35-119 (6) 43DREWSEN DR BP-2018-1081
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 35- 119 CITY OF NORTHAMPTON
Lot:-001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category'window replaced BUILDING PERMIT
Permit# BP-2018-1081
Project# JS-2018-001949
Est.Cost: $30712.00
Fee:$217.00 PERMISSION IS HEREBY GRANTED TO:
Const Class: Contractor: License:
Use Group: RENEWAL BY ANDERSEN 090125
Lot Size(so.8.): 13285.80 Owner: THURMAN LEONARD O JR&SUSAN M
Zoning: Applicant: RENEWAL BY ANDERSEN
AT: 43 DREWSEN DR
Applicant Address: Phone: Insurance:
30 FORBES RD (508) 919-0900 WC
NORTHBOROMA01532 ISSUED ON.4/2512078 0:00:00
TO PERFORM THE FOLLOWING WORKREPLACE 11 WINDOWS AND 1 PATIO DOOR
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector
Underground: Service: Meter:
Footings:
Rough: Rough: House Foundation:
Driveway Final:
Final: Final:
Rough Frame:
Gas: Fire Department Fireplace/Chimney:
Rough: 001: Insulation:
Final: Smoke: Final:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occupancy Signature:
FeeType: Date Paid: Amount:
Building 4/25/2018 0:00:00 $217.00
212 Main Street, Phone(413)587-1240,Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
tv, nc�acv s
-- Department use only
r- City of Northampton Slaws Of Permit:
A j Building Department Curb Cud0insil yPemAt
212 Main Street SeserlSepuc Avallabgty
Room 100 WatecMellAvailabFAy
oeacov auN..»a nraw->uus
Northampton, MA 01060 Two Sets of Structural Pieria
N0"11,'I'N A 13-587-1240 Fax 413-587-1272 PWVSge Plans
other Specify
APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 •SITE INFORMATION
1.1 Property Address: 43 Drewsen Dr, FThis section to be completed by oHreelorence, MA 01062 Q
Map Lot it Unk
Zone Overlay District
Elm St.District CB Dlsblel
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
Susan&Leonard Thurman 43 Drewsen or, Florence,MA 01062
Name(Pnnp Current Mailin Address:
413586108
See Attached Contract Telephone
Signature
2.2 Authorized Anent:
JAIME MORN 30 FORBES ROAD NORTHBORO,MA 01532
Name(Print) Current Mailing Address.
508-351-2277
Signature Telephone
SECTION STIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Oficial Use Only
completed by permitapplicant
1. Building 30,712 (a)Building Permit Fee
2. Electrical (b)Estimated Total Cost of
Construction from 6
3. Plumbing Building Permit Fee
4. Mechanical(HVAC)
5.Fire Protection
6. Total=(1 +2+314+5) 30,712 Check Number
This Section For Official Use Only
Building Permit Number: Date
Issued:
Signature: 12—
Building Commi nerllnspeclor of Buildings Date
Section 4. ZONING All Information Must Be Con ipletad. Permit Can Be Carried Due To Incomplete Information
Existing Proposed Required by Zoning
This reborn to be filled in by
Building Department
Lot Size
Frontage
Setbacks Front
Side L R L.. R:.
Rear
Building Height
Bldg. Square Footage
Open Space Footage %
(bot arca minus bldg&roved
parking)
N
ofParking Spaces
Fill:
volare&Location
A. Has a Special Permit/Variance/Findin ever been issued for/on the site?
NO Q DONT KNOW YES O
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO O DONT KNOW 0 YES O
IF YES: enter Book Page and/or Document#'.
B. Does the site contain a brook, body of water o-wetlands? NO O DONT KNOW QF YES O
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained O Obtained 0 , Date Issued:
C. Do any signs exist on the property? YES 0 NO O
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property? YES O NO
IF YES, describe size, type and location:
E. Will the construction activity disturb(clearing,giadirg,ex vation,or filling)over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES O NO
IF YES,then a Northampton Storm Water Manegen ant Permit from the DPW is required.
