HomeMy WebLinkAboutMiscellaneous - 5 WALKER ROAD 4/30/2018 (5)Date a��sf°.C7.
�'. �° •otic TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
,SSACNUS�
f
This certifies that ... �. �`. ��.. `�..... .?°�.. % ........... . .
has permission to perform .... y. .......................: .
plumbing in the buildings of .�?.�14ic «. L r C c 4
/ / f z 41 L.
at ................... . �................ North Andover, Mass.
Fee. 3�.�`�.Lic.No.. ..........`da..!,.......
1 p F
PLUMBING INSPECTOR
Check # ) C S �
7994
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
(Type or print)
NORTH DOVER, MASSACHUSETTS
Building Location ` /S A
of
New 0 Renovation Replacement 'rTI—A"
Date
Permit 41 g
Amount
Plans Submitted yes 11 No ❑
-- -W r-1
Installing.Con
Address
Olin.
Name of Licensed Plumber! / ( P,
Insurance Coverage• Indicate m
Check one: Certificate
I/ Corp'
Partner.
Firm/Co.
V type of insurance coverage by checking the appropriate box:
Liability insurance policy El Other type of indent»
tY � Bond ❑
Insurance Waiver. I, the undersigned, have been made aware that the licensee of this application does not have any one of the above
three insurance
Signature Owner ❑ ❑
Agent
I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the
best of my knowledge and that all plumbing work and installations performed under Permit Issued for this the will be in
compliance with all pertinent provisions of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws,
B y:
tgnawre on Lrcensea um er
Title Type. of Plumbing License
City/Town l a v
LZense umoer Mases--umeyman ❑
APPROVED ro�cE usE orrt.r (I �c
No 2393
NORTH
A
F A
Date .....�p. f��•
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
Thiscertifies that ....................................................................................
has permission to perform ... v R `�1. �C'a� wv2 �'C
......'). ,............. ........,t.............
Q�
wiring m the building of .....1..'.!.. P ..��...........................
...................
at ........ 1. ......—.......\,.r 1�t,..�. .............. Q........� North A�ndov ,Mass.
L
Fee.. S I� Lic.No../ U.!<<j..... :�:?...Y....: .............
//,, / ELEIN
CTRICAL SPECTOR
Check # V V J/
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
THECOAMON►'rEUHOFli%li,MCUUMM Office Use only 3 9 3
DF.FI�NTOFPUBIlCSAFEfY Permit No.
BOARD OFFREPREVEMONREGUL47YOAS527C M12 -J
Occupancy & Fees Checked
i
A -VI- LJCATTONFORTEtl<] IT TOPERFOI<M-hLECTRICAL WORK
ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE, 527 CMR 12:00 %
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION)
Town of North Andover
The undersigned applies for a permit to perform the electrical work described below
Location (Street &
Owner or Tenant
Owner's Address
Date (L/
To the Inspector of Wires:
AP PARCEL
Is this permit in conjunction
With a building permit: Yes �No (Check Appropriate Box)
Purpose of Building 1 eE �A V-,- 474 V ( � ` Utility Authorization No
Existing Service Amps_ / Volts Overhead F-1 Underground M No. of Meters
New Service Amps / Volts Overhead F7 Underground F7 No. of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work ek"Te qb,--to i
No. of Lighting Outlets
No. of Hot Tubs
No. of Transformers
Total
KVA
No. of Lighting Fixtures_ it
• 'mming Pool Above
Below
Generators
KVA
6��
'a �jground
ground
No. of Receptacle Outlets , r+
No. of Oil Burners
No. of Emergency Lighting Battery Units
No. of Switch Outlets
No. of Gas Bumcm
FIRE ALARMS _
No. of Zones
No. of Ranges
No. of Air Cond. Total
Tons
No. of Detection and
No. of Disposals
No. of Heat Total Total
Pumps
Tons
KW
Initiating Devices
No. of Sounding Devices
No. of Dishwashers
Space Area Heating KW
No. of Self Contained
Detection/Sounding Devices
LocalMunicipal
Other
No. of Dryers
Heating Devices KW
Cormcctions
No. of Water Heaters KW
No. of No. of
signs
Bailasis
No. IJydro Massage Tubs
No. of Motors
Total HP
OAR• WNSt LA P -"J 1saaae `PGCJ L -1)),\(! C%C t�--
. r: i a. n i . '•� a . .• • .•:r •.:.u.• • :r.... •. i� •.-i !P51 E.
I � ' • u :• 11 . • I'J' ' mac• •:a � 1 � I '�
ni.n.• /ar
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Alt. TdNTo
OWNER'SINSURAN(-tWAIVER;Iamaw&edrittrLimwdoesmthaaetheitmneo7,emWc t3stil bnbalegirivakriasrepmedbyMasadmg&Cxn-,MlI.aws
anddratmysigiahaecndwpmnitalplitabmwaiusthi m mw=i
(Please check one) Owner Agent F7
Telephone No. PERMIT FEE $
6ignature ot Uwner or Agent
�,
r
`'�
� r
�1S�
I
N° I j-62
Date. .........................
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies thatl" .........
-�- ....
has permission to perform ...r., - �.:.....:../. --� .............
wiring in the building of ...... .......................................
at ............................................... ................. , North Andover, Mass.
Fee? ................... Lic. N6!C?i fK.... .........................
-_.ELECTRICAL INSPECTOR
04/06/99 11:24 35.00 PAID
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
The Commonwealth of Massachusetts P,. nit No. Office Uw Onlc . C b z
,rte.
Department of Public Safety ocevo.�+c� a . ave blas
J J� 3/90 (k.ve t..r)lug; �—
BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12-00
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All Work to be performed In accordance with the Ma"achusetts Electrical Code. S27 CMR 12:00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date
City or Town of %.Jyer To the Ins—pe-ccorTof Wires: REG CPY_
The undersigned applies for a permit to perform the electrical work described below.
Location (S
Owner or Te
O.+ner's Address
Is this permit in con unction with building permit: Yes ElNo� (Check Appropriate Box)
Purpose of Building e�((�e%/%J
Utility Authorization N0.
Existing Service Asps / Volts Overhead ❑ Undgrd ❑ No. of Meters
New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters
Ngt>er of Feeders and Ampacity
)Location and Nature of Proposed Electrical Work
I
r4o. of Lighting Outlets
No. of Hot Tubs
Total
No. of Transformers KVA
No. of Lighting FixturesSwimming
Pool Above 11In- ❑
grnd. grnd.
Generators KVA
No. of Receptacle Outlets
No. of Oil Burners
No...of Emergency Lighting
Batte Units
No. of Switch Outlets
No. of Gas Burners
FIRE ALARMS No. of Zones
No. of Detection and
Initiating Devices
No. of Sounding Devices
g
No. ,of Self Contained
Detection/Sounding Devices
Local Municipal ❑Other
1:1Connection
No. o£ Ranges
g
Total
No. of Air Cond. tons
No. of Disposals
No. of Kent Total Total
P=Ds Tons KW
No. of Dishwashers
Space/Area Heating KW
No. of Dryers
Heating Devices KW
No. of Water Heaters KW
NoSi' sf Ballasts
UirinVoltage /1�_ .r,m
1�1�-/
No. Hydro Massage Tubs
No. of Motors Total HP
I
O-Lv-rR:
INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws
I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial
equivalent. YES E] NO C] I have submitted valid proof of same to this office. YES ❑ NO M
If you have checked YES, please indicate the type of coverage by checking the appropriate box.
INSURANCE BOND ❑ OTHER ❑ (Please Specify)
Estimated Value of Electrical Work S lExpiracion Date
Work to Start Inspection Date Requested: Rough Final
Signed under the penalties of perjury:
FIRM NAME_ r k_s N es �G � LIC. 141). C Is I y
Licensee /fit4rk J SYIl+tSie-r Signature 11 LIC. NO.
Address �S5 Wt',S+ $�}. S•e.�� �S �srr1,�l�ov► %yi e/ Bus Tel. No.qay SA -G,oyH3
Alt. Tel. No. .5 0,r- F'(.4-
OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the Insurance coverage or its sub-
stantial equivalent as required by Massachusetts General Laws, and that my signature on this is
ermit
application waives this requirement. Owner Agent (Please check one)
Telephone No. PERMIT FEE
Signature of Owner or Agent
BC; .44A
-ie -7
Date-.< .......... a. -
N2 4317
00-5 "- - " I
0 TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
This certifies that .......... ............
has permission to perform ... -!J• . . . . . . . . . . . . .
plumbing in the buildings of. . . . . . . . . . . . . . . . . . . . .
at .,'a... .,,e ................. .,,North Andover, Mass.
Fee. ?. Lie. No?-?," A
........ . 'V ............
PLUr'IN-6 INSPECTOR
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
(Print or Type)
0 A riJ ib 0 /lAk- , Mass. Date ac?dQPerm t # /=
Building Location Vv K3-� IR 'C� (� Owner's Name 44 f ►l AC�C, 1 el 461-1 /01U
-Z 1� N p JPS �Vj Type of Occupan i Ti r-'1 c_
New ❑ Renovation ❑ Replacement 12 Pla Submitted: Yes ❑ No C3FIX7URES
19
Installing Company Name �2 O 11E&r a - P(r r)'1 A -T A e Q Check one: Certificate
Aildress �-) (` Cli AC ti lY►r1 n) /' T J ❑ Corporation
IV E l N i' Fn) yY1 Ay 1 VL/ ❑ Partnership
Business Telephone _ -& F l - ,q -7 1 p' rm�Co
Name of Licensed Plumber _;4 f'r3 T h� SA rv►mto 1"r40c
INSURANCE COVERAGE:
I have a current I' bility insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142.
Yes No ❑
If you have checked Vis, please
/indicate the type coverage by checking the appropriate box.
A liability insurance policy ld" Other type of Indemnity ❑ Bond ❑
OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by
Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement.
Check one:
Owner ❑ Agent ❑
I hereby certify that all of the details and information 1 have submitted (or entered) in above application are true and accurate to the best of my
knowledge and that all plumbing work and installations w0ormed under the permit issu for this application will be in compliance with all
pertinent provisions of the Massachusetts State Plum ' g e and apter of the oral Laws.
Title . re of Licensed Plulluml
Type of License: Master % Journeyman ❑
City/Town ai
APPROVED OFFICE US ONL License Number 133 1
Y
•
•
Installing Company Name �2 O 11E&r a - P(r r)'1 A -T A e Q Check one: Certificate
Aildress �-) (` Cli AC ti lY►r1 n) /' T J ❑ Corporation
IV E l N i' Fn) yY1 Ay 1 VL/ ❑ Partnership
Business Telephone _ -& F l - ,q -7 1 p' rm�Co
Name of Licensed Plumber _;4 f'r3 T h� SA rv►mto 1"r40c
INSURANCE COVERAGE:
I have a current I' bility insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142.
Yes No ❑
If you have checked Vis, please
/indicate the type coverage by checking the appropriate box.
A liability insurance policy ld" Other type of Indemnity ❑ Bond ❑
OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by
Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement.
Check one:
Owner ❑ Agent ❑
I hereby certify that all of the details and information 1 have submitted (or entered) in above application are true and accurate to the best of my
knowledge and that all plumbing work and installations w0ormed under the permit issu for this application will be in compliance with all
pertinent provisions of the Massachusetts State Plum ' g e and apter of the oral Laws.
