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Building Permit #337-2016 - 392 MASSACHUSETTS AVENUE 9/16/2015
NORTFI i L O��S,tO 06 0 59 41 4,5 BUILDING PERMIT 3r ��::�. _`*"-. .6 0� TOWN OF NORTH ANDOVER ° X37 APPLICATION FOR PLAN EXAMINATION - y Permit N0: Date Received 2"gyp q '9 q�gATID Date Issued: f l I I `SSACHU`�� IMPORTANT: Applicant must complete all items on this page LOCATION ?012 IS-ISS t f Print PROPERTY OWNER (.(0)� \APr `S MAP NO: �� PARCEL: ZONING DISTRICT: Historic District yes/no Machine Shop Village yeno TYPE OF IMPROVEMENT PROPOSED USE Res• ential Non- Residential ❑ New Building &ne family ❑Addition ❑ Two or more family ❑ Industrial Iteration No. of units: ❑ Commercial Repair, replacement 11Assessory Bldg LiOthers: Demolition ❑ Other ❑ Septic ❑Well ❑ Floodplain ❑ Wetlands D Watershed District ❑Water/Sewer lVP,kAj rje.,J W 0 n1eAA1 rjarn �r t Identification Please Type or Print Clearly) OWNER: Name: 66AOi ►GYM is Phone: Q� q77- 00S_() Address: (4OV 5� A a6 CONTRACTOR Name: ^ Phone: L n nni dion 5 Address: qY r Aui cc, V Vn i Supervisor's Construction License: Exp. Date: _(� - 0 11 1 Home Improvement License: W Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost:$ 2 qC( , 8, n U FEE: $ o2 9 q(P - �O ` Check No.: I q 1 Receipt No.: t9_4 576 NOTE: Persons contracting w'h egistered contractors do not have access to the guaranty fund Signature of Agent/Owner )gnature of contractor . . C BUILDING PERMIT t%() RT 6A�o TOWN OF NORTH ANDOVER ur h,y`• O� APPLICATION FOR PLAN EXAMINATION Permit No#: Date Received gCHUs���y Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION Print PROPERTY OWNER Print 100 Year Structure yes no MAP 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 DESCRIPTION OF WORK TO BE PERFORMED: Identification- Please Type or Print Clearly OWNER: Name: Phone: Address: Contractor Name: Phone: Email: Address: Supervisor's Construction License: Exp. Date: Home Improvement License: 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: $ FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/OVuner-,r, Signature of contractor i Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑. Stamped Plans.0 i TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art E] Swimming Pools El Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS i CONSERVATION Reviewed on Signature 1 COMMENTS HEALTH Reviewed on Signature COMMENTS L 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 r DPW Town Engineer: Signature: Located 384 Osgood Street FIRE-DEPARTMENT - Temp,Dumpster onsite yes no. Located,at 12.4 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.: 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) I ❑ Notified for pickup Call Email Date Time Contact Name r Doc.Building Pennit Revised 2014 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 o Workers Comp Affidavit o Photo Copy Of H.I.C. And/Or C.S.L. Licenses o Copy of Contract o 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 I o Building Permit Application o Certified Surveyed Plot Plan o Workers Comp Affidavit o Photo Copy of H.I.C. And C.S.L. Licenses • Copy Of Contract a Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) Li 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) Li Building Permit Application Li Certified Proposed Plot Plan o Photo of H.I.C. And C.S.L. Licenses Li Workers Comp Affidavit o Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) Li Copy of Contract o Mass check Energy Compliance Report o 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:Building Permit Revised 2014 Location � �� �I(A S No. � '2 / Date / r • • TOWN OF NORTH ANDOVER En,�6' S Certificate of Occupancy $= Building/Frame Permit Fee $ ��•� Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check# �) t, Building Inspector COMMONWEALTH OF MASSACHUSETTS NORTHEAST HOUSING COURT TOWN OF NORTH ANDOVER, Petitioners No. 14-CV-243 V. ESTATE OF WILLIAM F. MATTHEWS,ET AL Defendants MOTION TO APPROVE RECEIVER'S BUDGET NOW COMES City Light Homes, LLC, the Receiver in this matter and hereby requests that this Honorable Court approve its budget, attached hereto as Exhibit A, for the renovation/rehabilitation of the building located at 392 Massachusetts Avenue, North Andover, Massachusetts. In support hereof the Receiver states as follows: I. The Receiver was appointed by this Court on June 19, 2015. 2. Following appointment the Receiver made thorough investigations of the property on its own and with a Building Inspector from the Town 3. The Receiver has already put up a temporary fence around the abandoned pool for liability protection. 4. The Receiver also states that the Town is very aware of the major problems with this property and it is approving of this Budget (See letters attached hereto). 5. Based upon this investigation the Receiver determined it required a budget of $366,531.20 to rehabilitate the property(see Attached). WHEREFORE,the Receiver requests that this Honorable Court approve the budget as attached. i City Light Hom s LLC Receive By its ttomey Jamed,WCote Co LA,Offices 2 6.. "�dover Street e,,body, MA 01960 (978) 278-5850 BBO No. 557178 CERTIFICATE OF SERVICE I,James M. Cote,Attorney for the Receiver hereby certify that on July 10, 2015 I forwarded by first class mail, postage prepaid and by email a copy of Motion to Approve Receiver's Budget and Notice of Motion: Abigail Fee, Esq. Assistant Attorney General Office of the Attorney General 1 Ashburton Place 18`h Floor Boston,MA 02108 :xl�iy�tjil.i�:etr;�ta1C.T11<3,Ils THE BANK OF NEW YORK MELLON f/k/a The Bank of New York as Trustee for the Certificateholders CWABS, Inc. Asset- Backed Certificates, Series 2007-8 Andrea V. Lasker, BBO # 6441982 Harmon Law Offices, P.C. 150 California Street Newton, MA 02458 alasker@.harmonlaw.com TOWN OF NORTH ANDOVER Thomas J. Urbelis BB04506560 Carol Hajjar McGravey BBO# 334640 Urbelis& Fieldsteel LLP 155 Federal St et Boston,M211 f-1 chm ow.co James M/0/ . COMMONWEALTH OF MASSACHUSETTS NORTHEAST HOUSING COURT TOWN OF NORTH ANDOVER, Petitioners No. 14-CV-243 V. ESTATE OF WILLIAM F. MATTHEWS, ET AL Defendants NOTICE OF MOTION Please take notice that the Motion to Approve Receiver's Budget is scheduled for hearing on July 17, 2015, at 9:00 am at Northeast Housing Court, 2 Appleton Street, Lawrence, MA. City Light Homy , LC Receiver By its att6me James Mo Cote 0 ices 246 Andove Zreet Peabody, MA 01960 (978) 278-5850 BBO No. 557178 r� citylight HOMES PROPERTY RECEIVERSHIP REPORT SUBJECT PROPERTY: ]BT Massachusetts Ave North Andover, M1i4 l city[ 19nt H O M F 5 246 Andover Street Peabody,MA 01960 Office: 978.977.0050 www.citylighthomes.com Citylight Homes Receivership Program Address: 392 Massachusetts Avenue North Andover,MA Description: Single family property-all violations are attached to this cost to cure and will be remediated by Citylight Homes. Construction Costs: $252,024.00 Citylight Homes Receivership Fee: $45,364.32 Legal Fees: $7,500 Finance Construction Cost: 6 points$15,571.44 +12%interest only for 12 months (6 month guaranty) =$15,571.44 Miscellaneous: $5,000 -Cost of insurance,utilities,construction contingency Cost to sell: 6%at a projected retail price of$425,000 =$25,500 Total: $366,531.20 Additional 6 month interest of up to $15,571.44 if project extends beyond 6 months. North Andover Health Department Community Development Division May 26,2015 Abigail Fee Assistant Attorney General Office of the Attorney General One Ashburton PIace Boston,MA 02108 Re: 392 Massachusetts Ave.,North Andover MA Update as of May 6,2015 Owners: Property Address: The Estate of William F.Matthews 392 Massachusetts Avenue 46 Harvard Street North Andover,MA 01845 Medford,MA 02155-6208 And The Bank of New York Mellon,F/K/A One Wall Street New York,New York 10286 Dear Ms.Fee, Please find below,the update for thero eri conditions p P y rtrons at 392 Massachusetts Avenue,North Andover. On Wednesday,May 6,2015,an inspection of sanitary conditions at 392 Massachusetts Avenue was conducted.This inspection was attended by me,Gerald Brown,NA Inspector of Buildings, Abigail Fee, Asst. Attorney General, along with the bank's property preservation staff. The purpose was to confirm that the bank had complied with the settlement agreement as stated by their communication to the Attorney General's office.This inspection included the interior of the building to determine if roof leaks and other factors have resulted in interior issues. This inspection-revealed the-following. 1) The condition of this property has not been brought up to the standards asset in the settlement agreement,approved by the Northeast Housing Court,as detailed in Section 4. a. Item 4b.17he improvements to the staircase do not meet building standards.Stair landing slab dislodged with simple pressure. (see photos 8c)410.452 1600 Osgood Street,Bldg 20 Unit 2035,North Andover,Atossadhusetls 01845 Phone 978.688.9540 Fox 918.688.8476 IVeh ws7w.f0wnolnorthondover.rom 392 Massachusetts Avenue May 21,2015 b. Item 4c.Leh over roofing debris and material Ieft in garbage cans and bins near garage 410.600 c. Item 4c,debris not removed from site;see section below 3)h 2) The inspection found that the general improvement of the yard has uncovered a dangerous and unsecure section of the property not previously visible.(see photos pg 1 a-d,pg 2 a,b) a. Stockade fence observed in severe disrepair,surrounding an old,abandoned in- ground swimming pool.Fence falling over in numerous places. IBC building code b. In-ground pool filled with brush and debris;unable to determine depth of hole.IBC building code c. Old couch,television,etc. found within the old fenced in area.Much of the area is overgrown therefore there maybe additional junk to be removed. 410.600 3) An interior inspection of the property has identified additional violations to the state sanitary code. a. Musty/moldy odor evident when entering building;front room water infiltration evident in ceiling from flat roof above(see photos 7d) 410.500 b. Front room broken window 410.501 c. Front room—probable squatters;mattress and graffiti on windows (see photos 3 a,b 4 a,b) 410.602 d. Room next to front room with hole in wall(see photos 7c) 410.500 e. Basement;filled with old homeowner items;Some wet from previous flooding 410.602 f. Kitchen dirty(see photos 2c) 410.602 g. Stairway to second floor;multiple stair balusters loose or broken 410.503 lr. Garage—All debris;toys,furniture etc.that was outside the garage is now inside the garage.