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HomeMy WebLinkAboutBuilding Permit #006-2011 - 28 JERAD PLACE 6/30/2016 L U� �10RTh 9 III 4W BUILDING PERMIT TOWN OF NORTH ANDOVER o APPLICATION FOR PLAN EXAMINATION Permit No#: - I Date Received A�R1TE0 a gSSAC Date Issued: wo—RTANT: Applicant must complete all items on this page LOCATION Print PROPERTY OWNER1!�Vld Print 100 Year Structure yes Dno MAP PARCEL: ZONING DISTRICT: Historic District yes Machine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑ Addition ❑Two or more family ❑ Industrial Iteration No. of units: ❑ Commercial ❑ R air, replacement ❑Assessory Bldg ❑ Others: P'Demolition ❑ Other ❑ Septic El Well ❑ Floodplain ❑Wetlands ❑ Watershed District 0 Water/Sewer -- DESCRIPTION OF WORK TO BE PERFORMED: D Identifi ac tion- Please Type or Print Clearly OWNER: Name: r�sv 1161 �� R� o�� Phone: Address: Contractor Name: X/z,? �� ��w Phone: dc)3 -BS'S�- O 3S/ Email Address 2 v✓1� 5��/ k �� �S �e� a3� �7 Supervisor's Construction License: D 7C `fG� Exp. Date: Home Improvement License. /-S j.9Exp. Date: f �1�l / ARCHITECT/ENGINEER �vi7�i�� �/ i//�� �i Phone: 1U Address: Reg. No. FEE SCHEDULE:BULDING PERMIT.$12.00 PER$1000.00qwTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ —FEE: $ Check No.: M,4\ Receipt No.: �1 NOTE: Persons contracting with u registered contractors do not have access to t e guaranty fund 4mfiirp of CQ r 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 ;rt Floor Plan Or Proposed Interior Work Engineering Affidavits for Engineered products OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks Building Permit Application ,rF 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 ,rF Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) .rr Copy of Contract 2012 I ECC 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 Doe:Building Permit Revised 2014 1 i D mensson 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) kct'i e- ® Notified for pickup Call Email Date Time Contact Name Doc.Building Permit Revised 2014 Plans Submitted ❑ 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 ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments r E .Conservation Decision: Comments t- Water & Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE-btPAR,TMENT - Ternp+®umpster on-site ,yes Locatedlat•124,Main3ftbet Fire.Department:sigpature/date COMMENTS -v F Town of North Andover 3ayment Date Thursday,June 30,2016 )eposit Number 1606301 )perator Counter pc 1 ACR(BUILDING INSPECTION) $288.00 0 'otal Paid $288.00 :ash $268.00 :hangs $0.00 c teceipt Number gov00004813 a 0012016 PM :ashler Id. treascoll-17 Location 2 b v e,g A A No. bap Date Co `�� 1 • - TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $Q Ye Foundation Permit Fee $ _ , Other Permit Fee $ ` TOTAL $ + Check# f ' Building Inspectort' y / i Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost 24,000.00 m $ - $ 288.00 Plumbing Fee $ 36.00 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 36.00 Total fees collected $ 460.00 28 jerad Place 006-2017 on 6/30/2016 ceiling demo to kitchen and family room NORTF{ Town of : Andover o - 0 leo• - 61 h ver, Mass1�� o > A- Co[NICM.WICK 1• 7�A°R�TED All N1_s Lj BOARD OF HEALTH Food/Kitchen PER IT LD Septic System THIS CERTIFIES THAT BUILDING INSPECTOR ............... ......... ......... .. .. has permission to ere .... �. . .. buildings on ..,z.% ....... cr.,.,,... .... .,., Ace. Foundation 1Rough to be occupied as .......lc.�. ® � le'44" t l , o 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 lothe I spe on Alteration and Construction of Buildings in the Town of North Andover. � PLUMBING INSPECTOR 1 VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTIO TRT Rough Service ... . , ..