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HomeMy WebLinkAboutBuilding Permit #330-15 - 148 MAIN STREET 10/1/2014 BUILDING PERMIT o� No DTH TOWN OF NORTH ANDOVER 02 h`:?t. 6'6 ° F ; '" - - APPLICATION FOR PLAN EXAMINATION �LO 3 1 a �' un � Permit No#: Date Received '~ Date Issued:/16;?.— ssued. A ACHus f IMPORTANT: Applicant must complete all items on this page rLOCATION PROPERTY OWNER __jefPrint ,(} Print 100 Year Structure MAP v PARCEL Lq__ZONING DISTRICT: Historic District Yes r no Machine Shop Village yes f I TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑ Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial hh ❑ Repair, replacement ❑Assessory Bldg El Others: ❑ Demolition ❑ Other ' ❑ Septic ❑Well ❑ Floodplain ElWetlands El Watershed District ❑Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: Identification- Please Type or Print Clearly OWNER: Name: Phone: - Address: COri1t I�� �5�'fw}tpf� Contractor Name:��I�;�cF�,F;,ticti Phone Address: rt et Supervisor's Construction License: Exp. Date: ( I J �( I Home Improvement License: "— Exp. Date: . ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BOLDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ ` FEE: Check No.:__20 Receipt No.: () � NOTE: Persons contracting with unregistered contractors do not have access to the guara r' - -- -_ _- -- n _ _ _- - _ Signature of Agent/Owner Signature of contractor Plans Submitted ❑ Plans Waived 0 Certified Plot Plan ❑ Stamped Plans ❑ TYPE"OF SEWERAGE DISPOSAL Public Sewer ❑ Swimming Pools 11Tanning/MassageBody Art ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Pennanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed On Signature_ i COMMENTS CONSERVATION Reviewed on Signature COMMENTS n HEALTH Reviewed on Signature ! I COMMENTS 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 FIRE DEPARTMENT - Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date COMMENTS i 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) i ❑ Notified for pickup Call Email 1 , Date —_ __- __ Time Contact Name .......-------- — -----......--- Doc.Building Pennit Revised 2014 Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ 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/Cross Section/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 B at the p Board of Appeals th appeal period is pP pp p over. The applicant t must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc:Building Permit Revised 2014 CRW i C O M P L E T E RESTORATION& WATERP1tOOFING WILLIAM ULCHAK Office: 978.255.2238 Fax: 978.255.1139 Mobile: 978.360.7378 E-Mail: crwbillu@aol.com 205 Northern Blvd. Newburyport,MA 01950 Location 6% artdo No. A Date /—,O .—/— y, . - TOWN OF NORTH ANDOVER • Certificate of Occupancy $ Building/Frame Permit Fee Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check,,?ON U Building Inspector ,acOR CERTIFICATE OF LIABILITY INSURANCEDATE(MM/DD/YYYY) 9/23/2014 E 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 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 CONTACT NAME: McSweeney&Ricci Insurance PHONENo, FAX 420 Washington Street E-MAIL E - - A/C No P.O. Box 850984 ADDRESS:M ri reception@ m cswi Braintree MA 02185 INSURERS AFFORDING COVERAGE NAIC# j INSURER A: r la Insurance Group 17000 INSURED COMPL-3 INSURERB:Guard Insurance GroU Complete Restoration&Waterproofing INSURERC: 205 Northern Boulevard INSURER D Newburyport MA 01950 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER:646972800 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. INSR TYPE OF INSURANCE ADDL UBR POLICY EFF POLICY EXP LTR INSR WVD POLICY NUMBER MM/DDIYYYY) [MM1DD1YYYYl