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HomeMy WebLinkAboutREPAIR FLOORS. REPAIR WALLS AND CEILINGS O�NORTH aN BUILDING PERMIT TOWN OF NORTH ANDOVER ° a APPLICATION FOR PLAN EXAMINATION Permit NO: _ Date Received 3=qoq TFo l�„� �'r 9sSACH�ISES Date Issued: IMPORTANT;Applicant must complete all items on this page TYPE OF IMPROVEMENT PROPOSED USE Residential Non-Residential L New Building -1 One family L Addition ❑Two or more family L Industrial L Alteration No.of units: N Commercial N Repair,replacement L Assessory Bldg ❑ Others: L Demolition L Other Q,J-„! nth�;ttrol '.-i =rte-. K2:n C' l' Identification Please Type or Print Clearly) OWNER: Name: Sebastian Valentin Phone: (978)490-5752 AddfeSS 163 Woodland Street Lawrence MA 01841 ARCHITECT/ENGINEER Marcos A.Devers Phone: (978)804-7588 Address: 16 Woodland Street,Lawrence MA 01841 Reg.NO. 33848 FEE SCHEDULE:BULDING PERMIT:$12.00 PER$?000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost:$ 26,000.00 FEE:$ 312.00 Check No.: -QaReceipt No.: NOS Persons contractingwit nr gistered contractors do not have access 'Town of � �ao�ry �. :.° . Andover No. ®I 15 7 - i - h ver,Mass, 7,Q q�RAT.o W�'P '�cl All s BOARD OF HEALTH Food/KitchenPERMIT TU ILU .:...`, Septic System q r c� THIS CERTIFIES THAT.......................IM.................. ......... ,,,,,,, BUILDING INSPECTOR has permission to erect......... Foundation .................bulldin sonL.....�h.�.l�....... .�1,�1d...... .�J�+wr�...... y Rough g to be occupied as.o?.6L.Je ........�.�,..... �,n. . t.�....11....... chimney provided that the person accepting this permit shall in eve respect co m to the termsbf thea application P p P� 9 p IY p pp� 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 3b� PERMIT EXPIRES IN 6 N .............. T ELECTRICAL INSPECTOR UNLESS CONSTRUCT Rough . . ........................... ....... ..... ......... Hwy BUILDING. .. . INSPECTOR... Final GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Display in a Conspicuous Place on the Premises—Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. 0�i IVtD1)inyn,A, Pe Construction 16 W,wd St .7,A.Do,�ns.P.E. Ia.vrcncc MA 01841 I2PEL1 33&18C.SLY47056 ]':978-804-7588978685-5691 mmmamHLC.L.k 106698 G-mail:mdjinooryorated�a_1.eomesst.net 380/2015 Building Repair Proposal Owner. Sebastian Valentin Job Site: 1 Mill Pond Address: 163 Woodland Street North Andover,MA 01845 Lawrence,MA 01841 Use:Residential Tel: (978)490-5752 Construction Type:Wood-framed Structure Job Breakdown and Cost: Materials Labor Total &Equipment 1.Framing a.Framing on 6x6 laundry room in basement Framing Total: $300.00 $300.00 $600.00 2.Floors&Stairs a.Install hardwood floors on living room and kitchen b.Install laminated floors on the loft and 2 bedrooms c.Install commercial tiles on playroom in the basement Floors&Stairs Total: $6,600.00 $6,000.00 $12,600.00 3.Drywall/Plaster a.Install 12 sheets drywall on living room ceiling b.Install 12 sheets drywall garage ceiling c.Install 32 sheets mold resistant drywall to playroom ceiling and walls d.Repair and patch wall in Bathroom and 1 Bedroom e.Repair and patch crack on walls and ceilign in hallway Drywall/Plaster Total: $1,000.00 $2,100.00 $3,100.00 4.Painting a.Prime and Paint related surfaces and trimming under repairs Painting Total: $400.00 $800.00 $1,200.00 5.Plumbing a.Relocate and reinstall washer and dryer hookups b.Retest all water pipes for leaks and damages c.Repair and/or replace force hot air Furnace and proper hookups Plumbing Total: $2,450.00 $3,250.00 $5,700.00 6.Electrical a.Rewire and Reinstall 220 connection and plug for washer and dryer b.Install 5 reset lighting fixures in the living room area. c.Repair and/or replace electrical fixures related to Furnace Electrical Total: $650.00 $750.00 $1,400.00 7.Clean up a.Tear-out,debris removal and clean-up b.Dumpers Celan-Up Total: $600.00 $1,000.00 .$1,600.00 8.Miscellaneous a.Permits Mise Total: $700.00 $700.00 Total $12,000.00 $14,900.00 $26,900.00 Total Amount to be paid for the work to be performed under the contract is $26,900,00: The Job will be completed within 30 business days.Beginning within 5 business days after the closing date and completed within 30 business days thereafter The contractor will obtain all necessary construction permits. Owners who secure their own constriction-related permits or deal with unregistered contractors shall be excluded from access to the Guarantee Fund DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES The contractor and the owner hereby mutually agree in advance that in the event that the contractor has a dispute concerning this contract,the contractor may submit such dispute to a private arbitration service which has been approved by the Office of Consumer affairs and Business Regulation and the consumer shall be required to bmit to such arbitration as provided in MGL c.142A Owners: Date: Sebastian Valentin I Subcontractor Date: -- MDJ Incorporated represented by Marcos A.Devers,P.E. - All home improvement contractors and subcontractors shall be registered and any inquaries about a contractor or subcontractor relating to a registration should be directed to: Office ofConsomerAf irs and Business Regulation Ten Park No—,Suite 5170 Boston,MA 012116 Massachusetts Home Improvement Sample Contract - This form satisfies all basic requirements of the state's Home Improvement Contract-Law(MGL chapter 142A),but does not include standard language to protect komeowners.Seek legal advice if necessary.Any person planning home improvements should first obtain a copy of"A Massachusetts Consumer Guide to Home Improvement"before agreeing to any work on yew residence.You may obtain a free copy by calling the Office of Consumer Affairs and Business Regulation's Consumer Information Hotline at 617-973-8787 or 1-888-283-3757 or on ourwebsite. Homeowner Information Contractor Information Name ' Company Name Stmet Address(do not use aPost Office Box add Contractor/Sales N Owner Name CitylTown state Zip Code Busi..AAddress(must include a slrcet address) Daytime Phone F.vemng Phone Cityfrowe State Zip Code Mailing Address{ihihfTerem from above) Business Phone Federal Employer Lb or S.S.Number t}g 3g Cj, ma,°` t� •tach•: �9�i� caesn�ba The Contractor agrees to do the following work for the Homeowner: (Describe in detail the work to completed,specifying the type,brand,and grade of materials w be used use additional sh is if ecess ) �c�-Pr'ei✓Y� ism ��6 ira.0 vtd ,rraor-� o n �"-Sz,kr�u-�� ��'t� �ia� � et-v�� S�-�t-'S. C;u� b2C�roo act 5° �r;rte_c_5 fid'c2i rt�. y 17e.- C� �Lecf acUt es �� c� 9 C Eec vk-b; iS, Required Permits-The following building permits are required Proposed Start and Completion Schedule-The following schedule will and will be secured by the contractor as the homeowners agent: be adhered to unless circumstances beyond the contractor's control arise (Owners who secure their own permits will be excluded from the Guaranty Fund provisions of Date when contractor will begin contracted work. MGL chapter 142A.) Date when contracted work will be substantially completed. Total Contract Price and Payment Schedule '? The Contractor agrees to perform the work,famish the material and labor specified above for the total sum of: G- p (*) Payments will be made according to the hollowing schedule: $ upon signing contract(not to a reed 1/3 of the total contract price or the cost of special order items,whichever is greater) $ by /_/_or upon completion of $ by_/ /_or upon completion of $ upon completion of the contract.(Law forbids demanding frill payment until contract is completed to both party's satisfaction) The following materialt quipment must be special $ to he paid for ordmd before the contracted work begins m order to meet the completion schedule.(°i) $ to be paid for NOTES:(*)Imi rding all nom Ge charges(*-)Law requires that any deposit or down-payment required by the comractor before work begins may oat exceed the greats of(a)one-third of the total-ndr oot price or(b)the acetal oast of any special equipment or custom made material which must be special ordered m advance to meet the oomplet on schedule. E n W tr- L h b' 'ded b th t dory No 0 Yes/all terms.1 11,warranty must be attached to the contract) Subcontrac4ors-The contractor agrees to be solely responsible for completion of the work described regardless of the actions of any third party/subcontractor utilized by the contractor The contractor further agrees to be solely responsible for all payments to all subcontractors for materials and labor under this amerit nce Contract Acceptance-Upon signing,this document becomes a binding contract under law.Unless otherwise noted within this document,the contract shall not imply that any lien or other security interest has been placed on the residence, the following cautions and notices carefully before signing this contract • Don4 be pressured into signing the contract.Take time to read and fully understand it.Ask questions if something is unclear. • Make sur-dr tr for has a valid Home Improvement Contractor Registration.The law requires most home improvement contractors and subcontractors to be registered with the Director of Home Improvement Contractor Registration.You may inquire about contractor registration by writing to the Director at 10 Park Plaza,Room 5170,Boston,MA 02116 or by calling 617-973-8787 or 888-283-3757. • Does the contractor have insurance?Ask the Contractor for his insurance company information so that you can confirm coverage,or ask to see a copy of a"proof of insurance"doctrment. Know your rights and responsibilities Read the Important Information on the reverse side of this form and get a copy of the Consumer Guide to the Home Improvement Contractor Law. You may cancel flus agreement if it has been signed at a place other than the contractor's normal place of business,lin yided you notify the contractor in wilting at ;/her main office or branch office by ordinary mail posted,by telegram sent or by delivery,not later than midnight of the third business day following the signing of this agreement. See the auwhod notice of cancellation f ret ran explanation of tbis right. DO OT SIGN THIS CONTRACT IF THERE A SM 7'wo i copra a—t—be oompi-d aad signed.Ono copy shoWd go b the riopy shaWd be 1.pt by tlt covhac[or. Homeownei's Signazure /' Contractor's Signature ° Date Date Contractor Arbitration The Home Improvement Contractor Law provides homeowners with the right to initiate an arbitration action(as an alternative to court action)if they have a dispute with a contractor. The same right is not automatically afforded to a contractor,however. The contractor would have to resolve any dispute he/she has with a homeowner in court unless both parties agree to the optional clause provided below. This clause would give the contractor the same right to arbitration as is afforded to the homeowner by the Home Improvement Contractor Law. The contractor and the homeowner hereby mutually agree in advance that in the event the contractor has a dispute concerning this contract,the contractor may submit the dispute to a private arbitration firm which has been approved by the Secretary of the Executive Office of Consumer Affairs and Businejhp"0 d the consumer shall be required to submit to such arbitration as provided In Massachusetts General LaHomeowner's SignatureSi nature NOTICE:The signatures of the parties above apply only to the agreement of the parties to alternative dispute resolution initiated by the contractor. The homeowner may initiate alternative dispute resolution even where this section is not separately signed by the parties. Homeowner's Rights A homeowners rights under the Home Improvement Contractor Law(MGL chapter 142A)and other consumer protection laws(i.e_MGL chapter 93A)may not be waived in any way,even by agreement. However,homeowners may be excluded from certain rights if the contractor they choose is not properly registered as prescribed by law. Homeowners who secure their own building permits are automatically excluded from all Guaranty Fund provisions of the Home Improvement Contractor Law. The contractor is responsible for completing the work as described,in a timely and workmanlike manner. Homeowners maybe entitled to other specific legal rights if the contractor guarantees or provides an express warranty for workmanship or materials. In addition to guarantees or warranties provided by the contractor,all goods sold in Massachusetts carry an implied warranty of merchantability and fitness for a particular purpose.An enumeration of other matters on which the homeowner and contractor lawfully agree may be added to the terms of the contract as long as they do not restrict a homeowner's basic consumer rights. If you have questions about your consumerlhomeowner rights,contact the Consumer information Hotline(lasted below). Execution of Contract The contract must be executed in duplicate and should not be signed until a copy of all exhibits and referenced documents have been attached. Parties are also advised not to sign the document until all blank sections have been filled in or marked as void,deleted,or not applicable. One original signed copy of the contract with attachments is to be given to the owner and the other kept by the contractor. Any modification to the original contract must be in writing and agreed to by both parties.Contracted work may not begin until both parties have received a fully executed copy of the contract,and the three day rescission period has expired. Accelerated Payments A contractor may not demand payments in advance of the dates specified on the payment schedule in cases where the homeowner deems him/herself to be financially insecure_ However,in instances where a contractor deems him/herself to be financially insecure,the contractor may require that the balance of funds not yet due be placed in a joint escrow account as a prerequisite to continuing the contracted work. Withdrawal of funds from said account would require the signatures of both parties. Additional Information If you have general questions or need additional information about the Home Improvement Contractor Law or other consumer rights,or if you wish to obtain a free copy of"A Massachusetts Consumer Guide to Home Improvement" contact: Consumer information Hotline Office of Consumer Affairs and Business Regulation 10 Park Plaza,Room 5170,Boston,MA 02116 617-973-8787,888-283-3757 or visit the OCABR website at httta: c�a-:'.:`3ass.�c=r ecabr% If you want to verify the registration of a contractor or if you have questions or need additional information specifically about the contractor registration component of the Home Improvement Contractor Law,contact: Director of Home Improvement Contractor Registration Office of Consumer Affairs and Business Regulation 10 Park Plaza,Room 5170,Boston,MA 02116 617-973-8787,888-283-3757 or visit the HIC website at h �i`--,,,"nias "o'o^ab" Go online to view the status of a Home Improvement Contractor's Registration: bdb_ta=e_:na.€uthomnu;evementrlic=r_.b-st.asn For assistance with informal mediation of disputes or to register formal complaints against a business,call: Consumer Complaint Section Office of the Attorney General 617-727-8400 AND/OR Better Business Bureau 508-652-4800,508-755-2548 or 413-734-3114 v—i-2-1-11/22010 1 � ■ D J Mnl Eielne-r RConsWcl 16 Wnndland Sl 11 ■ V M­A.D­P.E. Lew—Ma.018C R.P.EL.Y,:33848 C.S.L.F:47056 T:978-8P1-7588 978185-5691 x.IC.LA 1. 06698 >.jl me«o ae�e� aa.o m Certification on Structural Impact 3/30/15 Re:1 Mill Pond,North Andover,MA Owner:Sebastian Valentin I hereby,certify that the existing structural building assembly and its bearing capacity will not be impacted by the new framing to be built to house a laundry as part of the repairs and improvement works at the above-captioned property. Respectfully yours, i SACy�jsFj� #33848 Marcos A.Devers J.P.E.MAKE Q� Mass PE license REGIS 9 The Commonwealth gg'Massacfruseas Department of ludustrial Accidents 1 Congress Street Sane 100 a Bostorr, VSA 02414-2017 www.maS& op/dia Workers'kers'Compensation Insurance Affidavit:Builders/Contractors/Eleetricians/Plumbers. TO BE PILED WITH THE PERMITTING AUTHORITY. Applicant brit rsuation Please Print Lesi6ly Name(Business/Oromiizariowlndividual): MDJ incorporated Address: 16 Woodland"Street City/State/Zip: Lawrence,MA 01841 Phone#: (978)804-7588 Are you an empBiivcr^C6ecX tM1e apprapeiace box: Type of project(required): 1,E]l am a empkryer with 3 employees trail andbr pan-time).° T ❑New construction u,to p�",ieW,o,W'U-"i'ap td b-, --.epiuywx a'Iwg f.,�,nz to 8. F-1 Remodeling am capanty_]No narkm-comp,in reg required.] 3.®I am a homeowner dow,all pork myself.[M)nutters'comp,insursm:e rNuired.]t 9. ElDemolition 4,01 am-a homeowsrenand wtill to hia a- t tu-Ionondmia 1 Hoch mtn lxoperly.Swill 10 E]Building addition arc that all contractor cithor have porkers compensation insurance or arc sole 11❑Electrical repairs or additions propnotms nhh no cmployeos. l2.❑Phvnbing repairs or additions 13. Roofrepaim The eavtr- trncfon.l>v rnpl gees andl etaxkcrs' p soranc e.©we are a corporanon and usnrfi—txiue ezeresed per Mat.e. 14. Other Building Repairs 132,§1(4),-d..hat=e no omployees.]No workura'comp.ins+uancerequireJ.) 'Nry appli—t that cheek,bur XI most also fill out the section below showing their rvmk us'compeusatimt poliev information. "]lomwnner who submit this affidavit indicating they are doing all stork and then hue outside contractors must ummit a vewat75dnvit indicatine such. ^Convactors tiu�tcfieck this bor must anuched an additinnni she a shmvine flte name of ttm.wt,-contractors and sls(e whether or.1those entities hwe ernpios if e— r iruee ttnploy to t Pi ale tnxl erg comp.poli I ren an employer Pkat is providing warhers'eonepetrsaknn insurance for mg=etauloyees. Below is the policy and job site infarmation. Insurance Company Name: Continental Casualty Company Policy#or Self-ins.Lie.e. } ,y#: UB-5B759670t-14 Expiration Date: 11/20/2015 Job Site Address: ) 1`\I I I Pon Ci Ciry/State(Zio: �` F- AAA 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 maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do herebyre 'v:s acrd p of perjury that Ale information provided above is true and correct Sumawre: 9 Date: ,,enc,: (978)804-758 Official use anly.Do not nrite in this area,to he completed by citta or tower official. City or Town: Permit/License# Issuing Authority(circle one): 1..Board of health 2.Building Department 3.CityiTown Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other IContact Person: Phone#: CERTIFICATE OF LIABILITY INSURANCE s/sizois 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 WANED,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 NAONTACT Lou TOnry Albert J. Tonry Sr Co., Inc. PHONE (617)773-9200 300 Congress Street IN—M&S cert'@tonry.coa MSU S AFFOROINGCOVERACE NAI.. Quincy MA 02169 MSURERA:End=a'aCe American Specialty 41718 INSURED INSURER e' MDJ, Incorporated INSURER C: 16 Woodland Street INSURER D' INSURER E Lawrence MA 0.1841 INeURER F: COVERAGES CERTIFICATE NUMBERCL1511309745 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 5HOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. MSR TYPEOFINSURANCEPOLICY EFF POLICYEXP POLICYNUMBER DO D LIMITS GENERAL UNBILM EACH OCCURRENCE $ 1,000,000 X COMMERCUS GENERAL LIABILITY PREMISF.,'T="_'rn S 100,000, A 'CLAIMS-MME[i]OCCUR CBCIGOO1403802 2/22/2019 2/22/2015 MEO EXP(Arymie parsec) $ 5,000 PERSONALB AUVINJURY 8 1,000,000 _ GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT—LIES PER: PRODUCTS-COMP/OP AGC. $ 2,000,000 X -U- P Loc $ AUTOMOBILE LIABILITY fEOMBI�N4ED SINGLE LIMB MTO ROD-INJURY(—P—) $ 'ALLOWNED UT 6 AUTOS SCHEDULED BODILYINJURY(Peraai—) $ HIRED AUTOS NON—F. PROPERTY DAMAGE $ AUTOC lPerarrment UMeRELLALIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLNMS�hWDE AGGREGATE----- S DED RETENTIONS $ WORXERSCOMPENSATION WC STATLL OTH- ANDEMPLOYERS'LIABILITY y)NT_M ANY PROFRIETOWPARTNERIEXECUTNE ELEACHACCIOENT $ OFFICER/TAEMSER EXCLUDED'! NIA (Mantlnory fn NH) EASEI EMPLOYE S Iy'tl ai.UMar DESCRWPON OF OPEPAPONS beknv EL DISEASE-POLICY LIMIT I$ DESCRI—OF OPERATIONS I LOCATIONS/VEHICLES(AU—ACORD...AtltleionM Remarks 8cFetlule,if mwe apaw taraquirod) Re: 1 Mill Pond, North Andover. Operations usual to a sidential general contractor. When required by written contract executed prior to loss, the certificate holder and other parties are included as additional insured(s) for work performed by the named insured. CERTIFICATE HOLDER CANCELLATION (978)688-9542 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. Building Department 1600 Osgood Street AUTHORDED REPRESENTATIVE Building #20, Suite 2035 North Andover, MA 01845 _ -('----- "— L Tonry Jr./MFOLAN ACORD 25(2010!05) ®1988-20'10 ACORD CORPORATION.All rights reserved. INS025 nn,nns,n, Tf.s er•non------ -1® CERTIFICATE OF LIABILITY INSURANCEDATE IMM/DD/YYYYI TIFICATE 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'RC.UCC FC E O D . IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(les)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require and endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements. PRODUCER CONTACT NAME: _ ALBERT J TONRY&CO INC PHONE FAX 300 CONGRESS STREET (AIC,No,Ext): E-MAIL QUINCY,MA 02169 ADDRESS 2873Y INSURER(S)AFFORDING COVERAGE NAILIt INSURED INSURERA: CONTINENTAL CASUALTY COMPANY MDJ INC INSURER B: INSURER C: INSURER O: 16 WOODLAND STREET INSURER E: LAWRENCE,MA 01841 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 TXE POLICY PERIOD INDICATED.NOTRDING WHSTAN ANY REQUIREMENT,TERM OR CONDMON 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,UM-USIONS AND CONDITIONS OF SUCH POLICIES.LINTS SHOWN MAY HAVE BEEN REDUCED BY -PmOCLAIMs. INSR ADD SUB POLICY EFF DATE POLICY UP DATE LTR TYPE OF INSURANCE L R POLOYNUMBER (MNODIY ) (MNDDIYYYY) LIMITS GENERAL LIABILITY CH OCCURRENCE $ COMMERCIAL GENERAL LIABIUTY CLAIMS MADE OCCUR. DAMAGE TO RENTED $ PREMISES(Ea.wane-.) MED EXP(Anyone person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: ENERAL AGGREGATE $ POLICY PROJECT LOC RODUCTS-COMPIOPAGG $ AUTOMOBILE LIABILITY COMBINED SINGLE $ ANY AUTO LIMIT(Ea accident) ALL OWNED AUTOS BODILY INJURY $ -SCHEDULEAUTOS, (Perp—n) _ __ HIREDAUTOS BODILY INJURY $ (Peraxldent) NON-OWNED AUTOS PROPERTY DAMAGE $ (Per aaidenq UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION$ $ A WORKER'S COMPENSATION AND X wC STATUTORY OTHER EMPLOYER'S LIABILITY YIN U8-58759670-14 11202014 1120/2015 LIMITS ANYPROPERITOP/PARTN F—ECImVE NIA E.L.EACH ACCIDENT $ 500,000 CFFICERAIEMBER EXCLUDEM (MeMe[ory in NH) E.L DISEASE-EA EMPLOYEE$ 500,000 Ify.,d,,—I,antler E.L DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESIRESTRICTIONSISPE ML ITEMS THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO IID:CERTUTCATE HOLDER AFFECTING WORKERS COMP COVERAGE. CERTIFICATE HOLDER CANCELLATION TOWN OF NORTH ANDOVER,BUILDING DEPT. SHOULD ANY OF THEABOVE DESCRIBED POLICIES BE CANCELLED 1600 OSGOOD STREET,BUILDING#20 SUITE 2035 BEFORE TH PIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORD E WITH THE POLICY PRO 1'. AUTHOR E RESENTATNE N.ANDOVER,MA 01845 _ L�yyti.Q,.- ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD 1988-2010 ACORD CORPORATION.All rigWiereserved. Massachusetts Department of Public Safety Board of Building Regulations and Standards C 't-fi sup'. License CS-047056 7L MARCOS A BEVI i \ - - 16 WOODLAND3T ' -. .. LAWRENCE HM 1h 01&1 �\\3 � :l•'�^•�l s.•�¢- 1012512095 ol�aecooau��rnirwn;�a.�..�R�sm=1�oo y�►liaRs3'] �� eevl=ra�tlrcn�zacsoe ' tis rntss�€s�*�,es: ' an: 7724t2b16 PnvaleOaryorsBa - MaiNc. nasrda3s :. .: #ur thtc�s�uL�an 3riQusiry• Marcors Devers '- }2 61 WOOD LAND STREET LAWRENCE.MA 01841 Uaderser—" 63recisri5eet1/4�eRaq NamM=Tp`f>•r Project Address: i wok ?o,-)d NoY+v) Nnduuey- MR The above licenses are authorized for the project address stated above only. DO NOT REPLICATE. Aut -i Is t3= d t f f MDJ Engineering& ons nt 59e—A.0evers J.,P.E. 978-F04-7,8- -