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HomeMy WebLinkAboutBuilding Permit #327 - 32 STONEWEDGE CIRCLE 5/1/2018 VtORTII BUILDING PERMIT o� A St�eD ,6 �. TOWN OF NORTH ANDOVER o? '`:"'`- `~`'° o° APPLICATION FOR PLAN EXAMINATION Permit N0: 14217 Date Received /0/z 5_/o 7 "DAAVID►�"'`� - �SSACHl1`'�t Date Issued: IMPORTANT:Applicant must complete all items on this page A `i exr�,�a.'t :sy at . .`sT.i '^-Ti's a. ar-r*. '2"z z '.- #- •'e 7�^aE I r`r .- z•.3.x rkz.;y t- •c:.aE r.se i,T;�.k' ` -v,,-",�' ,.�"s{ -y .� 'a�" a, iS�'+X.� �..i.a' `' i^x`�'e4r �,,+.ekF ,S� u �r.��,-..� ,w"t�+ _ r ,�yw _ ��s` '� _'s'� �-�� �'r'.��,a`"��� x �'r',�� � .3^,f• ax +'� E ��;.a�a a.�`�^{,,., z+ 'ro ' + �7 .w:�� ti,l�o CA'TIOJf�. 4.'`r Aws•+s� u°"_ V 3^a � "o-....3 "tiw ,i�.m. .- �' .. r'`ix••S 'arri k'wa�t7`�srt, "T+�.�,*.. �.t r 1'• - '2f� ,6'4y1. 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If �machmer°Sho u Ila ems,: e 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 S� texlell � �od'"la�n '" letlads� �pll/aters#�edDistnct ,�.a .3ass� !, -h-fa `..a :"4cay.�.�y 'frrt.- Well ..$`-'-t- K•g�+3rz £ Yr�'� °j. Px'tC• 'S�2'�.5�.5+' � -1.. ,,�.�7y�,YE':y-�'.. 7.. �,i <,} t �? cru cE'w ar � 3,ir..c-r>= .°ah•#? ka;� �o�.� .r -r 4� {".. DESCRIPTION OF WORK TO BEPREFOR ED: e^h�Y1 e e �. t 1 Identification Please Type or Print Clearly) OWNER: Name: �}`o�b�s� �lc 1r\h�G W� Phone: -11?-OJ�3-7062- Address: e.dr e C Lie ^^� "ntPr^i• #'K�. � 'g�l,rk2 xsr '&"�` owl-,"rz- mn.', c yr'.���, ° y'� """�:Yi"�x�rr.a,.-.rr tir�_i }, .''r i✓x E"-..�i_y ',�t.ro rn •^t. 'srcy'�'�cr¢'X .Ls ?''a" k i r g§ 'St' 'if .. 9? .f F ✓.�` ,� r -, +�^ 7 x' 8, ,Yi•a. ^'" ,#7,..s a�, r-�'. rs 1°'".'":r ,x`r raa�, s `• f+ r .ss '�ic�.b•w C NTTRA�CTO:R (ta e r � �`�, i ox�e `� �F 4Y. '�' fk+„ e „r':y.""^7."is." "�.�=4, •FF`f' - ..,Fk'Si` '-¢'.' •x-,� 4. r �f ...� 'SSS.. .aar 'r^ .��•�- t''d' ��e ...:��sai�a-- s�.. � ..fx c..:z:y � � �� yy w�`�.r�� ��- ?'•1' .a..9 _."` - ? -_S �D .�'• r. "s ='�..-r,._. -� ,. •- -:P` fi .+ a �.. , r"y�-i't 'Ct e'c�a 'E - y wPs rr:• .�'Fsr> �-:` •,a rr `r�-��,(n,�4' ,.ea ri 'f'it 01��' ,' r s F�' nx � `t7? rl t G gr_ �GR� ✓6d A, NP 1 E �.FJJin :� r�,.n•" .. r sv u :sx'a" c"rr� .Y;:,�"�, .c'•".r .�k,yx y,''�..4.« F 7� ,a-w.v: RAN sv ��,ki"5�„'es,v�;^'�,�+ ve i .v�-•-czi �.•s n4` SL QQ ; _y�N :.•nr "xS-,s' :3�''xa. ? N�rEva •V 4' ;f�',rc �a� .'x"ljCr'arr,; e ^ry 1i' p ss-*,Ms'tructio License � �� �- E c sl.Day , S erv�sox A , - �-�r d.� es..^--r�� a Gc,�'�«..�� ,yyi��,.� .,���•s �',y-K.. •}.`.`",Y'sr�.&4 R..,pa•,� Kc.,a" x t t#,. rrSq "r f.iA a .,* fzi F 4c '..r^� '+'1 y„ "� �.i ,,r�• '2�" 6.+.n _ t�.'sanyr %.. - � •'��'�y�'• s �' "4�t ❑ �`k� '. �7�a. 5M--, a�Zu�',�-•e.�^�-�y�e�ya4,�--� r��' :.� '3'" ;_p,.�"�.��'K" "�i� � rr-�,''�•-^.,;° ��j'�.�'.�'x° -;*�-• . .4 � ,,4�,'�`�"i }tit 3 nt ome lrrnpraWeme RE BE, -11, Date n E, ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BOLDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ yS� 2laS`. FEE: $ Check No.: 34C 77 Receipt No.: o?D 717 ` NOTE: Persons contracting wit unrezisfeAd contractors`do not have access tot a guaranty and - ,._/.a._ .meq♦ / t .. S�gnat re`f'JAgen#/t3wner r s x' `�gnat arb ibb o i th06f i Plans Submitted Plans Waived Certified Plot Plan Stamped Plans T=OF SEWERAGE DISPOSAL Public Sewer Tanning/Massage/Body Art Swimming Pools Well Tobacco Sales Food Packaging/Sales Private(se