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HomeMy WebLinkAboutBuilding Permit #235-11 - 148 MAIN STREET 9/20/2010 BUILDING PERMIT cE NORTH TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION * � e Date Received Permit NO: ° p a• '� q°gwreo 'kyg9 Date Issued:_q_— r �SSgcHLl IMPORTANT Applicant must complete all items on this page 4 -^`� yo ..................� g7p41eii. 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: 0 Demolition Other Max 5 g 4'i4 Y r n S h 1 a FIoDd lai IWI a#la c�s� a r {' rs P ntersestict, fry §r 7 A-r... �� ,i�y }`'Y+�a-�Y4yY-'z.•. �. ��'�,ie�'7� .s...,-�1cT - r, F DESCRIPTION OF WORK TO BE PREFORMED: Identification Please Type or Print Clea lye -` OWNER: Name: Phone: Address: `tJ Z- ,_brL..n � 7F� :t rs r. a. � 11Wi 3_ alk rF`�' �r.z•r-fix � .r-€.�� � r i-.,,s sr,{ ,w' - & - .fi 3 =X�'' r*y.,ty`�"-' a .S - `Ja�"✓'wc.'' 'r zal+,fh` � .n�d r - 'Az-4 k.�.-q -rgl,�5,,� x'', ^v t -�" ✓ r .... r. =`!1 r'.s-� 4 Y� x - "• r r' rs�`' ('.ti.s. 2'`x{7`.'1 i�-F inn y-•+r . '4.-G` + 'Yr�?"., ,rr ,.1 -a ,3 '« - R�{ 1- `,'^x+ y5-axr. -a Y /�'7="�$ '-r�i`•��'- 7+�y,!��-:_ ��,cca`f�pi. : �`. 19i �]AIiJd � �VI/l7xIG C ..dam !l 1f n71`k 31'' +`V"'�- a'�r .rt.'' afro �r•s, r���1h��� ,'r- ^�v�`, ii. �� ter, r� ; �'��,.at i �¢. j�,rdr K;rkl -a�Y b -:���-y xa ;��y •k ,: � r. n 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. Total Project Cost: $ f�G7J•`'� FEE: $_ Ol •� Check No.: Receipt No.: �3 ! NOTE: Persons contracting with unregistered contractors do not have access to the aranty un ��natur-e.of Ag�rt/Owner Signature of�co���ract�r �� _ _ �� , � 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 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 I COMMENTS HEALTH Reviewed on Signature M COMMENTS i Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street _�IR�a.,DE�?�►R�'xME1�T .T.em� Dur�pster�on�rte ,yes n© 1 sLvcated�t 9�4�Ulam Street 4 _ 1 Y �-F�re Oe partme.r�t s i,�na�t�re/dale ' - - Yf yCQ111JlVIENT'S _ = l Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE:. Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— (For department use) ❑ Notified for pickup - Date i Doc.Building Permit Revised 2010 Building Department The following is a fist 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 _.h New Construction (Single and Two Family) ❑ Building Permit Application ❑ Ceiified Proposed Piot 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:Building Permit Revised 2008 I Location Nit, c�1 No. ) ' Date 9- 7-0 -10 NORTh TOWN OF NORTH ANDOVER F A ' ♦ i i Certificate of Occupancy $ • o� ' A— �'�s�CNusttA Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check #. 234bL6 Building Inspector i BUILDING PERMIT rl O R T►1 0 TOWN OF NORTH ANDOVER c � - APPLICATION FOR PLAN EXAMINATION �— nO� •eb Permit NO: J Date Received ���°-'•K• ^' �` 7 A�R�tT[o PSP` Date Issued: to r gCHUS IMPORTANT Applicant must complete all items on this page FF$Crl Mi'`.f. t �- r LOCDN tNM r a;t 3n.3' -, 1- � �€ ♦-7y ..,.�a � aE �'� .. T °l } � -�" YY1 4 A 1NJi'i zT"`iL S 1 ) t-� { 4_s, i�R1k,l tBIT2 ..ti ^ ct<= F-�"`�S. �pYcN '+ ���PTC�lYzall�lER x �, �5- ;1�3�`n.24"�-S��E, TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition Two or more family Industrial Alteration No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other 9 �� 7 ONE -'' ill eid�-1 tr. �S r� u, � � F�ionoplain� aU�lettands t r x - Z q r 'o- � ��✓'t c �:"•�§"�.�+�',�'-'' '�-ry`�t-Y 1• �-..fit---fn- , � . '-�•i f,, . ,eta DESCRIPTION OF WORK TO BE PREFORMED: `ryl J lylezaAM!6 )to Ex A Q lL CL 104A2 _ f J� Identification Please Type or Print Clea I (t) Z OWNER: Name: SW,..,�Phone: Address 0 a,+�.. ..$ r k. 'e-`� * 41 y .9 4 1"ti T sJ. T - FJ .K,- V y,i•Lyr-S 311 1)� .v- �.+ x-. va,y, � '� C OEM, `YrMf C c .r,.'��.,�., l,ay t 1L. Gr 3'.F.F ^!.-ru--'Y s cs^ p- $„ -2 3ayY i r- ✓ Fi,, �,�r �. ,p�p:.'J4 �. ,,,��r #s..--+•1�.�i s a �� 'cd'-5 r r- � a �,,.1 j���s 5,,�,1^y£�..r T 1�`3- `� a� '; N 5' '? t�hy fig-rzM' gni} YY7r}axan7l�y'r� y� r~." r4z,:'r' y�ti F _,,{•--i£ M 3 1 -,1. G'" <-•y� ,.}" -•�3k 5 S � Ld ao. �ili� l'I U ��4� r1:UGJi✓ F REM ? rA Mpr'":a"� l�ie% �i- -r ARCHITECT/ENGINEER ��� Phone: Address: Reg. No. FEE SCHEDULE:BOLDING PERMIT:$92.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ l 6C:V-`=ta FEE: $ OC U Check No.: Receipt No.: 3 _ NOTE: Persons contra with unregistered contractors do not have access to the aranty fun ntre frAg�nt%Ouuner� ti 4 Signa ut r f coe on Tactor_ 'r _ _ �, kWAL 09/17/2010 09:42 9782784008 GREAT NORTH PAGE 02/0' Elm & WeatherprCF4011, & iZC. 2C�.L�.• K Ate, 830 LIVINGSTON ST_#13 TEWKSBURY.MA 01876 (978)85I-8304 FAX(978)851-9884 ay Q 16 off - 114000 swornbcr iG,2010 Sutton Pond Condominiums Trust Phone.978-2784000 14$Mein Street North Andover,Ma 01845 Fax:97$-2781100$ Re:Sutton Pond Condo's North Andover.Ma. Base Bid LeClair Roofing&Weatherproofing,Inc.(-Seller")proposes the following to Great North Property Management("Buyer"). 1. Ruvfmg work not to exceed 3 t,$tlo square feet.This proposal dudes the roofs on Kittridge,Steven's,Bradstreet, Coolidge.and Fosw bmildings,with two lower trash rooms and one elevaWr room roof per site visit. 2_ Vacuum all gravel off roost and dispose of at She property next door and to include the 2141x2'concrete pavers.A9 w4uoa/ed by Cluis Spalehvrf 3. Remove and properly dispose of all existing rubber roofing membrane only. 4. Re-roo£over the existing 2.0"in-sulation. 5. Supply and b=ll the following: a. (1)layer of new 1/2"Firestone 1,SMARD MD cover board imulation LTTR-.S mechanically attached directly over the existing 2-ti"insulation.Note:To be fastened to meet 72 MJPH wind gust guidc$tie per 1"11restone Texhnivtl nt a rate of(12) in field and(16)for the first$'0"of the perimeter edges and(16)In an 81x8'inside and outside corners with an approved Firestone fasteners per 4'18' board. b. A Firestone.060 reinforced fully adhered f ray TPP roofing system as per manutilcture is specifications. c. Flashings included for all existing roof penetrations. d Flashing for al I existing roof drains and any broken or ologge:d drains will be charged as an extra. Note:Supply and Install(1)new roofdrain to match the existing at the same location that it was located included- e_ shop fabricated 7-piece edge guard plus.05t)ainimin um standard kynar fascia with continuous hook cleat at nil perimeter edges in lieu or the t-pawc Graver Stop wao 5.1.71p carried in the August 25,2f1't0 72 MPH Bid f. (585)lineal feet of Firestone 30"wide rolls of TPO walkway included to replace the existing 2'x2'x2" concrete pavers walkway. 6 _Supply Mamrfaeturees twenty(20)year material and labor wat7mity and 72 mph wind gust warranty included 7 (115)Existing Condensers to be luted only and the existing 4"x6"prenur c treated woad sleepers to be unfastened and hr rputrd And be reinaalled loose laid only on an approved slip sGeet and groups of multiple condensers wood sleeper to be joined together(2)pressure treated 20 included. Note:A 10"/.(11)Condenser Unit Allowance for Damages to the existing units during the roof replacement is included. 8. Below Base Bid pricing inclrxiec the cost to provide the Town of North Andovcr lto-Roofing Permit Special Note:(All Architect(Engineer Fees to Verify the Existing Structure will meet Loco)Code Minimum Weight Requirements to ietne-the rrgnired Re-Roofirtg Fertak If required is not included.) Pape 1 of 2 r— 09/17/2010 09:42 9782784008 GREAT NORTH PAGE 03/03 t +- Exclusions: Bond,conduitnighting fixtures beneath roof deck,winter conditions,snow shoveling,weather delays, rotten/damaged decking,asbestos,lead paint,ponding water,police details,parking permitslfees,cleaning of existing roof drains,replacement of wet of wet 2.0"existing roofing insulation(see alternate 112 bctowj replacement of any damaged or Oct running properly existing condenser roof units prior to the Colina of the exieting condenser enifs(Note:Great North Property Management to have the existing condo owners to verify the unit condition prior to roofing replacement and will not warranty any owner's e(taipment beyond our scope of work,disconnecting and re-connecting the connections Of the existing(115)condenser units so that the existing roofing system can be replaced.An existiag pitch porkefs to remain and any and all np grading of the existing condenser unit low voltage lines is not included. 5pecial Note: ASO*Scissor Lilt has been added to the below Base Sid Price for(2)Months in lieu of the(1)month previously bid to access the existing roof in lieu of the building elevator. Seller proposes hereby to famish material and labor-complete in accordance with the above specifications,for the sum of TWO HUNDRED NINE THOUSAND MVE HUNDRED FIFTY DOLLARS-------- X209,900.00 (Subject to manufacturers price increases as they occur) Notes: Additional work beyond the above scope will be done at a rate of 575.00/man/hour for roofing and$80.00/man/hour for sheet metal(rates subject to change)portal to portal,plus materials and a S.50 per mile travel expense and any per diem chargee. The above price is conthircux upon roof deck meeting manufactttner's listener pull requirements to issue warranty and access next to building for trucks,dumpsters,and crane. We may withdraw this proposal if not accepted within(30)days. Payment: 1/3 will be billed upon delivery of materials and the balance will be billed Net 30 Days as work is complete,a I.5'/o per month finance charge will be added to all invoices on the 31'day.All kgal and/or collection fees will be paid by Buyer. Alternate iiia Supply and install new 2.0"polyisv insulatiun tv replace arty wet or badly damaged existing 2.0"insulation to include dumpster prior to the immallation of the new roofing system as directed by Great North Property Management prior to any existing 2.0"insulation replacemcm Unit Cost Add of S.ZM/SF Date: Robert R 'i'licmen,Senior F,stunator LeClair Roofing&Weatherproofing,Inc. Acceptance:no above prices,specifications and conditions arc satisfactory and are hereby accepted.You are authorized to do the work as specified-Payments will be made as mitlined above. Date: �f�3'� j PezeaIA7L Prim and sign name and title Pago-1 of 2 The Commonwealth of Massachusetts r l Department of Industrial Accidents VtM A, I' Office of Investigations gra.J, f i iii' li r ' 600 Washington Street U « 11EBoston,MA 02111 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please PrintLeizibly Name (Business/Organization/Individual):. Ch , Address: �,�V J n4i 6+zm :ai� -�— t�1�7lv City/State/Zip: M' Phone#: -� Are pa an employer?Check the appropriate box: Type of project(required): 1.UK I am a employer with W 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers'comp.insurance. 9. ❑ Building addition [No workers' comp.insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑ Electrical repairs or additions 3.❑ 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 12.❑ Roof repairs insurance required.] employees. [No workers' 13.