SECTION 5-DESCRIPTION OF PROPOSED WORK(check allapplicable)
New House ❑ Addition ❑ Replacement Windows Alteration(s) Roofing Q
Or Doors In
AccessoryBldg. ❑ Demolition ❑ New Signs [Ei] Decks [p Siding[O] Other[p]
Brief Description of Proposed
Work: replace 11 windows and 1 patio door
Alteration of existing bedroom Yes No Adding new bedroom yes No
Attached Narrative Renovating unfinished basement yes No
Plans Attached Roll -Sheet
an.If New house and or addition to existing housing, complete the following
a. Use of building: One Fari Two Family Other
b. Number of rooms in each family unit: Number of Bathrooms
c. Is there a garage attached?
d. Proposed Square footage of new construction. Dimensions
e. Number of stories?
I. Method of heating? Fireplaces or Woodstoves Number of each
g. Energy Conservation Compliance. Masscheck Energy Compliance form attachedo
In. Type of construction
I. Is construction within 100 fl. of wetlands? Yes No. Is construction within 100 yr. floodplain_yes No
j. Depth of basement or cellar floor below finished grade
k. Will building conform to the Building and Zoning regulations? Yes No.
I. Septic Tank_ City Sewer Private well City water Supply
SECTION 7a-OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
Susan 8 Leonard Thurman ,as Owner of the subject
property
hereby authonze JAIME MORIN
to ad on my behalf, in all matters relative to work authorized by this building permit application.
SEE CONTRACT 4-16-18
Signature of Owner Data
1 JAIME MORIN ,as Owner/Authorized
Agent hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge
and belief.
Signed under the pains and penalties of perjury.
JAIME aRIN
Print Name
4-16-18
Signature o(Owner/ t Date
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder: JAIME MORIN 90125
License Number
30 Forbes Rd. , Northborough, MA 01532 10-06-18
Address Expiration Date
508-357.-2277
SgnaWTelephone
8.Realsterad Horne Improvement Contractor: Not Applicable ❑
RENEWAL BY ANDERSEN 170810
Company Name Registration Number
30 FORBES ROAD NORTHBORO,MA 01532 12-23-17
Address Expiration Date
Tuloptone508-351-2277
SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.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....... k'] No...... ❑
11. - Home Owner Exemption
The content exemption for"homeowners"was extended o include Owner-occupied Dwellines ofone(1) or two(2)families
and to allow such homeowner to engage an individual for hire who does not possess a license,provided that the owner acts
as supervisor.CMR 780, Sixth Edition Section 108-1.5.1.
Definition of Homeowner:Person(s)who own a parcel of land on which he/she resides or intends to reside,on which there
is,or is intended to be,a one or two family dwelling attached or detached structures accessory to such use and/or farm
stmctares.A person who constructs more than one home in a two-year Period shall not be considered a homeowner.
Such"homeowner"shall submit to the Building Official.on a form acceptable to the Building Official,that he/she shall be
responsible for all such work performed under the building permit.
As acting Construction Supervisor your presence on the job site will be required from time to time,during and upon
completion of the work for which this permit is issu(d.
Also be advised that with reference to Chapter 152(W or iters'Compensation) and Chapter 153(Liability of Employers to
Employees for injuries not resulting in Death)of the Ma�sachusetts General Laws Annotated,you may be liable for persons)
you hire to perform work for you under this permit.
The undersigned"homeowner"certifies and assume;resaonsibility for compliance with the State Building Code,City of
Northampton Ordinances,State and Local Zoning Lrws and State of Massachusetts General Laws Annotated.
Homeowner Signature
City of Northampton 212 Main Street,Northampton,MA 01060
Solid Waste Disposal Affidavit
In accordance of the provisions of MGL c 40, S54, I acknowledge that as
a condition of the building permit all debris resulting from the construction
activity governed by this Building Permit shall be disposed of in a properly
licensed solid waste disposal facility, as defined by MGL c 111, S 150A.
Address of the Work: 43 Drew en or,Florence MA 01062
The debris will be transported by: Renewal by Andersen
The debris will be received by: Renewal by Andersen
Building permit number.
