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HomeMy WebLinkAboutBuilding Permit #278-16 - 478 WAVERLY ROAD 9/2/2015 Dov TOWN OF NORTH ANDOVER z APPLICATION FOR PLAN EXAMINATION Permit NO• ` Y� Date Received Date Issued: ORTANT:Applicant must complete all items on this page LOCATION rint � PROPERTY OWNER Unit#. Print MAP NO: ZaPARCEL:37—ZONING DISTRICT: Historic District yes no Machine Shop Village yes no 100 year-old structure 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 ? fit+,"�v".* � nor ' .. Opfic ®We �� ® oo�dpTlam `��Wetlands ter' ©Wa ershedD`s n�cgt ; xx ate,. r} 'L� "� € }'' }°, *tiir! :. x`<'"'-`s' �';.: , {s. �i�;�� Water/Sewer ? t+ � . . -. � _� s::� �.s,_ � _ DESCRIPTION OF WORK TO BE PERFORMED: (Identification Ple se Type or Print Clear y) C1tJ SQ OWNER: Name: l Phone: 15 3G Address: LAJ, AAAU-�fr I CONTRACTOR Name: i4VA - d Phone: Address: -PW A6 k A' I-) k)1) Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT.$92.00 PER$9000.00 OF THE TOTAL ESTIMATED COST B SHP ON$925.00 PER S.F. Ll I CJS Total Project Cost: $ 13 7 V()& FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access o th gu r my fund 01 40 �,Si�natureofA`gerit%Ovvner - Signatu'reof{`cont"ractorf' J _ 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 DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ { COMMENTS CONSERVATION Reviewed on Signature COMMENTS s HEALTH Reviewed on Signature COMMENTS i �I t 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 FIRE DEPARTMENT -Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date COMMENTS 1 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.$10041000 fine NOTES and DATA— For department use I - I i ® Notified for pickup - Date i Doc:.Building Permit Revised 20117une/mi Building Department artment 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 Auilding Permit Application rkers Comp Affidavit hoto 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/Crossection/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) o Building Permit Application ❑ Certified Proposed Plot Plan ❑ 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) ❑ 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 khat the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording anust be submitted with the building application Doe: Doe.Building Permit Revised 2008mi Location t ^� No Date G- I . - TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee « $VO Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check# Building Inspector r 1 '� � NORTIy . wn . . _ � E : :. . . . ver O Coh ,y ver, Mass, L^K4 A- C OC MIC.t WICK y1' �d AOJ�ATE0 Pk*P S U BOARD OF HEALTH Food/Kitchen PER IT LD Septic System THIS CERTIFIES THAT .......... .. ........�;�.�!�,. BUILDING INSPECTOR ...... ... .... .. ......... ................ .. Foundation has permission to erect .......................... buildings on .......... `..