-......... ....................... BUILD G INSPECTOR Final GAS INSPECTOR Occupancy Permit Required to Occupy Occupancy Permit Required to Occupy Building Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. Goldman Contract 5/8/16 28 Jerad Place Summer 2016 Parties Aaron M.Scarpello Home Improvements, LLC the"Contractor" Full Identification,The TAX ID of principal is 20-3306885 Contractor address: 2 Magnolia Ave Salem NH,03079 The Contractor's Massachusetts HIC registration number is 153859 The Contractor's Massachusetts Construction Supervisor's number is CSFA-096462 The Contractor hereby proposes to perform the work described below for: Jared Goldman, homeowner, 28 Jerad Place North Andover,Massachusetts. 1. This preliminary contract for the Summer 2016 project at 28 Jerad Place North Andover, Massachusetts., consisting of the following: Jared Goldman wishes to Aaron M. Scarpello Home Improvements LLC. to perform some if not all of the changes to the Home located at 28 Jerad Place, North Andover, MA, listed below: o Install 130 sf new red oak flooring leading into the living room • Permitting $300.00 • Prep o Construction of 4 temporary walls to support second floor and roof rafters above, while beam/header installation is completed $330.00 o Removal of ceiling light fixtures/smoke detectors etc. $50.00 • Disposal o Estimated 3 trailer loads(24 yards) $700.00 • Demolition o Removal of existing wallboard and plaster in the living room ceilings and kitchen ceilings areas o Cleaning framing off old screws/nails o Removal of small remaining areas of wall board on the walls needed for clean install of patio door and beam as well as area started to be tom down by the homeowner. o Removal of framing between the kitchen and living room areas o Removal of closet framing o Removal of wall framing, HVAC ducts, wiring trim etc. between kitchen area and Drop down living room. o Removal of load bearing wall framing, HVAC ducts, wiring trim etc. to extend kitchen area o Removal of beam and joist above load bearing wall o Removal of tile floor and luan subfloor o Removal of load bearing wall and doorway out to deck creating space to frame in new doorway. $2000.00 • HVAC o HVAC tech move 2 ducts and rework return in kitchen area to fit under cabinets toe kicks $2000.00 1Page i • Central Vacuum o Re-routing of central vacuum pipes and wires Staring at$300.00 • Electrical/wiring needed to move walls and add doorway $700.00 • Walls beam installation o Installation of four 11-7/8"x14' LVL's as shown in the plans drawn by Manzi Engineering $600.00 0 1 double 2 x12"header to be installed to support over the new patio door $400.00 • Enclose doorway from kitchen to dining room $100.00 • Patio Door installation o Install patio door(door not included) o Re-insulate wall o Repair exterior siding and trim o Repair interior trim ■ $1800.00 • Hardwood flooring installation, staining and refinishing o Install 155 sf new red oak flooring leading into the living room $1250.00 o Install 110 sf new red oak flooring upstairs hallway $900.00 o Staining $700.00 o Sanding and 2 coats polyurethane to all first floor hardwood $2200.0 o Sanding and 2 coats polyurethane upstairs hall and front stairs $500.00 • Blue-board and plaster work(smooth finish) o '/z"blue board with plaster skim coat ■ Cover the living room ceiling approximately 400sf ■ Cover the kitchen ceiling approximately 554sf • Patching as needed to wall areas that were disturbed during demolition (estimated 150sf-200sf) $3500.00 Electrical upgrades o $210.00/recessed light o $150.00/under cabinet light 'V9N o $150.00 each pendant light(fixture not included) o $100.00 per receptacle(not dedicated) o $200.00/dedicated circuit if needed for new kitchen appliances \ o $100.00/new switch o Additional electrical work @$85.00/hr. • Sound system upgrades o Will be on a separate estimate • Plumbing in kitchen o Re-rout washer feeds to make way for beam o Re-size gas line for larger stove o Rework sink waterlines and drains for center island o Water feeds for refrigerator o Dishwasher hookup $3200.00 • Kitchen cabinet installation (estimated 3 days labor for 3 men) ............. _..._. . ._........ . .... ..... _....._. ._.._.. .... ....... _.... ......... 2Page $2500.00 • Vent hood installation (recirculate) $300.00 • Any additional carpentry work, not mentioned above(Lead)$60.00/hr. • Any additional carpentry work, not mentioned above(Helpers)$30.00/hr. o Examples:crown molding, baseboard moldings,window and door trim not mentioned above Estimated Total Price$24,000.00 before electrical and sound upgrades 2. Payment Schedule $1500.00 down payment needed no later than 5/17/16 $5000.00 due at start of work $5000.00 due upon completion of rough inspections $5000.00 after blue board and plaster $5000.00 after hardwood flooring installation Remainder upon completion of estimated work listed above Any additional work will be requested in writing and paid for within 2 days of completion. If materials for extra work surpass$500.00, a partial payment will be required,to cover material costs, prior to start of work. Finish Materials approx. $(This amount is subject to change based on actual choices of finished materials made by the homeowner) 100%due at time of order(finished materials will be ordered and purchased at various times during the duration of the job) Some finished materials may not be able to be returned or cancelled once the order is placed and some may be subject to a 20%restocking fee. These charges will be the responsibility of the homeowner if it is the homeowner requests the exchange or return. 3.This remodel is scheduled to begin 6/24/16,and be completed by 8/24/16 4.The Contractor agrees to provide and pay for all materials,tools and equipment required for the prosecution and timely completion of the work.Unless otherwise specified All materials shall be new and of good quality. There is a one year warranty on materials and craftsmanship.if manufactures warranty does not apply_ w, 5.In the prosecution of the work,the Contractor shall employ a sufficient number of workers skilled in their trades to suitably perform the work. 6.All changes and deviations in the work ordered by the Owner should be presented to the Contractor, by the homeowner in writing,the contract sum being increased or decreased accordingly by the Contractor. 7.The Owner,Owner's representative and public authorities shall at all times have access to the work. 8. Construction and Jobsite Details: Existing lawn&driveway may suffer some damage due to construction trucking;every attempt is made to minimize the damage,however the homeowner shall not hold the contractors liable for the extra cost if damage situations appear. Any unforeseen discoveries that may affect the construction costs are they responsibilities of the homeowner.For example:asbestos,mold, ledge,high water table etc. 3Pa e 9. In the event the Contractor is delayed in the prosecution of the work God,fire,flood or any other unavoidable casualties;or by labor strikes, materials;or by neglect of the Owner;the time for completion of the of for the same period as the dela o e e+to Y ccasioned by any of the aforemen' �extended 10.The Contractor agrees to obtain insurance to protect himself,his �s against claims for property damage, bodily injury or death due to his agreement. and subcontractors performance of this 11.This agreement shall be interpreted under laws of the State of Massachusetts. 