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HomeMy WebLinkAboutBuilding Permit #270-13 - 1250 OSGOOD STREET 10/5/2012 NORTH BUILDING PERMIT o�,��°° ;6q�o TOWN OF NORTH ANDOVER _ ." .'° oA APPLICATION FOR PLAN EXAMINATION Permit NO: L Date Receivedp�RACH Pa (5 �SSACHUS�,C Date Issued: � `� IMPORTANT:Applicant must complete all items on this page ,.1• of-= .. .- - _ `�' `TF.` - ' ~i'•~ -;-._. .. ..�. ...;fir._._,.... - ..- _.- fir.' _"['.. •:.S':.5:.��....-Y. LOCATION AZ. - 'MAP,NO'.<_ PARCEL: � ZONINGIDISTRICT:-�... Historic!Dist�ict yes`. o• Macliirie,Shbp* . illage. ;,-yes 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 V11ell 'g Floodplain Wetlands �.- WaterstiedDisirict W'ater-/Sew_e_r,` - DESCRIPTION OF WORK TO BE PREFORMED: Identification Please Type or Print Clearly) Phone: K 16 /0 OWNER: Name: �A �L is l Address: 6S 9,e L t ,,-,_ CGL. LokA Z�1- CONTRACTOR Name: i- Cz4- C/6Phone:. �t�'�8�"�9y6 Address` tZ-\ _ _ C SD�� 1ib5T0 - _ D Ex Date: Supery_isor=.s,Co'nst"ruction>Libense: P Home l_mproverneotivii_0rise:.- - ,Exp ARCH ITECT/ENGINEE Phone: 6 '3 Address:� �� �— ►� Reg. No. �, ���— /A FEE SCHEDULE:BOLDING PERMIT.$12.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER SyF. p� Total Project Cost: $ t�j'0(�_� FEE: $ z Check No.: /° / 3 Receipt No.: �2 NOTE: Persons contracting with u registered contractors do not have access to the guaranty fund Signature of Agent/Owner Signature:of contractor Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL ublic Sewer Tanning/N4assageBody 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 Signature COMMENTS *HEALTH Reviewed on Si nature COMMENTS Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments !later& Sewer Connection/signature&Date Driveway Permit DPW Town Engineer: Signature: ._ Located 384 Osgood Street FIRE DEPARTMENT'.-' Temp Dumpster on site yes .:no. Located at 124 Main Street Fire Department signature/date COMMENTS Dimension Number of Stories: f 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 DANCER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— (For department use) EJ Notified for pickup - Date Doc.Building Permit Revised 2008 1 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 ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Co of Copy 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) D Engineering Affidavits for Engineered products DOTE: 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 SpriAler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products OTE: 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:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2008 Location No. v7 0 r 43 Date Z._.. * ' TOWN OF NORTH ANDOVER � r��i1�LLD 1646 ., Certificate of Occupancy 4 Building/Frame Permit Fee $ Foundation Permit Fee Other Permit Fee $ TOTAL $ MY a - CD Check#/0/3 —6al 25789 / Building Inspector Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost $ 140,000.00 m $ - $ 1,680.00 Plumbing Fee $ 210.00 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 210.00 Total fees collected $ 2,200.00 1250 Osgood Street 270-13 on 10/5/12 Renovationof the old Beijing Restaurant NORTH Town ofaAndover 'I i"4 h h ver, Mass, 0 coc Nlc Mewicw ,y�• BOARD OF HEALTH PERMIT T LD Food/Kitchen Septic System THIS CERTIFIES THAT .......... ... .............................: BUILDING INSPECTOR .. . .... ... Foundation has permission to erect.............................. ` buildingson Z° -pS Q�?. .�...... / ................................ Rough (/1 Cr t�cl 16 (/ p to be occupied as ............ 1.....4r ..................�r :....:... ...... Q.�1.fa.�.cl: ©............. ............... 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 Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION STARTS Rough ............ Service ............. ...... � OLcw+.... llllY��'''''��•-• 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. SEE REVERSE SIDE 3 October 03, 2012 Town of N. Andover, Mass. CONSTRUCTION CONTROL AFFIDAVIT PROJECT TITLE: Renovation ADDRESS OF BUILDING: 1250 Os good St.N. Andover. Massachusetts. SCOPE OF PROJECT: Renovation In accordance with Section 107.6.1, 8t'Edition of the Massachusetts State Building Code, I, LaM young Massachusetts Registration No. 34133 M,being a registered professional engineer hereby certify that I have prepared or directly supervised the preparation of all design plans,computations, and specifications concerning the: ENTIRE PROJECT X ARCHITECTURAL_ STRUCTURAL MECHANICAL FIRE PROTECTION ELECTRICAL_ OTHER(Specify) I further certify that I, or a designated representative, shall perform the necessary professional services and be present on the construction site on the regular and periodic basis to determine that the work is proceeding in accordance with the documents approved the building permit and shall be responsible for the following as specified in Section 116.2: 1. Review of shop drawings, samples, and other submittals of the contractor as required by the construction contract documents as submitted for building permit, and approval for conformance to the design concept. 2. Review and approval of the quality control procedures for all code required control material 3. Special architectural or engineering professional inspection or critical construction components requiring controlled material or construction specified in the accepted general practice standard listed in Appendix A. Upon completion of the work, I shall submit a final report as to the satisfactory completion and readiness of the project occupancy. o���P�,•;tii 0F Il�a�,s�yG O Larry Young LARRY s Professional Engineer(34133-M) q YOUNG �+ NO.34133- �SS10 ANG 01 N�DTN1 . NQ D r Mio Y �NSSNCHUS" CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 270-13 on 10/5/2012 Date: March 6, 2013 THIS CERTIFIES THAT Hokkaido Restaurant THE BUILDING LOCATED ON 1250 Osgood Street MAY BE OCCUPIED AS a restaurant IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: Sam:Lei 65 Belvedere Street Lowell,MA 01852 Building Inspector Fee: Pre Paid Receipt: 25789 Check : 1012 14-ems 2b42. CD CD 4�1 Os 3 0 1IatisachWWI 1%- DtPartmenI of Public 5aretl Board of Building Regulations and Skadards Cortstruction Supervisor License License: CS 61356 . w w -LORRY Y -YOUNG 00 E 0 7 CEDAR BROOK RD. �D 1NEt1_ESLI'f.MA 02482 Frrpiraiion: 7242D13 ('umnd.�i„ncr Ir#: 17857 O tD O O O w N NORTII r Town of �. � E : ., ndover to No. 9-71) .. I Zb r h ver, Mass, 41 O 41w«t 1, coc«ic«ew.cw � ORATED U BO,IARD!OF HEALTH PERMIT T D Food/Kitchen ✓ �I�IF� (�� t '`�' v'3 Septic System BUILDING INSPECTOR THIS CERTIFIES THAT ................................ Z� .............................:.................................................. ' ./ � � y Foundation has permission to erect .......................... buildings on .. ............ ., ... ................................ � �° � Rough ' . .. a ' �: .�... . eL Chimto be occupied as : ....... llineverY'respect conform to the terms of the application accepting this permit s li*�aiprovided that the pers - 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 ECTQR• , I r i VIOLATION of the Zoningor Building Regulations Voids this Permit. Rou n /Q�L� 3J/�� �, ..n f 'r' .�c'''`'`fit J� PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION STARTS Rough � ' 11 Service ✓ ,C ..................... !u�v. „�,f/ :: : :. ............................ final ©I-( ' BUILDING INSPECT, Tyr' & `'�""�' S INSPECTOR, s a1 i Occupancy Permit Required to Occupy Building Jim J in f,�..�-�g Display in a Conspicuous Place on the Premises — Do Not Remove Final t 6� , No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. SEE REVERSE SIDE L(:-,-_.. GENERAL BUILDING NOTES/CHECKLIST-NOT LIMITED TO ITEMS BELOW POST ALL LOT NUMBERS,ADDRESS, AND PERMIT(COPY 0K)..or no inspections INSPECTIONS: (Minimum) Excavation , Footing, Foundation, Frame, Insulation, Final. FOOTINGS: Continuous Full 2x4 Keyway Continuous strip footings for interior columns _ FOUNDATION: Rebar as required Anchor bolts or straps Damproofing Foundation drain-pipelstone/fabric filter/cover and outlet connection. FRAME:Fireblock-over girts/plates between floor joist Penetrations for