62 VALIANT WAY - BUILDING INSPECTION kT1 � 9 __7
The Commonwealth of Mass i�LnGcl V L
Board of Building Regulationsar�a rtlSRAL SERVICE-, CITY OF
Massachusetts State Building Code, 780 CMR SALEM
� i S SAY e p. �.. Revised Mar
Building Permit Application To Construct,Repair,Pehb'6)tte U Dht3toti 1 a
Q One-or Two-Family Dwelling
This Section For Official U Only
I Building Permit Number. I Date A ied:
Cn it r /3
Building Official(Picot Nertme) w ` r. gignature -Daft
i SECTION 1:SITE INFORMATION
1.1 Property Address: 11 Assessors Map&Parcel Numbers
62 VALIANT WAY 21 21-0041-862
Us s Is this an accepted street?yes no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
CONDO
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.],c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Public❑ Private❑ Zone: _ Outside Flood Zone?Check if yesO Municipal❑ On site disposal system O
SECTION 2:<PROPEBTV OWNERSHIP'
2.1 Ownerr of Record:
BARBARA R07AVSKY SALEM, MA 01970
Name(Print) City,State,ZIP -
62 VALIANT WAY 978-224-2955
No.and Street _ Telephone Email Address
S1(11ON 3:BESCRIPTION OF PROPOSED WORK'(check all that spPly)
New Construction❑ Existing Building Owner-Occupied Repairs(s Alteration(s) ❑ Addition
Demolition O Accessory Bldg.❑ Number of Units_ Other QfSpcdfy. REPLACEMENT
Brief Description of Proposed Work': REPLACE 9 WINDOWS& 1 DOOR-NO STRUCTURAL CHANGE
SECTION 4:ESTIMATED CON3'1'RI)CTION f.'OS'YS
Item Estimated costs: Offtdal Use Only`-
(Labor and Materials
1.Building $ 17,355.00 1, Building Permit Fee.$ Indicate how fee is determined'
2.Electrical $ b"Standard Cit huwn Application Fee
❑Total Project Costs(Item 6)x multiplui r x
3.Plumbing $ 2. Other Fees•: $
4.Mechanical (HVAC) $ List
5.Mechanical (Fire $
Suppression) Total All Fees'$
Check No. Check Amount: Cash Amount:
6.Total Project Cost: $ 17,355.00 0 Paid in Full 0 Outstanding Balance Due:
SECTION 5:,'CONSTRUCTION SERVICES _
5.1 Construction Supervisor License(CSL)
90125 10-06-16
JAIMEMORIN License Number Expiration Date
Name of CSL Holder
List CSL Type(see below) U
86 GARDINER ST -- - -
No.and Street ., Type:> Descnpaon
U Unrestricted(Buildings up to 35,000 cu.1
LYNN, MA 01905 R Restricted 1&2 Family Dwelling
CitytFown,State,ZIP M -R&—spnyy
RC Roofing Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
508-351-2214 I hrsuIre
Tele bone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC)
170810 12-23-15
RENEWAL BYANDERSEN HIC Registration Number Expiration Date
HIC Company Name or HIC Registrant Name
30 FORBES ROAD
No.and Street Email address
NORTHBORO,MA 01532 508-351-2214
City/Town,State ZIP Telephone
SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M G L6 G 152.§ 25C{9)
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.........0 No...........❑
SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN '
OWNER'S AGENT OR CONTRACTORAPPLIES FOR BUILDING MOOT '.' `"• r
1,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:OWNER OR AUTHORIZED AGENT DECLARATION'
By entering my name below by attest under the pains and penalties of perjury that all of the information
contained in this ap7 11
on is a and accurate to the best of my knowledge and understanding,
g /J
Print Owner's or A r' Name(Electronic Signature) _ Date
0 NOTES. t
1. An obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor
(not VWstered in the Home Improvement Contractor(HIC)Program),will nor 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 MM .mass.gov/dos
2. When substantial work is planned,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 halffimths
Type of heating system Number of decks/porches
Type of cooling system Enclosed Open
3. "Total Project Square Footage"maybe substituted for"Total Project Cost"
i Cn Y OF SMENLI, INWSACHUSEM
Butw=DEmAntENT
' 120 WASHINGTON STREET,r FLOOR
TIIL(978)745-9595
PAX(978)740-984
IGN MFRLEY DRLSCQLL
MAYOR THoum ft.Pmus
dap-cro&of Puauc PitoPEa[Y/sL'1LDtNG commismNER
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,E 150X
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)
hue of gamut applicant
s/� /(s
- --- e
J�risatfduc
�en—� MA Home Improvement Contractor
License#170810(Expires 12/23/2015)
bYPUldlersen. Renewal by Andersen Corporation Federal Tax ID#41-1918413
saw a11.mwanr ..A.d��,.,..,
30 Forbes Rd. Northborough,MA 01532
(508)351-2200 Fax(508)-986-7072
CUSTOMER WINDOW AND DOOR REMODELING AGREEMENT
Buyer(s)Name Date:
BARBARA ROZAVSKY - CHRISTINE GERMAIN MARCH 28, 2015
Buyer(s)Street Address city State Zi Code
62 VALIANT WAY SALEM MA 01970
Email Address Home Telephone Number Work/Cell Telephone Number
ROZAVSKYB(9ME.COM 978.224-2955 617-257-5953
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)(collectively,this"Agreement').
