Loading...
HomeMy WebLinkAboutBuilding Permit #607-14 - 7 FULLER MEADOW ROAD 2/25/2014BUILDING PERMIT '�'`� �`•,ry� TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION * _ Permit NO: O"4 Date Received '►, , ,� Date Issued: I EWPORTANT: Applicant must complete all items on thispaae LOCATION���,e—C V-Cao,�� iitint PROPERTY OWNER Q �Q Print jb \ MAP NO: PARCEL:; o ZONING DISTRICT C 4,oiM Historic District yes VQaaA6A Machine Shop Village ves TYPE OF IMPROVEMENT PROPOSED USE Resi Non- Residential New Building One fatnil Addition Two or more family Industrial Alteration No. of units: Commercial air re lacem Assessory Bldg Others: Demolition Other Septic Well Floodplain Wetlands Watershed District Water/Sewer 3- OWNER- Name: -1 f4- fL kIIC + 144 Address: rAtr CONTRACTOR Name: ---� Address: 5, Supervisor's C 'c.a ItI Identification Please �Tpe or Print Cleary �ar1�A Pt Phone: R 13-465- SS5a pC -7&1 -IX-61 a6 License: CS _ (0,73 r), Exp. Date: 6 1/y Home Improvement License: (U t 4 r) Exp. Date: 5-1A hV ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE: B ULDING PERMIT. $12.00 PER $9000.00 OF 7HE TOTAL ESTIMATED COST BASED ON $923.00 PER S.F. Total Project Cost: $---2(, -7 00 FEE: $��—O Check No.: t C=c 1 0a Receipt No.: NOTE: Persozzs co tractiyg)witl zye tereontractors do not have acre Ig lz % [IzO", ignature of AgentlOwner , _ Signature of contractor Location &Jovv No. f—C( Date L TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee Other Permit Fee TOTAL $ Check# i U Building Inspector - Plans SubmittedPl ❑ _ ans Waived ❑ _ 'TYPE..-C7F-.e�ire„ :.Certified Plot Plan ❑ Stamped Plans ❑ Public Sewer Well Tanning/Massage/Body Art El _Swimming Pools ❑ Tobacco Sales Private (septic tank, etc_. Food Packaging/Sales ❑ Permanent Dumpster on Site ❑ ----------- -THE-,FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED: DATE APPROVED PLANNING & DEVELOPMENT El COMMENTS CONSERVATION Reviewed on Si nbfure COMMENTS HEALTH Reviewed on Si nature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Si nature & Date DPW Toiw.,z Englmeer: Signature: DrivewaI Permit IRE DEPARTMt Located 384 Osgood Street NT = Temp Dumpster on site yes -;L0 cated-bt'124 Mair Street Y no Fire Departi e►it-signature/date COMMENTS -Dimension erasion Number of Stories: Total square feet of floor area, based on Exterior dimensions. ..Total land area; sq. ft.: ELECTRICAL: Movement of Mester location, mast or service drop requires approval of Electrical Inspector Yes No DANGERZONE LITERATURE: Yes No MGL.Ch'apter 166 Section 21A—IF and G min.$100-$1000.fine NOTES and DATA — (For department use ® Notified for pickup - Date Doc.Building Permit Revised 2010 Building Department The folhwing'W'a-listof the required.forms to be filled ouffor the appropriate. permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑'' Building Permit Application 0 Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work o 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 o Workers Comp Affidavit o Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract o Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) o 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 o 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) o Copy of Contract ❑ Mass check Energy Compliance Report o 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 apw•>al 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 r Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost $ 263700.00 m $ - $ 320.40 