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Home My WebLink AboutBuilding Permit #422-15 - 77 WEYLAND CIRCLE 11/3/2014 NoRtti q BUILDING PERMIT ?b�`.`ao*°'06�°0� TOWN OF NORTH ANDOVER o APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received ,41 Date Issued: U 1 1/ IMPORTANT:Applicant must complete all items on this page CH LOCATION-7-7 LJeyla.'3 c;rCI L . N O,�k AK-Jow° Prin PROPERTY OWNER avl ,,,\ th Fe X110 VPrint MAP NO: y��7PARCEL:'Z --ZONING DISTRICT: Historic District yes n Machine Shop Village yes o TYPE OF IMPROVEMENT PROPOSED USE Residential Non-Residential F1 New Building ❑One family n Addition ri Two or more family ❑ Industrial 7 Alteration No. of units: 0 Commercial Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition 0 Other ❑ Septic 0 Well ❑Floodplain ❑Wetlands ❑ Watershed District ❑Water/Sewer ttQ Gyc �2��cce� (mac GJ `h0o U1; ►do LV �G Identification Please Type or Print Clearly) n q v OWNER: Name: 6,LJ V 6<4 \ P-eY-0) 0 Phone: Address: • CONTRACTOR Name: Phone: 6o3- Ll �t�Secr 1�CY�Ctt.�lhtk- irt, Address: "7'�_ Prcv.denee j-1,1t Rt) r\M Supervisor's Construction License: Exp. Date: C S-(37004 90,-/ACI 6 Home Improvement License: &9 1444 Exp. Date: 4 3G�aCt� ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. �Zr r Total Project Cost: $ 6 S a.S - G ® FEE: $ Check No.: 1�p 21 Receipt No.: 2 NOTE: Persons coq_ acting it re 's d contractors do not have access o the guarantyfund Signature of Agent/Owner Signature of contractor V, • AORTH BUILDING PERMIT o`Alt,- 16qua *6 TOWN OF NORTH ANDOVER 3? y ' APPLICATION FOR PLAN EXAMINATION F . Permit No#• Date Received �4"0q„TEo �SSACHUS�� Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION _ Print PROPERTY OWNER Print 100 Year Structure yes no MAP PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village yes 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 ❑ Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District ❑Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: Identification- Please Type or Print Clearly OWNER: Name: Phone: Address: Contractor Name: Phone: Address: Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owrier Signature of contractor 1 j Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swiimning Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ i Private(septic tank,etc. ❑ permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature - COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments i A, Conservation Decision: Comments Water & Sewer Connection/Suture& Date Driveway Permit i DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT - Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date COMMENTS Dimension Number of Stories: Total square feet of floor area, based on.Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— For department use � p ) i ❑ Notified for pickup Call Email I Date Time Contact Name Doc.Building Permit Revised 2014 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 ❑ 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/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 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 o 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 I 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 ni ust be submitted with the building application Doc:Building Permit Revised 2014 II Location No. 12-7 Date . - TOWN OF NORTH ANDOVER+ Certificate of Occupancy $ Building/Frame Permit Fee $—Z Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check# � Buil6ing Inspector � NORTt� Town o E A� Andover 4z,-zZ n h ver, Mass, C 01=11.. 7S V BOARD OF HEALTH Food/Kitchen PERM L D Septic System THIS CERTIFIES THAT BUILDING INSPECTOR .................. ..R�.. ................ ...G.r.o.�. .... ....... ........... ........... has permission to erect .......................... buildings on .. :)....... .. .. .1. ..•...... ��.►1. .......... Foundation Rough to be occupied as w1 .r ..................... Chimney provided that the person acce ting this permit 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 i VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTH ELECTRICAL INSPECTOR UNLESS CONSTRUCTI S Rough Service ........... .... ...................................................