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HomeMy WebLinkAboutBuilding Permit #402-15 - 89 WINDSOR LANE 10/27/2014 AORT#f BUILDING PERMIT6 Y 0 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION '` - � en Permit NO: Date Received ` '�, °AAT!°•� Date Issued: b 9SS�CNu4s�t PORTANT:Applicant must complete all items on this page A117 q LOCATION_ PROPERTY OWNER :Q l�C 5 /V�Wl, Print MAP NO: Cb PARCEL: ZONING DISTRICT: Historic District ye no Machine Shop Village y s no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial Wktb'pair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑Other ❑ Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District ❑Water/Sewer Ide/Jnttiifica�tioon Please Type or,P�ri�nt Clearly) Ca OWNER: Name: .C��P /1���/�! G(. 11,e__, lits/�faSPhone: Address: 79 CONTRACTOR Name: Phone: Address: �� .�� ��C ✓Uc � �"t �� ��'� Supervisor's Construction License: , Exp. Date: Home Improvement License: �� T C Exp. Date: ��— ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDIN,Gc�PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ / 5�'`�� FEE: $ +.)-•� Check No.: 2.2 QR, Receipt No.: 02 0 NOTE: Persons contracting with unregistered contractors do not have access to the guarantyfund �ignature of Agent/Owner Signature of contracto N Plans Submitted ❑ Plans Waived Certified Plot Plan ❑ Stamped Plans ❑ TYPE'OF SEWERAGE DISPOSAL i 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 - 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 Conservation Decision: Comments Water & Sewer Connection/Signature& Date Driveway Permit t 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 Ian � d area, sq. ft.. ELECTRICAL: Movementf o Meter location, mast or service drop q pp 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) ❑ Notified for pickup Call Email Date Time Contact Name Doc.Building Permit Revised 2014 Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. I Roofing, Siding, Interior Rehabilitation Permits Building Permit Application o Workers Comp Affidavit Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work o Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks o Building Permit Application ❑ Certified Surveyed Plot Plan o Workers Comp Affidavit a Photo Copy of H.I.C. And C.S.L. Licenses o 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) o 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 ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg. Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the 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:Building Permit Revised 2014 I Location No. Date t o - TOWN OF NORTH ANDOVER • s�u' �b �As' � • a- Certificate of Occupancy $ Building/Frame Permit Fee $��:7 tFoundation Permit Fee4-1 $ � �° � Other Permit Fee $ TOTAL $ QA Check# 2S1 .51} Building Inspector Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost $ 45,246.00 m $ - $ 542.95 Plumbing Fee $ 67.87 Gas Fee 100 comm. $ 1;00.00 Electrical Fee $ 67.87 Total fees collected $ 778.69 89 Windsor Lane 402-15 on 10/27/2014 Kitchen Remodel I r , tko 11 : ve . h ver, Mass, lspiI4 oc"'IcHewrcw y1' A�RArfo ►P�,�,�� S U BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System • THIS CERTIFIES THAT,., ,,,, �/.;� ,� ................................................. BUILDING INSPECTOR ..................... ..... ..... .... has permission to erect buildings on trwaftmv... Foundation -- - Rough s I to be occupied as ... ................... .. ...... ....................................... Chimney provided that the person accepting this permit sha I 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 �l�Kt 10 PERMIT EXPIRES IN 6 MONTPO ELECTRICAL INSPECTOR UNLESS CONSTRUCT S Rough Service ........... ..... ................... ......................... Final • BUILDING INSPECTOR 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. Northeast Cabinet Installations 206 South Main Street Middleton, MA 01949 Louis Melillo @ 781-244-7439 Cell or 978-774-8001 Office Discovery Proposal - Wiles 7/2/2014 Labor: Installation of Cabinetry- $5500 Permit Fee - $400 Demolition: Demo of Existing Cabinets to donate to Habitat - $400— Partial Demo of Wall between kitchen & eating area and increasing opening of doorway- $500 Electrical - $4785 (Permit Fee Not Included) Copy of Breakdown Available Upon Request at Northeast Plumbing- $1300 (Permit Fee Not Included) Copy of Breakdown Available Upon Request at Northeast Tiling: N/A Plastering: $450 Countertop: Approximately 77 Sq. Ft. @ $75 Sq. Ft. (includes 3" backsplash) Colonial White - $5775— i"w:f, r)c:r Appliances: N/A Hardwood Flooring: Patching Maybe Required after Demo - TBD Painting: N/A Cabinets: $24,317 ($1519.81 sales tax+ $300 delivery) = $26,136.81— Price based on layout dated 6/9/14 DeCora Cabinetry (Prescott— Beaded— Inset) Finish—Chantille Wood - Maple Total Job Estimate: $45,246.81 r e NORTHEAST CABINET INSTALLATIONS CONTRACT FOR RESIDENTIAL SERVICES THIS IS A LEGALLY BINDING AGREEMENT PLEASE READ CAREFULLY I. Contractor: Northeast Cabinet Installations Name: Louis Melillo Address: 206 S. Main Street Tel.No.: Middleton,MA 01949 HIC Registration# 170440 II. Customer: Name: Steve&Nathalie Wiles Address: 89 Windsor Lane Tel.No.: 978-380-0973 III. Property Address: 89 Windsor Lane ("Property") North Andover, MA 01845 IV. Start Date: Week of 11/3/14 Substantial Completion Date: Week of 11/17/14 This date may be modified by any changes made pursuant to a Change Order by and between the parties or any delays caused by permitting delays. V. Product Purchases: Kitchen Cabinetry(Invoice Received by Customer) VI. TOTAL CONTRACT PRICE AND PAYMENT SCHEDULE The Contractor agrees to perform the work, furnish the material and labor specified above for the Sum of$ 12,935 (*Includes permit costs, where applicable*) Permit Fee of$550 Needs to Be Paid Upon Signing Contract Payments will be made according to the following SCHEDULE: $4310 upon signing contract(*Not to exceed I/3 of the total contract price*). $ 4310 by Electrical,Plumbing Rough and Cabinetry Installation $ 3500 after Electrical&Plumbing Finish&Crown Molding Finish $ 815 upon completion of the contract If, in order to meet the completion schedule, material/equipment must be special ordered before the contracted work begins, then the Contractor shall not be obligated to commence services until the Customer advises that the same has been delivered. VII. DOCUMENTS INCORPORATED WITH CONTRACT 1. Kitchen Design as attached&dated 8/15/14 2. Discovery Proposal VIII. EXPRESSED WARRANTIES: We warrant, for one (1) year from installation, that the work performed pursuant to this Contract and any Change Order will be performed in a good workman like manner. We do not warrant the workmanship of the products used in this contract except to the extent that we provide the same. IX. CUSTOMER REPRESENTS AND WARRANTS THAT: 1. He/she is the owner or authorized agent of the owner of the above Property and has full authority to execute this Contract. 2. The Customer shall provide access to Contractor to the Property from 7:00 a.m. to 6:00 p.m., Monday through Friday, unless additional work is required, and the Customer shall provide the Property in a clean and safe condition. 3. The Customer will not have any animals or pets in the work area of the Contractor. 4. The Customer will provide the Contractor with all cabinets, and customer purchased items on or before the start date which shall be stored at the Property. The Customer shall bear the loss to such items unless they are damaged as a result of Contractor's own negligence. XIII. MISCELLANEOUS PROVISIONS 1. The Contractor is not responsible for any conditions which may exist on the Property which would impact the Contractor's ability to perform this Contract. 2. In the event that a condition exists and a Change Order or additional expense is mutually agreed, the Customer shall be responsible for said additional expense and the same shall be treated as a Change Order and paid upon completion of work. 3. Any inability or refusal in the payment of a Change Order or to pay the Contract Price when due, shall be at the option of the Contractor, grounds for ceasing all work under this Contract and if said failure to pay continues beyond seven (7) days, it shall be grounds for termination of the Contract by the Contractor. 4. Any additional work not within the scope of this Contract, to be performed shall extend the time for completion by a recommended period. 5. The Customer understands and acknowledges that any delays not occasioned by the Contractor may cause the Contractor to commence other scheduled work which may cause Customer's job to be delayed until the Contractor can reasonably reschedule the Customer's work to commence; in this event, Contractor shall not be responsible for said delays. NOTE: All home improvement contractors and subcontractors shall be registered and any inquiries about a contractor or subcontractor relating to a registration should be directed to: Director,Home Improvement Contractor Registration One Ashburton Place,Room 1301 Boston,MA 02108 617-727-8598 6. The parties agree that Contractor will not be responsible for consequential, non-direct or punitive damages to the Customer. 7. In the event that this Contract or any part of it cannot be performed due to causes that are reasonably outside the control of the Contractor, the Contractor shall not be responsible for the same or any delays occasioned by said cause. 8. In the event that the Customer purchases any materials or hires any other persons to perform work on the Property,the Customer shall bear sole responsibility for the same. XIV. BINDING ARBITRATION/DISPUTE: In the event of a dispute, the parties agree to submit to binding arbitration for all matters concerning this Contract and to equally split the cost of the same. The parties do not r Y 5. The customer bears of risk for any customer purchased items X. RIGHT TO CANCEL YOU MAY CANCEL THIS TRANSACTION, WITHOUT PENALTY OR OBLIGATION,WITHIN THREE (3)BUSINESS DAYS FROM THE ABOVE DATE. IF YOU CANCEL, ANY PROPERTY TRADED IN,ANY PAYMENTS MADE BY YOU UNDER THE CONTRACT OR SALE, AND ANY NEGOTIABLE INSTRUMENTS EXECUTED BY YOU WILL BE RETURNED WITHIN THIRTY (30) BUSINESS DAYS FOLLOWING RECEIPT BY THE SELLER OF YOU CANCELLATION NOTICE,AND ANY SECURITY INTEREST ARISING OUT OF THE TRANSACTION WILL BE ----CANCELLED.-- IF iCANCELLED. _IF YOU CANCEL, YOU MUST MAKE AVAILABLE TO THE CONTRACTOR AT YOUR RESIDENCE, IN SUBSTANTIALLY AS GOOD CONDITION AS WHEN RECEIVED, ANY GOODS, TOOLS OR EQUIPMENT DELIVERED TO YOU UNDER THIS CONTRACT OR SALE; OR BELONGING TO THE CONTRACTOR, OR YOU MAY, IF YOU WISH, COMPLY WITH THE INSTRUCTIONS OF THE SELLER REGARDING THE RETURN SHIPMENT OF THE GOODS AT THE SELLER'S EXPENSE AND RISK. TO CANCEL THIS TRANSACTION, MAIL OR DELIVER A SIGNED AND DATED COPY OF THIS CANCELLATION NOTICE OR ANY OTHER WRITTEN NOTICE, OR SEND A TELEGRAPH TO NOT LATER THAN MIDNIGHT OF OTHERWISE, YOUR RIGHT OF RECISION SHALL EXPIRE. I HEREBY CANCEL THIS TRANSACTION. Date: Buyer's Signature: XI.. DATE OF ORDER: Due to the right of recision, your order will not be placed until the fourth (4th) business day after the date of this Contract. XII. NOTICE REGARDING ACCELERATION OF PAYMENT Financial Insecurity-A Contractor may not demand payments in advance of the dates specified on the payment schedule unless agreed upon in writing.. R 1 agree to include, within the scope of the arbiter's authority, any claims pursuant to M.G.L. 93A. In the event of a dispute, the disputing party shall first contact the other parry and make a bonafide and earnest attempt to resolve their differences. If they cannot agree, then each parry shall cooperate and participate in a binding arbitration with the American Arbitration Association of Boston and shall, within two (2) weeks of any request,file the necessary documents,pay the fee, to initiate said arbitration proceeding. I acknowledge that I have received the following: A. A signed copy of this Contract B. A copy of the three(3)day right of recision as below. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES THIS IS A LEGALLY BINDING CONTRACT. PLEASE CONTACT A ~� LEGAL ADVISOR IF YOU DO NOT UNDERSTAND IT BEFORE SIGNING G�'2l,40 Cust&nokrignatuire / - / Contractor's Signa e ©Bretta&Grimaldi,P.A. i I n' ky�ri• ¢ } f xt I 4 'Aassac) u,"tts Department of Pubhc Satet,j '- 30aCd Of BU id—)q Regukatycr,s and Standards Construction Supenisor License CS-022301 D , . SALVATORE S LAFACE 55 gELLEVUE FALL RD _ West Roxbury MA 02132 10110!2015 ..y,"�``" x 1�� �,rte' ,�, � <•, r :ff'ura+yi'C unsurr�rr f,.i+r�.�, Itt:�inr •,}Zc�uiat'sun + DBA CC�BRr1 CC"��TR.�^T s C•, SAL ,ATO RE. LAFPL =ST ROXM; �"w, t,`.h 021==2 L ndersetrttars The Commonwealth of Massachusetts - Department ofIndustrlgl Accidents Office of Investigations to 600 Washington Street Boston,MA.02111 www.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please��Pr//int Legibly Name (Business/Organization/Individual): ///,�loe T�l,(�� /1 � 71el 4,2�Q S Address: rJ UlJ i/"?�^�J d )(2 City/State/Zip: CAOI� Phone Are you an employer?Check the appropriate box.: Type of project(required): 1.❑ lam a employer with 4. El am a general contractor and I 6. E]New construction ployees(fall and/or part-time).* have hired the sub-contractors 2. I am a sole proprietor or partner- listed on the attached sheet.x �• ❑Remodeling ship and'have no employees These sub-contractors have 8. []Demolition working for me in any capacity. workers'comp.insurance. 9. E]Building addition [No workers' comp.insurance 5. El We are a corporation and its ]Electrical repairs or additions required.] officers have exercised their 10. 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself. [No workers' comp. c. 152,§1(4),and we have no 12.0 Roofrepairs insurance required.] employees.[No workers' comp.insurance required.] 13.❑Other 'Any applicant that checks box#1 must also fill outthe section below showing their workers'compensation policy information. I-Homeowners who submit this affidavit indicating they tie doing all workand then hire outside contractors must submit anew affidavit indicating such. TContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp,policy information. lam an employer that isproviding workers'compensation insurance formy employees. Below is the policy and job site information. 1 _� Insurance Company Name:. - � �Y9N p 5 Policy#or Self-ins.Lie.#: � Expixation Date: ' 0 � Job Site Address: c� , VI 17,1�47/`2 City/State/Zip: fle 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 ofup to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. Ido hereby c rt' un r the ams andpenalties of erjury that the informationprovided above is true and correct. Si afar : Date: 7 Phone#: _ �/ 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#: Information and Instructions ' Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire,- express or implied,oral or.written." An employer'is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a j oint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced-acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance ofpublic work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit maybe submitted to the Department of Industrial Accidents for confirmationof insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or'-permit not related to any business or commercial venture (i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Mfassachusetts Department of Industrial Accidents Offlee of Iavestigafiions 600 Wa$hingtou Street Boston,MA:02111 Tel,#617-727�4900 eyt 4116 or 1-877�MA.SSAFE Revised 5-26-01 Fax#617-727-7749 wwwaass,gavfdla A oizo® CERTIFICATE OF LIABILITY INSURANCE 1DATE 0/21/2014YYY) 10/21/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(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 the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME; E A STEVENS CO INC AIC,No Ext): 888 6613938 aC No): 888 872-8921 P O BOX 188 EMAIL MALDEN,MA 02148 D RE -service.center@travelers.com (888)661-3938 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:TRAVELERS CASUALTY INSURANCE COMPANY OF AMERICA INSURED INSURER B:THE TRAVELERS INDEMNITY COMPANY NORTHEAST KITCHENS INC DBA NORTHEAST KITCHENS&STONE INSURER C: 206 S MAIN ST INSURER D: MIDDLETON,MA 01949 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 813017814461492 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. INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD MM/DD LIMITS 680-8489N737-14 08/05/2014 08/05/2015 EACH OCCURRENCE $1 000 000 A X COMMERCIAL GENERAL LIABILITY X DAMAGE TO RENTED CLAIMS-MADE OCCUR PREMISES Ea occurrence $300,000 X HIRED AUTO MED EXP(Any oneperson) $5000 X NON OWNED AUTO PERSONAL BADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 �( POLICY �ET LOC PRODUCTS-COMP/OPAGG $2,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED AUTOS PROPERTY DAMAGE (Per accident) $ $ B X UMBRELLA LIAR X OCCUR CUP-8746N838-14 08/05/2014 08/05/2015 EACH OCCURRENCE $1,000,000 EXCESS LJAB CLAIMS-MADE AGGREGATE $1,000,000 DED X I RETENTION$5,000 $ WORKERS COMPENSATION NIA STATUTE EORH- AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A LIMITED POLLUTION 680-8489N737-14 08/05/2014 10810512015 INCLUDED DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) AS RESPECTS TO GENERAL LIABILITY,CERTIFICATE HOLDER IS ADDITIONAL INSURED-BLANKET ADDITIONAL INSURED-OWNERS,LESSEES OR CONTRACTORS,CG D1 05,BUT ONLY AS RESPECTS TO WORK PERFORMED BY THE NAMED INSURED. CERTIFICATE HOLDER CANCELLATION STEVE AND NATHALIE WILES SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 89 WINDSOR LANE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN NORTH ANDOVER,MA 01845 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION.All rights reserved. —i Al%^13 \ i I I 15628-" 114 0" 7 43-1„ 56 'o 15,40 __g20016a0 �`•.�„....,w.�...__„_ ...�....._._.,.�.. � ,- _--1•� ....� W3033 W2133-FF3(<+�.....�. - Q- �.._.� ���� � 3DB24 O CDWT980RS SBC36FSPH-R 'f! M I rn _ _ 1 i7 a rJu. h 136<" II con J 11 B33 tD xWWpW*hWWWAW#WA*WWW*pW##A#fi WxwwWWA**WWhpWWWx##wppWxfiW CABINETRY: DECORA BEADED INSET n M . i� DOORSTYLE: PRESCOTT u� 4t WOOD SPECIES:MAPLE BEP.7 Q FINISH:CHANTILLE UB2 187RT- I 7 HINGE: INSET FINIAL BRUSHED NICKEL �K $7 3DB33 3DB33 N #w*w##*#axWWxwWx#WxW*#wwxwwWW###aw#WwWwwww*w#WwWwwwxw, m d RW3615 SIN W3333 MW307. 3318 y�� 68 88,s' 156-21" All dimensions-size designations NORTHEAST KITCHENS This is an original design and must Designed: 8/15/2014 given are subject to verification on 206 SOUTH MAIN ST not be released or copied unless Printed: 8/15/2014 job site and adjustment to fit job MIDDLETON,MA 01949 applicable fee has been paid or job r / conditions. 978-774-8001 order placed. SUSAN SHALKOSKI,C.K.D ` All Drawing##: 1 No Scale.