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HomeMy WebLinkAboutBuilding Permit #1075-16 - 874 SALEM STREET 3/26/2016 iAAY � tiUILUINIa F'tKMI ITOWN OF NORTH ANDOVER „ APPLICATION FOR PLAN A/) EXAMINATION Permit NO: � Date Received Arlo Date Issued: �9SSACHUS IMPORTANT: Applicant must complete all items on this page LOCATION Ck- ( I?- rv1 ':�t �i . $-,l C `v _ Print PROPERTY OWNER i6 `1- ICG F- e- Ct ti� Print MAP NO:aL� _...PARCEL ZONING DISTRICT: Historic District yesnn Machine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building XOne 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 f) / UJA /� �1/ti �( St"')-� vul i Identification Please Type or Print Clearly) OWNER: Name: 10-t.`a Phone: c'1-1 Address: —S`'l L-\ SO'k S fi CONTRACTOR Name: Phone: Address: Supervisor's Construction License: Exp. Date: y3 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: $ 1 v r 52) 1 FEE: $ "— Check No.: /6-q 7 Receipt No.: Zr .9 NOTE: Persons contracting with unregister d contractors do not have access to the guarantyfund Signature of Agent/Owner Signature,of contractor - - - - - y IAORTH BUILDING PERMIT o� TOWN OF NORTH ANDOVER o - APPLICATION FOR PLAN EXAMINATION * �o ey Permit No#: Date Received AC US Date Issued: IMPORTANT:Applicant must complete all items on this page A. '- •:r ti++ k .� y - t y �.i f .,fit r _+� � .r e-t tiy fir}"}.+' .��« 5 ' i Pnnt. � � � PROI?ERTYz OWNER; no �16..-: t r MAP IPARCEL t ZONING DISTRICT Historic << istr`ict�� � yes no �. _ L .,,, '- Machine ShopkVillage 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 a �j S Septi We,li [ filo dp�lan 1°NetlantlsalUateheElDistl ict4 k W��1"Na e DESCRIPTION OF WORK TO BE PERFORMED: i Identification- Please Type or Print Clearly OWNER: Name: Phone: r Address: im %Z4 Phone +rs t Contractor Name 77i, �♦{i'#�#.4+'.r-t•i�_..n ^t^'r,�a4k wa�'c+.....in„4.� �+ na+ rw+r?ha+ d''+«i+ne+,�+:. � ar.a er='.n f+tt+N�x++rr^ 7�h�+• �4++r*+5:�•� "."�"sr�"`X '^-. �Atldrzess:x : SupervisorzsConstructionLicerse � t is ry.,{1!a;kt o p r r a *^a s#7 �'R ", •.4.� t Y y-+' 'YS'. >�'e��'°?: t �v� y�y.,,�. is 4� - yf�{ Home�lmprovement4Ltcense Exp Date rk, ,}vim. µ: w .f.1J:PY ,_. i 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 gu-aranty fund - a` t Building Department i 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 46 Floor Plan Or Proposed Interior Work 4. 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 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 Hvdraulic Calculations (If Applicable) Copy of Contract 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 I 1 cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals In al P co and roof of recording period is over. The applicant must then get this recorded at the Registry of Deeds. one copy p that thea appeal er PP P must be submitted with the building application Doc:Building Permit Revised 2014 Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning/Massage/Body Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF m U FORM PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS CONSERVATION Reviewed on Signature COMMENTS c H LTH Reviewed on_ Signature COMMENTS Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water& Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT ,Ternp ®wrnpster on site} Lo�'c ed at 1►24 afn Street$ `. ; Fire De ; a f -I MMENTS Dimension Number of Stories: Total square feet of floor area,-.based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location,on, 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 i NOTES and DATA— (For department use) i i ❑ Notified for pickup Call Email Date Time Contact Name Doc.Building Permit Revised 2014 - r Location f No. Date • - TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Al Foundation Permit Fee $ L Other Permit Fee $ TOTAL $ f - c Check# 1 ? I f..� Building Inspector 502�} � Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost S 110„5341.00 m $ - $ 126.37 Plumbing Fee $ 15.80 Gas Fee 100 comm. 1$3 10,04,00 Electrical Fee $ 15.80 Total fees collected $ 257.97 874 Salem Street 1075-2016 on 4/29/2016 30" Round Above Ground Pool r , NORT#1 ' _ - : :. .c . : ve- 0 •.,.. �'` �n b15 oh ver, Mass, COCKIC Mt WICK 1' tE D 'ANS, �y U BOARD OF HEALTH Food/Kitchen P E R Septic System 7 THIS CERTIFIES THAT MA�l T c�i BUILDING INSPECTOR ............................................................................................................ has permission to erect ............ buildings on Foundation � a to be occupied as ................................. �.... . :. ;; Rough ... .6.: .1.................................................... Chimney provided that the person accepting this permit shall i'n 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 Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTIONS ARTS Rough Service ............... ..... .. .. . .. ... .7.^................................ Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Buildinje 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. North Andover MIMAP March 25, 2016 i 065 - v � 0-1 . - +��# _ •�: `�- � ��f � �. ' '�4� } � r_' y , If t P :�. f - �� �. a s v r 4 o w �: 898 ALEM ST < ti r n wr '� a ,. StIt a 065.0-00-70 i:. 855 SALEM ST -7- I - - ❑MVPC Bo Interstates Horizontal Datum:MA Stateplane Coordinate System,Datum NAD83, —I Meters Data Sources:The data for this map was produced by Merrimack —SR gORT1� Valley Planning Commission(MVPC)using data provided by the Town of -- Roads Of to '9� North Andover Easements .Additional data provided by the Executive Office of ♦ .e.s O O Environmental Affairs/MassGIS.The information depicted on this map is r a Q Parcels 3 L for planning purposes only.It may not be adequate for legal boundary O p definition or regulatory interpretation.THE TOWN OF NORTH ANDOVER MAKES NO WARRANTIES,EXPRESSED OR IMPLIED,CONCERNING # - # THE ACCURACY,COMPLETENESS,RELIABILITY,OR SUITABILITY # L ^ # OF THESE DATA.THE TOWN OF NORTH ANDOVER DOES NOT #09 ,« �� ♦ ASSUME ANY LIABILITY ASSOCIATED WITH THE USE OR MISUSE OF THIS INFORMATION cNusk� 1"=115ft ,�E Y g q.4�4tt� .y s rc •aU a i + f ;i� t �SyybY ►71). k .c> T S l,lt 41 i4 tee .. _ r It I � l - i { i 14Z,6 ' fc: t •es saisac 14 I 9 i � IN R Ty ,I� '\vim, 6+�,� F rrsaa.t K G Ca Eu+ �5 .A�atsxtiA-rE5 �.�T` SWIMMING POOL CENTER, INC. 603 South Union Street Lawrence, MA 01843 TEL: 978-682-6916 FAX: 978-685-0711 Federal Tax ID#04-3260232 Home Improvement Contractor#118519 CONTRACT FOR SERVICES —ABOVE GROUND POOL INSTALLATION Customer Name: John Conides Customer Address: 874 Salem St. North Andover, MA 01845 Customer Telephone: 617-699-2091 __(Work) (Cell) or(Home) EMAIL Address: icon idesmai 1.com Sales Person Name: Rick Varney Date of Contract by Parties: 03/19/2016 SERVICES TO BE RENDERED TO CUSTOMER Estimated Date Contract to Begin: Estimated Date of Substantial Completion of Services to,be Rendered: (NOTE: Contract for services DOES NOT BEGIN UNTIL any required pre-payment or materials deposit is received by SWIMMING POOL CENTER, INC.) TOTAL CONTRACT PRICE: $10531.00 MINIMUM PRE-PAYMENT OR MATERIALS DEPOSIT REQUIRED: $5265.50 MA-SPC CONTRACT- 2016 abovegroundpoolinstal lation Page 1 SPC agrees to install ONE 30' Round Dynasty —Above Ground Swimming Pool in a professional workmanlike manner pursuant to local installation standards and practice. This contract shall include all materials, tax and labor unless otherwise specified herein. MODEL SIZE PUMP/FILTER LINER PATTERN &GA Dynasty 54" _ 30' Round Pentair Above Ground MID("") STANDARD STANDARD PREMIUM WINTER PACKAGE POOL ONLY POOL PACKAGE POOL PACKAGE $ $ $ 7806.00 $ 449.00 RADIANT ONLY: Wall Style -Coping Color CHECK APPLICABLE PKGS STANDARD POOL ONLY INCLUDES: Pool, Skimmer, Pool Cove, Print Liner and Standard Installation. STANDARD POOL PKG INCLUDES: Pool, 1.0 - 1.5 H.P. Cartridge Filter, Shut Off Valve, Deluxe Vacuum Set (Pole, Vac. Head, Vac, Hose, Skim Vac.), Standard Resin Safety Ladder, Deluxe Skimmer, Inlet Fitting, 20 Gauge Printed Liner, Leaf Skimmer, Sustain Start Up Chemicals, Connecting Hoses, Hose Clamps, Pool Cove, Ladder Mat and Standard Installation. PREMIUM :POOL PKG INCLUDES: Pool, 1.0 - 1.5 H.P. DE Filter, Shut Off Valve, Deluxe Vacuum Set (Pole, Vac. Head, Vac. Hose, Skim Vac.), Deluxe Skimmer, Inlet Fitting, 25 Gauge Printed Liner, Leaf Skimmer, Sustain Start Up Chemicals, Connecting Hoses, Hose Clamps, Pool Cove, Ladder Mat, Armor Shield & Standard Installation. WINTER PKG INCLUDES: Winter Cover, Tie Down Cable, Winch, Deluxe Winter Chem. Kit, And Electric Cover Pump. OPTIONS Light $ Heater $ Auto Vac Dolphin Active 10 $ 599.99 Heater Install $ Step Unit Step 1 Bridge $ 510.00 Armor Shield $ Perma Salt System $ Solar Cover $ Filter Upgrade $ Ladder Upgrade $ Fencing w/ Install: $ Liner Upgrade 20-25 GA $ 20-28 GA $_ 25-28 GA $ Water Delivery# Loads 2 $ 700.00 Misc $ TOTAL OPTIONS $ 1810.00 MA-SPC CONTRACT- 2016 abovegroundpoolinstallation Page 2 TOTAL AMOUNT DUE FROM ABOVE SELECTIONS MA RESIDENTS TAX CALCULATION: Total Before Sales Tax $ 10,038.00 Pool Package: $ 7806.00 Less Installation (See Book)$ 1450.00 Winter Package: $ 422.00 Less Install of Options $ Total Options: $ 1810.00 Less Water/Deck/Electrical $ 700.00 Taxable Amount $ 7888.00 Sales Tax @.0625 $ 493.00 Total Before Sales Tax $ 10,038.00 Sales Tax: $ 493.00 Total Contract Price$ 10,531.00 Schedule of Payments Required Under Contract: Payment Amount Due Date Initial Pre-Payment(1/2) $ 5,265.50 At Signing—Payment Type & Final Payment $ 5,265.50 Day of Installation Services included: The installation of the above ground swimming pool shall be completed as follows: 1) Preparation of the site for the designated pool; 2) Deliver the pool and other necessary items to the site; 3) Deliver and supply a stonedust base; 4) Assemble, erect and level the pool structure with a patio block under each upright; 5) Install pool liner and begin filling from the homeowner's water supply with a garden hose; 6) Assemble and install skimmer, ladder, and light. We will ONLY install drop in stairs if deck is present at time of installation. SPC cannot and will not guarantee an exact fit between an existing deck and a new pool installation. 7) Will schedule a start-up visit to explain the operation of the pool after the pool is filled with water to the minimum operating depth and electrical is complete, inspected and approved. 8) Such other work as the site foreman deems necessary to accomplish and complete the services to be rendered hereunder. MA-SPC CONTRACT- 2016 abovegroundpoolinstallation Page 3 1 NOTE: All work to be completed in a workmanlike manner according to local standard practices. Any alteration or deviation from above specifications involving extra costs will become an extra charge above this contract. Our workers are fully insured under Workman's Compensation Insurance. Homeowner responsibility: The homeowner is fully responsible at his/her costs the following items: 1.) Selecting a decisive location for the pool and proof of a building permit, if necessary, prior to pool delivery and install. 2.) Provide full access to the job site for a small digging machine and dump truck without obstacle or other impediment, including but not limited to landscaping, trees, stumps, sod, boulders, rock, ledge, lawn furniture, grills, fencing, pets, electrical, plumbing, gas or other utility, sprinkler lines and drainage pipes. Should it become necessary to remove, relocate or otherwise affect any above stated impediment as determined by the site foreman, then the homeowner assumes and accepts full responsibility and costs for the removal, relocation, or rebuilding of such impediment obstacle. The homeowner agrees to accept and assumes all extra costs of additional material or labor necessary to complete the job as a result of the obstacle or impediment. 3.) Be responsible for any lawn or driveway or sidewalk/walkway disturbances caused by the pool installation machinery or trucks gaining site access. 4.) Any sod, rocks, ledge, trees, stumps, excess dirt, or other material shall be the sole responsibility of the homeowner for removal, relocation, or disposal. 5.) Supply sufficient water to fill the pool including timely scheduling and delivery of any water the homeowner chooses to have trucked into site. 6.) Procuring a licensed electrician for the grounding and electrical supply to the filter system, lighting, heater, and any other electrical connection; 7.) Procuring and providing any landscaping and required backfill with crushed stone around the outside of the pool; 8.) Maintaining proper pool maintenance and winterization; 9.) IF THE HOMEOWNER CANCELS THIS CONTRACT DURING CONSTRUCTION OR CONSTRUCTION IS NOT POSSIBLE DUE TO IMPROPER SITE CONDITIONS, THEN THE HOMEOWNER AGREES TO PAY ALL COSTS OF LABOR AND MATERIALS ALREADY ORDERED OR PROVIDED BY THE SWIMMING POOL CENTER. HOMEOWNER ACKNOWLEDGES AND AGREES THAT THE SWIMMING POOL CENTER IS HEREBY GIVEN A MECHANICS LIEN AGAINST THE SUBJECT PROPERTY FOR THIS CONTRACT UNTIL SATISFIED IN FULL. MA-SPC CONTRACT-2016 abovegroundpool installation Page 4 CONSUMER NOTICES This Contract for Services is governed by Massachusetts General Laws Chapter 142A as supervised by the Massachusetts Office of Consumer Affairs and Business Regulation located at 10 Park Plaza, Suite 5170, Boston, MA 02116 (Tel: 617-973-8700) c/o Director Jacqui Chandler. The services provider hereunder the Home Improvement Contractor#118519 Any disputes under this contract may be addressed through arbitration as provided by the aforementioned agency and should you wish to include this service the Customer must acknowledge by his or her signature: � 'I _ Date signed by the customer for arbitrate servic . 03/19/2016 Notice of Right to Cancel (3 Days) As the consumer you have a THREE (3) day right to cancel this contract from the date you sign at which point this contract shall become null and void in its entirety as governed by Massachusetts General Laws Chapter 93A, §48; or Chapter 255D, §14; or Chapter 140D, §10, as may be applicable. Limited Warranty: Swimming Pool Center agrees to provide without charge for one (1) year from the date the pool is installed the labor to remove, replace or repair any component of the pool that is subject to an independent manufacturer's warranty, provided that the Swimming Pool Center has certified the Pool and the Warranty is not otherwise voided as set forth below. At the discretion of the Swimming Pool Center, this Limited Warranty shall be voided if the following event(s) occur: 1.) Homeowner buyer has failed to satisfy all payment obligations including any extra charges, late fees or interest permitted under this contract; 2.) Homeowner failed to have crushed rock spread around the outside of the pool within 2 weeks of installation; 3.) Homeowner fails to properly maintain said pool with all required chemicals, water levels, or filters, and fails to properly winterize. NOTE Homeowner is fully responsible for all costs of supplying chemicals or water to refill the pool in connection with any warranty service. ALL WARRANTY CLAIMS MUST BE MADE IN WRITING TO SWIMMING POOL CENTER DURING THE WARRANTY TIME PERIODS. MA-SPC CONTRACT- 2016 abovegroundpoolinstal lation Page S Permits Required: The following permits will be required to commence this contract: Building Permit Electrical Permit NOTICE: The Contract named herein is required to obtain the permits stated above HOWEVER the homeowner may obtain the permits first at his or her own costs. BY THE HOME OWNER OBTAINING THE PERMITS YOU WILL BE EXCLUDED FROM THE GUARANTY FUND PROVISIONS OF MASSACHUSETTS GENERAL LAWS CHAPTER 142A. CUSTOMER UNDERSTANDS AND ACKNOWLEDGES THAT NO SERVICES UNDER THIS CONTRACT WILL BEGIN ON THIS MATTER UNTIL INITIAL PAYMENT ON ACCOUNT AS SET FORTH IN PAYMENT SCHEDULE IS PAID IN FULL AND ALL REQUIRED PERMITS ARE RECEIVED. We, the Customer and the SWIMMING POOL