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Building Permit # 8/19/2016
NORT11 BUILDING PERMIT o��y�no ,&pw TOWN OF NORTH ANDOVER - . APPLICATION FOR PLAN EXAMINATION Permit NO: Date Deceived °� pOlAreu AC Wi15&� Date Issued_ : I ORTANT: Applicant must complete all items on this page LOCATION Print" ,E" OPET ,°OWNER02 oL-i Prig MAP ,0:' ', PARCEL: ' ZONING EiISTR'ICT-_ Historic District yes Rno/lachi�e Shia " P Village ill a es TYPE OF IMPROVEMENT PROPOSED USE - _ Residential Non- Residential New Building One family �- Addition Two or more family Industrial (Alterat"io No. of units:_ Commercial Repair, replacement Assessory Bldg Others: --._.. Dem Other eptid WWII Floodplain Wetlands Watershed District UaterlSewer DESCRIPTION OF WORK TO BE PREFORMED: m pwm KA4 C»".V,,� VV Recic,e cle..0)O(t.4113 "00-% r'V"",VkVYM CL FOC —,34�u. '�w �," " �"..�p �tl ^t.✓'�;""*; Identification Please Type or Print Clearly) OWNER: Name:' a mi A 6 0 C, c Phone: 6 A Address: q0 � .Y �.�m 004-4 CONTRACTOR ,Name.;-i1tl i` a-, ,Phone; Address: Supervisor's Construction License ?4,511 '2 Exp, Date: Home:Improvement License: l8 6 t83 Exp, Date: ARCHITECT/ENGINEER P3 /4 , Phone: Address: Reg. No. FEE"SCHEDULE:BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Projekt Cost: $ 83 , 8 4 1 . F3 o FEE: w Check No.: Receipt No.: NOTE: Persons cont r actin with u a"egistered contractors do not have access to the guar ano fund W g � Sgnattare of contra Si nature c��� . , Plans Submitted Plans Waived Certified Plot Plan Stamped Plans OF SEW GP DISPOSAL Public Sewer Tanning/Massage/Body Art Swimming Pools e Tobacco Sales Food Packaging/Sales Private(septic tank,etc. Permanent Dumpster on Site THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE A PROVED LANNING & DEVELOPMENT COMMENTS �� i �� ' � � V V X ONSERVATION Reviewed on r/ Si nature, thi {fir r i� COMMENTS 'U` ; ) —� / / HEALTH Reviewed on Signature COMMENTS 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 Engineert-Signgture: Located 384 Osgood Street FIRE ©EPARTMENT Temp Durnster onsite es no p Y Located at 124 Male Street Fire Department gnatureldate y COMMENTS ............ ............... ....................-........... .......... ...........-....... To V%ORTFHI wn o �j 6 over No. -7 116 10sq h $.^Kf ver, Mass, coc"'C"EWICK A. A TE iD 0"? U BOARD OF HEALTH Food/Kitchen PERMI L D� Septic System THIS CERTIFIES THAT ..*%*.01 .f.W.... ... . ................ .....A0011&1111k�w BUILDING INSPECTOR am� .................. .* . ...... has permission to erect .......................... buildings on ..... .......Im.......... .... Foundation Rough to be occupied as I'm W t.e Chimney provided that the person accepting this per t shall in every respect conform to t e 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. 11% 24 3 UNIUri S OWAIL PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. 0 Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS C®NST TION Rough Service .... ........ ...... Final BUILDIN SPE OR GAS INSPECTOR Occupancy Permit Required t® Occui2v Puildin 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. BUSINESS CONDITIONS TO THIS CONSTRUCTION CONTRACT This Contract, dated 04129/2016 is by and between: Steve and Donna Mastrocola 40 French Farm Road North Andover, MA 01845 Blackdog project code MASTR-15858 (Hereafter referred to as OWNER), and Blackdog Builders, Inc. 7 Redroof Lane, Unit#1 Salem, NH 03079 (603) 898-0868 Hereafter referred to as CONTRACTOR). Work will be performed at: 40 French Farm Road, North Andover, MA 01845 (Hereafter referred to as PROPERTY) 1. GENERAL This CONTRACT is for the following work and materials to be performed by the CONTRACTOR on the PROPERTY address shown above. The project is generally described as follows: Remove porch space and build new larger 3-season room (Hereafter referred to as WORK) The CONTRACT consists of this document, any plans, the specifications, the Blackdog client package and the Construction Contract. (Hereafter collectively referred to as the"CONTRACT") 2. PRICE The total price for the WORK agreed upon is $83,841.50. Payment terms are set out below in Paragraph 6. This proposal may be withdrawn by us if not accepted within thirty (30) days. 3 STARTING AND SUBSTANTIAL COMPLETION PROVISIONS The WORK will begin on approximately 912016(likely mid-september) and will be substantially completed, on 1112016, absent unusual or unforeseen circumstances beyond the control of the CONTRACTOR, and providing this CONTRACT and any related CONTRACT documents are accepted when presented. Projects requiring two contracts (one for construction work and one for bath or kitchen product)will not be slotted into the schedule until both agreements have been executed. The aforementioned dates reflect our present workload. Projects are assigned a slot in our work schedule as they are accepted, on a first come first served basis. These dates may move based on the completion time of the project that immediately preceded yours. 4, PERMITS AND APPLICABLE CODES. COMPLIANCE WITH LOCAL LAW All work to be done under this CONTRACT will be in accordance with local, state and county building code. The CONTRACTOR shall obtain all necessary permits and pay all required permit and plan fees from the CONTRACT sum, unless otherwise agreed. The CONTRACT price does not include any fees, which may be incurred to obtain a variance, if required. The CONTRACT price does not include any unbid items required by any local building official to bring the project into compliance with any relevant local, state and county building code. 5. SPECIFIC REQUIREMENTS FOR MATERIALS AND WORKMANSHIP a. This CONTRACT will be completed by the CONTRACTOR in a good and workmanlike manner, using quality 04/29/2016 Contract Proposal—Page 4 of 23 materials. b. If applicable, the CONTRACT price includes the following allowances: See allowances under specifications. 6. PAYMENT a. Timely payment by the OWNER of all sums due under this CONTRACT is of the essence to this CONTRACT. The parties agree to the following schedule of payments: Deposit with this contract: $ 1,500.00 at time of signing Deposit e a $ 11,076.23 MOO b. Payment Sc>~iedule Start of demolition $9,169.15 Start of footings $9,169.15 Start of framing $9,169.15 Start of window installation $9,169.15 Start of electrical rough-in $9,169.15 Start of drywall hanging $9,169.15 Start of trim $9,169.15 Substantial Completion $3,488.26 Completion of Punch List $2,092.96 c. Allowances for Owner Selected Components d. The CONTRACTOR may cease operations if any payment is not made by the OWNER as required herein, and proceed to collect any balance due through any remedy provided by law. Payments are due when the aforementioned progress milestones have been reached. It is understood that minor adjustments to the payments schedule may be necessary due to the flow of work or delays beyond the control of the CONTRACTOR. . e. Delays in payment in excess of thirty (30) days shall be subject to interest charges of 18% per annum, and no event higher than the maximum interest rate provided by law. If the CONTRACTOR is required to engage the services of a collection agency or an attorney, the OWNER agrees to reimburse the CONTRACTOR for any reasonable attorney's fees and expenses expended in order to collect the unpaid balance. f. DEFINITIONS Substantially complete -The space or project is substantially complete when the space or project can be used for its intended purpose and only punch list items remain. Punch list-Work or product that has not been performed or provided. Warranty item -A product or service that has been provided or performed that does not meet or exceed industry standards. THESE CONDITIONS MUST BE ACCOMPANIED BY THE CONSTRUCTION CONTRACT 04/29/2016 Contract Proposal--Page 5 of 23 Section II Construction Contract of the Contract/ Proposal for Steve and Donna Mastrocola CONSTRUCTION CONTRACT This Contract is by and between: Steve and Donna Mastrocola hereafter referred to as "OWNER", and Blackdog Builders, Inc hereafter referred to as "CONTRACTOR" for work at 40 French Farm Road, North Andover, MA 01845 dated 04129/2018. This CONTRACT consists of this document, any plans, the Specifications and Business Terms that are enclosed and the Blackdog Builders Client Package. (Hereafter collectively referred to as the "CONTRACT") 1. CONTRACTOR'S DUTIES -- GENERAL a. To direct and control the work contracted for in accordance with the terms of this CONTRACT and all applicable codes, laws, and regulations, and as the building permits issued for this project, if any, require. b. To inspect the site, examine the plans and specifications, if any, and supervise all of CONTRACTOR's employees, and to direct the work of all subcontractors selected by CONTRACTOR. c. To maintain the work site in a safe and clean condition, to the extent consistent with the CONTRACT. d. To advise the OWNER promptly if concealed conditions are ascertained which require additional or different work, and to proceed in such event in accordance with this CONTRACT. e. To provide locked storage for any equipment, tools, or other PROPERTY used in the performance of this CONTRACT, unless otherwise agreed in writing. 2. OWNER'S DUTIES --GENERAL a. To provide adequate utilities for the work agreed upon. b. To advise the CONTRACTOR of any condition of the PROPERTY which affects CONTRACTOR's ability to perform. c. To provide secure storage areas for materials delivered to the work site. (The garage will not be used) d. OWNER shall be entitled to make periodic inspections of the work site, provided such inspections do not interfere with the work and can, in the judgment of the CONTRACTOR, be made safely. Any other entry onto the construction site shall be at OWNER's risk. e. OWNER shall notify his insurance agent of the execution of this agreement and obtain any necessary riders to his current coverage or any locally customary forms of coverage, such as builders risk, to cover OWNER's interests and liabilities during the construction process. f. To perform no work on the project without a written agreement with the CONTRACTOR. g. To make no agreements with any trades person, subcontractor, or CONTRACTOR'S employees outside the scope of this CONTRACT without the written consent of the CONTRACTOR. 3. MATERIAL SUBSTITUTION CONTRACTOR reserves the right to substitute other materials, products and/or labor of equal or superior quality, utility, or similar color. 4. DELAY CONTRACTOR shall not be responsible for delays caused by events beyond the control of the CONTRACTOR, including but not limited to:strikes,war, acts of God, riots, governmental regulations and restrictions. Delays caused by OWNER's failure to make allowance materials selections or caused by the performance by CONTRACTOR of extras or necessary work (as described in Paragraph 6) shall likewise be excusable delays. S. INSURANCE CONTRACTOR agrees to maintain all necessary forms of insurance to protect the OWNER from liability for any occurrence arising from the performance of this Contract. CONTRACTOR agrees that he shall cover his own employees for worker's compensation and carry general liability insurance, and that all forms of insurance referenced herein shall be with reputable companies licensed to do business in the state where the project is located, 6 HIDDEN CONCEALED and UNFORESEEN CONDITIONS a. The parties agree that in the event CONTRACTOR discovers a hidden, concealed or unforeseen condition 04/29/2016 Contract Proposal--Page 7 of 23 requiring an extra cost that they shall proceed as follows: The CONTRACTOR shall notify the OWNER verbally to expedite agreement as to any charge necessary to correct or cure such condition, and provide a written Work Order (as described in paragraph 7a) as soon as practicable. The parties must agree to such extra charges, or agree to a resolution method, or this CONTRACT may be cancelled by either of them. b. For purposes of this section, a "hidden, concealed and unforeseeable condition" shall mean a condition not readily observable to a prudent CONTRACTOR inspecting the subject PROPERTY for the purpose of performing this Contract. Examples of such conditions can include, but are not limited to; rot under siding; ledge below grade; pre-existing plumbing or electrical work not performed to code and pre-existing mold. c. Any change in the WORK required by building officials assigned to this project, including structural and/or any environmental hazards will be billed as an EXTRA charge to this CONTRACT and paid for by the OWNER as a Work Order. CONTRACTOR may cease operations if OWNER refuses to pay. 7. EXTRAS a. Any extra work or materials desired by the OWNER shall be agreed upon in writing and such extras shall become a part of this CONTRACT as if fully set forth herein. Unless otherwise agreed, extra work shall be paid for as performed. Failure of the OWNER to sign a Work Order shall not preclude recovery for any work performed by CONTRACTOR, and acceptance of said extra work or materials shall be presumed, unless there is written notice to the contrary. b. CONTRACTOR shall advise OWNER, at the time of agreement on an extra, as to any additional time required to perform this CONTRACT. CONTRACTOR may cease operations if OWNER refuses to pay. B. ESCALATION CONTRACTOR reserves the right to pass on additional costs to OWNER resulting from the escalation of the cost of lumber or lumber byproducts. This cost may be passed on only, if after the CONTRACT is signed but before the construction commences, an increase in lumber costs is experienced. The CONTRACTOR must substantiate the change with evidence of the difference between lumber costs at the time of the CONTRACT and lumber costs at the time of construction. Only direct cost differences may be passed on, no allowances for overhead and profit shall be included. Any additional costs will be collected per Work Order(as described in paragraph 7a.). 9. EXCESS MATERIALS ON SITE CONTRACTOR routinely stores extra materials on site to improve efficiency and reduce the likelihood of running out of stock in the middle of a task. Unless otherwise specified in writing all excess materials on site at the end of the project are the PROPERTY of CONTRACTOR. 10. SUBCONTRACTORS a. CONTRACTOR shall select subcontractors as required to complete this CONTRACT. OWNER acknowledges that subcontractors will do various portions of the work. Any subcontractor selected by the CONTRACTOR shall have all requisite licenses for the work to be done by such subcontractor. b. It shall be the duty of the CONTRACTOR to use reasonable care in the selection of subcontractors. Absent objectionable performance by any subcontractor, the selection of subcontractors shall be an exclusive right of the CONTRACTOR.The CONTRACTOR shall require all subcontractors to have workman's compensation and liability insurance in force. c. CONTRACTOR agrees to be solely responsible for the completion of the work described herein regardless of the 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 under this agreement. 11. TERMINATION AND CANCELLATION The CONTRACTOR may terminate and cancel this CONTRACT if any payment called for hereunder is not received as scheduled, provided that notice is given to the OWNER as provided below. Upon such termination, the CONTRACTOR shall have all remedies provided by law, including such lien rights as then apply. The OWNER may terminate this CONTRACT upon the following conditions: a, Failure of the CONTRACTOR, or his subcontractors, to pursue the work contracted for, absent excusable delay, as provided in Paragraph 4 above, for a continuous period of fourteen(14)days, without a written agreement permitting same, such agreement may be satisfied by a single notation to this CONTRACT. b. Failure of the CONTRACTOR to rectify any condition for which building code enforcement authority has issued a citation of violation notice, within fourteen(14)days' notice of such violation, unless OWNER and CONTRACTOR otherwise agree. 04129/2016 Contract Proposal—Page 8 of 23 c. Any other failure to perform this CONTRACT required by the terms of this CONTRACT. d. No termination shall be effective unless 10 days written notice of OWNER'S intent is given as required below, during which time the default may be cured by the CONTRACTOR. e. Deposit monies-Cancellation of this CONTRACT prior to the commencement of work shall result in the forfeiture of any and all deposit monies collected. All deposits are non-refundable. The parties hereby agree that upon such cancellation, the CONTRACTOR shall suffer damages including but not limited to the cost associated with designing and preparing the project for commencement. f. You may cancel this agreement by observing the requirements of The Notice of Cancellation attached hereto. 12. DISPUTE RESOLUTION If a dispute arises out of or is related to this Contract, or the breach thereof, the parties shall endeavor to settle the dispute first through direct discussions. If the dispute cannot be settled through direct discussions, the parties agree the dispute shall be settled by arbitration as follows: New Hampshire Consumers: If the dispute with a New Hampshire customer cannot be settled through direct discussions, the parties agree the dispute shall be settled by arbitration administered by the American Arbitration Association under its Construction Industry Arbitration Rules. In the event that arbitration is necessary, the parties agree that arbitration proceedings shall be conducted by a mutually agreed upon arbitrator in Rockingham County, New Hampshire. If the parties cannot agree on an arbitrator, either party may file a written demand for arbitration in accordance with the rules of the American Arbitration Association. The arbitration award shall be final and judgment on the award may be entered in any court having jurisdiction thereof. This CONTRACT shall be governed and interpreted in accordance with the laws of the State of New Hampshire. The parties acknowledge that this agreement to arbitrate shall be governed by Chapter 542 of the New Hampshire Revised Statutes Annotated. Either party may, without waiving any remedy under this CONTRACT, seek from any court having jurisdiction any interim or provisional relief that is necessary to protect the rights or PROPERTY of that party, including but not limited to the right to seek liens or attachment. The prevailing party in any dispute arising out of or relating to this CONTRACT or its breach that is resolved by a binding dispute resolution process shall be entitled to recover from the other party reasonable attorneys' fees, costs and expenses incurred by the prevailing party in connection with such dispute resolution