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Home My WebLink AboutBuilding Permit #431 - 296 BERRY STREET 11/21/2011 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued — — 1 IMPORTANT:Applicant must complete all items on this page LOCATION C� -B crr rint PROPERTY OWNER Cl-ny {1 Unit# Print MAP NO: Z I o PARCEL: iD$ ZONING DISTRICT: Historic District yes n Machine Shop Village yes no 100 year-old structure yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building K'One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other i �'S,eptics Welly q,Floodplaml D;Wetlands + n.WatershediDistrict, 0 Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: -I 1 VJ OA(-( res h 1 �_ moi -� (Identification Please Type or Print Clearly) OWNER: Name: �s Y-er�i 0-,, V v' (J hsn, Phone: q 7 76 6 - U 6� Address: 2- q (,, JV�tet 1` oyAl- Ayady f .A4 A d JYJ- CONTRACTOR Name: 0 L' Ua Phone: q7 - (o 3.3 a Q Address: "6 SuHzna, SV I UJ 2-n qA wqr Supervisor's Construction License: Ot q 135?) Exp. Date: —1 (o -JW L-3 Home Improvement License: 0 Ll S &C) Exp. Date: �— ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ �Go. 0 b FEE: $ /U 2 Check No.: 13�Z Receipt No.: aw—g� NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund ;SignatueofA . inafrof croritractor Location S� No. LA — Date, "ORT" TOWN OF NORTH ANDOVER F s A }�oCertificate of Occupancy $ SJACMuSEt Building/Frame Permit Fee $ Foundation Permit Fee $ E , Other Permit Fee $ TOTAL $ Check # � 24663 Building Inspector 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 i DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS i I Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Wetter & 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 signature/date COMMENTS Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: I, 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 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 o Building Permit Application ❑ Workers Comp Affidavit o Photo Copy of H.I.C. And/Or C.S.L. Licenses o Copy of Contract ❑ Floor Plan Or Proposed Interior Work o Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition or Decks Li Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract o Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And p p Hydraulic Calculations (If Applicable) o Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered neared roducts NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) o Building Permit Application ❑ Certified Proposed Plot Plan o Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit o Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract o 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 2008mi NORT►� 0" 0f ndover No. o o , dover, Mass.,LAKE • COCHICHEWICK ADRATED 7`S BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR �i THISCERTIFIES THAT................ ... ......K ........................... .................0 ............................................. Foundation has permission to erect... ... buildings on ....eg6.............��1 •� .......... Chimney I... Rough to be occupied as.............. �!!�! �- — c h' e . L . ...... ...... ...................................... ................................... _ provided that the person accepti this permit shall in every respe conform to the terms of the application on 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 Z PERMIT EXPIRES IN6 ONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUC TARTS 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. E I F SEE REVERSE SIDE Smoke Det. NORT1-o ovm of 3 0%_ o , dover, Mass., 0LAKE COC MICKE WICK V TED P'? Ci ST BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT............................................................................................................................................................... Foundation has permission to erect........................................ buildings on .............................................................................................. Rough t0 be Occupied as .... Chimney ...............................................................................................:.................................................................... provided that the person accepting this permit shall in every respect conform to the terms of the application on 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 PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION STARTS Rough Service BUILDING INSPECTOR Final Occupancy Permit Required to Ocmpy 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. .L.