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Home My WebLink AboutBuilding Permit #726 - 88 HEATH ROAD 5/17/2006Of NORT#f 1 TOWN OF NORTH ANDOVER '• ".* APPLICATION FOR PLAN EXAMINATION 9SSACHUSF� r, Permit NO: Date Received: Date Issued:�J 1 IMPORTANT: Applicant must complete all items on this page LOCATION 116:4174 11MD Print PROPERTY OWNER I HQYV �J S LA � Print MAP NO.: PARCEL: `7 TYPE AND USE OF BUILDING ZONING DISTRICT: 3 39,b01)I 11;r HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential 0 New Building ❑ Addition Alteration )KOne family ❑ Two or more family No. of units: ❑ Industrial ❑ Repair, replacement 0 Demolition ❑ Assessory Bldg ❑ Commercial ❑ Moving (relocation) ❑ Other ❑ Others: 0 Foundation only DESCRIPTION OF WORK TO BE PREFORMED Ca U -�oa-) �ri�y 9 Pyz,o � 0 No 3',A -Q I)0YA 4 5 � LLI , Type or Print Clearly) (�NTRACTOR Name: iL./)7 F.�'1!• phone: .. Address: &.94-euJow / AU7-0 /A) r 42W (0 Z y Z e--Sup--ervisor's Construction License: Exp.,>Date: 3 rHome Improvement License: /,360 3:7— {Exp. Date: A� - 3 - ZOO,( ARCHITECT/ENGINEER Name: Phone: 97 ? V � 9 - 0-761 Address: L 1 77-LFT1)',0 L_ uvv\,96L Reg. No. . S")O b FEE SCHEDULE: BULDING PERMIT: $10.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost :$ ;�PO, ODO x10.00=FEE:$%p0 Check No.: Zo Receipt No.: / 5 Page I of 4 TYPE OF SEWARGE DISPOSAL Tanning/Massage/Body Art ❑ Swimming Pools ❑ Public Sewer x Well 11Tobacco Sales ❑ Food Packaging/Sales 11 Private Private Permanent Dumpster on Site (septic tank, etc. Electric Meter location to project NOTE: Persons contracting( r contractors do not have access to the guaran , fand Signature of Agent/Owner Signature of Contra Plans Submitted Plans Waived . Certified Plot Plan _ . ❑ Stamped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT ❑ COMMENTS CONSERVATION COMMENTS p HEALTH • r ❑ 1\4n S Zoning Board of Appeals: Variance, Petition N Zoning Decision/receipt submitted yes PlanningkBoar`d Decision'. DATE REJECTED DATE APPROVED In ❑ Water Shed Special Permit ❑ Site Plan Special Permit ❑ Other DATE REJECTED 11 F01 DATE APPROVED 701 DATE REJECTED DATE APPROVED Comments Conservation Decision: . "; Comments Water & Sewer connection signature & date Temp Dumpster on site yesX--no_ Fire Department signature/date Building Permit Approved and Issued by: vi", Page 2 of 4 ■J Building Setback (ft.) Front Yard Side Yard Rear Yard Required Provided Required Provides Required Provided DIMENSION Number of Stories: Total land area, sq. ft.: NV►hJ anct UA►A— Page 3 of 4 Created JMC. Jan.2006 Total square feet of floor area, based on Exterior dimensions. 