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HomeMy WebLinkAboutBuilding Permit # 11/7/2016 1 BUILDING PERMIT "oRTij TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION ' Permit No#. Date Received �'SACFiU5 Date Issued: _.. - _ .. ENIPORTANT:Applicant must complete all items on this page L0"AT10 ', 7 ­­,"I'll)C. .4_t"I" Print PAOPERTY C7WNER Print 100 Year Structure yes €�o - MAP PARCEL. ZONING DISTRICT:' Historic District yes no Machine Sha° Villa q e es no TYPE OF IMPROVEMENT PROPOSED USE Residential CJon- Residential ❑ New Buildingefamily ❑Addition ❑ Two or more family ❑ Industrial ❑Alteration No. of units_ _ ❑ Commercial is,Re'pair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑ Well ❑ Floodplain 0 Wetlands C] Watershed District El Water/Sewer DESCRIPTION OF WORK.TO BE P ERFORMED• Identiri tion•- Please Type or Print Clearly OWNER: game: a Phone: t .,.. .. . _ Address: w. " Contractor Name. US 0 phone: 5- 11AlVa• .Address: . Date- _ Supervisor's Construction`License: Exp, Date: Home Improvement License: Exp. Dater 1 ARCHITECT/ENGINEER Phone: Address: Reg. No. FEF SCHEDULE.BULDING PERMIT.$92.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. total Project Cost: $ �_ FEE: $ y Check No.: -_...- Receipt No.- NOTE: Persorzs c®ntvacti'ag with wiregistered cr retractors cla not haves access t the guax my fun Si nature of A entlOwn —Signature of caritracto ........ ....... .. . ......................................... .... ........... .. ......... .......................................... ........... ............................. NORTIy Town of 3 n O ver, Mass, COC HICMt WICK �' P S U BOARD OF HEALTH Food/Kitchen PERMIT .T LD Septic System THIS CERTIFIES THAT R BUILDING INSPECTOR .......... ..1. 4� ...........1 ... ........,.. . ... .... ... . has permission to erect ..................... buildings on .. ..., .�.� ., �.., ............ Foundation Rough to be occupied as . .j%*'tr�j-r- .1 ' /•r` .......... Chimney provided that the person acceptingt shall in every respect conform o the terms of the application Final on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR LESS CONST I®N Rough Service 4 r... BUILD.. GeINSMOR Final GAS INSPECTOR Occupancy Permit Required to Occupy Ruildin 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. Proposal amwmw,uim,nmlamrmm»P�111GIU1�0/�Iy/ 325 Main Street North Reading, MA 01864 PAINTING & RESTORATION (978) 664-4300 derekCaa)pelusoservices.com David Laubner 84 Fox Hill Road North Andover, MA 1289 09/29/2016 E)u:SCII111P110r'l AMOUNI.. Carpentry 13,810.00 Remodel Main Bath, Master Bath andl/2 Bath. Main bath Demo floor, ,vanity, counter, sinks and toilet. Install new the floor, vanity,counter sinks and toilet. Install new bathroom fan light combo and vent out of house. Master bath Demo floor,shower surround, vanity, counter, sink and toilet. Install new the floor, shower surround,vanity, counter sink and toilet. Install new bathroom fan light combo and vent out of house. 1/2 bath Demo floor,vanity, counter, sink and toilet. Install new tile floor, vanity,counter sink and toilet. All permitting and trash removal paid for by contractor. Electrical budget of$1500 included is price. Plumbing budget of$2500 included in price. Customer responsible for tile, plumbing and electrical fixture costs including vanity and counter tops. Plumbing and electrical issues unforeseen in the walls would result in an extra. All extra work will be discussed financially be for work is started. We propose to furnish labor and materials in complete accordance with TOTAL $13,810.00 the above specifications. Accepted By Accepted Date r.' /u/dJ PeWso PAINTING & RESTORATION 01864 325 Main St.North Reading,MA RESIDENTIAL CONTRACTING AGREEMENT Read this agreement and make sure you understand it before signing it. This agreement has legal force and effect and binds those who sign it. Notice: All home improvement contractors and subcontractors engaged in home improvement contracting, unless specifically exempt from registration by provisions of Chapter 142A of the General Laws of Massachusetts, must. be registered with the Commonwealth of Massachusetts. Inquiries about registration and status should be made to the Director,Home Improvement Contract Registration,One Ashburton Place„Room 1301,Boston,MA 02108. OWNER(IIEREINAFTER"HOMEOWNER")INFORMATION No: Name: David Laubner Street Address: 84 Fox Hill Road City/Town: North Andover,MA Date: 11/2/16 `I'elephane, 617-308-0724 Peluso Painting iZeion agrees to do the following work for the HOMEOWNER at (Detailed specifications are provided in the proposal dated September 19th,2016,which is attached hereto and incorporated herein by reference). TOTAL CONTRACT PRICE AND PAYMENT SCHEDULE; e Haln eawnCl' S .tractor' the ( ) e Can y ials and work. erformanc�, specified above by t11 , labor, materials of the P , Irl consideration agree(s)to pay Contractor the total stun of $13,810 Payments will be made according to the following schedule; $ 1.300.00 Nan-refundable deposit upon signing. $ 5000.00 Start of the: demo $ 4000.00 Start of the: tile. $ 351.0.00 Completion of: vanity install All payments to be made the days of invoicing. If payments are not made within fifteen days of the invoice date,a late charge in the amount of 1.6%of said payment shall be assessed for every(30)day period that said payment(s)remain outstanding. If other contractors are employed by the Homeowner,payments to Contractor cannot be delayed due to incomplete or insufficient work of other contractors. If non payment becomes a legal matter,Homeowner will be responsible for all legal fees incurred by both parties. NOTES: (*)including all finance charges. (**)Law requires that any deposit or down-payment required by the contractor before work begins may not exceed the greater of(a) one-third of the total contract price or (b)the actual cost of any special equipment or custom-made material which must be special ordered in advance to meet the completion schedule. l PROPOSED START AND COMPLETION SCHEDULE Contractor will not begin work or order the materials before the third day following the signing of this contract unless specified herein in writing. The following schedule will be adhered to unless circumstances beyond the contractor's control arise: Date when Contractor will begin contracted work: within(10)business days of permit approval. Date when contracted work will be substantially completed: within (60) business days of start date above. NOTWITHSTANDING ACCEPTANCE OF THIS CONTRACT BY CONTRACTOR,THIS CONTRACT SHALL BE CANCELABLE BY THE CONTRACTOR IF HOMEOWNER IS UNABLE TO FINANCE THE PAYMENT OF THIS WORK THROUGH AN ESTABLISHED BANK OR OTHER FINANCIAL INSTITUTION, WHEN REQUIRED BY THE CONTRACTOR OR WITHIN FIFTEEN(1 S)DAYS. LIEN OR SECURITY INTEREST Unless otherwise noted,the contract shall not imply that any lien or other security interest has been placed on the property: SECURITY INTEREST YES NO ACCELERATED PAYMENTS Contractor may not demand payments in advance of the dates specified on the payment schedule. In cases where the Homeowner deems him/herself to be financially insecure,the Contractor may require 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. RE,QUIltED PERMITS-The following permits are required and will be secured by the Contractor as the homeowner's agent:(Building) Notice: Homeowners who secure their own permits will be excluded from the Guaranty Fund provisions of MGL Chapter 142A. The contractor shall not be deemed responsible for delays in the work described in this agreement caused by regulatory,permit granting or inspectional agencies,authorities or individuals. WARRANTIES Contractor guarantees its labor, materials and workmanship for one(1) year from date of completion. Contractor will replace defective labor,workmanship and material within the period of guarantee free of charge. All requests must he in writing. All warranties for equipment supplied by the Contractor under this Agreement shall be those given by the manufacturers of such equipment, which shall be and are hereby transferred through directly to the homeowner, Under such manufacturer's warranties,the Homeowner may be required to register or mail in a warranty card or other evidence of ownership and use of such equipment in order to activate such warranties. The Homeowner's failure to mail in or register such documentation,which failure voids the manufacturers warranty,shall not create any responsibility for the contractor to warranty such equipment. INSURANCE Contractor shall indemnify and hold Homeowner harmless for any third party damage or bodily injury caused by Contractor, its employees or subcontractors in the performance of or as a result of the work under this Agreement. Contractor agrees to carry workers compensation and liability insurance of no less than $1 million person $2 million accident to cover such damage or injury. Prior to the start of work Contractor shall provide Homeowner with an insurance binder naming Homeowner as an additional insured. 2 SUBCONTRACTING Contractor agrees that notwithstanding any agreement for materials and/or labor Contractor and a third party,Contractor is responsible to Homeowner fcompletion of all.work describin timely and workman like manner. Contractor shall indemnify and hold Homeowner or harmless for any mechanics liens ed or other liens filled by any subcontractor on the prqject, including all legal fees and costs incurred in resolving any lien issue. - e Homeowner's initials Contra tors orsAitials CONTRACTOR ARBITRATION ith the right to initiate an arbitration action (as an The Home Improvement Contractor Law provides Homeowner w alternative to court action)if s/he has a dispute with Contractor, The same right is not automatically afforded Contractor. The Contractor would have to resolve any dispute it has with a Homeowner in court unless Contractor andflomeowner agree to the optional clause provided below. The clause would give the contractor the same right to arbitration as is afforded to the Homeowner by the Home Improvement Contractor Law. Contractor and 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 tile Secretary of the Executive Office of Consumer Affairs and Business Regulation. Such arbitration is not mandatory and binding. Homeowner retains the right to resolve any dispute through the courts. n rning e tary cc] ere d binding. Contractor Homeowner NOTICE: The signatures of the parties above apply only to the ern of the resolution tto alternative dispute resolution initiated by the Contractor. The Homeowner way initiate alternative dispute resolution even where this section is not separately signed by the parties. MODIT41CATION c tu e entire agreement of the including the provisions relating to price and payment schedule, onsti t s I'llis contract, inc presentations and/or warranties,expressed or implied,shalltile be binding on either party parties and no other agreements,rept by a written statement signed by both contractor and Homeowner,Any performed hereto and cannot be changed exec ts ofmaterials or labor will be furnished and deviation on the specifications listed above involving extra cos parties and will be in addition to the cast price of the contract. bboth p only upon written change order dated and signed . - CONFLICT OF TERMS AND CONDITIONSregulation,ordinance or rule of law,such provisions shall If any provisions of this contract are in conflict with any statute be deemed null and void to the extent that they May conflict therewith,but without invalidating the remaining provisions hereof. HOMEOWNER'S RIGHTS A homeowner's rights under the Home Improvement Contractor Law (MGL Chapter 142A) and other consumer protection laws(IE: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. Contractor represents and warrants that it is duly licensed by the Commonwealth of Massachusetts # 75630 to perform the work provided for this Contract. 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. 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 any questions about your consumer/homeowner rights, contact the Consumer Information Hotline: Executive Office of Consumer Affairs and Business Regulation One Ashburton Place,Room 1411 Boston,MA 02108(617)727-7780 HOMEOWNER'S RIGHT TO CANCEL Subject to the provisions stated below (Contractor's Right to Cure), the Homeowner may cancel this contract if it has been signed by the Homeowner at a place other than an address of the Contractor which may be his main office or branch thereof provided that the Homeowner notifies the Contractor in writing at his main office or branch by ordinary mail, posted by telegram, sent or by delivery, not later than midnight of the third business day following the signing of the Contract. CONTRACTOR'S RIGHT TO CURE Should the Homeowner deem work completed by the Contractor unsatisfactory,the Homeowner must notify the Contractor in writing by first class mail and allow the Contractor 10 business days from receipt of the Homeowner's written notice in which to cure said work indicated in the written request to the Contractor. Homeowner shall not terminate any agreements with the Contractor,unless Contractor has been afforded its right to cure after Homeowner's written request as required by this clause. NOTICE OF CANCELLATION You may cancel this transaction,without any penalty or obligation,within three(3)business days from the date of execution of this transaction. If you cancel, any property traded in, any payments made by you under the agreement, and any negotiable instrument executed by you will be returned within ten (10) business days following receipt by the Contractor 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 contractor at your residence,in substantially as good condition as when received,any goods delivered to you under this agreement,or you may if you wish,comply with the instructions of the Contractor regarding the return shipment of the goods at the Contractor's expense and risk. If you do make the goods available to the Contractor and the Contractor does not pick the goods up within twenty (20)days of the date of your notice of cancellation,you may retain or dispose of the goods without any further obligation. If you fail to make the goods available to the Contractor,or if 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 contract. This transaction can be cancelled by mailing or delivering a signed and dated written notice identifying Homeowner's name, address, contract number, and stating"I wish to cancel" or any other written notice, or sending a telegram to: Not later than midnight of November 6,2016 (Date of third day after transaction date). 