LIMITS A GENERAL LIABILITY Y Y 8500052171 /9/2014 /9/2015 EACHOCCURRENCE $1,000,000 xDAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $300,000 CLAIMS-MADE 15F] OCCUR MED EXP(Any one person) $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 POLICY X PRO- LOC $ A AUTOMOBILE LIABILITY Y Y 1020018668 /9/2014 /9/2015Ea acHINED SINGLE LIMIT cident $1,000,000 ANY AUTO BODILY INJURY(Per person) $ ALL OWNED x SCHEDULED BODILY INJURY Per accident $ AUTOS AUTOS ( ) NON-OWNED PROPERTY DAMAGE X HIREDAUTOS X AUTOS Per accident $ A UMBRELLA LIABX OCCUR Y Y 4600052216 /9/2014 /9/2015 EACH OCCURRENCE $5,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $5,000,000 DED X RETENTION$10,000 $ B WORKERS COMPENSATION COWC474329 12/15/2013 2/15/2014 X WC STATU- 9TH- AND EMPLOYERS'LIABILITY Y/N TORY LIMITS I ANY PROPRIETOR/PARTNER/EXECUTIVEE.L.EACH ACCIDENT $500,000 OFFICER/MEMBER EXCLUDED? N❑ N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $500,000 If yes,describe under DESCRIPTION OF OPERATIONS below I E.L.DISEASE-POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Sutton Pond Condominium Trust, CBI Consulting, Inc, 250 Dorchester Ave, Boston, MA and the Town of North Andover are additional insureds on the Commercial General Liability policy for ongoing operations only where required by written contract or agreement but only for acts of negligence by the named insured in the performance of the contract obligations. I CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Sutton Pond Condominium Trust ACCORDANCE WITH THE POLICY PROVISIONS. 148 Main Street No Andover MA 01845 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD F NORTk Town of 2 . s ndover No. ' 115 h " ver, Mass, A_•QA [oc Nic 01WICK`y1' 7d DRAreU.D lS BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System •• A e, .� BUILDING INSPECTOR . THIS CERTIFIES THAT ...........S ......h ...... .......... ....................................... Foundation has permission to erect .......................... buildings on/ .�....���,......�, .................... g • • • Rou h to be occupied as .. .. ...... ... ... .... .... ... ..... Chimney provided that the person accepting this mithall in eve respect con to the terms o 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 MONTHO ELECTRICAL INSPECTOR UNLESS CONSTRUC ST TS Rough Service ........... ..... .... ....................... ........................ 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. CRW Im 11 VIAL COMPLETE RESTORATION& WATERPROOFING 205 NORTHERN BOULEVARD NEWIBURYTORT MA 01950 September 23,2014 Owners/Trustees The Sutton Pond Condominium Association 148 Main Street North Andover, MA RE: THE SUTTON POND CONDOMINIUM- FACADE AND BALCONY REPAIRS - AUTHORIZATION TO PERFORM CONTRACTED WORK Dear Trustee: By signing below,you are authorizing Complete Restoration&Waterproofing, Inc.(CRW, Inc.)to perform the agreed upon project repairs per our contract agreement and specifications/drawings provided by the engineering firm CBI Consulting, Inc. As a Trustee/Representative for Sutton Pond Condo Association I am signing below to authorize CRW, Inc.to per ontracted work: 4;t�Rzazve','�4. t6 TR E PRESENTAT/ E S TO POND CONDOMINIUMS rtu i90 ram CRW, Inc. Page 1 of 1 WWU/md Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supersi%or License: CS-085581 -;I �. , WILLIAM W ULCftAK 205 NORTHERN BLVD" NewburyportMA 0190, 1 Expiration Commissioner 11/15/2014 SUTTON POND CONDOMINIUM CBI Consulting Inc. FACADE&BALCONY REPAIRS 250 Dorchester Avenue 148 MAIN STREET Boston,MA 02127 NORTH ANDOVER,MA Tel: (617)268-8977 CBI JOB NO.: 13105-D Fax: (617)464-2971 