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HomeMy WebLinkAboutBuilding Permit #808-2017 - 1010 JOHNSON STREET 8/27/2017 (��+ ► TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO; 2 0 t 7 Date Received II �L 7 ' y Date Issued: IMPORTANT:Applicant must complete all items on this page � _. �.,. w: ;-.r--_ .. .m---_ __ __�,. _ K__.__ a ._ _. �_ � _._ _ _•. �.._ LOCATION. IND J H&ISb) Rant' PROPERTY,0INNER;TAlV1� A __._ VS�UZ Print 100 Year,Old Structure yes��rnMAP -ZONIN-- - TIRI PT _ Wistortc�®istrict yesioMachme,Shop Village; yeso, TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building One family ❑Addition ❑Two or more family ❑ Industrial Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other Septic EW-61i, Floodplain, D.Wetlands ® 1Natershed District; E Watet%Sewer DESCRIPTION OF WORK TO BE PERFORMED: 'holmoyO Kikh �A4ImY ICS W Uvt( -f0 wJ la.t> (. lvrX .curs 11 e� /cn✓ e�- X�At Int.rd- 4 -hs, u-U+ 5eeu d u a� 5 vze. �net cry �►, �s A?11.17ew cn h'i. A' �ill h Gcsn(a► h 1n5 1 G �cr►ch -b �uAnnrt >G ern �r�, bnCacpyft A ISM QyplAfdSkve!� nsl4(i h IU•kheo iSIA l D'u55 lotarn wl old le W" s,-1Yrrrot."t rt-cn Mff i &,i# ;x Yet "tcan �n v Q Fv � l Al I � � co L-jM411g,W Identification Please Type or Print Clearly) A Pflp"F-'`PA'Nt wr tn(wai/S� OWNER: Name:fA" A VASQUEZ Phone: Address: 1010 TQRJ504 5t IoA-r14 4NbevEV-, mA CONTRACT®R Name: ,1�LyA Z Rhone- ( I ) 3 aD _ Address: M Flim 11 Supervisor's Construction:License: L,� Exp: Date: . Home Improvement.Libense :__�to_g2 �Od1- Exp b ARCHITECT/ENGINEER Phone: , Address: Reg. No. FEE SCHEDULE:BOLDING PERMIT.$12.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. Total Project Cost: $ -1,500-0" FEE: $ Rn•°° Check No.: 4— Receipt No.: C&) i r NOTE: Persons contracting with unregistered contractors do not have access to the Signature of.A ent/Ovuner -—Sign of confiractor_. g g Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Sta ped Plans Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE-OF SEWERAGE DISPOSAL Public Sewer © Tanning/Massage/Body Art ❑... Swimming pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS CONSERVATION Reviewed on Siqnature 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 c Water & Seger Connection/Siqnature Date Driveway Permit DPW Towz ]Engineer: Signature: Located 384 Osgood Street FIRE Temp Dumpster on site yes no Located at 124 Main'Street Fire Departmefif signature/date COMMENTS Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions_ Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DARKER ZOITE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$10041000 fine NOTES and DATA— (For department use Ll Notified for pickup - Date Doc.Building Permit Revised 2010 Building Department Tine folowing is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses /❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products VOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products 10TE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the; apn•,al period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must hf- submAted with the building application Doc: Doc.Building permit Revised 2012 Location' J 0 N S 0.,-V S 'r No. t5 � �J� Date 3-1' ?617 TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ 70 u Fondation Permit Fee $ t Other Permit Fee $ TOTAL $ Check#�� SA Building Inspector Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost $ 71500.00 m $ - $ 90.00 Plumbing Fee $ 11.25 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 11.25 Total fees collected $ 212.50 1010 Johnson Street 808-2017 on 3/1/2017 kitchen remodel pORT1.1 Town of _ 6 ndover O to No. * _ ,� oh ver, Mass, 3 D/ 7 COCMICNEWICK R4TED I. ,�S U BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System ,4 `v� a E BUILDING INSPECTOR THIS CERTIFIES THAT ...... 6.9-01-pe......... ........!'�11 ..............4......................... .....to.to. �� N :T Foundation has permission to erect .......................... buildingson ...... ...................�..... � . .... � � . Rough to be occupied as ........ 4A.........v ..... . .. chimney 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 CONSTRUCT N YAR;j Rough Service ........ .. ...... ................................ Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building 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. INGLO Construction LZ _- Abraham Alvarez Customer: Licensed General Contractor Tannya Vasquez (617)435-7207 1010 Johnson St IngloconstructionCcbgmail.com North Andover, MA Re: 1010 Johnson Street, North Andover, MA SCOPE OF WORK: 1. Remove kitchen floor tiles and sub-floor 2. Level joist to match with house floor 3. Install new subfLoor, cement board and tiles 4. Level and secure 2 walls before cabinet installation 5. Install new cabinets 6. Install backsplash 7. Install a bench to support kitchen sink 8. Do carpentry finishes around stove hood 9. Install new kitchen island 10.Dress beam with old style looking woods 11. Remove and re-install one of the 2 front windows in order to adjust the level 12.Install all doors and windows and baseboard trims 13.Replace 2 windows with smaller windows by one inch 14.Patch, prime and paint kitchen (walls and ceiling)ng 15.Remove aluminum siding in the porch area and replace with vinyl siding Total cost: $9,000.00 Payments shall be made in 4 amounts of 25%each. 1'payment of$1,875.00 due at the start of project. This proposal is subject to the specific conditions note ow: Work shall be completed in 5 weeks from agreed upon start date between owner and contractor. The contractors shall not be liable, as regards to the completion of the work,for any delay which may be caused by reason or on account of any strike of workmanship,any act of God,unavoidable accidents,inability to secure materials or to use materials in the performance of the work by reason of laws or regulations of the U.S federal government,or the state of Massachusetts,or any other circumstance beyond their control. No such delay shall be deemed a default on the part of the contractors,and,in the event of any such delay,the contractor's time limit for performance of the work shall be correspondingly extended. The above prices,specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payment will be made as outlined above. Respectfully submitted and ACCEPTED by the following parties; Signature: - Owner Contract Agreed and accepted this Ji day of ' 2017 The commonwealth of Massachusetts _ Department of IndustrialAceidents -- Fess,S`tr`eet,,S' Ua 100 Congr Boston,MA 02_74 2017 www mass govldia ensaLiouTnsuxazice Affidavit:BuildexslCon aetoxs/Electricians/ lmnbexs. �c� kers' Comp G AU'IiIORTTT- TO BE F7LED WTZS�T' � fleas e Print Le bly Icant Information Lw cell, (Business/Oigat�a.io0 Q f Address: &A Ua Phony City/Statdzip: Axe you an employer?Ghecktiie appropriate box: Type off project(required): em loyees(full and/or part time).'` ']- ElNeW consttvction 1.❑I am a employer with__-- P 8. �Remodelvig 2.0Iam.asoleproprietororpar[nersbiPandv1e �d.)e no yeesWoz�ngfozmein 9_ El Demolition any capacty.INo-workers'comp.msuran q oworkers'comp.msurancerequired.]' 10❑Building addition 3.�I am ahomeownez doing ailworkmysel�[N o e IwiI1 4.❑I am ahomeowner andwi7l behiring contractors to conduct as work onmy pr P ty. I l❑Electricalpep vs or additions ensure that all contractors eitherhave workers'compensation insurance or are sole Plumbsug repairs or additions proprictorswithno5$- 4 emgiayees. I am a general contractor and Ihave hiredthesub-contractors listed on atsheet l3'.L]Rbofrepairs These sub-contactors have employees andhave workers'camp.insmance. 14.0 Other 6.FWe are a corpora-aov-and its.offices have exercisedtheir right of'exemption d-, c. 152,§1(4),and_Wehaveno employees.jNoworkers'comp.insivance_required *Aayapplicantthatcheccksbbx#1 � g eys doingaIIworkandthenhireouts:deaontrartors MILStsubrmtanewafadavitindicatingsach. i Homeowners who submittivs aifi.- the name of the sub-contractors and state whether or notthose entities have tConiractors that checkthis boxmvst attached'an additional sheetshowing olio number- .._-. - - - employees. Tfthe sub-contractors have employees,they must pYovide their workers'comp-P 3` ,.. , X am an ernployel'that is pi•oviding-woi�7te�s'comperzsation insurancefor°my errzployee.� Below zs tlzepo7icy arzdj•o�site information. [Zi Tnearance,CompanyNarae: CIO oZ d�() -3 '1(0 ExpirationData Policy 4 or Self-ins.Lic.9:. l _ �nd�/� _„ City/State/Zip: Tob Site Address: ' Attach a copy of the WQO Ckers'compensation policy deelaratlon page(showing the policy number and expia atzozi date). , Failure to secure coverage as required underMGL c.152,§25A is a criminal violation punishable by a flue up to$1,500-00 and/or one-year imprisonment;as well as civil penalties zn the form-of a STOP ceORK ORDER and a fine of uli to $- Tan 0 a day against the violator.A copy of this statement may be forwarded to the Of$ce of Xnvestigations of the DIA for insurance coverage verification. X do Iiereby ce�ti Date enaliies ofpeduvy tizat the infOTmation provided aiiave t€ue and correct ; a Si ature: 11GG Phone#: ` �J P 0 Official icse only Do not write in t7zis a?ecy to lie cornpleted by city or town official � T'exmit/Lieeuse# City or Town- Issuing Anthaxitg(circle one): ector 5.Plumbiug Inspector Z.Board of wealth 2.Building(Department 3.CitylTown Clerk 4.I+Iectxical Insp 6.Other Phone#: ContactPerson" Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their em I6 ees. Pursuant to this statute,an employee is defined as"...every-parson in the service of mother under any contract of hire, express or implied,oral or written." An employer fi d'ef bd as"an in dividaaj;partnership,also ciation,corporation or other legal entity,or any two or more Of the foregoing engaged in a joint enterprise,and includingthelegal representatives of a deceased employer,orthe receiver'or'mstde of an individual,partnership,association or otherlegal entity,employing employees.•However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds orbuilding ding appurtenant thereto shall not because of such employment be deemed to,be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the conaxnonwealth for any applicautwRd has not.produced-acceptable evidence of compliance with the iausuxance coverage xequicred" Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance ofpublic work until acceptable evidence of compliance with the in zaace requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes Haat apply to your situation and,if necessary,supply sub=contractors)name(s),addresses)and phone numbers)along with their cordfcate(s)of insurance. Limited-Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If m LLC or LLP does have employees,a policy is required. Be advised that this affidavit maybe submitted to the Department of Industrial Accidents for confiraaation ofinsurance coverage. Also be sure to sign and date the affidavit The af$davit should be returned to the city or town that the application for the permit or license is being requested,not the Department of IadusWal:Accidents. Should you have any questions regarding the law or if you are required to obtain a-�rorkers' compensatieri policy,please call the Department at the number listed below. S elf-insured companies should enter their self insurance license number on the appropriate line. Gity or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space attlia bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the p err it/license number which will be used as a reference number. In addition,an applicant that must submit multiple pert it/license applications in any given year,need only submit one affidavit indicating current policy infoxmation(ifnecessary)and under"Job Site Address"the applicant should write 5, locations in (city or town)"A copy of the affidavit thathas been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be flied out each year.More a home owner or citizen is obtaining a license or permit natrelated to any business or commercial venture (i.e. a dog license or permit to bunt leaves etc.)said person is NOT required to complete this affidavit. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Depar went of lnclustrialAccidents 1 Congress Street, Suite 100 Boston,MA 02114-2017 Tel. #617-727-4900 ext.7406 or 1-877 NaSSAFE Fax#617-727--7749 Rue ed 02-23-15 www.naa,5s.gov/dia Nor-4-5 3/1/2017 5 : 47 : 11 AM PAGE 2/002 Fax Server CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) TA KTIFICATE 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 and endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: ALPHA INS AGCY INC PHONE FAX 648 CENTRAL ST (A/C,No,Ext): (A/C,No): E-MAIL LOWELL,MA 01852 ADDRESS: 7775D INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A: HARTFORD UNDERWRITERS INSURANCE COMPANY INGLO CONSTRUCTION LLC INSURER B: INSURER C: INSURER D: 89 ELM HILL AVE INSURER E: DORCHESTER,MA 02121 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 ADD SUB POLICY EFF DATE POLICY EXP DATE LTR TYPE OF INSURANCE L R POLICY NUMBER (RWDDIYYYY) (MMDD\YYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ CLAIMS MADE 0 OCCUR. PREMISES(Ea occurrence) MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY [::]PROJECT E]LOC PRODUCTS-COMP/OP AGG $ AUTOMOBILE LIABILITY COMBINED SINGLE $ ANY AUTO LIMIT(Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULE AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) UMBRELLA LIAB MOCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ A WORKER'S COMPENSATION AND X ?WC STATUTORY OT ER EMPLOYER'S LIABILITY Y/N UB-9F423023-17 01/12/2017 01/12/2018 LIMITS ANY PROPERITOR/PARTNER/EXECUTIVEN/A E.L EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONS/SPECIAL ITEMS THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE, BUILDING INSPECTIONS CERTIFICATE HOLDER CANCELLATION TOWN OF NORTH ANDOVER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED C/O PAUL HUTCHINS IN ACCORDANCE WITH THE POLICY PROVISIO!, 120 MAIN ST AUTHORIZED REPRESENTATIVE NORTH ANDOVER,MA 01845 ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD 1988-2010 ACORD CORPWIR fi Wy Wf blits reserved. A, ® DATE(MM/DD/YYYY) O CERTIFICATE OF LIABILITY INSURANCE 02f2717 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER 'N'AME"' EDINA BRAGA Alpha Insurance Agency t4,PHONE No Ext: 978-459-4547 t.1C,No): 978-459 6131 648 CentralSt ADDRIE Lowell,MA 011852 SS: BUSINESS@ALPHAINSURANCEINC.COM INSURER(S)AFFORDING COVERAGE NAIL 0 INSURER A: WESTERN WORLD INSURED INSURER 13: HARTFORD INGLO CONSTRUCTION LLC INSURER C: 89 ELM HILL AVE INSURER 0: DORCHESTER,MA 02121 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 NAMEDABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT.TERM OR CONDITION OF ANY CONTRACTOR 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 POLICY EFF POLICY EXP LTR INSD WV POLICY NUMBER MMIDDIYYYY MMIDDIYYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 r;Z01 DAMAGE TOREN I ED CLAIMS MADE OCCUR PREMISES iEa occurrence) $ 100,000 MED EXP tAn y oneperson) S 5,000 A NPP8411067 01/11/17 01111/18 PERSONAL s ADV INJURY S 1,000,000 GLNT AGGREGATE LIMIT APPLIES PER GENE RAL AGGREGATE S 2,000,000 PoucY DEc°T F�t.00, PRODUCTS-COMP OP AGG S. 1,000,000 (7THErt AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S t[a a«oder I ANY AUTO BODILY INJURY iPer person/ c ALL OWNED SCH[DUd FO AUTOS AUTOS BODILY INJURY IPe�aCC�dentl < NON O W NE.1) PH RTY DAMAGE HII?EO AUTOS AUTOS Per acaden(I c � UMBRELLA LIAROCCUR EACH OCCURRENCES _ EXCESS LIAB HCLATAS MAO(. AGGREGATE S OED RETENTIONS S WORKERS COMPENSATION PER 0TH- ND EMPLOYERS'LIABILITY YIN 'P AND I ER ANY PROPRIETOR PARTNE-REXECUTIVEEL EACH ACCIDENT B )FFICER,MEMBEREXCLUDEO' ❑ NIA ASSIGNED RISK 01/12/17 01!12!18 Mandatory in NH) E.1- DISEASE-EA EMPLOYEE 5 I`ves.describe under DESCRIPTION OF OPERATIONS be:uvr - EL DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Job Location:1010 Johnson Street,North Andover,MA 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. Building Inspections c/o Paul Hutchins 120 Main St AUTHORIZED REPRESENTATIVE North Andover,MA 01845 v O 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD Massachusetts Department of Public Safefjr j Board of Building Regulations and Standards License: CS-089141 Construction Supervisor ABRAHAM A ALVAREZ 89 ELM HILL AVE DORCHESTER MA 02121 ^/IAS Expiration. �' Commissioner 12/1012017 ���e nirarnnirrnr�r�/�r/n�&KIiirrr�uvr �.._ c_ Office of Consumer Affairs&Business Regulatio �1 i �� �('%y HOME IMPROVEMENT CONTRACTOR ' Type: Individual f R691stratlon Exi2iration 167362 09/23/2018 ABRAHAM A.ALVARE ABRAHAM ALVARE�,.. i' 89 ELM HILL AVS DORCHESTER,MA 02121 U L, Undersecretary