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HomeMy WebLinkAboutBuilding Permit # 12/28/2015 t%ORTH BUILDING PERMIT TOWN OF NORTH ANDOVER 0 APPLICATION FOR PLAN EXAMINATION Permit No#: z� Date Received Areo c"tis Date Issued: IMPORTANT:Applicant must complete all items on this page 1111�� I LOCATION t 73 Print PROPERTY OWNER M034f�J'_ mcxf--%C�_ Print 100 Year Structure yesno MAP PARCEL: ZONING DISTRICT: Historic District ye no _(n 0 n Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential El New Building XOne family [I Addition [I Two or more family [I Industrial XAlteration No. of units: [I Commercial [I Repair, replacement El Assessory Bldg 0 Others: El Demolition El Other DESCRIPTION OF WORK TO BE PERFORMED: C41 J er 04 04x'r5'� Nk W0a-<—qA(914 - ease Ty Iden i Ratio& pe or Print Clearly 0-1 OWNER: Name: �Annz Phone: �-4 I--l-S Address: 171 Contractor Name: Phone: -79-1 20 k Email: (y\-Cxx-k Oe,)CUS'CQUE W Address: R0. :Zag 2 ' ey\q C) i Supervisor's Construction License: CS -0-73T7i _Exp. Date: '716 120 Q Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. III Total Project Cost: $ _!2 3, FEE: $ f 791 Z_ Check No.: 2_ Receipt No.: NOTE: Persons contracting W unregistered contractors do not have access to the guaran ung' t Siqnature t%oRTown ofrH 2 E 4, Amliftdover ® ® ® �( 1W77 0 h ver ass I 6 o tr,nt 9 COC NICMIMCK ArEo 'kP����S U BOARD OF HEALTH Food/Kitchen ER T. L D� Septic System THIS CERTIFIES THAT ,,,,,..,,1 01 - BUILDING INSPECTOR ..... .... . . ... ......... ......... . .. . ................. .......... ..... .. ................ ... ,.. Foundation has permission to erect .......................... buildings on ....... ... .. ,,,1 $.... ... .•....... . • a C� Rough AJto be occupied as .. ..... chimney . . ..... ..... . ...... ...... . .. . :..�. ....................... provided that the person accepting this permit shall in every resp t 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 th Inspection,Alteration anCL Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMITI IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CTI® S A TSRough /� Service 6�`. ... .. ..... .. . y................ Final BUILDING INSPECT®R GAS INSPECTOR ccupaucy 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 Approvedby the Building Inspector. Burner Street No. Smoke Det. 1212612()15 re:SPAM-LOW:RE:Pricing for your house projects...REPLY...Mark&Maria 4th time sent with Revisions... re: SPAM-LOW: RE: Pricing for your house projects...REPLY...Mark& Maria 4th time sent with Revisions... Sat 12/26/2015 11:16 AM From: "Mark Gotobed" To: "Mark Guarini" Cc: "Mark and Maria Guarini" ..................................................................................................................................................................................................................................................................................................................................................... Mark and Maria, I trust you,and the family had a great Christmas................ Please find attached the contract for the work at your home.As you will note the content is a"cut and paste"of the last email to cover the scope of work-everything else is just our standard contract.Please review and let me know if you have any questions.If everything looks good we should get something on the calendar to connect on Monday morning so I can go and see the building inspector before I leave town for a few days-let me know if you could connect early on Monday morning. Best, Mark Gotobed 781 7602031 www nexuscarPentry_.com From: "Mark Gotobed" <mark@nexuscarpentry.com> Sent: Friday, December 18, 2015 11:08 AM To: "Mark Guarini" <mguarini@AsmarterWindow.com> Cc: "Mark and Maria Guarini" <m.guarini@comcast.net> Subject: re: SPAM-LOW: RE: Pricing for your house projects...REPLY...Mark&Maria 4th time sent with Revisions... Mark, I think I got it all-the following is a "cleaned up"version of what I believe will be the final draft for the Nexus contract; Attic Electrical work: Remove the 220 volt outlet next to the panel in garage to create 2 new circuits for the attic Run a circuit to the attic to accommodate a single power source for a future fridge or heater Proposed cost including materials and labor is$790.00 Attic other work: Furnish and install new cross braces to existing roof rafters to help increase the overall height in the area to be "finished" only NOTE: No change to cross braces intended over the master bedrooms or bathrooms Furnish and install up to 10 electrical outlets,2-cable jacks for TV,(1 wall outlet for wall mounted TV location),re-install 2 existing porcelain fixtures utilizing existing switch (to higher elevation),to the existing framing layout of the current Page 1 of 6 Nexus II Carpentry and Construction Design P.O.Box 2823 Woburn,MA 01888 781 7602031 Fax 978 9751263 mark(i,nexuscarpentryxom Contract This is a contract between Mark and Maria Guarini of 173 Ingalls Street,North Andover MA 01845 (Hereafter referred to as the "owner/s") and Nexus H Services (hereafter referred to as"Nexus") dated December 24th 2015. GENERAL SCOPE OF WORK DESCRIPTION WE HEREBY SUBMIT SPECIFICATIONS AND CONTRACT FOR: work as stated below to your home Scope of work: General details ♦ Meet with local building official and apply for permits ♦ All work will be in accordance with local building code regulations and will be inspected by local officials prior to continuing with the next phase—Nexus will be responsible for arranging and being available for all inspections ♦ Nexus will contact"Dig Safe"prior to commencing any excavation work for their clearance —if appropriate ♦ All work will be coordinated directly between"owners"and Nexus ♦ Nexus confirms that it is fully licensed, insured and ensures any sub-contractors utilized on this site will have the appropriate insurance coverage ♦ Nexus will be responsible for the safe storage of all its property and any materials to be used on the site ♦ Owner is responsible for removal and return of all items of the house in the areas that will be affected and their safe storage prior to our work commencing ♦ Owner will then be responsible for returning all items to these areas of the home after completion of the scope of work SPECIALIZING IN QUALITY FINISH CARPENTRY,REMODELING,SPECIALIST ROOF SYSTEMS,SITE AND PROJECT MANAGEMENT Page 2 of 6 ♦ Remove and trash into Nexus supplied dumpster all trash associated with this project NOTE: appliances are not allowed to be put in dumpsters without additional costs"owners"are responsible for removal from site Scone of Work ♦ Provide an on-site dumpster for the duration of the project Attic Electrical work: ♦ Remove the 220 volt outlet next to the panel in garage to create 2 new circuits for the attic ♦ Run a circuit to the attic to accommodate a single power source for a future fridge or heater ♦ Proposed cost including materials and labor is $790.00 Attic other work: ♦ Furnish and install new cross braces to existing roof rafters to help increase the overall height in the area to be "finished" only NOTE:No change to cross braces intended over the master bedrooms or bathrooms ♦ Furnish and install up to 10 electrical outlets,2 - cable jacks for TV, (1 wall outlet for wall mounted TV location),re-install 2 existing porcelain fixtures utilizing existing switch(to higher elevation),to the existing framing layout of the current accessible attic space being "finished" - $2,240.00 NOTE: -price reduction ♦ Furnish and install blue board with smooth plaster finish to the existing wall layout coming up the stairs and around left side wall jog- $900.00-NOTE: existing wall framing and both gable ends to remain "as is" (open plan). No sheetrock or access doors included or intended ♦ Furnish and install blue board with smooth plaster finish to the ceiling ONLY in the area to be "finished" only- $1,800.00 -NOTE: Not in the area above the Master Suite ♦ Furnish and install 1 Andersen 400 series Tilt wash window for egress - $1,278.00 - NOTE: size to be 2' 5 5/8" x 4' 0 7/8" NOTE 2: Prefinished White interior, White clad exterior NOTE 3: 6 over 6 grill pattern with grills between the glass NOTE 4:No interior trim required or included Basement heat zone, ♦ Wire and install a 5 zone relay on the boiler to replace the existing 3 zone relay ♦ Add zone to existing boiler with new pump, check valves, shut offs and run pipe ♦ Proposed cost for plumber and electrician including materials and labor is $2, 590.00 Kitchen; NOTE: No cabinet or counter related work included ♦ Malce repair to existing crack in kitchen ceiling- included in painting price below ♦ Furnish and paint ceiling of kitchen through to living room- $900.00 Kitchen work at bathroom wall; Page 3 of 6 ♦ Install 2 kick space heaters under new cabinets (cabinets supplied and installed by others) and fed from the existing 1st floor zone - (FYI - $790.00 per heater) ® Move I wall outlet and raise up to counter height on RH side of bathroom door entry ♦ Install 2nd wall outlet to other counter on LH side of bathroom door entry e Proposed cost including materials and labor is $2,200.00 Sunroom• NOTE: Owner to remove and trash the existing panel board from the ceiling and the house wall ♦ Furnish and install 4 LED (wall washer/angled)recessed ceiling lights on a single switch with dimmers ♦ Disconnect existing wall thermostat and transfer the power source to the outlet below adds $275.00 ♦ Furnish and install 2 wall mounted wall heaters on the wall between the kitchen and the sunroom and fed from the existing I st floor zone-$1, 840.00 (FYI - $920.00 per heater) ♦ Furnish and install blue board with smooth plaster finish to ceiling only NOTE: house wall and all exterior perimeter walls to be left "as is" ♦ Paint new ceiling only NOTE: no walls or trim to be painted ♦ Cost for this scope as detailed above is $2,550.00 PLUS thermostat and wall heaters noted above Master Bed Room: Remove and trash existing sheetrock ceiling on one side of"cathedral" to allow access to the existing roof rafters by the insulators ♦ Remove and trash 4 existing ceiling can fixtures ♦ Furnish and install 4 new "insulation rated" ceiling cans onto existing wiring and switch ♦ Furnish and install new sheetrock with smooth plaster finish to underside of existing roof rafters only ♦ Proposed cost including materials and labor is $1,900.00 Master Bathroom; Remove existing sheetrock ceiling from one side of"cathedral" to allow access for the insulators NOTE: no ceiling elevation changes ♦ Furnish and install a Panasonic 110 CFM or better, ceiling exhaust bathroom fan (with light), utilizing existing wiring in wall advised,the hose and exterior vent grill- $475.00 ♦ Furnish and install new sheetrock with smooth plaster finish to existing exposed roof rafters - $740.00 ♦ Remove and trash existing pre-fab shower stall,then install a rubber base pan,then install a pre-fab shower stall unit/shower head and valve, all supplied by "owners" - $1, 800.00 NOTE: Standard shower door, supplied by you is included in the installation price quoted Page 4 of 6 Kids Bathroom; ® Furnish and install a Panasonic 110 CFM or better, ceiling exhaust bathroom fan (with light), utilizing existing wiring in wall advised,the hose and exterior vent grill - $475.00 Dumpster costs/fees: ♦ NOTE: this is a flat fee for a 15 yard dumpster with a predetermined tonnage of waste, daily rental fees and delivery charge $650.00 Work not included in this contract Building department fees Engineering or architect costs Permit costs Unseen conditions Painting or staining unless specifically included/detailed above Customer supplied electrical fixtures Utility upgrades if required Supply or installation of tile or grout —HVAC work — Cabinetry or counter top work or plumbing of sink and faucet Supply of items as noted throughout —Landscaping, hardscaping, drainage or vegetation work —Any additional work that may,may not be mandated by the building/conservation/board of health departments Insulation costs or applying for the insulation permit Moving of any personal items —Any other work not specifically noted above PERMITS "Nexus"will accept responsibility to obtain the necessary building permits."Nexus"will act as a GC and work in accordance with fair and reasonable practices,and cooperate fully and under the guidance of the"Owners"and authorized parties.Nexus will pass the cost of the permit directly on to the"Owners"once advised by the Building department. Standard Exclusions: Unless specifically included in the"General Scope of Work"section above,this agreement does not include labor or materials for the following work(any Exclusions in this paragraph which have been lined out and initialed by the parties do not apply to this Agreement): Removal