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HomeMy WebLinkAboutBuilding Permit # 8/10/2016 �i0R7ty BUILDING PERMIT p`�t,Ko bq�o h..,.::Sl 6 OL TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION " Permit NO: Date Received °�, o,,.•W.. ` �y °Rnrea PY q �SS�ICHu`a�� Date Issued: IM ORTANT: Applicant must complete all items on this page LQCATIQNIft Pant PROPERTY OWNER .,� ,� I'rartt MAPhtO .PARCEL ZONING DI�TR#CT l-�CstoncD�str�cf yes no . . Machm�Shoff Village yes no . TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building 'One family ❑ Addition ❑ Two or more family ❑ Industrial ❑ Alterations No. of units: ❑ Commercials ❑ Repair, replacement ❑ Assessory Bldg ❑ Others: ° Demolition ❑ Other ❑ Septic ❑Will Floodplain ❑�lletlands ❑ Watershed b- 't" 0,I�IlaterlSevuer ? '� Identification Please Type or Print Clearly) OWNER: Name: Phone: ��7 �� -3 .� q Address: CONTRACTOR' Name Phone Address V.-MV . . ,, Super�nsor's Canstrtrc#ion License .' Exp bate . . :: Home Improvement License Exp Date ARCH ITECTIENGINEER Ui ec r . ` te t Phone: 'C, Address: q I � F, , _ i I _Reg. No. q FEE SCHEDULE;BULDING PER $12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ 1 FEE: $ Check No.: ' _Receipt No.. NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Sigreture of AgentlOivner Signature al con tract or:T _ REVOL.U(.11 UN THIS HOME IMPROVEMENT SOLAR ENERGY CONTRACT (this "Contract") IS BETWEEN: Mike Damour ("Client") located at 98 Fuller Rd North Andover, MA 01845 ("Client's Propertyy') -AND- Northeast Solar Services, inc.@ ("Contractor") of 1 North Ave Suite A Burlington, MA 01803, with Home improvement Contractor Reg, No. 178137, which expires on March 17, 2016, and Federal Employer ID 46 0509853. Contractor's sales person for this contract Is David Bentley. The parties to this Agreement agree as follows: .A. Installation of PV System. The above Client(s) has engaged Contractor to perform the following residential contracting work (the "Work") in connection with the installation of the following photovoltaic solar energy system (the "PV System"): 34 SunPower - SunPower 327 watt modules (or equivalent) with 1 Solar Edge - Solar Edge SE 10000 inverters (or equivalent) and all mounting, disconnects, and all other PV System components necessary for a National Electric Code compliant PV System, totaling 11.118kW, located at Client's Property. B. Other Inclusions The Work shall further Include: Installation of the PV System to accordance with all State of Massachusetts Interconnection standards. All reasonable engineering and permitting costs. The following building permits are required and will be secured by Contractor as Cilent's agent: Building and Electrical Permit. Following the Installation, Client will receive a PV System orientation and a PV System Client's manual. Notice: It shall be the obligation of the Contractor to obtain all permits related to the Work. Clients who secure their own permits will be excluded from the guaranty fund provisions of Chapter 142A of the Massachusetts General Laws. If. COMPENSATION AND SCHEDULE A. Contract Price For Contractor's performance of the Work under this Contract, Client will pay Contractor a total of: $ 63,587.89 (SIXTY THREE THOUSAND FIVE HUNDRED EIGHTY SEVEN AND 89!100) DOLLARS USD (the "Contract Price"). B. Paymgpt SQbedula The Contract Price will be payable In accordance with the following payment schedule: Data Paid: $ 31.793.94 Initial Payment - 50% (Due upon Contract signing, which is an amount less than the cost of the materials and equipment which must be specially ordered in advance of commencement of PV System installation) S 28.614.55 Progress Payment - 45% (Due upon Substantial Completion) $,.13 79.40 Final Payment-' 5% (Due upon Final Completion) C. Schedule The "Start Date" of this Contract is the date Contractor receives the full amount of Client's initial payment of 50% of the Contract Price. Subject to adjustment for any Force Majeure reason stated In Section IV.J., the Work Is estimated to begin within 12-16 weeks from the Start Date of this Contract. The parties agree that this date shall be automatically extended to the date of delivery of all materials and equipment which mut be specially ordered. Is estimated to occur within 16-20 weeks from the Start Date of this Contract, but the parties agree that this date shall be automatically shortened or extended to the date on which all racking and electrical work are complete and the PV System is capable of generating power and ready and available for use subject to final government and utility approval. Enal Combietlon Is defined as the date on which all punch list items are complete, all permits are closed, all other government and utility approvals are obtained and the Work Is complete to the satisfaction of Contractor and Client. Client acknowledges and agrees that the Work Involves permits, inspections and approvals from various government agencies and utilities, and therefore the timing of the Work may vary and is not within Contractor's control. Client further agrees that Contractor shall not be liable for any losses, costs or damages related to any delays for reasons beyond Contractor's control, including all causes noted in the Force Majeure section of this Contract below. Norlheast Solar I North Ave Suite, A I'1+a116119ton, MA 01803 781 ,240,6655 i IlL IMPORTANT NQTiCES A. Contractor's Registration: All home improvement contractors and subcontractors engaged in home improvement contracting, unless specifically exempt from registration by provisions of Chapter 142A of the Massachusetts General Laws, must be registered with the Commonwealth of Massachusetts. Inquiries about registration and status should be made to the Director of the following state agency: Office of Consumer Affairs and Business Regulation Home Improvement Contractor Registration Ten Park Plaza, Room 5170 Boston, MA 02116 (617) 973-8700 B. Client's Cancellation Rights: Client may cancel this Contract, without penally or obligation, within three business days following the date on which Client signs this Contract. A Notice of Cancellation is attached hereto for Client's convenience. C. WayAntigs: For a period of ten (10) years from Substantial Completion, Contractor warrants that the PV System has been designed and installed in a good, workmanlike and substantial manner in accordance with all applicable building codes. In the event Contractor Is required to penetrate the roof of the Client's property in the course of installation, and causes damage to the roof within a three (3) inch radius of a penetration, Contractor will repair such roof damage for a period of twenty (20) years from Substantial Completion or the remaining term of the roofs existing installation warranty, whichever Is shorter, to prevent any water, rain or other moisture leak, seepage or entry directly caused by such penetration. These warranties are for normal use and conditions only. All warranty coverage to equipment and workmanship installed by Contractor will be VOID if any alterations or repairs are performed by any person or persons not expressly authorized, in writing, by Contractor. THIS WARRANTY DOES NOT COVER: (a) Damage caused by external forces such as, but not limited to, vandalism, theft, terrorism, fire or act of God; (b) Damage caused by weather effects exceeding manufacturer tolerances; (c) Normal wear and tear or aging of a PV System; (d) Any implied warranties: (e) Electric bills, water damages or any other consequential damages; or (f) Damage to the PV System or its efficiency due to adjustment, moving, or tampering with the PV System or any of Its components by individuals not approved by Contractor. D. Change Orders: Any alteration or deviation from above specifications involving extra costs must be subject to a written change order signed by both parties, which shall be incorporated Into this Contract, and Client shall be liable for any additional costs resulting from each change order. By initiating the space below, Client hereby specifically agrees to execute a change order, and pay the additional costs„ if it becomes necessary for Contractor to repair or replace un -approved or non -code compliant electrical work in order to complete the PV System Installation and satisfy code requirements. Client's Initials:/4''`;o' Client's Initials: ARBITRATION: CONTRACTOR AND CLIENT HEREBY MUTUALLY AGREE IN ADVANCE THAT IN THE EVENT CONTRACTOR HAS A DISPUTE CONCERNING THIS CONTRACT, THE CONTRACTOR MAY SUBMIT SUCH DISPUTE TO A PRIVATE ARBITRATION SERVICE WHICH HAS BEEN APPROVED BY THE DIRECTOR OF THE EXECUTIVE OFFICE OF CONSUMER AFFAIRS AND BUSINESS REGULATIONS AND CLIENT SHALL BE REQUIRED TO SU IT TO SUCH ARBITRATION AS PROVIDED IN M.G.L. c. 142A. OienL .,...... Date: CIIet Date: Coni c r: [ Date: 71 Jl 41 NOTICE: Th/e signatures of th partles above apply only to the agreement of the parties to alternate dispute resolution initiated by Contractor, Client may Initiate alternate dispute resolution even where this section Is not separately signed by the parties. E. 1 ve G r : By Client's initials below, Client acknowledges and agrees that Contractor has not and does not guarantee Client's qualification for, receipt of or amount of any tax credit, rebate, solar renewable energy credit (SREC) or other incentive amount in connection with the PV System, and any estimates of Incentives (wither in a PV System proposal or otherwise) are not guaranteed to be accurate or available. Client Is responsible for determining Client's and/or the PV System's eligibility for any Incentives and should consult with tax, legal and other advisors regarding availability and possible tax consequences of claiming the same. Client's Initials: Client's Initials: W Al Northeast Solar 1 North Ave Suite A Burlington, MA 01803 781.240.6555 MUM Wls.pip 0$02f2ols 1 �Qli� A. ss: To enable Contractor to perform its Work hereunder, Client shall grant during daylight hours adequate space on Client's property, as mutually designated by Contractor and Client, for the complete and proper installation, operation, maintenance and repair of the PV System as well as rights of Ingress and egress to, through and from such property and the space designated for the PV System. B. Scarcity of Matedals• Rights of Termination: The PV System components to be obtained under this Contract are scarce commodities. In order to meet the performance requirements of the PV System described In this Contract, Contractor may substitute the specified brand of solar module or inverter for a similar brand of module or inverter that allows for more timely completion of the installation. Such substitution, if necessary, shall be of UL approved devices, with aggregate performance criteria the same as equipment specified. The governing body for determining performance criteria shall be the CEC (California Energy Commission) that rales all UL approved modules. The key module statistic used for performance criteria will be the DC STC rating of the sum of the modules. The key Inverter statistic used for performance criteria will be the AC output of the device. If, due to code requirements, equipment substitution, final engineering, space availability, etc., the size of a PV System decreases, Contractor shall re- calculate the Contract Price using its standard pricing method and the Contract Price shall be automatically reduced, Client shall be credited by the reduced amount. If due to substitution the DC STC size of the PV System Increases slightly, then Client shall not have to pay Contractor similarly. Contractor shall make every reasonable effort to ensure that PV System size does not decrease from the specifications. If the DC STC size of the PV System decreases more than 15% from the Contract's specification amount for any of the reasons stated In this paragraph, Client shall have the right to terminate this Contract within ten (10) days of Contractor's written notification to Client of such decrease, and Contractor shall then refund in full all funds paid to date under this Contract, but shall have no other liability to Client. Contractor reserves the right to unilaterally terminate this Contract within 45 days of Its approval without any liability to Client if any of the PV System components required for the completion of Contractor's Work in a timely manner are not available. in the event of such termination, Contractor shalt refund all monies paid by Client to Contractor as of the date of termination. C. Limitation of Liability: In no event shall Contractor be liable in an amount exceeding the compensation paid by Client to Contractor under this Contract. Contractor shall not be liable for any incidental, consequential or special damages or for economic loss or expense of for loss or profits or Income of Client, or Client's consultants or agents or employees, or any of them, Including but not limited to any electricity costs incurred should installation of the PV System be delayed beyond the commencernent or completion schedule set forth above, D. Zoning: Client shall pay for all variances, special permits, or other costs related to zoning, Including without limitation any fees or costs related to attorneys or engineers. E, Cpl a 2i4pd7L: Client agrees to remove or to protect any of Client's personal property, Inside or out, which may interfere with or obstruct the Work, Including but not limited to landscaping, and Contractor shall not be held responsible for damage to such property. Client understands and acknowledges that proper operation of the PV System purchased hereunder Is dependent on Client's existing roof and equipment and Contractor shall have no obligation or liability for the condition thereof, or any other part of Client's improvements or equipment not purchased hereunder. Client expressly represents that the roof of the property upon which the PV System will be installed is in good condition, with no known water infiltration problems or other structural defects. R ura ce: Client must carry all fire, casualty, hurricane, earthquake, theft, and other insurance related to Client's real and personal property. G. Cancellation of Contract: If Client cancels or breaches this Contract after the opportunity to execute three (3) day rescission has passed but before commencement of construction, Client shall pay Contractor the amount of expenses Incurred to that date plus 20% of the Contract Price. If Client fails to pay said amounts within thirty (30) days of Contractor's demand for payment and Contractor files suit, Contractor shall be entitled to recover all of its damages Including its loss of net profits and attorneys' fees and costs If Contractor is the prevailing party. H. Costs of Collection: It Client fails to pay any amounts owed to Contractor when due, Client shall be liable for all costs of collection, including reasonable attorneys' fees, plus 18% Interest per annum on the unpaid balance. Contractor also shall have option of removing all or part of the PV System from Client's premises In addition to receiving payment equal to the value of the unpaid balance to cover all or a portion of Contractor's consequential damages. I. Liens: Contractor, any subcontractor(s) and any other persons or entities supplying labor and materials to Client under this Contract, have the right under applicable law to impose a lien on Client's real properly for the value of the labor or materials provided. Upon Client's payment of all amounts due under this Contract, Contractor will provide, upon Client's request, a release and waiver of any liens. J. Eorce Majeure: Contractor shall not be liable for any delay in material and/or equipment delivery or for failure to deliver or failure to perform the Work which results from any cause beyond the Contractor's control. Such causes include but shall not be limited to: an act of God or of the public enemy; an act (or failure to act) of any government or utility; a fire, flood or epidemic; quarantine, restriction, strike, freight embargo, terrorism, theft or unusually severe weather; Contractor's inability to obtain necessary materials, labor or transportation; custom permitting caused by Client's site conditions; homeowner association review or approval; building or other code requirements relating to Client's existing electrical system or building characteristics; and any other impediments to the installation of the PV System arising from Client's acts or omissions and/or the condition of Client's property. Northeast Solar 1 North Ave Suite A Burlington, MA 01803 781.240.6555 100318 W 5.Wg (All 20015 K. Legal .Cam plian-ce and3tyaratfliV. Contractor and Client acknowledge that the form, Substance, content and notices contained In this Contract are intended to comply with Chapter 142A of the Massachusetts General Laws, and regulations promulgated thereunder. In the event of any Instance of non- compliance, only such portion shall be invalid and the remainder of this Contract shall be In full force and effect. In addition, any such portion not in compliance shall be read and interpreted so as to have its intended meaning to the maximum extent allowed under Such law and applicable regulations. L. Entire Contract: No Waiver Unless In Writing: This Contract constitutes the entire contract between the parties; there Is no representation, warranty, collateral contract or condition affecting this Contract except as expressed In It. No provisions of this Contract shall be changed or modified, nor shall this Contract be discharged or waived, In whole or part, except In writing signed by both parties. This Contract shall not be effective until fully executed by Client and an Authorized Representative of Contractor. M. Client's. Representation of Authority.: If this Contract is signed by less than all of the persons or entities who own the subject property, then Client who signs this Contract (or any of the provisions hereof) represents to Contractor that he, she or It has full legal authority to bind the other persons and/or entities. N. Governing Law: The laws of the Commonwealth of Massachusetts shall govern any proceeding or dispute related to this Contract. 0: Production Gap Guarantee: This production guarantee covers 90% of estimated production in year I and decreases at .6% each year for a total term often (10) years. This guarantee Is determined on an accrual basis and payments are made when the aggregate system production falls below total production estimated on the schedule above. Payments will be made at the end of each anniversary of the system's In service date of Interconnection. Production Gap Garranty is void if site conditions ar cess change after the date of Interconnection. Client's Initials Client's Initials: P. 3rd party Financing: Should the client obtain financing from a 3rd party which Is approved by the Contractor, the payment terms of the tender will apply. Client: Contractor: A4 /)(0 Name: Date: Title: Date: Northeast SOar I North Ave Sulte A Burlington, MA 01803 781,240.6555 08378 W,501g 0,911WOIS If you decide that you do not want the goods or services described above, you may cancel this Contract by mailing or delivering a signed and dated copy of the cancellation notice, or any other similar written notice, to Contractor at the address set forth above no later than midnight of the third business day following the date on which you signed this Contract. If you cancel by the date and time indicated, any payment made by you under this Contract will be returned within ten (10) business days following receipt of your cancellation by Contractor, and any security Interest arising out of the transaction will be released. If you cancel, you must make available to Contractor, at your residence, in substantially as good condition as when you received, any goods delivered to You under this Contract; or you may, if you wish, comply with Contractor's written instructions regarding the return shipment of the goods at Contractor's risk and expense. If you fail to make the goods available to Contractor, or if you agree to return the goods to Contractor and fail to do so, then you remain liable for performance of all obligations under this Contract. If we do not pick up, or attempt to pick up, the goods within 20 days of the date of your notice of cancellation, you may retain or dispose of them without further obligation. I HEREBY CANCEL THIS TRANSACTION: DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. Client's Signature (sign here QNy If you wish to cancel this transaction) Date Client's Signature (sign here you wish o Date cancel this transaction) CLIENT ACKNOWLEDGES RECEIPT OF ORIGINAL OF THIS CANCELLATION FORM: Signature Date Signature Date (Client Initials): Northeast Solar 1 North Ave Suite A Burlington, MA 01803 781.240.6555 108378 Nr1.5.011g 06112,2015 ECTOR E n G 1 n E E R 5 Project Number: U1883-0192-161 July 27, 2016 RevoluSun 1 North Avenue Burlington, MA 01803 ATTENTION: Ian Clifford REFERENCE: Mike Damour Residence: 98 Fuller Road, North Andover, MA 01845 Solar Panel Installation Dear Mr. Clifford: Per your request, we have reviewed the layout and photos relating to the installation of solar panels at the above - referenced site. The following materials and components are proposed in the installation of the solar panels. Roof Structure: 2x8 Rafters at 16" O.C. Roof Material: Composite Shingles Based upon our review, it is our conclusion that the installation of solar panels on this existing roof will not adversely affect the structure of this house. The design of solar panel supporting members and connections is by the manufacturer and/or installer. The adopted building code in this jurisdiction is the 2009 International Building Code and ASCE 7-05. Appropriate design parameters which must be used in the design of the supporting members and connections are listed below: Ground snow load: 50 psf per Massachusetts amendments to the IRC (verify with local building department) Design wind speed for risk category It structures: 100 mph (3 -sec gust) Wind exposure: Category C Our conclusion regarding the adequacy of the existing roof is based on the fact that the additional weight related to the solar panels is less than 3.5 pounds per square foot, In the area of the solar panels, no 20 psf live loads will be present. Regarding snow loads, it is our conclusion that since the panels are slippery and dark, effective snow loads will likely be reduced in the areas of the panels. Solar panels will be flush -mounted, parallel to and no more than 6" above the roof surface, Regarding wind loads, we conclude that any additional forces will be negligible due to the low profile of the flush -mounted panel system. It is our conclusion that any additional seismic loadings related to the addition of these solar panels is negligible. During design and installation, particular attention must be paid to the maximum allowable spacing of attachments and the location of solar panels relative to roof edges. The use of solar panel support span tables provided by the manufacturer is allowed only where the building type, site conditions, and solar panel configuration match the description of the span tables. Attachments to existing roof joist or rafters must be staggered so as not to over load any existing structural member, Waterproofing around the roof penetration is the responsibility of others. All work performed must be in accordance with accepted industry -wide methods and applicable safety standards. Vector Structural Engineering assumes no responsibility for improper installation of the solar panels. Please note a representative of Vector Structural Engineering has not physically observed the roof framing. Our conclusions are based upon the site assessment and information provided by Revolusun and the understanding that all structural roof components and other supporting elements are in good condition, free of damage and deterioration, and are sized and spaced as outlined in the site assessment verformed by Revolusun, Very truly yours, VECTOR STRUCTURAL ENGINEERING, LLC Roger T. Alworth, S.E. Principal RTA/ssb 07/27/2016 9138 S. 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C7 � v c rr ^J' 1 / C C = CL C cc 65, j/ii / V)mJr.CD i cn ip m% if/! ( V $ ¢$ 4, G7 m di d, Ci m 1»l➢l, r MCVSx/ Ri !l �w Z O r n m /iii/ ll if I N Q @ a w c _ g CD N m it 1 to .._.... u >2 „`4 m ,-� Q7 { rrl xA" G O cr r HFD x 71 w" fTl Y car//� f o Q Ir/ CD ,rrrr Fl 3is CO z a a C rt 1. h N 6V. ry�ry' 'L { Y} Q1 M N o 55 o c�` •3aE''2 a' a :'�`..^:3 :�?3:x'3 �� tr•w'�:e ;�• .3 [� T" � -13;3 -147 2 :3 :3 :3� S E ,-3 $ :3: :q ,o i•�4 t CnD Crv:,y:�_o�.. :gi w: O:v :� M1 :� % Vh :9'7:":6•,., r:cryi � � z C;ft � Si ��: �',�'�',3 3' m�z ffC 0 w; : 0 z :74: 3 4 r ........ a m _� CD -% <q 1~Tt OZ z n: m ¢: µ: — CD S D a -° a 0 z 8 @ Ell i 9 � i A a G � i i ai 3 i i i-3 i i im!;Ai i iP iii i i n n, i i Aj � .......... .............. ........ .......... ............._ .,..... ......f` ..... ........ ....,.... fl y'�"� N m w z AT "'. z b r 3.' D T L c�p10 m.. 1" $ ci z .'� 20 'o 5C Vi y �� o �N Oa ma Z 2, a" gio A, C 00 Q7 rva i> iV a ul�` nip UCob efl� p a �,vz 0> V w 1 0 The Commonwealth of Mttssrrchasetls � Delrtmiment of Industriul Aceltlents Of,/lee of Inpestlgatiotts 1 Congress shvel, shute J 00 Boston, Mei 021.14.2017 IYt m.mutssgou/d1u Workers' Competesal]on lnsurfince Afftttavit: Diillclers/Contrtictors/Blectricialls/Pittmbet's AupflegMt WtQrmatloit Please Priul L0 1b MimeNortheast Solar Services Inc Address:l North AVO Stilte A t MA t 01503 Phone f:781- 270 - 0555 Are you art employer? Clieclt the Appropriate box; 1. d I call a employer with 12 4• [] I ant a general contractor and I employees (f1t11 and/or part-time). + 2. [1 i am a sole proprlolor or partner- ship and have no employees working for me In any capacity. (No %vorkers' comp. Insurance required.) 3. Q I am rt homeowner doing all work myself, (No workers' comp, insurance required.] t have hired the sub-conlaMors listed an the attached sheet. Those sub -contractors have employees and have workers' comp, insuronco,t 5. [] We are a corporation and its officers have exercised their right of oxemption per MOL o.152, § 1(4), and we have no employees. (No workers' Typo of project (required): b, ❑ Now consimelion 7. ❑ Remodeling 8, ❑ Demolition 9, ❑ Building addition I0.❑ Electrical repairs or additions 11.❑ Plumbing repairs or additiom 12.❑ Roof repairs 13123 Other501ar PV 4MY applicaal that checks box 91 must also All out Iha seotimbelowshowhls their nvorkers' contpmation polloy hrromiatlon. t Homeowners tvho submit this aflTdavtt indrealing Ibey era doing ail work and than hire outside contractors must submit a tiaw attidavil Indieatrns such. tConitactors that check this box ntust attached an additional sheet ahotving the pante or the sab•commoors slid Sinha whether or not those entities liavo otnphoyeas. Ittho sub•eorthotom We employees, they anust provlde their wak<rs' camp, polloy member. 