\`.�'l. �;v-•r;t.J- �` �IG�( s cy1.:.—a K r lit UY'Y, G y -f 1J �`7('_ 1 DAVID CASTRICONE CASTRICONE ROOFING& SIDING INC. w- ROOFING,SIDING&REMODELING REPLACEMENT WINDOWS F,Sat HOME IMPROVEMENT CONTRACTOR REGISTRATION NUMBER 104569 200 SUTTON STREET,SUITE 226,NO.ANDOVER,MA 01845 In North Andover 978-683-3420 In Boxford 978-887 6147 In IlaverhMI 978-374-7314 Uwe the owner(s)of the premises mentioned below,hereby contract with and authorize you as contractor,to furnish all necessary materials,labor and workmanship,to install,construct and place the improvements according to the following specifications,terms and conditions,on premises below d7 ribed: t� Owner's Name........ ./`t'4LL LLtYtJ.....,., ,Ll .... /:�...................................Te hone#.. `�'.... .....�r Job Address.....> l..lcr..... 1 l�l`. ......",2.i:........................City...M21.../...1.11„r�'.0 41.4.............State... ........ Specifications: !Strip existing shinglesko ✓ripply new drip edge to all edges. ltp�y!jl �'" ...................................................................................................................................................................................................................... Apply _feet ice and water shield membrane to bottom edges of house. 3 feet ice and water shield membrane in valleys and bottom edges of any unheated areas of house. .............................................................................................................................................................................. .T........................... ✓apply felt p er underlayment. -Install ridge vent to ' -1 %_1 C r--ti t >G�X r............................. !..c..........�.............. ....................... ,Reroof`using ./ ! shingles with a ,gh year warranty. ................................................................................................................................................................................................ -Counterflash chimney. -New vent pipe flashing. -t;cgal disposal of all debris. '................................ . .... .:.. ................................ e61Vvvwx e,nna—aaa��✓✓✓S Area(s)to be worked on: I �.. .tj...... .Z: .... 1`4�ds ..... .. ....Y��Lb.i.:�:.rn.......... /� k',!. i......... ..c ,~:. .J..f1.C4:k.....C'k°r...... ........ ................6•rr�u•5 ............................. ... ... .. ... r.'.o� ...:a .5.....w,. 1ao 4� �.o . `�................�.8 ApLD ..... ..........�,.........../sheet Cot`- �e 6e) �............ .Roof board r6placement if nEcessary @ �[? /sheet o `1/foot. .................. Two Year Workmanship Warranty(Not Transferable) Manufacturer's Warranty asspeciThe contractor agrees perform the work aandd furnish the materials specified above for the SUM ...... Uayable......./.?................on-i51'.K ,.Zr............. Payable........—................on..........=................. alance payable on completion of job Owner or Owners are no(responsible for Property Damage or Liability whi a job is m operation. Contractor is not responsible for any damage to the interior of property,including pre-existing conditions(i.e.water stains,crumbling plaster,exposed nails)or conditions resulting from application of materials specified above (i.e.objects coming loose from walls,crumbling plaster,exposed nails,dust in attic or other living spaces).Items in attic may need to be covered by homeowner.All materials are property of contractor. Any dumpster placed by contractor is for his use only.Upon completion of above work,all undersigned agree to execute and deliver to contractor,their joint note in accordance with his(their)above obligation as requested by contractor. Upon refusal to do so,contractor may at its option declare the entire contract price or so much as then remains unpaid,immediately due and payable. It is agreed that,if permitted by law,contractor shall be paid by the owner(s)all reasonable costs,attorney fees and expenses,in addition to the amount due and unpaid,that shall be incurred in enforcing the terms and conditions of the contract and/or any lien in connection herewith.It is further agreed that this contract may be assigned by contractor,and also that the obligations hereof shall bind and apply to their heirs,successors or estates of the panics.The undersigned