Buyers)hereby agrees to sign a completion certificate after Contractor has completed all work under this Agreement.
Est.Start Date Method of Payment
Total Job Amount $ 17,355 tuns Flrencad$ 0
Deposit Received(33%)$ 5,785.00 Deposit at signing$ 0.00 10-12 weeks v Check/Cash
Balance Start of Job(33%)$ 5,785.00 Check# 1439
Balance on Substantial At Sunslamial Est Install Time p Credit Card
Completion of Job(33%)$ 5,785.00 Completion$ 0.00
1-2 days If oedB DeN is srdtuilxl,please
No final menl shell ro demanded umil en adles are satisfied gee Credit Cerdpa Bn fOml
Buyer(s)agrees and understands that this Agreement constitutes the Smile understanding between the parties,and that there are no verbal understandings
changing or modifying 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(s)and Contractor. Buyer(s)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 first written above and 2)was
orally Informed of Buyers right to cancel this Agreement. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES.
Renewal by Andersen
��Corporation
n //� /1 Buy r(s Buyer(s)
U By: Yl6CPi L—Y.r:I(i ��[D�I�(-/�Y� let.
Signature of Consultant Signature J L - Signature
x BRUCE PECK BARBARA ROZAVSKY CHRISTINE GERMAIN
Printed Name of Consuaant Printed Name Primed Name
YOU,THE BUYER(S),MAY CANCELTHIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY AFTER THE OATS OF THIS TRANSACTION.
SEE THE ATTACHED NOTICE OF CANCELLATION FORMS FOR AN"PLANATION OF THIS RIGHT.
____ _______ __ ________
NOTICE OPCANCO.IATION NOTICE OPCANC03ATfON I
Date of Tramectlon 3/28/15 .Youmayrmaidsv Date of Tramactiev 3/28/15 .You may cancel dds
traveactioq without my penalty nor obligation,widdv three business days from the tromaction,without any penalty or obligation,widdv three business days Dom the
abuse date.If you cancel,an,property traded in,a payments made by you under ahme date.R you cancel,say property traded iv my payments crude byyov nudes
Me Contract of Sale,anal any negotiable ivsaamen[raaftd by you win be tbeControc[of Sale,and oy negotiable ivefr®evt necuud byyonsvmbe
rarormd within 10 day.(mowing r<caip[by the Contractor("Solve") or your I returned wkhtn 10 days following receipt by the Contractor("Bruce) ar your,
ancelation write,and any secust"terest arising out of use auvesedon will be I cancellation notice,and my,security interest arising out or the tramacdm wt'➢he
canceled. Dyou ravral,yoummt make available to the fieller at your asidensgfnI concerti. N or,coral,you most make available to N<Seller at your reldeme,iv
sabsmtialyasgoodronditlon sswbo race:ved,oy goods delivered rayon under I substantialymgmd condition as when received,any goods delivered to you under,
this Contractor sale:or you may,:f you w:sh,amply with We ivetrvctiom of the tbiu Contract or sale;as,you may;if you adult,comply wild the instmctlovs of tea
SuLec regarding the assure oldpmem of the goods at dre Sellers expense and risk. 1 Seller retreading the rats.e,shipment of dun goods at the Seller's expmue and risk.
If you do make the good.amflaMe a the Sense and&a S<Oer does ant pick them up l N you do make the goods avalable to the Seiler and the Selur don not pirh them up
widda 20 day.of&a daft of your Notice of Cancellation,you may retvn or dispose within 20 do"a the date of your Hours of Cancellation,yvv may resin or dispox
of the good.or if yo gran thceob us,goods
If ymreilromeke the go do se,Ilan t to n,getter,without a re to thneouthe . D unds tov6ammad tail m do so,
Ate
You mrs, or if you agreerorerora the goigaions Bruce aContnd fail tutu eq than rotes Better,Holds you performance
of thebligaions Seller andControdosq Wen
ytv remain liable far performance or all obligations mdce the contract.To canal you remain lahle mail
perFormame ig vU obligations c"o dad Contract.'Ile emcel
or may,
ouactlm,mailorr,ir snda tolred oddatedapy ofddecuoedbyAantics I t aamactiog nodeeirsmdgu<danddto Co yof.hie ravaDaby"dee
or F-E to Rd. os*omagissendvtelegramroCovtracton Renewal by Anderson, larIn. rwtrtm voticS or eA 0 532. rem to Covaxuwn Renewol by Avde.seq
SO Ftrbn Rd. Noethbarovgb,MA Ot332. I 30I»rbea Rd.Ntrthborovgh,MA m332.