(see photos 4 c,d) 410.602 i. Side porch ceiling in disrepair(see photos 8 a,b) 410.500 j. Family items throughout rooms(see photos 6 a,b 7) 410.602 Thankyou, Susan Sawyer; •S Health,1) ctor Enclosed:Photos Cc: Eric Kfourry,Community Development Director Gerald Brown,Inspector of Buildings — -- — -Abigail Fee,-Asst.Attorney-General--- 1600 eneral— —1600 Osgood Street,Bldg 20 Unit 2035,North Andover,Mossochusetls 01845 Phone 918.688.4540 Fox 918.688.8416 Web www.townofnarlbandever.com ! _77 Iz14 Nr 'AJ "Al sr -4. ik_�L A v4'.V';Z T..* I Nr z9l' '70 4t, r 1_0 ,Alt K'. ;+.(''' Z e j v m5' s"�'C �'l A, 4M f 1 1��, •..A..,}n •y4iil r•.�• f4 A-1 :Yteh - �etN� �[[''1� }}r' L,, Tt 1 rl ?.�y4r. .azr ��'s .i ,r+,��•V �,5�j!� �{ , ��•."� r'L'��1���5.•`•.� ,3���•" 'fir. s" '�'1•%r—. s �^„j _ ;-rr_j,,}l.i�;.,•�,iyb,r�� '��r'�{;�... �jiTr� ~� Y,;[���• ;� i t'.l`, ,i .� 1�t'b�y_r�H�,j.{S s�J:�•i1�7'7•. 71' ;� , r ,. �t• Ti�. 1• t` U�i ac',� ii r+ r4�e J' .r'S'',r+ ,�. 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'fie �4' DTZ ':f'�l � { f �x 4r T+.rtl,r tAC+� ot— t > ��T/•IIw���,'j �k?ti"? �j��L��iyg^f'*✓�f' �e. } 1.#R r+I.W ..yr ♦J r To Whom it may concern July 8, 2015 On Monday July 6,2015 , 1 met David Seymour from City Light Homes and General Contractor Todd Donaldson at the property of 392 Mass Ave in North Andover, Massachusetts. Mr Seymour is the receiver of this property that has been abandoned for several years. This property has been a safety hazard and nuisance in the neighborhood as the building commisioner in North Andover, I am well aware of what a problem it has been. Mr Seymour informed me that all the debris in the home,garage and outside were loaded in three dumpsters and disposed off. 1 then walked through the property with them and there are numerous areas of concern with this property. First and foremost is the inground pool that is overgrown in the back yard is a safety hazard and not secure. It should be noted a security fence was installed on 718115 and the pool is now safe to neighborhood. 1. the cellar appears to have been flooded several times.The oil tank needs to be removed before there is a hazardous waste spill. 2. the hvac system appears to have a consistent water line about one foot off the floor and is ruined 3. the room between the main house and garage is sub par construction. It has 14' 2x6 span and are two feet on center. The framing of this room needs to be addressed 4. there is no insulation in the basement 5. inside the house there are numerous issues,windows damaged, doors boarded over, frozen water pipes, kitchen cabinets in disrepair,bathrooms needs updating with proper ventilation and wiring, cleaning and painting,floors etc. 6. three rubber roofs need to be completely removed and new installed This are issues that need to be addressed as well as others to bring this house habitable under building codes and help the neighborhood. Respectfu y Geral Brown Inspector of Buildings North Andover, Massachusetts 978-688-9545 98A Billerica Ave Billerica, MA 01862 .. (978)5024325 ; k9diesel@comcast.net .1 rte+' ` r • • s ESTIMATE ADDRESS ESTIMATE# 1306 City Light Homes DATE 07/08/2015 392 Mass Ave North Andover, Ma 01845 acmrrrar P1Y ' RATE Arrt&W 05 Permits 1 1,895.00 1,895.00 Obtain permits from Town of North Andover to update existing home and bring up to current code and make it habitable saftey fence 1 1,289.00 1.289.00 supply 100 feet of saftey fence to secure inground pool that is not fenced in and is a hazard and danger to the neighborhood clean out work area 1 2,875.00 2.875.00 The property is full of contents and debris garage is full and basement in unpassable all contents will be put into dumpsters and removed labor 11 Dumpster and Removal 8 720.00 5,760.00 Fee for dumpster and removal of all waste produced on job site ACTIVITY QTY RATE AMOUNT 13 Demolition 1 17,765.00 17,765.00 The room between the kitchen and garage is a hazard it was built obviously with out permitting and is sub standard the joists span is over 14 feet and are 2x6s and are two feet on center the joists are shimmed up in the middle with cement blocks this area is not only safe but will be a major issue by a buyer and home inspection and will prevent selling the home the floor needs to be removed and disposed of the walls in this room will be required to be opened up there is a brick fireplace in the corner that is cracked and pulling away due to a insufficient footing entire room will be cleared and all debris will be put into dumpsters to be removed kitchen cabinets are damaged and hanging on left side all will be removed the pergo style kitchen floor is damaged and will need to be removed once cabinets are removed the second floor bathroom in the tub area appear to have been leaking and floor is all spongy and appears mold its appears the water pipes may have frozen in out side wall side bathroom will need to be gutted down to studs to eliminate these issues the venting of drains will need to be brought up to current plumbing code all areas labor and material oil tank removal 1 1,375.00 1,375.00 there currently is a oil tank in the basement