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33 FORRESTER ST - BUILDING INSPECTION (2) The Commonwealth of Massachusetts ' Board of Building Regulations and Standards FOR Massachusetts State Building Code,7.80 CMR, 7"edition MUNICIPALITY USE. wilding Permit Application To Cgnstruct,Repair,Renovate Or Demolish a RevfsedJanvary One=or 7vo-Family Dwelling 1, 2008 This-SectioaFor BuildingPetmitNumber DateApplied: 111 Signature: Building Commissioner/Inspc pr ofBuil SECTION 1:S ORMATION i . Proper�ttyy Address: 1.2 ASSe55n s Map 8c Parcel Numbers 3�: 0Y( ty ,1.1 a Is this an accepted street?yes no Map Number Parcel Number. o�u(( 1.3 Zoning Information_ 11.4 Property Dimensions: Q Co�,do • f�4 h Zoning District - Proposed llse. Lot Area(sq ft) Frg age(ft) d ✓ 1.5 Building Setbacks (ft). . . Front Yard - Side Yards Rear Yard- Required Provided -Required Provided Required Provided . .14 Water Supply: (TyLG.L e.40, §54) 1.7'Flood Zone Information:- . 1.8 Sewage Disposal-System Zone Outside Flood Zone?•. Public❑' Private❑ — -Municipal❑ On site disposal system ❑ ' Cheek ifyes[] SECTION 2: PROPERTY OWNMRSHIP' 2.I Owner]ofRecord �^� \\ \ � o tCAA ��Oe�t V•ert,.Jt t � 3S �frr�iz�. ST Uni� 3'1 ,U&,dYA CDIQ�c� Name(Print) Address for Service: . (o Signature .. Telephone SECTION 3:.DBSCRIP.�ION OF PI20POSED WORK 2.(check all tliat,sppjy !;'e c'{ cnsCuct 4 ❑ Exisdog Euiltling. O...n.r-'Occupied F�pai (s)''._. "aiw�tion(s) GT Addition'O _ _ .. _ . .. Demolition ❑ •Accessory Bldg:❑ mirnher ol'Units Other 4T-9�1ceiry:_. Brief Description of Proposed Work=: L to tAw CS T(` t'UU I- C - r. SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs:' (Labor and Materials Official Use Only ' 1.Building $ 1. Building Permit Fee:S 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 $ Su ression) Total All Fees:S Check No. Check Amount: Cash Amount: 6,Total Project Cost: 0 Paid in Full 11 Outstanding Balance Due: SECTION5: CONSTRUCW_N-Sfa SEES 5.1 Licensed Construction Supervisor(CSL) Cl S To 3- �,� Y]_—LlY.�1/11Set✓t LicroseNumbv Expiration Date. - NameofC_SL-Holder \ (� I_ \ . e.�. ] ",,,„ b� cJ 1.l f CY�6r-`'to2� I.ist'CSL Type(seebelow) - - •+Adddrreess�F� � -Dta lion U Unrestncted(d to 35,000 C 1.Ft) Signature - R Restricted 1&2 Family Dwelling . CLzq 351.>-r�o�dj _ .. M Masonry Only - .. RC Residential Roofin COVCrM Telephone. WS' Residential Wmdow and Sidin x,, ' SF Residential Solid Fuel Burning Appliance Installation D- Residential Demolition 5.k R�e 'ster re In rovpwent Contractor RIC Comp y Name or ]C�r�tstrant N�n e Registration Number ��_ � AJ r rJ b .v ro t ✓lg� �3 1 - �? 3:- t �. Address _.. .. aVJ lExpiration Date Signature _ - Telephone .. -. SEC LION 6:WORIKERS' COMPENSATION INSURANCE AFFIDAVIT(M.GJ-c:152_g 2SC(6)) . Workers Compensation4nsurarice affidavit must be completed and submitted with this application. Failure to provide .this affidavit will result in the denial of the-Issuance of theburlding pemait ... Signed Affidavit Attached?,' 'Yes .......... _ No..........0 ' SECUON7o oV-aZEX 4IJT�[��iI�AiTOhtTOBE•CpMP7�. .,..;t.,Vir'F1 N:.. QWN1ER'S AGENT`O .-.COI 1 1 3 OR APPLIES RO.,B119 MINI B it M I., l)Vy l\ ( nQ .i as Owner of the subject property hereby authorize : ' R f� ^ to act on my behal>,in all matters relative to work authorized by this building permit application Si arum of Owner {{�� s .cam?a :<nIt',ox� a® iArPanozit.:.:• ° '; }; k?