Loading...
HomeMy WebLinkAboutBuilding Permit #149-2016 - 19 PHILLIPS COMMON 8/3/2015 NORTy BUILDING PERMIT4. TOWN OF NORTH ANDOVER a APPLICATION FOR PLAN EXAMINATION Permit No#: Y' Date Received ��ssgcHusE��S Date Issued: � IMPORTANT:Applicant must complete all items on this page LOCATION ' Print PROPERTY OWNER Print 100 Year Structure Vyesno MAP PARCEL:6bZ Z DISTRICT: Historic District Machine Shop Village 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 _ Sep ictict ❑Welll` .t ®Flootlpla nJ1 �Wetlan°ds Watershed ®strr ` { ®Water/Ser _ DESCRIPTION OF WORK TO BE PERFORMED: L f Identification- Please Type or Print Clearly OWNER: Name: Phone: ! Address: I 1 /1I I _ V 1' r Contractor Name APhone: S'oas/ Email: Address:?- Supervisor's ddress:Supervisor's Cons ruction License: h � Exp. Date: Itp Home Improvement License: lt�Q'�� Exp. Date: 1-7 i ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST ASE ON$125.00 PER S.F. FEE: �' Total Project Cost: $�� ,'1 $ 6.6 `� 1 Receipt No.: 2! 1141 ' Rec Check No.: p NOTE: Persons contracting with un ' t contractors do not have access to the uaY fund ' _ i.. r _ _ Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ F OF SEWERAGE DISPOSALSewer ❑ Tanni�ng/Massage/Body Art ❑ SwimmingPools❑ 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 S 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 Plant'ling Board Decision: Comments 1 Conservation Decision: Comments I Water& Sewer Connection/Signature ®ate Driveway Permit _ DPW Town]Engineer: Signature: LFRIDaEt P182�4NRMTainT1 ESNtreet��"Te�m��,��u. - f" a '�' e _Located 84 Osgood dStreet � n oREd psteitey' � ? Fire Departmen#signature/date �� _ � : TFrP Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of deter 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 i NOTES and DATA— (For department use) ® Notified for pickup Call Email Date Time Contact Name Doc.Building Permit 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 OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks 4. 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 OTE: 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 2012 IECC Energy code 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 s , Location No. q�- Date 1S - r5 .Y 0 - TOWN OF NORTH ANDOVER eA Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ � TOTAL $ Check#'"(� t Building Inspector . 2.91.4 z c10RTf-� Town of ? E ,, Andover 0 No. I _ �6' 'Ix o h ver, Mass, " wic coc"IcaK 1. _ A-da !d Rpt TE D S U BOARD OF HEALTH PERMIT T LD Food/Kitchen Septic System THIS CERTIFIES THAT A� BUILDING INSPECTOR - . . . . .... .. . hp-o Foundation has permission to erect .......................... buildings on . ......... ....... . .... ........... . ................. • Rough to be occupied as ............................... .Swlft- ow-,Zi....... ...D)ww-IcAvsr., 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 ON S ELECTRICAL INSPECTOR UNLESS CONSTRUCT Rough Service .... ........ ..................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Buildinje 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. .°t next step living® home energy solutions This agreement is made by and among Mike Sady Next Step'Living,•Inc.("NSL") .21.Drydock Avenue,_2nd floor 19 Phillips Common phone Boston, 88702210 8729 North Andover, MA 01845 Site ID: 41.8135 22-Jun-15 I. DESCRIPTION OF VVORK T-O•BE PEBEQRMED NSL will perform or cause to be performed the following work on the customers address above,in a professional manner and in aocordance with the terms of this Contact, Including the attached recommendalionslwork order describing the work in detail(the°Work")which are incorporated herein by reference.Pricing reflected below may be subject to adjustments in program pricing and offerings and Is guaranteed for 30 days from the date the Contract is printed.. /• Y Investment Air Sealing Recommendations $850.00 Work Location: Attic Flat :Perform Air-Sealing at:Estimated 62.5 CFM50 Per Hour 10 $85.00 Hr :$850.00 Weatherization Work Location: Attic Fiat Replace Bath Fan Hose 2 $50.00 Each $1.00.00 Attcc_:Stacr Cover Therma(Bamer vuith Carpentry 1 $237:.65 Each Damming 58 $2.05 Lnft $118.90 P*avent'2` $7 $2:00 ;` Each $174 00`' Attic Floor Open Blow Cellulose 6" 1,012 $1.26 spit $1,275.12 Work Location. Knee.:Wall Install 2"Thermal Barrier Polyiso on Kneewall 176 $3.50 scift $616.00 Initial Investment: $3,371.67 77. 