I HEREBY CANCCBI..THIS TRANSACTION. IFrePBBYCANC®.TfIIS TRANSACTION.
I
euynf Sbamre elm Nate or. B W.9,.. NMNvm Dew
Rend Renewal bV Andersen Corporation MA Home Improvement Contractor
byAl ldeme 30 Forbes rd Northborough,MA 01532 License#170810 (Expires 12123/2015)
ar ao.w as (506)351-2200 Fax:(508)-986-7072 Federal lD#41-1 91 8 41 3
Window Specification Sheet
Bu e s Name Date of Agreement
BARBARA ROZAVSKY CHRISTINE GERMAIN SAT, MAR 28, 2015
The buyerjs)listed above herebyjointly and severally agree to purchase the goods and/or services listed below,in accordance with the prices and terms described
on the Specification Sheet and the front and the reverse of the accompanying CUSTOM WINDOW AND DOOR REMODELING AGREEMENT,of which
the Specification Sheet is part.
WINDOW&DOOR DETAILS
Room ♦ tan Mir aro� Wintlav/Ooor eDetall Fri CasrAm�rlor Color Hardaem Harewan Loai Grille Gras Glass
Arm Color stair.aman. Got. Sash 12 San Uae ortions
Uvlra 101 PS Into Int/Ext MF Flat while Standard FFG oxi Non.
Dining102 33 47 80 DB rail must intent el sill L-him while Standard FFG marlSu Gen 3/23/2No
Dlnln 103 33 47 80 DB null equal insert doped sill L-him 1 A while Standard FFG mango am 32 3/2No
Bad 104 33 47 80 De rail equal Indent sloped sill L-Trim White Standard FFG muds Gm W W2 No
Bed2 105 33 47 80 DB call must lower el all L-him White Standartl FFG mortar, am 32 3/2 No
Bed2 106 33 47 80 DB rail mud Instant domed sill L-him White Standard FFG rla Gm W W No
uvin 107 33 47 80 Da rail uel Intent el sill L-Trim White Standard FFG ma tsu cam 32 32 No
Uvin 108 33 47 80 off gq aril ual most el all L-Trim White Standard FFG metsu sea W WNo
Uvin 109 33 47 80 DB rail must lnsan aimed sill L-Trim White Standard FFG marts. sea 32 3/2No
Sees 110 33 47 80 DB se mil Karl lesone all L-Trim Wi+wH White Standard FFG smartan, am a2 32 No Tem
Total 10 ILAJ BOW&BUILD OUT DETAE S
&%:0 I/ M=11 MWor. Number Frame Wed. End Comer Ira.£/ Earl/ Hardwdm
Room Cmrm a enbm Coal e M lo A. luster Well Color Gdllea sashes samas Stems eastern Senn Color
SPECIALTY WINDOW DETAILS
Full/ Amos. LteE/ spedNty BAY/BOW ADDITIONAL WORK NOTES
Room corm We Its u.I, sm.nsr. artles Grin . FxMm Color Cumans h swam mN wnm m/row wmdm,a under 73 mares
merew;oxd ' t aalwe.
ADDITIONAL WORK DETAIS:
I No Contractor will wrap exterior casings with coil stock color of
Owner Is aware that Contactor does not do my palnting/sWIning or removal/inslalletion of alarm system or window treatmenls/Imrdwent H is the responsibility of
the homeo sm r to have the alarm system and widow freatmmts/hamWw renravedpnor to Installation. war make w guamnfee w to whetheralerms or window
2 hwarments/hadwars will fit afterreplacement Custon is a/m aware in some Cases there will bar glass loss. Hthere Is,the amount will be reinstatement the lym
—' of evrdng windows,type of lasralladon and window syda.We make no,guarantesas to the amount of glass Ness.Customerls aware and understands anyand all
unseen not Is not included In this contract.Shouldany rot be found have will be an addldonal change for time andmateriels unless so stafedln lids cnntrect.
3 yea Contractor will Insulate,Caulk and seal windows with 3-point system to prevent water and air infiltration.Removal and disposal of all job related debris,
windows,doors,sloml windows and vacuum nightly included. Upon completion of the fob and payment in full,a limited warranty shall be Issued.
