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HomeMy WebLinkAboutBuilding Permit #761-15 - 120 BRENTWOOD CIRCLE 4/6/2015BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received Date Issued: IMPORTANT: Applicant must complete all items oathis page TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential 0 New Building 0 Addition Alteration yoOne family 0 Two or more family No. of units: 0 Industrial 0 Commercial 0 Repair, replacement 0 Demolition 0 Assessory Bldg 0 Others: D Other Septic 0r:r„---' --- '; "-- 17.igtrpran Wetlands r.-;i-e• 7\.°.- '*v -', ''..:aESe atr10eker gt"etzial-- _ . DESCRIPTION OF WORK TO BE PERFORMED: Identification,- Please Type or Print Clearly OWNER: Name: Zoe.; Ste Address: 00 /,,79L Phone: c-f 0 ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE: BULDING PERMIT: $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. TotalProjeCtCOSISN ° Check No.: /Y Receipt No.: NOTE, Perso, .ontracting with unregistered contractors do not have access to fo fark6.1400. Ot:TW"-f' FEE: $ z4ogaitiblgitirettaritt8e-tok, 1 , Plans Submitted Plans Waived L Certified Plot Plan _ Stamped Plans P' TYPE'e3F SEWERAGE DISPOSAL Public Sewer V Tanning/Massage/Body Art — Tobacco Sales — Permanent Dumpster on Site Swimming Pools ❑ Food Packaging/Sales ❑ Well I Private (septic tank, etc. i THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH COMMENTS Reviewed on Signature Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes f-# POinning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/signature & Date DPW Town Engineer: Signature: Driveway Permit Located 384 Osgood Street Dimension Number of Stories: Total square feet of floor area, based on Exteibr'dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requiresapproval 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) 4u\/ \9-1_,11;\ Date ❑ Notified for pickup Call Email Time Contact Name Doc.Building Permit Revised 2014 Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits o Building Permit Application o Workers Comp Affidavit o Photo Copy Of H.I.C. And/Or C.S.L. Licenses o Copy of Contract o Floor Plan Or Proposed Interior Work o 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 o Certified Surveyed Plot Plan o Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses o Copy Of Contract o ..Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) o Mass check Energy Compliance Report (If Applicable) o Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application o Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses o Workers Comp Affidavit o Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) o Copy of Contract o 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 cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc: Building Permit Revised 2014 Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost $ 103,250.00 m $ - $ 1,239.00 Plumbing Fee $ 154.88 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 154.88 Total fees collected $ 1,648.75 120 Brentwood Circle 761-15 on 4/6/2015 Kitchen remodel Front Entry Remodel v C -. a) 0 O o o `b >co. cn - "*". cu -z c, cz v� o z o_ ;• CD CD o O Co wB. _. Cl) m co CD I z v S C o -aCD 0 o CD O CD 2101O3dSNI JNlallfl8 • z rn Cl)n O cn 0 z X -v cn z a) 0 --I cn g Regulations Voids this Permit. < o g O w CR = <I. 0- Cl) —I C O• M 0 CD O -. _ 3 _..� Z O�_ o Mn�a6.N • CD CD N • CD CD CD .D) colm (Q• co O. = N, O D) O = - 0 3m1 CD-0 • —Io= o<co o gCn -I - o -,D 0_o O 0_ - 7gu< et Q 1VH1 S3IdI12130 SIHI N v) co 3 , c OT. M c3 Z CD O m m v ITI DV) -I — m -I T Z) 7 0 Ol W D N ZCI m f1 0 T cm70 5 (D O v m iTi —I XI Z H 13 m 0 73 PLUMBING INSPECTOR Rough Final BOARD OF HEALTH Food/Kitchen Septic System BUILDING INSPECTOR Foundation Rough Chimney Final Malli v co C 11) Cl) � O "0n O CD CDCD 0 C o 2) eNd 0 va9 CD ' 0 0 .t. m CD O CDW _ Cl) 127.= corn c� m I o Z CD 0 0 r.�. o - cp.., 0 CD 210103dSNI JNlallfl8 • m Ta cn z. C) 0 cn VIOLATION of the Zoning or Building Regulations Voids this Permit. o o .� Q O W y O CD Q O FACD S �O Oe'ny O n O• s CD s CD CD ,aPt o,= og(" a, p1 CO cqo1- y 'a N rt O sst N CD n oo o o a)O O _< CD • Cr O' a n - rtM a-0 3 o. N. V! O. CD 3.4 IVH1 S31I112I30 SIHI Construction Contract SILVER 1 PHOENIX CONSTRUCTION Homeowner: Contractor: Mr. & Mrs. Steigerwald 120 Brentwood Circle North Andover MA 01845 1. General Silver Phoenix Construction LLC P.O. Box 306 Tewksbury MA 01876 In consideration of the mutual promises contained herein, Contractor agrees to perform the following work: furnish all labor, materials except cabinet customer provides, tools, equipment, and supervise to construct or renovate the Homeowner's residence according to this contract and the following documents (collectively with this contract, "Contract Documents"). The project is generally described back room renovation. The contract consists of this Document, Exhibit - I The Project, and Exhibit II -The Plans supplied by homeowner. Change orders and modifications shall be in writing and shall become part of this contract. 2. Price The Total projected price for the work agreed upon is $103,250.00 Payment terms are set out below in Paragraph 6. 3. Starting and Substantial completion Provisions The work will start on or around April 6, 2015 and the project will be finished within 4 months of start date, unless any changes are made and approved by client. 