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HomeMy WebLinkAboutBuilding Permit #462-2017 - 470 MAIN STREET 11/2/2016r1>GJ6-, L/7P- X2-3 -6076 7t4w of vv SCIANI� D NORTH BUILDING PERMIT 3 O�ttyeO ,616 TOWN OP NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION —/—U -2�1� Date Received �A ^" Permit No#: �� � �R^7ED tt/,54;, Ro ° �SSACHUSE� Date Issued: IMPORTANT: Applicant must complete all items on this page .LOCATION 7 76 � 19�� ���7 IVO- Awn),&" PROPERTY OWNER C YX% S �P�✓� Resioential Print 100 Year Structure yes 7 PARCELZONING DISTRICT: Historic District (noMAP yesoMachine ❑ Industrial ❑ Alteration Shop Village yeso TYPE OF IMPROVEMENT PROPOSED USE Resioential Non- Residential ❑ _ New Building_ _ _ _ . One family ddition 0 Two or more family ❑ Industrial ❑ Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other n Septic El Floodplain 0 Wetlands ElWatershed: District ., 0 1 Dater/Sewer DESCRIPTION OF WORK TO BE PERFORMED: 6,\z,3 6 #vx) // A - IXC ,t4,r — 44e_114W 101_ee_� - get -11- O?e-- #0 Identification - Please Type or Print Clearly OWNER: Name: Cff1t/ ,s. 4 -/ 0'6 Phone: `76 j Address: �%7 {"i'I 19-i PJ tie AM00 vr.-?f— /11,,!�- . ContracPhone: Email: 6-60 Address:'? i.%awe 5%/ Supervisor's Construction License Home Improvement License: f �t e .5 -Tl O46 Exp. Date: Exp. Date: ARCHITECT/ENGINEER � %'f 1-52i � Phone: Z.3 2—Z-9— (9 3 7 z' Address: /l0 iYe/AJ7"1�l?)J AtiUC, Ale6 Reg. No. FEE SCHEDULE: BULDING PERMIT: $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. r /r--7 Total Project Cost: $ &01, 70 a , FEE: $ /� ? Check No.: Receipt No.: 3 � 110 NOTE: Persons contracting with unregistered contractors do not have access to thej 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 4; Copy of Contract Floor Plan Or Proposed Interior Work Engineering Affidavits for Engineered products OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks :ar 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 Hydraulic Calculations (If Applicable) 4, Mass check Energy Compliance Report (If Applicable) Engineering Affidavits for Engineered products OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) 4 Building Permit Application 4 Certified Proposed Plot Plan 4 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 * 2012 IECC Energy code Engineering Affidavits for Engineered products TOTE: 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 Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Al Public Sewer well ❑ Private (septic tank, etc. ❑ Tanning/Massage/Body Art ❑ Swimming Pools Tobacco Sales ❑ Food Packaging/Sales Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT VCOMMENTsNA CONSERVATION COMMENTS HEALTH d COMMENTS Reviewed o Reviewed Onq)� t Signature. ) J "i� �,Q-t S Reviewed on Signature ❑■ x Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes 6 � Planning Board Decision: Comments r Conservation Decision: Comments Water & Sewer Connection/Signature & Date Driveway Permit DPW Town Engineer: Signature: ted 384 Osgood Street 12- ' f Dimension c .� 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 ®ANGER Z®NE LITERATURE: Yes MGL Chapter 166 Section 21A –F and G min.$100-$1000 fine �® Doe -Building Permit Revised 2014 Location Y71) t0g/lv S/ 4�(n� - d dI'7 No. Date TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $NO' Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # C� Slj 31110 (Building Inspector Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost $ 118,700.00 m $ - $ 1,424.40 Plumbing Fee $ 178.05 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 178.05 Total fees collected $ 1,880.50 470 Main Street 462-2017 on 11/2/2016 Addition 8x36 Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer Well ❑ Private (septic tank, etc. ❑ Tanning/Massage/Body Art ❑ Tobacco Sales ❑ Permanent Dumpster on Site ❑ Swimming Pools ❑ Food Packaging/Sales ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF m U FORM PLANNING & DEVELOPMENT COMMENTS Reviewed On Signature. CONSERVATION Reviewed on (n Sianature COMMENTS HEALTH Reviewed on Signature COMMENTS �U � c,i'L. Se, 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:_ . Street Dimension Number of Stories Total land area, sq. ft.: 11 1 f^, /< - Total square feet of floor area, based on Exterior dimensions. ELECTRICAL: Movement of Meter location,. mast or service drop requires approval of Electrical Inspector yes` No ®ANGER ZONE LITERATURE: yes No MGL Chapter 166 Section 21A —F and G min.$1oo-$l000 fine Doc.Building Permit Revised 2014 < n 0 -0 O = -. O a rto <. CD D O Q.. O v �5-C.0 = O .11, c Z O O. =-0 0 O N rt -• C --h= �� O N _W -c Fi, CD CD (n �. O S. v - p_L to O �. O fl1 O O " 0 W �D CD C7 Z cCD � O Z '� -i 0 0 to Oto v .�. Cl)� co °,N'. D CQ.Cl) N c O'er no m ort-� Z 0=: : �. O p� ro cn o o C— '� O --I 70 v, c. �M y CDU, � cC QC cr ,..� n - y WCD � CD CD CD o p - U) CD � (D Z CCD o � �_ 1 = �' b cn O%.- v CD =r Erp U) O IM N -a :N r•- co Z;z U) CD n r.r v c o� O CD y co ti O M:� m: 0: a) o N CD 0 O m N O — m .-� N O CD cD(1) rt O c co y b n n1 Ab ,� ,N, VA yb > 0 zr �S s u L W -n ;)o- T W T (� W T N T (ND O O O' O O (D O OT. O lu 2L _S 7 N QOC m S 0Oq Q N S S 7 S O_ f7 \ z (D N Ln ~ n m s W r m C c 3 3 W m O O W v 70 v D z v m z z D H r O O •i n y H � m m O m m m r z -nI s ow 0 c LtTY & LAE s CONTRACTING INC. "Couldn't your home use a little TLC?" Specializing in residential additions HIC #136779 87 Belmont Street Phone: (978)685-7447 North Andover MA 01845 Fax: (978)685-7446 1 9WIN 0611 AM Proposal/Specification 9/23/2016 Homeowner: Contractor: Chris Lembo Twomey & Legare Contracting, Inc. 470 Main Street 87 Belmont Street N. Andover MA 02810 N. Andover MA 01845 The following is a description of the kitchen addition and new bathroom per plan provided by customer. Demo: • Remove and dispose existing siding as needed to build new kitchen addition. Foundation Work: • Dig holes necessary to provide footings to be big -foot bases with 12" sonar tubes poured with concrete. • Contractor to back -fill with existing materials and level off grading. Framing & Rough: • Frame addition with 2X10 floor joist, % Advantec Plywood flooring • 2x6 wall construction • '/2" OSB plywood, 2x8 ceiling joist, 2x8 rafters, 5/8 CDX plywood on roof • Roof shingles to be IKO Architectural shingles of owner's choice • Siding to be primed Red Cedar shingles. • Provide and install one Harvey classic window in bath and one in sitting area. • Provide and install one Triple Mulled Harvey Classic white double -hung window over the sink. Customer Initial (PL-- Interior Specifications: • R38 batt insulation in floors, R21 batt insulation in walls, R41 batt insulation in ceiling • '/2" blueboard on walls, smooth wall finish, sand finish on ceilings • Provide 4 panel Masonite interior doors per plan • Finish carpentry to be 2'/2 Colonial casing and 3'/i baseboard trim • Kitchen floor to be tile with cement board subflooring. • Bathroom flooring to be the with cement board sub -flooring. • Provide 1 Therma-tru exterior door to deck (see allowance page) • Provide and install cabinetry in new kitchen area. Contractor to work with home owner creating the design. • Remove hardwood flooring in existing dining room area, install tile with cement board subfloor. Exterior Deck Specification: • Provide 6x30 p.t. deck at addition area • Provide 12x13 p.t. deck at new door location off dining room. • Contractor to install pressure treated rails and one set of stairs. Electrical: • Provide 1 Nutone ceiling fan/light on switch. • 1 GFI outlets at bathroom sink location. • Provide 1 vanity light on switch at bathroom sink. • Provide and install 1 - 4' florescent light in closet mudroom closet. • Install necessary outlets to code in kitchen addition. • Provide and install 8 recessed lights in kitchen on 2 switch locations. • Provide wiring to new appliances. • At back door in kitchen addition provide exterior light with switch. • Surface mounted light fixtures provided by owner. • Kitchen appliances provided by owner. Plumbing: • Provide plumbing for new toilet and sink. • Provide baseboard heat in bathroom as needed off existing zone. • Provide 2 Toe -kick heaters in kitchen area off existing zone. • Connect sink and dishwasher as needed. • Provide water -line for ice maker on refrigerator. • Cut up existing basement floor, run 3" drain line & repair floor. Job -Related Costs: • Contractor to supply dumpster that will be located in driveway. • Contractor to pay for building permit fee. • Contractor to meet inspector. • Contractor will work with owner on final plan. VWM Allowances Kitchen Addition Allowances: Kitchen Cabinet Material Allowance: Granite Countertop Allowance: Therma-Tru Door with Hardware: Bathroom Fixture Allowance: Kitchen Sink & Faucet Allowance: Tile Allowance bath, kitchen, dining. Architectural Plans Allowance: Customer Initial $6,000.00 $4,700.00 $ 400.00 $1,400.00 $ 400.00 $ 2500.00 $2,000.00 Customer Initial C -X' 0 TWO EY & L.EGARE CONTRACTING INC. "Couldn't your home use o little TLC?" SPeciaiiring In residential additions HIC #136779 87 Belmont Street North Andover MA 01845 Phone: (978)685-7447 Fax: (978)685-7446 EXHIBIT B Proposal/Specification 9/23/2016 Homeowner: Contractor: Chris Lembo Twomey & Legare Contracting, Inc. 470 Main Street 87 Belmont Street N. Andover MA 02810 N. Andover MA 01845 The following is a description of the first floor remodeling, removal of bathroom, remodel of mudroom, new fire door to garage, add new beam in center of kitchen. First Floor Remodeling: 1. Demo existing bathroom down to studs. 2. Floor height in mudroom to remain as is existing. 3. Remove existing beam in kitchen and extend new beam 3' to main house wall. 4. Existing exterior mud room door to remain. 5. Replace existing door from mudroom to garage with fire -rated door. 6. Remove door into kitchen and frame in. 7. Frame new mudroom wall to plan and install new interior door. 8. Move switches for relocated door from mudroom into kitchen. 9. Install hardwood flooring in sunroom — 2 '/4" Red Oak, sanded 3 coats poly. 10. Remove closet next to existing front door, patch walls and flooring. 11. Shim -up sunroom addition as needed for leveling with cedar shims. Allowance $ 300.00 12. Install new 6'-0" sliding or French door to back wall, where new deck will be located. 13. Install Harvey Classic Window in back wall of sunroom, size tbd. 14. Create pass through in existing window opening at location of sunroom area. 15. Install Y connector in basement for future bathroom. 16. Remove closet and 2 foot wall next to front door, repair floor. 17. In existing living room, repair floor as needed where walls removed, sand and finish floor with 3 coats of poly. Customer Initial 0,9L_ 18. In dining room and existing living room ceilings, overlay new %i" blueboard over existing ceiling, plaster and sand finish so there will be no drywall patches on ceiling. 19. Contractor to install 5/8" blueboard and skim coat 2 walls in garage adjacent to living area. 20. Contractor to insulate 2 walls in garage adjacent to living area to be R 13. 21. Build new closet in mudroom as discussed on September 20, 2016. 22. Frame up new doorway into kitchen from mudroom as discussed. 23. Repair areas of baseboard trim in areas of walls removed. Main House Roof: I. Main house roof to remain, strip and install new shingles on back of garage where new addition lay over is to be water tight. 