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Home My WebLink AboutBuilding Permit # 11/6/2015 C00RTF1 z 11t,mo � + PERMIT 0 0 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN A EXAMINATI N Permit NO: Date Received--- !,o 7— 4 0 Date Issued: V'SgCFiUS IMPORTANT: Applicant must complete all items on this page 77—7777777777 777 -7777 777777 7 LOCATI rrr w/F;� ... ..... 0'0P //,'_',"/........ M ` 577 h "ye L L, TYKE QF IMPROVEMENT PROPOSED USE Residential I Non® Residential N&Iew Building F-1 One family [I Addition El Two,or more family Li Industrial El Alteration Ng,.,-"6f units: 0 Commercial El Repair, replacement [YAS—Sessory Bldg El Others: Li Demolition 11 Other 7777 kt 77, e W �ep Jell'/://�a �-,LnAl I N,-10 &J Identification Please Type or Print Clearly) OWNER: (Name: (440 IW d. Phone: TIb Address: '�cD 597 dU , AMXJer U,-1 2�,6-L it r 2 4 ;g -40% , VCZ�, 6 ARCH ITECT/ENGOIEER (245co Ni e- i Phone: 201- 04— A800 Address: Reg. No. q FEE SCHEDULE:BULDING PERMIT.$1200 PER$1000.00 OF THE TOTAL ESTIMATED COST BASEL)ON$125.00 PER S.F. Total Project Cost: $ r FEE: $ "heck No.: Receipt No.: 11 `)TE: Pei-sons contract' , with ur reg er°ed contractors do not have ac s to the guaranty fund �Ltre of,Agent/Own Sign lre'of contractor Plans Submitted ❑ Plans Waived 11 Certified Plot Plan [I Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Pdblic Sewer ❑ Tanning/Massage[BodyAxl ❑ Swinuning Pools Well ❑ Tobacco Sales ❑ Food Packaging/Sales [I Private(septic tank,etc, ❑ Permanent Durapster on Site F1 THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF ® U FORM PLA NTNG & DEVELOPMENT Reviewed On Signature-- 7_ MEN. S e X/27\056,kff- f.05im,, M(YF &Akowe)> J CONSERVATION Reviewed on I Si nature` COMMENTS �H.EALTH Reviewed on Signat COMMENTS <w. _ 0 Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature & Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street mill WONSAN �/Z ........../"/"" ^� V40R t own oil Andover 00 . y h y ver, Mass, LAKE C- i PA CO CHICHEWICN BOARD OF HEALTH Food/Kitchen ' 'PEnMIT T LD Septic System" THIS CERTIFIES THAT � BUILDING INSPECTOR .............. ..........s................. ..................... �d,� undatio has permission to erect ........................... buildings on . ... ........... ............................... / o g to be occupied as ................ /....4:: ��.1... ::. : ,C��7Y,� chimney �.�.... . ............................:..:.:....:........ provided that the person accepting this permit shall in every respect conform to the terms of the application ginad j J t-�� 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 Rough ` VIOLATION of the Zoning or Building Regulations Voids this Permit. Final PERMIT EXPIRES IN 6 NS ELECTRICAL INSPECTOR I TARTS Servi c)Z— OW— ?,�33�L ....... ....... ... .......... BUILDI SPECTOR Fina GAS INSPECTOR Occupancy Permit equi�ed to Occupy Building 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 Approvedthe Building Inspector. Burner Street No. Smoke Det. F %,ORTH E r ]VO-twn d% l An tj c dx% v " ® to MP, No. Half& LA�5 h h Ver°, ass, COCHICME WICK A. � �i9�Rei r DE R U BOARD OF HEALTH P T Food/Kitchen M L D/ ,1 Septic System THIS CERTIFIES THAT .......... /4Z4/./a.1�1.��. ....................... .... ........................,... BUILDING INSPECTOR . has permission to erect .......................... buildings on ../�..�.�.....a:.0..0 .......v...................... Foundation ar ." Rough to be occupied as ............ �.... ... ............. 1 . /S u . ;1, .... C:��° ..... I Chimney provided that the person accepting this permit shall in every respect conform to th terms of the apcation 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 Regulations Voids this Permit. Rough Final EXPIRESPERMIT IN 6 MONTHS ELECTRICAL INSPECTOR UNLESSCONSTRUCT7NARTSRough 1e`� ........................... Service Final BUIL:DING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building 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 Approvedy the Building Inspector. Burner Street No. Smoke Det. Chad R. Lawlor 1679 Osgood Street North Andover, Ma 01845 978-687-8687 November 5, 2015 To whom it may