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HomeMy WebLinkAboutBuilding Permit #185-13 - 2303 TURNPIKE STREET 9/5/2012 TOWN OF NORTH ANDOVER /�l 9 APPLICATION FOR PLAN EXAMINATION Permit NO: / v �s /`� Date Received Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION 3� tr9/f'! . PROPERTY OWNER Print 100 Year Old Structure yesOno MAP NO: 16 4? PARCEL:063ZONING DISTRICT: Historic District yes Machine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential 0 New Building ❑ One family ❑#ddition 0 Two or more family ❑ Industrial Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑Well ❑ Floodplain 0 Wetlands ❑ Watershed District ❑Water/Sewer 1 // _ DESCRIPTION QF/WORK TO BE PE�FORMED: �_ a�==/ !/L w�l/S ✓/Gl thl�iv� e�11 G5 e �h S� G N. entification Pease Type or Print Clearly) OWNER: Name: I�iytJ� Phone: 979 3/Y I(f7� Address: CONTRACTOR Name: ) Phone: Address: f I Supervisor's Construction License: 0&966 Exp. Date: 3/2.Sf1Y Home Improvement License: 12-6 /Cif Exp. Date: 213o ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT.$12.00 $1000.00 OF THE TOTAL ESTIMATED COSTf _BASED ON$125.00 PER S.F. Total Project Cost: $_9n3,6 3,6 / FEE: $ Ul `6D Check No.: /,,2 �1� Receipt No.: �'r'��L NOTE: Persons contracting with unregistered contractors do not have accWlogularnantyfund Signature of Agent/Owner Signature of contractPlans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ s ❑ Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ElTanning/Massage/Body Art E] Swimming Pools El Well ❑ 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 � I DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS �E ning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes r Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Os ood Street FIRE DEPARTMENT - Temp Dumpster on site yes no Located at*124 Main Street Fire Depai-tment•signature/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 ® Notified for pickup - Date Doc.Building Permit Revised 2010 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 t ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract �I ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: Alldumpster permits require sign offrom 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 :s New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the 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: Doc.Building Permit Revised 2012 I Location No. l Date • - TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ pD Foundation Permit Fee $ ^ Other Permit Fee $ str�`t TOTAL $ Check# A& Bwtidin"Ins ector 25682 9 p NORTH c ver O y , No. i Y -. * ver, Mass, COCMICl/l WICK y1. RATED ►P�,�'�y S U BOARD OF HEALTH PER -T T D Food/Kitchen Septic System y�q BUILDING INSPECTOR / -/ ,��GN / ............................................................. THIS CERTIFIES THAT .................. ... .............. ........................ n�® •.�� �•• �i . Foundation has permission to erect buildings on P( .. 7 .......................... Rough G .5r1,tlCS6................ Chimney L > C. to be occupied as ......... /��dCI�....,rl.�..,.... �.�..............�.. ... ... 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,A teration and PLUMBING INSPECTOR f Buildings I�UC:J� °`^ ( Construction o s in the Town of North Andover.g Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final ,PERMIT EXPIRES IN 6`MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTI:O TRough ARTS •• 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 FIRE DEPARTMENT No Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. SEE REVERSE SIDE Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supers isor License: CS-036866 `1-F'1 I N. .1/ JOHN.J CALL 14 EDGEHILL RD' ° HAVERHILL MA 018 Expiration. Commissioner 03/25/2014. E, Office of Consumer