` ..... ... v....... .. .... ....... Rough to be occupied ass... .. .....I....1.1". 1wYl.or............. ...... . . ....................... Chimney provided that the person a epting this permit shall in every respect conform to the terms 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 CONSTRUCT40JLST S Rough Service ............. .... .... ..................................................... BUILDING INSPECTOR Final 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. Offices: 1 � 383(Rear)Lowell Street,Suite 2G Wakefield,MA 01880 Tel: 617-571-9056 IPETIR RYAN qnn 352 Main Street,Suite 3C •*'�v�" [lIA1� ON Gloucester,MA 01930 Tel: 978-559.7333 ROOFING, Me. www.PeterRyanAndSonRoofing.com . Submitted To: '. ` Job Location: BenCam bell P 478 Waverly Road 478 Waverly Road Orth Andover, MA 01845 North Andover,MA 01845 P one# 978-621-7936 Email: Rigatoni@comcast.net Proposal date, July 3,2015 We are pleased to hereby submit this proposal to furnish materials and labor,completely in accordance with the below specifications: (Additional chaises may applyfor any change's not included below in proposal either by request of owner, or if Peter Ryan and Son Roofingftnds unforeseen circumstances that will affect the performance, quality or integrity of this job).In the event legal action is taken to enforce any provision of this agreement, the prevailing party shall be entitled to all its reasonable costs, including reasonable in-house or outside attorney's fees. Not responsible for debris in attic. SCOPE Strip REAR fsectionl of roof to bare wood and re-shingle: $2,820.00 • Strip existing shingles down to bare wood • Check for rotted wood on roof decking,and replace as needed at titne and material(TBD) • Nail down any loose wood • Install ice&water shield to first 6-feet,and in all valleys and around any protrusions • Install premium synthetic underlayment(in place of standard 301b.felt paper) • Install all new 8"white drip edge on perimeter and step flashing,where needed j�`gyQpp Install manufacturer suggested starter course of shingles F�7�.iA7a • Install IKO or GAF Lifetime/architectural shingles in color of your choice • Install ridge vent 0 Drill venting holes in front and back for installation of Cap ridge vent • Cap ridge vent properly with manufacturers suggested cap(GAF Titnbertex@ or IKO Hip&Ridge 12) • Properly flash any protrusions and all new pipe flanges,if any on roof Replace rotted pine on rear rake boards I>fineandmet alwh: $320.00 Siding Replacement on T exposure to close the roof[TmeaadMarerjaiON[H: $200.00[NOTTO EXCEED$200.001 • Prepare existing walls of house where the 1'exposure is for installation of the vinyl siding • Install 3/8"Fanfold insulation board where the 1' exposure is located on the house • Install the necessaryvinyl.sidin