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HomeMy WebLinkAboutBuilding Permit #353 - 127 CHESTNUT STREET 11/29/2008 BUILDING PERMIT "ORT 6 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION * ,� Permit NO: Date ReceivedA " gSSACHUs�� Date Issued: PORTANT:Applicant must complete all items on this page LOCATION' pS wt,,c T Print PROPERTY OWNERg-nu C� ' �J e 1 Print MAPNO. J..0PARCEL: Q ZONING DISTRICT: Historic District yes Rno Machine ShopVillage yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family,r ' Addition 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 PREFORMED: Identification Please Type or Print Clearly) Y OWNER: Name: c, ot�" Q We-1"/ Phone: j Address: 1 e 4 YUL4S CONTRACTOR Name:lclvw to ` (`c Phone:_ 6cj 13 S3 ' Address: t o z Supervisor's Construction License: C C) 12 Exp. Date: D II ;. Home Improvement License:_ 12 Z... Exp. Date: d 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. -i Total Project Cost: $ Z 0o FEE: $ Check No.: 6101 Receipt No.: ;9-t- NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund signature of Agent/Owrner Signature of contractor ,r Location No.3 Date �ORTM TOWN OF NORTH ANDOVER ' O ,1 9 i Certificate of Occupancy $ • i „ i Building/Frame Permit Fee $ SACH Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 4kF/ 2 1 7 0 7 �. l Building Inspector Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning/Massage/Body Art Swimming Pools Well Tobacco Sales Food Packaging/Sales Private(septic tank,etc. Permanent Dumpster on Site iI I THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT COMMENTS CONSERVATION Reviewed on Signature i COMMENTS f HEALTH Reviewed on Signature I COMMENTS i Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submittedY es I Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature&Date Drivewav Permit DPW Town Engineer: Signature: j Located 384 Osgood Street , FIRE DEPARTMENT -Temp Dumpster on site yes no Located at 124Main Street Fire Department signature}date COMMENTS Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. 4 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 I ❑ Notified for pickup - Date Doc.Building Permit Revised 2008 I 4 J I 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 o Workers Comp Affidavit o Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ 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 o Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses o Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) o Mass check Energy Compliance Report (If Applicable) L3 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) o Building Permit Application Li Certified Proposed Plot Plan o Photo of H.I.C. And C.S.L. Licenses o Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) o Copy of Contract a Mass check Energy Compliance Report o 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 Dor.INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2008 ` tAORTH 'q 0" o No. . ..... VA - dover, Mass., ` O �A� COCHICHEWICK S R � ATED PP� � BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT ' / � `� ���� Foundation has permission to erect........................................ buildings on ......../z.2...C `r ...................... Rough to be occupied as................................ .1,! 14..................................................... .........I............... Chimney ' provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING,INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION TARTS "J Rough Service . . .. ............. BUILDIN.G SPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR 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. SEE REVERSE SIDE smoke Det. Massachusetts - Department of Public S.ife" Board of Building Regulations and Standards Construction Supervisor-.License License: CS 60112 Restricted to: 00 i THOMAS T DOYLE 8 WEST ST i SALEM, NH 03079 9 Expiration: 8/4/2010 nunisciunel- Tr#: 1698 Board of Building Regulafloq and Standards HOME IMPROVEMENT CONTRIX&OR Registration 128612 ? Expiration, 4/28/2009 Tr# 129477 Type DBA { t THOMPSON'S ROOFING 'j;,h THOMAS DOYLE �s 8 WEST ST. '°t"'`GIa�� 1 SALEM,NH 03079 AdministrnWr --j Home Improvement Contractor Registration Program Page 1 of 2 b� The Official We"site of the Executive Office of Public Safety and Security(EOPSS;. 2 � _. � Public Safety 7 ( Mass.Gov EOPSS Home Mass.Gov State Agencies State Online Services Home>Consumer Protection&Business Licensing>License Type by Business Area>Home SEARCH Improvement Contractor> Public Safety Home Improvement Contractor Registration Program Contracts-all contracts over$1,000(One Thousand Dollars)must be in writing. The law requires the following FOURTEEN items to be included in any contract between the homeowner and registered home improvement contractor in al contracts for home improvement work subject to MGL c 142A 1. The complete agreement between the contractor and the owner and a Gear description of any other documents which are part of the agreement. 2. The full names,federal I.D.number.(if applicable),addresses(NOT P.O.Box numbers),of the parties,the contractors registration number,the name(s)of the salesperson(s)involved,if any and the date the contract was executed by the parties. 3. The date on which the work is scheduled to begin and the date the work is scheduled to be substantially completed. 4. A detailed description of the work to be done and the materials to be used. 5. The total amount agreed to be paid for the work to be performed under the contract. 