4 CONTRACTOR'S RIGHT TO CANCEL This Contract may be cancelled by an officer of the Contractor,but only within three (3)business days ftom the date of execution and in a similar manner of the Homcowner('s)right of cancellation. EXECUTION OF CONTRACT This Contract must be executed in duplicate and should not be signed until a copy of all exhibits and referenced documents that are incorporated herein are attached hereto. Homeowner is ft-ther advised not to sign this Contract unless and until all blank sections have been filled in or marked as void, deleted or not applicable. I-lomeowner(s)hereby certify(s)that s/he has (they have)read this Contract, that the terms and conditions and the meaning thereof have been explained to her/hini(them)and s/he(they)fully understand said terms and conditions. HOMEOWNER: DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. TWO IDENTICAL COPIES OF THE CONTRACT MUST BE COMPLETED AND SIGNED. ONE COPY GOES TO THE, HOMEOWNER,THE OTHER COPY TO BE KEPT BY THE CONTRACTOR. ITNE'S' u hands and seals this day of 2016. By: Representative flomeown Accepted By: Homeowner 5 AllllITIfDNAL S 1. Contractor responsible for items that are listed in proposal documents provided by the contractor and accepted by the homeowner. 2. Contractor responsible for any accepted proposals(signed and dated by homeowner and contractor) accompanying this contract. 3. Change orders will be paid in full at time of signing and before work on the change order begins, 4. Homeowner is responsible to clear area for construction. Contractor: r-7 Homeowner III'. Homeowner: the Cotnmoniveazth ofHassachusetts _ ,Department of IndustriarAccidents `><te 1.00 I Congress Street, Su d Bosto.0 MA 0211420.).'% t www.mass.gov/dia b ygavkers' compensation bxsurance A da n:�uiidere}slCon actox s/ Xec rzcians/ 'num err. TO BE' `Xyl'E:[tMX.'SWN(x.&UTk0I0Y- Pleasek'rilnt Legibly A licant:)mornlation 4 NaMO(BusinesslOigahization/tzxdividual): ycit — — _ -4 Type of project(recpxired,); Axe you anexuployex?Cb cent tli e appropriate T�ox: r� ❑ (e 'CtQnStr'on 1,. `1 am a employer with 1 employees(full and/or part tune). - g. � emodel3iag 2.�Iarnasaleproprietororpartnerslripandhavenoemployeesrorking£armoire 9` ElDemolition any capacity.[Noworkers'comp,insurance required.] El 3.[j I am ahomeownerr doing all work myself [No workers'comp.insurance required.:]t 10[]:Building addition 4.�I am a homeowner and will be hiring eoutractors to conduct all work on my property. I will 11.0 Electrical repairs ar'additioxxs ensure that all contractors either have workers'compensation insluance or are solo � Lt Y b g ropaIrs or additions proprietors with na employees. S_�I am a general contractors and I wave hired the sub-coaltractozs listed an the attached sheet. 13�,]1�:b6 xeliairs Phase sub-contractors have omplayees andhave workers'aaznp.insurance t 14.r]Other 6,L—]We are a corporatiog and its,officers have exercised their right of cxemptio upder MGL Q. 152, V have no employees.[No workers'comp,insurance zequ l _ h applicautthat ehow showmg their worker ecJs beic#1 davitinsdi altnngtheyaredoingthe lallworkandtheahireoutsidecontracorsmustsubmiPolicy rtmanewaflidavituzdicafiaagsixch. Homeowners who submit thig a£tn• . actors lContractozs that checkthis 13ok oh va em ed bn,additional sheet y must provide their h orks'c orap.poli y number,�d stufe� wh er or not those entities ave employees. Hthe sub-contractor ` P te_—.-- ----eern. to ex that is providing for°ceras'compensation insurancefor my empl®yees. Belasv is the paZrcy ararl job site X erre an � .7' information. 1usurance Company ExpirationD�.te� f Policy#or Self ins.Lic.#: _ __ __ _ _ Ike ._. City/state/Lip:'OXAA rob Site Addxoss: - arc declaxationpage(rho vixagth0poHeynumberandexpxxatzoa� Attach a copy ot'the v�gx•lt_ers coxnpensatxan p y 500.00 Failure:to secure coverage as required under MOIL G. 152,§25A is a criz of a STOviolation punishable by a ne of up too $ anal/or one-year iluprisonment,as well as civil penalties in the aoled to the Ol ail ORDER ns of the D7A.for ixas�urallc0 a day against-the violator. A copy otlzis statementmay be iozw _ coverageverification. _ � - -- --- Xda1aereli under' painsan�ler2altiesoferjurythattheinfarr7zattonpravicle hove is �carrec. Sixataue: P—hono 4' pffcial use only. Do notwrite in triis area,to 7� completed by CRY ar'toft�n official City or own: - — — - Permit/MCWse# _ — ZssuingA.lxthoxity(circle one): i :1:.13oardoffloat fll 2"E3zxxldiugDepax€went 3.CitylToWAClerk 4.Elect a.PluxnbixxgZxxspectox 6.0 ther PlIouell ContactPexson:v i i I .�►Co DATE CERTIFICATE OF LIABILITY INSURANCE 1013112016 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 endarsement(s). PRODUCER NAME: Automatic Data Processing Insurance Agency,Inc. PHONE 01- lC I Ext): arC.No): ADDRESS:1 Adp Boulevard ADDRESS: Roseland,NJ 07068 INSURER(S)AFFORDING COVERAGE NA1C# INSURERA: AmGUARD insurance Company 42390 INSURED PELUSO PAINTING AND RESTORATION LLC INSURER 8: 325 Main Street INSURER C: Suite 301 INSURER D: North Reading,MA 01664 INSURER E: INSURER P COVERAGES CERTIFICATE NUMBER: 571801 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. LTR TYPEOFENSURANCE lNSD WVD POLICY NUMBER MMIU�YNYYY MNtIDDIYYYY LIMITS COMMERCIAL GENERAL.LIABILITY EACH OCCURRENCE $ CLAIMS-MADE ❑OCCUR -DAW�TFEI1 PREMISE'S Ea occurrence $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY❑PRO- ❑LOC JECT PRODUCTS-COMPIOPAGG $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS NDN-OWNED PROPERTY DAMAGE AUTOS $ Pet accident $ UMBRELLA LlAB OCCUR EACH OCCURRENCE $ EXCESS LUIS CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN X STATUTE ER"_ ANY A OF ICERIMEMBER EXCLUDED? NIA N PEWC734158 07/09/2016 07/0912017 E.L.EACH ACCIDENT $ 1,000,000 (Mandatory to If yes,describe under E.L.DISEASE-EA EMPLOYEE $ 1,000,000 DESCRIPTION OF OPERATIONS betpw E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attachad if mare space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of North Andover ACCORDANCE WITH THE POLICY PROVISIONS. Attn:David Laubner 84 Fox Hill Road North Andover,MA 07845 AUTHORIZED REPRESENTATIVE A©1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD i `4C"R" CERTIFICATE OF LIABILITY INSURANCE DArE(MMIDDmrvv) 2/3/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT. if the certificate holder is an ADDITIONAL INSURED,the pol)cy(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). PRODUCER CONTA AM E:CT Linnane Insurance Agency Inc. PHONE (978y564-2000 FAx (978)664-0180 280 Main. St. #101 E-MAIL INSURERS AFFORDING COVERAGE NAIC N N. Reading MA 01864 INSURER Main St. America INSURED INSURER B: Peluso Painting & Restoration LLC INSURER C: INSURER D: 325 Main 3t: Suite 301 INSURER E: North Reading MA 01864 INSURER F: COVERAGES CERTIFICATE NUMBER:CL1313100854 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. IAODL SUER LTR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER MM DD DD Y LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 11000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Eaoccurren.e $ 500,000 CLAIMS-MADE F0 OCCUR APT050114 /28/2016 /28/2017 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOPAGG $ 2,000,000 POLICY PRO- LOC Is AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident _ ANY AUTO BODILY INJURY(Per pe(son) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS NON OWNED AUTOS PROPERTY DAMAGE(Per accid $ $ UMBRELLALIABI»OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MAO AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION WC STATU- 47H- AND EMPLOYERS'LIABILITY ER ANY PROPRIETORIPARTNEMEXECUTiVE Y 1 N E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? NIA (Mandatory in under E.L.DISEASE-EA EMPLOYE $ If es,describe aund b SCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of North Andover ACCORDANCE WITH THE POLICY PROVISIONS. David Laubner 84 Fox Hill Road AUTHORIZED REPRESENTATIVE North Andover, MA 01845 M Linnane/LINKL1 ACORD 25(2010105) ©1988-2010 ACORD CORPORATION. All rights reserved. 1NS025{zaioo5).a1 The ACORD name and logo are registered marks of ACORD G �a1.Jrrr�rrle(/.7 Office od'Consumer Affairs&Bnsi less Regulation License or registration valid for individul use only msOME IMPROVEMENT CONTRACTOR before the expiration(late. If found return to: egistration: 169554 Typo: Office of Consumer Affairs.and Business Regulation I xpiration: -7/5/2017 . Individual 10 Park Plaza-Suite 5170 THOM S PELUSO Boston,MA 021.16 i THOMAS PELUSO 200 CHANDLER ROAD ANDOVER, MA 01810 Undersecretary Not valid without sign,._�e_. .t lata tattllsett Department Of Ptiblic Safety Bayard Of BUiiding Regulations and Standards 102590 THOMAS M PPL 200 Chandler.Roag ; J Andover 114A 01910 �' ..� grata�• Corramissione�r Pir«ana l"I 04/04/2017