concern: I am applying for a building permit for a fifty by forty(two thousand square feet) building to be built on my property at 1679 Osgood Street. I plan on using the building for general use and storage. If there are any questions please feel free to contact me at 978-265-4752. Thank you for your time. Sincere , Chad R. Law Final Construction Control Document To be submitted at completion of construction by a Registered Design Professional for work per the 8a'edition of the Massachusetts State Building Code,780 CMR, Section 107 Project Title: GIAA10 L,,bcVJ Date: Z I q I 1 Permit Nd. 16 Property Address: 116-11 O Sra&OD 9r Tot O MMR ArimNieX , MA 0104 5 Project: Check one or both as applicable: New construction 0 Existing Construction Project description: C0134-TF-00111W OF A Ne;uJ 40'x5o '5�YrLL-.r— tt.bt0C . MA Registration Number: g 4"7�3Expiration date: 6 0 l io am a registered designprofessiongl,,and I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: j ] Architectural � Structural [ ] Mechanical [ ] Fire Protection [ ] Electrical j ] Other: for the above named project. 1,or my designee,have performed the necessary professional services and was present at the construction site on a regular and periodic basis.To the best of my knowledge,information,and belief the work proceeded in accordance with the requirements of 780 CMR and the design documents approved as part of the building permit and that I or my designee: 1. Have reviewed,for conformance to this code and the design concept,shop drawings,samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Have performed the duties for registered design professionals in 780 CMR Chapter 17,as applicable. 3. Have been present at intervals appropriate to the stage of constriction to become generally familiar with the progress and quality of the work and to determine if the work was perfor anner consistent with the construction documents and this code. It OF 46� Nothing in this document relieves the contractor of its responsibility rega �� CMR 107, BIRD CIVIL Enter in the space to the right a` vet"or NO. 1 electronic signature and seal: '� Ifo tEl+ Phonenumber: Email: ( irn Building Official Use Only Building Oficial Name: PermitNo.: Date: Version 06 11 2013 j Final Construction Control Document To be submitted at completion of construction by a Registered Design Professional for work per the 8a'edition of the Massachusetts State Building Code, 780 CMR, Section 107 Project Title: CVA K> L'6' hl 1� Date: Q 1 Permit Nd. Property Address: i to7 9 O gr4Bop 9rR.+ T O MTU Oi p,45 Project: Check one or both as applicable: New construction ❑Existing Construction Project description: C*&34TRJ0T1rt71J 0f A Oew 40'+x5O' S%YrL.A--r-. 'IAVwW>t 1C7 I 6wuK C. 1 MA Registration Number: 4'- 13k Expiration date: D l b am a registered designprofessional,and I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: [ ] Architectural Structural [ ] Mechanical [ ] Fire Protection [ ] Electrical [ ] Other. for the above named project. I,or my designee,have performed the necessary professional services and was present at the construction site on a regular and periodic basis.To the best of my knowledge,information,and belief the work proceeded in accordance with the requirements of 780 CMR and the design documents approved as part of the building permit and that I or my designee: 1. Have reviewed,for conformance to this code and the design concept,shop drawings,samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Have performed the duties for registered design professionals in 780 CMR Chapter 17,as applicable. 3. Have been present at intervals appropriate to the stage of constntction to become generally familiar with the progress and quality of the work and to determine if the work was perfor anner consistent with the construction documents and this code. A of&,j� Nothing in this document relieves the contractor of its responsibility rega A CMR 107. BIRD « CIVIL ` Enter in the space to the right a"wet"or NO. 1 electronic signature and seal: FSSIO �f.