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HomeMy WebLinkAboutMiscellaneous - 141 AUTRAN AVENUE 4/30/2018 141 AUTRAN AVENUE U-L _ 2101022.0-0011-0000.L f Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost $ 38,975.00 m $ - $ 467.70 Plumbing Fee $ 58.46 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 58.46 Total fees collected $ 684.63 141 Autran Avenue 284-2017 on 9/15/2016 deck to three season room Plans SubmitIO U, Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ [Public OF SEWERAGE DTSP S Sewer Tanning/Massage/Sody Art ❑ Si't' ing Pools❑ Tobacco Sales ❑ Food Packaging/Sales ❑(septic tank,etc. ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF e U FORM PLANNING & DEVELOPMENT Reviewed On S/11 /1& Signature_ COMMENTS A11A CONSERVATION Reviewed on i Signature i G COMMENTS - S U,�cA HEALTH Reviewed on Si nature COMMENTS N u I Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water& Sewer Connection/signature& pate Driveway Permit DPW Town Engineer: Signature: - Located 384 Osgood Street FIRE DEPARTMENT cS,Te I Dempster Lo"c-a'ted at 1x24 Main S reett no Fire Department sign t r%date i k COMMENTS , 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 RITES and DATA— (For department use) 4-21) w 4y; ell ❑ Notified for pickup Call Email Date Time Contact Name Doc.Building Permit Revised 2014 Vincent Brandolini �uS� 6c�cb( Haverhill,Ma 01830 � raL (978)265-6936 ° BrandoliniConstru ction ,yahoo.com WWW.BrandoliniConstruction.com CSL#107805 HIC#157949 CONTRACT I/We the owner(s)of the premises mentioned below,hereby contract with and authorize Brandolini Construction to furnish all the necessary material,labor and workmanship to install,construct and place the improvements according to the following specifications terms and conditions on premises below described with reference to which I/We warrant the I/We are the record holder(s)of title: FOR: Audrey Martino Job Address: 141 Autran Ave. (508)265-3541 North Andover,MA Scope of Work: • Remove existing deck from side of house • Frame new three season room approximately 12'x 12' • Frame deck off three season room at same level also approximately 12' x 12' • Install new electrical on ceiling&walls of room • Install Harvey double hung windows on three walls of three season room&fix units inside top of gable as discussed • Install door to outside(to discuss with customer what type) • Install storm door over exterior door entry • Install insulation in walls&ceiling to meet code • Install spray foam insulation under floor of roof • Install sheet rock on walls and tongue and grove pine on ceiling of three season room • Install pine trim around windows&doors. • Install new tile floor(allowance of$4.25 per sq.foot, if customer picks higher end tile additional charges will be applied) Roofing: • Install 6ft of ice&water shield on entire perimeter(sides)of roof,3' up all rakes,and valleys • Install Ice&water shield around any roof transitions or roof penetrations • Install breathable synthetic underlayment on remainder of roof. • Install new 8-inch white aluminum drip edge around entire perimeter of roof,then apply 6"strip of ice& water shield over exposed edge of drip edge. • Install new pipe flanges around any vent pipes. • Install new Architectural Tamko roof shingle(homeowner to choose color)nailed to roof surface in hurricane nailing pattern. • Check ridge vent for proper ventilation and cut as necessary,&install a new shingle ridge vent. • Clean job site on daily basis and run magnet around entire house to minimize nails left behind from roof, � removal. • Install new siding(to match existing the best possible)and fie into house • Install Tamko decking on decks • Install white composite painted rails around deck • Enclose two sides of deck&3-season room using solid azek panels and PVC trim,leaving back side open for access&storage • All footings will be installed as needed to meet code. f EXPRESS WARRANTY IS IN LIEU OF AND EXCLUDES ALL OTHER WARRANTIES,WHETHER EXPRESSED IMPLIED OR STATUTORY,INCLUDING IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS OR A PARTICULAR PURPOSE.This limited warranty does not cover damages relating to(a)accident,misuse,abuse,neglect or normal wear and tear;(b)failure to use or maintain the product in accordance with manufacturers instructions,,and(c)alteration,repair or attempted repair by anyone other than contractor or its authorized representative.You shall be solely responsible for the correctness of the plans and specifications and shall release and hold harmless contractor from any damages resulting from improper,inadequate or vague intormation supplied by you. Contractor does not take on any obligations to inspect or evaluate the work other parties in any manner or aspect This warranty is not transferable. 3. INSURANCE.Contractor shall maintain workers'compensation(employer liability),as required by law,and general liability insurance while performing the work Contractor reserves the right to be self-insured to the extent allowed by applicable law.Contractor does not agree to name any other person or entities as additional insureds. 4. LIMITATION OF REMEDIES.Your sole and exclusive remedy against contractor for any and all claims for damages arising out of or alleged to have arisen out of the work will be limited to the repair or replacement by contractor,at contractor's option,of any nonconforming work or to the issuance of a credit for such nonconforming work in accordance with these terms and conditions provided contractor is given a reasonable opportunity to inspect the work and confirms such nonconformity.This exclusive remedy shall not be deemed to have failed its essential purpose so long as contractor is willing and able to repair or replace the nonconforming work,and in any event contractor's maximum liability for any damages shall be limited to the total amount paid to contractor for the work under this agreement.This limitation of remedies clause shall apply to the parties to this agreement as well as to the current owner(s)of the project and its their respective successors and assigns.if you receive a claim for damages by any owner arising out of or al leged to have arisen out of work,you agree to give written notice to contractor of the claim and provide contractor and opportunity to inspect the alleged damages within 30 days after contractor receipt of notice. If you fail to give the required notice and or fail to pillow contractor an opportunity to inspect the alleged damages within 30 days,you hereby waive any and all rights for damages and or correction of work against contractor.This limitation of remedies may be pleaded as a complete bar to any action in violation of this clause. S. LIMITATIONS ON ACTIONS AND LIABILITY.All claims and or lawsuits including but not limited to claims or lawsuits for indemnity and or contribution against contractor arising under this agreement must be made within 13 months from date of completion of installation.CONTRACTOR WILL NOT BE LIABLE FOR ANY LOSS,DAMAGE OR INJURY RESULTINGFROM DELAY IN DELIVERY OF THE PRODUCTS OR FOR ANY FAILURE TO PERFORM THA IS DUE TO CIRCUMSTANCES BEYOND ITS CONTROL CONTRACTOR DISCLAIMS ALL LIABILITY FOR ANY AND ALL DAMAGE WHICH MIGHT BE SUSTAINED BY ANY PERSON WHO MAY BE ALLERGIC TO OR AFFECTED BY THE EMANATION OF PARTICLES FROM CERTAIN TYPES OF INSULATION.THE MAXIMUM LIABILITY,IF ANY,OF CONTRACTOR FOR ALL DAMAGES,INCLUDING WITHOUT LIMITATION CONTRACT DAMAGES AND DAMAGES FOR INJURIES TO PERSONS OR PROPERTY,WHETHER ARISING FROM CONTRACTOR'S BREACH OF THIS AGREEMENT,BREACH OF WARRANTY,NEGLIGENCE,STRICT LIABILITY OR OTHER TORT WITH RESPECT TO THE PRODUCT,OR ANY SERVICES IN CONNECTION WITH THE PRODUCTS IS LIMITED TO AN AMOUNT NOT TO EXCEED THE CONTRACT PRICE. IN NO EVENT SHALL CONTRACTOR BE LIABLE FOR ANY INCIDENTAL,CONSEQUENTIL,LIQUIDATED,OR SPECIAL DAMGES,INCLUDING WITHOUT LIMITATION, LOST REVENUES AND PROFITS,ATTORNEYS FEES AND OR COSTS EVEN IF IT HAS BEEN ADVISED OF THE POSSIBILITY OF THAT ANY OTHER CONTRACTUAL REMEDY FAILS OF ITS ESSENTIAL PURPOSE. 