4 Yes Building Permit--Contractor will secure any and all necessary permits. The fee for the permlt(s)is Included In the total contract price.
5 Yes All discounts have been applied to this agreement.
6 E Yes 13 No Owner agrees to be present on the final day of installation for final Inspection and to deliver final payment/finance form(s).
It is agreed and understand by and between the parties that this Specification Sheet,along with the CUSTOM WINDOW AND DOOR REMODELING AGREEMENT,eourtitutes the entire
understanding between the parries,and there are no verbal understandings changing or modifying any of the terms.This Specifiestion Sheet maynot be dunged or in terms modified or varied in
any way unless such changes are in wrung and signed by both the Buyer(s)and Contrxtor. Bu) (s)hereby acknowledg-that Buyers)has read this Specification Sheet.
Renewal by Andersen Corporation n I Buyet(s)r L Buyet{s)
�. Bare P� OidiA,A,�IM'`V,LI',.61 (Q yg'
Signature of Consultant SignaturY Signature
BRUCE PECK BARBARA ROZAVSKY CHRISTINE GERMAIN
Print Name of Consultant Print Name Print Name
fr,
Norman Bogosian PO Box 4523
Property Manager Salem,MA 01970
Office (978) 745-2225
Fax(978) 745-2251
E-Mail: NormBogosian@Comcast.net
April 23 2015
Bruce Peck
Window/Door Consultant
email:Bruce.Peck@Andersencorp.com
CC: April.Oveka@AndersenCorp.com 5/6/15
RE: Village at Vinnin Square
62 Valiant Way (10 replacement windows)
Salem, MA 01970
Dear Mr. Peck,
Pursuant to my conversations with the unit owner of 62 Valiant Way (Barbara Rozaysky)
it is my understanding that the unit owner have selected your company to install replacement
windows in their unit.
As the property manager and on behalf of the Trustees of the Village at Vinnin Square
Condominium Trust your company has permission to install windows at units # 62 providing...
1. The exterior appearance of the existing windows are maintained with your
replacement units.
2. Your installation meets or exceeds the existing building codes in Salem, MA
3. Your company provides proof of insurance
4. Your Company works between the hours of 8 am and 5 pm, Mon through Friday
5. Your company cleans up all debris at the end of each day
If necessary, you have permission to store your scissor lift for one night behind garage #44-48.
If you should have any questions please call the office at (978) 745-2225 or email at
NormBogosian@Comcast.net
Very truly yours,
/Yolwar Bo�iv
Property Manager
cc: Trustees - Village at Vinnin Square Condominium Trust
Barbara Rozaysky & Christine Germain
Bogosian and Company LLC(Property Management Co.)
The Commonwealth ofMassachusetis
Department oflndmirwlAccidents
Office of Investigadons
9 l Congress Street,Suite 100
Boston,MA 02114-2017
www massgov/dia
Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Le gib
Name (Business/Organization/individual): RENEWAL BY ANDERSEN
Address:30 FORBES ROAD
City/State/Zip:NORTHBORO, MA 01532 Phone#:508-351-2200
Are you an employer?Check the appropriate box:
Type of project(required):
l.M I am a employer with 30 4. 0 1 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 Remodeling
ship and have no employees These sub-contractors have 8. Demolition
working for me in any capacity, employees and have workers'
[No workers' comp.insurance comp.insurance.: 9• ❑Building addition
required.] 5. 0 We are a corporation and its I0.❑ Electrical repairs or additions
3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions
myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs
insurance required.] t c. 152, §1(4),and we have no
employees. [No workers' 13T1 Other
i
comp.insurance required.]
*Any applicant that checks box Hl must also fill not the section below showing their workers'compensation policy intormatimr.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
:Contractors that check this box most attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have ?
employees. If the subcontractors have employees,they must provide their workers'comp.policy number. 3
lam an employer 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 Address: 62 VALIANT WAY SALEM, MA 01970 i
City/State/Zip:
Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine
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 E
Investigations of the DIA for insurance coverage verification. E
I do hereb ce the pains and penaides ofpe{fury that the information provided above is true and correct
Date: 05/08/15
..
Ph9ne#: 508-351-2200
i
Officlal use only. Do not write In this area,to be completed by city or town=Plumbing
City or Town: PermittUcense
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3. City/Town Clerk 4.Elec6.Other
Contact Person• Phone
ANDECOR-01 YADAVYO
s��4�Rv CERTIFICATE OF LIABILITY INSURANCE M1onne1 a)
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
CERTIFICATE DOES 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
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: N the certificate holder is an ADDITIONAL INSURED,the pollcy(les)must be endorsed. N SUBROGATION IS WAIVED,subject to
the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsements).
PRooucrfi CONTACT
NAME: cartificates@Mllls.com
Willis of Minnesota,Inc. En 977)94 -7378 No 886 467-2378Clo 26 Century Blvd �N
PO-Box 305191 nsnaEseDME
Nashville,TN 37230-5191
INSUR )AFFORDING COVERAGE NAx:5
INSURER A,Old Republic Insurance Company 24147
INSURED
INSURER B:
Renewal by Andersen Corporation INSURER C:
30 Forbes Road INSURERD:
Normborough,MA 01632 _ -
wSURaI e:
INSURER F:
COVERAGES CERTIFICATE NUMBER: 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.
INSR-1.131 TYPE OF INSURANCE
POLICY NUMBEa Mw0 LUaTB
A X COMMERMALGENERAL LIABILITY EACH OCCURRENCE E 1,000,0
CLAIN521AOEPx�OCCUR MWZY302940 10101l2014 101011201$ PREMISES Eaoaurtwux 'S 500,000
MED EXP(Airy are PN ) S 10,000
PERSONAL S ADV INJURY S 1,000,00
GENL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE f 4,000,00
X POLICY JECT [I LOC PRODUCTS-COMPIOPAGG E 4.000,00
OTHER: $
AUTOMOBILE LMIaB.RY BI EDSINGL MIT y 5,000,00
Ee 'em
A X ANYAWO MWTS302575 10101/2014 1010112015 BDDILVINJURY(Pw Pweon) S
ALL OWNED SCHEDULED BODILY IWURY(PIN emaenq S
AUTOS AUTOS
HIREDAUTOS AUTO) ED quo ) p E S
S
UMBREL LU1B OCCUR EACH OCCURRENCE S
EXCESS LIAR CLAIMS-01AOE AGGREGATE S
DED RETENTION$ Is
WORKERS COMPENSATION O -
ANpEMPLOYERS'UABILITY X STATUTE ER
A ANY PROPRIETORMARTNER, ECUTIVE YIN
NI=30293800 1010112014 1010112015 E.L.EACH ACCIDEM E 1,000,00
OFFICERRAEMBER EXCLUDED? N� NIA
prweMory In NH) E.L DISEASE-EA EMPLOYEE S 1,000,000
"iyr 4eApiTN1NR0er 1,000,00 DESCRIPTIONOF 4ERAIIONSIxI. EL DSEASE-POLICY LIMB S
i
OESCRS'110M OF OPERATIONS!LOCATIONS/VEHICLES(ACOR010/,Aadklona RamPHu SrhoaWe,may la elfecAed a mole epaoe Is requLea) i
i
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t
i
i
CERTIFICATE HOLDER CANCELLATION
e
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
1
AUTHORMPn REPRCSENTATNE
I
Evidence of Insurance }
01988.2014 ACORD CORPORATION. All rights reserved.
ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD ?
,
i f
Massachusetts-Department of Public Safety
Board of Building Regulations and Standards
Construction Sopemhor as;3
S
License; 25 €
JABS L MORIN
36 GARDINER SF
LYNN MA 01".f
Expiration
Commissioner 10fOB/Y01B
i
f
8'6e�Ooweowaru!ea/Gf o���enn6rweldi 4
c of Ceeanaler Affairs&Baines,Regsladon `
i
E IMPROVEMENT CONTRACTOR
Registration w
. 170810 'type=
Eupltation. 1y2312p15 supplement
RENEWALBYANbERSONCORPORATION
JAIME-MORIN -
t1., 104 OTIS STREET
NORTHBOROUGH,MA 01532
Uaderseercta ry � �3
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PRODUCT PERFORMANCE
Andersen'NFRC Cartiaied Total Unit Performance (aanwued)
21
Andersen'Product'. Glass Type H-Facmr' SHGC' VP
_ 290 Sens: .,,.._...,-_ ....._
Char Dual Pane 0.45 IV 0.63
-Gear Dual Pane•.vih Galles 0.45 0.54 0.5G
lilbWash lnvE GAO 032 0.55
nnuhle-flung Windom WwE wit GAIT. 0.30 029 0.49
OP I 4 SmaM1Sun 0.30 SAI 0.49
HP Unv-E4 Srn 5mw/Galles 9.31 0-19 0.43 2a
Char Oval Pane 0.45 0.61 0.64
Narmlihe' Clear 9aal Pane with Galles 0.45 0.S4 0.57
DouhteHung Window lmv-E 0.30 032 0.56
Imv-E rlh Gales 0.31 G_ OAS Li
Clear Dual Pane 0.44 0.63 0.56
Narmline' Clear Oaal Pane with Gnllaa 0.44 O.57 0.59
Transom Window Ww{ 027 034 0.58
W1wE,�Giles 027 03D 0.52
Clear Dual Pana 9.45 0.69 0.0
U.,0.1 Pane with Gnllr 0.45 O54 . 0.56
Ww-E 0.30 0.32 0.55
Oman,Windnw WmE with Gnllss 0.30 OAS 0.49 J
Ln ESmanSan 030 031 OA!9
Wn4 Sman.Sun with Galles 0.31 MO 0.43
Clear Dual Pane OAS 0.61 0.0
• Clear Oval Pane dth Gllas GAS 0.55 = 0.58
Fuod,Tmrsom;. law-E GAG OAS 0.56 M
CJ.1n To,'Wulhw Ww-E wilh Galles 0.28 O30 0.50
Imw{Sma .n 027 022 151 7�
tmv-E Sn,.al with Galles 927 020 0.45
Clear Dual Pana 044 0.61 0.64
Clear Dual Pane elh Gnlu OAS um 0.55
taw-E 019 032 0.56
Narraline' lmv-E with Galles OAG 029 0.49
Gliding Patio Ooms lnIE Sun OAS 020 0.31
. Imv-E Sun with Gall. 031 DAS 927,
t n,-E Smar15un 0.28 021 0.50 J
tmv{SmanSun with Galles 030 0.19 a."
Clear Dual Pana 0.43 0.61 0.64
Clear Dint Pane wdth Grilles 0.43 034 0.56
Ww-E 028 032 0.56
mia-ShbOd: Ww-E.vfh Galles 0.30 029 OA9
liding Pan.Ona Ww Sun 029 0.19 030,
law-E Sun with Galls GAO 11] 02] 2 ._m
wnE Smarl5un 021 022 0.50 5 JO3
Iaw-E Smarl$un with Gllg 029 O19 0.44 e�
Clam Dual Pane 0.43 OA5 9.47
- Glum Dual Pane with Gall. 0.43 039 OAD
- wnE 0.32 024 OAI ,k]
Hingnd_Inswing Imr-E wah Gnlles 0.33 021 OAS
'Patio Danrs Low-E 6ua U32 0.15 GAS
tmv-E Sun wN�G.H. 034 0.13 0.19
Ira ESmanSun 032 0.16 937
wlE snnn .a nit Galins OAS 0,14 0.31 -
6'f
Andersen.
t
Andersen'NFRC Certified Total Unit Performance lromhmed)
I
Anderson'Product Glass type i U-factor' SNGC' VP r. "i� Anderson'Product Glass type s U-Factor' SHGC' VP I
400 Seri. . AmhltenUuml
IIP Law Ed 0.27 035 0.60 ( UP Lme£4 032 0.28 0.47 5N
IIP ImwE4 with Galles 0.28 031 0.54 4rl IIP Lax-M with Grilles 0.32 1L25 0.42
Clrcle Top- IIP Law E4Sun 0.27 0.21 0.33 '•1 p'fy' IIP Low E4 Son 0.32 0.17 0.26 "!lea
Casement Window Casement Window
111'low-E4 Sun with Grilles 0.29 0.19 030 Tj 1 in III'Loy-E4 Sun with Grilles 0.32 0.16 0.23 '
IIP Low.E4 SmadSun 0.26 U.23 0.54 F'3 ".4 IIP bur Ed Sm urUird 0.31 0.18 0.42
UP tun E4 SmarUmse/Grilles 0.20 021 0.49 F1 IIA IlPtvn-E4 SamrlSim w/Gdes 0.31 0.17 0.38 "912
1 lip leer-E4 0.27 035 0.60 9a IIP IawE4 0.32 0.28 0.47 '"'DO
Ito law En wild Gdlcs 0.28 U31 0.54 P Lme-E4.79r Galles 032 1125 0.42
Circle 8 Oval Windows lip tow E4 Sun 0.27 021 033 -% Farrah Casement __- IIP law-M Sun 0.32 0.17 0.26
IIP Low,E4 Sun with Grilles 0.29 0.19 0.30 p Window IIP Ito.-E4 Sun with Galles 032 0.16 0.23 TOM
IIP Low E4 SmarlSmr 0.26 023 0.M PUI IIP Law E4 SmmlSun 031 DID 0.42
DPW E4SmmlSunw/Galles 028 07.1 0A9 Rg ;1�1.1, IIP Lae-Ed SmTr dui w/Galles 031 0,17 0.38 •6'�®
IIP M,N 028 0.33 0.58 FBI lip tan-E4 0,32 028 0.47 'NI
IIP Ime-M wilt Galles 0.29 030 0.52 ipI rat IIP Law-E4 with Gall. 0.32 025 0.42 '
IIP Low-E4 Sun 0.28 020 0.31 M •a Low Ed Sun 0.32 0.17 0.26
Arch Window Awarlog Mail. - --
HP Low Ed Sun with Grilles 0.29 DAB 0.28 53 �!,® IIP ImLEM1 Sun with Galles 0.32 0.16 0.23 '
IIP Imv{d SmmUun U.27 0.23 0.52 M7 I')� - HP Low E4 SmanSun 0.31 0.18 0.42
IIPLow-E4 SmeaSun w/Galles 0.28 0.21 0.46 HPLmwE4SmariSunw/G611. 031 0A1 0.38 PIR I
HP bee E4 O9 033 0.59 CL9 IlP leer-E4 031 032 0.55
IIP Low-Ed who Galles 0.28 0.3D 0.52 L'rl UP law E4 wah Grilles 0.31 029 U.49 Fl
HP bra Sun 0.27 020 0.31 6l �_ Cesement/Awning IIP tax�E4Sun 0.31 0.20 U.31
Flmrlfmme'WladoW IIP Wee Sun AM Gripes 029 0.18 U.28 Gib lip Facture MI. lip Dow FA Soh,with Grilles 0.31 0.18 028 El 13
! IIP Lmv-FA Smargan 0.20 023 0.52 Pd IIP IuwE45manimi 0.31 0.21 0.50 •'.P'!1®