on the 1'exposure of the house,to close the roof off g P Clean Up: • Will cover area with tarps to minimize debris and remove debris related to work • NOTE: Please cover any belongings in the attic,as they will get dusty,if applicable PAYMENT TI M;S= Cost details: Includes cost Sof ermiti labor,dun '&material Payment Schedule: 1St payment due upon signing:$1,114.00 Total Cost: $3340.00 Total balance due upon completion:$2,226.00 Kindly remit payment to"Peter Ryan". Thank you! PRespectfully Submitted by: ✓ Accepted by: Our craftsmanship is 100%guaranteed for 10-yea4All other w es are through the manufacturer.All warrantees will be null&void ifjob is not paid in full. Peter Ryan and Son Roof ic.License 4178871 —Thank you for letting us serve you!!! cc: Steve The C:`n�rrr>rc�rzrl'�rrlIr :€3f'i1�cr, srr�lrrr.c � l --�-- � 17e1:a:rrr�rtr.Errrf ofIrrrltrs�rlrrX.,�;c'�lrl��rr7;s Z C,nl...gtes,s 31-1,ed, ,S-ui(e :700 B��Van,, 1�:4 14 021 ?0.Z7 M11{:MI, cQInpJ1Sriuml his,(lit, tI1 .4'Af idavif )lir;;nt )1 �Ct1In1)'f.lo.I1 Please ea:iul 1 T:t1.1T:1:� (sr s.int:s.sfor-g,rl:ri.zatioii,'L) iaot..,u; Peter Ryan and Son Roofing, Inc, C� Ac'dil: ss: 383 [rear] Lowell Street, Suite 2G City/,stat.-e/Zip: Wakefield, MA 0188.0 Pllolle #; 611.571-9056 t1r:'e yuw nn enrl)lDye r7 C13ec:It fl-le:rrl)I)tnlrtinte 13'crl Tl'`j7e CJF.I).r:`o�elf �r'e:t�iEJre(1�; I.,Q I arrr n esrll)luye3 with 4, Q I.:,3.m a zner a:1 CC)rftt jC't.j and I enj. oyee,s (fitl.l ant$/ot para ti.rale},'r= lr v'e lure:cl tyre sirb <7trtractt,f' (5, ❑ to a consta:'etc-tiu:Er iL El I Erin a 5't)i.e pr a•1)r etor'C',3 la xr:tracr• listcrl all the, Otai: hf-d Sheet., 7 [`]Fenaorlelirrc ,h.ii)and'.hue na elrrployces These sl.il)-a�,rrtr��tol.s 'raatie 8, E] Dc.nrvliti().tt avnrl nr� :far me .in airy calaacity ertal,k)Ye-ts anti hmic \,\,-,.;kens' [Nt)�r of l�er.s' currrl), uasiw n,n c cucrrl�, inlw v.moe,l 9 0 Blulelingaddition a•Elci. its IC),❑ 1?arc t°ie<�1.rc.hatirs or iddi.t.ions 3,Or I'a n dbing all wal,k oflt�Cr. I'1:a�n exet'ci5e:c1 t.Ire..ii 1 !.[] pkylab'inru 'epaairs or addition-, nr�Jself [Nko w kea;s co;ir)l), r'.i:c;lrt Of exenil)fi.:ion IYea::1VK-1L ) 1 t e., 15 X10 �rnd wti z 11ri�e rl.r, I. ❑ .Foo.t'a'el,airs t11:517.1'Fi11Ce rZ:Cl1r1.CCt. ` l' 13,❑ (}the.]' citrl)J�)yzn.:s, [No`�oiler:rti` ccr.MpJn5or;<atwc 're<1t.riv,cd TAmy applie:n3rt Ih)t 0 0 Ckx hox..#a rrn.3 t.a:1sr, nli ont tlte:se,:hC�n UeIOw showi1)g fGreir wnrk,es'ct�3rape:ns,a ion 17okky in.fonraa ir,n. Hon.3.aoaamer5 who s3 W10 0115,ffk,'iavi�tdoit3,g al`:1 l xil* and thea.hilt oirtsi.de catatnactors tr.i lsi sul.)ir3it.a:nt.f� a#liday.ra ia3d:ic:ati r s'la:I3. is•. K C otatinctCrs t.hn.t claee.ktlxs.to ;an3sf a:ttacl3e•el art.ntl.dltifl M street sh(writiQ lige 111tt1t.o:G tltt:s.rib•catrCrnriC,rs and 'hate:sul3tahtr ar tae f tJaost.airl:it:ics Uavt. ernl)loyt.es. if th:e.stab c•olrfalcCors la 1vte :Igl0 Q's"llwy lllmt,p.rovide:l)1e.ir �woi}.tiS cnRLp.'poli.cy 11uitabe.r. IPra an e7qjrli.7l ar`dr•V iS r3rONW.:r.i:r8 rt or'Iier6!' cc.)rrr.�l.�>rtsrrr�orr;rar srrr�r:rt:c e�v'r trrl'�rrr�rfwj caFrr, H0011, is Me favQ andjob she 11tfor'.fnotlt7rr, IErst.3raa;ace C-oinpanyNnnie; N/A (I am not required to oarq VAT as I have no employees) Please seethe Sub-Contractor's W,C..affldavit atta Policy#ter' tielE'-irr.s r+/A Jot) Site:Aelrl ww.,� Af,fr;rich.a ctrl» o'F.tl'ae wor'ke.r:'s' comae' rstati:orr i)e,lrcy cleoinvadon .Page (s:lr.ow in:o dile Poli y trarirnl)er tine:] eNZ)rr,ition rlslte).. FniW t« seam=s covet,a, z ns 1nrptarl0 tsndv. S'e,c.httn 2 5A of NW c., 152 2 c a:n l:eWl to i.l.ie. uirp�asi•ti.c)rr of ct ilaritrFr[ j:erril.iir.s of a ii:t!3:e lip tt) ?1:,500.01)amp on arnt"eav i.nal)ri5a0a1u rent., nig W cl.l a5 c:i,it l)en 3'lt'tes indle Win do STOP `11ORIJ ORDER am! a fitac Of i.i,l, W $2 500 a(lay d9MMM tIl'Z YAW A i1C1`1 ad At a C,1Jy C):) tllfS M.CCn1ent may 1)� tC, tj:j,f71trC, t)f Iravn.>t:gatAn of the DIA fc,l rnstrt'ha.rc-e coV ra.Kc vei'.rfr.c•-:.tt.on. Zii;ta Freare+:I,r'ttr,�afr�rr.rr-rlt�r�rlte�j,rar':7rs cria:c �)errrrr(tres.t7 p.ci�rrr}• :i/rmttlr:� trtfc:>:rrrr<rrac3:r.j)rr7)�ra e�rJ �raia35a� Is (roe rrndvorm, Z. Plron� rt; ;w„%" 017.571.9050 _. .. l)JJlir:raarrsc vrflh V:0.rr:vr r,[aH*to, Irr (hls nr<.eaz) to Uc rnvr.17l.Ftc rl 1)}: crr(p yr t:att rr nffc!<al,. C:.l:ty.oe Town:; P'errtutr'LJr.elrse # Issui:rrg.AnGh:rlr:�lt7 {e.ia^cle oa;re), 1' J3onr'6 of H.etaltlr :2., Binlel'lra �e1)n 1 trn:errt3., C i{VTo)}rr Clerk 4, Flet tric.,al Ir�.sj>e:et.,)r �, Plicirrl)in las-pector C:oE_ra-ar.caF.erso-nf I?lto:la:e ;#, Tho C;vm,rrr.onwealfh ofMossaa/iti-5,els• Departmerrr' c!fIrrrlrt,m lrr.l:=l(!(r'(l.E,rr1.s a r c:,Ur.r,yr'E'S,S S(r<eef, S111(e 700 BoS(on, IVA 021144 0.1 7 r v }5� 11.111)W.In aS'S;g o v/l1%a Workers' Comperts.nflott Affida- it; Builder's/Co.ttti•ar.tot,s/E.ler.trir:i alis/PhimbeIlls' A llcatlt.Inforiq,, do°ir. Ple-ase Print Leg 'bly Ncl.11lt: Larva Construction, in, Address. 71 Proc-ped Street Citi//St:Me/Zip; Brockton, MA 02301 F',ilorlt #: 508-232-1'I04 Ave)+oil nn e:rnl)loy el,'1 Check tilenpp1'a;pt rate.box; T}�>ee of i)r'oje:r.t(recijllre.<l). 1,Q I.and A eanl)Ioyer\vit.11 '10 4 ❑ I am <�.�encra.l contl'A.c#ot Aa.rcl I c1111,,IQyees(iutti AI'ttlroTl)�blt•t.illl�,},�` 11nvC Ill I"zed:tile slit �.orztt.nct.ors ❑ Nt�a constl�:ictaon ?,❑ 1 mil sQlt plol.)rletor ol'.1)11'tuea'• 11s.te:<I.orl file A1tA•CllZt1 sleet.. 7• [] ftellloclelillg. sl'li).:ancl lAve Ilo ell'l i[o �zes Tlle:se stal•,:corltr;lctol'� hla.S+e - 1 1 7 8, [] DellZol.ition \\+ull<ln�+ for llle lIl rally cl�prloiry, Lllll)10 �V� mid hnv'e collip. itl�111 l.rtce,t ), ❑ Bnllctirll; lxticlitian (IAV\I01'.kC11 Co1111), u1Sti1'r1ttC� 1�' retilctred•J Vit, ❑ We n.i;e a Qoiponmioii mid its 10,7 or.m.ldit.iolls 3,❑ 1.A111 n ctoing nll wol It hgvc:e cerci seal tlleir 1 I,❑ .Pltlllibirl? rgmil's o1: ndditioll:s myself, [No workev.s' c01111), 1iOlt of rlGnlp.tion !)er T`CfL - ❑Roaf 1'epzzir's §'1(4),t 152, w�v mw�mwl lao 1`' llbsfll'AJ7Ce 1CS'illll'Zt'1 � <nlploye.ex• (Ntititoclreay t:i.