SECTION 00 30 00 FORM FOR GENERAL BID Bidder: Complete Restoration&Waterproofing Inc. Date: June 19th,2014 A. BASIC PRICE The undersigned, having carefully examined the contract documents for the "Sutton Pond Condominium, Balcony Piers Replacement" including: Amendments and Addenda Nos. nla , visited the site of the above project, and familiarized myself with the local conditions affecting the cost of the Work, hereby proposes to furnish all labor, materials, tools, equipment, protection, insurance, taxes, permits and to do and perform all things as provided in the specifications, all in accordance with the contract documents, for the sum of: One Hundred Thirty Five Thousand Fifty Dollars ($ 135,050.00 ) B. SUBSTANTIAL COMPLETION Substantial Completion shall be within four(4) weeks of the start date stipulated herein (for the entire scheduled Work), extended only by an official change order. C. BONDS Bonds are not required. D. PRICE GUARANTEE If this proposal is accepted within 30 calendar days of the date submitted,the undersigned agrees to execute a contract for the above Work for the price and phase schedule stated. E. BASIC PRICE BREAKDOWN (Bid may be judged invalid if not complete, fill in all blanks). The following breakdown of the bid price includes overhead and profit, all prices are for completed Work in place. F. Owner reserves the right to reduce and/or delete in its entirety any line item(s) from the bid form * Represents Estimated Quantities. FORM FOR GENERAL BID 003000 - 1 " z SUTTON POND CONDOMINIUM CBI Consulting Inc. FACADE&BALCONY REPAIRS 250 Dorchester Avenue 148 MAIN STREET Boston,MA 02127 NORTH ANDOVER,MA Tel: (617)268-8977 CBI JOB NO.: 13105-D Fax: (617)464-2971 BID FORM—BREAKDOWN OF COSTS A. Basic Work Elevation Description/Item (Qtv. Add/Deduct Base Bid 1. Project Mobilization. LS $ 1,200.00 2. Permits. LS $ 3,000.00 3. General Conditions. LS $ 5,000.00 4. Temporary Protection. LS $ 2,000.00 5. Demolition. LS $ 2,500.00 6. Masonry throughwall flashing *M *6 EA $ 19,000.00 at top of projected bay. 7. Remove and replace Balcony *5EA $ 15,000.00 Doors. 8. Remove and Replace Balcony *5EA $ 29,000.00 Sliders. 9. Remove and Replace Vertical LS $ 1,000.00 Masonry Control Joints. 10. (2) Coats of Penetrating Clear LS $ 3,500,00 Seal. 11. Misc. Concrete Patching at Concrete Balconies (as directed by Engineer). • Top Surface 0"-2" *20/SF $ 1,300.00 • Vertical Surface 0"-2" *10/SF $ 1,200.00 • Underside 0"-2" *15 /SF $ 2,250.00 12. Masonry throughwall flashing LS $ 14,000.00 at slider head. 13. Masonry Spot Repointing *800LF $ 14,000.00 14. Masonry throughwall flashing *40LF above Balcony slabs. $ 8.000.00 15. Masonry throughwall flashing at Mechanical Pipe and Light LS $ 5,600.00 Penetrations. 16. Allotment for Engineering ALLOT $ 2,500.00 Service for Balcony Shoring. FORM FOR GENERAL BID 003000 -2 I SUTTON POND CONDOMINIUM CBI Consulting Inc. FACADE&BALCONY REPAIRS 250 Dorchester Avenue 148 MAIN STREET Boston,MA 02127 NORTH ANDOVER,MA Tel: (617)268-8977 CBI JOB NO.: 13105-D Fax: (617)464-2971 17. All other Construction Not LS $ 5000.00 Listed within the Bid Form. TOTAL $ 135,050.00 ADD ALTENATE#1: Remove/Demolish two (2) existing cantilevered concrete balconies, repair deficient reinforcement, recast concrete, and apply new pedestrian traffic coating. $ 29,000.00 B. Unit Prices Add/Deduct 1. Masonry Spot Pointing $ 18.50 /$ 15.00 2. Masonry Replacement $ 225.00 SF /$ 200.00 SF 3. Concrete Repair: a) Top Surface 0"-2" $ 65.00 SF /$ 50.00 SF b) Vertical Surface 0"-2" $ 120.00 SF /$ 100.00 SF c) Underside Surface 0"-2" $ 150.00 SF /$ 130.00 SF 4. Masonry throughwall flashing at Top $ 4 000.00 EA Of Projected Bay (Add). 5. Masonry throughwall flashing at $ 200.00 LF Horizontal Location (Add) List all products, articles, assemblies, systems, or components that you consider"or equal" that are included in your bid: FORM FOR GENERAL BID 003000 -3 SUTTON POND CONDOMINIUM CBI Consulting Inc. FACADE&BALCONY REPAIRS 250 Dorchester Avenue 148 MAIN STREET Boston,MA 02127 NORTH ANDOVER,MA Tel: (617)268-8977 CBI JOB NO.: 13105-D Fax: (617)464-2971 G. STAFF The following staff members shall be assigned to the project and not replaced unless accepted by Owner in writing: Project Manager: Michele Diodati License Type and Number: Superintendent: David Donahue License Type and Number: CS-085581 Sincerely, CRW, Inc. 205 Northern Boulevard (Bidding Firm) (Street Address of Bidder) William W.Ulchak Newburypor,MA 01950 (By) (City, State, Zip Code) President 978-255-2238 (Title: Owner, Partner*, Officer) (Telephone) 6/19/2014 (Date) (Seal, if Corporation) *If the business owned by the individual or partnership is conducted under a trade or assumed name, a certified copy of doing business under an assumed name should be annexed. H. FIRM EXPERIENCE Submit list of Work of similar nature and scope. Brentwood Condominiums Facade/Balcony Restoration and New Patio Slider Installation-Arlington MA FORM FOR GENERAL BID 003000 -4 L • t I SUTTON POND CONDOMINIUM CBI Consulting Inc. FAQADE&BALCONY REPAIRS 250 Dorchester Avenue 148 MAIN STREET Boston,MA 02127 NORTH ANDOVER,MA Tel: (617)268-8977 CBI JOB NO.: 13105-D Fax: (617)464-2971 I. LIST OF SUBCONTRACTORS Owner reserves the right to reject any Subcontractor for any reason. NIA i J. INSURANCE CERTIFICATE Submit with proposal certificate of standard business insurance in the amount of$1,000,000 with umbrella. The certificate shall include CBI Consulting Inc., the Owner, and Owners' Representatives as co-insured. K. SCHEDULE Submit construction schedule with Form for Construction Proposal. Bid may be judged invalid if schedule is not included. FORM FOR GENERAL BID 003000 - 5 - - - - _ -A�N Intfial Construenon Control-Document - - � - - - - _ To-be submitted with the building permit application by a_ - - - Registered Design Professionalfor work per the 8'edition of the - - - - Massachusetts State Building.Code,780 CMR, Section 107 - - - _ Project Title:Sutton Pond Facade and Balcony Repairs Date:9/24/14 - - - - Property Address: 148-North Main St.- North Andover Ma. Project: Check(x)one or both as applicable: - New construction - X Existing Construction - - _ Project description:Masonry and flashing repairs,and concrete repairs I Craig E.-Barnes MA Registraiion Number: 39888 expiration date:6/36/16,am a registered designprofessional, and I have-prepared or directly supervised-the preparation of all design plans,computations and specifications concerningt: Architectural- X- Structural - = Mechanical - - - - Fire Protection Electrical - _ Other: for the above named project-and that to the best of my knowledge,information,and belief such plans,computations and =specifications meet the applicable-provisions of the Massachusetts State Building Code,(780 CMR),and accepted- enginee-nng practices for the proposed project. I understand and agree that I(or my designee)shall perform the necessary professional services and be present on the construction site on a regular and periodic basis to: _ 1. Review, for conformance tolhis code and the design concept,shop drawings,sample,-,and other submittals by the contractor in accordance with the requirements of the construction documents.- - - 2. =Perform the duties for registered design professionals in-780 CMR Chapter-17,as applicable. - _ 3. Be present at intervals appropriate to the stage of construction to become-generally familiar with-the progress and _ quality.ofthe work and to determine if the work is being performed-in a manner consistent with the approved_ _construction documents and-this code. - - - - - - - Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107. - - When required by-the building official;I shall submit field/progress reports(see item 3.)together with pertinent- = comments, in a form acceptable to the building official. Upon completion of the work,I shall submit to the building official a` inaf Construction Control Doc ument'. - Enter-in:the space to the right a"wet"or - - � �tH OF q - :electronic si ature and seal: s1 CR ST TUARL a Phone number:(617)268-8977: - Email: C-baines@cbiconsultingific.com - �a�`` r4 _ - S NAtti��' �- -Building Official Use Only = - Building Official Na mc: Permit No.: _ Date - - - - Note 1.Indicate with an`xproject design plans,computations and specifications that you prepared or directly supervised.If`other'is chosen, - provide a dekription.: _ Version 06-f I 2013 i i ACC) CERTIFICATE OF LIABILITY INSURANCE IDDIYYYY) 8/222/2012/2014 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 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 CONTACT NAME: McSweeney& Ricci InsuranceP"CONN :7 1-84 - FAX 1AJC No: 1- 4 - 8807 420 Washington Street E-MAIL P.O. Box 850984 ADDRESS:mrireceptionO-mcsween ric i. m Braintree MA 02185 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Ar ll Insurance Group INSURED COMPL-3 INSURERB:Guard Insurance Group Complete Restoration&Waterproofing INSURERC: 205 Northern Boulevard INSURER D: Newburyport MA 01950 INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER:1035346048 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. INSR ADDLSUBR TYPE OF INSURANCE POLICY EFF POLICY EXP LTR INSR WVD POLICY NUMBER MM/DD/YYYY) 1MM/DD1YYYYI LIMITS A GENERAL LIABILITY B500052171 /9/2014 /9/2015 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TENTED PREMISES Ea occurrence $300,000 CLAIMS-MADE 15F]OCCUR MED EXP(Any one person) $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 1-1 POLICY PRCj O LOC $ A AUTOMOBILE LIABILITY1020018668 /9/2014 /9/2015ED SINGLE LIMIT Ea accident $1,000,000 ANY AUTO BODILY INJURY(Per person) $ ALL OWNED Ix SCHEDULEDBODILY INJURY Per accident $ AUTOS AUTOS ( )X HIREDAUTOS NON-OWNED PROPERTY DAMAGE AUTOS Per accident $ A UMBRELLA LIAB OCCUR 4600052216 /9/2014 /9/2015 EACH OCCURRENCE $5,000,000 EXCESS LIAB X CLAIMS-MADE AGGREGATE $5,000,000 F_fDED I X I RETENTION$10,000 $^ B WORKERS COMPENSATION COWC474329 12/15/2013 2/15/2014 X I TAC STATU- 0TH' AND EMPLOYERS'LIABILITY Y/NCRY LIMIT i ANY PROPRIETOR/PARTNER/EXECUTIVE $500,000 OFFICER/MEMBER EXCLUDED? ❑ N/A E.L.EACH ACCIDENT (Mandatory in NH) E.L.DISEASE-EA EMP OYEE $500 0 If yes,describe under __DES ESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY L IT $500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) j Sutton Pond Condominium Trust and First Realty Trust, 151 Tremont Street, Boston, MA are additional insureds on the Commercial General Liability policy for ongoing operations only where required by written contract or agreement but only for acts of negligence by the named insured in the performance of the contract obligations. I I CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Sutton Pond Condominium Trust ACCORDANCE WITH THE POLICY PROVISIONS. 148 Main Street No Andover MA 01845 AUTHORIZED.REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD i