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HomeMy WebLinkAboutBuilding Permit #360-2017 - 47 PETERS STREET 10/5/2016 I ►v S Scpw+/is D / NORTF1 It ,to BUILDING PERMIT �y,� TOWN OF NORTH ANDOVER o ; `"� APPLICATION FOR PLAN EXAMINAAPI(90i Permit NO: %0 �� Date Received A°RATED Date Issued: G S-- dl-V/6 9SSgCHUS�t IMPORTANT:Applicant must cog lete all items on this page 4-116110�%'' 'rc°' a . r t g w. xt - °"" "+' g r s� 'a' • <rr• ," ' . ,02.�. *smut,'s"r[ . ra y. 3 kt r �` ::;y ( LOCATIDN �x ��§"�'��� �,�' '� ,a`+� 5• ,° � '���' "` � ,# � }�;�'Int �c,,.� r� �� � �' � q �.e��F� � '��:� °'�'a�A�z"t�'�` s a� �� '�+"�u s r. �PROf�ERTYINNER � . . x a awe ` �; � r MAP NO PA CEL" kk ZONING )Ib-I ICT H�stor c l��strict Shap,Vii4 ' TYPE OF IMPROVEMENT PROPOSED USE ' Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑Two or more family ❑ Industrial XAlteration No. of units: Xcommercial %Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other +iJ"e t1c ALJ Well � r tg r ,w ' 'q x s n p � , 111114 � Flc�o�dplaan ❑t/I�etlands � ❑ UVatershed�District�n y , „ :WaterVSewet. �, :. �46- : ro �sr a a a Y, 11 Identification Please Type or Print Clearly) OWNER: Name: Phone:9 � �D S305 Address: S $v .€�� � ' CONTRACTOR Name ' Phone 1$y $�7").� p ; .4 A ." .ss;�; Yr,rr- /4tldresS: t iO Su ervisor s�Construc ionzLic�nse q 1141 47, p Exp Date ° Home.Impro�ement:License �� TMS 4 Exp. ;Date �� E ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BOLDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project'Cost: $ �J� S ��. FEE: $ .`:Check No.: P/S 3 Receipt No.: "NOTE: Persons contracts ith nr ist co ctors do not have access to the guaranty fund Suture of.Agent/bwriei= ,` - ure ofxcontr�ctor` / :. NORTH BUILDING PERMIT `"` `� of�"r.D '61 TOWN OF NORTH ANDOVER 02 5 oZ. p APPLICATION FOR PLAN EXAMINATION Permit No#: Date Received ATED Date Issued: IMPORTANT: Applicant must complete all items on this page �a LOCATIONS - Pnnt, PROPERTY OVIINER" � - . . 900 Year St�uetur' w yes no % _ nci esu not. MAP PAR' EL _ ZONhNG DISTRICT° --JHisto stnct y,-r _ — ills -, Maclme Shop�V;age: yes nasi 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 _ ShelDiscfFI' 4J. Watersd ep#c ❑ ❑Vea 6 DESCRIPTION OF WORK TO BE PERFORMED: i R Y Identification- Please Type or Print Clearly OWNER: Name: Phone: Address: t, Phone - Address - y y . F _ , visor�sC©nstruction� License ills, _ Exp- 'ate H.orne�Im _r©vement,License t 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 � a Signature of Sigriatu.re of�contractor_ _ _ i 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 ❑ 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 Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street iFIRE�'iDEPAR�TMENT�'�Temp,D st`er�on�site� es � � �� rL©�cate�tl 1F24911/Iazin Sfreet . - {FirealD:eparfrnent signature/date >� .. . l s ��.ENTS� COMM � � R �� , - � •. � 4 e Cs. r Dimension i i Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: b i 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 i I i I ❑ Notified for pickup Call Email Date _ Time Contact Name Doe.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 ❑ 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 ❑ 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 r 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 ❑ 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 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 ? I t � , i Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans TYPE OF SEWERAGE DISPOSAL Public Sewer Swim Pools El Art ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ 0m COMENTS JA —o CONSERVATION ❑ ❑ ` (v d COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ ❑ COMMENTS Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature$Date Driveway Permit Located at 384 Osgood Street FIRE DEPARTIVIEIV ' Temp DUms#eron;si#e yes � b � LA Located at-1-2 I Adi S#reet '' � Fire DepartrnentJsig: 't ate � 4 w . g,I � •"r:'�. '"fit k ,�' ;• s ., + ' { r k'°• ' `„��r .�.