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HomeMy WebLinkAboutBuilding Permit #133-16 - 189 HIGH STREET 7/31/2015 Avll< . V F ORTN q BUILDING PERMIT TOWN OF NORTH ANDOVER ° APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received •v Date Issued: "I �9SScHus�t�y IMPORTANT:Applicant must complete all items on this page LOCATION _ 8 I(I Yr, Print PROPERTY OWNER OCIO Pr' t MAP NO:,� PARCEL: i ZONING D STRICT: Historic District yes ' no Machine Shap Village ye no TYPE OF IMPROVEMENT PROPOSED USE Resid ntial Non- Residential ❑ New Building ne family ❑Addition ❑Two or more family ❑ Industrial ❑AI eration No. of units: ❑ Commercial epair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑Other ❑Septic ❑Well ❑Floodplain ❑Wetlands 17 Watershed District 0 Water/Sewer s - SiI1-I0 �G�"��ll� pin64P 5(cc-5684) Identification Please Type or Print Clearly) OWNER: Name: Jowk t c-Foff Phone: q78 - C&• qS"A Address: pq CONTRACTOR Name: y Phone: 50-Z ed-oI ��t1hCk 1'tt�12,��1,y1". Address: Al. 1� l �l&kart ba, IAAIW13m, t� fT" 4 0 L e Supervisor's Construction License: Exp. Date: 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 BA�4 ON$125.00 PER S.F. p Uv Total Project Cost: $ 0 � FEE- $ Check No.: Receipt No.:VV NOTE: Persons contracts g itl u registered contractors do not have acce s t 1/1 g caranty fund ignature ofAgent/Owner SigVVVVUanature of contractor r '+ Location Nat2 Date U I �J Iry __-U TOWN OF NORTH ANDOVER mom._ Certificate of Occupancy $ Building/Frame Permit Fee $ u_ Foundation Permit Fee $ Other Permit Fee $ Tho p TOTAL $ Check# � .- Building Inspector 2931 i - 9 BUILDING PERMIT " e ORTH , o O��t�eo ,614, TOWN OF NORTH ANDOVER `%1. .11_^.'6 APPLICATION FOR PLAN EXAMINATION * .T o Permit No#: Date Received �RA�R,TEo a5 gSSACHUs�� Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION Print PROPERTY OWNER Print 100 Year Structure yes no MAP PARCEL: ZONING DISTRICT: Historic District yes no 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 ❑ Septic ETWell ❑ Floodplain- ❑Wetlands p Watershed District ❑Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: Identification- Please Type or Print Clearly OWNER: Name: Phone: Address: Contractor Name: Phone: Email: Address: Supervisor's Construction License`. Exp. Date: 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.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund _.. i ~ Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits Building Permit Application Workers Comp Affidavit Photo Copy Of H.I.C. And/Or C.S.L. Licenses Copy of Contract 4, Floor Plan Or Proposed Interior Work Engineering Affidavits for Engineered products OTE: 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 signn 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 In Sprinkler Plan And Hydraulic Calculations (If Applicable) Copy of Contract 4; 2012 IECC Energy code 4 Engineering Affidavits for Engineered products OTE: 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 2014 Plans Submitted Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL I Public Sewer ❑ Tanning/MassageBody Art ❑ Swimming Pools ❑ 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_ 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 a Conservation Decision: Comments Water& Sewer Connection/Signature Date Driveway Permit DPW Town ]Engineer: Signature: Located 384 Osgood FIRE D TMEIVT ;-� , pyo Street �. .r j EPA ir �Ternp Dum s#eronslte` es , { _, ,mss- N y� c fkpE.4-.