11 SETTLERS WAY - BUILDING INSPECTION (2) $c�Rl7b
The Commonwealth of Massachusetts
Board of Building Regulations and Standards CITY OF
Massachusetts State Building Code,780 CMR SALEM
Revised Mar 2011
Building Permit Application To Construct,Repair,Renovate Or Demolish a
One-or 71vo-Family Dwelling
This Section For Official Use Only
Building Permit Number: Date Applied:
i L
Building Of ctal(Print Nome) S' ate
SE ON 1:SITE INFORMATION
1.1 Property Address: 11 Assessors Map&Parcel Numbers
11 SETTLERS WAY 42 42-0005-811
1.1a Is this an accepted street?yes_ no Map Number Parcel Number
13 Zoning Information: 1.4 Property Dimensions:
condo
Zoning District Proposed Use Lot Area(sq ft) Frontage(ft)
1.5 Building Setbacks(ft)
From Yard Side Yards Rear Yard
Required Provided Acquired Provided Required Provided
1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public O Private 0 Zone: _ Outside Flood Zone?Check if yesJ3 Municipal El On site disposal system O
SECTION2: PROPERTY OWNERMW
LI Owner'of Record:
KATHY ARGUELLES SALEM, MA 01970
Nome(Print) City,State,ZIP
11 SETTLERS WAY 978-337-2422
No.and Street Telephone Email Address
,89CT ON 3:DESCRIPTION OF PROPOSED WORK'(check all that apply)
New Construction 13 Existing Building b Owner-Occupied b Repairs(s) (4 Alterstion(s) 17 1 Addition O
Demolition O Accessory Bldg.13 1 Number of Units_ Other Specify: REPLACEMENT
Brief Description of Proposed Workr:
REPLACE 1 DOOR- NO STRUCTURAL CHANGE
W/SIDELITE
SEC'1TON 4:ESTIMATED CONSTRUCTION COSTS
Estimated Costs:
Item (Laborand Materiels Ofllclat Use Only ..
1.Building $ 6,538.00 1, Building Permit Fee:$ indicate how fee is determined:
2.Electrical $ O Standird City/fowri Application Fee
D Total Project Costa(Item 6)x multiplier X.
3.Plumbing $ 2. Other Fees: $
4.Mechanical (HVAC) $ List:
5.Mechanical (Fire $Sion) Total All Foes:$
6.Total Project Cost: $ 6,538.00 Check No. Check Amman- Cash Amount:
0 Paid in Full ❑Outstanding Balance Due:
SECTIONS- CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL) 90125 10-06-14
JAIME MORIN License Number Expiration Date
Name of CSL Holder U
86 GARDINER ST List CSL Type(see below)
No.and Street type Desmpnun
LYNN, MA 01905 U Unrestricted s up to 35,000 m R
R Restricted 1&2 Family Dwe
Cityfrown,State,ZIP M Masonry
RC Roofing Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
5083512200 X 55285 1 Insulation
Tele hone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC) 170810 12-23-15
RENEWAL BYANDERSEN HICRegistratlonNumber Expiration Date
'%4%'9? Tmnc or MC Registrant Name
NNORT BH Sued
MA 01532 508-351-2200 X 55285 Email address
C' /rown,State,ZIP ref one
SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L,c.152.A 25C(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..........PSI No...........O
SECTION 7s:OWNER AUTHORIZATION TO HE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUMMING PERMIT
I,as Owner of the subject property,hereby authorize JAIME MORIN
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:OWNEW OR AUTHORIZED AGENT DECLARATION
By entering my a below,I by attest under the pains and penalties of perjury that all of the information
contained in application is and accurate to the best of my knowledge and understanding.
/ - '9 !
