Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
Building Permit #170-14 - 107 COVENTRY LANE 8/22/2015
Of No DT)j qN BUILDING PERMIT 3� d<<f. - 0 TOWN OF NORTH ANDOVER �o •, — t PPLICATION FOR PLAN EXAMINATION Permit NO: Date Received °9 • ��SsgI-Uzi Date Issued: 2" j EUPORTANT:Applicant must complete all items on this page r LOCATION D !J(' /4 AlL Print PROPERTY OWNER IV e9�60119_4 Print MAP NO:/j*PARCEL: ONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non-Residential ❑ New Building X One family ❑Addition ❑Two or more family ❑ Industrial k(Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑Other ❑ Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District ❑ Water/Sewer %� ti �S AY"�1 • .t�L� � S' dP Identification ,Please Type or Print Clearly) OWNER: Name: 2 Phone: Z6 — 3 Address; aL3A/ 1"—I? CONTRACTOR Name: Phone: qZ 3�vs" 7 Address: 3 ,3 C*p7 NGJ ��Q�!`P✓<'fa%�� r���' Supervisor's Construction License: Exp. Date: Home Improvement License: www Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE c;HEDULE:BOLDING PERMIT,•$12.00 PER$1000.00 OF THE TOTAL ES7IMA7ED COST BASED ON$125.00 PER S.F. Total Proje It Cost: $ FEE: $ 'ZZ Z r— Check No.:_i —� Receipt NOTE: Pesos ontracting with un gistered contractors do not have ac s to t le&dranty fund i nature of: .t/Owner nature of contractor ���---- �g.— _ 9 __ _ ` I TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit N0: Date Received Date Issued: IMPORTANT: Applicant must complete all items on this page t LOCATION Print, PROPERTY OWNER _ Print 100 Year Old Structure yes no MAP NO: PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition 0 Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District ❑Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: Identification Please Type or Print Clearly) OWNER: Name: Phone: Address: CONTRACTOR Name: Phone: Address: Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BOLDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ FEE: $ Check No.: Receipt No.: NOTE: Peis®.ns contracting with unregistered contractors do not have access to the guarantyfund Signatur --re-'of contractor Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ Location No. 4(71 / Date 7 Z • • TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $� Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check#1 4— CJ i �.J ! 1 Building Inspector Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPErOYSEA ERAGE DISPOSAL Public Sewer ❑ Tanning/MassageBodyArt ❑. . .Swimming Pools ' ❑ Well ❑ Tobacco.Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Permanent Dempster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY : INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED. DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS l CONSERVATION Reviewed 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 Water & Sewer Connection/S_ignature& Date _ Driveway Permit DPW Town Engineer: Signature: _ Located 384 Osgood Street FIRE DEPART��ViI_NT - Temp Dempster on site yes no Located at'124tMain Street-- Fire epa' merit.sigiiature/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 DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A-F and G min.$100-$1000 fine NOTES and DATA— (For department use D Notified foricku - Date p P E Doe.Building Permit Revised 2010 4 Building Department The folt'oWing 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 i ❑ 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 NOTE: Allumpster f permits require sign off from Fire Department prior to issuance of Bldg Permit New ConstructionSin le and Two Family) � g Y) I ❑ 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 NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit In all cas,2s if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the apw-al period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submAted with the building application Doc: Doc.Building permit Revised 2012 Enter construction cost for fee cal- North Andover Fee Calculation Construction Cost $ 269800.00 m $ - $ 321.60 Plumbing Fee $ 40.20 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 40.20 Total fees collected $ 502.00 107 Coventry Lane 170-14 on 8/22/2013 Remodel Master Bath i NORTH own of _ t EAndover o No. ®� T Y 0 LA - h , ver, Mass, !JS- A3, JS-Aoff- 1 COC NIC Kl WICK S V BOARD OF HEALTH Food/Kitchen PERMIT T LD tt Septic System THIS CERTIFIES THAT ........... ..... ........l.Gs.r. C.".,No*#.P■ .......................................................... BUILDING INSPECTOR ..... O has permission to erect buildings on �.f�� !1�; , Foundation .......................... ...... ......... .......... ....... ...... ....... Rough +L to be occupied as ....... R....... ......... .............................................. 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 CONSTRU RTS Rough Service ........ .... ................. ..................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy 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. t r Smoke Det. SEE REVERSE SIDE 77te Commonwealth ofMassachusetts Dient oflndustrial Accidents t (Vice of Investigations .1 r 600 MaskhVion Street Boston,MA 02111 www mas&gov/dia Workers' Compensation Insurance Affidavit:Buflders/Contractors/Elecb icians/Plumbers Applicant Information Please Print L. bly Name(Busines-dorganization&dividuai)_ Address: /33 City/State/Zip: 1. i j Phone#: 9 Are you an employer?Check the appropriate box: Typo of project(rcgeired): 4. contractor and I - 1„�I am a employer with� I am a general_ ❑ g 6_ New construction employees(fall and/or parttime).