HomeMy WebLinkAboutBuilding Permit # 6/30/2016 l
BUILDING PERMIT ®� ®��H
TOWN OF NORTH ANDOVER
®
APPLICATION FOR PLAN EXAMINATION ' M~
Date ReceivedPermit No#: .C;,`H e
usPpE,-c�5
Date Issued: °
IM O—WTANT: Applicant must complete all items on this page
LOCATION � ��
rc' C C
,�` Print
(�-
PROPERTY OWNER 0
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
El New Building ❑ One family
11A5dition [I Two or more family 11 Industrial
Iteration No. of units: ❑ Commercial
❑ZRepair, replacement [IAssessory Bldg [I Others:
L'Demolition ❑ Other
❑ Septic ❑1Nell ❑ Floodplain ❑Wetlands ❑ Watershed Distract
❑Water/Sewer
/ DESCRIPTION OF WORK TO BE PERFORMED:
l\� w�U✓cam / LJ ��`'tC� Gil
Identification/- Please Type or Print Clearly
OWNER: Name: C; /'� 1C� ►� / Phone:
Address:
Contractor Name: ,�-I Phone: C),-3 °® s - C) 3 5'l
Email
Address: �5 /`.>� ✓
Supervisor's Construction License: —Exp. Date:
Home Improvement License: Exp. Date: e
11-7
ARCHITECT/ENGINEER vt �lgcm Ll /ISL-, ZJ Phone:_,- L) `7) /,3
Address: Reg. No.
FEE SCHEDULE:BULDING PERMIT.$12.00 PER$1000.00 ,TJ1 WTIMATED COST BASED ON$125.00 PER S.F.
Total Project Cost: $ FEE: $
Check No.: Mc Receipt No.: l 1
NOTE: Persons contracting with u registered contractors do not have access to t e guaranty fund
t4®RTTown ofAndover
I.
9
p,
...q'"" ..f �p B"'
1
No. 006 -2.b [7
_
J(AJqL
�® AKE verb asst
coc"Ic"twocw
S �
BOARD of HEALTH
Food/Kitchen
PER LD Septic System
THIS CERTIFIES THAT ..".....".,.„..,,,,,."..." BUILDING INSPECTOR
.............. .................. ........................ .............. ......
hes permission to ere ........... ............. buildings on ....... . ....... ................ .... .... ........
.......,.„...."" Foundation
® Rough
® oug
t® he occupied as . . .... .. .................. .................................................................. 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 lothe I spa on Alteration and
Construction of Buildings in the Town of North Andover. 'A*'jjek PLUMBING INSPECTOR
VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough
Final
PERMITIN 6 MONTHS ELECTRICAL INSPECTOR
UNLESS CONSTRUCT'or , / 1 Rough
'- Service
Final
'L_,-BUILDING INSPECTOR
GAS INSPECTOR
0ecu,2ancj2 Permit Reguired to OccupLy Rough
Display S is SPlace on the Premises — Do Not Remove
Final
No Lathing r Dry Wall To Be Done EIRE DEPARTMENT
Until Inspected V Building S ec r® Burner
Street No.
Smoke Det.
i--%■■
Irw -
Goldman Contract
5/8/16
28 Jerad Place Summer 2016
Parties Aaron M.Scarpello Home Improvements, LLC the"Contractor"
Full Identification,The TAX ID of principal is 20-3306885
Contractor address: 2 Magnolia Ave Salem NH,03079
The Contractor's Massachusetts HIC registration number is 153859
The Contractor's Massachusetts Construction Supervisor's number is CSFA-096462
The Contractor hereby proposes to perform the work described below for:
Jared Goldman. homeowner,
28 Jerad Place North Andover, Massachusetts.
1. This preliminary contract for the Summer 2016 project at 28 Jerad Place North
Andover, Massachusetts., consisting of the following:
Jared Goldman wishes to Aaron M. Scarpello Home Improvements LLC. to perform some if not
all of the changes to the Home located at 28 Jerad Place, North Andover, MA, listed below:
o Install 130 sf new red oak flooring leading into the living room
• Permitting $300.00
• Prep
o Construction of 4 temporary walls to support second floor and roof rafters above,
while beam/header installation is completed
$330.00
o Removal of ceiling light fixtures/smoke detectors etc. $50.00
• Disposal
o Estimated 3 trailer loads(24 yards)
$700.00
• Demolition
o Removal of existing wallboard and plaster in the living room ceilings and kitchen
ceilings areas
o Cleaning framing off old screws/nails
o Removal of small remaining areas of wall board on the walls needed for clean
install of patio door and beam as well as area started to be torn down by the
homeowner.
o Removal of framing between the kitchen and living room areas
o Removal of closet framing
o Removal of wall framing, HVAC ducts, wiring trim etc. between kitchen area and
Drop down living room.
o Removal of load bearing wall framing, HVAC ducts, wiring trim etc. to extend
kitchen area
o Removal of beam and joist above load bearing wall
o Removal of tile floor and luan subfloor
o Removal of load bearing wall and doorway out to deck creating space to frame in
new doorway.
$2000.00
• HVAC
o HVAC tech move 2 ducts and rework return in kitchen area to fit under cabinets
toe kicks $2000.00
1Page
• Central Vacuum
o Re-routing of central vacuum pipes and wires
Staring at$300.00
• Electrical/wiring needed to move walls and add doorway
$700.00
• Walls beam installation
o Installation of four 11-7/8"x14' LVL's as shown in the plans drawn by Manzi
Engineering $600.00
0 1 double 2 x12" header to be installed to support over the new patio door
$400.00
• Enclose doorway from kitchen to dining room
$100.00
• Patio Door installation
o Install patio door(door not included)
o Re-insulate wall
o Repair exterior siding and trim
o Repair interior trim
® $1800.00
• Hardwood flooring installation, staining and refinishing
o Install 155 sf new red oak flooring leading into the living room $1250.00
o Install 110 sf new red oak flooring upstairs hallway $900.00
o Staining $700.00
o Sanding and 2 coats polyurethane to all first floor hardwood $2200.0
o Sanding and 2 coats polyurethane upstairs hall and front stairs $500.00
• Blue-board and plaster work(smooth finish)
o '/s'blue board with plaster skim coat
■ Cover the living room ceiling approximately 400sf
• Cover the kitchen ceiling approximately 554sf
• Patching as needed to wall areas that were disturbed during demolition
(estimated 150sf-200sf)
$3500.00
Electrical upgrades
o $210.00/recessed light
o $150.00/under cabinet light
o $150.00 each pendant light(fixture not included)
o $100.00 per receptacle(not dedicated)
o $200.00/dedicated circuit if needed for new kitchen appliances
o $100.00/new switch
o Additional electrical work @$85.00/hr.
• Sound system upgrades
o Will be on a separate estimate
• Plumbing in kitchen
o Re-rout washer feeds to make way for beam
o Re-size gas line for larger stove
o Rework sink waterlines and drains for center island
o Water feeds for refrigerator
o Dishwasher hookup
$3200.00
• Kitchen cabinet installation (estimated 3 days labor for 3 men)
2Page
$2500.00
® Vent hood installation (recirculate)
$300.00
® Any additional carpentry work, not mentioned above(Lead) $60.00/hr.
® Any additional carpentry work, not mentioned above(Helpers)$30.00/hr.
o Examples:crown molding, baseboard moldings, window and door trim not
mentioned above
Estimated Total Price$24,000.00 before electrical and sound upgrades
2. Payment Schedule
$1500.00 down payment needed no later than 5/17/16
$5000.00 due at start of work
$5000.00 due upon completion of rough inspections
$5000.00 after blue board and plaster
$5000.00 after hardwood flooring installation
Remainder upon completion of estimated work listed above
Any additional work will be requested in writing and paid for within 2 days of
completion. If materials for extra work surpass$500.00, a partial payment will be
required, to cover material costs, prior to start of work.
Finish Materials approx. $(This amount is subject to change based on actual choices of finished
materials made by the homeowner)
100%due at time of order(finished materials will be ordered and purchased at various times during
the duration of the job)
Some finished materials may not be able to be returned or cancelled once the order is placed and
some may be subject to a 20%restocking fee. These charges will be the responsibility of the
homeowner if it is the homeowner requests the exchange or return.
3.This remodel is scheduled to begin 6124/16,and be completed by 8/24/16
4.The Contractor agrees to provide and pay for all materials,tools and equipment
required for the prosecution and timely completion of the work. Unless otherwise specified
All materials shall be new and of good quality. There is a one year warranty on materials and
craftsmanship,if manufactures warranty does not aPPly_ ;
5. In the prosecution of the work,the Contractor shall employ a sufficient number
of workers skilled in their trades to suitably perform the work.
6.All changes and deviations in the work ordered by the Owner should be presented to the
Contractor, by the homeowner in writing,the contract sum being increased or decreased
accordingly by the Contractor.
7.The Owner,Owner's representative and public authorities shall at all times have
access to the work.
8. Construction and Jobsite Details:
Existing lawn&driveway may suffer some damage due to construction trucking;every attempt is
made to minimize the damage,however the homeowner shall not hold the contractors liable for the
extra cost if damage situations appear.
Any unforeseen discoveries that may affect the construction costs are they responsibilities of the
homeowner. For example:asbestos,mold,ledge,high water table etc.
3Page
9. In the event the Contractor is delayed in the prosecution of the work
God,fire,flood or any other unavoidable casualties;or by labor strikes,by acts of
materials;or by neglect of the Owner;the time for completion of the
for the same period as the delay occasioned by any of the aforemen ' Be t
exfonded
10.The Contractor agrees to obtain insurance to protect himself, his workers
against claims for property damage, bodily injury or death due to his
agreement. d subcontractors
Performance of this
11. This agreement shall be interpreted under laws of the State of Massachusetts.
12,Attorneys
es and court costs shall be
be,and is, obtain ed t enforce this agreement
by the defendant in the event that judgment must
nt or any breach thereof. 1
13. Insurance: Liability Insurance certificate available upon request.
14. NOTICE to Homeowner:All contractors must be registered and display
registration number. You have the right to rescid
Home Improvement Regulation Statute,IVLG.L.A.`c 142p givese days of
you ertainwan
and homeowners rights under the act. In the event of a dispute,your or the contractor h
right to request non-binding arbitration. warranties
NOTICE:DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. have the
IN WITNESS WHEREOF,the parties hereto set their hands and seals the day and
year written above_
�_tl1
O ER'S NAME
OW E 'S SIGNATURE
DATE
O R'S NA E
'S SIGNATURE
*ATE
OWNERS ADDRESS O �
Aaron Scarpello
CONTRACTOR'S NAM
2 Magnolia Ave Salem NH 03079 CONTRACTOR GNATURE
CONTRACTOR'S ADDRESS DATE
NO
4Page
(E)2x10
IV2" MIN. a
I
BETWEEN � <
LVL'S m —
fffz
3"MIN.
n 9 NAILS/5GREN5
(E)LVL BEAM i I OPPOSITE 51DE u
(SEE PLAN) OF COLUMN �/2" MIN. i4"mx&"Lg SD5 a
3-2x(o LAMINATIONS WITH TWO 5GREN5
ADD 5GREN5 AS ROW OF STAGGERED 30d DEPTH 1178 8 LESS -2 ROWS® I6" O.G.
REG'D TO MATCH COMMON WIRE NAILS.(D=0207", DEPTH 14"-15" -3 RON5® 16" O.G. °
" "TYPICAL BUILT-UP -=4I/2")OR 51MP5ON SDS Y x IV2" �
PO5T DETAIL" THISIJ 1!/2"MINIMUM EDGE DISTANCE.
4.2" STRONG DRIVE 5GREN5
SHEET 2.)3" MINIMUM FASTENER SPACING IN A ROK
•
3)5TA66ER 5GREN5 ON OPPOSITE FACES. <z
SECTION n TYPICAL NAILING SCHEDULES FOR TYPICAL SEAPSON"SDS" _
BUILT-UP MULTI 2x6 POST DETAIL DETAIL FOR MUTIPLE LVL'S
34'=114.1 S2 = F
U
NEW 374x7 VERSALAM a[J
P05T OR 5-2x6'5 '9
BELOW EACH END
(BLOCK 50LID DOWN
TO FOUNDATION Pi 7
NALLJ q
A
Ly E
o '
L � �
r
L
o -
A GUT.JOISTS AS"No
O
S.3 4 ADD NEN SIMPSON C IeNC:
Q "LUS210'J015T mmi�wr„
HAN5ER5(IYPICAU v—
EXISTING KITCHEN AREA
FIREPLACE (�HAK�Av-
'C
LIVING ROOM
g�i
,QTS <• �dby'y �-
4 � yJ W DrsnW�
c"ea e
Partial Second Floor Framing Plan
1
Homci
1/4"=l'-O" 0 2 4 8.
�pWgD Y� Iams
(�,/ DRnWIN
A
A
� 2
! ;
0
o .
d
, CD
�2
o m§
` o �
� p
. �
112! E222-2--
- §/)
�
f�)§!§ f\
\�
$! �
� Mh-p �
Am
OWN�#/
a
JARED PLACE
Goldman Re+ence � ,� � � � � m!_. .I'LLC.
The Commonwealth of IMassuchusetts
z f
Department oflndustr'ialACcidents
x x X Congress Street,Suite.100
Boston,MA 02114-2 017
www.mass.govIdia
Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers.
TO BE FILED WITH THE PERMITTING AUTHORITY.
Applicant InformationY ,
. Please Print Le ibI
g
Name usmosslOr aruz'a]tlanL[ndivxdual) Gw
: .�'fl���� � �. ,. �"�,.....
Address: .%`'
City/State/Zip: C:, vl,1 Phone
Are you an employer?Checktlie appropriate box: Type of project(Iequired):
1.❑1 am a;employer with employees(full and/or part-time).' 7. ❑New construction
Z.[JA''am a solo proprietor.or partnership and have no employees working for me in 8. F .J emodelirig
any capacity.[No workers'comp.insurance required.]
9. aIJ'"emolition
3.❑lam a homeowner doing all work myself[No workers'comp-insurance required.]t
4.F]I am a homeowner and will be hiring contractors to conduct all work on my property. I will 10 ❑Building addition
ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions
proprietors with no employees.
12:❑Plumbing repairs or additions
5. I am a general contractor and I have hired the sub-contractors listed on the attached sheet.
❑ b 13. Roof repairs
These sub-contractors have on ploye.es and have workers'comp.insurance.$ ❑
6.F1We are a corporation and its officers have exercised their right o£'exemption per MGL C. 14•❑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.
I Homeowners who submif'this affidavit indicating they are doing all work and then hire outside contractors must siibmit 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.
X ain an employer that is pi'ovidiizg workers'compensation insurance for my employees. Belo*is the policy acid job site
information.
Insurance Company Name:
Policy#or Self-ins.Lic.#: Expiration Date:
� .�
Job Site Address: ;: ,. ,,,, ��'t; _. City/State/Zip:
Attach a copy of the wozMA
�lcers' comperrsatioxr olicy 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 WORD 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 DIA for insurance
coverage verification.
X do hereby certify under th ams and penalties of perjarry that the information provided above is true and correct.
... - Date:
Si nature:
Phone#: f`~12, Z)
Official use only. Do not write in this area,to be completed by city or town official.
City or Town: Permit/License#
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#:
®MI 06-29-' 16 12:02 FROM- 9785572130 T-846 P0001/0002 F-8_32 _
®® � � CERTIFICATE OF LIABILITY 'NSU �/ DAVE IMM/DD/YYYY)....
® 06129/2016
® 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 endorsements).
CON
PRODUCER NAMEACT Mark S.Rowe,CIC
Michaud,Rowe And Ru5Cak Ins. PHONE 978 B88 5829 ae No).978 557 2130
P.O.Box 188 -M IL Fat:
North Andover,MA 01845 APDRL3a,
Mark S_Rowe,CIC
INSUR):R S AFFORDING COVERAGE NA1C#
wsuRERA:Essex Insurance Company 39020
INSURED Aaron Scarpello Home Imp,LLC INSURERS:
2 Magnolia Ave. INSURERC:
Salem,NH 03079
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,
EXCLUSIQNS.AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
LTRJam
TYPE OF INSURANCE POLICY NUMBER MM/DDY MM/DD YY LIMITS
A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,00
CLAIMS MAoE �OCCUR 3EC8512 •12/1012015 12/10/2016 PREMISDAME xwrrenc )' S -•• 100,00
.MED EXP An one wan S "•5r00
PERSONAL&ADV INJURY S 1,OD6,OO
GEN'LAGGREGATELIMIT APPUESPER: GENERAL AGGREGATE... ,- •S•...., 2,000,00
X POLIOY a jECT LOC PRODUCTS-COMPIOP AGO ,5 11000,00
S
OTHER;
AUTOMOBILE I]ABIIJTY COMBINED 8 NG LIMIT3--
Me accident
ANV AUTO BODILY INJURY(Per peroan) S
ALLOWNED SCHEDULED BODILY INJURY(Per accident) S
AUTOS' AUTOS
HIRED AUTO ROPE G _
NON-OWNED Per cc dent S
UMBRELLA LIAR OCCUR EACH OCCURRENCE $
EXCESS LIAB OLAIM8-MADE AGGREGATE S
DED RET@NTION3
WORKERS COMPENSATION X STA UTE ER
AND EMPLOYERS'LIABILITY
B ANY PROPRIEI'OR/PARTNHRiEXECUTIVE YIN *"WCCERT.TOCOME E.L.EACH ACCIDENT 5
OFFIOERm1EMBEREXCLUDED9 F-1 N/A .
(Mandatory In NH) DIRECTLY FROM INS CARRIER E:L.DISEASE-EA EMPLOYEE S
If yes,describe-under• E.L.DISEASE-POLICY LIMIT' S '
DESCRIPTION OF OPERATIONS below
DESCRIPTION OF OPERATIONS!LOCATIONS'/VEHICLES (ACORD 101,Addltlonar Rvmwks Schedule,mikY be attached tr more space Is required)
Interior carpentry and residential remodeling
RE:'Goldman 28 Jerad PlaICe North Andover,MA 01845
CERTIFIcATE HOLLER CANGELL,ATION
NORTH13
SHOULD ANY OF THE ABOVE.DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Town of North Andover ACCORDANCE WITH THE POLICY PROVISIONS,
Building Dept.
1600.Osgood Street AUTHORIZED REPRESENTATIVE '•' " "
Bldg 20,Sulte 2035 ,Q
North Andover,MA 01845
m 1988-2014 ACORD CORPORATION.' All rigK s"0e600d. "
ACORD 25.(2014101), The ACORD name and logo are registered marks of ACORD
06-29-' 16 12:02 FROM- 9785572130 T-846 P0002/0002 F-832
R 1 CERTIFICATE OF LIABILITY INSURANCEDATE(MM,DDnYYY,
06/29/2016
THIS CERTIFICATE I$ 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 pollcy(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 endorsements.
PRODUCER NAME:� Krista McMahon
NAME
MICHAUD, ROWE AND RUSCAK INSURANCE ASSOCIATES,INC. PHONELmit 978)688„8829 FaAxO No
E-MAIL
ADDREss: kmcmahon mrrjnsurance_com
P-O-BOX 1$8 INSURERS AFFORDING COVERAGE NAIC#
NORTH ANDOVER MA 01845 INSURERA. LIBERTY MUTUAL FIRE INS CO 23035
INSURED INSURER 8
AARON SCARPELLO HOME IMP LLC INSURERC:
INSURER D:
2 MAGNOLIA AVEINSURER E
SALEM NH 03079 INSURERF:
COVERAGES • CERTIFICATE NUMBER: 65542 REVISION NUMBER-
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED'BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN I$ SUDJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
N R ,TYPEOFINSURANCE gooLbusR POLIGPQLICYNUM9ER MM/DDYEFF �NIluDD EXP UNDTS - •-
90MMERCIALGENERAL UABII.ITY EACH OCCURRENCE $
41 i"U
CLAIMS•MADE F OCCUR PREMISES a accurrence .$.
MED'EXP(Anyone person) $
N/A 'PERSONAL&ADV INJURY $ "
GEN'L AGGREGATE LIMITAPPLIES PER GENERAL AGGREGATE,•••••• $.• .•••••.
POLICY a JECT LAC PRODUCTS-COMP/OP AGG,R5
OTHER: $
AUTOMOBILE LIABILITY " COMBINED SINGLE LIMIT2NN M,
:.
ANY AUTO' BODILY INJURY(Perpereon) $
ALL OWNED SCHEDULED N/A BODILY INJURY(Pereccldeat) S
AUTOS NOWOWNEG (Per a
HIRED'AUTOS AUTOS S
UMBRELLALIAB OCCUR EACH OCCURRENCE $
EXCESS LIAH ..... .. .._. .....
CLAIMS-MADE. N/A AGGREGATE $
DED RETENTION S S
WORKERS COMPENSATIONX STA UTE ERS
AND EMPLOYERS'LtABILIT1r
ANYPROPRIETORIPARTNER TI
/EXECUVE 7 NE.L,EACH ACCIDENT $
A OFFICER(M€MPE:REXCIUDED7, I NfAl N/A N/A .WC231S386493626. , 04/19/2016 04/19/2017• .. -••• --•-•••• • -••• •••-
(Mandatory In NH) E.I:.,DISEAgE-EA EMPLOYEE $ 100,000
QeeLrtbe unser.... . .. .. ... ' .
DESCRIPTION OF OPERATIONS below E.L.,DISEASE-POLICY LIMIT $. W,006
N/A
DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached If more space Is requlrod)
Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 05 S,no authorization is given to pay
Claims for b'enefits'to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts.
This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the
issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification
Search tool at www.inass.govAwd/workers-compensation/investigations/-
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED .IN
TOWCI Of NOdh Al1dOVEr ACCORDANCE WITH THE POLICY PROVISIONS:
Building Dept.Building 20 Suite 2035
AUTHORI7_ED REPRESENTATIV E
North Andover MA 01845 " "
DanieI:IVP Cr'
Y.CPCU,Vice President—Residual Market—WCRIBMA
' "" ' '"' -O 1988-2014'ACORD CORPOREiTIQN.'All'�i"gIi'ts.�eservsif:'
ACORD 25'(2014101) The ACORD name and logo are registered marks of ACORD ...
�cen e: .CSFA-096462
II
AARON M SCARPELLO t
2 IMAGNOLU AVENUE
SALEM NH 03079
Cur,�riiss,oner 07/07/2096
r
Mass
acltusefts.,Departure
' Board of suildi nt of P
Constr D- ulatio ublic Safety
n
ucton Supe�'asor I&2 ns and St ds
� License:CSF Fanvh�
andar
a Os.6462
AARONIWS
2 MAGIVI— CARL* �.,.
NH !
j r
v
i Co�nrnissioner
Expiration
07/07/2016
Office ore
mer y
` HOME IMPROV Affairs&Business
J egistr `4+E5 5 r CONTRAC
f 4 9 TOR
Piration: 118%2017 7_Pe: ..
A q ON M.SCA 'DBA
R LLO HO
AARON SCARPE�a �E�EIMPROVFMENT
2Ii i
LO
SALEM, GLIA AVE
MA 0307 .
ry
Undersecreta
� I