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HomeMy WebLinkAboutBuilding Permit #193-11 - 24 EAST WATER STREET 9/7/2011 AV TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: �� Date Received Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION PROPERTY OWNER ' /zfumyoP/� J' 4�/ Unit# Print MAP NO: PARCEL ZONING DISTRICT: Historic District yes no / / Machine Shop Villa e 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 ❑Alteration No. of units: 2. ❑ Commercial Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other _ ®;Septi ❑}Well' 0 Floodplain L]iWetlands 0,WatersliedDistrict, D+Water/Sewer - ! - DESCRIPTIO OF WORK TO BE PERFORMED: y Vti / AOFADfJ ems' a ck4- Yt c-1 �1G /C Hd Y16�fJ cS�`�/"� �iC/Sr7a•��` ��✓fr�f<i'i/�lr �rD .�L�?n/��-r� Yl/�/Vt ,,j`'��j/✓�r (Identification Please Type or Print Clearly) OWNER: Name: l _" Phone: Address: 025/ �� !.[(&nys CONTRACTOR Name: f c//t &4� �'ti✓��(✓�3� Phone:C� �—�n L"env('A Address: t d Tv./ .S;' 7M26!(-_,0 41 01W FOSupervisor's Construction License: OS d d<}� Exp. Date: Home Improvement License: /5Y3 7-f Exp. Date: Z ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE;BULDING PERMIT:$92.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$925 00 PER S.F. Total Project Cost: $ r� FEE: Check No.: ` Receipt No.: NOTE: Persons contracting with unregistered contractors do not haveccess tot e guaranty fund .Sianature.of Aaent/Qwner Signature of contract ;f `,l Location No. Date NORTM TOWN OF NORTH ANDOVER i } ° Certificate of Occupancy $ ;�J''••°',tom Mus Building/Frame Permit Fee $ AC Foundation Permit Fee $ Other Permit Fee $ • TOTAL $ Check # 24553 Building Inspector I Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans_❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑Y 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 DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS CONSERVA T ION 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 I Conservation Decision: Comments t Water & Sewer Connection/Signature&Date- Driveway Permit t DPW Town Engineer: Signature: " Located 384'Osgood Street FIRE DEPARTMENT - Temp D_umpster on site yes no " Located at 124 Main Street Fire Department 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 2011 June/mi 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 ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products CTE: 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 i� ❑ 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 N TE: 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 1'4i TE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg .Permit [a all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals th2t the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording nust be submitted with the building application i Doc: Doc.Building Permit Revised 2008mi NORTH ® of 0 NO- ►►(( = o ; dover, Mass.,2 . T O LAKE COCKICKEWICK V DRATED V BOARD OF HEALTH Food/Kitchen PERM IT T D Septic System / BUILDING INSPECTOR THIS CERTIFIES THAT........ ........ l l!LSA6 ................................... ......................................... Foundation has permission to erect........................................ buildings on .ay........C—A'5. ...! ............. ....5 ................... Rough to be occupied as ...1a�.. .. .... G .... :....G. .,h. � .... �..... ......�.�...1J1.�1.. �...SIG.III.. ... .....94 , Chimney e provided that the erso acce Yin this permit shall in eve res ect conform to the of the application o file in P P P g P rY P PP Final- this inalthis office, and to the provisions of the Codes and By-Laws relating to the Inspection, Afteretion 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 MONTHS ELECTRICAL INSPECTOR . a� UNLESS CONSTRUCTI S TS Rough . ..................................................................................... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building 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. tZoery GfSpsf7 r61�(} . " ° Tow of North Andover h Machine Shop Village Neighborhood Conservation District Commission. 