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31A-297 (6) BP-2023-1590 94 VERNON ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 31A-297-001 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-2023-1590 PERMISSION IS HEREBY GRANTED TO: Project# WINDOWS 2023 Contractor: License: Est.Cost: 15483 RENEWAL BY ANDERSEN 090125 Const.Class: Exp.Date: 10/06/2024 Use Group: Owner: A BUTLER STEPHEN&CHERYL 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: 11/15/2023 TO PERFORM THE FOLLOWING WORK: 5 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: • ` ' , >2 . 'Iv Fees Paid: $40.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Office of the Building Commissioner (,oi1/,YI t ,eim,t is fe4dy p tee te, ..e/o/' et copy - 4.4 cJecse, e ,4 D peir;CA .^off .---- The Commonwealth of Massachusetts w Board of Building Regulations and Standards FOR �� _j,% 9 Massachusetts State Building Code, 780 CMR MUNICIPALITY •\ : 2023 USE Building Per it Application To Construct, Repair, Renovate Or Demolish a Revised Mar 2011 nF r of r , One-or Two-Family Dwelling 1 11 nINr,INicDECTION3 ___1ORTHAMPION.HA 01060 This Section For Official Use Only Building Permit Number: /2, 3 / 0 Date Applied: ICevi4_> G2o il! /I-Jy zy Building Official(Print Name) Signature Date SECTION 1: SITE INFORMATION 1.1 Property_Address: 1.2 Assessors Map&Parcel Numbers i/C/Ad II .S t 1.la 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 0 On site disposal system 0 Check if yes❑ l SECTION 2: PROPERTY OWNERSHIP1 2.1__Qw riofR5ii ttei /re,r1ia.ti�J ri wlf4 o/o o NaCmme//'((PnTit)// /�� City,State,ZIP V e f Kim M 61- Y13- 611- 29o3 ati,-4.td/Grid ejmacl,co,+.. 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 Specify: fe/) miehmi1 Brief Description of Proposed Work': ,2v/Ylelows ie /' a v a, d �Q�l14 2C�G c AA,'syIK.us l/i - leAe G✓4-4 AD SluG(v+^—P e, , . tt ' di . 9 SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) 1. Building $ /!trgj j,.1? 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 Fee r Check No. eck Amount:14C Cash Amount: 6. Total Project Cost: $ /7 t/$jr,00 0 Paid in Full ❑Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) ,Aq_ pqo iZ s 0 06 1-3epi ALI rwf;n License Number Expir tion ate Name of CSL Holder l�✓S List CSL Type(see below) Fo.-kaes (l� No.and Street Type Description /1)0O p'"1 bJ ro..tq 1 l 0 '53 2- U Unrestricted(Buildings up to 35,000 cu.ft.) V R Restricted 1&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering Window and Siding Re / SF Solid Fuel Burning Appliances Re—°iz'9u — r sWWI) /744/ent �/,,,erive; I Insulation Telephone Email address ✓✓Ye D Demolition 5.2 Registered Home Improvement Contractor(HIC) ��))���,,�� L �?1v 2L 43 Q /1 4e4""- ''bd''� L HIC Registration Number Exp. tion ate HI Comp. Name or C egistrant Name :c()d S e�jt/�i1 Rd fe/�wt.�1j Qr!q/Acsee) � b ie'4l h.c_t1 Ng, Aid �� is3 Z � 0 �lf Z J Email address J 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 .......... DV 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: 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 couta. d in 's - •,lication is true and accurate to the best of my knowledge and understanding. 411-- (�.�iol L. Cljti P wn s or • . • ize.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" City of Northampton ">A" Massachusetts DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building C J., e Northampton, MA 01060 St h .'‘�� 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 rdikleS , AP/114 held--c) ii9 t'/i3•z The debris will be transported by: Name of Hauler: Naidi /"(Q/la tif/14/1 Signature of Applicant: Date: //� " z3 The Commonwealth of Massachusetts Department of industrial Accidents ' Office of Investigations =r in Lafayette City Center Uri tiler ,. ._r 2 Avenue de Lafayette, Boston,MA 02111-1750 www.mass.gov/dia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Renewal by Andersen Name (Business'Orpanir.ationalndividual) Address: 30 Forbes Rd. City/StatetZip:Northborough, MA 01532 Phone x:508-351-2277 Are you an employer? ( heck the appropriate hot: type of project(required): 1.i I am a employer with 30 4 ❑ I am a general contractor and 1 employees(full and/or pan-time). « have hired the sub-contractors 6. El New,constnu'tton listed on the attached sheet. 7. D Remodeling 2.❑ I am a sole proprietor or partner- ship and have no employees These sub.eontractors have g. Demolition workingfor me in anycapacity. employees and have workers' P tY 9. 0 Building addition [No workers' comp. insurance comp. insurance.: required] 5- ❑ We are a corporation and its 10.1D Electrical repairs or additions 3.0 I am a homeowner doing all work officers have exercised then 11.0 Plumbing repairs or additions [No workers myself. ' right of exemption per MGL Y comp. 12.0 Roof repairs insurance required.J ' c. 152,*1(4),and we have no Replacement employees. [No workers' 13. [Usher comp. insurance required] •Any applicant that checks box#1 must also fill out the sc.ikst below showing their workers'ecmpensation policy information. f Homeowners whu submit this affidavit indicating they arc doing all work and then hire outside contractors must submit a new affidavit indicaitinit such ;Contractors that check this hos must attached an additional slteet showing the name of the sub-contractors and slate whether or nut those entitles hake e'mplosces. If the s11b-c4,11tr9ct.Ks fast ctttpluyees.they iris ptu'de their wukctr'c„utp.l ih 's ewniber. i ant an employer that is providin,r' (corkers'compensatiott insurance/or nit•employees. Below is the policy and job site information. Insurance Company Name Old Republic Insurance Co. Policy#or Self ins.Lic. MWC 314158 22 Expiration Date: 101t010)23'/D/// 1-/ Job Site Addrims: ?Li UGC(/2011 54 - city Stale'bp -,661.4+, /cri /0/q 0/06 0 Attach a copy of the workers'compensation policy declaration page I.huising the polic+i number and rtpiration date). Failure to secure coverage as required under Section 25A of Mt&L e. 152 can lead to the imposition of criminal penalties of a fine up to S I.5()f)A($)and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a line of up to S250.00 a day against the s iolator. Be advised that a copy of this statement may be t nsardcd to the Office of Investigations of the DIA for insurance coserag serdreation J do hereby certifl• under the pains and penalties of perjure that the information provided above is true and correct. signature9a...4024- 7149,2 1�f. l>ttc liltumen: F60 '95 -- CO/2— Official use only. Do not write in this area.to be completed by city or town official ('its or I own: Permit.'license # luthority (check one): I QBoard of!leakh 20 Building Department 30('its n Clerk 4.0 Electrical Inspector 5I'lttmbin_o Inspector 6.00ther Contact Person: lM�sel :. Go Permits, LLC ' 105 Buttonball Lane Glastonbury, Cl 06033 �� 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 31415823 — 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: renewalbyandersenAgopermits.orq • If you unable to mail the permit to the homeowner please send to the below address and we will ensure the permit is at the home posted at the time of installation: Go Permits, LLC 105 Buttonball Lane Glastonbury, CT 06033 If we are required to pick up the permit in at the building department, please call 860-952- 4112 once it's ready and we will come to get it. Thank you, Go Permits 11- 1 Comensollos So Commonwealth of Massachusetts *"*41 perrioor Division of Occupational Licensure t thwastncted-Eloildisp of ow/use,grotto which cabbie Board of Budding Relations and Standards less than 35,0110 cubit loot Oil cubic meters)ot tindosed o.:;?' tnstktottlknri'Skityttry sdr SPsc. CS-090125 :*., ' metres 10i06/2024 JAIME I.MORON 54 NOTTINGWAM ROL , ) - .., RAYMOND NU 03077 ...: 0111Vta3- Failure to pieties,a eterreot odNioo of the Ilewsedameetio Cornrrims;oncr c,','14G f: r,:c..4ni.14..... Ude balmy Coos le come 0 or revoceitoo oll leis ilosome. For inisivrollos skid lies Sows Cali($in 721-321111 or Weil oeviivaisee.goveloi THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs 311d Business Regulation 1000 Washington Street- Suite 710 Boston, Massachusetts 02118 Home impro ethent • tractor Relipstration ji — Type Supplement Gard egAabOtl, 1701310 RENEWAL BY ANDERSEN LIC ' =-*','ie..;-,..., --- Eitturatton 12/2212023 30 FORBES RD NO4TI-B301400GPI MA 01532 ---- e , „t Boasts Addratil sod Pleimei Cosi THE COMMONWEALTH OF MASSACHUSETTS Office ot Conswow^Mors&Booms*Regulation Rogogratoo valid tot tottividual oile only betoto the HOME IMPROVEMENT CONTRACToot *lap.1.14.,.“tf spir. ff MOM,retuat ri to. Office of Consumer Attakes and Business Regulation TYPE buiViattOm Cl'id 1000 wasoington Street Suits 7 it gallia00 EttantiRD 170410 12t22/202.1 Boston.MA 02118 RENEWAL BY ANDERSEN ti,C ) JAIME MORIN 30 FORBES RD ,....- NORTHBOROUT.114,MA 01632 .. Under iecrclary Not Ifglid without Sgneture i -7 RENEWAL brANDERSEN To Whom It May Concern: This letter will authorize the following personls) to act as agent(s)on behalf of Renewal by Andersen 11C, 9900 Jamaica Ave South, Cottage Grove MN 55016 to pull for permits and inspections with respect to the installation, rnainteriarice and repair of windows and entry dnorc iaidar Ma5s.achiisprtc Stare Home ortnrovement Contractor iirerise number 170810 and Construction Supervisor license number CS-09012S If you have any questions, please call me at 508 351 2277 ext 6 Authonied person(5) Go Perrnts LLC Sarah Ha mmad David Anderson Maureen Kivel Scott Doughman Ryan B.ondo Sovannar a Kuy Mark Foster Cxlynn Norgan Jennifer winke Wendy Hoiden tierald ramer Nick Rae° Danel Vickerman Stephen Wilder Katie Grocott Bonnie Myers Carrie Folgno Michael Rogers Rachel Orloff SO*. amie Morin Renewal by Andersen 1,1C HIC 170810 CSL-CS090125 Local District Office Address 30 Forbes Rd Northborough, MA 01532 Page 1 of 1 ACORN CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) ��- 09/21/2023 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. c/o 26 Century Blvd wC"No.Ext): 1-877-945-7378 (A/C,No): 1-888-467-2378 P.o. Box 305191 E-MAIL ADDRESS: an certificates@willis.cc Nashville, TN 372305191 USA _ INSURER(S)AFFORDING COVERAGE NAIC# _ INSURER A: Old Republic Insurance Company 24147 INSURED INSURER B: Renewal by Andersen LLC 30 Forbes Road INSURERC: 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 ADDL SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DDIYYYY) (MM/DD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 3,000,000 DAMAGE TO RENTED CLAIMS-MADE X1 OCCUR PREMISES(Ea occurrence) $ 500,000 A MED EXP(Any one person) $ 10,000 MWZY 314161 23 10/01/2023 10/01/2024 PERSONAL BADVINJURY $ 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 6,000,000 X POLICY PR COT- 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 AND ER YIN A ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? No NIA MWC 319158 23 10/01/2023 10/01/2024 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1 DESCRIPTION OF OPERATIONS!LOCATIONS!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 REPRESENTATIVE J Evidence of Insurance "-' "�.`^• 4g4;1 ©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 Page 1 of 1 ACOREP DATE(MM/DD/YYYI)� CERTIFICATE OF LIABILITY INSURANCE 09/21/2023 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 Tamers Watson Certificate Center NAME: Willis Towers Watson Midwest, Inc. FAX c/o 26 Century Blvd PHONE No,Eld): 1-977-945-7378 No); 1-888-467-2378 E-MAIL P.O. Box 305191 ADDRE8certificates@willie.coa 8: Nashville, TN 372305191 USA INSURER(8)AFFORDINGCOVERAGE NAIC0 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:W30224609 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 LTAINSD INVD POLICY NUMBER (MMIDDIYYYY) 1MMIDDIYYYYI X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 3,000,000 DAMAGE TO RENTED 500,000 CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $ _ _- A MED EXP(My one person) $ 10,000 MWZY 314161 23 10/01/2023 10/01/2024 PERSONALBADVINJURY $ 3,000,000 GEM AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 6,000,000 X POLICY JJECTT L J LOC PRODUCTS-COMP/OP AGG $ 6,000,000 OTHER: $ AUTOMOBILE UABILITY COMBINED SINGLE LIMIT $ 5,000,000 (Ea accident) X ANYAUTO 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 UAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATIONOTH- AND EMPLOYERS'LIABILITY X STATUTE ER YIN A ANYPROPRIETOR/PARTNER/EXECUTIVE EL EACH ACCIDENT $ 1,000,000 OFFICER/MEMBEREXCLUDED? No NIA MC 314158 23 10/01/2023 10/01/2024 (Mandatory In NH) EL DISEASE-EA EMPLOYEE $ 1,000,000 Myer describe under 1,000,000 DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Boston AUTHORIZED REPRESENTATIVE 1010 Mass Ave /6a/Boston, MA 02118 ^•`�KL �p ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD SR ID: 24694639 Bnrca: 3138744 Commonwealth of Massachusetts Ct7{1�tlC1Sp1t l➢rlparYl�OI • ® Division of Occupational Licensure Unrestricted-Buildingsdeny use group which contain 7 r Board of Building Regulations and Standards less than 35,000 cubic h11(001 cable meter)of enclosed Constkiirdlon S1!>•jerv+sor space .J t CS-090125 EES.pires 10/06/2024 JAIME L OfIN , M ! 54 NOTTINGNAM RD _ ?' RAYMOND NTI 03071 i t,+r ` A�'J '' MORI to possess a current edition ot the Massachusetts Cc.^:::s:�,:ncr ,, , A. :, :,.,, , air Suikting Code tcanson this tcensot this license. For InformatiCall(tin 7'27-32tt or visit www.mass.govidpf THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration Type Supplement Gard Registiation. 170810 RENF WAL BY ANDERSI-N LLC Expiration 12122:2023 3C FORBES RD NORTHBOROUGH. MA 01532 Update Addrevb and Retain Card. THE COMMONWEALTH OF MASSACHU5E17S Registration val.d for individual us.r only begot.the Office v1 Gornutntx Alfalfa&Business Regulation e�r��as�� 14 found return to: HOME IMPROVEMENT CONTRACTOR Office of Consurnet Affairs and grrsInesu Regulation TYPE,SttFpinntam ali 1000 Washington Street -Suite 710 Rt� fir, 2)Z021 Boston,MA 02115 t70R1D 1212J�C1l7 Ri-^iF WAL H ANDERSEN LLC i fir` JAIME MORIN NUitTNBOROUtiH,MA 01532 Li- Not lid without signature RENEWAL BY ANDERSEN SPECIFICATION 8 TECHNICAL MANUAL TECHNICAL INFORMATION PERFORMANCE RATINGS AND TEST DATA NFRC Total Unit Performance U-Factor Renewal by Andersen® (BTUI(hr ft2 oF)) SHGC Product High Performance Class Type Vf': 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 S Low-Er 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®SmartSurP 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®SmartSue 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 Li.ht Grilles 0.34 0.31 0.28 0.28 Double-HungDB ® Without Grilles 0.33 0.30 0.20 0.19 .40 (All Frames) Low-E4 Sun Full Divided Light Grilles 0.35 0.31 0.18 0.17 thout Grilles 0.32 0.29 0.21 0.21 .65 L ow-E4®SmartSue Full Divided LightGrilles 0.34 0.30 0.19 0.19 "� ;,,,.a ...... .,.,, :acx. , wa .,,,,». • ,,' Pa :'nK '.A .3a.�.e: 1f 5lgaYa .n.. ;vs err* u; ur.".?!2w,1x},::.:~.+sw. . .arxaerg: «x.I with HeatLockTM' Full Divided Light Grilles 0.30 0.27 0.18 0.18 09-9 COMPANY CONFIDENTIAL- REVISION AA-01 M C " Agreement Document and Payment Terms DBA:RENEWAL BY ANDERSEN OF BOSTON Cheryl&Stephen Butler Legal Name: Renewal by Andersen LLC 94 Vernon St RENEWAL HIC#170810 Northampton,MA 01060 by AN D E R S E N 30 Forbes Road I Northborough,MA 01532 C:(413)687-2903 Phone:(508)351-2200 I Fax:(508)986-7072 1 rbaboston@gmail.com Cheryl & Stephen Butler 10/29/23 BUYER(S)NAME CONTRACT DATE 94 Vernon St, Northampton , MA 01060 (413)687-2903 BUYER(S)STREET ADDRESS PRIMARY NUMBER SECONDARY NUMBER chebutler56@gmail.com sdbutler7@comcast.net 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: $15,483 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: $15,483 Estimated Start: Estimated Completion: 9-13 weeks 1 day AMOUNT FINANCED: $15,483 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 11/01/2023 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 John Pitro Cheryl Butler Stephen Butler PRINT NAME OF SALES PERSON PRINT NAME PRINT NAME 10/29/23 Page 2/ 24 Itemized Order Receipt rev/577 DBA:RENEWAL BY ANDERSEN OF BOSTON Cheryl&Stephen Butler Legal Name: Renewal by Andersen LLC 94 Vernon St RENEWAL HIC#170810 Northampton,MA 01060 by ANDERSEN 30 Forbes Road(Northborough,MA 01532 C:(413)687-2903 Phone:(508)351-2200 1 Fax:(508)986-7072 1 rbaboston@gmaii.com ID#: ROOM: SIZE: DETAILS: PRICE: 101 Room 1 Window Double-Hung 1:1 Slope Sill Insert, Traditional Checkrail, Exterior White, Interior Pine, Performance Calculator PG Rating: 25 I DP Rating: + 35 / - 35 Glass, All Sash: High Performance SmartSun Glass, No Pattern, Hardware, Stone, Standard Color Finger Lifts, Screen, TruScene, Full Screen, Grille Style, Interior Wood Only (INTW), Grille Pattern, Sash 1: Colonial 3w x 2h, Sash 2: No Grille, Mac, None , 102 Living Window Double-Hung 1:1 Slope Sill Insert, Traditional Checkrail, Exterior White, Interior Pine, Performance Calculator PG Rating: 25 I DP Rating: + 35 / - 35 Glass, All Sash: High Performance SmartSun Glass, No Pattern, Hardware, Stone, Standard Color Finger Lifts, Screen, TruScene, Full Screen, Grille Style, No Grille, Grille Pattern, All Sash: No Grille, Misc, Maintenance Free Sill Nose, Maintenance free sill nose replacement (insert application). Insert from exterior/ Leave interior trim alone. , 103 Living Window Double-Hung 1:1 Slope Sill Insert, Traditional Checkrail, Exterior White, Interior Pine, Performance Calculator PG Rating: 25 I DP Rating: + 35 / - 35 Glass, All Sash: High Performance SmartSun Glass, No Pattern, Hardware, Stone, Standard Color Finger Lifts, Screen, TruScene, Full Screen, Grille Style, No Grille, Grille Pattern, All Sash: No Grille, Misc, Maintenance Free Sill Nose, Maintenance free sill nose replacement (insert application)., 10/29/23 Page 3/ 24 5 Itemized Order Receipt DBA:RENEWAL BY ANDERSEN OF BOSTON Cheryl&Stephen Butler Legal Name: Renewal by Andersen LLC 94 Vernon St RENEWAL HIC#170810 Northampton,MA 01060 byANDERSEN 30 Forbes Road I Northborough,MA 01532 C:(413)687-2903 Phone:(508)351-2200 I Fax:(508)986-7072 I rbaboston@gmail.com ID#: ROOM: SIZE: DETAILS: PRICE: 104 Living Window Double-Hung 1:1 Slope Sill Insert, Traditional Checkrail, Exterior White, Interior Pine, Performance Calculator PG Rating: 25 I DP Rating: + 35 / - 35 Glass, All Sash: High Performance SmartSun Glass, No Pattern, Hardware, Stone, Standard Color Finger Lifts, Screen, TruScene, Full Screen, Grille Style, No Grille, Grille Pattern, All Sash: No Grille, Misc, Maintenance Free Sill Nose, Maintenance free sill nose replacement (insert application)., 105 Living Window Double-Hung 1:1 Slope Sill Insert, Traditional Checkrail, Exterior White, Interior Pine, Performance Calculator PG Rating: 25 I DP Rating: + 35/ - 35 Glass, All Sash: High Performance SmartSun Glass, No Pattern, Hardware, Stone, Standard Color Finger Lifts, Screen, TruScene, Full Screen, Grille Style, No Grille, Grille Pattern, All Sash: No Grille, Misc, Maintenance Free Sill Nose, Maintenance free sill nose replacement (insert application)., WINDOWS: 5 PATIO DOORS: 0 ENTRY DOORS:0 SPECIALTY: 0 MISC: 0 TOTAL $15,483 Renewal by Andersen is committed to our customers'safety by complying with the rules and lead-safe work practices specified by the EPA. 10/29/23 Page 4/ 24 • NI: Payment Authorization Form DBA:RENEWAL BY ANDERSEN OF BOSTON Cheryl&Stephen Butler RENEWAL Legal Name: Renewal by Andersen LLC 94 Vernon St HIC#170810 Northampton,MA 01060 byANDERSEN 30 Forbes Road I Northborough,MA 01532 C:(413)687-2903 NUMMR'YMWMt 0001 MMK[rr Phone:(508)351-2200 l Fax:(508)986-7072 1 rbaboston@gmail.com Cheryl Butler Stephen Butler BUYER NAME CO-BUYER NAME 94 Vernon St Northampton ADDRESS CITY MA 01060 (413)687-2903 STATE ZIP CODE PHONE NUMBER 1 PHONE NUMBER 2 6.99%15 years 4569 $15,483 FINANCE PROGRAM* FINANCE PLAN# CONTRACT BALANCE John Pitro 2330200219 10/29/2038 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 ($15,483) CASH DEPOSIT(1) FINANCED DEPOSIT(2) SUBSTANTIAL COMPLETION(3) FINANCING $0 $5,161 $10.322 (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 fifty 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").For open-end credit loans,the Lender will not extend credit to the Buyer(s). For all financings,the 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)for open-end credit loans, (iii)the Buyer(s)will not owe any payments until Substantial Completion,and (iv)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. Cheryl Butler ( '4 10/29/23 BUYER NAME SIGNATURE DATE 10/29/23 Page 5/ 24 Stephen Butler 9rZ" 10/29/23 CO-BUYER NAME SIGNATURE DATE „M RENEWAL bYANDERSEN / {� FULL SERVICE WINDOW&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