31B-304 (5) BP-2023-0671
10 TRUMBULL RD COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
31B-304-001 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-2023-0671 PERMISSION'IIS HEREBY GRANTED TO:
Project# WINDOWS 2023 Contractor: License:
Est. Cost: 26742 RENEWAL BY ANDERSEN 090125
Const.Class: Exp.Date: 10/06/2024
SPONO ELIZABETH A SPONG &DAVID L
Use Group: Owner: BURTON
Lot Size (sq.ft.)
Zoning: URC Applicant: SPONG ELIZABETH A SPONG &DAVID L BURTON
Applicant Address Phone: Insurance:
10 TRUMBULL RD
NORTHAMPTON, MA 01060
ISSUED ON: 05/23/2023
TO PERFORM THE FOLLOWING WORK:
10 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: 6 >2 1
i
I
Fees Paid: $40.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Office of the Building Commissioner
The Commonwealth of Massachusetts / 41,0 W
Board of Building Regulations and Standart 9 Massachusetts State Building Code, 780 CMR n.. /
0 FOR
USE
Ty(gyp
Building Permit Application To Construct, Repair,Renovate(x9 • h a R ised Mar 2011
One-or Two-Family Dwelling 46sA
This Section For Official Use Only fl 0 o°Ns
Building Permit Number: 3✓") 3--G 7/ Date Ap lied:
4../hi-) (Z., / 5-23-2023
Building Official(Print Name) Signature Date
SECTION 1:SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map&Parcel Numbers
/ram•vt 5 4ci14-19-0-0-p7forrili
1.la Is this an accepted street?yes V no O,6d 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 CI On site disposal system 0
Check if yes❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 . d of�tec 11 /0aA Al 4 6/06 a
Name(Print) ��ll ff+v�� City,State,ZIP
C0 74,4--t /c/ 43'1 -65q- -Y3t,C d l km..-Ith‘@,s,►ti Ili .eci,
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) 0 Alteration(s) 0 Addition 0
Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify:
Brief Description of Propo :. Work':
4144-c g.frc( ';/(,eGe 0 wi s /r - 1
Wi44) /20 5' ( 0( , 30
SECTION 4: ESTIMATE CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1. Building $ 2,b Z op 1. Building Permit Fee: $ , Indicate how fee is determined:
I
2.Electrical $ ❑ Standard City/Town Application Fee
❑Total Project Costa(Item 6)x multiplier x
3. Plumbing $ 2. Other Fees: $
4.Mechanical (HVAC) $ List:
5. Mechanical (Fire $ ob
Suppression) Total All Fees: $ y01
Check No.y 7972Check Amount: Cash Amount:
6. Total Project Cost: $ (20 y2, ( f 'Paid•in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL) e o t z. 0 l 0 y
f
J�,yn C /14v.rin License Number Expiration ate
Name of CSL Holder GfS
List CSL Type(see below)
50 R).'I'S f C-
No.and Street Type Description
,,((��,, //JJ U Unrestricted(Buildings up to 35,000 cu.ft.)
z`"'� 't �v'^°''`�� �S3 2_ R Restricted 1&2 Family Dwelling
City/Town,State,ZIP M Masonry oR Roofing Covering
WS Window and Siding
/ SF Solid Fuel Burning Appliances
o-IQ//I Z ( 6444)el'✓ !st'4 /e�/,'FS,'() I Insulation
Telephone Email address( / D Demolition
5.2 Registered� Home Improvement Contractor(HIC) ( .i 62 IZI ZZ L3
lte4�"' A 6& C HIC Registration Number Expiration Date
HIC Company Na or HIC Registrant Name
f'V•44‹.-S /<CJ T 4€.,ra-eit;4.4'41✓ja.7 e�J .�f r c'.' j
No.and Street Email addrisss
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 .......... COY 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
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 accuripttla e best of my knowledge and understanding.
a G. C,twr ) ✓/9" Z 3
Print Owner's or Authorized Agent's Na e,Elec oni ignatur 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 vvww.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
oa%H�Mp?o S S'
% •''� Massachusetts s` �c�<<
1 11L, 4 19 DEPARTMENT OF BUILDING INSPECTIONS
♦ y�^1 ^ 212 Main Street • Municipal Building
t may+' Northampton, MA 01060 J'111, 10%
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:
76> boro-D k A 01
Location of Facility:
:-fix s /�" l Nr- i S3 L
/tQ/14/1,
The debris will be transported by: JQ' '
Name of Hauler: .t fr(aiit-t- e,pceAS
Signature of Applicant: 2-"‘ Date:
The Commonwealth of Massachusetts
Department of Industrial Accidents
.:,-., Office of Investigations
"er'-- Lafa►'ette City Center
i '; 2 Avenue de Lafayette, Boston,MA 62111-I 75(0
*;-..," 0 www mass.gov/dia
Workers' ('ompensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print l.egibls_
Renewal by Andersen
Name (Business Organization Indttidual):
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 I am a employer with 30 4 0 I am a general contractor and I 6. El New construction
employees(full and/or part-time).* have hired the sub-contractors
listed on the attached sheet. 7. 0 Remodeling
2.El I am a sole proprietor or partner-
ship and have no employees These sub-contractors have 8. ❑Demolition
workingfor me in any capacity. employees and have workers'
} apac ty. 9. 13 Building addition
[No workers' comp. insurance comp. insurance.:
required.) 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions
3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions
myself. [No workers' .com right of exemption per MCI
p C. 1S2, 1(4),and we have no 12.0 Roof repairs
insurance required.] Replacement
employees. [No workers' 13 P
comp. insurance required.]
•'Any applictmt that checks box or!must also till out the section below showing their wtxkers'emnpcnsatiun polity information.
+Hon cowners who submit this affidavit indicating they arc doing all wuti and then hire outside contractors must submit a new affrdat it indicating such.
:Contractors that check this box must attached an additional sheet showing the name of the sub-tuntr.►tturs and state whether ut nut those entities has e
employees. if the sub-contractors Kate employees.due mast prutrde theta v.urkers'comp.police nuutkcr.
I am an employer that is pro►iding 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.#: MWC 314158 22 Expiration Date:10/01/2023
lob site Address: /d -t �D Cityr"State'Zip:/aJ� I U" ' /� o NI, o
Attach a copy of the tw orkers'compensation policy declaration page(showing the polity number and expiration date).
Failure to secure cos crape as required under Section 25A of MCA_c. 152 can lead to the imposition of criminal penalties of 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 S250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance cosera_N verification.
I do hereby certify wider the pains and penalties of perjury that the faforaratioaprovided above is true and correct
Si atiae: ? d21-+L 03/31/23
Phone #: O g S ._..
OJTcial use only. Do not write in this area.to be completed by city or town official.
( its or Iossn: Permit i.icense a
Issuing Authority (check one): n
IOBoard of Health 20 Building Department 3 0( its loss n(kris 3.0 I lectrical Inspector 501'lumhink
Inspector b.❑Other
( intact Person: Phone a:
t _ .
5RENEWAL
7!,* brANDERSEN
/' FOIL SERVICE WINDOW&DOOR REPIA(EMENT
9
°s 1
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
Go Permits, LLC
105 Buttonball Lane
CPO_ Glastonbury, CT 06033
PERMITS 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: renewalbyandersen a gopermits.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
„.....meN Page 1 of I
A�'ORI1? CERTIFICATE OF LIABILITY INSURANCE DATE`aloDD`'m”'
��. 09/21/2022
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATNELY 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 policyfies)must have ADDITIONAL INSURED provisions or be endorsed.
H 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 endorsarnent(s).
PRODUCER ACT
R. WALLA Tamers Ratans Caz_ifi cat• Cal._az
Will Ls rower Watson Midrmat, Inc. PHONE 1-ITT-lOS-7170 yy FAX 1-9e5-467-237e
G c/o 2f ntory BlvdEMAIL
uY•me c.n- 1 LAC.ho4
P.O. boa 305191 Amerika sea tllLa'agsEmAlliA.Call
MAs1Lvil la, 111 3T2305391 USA IIIIIINIONSI AFFORDING COVERAGE NA1CA
INaIaE*A: Old Repnbl3c Insurance Company 2 414 7
INSURED MILNER II:
Aawal by Abdomen 1.1C
30 Forbes Rod INI RC:
bar tbboroagb, Mk 01532 NEWER D:
INSURERS:
_ININMERF.
COVERAGES CERTIFlCATE NUMBER:W26001431 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE PISURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDNIG 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
9r SR 7YPEOF INSURANCE ADDLiUINr POLICY EFF POLICY LIP UNITS LTA D"VDPOLICr RUINER aINO0'YY YY TYl IMNIOLVY I ,
IC 04CCML GEIERAL UAeam EACH.DC CURRE NC 1 2,000,000
1 CLAIM&trKDE ID OCCUR PREMISES Ea octant/Ku $ S00,000
a MEC,ElP;1 y err Amon' I 10,000
..'
IOW 3141E1 22 10/01/2022 10/01/2023 PEAHOMi1.lADVINRIRY S 2,000.000
r--
OEM.AGGREGATE LSAT APPLES PERGENERK AGGREGATE ,000,000
1PRODX POU P�RC6T El AC CY❑ L
UCTS•COMPOP AGO $ 4,000,000
1HE= f
AUTOMOBILE UNIL1lY COVEINED SINGLE LINT S S,000,000
X ANY AUTO BODILY INJURY IDir WWI S
A IeFT`r AUTOS ONLY `— ALR S 314159 22 10/01/2022 10/C1/2023 BODILY INJURY(Paaocmmii $
HMO NO CRWIED PROPER TY DAMAGE L
AUTOS CNIv AUTOS ON.Y Mee aotaWi
f
... UNIBELLAUTAB J OCCUR EACH OCCURRENCE 'i
E7OCEI6USS CLASNAAADE AGGREGATE 1
' OED I I F E'TEPRION L 1
WORKERS COYPFJRATIdI PE;Rt11TE I I E ORTH-
AND BILOYERS L.M1 LIrY Y/N X I SiA
A AkYPRCWRIETOR.RMRTNERIEAECUTNE EL EACH ACCIDENT $ 1,000,000
OFFCERMEISEREXCtuOEO7 N t A Ft 3141S0 22 10/01/2022 l0/0i/2023
(rleadFbry In Ice EL.DISEASE-EA ELPLOYEEk,$ 1.000.000
IT Ns deems u n2e
DESCRIPTION OF OPERATIONS i E L.DISEASE.POLICY UNIT $
1,OOC,000
rm
I _
DESCRIPTION OF OPERATIONS I LOCATIONS I ANKLES IACORD 101.AdNUeIW RamaAs aasWAA my be mNlW news NINA m WINO
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 PROWSPONS
AU T HORQEO REPRESENTATIVE
4/4
Ev Idance of Insurance 'zt �+ c'r/`-
1988-2016 ACORD CORPORATION. All rights reserved.
ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
.. _!..i`5_7] oATCn 2E'1E324
Commonwealth of Massachusetts Catfatieaisft lfgersMo►
it Division of Occupational Ltcensurc Unrestri ted-grYew of may use group snitch contain
Board of Building Regulations and Standards iess than 36,000 cubic lett(901 cubic motors)of enclosed
Jnstkilittikori ISUgervisor spoce
'Co
CS-090125 moires: 10/06/2024
JAIME L MO91N .;1S f
54 NOTTINGHAM RD ry; iE
RAYMOND PIN 0307T i,iF°
141/03 - Faltort to possess a CJIMfest edition at the MassacAwatlt
Carnmissrcncr destili }; 96at /rt.. St Suilding Code is cause tot nwocaSon MIMs Sosime.
For meets RIMi died this heat
Call 417)T27-7010 or Moil tr w.Mes.geshIp1
THE COMMONWEALTH OF MASSACHUSETTS
Office of Consumer Affairs and Business Regulation
1000 Washington Street - Suite 710
Boston, Massachusetts 02118
Home im - ent • tractor Registration
k—.......:— . --- 1 g
""'. .20It
y 'Y Supplement Gard
Re9i 170E10
RENEWAL BY ANDERSEN LLC is — on' t72
Expiration' 12/22'23
30 FORBES RD
NORTHSOROUGH..MA 01532 ; t
2
p.
7
Address one Renton Card.
THE COMMONWEALTH OF MASSACHUSETTS
Ofhce of Consumer'Affasis&Business Regulation Regsatration valid for individual use onty before the
HOME IMPROVEMENT CONTRACTOR .Mvr+,^..d■re it hound return to:
TYPE.Sutaplumreni i:acd Office of Consumer Affairs and Business Regulat►on
1000 Washington Street -Suns 710
RtfillUiSMIO Feed raitett Boston,MA 0211t)
VOI110 1122/201w
RENEWAL N•r ANDERSEN LLC
JAIME MORIN � ,/
30 FORBf S RD c,�lin...r. ,4,:<yr.+1 c
f ORTHBORCt J H,MA 01532 Undersecretary /'�Not, lid without signature
Page 1 of 1
ACGRd CERTIFICATE OF LIABILITY INSURANCE o9/dii/ro ou'
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 MOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the ceettflcate holder I.an ADDITIONAL INSURED,the poflcy{les)must have ADDITIONAL INSURED provisions or be endorsed_
If SUBROGATION IS WAIVED.subject to the terms and conditions of tits policy,certain pencils may require an endorsement. A stabment on
this certificate does not confer rights to the certificate holder In lieu of such endorsement(s).
PRODUCER mossa4gr�Millis Tows Matson CAA tit cats Canter
Millis Tessera Bataan IMAaeat, tan. PHONE
ale 24 Oantery Baon 1-S77-945-7370 I .RYA 1-e1e-997-237$
P.O. Max 305191 mamas oar tit icateseriilis.cam
Nashville, TN 372305191 OSA seUREMON AFFORDING COVERAGE NACs
NaURERA: Old Republic Uuuzaacs Company 24147
INURED
MUREX•:
aeearsi by Aadsssss LAC
30 fozbsa Mead INSURER C:
aasealoaeoya, eY 01532 gyp;
NEWER E
NNIRER F
COVERAGES CERTIFICATE NUMBER:W26007651 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 POLICES,L&IITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS
EXP
TYPE OF INSURANCE POLCY NUMBER YyYy1 POLl AeYmI'YYYYI Mara
X CDIMIEMCW.GENERAL LIAMILITY EACH OCCURRENCE ! 2,000,000
1 cLJdu •MACE OCCUR OA.MI 7f rRNTEU
S
x PgEheI ESEaoowmmou I 500,000
A LIED EW{My ore puIu1i a 10,000
WRIT 314161 22 10/01/2022 10/01/2023 PERBORA1tADYINAIRY ! 2,000,000
GENL AAOfEOATE WIT APPLES PER GENERAL AGGREGATE ! 4,000,000
POLICY El sEPFireiQ LOC PRODUCTS•COMPIOP AGG ! t,000,000
OTHER !
AUTOMOBILE LIAMILITI CCOOMBI ED SINGLE LIMIT ! 5,000,000
madmen
X ANY AUTO BODILY HAIRY(Per ovum) !
A F--. ONMED ^ SCHEDULED MIS 314159 22 10/01/2022 10/01/2023 BODILY lNAIRY(Per mrsind) I
AUTOS ONLY 4 TU OB
~ HYRED ^ D PROPERTY DAMAGE !
AUTOS ONLY AUTOS ONLY Moir accal m
WNSIELLALIAB OOCE.R EACH OCCURAFNCE !
.� EXCESS UAa CLAMS-MADE AGGREGATE !
OEO L IRE rttsI;UN! !
*OReERSCOMPENMTIOM x'STUTE I I¶
AND E IFUnERE LMNLRY
A MYPROPRIETCR.'PARTNERIEXECUTME YIN EL EACH ACCIDENT ! 1,000,000
OFF CERAAELBERE7cCLUOEDT D NIA NYC 31415E 22 10/01/2022 10/01/2023
0110MNIary M MIN EL DISEASE-EA EMPLOYEE a 1,000,000
II pas Osman:waver 1,000,000
DESCRIPTION Of OPERATIONS baloa E L.DISEASE•POLICY UNIT !
DESCRIPTION OF OPERATIONS I LOCATIONS r'VEHICLES IACOW N1.adeNanalgaus4$il IRANI a.Isar Is RIMIXI A Emma vacs a noose
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICES BE CANCELLED WORE
TIE EXPIRATION DATE THEREOF, NOTICE WLL BE DELNERED IN
ACCORDANCE II TTN TIE POLICY PROVISIONS.
M T wo11®REPRMERTATNE
C" ,L
Evidence of Insurance it 9•
0111011-201$ACORD CORPORATION. AM rights reserved.
ACORD 25(2016103) The ACORD name end logo are registered marks of ACORD
ml m. 23076070 WAxs. 2676324
Agreement Document and Payment Terms
46:y2
DBA:RENEWAL BY ANDERSEN OF BOSTON David Burton&Beth Spong
RENEWAL Legal Name:Renewal by Andersen LLC 10 Trumbull Road
HIC#170810 Northampton ,MA 01060
byANDERSEN 30 Forbes Road I Northborough,MA 01532 H:(734)657-4765
f W scree MBBOrt BOOT IEttKfY'Mf
Phone:(508)351-2200 I Fax:(508)986-7072 rbaboston@gmail.com C:(413)320-2401
David Burton & Beth Spong 05/12/23
BUYER(S)NAME CONTRACT DATE
10 Trumbull Road,Northampton ,MA 01060 (734)657-4765 (413)320-2401
BUYERS)STREET ADDRESS PRIMARY NUMBER SECONDARY NUMBER
dlburton@smith.edu
PRIMARY EMAIL SECONDARY EMAIL
NOTES: 10 windows
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: $26,742 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: $26,742 Estimated Start: Estimated Completion:
10-12 weeks 1-2 days
AMOUNT FINANCED: $26,742
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 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 05/16/2023 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
Randy Buck David Burton Beth Spong
PRINT NAME OF SALES PERSON PRINT NAME PRINT NAME
05/12/23 Page 2/ 37
Itemized Order Receipt
DBA:RENEWAL BY ANDERSEN OF BOSTON David Burton& Beth Spong
RENEWAL Legal Name:Renewal by Andersen LLC 10 Trumbull Road
HIC#170810 Northampton ,MA 01060
byANDERSEN 30 Forbes Road I Northborough,MA 01532 H:(734)657-4765
Phone:(508)351-2200 I Fax:(508)986-7072 I rbaboston@gmail.com C:(413)320-2401
ID#: ROOM: SIZE: DETAILS: PRICE:
101 living room Window Double-Hung (DG) 1:1 Slope Sill, Insert Frame,
Traditional Checkrail, Exterior Canvas, Interior Canvas,
Performance Calculator PG Rating: 40 I DP Rating: + 40 / -
40 Glass, All Sash: High Performance SmartSun Glass, No
Pattern, Hardware, Canvas, Screen, Aluminum, Full Screen,
Grille Style, Grilles Between Glass (GBG), Grille Pattern,
Sash 1: Colonial 2w x 2h, Sash 2: No Grille, Mlsc, None
102 living room Window Picture Base Frame, Exterior Canvas, Interior Canvas,
Performance Calculator PG Rating: 50 I DP Rating: + 50 / -
50 Glass, All Sash: High Performance SmartSun Glass, No
Pattern, Hardware, Canvas, Grille Style, No Grille, Mlsc,
Mulled Unit, Replacement of window frame and sash, mulled
to other units.
103 living room Window Double-Hung (DG) 1:1 Slope Sill, Insert Frame,
Traditional Checkrail, Exterior Canvas, Interior Canvas,
Performance Calculator PG Rating: 40 I DP Rating: + 40 / -
40 Glass, All Sash: High Performance SmartSun Glass, No
Pattern, Hardware, Canvas, Screen, Aluminum, Full Screen,
Grille Style, Grilles Between Glass (GBG), Grille Pattern,
Sash 1: Colonial 2w x 2h, Sash 2: No Grille, Mlsc, None
105 Living Window Double-Hung (DG) 1:1 Slope Sill, Insert Frame,
Traditional Checkrail, Exterior Canvas, Interior Canvas,
Performance Calculator PG Rating: 40 I DP Rating: + 40 / -
40 Glass, All Sash: High Performance SmartSun Glass, No
Pattern, Hardware, Canvas, Screen, Aluminum, Full Screen,
Grille Style, Grilles Between Glass (GBG), Grille Pattern,
Sash 1: Colonial 3w x 2h, Sash 2: No Grille, Mlsc, None
106 staircase Window
05/12/23 Page 3/ 37
A.�
Itemized Order Receipt
Y DBA:RENEWAL BY ANDERSEN OF BOSTON David Burton&Beth Spong
RENEWAL Legal Name:Renewal by Andersen LLC 10 Trumbull Road
