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14 MALL ST - BUILDING INSPECTION (2) ` bGZ7 "/�a The Commonwealth of Massach usetts ICIVED q1, Board of Building Regulations and St CfiibRAL 5ER 'ICETITY OF i LEM Massachusetts State Building Code,71 0� SAMar Building Permit Application To Construct,Repair,Reno :$eel ed Mar 2011 � � One-or Two-Family Dwelling This Section For O id Use Only I Building Per int Number: D te'k lied ;"; Ji -•. O Building otsetal(Print Name). . . _ ..° ignahae mate SECTION I-SITE INFORMATION :!MVP .. if 1.1 Property Address: 1.2 Assessors Map llc Parcel Numbers 14 MALL ST 35 35-0102-803 1.l a Is this an accepted street?yes__ no Map Numbs Parcel Number 1.3 Zoning Information:CONDO 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq fl) Frontage(11) 1.5 Building Setbacks(4) Front Yard Side Yards Rear Yard Required Provided. Required Provided Required Provided 1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.S Sewage Disposal System: Zone: _ Outside Flood Zone? Public❑ Private[3 Zone: if yes❑ Municipal❑ On site disposal system ❑ SECTION 2: PROPERTY OWNERSHIP` 2.1 Ownert of Record: JUSTIN CODINHA SALEM, MA 01970 Name(Print) City,State,ZIP 14 MALL ST 617-448-9498 No.and Street - Telephone Fanail Address SE, ::FION 3:DESCRIPTION OF PROPOSED WORK' cbeckili that i Lj New Construction❑ 1 Existing Buildin Owner-Occupied Repiairs(sW Alteration(s) ❑ Addition ❑ Demolition ❑ 1 Accessory Bldg.❑ 1 Number of Units I Other Specify: REPLACEMENT Brief Description of Proposed Work": REPLACE 6 WINDOWS-NOS TRUCTURAL CHANGE SECTION 4-ESTIMATED WNSTRUCTION COSTS Estimated Costs:item (Labor rand Materials Of8Cis1 Use Onlyf mi 1.Building $ 8,864.00 1 Building permit Fee:$ Indicate how fee is determined, ❑Standar Ci /T6w(nItAanpcein F 2.Electrical $ 11.111, _ dty11 st14 i ' u ❑Total Project Co 3.Plumbing $ 2-Other Few $ 4.Mechanical (HVAC) $ List. 5.Mechanical (Fire Total All Fees:$ S Ian $ ,. 6.Total Project Cost: $ 8,864.00 Chock No. Check Ammmti Cash Amount:<' ❑Paid in Full -r°13 Outstanding Balance Due: i � Za � t5 SECTIONS: CONSTRUCTION SERVICES ' ' 5.1 Construction Supervisor License(CSL) 90125 10-06-16 JAIME MORIN License Number Expiration Date Name of CSL Holder List CSL Type(see below) U 86 GARDINER ST Nn.sndSuuet IYpc.tf a _; ,:# Description <<° U Unrestricted uildia s up to 35,000 cu.ft. , LYNN MA 01905 R Restricted)&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances 508-351-2214 I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(RIC) 170810 12-23-15 RENEWAL BYANDERSEN HIC Registration Number Expiration Date HIC Company Nameor HIC Registrant Name 30 FORBES RD No.and Street 508-351-2214 Email address NORTHBORO MA 01532 City/Town,State ZIP Telephone SECTION&:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.GL.c.152.§ 25C(�) 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..........4 No...........O SECTION Tat OWNER AUTHORIZATION TO HE COMPLETED WHEN All OWNER'S AGENT OR CONTRACTOR APPLIES.FOR WILDING Pmthw X 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 hereby a under the pains and penalties of perjury that all of the information contained in this applicatio is true an accurate to the best of my knowledge and understanding. 