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35-135 (7) BP-2023-1405 20 WESTWOOD TERR COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 35-135-001 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-2023-1405 PERMISSION IS HEREBY GRANTED TO: Project# WINDOWS 2023 Contractor: License: Est.Cost: 12001 RENEWAL BY ANDERSEN 090125 Const.Class: Exp.Date: 10/06/2024 Use Group: Owner: A SULLIVAN DEBORAH Lot Size (sq.ft.) Zoning: WSP Applicant: RENEWAL BY ANDERSEN Applicant Address Phone: Insurance: 30 FORBES RD 508-351-227 WLRC50668058 NORTHBOROUGH, MA 01532 ISSUED ON: 10/19/2023 TO PERFORM THE FOLLOWING WORK: 6 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: 9-1 .; • f . (� Fees Paid: $40.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner �Cptc, �1ca �, eot to„,„, /,N i 71 f- Cork orra,,A@"weft,eh- • or l`' Commonwealth of Massachusetts `/ ,lip 7 G�1 `I �� and .f Building Regulations and Standards FOR t. li, , - ssac iusetts State Building Code, 780 CMR MUNICIPALITY USE QAuilgii�g')?� tit plic1tion To Construct, Repair, Renovate Or Demolish a Revised Mar 2011 1%01 ine-or Two-Family Dwelling ;;-5- GT 0Ns This Section For Official Use Onl B ildit ! milt r)v rt."'°''' - )). - OS Date Applied: Building Official(Print Name) Signature Date SECTION 1: SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers Lo Ge5t lib•el °F-/ 1.1a Is this an accepted street?yes no 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❑ On site disposal system 0 Check if ves❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: Deb ens ix Ski t«ret" _Ro/low AM Dlo62 Name(Print) City,State,ZIP AnWesf a, a /I oS t CA.°itl a OW41.(,,0 w% d Street Telephone YmairAddress 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 13/Specify: /i(f iacem-.4 c•owlivr Brief Description of Proposed Work': Rb*A .mod oil f 4 ce ' T-- ei•f �M a r,i44.- R1 la c 4 G l�rn A.061 r' i s Se SECTION 4: EST ATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ 1Z 00, 4,, 1. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical $ i ❑ 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 $ 1 Suppression) Total All V ,S )► Check No. V Check Amount:11, Cash Amount: 6. Total Project Cost: $ (j1 O t •CO ❑Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) D'70 IL s m eL�/ Ja:� �O/b-' License Number Expir onD Name of CSL Holder N.JS 3. F r hcs ,p d List CSL Type(see below) No.and Street vl Type Description /D '- n U Unrestricted(Buildings up to 35,000 cu.ft.) C�/TO ZIPo 'T 0,s 3 L M Restricted etr cted 1&2 Family Dwelling Masonry RC Roofmg Covering � S] Window and Siding SF Solid Fuel Burning Appliances g.o-95Z —W/2 fges .,25I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) Gkie- 171 ifelde are / 7-0 Rio HIC Registration Number Exp 'on Date Compa_n_y Name C Registrant Name No.and Street /Lh,-dui borokg t� g41* otf3L TGo roe-teta �:mziil<<���,. 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 11 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 accurate to the best o my kno. -•:e and understanding. ( ,-4 l L C - J‘t % g" CWO (,, — Z 3 Print Owner's or Authorized Agent's Name(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 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 if`" t Massachusetts a``�S,s x_ s,��`` ,{ * (c 'l, • DEPARTMENT OF BUILDING INSPECTIONS S w • w M 212 Main Street • Municipal Building Jti OD � +dw.�` Northampton, MA 01060 `� sHw �� 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: GJa 5 6- A4'` Location of Facility: 30 fwbes ie,d Ai 62)40"tti L Ya.t a of.13 4-- The debris will be transported by: Name of Hauler: 7Ar MO"'eN Signature of Applicant: 4 Date: I,--� ' L 3 The Commonwealth of Massachusetts 41111111111111111 Department of Industrial Accidents " ', Office of Investigations .-, - �. - Lafayette City Center ,R. t ?Avenue de Lafayette, Boston, MA 02>1 t 1.1750 .. = www.mass.gov/dia Workers"Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers .applicant Information Please Print I.egihIy Renewal by Andersen Name lousiness•'C)r}:,unitation'indiridual): � Address: 30 Forbes Rd. City/State/Zip:North borough, MA 01532 Phone #:508.351-2277 Are you an employer'! ('heck the appropriate box: Type of project(required): 1.14 I am a employer wiisli 30 - 0 1 am a general contractor and 1 employees(full and or part-time).4 have hired the sub-contractors 6. ❑New construction listed on the attached sheet. 7. 0 Remodeling 2.❑ lam a sole proprietor or partner- ship and have no employees These sub-contractors have g. 0 Demolition workingfor me in any capacity. employees and have workers' p 9. 0 Building addition [No workers' comp. insurance comp. insurance.: required.] 5. 0 We are a corporation and its 10.0 Electrical repairs or additions 3.0 I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. {No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required] ' c. 152.§1(4),and we have no Replacement employees. [No workers' 13.�(hher P comp. insurance required] *Any applicant dun checks box#1 must also fill out the section below Avowing their workers'eornpensation policy information. t Hanseonive s who submit this affidavit indicating they arc doing all wort and then hire outside contractors must submit a nc s affidavit indicating such teoattra:tors that check this box must attached an additional sheet shoeing the name oldie sub-contractors and state whether or not those entities have employees. if the stub-contractors have employees.they trust pro,.tdc thru ,oktiHi:crs'comp.policy number. I am an enrploptr that is providing workers'compensation insurance for my employees. Beloit is the policy and job site information. Insurance Company Name: Old Republic Insurance Co. Policy#or Self-ins. Lic.#: MWC 314158 22 Expiration Date:10/01j20,C1 A Job Site Address: EA, we's it woo et Ter c'rtyi'State:'Lip F/o(ence MA d I(76 2 Attach a copy of the workers' compensation policy declaration page(showing the policy amber and expiration date). Failure to secure coverage as acquired under Section 23A of MCA.c. 152 can lead to the imposition of criminal penalties of a fine up to 51.500.00 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 I)IA for insurance c«Acrag( ,cn tic atton. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct Signature ?4-1-111'n't , , u.tte. 03/31/23 ',trret:. '60— 9 2.— '(//V —.. Official use only. Do not write in this area.to he completed by city or town official. ( its or Iowa: Permit I.ict•nse # Issuing t,uthority (check one): I❑Board of llcalth 20 Building Depaartnieut 3 kyflowtn Clerk 4.0 I:trcirical Inspector tEI'lumhint; Inspector (►.❑Other Contact Person: l'hoac #: ,t,/- RENEWAL byANDERSEN FULSERACE WINDOW S 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 a TECHNICAL MANUAL TECHNICAL INFORMATION PERFORMANCE RATINGS AND TEST DATA NFRC Total Unit Performance Renewal by Andersen® BT 0-Factor SH6C Product High Performance Glass Type ( I(hr ft2 oF)) VT 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-E4® Full Divided Light Grilles 0.32 0.29 0.25 0.25 Casement Without Grilles 0.32 0.29 0.17 0.17 .40 a 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®SmartSun Full Divided Light Grilles 0.32 0.29 0.17 0.17 Low-E4®SmartSun Without Grilles 0.26 0.24 0.18 0.18 .63 with HeatLockTM 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-E4® 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-E4®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-E4®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-E4® 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 1 (All Frames) Low-E4®Sun Full Divided Light Grilles 0.35 0.31 0.18 0.17 • out Grille 0.32 1.29 0.21 0.21 .65 Low E4®SmartSunTM Full Divided Light Grilles 0.34 0.30 0.19 0.19 � � w Withrud nrillac n 97 n 95 n 2n nammomenei a� with Head ockTM Full Divided Light Grilles 0.30 0.27 0.18 0.18 09-9 COMPANY CONFIDENTIAL- REVISION AA-01 Agreement Document and Payment Terms /^b4 NMI% fl. DBA:RENEWAL BY ANDERSEN OF BOSTON Deborah Sullivan • Legal Name:Renewal by Andersen LLC 20 Westwood Ter. RENEWAL EN EWAL HIC#170810 Florence,MA 01062 30 Forbes Road I Northborough,MA 01532 H:(603)203-8721 Phone:(508)351-2200 Fax:(508)986-7072 I rbaboston@gmail.com Deborah Sullivan 09/25/23 BUYER(S)NAME CONTRACT DATE 20 Westwood Ter., Florence, MA 01062 (603)203-8721 BUYER(S)STREET ADDRESS PRIMARY NUMBER SECONDARY NUMBER Cranky@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: $12,001 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: $12,001 Estimated Start: Estimated Completion: 12-16 weeks 1 Day AMOUNT FINANCED: $12,001 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 09/28/2023 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 Matthew Pelletier Deborah Sullivan PRINT NAME OF SALES PERSON PRINT NAME PRINT NAME 09/25/23 Page 2 / 38 Itemized Order Receipt c,„scL DBA:RENEWAL BY ANDERSEN OF BOSTON Deborah Sullivan RENEWAL Legal Name:Renewal by Andersen LLC 20 Westwood Ter. HIC#170810 Florence,MA 01062 brANDERSEN 30 Forbes Road I Northborough,MA 01532 H:(603)203-8721 fWiYaR MOM I 00QIRIA[fAfN? Phone:(508)351-2200 I Fax:(508)986-7072 I rbaboston®gmail.com ID#: ROOM: SIZE: DETAILS: PRICE: 101 Dining Window Double-Hung (DG) 1:1 Flat Sill, Base 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, Mlsc, Standard, Replacement of window frame and sash, includes casing from standard options., 102 Dining Window Double-Hung (DG) 1:1 Flat Sill, Base 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, Mlsc, Standard, Replacement of window frame and sash, includes casing from standard options., 103 Guest Bedroom Window Double-Hung (DG) 1:1 Flat Sill, Base 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, Mlsc, Standard, Replacement of window frame and sash, includes casing from standard options., 09/25/23 Page 3/ 38 Itemized Order Receipt DBA:RENEWAL BY ANDERSEN OF BOSTON Deborah Sullivan RENEWAL Legal Name:Renewal by Andersen LLC 20 Westwood Ter. EN HIC#170810 Florence,MA 01062 Fwunx,wxoasno«SEN 30 Forbes Road I Northborough,MA 01532 H:(603)203-8721 AIPEMEKEW Phone:(508)351-2200 I Fax:(508)986-7072 I rbaboston®gmail.com ID#: ROOM: SIZE: DETAILS: PRICE: 104 Guest Bedroom Window Double-Hung (DG) 1:1 Flat Sill, Base 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, Mlsc, Standard, Replacement of window frame and sash, includes casing from standard options., WINDOWS: 4 PATIO DOORS: 0 ENTRY DOORS: 0 SPECIALTY: 0 MISC: 0 TOTAL $12,001 "i" Renewal by Andersen is committed to our customers'safety by complying with the rules and lead-safe work practices specified by the EPA. 09/25/23 Page 4/ 38 CC Payment Authorization Form �►�' j' DBA: RENEWAL BY ANDERSEN OF BOSTON Deborah Sullivan RENEWAL Legal Name:Renewal by Andersen LLC 20 Westwood Ter. HIC#170810 Florence,MA 01062 byANDERSEN 30 Forbes Road I Northborough,MA 01532 H:(603)203-8721 laISINUMONLMMUKUMW Phone:(508)351-2200 I Fax:(508)986-7072 I rbaboston@gmail.com Deborah Sullivan BUYER NAME 20 Westwood Ter. Florence ADDRESS CITY MA 01062 (603)203-8721 STATE ZIP CODE PHONE NUMBER 1 PHONE NUMBER 2 Greensky 4521 $12,001 FINANCE PROGRAM' FINANCE PLAN#' CONTRACT BALANCE Matthew Pelletier 2326802739 09/25/2024 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 ($12,001) CASH DEPOSIT(1) FINANCE DEPOSIT(2) START OF JOB(3) SUBSTANTIAL COMPLETION(4) FINANCING $0 $4,000 $4,000 $4,001 (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. Deborah Sullivan 09/25/23 BUYER NAME SIGNATURE DATE 09/25/23 Page 5/ 38 Go Permits, LLC 105 Buttonball Lane GO 11111 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 Page 1 of 1 AC(3RD" CERTIFICATE OF LIABILITY INSURANCE DATE A i2i/2o z 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 pollcyllee)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 certtf sate holder In lieu of such endorsement(s). PROOUCER EACT 111113a Towers Matson Certificate Center will is rows YaLaon i*ohrest• Inc. e!u 26 Century bird PHONE e.n 1-877-965-7378 IcLiIC mek 1-BBB-467-2378 P.O. boa 305191 Amami_ cer Lie icateeRmillia.coif NarLvi116, BR 3/2 30 5 191 USA INSUIREINSI AFFORDING COVERAGE NAIC INSURER A. Old Republic Insurance Company 24141' INSURED NBURERB. Menial by Andresen LLC n 3D 'orbs shad NSURERC. Moe tbbarawka, NA 01532 PISURER0. INSURER E INSURER COVERAGES CERTIFICATE NUMBER:11'26007651 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF".NSURANCE LISTED BE,_OW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT.TERM OR CONDIT.ON or ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO MUCH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO Alt THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS MISR ADOUSUISI POLICY EFF POLICY EEP LTR TYPE Of INSURANCE PRO WYD POLICY NUNEIER. IMNVOIYYYYI J11W9tkYYYYI UNITS • X CONIMERCIALGEMENALLINSILITY EACH OCCURRENCE } 2,000,000 CUAIM8.MADE Q OCCUR PREMISES(Eacca1mmee1 ,.9 500,000 A MEC,EYP,;Ary one meson, { 10.000 MIS 314161 22 10/01/2022 10/01/2021 PERSONAL&ADY INJURY { 2.000„000 GEM.AGGREGATE LOST APPLES PER CENERAL AGOREOATE } •.000.000 POLICY❑2636 LCC PRODUCTS-CCHAPOP AGO f 4,000.000 OTHER { AUTOMOBILE UAB{.RY COMB NED SINGLE LAST { 5,000,000 IEas aldAttl X AN',AUTO BODILY i PIN GecaOIN I A ONNED SCHEDULED )6F75 314153 21 10/01/2022 10/01/2023 BODILY INJURY',,Pararucenl} f AUTOS,ONLY ALa H37EDN ED PROPERTY DAMAGE AUTOS ONLY AUTOS OILY iPee aorde III MIME"LAX I OCCUR EACH OCCURRENCE tf EXCESS L*AB CLAiMS.AADE AGOREGA'E 5 1 DED I 1 RETENTIONS WORMERS COMPENSATION x I7410ITE I I'EpH. AND EMPLOYERS'UABIUTY Y N 1,000,000 RI A AN YAR]PETi.R'PARTNERAEXECUTNE El EACH ACCIDENT { OFFY.ERME►E£REXCU.OEO7 N,'A 90IC 314155 22 10/01/2022 10/01/2023 1,000,000 (YenrMry MONO El DISEASE-EA EMPLOYEE } II ye!dra1e0lr u(IMe DESCRIPTION OF OPERATIONS balTe EL DISF& .POLICY LIMIT { 1,000,000 MSC RIPTON OF OPERATIONS&LOCATIONS!VEHICLES IACORD 101.A9dlliunal Renate*Schaalude.ma,be nfKhrd it MON wet*.*new serer 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. AUTHORIZED REPRESENTATIVE •Bvldenoa of Insurance 4A'.i✓ [;t'� 1988-2016 ACORD CORPORATION All rights reserved ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD s. is 230'eal' AAT_e. 2676320 Commonwealth of Massachusetts Coa1>hl�afwfX �s Division or Occupational Licensure Unrestricted_Buildi gsdanywegroupwhich aa)loin Board of Buildingg Re Regulations and Standards less than 35,000 cubic het WI cubic meters)of fB/ i Ce!