83 TREMONT ST - BUILDING INSPECTION The Commonwealth of Massachusetts
° Board of Building Regulations and Standards FOR
Massachusetts State Building Code,780 CMR, 7" edition MUNICIPALITY S
Building Permit Application To Construct,Repair,Renovate Or Demolish a Revised January
One-or Two-Fairtily.Dwellfng 1, 2008 -
�"I This Section For Official Use Only, . -
Building Permit Number. Date Applied:
Signature:
Building Commissioner/InspectorofBu dings Date / V
SECTION 1:SITE INFORMATION
1.1 Prerty Addre`ss: 1.2 Assessors Map&Parcel Numbers
1.1 a Is this an accepted street?yes_ no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use Lot Area(sq ft) Frontage(ft)
1.5 Building Setbacks (ft)
Frons Yard - - Side Yards - - Rear Pard
Required Provided Required Provided Required - Provided
L6 Water Supply: (M.G.L c.40,§54) 1.7.Flood Zone Information: 1.8 Sewage Disposal System: -
Public❑' Private[ Zone: _ Outside Flood Zone?.
Check if yes❑ Municipal❑ On site disposal system ❑
SECTION 2: PROPERTY OWNERSF12'
2.1 Owners of ecord: 1
c�s�_n� ha �id � ��de�t�t .� SZ �� \y- A � CL
Name(Pfi t) Address for Service
lash
Signature Telephone
SECTION 3;DESCRIPTION OF PROPOSED WORK=(check all that apply)
;ie':iwn5ti t:�av:r ❑ �xISCn^ BtaILi:75 ❑ :�R' er'G°CC:: -^d ❑ :'.e. 31 S S ❑ -Aa:0iltiL`n�5) :dd.4io: ❑ - .
peinolition ❑ \ccessorv,Bldfl: ❑ NunbcrofUnitS
Brief Fteseripiiun of Proposed Woric'-:
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1.Building $ �� �� 1. Building Permit Fee:$ Indicate how fee is determined:
2.Electrical $ ❑Standard City/Town Application Fee
❑Total Project Cost' (Item 6)x multiplier 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: $ i I SCl11 Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5..11\Licensed
{�Construction Supervisor(CSL)
License Number Expiration Date. ,
Alam=of CSL Holder
List CSL Type(see be]ow)
� n WM�1in� x1\e plc
T'.`._e Descrition
U Unrestricted(tip to 35,000 Cu.Ft)
Si afore R' Restricted )&2Fami] Dwellin
l �� M MasomyOnly
RC Residential RoofingCovering -
Telephone WS Residential Window and Siding
SF Residential Solid Fuel Burning Appliance Installation
D Residential Demolition ,
2 Registered Home I�m/�prov11ement Contractor(HIC) 14�L6U/
r nr:.i.t( �r Y—lvt c'�e:'SC4 Registration Number
HIC Comp R Name HIC Re trent N e g
IS 3
A rens i ,� l�'(�l�{07
Expiration Date
7gnature Telephone
SECTION 6:WORIMRS' COMPENSATION INSURANCE AFFIDAVIT(M.GJ—c.152. § 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 ......... No...........❑
SECTION 7a.-OvtwEk 4,UTHORIZATION T.OBE COMELETED WF)EN .
OWNER'S AGENT OR.60N�TRACTOR APPLIES FOR BUILHiNG$ER1VIiT
as Owner of the subject property hereby
authori e ,i Cosi r'Cz� to act on my behalf,in all matters
relative to work authorized by this building permit application. .
Signature of Owner Date -
II-SECTION7b :OWNER'QRAilTHORI-ZEDA ElA;T1EC�:SRATION'':
1 6r�t t s 0uver or Afithhtizad A',dent loPrebv declate -..
flier the Ftat'cmen s and iiafotui tion on the faregeiu:apptnation'are to e and atcurafe,foto the best of m;1 'o s l'ttlee acid
behalf. I (�
CIA, C
ilea Irk
Signature of Owner or Authorized Agent Date
(Signed under the pains and enalties of e h
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 not 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 780`CMR Regulations 110.R6 and 110.85,respectively.
