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HomeMy WebLinkAboutBuilding Permit # 12/8/2015 BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION - �: : so�1 r Permit No#o Date Received RarEo Peal`c� Date Issued: q�SACHUS IMPORTANT: Applicant must complete all items on tiv page rERT / , //Irl. � � ii/���, /� � ., •, r. //ri /, 1/� r .,,1 rf�% .,,.. ..,. �r„ �, � ,i,, ,,:,//�.. _<. . ///<,✓/�, ✓//lJ/JL /r../o /( r.rr�.r/l r.lG r/, ,,,/,,:,.. TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential [INew Building One family ❑ [I Addition Two or more family 11 Industrial s: ❑ Commercial ❑Alteration N o. of unit ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other /rl fr r,/r r , , ❑W etlands r❑,Watershed District/,, rrrr/, , r , loud la r Well r � rr rr ,/ rr, ,rr //i °.;r L. /..,,. ,, r r, /, i, / ,r ,/ ,r // //ai r ,r,,, ,_ /,., // r,.., rr/../i , / , / is // r ✓/r, r � ,� rir%,�../�/�/�j/i�Jz�+�/�� :i, r //./ .✓�p� r/.y///�.. // /;/ it/G r,... rr ❑„Wa�el'�52Wer ��!/iO/� r, /i ri/i�rr//�,I����/r��� //�//�///r //.. i�„r� ,,;t;,,,,�;„�,�,,c,,,,,,;s, ,,,,,r,/% ,�,,,, ,,, ,,e✓l,ic,,,� /%.,/,/,,,„,,,,,,,,, , DESCRIPTION OF WORK TO DE PERFORMED. t In ific tion- Please I pe or Print Clearly �� OWNER: Name:/,I p� Phone:61 d l Address rj/ ,, r,,,!✓ r r/ ro r r/ rG „i ,.. .,// /,!r.:,%✓/ ,.-; r <,.i r/r, ., �%ra/ r„r%�%%/o..../,rte,r��/�L /�irri r„rr,:,„ ,///.. ..,r ,.. ✓./ „,/�DG �/ ,�//`. r ,�f,,...yl/Ir,r i,,,,:,�i,, , ,il „r,. r r.. ra, .r..r,:/ rr/%i i..;;;i r r r r r / / r r / /rr / r r r. / ✓ � / r� / ,✓ / /r I, / / / of / / r,. <.!/ �, /, r, r, / / r /i „ ;<, cr, r rr, %ter /a / / / r, / / !/ / / // �, /✓ i,J rr, /,l,,,r rr, �/,�����if,/ r ,�,/�r//, , ,✓r, r, � ///r / „� .,, , ,�� �r �r,l SRI r��i l r / / ,� /o' ,✓.. / .., ( /., r r,�e r ...., r./ /. r , r � r/, / r/ r ,,,,/r,o r,,,,, x �Home,lmprovement License, i/ sr � � � r/i// �, p ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$92.00 PER$1000,00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ / , ' FEE: $ Check No.: Receipt No.: NOTE: Persons contracting ivith re t re ractors do not have access to the uaran nri g Si nature of contractor Signature of Agent/Owner __ _:__ —_ _. __----- --� Town of 117", Andover r No. 6141 *, ' r 0 1 245. COCHICHIWICK 04 V C2 BOARD OF HEALTH PER L D Septic System �r r a< . •. Foundation has permission to erect .......................... buildin!'s on U. ............ Rough to be occupied as ...............�k..:SCA ..... ..... ................................... Chimney provided that the person accepting this permit shall it. VIOLATIONery 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 of the Zoning i Building • !,.• Voids Permit. Final PERMIT EXPIRES IN 6• MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION '.A' RTj, Rough Service a BUILDING • GAS INSPECTOR .. Occupancy Permit Reguired to Occupy Buildin Rough Display in a Conspicuouson D,• Not Remove No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved • BuildingInspector. Street No. Smoke • IS' Lose) next stepivi home energy solutions This agreement is made by and among Next Step Living,Inc.("NSL") Linda Borland 21 Drydock Avenue,2nd floor 161 Hillside Rd Boston,MA 02210 phone: (866)867-8729 North Andover, MA 01845 Site ID: 425716 16-Oct-15 1. DESCRIPTION OF WORK TO BE PERFORMED NSL will perform or cause to be performed the following work on the customer's address above,in a professional manner and in accordance with the terms of this Contract, Including the attached recommendatfons/work order describing the work in detail(the"Work")which are incorporated herein by reference.Pricing reflected below may be subject to adjustments in program pricing and offerings and is guaranteed for 30 days from the date the Contract is printed,. oQuantity • • 920.00" Work Location: Perform Air Sealing at Estimated 62.5 CFM50 Per Hour 12 $85.00 Hr $1,020.00 • • Work Location: Slope Attic Slope Enclosed Cellulose Dense Pack 6" 184 $1.86 sgft $342.24 Insulate Vinyl Sided Wali With 4"Dense Pack Cellulose 678 $1.85 sgft $1,254.30 Work Location: Knee Wall Install 2"Thermal Barrier Polyiso on Open Kneewall Slope 332 $3.50 sgft $1,162.00 Install 3.5"Fiberglass Batting In Open Kneewall 50 $1.32 sqft $66.00 Install 6"Fiberglass Batting In Open Kneewall Slope 332 $1.80 sgft $597.60 W�rkl.q��trort, ��Cu!! r'Y " ✓r 2 t w rJ .t �s� r � ' o y � Temporary Access 5 $85.00 Each $425.00 Work Location: Foundation Insulate Rim Joist With 2"Thermal Barrier Polyiso 194 $3.70 sgft $717.80 WorK 1~btra�r'oti'` �boore t ` ' r = t Door Weatherstripping w/Sweep 2 $75.00 Each $150.00 astomerSig ature Date 16 Oct 2015 Edward Yaracz NSL Signature Date Name of NSL Representative A1322350 The Terms of this Agreement are contained on both sides of this page Next Step Living 21 Drydock Avenue.2nd floor o Boston,MA 02210.(866)867-8729.inquiry@nextsteplivinginc.com o www,nextstepliving.com J c� D, c 1r 'E AND_ruA�iJ\ liCD J.r_r. dCLuJIcolituccustoh.1 _ .Jacncriulvthe'nru,k-o,(,; agroxbiC.tsii to 4. COirTI?ftC 4 OF LIZ E IS l(-ZA f K_)N ;ill d ^"r,li.a5.tulavd rcuuiro. io'n`s iiltprovern ni. oiiira.ctur� uifc sulccd ,t Ur` P uG'vuit i Ula f'ii CP lojne 11 ov'mai r o-tircaran, a. . I. i. °r r [: 'I t�(rrIW1-an01'I. YCltl rrlcV IngrllfG(aaJOtr!U?)ntra(IfA i(,fyl:q'bliort?4;Uti-lilts >.+.4%T`iEf,..(>:�uf3„C16t�C,a/�'ute.a., c..IL P4r0,f osGr c,MAG2f`( Li. PERMITS AIC t glt rnr reSk0115ible,for OMFIloinf,,:79111 t enfi!@_a`stir C 'sto.t f” ;sto4tIwf:fvl" o,;-vr('the;F of t, (C 1tin€t.1."' t filth Firf L411(,OIaCG'r"eu contractor 1f.i!il J.;e xclut,4mi fforG ih.vLulclli v i uiid llruvic Cn:)Lr ltta�rU, Ll LF,Q (Udall(I--'OF J JEVUGiZIf!•tivf�GI-iAfvC,- C..1 NSL will riot commence the trVork prior to signing this Agreement Sf id tsai iJ.airabl of C0[)y oi A!r( rilei d"to t Io Gusior',r. r.* This P,(reerilentrrivybecuppien`01ird,.ineofder?,o (.lodifier ,p):11t^f1.�!It.lzl�l�,�rC_.IilGili�i,`1ui.; ItP,,:1.)ll 4.ilt;t1I1f(IkluUir't,U" ru rdll'icea,ki-,cls this 110, - a "It boll b liindirfl a iesc it is IF, Iit+il Qr ii r pry: f L rC Ci., Al,unites,NSLs weathenization t alri d isG4rvei6 Jtuafions in ti d sur5c'ire, ,nrinU [,.,,!rig cif t.'I 'Afofit eile.l indicrgtee f.'sk ior c`:he61Y1 of safety exxic'err i for resident,-.Such COnG81nS Cf-frl indnk bot are riot itriit((i tG YfC:1Yl`c'dU,y oroLentip'lly hear rdous rratt:rialg 8,U01-1 c'.f Vt iGi Oi ES"0 5108,0)StruCii i*Ei.. conoeizls, in tmc case Of IlOaWh or safety concerns Laving identified,NSL reserves Yle iiuht,I sF s-c Guon 914"this cxfntract is *!or1f1tutir0 7fe..kerns to the Customer and ll-,it irrori-im it such concenis have been addresrtc �;.`. Fi&'obaies and in,",Invvos C.vaflablGfiorn mC:Mr}sc rave@ Hanle(_IGrg°., ..!vtt.' : r_C,Fain cat( c:a dPvl_r c.a:...tIC for elft base::on stmt.' b(st csfirnlats of Tie UIt71i7i101i ir,Vie Structure by ule NGL home ene,Cil m£oviSO;. I'10w(rUG',,atfir n6s"Our V:,eaY`ie11Ge"!tlo!?ic,a;Tf discovers sittiaHons in the horfie curing tie(.ours-.of ihe,Wori(that iinpaN the avEdlabilibr of r„h'Fie,anci illr,wrauvee I ,,,i rhe,IUIEt.-S avc.f ropiarfi. In such si Wations,NSL will e.,a�,.amurrrG�ite st!eIiehruue to Yme Custorner,indudinrr?y irrili�.elr1.: �r r�auri�trrc GtaJto art.:too�lYa he c,,:r .a�c.to iia, r`rar t it Worl:. `ff-Cusforrre;l wilt C . 114,vc tnG Opuon In rviriovo from,t!o v-DitrclG_tris tf o k vii lbi0.aly t 2 (��,��.cl"ifLs r>u.7t,�f JO c:a pc:rcafG cJntTcG fffI"(:'�CarO lrll,Iga r,n5 aC;yuBteC tuol f;., NSiL represents and+Imm-ante,to time Custorrie,!iihat(a)the mate„Ells a!ad C,gLlIPF00!it iURI kdi.,e undo tits Au!e rrenttJdi I)c of good qu€lftty as lc neral, (b)ILhat rhe Work will be ueo troth dafo (S',and(C;that dire Won,,VA!cunt in willf tis(.t`l& rf)vc (_iHho tr>101I detcdbec.in f a cgr61)i 6.E NK.may d0t0filine in tie CONTL:orpR.-InwaliaGofi ec,,irdc-al R;evicsw uiat Iriodnication'.are n(,d'e`Ed,-y-kj rid vv alit-C0 tfyoila;if ( ilC:iJ omsure pro'fUSvional qualkly of the Installation. in!i&assent bf such ilmodlfiCJflonEi,NSL Will req:jssu r o;wrnier ,IofNfd;.aei0fl Otuts Agro.rnCnt.( k 81c?nee r)p v!1 patios.In Lne event that Customer and NSL cannoi agros ori time mo,,Itit,o,iiorr Gl ,AgrCLnient play be teliniriaied by chuier putty'. 7. IN&LL/1NGC PI l IRL:Gl fiJ1 T fOfy S 6 4 6 f C' { s 7 I i P' r 62111 1", t h�rE.re,fn�e.rent,r and warrvni.,to file C a�torner that i.I�sa„�volts t~ionic,n1p avarnaiit Contractor,egrstralion(hlo:t��r:i)�ruc the riecessGry iir�urarlce required by applicable law,and normally rnafnialned by paident canta-admrs in NL,L a tick,indud.ing,but not mited to,Warhe s G.orrponsafiorl Insurance for all employees who will peribrin the Work, 8. QUALITY OF VYORif. NSL agreoe that the Work wul@ be perfol-mrsd in a good and work marilike manrier,and That NSL.will repair�jlo:rcpla(*_-,at iis own e)gaense,and prompVy upon Customer's request,any defects in woriunanshlp and materials provided by NSL which appsai up to one ycar after coinpiefion of iiia Work or within any io,Iger period as permitted or required udder applicable taw,provided IdSi_has received final payment as,provided hareiii. 9. PRF-EXISTING CONDITIONS is PROPERTY PROTECTION 09A NSL shall Trot be responsible for any damages as a consequence of the Waris performed in t'i'c home due to pre-axisb%conditions. These conditions: include but arc not limited to poorly fastened or broken drywall,moisture damage,rion-code construction,cracl(ed or fiagiie siding or shingles,old pipes and filings,rotting wood,etc. 9,2 NSL reserves the right not to perform,UVork upon the discovery of asbestos,mold,or any odor trctenfia!health risk to the Customs-. In this event,the Customer is responsible for remedying time at risk situation,including any necessaly removal of hazardous materials and all bills for services to date shall be paid immediately. Wort(cannot resume until remediation is complete. 9.3 Mile NSL will make best efforts to protect any property of tile,Customer, if is the Custorneft responsibility to remove or protect,including dust protection,any personal property including the home itself. NSL will riot be responsible for damages to or losses of any of time above mentioned property not properly protected prior to tie commencement of the Work. 10, GENERAL PROVISIONS. I DJ NSL reserves the right, the extent permitted by applicable law,to have,file or maintain a mechanido or material men's lien,or to file a notice of intention to lien,and to tale any otmer steps to psr sc't and enforce such a Ilen,if Customer fails to pay NSL as provided herein. 10.2 This Agreement shall be construed in accordance with the laws of the Commonwealth of Massachusetts. 10.3 This Agreement forms the complete integrated agreement between NSL and Custorner. The parities represent and warrarit that in executing this Agreement,they are not relying on any representations,warranties or terms other than as expressly contained herein. This Agreement supersedes Ili prior agreements between the Customer and Contractor and may not be altered absent a.subsequent written agreement signed by both parties. 11. ENERGY BENEFITS. The Sponsoring Utility Company(tire Utility)is entitled to 100%of time energy benefits associated tmiti all Energy Conservation Measuros,excluding the value of energy cost savings by Hie Customer,but including all rights to all associated ISO-NE Energy,Capacity and Reserves Products.NSL agrees to provide the Utility with such further documentation as the Utility may request to confirm the Utility's ownership of such benefits and Products. 