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23C-057 BP-2023-0424 144 WILLOW ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 23C-057-001 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-2023-0424 PERMISSION IS HEREBY GRANTED TO: Project# WINDOWS/DOOR 2023 Contractor: License: Est. Cost: 13181 RENEWAL BY ANDERSEN 090125 Const.Class: Exp.Date: 10/06/2024 Use Group: Owner: METZGER ANN Lot Size (sq.ft.) Zoning: WP/WSP Applicant: RENEWAL BY ANDERSEN Applicant Address Phone: Insurance: 30 FORBES RD 508-351-227 MWC31415822 NORTHBOROUGH, MA 01532 ISSUED ON: 04/11/2023 TO PERFORM THE FOLLOWING WORK: 3 REPLACEMENT WINDOWS AND 1 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: 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: ( 2 co..0 Fees Paid: $40.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner Department use only City of Northampton' Status of Permit: Building Department Curb Cut/Driveway Permit 212 Main Stree1P/? Sewer/Septic Availability Room 100 2023 Waterlwell Availability Northampton, MA 01060 Two Sets of Structural Plans phone 413-587-1240 Fax 41'3-5B7-1272 Plot/Site 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: This section to be completed by office y v., //e,,,' Cfr- c t Map Lot Unit Y/Ored(C �A Zone Overlay District e-/ 6.E Z Elm St.District CB District SECTION 2 -PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: 44,1 /Mc t Zs)e /(7(7 •C r f�o' ,-ilG '(/+ oc,/ Name(Print) Current Mailing Addres : , , ( /t ) Telephone Si na re ' r/ 2.2 Authorized Agent: &C'."U /cI L L. eretpter 6 41 .r Name(Prin Current Mailing Address: C033 Signature Telephone SECTION 3-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to be Official Use Only completed by permit applicant 1. Building ' (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 + 3 +4 + 5) / 3 /1/, et) Check Number 3 r 7 This Section For Official Use Only Building Permit Number: 6,- 4 L/lY Date Issued: Signature: tip L/" /1" 6Z3 Building Commissioner/Inspector of Buildings Date SECTION 5-DESCRIPTION OF PROPOSED WORK (check all applicable) New House ❑ Addition ❑ Replacement WiPdows Alteration(s) Roofing El Or Doors L'� Accessory Bldg. ❑ Demolition El New Signs [pi Decks [[=] Siding [0] Other[p] Brief Description of Proposed /� Work: e1k4-u- a,1t1 �i�41/4 �u,'. 1,41-'z •% ,�,t.� ��/k 'i' l�ltC a-J l /14' .5��� C �itti S !J' ;iT 3v Alteration of existing bedroom Yes i/' No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes ✓ No Plans Attached Roll -Sheet 6a If New house and or addition to existing housing, complete the following: a. Use of building : One Family 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? f. Method of heating? Fireplaces or Woodstoves Number of each g. Energy Conservation Compliance. Masscheck Energy Compliance form attached? h. Type of construction i. Is construction within 100 ft. 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 , 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. Signature of Owner Date C)c-, iki. 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. C Print Na Sign ure o wne ent Date 4 SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not Applicable� 0 Name of License Holder: -Tx-,�"-�- W !L' ''� 0 O /2 License Number 30 -6v/hc s k'd Ah'i lam-�w k MA ,is.-3 "z- /a/d 6/2- Expiration Date C1)- (, 2LdJ gee) if2 - r/f Signat Telephone 9. Registered Home Improvement Contractor: Not Applicable 0 41-1 c -r -C L / 9> g l 0 Company Name Registration Number 7 v f-:-,r-h.e > ✓Rr./ *?/i-di he rc. �7 I-, r✓I a/S 3 L, z z 1 2-3 Address Expiration Date Telephone ,S O -51 Se--1/t Z 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 buildin permit. Signed Affidavit Attached Yes No 0 11. - Home Owner Exemption The current exemption for"homeowners"was extended to include Owner-occupied Dwellings of one(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 108.3.5.1. 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 structures.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 issued. Also be advised that with reference to Chapter 152(Workers'Compensation) and Chapter 153 (Liability of Employers to Employees for injuries not resulting in Death)of the Massachusetts General Laws Annotated,you may be liable for person(s) you hire to perform work for you under this permit. The undersigned"homeowner"certifies and assumes responsibility for compliance with the State Building Code,City of Northampton Ordinances, State and Local Zoning Laws 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: /Y11 lW✓, //o 5) ridIene{ , 7A D i o 6 - The debris will be transported by: jai On A The debris will be received by: Wait-- Mu v ct yi1Ad Building permit number: Name of Permit Applicant (pera /I £ C4(14€ f (7z_ Date Signature of Permit Applicant The Commonwealth of.lfassachusetts t, ,�'i� Department of Industrial A ccidents lit ;_„ Office of Investigations slt4_,= „ ,, =�_ Lafayette Citl Center 2 .4venue tie Lafayette. Boston, MA 02111-17SO www.mass.gotldia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly_ Renewal by Andersen Name ll3 us' c..()rpnr,auan Indevidual is Address: 30 Forbes Rd. City/State/Zip:Northborough, MA 01532 Phone#:508-351-2277 Are you an employer?('heck the appropriate box: Type of project(required): 1.14 1 am a employer with 3° 4. ❑ 1 am a general contractor and 1 6. ❑New construction employees(full andlor part-time).* have hired the sub-contractors listed on the attached sheet. 7. 0 Remodeling 2.❑ i am a sole proprietor or partner- ship and have no employees These sub-contractors have K. 121 Demolition workingfor inemployees and have workers' me any capacity. 4. 0 Building addition [No workers' comp. insurance comp. insurance.: required.] 5. ❑ We are a corporation and its 10.1:1 Electrical repairs or additions 3.0 1 am a homeowner doing all work officers have exercised then 11.0 Plumbing repairs or additions myself. [No workers' right of exemption per MGL ys comp. 12.0 Roof repairs insurance required.]' c. 152,*1(4),and we have no Re meat employees. [No workers' 13.�Other comp. insurance required.] 'Any appiiaM that chats box M I must also RI out the section below showing their workers'compensation policy information. i Homeowners who submit this affidavit indicating they are doing all work and then hire outside coal ri.turs must submit a new affidavit indicating such. ;Contractors that check this box must attached an additional sheet showing the nape of the sub-cantr►:tar.and state whether or not those entities have employees. tithe stab-contractors have employee,they must pro%tde their workers'comp.policy nu nitric! I am an employer that is providing workers'compensation insurance for my employees. Bells►'is the policy and job cite information. Insurance Company Name: Old Republic Insurance Co. _ Policy#or Self-ins. Lic.#: MWC 314158 22 Expiration Date: 10/01/2023 Job Site Address: XX /V/ tvaiimi 5/ 'e ` City Stag lip. X( �e/2'A( /7v e/©e L Attach a copy of the workers'compeasat1es perk) declaration page show sag the police somber and expiratirs date). Failure to secure coverage as required under Section 25A of M(;L c. 152 can lead to the Imposition of criminal penalties of a tine up to S 1.500.00 and'or one-year imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a tine of up to S250.00 a day againstt the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for sinurance coverage verification I do hereby certify under the pains and penalties of peryurt that the information provided above is true and correct Signiain 5/4.4k.n.4... // 2.1.Ifi !Lit, X V/ - /Z ; i'hwtr .". .1 i Official use only. Do not wtikeist liking.,rkcompleted by city or torrw ial ('its or Iowa: Permit I iCellis Issuing ♦uthor itv (check oar): t�-1 ""n� ID Boa rd of 1leaith 20 Building Department 31J( it)�.lown( leek �-.ataectrical Inspector 5t3'lumhing Inspector 6.00ther . Contact Person: Phase ,; . RENEWAL ;,;, br A N D E R S E N MEOW WINDOW a DOOR REPUWMNT 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 Thermal Performer--"U-faclw/SHGC for SmoteSun'g aas) t ---_ A. ssiu Maims Ir 400 S 200 Sys WO Saes t nvrn.m 27/i$ .70/10 .27/.21 27/,1a t)nui+1.r„ng .77/20 30/as .30/,71 1 30/7* %Al. I m ing 1 311/3. c;i.fng Wr nw .32/21 .-iv/1v 20/71 27%71 GroS+Aq Potty p,«. ,.,'!S .31/10 .30/16 r 27%21 ,.;•..'a,i,„t,.-. .30/.16 .30/.10 .30/.16 .32/.16 - I I 1 -, once;U-focio./SHGC for SmoteSun."9osal A•Sacses E,Series 400 Se+.es 200 S«iu WO Swim osemsr✓ .27/.le y . .�. 77/,2i 2' I• I Hung •77/.70 3D/20 .30/,71 %Hoed*)1,n9 (44ng 4•1r4,', .32/2 .29/10 _I . ci4dely Duties Duce .30/.10 1 .31/.10 .30/.16 ! .20422 .' , 'rvotiDvIsv Chs..4 .30/.10 .30/.10 -30t.16 Mt, Agreement Document and Payment Terms DBA:RENEWAL BY ANDERSEN OF BOSTON Ann Metzger RENEWAL Legal Name:Renewal by Andersen LLC 144 Willow St HIC#170810 Florence,MA 01062 brANDERSEN 30 Forbes Road I Northborough,MA 01532 C:(413)695-4578 (Ili SUM 110110 1 1 0 0 1 WM1FID Phone:(508)351-2200 Fax:(508)986-7072 I rbaboston@gmail.com Ann Metzger 04/03/23 BUYER(S)NAME CONTRACT DATE 144 Willow St,Florence,MA 01062 (413)695-4578 BUYER(S)STREET ADDRESS PRIMARY NUMBER SECONDARY NUMBER ann.metzger1418@gmail.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: $13,181 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: $4,393 BALANCE DUE: $8 788 Estimated Start: Estimated Completion: 16-20 Weeks 1-2 Days AMOUNT FINANCED: $8,788 We schedule installations based on the date of the signed contract and secondarily on the date METHOD OF PAYMENT: Check in which we complete the technical measurements.The installation date that we are providing at Financing 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 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 04/06/2023 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. SIGNATURE OF SALES PERSON SIGNATURE SIGNATURE Christopher Johanson Ann Metzger PRINT NAME OF SALES PERSON PRINT NAME PRINT NAME 04/03/23 Page 2/ 34 ,_, . Itemized Order Receipt �r DBA:RENEWAL BY ANDERSEN OF BOSTON Ann Metzger RENEWAL Legal Name:Renewal by Andersen LLC 144 Willow St HIC#170810 Florence,MA 01062 brANDERSEN 30 Forbes Road I Northborough,MA 01532 