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HomeMy WebLinkAboutMiscellaneous - 64 FOREST STREET 4/30/2018 (2) 64 FOREST STREET 210/106.A-0006-0000.0 ---W*i UV IU: aH . 6. O CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDJYYYY) � 03113/13 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). CONTACT PRODUCER 978-744-6715 NAME: AHMED Insurance Agency,Inc. g7$-741-0127 PHONE –– – FAX Na PO BOX 449 (A/C,No,Ext): ( )i Salem,MA 01970 E-MAIL ADDRESS: Stephen G.Ahmed PRODUCER ABCAR-1 CUSTOMER ID M: INSURER(S)AFFORDING COVERAGE NAIC u INSURED A B Carnes Inc INSURER A:Essex Insurance CO 30 Arrowhead Farms Road INSURERB:Safety Insurance Company 33618 Boxford, MA 01921 INSURER C 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 INSR ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE POLICY NUMBER MM/DD/YVYY MMIDD/YY`/Y GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY 3DF9266 03/18/13 03/18114 PREM SES((Ea oAMAGE TO ccE once; $ 50,00 CLAIMS-MADE X OCCUR MED EXP Any one person; S 1,00 PERSONAL&ADV INJURY S 1,000,00( GENERAL AGGREGATE S 2,000,00 GENT AGGREGATE LIMI r APPLIES PER PRODUCTS-CONIPJOP AGG S 2,000,00 X POLICY PRO'ECT LOC PD Deduct 50 AUTOMOBILE LIABILITY COMBINED SINGLE 0MI• 1,000,00 E a eca 7e^ ANY AUTO BODILY INJURY:Per person S � ALL OWNED AUTOS BODILY INJURY(Per acciCor,; S B X SCHEDULED AUTOS 6213192 05/02/12 05/02/13 PROPERTY DAMAGE B X HIRED AUTOS 6213192 05/02/12 05/02/13 PeraCCidenl, $ inc B X NON OWNED AUTOS 6213192 05102/12 05102/13 s S UMBRELLA LIAB OCCUR EACH OCCURRENCE S EXCESS LIAB CLAIMS-MADE AGGREGATE S DEDUCTIBLE c RETENTION S S WORKERS COMPENSATION AC STATU OTH- AND EMPLOYERS'LIABILITY YIN TORY LIMITS ER ANY PROPRIETOR/PARTNEP/EXECUTIVE I— EL EACH ACCIDENT S OFF ICERPMEMBER EXCLUDED? N I A (Mandatory to NH) E L DISEASE EA EMPLOYEE $ If Yos Cescnbe antler DESCRIPTION OF OPERATIONS Delo. Ft DISEASE POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space is required) Roofing Contractor CERTIFICAT OLMR---- _- CANCELLATION TOWNN04 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of North Andover ACCORDANCE WITH THE POLICY PROVISIONS. 120 Main Street North Andover, MA 01845 AUTHORIZED REPRESENTATIVE ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 26(2009/09) The ACORD name and logo are registered marks of ACORD ,4`oRv® CERTIFICATE OF LIABILITY INSURANCE 11/4/2011) 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 CONTACT cOmmerCial Lines NAME: Harris-Murtagh Insurance Agency,Inc. PHONEO. (978)532-2844 ac No: 30 Central Street E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC# Peabody MA 01960 INSURER A.-Wes tern World Insurance CO INSURED INSURER B: AB Carnes Roofing, Inc INSURER C: 30 Arrowhead Farm Rd INSURER D: INSURER E: Boxford MA 01921 INSURER F: COVERAGES CERTIFICATE NUMBER.-CL1311417584 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDLSUBR TYPE OF INSURANCE POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MM/DD/YYYY MM/DD/YWY GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RFNTE X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ 50,000 A CLAIMS-MADE aOCCUR NPP137217 0/11/2013 0/11/2014 MED EXP(Any one person) $ 5,000 PERSONAL BADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN1 AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATIONWC RYSTATU- OTH- AND EMPLOYERS'LIABILITY y/N ANY PROPRIETOR/PARTNER/EXECUTIVE❑ NIA E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Town of North Andover 1600 Osgood Street AUTHORIZED REPRESENTATIVE North Andover, MA 01845 J S Scholnick/PJR ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INSn25 nninnsl m Tho ar:nRf1 nnmo 2nel Innn 2ro ronic4ororl mnr4c of annRr1 erkle Massachusetts Workers' Compensation Insurance Plan By Acadia Insurance Company NCC .acne,:ode Aonim stered by BerKiev.Assigned Rash Seri ces P 0 Box '100 Minneaoons Minnesota 5544C Phone 605 545-,'44 Fax 1kti6 -o gree 8" »-» vwvo berK evass gnedrs, CERTIFICATE OF INSURANCE T"� ^Saeed WCIP a, WC�20-20-004717.00 1 American Construction Inc 4 F 46-1868194 242 Belmont Street Unit 2 Brockton. MA 02301 Po icv Peri,.- 412412013 4124.2014 -► .Ate i. 5131201 '-e Cerilficate Is issued as a matter o* nrormation only and confers no rights upon the ,,e-11.ate `31ae, '1.s Cerfficate does not amend extend or alter the coverage afforded by *ne Policy fisted be .v `r s s to certify that the Policy of Insurance described herein has been issued to the -cored ^3rr -bcve a ­e colicv cenod indicated No:vvithstanding any requirement term or ccnd,t on of a^, or-ra^r ^F 7r 1 ,An; respect to which this Certificate may be Issued or may pertalr+ :he insurance aff^roeo b� int - "P"eir s subject to all the terms exclusions and conditions of such Policy TYPE OF INSURANCE LIMITS OF LIABILITY Part One 'corkers Compensatior Statutory MA Part Two Bodily Injury by Accident S1.000 000 each accident Employers' Liability Bodily Injury by Disease 51,000,000 policy limit. 6oduy -niury by Disease . ' u00 vo,' :ach F—r-nver- ~ou'o anv of the above descrbed policies be cancelled before the exp,,at.cn date .^e,ee` notice will oe del vered it accordance wit', the policy provisions ,+a Enwies-insureds _ertificate Holders Nameand address 1 American Construction Inc E-2 t,c, 7 AB Carnes Inc 30 Arrowhead Farm Road Officer Include Manuel ) Lema Caguan. Boxford. MA 01921 - f 5.'312013 Ace Insurance Services Inc 675 Warren Ave Brockton, MA 02301 Slanature _ _ MA SOC Filing Number: 201316881130 Date: 4/23/2013 10:36:00 AM The Commonwealth of Massachusetts Minimum fee:5250.00 William Francis Galvin ti Secretary of the Commonwealth. Corporations Division ' One Ashburton Place, l 7th floor Boston, MA 02108-1512 Special Filin¢Instructions Telephone: (617) 727-9640 Federal Employer Identification Number: 001098338 (must be 9 digits) ARTICLE I The exact name of the corporation is: 1 AMERICAN CONSTRUCTION INC ARTICLE II Unless the articles of organization otherwise provide, all corporations formed pursuant to G.L. C156D have the purpose of engaging in any lawful business. Please specify if you want a more limited purpose ARTICLE III State the total number of shares and par value, if any, of each class of stock that the corporation is authorized to Issue.All corporations must authorize stock. If only one class or series is authorized, it is not necessary to specify any particular designation. Par Value Per Share Total Authorized by Articles Total Issued Class of Stock Enter 0 if no Par of Organization or Amendments and Outstanding Num of shares Total Par Folur Sum of Share,, CNP $0.00000 20,000 $0.00 20.000 G.L. C156D eliminates the concept of par value, however a corporation may specify par value In Article III. See G.L. C156D Section 6.21 and the comments thereto. ARTICLE IV If more than one class of stock is authorized, state a distinguishing designation for each class. Prior to the Issuance of any shares of a class, if shares of another class are outstanding, the Business Entity must provide a description of the preferences, voting powers, qualifications, and special or relative rights or privileges of that class and of each other class of which shares are outstanding and of each series then established within any class. ARTICLE V The restrictions, if any, imposed by the Articles of Organization upon the transfer of shares of stock of any class are.- ARTICLE re:ARTICLE VI Other lawful provisions, and if there are no provisions,this article may be left blank. Note: The preceding six (6) articles are considered to be permanent and may be changed only by filing appropriate articles of amendment. ARTICLE VII The effective date of organization and time the articles were received for filing if the articles are not rejected within the time prescribed by law. If a later effective date is desired, specify such date. which may not be later than the 90th day after the articles are received for filing. Later Effective Date: Time: ARTICLE VIII The information contained in Article VIII is not a permanent part of the Articles of Organization. a,b. The street address of the initial registered office of the corporation in the commonwealth and the name of the initial registered agent at the registered office: Name: MANUEL LEMA-CAGUANA No. and Street: 12 WALL STREET City or Town: BROCKTON State: MA Zip: 02301 Country: USA c. The names and street addresses of the individuals who will serve as the initial directors, president, treasurer and secretary of the corporation (an address need not be specified if the business address of the officer or director is the same as the principal office location): Title Individual Name Address (no Po Box) First,Middle.Last.Suffix Address,City or Town.State,Zip Code PRESIDENT MANUEL LEMA-CAGUANA 12 WALL STREET BROCKTON.MA 02301 USA TREASURER MANUEL LEMA-CAGUANA 12 WALL STREET BROCKTON.MA 02301 USA SECRETARY MANUEL LEMA-CAGUANA 12 WALL STREET BROCKTON.MA 02301 USA DIRECTOR MANUEL LEMA-CAGUANA 12 WALL STREET BROCKTON,MA 02301 USA d. The fiscal year end (i.e., tax year) of the corporation: December e. A brief description of the type of business in which the corporation intends to engage: GENERAL CONSTRUCTION f. The street address (post office boxes are not acceptable)of the principal office of the corporation: No. and Street: 1'_ WALL STREET City or Town: BROCKTON State: MA Zip: 02301 Country', USA g. Street address where the records of the corporation required to be kept in the Commonwealth are located (post office boxes are not acceptable): No. and Street: 12 WALL STREET City or Town: BROCKTON State: SIA Zip: 02101 Country: USA which is X its principal office _ an office of its transfer agent an office of its secretary/assistant secretary _ its registered office Signed this 23 Day of April, 2013 at 10:37:21 ANI by the incorporator(s). tlf al'1 exislim"cnl poratioil lc ,seting,as I.neo postal, tvpe in the evaet mine of the hnsiliaSS el'711tl', the Rtcltc or Othel'tln'isC.lict1O11 whe i-e it lt'(7S 1nC01 j)(ii-ale(71, the 1lallle Of the persol7 si�gi?h1 c,,oil behalf Of.Said hitslltess entll_i'a11(1 the tille 17C",1hc holds or other authority h-v which such action is taken] MANUEL LENIA CAGUANA 2001 -2013 Commonwealth of Massachusetts All Rights Reserved MA SOC Filing Number: 201316881130 Date: 4/23/2013 10:36:00 AM THE COMMONWEALTH OF MASSACHUSETTS 1 hereby certify that, upon examination of this document. duly submitted to me. it appears that the provisions of the General Laws relative to corporations have been complied with, and I hereby approve said articles; and the filina fee having been paid. said articles are deemed to have been tiled with me on: April 23, 2013 10:36 AM Ir 21� WILLIAM FRANCIS GALVIN Secretai- .)- of the Commonwealth The Commonwealth of Massachusetts Print Form .rte Department of Industrial Accidents Office of Investigations E r� 1 Congress Street, Suite 100 Boston, MA 02114-2017 r www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Nate (Business%Organization/Individual):AB CARNES ROOFING,INC. Address:30 ARROWHEAD FARM RD Cit}'/State/Zip:BOXFORD, MA 01921 Phone #:978-887-1431 Are you an employer?Check the appropr' to box: Type of project(required): 1.❑ I am a employer with 4. Z I am a general contractor and i employees(full and/or part-time).* Ave hired the sub-contractors �' E] New construction 2.Fl am a sole proprietor or partner- listed on the attached sheet. 7. ❑✓ Remodeling ship and have no employees These sub-contractors have g, ❑ Demolition working for me in any capacity. loyees and have workers' P �`• [No workers' comp. insurance 'cot p. insurance.., 9. E] Building addition required.] . Q '-are a corporation and its 10.❑ Electrical repairs or additions 3.F1 am a homeowner doing all work • officers have exercised their I I.E] Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL. 12.[71 Roof repairs insurance required.] c. 152. y 1(4),and we have no employees. [No workers' 13.❑ Other comp. insurance required.] *AnN applicant that checks box#1 most also till out the section beIo%c showing their N%orkcrs'compensation policy int'omianon. +I tomeowners 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 ofthe sub-contractors and state whether or not those entities have cntploNees. Ifthe sub-contractors have emploNees.they must provide their worker,,'comp.police number. 1 am an entplt�yer ilia!is providing workers'compensation insurance for my employees. Below is the policy and job site information. insurance Company Name: _ Policy #or Self-ins. Lic.ii: Expiration Date: _ .lob Site Address: 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 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 may be forwarded to the Office of investigations of the DiA for insurance coverage verification. I do hereht, • r),under the pains indgenalties o f erju -that the information provided above is true and correct. Si Tnature: L 1--� e" Date Phone#: 1� Official use only. Do not write in this area,to he completed bt•city or town official. Citv or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone#: FORM 153 The Commonwealth of Massachusetts DiA Use Only :. Department of Industrial Accidents Office of Investigations - Dept. 153 1 Congress Street.Suite 100,Boston.Massachusetts 02114-2017 http://Nww.mass.gov/dia Invest./SWO ID# X'.vv . AFFIDAVIT OF EXEMPTION FOR CERTAIN CORPORATE OFFICERS OR DIRECTORS Chapter 169 of the Acts of 2002 untended X1.1 G.L. c. 152, §1(4) Uy udding the following paragraph: "This chapter shall be elective for an officer or director of a corporation kvho owns at least 25 percent of the issued and outstanding stock of the corporation. Notwithstanding section 46. these provisions shall apply only if the corporate officer provides the commissioner of industrial accidents with a written waiver of his rights under this chapter. Said commissioner shall promulgate regulations to carry out the purpose of this paragraph. Violations of this paragraph shall subject the corporation to the penalties set forth in section 25C." Pursuant to M.G.L. c. 152, §1(4) as amended. I/We the undersigned officers of. AB CARNES ROOFING. INC. (Name of Corporation and Address) each holding at least 25% of the issued and outstanding stock in said corporation. do hereby invoke the right to be exempt from the provisions of M.G.L. c. 152. §25A and therefore are not required to carry a workers' compensation policy covering the undersigned corporate officer(s) or director(s). I/We the undersigned do also waive any and all rights to make claims for benefits as defined in M.G.L. c. 152 for an}' injuries that may be sustained while in the employ of the above-named corporation. Further, I/we the undersigned do understand that. should the above-named corporation hire or have in its employ any employee(s) in addition to the undersigned corporate officer(s) or director(s). said corporation is required to obtain workers' compensation coverage for the employee(s) as prescribed by M.G.L. c. 152. §§'25A. I/We the undersigned have read and understand the statements and obligations as delineated above and I/we have checked the appropriate box below my/our nanre(s) indicating my/our desire to be exempt or t exempt frO n the provisions of M.G.L. c. 152. nder the ains and penalties of perjury: BARRY CARNES. PRESIDENT 09/24/2013 Print Name&Title Date(nvn;dd,�xercise tm right of exemption or R 1 wish NOT to exercise m} right of exemption r ANASTASIYA CARNES, DIRECTOR 09/24/2013 Signature Print Name& I itie, Date hnm%dd, ❑✓ I ish to exercise m} right of*exemption or I vvish NOT to exercise my right of exemption Signature Print Name x Title Date Imm-dd,\, I xcish to exercise my right of exemption or I kkish NOT to exercise m\ right orcxemption r;, Signature Print Name& Fitie Date(mm;dLlA\\\1 - 1 wish to exercise m} richt of exemption or ❑ I wish NOT to exercise rm right of exemption Note:,ALL ELIGiBLE CORPORATE OFFICERS MUST SIGN. THERE CAN RF:NO MORE THAN a SIGNATURES. fnstractions on hack. Form 14;,; -"2010 MA SOC Filing Number: 201340178570 Date: 6/26/2013 6:21:00 PM The Commonwealth of Massachusetts Minimum Fee:$250.01) William Francis Galvin Secretary of the Commonwealth,Corporations Division One Ashburton Place, 17th floor Boston.. MA 02108-1512 ',Pechd Filina Instructions Telephone: (617) 727-9640 g;totgi 9WD Federal Employer Identification Number: 00 1110484 (must be 9 digits) ARTICLE I The exact name of the corporation is: AB CARNES ROOFING. INC. ARTICLE II Unless the articles of organization otherwise provide, all corporations formed pursuant to G.L. C156D have the purpose of engaging in any lawful business. Please specify if you want a more limited purpose: COMMERCIAL& RESIDENTIAL ROOFING AND ROOFING RELATED WORK. TI IIS SHALL INCLUDE ALL TYPES EXTERIOR& INTERIOR REMODELING ARTICLE III State the total number of shares and par value, if any, of each class of stock that the corporation is authorized to issue. All corporations must authorize stock. If only one class or series is authorized. it is not necessary to specify any particular designation. Par Value Per Share Total Authorized by Articles Total Issued Class of Stock Enter 0 if no Par of Organization or Amendments and Outstanding N51177 0/'Shares Tolol Par l alve N11111 o/Shard+ CNP 50.00000 1,000 $0.00 1,000 G.L. C156D eliminates the concept of par value, however a corporation may specify par value in Article III. See G.L. C156D Section 6.21 and the comments thereto. ARTICLE IV If more than one class of stock is authorized, state a distinguishing designation for each class. Prior to the issuance of any shares of a class, if shares of another class are outstanding, the Business Entity must provide a description of the preferences, voting powers, qualifications, and special or relative rights or privileges of that class and of each other class of which shares are outstanding and of each series then established within any class. ARTICLE V The restrictions, if any, imposed by the Articles of Organization upon the transfer of shares of stock of any class are: ARTICLE VI Other lawful provisions, and if there are no provisions,this article may be left blank. Note: The preceding six(6)articles are considered to be permanent and may be changed only by filing appropriate articles of amendment. ARTICLE VII The effective date of organization and time the articles were received for filing if the articles are not rejected within the time prescribed by law. If a later effective date is desired, specify such date, which may not be later than the 90th day after the articles are received for filing. Later Effective Date: Time: ARTICLE VIII The information contained in Article VIII is not a permanent part of the Articles of Organization. a,b. The street address of the initial registered office of the corporation in the commonwealth and the name of the initial registered agent at the registered office: Name: BARRY CARNES No. and Street: 30 ARROWHEAD FARM RD City or Town. BOXFORD State: MA Zip: 01921 COLI11trV: USA c. The names and street addresses of the individuals who will serve as the initial directors, president, treasurer and secretary of the corporation (an address need not be specified if the business address of the officer or director is the same as the principal office location): Title Individual Name Address (no PO Box) First,Middle,Last.Suffix Address.City or Town.State.Zip Code PRESIDENT BARRY S CARNES 30 ARROWHEAD FARM RD BOXFORD.MAO 1921 USA TREASURER BARRY S CARNES 30 ARROWHEAD FARM RD BOXFORD,MA 01921 USA SECRETARY ANASTASIYA V CARNES 30 ARROWHEAD FARM RD BOXFORD.MA 01921 USA DIRECTOR BARRY S CARNES 30 ARROWHEAD FARM RD BOXFORD.MA 01921 USA DIRECTOR ANASTASIYA V CARNES 30 ARROWHEAD FARM RD BOXFORD.MA 01921 USA d. The fiscal year end (i.e., tax year) of the corporation: October e. A brief description of the type of business in which the corporation intends to engage: COMMERCIAL& RESIDENTIAL ROOFING f. The street address (post office boxes are not acceptable)of the principal office of the corporation: No. and Street: 30 ARROWHEAD FARM RD City or Town: BOXFORD State: NIA Zip: 01921 Country': USA g. Street address where the records of the corporation required to be kept in the Commonwealth are located (post office boxes are not acceptable): No. and Street: 30 ARROWHEAD FARM RD City or Town: BOXFORD State: MA Zip: 01921 Countrv: USA which is X its principal office _ an office of its transfer agent an office of its secretary/assistant secretary _ its registered office Signed this 26 Day of June,2013 at 6:23:02 PVI by the incorporator(s). t/1"(111 et-istii79 c'orporatioll is acting as ineotpoi-alor% type in the exact name of the husiness entity, the state or other im-isdiction where it wfis incotpovated, the name of'the person si�ning on behalf of said business entity and the title lac she holds or outer cnithorihv b_t•which.arch action is taken.) BARRY S CARNES 12)2001 -2013 Commonwealth of Massachusetts All Rights Reserved w MA SOC Filing Number: 201340178570 Date: 6/26/2013 6:21:00 PM THE COMMONWEALTH OF MASSACHUSETTS I hereby certify that, upon examination of this document, duly submitted to me. it appears that the provisions of the General Lags relative to corporations have been complied with. and I hereby approve said articles, and the film,, fee having been paid, said articles are deemed to have been tiled with me on: June 26, 2013 06:21 PM WILLIAM FRANCIS GALVIN Secretat-v o0he Co n1I7Tomilec{/lh Location No. ��� Date t MORT� TOWN OF NORTH ANDOVER Certificate of Occupancy $ iBuilding/Frame Permit Fee $ 4 i , i ''�b'••° '�� Foundation Permit Fee $ sJ�cMust Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL z Building Inspector r r W20/98 09:21 225.00 PAI U Div. Public Works Location No. Date kORTol TOWN OF NORTH ANDOVER Certificate of Occupancy $ ` Building/Frame Permit Fee $ �'�'',•°•'tom Foundation Per Fee $ SSACMUSt Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ Building Inspector Div. Public Works PERMIT NO. Z-14 APPLICATION FOIZ PERMIT TO 13UILD********NORTH ANDOVER, MA nl\I'NO. 1 LOI.NO. 2. HE('OHD OF ON'NLRSrlB' DATE BOOK PAGE ZONE SUB DIV. LOI'NO. LO( .1 IION PURPQSE OF 131111 DING A 2 ( OWNER'S NANIL Vn NO. (M STO(IES SIZE e O\4'NLR'S ADDRESS BASEMENT OR SLAB AR(IIll ECI'S NAME SIZE OF I LOOR'IIM13ERS i ST 2 RUD 3 RD 81111 DL•R'S NAME SPAN DIST ANCE"I O NEARES I BUILDING DIMENSIONS OF Sit LS DIS I ANCE I-R(-AI S IRFF I' DIMENSIONS OF POST S DIS TANCE FROM LOr LINES-SIDES REAR DIMENSIONS OF GIRDERS AREA OF Lor FRONTAGE IIEIGIIT OF FOUNDATION TI IICKNESS IS BUILDING NEW SIZE OF I OOTING X IS BUILDING AI)DLII(NJ MATERIAL OF Cl IIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FII LED LAND WILL BUILDING CONFORM TO REQIIIREMEN"I S OF CODE IS BUILDING CONNECTED iOTOWN WATER BOARD OF APPEALS ACTION, IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECT ED TO NATURAL GAS LINE a INSI'U("IIONS 3. PROPERTY INFORIIIAIION LAND COSI' jj EST. BLDG.COST 0 P4GE I FILL(X I r SECrRINs 1-3 �� �J� EST. Bif)G.COSI PER SQ. FT. ES'1. BLI)i.COS I PER R(X)t%1 EI F(-TRIC NIET ERS MUS(BE ON(xl"1'SIDE OF BUILDING SEVI IC PERMIT NO. AI'IACIIEDGARA(;ESMUST CONFORM'rOSFATE FIRE RE(i(ILATIONS J. APPROVE1)BY: PI-ANS MUST BE 1 1LEI)AND APPROVED BY 13111LDING INSPECTOR BUILDING INSPECTOR DA 11:P11 ED OWNERS'I'ELN C(NJTRAFI ll G U Z-N ZC� r ` CtNJ'rR.l.l('N ` 1\ Is l S((iNA rl IRI:OF O\N'NI:R OR AA(-I+/I1 lo[ZI6I I)AUI N'I �1J Irl: $ C3`J� — ll.L `A C.N to I'1-RA11-1-6R.ANII-D ` OR Town o t over 0 No.��` � 7 77 A over, Mass., (0) LAKE ..-COCHICHEW1 X Q7 BOARD CH-:11 Food/Kitchen PERMIT T Septic System P. G.Vtv* � BUILDING C'I'O THIS CERTIFIES THAT... tip%& Foundation . ........ .... .................................................... Rough has permission to erect.. ............ buildings on ... (9 e4A Chimney tobe occupied as....................................................................................................................................................................***' provided that the person accepting this permit shall in every respect conform to the terms of the application on 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 M� -VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 64MON S ELEC-MICA:X-R MDQ UNLESS CONSTRUCTI Rough 60 O� Service ............ . ...... W BUIL Final Occupancy Permit Required to Occupy Building GAS IN,E)R Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done Until inspected and Approved by the Building. Inspector. Burner FIRE DEPS__ Street No. Smoke Det.