process. Massachusetts Consumers: If a dispute with a Massachusetts customer cannot be settled through direct discussions, the parties agree the dispute shall be settled by arbitration administered by the Massachusetts Home Improvement Contractor Law (MGL.c142A). This 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. The contractor would have to resolve any dispute it has with a homeowner in court unless both parties agree to the following optional provision. This provision gives the contractor the same rights to arbitration as is afforded to the homeowner by the Home Improvement Contractor Law. The CONTRACTOR and OWNER, residing in Massachusetts, 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 approved by the Secretary of the Executive Office of Consumer Affairs and Business Regulation and the OWNER shall be required to submit to such arbitration as provided in Massachusetts Laws, chapter, 142A. Either party may, without waiving any remedy under this CONTRACT, seek from any court having jurisdiction any interim or provisional relief that is necessary to protect the rights or PROPERTY of that party, including but not limited to the right to seek liens or attachment. The prevailing party in any dispute arising out of or relating to this CONTRACT or its breach that is resolved by a binding dispute resolution process shall be entitled to recover from the other party reasonable attorneys' fees, costs and expenses incurred by the prevailing party in connection with such dispute resolution process. Consumers in Massachusetts shall be required to submit to such arbitration as provided in MGL c. 142A. 04/29/2016 Contract Proposal—Page 9 of 23 David Bryan, CGR President Dpnna Mastrocola Blackdog Builders, Inc. Notice: The signature of the parties above constitutes an acknowledgement of the agreement between the parties to alternative ,dispute resolution. Massachusetts consumers may have the right to initiate alternative dispute resolution even where this section is not signed by the parties. g. Unless otherwise agreed in writing, CONTRACTOR shall continue the WORK and maintain the agreed work schedule during any dispute resolution proceedings. CONTRACTOR's obligation to continue to perform is conditioned upon OWNER's timely payments in accordance with terms of this Contract. 13. ENVIRONMENTAL HAZARDS a. The CONTRACTOR is NOT responsible for the inspection, discovery, abatement or removal of any environmental hazard including, but not limited to: asbestos; mold; lead; radon; ground water or environmental pollution at the work site, unless specifically covered in the specifications. b. In the event that any hazardous material is discovered during the course of construction, the testing, abatement and/or removal shall be the sole responsibility of the OWNER. c. Any additional costs incurred on account of suspension of the construction or changes to the specifications due to a hazard or its removal are the responsibility of the OWNER and will be handled by a Work Order. d. In the event that work does not resume within 30 days of the stoppage, OWNER agrees to immediately pay the CONTRACTOR the pro rated amount of the CONTRACT price applicable to work done up to that point pursuant to the Contract. WARRANTY OWNER warrants that as of the date of this CONTRACT: (1) the PROPERTY (including the land, surface water, ground water, and improvements to the land) is, and will continue to be, free of all contamination, including (a) "oil, petroleum products, and their by-products" (b) any"hazardous waste" as defined by the Resource Conservation and Recovery Act of 1976, as amended from time to time, and regulations promulgated thereunder; (c) any hazardous substance as defined by the Comprehensive Environmental Response, Compensation, and Liability Act of 1980, as amended from time to time, and regulations promulgated thereunder, specifically including asbestos and mold; and (d) any other"hazardous substance" (2)the PROPERTY is in compliance with all environmental laws and regulations; and (3)there are no underground tanks on the PROPERTY INDEMNITY OWNER expressly acknowledges and agrees that it will reimburse, defend, indemnify and hold harmless CONTRACTOR, all Sub-contractors, their successors, assigns and employees from and against any and all liabilities, claims, damages, penalties, expenditures, losses or charges (including, but not limited to, all costs of investigation, monitoring, legal fees, remedial response, removal, restoration or permit acquisition) which may, now or in the future, be undertaken, suffered, paid, awarded, assessed, or otherwise incurred as the result of: (a) any contamination, existing in, on, above or under the PROPERTY (including, but not limited to, contaminated soil, mold, buildings, facilities and/or ground water); (b) any investigation, monitoring, clean up, removal, restoration, remedial response or remedial work undertaken on the PROPERTY; and (c) OWNER'S breach of any warranty given herein. 14. WARRANTIES a. The work of the CONTRACTOR, including materials and labor, shall be warranteed for a period of three (3) years, during which period CONTRACTOR shall at its own expense correct any defect arising from its work unless it is a non-warrantable condition as set out in the Blackdog Builders Client Package. That package shall become a part of this CONTRACT as if fully set forth herein. b. Any and all warranties for appliances or mechanical systems shall be delivered to OWNER as the CONTRACTOR receives them, Owner agrees to hold manufacturers solely responsible for all warranties for appliances or mechanical systems and agrees that no action may be brought against the CONTRACTOR on this Contract as a result of manufactures warranties. c. The quality of any work in question will be held to the standards issued in the Residential Construction Performance Guidelines— Fourth Edition published by the NAHB. 04/29/2016 Contract Proposal—Page 10 of 23 15. SEVERABILITY If any portion of this agreement is found invalid or unenforceable by any court, the remaining provisions shall remain in force between the parties. 16. ENTIRE AGREEMENT Upon signing this document becomes a binding CON'T'RACT under law. Unless otherwise noted within this document, this contract shall not imply that any lien or other security interest has been placed on the residence. This CONTRACT consists of the documents defined herein, and constitutes the entire agreement of the parties. It can be modified only by a written document. OWNER acknowledges that he has read and received a legible copy of this agreement signed by CONTRACTOR, before any work was done, and that he has read and received a legible copy of every other document that OWNER has signed during the negotiation of this Contract.. 17. THREE DAY RIGHT TO CANCEL THIS CONTRACT You may cancel this agreement if it has been signed at a place other that the CONTRACTOR'S normal place of business, provided you notify the CONTRACTOR in writing by not later than midnight of the third business day following your signing of this agreement. See the notice of cancellation form attached hereto for an explanation of this right. 18. Massachusetts Home Improvement Contractor Law MGL.c142A All home improvement contractorslsubcontractors working in the Commonwealth of Massachusetts must be licensed and registered by the Office of Consumer Affairs and Business Regulations. All inquiries concerning the CONTRACTOR should be transmitted to those offices. In Massachusetts Blackdog Builders, Inc. operates under License number CSO48847 and Registration number 106877. Federal Tax ID. Number 02-0477778. a. Massachusetts homeowners securing their own permits will be excluded from the Guaranty Fund provisions of MGL c. 142A. b. In Massachusetts the deposit shall not exceed 113 of the total contract price, or the cost of any special equipment or custom made material which must be special ordered in advance to meet the completion schedule, whichever is greater. PLEASE DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES Two identical copies of this contract must be completed and signed.One copy shall go to the OWNER with the second copy being retained by the CONTRACTOR. NO WORK shall commence until this contract is fully executed. SUBMITTED: - DATE : � — 04 29120 6 David Bryan, C President Blackdog Builders, Inc. ACCEPTED: A-1 _ DATE: �i�:, '2- �T� Steve Mastrocola r DATE: #DnnUaM4astrocola 04/29/2016 Contract Proposal—Page 11 of 23 Blackdog Builders, Inc. Notice of Canceration Received on this day: 04/29/2016 Steve and Donna Mastro ola You may cancel this transaction, without any penalty or obligation, within three business days of the aforementioned transaction date. If you cancel any property traded in, any payments made by you under the agreement, and any negotiable instruments executed by you will be returned within 10 business days following receipt by the CONTRACTOR of your cancellation notice. Any security interest arising out of the transaction will be cancelled. If you cancel, you must make available to the CONTRACTOR, at your residence, in substantially as good condition as when received, any goods delivered to you under this agreement. Alternatively you may comply with the instructions of the CONTRACTOR regarding the return shipment of goods at the CONTRACTOR's expense and risk. If you do make the goods available to the CONTRACTOR and the CONTRACTOR does not pick them up within twenty (20) days of your notice of cancellation, you may retain or dispose of the goods without further obligation. If you fail to make the goods available to the CONTRACTOR or you agree to return the goods to the CONTRACTOR and fail to do so, then you remain liable for performance of all obligations under the agreement. To cancel this transaction, mail or deliver a signed and dated copy of this Notice of Cancellation or any other written notice or send a telegram to: Blackdog Builders, Inc. 7 Redroof Lane, Unit#1 Salem, NH 03079 603 898-0868 Not later than midnight of which will be the third day after the aforementioned transaction date. I hereby cancel this transaction. Steve and Donna Mastrocola Date 04129/2016 Contract Proposal—Page 23 of 23 23 OLD FARM RpAD S hfICHAEL & ' �S DLD FARM ROAD Q PROPOSED DECK & STAIRS DETAIL (NDT 7a SCALE) BK 7159,P Ka rz ALID N/F a ,�•_ T 1595 PG 27p D �\ f « _� •_ ` / 154.43'S8i'J5' iO' 8 9 We 56 2 OIC Lu LL a SE k4aZW� 0 Lu DWELLING 1 fl o a br.r• WFENCE < ccS Lu LL c) [ct 1 g�PRaPO$p ` r 1 �RrRs f / X40 f \ U \ 55.9' F.Yi53YN'G s58•, DWFS_LIN�G� 3 � ' � SCRFENJ-- �3'w •oi � �►�ty r'6RCy CQNG N r�r RA(TD B� PA'RO y� v ffCffCpppp�� CURRENT OWNER: DONNA & STEPHEN MASTROCOLAC Lu S 0 TITLE REFERENCE: BOOK 6579 PAGE 41 PROPpSEDQUN p PLAN REFERENCE: PLAN 8926 oRrvEwq r SCREENED�epRcy aooL THIS PLAN WAS PREPARED VATHOUT A FULL TITLE EXAMINATION AND IS NOT AI W N CER71FiCA11014 TO THE 777LE OF THE LANDS SHOWN. THE OWNERSHIP OF w U N ABUTTING PROPER17ES 15 ACCORDING TO ASSESSORS RECORDS. T)41S PLAN MAY CL a 0R MAY NOT SHOW ALL ENCUMBRANCES WHETHER EXPRESSED, IMPLIED OR WOOD SA'Sp w x Z Q ,� o PRESCFUPT1VE. - FENCE �� n ty � 0 >b I ' SURVEYOR'S CERTIFICATION: LOT 54 TO: DONNA &STEPHEN MASTROCOLA r= 45,122 5.f.,+ I �' 1 CERTIFY THAT THIS PLAN AND THE SURVEY CN WHICH IT IS BASED WERE MADE IN ACCORDANCE 4'JTH THE GENERALLY ACCEPTABLE pRACTiC£S OF LAND J SURVEYORS IN THE COMMONWEALTH OF MASSACHUSETTS FOR A PLAN AND SURVEY OF THIS TYPE. THIS CERTIFfCATON IS MADE ONLY TO THE ABOVEo. Lu Lu NAMED INDIVIDUAL(S) AND IS NULL AND VOID UPON ANY FURTHER CONVEYANCE OF THIS PLAN. CL E'0 x s THE FIELD WORK WAS COMPLETED ON; JUNE 29. 2019 �V13 OF/� soNfl— i W n a DATE OF PLAN: AUGUST 17, 2016 � RICHARD {Gl 7g.43'Mal-35• cf)J. a MEDE)R, r i �R E p, 54J 87' 4 Q V r / 36864 0, u 0? 7 f l a `rroyFCIST 5v�a� (PUBLIC �R� R p,�D sarH u K z +puHo RICHARD J. M .L. DATE. d(IAN 4 WlDF) Of o f � i CONSERVATION DEPARTMENT Community Development Division NEGATIVE DETERMINXI'ION OF APPLICINBILITY SPECIAL,CONDI'I'IONS 40 French Farm Road, North Andover At the august 26,2015 public hearing, the North Andover ConseLvation Commission(NAC:C)voted to issue a Negative Determination of Applicability for the removal of an existing screen porch and the construction of a larger heated sunroom(28'x 14')within tl-w Buffer'Lone to Bordering Vegetated Wetland.The project will conform to the following: Applicant: Stephen.lllatrocola 40 French Farm Road North Andovet,T\Lk 01845 Record Documents: Request for Determination of Applicability Form 1,and supporting materials,submitted:August 12, 2015 Record Plan: "Certified Plot Plan 40 French Farm Road North Andover, HA." (with hand drawn sketch of sunroof») Date::06/29/2015 Stamped by: Richard j.Mcde j'r. P.1 S. SPECIAL CONDITIONS. 1. Prior to the start of construction the applicant shall ensure that the site contractor has reviewed the Determination and is aware of the wetland resource area and the liinits of the proposed work. 2, Accepted engineering and construction standards and procedures shall be followed in the completion of the project. 3. upon completion of the approved project and final site stabilization please contact the Conservation Department for a final inspection. 1600 Osgood Strect,Suite 2035,Nottlf.Andovcc,Massachusetts 01845 Phone 978.688.9530 Fxx 978.688.9542 Web:http://ww�u.to�vE�ofnartt�andnvcr.coon/PaOcs/N.lndoverlVL1_Conservativn/index I Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Form 2 -� Determination of Applicability � pig Y I Massachusetts Wetlands Protection Act M.G.Q. c. 131, §40 A. General Information Important: When filling out From: forms on the North Andover computer,use - --- ---- .. ... ..... . only the tab Conservation Commission key to move To: Applicant Property Owner(if different from applicant): your cursor- do not use the Stephen Mastrocola return key. Name Name 40 French Farm Road VQ Mailing Address ' Mailing Address North Andover MA 01845 Cify(rown State Zip Code Cityrrown State Zip Code 1. Title and Date(or Revised Date if applicable)of Final Plans and Other Documents: Certified Ptot Plan June 29, 2015 Title Date Proposed Plot Plan of Land November 25, 1983 Title Date Title Date 2. Date Request Filed: August 12, 2015 B. Detertmination Pursuant to the authority of M-GI. c. 131, §40, the Conservation Commission considered your Request for Determination of Applicability, with its supporting documentation, and made the following Determinatlon. Project Description(if applicable): Remove existing screen porch and construct a heated sunroom 28'x 14'. Project Location: 40 French Farm Road_ North Andover Ad • Streei dress Cityfl'own Map 36 Parcel 72 Assessors Map/Plat Number Parcelli-ot Number wpoform2.doc•Determination of Applicebiiily•rev.12114 Page 1 of 5 a Massachusetts Department of Environmental Protection Bureau of Resource Protection -Wetlands �. WPA Fora 2 — Determination of Applicability Massachusetts Wetlands Protection Act M.G.L. c, 131, §40 B. Determination (cont,} The following Determination(s)is/are applicable to the proposed site and/or project relative to the Wetlands Protection Act and regulations: Positive Determination Note: No work within the jurisdiction of the Wetiands Protection Act may proceed until a final Order of Conditions(issued following submittal of a Notice of Intent or Abbreviated Notice of Intent)or Order of Resource Area Delineation(issued following submittal of Simplified Review ANRAD)has been received from the issuing authority(i.e., Conservation Commission or the Department of Environmental Protection). ❑ 1. The area described on the referenced plan(s)is an area subject to protection under the Act. Removing,filling,dredging,or altering of the area requires the filing of a Notice of Intent. ❑ 2a.The boundary delineations of the following resource areas described on the referenced plan(s)are confirmed as accurate.Therefore,the resource area boundaries confirmed in this Determination are binding as to all decisions rendered pursuant to the Wetlands Protection Act and its regulations regarding such boundaries for as long as this Determination is valid. ® 2b. The boundaries of resource areas listed below are not confirmed by this Determination, regardless of whether such boundaries are contained on the plans attached to this Determination or to the Request for Determination. ❑ 3. The work described on referenced plan(s)and document(s) is within an area subject to protection under the Act and will remove, fill, dredge, or alter that area. Therefore, said work requires the filing of a Notice of Intent. ❑ 4. The work described on referenced plan(s)and document(s) is within the Buffer Zone and will alter an Area subject to protection under the Act. Therefore, said work requires the filing of a Notice of Intent or ANRAD Simplified Review(if work is limited to the Suffer Zone). ❑ 5.The area andlor work described on referenced plan(s)and docurnent(s) is subject to review and approval by. Name of Municipality Pursuant to the following municipal wetland ordinance or bylaw: Name Ordinance or Bylaw Citation wpeformMoa•Oalerminalion of Applloabillly-rev.12!14 Page 2 of 5 t I_ ...................__._ Massachusetts Department of Environmental Protection Ll Bureau of Resource Protection - Wetlands WPA Farm 2 — Determination of Applicabiiity Massachusetts Wetlands Protection Act M.G.I . c. 131, §40 t D. Determination (cont.) ❑ 6. The following area and/or work, if any, is subject to a municipal ordinance or bylaw but not subject to the Massachusetts Wetlands Protection Act: i ❑ 7. If a Notice of Intent is filed for the work in the Riverfront Area described on referenced plan(s) and documents), which includes all or part of the work described in the Request, the applicant must consider the following alternatives. (Refer to the wetland regulations at 10.58(4)c. for more information about the scope of,alternatives requirements); ❑ Alternatives limited to the lot on which the project is located, ❑ Alternatives limited to the lot on which the project is located, the subdivided lots, and any adjacent lots formerly or presently owned by the same owner. ❑ Alternatives limited to the original parcel on which the project is located, the subdivided parcels,any adjacent parcels, and any other land which can reasonably be obtained within the municipality. ❑ Alternatives extend to any sites which can reasonably be obtained within the appropriate region of the state. Negative Determination Note: No further action under the Wetlands Protection Act is required by the applicant. However, if the Department is requested to issue a Superseding Determination of Applicability, work may not proceed on this project unless the Department fails to act on such request within 35 days of the date the request is post-marked for certified mail or hand delivered to the Department.Work may then proceed at the owner's risk only upon notice to the Department and to the Conservation Commission. Requirements for requests for Superseding Determinations are listed at the end of this document. ❑ 1. The area described in the Request is not an area subject to protection tinder the Act or the Buffer Zone. ❑ 2. The work described in the Request is within an area subject to protection under the Act, but will not remove, fill, dredge, or alter that area.Therefore, said work does not require the filing of a Notice of Intent. 3. The work described in the Request is within the Buffer Zone, as defined in the regulations, but will not alter an Area subject to protection under the Act. Therefore, said work does not require the filing of a Notice of Intent, subject to the following conditions(if any). See Attached ❑ 4. The work described in the Request is not within an Area subject to protection under the Act (including the Buffer Zone). Therefore, said work does not require the filing of a Notice of Intent, unless and until said work alters an Area subject to protection under the Act. wpafo,mUoo.-Determination of Applcnbifily•rev i2il4 Pago 3 of 5 1 t Massachusetts Department of Environmental Protection Bureau of Resource Protection -Wetlands WPA Form 2 — Determination of AppliCability Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 D. Determination (cont.) ❑ 5. The area described in the Request is subject to protection under the Act. since the work described therein imeets the requirements for the following exemption, as specified in the Act and the regulations,no Notice of Intent is required: Exempt Activity(site applicable statuatory/regulatory provisions) ® 6.The area and/or work described 'n the Request is not subject to review and approval by: North Andover Name of Municipality Pursuant to a municipal wetlands ordinance or bylaw. North_Andover Conservation Commission Chapter 178 Name Ordinance or Bylaw Citation C. Authorization -.-............._ This Determination is issued to the applicant and delivered as follows: ❑ by hand delivery on ® by certified mail, return receipt requested on Bate Date This Determination is valid for three years frorn the date of issuance(except Determinations for Vegetation Management Plans which are valid for the duration of the Plan). This Determination does not relieve the applicant from complying with all other applicable federal, state, or local statutes, ordinances, bylaws, or regulations. This Determination must be signed by a majority of the Conservation Commission. A copy must be sent to the appropriate DEP Regional Office(see htt :11www.mass.g oWeea/a encies/massde /about/contacts/find-the-massdep-regional.-office-for-you€,- cit -or-town,htm])and the property owner(if different from the applicant). Signatures: Date wpal0rm2.0oc-petarminaGon of AApl wbBlity•rev,12!34 Page 4 of 5 t I r Massachusetts Department of Environmental Protection Bureau of Resource Protection -Wetlands PA Fora 2 ® Determination of Applicability Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 - D. Appeals The applicant, owner, any person aggrieved by this Determination, any owner of land abutting the land upon which the proposed work is to be done, or any ten residents of the city or town in which such land is located, are hereby notified of their right to request the appropriate Department of Environmental Protection Regional Office (see hit ://www,mass. av/eea/a encleslmassde /about/contacts/find-the- massdep-regional-office-for-yotir-city-or-to_wn,htmI to issue a Superseding Determination of Applicability. The request must be made by certified mail or hand delivery to the Department,with the appropriate filing fee and Fee Transmittal Form (see Request for Departmental Action Fee Transmittal Form)as provided in 310 CMR 10.03(7)within ten business days from the date of issuance of this Determination. A copy of the request shall at the same time be sent by certified mail or hand delivery to the Conservation Commission and to the applicant if he/she is not the appellant. The request shall state clearly and concisely the objections to the Determination which is being appealed, To the extent that the Determination is based on a municipal ordinance or bylaw and not on the Massachusetts Wetlands Protection Act or regulations, the Department of Environmental Protection has no appellate jurisdiction. era6f0rnn2.dor•Determination of APP1lcabllily•fav,12114 Page G of G t Residential Property Record Card Parfet ID: 210/035.0-0072-0000.0 MAP: 035.0 BLOCK: 0072 LOT: 0000.0 Parcel Address: 40 FRENCH FARM ROAD FY: 2016 PARCEL INFORMATION Use-Code: 101 Sale Price: 1 Book: 6579 Road Type: T Inspect Date: 02!1412012 Owner: Tax Class: T Sale Date: 12128/2001 Page: 41 Rd Condition: P Meas Date: 02114/2012 MASTROCOLA,DONNA L Tot Fin Area: 4020 Sale Type: P Cert/Doc: Traffic: M Entrance: X Address: Tat Land Area: 1.040 Sale Valid: F Water: Collect Id: RRC 40 FRENCH FARM ROAD Sewer: Grantor: STEPHEN MASTROCOLA Sewer. Inspect Reas: C NORTH ANDOVER MA 01845 Exempt-B/L% 0/0 Resid-BIL% 100/100 Comm-BIL% 0/0 Indust-B/L% 010 Open Sp-B/L% 0/0 RESIDENCE INFORMATION LAND INFORMATION Style: CL Tot Rooms: 8 Main Fn Area: 2308 Attic: NBHD CODE: 6 NBHD CLASS: 6 ZONE: R2 Story Height: 2.00 Bedrooms: 4 Up Fn Area: 1712 Bsmt Area: 1120 Seg Type Code Method Sq-Ft Acres Inf1u-YIN Value Class Roof: H Full Baths: 3 Add Fn Area: Fn Bsmt Area: 1000 1 P 101 S 43560 1.000 N 212,137 Ext Wall: AV Half Baths: 1 Unfin Area: Bsmt Grade: 2 R 101 A 0.040 N 304 Masonry Trim: 36 Ext Bath Fix: Tot Fin Area: 4020 Foundation: CN DETACHED STRUCTURE INFORMATION Bath Qual: T RCNLD: 410408 Kitch Qual: T Eff Yr Built: 1980 Str Unit Msr-1 Msr-2 E-YR-BIt Grade Cond I Good PIRE1R Cost Class Mkt Adj: Heat Type: FA Ext Kitch: Year Built: 1984 PG S 600 1998 V V /50//47 22,600 1 Sound Value: Fuel Type: O Grade: G Cost Bldg: 410,400 CB S 192 1998 V V /501147 6,200 1 Fireplace: 1 Bsmt Gar Cap: Condition: A Aft Str Vail: VALUATION INFORMATION Central AC: Y Bsmt Gar SF: Pct Complete: Att Str Va12: Current Total: 651,600 Bldg: 439,200 Land: 212,400 MktLnd: 212,400 Att Gar SF: 576 %Good P/FIE/R: 1100/100179 Prior Total: 653,600 Bldg: 444,700 Land: 208,900 MktLnd: 208,900 Porch Type Porch Area Porch Grade Factor E 224 W 120 Sketch Photo v\MM"14 1A \\ tY FM E 20 Ft y 4196S q.1%224 Ell FM FU* 360 ¢t 582 14 p G 30 30 FU/FMlB 576 Sq.F 23 1120 Sq.Ft 24 40 �0 L-�4 FRENGH FARM RQ1aD i i NORTH ANDOVER BUILDING DEPARTMENT Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in properly licensed solid waste disposal facility as defined by MGL Chapter 111, S 150 A. The debris will be disposed'of in: 10.!