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HomeMy WebLinkAboutBuilding Permit #939 - 37 STONINGTON STREET 5/1/2018 pORTH t BUILDING PERMIT Qo TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit N0: q��9 Date Received �1 t �9SSACHUS�t�y Date Issued: INIPORTANT:Applicant must complete all items on this page { Y >,'r v -:J' t, 7j v ✓� t' _r{9�ti -q&&12% .4 i4�:. r� GY `s �a'[ l%t':+:a �, ,y- ,�.....'+ �. e'p LIP AMC _ :` , ��r ar � JNI cJ t err �w ��r�y x, 3x � ?� �•��,��� �d:`�`r'„.'� -',,�"t"�•C +�+..h .'� ��'i}h(�PL" �x y>fc��' d:.: x i ',+ n, 7 Pf20, PERTLY OWNER11�.� {Y ,IN �'�'�£��� .'s^f' �u '�°��� 'SS' ��,_°=Pnnt �,...�'�', �-" �S.F a, ;v � •°�''.s'u ••fi a�, .'���¢'�u,�'��,; P,,ARCEL�0. �Z®NING DISTRIyC�Ti��raHistoricsDistnct � �es � �`dF`�.t�t� � �k r.,�Machine Sh#g Uilla(7e- \des w�, _.no >,�'• .'.....T.1riR+"+i "3'��i.tt�.. .xs�kraMar- 4c3�fi.v <' :.z ..�.� .�+d':i .-n fk�i�:�4i.$.^h>:�..s .<.<�.s n....: p :•..n..�J'.,.a?�Yt�'7., r.r.--.... .J�`Sce, TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One Ad ' ' t o or more fa Industrial era ' No. of uni s: Commercial Repair, replacement Assessory Bldg Others: Demolition Other 4T.w �r N Vlletlands F f3 V1fafershed District; -� Septic V1lell Y Flood Iain 5. t Water/Sewer. taS�at� -.4b:c3AN � r _r_ 6e �3`r f E DESCRIPTION OF WORK TO BE PR ;FqRME ❑: r c �` /ods �T ce- Va4 identification. Please Type or Print Clearly) ' OWNER: Name: �a1h Phone: Q11"r- �-o�l Address: c&, A.Aalll Aw�a� I(efli MiZANKN `CNTAACr ORNamegi4�s"�;tg y + �`.��fi .9'4 i �yjt,'L.�♦♦H.T♦ •v ho '�.# mow+• pi'� }I/' �y'a Lam. �iT't-•Y' ,"N' ,+e '!' r- z 'AF�"^v:,'ry' fir v :" �-_S;s y •'•' u�;^E i.5-. 'r't-.•.C; vie .� i Y #�� � �4.h lr r�} � ,� - .Tx/��S. C'P'�G•F,,,,�„�� a �' .��� i �•��`� ,'�. +y'F_ �+*Y'l� � 7 ��-? 'r•, {�, Address -vi: �� '�' �� y�s 2-3,Y r �S��e k.. a�-•''� -y�r'�� +-z:. r"4�?�r, ! ,�n�'�� .+.t �yrI�� r.�."�`•,.. � �x„i. "� : �' r:..-� .it� ��:.�fK'Yi k �,�".�° ,r�v� `35"3�y�..'s-"Z'{'r }�,�A'y',`�' -<,� �.(� •� M � t��,���d �s3�!' �j� ` ���•�'';�`�'�,�`���"�, ..'�� ;�,, ,�;;� �� .� � .� .�,�~�s= �,c �.<t�- �€ � - res. L:k� a-iG;,:�S'fae-�i �+.'� 5 ?+� �e•< ..w �e sp, "Sec'd��..o�''� �� � ,rs ) rC ; �Superv.isoConstruction License _` ,kExp bate � �� � r ���xs+.�e a; � ��� �� �'#�..._r kr` •�-� x.,. -xr+ f krf':'��-v � < r �:a ,i'C:u'C� <y'rrF�,r+- �`�`�. " p5ra °'r. Y'fr_r �F,• �r-{��� �!r A R � ' �`' E��r S3'3`.��u` A'$'?��: ��..'��,t} n�$'�''+`'° '�4?}a�...F` }�,�-•,fi,: ��'S -��,�� F '�-y�� �,, � (:r L1r �, oExp Date 'I: — l Home lmprovemen iceUse ARCHITECT/ENGINEER Phone: i Address: Reg. No. FEE SCHEDULE.BULDING PERMIT.,$12.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ FEE: $ Check No.: Receipt NOTE: Persons contracting with unregistered contractors do not have access to the guaran fund S.ignatureofAgent/Qwne - Az. h xStgnature of contractors .�; ` t,, _ ' �w : 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 i THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM I f DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT 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 I Conservation Decision: Comments Water & Sewer Connection/Signature &Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street �'^ 'w�Y ' ;y- � -" ;,c, -.vr...s�.�,...- —.•� .o c, ,: yt>s' FIRE.DEPARTMENT -_Tem0"D umpster on site yes , i ;� F-:, 'fi - sk"a• • ar�t .�a..�..x -�. L6ocated at�1241MNfi'Streetr Fire.Department ggnature .COMMENTS Dimension I+ Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— (For department use) ❑ Notified for pickup - Date Doc.Building Permit Revised 2008 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 Per Application ❑ Workers Comp Affidavit ❑ 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 ❑ Building Permit Application ❑ Certified Surveyed Plot Plan o 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 Hydraulic Calculations (If Applicable) o Mass check Energy Compliance Report (If Applicable) o 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 