6. PRICES,TERMS AND SHIPMENT.No cash discounts,back charges,set off or counterclaims are allowed unless specified by contractor. In addition to the prices specified,you agree to pay any federal,state or local excise,use,occupational,or similar tax now,in force or to be enacted in the future,assessed against contractor or you by reason of this transaction. No retention is permitted unless contractor agrees otherwise in writing.Any past due payment will be,at contractor's option,subjectto interest at 2%per month (20%per annum)to the extent permitted by law.You agree to receive(or permit contractor to receive)near the work site,any materials needed to complete the work You agree to protect such materials from damage or loss and provide contractor,free of charge,with reasonable use of light,heat,water,power,storage space and use of available elevators and hoists as needed.Title to all materials under this agreement shall not transfer to you until contractor receives payment in full.Contractor may charge you a fee and its actual expense if the job site is not ready for work on date you specify. 7. FORCE MAJEURE.Contractor shall not be liable for any delay,failures,or defaults in performance of this agreement or otherwise,in whole or in part,caused by the occurrence of any contingency beyond the control either of contractor or of suppliers to the contractor.Such contingencies include but are not limited to failure or delay in transportation, acts of any government or any agency or subdivision thereof,judicial action,labor disputes,fire accident,ads of nature,severe weather,product allocation or shortages,labor shortages,fuel shortages,raw material shortages,machinery or technical failure,or work that can't be completed because of another contractor covering the pertinent portion of the building. If any contingency occurs,contractor may allocate production,deliveries,and performance of work among its customers or substitute substantially similar materials,in its sole discretion,without liability for doing so. B. CONFIDENTIALITY.if you visit contractors premises or you otherwise receive any proprietary or confidential information from contractor,you shall retain such information as confidential and not use or disclose it to any third party without contractors written consent 9. CREDIT APPROVAL Shipment and delivery of goods and performance of work shall at all times be subject to the approval of contractors credit department and contractor may at any time decline to make any shipment or delivery or perform any work except upon receipt of payment or upon terms and conditions or security satisfactory to contractor. By signing this agreement,you authorize contractor to check your credit and references. 10. CANCELLATION.This agreement,or any partof it,may only be cancelled with contractors written approval. In the event of cancellation of this agreement,any part hereof,you shall park.(a)the contract price of all completed items;(b)that portion of the contract price that is equal to the degree of completion of products or work in process,effective on the date contractor receives notice of cancellation,(c)the cost of any material and supplies which contractor shall have purchased to perform and which cannot be readily resold or used for other or similar purposes;(d)a restocking fee;and(e)any expenses incurred by contractor(including legal fees and judgments)as a result of the cancellation of subcontractors or purchases related to this agreement. 11. DEFAULT.You may terminate this agreement for contractors default,wholly or in part,by giving contractor written notice of termirwtion as follows.You may give written notice of termination only if contractor has received a written notice from you specifying such default,the default is not excisable under any provision hereof,and the default has not been remedied within thirty(30)days(or such longer period as maybe reasonable under the circumstances)after contractors receipt of the notice of default. Del"livery of nonconforming products or work by contractor shall give you the rights set forth in paragraph 4 hereof but shall not be deemed a default for purposes of termination. In the event of termination for default,you shall be relieved of the obligation to pay for work not performed by contractor prior to the effective date of such termination.A default on contractors part shall not subject contractor to liability,through payment by contractor,set off or otherwise for any other damages,whether direct,consequential or incidental, and whether sought under theories of contract or tort.If customer breaches this agreement the contractor is entitled to reasonable attorneys'fees and litigation expenses as determined by a"court of Law". 