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8 SETTLERS WAY - BUILDING INSPECTION (3) The Commonwealth of Massachusetts Board of Building Regulations and Standards CITY Massachusetts State Building Code. 780 C'MR. 7'"edition OF SALEM Revised Junuu!v Building Permit Application To Conswet. Repair. Renovate Or Demolish a /. 201hy n One-or rwu-Fu i!P Dwelling This Section or Official Use Only Building Permit Number: Date Applied: a Signature: fluilding missioned Instt2f Idings Date nn TION 1:SITE INFORMATION 1..1 Pro pert y Address: 1.2 Assessors Map& Parcel Numbers O SGlk�vfC kar ,4 SA 41M . Akrx 1.1 a Is this an accepted street9 yes no Map Number Porcel Number 13 Zoning information: 1.4 Prop"Dimensions: Zoning District Proposed Use Lol Area(sq 11) Frontage(11) 1.5 Building Setbacks(B) 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: Zone: Outside Flood Zone? Public❑ Private❑ — Check if es0 Municipal O On site disposal system ❑ SECTION 2: PROPERTY OWNERSHIP' 12.1 Owner'ofTecordj v ` Q p Name(Print) Address for Service: r �7 � `, ' VJ T -Vib—C �{ Y Signature Telephone SECTION 3: DESCRIPTION OF PROPOSED WORK'(check all that apply) ,New Construction O TExisting Building O Owner-Occupied O 1 Repairs(s) O 1 Alteration(s) ❑ Addition ❑ Demolition ❑ 1 Accessory Bldg.❑ Number of Units_ Other A-Specify: Ve IQ Brief Description of Proposed Work-: .,yi — &L D r C V-A rz- C SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only Labor and Materials 1. Building S JL{, y3N.Go I. Building Permit Fee: S Indicate how fee is determined: 2. Electrical S ❑Standard City/Town Application Fee ❑Total Project Cost(Item 6)x multiplier x 1. Plumbing S 2. Other Fees: S 4. Mechanical (IiVAC) S List: 5. Mechanical (Fire S Suppression) Total All Fees:S Check No. Check Amount: Cash Amount: 6. Total Project Cost: S Li .4 3k4 00 13 Paid in Full 0 Outstanding Balance Due: SECTION S: CONSTRUCTION SERVICES 5.1 Licensed Construction Supervisor(CSL) 1 6kq S oZ 3 I.icenx Number Expiration Date Name ol'CC''SI..I Told r �1 List CSL Fype(see below)�_ 5� Ys olsa'3 F Dewriplion JJres U Unrestricted(up to 33,000 Cu.Ft. R Restricted 132 Famil thvellin ignature M Masonry Only tYKxkIG-r-A I RC I Residential Kwting Covering telephone we I Residenlial Window and Siding SF 1 ResiJential Solid Fuel Bumin A fiance Installation D Residential Demolition RegisteredI H- o�me ImPRrovemeot Contractor(HIC) Ct eAr c \ V� �nae''.sc�✓t --, Registration Number f IIC Company Name ur HIC Regist t Name S�$ �tici U`tCtt a Expiration Date lure Telephone SECTION 6: WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152.1 23C(6)) 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...........O SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1 H � , as Owner of the subject property hereby authorize aC:� to act on my behalf,in all matters relative to work authorized by this building permit application. Si um of Owner Date SECTION 7(b:—OWNERt OR AUTHORIZED AGENT DECLARATION 1 - y� ,as Owner or Authorized Agent hereby declare that the statements and information on theforegoing application arc true and accurate,toe,to the best ofmyitowledge and be lf� ✓, i 1 Lft) } 1 rintt Nme ryt 3 C J -Signature-off7wrier or Authorized Agent Dale L (Signed under the pains ar,dpenalties of 'u NOTES: 1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC)Program),will ffg have access to the arbitration program or guaranty fund under M.G.L.c. 142A.Other important information on the HIC Program and Construction Supervisor Licensing(CSL)can be found in 790 CMR Regulations I IO.R6 and I IO.RS, respectively. 2 When substantial work is planned,provide the information below: Total floors 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 Number of decks/porches T)peof cooling system Enclosed Open ). "Total Project Square Footage"may be substituted for"Twal Pmject Cost" �y t C{7 y.dJ ' CITY OF SALEM PUBLIC PROPRERTY �i DEPARTMENT % ,I„r I .N 5 ral,r r ♦ SAI I M, NI,t,;.tl it I II v73.'45 9;93 • f\A:978.74-�9846 I Construction Debris Disposal Affidavit (required for all demolition and renovation work) In accordance with the sixth edition of the State Building Code, 7S0 CNIR section 11 1.5 Debris, and the provisions of MGL c 40, S 54; Building Permit # is issued with the condition that the debris resulting front this work shall he disposed of in a properly licensed waste disposal facility as defined by MGL c l 11. S I50A. The debris will be transported by: -�.. (tame of hauler) TI lie debris will be disposed of in (mmn utfacility) S UlS3 (address of facility) signature of permit applicant � -� IL0 date -- I<Ivi.nud„� a IUG—tY-2010 02 :21 AN P. 01 104 Oris'St..Northbarough,NIA 01532 J&L WINDOWS,INC.,b/o/A MA Iionie Improvement Contractor (508)019-O900•ITae:(374)9E17.3013 MR//et.neWal License#14yFOl (EXpire6'1/24/2012) "lN Idersen• Feder¢I Tax ILl ifA3-P4L14201 W1.0.W 4111t00anr nn AmkrrenGnprnY CUSTOM WINDOW AND DOOR REMODELING AGREEMENT 3�y.rlrl Nome Dak of meal 9�y.,41 sa.a Add,3,,City,%1,and zla Cad. f Mall Ade,oe Home Tale hone Nembar cash telpher.Nombm II Buyer(s) hereby jointly and severally.agrees to purchase the products and/or services of I h L Windows,Inc.d/b/a Renewal by Andersen ('Contraatar"),in accordance with (1he terms and conditions described on the Front and the reverse of this agreement and on Ilse attached speel9catctl Ahech(,a) (collm:ively,this"Agrmmeut").Buver(i)hereby aIgreoa to s(ga a completion eertiRcate after Contractor hen completed all work under Ihis Agreement. Total lob Amount: st i g D ta: Method of Pymnt:D Cash IJ Check J Maslercard ❑VISA _/-% e a�tad p ✓� li% U Dlscovar. 0 FinaA<ed,Appo le: /7 L Deposit Received(33%): 8_ � -f--I �_- p Nome on Credit Card: Belvnce at Start of Job(33 p'i:,.yl.] / Estimate Pd Com lation Data: ��//��.. ,///,,qqqq _ Credit Cord t! Balance an Subv,ruial yh/ / ✓J // Completion f Job(3;3h): /tt// _.—. i CC Exp.Oafs: CC Security Code: By initialing here,you¢cknowledge Thar the Rall uce at Start of Job and the Balame on Suhslumi:d Completion Buyer[nidale of Job auniot ter made by credit card and must be made by persunal check,bunk check,or cash. Ruyer(s) agrees and understands that this Agreement constitutes the entire understanding between the parties, and that there are no verbal understandings changing ormodifying 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(a) and Contractor. Buyer(&) 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 fast 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. J&1.whndowe c.d/b/&Reaew.1 by And er&eo Buyers)) Buyer(s) nature Sig .li n¢mrc.q Print Nam,:of Product Mauagcr Print Nance Print Name YOU, THE BUYER(S), MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION.SEE THE ATTACHED NOTICE OF CANCELLATION FORMS FOR AN EXPLANATION OF THIS RIGHT. NOTICE OF CANCELLATION ' NOTICE OF CANCIIIATION Dab of Transaction _. - ...• You may cancel Dab ofTransaction .,� _.._ . You may cancel this transaction,without any penal y or obligation,within 1 this transaction,without any penalty or obligation,within three business days from the above date•If you cancel,any three business days from the above date.If you cancel,any property traded in,any payments made by you under the property traded in,any payments made by you under the Contract of Sale,and any negotiable instrument executed I Contract of Sale,and any negotiable instrument executed by you will be returned within 10 days following receipt I by you will be returned within 10 days following receipt by the Contractor ("Seller") of your cancellation notice, 1 by the Contractor ("Seller") of your cancellation notite, and any security interest arising out of the transaction will and any security Interest arising out of the transaction will be canceled.if you cancel,you must make available to the 1 be canceled.If you cancel,you must make available to the Seiler at your residence,in substantially as good condition Seller at your residence,in substantially as good condition as when resolved, any goods delivered to you under as when received,any goads delivered to you under this this Contract or Sale; or you may, If you wish, comply Contract or Sale;or you may,if you wish,comply with the with the instructions of the Seller regarding the return instructions of the Seller regarding the return shipment of shipment of the goods at the Seller's expense and risk. I the goods at the Seller's expense and risk.If you do make If you do make the goods available to the seller and the the goods available to the Seller and the Seller does not Seller does not pick them up within 20 days of the dote 1 pick them up within 20 days of the date of your Notice of your Notice of Cancellation,you may retain or dispose of Cancellation, you may retain or dispose of the goods of the goods without any further obligation.If you fail to without any further obligation. If you fail ro make the make the goods available ro the Seller, or if ou agroe 1 goods available to the Seller,or if you agree to retum the ro return the goods ro the Seller and fall to ofo so, then cods to the Seller and fail to do so,then you remain liable you remain liable for performance of oll obligations under for performance of ail obligations under the Contract. the Contract To cancel this transaction, mail or deliver a I To cancel this transaction, marl or deliver a signed and signed and dated copy of this cancellation notice or any dated copy of this cancellation notice or any other written other written notice, or send a telegram to Contractor J 1 native,or sand a role in ro Comracror.J&L Windows, &L Windows,Inc.d/b/d Renewal by Andersen, 104 Otis Inc. d/b/a Renewal bbyy Andersen, 104 Otis Street, Street, Northborough, MA 01532, BY NOT LATER THAN Notthberough,MA01533,BY NOT LATER THAN MIDNIGHT MIDNIGHT OF .(Date) OF •(Date) I HEREBY CANCEL THIS TRANSACTION. 1 HEREBY CANCEL THIS TRANSACTION. Baysrk slgnan,r� Oera 1 Bvyer43tenaNn Dab RITA Copy- White Buyer Copy-Yellow Buyer Copy-Fink RUG-17-2010 02:22 AM P.02 104 J a L Windows,Inc.d/b/a Phone 308.91..0900-Fax 774.9A C7593 MA HIC Liccnsc p eral Fax (expires 04 4 Z01 I'nonc 308.91 J.0f100 }'nx 774.9g7.3C13 Renewal a F'cdcral Tax lUN a:+-0404Zo1 byAnderser� WINDOWY.V^uceMrxr .n M2rnrnCempnv OF GREATER MA88ACtN8ETI8 Non NEW HsNiF6nIRE WINDOW SMMCA71ON SHBLT Buyer(S)Name Date of Agreement .t7.r! � e?it�yURL'U The ft.yvAs1 listed above herebyiointly and severally agree to purchau the woods and/or services lined below,to accordance with the prices and terms described on the Specificmion Sheet and the front and the reverse of the acenmpanylrrg CUSTOM WINDOW AND DOOR REMODELING AGREEMENT, of which this Specification Sheet is a part. WINDOW DEfAIIS 1. Contractor will Install.total of windows in Owner's home,using the following individual quantities: nouble Hun;inn) EMual sash ❑ Cottage sash(1/3 top,Z/3 bottom) ❑ Oriel sash 12/3 top. I/3 bottom) Glsemcnt(CW) ❑ Ilillge right ❑ Hinge left(as viewed from exterior): ❑ Standard handle ❑ Metro handle _.-...__.Double Casement(CDW) ❑ Standard handle ❑ Metro handle Casement!Picture/Casement(CPW) ❑ l:l a or ❑ 1:2:1 ❑ Standard handle ❑ Metro handle 2 Lite Gliding Window(GW) Glider/Ficp1re/Glider(GPW) ❑ CCt or ❑ 1:2:1 Awning Window(AW) Picture Window(FW) Bay or Bow Window Patio Doors(see separate Door Specification Sheet) 2. Yes ❑ No Qty of Windows to be Custom Fit Replacement: 3. ❑ ea �s'o Qty of Sills te,he replaced by Contractor: /' l 4. ) 1'cs ❑ No Qty of Windows to be New Construction Dull franc(includes new interior&exterior casings)`! Cxierior casigs: ❑ Pine ❑ Afaiutcnanez-free material ❑ Factory applied 908 Fibrex brickmold 5. Glazinglobe.: VH.P In -F.�SmartSunT"+ (7ka Qedit f]igible) ❑ Ofhes Ifother,pleasespecity: G. Exterior caber to be: White ❑ Sand ❑ Canvas ❑ Terratone ❑ Cocoa Bean; 7. Intenorcoloriobe: White ❑ Sand ❑ Canvas Q Ttrratone ❑ Pine.❑ Nlsple,❑ Oak Note: lilt or color can only be while,wood or same color as exterior. Wood interiors need to finished by Owner. ai 8. hardware: N'hue ❑ Stone ❑ Canvas ❑ Brasa ❑ Estate Hardware: Style: 0. ❑ Yes 29" o Install Lifts with Double Hung endows 10_ Screens windows to have: ❑ Half or Pith screens Screens to be: Fiberglass ❑ Aluminum ❑ TruSeene GRII.LB DETAILS 11.Windows have grilles: Ycs ❑ No If yes:❑ Grille Between Gfiye -.1 FTmovall,10 Interior Wood(,Nlw)❑ Full Disided L(gltt o'ou Qty: —f Qty: Qty, Qty: Qty: Qty: Qty: on ILL] LJ1 :=11 1)rasv grille prierm above 'Use additional sheet if needed Owner approved(initials):( ) ADDMONAL WORK DET.UIS 12.El Yes �'o Contractor will remove metal frames of windows. Qty of Units: Ps.❑ Ycs [g No Contractor will install new paint-ready cr slain-ready casings. lnteriU sing qty or openings: Exterior casings city of openings: ❑ Pine ❑ Maintenance-free material 14.❑ Yes No Contractor will install new paint-ready or stain-ready inside or outside stops qty of openings: hitcrior stops qly of openings:, Exterior stops city of open(ngn: ❑ Pine ❑ Maintenanu-free material 15. Owner is aware that Contractor does not do.Fly painting. ( F Owner initials 16.❑ Yes M/i to Contractor will wrap exterior casings with aluminum coil stock of color. /Note: Wrapping may br required wills storm window removal;removal of storm windows will leave screw hairs in casing. 17.� es ❑ No Contractor will insulate,caulk and seal windows With 3-point system to prevent water and air infiltration. 1 S.[�)'cs ❑ No A limited warranty stall be issued to Owner upon completion of the job and payment in full. 19.Wes ❑ Ms BuBdj,nB PeriniF-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 fcc. 20. Additional job details: 21. VYc.i ❑ No Owner agrees to be-present on the final day of installation for final inspection and to deliver final payment. An final pvyrneut shall Zv dernanded until the contract is nompleled to the satisfactwn ofat parties. It is agreed and understood by and between the parties that this Specificanun Sheet,along with the CUSTOM WINDOW AND DOOR REMODELING AGREEMENT,constitute.the mare understanding between the parties,and there are no verbal understandings changing or modifying tiny of the terms. This Specification Sheet may not be changed or its forma modified or varied in any way unless such changes are in writing and signed by both the Buyer(s)and Contractor. Ruyer(s)hereby acknowledge that uyer(s)has read this Specification Sheet. Renews ,der tt of, ester h A and NH But /J Buyer(s) \ igriature of Pro oyt Manager \ Signature Sig ahrre c-tint N I J 6FOoN/t� Print Name of Product Manager Print Name Mart Name The Commonwealth of Massachusetts Department Qf 1ndmrtrial Ardderts Cffece of Investigations 600 FF'ashington Street Boston,MA 02111 www.mass gov/dia Workers' Campessatittn Insurance A davit: Budders/Contractors/FIeatnciam/Flm-mbers A_niAlcant Infarmatiaa Please Print L& bfy - N®e (&nsiness/Or�nizafionnadividvat}: �en 2tJ a.� �v AYSr.�EYS e n Address: '^ City/State/Zip: /�/of h borot A4 G) 3-Z- Fhone#: Are yo4L an employer? Check the appropriate bozr Type of project(required): .'al am a employer With 00 4. ❑'I am a general contractor and I fi. ❑Nev, constmctioa employees (5bI1 and/or part-time).° ' have lured the sub-contractors ❑ I am a sole proprietor or partner- listed on the attached sheet t 7, modeling ship and have no employees These sub-contractus have R. �1 Demolition Working inane in any oagacity, workers' comp.insurance. g. ❑ Build-- addition [No Workers' comp.=11, arte 5. 0 We are a corporatim and its 10. required.] officers have exercised weir ❑Eiectdcal repairs or additions ❑ I am a homeowner doing au Work right of exemption p=MQ, l l.❑Plumbing repairs or additions myself [No workers' comp.' c. 152, gl(4), and we have ao 7 2.0 goof repair in arsare required.] t employees. [No workers' 13.❑ Other comp.mm=awe requdrnd.] +ny qpi=tha ohecl's box Rl mmt also fiin ooa the section brlow showing ffie¢vnd='compensation policy mfoxmatoa - H0meown3 wbo submit this affidavit iw5,ating thry=doing aU wo3 and then him out-side cooaaetvs most submit a new affidavit indicating sorb :oataetna fact chink this b=amst.t ,4..I as additional sheet rho the nano of the sob s+*+�r+*+.�wing cad daeSr comp.pofiry iafaaIIatioa. ars an employer that Is prmv€dtreg workers'cdnpensaffott&=a-once for my emeployees. Below.is i*e policy and job site cformadon. ,s.maac_e Company Name: OHL7#or Self-ins,Lin. _ 30� G1.�(� 1� /`{ Eryiration Date: r;L ob SitaAddzess: L t City/State/Zip: :1ewt S 6l9- tEacli acopy of the workers' compensation pahcy declaration,page(showhn the policy=m rr and expiration date). ailsre to secure coverge as required under Section 25A of MCrL c. 152 can lead to the imposition of criminal penalties of a be up'to S'1,5D0.00 and/or one-year imprisonment; as well as civil penalties in the form of a STOP WORK ORDER and a fine f up to �250.00 a day against the violator. Be advised that a copy of this statt meat may be forwarded to the Office of xvestigations of the DIA for insu=c coverage verincati.on. .. 'do hereby c render the pains and penatlies,ofperjoy that the information provided above is true and correct •inatnre J�rf ~ Date ��'J IC CI 'hone ) / /` of a Gjjicial use only. Do not write in this area, to be completed by city or tunw officiaL City orTimm: Permitrt ncense# Issui$g Aatltnrity (circle one): L Beard of Health 2.Bglltlsag Department 3. MY/Town Clerk 4.Dectrical h spect Dr 5.Pl=hixt;Inspector 6. Other Contxct Person. Phone# x=` Massachusetts - Department of Puhlic Safcth 3 Board of Building Rculations and Standards Construction Supervisor License License: CS 101952 Restricted to: 00' DAVID BANCROFT 5 JOHNSTON AVENUE WHITINSVILLE, MA 01588 - Expiration: 3(19Y2012 ('nmmis�iuncr Tr#: 101952 � fee;Po�xanrnureea��:���r��aToc�'ireel�3-� - Gnard 04 DTHWng R�rilia;uees andStacdafi_s HOME IMPROVEMENT CONTRACTORO P Registration:,, 146601 E pira}ion_=t 4/2010 ° T;Ypupplement Card RENEWAL BY ANDESQf; _�:'� DAVE BAf.,iC io'., zc . 104 OTIS STf2EET• NOR THBOROUGH,MA b'I.532 Administ:nEnr . E X?v. . GER I NuA i r. yr Lwam-1 p THIS CEATFIGATEs IS ISSUED AS A MATTER OF IHFORMATION Joseph 6ficKeone ONLY AND COFFERS tiD. RDOES UPON THE CEZTEND TE OR HOLDER. THIS CERTIFICATE ODES NOT AMEND, EXTEND OR JP PricKeons insurance Agency, Inc. ALTER THE COVER AGE AFFORDED BY THE POLICIES' BELOW- P.,D. Box 333 Fa.IC a Ann ArbDr,Tdt1 4B1D5-Q333 INSURERS r�aRDING coveRAeE Renewal Andersen IRsuRERa. *Hartford Insurance Co an - INsuRER a fdauIII J and L!KlndoLArs,Inc. Ir�uRFlic _- 1 D4 Otis St IRsuRER D Nortliborough,MA 01532 DtSURFRE AGES _ DUCIFS DF INSURANCE LISTED BELOW KAtrE BEEN ISSUED TO 7tiE INSURED NAFBED ABOVE FOR THE POLICY PERIOD INDICATED.mky BE NOTWITHSTANDING :EDUIREMENT, TERM DR CONOITIDN OF ANY DON OR OTHER DOGUMEN7 WITH RESPECT E 1A'HI5,Exc SIONSFAND CONDITIONS OF SUCH 'ERTAIN,THE WSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TD ALL TKE TERMlS, lEs.AGGREGATE LJINIrrs SRDNIN WAYKALE BEEN REDUCED BY PAID CLAIMS-Y EZPIRAnDN LJMITS L PDLRY RIIC®EA 10f01l20Q9 iO/Dil20i0 RAOK.00CURRE]10E i i 1 DDD DDD �,J,.���g�Tl• 1•JC35B461 PR[YlSEs M.�m,t'e j 1DD DDD CDMWlRG1AL OENERALu461Lm' IVIED E19(mYvne Pvicen/ S 50Dp CLAIMS MAOE' •❑OCCUR PERSONAL s ADVIRJURY s 1 DOD DOD GENERAL AGGREGATE s 2 DDD ODD PRODUOTS-C=PW AGG s z ODD DODO_ rG-ENNL A[Y7PEdATE LWU APPLIES PER. I I PODGY JR0. U= . AvroATD61LUABILTTY 35MC;C Y.D 6390 1DIQil20Q9 10/01/201 D' jEn ooe�msINOLE uwG I s 1,DDO,DDO ANY AUTO . ' BODILY INJURY s X ALL OWNEDAUTDS IPerP j SCNEDULD AUTOS BODILY IKlLTiiY s HIRED AUTOS HONOLATIEO ALTOS " . PROPERTY DASiAGE s JPAr e�aanp ' ALTO DHLrEAAccmENr s _-- _ DARADELIAMILITY OTHER THAN FAA= I f ARY AUTO AVID ONLY: AGO Is EACH DSURRENCE s EECSSTiIf''-CR-LLA LIASIIiT1' AGGREGATE s OxUR CLAIMS I=-= S _ 5 OEDUOTIBLE S RETENTION S' NC STATlY OTH•I _ lYD,s'_sGD�NsA ou 35 tAIECPP 144 Q2117/2050 DZ1 1712011 F.L.EACHA=DENT s 50D DDD ESSPLOTFRS uA=LUT ANY PROP0.1ElD_R?AR:NERT=ECUTR�E E1.DISEASE•EA EMPLOYSE S DDD DDD OFICERaVIEFJB�R F"GL[iDE6t E.L O:SEASE-POLICY LIMB s 500 ODD R pi` XMRO_S% SPECIAL PP.DNSIONS Wow I OTHER LRIFTTON OF OPERATIONS I LDGAx;gt fL3I"C mZiSIONS ADDS BT E19oRSFJBENTl EFEONI-PP-OT'ISIOPS ERTIFICATE HOLDER CAFdCELLATBON SHOULD ANY OF THE ASDVE DESCRIBED PDUCIES IL CANCER I ED SEFORE THE ELPIRATION DATE THEREOF, THE ISSUBID INSURER WILL ENDEAVOR TD MAIL iD DAYS WRITTEN INSURED COPY plGyTDE To SHE CERTIFICATE HOLDER RAATED T'O THE LEFT,BUT FAILURE TO DO SO SNALL I�DSE RO O5UGATION OR LAMLITY OF ANY iUKD UPON THE INSURER ITS AGENTS DR P,EPRESEKLATIvd. . AVTHOlIZEDREPRESENTATIVE •©9AADDjRDD•CORPORATION ID95 CORD 25(2DDi1DS) ' r e re®al nrnnnnzaPN• . woodMnyl Composite Frame . Na[onalFerestuXon Dual Arlon Lew ReongCOJW16 Glider ENERGY PERFORMANCE RATINGS U-Factor(U.S)A-P Solar Heat Gain Coefficient- 0 . 34 0 m3G0 ADDITIONAL PERFORMANCE RATIN Visible Transmittance 0 . 49 tNnubcWnr Npubm tivlMm nlb(R mnbmi b oPPOuhb NFNC pmubms brtleWmb�bP whets Pmtluel P�nvnvv.NFNC A1p1ynN tivbnnh brsnssE Ytol spMNbnmbl eeMlnero mtl•spvNe PnWuetsba NFRc tleM minwnunmtlsny Pmtluclmtltivn netnwmnt tlb mibhonY etsrry PmtluetbrvM SPseH'°�' � . CenMtmsnulebnh Ylmfun MPbm Pmtluel Mebmvnu lnbmutivn. - www.elhcbep . ' t DESIGN PRESSURE(PSF) Mam HS - LC25 100-00296313-006 ' Mmvlmm�c elbmp(enmvvmlhe IiaMenmdnNv • imledmRASYMM�MM11'�r`I0In5!NarN m - - Mmb wvsc+tls MEG.,CPC,nIEC.C.PtrinAbetlon nQuhammb WDMRNSIbuM CMMaWn PmO� ReneWal 1 FEC byAnd8* 'rsem i gzRomeF eEruc�eer ®h,�s� . i n DmIW=WEP j Dmvob G Argon Low E DmblB F4mp t DD-0D414�5-DD7 •EMSRSY PEMCEI�it=_r t S U-r=or(L!S}/[-F So13r�I_st Cain C`o= or�azt .030 • ��Fi't��'L4L F?F6P �;E ?i��Fs2�s-S- - ' YrSrh13 Transmi�anb= . . •-m 0 - . � ���s� �dICID_+3 .,... :re:un�•rn; t,�i1�..�ennl�r�e„z R . j Ce H'4�f •PRWM. Mid j sC25�1 C�j E etpldGl6E:9ui ��. Iq.t�lp6362! 36A D3 SZcp_d a^LI DH IN b 11F_�-@R�.AL.q�YSI SmA6MNg • j � ' �xbebb�wAT�mue� .. 1 Y.eer®�t.r� ,C,PL•nl2ZAFY��s�Ym�®G1gN. ry�y.. Renewal , Anderse � WINDOW I EPI L&CEUSH =Amrlr,tieaCesmp€ctF Whom It May Concern, . nclosed is a permit application package for a project we have been -a ntracted to do in your town. Thank you in advance for receiving this ackage by mail. As we work in every town in the state, it greatly helps us in ur process. Ve have also enclosed a self addressed and postage ostage paid envelope and ro'Uld request that when the permit 4ppincation has been processed,_that you vould mail it back to us. .nclosed for you review in this package is: ❑ Permit Application ❑ Home Improvement Contractor license ❑ Construction Supervisor License [:] 'Proof of'Insurance ❑ Proof of Energy Efficiency Rating ❑ Signed Contract from customer ❑ Permit Fee (if accepted at time of applying) Cf you have any question regarding this application please call €Ene at (503) 3 19-099Z. lest Regards, telley Donahue ?ermit Coordinator 104 Cods Street 1 Northb=ugh,MA, 01532 Phase(509)919-09DO Pas{509)919-0903 websitc www.rmuwalb=dm:sm.com