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04-009 (8) BP-2023-0640 702 KENNEDY RD COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 04-009-001 CITY OF NORTHAMPTON Permit: Exterior Res PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit # BP-2023-0640 PERMISSION IS HEREBY GRANTED TO: Project# WINDOWS 2023 Contractor: License: Est. Cost: 31747 RENEWAL BY ANDERSEN 090125 Const.Class: Exp.Date: 10/06/2024 Use Group: Owner: H GRIMM A RONALD &MARY Lot Size (sq.ft.) Zoning: WSP Applicant: RENEWAL BY ANDERSEN Applicant Address Phone: Insurance: 30 FORBES RD 508-351-227 MWC31415822 NORTHBOROUGH, MA 01532 ISSUED ON: 05/16/2023 TO PERFORM THE FOLLOWING WORK: REPLACEMENT WINDOWS 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: Final: Final: Final: Rough Frame: Gas: Fire Department ' Driveway Final: Fireplace/Chimney: Rough: Oil: Insulation: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: V" • yg . TAIT Fees Paid: $40.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner ri7 1)1./J;(53-e_ - (V cL l cM + t-k C 11. IL, The Commonwealth of Massachusetts MAY 1 $ f Board of Building Regulations and Standards r' � FOR Massachusetts State BuildingCode, 780 CMR' MUNICIPALITY t oFr�u �.._._. USE' Building Permit Application To Construct,Repair,Renovate Orn tldiish. 'J0'- fgdMar 2011 One-or Two-Family Dwelling ThAs Section For Official Use Only Building Permit Number: IV'a'5 " i 4V Date Applied: /6-1APAJ / oys ./ /Z 5 I G-2023 Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Property Andress: /� 1.2 Assessors Map&Parcel Numbers L Y1nei9 R °`cci St 1.la Is this an accepted street?yes .1/no 4"46 3, Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) 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: 1.8 Sewage Disposal System: Public 0 Private 0 Zone: — Outside Flood Zone? Municipal 0 On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 wner'of Record:, co / f O4 L(GS Q ritel Cc fl Namey(Print) City,State,ZIPZI Z� /� O/�1Sj mil"Z ken►neJ Rd 0? . 57 V 3.9J3 grIMM.ron( i is I, coM No.and Street Telephone 9 Email Addr�ss SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building 0 Owner-Occupied 0 Repairs(s) [0' Alteration(s) 0 Addition 0 Demolition 0 Accessory Bldg. 0 Number of Units Other Specify:ter/4e.4x of i 'Ld..• Bn f Description of Proposed / Work`G � 1 1 s p a—i elire I vr✓1CJ6 4IS k' v/ / w,/k ,,,a/d l v S . �TION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ 1. Building Permit Fee: $ Indicate how fee is determined: 31 / 0 Standard City/Town Application Fee 2.Electrical $ 0 Total Project Cost3(Item 6)x multiplier x 3. Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5. Mechanical (Fire $ Suppression) Total All Fees: If LIA Check No.'A 3Qheck Amount: 7 a Cash Amount: 6.Total Project Cost: $ 3) � 0 Paid in Full 0 Outstanding Balance Due: , SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) 'o/Z S 0 6 ?i y Q)A e, Morin License Number Ex ati Date Name of CSL Holder ��c 30 -rbS d List CSL Type(see below) J No.and Street Type Description A nc) (Q " 1 J a t \ ,IAn n J S3 Z U Unrestricted(Buildings up to 35,000 cu.ft.) 11Y � Restricted I&2 Family Dwelling City/Town,State,ZIP M Masonry R Roofing Covering S Window and Siding Q SF Solid Fuel Burning Appliances - 152- Y112 rc�e bh Q S �1�_ J I Insulation Telephone ail address 4)r�, D Demolition 5.2 Registered Home Improvement Contractor�y� (HIC) fivioJe• ?4_ L-LG HIC Registration Number Expiration Date HI Company Name orHRee istrant Name �� r S K rL(1P.We.Q 6 ar -rWo 0 iet"a TSi 0 N j(,�6 ` ,,,A* 0/63� —P _ Ce//Z Email address City/Town, State,ZIP Telephone SECTION 6: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 f the building permit. Signed Affidavit Attached? Yes ... No........... ❑ SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,as Owner of the subject property,hereby authorize 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, I hereby attest under the pains and penalties of perjury that all of the information contained in this application is true and accu to the best of my knowledge and understanding. (tat ,LrreVikkrJ(Print Owner's or Authorized Agent's Name(Electro igna( ;ps') Date NOTES: 1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration program or guaranty fund under M.G.L.c. 142A. Other important information on the HIC Program can be found at www.mass.gov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dps 2. When substantial work is planned,provide the information below: Total floor 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 half/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" City of Northampton Massachusetts �$elL'. 0. 14-4Nik � art i wD. F * `cZ C t N � DEPARTMENT OF BUILDING INSPECTIONS tjZ° 212 Main Street • Municipal Building yvy., ,{'►� --��� Northampton, MA 01060 f' "' 4� i CONSTRUCTION DEBRIS AFFIDAVIT (FOR ALL DEMOLITION AND RENOVATION PROJECTS) In accordance of the provisions of MGL c 40, S54, a condition of Building Permit Number is that all 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 disposed of in: m ern ri Location of Facility: 3o Fp s Rd //h be o`` D4 A 015-3 2- 16, Mall-a-rAll`AilL_Pt-(A/LjL The debris will be transported by: 60a_3 Name of Hauler: ( 1Cc.t/l �5 � L.-02/v Signature of Applicant: Date: C—lZ-)3 IN The Commonwealth of,liassachusetts Department of Industrial Accidents d '" Office of Investigations � Lafayette City Center ;X 2 avenue de Lafayette, Boston,MA 02111-1754 www.mass.go►/dia Workers'('ompensation Insurance Affidavit: Builders/Contractors/Electricians:Plumbers Applicant information Please Print Leg ihlt Renewal by Andersen Name (I3uainesst{)rganization lndiyr duo I): Address: 30 Forbes Rd. City/State/Zip:N©rthbor©ugh, MA 01532 Phone #:508-351-2277 Are you an emplm re:' ( heck the appropriate trot: 1}pr of project(required): 1.►.e i am a employer with 3Q 4 ❑ I am a general contractor and 1 employees(toll and/or pan-time).• have hired the sub-contractors h. ©New construction 2.0 I am a sole proprietor or partner- listed on the attached sheet, ?. ❑Remodeling ship and have no employees These sub-contractors have Z; ❑Demolition working for me in any capacity. employees and have workers' p ty. y. 0 Building addition [No workers' comp. insurance comp. insurance_; required.) 5. D We are a corporation and its I o.