2. When substantial work is planned,provide the information below:
Total floors area(Sq.Ft.). (including garage,finished basemmt/attics, decks or porch)
Gross living area(Sq.Ft.) Habitable room count
Number of fireplaces Number of bedrooms
Number of bathrooms Number ofhalflbaths
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"
104 Otis St.,Northborough,MA 01532 J&L WtNDows,INC.,D/a/A MA Home Improvement Contractor
(508)919-0900•Fax:(774)987-3013 - RenewalLicense#149601 (Expires 1/24/2012)
byAndersen. Federal Tax ID#83-0404201
WINDOW REPLACEMENT r,Ma� ry
CUSTOM WINDOW AND DOOR REMODELING AGREEMENT
Buyerisl Name C Dale of Aggmemenf
Buyer(s)sneer A ren,Ciry,Scare,and Zip Cade
3 2Z�'ud Ar r 4&At �IA o/926
Entail Address Home Telephone Number Work Telephone Number
Ui7-FJZ- /3 i8- 94e
Buyer(s)hereby jointly and severally agrees to purchase the products and/or services of J&L Windows,Inc.d/b/a Renewal by Andersen "
("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').Buyer(s)hereby agrees to sign a completion certificate after Contractor has completed
all work under this Agreement.
Method of pymm:O Cash a Check ❑Mastercard U VISA
Toto)Job Amount2 Estimated Starting Date:
�/ �/��'' < O Discover .L]Financed,App#:
Deposit Received(33%): .3607 ��^"v -
9c Nome on Credit Card:
Balance at Start of Job(33%):_?62& Estimated Completion Date:
P Credit Card#:
Ballance on Substanti I a'
Completion of Job 33%): 1 CC Exp.Dote: CC Security Code:
By initialing here,you acknowledge that the Balance at Start of Job and the Balance on Substantial Completion
Buyer Initials�' � of Job cannot be made by credit card and must be made by personal check,bank check,or cash.
Buyer(s) agrees and understands that this Agreement constitutes the entire 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 Buyer's right to cancel this Agreement.DO NOT SIGN THIS CONTRACT IF
THERE ARE ANY BLANK SPACES.
J&L Windows,Inc.d/b/a Re wal by Andersen Bu Buyer(s)
ra,
Si ature o Prod. anager S Signature.
Print Name of Product anager Print Name 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.
�— _ _ — — — — _ _ _ _X- - — _ _ _ _ _,_ — _ — — _ _ .X— — — — — — — — — — — — — — —x
NOTICE OF CANCELLATION X NOTICE OF CANCELLATION
Date of Transaction - . You may cancel Date of Transaction . You may cancel
this transaction,without any penal tyy or obligation,within this transaction,without any penalty or obligation,within
three business days from the abovedate.If you cancel,any throe business days from the above dale.If you cancel,any
properly traded in,any payments made by you under the property traded in,any payments made by you under the
Contract of Sale,and arty negotiable instrument executed i Contract of Sale,and any negofiable instrument executed
by you will be returned withdays following receipt by you will be returned within 10 days following receipt
by the Contractor ("Seller") of your cancellation notice, by the Contractor ("Seller'l of your cancellation notice,
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 be canceled.R you cancel,you must make available to the
Seller at your residence,in substantially as good condition Seller at your residence,in substantially as good condition
as when received, any goods delivered to you under as when received,any goods 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,comp) 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.R you do make
If you do make the goods available to the Seller and the I the goods available to the Seller and the Seller does not
Seller does not pick them up within 20 days of the date pick them up within 20 days of the date of your Notice
of your Notice of Cancelktfion,you may retain or dispose of Cancellation,you may retain or dispose of the goods
of the goods without an further obligafion.If you fail to without.any further obligation. If you fail to make the
ZZ the goods available to the Seller, or if u agree goods available to the Seller,or if you agree to retum the
ro rtNum the gods to the Seller and fail to do so, then gotxJs to the Seller and fail ro do so,then you remain table
you remain liable for performance of all obligations under for performance of all obligations under the Contract.