* have hired the sub-contractors 2111 am a sole proprietor or partner- listed on the attached sheet 7- g[Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. employees and have workers' o workers' ice$ 9- Building addition [N comp.insurance COW- 5. We are a corporation and its 10.0 Electrimi repairs or additions 3.❑ I am a homeowner doing all work offices bane exercised their I L[]Plumbing repairs or additions myself[No wo&ers'comp- right of exemption per MGI. 12-Q Roof repairs insurance required.]t c.152,§1(4),and we have no 13.0 Other employees.[No workers' comp-insurance required- ;Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. ;Any who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and share whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. . I am an employer that is providing workers'compensation insurance for my employees: Below is the policy and job site injorntatiam Insurance CompanyName: U Poli #or Self-ins.Lic.#: Policy tion Date: F�Pira Job Site Address: City/State/Zip: At_y1 )7* Attach a copy of the workers'c pensatioa policy declaration page(showing the policy number and expiration date). required Failure to secure coverage as under Section 25A of MGL c. 152 can lead to the imposition of criminal.penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine . of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify the pains and penalties ofperfin that the mfbrm don provided above rc true and rrarrort Si tore: Date- Phone#: `-1 ham` -3 7 oZ 2�F - Official use only. Do not write in this arteq to be completed by city or town o,oFdaL City or Town- Permit/License# Issuing Authority(circle one): 1.Board of Health .2.Building Department 3.Cityffewn Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: r'_://r��rurrmvrn:c�rlf/r�('llr.r�r�r/rri��fJ.; .� Office of Consumer Affairs&Business Regulation � - ;I,iOME IMPROVEMENT CONTRACTOR egTstration: 109080 Type: � piration: 9/112014 Individual F.DANIEL HICKEY,JR. F_Daniel Hickey,Jr. 133 8TH AVE -- — ;t HAVERHILL,MA 01830 Undersecretary Massachusetts -L'apartment of Public Safety Board of Building Regwations and Standa,ds Construction Supen iwr License: CS4004947 F DAN19L MCKE1'JR, 1/1 i1U 133 STH AVE = =_ HAVERIML MA. 01830 I \� J.•�.�Jy � � " '' Expiration Commissioner 0811412014 Proposal Dan Hickey Carpenter- General Contractor 133 8th Avenue Haverhill, Massachusetts 01830 Phone: (978) 372-2337 Fax: (978) 372-7529 E-mail danhickeyjr(cr�,earthlink.net Construction Supervisors License#004947 Home Improvement Contractor#1090809 RRP Certified R-1-18499-10-13024 OSHA Certification#000365694 Mass. Dept. Education; Carpentry(9-14)Certificate#413855 Federal ID#04-3252197 PROPOSAL SUBMITTED TO:Larry Cowan DATE: 8-20-2013 PHONE:978 6854535 Mobile:978 5014168 STREET: 107 Coventry Lane. CITY,STATE and ZIP CODE:North Andover,Ma 01845-2131 We propose hereby to furnish material and labor-complete in accordance with specifications bellow,for the sum of.Twentyone thousand xx/100 dollars.--------------------------------------------------- --- Payments to be made as follows:Five thousand upon signing of the contract.Additional payments upon ordering materials.Payments upon progression of work.Balance at completion Authorized Signature F.Daniel Hickey Jr. _ Note:we may withdraw this proposal if not accepted with, ith l 0 days We hereby submit specifications and estimate to remodel the master bathroom to include the following: Demolition:Remove the existing plumbing fixtures and partition wall between the existing shower unit and the vanity.Remove the existing floor tile and subfloor.Remove the plaster board as needed. Framing;frame for new 3'x 5'shower unit to include a shelf/seat.Frame to box in the front of the new tub. Pluming:Plumb and install new tub and new shower fixtures.Install a new toilet.Re-plumb the vanity area to allow for the new configuration of the vanity.Replace the bathroom baseboard with new Suntemp #700 with wall trim.If a hand held shower is to be installed with the soaking tub an additional charge will be added. Electrical:disconnect the existing bath tub.Add an additional plug for the middle of the vanity.Relocate the vanity lights to their new locations using owner supplied lights(the switching will stay the same), Disconnect the old bathroom fan and light and replace it with a new bathroom fan/ligbt combo.Relocate the existing shower light to center of new shower. If owners want to supply their own fan/light(there will be a$200.00 allowance.)All work is contingent upon the wires in the wall to be removed,has the wires entering from the ceiling.Addition cost will be added at a rate of$75 per hour. Plaster:Plaster all new work. Tiling:to include the riling of the new constructed shower and seat/shelf area.Tile the closed in area of the new tub.Tile the backsplash.Tile the floor.All tile area with the exception of the backsplash will have a permabase product install prior to the tile installation.The tile,grout and adhesive allowance is$2434.00. Cabinets:Purchase and install cabinets as per order established with Jackson Lumber.The allowances for these items are$2171.00. Windows:replace the existing mulled window with Haryey BP Majeq@ replacement windows. Painting:will include the painting of the walls and ceiling along with the staining of the new window sashes. • All job related permits will be provided • Price will include the removal of job related debris.This will be trucked away;if a dumpster is requested the related permits fees will be added. IV-The price includes an allowance of$5423_._00 for theplumb— fixtures and the cost and_ installation of a shower door: • Price does not includes electrical fixtures unless otherwise stated. • The owner will purchase and have the granite top installed. Time Schedule This project is schedules to start on or about .The expected completion time for the project should be on Time Schedule will be determined upon acceptance of this proposal. We are not responsible for delays due to inclement weather conditions or other unforeseen delays.The homeowner will be informed of any issues prolonging the completion date. All home improvement contractors and subcontractors shall be registered and that 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 Acceptance of Proposal-The above prices, specifications and conditions are satisfactory and are Signature hereby accepted.You are authorized to do the work as specified.Payment will be made as outlined above.Uwe Signature have read the attached Statement of terms and conditions.Do not sign,if these terms are not attached. Date of Acceptance: or there are any blank spaces. "The contractor and the homeowner hereby mutually agree in advance that in the event that the contractor has a dispute concerning this contras,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 consumer shall be required to submit to such arbitration as provided"n c 142A. Owner: Contractor: NOTICE:The signatures of the parties above apply onlyVoVe agreement of the parties to alternate dispute resolution initiated by the contractor. The owner may initiate alternative dispute resolution even where this section is not signed separately by the parties." Statement of Terms and Conditions NOTICE OF SCHEDULE CHANGES The Contractor agrees that when delays become known the Owner(s) will be notified as soon as possible. DELAYS IN COMPLETION DUE TO HIDDEN CONDMONS The Owner(s)hereby acknowledges that in certain remodeling work,the demolition of portions of the preexisting structure may reveal additional defects, conditions or the need for additional work which must be repaired,altered or carried out in order to commence or to complete the work described under the contract. In such case(s) the owner(s) become liable for the additional work to be performed and further agrees that the price, duration of work and the scheduled date of completion may differ from the original contract and that such variations which is not avoidable by the Contractor shall not be considered a violation of this contract. ADDITIONAL WARRANTY INFORMATION All warranties for equipment or materials supplied by the Contractor under this agreement shall be those given by the manufacturers of such equipment or materials, which shall be and hereby are passed through directly to the owner. Under such manufacturer's warranties, the Owner(s) may be required to register or mail in a warranty card or other evidence of workmanship and use such equipment or materials in order to activate said warranties. The Owner(s)failure to mail in or register such documentation, which failure voids the manufacturer's warranty,shall not create any responsibility for the Contractor to warranty such equipment or materials. The warranty gives the Owner(s)specific legal rights,and the Owner(s)may also have other rights which vary from state to state. Under Massachusetts law, sales of goods carry an implied warranty of merchantability and fitness for a particular purpose. All material is guaranteed to be as specified. All work to is to be completed in a workmanlike manner according to standard practices. Any alteration or deviation from the attached specifications involving extra costs will be executed only upon written orders, and will become an extra charge over the contracted amount. Extra charges are payable upon agreement as to the work to be performed and no charges shall be carried past the next to last payment as detailed in the contract.All carpentry-related work, charged on hourly bases, will be billed at fifty five Dollars per man-hour. In the event of a dispute the Contractor may,at option,demand that said dispute be determined by binding arbitration. In the event that the Contractor has to resort to litigation, court action or collection to obtain payment, the Contractor is entitled to attorney's fees,collection costs and reasonable interest(18%apr.) Due to duration of time, difference in lot runs, and the availability of existing products, the Contractor cannot guarantee that new product's color or styles will be an exact match to existing materials. The Contractor will do to the best of his/her ability to match the existing materials. Some times the discontinuing of certain products makes it impossible to provide an exact match. CONTRACTOR This company carries Liability and Workman's compensation Insurance. Subcontractors are required to supply required insurance. SUBCONTRACTING Contractor agrees that, notwithstanding any agreements for materials and/or labor between the contractor and a third party,the Contractor is responsible to the Owner(s)for the completion of all work in a timely manner. If the owner(s)hire others for work to be done in conjunction with contracted work they are responsible for coordinating this work and being responsible for the work being completed, inspected, and additional permits. Owner(s) must also insure that the additional work does not cause delays in the completion of the project.If delays occur due to this the homeowner will be liable for any cost or penalties to the Contractor. 1 NO ACCELERATION OF PAYMENTS,BUT ESCROWING ALLOWED The contractor may not require that payments be made in advance of the times specified in the payment schedule for the reason the contractor or the payments be insecure. If however the Contractor deems to be insecure,the Contractor may require,as a prerequisite to continuing the work described herein, that the balance of the payments under this contract that there are in the control of the Owner(s), shall be placed in a joint account administered by an attorney of the Contractor's choosing under the laws of the State that requires both signatures of the Contractor and Owner(s)for withdrawal. CONSTRUCTION RELATED PERMIT ACQUISITION The Contractor under the provisions of Chapter 142A of the General Laws of the State of Massachusetts is required to apply for and obtain all construction related permits.The Contractor shall not be responsible for delays in work described under this agreement caused by regulatory,permit-granting or inspectional agencies,authorities or individuals. *NOTICE-If the Owner(s)obtain their own construction related permits for the work described under this agreement or deals with unregistered contractors, the Owner(s) is hereby advised that in the event of a dispute,judgement or'ud ement nonpayment of the Contractor,the Owners will not be entitled to make a claim to P or collection from the guaranty fund established by the Chapter 142A MGL. MODIFICATION This agreement, including the provisions related to price and payment schedules cannot be changed except by written agreement signed by both Contractor and Owner(s). However, cancellation by the Owner(s)is allowed in accordance with MGL that requires that the Owner(s)provide a written notice of cancellation to the Contractor within 72 hours from the time of contract execution. If after 72 hours, the Contractor allows for the contract to be canceled then the amount of the deposit of the contract may not be refunded. PAYMENTS The Owner(s)are directly liable for all contractual payments, and inspections as may be required by the Owner(s) financial institutions, in a timely manner(72 hours.)Violation of the payment schedule could,at the Contractors option,null and void the balance of the agreement as yet undone.Notwithstanding all materials,either ordered,on site,or applied are the property of the Contractor until paid for. EXCLUSIONS Unless specifically detailed in the contract the Contractor does not supply or include the following; knobs and handles of cabinets/ medicine cabinets, shower curtains, rods, or enclosures. Bathroom items such as toilet paper holders, toothbrush holders, soap dishes, or towel rods/ floor coverings/landscaping or permits.These may be provided for additional cost of material and labor. OWNER(S)AGREEMENTS AND AUTHORIZATIONS Owner(s) authorizes the Contractor to make all openings in the building necessary for the fulfillment of this agreement. If the agreed work calls for the re-insulation of the sidewalls of the existing building, the Contractor will do its best to restore the appearance of the building, but cannot guarantee complete restoration of the same. Owner agrees that the prices quoted in this agreement are binding only for a 30 day period, from that date hereof, and that after such period, for each 1%increase in the cost to the Contractor of materials necessary to perform this agreement, the agreed price will automatically be increased by 1-1/2%, to the purchase to the Purchasers of the contract increase. Owner(s) agree to provide safe access by both man and equipment to work area; also to provide water,electricity and access to electric panel. Owner(s)agree to hold no retainage for work performed under this contract. Owner(s) agree no back charges or pro-rata expense charges are to be made against Contractor unless specifically agreed upon prior to incurring such expense. Any labor ordered other than normal working hours is to be paid at an overtime rate. Owner(s)acknowledges that all-oral or written agreements,statements or representations made on behalf of this company are expressed or superseded by this proposal. THIS CONTRACT CONTAINS IN WRITING AND PRINT THE ENTIRE CONTRACT BETWEEN THE PARTIES THERETO, NO 2 WARRANTIES OR GAURANTEES, EXPRESSED OR IMPLIED, ARE MADE BY THE SELLER EXCEPT THOSE SET FOURTH IN THIS CONTRACT.This company will not authorize or be held liable for offers or deeds made by employees or subcontractors. Owner(s)to cavy fire,tornado and other necessary insurance. CEDAR SIDING- Neither the contractor, distributor, or manufacturer will guarantee the siding against bleeding. (Steps are taken to help prevent this, by the use of stainless steel fasteners. Attention must be given to the applied finish to the materials installed. Roofing- Stripping of roofing will cause a great deal of deteriorated roofing material to fall between the spacing of the roof boards, it is our strong recommendation to have the owner cover and protect articles in this area. It is recommended that all windows be closed and all air conditioners and fans are off during the stripping of the roof. Heavy Equipment- During the course of some projects heavy equipment such as excavating equipment, concrete trucks,delivery vehicles and debris containers may be used.Neither contractor nor subcontractors will assume damage to driveways or lawns if it is necessary for these vehicles to use this area for the progress of the project. Concrete Pumping- is a process used to pour concrete in areas that are not accessible to standard equipment.Pricing for this is a cost above the existing contract price unless otherwise stated. *Notice-The contractor hereby advises the Owner(s)that certain individuals may be allergic to or affected by the enanmation of particles from certain types of insulation, and the Contractor hereby disclaims all liability for any and all damage which might be sustained by any person as a result thereof Restrooms-This necessity must be provided by the homeowner. If it is the wish of the owner not to allow use of the home then a portable unit will be place on the property and maintained at the owners expense. Snow Removal- It is not feasible to estimate a snow fall during the winter months, so if we receive snow during the construction of your project then the necessary snow must be remove from the project,materials and work area.This will be done at the per man-hour price. Job Related Debris At our discretion job related debris will either be removed in our equipment or a container will be place on the job site.Location of such will be predetermined prior to delivery.A container on site for any duration of time may cause wear to the surface it is placed on. We assume no liability for such wear. Also only job related debris will be placed in these containers;the mixing of household items, appliances and other hazardous materials is not allowed.If such items are found they will be removed prior to the extraction of the container.Cost for removal will be based on the hourly rate with a minimum of one hour.All non-qualifying materials will be left piled on the property. Personal Items- Neither Dan Hickey Contractor nor Subcontractors hired by Dan Hickey will be responsible for damage to the owner's personal items. Such items should be removed from the work area prior to the start of the project.All items hanging on the walls should be removed for safety. LAWS OF THE STATE OR COMMONWEALTH OF APPLICATION SHALL GOVERN THE TERMS OF THIS CONTRACT. 3 ACORD CERTIFICATE OF LIABILITY INSURANCEDATE(MM/DDIYYYY) *�+ 0812012013 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Cowan Insurance Agency,Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 359 Main Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Haverhill MA 01830 INSURERS AFFORDING COVERAGE NAIC# INSURED Dan Hickey INSURER A: Providence Mutual Insurance Company 133 8th Avenue INSURER B: Associated Employers Insurance Company INSURER C: Haverhill MA 01830 INSURER D: INSURER E: COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR PiDO'L POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATIONTYPE OF INSURANCE DATE(MMIDDNYI LIMITS GENERAL LIABILITY EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED A X COMMERCIAL GENERAL LIABILITY L118000104 05109113 05109114 $50,000 CLAIMS MADE a OCCUR MED EXP(Any oneperson) $5,000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $11,000,000 X I POLICY PRO LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accident) $ PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR EICLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ TH- WORKERS COMPENSATION AND X rw SI IMIT PR B EMPLOYERS'LIABILITY WCC5007139012011 04125113 04125114 E.L.EACH ACCIDENT $100,000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? Yes E.L.DISEASE-EA EMPLOYEE $100,000 If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $500,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Job Site:Larry 8r Janet Cowan,107 Coventry Lane,North Andover MA 01845 Residential carpentry contractor. Dan Hickey is not included on the workers compensation policy. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Town of North Andover DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN Building Department NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL 1600 Osgood St IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR North Andover,MA 01845 REPRESENTATIVES. AUTHORIZE=R1 IVE i ACORD 25(2001108) ©ACORD CORPORATION 1988 • S f)IAJ Close'( 0 E 0I cn N y, Ul► v n .. I� M ` ew o . ;wp LU C 4 PA N v M C E q C1 0