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HomeMy WebLinkAboutBuilding Permit # 4/15/2015 BUILDING PERMIT OO RYH � TOWN OF NORTH AVER APPLICATION FOR PLAN EXAMINATION _ Permit NO: ) Date Received SSACHNUS k Date Issued: ORTANT:Applicant must complete all items on this page LOCAT:I ON .. i `� c r"d �l � Print PROPERTY OWNER` rint MAP NO: PARCEL: . 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 Alteration No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other Septic Well Floodplain Wetlands Watershed District Water/Sewer_ DESCRIPTION OF WORK TO EE PREFORMED: i r 60b , Identification Please Type or Print Clearly) OWNER: Name: r. 406)_)d Phone: -, 'i3',) . Address: 72- LIMR 00D) _ CONTRACTOR Name °°e^ > - Phone: 4 J Address.. acnr w � � � ) Supervisor's Construction License: . , r) 1 _Exp. Date: Home Improvement License: N 66,s e1 Exp. ,Date; ° I ARCHITEGINEER Phone: C /EN Address: Reg. No. FEE SCHEDULE: ULDING PERMIT:$92.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. r Total Project Cost: $ - FEE: $ Check No.: Receipt No.' NOTE: Persons contrtrcti . with unregistered contractors do not have acces' `tiiie guaranty fund or Signature of Agent/Owner Signature of contract Rib tkORTH fown of2 E , ndover ® - 00 000- 115 ��Kff h0 ver, Mass, cocMIc"awic.c y1. �,�ADRATED y,Pp'�,`5 S L) BOARD OF HEALTH Food/Kitchen . ,, ERMIT T LD Septic System Li lb THIS CERTIFIES THAT ................ ........I.V.4.1�l....... ... .. .................................. .......... . BUILDING INSPECTOR ���� ............... ... ..... Foundation has permission to erect .......................... buildings on ...... ,�......... ....... ....................... Rough tobe occupied as ... ......... ...... ........... ......... 1lb�.. ................................... Chimney provided that the person accepting th 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 PERMIEXPIRES115 T I ® u ELECTRICAL INSPECTOR 3 • L ST CTI S Rough Service .............. .... .... ........ .................. Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Islay in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approvedthe Building Inspector. Burner Street No. Smoke Det. MA rceg#146583 Lia- - Contract# CT Reg#0605216 Federal ID#20-2625129 RI Reg#26463 Homelmprovemairt:SotuHons Corporate Headquarters,26 Cedar St,Woburn,MA,(P)800-342-2211(F)781-933-9626,www.newpro.com - THIS CONTRACT MADE THE�_day of 1 1 C 2015—between ��'11J lCi. L•,�I,en H�ana c'q`1R-qQ�°X51 � - O ). � �.. ,v.r,I (Home owners) (Home Phone) (Bu eii Phone) /� of Fos r n•1 NO 4-bver. ®t 5. (Address) (City) , gyp) L.1 A0,140 W1 _rot go trnatl.e®m the"Owner"and NEWPRO Operating,LLC,"NEWPRO". (---JV011))b1)Yrqpdet.,yYJe only NEWPRO hereby agrees that it will for the consideration hereinafter mentioned,furnish all labor and material necessary to install the following described work at t e premises located at: � The job address is a condominium. (✓ob Address) �► C V _ LJ f M Grids: YES NO CONTOUR SDL EURO DIAMOND Window color QTY I Window color QTY :(to ,bn) COM ATOP .RBOTrOM Int:WIP&A4Z Int: Screens:(Exterior color Full Screen Standard) 12HALF ❑FULL Ext: �+ Ext: Vent latches: ❑YES NO Capping Color: tease/ntt/at. PVC Smooth UNoMar LJ NoCappin `PnQI__s o MODE Col r In: Out: Double Hung Active. /Q Left Center Ri t customer understands that NEWPRO® 2 Lite Slider HDWR. SN BB BGE WH does not do any painting or staining. 3 Lite Slider (1/4,112,1/4) =I Yr (le:when removing or replacing interior 3 Lite Slider (113,1/3,113) Color In: Out: stops or trim).NEWPRM is not respo- Casement(Hinged Right) erglass S el nsiblefor conditions ordreumstancesbay- Casement(Hinged Left) HDWR: SN BB AGB AB ORB Dori its control Includingcondensation resu• Twin Casement i _ Ring from or due to pre-ex sfing conditions Stationary Casement Colorµ In: N ,6ut: (c/rc%one): Triple Casement (1/4,112,1/4) _: g ASH Triple Casement (1/3,1/3,113) ^ Color _ In: out: Balance paid to fns at completion Picture Window HDWR: SN AB AGB AB Sash Only Left Inge fight Hinge FINANCE Hopper �� n Bank completion form signed at installation Awning �� Color In: Out: Garden Window Fiberglass steel ��� Bay Window(Roof lsotfit) � HD SN BB AGB AB ORB Bow Window(Roof/Soffit) NERSOMM Other for In: out:HDWR: �. Other DESCR/BEWORK&PROMOT/ONSAPPLtED.• ) v e Est.Stan'Date: Est Comp.Date: 5- 1 15 Customer understands this is an"estimated date" Owner has read and agrees to the terms and conditions on the front and the reverse of this Agreement. Owner specifically agrees to the(1)Total Cash Price;(2)work being performed;and(3)work not being performed. Owner understands that this Agreement and any attachments contain all of the promises made by NEWPRO. Owner has been orally advised of his right to cancel this transaction at any time prior to midnight of the third business day after the date of this transaction and Owner was provided with two(2)copies of a cancellation form explaining this right. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. (Rhode Island Sales Only): Notice to buyer: (1)Do not sign this Agreement if any of the spaces intended for the agreed terms to the extent of then available information are left blank. (2)You are entitled to a copy of this Agreement at the time you sign it. (3)You may at any time pay off the full unpaid balance due under this Agreement, and in so doing you may be entitled to receive a partial rebate of the finance and insurance charges. (4)The seller has no right to unlawfully enter your premises or commit any breach of the peace to repossess goods purchased under this Agreement. (5)You may cancel this Agreement if it has not been signed at the main office or branch office of the seller,provided you notify the seller at his or heti rain:office or branch office shown in the Agreement by registered or certified mail,which shall be posted not;+l'atertha_midnight of the third calendar day after the day on which the buyer signs the -Ja y g Agreement,excluding Sunday anis anyholiday on which regular mail deliveries are not made. See the accompanying notice of cancellation form for an explanation of buyer's rights. (Rhode Island Sales Only): Owner acknowledges receipt of required Contractor's Registration and Licensing Board consumer educations materials. (Owner's initials) By. 21`6A 7L6Yn EIN# Signed: Product Special is fPrMtedName) Owner BY: � Signed: NEWPRO Opera ,LI-gS/gnataie) Owner US-15 WHITE: Branch Copy YELLOW: Customer's Copy PINK: File Copy GOLD: Finance Copy R0714 ADDITIONAL TERMS AND CONDITIONS Warranties: Any product warranties are provided by the manufacturers of the products that Owner is purchasing.NEWPRO is also providing Owner with a labor warranty, which covers NEWPRO's labor. Owner understands that Owner should read all the written warranties for complete details of warranty coverage and that warranties are available for complete review before signing this Agreement Late Cancellation: Ownel understands that Owner has:-three (3)=business days to cancel.this Agreement:'Owner understands,that if Owner wants to cancel this Agreement after those three (3) days,NEWPRO does not have to allow that. Owner understands that if NEWPRO does let'Owner cancel;however, that Owner will havp to pay to NEWPRO'a late cancellation fee equal-to X3.3%of the purchase price in order to cover NEWPRO's labor,administrative,and material costs. _ Delay/Unknown Conditions/Damages:Owner understands that if NEWPRO determines within thirty(30)days of the date of this Agreement that it-cannot perform the work according to NEWPRO's professional standards,NEWPRO can cancel this.Agreement;notify Owner of cancellation,and promptly return Owner's money.Owner understands that issues that may cause NEWPRO to cancel this- Agreement hisAgreement include incorrect pricing or unknown pre-existing conditions to the property.Owner understands that NEWPRO is,not responsible for structural or other defects in the proPerty,and that NEWPRO's products do not cure these problems.-Owner understands that the work could be delayed by events that NEWPRO does not control.Owner understands that NEWPRO is not responsible for(a) damages due to causes beyond NEWPRO's control,(b)damages arising from a delay in NEWPRO performing under this Agreement,or (c)unintentional damage to Owner's personal property,it being understood that it is'Own er's responsibility to remove/secure his personal property prior to commencement of work. F When Money Is Due:Owner agrees that when the work is"substantially complete",Owner will pay the balance due on this:Agreement. Owner understands that "substantially complete" means the work has been materially finished, functional as intended,-and a final inspection,permit,or occupancy certificate,if required,has been obtained.Owner agrees that once Owner bas-paid;the purchase price,if Owner believes any of the work performed by NEWPRO is defective or ineomplete,-NEWPRO will inspect;the work and perform any service Owner is entitled,to under this Agreement and/or any warranty.Owner agrees that if Owner does not pay any of the money when it is due,Owner can be charged a late fee of 1.5%on the amount owed fol each month the money is not paid.'Owner agrees that if Owner defaults on any promises under this Agreement,and NEWPRO hires an attorney to enforce this'Agreement,Owner will pay NEWPRO its reasonable legal fees and related costs or expenses,as long as it is legal for Owner to do that. Other Understandings:Owner agrees that Owner will assert a dispute,claim,or controversy(hereafter referred to_as a"Claim") arising under or relating to this Agreement only on behalf of Owner's own.self and that Owner will not.asserta.Claim on behalf of,or as a member of,a class or group in either an arbitration proceeding;a private attorney general action or in any other forum or action. If a court determines that this specific paragraph isnot fully enforceable,the court's determination shall be subject to appeal.- This ppeal.This paragrap,�-_does not apply to any lawsuit or administrative proceeding filed against NEWPRO by a state or federal government agency even when such agency is seeking relief on behalf of a class of buyers.Owner agrees and understand that if Owner finances the work,Owner's separately provided financing documents will include the number of monthly payments and the amount of each payment, including any finance charge.Owner promises that he will provide NEWPRO with access to the work area,including access to electrical outlets.Owner understands that this Agreement and any attachments make up the entire understanding between the parties.Owner agrees that any change to this Agreement must be in writing'and signed by both parties. (Massachusetts Sales Only):All contractors and subcontractors must be registered by the administrator of the Board of Building" Regulations and Standards 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,Boston,Massachusetts 02116 Telephone:(617)973-8700. It shall be the obligation of NEWPRO to obtain any and all permits necessary under this agreement,as the Owner's Agent.NEWPRO shall advise Owner of any necessary permits.The Owners who secure their own construction-related permits or deal with unregistered Contractors will be excluded from the guaranty fund provisions of MGLC, 142A. Any deposit required under this Agreement to be paid idadvance of the commenpement of work shall not exceed the greater_of one-third.of the total contract price or the actual cosf;of any_materials or equipment of'a special order oropstom-madc_nattue,which must be-ordered fn advance of the commencement of work,in order to assure that the project will proceed on schedule.No final payment shall be demanded until the contract is completed to the satisfaction of the parties. -- (Rhode Island'Sales Only):THIS IS ANON-NEGOTIABLE CONSUMER NOTE.During the term of this Agreement,NEWPRO shall maintain public liability and property damage insurance covering the work of not less than$500,000 combinedsingle limit,bodily injury and property damage and workers'compensation insurance as required under chapter 29 of title 28_NEWPRO_and/or subcontractors or material persons may file a lien in accordance with Rhode Island Mechanics Lien Act,chapter 28 of title 34. (Maine Sales Only): Consumers are strongly advised to visit the -Attorney General's publicly--accessible website (www.maine.gov/ag)to gather current information on how to enforce their rights when constructing:or repairing their homes. The Attorney General can be contacted by telephone at 207-626-8800. Any alteration or deviation from the