Loading...
43-128 (9) 51 GREENLEAF DR BP-2021-1367 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 43- 128 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category. Door Replacement BUILDING PERMIT Permit# BP-2021-1367 Project# JS-2021-002259 Est. Cost: $8469.00 Fee: $35.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor: License: Use Group: RENEWAL BY ANDERSEN 170810 Lot Size(sq. ft.): 39813.84 Owner: SUN MEIPING Zoning: Applicant: RENEWAL BY ANDERSEN AT: 51 GREENLEAF DR Applicant Address: Phone: Insurance: 30 FORBES RD (508) 919-0900 Liability NORTHBOROMA01532 ISSUED ON: TO PERFORM THE FOLLOWING WORK:REPLACE 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: Oil: 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 5/24/2021 0:00:00 $35.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner n. N . �� c . C,..1 COThe Commonwealth of Massachusetts `` I I�UNI Board of Building Regulations and Standards FOR P r..1 / Massachusetts State Building Code,780 CMR CTPAI'ITY z • Building Permit Application To Construct,Repair,Renovate Or Demolish a Revised Mar 2011 One-or Two-Family Dwelling . This Section For Official Use Only Building ennit Number:e.p_2o2!..-17j(o 7 Date Applied: h I l B l20 21 EU l tv 1 2'5 3 1//i•-"- 5-20-262I Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers • • 51 Green Leaf Dr Florence Ma 01602 .43-128-001 1.1 a Is this an accepted street?yes no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: • _ LA)5 P 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 L 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❑ On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP1 ' 2.1 Owner'of Record: Mei Sun Northampton, MA 01060 Name(Print) City,State,ZIP 51 Green Leaf Dr Florence Ma 01602 413-230-7650 . ' No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction 0 Existing Building 0 Owner-Occupied 0 `Repairs(s) Cl Alteration(s) 0 Addition 0 Demolition Cl Accessory Bldg.0 Number of Units Other Xi Specify: RPpIar.emcnt Brief Description of Proposed Worke: replacement of 1 patio door • SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: (Labor and Materials) Official Use Only 1.Building $8 469.00 1. Building Permit Fee:$ . Indicate how fee is determined: 2.Electrical $ ❑Standard City/Town Application Fee - ❑Total Project Costa(Item 6)x multiplier x 3.Plumbing S -2. Other Fees: $ ,5l.c oi' • .4.Mechanical (HVAC) $ List: 5.Mechanical (Fire Suppression) $ Total All Fees:$ -j,5 aE' c‘, 8,469.00 CheckNoci6/8 Check Amount 56 "Cash Amount 6.Total Project Cost: $ NI Paid in Full icy o Outstanding Balance Due: • • • • •SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) Jaime Morin CS-090125 10/06/2022 • License Number Expiration Date - Name of CSL Holder 86 Gardiner St List CSL Type(see below) U.' No.and Street Type Description Lynn MA 01906 U Unrestricted(Buildings up to 35,000 cu.ft.) City/Town,State,ZIP R Restricted'l&2 Family Dwelling • M Masonry RC Roofing Covering • ' WS Window and Siding . . SF Solid Fuel.Burning Appliances • 508.351.2277 rbabostonpermitting©andersen.com 1 Insulation Telephone Email ad s D Demolition • 5.2 Registered Home Improvement Contractor(FRIC) Renewal by Andersen • 170810 1 7/22/7021 HIC Compan Name or HIC RegistrantName • MC Registration Number Expiration Date • 30 Forbes Rd rbabostonpermittinqaandersen.com No.and Street Email address Northborough, MA 01532 508.351.2277 • 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 of the building permit. Signed Affidavit Attached?' Yes No 0 • • • 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 Jaime Morin to act on my behalf,in all matters relative to work authorized by this building permit application. . Mei Sun ttia-il-C-F 5/14/2021 . Print Owner's Name(Electronic Signature) Date SECTION 7b:OWNER1 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 i e an ccurate to the best of my knowledge and understanding. . Jaime Morin 5/14/2021 Print Owner's or Authorized A t' e(Electronic Signature) 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 nor 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.fr.) • (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 t • 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 SETBACK PLAN _ LOT: _ • LOT SIZE: REAR LOT DIMENSION REAR YARD • SIDE YARD • SIDE YARD • • • FRONT:SETBACK d FRONTAGE I a�-0NAM?ro . The City of Northampton r Building Department f 2 : 212 Main Street - „ Northampton, Massachusetts 01060 • Phone(413) 529-1402 Fax (413) 529-1433 CONSTRUCTION DEBRIS AFFIDAVIT (FOR ALL DEMOLITION AND RENOVATION PROJECTS) In accordance with the provisions of MGL c40, 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: 4 Techology Dr Westborough MA 01581 Location of Facility_ ___ ____ ___ The debris will be transported by: • Name of Hauler Renewal by Andersen Signature of Applicant:_ ___ _ ___ ___ ___ _Date:_ 5/4/2021 • • • The Commonwealth of Massachusetts 41 Department of Industrial Accidents 1 Congress Street,Suite 100 Boston,MA 02114-2017 www.mass.gov/dia \\orkers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERNHTTING AUTHORITY. Applicant Information Please Print Laciblti Name(BusinessiOrganization/individual): Renewal by Andersen Address: 30 Forbes Rd City/State/Zip:Northborough, MA 01532 Phone#: 508.351.2277 Are you an employer?Check the appropriate box: Type of project(required): l.EX I am a employer with 30 employees(full and/or part-time).' 7. El New construction 2.0 I an:a sole proprietor or partnership and have no employees working for me in 8. Remodeling any capacity.[No workers'comp.insurance required.] 3.01 am a homeowner doing all work myself[No workers'comp.insurance required.]t 9• ❑Demolition 4.01 am a homeowner and will be hiring contractors to conduct all work on my property. I will 10 Building addition ensure that all contractors either bave workers'compensation insurance or are sole 11.0 Electrical repairs or additions proprietors with no employees. 12.0 Plumbing repairs or additions 5.1:2 I am a general contactor and I have hired the sub-contractors listed on the attached sheet 13.0 Roof repairs These sub-contractors have employees and have workers'comp.insurance.: 6.0Weamacorporation and its officers have exercised their rigirtof exemption per MGL c. 14. ]Other replacement 152,§1(4),and we have no employees.[No workers'comp.insurance required.] "Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the subcontractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. • I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Old Republic Insurance Co. Policy#or Self-ins.Lie.#: M W C 3145820 Expiration Date: 10/06/2021 • . Job Site Address: 51 Green Leaf Dr . City/State/Zip: Florence Ma 01602 Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c.152,§25A is a criminal violation ptnzishable 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$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby• fy un a pains and penalties of perjury that the information provided above is true and correct Signature: 4/ Date: 5/14/2021 Phone#: ' : 351.227-7 Official use only. Do not write In this area,to be completed by city or town official • City or Town; Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/I`own Clerk 4.Electrical Inspector 5.Plumbing Inspector • 6.Other Contact Person: Phone/I: • City. of Northampton • :'r' g•, Massachusetts is% • �';. t,; tf DEPARTMENT OF BUILDING INSPECTIONS ' 212 Main Street • Municipal Building �'iF )a Northampton, MA 01060 1j, 11. HOMEOWNERS'EXEMPTION ELIGIBILITY AE1•!1)AVIT I, - • .(insert full legal name), born _(insert month, day,year),hereby depose and state the following: • 1. I am seeking a building permit pursuant to the homeowners'exemption to the permit requirements of the Massachusetts State Building Code, codified at 780 CMR 110.R5.1.3.1, in connection with a project or • work on a parcel of land to which I hold legal title. 2. I am not engaged in, and the project or work far which I am seeking the aforementioned homeowners'. exemption, does not involve the field erection of manufactured,buildings constructed in accordance with 780 CMR 110.R3. 3. I qualifij under the State Building Code's definition of"homeowner"as defined at 780 CMR 110.R5.1.2: Person(s) who owns 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 structures. A person who constructs more than one home in a two-year period shall not be considered a home owner. 4. I do not hold a valid Massachusetts constr action supervision license and, except to the extent that I qualify for and will abide by the Massachusetts State Building Code's requirements for the supervision of the project or work on my parcel, I am not engaged in construction supervision in connection with any project or work involving construction, reconstruction, alteration, repair, removal or demolition involving any activity regulated by any provision of the Massachusetts State Building Code. 5. If I engage any other person or persons for hire in connection with the aforementioned project or work on my parcel,I acknowledge that I am required to and will act as the supervisor for said project or work. Signed under the pains and penalties of perjury on this day of ,20_ (Signature) x .