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185 FEDERAL ST - BUILDING INSPECTION The Commonwealth of Massachusetts ' Board of Building Regulations and Standards FOR Massachusetts State Building Code,780 CMR, 7°edition ML. NICI ALITY Building Permit Application To Construct,Repair,Renovate Or Demolish a RevisedJmruorX - One-or No-Family Dwell' g 1, 2008 Thi ' cti For O al'Use Only• . . " piing Permit-N 1e Applied: Signature: a/J Building Commis5 cr/Insp 'of ings Date EC ON 1:SITE INFORMATION 1.1 PropercAddress: 1.2 Assessors Map&Parcel Numbers " -t $S� {-eAeral Ste_ . �� 604-.Ebi 1-1 a Is this as accepted street?yes no Map Number - Parcel Number. — 13 ��ypppn' glnformation. I 1.4 Property Dimensions:. Zoning District Proposed Use. Lot Area(sq fr) Frgutage(fl) 1.5.Building Setbacks (ft). Front Yard Side Yards Rear Yard 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:..:- -- Zone Outside Flood Zoae? Public❑- - Private❑ — Municipal.❑ On site disposal system ❑ ' Check ifyes❑ - SECTION 2: PROPERTY OWNERSHIP' 2�. nOwqer pf Reeox r� TVII (ye, P, V�I t�tt�n IgS 1 e.ra� ST. Sa�totn, ma Ol�i o Name(Print) Address for Service Signature .. Telephone . . SECTION 3::DESCRIPTION OF PR-POSED WORK 2`(cbeak'a11 that app)y) ts�eu•'C..ns4'uct4u ❑ ..,.:.....tg.,ut:.ditig.l7 O:;her-,,....,.pied ❑ . -pairs(s)'.❑ Ica.,) ' Additica ❑. Demolition ❑ AccessnryBldg. ❑ Numberofl-lnits_ Other,fi Spcciry:_. Brief Description of Proposed Work'': e etg L - l.J`t SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials 1.Building $ �. R(( :o0 1. Building Permit Fee:$ Indicate how fee is determined: 2.Electrical $ ❑Standard City/Town Application Fee ❑Total Project Cos??Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List S.Mechanical. (Fire Suppression) $ Total All Fees:$ Check No. Check Amount: Cash Amount 6:Total Project Cost: S.( ' q u q, 00 0 Paid in Full 0 Outstanding Balance Due- s SECTON 5: CONSTRU.CN'SERSCES 5.1 Licensed Construction Supervisor(CSL) .� tLen V 1vnn�So.... LicenscNumber Expiration Date. Name of CSL-Hold YL 0Lr-siA �if \J/1 ¢�� Ma OIL List CSLType(smbelow) Y+��/ Address T.aS`d.. on �.. U Unrestricted to 35 00o Cu.Ft . St—gnature - R Rcsuicted 1&2 Mly Dwelling . lci-6"9. M MaMmy Only Telephone RC Residential Roofing Coverm - WS Rrsidemial Wmdow and Siding.. SF Residential Solid Fuel tsumnig Appliance Installation D-- Residential Demolition 5.2-Registered'Ho ne Im rev ment Contractor(MC)VC err e wa 1 Esc l 4 96 0� $1C Company Name H CR istrantlqmne t .Registration Number Address - - Expiration Date . Stgnat fitt-�.`� Telephone SECTION 6:WORKERS, COMB ENSATfON INSURANCE AFFIDAVIT(Itd.GS.c 152.g 25C(6)) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide . this affidavit will result in the denial of the Issuance of thebntlding permit _. - 'Yes ---...-.: No. Signed Affidavit Attached? ' ..........❑ SECTION 7a1:0 .WINTERW7JTH®Rik.ATION TO BE Cp1VIPI ETi}D,W�'1;'N OWNER'fiAGtENT'02i;CO11'gRAbTf1RATPLIESFGRS I31 PS1 1aT I, l G�e l'' r✓lc7 as Owner of the subject property hereby authorize !�,C, p to act on my bebiiK in all matters relative to work authorized by this bmldmg permit application. Signature of Owner .. Date ' -SECS'IO2VJbtOWluEAt:ORf�iITH�Rt�ED`=,A� TZOPT - 1 1 Y1 i /1 1 FYI L d"T t Oubet prAtfthorized Ageltt tiehy tia4lafe drat the$intenienLs and information eu Lhe forcgeiva'applicatiun arefru�:aiid accura'ir, to the best of niy k iowledim and beh'alf. : ". .Print Name SignatureofO a Agent Date (Si ed under a pains and penalties of perjury) •,, - . . NOTES: 1. An 1-wnrr who obtains a building-permit to do his/her own work,of an owner who hires'an unregistered contractor (not registered in the Home Improvement Contractor(MC)Program),will ant liave access to the.arbitration program or guaranty fund under 1VM 1- c. 142A-Other important.ipformation on the HIC Program and Construction Supervisor Licensing(CSL)can be found in 780`C R Regulations 110.116 and I ID.R5,respectively. 