tip law Ed SmmLSun w/Galles 0.28 0.21 0.46 IE7 ''1�, IIP WwE45mantun w/(rives 0.31 0.19 0.44 E'J®
IIP L.-E4 0.31 0.33 0.58 He love-E4 0.30 0.37 0.64 _
IIP lawE4 with Grilles 0.32 020 0.52 IIP Law-FA with Grilles 0.30 033 0.57 ill'
Hp Low-E4 Sun 0.31 020 0.31 "'i IIP law-Ed Sun U.31 U22 0.36 5 n 9
spdngllm,"MMow --- -- easefully Window
HPLaw-E4 Sunnnh Grilles 0.33 0.18 0.28 ^9� IIP LuwE4 SinwM Grills e 0.31 02U 0.32 -•�® !
HP how Ed Smar65un 030 0.23 0.52 Iwl In HP Low Ed SmmUne 0.30 924 0.58
IIP GreEd Smardiun w/Grilles 032 0.21 0.46 " HP for EdSomalian /Grilles 0.30 022 0.52 P6�
IIP Imr-E4 0.30 U.27 0.45 1E5 %r 11P beer E40.32 M U37 FA (?7IN
IIP tiny EA with Grilles 0.32 0.23 0.39 9 Tv4 HP Lmv-E4 with Grilles 033 020 0.33 '
Feaci000M' HP Day E4 Sun 0.31 DAD U 25 M GI Hinged InsMng IIP law-E4 Sun 0.33 014 DM -
Gliding Patio Door I IP We E4 Sun with Gulf. 0.32 0.14 0.22 !r] 9191 Dutch Door IIP Low E4 Sun oti Grilles 0.34 0.13 0.19 -
lip 1.F4Smarghor 0.30 DID 0A1 €L{ '1ffd lip tan E4 Sman5un 032 0.15 U.33
! IIP Law E4 Sm DISun w/Grill. 031 GAS 0.35 -re ±R11 lip lmvf4 Salentine w/Grllw 0.33 OA4 0.30 ozi
_IIP Dow Ed 0.31 024 0.41 1114 a'I IN lip law Ed 0.33 0.25 0.41 c
lip low E4 with Grill. 0.32 0.21 0.35 rpl :I I lip lawE4,,Rh Grill. 0.34 022 036
resmlawod'Hinged ! UP law-E4 Sun 0.31 GAS 023 109 @PI R hinged OufsMng IIP Law Ed Sun 0.33 0.16 0.23 c c
IneMng Patio Door - IIP law E4 Sun with Gilles 0.32 0.13 0.19 9, y'l Ali French Door IIP Iwo-E4 Sun with Grill. 0.35 0,14 0.20 i'a6
IIP ber Ed Situation 0.30 0.16 0.37 i`J Ito LmwE4 Smar6nn 032 0.17 0.31 M 11999
IIP IE4 SmarlSun w/Galles 0.31 0.14 0.31 till IIP Ise-Ed SmerlSuu w/Grill. 0.34 0.15 0.32 - ova
mw
lip Loa E4 0.31 025 OAI i"�,'{ lip low,Ed 0.33 0.23 0.38
11P tow-E4 with Galles 0.32 021 035 f,7 Pj lip Im.E4 with Grilles 0,33 021 0.34 -
Frenethemd'Hinged' r IIP Law E4Sun 0.31 0.15 0.23 !? ^+I Good F eneh Do.- lip Day E4 Sun 0.33 0.14 0.21 -
Outming Patio Dam I IIP Lao-E4 Sun Th Grill. 0.32 U.13 0.19 r'i Sidelight- lip law-E4 Sun with Grll. 034 U-13 0.19
IIP Inn-E4 Sme tSon 0.30 0.17 037 6ri, V IT9 IIP LvwE4 SmmISan 0.32 0A5 034 -
lip InwE4Snmrt5enw/Galles 0.31 U.15 0.31 Rt HPlaw-E4Sman5anw/Gnff. 0.33 0.14 0.30 -
IIP 1.E4 0.31 022 0379 HP tan-M 0.32 025 OAS
HP LawE4 with Grill. 0.32 020 0.33 RP €ji 9 IIP law-E4 won Galles 0.33 U22 0.37 -
Farnchwmd IIP L.E4 Sri. 0.32 0.14 _021 W'j I"dA Feed Tmasom HP Dow B Sun 032 0.15 0.23 -
PaUo Hour Sidelight lip Law Ed Sun with Grilles 0.32 0.13 0.18 7n7 r'! French Hem tip tow-E4 Sun with Grill. 0.33 0.14 0.20 -
lip LmwE4Seasudin 0.31 0.15 0,33 ppl 1'71 lip Iran E4 barged 032 0.16 0.37 -
lip tow F4SmaaSmhw/Grilles 0.32 0.14 0.29 F D}(4If IIP Lem E4 Smar15un o/Grill. 0.32 0.15 0.33 -