µ Agreement Document and Payment Terms NI At: r--- 'Q# dba:Renewal by Andersen of Boston Mel Sun Legal Name:Renewal by Andersen LLC 51 Green leaf Dr RENEWAL HIC#170810 Florence,MA 01062 brANDERSEN 30 Forbes Road I Northborough,MA 01532 H:(413)230-7650 �uuv,xa noo„wa unru.n 9 , Phone:508-351-2200 I Fax:(508)986-7072 I rbabostonbooking@andersencorp.com Mei Sun 05/10/21 Buyer(s)Name Contract Date 51 Green leaf Dr, Florence, MA 01062 (413)230-7650 Buyer(s) Street Address Primary Telephone Number Secondary Telephone Number meipings@yahoo.com Primary Email 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 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: $8,469 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: $2,822 Balance Due: $5,647 Estimated Start: Estimated Completion: Amount Financed: S0 10-12 weeks 1-2 Days Method of Payment: Check We schedule installations based on the date of the signed contract 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 date and time at a later date. Rain and extreme weather are the most common causes for delay. Notes: $2,822 deposit; $2,823 start; $2,824 sub comp 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 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 05/13/2021 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. A—)25— Signature of Sales Person Signature Signature Steven Drury Mei Sun Print Name of Sales Person Print Name Print Name UPDATED: 05/10/21 Page 2 / 25 Itemized Order Receipt dba:Renewal by Andersen of Boston Mei Sun Legal Name:Renewal by Andersen LLC 51 Green leaf Dr RENEWAL HIC#170810 Florence,MA 01062 bYANDERSEhi 30 Forbes Road I Northborough,MA 01532 H:(413)230-7650 mo ru Ilaila w�wn[NINEO orou 9 Phone:508-351-2200 I Fax:(508)986-7072 I rbabostonbooking@andersencorp.com ID#: ROOM: DETAILS: 101 Family Room Patio Door: Gliding, 400 Series Frenchwood, 2 Panel, Active/ Stationary, Exterior White, Interior White, Glass: All Sash: Tempered High Perf. SmartSun Glass, No Pattern, Hardware: Albany, Gold Dust, Auxiliary Foot Lock Color Matched, Screen: Gliding, Full Screen, Grille Style: Grilles Between Glass (GBG), Grille Pattern: All Sash: Colonial 3w x 4h, Misc: Casing - Interior Wood Custom (Full Frame), Replacement of interior trim that does NOT require a knife to be made. Full frame application ONLY. WINDOWS:0 PATIO DOORS: 1 SPECIALTY:0 MISC:0 TOTAL $8,469 Renewal by Andersen is committed to our customers'safety by complying with the rules and lead-safe work practices specified by the EPA. UPDATED: 05/10/21 Page 3 / 25 If Using a Builder dba:Renewal by Andersen of Boston Mei Sun Legal Name:Renewal by Andersen LLC 51 Green leaf Dr RENEWAL HIC#170810 Florence,MA 01062 brANDERSEtlN 30 Forbes Road I Northborough, MA 01532 H:(413)230-7650 Phone:508-351-2200 I Fax:(508)986-7072 I rbabostonbooking@andersencorp.com Property Owner Must Complete & Sign This Section If Using A Builder I,as Owner of the said property,hereby authorize Renewal by Andersen LLC to act on my behalf,in all matters relative to building permit application for the property/address indicated on this agreement. Signature of Sales Person Signature Signature Steven Drury Mei Sun Print Name of Sales Person Print Name Print Name UPDATED: 05/10/21 Page 13 / 25 k, ConamostwoMth of Massectrusetts Construction Supervisor I , lion of Prafessionel Ricenlwe Unrestricted-Brdidinas of any which contain Board of Building Regulations and Standards I less than 36,000 cubic fast(a1 cubic meters)of enclosed kr.:1•ffin+. C8-000'(2b �� 'y irate: ltlltl�2rt 2 ' , �IIIIIi10 ' a , OpI .0 n 30* Failure to possess a current onion of the Massachusetts Vear Sale Bulidlna Code is can revocation for rocation of this Scenic. Commissioner K. ema�. For rdoneut on abort tido Moen. Call(i17)710.87N Or API wwwarnaa_ Biel CV-4I /!