❑ Ot:her GU1liI), ltl:ktit'A1.1C� 1"eChlil'�CI,� "Ally applic'mt lliatchecls bos#1 rntist.also till Out the section bef w show ng 111e.ir wori;ers'coulpenwtion policy uIi'onn pion. t Hcaireottimers lyho submit this al�rdal+Il iilCltl'Atttlg theyan doilla al`1 vrorl;RilGttllen(lire outs de contrulors nnls!stabmil'lan+'i iday.it indic.atinr skich. IC:olltrar•tors lhat check thi,box additional slma;t slrov,+ili:e the value of`theslib-cmirnlins acrd statee wh011er or not those entities clave. e.nlploye.es. If the,sirb•c.ontraca:vrs llave.enrploye.es, they mus:t:prov.ideltleil' tvorhm'comp,potiq ntruiher. I OW(M e naj)1(?YfY(11(0 lbs I)POVklill:g lrt-Sl 1wnc�e for aiy em.plo, vct ', Belori+ is(he pollcp an d)ob Of' lllfol'trl.ratrorl, Ins'vu•nllcz Comp ally 1tlilnet Insurer A; Northland Insurance, Insurer B: Arbella Protection, Insurer C. Travelers A/R 6S6C)UB-5886069-2-15 Policy 9or Self iil.s, Lic. w Exl)ir<7ticlrl Dn.t,.; 03.01-2016 Jab Site Address:... V"QC ��Y..:... ...,. C it}'St.ate" 1 � . Z1,: N , Aftndi li.copy of t:lle )yol'kets' cera:pemsntioll poliq, declill iffoll page, (Flmv ug the Polio 111.11Ml)e.l' nald.eel)tl.rltion tiri:tt). Fijilure 10 secell'z as rz.tl:llirecl vvndl r S�ectioii 25A dM TL c• 152 Call 1ra.d t.o the impoait.ioll o:f eri111inal pelltalt:ies of n time l.11) to,S1,500.00 tYCi.Ct++Ct1:Vlle:•yCkii' Irlll)I'14o1n11�1Tt, I15 wd ns civil 1JeIFv.I.1fICS in the fol-m of A STOP WORK ORDER.;ind a fill` of up to`$2.50.00 A tl,y Ci`n111.5t tale 1'IO.tator' Be �1ckli'Ee6 tl:lal a Copyof dlis tt1t0111zd1t 111,Ry 11e R-n-\;\+n:r6f d to t:llz Office of I11vZStiptions of til DIA fol'IJlsfllf l:l'1C� Co!'C.1'lcC 1+C1If1C'<�tlOn, I do 1'oeeby c ertlfy iolde.I'diff p(fbiS 'w!7Pd-'q t.(; 111y that the 117 fbi,m;t!ti n pi,ovide ! (7bave 1,5 1'I't!e and Da F!Daae T`; 508.232-1194 Offchd/toil Daly, Do not,wm're !tt ilrrc r'—weo' to be completed bh CO'),O:p t01rrl of Hol• City of Tmvllt Pe.rinitlLlc.e.11se # Lsslii.lh Authoa:'ity (r.ir'.c.le oale); 1, Board of He.rdth :?,.Bltildlil:g-D anvtvnell(. 3, City/Tav)rl C:l'e:rk. 4,.Elerat'ictll Iu Irerkor I'laltrrlrlu;.�Ln lrecfor 6. Other C-o-tlfl..d Pe.l'wll; p4r)lle 9; OATS(MMIgO(YYYY) �',1.: CERTIFICATE OF LIABILITY INSURANCE 04/09/2015 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 tho cerliflcato.holder IS an ADDITIONAL INSURED, the pollcy(los)must be-endorsed, If SUBROGATION IS WAIVED, sub)ect to the terms and conditions of the policy, certaln pollclos may require an endorsement. A statement on this cortlffcato does not confer