o Photo of H.I.C. And C.S.L. Licenses o 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 u 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 i Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2008 Location No. C1 Date e - TOWN OF NORTH ANDOVER `;CSI:CD lr46 • Certificate of Occupancy $ Building/Frame Permit Fee 2 Foundation Permit Fee $ ��n�kill,brti `t^ Other Permit Fee $ TOTAL $ Check# 25465N4 Building Inspector r ,_ NORTM t . . ver No. * - �, h ver, Mass, A (�► � o Cocsvco!'W ICK y1' S U BOARD OF HEALTH PERM :IT T LD Food/Kitchen Septic System • THIS CERTIFIES THAT .r1°.�.......le BUILDING INSPECTOR ............ .. ...................................... ..... ............................. 'j oundation has permission to erect .......................... buildings on .3*.*...... �.. Y`........... Rough to be occupied as . ..... � .... .. .�.. . ��. ..... � ..�IQ!!!�. .....'.�'.... ney provided that the person accepting this permit shall In every respect conform o the 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 Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final PERMIT EXPIRES IN NTHS ELECTRICAL INSPECTOR UNLESS CONSTRU 10 T S Rough leService ........... .................................................................. Final BUILDING INSPECTOR GAS INSPECTOR 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. SEE REVERSE SIDE All home improvement contractors and subcontractors engaged in home improvement contracting, unless specifically exempt from registration by Provisions of Chapter 142A of the general laws,must be registered with the Commonwealth of Massachusetts. Inquiries about registration and status should be made to the Director,Home Improvement Contractor Registration One Ashburton PI Room 1301 Boston,MA 02108 (617)727-8598 Co Goodwin Construction Fine Homebuilding and Remodeling 271 Washington Street Marblehead, MA 019+5 978-395-7405 Proposal/Contract Job Name: Cahill 15/2"d Floor kitchen/bath update Date: 5/11/12 Submitted to: Pare Cahill Contractor Information: (Owners Co.Name: C. Goodwin Construction Address:37 Stonington St North Andover,MA Address: 271 Washington Street Telephone: 978-395-7405 Telephone: Fax: Email: chca comcast.net E-Mail: colin.c oodwin(a mail.com Job Address: Same Pro'ect Develo ment: Goodwin Designer/.Architect: CS#: 104864 Exp.Date: 10-27-2012 Specifications For: To include all tasks noted on plans dated All work will be performed on a fixed price basis with assigned allowances for specific selections. These allowances are noted in Addendum A(Project Budget). Additional work or changes to the plans may be added and performed upon request by Owner. The parties shall execute a written Additional Work Order for such additional work or change in plans, which will define the work or changes,and any increase or decrease in costs associated with it. Job has been estimated and described in the ADDENDUMS below. ADDENDUM A Cost Breakdown ADDENDUM B Scope of Work ADDENDUM C Job Schedule t Contractor hereby proposes to furnish labor,complete,in accordance with specifications and fixed costs,noted above for the sum of:_$47 040-00 DOLLARS All allowance work and time and material work will be performed as follows if contracted by Additional Work order: 1. All carpentry related labor and supervision will be charged at$55.00 per hour. 2. All other subcontractors and materials will be charged at Contractor's cost. 3. 10% for profit and overhead will be added to 1.and 2.to arrive at the final cost to Owner. 4. Products and services purchased by others,which must be installed or otherwise handled or supervised,may be subject to some charge to defray potential costs and liabilities,this charge will not exceed 10%,and may be less depending upon exposure and liability. Customer may order changes in the work to reduce or enlarge the scope of work, and hence the costs associated,through written Change Orders at either a specific fixed cost or on a time and materials basis. Payment to be made as follows: 10% upon agreement. Invoices will be submitted at the completion of itemized tasks in the`Estimated Cost Breakdown' for payment. Some tasks may be invoiced in part prior to completion if needed. The owner may withhold final payment for tasks not completed at the time of substantial completion*or on punch list**items not completed. **Punch List:The Owner may not hold up the final payment because of punch list items. However,if some items need adjustment or need to be re-done,the Owner may hold up to ISO%of the value of this work from the Final Payment until the work has been completed or corrected satisfactorily. NOTICE:No agreement for residential contracting work shall require a down payment (advance deposit)of more than one-third of the contract price or the total amount of all deposits or payments which the Contractor must make,in advance,to order and/or otherwise obtain delivery of special order materials and equipment,whichever amount is reater, WORK SCHEDULE: The Contractor shall begin the work on or about: 6/27/12 ,and complete the work on or about: 7/25/12 . Variations in Scheduled Start and Completion of Work: The actual dates that construction will commence and be completed may vary due to circumstances beyond the control of the Contractor. These delays may include,but are not limited to: the time to apply for and obtain necessary permits,delays caused due to necessary inspections,delays in the scheduling of work crew(s),the presence of hidden conditions or necessary additional work discovered during construction; or delays in the receipt of equipment and/or materials which must be ordered and/or delivered to the site. Certain Delays-Not Violations: The Owner(s)hereby acknowledges and agrees that the scheduling dates are approximate and that such delays that are not avoidable by the Contractor shall not be considered as violations of this Contract. Notice of Schedule Changes: The Contractor agrees that when such delays become known to the Contractor,the Contractor will advise the Owner(s)as soon as is reasonable. CONSTRUCTION RELATED PERMITS: The Contractor under provisions of Chapter 142A of the General Laws is required to apply for and obtain all construction related permits. The Contractor shall not be deemed responsible for delays in the work described in this agreement caused by regulatory, permit granting,or inspection agencies,authorities or individuals. Other permits required(if any)for,but not limited to,Zoning Variances,Board of Health Permits, Conservation Commission Permits,which may require non-construction related surveying,engineering,technical or legal representation of the Owner(s),shall be the responsibility of the Owner(s). Should the Owner directly hire any contractors to perform Work on the property before C.Goodwin Construction has completed it's work, the Owner is solely responsible for all building permit,inspection,insurance,and liability issues that may be required or arise with that Contractor IMPORTANT NOTICE REQUIRED BY LAW: If the Owner obtains his/her own construction related permits for the work described under this contract.The Owner is hereby advised that in the event of a dispute,judgment and nonpayment by the Contractor,the Owner will not be entitled to make a claim against or collect from the guaranty fund established by Chapter 142A. HIDDEN CONDITIONS &NECESSARY ADDITIONAL WORK: Hidden conditions such as: (but not limited to)the presence of ledge, unsuitable bearing soil,structural defects, pipes,and/or wires hidden in wall cavities,etc.,may require additional work beyond the scope of this agreement that may require an adjustment in the overall price. In such cases the Contractor shall inform the Owner(s)of such conditions forthwith and,where necessary,a written amendment of this agreement will be negotiated and executed by the Contractor and Owner(s). The Contractor shall not be responsible for additional work that may be required by Building Inspectors,or other code enforcement officials that is not within the scope of this agreement. INSURANCE: The Contractor will be responsible to the Owner(s)or any third party for any property damage or bodily injury caused by himself,his employees or his sub-contractors in the performance of,or the result of,the work under this agreement. Contractor agrees to carry insurance to cover such damage or injury and shall provide a certificate of insurance to the Owner as proof there of. The Owner agrees to carry insurance to cover damage to any newly erected structure or portion thereof or equipment that has been installed or delivered to the site. Should the Owner directly hire any contractors to perform Work on the property before C.Goodwin Construction has completed it's work, the Owner is solely responsible for all building permit,inspection,insurance,and liability issues that may be required or arise with that Contractor SUBCONTRACTING: Contractor agrees that,not withstanding any agreement for materials and/or labor between the Contractor and a third party,Contractor is responsible to the Owner(s)for completion of all work described in a timely and workmanlike manner MODIFICATION: I This agreement,including the provisions relating to price anda ment schedule p Y ,cannot be changed except by a written Change Order signed by both Contractor and Owner. The Contract Price and the Completion Date shall be adjusted accordingly. WARRANTIES: (Limited Warranty Provision) The Contractor shall repair or replace,at his option and at his expense,any substantial defects in workmanship or materials supplied by the Contractor,or his agents,under this agreement that may occur within a one(1)year period from the date of installation. The Contractor makes no warranty of installed equipment. All warranties for equipment supplied by the Contractor shall only be those given by the manufacturer of such equipment,which shall be and are hereby passed through directly to the Owner upon the equipment installation,HOWEVER,IT WILL BE OWNER'S RESPONSIBILITY TO REGISTER OR MAIL WARRANTY MATERIALS OR OTHERWISE TAKE ACTIONS REQUIRED BY MANUFACTURERS TO VALIDATE A WARRANTY. WORK SITE SIGNAGE: The Contractor reserves the right to install a company sign on the property during the course of construction. Job site signage is a useful aid for deliverymen,and provides neighbors who may have questions or concerns with the Contractor's contact information. CONTRACT ACCEPTANCE: i I have read all pages of this document including any referenced attachments, and accept the prices, specifications and conditions stated. I understand that upon signing, this document becomes a binding contract under the law. You are authorized to do the work as specified. Payment(s)will be made as outlined above. i Contractor: Date: I C. Goodwin Construction Owner: Date: Owner: Date: r r r ' iVlussachusctts- Department of Public S;ifety Board of Buildin!, Regulations and Standurils Construction Supervisor License i License: CS 104864 j COLIN GOODWIN i 271 WASHINGTON ST NO 1 LAk MARBLEHEAD, MA 01945 I f I E:TfxeppliCtlii:7ltmislde� I 6` 7 Expiration: 4/7/2014 (',nuuiai mcr Tr#: 104864 61e�pan��iara�uea�Glz QeCa�jow'Am'J60 License or registration valid for individul use only Office of Consumer Affairs&Busi ess Regulation before the expiration date. If found return to: ME IMPROVEMENT CONTRACTOR Type. Office of Consumer Affairs and Business Regulation egistration: 172247 10 Park Plaza-Suite 5170 I 6/4/2014 expiration DBA Boston,MA 02116 C.GOODWIN CONSTRUCTION CO GOODWIN 271 WASHINGTON ST' g_��- 6�7 f valid without signature MARB AD MA 01945 L Undersecretary LEHE , The Commonwealth oflMlassachusetts . - Department oflnlustriglAccidents Office oflnvestigations 600 Washington Street Boston,.NIA 02.111 www.massgov/ilia Yorkers' Compensation Insurance Affidavit:Builders/Connactors/ElectriciansfPlumbers Applicant Information Please Print Leibly r Name(Business/Organization/fndividual): „� / Address: 2-7/ "r4h - City/State,/Zip: E� _sPhone yy SPrf� f Are you an employer?Check the appropriate box: Type ofproject(required): 1.❑ I am a employer with 4. El I am a general contractor and I ' El hired the sub-contractors 6. New construction employees(full and/orpart-time)* 2�I am a s ole proprietor or partner- listed on the attached sheet.x 7•Jam`emo doling ship and'have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers'comp.insurance. 9, ❑Building addition [No workers'comp.insurance 5. ❑ We are a corporation and its 10�,Electrical repairs or additions required.] officers have exercised their 3.❑I am a homeowner doing all work right of exemption per MGL 11.X..Plumbing repairs or additions myself.[No workers'comp, c.152,§1(4),and we have no 12,❑Roofrepairs insurance required.]t employees.[No workers' .13.❑Other comp,insurance required.] 'Any applicant that checks box Of must also fill out the section bel6w showing their workers'compensation policy information. T Homeowners who submit this affidavit indicating they Ere doing all work and then hire outside contractors must submit anew affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. lam an employer that is providing workers'compensation insurance for my employees Below is thepolicy and job site information. Insurance CompanyName:- Rose (,��i" � /C,J? �pMloa l Policy#or Self ins.Lic.#: f 1 W G 70 2.6 0 Expiration Datejr z_o 1 Job Site Address: City/State/Zip:j V 1417 &tiY1f4 )# . Attach a copy of the workers'compensationpolicy declaration page(showing the policy number and expiration date). failure to secure coverage as requiredunder Section 25A of MGL o.152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one=yearimprisonment,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. Ido hereby c ero under Aepains andpena[ties ofperjury that Me inform ationpro videdabove is true andcorrect, - Simature: Date: Phone#: '7'�/ --7/,Y ` / !ZQ_S Official use only. Do not write in this area,to he 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 S.Plumbing Inspector 6.Other - - Contact Person: Phone#: DATE ACORD,. CERTIFICATE OF LIABILITY INSURANCE 06/2MIDD o6i27i2012o12 PRODUCER (978) 745-6464 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Rose Insurance HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 66 Loring Avenue ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O. Box 958 Salem MA 01970- INSURERS AFFORDING COVERAGE NAIC# INSURED INSURERA:ESSEX INSURANCE COMPANY Goodwin, Colin INSURERB:AIM Mutual 271 Washington Street INSURER C: INSURER D: Marblehead MA 01945— INSURER E: COVERAGES . THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD'L POLICY EFFECTIVE POLICY EXPIRATION LTR INSRD TYPE OF INSURANCE POLICY NUMBER DATE MM/DD/YY) DATE MM/DDIYY LIMITS A GENERAL LIABILITY 3DK8335 04/13/2012 04/13/2013 EACH OCCURRENCE $ 500000 DAMAGE TO RENTED 50000 X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ CLAIMS MADE F-1 OCCUR / / / / MED EXP(Any oneperson) $ 5000 PERSONAL&ADV INJURY $ 500000 GENERAL AGGREGATE $ 1000000 GEN-L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $ 1000000 POLICY JECT LOC / / / / NOWND AUTOMOBILE LIABILITY / / / / COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ ALL OWNED AUTOS / / / / BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS / / / / BODILY INJURY NON-OWNED AUTOS (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO / / / / OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY / / / / EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ S DEDUCTIBLE / / / / $ RETENTION $ $ B WORKERS COMPENSATION AND AWC70265350 05/02/2012 05/02/2013 X TORY LIMITS OER EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 100000 OFFICER/MEMBER EXCLUDED? / / / / E.L.DISEASE-EA EMPLOYEE $ 100000 If yes,describe under 500000 SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT Town of North Andover FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE Building Dept INSURER ITS AGENTS OR REPRESENTATIVES. 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