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HomeMy WebLinkAboutBuilding Permit #279 - 611 SALEM STREET 10/10/2006 TOWN OF NORTH ANDOVER NORT1y APPLICATION FOR PLAN EXAMINATION O� . (S L6D �6• tiO 6 Fo Permit NO: Date ReceivedW - W OF Date Issued: 0/17L VSA US IMPORTANT: Applicant must complete all items on this page LOCATION T Print PROPERTY OWNER �3t- LTG i,- A 600- S d` �� �� ''� —J n C, Print MAP NO.: 3 PARCEL: . ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑New Building X One family ❑ Addition ❑Two or more family ❑ Industrial ❑ Alteration No. of units: ❑ Repair, replacement ❑Assessory Bldg ❑ Commercial ❑ Demolition ❑ Moving(relocation) ❑ Other ❑ Others: ❑ Foundation only DESCRIPTION OF WO TO BE P7FORMED Identification Please Type or Print Clearly) V, OWNER: Name: � �1 Cbv) C! CJ% 0-,moi j liCPhone:,SV -5-b!J':73® Address: �/� �� ;/� )1511 C 1.0 —ter--� CONTRACTOR Name: �Af �� Phone:SF S­02 q TO 1 Address:�za rn ?< 401 S1re4 A/ e9 n Supervisor's Construction License: r Z!Kz z7 Exp. Date: Cl© Home Improvement License: Exp. Date: ARCHITECT/ENGINEER P✓I je-1 ) EL oVA I Name: Phone: -2 Address: Reg. No. �f FEE SCHEDULE:BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED CASTBASED ON$125.00 PER S.F. Total Project Cost :$ � /�/�D_ —FEES Check No.: �G Receipt No.: Z2C71 Page I of 4 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 ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work Addition Or Decks ❑ Building Permit Application ❑ 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) 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 In all cases if a variance orspecial 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:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Page 4 of 4 i TYPE OF SEWERAGE DISPOSAL Tanning/Massage/Body Art ❑ Swimming Pools ❑ Public Sewer A Tobacco Sales ❑ Food Packaging/Salps, b Well F1 .'E Permanent Dumpster on Site ❑ >? Private(septic tank,etc. ❑ Electric Meter location to ` project 4 NOTE: Persons contracting with unregis red contractors do not have access to the guara fu Signature of Agent/Own Signature of contra Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans , THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF- U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ a COMMENTS DATE REJECTED DATE APPR VED CONSERVATION ❑ [� d �G� COMMENTS 5i h o ff -T-0 e- bC.I M'-f '60 Ir Sale- 9f 0rlcQel+f 117441 'Pre--�o� l�c�ic�c �' 1��"ti-Y •-h u-TS�ha�i DATE REJECTED DATE APPROVED HEALTH ❑ ❑ COMMENTS FIRE DEPARTMENT - Temp Dumpster on site yes no Fire Department signature/datej�e-V �1r w. c �,,(L���ac r�r a- n�d, (�,�, , �l f" ✓�d COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision:—2 y�•.-� �� Comments Water&Sewer connection/Signature& Date�� Driveway,Perm i t Building Setback (ft.) Front Yard Side Yard Rear Yard Required Provided Required Provides Required Provided d 33 120 1;v/ l Dimension Number of Stories:_ Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: NOTES and DATA—(For department use) Page 3 of 4 Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Created JMC.Jan.2006 I Location .� No. Date AI"ll-OA9,6 NORTH TOWN OF NORTH ANDOVER t Certificate of Occupancy $ - Building/Frame/Frame Permit Fee $ Ss�CHuss 9 t; Foundation Permit Fee $ — / 0 () Other Permit Fee $ TOTAL $ f Check #.9P6 r / /6uilding Inspector NORTH Town of No. A E dover, Mass., Aav AUA"a COCHICHEWICK7 worm 7� RATED `S BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT...... . .. COI�r �..... ..,........................................... Foundation has permission to erect........................................ buildings on.....4-��.....xis.. ..do.�........ !................ Rough to be occupied as ........... ... .. Chimney provided that the person acVeRmg is perm alf i can rm t��f 4 ap ation on file in Final this office, and to the provisions of the Codes and By-Law relating to the Inspection, Afteration Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough 3 36 0 PERMIT EXPIRES IN 6 MONTHS Final ELECTRICAL INSPECTOR UNLESS CONSTRUCTION TS Rough Joe— Service B G�9�i'►CTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove RoughFinal No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. Date 4$p 4 OBER OF NORTH PND 1 aa7F{ pWN qT 320? �0 , IVO E �9 R # 4SSACHVS t..�`_ that• ... ........................... ......................... This certifies ✓ ... o...................�.................j.l........ a'1........... has pfd.............. P� !/?!", ......... foj w ` P .......... ReCeivedby •... Treasurer CANARY:oePartment WNITE'. Applicant --------------- The Commonwealth of Massachusetts Department of Fire Services Office of the State Fire Marshal P.O.Box 1025 State Road,Stow,MA 01775 PERMIT Date: North Andover Permit No Dig Safe Nu m er (Ci ofTown) (IfApplicable In accordance with the provisions of M_G.L.1!+8 Chapier1Q_as provided in section_57 7 CMR 34 Start Date This Permit is granted to: O-C to�n'+J n0 AOU,M Full name of person,Firm or Corporation Permission to locate dumpster for construction/renovation/demolition of building. Comments: dumpster must be . 25 ' from structure if unable to place with required Restrictions: clearance dumpster must be covered with plywood or tarp end of work day at (Give location by street and no.,or describe in such manner as to provied adequate identification of location) Fee Paid$ 50.00 Fire Chief This Permit will expire 01a d 0 6 (Sitnature of o fi al granting permit) Offical granting permit (Title) r ' NEW ENGLAND ENGINEERING SERVICES 1600 OSGOOD ST., BLDG.20,SUITE 2-64 INC NORTH ANDOVER,MA 01845 JOB �O� ��� SALP/N ST. (978)686-1768-(888)359-7645-Fax(978)685-1099 SHEET NO. OF CALCULATED BY �Co `1�- DATE CHECKED BY DATE SCALE " 0 f 5 v MIA- K 0 i NA 01,1,iGO0 L1 _ �0.4,891 1 —1+ 1 1+ 6 NEW ENGLAND ENGINEERING SERVICES 1600 OSGOOD ST., BLDG.20,SUITE 2-64 I N C NORTH ANDOVER, MA 01845 JOB �7 f (978)686-1768-(888)359-7645-Fax(978)685-1099 SHEET NO. OF CALCULATED BY 9Gy 13 DATE f6 CHECKED BY DATE SCALE ZZ I U,F-a 4 g-L(t.a M o c P 03 00i ,A„ 48 9� I t . L N Permit# Permit Date i REScheck Software Version 3.7.3 Compliance Certificate Report Date:10/09/06 Data filename:K:\FPG\FPG2006\FPG06168_RAE_GSE06113\GSE213_RES_RAE.rck i Energy Code: Massachusetts Energy Code Location: North Andover,Massachusetts Construction Type: 1 or 2 Family,Detached Heating Type: Other(Non-Electric Resistance) Glazing Area Percentage: 17% Heating Degree Days: 6322 ! Construction Site: Owner/Agent: Designer/Contractor: 611 SALEM STREET MARK RAE NORTH ANDOVER,MA BELFORD CONSTRUCTION Ceiling 1:Flat Ceiling or Scissor Truss: 1120 30.0 0.0 39 Wall 1:Wood Frame,16"o.c.: 1099 13.0 0.0 71 Window:A:Vinyl Frame,Double Pane with Low-E: 117 0.350 41 Window:C:Vinyl Frame,Double Pane with Low-E: 9 0.310 3 Window:B:Vinyl Frame,Double Pane with Low-E: 36 0.350 13 Door.ENTRY:Solid: 20 0.350 7 Door.SIDELITE:Glass: 16 0.370 6 Door.DINING RM.:Glass: 40 0.370 15 Wall 2:Wood Frame,16"o.c.: 1099 13.0 0.0 78 Window:H:Vinyl Frame,Double Pane with Low-E: 103 0.350 36 Window:K:Vinyl Frame,Double Pane with Low-E: 29 0.350 10 Window:L:Vinyl Frame,Double Pane with Low-E: 19 0.310 6 Floor 1:All-Wood Joist/muss,Over