the Contract.To cancel this transaction, mail or deliver a I To cancel tins transaction, mail 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 notice,or send a telegram to Contractor.J&L Windows,
&L Windows,Inc.d/b/o Renewal by Andersen, 104 Otis Inc. d/b/a Renewal by Andersen, 104 Ofis Street,
Street, Northborough, MA 01532, BY NOT LATER THAN Northborough,MA 01532,BY NOT LATERTHAN MIDNIGHT
MIDNIGHT OF A(Date) OF .(Date)
I HEREBY CANCEL THIS TRANSACTION. I HEREBY CANCEL THIS TRANSACTION.
Buyer'ssignabsre Dote I Buyer's signature Date
RbA Copy- White Buyer Copy-Yellow Buyer Copy-Pink
J
104 Otis Street,Northborough,MA 01532 � "— &L Windows,Inc.aro/a
_ —." MA HIC License#149601(expires 1/24/12) .
Phone 508.919.0900•Fax 774.987.3013 _ Renewal Federal Tax ID# 83-0404201
MAndersen.
WINDDW NEPr CEMENT anp Cnmpny
OF GRessrx MASGCHoseTle Arm New HAxwsxma:
WINDOW SPECIFICATION SFIEEF -
Buyer(s)NameDate of Agreement
(
(57118/_,55 — d
The Buyers) above hereby jointly 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 this Specification Sheet is a part.
WINDOW DEPABS
1. Contractor will Install a total of
windows in Owner's home,using the following individual quantities:
1�
Double Hung(DB) Equal sash ❑ Cottage sash(1/3 top,2/3 bottom) ❑ Oriel sash(2/3 top.I/3 bottom)
Casement(CW) ❑ Hinge right ❑ Hinge left(as viewed from exterior): ❑ Standard handle ❑ Metro handle
Double Casement(CDW) ❑ Standard handle ❑ Metro handle
Casement/Picture/Casement(CPW) ❑ 1:1:1 or ❑ 1:2:1 ❑ Standard handle ❑ Metro handle
2 Lite Gliding Window(GW)
Glider/Picture/Glider(GPM ❑ 1:1:1 or ❑ 1:2:1 -
Awning Window(AW)
Picture Window(PW)
Bay or Bow Window _
Patio Doors(see separate Door Specification Sheet)
2. Yes ❑,--,/No Qty of Windows to be Custom Fit Replacement:
3. ❑ Yes K No Qty of Sills to be replaced by Contractor:
4. ❑ Yes to Qty of Windows to be New Construction Full frame(includes new interior&exterior casings)
Exterior cos : ❑ Pine ❑ Maintenance-free material ❑ Factory applied 908 Fibrex brickmold
5. Glazing to be: HP Lo -E®SmartSUr— (Tex 0iniYtLkvble) ❑ Other If other,please specify
G. Exterior color to be: � ice ❑ Sand ❑ Canvas ❑ Terratone ❑ Cocoa Bean
7. Interior color to be: �te ❑ Sand ❑ Canvas ❑ Terratone ❑ Pine ❑ Maple ❑ Oak
Nate: Inte " r color can only be white,wood or same color as exterior. Wood interiors need to finished by Owner.
8. Hardware: ixite ❑ Stone ❑ Canvas ❑ Brass ❑ Estate Hardware: Style:
9. ❑ Yes ❑ No Install Lifts with Double Hung 1priclows
10. Screens: windows to have: ❑ Half or [A'TWI screens Screens to be: Fiberglass ❑ Aluminum ❑ TruScene
GRILLE DEFABS
11.Windows have grilles: ❑ Yes No If yes:❑ Grille Between Glass teed❑ Removable Interior Wood atmwt❑ Full Divided Light(ruu
Qty Qtr Qtr Qtr Qtr Qtr Qtr
71'
oN DN oN CWNlqure GIiEW cP .'G
Draw grille patterns above 'Use additional sheet if needed Owner approved(vutials):(_ )
ADDITIONAL WORK DEFAIIS
12.❑ Yes No Contractor will remove metal frames of windows. Qty of Units:
13.[JYes 52"No Contractor will install new paint-ready or stain-ready casings.