HIC#170810 Northampton ,MA 01060
byANDERSEN
30 Forbes Road I Northborough,MA 01532 H:(734)657-4765
Phone:(508)351-2200 I Fax:(508)986-7072 I rbaboston@gmail.com C:(413)320-2401
ID#: ROOM: SIZE: DETAILS: PRICE:
Double-Hung (DG) 1:1 Slope Sill, Insert Frame, Traditional
Checkrail, Exterior Canvas, Interior Canvas, Performance
Calculator PG Rating: 40 I DP Rating: + 40 / - 40 Glass, All
Sash: High Performance SmartSun Glass, No Pattern,
Hardware, Canvas, Screen, Aluminum, Full Screen, Grille
Style, Grilles Between Glass (GBG), Grille Pattern, Sash 1:
Colonial 3w x 2h, Sash 2: No Grille, Mlsc, None
107 living room Window Double-Hung (DG) 1:1 Slope Sill, Insert Frame,
Traditional Checkrail, Exterior Canvas, Interior Canvas,
Performance Calculator PG Rating: 40 I DP Rating: + 40 / -
40 Glass, All Sash: High Performance SmartSun Glass, No
Pattern, Hardware, Canvas, Screen,Aluminum, Full Screen,
Grille Style, Grilles Between Glass (GBG), Grille Pattern,
Sash 1: Colonial 3w x 2h, Sash 2: No Grille, Misc, None
108 living room Window Double-Hung (DG) 1:1 Slope Sill, Insert Frame,
Traditional Checkrail, Exterior Canvas, Interior Canvas,
Performance Calculator PG Rating: 40 I DP Rating: + 40 / -
40 Glass, All Sash: High Performance SmartSun Glass, No
Pattern, Hardware, Canvas, Screen, Aluminum, Full Screen,
Grille Style, Grilles Between Glass (GBG), Grille Pattern,
Sash 1: Colonial 3w x 2h, Sash 2: No Grille, Mlsc, None
109 Itop of stairs Window Double-Hung (DG) 1:1 Slope Sill, Insert Frame,
Traditional Checkrail, Exterior Canvas, Interior Canvas,
Performance Calculator PG Rating: 40 I DP Rating: + 40 / -
40 Glass, All Sash: High Performance SmartSun Glass, No
Pattern, Tempered Glass, Hardware, Canvas, Screen,
Aluminum, Full Screen, Grille Style, Grilles Between Glass
(GBG), Grille Pattern, Sash 1: Colonial 3w x 2h, Sash 2: No
Grille, Misc, None
110 upstairs storage Window
05/12/23 Page 4/ 37
Itemized Order Receipt
DBA:RENEWAL BY ANDERSEN OF BOSTON David Burton&Beth Spong
Legal Name: Renewal by Andersen LLC 10 Trumbull Road
RENEWAL HIC#170810 Northampton ,MA 01060
byANDERSEN 30 Forbes Road I Northborough,MA 01532 H:(734)657-4765
RC MCI AIMS 60011MIRI011
Phone:(508)351-2200 I Fax:(508)986-7072 I rbaboston@gmail.com C:(413)320-2401
ID#: ROOM: SIZE: DETAILS: PRICE:
Double-Hung (DG) 1:1 Slope Sill, Insert Frame, Traditional
Checkrail, Exterior Canvas, Interior Canvas, Performance
Calculator PG Rating: 40 DP Rating: + 40 / - 40 Glass, All
Sash: High Performance SmartSun Glass, No Pattern,
Hardware, Canvas, Screen, Aluminum, Full Screen, Grille
Style, Grilles Between Glass (GBG), Grille Pattern, Sash 1:
Colonial 3w x 2h, Sash 2: No Grille, Misc, None
111 front bedroom Window Double-Hung (DG) 1:1 Slope Sill, Insert Frame,
Traditional Checkrail, Exterior Canvas, Interior Canvas,
Performance Calculator PG Rating: 40 DP Rating: + 40 / -
40 Glass, All Sash: High Performance SmartSun Glass, No
Pattern, Hardware, Canvas,Screen, Aluminum, Full Screen,
Grille Style, Grilles Between Glass (GBG), Grille Pattern,
Sash 1: Colonial 3w x 2h, Sash 2: No Grille, Misc, None
WINDOWS: 10 PATIO DOORS: 0 ENTRY DOORS: 0 SPECIALTY: 0 MISC: 0 TOTAL $26,742
N., F Renewal by Andersen is committed to our customers'safety by
& ` complying with the rules and lead-safe work practices specified by the EPA.
05/12/23 Page 5/ 37
RENEWAL BY ANDERSEN SPECIFICATION 8 TECHNICAL MANUAL TECHNICAL INFORMATION
PERFORMANCE RATINGS AND TEST DATA
NFRC Total Unit Performance
U-Factor6'- SHBC
fRlnlwai High Peron**, (BTUI(hr f oF))
VT
Product Air HP Gas Blend Air HP Gas Blend
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-E4s
Full Divided Light Grilles 0.32 0.29 0.25 0.25
Casement Without Grilles 0.32 0.29 0.17 0.17 .40
6 Low-E4®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-E4•SmartSunTM
Full Divided Light Grilles 0.32 0.29 0.17 0.17
Low-E48SmartSun Without Grilles 0.26 0.24 0.18 0.18 .63
with HeatLockw 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-E4a
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-E48 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-E4®SmartSunTM
Full Divided Light Grilles 0.32 0.29 0.17 0.17
Low-E48 SmartSun Without Grilles 0.27 0.25 0.18 0.18 .63
with HeatLockTM 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-E4a
Full Divided Li ht Grilles 0.34 0.31 0.28 0.28
Double lung 08 ® Without Grilles 0.33 0.30 0.20 0.19 .40
Gil Frames) Low-E4 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-E4s SmartSunm
ll Divided light Griii� 0.34 0.30 0.19 0.19
j1iD �►�► ►firnme rri1Ip n 97 a 2g n 9n n�n RI
with HeatLockm 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 TECHNICAL INFORMATION
PERFORMANCE RATINGS AND TEST DATA
NFRC Total Unit Performance (continued)
U Factor SHBC
Renewal by Andersen•
(B1Ul(hr ft2 oF)) in
Product
Air HP Gas Blend Air HP Gas Blend
Without Grilles 0.44 0.42 0.61 0.61 .82
Clear
Full Divided Light Grilles 0.45 0.43 0.55 0.55
Without Grilles 0.31 0.27 0.33 0.32 .72
Low-E4®
Full Divided Light Grilles 0.32 0.28 0.29 0.29
Picture Without Grilles 0.31 0.27 0.20 0.20 .40
(Full Frame) Low-E4e Sun
Full Divided Light Grilles 0.33 0.29 0.18 0.18
Without Grilles 0.30 0.26 0.22 0.22 .65
Low-E4e SmartSunTM
Full Divided Light Grilles 0.32 0.28 0.20 0.20
Low-E4a SmartSun Without Grilles 0.25 0.22 0.22 0.21 .63
with HeatLockTM Full Divided Light Grilles 0.25 0.22 0.20 0.19
Without Grilles 0.45 0.43 0.64 0.64 .82
Clear
Full Divided Light Grilles 0.46 0.44 0.57 0.57
Without Grilles 0.31 0.27 0.34 0.34 .72
Low-E4•
a Full Divided Light Grilles 013 SUR 0.31 0.31
Picture Without Grilles 0.31 0.28 02\ 0.2 .40
• (Insert Frame) Low E4•Sun
Full Divided Light Grilles 0.33 0.29 0.19 0.19
...L
1 ryithout Grilles) 0.30 0.27 023 0.23 .65
Low-E4•SmartSunTM
Full Divided Light Grilles 0.32 0.28 05f 0.21
Low-E4•SmartSun nip o t riles 0.25 022 22 0.22 .63
with HeatLockTM Full Divided Light Grilles 0.25 0.22 0.20 0.20
Without Grilles 0.44 0.42 0.61 0.61 0.82
Clear
Full Divided Light Grilles 0.45 0.43 0.55 0.55
Without Grilles 0.31 0.27 0.33 0.32 0.72
Low-E4'
Full Divided Light Grilles 0.32 0.28 0.29 0.29
Picture Without Grilles 0.31 0.27 0.20 0.20 0.40
(Universal Frame) Low-E4®Sun
Full Divided Light Grilles 0.33 0.29 0.18 0.18
Without Grilles 0.30 0.26 0.22 0.22 0.65
Low-E4®SmartSun
Full Divided Light Grilles 0.32 0.28 0.20 0.20
Low-E0 SmartSun Without Grilles 0.25 0.22 0.22 0.21 0.63
with HeatLockTM Full Divided Light Grilles 0.25 0.22 0.20 0.19
09-11 COMPANY CONFIDENTIAL-REVISION AA-01