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HomeMy WebLinkAboutBuilding Permit #631-2011 - 1820 TURNPIKE STREET 5/1/2018 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued: IlMORTANT:Applicant must complete all items on this page LOCATION _ l Y3 O ' 1 Print PROPERTY OWNER Print MAP NO: /6)19)PARCEL:_ '616, ZONING DISTRICT: Historic District yes no j Machine Shop Village yes no 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 an d� D Septic ®AWell� �`► �° f. `��Flgodp aui, ©I+ a Isi. ;0 watersliedtDig trid DESCRIPTION OF WORK TO BE PERFORMED: A� Identification P ease Type or riot Clearly) OWNER: Name: G C 0 a Phone: Gi 7-x'77- 9'y6� Address: �,Z /� � r•, S4 , / A d d le- M/4 c)1 9 Y 9 Name: 'fn h G e,r-e p � -C�-^ Phone: 7� 7 -2- CONTRACTOR g 7 Address: �,7�`7 �. �1h S� Uni� � , �ddl-c - v , 07/� X17 1 Supervisor's Construction License: / -7 Exp. Date: -7/�2- YZ-Z z9 Home Improvement License: Exp. Date: ARCHITECT/ENGINEER R 00461 S r t Y Sc&�,ns'�,Sc�� Phone: 1W- 36 2 Z Z Z Address: 4�Ln Iii �•r�• ELAnM)"4. ary), A d/7491 Reg. No. -Z� C FEE SCHEDULE:BULDING PERMIT:$92.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ 0`0 C��d, ®® FEE: $ �/ E Receipt No.: Check No.: NOTE: Persons contYact' g with egist a contractors do not have access to the ua my fund - -- - -- - - -- --- _: - _--------_-- -- -- - _ - - --- ..', ---9___--------_--- _ Plans Submitted ❑- Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ F WERAGE DISPOSAL ❑ Tanning/MassageBody Art ❑ SwimmingPools❑ Tobacco Sales ❑ Food Packaging/Sales ❑c tank,etc. ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature 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 Locate i d at 124 Main Street Fire Department signature/date COMMENTS Dimension Number of Stories: L Total square feet of floor area, based on Exterior dimensions. Lt/ P Total land area, sq. ft.: 9 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 U Notified for pickup - Date Doc:.Building Permit Revised 2008 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 DOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit n all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals iat the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording Lust be submitted with the building application Doc: Doc.BuRding Permit Revised 2008mi I Location o �U �/�1_2 I//- No -3� - 2 0// Date TOWN OF NORTH ANDOVER O'tNo ,•'�7r0 0 s 9 Certificate of Occupancy $ — �'�s,cMus,�' Building/Frame Permit Fee $ 3� Foundation Permit Fee $ Other Permit Fee $ TOTAL $ � Check #/ y 6 7 2 3 / � 3 Building Inspector MOR , I F CERTIFICATE OF USE & OCCUPANCY 'OWN OF NORTH ANDOVER Building Permit Number 631-2011 Date: July 19, 2011 I THIS CERTIFIES THAT THE BUILDING LOCATED ON 1820-1830 Turnpike Street, North Andover, MA 01845 Queen Cleaners no cleaning on site) MAY BE OCCUPIED AS tenant fit-up IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY, Certificate Issued to: Stonewall Plaza,LLC (Gino Fodera) 325 N Main Street Middleton,MA 01949 I I Building Inspector I Fee: 100.00 previously paid Receipt: 23983 i ORT#q own of And 0 No. �71�/ _ r •M«w V 5' . A K E O dover, Mass., COCMIC".,; ADRATED p'P�t�� `SS ` BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System THIS CERTIFIES THAT BUILDING INSPECTOR . Fqpndation has permission to erect..............:......................... buildings on ..... �.�'D...�.�✓..��lj.�.�...:.`.!�.......... ................. 60gugto be be occu ied as Chimney i provided that the person accepting this permit shall hi every respe con orm to the terms of the applicati on file in ina this office, and to the provisions of the Codes and p By-Laws relatingto Inspection, Alteration and Construction •�' Buildings in the Town of North Andover. /4fe► ��C�• �rr�y 4.,�>Al -r/' �' -1---KYYdKf4G INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. 5in )- �-�� o.(, PERMIT EXPIRES IN 6 MONTHS UNLESS CONSTRUCTI N TARTS ELECTRICAL INSPECI,/—z .,rTO ou � r f �� ...... ..... 7/. ...........................................................� ervi Bi ING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR OL•• (-�7-�1 �c,, Display in a Conspicuous Place on the- Premises — Do Not Remove RoughFinal V O V•, , ,-1 13 �i�• No Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building Inspector. Burner', DEPARTMENT - Street No. 4 SEE REVERSE SIDE Smoke Det. ORTH T0VM of p _ Andover 0 dower 1Vlass. O �+ LAKE ' • COCKICMEWICK 7 �d ADQATED p`Pa`ttC P ERMIT T SS BOARD OF HEALTH Food/Kitchen Septic System 1 THIS CERTIFIES THAT � �NF Ala (/—�G' �. �� FRh ING INSPECTOR .................... . ............... G "•""'"• has permission to erect.... ............... buildings on ..........:.......... `✓ / ! T tQ �_ f to be occupied as.........7 �'�ele, :-..,�......4�2.. ........ provided that the person accepting this permit shall h(every �`� �� '�'� z'' ' 1 y Chimne ery respe con orm to the terms of the applicati on file in this office, and to the provisions of the Codes and By-Laws relating to t Inspection, Alteration and Construction Final j Buildings in the Town of North Andover. .,y /S PLUMBING INSPECTOR j VIOLATION of the Zoning or Building Regulations'Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTI N TARTS ELECTRICAL INSPECTOR Rough Gd:�a . ............... ......... Service « � ..'Yii LADING INSPECTOR � Final Occupancy Permit Required to Occupy Building FRnal S INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove No Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building Inspector. FBur,ner' DEPARTMENT SEE REVERSE SIDE smoke Det. I I TOWN OF NORTH ANDOVER GAS INSPECTION 0•MO.t`, C� TESTED DATE INSPECTOR STREET/ ST. NO. LOT NO. PERMIT NO. FIXTURES r i GP ASSOCIATES. Inc Consulting Engineers Mr. Gerald Brown Inspector of Buildings 1600 Osgood Street No. Andover, Ma 7-7-2011 Reg: 1820 Turnpike Street, Suite 102 (Queen Cleaners) i Final Report: The fit up work is complete. The completed work meets the requirements of the Massachusetts Building code. Work completed includes Drywall, Ceiling, Electrical and Plumbing. All work is as per drawings issued. If you have any questions, pl contact our office. Sincerely V'AS AS TA .•,U 1.,y r Ram Satyaprasad No.2se9s 29 Cresthaven Drive, Burlington, Ma 01803 Tel: 781-572-2768 E mail: run4am@comcast.net GP ASSOCIATES. Inc Consulting Engineers Mr. Gerald Brown Inspector of Buildings 1600 Osgood Street No. Andover, Ma 6-16-2011 Reg: 1820 Turnpike Street, Suite 102 (Queen Cleaners) Progress Report: Metal Stud Framing---100%Complete Dry wall---100% Complete Electrical---80% Plumbing---80% HVAC---80% Ceiling Work---90% Work conforms to the Mass Building Code and is acceptable. Sincerely fAPRASAD rn 1 Ram Satyaprasad - �No.28096 O � 29 Cresthaven Drive, Burlington, Ma 01803 Tel: 781-572-2768 E mail: run4am@comcast.net GP ASSOCIATES. Inc Consulting Engineers Mr. Gerald Brown Inspector of Buildings 1600 Osgood Street . Andover,, Ma 5-18-2011 Reg: 1820 Turnpike Street, Suite 102 (Queen Cleaners) i Progress Report: Metal Stud Framing---100%Complete Dry wall---85%Complete o Electrical---50/o Plumbing---50% HVAC---50% i Work conforms to the Mass Building Code and is acceptable. Sincerely 4Ramtyapras fo WRASAD C 2809E ti � 'J W 29 Cresthaven Drive, Burlington, Ma 01803 Tel: 781-572-2768 E mail: run4am@comcast.net GP ASSOCIATES. Inc Consulting Engineers Mr. Gerald Brown Inspector of Buildings 1600 Osgood Street No. Andover, Ma 4-27-2011 Reg: 1820 Turnpike Street, Suite 102 (Queen Cleaners) Progress Report: Metal Stud Framing---90% Complete Dry wall---50% Complete Electrical---Started i Plumbing--- Started HVAC--- Started Work conforms to the Mass Building Code and is acceptable. Sin erely a rasa YP 29, Cresthaven Drive,Burlington, Ma 01803 Tel: 781-572-2768 E mail: run4am@comcast.net GP ASSOCIATES. Inc Consulting Engineers Mr. Gerald Brown Inspector of Buildings 1600 Osgood Street No. Andover, Ma 4-16-2011 Reg: 1820 Turnpike Street, Suite 102 (Queen Cleaners) Progress Report: Metal Stud Framing---0% Complete Dry wall---10% Complete Electrical---0% 0 Plumbing---0/o HVAC---0% Work conforms to the Mass Building Code and is acceptable. Sincerely iv ^SASTftY G z .;x.280^G am Satyaprasad i I 29 Cresthaven Drive, Burlington, Ma 01803 Tel: 781-572-2768 E mail: nm4am@comcast.net I OFFICE OF BUILDING INSPECTOR TOWN OF NORTH ANDOVER CONSTRUCTION CONTROL. ss,twu+ PROJECT NUMBER: PROJECT TITLE: re✓i e(-�) �'�,� �,� C-- ,I 1 4 PROJECT LOCATION:- a 0 C-n k e S 4. 7� NAME OF BUILDING: .) �-Oh e Lh.�CJ` �/ �l a Z NATURE OF PROJECT: ��✓► G �' �=i f - U ,� y , 1 ee�n e- IN ACCORDANCE WITH ARTICLE 116 OF THE MASSACHUSETTS STATE BUILDING CODE, REGISTRATION NO. ;�—F©cI6 BEING A REGISTERED PROFESSIONAL ENGINEER/ARCHITECH HEREBY CERTIFY THAT I HAVE PREPARED OR DIRECTLY SUPERVISED THE PREPARATION OF ALL DESIGN PLANS, COMPUTATIONS AND SPECIFICATIONS CONCERNING: ENTIRE PROJECT ARCHITECTURAL 0 STRUCTURAL UC URAL 0 MECHANICAL 0 FIRE PROTECTION 0 ELECTRICAL 0 OTHER(SPECIFY) FOR THE ABOVE NAMED PROJECT AND THAT,TO THE BEST OF MY KNOWLEGE, SUCH PLANS, COMPUTATIONS AND SPECIFICATIONS MEET THE APPLICABLE PROVISION OF THE MASSACHUSETTS STATE BUILDING CODE,ALL ACCEPTABLE ENGINEERING PRATICES. AND APPLICABLE LAWS AND ORDINANCES FOR THE PROPOSED USE AND OCCUPANCY. I FURTHER.CERTIFY THAT I SHALL PERFORM THE NECESSARY PROFESSIONAL SERVICES AND B EPRESENT ON THE CONSTRUCTION SITE ON A REGULAR AND PERIODIC BASIS TO DETERMINE THAT THE WORK IS PROCEEEDING IN ACCORDANCE WITH THE DOCUMENTS APPROVED FOR THE BUILDING PERMIT AND SHALL BE RESPONSIBLE FOR THE FOLLOWING AS SPECIFIED IN SECTION 116.0 1. Review, for conformance to the design concept, shop drawings, samples and other submittals which are submitted by the contractor in accordance with the requirements of the construction documents. 2. Review and approval of thequality control procedures for all code-required controlled materials. 3. Be present at intervals appropriate to the stage of construction to become, generally familiar with6the progress and quality of the work and to determine, in general, if the work is being performed in a manner consistent with the construction documents. v5 SIT TO SECTION 116.2 .2 1 SHALL SUBMIT WEEKLY , A PROGRESS REP(:,) .,,- WITH EPORWITH PERTINENT COMMENTS TO THE NORTH ANDOVER BUILDING�I $l� O V. F .f•4 - �, o o ETION OF THE WORK, I SHALL SUBMIT A FINAL RB IORT AS TO' RAMASASTRY SATYAPRASAD 1+ Y COMPLETION AND READINESS OF THE PROJE& FOR O CU YNo. gp96 V IG T S10NA� •,I,,��NN.. BE GVOR BEFORE ME THIS DAY OFn& N PU MY COMMISSION EXPIRES M.E.A. Engineering Associates Inc. Consulting Mechanical Engineers 20 Felton Street, Waltham, MA 02453 781/894-6730 FAX 781/647-3542 CONSTRUCTION CONTROL AFFIDAVIT START OF PROJECT PROJECT TITLE: Tenant Fit Up Dryer Cleaner PROJECT LOCATION: 1820 Turnpike Street North Andover MA NAME OF BUILDING: Stone Wall Plaza North Andover MA In accordance with Section 116 of the Massachusetts Building Code,I,Alfred E.Muccini,Registration No. 23539, hereby certify that I am a Registered Professional Engineer. I have prepared or directly supervised the preparation of all design plans,computations and specifications concerning: ENTIRE PROJECT ARCHITECTURAL STRUCTURAL MECHANICAL ✓ FIRE PROTECTION ✓ ELECTRICAL ✓ OTHER(SPECIFY) PLUMBING ✓ FIRE ALARM ✓ for the above named project,and that,to the best of my knowledge, such plans,computations, and specifications meet the applicable provisions of the Massachusetts State Building Code 7`h edition, all acceptable engineering practices and all applicable laws and ordinances for the proposed use and occupancy. I shall perform the necessary professional services and be present on the construction site in accordance with my contract with the owner to determine that the work is proceeding in accordance with the documents approved for the building permit,and I shall be responsible for the following: 1. Review of shop drawings, samples and other submittals of the contractor as required by the construction contract documents as submitted for building permit and approval for conformance to the design concept. 2. Review and approval of the quality control procedures for all code-required controlled materials. 3. Special engineering professional inspection if critical construction components requiring controlled materials or construction specified in the accepted engineering practice standards listed in Appendix B. 4. Periodic progress report with comments to the Building Inspector. UPON COMPLETION OF THE WORK, I SHA LJ B11✓IIT AL REPORT AS TO THE SATISFACTORY COMPLETION AND READ 4 ,' CT FOR OCCUPANCY. A L Signature G � f:. Subscribed and swo to b ore me this � - ,,,, lDi& otary Public ission OEY Public COMMONWEALTH OF MASSACHUSETTS My.Commbdon Expires Fobruory 2E,2014 M.E.A. Engineering Associates Inc. Consulting Mechanical Engineers 20 Felton Street, Waltham, MA 02453 781/894-6730 FAX 781/647-3542 Document Ref. No.: Stonewall North Andover MA Dry cleaner.doc March 21, 2011 Fire Prevention Office City of North Andover Fire Prevention Department 124 Main Street North Andover, MA 01845 Attention: Fire prevention officer. Reference: Fire Alarm and Sprinkler Narrative Ise Floor Tenant Fit Up for Dry Cleaner Stonewall Plaza 1820 Turnpike St. North Andover MA Dear Fire Prevention Officer: (1.a) BASIS(METHODOLOGY9 OF DESIGN Section 1—Building Description a) Building "Use" group: Business b) Total footage of building: 38,430 c) Building height: d) Number of floors above grade:) 3 e) Number of floors below grade: 1 f) 1St floor tenant square area: 803 sq.ft g) Access type of occupancies within the building: Business h) Type(s) of construction:2C Unprotected with an automatic sprinkler system i) Hazardous material usage and storage: none j) High storage of commodities within the building: none 1 J k) Site access arrangement for emergency vehicles is through: Front access Type Section 2—Applicable Laws, Regulations and Standards The following is a list of reference standards that shall be used in system design, operation and maintenance. a) M.B.0 780 CMR 7th edition.). b) N.F.P.A. 13 (2007 Edition) c) 527 CMR 12.0, the Mass Electric Code 2008, N.F.P.A. 70 with Mass. Amendments. d) N.F.P.A. 72 2007 Edition e) ADA strobe meeting code reference 780 CMR N.F.P.A. 72-2007, and 521 CMR. The Massachusetts Architectural Access Code. f) Authority Having Jurisdiction —City of North Andover Section 3—Design Responsibility for Fire Protection Systems MEA Engineering associates; Inc. is responsible for 1st level only. The Fire alarm contractor shall submit complete information regarding the fire alarm notifications devices shop drawing to the engineer for approval. The Sprinkler Contractor shall submit and shop drawings and proposed sprinkler equipment to the engineer for approval. The contractor will submit all approved shop drawings and product information to the North Andover Fire Department for approval. Section 4—Fire Protection Systems to be installed The proposed new work is summarized as follows: A. Sprinklers 1. New sprinkler heads shall be utilized in all locations. (Quick response type sprinkler heads to be installed with an ordinary temperature rating.) Stonewall North Andover dry cleaner.doc 2. New seismic support for new sprinkler piping. 3. Sprinklers shall connect to existing zone flow station currently serving space. The existing sprinkler grid shall be reused and modified for new floor plan. 4. Existing sprinkler service is provided with a backflow preventer. 5. Existing system serving adjacent space shall be kept live. B. Fire Alarm System 1. The proposed first floor tenant fit up shall tie the fire alarm device to existing landlord building main fire alarm control panel. 2. Smoke detectors located in electrical, telephone equipment room and similar rooms and are provided throughout as required per code. Audible alarms in common areas shall be sized to insure maximum sound levels throughout the tenant space. 3. The existing Fire alarm system shall be activated thru new manual pull stations, and common area smoke detectors. 4. The new Notifications fire alarm devices shall meet N.F.P.A. 72, 2002 ADA and local Fire Department requirements. 5. Manual pull station shall be located at exits, ADA strobes shall be in the public common areas and horn/strobes shall be in accordance with N.F.P.A. 72 2007. 6. Common areas shall contain system smoke detectors wire to F.A.C.P Section 5—Features used in the Design Methodology A. Basis Of Design New portions of the sprinkler piping have been designed using the pipe schedule method for Light Hazard occupancies. Stonewall North Andover dry cleaner.doc B. Sequence Of Operation Upon actuation of a sprinkler head (designed to release at 155°F) water shall start to discharge from the sprinkler head and water flow switch shall signal a water flow condition to the fire alarm panel. C. Testing Criteria Sprinkler System The new piping and heads shall be tested in accordance with all applicable codes. At a minimum this shall include notifying the Building Inspector and Engineer of Record of the time and date testing will be performed, completion of the contractor's material and test certificate (N.F.P.A. 13, Figures 8-1a and 8-1 b). The system shall be hydrostatically tested in accordance with N.F.P.A. 13 Section 8-2.2.1 "hydrostatically tested at 200 PSI and shall maintain that pressure without loss for two (2) hours." (1-b) SEQUENCE OF OPERATION Section 1 1. The operation of a manual station or activation of any automatic alarm initiating device (system smoke, system heat detector) shall initiate a system- wide response as follows: a. Initiate the transmission of the alarm to master box and central station. b. Sound a code 3 temporal evacuation signal over all audio circuits and shall be in sync. c. Flash all visual signals throughout the building. Visual notification shall be synchronous in accordance with NFPA 72 guidelines. Synchronization shall be system-wide, and shall be subject to the N.F.P.A. 72 2007 edition adopted as Massachusetts code. The failure of one visual NAC shall not cause a failure of other NACs serving the same evacuation zone. 2. The operation of any activation of other device designated to initiate a system Supervisory condition shall cause the following to occur: a. Duct smoke detectors shall be installed in accordance with manufacturer spec's NFPA72 and NFPA90 they shall be resettable at the fire alarm control or other location approved by the local fire department. Remote duct smoke indicators shut down latching supervisory signals for all remote duct smoke indicators shall report to a central supervising station. The station shall notify the building owner. Stonewall North Andover dry cleaner.doc (1.c) TESTING CRITERIA Section 1— Testing Criteria A. The fire alarm system shall be completely tested in accordance with N.F.P.A.-72 by the Contractor when the tenant renovation is complete in the presence of the Owner. Upon completion of a successful test, the Contractor shall so certify in writing to the Owner and General Contractor. Section 2—Equipment and Tools A. The complete fire alarm system shall be installed in accordance with manufacturer's recommendations. All necessary equipment needed for a complete installation shall be available at the site. Section 3—Approval Requirements A. Upon completion of fire alarm and fire protection system installation, the Contractor shall obtain written approval from the Owner stating that systems satisfy all operational code compliance requirements. B. Owner shall provide to the City of North Andover Fire Department, the name and address of the Fire Alarm Contractor responsible for relocation of existing equipment and installation of new equipment. If you have any questions or comments, kindly contact our office. Sincerely yours, M.E.A. ENGIN ERING ASSOCIATES THfq' 4 ALFRED UCCINI m cn fiAred E. uccini, P. leaco235 President ''}? ;Y L Stonewall North Andover dry cleaner.doc acoao. CERTIFICATE OF LIABILITY INSURANCE OP ID SCO- OATE(YM/ppmv ( 6Fb1C0-1 01/07/11 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Dadgar Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON TNS CERTIFICATE 400 hest Cumming* Park HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR Suite 6725 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Woburn MA 01801 Phone: 781-933-2626 Fax:781-932-6341 IINSURERS AFFORDING COVERAGE NAICK INSURED ......---....- - NSURER A •9olyots w4tuel ins Co Ln 84100 14206 INSURER S' GF15� Contract}nq INSURER C 1 MiddNoh Mai019108unit 158 INSURER 0. rt ' INSURER E COVERAGES THE POLICIES OF INSURANCE IJBTEO 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 MTN 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 AOOREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR MSR TYPE OF INSURANCE POLICY NUMBER 110 w=0M�? DATE MMI LIMITS G!NlRAL LIABILITY EACH OCCURRENCE i 1000000__ A I X 1 COMMERCIAL GENERAL LIABILITY CPP7017804 01/01/11 01/01/12 PgE�gSES(EA ooeu�nee) S 100000 +_.. 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K.describe ufMa E.L DISEASE•EA EMvIOYEE i If 1 SPECIAL PROVISIONS Ealar E.L.DISEASE•POLICY LlM1T S OTHER i 09SCRIPTION OP OPERATIONS/LOCATIONS I VEHICLES I EXCLU31ONS rQUED BY ENDORSEMENT I SPECIAL PROVISIONS Masonry Contractor fax: 97e-374-2337 CERTIFICATE HOLDER CANCELLATION CITHA4S SHOULD ANY OF THE ABOVE 688CRIOLD POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF.THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE MOLDER NAMED TO THE LEFT.OUT FAILURE TO 00 SO SMALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON TME INSURER,ITS AGENTS OR R[PRl6ENTAT0E6. 4 RIZED RFPqUQTATIIVC I ACORD 26(2001108) 9)ACORD CORPORATION 1988 DATE(MNVDOMYYYY) ACORD CERTIFICATE OF LIABILITY INSURANCE 3/22/2011 ER. THIS THIS CERTIFICATE IS ISSUED S A MATATIVELYEOR NEGATIVELYR OF AMENDON , EXTEND OR AND ALTER NO RIGHTS COVERAGE AFFORDED ABY THE TE DPOLICIES CERTIFICATE DOES NOTA BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. to IMPORTANT: If the certificate er if c the policy'celteip anAnpollcOiesAm9y©quEre�an ethe ndorsemeiesnts A statement onust be n dthis ertificcate does not OGWTIoN IS conferDr�igh rights subject the terns and con certificate holder In lieu of such endorsement 5. CpNTACT Jcenni$or Dodge NAME: _ . PRODUCER PHONE (978)696-0007 FAR (978)315-6A1; Employers Insurance Group, Inc. I F.-MAIL 281 Main Street -aovRZODucER DUCEL9SA _. ...__. p0000. 85 --- Suite 7B CUSTOMER ID n•.. . _ .. ._... _ .... INAIL M ..._.. MA 01420 INS URCR(S)AFGOROING COVRRRAOE ,. . ,.. Fitchbur.9. ._.. . • _ wsuRER_q•Savvza Property ¢ Casua __Y ..- ..I . INSURED INSURER 6 ,. Resource Management, Inc. •• - Alt Employer: GFM General Contracting INSURER 0 - 281 Main Street, Suite 5 �NsuAg.o INSURER E: Fitchburg MA 01420 INSURERP COVERAGES CERTIFICATE NUMBER:CL10123003276 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIF_S 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 Thl[ TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN RFOUCED BY PAID CLAIMS, _... POLICY EFF I POLICY EXP LIMITS INS TYPE DP IN$U�NcE AD RI POLICY NUMBER ! MIDDIYYYY) MMI00 YYY LTR I I EACI•IOCCURRENCE .. ..... GENERAL LIA131LITY BhraAM;>:"rt7RENT[6 FREMISES..(Ee OCCUT01W COMMERCIAL CIFNERAL LIADILITY (MED EXP(Any ann pnr9on) = j CLAIMS�tADE l OCCUR I I I PERSONAL 6 ADV INJURY ;t GENERAL.AGGREGATE... . —. 4PRODUCTS•COMPIOPAGO .,.,3 _. iGEN'L AGGREGATE LIMIT MAPPLIES PER' S POLICY I.00 COMOINEO SINGLE LIMIT j AUTOMOBILE LIABILITY ANY AUTO I , � I i DODII,Y INJURY(Por perl•on) ! f BODILY INJURY(Pnr atxidgnl) 3 ALI.OWNED AUTOS r%ROPrRTY DAMAGE 4 SCHEDUI.En AUTOS I I(Pn,1CCIdgnl) I.. HIRCD AUTOS 1 S .' I I NON•O"MED AUTOS # I I 'UM[tRELLA LIAD 'EACH OCCURRENCE S OCCUR I j AGGREGATE EXCESS LIAO I CLAIMS•MAUEI R _ . . �RCTENTION RLr: 7. 1A MPEN9AT10N .AND E . ERS'LIABILITY Y f N It/l/2011 E.L EACH ACCIDENT1,OOO,,DOC ANY pROPRIETORPARTNERIL-XECUTIVE EL OBEASr CAEMPI.OYE I) ,L-,.00O.,OOC OFFICERIMEMBER CXCLUDEW Nf A p�C0002526 1/1/2012 (M3ndptory In NN) II 000 yqp do:cribs undgr C L DISEASE POLICY LIMIT t 1� OOC DE9614iPTION 0r OPERATION$D�Iow DESCRIPTION OF OPERATIONS I LOCATIONS f VEHICLES (Attach ACORO 101,Additional Rtmnrka SUtadule,It mar*spat^1s raqulrnd) COVe�CO the he of tho named ineunmd leds4nd to: GSM GENERAL CONTRACTING CORPORATION 225 NORTH MAIN STRF..ET - UNIT 15 B MIDDLET014, MA 01949 CANCELLATION CERTIFICATE MOLDER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTMORIZEO REPRESENTATIVE Kathy Morgan/JEN 1988-2009 ACORD CORPORATION. All rights reserved ACORD 25(2009109) The ACORD name and logo are registered marks of ACORD INS025(20009) i Gri M 4,6 v 325 North Main Street Unit 15-D Middleton, MA 01949 Office: 978-777-8007 Fax: 978-777-5004 3 �i `��/l 6o. 1 k, n"► }', —�J ,C 4 pi �- t F S Q ✓''' ' / l F 4 AP F4 -2- i i Total �� e2,PLO. C9 J