100%A rsealing Incentive up to Program Max $850.00 75%VVeathenzation Incentive up to Program Max $1,89126;:; Total0 . ESUmated Annual l=nergy Savings from the Aboxe improvements $187 00` 2. PAYMENT CUSTOMER agrees to pay NSL for the work as follows: Payment ft $100.00 -A non-refundable Deposit by credit card(Mastercard,Visa,or Discover card)Is due at the time the Work is scheduled.Required payment information will be collected at the time of scheduling. Deposit Is not to exceed 113 of the total contract cost.. Additional Payments and Fina Invoice: 530.41 -Additional payments for the Works II be due upon completion of the Work and will be charged to the credit cans on file within 24 hours of delivery of the Final Invoice.If this credit card charge is declined for y naso ;upon noll SL you will be responsible for providing valid aitemative credit card information necessary to complete payment. 76 Cus re IDath 22 Jun 2015 Joe Staropoli NSL Stgn re Date Name of NSI-Representative A1058614 The Terms of this Agreement are contained on both sides of this page Nerd tep Living 21 Drydock Avenue 2nd floor.Boston,MA 02210.(866)867-8729.lnquiry@nextsteplivinginc.com.www.nextstepliving.com I next step living(,, home energy solutions This agreement is made by and among Next Step Living,•Inc.("NSL") Mika Sady .21 Drydock.Avenue,-2nd floor 19 Phillips Common phoneA 0 210 729 North Andover, MA 01845 Site ID: 41•$135 22-Jun-15 1. DESCRIPTION OF WORK TO BE PERFORMED NSL will perform or cause to be performed the following work on the aretomer's address above,in a professional manner and in accordance with the terms of this Contract, Including the attached recommendationslwork order describing the work in detail(the°Work j which are incorporated herein by reference.Pricing reflected below may be subject to adjustments In program pricing and offerings and is guaranteed for 30 days from the date the Contract Is printed.. t- quantity... Investment Other Recommendations Work Location: Affic.flat Recessed Light Cover (Not.Rebate Eligible) .5 $31.25 Each -$156:25 Initial Investment: $156.25, Not Rebate:Eltgjble :$000`': Total Net Investment: $156.25 estimated Annual Energy Savings from th�?At�ove Improvements $21:00 2. EMMENT CUSTOMER agrees to pay'NSL for the work as follows: Payment#1: $50.00 Additional Payments and Final Invoice: $106.25 I � .k Customer Signature Date AI - 22 Jun'2015 Joe'Staropoli NSL Signature tate Name of NSL Representative FTAl U58614 he Terms�ofls Agreement are contained on both sides of this page TERMS OF AGREEMENT 3. PROPOSED START DATE AND COMPLETION SCHEDULE NSL will contact customer to schedule the Work at a mutually agreeable time,subject to the availability of subcontractors or materials,or to delays attributable to the weather or other events beyond NSL's control. 4. CONTRACTOR REGISTRATION Massachusetts law requires home improvement contractors and subcontractors to be registered with the Director of Home Improvement Contractor Registration. You may inquire about contractor registration by writing to Office of Consumer Affairs and Business Regulation,Ten Park Plaza,Suite 5170,Boston,MA 02116.617.973.8700. 5. PERMITS NSL will be responsible for obtaining any necessary permits as the Customer's agent Customers who secure their own permits or deal with an unregistered contractor will be excluded from the Guaranty Fund provisions of the Home Improvement Contractor Law. 6. PERFORMANCE OF THE WORK AND CHANGES. 6.1 NSL will not commence the Work prior to signing this Agreement and transmittal of a copy of Agreement to the Customer. 6.2 This Agreement may be supplemented,amended,or modified only by the mutual agreement of the parties.No supplement,amendment,or modification of this Agreement shall be binding unless it is in writing and signed by all parties. 6.3 At times,NSL's weatherization team discovers situations in the structure during the course of the Work that indicates a risk for a health or safety concern for residents.Such concerns can include but are not limited to ventilation,potentially hazardous materials such as mold or asbestos,or structural concerns. In the case of health or safety concerns being identified,NSL reserves the right,per section 9.2 of this contract,to communicate concerns to the Customer and halt work until such concerns have been addressed. 6.4 The rebates and incentives available from the Mass Save@ Home Energy Services Program and amounts due from the Customer are based on the best estimate of the situation in the structure by the NSL home energy advisor. However,at times our weatherization team discovers situations in the home during the course of the Work that impact the availability of rebates and incentives from the Mass Save Program. In such situations,NSL will communicate such changes to the Customer,including any impact on amount the Customer would be expected to pay for the Work The Customer will have the option to remove from the Contract the work elements that need adjustment,or set up a separate contract for performing the adjusted work 6.5 NSL represents and warrants to the Customer that(a)the materials and equipment furnished under this Agreement will be of good quality and new, (b)that the Work will be free from defects,and(c)that the Work will conform with the description of the Work described in Paragraph 1. 6.6 NSL may determine in the course of pre-installation Technical Review that modifications are necessary to the scope of Work in order to ensure professional quality of the installation. In the event of such modifications,NSL will request a written modification of the Agreement to be signed by all parties.In the event that Customer and NSL cannot agree on the modification,the Agreement may be terminated by either party. 7. INSURANCE AND REGISTRATION NSL represents and warrants to the Customer that it has a valid Home Improvement Contractor Registration(No:162111)and the necessary insurance required by applicable law and normally maintained by prudent contractors in NSL's field,including,but not limited to,Workers Compensation Insurance for all employees who will perfohn the Work. 8. QUALITY OF WORK. NSL agrees that the Work will be performed in a good and workmanlike manner,and that NSL will repair and replace,at its own expense,and promptly upon Customer's request,any defects in workmanship and materials provided by NSL which appear up to one year after completion of the Work or within any longer period as permitted or required under applicable law,provided NSL has received final payment as provided herein. 9. PRE-EXISTING CONDITIONS&PROPERTY PROTECTION 9.1 NSL shall not be responsible for any damages as a consequence of the Work performed in the home due to pre-existing conditions. These conditions include but are not limited to poorly fastened or broken drywall,moisture damage,non-code construction,cracked or fragile siding or shingles,old pipes —a`fittings;ro ng wood,etc.-- -- - - - — - -- -,- 9.2 NSL reserves the right not to perform Work upon the discovery of asbestos,mold,or any other potential health risk to the Customer. In this event,the Customer is responsible for remedying the at-risk situation,including any necessary removal of hazardous materials and all bills for services to date shall be paid immediately. Work cannot resume until remediation is complete. 9.3 While NSL will make best efforts to protect any property of the Customer, it is the Customer's responsibility to remove or protect,including dust protection,any personal property including the home itself. NSL will not be responsible for damages to or losses of any of the above mentioned property not property protected prior to the commencement of the Work. 10. GENERAL PROVISIONS. — 10.1 NSL reserves the right, the extent permitted by applicable law,to have,file or maintain a mechanic's or material men's lien,or to file a notice of intention to lien,and to take any other steps to perfect and enforce such a lien,if Customer fails to pay NSL as provided herein. 10.2 This Agreement shall be construed in accordance with the laws of the Commonwealth of Massachusetts. 10.3 This Agreement forms the complete integrated agreement between NSL and Customer. The parties represent and warrant that in executing this Agreement,they are not relying on any representations,warranties or terms other than as expressly contained herein. This Agreement supersedes all prior agreements between the Customer and Contractor and may not be altered absent a subsequent written agreement signed by both parties. 11. ENERGY BENEFITS. The Sponsoring Utility Company(the Utility)is entitled to 100%of the energy benefits associated with all Energy Conservation Measures,excluding the value of energy cost savings by the Customer,but including all rights to all associated ISO-NE Energy,Capacity and Reserves Products,NSL agrees to provide the Utility with such further documentation as the Utility may request to confirm the Utility's ownership of such benefits and Products. 