print Owner' o Agent's Name(Electronic Signature) Date
NOTES:
1. An Own who obtains a building permit to do his/her own work,or m owner who hires an unregistered contractor
(not registered m the Home Improvement Contractor(H]C)Program),will act have access to the arbitration
program or guaranty fund under M.G.L.c. 142A.Other important information on the IIIC Program can be found at
mma mgKjUj=Information on the Construction Supervisor License can be found at MMM mass.go tj
2. When substantial work is planned,provide the information below:
Total floor area(sq.ft.) (including garage,finished basmtenUattics,decks or porch)
Gross living area(sq.fQ Habitable room count
Number of fireplaces Number of bedrooms
Number of bathrooms Number of half/baths
Type of heating system Number of decks/porches
Type of cooling system Enclosed Open
3. "Total Project Square Footage"maybe substi uteri for-Total project Cost" $ 6,538.00
CITY OF SALEbi, MUSACHUSEM
BLIM04G DEPAMa Nr
120 WASHINGTON S7RSfiT,3m PLOOR
TEL qM 74S.9595
FAX(978)740-9846
KIJSBERI.E.'1!DRLSCOLI
MAYOR THOU"Sr.Prt?RU
DIBECTOY OF PUBLIC PROPEM/HU MZ)ING CONOMSIONER
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 111,5
Debris,and the provisions of MGL c 40,S 54;
Building Permit# is issued with the condition that the debris resulting from
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 beutos)
The debris will be disposed of in :
RENEWAL BY ANDERSEN
(same of facility)
104 OTIS ST NORTHBORO,MA 01532
(address of facility)
taro o 't applicant
01/08/2014
data
A_n-6 MA Home Improvement Contractor'
(�•N Ide(Sen� License#170810(Expires 12/23/2013)i
Renewal by Andersen Cor r n poatio Federal Tax ID#41-191841
mnoew ae.ueewtxr 1040fis St. Nodhborough,MA 01532
(BOB)351.2200 Fair(508)-98fi-7072
CUSTOMER WINDOW AND DOOR REMODELING AGREEMENT
Bu ers Name 1
Date: 1
KATHY ARGUELLES SEPTEMBER 28 2013
Buyers) Street Address,City,State arW ZIPCode
11 SETTLERS WAY SALEM MA - 01970
Email Address Home Tele hone Number Work/Cell Telephone Number
Arquelles.katherine@gmail.com 978-337-2422 978-275-6912
Buyer(s)hereby jointly and severally 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)(oolleciNey,this
"Agreement"). Buyer(s)hereby agrees to sign a completion certificate after Contractor has completed all work under this Agreement.
Toted Job Amount$ 6,538.00 Ammnt Flaimced$ 0.00 Est,Stall Date Method of Payment
Deposit Received(33%)$ 2,179.33 Check/Cash
8-11 weeks
Balance Stan a J0b(33%)$ 2,179.33 From Deposit(50%)$ 0.00 `x
Bdmceon Substamid Est,Install Time iTJ Credit Card
Coro Iedion of Job 33%$ 2,179.33 Lion(60%)
p I ) Completion(50%)$ 0.00 T.B.D. a credit lCursolooker.
Trent or
gee Credit Cam Pa ere From.
Buyers)agrees and changangunderstands
mod that this Agreement constitutes the ant Nounderstandingalteration
t between the parties,and that there are a verbal
signed,written
consent
o or modifyingBuyinganyvl the ontrarms of thisAgreement acknowledges
ie that Buyer(s)
1 h as madom this
Ament willgreemen undlltlwiNout the
terms o written consent of both Buyer(-)and completed,
Buyer(s)hereby copyof
that Agreement,
Including
has he t that Agreement,es of Cancellation,
the
terms of this Agreement,and has received n c y Informed
signed and tlewd o cancel
cel this
Agreement,IncO NO the two attached Notices of HERE lalE
on the data Bret written above and 2)was orelly Informed o/Buyer's right to cancel this Agreement. fill NOT SIGN THIS CONTRACT IF THERE ARE
ANY BLANK SPACES. '
Renewal try AnderssonaCorporsdon Buyers) Buyer(s)
Signature of Project Manager Signature V Signature
ROBERT MURPHY KATHY ARGUELLES
Printed Name of Project Manager Printed Name Printed 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 NOTCIE OF CANCELLATION FORMS FOR AN EXPLANATION OF THIS RIGHT.
�_____________________________ _________________
7
NOTICE OF CANC®dAAT'ION d NOTICE OF CAIiCHlAT10N
Date of Tra odon 9/2ei I3 .Yovmayeaviceltuki Date of Tmnaacdon 9i28i13 .You may caned this
traneactlm,widhmt any Penalty er obu6—d.,wid.in fhhee teamvctio4 witimut any Penalty,or,obligation,within tkree
hod .clay-Over We oboes date.If your cantµ any property d love..days fiver the above date.If you caveµ a,Property
traded in,any payments made by you order the Contract ofBute, d traded in,. peymmte made by you order,the Contract of Bale,
andin10"tableiunamevtmemded noar wNberetvrned I and myvegotlable:uvvmevt mecvted by you whT be rewrved
with:v 10 days followl..g receipt by the Cmtranm("Seiler") of I within 10 days following receipt by the Contractor("Seller") of
yom cavice➢vdm votice,andanY uooriry ivte.est arising ant o[ I your reuce➢adonnotice,and ony.recurity interest arLing or of the
the tremudm wID be eancded. IF you ranµ your mud Mahe I braysacdovw.Lbecanceled. Ifyovcancµyvumutmahe
available m the Se➢m atyour midmce,in substantlak as goad ava➢aWe w the Seiler asyam.esideue,iv-vbrtantia➢y u goad
eoudidm a.when reeeaed,any goodsde➢veeredl to .®drr I condfdm a.when received,any goodir dairaed m you node tbi.
this Covbre"ur SOT, yr you may,IF roo wi.b,comply with the I Cmtract or 8alr or you may,0 Too w ,comply with the
is-tmNouw of the Sa—regarding th /scon r e rhipon.a the I im d irocons of the Setter hegmdivg the retmo A n witevt of the
goad.at the BRDer'B mpemeoed rich. If yav do make tbegoods I goads at the Se➢er'.espevsu and risk. If you do make the goods
ava➢aMe w dre Se lm and A.Seer does not pick th®vp wful io available to the Setter and the Setter doer not Pick drum up within
20 drys of the date of your Notice of Cmceiladm,your may d 20 days of the date of y.m Notice of CanceRadm,you nor,retain
retdnerdiapaee a(We good.w:Jhmsany[oohs/ob➢gadov. B I or diApme of We goods without any fiuxher ob➢gadon. Wyou fail
you Full to make dbe goods avaRable to the SeDeq or if your agree i to make do,foods avi iiabir to the Seller,or IF you agree w M.
to return the good-to the Seller and hR se do m,thm you remain I the goods nitre Seiler and fall to do m,dm you aemaiv liable for
➢able for performmce of ail ohliadovs coder the Contract.To Performmce of e➢obligstlav-vvder ribs Contract.Tocavcdtdris
cancel this tramwod.,mall M deilvor.sighed and dosed copy I trmsacton,maB or di➢ a signed and dated copy of this
of this conceDadm notice or my other written notice,or send a I caocawtion nodee or any other wdnm notice,or send a tdegram
telegram w Contractor: Renewal by Anderem,104 0d-Se 1 w Cmttacton Rmewd by Mdeheen,104 Cn6 SL Nsrdhb vmugb,
Noeshbmoush,MA 01532.BYNOTIATERTBA MGM I MA 01532,By NOT LATER ITIAN b1IDMG1TT _
OF 10r1i13 .(Dam) I HEREBY CANCEL THIS TRANSACTION. I OF 10i1113 .(Date) I HEREBY CANCEL THIS TRANSACTION.
I iauyw'e sgrtl,oe qM Nema peh i auyYe abreN,e evONeme pp
1
_ -
Renewal Renewal loss Andersen Coreoration MA Home Improvement Contractor I
byw Ide(sen. 104 Otis St. Northiwrough,MA 01532 - License#170810 (Expires 12r23/2013)
w, eew aoucawaar as„a.c..,..M (508)351-2200 Fae:(508)-986-7072 Federal lD#41-1 91 8 41 3
e Window Specification Sheet
13u e s Name Date of amen
KATHY ARGUELLES September 28.2013
Th,buyer(s)lined above herebyjoindy and severally agree to purchase the goods and/or arnica listed below,in accordance with die ptica and terms described
on the Specification Sheet and the front and die revers,of the accompanying CUSTOM WINDOW AND DOOR REMODELING AGREEMENT,of
which the S edfiestion Sheet is pm.
WA`DOW DETAILS
Style Full/ Approa. Eaenor hands, HaNwere Ha Were tnwE4/ enlb Mile Glass
Roam # safe
Oetdl Irwon U.I. course Db Sills Color Color Color e e Soeev SmaMun Grilles SaaM1 t(J siesta into opit..
Living 1 PS Sintilel Full k138Z Int-E)d Shield WH I WH bt.Ni.1allihillinsa None SnaimuA None — Tam
ner
1 PS R/L Full b282.. nt/Ex Slorsec. WH I WH 13atAk;k6Imxxs HFG SarmSial None — rem
ser
Tom 2 BAY&BOW DETAILS +See Ba /Bow Measure Sheet
Style Detail/ Appmx. Appmx. Number Exterior INnbr End Center Lowe/ Root/ HaNwars
Room Count b Rankem U.I. Cesin M b tiles Color Color Gdlbs sesM1es saaha Screme Smensun son Color