[I Electrical repairs or additions 3.D I am a homeowner doing all work officers have exercised then 11.0 Plumbing repairs or additions myself. [No workers'corny. right of exemption per M(iL 1 ❑Roof repairs insurance required.)t c. 152,p 1(4),and we have no Replacement employees. [No workers` 13.�(kher comp. insurance required_) 'Any applicant that checks buy 4,I must also fill out the section bduw slowing their workers'compensation policy information. t tia neomrtxx who submit this affidavit indicating they ate doing all work and then hire outsideenntractors must submit a new attidata indiiAiting such.. 'Conttaaora that check this bus must attached an additional sheet showing the tame of the sub-cuntractois and state gilled ler or not those entities base ca ipl.*cc,,. If the sub-Cattractoes has c cntployc`s.they must pro's idc their wallas'comp.policy number. I erne on employer that is providing worker'compensation insurance for my employees. Below is the policy and lob site information. Insurance Company Name: Old Republic Insurance Co. Policy tf or Self ins.Lie.#: MWJ(C 314158 22 Expiration Date:10/�01/202n3n Job SiteAddtc.. �Z ile/1)f'A V 'D�L� City/StateiLbp AfedS ,Jtil0 6!0s3 Attach a Copy of ire msrken'contlxensatitn pulie+ declaration page(showing the polio► moonier and cspiratiun date). Failure to secure coverage as required under Section 25A of M(iL e. 152 can load to the rntpt,sallow%of criminal penalties of a fine up to Sl.50O.00 and or one-year tmpri onrnent,as well as civil penalties in the form of a 5T()P HY)KK()KI)LR and a fine of up to S250.O0 a day a,ainst the s iolator. Be advised that a copy of this statement may he tivrv.arded to the Office of Investigations of the 1)1 \ for insurance coverage verification. I do hereby certify under the pains meipeaabks*primly fiber the information prowdld above is true and correct. Ss nature: nc. 11" 2Id - 1).t1, 03j31/23 w —Ph n # 9S Z Y//v �___T_ Official use only.. Do nor write in this area,to he completed ht.cite or town official City or John: Pernritl.iccnse # Issuing.%uthorits (check(ne): 10Boartf of Health ZE Ku /din Ituildin2 Department 3D'it)/Iowa Clerk 4.13Electrical Inspector 51:31umbiag Inspector 6.[DOther contact Person: Phone#: 5RENEWAL �� brANDERSEN / JF FULL SERVICE WINDOW d DOOR REPLACEMENT Re: Massachusetts Solid Waste Affidavit Good day, Please find attached location where the installers will bring their debris from the jobs.These are all Renewal by Andersen location. • WASTE MANAGEMENT—30 FORBES RD, NORTHBOROUGH, MA 01532 When filling out any solid waste affidavit, it's the installer whom will be removing the garbage and dumping the trash at the Renewal by Andersen dumpster locations closest to that job. Thank you, Go Permits RENEWAL BY ANDERSEN SPECIFICATION&TECHNICAL MANUAL i" l N I 11.11'.)1 \"` ), PERFORMANCE RATINGS AND TEST DATA NFRC Total Unit Performance .. &fir, 0-Factor Renewal kyAndersen° HighPertdrmanceGlassType (BTII!(hift2OFl) n � Product Air HP Gas Blend -'' 'Air ` ias:,end Without Grilles 0.42 0.41 0.51 0.51 .82 Clear Full Divided Light Grilles 0.43 0.41 0.46 0.46 Without Grilles 0.31 0.28 0.28 0.27 .72 LOW-E4e rmiUNIUPU uynr urines o.ac u.ca u.cs 0.25 Casement Without Grilles 0.32 0.29 0.17 0.17 .40 a Low-f4a Sun Fixed Full Divided Light Grilles 0.33 0.30 0.16 0.15 Without Grilles 0.31 0.28 0.19 0.18 .65 Cow-Eel SmertSun'� Full Dividetl Light Grilles 0.32 C.0.21...) 0.17 0.17 Low E4,a SmartSun Without Grilles 0.26 0.24 0.18 0.18 .63 with Heatlock'M Full Divided Light Grilles 0.26 0.24 0.17 0.16 Without Grilles 0.43 0.41 0.51 0.51 .82 Clear Full Divided Light Grilles 0.43 0.41 0.46 0.46 Without Grilles 0.31 0.28 0.28 0.27 .72 Low-E0 Full Divided Light Grilles 0.32 0.29 0.25 0.25 Without Grilles 0.32 0.29 0.17 0.17 .40 Awning Low-E0 Sun Full Divided Light Grilles 0.33 0.30 0.16 0.15 Without Grilles 0.31 0.28 0.19 0.18 .65 low-Ee SmartSun'M Full Divided Light Grilles 0.32 0.29 0.17 0.17 Low-E0 SmartSun Without Grilles 0.27 0.25 0.18 0.18 .63 with Heatlock'M Full Divided Light Grilles 0.27 0.25 0.17 0.16 Without Grilles 0.46 - 0.58 - .82 Clear Full Divided Light Grilles 0.46 0.52 - Without Grilles 0.33 0.30 0.31 0.31 .72 Low-E0 Full Divided Light Grilles 0.34 0.31 0.28 0.28 Double-Hung DG Without Grilles 0.33 0.30 0.20 0.19 .40 1 (All Frames) low-E0 Sun Full Divided Light Grilles 0.35 0.31 0.18 0.17 Without Grilles 0.32 0.29 0.21 0.21 .65 Cow-E4Q Smartsunr"., Full Divided light Grilles 0.34 0.30 0.19 0.19 bwfillaiikiwelt.. Withruit rrimlas n 27 . (125 ❑2(1 n 2(k q4 1 with HeatlockrM Full Divided Light Grilles 0.30 0.27 0.18 0.18 09-9 COMPANY CONFIDENTIAL-REVISION AA-01 RENEWAL BY ANDERSEN SPECIFICATION Et TECHNICAL MANUAL "I'L'C'I II 'C/11.'JF'1,:.„iATTiC)H PERFORMANCE RATINGS A:ND TEST DATA NFRC Total Unit Performance ' 0fact. Renewal by Andersen' High Performance Glass Type (BTUt(hi f Product Air Without Grilles 0.42 0.41 0.51 0.51 .82 Clear Full Divided Light Grilles 0.43 0.41 0.46 0.46 Without Grilles 0.31 0.28 0.28 0.27 .72 Low-E0 Full Divided Light Grilles 0.32 0.29 0.25 0.25 Casement Without Grilles 0.32 0.29 0.17 0.17 .40 & Low-Eir Sun Fixed Full Divided Light Grilles 0.33 0.30 0.16 0.15 Without Grilles 0.31 0.28 0.19 0.18 .65 Low-E46 SmartSun"" Full Divided Light Grilles 0.32 0.29 0.17 0.17 Low-E4v SmartSun Without Grilles 0.26 0.24 0.18 0.18 .63 with Heatlock'" Full Divided Light Grilles 0.26 0.24 0.17 0.16 Without Grilles 0.43 0.41 0.51 0.51 .82 Clear Full Divided Light Grilles 0.43 0.41 0.46 0.46 Without Grilles 0.31 0.28 0.28 0.27 .72 inw-Fe f Full Divided Light Grilles 0.32 0.29 25 0.25 ( Without Grilles 0.32 0.29 0 7 0.17 .40 Awning Low-E4e Sun Full Divided Light Grilles 0.33 0.30 0 0.15 thout Grille 0.31 0.28 0 0.18 .65 low-EC SmartSunTM - Full Divided Light Grilles 0.32 0.29 0 0.17 \„.. Low-E0 SmartSun Without Grilles 0.27 0.25 .8 0.18 .63 with HeatLocV Full Divided Light Grilles 0.27 0.25 0.17 0.16 Without Grilles 0.46 - 0.58 - .82 Clear Full Divided Light Grilles 0.46 - 0.52 - Without Grilles 0.33 0.30 0.31 0.31 .72 Low-E0 Full Divided Light Grilles 0.34 0.31 0.28 0.28 Double-Hung 06 Without Grilles 0.33 0.30 0.20 0.19 .40 (All Frames) Low-Ee Sun Full Divided Light Grilles 0.35 0.31 0.18 0.17 Without Grilles 0.32 0.29 0.21 0.21 .65 Low-E4®SmartSun'" Full Divided Light Grilles 0.34 0.30 0.19 0.19 Low-E4v SmartSun Without Grilles 0.27 0.25 0.20 0.20 .63 with HeatLockm Full Divided Light Grilles 0.30 0.27 0.18 0.18 09-9 COMPANY CONFIDENTIAL-REVISION AA-01 AsN°' �rrAgreement Document and Payment Terms 40 Il DBA:RENEWAL BY ANDERSEN OF BOSTON Ronald Grimm RENEWAL Legal Name:Renewal by Andersen LLC 702 Kennedy Road HIC#170810 Leeds,MA 01053 byANDERSEN 30 Forbes Road I Northborough,MA 01532 H:(413)584-3753 Phone:(508)351-2200(Fax:(508)986-7072 I rbaboston@gmail.com C:(207)210-5876 Ronald Grimm 05/02/23 BUYER(S)NAME CONTRACT DATE (02 Kennedy Road, Leeds, MA 01053 (413)584-3753 (207)210-5876 BUYER(S)STREET ADDRESS PRIMARY NUMBER SECONDARY NUMBER grimm.ronnmail.com PRIMARY EMAIL SECONDARY EMAIL NOTES: 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 the Table of Contents,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 Agreement. TOTAL JOB AMOUNT: $31,747 By signing this Agreement,you acknowledge that the Balance Due,and the Amount Financed must be made by personal check,bank check,credit card,or cash. DEPOSIT RECEIVED: $0 BALANCE DUE: $31,747 Estimated Start: Estimated Completion: 12-16 Weeks 2-3 Days AMOUNT FINANCED: $31,747 We schedule installations based on the date of the signed contract and secondarily on the date METHOD OF PAYMENT: Financing 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 date and time at a later date.Rain and extreme weather are the most common causes for delay. NOTES: 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 orideviations from this Agreement will be valid without the signed,written consent of both the 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. 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 05/05/2023 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. c9,---,x,o_ P\00'- , SIGNATURE OF SALES PERSON SIGNATURE SIGNATURE Jesse Kaminski Ronald Grimm PRINT NAME OF SALES PERSON PRINT NAME PRINT NAME i 05/02/23 Page 2/ 27 . GC. Itemized Order Receipt 40, DBA:RENEWAL BY ANDERSEN OF BOSTON Ronald Grimm RENEWAL Legal Name:Renewal by Andersen LLC 702 Kennedy Road ENL HIC#170810 Leeds,MA 01053 30 Forbes Road I Northborough,MA 01532 H:(413)584-3753 ,X.SEI is wumo`LOW RIW&IM Phone:(508)351-2200 I Fax:(508)986-7072 I rbaboston@gmail.com C:(207)210-5876 ID#: ROOM: SIZE: DETAILS: PRICE: 101 Sunroom Window Casement Fixed W ndow Base Frame. Exterior Dark Bronze, Interior Pine. Performance Calculator PG Rating: 4011 DP Rating: + 40 / - 40 Glass, All Sash: High Performance SmartSun Glass, No Patten, Grille Style, No Grille. Misc, Standard, Replacement of window frame and sash, includes casing from standard options., Remove and Replace/ Reinstall Wood/Composite Siding. Remove wood/composite' siding and replace/reinstall. 102 Sunroom Window Casement Fixed Window Base Frame, Exterior Dark Bronze, Interior Pine, Performance Calculator PG Rating: 40 DP Rating: + 40 / - 40 Glass, All Sash: High Performance SmartSun Glass, No Patten, Grille Style, No Grille. Misc, Standard. Replacement of window frame and sash, includes casing from standard options., Remove and Replace/ Reinstall Wood/Composite Siding, Remove wood/composite siding and replace/reinstall. 103 Sunroom Specialty Trapezoid Left Full Frame. EJ Frame, Exterior Dark Bronze. Interior Pine, Performance Calculator PG Rating: 50 DP Rating: + 50 / - 50 Glass,All Sash: High Performance SmartSun Glass, No Pattern. Grille Style, No Grille, Misc, Mulled Unit. Replacement of window frame and sash, mulled to other units. 104 Sunroom Window Casement Single Left. Base Frame, Exterior Dark Bronze, Interior Pine, Performance Calculator PG Rating: 40 1 DP Rating: + 40 / -40 Glass, All Sash: High Performance SmartSun Glass. No Pattern, Hardware, Stone. Screen, Fiberglass. Full Screen, Grille Style, No Grille. Misc, Mulled Unit, Replacement of window frame and sash. mulled to other units. 105 Sunroom Specialty Trapezoid Left FL II Frame, EJ Frame, Exterior Dark Bronze, Interior Pine, Performance Calculator 05/02/23 Page 3/ 27 ' C= Itemized Order Receipt DBA:RENEWAL BY ANDERSEN OF BOSTON Ronald Grimm RENEWAL Legal Name:Renewal by Andersen LLC 702 Kennedy Road HIC#170810 Leeds,MA 01053 by ANDERSEN 30 Forbes Road I Northborough,MA 01532 H:(413)584-3753 .H.411':: 10.6 C,Ve Y.RCgDe Phone:(508)351-2200 I Fax:(508)986-7072 I rbaboston@gmail.com C:(207)210-5876 ID#: ROOM: SIZE: DETAILS: PRICE: PG Rating: 50 ( DP Rating: + 50/ - 50 Glass, All Sash: High Performance SmartSun Glass, No Pattern, Grille Style, No Grille, Misc, Mulled Unit, Replacement of window frame and sash, mulled to other units. 901 Basement Living Window Awning Base Frame, Exterior Terratone, Interior White. Performance Calculator PG Rating: 40 I DP Rating: -+' 40 / -40 Glass, All Sash: High Performance SmartSun Glass, No Pattern, Hardware,White, Screen, Fiberglass, Full Screen, Grille Style, No Grille, Mist, Standard. Replacement of window frame and sash. includes casing from standard options., Remove and Replace/Reinstall Wood/Composite Siding, Remove wood/composite siding and replace/reinstall. 902 Basement Living Window Awning Base Frame, Exterior Terratone, Interior White, Performance Calculator PG Rating: 40 I DP Rating: + 40 / - 40 Glass, All Sash: -ligh Performance SmartSun Glass, No Pattern. Hardware,White,Screen, Fiberglass. Full Screen, Grille Style, No Grille, Misc, Mulled Unit, Replacement of window frame and sash, mulled to other units. ' Window AwningBase Frame, Exterior Terratone,Basement Living Interior White. Performance Calculator PG Rating: 40 I DP Rating: + 40 / - 40 Glass, All Sash: High Performance SmartSun Glass, No Pattern, Hardware,Whi•.e,Screen, Fiberglass, Full Screen, Grille Style, No Grille, Misc, Standard. Replacement of window frame and sash, includes casing from standard options., Remove and Rep ace/Reinstall Wood/Composite Siding, Remove wood/composite siding and replace/reinstall. ---_ ______________ 05/02/23 Page 4/ 27 4*4/11111 Itemized Order Receipt / DBA:RENEWAL BY ANDERSEN OF BOSTON Ronald Grimm RENEWAL Legal Name: Renewal by Andersen LLC 702 Kennedy Road HIC#170810 Leeds,MA 01053 byANDERSEN xKKp 30 Forbes Road I Northborough,MA 01532 H:(413)584-3753 Phone:(508)351-2200 I Fax:(508)986-7072 I rbaboston@gmail.com C:(207)210-5876 ID#: ROOM: SIZE: DETAILS: PRICE: 904 Basement Living Window Awning Base Frame, Exterior Terratone, Interior White. Performance Calculator PG Rating: 40 DP Rating: + 40 / - 40 Glass. All Sash: High Performance SmartSun Glass, No Pattern, Hardware, White. Screen. Fiberglass, Full Screen, Grille Style. No Grille, Misc. Mulled Unit, Replacement of window frame and sash. mulled to other units. WINDOWS: 7 PATIO DOORS: 0 ENTRY DOORS: 0 SPECIALTY: 2 MISC: 0 TOTAL $31,747 RfiFcommitted to our customers' et Renewal by Andersen is roan ntt ed o safety by 120 ctf r ra complying with the rules and lead-.safe work practices specified by the EPA. 05/02/23 Page 5/ 27 Go Permits, LLC 113 105 Buttonball Lane 11111 Glastonbury, CT 06033 PERRMI%S ` Scott Doughman Phone: 860-952-4112 Fax: 860-430-6719 scottdoughman@gopermits.org Re: Building Permit Application - Licenses Good day, Please find attached permit application, licenses and supporting documents. Renewal by Andersen sold the job and is the G.C. and CSL - CSL #CS-090125 -- Exp. 10/06/24 - HIC #170810 -- Exp 12/22/23 - Workers Comp -#MWC 3145822 — Exp. 10/01/23 Old Republic Insurance Co All licenses and insurances are attached. Once the permit is ready: • Please fax or e-mail a copy of the permit and receipt to the below address and mail the original to the homeowner: Fax: 860-430-6719 Email: renewalbyandersent gopermits.org • If you unable to mail the permit to the homeowner please send to the below address and we will ensure the permit is at the home posted at the time of installation: Go Permits, LLC 105 Buttonball Lane Glastonbury, CT 06033 If we are required to pick up the permit in at the building department, please call 860-952- 4112 once it's ready and we will come to get it. Thank you, Go Permits rags 1 of 1 ACC3)R' CERTIFICATE OF LIABILITY INSURANCE DATE `�01NYV V' Ass.--- D9/22/202z 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,MO THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the polcyllea)must have ADDITIONAL INSURED provisions or 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). PROOUCER MMTACT FL111s Towers Watson Cos tlf1 cats Contsr VL11as S wrss rL a Midswat, 3ne. PHONEEwa 1-077-945-717S 1f N , 1-888-467-2378 It Ye25 c.,t.xsy Blvd Tillik ,0. boa 301141 Aorems onrtlfl.CatasPw1111.a cow Mashva11w. IV 312305191 USA. insuael{81AFFOROe10 CONERAOE NAM NSUNERA. Old 9aepubtic Insurance Company 2 414 7 ReSUIEEO INSURER: aanwal by Aauisssea I.S.0 30 rorbss Arid N MISER C. - _ _ wsr tbbasaog6, ak 0::532 ASSURER 0. N5U ERE INSURER F COVERAGES CERTIFICATE NUMBER:■26007631 REVISION NUMBER. -HIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR PIE POLICY PERIOD INDICATED. NOTYIIT+IS€AIDING ANY REQUIREMENT.TERM OP.CONDITION or MY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED CR 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[-PA MAIMSNSA ADOLISLISIU . Tr/E OFat♦tmAOCE POLICr NUWBEdtL. MLfOlrr'1 i "c , "NITS '�"�X CQ�bCW.dE#EaAL.LMA3l 1V EACH OCCURRENCE 1 2,000,000 I c1AlYaait.. p ncs-tat Urweluc t e ocnsr 500,000 P ssabia lE4 owart4naal 1 H-.� LIED En,ANanpasoni 1 10,000 t152T 314161 22 10/01/2022 10/01/2023 PERB:JNALA ADVINaIR', 1 2,000,000 GENT.AGGREGATE LAST NWAtE 5 FEB GENERAL AGGRECA TE 5 4.000.000 RX POLICYPPR6flL : PRODUCTS f_C4AR JF AGa:i S 4,000.000 OTHER _ 1 AUTOMOSILELIAINLITY COMBINED SINGLE LIM' S 5 000,000 Ora wsmAsi X ANY AUTD BODILY INJURY'{Per meson. 4 A ONTIE:9 -SC.- OLL.L t awns 314159 22 10/01/2022 10/01/2023 BODILY INJURY{Pei 444102n0 I HIRED AUTOS ONLY "� NON-OWNED PRQEER7w DMAAGE ,. AUTOS ONLY AUTOS ON.Y toss amlcnh I UMBRELLA LIAR OCCUR E:.son Cr::Cuo.o.NCE I EXCESS LLAO Cl.ASASMADF ADORE::1A,ATF I :Er. I 1 001TES-ON$ I WOiKKERS'COMPENSATIOR PER H. AND EMPLOYERS'LLA81UTY Y N a,..XSTATUTE I �L-OR • 1.000.000A p,t ptigPA2EUeutilm:NOSECUTIY INuttoN A WIC 314156 22 10/01/2022 10.11 j2023ElEACHACC0ENT IMandatary in tat a E L DISEASE-FA E3pLOYFE I 1,COO,000 I,'1"', -"os mne. 1 1.000.000 DES CRIPTOIN OF OPERATIONS Barer $ ,El,OiSFAAF.POLICY LIMIT I 9 i OESCRIPTCON OF OPERATIONS,'LOCATIONS'WE*IYCLES IACORO 141..AMfttwwsA ammarhs SsAurAAL,mitt be marched:Noble spats.4 r.qusea1 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. AUTHORIZE:,R£PRE5EITATNE 44 Evidence of Insurance T;! , om`" W'1988-201S AGGRO CORPORATION. AM nghts reserved. ACORD 25(201E.103) The ACORD name and logo are registered marks of ACORD its II 23076070 111,..ti 261f 324 1 0 Commonwealth of Massachusetts Division of Occupational Licensure Construction Supervisor Unrestricted-Suidlinpli otarry toso group whictt confab Board of Budding Regulations and Standards less than 35,000 cubic test MI cubic meters)of enctosed "its S tkfottlVri tS‘if;rri i sor 1411505 CS-090125 Espires 1010612024 JAIME L MORIN .._, 54 NOTTINGHAM RD -:-.RAYMOND NM 03077 '0/%0/4113 Failure to posses*a car adNioa al Ih•likassachusetis ff FAii,...b.:1 Slate Suilding Code is cane for revocation of this license Fof inforamstion about*is limn= Caill(VT)77741ne er vise warweiass oowcipt THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs and Business Regulation toot)Washington Street- Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration Type Supplement Card RENEWAL BY ANDERSF N LLC ration 12/2252023 30 FORBES RD NOE1THBOROUGH MA 01532 .1;,-,. ,N.i:!4 ,, •'14„."'F' \11;,•,s• '''.7=12-94VE" ' '\-• < itodoto Acktrato and Return Card. THE COMMONWEALTH OF MA55ACHUSE1 TS Office of Consumer Affairs&Business Regulation Registration valid for individual use only bc4ore ins HOME IMPROVEMENT CONTRACTOR owl,.wh,sn dw. if found return to: TYPE,burvitenem r....vd OrfIce of Con curlier Affairs and&minims Restulatkon R000,0911 EP174rigtOD IOW WasOington Strout -51,10*710 1701110 1262.;0..1 Hustoe,MA 02110 RENEWAL 11T ANDERSEN LLC •,.../-*''--- --za.2 „(...__ JAIME OADRIN 34 FORBES RD NORTHBOROUGH,MA 01532 Undersecrelary ..0"-- Plot lid without signature r-T-7 RENEWAL - bYANDERSEN Fittiewsr;wt4w, if- I Of Ta V,inom it May Concern: This letter will autrinnze the following oirsorils) to act as agent(sl on behalf of Renewal by Andersen LIC, 9900 Jamaica Ave Soutn, Cottage Grove MN 55016 to pull for per and inspections with respect to the installation, maintenance and repair of windows and entry rnrr meim iviAcca.chi mots State.i-iome Amprevernent Contractor license number 170810 and Construction Supervisor License number CS-090125. If you have,3ny questions,please call rrie at 508,351-2277 et 6. Authorised bersori(si: Go Permits LLC Sarah Harriman David Anderion Maureen Kivet Scott Doughman Ryan Boncto Soyannara Kioy Mark Foster l3iynn No rgan lermirer wir ke wency holden Gerald Cramer Nick Rago Dane\fkkermari Stephen Wilder Katie Grocott Bonnie Myers Carrie fokgrio Michael Rogers Rachel Orloff 7 415E4-,7M 71124k1.0 via mie Mo-in Penewal by Ancier‘en Lt.( HIC 170810 CSL—CS090125 Local District Office Address 30 Forbes Rd Northborough, MA 01532 r4enewal1wArdets.94 LA: Ved Jamaica Ayr!zeutt= Cnotwise Grave Mk S5016