p 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 DATE REJECTED DATE APPROVED CONSERVATION COMMENTS DATE REJECTED DATE APPROVED HEALTH 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 Located at 384 Osgood Street FIRE :DEPARTNIEiVT Temp Dempster on s i yes7, 77 no - r.. :'Located at 12 Main jre'Departrnent signatureldate COMMENTS - - <, i 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.s100-s1000 fine NOTES and DATA— (For department use) ❑ Notified for pickup - Date Doc.Building Permit Revised 2007 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 . o Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract o Floor Plan Or Proposed Interior Work o Engineering Affidavits for Engineered products 9 9 9 NOTE: 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 ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses o Copy Of Contract o 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) o Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses o Workers Comp Affidavit ❑ 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 Li 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:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2007 Location������� -No. Date ` NORTH TOWN OF NORTH ANDOVER 3j0�,,`•D I•,h0 9 . • : ; . Certificate of Occupancy $ J�CM�S<�' Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 20737 Building Inspector l NORTH 0VM Of `.: _ Andover . O No. JA7 o Z-_ LA ' O dover, Mass., `. I� COCHICHEWICK ADRATED O' �C `S BOARD OF HEALTH PERMIT D Food/Kitchen Septic System 0 BUILDING INSPECTOR THIS CERTIFIES THAT .r'd�! /.....:..:............................................... ......... ......... """" Foundation ` has permission to erect........................................ buildings on ff.g........... Rough to be occupied as..............................:. �.lC. ...... G mney .. ... . ............................................ ............. Chi 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 1✓. Service BUILD 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. t J. I t99Z4�IZU/P,CdGCiLp�yr�� LIIQC�b ' r• BfJiARp'OF'�(t{L LNG l:iU ATIONS License CONSTRIkT ,ER.VISOR I Cff,,e �Danrmcamrue �✓��d U° Number CS Board of Building Regulations and Standards �A r A i - Btrt datg 2�fifi1� � i<r �.�� � �� � HOME IMPROVEMENT CONTRACTOR ' w • -. Ezpir1: M9 77 r nQ=' .7OFJ89 _€• Registration: 119555 Efcpiiation: 7126/2009 TO 130084 RestdCted 0=.r SCOTT A BER17B(:,r= _;�_ r.;1 r i Type; DBA ' 771 SALEM-ST � .` i gERUBE CONSTRUCtfON G'ROYELAND; MA 01`834> . t`: I � m1zs►ager I SCOTT BERUBE _ 4 :Z 771 SALEM ST GROVELAND,MA 01834 Administrator 00-35,000 cf enclosed space License or registration valid for individul use only (MGL C.112 S.60L) �A_Masonry only before the expiration date. If found return to: 1G:1&2 Family Homes Board of Building Regulations and Standards Failure to possess a current e'C deof the One Ashburton Place Rm 1301 Massachusetts State Building_ Boston,Ma.02108 e is Ouse for revocation of thlslicense. . I Nt Not valid without signature DIG SAFE CALL CENTER: ($881 ggq'7233 1 Residential Property Record Card PARCEL_ID:210/106.6-0163-0000.0 MAP:106.6 BLOCK:0163 LOT:0000.0 PARCEL ADDRESS:32 STONEWEDGE CIRCLE PARCEL INFORMATION Use-Code: 101 Sale Price: 1 Book: 9141 Road Type: T Inspect Date: 07/09/2004 Tax Class T Sale Date 10/25/_2004 Page: 89 Rd Condition: P Meas Date: 07_/0.9/2.004 Owner: -- JOHNSON, MONIQUE&NORBERT JR,TR Tot Fin Area- 3518_ Sale Type:- P �Cert/Doc: Traffic. IVI Entrance: X Tot Land Area: 1.55 Sale Valid: A Water: Collect Id: RB Address: -- - - 32 STONEWEDGE CIRCLE Grantor. JOHNSON, NORBERT JR Sewer: Inspect Reas: S NORTH ANDOVER MA 01845 Exempt-B/L% 0/0 Resid-B/L% 100/100 Comm-B/LM Indust-B/L% 0/0 Open Sp-B/L% 0/0 RESIDENCE INFORMATION LAND INFORMATION Style: CL Tot Rooms: 9 Main Fn Area: 1788 Attic: NBHD CODE: 8 NBHD CLASS: 8 ZONE: R2 Story Height: 2 Bedrooms: 4 Up Fn Area: 1730 Bsmt Area: 1758 Seg Type T Code Method Sq-Ft Acres' Influ-YIN Value Class Roof: H Full Baths: 2 Add Fn Area: Fn Bsmt Area: 1 P 101 S 43560 1 238,708 Ext Wall: FB Half Baths: 1 Unfin Area: Bsmt Grade: 2 R 101 A 0.55 4,400 Masonry Trim: Ext Bath Fix 1 Tot Fin Area: 3518 VALUATION INFORMATION Foundation: CN Bath Qual . RCNLD: 559677 Current Total: 802,800 Bldg: 559,700 Land: 243,100 MktLnd: 243,100 Kitch Qual: L Eff Yr Built: 2003 Mkt Adj: Prior Total: 729,000 Bldg: 509,100 Land: 219,900 MktLnd: 219,900 Heat Type: FA Ext Kitch: Year Built: 2003 Sound Value: Fuel Type: G Grade: V Cost Bldg: 559,700 Fireplace: 2 Bsmt Gar Cap: 3 Condition: VE Att Str Val 1: Central AC: Y Bsmt Gar SF: Pct Complete: 100 AttStr VaI2: Att Gar SF: %Good P/F/E/R: ///100 Porch Type Porch Area Porch Grade Factor W 180 SKETCH PHOTO 15 ti W IR 12 180 Sq.R.12 7 FM/B IS 40 14 2 FU/FM/B 33 1730 Sq.R. " 28 2 2 2 R. R. 32 STONEWEDGE CIRCLE Parcel ID:210/106.6-0163-0000.0 as of 10/26/07 Page 1 of 1 o �i Qj � L � e y ' ^n l..,L]<D©� i s j 3propoal V BERUBE CONSTRUCTION 771 Salem Street Fully Licensed & Insured ~ Groveland, MA 01834. Phone: 97,8=521-2544 Remodeling • Additions • Custom Homes R POSAL SUBMITTED T PHONE# j� (��?3,_115L,2— DATE + brFAX# STREET � JOB N 32- CITY,STATE AND ZIP CODE JOB LOCATION et' CLW C) ESTIMATOR DATE.OF,PLANS JOB PHONE We hereby submit specifications and estimates for: t `� ��� . . . . . . . . . . . . . . . . . HCl\. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Job. . .�-��. .�.o1C-.\'-eta-. :�a©� Wi-d' . CL LLD-CL r-. ` . . . . . . .�Cal:s-�.•. ..�.�-v�p 1.�..ti u V� . CU-� . .S:t.�.-�:`int a-A:�. . til Ca-L.t_. .�D. (��-C1 r--li'1� . .�?� .(;�l"�.�-. �I�.-.�T. �.1�... r-� J :e.e� . .���-k<'�.Q-c.,-�r..1. . .V��I�a�-e . � .��.•. �e:e-c:tr►�-�-�-.rl�i i. t 1 . .�:-�-Gd�t��-. "�.G�c�d.� . f�+<�� . . . . . !. . .CQDy. .r-e.r�S�.�.c1 1 i�)�tstl�rtt f�;tet. ,�-5���.2V1t. .a-S. . >3'`u�-l.�c�;. Dr".D.-. . . . . . . ,t��ce C? �r1. if���t ' c t� Cil t^(1??D. .,. . C��l�'-. .i� 11'► . .�. ;�h ... G? hG1 . C?� FT. .OLLOl ►�`+ - - �W4 Too ti',',. -ti . . . . . . . . . .MV.IIL. .1.V. I C .,. � . D ! _. 1!?_ 21�—_)D. `.I! .�. .i DBL k �t�:�. . ++.G���--. ? c c'x..�--. .C.� . . . . .�.c?�1�-i.�� . C?�. . �.t, �ll. . . . . .i a►1 . a 0 r1 e.. ,. .C>.1. . , t. .l C.... i . . .6,.re, �-t<ixr'CA(�_r 4 . . . .be. . . . . . . � �� .CC). t .o . . . . . . 7p_C . .. . .��r •. . . . . . C rC� f t �. . . . . . . . . . . . . . . . . ! l . . r -. "C�r� C�a�'C -�C -t C` 2- VC 3prOP00 hereby to furnish material and labor — complete in accordance with above specifications, for the sum of: dollars($ ). Payment to be made as follows: I All work to be completed in a workmanlike manner according to standard practices.Any alter- ation or deviation from above specifications involving extra costs will be executed only upon Respectfully written orders,and will become an extra charge over and above the estimate.This estimate is submitted by for completing the job as described above.It is based on our evaluation and does not include material price increases or additional labor and materials which maybe required should unfore- Note:This prOpOSdI may be seen problems or ads erse weather conditions arise after the work has started,or delays beyond withdrawn by us if not accepted within days. our control.Our workers are fully covered by Workmen's Compensation Insurance. 01treptance Of 3propooaf—The above prices, specifications " Signature and conditions are satisfactory and are hereby accepted.You are authorized to do the work as specified.Payment will be made as outlined above. Signature Date of Acceptance: i I i BE RUBE CONSTRUCTION Fully Licensed & Insured • � 771 Salem Street Phone: 978-.521-2544 Groveland, MA 01834 Remodeling • Additions • Custom Homes T 76—r+- L SUBMITTED TO DATE � PHONE#a—[fJ , • �©�'.� ®��1 at.'� FAX# �7 STREET_� � r- CITY,STA E AND ZIP ODEt ' JOB LOCATION D r ESTIMATOR DATE OF PLANS JOB PHONE 011e hereby submit specifications and estimatesfor: . . . . . . . . . . . . . . . . . . . \^ILst—\�L � 1 C1 S {l . . . . . . . . . . . . . . . . . . . . . . . . . . . i l�i.S11 . .v`la.v-L. C0t1Si.S$i . .+ . . 0.C ?(?( -e 2L_ (.)�51. W► �1. . lf�-lY rt?d�5kl�l ��5. . . fid '- (� . .<�c���. .•. . f�Q,.i 1��!Chi:�-. .��G�$:.t StS . (°��. .C�.1'1�L... . °C.,C?c"A-t h�S�. . Y1. � . .v�lff l!`�. . Lllt . . �i.l1r� •. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ri c�- . . ,iii OT. . �.lC.� -n . . . . . . . . . . . . . . . I . — . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . �tc?p r.t'r-d.), . . . . . . . L�t�� . . to t�ti�.i. r-)�. . . . . . . . . riX{-� r..ate. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . �rrot,d� . . .,;.� �a . . . . . I . . . . . . . . . . . . . 444.V-i. )' ... . . . . . . . . . . . . . . . I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Utc L r:i.c�, . A-�f 1$. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Ve propoge hereby to furnish material and labor — complete in accordance with above o e specifications, for the sum of: 'ayment 4be made as follows: dollars($ �n Cc, �� ���1 %II work to be completed in a workmanlike manner according to standard practices.Any alter- .,.� ition or deviation from above specifications involving extra costs will be executed only upon Respectfully yritten orders,and will become an extra charge over and above the estimate.This estimate is submitted by or completing the job as'described above.It is based on our evaluation and does not include naterial price increases or additional labor and materials which may be required should unfore- OfS te:This proposal may be O ceen problems or adverse weather conditions arise after the work has started,or delays beyond iur control.Our workers are fully covered by Workmen's Compensation Insurance. withdrawn by US If not accepted within days. 3(rreptance' of propoal—The above prices, specifications Ind conditions are satisfactory and are hereby accepted.You are authorized Signature b do the work as specified.Payment will be made as outlined above. Signature )ate of Acceptance:`° l The Commonwealth of Massachusetts Department of Industrial Accidents W Office of Investigations d 600 Washington Street W= Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): t:��� P-K Address: SA— City/State/Zip: ACity/State/Zip: (\/-oV c-_ M,r,, G:,3 y Phone.#: q 7 l Z( ZS Are-you an employer?,Check the appropriate box: Type of project(required):.,, 1.[`/I am a employer with \)0 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. E]New construction 2.Ft2'I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g, I,] Demolition workingfor me in an capacity, employees and have workers' Y P tY• � 9. E]Building addition [No workers' comp.insurance comp. insurance. re uired. 5. ❑ We are a corporation and its 10.[]Electrical repairs or additions q ] officers have exercised their r additions 3.❑ I am a homeowner doing all work 11.❑ Plumbing repairs o 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.[:1 Other JF S t1 comp.insurance required.] C.!�ef wo e 1A� *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: Policy#or Self-ins. Lie.#: Expiration Date: Job 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. I do hereby ce under the pains and penalties of perjury that the information provided abov .is tr and correct. -7 Sig �"`--- Date: % , Z- C/ Phone#• �� S-2 � 7 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#: a � f i 'i i Oct 25 2007 14:41 P.01 •. DATE(MMIDDlTYfif) ...ADD-RD, CERTIFICATE OF LIABILITY INSURANCE l0/25/2007 A (603)38Z-2034 YNFETR OF INFORMATION PRODUCrx (603)38--4600 ONLAND CCERTIFORS NO RIGHTS UPON CEICATE * Insurance Sol utions.Corporation HOLDER,THIS-CERTIFICATE DMS NOT AMEND,EXIEN,D'OR 60 Westville Rd ALTER THE COvF-RA(3E AFFORDED BY THE POLICIES BELOW. Pl aistdw, NH-03965 INSURtRS APFORDINd COVERAGE` NAIC 8 .Cynthia St. Amand " 24198 muwx Stott Berube, dba-Berube Construction INsuRERn less Peer 771 Salem Street IrIsuREaB Groveiand, MA 01834 �NSUREa c: INSURER A; ' INSURER E:•• COVERMES 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 LpdITB POLICIES.AGGREGATE UNITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POU N 001 GENERAL LIABILITY CCP'9$71262 OSJ22/2007 OS/22J200$ EACH OCCURRENCE _ s 1000.0 DAMAGE TO RENTED $ 51(1) X COMMERCIAL GENERA.LIABILITY — CWMS MADE X OCCUR M1:D EXP(Any oma Parson) 8 ❑ PERSDRAL a anv INJURY s 1,00 A GENERAL AGGREGATE $ 2,00GEN L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG S Z 00 POLICY •,'ERCT ►DC AUTOMODILE LIABILITY COMBINED SINGLE LIMIT L (Ea aetde, ANY AUTO ' ALL OWNED AUTOS 90DILY INJURY 6 (Per person) SCHEDULED AUTOS HIRED AUTOS BODILY INJURY y (Par eocmem) NON-0WNED AUTOS PROPERTY DAMAGE $ (Per accident) GARAGE LUlB1UTY AUTO ONLY-EA ACCIDENT• $ ANY AUTO OTHER THAN EA ACC E ALTO ONLY; AGG 'S LLABILITY EACH OCCURRENCE EXCE6WUMBRELLA 6 OCCUR CLAIMS MADE AGGREGATE S 3 S DEDUCTIBLE . f RETENTION i WC ATU• oTFh WORKERS COMPENSATION AND E'MPLOYW'UABUTY E.L.EACH ACCIDENT S �IPCE ATBOER ARTN�DEI�CUTNE E.L DISE,ASE-E/(EMPLOYEE 11 N yes,desalDe lulder E.L.DISEASE-POLICY LIMIT S SPECIA!PROVISX)NS below OTHER BESMPIM OP OPERATIONS 1 LOCAT1ONS)V5"rAAS I'E)L%USIONS ADDIED BY ENDORSEMENT I SPECIAL PRWISIONS eject location: #3.2 StotJeWedgle;Circle N Andover MA r,ERTIFWATE gANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES®E CANCELLED BEFORE WE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL LO 4RA N NOTICE TO THE CERTIFICATE HOLDER NAMED TO TME LEFT, The Town of North Andover DUYFAISUCHNOTICE HALL OBLIGATTONORLWBILRY ,Attn: Building Dept1600 Osgood Street OFANYE ISAN Andover , MA 01845. Aun+DE ACORD 26(2001/08) FAX: (97$)688-9S42 OACORD CORPORATION 1988