4. Specific requirements for materials and workmanship a. This contract will be completed by the contractor in a good workmanlike manner, using good quality materials. b. If applicable, the contract price includes the allowances listed in the contract details section. c. The Contractor agrees to coordinate with plumber/electrician for furnace install and electrical work. d. To acquire all necessary permits with the town of North Andover and to maintain compliance with town laws, regulations and requirements during construction." 5. Expiration of Contract This contract will expire (30) days after the date first written above if not accepted in writing by the homeowner and returned to the contractor within that time. 1 Construction Contract SILVER t PHOENIX CONSTRUCTION 6. Payment Schedule a. Timely payment by the homeowner of all sums due under this contract is of the essence to this contract. The parties agree to the following schedule of payments. Payment Schedule as Follows: 1. Initial Payment due at contract signing 2. Completion of Rough Plumbing 3. Completion of Plaster 4. Final payment at completion of job $34,000.00 $28,000.00 $25,000.00 $15,250.00 The Contractor shall provide the homeowner with his own waiver or cumulative subcontractors' waivers equal to the amount paid for any progress payment. b. The Contractor may cease operations if the Homeowner as required herein does not make any progress payment, and proceed to collect the balance due with any legal remedy. Alternatively, the Contractor may continue operations, as set forth in the attached. 7. Signature Attached hereto as Exhibit I are the general conditions governing the rights and obligations of the parties to this Contract. The parties are further subject to the laws of Massachusetts governing Contracts and mechanics' liens, and acknowledge the right of the Contractor to place a lien of security interest on the property of the Homeowner. IN WITNESS WHEREOF, we have hereunto set our hands and seals this 28 day of March , 20 15 DO NOT SIGN THIS CONTRACT IF THERE ARE BLANK SPACES HOMEOWNER(S HOMEOWNER(S) The homeowner may cancel this Contract if it has been signed by the Homeowner at a place other than the office of the Contractor, provided that the Homeowner notifies the Contractor in writing at the Contractor's office by ordinary mail, telegram or personal delivery, not later than midnight of the third business day following the signing of the Contract. See attached Notice of Cancellation for further explanation of this right. GENERAL CONDITIONS These General Conditions are part of the Contract between Mr. & Mrs. Steigerwald ("Homeowner") and Silver Phoenix Construction LLC ("Contractor") for work at 120 Brentwood Circle North Andover Ma 2 Construction Contract SILVER PHOENIX CONSTRUCTION 1. CONTRACTOR'S DUTIES -GENERAL a. T o direct and control the work contracted for in accordance with the terms of this Contract and all applicable codes, laws, and regulation, as the building permits, if any, issued for this project require. b. To inspect the site, examine the plans and specifications if, any, and supervise all of Contractor's employees, and to direct the work of all subcontractors selected by Contractor. c. to maintain the work site in a safe and clean condition, to the extent consistent with the contract. The work site will be left in "broom clean condition" d. To advise the Homeowner promptly if concealed conditions are ascertained which require additional or different work, and to proceed in such event in accordance with this agreement. e. All interior furnishings and rugs to be protected during construction from damage. 2. HOMEOWNER'S DUTIES -GENERAL a. To provide adequate utilities for the work agreed upon. b. To advise the Contractor of any condition of the property which affects Contractor's ability to perform. c. To provide secure storage areas for materials delivered to the work site. d. To perform no work on the project without a written agreement with the Contractor. To avoid interfering with workers. e. To make no agreements with any trades person, subcontractor, or Contractor's employee outside the scope of this Contract without the written consent of the Contractor. f. Homeowner shall notify his insurance agent of the execution of this Contract and obtain any necessary Riders to his current coverage or any locally customary forms of coverage. 3. DELAY Contractor shall not be responsible for delays caused by events beyond the control of the Contractor, including but not limited to: strikes, war, acts of God, riots, governmental regulations and restrictions. Delays caused by Homeowner's failure to make allowance materials' selections or caused by the performance by Contractor of additional necessary work shall likewise be excusable delays. 4. PERMITS The contractor will obtain the following permits from the Town of Billerica if applicable. Note: if the Homeowner secures its own permits or deals with unregistered contractors, the homeowner is excluded from the Guaranty Fund provisions of MGLc. 142 A. 5. INSURANCE Contractor agrees to maintain all necessary forms of insurance to protect the Homeowner from liability for any occurrence arising from the performance of this Contract. Contractor agrees that he carry general liability, and that all forms of insurance carried here under shall be with reputable companies licensed to do business in this state. Contractor shall provide insurance certificate to homeowner prior to commencement of work. Homeowner agrees to carry full coverage on the subject property covering Homeowner's risk of loss during the construction period, together with all special forms required by reason of the performance of this Contract. 