Affairs&Business Regulation OME IMPROVEMENT CONTRACTOR r egistration: 127191 Type: xpiration: 9/17/2014 Private Corporatio HOME ENERGY, INC JOHN CALL 14 EDGEHILL RD HAVERHILL,MA 01830 Undersecretary The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Leeibly Name (Business/Organization/Individual): IA,tPC!y C Address: & City/State/Zip: tl J l&-" & Phone#: 979 37 y J,ZS�,' Areru an employer?Check the appropriate box: Type of project(required): 1.LI I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.E] I am a sole proprietor or partner- listed on the attached sheet. ? ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers' comp.insurance. 9. ❑Building addition [No workers' comp.insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.El Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.❑Roof repairs insurance required.]t employees. [No workers' comp.insurance required.] 13T]Other *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. #Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp,policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. w� Insurance Company Name: 7 Policy#or Self-ins.Lic.#: Z 3D Zj Expiration Date: 3d Z fob Site Address: City/State/Zip: /tea Attach a copy of the workers'co pensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a the 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 )f up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of nvestigations of the DIA for insurance coverage verification. .r do hereby ce t nder the pains and penalties of perjury that the information provided above is trite and correct. ii nature: /' Date: OS Z ?hone#: A' g —I CJ Official its y. o not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE revised 5-26-OS Fax#617-727-7749 www,mass.gov/dia 1 8/27/2012 Job Number : 457 I Client Melanie Dube . . .address 2303 Turnpike St city 1 own. North Andover contractor 1.WEATHERSTRIPPING/CAULKING QUANTITY TOTAL AUDITOR NOTES 1 Door Kits Q-Lon or Equiv. 1 .45:50 Door Sweeps(Regular) .; 0 0.00 Door Sweeps(Automatic) 1 23.00 Reglaze Windows lln.inch p 0.00 Wiridow.Weathstr Schlegel per side 0 0.00 Tenmat Recessed Can Cover 0. 0.00 At(IclBasement bypass sealing man1hr 1.6 112.60 . AtUC,,sealing with 2-part foam man/hr 0 .0.00, SUBTOTALS 181.00 2A.INFILTRATION/INSULATION AUDITOR NOTES Domestic pipe Hot Water Tank 1st 8' 1 15:713 Sill Insulation R-19 CF 0_ 6.00 Sill.Two Part Foam w/Fiberglass Bat( . 0 0.00 Drape Perimeter R-5 Anch.Sq.ft, 0 0.00 Perimeter 2"T-max or equivalent foam board sq.ft. 0 0.00 Drape DOOR R-5 or T-max or equivalent on door. 0 0.00 Tape Joints(Alums Grip only)per hr. 1 65.00 Duct Insulation&Tape sq.ft.R-5 . 228 706.80 150 Sq-78 Round illl Rigid Foam Board Anch. 1"per board 0 0.00- Mydronic pipe insulation to 1"R-5 0 0.00 Hydronic pipe ins.1.25"-1.5"R-5 0 0.00 ' Steampipe Ins.to1.25"iron pipe R-5 0 0.00 I Steampips ins.1.5"-2"iron pipe R-5 0 0.00 I Steampipe Ins.3"iron pipe W5 . .. 0 0.00 . . ..... .. Air Conditioner Meeting Rail 0 0.00 Air Conditioner Cover 0. 0.00 i Air conditioner Cover SpeGal Order .0 0.00 SUBTOTALS 787.68 2B.INSULATION . AUDITOR NOTES. Open Unrestricted R 48 0 0.00 Open Unrestricted R 38. 336 493.92 Open Unrestricted R 30 0 0.00 Open Unrestricted R 20 0 0.00 Open Unrestricted R 10 73,7 .891.77 Restrict FL R 30 0 0.00 Sloped R 20 292. 414.84 Restrict FUSloped R 10 0 0.00 R-18 FGS open rafters/walls/kneswalls 0 0.00 AI RFGB open rafters/walls/krieewalls 0 :.. 0.00 Attic Stairs(stairwell&common wall) 0 0.00 Cover Pull Down Stairs Thermedome.' 0 0.00 Site built pull down stairs 2"foam box. 0 0.00 y AUDITOR NOTES: . Attic I Kneewal Floor Transition.Dense pack cellulose 0 0.00 W.S.Hatch Q-Lon or equal, 2 63.00 W.S.&bat Hatch R-30 IQ-Lon or= C. .0.00 Kneewall R-12 cell behind Per:Memb 0 0.00: Open.Rafter R-20 Coll.Iw poly . 