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HomeMy WebLinkAboutBuilding Permit #675-15 - Exception 2/26/2015TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION ' Permit NO: / ! / Date Received 24 1( 19 Date Issued: 02 IMPORTANT: LOCAT PROPERTY OWNER 1 MAP NO: PARCEL: 6. must complete all items on this Y > . P'T, Print. l EI ,JP3 p 2014 OF *Cy h AN[)Cj NT DrJENT Y'OVvnr Vr i, �r, t n 2 Print 100 Year Old Structure yes ZONING DISTRICT: Historic District yes Machine Shop Villaqe ves to TYPE OF IMPROVEMENT. PROPOSED USE Residential Non- Residential K.New Building ❑ One family�G141%,� , (9 vvui ❑ Addition ❑ Two or more family ❑ Industrial ❑ Alteration No. of units: XCommercial ❑ Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑ Well ❑ Floodplain ❑ Wetlands ❑ Watershed District ❑ Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: r tI Identification Please Type or PiJnt OWNER: Name: V RO Az"ij n ,LLC- (AAe , Address: CONTRACTOR Name: Pys Phone: ) , 6H'43-6-7 Address: �a Eo `7�y-bcd wz,, 1-1 Supervisor's Construction License: o 1 o 330 Exp. Date: Home Improvement License: Exp. Date: 07-- C 3 t s - ARCHITECT/ENGINEER IML, hone: 17 S-" Address: & YA'Y _f &' C M If O (S -t Reg. No. FEE SCHEDULE. BULDING PERMIT. $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $11225.00 PER S.F. Total Project Cost: $ 2'fL/UO FEE: $ Check No.: G%:2 Receipt No.:�i� . NOTE: .Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Own —� Sig nature of contractor Plans Submitted E Plans Waive ❑ Certified Plot Plan ❑ Stamped Plans El e -Plans -Submitted ❑ Plans Waived ❑ , Certified Plot Plan ❑ Stamped Plans F1 L 1 TYRE :OF:;SEWERAGE.DiSP.OSAL Public Sewer ❑ Tanning/Massage/BodyArt ❑ ... Swimming Pools ❑ Well ❑ Tobacco.Sales E ToodPackaging/Sales ❑ Private.{septic tank, etc_. ❑ --> -Permanent Dumpster on Site ❑ THE- FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM - -DATE REJECTED: DATE:APPR-OVED PLANNING & DEVELOPMENT` ❑ ❑ COMMENTS CONSERVATION COMMENTS �Vu1'� � HEALTH COMMENTS Reviewed on C.,J Reviewed o �(L ature Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection lSignature cY; