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HomeMy WebLinkAboutBuilding Permit # 3/1/2016 5 f r , f t t IN 4' ,4 j A .j v'y allow, �i%, ,: , r � i r.. , A i i Mn Arb NORTH town of ? - ? ^' Al"11 ® w c No. An 201 LANE11 ver,ver, Mass, o 1. COC NIC"9WJCK QAD �`V RAreo U BOARD OF HEALTH PERMIT T LD Food/Kitchen Septic System THIS CERTIFIES THAT /�U� l BUILDING INSPECTOR has permission to erect .......................... buildings on It ...�::.:;:,f C, Foundation ... :....................................... Rough to be occupied as /l 4G':�?:?, c�k j f ;l, � 6 �✓��� _ Chimney provided that the person accepting this permit shall in every respect conform to the terms of theapplication Final on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection,Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building ReguFations Voids this Permit. Rough Final PERMITEXPIRES MONTHS A I ONT S ELECTRICAL INSPECTOR UNLESS CONSTRUCTION STARTS Rough Service ............... .: ............................................ BUILDING INSPECTOR Final GAS INSPECTOR Occupancy Permit Required t0 Occupy Bulldtnq Rough Display in a Conspicuous Place on the Premises - Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approvedby the Building Inspector. Burner Street No. Smoke Det. Hub ity Builders, LL 10 Lacy Street North Andover, MA 01845 WILLIAM POGOR as GENERAL CONTRACT® Representing uCity Builders, LL MA CSL License No.083917 MA HIC License No.180234 Inquiries may be made to: Contractor Registration One Ashburton Place Boston,RIA 02105 (617)727-5595 CONTRACT Customer: Jonathan&Michelle Hurtig 66 Palomino Drive North Andover,Ma 01845 Project Location: Same as above Nature ofWork: X Design/Layout/Concept Bid Services, Permit Acquisitions X General Contracting Services This Contract relates to the above checked services Hub City Builders, LLC shall provide to Customer. The services being provided are spelled out in the next section. The Customer's Payment Schedule is provided for in the section following that. This is a written binding contract: Do not sign if there are any sections or spaces remaining blank. If the contract is not understood, please have it reviewed by an attorney of your own choice. �� YN Customer Initials Contractor Initials 1 Hub ity Builders, LLC 10 Lacy Street Forth Andover,MA 01845 Services to be performed: . General Description 1. PERMIT ACQUISITIONS 1.1. Building Permit. 1.2. Waste Removal Permit. (If required)as determined by Hub City Builders,LLC. 1.3. Electrical Permit. 1.4. Plumbing Permit. 1.5. Forms and Filings necessary. 1.6. Meetings On/Off-site as required. (Owners agent) 1.7. Pertaining to permits, any extra permits beyond the scope of this contract, if required,the financial burden shall be subsequent to this contract and shall be billed on a time and materials basis and stated in the change of work order. Note: Design Professionals or other professionals engaged for consultation, (energy envelope, Structural engineer, ect)if required,the financial burden shall be subsequent to this contract and shall be billed on a time and materials basis and stated in the change of work order. *NOTE: If applicable all working drawings were prepared as an instrument of services for the two fold purposes of making these designs available scrutiny (client services, design professionals and contractors) for the securing of construction material and trade bid costs for the project secured herein. Although they have fulfilled their purpose when such is accomplished, they are complete set of documents from which the project may be constructed provided they conform to all local and state building requirements. Since these drawings are artistic and conceptual in nature ALL DIMENSIONS SHOULD BE FIELD VERIFIED. At no time should these drawings be considered or mistaken as Architectural or Structurally Verified drawings unless the corresponding seals have been placed appropriately upon these documents by registered licensed professionals. 