160 Osgood SLreeL Nardi Andover, MA 01845 SSACmust. A..'P.Phcation For EXCLUSION From Certificate to Alter Certain alterations are ercclud'ed, om review by the Machine,%op Village Neighborhood Conservation District Commission in accordance with the Bylaw. iplicants,for exempt projects must fill out the form below and submit to the Commission, Chairperson (contact fifio below). Date: A L/ -- 01 Contact Name Sr Address: S -Tla- Project Address: Li E Vi A 16,r`Z-.. S 1 &I , A N' J2— Project Description (attach additional pages, if heeded): 2 X iS j 1 NC7 PYAA`_Xe ti i r6 'G+6s I l i t.,16 A ti Q C tr l� C Vi t x H Exclusion From Review Requested For. ❑ 1. Inteeior Alterations existing;conditions including materials, design and dimensions. ❑ 2. Stormer.windows and doors, screen windows and doors. 9. Replacement of existing substitute /Y\ doors}substitute siding or substitute ❑ 3. ;lt.emoval,replacement or installation of xindows with new materials that are gutters and downspouts. substantial)}' similar to the existing condi ' n. ❑ 4. Removal,replacement or installation of window and door shutters. ❑ 10. Replacement of original fabric windows or doors with. substitute ❑ 5. Accessory buildings of less than 100 windows or doors that maintain the square feet of floor area,. architectural integrity with respect to form, fit and function of the original. 6. Removal of substitute siding. windows or doors. ❑ 7. Alterations not visible from a public: ❑ 11. Reconstruction, substantialLy similar in Way, exterior design, of a.building, damaged or destroy=ed by fire,,storm or other disaster, ❑ 8. Ordinary nlainten:ance and repaar of provided such reconstruction is begun architectural features that match the within one year thereafter. 1 MSV NCDC Page 1 Cu.rren.t Chair:Liz Fennessy,77 Elm Stet, l izettafennessy c yahoo.com,978-688-2915 tkaRTI p`Tan raa`�Q 'down of Norte Andover - JoMachine Shop ViUaW Neighborhood Conservation District Commission 1614 Osl cao : creel. North �4ncie-tier, MA,4184.5 ssacNusa Application For EXCLUSION From Certificate to alter. For ms 9, 10 or 11,}provide the following documentation: hotasldret raw of existing doors, windows or siding, as applicable nlCatalo Cues o ,ro osed materials to be used' or doors, windows or siding �. Descrrptto g ,}Fp p f g Plan and elevation of reconstruction for Iters: 1 I Determination; This project is determined to be exempt U not exempt from review,by the Machine Shop Village Neighborhood Conservation District Commission. Projects that are not exerntrt roust complete the Application far Certificate to Alter, availablefrom the Building Department and be reviewed by the Commission. Determination ,made by Signature J Cto i _�r �1 Neighborhood Conservation District Commission c/ ' �t Date MSV NCDC Page 2 Current Chair: Liz Fennessy,77 Elm Strwt, lizettafennessvr?vahoo.com,978-688-2.915 1 HIC#167567 OLYMPIC E1N#56-2618812 Job#: Roofmg—Siding-Painting Office:978-887-5870 239 Boston Street Tousfield,MA 01983 Fax:978-887-5875 Richard Robinson 24 East Water St. North Andover,MA 01845 (978)685-4653 Email: rtr24Qcomcastnet Job Location: 22-26 East Water Street—North Andover,MA June 9,2011 Revised: June 15,2011 Revised: June 24,2011 Dear Richard, I have prepared the following estimate for the installation of the vinyl siding at the above location. This will be a hill coverage job with no maintenance required and lifetime warranty. All work will be performed to the manufacturer's specifications to ensure a lifetime warranty. Below is a brief description of the work that will be performed. Vinyl Siding: • Strip existing masonite siding on front,left and right sides of duplex • Price does not include all(4)both sides of rear section of building with(2)car garage • Price includes PVC trim around(2)garage doors,vinyl soffit,metal coil on rakes and fascia,and(3)corners of rear addition • Inspect the sheathing • Install Tyvek over all areas prior to vinyl installation • Install CertainTeed MainStreet Double 4"vinyl siding • Flash all windows and doors • Securely nail all loose boards and wood • Replace any rotted wood Q'$12.00/R • Scrape away any old caulking around any doors and windows • All overhang and eaves will be dressed with soffit panel • All trims will be wrapped with aluminum coil stock • We will install new vinyl corner,j-channels and casements throughout • The soffit and face boards will be done to match the windows • You may choose to have the vinyl match the color of the soffit • You may choose to have us install vinyl shutters(this is an option and is not included in estimate) • Foundation will not be covered • We will remove alljob related debris • Job will be started and completed without any interruption • Vinyl perm' vary from town to ton andare not included in