�`l,(> rA 6 r171 1 Ski t ai O«net nr fcnthMizcd Agent 4ier6y deFlait dial tIte$ft to ne its ntid nfotnietion on,the forceoiog'applicatinn'aretire ai3d accurate;to the of my 1 t10wl'etlg�and bebalf. :- . .Print Name Signature of Owner or Authorize Agent Date (Signed under the pains and penalties of "u - - - , NOTES: 1. An Owner who obtains a building-permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(1 1C)Program),will not liave access to the arbitration . program or guaranty fund under M G.L.c. 142A. Other importantinforniation on the MC Program and Construction Supervisor Licensing(CSL)can be found in 780`CMR Regulations 110.R6 and 110.R5,respectively. 2. When substantial work is planned,provide the information below Total floors area(Sq:Ft). (including garage,finished basement/attics, decks or porch) Gross living area(Sq.Ft.) Habitable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of hal f/baths Type of heating system Number of decks/porches Type of cooling system Enclosed Open 3. "Total Project Square Footage'may be substituted for"Total Project Cost" SS E FOB Mig form is to be sabnitted with builaingpermit applications whiaever thy,e is debris to be. disposed of. Property Address: >S F o r r dk-C ST In Accordaace .a with&c provisiaas'of MOL c.40,.§54, condition of the Build Penuit Number is tbat the debris resulting ft. this work shall bi disposed of in a properly fieensed , solid vast~disposal fac0ity zs defirird by 1�iGL a III§ 150_A. . •.. �C✓lLWli•� /1�?[/SCn -�b"� VY-l.� �l'l l�lJ r`4�hV)lSV!) . �lC . V�`S 71 D�Cafim of Facility) .. . 5ipatum of Permit°.ppli.a++t • � t III ` i.Z , . Date Renewal )�� MA Home Improvement Contractor {,,'IA.I�' eYY .�4i L License#170810(Expires 12/23/2013) by Andersen. Renewal by Andersen Corporation federal Tax ID#41-1918413 WINDOW REPLACEMENT an Mderxn Company 104 Otis St.,Northborough,MA 01532 (508)351-2200•Fax:(651)351-4810 CUSTOM WINDOW AND DOOR REMODELING AGREEMENT eayerlsl Name Dote of Agreement �912(PA) fly /U 1 euyerhl Street Address,City,State,and Zip C de EMail Address Home Telephone Number Work Telephone Number Buyer(s) hereby jointly and severally agrees to purchase the products 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').Buyer(s)hereby agrees to sign a completion certificate after Contractor has completed all work under this Agreement. ��,/,�y---�� Estimated Staging Date: Method of Payment: Total Job Amounl✓V / Amount Financed OCheck OCash Deposit Received(33%(: 857 iso/MC 13Discover Balance at Stag of Job(33%(: �5 77 0 ❑Financed LIAMEX (� Estimated Completion Date: If credit card is selected,please Balance on Substantial U15Z see Credit Card Payment Form. Completion of Job(33%f y Buyer(s) agrees and understands that this Agreement constitates 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 &rem 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. - Renewal by An Corpor don uyer(s) Buyers) B / ; t d tgnat re of Prods nogg' ignamre Signature /v .hr� lt�� Print Name of Productd anager Print Name Print Name YOU, THE BUYEII 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. _ _ _ _ _ _ - _ _ _ _ _ _ _,_ _ _ _ _ _ _ .Sc— _ _ _ _ _ _ _ _ _ _ _ _ _ _ NOTICE OF CANCELLATION K NOTICELLATION Date of Transaction /C)—.4r_—/D_ You may cancel Date of Transaction IC) /'DYou may cancel this transaction,without any pens or obligation,within this transaction,without any patio w obligation,within three business days from the above .If you cancel,any three business days from the above date If you cancel,any property traded in,any payments made by you under the property traded in,any payments made by you under the Contract of Sale,and any negotiable instrument executed Contract of Sale,and any negotiable instrument executed by you will be resumed within 10 days following receipt by you will be returned within 10 days folkvAng receipt by the Contractor ("Seller") of your cancellation notice, I by the Contractor (''Seller") 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.If 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 Conraact or Sale; or you may, if you wish, comply Contract w Sale;or you may,if you wish,comply with the wish 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 Sellers 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 up within 20 days of the date of your Notice of your Notice of Cancellation,you may retain or dispose of Cancellation, you may retain or dispose Jobs goads of the goods 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 yyou agree goods available to the Seller,or if you agree to retum the to return the goods to the Seller and fail to do so, then goods to the Seller and fail to do so,then you remain liable 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 To cancel this transaction, mail or deliver a signed and signed and dated copy of this cancellation notice a any dated copy of this cancellation notice or any other written other written notice,or send a telegram to Contractor: notice,or send a telegram to Contractor: Renewal by Andersen Corporation, 104 Otis Renewal by Andersen Corporation, 104 Otis Sheet, Street, Northborough, MA 01532, BY NOT LATER THAN Northborough,My01532,BY NOT LATER THAN MIDNIGHT MIDNIGHT OF c9 — —/:�— ,(Dote) OF_�S—LaL -(Date) I HEREBY CANCEL THIS SACTION. I HEREBY CANCEL THIS TRANSACTION. Buyer',Signawre Prim Name Dune Buyer i Signmure Prim Name Dune RbA Copy- White Buyer Copy-Yellow Buyer Copy-Pink CsKLP2009.EBAPh.&%NH Ren enewal by Andersen Corporati` MA Home Improvement Contractor ►Andersen. 104 Otis St.,Northborough,MA 01532 License#170810(Expires 12/23/2013) WINDOW REPLACEMENT an MdersenQ,mp (508)351-2200•Fax:(651)351-4810 Federal Tax ID#41-1918413 • WINDOW SPECIFICATION SHEET Buyeris)Name Date of Agreement The Buyers)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 Specificaton Sheet and the front and the reverse of the accompanying CUSTOM WINDOW AND DOOR REMODELING AGREEMENT, of which this Specification Sheet is a part. W WDON'DETAILS I. Contractor will Install-to of windows in Owner's home,using the following individual quantities: Double Hung(DB)_Equal sash_Cohage sash(1/3 top,2/3 bottom)_Oriel sash(2/3 top.1/3 bottom)_Flat sill aw•(o lavF cuss f Casement(CS)_Hinge right_Hinge left(as viewed from exterior) Double Casement(CD) 2 Lite Gliding Window(GW) Casement/Picture/Casement(CT)_1:1:1 or 1:2:1 Glider/Picture/Glider(GPM_1:1:1 or_1:2:1 Picture Window Bay or Bow Awning Window _#Lights Soffit/Roof Shingle/Copper Specialty Window Patio Doors(sac separate door ear shme Seat to be Primed/Oak/Noe ElDF-1 I E-1 2. Qty of Windows to be Cullom Fit Replacement: 3. Qty of Windows to be Custom Fit Full frame(INCLUDES NEW INTERIOR&EXTERIOR CASINGS) Exterior casings:_Pine—Ma intenance-free material_Factory applied 908 Rbrex bnekmold 4.Glazing to be:_HP Low-EA I- —Tempered _Other If other,please specify: 5.Exterior color to be:_✓White Sand Canvas Terratone Cocoa Bean Dark Bronze Forest Green Black 6.Interior color to be: s�White_Sand_Canvas Pine_Maple_Oak_Same as Exterior Note:Wood interiors need to finished by Owner. 