2_ When substantial work is planned,provide the information below. Total floors area(Sq.Ft-). (including garage,finished basement/attics, decks or parch) Gross living area(Sq.Ft.) Habitable room count Number of freplaces Number ofbedrooms Number ofbathrgonrs Number ofhalf/baths 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 C(�LI UO 104 Otis St.,Northbomugh,MA 01532 �J pJ&L WiNDows,INC.,D/B/n 'MA Home Improvement Contractor (508)919-0900•Fax:(774)987-3013 kf,�Iet]N I,neural ,,icense#149601 (Expires 1/24/2012) " def$en. Federal Tax ID#83-0404201 er.eaaw eeeueeasv mwnemmcomwm CUSTOM WINDOW AND DOOR REMODELING AGREEMENT ' Buyer�sl Nam/e / �J Dab of Agreement - Sm,mrls)Street Address,City,Sore,and Zip Code EhlailAddrass Home Tale hone Number Work Telephone Number the// O��SCvc�.-.�Grl�r �7fs-7G6-S3/o �C7g'- 76d -/S73 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. E l Job Amount y,V Estimated Starting Date: Method of Payment:OCheck OCash Idi monced ceived(33h(: /b-/2of Job(33/): Credit Cards are accepted for deposit estimated Completion Do%: only--maximum 1/3 of the project cost. on SubstonfialPlease see Credit Card Pa ment Form. of Job(33%l: Y agreement,you acknowledge that the Balance at Start of Job and the Balance on Substantial Completion 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, c.d/ /a Renewal by Andersen Buyer(s) Buyers) B ) Signature of Product Manager Signature Signature Z1,k1-1f�r, Print Name of Product Manager 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. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ -�_ _ _ _ _ _ _ _ _ _ _ _ _ _ _� NOTICE OF CANCELLATION X NOTICE OF CANCELLATION Date of Transaction /-/`1- // . You may cancel Date of Transaction //-/c/-// . You may cancel this transaction,without any penal or obligation,within this transaction,without any penalty or obligation,within three business days from the above dale.if you cancel,any l 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 instrt m s m executed I Contract of Sale,and any negotiable instrument executed by you will be returned within 10 days following receipt 1 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,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 date pick them uft within 20 days of the date of your Notice ' of your Notice of Cancellation,you may retain or dispose l of Cancellation,you may retain or dispose of the goods of the goads without any further obligation.If you fail to without any further obligation. If you fail to make the make the goods available to the Seller, or if you agsee goods available to the Seller,or if you agree to return the t to return the goods to the Seller and fail to d so, then cads to the Seller and fail to do so,then you remain liable you remain liable for performance of all obligation under performance of all obligations under the Contract. the Contract.To cancel this transaction,mail or deliver a I To cancel this transaction, mail or deliver a signed and siggned and dated copy of this cancellation notice or any dated copy of this cancellation notice or any other written otiter written notice,or send a telegram to Contractor.J l notice,or send a telegram to Contractor.J&L Windows, &L Windows,Inc.d/b/a Renewal by Andersen, 104 Otis Inc. d/b/a Renewal by Andersen, 104 Otis Street, Street, Northbomugh, MA 01532, BY NOT LATER THAN Northborough,MA 01532,BY NOT TATERTHAN MIDNIGHT MIDNIGHT OF //—/7—// .(Dote) OF //—/ 7—J/ .(Dale) I HEREBY CANCEL THIS TRANSACTION. I HEREBY CANCEL THIS TRANSACTION. Buryi r SipnaNn Print Nome Dole Buyde S,mmune Met Name Dab RbA Copy- White Buyer Copy-Yellow Buyer Copy-Pink n j&L Windows,Inc.d/b/a 1040ti58.91 .0900-s Street, m774.9p .3018ugh,MA ^ ^�����' MA HIC Lirense#149601(exp n,I 1/24/12) Phone B08.919.0900•Pen]74.98].3013 - K Federal Tax ID# 83-0404201 bAndersen. WINDOW REPLACEMENT MMd Coin y OF GREATERMASSAL}B)SETT$AND NEW HAM1vswaE . WINDOW SPEMCATION S= Buyers)Name Date of Agreement The Buyer(s)listed 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 DEFAIIS 1. Contractor will Install a total of windows in Owner's home,using the following individual quantities: Double Hung(DB) g-Equal sash ❑ Cottage sash U/3 top,2/3 bottom) ❑ Oriel sash(2/3 top. 1/3 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(GPW) ❑ 1:1:1 or❑ 1:2:1 Awning Window(AM �_Picture Window(PW) Bay or Bow Window Patio Doors(see separate Door Specification Sheet) 2. E�'Ies ❑ No Qty of Windows to be Custom Fit Replacement: 3. ❑ Yes E^?�&o Qty of Sills to be replaced by Contractor: 4. ❑ Yes,[y 1Yo Qty of Windows to be New Construction Full frame(includes new interior&exterior casings)and actual Exterior casings: ❑ Pine ❑ Maintenance-free material ❑ Factory applied 908 Fibrex brickmold 5. Glazing to be: BHP Low-E-4 Tr+ ❑ Other If other,please specify: 6. Exterior,color to be: E� ne El Send [ICanvas ❑ Terratone ❑ Cocoa Bean 7. Interior color to be: to ❑ Sand ❑ Canvas ❑ Terratone ❑ Pine ❑ Maple ❑ Oak Note: Interior color can only be white,wood or Same color as exterior. Wood interiors need to finished by Owner. 8. Hardware: White ❑ Stone ❑ Canvas ❑ Brass ❑ Estate Hardware: Style: 9. ❑ Yes 2-No Install Lifts with Double Hung Windows 10. Screens: windows to have: ❑ [i Half or ,<B screens Screens to be: Fiberglass ❑ Aluminum ❑ TruScene GRILLE DETAILS 11.Windows have grilles: ❑ Yes No If yes:❑ Grille Between Glass(GBG)❑ Removable Interior Wood otnwl❑ Full Divided Light(Fou Qty: Qty: Qty: Qty: Qty: Qty_ Qty: . oN 'oN or oN awnmwre cower caW arc - Drawgrille patterns above 'Use additional sheet if needed Owner approved(initials):( ) ADDITIONAL WORK DETAILS 12.❑ Yes ffN. Contractor will remove metal frames of windows. Qty of Units: ` 13.❑ Yes Q'Go Contractor will install new paint-ready or stain-ready casings. Interior inS qty of openings: Exterior casings Iffy 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 illy of openings: ❑ Pine ❑ Maintenance-free material 15. Own 'a aware that Contractor does not do any painting. ( 1 Owner Initials 16. es ❑ No Contractor will wrap exterior casings with aluminum coil stock of ,--4✓Le color. ,Notc: Wrapping may be required with storm window removal;removal of storm windows will leave screw holes in casing. 17. ❑ No Contractor will insulate,caulk and seal windows with 3-point system to prevent water and air infiltration. 18.�❑No Clean up alljob related debris including old windows will be removed.Vacuum nightly. 19. - Yes ❑ No A limited warranty shall be issued to Owner upon completion.of the job and payment in fulL 20. Yes ❑ No B ' Permit—Contractor will secure any and all necessary permits. The fee for the permits)is not eluded in the Contract Price and a separate check is required at the time of sale for this fee. 21. Yes.❑No All discounts have been applied to this agreement price. 22. Additional job details: _ 23. 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 used the contract is completed to the satisfaction of Allpartics. - It is agreed and understood by and between the parties that this Specification Sheet,along With the CUSTOM WINDOW AND DOOR REMODELING AGREEMENT,conslimtes the entire understanding between the parties,and there are no verbal understandings changing or modifying any of the terms. Thu Specification Sheet may not be changed or its terms modified or varted in anyway unless such changes are in writing and signed by both the Buyer(s)and Contractor. Buyer(s)hereby acknowledge that Buyer(s)has read this Specification Sheet. Renewal der• tfo eater B r s) Buyer(s) Signature,of Product Manager ignal= Swurtare A7,"l/ T-97 - Q iehelle Alyin�) Print Name of Product Manager Print Name Print Name I i DEC. 1. 2011 11 : 13AM DCF MALDEN _ NO. 0264 P. 1 Renewal , .. byAndersen. WINDOW REPLACEMENT anAndetsenGompany CONDOMINIUM PF=RMISSION FOIRIM FOR BUILDING PERMIT 185 Federal Street Salem. MA 01970 I, Michelle Alvino, being the homeowner, have reviewed and approve the specifications for improvements to my home 185 Federal Street Salem, MA 01970. The Condo Association or Management Company agrees that the above owners have permission to seek permits and to carry out the proposed work. �a Signati of Toh*k—sbeation Fepresentatne Title ❑ to \Md V► Print Name (In lieu of this form, a letter stating the same purpose as above, on the Condominium Management Company stationary may be substituted,) The Commonwealth ofMassachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 u,p www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers ApyHcant Information Please Print Legibly Name (Business/Organization/Individual): Te n E U/a IA( 41)der an Address: Jbil 61 i S y r(frC 1L / \ _ City/State/Zip: Alo rih b 6 r61 l/l/1 Phone#: ll f-d 9 D o Are you an employer?Check the appropriate box: Type of project(required): 1.�!kI am a employer with �90 4. ❑ 1 am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. X �• ] Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL . 11.❑Plumbing repairs or additions myself [No workers' comp. c. 152, §1(4),and we have no 12.❑ Roof repairs insurance required.] t employees. [No workers' comp. insurance required.] 13.❑ Other 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 contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the subcontractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: J /'/C� C' l/�SC/�Cf I)C(Z�_ J o Policy#or Self-ins, gqLic. #: .�.9 �,5 C w /'/�y Expiration Date: ( �a_ Job Site 2 Address: 1 g�i t g c� P! c�` K City/State/Zip: J 1 yi 3 t 010\ �Cj C� 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 Investigations of the DIA for insurance coverage verification. I do hereby c rt' under th pain and penalties o rjury that the information provided above is true and correct. Signature: Date: Z I (t � e Phone#: eqQ Official use only. Do not write in this area, to be completed by city or town ofciat City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: A� CERTIFICATE OF LIABILITY INSURANCE °A 0/014/2011 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: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If 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 endorsement(s). PRODUCER CONTACT J.P. McKeon Insurance Agency Inc PHONE FAx JP McKeon Insurance Agency,Inc. (734)662-8100INC.No: P.O.Box 333 E-MAIL ADDRESS: Ann Arbor, MI 481060333 _ _ INSURER(S�AFFORDING COVERAGE NAIC# INSURER A: Nautilus 19682 INSURED J&L Windows,Inc. Renewal by Andersen INSURER B: Hartford 37478 104 Otis St. Northborough,MA 01532 _ INSURER C: INSURER D INSURER 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. ILTB TYPE OF INSURANCE ADDLB BR Wall WVDPOLICY NUMBER MM/OUmFF MMNOY ) LIMITS A GENERAL ABILITY NCi958461 10/01/2011 10/01/2012 EACH OCCURRENCE $ 1,000,000 AG COMMERCIAL GENERAL LIABILITY pgEMISESI a oa o rance $ 100,000 CLAIMS-MADE IV OCCUR MED EXP(Any one person $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 I GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: `PRODUCTS-COMP/OP AGG $ 2,000,000 JECT POLICY PRO LOC - $ AUTOMOBILE LIABILITY 35 MCCXD6390 10/01/2011 '10/01/2012 !CO SINeD SINGLE LIMIT 1,000,000 ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS PP HIRED AUTOS AUTOSWNED pner0a caen DAMAGE $ $ UMBRELLALIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DIED RETENTION$ $ A WORKERS COMPENSATION 35 WECPP1444 0?