Name of Permit Applicant Jaime Morin
4-26-28 rx�d,
Date Signatu of Parmit Applicant
PRODUCT PERFORMANCE
Andraeea'WC Certified Total Unit Perfiarmance t�
'. aera�n'rdi ebRv unm' 8160 . e-
.: yarv.. ass am
US--
Mo av
W IsfHmar a31 m bei -:']
vwuesvevar m av
ynrr.. atl m ar
1 neap---
W nR5 W n5l
fraaeeaha�
a.s W ave m u m _
yar5a aA a8 ae
r..o.• yrir.rar ow m wWN
o
*.rrr
rerGae So nlr n]5 w nxr am as �y
yam a,d m m
o-ramm.rear m ea5 ss5
5� aaa ass 12—P—
WM u as .7 A
r[eeor o,e m awe g '?
IeHaoY W R!a m nv ae ;1 :7:!
yo.+5r 40 m osl
o.,awn®rer 'm a$ - oe
o.....s aae m ase
oa.vs'avm. a.e Wre. 4m ai
rca..5ne an as m v _'s
wro.rm. ar am m 7S
yoprar aM m ar
vrewr.r evr as as ase
��. a..04oM M--" oA 11
ueq rm.r 0L Qm on m 7 .'li
'—u•sr.aa,
v.ae..v. u as m 7 731
a.cv.ceWanv Sv av av :ll Mimi
maw5r ae m ax
yarovrar m au m
rf as m m
r5.+w iscr 6Zt ass m m la
uwrru. om me
a.ar,r esr as om 9 _I7Ja-
ISC96aLyWa a9 aM J y�
yarae.
as,a,a a ,
yopr5rr m nw
� m aa5 ag .131
ayey yeR reram. an m nv
rWr Wea. m av 9
07
v.samror nx m m
ureaey m ev ear p ".1
meyu.r ae aae nv m
R'�
!L"� The Commonwealth of Massachusetts
Department of IndushialAccidents
I Congress Street,Suite 100
Boston,MA 02114-2017
%ni,tu.mosxgov/dia
V11,urkers'Compensation Insurance Affidavit:BuildersiContr tors/Electricians/Plumbers.
TO BE FILED WITH THE PERMITTING AUTHORITY.
Applicant Information Please Print Legibly
Name(Business/Organitation/individual):Renewal by Andersen
Address:30 Forbes Rd.
City/State/Zip:Northborough,MA 01532 phone#:508-351-2277
Are pap an employer?Cheek We appropflmc box: Type of project(required):
Iama empbyer—ro30 emplopm(full mo'orom-time)• 7. ❑New construction
2.❑lemasole propriebrmlmmershry ed have mevgiloyeawMing formem 8. ❑Remodeling
my capacity.[Noxor cm comp,hatusom m,mm .]
3.❑Ian ahomeoomcr doing al wmk mself[No xwkers'comp insurerce«quird l9. ❑Demolition
a.❑i w a Mmcow,er rod win x nidmg eomcenors to mdva ell wmk w my popery. 1 wa1 10❑Building addition
muaoe sot all mmoarors ellerove workm'compmsaton imurance or are sole 11.❑Electrical repairs or additions
prmpri[tors wiW re cmployas. 12.Q Plumbing repairs or additions
501smagmetslconmacsorand1havehirdW wb am morshodontheamWsheer.
1 3.�Roofrepairs
me subcmrtmnov
ors e employees and have xurkms'comp.imumsee
6.❑Weare,cotpamom,-d itsomamnavecxemi WekrightofeasmWtionper MGL c. 14.❑7Other Replacement
152.41(J),and oe have,w employees INo ourlcm comp insurance required.(
'My applicant dust chmks box#1 mus also fill out she ration below shooing their workers'mn mastion p los,afsoustion.
'Hommwners who submh Wil,,davit iodicaMg utey are doing all work end dcen hire outside convectors most submit a new affidavit indicating such.
:Convacmrs dot ehak Wis box must muchdan additiomishatshowing we oamc of We srdr ovarmcmrs vd ruse whedxx or am uase entities love
employers. If We sub vm r=mm,have employees,ill must provide their workers'comp.polity number.
I am an employer that isproviding ssorkers'compensation insurancefor n0,employees Below is thepoliey andjob site
information.
Insurance Company Name:Old Republic Insurance Co.
Policy#or Self-ins.Li,,#:MWC 311129 00 Expiration Date:1011/2018
Job Site Address: 43 Drewsen Drive, Florence MA 01062 City/State/Zip: Florence MA 01062
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration dare).
