Loading...
HomeMy WebLinkAboutBuilding Permit #589-2017 - 47 EAST WATER STREET 12/2/2016 J � L OF NORTH q J BUILDING PERMIi 4a �/( TOWN OF NORTH ANDOVER o I AMINATION APPLICATION FOR PLAN EX Permit No#: Date ReceivedR4TEo SACHUS Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION q7 1% � r PROPERTY OWNER (! I? �C tl Uvd Prinf 100 Year Structure yes no MAP —_PARCEL: 00 ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition El Two or more family 11 Industrial ❑ eration No. of units: ❑ Commercial epair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other _ - = . ,_ r _ ❑ Septic b Well Floodplain fl:`Wetlands: VVatershedbDistriot ❑Water/Se,Wer._ ESC IPTION OF WORK TOn PERFORMED: AA � �.S lV .S rtQ v��U Identification- Please Type or joint Clearly OWNER: Name: Q��'`t1+ �Po� P �'s�- zqei`a i�l Phone: u j Address:_ �� k A4-9,r S 1 J f� t,�o n d utiJ Contractor Name: WIA Phone: R 7 Email: Address: • y u t'n vh n r (C �n ��tt ✓Y} c�I v Supervisor's Construction License: 0 7 oC •7 Exp. Date: y' 7 Home Improvement License: ' X02 S� Exp. Date: V- r2 ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BOLDING PERMIT:$92.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S-F- Total Project Cost: $ I t FEE: $ < < Check No.: Receipt No.: 3 »''' unre istered contractors do not have access to the uaran and NOTE: Persons contracting g g tyf r• Sianatu_r iw 'r,+/Owe r Signa ir�of coil racto� ��r r—_l s E; Location q7 f- W 14 J(c A 57 No. SGt - �017 Date . - TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ t �^ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check#_LWF IL-- Ll Building Inspector Plans Submitted ❑ Plans WaivedV❑ Certified Plot Plan ❑ Stamped Plans ❑ -YY-PF-OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/MassageBody Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank, etc. ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes A Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/signature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT - Temp Dumpster on site yes no Located at 124.Main Street Fire Department signature/date COMMENTS 1 r limension 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 Ido 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 Call Email ate Time Contact Name t Doc.Building Permit Revised 2014 '�I�fldl,llt�l I C? irvvv r - . Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. I Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ 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 ❑ Building Permit Application o Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (if Applicable) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan o Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products VOTE: 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 i I I 1 � NORTIi Town of : ndover . No. �o h ver, Mass, / a ; of �/_ COCNICNlWICN �1. 7,9SORtTEO Ppa��S U BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System THIS CERTIFIES THAT 1I11I Dove waKt BUILDING INSPECTOR /� has permission to erect .......................... buildings on ..�.0)........Ir.�.....1W .... .M .4.10t. ........... Foundation ` �� I Rough to be occupied as .....! . ..... / .......... ..,..............") ........................ 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 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 CONSTRUCTIONS ARTS Rough Service 4 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. (' avtTuGT 'Window World of Bbstori,,LLC MAHICRegistration jJA r •� Number: R Qg2f �l , & f`�° t[nn 'SftoEvroom5 11 �' 7>'tSACuT.,It'QS,Parn �'393Q;d0a:,Street 166025 wy/ ttiobur t RtA OY Ot Pc'n ro,e»'a0�3F�a Fcd14616 9 �^ �O i' Y•# -y o 6 y 27 1461669 tv r �,�s (?61j;S�.ob28t "Simply tFre,Best for Less" anuv.�Vtnd4l:�VafdOfEnston Corn. �y 7o -81,5 O -p ¢I� ' V;? /� 7) Customer: ALV2Y1 r.O Phon�ttr� Sfo(a-833-?8►��/ U `t Cay: /Yo�_I�_.-- A_ndd mer s, U :4�_;p•U_jS ..S i ma.l _ v/il WORLD MASSOPTIONS te"vD.SenesSingtd.hil gAll.VtOtJ St8'9^_ Soiar_onoale S93_138(� 2Cd0'Series DF(MechWalded Sash 51'?5' _Ti G•scd TG-', 5175 ,�_d000Sene54H:Alta�efd 5245��',f (-�a.a7hJ3^'�t: 6t1o13 Senes'DH'Aii•17e1d :?�0 WINDOW`OPT-IONS te5Bder '333 3 _✓GI sB�3tpratYhrranT}+ Sts ;GIU(1(1: 0525 _iG Q screans - PtWTO.lFMedLlte. -5331 „ %FoarnIngut6fibrtonJiralig.ar[dHe3c! 51t'l1tCLU[T_-f1 Dactyre.Streh9,b.G4us. nnS260— S15_IJ^PLIJDif*}:: Avng Sd60 > 55! C3U0-°pr ~C2aement SZgO.. v Double Loci fl 20) Fu0 5cmeps 22° .=2 Life ctu-ri gilt - '�., 5_ Eclo;na).Grids nrn r Fiat} .V•3i1L.. _3 U(e Citsernerit e6 P-7,7- rapno.y:ids _BafeTrtent.l njiper S334Grids --fhamanaGrids S89 _Bay Winddw Soi6t.m6uIttlINS 3ba1 S26t0r_ S,rruliied.Divided'ule —.3biv-1Yiad01�•-Stittit.ASounCL iNS:Sea{52:... —�erpptred-DHtS,istr(BSfl�50)—S`fi: Garder0Wndovv-.— 5oaualty�tYimloav^____,�. 5' -t7nclStytrf 0£6obr.66'a0)' SSO Be,flq'i�Imottd SAO _Foam Entiafti:etmaine 535 MttUod Gipiri(niendrl&c?esfooC;r Fi!o0.a q,$1C0 PRe 197&$U1LT'Ko?.jF5(FW"lLead Corifafnmentlaw) . alignrk•gatfCnc.3 ,cipiD .1 FC4.Y'4od' �] LeadSoiePlaeuces.R@gulieii $25 SO R:cA liia.'c) A111:HO�tEWAS.81tL'f'1N'ftiE,YFJIR f 9•�? Ini11aT ' _&c+-tEeertdrt 'c ErSn et �h�rt7erra)S10O MISCELLANEOUS Oby p.srph.. �c rjr 51.55 _ C(utom Ektorsoi Altrmfnuirt Cladding _> �•i t f,J h i :,7 Yexmred s7soih'G a$us: s t d4 l�ndoly Cb1oP 'Faging Qplpr + G... rnc.�r fk":�'c Mettil�'JtndalvRemova). 550'.... 'NON CUSTOM.DOCRS —New&OM F.opmitylRemove! .5175 �_yn}1Rtitl�ng.PaAot3aot SR; to ss9s 445_' J_Sp@cta7(Yvit,ndovvbderigrTdm _lve}9 RC.irng Pabo oaoi-BR, Sloss_ _R1t�i IC I:crni Mtlln batt.. .590.,x,!„ :.,,,-�basbt7rt:e)a!C+mxt.'nok`n.1'Palb.6bx Srlsa�_ r lflsiafl lntenGrlExfeno[Slops. S56-jil SO. ft _F,renthil5ttdtng.Patiot7oiit'St[,ot.% $1295 Installln�enorCasing StansA{.S35;j,,. _ peit.sirmnlyalf.6 dr ah; S1395 �InstilataWetgh�:Bi5x05 - 'S20.. s=ren tt Ragsudtng;Pann Door 911. SUM Roof fol Bay(Bo'vt UVtil 5500. �_Custom.ExtencrCladding St50 ISO, iStngNevaCanst F�a.f�¢iroFf` S350 �_SoiarZcnefiiieorSTC'Glass. 