C:(413)695-4578 Phone:(508)351-2200 I Fax:(508)986-7072 I rbaboston@gmaiLcom ID#: ROOM: SIZE: DETAILS: PRICE: 000 Patio Door Notes Mlsc Misc, Additional Job Notes, Quantity 1, Use 3.5" interior trim to cover paint line 101 Patio Door Patio Door Gliding 200 Series Perma-Shield 2 Panel Active / Stationary, Exterior White, Interior White, Performance Calculator Performance Data Unavailable Glass, All Sash: Tempered High Perf. SmartSun Glass, Hardware, Albany, Stone, Auxiliary Foot Lock Color Matched, Screen, Gliding, Full Screen, Grille Style, No Grille, Misc, Remove and Replace/Reinstall Vinyl Siding, Remove vinyl siding and replace/reinstall. 201 Master Bedroom Window Double-Hung (DG) 1:1 Slope Sill, Insert Frame, Traditional Checkrail, Exterior White, 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, Misc, Aluminum Wrap Casing, Aluminum wrap of exterior casing. 202 Master Bedroom Window Double-Hung (DG) 1:1 Slope Sill, Insert Frame, Traditional Checkrail, Exterior White, 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, Misc, Aluminum Wrap Casing, Aluminum wrap of exterior casing., Sill Body Replacement, Sill body replacement. Includes maintenance free sill nose (insert application). 04/03/23 Page 3/ 34 Itemized Order Receipt �* DBA:RENEWAL BY ANDERSEN OF BOSTON Ann Metzger RENEWAL Legal Name:Renewal by Andersen LLC 144 Willow St RENEWA HIC#170810 Florence,MA 01062 ANDERS L EN 30 Forbes Road Northborough,MA 01532 C:(413)695-4578 Phone:(508)351-2200 I Fax:(508)986-7072 I rbaboston@gmail.com ID#: ROOM: SIZE: DETAILS: PRICE: 203 Upstairs Bathroom Window Double-Hung (DG) 1:1 Slope Sill, Insert Frame, Traditional Checkrail, Exterior White, Interior White, Performance Calculator PG Rating: 40 I DP Rating: + 40 / - 40 Glass, All Sash: High Performance SmartSun Glass, No Pattern, Tempered Glass, Hardware, White, Screen, Fiberglass, Full Screen, Grille Style, No Grille, Misc, Aluminum Wrap Casing, Aluminum wrap of exterior casing. WINDOWS: 3 PATIO DOORS: 1 ENTRY DOORS: 0 SPECIALTY: 0 MISC: 1 TOTAL $13,181 Renewal by Andersen is committed to our customers'safety by complying with the rules and lead-safe work practices specified by the EPA. 04/03/23 Page 4/ 34 Payment Authorization Form 5.! DBA:RENEWAL BY ANDERSEN OF BOSTON Ann Metzger RENEWAL Legal Name:Renewal by Andersen LLC 144 Willow St HIC#170810 Florence,MA 01062 brANDERSEN 30 Forbes Road I Northborough,MA 01532 C:(413)695-4578 Phone:(508)351-2200 I Fax:(508)986-7072 I rbaboston@gmail.com Ann Metzger BUYER NAME 144 Willow St Florence ADDRESS CITY MA 01062 (413)695-4578 STATE ZIP CODE PHONE NUMBER 1 PHONE NUMBER 2 15 Years 6.99% 4569 $13,181 FINANCE PROGRAM` FINANCE PLAN AI* CONTRACT BALANCE Christopher Johanson 2309302439 SALES REP APPLICATION ID OFFER EXPIRATION DATE *If your financing is pending,the Finance Program and Finance Plan Number are subject to change PAYMENT SCHEDULE ($13,181) is CASH DEPOSIT(1) FINANCE DEPOSIT(2) START OF JOB(3) SUBSTANTIAL COMPLETION(4) CHECK $4,393 $0 $0 $0 FINANCING $0 $0 '„ $4,394 $4,394 (1) CASH DEPOSIT: 1/3 of the purchase price is due at Contract Signing. This may be paid in part or in whole by cash,check,or credit card ("Cash Deposit"). (2) FINANCE DEPOSIT: 1/3 of the purchase price is due at Contract Signing. This may be paid in part or in whole with financing("Finance Deposit"). (3) START OF JOB: 1/3 of the purchase price is due