6. A time schedule of payments to be made under the contract and the amount of each payment state in dollars,including all finance charges,if any.Any deposit required to be paid in advance of the start of the work SHALL NOT EXCEED one-third of the total contract price or the actual cost of any material or equipment of a special order or custom made nature,which must be ordered in advance of the start of the work to assure that the project will proceed on schedule. No final payment shall be demanded until the contract is completed to the satisfaction of all parties. 7. All parties must sign the contract. 8. There shall be a clear and conspicuous notice stating; a.That 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; Registration Divison,Program Coordinator . One Ashburton Place Room 1301 Boston,Ma 02108 Tel:(617)727-3200 ext.25239 b.The contractors registration number must be on the first page of the contract c. the homeowners three day cancellation rights under MGL c 93 s 48; MGL c 140D s 10 or MGL c 255D s 14 as may be applicable. d. All warranties on the owner's rights under the provisions of 780 CMR R6 and MGL c 142A e. In ten point bold type or larger,directly above the space provided for the signature,the following statement; DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. f. Whether any lien or security interest is on the residence as a consequence of the contract http://www.mass.gov/?pageID=Oopsterminal&L=4&LO=Home&L 1=Consumer+Protectio... 10/10/2008 Home Improvement Contractor Registration Program Page 2 of 2 1 9. An enumeration of such other matters upon which the owner and contractor may lawfully agree. ree. 10. Any other provisions otherwise required by the applicable laws of the Commonwealth. 11. Permit Notice:Every contract shall contain a clause informing the owner of the following; a.any and all necessary construction-related permits; b.that it shall be the obligation of the contractor to obtain such permits a the owner's agent. c.that owner's who secure their own construction-related permits or deal with unregistered contractors shall be excluded from access to the Guarantee Fund. 12. Acceleration of payment: No contract shall contain an acceleration clause under which any part or all of the balance not yet due may be declared due and payable because the holder deems himself to be insecure. .However,where the contractor deems himself to be insecure he may require as a prerequisite to continuing said work that the balance of funds due under the contract,which are in possession of the owner,shall be placed in a joint escrow account requiring the signatures of the home improvement contractor and the owner for withdrawal. 13. No work shall begin prior to the signing of the contract and transmittal to the owner of a copy of such contract. 14. Arbitration: If the contractor determines that in the event of a dispute,the contractor wishes the dispute to be settled by arbitration,this fact must be signified on the contract and both the contractor and owner shall sign this clause separately. The following format is acceptable(in 10 point type or larger); "The contractor and the homeowner hereby mutually agree in advance that in the event that the contractor has a dispute concerning this contract,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 in MGL c 142A. Owner. f E / l�r✓ Contractor NOTICE. The signatures of the parties above apply only to the agreement of the parties to alternate dispute resolution initiated by the contractor. The owner may initiate altemative dispute resolution even where this section is not signed separately by the parties." 200UE Commonwean c`tvMassachusetts Site°o[Me; Cont« ac:UT_ Sd Map http://vvv�-w.mass.gov/?pageID=eoDsterminal&L=4&T.0=HnmPR T.t=CrmcrrcnPr4-Pr^f i-;, 1 nn Wlr%no Page of jl Free Estimates 105 Haverhill Street li Fully Insured Methuen, MA 01844 Federal 11D# THOMPSON'S ROOFING (978) 691-1355 04-3178801 Shingles - Slate - Rubber Roof Single Ply - Copper Work i j PROPOSAL SUBMITTED TO PHONE r1l-3--08 Mary O Neill { STREET JOB NAME 127 Chestnut Street CITY,STATE AND ZIP CODE JOB LOCATION t North Andover MA 01845 ARCHITECT DATE OF PIANS PHONE j j We hereby submit specifications and estimates for: t Strip off all roof shingles on entire house garage,small roofs and shed IiRenail all loose boards and replace any rotten boards at $4 . 00 a ft. 3j On back side of house remove gutter, replace rotten boards with prime ones Mand rehang gutter E j, On back side on garage board up 2 skylights and 1 chimney hole ! Install , 024 white aluminum drip edge around roof line �IApply ice and water shield 6 ft. up all along edge and in valleys '! Apply 15 lb. felt paper on rest of roof area jiReshingle with a GAF/ELK timberline 30 shingle to match addition i: Install new flanges around soil pipe Cut in a ridge vent on house lCut in new lead flashing around chimney 3 ti jInstall water diverters over doorway ; Remove all work related debris i! " 30 year warranty on material I: 15 year guarantee on labor i' ljconstruction lic. #060112 ? 11improvement #128612 i {I i I P ;3Pm_rOP00e hereby to furnish material and labor--complete in accordance with above specifications,for the sum Of- Nine fNinethousand two hundred dOUam 9 ; 00 . 00 ; i1 Payrnent to be made as 109ows: ($.3,000 . 00 start of iob balance upon completion i� #E AI!materia!is guaranteed to be as specified.M work to be complated in a worlor�IGke trkerrter j r ;; i according to standard prateices.Any alteration or deviation from above 1; -i ieatiorra fnvolv6gAWJdad �!