Failure to secure coverage as required under MGL c. 152,p25A is a criminal violation punishable by 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 5250.00 a
day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance
coverage verifici
/dohere ndfy under lh ins andpenolties ofperjury that the informadonprovided abore is true and comet
S" t Date 4-16-1B
Phone#:5 1-2277
Oficial use only. Do not svrite in this area,to be completed by city or town official.
City or Town: Permit/Liceme#
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#:
/-14 Fees 1 .f 1
A�oe CERTIFICATE OF LIABILITY INSURANCE o9/2T/
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, E)ITEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORQED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER
IMPORTANT: H tho OfNflces holder Is an ADDITIONAL INSURED.iNe polis fles)must have ADDITIONAL INSURED prevlslons or M endorsed.
H SUBROGATION IS WAIVED,subleol to the bums and sondMNns of the polky,fallen polkles may require an endoreemem. A statement on
MIs Dertifleate tloe6 not confer rights to She IxdMTab holder In lieu of such Mdonwma s.
.P. RAW
Willis of M1noe.Ot., lx. ---
0/o 16 Century B1-1 FNONE 1-8]]-915-]3]8 _ _.M No 1-988-6041]8
EJWL eertl[lcntenMllin.cm
P.O. 8u 305191
PeaGv111e, 'fR 373305193 OBA IXSNR 3.5FFd101X000YFAKE MMC
NryRERA: Old RgaDliC Ineoruee Capmy Mile
MWRED MWRFA B:
.—1 or And.—
30 rod. Fad N6WER0:
..—as. as 013v NBURER D'
Nsumf:
COVERAGES CERTIFICATE NUMBER:W3761206 REVISION NUMBER:
THIS IS TO CERTIFY THAT TIE POLICIES OF INSURANCE LISTED BE OW AkVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POJCY PERIOD
INDICATED NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITk3N OF ANY CONTMCT OR OTHER DOCUMENT WITH RESPECT TO WHICH THM
CERTFlCATE WY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
ERCLUSIONSAND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HA UE BEEN REDUCED BY PAID CIAIMS.
TWE OFN6YRIMCE — �pLICyX POLX:Y EFF ' FaICY EO SYIfO
Mi X Cg1MFACML4EXEML ABIL1rY : 'EALNIX:CURRENCE f 1.000.000
Lrf _.,(SAM6AUGE x LOCCUR IpREMSES j 100,000
A MED"P(A o,s Pbw,) f 10.000
—, RKY 311131 30/O1/a01]110/01/1038 FERIOIOLIN WARY 3 1.000.000
GEHL AGGREGATE UMn APPUE5 PER GENEMAGGREGArE :s 6,000.000
�6POUCY: PRO.
JECT LCL' ''.yROWCis-COMPNPAGG�3 __ 4,00,000
OTHER. ,.
''i A1n0M0alE WRI11rY N N L IlNli 3 5.000.000
K i.WYAUM t 0
BJpLY IW1IRVIPa pwnl :s
AUTO90ONLY �AYiO8M0 RNIB 311130 10/01/10171 10/01/2019 WOOLY INJURY(PW wa M S
~—W!. ONLv N.iOSgEv PROPERlVa0.VwGE :.S
IS
MWP[W L10e '�OLWR UtC OWURRENE _ S _
EYCFSS Lose CWMS4MCE' M33REG.ATE f
OED 1 RETENTION SassesseCOMPSOMmOu f
AMDBNLOYEIIf WVMm' I'M x :STAME
A 'ANYMOPRIEFCARaRTNENEiECU3IVE iN/A EL.EACHACGCENT $ 11000.000
I£ EPAEMBEREFCLUoso, F YNC ]11139 Pi 10/01/1017 10/01/2018 1.000.000
i1M.rJMp'bNMI :ECMEA E-EA EMPLOYEE S
RYYrr NLmO 1.000,000
=M M.
OFOPEMiKK36 Wb✓ '.EL.g5FP5E-PoIKYSJMR-3
OEKNPTNR OFOPER1TgN81loCA11011a/YEMCLEB IACORO AN.AMINn.I Wmv3.4M4,I.,mry 4.N.MOXmwa.Npb�pNl.61
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OFTHE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE VPIRATMN DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WNH THE POLICY PROVISIONS.