7.Hardware:L/White_Stone_Canvas Estate Hardware: Style: 8. Install Lifts with Double Hung Winliows / 9. Screens:windows t, have: Half or FulI screens Screens to be: Fiberglass Aluminum Tru3cene �,r GRILLE DETAILS 10. U 0 Windows have grilles:Grille Between Glass(GBG)—Removable Interior Wood(INFW)_Pull Divided Light(FDQ ( )Owner approved(initials) Draw grille patterns below 'Use additional sheet if needed Qty: Qty: Qly: Qty: Qty: Qty: Qty: :1- ADDMONAL WORK DETAILS 11, Qty ofx Sfllse!YL Sill noses to be replaced by Contractor G 12. Contractor will remove metal frames of windows. 13. Contractor will install new_paint-ready or_stain-ready_Interior_Exterior casings in_line Maintenance-free material 14. Contractor will install new_paint-ready or_stain-ready_Interior_Exterior stops in_Pine_Maintenance-free material 15.( )Inds Owner is aware that Contractor does not do any painting. I G. Contractor will wrap exterior casings with coil stock of color. Note:Wrapping may be required with storm window removal;removal of storm windows will leave screw holes in casing. 17. Contractor will insulate,caulk and seal windows with 3-Point system to prevent water and air infiltration. Removal and disposal of alljob related debris,windows,storm windows and vacuum nightly included. Upon completion of the job and payment in full,a limited warranty shall be issued. 18. yes 0 No Builditlg BiTa if—Contractor will secure any and all necessary permits.The fee for the permits)is not included in the Contract Rice and a separate check is required at the time of sale for this fee. Ck# $ 19. es 0 No All discounts have been applied to this agreement price. 20.Additional job details: 21.5es 0 No Owner agrees to be present on the final day of installation for final inspection and to deliver final payment/finance fortn(s). It is agreed and understood by and between the parties that this 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.This Specification Sheet may not be changed or its terms modified or varied in any way unless such changes are in writing and signed by both the Buyers)and Contractor.Buyeris)hereby acknowledge that Buyer(s)has read this Specification Sheet. ;Z1,by A en Cor7sma L n euyer(a) Buyer(s) gnature of Product Manager Signature Signature 1 � 6. rt� 66mplZ Print Name of ro ct anger Print Name Print Name Renewal bYAndersen. WINDOW REPLACEMENT an Andersen Company CONDOMINIUM PERMISSION FORM FOR OUI DING PERMIT 35 Forrester St. UKi-f-3 Sal.Uuw, MA 01970 We, 33-35 Forrester S-t: Trwsf-bei*%,q B{ti d -tg aAx&4-ri ze& repre ev� of 33-35 Forrem er Sf: Have revi ewer fig s}au i fi,u a li o for i.vw Ove v4vvfs.jr- 35 Forresfer St• Uni f-3 Sak"w, MA 01970 Owv*.ed, by Joel,Gerwi z. T6v&C vkdo Aswt a#iowor Ma.Lagew&ewt-CovApa.rs.y agrees.fko,f fig above•owwu-y k4,ve perwmi s yi.o*v iv-seeks permi;tp a.w d,fo-carry atA4- e propo- e,C& work. Sig-aot, rr.of Avori.a4i.ow P wevn4afvH,a-4-TUt, Daft. I AT !' 6�s�� LC o PrZA,t Naw (10 Utv,of fki5-forvw, a� Uffe r sf� fttie sa w e purpose-ay above, ov fbw cot�i.wm,Ma.vw.ge+",w,1-Cow "a Y Atafi,ov ,q YU Pf nrr�r�rans�r�t�,� • 600 Wgzi rgta►►S&e& 'Baatan;lFt.4 P1111 www.nw g Wifia Workezi' Compensation bum-ante A Rdavih Rorders/Contrset)DrsMectricims/Pivmbere A�Rlicaat IafermatiRn t -Please Print LejOIT Name : Q,'F p Address: 6 I-( D41 S. 97 CifylStateJGrg: ,� �, o+ rhrS �I S 3� PhRna# Sd 1? - s S I Are you eR employer.? Check&e mppropdah:'bon Type of project(requhT4: 1. I®e employer roves '3P 4. ❑ I em a gmeasl cmmmdor and I 6. ❑New canelmctirm emPlopees (fill end/orpect-fine),• brut bird the �-,��� ' � 2.❑ I mm a sole prvpoetz orperme- 8sb!d=&e of w-hm&best f 7..��s ship mad have ao eaaployees Tbra6�b comtrac�s Lave S. ❑Demolitina y wor}jag far me in may ca)acity, wmk=' gip•i ;,.xn 9. ❑Bngft [No wod=a' Damp inimnmee 5. ❑ We are a Dmpoaalimz aid ib lQ ❑ potdcalz DI addtions ] afficem hmve eyed their11.❑Phr�ingnpaiis tff additinas 3,❑ I am a hamwwma damg all mode 0&of T per MM MyWaf [ND mochas'-00MP• a 152 §1(4), and we hsve no 12❑RnDf rapBII& msmancD regmrod] f [N° iegaiadj 13.0 ofl= •Aay gphma tlm ck�b:Et nmst akw fin m¢mm mob=Edon 6awmz fi wW=k a'�®ro5er iato� t sooun.mm who adm6 tbb�dava s mey a domY•n wa�aod tbm hce made o aA�.aaew e®p �C.a®ooa:-ma ohmt thss 6or��ohd m.adm®I rhec mOvn+r t6emvs ofex'�aao�+eda aoa ffieP woamr' .pot6q'i�moa I mm sm mrployc that aprovidbrg wjorkwe coarv=P260a brsort&ee for my eiaploY= AcIPW iP$w po6ry a:+d job du hoornme C;ompmName:_ Policy w See-in.ISc # 1 ( VJ C 11 y Ptpiretirm nmh: 1 © — 'i = , 3 Job Mic Adihrss Arch a copy of.the workesa'tOmP�ffan ply ciMtr.sfim pap(dwwg the p�y number and eMphTfsDa daft), Pmi'Jare.to pecme ca*=p as reqaied finder Sectirm 25A ofMC3,a 152'cm Irad to the imposi&u of®iaal Pia of a fine-4 to S1,5M.00 M3&w ono-ycm=VcGm=mzLtes well as civflpongfm is fhe form of a SMP WORK ORDER mnd a fine of aP to M50.00 a day against the VMbdnr. Be.advised•&af a copy cnbis ptrtm wadod may-be for .tn&c OBice of of tha MA,fibs iaeniaaec covmW w[ifieaiiam n .I do Awrby.eerliJy P ofPWY duddie b[fiw a3ion provideda6TW ,mnd rnl rprt om.D - �ffsrial use o,fZy. Do norwriu in*it= 4 m be eompletrd by city or wowa•offrdad . C y or Inning An&nrftyi*d?r'k-exa1.' I Board of HmI& 2.Bu3ldmg Dgmriment I DtV Town C IM* 4:Mwtd ai bnpedar S MMMI g 3aspedur oDbaet rtsoa Phone __ _ CERTIFICATE OF LIABILITY INSURANCE r a7512022 THIS GERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THI CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIE BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORQE REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER IMPORTANT: N the certificate holder Is an ADDITIONAL INSURED,the polley(iss)must be nMorced. H SUBROGATION IS WAIVED,subject t the terms and conditions of the policy,certain policies may require an endorsement. A statement on this Certificate does net Cenfar rights to th cartiNcata holder In lieu of such andorsame c. PRODUCE CONTACT Jenelie Be Rays Companies rgrove or Eric Johnson PHONE . 612-333-3323 F gNe: 612-373-7270 00 South Bch Street MAIL - Suits 700 PReD Minneapolis, NN 55402 $ AFFORDIN INSUREDG COVERAGE MRCS INSURER A: OLD REPDSLIC INS Co 24147 Renewal BY Andersen Corporation INSURER a: NNLTICIUM DNIOT FXRR INS CO OF PITTS 19445 104 Otie Street NBURERC: Northborough, NA 02532 PNIURERD: BMURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 29229436 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOE 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. - NTN TYPE OF INSURANCE POLICY EFF POLICYERP POLICY NUMBER LYE A GENERAL LIABILITY IMIaY 59820 30/01/1 10/02/13 EACH OCCURRENCE S 11000,000 X COMMERCVLL GENERAL 11l1BLLfTV S S 300,000 CLAIMS-MADE �OCCUR NED EXP ene reon- S 30,000 PERSONAL a ADV INJURY S 2,000,000 GENERAL AGGREGATE S 4,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $ 3.000.000 a POLICY PRO- LOC $ A AUfOYOB LELNBRMY NNTB 22700 10 02/1 10 Ol 13 COMBINED SINGLE LIMIT a �,ALTO WA=ddud) t 3,000,000 ALL OWNED AUTOS BODILY INJURY(Per Pawn) : SCHEDULED AUTOS BODILY INJURY We,ao*Mrd) S a MIREDAI/TOS PROPERTY DAMAGE c a NON-OWNED AUTOS t s 8 a IRNREIJ,A LIVE a =S 23273355 10/01/1 10/02/13 E1ICM OCCURRENCE s 25,000,000 EXf�LW CWM54MDE AGGREGATE s25,000,000 DEDUCTIBLE a RETENTION S 25,000 - A WORMRBCDI ' aA�nom Y/N IONIC 1179411 00 3 a WC STATI- OTH- /Ol/1 ANY PROPRIETORIPAATNERIEXECUTNE OFOFFI SER EXCLUDED? N/A EL EACH ACCIDENT S 1,000,000 Nyyee6e dppee nddWy in MR) e,ye, El.DISEASE-EAEMPL 51.000.000 OES(MIPTION OF OPERATIONS bebw E.L.DISEASE-PO uw,vw, S 1.000.000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEIOCLES NKAeIr ACORD lot,AddMeNl Rerrrrb Schedule,Knew,epeee h,.eub.a) Evidence of Insurance. CERTIFICATE HOLDER CANCELLATION Evidence of Insurance SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELNERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTMORD3D REPRESMATWE erici Massachusetts -Department of Public Safety Board of Building Regulations and Standards ' Construction Supenisor License: CS4)95707 , BRIAN D DENNISON 7 LAMBS POND 61RCX$ Charlton MA 01507 4 S. - Expiration I Commissioner 09/08/2014 i i 71. �� I Office of Consumer Affairs&Business Regulation j WWA HOMEIMPROVE CONTRACTOR egistration: MENT TYPeiration -12Q32013 Corporation L IMPROVEMENT By ANDERSEN1CORPORATION } i r BRIAN DENNISON -4!etl 104 OTIS ST NORTHBOROUGH,MA 04532: Undersecretary I Wa byAn ers&= n teamWINDOW ucCe MA.4..� °ea" F� o Low a onsum Dm +oo-oo�rasts•wo EMEMY PE CE PATINGS U-Factot(ti.S)/I-P Solar Heat Clain Coefficient ADDITIOKAL PERFOJWTIEIGS • Visible Tmnomitkr)ce awe s.r.re.rwcr.rawr�r�A�w.r�. . rOratw.� �� fti�( t�R�wrrrrowu =IL Woo ..1 ' ..a..r... OEPIGH PREVSURE(PSG '°LC25 RbA D® SIOPGd 8111 DH rslslrYMlOrOa�O�OOa •........r.vs.ese..�cacr.�.�.r.�r�.o�.«+...e�....w�O.,;., , • . i . - .. Renewa W[RDQW KEPIACEREBT aaAu mp To Whom It May Cmncem: Fmclosed is a permit applicafion package for a pmj ad we have been contracted to do in your town Thank you m advance fm receiving this package by mml As we work m every town in the state,it greedy helps us . in our process. We have also enclosed a self addressed and postage Paid envelope and would request that when 6e Permit application has been pinoassod, tbAf you would marl if back to vs. Enclosed for you review m this package is: ❑ Permak Appheation ❑ Home}mprovemenf Cont U tOr License ❑ Constrnctinn SuperPisor License ❑ Proof of lummDee ❑ Pmof of ltnergy Mcieney RI&Mg ❑ b4gued Contract from Casfomer' *❑ Permit Fee Cxr A.mepted at time of applying) If youhave any questions regarding this applicoian please call me at; 508-3 51-2200 X 55285 Kelley Dmabue Peaui# CoardiIIatar ,. - _ - ' 10aa$Mead • Nmthbmooy�MA. D1532 - . rb�Yso�3st,uo6�sszts - Pa{SM TJ4-W-3013