�strMC41nlSlit?ery sti,• space CS-090125 Etcpires: 10/06(2024 JAIME L MOIIIN — ) 54 NOTTINGHAM RD t RAYMOND N/1 030TT �` t -w 0 4MM► i �''f i.t dzT) .41tad 1ID Failure to possess a current*Orion of the Massachusetts C .. P'p'r', +rr:.:r. ))tile Budding Code is came for revocation of this license. V VII IiiZIJJt t�111cr �,,/)ai r." V V7.• I'I'...., For sr:lo n::dion about this licensc Call I,Uy 4H7)TV-32N/Nort about I w inass.govrdp THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs and Business Regulation 1000 Washingtoft Street - Suite 710 Boston, Massachusetts 02118 Home lm ro ernent Cp tractor Registration ' :X. 11,......4 71.irt mow: eta Type 5upplament c;art Regtstre1ssal. 170810 RENEWAL BY ANDERSFN LLD Espiration 12/2212023 30FORBESRD '" ... O. NOl THeOROUC;N,MA 01532 "_" «- Update Address and Rattan Card. THE COMMONWEALTH OF MASSACHUSE1TS Office of Crmsumet Affairs&Bua+nase Regulation Registration valid for individual use arty before the HOME IMPROVEMENT CONTRACTOR e■tireli"n art. b1 fmrnd return to: TYPE.Suppleerent Card Office of Consumer Affairs and Business 00 Regulabon 10 10 Washington Street -Suite 710 R t Boston,MA 02116 7ltkllQ 1122/2023 RE-if WAL ri'r ANDERSEN LLC: I NORTHBOR006,t4,MA 01532 Undersecretary T f Not 1k1 without signature I . Page 1 of 1 AC RIt CERTIFICATE OF LIABILITY INSURANCE GATE<MaUDO,YYYY} 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 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 policylles)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 c ITTAcr Millis Towers Matson Certificate Canter Will as Towers Matson NYderat, Ice. PHONE ;,WW 1-671-94S-137S r1 X.Not 1-BIB-467-237a c/o 26 Genius). BlvdEMAIL V.O. boa 305191 AncssEss car tit lcatasNwi111a_coo Nashville, TN 312305191 USA INSURER(BI AFFORDING COVERAGE NAICR NSU-RERA. Old Republic Insurance Company 24147 INSURED 15194.1RER B Manewal by Anderaeo LLC 30 rorbea sued NSURERC. Ion tbborvugb, MA 01532 INSURER INSURER E INSURER F COVERAGES CERTIFICATE NUMBER:W26007631 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 WHIC 1 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. LIR TYPE OF INSURANCE woo wvo POLICY NUMBER ADOLNUINF m_�� UNITS X COMMERCIAL.GENERAL LIABftITY EACH OCCURRENCE f 2,.000,00D MI CLAIMS VALE- n OCCUR FREMISESIEA a_cuurnu�ENn'EN 500,000 Pmf A MED EAP,Any cea pu.an) ` 10.000 r-4 iMZY 314161 22 10/01/2022 10/01/2023 2.000.000 PERSONAL AtN INAIRY f GEHL AGGREGATE LIVIT APPLES PER GENERAL AGGREGATE 9 4.000.000 POLICY Q JE FRC' EjLCL PRODUCTS-COMP.WDP AGO f 4.000.000 I OTHER S AUTOMOBILE 13ABS1TY COMBINED SINGLE 11147 f 5,000,000 tEa arodrb X ANY AUTO BODILY INA)RY IP4r 0e11004 f A ~" :WINED scr4EDULEL HMS 314159 22 10/01/2022 10/01/2023 GOOEY INJURY(Par aoG0anI I AUTOS ONLY AUTOS -PIED NOPw.OAHED PROPERTY+DAMAGE F�AUTOS ONLY �•� AUTOS ONLY 'Pre ciuenll •f UMBRELLA t.AS EACH OCCURRENCE EXCESS LAB c*. s.MADE AGGREGATE S DEG 1 RETETVTKON f S WORKERS COMPENSATION i PER vTH. ANDEMPLOYERB'LMBILITY X STATUTE I HER , A ANYPRDPRIETCRPARTNEREXECUTF/E Y N ( EL EACH ACCIDENT f 1.000.0G0 OFF CERM£MEAREACLUCED? Mo NIA MSC 314158 22 10/01/2022 10/01/2023 1,1>00,000 (Mandsbry Inlet E L DI�A.5E-EA EMPLOYEE)f 1,000,000 Ir�a d4•lT N OF O DE9CRIPTI ON OF OPERATIONS term. E L DISEASE-POLICY LIMIT ,4 DESCRI►'MOM OF OPERATIONS I LOCATIONS r VEHICLES IACONO 101,AdMllanal RamaAs SCINO as.may be ens eMae Rowe seers b rMues 0 CERTIFICATE HOLDER CANCELLATION SHOULD ANY Of THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL SE DELNERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED RREPRESENTATNE Evidence OI Insurance I{ '1- 196E-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD �' 2)076070 Intl 2676321 RENEWAL � byANDERSEN To :'fnom It May Concern:. This letter will authorize the followng personls) to act as agent(s)on behalf of Renewal by Andersen LLC, 9900 Jamaica Ave South, Cottage Grove MN 55016 to pull for permits and Inspectlons with respect to the installation, maintenance and repair of windows and entry doors txnrlar Masc�rrlii;ptts State Home improvement Contractor license number 170810 and Construction Supervisor License number CS•09012S. If you have any questions,, please call me at 508,351,2277 ext 6. Authorized person(sl; Go Permits LLC Sarah Hammad David Anderson Maureen Kiwi Scott Doughman Ryan Riondo Sovannara Kuy Mark Foster Glynn Norgan iennirer Winke wenay rsolden Gerald Cramer Nick Rago Dane!lfrckerman Stephen Wilder Katie Grocott Bonnie Myers Carrie Folrgno Michael Rogers Rachel Orloff 0:11-2e_ 'Jamie Morin Renewal by Ora ersen LLC H lC 170810 CSL-CS090125 Local District Office Address 30 Forbes Rd Northbaraugh, MA 01532 c'wwal ter Ar'dersen L'_C '4)tam iu:a Ave South..(mute Grove AMH 55016 Page 1 of 1 ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(M�2023� 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 policy(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 CONTACT Willis Towers Watson Certificate Center Willis Towers Watson Midwest, Inc. PHONE NAME: FAX c/o 26 Century Blvd ; 1-877-945-7378 UVC No); 1-888-467-2378 P.O. Box 305191 ADDRUNk cartificates8willis.cam Nashville, TN 372305191 USA INSURER(8)AFFORDING COVERAGE NAICA INSURERA: Old Republic Insurance Company 24147 INSURED INSURER B: Renewal by Andersen LLC 30 Forbes Road INSURER C: Northborough, MA 01532 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: W30224860 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. INER ER TYPE OF INSURANCE ADDL SUM POUCY EFF POLICY EXP UMIlB LTR INSD INVD POLICY NUMBER (MMIDD/YYYY) IMMIDD/YYYYI X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 8 3,000,000 TO CLAIMS-MADE X OCCUR PRGSES(EsENTED ocamence) $ 500,000 EM MED EXP(Anyone person) $ 10,000 MNZY 314161 23 10/01/2023 10/01/2024 PERSONALRADVIN,iURY $ 9,000,000 GEN'L AGGREGATE UNIT APPLIES PER: GENERAL AGGREGATE 8 6,000,000 X POLICY JJECOT LOC PRODUCTS-COMP/OP AGG $ 6,000,000 OTHER: 8 AUTOMOBILE LIABILITY COMBBIINdEDD SINGLE LIMIT $ 5,000,000 X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED NWTB 314159 23 10/01/2023 10/01/2024 BODILY INJURY(Per accident) ; AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Per accident) ; UMBRELLA UAB _ OCCUR EACH OCCURRENCE 8 EXCESS UAB CLAIMS-MADE AGGREGATE ; DED RETENTION; ; WORKERS COMPENSATION X AND EMPLOYERS'LIABILITYMUTE ERA A ANYPROPRIETOR/PARTNER/EXECUTIVE YIN E.L EACH ACCIDENT ; 1,000,000 OFFICER/MEMBEREXCLUDED? No NIA MWC 314158 23 10/01/2023 10/01/2024 (Mandatory In NH) EL.DISEASE-EA EMPLOYEE $ 1,000,000 N yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY UNIT 8 1,000,000 DESCRIPTION OF OPERATIONS!LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached H more space is required) 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. AUTHORIZED REPRESENTATIVE ►► Evidence of Insurance "-" .L`^• 4844 4. ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD SA ID: 24694639 BATCH: 3138744