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HomeMy WebLinkAboutBuilding Permit # 4/4/2016 FORTH BUILDING PERMIT o& TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION _ A . h 1 �• ON 70 Permit IVo#: �-7,) ;'" Date Received t `� �R"�R,rEo gSV CHU`S Date Issued: / I IMPORTANT:Applicant must complete all items on this page LOCATIONTpu Y . r ' 1�"Gd�r Print PROPERTY OWNER 'L r� t `��fCr Print 100 Year Structure yes no MAP PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building One family VAddition ❑ Two or more family ❑ Industrial VAlteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other DESC IPTIO OF WORK�O BE PERFORMED: 9P>�23 3�"te- 6-6y AdAu �el Identification- Plea a Ty e or Print Clearly OWNER: Name: ` � ,(,�I�L� i Phone: Address: 62Yf2-&k , A Contractor Name: k) Phone: - Email ' Address: Supervisor's Construction License: ey Exp. Date: Home Improvement License: Exp. Date: 1 'L ARCHITECT/ENGINEER , ( [_� (�, Phone: 1 ,f Address: j�/J tt.� S2S 1, 46,1W.Reg. No. �� FEE SCHEDULE.,BULDING PERMIT.$12.00 PER$1000.00 OF THE T TAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ % FEE: $ �' ' ��0 Check No.: ?l 7 Receipt No.: 0 NOTE: Persons contracting with unregistered contractors, t have access t e guaranty fund f" r'.�6v �,_�, ��-u.• ,< ��uiT i"l' r � t✓ ; ( x i t Siaft"a of'AaPnt/Owner, ,, F ,�, i „, Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans El TYPE OF SEWERAGE DISPOSAL Public Sewer lox, Tanning/Massage/Body Art ❑ Swimming Pools El Well ❑ Tobacco Sales El Food Packaging/Sales D Private(septic tank,etc. ❑ Permanent Dw-npster on Site F1 THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING DEVELOPMENT Reviewed On I Signature k0()vVw- �if ly') )401-1�':Olw P.) Q- CONSERVATION Reviewed on --Signature COMMENTS HEALTH Reviewed on Signature MMENTS-0 "t -We4o 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 61 "j,"",.................. C 0 t 1\,j O TH Town ofiAndover ® _ vee°, ass, �i l COC HIC"e WICK ,Q ®SATE® BOARD OF HEALTH PERMIT T . LD Food/Kitchen Septic System THIS CERTIFIES THAT % "` ...............4" ..... .......... ...... ........................................ ........ BUILDING INSPECTOR ................ buildings on .................................... ✓ .............. Foundation has permission to erect ........ ............. ........ ... 'P Rough U la tohe occupied as .................�!.'�cJ ,.....!.......�............................................................................ Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application 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 PERMEXPIRES IN 6 MONTHS IT ELECTRICAL INSPECTOR UNLESS Rough Service ...... ..... ............. ..... � 0�� :.— �................ Final BUILDING INSPECTOR �p �p GAS INSPECTOR Occupancy Permit Required to Occupy lul�`L1�2,� Rough Display in S is S Place on the Premises — Do Not RemoveFinal No Lathing r Dry Wall eDone FIRE DEPARTMENT Until Inspected and ApprovedBuilding s ro Burner Street No. Smoke Det. Kevin Cunniff 211 Seven Star Road Grov,61and,MA 01834 Phone (978)-968-8087 Match 21,2016 Page I of 5 Tom and Nicole Friel 254 Great Pond Road North Andover, MA General: • Engineering and plans to be supplied by the homeowner. • Town approvals to be handled by the homeowner. • General Contractor,Seven Star Builders, Inc., Kevin Cunniff will apply for and pay for building permit, permit allowance is$51,000.00 • Portable toilet on site and serviced weekly is the responsibility of the General Contractor. ® Trash removal-and disposal is the responsibility of the General Contractor, Site Work and Foundation: ® Excavating of foundation and backfilling. • Pour footing for addition 20"x 10"with key way. • Interior footing as per plan. • Pour 10"concrete wall on top of footing. • Damp proof exterior of wfoundation below grade. • Create opening through existing foundation. • Place 6"of%wasted stone inside new foundation. • Pour 4"slab inside of new foundation. • Back fill foundation and grade yard. ® Dig and pour 12"Sono Tubes for rear deck and front porch as per plan. Steel: e Supply inside steel beams as follows; 2-W8 x 24 approximately 16' running front to rear. I-W8 x 40 approximately 21! running front to rear. 1-W14 x 38 approximately 21' running front to rear. 1-W 14 x 68 approximately 24' running left to right. a includes all necessary connections, padding and re-hanging of existing joists. 9 Includes 7-4x4x X"steel columns with base plates down to footing or existing foundation. n + Kevin Cunnif€ 211 Seven Star Road Groveland,MA 01834 !Phone (978)-968-8087 March 21,2016 Page 2 of 5 Framing: • Frame addition, 22x23 according to plan. • Re-frame rear section of roof in master bedroom with new ridge according to plan. • Frame front porch,PT platform, roof system to be KD approximately 290 square feet. • Frame rear deck using PT lumber according to plan approximately 835 square feet. • Frame interior walls as show on plan. • Frame in fire place,showers and do all necessary firing and shimming. • Frame trade ceiling in master bedroom. Roof: • Strip and re-roof entire house(except garage). • Install Ice and Water Shield on the bottom 6' of roof deck flash points and valleys. • Install 8"aluminum drip edge on all exterior edges. • 15 LB felt on rest of roof. • Install GAF Architectural roof shingles 30 Year warranty. • Color to be chosen by the homeowner. • Standing seam metal roof on Farmers Porch off the driveway. Windows and Doors: • Remove and dispose of all windows. • Move and adjust opening as needed. Frame window as needed. • Cover bottom of openings with Ice&Water Shield. • Install new Harvey Tribute Windows Low E Glass,vinyl,with full screens and grills as per plan. • Factory paint exterior of window and grills black,factory applied trim to stay white. • Install Anderson hinged patio doors,pre=finished white inside with screens, Low E Glass, 400 Series; one double operating from driveway and one double dead light on the front porch. • Install new Thermo Tru doors with composite jamb,-fiberglass door;style to be chosen by the homeowner, allowance of$800.00 for the door and lock set with two operating units in rear on deck. • Four operating doors will be changed to Thermo Tru stationary panel,bead lights,all on deck. J Kevin Cunniff J 211 Seven Star Road Grovetand,MA 01834 Phone (978)-9688087 March 21, 2016 Page 3 of 5 Siding and Trim: 0 Remove and dispose of existing siding. Is Re-nail sheathing and cover with house wrap and tape. 0 Replace exterior trim or cover using PVC,fasten using stainless nails or concealed fasteners. • Install fiber cement(pre-finished)color chosen by the homeowner. • Rear deck to be decked with 5/4 x 6 PVC decking with an allowance of$7.00 per square foot. • Rear deck will have Timber Tech Composite Rail Reliance Series(white) close in underneath with PVC lattice. Siding and Trim-Continued: • Front porch will have 5/4 x 6 PVC decking allowance of*0 per square foot. • Ceiling on front porch will be beaded PVC with 10 x 10 PVC wrapped columns. HVAC: e Supply and install 2; 96916 100,000 BTU System. 0 Both with 4 ton seer a/c condenser and coil. 0 First floor will be 2 zones;one zone for the bedroom suite and one zone for the rest of the first floor. 0 2N° Floor will have a single zone. Electric: • Wire according to Massachusetts Electric Code. • Wire phone and cable,6 cable TV,2 CAD 5 and 4 phones. • Install vent fans in bathrooms with exterior venting. • Supply and install 30 recessed air tight 6" lights with trims. • Wire doorbell. • Wire heating units and condensers. Plumbing: • Install drain,vent and hot&cold supply to one kitchen and 3 X bathrooms. ® 1st Floor to have handicap bath with custom roll in shower with tub inside shower, and Yz bath. • Master bath to have double bowel vanity, custom shower and soaking tub. ® Main bath will have re-installed exiting sower vanity and toilet. • Plumb gas piping to;two gas furnaces,one fire place and kitchen stove. 7 T Kevin Cu7nniff _. u_ _ 'J} 211 Seven Star Road Groveland,'MA 01894 Phone (978)-968-8087 March 21, 2016 Page 4 of 5 Insulation and Plaster: • Insudate ceiling to R-38 where possible. ® Insulate walls to R-15 where possible. • Insulate floors to R-30 where possible. • Cover all walls and ceiling on the first and second floor with 36" blue board and apply unical skim coat plaster,smooth finish on walls and ceilings. • Walls on the front will have W Homosote for sound applied before blue board. Interior Trim: • Install two panel Masonite pre-hung doors that are hung in primed FJ jambs with 1x4 casings. • Case window with extension jambs, (panel grade), U4 primed casing and stool • Install 7%speed baseboard primed. • Install kitchen cabinets, install vanities see allowances. • Crown molding throughout. • Custom built-in around the fireplace. • Three foot high bead board in master bath and% bath. Flooring and Wall`file: Install and finish 3%"Red Oak Flooring in.all rooms except bathroom,with an allowance ( ' of per foot for materials. ® Install underiayment and file in bathrooms with an allowance of$2.50 per foot for tile. 0 In custom showers install f"wonder board (cement board)and water proof. 0 Install the on walls and floors, colors and style chosen by homeowner,with an allowance of$2.50 per square feet. Paint: • Paint ceiling;two coats ceiling white. * Prime walls and paint two coats finish,with an allowance of 4 colors and trim. Additional colors$250.00 per color matte finish. • Prime and paint woodwork two coats finish semi-gloss. Miscellaneous: • Closets; shelving wood shelves and pole. • Install gas fire place model,standard 36" unit. • Kitchen allowance is$20,000.00, includes kitchen cabinets,vanities,counter tops,sinks and faucets. • Tile and flooring allowance for material is$2450 per square foot. • Paint 4 colors and trim included,additional colors are$250.00 per color. oRrN Town of North Andover Office of the Planning Department 2016 JAH 6 19 Community Development and Services Division 1600 Osgood Street North Andover,Massachusetts 01.845 HA ')A NOTICE OF DECISION—Watershed Special Permit Any appeal shall be filed within (20) days after the date of filing this notice in the office of the Town Clerk. Date: January 5,2016 Date of Hearings: December 15,2015, January 5,2016 Date of Decision: January 5,2016 Petition of. Thomas and Nicole Friel,254 Great Pond Road,North Andover,MA 01845 Premises Affected: 254 Great Pond Road,North Andover,Massachusetts,01845. Assessor's Map 37A,Parcel 6 and located in the Residential I Zoning District. Referring to the above petition for a Watershed Special Permit from the requirements of the North Andover Zoning Bylaw,Sections 4.136& 10.3. So as to allow the constniction of a 22' x 23'single story addition to the side of the dwelling, demolition of an existing deck, and addition of a now deck within the 250' Non-Disturbance Zone of the Watershed Protection District. After a public hearing given on the above date, and upon a motion by L. Rudnicki and 2nd by P. Boynton to APPROVE the Watershed Special Permit as amended and based -upon the following conditions. The vote was 5—0 in favor of the application. P] (iiing Board JOVIIsinions,Chair LynnclZudnicki David Kellogg Lora MeSherry Peter Boynton E Kevin Cunnif 211 Seven Star Road Groveland,MA 01834 Phone (978)-968.8087 Larch 21, 2016 Page 5 of 5 Miscellaneous nVd: • Light fixtures supplied by homeowner. • Appliances,supplied by homeowner, • Not included. Landscaping,driveway or walkways. Total Cost. $450,000.00 Payment Schedule: Sign Contract $33,000.00 Steel Installed $33,000.00 Foundation In $33,000.00 Framing Complete $$5,000.00 Exterior Trim Complete $33,000.00 Roof Complete $33,000.00 Rough in Complete $33,000.00 Plaster Complete $33,000.00 Kitchen Cabinets Installed $33,000.00 Interior Trim Complete $33,000.00 Rear Deck Complete $33,000.00 Flooring installed $33,000.00 Painting Complete $33,000.00 Certificate of Occupancy $21.,000.00 Total Contract: $450j000.00 Kevin Cunniff ° '' Date � Seven Star Builders,Inc. Tom and Nicole:Friel Date `� 254 Great Pond Road Map 37A Lot 6 Watershed Special Permit—Addition to Single-Family Residence January 5,2016 The public hearing on the above referenced application was opened on December 15, 2015 closed by the North Andover Planning Board on January 5,2016, On January 5, 2016 upon a motion made by L. Rudnicki and seconded by P. Boynton to GRANT a Watershed Special Permit for the construction of a 22' x 23'single story addition to the side of the dwelling, demolition of an existing deck, and addition of a new deck within the 250' Non-Disturbance Zone of the Watershed Protection District, under the requirements of Section 4.136 & 10.3 of the North Andover Zoning Bylaw. This Special Permit was requested by Thomas and Nicole Friel, 254 Great Pond Road, North Andover, MA 01845 on November 13, 2015. The applicant submitted a complete application, which was noticed and reviewed in accordance with Section 10.52 of the Town of North Andover Zoning Bylaw and MGL Chapter 40A, Section 9. The motion to approve was subject to the FINDINGS OF FACTS and SPECIAL CONDITIONS set forth in this decision. The Planning Board vote was unanimous. A special permit issued by the special permit granting authority requires a vote of at least four members of a five-member board. The applicant is hereby notified that should the applicant disagree with this decision, the applicant has the right, under MGL Chapter 40A, Section 17,to appeal to this decision within twenty days after the date this decision has been filed with the Town Clerk. In accordance with 4.136 the Planning Board makes the finding that the intent of the Bylaw, as well as its specific criteria are met. This decision specifically stated. by the Planning Board makes the following FINDINGS OF FACT: 1) That as a result of the proposed construction in conjunction with other uses nearby,there will not be any significant degradation of the quality or quantity of water un or entering Lake Cochichewick. The Planning Board bases this finding on the following facts: a) The construction has been reviewed by Town Staff and the Town's consulting engineer, Eggleston Environmental, and with the application of the erosion control measures and modifications to the proposed deck location,drainage and stormwater management designs,the consultant concluded that there will not be significant degradation to the quality or quantity of water in or entering Lake Cochichewick. The footprint of the new addition is diminutive and the layout of the proposed deck was reconfigured to ensure there was no encroachment into the Conservation Zone. The site drainage system and storm water management design are designed in accordance with the Town Bylaw requirements and Best Engineering and Management Practices. The plan has been reviewed by the outside consulting engineer, Lisa Eggleston, as evidenced by a letter from L. Eggleston dated December 8, 2015 and email dated December 24, 2015 as well as a letter from Sullivan Engineering Group dated December 22, 2015. Further, adequate safeguards have been provided to mitigate pollutants from entering Lake Cochichewick through the installation/implementation of the following Best Management Practices relative to a single- family dwelling: i) The new addition will create 506 sq.ft. of new impervious area.All of the roof runoff will be routed to a 500 gallon drywell. ii) No new lawn area is being proposed and there will be no tree-cutting required for construction. 2 254 Great Pond Road Map 37A Lot 6 Watershed Special Permit—Addition to Single-Family Residence January 5,2016 iii) Fertilizers are limited to those which are either organic or slow-release nitrogen and phosphorous-free, non-organic pesticides and herbicides use will be prohibited, and the use of coal tar-based pavement sealants will be prohibited.These restrictions will be noted on the deed. b) The existing structure is connected to the Town sewer and water systems. 2) There is no reasonable alternative location outside the General, Non-Disturbance, and the Discharge Zones for any discharge,stricture or activity. 3) In addition, in accordance with Section 10.31 of the North Andover Zoning Bylaw, the Planning Board makes the following FINDINGS OF FACT: a) The specific site is an appropriate location for the proposed use as all feasible storm water and erosion controls have been placed on the site; b) The use will not adversely affect the neighborhood as the lot is located in a Residential 1 Zoning District; c) There will be no nuisance or serious hazard to vehicles or pedestrians; d) Adequate and appropriate facilities are provided for the proper operation of the proposed use; e) The Planning Board also makes a specific finding that the use is in harmony with the general purpose and intent of the North Andover Zoning Bylaw. Upon reaching the above findings,the Planning Board approves this Special Permit based upon the following SPECIAL CONDITIONS: 1)Permit Definitions: a) The"Locus"refers to the 89,627 sq.ft. parcel of land with frontage on Great Pond Road as shown on Assessors Map 37A,Parcel 6 and also known as 254 Great Pond Road,North Andover, Massachusetts. b) The"Plans"refer to the plans prepared by Sullivan Engineering Group, dated November 10,2015 and revised to December 24,2015, entitled"254 Great Pond Road Plot Plan of Land located in North Andover,Massachusetts(Essex County)prepared for Thomas and Nicole Frier". c) The"Project"or"254 Great Pond Road"refers to the construction of a 22' x 23'single story addition to the side of the dwelling, demolition of an existing deck,and addition of a new deck within the 250'Non-Disturbance Zone;however,outside on the Conservation Zone of the Watershed Protection District. d) The"Applicant"refers to Thomas and Nicole Friel,the applicant for the Special Permit. e) The"Project Owner"refers to the person or entity holding the fee interest to the title to the Locus fi•om time to time,which can include but is not limited to the applicant, developer, and owner. 2) The Town Planner shall approve any changes made to these plans. Any changes deemed substantial by the Town Planner would require a public hearing and modification by the Planning Board. 3 254 Great Pond Road Map 37A Lot 6 Watershed Special Permit—Addition to Single-Family Residence January 5,2016 3) Prior to issuance of a building permit: a) A performance guarantee bond of four thousand dollars ($4,000.00) made out to the Town of North Andover must be posted to insure that the construction, erosion control, measures, and performance of any other condition contained herein will take place in accordance with the plans and the conditions of this decision and to ensure that the as-built plans will be submitted. b) All erosion control measures as shown on the plan must be in place and reviewed by the Town Planner. c) In consultation with the Town Planner,the Applicant shall designate an independent construction monitor. The monitor shall read, sign,and return to the Town Planner the Letter of Agreement for Independent Monitors. The monitor shall make weekly inspections of the project, provide monthly reports to the Planning Department, and detail any areas of non-compliance and corrective actions. The monitor will also provide reports following heavy rain events. The monitor must also be available upon notice to inspect the site accompanying a Planning Department designated official. d) Fertilizers are limited to those which are either organic or slow-release nitrogen and phosphorous- free,non-organic pesticides and herbicides use are prohibited,and the use of coal tar-based pavement sealants is prohibited. The applicant shall incorporate this condition as a deed restriction and a copy of the recorded deed shall be submitted to the Town Planner and included in the file. 4) Prior to release of the Performance Bond: a) The applicant shall submit an as-built plan stamped by a Registered Professional Engineer in Massachusetts that shows all construction and other pertinent site features. The as-built must be provided in paper form as well as in SDF(Standard Digital File)format.This as-built plan shall be submitted to the Town Planner for approval. The applicant must submit a certification from the design engineer that the site was constructed as shown on the approved plan. b) The Planning Board must by a majority vote make a finding that the site is in conformance with the approved plan. 5) No open burning shall be done except as is permitted during burning season under the Fire Department regulations. 6) The Contractor shall contact Dig Safe at least 72 hours prior to commencing excavation. 7) The provisions of this conditional approval shall apply to and be binding upon the applicant, it's employees and all successors and assigns in interest or control. 8) This Special Permit approval shall be deemed to have lapsed January 5, 2018 (two years from the date of issuance) exclusive of the time required to pursue or await determination of any appeals, unless substantial use or construction has commenced within said two-year period. Substantial use or construction will be determined by a majority vote of the Planning Board. 9) This decision must be filed with the North Essex Registry of Deeds. The following information is included as part of this decision: 4 254 Great Pond Road Map 37A Lot 6 Watershed Special Permit—Addition to Single-Family Residence January 5,2016 a) Plan titled: "254 Great Pond Road Plot Plan of Land located in North Andover, Massachusetts(Essex County)prepared for Thomas and Nicole Friel' Prepared for: Thomas and Nicole Friel 254 Great Pond Road North Andover,MA 01845 Prepared by: Sullivan Engineering Group 22 Mount Vernon Road B oxford,MA 01921 Scale: 1"=20' Date: November 10,2015 and revised December 24, 2015. Sheets: 1 cc: Building Inspector Conservation Administrator Applicant Engineer File 5 The Commonwealth of Massachusetts Department of IndustrialAccidents " r tl= 1 Congress Street,Suite 100 Boston,MA 02114-2017 www mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/ElE lectricians/Plumbers. TO BE FILED WITH THE PERNIITTING AUTHORITY. Applicant Information Please Print Legibly Name (Business/Organizationgndividual): U K I L Address: City/State/Zip: �Y/�V6& /Kq- ff key Phone#: M �0 AWla.7a employer?Check the appropriate box: Type of project(required): 1. employer with_ f employees(full and/or part-time).' 7. New contraction 2.❑I am a sole proprietor or partnership and have no employees working for me in 8. Remodeling any capacity.[No workers'comp.insurance required.] 9. ❑DemoIition 3.Q I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 10 Building addition 4.F]I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions pro'p'rietors 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. 13.0 Roof repairs These sub-contractors have employees and have workerscomp.insurance.t 6.Q We are a corporation and its officers have exercised their right of exemption per MGL c, 14.Q Other 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#his affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors 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 am an employer that is providing workers'compensation insurance for my employees.'Below is the policy and job site information. Insurance Company Name: S xpirationDate: Policy#or Self-ins.Lic.#: Job Site Address: ��f `'r �L��_`��,�- City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). 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/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DTA for insurance coverage verification. I do hereby cer ' and le ai andrUiesofp ui tat the information provided above is true and correct. Si nature: Date: Phone#: ` Official use only. Do not write in this area,to be completed by city or town official.. City or Town: PermitlLicense# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: ��®� 0 DATE(MM/DD/YYYY) CERTIFICATE LIABILITY INSURANCE1/7/2016 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: If the certificate holder is an ADDITIONAL INSURED, the policy(les) 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 Heidi. Shea NAME: Fabri & Rourke Insurance Agency, Inc. ac NN Ext: (978)352-4990 A No:(978)352-4991 2 Central St., 1st Floor ADMDRIESS: INSURERS AFFORDING COVERAGE NAIC# Georgetown MA 01833 INSURERA:Essex Insurance Company INSURED INSURER B: Seven Star Builders, Inc. INSURER C: 211 Seven Star Road INSURER D: INSURER E: Groveland MA 01834 INSURER F: COVERAGES CERTIFICATE NUMBER:Master 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 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 I TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR I D D POLICY NUMBER MM/DD/YY MM/DDIYYYY X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DA A CLAIMS-MADE ❑X OCCUR PREM SESOEa occu ence $ 100,000 3EB6694 9/17/2015 9/17/2016 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY� PRO ❑ LOC PRODUCTS-COMP/OP AGG $ 2,000,000 JECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident $ UMBRELLA LU\B OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION STATUTE ER H AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under 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 asabnow@yahoo.com 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 William Fabri/HSHEA ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025 r2n1an1i DATE(MM/DD/YYYY) AC"R" CERTIFICATE LI lJ LIABILITY INSURANCE 01/08/2016 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: 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). ACT PRODUCER 04066-001 NAME: Branch 4066-1 Fabri&Rourke Insurance AICNNo.Ext: (9 7 8)352-4990 A/C.No.: (978)352-4991 2 Central Street 1st Floor EMAIL Georgetown,MA 01833 ADDRESS: INSURERS AFFORDING COVERAGE NAIC# INSURER A: A.I.M. Mutual Insurance Company 33758 INSURED INSURER B: Seven Star Builders Inc INSURER C: 211 Seven Star Road INSURER D: Groveland, MA 01834 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSR WVD MMIDDIYYY MM/DD/YYYY GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ PREMISES Ea occurrence CLAIMS-MADE D OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ EN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ ____]POLICY ECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS HIREDAUTOSr $ NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS MADE AGGREGATE $ yyyypp KKDEEERRDgg MM RETENTION $ $ AtJD EMPLOYOERSF`LIABILOITY X TORY LIMITS OER A P EWWJ�ER/EXECUTIVE Y/N E.L.EACH ACCIDENT $ 100,000.00 A o� Ic�C�rnE DED Y NIA VWC-100-6018531-2015A 5118/2015 5118/2016 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 100,000.00 If es describe under E.L.DISEASE-POLICY LIMIT $ 500,000.00 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) '.. CERTIFICATE HOLDER CANCELLATION Anthony Sabatino 22 Beaver Road SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Reading,MA 01867 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD 7 Massachusetts - DepaCcrnent cr Public Safety card ?uilu nye�ulatio,� a>y! wards i.•ii 3y til C'is rt? S7.Sliil i-ii i' License: CS-069599 � KEVIN F CUNNIF" ' w � 211 SEVEN STANRD GROVELAND MA- 01834 o-' a Expiration Commissioner 09/29/2016 ®RIVER'S LICENSE x; t �r Tv � �J9a NONE 4d NUMBER - r X11 EYP S05087065 3 DDB 0,94 -- 1r ,s sex M ri + Gr 1 f KEVIN V' a 211 SEVEN STAR Rb GROVELAND,MA 018342309 5 DD 10.07.2013 Rev 07-15-2009 (sg" TXea-��r-»rrivac<t Office of Consumer Affairs&Business RegulationLicense or registration valid for individul use only f= (3 J�rVOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: - Registration: 138835 Type: Office of Consumer Affairs and Business Regulation Expiration: 5/21/2017 Individual 10 Park Plaza-Suite 5170 KEVIN F.CUNNIFF Boston,MA 02116 KEVIN CUNNIFF 211 SEVEN STAR RD. GROVELAND,MA 01834 4` — Undersecretary / ` Not valj witho signat r '