0 0.00 Open Rafter R-30 Gell.iw poly 0" 000 Basement Overhead R-19 fiberglass 0 0.00 Basement Overhead R-30 fiberglass 0 0.00 CraWpace Overhead<4'high.R19 0 0.00 Cra0pace.Overhead<4'high R30 0 0.00 Garage Ceiling cavity filled wi cellulose 0 0.00 Wood,Shake,Clapboard,Shingles Vinyl. 1290 .2309.10 Asbestos(single nail)!Asphalt 0 0:00 -- Asbestos(doub.Nail)I Aluminum 0 0.00 Brick/Stucco 0 0.00 Vinyl over Asbestos 0 0.00 Multi-layered 3 or more layers 0 0.00 Ddll rough plaster or finish wood plug 0. ' 0.00 " 1 . Drill finish plaster � " 292.60 Test Drill Walls(ell 4) 0 0-00 SUBTOTALS- 4466,03 2.INSULATION TOTAL 2A.+2B.' 5252.61 3.STORM YYINDOYVS!DEADLiTE3 AUDITOR NOTES Ple)dglass up to 88 W. 0 0.00 Additional per(it over 88" 0 0.00 Other(Negotiated Price) 0 0.00 SUBTOTALS 0.00 5 OTHER MATERIAL AUDITOR NOTES. Ridge vent In ft. 0 0.00 Vents Gable rectangular 0 0.00 Vadpttch Vent 0 0.00 Vent Roof 135(1-sq ftNFV)Large 0 0.00 Vent Roof 865(A sq ft NFV)Small 0 0.00 Vent Soffit Rectangular 0 0.00 . Turbine Vents All 0 0.00, Stack Vent 0 0.00 Props Vent 0 0.00 PermabieHouse Wrap, 0 O:QO . Vapor barrier.. 0 0.00 Energy Star R-1 Rigid Vinyl Repl 94-101 U.I. 0 .0.00 SUBTOTALS 0.00 6.17.E.C.MA'TERIAULABOR. 543S.Bt Page 3 89. HEALTH&SAFETY AUDITOR NOTES Vent 13ath/Kitchen Fan 0 0.00 Dryer vent w/exhaust duct Heartland 0 0.00 Dryer Transition Duct only.. 1 40.00 Blower Door Test PrePost 0 0.00 SUBTOTALS 40.00 Sb.REPAIR MATERIAL/LABOR AUDITOR:NOTES Basement'outside door only 0 0.00 Basement outside doorw/jambs, 0 0.00 Door Rapt pre hung 32-36"Steel"w/Lite 0 0.00 Door Rept interior.solid core 28-32" 0 0.00 Door Repi pre.hung 32-W wood"w/Lite 0 0.00 Window Replacement w/SIR less than.1 0 0.00 Basement Window Repl.Awning/Hopper. 0 9.00 Basement Window Repl.With:a frame 0 0.00 Lockset(door)Schlage'or equal' 0 0.00:. . Repair./Refil.DOor,.. 0 0.00 ReplaceSide.Stop . 0 0.00 Replace Casing - 0 0,00 Glass Replacement to 64 W. 0 0.00 Glass Replacement per u.i.over 64, 0 0.00 Sash Sideiock[Top Replacement 0 0.00 Threshold(Wood). 0 0.00 Threshold(Aluminum) -0 0.00. Slide Bolts 0 0.00. . -Plug Plate.Cover 0 0.00 Cut Y finish atticAkneewall access 0 0.00 Cut:/Gose a8ic*neewall access: . 0 0.00 Labor Rate Hours 0 0.00 Permits.!Pees.(Wap only) 0 0.00 SUBTOTALS 0.00 TOTALREPAIR+HEALTH&SAFETY 40.00 GRAND TOTAL WORK ORDER# (A) 4367 6473.61 Melanie Dube 2303 Turnpike St North Andover. I Any alterations or deviations from the above specifications involving extra.costs must be cleared in wntiing before installation: The Work Order must be complete within 15 working days from acceptance date below:... .. . CO.NTRACTORICOMPANY: Q. ACCEPTANCE:Company/Contractor AUTHORIZED SIGNATURE: Dat@ AGENCY APPROVALS: CTI Authorized Signature: Date GLCACAuthorizedSignature' ... Date. 49 WAP STANDARD AGREEMENTS TenaotWmperty O"er/Agency Weatherbation Agreement 1.The Parties to this Agm_mmt are the following: A44E e4yle; 0 /j4' (hereafterTmumt) Au_,,x, -(hereafter Pmpady Owmer),and lnc.hegreafter Agoac}+} . 7n consideiation ofthe mirtuai promises hereafter,sA,94 the 1°mfies.99ea as-Mows:_..__.,_....:.,..... .. .__ :. ,.... 2.The date of Agences signature will be the e!I'ocdva date of this Agreement. 3.Tho Property Owner consents and agrees that the gay do the following with r08peCt to the property locate at Z 3b 3 Tt/2NP i/Gr � fy{/L rya 01 q 5 .and eUnMtly.leased oriented to thOTenam:. ., _. . _. .nterth - ---_-_the ;of aweatherinfminspedion.' . s.Enter the pismires for the purpose of performing b.Perform weatheriedon work-which fire Agency determines in its discretion is necossmy and e palate as a rem*of the Agency's inspection of the property and in accordenc a with the appropriate priority list for the,We of dwelling(See Attachment A).The ProMW Owner also agrees to permit the Agency and the