRZP MIJ- NOTICE TO THE W-"VICATIr NOLOLR NAMED TO THE LEFT, BUT FAILURE TO DO BO SHALL
WORTH ANDOVER MA 01845 IMP09E NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
AUV REPRu ATIVE
I
CORD25(2001108) VACORD CORPORATION 1988
ENERGY CONSERVATION APPLICATION FORM FOR ENERGY EFFICICIENCY FOR
ONE- AND TWO-FAMILY DETACHED RESIDENTIAL CONSTRUCTION (780 CMR 61.00)
Applicant Name: �l5ol�el���, Site Address:
print
Town: 0 ,—
Applicant Phone: 197 &9�g - J �
Applicant Signature: Date of Application:
NEW CONSTRUCTION: (choose ONE of the followin two options)
780 CMR TABLE 6107.1
PRESCRIPTIVE ENVELOPE COMPONENT CRITERIA FOR
NEW ONE- AND TWO-FAMILY BUILDINGS
72a1 SF
MAXIMUM
MINIMUM
Option l:
k
780 CMR TABLE 6101.3
Ceiling or
LOW-RISE RESIDENTIAL BUILDINGS
Basement
Slab
Fenestration
Ceiling and
Exposed floors
Wall
Fenestration
exposed
Wall
Floor
Wall
Perimeter
AFUE
HSPF
SEER
and Depth
U -factor
floors
R -Value
R -Value
RVl
-Value
R -Value
R-10, 4 feet
a R-30 ceiling insulation may be used in place of R-37 if the insulation achieves the full R -value over the entire ceiling
area (i.e. not compressed over exterior walls, and including any access openings).
❑
SUNROOM - An addition or alteration to an existing building/dwelling unit where the total
R -Value
glazing area of said addition exceeds 40% of the combined gross wall and ceiling area of the
addition.
and Depth
Note: Owner to fill out Consumer Information Form (found in Appendix 120.P)
R-10,
National Appliance Energy
Conservation
.35
R-38
R-19
R-19
R-10
Act (NAECA) of
4 ft.
1987 as amended, minimums or
greater as applicable
Note: This form is not required if you choose either of the two versions of REScheck as listed below.
❑ Option 2:
v
REScheck Version 4.1.2 or later variant software analysis must be completed
(780 CMR 6107.3.2)
v
REScheck-Web which can be accessed at http://www.energvcodes.gov/rescheck/
ADDITIONS OR AL'TERATIONS TO EXISTING BUILDINGS OVER 5 YEARS OLD*
*Buildings under 5 years old must use option #1 or 42 in New Construction section above.
Complete the following formula to determine the % of glazing:
(a) Gross Wall & Ceiling Area equals Formula: (100 x b _ a)
72a1 SF
100 x 10 % of glazing
(b) Glazing area equals 75SF b a
If glazing is = 40% use the chart below. If glazing is > 40 %proceed to "SUNROOM" section
780 CMR TABLE 6101.3
PRESCRIPTIVE ENVELOPE COMPONENT CRITERIA ADDITIONS TO EXISTING
LOW-RISE RESIDENTIAL BUILDINGS
MAXIMUM
MINIMUM
Fenestration
Ceiling and
Exposed floors
Wall
Floor
Basement Wall
Slab Perimeter
R -Value
U -factor
R -Value
R -Value
R -value
R -Value
and Depth
.39
R-37 a
R-13
R-19
R-10
R-10, 4 feet
a R-30 ceiling insulation may be used in place of R-37 if the insulation achieves the full R -value over the entire ceiling
area (i.e. not compressed over exterior walls, and including any access openings).
❑
SUNROOM - An addition or alteration to an existing building/dwelling unit where the total
glazing area of said addition exceeds 40% of the combined gross wall and ceiling area of the
addition.
Note: Owner to fill out Consumer Information Form (found in Appendix 120.P)
* Y X 41.11 /
cEnnsreo ENERGYjSTAR
Craftsman Windows
�R� 000 - Dual Glazed
When shopping for windows, quality
L� ble Hung
L
counts. Look for windows that are
NationaF-ene�?bons
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tested and certified for strength,
PERFORMANCE RATINGS
durability and energy savings.
ENERGY
actor (U.S./f-R) sola at Gain Coeffici nt
Understanding and comparing this
0.3 .32
information will help you to select a
' ADDITIONAL FORMANCE RA GS
stronger, more durable more energy
gY
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nt window.
Visible Transmittance
0.56
Compare Solar Heat Gain Coefficient
i Manufacturer stipulates that these ratings conform to applicable NFRC p utas for determining whole
C ratings arodelerminedtorafixedselofenvironm alconditonsanda
product performance. NFRbility of any
any product and doesnot wawa a suit
The LOWER the SHGC, the less solar heat
specific product size. NFRC does not recommend Information.
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your window transmits, the LOWER your
wNw+.nfrc.org
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This window is ENERGY STAR® qualified
in al
Compare U -Factor
" t -
The LOWER the U -Factor, the better it
__
1"..:2;x; _
insulates, the LOWER your heating bills.
3000' Design Pressure Kai
Ratings for sizes up to 34" x 65' : DP -50
Ratings for sizes up to 38" x 65k: DP -45
QUALITY CERTIFICATIO
Design Pressure Ratings are Independently Certified
MANOFACTUREA STIPULATES CONFORMANCE TO CCUE "19-1HUD
AMti /� SPEC: H•FWS ACCEPTED
(..� AAMA/NWWOA 101/L.S.2-97 SERIES: 1 MST 38�SD CERTIFCAATIO
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[Wind--o w s fol i f e TM
--- --- - -
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jV.7I <.%JIIIF%.A1 G...
A Good Window...
A Beater Window...
• Has a U -Factor of 0.50 or less
• Has a U -Factor of 0.40 or less
• Has a Solar Heat Gain Coefficient
• Has a Solar Heat Gain Coefficient
(SHGC) of 0.65 or less
(SHGC) of 0.55 or less
• Has a Design Pressure rating
• Has a Design Pressure rating
(DP rating) of 35 or better
(DP rating) of 40 or better
0.32
• Meets most ENERGY STAR®
1400
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requirements
American Craftsman Windows & Patio Doors Performance Data
A Superior Window...
• Has a U -Factor of 0.35 or less
• Has a Solar Heat Gain Coefficient
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requirements in all 50 states
1
Model`
Number
_
ti Window
Type
Glass
Thickness `
I.
U Factar�By Glasspe SHGC By Glass Type a DP
i°g Ei i°'" Eite
"Clear Low E_. Ar on �° 'Clear Low E �w Argon Rating
3000
Double Hung
7/8"
-
0.35
0.31
-
0.32
0.32
50
1400
Double Hung
5/8"
0.49
0.35
0.32
0.63
0.34
0.33
35
2900
Single Hung
5/8"
0.49
0.35
0.31
0.63
0.34
0.33
50
2710/2760
Single Hung
5/8"
0.52
0.38
0.34
0.60
0.33
0.33
60
2110/2200/2300
Single Hung
5/8"
0.49
0.35
0.30
0.65
0.35
0.35
50
9500
Double Hung
7/8"
NIA
N/A
0.32
N/A
N/A
0.31
45
8500
Double Hung
7/8"
N/A
0.35
0.32
N/A
0.31
0.31
45
1200
Double Hung
5/8"
0.49
0.35
0.32
0.62
0.33
0.33
35
8700
Slider
7/8"
0.48
0.36
0.33
0.60
0.32
0.32
40*
5500
Patio Door
1 "
0.48
0.35
0.31
0.63
0.34
0.33
35
5600
Patio Door
1 "
N/A
0.35
N/A
NIA
0.34
N/A
35
5800
Patio Door
7/8"
N/A
1 0.34
0.30
N/A
0.34 1
0.34
30*
Notes -
1. Some products not available in certain areas.
2. For more specific performance data, please visit our website at www.americancraftsmanwin.com or call our Customer Care Department at (888)504-0005.
*Available with an optional DP -50 upgrade
(888)504-0005
www.americancraftsmanwindows.com
Effective January 1,20D6 Exclusively Sold in The Home Depot'
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CHECKLIST FOR CA1113ON MONOXIDE
Location of Incident: 4� �),b ej L h Date of incident — (/— / P
OU(C.K CIIECKLIST Of,- OCCUPANfS
Ileadache yes no ✓ Fatigue yes no
Nausea yes no Dizziness yes no
Confusion yes no L, -
Are
Are any members of the household feeling ill? yes no
Do the residents feel better away from the house? yes no
Since the detector's alarm went off, what have you done?
Shut- off carbon monoxide sources yes no �—
lf yes which sources
_ Let in fresh air? yes no
If yes how did you let the air in ti Ac (le-Cp
I low long did you let the air in
I'M reading ambient outside the dwelling
I lighest PPM reading in the dwelling
Carbon monoxide detector present? yes r no
If yes list the number of detctors locations and make, and serial number of each below.
T 7t5- a 9
2.
3.
4. ---
Which detector(s) by number above activated? # �
SOURCE CII6CKLI5,r LOCATIO PPM READING
Chimney clogged flue, blocked opening
Fireplace(s) Natural gas, U'G, Wood(indicale type for tach fireplace)
Gas Appliance (if Gas Company on Scene they can perform this check)
(IF MORE THAN 1 O(, THE FOLLOWING APPLIANCES LIST EACI I ADDITIONAL
ON THE COMMENTS PAGE WITH ITS LOCATION, AND PPM READING)
refrigerator ST ?rte,?
stove /s7, -
vent
Stvent over stove V
clothes dryer Ce ((e,-
water healer '
furnace
Oil burner
car garage
Entranceway from garage to house
Name of individual operating the CO monitor i o C✓� ^ ty
Person completing the Checklist LT: �_r_