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17C-043 (4)
BP-2023-1520 5 HILLCREST DR COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 17C-043-001 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-2023-1520 PERMISSION IS HEREBY GRANTED TO: Project# WINDOWS 2023 Contractor: License: Est.Cost: 27246 RENEWAL BY ANDERSEN 090125 Const.Class: Exp.Date: 10/06/2024 Use Group: Owner: OLUM-GALASK GALASKI PHILIPPE G&JOYCE N Lot Size (sq.ft.) Zoning: URB Applicant: RENEWAL BY ANDERSEN Applicant Address Phone: Insurance: 30 FORBES RD 508-351-227 WLRC50668058 NORTHBOROUGH, MA 01532 ISSUED ON:10/26/2023 TO PERFORM THE FOLLOWING WORK: REPLACEMENT WINDOWS POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Service: Meter: Footings: Rough: Rough: House# Foundation: Final: Final: Final: Rough Frame: Gas: Fire Department Driveway Final: Fireplace/Chimney: Rough: Oil: Insulation: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: X . 5r.°"1 • I ' I Fees Paid: $40.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner W it.tt1 t - / ?/'.lrlitS /S eaM©41.W . /'i-c-c4.y40. . . -✓- J 0 4-- . ._ fere"4 .-kh The Commonwealth of Massachusetts � ,EIS . 1 . , Board of Building Regulations and Standard FOR Massachusetts State Building Code, 780 C ' r CIPALITY Building Permit Application To Construct,Repair, Reno ate 0 Deig6Iiish n '•. •it'r -! 1 One-or Two-Family Dwelling Rp y,, This Section For Official Use 0 .�Aj o `10 Building Permit Number: �^ �-3 IS"� Date Applied: ^OR yqu,,ni•iJo� 4i.--) / Kp"›S /f�G ��Aln°e0OA's 4-4 a23 Building Official(Print Name) Signature Date SECTION 1: SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers S' fl l t e.i- s - D,- ,-cnce- A fo 2 1.la Is this an accepted street?yes f 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 0 On site disposal system 0 Check if yes❑ SECTION 2: PROPERTY OWNERSHIP1 2.1 Owner'of Record: Phil!0. b.elash-' f--loecnte- /N/� o/v6L. Name(Print)' City,State,ZIP c #t7kat F prev- - cm - 31-Y-4W/ /oh"4/.e,r4frk'il"w4 No.and Street Telephone Email Addre 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 ecify: .ff me.1.'b 9 -, BrieefDescription of Proposed Work': ifeerbl.4 A,..I t'e fl rtt 6' wiri4/o.rs• hiie, yil/ l kG , 4-, /10 S `CJi-'rJ c A4,144 SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ t- - Zy6.or., 1. Building Permit Fee: $ Indicate how fee is determined: ❑ Standard City/Town Application Fee 2.Electrical $ ❑Total Project Costa(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire $ Suppression) Total All F Check No. 9) Check Amount: 140 Cash Amount: 6.Total Project Cost: $ 2,4J&4/cto ClPaid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) pck izs /0%E /Zy eTa.4 M..t it40 License Number Expiration D/ate Name of CSL Holder 30 A)ij gd List CSL Type(see below) Lis No.and Street Type Description fiO/ik ho- L n A- 0/r •Z U Unrestricted(Buildings up to 35,000 cu.ft.) R Restricted 1&2 Family Dwelling City/Town,State,ZIP M Masonry Roofing Covering t W Window and Siding SF Solid Fuel Burning Appliances f o-9Sj- WIZ- fyleww(6 a-1h/s-rn@yd,v't'fJ-0 I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) s / e4e,.✓al Li if tdefVel GGG / 8/0 2z Z3 WC Registration Number xpuation Date HIC Company Name or HIC Registrant Name No.and Street S K d /mews 4 gJefsery��oteris vov3 Vo/fth jo/J KA aiSS L cO —IQ.4//Z— Email address City/Town, State,-ZIP Telephone SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152.§ 25C(6)) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the Issuance of the building permit. Signed Affidavit Attached? Yes [!" No ❑ SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,as Owner of the subject property,hereby authorize to act on my behalf,in all matters relative to work authorized by this building permit application. Print Owner's Name(Electronic Signature) Date SECTION 7b: OWNERI OR AUTHORIZED AGENT DECLARATION By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information con .' in this application is true and accurate to the best of my knowledge and understanding. • Print Own• r Au orize gent'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" 1H�MP �, City of Northampton a r ? 'st, Massachusetts ,,44, 1.- 'e ( t c-r t ' DEPARTMENT OF BUILDING INSPECTIONS y +r f' f3 212 Main Street • Municipal Building vti, ra\\ ji10_'k'-a' Northampton, MA 01060 J`sb ir3e. �C 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: Location of Facility: '30 ' s gd / ,/- err--' ` err3Z— The debris will be transported by: Name of Hauler: 6,./a..sta' Ma's Cr Signature of Applicant: a-7 Date: The Commonwealth of Massachusetts Department of Industrial Accidents , _ t Office of Investigations r;� ,,,,,,,, Lafayette City Center �f» 4., 2 Avenue file Lafayette,, Boston,MA{l?l I l_l 75t1 '`"4",:-I" WWW.niass.g,ovlelta Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Lcgihlv Renewal by Andersen Name (Business Illreaniratic 'Individual): __ TM Address 30 Forbes Rd. , City/State Z:p:Northborough, MA 01532 Phone # 508-351-2277 Are you an employer?( heck the Appropriate hos: I,,pi of project(required): 1.N1 I am a employer with 3° 4. 0 1 am a general contractor and t 6. ❑ 1's.ew construction employees(full and/or part-time).* have hired the sub-contractors 2 El 1 am a sole proprietor or partner- listed on the attached sheet El Remodeling ship and have no employees These sub-contractors have 's. Demolition workingfor me in an capacity employees and have workers' Y P tY 9. []Build ng addition [No workers' comp.insurance comp. insurance. required] 5. ❑ We are a corporation and its 1.0 Electrical repairs or additions 3.=j I am a homeowner doing all work officers have exercised their MO Plumbing repairs or additions myself. [No workers" comp. right of exemption per MGL 12.0 Roof repars insurance .d rre uire c. 152. O1(4),and we have no required] 13.�[Other Replacement employees. [No workers' comp. ttsurance required.] •Any applicant that Ghee box nil must al u ftU out the section hek.sv showing their workers"compensation folic inform:1i a1 t Houuowners who submit this affidavit indicating the,are doing all work and then him outside contractors mu,t submit a no, atfidas t rnd sting such Contracture that check this tam musr at isehkd am,additional shoo shuwusft the name attic sub nimactoty easel state whether or not those entities here c.nh.,..:c.. ift[IC•Ll,c.narac'.i:-I'.a\c ariph'ser'.du} Int.•1 PIC1 (.1c Il;:a •.ut1 'comp I.,,li:;. unhcl. t ,sue i one en employer that isproviding workerst compensation insurance for Mel employee'!_ Below is thepo(ici and job site information. Insurance com ans 'dame: Old Republic Insurance Co. Polley#or St:It•ins Li c. t:„_MWC 314158 22 LxpiratOn Date 10/01/2024 Job Site Address: 5 hlllcrest drive C kids taite:+7.ip Florence,MA 01062 Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of Wit c 152 can lead to the mtpi»ihon of criminal penalties of a fine up to$1,500.00 andlor one-year imprisonment, as well as civil penalties in the form ofa STOP WORK ORDER and a tine of up to S250.00 a day against the violator. Be advised that a copy of this statement may he forwarded to the office of Investigations of the DIA for nt:urance coscrnce verification. 1 do hereby certify under the pains and penalties of pewrjur'.that the information provided above is true and correct. Sibrwture. 2 .�'yl.Q. 7,4,41 _ �. Dec: y10/02/23_ Phone r,. ." Ci 5-7 — We Z., Official use only. Do not write in this area,to be completed by city or town official. City or Tossn: .__.._ Permitilicenstr 0 Issuing Authority (check one):I OBoard of Health 20 Building Department 30('its''foss n Clerk 4.OElectrical Inspector 'taluntbifig Inspector G.QOther______ ____ ______ ('outset Person: Phone al:► ._.,_.... ....___._.,___....._.._..._..o. ..,..._,___.._......_.�-._.,. ._. Page 1 of 1 ,4 ROB DATE(MMI ) CERTIFICATE OF LIABILITY INSURANCE 09/21/2023/2023 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(ies) 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 NAME: Willis Towers Watson Midwest, Inc. PHONE 1-877-945-7378 IFAX 1-888-467-2378 c/o 26 Century Blvd LALC.No.Ext):AIL (A/C,No): P.O. Box 305191 ADDRESS: certificates@willis-corn Nashville, TN 372305191 USA INSURER(S)AFFORDING COVERAGE NAICO INSURER A: 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER (MMIDDIYYYY1 (MMIDDIYYYYI X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 3,000,000 DAMAGE TO RENTE CLAIMS-MADE X OCCUR PREMISES Ea occurence) $ 500,000 A MED EXP(Any one person) $ 10,000 MWZY 314161 23 10/01/2023 10/01/2024 PERSONAL&ADVINJURY $ 3,000,000 GENII AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 6,000,000 X POLICY L J PECOT- LOC PRODUCTS-COMP/OP AGG $ 6,000,000 OTHER $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 5,000,000 Ea accident) X ANY AUTO BODILY INJURY(Per person) $ A OWNED SCHEDULED MWTB 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 LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION X PER OTH- AND EMPLOYERS LIABILITY STATUTE ER YIN A ANYPROPRIETOR/PARTNER/EXECUTIVE EL.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? No NIA MSC 314158 23 10/01/2023 10/01/2024 (Mandatory in NH) EL DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if 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/Zr}�RE�P�RESENTAATTIIVVEE � Evidence of Insurance eV7VU 14g4: ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD SR ID: 24694639 BATCH, 3138744 Commonwealth of Massachusetts CoNetr�kfn fYpMvisor ItOmswn of Occupational Licensure Unrestricted-SulMMus of soy use group which mn bilo I Board of Budding Reau;lahons and Standards kss than 35.000 cubic feat( cubic asters}of elltiM s Constk-Ht n 5\1Ce•russot 1Pcif. CS 090125 Espnres_ 10/06/2024 JAIME L MOIBN 54 NOTTINGHAM RD RAYMOND 1411 03077 l\PIIIL446. i)/1)1 3 panes,00 posee a comma ft of the Massachusetts Comm.ssl o nc r ,'9 i,p:.3 �l_ ll" Mats l _Code is aim k r+evocabon of this hcettse. 1 f°. .r vt7 For infaessstloo about this accrete Call($17)771-32S S or total www.ftgss.govfdpt THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs and Business Regulation 1000 Washingtof Street- Suite 710 Boston, Massactuasetts 02118 Home Impro.emegt Co tractor I e istration ti i-fL % `. Type Supp4enwnt( ;aid t.,,;, Fkogrsaletixb: 170610 RENEWAL BY AtdDERSt-N LLC M Ettprahon 12122I2023 3C FOitEIES RD .ii 1. NOR THBOROt)GH MA 01532 .a. i! sr— ..ti UpdM*Address and Retain Card. THE COMMONWEALTH OF MA5SACHUSE11S Office of Consumer Affairs&Busrneae Regulation Registration Valid for individual uso only before the .voiree>o0.far.. W found return to' HOME IMPROVEMENT C4»t`rRACTC�nt Office of Conformer Aftatrs and Brrsir>esn Registration TYPE,Gu plornent Czar] t000 Washington Street iu 1a 710 170810 p i<12a1t4 i22212rJi3 Boston,MA 92110 ll]81C RENEWAL BY ANDEftSEN LLC JAIME MORIN 0 FORBES RD ,,,,...,w <-F.+••r L-'r- NORTHBOROUGH,NA 0153:2 t)rnler3e rCtnry Not lid without signature U.S. Canada ENERGY ENERGY tr o STAR STAR Andersen. Andersen NFRC Certified 13 IsU w v 6.0 v 4.1 Product Line& Glass Grille Type Products a w e 0 5 4Product Type Type Directory Number > j w a t Y w Z U N N N N N c Simulated Divided Lite or Installed Interior Removable AND-N-63-00885-00003 0.25 1.48 0.38 0.46 29 <02 NC - - 21 22 - • IS i. Y - - - N u Full Divided Lite ANDa163-00897-00001 0.28 1.9 D.38 Oa8 28 <02 NC 21 vs 2 a; FineligM"'(grilles-between-the-glass) AND-N-59-00897-00001 0.27 1.53 0.43 0.52 31 <02 3.0 Annealed or 3.1 Tempered Glass-w/No Grilles and Grilles Less Than 1" No Grilles AND-N-63-00792-00001 0.30 1.70 0.32 0.54 20 4 02 - NC iSimulated Divided Lite or Installed Interior Removable AND-N-63-00792-00002 0.30 1.70 0.28 0.48 18 <02 - NC 9# Full Divided Lite AND-N-53-00798-00001 0.31 1.78 0.28 0.40 17 <02 FlnNipht T.(grilles.between-the- lass) AND-N-63-00810-00001 0.31 1.76 0.28 Dap 17 402 No Grilles AND-N-63-00793-00001 0.30 1.70 0.20 0.30 14 <0.2 - NC SC - - - Simulated Divided Lite or Installed Interior Removable AND-N-63-00793-00002 0.30 1.70 0.18 0.27 12 <0.2 NC SC - - - 3 Full Divided Lite AND-N-63-00799-00001 0.31 1.76 0.18 0.27 11 <0.2 - - - - - - 0,...............,......_........ a.e_ ..ner i. ce_ .. Hi lac AND-N 63-00794 00 0.29 1.85 0.21 0.49 15 <0.2 NC SC 5 - - w s Simulated Divided Lite or Installed Interior Removable AND-N-63-00794-00002 0.29 1.65 0.19 0.43 14 <0.2 - NC SC S - - r ▪ Full Divided Lite AND.N-63-00800.00001 0.30 1.70 0.19 0.43 13 <0.2 - NC SC S - - FinellghtV•(grilles-between-the-glass) AND-N-63-00812-00001 0.31 1.76 0.19 0.43 12 <0.2 - - - - - MSS No Grilles AND-N-63-00791-00001 0.31 1.76 0.52 0.60 31 <0.2 - - - '1 - c u, r'n Simulated Divided Lite or Installed Interior Removable AND-N-63-00791-00002 0.31 1.76 0.46 0.53 27 <0.2 - - - 21 - - 9 • Full Divided Lite AND-N-63-00797.00001 0.32 1.82 0.46 0.53 26 <0.2 - - - 21 - - ri Finelight'•(grilles-between-the-glees) AND-Nh633-001309-00001 0.32 1.82 0.48 0.53 26 <02 - - - 71 - - No Grilles AND-N-5400901-00001 0.26 1.48 0.31 0.53 25 <02 N NC - - 21 - - ! 1 w Simulated Divided Lite or Installed Interior Removable AND-N-53-00901-00002 0.26 148 0.26 0.47 23 4 02 N NC - - Z1 - - 3 �° Z Full Divided Lite AND-N-63-00904-00001 0.28 1.59 0.28 0.47 21 <02 11 NC - - 21 - - 3 Flnelightr•(grilles-between-the-plass) AND.N.63-0091 0-0 00 01 0.27 1.53 0.28 0.47 22 <02 N NC - - Z1 - - 00 Series Gliding No Grilles AND-N63-00902-00001 0.26 1.48 0.21 0.47 19 <02 N NC SC Zi va N 1 Simulated Divided Lite or Installed Interior Removable AND-N.83.00902-00002 0.26 1.48 0.19 0.42 18 <0.2 N NC SC Z1 - - 2 - - E = Full Divided LiteLae AND-N69-00905-00001 0.26 1.9 0.16 0.42 15 <02 NC eC N ; Finelightr•(grilles-between-Ole-glass) AND-N63-00911-00001 0.27 1.53 0.10 0.42 17 .1 0.2 N NC SC Z1 - - - No Grilles AND-N-63-00900-00001 0.27 1.53 0.47 0.58 33 <02 N - - - 21 - c▪ r • 1 Simulated Divided Lite or Installed Interior Removable AND-N-83-00900-00002 0.27 1,53 0.42 0.52 30 <0.2 N - - - 21 - 9 .N = Full Divided Lite AND-N-63-00903-00001 0.29 1.55 0.42 0.52 27 <02 N - - - 21 - - a 3 Flnellghtr•(grilles-between-the-glass) AND-N-63-00909-00001 0.28 1.9 0.42 0.52 29 <02 N - - - 21® - 3.0 Annealed or 3.1 Tempered Glass-w/Grilles 1"or Greater Simulated Divided Lite or Installed Interior Removable AND-N-83-00792-00003 0.30 1,70 0.25 0.42 16 <02 - NC SC - - - 3 Full Divided Lite AND-N-83-00804-00001 0.31 1.76 0.25 0.42 15 4 02 - - - - - - Finelightr•(grilles-between-thoglass) n/a Na Na Na Na Na n/s Simulated Divided Lite or Installed Interior Removable AND-N63-00793-00003 0.30 1.70 0.15 0.24 11 <02 - NC - - - 3 S Full Divided Lite AND-N63-00805-00001 0.31 1.76 0.16 0.24 10 4 0.2 - - - - - - 9 '^ Flnellght<•(grilles-between-the-glees) Na Ns Na Na Na NS Na - - - t Simulated Divided Lite or Installed Interior Removable AM NN-53-0079440003 0.29 1.65 0.17 0.38 13 <02 - NC OC - - - c i - - - - 599 '� Full Divided Lite AN0a1.89-Dp505-00001 0.30 1.70 0.17 0.38 12 <02 NC SC N FInelight^'(grilles-betweentloylass) Na Na vie Na Ns Na Ns c s Simulated Divided Lite or Installed Interior Removable AND-N-83.00791-00003 0.31 1.78 0.41 0.47 24 4 0.2 iI Full Divided Lite AND-N63.00803-00001 0.31 1.70 0.41 0.47 24 <0.2 o. FInellg hi,.(grilles-between-the-glass) Na ate Na Ne Na Ns Ns er Simulated Divided Lite or Installed Interior Removable AND-Ni3-00901-00003 0.2:8 1.48 025 0.41 21 <0.2 © NC SCI 21 - - 9 9 Full Divided Lite AND-N-63-00907-00001 028 1.9 0.25 0.41 19 <0.2 - NC SC Z1 - - d I _ 1 1 FinsllgM*•(grilles-between-the-glass) Na Ne Na Na Ne ode n/a This information is for reference only. Performance varies byunit size and options selected. 21 o196 Data is content sad Dxwnte 1See pa e1forarid Is moje Information ormation P Pap see page,for more Inlormatlm. For specific unit performance information,please contact your dealer or Andersen Sales Representative. U.S. Canada ENERGY ENERGY ix o STAR STAR Andersen. Andersen NFRC Certified `o `o u - w v 6.0 v 4.1 u Product Line 8 Glass Grille Type Products u u (3 > v .14 Product Type Type Directory Number A A g rn c 5 m m U N M q r E � 5 m ° U U ° 0 Z N N N N y c Simulated Divided Lite or Installed Interior Removable AND-N-1-01262-00003 0.24 1.36 0.17 0.39 20 <0.2 NC SC I 21 - ro N C " Full Divided Lite AND-N-1-01271-00001 0.26 1.48 0.17 0.39 17 <0.2 NC SC 21 - - 9 E x v+3 FinelightTM(grilles-between-the-glass) Na Na n/a Na n/a Na n/a - - - - - c L Simulated Divided Lite or Installed Interior Removable AND-N-1-01260-00003 0.25 1.42 0.39 0.47 31 <0.2 NC - - Z1 - W , 9 i2 d Full Divided Lite AND-N-1-01269-00001 0.27 1.53 0.39 0.47 29 <0.2 NC - - Z1 x J a 3 Finelight^"(grilles-between-the-glass) Na Na n/a Na nla n/a Na - • • -3.0 Annealed or 3.1 Tempered Pattern Glass-w/No Grilles and Grilles Less than 1" No Grilles AND-N-1-01175-00004 0.29 1.65 0.31 054 22 <0.2 - NC -Fit, Simulated Divided Lite or Installed Interior Removable AND-N-1-01175-00005 0.29 1.85 0.29 0.49 20 <0.2 - NC 3 9 Full Divided Lite Na Na n/a Na n/a Na n/a J. Finelight"(grilles-between-the-glass) Na Na Na Na n/a Na n/a - - - No Grilles AND-N-1.01176-00004 0.29 1.65 0.20 0.30 15 <0.2 - NC SC - - - we c Simulated Divided Lite or Installed Interior Removable AND-N-1-01176-00005 0.29 1.65 0.18 0.27 14 <0.2 - NC SC - - - 9 Full Divided Lite n/a Na n/a Na n/a Na n/a • - - - - - - FinelightTM(grilles-between-the-glass) Na �Na n/a Na n/a n/a Na • - - - - - No Grilles AND-N-1-01177.000(w Q28 1.59 0.21 0.48 17 <0.2 - NC��$C' 21 - - Et Simulated Divided Lite or Installed Interior Removable AND-N-1-01177-00005 0.28 1.59 0.19 0.44 16 <0.2 NC ISIS Zt - - 3 Y 400 Serie 9 H Full Divided Lite n/a n/a Na n/a Na n/a Na - - - - - - Casemen Finelight"(grilles-betweenthe-glass) n/a n/a Na n/a Na n/a Na No Grilles AND-N-1-01174-00004 0.29 1.65 0.51 0.59 33 <0.2 - - - Z7 c eeerr Nyy Simulated Divided Lite or Installed Interior Removable AND-N-1-01174-00005 0.29 1.65 0.47 0.53 31 <0.2 - - - 21 - A.N Full Divided Lite Na Na n/a Na n/a Na n/a - - - - - - - A a Fineligh0"(grilles-between-the-glass) Na Na n/a Na n/a Na n/a • - • - - -3.0 Annealed or 3.1 Tempered Pattern Glass-w/Grilles 1"or Greater e Simulated Divided Lite or Installed Interior Removable AND-N-1-01175-00006 0.29 1.65 0.26 0.44 19 <0.2 - NC i Full Divided Lite Na Na n/a Na n/a Na n/a • - . - - J Finelight^"(grilles-between-the-glass) Na Na n/a Na n/a Na n/a • . - - i Simulated Divided Lite or Installed Interior Removable AND-N-1-01176.00008 0.29 1.65 0.17 0.24 13 <0.2 - NC SO - - - a 3 N Full Divided Lite Na Na nla Na n/a Na n/a - - 9 Finelight"..(grilles-betweentheglass) Na Na n/a Na nla Na n/a • - - • - t Simulated Divided Lite or Installed Interior Removable AND-N-1-01177-00006 0.28 1.59 0.18 0.39 15 <0.2 - NC SO - - - w 5 Y Full Divided Lite Na Na nla Na n/a Na n/a - - m 9 FinelightTM(grilles-0etweentheglass) Na Na n/a Na n/a Na n/a - - - - - • Simulated Divided Lite or Installed Interior Removable AND-N-1-01174-00006 0.29 1.65 0.43 0.48 29 <0.2 ® - - - 21. I - W in 3 1 Full Divided Lite n/a n/a Na n/a Na n/a Na - 9 a FinelightTM(grilles-between-the-glass) nla n/a Na n/a Na Na Na This information is for reference only. Performance varies byunit size and options selected. r 4of 155 Date is current es of December 15,2D14e 1 for mosi f change. P ageSr page 1 fa mac information. For specific unit performance information,please contact your dealer or Andersen Sales Representative. L 41, byANDERSRENEWAEN FULL SERYfQ WINDOW INDOW&8 DOOR RFRt ACM N1 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 473 ; Agreement Document and Payment Terms �►�/' DBA:RENEWAL BY ANDERSEN OF BOSTON Philippe Galaski RENEWAL Legal Name: Renewal by Andersen LLC 5 hillcrest drive HIC#170810 Florence,MA 01062 byANDERSEN 30 Forbes Road I Northborough,MA 01532 C:4133746491 rw WWI WON t oaa(MIAOW Phone:(508)351-2200 I Fax:(508)986-7072 I rbaboston@gmail.com Philippe Galaski 10/23/23 BUYER(S)NAME CONTRACT DATE 5 hillcrest drive, Florence, MA 01062 4133746491 BUYER(S)STREET ADDRESS PRIMARY NUMBER SECONDARY NUMBER phgalaski@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: $27,246 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: $27,246 Estimated Start: Estimated Completion: 12-16 WEEKS 1 day AMOUNT FINANCED: $27,246 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: GS 1/3 start, 1/3 install, 1/3 sub complete 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 10/26/2023 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 Michael Richardson Philippe Galaski PRINT NAME OF SALES PERSON PRINT NAME PRINT NAME 10/23/23 Page 2/ 22 • Itemized Order