UPI De,F.4 0.30 0.24 0.40 '`i� UP Wa 14 0.35 0.26 0A4
tip Law.E4 with Grilles 0.30 021 0.35 7:h c3 R IIP LiewE4 with Grill. U 36 0.23 0.38 -
Frinclreaur IIP Lips E4Sun 030 U.15 0.22 F47 ''`y&11 IIP La,Ed Suo 0.35 0.16 0.24 - _
P.U.Door Transom tip Ime-F.4 Sun with Gales 0.31 U.13 0,20 Tl( '•";OA Folding Don, -pP Ito M Sun with Gtl11. 0.36 0.14 021 -
UP Lay,F4Squadron 0.29 DID 0.36 jr7 -.n� IIP Irwr E4 Squagun 0,34 0.17 0.39 __
IIP Low E4SmarvSunw/GdUer 0.30 0.14 0.32 �I( Y'-.� IIP Dry,Ed 036 0.15 0.34 -
-- mnlinwewennertpat¢
•Far NFRC cmtified total limit perfommnce on writs wilh cap111ary breailmr tribes fee high altitudes,plmse,visit andemenrimdaws.mm.
•'High-Pwfarmmee"lawF4`RIP Imv-EM1),'lligh-Performance Lon-E4'SmaelSun''L11P LnW-F.4 SmanSmU nd'lligh Performance Law-E4'Sun (lip Law-E4 San)are Andersen trademarks for Yaw-E'glass.
11-Factor centers the amount of heal loss through the total unit in 8TU/fir sq.fl.-F.The lacer the value,are less heat is lost Waugh the entire product Window values represent non-lempared glass.Use of Prepared glass can
increase U-Factor ratings.See i ndermsevintim s.rom for specific performance values.Door valves represent tempered glass.
'Same Heat Gain Confident(SUGC)defines the burden of solar radiation admitted through the glass both directly transmitted and absorbed and subsequently released round.the rawer the value,lire Ls heat is transmitted
through the product
'Visible Transmittance IVIl me a mes how,much light comes through a product(glass and frame).lho higher the value.boa 0 to 1.the more daylight We product lets in over the products total unit area.Visible transmittance
is measured aver the 380 to 760 mnameter portion of tie,saint spectrum.
•NMC stings am barred an marveling by a guru party agency as validated by an independent lest lab in compliance with NFRC program and procedure]reaniremaais.
•This data is accurate as of December 2V 10.Due io mgaing product cimages,ordered lest results or industry standards or remaremenis,ties data may change over lime.Ratings are for sure speeHfied by NHRC far
testing read cedificalion.Ratings may vary depending an use nl tempered glass,different gdlle uPUnns,glass far high allilmles,etc.
•lbssiveSsn'glass values me available online al uedurre soma.,cum.
277
Renewal .
byAndersene
WINDOW REPLACEMENT an Mde C6mpnny
.< arx!r€rRa, ,�,., WooilMnyl Composite IF„
} p;.:g fpxg: Dual Argon Low E4SmanSun
Double Hung
100-00473518-010
ENERGY PERFORMANCE RATINGS
U-Factor(U.S)/I-P Solar Heat Gain Coefficient
0n29-- Onig
ADDITIONAL PERFORMANCE RATINGS
Visible Transmittance
0n42
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