12.Attorney's fees and court costs shall be paid by the defendant in the event that judgment must be,and is,obtained to enforce this agreement or any breach thereof. J g 13. Insurance: Liability Insurance certificate available upon request. 14. NOTICE to Homeowner:All contractors bthss registered and display registration number. You have the the Home ImprovementGoRfrBCfo(R �S and homeowners rights under the Regulation the eavent of a dispute, 42A o ds��.T� right to request non-binding arbitration. Ives you certain warranties the NOTICE:DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANKSPACES. r the or have the IN WITNESS WHEREOF,the parties hereto set their hands and seal Year written above. s the day and 3 O ER'S NAME OW E 'S SIGN TURE DATE O R'S N E 'S SIGNATURE *ATE f OWNERS ADDRESS g Aaron Scarpello CONTRACTOR'S NAM 2 Ma4nolla Ave Salem NH 03079 CONTRACTOR— ' SIGNATURE CONTRACTOR'S ADDRESS DATE ' r ........... ..........._. flPage - (E)2x10 I�"MIN. BETWEEN Ip n+ LVL'5 i d I3" MIN. w NAILS/5GREW5® L�,, _ 3 a OPP051TE SIDE W (E)LVL BEAM i OF COLUMN Va"mxb' L 5D5 (SEE PLAN) I MIN. 93-2xb LAMINATIONS WITH TWO 5GREW5 ADD 5GREW5 AS ROW OF STAGGERED 30d DEPTH 1118 8 LESS-2 ROWS® Ib"O.G. REG'D TO MATCH COMMON WIRE NAILS.(D=0.20?", DEPTH 14"-18" -3 ROW5® 16"O.G. S " "TYPICAL BUILT-UP L=4V2")OR SIMPSON 5D5 Lx 117" P05T DETAIL" TH15 4V2" STRONG DRIVE 5GREW5 i wl—lye IJ 1!-!?"MINIMUM EDGE DISTANCE. 1 SHEET 2)3" MINIMUM FASTENER SPACING IN A ROW. 1 3.)5TA66ER 5GREW5 ON OPPOSITE FACES. t TYPICAL NAILING SCHEDULES FOR TYPICAL SIMPSON"SDS" 3 SECTION n BUILT-UP MULTI 2x6 POST DETAIL DETAIL FOR MUTIPLE LVL'S ? 34,=V-0" S2 = F C NEW TORI VERSALAM POST OR 5-2.65 BELOW EACH END (BLOCK SOLID DO TO FOUNDATION tyi L C L x14�.n. � � • o A CUT JOISTS AS REOT7 S3 t ADD NEW SIPP90N cL�Nr e 'W5210'JOIST ra a: HANGERS(TYPICAL) E%15TING KITONEN AREA FIREPLACE %�q LN' t C ' z . LIVING ROOM �S TTS k Sw W DRAR'� Partial Second Floor Framing Plan , I L� (V Cj SHEET.: 1/4H=1'-0" 0 2' 4' 8' ��J DMWI/N 1 A §2 2� § \ � � § � ; 7 � � 0 o . d o k| ` o \) p � � |� E22----- - 2 § 2( |t & ®- ~gip \ J M".1 R #32341 - il � , . �A PWII JARED FLAGE . / §h ee��ka� __�__ , _,_�_.�c : The Commonwealth of Massachusetts . f Department of Industrial Accidents 1 Congress Street,Suite 100 Boston,MA 02114-2017 www mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Ledb Name(Business/Organization/Individua1): f ez v) Address: 69, y r cg ylc)/'1 61 City/State/Zip: -y) IPV AQ)3y/moi Phone Are you an employer?Check&e appiopriaie box: Type of project(required): 1.❑I am a mployer with employees(full and/or part-time).* 7. ElNew construction 2. am a sole proprietor or partnership and have no employees working for me in $, emodeling any capacity.[No workers'comp.insurance required.] 9. [demolition 3.❑I am a homeowner doing all work myself[No workers'comp.1-tsurance required.]t 10 F1 Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5. I am a general contractor and I have hired the sub-contractors listed on the attached sheet. ❑ • 13.�Roof repairs These sub-contractors have employees and have workers'comp.insurance.$ 6.FJ we are a corporation and its officers have exercised their right of exemption per MGL c. 14.FJ Other 152,§1(4),and we have no,errap1' s.[No workers'comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. i Homeowners who submit#his 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 state whether or not those entities have employees. If the sub-con6cEors have employees,'tkicy must provide their workers'comp.policy number. Iain an employer that is providing workers'compensation insurance for my employees'Below is the policy acid job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: // Expiration Date: / Job Site Address: 2 l C City/State/Zip: /►,� o/�1✓� �/� Attach a copy of the workers' compensation olicy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by 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.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 tlz ains andpenalties ofperjury that the information provided above is true and correct. Si a re: Date: 6, / C� Phone#: Official use only. Do not write in this area,to be completed by city or town offzciaL. City or Town: PermitMcense# 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 commonryealth 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-contractors)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 pen-nit/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 burn leaves etc.)said person is NOT required to complete this affidavit. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston,MA 02114-2017 Tel. #617-727-4900 ext. 7406 or 1-877-MASSAFE Fax#617-727-7749 Revised 02-23-15 www.mass.gov/dia 06-29-'16 12:02 FROM- 9785572130 T-846 P0001/0002 F-832 �oRv CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDlYYYY) 06/29/2016 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 term$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 endorsemen s). PRODUCER CONT Mark S.Rowe,CIC Michaud,Rowe And Ruseak Ins. PHONE 978 6888829 A/C Nc;978 557 2130 P.O_Box 188 ac No E]R North Andover, MA 01845 ADDRESS: Mark S.Rowe,CIC INSURER(S) AFFORDING COVERAGE MAIC# INSURERA:Essex Insurance Company 39020 INSURED Aaron Scarpello Home Imp,LLC INSURER 13: 2 Magnolia Ave. INSURERC: Salem,NH 03079 -INSURERD: 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, EXCLUSIQNS.AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE POLICY NUMBER MWDDfYEY MFF M/�EXP LIMITS . A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE _ $ 1,000,00 CLAIMS=MADE[K OCCUR EC8512 12/10!2015 12/10/2016 PREMISES Ea occurrence S 100,00 ,MED EXP ft ons 2=n) S ".5,00 PERSONAL&ADV INJURY S 1,Ob0,OO GEN'L.AGGREGATE OMIT APPLIES PER: GENERAL AGGREGATE••. .• S ..... 2,000,00 PRO• 1 000 00 MP7 P X POuOY T LOC PRODUCTS CO O AGG .5 > > JEC OTHER; $ AUTOMOBILE LIABILITY COMBINED'$NG LIMI $ e accident ANYAUTO ' BODILY INJURY(Per persw) S ALL OWNED SCHEDULED BODILY INJURY(Per accfdent) S AUTOS AUTOS NON-OWNED OP G $ HIRED AUTOS AUTOS Perxceident $ UMBRELLALVU3 OCCUR EACH OCCURRENCE $ EXC�°S LIB CLAIM&MADE AGGREGATE S DED RETENTION $ WORKERS COMPENSATION X I ST TUTE OR H AND EMPLOYERS'LIABILITY B ANY PROPRiMRMARTNFR/EXECUTIVE YIN NSA --WCCERT.TOCOME E.L.EACH ACCIDENT 5 OFFIMNMGmBER.EXCLUDED9 El (Mandatory in NH) DIRECTLY FROM IN$CARRIER -E:L.DISEASE-EA EMPLOYEE 5 Ifes.•deaeribe-under. . DESCRIPTION OF OPERATIONS below E.L.DISEASE-'POLICY LIMIT' S ' DESCRIPTION OF OPERATIONS/LOCATIO1145/VEHICLES(ACOW 101,Additional RemarUs Scnedulo,may be anacned If more apace Is required) Interior carpentry and residential remodeling RE:'Goldman 28 Jerad Place North Andover, MA 01845 CERTIFICATE HOLDER CANCELLATION NORTH13 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. Building Dept. . .. ..1.600 Osgood street AUTHORIZED REPRESENTATIVE ... .. .. .. . ...... .... ... ....... . ...... Bldg 20,Suite 2035 North Andover,MA 01845 21� ®1988-2014 ACORD CORPORATION, All ri'gh'ts_reserV'ed.' ACORD 25.(2014101). The ACORD name and logo are registered marks of ACORD 06-29-'16 12:02 FROM- 9785572130 T-846 P0002/0002 F-832 AEt � V CERTIFICATE OF LIABILITY INSURANCE DAT06622D/ /299/201166 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). ONTACT PRODUCER NAME: Krista McMahon MICHAUD, ROWS AND RUSCAK INSURANCE ASSOCIATES,INC. PHONE 978)68&8829 FAA/XC NO); ao" E-MAIL kmcmahon mrrnsurance_COm P-O-BOX 188 INSURERS AFFORDING COVERAGE NAIC 0 NORTH ANDOVER MA 01845 INSURERA: LIBERTY MUTUAL FIRE INS CO 23035 INSURED INSURER B AARON SCARPELLO HOME IMP LLC INSURER C: INSURER D: 2 MAGNOLIA AVE INSURER E SALEM NH 03079 INSURERF: COVERAGES • CERTIFICATE NUMBER: 65542 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED'BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. N R AOOL UeR POLICY EFF POUCY EXP R TYPE OF INSURANCE INSD WVD POLICYNUMBER MM/DD MIDI) Amis COMMERCIAL GENERAL UABILMY EACHOCCURRENCE $ CLAIMS•MADE OCCUR PREMISE (Ea cac nc ) MED EXP(Arty ona person) $ N/A P£RSONALSADV INJURY $ GEN'L AGGREGATE UMITAPPLIES PER •GENERAL AGGREGATE.• $•• - POLICY a JECT LOC -PRODUCTS-COMP/OPAGG, $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT(Ea igcdderid $' ANY AUTO' BODILY INJURY(Per:pereen) $ ALL awNEO SCHEDULED N/A BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED E G $ HIRED'AUTOSAUTOS Peraccident UMBRELLAUAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE. N/A - AGGREGATE ..... .. .._. ..... $ DED RETENTION S $ WORKERS COMPENSATION X AND EMPLOYERS'UAINUry STATUTE ER ANYPROPRIETOR/PARTNER/EXECUnVE YIN N E.L.EACH ACCIDENT $ 100,000 A OFFICERIMEMB€REXCLUDED7, NIA N/A. NIA WC231S380493026. 04/192016 04/19/2017• (Mandatory In NH) E-L-.DI$EASE.EA EMPLQYEE $ 100,000 .. tfyes;des6fbe under.... ... .. ... . DESCRIPTION OF OPERATIONS below E.L.,DISEA85-POLICY LIMIT $. 500400 N/A DESCRIPTION OF OPERATIONS I LOCATIONS/.VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached If more space Is required) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 5,no authorization is given to pay Claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force On the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status Of this Coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at Www.iilass.gov4Wd/4u6rkers-compensation/inves6gations/. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELNSRED .IN TOWCI Of NOffh AndoverACCORDANCE WITH THE POLICY PROVISIONS: Building Dept.Building 20 Suite 2085.. AUTNORIZEDAEPRESENTATtVE _ .,. .. ._:... .....: ..._...,...:...... ...... .,., North Andover MA 01845 Daniel Nt:Cr y,CPCU,Vice President—Residual Market—WCRI6MA ©1988-2014'ACORD CORPORATION.'All'rig h'ts-.reserved: ACORD 25'(2014101) The ACORD name and logo are registered marks of ACORD t Massachusetts -'Department of Public Safe• Board of Buildin 9 Rcg ,r at,ons and Standards Comtrurtirrn Supen icor 1 S 2 F'amih l License:.CSFA-096462 AARON M SCARpELLO 2 MAG NOLIA AVENUE SALEM NH 03079 fI Commissioner Expiration t• 07/07/20.6 r Massachusetts_ rd of Department of public Building Regitlatians Safety ConsiruCho"Superv- 1 a i dards an„Stan licehse:CSF Fath. AARO M S ``A-096462 N AGN LIAR - ,� � A MNg 03 ✓ s• ,l-ia IA t� Convnissioner 'E�xpiratien 07/07/2016 02 eOfIl of Const '*7 Ir.irs, WOMEiMPROV &$uessR` Regisr -,�1 ME"�NT NTRACTOR gala fion jV0,v',, Expiration; S`_ 53$'5 - C1#18% 2017 �Y'AeSCgR "~'- OBA 11ILQ HOj , ; i . MOVEMENT i 'SON SCARP x �MAGNOLIq AVE_�_�l --:_'?'rte•_ . . LENT,MA p Undcretar ' I