rlghts to (h( ceronoato holder In Ileu of such ondorsement s , PROOVCERCO ACT MassPaylnsurance Services,LLC NAMa•... Joyce M K01or 27 Garden Slrael,Unll 18 P.HONF T (978)77A•A338 15 -- '._...rFAx{ac,No),(978) 774-1318 I DarlverS,MA D1923 anDRFss; IoycB@masspay nsurance,com NSURERIS)AFFORDING COVERAOE NNC N INSURHR A; Northland InSuranco _ NOR NSUR�D Lema Conslruclion,InC NSVRE_R a Arbella Protection -- 41360 Jesus Lema INSURER C: TRAVELERS AIR _ TRC — 71 Prospecl51ree1 _ Brockton,MA 02301 NsuRER D INSURER H INSURER F COVERAGES OERTIFICATE NUMBER; REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIIiS OF INSURANCE LISTED BELOW HAVF BEEN ISSUED TO THE INSURED NAMEI) ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMEM', 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 15 SUBJECT TO ALL THE .TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLIOIFS,LIMITS_SHOWN MAY HAVE BEEN RGOUCE:D BY PAID CLAIMS• LTR TYPE OF INSURANCP. R POLICY NUMROR I'QUCY EPF POLICY exp _ _ (MM/DO(YYY�I(MM/OO/YYYY _ LIMITS A GENERAL LIABILM VVS236181 _ 01/31/201.5 01/31/2016 EACH OCCURRENCE _ 5 2,000,( \ COMMERCIAL GENERAL LIABILITY DAMAGE T PRE IBES a o urr nc 5 100,( CLAIMS M40E a OCCUR MED EXA(Any one person) S -5,( PERSONAL&ADV INJURY 5 2,000'( GENERAL AGGREGATE S 3,000,( GE/NL AGGREGATE LIMIT APPLIES PER; I PRODUCTS•COMPIOP ADO $ 3,000,( V POLICY PR� LOC i S Q AUTOM091LELWILITY 1020009274 11/z8/2ot4 11I2a1zo15 ]0881N OsNGLELMR 1,000,( ANY AUTO BODILY INJURY(Per person) $ ALL OWNED / SCHEDULED — AUTOS AUTOS BODILY INJURY(Per eccldenq $ Not'OWNEO _.. _.._._..................._. HIRED AUTOS \� AUTOS PROPERTY DAMAGE S I (Per accldenl) ,„•_ 5 UMBRELLA LIAB. OCCUR EACH OCCURRENCE _ 5 excess uAD CLAIMS MAGE AGGREGATE S DEC RETEN71gN s C WORKERS Qon1PENSATON 6S6QU8.5886069 7. 15 03/01/2015 1 03101/2016 wcsTATLJ oTK s ANO EMPLOYERVI.IABILITY Y/N , ANY PROPRIETOWPARTNEWETECUTIVEr OFFICEP/MEMBEREXLLUOED7 NIA E•L_EACHACCIDEM $ 500,' (MandalorylnNHlBOO, If yas,dasclibe vndar E,L•DISEASE•EA EMPLOYEE S DESCRIPTIONOF OPERATIONS below �.. •��.^_ E.L.DISEASE•POLICY LIMIT 5 500,' DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (Nisch ACORO 105,Addlllonat Remarks Schedule,II more space Is required) __ Proof of Insurance CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFOR13 Peter Ryan and Son Roofing,Inc THE EXPIRATION DATE THEREOF, NOTICE WILL, BE QELIVF.RED IN 383(Rear)Lowail Siroel ACCORDANCE WITH THE POLICY PROVISIONS, Sults 2G Woksheld,MA 01880 A510RIZEO RFPRESeNTArIVE n 1988.2010 ACORD CORPORATION, All rights reserve ACORD 25 (2010/05) Tho ACORD name and logo aro registered marks of ACQRD LICENSURE Peter Ryan and Son Roofing, Inc, Re�tser R van . .^. �.•j�l'h�:vnnrrrla,r�.l!/,r�'" (ml:w«I/r,^n/h,, I�ICalso ur ruy;isn•irlion vnihlinr Indlvidnl use nnf,. 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