plumbing, heat, elec,etc. Walls at stair stringers. Windbrace corners and center bearing partitions. Size ridge to provide full bearing at rafter cuts. Hip and Valley rafters-watch bearing at walls. . Ridge&Hip-Provide proper connections. ; Cathedral roof rafters provide proper connections and use"Hurricane Clips"tie to plate. Stair stringers-watch cuts and heal support. Joist hangers-fully nailed w/hanger nails. Sill plates 2-2X6(1 PT)w/sill seal. Girls-solid brick or steel plate bearing at foundations '/"air space at sides in foundation pockets. Lateral bracing at ends. Certified calculations. required for Beams/LVL's Trusses. Solid bearing support for Headers/Beams etc. Check headroom clearances-stairways, under beams Attic Access. (min.22x30 w/3'headroom above). Crawl space access. (min. 18x24). Bath exhaust fans to have metal duct to exterior(not in soffit). '^ Firecode S/R wood frame of"0"clearance fireplaces&stoves : Window Schedule or Every Habitable Room Must Have: Natural light equal to 8%of floor area. of required glazing shall be openable. Bedrooms required min.20x24 egress window or door, �. Vent attic spaces-"proper vent", soffit and required ridge vents. Firecode under stairs if used for storage , R FIREPLACES: Separate permit required. Inspections at Footing-Smoke Chamber-Finish �n Smooth parging, clean joints, 8"solid @ combust. DECKS: Lag to house, provide flashing., Rails min. 36" high, Baluster max space 4"on center. Over 8'above grade, use 6x6 posts w/lateral bracing. Lag all posts and rails. V Pier footings down 48", Conc. pad at stair base. �� FINISH: Handrails returned to wall/newall post. - _. ---_-- -- Guardrails required alongside open cellar stairs. Exterior grading complete. Certificate or occupancy required prior to occupying structure. Temporary Stairs required for inspection. Re-inspection fee- $30.00(Be Ready). Certificate of occupancy required prior to of occupancy required prior to occup ing structure. NORTH ndover E Town of o ; i Pah ver, Mass, A-O C00041c"twicK �• �J,9 A�RgTEO S U BOARD OF HEALTH PERMIT T LD Food/Kitchen 011d4li Coll + �Y: Septic System ' � BUILDING INSPECT .......................y .l a."?r THIS CERTIFIES THAT ..... .. . . ...........................��.,.................................................... Foundation has permission to erect ......................... buildings on ................... .. J,.. .... ................................ Rough to be occupied as ..... :: : ............... e... rm.............. ............. nim cfh��� provided that the person accepting this permit shall in every respect conform to the tes of theapplication and By-Laws relating to the Inspection,Alteration and �-- on file In this office, and to the provisions of the Codes y g p Construction of Buildings in the Town of North Andover. � uMBINGEcrq �1✓ Rou h VIOLATION of the Zoning or Building Regulations Voids this Permit. na PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION STARTS Rough � yf � 11 i;` , Service :�% �'� y,'�..��: ............................ final .............G.....� •.-! N. BUILDING INSPECT W—" © r 3" INSPECTOR'' Occupancy Permit Required to Occupy Building g 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 Smoke Det. SEE REVERSE SIDE GENERAL BUILDING NOTES/CHECKLIST- NOT LIMITED TO ITEMS BELOW POST ALL LOT NUMBERS,ADDRESS, AND PERMIT(COPY OK)..or no inspections INSPECTIONS: (Minimum) Excavation, Footing, Foundation, Frame, Insulation, Final. FOOTINGS: Continuous Full 2x4 Keyway Continuous strip footings for interior columns ► _ FOUNDATION: Rebar as required Anchor bolts or straps Damproofing j. Foundation drain-pipelstone/fabric filter/cover and outlet connection. FRAME:Fireblock-over girts/plates between floor joist Penetrations for plumbing, heat, elec, etc. Walls at stair stringers. Windbrace corners and center bearing partitions. Size ridge to provide full bearing at rafter cuts. Hip and Valley rafters-watch bearing at walls. Ridge&Hip-Provide proper connections. Cathedral roof rafters provide proper connections and use"Hurricane Clips"tie to plate. Stair