12. NOTICE CONCERNING SPONSORSHIP. 12.1 Customer understands and acknowledges that NSL is not an agent,vendor or sub-vendor of The Sponsoring Utility Company(the Utility)with respect to the installation of an energy efficiency measures.In the event of the failure of an energy conservation device to perform as expected, Customer's sole recourse is to Contractor and not to Conservation Services Group(CSG)or to the Utility.The Utility and its operating companies shall not maintain,remove or perform any work whatsoever on the energy conservation measures installed. 12.2 Customer understands and acknowledges that their participation in the Mass Save Home Energy Services Program is voluntary and that they have consented for Contractor to install the proposed energy conservation measures. 12.3 Customer agrees that it shall not hold CSG,the Utility,their affiliates or operating companies liable for Contractor's to perform its obligations under this agreement,for failure of the energy conservation measures to function,for any damage to Customer's Premises caused by Contractor or for any and all damages to property or injury to persons caused by the energy conservation measures. 13. LIMITED TIME OFFER, The prices and incentive offered in this Contract are subject to change in accordance with The Sponsoring Utility Company Mass Save Home Energy Services Program offers. 14. CONTRACT CANCELLATION Under Massachusetts law,you may cancel this agreement if it has been signed by a party thereto at a place other than an address of the seller, which may be his main office or a branch thereof,provided you notify the seller in writing at his main office or branch by ordinary mail posted, by fax,or by e-mail sent or by delivery,not later than midnight of the third business day following the signing of this agreement. i ' ;`Mass S�Iv;�;Pla'r�rri�w Dagrart�; rustoiner �'"fit ��,e—r--- p1 :AOlsor IVuMber $1 oVvri o :Any Jimltatons to access by:truck? BY (2 \oGefi ; : dA'n�n . , S w. f r -. 77 1�r 5: -0 -_7 { The Commonwealth of Massachusetts Department of Industrial Accidents m F Office of Investigations a d I Congress Street, Suite 100 w Boston,.SIA 02114®2017 www fasssgov/dna Workers'Compensation Insurance Affidavit Builders/Contractors/Electricians/Plumbers Applicant Information Next Step Living Please Print L Ne (Bu5IlnesSlOrganizatiott/1ndE=risfluafl)o Address: 21 Drydock Ave Ci r/State/Zip: Boston, MA 02210 phone#=(656)667-3721 Are you an employer? Check the appropriate bozo 'hype of project(required): 1.9 I am a employer with 650 4. ® I arm a general contractor and I employees (full and/or part-time). have hired the sub-contractors 6. EJ New construction 2.E1 I area a sole proprietor or partner- listed on the attached sheet. 7. ®Remodeling ship and have no employees These sub-contractors have 8. ®Demolition working for me in any capacity. employees and have workers' insurance.t ®Euildixig addition comp.[No workers' comp. insurance 10.E]Electrical repairs or additions required.] 5. El We are a corporation and its 3.El I aiaa a homeowner doing all work officers have exercised their l I.®Plumbing repairs or additions myself: [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.M Other Insulation comp. insurance required.] *Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. t Homeowners whe submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new afftdal it indicating such. �Coatractors that check this box mist attached an additional sheet showing the name of the sub-contractors and state whether or foot those entities have employees. 4 the sub-contractors have employees,they must provide their workers'cetmp.policy number, f ani an employer that is providing workers'coaapensation insurance for my employees. Below is the policy andjob site d��t'®raaaatB®no Insurance Company Name: A.I.M Mutual Insurance Company Policy#or Self-ins. Lie.#:AWC-400-7030025-2014A Expiration Date: 0/30/15 Yob 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 NIDI,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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage pfifition. Ido hereby certify under the pains and pen es perjury that the information provided above is true and correct. Signature: / Date: lo/ 81 /1 Phone#: Lo) -&-7 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License.# Issuing Authority(circle one): Ila Board of health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#° NEXTS-1 OIC 0:EL CERTIFICATE OF LIABILITY INSURANCE DAYE(M11201 1®�® f2® 4 - � THIS CERTIFICATE lS ISSUED AS A MATTER OF INFORMATION ON�y AND CONFERS NO RIGHT4 UPON TH9 O911TIFIGATP HOLDER,THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR Ap TER THE COVERAGE AFFORDED BY THE POLICIES BELpVV. THIS CERTIFICATE OF INSURANCE DOLES NOT CONSTITUTE A CONTRACT BETWEEN TIME ISSUING 1NSURER(S), AUTNOROMP RgP FSENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. INIP RTANT: Of the s ertificate holder is an ADDITIONAL INSURED,the policy(les)must be endorsed. if SUBR®GATTON 14 WAIM,quhgmyl tq the terms and conditions of the policy,certain Policies may require an endorsement. A statement an this certificate does not confer rights to gip Certificate holder in lieu Of such endorsements. PRODUCER CONTACT — M�Lauohllp Igg��suranco Agency IVAh9Ei..__�I/Or8 Ly®6I� — B2B Lynn fi$s ParkWpy PAIIC No Etct:781-1665=2a75 �c No:��1 Melrose,I=AA 021176 E•IiIAIL Sohn E.McLaughlin jr. ADDRESS: INSURERS AFFORDING COVERAGE MAIC 0 INSURER A;Nautilus Insurance INSURED 21 D Step Iii Avenue, Inc, INSURER B:CGMM8FCe Insurance Company 21 ton,MA 022dIOAe,2rld FI®®c INSURER c:A.I.M.Mutual Insurance Co. Boston,BVOdaE®221® INSURERD:AXIS On WranCe COMPany 15610 INSURER E: INSURER F; � COVERAGES CERTIFICATENUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PffRIOP INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH 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. INSRTYPE OF INSURANCE L BR POL cV EFF POLICY EXP LTR POLICY NUMBER IMMIDDIVYYYI (MMID131Y")nLIMITS A X COMMERCIAL GER Wl.LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE ®OCCUR 00/30/2014 00/30015 DAMAGE TO PREMISES Ea occurrence $ 100,000 MED EXP(Any one person) $ 01900 PERSONAL&ADV INJURY $ 11"9109 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE POLICY F71 jEC r LOC PRODUCTS.COMPIOP AGG OTHER: $ AUTOMOBILE LIABII.ITV COMBINED SINGLE LIMIT q� Ea accident ANY AUTO 14MMBGKK0M iDe/�®/2014 09/30015 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS• AUTOS - BODILY INJURY(Per accident) HIRED AUTOS NON-OWNED PROPERTY DAMAGE AUTOS Per accident UMBRELLA 0)AS OCCUR CACI-I OCCURRENCE $ 51000 Q® ® EXCESS LIAR CLAIMS MADE EI,U783541012014 09/30/2014 09/30/2015 AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY VIN x STATUTE ER C ANY PROPRIETORIPARTNERIEXECUTIVE TO BE ISSUED BY CARRIER 09/3012014 0t/20/2015 E.L.EACH ACCIDENT $ 500,000 OFFICERIMEMBER EXCLUDED? N I A (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) FOR INFO TION ONLY CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE For Information Orly THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE i'�2Li�s� la?s �s ©1900-20`14 A CORD CORPORATION. LFII rights reserved. AIS®R®25 Q2014/�a) hR AQQRP q@Mg e p� ado U��is&r��� cif ACORN!, Massachusetts Department of Public Safety Board of Building Regulations and Standards Construction Super0sor Specialty t_icense ROGER A OV1 LLET 1� 1 a5 S 7IAMW0I3'I E xpi ration rrutrtSS�nrer 0`��1������� Rc,eWtsd To: CSS 0C-VnsulaitionContrra(Morr Niue to possess a current edition of the VV1assachusettt.s Stogie 0 u!I inn Undo is cause Torr rrevo a oon cirri this Iice nsee For©PS Umn ft i oPmation vid t' CAft'IJ^S-UQCeeG-0VID S L1 / Office of Consumers AffaiA and Business Regulation 10 Park Plaza o Suite 5170 Boston9Massachusettts 02116 Home Improvement Contractor Registration Registration: 162111 Type: Supplement Carol Expiration: 1/14/2017 NEXT STEP LIVING INC. ROGER OUELLETTE 21 ®RYDOCK AVE. 2TH FL BOSTON, MA 02210 Update Address and return card.P\/Warrie reason for change. Address F� RenewaP F-] Employment Lost Card CA' 313M-04;04-G101216 .'l�� fnonxmca�ut,eraf!/ f, I��..�arLu.tvlla Office of Consumer Affffairs&Business ReguRatiora License or registration ersli€i for indlividu9 use ongy # HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to- ' Office of(Consumer Affairs and Business RegWaation Registration. 162111 Type: 10 Park Plaza-Suite'5Il99 r Expiration_.1-/44/2017 Suppiersieni Caad Boston,IvflA 021164, NEXT STEP LIVING INC. ROGER OUELLETTE 6 J 21 DRYDOCK AVE.2TN FL BOSTON,MA 02210 Underseevetnry N6,'�aliai without signature u