01/20/15 Print Owner's or Author' A s Nutria(Electronic Signature) � Date NOTES: 1. An Owner who o ms 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.Otter important information on the HIC Program can be found at www.mass.ao-ko Information on the Construction Supervisor License cart be found at www.mass. ovg /dus 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) (including garage,finished basementiattics,decks or porch) Gross living area(sq. ft.) Habitable room count Number of fireplaces Number of bedrooms Nrunber of bathrooms Number of half/baths Type of heating system Number of decks/porches TyW of cooling system Enclosed Open 3. "Total Project Square Footage"maybe substituted for"Total Project Cost" r CITY OF S.URUtiI, T%LksSACHUSETTS SI ILIMM DEP.AMM NT 120 WASH NGTON STILEE .r FLOOR TIS.. (978)745-9595 PAX(978)740.98M KIatBERI EY DAL42OLL MAYOR THOU"sr.pumn D11 EcroR of PusLic PR0PEXW/9UUX i 4G COOLM1S MNER Construction Debris Disposal Affidavit (required for all demolition and renovation work) In accordance with the sixth edition of the State Building Code,780 CMR section 111.5 Debris,and the provisions of MGL c 40,S 54; Building Permit# is issued with the condition that the debris resulting from this work shall be disposed of in a properly licensed waste disposal facility as defined by MGL c 111,s 150A. The debris will be transported by: RENEWAL BY ANDERSEN (name of hauler) The debris will be disposed of in : RENEWAL BY ANDERSEN (name of facility) 30 FORBES ROAD NORTHBORONA 01532 (address of facility) turc aof portnit applicant / Vo date Renewal _ MA Homo Improvement ComraDtorl byAnlJcense a170810(Expires 12123Y2015)) u"... el'Sf'n. Renewal by Andersen Cbrperatioa. Federal Tax 10#41.19184131 lv,NpaW p.Ip IACYMYNI' .ry A��au.'"t'rvwa..p 30 Forbes Rd- Northborough,MA 01532 I (508)351-2200 Fax(508)•986-7072 i CUSTOMER WIND0111 AND DOOR REMODUISNG AGREEMENT Buyer(s)Narne m_4 .. Date: JUBTIN COCAIN HA NOVEMBER 8r 2014 � Buyer(s)Street Address City State Zip Code 14 MALL STREET SALEM MA Email Address Home Telephone Number Work/Cell Telephone Number I JCO D I N HA(±1G MA I L.CbM 6174489498 Buyer(s)hereby jointly and severally agrees to purchase the goads Sector services of Renewal.by Andersen Corporation("Contractor'),1n accordance with the terms and conditions described On the front and the reverse of this agreement and on the attached specification sheets)(collectively,this"Agreemenr'). �Buyer(s)hereby agrees to sign a completion certificate after Contractor has Completed all work under this Agreement I Est.Start Date Method of Payment Total Job Amount $ 8,864.00 4mum Financed 8,864.00 Deporl[ReOaived 133°w)$ 0.00 Check/Cash IP-14 weeks Balance Stan of Job(33%)$ 0.00 oeposa nt sigrdne S 4,432.00 Chotf, j Balance on Substantial F;,f_a [0ak�il 0IM - At Smr4aitil Credit Card Cmnplation of Job.(330.).$ 0.00 ce n,lllawm$ 4,432.00. 1-e days If erOolt Card is sainted,places 1 sea Credit Card Pa mont.form 1 Buyer(s)agrees and understende that this Agreement consitionce the entire understanding between the parties,and that there are no verbal understandings changing or modifying any of the terms of this Agreement No alteratlon to or deviation from this Agreement will be valid without the signed,wfklen consent of both Buyers)and Contractor. Buyel(s)hereby acknowledges that Buyer(s)1)has read thisAgraement,understands the terms of this Agraereant,and has received a completed,signed and dated copy of this Agreement,including The Iwo attached Notices of Cancellation,on the data first written above and 2)watil omily Informed of Buyor"s tight to cancel this Agroomdot. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. Renewal by Anderson Corporation Buyer(s) Guyette) Signature of Consultant Signature gignalure j KEVIN MONAHAN JUSTIN CODINHA Printed Name of CAnsuliaft Praha!Name printed Name YOU,THE BUYEIRS),MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD OUSINESS DAY AFTER THE DATE OFTT113 TRANSACTION. SEE THE ATTACHED NOTICE OF CANCELLATION FORMS Fork AN exPLANATioN OF This NIGHT. L ---—- -- - --- ------ ------- -- her--- _ --- - -_.,„__a__ _ e_-- _----_- y N(ATICKOEO wCu ATION NOT•Hb OF DANCtE14WFJON l D.A.of7' nanmbn Ilfetli Von may caaeil ehio i Oats, Ilau aucdop IAlitd Snv may caouel tNLt 1 �eranxattion'Mitbrm any fanahyarable.daa,within dame busAdeaadays from the tmocuccOoo,evince.,cry turacky,or A Ibsttian,whhin three bos ess days lane'the nbave date'If you.anrel,any property traded 1,my µayearms mad.by you Mader. 1 .1000t date,If you coped,au,pmptrty traded In,any µsymmtA mode by you Mader !,he Comaslut of Rule,and say augaAkAbk hoaaatem eaer.0d by)oawiU ba W Coowetuf Sole,and Amy n.goUnWeimtrum nfeaeeaMd hyyeuwiabe 1 ,v,orroo-d apron 10 do,hourcu1ng ratdpt by Abu C.mx eau"( Sett r")of your avt re' d eith1d 10 days pdtnwing ra eipt by der 4umvuu {'.5nilur} of your eimcntladMA vo%far,and say eM rilyi Metal seising nut.1 the(ems nu..will be I ll a c mier,and am, rou uy tears,ariuing t .'ar era np ti m Tit as, ....led. If you c+ncaluy t make available tv tb,heae aA your reead in I ry led, tf you can 1,you must anah blab{ t the.Seller az y res detrre,:P etdurantlollyasi odouadAdu as when eere{ved,Huy goods daLLtm.avfwyo wvder s bt ndallyasgoodmndldaa us h clued, ggaods desa dt ynu under this Cuutmet ar Sale; Ace yet may,If you wish ramply wtlb tl a Iummalons or the' dy7.CmAMuea er%al i u yaM may,if fl tdsh,to pTy WiW the..i s. ri A or de. Seller regurtilug rlw rrmrn Nhipmnor of for goadsw the%.11ar'a aaµ.use wArlslt. I Nancr,ogording rbe return NhiptA nt or the gamic utU eSuner'sa pe Ya and rixA.: If you do nuke dM j}uods avaiWb)n w tbp% 11 r onJ the aeDer doe.nut pick tbe,a up i 1f yvM dp Dean 1hx goods mnnoh[e n A e Seller and tbs S.B,r d,xv pot pith them Mp ii widelu 20 days of the'date of your NMI.ofC.MUudon,yea may retain or dispose 1 %elthm 20 days ofthe dace of your Nobs,ar Camrliaduoa you may ertma or dlspes'. jot the goods whbaw May anther eldlradoa. If you fall M make tbo.goads.v tuble I If you fail tp make the guada available �tn We%eB.r,irr iP you ogreewrel...the goods,ra Abe%.Tier and[AU M do u,,she. 1 toil'.9dlen or if v.streo Mrnlvan she good, .,he Retire rain fdt M d.v..dtrn i 1 You",male UAblo far jursomMus,or an Wilpid...andorfls V ul ,, fM iapCelI you{'emNiP lableforTarfermNuln or all ebngptinn.¢rater Ah.Commit, To fANed !Ibis wasaedm,Mail or dAlvere sieved Mddated ruby of,bls camell.b.mourn I ,hie tra. .aiaq it or deliver e abroad and dated very of thus,vaeenvioa Madre far any other otiose cerise,ar aepda tdegu-am to f:nm actmv NetrwWby Ambasen,l eny uraor written notice,arsend o,elegram to Coe,matm: tleaeM-a14 Aad.m,., IOd Ode fir. Nnet6hrlraugh,>U p1392;UY N0'r WT'gR'l'tiAN hflUNl011'1'OI' 1 104Odv 9l.NurthAsraugb,MA 0I532. MY NOT fATIUCTrIANMfUNtGHTOµ IIA 1r17 .(Dam) I UEREfiv CANCELTILAS r"NSICtION. 1 .(oat., ItIL'IlEaY CANC1iLT1Os'1'aAP7iAC'PION. I _ Renewal Renewal by Andersen Corporation MA Home Improvement C intractor byA ldersen � 30 Forbes rd Nonhbaough,MA 01532 License k170810 (Expires 122312015) (508)351-2200 Fax:(508)-986-7072 Federal IDd41-1918413: s Window Specification Sheet 'Ailerons}'Name Date.of A„me icnr JUSTIN CODINHA SAT, NOV 8, 2014 �I hr tw.ycrts)htitud sbovelurchp jnindv mxt.,eve:rdly agree to purdtAse the gixxl+-.mcVar u.nsces hared lJe[oa;in aerodattce nridt die plies awd tesrre; dtticiibed on thv bpeci is uhm Shmt and tht,flxlin and the revtnlc oi'theacewnpanting CG5170Nf 1VINDOW AND DOOR REMODELING !.A(;RLE\IF_VT or which the Siteci(imLion Shectis pare. WINDOW DETAILS A. 4 n.l. Ylindo./Dom Stife Delay Ca*4% Ext�lnt cram aty:e screws 3mntswr Gniks s 1,b Se,h2 Lifts Optima Bed 1 3 86 DB ad rail equal insert sLc22d sill Fitt.MF 9D8 NHAvH Ant.Brass arms FFG 6,nevsir Goa 32 312 No Bath 1 2 84 DB so rail equal insert sloped sill Ext.MF 908 AIHNVH Ant.Bms Estate .FFG mansu rise 32 312 No Kitchen 1 74 DB ad rail equal insert sloped sill Ext.MF 908 NKwH Ant.Brass Estate FFG ner nsu ces 3t2 312 No Tonal fi BAY&BOW DETAILS *See Ba /Bow Measure Sheet SiYk Do4r;I Ayruox P o- Numnm r— 4vineaw r L End Canter X/ Boor i HO nvo Roan Count style Franked Ui. Gu'n5s Aer�a Was Ineinar EVlnt Oafor Gliilas slsh. sashes Sawrs Sxatun Soffit Cobr 0 0 SPECIALTY WINDOW DETAILS uu/ Appmx taaf Sparialry BAYIBOW ADDITIONAL lYOI11SN03'ES. Roam Count style IF=1 U.1. sindrtsm Gnlffi GrNs style di/bn Color Coss,n��k xnirc,a7lr i,h terc/im..draawniwf�i^e=,S d",Hill lY ilyailicam gixtc P . ADDITIONAL WOR%DETAILS: j i No Contractor will wrap exterior casings with cad stock color of I Owner is aware that corenictordoes not do anypafnfmg/stauting ormrrmvallinslakarton of alarm system or window tmatmanfsfPurdwam..It fs the ! responsibiaty al the homeow - to have the alemr system and window treatmenrsfliamlvare removed prig to installation. Wee make no guaramae as fo 2 whether alarms or window trea rnents/hardwam wiif fit aftermpfacemenL Customer's also aware w some cases thaa twlf be gcvs bss, tf there rs,the 1 amount will be dependent on Me"of existing windows,type of installation and window style.41h make no guarantee as to the amount of glass toss. ICustomer is aware and understands any and all unseen rot is net included in This contract.Should any not be found there will be art add'ionat charge for time and materiels unless so slated in this contract 3 Yes Contractor wit insulate,caulk and seal windows with 3-point system to prevent water and airinfihration.Removal and disposal of all job related debris, windows,dears,stomt winnows and vacilum nightly included. Upon completion of the job and payment in fuk,a[Tried warranty shall be issued. 4. Yex Building Pemtit--Contractor will secure any and all necessary pelmets. the fee for iha pennit(s)is riot included in the Contract Price and a separate check is required at the time of sale for this lee Check il 117- $ 90 I", Yes All discounts have been applied to this agreement. r ':% 1es m4�4. N<r 0l Her agrees to be present on the final day of installation for final inspection and to deriver final payment i finance tom(s)- NI umvtaw.0,,: (i lti utrl,n_Lmding tut eav tim gnnGsnnd il.ww nr x vdral unek.n immliohs.tiling on-11 .,'e fhewnn,"I'lo,Sl .c ifx nxl 'driLu i II dr iq,d<rw icr-rs ,,.fifl,do,\'A ivd to u,vtv'dV xf6nPa551h'flffl:x)C]h(C LL1 Nf x11Al bIQl fAt uy tkLtlS 111 ttU4f`T�t AnilA nYllt.ta.4u1 fill\tlt)t1t Y fH*ilCtlWi}Il ltjs"t{i.Il lniY tt�iLv{x Ri{IIIL SIN 1�11'i119n ?Ra.1 by Andersen Carperatien Buyvr(si 1 ,,, /�tYUl t t'�rr1111 fIVL ! Signature of Project Managet Signature Signature Y KEVIN MONAHAN JUSTIN CODINHA i Print Nam©of Project Manager Pilot Name Print Name i Renewa i byAndersen, WINDOW AtPLACEMENT ,€ 4j +Mie4 a,gijniify *W614,wws 44re cr"tovo ortfeYrO 11110(he 01-dor will not Ise Sk4buivittett to the WAly mood Approval lotnt is sigard grad rewived(coat the Candy A -NoclatIA00 �; #�1es}gall S'l v,L4tn00fniaa windA soditnott1whi ,IhAs 41411yaLith4n1wvi6rn� vti air ,` Have 6ne 24.1at[Smixt Unit C Salem,Nei 41970 �s�tt���9�v}*�uxals4t;awlsu,3� t7 Gr ndo A,% ea, n or NI II opmont cm1pamy rIaveas hIvo V ruil�shio w ;t}g,��Mt�ECFa.