3 Construction Contract SILVER 1' PHOENIX CONSTRUCTION 6. HIDDEN, CONCEALED and UNFORESEEABLE CONDITIONS The parties agree that in the event Contractor discovers a condition requiring an extra cost that they shall proceed as follows: The Contractor shall notify the Homeowner verbally at once to expedite agreement as to the charge to corrector cure such condition, and provide a written estimate as soon as practicable. The parties must agree to such extra charges, or agree to a resolution method, or this Contract may be canceled by either of them. For purposes of this section, a "hidden, concealed and unforeseeable condition "shall mean a condition not readily observable to a prudent contractor inspecting the subject property for the purpose of performing this Contract. 7. ADDITIONALWORK Any additional work or materials desired by the Homeowner shall be agreed upon in writing or by email and such extras shall become a part of this Contract. Unless otherwise agreed, any additional work shall be paid for as performed. Failure of the Homeowner to sign a change order shall not preclude recovery for same by Contractor, and acceptance of said additional work or materials shall be presumed, unless there is written notice to the contrary. Contractor shall advise Homeowner at the time of agreement on any additional work as to any additional work performed under this contract. 8. TERMINATION and CANCELLATION Contractor shall have the right to stop all work on the project and keep the job idle if payments are not made to Contractor in accordance with the payment schedule set forth above, or if Homeowner repeatedly fails or refuses to furnish Contractor with access to the job site or product selections or information necessary for the advancement of the work. Simultaneous with stopping work on the project, Contractor shall give Homeowner written notice of the nature of Homeowner's default. If work is stopped due to any of the above reasons (or for any other material breach of Contract by Homeowner) for a period of seven (7) days after notice, and the homeowner fails to cure the default, then contractor may without prejudice any other remedies Contractor may have, give written notice of termination of the Contract to Homeowner and demand payment for all completed work and materials ordered through the date of work stoppage, and any other loss sustained by Contractor, Silver Phoenix Construction Thereafter, Contractor is relieved from all other contractual duties. Upon such termination, the Contractor shall have all remedies provided by law, including such lien rights as they apply. The Homeowner may terminate this Contract upon the following conditions: a. Any other failure to perform this Contract required by the terms of this Contract. c. No termination shall be effective unless 10 days notice of Homeowner's intent are given as provided below, during which time the default may be cured by the Contractor. 9. DISPUTE RESOLUTION AND ATTORNEYS'FEES Dispute Resolution. The Contractor and the Homeowner here by mutually Agree that in the event that the Contractor has a dispute concern -in the contract, the Contractor may submit such dispute to a private arbitration. Inquiries Regarding Contractor all home improvement contractors and subcontractor shall be registered and that any inquiries regarding a contractor or subcontractor relating to a registration should be directed to: Registration Division, Program Coordinator One Ashburton Place, Room 1301 Boston, MA 02108 4 Construction Contract SILVER F PHOENIX CONSTRUCTION NOTICE: The signatures of the parties above apply only to the agreement of the parties to alternate dispute resolution initiated by the Contractor. The Homeowner may initiate alternative dispute resolution even where this section is not signed separately by the parties. b. Small Claims Court. Any controversy or claim arising out of or related to this Contract involving an amount of less than $2,500.00(or the maximum limit of the court) must be heard in the Small Claims Division of the District Court in Essex County. 10. WARRANTIES The work of the Contractor including materials and labor shall be guaranteed for a period of one (1) year Contractor shall at its own expense correct any defect arising from its work unless Paragraph7 of these General Conditions applies. This provision is in lieu of all other warranties, express or implied, Silver Phoenix Construction Page6 and Homeowner have no action at law or in equity against the Homeowner after said date. b. Any and all warranties for appliances or mechanical systems shall be delivered to Homeowner then Contractor's final payment is received. c. Not with standing any manufacturer's warranty of any component, appliance, or System, no action may be brought against the Contractor on this contract, for the performance of this work, except as provided above. 11. OTHER ITEMS a. The Contractor may place a trash container, commonly called a dumpster, on your Property during the course of the project. The Contractor will make every effort to locate the dumpster in a location that is convenient for the Homeowner. The Contractor is not responsible for any damage to your lawn or driveway caused by the delivery or removal of the dumpster. Contractor shall protect the septic field and pump areas as outlined in the drawings provided, and will be responsible for repairs if damaged 12. NOTICES Notices maybe sent to either party at the addresses shown above or, mailed by certified or registered mail. Any mailed notice shall be deemed given as of the date of mailing. 13. SEVERABILITY If any portion of this agreement is found invalid or unenforceable any court, the remaining provision shall remain in force between the parties. 14. ENTIREAGREEMENT This Contract consists of the documents defined above, and constitutes the entire agreement of the parties. It can be modified only by a written document. 5 Construction Contract SILVER ! PHOENIX CONSTRUCTION NOTICE OF CANCELLATION You may cancel this Contract, without penalty or obligation within three (3) business days from the date this Contract is fully executed. If you cancel, any property traded in, any payments made by you under the Contract, and any negotiable instruments executed by you will be returned within ten (10) business days following receipt by the Contractor of your Cancellation Notice, and any security interest arising out of the Contract will be cancelled. If you cancel, you must make available to the Contractor at your residence in substantially as good condition as when received any goods delivered to you under this Contract; or you may, if you wish, comply with the instructions of the Contractor regarding the return shipment of the goods at the Contractor's expense and risk. If you do make the goods available to the Contractor and the Contractor does not pick them up within twenty (20) days of the date of Cancellation you may retain or dispose of the goods without any further obligation. If you fail to make the goods available to the Contractor, or if you agree to return the goods to the Contractor and fail to do so, then you remain liable for performance of all obligations of the Contract. To cancel the Contract, mail or deliver a signed or dated copy of this Cancellation Notice or any other written notice, or send a telegram to Silver Phoenix Construction 1 Starbird Lane, Tewksbury, MA 01876 not later than midnight of the third (3'd) business day after the execution of the Contract. I HEREBYCANCELTHISCONTRACT. Date: Homeowner: Massachusetts's law requires that all home improvement contracts contain two notices of cancellation. If you do not intend to cancel this contract, please do not sign this page. I HEREBY CANCEL THIS CONTRACT. DATE: HOMEOWNER Massachusett's law requires that all home improvement contracts contain two notices of cancellation. If you do not wish intend to cancel this contract, please do not sign this page. 6 • Construction Contract SILVER 1 PHOENIX CONSTRUCTION NOTICE OF CANCELLATION You may cancel this Contract, without penalty or obligation within three (3) business days from the date this Contract is fully executed. If you cancel, any property traded in, any payments made by you under the Contract, and any negotiable instruments executed by you will be returned within ten (10) business days following receipt by the Contractor of your Cancellation Notice, and any security interest arising out of the Contract will be cancelled. If you cancel, you must make available to the Contractor at your residence in substantially as good condition as when received any goods delivered to you under this Contract; or you may, if you wish, comply with the instructions of the Contractor regarding the return shipment of the goods at the Contractor's expense and risk. If you do make the goods available to the Contractor and the Contractor does not pick them up within twenty (20) days of the date of Cancellation you may retain or dispose of the goods without any further obligation. If you fail to make the goods available to the Contractor, or if you agree to return the goods to the Contractor and fail to do so, then you remain liable for performance of all obligations of the Contract. To cancel the Contract, mail or deliver a signed or dated copy of this Cancellation Notice or any other written notice, or send a telegram to Silver Phoenix Construction LLC 1 Starbird Ave, Tewksbury, MA 01876 not later than midnight of the third (3'd) business day after the execution of the Contract. I HERE BYCANCELTHISCONTRACT. Date: Homeowner: Massachusetts's law requires that all home improvement contracts contain two notices of cancellation. If you do not intend to cancel this contract, please do not sign this page. I HEREBY CANCEL THIS CONTRACT. DATE: HOMEOWNER Massachusett's law requires that all home improvement contracts contain two notices of cancellation. If you do not wish intend to cancel this contract, please do not sign this page. Construction Contract SILVER PHOENIX CONSTRUCTION Exhibit 1 The project will include the following: 1. The jobsite will be broom swept, locked and weather tight at the end of each day and all debris removed. 2. Remodeling of your kitchen, dining room, foyer and deck. 3. The project start date will commence on or around April 6, 2015 and finish 4 months from start date. 4. Also See Proposal Below, which becomes part of the contract upon signatures between homeowner and contractor. 8 Construction Contract SILVER i PHOENIX CONSTRUCTION Proposal: Mr. & Mrs. Steigerwald 120 Brentwood Circle North Andover Ma THE PROJECT PROPOSAL: See Attached Contractor: Silver Phoenix Construction P.O. Box 306 Tewksbury MA 01876 This is only a proposal for the project and will not become binding upon the signatures between the Contractor and Client at the bottom of this document until a formal contract is signed between the parties. Client: dvoia Date: (..\X yacx 0$1 00,s- Silver Phoeni'Construction: Date 3 7.1-0-075-' PROPOSAL SILVER 1 PHOENIX CONSTRUCTION Silver Phoenix Construction LLC PO Box 306 Tewksbury Ma 01876 March 28, 2015 Lori & Jake Steigerwald 120 Brentwood Circle North Andover Ma Dear Lori & Jake Scope of work: Reconfigure First floor to create a larger kitchen and open a more functional flow to the home. Demo: Demo walls and ceiling to studs in kitchen area Remove all tile in entry & kitchen, Remove exterior back brick stairs and cellar entry Remove front exterior wall $7,200 Site Work: $1,500 Put in new footing to support new extended living area Carpentry: Install all barrier/ demo protection prior to demo Install load caring beams flush mounted with ceiling Build new exterior walls for expanded area Frame exterior walls for new windows and doors, Frame all new interior walls Install blocking as needed Side exterior Build Deck Build new front entrance Blend new and old roof together $17,750 Insulation: $1,250 Insulate all exterior walls to code PROPOSAL SILVER PHOENIX CONSTRUCTION Plumbing: Demo existing plumbing to make safe for demo Redo plumbing in kitchen Move heat and rework heat Plumbing Fixture Allowance of $350 Electrical: Remove and replace old circuits to bring up to code Demo electrical in walls that are to be removed Install all new wiring in remolded area Install new lighting in all remodeled areas Fixture Allowance $300 $7,500 11,000 Plaster: $6,000 Blue board and plaster all walls Hardwood: Install hardwood in remodeled 1st floor area (match existing) Sand and finish all new flooring and old dining room area Tile: Install new tile on floor of entry Install new tiled back splash $6sqft allowance Finish Carpentry: Install new doors to match existing Install new trim to match existing Install all new cabinetry as designed Paint: Paint all newly remodeled interior Paint newly installed siding (weather dependent) Building Materials: Studs, LVL beams, Nails Siding & exterior trim Trim work Doors interior & Exterior Windows Roofing material Columns $5,800 $3,200 $9,750 $8,250 $19,500 PROPOSAL SILVER PHOENIX CONSTRUCTION Counter Tops: Hardware: Door Knobs Cabinet Pulls $5,500 $550 Total Project Cost $103,250 r 9'-0" ± to finished floor .v 7" Second Floor Level LVL beam provided for support of second floor attic joists, partition wall and and second floor sleep areas floor joists / ceiling Saddle connector; Simpson column cap connector CC7%8" -4 type , coordinate in field conditions provide king studs adjacent when possible, typical .1r 13`0" - New joist hangers typical for existing 2x10 joists This framing assembly has been structurally sized according to MA building code minimum load standards. These details have been prepared under the supervision of the undersigned and are in conformance to acceptable engineering standards 0 0 L___J l• New Beam Spans up to 16'-0" ± (4) 1 3/4" x 117/8" " (Gr. E2.0) Microlam LVL; Ply's to be bolted together at 16" o.c. w/ (2) %2" 0 bolts, washers and nuts, typical New engineered wood column 31/2" x 7" PSL (Gr. 1.8E), each end typical coordinate fit in existing space and align over support below align all post framing with foundation or girder and column elements below, typical SECTION THROUGH NEW Bu It Up Microlam LVL at SECOND FLOOR SPANS 16'-0" ± AM, NORTHEASTERN ENGINEERING CORP. Structural Engineers and Construction Consultants www. northeastemeng. corn 19 Campbell St. Woburn, MA 01801 tel. 781-503-0241 fax. 781-503-0247 140 Brentwood Drive North Andover, Massachusetts Scale : N.T.S. Sheet Title First Floor Renovation Sheet No. s-1 12-11 114' a Cl)rn 1/4 m 6 27-9 1Q' 3 11'.2" PLAN DATE: - Lori Steigerwold _ Proposed - Designs I)enne 2/26/2015 140 Brentwood Drive North Andover MA Design r 0. ryn2:.42DuaitAbit MAO t$27 ,478-sii:-,olo NJ) C-C-2015 ©2015 SIMPSON STRONG -TIE COMPANY INC. PRINTED 12/14 CC/ECC/ECCU Column Caps Column caps provide a high -capacity connection for column -beam combinations. MATERIAL: CC3%, CC44, CC46, CC48, CC4.62, CC64, CC66, CC68, CC6-7%, ECC3%, ECC44, ECC46, ECC48, ECC4.62, ECC64, ECC66, ECC68, ECC6-71/4-7 gauge; all others-3 gauge FINISH: Simpson Strong -Tie® gray paint; may be ordered HDG; CCO, ECCO—no coating INSTALLATION: • Use all specified fasteners. See General Notes. • Bolt holes shall be a minimum of/32 to a maximum of Me larger than the bolt diameter (per 2005 NDS, section 11.1.2). • Contact engineered wood manufacturers for connections that are not through the wide face. OPTIONS: • Straps may be rotated 90° where W1. W2 (see illustration) and for CC51/4-6. • For special, custom, or rough cut lumber sizes, provide dimensions. An optional W2 dimension may be specified. (The W2 dimension on straps rotated 90° is limited by the Wt dimension.) • CCO/ECCO—Column cap only (no straps) may be ordered for field -welding to pipe or other columns. CCO/ECCO dimensions are the same as CC/ECC. CCOB—Any two CCOs may be specified for back-to-back welding to create a cross beam connector. Use the table loads; the load is no greater than the lesser element employed. CODES: See page 12 for Code Reference Key Chart. kW1�1 ECCO w1''\ L �. • 23` a `bolts' its bolts) ECC44 E=13a Unless otherwise specified --► E Optional ECC with straps rotated 90° SIMPSON Strong -Tie ECCU (ECCU44 has only 2 bolts to beam) Optional CC with straps rotated 90° ak These products are available with additional corrosion protection. Additiona products on this page may also be available with this option, check with Simpson Strong -Tie for details. Model No. (CC shown ECC/ECCU similar) Beam Width Dimensions Machine Bolts Allowable Loads (DF/SP) Code Ref. CCO Model No. (No Legs) ECCO Model No. (No Legs) W1 Wz L H1 Size Beam Post Down Up itt CC ECC ECCU CC ECC ECCU . > •...cc ECC/ CC :. ECCU ECCU (160)37 ;! (160) CC3%-4 3% 3% 3%s 11 7'/z 91/2 61/2 % 4 2 4 2 16980 6125 3640 1010 112, F4 CCO3'/a ECCO3'/a CC3' -6 3%3%5'/2 11 7% 91/2 6% 5 4 2 4 2 19250 9625 3640 1010 CC44 4x 3% 3% 7 5'/2 6'/ 4 ` % 2 1 2 2 15310 . 