5475 17;' Reitovalbfrt�iistrng�ay)Bocr 5`250. _Ged&'Oe:to Coon 5129 ( Reparr Sitl Jamb or replace silt no`slrig 550 SO_ _W=dgrain Interlom 5295 ^LNiSuli Sll°(5ingte)reptaeement __EAorlDel Cfots d 5395 tvlulroRRembval 530 �,tntenar Casing;2+ 3- stzS_i TS' T3ayiElovrCarsvets'ion Ext Rebid Ft `$350. ,.H,ondleset Qat Ons S (Nevi Sld',hg Will Nbt hA8tch1; 1 5— 1'quo ling.fti mri 5'150 FSO Door Color s 1 T? 1 i,�rl i:7.P O ROtJNt7�t�P FQR W1111iO1N.1NOli OARicS rsrae pie V SLJodsCMfdteFsttraearoTrHosp1151: S. CustdArtet declines exleriorsviap aYtd undeisIM01 painting:and)ot y2pair may lie r 606d laitial Customer dl-lines gilds do tvindavrsldobrS.ltiTttal ` , nt_`r ell.rdEt!e�ustbmuisresrOhbb4riat16otetdKngNtianneetlonviPtrllscantn(CP aO:SplNnyNarm, uA&stanneet4eeemeCtBir'Qa9tkrinsialEsm eatxss.c152500.1iamoo•+rttand ar CendiG/sSEeabanApDio}at.tf�sfona:OiStAfrLwv&.CM1yatBoston tr>f�rWsrgav71k1"irmt[feesin.eonnithon,>th insta9atiaa: ILHOTem eragrees to ince tgttgs of payment asifoitoWsc. Emo. .EnFmKIfNOTIN Wf• ExUatdbol.&taaterfats teSaLUp.MsposlDeliveryFee 5Toilamounts84. 00 Gust®m Order Deposit 50% SgLiLi 'Ot1kwr0ompistiAmount Filial 5yhh4ariPioriQol9ostabanGitpalesslatu7rp:tfisbegpsubstIMNYcempietee oL days$dvanc:.of the scan ottl )3 Ct the lOttl cOnftact plica or trte actual"cast of any Mile n` Dm a m fit y a, as tpnclatald¢rareu;tarama6enatute v+Myhmuribearderedlail&nceolmestar;aylhewarktopsslhethatlbeprotat+Hllpmcced.onseR._a p 9 sry?il be debanded viol]tie co[IDact is comfillib t w>fie 5a4SlachGn of hcU[patbet ABJtorneimpmvaraeettontuctcrsanpsu'5cantiactdnsnanbe-rdoWeliedMad IIIMI:iijinrulrlraboNa'co�dtacftrsubcortnitorniitno16a110mratiae,shellbe aired ImOffice elconsumer Allatrsand au:ktessReau1a11dnTonPMrkPlimSuits 5170Boston,AIA 6N1Is.Phone:(617)913-8700 �Ira Walk shah 5egl94 odorlo the signb;§06he coni'rat and lropsmfnel(o[.be owner al a copy al such ryoiitracl tYmdaxVlpildotostdn,ender,ptgv73grr:o(Cbap,ett4?Aot>K¢0��?arrsl)equiredt0ap61y'arandabtunaBsonslmebonretatrilporrrp;IslYmdatvl7add;ot 0astsuiSltoloot,Dedeemed'raspadsthkrordelaysfnthevbtkdesetibedin'0lsagr¢eaviAlcWs6dAj1Maliibi,prim,Fdrantingagenees,amharNesofiholl als. llotfeetitthePl1flCs. RASEp(9)dttaittshTsovmedhstnlhtibntehledpermflitoeinswertdesaedheeupdgPUACCHF tu111fitfbetdl)Il or deals With n1eEt0�iriatttred a1rJalmMof fhtr,FURCRASER(S)is tigir by adiised rhMfInd)eevenl ola AspWE,ledlignii ani tiaop..ym the'. eoltaelidnlydrrsthggoaianljrf000 Wbllsti tinMptentA?AI MQ.L. - OU Ufe+htfyer.may OafrC¢I Ibis transaction-atanyWil plifor-to tntdnighto 108 til tQ.bUbiness day-ada[.me.date.bf IelLnanSBCt)od+ Nelf ce df eaneelation.musthe lit wtiling postmarked no.faler Ihan midnight of the'foltow(n1.Ulird businessttgY TtnsYArddw,yloddrFramNseisimleirdi oanidaaCa 'uea'tYindovi"mfaol8osloh.tLCtmderBc�[uelrcmNtndoivtYoaa,lnc: �¢��,y r f� OWner.Do nOR}lertlrther to ny btankap o3. Data�� V7r' N Scanned b�amScanner Sal ma not sign;trlol are 3ny-blank-ores .Date' DytlQhr DO not along inetoeireny nk'appees.. Date Des.itiion to whtto:Cd'py•CgXj yill Copy•Pia Flnk Copy*.Ct,%CTar 'Mevnnvnmaxrsrma MI Windows And Doors 650 West Market St NI RC Gratz,PA 17030 1650 DHNINYL/Grids NaGonfllFsnesfration Panel 1&2:Lite-1:(3/32",Clear,LOE,Annealed);Lite-2: Rating Councils (3/32",Clear,NONE,Annealed);Argon;35 3/4 X 411/4 SIZE= MEI-A-111-04220-00002 Indlvldual products may be subject to varlatlon In performance ENERGY PERFORMANCE RATINGS U-Factor(U.S./I-P) Solar Heat Gain Coefficient 0.29 0.26 ADDITIONAL