stringers-watch cuts and heal support. Joist hangers-fully nailed w/hanger nails. Sill plates 2-2X6(1 PT)w/sill seal. Girts-solid brick or steel plate bearing at foundations '/3"air space at sides in foundation pockets. Lateral bracing at ends. Certified calculations. required for Beams/LVL's Trusses. Solid bearing support for Headers/Beams etc. Check headroom clearances-stairways, under beams Attic Access. (min.22x30 w/3'headroom above). Crawl space access. (min. 18x24). Bath exhaust fans to have metal duct to exterior(not in soffit). Q '^ Firecode S/R wood frame of"0"clearance fireplaces&stoves . Window Schedule or Every Habitable Room Must Have: Natural light equal to 8%of floor area. of required glazing shall be openable. Bedrooms required min.20x24 egress window or door, Vent attic spaces-"proper vent", soffit and required ridge vents. Firecode under stairs if used for storage �, R �► �, �� Win. FIREPLACES: Separate permit required. Inspections at Footing-Smoke Chamber-Finish Smooth parging,clean joints,8"solid @ combust. DECKS: Lag to house, provide flashing., Rails min. 36" high, Baluster max space 4"on center. Over 8' above grade, use 6x6 posts w/lateral bracing. Lag all posts and rails. Pier footings down 48", Conc. pad at stair base. ry. FINISH: Handrails returned to wall/newall post. _ -- Guardrails required alongside open cellar stairs. Exterior grading complete. .- Certificate or occupancy required prior to occupying structure. Temporary Stairs required for inspection. Re-inspection fee- $30.00(Be Ready). Certificate of occupancy required prior to occupying structure. 10/05/2012 12:40 6174827318 WALTER KWAN INS AGCY PAGE 01/01 8:9.1:54 All P5T (GMT-8) FRT 11: 100 005-72).is 16174027,1P, Page: 2 0£ 2 '`tom" CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) r THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($), 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). PRODUCCR WALTER KWAN INS AGENCY INC cam/ 72 KNEELAND ST SUITE 301 PHONE - C No BOSTON, MA 02111 I5,MAIL ADDRESS: �INSURUR($)AFFQRo1NGCOVERAGE NAIC0 INSURER A INSURED INSURERS: MING YANG ZHENG DBA MING YANG REMODELING INSURERC: 23 EDGEWOOD CIRCLE INSURERD: QUINCY MA 02169 INSURER E MSVRERF: COVERAGES CERTIFICATE NUMBER: 14335424 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 0ESCR11360 HPREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY 14AVE SEEN REDUCED BY PAID CLAIMS. IN5R TYPE OF INSURANCEP LI YEFF P U Y EXP JXL WVn POLICY NuMae LIMITS GENERAL LIABILITY EACH OCCURRENCE $ CCMMCRCIAL GENERAL LIABILITY PREMIZIES tee DCCUri BIICe $ CLAIMS-MADE ❑OCCUR MED EXT'(Any onePerson) $ PERSONAL&ADV INJURY $ OFNERALAGGREGATE S OEM.ACCREOAIF LIMIT APPLIES PER: PRODUCTS-COMPIOP AGO $ P01_ICY P - LOC RO $ — –--- AUTOMOBILE LIABILITYNr.LE-L IM IT B 9CC10f9n1 $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AODILY INJURY(Por a-CId4nt) AUTOS AUTOS S NON•OWNED PROIaER7Y AMACE HIRED AUTOS _ AUTOS Pei oecitl9nl $ UMBRELLA LIAe OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DFr) RETENTIONS $ S A WORKERS COMPENSATIONYIN VVCS-313-375764-022 8/2/2012 8/2/2013 Cgy ATIT Mt�Tl- AND EPLOYERS'LIABILI I V ANY FROPRIFTOR/PARTNERrXCCVTNC 0FrICER/1,IFh1RFR FXQI•I lr) Y N/A E.L.EACH ACCIDENT S 1000000 (Mandatory in NH) E.LDISEASE-EAEMPLOYEE S 100000 If y6F.d6rral(Z lill pr r)FGcRIPTIM OF OP RATI N9 halow I E.L,DISEASE-POLICY LIMIT S 1000000 VESCRIFnON Or OP[RA'TIONS/LOCATIONS IvrmICL[S(Altnrh ACORD 101,Additional Kamnrko Sshadula,If n m spaed Is required) THE WORKERS COMPENSATION POLICY DOES NOT PROVIDE COVERAGE FOR MING YANG ZHENG Workers compensation insurance coverage applies only to the workers compensavon laws of the state MA. CER IFICATE HOLDCANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF NORTH ANDOVER THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1600 OSGOOD ST ACCORDANCE WITH THE POLICY PROVISIONS. NORTH ANDOVER MA 01845 AUTHORIZED REPRESENTATIVE f GAIL Jeff Eldridge 01988-201 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD f UP.0 N:..: 113::Ia JV CLI.LNT (:^DG L•:P19:L Dt•L U.'.U.:;htrl nt. Ln/5/.O1T. Pc3711'I AN F?aa 1 n! t . TI+Ls •xct,1.£�•:.,g., .„�.l.a noxi. aoc'x.rie. ALL, Dxev L,.a5L, ).5." d i ACORD�„ CERTIFICATE OF LIABILITY INSURANCE �0/3i2012 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Betgoon Maria Wong Insurance Agency HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 338B Tremont Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Boston MA 02116 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A:Atlantic Casualty Ming Yang Zheng dba Ming Yang Remodeling INSURER B: 23 Edgewood Circle INSURER C: Quincy,MA 02169 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 ADD'LINSRD POLICTYPE OF INSURANCE POLICY NUMBER DA EYMM DD/YYE POLICY MMI D/YY EXPIRATION LIMITS LTR INSRD ( 1 ( ) A GENERAL LIABILITY L143002216 7/13/2012 7/13/2013 EACH OCCURRENCE $ 1,000,000 NTE X COMMERCIAL GENERAL LIABILITY P EMISES TO occur ence $ 100,000 CLAIMS MADE F] OCCUR MED EXP(Any oneperson) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 PRO- POLICY JECT 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 FICLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND WC STATU- OTH- EMPLOYERS'LIABILITY TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE$ If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS/LOCATIONSA/EHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE City of North Andover EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE / ACORD 25(2001/08) dfACORD CORPORATION 1988 INS025(0108).07 AMS VMP Mortgage Solutions,Inc.(800)32 545 Page 1 of 2 0 I� Ming Yang Remodeling "Fine Workmanship and Guaranteed Customer Satisfaction for Over 20 years!" July 23, 2012 Sam Lei Hokkaido Restaurant, Inc 1250 Osgood Street North Andover, MA 01845 RE: Building Renovation Dear Sam: Thank you for the opportunity to provide you with a scope of service and bid for the restaurant to be opened at 1250 Osgood Street, North Andover. Ming Yang has over 20 years of experience in residential and commercial renovation and construction. We employ high quality workers and subcontractors, and have been able to deliver project on-time and on-budget. Given that the existing building has been used by another Asian restaurant, and that the interior is in relatively good shape, we should be able to complete the project in a relatively short time period. Attached please find a priced scope of work summary, we look forward to discussing the details with you, and to better define our project once we have access to the building. Thank you for the opportunity to work with you on this interesting project. Sincerely, Ming 23 Edgewood Circle, Quincy, MA 02169 Tel. 857.891 .9725 4 Ming Yang Remodeling "Fine Workmanship and Guaranteed Customer Satisfaction for Over 20 years!" ATTACHMENT—Scope of Work, 1250 Osgood Street, North Andover Revised 9/28/2012 SYSTEMS Install three HVAC units $ 15,000.00 Replace fire protection system (sprinkler heads) $ 11,000.00 CONSTRUCTION AND FINISHING Paint all exterior walls $ 12,000.00 Reconfigure beverage storage room access, finish interior $ 9,000.00 Paint all interior walls $ 6,000.00 Refinishing all existing wood floors $ 5,000.00 Reconfigure and replace kitchen doors; create barrier $ 1,000.00 DINING AREA Replace 30-ft sushi bar top with granite $ 9,000.00 Install tables with inductive cook tops (30) provided by Client $ 3,000.00 Rebuild/reduce storage closet at rear of dining room $ 1,000.00 BAR AREAMINING AREA Install new electrical system (lighting, wiring) $ 17,000.00 Repair leaky"greenhouse" glass panels and structures $ 10,000.00 Replace drop ceilings $ 15,000.00 Install FRP, sinks, center island behind bar per Health Dept $ 8,000.00 Replace carpeting with hardwood $ 10,000.00 Install raised floor area for 4 booths along one side of bar $ 5,000.00 Install decorative lighting around bar $ 3,000.00 KITCHEN Repair floor tiles $ 2,000.00 Install washable panels behind beverage station $ 4,000.00 Other repairs and refinishing per Health Dept $ 1,000.00 DESIGN AND SOFTCOSTS Architectural and Permits $ 3,000.00 $ 140,000.00 Client acknowledgment: 23 Edgewood Circle, Quincy, MA 02169 Tel. 857.891 .9725