Plumbing Fee $ 40.05 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 40.05 Total fees collected $ 500.50 7 Fuller Meadow Road 607-14 on 2/25/14 Interior Remodel rA 0 0 ENO 0 O c� Q cc U) �-COL 45 L N O O Q' O • V L CL Cc E h 40 > _ 0 v > N o _CD c N M E c s o CL C C d .:c .N 3 = > o s c o H Qom CD 4 t m : tiea N rn c c = E Q w .o 2 Q N WF ca � jE m w = •O +-� o O LUIL .y cD5N C O •� H Z V Q O_� N 0> > CO) J m rc CAU -0 O 0 o a U) 0 Cl) F- 0 Cl) Z Z W a. Z W H U cn W W a. Z E O Z 0 N W .E CL t O V cc CL w 0 0 .y C U cc !c CLN W w cc cr O0 i- FO u � z W a a a LLIIA Z Z a LL z a Z O z z u W 0 cc H O E u C9 E5 m C E J W LL m d W t u C N z ]C Ln fY0 N ` Y O _ _ _ _ OO _ O O0 a). 7 LL LI) LL W u LL 0. LL 2' N LL LL m Ln N 0 0 ENO 0 O c� Q cc U) �-COL 45 L N O O Q' O • V L CL Cc E h 40 > _ 0 v > N o _CD c N M E c s o CL C C d .:c .N 3 = > o s c o H Qom CD 4 t m : tiea N rn c c = E Q w .o 2 Q N WF ca � jE m w = •O +-� o O LUIL .y cD5N C O •� H Z V Q O_� N 0> > CO) J m rc CAU -0 O 0 o a U) 0 Cl) F- 0 Cl) Z Z W a. Z W H U cn W W a. Z E O Z 0 N W .E CL t O V cc CL w 0 0 .y C U cc !c CLN W AIM �TRAVELERS ,02080 WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY TYPE AR INFORMATION PAGE WC 00 00 01 ( A) POLICY NUMBER: (6HUB-426OP87-9-13) RENEWAL OF (6KUB-426OP87-9-12) INSURER: THE TRAVELERS INDEMNITY COMPANY OF AMERICA 1 NCCI CO CODE: 13439 INSURED: PRODUCER: TARBELL CONTRACTING CORP THE DOUGLAS INS AGCY 5 FLOYD ST 220 BROADWAY #301 WOBURN MA 01801 LYNNFIELD MA 01940 Insured is A CORPORATION Other work places and identification numbers are shown in the schedule(s) attached. 2. The policy period is from 06-10-13 to 06-10-14 12:01 A.M. at the Insured's mailing address. 3. A. WORKERS COMPENSATION INSURANCE: Part One of the policy applies to the Workers Compensation Law of the state(s) listed here: MA B. EMPLOYERS LIABILITY INSURANCE: Part Two of the policy applies to work in each state listed in item 3.A. The limits of our liability under Part Two are: Bodily Injury by Accident: $ 100000 Each Accident Bodily Injury by Disease: $ 500000 Policy Limit Bodily Injury by Disease: $ 100000 Each Employee C. OTHER STATES INSURANCE: Part Three of the policy applies to the states, if any, listed here: COVERAGE REPLACED BY ENDORSEMENT WC 20 03 06A D. This policy includes these endorsements and schedules: SEE LISTING OF ENDORSEMENTS - EXTENSION OF INFO PAGE 4. The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating Plans. All required information is subject to verification and change by audit to be made ANNUALLY. DATE OF ISSUE: 06-14-13 CH OFFICE: ORLANDO INDUS AFF 161 PRODUCER: THE DOUGLAS INS AGCY 72MLX ST ASSIGN: MA Feb 18 2814 11:84:48 918-383-8343 -! 1-781-394-7779 RSC Certificate Requ Page 882 A#*'.� i°� CERTIFICATE 4F L.IABIL.ITY INSURANCE 2 DATEIMMfDDIYY1.4YY) 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)ies), must be endorsed. It SUBROOATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu at such endorsement(s). PRODUCER Risk Strategies Company 15 Patella Park Drive Suite 240 Randolph Xi 02368 NAME: Colleen Crowley PHONE, , (Tgi)985-4400 FA (7A]5049-4420 Amilu. COroarleyprisk-strategies . cam IN41.000,A% AFFCROINOCCYERAOt NAICir INSUKRA:AmiCivard 42390 INSURED J No Hardwood Flooring 111 Bowen Ave Madford MA, 02155 INSURSR 0; INSUI�Rc;_�„�^__, INSURPR INSURER E: i su RF• COVERAGES CFRTIFICATF N1]MRFR•CL1312369968 RFVIRIQN IUIJMRFR! 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, EXCLUrAONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, IL TR AN TYPE OF INWRANCE G ENER A L LIAB)LITY X COMMERCIAL GGNERALLIAUIUTY971 cLA1M.,MADE OX OCCUR X p0 V R MMP405046 /13/2013 LIMITS /13/2014 EACH OCCURRENOF S 11000,000 r:15 % S 501000 MED EXP An ono rw S 5,000 PERSONAL A AL1V INJURY $ d(i!NE'RAL AOGRf"GATr. 9 21000,000 GI N'L AICAEGATE LIMIT APPLIES PER: PRO - POLICY z;z LOC PROCIL)OTS-COMP OPArS S 21000, 000 S AItTClM0814�1,10.p31L,ITY ANY AUTO AIA. OOMIM SC:HEDULEll AUTOS AUTOS Hf l) AUJ Or, N(.*-OWNET) AUTO. C'OR FF 11 M 117-3 J��..�....W..,., a-. .. BODILY INJURY (Per person) 5 BODILY INJURY {Per m�kfenq S PROPERTY DAMAGE S UMBRELLA LIAtl EXCE8S LIAR C•�f:;VR eA.AIMS•MADE EACH (X CI)RRENCE ACCREraA'EE 3 C)FD I I RETE.NTION s” $ A WORKERS ND EMPLCOMPENSATION YS slwerilTNY YIN ANY PROPREETORIPARTNER/EXL--CEITIVE OFFIC`ERIMEMBER EXf':I.110E"Da (Mandatory in NH) If yes, desodht� under DM;CRIPTEON OF OPERATIONS below N f A l i euza Tacluded for rage C450198 r 1/30/2013 1/30/2014 , { TR - E.L.EACH ACCIDENT S l 000 000 d 6 ..,.,.., F..l.. DI$EAiSE . EA EMPLOYE r 1,000,000 f•;.1, QL9E:A5E: • POLICY LINST $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATION$! VEHICLES IAUdoh ACORD f01, Addltlonal Fto"rkt, Sch,+dule,, d nior* aPacs la required) Tarba+ll Contracting Corp. in included as An additional i.... ad. '(781)394-7779 Tarbelll Contracting Corp. 5 Floyd tit. Woburn, MA 07.801 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL OF- DELIVERED IN ACCORDANCE WITM THE POUOY PROVI8tONs. AUTHORIZED REPReS NTATIVE I Chribtian/CLC Auu"u Z5 (zU7VI05) 0 9888-2010 ACORD CORPORATION. All rights reserved, MOM poiowoi The ACORD name and logo are registered marils of ACOAD C & CERTIFICATE OF LIABILITY INSURANCE 2/22/20 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONPItPb NO MONTS UPON THE CERTIF 0ATIR 140 R- THIS CERTIFICATE DOES NOT AFFIRMAWELY OR NEGATIVELY AMEND, ExTEND OR ALTER THE COVERAGE AFFORDED 13Y THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE COM19CATE HOLDER. IMPORTANT: If the certifleate hoG;r, IS an ADDITIONA4 INSURED, the policy(I06) must be endorsed. 0 SUBROGATION IS WAIVED, subject to ttm tams and candlNons of the policy, certain policies may raqulfe an endorsement. A etabmwnt on this cerdflcade does not confer rights to the certif Icata holder In lieu of such endogemenw. PRODUCBR M,l,e>Ci3.inerd Inc ACt Scott Leavitt, C1C, L1A ENDIVE (978) 567-5031 � • (99616671016 1A Andover Road scott1ebra:Lnardinsure . o** IN9 APPORDING COVERAGR K4X 6 um"s IN5URERA•Pxvferred Mutual Ina Co 15g24 Billerica MA 01821 INSURRo INSURER B : MBURBRC: Lric Sullivan, DBA: Sullivan Electric INsuRaRO: 9 Eastvjaw Ave INSURER E ars R6 P &LIlorica MA 01821 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMES) ABOVE FOR THE POLICY PERIOD INDICATED, NOiVVITHSTANDING 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. INIIR TYPE OP INSURANCE 5 Floyd Road Woburn, I& 01801 AUTROARM REMSENTAYNE UM PO4rCY 6FP POLICY EXP MM um"s GENE'RALUABW:Y EACH OCCURRENCE $ 11000,000 Doc s 7 00 000 X COMMERCIAL GENERAL LlAeamEa MED EXP (Any one S 5,0()0 A CLANS-MAM Cil OCCUR 2PP01305991077 /5/2013 /9/2014 PUMONAL A AOV INJURY S 1,000,000 GENERAL AGGREGATE $ 2,000,00 GERL AGGREGATE LIMIT APPLIES PER; PRODUCTS - COMPIOP A= S 21000,000 T POLICY 2,0f. LOC5 AUTOMOBILE LIABILITY (E4 ti LIMB BODILY INJURY (Per person) S ANY AUTO BODILY INJURY (Pot nWdrAtl $ ALL SCHEDULED Par ftitl 6 NOrW WO HIRE O AUTOS PAUTOS 0 UMBRELLA LUUB OCCUR EACH OCCURRENCE i AGGREGATE & B)(CMM LUUI CLAM44AUS O>=0 N M ORKERS COWMISATION VYcs 9TATU- ETH- AND BMPLOYEW LIABILITY Y ANY PIQPMEMPIPARTNERIEXECUnVE I^� NIA E,L EACH ACCIDENT b F-LDISEAGE-FA%MKOYRE S OFFICERIMErWR EXCLUDED? (Manmtmy In ryH) Iyee, MMunder DQ$CRIPTION OF OPERATIONS bdow E L, DHEAS£ -POLICY LIMIT $ DESCRIPTION OF QPEftATTON3 f LOCATIONS t VE]IICLEC (A1tiMf ACORb 147, Add5loaal Rwnp+ke Bahl, R mem igpan la nqulmd) This certificate of insurance mpreaents coverage cumrent ly in erect and may or may not bin in compliance with any .mitten contract. ,14:. 1JM ACD (781) 394-7779 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE TH9REOF, NOTICE WALL BE DELIVERE=D IN Ken Tasbell Cprtt=kdt.i.ng ACCORDANCE WITH THE POLICY PROVISIONS. 5 Floyd Road Woburn, I& 01801 AUTROARM REMSENTAYNE S LGAvitt, Cie, twa`--- ACORD 25 (2010105) INS025 (sotonpi ®1906-2010 ACORD CORPORATION. All rights reeerVed- Tate ACORD name and logo are registered nmeft of ACORD WORKCOMi ENSAMON AND SMI PL,OyERS L1AMUTV INSURANCE POLICY AR tNFrJRINA'TION PAGE Issued by 1iAaBM"Y NOT= S1» xW8VRA= Policy Number WC2-31S-374118«013 RRMEM OW: >NC2-313-374118-012 Account Number 1-3741.18 1. Insured and Wiling Address ERX a ti0'fi JVAN DIA XW J WUJVAt4 ELWfWAL Iftmut". INSURANCE 178bIp}aJ1gSM R1 At, 1+,IIAMIS 16586 Issuing hike 16C Issue Dabs 08-06-13 Sub Account 0000 91 0 EAsTvnw ave RISK XD 83831 »nt,>t.UXA, fes, 01121 status 01 — 119DTV1DM Other Workplaces not shown above: SEE ITEM 4. PREMIUM• EXTENSION OF INi=C7ptW71ON PAGE 2. Policy Period: The policy period Is from 08-14-•2013 to 08-X14-2014 ' Zoi A.M. standard time at the Insured's mWiling address. 3, Coverage A. Workers Compensation Insurance: Part One of the policy appka to the Wbrksrs Compensation LAW of the states IWO here: ba B. Employers Liability Insurance: part Two of the policy applies to work In each state Iistad in Item 8.A The Nrnits of our liability under Part Two are: 80dq Injury by Accident $ 100,000 each socident Bodily Injury by 0imm $ $00,000 policy Nmit Bodily Injury by Disease $ 100, 000 each employee C. Other States Insurance: Part three of the policy Votes to the states, is any, Astad here: WE L:ND WC 20 03 06B D. This policy Includes them endorebments and schedules: SEE SCrENSION OF INFORMATION PAGE 4. Pmrnium: The premium for this policy wig be determined by our Mums of Rules, Ckesitioations, Rapes And Rating Plans. All Information required below is subject to verification and change by audit. Code Premium Imsis Total Rale per $100 Estimated Annual classNicAtions Number Es#mvbad Annual Remuneration of Remuneration premium Minimum Premium $ 308 (14A ) Premum will be billed ANNUAL Producer 0004016546 um tali AZNXM ZNSDRANIZ Inc 1—A ANDOVER RORD BXZJA AICA MA 01821 � Total Estimated Annual Pnehthlum 694 YYC 00 00 01 A rD 1987 Nationgi Council on Compensation Insumnce,inc. WO 00 00 018 (NJ) Ed. 07/01/2011 AN Rights Reserved Page 1 of i Cer-kCscEto--, +c> @Ho� Nexr Oeek- ( y, From: 781-438-3305 To: 17813947779 Page: 4/4 Date: 2/14/201410:50:52 AM ACoRof CERTIFICATE OF LIABILITY INSURANCEDATE(MMMDIYYYY) 16 � 2/14/2014 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(ies) must be endorsed. If SUBROGATION IS WANED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endomement(s). PRODUCER NAME: CONTACT LOPrlOre ACCO11Ilt LoPriore Insurance Agency 426 Main Street PHONE (781) 435-1375 FVC, p. (781)438-679D E-MAIL ADDRESS: Shite Two INSURERS AFFORDING COVERAGE NAIC # Stoneham MA 02180 INSURER A Vermont Mutual Insurance 26018 INSURED INSURERB:Hartford Casualty Insurance 29424 NICK'S PAINTING SERVICES INC NICHOLAS BOULAS WSURERC: 5 FURBISH POND IN INSURERD: INSURER E : $ NORTH READING MA 01864-2636 WSURERF: COVERAGES CERTIFICATE NUMBER-CL1311704371 REVISION NUMBER - 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 LTR TYPE OF INSURANCE ADDLISUBR NSR WVD POLICY NUMBER UmFF MM1D EXP MMIDDYIYYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR Rich Moretti/RICH aP17046355 1/1/2013 1/1/2014 EACH OCCURRENCE $ 2,000,000 PREMISES Ea occurrence $ 50,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 2,000,000 GENERAL AGGREGATE $ 4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: RO LOC X POLICY[71 PEC PRODUCTS - COMPIOP AGG $ 4,000,000 $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) ) $ PROPERTY DAMAGE Peraccdent $ $ UMBRELLA LIAB EXCESS LU1B OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED I RETENTION $ $ B WORKERS COMPENSATIONWC AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? ❑ (Mandatory in NH) H yes, describe under DESCRIPTION OF OPERATIONS below NIA 8WECLI39100 1/1/2013 11/1/2014 STATU- OTH- Y LIMITER E.L. EACH ACCI DENT $ 1,000,000 E.L. DISEASE - EA EMPLOY $ 1,000 000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) CERTIFICATE HOLDER CANCELLATION (781) 394-7779 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Tarbell Contracting Corp ACCORDANCE WITH THE POLICY PROVISIONS. 5 Floyd St AUTHORIZED REPRESENTATIVE Woburn, MA 01801 Rich Moretti/RICH ACORD 25 25 (2010105) INS025 onlow ni ©1988-2010 ACORD CORPORATION. All rights reserved. Tho ACr1Rl'1 nnmo and Innn aro ronictararl mnrlrc of ACARn This fax was sent with GFI FAXmaker fax server. For more information, visit: http:/twww.gfi.com tft Massachusetts - Department of Public Safety ! Board of Building Regulations and Standards Construction Supervisor License: CS -101732 KENNETH G TARtELL 5 FLOYD STREET W OBURN MA O1801 ` .f �. xoiration Commissioner 06106/2014 -9.4e yu� ; Office of Consumer Affairs and llusiness Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Reqistration: 166472 Type: Corporation Expiration: 5/26/2014 Trtt 223079 TARBELL CONTRACTING CORP. KENNETH TARBELL 5 FLOYD ST WOBURN, MA 01801 DPS -CAI 0 5OM•04/04-G101216 �,� ✓��e {nam��aarruw�all�a. c� .t��z,z�ar.�iuwl% Office of Consumer Affairs & Business Regulation = HOME IMPROVEMENT CONTRACTOR ---��#rrr Registration:166472 Type: Expiration: 5/26/2014 Corporation TARBELL CONTRACTING CORP. KENNETH TARBELL 5 FLOYD ST WOBURN, MA 01801 Undersecretary Update Address and return card. Mark reason for change. Address Renewal M Employment Lost Card License or registration valid for individul use only before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, MA 02116 Not valid without signature The Con:ntonlvealth ofMassachuselts Print Form Department oflndustrial Accidents Office of Investigations U9. I Congress Street, Suite 100 Boston, MA 02114-2017 wwwanass.gov/dia '%Yorkers' Compensation Insurance Affidavit: Buil,den/Contractors/Eiectr-icians/Plumbers Applicant Information Please Print LeQibl�� Name (Business/Ormizationgndividual): �G - a Address__ 1 \t`�`.�; .. ..� City/State/Zip: (��bt JM Mf - 0%q Phone #: Are you an employee Check the appropriate bo tam Type of project (required): LEI ® I am a employer with 4. a general contractor and I 6. = construction employees {full and/or part-time). have hired the sub -contractors Vernodeling ?. © I am sole proprietor or partner- listed on the attached sheet. 7. ship and have no ernployees These sub -contractors have g. E]Demolition worming for mein any capacity. employees and have workers' 9. ❑ B mg addition [No workers' cote. irns ranee cotes' nuance required.] 5. We are a corporation and its 10. Electr al airs or additions. repairs 3.El I ain a homeowner doing all work officers have exercised their 11.0 Phm3bing repairs or additions myself [No workers' corm. right ofexemptionper MGL 12.0 Roofrepairs insurance required.] i c. 152, § 1(4), and Ave have no 13.0 Other errployees. [No workers' corm, insurance required.I "Any applicant that checks box �-' l crust also fill out the section bebw showing thea workers' condensation policy infocuetian Hourowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavi indicating such. tC ontractors that check this box must attached an additional sheet shove ing the name of the sub-co=actors .and state whether or not those entities have employees. Ifthe sub -contractors have empbyees, they must provide thea workers' comp_ policy nuni)er_ I am ann employer that is providing workers' compensation insurance for M., emplot,ees. Below is the policy and job site information. _ Insurance Company Narr>z �d1`�VQ,'Clsy�l^, Policy # or SeIf-itis. Lic. #: �O No��%q" t ExpirationDate: - Job Site Address:: U�Q� M�a�'C� � City/State/Zip: �. �tl0Jec— Mpt Q�I�i'fJ— Attach a coPy of the ssnrlcers' compensation police declaration page (showing the policy number and expiration date). Failtue to secure coverage as required under Section 25A ofMGL c. 152 can lead to the irnpositionofcriavnalpenalties ofa fine up to 51,500.00 and/or one-year imprisornnent, as well as civil penalties in the form ofa STOP WORK ORDER and a fine ofup to $250.00 a day against the violator. Be advised that a copy ofthis statement nnaybe forwarded to the Office of Investigations ofthe DIA for instu tice coverage verification. I do hereby= that the information provided above is true and correct: Oficial use only. Do not write in this area, to be completed by city or town official. Cit`- or Tossn: Permit/License # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. Cit%/Tosi=n Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone #: Feb 48 14 01:10p Information Systems 617-724-8854 p.2 CONTRACTING CORP. 5 Floyd Street, Woburn, MA 01801 P 781-726-0106 F 781-394-7779 I<gt@tarbelicc.com Date: Feb. 17, 2014 _Work to be completed for; Todd Moriarty 7 Fuller Meadow Rd North Andover, Ma 01845 Project; Floor, paint and electrical alterations 7 Fuller Meadow Rd North Andover, Ma 01845 Tarbell Contracting Corp. is pleased to submit this Contract to Todd Moriarty as outlined below. Flooring • Remove & dispose of all carpeting, carpet pads & tack strips on 2nd floor. • Install 3-1/4" red oak flooring throughout 2nd floor. Sand & finish w/3 coats of polyurethane. • Sand & refinish stair treads w/3 coats of polyurethane. • Sand & refinish hardwood floors in living room, dining room & family room on 1st floor. • Remove & dispose of laminate floor in kitchen. • Install 2-1/4" natural colored prefinished red oak hardwood floor in kitchen. Price for flooring $13,500.00 Electrical • Install fan/fight w/remote in family room. • Install ceiling light in office/living room w/dimmer switch. • install fan/light combo & fan switch in three 2nd floor bedrooms. • install fan/light combo & fan switch or remote in master bedroom. $125 allowance for electricians cost to remove & reinstall entry chandelier while electrician is on site. • All remote kits or fan switches included. • Owner to supply all fans, fixtures, pendants, etc. Price for electrical $2,800.00 Page 1 of 3 Feb X18 14 01:11p Information Systems 617-724-8854 p,3 Painting • Paint ceilings and closets on 2nd floor w/2 coats of Benjamin Moore white flat latex paint. • Paint waifs on 2nd floor & front entry w/2 coats of Benjamin Moore Aura matte latex paint. • Prime all trim, doors & baseboard heaters on 2nd floor w/1 coat of Bins primer followed by 2 coats of Benjamin Moore satin impervo oil paint. • Prime stair risers w/1 coat of Bins primer followed by 2 coats of Benjamin Moore satin impervo oil paint. • Priming and painting of stair rails & newel posts included if owner decides to have it done. • Paint front entry trim w/2 coats of Benjamin Moore satin impervo oil paint. • Paint ceilings in living room, dining room, kitchen & family room w/2 coats of Benjamin Moore white flat paint. Caulk will be applied along the top of crown moldings. • No painting to be done in two 2nd floor bathrooms. Particle board shelving in closets will not be painted. Exposed beams in master bedroom will not be painted. • Walls & trim will be sanded with 120 grit sandpaper. • All curtain rods & shades will be removed. • Wall imperfections will be joint compounded. • caulking will be applied to trim around windows, door frames & baseboards. • Nail holes will be filled w/wood filler. Price for painting $9,6001.00 Administration Pre and post construction services and permit fees. Price for administration $800.00 Total Pro'ect Cost 26 700 Page 2 of 3 ,.Feb b18 14 01:11p Information Systems 617-724-8854 p.4 Contract Qualifications • All work is contingent upon weather and/or delays beyond the control of Tarbell Contracting Corp. The contract and payment terms shalt be agreed upon by all parties. • This contract is based upon no lead paint or other hazardous materials being encountered on the project. This contract is good if executed within 30 days • Tarbell Contracting Corp. cannot be held liable for any negative effects caused to the owners resulting from the refinishing of the flooring. The owners assume all responsibility when they return to the home. Contract Terms: • Payment terms: Todd Moriarty of 7 Fuller Meadow Rd, North Andover Ma 01845 agrees to pay Tarbell Contracting Corp. the contract price of $26,700 to perform the work at 7 Fuller Meadow Rd, North Andover Ma 01845 as outlined above. Ail work under this contract is to be completed within 45 days of contract execution and receipt of deposit. • The payment schedule agreed upon is as follows; $8,900.00 deposit due before work begins. $9,600.00 due at substantial completion of painting $8,200.00 due at completion of work. All work performed under this contract will be warrantied for 2 year from date of completion. • All materials are guaranteed by the manufacturer. • All work under this contract will be done in a professional manner according to standard practices. • Any alteration or deviation from the work outlined in this contract may be subject to additional costs. Contract documents included under this contract: dated 2/12/14 ,Signature ~ - Date Kenneth Q. T&bLll President Print Name Title 11 -ACCEPTANCE OF Contract: ?"re2 �aw3 rrlGc .. Specificatiors ana corsdidi s . f `R....' and hereby accepted Tarbell Co .:,acting Co -.,p. is authorized to do LhC-1VU. `< aS SRe'--Iyled. J flute Page 3 of 3