above contractual specifications that results in revison.of the contracfprice will be.executed only upon the parties entering into a written change order. In addition to any additional warranties agreed to by the parties,NEWPRO warrants that the work will be free from faulty materials; constructed according to the standards'of the building code applicable'for'thWlocation; constructed in a skillful manner and fit for habitation or appropriate use: The warranty rights and remedies'set'forth in the Maines Uniform Corrimercial Code apply to this Agreement. If a dispute arises concerning the provisions,of this contract or.ibp'performance by the parties that may not be resolved.through•a small claims action,then the parties agree to settle this dispute by jointly payini four one of the following:0 Binding arbitration as regulated by the Maine Uniform Arbitration Act,with the parties agreeing to accept as final the arbitrator's decision;El Nonbinding,arbitration,with the parties free to not accept the arbitrator's decision and to seek satisfaction through other means,including a lawsuit;or 0 Mediation, with the parties agreeing to enter into good faith negotiations through a neutral mediator in order to attempt to resolye.their differences. (Connecticut Sales Only):THIS INSTRUMENT IS BASED UPON A HOME SOLICITATION SALE;WHICH SALE IS SUBJECT TO THE PROVISIONS OF THE HOME SOLICITATION SALES-ACT.THIS INSTRUMENT IS NOT NEGOTIABLE. The owner(s) of NEWPRO is or has been shareholder, member,partner, or owner bf,the,following.corporat ons; liinted liability companies,partnerships,sole proprietorships or other legal entities that have been a home improvement contractor during the-previous five years:NONE Job#; Product Specialist WF.W10no Home Improvement Solutions Page—of— Date ageofDate 20-Cedar St•Woburn,MA•01801 781.933.4100•newpro.com Lead int status �ll V"J',4 U,-1G(C, /t ' Yr Built 'r?� Homeowner Name(s) LSWP ` `�,�Unq Must / /Z(�=UGi� �/3✓ �li� ���ll(1� V/4 r %.(J` Exempt Be Selected ,v Address City State Zip t 4-Z-4 ell h ()`!yl 1, M T W TH F Phone Other/Cell Email 6' 144:j:Best Day To Install Est.Star Date tot—'(circle one) — TOTAL#OF #OF BOW/BAY/ "EXTERIOR GRID COLOR s WINDOWS GARDEN CLADDING #OF DOORS (Inside/Outside) CAP COLOR / Bay Bow*_ whitco SD MFG: NAPCO/ Norandex/ J� Garden_Shelf_ Steel ontour L14/^� Other Roof or soffit Painted patio Prairie (circle one) _ Diamond (PVC,)/ Smooth Locks&Keepers(circle one): h t Almond Bronze Brass Satin Nickel (circle one) (circle one) candles&Night Latches(circle all that apply): kite Almond Bronze Satin Nickel Brass No Bottom Handles Night Latches nside Color: hite Natural Oak Colonial Cherry Barrister Oak )utside Color: hie Basic Brown CT Beige Forest Green Tuxedo Gray Claystone Terra Brown Bronze Winterberry Wedgewood Blue Nindow Model: OPENING SIZE STOPS NO. MODEL W x H U.I. LOCATION GRIDS SCR IN OUT CONV ADDITIONS OPENING , CUT x a, x ;/ Li t to 6— (v xK2 �- r � ✓ )�i x � j x _ n x y /015' yZ�L ) i �� t, 1410 I I f bv) x 10 ) 3G k y.L rz "� �) ! ,gra i t nor) I x x x 7 /a 3 ' ZIr �-�. ,) �. y.� / v I l ,,`S x ft�v x°1 /S 1 Z K /0 9 5 3b ti l'IL } 1k�> Z r���. �� 1� �4� 1 I 'i � x x x x x x x x x x X x x x x x x x easureman: \,,,,,1'+ t Initials Elate Crew Size Needed Time Frame to complete ob Capping Type 04, )ecial Installation Instructions: ' r} I�l [r; WD-017B PRE-INSTALLATION INSPECTION MATERIAL CHECK LIST CUSTOMER NAME ADDRESS PHONE: DATE: Please Circle TYPE OF HOUSE EXTERIOR OUTSIDE CASING CASINGS 2 Story Aluminum Siding 908 Brick Mold 2 1/2 Clam 3 Story Asbestos 4 Bend 2 1/2 Colonial Camponelli's Brick Blind Stop 3 1/2 Clam Cape Clap Board Crown Headers 3 1/2 Colonial Raised Ranch Stucco Flat Belly Ranch T1-11 �� arrlow Meta( in 9� Flat Split Entry Vinyl Siding Perrr�aieid� Wood Shingles CONSTRUCTION TYPE OF INSTALL STOOL STOPS Barn Sash _Aluminum Tracc 2 1/2 15/8 Colonial Bay Removal Anders - 3 1/2 2 1/2 Colonial Bow-Romoval Outside Install ---.._.