7655 1465 ,,;; >-205 CCO4 ECCO4 CC46 4x 3% 5% 11 .81/2 9% 61/2 ' % 4 2 4 2 24060.. 12030 2800 740 CC04/6 ECC04/6 CC48 4x 3% 7'/2 11 ' 8'/ 9'/ 6'/2 % 4 2 4 2 24060 16405 ; 2800 ' •',,:, 740 160 CC4.62-3.62 41/2 4s%e 3% 11 81/2 91/2 61/2 % 4 2 4 2 19020 7655 2800 740 170 CC04.62 ECC04.62 CC4.62-4.62 41/2 4% 4% 11 81/2 91/2 61/2 % 4 2 4 2 24450 9845 2800 740 CC4.62-5.50 41/2 4% 51/2 11 81/2 91/2 61/2 % 4 2 4 2 28585 12030 2800 740 CC5?/-4 5'/e 5'/a 3% 13), 91/2 101/2 8 ' 4 2 4 2 '' 26635 10045 ; .7530 2735:. L4 ' F11 CC05% ECC05'% CC5'4-6 5% 5% 51/2 13 91/2 101/2 8 % 4 2 4 2 '28190 •15785 7530 2735.3: CC5'/-8 5'% 5'/ 7' 13, 91/2 101/2 8 % 4 2 4 2 i,37310 21525 7530• . 2735 °- CC64 6x 5'/ 3% 11 7'/2 9'/2 6'/ 5 4 2 4 2 28586 12030 4040 1165 CCO6 ECCO6 CC66 6x 5'12 5'/2 11 7'/2 9'/2 61/2 %4 2 4 2 30250 18905 4040 1165 CC68 6x 5'/2 7Y2 11 91/2 91 612 5 4 2 4 2 37810 25780 4040 1165 ECC068 CC6-7% 6x 5'/2 7%11 91/2 9' 61/2 5 4 2 4 2 37810 24060 4040 1165 160 CC74 6% 6' 3% ' 13 10% 101/2 8 % 4 2 4 2 33490 ;: 13230 . 7525. 36050' 170 CC07 ECCO7 CC76 6% 6% 51/2 13 101/2 101/2 8 % 4 2 4 2 37125 ' 20790 7525 3605 -'. 112,• L4, F11 CC77 6% 6% 6% 13 , 10'/ 10'/ 8 % 4 2 4 2 " 49140 : _ 25515 . ': 7525 : 3605, a CC78 6% 6' 71/2 13 101/2 101/2 8 4 4 2 4 2 1'49140 ' - 28350 *'" 7525 3605 , CC7%-4 7 7% 3s%s 131101/2 101/2 8 3 4 2 4 2 34736 18375 7510 4855 160 CC07'/e ECC07'/8 CC7'/e-6 7 7% 51 13 1012 101/2 8 ' 4 2 4 2 58500 28875 7585 4855 CC7'/e-7'/a 7 7% 7'/ 13 101/2 101/2 8 % 4 2 4 2 57750 36750 7585 4855 CC7'/e-8 7 7% 71/2 13 101/2 10' 8 ' 4 2 4 2 52500 36750 7585 4855 CC84 8x 71/4 3% 13 101/4 10 8 3;• 4 4 4 2 ; 37210 '. 16405 ' 7440 i :2625 112 L4, F11 CCO8 ECCO8 CC86 8x 71/2 51/2 13 101/2 101/2 8 s 4 2 4 2 . 41250 " ' 23100 . 7440 . '' 2625 !!: CC88 8x 71/2 712 13 101/2 101/2 8 3/a 4 2 4 2 54600 ° 31500 _ 7440. ' 26250'- CC94 RI 81 3% 13 101/4 101/4 8 14 4 4 4 2 43410 19905 7515 3990 CCO9 ECCO9 CC96 8% 8' 51/2 13 101/2 101/2 8 % 4 4 4 2 48125 26950 7515 4670 CC98 83A 8'% 71/2 13 10/ 101/2 8 % 4 4 4 2 63700 36750 7515 4670 CC106 10x 91/2 51/2 ' 13 ''101/2 101/2 8 3/a 4 4 4 2 "°52250 •, 29260 , 7515 '3325 j CC010 ECC010 1. Uplift loads have been 'ncreased for wind or earthquake with no further increase allowed; reduce where other loads govem. 2. Down loads may not be increased for short-term loading and shall not exceed the post capacity. See pages 245-246 for common post allowable loads. 3. CC uplift loads do not apply to splice conditions. 4. Splice conditions with CCs must be detailed by the Designer to transfer tension loads between spliced members by means other than the column cap. 5. Column sides are assumed to lie in the same vertical plane as the beam sides. CC4.62 models assume a minimum 31/2' wide post. 6 Structural compos'te lumber columns have sides that show either the wide face or the edges of the lumber strands/veneers. Values in the tables reflect installation into the wide face. See technical bulletin T-SCLCOLUMN for values on the narrow face (edge). 7. Beam depth must be at least as tall as Hi. 8. For 5'/<' engineered lumber, use 51/2' models. 9. CCO and ECCO welded to steel column will achieve same load as CC and ECC. Steel column width shall not be less than beam width. Weld by Designer. 69 • 'The products in.this guide arse rea available through ourationwide network of distributors and dealers For more information on other applicatio s; or otherTrusJoiste products contact your Weyerhaeuser representative. TABLE OF CONTENTS Design Properties General Assumptions a..d ,Sizing Tables Window and Door Headers r Headers Supporting Roof 849: RidgeBeams Headers Supporting Floor,„,,' and Roof '12-13 • Floor Beams= 14-15, Floor toad Tables TimberStrand® LSL 1617„:; Microllam® LVL 18 :19 Parallam® PSL • t 20 -21. Snow Roof Load Tables TimberStrand® LSL '.,x2228 Microllam® LVL mm2425 Parallam® PSL Aloe -Snow Roof Load Tables TimberStrand® LSL Microllam® LVL 30-31,. Parallam® PSL 32-33, Beam Details ._ Window and Door` Header,Details' 34-35 Nailing on Narrow Face; Allowable Holes Bearing+Length Requirements y36 4 Tapered End=Cuts .a Multiple -Member Framing Connectors Columns Product Warranty SUSTAINABLE FORESTRY* INITIATIVE. Certified Sourcing www.sfiprogramorr, 6227 28=29 40-41 42-43 44 Why Choose Trus Joist® Beams, Columns, and Headers? • Reliable performance • Consistent quality and dependable uniformity • Flexible solutions for your beam and header needs • Backed by a limited product warranty Using advanced technology, Weyerhaeuser manufactures engineered lumber that is consistently straight and strong, and resists bowing, twisting, and shrinking. That means