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HomeMy WebLinkAboutBuilding Permit #127-12 - 220 SUTTON STREET 5/1/2018 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: , Date Received r Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION 2Zo v'[T°'�' �T�-��T l�o� t-16- Print PROPERTY OWNERC'•T• ' 9q!2E5 "64.. Unit# Print MAP NO: PARCEL: ZONING DISTRICT: Historic District yno Machine Shop Village y s no 100 year-old structure ye no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑Two or more family ❑ Industrial R"Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ DemolitionEl Other _ _ _ _ ' ;D,Sept%; i� Vdell I ❑sFloodpl_ain Wetlands ,[o°Waters dD str - Y y _ _ lie � "iet ` ,❑ Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: (Identification Please Type or Print Clearly) OWNER: Name: C -T "L)' s J�eaj-j-, Phone: X8. 6108-723Z-7 Address: Zoe ova ►.� �►.m� r CONTRACTOR Name: Oubizl.FS CoN=U Phone: Ilk Address: `Zoo 6g l v� -� , •Q,.yyo�/�, ; V-n Supervisor's Construction License: 0c7 5-7 1-L- Exp. Date: to l�z Home Improvement License: Exp. Date: x: ARCHITECT/ENGINEERPhone: Address: 'Loo 5-J1rvra 'J ,grr fit•�^�Qy� , 1\14% Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COSTBASED ON$125.00 ERS.F. �. 00 Total Project Cost: $ 40-0-4 oOO. 0 0 `i FEE: $ 00 Check No.: �1 4 Receipt No.: y y NOTE: Persons contracting wit unregistered contractors do not have acces o th guaran fu Cinnatira nf-Ariantl(11A/nar' :Sian'Ifin nfs' antra t`nr Plans Submitted EV" Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑ a. THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS CONSERVATION Reviewed on Signature COMMENTS i HEALTH Reviewed on Signature COMMENTS J 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 sigriatare/date COMMENTS 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 j y)A 'i ❑ Notified for pickup - Date Doc:.Building Permit Revised 2011 June/mi Ir"O' 7 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 MOTE: 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) L, ❑ Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products MOTE: 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 MOTE: 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 e. k Doc: Doc.Building Permit Revised 2008mi Location _ r* ST— No. Date MOR7q TOWN OF NORTH ANDOVER i + >o Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # I 4f S�' 244 / 0 Building Inspector NOlt F Y � aSCIMIt�� CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 127 -2012 Date: DECEMBER 28,2011 THIS CERTIFIES THAT THE BUILDING LOCATED ON 220 SUTTON STREET, UNIT 7, North Andover, MA 01845 ARIES SYSTEMS MAY BE OCCUPIED AS INTERIOR FIT-UP FOR UNIT #7 IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: C.T.MATSES REALTY 200 SUTTON STREET NORTH ANDOVER,MA 01845 Building Inspector Fee: 100.00 PREVIOUSLY PAID Receipt: 24470 AORTH ToNvn of 0 No. ? �a �, _ o , over, Mass, ohs 1(• l Q -- LAKE '�*Aj . COCMICMEWICK 7�S0RA TE D BOARD OF HEALTH Food/Kitchen PERMIT T Septic System BUILDING INSPECTOR THIS CERTIFIES THAT.......... .<<... .......b%%A.v. ................................. ............. .... ........................... Foundation has permission to erect ct........................................ buildings on ....?r. ...... ... .. ..... .......... ..�............. Rough to be occupied as............... ... .. T............. .. chimney +� ►...... .#-..�+. V. .�T.... ... provided that the person accepting this permit shall in every resect conform to the terms of thea plication an file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIV T � JL" R EXPIRES IN 6 MONTH _ ELECTRICAL INSPECTOR �,.. `�LESS CO STRU x �S Rough ......... Service BUILDING INSPECTOR Final Occupancy Permit Required to OccupyBuilding GAS INSPECTOR Rough Display in a Conspicuous. Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE-DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. THE AMERICAN INSTITUTE OF ARCHITECTS AIA DocumentA101/CM CONSTRUCTION MANAGEMENT EDITION Standard Form of Agreement Between Owner and Contractor where the basis of payment is a STIPULATED SUM 1980 EDITION THIS DOCUMENT HAS IMPORTANT LECAL CONSEQUENCES;CONSULTATION WITH AN ATTORNEY IS ENCOURAGED, This document is intended to be used in conjunction with AIA Documents A201/CM, 1980; B141/CM, 1980; and B801, 1980. AGREEMENT made as of the First day of August in the year of 2011 BETWEEN the Owner: C.T. Matses Realty Trust 200 Sutton Street North Andover, MA and the Contractor: Charles Construction Co. Inc. 200 Sutton Street North Andover, MA 01845 The Project: Aries Systems Inc. 200 Sutton Street North Andover, MA 01845 the Construction Manager: N/A the Architect: Architectual Design Concepts(ADC) 200 Sutton Street North Andover, MA 01845 The Owner and the Contractor agree as set forth below. Copyright 1975@ 1980 by The American Institute of Architect,1735 New York Avenue,N.W.,Washington,D.C.20006.Reproduction of the material herein or substantial quotation of its provisions without written permission of the AIA violates the copyright laws of the United States and will be subject to legal prosecution. IA DOCUMENTA101/CM-OWNER—CONTRACTOR AGREEMENT-CONSTRUCTION A101/CM --1980` 1 NAGEMENT EDITION-JUNF 1980 EDITION- AIA(x)1980-THE AMERICAN INSTITUTE ARTICLE 1 THE CONTRACT DOCUMENTS The Contract Documents consist of this Agreement, the Conditions of the Contract(General, Supplementary and other Conditions), the Drawings, the Specifications, all Addenda issued prior to and all Modifications issued after execution of this Agreement. These form the Contract, and all are as fully a part of the Contract as if attached to this Agreement or repeated herein. An enumeration of the Contract Documents appears in Article 7. ARTICLE 2 THE WORK The Contractor shall perform all the Work required by the Contract Documents for: Interior fit-up for Aries Systems per drawings. ARTICLE 3 TIME OF COMMENCEMENT AND SUBSTANTIAL COMPLETION The Work to be performed under this Contract shall be commenced August 15, 2011 and, subject to authorized adjustments, Substantial Completion of the Work shall be achieved not later than Jan, 15, 2012 (Here insert any special provisions for liquidated damages relating to failure to complete on time.) Damages of any kind are excluded from this Contract. ARTICLE 4 CONTRACT SUM The Owner shall pay the Contractor in current funds for the performance of the Work, subject to additions and deductions by Change Order as provided in the Contract Documents, the Contract The Contract Sum is determined as follows: $400,000.00 (State here the base bid or other lump sum amount,accepted alternates and unit prices applicable.) See AIA Application for Payment Form. IA DOCUMENT Al 01/CM-OWNER-CONTRACTOR AGREEMENT•CONSTRUCTION A101/CM --1980 2 NAGEMENT EDITION•JUNE 1980 EDITION- AIA 01980-THE AMERICAN INSTITUTE ' 1 ARTICLE 5 PROGRESS PAYMENTS Based upon Applications for Payment submitted by the Contractor and Project Certificates for Payment issued by the Architect, the Owner shall make progress payments on account of the Contract Sum to the Contractor as provided in the Contract Documents for the period ending the day of each month as follows: Not later than days following the end of the period covered by the Application for Payment, percent(95%) of the portion of the Contract Sum properly allocable to labor, materials and equipment incorporated in the Work and percent(95 %)of the portion of the Contract Sum properly allocable to materials and equipment suitably stored at the site or at some other location agreed upon in writing, for the period covered by the Application for Payment, less the aggregate of previous payments made by the Owner; and upon Substantial Completion of the Work, a sum sufficient to increase the total payments to percent(100%)of the Contract Sum, less such amounts as the Architect shall determine for all incomplete Work and unsettled claims as provided in the Contract Documents. (If not covered elsewhere in the Contract Documents,here insert any provision for limiting or reducing the amount retained after the Work reaches a certain stage of completion.) Payments due and unpaid under the Contract Documents shall bear interest from the date payment is due at the rate entered below, or in the absence thereof, at the legal rate prevailing at the place of the Project. ARTICLE 6 FINAL PAYMENT Final payment, constituting the entire unpaid balance of the Contract Sum, shall be paid by the Owner to the Contractor when the Work has been completed, the Contract fully performed, and the Architect has issued a Project Certificate for Payment which approves the final payment due the Contractor. ARTICLE 7 MISCELLANEOUS PROVISIONS 7.1 Terms used in this Agreement which are defined in the Conditions of the Contract shall have the meanings designated in those Conditions. 7.2 The Contract Documents,which constitute the entire agreement between the Owner and the Contractor, are listed in Article 1 and, except for Modifications issued after execution of this Agreement, are enumerated as follows: (List below the Agreement the Conditions of the Contract[General, Supplementary and other Conditions], the Drawings,the Specifications,and any Addenda and accepted altemates,showing page of sheet numbers in all cases and dates where applicable.) The Owner will procure the Builders Rick Insurance Policy and will be Reimbursed by the Contractor no more than$1,000.00 IA DOCUMENT A101/CM-OWNER-CONTRACTOR AGREEMENT-CONSTRUCTION A101/CM --1980 3 MANAGEMENT EDITION•JUNE 1980 EDITION- AIA 0.1980-THE AMERICAN INSTITUTE n ! r 7.3 Temporary facilities and services: (Here insert temporary facilities and services which are different from or in addition to those included elsewhere in the Contract Documents.) 7.4 Working Conditions: (Here list any special mditions affecting the Contract) This Agreement entered into as of the day and year first written above. OWNER CONTRACTOR C. . a s s Re Ity In es Constructi C . Inc. IA DOCUMENTA101/CM•OWNER-CONTRACTOR AGREEMENT-CONSTRUCTION A1011CM --1980 4 NAGEMENT EDITION-JUNE 1980 EDITION• AIA 01980-THE AMERICAN INSTITUTE mik-bv Nlassachusetts- Department of Public Safet Board of Buildinf; Re�nilations and Stand;trds . Construction Supervisor License U.nse: 08 22855 r9 'Al C;> MICHAEL E NOYES 26 CHAPEL ST { NEWBURYFORT MA 01950 *' ,a Expiration:µ6/20/201 p 2 ('o�nnrissin°et Tr#: 29459 a"'''�'• OFFICE OF BUILDING INSPECTOR ' TOWN OF NORTH ANDOVER CONSTRUCTION CONTROL s�cwM PROJECT NUMBER: �o�f PROJECT TITLE: PF/GLS' PROJECT LOCATION: D—S" 73'6, NAME OF BUILDING: NATURE OF PROJECT:�[ R,ldlL drl4 �►U S . IN ACCORDANCE WITH ARTICLE 116 OF THE MASSACHUSETTS STATE BUILDING CODE, AZO ' �i YkREGISTRATION NO. 1:70 Of BEING A REGISTERED;PROFESSIONAL•EN(92MEE1q/ARCHITECH HEREBY CERTIFY THAT I HAVE PREPARED OR DIRECTLY SUPERVISED THE PREPARATION OF ALL DESIGN PLANS, COMPUTATIONS AND SPECIFICATIONS CONCERNING: ENTIRE PROJECT 0 ARCHITECTURAL STRUCTU RAL D MECHANICAL FIRE PROTECTION D ELECTRICAL 0 OTHER(SPECIFY) FOR THE ABOVE NAMED PROJECT AND THAT,TO THE BEST OF MY KNOWLEGE, SUCH PLANS,,Vj T*D COMPUTATIONS AND SPECIFICATIONS MEET THE APPLICABLE PROVISION OF THE STATE BUILDING CODE,ALL ACCEPTABLE ENGINEERING PRATICES. MASSACHUSETTS 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 PERMIT AND SHALL BE RESPONSIBLE FOR THE FOLLOWING AS SPECIFIED IN SECTION 116.0 THE WORK IS PROCEEEDING IN ACCORDANCE WITH THE DOCUMENTS APPROVED FOR THE BUILDING 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 the quality 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. PURSUANT TO SECTION 116.2 .2 1 SHALL SUBMIT WEEKLY , A PROGRESS REPORT TOGETHER WITH PERTINENT COMMENTS TO THE NORTHi ANDOVER BUILDING INSPECTOR. UPON COMPLETION OF THE WORK, 1 SHALL SUBMIT A FINAL REPORT AS TO THE SATISFACTORY COMPLETION AND READINESS OF THE PROJECT FOR 0 UPANCY IGNAT RE SUBSCRIBED AND SWOR FORE ME THIS DAY OF a NOTAR PUBLl� MY COMMISSION EXPIRES© d 1 OFFICE OF BUILDING INSPECTOR TOWN OF NORTH ANDOVER ._ ..� CONSTRUCTION CONTROL i°a�nari. { PROJECT NUMBER: ( t�C/� l a7j 9T) PROJECT TITLE:Q �'/C�r�/�l�t��l/�/ �fi°�/$ Y//L /21� ✓ l'S%GS PROJECT LOCATION: Z� % ✓/Z/r ltliMZ i NAME OF BUILDING: NATURE OF PROJECT: 1A1 77-17-id lL /Zf-A-1a11,*Z-70W IN ACCORDANCE WITH ARTICLE 116 OF THE MASSACHUSETTS STATE BUILDING CODE, I, `7—iUl !/ �x / �t,/L REGISTRATION NO._q-4;7- BEING A REGISTERED,PROFESSIONAL ENGINEERIARCHITECH HEREBY CERTIFY THAT I HAVE PREPARED OR DIRECTLY SUPERVISED THE PREPARATION OF ALL DESIGN PLANS, COMPUTATIONS AND SPECIFICATIONS CONCERNING: ENTIRE PROJECT Q ARCHITECTURAL D STRUCTURAL U MECHANICAL, FIRE PROTECTION ELECTRICAL 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 the quality control procedures for all code-required controlled materials. 3. Beresent at intervals appropriate to the sta a of construction to become, generally familiar P9 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. PURSUANT TO SECTION 116.2 .2 1 SHALL SUBMIT WEEKLY , A PROGRESS REPORT TOGETHER WITH PERTINENT COMMENTS TO THE NORTH ANDOVER BUILDING INSPECTOR. UPON COMPLETION OF THE WORK, I SHALL SUBMIT A FINAL REPORT AS TO THE `�+using SFACTORY COMPLETION AND READINESS OF THE PROJECT FOR OC NCY. ���.C... ... , =�VP'• MY SIGNAT?UIIE — ��~' COMM► SCt [BED AND SWORN TO EFORE ME THIS DAY OF ' EXPI •- OCT.17,2012 ; _ '% •20r UBLIC MY COMMISSION EXPIRES—/0- l U8/U2/1011 TUE 12: 02 FAX 781670993916001/:001 AUG . 2. 2011 45RM VYSH111 UILMERS 1ilr .a. It!i i, kN3V rn!.'.. OFFICE OF BUILOING INSPECTOR F 1 t y P TOWN OF NORTH ANk+ ��... . CQNSTRyCTjQN PROJECT NUMBER; Af PROJECT TITLE: / �^' E;� _ 1t nF t$ PROJECT PROJECT LQCATION' '" /'V `I9i "�tC(`vlr t s NAME OF BUILDING,. H NATURE OF PROJECT: � V / 4 _ i j 3 IN AC ORDANCE WIT A TICLE 116 OF THE.MASSACHUSETTS STATE BUILDI C: ISE, �. s j �.!✓ REGISTRATION Nf l BEING A REGISTERED PROFESSIONAL ENGINEEPJARCHITECH HEREBY CERTIFY THAT I _ HAVE PREPARED OR DIRECTLY SUPERVISED THE PREPARATION OF ALL DESIGN PIANS, OMP TAT G U IONS AND SPECIFICATIONS CONCERNING: ENTIRE PROJECT D ARCHITECTURAL STRUCTURA Ik MECHANICAL 0 FIRE PROTECTION D ELECTRICAL 0 OTHER,( PECIFY) E FOR THE ABOVE NAMED PROJECT AND THAT, TO THE BEST OF-MY KNOWLEGE, SUCH PLANS, E Pt COMPUTATIONS AND SPECIFICATIONS MEET THE APPLICABLROVISi'dN OF THE-MASSACHUSETTS I STATE BUILDING CODE,ALL ACCEPTABLE ENGINEERING PRATI'ES ' AND APPLICABLE LAWS AND ORDINANCES FOR THE PROPOSED USE AND'OCCUPANCY. I FURTHER QERTIFY THAT I SHALL PERFORM THE NECESSARY PROFESSIONAL SERVICES AND 6 i EPRESENT ON THE CONSTRUCTION SITE ON A REGULAR AND PERIODIC BASIS TO DETERMINE THAT t THE WORK IS PROCEEEDING IN ACCORDANCE WITH THE DOCUMENTS APPROVED FOR THE BUILDING PERMITAND SHALL BE RESPONSIBLE FOR THE FOLLOWING AS$PECIF.IED IN SECTION 118.0 1. Review, for conformance to the design concept, shop drawings, sainpl'es and other submittals ' which arg submitted by the contractor In accordance with the:requihements of ttie conatrudlon documents. i 2. Review and approval of the quality control procedures for all code=required con#trolled materials. I 3. Be present at intervals approprlaW to the stage of construction to become, generally famlliar i with6the progress and quality of the work and to determine, In general If the worts is being f performed in a manner consistent with the construction doaumeerlts, ', , I PURSUANT TO SECTION 116.2 .2 1 SHALL SUBMIT WEEKLY,,, A-AbGRESS REPORT s TOGETHER WITH PERTINENT COMMENTS TO THE NORTH'ANDOVER BUILDING INSPECTOR. j 4ek i UPON CPMPLETION OF THE WORK, I SHALL SUBMIT A FINAL REPORT AS TO THE SATIS ORY COMP ETION AND READINESS OF THE'PROJECT'FOR O N `_ P;,�,• arwrU i S SC B D A RN T HI$ DAY Q7,[ IFUNOLISA A. GILLIG,:]60' TARY PUBLkNOTARY PU8L1 MMONWEALTH aM1EXPIRES MY Commission Expies Mey 1 i ;4 �'it A�Q- CERTIFICATE OF LIABILITY INSURANCE DATE(MM/°D/YYYY) R1 1/2011 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Mathias Insurance Agency, Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 200 Sutton Street, Suite 160 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. North Andover, MA 01845 97 8-688-5531 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Nautilus Insurance Company Charles Construction Company, Inc INSURER B: Travelers Indemnity Company 200 Sutton Street INSURER C: North Andover, MA 01845 INSURER D: INSURER E: COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. NSR ADVIL POLICY EFFECTIVE POLICY EXPIRATION TR INSRD P 0 INSURANCE POLICY NUMBER DATE (MM/DD DATE MM DD LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1 000 000 X COMMERCIAL GENERAL LIABILITY PREMISES Eaoccurence $ 50,000 CLAIMSMADE [i]OCCUR MEDEXP(Anyone person) $ 5,000 A NN148707 06/22/11 06/22/12 PERSONAL&ADV INJURY $ 11000,000 GENERAL AGGREGATE $ 2 ,000,00o GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $ 2,000,000 �( POLICY PES LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANYAUTO (Ea accident) $ ALL OW N ED AUTOS BODILYINJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS NON-OWNEDAUTOS B eracci ent) $ (Peraccident) PROPERTY DAMAGE $ (Peraccident) GARAGELIABILITY AUTO ONLY-EAACCIDENT $ ANYAUTO OTHER THAN E/+ACC $ AUTOONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR FCLAIMSMADE AGGREGATE $ $ DEDUCTIBLE RETENTION $ $ WORKERS COMPENSATION AND WCSTATU- OTH- EMPLOYERS'LIABILITY TORY LIMITS PER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1 000 000 B OFFICER/MEMBER EXCLUDED? 6KUB-980OM24-7-11 06/11/11 06/11/12 E.L.DISEASE-EA EMPLOYE $ 1 000,000 Ifyes,describeunder SP EC IAL PROVISIONS below E,L.DISEASE-POLICY LIMIT $ 1.0 00 000 OTHER ESCR IPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS ERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Town of North Andover DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL20 DAYS WRITTEN 120 Main Street NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL North Andover, MA 01845 IMPOSE NO 0I TION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESE I S. AUT HORI RESENT -ORD25(2001/08) PORATION 1988