AUTHORMEDXEPPESEM,TJA.7NE
Le 5 . r/
®1988-2015 ACORD CORPORATION. All dBNLs,.served.
ACORD 25(2016/03) Th.ACORD name and logo are registered marks of ACORD
Sa m: 151:630N --u 459145
6io'D
00 591 : 5 '0
Renewal
byAndersen.
w)XYOe {[RAe[N[Irt neNdeoenCnopw)
WaeoMnyi Cau4osite fF
- DUN DpONN Low E45a1wWIn
ENERGY PERFORMANCE RATIRGS
Li-Factor(U.S)A-P Solar Heat Gain Coefficient
0 . 29 0 . 19
ADOMMIAL PERFORMANCE WINGS
Visible Transmittance
0 . 42
MWr�YWMYOr��TaW.wiltl�illMA�bu�mW W.�ww
/w1�-111N^NPr-w�-eb�W rtlMe1rwaeuW w�rts.npMr Vt
ImMp+wrw.wr'Pw-r<mrr'rrYwY.ytl.rygoarbrirNi r�
-wMWYYYwbuX�GrtW I�In-�Yb�-IL
vw.Mva
SAQr
�� 4�YawwYa�rW77*0W
_DEswNPRSSUNE(MO
H-1 C2S RbA DR Sloped Sill DH IN
NNMd6
+.-4«aN.ec.,om,•usc..ir-i...+...+NIW irnr..em.nyr.
}u Y
� 1 k t
SU �
e MORIN A .
' MIAMI xw `
cotr _
ssloner
1
Office of Consumer Atfalrs and Business Regulation
One Ashburton Place-Sults 1301
Boston, Massachusetts 02108
Home Improvement Contractor Registration
7yPr SLPPWrWACWd
RENEWAL BY ANDERSON LLC. RaOarieft: 170810
30 FORBES RD E***W: 19!77!2019
NOR7HBOR000H,MA 01632
0p1111 AdOw wM Rd6m GA.
Oalw NCewwwrAaJ�IY�W RpuYNn
NOME WPROYEMBROON7MO7011 RNMwwMRwSdbr SWNWMw "
7YPe:SippMnnlCwd b expmw, wfft Mumlw
8 210110121M, ad w AlNl oldau�Yww Iftq w n
iNa10 12f22k019 1 PM s-awbalm
RENEWAL SY ANDERSON LLC. M 02/19
.AIME MORIN30 FORBES
NORBOROW
MH,MA 01632 Not VaUd wNhout aIanBWre
Renewal Agreement Document and Payment Terms
bi'AndemrL db.Renewal by And.—of Burton Susan&Leonard Thurman
Legal Name'.Renewal by Andersen LLC 43 Drewsen Dr
HIC#170810 Fbreum,MA 01062
wnvow ve uorwrar 30 Forbes Road I Northborough,MA 01532 M.0135861028
Phone:508 351-2200 1 Fax:I50R)986-20221 rbabonanOgmail com
Buyer(s)Name: Susan & Leonard Thurman Contract Date: 03/26/18
Buyer(s)Street Address: 43 Drewsen Dr, Florence, MA 01062
Primary Telephone Number: 4135861078 Secondary Telephone Number:
Primary Email: lillb260eemeast.net Secondary Email:
Buyer(s)hereby jointly and severally agrees to purchase the products and/or services of Renewal by Andersen LLC d/b/a Renewal by
Andersen of Boston("Contractor''),in accordance with the terms and conditions described in This Agreement Document and Payment
Terms,any documents listed in tba Table of Contems,and any other document attached to this Agreement Document, the Terms of which
are all agreed to by the parties and incorporated herein by reference(collectively this"Agreement").Buyer(s)hereby agrees to sign a
completion certificate after Contractor has completed all work under This Agreelrgnt.
Total Job Amount. $30,712 By signing this Agreement,you acknowledge that the Balance Due,and the Amount
Financed must he made by personal check,bank check,credit card,or rash.
