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HomeMy WebLinkAboutBuilding Permit #020-14 - 315 TURNPIKE STREET 7/8/2013 O OO oT BUILDING PERMIT TOWN OF NORTH ANDOVER ° t APPLICATION FOR PLAN EXAMINATION '` - •" h Permit NO: Date Received ��SSATeD Date Issued: IMPORTANT:Applicant must complete all items on this page L:OCAQON ''� t Print PROPERTY OWNER ' '%i ''t tt;Art , ,► a Print MAP NO: - PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: Commercial Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other Septic ❑ Well ❑ Floodplain ❑ Wetlands ❑ Watershed District Water/Sewer oj� (2o&E Vo( 12_ ����� Identification Please Type or Print Clearly) �► OWNER: Name: �[zf�lKhw W"*-t►E Phone: (��a)837• Address: sIS JR- FIVC-C S-tezee( AaGoverz, MSA O(m s CONTRACTOR Name: Phone: "w 1 Address: - - a Supervisor's Construction License: Exp. Date: Home Improvement License: I x l Exp. Date: ARCHITECT/ENGINEER OLA 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: $ 3n, DDO to FEE: $ In I Check,No.: Receipt NO- NOTE: Persons 64ctfnev t unregistered contractors do not have&WWWWguaranty fund Signature of Agent/Owner Signature of contract ,J 4 Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF.SEWERAGE DISPOSAL - Public Sewer ❑ Tanning/MassageBody 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 DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature f COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature& Date Driveway Permit DPW'Tovv;! Engineer: Signature: Located 384 Osgood Street FIQE�DEPARTMENT Temp Dumpster on site yes no Located at 124 Mair,, Street Fire Department signature%date COMMENTS J 1 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 . U 6 � - El Notified for pickup - Date I Doe.Building Permit Revised 2010 11cu 1 1011)-LJ- . i Building Department The fol?wing 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 o Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract a Floor Plan Or Proposed Interior Work ❑ 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 L3 Certified Surveyed Plot Plan Li Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses a Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) o 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 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 o Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) o Copy of Contract ❑ Mass check Energy Compliance Report a Engineering Affidavits for Engineered products j NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit i 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 apw-al period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submAted with the building application Doc: Doc.Buhding Permit Revised 2012 Location W l i4— C'Ta— �Z... Cdt Z No. .dDate t ' • - TOWN OF NORTH ANDOVER • • Certificate of Occupancy � Building/Frame Permit Fee r$,� [/{A / Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check# '15uilding Inspector OORTH own of ndover No. OZO — - ti h , ver, Mass,0 4�A. 1 3 coc NIc"aw,ck S U BOARD OF HEALTH Food/Kitchen .PERMIT T LD Septic System THIS CERTIFIES THAT I D`.. .' .�ia......�i� .... .N�4'..�i�........... BUILDING INSPECTOR ....... �.. ... ... .... �.... .. has permission to erect buildings on 931. .7.VA +!,�f1.. Foundation Rough to be occupied as .....Old......= .i ........ .... .l..........�.. .. ..®............................ Chimney provided that the person accepting this permit shall in ev respect conform to terms of the application Final on file in 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 PERMI EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTI STTS A Rough • IAM Service .............. .. ................................. ...................... BUILDING INSPECTOR Final GAS INSPECTOR Occupancy Permit Required to Occupy Buildinz 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. SEE REVERSE SIDE NORTH ANDOVER BUILDING DEPARTMENT Tel: 978-688-9545 DEBRIS DISPOSAL FORM In 9=== of MGL c 40 S 54, a condition of Building Permit at: that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c 11, S 150 A. Also, note Permits are required under Fire Prevention laws Chapter 148 Section 1 OA. The debris will be disposed of in: (Location of Facility) /�ignature of Permit Applicant Date 1 P fl p i5Sa� Qe h s l J-/ - LAV4P e 4 ree J r _ e t s APO', s w a "lip :..;F--.. t ell w _ r . ; to a� k T r ^A A&M Roofing Services, LLC 1 Merrimack College June 27,2013 315 Turnpike Street—Room#112 Austin Hall North Andover,MA 01845 Attn: Maria Serrao Re: Merrimack College-Volpe Athletic Center Hockey Arena&Gymnasium Roof replacement North Andover,MA Dear Maria, Subsequent to our review of the existing conditions,we are happy to provide the following proposal for replacement of the existing Volpe Athletic Center hockey arena and gymnasium roofs. Please review and let us know if you find any omissions or discrepancies with the scope as included herein. Scope of Work: • Bid areas include the following: o The main high existing hockey arena roof o The main high existing gymnasium roof o We propose to use either a Carlisle or Firestone Roof system Hocks Arena o Remove and dispose of existing stone&top layer of existing built up roofing to expose the existing 2"insulation designated to remain o Bid assumes no abatement will be required for removal or disposal of any existing roofing or flashing o Bid includes an allowance to cut out and replace approximately 10% (3,500)SF of existing wet/deteriorated 2"insulation hockey arena roof. If required,additional wet or deteriorated insulation will be removed/replaced at a unit cost of$2.50/SF—please note that unit price is negotiable based on quantity. o In areas where existing insulation is replaced,we will examine steel roof deck. If required,any damaged or deteriorated steel deck will be removed/replaced at a unit cost of$5.50/SF—please note that unit price is negotiable based on quantity. o Please note that owner or owner's representative will be informed when areas of unit price work will be required. If owner or owner's representative is not available,we will provide documentation of areas where unit price work has been performed. o Install(1)new layer of 2"polyisocyanurate insulation(R12)over existing 2"insulation designated to remain o New R12 insulation will augment existing in order to bring system into compliance with overall R20 code requirements o Insulation will be fastened to roof deck utilizing white fasteners per manufacturer's installation guidelines o Install new white 60 mil TPO membrane over new layer of insulation. Membrane will be mechanically fastened utilizing the Rhinobond induction plate welding application per roof manufacturer's installation guidelines. ttttttttttttta Volpe Athletic Center—Hockey Arena&Gymnasium Roof Replacement June 27,2013 Page 2 Gymnasium o Remove and dispose of existing roof system down to the structural deck o Bid assumes no abatement will be required for removal or disposal of any existing roofing or flashing o Upon removal of existing roof we will examine steel roof deck. If required,any damaged or deteriorated steel deck will be removed/replaced at a unit cost of$5.50/SF—please note that unit price is negotiable based on quantity. o Please note that owner or owner's representative will be informed when areas of unit price work will be required. If owner or owner's representative is not available,we will provide documentation of areas where unit price work has been performed. o Install(2)new layers of 2"polyisocyanurate insulation(R24) o Insulation will be fastened to roof deck utilizing white fasteners per manufacturer's installation guidelines o Install new white 60 mil TPO membrane over new layer of insulation. Membrane will be mechanically fastened utilizing the Rhinobond induction plate welding application per roof manufacturer's installation guidelines. Additional cla6Lkations • We include removal and metal deck infill of(6)capped curbs on the hockey arena roof. • Please note there is(1)AC unit on the hockey arena roof that appears to be in a state of significant disrepair. It is unclear at the time of this bid whether this unit is functioning or not. This proposal assumes this unit is functioning and will be re-flashed into the new roof system. We would require that the AC unit feeds be shut off and disconnected by Merrimack College HVAC contractor. A&M Roofing will lift and reset the unit as needed for roof installation,however we would require the same HVAC contractor to return to reconnect feeds. • We assume any HVAC shut-offs/disconnects/reconnects will be done by Merrimack College's HVAC contractor at no cost to A&M Roofing. • Unless otherwise stipulated within this proposal,we assume the existing roof penetrations will remain in place. We include flashing equipment into the new roof system as required to meet roof manufacturer's warranty guidelines. • Please note the existing roof hatches on both the hockey arena and gymnasiums appear to be in advanced states of disrepair,and therefore we have included replacement of the roof hatches on both roofs. • Due to the relative proximity of the roof hatches to the roof edge,we would recommend installation of a safe-rail at the roof hatches. Pricing is available for additional of roof hatch safety rails upon request. • Bid includes new TPO flashing membrane installed up and over perimeter parapet to provide complete parapet weatherproofing. • Bid includes new parapet coping to match profile of existing coping/fascia at the perimeter parapet. New coping to be shop fabricated white aluminum to match new white coping on Volpe Expansion roofs. • Bid includes allowance to provide(5)I..F membrane walkway pads at each roof hatch access point. • We include roof manufacturer's(20)year roof system warranty. 123 Tewksbury Street,Andover,MA 01810 rroNE 800.545-3619•FAX 978-475-877 Volpe Athletic Center—Hockey Arena&Gymnasium Roof Replacement June 27,2013 Page 3 • The proposed roof systems are compatible to receive new PV solar panels. We assume the PV solar panels to be mounted on a ballasted racking system above the finished roof by others under separate contract. • We include replacement of(6)existing roof drains with new cast-iron drain bowl assemblies. We feel new drains are important for maximizing long-term life cycle of the roof system. • Bid includes all hoisting and staging as required to perform our scope of work. • Bid assumes staging/setup area will be provided in close proximity to the roofs as needed to complete the work. • Bid includes cost to obtain local building permit. • Bid excludes sales tax. • Bid assumes all work to occur during normal business hours Mon-Fri 7am-5pm. The ricin for the above scope of work i Three hundred n two thousand dollars 302 . p g Pe o k s u red a d t {$ ,OOO.QO) Please contact our office if you have any questions or need any additional information. We appreciate the opportunity to quote you on this project and look forward to working with you. St�.Sincere, ��''.-f` P ood ABtM R'C>Or1 S Services, LLC Payment Terms: A&M Roofing will submit AIA invoices for payment on a 2-week schedule. Invoices will be based upon schedule of values which will be provided to Merrimack College prior to the commencement of our work. The proposal,to - d conditions found herein are accepted and you are authorized to proceed: Signature: Print: C -AL-�-AB®W tT9. Title: V? c /S►tItnitdTTtot�. itt� Company: Mj=trhAGlG. GLLfA9 Date: T1. 2013 123 Tewksbury 5treel Andover,MA 01810 PHONE 800-5453619•Fax 978-475-8778 Volpe Athletic Center—Hockey Arena&Gymnasium Roof Replacement June 27,2013 Page 4 Additional Provisions of this Proposal 1. Concealed electric and communication lines:A&M shall not be liable or held responsible for the repair,replacement or for losses incurred in connection with electric wiring or communication cabling affixed to the roof deck,strung through the upper rib of the roof deck,located less than 3"from the bottom of the roof deck or otherwise failing to comply with the state electrical code. Preexisting Conditions:Prior to commencement of work,A&M will be provided notice as to any roofing, plumbing or HVAC related leaks or other types of water infiltration having occurred on the property within 2 years of commencement of roof work.A&M shall not be liable or held responsible for the repair, replacement or losses incurred in connection with preexisting conditions.Owner's failure to disclose preexisting conditions will result in forfeiture of right to assert any claim for damages against A&M. Roof Leaks between commencement and completion of Work:A claim asserted for roof leak damage occurring after commencement of roofing work but prior to substantial completion of the work will be governed by the following procedure and limitations: 1)the Owner will notify A&M immediately by phone and in writing by fax of any alleged damage.2)A&M will be given prompt access to the area where damage is alleged prior to any remediation work for the purpose of performing a damage inspection.A&M shall not be liable or held responsible for any remediation work,if timely access is denied or if remediation has commenced prior to inspection by A&M.3)During damage inspection A&M may photograph and/or videotape for the purpose of maintaining an accurate record of the damage.Likewise and as necessary this right of timely inspection shall also be accorded A&M's insurer or public adjuster for the purpose of placing a monetary value on the loss.4)During damage inspection,AMA will determine in its sole professional judgment whether it was responsible for causing the alleged damages and will advise Owner of its findings.5)In the event a claim for damages is asserted,and if either timely access is denied for whatever reason or if A&M is denied an opportunity to obtain an accurate record of the damage;then in such an eventuality,Owner shall indemnify,defend against and hold A&M harmless from any claim asserted therefrom. Right of Survivorship:Notwithstanding any contract language that may be to the contrary,these additional provisions of this roofing proposal shall survive the Project and shall be valid and enforceable by or against the parties hereto and their respective successors,subrogates and assigns. 123 Tewksbury Street,Andover,MA 01810 PmoNE 800-545-3619•FAX 978-475-8778 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 ADolicant Information Please Print Legibly Name(Business/Organintion/Individual): A&M Roofing Services, LLC Address: 123 Tewksbury Street City/State/Zip: Andoverr MA 01810 Phone#: (978)475-4500 Are you an employer?Check the appropriate box: Type of project(required): 1.10 I am a employer with 60 4. Q I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. Q New construction 2.0 .1 am a sole proprietor or partner- listed on the attached sheet. 7, Q Remodeling ship and have no employees These sub-contractors have g. Q Demolition workingfor me in an capacity. employees and have workers' Y P tY� 9. C]Building addition [No workers'comp.insurance comp. insurance.$ required.] 5. Q 'We are a corporation and its 10.Q Electrical repairs or additions 1❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.®Roof repairs insurance required.]t c. 152, §1(4),and we have no employees.[No workers' 13.Q Other comp.insurance required.] "Any applicant that checks box#1 must also fill out the section betow 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 state whether or not those entities have employees. If the subcontractors 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 thepolky and job site information. Insurance Company Name: Star Insurance Policy#or Self-ins.Lic.M WC0 6 7 0 2 4 4 :Expiration Date: 5/15/14 .lob Site Address: City/State/Zip: 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. 1 do hereby certify under the/pains and penalties of perjury that the information provid ed above is true and correct Si afore• !te l ate: S �3 Phone M (978)475-4500 O icdal use only. Do not%Wle in this area,to be completed by wily or town offleial City or Town: Permit/Lkense# 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 M 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 burn 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 4-24-07 Fax#617-727-7749 www.mass.gov/dia A&MROOF-03 BSULLIVAN ACRD` CERTIFICATE OF LIABILITY INSURANCE 77/3/2 DIYYYY) 013 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). PRODUCER CONTACT NAME: Salem Five Insurance Services,LLCPHONE FAX 445 Main Street Arc No Ell:(781)933-3100 5595 A/C No):(781)933-9048 Woburn,MA 01801 E-MAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:Acadia Insurance Company 31325 INSURED INSURER B:Star Insurance Company A&M Roofing Services LLC INSURER C:Scottsdale Insurance Company A&M Roofing&Sheet Metal Co Inc 123 Tewksbury St INSURER D: Andover,MA 01810 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 MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDLISUBRI POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INqR VdVn POLICY NUMBER MMIDD/YYYY MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY CPA0110399-19 5/15/2013 5/15/2014 PREMISES Ea occurrence $ 250,00 CLAIMS-MADE I—XI OCCUR MED EXP(Any one person) $ 5,00 PERSONAL&ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,00 POLICY PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1 000,00 Ea accident $ A ANY AUTO MAA0110400-19 5/15/2013 5/15/2014 BODILY INJURY(Per person) $ ALL OWNED LX SCHEDULEDBODILY INJURY Per accident $ AUTOS AUTOS ( )X HIREDAUTOS NON-OWNED PROPERTY DAMAGE AUTOS Per acc dent $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,00 A EXCESS LIAB CLAIMS-MADE CUA0110401-19 5/15/2013 5/15/2014 AGGREGATE $ 5,000,00 DED RETENTION$ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY YIN X TORY LIMITS ER B ANY PROPRIETOR/PARTNER/EXECUTIVEWC06702" 5/1512013 5/1512014 E.L.EACH ACCIDENT $ 1,000,00 OFFICER/MEMBER EXCLUDED? ❑ N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEd$ 1,000,00 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,00 C Umbrella(C) XLS0088427 5/15/2013 5/15/2014 Excess 5,000,00 A Equipment Floater CIM012131419 5/15/2013 5/15/2014 Limit:$325,824 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Project:Merrimack College -Volpe Athletic Center-Hockey Arena&Gym Roofs North Andover MA Additional insured regarding general liability:Merrimack College CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Merrimac College THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 315 Turnpike St ACCORDANCE WITH THE POLICY PROVISIONS. North Andover,MA 01845 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD / 4 Massachusetts - Department of Public Safety Board of Building Regulations and Standards Construction SuperN icor License: CS-072964 JAMES A LOUIS - 12 DUNVEGAN DR = + • MERRIMACMA,01966' r A i X41 '`` Expiration Commissioner 1211712013 Unrestricted-Buildings of any use group which contain less than 35,000 cubic.feet (991m) of enclosed space. t Failure to possess a current edition of the Massachusetts j State Building Code is cause for revocation of this license. For DPS Licensing information visit: www.Mass.Gov/DPS =, t C Office Wkngmer airs' 0611ne4AWe9 nn i HOME IMPROVEMENT CONTRACTOR Registration: 452673 Type: Expiration: 9.1.20/2014 Private Corporation A OFING &SI-It-E7 TAL CO, INC. JAMES LOOS 123 TEWKSBURY VI2E T ANDOVER, MA 01816.. Undersecretary i f