Agency's contractors to enter both the Tenant's apartment and appropriate common areas-oftha budding fdi the Purposes of accomp g :..._....._.._._..... ...,weron�ork..Theweatiterizatton:�rkw�lbe,performo_d�aactx�rd�auoeahok�B�Y.: _ .. - . . . _ ONnees ccnsont as further specifod below~(Initial aw) .: .. I consent to performance by the Agency and its contractors of nay wea6wimtibn.wark detasmined necessary and q*mpddo by the Agency as a reaft of its inspection of tip property.I ::uQdinstsad flirt tire.AWW will pm W a detailed statement of the.adual work pe fmmed and ®cleated MdW m ffio COMPletion offhework.. .. . .:...... . . or ` I wi U provide$consent to performance by fire Agency and its co*sauna of WFUMMUINJAMMAWAAwaik following my receipt of die Agency's inspection report and a statement of the estimated work and associated valve. ,.. :`Ti<is�drhoim�' wvil!-bw-aualgd-toftAnt-as-AtB:Iunderstand.thetthe-:::.;-.. . ...._ .... .....:.A®arol► ll provide detastatemcutof tha_aciital work performe�l.ead the OWAt M. .�.. . the completion of the work. t 4.The maxim n n value of the materials and labor to be supplied by the Agency is S IDA be exclusive of related repairs im r asbestos abatement work for which the property may also:. CH d.The property Owner understands and agees that.any and all work will bepw=fwmed at ttie Agency�s d�scaehon"and tha value of materials and labor actually reeved wiU be. ower ._,. . .::.:.:. :_._,;..::.........__..:,... oris•maximum.The Agency agrees to camp10e the we_at Wization work by the and of (month and ye4 S.#the Property Owner is required to make repairs to the property prior to the commencement of weatherization work by.the Agency.the Property Owner agrees to complete the repairs by. Enept when the Property Owner receives a written extrusion from the Agcy,time is of the em ee in the performance of repairs by the Property Owner. :... .. The Propeit ,Owwand Tenant authmize:the Agency to receive a statement the fuel 6. suippller/urtilily supplier.as to due quantity of fuelludilitles used at the above address in each ofthe_. w. _ . . ._.. pestdm years and the future thmyears.The information is to be used only to detsrnrino tt� const eMbfivenewofthe weatherization b*wvw=ts. 7.Tho Pmperty owner agrees.tliat the rent for the dwelling unit will not be raised,because of any iiaaease in the value thereof due solely to thew h2 ion work performed.. S.In consideration of the weatherization work performed by the Agency.the Property owner one 1 following the date of con stion-of the weatherization work,as certified by _ agenthataupon--due aflbct{vedata ofth>s, greement artd doring pen w ::::::. ---- - .�u8h { }Year' g pl the Agency: t ._,..t of$ �00 ` : per o will not be raised for any reason. ren ... _ an leased under a stats or federal rem subsidy program,in which case the actual rpt -- -----: charWby the Owner shall conform to the standards of the rent subsidy piog sin. b.The PnmedOwner institute crus prouxss action possession amept In*a ..._ c�se•ofnosrpayment neatorolher': ... ,`... . .. . ....` rrc.In due event ire property Owner decides to sell the premises,the Property Cwvaer 6160ply , with one oft o two requirements below. -nm Property Owner shall not sell the premises unless the buyer agneas(with a copyr i Qfthe. forwarded to due Agency)in writing prior to sale to assume all the obligation property Owner sat out in this Agreement:or �.. ._,.. ._„......: ....._.... a +Opergr Owren sbau-pay t##is Agee ran amount equal m tke'cost;as certified by thsale e . ...< .� . ,_.. _ r ., _. Y=of the xu►sadrerization materiels:instslled..a�rul. x p 'o #�ti�.premisa_4 as..,„�,,,,__ .,_ of the date of sale.Said amount shall be paid to the Agency immediately upon • III ... r f T heat is i.i�h�aed in re�tat na and b1+Mtia Ana filled Dain.) 9. + i n)At the 8 above,the rent shall net be raised more . _...