��/!YY?r(ivlL�.«E�1��1 PA /Mae Office of Consumer Affairs and Business Regulation 1000 Washington Street-Suite 710 Boston, Massachusetts 02118 Home Improvement Contactor Registration _ Type Supplement Card RENEWAL.BY ANt EN LLC =r � RI � 70810 30 FORBE8 RD _I 11?/22/rt027 77-4 NOR HBOROUGH,MA 01832 � — 'tar. = Zz l sca o Upham Address and Rtlan Card, ,- Office of Consur:ter Maks A tkat e-■s RagitalGon HOME IMPROVEMENT CONTRACTOR Registraton valid for individual use only TYPE:SuopN m 'tt Card before the eopirodon date. if found return to: Reolstretlen batman OMos of Consumer Affairs and Business Regulation 170810 12122/2021 1000 Washington Street -Sults 710 RENEWAL BY ANDERSEN L.LC Boston,MA 02118 90 FORBES RD Si~of4.glAiwi• _ NORTHSOROUGH,MA 01092 Urhisfsec .ti Not valid out Npnaturs Page 1 of 1 AR?J CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 09/21/2020 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the pofcy(les)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). PRODUCER CONTACTW -s Tolnrs Watson Certificate Center lsHk€_ 1-877-9457378 Willis Towers Watson Midwest, Inc. PHONE FAX 1-888-467-2378 c/o 26 Century Blvd piC..ti.Erb--_ INC.N91._.. F.O. Box 305191 ADDRESS: cart ificatesawillis.con Nashville, TN 372305191 USA IN9URENS)AFFORDING COYERAGE NAICE INSURER A: Old Republic Insurance Company 24147 INSURED INSURER d. Renewal by Andersen LLC - - .. -- 30 C Forbes Road _1NSURORC: -- I Northborough, MA 01532 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:W17904932 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTRX COMMERCYLLG@SURANCERAL A91l)TY .. "ABOI.,SLBRi.. _._- _. -IC _ .._--;. POLICY YFF4..POLICY EX _.---- LTR weq;yyyD POLICY NUMBER IMMIDD/YYYY .IMM100/YYYY1� LIMITS • EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE I X,OCCUR PREMISES(Ea occurrence) S_-- A -� I MED EXP(Any one person) 4 S- 10,000 I MMIV 314161 20 !10/01/2020'10/01/2021 PERSONAL&ADVINJURY $ 1,000,000 GEM AGGREGATE LIMIT APPLIES PER iGENERAL AGGREGATE S 4,000,000 { `POUCY J [ I LOC i PRODUCTS-COMP/OPAGG $ 4.000,000 Xi I ;OTHER: $ r I AUTOMOBILE UABIUIY COMBINED SINGLE T I$ 5.000,000 -!Es✓POPI! I X I ANY AUTO BODILY INJURY(Per person) $ A 1 �AUTOS Y NWTB 314159 20 10/01/2020 10/01/2021 BODI.YINJURY(Per accident) $ HIRED NON-OWNED I PROPERTY DAMAGE ; AUTOS ONLY _ .AUTOS ONLY • I Leer accident! ;$ I I$ i UMBRELLA UAB OCCUR I I EACH OCCURRENCE r S EXCESS LIAR - 1 CLAMS-MADE I !AGGREGATE .$ i DED RETENTION S '$ WORKERS COMPENSATION I - I` : X PER OTH- AND EMPLOYERS'LIABILITY i N/A • ;STATUTE ER A OFFPICER/MEMBEREXC UDE07 Cl/TIVE I HNC 314158 20 10/01/2020 10/01/2021;E.L.EACH ACCIDENT $ 1.000,000 YIN (Mandatory In NH) I If yes, DIcF&SF-EA EMPLOYEE $ 1.000,000 yes describe under _- DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL. BE DELIVERED IN ACCORDANCE WITH THE POUCY PROVISIONS. AUTHORIZED REPRESENTATIVE evidence of Insurance ""‘-If. / . //'1 - 01988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD SR ID, 20103273 ERT M: 1820957 WuNDOwc.DOOIS I AnderseR e 4 0 0 S e r a. e S s , Andersen'NFRC Certified Totai Unit Performance (centime • AOeersea•Product Grass u•iaabd I Mee yr . Arwlesseri Product Gals7yw I u•r nor I shoe . ire i 1 au-Series 4rt8LtaaArrai NPLba-E4. 