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HomeMy WebLinkAboutBuilding Permit #144-2017 - 71 WAVERLY ROAD 8/16/2016 ttORT)i BUILDING PERMIT '616 TOWN OF NORTH ANDOVER o � .•. - �• APPLICATION FOR PLAN EXAMINATION ti Cl- �f K. ,. Permit No#: / < �_ �(-7 Date Received ��SSgcHeS���� Date Issued: ��/� IMPORTANT: Applicant must complete all items on this page LOCATION —7/ V] /� Print V PROPERTY OWNER / Lam' F Print 100 Year Structure yes no MAP D PARCEL:U" ZONING DISTRICT: Historic District ye no Machine Shop Village ye no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial Repair, ,replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other - —__ - _ _ - -a - YI3 Septic >jW1--bI Flootlplain; � ® _ a} Y a Wetlands r ❑ Watersheds®isttrlct�, DESCRIPTION OF WORK TO BE PERFORMED: Idenpification- Plea e Type or Print Clearly / OWNER: Name: �/'I°G � � � Phone: Address: Contractor ame:�e �f� Phone: 1— z'? Email: G4,k le-Pt; e ct Z0� ' Supervisor's Construction License: 4TV a14 Exp. Date: G?- 2 — 20/-! �� f Home Improvement License: 7 7� —Exp. Date: 2-6 — Z0 ARCHITECT/ENGINEER Phone: r 7 Address: Reg. No. J FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ 8 % '— FEE: $ /h Check No.: a ,`/ Receipt No.: -347 3 4k 1Z 1.7 NOTE: Persons contracting with unregistered contractors do not have access to a fund �I 1 Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ S'�"""''ung Pools ❑ Well ❑ Tobacco Sales ❑ I Food Packaging/Sales ❑ Private(septic tank, etc. ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed Onnature' Si 9 COMMENTS CONSERVATION Reviewed on Signature 'i COMMENTS HEALTH Reviewed ons Signature COMMENTS Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments 9 Conservation Decision: Comments �iater & Sewer Connection/Signature Date Driveway Permit DPW Town Engineer: Signature: .. Located 384 Osgood Street T NT `-4 .....�. FAIRE DEPAR T�ernp Dumpsfier on;site; -ayes► , �-k ,, ; o �` �f L 4ated at=:�F24MainStreet F r. . ;r -, •�44��• ' '` `c, sR Fire De partmentsignaure/dame .�, , rF i•yl 4.CO J u r 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 i DANGER ZONE LITERATURE: yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA-- (For department use) I i � I i LI Notified for pickup Call Email Date _ Time Contact Name Doc.Building Pennit Revised 2014 r 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 4 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 Engineering Affidavits for Engineered products OTE: 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/Cross Section/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 IS OTE: 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 1 2012 IECC Energy code Engineering Affidavits for Engineered products OTE: 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 Doe:Building Permit Revised 2014 d J �✓ Location t�lu L�''-�' �� t`• �; -'J / f No. � f� � C)� / � �Date f • • TOWN OF NORTH ANDOVER r, Certificate of Occupancy $ Building/Frame Permit Fee 0-1 Foundation Permit Fee $� Other Permit Fee $ v TOTAL $ Check# : - Building Insrpectorf NORTH own Of t eAndover p ..... 0 No. Wh ver, Mass �L COC NIc"eCNlWKK � 7,4 AoRATEo S U BOARD OF HEALTH Food/Kitchen PERVI LD Septic System THIS CERTIFIES THAT BUILDING INSPECTOR ............................ .............. ....... ........................ ........ W 7' .��� � Foundation has permission to erect .......................... buildings on ............... ..... .. ............. ..............�................. p� / . . .. S............................... Rough y t0 be occupied as .... ... .............. ..... ..�� .� Chimney provided that the person accepting this p rmit shall in every respect conform to the terms of the application Final on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR— UNLESS CONS CTIO Rough Service . ...... . . .... . . ........ ..... ..... Fina BUILDING 1 PEC R GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Display in a Conspicuous Place on the Premises - Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. Proposal HIC#136779 TWOMEY & LEGARE CONTRACTING INC . "Couldn't your home use a little TLC?" Specializing in Residential Additions 87 Belmont Street • North Andover, MA 01845 P: 978-685-7447 • F: 978-685-7446 NAME OF OWNER V/' G ''"" I 4--) ►f'T ADRESS OF JOB �' WI%C �� -Zu! ��> !v ' //✓� . l� TEL. DATE We hereby submit estimates for: �►� Ems'' S�-�^,� � �-�' �D, �. (��,�✓✓r�,�t,...r i w rQN&-.e)2!1 CA44 JAJI Ivb o L.) A- / I T " V 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 U U a i i aw Authorized Signature NOTE:This proposal may be withdrawn by us if not accepted with in_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: - J Signature: r 1 1 TWOMEY&LEGARE CONTRACTING INC. HOME IMPROVEMENT CONTRACT TERMS AND CONDITIONS M.G.L.142A I.WORK:Provided the Homeowner performs under this agreement,the Contractor shall perform the work on the Property lt specified incorporated herein.The work does not include extraordinary conditions of which the Contractor could not reasonably erawi(re.If such co ditions arehed 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.Contractor to leave site Broom Clean,any additional cleaning by owner. 2. PERMITS:If a building permit is required for the work,the Contractor shall obtain same as Homeowner's 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_ days of commencement,except for longer periods as may apply to particular projects as Contractor shall notify Homeowner it the Proposal,and subject to delays for circumstances beyond Contractor's 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 o t Contractor's 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 2 years 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; lig 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 thanby Contractor;and(vi)loss or injury due to the elements.There are no other expressed or implied warranties or representations made or given. I 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 have been completed and signed.Homeowner acknowledges receipt of a completed contract signed by the Contractor. 7. HOME IMPROVEMENT REGISTRATION:In accordance with M.G.L.c. 142 A,§9,Contractor is registered with the Burl au of Building Regulations and Standards Registration No: 136779.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 ontract,or seek a lien if the Homeowner breaches this Contract. 9. HOMEOWNER COVENANTS:The Homeowner agrees,represents and warrants that(a)the Homeowner grants permissionIto 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 tthe 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 mi dnight of the third business day following the signing of this agreement. )Cs HOMEOWNER: / DATE: Job Description:. j-� / w� (/(////► DEPOSIT: T he'CommonweaLM-of Mgssachusetts Departmant.ofrj2dush-irrl_gccidents office ofrizvestiaations �► 6061 Washiia�inStreet -_ Bvstarz,, M4 Q?III - uzssgnv/rile Workers'Compensation. zsuranceAffidiw, BUiiders/COnfr-ac arslEiec cia4/P umbers 4.�Ducan�t Inforn;aon Please :..- atrie tBnsin slOreanzzation/Inciviaual) Adaress: ` �J - 42�ILy/St3`�/Gi . �1 Ore y a an employer?Check-the appropriate bob. i = T e ofPro1'ect fre quired): - 1. I am a employer with: _ �:I am a gene—ral contiactor,and I . employees(full Md/Or par tim )_ havehira the sub-contractors: ' New cc) M—tion '�-❑ I am a sole proprietor oras .- lieu d on theattached sheet4.