�QK3 (Location of Facility) re of Permit Applicant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector The Commonwealth of Massachusetts Department of'IndustrialAccidents 1 Congress.Street, Scute 100 Boston,AIA 02114-2017 wlviv.mass.gvv/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/E lectricians/Plumbers. TO BE FILED 1VITI1THE PTRtbIITTING AUTHORITY. Applicant Information Please Print Legibly Laine (Business/Organization/Individual): 3 k C to Address:-1-R,,e1t 6 f Lr,� \ City/State/Zip: , t ` Phone#: r" t Are you an employer?Check the appropriate box; Type of project(required): 1.0am a ernployer with�employm(frill and/or part-time).* 7. d New coIlstruction 2.0 lam a sole proprietor or partnership and have no employees working for me in $, [q-Remodeling any capacity.[No workers'comp,insurance required.] 9. ❑Demolition In I am a homcowner doing all work myself.[No workers'comp.insurance required.]t 10❑Building addition 4.❑I am a homeowner and will be hiring contractors to conduet all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions proprietors with no employees. 12.F]Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.E]Roof repairs 'these sub-contractors have employees and have workers'comp.insurance,# &.Q We are a corporation and its officers have exercised their right of exemption per MGL c. 14.[]Other 152,§1(4),and we have no employees.[No workers'camp.insurance required.] *Any applicant that checks box##1 must also fit]out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the subcontractors and state whether or not those entities have r employees, If the sub-contractors have employees,they must provide their workers'camp.policy number. 1'arrr mr elrrployer that is pr'ovidirrg rva-lfer•s'eortipensatiorr iusrrrmrce for rriy erralrinyeesY. Below is the policy arrd,lob site information. Insurance Company Name, . t _ 4 -k,,1,4,,o Policy#or Self-ins.Lie.#:X*Y,cN �_ i lq Expiration Date;- Job ate:Job Site Address: 410 ,X 1, J?. City/State/Lip: 11 r 4 Attach a copy of the workers'compensation policy declaration Mage(showing the policy number and expiration date). Failure to secure coverage as required under MGI,c. 1.52,§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 tip 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. e 71' i pntr :. rrdpert es of perjury that the btforniatiou provided above is tare and correct, SI n r4 r eb icer tr rrlt Irol y y Date: 'o .b� Official use only. Do not write It:this area,to be completed by city or town official City or Town: Perinit/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 M BLACK-1 OP ID: 13I3 p^� CERTIFICATE LIABILITY I I„Ila„I a Y s INSURANCE DATE{MMIDDIYYYY) l._.. 07r0712016 .111 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 Phone:603-424-9901 NAAME: Brown&Brown(Merrimack) PHONE - 309 Daniel Webster Highway FsX:866-848-1223_tAlc N%94):1 _ 1(A+p,..M4) _ - - Merrimack,NH 03064 ADDRESS: Chris McPhail INSURER S AFFORDING COVERAGE MAIC k INSURER A:Peerless Indemnity Ins Co 18333 INSURED Blackdog Builders, Inc, --- INSURER B:Peerless Indemnity Ins Co 18333 Blackdog Builders ---- - -- Investment Holdings,LLC INSURERC: _ Total Bsmnt Finishing Systems INSURER D: 7 Red Roof Lane Unit#1 Salem,NH 03079-2984 INSURER 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. ._._-._ ADDL SU5-it..... -------- POLICY POLICY E" ILTR TYPE OF INSURANCE POLICY NUMBER MMIDDIYYYY MMIDDPYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE_ $ 1,000,000 DAMAGE iOR"rNTr6 A X COMMERCIAL GENERAL LIABILITY BKS55511514 0710112016 07/01/2017 PRE•MISFS(Ea,occurrence $ 300,000 CLAIMS-MADE IX_..I OCCUR _MED EXP(Any.onape .. $ - --16,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000 000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ 2,000,000 1-1 POLICY PRO- LOC I $ COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY accident) 1,,000,000 jEa $_ A X ANY AUTO BAS55511514 07/01/2016 07101/2017 BODILY INJURY(Per Pe11 rson) $ -- ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS X. AUTOS — — NON-OWNED PR(3PERTY DAMAGE $ XHIRED AUTOS X AUTOS LPer accident)__ _- _ ._ S X UMBRELLA LIAR X I OCCUR EACH OCCURRENCE $ 1,000,000 B EXCESS LIAR CLAIMS-MADE US056511514 07/01/2016 07101/2017 AGGREGATE $ _ . _ .10000 DED X RETENTION$ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY QR U LMI TS. ER ...__.. ...... B ANY PROPRIETORIPARTNERlEXECUTIVE Y("1 i N 1 A XW�D56611514 07!0112016 07/0112017 E.L EACH ACCIDENT $ 500,000 OFFICERIMEMBER EXCLUDED? L� ---- .._,_ __- ---- ,. (Mandatary in NH) E.L DISEASE-EA EMPLOYEES 500,000 If yes,desaVbo under ........._ _..._........ .. ...__ _, ,....._...----- —........... DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 600,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) *David Bryan is excluded from Worker's Compensation coverage. CERTIFICATE HOLDER CANCELLATION Informational SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN onal Purposes Only J� ACCORDANCE WITH THE POLICY PROVISIONS. r AUTHORIZED REPRESENTATIVE O 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD M Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-094513 office of Consumer Aifairs&Bu inessRegnlxtion Construction Supervisor ����, r�s�� 1 HOME IMPROtJEiAEW CONTRACTOR �,`I Registration: 185183 Type: TIMOTHY S WILLIAMS � ��r � of Expiration; 5 O18 Corporation 272 CHESTNUT HILL ROAD ROCHESTER NH 03867 BLACK DOG BUILDERS„INC. DBA TOTAL BASEMENT FINISHING DAVID BRYAN f` 7 RED ROOF LN. :a m. ,aw-- 4 - Expiration: Commissioner 08/2812017 SALEM, NH 03079 Undersecretary 11-00262,5049 i Ttnis card ad dyes that the recipient has successfully completed a IC-hour tioruauf Safety and Health Training Course In Construction Safety and Health Timothy Williams "1 William Kershaw-NE01009 07/29/2010 (Trainw mare—primnt or type) (Course end ciato�w