027 035 0.80 HPlarb{ 032 028 0.47 -"E' HP tarf4 set Mks 028 0.31 054 IR lara sill . 0.32 1<25 0A2 .'la C)rde Tr..- HP tar E4 Son 027 0.21 033 ) f+ FP 1 4 Slav 032 0.17 028 .T" - Cameo*Wfedaw iR tar64 Sue 1319 gegees0.28 019 030 t II GftrrmeM Nodes HP 1ar it di S MIN 0.32 0.16 0.23 .•IIHP In-E4 S of a= 028 023 0.54 :n HP taw•64 snert9aa 031 018 0A2 'iI n�.E{rim HP 1 et*Gen 028 021 0.49 : f11 ; FP Inr 5la 54 ngru*SUN 031 0.17 038 ' "1$11 1?tarF4 027 035 0.80 r,. If WWII 032 428 OAT HP Low-64 etor Gas 0.28 -0.81 0114 HP Lora w811GAM 0.32 025 0A2 HPlaar•E4 Sat 0.27 021 033 'K _S Neese casement • HP Iowa Sao 032 017 030 .N circle I that W4a4sw --Fi Law1E4 Sao win sass 029 0.10 0.90 'Pt 41Ydow IP Iarr 64 Sit se Glue 032 0.10 0.23 GI ________ HP Inr64 Sne4,5w 028 023 0.54 +It iv Last MHO 0.81 0.18 Q42 •r HP 1ar64 SutsrtSen w/Oiaa 0.28 021 0.4P .a r61. :RI HP 1a Smetanaw/eIlls 0.31 017 0.98 4 i id a HPIor64 0.211 ' 0.33 0.58 P. I1s .M 0.32 028 0.47 I. sP Lora W.Qin 029 030 052 /i ' IP1a.E4MOSibs 032 025 0A2 • S+ni -- sr Lana sus 028 020 031 IR HP 1Lr64 Sao C32 Q17 02B ;:n Arch Window Nesting Moser, • HPtae-E4Svtealt0is 029 MIS 0.28 r1: 411 1PIar645seMrais 032 QUI 023 -liE HP Low-64 Srat40ea 027 023 OM '"1NP Lar648aaeSon 031 0.18 0A2 •.r"sr HP Low-64 Somas*Odin 0.28 021 0.48 R.)_.__;n HP Iore4 SreirBa eVBeles 031 0.17 038 '•V Fr law•64 0.27 0.33 0.58 ,71 HP Ism 24 031 032 0.56 -. IP1arE4MA Gila 028 0.30 0.52 T'1 IPLso►64 with Gvahm 031 02G 0.40 ' ^-- IP Lew-E4 son 027 020 031 'r , Et casement/And* r IR tale-E4 Sir 031 020 0.31 '. Q' ' 'silt ''Wtedew _HP InrE4 Son rRi Gills 022 0.18 0.28 : pi Muni Vale*" iP IwE4 Sea td i Giles 0.31 0.18 0.28 '�. iP laetl Sslsrl3rat 020 423 0.62 HP lava Sa1Ssn 031 0.21 0.60 ''M - IPlareb4SoigeeWGels 028 021 0.411 '' it RPLr£48arfaWGIes 031 0.19 0.44 7";_ IPlora 031 033 0.80 IRI4rE4 030 037 0.64 r- IP lev E4 eeb Gapes 0.32 030 0.22 HP 1arM4 mh Gem 030 0.33 057 ' __ HP Iowa Bun 0.31 010 031 •• pi lP law-64 Soo 0.91 022 036 . `"Is aural wutdow Spdngine-Window W LIMO Sun l ila 1v1Als 033 au an .r! HP Iowa Sin 106 Gibe 031 0.20 032 a •low-64 Smarm 0.30 t123 0.52 ' . • F1 HPtwe5481oerffilto 030 024 058 p HP tan-E4 SweiWlal e/8lls 0.32 021 0.46 f. HP Lava Snewt3sw ayihiss 030 022 0.52 - HP LoeE+4 0.30 027 0.45 W IP torsi 032 0.2Z 037 - ; pl sr Low-64 wilt MN 0.32 023 0.30 ;l '••F7 Hp Lor61 WM ea.s 033 0.20 0.33 - Fsenchsroed' __ __ HP um-En sun 031 cue 0.26 i•-12 t�edhrawiag IRIa.6Il. 033 OJ4 021 - Gliding Pan Doer HP larE4 Scat'Nth rills 032 0.14 0.22 fa Flerrsh Dom IR tenth as well Cis 0.34 0.13 0.18 - - IP 1ar84 8m ats 0.30 018 0.41 r 14 IP lard!Semen 0.32 0.15 033 'ipl IP lnva Sleet*.*Mew 031 0.10 0.35 -• f4 . HP 1ae-E4 Stowl9a*Gnu Q33 0.14 030 AI - IPIar64 0.31 0.24 0.41 I • .11A le Lora 0.33 025 041 IPInrE4sillG10ks 032 021 035 71 ' ,Ill HP Weal eatGAIN 034 022 035 - a Pdrw ienoed'tinged ^_- HPlar84 Son 0.31 0.15 023fL Mimi OMeseg IP lm►G4 Sot OM 018 023 a E 1 Rawl Ow - HPI 448a ea iS 035 0.14 020c inwbg Pails Dew NP InwE4 Ss hash GIGS 0.32 0.13 0.10 t•® -IW LrE4 Sts1Sa 0.30 0.10 OAT :.! '•'t a !P thet a SuarlSen 0.32 417 0.37 ;:i -. A - tR Low-64 salami ta/0d0a 031 