12. ASSIGNMENT.You may not assign this agreement or any daim against contractor relating to this agreement 13. GOVERNING LAW.This agreement shall be construed,interpreted and the rights of the parties determined in accordance with the laws of the state of contractors addressing first listed on the front of this agreement 14. DISPUTES AND MANDATORY MEDIATION.In the event that a dispute arises over the reasonableness of or entitlement to fees charged by contractor,the prevailing party will be entitled to reasonable attorneys fees and costs. In all other disputes of any nature,each party shall pay its own fees and costs.Except as required to protect confidential information and to obtain preliminary injunctive relief to prevent irreparable harm,you and the contractor agree that prior to the initiation of any legal action the parties will engage in facilitative mediation of any and all disputes in anyway related to this agreement If the parties_camiot agree upon a facilitative mediator Within 30 days of when the dispute arose,one will be selected pursuant to the commercial mediation rules of the Americanarbit_ration association. Each party will share equally the fees of the facilitative mediator and costs of the mediation. 1S. Three-day cancellation rights under section forty-eight of chapter ninety-three,section fourteen of chapter two-hundred and fifty-five,D or section ten of chapter one hundred and forty D as may be applicable. 16. SEVERABILITY.If any provision of this agreement is not enforced,that provision shall be effective only to the extent permitted by law and all other provisions of the agreement shall remain. 17. ENTIRE AGREEMENT.This instrument contains the entire agreement of the parties relating to the subject matter hereof and may only be waived,changed,modified,extended or discharged orally by a writing signed by the party against whom enforced any such waiver,change,mortification,extension or discharge is sought the terms and conditions of this agreement supersede any agreement to which it is attached. 18. INDEMNITY.Each of the parties to this agreement agrees to defend and indemnity one another from any and all claims,actions and or lawsuits caused by the party's negligent ads or omissions.This indemnity clause and the obligations created herein shall control and take priority over any contrary indemnity agreement entered into prior to this agreement Furthermore,this indemnity clause and the obligations created herein shall control and take priority over any contrary indemnity agreement entered into subsequent to this agreement unless the subsequent agreement specifically refers to this Indemnity clause and declares it null and void. I o, i lQ f i Q I f I k.t < Aditf � v r i ! ell i j i N Z I C i t I �X i I i E ! ,�A6C 1 fl)A 'or-, 3 l I j�,2 JX � c� SHtA ',G) 1 I • � f ! i_ aK1�� SPA AJ rru}4- �v 4 i ,NA —1-F /, �/A 6_S N Icl 4rlosi�� Sozotj: IA GG 1 , I ? � I ell�l 51 ! --------- Q i i 11 } Or / --..... i fl t ti \J Ad 01 x l ( # + P \ k a 1 y , i, u , I 5 2 S , f . 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S � l t, 1 i� 7 { i � 1 1 1 1 � .._...- 1 5 ! ; I I t I 1 i i S : f � i 1 4 g r r ' i - t j } i 't ell 4. .,4 —� Y F f Gree � r 1 4 ii d •ice;„. i s b {FttCC i IF}{r{ i 2 1 1 r f� r k 1 t i A k t North Andover MIMAP May 2, 2016 O Y �€ t M AU'tran etil i MVPC Bo Interstates Horizontal Datum:MA Slateplane Coordinate System,Datum NAD83, —SR Meters Data Sources:The data for this map was produced by Merrimack Valley Planning Commission(MVPC)using data provided by the Town of Roads ©, cm North Andover.Additional data provided by the Executive Office of t Easements 3,1i l�sf` rhe`®A Environmental Affairs/MassGIS.The information depicted on this map is CJ Parcels ' a for planning purposes only.It may not be adequate for legal boundary definition or regulatory interpretation.THE TOWN OF NORTH ANDOVER MAKES NO WARRANTIES,EXPRESSED OR IMPLIED,CONCERNING i F THE ACCURACY,COMPLETENESS,RELIABILITY,OR SUITABILITY it c # OF THESE DATA.THE TOWN OF NORTH ANDOVER DOES NOT o E ASSUME ANY LIABILITY ASSOCIATED WITH THE USE OR MISUSE OF THIS INFORMATION 1"=44ft North Andover MIMAP May 2, 2016 ' �� ST ©mar=oa o �s Kv 82' 0,45 � 0® 22:0=0050„1 i6-0,AQA'MS)A1J,__ i 1D45F=E)O } _,.. 102�ADAMS AVE 32E_,}ADEiM_SdAVE� r 0226�06F 3'24)AUAMS;,AV V �` 3SiAl!'�F'RAi SRV 61220-0E122�. y 045�f3-610C}6j `.022:0-`003 , 1t-, N339tAtITRPiNjAVE R k �• �AVEr ,` 70 022 057a , ^— ,Autrani Yeu 7fl� J27i1Nt3aQ}LN; A4r5:Q�-�EF26 `�Lo !122,:0=008 6145 077L7/3� 1381AU�TFtiAhi YEj �,d� � 140�AU1'RANIAVE� 4 0336E O61t_17� 3,376Q V 03 MVPC Bo Zoning Overlay Zoning 93 Municipal Boundary O Adult Entertainment Distric .-Busine s 7 Distri E3Machine Shop Village Ove C Busine s 2 Districtct Horizontal Datum:MA Stateplane Coordinate System,Datum NAD83, —Rail Line +f$Watershed Protection Dist G Busine s 3 District Meters Data Sources:The data for this map was produced by Merrimack Interstates 0 Historic Mill Area i6 Busine s 4 District K��� Valley Planning Commission(MVPC)using data provided by the Town of _I ®1 Medical Marijuana 6 Genera,Business District .CTE gtw[m ' North Andover.Additional data provided by the Executive Office of —SR 01 Downtown Overlay District C PlanneCommercial Dev a*� '•:�Q� Environmental Affairs/MassGIS.The Information depicted on this map is 13Historic District b Corrido Development Dist 3 L for planning purposes only.It may not be adequate for legal boundary Roads U Osgood Smart Growth(40 0 Corrido Development Dist Q R definition or regulatory interpretation.THE TOWN OF NORTH ANDOVER 17.Easements 0 Hydrographic Features n Corrido Development Dist t 9 MAKES NO WARRANTIES,EXPRESSED OR IMPLIED,CONCERNING Industri I 1 District * THE ACCURACY,COMPLETENESS,RELIABILITY,OR SUITABILITY ED Parcels - Streams Industri 12 District 4L i . OF THESE DATA.THE TOWN OF NORTH ANDOVER DOES NOT Wetlands >D Industri 13 District �* _ e ASSUME ANY LIABILITY ASSOCIATED WITH THE USE OR MISUSE OF II'Industri I S District THIS INFORMATION #Exempt Lands Reside ce 1 District �►� _ Reside ce 2 District .45� Gt Reside ce 3 District deice 4 District 1"=44 ft e ce 5 District + e ce 6 District ,a a esidential District The Commonwealth of Massa chusetts Department oflndustrialAccidents 1 Congress Street,Suite 100 Boston,MA 02114-2017 www mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legib Name (Business/Organization/Individual): Address: �l1y�Cr1C pi 1 - City/State/Zip: r-J�NLn, /l.)/ d Phone Are you an employer?Check the appropriate box: Type of project(required): 104 am.a.employer with__!1___employces(full and/or part-time).* 7, ❑New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in 8. d8�Remo deliug any capacity.[No workers'comp.insurance required.] 3_Q I am a homeowner doing all work myself.[No workers'compAnsurance required.]t 9. ❑Demolition 10 Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions proprietors with no employees. 12. Plumbing repairs or additions 5. I am a general contractor and I have hired the sub-contractors listed on the attached sheet. ❑ 13. Roof repairs • These sub-contractors have employees and have workers'comp.insurance.$ 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.❑Other 152,§1(4),and we have no.employees.[No workers'comp.insurance required.] *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 then 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 state whether or not those entities have employees. If the sub-contractors have employees,'they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees.' Below is thepolicy and job site information. Insurance Company Name:_'�-� &, N- c� t J IV)su- L a 1 a Policy#or Self-ins.Lie.#:�n�lt1�LLf) ,, P� b L f S Expiration Date: �a-"9_7- f Job Site Address: ItA4 City/State/Zip: ' Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. Ido hereby ce7,o,, - SiRnature: under the p ins and enalties ofp r* ry that the information provided above is true and correct. Date: '! Phone#: Z _ Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# i Issuing Authority(circle one): ; 1.Board of Health 2.Building Department 3.City/'I'own 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 6f 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 joint 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 of public 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 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 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 burn leaves etc.)said person is NOT required to complete this affidavit. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston,MA 02114-2017 Tel. # 617-727-4900 ext. 7406 or 1-877-MASSAFE Fax#617-727-7749 Revised 02-23-15 www.mass.gov/dia 09-07-'16 10:38 FROM- 9785572130 T-305 P0003/0003 F-299 AC<>RV CERTIFICATE OF LIABILITY INSURANCE DATE / 6YI) i 09//0707/2201016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the Policy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER COAME:NTACT KdSta McMahon N MICHAUD,ROWE AND RUSCAK INSURANCE ASSOCIATES, INC, PHONE 978 688-8829 aC Ne ADORESS: kmcmahon@mrrinsurance,com P.O.BOX 188 INSURER AFFORDING COVERAGE NAIC# NORTH ANDOVER MA 01845 INSURER A: ACE AMERICAN INSURANCE CO 22667 MSUREO INSURER B: BRANDOLINI CONSTRUCTION LLC INSURER C: INSURER 0; 6 PROVIDENCE HILL ROAD INSURER E: ATKINSON NH 03811 1 INSURER F; COVERAGES CERTIFICATE NUMBER: 82800 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. INTR TYPE OF INSURANCE ADDL SUER POLICY NUMBER MM10p EFF POLICY ISP uMrrs COMMERCIAL GENERALUABILITY EACH OCCURRENCE $ DAMGr=1u €N i tU- CLAIMS-MADE 17 OCCUR PREMISES Ea occurrence)8 MED EXP(Anyone person) S NIA PERSONAL S ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY !ECT � PRO- F LOC PRODUCTS-COMP/OP AGG $ OTHER $ AUTOMOBO.EUABILITY COMBINEDSINGLEUMIT $ E tcid¢n ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS NSA BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE $ HIREDAUTOS AUTOS P eeid rrt $ UMBRlLLALIAB OCCUR EACH OCCURRENCE i $ EXCESS UAB 11 CLAIMS-MADE N/A AGGREGATE � S DED I RETEN'noN$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY X STATUTE E YIN E.LEACHACCIDENT i $ 100,000 ANYPROPRIETOR/PARTN ER/EXEC uTIVE A OFFICER/MEMBEREXCLUDED? NIA N/A NIA 6S62UB4511P55516 03/27/2016 03/27/2017 (Mandatory in NH) E.L.DISEASE-EA EMPL6YEE S 100,000 li Yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ $00,000 NIA DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,maybe aCached if more space is required) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance Shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance)- The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.govAwd/workers-compensation/investigations/, CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELMERED IN Town of North Andover ACCORDANCE WITH THE POLICY PROVISIONS. 1600 osgood street AUTHOR=REPRESENTATIVE North Andover MA 01845 "y 1/ Daniel M.Cr y,CPCU,Vice President—Residual Market—WCRIBMA ®1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD 09-07-'16 10:38 FROM- 9785572130 T-305 P0002/0003 F-299 .4corrotl CERTIFICATE OF LIABILITY INSURANCE DATE(MM/°D/YYYY) `••+� 09/07/2016 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 AFFORDEb BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsemen s. I PRODUCER CONTACT Michaud,Rowe&Ruscak Michaud,Rowe And Ruscak Ins. PHONE 978 688 8829 FAX: P.O.Box 188 Arc No A/c$a2l:978 557 2130 North Andover,MA 01845 E-MAIL s: Michaud,Rowe 8 Ruscak AD INSURE 3 AFFORDING COVERAGE NAIC F INSURER A.River ort Insurance Co INSURED Brandolini Construction LLC INSURER 13:Hanover Insurance Company j 22292 Vincent Brandolini 6 Providence Hill Road INSURER C:Essex Insurance Company ! 