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HomeMy WebLinkAboutBuilding Permit # 12/19/2016 BUILDING PERMIT 3? g" =° 04 TOWN OF NORTH ANDOVER ° d APPLICATION FOR PLAN EXAMINATIO 1`7 Date Date Received dpi o Permit NO: (�' 'li �AATed �SS¢1CH�1S�� Date Issued: IMPORTANT: Applicant must complete all items on this page w / IR Fx d � G l ✓ � (f y Cr TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building VOne family ❑ Addition 11 Two or more family El Industrial 'Alteration No. of units: El Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other t1�eC[ l l O� � Remodel second floor hallway bathroom approx. 75 SF in existing footprint. Remove fixtures and finishes. Install new Mures and finishes. Update electrical and plumbing. Remodel Master bathroom in expanded footprint into hallway and closet approx 58 SF. Remove existingfixtures and finishes. Install new fixtures and finishes. U date electrical and lumbin . Identification Please Type or Print Clearly) OWNER: Name: Joshua and Astrid Sheehan Phone: 617 935-3141 Address 759 Great Pond Rd North Andover MA 01845 C111. ITT, �a€�� tel Itl� 1 �i / l� NORTkf own of ndov( O M No. C)611 it - _ 0 ' h LAKE ver, Mass O �w .p COCHICNRwICK RArev J'p�`,��(`7 U Food/Kit PERMIT T D Septic Sy THIS CERTIFIES THAT .Thf! 4.0 144.44!"Y............I....................... .................. &b Foundat 7_50f ' has permission to erect.......................... buildings on .... ...... .�. ! ..,,... oo......... .RgMOEI. .44!!x.0. ... . .. . ..... .......p rlocol Rough to be occupied as . ..,.. chimney provided that the person accepting this permit shall in every res ect conform to the t ms 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. VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS UNLESS CONSTRUCTI TART Rough ......... .. .. ... .................... ...,.......... Service Final BUILDING INSPECTOR Occupancy Permit Reguired.to Occupy Building Rough Display in a Conspicuous Place on the Premises - Do Not Remove Final No Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building Inspector. Burner Street N( Smoke D 214 Sutton Hill Rd ON Contract North Andover MA 01845 ' ' Sheehan_759_Great_Pond_Rd_3 978 852-4491 Tm www.TMKremodeling.com REMODELING CONTRACTOR AGREEMENT THIS AGREEMENT made this _ s • _ y 20\L� by and between TMK Remodeling, LLC Construction Supervisor License#105086,214 Sutton Hill Rd, North Andover MA 01845 hereinafter called the Contractor, and Astrid&Josh Sheehan hereinafter called the Homeowner. WITNESSETH,that the Contractor and the Homeowner for the consideration named herein agree as follows: ARTICLE 1.SCOPE OF THE WORK The Contractor shall perform all of the work described in the specifications entitled Exhibit A—Statement of Work, as annexed hereto as it pertains to work to be performed on property located at 759 Great Pond Rd North Andover MA 01845. Work Scope Summary:Remodel second floor hallway bathroom approx. 75 SF in existing footprint. Remove existing fixtures and finishes. Install new fixtures and finishes.Tile tub/shower stall and tiled floor over radiant heat mat. Build recessed shelf over right end of vanity in closet area. Frame 2 recessed medicine cabinets. Relocate closet doors away from shower stall. Install approx 12 LF 42"wainscot PVC beadboard, base and cap. Remodel Master bathroom in expanded footprint into hallway and closet approx 58 SF. Remove existing fixtures and finishes. Install new fixtures and finishes. Remove hallway closet and floor. Remove existing door and frame. Construct new entry door from bedroom. Install 72x21"double bowl vanity and countertop, lav faucets. Frame out 48x32 shower stall. Relocate toilet. Reframe floor as needed.Tile shower walls wl bench if possible. Tile floor over radiant heat mat. Install heattfan combo unit. Remove baseboard radiator. ARTICLE 2.TIME OF COMPLETION The work to be performed under this Contract shall be commenced on or before December 12,2016 and shall be substantially completed on or before February 03,2017 ARTICLE 3.THE CONTRACT PRICE The Homeowner shall pay the Contractor for the labor and materials to be performed and supplied under the Contract the estimated sum of Sixty Six Thousand One Hundred Eighty Dollars and No Cents($66,180.00), subject to additions and deductions pursuant to authorized change orders. The contract price includes two components; Fixed cost of Forty Nine Thousand Six Hundred Twenty Seven Dollars and No Cents($49,627.00)for the building materials and construction labor as specified in Exhibits A and B. Variable cost of Sixteen Thousand Five Hundred Fifty Three Dollars and No Cents($16,553.00)for the allowance items listed in Exhibit B Allowances and will be 190%of the actual invoice price paid by the Contractor to his suppliers. Exhibit B lists the allowance items and budget costs the Contractor will purchase for the Homeowner. Sales tax and freight are not inlcuded in allowance budget. Contractor will furnish and install all building materials,fixtures and finish items unless noted otherwise. Any Homeowner supplied materials will be charged a 15%handling and coordination fee based on actual invoice, Project Breakdown Project admin and overhead;$11,078.00 214 Sutton Hill Rd Contract North Andover MA 01845 Sheehan 759 Great Pond Rd 3 978 852-4491 Tm _ www.TMKremodeling.com REMODELING 12. Contractor warrants all work for a period of 12 months following completion. 13. Contractor may post small signage(36x36")on property advertising services during the duration of the ' project. 14.The Contractor and subcontractors shall be registered and any inquiries about a contractor or subcontractor relating to a registration should be directed to: Office of Consumer Affairs and Business Regulation Ten Park Plaza, Suite 5170 Boston, MA 02116 Phone: (617) 973-8700 15. The Contractor or Homeowner may terminate this contract at any time for reasonable cause by giving 3 days notice in writing to the other party. If either party terminates the contract as provided herein,then the contractor will be paid for work(labor and materials) completed as of the date of termination plus any materials or equipment that are backordered and not delivered. Payment is defined as actual job costs for the project plus 15%overhead charge,plus 15% profit. The contractor will provide a written report detailing actual job costs plus overhead for payment. The Contractor will refund any funds paid by the Homeowner that are a remaining balance for the labor and materials used as of the date of termination, plus any materials or equipment that are backordered and not delivered, plus 15%overhead charge, plus 15%profit. The Contractor will make arrangements for the backordered items to be delivered to the Homeowner. Upon written notice of termination,the Contractor will have 3 days to close down the job site including removing tools, equipment, materials and ensuring the job site is safe and clean. The Homeowner will provide access to the job site to the Contractor over this 3 day period. 16. The Homeowner is responsible for maintaining adequate access to the property including snow removal, personal property storage, and working doorways, stairways and walkways. In the event the contractor is required to provide access or repair to the doorways, stairways and walkways,then the Contractor will bill the Homeowner at the hourly bill rate for same. ARTICLE 6.OTHER TERMS _ ARTICLE 7.ACCEPTANCE Signed this ti� day of 20 214 Sutton Hill Rd North Andover MA 01845 978 852-4497 TKOK www.TMKremodeling.com REMODELING A B C D 1 Owner: 2 Astrid&Josh Sheehan Estimate No:2016-115.3 3 759 Great Pond Rd Estimate Date-.1 1/2912016 4 North Andover MA 01845 5 astridl.sheehan@gmail 6 617 935-3141 7 8 Scope of Work Remodel second floor hallway bathroom approx.75 SF in existing footprint.Remove existing fixtures and finishes. Install new fixtures and finishes.Tile tub/shower st4 Build recessed shelf over right end of vanity in closet area.Frame 2 recessed medicine cabinets.Relocate closet doors away from shower stall.Instal approx 12 LF 4, cap.Remodel Master bathroom in expanded footprint into hallway and closet approx 58 SF.Remove existing fixtures and finishes. Install new fixtures and finishes.Ri existing door and frame.Construct new entry door from bedroom.Install 72x21"double bowl vanity and countertop,lav faucets.Frame out 48x32 shower stall.Reloca 9 shower walls wl bench if possible.Tile floor over radiant heat mat.Install heat/fan combo unit Remove baseboard radiator. 10 Notes: 11 Pricing includes labor and materials to install finished item+allowances. EA=Each LF=UnE 12 EA LF 13 Quantity Cost Quantity _ . 14 i.0 Adm{nistratton_._., -. _._.._"_ __._.. -. _ _.m_.. _.._.._. __. _...._- _._ _ _ _.._ _ __..._ :-15.$11,078 T 15 01 Plans and Permits.01.2 Building Permits 3 $1,042 16 07:0 Permit-Building 1 $792 17 02.0 Permit-Electrical 1 $125 18 03.0 Permit-Plumbing 1 $125: 19 01 Plans and Permits:01.3 Building Inspections 6 $390 24 .06.0 Rough.Inspection-Electrical 1'': $65 21 07.4 Rough Inspection-Plumbing 1 $65 22 08.0 Rough;Inspection-Building 1 $65 23 09.0 Final Inspection-Electrical 1 $65 24 ':10.0 Flnai;Inspectron.=Plumbing . 1 $65': 25 11.0 Final Inspection-Building 1 $65 26 nSlte Work 5' $1,012:. 27 20 Yd Dumpster 1 $605 28 Adjacent spaces to.be protected byy temporary barriers from dust infiltration 1 $132 29 All floor coverings and hand rails between the work area and primary entrance to be covered with protective covering material 1 $171 30 ,Ow[ier`responsible for storing any Items to re-installed 1 $0 31 Work area to be vented during demolition and construction to minimize dust infiltration 1 $105 32 31:'.Ovarhead&Expenses 1.? $8,634 33 Overhead and project administration 1 $8,634 34 26d Fir Hallway Bathroom' 75 SF _ _:. _ ._... _. m .m_ _ __.. __.m. .44 575,507-- 271 35 02 Site Work:02.10 Demo 9 $679 36 Disconnect and remove doorframe and molding 1 : $105 37 Disconnect and remove electrical fixture 3 $157 38 Disconnect and remove plumbing fixture % 4 $209` 39 Remove finished floor and sub#four. 40 _Rernove tublshower stall . 1 $209 41 Remove wall/celling(partial)finishes to expose framing. 42 07Wall Frame 5 $791.. 43 Frame out shower/tub stall for tub and finish file installation. 1 $209 ©Copyright TM Remodeling,LLC All Rights Reserved ;3. Page-4 Unlaw 214 Sutton Hill Rd North Andover MA 01845 978 852-4491 TmlwK www,TMKremodeling.com REMODELING LING A B C D 44 :Frame wall for recessed medicine cabinet 2 $327 45 Install blocking in wails for fixtures,cabinets or accessories 1 $118 46 install fire stopping in stud wall cavities 1 . $138- 477-12 Doors&Trim 2 $1,050 48 30x78180"interiordoor opening in load bearing wall 1 $236 49 Furnish and install Pair 15118/21124x78180"interior doors,frame,trim,handset,painted 1 $814 50 14 Plumbing 6 $3,176 51 Furnish and install 10'of 112"PB(supply lines 1 $319 52 Furnish and install 6Ox30 tub AS Amerioast tub - 1 $1;157' 53 Install 66x21"bathroom vanity,countertop,2 sinks,2 faucets+fixture allowance 1 $679 54 Install toilet w/new flange,-shut,off,wax ring+fixture allowance 1 $353. 55 install Tub Shower Setup:Valve w/diverter,trim,tub spout and overhead spray +fixture allowance i $493 56 Remove.baseboard radiator,re-connect heating loop..: 1 $175 57 15 HVAC 1 $440 58 Furnish&install. metal ducting,and vent caps,vented to exterior for appliance 1 $44p 59 i6 Electrical&Lighting ..8 $2,792 60 Electrical Demo Budget:Invoiced at1`T&M+15%. $500' 61 Fumish and install 5"recessed wet space fixture on new switch 1 $242 fit Fumish and..instap GFCI outlet on new circult ~, '2: $472', 63 Fumish and install Panasonic 110 CFM fanAight combo unit on new switch 1 $638 64 Furnish and install Radiantheaftbermostat on new circuit 1 $463 65 Furnish and install surface mounted fixture on new switch+fixture allowance 2 $477 66 181nterlor:Walis 252 67 1 side wall finish: 42"H wood wainscot bead board panels over 112"drywall,wood rail,wood baseboard,painted 12 68 :1:,side wall finish:1/2"plasterbase,plaster skim.coat,3 coats paint 69 Prep,Prime(1 coat)and Paint(1 coats)trim 24C 70 19 Ceilings.&Cover 71 Ceiling-112"plasterbase,plaster skim,2 coats paint on 1x2 strapping 72 20 Millwork.&.Trim. 12 73 Install and finish custom millwork+materials,painted 12 74 22 Specialty: 5' $2,130 75 Fumish&install Wheat radiant heat mat 8x4' 1 $756 76 install Accessories:towel rod,,TP.holder,fiend towel +fixture:allowance 1, $169 77 Shower 12x18"2 tiered wall niche,3/4"granite shelves 1 $611 78 .Shower Accent 4"strip-12 LF grout and seal joints+file allowance 1 $352' 79 Shower Bullnose 3x6 30 pes,grout and seal joints+the allowance 1 $242 80 Shower:Walls custom the on cement board backer, grout and seal.joints :the allowance 81 23 Floor Coverings 82 Floor 12x12 porcelain or ceramic tlle,.grout and seal joints+-tile allowance 83 33 Allowances 8 $4,450 1: 84 66x21!'Vanity,2 sink;2aav faucet f $2,500 85 Accessories:towel rod,TP holder,towel rings,shower curtain rod 1 $300 86 :Bullnose.tile: 87 Floor'file 88 Granite'Countertop 89 Light Fixture 2 $15fl 90 Mlrrorlmedicine cabinet 2 $609;': ©Copyright TMK Remodeling,LLC ? i All Rights Reserved �� ' Page-5 Unlaw 214 Sutton Hill Rd North Andover MA 01845 978 852-4491 TK- www.TMKremodeling.com Mib ODEt LNG A B C D 91 Shelving materials 12 92 =Shower:wall accent file " 93 Shower wali file 94 ;Toilet 1 : $450' 95 Tub Shower setup:valve,diverter,tub spout,spray,unions 1 $450 96 2nd Fir Master..Batlironm="58-5F 47 $20,181 ' " 13f --------- .._.-.._ -___.,_.._ 97 02-SiteWork.02.10Demo __... ..,.. _.._. .._ 10 $836 98 Disconnect and,remove.door,frame'and:molding 3. $314: 99 Disconnect and remove electrical fixture 3 $157 104 Disconnect and remove plumbing fixture" _ 3:.` $157. 101 Remove finished floor and sub floor. 102 Remove tub/shower stall1 :. . $209 103 Remove walllc6ling(partial)finishes to expose framing. 104 07.Wa1l Frame2 $255 A 105 Install blocking in walls for fixtures,cabinets or accessories 1 $118 106 install fire stopping in stud wall.cavities, 1 ' :$138. 107 interior 2x4 Wall Construction 2 sides,8'high,plaster base,plaster skim coat,3 coats paint,wood baseboard 108,12 Doors&Trlm 2 $709" . 109 30x78180"interior door opening in load bearing wall 1 $236 110"Fumish:and install 24/28130x78/80"interior door,frame,trim,handset,:pa€nted 1 $473 111 14 Plumbing 8 $3,789 112 Furnish and install IV of 112"PEX supply.lines 1 $319 113 Furnish and install 10'of 2"PVC waste fine and vent 1 $330 114 Furnish and install 10`,of 3"-PUC waste dine and vent 1 $341: 115 Furnish and install 6ox3o tub AS Americast tub 1 $1,157 116 Install 72x21"bathroom.vanity;:countertop,2 sinks,2 faucets+fixture allowance 1 $679 117 Install Shower Setup:Valve,trim overhead spray,hand held spray,union +fixture allowance 1 $435 118 Install tolletwl new flange',:shut-off,.wax ring+fixture allowance 1 $353 119 Remove baseboard radiator,re-connect heating loop 1 $175 120 15 HVAC 1 $440 121 Furnish&install 4"metal ducting and vent caps,vented to exterior for appliance 1 $440 122 16 Elactrlcal&Lighting a $3;089 123 Electrical Demo Budget.Invoiced at T&M+15°/a 1 $500 124 Fumish and.install'5'"',recessed wet space fixture on new switch 1 .$242 125 Furnish and install GFCI outlet on new circuit 2 $472 126 Famish acid install"P.anason-ic 110 CFM'.heat/fanhight combo unit on.new switch&circuit T $935': " 127 Furnish and install Radiant heat thermostat on new circuit 1 $463 128 Famish and install surface mounted fixture on new switch+fixture allowance 2:: $477 129 18 interior Walls 121 130 1 side wall finish,1/2r plasterbase,.plaster skirl coat,.3 coats pant 131 Prep,Prime(1 coat)and Paint(1 coats)trim 121 132 19:Ceilings&cover: 133 Ceiling-1/2"plasterbase,plaster skim,2 coats paint on 1x2 strapping 134.211 MiiluVork&Trlm` 1; 135 install and finish custom millwork+materials,painted 1: 136 22.Specialty 7 '$4,049' 137 Furnish&Install Nuheat radiant heat mat 8x4' 1 $756 Q Copyright TMK Remode€ing,LLC �a All Rights Reserved �� Page-6 Unlav+ 214 Sutton Hill Rd IPM North Andover MA 01845 " 978 852-4491 www.TMKremodeling.com REMODELING A 8 C---J D 138'Install:Accessories:towel rod,TP holder;.hand towel ring+fixture allowance 1 $169 139 Shower 12x4'2 tiered wall niche,314"granite shelves 1 $611 14o Shower Accent 4"strip-:12 LF,grout and seal joints+tile allowance 1 $352 141 Shower Bench seat 18x36"1 114"granite slab with standard edge 1 $467 142 Shower:Bulinose 3x6 30:pcs,grout and seal joints+the allowance 1 $242 143 Shower Floor 2x2 porcelain or ceramic tile,grout and seal joints+the allowance 144 Shower Stall-2x4 frame rubber membrane floor,pitched mortar mud pack floor,drain,112"cement board walls;taped and mortared 1 $1,453 145 Shower Walls custom tile on cement board backer, grout and seal joints+the allowance 146 23 Floor Coverings 147 Floor 12x92 porcelain or ceramic tile,grout and seal joints+the allowance 148 33 Allowances: 9 ' $7,fl t5 149 72x21"Vanity,2 sink,2 lav faucet 1 $2,500 150 Accessories:towel rod,TP holder,towel rings,shower curtain rod 1 $300 151 Bullnose file _ 153 Granite Countertop 154 LightFixture: 2 $150 155 Mirrorlmedicine cabinet 2 $600 156 Shower floor file.: 157 Shower Glass:112"Tempered frameless glass door and panel system 60x66" 1 $2,365 158.Shower pieces 159 Shower setup:valve,diverter,sprays,unions 1 $650 160 Shower wall accent file 161 Shower wall tile 962 .Toilet .$450 163 Grand Total _.___. _ 106 $46,766 41 l T ©Copyright TMK Remodeling,LLC All Rights Reserved Page-7 Unlaw 214 Sutton Hill Rd oph Exhibit B-Allowances North Andover MA 01845 Sheehan T759_Great_Pond�Rd 3 978 852-4491 TOC www,TMKremodeling.com RE,MODELING Owner: Astrid&Josh Sheehan 759 Great Pond Rd North Andover MA 01845 astridl.sheehan@gmail 617 935-3141 Estimate Date:11/29/2016 Estimate No:2016-115.3 Note: Tax and freight charges not included in allowance budget. Allowances Schedule Category 33 Allowances Row Labels Quantity Cast 2nd Fir Hallway Bathroom 75 SF.. 200 $6,694 - _..:._.... .... . _. x21"Vanity, 2 sink, 2 lav faucet 1 $2,500 Accessories: towel rod, TP holder, towel rings, shower curtain rod 1 $300 Bullnose tile 24 $144 Floor tile 60 $420 Granite Countertop 12 $900 Light Fixture 2 $150 Mirror/medicine cabinet 2 $600 Shelving materials 12 $120 Shower wall accent tile 4 $100 Shower wall tile 80 $560 Toilet 1 $450 Tub Shower setup: valve, diverter, tub spout, spray, unions 1 $450 2nd Fir Master Bathroom-58 SF 209 $9,859 72x21 ..i... . Vanity 2 sink, 2 lay faucet 1 $2,500 Accessories: towel rod, TP holder,towel rings, shower curtain rod 1 $300 Bullnose tile 24 $144 Floor tile 50 $350 Granite Countertop 12 $900 Light Fixture 2 $150 Mirror/medicine cabinet 2 $600 Shower floor tile 12 $120 Shower Glass:1/2"Tempered frameless glass door and panel system 60x66 1 $2,365 Shower pieces 8 $600 Shower setup: valve, diverter, sprays, unions 1 $650 Shower wall accent tile 4 $100 214 Sutton Hill Rd Contract North Andover MA 01845 Sheehan 759_Great_Pond_Rd�3 978 852-4491 Tm www.TMKremodeling.com IMIMODLUNG The contract cost for mutually agreed to change orders will be paid 50%at time of change order signature and 50% after completion and Homeowner sign-off. ARTICLE 5. GENERAL PROVISIONS 1.All work shall be completed in a workmanship like manner and in compliance with all building codes and other applicable laws. 2.To the extent required by law all work shall be performed by individuals duly licensed and authorized by law to perform said work. 3.Contractor may at its discretion engage subcontractors to perform work hereunder, provided Contractor shall fully pay said subcontractor and in all instances remain responsible for the proper completion of this Contract. 4. Contractor shall furnish Homeowner appropriate releases or waivers of lien for all work performed or materials provided at the time the next periodic payment shall be due. 5.All change orders shall be in writing and signed by both Homeowner and Contractor. The cost for mutually agreed to additional work, required due to unknown conditions or substantive change orders,will based on the current bill rates for the actual time used.Additional materials will be billed at contractor cost.All change orders subject to 15% markup for overhead. 6. Contractor warrants it is adequately insured for injury to its employees and others incurring loss or injury as a result of the acts of Contractor or its employees and subcontractors. 7. Contractor shall obtain all permits necessary for the work to be performed. 8. Contractor agrees to place all debris in an on-site trash receptacle(dumpster)and leave the premises in broom clean condition. 9. In the event Homeowner shall fail to pay any periodic or installment payment due hereunder, Contractor may cease work without breach pending payment or resolution of any dispute. 10.The Contractor and the Homeowner hereby mutually agree in advance that in the event that the Contractor has a dispute concerning this contract, the Contractor may submit such dispute to a private arbitration service which has been approved by the Office of Consumer Affairs and Business Regulation and the Homeowner shall be required to submit to such arbitration as provided in MGL c 142A. Hamed ner Date: Contractor Date: E a � e ne commonwealth of Massachusetts De'partment ofIndastrial.Aceldmis r 1 Congress S`h'eet, Suite Y00 Boston,MA.02114-2017 IY 1'Y f�''I�P �j ass. o-pldia ' '�4�kexs' Cempensat9.o:a�Yr:r'anc '�P���x�N�,e�TJ'k�Osl�'���ciansl�'� .bexs. TOSZrLEa7 ?Zease 'lint Le '7oI A dcant wor mation Name{BusinesslOrgariizazonlSndi ideal): Z 4:u Al .A.ddxesx o 13hont;4: Cita lstato/zlp: Typo of proiect(�•epiated); Alreyoa an cre�plcyer?CZrec�flie appropriafe box: , 1 a employer with -employees(fall and/or part time).; 7. �(I�'o'vJ constrddion S. [ Remodeft 2 asole pzopriet orkers�fhip comp.insurance quired]yces Working forma in 9. Detnolitio any capacity.[Now 3.�I am ahorveowoer daingaIlwozkmyself.jNovrorkers'Damp.insurancerequired.] 10❑BuUding addition contractors to conduct all workonmyproperty_ Iwili aiKSnradditiaps 4.0 Iam ahomeowzxer andwillbaUirsng .�Electrical IWAKS ensure that al(contractors eithezhaveworkere compensation insurance or are sole r,-1, vmbixt€g xepaixs or additions t. ee-S. i proprietors with.nomp�dy 5.[]I am a general eontracto+and Z�yehixedthesab cozcfracfors listed onthe attaehod sheet 13'.[�Roof re�aars These sub-contractors have employees andhave workers'comp.ins once 14,rl Other b,Qe are a carporatio?i and its o£ficers have exercisedtheir right o£'exempf[on per M rCZ c- 15e 10 a c and eve have no employees.tNo workars"comp.rnsaranc-Irpired_1 *Anyapplicautthat checllls b'ox#I test�insd t fey$re doinglail-v�arkandthen hire outside Contractors ow showing their mousE sa7�mic anew affidavit indicating such i I3omeowners who subs.6I;aMhavr g _ Contractors that check this 17oX t�lust attaclied.an additional sheet t rovide then 110 n zs'comp.policy n a�'��d state whethez or gotfirose entat as have employees. Ifthe sob-contractors Mayo employees,fhty sus i3 ern Za erg that rs prDviciing r�Drkers'compemati0A h1suraace for lily er?zPlayee� 1 elor�rs ttiepartcy orad job sits f am an p y Zr2fDT712a�1Or2. � . ftM:jran.ce Company Name; Z —0<31 L ExpirationD05: City/State/ ip: �] 7o�b,5iteAddrCSS: Clic declalit$on page(sboTr a��tie polies xrn�n�aex and e psx'atS�nxz date). Attach a copy of fhe WQI:kexs compe satiau p Failure to s ecce coverage w xegi=ed oadez MGL c.X52,§25A is a crin�inalvioloR ORU�Zpmlishablartd a Niue o pto $250.00 a and/or one year inapxisanment,as well as civil p enalises ins form a a STOW day against t1�e violator.A aop�'oftbis statement may be forwarded to-die© ca ofnvestigatians o Ftbe D]A fox irssuxance A�'�RL7►" OP ID:J( °ATE(MMlnynCERTIFICATE OF LIABILITY INSURANCE 12/19/201 6) THIS CERTIFICATE 15 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE 130ES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the pollcy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the pollcy, Oertain policies may require an endorsarnent. A statement on thig certificate floes not confer rights to the certificate holder in lieu of such endorsements. PRODUCER CONTAC Segr+eve&Hall Insur.As5oc.Inc NAME: 305 North Main St, PHONE Andover,MA 0'1910 ,� wC Na: LawmnceJ. Ball ADDRESS: CUSTOMER CER Ing,TMKRE-1 INSURERIS)AFFORDING COVERAGE NA€C g INsuI.Ep 7MK l,<ernodeiing LLC IN6URERA:Ar4el)a Protection Ins.Co. 41360 214 Sutton Hill Rd INsuRERg:AEIC 411p4 North Andover, MA 04$45 INSURER C; IHSURI%Iy P, INSURER E INeURER F COVERAGES CERTIFICATE NUMBED; REVISIAN NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIRI MENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TR TYPE OF IN6URANCE POLICY NUMBER IIAIDDAEFF M !yy P LIMIT6 GENERAL L[A6ILITY EACH OCCURRENCE s 1,400,400 A X COMMERCIAL GENERAL.LIABILITY P I$ES Ea occu rents $ 180,OOU ctalMs-MADE accuR MED EXP(Any ono poroan) $ 6,000 PERSONAL&ADV INJURY 6 11000,000 9520037133 02118/2016 03/1812017 GENERAL AGGREGATE S 2,000,000 GEN'3 AGGREGATE LIMIT APPLIES PER: PRODUCT3,COMPlORAGG 5 2,000,000 POLICY PRv- LOC $ AUYOMOSILE LIABILITY COMBINED SINGLE LIMrr (Em ANY AUTO accident] UOD[LY INJURY(Por psrBort) S ALL OW N ED AUTOS BODILY INJURY(Par acclden€) S SCHEDULED AUTOS HIRED AUTOS PROPERTY DAMAGE (PER ACCIDENT) S NON-OWNED AUT03 $ 8 UMfIRELLA LIAB IU Id EACH OCCURRENCE $ FXCESS LIA9 AIM$-MADE AGGREGATE 8 DEDUCTIBLE RETENTI N g $ WORKERS COMPENSATION VYC 9TATU. 10TH AND EMPLOYFRW LIABILITYT OFFICERIMEANY €MBER EXCLUDDEEDD9 EGU�VE YIN W -600-601 NIA O'O'•BBO.80�1 872 GA1phr x{?1 B 0410112017 f=L EACH ACCIDENT S 500,000 (Mandatory in NH) If sae,deaortba undor, E.L.DISEASE,FIA EMPI DYE 1;00,00 DESCRIPTION F OPERATIONS he[ow E,L.DISEASE-POLICY LIMIT S 500,00 USUORIPT[ON OF OPERATIONS I LOCATIONB I VEHICLES (Att ich ACORD 101,Adt floph€Rem;1*9 Behedule,If mwe sP;ca Is requ€rad) �, C���e�nrieviairrneal//r.o/�(�,l�r�lac�r%lcfli Office of Consumer Affairs&Business Regulation 'HOME IMPROVEMENT CONTRACTOR ;�Registration: 165887 Type: 7 Expiration 415120'!8, DBA TMK REMODELING THEODORE KELLEY 214 SUTTON HILL RD NORTH ANDOVER, MA 01845 Undersecretary Massachusetts Department of Pubiic Safety Board of Building Regulations and Standards License: CS-105086 Construction Supervisor g. THEODORE M KELLEY 214 SUTTON HILL RR r NORTH ANDOVER M {�,.v� Expiration: Commissioner 10108/2017