0.14 03I :1 f* sr t e E•4 eltr eww/Cls 0.34 0.15 032 -- •I If Law04 031 025 0.41 +' r .IR -- HP Lor64 033 023 038 . - a4! HP UotG4 won 65lie 0.32 0.21 0.8e ►a . c • HP Ia*E4 ell GLBs 033 021 034 - Pr chweod'Hived + HP Lr64 an 031 018 023 • Ft find 135919 Nur- IP Lar64ltos 0.33 014 021 - Batwing Eatio Ossr IR farE4 See Walt 0111s 032 0.13 0.19 i 1 PI Wit H larE4 Sonya hers 0.34 0.13 045 - HP 1ar64 SseOAer 0.30 017 037 r ' •y IR IowaIsuiler 032 Q15 034 - HP tae•E4 SarctSrer Wedges 031 016 031 1 pi HP Weal awsl s*Cies 0.33 014 030 IPla►E4 Q31 022 0.37 . ' III HP toe-FA 032 025 0.41 - HP Lora WA 601sa 0.32 020 a33 ••• ; Ft HP Iae►F4 elf rips 033 022 037 - Frerrchhmod' HP Lora Sun 0.32 0.141321 '1 ' •111 ilia.Fl Laa HP lair-64 Ss 032 0.15 0.23 - Valhi Don;StC.Tlhi sr tow-S4 Saar wish 64114s 022 0.13 0.18 /1 i Rosh our IP lew-E4 Smw wth GSM 033 0.14 0.20 - HP tae{4 Semtflun 0.31 0.15 033 HP1awE S4 ose5Snr 032 QM037 - '" Ip Ili-44lasttSn Weans 0.32 0.14 020 , ' in' &s HP luw.E4 ot6a wIOire 032 045 033 - - HPLaw-61 0.3o 024 0-40 7. el IP(orE4 036 0211 0A4 - IPInv-E4erlhtiffs• 0.30 0.21 036 E'! se Loma W0G = 038 (23 038 - Frerrchwnod' -----_.._HP I.�4 Sir 030 0.15 0.22 ( ' P1 p IR Iowa Sit 03e 010_ 024 Palle tree,Trauma _ HP leaf Sat with Gina 0.31 0.13 020 , "i's IP laver Sit et0(t Gigs 038 Q14 Q21 - 10,lee-E4 5osa&un 029 0.18 036 --r HP Iowa 8astles 034 41.17 0.30 - IR 1aw•64 Smaeus w/G1ls 0.30 0.14 0.12 ' i 'tr1 )P IaiE4 Smartie w/Glee 038 015 0.34 - caedeaOwsets* -cm NFIiC certified total unit perfumlance on units with cap0lary Iveather tubes for high altitudes,please visit endereeawindess.com- •'High-Performance"low-E4'-(IIP Lao-E4),'ligh-Performaace"Low-E4•5mertSee"(HP law-Ed SmedSun)and'Hiih-Pedumrenci Low-E4'Sun'(HP Lew-Ed Sun)are Andersen tralemartsfor-I cm-E" lass. ' U-Factor aehnes the amount a'heat icon Through the total uni_in BTU/fir sq.ft'F The lower the iatuh.the leas heat is lost through the entire1 g product_Window values represent non-tempered glass.Use of tempered glass can Incn;ese U-Factor ratings.See enderseneladows-corn for spectres performance values.Dour values represent tempered glass_ 'Solar Heal Gain Coefficient(SHGC)d.fines the fraction of solar radiation admitted through pre glass both directly transmitted and absorbed end subsequently released inward.The Waver the value,the less heat is transmitted through the product Vr.ibte Transmittance(VI)measures low much light cornea through a product(glass and frame).The higher the value,from 0 to 1.the mem daylight thn product lets in over the product's total unit are_.Insible Transmittance is measured over the 3R0 to 760 nanometer portion of the sold speunun. •NFRC ratings are based en modeling by a third party aLeitcy as validated by an independent test lab in compliance with NFRC program and procedural requirements. •This n.to accurate rrrfieation-Re s December cram IO.Our to mguleg eroded changes,updtted lest resells or new industry stnneuds or requirements,Ws rlaa nit; chsete sun time Ratings are for sizes specified s4 Nlit ler testing Ratings may very pending an use of tempered g-:es,different grille optons.glass fur high altitudes.etc. •PesslviSue glass values are available online at andersem+lndows.com. 277