CENTER, INC., have read this Agreement on this 19 day of March 2016 and understand its terms and both have signed it as our free act and deed. SWIMMING POOL CENTER, INC., By its authorized Agent SEE NEXT PAGE FOR CUSTOMER ACCEPTANCE AND SIGNATURE. MA-SPC CONTRACT-2016 abovegroundpoolinstallation Page 6 1 The Customer acknowledges a full understanding and agreement to the terms of this contract and hereby additionally acknowledges a receipt of a copy of this Agreement. THIS IS A LEGALLY BINDING CONTRACT. ASK TO HAVE EACH TERM YOU DO NOT UNDERSTAND FULLY EXPLAINED TO YOU SO THAT YOU UNDERSTAND THE AGREEMENT YOU ARE MAKING AND BY SIGNING THIS AGREEMENT YOU ACKNOWLEDGE AND AGREE THAT YOU UNDERSTAND AND ACCEPT ALL TERMS HEREUNDER. ��a/j/yj — Cust, er Sig ture Print Name: ����~ >> ,�� Date: 03/19/2016 SEE ATTACHED MECHANIC LIEN AGREEMENT FOR SIGNATURE MADE A PART OF AND INCORPORATED HEREIN THIS CONTRACT, MA-SPC CONTRACT- 2016 abovegroundpoolinstallation Page 7 OP ID: PS , CERTIFICATE OF LIABILITY INSURANCE DATE 0211 212 0 112/20Y6 0 1 6_ 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 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 of such endorsement(s). PRODUCER CONTACT Pete Sullivan Foster Sullivan Insurance 163 Main St. AICCNo Ext:978-686-2266 ac No): 978-686-6410 North Andover, MA 01845 -MAIL Stephen Sullivan SS: sullivan@fostersullivangroup.com PRODUCER CUSTOMER ID#:SWIMM-1 INSURER(S)AFFORDING COVERAGE NAIC# INSURED SWIMMING POOL CENTER, INC. INSURERA:ACADIA INSURANCE 31325 SWIMMING POOL CENTER OF HAMPSTEAD, INC INSURER B: R&S REALTY INSURER C_ Roy Charland INSURER D: 603 SOUTH UNION STREET INSURER E: LAWRENCE MA 01843 1 INSURER F: COVERAGES CERTIFICATE NUMBER: 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. ILTR TYPE OF INSURANCE A IDIK B POLICY NUMBER MMIDD YYYY MMIDD YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,0001 A X COMMERCIAL GENERAL LIABILITY X CPA0290628 05/01/2015 05/01/2016DAMAGE TO RENTED PREMISES Ea occurrence $ 300,000 CLAIMS-MADE 7 OCCUR MED EXP(Any one person) $ Ei,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 X I POLICY JECT —1 PRO LOC $ AUTOMOBILE LIABILITY X COMBINED SINGLE LIMIT A i ANY AUTO MAA0290632 05/01/2015 05/01/2016 (Ea accident) $ 1,000,000 X ALL OWNED AUTOS CAA0293871 05/01/2015 05/01/2016 BODILY INJURY(Per person) $ BODILY INJURY(Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE _X HIRED AUTOS I (PER ACCIDENT) $ X NON-OWNEDAUTOS $ $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 EXCESS LIAR CLAIMS-MADE AGGREGATE $ 1,000,000 A X CUA0290633 05/01/2015 05/01/2016 DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY YIN T I X FR _ A I ANY PROPRIETOR/PARTNER/EXECUTIVE WCA0290634 05/01/2015 05/01/2016 E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? ❑ N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under — DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1 $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN EVIDENCE " ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009109) The ACORD name and logo are registered marks of ACORD 1 M0 J/X;(91 0}!��l��iGl/�i�il Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 118519 Type: Private Corporation SWIMMING POOL CENTER INC Expiration: 3/29/2017 Tr# 264474 ROY CHARLAND - - -- --- --- -- ------- _. _.. 670 S UNION ST - -- ----- -------- - LAWRENCE, MA 01843 -----__........._...... ---.-_-..----- Update Address and return card. Mark reason for change. sc/,, <; zors os/r r Address —; Renewal F Employment Lost Card //60 ((-0I/f/lll'/I!!1['(l/l/, free of Consumer Affairs& Business Regulation License or registration valid for individul use only .-"bME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: r = registration: 118519 Type: Office of Consumer Affairs and Business Regulation -WE IR piration: 3/29/2017 Private Corporation 10 Park Plaza-Suite 5170 _ ,(: . SWIMMING POOL CENTER INC Boston,MA 02116 ROY CHARLAND 670 S UNION ST LAWRENCE, MA 01843 Undersecretary Not valid without signature