`��-� �� :•" ° � '� t„`� t �"'sa z.,y .. ` ' 4 t COMMENTS t �� � � � , !'L F S etik:. e. "n # 4, ;+S. .:�"a. �" �• . r Location No. �; * Date U • - TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other.Permit Fee $ TOTAL $ Check# 0 9 9 Building Inspector NORTH Town of f 6Andover O W . va soh ver, Mass, • s• O/ �D coc MICNlw�c■ ��• �•9 AORATEo 0kPa��S S U BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System �.Y►�V 777VOW.e.4THIS CERTIFIES THAT ........... N......... ........................................................ BUILDING INSPECTOR � S has permission to erect .......................... buildings on ............................P..........r ................................... Foundation 0• Rough to be occupied as R44-40140 #1 D E C IC )z /� I M .......................................................................�...... .. ....... .. .� ............ 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 Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTIO STAR Rough Service ........... ................... .. ....................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Buildin,:; 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. 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) h164I.- \-14' 16k ❑ Notified for pickup Call Email Date _ Time Contact Name Doc.Building Permit Revised 2014 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 ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ '7—S I COMENTS .V CONSERVATION ❑ ❑ ` ��, to COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ ❑ COMMENTS Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature&Date Driveway Permit Located at 384 Osgood Street FIRE DEPARTMENt — s Temp Dempster on site ..r .. e no _ 'Located at 124 Main Street _ , . t a t Fi�e'Department`si. nature/date COMMENTS vID k k" r 7 _ l MASSACHUSETTS HOME IMPROVEMENT CONTRACT Homeowner Information First United Methodist Church 57 Peters St. N. Andover,MA 01845 978-994-3631 Contractor Information Turner Carpentry CSL# 108738 EXP 10/17/2018 Ryan Turner HIC # 178626 EXP 5/5/2018 17 Baypoint Ln. Tax ID 46-4976419 Haverhill, MA 01835 978-478-7756 WORK TO BE PERFORMED AND MATERIALS TO BE USED Work to be done by contractor: Remove Decking on rear deck, demo concrete steps under deck. Repair framing of deck. Reducing the size of the deck from a 17x14 to a 12x17. This will require pouring footings and adding a beam to the underside of the deck. Removing and replacing railings and railing posts. Removing and replacing deck stairs. Replace lattice and trim. Remove and dispose of all Debris Materials to be used by contractor. Builders tube, concrete, pressure treated 2x10 triple beam, all pressure treated 5/4x 6 decking, all pressure treated framing and railings. Pvc lattice and trim. Work Scheduled To Begin 9/26/2016 on or around Expected Date of Completion: 10/7/2016 TOTAL CONTRACT PRICE AND PAYMENT SCHEDULE The Contractor agrees to provide the work, furnish the material and labor specified above for the sum of$5,583.78 Payments will be made according to the following SCHEDULE: 1 n $1,842.65 Deposit before work is started. Balance of$3,741.13 due upon completion of the contract. In order to meet the completion schedule,the following material/equipment must be special ordered before the contracted work begins: DO N T GN S CONTRACT IF THERE ARE ANY BLANK SPACES Customer ignature Contractor's Signature Paul arlotto Ryan Turner Date Date You may cancel this agreement if it has been signed by a party thereto at a place other than at the address of the seller,which may be his main office or branch thereof, provided you notify the seller in writing at his main office or branch by ordinary mail posted,by telegram sent or by delivery,not later than midnight of the third business day following the signing of the agreement. See attached notice of cancellation for an explanation of this right. REQUIRED PERMITS The following building permits are required: Town of North Andover, MA Building permit. It is the obligation of the contractor to secure such permits as the homeowner's agent and any costs which contractor will incur in doing so are included in the price for this job as set forth above. Please note that homeowners who secure their own permits or deal with unregistered contractors are excluded from the Guaranty Fund provisions of MGL C. 142A. Is an EXPRESS WARRANTY being provided by the contractor? No Yes X The following warranty will be provided by the contractor under this contract: 1 Year Workmanship and material warranty any materials under warranty will be through manufacturer of such materials. Please note that all home improvement contractors and subcontractor shall be registered and any inquiries about a contractor or subcontractor relating to registration should be directed to: Director, Home Improvement Contractor Registration, One Ashburton Place, Room 1310, Boston, MA 02108, 617-727-8598. 2 Unless otherwise noted within this document, the contract shall not imply that any lien or other security interest has been placed on the residence. Homeowner's Rights A homeowner's rights under the Home Improvement Contractor Law(MGL chapter 142A) and other consumer protection laws (i.e. MGL chapter 93A)may not be waived in any way, even by agreement. However,homeowners may be excluded from certain rights if the contractor they choose is not properly registered as prescribed by law. Homeowners who secure their own building permits are automatically excluded from all Guaranty Fund provisions of the Home Improvement Contractor Law. The contractor is responsible for completing the work as described, in a timely and workmanlike manner. Homeowners may be entitled to other specific legal rights if the contractor guarantees or provides an express warranty for workmanship or materials. In addition to guarantees or warranties provided by the contractor, all goods sold in Massachusetts carry an implied warranty of merchantability and fitness for a particular purpose. An enumeration of other matters on which the homeowner and contractor lawfully agree may be added to the terms of the contract as long as they do not restrict a homeowner's basic consumer rights. If you have questions about your consumer/homeowner rights, contact the Consumer Information Hotline (listed below). Execution of Contract The contract must be executed in duplicate and should not be signed until a copy of all exhibits and referenced documents have been attached. Parties are also advised not to sign the document until all blank sections have been filled in or marked as void, deleted, or not applicable. One original signed copy of the contract with attachments is to be given to the owner and the other kept by the contractor. Any modification to the original contract must be in writing and agreed to by both parties. Contracted work may not begin until both parties have received a fully executed copy of the contract, and the three day rescission period has expired. ARBITRATION The contractor and the homeowner hereby mutually agree in advance that in the event the contractor has a dispute concerning this contract, the contractor may submit such dispute to a private arbitration service which has been approved by the Secretary of the Executive Office of Consumer Affairs and Business Regulation and the consumer shall be required to submit to such arbitration as provided for in MGL C. 142A. Contractor: Homeownera-1- �� T Date: Date: b NOTICE: the signatures of the parties above apply only to the agreement of the parties to alternative dispute settlement initiated by the contractor. The owner may initiate alternative dispute resolution even where this section is not separately signed by the parties. ACCELERATION OF PAYMENT 3 m �n � r� w � � w • eee � w � nr� r � mm � • n as � � � • ��i� R � s� n � eo e. MENOMONEE No 10 M r- I ' !79T t I I a ice' , •'�� '� - I - - - 51�. �. `� ' s e r The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street,Suite 100 Boston,MA 02114-2017 UV www mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. AAulicant Information Please Print Leeiibly Name (Business/Organization/Individual)R v �V Y „e( M%�_U`t'Y1 w �Y V� ^ T�T� Address. Qo \-IV-, City/State/Zip-.)�4sVr\�*.�\A�A Phone#: Are you an employer?Check the appropriate box: Type of project(required): 1.Q I am a employer with employees(full and/or part-time).* 7. Q New construction 2NI am a sole proprietor or partnership and have no employees working for me in 8. Q Remodeling y capacity.[No workers'comp.insurance required.] 3.Q I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 9. F1 Demolition 4.Q I am a homeowner and will be hiring contractors to conduct all work on my property. I will 10❑Building addition ensure that all contractors either have workers'compensation insurance or are sole I LE]Electrical repairs or additions proprietors with no employees. 12.Q Plumbing repairs or additions 5.Q I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.Q Roof repairs These sub-contractors have employees and have workers'comp.insurance. 6.Q 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#I 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 tltat sprovidirsg ivorkers'compensation insurance for my employees. Below is thepolicy and job site information. Insurance Company Name: Policy#or Self-ins.Lie.#: Expiration Date: b Site Address: City/State/Zip: Atta h a copy of the workers'compensation policy declaration page(showing the policy number and expiration 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., Ido hereby certify and hepains and penalties ofperjury that the informationprovided above is true and correct. Signature: Date: 7 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#: � � "� .. . ____ I t .. � � t ��L r. � tI�' t , ' Z,' �,� - na •5 l 0 DATE(MM/DDIYYYY) A�REPCERTIFICATE OF LIABILITY INSURANCE 7/11/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Kimberly Savage PHONE Sullivan Insurance & Financial, Inc. (978)372-2790 0.(978)373-2261 487 Groveland Street ksavage@sullivanIF.com D INSURER(S)AFFORDING COVERAGE NAIC p Haverhill MA 01830 INSURER A:Harle sville Worcester 26182 INSURED INSURER B: Ryan Turner, DBA: Turner Carpentry INSURER C: 17 Baypoint Lane INSURER D: INSURER E: Haverhill MA 01835 1 INSURER F: COVERAGES CERTIFICATE NUMBER:CL1671102904 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR POLICY EFF P TYPE OF INSURANCE OLICY EXP LTR INSD WVD POLICY NUMBER MMIDDIYYYY MMIDD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS MADE X f OCCUR OAMAGETOE occurrence)RENTED $ 300,000 SPP00000027152Y 7/1/2016 7/1/2017 MED EXP(Any oneperson) $ 15,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY u PRO- I I LOC PRODUCTS-COMP/OP AGG $ 2,000,000 JECT u OTHER: $ NED SINGLE LIMIT AUTOMOBILE LIABILITY Ea aceident $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AI ITOS At ITOS NON-OWNED PROPERTY DAMAGE $ NON-OWNED HIREDAUTOS AUTOS APer accident) UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY Y/N STATUTE OERH ANY PROPRIETOR/PARTNERIEXECUTIVE ❑ N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ If ves describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Construction Operations CERTIFICATE HOLDER CANCELLATION North Andover SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Building Department THE EXPIRATION DATE THEREOF,_NOTICE WILL BE DELIVERED IN 1600 Osgood St. ACCORDANCE WITH THE POLICY PROVISIONS. suite 2035 N. Andover, MA AUTHORIZED REPRESENTATIVE 01845 Kayt Holland/KSAV ©1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD 9� Massachusetts -Department of Public Safety ' i Board of Building Regulations and Standards Construction.Supervisor License: CS408738 RYAN TURNER 17 BAY POINT LANE Haverhill NIA 01935', Expiration Commissioner 10/17/2018 - �j - . Pat - ' U1re tpanzo�zo�rulcall�o�C���iiaaucl��ae� Office of Consumer Affairs&Business Regulation ' 9^- 1 HOME IMPROVEMENT CONTRACTOR ' Registration:i-1)78626 Type: V- Expiration:,�%5120a18, DBA TURNER CARPENTRY- i Ips� s�`• �; . . ' RYAN TURNER 17 BAY POINT LN y i HAVERHILL,MA 01835 _-� ~ ` Undersecretary f - JI.