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Home My WebLink AboutBuilding Permit #139-12 - 1348 SALEM STREET 8/18/2011 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued: '✓`/�✓✓ IMPORTANT:Applicant must complete all items on this page LOCATION L` �� °-1 S Print PROPERTY OWNER ►• S `� r - w Unit# Print MAP NO&_N41ARCEL:A3.ZONING DISTRICT: Historic District yes Machine Shop Village yes o 100 year-old structure yes o TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial 11 Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other trt^G Y -- }=.-r cawsa�wr Fn T ref �;Septic (]Well , �Floodp ain'� � Wetlands r ` �{, ® Wat�ershed District, , ®Water`/Sew r, TS�` Li .z DESCRIPTION OF WORK TO BE PERFORMED: �YU d vt^ Id ratification Please Type or Print Clearly) OWNER: Name: o l — Phone: ? �d`6 �( 3 Address: �( CONTRACTOR Name: 1 �-- Phone: 4' ? �j ,� ® • Z v Z Address: j e�,S�, T—, Supervisor's Construction License: O� Exp. Date: 1' - jj Home improvement License: �ok Z- Exp. Date: /7 S /Zo 1 2. ARCH ITECTIENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$92.00 PER$1000.00 OF THE TOTAL ESTIMATED COSTf ASED ON$925.00 PER S.F. Total Project Cost: $ 0 FEE: Check No.: 6l K R eip NOTE: Persons contracting with unregistered contra to s np v access to the guaranty fund �S+anature.of Aaent/Owner Signature of_contrac or 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 ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products 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 ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg .Permit In all 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: Doc.Building Permit Revised 2008mi i 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 ❑ I, Private(septic tank,etc. ❑ ' Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORINT DATE REJECTED DATEAPPROVED OVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS CONSERVATION Reviewed on Signature COMMENTS s. HtALTH Reviewed on Signature I COMMENTS Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Waiter & 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: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$10041000 fine NOTES and DATA— For department use ® Notified for pickup - Date Doc:.Building Permit Revised 2011 June/mi Location S q f> ! No. f Date 13 1 i huoTM ,� TOWN OF NORTH ANDOVER o � F w Certificate of Occupancy $ ss SE< Building/Frame Permit Fee $ ►cHu Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # E Building Inspector The Commonwealth ofMassachusetts Department of Industrial Accidents Office of Investigations, 600 Washington Street Boston,MM 02111 ` SY www mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Alpylicant Information Please Print Le ibl Name(Business/Organization/Individual): Address: , i City/State/Zip: M'I Phone#: 3� o -42r; .Z Are you an employer?Check the appropriate box: 1. I am a employer with _�S- - 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.❑ I am a sole proprietor or partner- listed on the attached shget. 1 7. ❑Rem.odeling ship and have no employees These sub-contractors have working for mein any capacity, workers'comp.insurance. g' ❑Demolition [No workers' comp,insurance 5. ❑ We are a corporation and its 9• ❑Building addition 3.❑ required.] .officers have exercised their 10.❑Electrical repairs or additions I am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no insurance required.]t employees. 12.0Roof repairs [No workers comp,insurance required.] 13.❑Other *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation polis information. Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors 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 insurance for my employees Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: 1�`1�➢ C oZ / Expiration Date: �@ Job Site Address:_ '`� '� �c I � City/State/Zip: t Attach a copy of the workers'compensation policy declaration page(showing the policy number 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 maybe Investigations e forward tigahons o the DIA for insu anc coverage verification. y ed to the Office of Ido here b certify n thefp y �, ' s o er u that the information provideW7,e is tr a and correct. Signature: 7 f Z i Date: Phone#: 1`7�.'�� 'cj Z ZS FOther only. Do not write in this area,to be completed by city or town official. n: Permit/License# hority(circle one): I. Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing g Inspector son: 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 apartinents 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 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. pity 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 bum 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 Col-nruonwealth o f Massachusetts Department of Industrial Accidents Office of InVestigatlons _ 600 Washington Street Boston;M-A 02111 TO. #617-727-4900 ext 406 or 1-877-MASSAFE Revised 5-26-05 Fax#617,727-7749 www.mass.gov/dia C NORTH 0 0 : Andover No. 13�t o dall ower, 1VMass., ' lie ' I * 10 • 0� COCHICHEWICK V O`QATFD BOARD OF HEALTH i PERMIT . T D Food/Kitchen Septic System I � BUILDING INSPECTOR THISCERTIFIES THAT..........:... ..................... . .......................... . . .......................................................:............... Foundation i has permission to erect. buildings on �. � ...... ... i ..... . ............... Rough to be occupied as........ 9 Chimney 11 ... Ch' e .. ... ............. .. ...................................................................................................... provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final j 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 i VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough i Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR J7NLESS CONSTUCTI START) Rough .................................................. BUILDING INSPECTORService Final Occupancy Permit Required to Occlupy 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. I ' 1 S GENERAL A 56 Pleasant Street Methuen, MA 01844 Phone/Fax: 978-688-3944 Company Email: DavidReitano@verizonnet Proposal Date: 8/1/2011 Submitted To: Mr. and Mrs. Phillip Canning Salem Street N.Andover Mass, 01845 Home: 978-689-8643 Work: Mobile E-mail Job location - Job Description: Bathroom Remodel We herby submit specifications and estimates for: Bathrooms Located on second floor will be demoed in tub area to expose framing including removal of all fixtures.Majority of walls and vanity will be salvaged. All debris will be removed from job site. Contractor will supply dumpster—dumpster location to be confirmed prior to construction.. Electrical will be salvaged.Additional ceiling vent will be properly wired and vented,.new wall lite will be installed in exsisting location. Plumbing will be updated to meet Mass Code requirments including water supplies, shutoffs, drains, etc. to accommodate a Swanstone 5 foot shower pan Wellworth Lite toilet, " solid surface countertop/sink combination, tub and shower valve, and faucetts. Floor will be prepared for tile including plywood underlayment Allowance outlined below. Walls in tub area will be surfaced with Swanstone material All walls disturbed during construction will be repaired. Finish including window trim ,vanity ,door trim etc. will be salvaged. Above total price$8800.00 a f *Contractor is responsible for allowances mentioned,anything that exceeds these allowances- Homeowner is responsible for. *Homeowner is responsible for paint and stain *Please review.his proposal carefully for any items which may be missing. Contractor is not responsible for items not mentioned here. I j *Please do not hesitate to contact us if you h e any a ions. - Thank you for considering us for this project- David Reitano Workmanship Completely Guaranteed/Sullivan Insurance (Please sign and return one copy) Signature: Date: Signature: Date: I i I � E `ACOR� DATE(MM DD M C °R1�� MC1T� �x �� ►I�I�.I t611F�A�IE nY, N w.. ..� 07/19/11 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE nR 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,nay require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER COMPANIES AFFORDING COVERAGE PAYCHEX INSURANCE AGENCY,INC. COMInPANY AMGUARD 150 SAWGRASS DRIVE ROCHESTER,NY 14620 COMBPANY INSURED COMPANY DAVID REITANO C DAVID REITANO BUILD&REMODEL 56 PLEASANT STREET METHUEN,MA 01844 COMDPANY COUF2AGE5 f2EVISiON NUMBER:; THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUEL:TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Co TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR DATE(MM/DD/YY) DATE(MM/DD/YY) GENERAL LIABILITY GENERAL AGGREGATE $ COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OPAGG $ =]CLAIMS MADE[=]OCCUR PERSONAL 8 ADV INJURY $ OWNER'S&CONTRACTOR'S PROT EACH OCCURRENCE $ FIRE DAMAGE Any one fire) $ MED EXP(Any nne person) $ AUTOMOBILE LIABILITY t— ANY AUTO I COMBINED SINGLE LIMIT $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY $ (Per person) HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN AUTO ONLY: EACH ACCIDENT $ AGGREGATE S EXCESS LIABILITY EACH OCCURRENCE $ UMBRELLA FORM AGGREGATE $__ OTHER THAN UMBRELLA FORM WORKER'S COMPENSATION AND EMPLOYERS'LIABILITY DAWC226669 06/11!11 06!11/12 X TO Y_,.,T OTH- _ EL EACH ACCIDENT $ 100,000.00 THE PROPRIETOR/ INCL PARTNERS/EXECUTIVE � EL DISEASE-POLICY LIMIT $ 500,000.00 I OFFICERS ARE: ^ EXCL EL DISEASE-EA EMPLOYEE $ 100,000.00 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) i CEaTIP)CATE HOLDER,: , u. CANCEL"CATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS,BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR nLIABILITY OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE vie e I i titassachusctts- Department of PaI)Ilc Safet, Board of Building Rr,'ulatiun, and Standard. Construction Supervisor License License: CS 23365 Restricted to: 00 DAVID REITANO ; 56 PLEASANT STREET METHUEN, MA 01844 eek ri-- �"'C' Expiration: 121.42011 t u�nmi..imcr Tr#: 11861 i Office o onsumJairssioessegu a on HOME IMPROVEMENT CONTRACTOR Registration: -..,_108782 Type: Expiration: ,8125/2012 Private Corporatio I D REITANO REMQDEt$BiJftD David Reitano - 56 Pleasant St Methuen,MA 01844 Undersecretlry. i e GEAERAI CONTRACTORS 56 Pleasant Street Methuen, MA 01844 Phone/Fax: 978-688-3944 Company Email: DavidReitano@verizonnet Proposal Date: 8/1/2011 Submitted To: Mr. and Mrs. Phillip Canning Salem Street N.Andover Mass, 01845 Home: 978-689-8643 Work: Mobile E-mail Job location - Job Description: Bathroom Remodel We herby submit specifications and estimates for: Bathrooms Located on second floor will be damned in tub area to expose framing including removal of all fixtures.Majority of walls and vanity will be salvaged. All debris will be removed from job site. Contractor will supply dumpster—dumpster location to be confirmed prior to const,uction.. Electrical will be salvaged.Additional ceiling vent will be properly wired and vented,.new wall lite will be installed in exsisting location. Plumbing will be updated to meet Mass Code requirments including water supplies, shutoffs, drains, etc. to accommodate a Swanstone 5 foot shower pan Wellworth Lite toilet, " solid surface countertop/sink combination, tub and shower valve, and faucetts. Floor will be prepared for tile including plywood underlayment Allowance outlined below. Walls in tub area will be surfaced with Swanstone material All walls disturbed during construction will be repaired. Finish including window trim ,vanity ,door trim etc.will be salvaged. Above total price$8800.00 I` *Contractor is responsible for allowances mentioned,anything that exceeds these allowances- Homeowner is responsible for. *Homeowner is responsible for paint and stain *Please review,his proposal carefully for any items which may be missing. Contractor is not responsible for items not mentioned here. *Please do not hesitate to contact us if you h e any,, a ions. 3 t f Thank you for considering us for this project- .r j David Reitano Workmanship Completely Guaranteed/Sullivan Insurance (Please sign and return one copy) Signature: Date: Z� Signature: Date: I .,ACORD DATE(MM/DD/YY) _ TM CERTIF.IC�4TE t7F LI CHILI 0[ol$1 RA,.'N E 07/19/11 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CFRTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEWU 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 COMPANIES AFFORDING COVERAGE PAYCHEX INSURANCE AGENCY,INC. COMPANY 150 SAWGRASS DRIVE A AMGUARD ROCHESTER,NY 14620 COMPANY B INSURED DAVID REITANO COMPANY DAVID REITANO BUILD&REMODEL 56 PLEASANT STREET METHUEN,MA 01844 COMPANY D COVERAGES CERTIFICATE(UMBER: REVISION±NUMBER:. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LT DATE(MM/DD/YY) DATE(MM/DD/YY) LIMITS GENERAL IABILITY COMMERCIAL GENERAL LIABILITY GENERAL AGGREGATE $ LAIMS MADE�CGUR PRODUCTS-COMP/OP AGG $ OWNER'S 8 CONTRACTOR'S PROT PERSONAL&ADV INJURY $ EACH OCCURRENCE $ FIRE DAMAGE Any one fire) $ AUTOMOBILE LIABILITY MED EXP(Any nne person) $ ANY AUTO COMBINED SINGLE LIMIT $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY $ (Per person) HIRED AUTOS _ NON-OWNED AUTOS BODILY INJURY $ (Per accident) PROPERTY DAMAGE $ GARAGE LIABILITY ANY AUTO AUTO ONLY-EA ACCIDENT $ OTHER THAN AUTO ONLY: EACH ACCIDENT $ EXCESS LIABILITY AGGREGATE $ UMBRELLA FORM EACH OCCURRENCE $ OTHER THAN UMBRELLA FORM AGGREGATE $ $ WORKER'S COMPENSATION AND WC STATU- OTH- EMPLOYERS'LIABILITY I DAWC226669 06/11/11 06/11/12 X THE PROPRIETOR/ EL EACH ACCIDENT $ 100,000.00 PARTNERS/EXECUTIVE INCL EL DISEASE-POLICY LIMIT $ 500,000.00 OFFICERS ARE: Ell,!_I EL DISEASE-EA EMPLOYEE $ 100,000.00 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION . SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS,BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. ��. G D AUTHORIZED REPRESENTATIVE f . )lassachusetts- Del►iu-tmcnt of Public Safch ' Board of Building] Reti and Standards Construction Supervisor License License: CS 23365 'Restricted to: 00 DAVID REITANO 56 PLEASANT STREET METHUEN, MA 01844 Expiration: 1.21.412011 COMM sancr Tr#' 11861 i i I n�nam ��l Office o onsutner A airs siness egua on HOME IMPROVEMENT CONTRACTOR Registration: ;, 08782 Type: Expiration: 012 Private Corporatio REITANO::REM.QQEt$�$UttD David Reitano _ 56 Pleasant St Methuen,MA 01844 Undersecretary