39020 Atkinson, NH 03811 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 ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE INAD WVD POLICY NUMUFRPOLICY EFF MM/D Y EXF LIMITS C X COMMERCIAL GENERAL LIABILITY (MWDEACN OCCURRENCE I $ 1,000,00 CLAIMS-MADE Ln J OCCUR 3ED4968 02/29/2016 02/28/2017 PREMISES ES 000urrencol $ 50.00 MED EXP(Any one pereon i $ 1,00 PERSONAL&ADV INJURY $ 1,000,00 GENL AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE I $ 2,000,00 X POLICY E LOC PRODUCTS-COMP/OP ACG $ 1,000,00 OTHER: AUTOMOBILE LIABILITY CEOMBINED SINGLE LIMI 1 $ 1,000,000 S X ANY AUTO AWNA81987400 01/05/2016 01/05/2017 BODILY INJURY(Per person) $ ALLOWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED P@OaERTY DAMAGE $ $ UMBRELLA LU1B OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS-MADE AGGREGATE' � g DED I I RETENTIONS $ WORKERS COMPENSATION AND,EMPLOYERS'LIABILITY X STA IJTE ER! A ANY PROPRIETOR/PARTNER/EXECUTIVE Y/Y❑N N/A C-28-83-007025-00 01/05/2016 01/05/2017 E L EACH ACCIDENT i 100,00 OFF(CERIMEMBER EXCLUDED? (Mandatory In NH) NH WC E.L.DISEASE-EA EMPLOYEE $ 100,00 11 yae,de.-be uncle/ DESCRIPTION PF OPERATIONS below E.L DISEASE-POLICY LIMB $ S00,00 I I DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional RemaAta Schedule,may be attached If more Space id required) i y 1 CERTIFICATE HOLDER CANCELLATION I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of North Andover THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 1600 Osgood Street North Andover, MA 01845 AUTHORIZED REPRESENTATIVE ®1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD I ���� „rrru r-rrm�u�C�r/ 'flir ac�rr r(/3 License or registration valid for individul use only Office of Consumer Affairs&Business Regulation before the expiration date. If found return to: '-AOME IMPROVEMENT CONTRACTOR Type Office of Consumer Affairs and Business Regulation M1{tegistration 157949 10 Park Plaza-Suite 517 MY Expiration: 1171612017 DBA Boston,MA 02116 BRANDOLINI CONSTRUCTION VINCENT 13RANDOL1141 109 GILE ST �"" — ot valid without signature HAVERHILL,MA 01830 Undersecretary e5��:Massachusetts --Dep artment of Public Safety } •�' $tx3'1 Q BpikiingtFRY lafins and StanElrris' _ .. Conc3rtrtAsn�S �trtito►•- _ License: CS407805 VINCENT BRAND-OLINI 109 GILE STREET- Haverhill TREETHaverhill MA 01830 d �..G...�J.6 • „ ` Expiration Commissioner 02/05/2018 1 ROBERT McCL'CAN RONALD � RONALD HEBERT 138 ' *0 WF 6 13 WF 7 ; - \ 132. 0' 1 IPROPOSED 14' X , F 18 WF a (PROPOSED ER ION CONTROL (TY ) SUPPORT POSTS BEYO D D50'DECK o / 142 0_ / As EXISTING WOOD 10' X 3.5' DECK 9 ENCLOSE FOR 3 SEASIN ROOM WF 17 / i� 1.3' 21.3' 25.0' O / Iq O 2 STORY W.F.D. Z � O 1 W 10 M U T L UNIT R NSF DANIEL JAQUES #135 WF �� ,y�' # 141 # 139 TERRY COOK #133 WF 6 CP SUS SUSAN OLSON `` I 144 I WF 15 I w 1 12 N 10 I �' 24" HDPE DRAIN OUT INV. 136.80 WF 1 C.B. EOP RIM 1 .3 X DM R 140.7 / 5 BUFFE�,� x EOP � I i �l TR AN so, (PUBLIC 50') AVENUE BUFFER — N/F SVETLANA GRIMAYLO #140 GERALD CASALETTO #138 NOTES: LEGEND: 1. EROSION CONTROL TO BE V DIAM. "SILT SOCK" STAKED IN 0 IRON PIN OR PIPE PLACE AS PER PLAN, PRIOR TO START OF WORK. 2. EROSION COTROL SHALL DEFINE THE LIMIT OF WORK. NO WORK 0 C.B. CATCH BASIN BEYOND THE BARRIER. WF® WETLAND FLAG 3. ALL DISTURBED EARTH SHALL BE GRADED , LOAMED, SEEDED EOP EDGE OF PVMT. AND MULCHED AS SOON AS POSSIBLE 4. EROSION CONTROL TO REMAIN IN PLACE UNTIL APPROVED Q DMH DRAIN MANHOLE ESTABLISHMENT OF VEGETATION. ---— WETLAND AND BUFFER 5. INTERMITTANT SWALE AND WETLAND FLAGGED BY DR. GREGG EXIST 2' CONTOUR MOORE, ZODIAK ENVIRONMENTAL MAY 2016 — — 138 x EROSION CONTROL PLOT PLAN OF LAND AT 141 AUTRAN AVENUE I CERTIFY THAT THIS LOT IS NOT IN THE F.E.M.A. FLOOD ZONE. NORTH ANDOVER, MA. AND THE BUILDINGS ARE LOCATED AS SHOWN. MAY 31, 2016 SCALE: 1" = 20' AS DRAWN FOR: � �"OF,�q� � AUDREY MARTINO DEED BOOK 4304 PAGE 14 �o�' ROBERT ALAN- ��, 141 AUTRAN AVENUE AREA 0.24 AC. U MASYS NORTH ANDOVER, MA. PLAN #406, E.C.N.R.D. q No.291740 REV. SEPT. 13; 2016 ASSESSOR PARCEL # 210/022.0-0011-OOOO.L S ZONE: RES. 4 8svedrW. 01830 R BERT A. MASYS, ff.E. 1>�t(47i)!?Zdlti BA7C�97s)aT�Jlt3 . I �I I I