this estimate: • COLOR La81f,L tJyvr/ Cost for Labor&Material for Vinyl Siding: $16,295.00 Payment Terms: 1/3 deposit due upon signing contract: $ O 1/3 payment due upon sbft of job: $ 1/3 payment due upon completion of job: $ Remit to: Turnpike General Contracting Ina-P.O.Box 365,Topsfieg MA 01983 The following schedule will be adhered to unless circumstances beyond Turnpike's control arise: Work Scheduled to Begin: TBD Expected Date of Completion TBD Warranty ike General Co g Inc.guarantees.all workpm fmmied for aperiod ofone year. If blems occur we will cover.the cost of material to the lem and meet the customer's satisfaction. ael Connors,Proj ct Richard Robinson Turnpike General Con c. Homeowner r� MC#167567 OLYMPIC EIN#56-2618812 Roofing—Siding-Painting Job#: Office:978-887-5870 239 Boston Street—Toasfield,MA 01983 Fax:978-887-5875 Richard Robinson 24 East Water St. North Andover,MA 01845 (978)685-4653 Email: rtr24@comcast.net Job Location: 24 East Water Street—North Andover,MA May 24,2011 Revised:June 9,2011 Revised:June 24,2011 Hi Richard, The following estimate is for the window installation for the property located at the above address. The following paragraphs describe the work to be performed. All work will be performed on a timely basis and in a professional manner. Window Installation: • Install Harvey White Classic Double Hung Replacement Windows • Install(1)Harvey Triple Casement Bay Window • Windows will be double glazed with Low E,argon filled with tempered glass • No grids with half screen • Close up(1)window in master bedroom.Price includes plywood,2 x 4,insulation,sheetrock,drywall and tape • We will remove all job related debris Please initial all ondons you are choosing below: Cost for Labor&Material for(2)30%x54 Living Room Windows: $ 425.00/ea=$ &50.00 Cost for Labor&Material for(2)26%x38%Bathroom Windows: $ 395.00/ea=$ 790.00 Cost for Labor&Material for(1)3607 Kitchen Casement Window: $ 525.00/en=$ 525.00 Cost for Labor&Material for(1)30%x57 Dining Room Window: $ 425.00/ea=$ 425.00 Cost for Labor&Material for(2)30x56 Den Windows: $ 425.00/ea=$ 850.00 Cost for Labor&Material for(4)30'!x54 Master Bedroom Windows: $ 425.00/ca=$1,700.00 Cost for Labor&Material for(1)50%40 Triple Casement Bay Window: $1,895.00/ea-$1,895.00 Cost for Labor&Material to Remove&Install Plywood: $ 395.D TOTAL: Payment Terms: ! 1/3 deposit due upon signing contract: .$ y 1/3 payment due upon start of job: $ 1/3 payment due upon completion of job: $ Total Amount Agreed To Be Paid: $ Remit to: Turnpike General Contracting Ina-P.O.Box 365,Topsfidd,MA 01983 The following schedule will be adhered to unless circumstances beyond Turnpike's control arise: Work Scheduled to Begin: TBD Expected Date of Completion: TBD W Turnpik General Co trading Inc.guarantees all wor perfo ed for d one year. If any problems occur we will er a ost of abor and ma er'al to correct the problem and eeti1the stomer' sa sf i n. Mic el Conno Project er Richard Robinson pike General g Inc. Homeowner a Gr°"P HIC#167567 Richard Robinson Roofing • Siding • Painting • Masonry EIN#56-2618812 24 East Water St. Job#: North Andover,MA 01845 (978)685-4653 Job Location: 24 East Water Street—North Andover,MA May 24,201 I Dear Richard, The following estimate is for the roof installation for the property located at the above address.The following paragraphs describe the work that will be performed. Installation Procedure • Strip existing small roof above rear deck with slider down to the roof deck • Price is for small roof above rear deck with slider • Install an 8 inch white drip edge on all leading edges(rakes&fascia) • Install 6 feet of ice&water shield on all leading edges • Transitional walls are optional and incur an additional cost for the siding repair • Install new vent pipe flanges • Replace any rotted or damaged decking a $70.00/sheet • Replace any rotted or damaged ledger board a $4.00/ft. • Install 15 pound felt paper on all areas that is not covered by ice&water shield • Install new GAF Royal Sovereign 25-year 3-TAB shingles • Install new ridge vent system • Install roofing cement on chimney lead flashing Additional Specifications • Homeowner to choose color of shingles COLOR: CHARCOAL • Our dumpsters are sent to a recycling facility;therefore no additional trash may be placed in them. The transfer station will charge us a fee for additional trash which will be passed on to the homeowner. • Chimney