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HomeMy WebLinkAboutBuilding Permit #670-13 - 535 PLEASANT STREET 4/12/2013TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATIO Permit N0: Op --- Date Received —4 Date Issued: I42 IMPORTANT: Applicant must complete all items on this page LOCATION J ��/� -f P int PROPERTY OWNER /—/4rjtY Unit # (� Print MAP NO: v PARCEL ZONING DISTRICT: Historic District yes Machine Shop Village yes 100 year-old structure yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential 0 New Building ❑ One family ❑ Addition ❑ Two or more family ❑ Industrial ❑ AI tion No. of units: ❑ Commercial epair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ---T S�ptc OWLI O Flo©dplain �Wetl'and Wateresfie trio - ® Address DES MP 11UN OF W URK TO BE PERFORMED: /7 CONTRACTOR Name: t*A Phone: c % , 1 Address: Supervisor's Construction License:�v Exp. Date: /3 Home Improvement License: /3 /a77 Exp. Date: ARCHITECT/ENGINEER �'✓� Phone: Address: Reg. No. FEE SCHEDULE. BULDING PERMIT. $12.00 PER $9000.00 OF THE TOTAL ESTIMATED COST SED ON $125.00 PER S.F. Total Project Cost: $ � FEE: S Check No.:Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to theguaranty fund I 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 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) ❑ 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: Doe.Building Permit Revised 2008mi 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, HEALTH COMMENTS. 1P Reviewed on Signature Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Conservation Decision: Comments Comments Water & Sewer Connection/Signature & Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT - Temp Dumpster on site yes Located at 124 Main Street Fire Department signature/date COMMENTS no 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 ❑ Notified for pickup - Date Doc:.Building Permit Revised 2011 June/mi Location 6-� 0,,4 CA ` No. 16— C7 Date i Z 1Zj Check #� 26283 TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ - rty'�b Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Building Inspector 11. A r0, n 'V'Cot, nEfi-* p n iz- J W 2 LL pZ U Y O LL ,F; N to .0. N ° d of z Z p J m C O 7 C LL 7 0' T CC CO U LL W N m d L to d' LL N V W W L to 7 d' U N LL oc O Z Q L... to z W W p W 6L y i O Z a.. O +� d .OY O �L y O u] as c S: O t: ,C_ N > �� `_; p •a OEM Oz 0 Z: Cz D O N o 0 M 4: �•> p Q : a) 4 �. 0•rn v O = C Q L c = d d F- O to 4) v m U) a.+ cc m `� W a y-- •a +r O O LL •� N C 0-=uj•7 --. ••�•+ :ir Lu 0 wE v m 0-0 O Jh am E w o %- c 0 N n CD c N = 0 E d CL N t N N a a� c m L O 0) C N N t O z O a J 0 0 W CL cn V 0 J in V/ =I j< o m � Z Z ~ CLul) I.L.. � • CL U) x0 LL, U �w LLJ -i CL Z M I A HIC # 136779 TWOMEY oc LEGARE C` • "Couldn't your home use a little TLC?" Specializing in Residential Additions pg-a-72�qC)187 Belmont Street • North Andover, MA 01845 P: 978-685-7447 • F: 978-685-7446 J NAME OF OWNER K ADRESS OF JOBl TE DATE: We hereby submit estimates for: `>/v' ✓ y� �j k/ 'all l lee 6 y r r ®' r ter. �� plc• � '� U We Propose herby to furnish material and labor - complete in accordance with above specifications, for the sum of: dollars ($ ). Payment to be made as follows + � � � jar"✓✓ Authorized .� Signature ` NOTE: This proposal may be withdrawn by us if not accepted with irl�days Acceptance of Proposal - The above prices, specifications and conditions are satisfactory and are herby accepted. You are authorized to do the work as specified. Payment will be made as outlined above. Signature Date of Acceptance: S�/'� Signature HOME IMPROVEMENT CONTRACT TERMS AND CONDITIONS (M.G.L.142A) 1. WORK: Provided the Homeowner performs under this agreement, the Contractor shall perform the work on the Property as specified Proposal, attached incorporated herein. The work does not include extraordinary conditions of which the Contractor could not reasonably be aware. If such conditions are encountered, this shall be an additional cost to the Homeowner. Materials selected by Homeowner may have to be ordered or custom made, which items are specified in the Proposal. The Contractor is not obligated to agree to any modifications, extras or change orders unless such items are agreed to in writing by the Contractor. All extras and changes shall be at an additional cost to the Homeowner. Contractor shall perform the work in a good and workmanlike manner using materials consistent with this contract. Lawn or Driveway may be damaged by dumpster or equipment. Due to material shortages Contractor may substitute materials of equivalent grade. 2. PERMITS: If a building permit is required for the work, the Contractor shall obtain same as Homeowners agent. Contractor is not responsible for any other permits that may be required for the Work, and Homeowner is responsible to determine whether any zoning, planning or wetland related permits or approvals are necessary. Homeowners who secure their own permits or deal with unregistered contractors will not have access to the Guaranty Fund. 3. COMMENCEMENT AND COMPLETION: Homeowner acknowledges the commencement date of the work is fluid, and is subject to numerous factors such as scheduling other contractors, delivery of materials and weather. Contractor and Homeowner shall determine the commencement date of the Work when a more definite determination can be made and shall execute a written acknowledgment of same. The Work shall be substantially completed within 7 days of commencement, except for longer periods as may apply to particular projects as Contractor shall notify Homeowner in the Proposal, and subject to delays for circumstances beyond Contractors control. Notwithstanding, the commencement date and substantial completion date may be extended, and the Contractor will not be liable for delays caused by, labor or material shortages, delays in delivery of items selected by the Homeowner, governmental action, and unforeseen events beyond the Contractor's control, including but not limited to weather, strikes, war, the acts of third persons or the acts of the Homeowner. The Homeowner recognizes that the commencement date may be delayed due to scheduling or the completion of Contractors other jobs. 4. PAYMENTS: Contractor agrees to perform the Work and to furnish the materials and labor specified in the Proposal for the amount as stated in the Proposal. Thirty percent (30%) of the total is to be paid as a deposit with the signing of this contract. Upon cancellation prior to commencement of the Work, any remaining deposit will be returned less the costs for materials ordered for which Contractor was unable to cancel. Final payment shall be due upon completion of the Work and Homeowner agrees it may not hold any retainage. Late fees may be applied for late payments. Homeowner shall pay Contractor's reasonable costs of collection, including attorney's fees and costs. Time is of the essence hereof. 5. WARRANTY: For a period of 1 year after substantial completion of the Work the roof will be free of leaks caused by defects in workmanship, but not those caused by ice backing -up or extraordinary weather events, including blizzards, tornadoes, hurricanes or storms of greater than a twenty-five year duration or intensity. Contractor gives no warranties with reference to any materials or equipment installed in the Premises, passes any such warranties directly to Homeowner, and Homeowner agrees to look only to the manufacturer with reference thereto. This limited warranty extends to the Homeowner only and is not transferable to succeeding Homeowners. This Limited Warranty specifically excludes (i) all consequential and incidental damages; (ii) damage due to ordinary wear and tear, abusive use, misuse, or lack of proper maintenance; (iii) defects which are the result of characteristics common to materials used; (iv) defects in items installed or supplied by anyone other than Contractor; (v) work done by anyone other than by Contractor; and (vi) loss or injury due to the elements. There are no other expressed or implied warranties or representations made or given. 6. ENTIRE AGREEMENT: This contract and all documents referenced herein constitute the complete and final agreement between the parties. In the event that any of the provisions of this contract shall be held to be invalid, the remainder of the provisions of this contract shall remain in full force and effect. Two identical copies of this contract haxe been com leted and signed. Homeowner acknowledges receipt of a completed contract signed by the Contractor. OV 7. HOME IMPROVEMENT GIST TION: rin accordance with M.G.L.c. 142 A,-§ 9, Contractor is registered with the Bureau of Building Regulations and Standards Registration Na444RT: Homeowner may verify by contacting the Director at (617) 727-3200, ext. 25205. A Homeowner's rights under the Home Improvement Law (M.G.L.c. 142A) and other consumer protection laws may not be waived in any way. Homeowner acknowledges receipt of a copy of 780 CMR R6 and Massachusetts General Laws chapter 142A, and which are available online at www.mass.gov. Questions may be directed to the Consumer Information Hotline, (617)727-7780. 8. ARBITRATION: 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 Regulations and the consumer shall be required to submit to such arbitration as provided in M.G.L.c. 142A. No lien or security interest is imposed on the Property as a consequence of this contract, but Contractor has the right to record this contract or a notice of this contract, or seek a lien if the Homeowner breaches this Contract. 9. HOMEOWNER COVENANTS: The Homeowner agrees, represents and warrants that (a) the Homeowner grants permission to the Contractor to enter the Property to perform the work as covered by this contract; (b) the Homeowner has funds available to make full payment under this contract to the Contractor upon completion; (c) the Homeowner understands that construction as contemplated by this agreement creates a dangerous condition, and agrees not to enter portions of the Property under construction until the Contractor advises the Homeowner that the construction is completed; (d) Contractor may need use landscaped areas of the yard during the Work and Homeowner is responsible to provide protection for landscaping and (e) that code requirements may result in roofing nails penetrating through roof decking and will be visible on the underside of some surfaces. The Homeowner indemnifies, exonerates and holds harmless the Contractor from any loss, damage, claim, liability or expense (including reasonable attorney's fees, deposition costs and court costs) resulting from a breach of this provision. Contractor is not responsible for damage to landscaping that will grow back during the next growing season. 10. CANCELLATION: Homeowner may cancel this agreement provided Homeowner notifies the Contractor in writing at the address listed in the Proposal not later than midnight of the third business day following e signin of this agreement. HOMEOWNER: DATE: Shingle: DEPOSIT: ��`�� AonLeant Information Please :Print,tily , Na a (Business/Orgautzation/Individuai):\ J^ - `Address: City/State/Zip: -,orA'- Phone #: Are you an eiQmployer? Check the appropriate boa: ' 1, Ll am a employer with ¢. ❑ I am a genes contractor and I employees (full and/or part-time).* have hired the sub -contactors 2. ❑ I am a sole proprietor or partner- listed on the attached shit t ship. and have no employees These sub -contractors have working for me in any capacity. workers' comp. ms rance. 0. [No workers' comp. insurance S. We area corporation and its required) officers have exercised their 3. ❑ I am.a' homeowner doine.all work _ right of exemption.per MGL. myself :[No workers' comp: c. 1 52, § 1(4), and we have no insurance required.) t employees: [No vorkrs' : comp ;ust3xance required:) gtirre ] Type of project (required): , 6..O Nev, construction 7. ❑ Remodeling 8. 0 Demolition L. 9.. 0 Building.addition 10.0 Electricalrepairs or, additions .11.0 Plumbing repairs or additions 12.0 Roof repairs_ 13.0 Other .... ...r:: ..,� .ru -- :uc., ,.•"u :1ti Utrt CCC SCC'QCL''.'^.:OP.+:.aQ4'L^a i -=-w wCi---rs CQMr—.-S'..^. -Y,,:2 � rfC:....�ffR Flo eownets who suomit fns a�adavit indicating theE+ a _ 3ciag all :pork and tu® hire outside cont aemn must submit a new a5davit indicating such. 'Contractors that chleckthis box must attached an additional sheet showing the Ume of the mb-cannactors and their workers' gip• poncy information: lam an employer that isproviang workers' compensa&n insurance for my employees. 'Below is the policy and job site information. Insurance Compam, 3,?ame:_ Policy. or Self -ins. Lic. r Expiration Date: Sob Site Address: City/StatelZip:d'' �A/'k " Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Fa2ure to secure coverage as required under Section 25A ofMGL c.152 can lead to the imposition of criminalORpenattties of a fine. to $1;500.00 and/or one-year imprisonment, as well as civil penalties in the font of a STOP WORK DER and a fine of up to $250:00 a. day against the violator: Be advised that a copy of this statement maybe forwarded -to the Of–nee of Investigations of the DTA for insurance coverage verification I do hereby certify under the pains and penalties of perjiuY that the information provided above is true and correct Signature: Date ._.. C Of �,MAVa Official use on N. Do not write in this area, to be completed bit city, or town official City or Town: PermitUcense issuing Authority (circle one): T. Board of Health Z. Building Department 3. City/Town Clerk 4. Electrical inspector 3. Plumui� 6. Other inspector Contact person: — Phone -.4- Rightfax C2-2 1/16/2013 5:01:57 AM PAGE 2/002 Fax Server CERTIFICATE OF LIABILITY INSURANCE DATE(MMlDDIYYrn T TIFICATE IS ISSUED ASA 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 and endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: PHONE FAX DOHERTY INS AGENCY INC PO BOX 1985 (AIC, No, Ext): (A1C, No): E-MAIL ANDOVER, MA 01810 ADDRESS: 22YI\' INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A. TRAVELERS INDEMNITY CO- TWOMEY & LEGARE CONTRACTING INC INSURER B: INSURER C: INSURER D: PO BOX 366 INSURER E: NORTH ANDOVER, MA 01845 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: IS is TO CERTIFY THAT THE POUCIESOF INSURANCE LISTED BELOW HAVE B D 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 CLAMS. INSR ADD SUB POLICY EFF DATE POLICY EXP DATE LTR TYPE OF INSURANCE L R POLICY NUMBER WDDIYYYY) (MMWDIYYYY) UMTS GENERAL LIABILITY ACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY CLAIMS MADE r7 OCCUR- DAMAGE TO RENTED EMISES (Ea occurrence) $ ED EXP (Any one person) $ ERSONAL 8 ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY 0 PROJECT ❑ LOC ENERAL AGGREGATE $ ODUCTS - COMP/OP AGG $ AUTOMOBILE LIABILITY COMBINED SINGLE $ ANY AUTO LIMIT (Ea accident) BODILY INJURY $ ALL OWNED AUTOS SCHEDULE AUTOS (Per person) BODILY INJURY (Per accident) $ HIRED AUTOS NON�OWNED AUTOS PROPERTYDAMAGE $ (Per accident) UMBRELLA LIAB r7 OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE 1 DEDUCTIBLE $ $ RETENTION $ A WORKER'S COMPENSATION AND EMPLOYER'S LIABILITY YIN UB-029OM994-12 09/18/2012 09/18/2013 X WC STATUTORY LIMITS OTHER ANY PROPER Ti OR/PARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? (Mandatory in NHI NIA E- L. EACH ACCIDENT $ 500,000 E -L. DISEASE - EA EMPLOYEE $ 500,000 I yes, describe under DESCRIPTION OF OPERATIONS below E -L. DISEASE - POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLESIRESTRICTIONS(SPECIAL ITEMS THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE CERTIFICATE HOLDER CANCELLATION - - SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED - BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED ` IN ACCORDANCE WITH THE POLICY PROVISIONS. - AUTHORIZED REPRESENT ■ � �n 1n,�.�., .lam „" 3..Ztw4:trt:. AGUKU ZD JZU1UlUS) Ine AGUKU Dame ano logo are regisierea marKS OT AVUKU Taoo-Lulu ALUKU LUKYUKA I IVIr. All rlgm5 re5erVe0. r_Ih%nfdf• 11701t TwnMFVA ACORD. CERTIFICATE OF LIABILITY INSURANCEDATE(MMIDDIMN) 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 08107112 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Doherty Insurance Agency, Inc. P.O. Box 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 PODATE MUMMI)fM Andover, MA 01810 INSURERS AFFORDING COVERAGE MAIC # INSURED Twomey & Legate Contracting, Inc. PO Box 366 North Andover, MA 01845 INSURER A: Arbella Protection ins Company INSURER B. INSURER C. INSURER D: INSURER E: COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE EFIDDIYYE PODATE MUMMI)fM LIMITS A GENERAL LIABILITY 8500043255 06122!12 06122113 EACHOCCURRENCE S1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $100,000 CLAIMS MADE O OCCUR MEO EXP (Any am person) $5,000 PERSONAL 8 AOV INJURY $1.000.000 GENERAL AGGREGATE s2,000,000 GENL AGGREGATE LIMIT APPLIES PER PRODUCTS- COMPIOP AGG $2,000,000 X POLICY ja LOC AUTOMOBILE LIABILITY COMBINED SINGLE U611T ANYAUTO IEn accident) S BODILY INJURY ALL OWNED AUTOS SCHEDULED AUTOS (Per person) S 8001LY INJURY S HIRED AUTOS NCN-OWNED AUTOS (Per accident) PROPERTY DAMAGE S (Per accident) GARAGE LIABILITY AUTO ONLY -EA ACCIDENT S OTHER THAN EAACC S ANY AUTO AUTOONLY: AGG S EXCESSIUMBRELLALIABIUTY FACHOCCURRENCE S AGGREGATE S OCCUR ® CLAIMS MADE S S DEDUCTIBLE S RETENTION S - WORKERS COMPENSATION AND INC STATU• OTH- EMPLOYERS' LIABILITY " ANY PROPRIETORIPARTNERIEXECUTNE E.L. EACH ACCIDENTS E.L. DISEASE - EA ELAPLOYEE S OFFICERIMEMBER EXCLUDED? It yes• describe under SPECIAL PROVISIONSbebw E.L. DISEASE - POLICY UMR S OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Covering operations usual to Twomey & Legere Contracting, Inc... SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL In OAYSWRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO 00 SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER. ITS AGENTS OR ACORD 25 (2001108) 1 of 2 #S284671M28466 / / ` DML G)CCORO CORPORATION 1988 Massachusetts - Depat-tment of Public SafetN Board I of Building Regulations and Standards Construction Supervisor License License: CS 67560 SHAUN M TWOMEY 61 PATROIT ST ANDOVER, MA 01845 Expiration: 10125/2013 Commissioner Tr#: 4913 Massachusetts - Department of Public Safety Board of 'Building Regulations and Standards, Construction Supervisor License: CS -455108 DOUGLAS J LEqAVE 79 GARY AVE HAVERHELL MA 01830 Expiration Commissioner 09/02/2014 Office of Consumer Affairs & Business Regulation ME IMPROVEMENT CONTRACTOR 13 1 6779 Type: gistration: — xpiration: Partnership TWOMEY+ LEGARECONTRA CONTRACTING INC. SHAWN TWOMEY 87 BELMONT ST. N. ANDOVER, MA 01845 Undersecretary