1. CLIENT LOGISTICS Remove all items in the Entry, Hallway, 2"a floor master bedroom and master bath, to inter-house storage areas designate by client, (as needed). Note* Limited liability to use a"best care scenario"is expressed, and is not a replacement liability when moving Personal Affects or furniture. All personal affects of any value (jewelry, paintings, sculptures, ect.)should be removed to a secure environment by the owner project start date.No liability is expressed or implied. -sq _ o Contractor initials 2 Hub ity Builders, LL 10 Lacy Street North Andover,NIA 01845 2. Demolition 2.1. Remove flooring to sub-floor in master bath and master toilet area. 2.2. Remove exterior second floor master bathroom walls and flooring, (sheetrock for insulation and floor assessment).If water penetration has occurred in either walls or floor area due to either exterior or interior element/H2O penetration that is unforeseen by either the homeowner or contractor. A time and materials scenario will be used for separate billing and repair of this work to existing Massachusetts Building Code Levels. 2.3. Remove 2"a floor master bathroom, soaking tub, bath shower surround,toilet, mirror,vanity drawers, vanity top,and all plumbing and electrical fixtures as needed to complete demolition as determined by Hub City Builders,LLC. 2.4. All Debri is to be removed off site or to an on site dumpster daily. 2.5. Remove and secure bathroom plumbing outlets(sanitary&feeds lines). 2.6. All demolition&disposal necessary to accommodate 2nd floor master bath remodeling, as needed,and determined by contractor. Hazardous waste removal s required by Federal, State or local authorities is based on separate disposal fees and not enclosed as a cost herein. All hazardous waste generated by normal house remodeling. (Note: lead based products/debris generated herein are designated Under 40 CFR 261.4(b)(1)house hold wastes) and not subject to special disposal conditions. 3. Framing 3.1. All framing necessary to accommodate second floor entrance bath remodeling. To include flooring to accommodate new plumbing fixtures, shower walls, shower surround and blocking. As needed,determined by Hub City Builders, LLC. 4. Plumbing Remove existing and re-plumb new Bath Tub (Giagni LH2 Hawthorne 60" Free Standing Soaking Tub Package - Includes Tub,Tub Feet, Floor Mounted Tub Filler Faucet, and Drain Assembly). 4.1. Remove existing and re-plumb new shower valve (Kohler K-T396-4-B -K- 304- -NA). .2. Install "KERDI-SHOWER-KIT"by Schluter Systems 36 X 60"with one 16" wide seat. 4.3. Install shower drain,no extra body sprays. . . Remove toilet and reinstall. (Toilet upgrade is cost plus of$500 approximately depending on unit requested by client). 4.5. Remove Sink Basins, faucets&vanity drawers and tops. 4.6. Vanity Faucet replacement allowance($250)per unit. 5. Finish Plumbing 5.1. Finish Trims- Install all finish surface trims guest bathroom and kitchen. 4 0 Customer Initials Contractor Initials 3 Hub ity Builders, LL 10 Lacy Street North Andover,MA 01845 11.2. Install 10 X 12' (approximate floor area including water closet). Bianco Carrere marble 1"hexagonal tiles sheets,no patterns, with sanded grout(color match by client). $11/sgft(on-line order) allowance. 12. Walls 12.1.Bath walls and any wall the areas will have 1/2" cement board installed as sub- wall area,with fiberglass tape at all seams and corners covered with a skim coat of thinset for bonding. 12.2.Apply white subway style"soft"file surrounding bath tub area with a matching four foot high border around the exposed bathroom walls, toilet area, and vanity area$2.00/sgft. Bull nose($7.00/Lnft)areas determined by Hub City Builders, LLC and presented in wall elevations.Base board the to match(white only). 12.3. Grout wall tiles with non-sanded grout(White match). 12.4.Patch,repair or replace as required. As needed and determined by Hub City Builders,LLC. 12.5.Finish sand all affected areas. 12.6.This does not include shower shelving, corner ceramic or porcelain shelving, recessed soap areas. This is a time and materials extra. 13. Tile 13.1.Prepare Floor and place the with 1/8 "grout lines in a bed, "Versa bond Thinset" mortar SKU: YFY1077 or comparable. 13.2.Prepare Wall and place file with 1/16"grout lines in a bed, "Versa bond Thinset"mortar SKU: YFY1077 or comparable. 13.3. Grout Floor tile with client's choice accu-color sanded grout. 13.4. Grout Wall tile with client's choice accu-color non-sanded grout 13.5. Finish Tile Seal file with satin sealer before grouting. 14. Carpentry 14.1.Paint Vanity with Sherwin Williams epoxy coat paint(color match by client) or acquire new vanity (client's choice$800.00 allowance). 