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Home My WebLink AboutBuilding Permit #977-15 - 49 PADDOCK LANE 5/28/2015TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION PermitNO. Date Received Date Iss-ued: -oplicant must complete all items on this page IMPORTANT: A LOCATION �/ z nt PROPERTY OWNE Print 100 Year Old Structure yes no MAP NO: 167 PARCEL: A 5- ZO,N ING DISTRICT:_Historic District yes no 0 Machine Shop Village y e s rno TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential 0 New Building family D Addition El Two or more family El Industrial ><Alteration No. of units: El Commercial El Repair, replacement El Assessory Bldg D Others: 0 Demolition El Other El Septic 0 Well El Floodplain 0 Wetlands El Watershed District 0 Water/Sewer OWNER: Name: Address: DESCRIPTION OF WUMCK I U Ut 1-tMrUM1V1r-L)- 7A &e/ug Identification Zlease Type or Print Clearly) A / 5- 25' �RA- A^ Oui r P h CONTRACTOR Name: Address: - 76. 2,5-3- Zl1TlMLWZWeKr1A Supervisor's Construction License: L,2 Exp. Date: Home Improvement License: Zz,�- 'y --I-: 1"7 0 A -z", . Date: ZO �/D- ARCH ITECT/ENGI NEER — Phon Address: Reg. FEE SCHEDULE: BULDING PERMIT.'$12.00 PER $1000-00 OF THE TOTAL ESTrIATED COST BASED ON $1 "r 4. 1 0 6 P) 9ao - F E E: S le-,;' Check No.: el I Re��iptN—d—. NOTE: Persons contracting with unregistered contractors do not have act Ir u S, f C ent/Owne 06 nature o contract .5igqat. reof Ag. 01 .- – Plans Submitted Plans Waived Certified Plot Plan S.F. guara*fund Stamped Plans [I L r Plans Submitted El Plans Waived El Certified Plot Plan El Stamped Plans F1 TYPE OF SEWERAGE DISPOSAL - I Public Sewer 0 Taiming/Massage/Body Art E] Swimming Pools Well L] Tobacco Sales 0 Food Packaging/Sales El Private (septic tank, etc. El Permanent Dumpster on Site El THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATEAPPROVED PLANNING & DEVELOPMENT El 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: Comm Water & Sewer Connection Driveway Permit DIPW Tuvv;� Engineer: Signature: Located 384 Osgood Street FIRE 'DEPARTMENT -Te'm'pDurnptterbnsite yes-. no Located at 124 Main Street Fire Department signature/date COMMENTS Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions.__ Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A =F and G min.$100-$1000 fine Doe.Building Pennit Revised 20 10 %.1 Building Department The fohowing is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofivg, Siding, Interior Rehabilitation Permits u Building Permit Application o Workers Comp Affidavit u Photo Copy Of H.I.C. And/Or C.S.L. Licenses u Copy of Contract u Floor Plan Or Proposed Interior Work u 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 Lj 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 apwal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be subm.tted with the building application Doc: Doc.Building Permit Revised 2012 A&N Location T- PACQJ&--�- L,.,4. No. Date '��IICA Check # Q —1 1 2j 21, � TOWN OF NORTH ANDOVER Certificate of Occupancy $—I Building/Frame Permit Fee 16k Foundation Permit Fee 1 iw, Other Permit Fee TOTAL $ Building Inspector ko co cl� I 6 \0 WON= a, LLI LL. 0 0 co a) = u 0 0 Ll E Ln (1) V) 0 Z (D z C: .2 c D 0 LL to =5 o = a) c E U LL 0 to D 0 -7m LE 0 u ui txo 0 W (U 2! cu Ln cr 0 :3 0 u F- z LLJ ui LU W LL C =1 CO Q) Ln co 797 %I- o 0 z CL ?A ..- r- 0 (n o MI) > 0 cc 0 U) tm u 10 r c m (D co (n cc 'm r_ 70 0 .2 w w c EL :E .2 LU E cc 0-0 co CL cn m 0 " a 0 o 0. 0 U CA CL Ch 7d s... 0 E r r cc 0 10 M —J %I- o 0 z CL ?A ..- r- 0 (n o MI) > 0 cc 0 U) tm u 10 r c m (D co (n cc 'm r_ 70 0 .2 w w c EL :E .2 LU E 0-0 co CL cn m 0 " a 0 o 0. 0 U E 0 .2 CO 0 C/) LLI w CL x LLI LLI a- 0 L) LLJ a. Cl) z 0 C-) U) U) LLI —j z 0 E 0 0 CL 0 0 r_ (D IM r— a 0 cn E 4) 0 CD CL CL 0 0. 0 Cc .2 CL 0 0 CL L) U) cc r_ V% Proposal AB Carnes Roofing, Inc. Page I of 1 30 Arrowhead farm Rd Boxford, Ma. 01921 978-887-1431 MA. CS -000230 and HIC Reg. 176928 Proposal Submitted To: CHRISTOPHER MOULSON Date May 8, 2015 56 SALEM ST Project Name 49 PADDOCK ST NORTH ANDOVER ANDOVERMA Address 978-258-5463 OR 617-669-7491 CHRIS We propose to furnish material and labor- in accordance with the specifications below: Eighty Nine Hundred Dollars ($8,900.00) Payment to be made as follows: $300.00 Deposit, Balance Upon Completion Notice: All home improvement contractors and subcontractors engaged in home improvement contracting, unless specifically exempt from registration by provisions of Chapter 142A of the General Laws, must be registered with the Commonwealth of Massachusetts. Inquiries about registration and status should be made to the Mass.gov/lloenses website. ROOF PROPOSAL 0 STRIP ROOF OF ALL LAYERS OF ASPHALT SHINGLES. COVER ROOF DECK WITH THE UPGRADED WATERPROOF TITANIUM HIGH PERFORMANCE SYNTHETIC UNDERLAYMENT MEMBRANE. COVER EXTERIOR WALLS AND FOLIAGE WITH TARPS TO HELP PREVENT DAMAGE. 0 ICE DAM PROTECTION: INSTALL CARLISLE HIGH PERFORMANCE ICE & WATER BARRIER OVER ALL HEATED AREAS SIX FEET WIDE AT THE LEADING EDGE OF ROOF AND THREE FEET IN ALL VALLEYS. WRAP THE CHIMNEY(S) AND SKYLIGHT CURBS UNDER THE FLASHINGS WITH SAME. E COVERALL PERIMETERS WITH EIGHT INCH PREFORMED ALUMINUM DRIP EDGE. E INSTALL GAF COBRA RIDGE VENT AND/OR 0 ROOF LOUVERS FOR ADDED ATTIC VENTILATION. E COVER SOIL PIPES WITH NEW RUBBER FLASHING BOOTS AND FLANGE. E REPLACE WALL FLASHING (S) AS NEEDED WITH ALUMINUM OR LEAD AT THE ADDITIONAL COST OF $25,OOPLFT. WE MAY NEED TO REMOVE THE SIDING TO PERFORM THIS WORK AND YOU MAY NEED TO HAVE A CARPENTER REINSTALL OR REPLACE THE SIDING THAT WAS REMOVED. E CHIMNEY FLASHING: CUT ALL EXISTING TAR AND LEAD FROM TOP AND BOTTOM CHIMNEY(S). CUT NEW REGLET WITH CARBIDE SAW AND SECURE NEW LEAD FLASHING IN PLACE WITH METAL ANCHORP-P90—P—E:RL :tSEAL REGLET JOINT. PLEASE ADD $500.00 TO ABOVE PRICE. Z COVER ROOF SURFACE WITHCERTAINTEED LANDMARK 24QLB LIFET ARRANTY DESIGNER SHINGLES. REPLACE DEFECTIVE ROOF DECK AS NEEDED WITH CDX PLWOT-D—AT MAN ADDITIONAL COST OF$4.00PSQFT. El COVER ROOF DECK WITH CDX PLYWOOD AS NEEDED TO REPLACE OR REPAIR DEFECTIVE DECKING, AT AN ADDITIONAL COST OF E NAILING: SECURE SHINGLES WITH 1 Y4" GALVANIZED ROOFING NAILS AS PER CERTAINTEED SPECIFICATIONS. El SKYLIGHTS: REPLACE EXISTING SKYLIGHTS WITH NEW VELUX OR WASCO UNITS. WE WILL PROVIDE THE SKYLIGHTS & FLASHING KITS AT OUR EXACT COST FROM OUR SUPPLIER. INTERIOR WORK IS EXCLUDED. 0 REMOVE EXISTING GUTTERS El INSTALL NEW SEAMLESS.032 ALUMINUM GUTTERS USING THE HIDDEN ZIP SCREW HANGER SYSTEM. 0 REPLACE ANY ROTTED TRIM BOARDS AS NEEDED WITH 30 YEAR PRIMED PINE, ADD PER FOOT TO ABOVE PRICE. El INSTALL NEW ALUMINUM DOWNSPOUTS AND MECHANICALLY FASTEN ALL CONNECTIONS. CLEAN ALL PROJECT RELATED DEBRIS FROM OUTSIDE WORK AREA. THE PROPERTY OWNER AUTHORIZES AB CARNES ROOFING TO OBTAIN ALL PERMITS. WE CANNOT ACCEPT RESPONSIBILITY FOR DEBRIS FALLING INTO ATTIC AREAS. CUSTOMER SHOULD COVER VALUABLES, GREAT CARE WILL BE USED TO PROTECT THE STRUCTURE AND FOLIAGE. HOWEVER, SOME MARRING AND OR MINOR DAMAGE COULD OCCUR. SPECIAL INSTRUCTIONS: THE ABOVE PROPOSAL INCLUDES ALL ROOF SECTIONS OF THE HOUSE. CHIMNEY FLASHING: THIS SHOULD BE DONE AS PROPOSED ABOVE OR LEAKS MAY OCCUR. WARRANTY UPGRADE: THE CERTAINTEED WIND WARRANTY WILL BE UPGRADED FROM 110 MPH TO 130 MPH W PGRADE TO THE CERTAINTEED HIGH PER ORMANCE HIP & RIDGE CAPS AND STARTER COURSE AT NO ADDITIONAL CHARGE. YEJr EMAILADDRESS:-, 7 A^-0 0 Warranty: A . 11 work warranted against installation defects for 5 years; this warranty is limited to the installed item (s) and its repair only. Material is warranted by the manufacturer against defects for 50 years; see the manufacturer's warranty. for exact warranty performance. Cancellation: Customer has legal right under federal law to cancel this contract without penalty or obligation within three business days from the date of signing this agreement via Priority Mail Delivery Confirmation. Please see reverse side. Dispute Resolution under Massachusetts Home Improvement Law 142a: All parties agree that any and all disputes relating to this proposal shall be settled by arbitration. This forum is user friendly and does not require lawyers. Please see reverse side. Signing this Proposal means, y u have accepted all the terms as stated on the front and back of this agreement. Please see reverse side. Date of Acceptance Signature * Signature J,, (�f Signature PLEASE SEE REVERSE SIDE 0 DATE (MMIDDIYYYY) ACC)R" CERTIFICATE OF LIABILITY INSURANCE 9/26/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORN ATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIV LY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NO" CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICAT: HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL 11 ISURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies mal require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT rcial Lines NAME: Comme HONE -284 FAC. Harris -Murtagh Insurance Agency,Inc. lPAC.N._,,, (978)532 4 No): 30 Central Street E-MAIL annwriqq- INSURED Barry Carnes, DBA: A13 Carnes Roofing, 30 Arrowhead Farm Rd Boxford MA 01921 Wastern Worl E: C0`VFRAC;FS_---CFRTIFlC_ATF NI)MRFRiCL1492319366 RFVl_qII0NI NIIMRFR- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LIST INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM C CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHC :D BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD R CONDITION OF ANY CONTRACT OR OTHER DOCUMENT VVITH RESPECT TO WHICH THIS AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, NN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDLSUBR THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PC LICY NUMBER POLICY EFF (MMfDD/YYYy1 POLICY EXP (MMIDO/YM) LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 7x OCCUR or ov r.�Zove North Andover, MA 018 018 9PP137217 10/11/2014 10/11/2015 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTrff'— — PREMISES (Ea occurrence) $ 100,000 MED EXP (Any one person) $ 5,0000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRO - X POLICYE]JECT D LOC PRODUCTS - COMPIOP AGG $ 2,000,000 $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS S NON -OWNED HIRED AUTO AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERIDAMAGE tp.,..Id $ UMBRELLA LAB EXCESS LIAB HCLAIMS-MADE OCCUR EACH OCCURRENCE $ AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N IE ANY PROPR ETOR/PARTNER/EXECUTIVE OFFICERtMEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A WC STATU- I JOTH- TORY I IMITS L11— E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEd $ E.L, DISEASE - POLICY LIMIT 1 $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 11011, A ddltlonal Remarks Schedule, It more space Is required) CIFIRTIFICATE HOLDER I rAPJrF:1 I ATIr)M A1,UKU LO tL1U-I1U1U0) 9 19BB-201 0 ACORD CORPORATION. All rights reserved. INS025 (201005).01 The ACORD na�e and loqo are reqistered marks of ACORD 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 or ov r.�Zove North Andover, MA 018 018 J S Scholnick/SJG < �21 A1,UKU LO tL1U-I1U1U0) 9 19BB-201 0 ACORD CORPORATION. All rights reserved. INS025 (201005).01 The ACORD na�e and loqo are reqistered marks of ACORD Massachusetts - Department of Public Safety Board of Building Regulations and Standards Construction Supenisor License: CS -000230 V"I IN BARRY S CARNE9- 30 ARR0WBEA1jFARM,,1R'DJF Boxford MA 019 Expiration Commissioner 03107/2016 Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5 170 Boston, Massaq�,usetts 02116 Home Improvement C6ntractor Reizistration AB CARNES ROOFING, INC. BARRY CARNES 30 ARROWHEAD FARM RD BOXFORD, MA 0 1921 SCA 1 5 20M-05/1 I Registration: 176928 Type: Corporation Expiration: 10110/2015 Tr# 245633 .... ....... Update Address and return card. Mark reason for change. -] Renewal R Employment R Lost Card E] Address F NORTH ANDOVER WASTE AFFIDAVIT As a result of the provisions of MGL Ch.40-sS4, I acknowledge that as a condition of building permit # all debris resulting from the construction activity governed by this building permit shall be disposed of in a properly licensed solid waste disposal facility, as defined by MGL Ch.111-s150A. Waste Disposal or Solid Waste Facility: ALLIED WASTE Address: 300 FOREST ST Town/City, State, Zip: NAME OF HAULER: DATE: 5-26-2015 PEABODY, MA 01960 AB CARNES ROOFING, INC. DUMP TRUCKS SIGNATURE OF APPLICAIN The Commonwealth of Massachusetts Department of Industrial Accidents I Congress Street, Suite 100 Boston, MA 02114-2017 www. mass.gov1dia Workers' Compensation Insurance Affidavit: BaUders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Le2ibl Name (Business/Organization/individual):AB CARNES ROOFING INC Address: 30 ARROWHEAD FARM RD City/State/Zip: BOXFORD, MA 0 1921 Are you an employer? Check the appropriate box: 1.0 1 am a employer with _employees (Ul and/or pan -time).* Phone #: 978-887-1431 2.F� I am a sole proprietor or partnership and have no employees working for me in any capacity. [No workers' comp. insurance required.] 3.F� I am a homeowner doing all work myself [No workers' conip. insurance required.] t 4. n I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers' compensation insurance or are sole ,,.--Xopiietors with no employees. a general contractor and I have hired the sub -contractors listed on the attached sheet. e sub -contractors have employees and have workers' comp. insurance.,' 6. n,/ w! are a corporation and its officers have exercised their tight of exemption per MGL c. 1 _,02, §10), and we have no employees. [No workers' comp. insurance required.] Type of project (required): 7. E] New construction 8. FJ Remodeling 9. El Demolition 10E] Building addition I I. F� Electrical repairs or additions 12.Fl Plumbing repairs or additions 13.F, -/J Roof repairs 14. [] Other Any applicant Win cliecks box 41 must also fill out the section below showing their workers' compensation policy information. Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. TContractors 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. Ifthe sub -contractors have employees, they must provide their workers' comp. policy number. I am an employer that isproviding)vorkers'conipensation insurancefor my employees. Below is the policy andjob site information. Insurance Company N Policy # or Self -ins. Lic. #: Expiration Date: Job Site Address: City/State/Zip: Attach 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 covera2e verification. I do hereby ce nder the pfains andpenalties ofpeijury that the inform ation provided above is true and correct. -1431 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 #: FORM 153 The Commonwealth of Massachusetts! DIA Use Only Department of Industrial Accidents Office of Investigations - Dept. 153 6 I Congress Street, Suite 100, Boston, Massachusetts 02114-2017 http://www.mass.gov/dia Invest./SWO ID AFFIDAVIT OF EXEMPTION FOR CERTAIN CORPORATE OFFICERS OR DIRECTORS Chapter 169 of the Acts of 2002 ainended M. G.L. c. 152, §1 (4) by adding thefiollowingparagraph: "This chapter shall be elective for an officer or director of a corporation who owns at least 25 percent of the issued and outstanding stock of the corporation. Notwithstanding section 46, these provisions shall apply only if the corporate officer provides the commissioner of industrial accidents with a written waiver of his rights under this chapter. Said commissioner shall promulgate regulations to carry out the purpose of this paragraph. Violations of this paragraph shall subject the corporation to the penalties set forth in section 25C." Pursuant to M.G.L. c. 152, § 1 (4) as amended, I/We the undersigned officers of: AB CARNES ROOFING, INC. (Name of Corporation and Address) each holding at least 25% of the issued and outstanding stock in said corporation, do hereby invoke the right to be exempt from the provisions of M.G.L. c. 152, §25A and therefore are not required to carry a workers' compensation policy coverina the undersigned corporate officer(s) or director(s). I/We the undersigned do also waive any and all rights to make claims for benefits as defined in M.G.L. c. 152 for any injuries that may be sustained while in the employ of the above-named corporation. Further, I/we the undersigned do understand that, should the above-named corporation hire or have in its employ any employee(s) in addition to the undersigned corporate officer(s) or director(s), said corporation is required to obtain workers' compensation coverage for the employee(s) as prescribed by M.G.L. c. 152, §25A. I/We the undersigned have read and understand the statements and obligations as delineated above and I/we have checked the appropriate box below my/our name(s) indicating my/our desire to be exempt or not to be 9Xempt -ftbp the provisions of M.G.L. c. 152. under theAains and penalties of perjury: BARRY CARNES, PRESIDENT 09/24/2013 Qa-wre� Print Name & Title wish to exercise my right of exemption or 1:11 wish NOT to exercise my right of exemption �r4 — ANASTASIYA CARNES, DIRECTOR Signature Print Name & Title F,(] i wish to exercise my right of exemption or F-1 I wish NOT to exercise my right of exemption Signature Print Name & Title n I wish to exercise my right of exemption or F] I wish NOT to exercise my right of exemption Date (mm/dd/yyyy) Signature Print Name & Title Date (mm/dd/yyyy) El I wish to exercise my right of exemption or El I wish NOT to exercise my right of exemption Note: ALL ELIGIBLE CORPORATE OFFICERS MUST SIGN. THERE CAN BE NO MORE THAN 4 SIGNATURES. Instructions oti back. Form 153 - 7/2010 C-0 09/24/2013 Date (mm/dd/yyyy)r\-) t r., C_n C--., Date (mm/dd/yyyg CD k Signature Print Name & Title Date (mm/dd/yyyy) El I wish to exercise my right of exemption or El I wish NOT to exercise my right of exemption Note: ALL ELIGIBLE CORPORATE OFFICERS MUST SIGN. THERE CAN BE NO MORE THAN 4 SIGNATURES. Instructions oti back. Form 153 - 7/2010 MA SOC Filing Number: 201340178570 Date: 6/26/2013 6:21:00 PM The Commonwealth of Massachusetts Minimum Fee: $250.00 William Francis Galvin Secretary of the Commonwealth, Corporations Division One Ashburton Place, 17th floor Boston, MA 02108-1512 special Filing Instructions Telephone: (617) 727-9640 Federal Employer Identification Number: 001110484 (must be 9 digits) ARTICLE I The exact name of the corporation is: AB CARNES ROOFING, INC. ARTICLE 11 Unless the articles of organization otherwise provide, all corporations formed pursuant to G.L. C156D have the purpose of engaging in any lawful business. Please specify if you want a more limited purpose: COMMERCIAL & RESIDENTIAL ROOFING AND ROOFING RELATED WORK. THIS SHALL INCLUDE ALL TYPES EXTERIOR & INTMOR REMODELING ARTICLE III State the total number of shares and par value, if any, of each class of stock that the corporation is authorized to issue. All corporations must authorize stock. If only one class or series is authorized, it is not necessary to specify any particular designation. Par Value Per Share Total Authorized by Articles Total Issued Class of Stock Enter 0 if no Par of Organization or Amendments and Outstanding Num ofShares Total Pat- Value Num ofShares CNP $0.00000 1,000 $0.00 1,000 G.L. C156D eliminates the concept of par value, however a corporation may specify par value in Article Ill. See G.L. C156D Section 6.21 and the comments thereto. ARTICLE IV If more than one class of stock is authorized, state a distinguishing designation for each class. Prior to the issuance of any shares of a class, if shares of another class are outstanding, the Business Entity must provide a description of the preferences, voting powers, qualifications, and special or relative rights or privileges of that class and of each other class of which shares are outstanding and of each series then established within any class. ARTICLE V The restrictions, if any, imposed by the Articles of Organization upon the transfer of shares of stock of any class are: ARTICLE VI Other lawful provisions, and if there are no provisions, this article may be left blank. Note: The preceding six (6) articles are considered to be permanent and may be changed only by filing appropriate articles of amendment. ARTICLE Vill The effective date of organization and time the articles were received for filing if the articles are not rejected within the time prescribed by law. If a later effective date is desired, specify such date, which may not be later than the 90th day after the articles are received for filing. Later Effective Date: Time: ARTICLE Vill The information contained in Article Vill is not a permanent part of the Articles of Organization. a,b. The street address of the initial registered office of the corporation in the commonwealth and the name of the initial registered agent at the registered office: Name: BARRY CARNES No. and Street: 30 ARROWHEAD FARM RD City or Town: BOXFORD State: MA zip: 01921 Country: USA c. The names and street addresses of the individuals who will serve as the initial directors, president, treasurer and secretary of the corporation (an address need not be specified if the business address of the officer or director is the same as the principal office location): Title Individual Name Address (no PO Box) First, Middle, Last, Suffix Address, City or Town, State, Zip Code PRESIDENT BARRY S CARNES 30 ARROWHEAD FARM RD BOXFORD, MA 01921 USA TREASURER BARRY S CARNES 30 ARROWHEAD FARM RD BOXFORD, MA 01921 USA SECRETARY ANASTASIYA V CARNES 30 ARROWHEAD FARM RD BOXFORD, MA 01921 USA DIRECTOR BARRY S CARNES 30 ARROWHEAD FARM RD BOXFORD, MA01921 USA DIRECTOR ANASTASIYA V CARNES 30 ARROWHEAD FARM RD BOXFORD, MA 01921 USA d. The fiscal year end (i.e., tax year) of the corporation: October e. A brief description of the type of business in which the corporation intends to engage: COMMERCIAL & RESIDENTIAL ROOF1NG f. The street address (post office boxes are not acceptable) of the principal office of the corporation: No. and Street: 30 ARROWHEAD FARM RD City or Town: BOXFORD State: MA zip: 01921 Country: USA g. Street address where the records of the corporation required to be kept in the Commonwealth are located (post office boxes are not acceptable): No. and Street: 30 ARROWHEAD FARM RD City or Town: BOXFORD State: MA Zip: 01921 Country: USA which is X its principal office an office of its transfer agent — an office of its secretary/assistant secretary its registered office Signed this 26 Day of June, 2013 at 6:23:02 PM by the incorporator(s). (If an existing corporation is acting as incorporator, type in the exact name of the business entity, the state or otherjurisdiction where it was incorporated, the name of the person signing on behalf ofsaid business entity and the title helshe holds or other authority by which such action is taken.) BARRY S CARNES @ 2001 - 2013 Commonwealth of Massachusetts All Rights Reserved MA SOC Filing Number: 201340178570 Date: 6/26/2013 6:21:00 PM THE COMMONWEALTH OF MASSACHUSETTS I hereby certify that, upon examination of this document, duly submitted to me, it appears that the provisions of the General Laws relative to corporations have been complied with, and I hereby approve said articles; and the filing fee having been paid, said articles are deemed to have been filed with me on: June 26, 2013 06:21 PM WILLIAM FRANCIS GALVIN Secretary of the Commonwealth r",OA DATE —1 ACC>RhP CERTIFICATE OF LIABILITY INSURANCE 1 10-28-2014 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(iss) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement an this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT -NAME: ACE INS SERVICES INC PHONE TF—AX 675 WARREN AVE BROCKTON, MA 02301 (A/C, N2. Ext): I (AIC, No): E-MAIL AnnRF:qq. INSURER(S) AFFORDING COVERAGE NAIC It EACH OCCURRENCE INSURER A: AMERICAN ZURICH INSURANCE COMPANY INSURED INSURERB: APC CONSTRUCTION INC 51 FORD STREET UNIT 1 INSURER C: INSURER 0 BROCKTON, MA 02301 INSURERE: AU1 — — OMOBILE LIABILITY ANY AUTO ALL O�NED EJ -SCHEDULED AUTOS AUTOS HIRED AUTOS NON -OWNED AUTOS INSURER F: CnVFRAnF9 rr-RTIFIrATF NIIPARI:R- RI:VIQInM 10111willat:12. 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. I INSR LTR TYPE OF INSURANCE ADDIL INsR SUBS wvo POLICY NUMBER POLICY EFF ZoDfyyyy) POUCYEXP jMm1DDrfyyy) LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR t EACH OCCURRENCE DAMAGE TO RENTED S PREMISES IEa occurrence, MUD EXP (Any ono person) S PERSONAL & ADV INJURY S GEN'L AGGREGATE LIMIT APPLIES PER POLICY I R0j —1 PJEC LOC GENERAL AGGREGATE $ PRODUCTS - COMP/011 AGO S $ AU1 — — OMOBILE LIABILITY ANY AUTO ALL O�NED EJ -SCHEDULED AUTOS AUTOS HIRED AUTOS NON -OWNED AUTOS JOMBICINE n ?INGLE LIMIT S A ac loeg BODILY INJURY (Per person) S BODILY INJURY (Per Accident) $ R 0F.P9 PINT'y" I ?AMAGE UMBRELLA LIM EXCESS LIAB OCCUR CLAIMS,MADE EACH OCCURRENCE S AGGREGATF DED7— I RETENTION S T- S WORKERS COMPENSATION AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/E OFFICERIMEMBER EXCLUDED? IN (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA 6ZZUB 2ES2818A 10-22-2014 10-22-2015 WC STATU. TORY LIMITS1 orH. I ER E.L. EACH ACCIDENT $1,000,000 E.L, DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE - POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS/ LOCATIONS /VEHICLES (Attach ACORD 101, Additional Reniarks Schedule, If mre space 13 mquIred) r=I2TIVIf'AT1= uni npg; rAFJ1%Fl I ATinki AB CARNES ROOFING INC. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE 30 ARROWHEAD FARM ROAD CANCELLED BEFORE THE EXPIRATION DATE THEREOF, BOXFORD,MA019211 NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPREkENTATIVE W 1V55-ZU1U AG0110 GUIRVILIKATIEW All rights reserved. ACORD 26 (2010105) The ACORD name and logo are registered marks of ACORD MA SOC Filing Number: 201499735200 Date: 10/21/2014 1:24:00 PM The Commonwealth of Massachusetts Minimum Fee: $250.00 William Francis Galvin JO Secretary of the Commonwealth, Corporations Division One Ashburton Place, 17th floor Boston, MA 02108-1512 :L- Telephone: (617) 727-9640 ............ Federal Employer Identification Number: 00 1149988 (must be 9 digits) ARTICLE I The exact name of the corporation is: A P C CONSTRUCTION, INC ARTICLE 11 Unless the articles of organization otherwise provide, all corporations formed pursuant to G.L. C156D have the purpose of engaging in any lawful business. Please specify if you want a more limited purpose: CONSTRUCTION RE -MODELLING AND OTHER OTRER SERVICES PERTAINING TO CONSTRU CTION WORK ARTICLE III State the total number of shares and par value, if any, of each class of stock that the corporation is authorized to issue. All corporations must authorize stock. If only one class or series is authorized, it is not necessary to specify any particular designation. Par Value Per Share Total Authorized by Articles Total Issued Class of Stock Enter 0 if no Par of Organization or Amendments and Outstanding Num ofShares Tolal Par Value Num qfShares CNP $0.00000 20,000 $0.00 0 G.L. C156D eliminates the concept of par value, however a corporation may specify par value in Article Ill. See G.L. C156D Section 6.21 and the comments thereto. ARTICLE IV If more than one class of stock is authorized, state a distinguishing designation for each class. Prior to the issuance of any shares of a class, if shares of another class are outstanding, the Business Entity must provide a description of the preferences, voting powers, qualifications, and special or relative rights or privileges of that class and of each other class of which shares are outstanding and of each series then established within any class. ARTICLE V The restrictions, if any, imposed by the Articles of Organization upon the transfer of shares of stock of any class are: ARTICLE VI Other lawful provisions, and if there are no provisions, this article may be left blank. Note: The preceding six (6) articles are considered to be permanent and may be changed only by filing appropriate articles of amendment. ARTICLE VII The effective date of organization and time the articles were received for filing if the articles are not rejected within the time prescribed by law. If a later effective date is desired, specify such date, which may not be later than the 90th day after the articles are received for filing. Later Effective Date: Time: ARTICLE Vill The information contained in Article VIII is not a permanent part of the Articles of Organization. a,b. The street address of the initial registered office of the corporation in the commonwealth and the name of the initial registered agent at the registered office: Name: ANGELO PINQUIL No. and Street: 51 FOR D STREET UNIT I City or Town: BROCKTOPN State: NIA Zip: 02301 Country: USA c. The names and street addresses of the individuals who will serve as the initial directors, president, treasurer and secretary of the corporation (an address need not be specified if the business address of the officer or director is the same as the principal office location): Title Individual Name Address (no PO Box) First, Middle, Last, Suffix Address, City or Town, State, Zip Code PRESIDENT ANGELO PINGUIL 51 FORD STREET BROCKTON, MA 02301 USA TREASURER ANGELO PINGUIL 51 FORD STREET BROCKTON, MA 02301 USA SECRETARY ANGELO PINGUIL 51 FORD STREET BROCKTON, MA 02301 USA DIRECTOR ANGELO PINGUIL 51 FORD STREET BROCKTON, MA 02301 USA d. The fiscal year end (i.e., tax year) of the corporation: December e. A brief description of the type of business in which the corporation intends to engage: CONSTRUCTION AND RE -MODELLING f. The street address (post office boxes are not acceptable) of the principal office of the corporation: No. and Street: 51 FORD STREET City or Town: BROCKTON State: MA Zip: 02301 Country: USA g. Street address where the records of the corporation required to be kept in the Commonwealth are located (post office boxes are not acceptable): No. and Street: 51 FORD STREET City or Town: BROCKTON which is X its principal office — an office of its secretary/assistant secretary State: MA Zip: 02301 an office of its transfer agent its registered office Country: USA Signed this 21 Day of October, 2014 at 1:26:45 PM by the incorporator(s). (If an existing corporation is acting as incorporator, type in the exact name of the business entity, the state or otherjurisdiction where it was incorporated, the name of the person signing on behatf ofsaid business entity and the title helshe holds or other authority by which such action is taken.) ANGELO PINGUIL @ 2001 - 2014 Commonwealth of Massachusetts All Rights Reserved . I MA SOC Filing Number: 201499735200 Date: 10/21/2014 1:24:00 PM THE COMMONWEALTH OF MASSACHUSETTS I hereby certify that, upon examination of this document, duly submitted to me, it appears that the provisions of the General Laws relative to corporations have been complied with, and I hereby approve said articles; and the filing fee having been paid, said articles are deemed to have been filed with me on: October 21, 2014 01:24 PM WILLIAM FRANCIS GALVIN Secretai-y of the Commonwealth