37 MOFFATT RD - BUILDING INSPECTION 11
11
What is VW Current us@ of Uw Suk%V7 It dwa 11 MnO.I+ow maefi u n ft9----- -
M.W1a1 of 9uw*? Asbestos?
we the*`yyt Cp,lorm to LA*? - bC -
lt1CAtYL Munn ° ST1�LTT tiInAY11 2O
enk'a NfrtM
AddreM and PIMM~ HIC R*GWNWO r
Cow swowl"s Ljcanss�8, 0 0 o rni FM C—'r.'I�or1
Esw�roA d Ftd , 9 C.4 X WISiODO
RadderAld
penrA Fes$ Xs*ndlAd Co@t X:11/f1000 Cane-
M AddNlo^r
._ M added as an
}INds are OroPwy wrl�+to avoid dala+ys
inMay sots that
The w-40, rad Was hereW aVvb for
a BuYdInO
to
to the above als0ed
sla+•d
undM penal
of
very
a
Datr � 3 0 C9
v °^a'
II �I
g
a
\ --
PUBUC PROPERTY
uow.wwae„y�.s� rwo»7e V
AWy*y
amm As
• L3 31TN INf011YAT10N
London Narnee p -r 1,2o6
Properey A*kwsac
37 17-)OFFA-7'7 - Ro,q-D -
s />Z.4- D 70
b Y kx�sled ti a;Caewatbrr Area YM des obwa YM
23 t71A1NIdRtalllP INfORYATION
2/ OwearofLand
~ OL F%e G
Adr}eeec 77 /Y)O,�,c,9-7 r .20
Tilephorw l'/9 70
S- O
3ACOMP6E1N THIS sECT10N IOA !:-A
1A1Otsl(IN CAULLUM
134"Mas ONLY
Add dcn
Rwwadw Zdsgng
Number of stones RenovatedChan"In Use
Cemolitlon Now
Approximate year of Area per floor oonetnrctton a renovation (SO Renovated
of aid ,rq b MOV
New
Safe!Ceserfptfon of Proposed Work:
k_CpCl4C-� CffJ /NDoc�S
Mad Permit to. — -
�I re newal
�BY ANDPRSEW v,Me.,npl wm� _. •+ " " __
Customer Service 800-573-7606
104WeSVNodhb ugh,MA0IM2-Man:(508)91frOSM Fin:S0e1919-0903
JAL W1n#ows,Inc dbe Renewal by Anse sen-Conbepor Ucenae#149601 Expretlon Oae gw29IT00a
n �l "D 'OW A REEMENT (}�
SOLD TO: ( 1 . 1 fA � DATE:
ADDRESS' C 4 PHONE-Home:
CITY: �Or dY\ STATE:r• .Q_ZIP:QJCI:2Q_PHONE-Work: (_)
JOB SITE.ADDRESS(ifdiferen): - E-mail:
Approximate Stan Date:-- Approximate Completion Date:
SPECIFICATIONS
Renewal by Ander pproved materials will be furnished and installed to these specifications: -
1. Install total o/: windows.
2. Quantity of windows: -
'&Double Hung(DEL)?,Equal sash D Cottage sash(1/3 top,213 bottom) O Oriel sash(2/3 top,113 bottom)
_Casement(CW) Hinge right O Mingo left(as viewed from exterior):OStandard handle OMetro hantlle
_Double Casement(COW) OStandard handle OMetro handle
_Casement/Picture/Cas6ment(CP101) 01:1:1 or 131:2:1 OStandard handle OMetrohandle
2 Lite Gliding Window(GW) -
_Glider/Picture/Glider(GPM 0 1:1:1 or O 1:2:1
_Awning Wiindow(AW) -"- -
_Picture Window(PW),
Bay or Bow Window:
3.yl Yes O No #Windows to be Custom Fit Replacement:_
4. ❑Yes 0�1,10 If of sills to be replaced:_
5. ❑Yes I_�1.N* o If Windows to be New Construction Full frame(Includes new interior&exterior casings):
Exterior.casings: 0 Pine 0 Maintenance-free material 0 Factory applied 908 Fibrex brickmold
6. Glazing to be: 0 High Performance 0 Other If other,please specify:
7. Exterior Color to be:.0 White 0 Sand_ �C,anvab 0 Tenalone -
8. Interior color to be: 0 White OSand qA- anvas 0Tensions 0 Wood.
Note:Interior color can only be white,wood or same Color as exterior. Wood interiors need to be finished by cust.
9. Hardware: 0 White 0 Stone 3LCanvas 0 Brass Double Hung: Install lifts? 0 Yes 0 No _
O. 0 Yes o Removal of metal frames or grilles #of Unme:
11. 0 Yes PLINIO Install new paint-ready or stain-ready casings. Inside or outside stops#of openings:_
Interior using#of openings: Exterior casings#of openings:— 0 Pine 0 Maintenance free material
12. Customer aware that RDA does not do any painting. Cast.initials
13. 0Yes LXNo Wrap exterior"sings with aluminum coil stock: color.
Note:Required with storm Window removal.Removal of alone Windows will leave screw holes in using.
14. New windows to have:. 0 Half or IWFuII screens Screens to be:-g Fiberglass 0 Aluminum
15.Wndows to have grilles: 0 Yes LQ No If Yes: 0 Grille Between.Glass(GBG) 0 Removable Interior Wood(INTW)
❑ Full Divided Light(FOL) Grile patterns:
#:_ #:_ #:_. #:_ #:_ #:_ #:__
B F B 1-1 M
DH DH DH OH CW/Pldure Glider CPWor GPW
'use di ilonal sheet if needed Customer approved(initials):_
16.JYes 0 No Insulate,caulk and seal windows with three-point system to prevent water and air infiltration.
17. Yes 0 No Remove and dispose:of existing windows and storm
18. Yes 0 No Clean Up. All job related debris removed.Vacuum nightly.
19.MYes ❑No Insurance. Al workers Compensation and liability insurance maintained.
20. Yes 0 No Warranty.Given to Customer upon completion and receipt of full payment.
21.Additional information: -
22. Regular Retail Price:$ Q
23, Total Project Amount$ All available discounts have been applied:❑Yes ❑ No
24. Is Project to be paid in sh 0 Ca Financed 0 Combination of Cash and Finance
25.Cash DeposdapF3a:$ 113 of balance due at Stan ofjob and final 1/3 due at wmpletion of job.
If remaining 213 payment is made Dy redit card,an additional fee of 3%"w�itll�b.e added to cover fee charged by Credit Card
26. fij,/�Yes 0 No Financed. If Yes,Amount Financed:--p.ccount it: )
27.tYes ❑No Customer agrees to be prevent on the final day of installation for final inspection and to deliver final payment.
28.10,Yes ❑No Homeowner gives REA approval to place a yard sign on their lawn at the time of measure.
29. Yes O No Building Permit-As a Convenience the company will secure the building permit.The fee for the
permit is not included in the agreement price and a separate check is required at the time of sale for this fee.
'RENEWAL BY ANDERSEN'IS NOT RESPONSIBLE FOR ANY EXISTING SECURITY SYSTEMS OR CONDITIONS THAT COULD NOT HAVE
BEEN SEEN PRIOR TO OPENING THE WALLS. PLEASE REMOVE ALL SHADES,VERTICALS.BLINDS.CURTAINS,DRAPES OR WINDOW
MOUNTED AIR CONDITIONERS.AND ANY FURNITURE AT LEAST SIX FEET AWAY FROM WINDOWS AND ODORS PRIOR TO THE
INSTALLATION OF YOUR NEW WINDOWS, INSTALLERS ARE NOT RESPONSIBLE FOR THE REMOVAL OR INSTALLATION OF THESE TYPES
OF ITEMS.'SALESMAN HAS NO AUTHORIZATION TO CHANGE ANY ITEMS OR MAKE ANY REPRESENTATIONS OTHER THAN CONTAINED IN
THIS AGREEMENT AND'OWNEM REPRESENTS THAT NONE HAVE BEEN MADE TO,OR RELIED UPON BY'OWHER.'YOU ARE ENTITLED TO
A COMPLETELY FILLED IN DUPLICATE OF THIS AGREEMENT.'CONTRACT SUBJECT TO FINAL INSPECTION BY RENEWAL BY ANDERSEN
CONSTRUCTION DEPARTMENT.TERM$AND CONDITIONS THAT GOVERN THIS CONTRACT ARE PRINTED ON THE REVERSE SIDE. This
cumrect is a legal dwu rent.Ywr Renewal by Andersen pradues till bs in Fadaty matle-iOgNer for you.UNDER R NO CIRCUMSTANCES WILL
DOSSIBLE BEYOND THE THIRD BUSINESS DAY AFTER THE CONTRACT HAS BEEN 51UNED AND
ORDERING ARE CORRECT.
RDA Rep.Signature: Date:Customer Signature: / u Omer Signature:
Win nexrelby .e ii Yellow-Inatalaion Pink-Ho r _
US-92-0y
y� Ths ComtisoniDeolrh ojMassgchwserts .
�—\ Department of Industrial Accidents
Oc� ojTnvestrgotions: . . . ..
-Sfreef
600 Wcshingiori .
Boston, MA.O1111
vd .
�v►vw
8
I �Vorkers�• C . .,
:.
d r /C
tra. ors/]E1ictena Cia nsr/io
ltuLtlneb ei
rs
o�Pe Dsatl n Insurance Atrtd •tB wl
IicinLIn�o3matio>d
'fir.'(Hos[ne31/orszation/Ine;v dual):
ity/State/Zi
tyou an employer? Checktbe-approptiate box Type.of project (required)
G � . 4.- I pm i general cnntractar and I 6, Q Ne cots'truction
1 t aTn a erv)oy �2s '
cnryloycc3:(fun atd/oxwn-ti7ne-)_I- bavc blred the sub-cOntractvri 7 odclwg ,
`IiStcdoathcati2cbCAShect 1
.I:acria,Solcprvprictororpartncr- - ncscSub-co�¢actu7sbavc 8, ODapolitioa
sDip aadbavcno.eutploycu , - `
workers' corup,ansvraDea 9- .Q Building addi4on
-'�yorkitiP for m4 is any capacity. a co Hoot and its . ..
5, .0: c �°, 10!Q t1cctricalicpairs-or additions '
(NG wotktrs' comp- i4sumcc .. . o ceri hake cxetcii tlicu, _.
requirtd_J, 11.0 Plumbing rep Ats Cor additions
]d am abomcorYncr doing all work
ngbi of exemption pci MGL
..myself. [No wOrkcis' cow c ).o e.", sad wc'baycAo 1Z:� Roof{cpaas.
insauaneacogtitarcd.J 4
eTgployecs. [No workers' 13,0 pdc it
;c?cr>p.iasurincc cequued)' '
'Ik.niU� [c ectYbon f�l irulst also,fill oulMe•e coon belpM alrowuta lAen wsken'eomp•*�t•?dn yoltny in Co[tltanosF -
rpp • A. such -
co`Mhcr: aLo atrnit thii CIS nt z4clz;ne Ibcy sm doing ill..psY'snd thc0 Lits ouicldc'�Llnctv?i mWl cubrnit•ocw. di v�l rim cari.�a .
•cvn[Dsr,nh eclC IMt boi`-must stfieh cd�n:sddilidhsl'sheet•IWNIne the nuns eC'tl�s �i.b«ontn clan sad then wolisn�'ccnp.'PoLry intoT'e[sa[i ..
en trnployu iha[it p�ovidiM`)Vorkerl'compenaalw stisura>.eefocrl+y employtes Below Ls rhi po4ey Ind ob Jilt
Galion /� Jl l
iacc Corrspanytdamo: 5 1' J�Li K(.°Ol�lt' � ti
p
i1�oi Sclf Ins. ):.rc * -1 Uy P
:teAddress 3-7 /I�oF�ff7 T �'Q.9111 City/st triz� c�1974
sLowic the oLcy number and experalt;00 dste)
is copy of the Workers! compeasstion policy Aiclaralion p.;ic ( g R
c to sccurc.covcragc u acquired il' act scction ZA of MGL c. 132 c�ii liaQ w.t>?c►mpositi'pn oflwiltlmal pcnalncs of a
r to s i,500:00 a13d/ox one year impnsonrne¢k u wcll.as civil penalties in the form pf x STOP WORK ORDE1?�d a `
oS2S0;1)D a bay.againsitheviolatot- �e advised'thata-copy ditLigstatcmrritrnaybc of
fortivardodto the Office
igations.of tLe>SIA for ilisuranc•c eoyctagavuifiration
eby ce u�_ r the ats and/pehalties v 'pWJµry�hAt yhc niformattonplovlded above 1s ake gnr(corre"
are 6L<G%5kt_ / DZtc. .' Qh
�.
ilia! l<7e:ohCy. Dv i+ot ivrilc'iti Ihi-t area;fo br c4i leyed'by city or to7�ry
Information and'Instructions
Mass achuscrts Gcncral,Laws cbaptc l'S2 requucs all.EiTloyers"ftspT6Yideiyoikas' comp.cnsationfor the' CS
pursuant to,
_ this statnte, anctirrployeeisdefinul as." ..every. p,ersottin:tic sdi icc'ofanotherundcranycoafraefofhire
cxpross;or licd, oral or written,"
An employer is dcfip•ed as "an individual,partnership,,assd.ciatioa,•toxpwation.oiothcr legal entity, or any two.or rMte.
ofthefo, oineengagedinDjointenterprise;and.includingtheleggyiepicscntativcs'oftdeceasede4loyci, oTthe
rcceiv"er or Wstee of ail, partnership; association or other legal enij•ty,.crnploying errrployecs.;HoWcvef.iLe:
owne►of a dwplinghouselam- gnotmore than three ap art uicats2nd.wbo TCsidtf therein, oY the occupantdithc
-0welling house of anot?ler•wDo'Gmployspertotu tb do•maii3tenancr; construction or repair Work' i such dvelling�house.
or on the grounds..orbulldimgappu7kbant thereto_thall.notbcoausc ofsuct employrnentbe deemed tobc an crrryloy.cr_'!
MGLcbapter1S2, §25C(6)aisoalatesthat"every stateotlotallicensingagencyshallavithholdtb'cissuanceof
reloil' l'of a lic- Dilt or permif to operite-a business or to coo;trµct buildiogsio'tbe cornmowealth for'.aay .
applii-"''t.wbb haunt produce) acceptable evidence of compliauce,.M t!<t osuraace,covera`cregmired,'
AddiTiopally;.MCL chapter7S2; ¢2 C(7)abtcs"NcithcstDc conunonWcaltL'iioranyaf its poliacal3»bdivistoms shall
enter iatb;any contract for:the perfomuncc ofpublic yvork until ieceptablc mdenbe of eompliince with the,insuraaco"
rcquireffi , TOfTbitchaptabayebettprescw[ dtothecotitractiiigautbority;'' "
App uc.in is
Pleasa fi)I out. rDAworiCerst corMewaoom bffidavitcompletely,bychtckiygthoDoxcs that-apply toyouisituatzoa and, i[
nccesspry, supply s0-contrador(s)nunc(s), addresi(es) and'pbopenuinbcr(s) along with theirceiti6cate(s) off'•
inssirai;ce. •I imitedLiabilityCvr�anics (LLC)or Limited l ialir(ity PirmerjDips (LLPj With'no cirtployees otJscz tban.:Me,
merttbcrs orprrtners, are n'otrequirad, to curfwoi eis' corn eoa2noo ms,2oce. If an LZC orLLP.docs have,
etrpl oyoes;,a p oli.ey is req uircd- .B c•adVis ed that ibis a lfida Vie may:D c sutirrii ged.tp ily c Dcp ai=cnt.o f jud,•usrrial
Accidcats.foi confuination otiiadranoc cgvcrzge. Also be suri'to sign and dil`tbehMdavX. 7Dc affidaytt sbouJd ,
be cnvne� .Eo the city pTtown tLaTthE applicah'b�for-tb't'perts itpr)ictnscis bbwgrcqucstcd nbt tDcDcpa7rtrtscnt.of
Industrial Atcidenti "Should.youhavcanyguations regarding the La*ori(you arcr.cquircd to obtain 7lyoikers
corapcnsabon pnitey;ptt;ase call the Depiitrgentprthc'tiumber R5tedbclgW, Sdf-iatiured`corrDaaics shoiild enccrtbe¢'
self insurance laccnse jouynter ou tGc appropriateline:
(44
Clty.or Totvtt►,om Sls
Pleas c be scirothi[the affidavjtiscompJcicandpriutcd.lcgrl>ly. TIlcbcpartYncntha'sprovjdcd'i space R die,bottvm
of the-affidavit foi,you no-SIT out in the event'the Office of Inyestigations I;_ ro contact you,regarding the applicant
Please be.sure to fill in the pernsit/licctuc nuiribetivkpb willbc•uied as i refvenccnumber. In addition, an -JacanT
tbattnust submit multiple.pier.m`t decade applications;ia-anygiven.yc4T,need onlysutimit one,aI idayitmdicatina cwrint
Policy h*?mation•(ifneccssiry)aid undcr'Job SitcAddress"thc?pplicantsbould pfitr "alllo64tiowin (city or
aw`o)-"'k-.cvpY o ftLe a f5d a vit that has bccz officially statrspcd or m arkFd bytha city:Of tom may b cpro yid ed lro the
pphcaiDt af.yrooltLptavalid afhdayjtis:onfjlc.for futyropemtits orliccascs .Aocw9fBdavitmustb.efilleH ou-C'eacb
zar•.Where.a.bOme opyner or:cihxep is obtaining A license orperptit.00ttelatcd to am' business of COMM ItYcial lccq°ue .
a
do*g lscense Orperrnifw burp lea Yes etc.)slid person isNOTicgpiied.to corMletc this:iffidavit
De Office oflnvestigationi woWdlikc to tDankyonin advasico.for your coop'eration and.shoiild you.have any gts�IIo�;
ease donut b4sifatc to:giyc us.t.call: .
eDcpaitmeRfS:address, telcphonc
and-fax n'µmber: ' ,
The Commonwealth-'of Massachusetts
Departrnent'bf lndust i ial Accident§ 1
Office of I6vestigition7
600 Washington Streef
.. - Boston 'Ivfri 02111.
Board of Building Regulations and Standards
Construction.Supervisor License
License:' CS 74251+- -
Birt
`3)9AN s
it
.anon::H
::'
3/9/2009 Tr# 11065
, RePsUiction`_00 '`
JOHN K ESLER L�
4
104 OTIS ST
NORTHBORO,MA 01532 Commissioner
7k �iammeamtiira i �.�l.,noaT.lzuaalA
Board of Building Regulations and Standards
HOME IMPROVEMENT CONTRACTOR.
Registration., 149601 +
ExplFatton__1/24/2008
air
1 $ i6Te. Sdpplement Card
RENEWAL BY ANDERSON ''sj
KATH -
r.
LEEN BLANCHARD
i
104 OTIS STREET
1
NORTHBOROU 1
GH, MA 0332
Administrator
voi, v� LUVT LJ:'GO Jr NI'ILi 1�COTll A"1'n3 " /J1 E)'Ot E)ZV] " " " - _
ACORD, .CERTIFICATE OF LIABILITY INSURANCE DATE ROW " M
09/1212006
moOucel THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Joseph MG►Ceone - ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE'
JP McKeon Insurance A enCy, Inc- HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
9 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P.O. Box 333
.Ann Arbor. MI 48106-0333 - INSURERS AFFORDING COVERAGE NAIc N
wwEn
RenewaltiyAnderson IiIEIIRERA: liar ftd Insuranoe
J&L VVIndaws, Inc NEVER B:
104 Otis St 104UIER c:_
Northborouyh, MA 01532 EImes
LAERo:
COVERAGES
e
THE POLICIES OF INSURANCE LISTED BELOW WIVE BEEN ISSUEDTO THE.INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWI14STANIDING -
ANY REQUIREMENT. TER t F Y M OR CONDITION AN CONTRACT OR OT
HER THEH DOCUMENT wrtH RESPECT To WMS. THIS CERTIFICATE MAY BE ISSUED CR
MAY PERTAIN,.THE INSURANCE AFFORDED A THE POLICIES DESCRIBED HEREIN SUBJECT TOALI THE TERMS, EXCLUSIONS AND CONpTpNb OF SUCH{
POLICIES.AGGREGATE LIMBS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAW. " -
;„/ R POIKYEFFECTNE POLICYESPPAT10Y - VYRS
III
B aWN.uLiAABuiv HER8858850 9/7108 9(7107 cACN ooclR aNCE A2('100
o
COMMIUM LL DENEPAL 11AMLITY PREMISES -
GLNMBMADE Q.00cuR . . MEDETA Ann PiI.'.AM
III PERSONALAAOVINAJBV
. OENERAL AGGREGATE -OEHL AOOREGAtE UMrT APPLIES PER. PRODUCTS-C6WJOPAGO POl1CY FAO. - LOC
AT
" 010"'i�'"OE++Y 35 MCC XD 6388 10/1/05 10/1/07 COMMNED SNOLE JM T
uro . (Ea6WWr,q1.400,000
ANEDAUTOS. BOdLY WJLIRYDUUDAUTOS. SOLYMJ AUTOSBDDILV DIJUR�
VQ•IEaAuios PROPvtTY CAW461PWartyAUTO ONIr-EA ACC OEM' i
O -
VTOMER'TM
AAU700'(lV:
rIIELLALWR.RY ' EACH OCCVRRENOE SR CIABISWIOE AGGREGATE 11BLE
ION '
i
TYoRm"ODABENBAIioR ANO
A, � 35 WBGNC8861 1/l/07 1/1108
ONll1'VABLm
El EACH ACCDENT t
ANY PROPNlTOIWARTIIER/ERECUTNE .
�'� OEFICtNMENBfR E1lCI11fZbf E.L gEEA 000
SE-EA EMPLOYEE /
E arirMVlEr
PROV,SIONSSWOOO
ww E.L DISEASE-POLICY LOAM Is 500,DOO
OTHER- .
OESCAIPI07N OF OFlMTDNS I LOCATWO&SI VEHICLES I EACLVPONS WDED BY nooptSEIENTI SPECIAL PROVISIONS-
CERTWICATIE MOLDER - CANCELLATION
' - WOULD ANV OP M ABWE D[SCRBFD PONCI[7 Be CANClll2D iKfg1E TIE.FIOIM710N
.INSURED COPY .. "m TMEASGF,"a amim 10 mem WLL EMOEAVOIt 1O WAIL 10 'DAYS'W Frt& ..
.. wrist Tb T!MATIRCATE HOLDER IAM.ED TO THE LEFT,BUT FAILURE TO DO SD SMALL
. - IM► O 04UBAmN.OR UAEIUrr OF ANT RIND VON THB NRDRR,ITS AOENT11 Oft
SEN TNEL.
. .. - . OR@ Avmsen
ACORD�6:IR001108) m,ACORD RATION 1 988.---
- re al
wIb eiFanewaea WoodNinyl Composite Frame
. Rluig Cnix#c4 - .Dual Argon '. Low _ -
- Double Hung
l "
ENERGY PERFORMANCE RATINGS '-
U-Factor(U,S)/1-P Solar Heat Gain Coefficient
r .rdi
Ow32 0 . 33
ADDITIONAL PERFORMANCE RATINGS
Visible Transmittance
Q054
M•mrl•elw•r•tlnw.w dn.NY•nfnn\eennrm le•n41k•RM WAC
Nnnf, pee.R.4••N.AMmJ.1p wMl.yreduer
Fnc'Pn<•.N•1{C ntlnp •nQ•kmdrnd urdnr•d♦.r•1•mbm,•nPl.•Wlr4nr yrd••palf p•d+.lrh•
de..u•tne.�nrrund•wy ped.c{.nda...n•1•vnM P•NrWb.r.nr peauel k.w.•p•rlr<m.. -
dnwllp•nsl�cWrp'•Rnnd4•I.r•Mn pedw{p✓hnenp:MdmPMn, .. . .
da '
DgI [GN PRESSURE'(PSF)
H LC25 100-0027 239.0
'LvJb AtN{' M.�. '4A IY RS]Ai IJJStli Nu.m• \Mr Ir. .ruWr1.
' M••Par..c•.0..M.6-GJ4E C,d6EAF,A41pWbrrf•R nPdr•.MnN WUMA M•nm•hc•rtlRwd.rr lr•yron. '