�, and ofthe one(1)year period sat forth in paragraph _ ...�........__ ._.. ..�..._.. .... of ._. ...... . . .. .: .._.. .:.: for�ari=additio�el- od�uf::;..�.;:.�.� pr8visof�is .� Dom'YM period.However, the jug provisions state �" _ a�aW AA centime m effect for such peri we(eased under may be waived by the Agency in writing i an only. conform to federal rent subsidy pr+�,in which case*a actual rent charged by the owner shall the Standards of the rent subsidy program that the terms'of this Agraemelt are income into any other lease or 10..The Parties agree Owner and they Tenant,and between iha Y Owner and any ereementsumesm between property and the terra and if*m is any conflict between the purov�>sioas of t>,is A .._....... prmr Ons of such other -haw— or ag ' WXpA egmamed if.such other lease or agreement,including or under a state or federal rant subsidy program,Mains ste 'pans for t �e "such - stroaW protections"apply. 11.For breach of this Agreement by the propertyOwner,the Property shall remm burse do .tithe w . Agency m en-eoio'unf'�egaai to the.cam,as casElfied by the Agency.. _. ed an the- as wall as attorne3rs fear and cont costs.lfie mailed and labor perform as' to the Tenant in accordance with applicable law; prapaiy Owner Wray also be liable for damages s fees and curt such ink the Property Owner shall reimburse the Tenant for attorney' costs. 12.Ito Parties acknowledge that tbis Agreement is under seal.It is intended by the Parties that .the.Tamdor any, spceessa..tenaut is the intended beneficiary of this Agreement and shall have-a right of enfomemot Tenant owner. Date Date ChristionW.Dam kWrjmBxecufiv*DirecWCE0 DEC 0 5 2011 From:Gerry McDonald FaxID:McSweeny Ricci Page 2 of 2 Date:9/5/2012 12:54 PM Page:2 of 2 HOMEE-1 OP ID: GM ACORO" 709/05112 CERTIFICATE OF LIABILITY INSURANCETE(MM/DD/YYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). CONTACT PRODUCER 781-848-8600 NAME: McSweeney&Ricci Ins Ag IncPHONE FAX 420 Washington Street 781-843-8807 A/c No Exti: A/C,No): P.O. Box 850984 E-MAIL Braintree, MA 02185 ADDRESS: Hse mkt INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Guard Insurance Group INSURED Home Energy Inc INSURERB:Acadia Insurance Company 31325 John Call 14 Edgehill Rd INSURERC: Haverhill, MA 01830 INSURER D: 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 MAYHAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE POLICY EFF POLICY EXP LIMITS LTR INSR VIfVD POLICY NUMBER MM/DDlYYYY MM/DD/YYYY GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 B X COMMERCIAL GENERAL LIABILITY CPA0330083 02/04/12 02/04/13 AMAG O N 250 000 PREMISES Ea occurrence $ , CLAIMS-MADE a OCCUR MED EXP(Any one person) $ S,000 PERSONAL&ADV INJURY $ 1,000,000 X Per Project Aggre GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 17 POLICY X PRO LOC $ JECT AUTOMOBILE LIABILITY - COMBINED SINGLE LIMIT 1,000,000 Ea accident) BI AUTO MAA 0330084 02/04/12 02/04/13 BODILY INJURY(Perperson) $ ALL OWNED X SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS X HIR ED AUTOS X NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 B EXCESS LIAB CLAIMS-MADE CUA0330085 02/04/12 02/04/13 AGGREGATE $ 1,000,000 DED I X I RETENTION$ U 1 $ WORKERS COMPENSATION X WC STATUOTH- AND EMPLOYERS'LIABILITY T YORY IM - ER _ A ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ N/A HOWC218908 10/01/11 10/01/12 E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? 500 DUO (Mandatory in NH) E.L.DISEASE-E4 EMPLOYEE $ , If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT I$ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of North Andover THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 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