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Home My WebLink AboutBuilding Permit #422 - Suite 345 11/18/2011 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: �'y Date Received Date Issued: ORTANT:Applicant must complete allitemson this page LOCATION `�` �j r `n JO(Ae Print PROPERTY OWNER�h4 ,� C Print MAP NO: PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ ( Iew Building ❑ One family OV Addition ❑Two or more family ❑ In ustrial ❑Alteration No. of units: ommercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other '�® Se tic��Welly i f�sFloodplauir CO0Wetland's; `®`,yVatershe'dlDistrict Pi 4 gnR71PTIONN OF WORK TO BE PERFORMED: Id itification Please Type or Print Clearly) OWNER: Name: -40 L L C Phone Address: /? 410 re 3l ,/��'r.�/�a �'1 .2 CONTRACTOR Name: •S��✓�Or/G //DIry �� LY�?� Phone: Address- 52L 06&9 1• �o�— n�� / C L%6�� ' Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date: / ARCHITECT/ENGINEER,�o� (� �Lf hone: fly-7 ?6JG Address: 6 Reg. No. 7-f FEE SCHEDULE:BULDING E !T:$92.0 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ SCJ FEE: $ Check No.: 7 Receipt No.: 0 Y 6 2-kf NOTE: ` Per ons conte cting with unregistered contractors do not have access to the arae fund -------- .. - �----- .- - - -- -- - ��- :- ----ate- - -- - -, re o Signatu nee Signatuf contrac_ - Location -2Z No. Date —1 NpRTM TOWN OF NORTH ANDOVER f � to w A Certificate of Occupancy $ CHU Building/Frame Permit Fee $ Foundation Permit Fee $ t" Other Permit Fee $ TOTAL $ Check # 1 a 2482 4 Building Inspector Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL ' Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools.1' Cl ' 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 DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ 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 DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTAMNT- —Ternp.Dum star on s'te yes no Located at 124 MV in Street Fire Department signature/date CONfMENTS 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 El Notified for pickup - Date Doc:.Building Permit Revised 2008 1 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 ' I o Building Permit Application o Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses o Copy of Contract o Floor Plan Or Proposed Interior Work o Engineering rin Affidavits for Engineered products NOTE: All dumpster permits require sign offrom 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/Crossection/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 o Certified Proposed Plot Plan o Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit o 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 o Engineering Affidavits for Engineered products DOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit a all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals iat the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording lust be submitted with the building application Doc: Doe-Building Permit Revised 2008mi NORTH Town of _: tAndover O '"N a �ti-�•1• .,Y•r`:1*. ' No. � �,o o ; dover, Mass., " it •it LAKE COCHICHEWICK RATED PA1?��.(5 U BOARD OF HEALTH Food/Kitchen Septic System .PERMIT T BUILDING INSPECTOR THIS CERTIFIES THAT.........N.A.0-F,....cic........................................lr.e ..x........ve!.&P 1 Foundation has permission to erect........................................ buildings on ........q . ........... fnd.Q. .hM....... Rough 00000 !!r � Chimneyto be occupied as ........ .f.....- 1 ^* � provided that the person accepting this permit shall in'.evres ect conform to the terms ofth �PPlicationcn file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS UNLESS CONSTRUC ELECTRICAL INSPECTOR Rough ...... ......... Service ......... ........ ................. BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIR_ E_DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE smoke Det. RightFax N2-1 11/17/2011 7:23:57 AM PAGE 3/003 Fax Server .., ISSUE DATE A. �`"'^�.�;.. �.-,,. �;`..3i,"..,.�r. .� *��>--�, .>:,,i„>. �� .:,.:r.. _ ,:-r. .::.,.:. . ,,---•��{:,:, -..,: ,.. .r_. ,--�-r 11(17.201] THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CER9-1CCA'11 DOES NOT AFFRMAIT.VELV OR NEGAT1VELY AMENll,EXTEND UR ALTER Ta(:OVERAGE AtFFOIRDED DV THE P0LICIE& 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 Ileu of such endorsement(s). PRODUCER CONTACT SABRINA GILLIS INS NAMS 85 MAIN STREET C7 PHONE FAX (AIC,No,Ext): {AfC,No): PEAOBODY,MA 01960 E-MAIL ADDRESS: PRODUCER CUSTOMER ID t: INSURED INSURERS AFFORDING COVERAGE NAIC# RTAR TCli 1('.T-I DR(IDRRTV RRR VTt".RR rhv�rroun w .. rw... w.w,rra�.... ----••� •----«--•--�--•�-�- vay.a.� lI1L` 1hYY CLC1�J ll\LL'IYll\1111,V1YlrHl�l INC INSURER B 515 LOWELL ST STE 3 INSURER C PEABODY,MA 01960 INSURER D INSURER E 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 ALLTHETERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IJSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LITE Ulan -M mMI)w YY YY hIhUDD1Y Y YY) GENERAL LIABILITY EACH OCCURRENCE f .DAMAGETORENTED S 0 COMMERCIAL GENERAL LIAEILTTY PREMISES(Each occurrence MID.EXPENSE(Anyone S 0 CLAIMS MADE 0 OCCUR Soil 0 PERSONAL&ADV. S IIJTVRY 0 GENERAL AGGREGATE S GENL AGGREGATE 122 APPLIES PER: PRODUCTS-COMP/OP S 0 POLICY 11 PROJECT 0 LOC AGO AUTOMOBILE LIABILITY COMBINED SINGLE S LIFT (Each accident) 0 ANY AUTO BODI.YINJURY S (Per Person 0 ALL OWNED AUTOS BODB.YDUURY S (Per Accident.) 0 SCHEDULED AUTOS PROPERTY DAMAGE S er accident 0 HIRED AUTOS $ 0 NON-OWNED AUTOS S 0 0 UMBRELLA LLAB 0 OCCUR EACH OCCURRENCE S 0 EXCESS LIAB 0 CL AIS-MADE AGGREGATE S 0 DEDUCTIBLE S 0 RETFN170N S S WORKERS'COMPENSATION WC A AND EMPLOYERS LIABILITY N/A STATUTORY YIN LI�1S ANY PROPRIFI OR/PARTNEW ExEcuTHvEGFETCFlrtME'0ER Y NJA 6KUB4902P95A 10/28/11 10/28/12 L.EACH ACCIDENT S100,000 EXCLUDED? (MANDATORY IN 7.`TH) EL DISEASE—EACH EMPLOYEE $100,000 byes,describe under DESCRIPTION OF E.L.DISEASE-POLICY OPE RATIONS below 5100,000 DESCRIPTION OF OPERATTONS/LOCATTONS/VEMCLES(AUadh ACORD 101,Additional Remmis Schedule,ifrnwe space is required) THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECLVG WORKERS COMP COVERAGE ... }y� .. < ...a ::' gu.y_...>`....,\r--.-.:y.,--:...,..:✓,....,..,« .,�...3,-,-..«a«,-.-,-«c,.,-....,. J..««. .- .. ::.. .:...,......,.,..r{:.:-:,.✓,...«L.:..,.:-�J,-�«•:J.:J.:✓.�::. - T°jIl'Li'�y`�' ..........:...a` ..:.-- ..: �,,,"s«c3;b'S.x:>`;£.]".f.,x7;27,-;?ra':r�T',�' ., .. :-:�.` i�, ?rr _ �i:°.) -,x,«,.x:`- 'x°p .fi.^.r: >ss ,.'':•;a.,.1>. .r".x a>... '..:r..-,....,. NAOP LLC 415 ANDOVER ST SMUULU ANY OF THE ABOVE OESCRIBtD POUCIE.S'BE/.AHG:ELLCU BEFORE NORTH ANDOVER,MA 01845 THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUMORIM RIYRESEWATIVE $Yt.GI.WltiiA.GZ.P.q.V11 ', Massachusetts- Department of Public Safety Board of Buildin�a, Rc�'uiations and Stand-l"I. Construction Supervisor License License: CS 104350 LISA GOMES 40 HIGHLAND ST PEABODY, MA 01960 Expiration: 9/1/2013 (nnmii••iuncr Tr=: 104350 Proposal 9477 StarTouch Property Services Page 1 515 Lowell Street, Suite 3 Date 11/08/2011 Peabody, MA 01960 I. General.Information Proposed by: StarTouch Property Services Telephone: 978 836-1206 515 Lowell Street,Suite 3 Peabody',MA 01960 Submitted To: Mrst General Realty Corporation Work Performed At: 451 Andover Street 93 Union Street,Suite 315 1 Suite 345 Newton Centre,MA 02459 II. Work Description: We hereby propose to furnish the materials and perform the necessary labor for the completion of the work described herein: Remove and relocate entrance Install one metal frame Install one fire doors with hardware Install Sheetrock mud,tape and sand Fire blocking all exterior walls. Patch and painting only new wall to match existing colors Perform building standard electrical to bring space up to code III. Exclusions: • Dumpster to be supplied by FGR W. Terms: All material is guaranteed to be as specified and is to be completed in a substantial workmanlike manner for the sum of: Eight Thousand,Seven Hundred and Eighty DoIlaas($8,780.00) Payments to be made as follows: 1/3 deposit, 1/3 progress payment and 1/3 final payment *Any alteration or deviation from the above specifications involving extra costs will be executed only upon written order, and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays beyond our control. **Note—This proposal may be withdrawn by us if not accepted within 30 days Respectfully submitted on behalf of Frank Gomes, StarTouch Property Services By signing below ou cc terms and conditions of this contract: DATE A 1 Architects JDLaGrasse & Associates, Inc. Joseph D.LaGrasse,AIA Architects, Engineers & Lana Planners Thomas E Galvin,AIA Julianna E.Hoch,RA CONSTRUCTION CONTROL AFFIDAVIT PROJECT NUMBER: 2161 —Suite 345 PROJECT LOCATION: 451 Andover Street,North Andover,MA NAME OF BUILDING:North Andover Office Park SCOPE OF PROJECT: Interior remodeling for Unit 335,Suite 345 In accordance with the Massachusetts State Building Code Amendment Section 107.6"Construction Control under IBC 2009 Section 7"submittal documents". 1, Joseph D.LaGrasse,AIA MA.Reg.# 4153 being a registered professional engineer/architect hereby certify that I have prepared or directly supervised the preparation of all design plans,computations as specifications concerning: Entire Project X Architectural Structural Mechanical Fire Protection Electrical Other For the above named project and that, to the best of my knowledge, such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, all acceptable engineering practices and all applicable laws for the proposed project. I further certify that I shall perform the necessary professional services and be present on the construction site on a regular and periodic basis to determine that the work is proceeding in accordance with the documents approved for the building permit and shall be responsible for the following as specified in Section 107.6.2.2: 1. Review of shop drawings, samples, and other submittals of the contractor as required by the construction contract documents as submitted for building permit,and approval for conformance to the design concept. 2. Review and approval of the quality control procedures for all code-required controlled materials. 3. Special architectural or engineering professional inspection of critical construction components requiring controlled materials or construction specified in the accepted engineering practice standards listed in Appendix 1. Pursuant to Section 107.6 as stated above,I shall submit periodically,a progress report together with pertinent comments to the Building Inspector. Upon completion of the work,I shall submit a final report as to the satisfactory completion and readiness o t e project for occupancy. S��D ARC'Si Joseph D.LaGrasse,AIA a No.4153 ANDOVER o Signature of Architect Date y � One Elm Square `cq��Fl QF MP`'SP T 978.470.3675 1420 Celebration Blvd. Andover,MA 01810 F 978.470.3670 Celebration,FL 34747 file:2161 —Unit 335,Suite 345 AA26001333 F:Hconstruction control affidavit.doc www.lagrassearchitects.com The Commonwealth ofMassachusetts Department oflndustrial Accidents y: a Office of Investigations a ■i Y+`e 600 Washington Street Boston,MA 02111 -` www.mass gov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information Please PrinfLe2 ibly Name(Business/Organization/Individual): G Address: City/State/Zip: Phone#: � l G A,re you ap employer?Check the appropriate box: Type of project(required): 1.Uv I am a employer with 4. ❑ I am a general contractor and I 6. ❑ljcw construction employees(full and/or part time) have hired the sub-contractors 2.El am a sole proprietor or partner- Listed on the attached sheet.# �• Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers'comp.insurance. g, ❑Building addition [No workers'comp.insurance 5. ❑ We are a corporation and its red quire ] officers have exercised their 10.E]Electrical repairs or additions 3.El 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.E]Roof repairs insurance required.]1 employees.[No workers' . comp.insurance required.] 13.❑Other *Any applicant that checks box#1 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 their 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 their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. i Insurance Company Name: ' /i�j��✓�' r5 ngmYl i/ n Policy#or Self-ins.Lie.#: /�(!U"" �� l .q1l Exp' ZO" '� Expiration Date: ys� �Job Site Address: Yl t U lc,-- 5( City/State/Zip: �i7��i�U✓�/ �� 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 up to$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. Ido hereby certify under ae-aims nd penalties ofperjury that the information provided above is true and correck Signature - - - Date: Phone#: �% z Official use only. Do not write in this area,to be completed by city or town ofj&W City or Town: Permit/License# = Issuing Authority(circle one): I. Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Mmsachuseffs General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuantto flus statute,an employee is defined as`:,.every person in the service of another rrrlder;any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other le gal entity;of the foregoing engaged in a joint enterprise,and including the legal re resentatives of a dere em Jany two or more receiver or trustee of an individual,partnership,association or other legal ' employer,or the owner of a dwelling house haulm �entity;employing employees. Ho g not more than three Y Wever the dwelling house of another who employs persons to do m� and amides therein,or the occupant ofthe or.on the grounds or building �cOn��gn or repair work on such dwelling house g aPPu arrt thereto shall not because ofsuch employment be deemed to be an employer." MGL chapter 152,§25C(6)also sues 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 ins the co coverage required." Additionally,MGL chapter iS2,§25C('7)states"Neither the commonwealth nor. of its political subdivisions shall enter into any contract for the performance ofpublic work until acceptable evidence of compliance with the insurance requirements ofthis chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the bones that ( ) p apply to your situation and,if necessary,supply sub-contraeto ifs)name(s),address es and hone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerph members or partners,are not required to carr,workers' �(LLP)tvrtir no employees other than the employees,a policy is compensation ma insurance. If an LLC or LLP does have P cY required. BeSe advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit The affidavit should In returned c the city or town that the application for the permit or license's being requested,not the Department of Industrial Accidents. Should you}lave ate+questions compensation policy,Please call the D ring the law or if you are required to obtain a workers' Department the number listed below. Self-insured companies shou self-insurance license number on the appropriate line.li ne. ld enter their City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom ofthe affidavit frn 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-permifi/license applications in any given year,need only submitone affidavit indicating current Policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in town)."A copy ofthe affidavit that has been of (city or l-rciaily stamped or mtown arked by the city or maybe provided to the Y applicant as proofthat a valid affidavit is on file for future Per or licenses. Anew affidavit must be filled out each om: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 burn 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 M.awuhusetts Department ofIndu*ial Accidents Office Of Investigations 600 Washington Street Boston,Mao 02111 y Tel.#617727-4900 ext 446 or 1-877-MASSAFE Revised 5-26-05 Fax#617-727-7749 Hc,vrsu CERTIFICATE OF LIABILITY INSURANCE 11/09i2011 TM. PRODUCER Phone: 413-781-7475 Fax (413)781-0050 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION INSURANCE CENTER SPECIAL RISKS ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 20 GOLD STREET HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P O BOX 1250 ALTE AF AGAWAM MA 01001 INSURERS AFFORDING COVERAGE NAIC# r r INSURED INSURER A: Essex Insurance Company STAR TOUCH PROPERTY SERVICES INC INSURER B: 515 LOWELL STREET,STE 3 INSURER C: 01=A0nr%V RRA Alfl&1 _ I rcrwvv t nr,n ��,�, INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADUL TYPE OF INSURANCE POLICY NUMBER POLICY EFPECrnE POLICY EXPIRATION LIMBS LTR INSR DATE MID DATE MID GENERAL LIABILITY 3DJ2231 10/19/11 10/19/12 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 50,000 PREMISES(Ea occurence) CLAIMS MADE[X] OCCUR MED.EXP(Any one person) $ 1,000 A X $250 Deductible PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG. $ 1,000,000 X POLICYLl PRO JECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accident) $ PRnPFRTY nAMArF Per c ( accident) _ GARAGE LIABILITY $ AUTO ONLY-EA ACCIDENT ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ 66CUR E_1 6LAIM5 MABE A156REGAT£ $ $ DEDUCTIBLE $ RETENTION$ $ WORKERS COMPENSATION AND wIC srA1T� DIRER EMPLOYERS'LIABILITY roRv uMlTs F IFACH Ar.rinrNT RI ANY PROPRIETORIPARTNEEXECUTIVE "" .... OFFICERIMEMSER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ It yea,describe under SPECIAL PROVISIONS below E.L DISEASE-POLICY LIMIT $ OTHER: CERTIFICATE HOLDER CANCELLATION NAOP,LLC. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFOE 451 ANDOVER STREET EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MDAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT,:RE TO NORTH ANDOVER,MA 01845 DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE IN ,ITS AGENTS OR REPRESENTATIVES. I AUTHORIZED REPRESENTATIVE a Attention: avid . Florian &0"—