Receipt DBA:RENEWAL BY ANDERSEN OF BOSTON Philippe Galaski RENEWAL Legal Name:Renewal by Andersen LLC 5 hillcrest drive HIC#170810 Florence,MA 01062 bYANDERSEN 30 Forbes Road I Northborough,MA 01532 C:4133746491 fSt SEMI WNW t WON t IL111NI Phone:(508)351-2200 I Fax:(508)986-7072 i rbaboston®gmail.com ID#: ROOM: SIZE: DETAILS: PRICE: living room Misc Misc, Bay & Bow, Bay & Bow Frame, Quantity 1, [e5 Degree], [wood Seat Board 3' INSULATED SEAT, Species], [4 Lites], [Ratio], [Prefinish color] 101 Living Window Casement Single Left, Base Frame, Exterior White, Interior Pine, Performance Calculator PG Rating: 40 I DP Rating: + 40/ - 40 Glass, All Sash: High Performance SmartSun Glass, No Pattern, Hardware, Stone, Screen, TruScene, Full Screen, Grille Style, No Grille, Mlsc, None , 102 Living Window Casement Fixed Window Base Frame, Exterior White, Interior Pine, Performance Calculator PG Rating: 40 I DP Rating: + 40 / - 40 Glass, All Sash: High Performance SmartSun Glass, No Pattern, Grille Style, No Grille, Misc, None , 103 Living Window Casement Fixed Window Base Frame, Exterior White, Interior Pine, Performance Calculator PG Rating: 40 I DP Rating: + 40/ - 40 Glass, All Sash: High Performance SmartSun Glass, No Pattern, Grille Style, No Grille, Mlsc, None , 104 Living Window Casement Single Right, Base Frame, Exterior White, Interior Pine, Performance Calculator PG Rating: 40 I DP Rating: + 40/ - 40 Glass, All Sash: High Performance SmartSun Glass, No Pattern, Hardware, Stone, Screen, TruScene, Full Screen, Grille Style, No Grille, Mac, None , 105 A MUD ROOM Misc Misc, ProVia, Storm Door System, Quantity 1, See attachment for details. 10/23/23 Page 3/ 22 Itemized Order Receipt DBA:RENEWAL BY ANDERSEN OF BOSTON Philippe Galosh' RENEWAL Legal Name:Renewal by Andersen LLC 5 hillcrest drive HIC#170810 Florence,MA 01062 byANDERSEN 30 Forbes Road I Northborough,MA 01532 C:4133746491 rw WW1 whoa t o0ue vm uuwwr Phone:(508)351-2200 I Fax:(508)986-7072 I rbaboston®gmail.com ID#: ROOM: SIZE: DETAILS: PRICE: 105 B MUDROOM Misc Misc, ProVia, Entry Door System, Quantity 1, See attachment for details. 106 LAUNDRY Window Gliding Double 1:1 Active / Passive, Base Frame, 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., 107 Kitchen Window Gliding Triple 1:1:1 Base Frame, 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., WINDOWS: 6 PATIO DOORS: 0 ENTRY DOORS: 0 SPECIALTY: 0 MISC: 3 TOTAL $27,246 5 `7". Renewal by Andersen is committed to our customers'safety by SEPA ) complying with the rules and lead-safe work practices specified by the EPA. 10/23/23 Page 4/ 22 yPayment Authorization Form R �' ' DBA:RENEWAL BY ANDERSEN OF BOSTON Philippe Galaski •RENEWAL Legal Name:Renewal by Andersen LLC 5 hillcrest drive HIC#170810 Florence,MA 01062 byANDERSEN 30 Forbes Road I Northborough,MA 01532 C:4133746491 Phone:(508)351-2200 I Fax:(508)986-7072 I rbaboston@gmail.com Philippe Galaski BUYER NAME 5 hillcrest drive Florence ADDRESS CITY MA 01062 4133746491 STATE ZIP CODE PHONE NUMBER 1 PHONE NUMBER 2 greensky 4521 $27,246 FINANCE PROGRAM* FINANCE PLAN#' CONTRACT BALANCE Michael Richardson 2329604424 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 ($27,246) CASH DEPOSIT(1) FINANCED DEPOSIT(2) SUBSTANTIAL COMPLETION (3) FINANCING $0 $9.082 $18.164 (1) CASH DEPOSIT: Renewal by Andersen requires thirty-three percent(33%)of the purchase price paid at Agreement Signing. Buyer(s)may pay through the following payment methods:cash,check,debit card,or credit card("Cash Deposit"). (2) FINANCED DEPOSIT: Renewal by Andersen requires thirty-three percent(33%)of the purchase price advanced at Agreement Signing.For Buyer(s)that receive approved financing through a Renewal by Andersen lender("Lender"),the Lender will advance this required amount directly to Renewal by Andersen("Financed Deposit"). The Lender will not extend credit to the Buyer(s)and Buyer(s)will not owe any payments until Substantial Completion(as defined in item 3 below)and the Lender has advanced or otherwise delivered the remaining balance to Renewal by Andersen. (3) SUBSTANTIAL COMPLETION: Renewal by Andersen requires the final payment(which shall be delivered by the Lender in the case of projects financed through Lenders)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 Change Orders associated with the project covered by this Agreement,the difference in the Job Amount will be reconciled in the final payment requested from the Buyer(or the Lender in the case of a project financed by a Lender)upon Substantial Completion. BY SIGNING BELOW, I/WE,THE BUYER(S): 1. Buyer(s) authorize Renewal by Andersen to transact payments, including with Lenders, based on the amount(s),form of payment(s), and timing as specified in the Payment Authorization Schedule above and, if applicable,final payments in the amount requested by Renewal by Andersen upon the execution of a Change Order. 2. For Buyers that finance a project through a Lender, Buyer(s): (i) understand that the Lender will disburse the Financed Deposit and final payment at Substantial Completion to Renewal by Andersen as specified in the Payment Authorization Schedule,(ii) understand that the Lender will not extend credit to the Buyer(s) and Buyer(s)will not owe any payments until Substantial Completion, and (iii)acknowledge the use of the loan proceeds for payment upon Substantial Completion will constitute reaffirmation by all Buyer(s) of the loan agreement with the Lender. 3. Buyer(s) agree to notify Renewal by Andersen in writing of any change in payment method at least three business days' prior to the respective payment due date. 4. Philippe Galaski 10/23/23 BUYER NAME SIGNATURE DATE 10/23/23 Page 5/ 22 Go Permits, LLC `GO IL 105 Buttonball Lane 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 31415822 — Exp. 10/01/24 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 r-r-7 RENEWAL , k• .: _ byANDERSEN -1-7 1111 , , .1.......fr. mum 111001W 4 DON IKKAIlltir To Whom it May Conce,ry This letter will authorize the following pesonls) 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 inspections with respect to the installation, maintenance and repair of windows and entry riocirs untiPt Mc.-Irhusetis State Home improvement Contractor ficee number 170810 and Construction Supervisor License r umper CS-090125 If you have any question,,, pleae call me at 508 351 2271 et 6 Authorized person(s): Go Permits LLC Sarah Hammed David Andersol Maureen Kivel Scott DoLghrran Ryan 8,ondo Sovannara Kuy Mark Foster Glynn Norgan Jennifer winke wenev Holden Gerald Cramer Nick Rago Danel Vickerman Stephen Wilder Katie Grocott Bonnie Myers Carrie Foligno Michael Rogers Rachel Orloff 1 - ...— ,,;" amie ?violin Renewal by Andersen LLC HIC 170810 CSL—CS090125 Local District Office Address 30 Forbes Rd Northborough, MA 01532