PERFORMANCE RATINGS Visible Transmittance 0.46 Manufacturer stipulates that these ratings conform to applicable NFRC procedures for delerminng whole product partoimance.NFRC Ratings are determined tar a flited set of envireonmentai conditions and a specific product sme. NFRC does not recommend any product and ones not warrant the suitability of any product tar any specific use.Consult manufacturer's literature for other product performance Intormatibn. wwe.nfrc.org ENERGY I 1 R""Qualified,.In All 50 States Perf Grade +DP(ASD) -DP(ASD) Water R-40 50.13 55.14 6.06 Max Test Size Report# Florida ID - 38.00 X 80.00 B7962.01 12234 . Ratings are for individual windows and doors only. For information regarding mulled or stacked units,please contact your sales representative. Pos and Neg DP limited by unit test size.Tested to AAMAVDMA/CSA 101/I.S.2/A440-05 Glass According to ASTM E1300. Printed on 26474612.6.1 .2 4/2812013 11:44:62 PM � 1 2 f t s* I tfi 2 '# f ��y The Commonwealth of Massachusetts Department oflndustrialAccidents f Office of Investigations 600 F,jashingfon Stfeet L / "' Boston, MA 02111 www.rrcass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Please Print Ledbly Applicant Information L L� Name(Bushess/Organization/ladi,dduai): Address: J 5- /-r C Uf'n 44 i A/- ;t: �g�� Z 3� •' "/ S�S City/State/zip: tooio-Aw, N�. O/ 80/Phone Are you an employer? Check the appropriate box: Type of project(required): a. I am a general contractor and I 1.[�I am a employer with 6. ❑New construction have hired the sub-contractors employees(full and/or part-time)-* listed on the attached sheet. 7. []Remodeling 2.❑ I am a sole proprietor or partner- These sub-contractors have 8. ❑Demolition ship and have no employees employees and have workers' 9. (]Building addition working forme in any capacity. comp.insurance. [No workers' comp.insurance 5 We are a corporation and its 10.❑Electrical repairs or additions required.] officers have exercised their 11.0 Plumbing repairs or additions 3.❑ I am a homeowner doing all work nght of etie tionP'er MGL myself-[No workers' comp. 12.❑Roof repairs c. 152,§1(4),and we have no 13 [�'U.ther � � insurance required.]t employees,[No workers' comp.insurance required.] � 5 *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy-information. Homeowners who submit this affidavit indicating they are doing all work andthen o soutside l�contractors and state ontra.ctors must wh the othose a new affidavit entitiesnhave such. $Contractors that check this box must attached an additional sheet showing 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. 1W, -fs Insurance Company Nam / 7 � / Expiration Date: Policy#'or Selfins.Liicl7• W.r: rVrA cit / A .A State/zip: Job Site Address: `7 Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). riming penalties of a Failure to secure coverage as required under Section SwA ofMGL • 152 alti inethe toforrmthe imposition STOP WORK.ORDER and a fine fine up to$1,500.00 and/or one-year impnsonment, P of up to$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for insi -ince coverage verification. I do hereby certify and the ains and p es of that the.information provided above is true and correct " Date: Sienatare: 2 Phone ft- official t 4 3 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.BuildingDepartmeat 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Phone A: Contact Person: 0 WINDO-2 OP ID: HI �...� CERTIFICATE OF LIABILITY INSURANCE =7�DA7TE /YYYY) ;terms RTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HO01 HIS ATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED ENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. [,REPRES NT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to tand 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 Senn Dunn-GSO NAME: Carli Witcher CISR,CBIA, CIC 3625 N.Elm St. PHONE Greensboro,NC 27455 ac No Ext).33 -272-7161 ac,No: 336-346-1397 C.Timothy Ward,CPCU,CIC ADDRess:cwitcher senndunn.com INSURERS AFFORDING COVERAGE NAIC# INSUREDWindoINSURER A:Citizens Ins Co Of America 31534 w World of Boston,LLC 118 Shaver Street INSURER B:Allmerica Financial Benefit North Wilkesboro,NC 28659 INSURER C:Hartford Fire Insurance Co. 19682 INSURER D: INSURER E: COVERAGES CERTIFICATE NUMBER: INSURER F NU THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAIMED SION ABOVEB TOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDLSUBR LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER POLICY EFF POLICY EXP MM/DD/YYYY MMIDD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EAC CLAIMS-MADE T OCCUR OB6790252707 DAMHGE-TO RENTEOCCURRENCE $ 1,000,000 Business Owners 04/01/2016 04/01/2017 PREMISES Ea occurrence S 500,000 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY❑JE O- LOC GENERAL AGGREGATE $ 2,000,00C. OTHER: PRODUCTS-COMP/OP AGG $ 2,000,00 AUTOMOBILE LIABILITY $ COMBINED SINGLE LIMIT B X ANYAUTO Ea accident $ 1,000,00 AW68757615 06/1612016 06/16/2017 BODILY INJURY(Per person) $ ALL OWN ED SCHEDULED AUTOS AUTOS BODILY INJURY Per accident) $ HIRED AUTOS NON-OWNED ( ) AUTOS PROPERTY DAMAGE $ Per accident X UMBRELLA LIAB X OCCUR $ A EXCESS LIAB CLAIMS-MADE 086790252707 EACH OCCURRENCE $ 1,000,000 04/01/2016 04!01!2017 AGGREGATE $ DED RETENTION$ WORKERS COMPENSATION $ AND EMPLOYERS'LIABILITY I PET C ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N 22WECLJ2635 X STATUTE I RTH- OFFICER/MEMBER EXCLUDED? ❑ N/A 01/27/2016 01/27/2017 E.L.EACH ACCIDENT $ 500,000 (Mandatory In NH) If yes,describe under E.L.DISEASE-EA EMPLOYEE $ 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of North Andover ACCORDANCE WITH THE POLICY PROVISIONS. 120 Main Street North Andover, MA 01845 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-072772 Construction Suoeriiso, JEFF C STEELE ' ,F 24 SHERWOOD-AVE DANVERS MA 01923 4 t P x r` Expiration: Commissioner 04/07/2018 Q -frir t=..rdN/r_iltvr,rr/ ,! l/•f.:..nClrlt�eC� "- OfSce of Consumer Affairs&Business Regulation - _ — HOME IMPROVEMENT CONTRACTOR t _ Registration: 166025 Type: Expiration: 4/12/2018 LLC WINDOW WORLD OF BOSTON,LLC. JEFF STEELE 24 CUMMINGS PARK SUITE 15-A WOBURN,MA 01801 Undersecretary License or registration valid for individual use only before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 Boston,MA 02116 1 / ,,got valid without signature