14.2. Reinstall Vanity, Vanity Top, and Back splash as required. 14.3.remove doors and drawers. Acquire new doors and drawer fronts paint to match Vanity. 14.4. Install two mirrors (as provided by Peabody glass, $280.00 allowance for both). 14.5. Install Blum slow close slides drawers. 14.6. Install Blum slow close European style hinges. 15. Hardware 15.1.Install towel bars, Towel rings,toilet roll holder, new knob or hinges interior to bath remodel. ($250)Allowance 15.2. One Shower Surround- 36 X 60""Tempered-3/8" (32" x 67") 3/8" Clear Tempered$491.83 20, Polish-3/8" 2W 2L Polished Edge, Shower Door-3/8" Hinge/Handle Cutout,Tempered-3/8" (30"x 67") 3/8", Polish-3/8" 2W 1L Polished ro 1A Customer Initials Contractor Initials 5 Hub ity Builders, LL 10 Lacy Street North Andover,MA 01845 Edge, Miter-3/8" OW 1L (30" x 67")45°Miter,Notch-3/8" Notch Cut-out, Tempered-3/8" (19" x 32")3/8" Clear Tempered,Polish-3/8" IW 2L Polished Edge, Miter-3/8" I W OL(19" x 32")45°,BM6X6CH 6" C-Pull (Chrome), GEN037CH Geneva Wall Mount Hinge (Chrome), SDCD38BA 3/8" U-Channel (Chrome), P880WS Seal w/wipe,P990WS Drip Rail,PCC 10 H-Jamb Soft Leg". Inclusive 15.3. Door&Drawer Hardware allowance$1 O/Knob 16. Paint 16.1.Prep-one coat mold resistant Primer/sealer all affected areas. 16.2. Finish- Two coats finish(color match by client) Sherwin Williams Interior Grade. 17. Communications (Cable,Phone, Internet, Security, House speaker system)-None 18. Substantial Completion-959/opoint of any milestone,as notified by contractor, defined here-in. 19. Clean up-all affected areas as determined by contractor. 20. Communications-None 21. Vanity Cabinets Tops 21.1.Natural Stone for 24 X 72"two sink cut out will be acquired by Hub City Builders, LLC. Client is obligated to pick out the stone at Napolitano's Marble and Granite 448 Andover St Lawrence, MA 01843 Phone (978) 688-2225 Builders, LL a olitano ranite com with-in seven days of notification by Hub City Builders, LLC. 21.2.Natural stone shower seat 16 X 36"max. 21.3.Both nose details round over detail (sanded edge). 22. Substantial Completion-as notified by contractor as defined here in. 23. Clean up- Construction clean, all surfaced wiped clean and vacuumed if required. 24. Return all items moved in Item#1,#2 in a"best case scenario"to the same locations as pictorially documented. I . Dates of Performance: Commencement Date: As Soon as Deposit for services is received and within two weeks after the rescission date as stated herein. Substantial Comgletlon Date: A.S.A.P—target date, as indicated herein. (60 Days) Customer Initials Contractor Initials 6 Hub City r! r ,, LLC la Lacy Street North Andover,MA 01845 Note: Definitions 1. As defined herein the phrase"owners a e�nt"refers to the ability of William Pogor through Hub City Builders Owner's or Representative designation as used in the construction industry to describe an individual tasked with controlling the design and development and process while protecting the best interests of the owner, in the contracting individuals, local, State and Federal authorities. This Authority is limited to the project scope contained herein. 2. As defined herein the phrase"substantial completion"refers to 95%point where work on a specific requirement is complete,as defined by contract herein, and or a point designated by the contractor. 3. As defined herein the phrase"Pre redness only"refers the state where the next action can be taken by the owner or a separate/different contractor. But a previous action/paper work will be filled out and completed. 4. As defined herein the phrase"on offing desks"refers the state where daily as build's drawings are required by either the building dept, design professionals,or building contractors as the General Contractor(Hub City Builder's or their designated agents) determines necessary to proceed expediously to a specific tasks conclusion. 5. As defined herein the phrase"max fixture allowance"refers the state where a allowance for a single fixture,materials or services is specified on a line item contained herein. Example, "max fixture allowance($40.00)". This means in the context of this contract that you can spend up to$40.00 per fixture type indicated by the line item where the amount is listed. If allowance in question does not reach the example amount,there is no credit implied or realized. If the amount exceeds the per fixture allowance a change of work order would be required, signed by all parties and the allowance amounts will be predetermined. 6. As defined herein the phrase"best case scenario"refers to the state where workers are doing the best they can overall to perform the task assigned. Through no fault or malicious behavior a fault occurs, (breakage,scratch, dent,misplacement, ect.) of objects furniture, appliances, artwork,jewelry, dishes, lugs, walls, doors, rails, floors, granite, sinks, ect.) Other Particular tes 1. Target Date 03/01/2016 Commencement,or as soon as permitted by the North Andover Building Department. 1.1. Item#1 Agreed Date: 03/01/2016 Commencement Contractor Int: Date: Owner Int: Date: Customer Initials Contractor Initials 7 Hub City dl r , LLC 10 Lacy Street North Andover,MA 01845 III.Dates of Performance.- Commencement Date: As Soon as Deposit for services is received and within two weeks after the rescission date as stated herein building permit application is applied for. ,Substantial Pletion Date: A.S.A.P—target date, as indicated herein. Other arfacu1arly Agreed Dates 2. 'Target Date 2.1. Item#1 Agreed Date: 05/15/2016 Contractor Int: Date: Owner Int: Date: 3. No-work on weekends, (unless constrained by completion date), no work Thanksgiving and Christmas and recognized holidays. Ie Work Any changes to this contract must be mutually agreeable and put in writing under a Change Order Form. A blank Change Order Form is attached after the signature lines below and shall be the form used for any changes to this contract. It shall be the obligation of both parties to adhere to this provision. CusWiner Initials Contractor Initials 8 Hub it Builders, 10 Lacy Street North Andover,MA 01845 Contractor's 1Performance All dates of performance are subject to reasonable extension(s), at the Contractor's request, if request is made due to inclement weather, labor disputes, issues involving acquisition of materials or permits from appropriate authorities, mutual dissolution of contract by the parties, stop work order(s) by state or local municipalities, or act(s) of God. .Approval of such request(s) shall not be unreasonably withheld. No acceptance of liability is expressed, assumed or implied due to any of these circumstances. Work may be stopped, interrupted or ceased at the sole discretion of Contractor if payment(s) under the terms of this contract, or any written amendment thereto, is not made by Customer as agreed herein. Work shall be performed in an ordinary standard. It is understood that certain portions of Contractor's consulting and drafting work is deemed artistic and/or subjective in nature, and therefore, disputes related to subjective portions of Contractor's work shall never be grounds for non-payment by the Customer. Permits for Work The type(s) of permits that will be required for the Contractor's work herein shall include: 1. North Andover Building Permit. 2. North Andover Electrical Permit. 3. North Andover Plumbing Permit. 4. North Andover Rubbish Removal(Dwnpster Permit) as Needed. Owners Customer T' t ' Unless otherwise requ ted by the Customer, the Contractor shall act as the OWNERS .GENT with regard to Andover Building Department for the sole purpose of obtaining all necessary permits required to undertake and complete the project. If the Customer undertakes to obtain their own permit(s)the Customer will be excluded from the guaranty fund provisions of M.G.L. c. 142A. Customer Initials Contractor Initials 9 Hub its Builders,, LLC 10 Lacy Street North Andover,M A 01845 Special Conditions of Services: this section is intended to be left blank,state"none"): 1. Mone. Customer Payment Schedule.- This chedule:This Contract is: Agreed Fee ❑ Time and Materials Invoiced ❑ Combination Agreed Fee and Time and Materials Invoiced Agreed Fee(If applicable): Contract Base Price Total $32,838.25 Remainder due: *Time and Materials billed on weekly basis (see below) Int Payment/Deposit $10,946.08 Special orders $4500.00 $15446.08 2° Payment on completion of item#3.1 as referred to herein $5,797.39 P Payment on completion of item#13.5 as referred to herein $5,797.39 4th Payment upon substantial completion as defined herein and notified. $5,297.39 Final Payment, due upon submission as invoiced. $500.00 *Time and Materials billed on weekly basis (see below) customer Initi�Is Contractor Initials 10 Hub ity Builders, LLC 10 Macy Street North Andover,MA 01845 *Time andMaterials/Labor Invoiced as needed (If Applicable): Contractor shall be paid at a rate of$50.00/per man hour for (Design Bidding services only). Building contract requires $120.00/per two men per hour. Both rates are subject to the addition of all materials and out of pocket expenses, including, but not limited to invoiced subcontractors, consultants and materials suppliers. Contractor shall provide an itemized entry of his time billed as part of his invoice together with incurred expense invoices. Invoices shall be issued weekly. Payments due under invoice shall be made within seven(7) days of receipt of invoice. Receipt shall be upon delivery to Customer's address, email or in person. Contractor may suspend or cease work under this contract if payment is more than seven(7)days overdue. ,special materials, or materials of a special order or custom made nature,shall be separately invoiced and require advance payment by Customer prior to order. Description of Combination Agreed Fee and Time and Materials: 1. As specified by any extra work orders Payment terms may not be altered Unless expressly agreed by the parties in writing: Deposit'Perms If there is an initial deposit, it shall be refundable only after a full accounting of incurred cost by the contractor. Incurred costs shall be considered nonrefundable inclusive of the Contractors time. The Customer acknowledges and agrees that the Contractor shall commence work in good faith upon receipt of said deposit, utilize his time and that of contractors and/or consultants he may work with, and that the Contractor shall be fairly compensated for such commencement of work and dedication of time to this Customer that might otherwise be devoted to other projects. The parties agree there is valid consideration for the nonrefundable deposit. Customer Initials Contractor Initials 11 Hub ity Builders, LLC 10 Lacy Street North Andover,MA 01845 DEFAULT OF CUSTOMER If the Customer defaults for any reason, the Contractor shall be entitled to immediate payment of all monies owed as of the date the Contractor notifies the Customer in writing that he deems the Customer to be in default. The Contractor's Notification shall state all sums deemed to be owed and due from the Customer. Said sums shall be due and payable within seven(7) days of delivery of said notice. Any sums due after such notice of default shall be assessed an interest charge of 1 '/z%per month, or 18%per year until all sums are paid in full. If the Customer defaults, and does not tender payment of all sums due within said seven (7) days, the Contractor may record this contract in the registry of deeds and seek a lien on the property for the enforcement of payment. The Customer shall be responsible and owe the Contractor all costs and expenses incurred in the collection of monies owed under this contract,including,but not limited to reasonable attorney fees. ALTERNATIVE ATDISPUTE RESOLUTION The Customer and the Contractor mutually agree that in the event the Contractor has a dispute with the Customer, the Contractor may submit such dispute to a private arbitration service, of the Contractor's sole choosing; provided however, such private arbitration service shall have been approved by the Secretary of the Executive Office of Consumer Affairs and Business Regulations and which shall have been in business for more than five (5) years, and shall be staffed with at least one retired justice of the Massachusetts Court System. This provision is an election at the sole discretion of the Contractor. This provision is in addition to any rights afforded the Customer under M.G.L. c. 142A. The arbitration, if elected by the Contractor, shall follow the rules and regulations of the American Arbitration Association. Nothing in this provision shall prohibit the Contractor from initiating a civil action for any such defaults. The Contractor may have the right to institute a civil action to obtain and enforce any statutory liens rights the Contractor may have, while contemporaneously seeking arbitration of the underlying disputed claims, which determination shall be conclusive as to the amount,if any the Contractor may enforce through such civil action lien. �m V4— Customer Initials Contractor Initials 12 Hub fty Builders, LLC 10 Lacy Street North Andover,MA 01845 This Contract shall be construed in accordance with the laws of Massachusetts. This Contract may be executed in duplicate. Customer acknowledges receipt of copy by signing below. THIS IS A BINDING LEGAL DOCUMENT. D® NOT SIGN THIS CONTRACT IF 'RE ARE ANY BLANK SPACE S OR YOU DO NOT UNDERSTAND ANY TERMS HEREIN. r���ae�� M('i C stomer /( ail 'fit ' 9 callkl;� "I -"V-- Customer Date Email X biMwilliampo or.com Date Email Hub City Builders, LLC -0 Customer Initials Contractor Initials 13 Hub City uil r , LLC 10 Lacy Street North Andover,MA 01845 WORK CHANGE ORDER FORM Owner Jonathan&Michelle Hurtig 66 Palomino Drive North Andover,Massachusetts 01845 Project Location Same Original Contract Date: Time and Materials Billing: Description of Change(s): This Work Change Order changes only those items specifically addressed herein. Nothing in this Change Order shall be construed to change any other term or condition of the Original Contract. 4 Customer Initials Contractor Initials 14 ••The Commonwealth of Massachusetts . ' Department of IndiustrialAccidents �r 1 Congress Street,Suite 100 d02114 2017 Boston,MA. ,•,i �^- �r www.mass.gov/dza �01M Sy,V ',. Walkers'Compensation Iusuxaned Affidavit:Builders/Contractoxs/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHOIUI Y- Blease Print Le0b A •'licant information f L Name (Business/Orgariization/Individual): Address: 7 7_4City/State/Zip: ,9 Phone#: — Type ofpxoject(required): - Axe you an employer?Check t�appropriate box: em to t tune). 7. New dOnStrLlCtion 1. I am a employer with_ P yees(Rill and/or par 2.❑Iain a sole proprietor or partnership and have no employees Working for me in 8. em o deliiig any capacity.� 'oworkers'comp.insurance required.] 9• Demolition p 3. I am a homeowner doing all work myself,.[No workers'comp.insurance required.]t 10❑Building addition 4•❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will 11❑Electrical repairs or additiojs ensure that all contractors either have workers'compensation insurance or are sole bin airs or additions proprietors with no employees. C�Pry g re p 5.❑I am a general contractor and I have hired the sub-contractors listed onthe,attached sheet. 13 0 Roof repairs These sub-contractors have employees and have workers'comp.insurancet 14.['Other 6,❑We are a corporation and its,officers have exercised their right of exemption per MGL c. 152,§l(4),and ive have no employees:[No workers'comp.insurance required.] *Any applicant that checks bbk 41 must also fill out the section below showing their workers'compensation policy information: i mrt•tbis aff�taavit indicating they are doing all work and then hire outside contractors must submit a new affid homeowners who subavit indicating such tContractors that check this liok must attached au additional sheet showing the name of the sub-contractors and state whether or pot those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. X am an employer tat is providing workers'compensation insurancefor my employees. ?3elow is tilepolicy and j o$site h information. �p Insurance Company Name: f �l�Af /a/S' ��7 —20 piration Dato' — Policy#or Self-ins.Lic.#: t� �rt� p �5 Job Site Address: k7 /. � p�Ci /State/Zi �i� I� � ���`� ' �"�' Attach a copy of the workers' compegsation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c.152,§25A is a crimi�aOlPviOEoJp punishable ORDER and fine of up to $250.0 0 a and/or one-year'imprisonment,as well as civil penalties in the form of S be forwarded to the Office of Investigations of the DIA for insurance day against the violator.A copy of this statement may coverage verification. I do hereby ertify and tli pains andpenalties ofpeijury that the information provided wave is tr�u`e�and correct. Date: Si ature: Phone#: official use only. Do not write in this area,to be completed by city or town official. City or Town: Perm�it/L�icense# Issuing Authority(circle one): 1.Board of health 2.Building Department 3.city/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Phone#: Contact Person: WILLI-1 OP ID:JF TE CERTIFICATE F LIABILITY INSURANCE DA 022/19/19//22016016 Y) 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 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 Jeff C.Manna Michaud,Rowe And Ruscak Ins. PHONE 978 688 8829 FAx P.O.BOX 188 A/c No Etl: AIc No 978 557 2130 North Andover,MA 01845 E-MAIL Lawrence R.Michaud,CIC ADDRESS: INSURERS AFFORDING COVERAGE NAIC# INSURER A:Preferred Mutual Insurance Co. 15024 INSURED Hub City Builders LLC INSURER B: William Pogor 10 Lacy St INSURER C North Andover, MA 01810 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 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. I TR TYPE OF INSURANCE D POLICY NUMBER MMIDR EFF MM/DDS LIMITS A COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE FIOCCUR BOP0100721169 10124/2015 10/24/2016 PREM SES(Ea occu RENTED ) $ X Business Owners MED EXP(Any one person) $ 10,00 PERSONAL&ADV INJURY $ GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY❑PRO- ❑ JECT LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea acddent ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED ( ) AUTOS AUTOS dent Per BODILY INJURY accident) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION PER 0TH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETORIPARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A -- (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ BUILDING 0 PROPERTY 1,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) Carpenter Office/Home CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Jonathan Michelle Hurtii THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN g ACCORDANCE WITH THE POLICY PROVISIONS. 66 Palomino Drive North Andover, MA 01845 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD - _ LIABILITY a1 ' INSURANCE DATE(MMIDD/YYYY) 02/19/2016 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: H the certificate holder is an ADDITIONAL INSURED,the pollcy(ies)must 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 NAME: Jeffrey Manna CDN Insurance Brokerage PHONENo Ext): (978)851-3436 FAX No (978)455-2601 ac P.O.Box 121 ADE'LE JCJM@aol.com Tewksbury,MA 01876 INSURERS AFFORDING COVERAGE NAIC 0 Phone (978)851-3436 Fax (978)455-2601 wsURERA. A.I.M.Mutual Insurance Co. 33758 INSURED INSURER B: Hub City Builder LLC INSURER C: 10 Lacy St INSURER D! North Andover MA 01845- INSURER E: F COVERAGES CERTIFICATE NUMBER: 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. (LYR TYPE OF INSURANCE ADDL UBR POLICY EFF POLICY EXP INSR WVD POLICY NUMBER MM/DD/YYYY MM/DD LIMITS ❑ COMMERCIAL GENERAL LIABILITY - - EACH OCCURRENCE $ ❑ CLAIMS-MADE ❑ OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ ❑ MED EXP(Any one person) $ ❑ -.... __.. -. PERSONAL&ADV INJURY $ '.. GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ ❑ POLICY ❑ PRO- ❑ LOC PRODUCTS-COMP/OP AGG $ ❑ OTHER AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident) ❑ ANYAUTO BODILY INJURY(Per person) $ ❑ ALL OWNED SCHEDULED BODILY INJURY AUTOS ❑ AUTOS (Per accident) $ ❑ HIRED AUTOS NON-OWNED PROPERTY DAMAGE Ll AUTOS Per acddent $ ❑ ❑ $ ❑ UMBRELLA LIAB ❑OCCUR EACH OCCURRENCE $ ❑ EXCESS LIAB ❑CLAIMS-MADE AGGREGATE $ ❑ DED ❑ RETENTION$ $ WORKERS COMPENSATION ®PER ❑OTH- AND EMPLOYERS'LIABWTY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE�� y � E.L.EACH ACCIDENT $ 100,000.00 A OFFICER/MEMBER EXCLUDED? I ' i N/A VW C-100-6021323-2016A 02/18/2016 02/18/2017 (Mandatary in NH) E.L.DISEASE-EA EMPLOYE $ 100,000 00 if yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000,00 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Jonathan&Michelle Hurtig THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN 66 Palomino Drive ACCORDANCE WITH THE POLICY PROVISIONS. North Andover,MA 01845 - - AUTHORIZED REPRESENTATIVE @ 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01)QF The ACORD name and logo are registered marks of ACORD ,/r M'd 0" FF 4°/YMM'd%"✓PY ArAul�'.d�d'P I° d '�� �o C7'd 1 'u^a'b"f C)ffic¢c►f Cousu►nu+r t�th►r �t:Biavio ss Tir lialr ion Limme r regivration valid for indiwidul use only wawa , , �iME IMPROVEMENT CONTRACTOR before the expiration date. 'If found return to: 1' � 180234 'Type: Office of Consumer Affairs and Business Regulation 4,0/2-7/2016 10 I'aa lc l'laaa�-Suite,51"70 100egistration: ►piraiora: Irbalia� yt6 ► ., Rdaa„A#A f T f WILLIAM M. POGOR WILLIAM POGOR 10 LACY S7 NORTH ANDOVER, NIA 01845 !l►sclersetrctntr �� 4 Y N valid iyiti►oat sign►rfure �,�?' �� � Gti�Ayl�°� fel 'o->G�`r�ila �►i r i � __. uq � `" '" �6 �, V2 kvdi �.'�JIfflV� �z,�',6pfl bIrt,Ufti,, ,l d� °;a(.�kr(halRFf'6✓i,�v ppr! ppdryry �p"-y tyy'7WILLIAM H POGOR 1 1' 9 10 LACY ST NO ANDOVER MA 01M 06/28/2016