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HomeMy WebLinkAboutPermits Permit # 8/12/2016 txORT#1 BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION 0 Permit No#: Date Receivedr 10 Date Issued: 31 --------- 1101RTA4T- A LOCATION, �>r .............. Print PROPERTY OWNER US m.A I/- �TC­PAEqS Print 100 Year structure yes no tn MAP PARCEL: ZONING DISTRICT: Historic Districtt ye no Machine Shop Village yes no ............ TYPE OF IMPROVEMENT PROPOSED USE Non- Residential E New Building F/One family D Addition [I Two or more family 0 Industrial E Alteration No. of units: mm� 0 Commercial El Repair, replacement - F1 Assessory Bldg [I Others: F1 Demolition El Other E Septic 0 Well 0 Floodplain 0 Wetlands El Watershed District El Water/Sewer ---------- DESCRIPTION OF WORK TO BE PERFORMED: ---------- 'Identification- Please Type or Print Clearly OWNER.- Name: re-S,tfra,)as Phone. Address:___3", Uq-A Contractor Name: Phone: '21`14, Email: Address: Supervisor's Construction License: c� "' ' 4� Exp. Date: i Home Improvement License: '7+,3>(5 Exp. Date: Zc i ARCHITECT/ENGINEER Phone: Address: Rea. No. FEE SCHEDULE.BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ _Siss , ob FEE: $ Check No. M Receipt No.: NOTE: Persons contracting with nregistered contractors do not have access to the gua1�qnp�fi_' .............. ,e w_tier_-___ tjO T1HI Town o � ? Fb Hover 0 - .................. 13 0% -' h ver, Mass, A COCN.CNl WIC. y�. �RArED S U BOARD OF HEALTH PERMIT T LD Food/Kitchen Septic System THIS CERTIFIES THAT ....Q ... '.., BUILDING INSPECTOR ................. .... ...�!.. ...,.............,......,. has permission to erect Foundation .........A...... buildings on ...,.,....�.......�. .. !.T�. �...........,....... �j c 0 Rough to be occupied as .N.t ...... .....W24....t.3l�.�c.� .. .... ...�.. . ... . .. Chimney provided that the person accepting this permit shall in every respect onform to the terms of the application Final on file in this office, and to the provisions of the Codes and By-haws relatinWo the Inspection,Alteration and Construction of Buildings in the Town of North Andover. � � h PLUMBING INSPECTOR Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. 7 0 Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR LESS CONSCT I® T Rough Service ....... ....... Final BUILD INSPEC OR GAS INSPECTOR ccupancy Permit Required to Occupy By 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 Approved by the Building Inspector. Burner Street No. Smoke Det. Sj'K I F1 N I N Jul. 20, 16 scope of Work. Jason K.Stephens. 33 Pilgrim St. North Andover. Ma, 01845. 978-994-4707 jaykstephelisogmail.com _1St floor aQo ra ng r rLS!, All work is being performed on the front left side of the house, as viewed from the street, between the chimney and the front left side of the home. Install 5 new 1&3/4"by 70/4" LVL's sistered up to the existing sagging floor joists and jacked into place at the center beam with new double joist hangers. Remove the existing 2" by 2" ledger between the new LVL's and the left basement wall and install new joist hangers on the existing floor joists. Remove and replace the existing sheetrock panel above the boiler with a new 5/8" fire rated piece of sheetrock and install solid blocking at the center span of the new LVL's and the existing floor joist from the LVL's to the left basement wall. Option 1: Relocate electrical wiring to allow installation of new framing: $100.00 per hour per licensed electrician plus materials. one electrician. ��- Anticipate approximately 4 hours for Date: Accepted: Homeowner: Date: - Dave Hope. President,HRH Construction, Inc. Date: Uj,,( 2-5A AJ16 HRH Construction,Inc. 80 Campbell Rd,North Andover,Ma.01845 drlvc,fphriic,otist�tiction.fiet www.1,al•licol�istruci:-i-o.ii.,ne,t 978-314-7263 CS-057754 HIC 101730 This form satisfies all basic requirements of die state's Home Improvement Contractor Law(MGL chapter 142A),but does not include standard language to protect homeowners, Seek legal advice if necessary. Any person planning home improvements should first obtain a copy of"A Massachusetts Consumer Guide to Home Improvement"before agreeing to any work on your residence.You may obtain a free copy by calling the Offico of Consumer Affairs and Business Regulation's Consumer Information Hotline at 617-973-8787 or 1.888283-3757 or on our websiie. Homeowner Information Contractor Information Name -company Name . I -C Street Address(da not use a Post Office Box address) Conuaetorr Salesperson/Owner Name 'ST 'J1ZSV"V-' City/Town State Zip Code Business Address(must include a street addim) Daytime Anitic Evening Phone City"rown State Zip Code Mailing Address(It different from above) -26 i; I Federal Employer ID or S.S M2!�C, A + The Contractor agrees to do the following work for the Homeowner: (Describe in detail the work to completed,specifying the type,brand,and grade of materials to be used, (J- Required Permits-The following building permits are required Proposed Start and Completion Schedule-The following schedule will and will be secured by the contractor as the homeowner's agent: be adhered to unless circumstances beyond the contractors control arise (Owners who secure their own permits will be1L�i C excluded from the Guaranty Fund provisions of �"2oatie when contractor will begin contracted work. MGL chapter 142A.) -,L 2o(, X(X"5;LDa1e when contracted work will be substantially completed. Total Contract Price and Payment Schedule The Contractor agrees to perform the work,furnish die material and labor specified above for die total sum of: .. I'll< Payments will be made according to the following schedule: upon signing contract(not to exceed U3 of the total contract price ar the cost of special order items,whichever is greater) sAoLNLjLkU by kL- _16or upon completion of $_j. by AL I ,or upon completion of 1-4 e2&,j L _L,- _2 $ upon completion ofthe contract, (Law forbids demanding foil payment until contract is completed toboth party's satisfaction) The following materialliquipment must be special s- I Irk .be paid for ordered before the contracted work begins in order am—nor-o.shM.1c(­) s___jSQ I.be raid for NOTES:(*)Including all finance charges(11)Law requires that any deposit ordown-payment required by the contractor before work begins may not exceed the greater of(a)one-third of the total contract price or(h)the actuat cost of any special equipment or custom truide material which must be special ordered in advance to meet the completion schedule Lxnress Warranty-Is an gauress)xtirranty being provided by the contractnr7 N ELYRE.frdl torm gfille warranty must be attached tot contract) Subcontractors-'rho contractor agrees to be solely responsible for completion of the work described regardless of tine actions of any third party/subcontractor utilized by the contractor. The contractor further agrees to be solely responsible for all payments to all subcontractors for materials and labor tinder ihis aLugmiiat Contract Acceptance-Upon signing,this document becomes a binding contract under law. Unless otherwise noted within this document,the contract shall not imply that any lien or other security interest has been placed on the residence. Review the following cautions arid notices carefully