wanant(s)that he is(they are) the owners(s)of the above mentioned premises and that legal title thereto stands of record in his(their)names(s).There are no representations,guaranties or warranties,except such as may be herein incorporated,if any,nor any agreements collateral hereto,nor is the contract dependent upon or subject to any conditions not herein stated.Any subsequent agreement in reference hereto shall be binding only if in writing and signed by all parties. All Home Improvement Contractors shall be registered and any inquiries about a contractor or subcontractor relating to a registration should be directed to:Director,Home Improvement Contractor Registration, One Ashburton Place, Room 1301,Boston,MA 02108 Tel:617-727-8598 Any and all necessary construction-related permits shall be obtained by the Contractor, Any Owner who secures his own construction- related permit or deals with unregistered contractors is excluded from the Guaranty Fund provisions of MGL c. 142A. Approximate starting date of work................................................ Completion date......................................................... Receipt of a copy of this contact is hereby acknowledged,and it is further acknowledged by the undersigned that the foregoing provisions have been read and the contents thereof understood and that no representation or agreement not herein contained shall be binding upon the parties and that all of the agreements and understandings of said parties are contained herein. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES Owner has three business days to cancel this contract and incur no penalty (see notice .ffancellation), IN WITNESS $f2EOF,the parties have rherejiTct their names this..../� kday of...W;,1.V........,20..).,.. Accepted: �f�V13 / Signed A4__ .Wv�� .................... ........................... Owner ISigned............................................................................. Owner . CIz1t'. ... David Castricone,President i Town of North Andover NnkrN 01 16,0 Building Department o 27 Charles Street '' A North Andover, Massachusetts 01845 (978) 688-9545 Fax (978) 688-9542 °� ° �.:,w.• 'SA DEBRIS DISPOSAL FORM In accordance with the provisions of MGL c 40 s 54, and a condition of Building permit # the debris resulting from the work sliall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c11, s150a.. The debris will be disposed of in/at: � Z' l is ems► /�� Facility location Signature of Applicant Date NOTE: A demolition permit from the Town of North Andover must be obtained for this project tluough the Office of the Building Inspector, I The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 kv www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): /qST�/ nfF ()FrlSlG Sib//GtT ��C Address: :,2 C L acs 7-7'bZ2-(- City/State/Zip: L(City/State/Zip: No, A/VboVe K . MA Lir eVf Phone #: 971 6�3 Are you an employer? Check the appropriate box: Type of project(required): G 4. I am a general contractor and I 1.IR I am a employer with D ❑ 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g. ❑Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers coin . insurance.$comp.insurance p required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.E] Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12XRoof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other comp. insurance required.] *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 state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:dq 66 9 n S — Policy#or Self-ins. Lic.#: W Cy QJ 2 fl 2 2 01.3 Expiration Date: 'Z-a3-1,4 Ap (( Jati Site Address: Ci /State/Zip: . �7A (1 1 yr Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of 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 and penalties of perjury that the information provided above is true and correct Signature .�� C Date: Phone# 7 4 k-3 .3 CI C-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#: Massachusetts - Uep.af-tMent of Public SaFet% Board of Building Re�gulationv and 5tund.ud Construction Supervisor Specialty License License: CS SL 99358 Restricted to: RF,WS DAVID CASTRICONE 31 COURT STREET NORTH ANDOVER, MA 01845 Expiration: 12/16/2013 ' ('�uuuissiuner Tr#: 7924 ,.;�.. U�17e "CCcLntnurnuw.ct�� c/�.•'GGUJducfudeC(d -------- Office 01'C011sumer.•lffairs& Business Regulation yHOME IMPROVEMENT CONTRACTOR Registration: 104569 Type: . Expiration: 7!14/2012 / Private Cor oratio DA ID CASTRICONE ROOFING, SIDING& David Castricone 200 SUTTON ST SUITE 226 _ NORTH ANDOVER, MA 01845 Underseeretary 4' 0 DATE(MMIDDIYYYY) ACoRO CERTIFICATE OF LIABILITY INSURANCE 9/23/2011 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 •T,1Ir AA A/.AAIIAr1► •\II►Tllr A//�TIr1I�\Tr, AI 11rl� IMPORTANT: H the certificate holder Is an ADDITIONAL INSURED,the pollcy(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). NT CT PRODUCER NAME: Eastern Insurance Group LLC - Main PHONE _ _ F7700 A No: - - 233 West Central Street MAIL Natick MA 01760 ADDR S : INSURERS AFFORDING COVERAGE NAIC 0 d [-NSURERA:Cormerce insurance ComIzany 34754 INSURED 31 969 INSURER B David Castricone Roofing & Siding Inc INSURER C: 200 Sutton Street #226 INSURER D: North Andover MA 01845 INSURER E INSURER F COVERAGES CERTIFICATE NUMBER:2141633407 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. INSR imb" "Vu GENERAL LIABIUTY EACHOCCURRENCE M $ R TE COMMERCIAL GENERAL LIABILITY PREMISES a oc rrence $ CLAIMS-MADE E OCCUR MED EXP(Any one, arson) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY 7 PRO- LOC $ A AUTOMOBILE LIABILITY BCNGCV /1/2011 /1/2012 LXW Ea aockien i 1000000 ANY AUTO BODILY INJURY(Per person) $20000 ALL UTOS AUTOS OX SCHEDULED AUTOSBODILY INJURY(Peraccidant) $40000 NON-OWNED PROPERTY DAMAGE X HIREDAUTOS X AUTOS Peraocklent $ UMBRELLA UAB F0CCUp EACH OCCURRENCE $ EXCESS UAS CLAIMS-MADE AGGREGATE $ DED I I RETENTION $ g WORKERS COMPENSATION WC003999723 9/23/2011 9/23/2012 X WCSTATU- OTH- AND EMPLOYERS'LIABILITY Y/N — ANY PROPRIETOPWARTNER/EXECUTIVE r E.L.EACH ACCIDENT $100000 OFFICERIMEMBEREXCLUDED? N/A (Mandatory in NH) E-L.DISEASE-EA EMPLOYE $100000 11 Ires,describe under _ DESCRIPTIONOFOPERATIONSbelow E.L.DISEASE-POLICY LIMIT $.500000 I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,It more spaoe Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE Castricone Roofing & Siding THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Suite 226 ACCORDANCE WITH THE POLICY PROVISIONS. 200 Sutton Street AUTHORIZED REPRESENTATIVE ..North Andover, MA 01845 �_�.� ®1988.2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD ''� CERTIFICATE OF LIABILITY INSURANCE DrVDO/YYYY7 9//9/29/2011 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 DOER 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 pollcy(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 dose not confer rights to the certificate holder in lieu of such endorssmen a. PRODUCER CONTACT Willows Insurance Agcy _ 97B 475 3414 PAX .(NN.o 51 Coehichewik Dr E-Se.. ..Eictl�MNL ---"" PRYCERCU%OMFA 10 N. - �_. North Andover MA 01845 INUMER(S)AFFORDING COVERAGE NAIL NAI _ - 0 INSURED INBURERA:Maiden Specialty Ins Co DAVID CASTRICONE ROOFING & BIDING INC e_.. _..._._._._ 200 Sutton St Suite 226 INSURER 0; — - - INSURER E: NORTH ANDOVER MA 01845 _......_ . . INSURER F COVERAGES CERTIFICATE NUMBER:CL1199062$5 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. i�iR TYPE OF INSURANCE -- - bL bUsp aa WVD POLICY NUVeER ��EPF MPOLICY --- LNdRa _.—._. OENERAL LIAa1LIT1 EACH OCCURRENCE S 100_0_000 X COMMERCIAL GENERAL LIABILITY DXMGE TO PREMIy�F§lCy eeeurran e I S — —50000 A = CLA.IW4AADE 70CCUR 00031600 9/06/2011 /6/2012 MEDEXPUnyane person 7 1000 _...•.._.. .._ F!VL%ONAL d ADV_INJURY 6 1000000 GENERAL AGGREGATE S 200000_0 GEMGREGATE LIMIT APPLIES PER L AGPRODUCTS-CDMPlOP AGG S 1 OOOOOO POUF7 2"COT F7 LOC S AUTDNOBILE LIABILITY COMBINED SINGLE UMIT ANT AUTO (Ea pGodenl) S ALL OWNED AUTOS BODILY INJURY(Por Damon) S SCHEDULED AUTOS BODILY INJURY(Par accident) $ I_ HIRED AUTOS PROPERTY O AiE (Pw acclda : NON-OWNED AUTOS n� S S UMBRELLA LIMB OCCVR EACH OCCURRENCE S "Cosa LUe CLAIMSA"OE AGGREGATE S DEDUCTIBLE S RETENTION S —"— — ---- - WORKERS COMPENSATIONS &W EMPLOYERS'LIABILITY YIN WC 5IMIT,S OTIi- ANY FROPRIETOWPARTNERexEcUTIVE _ .. 7p,gYLLIMIT OFFICEWNEMBER EXCLUDED7 N 1 A E.L.EACH ACCIDENT i (Mkndetm In NH) —.....- tt yes describe under E.L.DISEASE.EA EMPLOYE f DESCRIPTION OF OPERATIONS WM E.L.DISEASE•POLICY LIMIT {• -V••—_— i DESCRIPTION OF OPERATIONS!LOCATIONS!VEHICLES (Much ACORD tot,AddNlonal Remarks Schedule,Nmere epaea Is mqu)red) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN David CastricOng Roofing & Siding Inc ACCORDANCE WITH THE POLICY PROVISIONS, Castricone Roofing 200 Sutton Street Suite 226 AUTHORMAMRUKIWMATIVG N Andover, MA 01845 / n ACORD 25(2009/09) IN5025(2DMM) The ACORD name and logo are registered marks of 0 ORD RD CORPORATION. All rights reserved.