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HomeMy WebLinkAboutBuilding Permit # 1/25/2017 BUILDING PERMIT o ��LEo 8gti TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION f Date Received + c� ! Permit No#: � , � �kArED PYA' C14us�� Date Issued: EWORTANT: Applicant must complete all items on this page .. ... :� LOCATION ... _.... . .._ _ Print PROPERTY OWNER ...: t Pnn 140 Year StEucture yes MAP _- PARCEL. ZONING DISTRICT: Histor�c District yes Ta MachineShop 1hlla e es no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building KOne family ❑Addition ❑ Two or more family ❑ Industrial Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑Septie ❑ Well ❑ Floodplain 0 Wetla ds: ❑ Watershed District i]WaterlSewer DESCRIPTION OF WORK TO DE PERFORMED: e aarsr �m GCSE dQkr ,; Identification- Please Type or]Print Clearly OWNER.- Name. S<4� e.-,j K- Phone: Address: � � 0�1 5 k;.,.j -S Phone- Contractor Name: Phonei� ,.�. = .. Address: S PConstruction Exp: Date.w. 1 Su ervisor's Lrcense .. - Home Improvement License, � � Exp. Date.. IDA, 7 ARCHITECTIENG[NEER a Phone: Address: � 1� �- 1 � V Reg. No. 3 FEE SCHEDULE.BULDING PERMIT. $72.00 PER$1000.00 OF THE TOTAL ESTIMATED COSTBASED ON$125.00 PER S.E. rotal ProjeGt Cost: $_ CCS( FEE: $ ® 3- C) Check No.: ,5 O� `-I Receipt No... [;V`7 NOTE: -Persons contracting with unregistered conk"tors do not have:access to the guaranty fund 5_igi attire of AgentLOwner re df contractar�, LL N1®RTFi i Town �_ Andover h ver, Mass, - - QI Y OLAM! 1 COCHIC Hl WECN 4 U BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System THIS CERTIFIES THAT ......3#4*........arf STA................. BUILDING INSPECTOR •' has permission to erect .......................... buildings on ......57.........3..........V... .14fY........r� Ij.l................sr. Foundation...... Rough to be occupied as .............. .,�`.................................. . .�:� ®� I+w � ` ..... ® .. chimney ........... . .......* ....., .... .... ......... .......... �+...�!!!.... i �*,®... provided that the person accepting this permit shall 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 CONSTRUCTION STAMT S Rough ................. ,.. .�/... ......... Service " Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Re uired to Occupy 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 filo. Smoke Det. TES TA Building and Remodeling Start date Jan 30 2017 5 APPLETON STREET Finish date rill 2017 NORTH ANDOVER, MA 01845 HIC Lie. 120296 Expires 11/19117 (978) 682 2023 CSL Lie. CS 54718 Expires 6/8/18 Prat January 21, 2017 Proposal Submitted.To: Paul and Cheryl Sciaudone Phone: (781) 799-6231 573 Johnson Street North Andover, MA 011345 Job: Remodel kitchen Obtain building permit Complete removal of all demolition and construction materials Generated by Testa Building and Remodeling and its subcontractors. DEMOLITION: Remove all cabinets, counter tops, appliances, tile floor and underlayment, walls, ceiling And remove all insulation. CONSTRUCTION: Remove the existing window and frame a larger opening to receive a new Anderson 400 series double hung triple window. Patch the siding and trim on the back of the house. Remove the center wall that divides the kitchen from the living room and the wall that divides the living room from the foyer. Install an LVL that was designed by the structural engineer. Add a Lally column in the basement under the new point load. PLUMBING: Kitchen sinks to stay in same general location. Hook up the rest of the kitchen plumbing fixtures. Vent the hood over the cook top vent to be in the back yard. Install new toilet and vanity in half bathroom. Note: There is no allowances for plumbing fixtures ELECTRICAL: Add new circuits in the kitchen area where needed. Rewire kitchen to code. Supply and install 14 recessed lights.Wire all new appliances. Wire and supply one angle plug strip under the window. Run two new circuits for the electrical floor heat. Note: There is no allowances for light fixture other than the Recessed. INSULATION Insulate the walls and the ceiling to code. PLASTER: Hang t/2 blue board and plaster all walls and ceiling. Hang Cement board behind the stove as fire proofing. CARPENTRY: Install all the kitchen cabinets and molding as per the designers drawings. Install new trim in the kitchen around the windows and doors to match the existing trim in the house. Installation of all kitchen appliances and wood fronts. Note: There is no allowance for cabinets and or countertops. FLOOR: Prep the floor for tile. Install Ditra Heat underlayment throughout the kitchen area, living room , foyer and half bathroom. Install large format the allowing grout lines as expansion joints. TILE: Install tile along the back splash. Labor and adhesive supplied by contractor. Note: There is no allowance for tile or grout. PAINTING: Prime and paint the ceiling, walls, and new trim in the kitchen, living room and in foyer. A finance charge of 11/2%per month(18%per year)will apply to all accounts over 30 days past due. in the event collection activity is required the customer shall be responsible for all costs associated with collection,including reasonable attorney's fees. I propose hereby to furnish material and labor complete in accordance with above specifications, for the sum of: $36,790 Thirty six Thousand Seven Hundred Ninety Dollars One- third to start,one-third after rough inspection, one-third upon completion. Authorized signature cn� I reserve the right to cancel this contract if not accepted in- 30_days Signature -��,,.� Signature AA DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES This form satisfies all basic requirements of the state's Home Improvement Contractor Law(MGL chapter 142A),but does not include standard language to protect homeowners.Seek legal advice if necessary.Any person planning home improvements should first obtain a copy of"A Massachusetts Consumer Guide to Home Improvement"before agreeing to any work on your residence.You may obtain a free copy by calling the Office of Cansutner Affairs and Business Regulation's Consumer Information w Hotline at 617-973-8787 or 1-888-283-3757 or on our website. p (Owners who secure their own permits will be excluded from the Guaranty Fund provisions of Date when contractor will begin contracted work. MGL chapter 142A.) Express Warranty-is an express warranty being provided by the contractor? 9 No Yes(ail terms of the warranty must be attached to the contract) Subcontractors-The contractor agrees to be solely responsible for completion of the work described 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 agree►nent. Contract Acceptance-Upon signing,this document becomes a binding contract under law.Unless otherwise noted within this document,the contract shall not imply that any lien or other security interest has been placed on the residence.Review the following cautions and notices carefully before signing this contract. •Don't be pressured into signing the contract.Take time to read and fully understand it.Ask questions if something is unclear. •Make sure the contractor has a valid Home Improvement Contractor Registration.The law requires most home improvement contractors and subcontractors to be registered with the Director of Home Improvement Contractor Registration.You may inquire about contractor registration by writing to the Director at 10 Park Plaza,Room 5170,Boston,MA 02116 or by calling 617-973-8787 or 888-283-3757. •Does the contractor have insurance?Ask the Contractor for his insurance company information so that you can confirm coverage,or ask to see a copy of a"proof of insurance"document. •Know your rights and responsibilities.Read the Important Information on the reverse side of this fon n and get a copy of the Consumer Guide to the Home Improvement Contractor Law. You may cancel this agreement if it has been signed at a place other than the contractor's normal place of business,provided you notify the contractor in writing at his/her main office or branch office by ordinary mail posted,by telegram sent or by delivery,not later than midnight of the third business day following the signing of this agreement.See the attached notice of cancellation form for an explanation of this right. DO N GN THIS CONTRACT IF THERE ARE ANY BLANK SPACESIll Two c id ical c es f the ract must be completed and signed.One copy should go to the ho eowner.The other copy should be kept by the contractor. Homeow er's Signature Contractor's Signature 1 Date Date Contractor Arbitration The Hobe Improvement Contractor Law provides homeowners with the right to initiate an arbitration action{as an alternative to court action) if they have a dispute with a contractor. The same right is not automatically afforded to a contractor,however.The contractor would have to resolve any dispute he/she has with a homeowner in court unless both parties agree to the optional clause provided below.This clause would give the contractor the same right to arbitration as is afforded to the homeowner by the Home Improvement Contractor Law. The contractor and the homeowner hereby mutually agree in advance that in the event the contractor has a dispute concerning this contract,the contractor may submit the dispute to a private arbitration firm which has been approved by the Secretary of the Executive Office of Consumer Affairs and Business Regulation and the consu s require o submit to such arbitration as provided In Massachusetts General Laws, chapter 142 Homeowner's Signature Contractor's Signature NOTICE: The signatures of the parties above apply only to the agreement of the parties to alternative dispute resolution initiated by the contractor.The homeowner may initiate alternative dispute resolution even where this section is not separately signed by the parties. Homeowner's Rights A homeowner's rights under the Home improvement Contractor Law(MGL chapter 142A)and other consumer protection laws(i.e.MGL chapter 93A)may not be waived in any way, even by agreement. However, homeowners may be excluded from certain rights if the contractor they choose is not properly registered as prescribed by law. Homeowners who secure their own building permits are automatically excluded from all Guaranty Fund provisions of the Home Improvement Contractor Law.The contractor is responsible for completing the work as described, in a timely and workmanlike manner. Homeowners may be entitled to other specific legal rights if the contractor guarantees or provides an express warranty for workmanship or materials. In addition to guarantees or warranties provided by the contractor, all goods sold in Massachusetts carry an implied warranty of merchantability and fitness for a particular purpose.An enumeration of other matters on which the homeowner and contractor lawfully agree may be added to the terms of the contract as long as they do not restrict a homeowner's basic consumer rights. if you have questions about your consumer/homeowner rights, contact the Consumer Information Hotline(listed below). Execution of Contract The contract must be executed in duplicate and should not be signed until a copy of all exhibits and referenced documents have been attached. Parties are also advised not to sign the document until all blank sections have been filled in or marked as void,deleted, or not applicable. One original signed copy of the contract with attachments is to be given to the owner and the other kept by the contractor.Any modification to the original contract must be in writing and agreed to by both parties. Contracted work may not begin until both parties have received a fully executed copy of the contract, and the three day rescission period has expired. Accelerated Payments A contractor may not demand payments in advance of the dates specified on the payment schedule in cases where the homeowner deems him/herself to be financially insecure. However, in instances where a contractor deems him/herself to be financially insecure,the contractor may require that the balance of funds not yet due be placed in a joint escrow account as a prerequisite to continuing the contracted work.Withdrawal of funds from said account would require the signatures of both parties. Additional Information If you have general questions or need additional information about the Home Improvement Contractor Law or other consumer rights,or if you wish to obtain a free copy of"A Massachusetts Consumer Guide to Rome Improvement" contact: Consumer Information Hotline Office of Consumer Affairs and Business Regulation 10 Park Plaza,Room 5170,Boston,MA 02116 617-973-8787, 888-283-3757 or visit the OCABR website at http://www.Illass.gov/()cabr/ If you want to verify the registration of a contractor or if you have questions or need additional information specifically about the contractor registration component of the Home Improvement Contractor Law,contact: Director of Home Improvement Contractor Registration Office of Consumer Affairs and Business Regulation 10 Park Plaza, Room 5170,Boston,MA 02116 617-973-8787, 888-283-3757 or visit the HIC website at http://www,mass,g0v/oc11br/ Go online to view the status of a Home Improvement Contractor's Registration: http-Hdb.state.iria,us/],iomeiiiiprovement/iicc:tiseelist.as For assistance with informal mediation of disputes or to register formal complaints against a business,call: Consumer Complaint Section Office of the Attorney General 617-727-8400 AND/OR Better Business Bureau 508-652-4800, 508-755-2548 or 413-734-3114 F Version 2.1—11/22/201 NOTICE OF CANCELLATION YOU MAY CANCEL THIS TRANSACTION,WITHOUT PENALTY OR OBLIGATION,WITHIN THREE BUSINESS DAYS FROM THE ABOVE DATE. IF YOU CANCEL,ANY PROPERTY TRADED IN,ANY PAYMENTS MADE BY YOU UNDER THE CONTRACT OR SALE,AND ANY NEGOTIABLE INSTRUMENTS EXECUTED BY YOU WILL BE RETURNED WITHIN TEN BUSINESS DAYS FOLLOWING RECEIPT BY THE SELLER OF YOU CANCELLATION NOTICE,AND ANY SECURITY INTEREST ARISING OUT OF THE TRANSACTION WILL BE CANCELED. IF YOU CANCEL,YOU MUST MAKE AVAILABLE TO THE SELLER AT YOUR RESIDENCE, IN SUBSTANTIALLY AS GOOD CONDITION AS WHEN RECEIVED,ANY GOODS DELIVERED TO YOU UNDER THIS CONTRACT OR SALE; OR YOU MAY, IF YOU WISH, COMPLY WITH THE INSTRUCTIONS OF THE SELLER REGARDING THE RETURN SHIPMENT OF THE GOODS AT THE SELLER'S EXPENSE AND RISK. d IF YOU DO MAKE THE GOODS AVAILABLE TO THE SELLER AND THE SELLER DOES NOT PICK THEM UP WITHIN TWENTY DAYS OF THE DATE OF CANCELLATION,YOU MAY RETAIN OR DESPISE OF THE GOODS WITHOUT ANY FURTHER OBLIGATION. IF YOU FAIL TO MAKE THE GOODS AVAILABLE TO THE SELLER, OR IF YOU AGREE TO RETURN THE GOODS TO THE SELLER AND FAIL TO DO SO, THEN YOU REMAIN LIABLE FOR PERFORMANCE OF ALL OBLIGATIONS UNDER THE CONTRACT. TO CANCEL THIS TRANSACTION,MAIL OR DELIVER A SIGNED AND DATED COPY OF THIS CANCELLATION NOTICE OR ANY OTHER WRITTEN NOTICE, OR SEND A TELEGRAM TO [Name of Seller],AT [Address of Seller's Place of Business] NOT LATER THAN MIDNIGHT OF (date). I HEREBY CANCEL THIS TRANSACTION. Date: Buyer's Signature: FIX ENGINEERING M 2 Silver LedgA e Road SHEET Newburv, M 01951 CALCULATED BY_ DATE 1, 78-462-4331 GHECKED BY----- DATE v� yz/, 7// P"? ro IOVi 7 A 6" RAI. JOB_ FIX ENGINEERING SHEETOf___ 2 SAver Ledge Road Newbury, 1\AA 01951 9714624331 Email: jf lx@com cast.riot CHECKED %ME 17"! 1 T 77777�71 77 in 1 f 1 y-1 in, r v "AA + +1 K 4- LA Ux,,,;a ell QW, A A—>"f 17T , 1 11 ............ 77 A-0-A _ J 4, v j 14 t f z4 444- +- x I') t In _0 44 14 , E W20.554 614; 53 48`"RANGE dAINS CHIMNEY 619;DS3 812; D{ 5836;FARMSINK 61$' 835; 18" 3P REC TOE L HOOD ABOVE BSP PC1W82 SUS VIFL 1.5" 3 ADDKNIFE DRA W41S4 87.675 WALL TO CENTER OF ISLAND INCL OVERHANG 18,DP 42.130"DOOR TO DOOR B27;D53 1B6 63.125-SEP TO DOOR 1 TEP 3{4 X 90 X 26 IRIS 30 89-314H 4NEP4q.S x B34;DS3 6-1.3 DP 834, B24;MICROI DRA CUTLERY B24;FH[? FRIDGE 62.0 "SEP TO 2f"DP CASE (2)PLATE BRAS OPENING TO BE 41.5w x 83.75H WAINS 314 X 90 X 26 TRIM TO 89-3{4�i *SEE SEPARATE ISLAND PLAN FOR MORE DE 9"AIL" ISLAND>�13LL RECEIVE 2 112"`CHICK WATERFALL EDGE COUNTERTOP 149.50"FALL TO CENTER OF ISLAND WHICH 15 NOT DEPIC"ED ON PLAN-PLAID SHOWS CABINETRY ONLY BACK OF COUNTERTOP OVERHANG SHOULD ALIGN WITH WAINSCOT TO RJGHT OF FRIDGE the commonwealth of Massachusmffs .Department of-IndustrlalAccrdents - _ s StreetF5`uite Z 00 Cofigress�,7t! , MA 021.x•4 ��� www.mass.govldza ce Afffda is Bui(der,/Coxa aetoxslElec zeza:usl Xnmbexs. a kexs' Comp 7C'H t1V �NG.A.U'.�S �-`S'O� - TO BB MED WrM please Print ficant Worma-don Na (BusesslOzgaxi�za€3oxi/Jndividual): Civ/,stato/zip- Type o pxareet(xec�rxza ea}; Axcport a�z ezapXoycr?C]recktIie appropri�tehax: employees(full and/or Part-time,).' 7. ❑N� T`Gonsteiictia� .�Iamaemployerwifih S. emodeliaig 2.�amasoleproprietororpaat�aersbipaudhavenoemployees nzlingformein any oapaciiy.lllawozJcers'comp.insuraace required.] 9. Q Demolitigzt 3.0Iam.ahomaow erdoingat1workraysolf,[ oworkers'camp.insaranceretluired]' ]o n Bading addition lI coafractozs to conduct all work onmy property. I-WM airs or•additiaP,S 4. - I acct ahomeowaer andwall be hiring 11.Q Electrical rep. ensure Brat all contracFoss sitherhave workers'compensation insurance or are sole n-p g repairs o7�adclitioxts proprietors with.rto 1m11WYee's. 5.❑Ism a general contractor and I have Wei the sub-confraetors listed onthe attached sheet These sub-con#rsctorsrave enzployecs andhavevrnzkers'camp.irsuzanae 14.�Otber , andtiavteo aavndnits. offlee e rs'O � o6.F]We areaeorpozlenDn •[No p y -walk, mp.irsm-ann ]1VtGI,c. Dzafl ll tiCHL PBMRfl Any applicantthat checks bX#1 must also fr[1 orat e sectiorL are doing all rozkazadthenhire outside Cron rtractoors mousy sahfma'ffiaraewaffidavztindicate such z Homeowners rube sulamit•this affidavit indicating Y the name ofthe sub contractus and state whether ornotflaose entities hate �:. Confractozs that oltec3Ctttis 3iox yausti aftacliedan additional sheetslroWiei empleyees. Ifthe sub-conisactorshaveamployees,t]reymustpzosidetttaiz vvoz1�ers'comp.po3icynunrbet. eZoN�is theoricy a72t jola site X am an er�zp7ayer that isproWdirzg7Wo,,ker�s'conrpensatiorz irzsr�rancefor rrzy employees. B P infomafion. fn$tt Mce CorapanyName: g�pixationDatez 1'ol2oy#1 or Selix>s•Lic.#:. City/StatelZip: r ancl expiration da Yob Site Address: Attacb a copy o t e orkers' coxnpensaffoupolzcydeclaxatio page(sk�o�vzngt epuncpn�.bea�bUp10$x,50000} Failure to SOGUX0 covoxage�req ixod di,-rMGL penaltles2anthe f rm o criminal WORD ORDER aid a fine of 1i to $250.00 a and/or oI'ircmprlsonmor"t,ao tbis statement may be forwarded.to the Office oflrovestigatzaus oftbeD�for irlsutance day against the Violator.A copy coverage veARCAicn. do Izereby cerci zzxzder t7zepazns am,penalfies ofperjury that theinforcationproired aliave true ar?rcarrecz Si attire: Phony#: pfficiaz rasa only. Da not write in this 471e7;to be corr�pzeted by city or tow official. • Perxn.iflLicexase f# City or Tam" i )[ssulugA.uthoAty(ci'rele one): ' C 1.poaxd of:�[ealth 2-Building 1]epa,YtrnexRt 3. �itylTowzx Clerk 4.Ei IactxzcaX Inspector 5.Numbinglnspec-tox 6.Other I phone#= Ac a� CERTIFICATE OF LIABILITY INSURANCE DATE` 1i YM )17 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 E the terms and conditions ofthe policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsemenf(s). CONTACT PRODUCER NAME: Rich Testa R.W. Testa Insurance Agency, I PHDNE {g78 685-1150 FnrX rye: (978) 681-9002 855 Turnpike Street n©.'Ess: rich@testainsurance.com North Andover, MA 01845 INSURE S AFFORDING COVERAGE NAIC# INSURERA:COMMERCE INS CO INSURED I NSU RER B: Testa Building And Remodeling INSURER C: 5 Appleton Street INSURER D: North Andover, MA 01845 INSURER E: 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. INSR TYPE OF INSURANCE ADIILSUBR - - POLICY EFF POLICY EXP LIMITS ANCE POUCYNUMBER M1ODlY MM1D0lYYW A GENERAL LIRBILITY 516388 6/1/16 6/7./17 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED $ 100,000 X COMMERCIAL GENERAL LIABILITY PREMISES(Fa.M0ffanLd_ CLAIMS-MADE FXI OCCUR MED EXP(Any are perscn) $ 5 000 PERSONAL.$ADV INJURY $ 1'.000,000 u. V GENERAL AGGREGATE $ 2,0 0 000 GEN'LAGGREGATELIMITAPPLIESPER PRODUCTS-COMPlOPAGG $ 2,000,000 $ u. POLICY PRO- LOC COMBINEDSINGtELIMIT AUTOMOBILE LIABILITY a accident BODILY INJURY(Per person) $ ANY AUTO ALLOWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS PROPERTY DAMAGE NON-OWNED erauidenl $ HIREDAUTOS AUTOS $ BRELLA LIAR OCCUR UMEACH OCCURRENCE $ EXCESSLIAB CLAIMS-MADE AGGREGATE $ DED RETENTION 5 $ WC SiATU- I JOTH- WORKERS COMPENSATION AND EMPLOYERS'LIABILITY Y!N ANY PROPRIETORIPARTNERIEXECUTNE NIA E.L.EACH ACC DENT $ OFFICERMEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ [f yes,descrlbeunder E.L.DISEASE-POLICYI-IMIT $ DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS)VEHICLES (Attach ACORD 163,Additional Remarks Schedule,If more space Is requl red) 573 JOHNSON ST, NORTH ANDOVER, MA 01845 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, 120 MAIN ST NORTH ANDOVER, MA 01845 AUTHORIZED REPRESENTATIVE RICHARD W TESTA JR ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD Phone: Fax: E-Mail: Department of Public Safety Massachusetts Board of Building Regulations and Standards License: CS'054718 Construction Supervisor JAMES mTESTA mAPPLsTomaT mANDOVER MAomus a_— Expiration: Commissioner 0610812018 Officeof Consumer Affairs&Business ( Regulation � ,1�- 1,11HOME IMPROVEMENT CONTRACTOR Registration: 120296 Type: Expiration: 11/1912017 DBA TESTA 13UILDING&REMODELING JAMES TESTA sxpPLET0wSTREET N.ANDOVER.W*O1o4u Uuuo,accvmn/ / 7