�;r �s:c�refiue, tziett�txsa;r �s��: ,���iry ilul4rnorLho(off%i;I torstwalat� run AwAwsimpo-Mowu4,uyr,ORlite("Ad„mtt)ltimNinagmW Comp ny-;4,oW mAy l -10 t*k4Ng f5 mart€mi} i -y aR F'iix r',�o7Np y ��# The Commonwealth of Massachusetts Department of lndustrialAccidents Office of Investigations #Work 1 Congress Street, Suite 100 Boston, MA 02114-2017 www.mass.gov/dia ompensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Busi ess/Organization/lndividuaq: RENEWAL BY ANDERSEN Address:3 FORBES ROAD City/State/ ip: NORTHBORO, MA 01532 Phone#:508-351-2200 Are you an a ployer? Check the appropriate box: Type of project(required): L❑■ I am a e nployer with 30 4. 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 side proprietor or partner- listed on the attached sheet. 7. Q■ Remodeling ship and have no employees These sub-contractors have g. Demolition working for me in any capacity. employees and have workers' [No wor ers' comp. insurance comp. insurance.: 9. Building addition required] 5. We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a h meowner doing all work officers have exercised their I LEI Plumbing repairs or additions myself.I I No workers' comp. right of exemption per MGL 12.❑ Roof repairs insuranc required.] t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other comp. insurance required.] 'Any applicanithal checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners whc submit this affidavit indicating they an;doing all work and then hire outside contractors must submit anew affidavit indicating such. =Contractors that c eck this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the�s b-contractors have employees,they must provide their workers'comp.policy number. I am an emplojl er that is providing workers'compensation insurance for my employees. Below is the policy and job site information. i Insurance Co m any Name:OLD REPUBLIC INS.'CO. Policy#or Self ins. Lic. #:MWC 30293800 Expiration Date: 10/011/15 Job Site Addres : 14 NA rr.�� S I-• City/State/Zip: S. \, lug, p lq:�-3 Attach a copy] f the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secur' 1 coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,50 .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 $250.0 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations o the DIA for insurance coverage verification. I do hereby c fy der pains and penalties ofperjury that the information provided above is true and correct Si azure: Date: Phone#: 508 351-2200 Official use nly. Do not write in this area,to be completed by city or town =fficia City or Tow Permit/License# Issuing Ant rity(circle one): 1.Board of ealth 2.Building Department 3. City/Town Clerk 4. Elect 6.Other Contact Per on: Phone M ANDECOR-01 YADAVYO AIR f CERTIFICATE OF LIABILITY INSURANCE °�'E F 10/1/2014/1/2014 THIS CERTIFIC TE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE I DES 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 REPRESENTAT E OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: !I the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and I onditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holds r in lieu of such endorsement(s). PRODUCER