Interior casing qty of openings: Exterior casings qty 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:
Interior stops qty of openings: Exterior stops qty c nings: ❑ Pine ❑ Maintenance-free material
15. Owner is aw that Contractor does not do any painting. Owner Initials
16.❑ Yes No Contractor will wrap exterior casings with aluminum coil stock of color.
Note: Wrapping may be required with storm window removal;removal of storm windows will leave screw holes in casing.
17. es ❑ No Contractor will insulate,caulk and seal windows with 3-point system to prevent water and air infiltration.
18. F1No A limited warranty shall be issued to Owner upon completion of thejob and payment in full.19. Yes ❑ No Buildir)g Permit--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 fee.
20. Additional job details:
21. Yes ❑ No Owner agrees to be present on the final day of installation for final inspection and to deliver final payment.
No final paymentshall be demanded utm7 the contract is completed to the satisfaction ofall parses.
It is agreed and understood by and between the parties that flus Specification Sheet,along with the CUSTOM WINDOW AND DOOR REMODELING
AGREEMENT,constitutes the entire understanding between the parties,and there are no verbal understandings changing or modifying any of the
terms. Tlus Specification Sheet may not be changed or its terms modified or vaned in any way unless such changes ase in writing and signed by both
the Buyer(s)and Contractor. Buyer(s)hereby acknowledge that Buyer(s) , read this Specification Sheet.
Renew of MA end NH Buyers Buyer(s)
�✓
S' tare of Prcii[T' att S' tore signature
/l ,eYer _
Print Name of Product Manager Print Name Print Name
AC Commonwealth of Massachusetfs
Department Wealth
Office of Investigations
600 Washington Street
Boston,MA 02111
www.rnassgov/dia
Workers' Compensation bsessurance Affidavit: Builders/Cona4ractors/Electracizus/Plumbers
A-pplicant Innformation Please Print Ledbly
Name (Businnar' axi=s n/tadividual): wen P_0 1 Ny �nde--Sen
Address:
City/Statomp: Alai-6 be(e , CSS �� Phone#: ��h�J�� lrly D/r00
Are you an employer? Check the appropriate bor. Type of project(required):
L E-I am a employer with jig 4. EI'I an a general contractor and I 6. ❑New construction
employees (fnIl:mdlor part-fima)G , have hired the gab-contractors
2.�] I am a sole proprietor or partner- listed 031 the attached sheet t 7,Cp4t5rooTatung
ship and have no employees Tbese anb cantractrs have B. Demolition
working for me m any capacity. workers' comp.Maursnee. 9. ❑Building addition
[No workers' comp.insurance 5. ❑ we are a corporation and its
rei.ired.]' officers have exercised their. 10.0 Electrical repairs or ad iitions
3.0 I am a homeowner doing all work right of exemption per MGL 11.EjPlnmhfng repairs or additions
myrelt [No workers' comp: c. 157, 1(4),and we have no 12.0 goof repairs .
insurance requited,)t employees.[No workers' 13.0 Other
Damp,insar c.required.]
`Amy vpHawut that check box Rl mmst also M om the secdmbrIuw showing ffiea workers'comp�se<ioa polieY adn®mioa .
t Homeowner who smbmit this sf dzvG imdirating$ey aro domg sH wmi,and tbeahim outside uo d=umd smbmk anm aiiidavh indicating smelt
f—'=taetem$at=hrek floc box mmst azt -d m addidang sheC sowing them®e of the=6--Mtm- ®d tbra wod='comp.policy brR=alim .