/17/2011 02/17/20121 We sraTu- OTH AND EMPLOYERS'LIABILITY YIN MY PROPRIETOR/PARTNER/EXECUTIVE N/A - E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? SOO,000 (Mandatory In NH) EL DISEASE-EA EMPLOYEE $ If yes,describe under 500,000 DE Ins, OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ R PEOOH55500 0507 09/27/2011 09/27/2012 i DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Afton ACORD 101,Additional Remarks Schedule,If more space IS required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. - AUTHORRED REPRESENTATIVE ©1988-2010 ACORD.CORPORATION. All rights reserved., ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD Massachusetts - Department of Public �:dfer.011113111111. - ��yy -Board of Buii( in_ Rc_ulariuns and Standards - Construction Supervisor License License: CS 95707 - - BRIAN DENNISON _ 86 CREST CIRCLE WORCESTER, MA 01603 ��- —,` Expiration: 9/8/2012 _ ('...... imu•r Tr--: 2622 „��ee '� roweoarwie¢/.7/z� 0�.,/2aaoar�i�eCCirieeCCi �� - d. Office of Consumer Affairs&Business Regulation - lug HOME IMPROVEMENT CONTRACTOR . . Registiatior:�4bP01 ratty g} 012 l tt- -lEnt Card RENEWALBY =I'' BRIAN DENNIS 104 OTIS STREE,., - 'A NORTHBOROUGHMO'1332 — Undersecretary .-. 99 Do not remove until final code inspection. Save label farfuture reference.19 - 3. Canada m � I N C a � 6 Q >, Q EF U c E a gm- , � 'enerBysbr.B¢Y �-Ouard+ed/Admk�ltle - Renew, ,: fec byAnderserL. . wf¢aoW RtT�ACeM6ni r.NJen.vG.uw^�s. AND-N-37 NsIL-.:SEF VinylNNod composite Material 3jS <.uw* Dual Argon Low-E4 SmartSun. product Type: Picture . ENERGY PERFORMANCE RATINGS U-Faotor . Solar Heat Gain CD5FTI ant 0 g . 27 1 .53 Os22 . U.S./�P MefirJSl ADDITIONAL PERFORMANCE RATINGS Visible Transmittance town 0951 MmMmmrnlpWa¢sm¢mEe rtlnps cvNminm°pprr.+me NFRC Pmvnm¢Nrve¢imlNnp N'v E..RE. Rmftmn,,.. HWCtetlnps art veximneof¢.(pxp a¢d emtmmnvnW ranuDom.-W-Ws-IM•,"• ' µWC ovn n¢i¢mvmcnn vry PlCOu¢LlO con me vmml�p¢*m'Po° . Cnnsu[mmNeoure"slorrnvrt mr omerPmvu¢PMarmw-e lNo�mWon' e is 91 B 4 - Andersen Ca oration: RbA P6c� enured e s Conmrlllml0° . Standard - Rating .. NpS.82 mAAN0A.Y.IMUC3A IDUSF fWMS DP pst F-050 M"pmeucmeev ykt5' mcen sun C.. ; eMu°vmeRME°mne°ms . py pepenllep ene�v ' S a&Irnry, ©W EU In m mR,jR.VERM en°sun ER=E ,.MME men0 MMMAn�eowtv�u - 106-005110�6-t1D1 Meee w.M•"e NE.C-C.EC,lamAr.—im raw='.VAMlMelwv[Cemll�vPn P�vID'ev� Renewal x� byMderserl • W[NppW' nEPIl.CEMEM noMdeucnCav�nm r Wuod/fiHyi Cumpwite IF ` MR Dual Arghn Iwu�E4 StnartSln f""`�« .,�.•gCZEz,k Dauhle Hung . 1 DD-DD473515-01 D -ENERGY PERFORWGE RAP[NGS LS)A-P Solar Hsaf Gain Coefficient j ADO[TIONAL PERFORMUDE RATINGS visible Transmittance if a • Lhaukmmmctiovmssxnv[baa ntia��nkrn baPP�ahh NFNCpb-.cw..fa ennm�iiwvwbo P.m� . p.nmmm.R xmc minp=.mamnmew mr:[�a.aw.maaom.mdaa�wrt'oKaw�w•�=pn,a,.e,� . .... NAiC tloarnm mmmmnvdWPmdam v.tl dwcoYwemav:L4 mdmhQry NmY Pmaun fawY�advun ' CmavtmavN+uum4fnaruvn lmaMa;pmaum pMemmnNfamNEm WMCl�fvnlp I �'F�t C�,�t 'Ih Pemvet mamvGnu 5 Yk nvlmmnnM M l 1"y� zvm bnm.aaa oa D61GIN PRESSURE(PS9 ® l �LC21. - _RhE-R6_S1oped_Sill DH IN . i�mnusmrAvumuausi.imsuuiwc uvu.wrmmurommmrasm...w�..,maw. ua.mar�..d.ut-c.r..�c,+.�Etau=imrxnas.mvuu.mnn�vmw.mom.rec.ne�rMv+m i• II I; II . Renewal : �. 420- byAnde enm '- WINDOW REPLACEMENT --nAndersenCompany To Whom it May Concern, Enclosed is a permit application package for a project we have been contracted to do in your town. Thank you in advance for receiving this package by snail. as we work in every town in the state, it greatly helps ens in our process. We have also unclosed a self addressed and postage paid envelope and would request that when the permit applications has been processed, that you would assail it back to us. Enclosed 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) if you have any question regarding this application please call sate at (508) 9Z9-o992. Best Regards, Kelley Donahue Permit Coordinator 104 Otis Street 1 Northborough,MA,01532 Phone(508)919-0900 Fax(508)919-0903 Website:www.renewalbvandersen.com 1