0
0
Full/ Appma. Loll Eaerlor 1.6.1 ADDITIONAL WORE:DETAIL-NOTES -
Room count We Insert U.I. swarsun Grills.. Grillfhove color Color
D Dom ornoute ' to I&from etude
0
0
ADDITIONAL WORB'.DEEAILS
I No otty of o sm o SiB noses to be replaced by Conerecroc
2 No Cono-utor vein..mend f es of windows
3 No (lontlanorwA'vwpnew 0 paint-mayor 0 Stain-ready 0 Interne 0 Enenorurwgsin 0 Ems 0 Mainrcnance-fmmetdal
4 No ConvacmrwlL Naail new 0 paint-ready., o Smio-ready 0 Interior 0 Exteriorstooin 0 Erne 0 Maivtaance-Beemasoal
3 No Conan or will wrap ea dor easing with coB stock of colon.
Owner Is aware that Contactor does not do any painting/staining dr removal/installation ofalann system,window,beetnenfs/haMwmre.It Is the
responsibility of the homeowner to have,Me alarm system,window,teatments/hardwere removed prior instal/ We make no guarantee ro
g. � whether alarms,window treatments,hardware will fit after replacement Customeris also aware in somee cases them there will be glass loss. Hthere is,me
amount will be dependent on the type of existing windows,type of installation,insert or full flame and window style.We make no guarantee as to the
amount of glass loss.Customer is aware and understands any and all unseen not is not included In this conbact Should any rot be found there will be
an additional charge for time and materiels unless so started in this contract
I 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 debts
windows,doors,stone windows and vacuum nightly included. Upon completion of the job and payment in full,a limited warranty shall be issued.
0 Yes Building PennR—Contractor will secure any and all necessary pemlits. The fee for the permits)Is not included in the Contract Price and a separate
check is required at the time of sale for this fee. Check# 2441 $ 54
a Yes All discounts have been applied to this agreement.
10 0Yea 0 No Owner agrees to be present on the final day of installation far Anal inspection and to deliver final payment/finance fertile).t is agreed and understood by and between be parties that this Specification Shees,along with she CUSTOM WINDOW AND DOOR REMODELING AGREEMENT rwsioses du entire
undennnd"vrg bcrwcen Ne pnrde,and Here are vo uxrbal uodcnavd'm�,haogiog or mad'dyiagany of y soma This Speouymis) rim sruynotberA6m arcs rcrms madifidrevariedlo
anYwaY uNea such b•naa an mwrilmgarld eignd by both Ne BuysAa)avd C000anon Buyerisl hereto arhvowledge Naz Buyer(sl has read ihYv Bpuif don Sheee
Renewal by Andersen Corporation Buyer(s) Buyers)
BY &6: MV74 #
Signature of Project Manager -?Slgnature _ - ,, i:SlgnaNre
ROBERT MURPHY KATHY ARGUELLES
Print Name of Project Manager Prim Name Print Name
1
11/19/2013 13:58 7816393149 PAGE 01/01
Renewa �
byAndersen r-:-
WINDOW REPLACEMENT r.:,?,n,lvrh.❑i.::..inr'inv
CONDOMINIUM PERMISSION FORM FOR BUILDING PERMIT
11 Settlers Way Salem, MA 01970
We, Collins Cove Condominiums being the duly authorized representatives of
Collins Cove Condominiums,
Have reviewed the speCifications for improvements to
11 Settlers Way Salem, MA 01970
Owned by Kathy Arguelles.
The Condo Association or Management Company agrees that the above owners have permission to seek permits and
to Carry-out the proposed work.
sign Pure of o Assocla' Represent ative and Title Date
Lt
Print Name
(In lieu of this form, a letter stating the same purpose as above,on the Condominium Management Company
stationary may be substituted.)
104 Otis straet
-Northborough,MA,01532
Phonc(5D8)351-2200
Fax(508)986-7072
Websitc:www.rcncw:albyanderscn.c�m
The Commonwealth of Massachusetts
Department dflndustrialAccidents
Office of Investigations
600 Washingion Street
Boston,MA 02111
www.mass gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Leetbly
Name (Business/Organization/Individual): �erl ZW C ` `O, G\ V_V�er C�
Address:� b y C4 t a,
City/State/Zip: �� ( Y��,r� G S3 hone#:_ 51 8 - s_(-
Are you an employer?Check the appropriate box:
Type of project(required):
1.,2 t am a employer with 7 J 4• ❑ I am a general contractor and I
employees(full and/or part-time).' have hired the sub-contractors 6. ❑New construction
2.❑ I am a sole'proprietor or partner- listed on the attached sheet. 7. Q e odeiing
ship and have no employees These sub-contractors have g• ❑Demolition
working for me in any capacity. employees and have workers'
[No workers' comp. insurance comp.insurance.:
9. El Building addition
required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions
3.❑ I am a homeowner doingall work officers have exercised they
11.❑Plumbing repairs or additions
myself. [No workers' comp. right of exemption per MGL 12. Roof re ays
insurance required.]t c. 152, §I(4),and we have no P
employees, [No workers' 13•❑Other
comp.insurance required.]
"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 contredtms must submit'a new affidavit indicating such.
1Contractors that check this box must attached an additional sheet showing the name of the sub-conlrnetors and state whether or not those entities have
employees. If the sub-contractors have employees,they must provide their workers,comp.policy number. n_
I am an employer that is providing workers'compensation Insurance for Nry employees. Beiow'is the pgpcy and job site
information. `` n
Insurance Company Name:_Dk c� 1�Q 1� o
Policy#or Self-ins.Lic.#: I�WII 3 ) G[ 0 6 Expiration Date- I ( (�' ) —
Job Site Address:l SL + \e r S ( City/State/Zip:J(l \r.
coil ✓t'i.� �I � �O
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 foim of a STOP WORK ORDER and a me
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 "fire pains and penalles ofperjury that the information provided above is true and correct.
Sitmature: Date• � � �'
Phone#: 5 p"SZ
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):
I. Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone#:
AC6RIs CERTIFICATE OF LIABILITY INSURANCE 10/01//n/20013
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
CERTIFICATE DOES NOT AFFIRMATNELY 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: N the certificate holder Is an ADDITIONAL INSURED,the pollcy(les)must be endorsadi H SUBROGATION IS WAIVED,subject to
the terms and conditions o/the policy,certain policies may require an endorsement. A statement on this DartlBDate does not DIVE rights tot to
certificate holder in lieu of such endorsement's).
PRODUCER 1-612-333-3323 Cohen
Bay, Coapanles
CT
PXaNE 3323
80 South Bth Street JIAII 612-333- x w 612-373-7270
Suite 700 ADDRESS. _
Mimeapolis, MH 55602 INSURERDIIAFFORDINGCOVBRJIGE HMCo
INSURED INSURERA: OLD REPUBLIC INV CO 24167
ReveFAl By Aadeteev corporation INSURERa:lULTIONAL TaiIOR FIRE IN8 CO OJ P2TTB 19465
MSURER C:
106 O[Se Street
dSUgER D
Northboravgh, NA 01332 INSUn E-. .
MsURER F
COVERAGES CERTIFICATE NUMBER: 36122490 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.
ILTR NSR TYPE OF INSURANCE FOUCYEFF PO EYP
FOUCYNUMBER MM LMITS
A GENERAL LLIBILIIY N Y 300361 10/02/1 20/01/14 EACH OCCURRENCE f 1.000,000
X COMMERCIAL GENERAL LIABILITY EMLSES f 500,000
CLUMSNADE Fil OCCUR NED EKP me f 20.000
PERSONALAADVINJURY f 1.000,000
GENERALAGGMOATE f 6.000.000
GENT AGGREGATE LAIR APPLIES PER:E PWCI• PR PROplICT3-COMP/OPAGO 36,000,000
IECT
LOC f
A AUTOYOBnP uAsILnY MN79 300026 1 1 COM INED&
Y E,emn 1 s,000,000
ANYAUtO SODILYDLURY(INN".) f
ALLOWNEO SCHEDULED
AUros ALROa BODILY INJURY IPaeMiaeri0 S
E HIREOAUf0.5 E AUrrceLEE RM1112119 PROPERTY DAMAGE f
f
S X UMBRELIALMB Y OCCUR 20562235
10/O1/1 10/01/lE EACH OCCURRENCE E]5,000.000
EXCESS tMB CLNMSMADE
DED X RETENTION 25,D00 ��`� i]5,000,000
WORKERS COMPEMSAININ t
A AND EMPLOYERS.LMBLLBY YIN MnC 300359 00 10/01/1 10/01/14 E STAN OT14
ANY PROPRIETONWARTNEWEJO:CUTNE
OFFICERMEl.1BER E%CLUDED'I N NIA El EACH ACCIDENT t 1.000,000
"boUrn EL.NwHI
DESLIMKION Eer EL.DISEASE-EA EMPL f 1,000.000
M OPEMTIONS below E.L DISEASE-POLICY DMR 1 f 1,000,000
DESCRIPl10N OF OPEMTONS ILOCAWONS IYEKKLES(AMAcb ACORD fOl,Ad6XIeReIMmeHe SrAeauN,MMen epn MngWM6)
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
To Wben It My Concern THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
For Insurance Purpose, only ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHOkEEO REPRE6ENTANVE
01988.2010 ACORO CORPORATION. All rights reserved.
ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD
ibargrove
36222490
r Massachuse,'ttS Department'of Public Safety
'Board of Building Regulations and Stanitard5
Clmstruchon Su Pen i.wr
License CS-0W125 aw
JAM L MORIN
86,CARDINER S'F
LYNN MA 0190
I I UP
�.�r...�li3f¢. Al Expiration
*.Commissioner 10/05/2014 ,
r ' I
I
SCA 1 0 20M-05/11
free of Consumer Affairs&Business Regulstiou
OME IMPROVEMENT CONTRA CTOR
Registra00n 1708to .
Expiration 1l-- -Z015' Type: .
. RENEWAL BYANDERSONCORPORATION Supplement
s:
JAIME MORIN �sl
ID4 0TIS STREET
NORTHBOROUGH,MA 01532 � �--
Underse— er— etsry�
PRODUCT PERFORMANCE
Andersen' NFt3C Certified iota] Unix Performance (l9n6nNEd)
Andersen Product. Glass Type 0.Eactoo SHGC VT,
200 Series
-
ClearOualPane 0.45 0.60 0.0
C!ear0val Pane.vOn Gallas 0.45 0.54 0.56 -
GII IsvE 0.30 Gm a55 M
UoublPNnng.Mud. Low-EwRN Gales 030 029 DAG s _]
HP IarE45maM15un 0.30 D2] 0.49 yJu� `
HPlaw-E4Smar[iunw/Gdlles 031 0.19 0.43 �
Clear Dual No, 0.45 0.61 0.64
N 1 e: Clear Dual Pane win 6n11es GAS 0P 0.57
'Ouuhla-HuagMininW$ Irrw-E 0.30 032 0.56
- ImaE=do Gales 0.31 029 050 -
Clear Dual Pane a." D63 0.66
N Ilnu- Clear Oual Pane will,Gales 1A4 057 0.59
Trdnmin.Wi tl Inw{ 027 034 a58 �.
Imv-E w4N Gnus 027 020 am
Gear Oual Pane 0.45 0.60 0.0
Clcr Dual No.rvLp Galles 0.45 054 . 0.56
GlidingWintl tnw-E 0.30 am a55
- Wwr with Grilles 0.30 029 0A9
Ww£SioaaSun 030 021 0.49
IowF Sm pr iui win Galles a31 0.19 0.43
- Oear Oval Pane a43 0.61 0.65
Clear Dual Pane iM Galles 0.43 0.55 0.59
F d,Tm¢s m Inw-E US US 0,56 _
`-and.TOP.Window law-Ew GNIes 028 030 ass _ ] ,
= Im+f SmahSuO - a37 Om 0.51 �
I ,E SauntSun win Galles o21 020
ClearDad Pzna 0.44 a61 064
Clear Dual Pane with Guam 0.45 053 0.56
019 am 0.56
Narmline'. Inw-E win Grilles 030 US a.49
GI djq liata 0 ors �( ImrE Sion US, 020 a31
Inv.{Sunwin Ga. 031 0.18 027r +�
Mv-E smad5an 0,28 021 0050
Imv-E SmartSun win GLs 030 US 0.44
Clear Dual Pana aQ 0.61 0.64
Cear Dual Pane win G.M. 0.43 054 0.56
Isv-E 028 O32 0.56
Penoa Snieltl ImeE with Galles 0.30 029 0.49 ] -'
Gliding Patio Do.. Ww{&ri 029 019 0.30 M
San with SAN. 0.30 0.19 027
lam-E S,anu Sun 027 am 0.50
InrvE SmartSuow GO. a29 0.19 0.44 ] ��
Clear Dual Pane 0.43 0.45 0.47
Clear Lord Panewin Galles 0.43 DM 0.40
Inw.E 032 024 0.41
Ninged.lruwi g Iuw-E win Grillo 033 021 0.35
Pam Onnes ImrE sun am 115 am 3� i
- law-E Sun win Gduas 0.34 0-3 0,19
I ESmartun 032 016 037
Law-E SmanSun win Gales am 0.14 0.31
' r
Raw-
Andersen.