and disposal of any materials containing asbestos or any other hazardous material as defined by the EPA. Custom milling of any wood for use in project. Moving"Owners"property around the site. Labor or materials required repairing or replacing any"Owners"-supplied materials. Repair of concealed underground utilities not located on prints or physically staked out by"Owners",which are damaged during construction. Surveying that may be required to establish accurate property boundaries for setback purposes(fences and old stakes may not be located on actual property lines). Final construction cleaning("Nexus"will leave site in "broom swept"condition). Landscaping and irrigation work of any kind. Temporary sanitation,power,or fencing. Removal of soils under house in order to obtain 18 inches(or code-required height)of clear space between bottom of joists and soil. Removal of filled ground or rock or any other materials not removable by ordinary hand tools(unless heavy equipment is specified in scope of work section above),correction of existing out-of-plumb or out-of-level conditions in existing structure. Correction of concealed substandard framing.Removal and replacement of existing rot or insect infestation. Construction of a continuously level foundation around structure(if lot is sloped more than 6 SPECIALIZING IN QUALITY FINISH CARPENTRY,REMODELING,SPECIALIST ROOF SYSTEMS,SITE AND PROJECT MANAGEMENT Page 5 of 6 inches from front to back or side to side,"Nexus"step the foundation in accordance with the slope of the lot). Exact matching of existing finishes. Repair of damage to roadways,sidewalks,or driveways that could occur when construction equipment and vehicles are being used in the normal course of construction. The"Owner"is to enter into contracts for all of the above-mentioned services and provide direct payment to"Nexus" for all of the services we are to provide."Nexus"will be responsible for removing all components and all construction materials relevant to the"scope of work"in this contract.The"Owners"have received a copy of the lead hazard information pamphlet informing them of the potential risk of the lead hazard exposure from renovation activity to be performed in the dwelling unit.This was received before the work began and the"owners"are responsible for informing their tenants of all potential hazards. Dumpsters,trailers and signs "Nexus"will provide as included in the cost of this project,a dumpster for the sole purpose of the removal of trash associated with this project.This dumpster should not be used by any persons for any other waste items or for any purpose outside of the specific use under the scope of work,unless authorization is received from"Nexus".Nexus may have on site for part,or the whole of the project,a trailer containing materials and tools belonging to"Nexus".This trailer will be parked in a position agreed to in coordination with the"Owners"and will be covered under the insurances of"Nexus"at all times."Nexus"will have on site,a sign,with our contact details,in the event that anyone has a need to contact us directly. Photographs "Nexus"reserves the right to,from time to time,take photographs of the contracted work for use in its general marketing or for production on its web site.At no time will"Nexus"share any personal contact details of the"owner" for any photographs that it may use without seeking authorization from the"owner". Warranties All the components supplied by"Nexus"as part of the original order are covered under the warranty exercised by "Nexus"and supported by the vendors.All labor and materials purchased from other suppliers to achieve completion of contract are warranted(1)one year from completion of the construction. Expiration of this Agreement: This Agreement will expire 30 days after the date at the top of page one of this agreement if not accepted in writing by "Owners"and returned to"Nexus"along with the necessary deposits within that time frame. Changes in the Work: During the course of the project,"Owners"may order changes in the work(both additions and deletions). "Nexus" will determine the cost of these changes and the cost of this additional work will be added to"Nexus"profit and overhead. People Authorized to Sign Change Orders: The fo re authorized to sign Change Orders: "Nexus": ark Gotobed or Ged White " lienf ark or Maria u rini Concealed Conditions: This Agreement is based solely on the observations"Nexus"was able to make with the area in its current condition at the time this Agreement was bid. If additional Concealed Conditions are discovered once work has commenced which were not visible at the time this proposal was bid, "Nexus"will stop work and point out these unforeseen Concealed Conditions to"Owners"so that "Owners"and"Nexus"can execute a Change Order for any Additional Work. SPECIALIZING IN QUALITY FINISH CARPENTRY, REMODELING,SPECIALIST ROOF SYSTEMS,SITE AND PROJECT MANAGEMENT Page 6 of 6 Schedule of work It is agreed by both parties that this work will be coordinated with the"Owners"and "Nexus"to be undertaken in various stages to avoid complete disruption of the home environment."Nexus"will give"Owners"no less than 2 days notice prior to arriving on site for commencement of any of the agreed stages of work to allow"Owners"to prepare. "Owners"commits to have sites identified for construction work available for start at the beginning of the scheduled day so as to avoid any unnecessary delays. Contract Cost and Payment Schedule: Total cost of work description and materials included in the proposal(except materials/work stated)-$23, 403.00 (Twenty three thousand four hundred and three dollars and zero cents) PAYMENT SCHEDULE 1st Payment due upon signing this contract 2nd Payment due upon rough framing inspection TOTAL$8,000.00 TOTAL$7,500.00 3rd Payment due upon completion of sheetrock work TOTAL$6,000.00 Final payment due upon completion of scope of work Amount due upon signing this contract-$8,000.00 TOTAL$1,903.00 I have read and understand,and I agree to,all the terms and conditions contained in the propos/al above. Date....(. .2/J. .MS"Nexus"Authorization....... ... .... Date...� . .z � (,1 . "Client"Authorization.. . Date.' 12 ...... .. "Client"Authorizatio SPECIALIZING IN QUALITY FINISH CARPENTRY,REMODELING,SPECIALIST ROOF SYSTEMS,SITE AND PROJECT MANAGEMENT }� v lv t o `.o i --) Ins l 1J cN . �- -} b - - 3po saw � s -Aa �- a VW *4j5 -O' ,l L-1 Me Commonwealth ofMassachusetts Deparfinent of IndustrialAceidents M a P X Conglress Street,Suite.700 Boston,MA 02114-2017 SV{V94 www.mass.gov/dia Workers'Compensation Insurance Affida-vit:Buffders/Contractors/Elactrcieians/Riumlbexs. TO BE MED WITH THE PERMZTTJ V'G AUTHORITY. Please Print Legitbly A.pplzcant Information Name($tusin.ess/Organization/Tia.dividttal). OC%rr Address: ® r OX 2 lr�®�Ul(� m� OI Phone#: -791 '776c City/State/Zip: Are you an employer?Check the appropriate box: Type of project(Tgjuired): 1.D I am a employer withemployees(fuU and/or part Time) ` 7. [1 NOW construction 2.❑lain a sole proprietor or partnership and have no employees Working for me in 8. Renlo delirlg any capacity.[Nb workers'comp.insurance required.] 9. El Demolition 3.❑I am a homeowner doing all work myself[No workers'comp.insurance required.]t 10F1 Builqing addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my properly. I will ❑ 11. Electrical repairs or additions ensure that all contractors either have workers'compensation insurance or are sole ; proprietors with no employees. _ 12, Plumbing repairs or additions 5..01 am a general contractor and I have hired the sub-contractors listed on the attached sheet. r 13. Roof repairs These sub-contractors have employees and have workers'comp.insurance., (--I L+% ' 14 ❑Other 6.E]We are a corporation and ifs officers have exercised their right of exemption per MGL G. 152,§1(4),and we have nq eployees.[No workers'comp,insurance required.] *Any applicant that checks box#1 must also fill tion outtho section below showing their workers'compensation policy informa t Homeowners who submit this affidavit indicating they are doing all work andthen hire outside contractors must submit anew affidavit indicating such. rContractors 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. Ifthe sub-contractors have employees,tliey utast provide their workers'comp.policy number. I am an employer that is pi'ovidiiag work rrs'compensation insurance for my employees'Below is the policy and joh site information. Insurance Company Name: Policy#or Self-ins,Lic.#: Expiration Date: fob Site Address- City/State/Zip: Attach a copy of the workers, compensation policy declaration page(shOlving the policy'nu ber and expiration date). Failure to secure coverage as requited 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 foam 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. X do re,eby certify under t"11 dpenatties 0 perjury that the inforrnutionpr ovidecl above is true and correct Date: 1R , Si nature: 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 Inspectors 5.Plumbing Inspector 6,Other Contact Person: Phone##: ACORU® DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 12/2E/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 Lauren Goldman NAME: Cross Insurance-Peabody PHONE Ext: (978)532-5445 AX'JCNo:(978)532-2217 139 Lynnfield Street AIL ADDRESS:lgoldman@crossagency.com INSURERS AFFORDING COVERAGE NAIC# Peabody MA 01960 INSURER A.-Wes tern World Ins. Co. INSURED INSURERB:Safety Indemnity 33618 Nexus II Services LLC INSURER C: P.O. BOX 2823 INSURER D: INSURER E: Woburn MA 01888 INSURER F: COVERAGES CERTIFICATE NUMBER:CL15102253381 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LTR INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS-MADE OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ NPP8290737 8/12/2015 8/12/2016 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY JET LOC PRODUCTS-COMP/OP AGG $ 1,000,000 OTHER: Damage to Rented $ 50,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident B ANY AUTO BODILY INJURY(Per person) $ 500,000 AOX SCHEDULED 3116632 11/10/2015 11/10/2016 BODILY INJURY(Per accident) $ 500,000 AUTOS AUTOS X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ 100,000 AUTOS Per accident Medical payments $ 5,000 UMBRELLA LIABOCCUR EACH OCCURRENCE $ EXCESS LAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION PER DTH- AND EMPLOYERS'LIABILITY Y/N ISTATUTE IER ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? LJN/A E.L.EACH ACCIDENT $ (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Mark and Maria Guarini THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 173 Ingalls Street ACCORDANCE WITH THE POLICY PROVISIONS. North Andover, MA 01845 AUTHORIZED REPRESENTATIVE Lauren Goldman/MD1 ©1988-2014 ACORD CORPORATION. All rights reserved. r/. rr�/a/r/s%iri, '„ „ „° r';G/ � ','. ,,v � �/,cr7 / "r//// ,Oi/�% � r�/�✓ � /r/ / '. r �//,/ / / � // � "' /., %i f /// r ✓ / > r a /i I/ /% /// / / ' I /ri // /�'/r / r / /fir /ii /i-/;r. ✓�/i,,,, / ,,,, r r/ / �% � i r i r i rn //%f // r / �rrr/G rr/ � !I/ // / /r / o' s' J/ / ii/ % / ro ✓ rr r// ' � 9 /F / v r /lir y frf 3�r/ rr// � /r ra %i Ar r r r /l. j nam/, ✓rr fr / /o / /ri r // ,/ o // ✓i / /i /l % r1 / r r r r i, / r ri ✓// 'r / r / / nl 0 r v r /(/f Jr1��// �",i! ��,�(t ""'.�" ''�'� l( �'�'�,�J'��tt�✓��Ir��1�}��1Y/I.-' t!I"4�-„�(,("�1�/C�f/L'�{;l C?��S' �;,; ;4 r Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 Boston,Massachusetts 02116 Home Improvement Contractor Registration I Registration: 129177 , � Type: Individual 017 Tr# 26NOO Expiration: 7119f2r Update.. )' Address and return card.Mark reason for change. Renewal " mplayment Last hard Address J� + /� rsa Regulation �i,iccnac or registration valid for individul use only naln / CTf7R before the expiration date. 1f found return to: office of Consurner,Affairs and Business Regulation T uJ oa WY til o yPa- 10 Park Plaza-Suite$170 dual Bostorr,'MA02116 Not valid vwithoataigaaturc nr " rrr +i r o, �✓r/ o/ r fr iii/ / �/ 1 jj/91/!/y/ %i/f l✓�i i/ /// //. /rr/ r//i � � ✓� / r r�i / Massachusetts a6 ata a:a and tandord t�czarct Department at Pubic Safety of suild'iug'Rog 73991 SE/l/'11!19 . CERA-LD WRIfF; iV 23 GLENDALE DAN'V'ERS KA 01923" � �r 0410712416 C:orcrsrxissco�aer f h4 9; 1 M,° /1r° '1 � Office of Consumer/affairs&Boniness Rc ulatio � License or registration valid for mdividul use o��y e istrati R 1MENT �r�r�r Type:� � before the expiration date. If found returpegu p ONIE IMPROVEMENT CONTRACTOR / fO P �= befo 29177 { i 9 T e: of Consumer Affairs and Bas/n Regulation a'rkElaa* Suite 511 400' potion 7119/2018 V � Individual �P Boston,MA 02�"lea Iwrp, Geta 't p���/yy, °YN9JHMi G �� �M111AbP etaid YWIAite Gerald White t 23 Giendae01923 i1Y Undersecretary ot valid without signature / /