re-pointing and re-leading is not part of the roofing contract and will be quoted separately. • A new roof does not guarantee that there will be no ice dams • Ice dams are caused by poor attic insulation and not enough ventilation • During a roof job,the nails could break the sheathing during the nailing of the shingles • We are not responsible for any of the cracks that may arise in any walls or ceilings • Please cover all your floors in your attic to protect from dust and debris • We will remove all of the job related debris from property and dispose in designated waste facility • Permit costs vary from town to town and are not included in this bid Cost for Labor&Material for Rear Section of Roof for 24 East Winter Street: $995.00 Payment Terms: f 1/3 deposit due upon signing contract: $ 1/3 payment due upon start of job: $ 1/3 payment due upon completion of job: $ Remit to: Turnpike General Contracting Inc.-P.O.Box 365, Topsfteld,MA 01983 The following schedule will be adhered to unless circumstances beyond Turnpike's control arise: Work Scheduled to Begin: TBD Expected Date of Completion: TBD Warranty: Turnpike General Contracting Inc.guarantees all work performed for a period of one year. If any problems occur we will cover the cost of all labor and material to correct the problem and meet the customer's satisfaction. Do not sign this contract if re any blanks c . (add lona!provisions follow and ar incorp rated herein F alxl�� A'i s fer ence) icha onnor , roject a Richard Robinson ike General Contracting Inc. Homeowner Tel: (800)535-4312 • Fax: (978)887-5875 • 239 Boston Street • Topsfield,MA 01983 1-888-5-OLYMPIC • wwwAympicroofing.com The Commonwealth of Massachusetts I�- Department of Industrial Accidents ' Office of Investigations jp_ 600 Washington Street Boston, MA 02111 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): TL f dA4,,! 9,Al . G0t-L— Address: City/State/Zip: �'yP���C'L/� � 0/9[3%one #: �V 7 h if 7-_ 7 Are you an employer? Check the appropriate box: Type of project(required): 1.❑ 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.❑ I am a sole proprietor or partner- listed on the attached sheet. $ E]Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition workingfor me in an capacity. workers' comp. insurance. Y P tY• 9. ❑Building addition [No workers' comp. insurance 5. �&We area corporation and its required.] officers have exercised their 10.❑ 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.[R Roof repairs insurance required.]t employees. [No workers' comp.insurance required.] 13.❑ Other ��1� � S� j,✓(/ *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. tContractors 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. Insurance Company Name: /77T"��;� Policy#or Self-ins.Lic.#: (J - t,/ 7,j N- Expiration Date: Z /� Job Site Address: __ -L/ ("Q-c1''(r &JAf7it City/State/Zip: A1OyL7W i�t�/l✓� /j,jj►�- Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date)Off' rS Failure to secure coverage as required under Section 25A of MGL 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 verification. I do hereby certify under the pains n7eftes of perjury that the information provided above is true and correct. Si ature: / Date: Phone M .2 (� a 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): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: ACORD. CERTIFICATE OF LIABILITY INSURANCE 05/04/2011 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:H 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 and endorsement. A statement on this certificate does not corder rights to the certificate holder in lieu of such endorsemort(s). PRODUCER CONTACT NAME: PHONE FAX CHASE&LUNT LLC (AIC,No,Ext): FAX , POB 590 E-MAIL (acNa): ADDRESS: PRODUCER NEWBURYPORT,MA 01950 CUSTOMER ID If: 77BPK INSURER(S)AFFORDING COVERAGE NAIC It INSURED INSURER A: TRAVELERS DIRECT ASSIIDWENT INSURERB: TURN BE GENERAL CONTRACTING INC DBA OLYMPIC INSURER C: PAINTING& INSURER D: 239 BOSMIN STREET INSURER E: TOPSFIELD,MA 01983 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TOTHE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECTTO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN.THEINSURANCE AFFORDED BYTHE POLICIES DESCRIBED HEREIN 16 SUBJECTTO ALLTHETERMB,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDLSUBR POLICY EFF DATE POLICY EXP DATE LTR TYPE OF INSURANCE INSR WVD POUCYNUMBER (MHhDMYYYY) (MNADDIYYYY) LIMITS i GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ CLAIMS MADE OCCUR. PREMISES(Ea occurrence) MED EXP(Any one person) $ PERSONAL 11,11,ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PROJECT LOC PRODUCTS-COMP/OP AGG $ AUTOMOBILE LIABILITY COMBINED SINGLE $ ANY AUTO LIMIT(Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULE AUTOS (Per person) HIRED AUTOS BODILY INJURY $ (Per accident) NON-OWNED AUTOS PROPERTY DAMAGE $ (Par accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION$ $ WORKER'S COMPENSATION AND WCSTATUTORY LIMITS OTHER EMPLOYER'S LIABILITY YIN US-4419PO94-10 102212010 10/22/2011 E.L.EACH ACCIDENT $ 1,000,000 ANY PROPERIToRfPARTNERrExEcLmvE N E.L.DISEASE-EA EMPLOYEE $ 1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-POLICY LIMIT $ 1,000,000 If yea,describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/RESTRICTIONSJSPECIAL ITEMS THIS REPLACES ANY PRIOR CERTIPLCATE ISSUED TO THE CPRTIPICATE HOLDER APFE17MG WORICERS COMP COVERAGE. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Charles J Clark ACORD 25(20D9/09) ISM2009 ACORD CORPORATION. All rights reserved. i DATE(MWDDIYYYY) AC-080 OP ID LB CERTIFICATE OF LIABILITY INSURANCE TURNP-3 05/03/11 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Chase & Lunt LLC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P O Box 590 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 47 State Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Newburyport MA 01950 Phone: 978-462-4434 Fax:978-465-6204 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Ncrthla d Snsuranca Companies Turnpike General Contracting, INSURER 8: Torus Specialty Xn ranca Cc Inc. INSURERC: Commerce Insurance Company dba Olymic Painting & Roofing 239 Boston Street INSURER D: Topsfield MA 01983 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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. iFYbK LTR RATION NS TYPE OF INSURANCE POLICY NUMBER DATE MMIDDIYY DATE MMIOLICY EF ECTIVE POUCY DD/YY LIMITS GENERAL LIABILITY r CCURRENCE $1,000,000 rNMU A X COMMERCIAL GENERAL LIABILITY WS084566 10/20/10 10/20/11ES Eaoccvrence $100,000 CLAIMS MADE a OCCUR P(Any one person) S5,000 NAL 8 ADV INJURY $1,000,000 AL AGGREGATE s2,000,000 GEN'LAGGREGATELIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 POLICYX JER LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000 C ANY AUTO BDBRJM 10/20/10 10/20/11 (Ea accident) ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Par person) $ X HIRED AUTOS BODILY INJURY S X NON-OWNED AUTOS (Peraccident) PROPERTY DAMAGE S (Per accident) GARAGGARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ E AUTO ONLY: AGG 1$ EXCESSIUMBRELLALUWILITY EACH OCCURRENCE S 5000000 B X OCCUR 0 CLAIMS MADE 40342AI00ALI 11/23/10 10/21/11 AGGREGATE $5000000 S DEDUCTIBLE S NX RETENTION so S WORKERS COMPENSATION AND TORY-UM S ER EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ If yes,desalbe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT 1$ OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. R RES: tA / ACORD 25(2001108) v ©ACORD CORPORATION 1988 Restricted to: 00 00- Unrestricted 1G-1 2 Family!homes Massachusetts- Department of Public Safety Board of Building Regulations and Standards : Construction Supervisor License Failure to possess a current edition of the License: CS 80145 Massachusetts State Building Code z x is cause for revocation of this license. Restricted00 ,,:; WASILIi413ES "'' ' " Refer to: WWW.Mass.Gov/DPS GEORGE.- 5 EORGE 5 PITCAIFMf, " IPSWICH, ,'ice' •`::j C� Expiration: 10!26/2011 Commissioner Tr#: 6238 Office of Consumer Affair and Business Regulation 10 Park Plaza - Suite 5170 M Boston, F ssachusetts 02116 Home Improve .' ontractor Registration Registration: 167567 ' Type: Supplement Card Expiration: 10/4/2012 TURNPIKE GENERAL CONTRA' GEORGE VASILIADES 239 BOSTON STREET BOX 365 v - w TOPSFIELD, MA 01983 4 _ fr1 � Update Address and return card.Mark reason for change. ]PS-CA1 0 50M-04(04-G101216 0 Address E] Renewal E] Employment ❑ Lost Card 7/. �ammaa uvea a� aoaacfuiaelld _ Office of Consumer Affairs&Business Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: : �a Office of Consumer Affairs and Business Regulation Reg!stration lj E� 567 Type: 10 Park Plaza-Suite 5170 Expiraa3y:=``: 432012, Supplement Card Boston,MA 02116 TURNPIKE GEN1=,E2#.i 501?ft&ING INC. b _ = GEORGE VASILt�S�S 239 BOSTON ST -E7� — _ TOPSFIELD,MA 019$ 5 Undersecretary Not valid without signature