111m an employer t/11111s pravir11ar8 svorkem, compensatiofs /irsarrnaaee for aapr employees Belorp 1s the pollcy aaarl job slle 111formatlou. Insurance Company Name: federated Mutual Insurance Corn any Policy 11 or Sol i=ins.1,1u, 8;9884088 Expiration Date; 12/31/2016 Job Site Address; �' ` ��� 0 • f v�' t'� � —f City/Statemp: Atlneh n copy of the workers' compensa tion policy declaratlou page (shoiring the policy 111imber and oxplrAtlon Unto). Iraltttre to seouro coverage as required under Section 25A of MOL e. 152 can lead to the imposition of criminal penalties of fine tip to $ 4,500.00 andlor one-year Imprisonmont, as ►vell as civil portal ties in the Form of a STOP WORK ORD13R and a fine of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Invostigaiions of the DIA for f ntirnneo coverago verifiontlon, I do It ereby certlb under tit eluates r idpetsaf les ofpsilrery tient the hAraalatlon provided above 1s trite and correct. Phone 11: 781-270.4898 Offlclel rase only. Do not write lea this arery to be compleled by O/V or torvta gjJlelal City or Town: _ Pormilll,ieerlso 9 Issuing Authority (circle 0110)1 1. Board of fleAlth 2.81111ding Dcparimcnt 3, Ciiytrowo Clerk 4. T+Ieetrlcal Inspector S. Plumbing Inspector G.'OtllEtr ........ Contact Persons_.,.,,,, _ __ PhonOfi: Ca..�RLJ DATE fMwD01YYYY! ',..� CERTIFICATE OF LIABILITY INSURANCE 11/1862015 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, WEND 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 BOLDER. IMPORTANT. It the certificate holder Is an ADDITIONAL INSURED, the pa)Icy(les) must be endorsed. it SUBROGATION IS WAIVED, subject to the terms and conditions of the pallcy, certain policies may require an endorsement. A statement on this eerttficata does not confer rights to the certificate holder PRODUCER FEDERATED MUTUAL INSURANCE COMPANY HOME OFFICE, P.O. BOX 326 OWATONNA, MN 55060 INSURER A: FEDERATED MUTUAL INSURANCE COMPANY 13935 INSUREO 297.073-8 NORTHEAST ELECTRICAL INC 1 NORTH AVE BURLINGTON, MA 01803 INSURERS: INSURER C: INSURER 0s INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 0 REVISION NUMUCH: U THIS 13 TO CERTIFY THAT THE POLJCIBS 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 POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS ANn coNnITIONR OR RUCH PnLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORI THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED It ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZHD RiPRESENTATIYE 0 1988.2010 ACORD CORPORATION, All ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD reserved TYPE OFINSURANCE DL URR POLICY NUMBER IMIUDODMI POLICY E71P 12/31/2016 LIMITS A DEIIERAL X LIAMLITY COMMERCIALDENERALLlAe1L1TY CLAIMS•SlADE � OCCUR N N 8884084 12131/2016 EACH OCCURRENCE $1.000.00L DAO RENTED $100.00C MED ERP (Any aria person) EXCLUDEC PERSONAL 8, ADV INJURY $1,000,60{ OEHERALAOOREOATE $2,000,OOC PRODUCTS =COIJPIOPAGO 52,000,00( OEN'LAOOREOATE X LIMIT APPLIElPIN: POLICY 05f.0, LDC A AUTOMOeD X 8 LIABILITY WIY AUTO ALLAUT07 E0 AUT DULEO RIRIDAUTOS NON -OWNED AUTOS N N 8$84085 12/31/2015 12!31!2010 0.000MD , BODILYINJURY(PoePenen) BODILY INJURY (per aeddend OPE TY AMA06 A X UMBRELLALIAB EXCESS LIAR I X I OCCUR CLAIMS -MADE N N 8$84087 1213112015 12411!2018 EACH OCCURRENCE $2,000,40{ Aaaaeo TE DEO I I RETENTION A IWORI(fiRSCOMPINIATIOM AND EMPLOYERS' LIABILITY ANY PROPAIETORIPARTNER(EX90011ve OFncERIMEMetR EXCLUDSDI In NH) H yaL dowths under DESCRIPTIO,, 00 OPERATIONS below NIA N 8864088 12/31/2015 12/31/2018 yyQgyyT�ppTT Ty X TORYLLMITS I IO6R� 8 £.LEAOHACCIOENT 31.0410,000 $11,000,0% F.LDISEASE•EAEMPLOYeE $11,000,0%(Wrwfalory 91DI86ASE • FOLICY LIMIT $1,000,000 DESCRIPTION Of OPERATIONS I LOCATIONS I VEHICLES (Attuh ACORD t01. Addllenal Remarks Schedute, If more spate H requlrod) THIS COPY IS NOT TO BE REPRODUCED FOR ISSUANCE OF CERTIFICATES. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORI THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED It ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZHD RiPRESENTATIYE 0 1988.2010 ACORD CORPORATION, All ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD reserved ■mak @� ,E1 ; o I� oto �■« �k �y We m § o \§/1 » ° k2 §R §& ~\ &R A@ Co E W- c-- Z c oc Rp a X m n m 0 9 m 0 n � • aC A W- c-- Z c oc Rp a X m n m 0 9 m