cONT T Cer'flfiCateS�W1111S.COm Willis of Minneso ,IOC. -NAPHONE FI 1 ( j c/o 26 Century Blv _Lc No Enl:(877)945-7378 rvc No: 888 467-2378 P.O.Box 305191 E-MAIL —2378 Nashville,TN 3723 .5191 ADDRESS: INSURER(S)AFFORDING COVERAGE NAICH _INSURER A:Old Republic Insurance Company 24147 INSURED INSURER B: Rene Nat by Andersen Corporation INSURER c_ 30 Fc rbes Road INSURER D: Nortt borough,MA 01532 INSURER E: INSURER F: ---- �— COVERAGES 1 CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CER rIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NO THSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MP Y BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AN CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBIi POLICY EFF POLICY EXP -- LTR TYPE OF INSURANCE POLICY NUMBER MMIOOIYYYY MM/ODIYYYY LIMITS A X COMMERCM L GENERAL LIABILITY EACH OCCURRENCE_ 500,00 CLAIM $ 1,000,0 MADE L 1 OCCUR MWZY302940 10101/2014 10/0112015 AhIAGETSIIENTED PREMISES Eaoccu..) S _ ME_D EXP(My one person) $ 10,00 PERSONAL S ADV INJURY $ 1,000,00 GENT AGGREGA E LIMIT APPLIES PER GENERAL AGGREGATE $ 4,000,00 X POLICY ' J JECT LOG PRODUCTS-COMPIOP AGO S 4,000,00 OTHER: 11 $ AUTOMOBILE ILITY C MBINED SINGLELIM S A JX (EaaaGdent) ___ 5,000,00ANY AUTO MWTB302575 1010112014 1010112015 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per aWdenp $AUTOS AUTOS NON-0WNED PROPERTY DAMAGE HIRED AUTC AUTOS _(Per accitlenl S -- UMBRELLA LAB OCCUR EACH OCCURRENCE $ EXCESS LIA CLAIMS-MADE AGGREGATE $ DED I ETENTION$ $ WORKERS COMPENSATION X PER OTH- AND EMPLOYERS LIABILITY STATUTE ER ____ A ANY PROPRIETOR PARTNERIEXECUTIVE YIN NIA MWC30293800 10101/2014 10/0112015 E.L.EACH ACCIDENT $ 1,000,00 OFFICERNEMBE EXCLUDED? (Mandatory In NX) E.L.DISEASE-EA EMPLOYEE S 1,000,00 It d cdI,eund,, RIPTION OF DPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,00 DESCRIPTION OF WE: TIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Ram*s Schedule,may be snatched It 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. AUTHORIZED REPRESENTATIVE Evi1j Jnce of Insurance ©1988.2014 ACORD CORPORATION. All rights reserved. ACORD 25(201 f 1) The ACORD name and logo are registered marks of ACORD ZW!U Massachusetts -Department of Public Safety Board of Building Regulations and Standards i Construction Supenisor License: CS-090125 JAIME L MORIN=` I 86 GARDINER Si ws LYNN MA 01905 Expiration Commissioner _ 10/06/2016 _... a _ �/Le 1po9niY/LdHA4fRll/t p�C-YKPJ1elfiJ �\ !lice of Consumer Affairs&Business Regulation i WE IMPROVEMENTCONTRACTOR ^4 - .Registration 170810':. 'Type r, Ex iretto n: P i t12/23/2015' Supplementnt T RENEWALBYANDERSOW'CORPO RATION : +' ``ter-, JAIME MORIN 104 OTIS STREET ^% NORTHBOROUGH, MA 01532 :Undersecretary f Renewal tryAndersem WINDOW REPLACEMENT LRAIIJC Cacvay WooUMnyl Composite IF Dual Argon Low E4 SnartSun Double Hung 100-M73610-010 ENERGY PERFORMANCE RATINGS U-Factor(U.Syl-P Solar Heat Gain Coefficient 0 ®29 0 ® 1 • ADDITIONAL PERFORMANCE RATINGS Visible Transmittance 0 ., 42 ra.ewmutl�..maoww�w...wowtl.w.wwvu.n wnc,o,.mo.w,w,w.nOwtl.pm.a promera..Hro rYbpw.wmMeb.6.J..a.-• -"'m.mbm.W..pem pm.el W. .mc Dee em e.me.n.w proeeslm.e..a w.mm w amr.xw v��wwu.tl a.a COMN Ope�tlGlefi/.oOO1tlR I.l1tlOGfppClpl p1.M.if�G Y�OLiI.. _ YMtlAW.AO ,�� SD�d T..aemw..maesa ' aRfecy,'N.ryww�Y � `� ..E DESIGN PRESSURE(PSF) r RbA D8 Sloped Sill DH IN . Teaa.nxsffiWAWNwmfa0404 a Irnutl..« m.m..m... .Wmae, NtlevM.mem MPACEgat¢GG.KMmbe eryirmeW YAYAIYNekQa.Sslb v1egtlro rt+{I I