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=uilding Permit Application o�Workers Comp Affidavit o tP to Copy Of H.I.C. And/Or C.S.L. Licenses ❑ c'Coy of Contract ❑ Floor Plan Or Proposed Interior Work Addition Or Decks ❑ Building Permit Application ❑ Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report In all cases if a variance 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 Doc: INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Page 4 of 4 Location C2>U 12d - No. '�/ Date AORT" TOWN OF NORTH ANDOVER ' _ C o ; ; Certificate of Occupancy $ Y '+ s„CwUs <� Building/Frame Permit Fee $ bC� Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 191 �5 Building Inspector okh W s: 0 FM4 r� �50 o x C ti 4- O i O y � O V � •c � � t0 O w w w ° o 0 FM4 r� O CO Li iol H. v 4.4 O z O I C43 CD .y O 0. C Q mw CL 93 O .CL h O O C CL ul N V) 19 W W V9 //Wj� (A �50 C ti 4- O i O y O V � •c � � t0 O owd w .$ :tsCD vi m� y rp O CD z y CI m � y C m O - 0 C zip C y O t.. y O mocon OI y d C L 10 w�0 z " �. � H C ConoOeO c Z c� H y CC E amLu a- (/l 10 CM Z O CL y CHOE g Go = s O CO Li iol H. v 4.4 O z O I C43 CD .y O 0. C Q mw CL 93 O .CL h O O C CL ul N V) 19 W W V9 //Wj� (A CONCORD LUMBER CORPORATION LITTMN WMIER ARCHITECTURE DEPARTMENT P.O. Box 1526 Littleton, MA 01460 (978) 486-0761 Fax (978) 486-0762 Domenic Spinosa 3 Morning Glory Circle Westford, MA 01886 Project: Bedroom Stamped Drawing Contractor: Outside Salesman: PROJECt° C1ATE: 4/10/2006 JOH MMBER:''06D7-09 f. $UDGEZ:Mourl 11b11R1 l' RATE$80.00 per hour Our credit policy requires payment in full within 30 days. Please check your records, if you have already sent a payment, disregard this notice and accept our thanks. If you have overlooked your payment, please send the amount promptly to: Littleton Millwork, Attn: Architecture Department. P.O. Box 1526 Littleton, MA 01460 Concord Lumber Littleton Lumber Littleton Millwork Kitchen Works 126 Lowell Road, Concord, MA 55 White street, Littleton, MA 2 Omega Way, Littleton, MA 69 Great Road, Acton, MA 12 030001VI1N301S3a IVNOIIVNE13INI £OOZ (panu.luoo) \uV6 - v/ 1 OVOI MONS 0N110dJ dSd OL 80d SNVdS 831AVE1 Mrs'Z081i 3-18V1 NOI10(1d1SN00 JN11130-d00li 9-8 TT -9 9-9 6-£ S'01TVF7 1-9 0-b E# zi;-aur -aonz S OT -6 0 £i £ TI Z-6 E L 0 S OT ET -L £-S Z# zg-aurd-oonzdS0-ET £-II Z-6 E -L 0-S 01-ET8-L £-S t# zg-autd-aonzdSL-91 S -EI 0-1I 9-8 S -S 9-919-8 S -S SSzg-aurd-aonzdSL-01 OT -8 9-L TI -S 0-b Z -T 1£-9 £-b £# auid uzaginoS6-£1 6 -IT OT 6 L L b S L bTT-8 9 S Z# outd uzaginoS L -SI 1-0 0-11 6-8 8-9 9-91 01 -EI 8-11 11-8 8-S I# aurd tuaginoS 9-81 £-ST 11 -TI I-6 6-9 9-81 £-SI 1I-11 1'6 6-9 SS autd uaatpnoS Z•61 01-6 9-8 11-9 9-9 6-£ 9-01 0-6 b -L 01-9 0-b �"tua zt E# H OT-ZI T -IT I-6 Z -L TI -b L -ET 6-I1 L-6 L -L Z -S Z# n;-UJOH L -ET 8-I1 L-6 L -L, Z -S S-bT S-ZI Z-Oi 0'8 S -S L# zg-uraH S -ST Z-bT 9-11 8-8 9'9 b -LI 8 -ti 9'1I 8-8 9-9 SS zg-tuaH gozel-zg selBnoQ 01-6 9-8 11-9 9-9 6-E 9-01 0-6 b -L OT -9 0-b £# gone[-zt; sq'onoQ 0-0 C-11 Z-6 £-L 0-9 OT -£I 11-11 6-6 8'L E -S -S Z# Boct gjjj i1 -EI 0-ZT OT -6 6-L b -S 6-bI 6-ZT 9 -OT E-8 L T# gQ 6-91 S -b1 OT -T 1 £-6 01-5 6 -LI 17-91 Z-ZI £-6 01-9 SS 6 OT b-6 L L 0 9 T -b S -TT - i 8 b -9F6- £# SE -b1 b-ZI 1-01 II -L 9-9 Z-91 I -ET 8-01 S-8Z#SE-bT b-ZI T -OT TI -L S-9 Z -S1 - T 8-01 S-8I#dS zy-aurd-aonzdS T -Li 8 -ti T1 -IT I-6 6-9 1-81 £-SI II -IT 1-6SS aurd uzatpnoS L -II 6-6 £-8 9-9 b'b £-ZT b -OI 6-8 01 -9 8 b £# quid uzaginoS T-91 OT-ZI 6-01 b-8 01-9 0-91 L -EI S -II 01-8 11-9 Z# aurd uzaginoS T -LT b-bl 0-ZI S-6 0-9 I -8I Z-91 S-ZI 9-6 0-9 T# quid uzaganoS 8-61' Z -9I 8-Z1 L-6 1-9 8-6T Z-91 8-ZI L-6 1-9 SS 9I 6-01 17-6 L -L 0-9 1-17 9-11 01-6 1-8 b=9 b -b £# zr.l-tual-1 I-bI I-ZT TT -6 01-L b -S TT-bT OI-ZT 9-01 b-8 9-9 Z# n;-UJOH OT'bi OI-ZT 9-01 £-8 8-9 6-9i L -£t I Z -TI 6-8 6-1 T# zg-uraH 0-81 L -SI Z-ZT E-6 TI -S I1-91 L-91 Z-ZT £-6 11-9 zq-ulaH SS o zt se 8no g l- 3 I Q 6 O[ t,-6 L L 0 9 T -b 9-11 01-6 I-8 b-9 b -b £# gozrl-zi; seTBnoQ £ bT b-ZI I -OI 11-L S -S Z -Sl I -ET 8 Oi S-8 6-9 Z# gozrl-zg oftoQ E-91 Z -EI 6-01 9-8 OT -9 Z-91 11-E1 9-11 0-6 0-9 T# gozeln3srl8noQ b -8i OT St TT Zl 01 -6 E-9 961 9-9T iT ZT OT 6 £9 SS S -Z1 6-01 6-8 il-9 6'b Z -£T S -TI b-6 b -L 0-S £# n; -aur -aonzd S zg-ouid-aonzdS 9 9T Z bt 8 TI Z 6 Z 9 9 -Lt T -ST b-Zl 6-6 Z-9 Z# zg aurd-aonadS 9-91 Z -VI 8 -TI Z-6 Z-9. 9 -LI 1 -SI b-ZT 6-6 Z-9 I# n;-aurd-oonzdS 8-61 6-91 Z -ET 0-01 b-9 S -OZ 6-91. 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( y (sayaul (sayaul 3avuo 0Ntl S3103dS (sayaul) MOWS 1881) 1881) 1881) -1881) -1881) 1881) -1881) 3881) 1881) -1881) 83JAVU esueds JaUeJ wnwlxeW ZLXZ I OLXZ 8x 9xZ fyXZ ZLXZ OLXZ Sx 9xZ t xxZ 1sd OZ = Otl01 0tl30 19d OL = OtlOI Otl30 \uV6 - v/ 1 OVOI MONS 0N110dJ dSd OL 80d SNVdS 831AVE1 Mrs'Z081i 3-18V1 NOI10(1d1SN00 JN11130-d00li 0 0 6 -9 )-7 i-7 3-0 13-0 9-10 CODE® { X 1 ROOF -CEILING CONSTRUCTION TABLE R802.5.1(8) --continued RAFTER SPANS FOR 70 PSF GROUND SNOW LOADS (Ceilina attached to rafters. L/4 = 240) Check sources for availability of lumber in lengths greater than 20 feet. For Sl: I inch = 25.4 mm, 1 foot = 304.8 mm, 1 pound per square foot = 0.0479 kN/mz. a. The tabulated rafter spans assume that ceiling joists are located at the bottom of the attic space or that some other method of resisting the outward push of the rafter, on the bearing walls, such as rafter ties, is provided at that location. When ceiling joists or rafter ties are located higher in the attic space, the rafter spans shall b, multiplied by the factors given below: HcIHR Rafter Span Adjustment Factor 2/3 or greater 0.50 1/2 0.58 1/3 0.67 1/4 0.76 115 0.83 1/6 0.90 1/7.5 and less 1.00 where: H, = Height of ceiling joists or rafter ties measured vertically above the top of the rafter support walls. HR = Height of roof ridge measured vertically above the top of the rafter support walls. mor--' et SPAP P%03U stW = VAGTO KL. &�+y31..1Ill - '9 Oto CeI�INC, JoISTs�t1ES vuA� �i� Iw � 7pC.rL ��3 0F t2_At�'VL k4GT. 2003 INTERNATIONAL RESIDENTIAL CODE® 23 DEAD LOAD =10 psf DEAD LOAD = 20 psf 2 x 4 2x6 2x8 2.10 1 2.12 2.4 1 2x6 2.8 2x10 2x12 Maximum rafter spans' RAFTER SPACING (feet - (feet - (feet - (feet - (feet - (feet - (feet - (feet - (feet - (feet - (inches) SPECIES AND GRADE