- 7. YRemodelina ship.andhavenoemployees . These sub-coniractoishaiTe S. worldnQ for Mein aM,T can a ire' c ❑Demol2tEon omp 7n�*�+ce. . Q [No word mss'coma.inmLr � W!e are a c 1_(Building addition anm 5. oiporaiion and iLs. require officers 1G.L►Electrical repairs or additions � �aue e�ercis:.d-their �. I am a nomeoaraer doing all *tght of, xemption-perMGL- 11.0 Plumbing repairs o-additions mysel v0 worbers':oinp. c i52_§1(4),and we have no insurance reau= r emplo ems. INTO v✓or ;r 1� Roof repairs . GO1�aB,mc�a ar,C. ri'QL1r�Q] j Other IOrlti cto' WII�SIlOIDIE tII35 aind8tr lIlCiraLlnc they a._ _cu:Juin 2EiC ihmH-T:OII&idj °Con dor�t h=h this boxmust atm.;nee an additional shit showing the ceayz^m L submit a n- atria vit mdimtim sseh. name of the sub-rogsa_aws.and the wmi= comp-pouch�fo�u.mom am an e*IgjYer that is providing workerscompensadon inform¢fion. or insurance f mY employee& BeI6v-is the polio:azul job site Tncurance Comminyl'tiame: (121-kv- ----------------------- Policy `or SeL.-"-las:Lac.i Farion Date: 57 �,•^''' ''�° Sob Site Address: lyj7 e/`l �x.� �� City/State&ijr. - ;C , , vv. 47*. Attaca a Bogy of the workers'compensation policy declaration page,showiig she policy uuiaQer-_and egniraiion uatel. Failure to secure coverage as required urine-: Section?;A ofMGLc. 1-2;an lead to the imposition of cZmirial penalties of a line up M. S1,500.40 andiar on nearv'-sonmen` as well as Divi p=aaiues in elle:ion-of a STOP WORK©RDS md ae o up to S250.00 a day.agab=tae violator. Be advisee that a copy of this stat=='maybe forwarded to the Ofce oI iQves�iQafions of the DIA for_inmrance cov�ge verincation. 1-do hereb,:c rider the pains and penabies ofperjury that the information provided above.is arae¢nit correct Signature: Phone-4- C?OL-ial use only-Do riot turtle it fizis area, to be compi.2d hJ:cii1-ar torvtz offzcia7_ City or Tots PermitlLiceitse_ Issuing Authority(circle one): L Board of Health ?Building Deuarraent 3_Citv!ToR'n Clerk- Electrical inspector �.Plumbing Inspector 5. Other i I . Conmcr Persor" piloae= I Aug 1b 1bU32bp Iwomey& Legare 918-68b-/446 p.2 AC R® CERTIFICATE OF LIABILITY INSURANCE DATE(MMMDft*Y Y) D612V2016 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(les)must be endorsed. If SUBROGATION 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 Ike certificate holder In lieu of such endorsement(s). RODIrCER NAME.CONTACT Diane LeBlanc DOHERTY INSURANCE AGENCY INC PHONE (978),475-0260 � No: A83.Ess dleblancQdohertyinsurance.com P.O BOX 1985 INSURERISI AFFORDINGCOVERAGE NAICS ANDOVER MA 01810 INSURER A- TRAVELERS INDEMNITY CO OF ERICA ! 25666 NSURED INSURERe- TWOMEY&1_EGARE CONTRACTING INC INSURERC: INSURER D: `--•—•_�•--_-- __ _ 97 BELMONT STREET INSURER E. NORTH ANDOVER MA OIB45 INSURER F: I — 'OVERAGES CERTIFICATE NUMBER- 64822 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. _ ISR TYPEOFINSURANCE POUCYEFF POLICY EXP — — POLICYMUMBER 1AM1D LIMITS COMMERCIAL GENERAL LIABILITY ( EACHOCCURRENCE S CLAIMS-MADE 0OCCUR PRE LILSES(Ea ocaxrarueL S —_-- HIED EXP(Anyone parsonl S — NIA PERSONAL d ADV INJURY GENt AGGREGATE LIMITAPPLIES PER: + ! GENERALAGGREWE _ POLICY[j QCT L_I LOC I PRODUCTS• MPIOP AGG,s OTHER. I —�S —---- AUTOMOBILE LIABILITY CONIBINEOSINGLELIMIT 5 Ea ncadaw ANY AUTO BODILY INJURY tPer Person) S ALL OWNEDSCHEDULED AUTOS AUTOS N/P1 BODILY INJURY(Poracaderu)i S — i HIRED AUTOS NON OWNED PROPERTY DAMAGE 15 —— AUTOS rPERIe ! I I 5 UMBRELLALIAS OCCUR EACHOCCURRENCE 5 EXCESS LIAB CLAIMS•MADEI NIA AGGREGATE OED F I RETENTIONS I S WORKERSCOMPENSATION i PER DTH• AND EMPLOYERS'LIABILF!"T STATUTE PINI ANYPROPRIETORIPARTNERIE XECU IVEI E.L.EACH ACC DENT S 500.000 A OFF rC EWMEMB E R EXCLUDED? MA 3 NIA wA 6HU13029CM99415 09/18/2015 09118(2016 (Mandmary In NH) E.L.DISEASE•dAEMPLOYEE S 500,000 I yas,dowbeunder 0ESCRIPTIONOF OP£RATIONS balow E L.DISEASE-ROLICYI MMIS 500,000 E WA I 3ESCRIPTION OF OPERATIONS I LOCATIONS t VEHICLES(ACORD 101.Additional Romaft Schadut%may Igo attached Um*m speco Is npulmd) Workers'CompensatiDn benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no aulhonzaticn is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires.Or has hired those employees outside df Massachusetts. This certificate of insurance shows the policy in force an the date that this certificate was issued(unless the expiration date on tyle above policy precedes the issue dale of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Cove ge-Coverage Verification Search tool at www.mass.gov/iwd/workers-compensatiortr4nvestigaticnsl. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. NOTICE MLL HE DELIVERED IN Town Of North Andover ACCORDANCEWITHTHE POLICY PROVISIONi. 1600 Osgood Street AUTHORIZED REPRESENTATIVE North Andover MA 01845 Daniel M.Cr,4*y.CPCU,Vice President-Residual Market-WCRIBMA O 1988.2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD i I Client#: 13298 TWOMEY6 A RDL CERTIFICATE ®F LIABILITY INSURANCE 0DATE 710612016YYY) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Doherty Insurance Agency,Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P.O.Boz 1985 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 21 Elm Street Andover,MA 01810 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A. Arbella Protection Ins Company Twomey&Legare Contracting,Inc. INSURER B. 87 Belmont Street INSURER C: North Andover,MA 01845 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. SH WDALTA NS TYPE OF INSURANCE POLICY NUMBER P ABY EFFECTIVE POLICY EXPIRATION LIMITS A GENERAL LIABILITY 9520040230 06/22116 06/22/17 EACH OCCURRENCE $1,000,000 Nfaolm MERCIAL GENERAL LIABILITY DAMAGE TORENTED S100 O00 CLAIMS MADE aOCCUR MED EXP(Any one person) 55000 PERSONAL 8 ADV INJURY 51,000,000 GENERAL AGGREGATE 52 000 000 GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS•COMP/OP AGG s2,000,000 X POLICY ECT r LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea awdent) S ALL OWNED AUTOS BODILY U1lURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per acadent) S PROPERTY DAMAGE S (Per aa3dent) GAR AGE LIABILITY AUTO ONLY.EA ACCIDENT S _ ANY AUTO OTHER THAN EA ACC S AUTO ONLY: AGG $ EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE S OCCUR CLAIMS MADE AGGREGATE S S OEDUCTIBLE 5 RETENTION S S WORKERS COMPENSATION AND &STA;T,_U &7 DTH• EMPLOYERS'LIABILITY FR ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT S. OFFICER/MEMBER EXCLUDED? E.L.DISEASE•EA EMPLOYEE S If yes.dcscnDe under SPECIAL PROVISIONS Detpw E.L DISEASE•POLICY LIMIT S OTHER DESCRIPTION OF OPERATIONS I LOCATIONS!VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Covering operations usual to Twomey&Legare Contracting,Inc... CERTIFICATE HOLDER CANCELLATION 10 Days for Non-Payment SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF.THE ISSUING INSURER WILL ENDEAVOR TO MAIL 1.p_ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER.ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPR TMVE ACORD 25{2001108}1 of 2 #S33888/M33740 DML fi696RD CORPORATION 1968 - --r`%�c �o»vnanrrrrrll�r�^jlc.;,;rrr•�rc�e/t Office of Consumer Affairs R Business Regulation y =_90ME IMPROVEMENT CONTRACTOR 13 - tegistration: 136779 Type: Expiration: 812612016Partnership TWOMEY+LEGARE CONTRACTING INC_ SHAWN TWOMEY 87 BELMONT ST. 4a �� N.ANDOVER,MA 01845 . Undersecretan. Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-067560 Construction Supervisor SHAUN M TWOMEY , 61 PATROIT ST NORTH ANDOVER MA 01845 ,nom l� Expiration: Commissioner 10/2512017 C 7,!!1[i iiCfiiief,Liis,zi t Nn _ CS-055108 DOUGLAS J LEGARE '_ 79 GARY AVE HAVERHILL MA 01830 09/02/2016