2. Head off roof line and ceiling joists where needed to create head room as discussed with Chris in mudroom area. Ceiling area in step up to be flush with addition ceiling. Job -Related Costs: • Contractor to supply dumpster that will be located in driveway. • Contractor to pay for building permit fee. • Contractor to meet inspector. • Contractor will work with owner on final plan. Costs Not Associated With Contract: • Painting. • New Exterior Garage Door. • Cost for removing wall at interior stairway. • Central Air Conditioning. Potential Credits Requested by Owner: • Credits if demo work done by owner: Demo existing deck $400 Demo First floor bath walls, floor & ceiling $600 Demo existing kitchen walls to studs and demo floor $750 Customer initial CD L Allowances New Fire Door to Garage with Hardware $ 500 New Slider or French Door $1800 Customer Initial eA I- Project Total and Payment Schedule Job Total $118,700.00 I - A Start of construction drawings deposit $ 1,500.00 p©` f ` Z F 1st Signing of contract. $ 8,500.00 /"0' 7-36 2nd Completion of Architectural Plans $10,000.00 3rd Completion of contractor obtaining building permit $ 10,000.00 4th Completion of footings for kitchen addition $ 10,000.00 5th Completion of roofing on kitchen addition $155000.00 6th Completion of plumbing and electrical rough -in $16,000.00 7t'' Completion of insulation in kitchen $12,000.00 8th Completion of beam work in main house $ 9,000.00 9th Completion of drywall and plaster $1000.00 10th Install of hardwood floors, 1 coat of poly. $ 5,000.00 11th Completion of installation of cabinetry $ 5,000.00 12th Completion of installation of granite and appliances $ 4,000.00 13th Substantial completion of project $ 2,700.00 . Customer Signature DateW2? 2? l� Contractor Signature Date "24 ***This contract dated September 23, 2016 supersedes any other proposals submitted *** 87 Belmont Street North Andover MA 01845 T O iEY & LEGARE CONTRACTING INC. "Couldn't your home use a little TLC?" Specializing in residential additions HIC #136779 CONTRACT: 9/23/2016 1. Date of Contract Signing: q 2. List of Documents/Counterparts of this agreement: Phone: (978) 685-7447 FAX: (978)685-7446 A. Contract B. Specifications/Proposal (See Exhibit B attached) C. Drawing/Plan (see Exhibit C attached) D. Payment Schedule (see Exhibit D attached) E. Limited Warranty (see Exhibit E attached) F. General Notes (See Exhibit F attached) 3. Parties to Contract: A. Contractor: Twomey & Legare Contracting, Inc. Shaun Twomey/Doug Legare Federal ID# 20-3436110 Address: 87 Belmont Street, No. Andover MA 01845 Contractor Registration No.: 136779 B. Homeowner: Chris Lembo 470 Main Street North Andover MA 01845 781-856-4951 4. Description of work to be done and the materials to be used: See Specifications (Exhibit B) 5. Total amount agreed to be paid for work to be performed under the contract: $118,700.00 Owner Initials: C -DL Contract Contractor Initials: -p< L . Page 1 of 4 no 7 9. 10 Time schedule of payment to be made under the contract, finance charges for late fees (if any)*: See Payment Schedule (Exhibit D) *Any deposit required to be paid in advance of the start of the work shall not exceed one third of the total contract price or actual cost of any material or equipment of a specific or custom made nature, which must be ordered in advance of the start of the work to assure that the project will proceed on schedule. No final payment shall be demanded until the contract is completed to the satisfaction of all parties. A. Date work is scheduled to begin: (see No. 14 below) B. Date work is scheduled to be substantially completed: (see No. 14 below) Notice: A. All home improvement contractors and subcontractors shall be registered and any inquiries about a contractor and/or subcontractor relating to a registration should be directed to: Office of Consumer Affairs and Business Regulation 10 Park Plaza, Suite 5170 Boston, MA 02116 (617)973-8700 B. For contractor's registration number, see first page. C. Homeowners have a three (3) day cancellation right under MGL Ch. 93 § 48; MGL Ch. 140D § 10; or MGL Ch. 255D § 14 as may be applicable. See attached Notice of Cancellation. D. For homeowner's warranty rights, see 780 CMR R6 and MGL Ch. 142A. There is no lien or security interest on the residence as a consequence of this contract. Permit Notice: A. B. Owner Initials: The following permits will be required in connection with the work to be performed on your property: Building – Electrical – Plumbing It is the obligation of the contractor to obtain these permits as the Homeowner's agent. C -9L— Contract Contractor Initials: 17 � ' C, Page 2 of 4 C. Any homeowner who secures their own construction -related permits or deals with unregistered contractors shall be excluded from access to the guarantee fund. 11. Contractor reserves the right, if he deems himself to be insecure, to require, as a prerequisite to continue work, that the balance of funds due under the terms of the contract, which are in possession of the owner, be placed in a joint escrow account requiring the signatures of the contractor and the homeowner, for withdrawal. 12. The parties agree that no work shall begin prior to the signing of the contract, transmittal to the owner a copy of the contract and the expiration of any applicable rescission period. 13. Arbitration Clause: The contractor and the homeowner hereby mutually agree in advance that in the event that 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 Office of Consumer Affairs and Business Regulations and the consumer shall be required to submit to such arbitration as provided in MGL Ch. 142A. 14. Other Provisions: A. Commencement and Completion of Work - Contractor agrees to proceed diligently with the agreed upon work, commencing promptly, following: 0 Issuance of a building permit by the town. B. Final payment shall be upon the satisfaction of the homeowner. The parties agree that the issuance of a certificate of occupancy and/or final inspection shall be the objective standard that the contract has been complete and the parties satisfied. Any final punch list items shall be reduced to writing, with an estimated date for completion. The parties agree that no escrow will be held for punch list items. C. Insurance — Contractor agrees to provide evidence of liability, workers compensation and other risk insurance. Owner agrees to provide copy of hazard insurance as is required by contractor to coordinate policies. Owner Initials: cv L Contract Contractor Initials: �' ` Page 3 of 4 Notice: The signatures of the parties above apply only to the agreement of the parties to alternate dispute resolution initiated by the contractor. The owner may initiate alternative dispute resolution even where this section is not signed separately by the parties. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES y,1,116 0 D e Owner Date Contractor Date Contractor Date Owner Initials: CVL' Contract Page 4 of 4 Contractor Initials: -P• C TWOMEY & LEGA RP o CONTRACTING INC. "Couldn't your home use a little TLC?" 51eclalull€" ill re-sh- elide# addition -3 HIC #136779 87 Belmont Street North Andover MA 01845 Phone: (978) 685-7446 FAX: (978) 685-7447 EXFHBIT F General Notes Unforeseen Changes & Extras 1. Existing, unforeseen code violations are not included in this contract and will be priced at time and material. 2. Any unforeseen frame or sheathing rot is not included in this price. 3. All subcontractors are in -contract with Twomey & Legare Contracting, Inc. and are not available for direct hire by homeowner for a time of six (6) months after completion of project. 4. Contractor will keep home and site as neat as possible. At end of job, the homeowner is responsible for final cleaning and window washing. 5. Any plumbing, electrical or miscellaneous material purchased by homeowner is homeowner's responsibility to get product to site in a reasonable time for installation. Contractor does not hold warranty on these items. 6. If contractor is needed to pick up project, homeowner will incur a trip charge of $50.00 per hour, with one hour minimum. 7. Any additional work beyond contract will only be done with a signed and agreed to price change order sheet. Said payment is due in full on next progress payment. 8. Please review all items on Specification pages. Verbal additions and wants, if not in writing, are not included in the project. 9. Due to large trucks, equipment, dumpsters, etc, driveway may crack, create divots, etc. Also during construction, lawn may be damaged. Contractor is not responsible for same. 10. During excavation, any ledge or boulders over 20 inches will be an extra priced on site. 11. Please review plans when received to ensure design is correct. 12. Any changes made when customer is with architect will not be included if not on original Specification pages. It will only be included if a change order sheet is created and executed. Owner Initials: Cbt_ General Notes Contractor Initials: Page 1 of 1 fLN� 87 Belmont Street North Andover MA 01 845 T MEY & LEGARE CONTRACTING INC. "Couldn't your home use a little TLC?" a :� S ec1alkin in E'esi l�nttal£ autdldo HIC #136779 Phone: (978) 685-7447 Fax: (978) 685-7446 NOTICE OF CANCELLATION Date You may wish to cancel this transaction, without any penalty or obligation, within three (3) business days from the above date. If you cancel, any property traded in, any payments made by you under the Contract, and any negotiable instrument executed by you will be returned within ten (10) business days following received by the Contractor of your cancellation notice, and any security interest arising out of the transaction will be cancelled. If you cancel, you must make available to the Contractor at your residence, in substantially as good condition as when received, any goods delivered to you under the Contract; or you may, if you wish, comply with the instructions of the seller regarding the return shipment of these goods at the Contractor's expense and risk. If you do make the goods available to the Contractor and the Contractor does not pick them up within twenty (20) days of your Notice of Cancellation, you may retain or dispose of the goods without any further obligation. If you fail to make the goods available to the contractor, or if you agree to return the goods to the contractor and fail to do so, they you may remain liable for performance of all obligations under the contract. To cancel this notification, mail or deliver a signed and dated copy of this Cancellation Notice or any other written notice, or send a telegram to Twomey & Legare Contracting, Inc at 87 Belmont Street, North Andover, MA 01845 no later than midnight of I hereby cancel this transaction. Date: Signature of Owner Owner Initials: CVL Notice of Cancellation Contractor Initials: Page 1 of 1 f_llanta- 139QR TWOMEYs ACORDi CERTIFICATE OF LIABILITY INSURANCE DATE 07106/2016YYY) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Doherty Insurance Agency, Inc. P.Q. Boz 1985 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 21 Elm Street POLICY EXPIRATION LIMITS Andover, MA 01810 INSURERS AFFORDING COVERAGE NAIC # INSURED Twomey & Legare Contracting, Inc. 87 Belmont Street North Andover, MA 01845 INSURER A: Arbella Protection Ins Company 06/22/17 INSURER B: AMAGE TO RENTED S100,000 f1S E INSURER C: PERSONAL 8 AOV INJURY $1,000.000 INSURER D: INSURER E: COVERAGES l �� THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUEDdD4Met4YRED NAM I-VE'FQR-THS POLICY�REATOWNDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF, ANY CONTE CT OR OTHER DOCUMENT WITH RESPECT TO WH'1(,1I THIS CERTIF1 -AT MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AF, . R _ _67Y THE POLICIES -DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS�Wb CONDITIONS OF SUCH POLICIES. AGGREGATE LIMIT_ N MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTA NSFICPAT TYPED INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS A GEN636 LIABILITY NCOMMERCIAL GENERAL LIABILITY CLAMS AUiDE Q OCCUA 9520040230 06/22/16 06/22/17 EA ^6CURRENCE $1,000,000 AMAGE TO RENTED S100,000 f1S E MED EXP (Any one person) S52(100 PERSONAL 8 AOV INJURY $1,000.000 i GENERAL AGGREGATE S2.000.000 GEML AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG s2,0 0 000 7X POLICY ECT LOC AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT IEA acodeni) S ALL OWNED AUTOS SCHEDULED ALTOS BODILY INJURY $ (Per person) HIRED AUTOS NON -OWNED AUTOS BODILY INJURY (Per acadent) PROPERTY DAMAGE S (Per ecodent) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT S OTHER THAN EA ACC S AUTO ONLY. AGG S ANY AUTO EXCESS(UMBRELLALIABILITY OCCUR D CLAIMS MADE EACHOCCURRENCE S AGGREGATE S S DEDUCTIBLE 5 5 RETENTION 5 WORKERS COMPENSATION ANDWC STATU• OTH. EMPLOYERS' LIABILITYI ER E.L. EACH ACCIDENT S. ANY PROPRIETORIPARTNEWEXECUTIVE OFFICEP AIEMBER EXCLUDED? If yes.dcscnbe under E.L. DISEASE - EA EMPLOYEE S E.L. DISEASE - POLICY LIMIT S SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS I LOCATIONS f VEHICLES l EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Covering operations usual to Twomey & Legare Contracting, Inc... LO ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL _1 fl DAYS WRITTEN T TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO DO SO SHALL iE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER. ITS AGENTS OR AUTHORIZED ACORD 25 (2001!08)1 012 #S33888/M33740 / / ` DML A(A96RD CORPORATION 1988 Aedi*&- CERTIFICATE OF LIABILITY INSURANCE IIII.� DATE(MWDDIYYYY) 1 10/13/2016 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(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 DOHERTY INSURANCE AGENCY INC NAMECy- Diane LeBlanc _ �tl,:.PaIU: (978)475-0260 �lN NO,c ADDRESS: dleblanc@dohertyinsurance.com_ P.O BOX 1985 INSURER(S)AFFORDING COVERAGE NAIC 0 _ INSURER A : TRAVELERS INDEMNITY CO OF AMERICA 25666 ANDOVER MA 01810 INSURED INSURER B: MED EXP (Any one person) S TWOMEY & LEGARE CONTRACTING INC INSURERC: INSURER D: 87 BELMONT STREET INSURER E: A NORTH ANDOVER MA 01845 1 INSURER F: v COVERAGES CERTIFICATE NUMBER: 93248 RFVISInN N11MRFD. 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 LTR I TYPE OF INSURANCE A L SUOR POLICY NUMBER POLICY EFF IMMIDD POLICY EXP MMIDOnTmLIMITS - COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR EACH OCCURRENCE $-1 DAMAGE _ PREMISES(Fa oro occurrence) S ` MED EXP (Any one person) S NIA PERSONAL 6 ADV INJURY S GEWL AGGREGATE LIMIT APPLIES PER: POLICY ❑ JP LOC GENERAL AGGREGATE S PRODUCTS . COMPIOP AGG S is OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S Ea accident) _ BODILY INJURY (Per person) E '---_ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS AUTOS NON-OWNEO WA BODILY INJURY (Per accident) E PROPERTYDAMAGE S Por accident S UMBRELLA LMB EXCESS LMBr•�" OCCUR, CLAIMS -MADE 1 EACH OCCURRENCE E r- WA _ -A E � OE RETt.NTION 5 S W99kfRSCOMPENSATION AdItD EMPLOYERS' LL481LITY Y t N ANYPROPRIETORIPARTNERIEXECUTNE OFFICERIMEMBEREXCLUDED? W (Mandatory In NH) II describe under DESCRIPTION OF OPERATIONS below WA NIA 6HUB029OM99416 09/18/2016 09/18/2017 PER DTH• STATUTE ER E.L. EACH ACCIDENT, E 500,000 .,,rr E L DISEASEA EMPLOYEE E 500.000 _� �__ _ t�EA E • POLICY LIMIT I S 500.000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101. Additional Remarks SchoWto. may be mmchod it more space is required) Workers Compensation benefits will be paid to Massachusetts employees only. Pursuant to Endorsement WC 20 03 06 B. no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires, or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued (unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage - Coverage Verification Search tool at www.mass.govfwd/workers-compensationfinvestigabons/. 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. 1600 Osgood Street AUTHORIZED REPRESENTATIVE Ili e �'. `C`�: North Andover MA 01845 Daniel M. Cro y, CPCU. Vice President —Residual Market — WCRiBMA Vc 18013-Z014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD The Commonwealth of Massachusetts Departiaaettt of Itatiaastrial Accidents Office of Investigations 600 Washington Street Boston, SIA 02111 woo anass govIdia Workers' Compensation Insurance Affida-6t: Builders/Contractors/Electricians/Plumbers Name (Business/Organization/Individual): Address: CJ' -? Citv/State/Zip: A),, � � Phone#: ?Zr' YZ-3>— g V,? Are u an employer? Check the appropriate box: 1 _ I am a employer Width i 4. ❑ I am a general contractor and I employees (full and/or part-time).* 2. ❑ I am a sole proprietor or partner- ship and have no employees working for me in any capacity. [No workers' comp. insurance required.] I ❑ I am a homeowner doing all work myself. [No workers' comp. insurance required.] have hired the sub -contractors listed on the attached sheet. These sub -contractors have employees and have workers' comp. insurance, - We are a corporation and its officers have exercised their right of exemption per MGL c. 152, § 1(4), and we have no employees. [No workers' comp. insurance required.] Type of project (required): 6. Q New construction jzj-c 7. ❑ Remodeling. 8. ❑ Demolition 9. wilding addition 10. El Electrical repairs or additions 1 LQ Plumbing repairs or additions 12.n Roof repairs 13.❑ Other "Any applicant that checks box rl must also fill out tate section below showing their workers' compensation policy informutiou. 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-coutmctors have employees, they must provide their workers' comp. policy number. I ani mi entplo}rer that is providing ivorlrers' cottipetisatioti insurance for rti}1 employees. Beloit, is the policy and job site information. Insurance Company Name:�- Policy # or Self -ins. Lic.n-: #Ul7 6 2, 9 �! 7 l Expiration Date: F-19— Job �� ? Job Site Address: < Q l xI / City/State/Zip: Al. Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one;yJ imp " eat, as well as civil penalties in the fomi of a STOP WORK ORDER and a fine of up to $250.00 a day aQ vio or. a advised that a copy of this statement may be forwarded to the Office of Investigations of the r cc verage verification. - I do hereby ceryl mz4J1f4Zh&rs an4jlenalties of peritiq that the information provided above is free and correct. Phone L"', / �/ ) — //?_3— S / ? 61 Official use on1}. Do not it,rite in this area, to be completed by city or town officiaL City or Town: Permit/License # d -0Y- ?moi 6/ Issuing Authority (circle one): 1. Board of Health 2. Building Department 3.. City/Town Clerk 4. Electrical Inspector S. PIumbing Inspector 6. Other Contact Person: Phone #: \. Office of Consumer Affairs & Business Regulation -- . „�- - HOME IMPROVEMENT CONTRACTOR e Registration: 136779 Type: Expiration: 8126/2018 Partnership TWOMEY + LEGARE CONTRACTING INC. SHAWN TWOMEY 87 BELMONT ST. N. ANDOVER, MA 01845 Undersecretary Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS -055108 Construction Supervisor DOUGLAS J LEGARE 79 GARY AVE 1 f } HAVERHILL MA 01830 = NO)IV P/ �ZU, vim— Expiration: Commissioner 09/02/2018 z T m .0 20.29' 15.67' 15.34' 4 z �Lq 12.41' 4. 00 t 01 11 rn i t�' LOT 1 AREA=12,747 SY =0.2926 AC PROP. DEC 36 PROP. ADDITIO -2 AN & W F, D. C, r 'k F. GARIi al s A'. S Tll/ti #47 0 f z < 0 U-1 145.00' N48*18'00"W M4 JN STREET NOTES 1. SEE TOWN OF NORTH ANDOVER ASSESSORS MAP #57 LOT #8 AND DEED BOOK #6176 PAGE #93 co E.N.D.R.D. FOR SITE. 2. ZONING DISTRICT IS RESIDENCE 4 0 PLAN OF LAND IN NORTH ANDOVER, MASSACHUSETTS DRAWN FOR CHRISTOPHER LEMBO 470 MAIN STREET NORTH ANDOVER, MASSACHUSETTS 01845 SCALE: 1"=20' DATE: OCTOBER 26, 2016 10/26/16 MERRIMACK ENGINEERING SERVICES '66 PARK STREET STEPHEN SKI, R.L.S. DATE ANDOVER, MASSACHUSETTS 01810 O 0 �16 0 01t PLAN OF LAND IN NORTH ANDOVER, MASSACHUSETTS DRAWN FOR CHRISTOPHER LEMBO 470 MAIN STREET NORTH ANDOVER, MASSACHUSETTS 01845 SCALE: 1"=20' DATE: OCTOBER 26, 2016 10/26/16 MERRIMACK ENGINEERING SERVICES '66 PARK STREET STEPHEN SKI, R.L.S. DATE ANDOVER, MASSACHUSETTS 01810 MAIN STREET ND TES 1. SEE TOWN OF NORTH ANDOVER ASSESSORS MAP #57 LOT #8 AND DEED BOOK #6176 PAGE #93 E.N.D.R.D. FOR SITE. co 1 2. ZONING DISTRICT IS RESIDENCE 4 3 0 0 I ol 0 rn 0 �� STEPHEN ��H{3F A9gSSA� 'K 4/15/16 NSKI, R.L.S. DATE PLAN OF LAND IN NORTH ANDOVER, MASSACHUSETTS DRAWN FOR CHRISTOPHER UMBO 470 MAIN STREET NORTH ANDOVER, MASSACHUSETTS 01845 SCALE: 1"=20' DATE: APRIL 15, 2016 MERRIMACK ENGINEERING SERVICES 66 PARK STREET ANDOVER, MASSACHUSETTS 01810