12. NOTICE CONCERNING SPONSORSHIP. 12.1 Customer understands and acknowledges that NSL is not an agent,vendor or sub-vendor of The Sponsoring Utility Company(the Utility)with respect to the installation of an energy efficiency measures.In the event of the failure of an energy conservation device to perform as expected, Customer's sole recourse is to Contractor and not to Conservation Services Group(CSG)or to the Utility.The Utility and its operating companies shall not maintain,remove or perform any worts whatsoever on the energy conservation measures installed. 12,2 Customer understands and acknowledges that their participation in the Mass Save Home Energy Services Program is voluntary and that they have consented for Contractor to install the proposed energy conservation measures. 12.3 Customer agrees that it shall not hold CSG,the Utility,their affiliates or operating companies liable for Contractor's to perform its obligations under this agreement,for failure of the energy conservation measures to function,for any damage to Customer's Premises caused by Contractor or for any and all damages to properly or injury to persons caused by the energy conservation measures. 13. LIMITED TIME OFFER. The prices and Incentive offered in this Contract are subject to change in accordance with The Sponsoring Utility Company Mass Save Horne Energy Services Program offers, 14. CONTRACT CANCELLAT@OR Lrarder EVJassauhursetts claw,you,riqay;earmccG sirs agJrecruicrat if it daps iaeera src;amicr%by a ikiet ate,ata!iilaoe ostler t4mar;art acld,esu of Gare'seller, whictrr nlay be his wain offlee 01r a byanodi thereof,provided you rirstify Ghc SoHer dr wr;G qQ aG hie,ntiadri ofte or Lwanch by cordinavy rivafi posted, by tans:,Qr by&m@la'spent or by cielivery,nolatertttr,ri midnadgEnfi of GGae G dvd bushic:ss days foltowirngtim £;ig,rnarrL cr4daaE agFOUIRMU" Planviw Diagram Customer - 1W. 6�r1Q0A Advisor Name: EjW0A Address 10 Iimitae, Rq Advisor Phone #: I'5-7 Town N, Any limitations to access by truck? Site TDNOTES Any Any work scoped outside of Best Practices? KWs d GaAs Wolf ell ASS Approved by: NA VL 11\rS „� W orce11 Vi,Ik \405 FGA �' Poi SMT aobr 2 LW Tfo'A -1A ' �, a6, �� �' Shea Darner' `TO g�n[,k VPCs. N�� SaCG C.g�,�d.J The Commonwealth of Massachusetts .Department oflndustrialAccidents ;r 1 Congress Street,Suite 100 ' �..... Boston,AM 02114-2017 / wipw inass.gov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name (Business/Organization/Individual): Next Step Living Address: 21 Drydock Ave City/State/Zip: Boston MA 02210 Phone#: (866)867-8729 Are you an employer?Check the appropriate box: Type of project(required): 1.0 I am a employer with 850 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. F-1 Remodeling any capacity.[No workers'comp.insurance required.] 9. ❑Demolition 3.01 am a homeowner doing all work myself. [No workers'comp.insurance required.]t 10E]Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole l l.❑Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.®I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑Roof repairs These sub-contractors have employees and have workers'comp.insurance.$ 14.[E]Other Weatherizatipn 6.®We are a corporation and its officers have exercised their right of exemption per MGL C. 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. f Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name 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 atn ati employer that is providing workers'conipettsativn insurance for ttty etttployees. Below is the policy and job site information. Insurance Company Name: A.LM Mutual Insurance Company Policy#or Self-ins.Lic.#: AWC-400-7030025 Expiration Date: 9/30/16 Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under 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 stat me may be forwarded to the Office.of Investigations of the DIA for insurance coverage verification. I do hereby certify under thepains dp talties ofperjury that the information provided above is true and correct Signature ` ` i . Date: B ,.,,I Phone#: (866)867-8729 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#: NEXTS-1 OP ID: EL CERTIFICATE OF LIABILITY INSURANCE DATE �----''� 09//30/201530/2015 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 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(les) 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 McLaughlin Insurance Agency PHONE FAX 828 Lynn Fells Parkway Arc No Ell:;781.665-2775 ac,No; 781-665-0295 Melrose,MA 02176 E-MAIL John E.McLaughlin Jr. ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:Nautilus Insurance Company 17370 INSURED Next Step Living,Inc. INSURERB:A.I.M. Mutual Insurance Co. 21 Boston, ck MA 02210 Avenue,2nd Floor Boston,MINSURERC:Commerce Insurance Company 34754 B INSURER D:AXIS U.S.Insurance Company 15610 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ?NSR 7ypE OF INSURANCE DDL 6 BR POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MWDD/YYYY MM/DD/YYYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE ❑X OCCUR ECP2010198-13 09/30/2015 09/30/2016 DAmAut:PREMISES Ea occurrence $ 100,000 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY❑P JRO ❑ LOC PRODUCTS-COMP/OP AGG $ 2,000,000 ECT OTHER: Is AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1 000 000 Ea accldent r CANY AUTO 15MMBGKKDM 09/30/2015 09/30/2016 BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS X HIRED AUTOS X A�OS NED PROPERTYDAMAGE$ X Comp$1000 X Coll$1000 $ UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 D EXCESS LIAB CLAIMS-MADE ELU783547/01/2015 09/30/2015 09/30/2016 AGGREGATE $ 5,000,000 DED I RETENTION$ $ WORKERSCOMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER B ANY PROPRIETOR/PARTNER/EXECUTIVE Y/❑N N/A [TO BE ISSUED BY CARRIER 09/30/2015 09/30/2016 E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEd$ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$ 500,000 DESCRIPTION OF OPERATIONS!LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) FOR INFORMATION ONLY CERTIFICATE HOLDER CANCELLATION INFO-01 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE For Information Only THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN y ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD . ��. Afai a Oficid Business Regulation at1�o n 10 Park Plaza e Suite 5170 Boston, Massachusetts 02116 Home Improvement Contract®r Registration Registration: 162111 Type: Supplement Card Expiration: 1/14/2017 NEXT STEP LIVING INC. ROGER OUE.LLETTE 21 ®RY®®CK AVE. 2TH FL BOSTON, MA 02210 Update Address and return card.Mark reason for change. E] Address [:] Renewal [:] Employment )Lost Card �,:':✓�'a� Pr�,4.:e�<.eH�aarrrxarerd�� "� a'�az;,araa aiar,.za�x���f Office of Consumer Affairs&Business Regulation License or registration valid for individul use only a HOtVIE IMPROVEMENT CONTRACTOR before the expiration date. if found return to: " } Office of Consumer Affairs and Business Regulation Registration. 162111Type 10 Parkplaza AWY Su)te 5130 Expiration: 1/14/2017 Supplement Card Boston,MA 021�6�' NEXT STEP LIVING)NG: ROGER OUELLETTE BOSTON,MA 02210 21 DRYDOCK AVE;2TH Fl �� ,� ----- Undersecretary i ft'valid without signature �A ass s Departrnen� o� Put)hc, Safety Br) and cJ [,",,luOdung Read,p fla'6unare�,-,I (,'ujfj%trw,,,vwn k4cir Spec*14,1 iJcense CSSL-102811 Its OGEIS AOVELLET 55STANMORE WaMck Rff 0288 P 0911312016 Restricted To: CSSL-OC-ffisulation Contract®r Failure t®possess a current(edition of the Massachusetts State Building Code is cause for revocation of this license. For DPS Licensing information visit- www.Mass.Gov/DPS