inches) inches) inches) inches) inches) inches) inches) inches) inches) inches) Douglas fir -larch SS 5-5 8-7 11-3 13-9 15-11 5-5 8-4 10-7 12-11 15-0 Douglas fir -larch #1 5-0 7-4 9-4 11-5 13-2 4-9 6-11 8-9 10-9 12-5 Douglas fir -larch #2 4-8 6-11 8-9 10-8 12-4 4-5 6-6 8-3 1.0-0 11-8 Douglas fir -larch #3 3-7 5-2 6-7 8-1 9-4 3-4 4-11 6-3 7-7 8-10 Hem -fir SS 5-2 8-1 10-8 1.3-6 13-11 5-2 8-1 10-5 12-4 12-4 Hem -fir #1 4-11 7-2 9-1 11-1 12-10 4-7 6-9 8-7 10-6 12-2 Henn -fir #2 4-8 6-9 8-7 10-6 12-2 4-4 6-5 8-1 9-11 11-6 24 Hem -fir #3 Southern pine SS 3-7 5-4 5-2 8-5 6-7 11-1 8-1 14-2 9-4 17-2 3-4 5-4 4-11 8-5 6-3 11-1 7-7 14-2 8-10 1.7-2 Southern pine #1 5-3 8-3 10-5 12-5 14-9 5-3 7-10 9-10 11-8 13-11 Southern pine #2 5-0 7-3 9-4 11-1 13-0 4-9 6-10 8-9 10-6 12-4 Southern pine #3 3-9 5-7 7-1 8-5 10-0 3-7 5-3 6-9 7-11 9-5 Spruce -pine -fir SS 5-0 7-11 10-5 12-9 14-9 5-0 7-9 9-10 12-0 12-11 Spruce -pine -fir #1 4-8 6-11 8-9 10-8 12-4 4-5 6-6 8-3 10-0 11-8 Spruce -pine -fir #2 4-8 6-11 8-9 10-8 12-4 4-5 6-6 8-3 10-0 11-8 Spruce -pine -fir #3 1 3-7 1 5-2 1 6-7 1 8-1 9-4 3-4 4-11 1 6-3 1 7-7 1 8-10 Check sources for availability of lumber in lengths greater than 20 feet. For Sl: I inch = 25.4 mm, 1 foot = 304.8 mm, 1 pound per square foot = 0.0479 kN/mz. a. The tabulated rafter spans assume that ceiling joists are located at the bottom of the attic space or that some other method of resisting the outward push of the rafter, on the bearing walls, such as rafter ties, is provided at that location. When ceiling joists or rafter ties are located higher in the attic space, the rafter spans shall b, multiplied by the factors given below: HcIHR Rafter Span Adjustment Factor 2/3 or greater 0.50 1/2 0.58 1/3 0.67 1/4 0.76 115 0.83 1/6 0.90 1/7.5 and less 1.00 where: H, = Height of ceiling joists or rafter ties measured vertically above the top of the rafter support walls. HR = Height of roof ridge measured vertically above the top of the rafter support walls. mor--' et SPAP P%03U stW = VAGTO KL. &�+y31..1Ill - '9 Oto CeI�INC, JoISTs�t1ES vuA� �i� Iw � 7pC.rL ��3 0F t2_At�'VL k4GT. 2003 INTERNATIONAL RESIDENTIAL CODE® 23 12A 1\ The Commonwealth of Massachusetts Department of Fire Services Office of the State. Fire Marshal P. O. Box 1075 State Road, Stow, MA 01775 PERMIT Date: Jr North Andover Ie (City 1Digsafel`7mm6er ( City of Town) (If Applicable ) In accordance with the provisions of M.G.L.14 8 Chapter10_ as provided in section 5 ? 7 (MR 34 Start Date This Permit is granted to: Full name ofpersoq Fmnor Corporation Permissionto locate dumpster for construction/re:novation/demolition of building. Comments: dumpster must be 251 from structure if unable to place with required Restrictions: c I e a r a n c e dum.pster must be covered with plywood or tarp end of work day at ( Give location by street and no., or descn�be in such manner as tgprov' ate identification of location) Fee Paid$ 50.00�7 Gni Fire Chief This Permit will expire / — 71-C ( Signature of oiTical granting permit) Offical granting permit ( Title ) TOM GAFFNY 88 HEATH ROAD NORTH ANDOVER, MA 01845 ACORD 556805 0011N586 .J � BOARD 1 ' License: CONSTRUCTION SUPERVISOR r ' Number. CS 084943 `. Birthdate: 03/15/1955 Expires: 03/15/2007 Tr. no: 84943 j f Restricted: 1G EDWARD OTERI 83 BARNARD AVEC WATERTOWN, MA 02472i Administrator � r G ti ✓ize �Janrosum�tieet� a�Jt'�J3«c�u4e�s ! . , �-n\ Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registratioq; 136032 ExpiraUon 6/13/2006 .Type. dridividual (' ~ EDWARD OTERI. EDWARD OTERI 83 BARNARD AVE..',r.•✓ WATERTOWN, MA 02472 Administrator 05/03/2006 13:36 FAX 16179242274 KELLY INSURANCE IA 001/002 ACORD CERTIFICATE OF LIABILITY INSURANCE >« ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR DATE(MMIDONYYY) 05/03/06 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION MICHAEL WRIGHT KELLY ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR JOHN J KELLY JR xNST7RANCE AGENCY ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 110 XAXN STREET COMMERCIAL GENERAL LIABILITY WATERTOWN, MA 02472-4425 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A COj*ZRCE INSURANCE EDWARD D OTERI INSURER 0 DHA OTERI AND SONS CONSTRUCTION INSURER C: 03 BARNARD AVENUE INSURER G' _ — -- WATERTOWN MA 02472-3412 INSURER 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 I$ SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, IN3Iq AWL INBRO' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVELTR DATE(MMIOD/YY) EXPIRATION OLICY MMID" LIMITS A GENERAL LIABILITY YT980 08/25/05 08/25/06 EACH OCCURRENCE 31,000,000 PREMISES V6nC IES OCCe) s COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR MED EXP (A -Y one pevmn) f 5,000 PERSONAL & ADV INJURY f .. GENERAL AGGREGATE_ f PRODUCTS • COMP/OP AGG f GEN'L AGGREOATE LIMIT APPLIES PER I I ) POLICY JECPRD.T LAC AUTOMOBILE LAAMLITY COMBINED SINGLE OMIT ANY AUTO (Ea uddem) f BODILY INJURY ALL OWNED AUTOS SCHEDULED AUTOS I I (Papa son) 3 , BODILY INJURY HIRED AUTOS NON-OWNEO AUTOS (Per acudenq f PROPERTY DAMAGE S (Per aacdenq GARAGE LIABILITY AUTO ONLY.&AACCIDENT S OTHER THAN EA ACC f ANV AUTO AUTO ONLY: AGO 6 EXCESSNMBRELLALIABILITY EACH OCCURRENCE S I AGGREGATE S OCCUR ❑ CLAIMS MADE S �� OEOUCTIBLE f S RETENTION f WORKERS COMPENSATION AND TORY LIMITSQTM ER EMPLOYERV L ABILITY ) -- ANY PROPRIETOR/PARTNER/EXECUTIVE ' E L. EACH ACCIDENT f OFFICER/MEMEER EXCLUOED1 E L. DISEASE • EA EMPLOYEE S It yea. ducabe under ' SPECIAL PROVISIONS "tow EL DISEASE•POUCYLIMrT 3 OTHER f DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES l EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION TOM GAFFM SHOULD ANY OF TME ABOVE DESCRIBED POLICIES 9E CANCELLED BEFORE THE EXPIRATION 88 HEATH ROAD DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITTEN NORTH ANDOVER M,A 01645 NOTICE TO TWE CERTIFICATE NOWER NAMED TO THE LFFT, BUT FAILURE TO 00 60 SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR U(O�)Duubllink/ MirrorQ (0 ID