--41/4 1518 Ranch Enlarge Opening Plastic Track 5 7/8 Colonial Garden Removal Replacement 6 Bull Nose Metal Fin Steel Frame Clear Silicone Scotia Mullion Removal Thumb Latch Latex Reduce Opening P 9 Weight Pockets White Silicone Vinyl Fin Wood Conversion J List all other information and Stock Needed � W\ `` y in Highlighted Regions ® = qualified In all zones NEVIWPRO MANUFACTURING NE0RC SERIES G NEWPRO 2000 �� DOUBLE HUNG Cellular PVC frame,Triple glazed, National Fenestration Low E coating(e=0.027,S2&5), Rating Council® Krypton/air filled DEV•K-27.00030.00001 ENERGY PERFORMANCE RATINGS LI-Factor(U.S.A-P) Solar Heat Gain Coefficient 0. 17 0.24 ADDITIONAL PERFORMANCE RATINGS Visible Transmittance Air Leakage (U.S./1-P) 0.40 0A Condensation Resistance 70 Manufacturer allpWateathat those rafts conform to applWe NFHO pwAdree for determining whole productperformance.NRiGratings amdeterminedfor itfbted*of envlronnron6Wconditions and a epeaMcCd ctetre.NFRCdoesnotmcammend gpprroodductanddoesnotweraMtirosubbliltyofany product for arty epeclftc use,Coneuft manmrtecturer'a fgerahrre for otharproduCt performance Gnformaflon, www.nfmorg - 7 r I From Gu- tome•taYouo_ 1 �»dows,.Sidk►g.and.lYloie Authorization to Perform Work For Management Company/Association This authorization to replace windows/doors serves as an of pial do cument i providing NEWPRO Operating, LLC (hereafter called NEWPRO) th(; approval now and in the future to install windows/doors in any unit at: 4eek krxar7 6��epi N_o� A n ol/r , I"A Condominiu o ouss Name Gift' State Manoeit ant Company N me City state This approval is in effect providing the homeowner, Management C)mpany and NEWPRO understand the style of window replaced will remain the,came(I.E. double hung to double hung, slider to slider, etc.). When replacing an existing metal window with our non-metal windoN, the j exterior appearance will be different due to the difference in frame s ize. When replacing existing wood windows, the exterior trim will remain the seime and be covered with vinyl coated aluminum to seal the window and frame from the elements. The interior and exterior of the windows will be white frarne and sash. Homeowners contracting with NEWPRO will verify styles,colors and exterior appearance, as described below, by seeing a window sample as wool as before ' and after pictures. 62 Cli- y NEWPRO will perform in a workman like manner according to state building codes. NEWPRO will keep worksite in a clean and safe manner anJ remove all debris from the property. Attached you will find a copy of NEWPRO's Workman's Compensai ion and liability insurance certificates. tinted doe TWO i z � n Si stun: ���'.'_` L�' �a<e'c`-'��' �'��� �}ts,✓�a �''+ ir'<��.j�, 179f6 I I I I I R0308 -- 26 Ceder 8t,Woburrk MA 01801 (P)800-342-2211 a(f=)781-933-0717,►www.n awpro.com .-------- -- --- - -- - -- — i From Our Home to Yours... Windows,Siding and Mote Authorization to Perform Work For Homeowner(s) tt 1�V1 l V 60 , have seen a working sample of the NEWPRO Homeowner(s) Window and have reviewed before and after photographs. I understand the style of my windows to be replaced will remain the same (I.E. double hung to double hung, slider to slider, etc.). The interior and exterior sash and master frame will be white in color. ® When replacing a wood window the exterior trim will remain the same '.... however, will be covered with vinyl coated aluminum to seal the exterior trim from the elements. • 1 understand when replacing a metal window the exterior appearance will be different due to the difference in frame size between a non-metal window and the existing metal window. The exterior trim will be covered with vinyl coated aluminum to seal exterior trim from the elements. ,i 1 e SIV Oval Homeowner �l 2 a d_ Nve 19 M 4 IW 0vw j1-1 C�1 $GI 5 Address City "State Zip Homeowner Signature mss' Homeowner Signature 2, 1 Salespresen F jgnature Date t, ?L1�W0y R0308 26 Cedar St,Woburn, MA 01801 e (P) 800-342-2211 e (F)781-933-0717 e www.newpro.com ? f The Commonwealth of Massachusetts Department oflndustrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 VM www.niass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Nanle(Business/Organization/Individual): /�� ' L_C), e ra h� LLC_ Address: k City/State/Zip: �)n b u rn . /'17 A C)/ ,?c-31 Phone#: / 9},2-q r�� Are you an employer?Check the appropriate box: Type of project(required): 1.0 lam a employer with SO 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. t 7. Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers'comp.insurance. 9. ❑Building addition [No workers'comp.insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.El Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself. [No workers'comp. c. 152, §1(4),and we have no 12.❑Roof repairs insurance required.]t employees. [No workers' 131-1 Other 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 new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I km ait employer that is providing workers'contpettsatioti insurance for my employees. Below is the policy and job site information. Insurance Company Name: Mo C 1\i,-V)re I n s t rcFnc a n z 0 Policy#or Self-ins. Lie.#: (t) (?, y c�cJ3�C�F a c, Expiration Date:` ( Job Site Address: 72 ro r r Lo C> el City/State/Zip:/State �1 ty /Zi p: . `l '1 c�"�l� fy)iA DiS,� 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 hereby certify under the pains and penaltieso perjury that the information provided above is true and correct. Si ature: Date: Phone#: Official use only. Do not write in this area,to be completed by city or town official City 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#: DATE(MM/DD/YYYY) A �® CERTIFICATE OF LIABILITY INSURANCE 1/6/2015 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 (YTHE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURERS)' 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 NAME: Melissa Pflug PRODUCER PHONE Mack-int-ire Insurance Agency Inc . (508)366-6161 AIC No; (506)366-5202 E-MAIL melissap@mackintire.com 11 West Main Street ADDRESS: INSURERS AFFORDING COVERAGE NAIC# Westborough MA 01581-1931 INSURER A.Netherlands 24171 INSURED INSURER B:Libert Mutual/Peerless 24198 Newpro Operating LLC INSURER C Acadia Insurance Co. 26 Cedar St. INSURER D: INSURER E: Woburn MA 01801 INSURER F: COVERAGES CERTIFICATE NUMBERMas ter 14-15 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 PPDODLICuBR LIMITS SHOWN MAY HAVE BEEN REDUCED POLICYP IILDICI XP CLAIMS. LIMITS INSR TYPE OF INSURANCE D POLICY NUMBER MMIDDIYYYY MM/DD/YYYY 1,000,000 LTR EACH OCCURRENCE $ GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $ 100,000 X COMMERCIAL GENERAL LIABILITY 12/31/2014 12/31/2015 5 000 CLAIMS-MADE �OCCUR HP 8589577 MED EXP(Any one person) $ r A 1,000,000 PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ 2,000,000 PRODUCTS-COMP/OP AGG $ 21000,000 GEN'L AGGREGATE LIMIT APPLIES PER: $ X POLICYFI PRO LOC COMBINED SINGLE LIMIT 1,000,000 AUTOMOBILE LIABILITY Ea accident BODILY INJURY(Per person) $ A ANY AUTO 12/31/2014 12/31/2015 ALL OWNED X SCHEDULED 8584174 BODILY INJURY(Per accident) $ AUTOS AUTOS PROPERTY DAMAGE $ X X NON-OWNED Peraccident HIRED AUTOS AUTOS Uninsured motorist 81 s til limit $ 250,000 EACH OCCURRENCE $ 5,000,000 X UMBRELLA LIAB X OCCUR 5,0001000 AGGREGATE $ B EXCESS LIAB CLAIMS-MADE 12/31/2014 12/31/2015 10,00 U 8582578 $ DED X RETENTION$ WC STATU- 0TH- - C WORKERS COMPENSATION AND EMPLOYERS'LIABILITY Y/N E.L.EACH ACCIDENT $ 500 000 r ANY PROPRIETOR/PARTNER/EXECUTI=❑ NIA 05/01/2014 5/01/2015 E.L.DISEASE-EA EMPLOYE $ 500000 OFFICER/MEMBEREXCLUDED? C-20-20-003506-02 (Mandatory in NH) E.L If yes,describe underOF .DISEASE-POLICY LIMIT $ 500,00 DESCRIPTION OPERATIONS below 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. To Whom It May Concern AUTHORIZED REPRESENTATIVE T Moynagh/KRISTI ACORD 25(2010105) ©1988-2010 ACORD CORPORATION. All rights reserved. unnnr Thi Af�non..�.++..onA tn..n ern e•nnic4n rnrl m��ltc of Ar(IRr1 I ��e�a�rr»ra�ra�ea�f�o���/��atiac�crdef/d ffice of Consumer Affairs&Business Regulation License or registration valid for individul use only ME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration 146589` Office of Consumer Affairs and Business Regulation y piration Type: Ex 5/5/2015 10 Park Plaza-Suite 5170 Supplement_:ard Boston,MA 02116 NEWPRO OPERATING,;LLC THOMAS FOXON 26.CEDAR ST. WOBURN,MA 01801 Undersecretary Not valid without sig ture Massachusetts-Department of Public Safety Board of Building Regulations and Standards Construction Supen•isor License: CS-029090 THOMAS P FOXgN 230 WALNUT ST` _ v READING MA 61867 tXQ:tatlOn Commissioner 11/19/2015