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Buildinz 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. r JOSCON Management, BUILDING&REMODELING CONTRACTOR MASSACHUSETTS HOME IMPROVEMENTS CONTRACT This form satisfies all basic requirements of the state's Home Improvement Contractor law(MGL chapter 142A),but does not include standard language to protect homeowners.Seek legal advice if necessary.Any person planning home improvements should first obtain a copy of"A Massachusetts Consumer Guide to Home Improvement"before agreeing to any work on your residence.You may obtain a free copy by calling the Office of Consumer Affairs and Business Regulation's Consumer Information Hotline at 617-973.8787 or 1.888-283-3751 or on our website. Homeowner Information Contractor Information Name Company Name Mr.&Mrs.Ferullo Joscon Management,Inc Street Address(do not use a Post Office Box address) Contractorl Salesperson/Owner Name 77 Weyland Circle Jonathan O'Sullivan Cityaown State Zip Code Business Address(must include a street address) N Andover,MA 01845 185 Atlantic Avenue Daytime Phone Evening Phone City/Town State Zip Code Email:pferullo@yahoo.com 978- Salisbury,MA 01952 Mailing Address(It different from above) Business Phone Federal Employer ID or S.S,Number 603.489.1568 61.1403121 Home Improvement Contractor Reg.Number 159444 Expiration date 4-30.2016 The Contractor agrees to do the following work for the Homeowner: (Describe in detail the work to complete;specifying the type,brand,and grade of materials to be used,use additional sheets if necessary.) The following scope of work below is to replace(2)windows in the master bedroom. Scope of Work I Master bedroom back window: • Remove and replace the existing window unit. Install an Anderson triple mulled double hung window unit with the same specifications as the windows installed in 2011. Double hung units,white interior and exterior,full screen,High Performance Low E,finelight grilles between the glass. • Field measurements needed prior to ordering to confirm sizing. • Work to include staging,int I ext trim,permit,window unit and misc.siding repair as needed around the window. • Window sizing has been figured on Anderson standard stock sizing. Sizing may be slightly smaller than the existing unit due to a different manufacturer. • Rot may be exposed beyond the window opening. Rot 1 damaged wood at the sills,.header and outside of the window opening will be considered additional work billed on a Time and Materials basis. TBD once the opening has been exposed. • Exterior painting of disturbed areas. Homeowner to supply paint. • Disposal of all construction related debris. Total for the master window unit @$3,375.00 Master bedroom front window: • Remove and replace the existing window unit, Install an Anderson triple mulled window unit with a half circle above the middle unit. Please see picture. All 3 windows will be double hung operable. All the same specifications as the windows installed in 2011. Double hung units,white interior and exterior,full screen,High Performance Low E,finelight grilles between the glass. • Re frame the top section of the window opening to allow for the new half circle unit to fit, • Field measurements needed prior to ordering to confirm sizing. • Window sizing has been figured on Anderson standard stock sizing. Sizing may be slightly smaller than the existing unit due to a different manufacturer. • Rot may be exposed beyond the window opening. Rot I damaged wood at the sills,header and outside of the window opening will be considered additional work billed on a Time and Materials basis. TBD once the opening has been exposed • Includes the window units,int I ext trim,misc siding repairs and labor to fit the new window units into the openings. • Painting by others unless agreed upon. • Disposal of all construclion related debris. Total for the master window unit $3,450.00 Required Permits— Building permit Proposed Start and Completion Schedule-The following schedule will be adhered to unless circumstances beyond the contractor's control arise. (Owners who secure their own permits will be excluded from the Guarantee Fund provisions of 10-20-14 Date when contractor will begin contracted work. MGL chapter 142A,) 10-28-14 Date when contracted work will be substantially completed. (Actual Start and completion date will be determined once the windows arrive) Total Contract Price and Payment Schedule The Contractor agrees to perform the work,furnish the material and labor specified above forte total sum of,$6,826,00 () Payments will be made according to the following schedule: $2,275.00 1/3rd Deposit Upon signing contract(not to exceed 113 of the total contract price or the cost of special order items,whichever is greater) $2,275.00 213rdsUpon the start of work $2,275,00 Final 31d upon substantial completion of the contract, (Law forbids demanding full payment until contract is completed to both party's satisfaction) The following material/equipment must be special $0 to be paid for N/A ordered before the contracted work begins in order to meet the completion schedule.("`)$0 to be paid for NIA NOTES:(")Including all finance charges('")Law requires that any deposit or down-payment required by the contractor before work begins may not exceed the greater of(a)one-third of the total contract price or(b)the actual cost of any special equipment or custom made material which must be special ordered in advance to meet the completion schedule. Express Warranty-Is an express warranty being provided by the contractor? Flo o Yes(all terms of the warranty must be attached to the contract) Subcontractors-The contractor agrees to be solely responsible for completion of the work described regardless of the actions of any third party/subcontractor utilized by the contractor.The contractor further agrees to be solely responsible for all payments to all subcontractors for materials and labor under this agreement. Contract Acceptance-Upon signing,this document becomes a binding contract under law,Unless otherwise noted within this document,the contract shall not imply that any lien or other security interest has been placed on the residence,Review the following cautions and notices carefully before signing this contract. Mont be pressured into signing the contract,Take time to read and fully understand it.Ask questions if something is unclear. Make sure the contractor has a valid Home Improvement Contractor Registration,The law requires most home improvement contractors and subcontractors to be registered with the Director of Home Improvement Contractor Registration,You may inquire about contractor registration by writing to the Director at 10 Park Plaza,Room 5170,Boston,MA 02116 or by calling 617-973-8787 or 888-283-3757. TDoes the contractor have insurance?Ask the Contractor for his insurance company information so That you can confirm coverage,or ask to see a copy of a"proof of insurance"document. Wow your rights and responsibilities.Read the Important Information on the reverse side of this form and get a copy of the Consumer Guide to the Home Improvement Contractor Law. You may cancel this agreement if it has been signed at a place other than the contractor's normal place of business,provided you notify the contractor in writing at his/her main office or branch office by ordinary mail posted,by telegram sent or by delivery,not later than midnight of the third business day following the signing of this agreement.See the attached notice of cancellation form for an explanation of this right. ktDONOT SIGN THIS CONTRAC IF THERE ARE ANY BLANK SPACESM ent alcopi o con a st be completed and signed.One cop should go to the homeowner.The other copy should be kept by the t r Homeowner's Sig atur n actor's Signature (Ci IV //v I�t Date Date Contractor Arbitration The Home Improvement Contractor Law provides homeowners with the right to initiate an arbitration action(as an alternative to court action)if they have a dispute with a contractor.The same right is not automatically afforded to a contractor,however.The contractor would have to resolve any dispute he/she has with a homeowner in court unless both parties agree to the optional clause provided below.This clause would give the contractor the same right to arbitration as is afforded to the homeowner by the Home Improvement Contractor Law. The 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 the dispute to a private arbitration firm which has been approved by the Secretary of the Executive Office of Consumer Affairs and Business Re o the consumer shall be required to submit to such arbitration as provided In Massachusetts General Laws, 2A. Ho w es Signatureactor's Signature NOTICE:The signatures of the parties above apply only to the agr meet of the parties to alternative dispute resolution initiated by the contractor. The homeowner may initiate alternative dispute resolution even where this section is not separately signed by the parties. Homeowner's Rights A homeowner's rights under the Home Improvement Contractor Law(MGL chapter 142A)and other consumer protection laws(i.e.MGL chapter 93A)may not be waived in any way,even by agreement.However,homeowners may be excluded from certain rights if the contractor they choose is not properly registered as prescribed by law.Homeowners who secure their own building permits are automatically excluded from all Guaranty Fund'provisions of the Home Improvement Contractor Law.The contractor is responsible for completing the work as described,in a timely and workmanlike manner.Homeowners may be entitled to other specific legal rights if the contractor guarantees or provides an express warranty for workmanship or materials.In addition to guarantees or warranties provided by the contractor,all goods sold in Massachusetts carry an implied warranty of merchantability and fitness for a particular purpose.An enumeration of other matters on which the homeowner and contractor lawfully agree may be added to the terms of the contract as long as they do not restrict a homeowner's basic consumer rights.If you have questions about your consumer/homeowner rights,contact the Consumer Information Hotline(listed below). Execution of Contract The contract must be executed in duplicate and should not be signed until a copy of all exhibits and referenced documents have been attached. Parties are also advised not to sign the document until all blank sections have been filled in or marked as void,deleted,or not applicable.One t original signed copy of the contract with attachments is to be given to the owner and the other kept by the contractor.Any modification to the original contract must be in writing and agreed to by both parties.Contracted work may not begin until both parties have received a fully executed copy of the contract,and the three day rescission period has expired. Accelerated Payments A contractor may not demand payments in advance of the dates specified on the payment schedule in cases where the homeowner deems him/herself to be financially insecure.However,in instances where a contractor deems him/herself to be financially insecure,the contractor may require that the balance of funds not yet due be placed in a joint escrow account as a prerequisite to continuing the contracted work.Withdrawal of funds from said account would require the signatures of both parties. Additional Information If you have general questions or need additional information about the Home Improvement Contractor Law or other consumer rights,or if you wish to obtain a free copy of"A Massachusetts Consumer Guide to Home Improvement"contact: Consumer Information Hotline Office of Consumer Affairs and Business Regulation 10 Park Plaza,Room 5170,Boston,MA 02116 617-973-8787,888-283-3757 or visit the OCABR website at http://www.mass.gov/ocabr/ If you want to verify the registration of a contractor or if you have questions or need additional information specifically about the contractor registration component of the Home Improvement Contractor Law,contact: Director of Home Improvement Contractor Registration Office of Consumer Affairs and Business Regulation 10 Park Plaza,Room 5170,Boston,MA 02116 617-973-8787,888-283-3757 or visit the HIC website at http://www,mass.gov/ocabr/ Go online to view the status of a Home Improvement Contractor's Registration:http://db.state.ma.us/homeimprovemenOicenseelist.asp For assistance with informal mediation of disputes or to register formal complaints against a business,call: Consumer Complaint Section Office of the Attorney General 617-727-8400 AND/OR Better Business Bureau 508-652-4800,508-755-2548 or 413-734.3114 Massachusetts-Department of Public Safety Board of Building Regulations and Standards Construction Supervisor j License: C"70043 JONATHAN OSUYdV� '�,_ J 185 Atlantic Ave 94 Salisbury MA 01952 { Expiration Commissioner 08/26/2016 1 i �ie �Oa»a��ra�tcuea�l�a��i'ir�.tac�usc� Rice of Consumer Affairs&Business Regulation . ME IMPROVEMENT CONTRACTOR . gistration: 158444 Type* xpiration: 4130l2016�: Private Corporatio 4 JOSCON MANAGEMENT iNC. JONATHAN O'SULLIVAN 72 PROVIDENCE HILL RD. ATKINSON,NH 43811 Undersecretary I i`'" r !Iw Ot�+Wi�Y�YWfa+WW.o.na KiiY I Print Form The Commonwealth of Massachusetts _ Department of Industrial Accidents Office of Investigations I Congress Street,Suite 100 ./ Boston,MA 02114-2017 www massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): -�O S C C h fy�C`n CS e'er, Address: '7�-, Pr oar Jy)r< �k, }1 YL J City/State/Zip: "S e`, YJ 1-I 0 ( Phone #: Are ypu an employer?Check the appropriate bog: Type of project(required): 1. I am a employer with 3 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. F1 New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g. []Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers'comp.insurance comp.insurance.$ required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their ME]Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152,§1(4),and we have no employees. [No workers' 13.8'Other .t JO ,a e PV comp.insurance required.] *Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. T Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: r 1''f lec^ Policy#or Self-ins.Lic.#: C�l - m � 0 G n,, Expiration Date: Job Site Address: 77 Ve )cL v J C:r t l f /0• City/State/Zip: fu-A Y`J' 0 Vek. PAA Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of u to 250.00 a da against the violator. Be advised that a co of this statement may be forwarded to the Office of p $ Y g PY Y Investigations of the DIA for insurance coverage verification. I do hereq cern nder the pains and enalties ofpedury that the information provided above is true and correct Signature: ID.ef Phone#: (,G Official use only. Do not write in this area,to be completed by city or town officiaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: oct.28.2014 08:50 AM Advantage Insurance Agenc 973 794 4533 PAGE. 1/ 1 CERTIFICATE OF LIABILITY INSURANCE IJAYE IMM11311MMI F,0/28/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES aELOW- THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($), AtIlIMP17,ED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, IMP he certificate holder-Man ADDITIONAL wguwto, the po ey(le1) must be 'endorsed. IS WAIVED. aAed to the terms and conditions of the policy, certaln policies may require an endorsement. A statement on this cer(Iflcate does not confer rights to the certftate dolor In 11OU of Such amtorsernanUe). PR4DUCCR HNaA1E; PAUL D$VIN wIJYH1,94.�yNTAPLEASANT VALLEY STREET A�RrES Exez.. 978-681-1055 i,�;�19T6-794-A83$ ADVANTAGE INSIIRI►>iGF AGENCY INC. PHONE METHUEN MA 01844 INS URIIR(eIAFFORDINOCOVMAGE NNCM INPURERA;ARBELLA PROTECTION INSURA,NCR COMPANY ----. _ _.-....... :._._ INSINtED HJevmpta:ARBBLLA PROTECTION INSURANCE COMPANY JOSCOV M&HPAEMENT INC. -- _ INSURER D: 72 PROWUNCE HILL ROAD - INBURER b; A,TKINSON, NH 03811 INSURlRL: - .--- COVERAGES CERTIFICATE NUMBER: REVISION NUMBER' THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE 'INSURED NAMED A80VE FOR THE POLICY PERIOD INDICATED, NOTWTHSTANNNO 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. LTR T TYYNOFINSURANClI C'0MR"""'--- up ---. . INBR VJVD POLICY NUMBER IMMMONYYY) PNAMDNYYY) UMITe X aeNKRAL LIABILITY 8500055690 05/30j2614-05/30/201.5 PAC.OCCURRENrC f ,000,000 COMMERCIAL GENERAL LIABILITY D` PREMISES(Ee oaraaranm 100,0 00 CLAIMS-MADE Fx f OCCUR MED EXP(AnT om person) ... .1.10,000 PERSONAL&ADV IWURY ••,. 1,000,000 ,,,,•,••___ GENERALAGGREOATE f 7,000,000 GEN'LAWkEGATELIMIT APPLIES PER: YPRDDUGTQ-GOMPJOPAGG = 2,000,000 POLICY JEC- T LOG . ..__ a AUTOMOWLE UABIUTY Ea aaaldaM _ 3 ____ ANY AUTO BODILY INJURY(P4tpntbn) i ALLOWNE13 SCHEDULED AUTOS AUTOS BODILY INJURY(P4f 4eeldw) $ NON-OWNED rtTV DAMAOE-• 1 ----....... - HIREDAUTOS AUTOS —1 �araacltlsnt) UMBRELLA UAB LQUR EAClI OCCURRENCE 1 EXCESS LMB CLAIMS-MADE AGGRFAATE OED REiENTrON 1 1 g WORKERS COMPaNSATION 9121 A 610!2 x ER AND EMPt WOW UABAMY YIN 10/05/? 10/05/2015 TORY UMiTS ANY PROPRIU0A1PAATNLAfucECUTIVE N f A E.L.I?AGYI ACCIDENT B 1,000,000 gFFX;ERAMMBER FXCLUDEW __._.._.. (MPWRIPry Ai NH) El DISEASE-EA EMPLOYEES 1,000,040 II yyeea6,,daaalba Under .. ......_.___. „ DESCRIPTIONOFOPERATIONS"'Ow E.LOISEA$E-POLIOYLIMIT 1 1,000,004^ v DIMIPTION OP OPERATIONS r LOCATIONS t VEHICLES(Atwh ACORb iet,AuaUonal Reffw s BchedWk if nary/paoelt rowEeo CENI$F L CARPENTRY CERTIFICATE HOLDER CANCELLATION TOWN OF NORTH ANDOVER BUILDING DEPARTMPrNT SHOULD ANY OF THE: ABOVE DESCRIBED POLICIES Sh CANCELLED SIFORE THS EXPERATION DATE THEREOF, NOTICE VNLL BE DELIVERED IN 1600 OSGOOD STREET ACCORDANCE VWH THE POuCT PROVISIONS. NORTH ANDOVER MA 01845 AUTHOMMO RlPRIcbBNTAmrE rO 19811..2010 ACORD CORPORATION. All fights rasarvatl, ACORD 26(2090105) The ACORD name end logo are reglstarod marks of ACORD