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23 MOFFATT RD - BUILDING INSPECTION (2) The Commonwealth of Massachusetts CEIVE$ER Board of Building Regulations and S NAL d SEES CITY OF i Massachusetts State Building Coda SA'EM Revised Mar 2011 Building Permit Application To Construct,Repair,R$��QQv10t�et�lis�t One-or Two-Family llwellin�1 Jl1�u,,, h a. This Section For OfliciaWse Only Building P&mitNumber "" ` Date' pphed Building Official(Print Name) _.. ,�.-Signahrze • ..: .. <% `. . ,Date SECTION 1:SITE INFORMATION ' 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers ' 23 MOFFATT ROAD 31 31-0039-0 Lla Is this an accepted street?yesT no Map Number.. Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: R1 TWO FAMILY Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public❑ Private❑ Zone: _ Outside Flood Zone?Check if es❑ . Municipal❑ On site disposal system ❑ ' SECTION 2:`PROPERTY OWNERSHIPr 2.1 Owner'of Record: GALE NIKOLOPOULOS SALEM, MA 01970 Name(Print) City,State,ZIP 23 MOFFATT ROAD 978-745-7078 No.and Street - Telephone Email Address 'SECTION 3:DESCRIPTION OF PROPOSED WORK=(check all that New Construction❑ Existing Buildin Owner-Occupied 10F 1 Repairs(s)qg I Alteration(s) t] Addition Q Demolition ❑ Accessory Bldg.❑ 1 Number of Units_ I Otherqr Specify: REPLACEMENT Brief Description of Proposed Work": gEpLACE 5 WINDOW - NOS TR I T RACHANGE SECTION 4s ESTIMATED+C`ONS7 UCTION COSTS=` 77, Estimated Costs: Item (Labor and Materials flfflellal Gse(7nly 3 1.Building $ 5,993.00 1 Building Permit Fee: `Indicate how fee is detemdueU ❑Stan tlerd Cttyffown Appticerion Fee 2.Electrical $ w ❑TO@tot_al Proloct Costa tltem 6)x mnlhpher x �" "'. 3.Pltmtbing $ 2 rn 4.Mechanical (HVAC} 5.Mechanical (Fire w Suppression) $ Total All Fees.$ 6.Total Project Cost: $ 5,993.00 Check No.,!Check Amount: Cash Amount ❑Paid in Full ❑Outstanding Balance Due: Mlatt� l � z� SECTION 5::CONSTRUCTION SERVICES: 5.1 Construction Supervisor License(CSL) 90125 10-06-16 JAIME MORIN License Number Expiration Date Name of CSL Holder List CSL Type(see below) IJ 86 GARDINER ST No.and Street 'IYpe ` Description U Unrestricted uildi s u to 35,000 cu,ft. LYNN, MA 01905 R Restricted 1&2Fami{ Dwelling City/Town,State,ZIP . . M masomy RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances 508-351-2214 I Insulation Tale bone Email address D Demolition 5.2 Registered Rome Improvement Contractor(HIC) 170810 12-23-15 RENEWAL BYANDERSEN HIC Registration Number Expiration bate HIC Company Name or HIC Registrant Name 30 FORBES RD No.and Street 508-351-2214 Email address NORTHBORO MA 01532 City/Town,State ZIP Telephone SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the Issuance of the building permit. Signed Affidavit Attached? ' Yes.......... No.... .:....❑ SECTION 7s.OWNER AUTHORIZATION TO BE COMPLETED WHEN "='-`OWNER'S AGENT OR CONTRACTOR APPLIE9I OR 1111)"INC PERMIT . '"" ' I,as Owner of the subject property,hereby authorize JAIMEMORIN to act on my behalf,in all matters relative to work authorized by this building permit application. Print Owner's Name(Electronic Signature) Date SECTION.7b: W OR AUTHORIZED'AC.ENT DECLARATION`; ' ' ;. By entering my name below hereby attest der the pains and penalties of perjury that all of the information contained in this applicatio is true and to to the best of my knowledge and understanding. 01/20/15 Print Owner's or Author' is Name(Electronic Signature) Date 77 d. b,., a' ,ti,,,d� m3rN,�,.r '`°_ NOTES.€�. xi.: -i ,+ '„r'^� .,"m','1� . , . .,,,. .._4 , ti .n_ 1. An Owner who obtains a building permit to do his/her own work,or on owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration program or guaranty fund under M.G.L.c. 142A.Other important information on the HIC Program can be found at www.mass.eov/oca Information on the Construction Supervisor License can be found at www.mam-goy/dos 2. When substantial work is plarmed,provide the information below: Total floor area(sq.ft.) (including garage,finished basement/attics,decks or porch) Gross living area(sq.ft.) Habitable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of half/baths ` Type of heating system Nnmber of decks/porches Type of cooling system Enclosed Open 3. `"Total Project Square Footage"maybe substituted for"Total Project Cost" f CITY OF S,. 'tit, NfAssACHmTTS Bi;iLmm DEP.,tanm+lT 120 WASITYNGTON STREET,9 a BLooR TEL,(978)745-9595 PAX(978)740-98" KIMBERLEY DRISCOLL MAYOR THOMAS Sr.PMUE &mmrott of Pt:atc PRop"T1r/BcnzmC,CoNtaMWONER Construction Debris Disposal Affidavit (required for all demolition and renovation work) In accordance with the sixth edition of the State Building Code,780 CMR section It 1.5 Debris,and the provisions of MGL c 40,S 54; Building Permit# is issued with the condition that the debris resulting frmn this work shall be disposed of in a properly licensed waste disposal facility as defined by MGL c 111,S 150A. The debris will be transported by: RENEWAL BY ANDERSEN (name of hauler) The debris will be disposed of in : RENEWAL BY ANDERSEN (name of facility) 30 FORBES ROAD NORTHBORO,MA 01532 (address of facility) of permit applicant 01-20-15 date drbrisaffdac ' � MA Homelmprovement Convector) Renewal License#170810(Expires IZ23Y2015) byA1 dersetl Renewal by Andersen Corporation Federal Tax ID 447-1916d13� winnow urrt*cawrn+ L,,, ..,,r, 30 Forbes Rtl NonhborouglT MA 07532 (508)351-2200 Fax(508)-986.7072 j CUSTOMER WINDOW AND DOOR REMODELING AGREEMENT !Buyer(s)Name Date: i GALE E. NIKOLOPOULDS - GEORGE NIKOLOPOULOS NOVEMBER 29, 2014 -I jBu ar s Street.Address City slate Zip Code j 2&MOFFATT RO 9AL&M MA 1 01970 jEmail Address Home Telephone Number Worti Telephone Number 978-745.7078 978-595.4775 Buyer(s)hereby jointly and severalty agrees to purchase the goods and/or services of Renewal by Andersen Corporation("Contractor;'),in acc'onlanca will) the terms and conditions described on the front and the reverse of phis agreement and an the attached specification sheets)(collectively,this"Agreement'). JBuyer(s)hereby agrees to sign a completion certificate after Contractor has completed all work under this Agreement. i Total Job Amount $ 5,993 kabount[rnarrnedS 5,993 9W12WLQWfif%1911tod of Payment Deposit Harrowede 12-14 weekslvad(33%)$ 0.00 I•;'� ChecktCash- Balance Sian of Job(33%)$ 0,00 DoWdl at ngrma$ 2,,996.50 Chock# Balance on Substantial plauAuwd,ol Eat.Install'flme °i Credit Cafd Completion of Job(33P4)$ 0.00 Comptaaox S 2,996.50 1-2 days aea Ifcreditdialardalsdad.plom Credit Card pTymMt form 1 iBuyor(s)agrees and undormands that this agreement constitutes the entire understanding hahvaen the parties,and that there are no verbal understandings lchanging or modifying any of the forma of this Ageemen6 No adoration to or dovtation train this Agreement will be valid wllhout the signed,written consent of bath Suyor(s)and Contractor. Safaris)hereby acknowledmoa that Beyond)1)has read whit Agreement,understand$too terms of this Agreomonq and has lot both completed,signed and dated copy of this Agreement.Including the two attached Notices Of Cancellation;on the date that written above and 2)was ;orally informed of Buyers right to cancel this Agreement. GO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. I I Renewal by Anderson Corporation File) Buyer(s) Signe1U201 Consultant Signoras - - $Ignatara ' i M WILL 9ALHM GALE E, NIKOLOPOU40S GIIORGE NIKOLOPOU40S Pdn9d Naemo!Carsellaw PdniadName PtinWd Noma j I t! I i YOU. EUYER(S),MAY CARD" TINE This TRANSACTION AT ANY NE PRIOR TO MIDNIGHT OF THa THIRD pUSINSSS DAY AFTOR THE OATS OF The TRANSACTION, I SEE THE ATTACHED NOTICE OF CANCELLATION FORMS F41R AN EXPLANATION OF THIS RIGHT, ______ >____._ ________________I NOTtr'E OF t.LNCEWA'yfON I NOfIrd.OFCANCw.IAI'IDN I D.L eP1la.xn5lhm Ut;l11 You,n.y,rargl Lhia ; p.{e oP TYaaadtim, IVih/II r YtM,npyaae.lildc in ...a Nov,wdorg.auy penalty or.bkfgnuoy wpbfa,hrw bans iexa do,Wm who l ,abe..cruo, blaaaa y,amak, rahHxadno .Wile rhino faxla '."" hen,the 'aboav dia.It you.,.I,Any raniaty',ruded W,ray payuunw made by yo.undo, , alone date.if yog, e~rl,any pmpeny,rAded in,any paya,teals mode by yvu under 7,heL'owraceoPffily sal any,.got:aweinsbma,entese.n,ed hyytiaaval he. i xhe.Cm,rren ufaak,coil any aeg.t6weinx,xvmen,eaeemed ayyvau:gbe ,oOmnedwldua la do"adlnwiagr,rceip,by the Cwn,rm.[ne("Seaee")-.ref yaw , ,etwnea w:W:n lUaaya toanwieg,eaoip[by the Cnnusseu,r("Seaav"j afyom • $cutcollatini,.erica,aodany.ocurNy W,areal ar6iag car of duvurva.aotim wilt He rw.U.0a.aorta.,and any.eaurity Wte.,arfeWgovt ol',ba lranxaett.a not be 7e—fins, If you wmai,yvu mural make grailoble,u,he EaUae o,yeas rcaidaoce,in cnvrnlad. 11'yea sassy/,feu ml!*t,nakn urpUablcmWe seller ac yuue midnuce,in ixubx,umlally..goal randbloa ue war.rrmfd,any gouda kIbmnd sage.vrafoe I a*wiwo rnraivml,any goad*,Nlimmd larva.nor ;,b1A G'mnror[or S*tel or you may;/[You wish rungdy whbn*inaeuedaaw of,hn I Wlx famrua,nrS Wi Y. ye rrY Ih am,ply wiW daA.uurtio..rtl',ho ISeger re.gnxiing We mt wp teen,of ram gnoax at d,e`ieN J.. pr.*e and rick. I Seller mg.rtleng tb eawru xidpmant ofWe goals e,the 9eanrx a. p. -.and rlxk. ?If youao r„akc,hegmdc aaailalria,o the Seller avd Wegearrdme sot ptrL W<m apt I<feu art make the gaadx cocoa. ,a Wa Seller arut We caller dose m,p,rk Wem up iuiaaa 2U dare u<Wean,a of your No,iae oFCnaaal6umb you stay retain dlapnaa,l Win 20a y.of toe du of yv rNmt ed'L`sacetl tW y rttay t or Wnpase jof,bra geode.:/acute ryf eth .w:geNna. If ym,ma ,oaks We g.bd ay.flawa fit g J vhha , ')lank tnggh . it felt ahIW go nrallakle Na tba eearp.rLr you ag,e Wremrn thrtg�saA.mtho cell real PoUmdu xla,han 1 t tl Sellrvy aril'). grea rovmurn she goods to tad 5¢11r n, ran l Wd.dn en,dum you,tnnuhrlt.hN Arpafi,nnauca at ell eb9gaNnn*uadrr lbn dansrach lb aeunel yvvrrnl.in liable[fir pa.tarn,amarat all nlrllgmia,u under Wo Ceat¢aoi. li,auand 'IWx trn.*mdao,mall rzr decree pxigned nn,fAmod eom'ol'Oti*omaaraadonaNea W1.4 ,art nfnn, r it d U .ro IgaM and G. re Uha.aam0annn nmlce j3nr any other wdlaen nail yoIA 015tlyrmnmBa ERnln Rnwwatby I'OF q, 1"0161O.N.rfloo— u,or xeudntalagranuo Oontmnnry R.nmrN by Andmen, 1010rs5t. Norxabury gh,MA 01932 tlY NOl'LATER T1fAN MIIDNif.H'1'OE I f0[Otis g, Nenbtmmugh,A1A Ot532, HY NOT UTtdt 1'ILLY Jf1UNl61{T GF i .inaal...11{gaYgYGA,YDELTItIa'tAA.N£.C770N. I _.lb.lel If1EREB5'f_L.ti Doi.TTOS TRA'iSADTION. i I ; I I � I { anon 5,ywun .erP hire+ nYn Ou,T, ay..a:e Poll. o Pen Renewal Renewal try Andersen Corporation dA Home Improve here Contracto byAndersen. 30 Foibes rd Nonhborough.MA 01532 License d170610 (Expires 1212a2015) wrnoow acrrncrwcxr ,"n..:...oc.�.,,:.\ (508)351-22M Fax:(508)-986-7072 Federal ID 541-1918413 Window Specification Sheet (Buvov(ki Nano Date nt tgnaentent GALE E. NIKOLOPOULOS GEORGE NIKOLOPOULOS SAT, NOV 29, 2014 Till'(Nl\Uf(Aj I(SICd a{MN'C ill tt tYl�cliltdY aIId SbYCYaiil'a1,rICP t0 jlunvl vs.:tit[)good"and/or 3%'t'Ifln3lti(Cd(9P.{II4Y {n a(fQrdaHb)NYth IIIC{)1'IfCti aiYd tnYIIls �dc'tailxd mr the Specification Slwel and the frnnr and the re vm. or t9te accomparfying C.1C4`1frM WLVD1OW AND DOOR REMODELING )AGldUMEN9;of which ihc;Spfcilieation Sheet ix part. i WINDOW DETAILS Aro. Na rya. E%[e(19rMte1FT Odor Herl',xv Stmewae L.64t a,o Grae Oil. Doan D ism gtynt U.I.. wndowiboor Suite betall Pia-Inn Cob, chi, srXmns smmmx, GrIIISS 3a61,a exo2 Lift, Ontom easernnt 5 :30 12 1 42 Cw insert laid, Ekt.Wrap HA4H WNte Standard FFG tow-Ea oboo Yea No lord 5 BAY&BOW DETAILS Aoprox slyenelaa FW'ntkers! M&wmtaJ A wmesr I. Wirldcw FAd comer LpwEr W.ni/ Haldwa:a Poem Cnurrt st✓w M Cma�s An tees Imeimr ExVint Color Ciffe:l sasrres sashrs 6weans 9mnstm wxil CWa SPECIALTY WINDOW DETAILS Furst Ap L—ar i3witn BAY/BOW ADDITIONAL WORK NOTES Poem Court at" Insert Ut. serrd&n (1[Iles ON10 Ervklt cxmr C;uw. ne:Al ei�h nwFl.acw+nr.�rvs m.,tor:�;nNrce don•; JHzyeulfia.x d.0 kc ADDITIONAL WORK DETAILS: I No Contractor will wrap exterior casings with wit stock cater of Owner is aware that Contractordoes net do any painikgistaming ornerpovallinshuralion of atann system or window lreafrenLslhardware.It is the responsiblity of thehomeowrtni to have the alarm system and window treaunenfsthardware removetl prtar fo instaaation. Yrt make no geuraNee as fo wHether aramsnrwindow ..J treafinenmfhardwam Wlli fit aft rmplaceJrlant. Caitemerm afs0 tomato sore cares there will be glass bay- I1lhera ls,ate amount will be dependent on the type of existing windows,type otinstalmthin and window style."make no guarantee as to fee amount of glass toss Customer rs were and understands any and all unseen tor is not imitated it)this cnahact-Shoutdanyrot be found mete.0 bean additional charge tar time and materfeis unless so stated in this contract 17, yea Contractor will insulate,caulk and seat windows with 3-poVot system to prevent wale,and air infiltration-Remoral and disposal of all job related debds, windows,doors,storm windows and eactalm nightly included. Upon cofnplmon of the job and payment in full,a fimired warranty shall be issued. iI Yes Building Permit—Contractor will secure any and at necessary permits.The tee for the permits)L not included in the Contract Price and a separate Uteck is required at the time of sale for thin tee. Check li § `+ Yes All discounts have been applied to this agreement. a \is Pt No Owner agrees to be present on tree final day of installation for I"inspemon and to deliver final payment I finance f xdrlflf- h yM Iduu'ustnd In"uily t'.ut .Itv le dot tl � .Jnal 11 ui Ltd Ct 41f>At It IVI]<7A LAD 110U2 RF VUL17tV[ 1t hl LV11V k ursd '.n ,m+q.rsun(k,g Leo.crn tbe#mnns,ant tAerc urc ro.erlr-a nndvnraz i,sk c&m�.�or and Fiixy my-r f eM I.m�:. I!lo Six nu d ra,Stxm Imxt n �t"cl4ulg d r¢.a,vu..as 1! d ur.ari,d in Iwlp n-.q^unlu\s etc rllnngeemeumntius rml gigtxil L_v llpth t#w 8u n tw Gum,. to Yxnvts}Cet to.,t,vMfiiLe ll.u8,},r,_6snadilllti fiPt':31eiw,n Mho1, iRere.1 by Anders en Corparedoe 8u� rsj Signature of Project Manager Signature Signature WILL SALEM GALE E. NIKOLOPOU LOS GEORGE NIKOLOPOULOS Print Name of Project Manager Print Name Print Name i The Commonwealth ofMassaehusetis Department of IndustrialAccidents Office of Investigations #Work I Congress Street, Suite 100 Boston,MA 02114-2017wwwmassgov/dia ompensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (BuSi ess/Organization/Individual): RENEWAL BY ANDERSEN Address:3 FORBES ROAD City/State/ ip: NORTHBORO, MA 01532 Phone#:508-351-2200 Are you an a ployer? Check the appropriate box: F�o oject(required):1.9 1 am a e ployer with 30 4. ❑ I am a general contractor and 1 employ s (full and/or par[-time). have hired the sub-contractors construction2.❑ 1 am a s le proprietor or partner- listed on the attached sheet. odelingship and have no employees These sub-contractors have olitionworking for me in any capacity, employees and have workers'com insurance.# ding addition [No wor ers' comp. insurance P• required] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions officers have exercised their 3.El am a li meowner doing all work 11.❑ Plumbing repairs or additions myself o workers' com right of exemption per MGL Y p 12.❑ Roof repairs insuranc required.] t c. 152, §1(4),and we have no employees. (No workers' 13.❑ Other comp. insurance required.] 'Any applicarathal checks box#I must also fill out the section below showing their workers'compensation policy information. t Homeowners wh submit this affidavit indicating they are doing all work and then hire outside contractors must submit anew affidavit indicating such. tContrectors that dI eck 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 s b-contractors have employees,they must provide their workers'comp.policy number. I am an emploj er 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: 10/01/15 Job Site Addres : City/State/Zip: JUp,,. V ,6\ O\Q qp Attach a copy. f the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secui• coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,5 .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 $250.0 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations o the DIA for insurance coverage verification. I do hereby ce' 'y u er the ' s and penalties ofperjury that the information provided above is true and correct Signature: 1 lZff Date: � ' O- Phone#: 508 351-2200 Official use nly. Do not write in this area,to be completed by city or town official. City or Tow Permit/License # Issuing Autp ority(circle one): 1.Board of I lealth 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5.Plumbing Inspector 6.Other ' Contact Per on: Phone#: ANDECOR-01 YADAVYO 4�oR j CERTIFICATE OF LIABILITY INSURANCE DATE(MMDDYYYY) 10/1/2014 THIS CERTIFICj TE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE E DES 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 REPRESENTA E OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: 'I F the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and I onditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holds r in lieu of such endorsement(s). PaoouceR CO NTACT certificates@willis.com NA Willis of Minnesota,Inc. -PxoME FAx --- c/o 26 Century Blv INC Na Ertl:(877)945.7378 Ale Nol:(888)467-2378 P.O.Box 305191 1 EMAIL Nashville,TN 3723 -6191 ADDRESS:, I INSURER(S)AFFORDING COVERAGE NAICIt _INSURER A:Old Republic Insurance Company 24147 _ INSURED INSURER B: Rene Nat by Andersen Corporation INSURER C_ —_ 30 PC rbes;Road _INSURER D: Nort borough,MA 01532 INSURER E: INSURER F: COVERAGES I CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CER riFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NO THSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE WY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECTTO ALL THE TERMS, EXCLUSIONS AN CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE ADD SUER POLICY EFF POLICY E%P JNqD POLICY NUMBER MWDDrfYYY MM/OBIYYYY LIMITS A X COMIMERCI L GENERAL LIABILITY EACH OCCURRENCE _ $ 1,000,00 TCLAIM MADE1XI OCCUR MWZY302940 10101/2014 10/0112015 AMAGET6RENTED— PREMISE�EaocWTence $ 500,00MED EXP(Any one person) $ 10,000 _ PERSONAL B ADV INJURY $ 1,000,00 GENT AGGREGA E LIMIT APPLIES PER GENERALAGGREGATE $ 4,000,00 X POLICY J PEo � LOG PRODUCTS-COMPIOP AGG $ 4,000,00 OTHER' $ AUTOMOBILE I ILITY MBINED SINGLE LIMIT $ 5,000,00 JX (Ea acGtlenll A ANY AUTO�i, MWTB302575 10/0112014 1010112015 BODILY INJURY(Per parson) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE -- HIRED AUT AUTOS (Per accident)$ UMBRELLA JAB OCCUR EACH OCCURRENCE $ EXCESS LIA CLAIMS-MADE AGGREGATE $ OED RETENTION$ $ WORKERS COMPI NSADON X PER O H- AND EMPLOYERS LIABILITY STATUTE ER' A ANYPROPRIETO PARTNERIEXECUTIVE YIN MWC30293800 10101/2014 10/01/2015 E.L.EACH ACCIDENT $ 19000,00 OFFICERMIEMBE EXCLUDED? IN] NIA -- - (Mandatory lnNH) EL DISEASE-EA EMPLOYEE $ 1,000,00 n yyae,deeplbe un r DESCRIPTION OF OPERATIONS below E.L.OISFASE-POLICY LIMIT $ 1,000,00 DESCRIPTION OFOPER knONSILOCAMONSIVEHICLES(ACORD 101,Additional Rur arhe Schedule,may be attached H more space Is required) CERTIFICATE HOLDER CANCELLATION I 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 Evid nce of Insurance LSaW ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 26(2014�1) The ACORD name and logo are registered marks of ACORD 4�) Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction S,upen isor 55 License. CS-MI25 JAM L MORDV 66 GARDINER Si LYNN MA 0190� " J2�� "" Expiration Commissioner 1010=016 .,,..... �\ C-�fie �pavrema/wiear�aP�paadaeteuJelGl fficeof Consumer Affairs&Business Regulation iCiC' OME IMPROVEMENT CON7RpCTOR 1j1j Registration 1170810 Is w.•S .,. 3 . Type Expiration 41 2/2 31201 5- Supplement kk RENEWAL BY ANDERSON,CORP,ORATIO14 p9 • .JAIME MORIN 104 OTIS STREET NORTHBOROUGH, MA,01532 -Uadtrsetretary y��y t9 Do not remove until final code inspection. Save label for future reference. Qualified ITT ama 13 Y.< �.: � I enereystarnrcan- . �. ), Ol .d rnean.9c.ce �i `: 1...�rrY,� t'�a;'l✓ v w Q w w t U W 1 LSYL76'llCititil energystaraov w 1 w =Owlified/admissible Renewal WINDOW REPLACEMENT un Amtersen Cumpuny 'c:3:rE zsksY:�? AND-i ....... Dual Argon Low-E4 SmartSun Product Type: Glider ENERGY PERFORMANCE RATINGS U-Factor Solar Heat Gain Coefficient 0.29 1.65 0,21 U.S.4-P Metric/SI ADDITIONAL PERFORMANCE RATINGS Visible Transmittance 0.49 Manuraccu"r sdpulams matalese man,conform to apoicame NFRC procedures for determining mole product paROnnance.NFRC nar m,ere Oa armine0 far 9 fcoam set of awrOnmental c0 airuna and 3 specl(IL pr00ucc ePa. NFRC does not l dc,M,nd arN pNOu[[and d0es not N8.r m0 sumn,1ty 0r any pred..for an,'speLRlc use. Cdnsu6 manufacturers Nenevre for ONar preaucc peRormance information. I e wingdow snd Door NAS°OL a00�rs Andersen Cor oretion:RbA Glidin Window Manufacturer s pu a as ddnrdrmenca o e ma.,s n er s Standard Rating NA5024, .:M."JBMAMSA?4?,'.::^e]If lCg ni...... .. DP psf�HS-C35. . gt Tnla prddua mean Goren sears C / emirdnmenml standards CZt gmarning energy efpman"navy metal, In me frame and sasn rademal,p3cl6ging,and Ya,�l consume eaua5oan21 L A 100-00512036-015 Naem ar aaceads m.EL„C EL,s ELL.formFlu Zrapuirements9 M NaemaM CemHcatian Program.