at Start of Job. (4) SUBSTANTIAL COMPLETION: Final payment is due on the day of installation when all windows and/or doors included in this agreement have been installed into their openings and any interior and exterior trims have been applied("Substantial Completion").If there are any outstanding warranty claims or service items,customer may retain an amount equal to the value of the outstanding item(s)or work to be done,not to exceed 10%of the total purchase price. Due to project changes after Contract Signing,the final payment Is subject to change. BY SIGNING BELOW, I/WE,THE BUYER(S): 1. Authorize Renewal by Andersen to transact payments based on the amount(s),form of payment(s),and timing specified in the Payment Authorization Schedule above. 2. Acknowledge the use of the loan to make a purchase will constitute acceptance by all Borrowers of the Loan Agreement. 3. Instruct the Lender(if applicable)to disburse the proceeds of the loan to Renewal by Andersen as identified above in the amount(s) and timing specified in the Payment Authorization Schedule. 4. Understand that Renewal by Andersen must be notified in writing of a change in payment method in advance of the respective payment. Ann Metzger 04/03/23 BUYER NAME SIGNATURE DATE 04/03/23 Page 5/ 34 Go Permits, LLC 105 Buttonball Lane GO s Glastonbury, CT 06033 PERMITS Scott Doughman \\ss,,,404000000.00.00000/1 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: renewalbyandersenagopermits.orq • 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 Pager I of 1 AC RD° CERTIFICATE OF LIABILITY INSURANCE o9 I, ,21i THIS CERTIFICATE IS ISSUED A3 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: N the certificate holder is an ADOITIONAL INSURED.the pollcy(ies)must Mir ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WANED,sub(ect to the terms and conditions of the policy,certain poach"may esquire an endorsement A Malement on this certificate does not confer rights to the certificate holder In lieu of such erdaeement(a). PRODUCER CONTACT Willis Tones. Mateyo Certificate Gatos Willie Test. Rat..a INAieet, lac. IFAX c/o 26 Coattail, sisal sr,. 1-e77-1AS-737e yam. 1-sera-As7-237e P.O. Boa 305121 moms certlficstesevilli..coR Il..kville, Se 312305191 OITA W RIRED6)AFFORDING COVEDAOE NAIC INaURERA Old aepubllc Iaaus..c. Company 26147 SOUSED INSURER Ne..ral by A.uteri.Ile 30 Pone.. Road NO MA C: aestaberaayA, nY 01532 SOURER D: INSURER E INi5IER F: COVERAGES CERTIFICATE NUMBER:W26007431 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE WSJREO 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 POLICES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS POUCY EFF POUCY VIP LTR TYPEOF INSUR NCE JIRO WMPOUCY TIMM 1110110NYYTYI RiEOfYTYYYI, UNITS X COMMERCIAL DE1SRAL 11Metil1Y EACH OCCURRENCE { 2,000,000 CWMSMAX.E X OCCUR PREMISES occu intymsnati { 500,000 A MED EXP SARI ors Pao.) { 10,000 retn! 314161 22 10/01/2022 10/01/2023 PERSONAL a ADVINAXRY { 2.000,000 GENT AGGREGATE LINT APPLES PER: GENERAL AGGREGATE { 4,000,000 POUCY QJECT LOC PRODUCTS•COP AGO { 4,ODD.000 , OTHER { AUTONOO E 1IABLJTY COANNED SINGLE LSAT E S.000.000 EnaccearAL X ANY AUTO BODILY INJURY(Pr preen) { A OARED SOEOIHED NRa 316131 22 10/01/2022 10/01/2023 BOOO.INJURY(Pr acuamtl { AUTOS D ONLY .� NO D PROPERTY DANAGE- ��AUTOS ONLY AUTOS ONLY 1Per Agsonn { UIMIINLIA UM. _J OOC*Ri EACH OCCURRENCE { EXCESS LNB CLAIINSWIDE AGGREGATE { OEO I 1 RETENTION op { EOFLorEAYNsAuosUNNUTY X I STATUTE I I W- AND A NOPROPRIETOR'PARTNEREXECUTNE Y) EL EACH ACCIDENT { 1,000,000 OF yE3 RnLCEO Q NtA WIC31t1SS 22 10/01/2022 10/01/2023Olenealls EL DISEASE-EA EMPLOYEE { 1,000,000 If yes awn*anFO 1,D00,000 DESCRIPTION ON OF OPERATIONS teete EL.DISEASE•POUCY LIMO 6 OEaCR/IION OF OPERATIONS/LOCATIONS 111BINSEa(ACORD III AYINa.I Ifte.Aa ae•YY,map M mata.a Mery caeca N r rye..q CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED PONCES B!CANCELIFO BEFORE THE EXPIRATION DATE THEREOF. NOTICE WLL BE OSLNERID M ACCORDANCE WITH TN!POLICY PROVISIONS. I JT ORQE0WFPRESI TATHE C Evidence of In.ur..o. A �. 'y.„-_ O 1fg8-201f ACORD CORPORATION. AN rights reserved ACORD 23(2016103) The ACORD name and logo are mislead marks of ACORD m m: 23076070 .tics. 2676324 sii- Commonwealth of Massachusetts C000ilrtitt�tgarviaor Division of Occupational Lrcensure Unnistrtdad_t11mililklgsofa l tsiegroup Wtkh contain , Board of Bolding Regulra_tions and Standards s than MI MtIcubic Nat(M1 cubic frtaters)of mdaood " C,:;nst�t/L` `FJf S ervisor e CS-090125 y,I pites. 10/0612024 JAIME L MO9M1 :� 54 NOTTINGHAM RD ,. RAYMOND NM 0307T: i r t,LYiifl Failure to pomade a crinelst'Oboe el the MasseCkueelis 4 Ca t z:s>:as;ct ,�?,z /iMa Bo al ding Coda is cams for revocation of this license. I ie For inborn/km about this license ! Call 4617)727.3' or visit wwW.elase.9ovAlel I THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs and Business Regulation 1000 Washington$try- Suite 710 Boston, Massachusetts 02118 Home Im -nt • tractor Registration 5 �a a µ.r .I' y rype Supplement(;and ft gr.tlatiun 170410 RENEWAL BY ANDERSEN LLC ;,t2 Expirat��n 12122,2023 "" 1z 30 FORBES RD "" I' .. NORTHBOROl/GH.MA 01532 . __,.... " t. .4 Update Address and Return Card. THE COMMONWEALTH OF MASSACHUSETTS before the Registration valid for individual use only Office of Consumer Affairs &t RsyulRegulationeepiret4+�rialto H tound ret rn to: HOME IMPROVEMENTT CONTRACTOR Of Roe of Consumer Affairs and Business Regulation TYPE:Supplement Cord 1000 Washington Street -suns 710 17 ratign Boston,MA 02111 1jQ010 12122/2023 RmNEwAL BY ANDERSEN LLC JAIME MORIN ! 30 FORBES RD `4.0,0e.r ......4...i NCiRTHBOROUGI4,MA 01532 Not lira without sign13tU55 Underyesretrtl?' ` -, RENEWAL III ~ � ?� ►ANDERE now 4oar MAW 1 To Whom It May Concern: This letter will authorize the following personas) to act as agent(s)on behalf of Renewal by Andersen tIC, 9900 Jamaica Ave South, Cottage Grove MN 55016 to pull for permits and inspections with respect to the installation, maintenance and repair of windows and entry rinnri trnd.'r Massachusetts State Home imprcwement Contractor license number 170810 and Construction Supervisor license number CS-090125. If you have any questions, please call me at 508 351.2277 ext 6 Authorized person(si: Go Permits L.LC Sarah Hammaci David Anderson Maureen Kivel Scott Doughman Ryan Btondo Sovannara Kuy Mark Foster Glynn Morgan Jennifer Winke Wendy Holden Gerald Cramer Nick Rago Danel Vickerman Stephen Wilder Katie Grocott Bonnie Myers Carrie Fol+gno Michael Rogers Rachel Orloff T ,740gh -::V arnie Morin Renewal by Andersen LLB' HIC 170810 CSL-CSO OI2S Local District Office Address 30 Forbes Rd NorthborouBh, MA01532 Rer r4val fay Ar'drt:e-n L:C 30431amatraa Ayr South,root:apr Grave 11.114 SSb16