I am an emptoyei that isproviding workers'cow;pensation insrvancetbr my ennployam Below.is:fie polky and job site
informadwL ) -
Insurance Company Name: �1 /!/(: /��n r7•t:' l f�7 Cr{J�• n C Z .
Policy#or Self-ins.Lit. 3'J� ltl �(���'/`{i/ txpirafionDatr: �2—
Job Site Address: 3 VV1_0+'V �A. City/Stat--Z : �CArm
Attach a copy of the workers' compensation policy deciaration page(showing the policy mmnber and expiration date).
Failure to secufe coverage as required under Section 25A of MGI.c. 152 can lead to the imposition of criminal penalties of a
fine up to$1,500.00 and/or one-year finprisDnruzut, 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 statemeat may be forwarded to the Office of .
Investigations of the DIA for insurance coverage verification.
Ido hereby uAder the pains and pertrrltiesyfperjvey that the information provided above is true and correct
Si�smre: Date-:
Phone
091cial use onEy. Do not write in this area, to be completed by city or town o cid
City or Town: PermiVI kense#
Fsming Authority(circle one):
L Board of Health 2.Buil Department 3. City/Town Clerk 4.Elect ricai I nspector 5.Pla nbing Inspector
6.Qltleer
Contact Person: Phone M.
r;Box
CERTIFICATE OF LIABILITY INSURANCE 02/10/20 0
*HOLDEM
CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ph MCKOone AND CONFERS NO RIGHTS UPON THE CERTIFICATE
ER. THIS .CERTIFICATE DOES NOT AMEND EXTEND OR
CKeOne (RSUf?nC8 Agency, IRC. THE COVERAGE AFFORDED BY THE FOLICIES BELOW.
333
Ann Arbor, MI 48146-0333 RS AFFORDING COVERAGE NAIC#
INSURED Renewal by Andersen . d ,J and L Windows,Ina. : Nau RUE104 Otis St C:Northborough,MA. 01532 D;,,E ....
COVERAGES
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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INBA ADD'L POLICY EFFECTIVE POLICY EXPIRATIONE OF INSURANCE LIMITS POLICY NUMBER
GENERAL UABdTTY NC958461 10/01/2010 10701/2011 EACH OCCURRENCE a 1 DQ D00
COMMERCIAL GENERAL LIABILITY
REM° °R len s 1000
DO 0 0
1 CLAIMS MADE E3 OCCUR MED EXP(An ane person)
l 1 PERSONAL k ADV INJURY $ 1 00.000
I GENERALAGGAEGATE S 2 DO D
1OFLAGGREGATEUMITAPPLIESPER: PRODUCTS-COMPmPAGG F 200)DD OO
POLICY El
JECTPRP F7 LOC
A AUTOMOBILE LIABILITY 35MCC XD 6390 1010172010 1010112011 COMBINED sam sLOST a 1,000,000
ANY AUTO (Ee acdtlmS
ALLOWNED AUTOS BODILY INJURY
(Par Pannn) s
SCHEDULED AUTOS '
HIRED AUTOB BODILY INJURY,
NON-OWNED AUTOS (Per=ldent)
I PROPERTY DAMAGE $
(Par=Jdent)
GARAGE.LIABILITY , AUTO ONLY-EA ACCIDENT 6
IANYAUTO OTHER THAN EAACC i
AUTO ONLY: AGE S
EXCESSRIMBRELLA LtaBTUTY EACH OCCURRENCE 5
OCCUR �CLANS MADE AGGREGATE S
i
DEDUCTIBLE s
i RETENTION S n� S
WORKERS COMPENSATION AND 35 WECPP 1444 02/17/2010 02(17/2011 WCSTATU- Ohk
A EMPLOYERS LIABTLRY ELL EACH ACCIDENT S 00.000
OFFICFRR°IMEN�EflEXOWDFM4 ECUTNE EL DISEASE-EA EMPLOYEE s 60Q ODD
N tlessrPoe urMer - E.L DISEASE-POLICY LIMIT S DD D
SPECIAL PROVISIONS below
OTHER
DESCRIPTION OF OPERATIONS I LDCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT'I SPECIAL PROVISIONS
CERTIFICATE HOLDER CANCELLATION
COPY SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCSLIID BEFORE THE EXPIRATION
INSURED COPY DATE THEREOF,THE DO INiD MuivER W4L ENDEAVOR TO MAR 10 DAYS WRR'TEN
NOTICE TO THE.CERTIFICATE HOLDER NAMED TO THE LET,BUT FAILURE TO O°SO SHALL
BAPOSE NO OBLIGATION OR LIABILITY OF ANY KINE)UPON THE INSURER,ITS AGENTS OR
REPRESENTATIVES
.. AUTROROND AEPRESENCATIVE / J` l n ,�
ACORD 25(200IMB) 0 ACORD CORPORATION 1988
x
x Massachusetts- Department of Public Sated
Board of Building Regulations and Standards
Construction Supervisor License
License: CS 101952
Restricted to: 00
DAVID BANCROFT
5JOHNSTON AVENUE
WHITINSVILLE, MA 01588
Expiration: 311912012
w
.. t'nnuni+siuner Tr#: 101952
�p i
Office of Consumer Affairs&Bavuess Regulation -
OMEIMPROVMEN•fCONTRACTOR
Rsgistratlong�M9601
Expi e _ 1217)
.
u E nt Card a
RENEWAL BY
DAVE BANCRO -
103 0713 STRE •�
NORTHBOROUGH,7J'A(t?35' Undersecretary
' 1
I
F
RenewalbryAndersen
WINDOW REPLACEMENT anMdet$Ca¢g>Aos '
Wood/Vinyl Composite IF
�,. Dust Argon Low E4 Sf mr&m
Double Hung
2044447352$-{}20
ENERGY PERFORMANCE RATINGS
U-Factor(U.S)tl-P Solar Heat Gain Coeffipient
08290219
ADDITIONAL PERFORMANCE RATINGS
Visible Transmitanoe
0 � 4
x,.w�,..r<mw.a.mc.e«.v�W. w.PPtranst�,Pmewm+.r«en�mt�W..mie qo� '
P.nnenme.NFPC miinRm MunvNae m..mw��w.nMnnafueiauehen..m..p..-r<P •,a..
NFRC Em Not meenuMeCaPY PmGuC W Ee..aet vnn'em IW w'eGTaCPIfM PmGud
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DESIGN PRESSURE(PSF)
. �. �m�tln IAC .
Ill-LC25 ' . RDA DB Sloped Sill DH IN
iYWEtlIW3-02CAI11MNLAk8ll01LNFiW6[ RWi<Yn.f sllMVe MY14YfmaIWOW tl.v
tlaaHm+auad+6t.E:C.C,EC 1LEC.C.3i b4lofoe w4ui+aY1.XRHV.WBm�CCutPuSUC Plogfel .
.
Kenewal .
byAnerserL
WINDOW RS?LACEMCF41 aaA =mComsyny
o Whom It May Concern, .
.nclosed is a permit application package for a project we have been
ontracted to do in your town. Thank you in advance for receiving this
,ackage by snail. As we work in every town in the state, it greatly helps us in
Dur process.
Ve have also enclosed a self addressed and postage paid envelope and
vo.uld request that when the permit application has been processed, that you
vould mail it back to us.
Enclosed for you review in this package ls:
❑ Permit Application
❑ Home Improvement Contractor License
❑ Construction Supervisor License
❑ Proof of Insurance
❑ Proof of Energy Efficiency Rating
❑ Signed Contract from customer
❑ Permit Fee (i€ accepted at time of applying)
If you have any question regarding this application please call me at (508)
Best Regards,
Kelley Donahue
Permit Coordinator
104 Otis Street 1
ND thbmvn M&01532
Phone(508)919--0900
Fax(509)919-0903 -
Website 1VWW. aewaIbYmdmwn-com