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HomeMy WebLinkAboutBuilding Permit # 1/11/2017 BUILDING PERMIT tsat�ry Q�,C,.LEa S TOWN OF NORTH ANDOVER APPLICATION FOR.PLAN EXAMINATION `- Permit XAMINATION `-Permit No#: Date Received �l "� R•zrEa�e • �SSAC H1.l�� Date Issued: LWORTANT:Applicant must complete all items oaa this page LOCATIDN � ., Pnnt'• PROPERTY OWNER - pnnt I OD Year Structure yes MAF' PARGEE: ZONING DIST ICT: H�sfiortc-D�str�ct yds ice/ , r _. _ — Machrne,5hop_VEllage TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑ Two or more family ❑ Industrial ❑ ration No. of units-, ❑ Commercial epair, replacement D Assessory Bldg ❑ Others: ❑ Demolition ❑ Other Cl Septic 1Nell `:, ❑ F[oodplalllletlands Wafersheet District WaterlSewei - - DESCRIPTION OF WORK TO DE PERFORMED: Id e a�io�u Plea Type or Print Cieary" OWNER: Name: P Address: �✓ A/i 4L�6 XL��16 cin radar Name. .: Address: /F V _ Supervisor's ConStructiori L�cens Exp Date " ✓ /- ... Horne Irrapxoveme-if License r��. _ ARCH ITECTIENGIN EER Phone: Address: Reg. No, FEE SCHEDULE;B ULDING PE IT.-.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. le).11 �- ,rotal Projeot Coag $ FEE: $ Check No.: 1 Receipt No,: NOTE: Persons contracting with unregistered eontract0rs d n t hc�ve-cacces to the guarantyfund 5`igna r e>of.Ager tlO:wner urs 0f co'. ctor Plans Submitted ❑ Plans Waived 0 Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL .Public Sewer ❑ Tanning/NlassageBody Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank, etc. ❑ Pennaneut Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY —INTERDEPARTMENTAL SIGN OFF w U FORM PLANNING & DEVELOPMENT Reviewed On Signature COMMENTS CONSERVATIONCONSERVATIONReviewed on Signature _-- COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Wafer & Sewer Conneetionisianatu re& Date Driveway Permit DPW Town Eng- eer: Signature: Located 384 Osgood Street FIRE DEPARTMENT' - Temp Dumpster on site yes no Located at 124 Main Street Fire Department signatureldate COMMENT.S VIORTL- own of A No. 0g ry �. oh ver, Mass, C0Cn1Cn1W.C1K y�'G !�40 RATED S U BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System j� ., � .... a V N BUILDING INSPECTOR THIS CERTIFIES THAT . i/r �r ...... ... .. ........ ............. ,, has permission to erect ..... buildi sort .......I .. ."�.�.�: ..,d.... Foundation .................... .... .. .� ... Rough to be occupied as ... Chimney provided that the person accepting this permit snail in every respect conform to 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 UNLESS CON STRCTI RTS Rough Service ........... .. ................. .. ......... ................ Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required t® Occupy By Rough Display in a Conspicuous Place on�� Bethe Premises — Do Not Remove Final YY No Lathing or Dry all To Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. Proposal==== HIC#174377 Damphousse Roofing LLP A trusted name since 1938 Roofing o Siding ®Windows 87 Belmont Street - North Andover, MA 01845 P: 97 83-4588 - F: 978-685-7446 NAME OF OWNER ADRESS OF JOB 117- DATE: TEL. –'Z �� - We will remove all roof shingles off total roof area layer. Replace any boards or sheathing at additional cost. A new 8" white aluminum drip edge applie/o—nall edges. Approx. Eft of ice and water membrane applied on eaves, aft in valleys, strips around skylights, along chimney flashing and sidewall junctions. Existing step flashings to remain. A new base sheet applied. Architectural roof shingle installed with a limited lifetime warranty. Install new ventpipe boot flashings. W terpro f existing chimney flashing and remove debris. Shingle Calor: -AY21V� Ridge Vent UpgLqde_. /Z 3.50 per ft Wood Sheathing_Repair$3.50 er ft We Propose herby to furnish material and labor-complete in accordance with above specifications,fo e sum o: ($ Payment to be made as follows Authorized Signature NOTE:This proposal may be withdrawn by us if n t accepted with in_�l Acceptance of Proposal - The above prices, specifications and conditions are satisfactory and are herby accepted.You are authorized to do the work as specified.Payment will be made as outlined above. Signature— . ce: Signature—,- Date of Acceptance: HOME IMPROVEMENT CONTRACT TERMS AND CONDITIONS M.G.L.142A 1,WORK:Provided the Homeowner performs under this agreement,the Contractor shall perform the work on the Property as specified Proposal,attached incorporated herein,The work does not include extraordinary conditions of which the Contractor could not reasonably be aware. if such conditions are encountered,this shall be an additional cost to the Homeowner.Materials selected by Homeowner may have to be ordered or custom made,which items are specified in the Proposal.The Contractor is not obligated to agree to any modifications,extras or change orders unless such items are agreed to in writing by the Contractor.All extras and changes shall be at an additional cost to the homeowner.Contractor shall perform the work in a good and workmanlike manner using materials consistent with this contract.Lawn or Driveway may be damaged by dumpster or equipment.Due to material shortages Contractor may substitute materials of equivalent grade. 2. PERMITS: If a building permit is required for the work,the Contractor shall obtain sante as Homeowner's agent. Contractor is not responsible for any other permits that may be required for the Work,and Homeowner is responsible to determine whether any zoning,planning or wetland related permits or approvals are necessary.Homeowners who secure their own permits or deal with unregistered contractors will not have access to the Guaranty Fund. 3. COMMENCEMENT AND COMPLETION:Homeowner acknowledges the commencement date of the work is fluid,and is subject to numerous factors such as scheduling other contractors,delivery of materials and weather.'Contractor and Homeowner shall determine the commencement date of the Work when a more definite determination can be made and shall execute a written acknowledgment of same.The Work shall be substantially completed within 7 days of commencement,except for longer periods as may apply to particular projects as Contractor shall notify Homeowner in the Proposal,and subject to delays for circumstances beyond Contractor's control.Notwithstanding,the commencement date and substantial completion date may be extended,and the Contractor will not be liable for delays caused by,labor or material shortages,delays in delivery of items selected by the Homeowner,governmental action, and unforeseen events beyond the Contractor's control,including but not limited to weather,strikes,war,the acts of third persons or the acts of the Homeowner.The Homeowner recognizes that the commencement date may be delayed due to scheduling or the completion of Contractor's other jobs. 4. PAYMENTS:Contractor agrees to perform the Work and to furnish the materials and labor specified in the Proposal for the amount as stated in the Proposal.Thirty percent(30%)of the total is to be paid as a deposit with the signing of this contract.Upon cancellation prior to commencement of the Work,any remaining deposit will be returned less the costs for materials ordered for which Contractor was unable to cancel.Final payment shall be due upon completion of the Work and Homeowner agrees it may not hold any retainage.Late fees may be applied for late payments. Homeowner shall pay Contractor's reasonable costs of collection,including attorney's fees and costs.Time is of the essence hereof. i 5. WARRANTY:For a period of 2 years after substantial completion of the Work the roof will be free of leaks caused by defects in workmanship, jbut not those caused by ice backing-Lip or extraordinary weather events,including blizzards,tornadoes,hurricanes or storms of greater than a twenty-five year duration or intensity.Contractor gives no warranties with reference to any materials or equipment installed in the Premises,passes any such warranties directly to Homeowner,and Homeowner agrees to look only to the manufacturer with reference thereto.This limited warranty extends to the Homeowner only and is not transferable to succeeding Homeowners.This Limited Warranty specifically excludes(i)all consequential and incidental damages;(ii) damage due to ordinary wear and tear,abusive use,misuse,or lack of proper maintenance;(iii)defects which are the result of characteristics common to materials used;(iv)defects in items installed or supplied by anyone other than Contractor;(v)work done by anyone other than by Contractor;and(vi)loss or injury due to the elements.There are no other expressed or implied warranties or representations made or given, i 6. ENTIRE AGREEMENT:This contract and all documents referenced herein constitute the complete and final agreement between the parties.In the event that any of the provisions of this contract shall be held to be invalid,the remainder of the provisions of this contract shall remain in full force and effect.Two identical copies of this contract have been completed and signed.Homeowner acknowledges receipt of a completed contract signed by the Contractor. 7. HOME IMPROVEMENT REGISTRATION:In accordance with M.G.L.c. 142 A,§9,Contractor is registered with the Bureau of Building Regulations and Standards Registration No: 174377, Homeowner may verify by contacting the Director at(617)727-3200,ext.25205.A Homeowner's rights under the Home Improvement Law(M.G.L.c. 142A)and other consumer protection laws may not be waived in any way.Homeowner acknowledges receipt ora copy of 780 CMR R6 and Massachusetts General Laws chapter 142A,and which are available online at www.mass.gov.Questions may be directed to the Consumer hiformation Hotline,(617)727-7780. 8. ARBITRATION:Contractor and the Homeowner hereby mutually agree in advance that in the event the Contractor has a dispute concerning this contract, the Contractor may submit such dispute to a private arbitration service which has been approved by the Secretary of the Executive Office of Consumer Affairs and Business Regulations and the consumer shall be required to subunit to such arbitration as provided in M.G.L.c. 142A.No lien or security interest is imposed on the Property as a consequence of this contract,but Contractor has the right to record this contract or a notice of this contract,or seek a lien if the I-Iormeowner breaches this Contract. 9. HOMEOWNER COVENANTS:The Homeowner agrees,represents and warrants that(a)the Homeowner grants permission to the Contractor to enter the Property to perform the work as covered by this contract;(b)the Homeowner has funds available to make full payment under this contract to the Contractor upon completion;(c)the Homeowner understands that construction as contemplated by this agreement creates a dangerous condition,and agrees not to enter portions of the Property under construction until the Contractor advises the Homeowner that the construction is completed;(d)Contractor may need use landscaped areas of the yard during the Work and Homeowner is responsible to provide protection for landscaping and(e)that code requirements may result in roofing nails penetrating through roof decking and will be visible on the underside of some surfaces.The Homeowner indemnifies,exonerates and holds harmless the Contractor from any loss,damage,claim,liability or expense(including reasonable attomey's fees,deposition costs and court costs)resulting fiom a breach of this provision.Contractor is not responsible for damage to landscaping that will grow back during the next growing season. 10.CANCELLATION: Homeowner may cancel this agreement provided Homeowner notifies the Contractor in writing at the address listed in the Proposal not later than midnight of the third business day fo owing the signing of this agreement. l HOMEOWNE - DATE: �/17/f/� Shingle: DEPOSIT: The Cottttr10,11pealtlt of jMrlassaeltusetts Department of Iradtistrial Aeeidenis p ffxce of illresUgations baa T rtrshiligtott Shwet T � Boston, 02I11 ]viow.tttass.golt/ilia ctriciansfflumbers Workers' Compensation insurance�daAt: Builders/ContractorslEl Please Print Le tbly ,� licznt Il��ormation = � ` Name (B1U5iness/4r anizatiandndi>ideal): / Address: Phone 1have City/State/ZiP" Type o£project(required). Are y an employer? Check the appropriate box: general contza =I_ [] I am a g G. Q New constrUctiOn 1. I ant a employer���iElr - knave hired the sub-c employees(full and/or part-time).$ listed on the attache7. ❑ Remodeling d 2 ❑ I am a sole proprietor or partner- -Mese sub-contracto8. []Demolition ship and/rave no employees employees and have9. ❑Building addition working for me in any capacity. comp.insurance.=[Na waders' comp.insurance 5 We axe a corporatio10.Q Electrical repairs or additions ❑ dditions required. officers have exercised their 11.0 Pll rng repaus or a i` ❑ I am a kro neowner doing all work �. xight of exemption per MGL I2. oaf repairs myself [No workers' comp. c. 152.§I(4)=rtnd we have no 13.❑ Other insurance required.] ' employees. [No workers' camp, insurance required.] ti ,`Atil applicant tlnit checks box s.l mu a1sO fill aULdle ate Ille ldO ng all iVon belox, looli an4t E1SeR 1lirN 011their wnrkttSldC CUULnlC[Opens is InU15t subrpiEntlane L effidavlL 1ndicalinE sUCll. t Homdowliers tallo sub this allidni'dt indicating Yf the ContrIIetQrs that check this box must attached an additional sheer provide tile it or name a omP S Policy nmpmber and state whether or not thane entities 3tnvc eulployces. If the sub-contructaTs]tat a emplryces, Y I ant an errrpla}ler that is pi•oridrrrg rvoricers'caarrpensatian it:surarrce for 111y errapda�sees. Iietart�is filepolicy andjob site ilrforrrraiiot1. iJ � � �-•°" �-C�� Insurance Company Name: „� .i , d.'i �` Expiration Date: J Policy or Self-las.Lic.',Ai i �/ /� •/ � CitylStatelZip: Sob Site Addres ' C slrowin the policy number and expiration elute). Attach a coley of the Workers' corn ensatiorr policy declaration page E g ti Failure to secure coverage as required under Section?5A of MGL c. 157 can leads forcto e of a STOP WORK ORDER and ositioll of criminal pen I es a fine finer imprisonment,as well as civil penalties ln>ir frac up to�1,50Q_OD and/or ane-year 4f u to 1;250.01) a day against the violator. Be advised that a copy of this statement may be Ior�varded to the Office ai p InvesCigations of the DIA for insurance coverage verification. I do hereb}�eerfi `rrtd r the pains acrd panalties of perjurl7 that the iriforvrlatiarr prnt�icicTcl abo»e is true and car root. Simzature: Date: --. ,�• eui Pllone r: �- / Official rtxe orrl3. Do irvt rvrltc in flu's area,to be courpleted by city or tor+�rr offrciai Permit/Lieense City or`Town' Issuing Authority (circle ane); 1.Board of health z.Building Department 3.City/Town Clerk 4.Liectrical Inspector +.Plurrrbirig Inspector G.Otter Phone n: Contact Person: CERTIFICATE 4F LIABILITY INSURANCE P ATE(MWDDfYYYY) 11109/2016 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 pollcy(les)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 floes not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER NAME: Diane LeBlanc DOHERTY INSURANCE AGENCY INC PHONE 978)A75.02ti4 rimes: s4cc.xs:.FIJI. FAX ( — E-MAIL Do KESS: dlebtanc@doheriyinsurance.com P.0 BOX 1985 INSURERS AFFORDING COVERAGE" _ NAIC a ANDOVER MA 01610 INSURERA: AIM MUTUAL INS CO .— 33758 INSURED INSURER 8: _— DAMPHOUSSE ROOFING LLP WSURERC: INSURER D 87 13ELMONT STREET INSURER E: — _-- NORTH ANDOVER MA 01845 INSURER F COVERAGES CERTIFICATE NUMBER: 101761 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. ILT R AD TYPE OF INSURANCE B POLICY NUMBER MM1QDY EFF 1POLOQY£XP LIMITS COMMERCIAL GENERAL LIAaiknY EACHOCCURRENCE E DAMAGETONFrNT CLAIMS•MADE D OCCUR PREMISES En o nencal S MED EXP(Any one person) S NIA PERSONAL&ADV INJURY S GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S e PRODUCTS-COMPlOP AGG E POLICY JECT LOC I E I OTHER: I AUTOMOBILLIABILITY COMBINED SIN LE LIMIT E $ (Ea acadonl) _ dANY AUTO BODILY INJURY(Por porsm) S i ALL OWNED SCHEDULEDNIA BODILY INJURY(Pur accidoni) $ AUTOS AUTOS NON OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident S UMBRELLALFABOCCUR F.ACHOCCURRENCE ' EKCESSLIABCLAIMS-MADE! NIA AGGREGATE S _ t DED RETENTIONS S WORMERS COMPENSATION X STATUTE ER _ AND EMPLOYERS'LIABILITY Y f N ANYPROPRIETORJPAfiTNEPoFXECUTIVE E.L.£ACHACCIDENT $ 600,000A OFFICERMEMBEREXCLUDED? NA PNA H(A AWC40070287742016A 0411712016 04/1712017 EL DISEASE•EAEMPLovEE S 504,404 (Mandalory In NH) -- II yes,describe under I` DESCRIPTION OF OPERATIONS below E L.DISEASE•POLICY LIMIT S 540,000 NIA DEiSCRiPTION OF OPERATIONS I LOCATIONS f VEHICLES tACORD 101,Additional Remarks Schaduto,may be altached It more epacO fa regUIM451 Workers'Compensation benefits will be paid to Massachusetts employees only,Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in slates other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in farce on the date that this certificate was issued(unless the expiration dale on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.govllwd/workers-componsatiorlrinvestlgalions/. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLER BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of North Andover ACCORDANCE WITH THE POLICY PROVISIONS, 160G Osgood Street AUTHORIZEDREPRESENTATIVE North AndovMA 01845 er I Daniel M.Cron ey,CPCU,Vice President–Residual Market–WCRIBMA O 1988.2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD Client#:14415 DAMPFtOUSSE ''ACORD. CERTIFICATE OF LIABILITY INSURANCE 11109/ 6"Y"' PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Doherty insurance Agency,Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR P.O.Sox 1985 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 21 Elm Street Andover,MA 41810 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER& Western World Damphousse Roofing LLP INSURER B: 87 Belmont St INSURER C. North Andover,MA 01845 INSURER 0: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY RE=QUIREMENT,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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, LTA SR NUO'LTYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POOAT_LICY E PIRATI I LIMITS A GENERAL LIABILITY NPP8296488 04112/16 04/12117 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED x100 000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE QOCCUR MED EXP tAnyono person) $5000 PERSONAL 6 AOV INJURY 61.000.000 GENERAL AGGREGATE s2,000,000 GENLAGGREGAIELIMIT APPLIES PER: PRODUCTS-COMWOPAGO 52000000 X POLICY PRO LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S IEa awdem) ANY AUTO ALL OWNED AUTOS BODILY INJURY $ p3 SCHEDULED AUTOS (Por person) B HIREDAUTOS BODILY INJURY S (Por ecddenll 9 NON-OWNED AUTOS 0 PROPERTY DAMAGE S (Por atddom) AGE LIABILITY AUTO ONLY.EA ACCIDENT S ANY AUTO OTHER THAN EA ACC 5 AUTOONLY: qGG $ ii EXCESSIUMBRELLALIABILITY EACHOCCURRENCE $ OCCUR F1 CLAIMS MADE AGGREGATE $ S DEDUCTIBLE $ RETENTION S5 WC STATU- OTR- WORKERS COMPENSATION AHD EMPLOYEAW LIABILITY E.L.EACH ACCIDENT S ANY PROPRIETORIPARTNEWEXECUTIVE OFF(CERWMEMBER EXCLUDED? E.L.DISEASE•EA EMPLOYEE S If yos,dounoo under SPECIAL PROVISIONS betav E.L.DISEASE•POLICY LIMIT S OTHER DESCRIPTION OF OPERATIONS!LOCATIONS IVEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT!SPECIAL PROVISIONS Covering operations usual to Damphousse Roofing LLP... CERTIFICATE HOLDER CANCELLATION 10 Days for Non-Payment SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Town of North Andover DATE THEREOF,THE ISSUING INSURER WALL ENDEAVOR TO MAIL IR DAYS WRITTEN 1600 Osgood Street NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL North Andover,MA 01845 IMPOSE NO OBLIGATION ORLIABILITYOF ND UPON THE INSURER,ITS AGENTS OR REPRESENTAnvES. AUTHORIZED REP fSENTATI E D CORPORATION 1988 ACORD 25(2001108)1 of 2 ##S34292/M34248 DML © A Massachusef-ts Department of Public Safety Board of Building Regulations and Standards License: CS-067560 C0r1strt,rctiM1 SUPCrvisor SHAUN M TWOMEY 61 PATROIT ST NORTH ANDOVER MA 01845 �r,/IL^^✓� 4✓�--- Expiration: Commissioner" 10125!2017 �---M--:� _ G/✓z�; u��a��cosrul�alC� o,�✓��,aavcr�:�rtJ�C�s .. Office of Consumer Affairs&Bi siness Regulation HOME IMPROVEMENT CONTRACTOR �=+. Registration: 174377 Type: J Y Expiration 2/4/2017 LLP DA&OUSSE ROOFING LLP SHAUN TWOMEY 87 BELMONT ST r� N.ANDOVER,MA 01845 Undersecretary i i