Deposit Received: $0
Balance Due: $30,712 Estimated Start: Estimated Completion:
Amount Financed: 530,712 8 weeks 10 weeks
Method of Payment: Financing We schedule installations based on the date of the signed cuntract and secondarily on
the date in which we complete the technical measurements.The installation date that
we are providing at This time is only an estimate.We will communicate an official dam
and time at a later date. Bain and esmeme weather are The most common causes for
delay.
Notes: $10237 down; $10234 on start; $10235 on completion
Buyer(s)agrees and understands that this Agreement constitutes the entire understandings between the parties and that there are no verbal
understandings changing or modifying any of the terms of this Agreement.No alterations to or deviations from this Agreement will be
valid without the signed,written consent of both the Buyer(s)and Commaor.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.
NOTICE TO BUYER: Do not sign this contract if blank.You are entitled to a copy of the contract at The time you sign.
YOU,THE BUYER,MAY CANCEL THIS TRANSACTION AT ANY TIME NOT LATER THAN MIDNIGHT
OF 03/29/2018 OR THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION,
WHICHEVER DATE IS LATER.SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN
EXPLANATION OF THIS RIGHT.
lapl Name Renewal by Andersen IAC
A. Renewd by Andeanof1s.e.. Bwym(a
Signature of Sales Person Signature Signature
Bruce Peck Susan Thurman Leonard Thurman
Print Name of Sales Person Print Name Print Name
UPDATED. 03126/18 Page 2120
Re_nJewal Itemized Order Receipt
�N Memn' Aw Reoee d by And—of Bonoo Suzan R L o.el Thurman
Legal Name'.Renewal by Andersen me 43 Drewsen Dr
HIC#170810 Florence,MA 01062
.ns.r .. ucrrar 30 Forbes Road I Northborough,MA 01532 H,4135861078
Phone'.508-35182WI Fax:(508)986-70221 rbabostonOgmail con,
rO: R00Nl DETAILS
101102V Window: Gliding, Double, 1'.1, Active/Passive, EJ Frame,
Brickmould/ Traditional, Exterior Canvas, Interior Canvas,
Glass: All Sash. High Performance SmartSun Glass, No Pattern,
Tempered Glass, Hardware: Canvas, Screen: Fiberglass, Full
Screen, Grille Style: Grilles Between Glass USBG), Grille
Pattern: All Sash. Prairie, Mise None
103 LW Window: Double-Hung, Equal, Full Frame, Traditional
Checkrall, Brickmould / Traditional, Exterior Canvas, Interior
Canvas, Glass: All Sash: High Performance SmartSun Glass, No
Pattern, Hardware: Canvas, Screen: Fiberglass, Full Screen,
Grille Style: Grilles Between Glass (GBG), Grille Pattern: All
Sash Praine, Mise None
104 105i Window: Gliding, Double, 1:1, Active/ Passive, Base Frame,
Bnckrnould /Traditional, Extecor Canvas, mtenor Canvas,
Glass: All Sash'. High Performance Smad$uo Glass, No Pattern,
Hardware: Canvas, Screen: TruScene with Exterior Color
Match, Pull Screen, Grille Style: Grilles Between Glass (GBG},
Grille Pattern: All Sash. Prairie, Mise None
10411 Mise. Mec - Bampovt Frame, 12 ' bump, Maple natural
frame_ Ranch natural cases interior. Gable shingle roof_
106 Kit Patio Door: Gliding, 200 Series Perma-Shield, 2 Panel, Active/
Stat*cnary, Exterior Canvas, Interior Canvas, Glass: All Sash:
Tempered High Peri. SmartSun Glass, Hardware:Tribeca®,
Slone, Exterior Keyed Lock, Auxiliary Foot Lock Color Matched,
Screen: Gliding, Grille Style: Grilles Between Glass (GBG),
Grille Pattern: All Sash: Prairie, Mise None
UPDATED 03/26/18 Page 3 / 20
RenJenewal Itemized Order Receipt
�N_we ' d6e:Rmewil by Andersen ii Boston Susan IS Leonard Thurman
Legal Name:Renewal by Andersen LLC 43 Dreween Dr
HIC#170810 Florence.MA 01062
neam xaea ae 30 Forbes Road I Northborough,MA 01532 H.4135861078
Phone.508-351-22001 Fax.(508)986-7072 1 rbaboston0gre i xom
a . ROOM DETAILS
10710Yd1 Window: Gliding, Double, 11, Active/Paselve, EJ Frame,
Brickmould /Traditional, Exterior Canvas, Interior Canvas,
Glass: All Sash: High Performance SmartSun Glass, No Pattern,
Hardware: Camas, Screen: Fiberglass, Full Screen, Grille
Style: Grilles Between Glass (GBG), Grille Pattern: All Sash.