❑ Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t 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 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. J� Insurance Company Name: J?L� 1VU'I 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 Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby cerdu r the p . s penalties((of perjury that thein ormation provided above is true and correct.' St atur . TDN'" Q�rlQ r Date: P hfr�t rF�Yfq;! Phone#: cS` Official use only. Do not write in this area,to be completed by city or town offcial. City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2. Building Department 3.City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6.Other 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 Ao ernpldys 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' of permit-to operate a business or to construct buildings i4 the commonwealth for any applicaiit,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 nutnber(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 confinnation 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 pen-nit 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 sur&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 pen-nit/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 pen-nits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or pen-nit 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 Depar-trhent's address,telephone and fax number: ~^ y The Commonwealth df Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel. #617-727-4900 ext 406 or 1-877-MASSAFE Fax#617-727-7740 Revised 5-26-05 ww4v.mass.gov/dia � NORT1y 0 o r . , ove No. o dover, Mass.,LAKE a1� COCHICHEWICK RATED P'P�,`�� �l BOARD OF HEALTH Food/Kitchen PERM IT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT........ •OTn ,f . ... ...0....... �.n ........ 1 ................................. ............................... Foundation has permission to Act........................................ buildings on ... .............................. ..... .......... ....................�............... Rough A,1 I to be occupied as xe.. Io/Y.t.....�,,� -44 ... ......... .... 10.�L. .... .... .�{• �^Q. Chimney provided that the person accepting this permit shall in every respect conform th erms of the application onrfile 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 CONSTRUC TAR Rough Service ........ ....................................................................................... BUILDING INSPECTOR 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. tcGu.itt. - U��r;tr rrncnr of Public s; Board of Buililin�f Rr, +frt trl:ttiou.:uu1 -staff(l:trtl. Construction SaerVisor License License. CS 79509 Restricted to: 00 STEPHEN P LECLAIR _ 38 BRETT CIR PELHAM, NH 03076 (r,ioini.. Expiration: 9/27/2010 i„q•r TrtE: 3681 -For Rw)v ovN ..BOARD:-,OF BUILDING REGULATIOiV.B License: CONSTRUCTION SUPERVISOR r '= Number:.:CS 079509 Birthdate .09f27fl960 Exptres- Restrtcfect: Qa STEPHEN P LECLAIR 38 BRETT'CIR PELHAM, NH 03076 Commissioner AGaRD_ CERTIFICATE OF LIABILITY INSURANCE OP 1D Rs ,DATE("w" m PRODUCERLECLA-1 1 09/17/10 - - THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE DeSanctis Insurance Agcy, Inc. HOLDER.THIS CERTIFICATE DOES NOT AMEND.EXTEND OR 36 Cummings Park ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Woburn MA 01801 Phone:781-935-8480 Fax:781-933-5645 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A. Acadia Insurance INSURERS: A= Pray�ty i Casealty Ina Co LeClair Roofing 1G ��c: 830 Livv3m stoonlitlrset Tewksbury NA 01876 INSURER E COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTVATHSTANDING ANY REGUREMENR,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 SMECTTO ALL THE TERMS EXCLUSIONS AND COMMONS OF SUCH POLICIES.AGGREGATE UMHi3 SHOWN MAY HAVE BEEN REDUCED BY PAID CLAMS_ PJJM LTR KSR1 TYPEOFINSURANCE POLICYNUMBER PIDOALTE70OW MMUMM. Lam GENERA.LIABIL.ITYEACH OCCURRENCE 51,0 0000 A R commmCALGENERALLmum CPA023659612 01/01/10 01/01/11 PRerlsFs Eeooaaence) s250,000 CLAMS MADE ®OCCUR MED EXP(Am one Person) $5,000 PERSONAL a AM INJURY $1,000,000 GENERAL AGGREGATE s2,000,000 GEMLAGGREGATE LMRAPPLIES PEIt PRODUCTS-COMPlOPAGG s2,000,000 POLICY R-1. LOC AUTOMOBILE Lu81LLTY A ANY AUTO CRA023659722 01/01/10 01/01/11 ms)etai 11,000,000 ALL OWNED AUTOS BODILY HAIRY i X SCHEDULED AUTOS (Pec Canon) X HIRED AUTOS X NON<IWNEDAUTOS BODILY )PROPERTY i (P-ecciderM)AMA(aE s GARAGE L IABRM AUTD ONLY-EA ACCIDE NT i ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AM i ■XCESSIUYB11113"LU BILITY I"OCCURRENCE s3 000 000 A R wxUR ❑CLAMSMADE CUA023659912 01/01/10 01/01/11 AGGREGATE s3,000,000 s DEDUCTIBLE i RETENTION $ $ WOTB�1SCOMPENOATIONAND X TORYLIMITS I I ER EWILO"WLIABLITYIS ANY MCC45895476 Ol/Ol/10 01/Ol/1Z EL EACH ACCIDENT $1000000 OFFICEIMEMBER EXCLUDED? I�,NH ELDISEASE-EAEIPLO $1000000 S R pNSbebw EL DISEASE-POLICIILMR $1000000 OTHER A Installation Float CPA023659612 01/01/10 01/01/11 Limit $100,000 Stored Materials Deduct $500 DATION OF OPER MM I LAXAMW I VEHCLW I EXCLUMM ADDED IW B If N SPECIAL.PROVMKMS ^ADDITIONAL INSURED LIMITS ARE NO GREATER THAN THOSE REQUIRED BY SMITTEN CONTRACT." PROJECT: Roofing at Sutton'Pond Condominium, 148 Main St., North Andover, MA 01845. Additional insured as respects GL: Sutton Pond Condominium Trust and Great North Property Management. CERTIFICATE HOLDER CANCELLATION $UTTO-3 OUI.DANKOFTL�ABOVE I SLIE CANCF3L®B THE EXPXtATTON DATETmENEI OF.THEmsunmPmmERmLLEwEAvoRTow& 30 ILLYSWRITTEN Sutton Pond Condominium NOTICE TO THE CERTY LATE HOLDER NAMED TO THE UEF.Btf FAILURE TO DO$O SHALL Trust MPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE WSUTER,ITS AGENTS OR 148 Main Street North Andover MA 01845 HtFpRtrrwTroEs AUTHORITATIVE ACORD 25(2M=) ®ACORD CORPORATION 1988 9,4e &mmomweala Office of Consumer Affairs andBusiness Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 121050 Type: Private Corporation Expiration: 4/1/2012 Tr# 294944 LECLAIR ROOFING &WEATHERPR INC STEVE LECLAIR 830 LIVINGSTON ST TEWKSBURY, MA 01876 Update Address and return card.Mark reason for change. E] Address [:] Renewal ❑ Employment Lost Card DPS-CA1 0 5OM-04/04-G101216pp 0— /21C�omronanccmealM, a�,l�aasac�uaet� --- - == Office of Consumer Affairs&Business Regulation License or registration valid for individul use only before the expiration date. If found return to: r ' HOME IMPROVEMENT CONTRACTOR 1 Registration": -121050 Office of Consumer Affairs and Business Regulation l i10 Park Plaza-Suite 5170 ,. Expiration._--41-1120;12 Tr# 294944 Boston,MA 02116 Type;. PrivateCorporation LECLAIR ROOFING'&WEATHERPR INC STEVE LECLAIR< 830 LIVINGSTON ST TEWKSBURY,MA 01876 Undersecretary Not valid without signature i & WeatheirproolUgo Pwo 830 LMNGSTON ST.#13 TEWKSBURY,MA 01876 (978)851-8304 FAX(978)851-9884 June 3,2010 To Whom It May Concern I Stephen LeClair President of LeClair Roofing&Weatherproofing Inc. grant authority and authorize: (Benjamin_Goodno)=i0f LeClair Roofing&Weatherproofing Inc. To act in my absence regarding all maters concerning applications and other business pertaining to the acquisition of building permits for LeClair Roofing and weatherproofing Inc. This authorization is valid until December 31,2010 Signed Stephen au President LeClair Roofing&Weatherproofing Inc. Notary Public 1 M Commission Expires ROMW R.TM�EN'Notary Pubft Y P W +E 8,2012 Seal Corporate seal