Loading...
HomeMy WebLinkAboutBuilding Permit # 10/21/2015 t%ORTH BUILDING PERMIT ®F R.1LFo '616 TO O O TJ-I ANDOVER - h ::�. _ ..�a ° APPLICATION FOR PLAN EXAMINATION � Y tn'ta my Permit No#: Date Received �r �RArEo Ppa�5 "f �S"SACH►15�'� Date Issued: r "y `' ✓=w IMPORTANT: Applicant must complete all items on this page LOCATION "CSL .. ; �. Print PROPERTY OWNER Print 100 Year Structure yes MAP PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village yesno rr TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial epair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other i r r. ilr.;ii.,r l, ,. ,tier f, ,rJi > > , f //�D/�/C,yerc�r1,I„5„4..S, ea�t�eI,NGrY,ru!S/erfrwr,,/We /e�lel,t�lt,/J%!//T,,,�//��r,,,//��//,G1Ir�,(%,�/✓,�r�f,r/N„/�/,/i�,�/f,/�)/,,✓�1/(r,,,,J/1,�rfl i/, /r/J/1/,//,f/'/t,'f;fif iyi�I//1,(%ri /rr/�,,% ,»b �� ,/� � oated D,i trG �/t� odlai WetI/ /,/, r��/� Wers 1150, � , , DESCRIPTION OF WORK TO BE PERF RMED: C C1) tr ri 'I 1A � L�m tC>C), :��-�, -, C) )< Identification- Please Type or Print Clearly OWNER: Name: i a cLN C Phone: Address: - Contractor Name: Email: C Aio � , Kort �4 !� r� o LA 1-iAddress: `' e ��. �� 6�1�. Supervisor's Construction License: 0S " Exp. Date: /Z / t ° / Home Improvement License: i C Exp. Date: I Z r ARCHITECT/ENGINEER b..0 ( Cy Phone: ( 7r�3- ' (BC) >ICc �� g Address: .�� �1 - i�- Ike No. FEE SCHEDULE:BULDING PERMIT,$12.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$925,00 PER S.F. Total Project Cost: $ L�` �� FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access my fund FORTH r -41 A ' I ' ow*n of ndover ® • - �A�. h ver, MasS, C 42 ( 7 61 C0C"1C"t W.CK �,9 0, L) S l) BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System THIS CERTIFIES THAT .....C9.l i"�. � ®�"J °�'1 �"LS .......................... BUILDING INSPECTOR ........... ................ ......... ......... .. .... ... ..... ..... .... ... . � I 09 „� J, _ Foundation has permission to ere ......................... buildings on .. ...................... .............................................. Rough to be occupied as Ah . 4? .....tJ�. .. ................. . ..... .... ..!� ii',f,��h��5 -... ' o.. rte) Chimney provided that the person accepting this 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. re�& lby,17- PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final IT EXPIRESI6 MONTHS ELECTRICAL INSPECTOR LESS CONSTRUCTION STARTS Rough Service 1000 ...............y .. ..................................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy BulldlnRough 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. i M Proposal for Services Project: The Colonnade 1401 Great Pond Road North Andover, MA. 01845 Prepared For: Rick Stern Sutton Management Company, Inc. PO Box 773 North Andover,MA 01845 (978) 689-9994 Prepared By: Chuck Huntley Sohernecker Property Services,Inc. 283 Second Ave,Waltham,MA 02451 (781) 487-2516 cllllclk.hunttey t@spsinconline.com www.spsinconfine.com SPS HIC#: 123615 Expiration Date: October 22, 2015 Date Submitted: October 1, 2015 Proposal it: 5441821 I The Colonnade Pro OSAI:5441921 1'hc:Colonnade-GutWr,Roof,Siding,and Decks � P j i The work heretofore described is scheduled to connuellce on October 1,2015 with an expected duration of r approxirnatety 42 days.Substantial completion is expected by November 12,2015. i i Acceptance of Proposal The undersigned,as authorized representatives)of the property listed,have read the terms stated herein and accept i the tenns as written. ! A/ f �gHd ' 10/01/15 .i(:hATU0._ T UAIL' 9'urGO; U Tli I Chuck Hund Vice President Ri�tarn Oyl��� C OSG1�► Q II�`1`/ ;.cite niL�: NAME- -'111M.. 5chemeckar L'roperry Services!283 Second Av�nuc,Vtafil�am NSA 02451(3110.424.2iri8!slninWnfino.cum The Colonnade-Gutter,Roof,Siding,and Decks The Colonnade I Proposal#:5441821 p to JI1w r °> General Description: SPS,Inc.will provide the necessary supervision,labor,and materials to perform the work specified in this PFS in a good and workmanlike manner and in compliance with applicable laws and codes.The pricing provided in this PFS encompasses,in general,the following: Roofing: Garage roof replacement to include removal of existing roof system to expose the roof deck for inspection.Repairs to the roof deck will be completed using the allowances provided in this proposal. If additional work is required a written change order will be required.The new roof system will included waterproof membrane, synthetic underlayment and metal edge flashing to prepare the surface for GAF architectural shingle. Included Areas: ® Detached garage soffit ® Steep roof areas of the detached garage '.. ® Low slope area of the detached garage will received a fully adhered EPDM membrane • Dumpster costs and permits • Roof deck and framing replacement up to the allowance quantity • Replace deteriorated fascia with new PVC Excluded Areas: ® Siding repair or replacement Total Price for work as specified in the Scope of Work: $53,345.00 Additional Items,Alternate Items and Unit Prices Pricing provided on Page 3 is for specific items not included in the contracted Scope of Work.Please note that these items are additional to the"Total Price". Schedule of Work The work heretofore described is scheduled to commence on October 1,2015 with an expected duration of approximately 42 days.Substantial completion is expected by November 12,2015. Acceptance of Proposal The undersigned,as authorized representative(s) of the property listed,have read the terms stated herein and accept the terms as written. 10/19/15 , SIGNATURE DATE SIGNAIME-" _ DATE Chuck Hund Vice President V, e' S1 A k A A A— r NAME TITLE NAME TITLE Schernecker Property Services 1283 Second Avenue,Waltham MA 02451 1800.424.24681 spsinconline.com The Colonnade-Gutter,Roof,Siding,and Decks The Colonnade I Proposal#:5441821 Type of Price/Type Item Description Quantity Quantity of Quantity Extended Price 1. New roof on freestanding garage(see attached 1.00 Job $26,825.00 $26,825.00 addendum for specific contract quantities included for rotted sheathing and framing) 2. New vinyl on front of freestanding garage 1.00 Job $7,500.00 $7,500.00 3. New PVC soffit on front of freestanding garage 1.00 Job $2,000.00 $2,000.00 4. New gutters and downspouts on front of freestanding 1.00 Job $2,800.00 $2,800.00 garage 5. Repair roof leaks on upper rear rubber roof at 1.00 Job $6,600.00 $6,600.00 mansion 6. Replace upper rear 1O 12 deck at mansion 1.00 Job $4,500.00 $4,500.00 7. Power wash existing vinyl siding 1.00 Job $1,500.00 $1,500.00 8. Rake Board Replacement with New PVC Rake 1.00 Job $1,620.00 $1,620.00 Boards on the Freestanding Garages Only (135 LF) Total: $53,345.00 Type of Price/Type Item Description Quantity Quantity of Quantity Extended Price 1. Replace damaged sheathing 1.00 SF $3.50 $3.50 2. Replace damaged framing 1.00 BF $15.00 $15.00 Schernecker Property Services 1283 Second Avenue,Waltham MA 024511800.424.2468 1 spsinconline.com i I 'Che Cotounnde-Guuer,Roof,Siding,and Decks The Coh,unude I Pmposa111:5.141821 i f Proportyi Note,, Sc Pre;Soia Job Conditions The following conditions were identified during the visual analysis of the property,These notes are not meant to be, nor to replace,an engineering report.Additional historical information and/or an invasive analysis would be likely to provide further information. Pricing NOWS EPA RRP /Lead paint The pricing provided assumes that the property was built after 1978 or that the work being performed will not require SPS,Inc,to follow the EPA guidelines for renovation,repair and painting(EPA M)rule).If the work is subject to the guidelines of the EPA RRP rule or any DEP or local Mlle regarding lead paint,then the pricing will be re-evaluated and will likoly increase. Permit SPS, Inc. acting as the Owner's agent;will apply for and obtain any necessary construction-related permits. The cast of any suoh permits will be paid by SPS,Inc.and shall be included in the pricing provided,unless specifically excluded,The Owner or its agent shall assist SPS,Inc.,with any required signatures,documents,or other cooperation necessary to obtain such permits.Construction control by a licensed engineer or architect,if required by the permitting authority or if elected by Owner,is not included in the pricing provided and is to be contracted directly by the Owner. Unforeseen Conditions/Change Orders Renovation work involves removal oFexisting materials to expose hidden surfaces.By its nature,renovation work is likl to resulfin uncovering conditions that were not foreseen.it is likely that unforeseen conditions will be uncovered when existing materials are removed.Unforeseen conditions usually necessitate changes in the scope of work and an increase in the total price of services.Changes to the scope of work as a result of unforeseen conditions will be presented to the.Owner or managing agent in the form of a written Change Order.All Change Orders,regardless of the reason for the Change Order,must be docitmented and approved in writing by ST'S,Inc. and Owner or Owner's abent.Change Orders may be approved by email. Additional I'66111ay 'gUtes The pricing provided assumes that the property will require SPS to follow the EPA guidelines for renovation,repair and painting(EPA RRP Rule). ° Architecture and engineering work and/or biting of licensed architects or engineers is excluded unless specifically included.if the municipal authority requirm'construction control'by a licensed architect or engineer the cost of such constriction control will be estimated and presented as a change order to the work.Such change order will require owner approval before continuing work. ° All carpentry are dependent on town of North Andover building inspector approval.Any additional work required by the building inspector will be priced separately as a change order. .1chemcckar frop<ty Services 133 Second Maim,WMlbam MA(12451 1900.424.2469 I spsinconlinexom The Colonnade-Gutter,Roof,Siding,and Decks The Colonnade I ProposaA 5441821 i Prt posa( Terms Proposal:This proposal is valid until October 22,2015.If this proposal has not been accepted by said date,then this proposal is deemed withdrawn by SPS. Acceptance of Proposal,The signature of the Owner or Owner's authorized agent shall constitute Owner's agreement to the terms and conditions contain hcrcio, Owner's Managing Agent;If Owner has engaged the services of a properly management company("mtmaging agent")to not on its behalf with regard to the subject matter of this agreement,the managing agent and its representatives shall be considered authorized agents of the Owner.With regard to the subject matter of this agreement,Owner shall be bound by and SPS,Int:.shall be entitled to rely upon statements and actions of the managing ugent. Entire Agreement,This proposal and any docume-its specifically listed under Contract Documents or incorporated by reference constitute the entire agreement between SPS,Inc.and Owner.Both parties warrant that there have been no promises,obligations or undertakings,oral or written,other than those herein set forth.No muterial modification of the tenns of this Agreement shall be effective unless approved in writing by SPS,Inc,and Owner or Owner's agent,Modifications may be approved by email. Work Progression:Start dates,amount of time needed to complete the work,and completion dates will be estimated at the time of signing of the PFS,prior to die:commencement of the work.The schedule may he modified by mutual agreement for any reason.Changes in the Scope of Work are likely to impact the schedule,Inclement weather and other ciremnstances beyond SPS,Ine.'s control are also likely to cause changes in the work progression.belays caused by Owner,its managing agent or their representatives,may result in additional charges. Representations;SPS,Inc,is in the business of providing maintenance and capital improvement services to real property.The PfS contained horein has been prepared on the basis of u visital iw.pection of the property.SPS makes no wanunth:s or reprrscntalions about the physical condition of the property at the time of this proposal. Materials Storage and Inspection:SPS,Inc,requires that it be allowed to store tho materials and equipment necessary for the performance of the specified work on the property in a_annually ngtceahle.location.Such materials and equipment shall be subject to inspection tad approval by the property agent. Protection of Work Areas:The work areas tire to be secured and protected during the performance of the work.Unless otherwise,noted,SPS Inc,will be responsible for damages to the Owner's property caused SPS Inc,during the performance of the work, Rubbish Clean Up and Removal:SPS,Inc,wOl dispose of rubbish,trash and debris resulting from the performance of the work in a manner approved by the Owner or authorized agent.Such disposal will be in compliance with applicable laws and regulations.SPS,Inc,shall maintain the job site in reasonably neat and olcan condition during the performance of the work, Completion and Acceptance;The work will be deemed to be complete when the conditions as described in the PPS have been performed by SPS,Inc.Upon completion,SPS,inc.will provide notice to tlhe Owncr that the entire work or an agreedportion thereof is complete.Upon such notification,the Owner or Owner's ngent will promptly inspect the work and will notify SPS,Inc,of any incomplete or defective work.SPS, Inc.shall take such measures as are reasonably necessary to complete such work or remedy such deficioncios, Insurance:SPS,hie.maintains Worker's Compensation Insurance,General Liability Insurance and Automobile Insurance.Upon request,SPS, lac.will facilitate the delivery of a Cerlilicate of Insurance from its in3utvnce agent naming like property Owner as an"Additional insured." Warranty:Unless otherwise noted,SPS,Inc,warrants tine work performed undcr this PFS against defective workmanship for a period of two (2)years from the Hatt:ofconpletion and acceplancz.This warranty is expressly conditioned upon the Owner's fidl perfomhanee of its payment obligations hereunder,Any holdback or nonpaymentby Owner will invalidate this warranty. Owner shall also have the right to terminate the agreement for convenience.Owner shall give SPS,Ino.ten(10)days advance written notice, Owner shall be responsible for paying SPS for all work perfonned to the(late of termination plus SPS reasonable costs of dornobilicing plus twenty percent(30%)of the value of the work remaining to be performed under the agreement. Nominal versus actual dimensions:The actual dimension of a 2x4 is approximately 1.5"x 3.5".112x4"is the nominal dimension.The actual dimensions of many material;differ from their advertised nonhinal dimensions.Nominal dimensions are used in proposals and specifications, SPS docs not assume responsibility or liability fir titc discrepancy between any nominal versus actual measurements. Indemnity:To the hillesl extent permitted by law,the Ownershalt indonnify,defend,and hold liannicss SPS,hie.anti its agents and employee: of and from any claims by third parties or unit owners arising out orSPS,Inc.'s performance hereunder unless it is finally adjudicated that such Schumecker Napetty Services',293 Second Avenue,Waltham MA 02451 1800.424.2468 1 spxinuo line.eom i 1 The Colonnade•Clutter,Roof,Siding,nod Decks The Colomtude l Proposalil:5941821 1 damages,loss or expense was doe to gross negligence,willful miscouduct or material breach by SPS,Inc:,Owner shall indemnify SPS,Inc., for any and all damages,losses,and expenses arising therefrom including but not limited to attorney's rees and expenses. Termination;SPS,Ine.'s termination for cause.Should(1)the wodt be stopped by any public authority Fora period of thirty(30)days ormore, through no fault of SPS,Inc.;(2)the Owner fail to make any payment properly clue hereunder in a timely manner;(3)the Owner cause or flail to prevent a condition that results in nn unreasonable delay in SPS,inc.'s ability to perform hereunder;or(4)the Owner fail to Comply with other muterial tenns of this agreement,then SPS,lite.,shall give written notice by certified mail or by hand to Owner or Owner's authorized agent specifying the grounds for termination.Owner shall have seven(7)days to correct the condition giving rise to the notice.If the Owner fails to cure within seven(7)days aftor receipt of the notice,then SPS,Inc.may stop work or terminate the Contract.SPS,Inc.shall be entitled to it.-cover from Ownerpayment for all wont executed plus twenty percent(20%)of the value of thework remaining to beporforned under the agreement. Owner's termination for cause.Should SPS,lite.(t)abandon the work;('l)tail to diligently prosecute Its obligations tinder this agreement;(3) or blatantly disregard applicable laws and codes;then the Owner shalt give written notice by certified mail or by hand to SPS,Inc.,specifying the grounds for termination.SPS,Ino.,shall have seven(7)days to correct the condition giving rise to the notice.if SPS,Inc.,fails to cure within seven(7)days ager receipt of the notice,then the Owner maty terminate the Contract.SPS,Ire.shall be entitled to recover from Owner payment for all work porfoiTned to the date of termination, Safety;SPS,Inc.will maintain a safe work zona.Anyone entering the work zone should wear approprinte Personal Protective Equipment (PPF),At a minimum this includes hard hat and safety glasses.Other PPB may be required depending on Ute work being performed.Once inside the work 7.one,any outside party including inspectors shall comply with SPS,Ina and OSIiA safety guidelines.Inspectors and/or outside porlies should be escorted by an SPS,Inc.employee inside the work zone. Governing 1,awfVonuclDispute Resolution:This agreement is governed by and subject to the law ofthe Commonwealth of Massachuselts.In the event ofa breach of this agreement,the non-breaubing party shall be entitled to recover its reasonable attorney's fees and expenses.Any issue, claim,or dispute related to this agreement,its performance or a breach thereof shall be shall be decided by an independent single arbitrator in or within 25 miles of the city ofBoston using American Arbitration Association,JAMS,or another similar mutually acceptable arbitration servioe. The arbitration shall be condttined in accordance Willi the Construction hidustty Arbitration Rules of dw American Arbitration Associntion currently in effect.The award rendered by the arbitrator or arbitrators shall be final,and Judgment may be entered upon it in accordance with applicable law in any court having jurisdiction thereof.The finding shall be binding with no other recourse.The parties shall share equally the cost of arbitration and arbitrator's fees.The prevailing party shall be entitled to recover its attorney's fees and expenses including its share of the cost of arbitration and arbitrator's fee. No Consequential or Delay Damages:SPS,Inc.and Owner waive claims against each other for consequential darrnges arising out of this agreement.This mutual waiver includes damages incurred by Owner for delay,rental expenses,loss of use,income,profit,and the like,This mutual waiver includes damages incurred by SPS,lite. for office expenses,office personnel,business and reputation,and for loss of profit except anticipated profit arising directly from the work,as speeiftealiy provided for herein. No Third Party Beneficiaries:This Agreement will not confer any rights or remedies upon oily person other than SPS,Inc.and Owner. Specifically, this is not an agreement with any individual unit ownew of a condominium association when the Owner Is a condominium association.No unit owner has the right to expect or demand any work or performance by SPS,inc. Flidden building components:Fasteners are required to penelm(o the sheathing in order to achieve the material manufacturer's installation guidelines.Any mechanical lines,electrical lines,pipes,ducts,other means of conveyance,or equipment located directly behind/beneath the sheathing may be subject to hnnn.SPS is not liable for any damage to items in this zone. lee Dam Warranty Lrxeluslon:Water backup behind an ice dant results in building components being submersed in water.Duilding envelope systems are not deAgnud to prevent Witter intrusion when the building components are subruersed in water.Leaks are likely to occur in these situations.Unless specifically noted otherwise,Ute work is not warnntoed against leaking caused by water backup from ice dams or similar conditions. Seltemecker 1'mpeay Setvic,!s 122 Second Avenue,Waltham 1vL\Q7.4S 1 i SOt).42d.7�IC8 l splint amine cora The Commonwealth of Massachusetts Department of IndustrialAccidents d 1 Congress Street, Suite 100 Boston,MA 02114-2017 www.mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/E lectricians/Plumbers. TO BE PILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Leaibly NaTrie(Business/Orgaauzation/Individual)' Address: Z" S City/State/Zips: c w f mow_. YZ,. Phone#: 2- Are you an employer?Check the appropriate box: Type of project(required): V. Iain a employer with .16- employees(full and/or part-time).* 7. ❑New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in 8. O-1temodeling any capacity.[No workers'comp,insurance required.] 3.FJI am a homeowner doing all work myself,[No workers'comp.insurance required.]t 9. El Demolition ❑ 4.F]I am a homeowner and will be hiring contractors to conduct all work on my property. I will 10 Building addition ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5. I am a general contractor anI have hired the sub-contractors listedon e attachedsee. ❑ d hidb ttthht 13. oof repairs These sub-contractors have employees and have workers'comp,insurance.t 6.F-1Weare a corporation and its off-rcers have exercised their right of exemption per MGL c. 14.❑Other oyees.[No workers'comp.insurance required.] 152,§1(4),and we have no.empl *Any applicant that checks box 41 must also fill out the section below showing their workers'compensation policy information. I Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer ttiat is providing workers'compensation insurance for•my employees.'Below is the policy and job site information. Insurance Company Name: F4 P411";1114,C i, � [.. . Policy#or Self-ins,Lie.#: ,i ", (")c2"'3 Expiration Date: /t Jj ^ Job Site Address: I LJ.mr r , 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 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 WORD ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby cer ' un er the p ' s a enalties of perjury that the information provided above is true and correct. Si nature: 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 Penson: Phone#: ® ­DATE(MMIDO[Yyyy) CERTIFICATE LIABILITY I 12/18/2014 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 Claire BOutilier NAME Cleary Insurance Inc PHOIAICNE (617)723-0700 AIC N -t617>723-7275 226 Causeway Street ADORIess:cboutilier@ clearyinsurance.com INSURERS AFFORDING COVERAGE NAIC# Boston MA 02114-2155 INSURERA:Continental Western Insurance 10804 INSURED INSURERB:Union Insurance Company 5844 Schernecker Property Services, Inc. wsuRERcAcadia Insurance Company 31325 i 283 Second Avenue INSURER D: INSURER E: Waltham MA 02451 INSURER F: COVERAGES CERTIFICATE NUMBER:2014-15 Liability 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 POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE POLICY NUMBER MMIDDIYYri MMIDDIYYYY GENERAL LIABILITY EACH OCCURRENCE 5 1,000,000 D MAGE TO RENTED 300,000 X COMMERCIAL GENERAL LIABILITY PREMISE Ea urrence S _ A CLAIMS-MADE ❑X OCCUR CPA 0183614-18 12/31/2014 2/31/2015 MED EXP(Any one person) $ 5,000 PERSONAL 8 ADV INJURY $ 1,000,000 GENERAL AGGREGATE S 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMROP AGG $ 2,000,000 POLICY X PRO- LOC $ BINED AUTOMOBILE LIABILITY EO acciden SINGLE LIMIT S 1,000,000 ANY AUTO BODILY INJURY(Per person) S -_ B ALL OWNED X SCHEDULED 0183615-18 2/31/2014 2/31/2015 BODILY INJURY(Per accident) S AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ X HIRED AUTOS I X I AUTOS (Per accident S X UMBRELLA LIAR- X OCCUR EACH OCCURRENCE S 5,000,000 C EXCESS LIAR CLAIMS-MADE AGGREGATE S 5,000,000 DED RETENTIONS IIA 0183616-18 12/31/2014 12/31/2015 b C WORKERS COMPENSATION X WC STATU- OTH- EEL AND EMPLOYERS'LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE YIN E.L.EACH ACCIDENT $ 1,000,00 0 OFFICEPJMEMSER EXCLUDED9 NIA ICA 5074780-12 2/31/2014 12/31/2015 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under (Excludes MA) E.L.DISEASE-POLICY LIMIT S 1,000,00 DESCRIPTION OF OPERATIONS below, DESCRIPTION OF OPERATIONS I LOCATIONS I 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. Schernecker Property Services, Inc. 263 Second Avenue AUTHORIZED REPRESENTATIVE Waltham, MA 02451 Claire Boutilier/JCB ACORD 25(2010105) (D1988-2010 ACORD CORPORATION. All rights reserved. Iusm ,mss; , The ACORD name and loclo are registered marks of ACORD Client#: 1025557 SCHERPRO DATE(MM1DD/YYYY) ACORD,. CERTIFICATE OF LIABILITY INSURANCE 12/18/2014 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). ACT PRODUCER NAh1E: Kathy Wagner USI Insurance Solutions LLC PHHc0 No,Ext,413-750-4222 FAX Na): 610-537-4670 123 Interstate Drive E-MAIL-ADDRESs: kathy.wagner@usi.biz West Springfield, MA 01089 INSURER(S)AFFORDINGCOVERAGE NAICN 855 874-0123 j INSURER A:ABC Mass Workers Comp SIG 199999 INSURED INSURER B: Schernecker Property Services, Inc. INSURER C 283 Second Avenue INSURER D Waltham, MA 02451 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER MM/DDIYYYY MWDD/YYYY GENERAL LIABILITY EACH OCCURRENCE S__ DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence S _ CLAIMS-MADE ❑OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GENT AGGREGATE LIMIT APPLIES PER: ( PRODUCTS-COMP/OP AGG IS POLICY 0 PRO- LOC $ JECTI COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY Ea accident S ANY AUTO BODILY INJURY(Per person) S ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED 'PROPERTY DAMAGE HIRED AUTOS AUTOS Per accident $ S UMBRELLA LIAB OCCUR EACH OCCURRENCE s EXCESS LIAR CLAIMS-MADE AGGREGATE $ '.. DED RETENTIONS S A WORKERS COMPENSATION ABCMA12000115 1/01/2015 01/01/201do, X W RYLIII ORH- AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE Y/N E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBEREXCLUDED? NJ N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below _ E.L.DISEASE-POLICY LIMIT 1$1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,it more space is required) Proof of MA Workers'Compensation Coverage Proof of Massachusetts Workers Compensation Coverage CERTIFICATE HOLDER CANCELLATION For Insurance Purposes only SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S13921784/M13920367 PZPZP Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License: CS-083665 {rr.ti KURT M. SLIMAK 42 SEARLE ST. ; } Georgetown MA X1833 <`ag f �S \J Expiration Commissioner 03/07/2016