� R "r �P y r'aT �._. ..t 4�. nod 4 1lC ted of 124jMain St`ret, , �, _ a `�.}�<" ` �QpV, IDepart� m nt�s�i,g azure/da�tte� ` � C®MMENTS` d d . 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 M—F and G min.$100-$1000 fine NOTES and DATA— (For department use) ❑ Notified for pickup Call Email Date Time Contact Name Doc.Building Pen-nit Revised 2014 � r10RT1� Town of E n over O . - ;` 0 No. _ 2 ,� oh ver, Mass, �j t coc"Ic Ml WICK y1. AERATED r`Pa�,�S S U BOARD OF HEALTH Food/Kitchen -MIT TPER D Septic SystemTHIS CERTIFIES THAT 3)6�............ �?.......... ,,,,,,,,,,,,............................ BUILDING INSPECTOR ��jj I, Foundation has permission to erect .......................... buildings on l�...1....7fli� ....5 ........................... r Rough to be occupied as ..................... ........ ..:. ...!�(Zcl'1'............................................................... Chimney provided that the person accepting this permit shall in every respect conform to the terms of 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 VIOLATION of the Zoning or Building Regulations Voids this.Permit. Rough -- — -- Final PERMIT EXPIRES IN 6 M THS ELECTRICAL INSPECTOR UNLESS CONSTRUCTIO S AR 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. Project 31-60693 - Signed Sales Agreement haps://nitro.powerhrg.com/project_documents/5277485?pages=l Project 31-60693-Signed Sales Agreement JPEG(1.8 MB,2448x3264) Device:iPad6,4 Cv e B E,mii Vb P- ]Hxb NAt]%ON'At mfiADQUARTEeS kLem" 2Sit Seapo Dike.Ctesm-H419013, POWER :314•6 888-REMC)DE�. ••- - ... its�4r aseSnY, CUSTOM REMODELING AND IMPROVEMENT AGREEMENT 8ayer(sp Il tor>aetioe and d Ihe ftgpenr P ta)ect Nth:$1-6069ti Jali tea 73rf5 .fohrt Lesofslw � t&Q tom]& 197E)6S�6t6�#1Exae3 hb!A Andw,'MA,ElIM 00".EwaIS � e sverifts(Contra 3 Wed VbM hereby haaordarr with a o Pmdud speeftaborts,wtadt ate'vtcorporated as part of me Agree riert(coheCdOW this•Agreesh '4 Illb AWeear0111 feprasetas a cash sale d goods and services. eu}erts)sgees w pay ate ow d the goods end services Purchased as destttbed hemb r:g tknkV or apprMl of any T3WWS)May seek IW their WmtWsa. Pumbase Price: Sf4,e" Pre filtsteftum blisSecrwtt Doles: DDwn Paymert SOHO sua moil aM t4wsat2r�ft Balance Due w Stl,80ti 9ti Estimated Proleet Start-3 to 41 tlraaits SubstwMal Co roetbn. Estiinaiss!'Pra)ee!Cbmpfeftn:t to 2 dors PlAeOwddPsymertt: [)titer ar.am"0T ift*Md: DWO �a vac«�oxtrcbaad� how saeDawirr Buyers)hemby a edges reit of a c0W d ttte pamphlat,"itte.LeadSaie CNLT*d CoAde to RAnOvete P49W, Buyers)o1 the potential tisk 61 Wed hazard er¢tesura from MWleetion ao&*to be perloi at oral Buyer(sy Ptaperty al ttte above.Buyers)repel ed tttb pamphlet onthe date of VdsAareentent,tore Ott d work r t3tryers)'9ittlats. Agreement cwWWes the entre agrawnsnt and ur derstani ft iretrreen to parries.and this Agwriart replaces WV and tri prior rtegOtiaBonS,representatbr>s,nor agraernerts,either wrhtert or ural,tVo arr>artdrrrerR,rrtod'lcatlore a teener of Agratrrrtattt shah be velid or effective uftw lnv ftV wA BWW by both parties Buyers)ltareby Btyers)t)has reed Vie entire Agreement&-a fres raceW s icernpteied.signed]and dated copy dthis A"ernsre,tndto*V the trro aocartpertying ttt�boe c 01 carroeMdat#on for M on'the taste that"Ven atwva and 2)was Ordty kftMed d hlStlter Vtt b eanoei Utls trartsat*M i Buyars)also agrees and understands thatif Buyer(s)1ir>artces tha,whit grim a third"rty,the terrrtsd that htmrxirg vd1 be ( ooMained on separate documents,ittduding arty 11rtame,dww. j future pranotiorts not sppik". DO NAT SIGN TM AGFtEEMENT IF THERE ARE ANY.SLANK SPIKE& I I 1 tAm read arid root-h♦d each prlped tags 6 papeapramwrrt {� ftOylrM � JGyl16ti5 AD7l16/f5 Cf RemodaAng�t Ot#"Ronchford .f0?tn fi Yot#,THE BUYERft MAY CANCEL THIS TRANSACTION AT ANY TME MOR M MIDNIGHT OF THETWIDWOOMMY AFTER THE DATE OF THIS TRANSAGTi ,SEE THE ATTACHED NOTICE OF CANCELLATION FORM PDA AN tEXPUkHAIM Or THIS RiGHT July 16]205 14~15 1 of 1 7/29/2015 11:37 AM NATIONAL HEADQUARTERS John Lesofsky 2501 Seaport Drive,Chester,PA 19013 'f?WER' 31-60693 "°^�'m^°d"'^9� July 16,2015 888-REMO®EL • - �1.. .e a •• .e• - MA HIC#168616 PRODUCT SPECIFICATIONS Buyer(s)'Information and Description of the Property: Project Number: 31-60693 July 16,2015 John Lesofsky Date of Agreement 189 High St (978)682-9546(Home) North Andover,MA,01845 County:Essex Township: i Buyer(s)listed above hereby jointly and severally agrees to purchase the goods and/or services listed on the accompanying specification sheets,in accordance with the prices and terms described in the Custom Remodeling and Improvement and the Product Specifications (collectively,this"Agreement"). Pre Installation Inspection Date:Your pre installation inspection is tentatively scheduled for Tue 7/28 between 2:40p and 3:40p. Roofing -GAF Inclusions: Includes Timberline Ultra HD Lifetime shingles with 50 year non prorated labor warranty.Also includes removal of existing shingles, installation of F-Style drip edge,Weather Watch ice and water shield, Deck Armor breathable roof deck protection, Pro Start starter strip, Snow Country ridge vent exhaust, Timbertex premium ridge cap shingles, PowerVent intake ventilation, all flashing where needed and 6 nails per full shingle. All steep slope installation applications used only where applicable, Low slope roofs, ones below a 4/12 pitch and flat roofs do not apply. Clean up and haul away all job related debris. *Low slope roofing installations include a 15 year non prorated labor and material warranty, removal of all existing roofing materials, new decking, TriBuilt base and cap sheet, drip edge and flashing where applicable. To protect our clients, Power HRG includes at no additional cost, the removal and replacement of up to 300 square feet of soft or rotted roof decking if needed. Low slope roofs below a;4/12 pitch and roofs with cedar shingle removal do not apply as they will include all new decking as part of the installation.Any additional wood replacement needed, over and above the 300sq/ft we provide, will be done at a cost to the homeowner of$3.57 per sq/ft. (Buyer initials ) For Example:After the shingles have been removed, if we find there is a need to replace 325 sq/ft of wood, Power HRG will pay for the first 300sq/ft. It is the responsibility of the homeowner to pay for the cost of 25sq/ft of replacement wood at$3.57 per sq/ft,which in this example is$89.25 It is agreed and understood by and between the parties that the Product Specifications,along with the Custom Remodeling and Improvement Agreement,constitutes the entire understanding between the parties,and replace any and all prior negotiations, representations,or agreements,either written or oral. The Product Specifications may not be changed, modified,or varied in any way unless such changes