Title . re of Licensed Plulluml
Type of License: Master % Journeyman ❑
City/Town ai
APPROVED OFFICE US ONL License Number 133 1
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Check #,-? 1/57a 1
Date -Z/
TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
n
Building Insp`, Or
TOWN OF NORTH ANDOVER
BUILDING DEPARTMENT
APPLICATION TO CONSTRUCT REPAI RENOVATf OR DEMOLISH A ONE OR TWO FAMILY DWELLING
71 , �
BUILDING PERMIT NUMBER: � � DATE ISSUED: � ®/ � .�• D /�
SIGNATURE:
Building Commissionerfl for of Buildings Date
SECTION 1- SITE INFORMATION
1.1 Property Address: z
1.2 Assessors Map and Parcel Number:
1�� �
7�
lorm�
Map Number Parcel Number
1.3 Zoning Inf ation:
1.4 Property Dimensions:
Zoning Diaiic—t Proposed Use
Lot Areas Frontage ft
1.6 BUILDING SETBACKS ft
Front Yard Side Yard
Rear Yard
Required Provide Required Provided
Required Provided
1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information:
1.8 Sewerage Disposal System:
Public 0 Private ❑ Zone Outside Flood Zone ❑
Municipal 0 On Site Disposal System ❑
SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record
Name (Print) Address for Service:
G
Signature Telephone
2.2 Owner of Record:
Name Print Address for Service:
Signature Telephone
SECTION 3 - CONSTRUCTION SERVICES
3.1 Licensed Construction Supervisor:
Not Applicable ❑
i�ot�,liEy {' D�Lv b�PE�v..s'
Licensed ConstructA Supervisor:
01 7 fY
License Number
U R�Pv/��lc. di D, ,G./3/L1E�lL/4 i+Ip O/8G2
Address
/
Yeo
Expiration Date
Signa a Telephone
3.2 Registered Home Improvement Contractor
Not Applicable ❑
Amo Q�t,U 54 /T Ca
Company Name
13 Z72-
G �Ep�3,uc an �aLFap� A?t� o/ 8G7
Registration Number
Address
2 Z-
Expiration Date
Sin ure Telephone
9
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1-
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0
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0
SECTION 4 - WORKERS COMPENSATION (M.G.L. C 152 & 2506)
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result
in the denial of the issuance of the building permit.
Signed affidavit Attached Yes .......❑ No ....... ❑
SECTION 5 DescHi tion of Proposed Work check au
applicable)
New Construction ❑
Existing Building ❑
Repair(s) ❑
Alterations(s)
Addition ❑
Accessory Bldg. ❑
Demolition ❑
Other ❑ Specify
Brief Description of Proposed Work: ,
SECTION 6 - ESTIMATED CONSTRUCTION COSTS
Item
Estimated Cost (Dollar) to be
,Completed by permit applicant
USE UNLY '
1. Building(a)
(a) Building Permit Fee
Multiplier
2 Electrical
(b) Estimated Total Cost of
Construction
3 Plumbing
Building Permit fee (e) x (b)
Q3
4 Mechanical HVAC
5 Fire Protection
6 Total 1+2+3+4+5
Check Number
SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
1, as Owner/Authorized Agent of subject property
Hereby authorize to act on
My behalf, in all matters relative to work authorized by this building permit application.
Signature of Owner Date
SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION
�.,..I, UWV) l� l as OwNer./Authorized Agent of subject
property
Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge
and belief \ `1
Print Name
Q_—_ :> ILQ'X
Signature ofA /A ent Date
NO. OF STORIES SIZE
BASEMENT OR SLAB
SIZE OF FLOOR Tl vIBERS 1 2ND 3
SPAN
DIMENSIONS OF SILLS
DIMENSIONS OF POSTS
DIMENSIONS OF GIRDERS
HEIGHT OF FOUNDATION THICKNESS
SIZE OF FOOTING X
MATERIAL OF CHIMNEY
IS BUILDING ON SOLID OR FILLED LAND
IS BUILDING CONNECTED TO NATURAL GAS LINE
FORM U - LOT -RELEASE FORM
INSTRUCTIONF,: This form is used to verify that all necessary approvals/permits from-
Boards and Departments having jurisdiction have been obtained. This does not relieve
the applicant and/or landowner from compliance with any applicable or requirements.
�'AFPLICANT FILLS OUT THIS SECTION
APPLICANT
LOCATION: Assessor's Map' Number
SUEDIVISION
PHONE
PARCEL
LOT (S)
ST.NUMEER
OFi ICTAL USE ONLY _ I
COMMENDATIONS OF TOWN AGENTS: c9\3 _�� q P001 1 n.) bt t e 1cc Srt1u l
(i�ScRVATION ADMINISTRATOR DATE APPROVED �1
DATE REJECTED
COMMENTS
TOWN PLANNER DATE APPROVED
DATE REJECTED
COMMENTS
FOOD INSPECTOR -HEALTH DATEAPPROVED
DATE REJECTED
,,;5tIS'OTbC'1NSPECTOR-HEALTH DATE APPROVED
DATE REJECTED
COMMENTS
PUBLIC WORKS - SEWERIWATER CONNECTIONS
D RIVE'NAY PERMIT
FIRE DEPARTMENT
RECEIVED EY BUILDING ii ISPECTOR
Revised 919; im
DATE
03/23/2000 12:49 508-688-3400 MEADOWIEW PAIS 01
Mar 23 00 06:22a Gersarn 5766821426 p.l
ADOW VIEW CONDO
Burd of Trustees
VOM VIOY a)?I MINVIN. %'VIC),, 'f'nj. Tll109?: (gI&Y7RR-=O
rle� '-'t 3$WA1dSElt[iOiD
CAP I, CAUAW-N
Match 22, 2000
Town of North Andover
Buitdio.g Inspector
main Street
North Andover, MA 01.845
Re Meadow View C,ondowiniuuv/Pool
Dear Sir/ Madam:
Be advised haat the Board of Trustees of Meadow
View CondomWuzn has contraded vaith Andrews Ganite Company, inc, for the installation of a
•
replacement pool on the condominiulu grounds. Be advised furtber advised that Andrews Cmaite
Company, Inc. is authorawd to represent Meadow View Condomouium before livens ng and permitting
authorities relative to submission of flans and applications in the permitting process necessary to
complete said contraq..-if yoa have any questim or comments please contact Tom Roy, Property
Manager at the above address.
Sian
The Boatd Of Trustees
Meadow View Cvndomiuium
a
Ate &Mmowuwaa
Board of Building egulations
One Ashburton Ace Rm 1301
Boston, Ma 02108-1618
License: CONSTRUCTION SUPERVISOR LICENSE _ Birthdate: 03/14/1934
Number: CS 027999 Expires: 03/14/2002 Restricted To: 00
RODNEY P ANDREWS
1647 LOWELL RD
CONCORD, MA 01742
Tr. no: 17928
Keep top for receipt and change of address notification.
. • �... ��VrQOi'►✓i�20�21UE'GLUfG O�i.i�'GQQaI�ZUQP.�b j .
HOME IMPROVEMENT CONTRACTORS REGISTRATION I
s. Board of Building Regulations and Standards
One Ashburton Place _ Room 1301
Boston, Massachusetts 02108 }
•
___-
HOME IMPRQVEMENT ----------- CONTRACTOR
_ .
Re4istration:113772 Expiration 07/15/01._
Type`. _= PtVATE CORPORATION—
P.
-
-a HOME IMPROVEMENT CONTRACTOR A,
I Registration 113112
ANDREWS GUNITE CO. , INC. 1 Type - PRIVATE CORPORATION ,'
RODNEY P. ANDREWS Expiration'. .07/15101
6 REPUBLIC RD.
N BILL"ERICA : M 01862 ANDREWS &UNITE CO:, IN'C.
ONEY P'. ANDREWS
I ADMINISTRATOR .
6 REPUBLIC. RD
L . N BILLERICA MA 01862 1
�CERTFICATE`:F
CO ::: •: •.J Aw::: ;.. •:::: :•::::
:;: iii<:•%a>:a•����:�•r.:%ro.xSHh�w.�.lallirr•f:R•:•�•r:G:�i,�lr>i�3::,>:.a �'t.:ti�?ii:'•;:\�.+i>\;te�:;:;�f:::::
PRODUCER (603)893-9450 FAX (603)893-9480
_akeside Insurance Agency, Inc.
,88 Stiles Road
Salem, NH 03079
am: Ext:
NSURED
Andrews Gunite Co Inc
Andrews Realty Trust ATIMA
6 Republic Rd
N Billerica, MA 01862
DATE MM/DDIYY
�:.l.r r. {i�;'•'+'%:^i:;:•f.;'/,:�1.•i�Yi'r':•::.;%:;•?';;'':i:•: Y•%•'lrl y..
:::�: a :;,;>.�.� .. ..:%%•.......... k....,:::.s:.>::�»���<:>'>:
02/22/2000
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INDICATED, NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACTOR 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.
TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
LTR DATE (MMIDDIYY) DATE (MWDDNY) i
GENERAL LIABILITY
COMPANIES AFFC
COMPANY
Transcontinental
A
'
X COMMERCIAL GENERAL LIABILITY - -
COMPANY
Transportation
B
1,000,000
COMPANY
: 03/01/2000
C
$
COMPANY
OWNER'S & CONTRACTOR'S PROT :
D
EACH OCCURRENCE
INDICATED, NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACTOR 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.
TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
LTR DATE (MMIDDIYY) DATE (MWDDNY) i
GENERAL LIABILITY
: GENERAL AGGREGATE
:..................
$
....................................
2,000,000
'
X COMMERCIAL GENERAL LIABILITY - -
'
PRODUCTS - COMP/OP AGG
$
1,000,000
`:`:? `• CLAIMS MADE X OCCUR
A **i*`-:;:....... :......: 174087794
: 03/01/2000
PERSONAL &ADV INJURY
03/01/2001........................................................
$
1, 000 , 000
.........
OWNER'S & CONTRACTOR'S PROT :
EACH OCCURRENCE
$
1,000,000
FIRE DAMAGE (Any one fire)
$
50,000
..........
:..........................................................................
MED EXP (Any one person)
$
S'000
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
$
ANY AUTO
1,000,000
ALL OWNED AUTOS
BODILY INJURY
S
X :SCHEDULED AUTOS
A SAP1082055940
03/01/2000
(Per person)
i
03/01/2001
X HIRED AUTOS
BODILY INJURY
$
X NON-OWNEDAUTOS
'(PeracddeM)
.....................................................
PROPERTY DAMAGE
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
.................................... ..........
S
:::::.:.: .
ANY AUTO
: OTHER THAN AUTO ONLY:
:: :::..............................
EACH ACCIDENT
........................................................................................
E
............................................................
AGGREGATE $
EXCESS LUUBILITY:EACH
OCCURRENCE ...............5..........
2 , 000 , 000
B X . UMBRELLA FORM 174087827
03/01/2000
03/01/2001: AGGREGATE
$
2,000,000
OTHER THAN UMBRELLA FORM
S
WORKERS COMPENSATION AND
TORY LIMITS : ER
.. ..............
......
EMPLOYERS' LIABILITY i
'
EL EACH ACCIDENT
$
1,000,000
A 120530275
: 03/01/2000
03/01/2001`............................EMPL.v1,000,000..........
THE PROPRIETOR/ INCL :
: EL DISEASE - POUCY LIMIT
$
1,000,000
PARTNERS/EXECUTNE
OFFICERS ARE EXCL
: EL DISEASE - EA EMPLOYEE
S
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATETHEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
_3Q_ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
BUT FAILURETO MNL SUCH NOTICE SHALL IMPOSE NO OBUGATION OR LIABILITY
OF ANY KIND UPON THE COMPANY. ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
Joseph Rossetti/USER39
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