Tess waste, easier installation, and higher design values for starters; plus fewer callbacks, shorter cycle times, more design flexibility, and lower overall installed cost in the end. Trus Joist® TimberStrand® LSL, Microllam® LVL, and Parallam® PSL are structural solutions you can count on —guaranteed. This guide features Trus Joist® engineered lumber in the following widths and depths: TimberStrand® LSL 1.55E TimberStrand® LSL sizes: Widths:13/4" and 31/2" Depths: 91/4", 91/2",111",117%",14", and 16" 1.3E TimberStrand® LSL header sizes: Width:31/2" Depths: 4%", 51", 71/4", 84/8", 91", and 111/4" 1.3E TimberStrand® LSL column and post sizes: 31/2" x 31" 31/2" x 4413" 31/2" x 51/2" 31/" x 71/4" 31/2" x 8Wa" Microllam® LVL 2.0E Microllam® LVL header and beam sizes: Width: 13/4" Depths: 51/2", 71/4", 91/4", 91/2", 111/4",11�/a", 14", 16", 18", and 20" Parallama' PSL 2.0E Parallam® PSL header and beam sizes: Widths: 31/2", 51/4", and 7" Depths: 91/4", 91/2", 111/4", 117/8", 14", 16", and 18" 1.8E Parallam® PSL column and post sizes: 3/" x 31/2" 3112" x 51/4" 3/" x 7" 51/4" x 51/4" 51/4" x 7" 7" x 7" for deePer depth Parallama PSL beams,' see the TrasJoiste 22EParaiani"+PSL Deep'Beam guide,'TI-7001, or, contact your, Weyerhaeuser representative. Some sizes may not be available.in your regron n' Trus Joiste Beam, Header and Column Specifier's Guide TJ-9000 I May 2014 2 STRUCTURAL SOLUTIONS Trus Joist® TimberStrand® Laminated Strand Lumber (LSL) • One-piece members reduce labor time • Every piece is straight and strong • Unique properties allow you to drill larger holes through 1.55E TimberStrand® LSL. See Allowable Holes on page 36. TimberStrand® LSL Grade Verification TimberStrand® LSL is available in more than one grade. The product is stamped with its grade information, as shown in the examples below. With 1.55E TimberStrande LSL, larger holes can be drilled through the beam. TimberStrand® LSL 1.3E ICCES ESR-1387 n Certified Sourcing Made in Canada CCMC 12627-R SF� SR-00008 0572 0&15 11 02 03:20 ■ ■ WAVeyil TimberStrand® LSL 1.55E ROUND HOLE ZONE ICCES ESR-1387 Certified Sourcing Made in Canada NO holes within 8" of beam ends CCMC 12627-R SFiet SFl-00008 0572 a 09-15-11 02 03:20 Actual stamps shown. Code Evaluations: See ICC ES ESR-1387 Trus Joist® Microllam® Laminated Veneer Lumber (LVL) • Can easily be built up on site to reduce heavy lifting • Offers reliable and economical solutions for beam and header applications • Manufacturing process minimizes many of the natural inconsistencies found in wood • Available in some regions with a Watershedim overlay for on -site weather protection Code Evaluations: See ICC ES ESR-1387 Trus Joist® Parallam® Parallel Strand Lumber (PSI) • Allows long spans for open floor plans without intermediate posts or columns • Has warm, unique grain that is perfect for applications with exposed beams • Provides ideal solutions for cantilever and multi -span applications • Solid sections save time on site assembly • Available in some regions with preservative treatment for exterior applications Code Evaluations: See ICC ES ESR-1387 Trus Joist® Beam, Header and Column Specifier's Guide TJ-9000 I May 2014 3 The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston, MA 02114-2017 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information C T/ 7 Please Print Legibly Name (Business/Organization/Individual): J -.- fi' e..1 L__C Address: PO -8 Gr,c D oc City/State/Zip :/ta--'( /4'1 a t 2 Phone #: Are you an employer? Check the appropriate box: 1. am a employer with •) .. • employees (full and/or part-time).* 2. ❑ I am a sole proprietor or partnership and have no employees working for me in any capacity. [No workers' comp. insurance required.] 3.111 I am a homeowner doing all work myself. [No workers' comp. insurance required.] 4. ❑ I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers' compensation insurance or are sole proprietors with no employees. 5. ❑ I am a general contractor and I have hired the sub -contractors listed on the attached sheet. These sub -contractors have employees and have workers' comp. insurance.: 6.0 We are a corporation and its officers have exercised their right of 'exemption per MGL c. 152, § 1(4), and we have no employees. [No workers' comp. insurance required.] Type of project (required): 7. ❑ New construction 8. ❑ Remodeling 9. ❑ Demolition 10 ❑ Building addition 11. ❑ Electrical repairs or additions 12. ❑ Plumbing repairs or additions 13. ❑ Roof repairs 14. ❑ Other *Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. Homeowners 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 state 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 information. Insurance Company Name: Policy # or Self -ins. Lic. #: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by 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. A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereb y under the s and penalties of perjury that the information provided ' bove is true and correct. Si • nature: Phone #: Date: G Official use only. Do not write in this area, to be completed by city or town official. City or Town: Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Permit/License # Contact Person: Phone #: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as "an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal 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 or building 