T O N co 1YYY \ �/1 poo, A loodlalUM UOSJad Z N 7 V) TM PRODUCER:::::............................................... PAYCHEX AGENCY INC. 1175 JOHN STREET' WEST HENRIETTA, NY 14586 EDWARD D OTERI DBA OTERI & SONS CONSTRUCTION 83 BARNARD AVENUE WATERTOWN, MA 02472 - ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELON COMPANIES AFFORDING COVERAGE COMPANY A GUARDINSURANCE COB ANY COMCPANY COMPANY D 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. CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR DATE (MM/DD/YY) DATE (MM/DD/YY) GENERAL LIABILITY GENERAL AGGREGATE $ COMMERCIAL GENERAL LIABILITY PRODUCTS - COMP/OP AGG $ =�LAIMS MADE [=DCCUR PERSONAL &ADV INJURY $ OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE $ FIRE DAMAGE (Any one fire) $ MED EXP (An, one person) $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT $ BODILY INJURY $ (Per person) BODILY INJURY $ (Per accident) ANY AUTO PROPERTY DAMAGE $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS F# 617-926-5337 TOM GAFFNY 88 HEATH ROAD NORTH ANDOVER, MA 01845 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. TAORIZEqmIE-0FIESENTATIY,E GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN AUTO ONLY: EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ UMBRELLA FORM F] AGGREGATE $ OTHER THAN UMBRELLA FORM WORKER'S COMPENSATION AND XWC STATU- oTH- A EMPLOYERS' LIABILITY oLIMITS EL EACH ACCIDENT $ 100,000.00 THE PROPRIETOR/ INCL EDWC600820 01/06/06 10/01/06 EL DISEASE - POLICY LIMIT $ 500,000.00 PARTNERS/EXECUTIVE OFFICERS ARE: ® EXCL EL DISEASE - EA EMPLOYEE $ 100,000.00 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS F# 617-926-5337 TOM GAFFNY 88 HEATH ROAD NORTH ANDOVER, MA 01845 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. TAORIZEqmIE-0FIESENTATIY,E Proposal Date: 4/28/06 Oteri & Sons Construction To: Tom Gaffey 83 Barnard Ave. Of (company): 88 Heath Rd. Watertown, MA 02472 City, State, ZIP: N. Andover MA 01845 617-470-4341 Good until: 5/30/06 Project name: Renovation Constuction supervisor's #CS 084943 Home Improvement Contractor #136032 We propose to perform all labor necessary to complete the following: Renovate existing master bedroom. Add two skylights. Install new tile in bathroom floor and tub area. See attached floor plan for details. Finished according to plan. Start date May 15, 2006 Approximate finish date June 26, 2006. We propose to furnish material and labor, complete in accordance with above specifications, for the sum of: I Nineteen thousand seven eigh two I Dollars$ 11,782.00 Payments to be made as follows: 33.33% deposit in the amount of $3926.94, progress payment of $3926.94.00 after drywall is complete. Balance of $3928.12 upon completion of work contracted. Customer to supply all windows, doors and tile. Contractor's signature: Acceptance of proposal The above price, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payment will be made as outlined above. Owner's signature: I I Date: