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HomeMy WebLinkAboutBuilding Permit # 8/19/2015 _ i 'V TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO:: Date Received Date Issued: IMPORTANT:Applicant must complete all items on this a c LOCATION PROPERTY N1,APNO (= ARCEL �OaING 4tSTRICT \Historic Disffiet�� �. eyes. no �� " '��Machme SFioillago�yes, ono TYPE OF IMPROVEMENT PROPOSED USE Residential Non-Residential ❑New Building One family E Addition E Two or more family E Industrial E Alteration No.of units: E Commercial E Repair,replacement E Assessory Bldg ❑ Others: E Demolition Other aseptic `Well-: EFwatershed loodplain, EWetlantls .. ater 'District istrret a.. E Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: v IdentificationPlease Type'or Print Clearly) OWNER: Name: t -=,€'efii. t& -/' Phone''72-2 Address: c�-"La-✓J t""'� [Add RACTOR Names � tnef ss' visors Construction Li\ensef Exp Date �F M Home ImproJeirteit Licepse 1, '.` Exp_ ARCH ITECTIENGINEER Phone: Address: Reg.No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED"LOSTBASED ON$'12. PERS.F. ` l Total Project Cost:$,,V FEE:$ s Check No.: t Receipt No.: (Q9 NOTE: Persons contracts s ith unre stered ontractors do not have access e guargntyfund Signature of Ageni/Own�rr Signature of contractor Plans Submitted El '�.Plans Waived❑ Certified Plot Plan❑ tamped Plans❑ , Mass,Town of Andover � BOARD OF HEALTH PERMIT TO ILD - form to the terms of the applicat'l'o'n provided that the person accoting this permit.a n v. asp con rml 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. R-gh PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR � ' UNLESS BUILDING INSPECTOR fGAS INSPECTOR � r � DisplayinuConopicuouuPlaouonUmPmmisos—DoNotRnmuve NoLathing mDry Wall ToBoDone FIRE DEPARTMENT Until Inspected and Approved bythe Building Inspector. SECTION S:CONSTRUCTION SERVICES 5.3 Construction Supervt or License(CSL) uv F t > ({ L e N tuber Exp on D- Lilt fCSL HoIdf / � s -f'Y F l - _ List CSL Type[see below) and Street Ty Descriptio _ U U—Iicted(Buddhas up to 35,000 Restricted 1&2 Family Duelling C iy/T State,ZIP M Masonry RC :Roofing Covering WS Window oad Siding _ - SF Solid Fuel Bumiag Appliaces I -Insulation Tel hone. Emailaddress D Demolition 5.2 R.giatur,d He..I p vein t Chat racto (IHC) -. C H[C R snanoa Numb Pxpmation Date HIC C�pany Nam HI ` N d S[ Email address Q at�`- !� to F I City/Tow,State.ZIP > ` T--- SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.,152.§25C(6)) Workers Compensation Insurance affidavit must be completed and submitted witfi this application.Failure to provide this affdevit will result in the denial fthe lesuanarsvfthe building oarrnit. Signed Affidavit Attached? Yes......--if No...........❑ SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,as Owner ofthe subject property,hereby authonze ..7 { -✓f r' f-- -2,>> / to not on my byhalf,in all matters relative to work authorized by this building permit application. — ' Pnnt Owners Manw,(Electronic Sig ure) T a/-w SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION Boan ng-mom¢below,I hereby attest under the pains and penalties ofprujury that ell ofthe information tdained in this opp)fcation is true and accurate to the best of my 6 owledge and uadarstanding. 5 P{int Owner's or Authorized Agent's Name(Electronic Signature) Done NOTES: I. An Owner who obtains a building permit to do his/her own work,or an ownerwho hires an nregistered contractor (not registered in the Home Improvement Contractor(HIC am Pro ),will not have access to the arbitration program or guaranty fund under M.G.L.c.142A.Other important information on the HIC Program can be found ai ca Information on the Constmetion Supervisor Lice an be found at www.mass.sov/dps 2. Wh nsubstantial work is planned,provida the information below: Total floor area(sq.ft) (including garages,finished basemer-mics,decks or porch) Gross living area(sq.fL) Habitable room count Number of fireplaces Number of bedrooms Number of baths roomNumber ofhalf/baths Type of heating system Number of decks/porches Type ofe..Ii.g system Enclosed ope. 3. "Total Project Square Footage"may be substituted for"Total Project Cost" AB Carnes Roofing,Inc. _ 30 Arrowhead farm Rd Page 1 of 1 = Boxford,Ms.01921 978.887.1431 - MA.CS-000230 and HIC Reg.176928 - Proposal Submitted To: - MICHAEL&KATHLEEN FANNING out. July 29,2015 140 COLONIAL AVE Pmjsm Name SAME - NORTH ANDOVER,MA 01845 Address a 978-685-7877 , We propose to furnish material and labor-in accordance with the specifications below: Nine Thousand One Hundred Dollars($9,100.00) Payment to be made as follows:$300.00 Deposit,Balance Upon Completion - Noaice:All home improvementcontadors antl subcontractors engaged in home improvementmntracling,unless speciflddir exemptfmm reg'wtration by provisions of Chapter 7 142A Df The Genemi Laws,must be regisrxred withNe Commomveabh of Massachusetls.Inquires about registration and rodus should be made to the Mo s.govdicenses website. ROOF PROPOSAL 7.STRIP ROOF OF ALL LAYERS OF ASPHALT SHINGLES.COVER ROOF DECK WITH THE UPGRADED RHINOROOF TITANIUM U20 HIGH = PERFORMANCE SYNTHETIC UNDERLAYMENT MEMBRANE.COVER EXTERIOR WALLS AND FOLIAGE WITH TARPS TO HELP PREVENT DAMAGE, _ Z, ICE DAM PROTECTION:INSTALL CARLISLE HIGH PERFORMANCE ICE&WATER BARRIER OVER ALL HEATED AREAS SIX FEET WIDE AT THE = LEADING EDGE OF ROOF AND THREE FEET IN ALL VALLEYS,WRAP THE CHIMNEYS)AND SKYLIGHT CURBS WITH ICE AND WATER BARRIER. 6L COVERALL PERIMETERS WITH EIGHT INCH PREFORMED ALUMINUM DRIP EDGE, r 7 INSTALL GAF COBRA RIDGE VENT ANDIOR'Z.THREE ROOF LOUVERS FOR ADDED ATTIC VENTILATION. COVER SOIL PIPES WITH NEW RUBBER FLASHING BOOTS AND FLANGE. _ - REPLACE WALL FLASHING(S)AS NEEDED WITH ALUMINUM OR LEAD AT THE ADDITIONAL COST OF$25,00PLFT,WE MAY NEED TO REMOVE (. THE SIDING TO PERFORM THIS WORK AND YOU MAY NEED TO HAVE A CARPENTER REINSTALL OR REPLACE THE SIDING THAT WAS REMOVED. CHIMNEYFLASHING:CUT ALL EXISTING TARAND LEAD FROM CHIMNEY(S).CUT NEW REGLET WITH CARBIDE SAW AND SECURE NEW LEA9FLASHING IN PLACE WITH MET-AL ANCHORS PROPERtYSERC'RHOLEY.701NT:-PLE4SE ADD TOABOVEPRICE.- --�'COVER ROOF SU RFACE WITHCERTAINTEED LANDMARK 240CB LI FETIME WARRANTY DESIGNERSHINGLES, REPLACE DEFECTIVE ROOF DECK AS NEEDED WITH SIMILAR AF-AHADDITIONAL COST OF$4.00PSOFT. O^ COVER ROOF DECK WITH COX PLYWOOD AS NEEDED TO REPLACE OR REPAIR DEFECTIVE DECKING,AT AN ADDITIONAL COST OF 7,NAILING:SECURE SHINGLES WITH EIGHT IN TOTAL COATED ROOFING NAILS AS PER CERTAINTEED SPECIFICATIONS. - SKYLIGHTS:REPLACE EXISTING SKYLIGHTS WITH NEW VELUX OR WASCO UNITS,WE WILL PROVIDE THE SKYLIGHTS&FLASHING KITS AT OUR EXACT COST FROM OUR SUPPLIER.OUR LABOR CHARGE IS$75.00 EACH IF THEY ARE THE SAME SIZE.INTERIOR WORK IS EXCLUDED. '..REMOVE EXISTING GUTTERS u.INSTALL NEW SEAMLESS,032 ALUMINUM GUTTERS USING THE HIDDEN ZIP SCREW HANGER SYSTEM. REPLACE DEFECTIVE TRIM BOARDS WITH CUSTOMERS APPROVAL USING NO.2 PRIMED PINE,ADD PLFT TO THE ABOVE PROPOSAL. C.INSTALL NEW ALUMINUM DOWNSPOUTS AND MECHANICALLY FASTEN ALL CONNECTIONS. CLEANALL PROJECT RELATED DEBRIS FROM OUTSIDE WORKAREA THE PROPERTY OWNER AUTHORIZES AB CARNES ROOFING TO OBTAIN ;-I �L PERMITS.WE CANNOT ACCEPT RESPONSIBILITY FOR DEBRIS U.nOATT1 AREASCUSTOMERSHOt1LQCOVER VALUABLES, � �_ _ GREAT CARE-WILL BE USED TO PROTECT THE STRUCTURE AND FOLIAGE.HOWEVER,SOME MARRINNO AND OR MINOR DAMAGETMt DOCCUR. —IN ADDITION WE CANNOT BE RESPONSIBLE FOR ITEMS FALLING FROM WALLS SHELVES OR CEILINGS DURING THE ROOFING PROCESS. t = SPECIAL INSTRUCTIONS: THE ABOVE PROPOSAL INCLUDES ALL SHINGLED ROOF SECTIONS OF THE HOUSE, SHINGLE UPGRADE:UPGRADE TO THE LANDMARK 300LB HIGH DEF PREMIUM SHINGLES,ADD§1375.00 YES()NO( THIS IS OUR COSY WARRANTY UPGRADE:THE CERTAINTEED WIND WARRANTY WILL BE UPGRADED FROM 110 MPH TO 130 MPH WITH UPGRADE TO THE CERTAINTEED HIGH PERFORMANCE HIP&RIDGE CAPS AND STARTER COURSE AT NO ADDITIONAL CHARGE.YE$k _ EMAILADDRESS: �/ v [V Q,�Ci.,VfY!!Y)F11��O iitGl;rLtOr^.�i.�rYl Warranty:All work warranted against installation defects for 5 years;this warranty is limited to the installed item(s)and its repair only.Material Is warranted by = the manufacturer against defects for 50 years;see the manufacturers warranty for exact warranty performance. - Cancellation:Customer has legal right under federal law to cancel this contract without.penalty or obligation within three business days from the data of signing this agreement via Priority Mail Delivery Confirmation.Please see reverse side. Dispute Resolution once,Massaclluseffs Home Improvement Law 142a:All parties agree that any and all disputes relating to this proposal shall be settled by arbitration.This forum is user friendly and does not require lawyers.Please see reverse side. Signing this Proposal means,you h accepted all the terms as stated on the front and back of this agreement.Please see reverse side. 3 = "Date of Acceptance / 3 Signature ` '!°'_—� Si m.' / -"✓ - - Signaturea gnature * - PLEASE SEE REVERSE SIDE i TOWN OF NORTH ANDOVER WASTE AFFIDAVIT As a result of the provisions of MGL Ch.40-s54,1 acknowledge that as a condition of building permit N all debris resulting from the construction activity governed by this building permit shall be disposed of in a properly licensed solid waste disposal facility,as defined by MGL Ch.111-s1SOA. Waste Disposal or Solid Waste Facility: ALLIED WASTE Address: 300 FOREST ST Town/City,State,Zip: PEABODY,MA 01960 NAME OF HAULER: AB CARNES ROOFING,INC.DUMP TRUCKS DATE:8-17-2015 SIGNATURE OF APPLICANT: J r The Commonwealth ofMassaclzasetts 4`1 0 Deparhnent oflndustrialAccidents I Congress Street Suite 100 %W,-?, Boston,M4 02114-2017 !1 wwwmueogov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Eleewieians/Plnmbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Pi as P'nY L 'hl Name(sus;nesyorganizadominaiviauap:A6 CARNES ROOFING INC Add res5:30 ARROWHEAD FARM RD City/State/Zip:BOXFORD,MA 01921 phone#:978-887-1431 re you an employer?Coo the appropriew box: Type ofiproject(required): i-❑I am a unptcyer witty ednployees lfull vnW"part-[rape) 7.❑New construction, z❑1 am a.role propaeror or parzn h,and haveno e,np!oyus worx ft,w,n, any`aPaatr-1No[,omen amnp.insnance aaneval S.❑Remodeling a7_t am a nomeowner doing all work m if kers°tom wus.xe ,nirea]• 9.❑Demolition � tae Mo won pis 4.❑lamahotneowaer and wul ba hmng nono-aa[ocsm—d-a11 wo:#on:nm 1wiR 10❑Building addition Prof Ty- reihatoil eonaaomra ehher nave workers'rompan anon usafrmrw or ar�so!a 11.❑Electrical repairs or additions praPriuors with vo unPlcye�s- a 12.❑Plumbing rapairs orJiaddiri�t in e 1-1—t-1 and 1 have hired the subaen e listed on ficauached space ons .,These subcron-n—hnveemptoyees and have urotAets comp.innmance- 13.QROOf Lepali5 6.,/Weareaco '- £Stas nave exercrosed their-im ofeee:n 14.❑Other ❑ ipornucnmctua. g pvan par MOLa 4i2,(1(4J,and we neve no employees.INo.vorlser comp.insurance required.] H.— .epphoaR[hat anecks box pl must ako fill oul[hesecdon below mowing theirwotke6'nompe:uation policy infornutiov- t nomeovnets wno mbnu[Ihi>e}5dnvi[indieetivg!racy aze doing al!work rand Wav hue ou6ideeonrrdctois must xibmit a new affidavit mdivating such. -Cov rs ihvt eheckthis bnx mug vttaehed an additional brace[nhowine the vameof the subcov[rue[ors and s:atcwhcrltmor mtthose enuities havz umple­lfthe sub-contmuorshove anployees_fney m:ut provide their wocken omp.policy vumbet i ala an employer that is providtixg workers'canpensation orsaraace for my employees.Below R rhe parity and job site information. Insurance Company Name: Policy it or Self-ins_Lie.H: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy—.the,and expiration date). Failure to secure coverage as required under MGL c.152,§25A is a criminal violation punishable by a fine up to 51,500-00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a Far,of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of to,DIA for insurance coverage ve}ification. I in hereby ter ynder the pales and p i.Ilies ofperiu,Su¢rhe inforn.ali u provided ab...iijs nue gad correct Signature ?' �/" - = Date-= ZS ! Phone#:978 887-1431 Official use only.Do not write in this area,to be completed by city or town ficial. City or Town: Permit/Lieense# Issuing Authority(circle one): I.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] D1A use o ly Department of Industrial Accidents yid r Office of Investigations Dept.253 1 I Congress St—t,Suite Soo,Boston,Massa.hasetts 021€4-ZO17 / alp.//--ass.g-Mill I.-At./swo ID AFFIDAVIT OF EXEMPTION FOR CERTAIN CORPORATE OFFICERS OR DIRECTORS Chapter 169 of the Acts of 2002 amended MG,L,c.152,§1(4F)by adding the following paragraph: "This chapter shall be elective for an officer or director of a corporation who 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. .Nam,of C.1Fn B.a and Addis) 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). !/We the undersigned do also waive any and all rights to make claims for benefits as defined in M.G.L_c.152 for any 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.1527§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/ouy name(s)indicating my/our desire to be exempt or not to be exempt from the provisions of M.G.L.c.152. I_3whed under the-dins and penalties of perjury: /- BARRY CARNES,PRESIDENT 09/24/2013 S�oat_e Pr,I Name&Title Date(mm/dd/yy),) Q it wish to exercise my tight of exemption or' :1, 7 wish NOT to e-misa my right Wftotptien �- ANASTASIYA CARNES,DIRECTOR 09/24/2013 5'e ur PnOtN &Th1 Date(mm/ddhy,y)-t ❑J I wash to e��ens ny right of exemption o ❑1 wish NOT to­­io mydZht.l'e­p,o,o­­i Signature Print Name&Title Date( dd/y ❑Iwish to asercise my right of 1,..pt on or ❑Iwish NOT to eXerci_ae my right of ezemptioo ,-�' sioaeture Print Name&Title Date(mavdd/)yyy) ❑Iwish to cxatcise my right of exemption or❑Iwish NOTto—isemy righti,fe-,aption Note;ALL ELIGIBLE CORPORATE OFFICERS MUST SIGN.THERE CAN BE NOMORE THAN 4 SIGNATURES.Instructions ort hack. .o.r,-- lon MA SOC Filing Number:201340178570 Date:6,12612013 6:21:00 PM The Commonwealth of Massachusetts Mmimmm Fee:szso.00 _ -- William Francis Galvin Secretary ofthe Commonwealth,Corporations Division ` One Ashburton Place,17th floor Boston,MA 02108-1512 Telephone:(617)727-9640 Federal Employer Identification Number:001110484(must be 9 digits) ARTICLE€ The exact name of the corporation is: AB CARNES ROOFING,INC. ARTICLE It Unless the articles of organization otharwid,provide,all ccrporaiions formetl pursuant to G.L.C166D have the purpuse of of in any lawful business.Please specify If you want a more limited purpose' COMMERCIAL&RESIDENTIAL ROOFING AND ROOFING RELATED WORK.THIS SHALL INCLUDE ALL TYPES EXTERIOR&INTERIOR REMODELING ARTICLE It State the total number of shares and par value,if any,of each class of stock that the corporation is authorized to issue.Ali corporations must authorize stock.If only one class or series is authorizei it is not necessary to specify any particular designation. Par Value Per Share Total Authorized by Articles Total Issued I Class of Stock Enter 0 if no Par of Organization or Amendments and Outstanding Nun,of sh— Total Par Voh,e Nrmr af'Sh". cup ifereCC laso ps- 1,Coo G.L.C156D eliminates the concept of par value,however a corporation may specify par value in Article III.See G.L. C1 56D Section 6.21 and the comments thereto. € ARTICLE IV If more thanane 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 l 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 data oforganization and lime the articles were received for filing if the articles are not rejected within he 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. ti 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 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 BO eox) F-,M;ddle.Lash,SuffixCotle Atltlre Town,5 a[e Z p PRESIDENT BARRY S CARNES 30 ARROWHEAD FARM RD BOXFORD,MA 01921 USA TREASURER BARRY S CARNES 0 ARROWHEAD FARM RD BOXFORD.MA 01921 USA SECRETARY ANASTASIYA V CARNES 30 ARROWHEAD FARM RD C—OND. MA 01921 USA DIRECTOR BARRY S CARNES 30 ARROWHEAD FARM RD BOXFORD,MA 01921 USA DIRECTOR ANASTABIYA V CARNES 30 ARROWNrAl'All DID BOXFORD,MA 01921 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:MA Zip:01921 Country:USA g.Street address where the records of the corporation required to be kept in the Commonwealth are located(post office bones are not acceptable): nio.and Street: 30 ARROWHEAD FARM RD City or Town: BOXFORD State:MA zip:01921 Country:USA which is _ itsprincipal office _ n office of its transfer agent n offce of its secretary/assistant secretary _ its registered office Signed this 26 Day of June,2013 at 6:23:02 PM by the incorporator(s).(Lf an existing corporation is —mg as m poratmt type in the exact name of the business entn0;the state or otherjurisdiction where it was incorporated,the name of the person signing on behalf o(said business entity and the title he/she holds or other aarthorig•by which such action is taken.) BARRY S CARNES AlI2RigM1[sZReservedmomvealtM1 of Massachusetts 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 Laws relative to corporations have been complied with, and I hereby approve said articles;and the filing fee having been paid,said articles are deemed to have been filed with me om June 26,2013 06:21 PM WILLIAM FRANCIS GALVIN Secretary of the Commonwealth Ao CERTIFICATE OF LIABILITY INSURANCE 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($),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER IMPORTANT:If the carifcate h.W.,i.an ADDITIONAL INSURED,the plilcy(ill)must be Ild,m,d.If SUBROGATION IS WAIVED, _bIaPt to the IaNna and conditions of UI,Policy,Fannin Wild-may require an endorsement.A statement on thisanflficte dina, .at confer rights to the certificate holder in lieu of such-&—nant(Q. -TACT N'A' "TACT ACE INS SERVICES INC 675 WARREN AV BROCKTON,MA 02301 � Nlll�11 2p7 APC CONSTRUCTION INC ' 51 FORD STREET UNIT BROCKTON,MA 02301 COVERAGES TIF NUMBER' MISION NUMBER: -F THIS IS TO CERTIFY THAT THE POLICIES LISTED BELOW HAVE BEEN ISSUE'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. ="111 P0UCYMM8E!I na-II11 IEFF,. - II w.oE­EBA_0 cure U-1U- V "XpAll NoeltEilaewn Mentos wc LY YA I 7LL.WNB. �B�U­ A_. 10 1-Ly N— - A. Y--d ) s Taa ­—U ­AT1 IN A-1—NT �tlNEGZZUB 10,22-20 4 10-22-2015 01 FA- S­IIA - 1,15122 00 Y Um'T 0�2 000 .s--.N000vewnraes I LocnnOxs I—S I—..an —Iae�rxzsrnmma,Ire pa is rsyuvaa) ­ ,CERTIE; ER INC. ICANCELLATION ROOFING SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE ARROWHEAD FARM ROAD CANCELLED BEFORE THE EXPIRATION DATE THEREOF, BOXFORD,'A0192I NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. I ACORD 28(2010105) The ACORD am and Ing,an, tar.©1988-2079 ACURD CORPORATION,All rights­ci. r.d..Nk..fACORD MA SOC Filing Number:201499735200 Date:10/21/2014 1:24:00 PM The Commonwealth of Massachusetts Min;mam F.:$250.00 William Francis Galvin - Secretary of the Commonwealth,Corporations Division One Ashburton Place,17th floor Boston,MA 02108-1512 Telephone:(617)727-9640 EN � slow Federal Employer Identification Number:001149988(must beg digits) $ ARTICLE I I The exact name of the corporation is: A P C CONSTRUCTION.INC ARTICLE II Unless the articlesof 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: CONSTRUCTION REMODELLING AND OTHER OTHER SERVICES PERTAINING TO CONSTRU CTION WORK 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 9 If no Par of Organization or Amendments and Outstanding Num aJ Sir— T-1 Par vo/vr Num fSlr— CNP a0b—i, 2rcrsr Mac 0 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. E€ I ARTICLE IV If more than one class of stock is authorized,state a distinguishing designation for each class.Prior to the issuance of any snares 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 V€ 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: ANGELO PINGUIL No.and Street: 51 FOR D STREET UNIT 1 City or Town: BROCKTOPN 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 I-Po a..) Firs[,M-1,Last—w Add,—,Cay o,Town,Si-Zip C— PRESIDENT ANGELO PINGUIL 51 FORD STREET BROCKTON,MA 02301 USA TREASURER ANGELO PINGUIL 51 FORD STREET BROCKTON,MA 02301 USA SECRETARY ANGEL.PINGUIL 51 FORD STREET BROCKTON.MA 02351 USA DIRECTOR ANGELO PINGUIL 1 FORD STREET BROCKTON.MA 02301 USA it.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: CONSTRUCTION AND RE-MODELLING I.The street address(post office boxes are not acceptab/e)of the principal office of the corporation: No.and Street: 51 FORD 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: 51 FORD STREET City or Town: BROCKTON State:MA zip:02301 Country:USA which is X its principal office _ n office of its transfer agent n office of its secretary/assistant secretary _ its registered office Signed this 21 Day of October,2014 at 1:26:45 PM by the incorporator(s).(Lfan existing corporation is acting as incorporator,type in the exact name of the business entity,the state or other jurisdiction where it was incorporated,the name of Phe person signing on behalf of said business entity and the title he/she holds or other authority by which such action is taken.) ANGELO PINGUIL 0 2001-2014 Common—rh of w,--- All Righis--d MA SOC Filing Number:201499735200 Date:10/21/2014 1:24:00 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 Laws relative to corporations have been complied with, and I hereby approve said articles;and the filing fee having been paid,said articles are deemed to have been filed with me on: October 21,2014 01:24 PM WILLIAM FRANCIS GALVIN Secretary of the Commonwealih Boa,.,of B.€ding Regu:at€Ens a—S.a d3 e cyt... SCS-000230 -- BARRY S CAR11'ES`` 30 ARRoVV"1Ai5FAM&Rn- _ Boxford MA 01921 03107/2016 t Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 Boston,Massachusetts 02115 Home Improvement Contractor Registration Registration: 176928 "" -- Type: Corporation Expiration: 10/10/2015 Tre 245633 AB CARNES ROOFING,INC - BARRY CARNES - 30 ARROWHEAD FARM RD `-- --- _ -- BOXFORD,MA 01921 - Update Address and return card.mark reaso f -hang. C Address n Ra-1 n Employment ❑Lost Card