Unconditioned Space: 1120 19.0 0.0 53 Furnace 1:Forced Hot Air:90 AFUE i I Compliance Statement.The proposed building design described here is consistent with the building plans,specifications,and other calculations submitted with the permit application.The proposed building has been designed to meet the Massachusetts Energy Code requirements in REScheck Version 3.7.3 and to comply with the mandatory requirements listed in the REScheck Inspection Checidist.The heating load for this building,and the cooling load if appropriate,has been determined using the applicable Standard Design Conditions found in the Code.The HVAC equipment selected to heat or cool the building shall be no greater than 125%of the design load a pecified In Sections 780CMR 1310 and J4.4. AZ- T-L C /0—/a —C" I � f Burlder/Designer Company Name Date Project Notes: PLANS BY:DRAWINGS UNLIMITED 603.434.2780 RESCHECK BY:GELINAS STRUCTURAL ENGINEERING LLC 978.465.6436 Page 1 of 4 REScheck Software Version 3.7.3 Inspection Checklist Date: 10/09/06 Ceilings: ❑ Ceiling 1:Flat Ceiling or Scissor Truss,R-30.0 cavity insulation Comments:SECOND FLOOR CEILING Above-Grade Walls: ❑Wall 1:Wood Frame,1W o.c.,R-13.0 cavity insulation Comments:2FLR WALLS ❑Wall 2:Wood Frame,16"o.c.,R-13.0 cavity insulation Comments:1 FLR WALLS Windows: ❑ Window:A:Vinyl Frame,Double Pane with Low-E,U-factor.0.350 For windows without labeled 1.1-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments:DBL HUNG ❑ Window:C:Vinyl Frame,Double Pane with Low-E,U-factor:0.310 For windows without labeled U factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments:DBL.CASEMENT ❑Window:B:Vinyl Frame,Double Pane with Low-E,U-factor:0.350 For windows without labeled 1.1-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments:DBL.HUNG ❑ Window:H:Vinyl Frame,Double Pane with Low-E,U-factor:0.350 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments:DBL.HUNG ❑ Window:K:Vinyl Frame,Double Pane with Low-E,U-factor.0.350 For windows without labeled U-factors,describe features: #Panes_Frame Type Thermal Break? Yes No Comments:2-DBL HUNG ❑ Window:L:Vinyl Frame,Double Pane with Low-E,U-factor:0.310 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments:DBL.CASEMENT Doors: ❑ Door.ENTRY:Solid,U-factor.0.350 Comments:ENTRY DOOR ❑ Door.SIDELITE:Glass,Ufactor.0.370 Comments:SIDELITES ❑ Door.DINING RM.:Glass,U-factor:0.370 Comments:FRENCH PATIO Floors: Page 2 of 4 ❑ Floor 1:All-Wood Joist/Truss,Over Unconditioned Space,R-19.0 cavity insulation Comments:FIRST FLOOR OVER BASEMENT Heating and Cooling Equipment: ❑ Furnace 1:Forced Hot Air:90 AFUE or higher Make and Model Number. Air Leakage: ❑ Joints,penetrations,and all other such openings in the building envelope that are sources of air leakage must be sealed. ❑When installed in the building envelope,recessed lighting fixtures shall meet one of the following requirements: 1. Type IC rated,manufactured with no penetrations between the inside of the recessed fixture and ceiling cavity and sealed or gasketed to prevent air leakage into the unconditioned space. 2. Type IC rated,in accordance with Standard ASTM E 283,with no more than 2.0 dm(0.944 Us)air movement from the the conditioned space to the ceiling cavity.The lighting fixture shall have been tested at 75 PA or 1.57 Ibs/fl2 pressure difference and shall be labeled. Vapor Retarder: ❑ Required on the warm--in-winter side of all non-vented framed ceilings,walls,and floors. Materials Identification: ❑ Materials and equipment must be identified so that compliance can be determined. ❑ Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment must be provided. Q Insulation R-values,glazing U-factors,and heating equipment efficiency must be dearly marked on the building plans or specifications. Dud Insulation: Q Duds shall be insulated per Table J4.4.7.1. Dud Construction: ❑All accessible joints,seams,and connections of supply and return ductwork located outside conditioned space,including stud bays or joist cavities/spaces used to transport air,shall be sealed using mastic and fibrous backing tape installed according to the manufacturer's installation instructions.Mesh tape may be omitted where gaps are less than 1/8 inch.Duct tape is not permitted. ❑ The HVAC system must provide a means for balancing air and water systems. Temperature Controls: ❑ Thermostats are required for each separate HVAC system.A manual or automatic means to partially restrict or shut off the heating and/or coding input to each zone or floor shall be provided. Heating and Cooling Equipment Sizing: ❑ Rated output capacity of the heating/ooding system is not greater than 125°/6 of the design load as specified in Sections 780CMR 1310 and J4.4. Circulating Hot Water Systems: ❑ Insulate circulating hot water pipes to the levels in Table 1. Swimming Pools: Q All heated swimming pools must have an on/off heater switch and require a cover unless over 20°x6 of the heating energy is from non-depletable sources.Pool pumps require a time clock. Heating and Cooling Piping Insulation: ❑ HVAC piping conveying fluids above 120 degrees F or chilled fluids below 55 degrees F must be insulated to the levels in Table 2. Page 3 of 4 Table 1:Minimum Insulat/on Thickness for Circulating Hot Water Pipes Insulation Thickness In Inches by Pipe Sizes Non-Circulating Runouts Circulating Mains and Runouts Heated Water Temperature("F) Up to 1" Up to 1.25" 1.5"to 2.0" Over 2" 170-180 0.5 1.0 1.5 2.0 140-160 0.5 0.5 1.0 1.5 100-130 0.5 0.5 0.5 1.0 Table 2:Minimum Insulation Thickness for HVAC Pipes Fluid Temp. Insulation Thickness In Inches by Pipe Sizes Piping System Types Range("F) 2"Runouts 1"and Less 125"to 2.0" 2.5"to 4" Heating Systems Low Pressure/Temperature 201-250 1.0 1.5 1.5 2.0 Low Temperature 120-200 0.5 1.0 1.0 1.5 Steam Condensate(for feed water) Any 1.0 1.0 1.5 2.0 Cooling Systems Chilled Water,Refrigerant and 40-55 0.5 0.5 0.75 1.0 Brine Below 40 1.0 1.0 1.5 1.5 NOTES TO FIELD:(Building Department Use Only) Page 4 of 4 ���'« �+���^✓fie- anvm9auuea�c'�`/vGa�dar3`uef8l��4�' w * • °BOARD OF DUILDIi REGULATIONS u Li�ensa CONSTRUCTION SUPERV. �# Nunip4ri`GS'' 014197 ,1 irtldate 04/24/1957 I �E p $ 04/24/2008 Tr;no: 20344 Oil- -40 . x MARK F RAE x 85'JOHNSON NO-ANDOVER MA01845' Commissioned r DATE(MM/DD/YYYY) ACORD. CERTIFICATE OF LIABILITY INSURANCE 10/6/2006 RooucER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE M.P.ROBERT$ INSURANCE AGENCY INC. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1060 OSGOOD STREET ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. NORTH ANDOVER MA 01845 INSURERS AFFORDING COVERAGE NAIC# 978-683-8073 4SURED BELFORD CONSTRUCTION, INC. INSURER A: WE WORLD INS CO INSURER B: 1049 TURNPIKE STREET INSURER C: NORTH ANDOVER, MA 01845 INSURER D. GRANITE STATE INS CO NSURER E: :OVERAGES 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. vsR DD•L POLICY EFFECTIVE POLICYEXPIRATION LIMITS _TR NSRD TYPE OF INSURANCE POLICY NUMBER DATE MM/DD/YY DATE MM/DD/YY EACH OCCURRENCE $ 1 ,000,000 GENERAL LIABILITY PREMI $ 5O 000 SES Ea occurence X COMMERCIAL GENERAL LIABILITY MED EXP(Any one person) $ 5 000 CLAIMSMADE CI OCCUR PERSONAL&ADV INJURY $ 1 000,0001 A I NPP873317-2 02/11/06 02/11/07 GENERAL AGGREGATE $ 2 000 000 PRODUCTS-COMP/OP AGG $ 1 000 0 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PROJECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO ALLOWNEDAUTOS BODILY INJURY $ (Per person) SCHEDULED AUTOS HIRED AUTOS BODILY INJURY $ (Per accident) NON-OWNEDAUTOS PROPERTY DAMAGE $ (Peraccident) AUTOONLY-EAACCIDENT $ GARAGE LIABILITY OTHER THAN EA ACC $ ANYAUTO AUTOONLY: AGG $ EACH OCCURRENCE $ EXCESS/UMBRELLA LIABILITY AGGREGATE $ IOCCUR CI CLAIMSMADE DEDUCTIBLE $ RETENTION $ WCSTATU- OTH- TORYLIMITS ER WORKERS COMPENSATION AND EMPLOYERS'LIABILITY E.L.EACH ACCIDENT $- ANY PROPRIETOR/PARTNERiEXECUTIVE E.L.DISEASE-EA EMPLOYE $ D OFFICER/MEMBER EXCLUDED? *SEE BELOW Ifyes,describeunder E.L.DISEASE-POLICY LIMIT $ SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS *WE HAVE SENT A REQUEST TO GRANITE STATE INSURANCE COMPANY TO ISSUE A WORKERS COMPENSATION CERTIFICATE OF INSURANCE TO YOU. * FAX 978-682-2397 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION TOWN OF NORTH ANDOVER DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN ATTN BUILDING INSPECTOR NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL 1600 OSGOOD STREET IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR NORTH ANDOVER MA 01845 REPRESENTATIVES. AUTHORI E%REPRE517ATIVf jVlA v; (Fl A!`l1DIl!`l1DDl�D ATIf011�OflG DATE(MM/DD/YYYY) ACORD. CERTIFICATE OF LIABILITY INSURANCE 10/6/2006 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION M.P.ROBERTS INSURANCE AGENCY INC. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1060 OSGOOD STREET ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. NORTH ANDOVER MA 01845 978-683-8073 INSURERS AFFORDING COVERAGE NAIC# INSURED BELFORD CONSTRUCTION, INC. INSURER A: WESTERN WORLD INS CO INSURER B: 1049 TURNPIKE STREET INSURER C: NORTH ANDOVER, MA 01845 INSURER D: GRANITE STATE INS CO 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. INSR AWL POLICY EFFECTIVE POLICY EXPIRATION LTR NSRD TYPE OF INSURANCE POLICY NUMBER DATE MM/DD/YY DATE MM/DD/YY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 AU IL)X COMMERCIAL GENERAL LIABILITY PREMISES Ea oK"Nccurence $ 50 000 CLAIMSMADE CI OCCUR MED EXP(Any one person) $ 5,000 A NPP873317-2 02/11/06 02/11/07 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 1 000,000 POLICY PRO LOC JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANYAUTO (Ea accident) ALL OWNED AUTOS BODILYINJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON-OWNEDAUTOS (Peraccident) PROPERTY DAMAGE $ (Peraccident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANYAUTO EAACC $ OTHERTHAN AUTOONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CI CLAIMSMADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ Is WORKERS COMPENSATION AND WCSTATU- OTH- EMPLOYERS'LIABILITY TORYLIMITS I ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ D OFFICER/MEMBER EXCLUDED? *SEE BELOW E.L.DISEASE-EA EMPLOYE $ Ifyes,IAL P OVIST r E.L.DISEASE-POLICY LIMIT $ eu SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS *WE HAVE SENT A REQUEST TO GRANITE STATE INSURANCE COMPANY TO ISSUE A WORKERS COMPENSATION CERTIFICATE OF INSURANCE TO YOU. * FAX 978-682-2397 CERTIFICATE HOLDER CANCELLATION TOWN OF NORTH ANDOVER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION ATTN BUILDING INSPECTOR DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN 1600 OSGOOD STREET NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL NORTH ANDOVER MA 01845 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHO VEPRES�rATIVF ACORD25(2001/08) @ACORD CORPORATION 1988