Andersen*NFRC Certified Total Unit Performance (conhcted) +I
Ft
Andeaen'Praducti Glass Type U-Factor' SNGCv Vf" ix Andersen'product Glass Type U-Falpr' SHGC' VP
4005atles g hitectuml �. ..�
M,law E4 027 035 0.60 F3 HP tan-Eil 032 018 0.47
HP taw-E4 wiN Galles 028 0.31 0.54 t'+ Hp lmv-E4 wM Golles 0.32 025 0.42 "1R
Circle Top- HP Low-E4 Son 0.27 0.21 0.33 "%® Gsement 4Wndaw HP Uni Sun 032 OST 026 f•7i A
CasementM dmY HP Lax-E45un who Gilles; 0.29 019 030 FI �`%® HP lax-E4 SM:iMG11. 032 0-12 0.23
. . n NP ma Ed SmarlSun 026 013 0'M �� y]!® NPluvr-E45man15un 0.31 0.18 0.42 !!�®
`- IT lax-E45mantSun w/Galles 0.28 021 0A9 tt 2i® HP Inn-E4 SmarlSun w/Galles 0.31 0.1] 038 F*-1one
HP Lmv-E4 027 035 0.60 r9 - HP Imv-EA 0.32 Dili0.4] 'j 0.7
HP Uri MGIi. 0,28 0.31 0.54 �§ liplmv-Eq with Galles 032 025 0.42
HP Imr-E4 Sun 027 all 0,33 FA French Casement His 1mv-E4 Sun 0.32 017 0.26
Circle 8 Oval Window;'; HP Imv-E4 Sun with Grilles 029 019 030 �A wl Window HP Low,E4 Sun with Gall. 032 DAD 023 t
HP ber-E4 Smartinn 026 013 0.54 iq " HP tow{q Smah9un 031 0.17 9. :"poll
HP low-E45manlSun w/Galles 0.28 0.21 OA9 Si t9® HPLax-E4 SmwM;rm,,/G1les 031 O.S 0.3368 0?(��
HPimv-E4 028 0.33 0.58 PA - HIP tun-E4 0.32 028 0.4] yt�
HP hrw-E4 wait Gull. D29 030 Ob2 F, ' t{ HPlax{4 wiN Galles 0.32 025 0.42 S":�61®
HP Low-E4Son 028 0.20 0.31 In F1 HP row-E4 Sun 0.32 0.17 026 ,a Ea®
Audit Wtodow Awning Wed. HIP Low-E4 Sun with Galles 0.32 01fi 013 FS
HP tMA4 Sun win Grilles 0.29 018 028 R'n f:'t®
HP low,E4 SmaaSun O2T 013 0.52 � `iR HPLmv-Eq w/Gratin 0.31 0.17 042 `itBe
pe} HP low E4w/Galles 031 01T 0.38
HP tan{45man5uHw/Gn- 028 033 058 ® F4
I, HP lux-E4 0.2] 033 0.58 N� -. _ HP taw{4 03l 032 O55
HP Uw-E4 with Gml. 018 030 0.52 C'I HP Ian-E4 with Galles 0.31 029 0,19 r
s ' ! HP mw-E4 Sun 0.27 U2U 031 mmmpmm/Rwnin6 His tax-E4 031 020 0.31
Flelfre M dew HP Ian-E4 5un xfiM Grills 0.29 0,18 028 picture Window HP Inw14 Sun with Galles 0.31 0.18 0.28 E
HP Imr-E4 SmaaSun 026 023 0.52 `"1 HP tax-E4 Separation 0.31 021 0.50 FA
IN
NP lax-E45manL5un w/Grilles 028 021 0.46 d�® NP Ww-E4 SmaM1Sun w/Gnlles 031
HP tax{4 031 033 0.58 - HP liter E4 0.30
tl HP torv-EO with Galles 0.32 030 052 {t HP law-E4 wiN Gag. 030 033 0.51 {b 1
NP Imv-E45un 0.32 U2U 031 C9® HP lei Sun 031 022 0.36 {A
Spdnpine Window Specialty Window
NP tax{q 5un with Galles 033 0.18 028 y)� HP Low-E95uH wMGlcs 0.30 024
I HP LUM E4 SmartSun 0.30 023 0.52 ,, I`o® 4 Smard5unHP Upv-IE4 W/GlSua 030 022 0.58 ! A
IM lax-EA Smaa5pH w/Galls 032 021 O.q6 nb' R'q® NP lax-E4 w/Grilles 030 012 0.52
lip Um-E4 0.30 02T 045 RR HP lux E4 0.32 022 0.37 �?"'.�®
M lux-E4 withG11es 032 023 0.39 9 h r Q HP Imv{q with Grills 033 020 0.33 -
Fractionated' NPlaw-E45un 031 016 025 lifil 949 Hinged In! HPIawE4Sun 0.33 0-14 0.21 -
G1ltlingPaU Door rI HP lux-E4 Sun wM Grilles 0.32 014 022 Eg 03® French Door I HP Imr EL Sun Man Giles lulloil 013 0.18
HP iww{d SmadSun 03 h3®0 0.18 041 Fl I NP Low-E45meh5vn 032 0.15 0.33 t
jHP tmv-E4 Smartish w/Galles 0.31 0.16 an 1"® ! NP Uw-E4 Sman5un w/Grilles 033 0-14 0.30 - will
HP low{4 031 U.24 041 Illy] Y'il® NP lax-E4 0.33 025 0.41 an.. -w°m
IIPUw-E4 won,Grills 0.32 021 035 f�® HP Mt E4 wM Grills 034 022 0.36
1 HP Imr-E45un or
031 0.15 023 P i4M Hinged Oulsxing HP Mw{4 Sun 033 0-16 023 e
Frentchw tl Hmged French Do . HP mM-E4 Sun wood Galls 0.35 014 0.20 - e m
Inswing Palo Door I NP lax-E4 Sun win Giles 032 0-13 019 fell €4 f m6
NPlmv-E45marlSun 0.30 0.16 0.3] HP tun-E4 Smarl 032 0.17 0.37 ®` IA
` I NP law-EG SmaaSpn w/Gall. 0,31 0.14 0.31 i7� NP lax-E95mart5un w/Grilles 034 0.15 0.32 =
HP Law{4 0.31 025 041 �tP� Hislmv{4 033 023 038 cmFd
HP lux-E4 apt Galles 032 021 035 �- iT+�t HP taw{4 wall Galles U33 021 034 -
Frenchwootl Hinged �� No ImrEq Sun 031 015 0.23 �4 Gil Mod Fren6 Dour HP Sun 033 0.1 021 =
planning Pabo Door. '. HP Wx{4 Sun who Giles 032 013 019 P1 FA,® Side1tg-M1t HP tan-E45un with
in U Galles 0.34 0-13 0.19
HP1mwE4Sman5un 0.32 015 0.34 -
HP Low EdSmarrSurt 030 0.1] 03T 7: "`t�i -
NPtan-E45maaSun el/Galls 031 0.15 0.31 T1 P;I�1 HP Ian-E4 SmMSpn w/Galles 0.33 0.14 030
HP lux-E4 0.31 U.22 0.37 F? ® NP law-E4 032 025 0.41 -
{ HP lmv-E4 wit,Grill. 0.32010 033 It+. f-t0 His tax-E4 withGelies 033 022 03] -
Ftomchwood' HP Ww-E45un 0.32 014 021 6"{ "{� phred Transom- , NPlax-E4 Sun 032 0-15 0.23 _
Patio Duet Sidelight HP 1ow-E4 Sun win Gropes 0.32 0.13 0.18 French Door HP Law EdSun with Galles 0.33 O.14 0.20HPlmv-E4SmadSun 031 0.15 033 W1 R?ill HP Lmv-E4 SmmISuH 0.32 016 03 -
HP tax{45mart5vn w/Gall. 0.32 0.14 029 RR i.4?� NP 1ax-E48mah5un w/Galles 032 00.150.333 -
HP lax{4 030 024 0.40 �4® HP tux{4 035 026 0.44
HP Love E4 with Gall. 030 021 035 F1 NP lax-E4 with Grill. 0.36. 023 0.38 -
Fren h .ma& HP tux-Ed Sun 0.30 015 0,22 ` Folding Dovr HP Imr14 So. 0.35 0-16 014 _
Patlx Dnwr Transom .;71 NP lmrE45unwM Grill. 031 0.13 0.20 A:f-.V"d® - HP tan-E45un van Galles U36 0.14 021
NP Lmv-E45mantSun 029 O.lfi 036 ;1�t HP ImwE45man5un 034 01T 0.39 -
HP Law-E4 Small w/Galles 030 014 032 �I P.`i C$ HP imx-E4 SmarLSm w/6nli. 0.36 0.15 034 -
mndnuedannertpag
•For NFRC rectified total unit per(oanance an units with capillary brelhertums for high altitudes,please visa antle(pehwindaws.com.
•"Nigh-Peam mma7Law-E4-(HP Low-E4),'Nigh-Peammance'Low-E4-Som rtsun-MM Law-E4 Smarl6m aid'Higni eaoanance"Low-E4-Sun'Hitt 1aw-E4 Sun)are Anderson oademahs for'Law-F glass.
' U-Fatter defines the amount of heat loss through Me tire undid W/hrsq.fL"F Thd Mberfoe inlue,0,Ls beat is Metthmugh Me entire proMML Window values representnon-tempered glass.Use of tempered glass Can
crease U-Factor ratings-See andersenwindows.com for specific performance values.Door values represent tempered ebss-
' Solar Heat Gain Coeficient(SHGC)definesthe0acord ofslacadiabon admitted UMpugh Me glasshoMdirectlylansmitted and absorbed antl subsequen0y released inward.Thelower Me value,the leas heat is bansmitted
through Me product from Olo l.themore da i'MHNe gdvc[Ie6 in overthe product's Mlal unilarea.Visible Transmittance
'Visible TmusmHton[e(VF)measures how much light tames Umbria a product(glass and frame)-the figherthe vaind, y'g predictions
is measured over Me 390 to 760 manometer portion of Me SMO specimen program and procedural requirements.
NFRC ratings are based on modeling by a Mind party agency as validated by an broad ntlentte4lab in compliance with NFNC o
•This data is Mercer.as of December 2010.Due to ongoing Product changes,updated test results or new industry standards or requirements,this data may change over Med-Ratings are lot sizes spedfied by NFRC for
1 testing and comminute Ratings mayvaty dependingon use oftmencred glass,differentgrille oldfim,glass tough altitudes,etc.
•PassneSun-glass values are available online at andarsenwindmws corn.
277