� Phone number: Email: C'�d-u( �i {2�!r�ZU tI1Q(�IePll '1A. GIJri'1 Building Official Use Only Building Official Name: PermitNo.: Date: Version 06 11 2013 nabc po box 132 n andover,ma 01845 ; 69-9616 i crl landsca in division description total all total General conditions $ - -" permit $ - included plans/engineering $ - included V, -t i project manager $ - included layout $ - included dumpster $ - included ; tools $ - included l equipment $ - included heat,light.Power $ - by owner toilet $ - by owner g water $ - by owner demolition $ - site $ - building $ - sitework $ 2,600.00 excavation $ 2,600.00 included backfill $ - driveway concrete $ 39,800.00 footings $ - foundation $ 39,800.00 included slab $ - above walkways $ - masonry chimney $ - $ - walls $ - steel building $ 62,350.00 $ 62,350.00 included decking $ - rough carpentry $ - framing $ - roofing $ - rubber roofing $ - siding $ - windows $ - sky lights $ - fire door $ - exterior doors $ - nabc po box 132 n andover,ma 01845 garage doors $ - 978-869-9616 trim $ - finish carpentry $ - base/trim $ - doors $ - stairs $ - ceiling tiles $ - kitchen cabinets $ - bathroom vanity $ - counter tops $ - other cabinetry $ - insulation $ - $ - above flooring $ - wood $ - carpet patch $ - carpet clean $ - other $ - finishes $ - drywall $ - plaster $ - paint exterior $ - paint interior $ - wallpaper $ - hvac $ heat $ - air conditioning $ - plumbing $ - $ - sprinkler $ - electrical $ - $ - $104,750.00 $104,750.00 nabc overhead $ 14,665.00 $ 14,665.00 total $119,415.00 $119,415.00 qualifications no unforeseen conditions no hazardous materials 16.3 Corridor Development District 2 (CDD2) -Permitted Uses In the Corridor Development District 2,no building or structure shall be reconstructed, erected, altered or used for any other purpose than the following: 1. Retail uses provided there is no outdoor sales or storage of materials and products. However, auto sales and repair are not allowed. 2. Restaurants excluding drive-through facilities. 3. Personal service establishments. 4. Indoor recreation, fitness, and health care facility. 5. Indoor place of amusement or assembly. 6. Public building or use and Public Service Corporation. 7. Professional offices including,but not limited to banks,real estate offices, insurance offices, physician offices, dentists, attorneys, architects, engineers or accountants.No drive-through facilities are permitted with these uses. 8. Art Gallery 9. Cultural Center or Museum. 10.Place of worship. 11. Same-structure/On-site Mixed Use Developments a. Residential uses shall not be located on the first floor of a structure or building. b. Apartments and condominiums shall be allowed where such use is not more than fifty percent (50%) of the gross square feet for a two (2) story building and seventy-five percent(75%) of the gross square feet for a three (3) story building. 12. Farming,Livestock,Animal Care: a. Farming of field crops and row crops,truck gardens, orchards,plant nurseries, and greenhouses. b. On any lot of at least three (3) acres,the keeping of a total of not more than three (3) of any kind or assortment of animals or birds in addition to the household pets of a family living on such lot, and for each additional acre of lot size,the keeping of one (1) additional animal or bird up to a maximum of five (5) animals;but not the keeping of any animals,birds, or pets of persons not resident on such lot. c. On any lot of at least five (5) acres,the keeping of any number of animals or birds regardless of ownership and the operation of equestrian riding academies,stables, stud farms, dairy farms, and poultry batteries d. The sale of products raised as a result of the above uses on the subject land. 13.Fence businesses,fence contractor's yard, sales of sheds, swings sets and like equipment and supplies, including outdoor sales and outdoor storage of material,equipment, and supplies." 14. Drive-Thru restaurants shall be permitted within the CDD2 zone provided that they are located on a parcel or parcels collectively comprising at least five(5) acres or more of land, and further provided that such restaurant structures are located more than 400 feet from a lawfully permitted residential dwelling located within the R-3 zone. 16.4 Corridor Development District 3 (CDD3) -Permitted Uses In the Corridor Development District 3, no building or structure shall be reconstructed, erected, altered or used for any other purpose than the following: 1. Retail uses provided there is no outdoor sales or storage of materials and products. However, auto sales and repair are not allowed. 2. Restaurants excluding drive-through facilities. 3. Personal service establishments. 4. Indoor recreation, fitness, and health care facility. 158 5. Indoor place of amusement or assembly. 6. Outdoor place of amusement or assembly. 7. Public building or use and Public Service Corporation. 8. Professional offices including, but not limited to banks, real estate offices, insurance offices, physician offices, dentists, attorneys, architects, engineers or accountants. One drive-through facility shall be permitted every 500 linear feet of street or highway as measured along centerline. 9. Medical Center. 10.Research and Development Facility not to exceed 25,000 square feet. 11.Printing and Reproduction. 12. Warehousing and Wholesaling. 13. Motel and Hotel. 14.Art Gallery. 15. Cultural Center or Museum. 16.Place of worship. 17. Day Care Center. 18. Same-structure/On-site Mixed Use Developments: a. Residential uses shall not be located on the first floor of a structure or building. b. Apartments and condominiums shall be allowed where such use is not more than fifty percent (50%) of the gross square feet for a two (2) story building and seventy-five percent (75%) of the gross square feet for a three (3) story building. 16.5 Uses Subject to a Special Permit The following uses may be allowed in the Corridor Development Districts by granting of a Special Permit pursuant to Section 8.3 and 10.3 of the Bylaw: 1. No building or structure in excess of 3,000 gross square feet of building area shall be constructed, reconstructed, erected or altered in the Corridor Development District without the granting of the Special Permit. The granting of the Special Permit shall be pursuant to Section 8.3 and 10.3 of the bylaw and subject to the following conditions:" a. Submission of a traffic impact and mitigation plan by a professional traffic engineer/consultant. b. For those parcels abutting residential zoned properties, sufficient evidence must be provided to demonstrate that no reasonable alternatives to the site layout,site design, and parking configuration exist. c. A determination by the Planning Board that the proposed development will-not create adverse traffic and safety impacts and neighborhood sheets and uses are harmonious with the character of the area. d. A determination by the Planning Board that the proposed development provides sufficient screening and buffering for those parcels abutting residential zoned properties. 2. For outdoor storage, display, and sales of materials,products and goods in connection with retail uses and provided: a. Permissible area of land devoted to the specially permitted outdoor use may not exceed twenty percent(20%)within CDD1 and thirty percent(30%)within CDD2 of the indoor principal use devoted to retail sales. b. The products,materials or goods displayed, stored or sold outdoors,by special permit, must not be visible from any residential use. c. The goods,materials, and products permissible for outdoor storage, display and sales hereunder, shall explicitly exclude automobiles,motorcycles, or other wheeled vehicles and include only goods,materials, and products,which are customarily stored, displayed,or sold 159 c) Parking on Rights-of-Way. No parking area or aisles shall be laid out on land, which is reserved as a vehicular right-of-way, whether developed or undeveloped, and whether public or private unless otherwise permitted as provided in Section 8.1.4. d) Parking in Required Setbacks. No unenclosed parking area shall be allowed within five (5) feet of a front lot line except on a residential driveway. e) Village Commercial District. i) Parking lots shall be provided only at the side or to the rear of the buildings. The Planning Board may, at their discretion, allow up to 50 spaces, or 25% of the total parking,whichever is greater, to be located to the front of the structure as long as all other dimensional criteria are adhered to. ii) No single section of parking may contain more than twenty-:five percent (25%) of the total proposed -parking spaces or more than fifty (50) spaces, whichever is less. As a method of division, 6' wide parking lot islands shall be installed to provide the proper break between adjacent parking lots. For projects which require less than fifty (50) spaces in total, the Planning Board may allow fifty (50) spaces to be located together if all effective visual buffer is provided. Each landscaped island must be 6' in width at The minimum. In locations -where the possibility exists to enlarge the entire island or portions thereof, the Planning Board would recommend that such measures be taken, f) Residential Zoning Districts. i) For single- and multi-family dwellings, the front yard shall not be used for parking for accessory uses. ii) Parking or outdoor storage of one (1) recreational vehicle (camper, etc.) and one (1) boat per dwelling unit may be permitted in an area to the rear of the front line of the building. All other recreational vehicles and boat storage (if any) shall be within closed structures. iii) Garaging of off-street parking of not more than four (4) motor vehicles per dwelling unit may be permitted, of which four (4) motor vehicles, not more than two (2) may be commercial vehicles other than passenger sedans and passenger station wagons, but not counting farm trucks nor motor-powered agriculture implements on an agriculturally active farm or orchard on which such vehicles are parked. 7. Exceptions. The regulations of this section shall not apply to residential and non-residential uses or structures whose minimum parking Linder the above schedule would amount to five (5)parking spaces or less. S. Special Permits. The Planning Board as SPGR, may grant a Special Permit modifying certain parking/loading standards of this Section and/or Section 8.4 (Screening and Landscaping Requirements for Off- Street Parking), but only in the specific circumstances listed under "a" through "h" below. The SPGR may grant such special permit only when: (a) consistent with the purposes set forth in Section 8.1; (b) making the findings and determinations set forth in Section 10.3; (c) making a finding that the requested relief falls within one or more of the categories for the specific relief requested (any of cases a"through "h" below); and, (d) upon a determination that the relief does not cause detriment to the surrounding neighborhood based upon any of the following applicable criteria: (i) Increase in traffic volumes; 92 through facility) Fast Food 15.0 per ksf GFA Fast Food(with-drive through facility) 12.0 per ksf GFA Office and Buslpe�s,�ertvicesF �w. - - Data Processing/Teleinarketing/O orations 6.0 per ksf GFA Medical Offices (multi-tenant) 4.5 per ksf GFA Clinic (medical offices with outpatient treatment: no 5.5 per ksf GFA overnight stays) _ Veterinary Establishment,Fennel or Pet Shop or 0.3 per ksf GFA Similar Establishments Bank Branch with Drive-in _ 5.5 per ksf GFA Funeral or Undertaking Establishment 0.05 per ksf GFA Other BLrSiness or Office Uses Not Otherwise Listed 3.0 per ksf GFA Above Indust><>al R&D establishment,manufacturing, industrial 0.8 per ksf GFA i services, or extractive industry Industrial 2.0 per ksf GFA Manufacturing/Light Industrial(Single-Use) 1.5 per ksf GFA Industrial Park(Multi-tenant or mix of service, 2.0 per ksf GFA warehouse) Warehouse 0.7 per ksf GFA Storage 0.25 per ksf GFA Other Industrial and Transportation Uses Not As determined by the Planning Board,but Otherwise Listed not less than 0.25 per ksf GFA i Goue�umental ant►onal Elementary,and Secondary Schools 0.35 per student; plus 1 per 2 employees College University Determined by parking study specific to subject institution_----- 77"J Curtin al/Ft�c�=cat�onal/1Cirte�=taa�zmeut ,y _ Public Assembly _ 0.25 per person in permitted capacity _ Museum 1.5 per 1,000 annual visitors Library — 4.5 per ksf GFA Religious Centers 0.6 per seat Single-Screen: 0.5 per seat;Up to 5 screens: Cinemas 0.33 per seat; 5 to 10 screens: 0.3 per seat Theaters (live performance) 0.4 per seat Arenas and Stadiums 0.33 per seat 50 per nine(holes); plus the parking Golf Course or Country Club requirements for food or beverage uses described above Health Chrbs and Recreational Facilities 2 per player or 1 per 3 persons permitted capacity 88 The Commonwealth of Massachusetts Department of XndustrialAccidents I Congress Street,Suite 100 Boston,MA 02114-2017 www.mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/PIumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Ap hcaut information Please Print Les:ibly Name(Business/Organization/Individual): Address: C° 6", 13'Z City/State/Zip: �``' • �tiD�"�� Phone#: P c, L' C l Are you an employer?Check the appropriate box: Type of project(required): 1.[6'am a employerwith L& employees(full and/or part-time).* 7. Tew construction 2.❑I am a sole proprietor or partnership and have no employees working for me in 8. E]Remodeling any capacity.[No workers'comp.insurance required.] 9. Demolition 3.0 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. 1 will 11.Q Electrical repairs Or additions ensure that all contractors either have workers'compensation insurance or are sole proprietors with no employees. 12.[]Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.Q Roof repairs These sub-contractors have employees and have workers'comp.insurance I 14.Q Other 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. #Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I aiti att etttployer tliat is providing ivorlrers'conipetisation irtsut•allee for my employees. Below is the policy and job site information. Insurance Company Name: _ 2Q l Ex iration Date: it tl 15 Policy#or Self-ins.Lie.#: A✓( 7 w 7t'Z3 Z e p Job Site Address: City/State/Zip: icy declaration page(showing the policy number and expiration date). Attach a copy of the workers'compensation pol Failure to secure coverage as required under MGL c.152,§25A is a criminal violation punishable by a fine up to$1,500.00 and/oruove-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a may be forwarded to the Office of Investigations of the DIA for insurance day against the violator.A copy of this statement coverage verification. I do hereb certify tinder the pains and penalties of pet jury that the inforn:at1 11 provided above is true and correct. Date: Si nature: Phone#: b(ol Lissuing only. Do not write in this area,to be completed by city or town official n: Permit/License# hority(circle one): Health 2.Building Department 3.City/Town Cleric 4.Electrical Inspector 5.Plumbing Inspector son: Phone#: i.• DATE(MMIDDrYYYY) CER11FICATE •.�.OF LIABILITY INSU NC 9/9/2015 IR. THIS GHTS UPON THE CERTIFICATE HOLDE ,HIS CERTIFICATE IS ISUED'AS YIVE Y�4R NEGATIVELY AMENDOF INFORMATION , EXTEND ORAND ERS NO ALTER RINE COVERAGE A FORGED i3Y THE POLICIES CERTIFICATE DOES NOT'd6FbF'IN BELOW. THIS CERTIFlCATE`'17F'INSURANCE DOES NOT CONSTITUTE A CONTRACT HETWEEN THE ISSUING INSURER(6), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND T:HH;CERTIFICATE HOLDER, IMPORTANT: If the certificake'hotder,is an ADDITIONAL INSURED,the policy(ies)ItIUSt be andar6ed. If SUBROGATION 19 WAIVED,subject to tfie terms and conditions of fhe policy,certaih policies may require an endorsement;.A statement an this certificate does not confer eights to the certificate holder In lieu of succi endorsement(s). I CONTACT Li aa London PFt000CER % NAME: PH NE . (978)6815700 aCNo:I0T8I66x-577 MTM Ynteurance Associates , t lisal@mtmxnsure.com 1320 Osgood Street n0 '• INSURERS AFFORDING COVERAGE NAIC tl North Andover MA 01845 r!• INSVRER'AaHudeon Insurance Cc an FNED INSURE B:` Leaman, DBA: Nbith Andover'Suilding Corp:' INSURERc, ox 132 INSURERD: INSURER E: ndover -MA 01845 INSURERF: COVERAGES CERTIFICATE NUMBER:15�16 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 CERTIFICATE MAY 8E ISSUED OR MAY QUIPERRE NE THE INSURANCE AFFORDED BY THE POLFI, CONDITION OF ANY LIIC ES DESCRIBED HEREIN I SCT OR OTHER DOCUMENT )UBJE.CT TO ALL RESPECT O THE TERMS, CAIM EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.-LIMITS SHOWN MAY HAVE BEEN REDUCY E BY POIDcYLEXP S LIMITS INTR ADDL UeR, P LICY NUMBER MkDY RTYPE OF INSURANCE NCE $ 1,000,000 EACH OCCURRE X COMMERCIAL GENERAL LIABILITY •; ...Id; F;I S 100,000 '11t; PR MI E A 5,000 CLAIMS-MADE. �X OCCUR 13/Z015 8/13/2016 MEOEAP(Anyone,perEon S i'••RBD10011577 1,000,000 PERSONALS ADV INJURY S GENERAL AGGREGATE 5 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER; •I "� "' , I'4 1 r 000'000 ,.I; ••:I;' ' PRODUCTS•COMP/OP AGG S i X POLICY pER0T• LOC JCiC : i'•.' OTHER: t; aaeccMenISINGLELIMIT S AUT0rA0BILE LIABILITY I:. _:r"0 •I '• BODILY INJURY(Per pe(son) S A AUTO BODILY INJURY(Par amdan0 F ALL OWN EO $CHEDULED PROPERTY DAMAGE S AUTOS AUTOS NON•OWNED : Per accident HIREDAUTOS AUTOS ( S EACH OCCURRENCE S UMBRELLA UA8 OCCUR • I;�'� AGGREGATE S EXCESS UAB CLMMS•MADE,�.:ty r' S .TrLr� lS pit: S DED RETENTI N 0TH- WORKERSCOMPENVATION ;,, %` ` '..• `:' i' T T ER AND EMPLOYERS'L(ABILr*.'¢`' r p;;r �) j iy• E.L.EACH ACCIDENT ANY PROPRIETORIPART1,190 E&TWE 'i „ ), �; QFF)CERrMEMBER EXCLUD609' E L.DISEA6E-EA EMPLOYE S (Mandatory In NH) :.•t. L. -,li}'+ 1'�' t ti(41••( {' :i• E.L.OISEA$E- '".1 LIMIT E DESCRIPTION OF OPERATIONS oe10n DESCRIPTION OF OPERATIDNSI LOCATIONS I VEHICLES(ACORD 407,AdelllOnpl Remarks 9chetlul9, be attached N more space Ia rapt/may not be in COMPlianC8 This certificate of insurance represents Coverage cu rrentnt ly in 'effeCC'and may or may with any written Contract. CERTIFICATE HOLDER Mn CANCELLATION SHOULD ANY or-THE- EXPIRATION H DATE POLICIESE DESCRIBED E THEREOF, NOTICE WILL CBE CBEFOREELLED DELIVEREDIN ACCORDANCE WITH THE POLICY PROVISIONS, AUTHORIZED REPRESENTATIVE ( ; ' P MacDonald CFCU, CIC I">' -p1999.2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD INS028r201401t 6 INSURANCE 0AT1;(MM1001YYYY1 ® CERTIFICATELIABILITY 09!91!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 ODES 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 be endorsed. if SUBROGATION 13 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 endarsement(s). PRODUCERCONTACT 049tH-001 NAMNEE MTM Insurance Associates LLC [RIM, (978)681^6700 M.Nm! (970)681-5777 1320 Osgood Street pp0 �; North Andover,MA 01846 INSURERISI AF O GING . A.I.M-Mutual Insurance Company 33758 IN6URE0 INSURER 8 North Andover Building Corp (NSU E p0 Ha% 132 INSURER D, North Andover, NIA 01845 U E E: 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. N07WITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS EXCLUSIONS ANDVCBE ISSUED OR OND CONDITIONS OF UCH OLICIEIN, THE INSURANCE AFFORDED BY THE POLICIES S.LIMITS SHOWN MAY HAVE BEEN REOUCpp1Eo BY PAID CLAIMS. HEREIN IS SUBJECT TO ALL THE TERMS, I TYPE OF INSURANCE INdSR LW POLICY NUMBER MMlD� MM/DDIYYYY LIMITS GENERAL LIABILITYEACHOGWRAENCE S 6A19MT17tEATfitf S COMMERCIAL GENERAL LIABILITY PREMISES Fa o 0.ARe6•MApE OCCUR MED EXP(Any one W604) S PERSONAL dAOVINJVRY S GENERAL AGGREGATE S EN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS•COMPIOPAGG S OLICY PRO' F]LOC AUTOMOBILE LIABILITY I INGLE LIM $ ANY AUTO BODILY INJURY(Per Derian) S ALL OWNED SCMEovLED BODILY INJURY(Par aaoidont) S AUTOS HIR DAUT05 NON AUTOS ONNED j PROPaudenl S ' UM13RELLALIAB OCCUR I EACH OCCURRENCE S EXCESS LIAR CLAIMS MADE! AGGREGATE S pp-DEDS �RNUTTr NnTIIONN g APS . •• xE.L.FTAOCRHYSALCAtCI1D'$ENT K S 1001000100 A NAIMPI85ECUTiVE• J 'iNfA AWCa00-70232872014A fi/1112094 11!11!2(116 ,E.L.DISEASE•EAEMPLOYEE S 100,000.00 (Mandatory In NN) +).,.•• ) .• • ��t(�ytBe@�e� npo nc t I ti dpn. E.L.DISEASE•POLICY LIMIT s 600,000.00 DESCRIjWION�F OPERATIONS beb- 1 i DESCRIPTION OF OPERATION$I LOCATIONS I VEMI@LES(Attach ACORD 101,Additional RemerRe SCladula.If mory spacaiz mquimd) CERTIFICATE HOLDER ,_ CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE I THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE (p 1908-2010 ACO PORAATII]ONN.All rights reseryed. ACORD 26(2010106) The ACORD name and logo are registered marks of ACORD g` PA,7ssac!'UGetts -]epa!- S d � ;-tcrlt nr P_:biic ~' E30a;d of Sui?ding Rcglilations ar,d Star, '_arc', cOnstnactiun .suprn icor License: CS-082816 JOHN R g g.g,. 70 PI LLO RoAD %ULTON ASA 02186 Cornniissin ner 06116/2;116