Prairie, Mise None
109 8ed2 Window: Double-Hung, Equal, Full-Frame, 'traditional
Checkrad, Brickmould/Traditional, Exterior Canvas, Interior
Canvas, Glass: All Sash. High Performance SmartSun Glass, No
Patten, Hardware: Canvas, Screen: Fiberglass, Pull Screen,
Grille Style: Grilles Between Glass (GBG), Grille Pattern: All
Sash. Prairie, Mise None
110 Hall Window: Double-Hung, Equal, Full Frame, Traditional
Checkor, Bnckmowd /Traditional, Exterior Canvas, Interior
Canvas, Glass:All Sash High Performance SmartSun Glass, No
Pattern, Tempered Glass, Hardware: Canvas, Screen:
Fiberglass, Full Screen, Grille Style: Grilles Between Glass
(GBG), Grille Pattern: All Sash_ Prairie, Miss: None
201 Hall Window: Double-Hung, Equal, Full-Frame, Traditional
Checkrad, Brickmould/Traditional. Exterior Canvas. Interior
Canvas, Glass: All Sash: High Performance SmartSun Glass, No
Pattern, Hardware: Canvas, Screen: Fiberglass, Full Screen,
Grille Style: Grilles Between Glass (GBG), Grille Pattern: All
Sash: Prame, Misc None
UPDATED. 03/26/18 Page 4 1 20
Re�_neWal Itemized Order Receipt
`yA &rsen' tibia Renal by Andersen of Boston Susan IS Leonard Thurman
Legal Name.Penewal by Andersen LLC 43 Drewsen Dr
Hill170810 eceamr,MA 01062
.0.2 uceaexr 30 Forbes Read I Northborough,MA 01532 H.4135861078
Phone:508-351-22M I Fax:(508)986 7072 1 rbaboston0gmaiLcore
Mil ROOK DETAILS
202 Bath Window: Double Hung, Equal, Full-Frame, Traditional
Checkrail, Brickmould /Traditional, Exterior Canvas, Interior
Canvas, Glass: All Sash. High Performance SmdrtSlln Glass,
Obscure, Tempered Glass, Hardware: Canvas, Screen:
Fiberglass, Full Screen, Grille Style: Grilles Between Glass
(GBG), Grille Pattern: All Sash: Prairie, Mise None
203 Bed2 Window: Double Hung, Equal, Full-Frame, Traditional
Checkrail, Brickmould /Traditional, Exterior Canvas, Interior
Canvas, Glass: All Sash'. High Performance SmartSur Glass,
Obscure, Hardware: Canvas, Screen: Fiberglass, Full Screen,
Grille Style: Grilles Between Glass(GBG), Grille Pattern: All
Sash: Praire, Mise None
204 Bed2 Window: Double Hung, Equal, Full-Frame, Traditional
Checkrail, Bnckuri /Traditional, Exterior Canvas, Interior
Caevas, Glass: All Sash- High Performance SmertSun Glass,
Obscure, Hardware:Canvas, Screen: Fiberglass, Full Screen,
Grille Style: Grilles Between Glass(GBG), Grille Pattern: All
Sash: Prairie, Mise None
205 Bed2 Window: Double Hung, Equal, Full-Frame, Traditional
Checkrail, Brickmould /Traditional, Exterior Canvas, Interior
Canvas, Glass: All Sash. High Performance SmartSun Glass,
Obscure, Hardware: Canvas, Screen: Fiberglass, Full Screen,
Grille Style: Grilles Between Glass (GBG), Grille Pattern: All
Sash. Prairie, Mise None
WINDOWS:11 PATIO DOORS:1 SPECII 0 MISC:1 TOTAL $30,712
-�, Renewal by Andersen is committed to our curtomeri safety by
-� complying with the rules and lead.safe work practicer specified by the EPA.
UPDATED'. 03/26/18 Page 5 / 20