/� � _�' s�l ✓ f{ [@! ii 2xtfB COSSS will be B7cBC4J2@d Oflly upon written orders,and wit becorrre an am'a Ct1af90 over and above the estimate.M agreamerfs contingent upon swces,aocidamts or do*s beyond ow sr corrrol. Owner to can fire, tornado and ather necessary i swanoe.Our worims are My Note:This proposal may be �� cov J by rs:+'s Compensation insurance. widub wn by us if not aocepted wMin �/! f� r RCr[13�aEIirP 0$ i9rop0zat—'cute above prices,specifications and (I k t, conditions are satisfactory and are hereby accepted.You are autltarized to do the � c f work as Specified_P will be made as outlined above. � Payment � I �. date of Acceptame: I NORTH ANDOVER BUILDING DEPARTMENT Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit at: is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c11, S150A. Also, note Permits are required under Fire Prevention laws Chapter 148 Section I OA. The debris will be disposed of in: PCO (Location of Facility) i Signature of Permit Applicant 2- o � Date The Commonwealth of Massachusetts Department of Industrial Accidents r'1 � ,1 ' Office of Investigations 600 Washington Street �U E s Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/individual): Address: /.05- city/state/zip: 5-City/State/Zip: Q k- Phone #:__4 ( - 13 S7S— Are you an employer?Check the appropriate box: 1.❑ I am a employer with 4. ❑ I am a general contractor and I Type of project(required): employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.Eli am a sole proprietor or partner- listed on the attached sheet 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. o workers' comp. insurance 5. 9. Building addition [N p. ❑ We are a corporation and its required.) officers have exercised.their 10:❑ Electrical repairs or additions 3.❑ 1 am a homeowner doing all work right of exemption per MGL 1 1.❑ Plumbing repairs or additions myself. [No.workers' comp. C. 152, §1(4),and we have no 12.en'lRoof repairs insurance required.] t employees. [No workers' comp, insurance required.] 13.❑ Other *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. Homeowners who submit.Ri»s a�e�davit utdicatiitg Gley are ui,iiid ail v:urk slot tiler,hire outside contractors must submit anew affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation information. insurance for my employees. Below is the policy and job site Insurance Company Name: COY r Policy#or Self-.ins. Lie.#:—'Z 01 LL /,-(O 12-001 Expiration Date: Y - 2 8 - o Job Site Address: C�e5.- City/State/Zip: � Attach a copy of the workers' compensation policy declaration page(showing the policy num-bI tang b p y umber and expiration date). Failure to secure coverage as required 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 ver coverage verification. tcation. I do hereby certif under the pains and penalties of perjury that the information provided above is true and correct Signature: Date: - I L - O Phone#: Official use only. Do not write in this area,to be completed by city or toE#: =-cia City or Town: Permit/Licen Issuing Authority(circle one): 1. Board of Health 2. Building Department 3.City/Town Clerk 4. E 6.Other Contact Person: Pho 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-contractors)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 maybe 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 permittlicense 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 Office of Investigations would like to.thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Revised 5-26=05 Fax# 617-727-7741 www.mass.gov/dia ACORV_ CERTIFICATE OF LIABILITY INSURANCE DATE /DD/ 07/1177/lo0os08 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Pelham Insurance Services, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. Box 960 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 122 Bridge Street Pelham NH 03076 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A:St Paul Surplus Lines Thomas Doyle INSURER B:Associated Industries dba Thompson Construction & INSURER C: 8 West St. INSURER D: Salem NH 03079 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 P-FFMCED BY PAID CLAIMS, INSR ADD'L POLICY EFFECTIVE POLICY EXPIRATION LTR INSRD TYPE OF INSURANCE POLICY NUMBER DATE(MM/DD/YY) DATE(MM/DD/YY) LIMITS A GENERAL LIABILITY EACH OCCURRENCE $ 11000,000 X COMMERCIAL GENERAL LIABILITY CP555146 04/15/2008 04/15/2009 DAMAGE TO RENTED 50,000 PREMISES Ea occurrence $ CLAIMS MADE [—]OCCUR MED EXP(Any one person) $ 1,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GE N'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 1,000,000 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 El CLAIMS MADE AGGREGATE $ RRDEOUCT!BLE $ ETENTION $ - $ B WORKERS COMPENSATION AND AWC7012214012008 04/21/2008 04/21/2009 X TDRIS'LAjb➢TSOT EMPLOYERS'LIABILITY I ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 100,000 OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE$ 100,000 If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 OTHER DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Roofing 6 carpentryfor Sabdra Dufour @ 12 Edwin Avenue CERTIFICATE HOLDER CANCELLATION Methuen Housing Rehabilitation SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Program EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT Searles Building FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE 41 Pleasant Street, Suite 217 INSURER,ITS AGENTS OR REPRESENTATIVES. Methuen, MA 01844 AUTHORIZED REPRESENTATIVE f Fax: 978 983-8976 k/ svL v�-- ACORD 25(2001/08) ©ACORD CORPORATION 1988 INS025(0108).07 AMS VMP Mortgage Solutions,Inc.(800)327-0545 Page 1 of 2