that is rusted and needs to be removed permit to remove and dispose off labor and material AC FtlfrfY (Ily RATE AMOUNT 18 Roofing _ 1 23,875.00 23.875.00 The main roof appears to be in good enough condition to save, but does need a ridge vent to allow proper ventilation and prevent ice damns There are three sections of the house that have rubber roofs the front of the house flat roof is failing there is a large rotted area that has allowed a large water area to form this roof will need to be removed down to roof boards, once down boards will be assessed and repaired as needed.the rooted railings on the roof will also be removed and disposed of new insulation boards will be installed new drip edge and rubber roof will be installed with a slight pitch to prevent puddling that has been there previously The second flat roof area is in between the kitchen and garage that was not built correctly this entire area will be taken down to the rafters and have rafters sistered up to guarantee it is built properly and and will handle new roof correctlty all new insulation, drip edge and rubber roof installed the last flat area is above the garage will be addressed the roof will be taken out and disposed of the joists will be sistered and secured properly new insulation,drip edge and rubber will be installed labor and material for all work required 30 Windows 22 398.00 8,756.00 The front of the house has several windows that were vandalized and will need replacement the bedroom windows appear they can be saved and reused a total of 22 windows will be needed windows will be Simonton replacement and meet Massachusetts energy star rating labor and material 29 Doors 0 4,210.00 4,210.00 The front door is boarded over and kicked in new front door with side lights will be needed to install the driveway side door is also damaged with side lights both doors will need new lock sets doors properly installed with new exterior trim fire door is required from garage into living room labor and material EtCTlvmr ,?Tr PATE AMMMT 26 HVAC:26.1 MVAC-Subcontractors 1 17,899.00 17,899.00 the has a forced hot air and ac for climate control the unit is in the basement and has water lines on it approximately 11 inches off the floor from when the cellar was flooded the basement has been flooded numerous times in the four years the home has been abandoned.The existing sump pump has not functioned during this time. the basement would in effect flood and then slowly drain off over time This water damage has in effect ruined the water heater and furnace the unit will have to be replaced new unit will be installed and hooked up The duct work is all corroded and numerous flex ducts are all over and not up to code the ducts will need to be replaced and brought up to current code , which only allows 8 feet of flex ducts labor and material for entire new hvac system sized property 24 Electrical 1 18,995.00 18,995.00 The house has a 200 amp service coming into the house that appears acceptable the problem is the panel is completley oxidized which is caused by all the moisture in the basement from all the moisture. The panel will be removed and updated and will require all new breakers and arc vault breakers due to new codes the hvac unit will need new wiring the kitchen will need updating to current codes with ground faults and arc volt breakers the bathrooms will also need updating and per code exhaust fans installed and vented the outside doors will require porch lights per code the garage needs wiring per code the basement needs lights and plugs labor and material 28 Plumbing 1 17.544.00 17,544.00 the bathrooms will require all new water piping and drains new tub shower unit and valve new toilets new vanities the kitchen will need new water piping and drains the dishwasher,sink,faucet new gas water heater that will be power vented labor and material ACTi1ttTY _� QTf RATE aMC�Wh6? basement water dry system 1 13,865.00 13,865.00 The basement is extremely wet due to high water table the basement will need to have the perimeter saw cut on the floor and a trench dug in around leading to sump pump container the trench will be lined and have a four inch pipe leading to container that will then pump it outside once trench is complete cement will be poured into trench and floor even a pump will be installed and wired to automatically come on labor and material 31 Insulation 1 5,877.00 5,877.00 The attic requires additional insulation for code all walls opened up will require foam to bring up to code the cellar currently has no insulation and will need to be brought up to code the garage currently has no insulation labor and material 23 Exterior Work 1 26,689.00 26,689.00 The exterior of the house has several issues first and foremost the inground pool is collapsed and full of debris and is a hazard the pool needs to be dug out, all debris will trucked away and disposed of the pool area will be filled in and leveled off all over grown brush will be removed several trees are over grown and need to be cut down for saftey around the house are over twenty overgrown bushes that need to be removed on the back side of the house is all over grown and will need to be removed there are cement pads in the back yard that will need to be removed and disposed of new loam will be spread and seed planted new shrubs and bushes will be installed all new landscaping will be complete labor and material 32 Blue Board& Plaster 1 9,310.00 9,310.00 all walls and ceiling that were opened will need new half inch blue board installed and finished with a smooth glass like finish kitchen, bathrooms,room between garage and kitchen front entry that has water damage bedroom ceiling garage will need 5/8"sheetrock on wall in between garage and living room labor and material ACTMW MY �x>: AMOUNT j garage doors 1 1,775.00 1,775.00 current garage door is damaged and needs updating all new tracks and garage door is needed with opener labor and material 35 Kitchen 1 18,237.00 18,237.00 new kitchen cabinets to be installed per design of original kitchen counter tops included appliances to be included,stove, mimcrowave,refridgerator cabinets will be installed handles will be installed labor and material 39 Finished Interior Work 1 14,788.00 14,788.00 windows will need new trim that were installed new trim baseboard,window trim, doors in bathrooms living room will need all new baseboard,window and door trim front mudroom will need all new baseboard and trim labor and material 41 Painting 1 8,934.00 8.934.00 entire interior of house will need to be painted all rooms will be primed ceilings will have two coats all walls two coats all trim two coats all paint will be california labor and material flooring 1 13,422.00 13,422.00 all hardwoods in house will need to be sanded and refinished kitchen will need new hardwood installed to match rest of house once pergo is removed living room will need new hardwood once floor is rebuilt stairs will need to be sanded and finished the bathrooms will need tile installed the front mudroom will need broken tile removed new sub floor installed and new the installed the garage floor has many cracks in cement and opening up this will have to be jack hammered and removed and new cement floor poured labor and material QW RAs ' EXT 19 Siding 1 16.889.00 16.889.00 The current siding has many areas that are broken and pulling out it is a low grade white vinyl and is in need of repair all siding will be removed and disposed off new 3/8"styrofoam will be installed on exterior of home to increase Rvalue new siding installed and all trim will have white aluminum installed labor and material TOTAL c$2527024.00 Accepted By Accepted Date I Location �qcz I`/t��s �fi� �' /" J. r / No. ✓ 7 e�c / ." Date • - TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check ���� i - , Building Inspector "' O1 HORT.,N O O m *�o 3�'r AC,HUSE, ' CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 337-2016 on 9/16/2015 Date: June 28, 2016 THIS CERTIFIES THAT THE BUILDING LOCATED at 392 Massachusetts Avenue MAY BE OCCUPIED AS a single family home IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: City Lights Homes 392 Massachusetts Avenue North Andover, MA 01845 !u2ilding InspectorCl/ Fee: $100.00 Receipt: 30561 Check : 2064 i �INC,RTH o' wn- of � � � E 1. .Andover 0, No. * y. 1 Z ► (, h ver. . o!" � Mass. ' . C OCMIC"IWICK RATED C> _ 'QS 11 BOARD OF HEALTH Food K itches Septic System THIS:CERTIFIES THAT .. DING INSPECTOR K _ .....,. '... ...... � ............ . ... ................. ....... BUIL , .:i on .. :.: .. .:X: :.: :P...a����i ;,, Foundation � h'as permission to erect :.:.....:..::...:.....:.:. buildings on . ... ��� g ; �j 'ou I -7 ' �• t to be occupied as ...�` .:: .. ... .+!:�� Y provided that the person accepting this.permit shall in every respect conform to the.terms o -the application 71 // on file in this office, and to the provisioins.of the Codes and By-Laws relating to a Inspection; Alteration d Construction of Buildings in the Town of North Andover. P•_.LUMBING II�SPETOR;%°rf Rough -•c=�g �. VIOLATION of the Zoning or Building Regulations-Voids this Permit.' l Final. .j(tC2 PERMIT EXPIRES IN 6 MONT, , S :". ELECTRICAL INSPECTOR UNLESS `CONSTRUC.: S T Roug ' ✓;✓;: .. Service ... .1,.1 ......... .... ..................... Fina 0 •.BUILDING INSPECTOR GAS INSPECTOR Occupancy Perfnit Required to Occupy.Building : Rough j1; Display.in-'a Conspicuous-Place on the Premises%-.Do.N•ot Remove. Final S , ,;;._ No Lathing or Dry .YYC�.II To .Be Done,. . . FIRE DEPARTME PERMIT T LD Until Inspected and Approved by the Building Inspector. : Burner reet No OS AORYN,k �2 c..•u`+` BOG 4 MSS ACRl15E1,9 CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 337-2016 on 9/16/2015 Date: June 28, 2016 THIS CERTIFIES THAT THE BUILDING LOCATED at 392 Massachusetts Avenue MAY BE OCCUPIED AS a single family home IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: City Lights Homes 392 Massachusetts Avenue North Andover, MA 01845 l2uilding Inspector Fee: $100.00 Receipt: 30561 Check : 2064 . . F Nr,RTM Town o 2 � _E n _ over --A 0, No. J 0 * •t h 1 z C o h ver. .M.ass COCMICM WICK ��• AERATE D S U BOARD OF HEALTH Food/Kitchen septic System FF . 1H�. DING INSPECTOR THIS CERTIFIES THAT ..:....... ... ........................... BUIL r'n •• :•: Foundation has permission to erect ...... .... buildings on .". ..�. ...................- , .. to be occupied asw► :.. A .:!& !:�.t':! ' ...: MQA �: .:= � cn provided that the person accepting this permit shall in every respect conform to the.terms of the application !,-a� PERMIT T LID on file in this office, and to the provisions.otthe Codes and By-Laws relating to a Inspection; Alteration d `` : ��f PLUMBING II SPE TOR;'" Construction of Buildings in the Town of North Ando..ver. , .. W. Rough VIOLATION of the Zoning or Building Reg uIations.Voids this Permit.' X31 i Final,. PERMIT EXPIRES IN 6 MONT, , S ELECTRICAL INSPECTOR UNLESS CONSTRUC S c Service . . . . ..........* •�� ..11. ............. ... ..F• 4K ea � Z REBUILDING INSPECTOR GAS INSPECTOR : Occupancy Permit Required to Occupy Buildinz . Rough Final Display.in a Conspicuous Place on the premises--,Do-N.ot Remove s � � FIRE DEPARTME No Lathing:or- Dry N ]I To Be Done.. : - Until Inspected and ApproVed by -the Building Inspector. : Burner 1 . reet No ��� • .. :. •. Smoke Det ��.✓v,��fi ..- NAORTh " own Of... _ 0 Noe T h ver .Mass ; c • COCNICNEW1CK V _ 7,9 AORATE p .S U BOARD OF HEALTH Food/Kitchen Septic System i DING INSPECTOR THIS,GERTIFIES THAT .............. ... ................. ....... ....... ... .... BUIL '. '. . Foundatio . ...................;k..(A. . has pn � ermission to erect ..:........:...........:... buildings on . ` °Ugh � i to be occupied as ... ... !...... .... . �!.1Ws. �!`�• mney provided that the person accepting this permit shall in every respect conform to the.terms of the application al J on fele In this office, and to the prelatintorovlslons.of the Codes and By-Laws g a Ins pection Alteration d PLUMBING INSPE TOR%r" Construction of Buildings in the Town of North Andover. iA.. o{ Wt Rough VIOLATION of the Zoning or Building Regulations-Voids this Permit. Final,. PERMIT EXPIRES IN 6 MON:T, S ELECTRICAL INSPECTOR UNLESS CONSTRUC _N S T Roug Service / * 9( ... .. ... • ... .•*�••........ ......... :. ..... Fina BUILDING INSPECTOR PERMIT T LD GAS INSPECTOR Occupancy Permit Required to Occupy $uildin Rough j� . Final J/ � , � J/ 'a Display.in a Conspicuous -Place on��t/he Premises - Do'N.ot Remove No Lathing or D'.. all To Be Done•. • . FIRE DEPARTME T g rY . Unti1 .Inspected and Approved by the Building Inspector. : . , • . Burner 1 reet No ��� • •• Smoke Det - -�i�� NORTH E own o : ndover . .,.. :, No. h ver. .M.ass LAKE o COC NIC Nl WICK V '9S U BOARD OF HEALTH Food/Kitchen eg . Septic System •6�yh BUILDING INSPECTOR THIS CERTIFIES THAT .. •......••••• . ••• •••........................ ..... C.14. .... +5�� ..... Iii,; .. Fodation has ermission to erect ...... buildin son.. ... . .: .- p ...... .... g . ... �2ough-� to be occupied as ..,.. :! :.. Xk,V*.1..a1^:+. '�. ...• nev. ...... chim provided that the person accepting this permit shall in every respect conform to the.terms .4. to application �' ai v6"on file in this office, and to the provisions.of the Codes and By-Laws relating to a Inspection, Alteration d Construction of Buildings in-the Town of�North Andover. ,�. �` '�T4 �� PLUMBING INSPE. TOR'y" Rough VIOLATION of the Zoning or Building R.egulations.Voids this Permit.: Final.. LD PERMIT EXPIRES IN 6 MON T, S :'.. ELECTRICAL INSPECTOR v 0� UNLESS `CONSTRUC N $ Roug 0 Service ... ..1�./........ .... ;. ... _ ... . . Fina (� � 2�Q .BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy wilding . Rough Display.in. a Conspicuous Place on the Premises, - Do-N.ot Remove. F'na' X �'�'� N.o Lathing or Dry YYal To Be Done• . ' FIRE DEPARTME PERM -IT T Until Inspected and Approved by the Building Inspector. ; Burner reet No i Enter construction cost for fee cal- North Andover Fee Calculation Construction Cost $ 2493738.00 m $ - $ 2,996.86 Plumbing Fee $ 374.61 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 374.61 Total fees collected $ 3,846.07 392 Mass Avenue 337-2016 on 9/16/2015 Total House Remodel i tk TH own_ Of E . ,, ndover O 0 No. 3 ( * - 1 � zap fh ver, Mass, o 1. COC NIlC c"t Ht WICK � A°RATEo �'fA,�•cy s U BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System t BUILDING INSPECTOR THIS CERTIFIES THAT ..........Cr..... .......... ........... ................A.. !f!9x4:*A-t ........................... .. . ..... Foundation has permission to erect ...... buildings on ..394 �m. .. Rough a a to be occupied as�Q:"o...a . ..�.. R.1.�!� 1 A�►.r Z:.. Mg}... !J� Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application Final on file in this office, and to the provisions of the Codes and By-Laws relatingto a Inspection, Alteration d Construction of Buildings in the Town of North Andover. 1404 bbJll �, PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 M NTJYS ELECTRICAL INSPECTOR UNLESS CONSTRUC S Rough 61qf4 * Service .......... ..... ........... ..................: .................. Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Reguired 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. Donaldson Home Improvement Contract for Services This form satisfies all basic requirements of the state's Home Improvement Contractor Law(MGL chapter 142A)but does not include standard language to protect homeowners. Seek legal advice if necessary. You may obtain a copy of the Massachusetts Consumer Guide to Home Improvement by calling the Office of Consumer Affairs and Business Regulations Consumer Information hotline at 617-973-$787• 1. HOME OWNER INFORMATION CONTRACTOR INFORMATION Cit Light Homes MA Home DON�� i MA Unrestricted Improvement ALD 11 Construction Supervisor 392 Mass Ave License#177721 Ht� or CS-105410 Expires 1/28/2016 �,m Expires 11/30/2015 North Andover MA 01845 Donaldson Home Improvement,LLC—Emp#45-3364045 98A Billerica Ave.Billerica,IVIA 01862(978)502-4325 Diane Donaldson,Owner D.Todd Donaldson,Estimator,Licensee 2 Donaldson Home Improvement, LLC agrees to do the following work ('detailed in attached estimate)for the homeowner: Home Remodel including roofing, exterior work,kitchen, and garage. Proposed Start Date: 10/01/15 Date work will be substantially completed: 3-4 months Required Permits-The following building permits are required and will be secured by Donaldson Home Improvement, LLC as the homeowner's agent: Building Permit,Siding Permit, Electrical, and Plumbing Permit. 3. Donaldson Home Improvement agrees to perform the work,furnish materials and labor specified above and in the attached documents for the total sum of: $249,738•oo Payment Schedule: $i5,000.00 due upon Contract Signing 5 Payments of$46,947.6o upon progress of work. (Initiates scheduling,permitting etc.this is a non-refundable deposit) Payment will be discussed and finalized prior to start of work. 4. The following material/equipment must be s special ordered before the P contracted work begins in order to meet the c . completion schedule.Special payment arrangements if needed noted below. Page 2 of Donaldson Home Improvement Contract for Services 5. CHANGE ORDERS Both parties acknowledge that unforeseen items may arise during the project that can impact the timeframe and cost of the project. If and when any of these items arise,it is agreed that any items requiring additional i t majs2chuseiis-Deoarrmenl aF pubii Safety 3aaid or 8uiiding Regulations and St indards cortsTYUciion supr-z lwr 4 _icense:CS-10"10 • ;;811���,�D501�3=y� ' t. ;,� - .•,t'�`"�` 23 BTB LOVMMAf t x pirabon Commissioner .� �/e`r�nrtt�nQtrrtretrll` ofG�`aJJrrc�uuc!!J•• .0mccefCfiumerAffdm&BoinessRephtion 40ME 0WROVEMENT .CONTI A=R 177721 Type. 'raSon., 9/2812016 Corporation DONALDSON HOME IMPROVEMENT.IN TODD DONALDSON 23 ELLIOT DRIVE LOWELL,MA 018$2 nderseerebry w" r work will be addressed in writing with a representative of Donaldson Home Improvement prior to beginning said work. A customer may initiate additional work orders as well, and they will be addressed in a similar fashion. These change orders must be accepted before the work begins, or in some instances before the contracted work continues if said work impacts the completion of the project. 6. WARRANTY Warranty Terms as Follows: Donaldson Home Improvement,LLC agrees to be solely responsible for the completion of the work described regardless of the actions of any third party/subcontractor that is contracted by Donaldson Home Improvement,LLC and utilized in the scope of work of the project. Donaldson Home Improvement,LLC agrees to be solely responsible for payments to all subcontractors for materials and labor under this agreement unless otherwise negotiated prior to acceptance. (See section 4) Donaldson Home Improvement,LLC offers a One-year Express Warranty of workmanship and installation(all labor)associated with the scope of work and materials described in the project,normal wear and tear excepted. Materials and products utilized in the project are the responsibility of the individual product manufacturer/supplier. (Customer is responsible for retaining and registering all products procured for project) 7. ADDITIONAL CONSIDERATIONS Donaldson Home Improvement, LLC reserves the right to use photographs taken of our projects for use in media, advertising and web use. Donaldson Home Improvement will not use personal information or specific locations to describe the work featured in any of these areas without express written consent of disclosure. 8. CONTRACT ACCEPTANCE Upon signing,this document becomes a binding contract under law. Unless otherwise noted within this document,the contract shall not imply that any lien or other security interest has been placed on the residence. Review the following cautions and notices carefully before signing this contract. Neither party should sign this document if there are any blank spaces. This contract is to be signed in DUPLICATE. One copy is to go to the customer/homeowner or business owner, the other copy to be on file at Donaldson Home Improvement,LLC. You may cancel this agreement if it has been signed provided you notify an officer of Donaldson Home Improvement,LLC in writing at his/her main office or by ordinary mail posted,by ram or personal delivery,not later than midnight of the third business day following the signing of this agreement. Cu tomer/ o eo a Signat re: Date: Donaldson ome p vement Representative: Title / Date: c � f The Commonwealth of Massachusetts x Department of Industrial Accidents I Congress Street, Suite 100 -Rn,sign, -A..0-2-714-20-17 -.. . www.mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly r Name(Business/Organization/Individual): Address: Gil A Ja Iy ( ej C A �y r City/State/Zip: Phone#: WW�02 __ 5z Are you an employer?Check the appropriate box: Type of project(required): ` l am a employer with(% mployees(full and/or part-time).* 7�New construction I am a sole proprietor or partnership and have no employees working for me in 8. [] Remodeling any capacity.[No workers'comp.insurance required.) 3.EJ I am a homeowner doing all work myself.[No workers'comp,insurance required.] 9. ❑Demolition 4.❑1 am a homeowner and will be hiring contractors to conduct all work on my property. 1 will 10 EJ Building addition ensure that all contractors either have workers'compensation insurance or are sole 11.0 Electrical repairs or additions pprietors with no employees. 12.E]Plumbing repairs or additions 5.[ am a general contractor and 1 have(tired the sub-contractors listed on the attached sheet. 13. Roof re airs These sub-contractors have employees and have workers'comp.insurance.; ❑ P 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.❑Other 152,§1(4),and we have no employees..(No workers'comp.insurance required.] *Any applicant that checks box Ill 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:_�PC, r C, Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address:-- _-rk —V ACA!&S , City/State/Zip: -/ 01 Attach a copy of the woers'compensation policy declaration page(showing the policy number and expiratio date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a-fine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do Hereby certiJ uder t ains and penalties ofperjury that the information provided a ove is true and correct. Sign Date: q110 1p;� Phone#: 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#: CERTIFICATE OF LIABILITY INSURANCE 09/10/2015Dm'YY) 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). 20DUCER CONTNA ACT Paychex Insurance Agency Inc PAYCHEX INSURANCE AGENCY, INC. 0. 150 SAWGRASS DRIVE PHONE 877-266-6850 F' . 585-389-7426 ROCHESTER, NY 14620 E-MAIL AD RESS: Certs@paychex.com INSURER(S)AFFORDING COVERAGE NAIC# SURED INSURER A: NorGUARD Insurance Company 31470 DONALDSON HOME IMPROVEMENT LLC INSURER B: 98 A BILLERICA AVE NORTH BILLERICA,MA 01862 INSURER C: INSURER D: INSURER E: INSURER F: OVERAGES 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. R TYPE OF INSURANCE ADDLPOLICY NUMBER POLICY EFF POLICY EXP LIMITS INS D (MM/DD/YYYY) (MM/DD/YYYY) GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ CLAIMS-MADE�OCCUR EREMISES(Ea occurrence)MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY =PROJECT=LOC PRODUCTS-COMP/OP AGG $ $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ ALL OWNED SCHEDULED BODILY INJURY AUTOS AUTOS (Per person) $ HIREDAUTOS AUTOSWNED BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION AND X WC STATU- OTH- EMPLOYERS'LIABILITY DOWC663376 03/10/2015 03/10/2016ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 100,000.00 OFFICERIMEMBER EXCLUDED? WN E.L.DISEASE-EA EMPLOYEE $ 100,000.00 (Mandatory in NH) FY N/A and If yes,describe under E.L.DISEASE-POLICY LIMIT $ 500,000.00 :SCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) ERTIFICATE HOLDER CANCELLATION CITY LIGHT HOMES SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION 392 MASS AVE DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY NORTH ANDOVER,MA 01845 PROVISIONS,BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE CORD 25(2010/05) @1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD OP ID: PW A�oRom CERTIFICATE OF LIABILITY INSURANCE DATE(M0/20 09/10/20 5 15 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Todd Donaldson Segreve&Hall InSUr.ASSOC.Inc PHONE FAX 305 North Main St. (PA/C, A/c No E.1):978-502-7789 A/c No): Andover,MA 01810 E-MAIL Patrick D.Hall ADDRESS: PRODUCER TODDD-1 CUSTOMER ID#: INSURERS)AFFORDING COVERAGE NAIC# INSURED Donaldson Home Improvement LLC INSURER A:Commerce Insurance Co. 34754 98A Billerica Ave. INSURER B:Utica National Ins. Co. No.Billerica, MA 01862 INSURER C: INSURER D: 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. _NSR LICY EXP L B LTR TYPE OF INSURANCE POLICY NUMBER MMIDDY/YYYY MEFF M/DIYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 LU X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ 100,000 CLAIMS-MADE �OCCUR MED EXP(Any one person) $ 5,000 B PERSONAL&ADV INJURY $ 1,000,000 A BGPYKG 06/25/2015 06/25/2016 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY PRO. LOC $ jECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 ANY AUTO BODILY INJURY(Per person) $ ALL OWNED AUTOS BGMMZH 02/15/2015 02/15/2016 BODILY INJURY(Per accident) $ A X SCHEDULED AUTOS PROPERTY DAMAGE X HIRED AUTOS (PER ACCIDENT) $ X NON-OWNED AUTOS Underinsured $ 100/30 Uninsured $ 100/30 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LUIBILITY Y/N TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N/A E.L.EACH ACCIDENT $ (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ -7 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City Light Homes THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 392 Mass Ave ACCORDANCE WITH THE POLICY PROVISIONS. North Andover, MA 01845 AUTHORIZED REPRESENTATIVE ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD