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HomeMy WebLinkAboutMiscellaneous - 1401 GREAT POND ROAD 4/30/2018 (16) Form of Notice of Casualty Loss to Building Under MASS. GEN. LAWS, Ch. 139, Sec. 3B To: Building Commissioner or Inspector of Buildings 1600 Osgood Street North Andover, MA 01845 RE: Insured: Bridget Sullivan Property Address: 1401 Great Pond Road, #4 Policy Number: HP0635897 Date/Cause of Loss: 2/12/2013, Water/Plumbing File or Claim Number: 27817-J Claim has been made involving loss, damage or destruction of the above captioned property, which may either exceed $1,000.00 or cause MASSACHUSETTS GENERAL LAWS, CHAPTER 143, SECTION 6, to be applicable. If any notice under MASSACHUSETTS GENERAL LAWS, CHAPTER 139, SECTION 3B is appropriate, please direct it to the attention of the writer and include a reference to the captioned insured, location, policy number, date of loss and claim or file number. Jim Taylor On this date, I caused copies of this Notice to b sent to the pers name above at the addresses indicated above b First Class Mail. Y Signatur D e ANDERSON ADJUSTMEN ., INC. 50 Nashua Road, Suite 303 PO Box 1098 Londonderry, NH 03053 Cf NOeoT 6'9h BUILDING PERMIT �� 4�::._ • .•� °L 1/I•� I TOWN OF NORTH ANDOVER o APPLICATION FOR PLAN EXAMINATION - Permit NO: (go a0 1 7 Date Received �igss ATeD 5 t�5 Date Issued: I A - 0 1 ACHU IMPORTANT:Applicant must complete all items on this page LOCATION 1401 Great Pond Rd Unit 4 North ANdover MA 01845 Print PROPERTY OWNER Jeffrey&Julie Clements Print MAP NO: C1 0_PARCEL()IL5 ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential �. ❑ New Building ®'One family ❑Addition ❑Two or more family ❑ Industrial VIAlteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other 0 Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District 13/Water/Sewer i i Remodel ground floor hallway bathroom approx.40 SF in reconfigured footprint. Remove existing fixtures and finishes. Frame 36x36 shower stall from adjacent closet. Install pocket door in bathroom. Install new fixtures and finishes.Tile shower stall and tile floor over radiant heat mat. Identification Please Type or Print Clearly) OWNER: Name: Jeffrey&Julie Clements Phone: 614 569-2909 Address: 1401 Great Pond Rd Unit 4 North Andover MA 01845 CONTRACTOR Name: Phone: Theodore Kelley 978 852-4491 Address: 214 Sutton Hill Rd North Andover MA 018454 Supervisor's Construction License: Exp. Date: CSL105086 10/08/2017 _ Home Improvement License: Exp. Date: HIC 165887 4/5/2018 ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULD/NG PERMIT:$1200 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ 25,200 FEE: $ 2 0 a,_ '�'_ Check No.: a%42) 1 Receipt No.: 3 1 o't$ y NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner Signature of contractor Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. r Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products 40TE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg. Permit N 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 1 limension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, roast or service drop.,,..,r res 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 ate Time Contact Name Doe.Building Pennit Revised 2014 r rr�Submitted ❑ Plans Waived Certified Plot Plan ❑ Stamped Plans ❑ 'rypjf`0F SEWERAGE DISPOSAL Public Sewer ❑ Tanuing/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 Siqnature COMMENTS HEALTH Reviewed on Signature COMMENTS i 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 - Temp Dumpster on site yes no Located at 124 Main Street Fire Department signatureldate COMMENTS Location 1 4 0 1 CT r e A T P o ry l-N 2 D V ^ 1 T q No. (o n 2 0)7 Date l a - S - 001 (9 . - TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ 3,00, Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check z&— _ ,,` Building Inspector Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost $ 25,200.00 m $ - $ 302.40 Plumbing Fee $ 37.80 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 37.80 Total fees collected $ 478.00 Foundation 100 1401 Great Pond Road Unit 4 602-2017 on 12/5/2016 Bath Remodel "i tAORTH own of 32 _ Andover a� . � . - No. 10 rI o CN CN! > >h ver, Mass s A 0 It COC NIC Nl WICN p BOARD OF HEALTH PERMIT T LD Food/Kitchen Septic System THIS CERTIFIES THAT ., .. !N!�. '� C,,,,,,,,,,, ,��,,��,,,y, BUILDING INSPECTOR Qq ....".... - 04 has permission to erect .......................... buildings on wo!—wo.a?...es.........si. ... foundation /� to be occupied as .....&VT...... ......rl�.�..�.�..�.......A ......�.. Chimney s .. .... Rough heY provided that the person accepting this permit shall in every respect conform to the terms of the application Final on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection,Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUC7U,tO TART Rough Service ......... ... ............ BUILDING INSPECTOR Final 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. i y a 149X2 o�� 214 Sutton Hill Rd Contract North Andover MA 01845 Clements-1401—Great—Pond—#4-2 978852 www.TMKremodeling.com REMODELING CONTRACTOR AGREEMENT THIS AGREEMENT made this 20J�by and between TMK Remodeling, LLC Construction Supervisor License#105086, 214 Sutton Hill Rd, North Andover MA 01845 hereinafter called the Contractor, and Julie&Jeffrey Clements hereinafter called the Homeowner. WITNESSETH,that the Contractor and the Homeowner for the consideration named herein agree as follows: ARTICLE 1.SCOPE OF THE WORK The Contractor shall perform all of the work described in the specifications entitled Exhibit A—Statement of Work, as annexed hereto as it pertains to work to be performed on property located at 1401 Great Pond Rd#4 North Andover MA 01845. Work Scope Summary:Remodel ground floor hallway bathroom approx.40 SF in reconfigured footprint. Remove existing fixtures and finishes. Frame 36x36 shower stall from adjacent closet. Install pocket door in bathroom and new door in hallway closet. Install new fixtures and finishes. Tile shower stall and tile floor over radiant heat mat. 36x21 vanity, countertop, sink, faucet. New toilet. ARTICLE 2.TIME OF COMPLETION The work to be performed under this Contract shall be commenced on or before November 28, 2016 and shall be substantially completed on or before December 23, 2016 ARTICLE 3.THE CONTRACT PRICE The Homeowner shall pay the Contractor for the labor and materials to be performed and supplied under the Contract the estimated sum of Twenty Five Thousand Two Hundred Dollars and No Cents ($25,200.00), subject to additions and deductions pursuant to authorized change orders. The contract price includes two components; Fixed cost of Twenty Thousand Forty One Dollars and No Cents($20,04 1.00)for the building materials and construction labor as specified in Exhibits A and B. Variable cost of Five Thousand One Hundred Fifty Nine Dollars and No Cents($5,159.00)for the allowance items listed in Exhibit B Allowances and will be 110%of the actual invoice price paid by the Contractor to his suppliers. Exhibit B lists the allowance items and budget costs the Contractor will purchase for the Homeowner. Sales tax and freight are not inlcuded in allowance budget. Contractor will furnish and install all building materials, fixtures and finish items unless noted otherwise. Any Homeowner supplied materials will be charged a 15% handling and coordination fee based on actual invoice. ARTICLE 4. PROGRESS PAYMENTS Payments of the Contract price shall be paid in the following manner from the Homeowner to the Contractor: Payment 1: 33% upon contract acceptance and signature; $8,400.00 Payment 2: 33% upon rough building inspection;$8,400.00 Payment 3: 33% upon final building inspection and 90%completion of finish; $3,241.00 plus the actual contract price for allowance items as defined in Article 3; Budget:$5,159.00 The contract cost for mutually agreed to change orders will be paid 50%at time of change order signature and 50% after completion and Homeowner sign-off. ARTICLE 5.GENERAL PROVISIONS 1.All work shall be completed in a workmanship like manner and in compliance with all building codes and other applicable laws. Copyright TMK Remodeling, LLC Initials i. ` All Rights Reserved Page 1 214 Sutton Hill Rd 4PA Contract North Andover MA 01845 r Clements-1401-Great-Pond-#4-2 978 852-4491 www.TMKremodeling.com REMODELING 2.To the extent required by law all work shall be performed by individuals duly licensed and authorized by law to perform said work. 3. Contractor may at its discretion engage subcontractors to perform work hereunder, provided Contractor shall fully pay said subcontractor and in all instances remain responsible for the proper completion of this 4. Contractor shall furnish Homeowner appropriate releases or waivers of lien for all work performed or materials provided at the time the next periodic payment shall be due. 5.All change orders shall be in writing and signed by both Homeowner and Contractor. The cost for mutually agreed to additional work, required due to unknown conditions or substantive change orders,will based on the current bill rates for the actual time used.Additional materials will be billed at contractor cost.All change orders subject to 15% markup for overhead. 6. Contractor warrants it is adequately insured for injury to its employees and others incurring loss or injury as a result of the acts of Contractor or its employees and subcontractors. 7. Contractor shall at its own expense obtain all permits necessary for the work to be performed. 8. Contractor agrees to place all debris in an on-site trash receptacle(dumpster)and leave the premises in broom clean condition. 9. In the event Homeowner shall fail to pay any periodic or installment payment due hereunder, Contractor may cease work without breach pending payment or resolution of any dispute. 10. The Contractor and the Homeowner hereby mutually agree in advance that in the event that the Contractor has a dispute concerning this contract, the Contractor may submit such dispute to a private arbitration service which has been approved by the Office of Consumer Affairs and Business Regulation and the Homeowner shall be required to submit to such arbitration as provided in MGL c 142A. � � Ho o Date: ll / Contr ctor Date: ` Notice: The signatures of the parties above apply only to the agreement of the parties to altemate dispute resolution initiated by the Contractor. The Homeowner may initiate alternative dispute resolution even where this section is not signed by the parties. 11. Contractor shall not be liable for any delay due to circumstances beyond its control including strikes, casualty or general unavailability of materials, or inclement weather. 12. Contractor warrants all work for a period of 12 months following completion. 13. Contractor may post small signage(36x36")on property advertising services during the duration of the project. 14. The Contractor and subcontractors shall be registered and any inquiries about a contractor or subcontractor relating to a registration should be directed to: Office of Consumer Affairs and Business Regulation Ten Park Plaza, Suite 5170 Copyright TMK Remodeling, LLC Initials All Rights Reserved Page 2 214 Sutton Hill Rd 0-1 Contract North Andover MA 01845Clements_1401_Great_Pond #4_2 978 852-4491 Tm'rK www.TMKremodeling.com REMODELING Boston, MA 02116 Phone: (617) 973-8700 15.The Contractor or Homeowner may terminate this contract at any time for any reason by giving 3 days notice in writing to the other party. If either party terminates the contract as provided herein, then the contractor will be paid for work(labor and materials)completed as of the date of termination plus any materials or equipment that are backordered and not delivered. Payment is defined as actual job costs for the 0 0 project plus 15% overhead charge, plus 15% profit.The contractor will provide a written report detailing actual job costs plus overhead for payment. The Contractor will refund any funds paid by the Homeowner that are a remaining balance for the labor and materials used as of the date of termination, plus any materials or equipment that are backordered and not delivered, plus 15%overhead charge, plus 15% profit. The Contractor will make arrangements for the backordered items to be delivered to the Homeowner. Upon written notice of termination,the Contractor will have 3 days to close down the job site including removing tools, equipment, materials and ensuring the job site is safe and clean. The Homeowner will provide access to the job site to the Contractor over this 3 day period. 16.The Homeowner is responsible for maintaining adequate access to the property including snow removal, personal property storage, and working doorways, stairways and walkways. In the event the contractor is required to provide access or make repairs to the doorways, stairways and walkways,then the Contractor will bill the Homeowner at the hourly bill rate for same. ARTICLE 6.OTHER TERMS ARTICLE 7.ACCEPTANCE Signed thist day of_, LVA , 20J. 1 -Alusotl� H OM-sl eown r Con ractor 67 NOTICE: The signatures of the parties above apply only to the agreement of the parties to alternate dispute resolution initiated by the contractor. The Homeowner may initiate alternative dispute resolution even where this section is not signed separately by the parties. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES Copyright TMK Remodeling, LLC Initials All Rights Reserved Page 3 214 Sutton Hill RdExhibit A-Statement of Work _ North Andover MA 01845 K Clements-1401—Great—Pond—#4-2 978 852-4491 www.TMKremodeling.com RE!VIODELING i A B C D E F G I 47 Furnish and install 36x78/80"pocket door,wall frame kit,pull,trim,painted 1 $1,072 $1,072 48 14 Plumbing 1 8 $2,900 $2,900 49 Furnish and install 10'of 1/2"PEX supply lines /krn ���O1 ' 1 $319 $319 50 Furnish and install 10'of 2"PVC waste line and vent 1 $330 $330 51 Furnish and install 10'of 3"PVC waste line and vent 1 $341 $341 52 Install 36x21"bathroom vanity,countertop,sink,faucet +fixture allowance 1 $353 $353 53 Install Shower Setup:Valve,trim overhead spray +fixture allowancej� 1 $353 $353 54 Install Shower stall:`JOW acrylic shower base+fixture allowance '3 lY 'Se Li 1 $276 $276 55 Install toilet w/new flange,shut-off,wax ring+fixture allowance 1 $353 $353 56 Provide plumbing demolition of existing pipes,vents and drains.Budget.Billed T&M+15% 1 $575 $575 57 15 HVAC 1 $440 $440 58 Furnish&install 4"metal ducting and vent caps,vented to exterior for appliance 1 $440 $440 59 16 Electrical&Lighting 6 $2,317 $2,317 60 Electrical Demo Budget.Invoiced at T&M+15% 1 $500 $500 61 Furnish and install 5"recessed wet spacefixture on new switch 1 $242 $242 62 Furnish and install GFCI outlet on new circuit 1 $236 $236 63 Furnish and install Panasonic 110 CFM fan/light combo unit on new switch 1 $638 $638 64 Furnish and install Radiant heat thermostat on new circuit 1 $463 $463 65 Furnish and install surface mounted fixture on new switch+fixture allowance 1 $239 $239 66 18 interior Walls 120 $336 168 $1,844 $2,180 67 1 side wall finish:1/2"plasterbase,plaster skim coat,3 coats paint 168 $1,844 $1,844 68 Prep,Prime(1 coat)and Paint(1 coats)trim 120 $336 $336 69 19 Ceilings&Cover 40 $383 $383 70 Ceiling-1/2"plasterbase,plaster skim,2 coats paint on 1x2 strapping 40 $383 $383 71 22 Specialty 3 $1,167 73 $1,290 $2,456 72 Furnish&install Nuheat radiant heat mat 8x4' 1 $756 $756 73 Install Accessories:towel rod,TP holder,hand towel ring+fixture allowance 1 $169 $169 74 Shower Bullnose 3x6 30 pcs,grout and seal joints+the allowance 1 $242 $242 75 Shower Corner Shelf 1 $83 $83 76 Shower Walls custom tile on cement board backer, grout and seal joints+the allowance 72 $1,207 $1,207 77 23 Floor Coverings 32 $537 $537 78 Floor 12x12 porcelain or ceramic tile,grout and seal joints+the allowance 32 $537 $537 79 33 Allowances 31 $4,019 126 $1,140 $5,159 80 36x21"Vanity,1 sink,1 lav faucet 1 $2,000 $2,000 81 =S@x56 Acrylic shower base 3 U €j 1 $300 $300 82 Accessories:towel rod,TP holder,towel rings,shower curtain rod 1 $300 $300 83 Bullnose the 24 $144 $144 84 Floor file 40 $280 $280 85 Granite Countertop-remnant 6 $300 $300 86 Light Fixture 1 $75 $75 87 Mirror/medicine cabinet 1 $300 $300 88 Shower setup:valve,diverter,spray,unions 1 $450 $450 89 Shower wall tile 80 $560 $560 90 Toilet1 $450 _ _ _$450 —97 Grand Total — — 77 $18,676 120 $336 790 $6,188 $25,200 ©Copyright TMK Remodeling,LLC All Rights Reserved Page-5 Unlawful to distribute without permission 214 Sutton Hill Rd 4p-q Exhibit A-Statement of Work North Andover MA 01845 Clements-1401—Great—Pond—#4-2 978852-4491 TM www.TMKremodeling.com REMODELING A B C D E F G I 1 Owner: 2 Julie&Jeffrey Clements Estimate No:2016-124.2 Estimate valid for 30 days 3 1401 Great Pond Rd#4 Estimate Date:11117/2016 Expiration Date:12/17/2016 4 North Andover MA 01845 5 jclements@northrock.bm 6 614 596-2909 7 8 Scope of Work Remodel ground floor hallway bathroom approx.40 SF in reconfigured footprint.Remove existing fixtures and finishes.Frame 36x36 shower stall from adjacent closet.Install pocket door in bathroom and new 9 door in hallway closet.Install new fixtures and finishes.Tile shower stall and tile floor over radiant heat mat.36x21 vanity,countertop,sink,faucet.New toilet. 10 Notes: 11 Pricing includes labor and materials to install finished item+allowances. EA=Each LF=Lineal Feet SF=Square Feet 12 EA LF SF Total Cost 13 _ _ _ _ _Quantity Cost _Quantity Cost Quantity Cost 14 1.0 Administ $5'082 ration _ _� ._ _._.. __. _ _.. _ ._ _ -._ _ _ _ -- 15 $5,082 --- - - - 82 15 01 Plans and Permits:01.2 Building Permits 3 $438 $438 16 01.0 Permit-Building 1 $288 $288 17 02.0 Permit-Electrical 1 $75 $75 18 03.0 Permit-Plumbing 1 $75 $75 19 01 Plans and Permits:01.3 Building Inspections 6 $390 $390 20 06.0 Rough Inspection-Electrical 1 $65 $65 21 07.0 Rough Inspection-Plumbing 1 $65 $65 22 08.0 Rough Inspection-Building 1 $65 $65 23 09.0 Final Inspection-Electrical 1 $65 $65 24 10.0 Final Inspection-Plumbing 1 $65 $65 25 11.0 Final Inspection-Building 1 $65 $65 26 02 Site Work 5 $952 $952 27 15 Yd Dumpster 1 $545 $545 28 Adjacent spaces to be protected by temporary barriers from dust infiltration 1 $132 $132 29 All floor coverings and hand rails between the work area and primary entrance to be covered with protective covering material 1 $171 $171 30 Owner responsible for storing any items to re-installed 1 $0 $0 31 Work area to be vented during demolition and construction to minimize dust infiltration 1 $105 $105 32 31 Overhead&Expenses 1 $3,302 $3,302 33 Overhead and project administration 1 $3,302 $3,302 34 Grnd Fir Hallway Bathroom-40 SF^ - _—-_- - _ ,__ �A 62 $13,595 120 $336 !_790 _56,188 320,118 35 02 Site Work:02.10 Demo 7 $470 351 $994 $1,464 36 Disconnect and remove door,frame and molding 2 $209 $209 37 Disconnect and remove electrical fixture 3 $157 $157 38 Disconnect and remove plumbing fixture 2 $105 $105 39 Remove finished floor and sub floor. 40 $170 $170 40 Remove wall/ceiling(partial)finishes to expose framing. 311 $824 $824 41 07 Wall Frame 2 $255 $255 42 Install blocking in walls for fixtures,cabinets or accessories 1 $118 $118 43 Install fire stopping in stud wall cavities 1 $138 $138 44 12 Doors&Trim. 4 $2,027 $2,027 4530x78/80"interior door opening in load bearing wall ,Y $471 $471 46 Furnish and install 24x78/80 interior door,frame,trim,handset,painted ' $484 $484 @ Copyright TMK Remodeling,LLC All Rights Reserved Page-4 Unlawful to distribute without permission OP ID:M CERTIFICATE OF LIABILITY INSURANCEDATE(MM/DDNY" THIS CERTIFICATE I12016 S ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER . THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($), 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). PRODUCERNTACT Sogreve&Hall Insur.Assoc.Inc NAME: 306 North Main St. PHONE FAX Andover, MA 01810o E A!C No Lawrence J.Hall E ORE9s; cusTo ER rr:TMKRE-1 INSURED INSURERS AFFORDING COVERApR 214 Sutton Hill Rd E NAIC Remodeling LLC INSURER A:Arbella Protection Ins.Co. 41360 214 AEIC North Andover. MA 01845 INSURER B: 11104 INSURER C: INSURER 13; INSURER F; 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, R R TYPE OF INSURANCE POLICPOLICY NUMBER M DDYtYEYYY M D✓YP LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,001 A X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurroS 100,00( CLAIMS-MADE a OCCUR MED EXP(Any one person) $ 5,001 PERSONAL&ADV INJURY $ 1,000,OOC 8520037133 0311812016 03/18!2017 GENERAL AGGREGATE $ 2,000,OOC OEN'L AGGREGATE LIMIT APPLIES PER7' PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY PRO- LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea 2addenl) ALL OWNED AUTOS BODILY INJURY(Per person) $ SCHEDULED AUTOS BODILY INJURY(Per scoidant) $ HIRED AUTOS PROPERTY DAMAGE $ (PER ACCIDENT) NON-OWNEDAUTOS UMBRELLA LIAR OCCUR EACH OCCURRENCE $ BKCE99 LIAR CLAIMS-MADE AGGREGATE $ DEDUCTIBLE S RETENTION $ WORKERS COMPENSATION S AND EMPLOYERS'UA131UTY _ WC STATU- OTH- ANY B OFFICER/MEMBER/EXCLU gb7ECUFA TNE Y� N/A WCC-500-5011$72 04/01/2016 04/01/2017 E.L.EACHACCIDENT S S(IO,O(1. (Mandatory In NH) If yea,describe under E.L.DISEASE-EA EMPLOYEE $ 500,000 DE66RIPTION OF OPERATIONS below E.L.DISEASE-POLICY L'MIT $ 800,000 DE59RIPTION OF OPERATIONS/LOCATIONS I VEHICLE$ (Attach ACORD 1011 Additional Ramarhs Schedule,If more space to required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE.CANCELLED BEFORE Town of North Andover THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 120 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. North Andover, MA 01845 AUTHORIZED REPRESENTATIVE C 1888-2009 ACORD CORPORATION, All rights reserved. ACORD 25(2009109) The ACORD name and logo are registered marks of ACORD i �,�/ ,[/J9/Ic%[IJB��JI /C r(677177707f/CCfIII�L� 6/ Office of Consumer Affairs&Business Regulation _- HOME IMPROVEMENT CONTRACTOR e• . Registration: DBA Type: yp Expiration-:—A/0018_ TMK'RE'MODELING i THEODORE KELLEY 214 SUTTON HILL RD.:. >-Q NORTH ANDOVER,MA 01845 Undersecretary I Massachusetts Department of Public Safety Board of.Building Regulations and Standards License: CS-105086 . Construction Supervisor THEODORE M KELLEY ,� 214 SUTTON HILL RDoU NORTH ANDOVER M r,,"[ZZ l—r Expiration: Commissioner 10/08/2017