are in writing and signed by both Buyer(s)and Contractor. Buyer(s)hereby acknowledge that Buyer(s)has read the Product Specifications. I have read and received each page of this 2 page agreement. Power Home Remodeling Group Buyer(s) /07/16/15 /07/16/15 Signature of Remodeling Consultant Signature Daniel Roachford John Lesofsky YOU,THE BUYER(S),MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION.SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. July 16, 2015 14:15 III IIII IIIII IIII 111111 IIIII IIIII IIIII IIIII IIII IIII Page 1 of 2 NATIONAL HEADQUARTERS John Lesofsky 2501 Seaport Drive,Chester,PA 19013 'POWER 31-60693 July 16,2015 ��1888-RIEMODELRj� - _- MA HIC#168616 Project Specifications Roofing: Whole House 1 1625:0'x1.0' ROOFING: Models GAF Styles Architectural Shingles Types None Configs None OPTIONS: Color Pewter Gray I Removal Standard Shingle I Installation Details None , OOR'PORATION PewftrGray 0 }i 'iYx y' i „ x � f Aerial MeasurementLi July 16, 2015 14:15 I IIIIII IIIII IIII IIIIII IIIII IIIII IIIII IIIII IIII I II Page 2 of 2 �1��t�L��ke�T�7Zs��'Ci�k7r��T11i4�'S�Gi�lcr.EsG?�S' i� .. ri�Tl--�-'>'\ 1t'� J�1+l'�.1,U�u�C•l ect.- u ] sSriTS1 G 01" _ '7 r�Dt Name :Jf 'o-�'lndr�r '• ; ���rZa17�r �dU2,1�.. �,[,�#1'<�''� 1 ; � 3trl• � �.� `a,. •`�,.y f'�(�i` �-�r �� ! �i ! 1:/ r t- v L AY OL i. °f Jute el pxo est<required).: 1 am emxrloyer wit3� employees(fall a ndlor pa e-time)- i. j am's sole ED New S,47Z1�S(f1,mail propretor ms par8ners'fatp aao lrave vo ea�r><oyees'wm�ng for me� MY caP- m workers`comp.ancauan.e nq:ajX&j �.� Pomeov�er¢ieiLg di v ork myself.[No raorke d'eosp,insvznce reaataera.j 1 S. �.�j l 2m homeowner ani v ii]b ?gig cm=sior:k monauct all wok mnr t �il7TQIIlg a(3A)?itrfl e��ar�z}sa� i s®ntrctor�eiEher7 € ers's �p ] �tl � ED ompensation ius-ararc€or We�eie 11. 1�Se�s$r7C6.t 7ej�?cJFS©�atictl�or�6 p!-�etrn��mmo employee., `--�(�zan 6 2enerdZ cv earn�o I Y e.�ir�a itis eaor.lien®E thf aaa 2rea��eei 1:2.E!P ilmbhng j-.e a-T�<U a,id-icm. �.e gab ccrmoci h�ae employee:sa c li�ye�srkers'comp.�s �cfi.= 1�- Rod 3-q ai7d 6.��rF ase corpar8tioz asxa i2 m SScer ?nave excrcisf�d tai,rigbt of exemption per j11Er1,c. 1.4• Otho-T j 52 E 1(4),and vas have no employees.[NO workers'camp.•insurance required.j *'Any applicant thett chmis box#l must a@so fill out the section below showing their workers' 13omeowncoffips nsatiron.Po 3 ,go�sbon ers tubo submit this affidavit indicating they are doing all work and?leen leire outside contractors mug submit a new davit indicating such 1Contractors that check this box must anacbed an additional sheet showing the name of the sob contractors and suite mitwhetha n w not those entities have employees. If the sub contractors hese a employees,they m=ist proN ids their workers'comp.policy number. ain Fara enapmoyer that as prvyhUng workers'eompensatzon insurance for my empleyee� Below is thepo[isy csrdjob site inVormadorao Insurance Company Name: �1Z� L1 C' d ice. Policy#or Self--ins.Lic.#: i q 01D. �!3 p ERpiration Date• ` ®6 Jab Site Address: 09I 1\Q� S� A`^`' _� 1 ' 1 �,�, Attach a copy of the woriCers' co�npensataon poFiey decla�ra4ioa a s[ro City(State/Zip: F�f CWS p� ( g tke policy number and ex}iirutaon tate). Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation pUbjshable by a fine up to$1,5DD.0® and/or one-year imprisonment,as wedl as civil penalties in the form of a STOP WORK ORDuR and a ane of up to$25D.DD a day against the violator.A copy of this statement may be forwarded to the OMM of Investigations of the DIA for insurance coverage ve ' h Ido hereby rti the pains rand peaeallres of perjury that the inforrrcation provider[a6iwe is true and correct: Si A Date: Official use only. Do not write en this aroma,to be completed by COY or fowee off kL City or Town- Permit/License# Issuing Authority(circle one), I.Board of lirealth 2.Building]Department 3.City/'l'own Clerk- 4.Elvetrivad Inspector 5.Plumbing inspector f.Other CoRAMCt Permn: PlDone#e POWER-1 OP ID:EL CERTIFICATE OF LIABILITY INSURANCE DATE 09(MM/ 09/11122014014 ) 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(les) 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. Lacher&Associates Ins AgencyPHONE FAX Lacher Insurance Group A/c No Ell:216-723-4378 A/C No): 215-723-8604 632 E Broad St P 0 Box 64398 E-MAIL Souderton,PA 18964 ADDRESS: Chad Lacher INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Harleysville Preferred Ins.Co 35696 INSURED Power Home Remodeling Group, INSURER B:Harleysville Worcester Ins Co 26182 LLC INSURER C:Nationwide Mutual Ins Company 23787 2501 Seaport Drive,Suite B110 Chester,PA 19013 INSURER D:Pennsylvania Manufacturers 12262 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 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 SUBR POLICY EFF POLICY EXP LTR POLICY NUMBER MM/DDIYYYY MMIDD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE Fi-I OCCUR MPA00000089793N 10/01/2014 10/01/2015 DAMAGE TO RENTED 1 000,000 PREMISES Ea occurrence $ MED EXP(Any one person) $ 15,00 PERSONAL&ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 POLICY FX]PET F-1 LOC - PRODUCTS-COMP/OP AGG $ 2,000,00 OTHER: $ AUTOMOBILE LIABILITY EOa aBINED1SINGLE LIMIT $ 1,000,00 B X ANY AUTO BA 00000089796N• 10101/2014 10/01/2015 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS - HIREDAUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident $ UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10,000,00 C X EXCESSLIAB CLAIMS-MADE CMB00000089794N 10/01/2014 10101/2015 AGGREGATE $ 10,000,000 �rr DED RETENTION$ $ I WORKERS COMPENSATION X I PER STATUTE EOR H AND EMPLOYERS'LIABILITY D ANY PROPRIETOR/PARTNER/EXECUTIVE YIN N/A 201400 6620967 •I 10/01/2014 10/01/2015 E.L.EACH ACCIDENT $ 1,000,00 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,00 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,0009000 B Mass Auto BA 00000018227P 10/01/2014 10/0112015 Auto Liab 1,000,00 B NY Auto BA 00000074849R 10/01/2014 10/01/2015 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION NANDOVE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Town of North Andover 120 Main Street AUTHORIZED REPRESENTATIVE North Andover,MA 01845 e�41CL 91988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD p.. 1 1 .[ v-�k`5 c.: R�.. rs l 45 C`• LicenFt, CS-057645 TdARK E MO E_. 18 NEW,ELL SFR NATTLEBORGMA. 0110 Con;n�ic�iane / 09/1592015 -lJ�rk L.a�lzm�oarrinr,���4�✓�Ja'�,:r�.r�.ase� ffce of Consumer Affairs&Business Regulation OME IMPROVEMENT CONTRACTOR Registratio� : .fEsEf . Typ<1 Expiea i §l591 8120 1 7, Supplemeni POWER HOME REI11flDELl{ G_ C3ROUP LLC. MARK,MORDINI V_'_ 2501 SEAPORT DRIVE ST B110 CHESTER,PA 19013 Undersecretary K. _ y — "1'eu sr� r--: t" a'•�t 9afFdD ad°'Ntf�lle�t 5�5 J Y'. 'NONE494 ; 9ttccQ 6 NT IF 0 NA1TL�130i301lGN MA 060`3625 .' i i �(Y 5 DDD5.22-2014Rev DT-95�2D.D9 T X 'j)