before signing this contract, . Don't be pressured into signing the contract.Take time to read and fully understand it. Ask questions if something is true]ear, . Make sure the contractor has a valid Home Improvement Contractor Registration. The law requires most home improvement contractors and subcontractors to be registered with the Director of Horne improvement Contractor Registration. You may inquire about contractor registration by writing to the Director at 10 Park Pizza,Room 5170,Boston,MA 02116 or by calling 617-973-8787 or 888-283-3757. . Does the contractor have insurance? Ask the Contractor for his insurance company information so that you can confirm coverage,or ask to see a copy of "proof of insurance"document. . Know your rights and responsibilities. Read the Important information on the reverse side of this form and get a copy oftlic Consumer Guide to the Home Improvement Contractor Law. You may cancel this agreement if it has been signed at a place other than the-contractor's normal place of business,provided you notify the contractor in writing at his/her main office or branch office by ordinary mail posted,by telegram sent or by delivery.not later than midnight of she third business day following the signing of this agreement. See the attached notice of cancellation form fbr an explanation of this right. DO NOT SIGN THIS CONTRACT IF THERE,ARE ANY BLANK PACES!!! Toa Idcnucal copier china coMraG mnrr be complptrd and ntpncd Onc cop.shouldµo to .,.�N� it, kept be kept u)die—v=., Contract er`s Signature AJ, Date Date Contractor Arbitration The Home Improvement Contractor Law provides homeowners with the right to initiate an arbitration action(as an alternative to court action)if they have a dispute with a contractor. The same right is not automatically afforded to a contractor,however. The contractor would have to resolve any dispute helshe has with a homeowner in court unless both parties agree to the optional clause provided below. This clause would give the contractor the same right to arbitration as is afforded to the homeowner by the Home Improvement Contractor Law, The contractor and the homeowner hereby mutually agree in advance that in the event the contractor has a dispute concerning this contract,the contractor may submit the dispute to a private arbitration firm which has been approved by the Secretary of the Executive Office of Consumer Affairs and Business Regulation and the c sumer shall be required to submit to such arbitration as provided in Massachusetts General Laws,chapter 142 c Home ner's Signature Contractor's Signature NOT CE:The signatures of the parties above apply only to the agreement of the parties to alternative dispute resolution initiated by the contractor. The homeowner may initiate alternative dispute resolution even where this section is not separately signed by the parties, Homeowner's Rights A homeowner's rights under the Home Improvement Contractor Law(MGL chapter 142A)and other consumer protection laws(i.e.MGL chapter 93A)may not be waived in any way,even by agreement. However,homeowners may be excluded from certain rights if the contractor they choose is not properly registered as prescribed by law. Homeowners who secure their own building permits are automatically excluded from all Guaranty Fund provisions of the Home Improvement Contractor Law. The contractor is responsible for completing the work as described,in a timely and workmanlike manner. Homeowners may be entitled to other specific legal rights if the contractor guarantees or provides an express warranty for workmanship or materials. In addition to guarantees or warranties provided by the contractor,all goods sold in Massachusetts carry an implied warranty of merchantability and fitness for a particular purpose. An enumeration of other matters on which the homeowner and contractor lawfully agree may be added to the terms of the contract as long as they do not restrict a homeowner's basic consumer rights. If you have questions about your consumer/homeowuer rights,contact the Consumer Information Hotline(listed below). Execution of Contract The contract must be executed in duplicate and should not be signed until a copy of all exhibits and referenced documents have been attached. Parties are also advised not to sign the document until all blank sections have been filled in or marked as void,deleted,or not applicable. One original signed copy of the contract with attachments is to be given to the owner and the other kept by the contractor. Any modification to the original contract must be in writing and agreed to by both parties.Contracted work may not begin until both parties have received a fully executed copy of the contract,and the three day rescission period has expired. Accelerated Payments A contractor may not demand payments in advance of the dates specified on the payment schedule in cases where the homeowner deems hini/herself to be financially insecure. However,in instances where a contractor deems him/herself to be financially insecure,the contractor may require that the balance of funds not yet due be placed in a joint escrow account as a prerequisite to continuing the contracted work. Withdrawal of funds from said account would require the signatures of both parties. Additional Information If you have general questions or need additional information about the Home Improvement Contractor Law or other consumer rights,or if you wish to obtain a free copy of "A Massachusetts Consumer Guide to Home Improvement" contact: Consumer Information Hotline Office of Consumer Affairs and Business Regulation 10 Park Plaza,Room 5170,Boston,MA 02116 617-973-8787,888-283-3757 or visit the OCABR website at nur IL•t4 If you want to verify the registration of a contractor or if you have questions or need additional information specifically about the contractor registration component of the Home Improvement Contractor Law,contact: Director of Home Improvement Contractor Registration Office of Consumer Affairs and Business Regulation 10 Park Plaza.Room 5170,Boston,MA 02116 617-973-8787,888-283-3757 or visit the HIC website at httt) _L\ Go online to view the status of a Home improvement Comractor's Registration: htq,: db.<t_lt�mti-u,klt,lthillt?I'U�enl�'dt j,l��t7 d.li [.,i±l For assistance with informal mediation of disputes or to register formal complaints against a business,call: Consumer Complaint Section Office of the Attorney General 617.727-8400 AND/OR Better Business Bureau 508-652-4800.508-755-2548 or 413-734-3114 ' ti'ecson=k•I IR2rM010 2"';0 NOTICE OF CANCELLATION YOU MAY CANCEL THIS TRANSACTION, WITHOUT PENALTY OR OBLIGATION, WITHIN THREE BUSINESS DAYS FROM THE ABOVE DATE. IF YOU CANCEL, ANY PROPERTY TRADED IN,ANY PAYMENTS MADE BY YOU UNDER THE CONTRACT OR SALE,AND ANY NEGOTIABLE INSTRUMENTS EXECUTED BY YOU WILL BE RETURNED WITHIN TEN BUSINESS DAYS FOLLOWING RECEIPT BY THE SELLER OF YOU CANCELLATION NOTICE,AND ANY SECURITY INTEREST ARISING OUT OF THE TRANSACTION WILL BE CANCELLED. IF YOU CANCEL,YOU MUST MAKE AVAILABLE TO THE SELLER AT YOUR RESIDENCE,IN SUBSTANTIALLY AS GOOD CONDITION AS WHEN RECEIVED,ANY GOODS DELIVERED TO YOU UNDER THIS CONTRACT OR SALE; OR YOU MAY, IF YOU WISH,COMPLY WITH THE INSTRUCTIONS OF THE SELLER REGARDING THE RETURN SHIPMENT OF THE GOODS AT THE SELLER'S EXPENSE AND RISK. IF YOU DO MAKE THE GOODS AVAILABLE TO THE SELLER AND THE SELLER DOES NOT PICK THEM UP WITHIN TWENTY DAYS OF THE DATE OF CANCELLATION, YOU MAY RETAIN OR DESPOSE OF THE GOODS WITHOUT ANY FURTHER OBLIGATION. IF YOU FAIL TO MAKE THE GOODS AVAILABLE TO THE SELLER, OR IF YOU AGREE TO RETURN THE GOODS TO THE SELLER AND FAIL TO DO SO, THEN YOU REMAIN LIABLE FOR PERFORMANCE OF ALL OBLIGATIONS UNDER THE CONTRACT, TO CANCEL THIS TRANSACTION,MAIL OR DELIVER A SIGNED AND DATED COPY OF THIS CANCELLATION NOTICE OR ANY OTHER WRITTEN NOTICE, OR SEND A TELEGRAM TO Roil s NOT LATER THAN MIDNIGHT OF 2r 1 (date). I HEREBY CANCEL THIS TRANSACTION. € Date: Buyer's Signature: yhe Commonwealth of'Hassa.ehasetts x Department of Indlust-FtaZAccidents ,I Congress Street,Suite 100 .Boston,HA 02114-2017 .�, www rnass.gov1dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Ek gtricians/12lxxmbers. TO BE FILED WWUXI M,RERtV.t["fNG AUTECO'W"St'. �1 eantInformation Please Print.Le ibly I`aMe(Business/Organizatlaa/Individual): 1f c f t i Address: t r ' 1 � 'hone#: Ef6 _.._°tet 4,. ., City/Stato/Zx : -- ..5 — Are you an employer?Checic&o appropriate box: Type of project(Tgquired)` 1.[5 am a employerwith_ employees(full and/or part time). ]. [J New construction .2.E]I am a sole proprietor,or partnership and have no employees worldn'g for me in 8. Remodelirig any capacity.[No workers'comp.insurance required.] �. ❑Demolition i F]I am a homeowner doing all work myselt.[No workers'comp.Jusuranca roqu red.]t 10 [Biding addition 4.E]I am a homeowner and will be hiring contractors to conduct all work on my property. Iwill 11 Electrical re airs or.additions ensure that all contractors either have workers'compensation insurance or are sole p16&jetors with no ernployces. 12:Q Plumbing repair's or additions 5.[]I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13. oofrepair these sub-contractors Have employees and hav©workers'coms p.insurance't 14. Qtlll 6.[]We are a corporation dud its officers have,exercised their right of exemption per MGL C. 152,§1(4),audwt have rl4Prnployees.pp workers'comp.insurance required.] *Any applicant that checks box#1 must also fill outtho section below showing tbeirworkers'compensation policy information, T kromeowners v�ho subUnuttaus 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 pot those entities have employees,'If the sub-cnriteaciors have empleyess,#icy'must pravidethe workers'camp.policy number. r, am are employer that is pPovidirzgjpor'lcers'compensation insurancefor nzy employees.'SelOW is'the policy and job site information. Insurance Company Name: " x�— Policy#or Self-ins.Lie. Expiration Data: ��. _ ' 1. ". fob Site Address: "x City/State/Zip: 1 _9 Attach a copy of the Ivor hers' compelrsation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MOL o. 152,§2.5A is a criminal violation punishable by a fano 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 Erne of up to$250.00 a day against the violator.A copy ofthis statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under'the p °ns andpenat"ties ofperjury that the information pr'ovid'ed above is true and correct Sievature: Date• "Ill.�°l � P_hona it Official use only, Do notrvrzte ill dais area,to be completed by city or town official Termit/License# City or Town — — — Issuing Authority(circle ane): ' 1.Board of health 2.Building Department 3.City/'Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other —_ Contact Person: —_— PAGE 01/02 08/12/2016 09:11 17819353539 HRHCONS-01 JBUCKLEY DATE(MMIDDfYYY'6 CC7�FZQ' CERTIFICATE OF LIABILITY INSURANC e11DEKT R NEGATIVELY AMEND, EXTEND OR ALTER THE -THE ISSUING AFFORDED (),AUTHORIZED CERl'll'ICATE IS:ISSUED A5 A MATTER 0 OF INFORMATION ONLY AND CONFERS NO RI ANTS UPON THE CERTIFIGABY THE POLICIES 7E HOLDER.T CERTIFICATE DOES NOT AFFIRMATIvE BELOW, THIS CERTI PICATE OF INSURANCE RODUCER,AND TNN CERTIFICATE CAT6 HOLDERES NOT CONSTITUTE A CONTRACT BETWEEN ub'sct to kEpitESENTATIVE OR . Cllcy(iea)m,rSt be endorsed' If SUgROGA710Tt IS WAIVED,9 INIPpftTANT If the certificate holder is an ADDITIONAL IIyS►iRNDr the p the terms and Conditions of the policy,certal5 pofioies rrlay require an endorsement"'A statement on this certificate does not confer rights tot e Certificate holder in lieu of such endorsement( ) CONTACT NAME: 781)935-3539 PRODUC9R PHONE EKI.,(617)876-9454 PA/C No Soaringstdr Insurance,Inc. AIG L 130 New Boston Street ADDROS: NATO a Suite 105A INSURER(& AFFORDING COVERAGE 15024 Woburn,MA 01801 INsURER A.Preferred Mutual 1001 IN,URsaq.Arbella Indemnity Insurance COmpany IN9URE0 INSURER*,- I HRH Conglilyurtion Inc INSORERD; 80 Campbell Rd INSURER t: North Andover,MA 01845 INSURERV; I REVISION NUMBER: COVERAGES CERTIFICATE NUMBER: CONDITION OF ANY CONTRACT OR OTHER DOCURM�I�'s SUBJECT IS TO ALL THEITER HS, THIS IS 70 CERTIFY THAT 1 HE POLkCIES OF INSURA GER LISTED BELOW HAVE BEEN ISSUED TO THE I DRUB EDD HUMEp ABOVE FOR THE POLICY PERIOD INDkCATED, NOTVNTNSTANDING ANY REQUIREMENT. pERTIFICATE MAY 19E ISSUED OR MAY PERTAIN, THE 1N5URA1dCE AFFORDED BY THE ED BY AID ILIMITS POLICY EFF EXCLUSIONS AND CO OF SUCH ADDL`SU LIMITS SHOWN MAY HAVE SEEN REDUCED rDDIYYYY PAID CLAIMS- 1,000,000 ILTR POLICY NUMBER TYPEOFINSEACH OCCURRENCE 9 URANCE IN&D Vr111 A X COMMERCIAL GENERAL LJABLLITY gOP010072270$ 03/0612016 0310612017 PREM SES es occurrence $ 101000 Cu11M5•MAOEFX]OCCUR MED EXP(Any ane person) S 4,000,000 PERSONAL&ADV INJURY $ 2,000,000 GENERAL AGGREGATE 3,000,001) PRODUCTS.COMPIOP AGO S GEN'L AGGREGATE LIMIT APPLIES PER; 5 POLICY JEGT LOC LI MSINED SIN s LIMIT s 4,000,001: OTHER: Es accident AUTOMOBILE LIABILITY 102003397€3 11!0312015 1410312016 BODILY INJURY(pet person) S BODILY INJURY(Par ace;dent) $ f3 ANY AUTO SCHEDULEDl Y DAMA S ALL OWNED AUTOS P er accident AUTOS K XNDN•OWNED � X HIRED AUTOS AUTOS EACH OCGIJRRENCI= S UMBRELLA L1A8 OCCUR AGGREGATE S 1� EXCESS LIA0 CLAIMS-MADE $ OTH- DED RETENTION S STRTUTE ER WORKERSCOM1'IPENSATION E.L.EACH ACCIDENT S 'j AND EMPLOYERS LIABILITY YIN E,L,•DISEASE-RA EMPLOYE S V ANY PROPAIET0 PAQ7NERIEXE0U'rVE ❑N J A OFFICER)MEM13ER EXCLUDED? E,L,D€SEASE-POLICY LIMIT 9 (Mandatory In NH) IfYe6,dose ioe under DESCRIPTION OF OPERATIONS below I hetl a nsaro space is required) gR6CRIPTION CF GPERATIONB 1 LOCATIONS 1 VBNI*LES(ACORD 141, Aaaltlortll R811Sar1Ls Schedule,may be adec CANCELLATION CERTIFICATE HOLDER SHOLD ANY TNEU KP RA�ONH DATE TMERHOF,E CANCELLED R DELIVERED It ACCORDANCE WITH THE POLICY PROVISIONS. Town of North Andover MA 1600 Osgood St SLlite 2043 North Andover,MA 01845 AUTHORIZED REPRESENTATIVE ®1988-2014 AGO1iD CORPORATION. All rights reserved The ACORD name and logo are registered marks of ACORD ACORD 25(2014101) 08/12/2016 09:11 17819353539 PAGE; 02/02 DATE IMMIDDMr'ryl ACoR� CERTIFICATE OF LIABILITY INSURANCE 08,121201$ THIS CERTIFICATE IS tBSVEO AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER,THIS CERTIFICATE DOES NOT AFFIRMATIVi;LY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES ' BELQW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE BOLDER1111111 — . Mas IMPORTANT: If the certificate holder Is a ,subject to n ADDITIONAL INSURED. an endolr�ament. A statement ron this certificate does not f SUBROGAT11ON 19 conferDrights to the the terms and conditions of the policy,certain policies may req certificate holder in lieu of such endorssment 5. CONTACT ,lariot Buckle PRODUCER NA E' PHONe €. 978 767-9211 �c SEARINGSTAR INSURANCE No: EMAIL DRESS: ianet,buck(eyebearin ster.com IMIGURER&AFFORDING COVERAGE NAIC 19 111 TORREY ST. MA 02301 TRAVELERS PROPERTY GAS CO OF AM 25674 Bracittan €NsuRlmfl € INSURED INSURER B HRH CONSTRUCTION INC INSURER I' INSURER O 80 CAMPBELL Rn INSURER E NORTH ANDOVER MA 01846 INSURERF: COVERAGES CERTIFICATE NUMBER: 76783 REVISION NUAfIBER' THIS 15 TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERTHIS IOD CERT FICAATENMAY�OTHSTANDING BE ISSUED OR MAYANYS ERiTAINRSMr.THE TNSURANCE AFFORDED BY THE POLICIES 0 SCRIBED HEREIN S SUB ECT TO ALO EERM OR CONDITION QF ANY CONTRACT OR OTHER DOCUMENT WTH RESPECT Ti TERNS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED UY PAP CV IIM$. LIMEYS [M1I6�Y1 IN$URANCE A EV POLICYNUMBER MMIDD1Ww M IDDtY Y LTR TYPEOF EACH OCCURRENCE S COMMERCIAL GENERAL LIAGIUTY Eq MIsES EGO CLAIMS-MADE M OCCUR MED EXP An one person} S NIA FaR50NAL&ADVINJURY S GENERALAGGREGATE S _ GEN'LAGGREGATELIMIT APPLIES PER PRODUCTS-COMPIOPAGG 5 _ POLIOY F�LOC $ OTHER: all EDSIN LELIMIT g Ea eGCI n ,..-- AUTOMOBILE LIASILIT'/ BODILY INJURY(Per persoAl S ANY AUTO BODILY€WURY(Par eccldern) s ALL OWNED aCqEDULED NIA OPERTYDAMA AUTOS AUTOS NOH-OWNED p r cCldanl 5 HIREDAUTOS AVTOS S EACH OCCURRENCE 6 UM6RELLALIAB QCCUR EXC685 LIAR CLAIMSMADE NIA AGGREGATE S — 3 pEp RETENTION$ X RTA T ERH WORKERS COMPENSATION AND EMPLOYERS'LIAWLITY YIN E.L EACH AGC€ORNT S 500,000 ANyPROPRIETORrPART'NERMXECUTIV B A o1=fICERrMEMSFR"CLUDED? NIA NIA NIA 7PJUBOG0961191B 08l041201(i 08!0412017 E,I..DISEASE-EAEMPLOYEE S 500.040 IManletarylnNH} E.L.DISEASE-POLICY LIMIT $ 500,000 if gy ,d85q*a under DE5CRIPTI M OF OPERATIONS below NIA DESCRIP'nON Of OPERATrDNSI LOCATICN5!VEM(CLES(ACORD M16t,Adammna(Romatk$!Scnadmo,mlty ba a€laahQd Ir TOra APkca 15 rQyu€red! Workers'Compensation benefits' lbe sf � aonly, nEndorsement e authorization givento pay Claims for benefits to employees In states other hen Mrsachue" f the insured hires,or hshired hose employees outside f Masaacruset . This certificate of insurance shows the policy in farce on the date that this certificate was issued(unless the expiratlan date on theabove policy precedes the Search date of th€s c mi caleo f in3uran errs comp talus of this coverage can be monitored dally by accessing the Proof of Coverage9 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE P63CRIBED POLICIES BE CANCELLRB BEFORE THE EXP1itATION PATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE:WITH THE POLICY PROVISIONS. Town of North Andover MA 1600 Osgood St Suite 2043 AUTHORVEDREPRESENTATIVE MA 01645 ` Norah ADdaver Denial M.CTC' y,CPCU,vice Pr2sldent T Residual Market—VVCRIBMA ®1988-2014 ACORD CORPORATION. All rights reserved. ACORD 26(2014101) The ACORD name and logo are registered marks of ACORD l I f L 'lass acNl USetts Dep)rTMent rt �,'ubhc Safety 9 oard Of BU10disiq Reguatv)jjs Jnd Standar,js LCense CS-057754 WILLIAM D HOPE 80 CAMPBELL RD N ANDOVER MA 01846 1 yi —A- 03ID4/2018 vZ, Office of Consumer Affairs&Bus ness Regulation License or registration valid for individual use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: 101730 Type: Office of Consumer Affairs and Business Regulation Expiration: 6/29/2018 10 Park Plaza Private Corporation -Suite 5170 HRH CONSTRUCTION INC. Boston,NIA 02116 William Hope 80 CAMPBELL RD NORTH ANDOVER,MA 01845 [Ttidersecrelary Not valid without sr attire