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 commonwealth for_any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally, MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall. enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary, supply sub-contractor(s) name(s), address(es) and phone number(s) along with their certificate(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 an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. Self -insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the 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 permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current policy information (if necessary) and under "Job Site Address" the applicant should write "all locations in (city or town)." A copy of the affidavit that has 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 filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.) said person is NOT required to complete this affidavit. The Department's address, telephone and fax number: Revised 02-23-15 The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston, MA 02114-2017 Tel. # 617-727-4900 ext. 7406 or 1-877-MASSAFE Fax # 617-727-7749 www.mass.gov/dia A b5 CERTIFICATE OF LIABILITY INSURANCE DATE( 4/6 )15 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFlCATE 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 T L Southmayd Insurance Agency 668 Main St, Suite 9 Wilmington, MA. 01887 CONTACT NAME: Louise Southmayd AI N a l: (978) 657-0263 (AAA Nd: (978) 657-0201 ADDRESS: louise@tlsins.corn INSURER(S) AFFORDIPh3 COVERAGE NAICtt INSURER A: Western World INSURED Brian Charron DBA Sliver Phoenix Construction LLC 1 Starbird Ave Tewksbury, MA 01876 INSURERB:Travelers Insurance INSURER C: INSURER D: INSURER E: INSURER F: CERTIFICATE 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 TFE 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 LTR TYPE OF INSURANCE ADOL INSR SUER %VD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY MCP (MM/DD/YYYY) UNITS A GENERALLIABIUTY COMMERCIAL GENERAL LIABILITY NPP1374938 2/21/15 2/21/16 EACH OCCURRENCE $ 1,000,000 $ 300,000 X DAMAGE TO RENTED PREMISES fEa occurrence) CLAIMS -MADE X OCCUR MED EXP (Anyone person) $ 5,000 PERSONAL& ADV INJURY $ 1 000 000 GENERAL AGGREGATE , , $ 2,000,000 GEN'LAGGREGATELIMITAPPLIESPER PRODUCTS -COMP/OPAGG $ 2,000,000 $ POLICY n ACT n LOC AUTOMOBILE UABIUTY ANY AUTO ALL OWIED SCHEDULED AUTOS AUTOS) NON -OWNED HIRED AUTOS AUTOS COIVBINED�SINGLELIMIT $ BODILY INJURY (Per person) $ BODILYINJURY(Peraccident $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAB EXCESS LIAB I OCCUR EACH OCCURRENCE $ CLAIMS -MADE AGGREGATE $ DED RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRTOOerPERATIONS YIN N I A ORIG TO FOLLOW 4/23/14 4/23/15 WC STATU- OTH- TORY LIMITS ER E.L.EACH ACgCENT $ 100,000 p E.L. DISEASE -EA EMPLOYEE $ 100 , 000 below E.L. DISEASE -POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (Attach ACORD 101, Additional Retrofits Schedule if more space is requ red) Email: mdeems@townofnorthandover.com Fax : 978 623 8320 CANCELLATION Town of Andover 36 Bartlett St Andover, MA 01810 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DEUVERED IN A F a ANCE WITH THE POLICY PROVISIONS. © 198 - 10 ACORD CORPORATION.) All rights reserved. ACORD 25 (2010/05) The AC ORD name and logo • re registered marks of ACORD Phone: Fax: E-Mail: .� CERTIFICATE[DATE7 OF LIABILITY INSURANCE TNLGERTIFICATE IS.ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED OR PRODUCER. AND THE CERTIFICATE HOLDER. HOLDER. THIS POLICIES BELOW. REPRESENTATIVE 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 TL SOUTHMAYD INS AGCY 668 MAIN STREET WILMINGTON, MA 01887 76JRH CONTACT NAME: PHONE (NC, No, Ext): FAX (A/C, No): E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURED SILVER PHOENIX CONSTRUCTION LLC 1 STARBIRD AVE ' TEWKSBURY, MA 01876 INSURER A: TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA INSURER B: INSURER C: INSURER 0: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS ANY AFFORDED PAID IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY CLAIMS. INSR LTR TYPE OF INSURANCE ADD L SUB R POLICY NUMBER POLICY EFF DATE (MMIDDIYYYY) POLICY EXP DATE (MMIDDIYYYY) LIMITS GENERAL UABILITY COMMERCIAL GENERAL CLAIMS MADE LIABILITY EACH OCCURRENCE $ — DAMAGE TO RENTED PREMISES (Ea occurrence) $ OCCUR. MED EXP (Any one person) $ — GEN'L AGGREGATE LIMIT APPLIES PER: PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ POLICY PROJECT ❑ LOC PRODUCTS - COMP/OP AGG $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULE AUTOS HIRED AUTOS NON OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ — PROPERTY DAMAGE (Per accident) $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ A WORKER'S COMPENSATION EMPLOYER'S LIABILITY ANY PROPERITOR/PARTNERIEXECUTNE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS AND YIN N/A UB-2E166937-14 04/23/2014 04/23/2015 X WC STATUTORY LIMITS OTHER Y E. L EACH ACCIDENT $ 100,000 below E.L. DISEASE - EA EMPLOYEE $ 100,000 E.L. DISEASE - POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/RESTRICTIONS/SPECIAL ITEMS THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE. CERTIFICATE HOLDER CANCELLATION TOWN OF NORTH ANDOVER 120 MAIN ST. N. ANDOVER, MA 01845 AcORn 9R onInms► SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENT E 1988-2010 ACORD CORPORATION. All rights reserved. a 0 / \ § BRIAN CHARRON 1 STARBIRD AVE. TEWKSBURY, MA 018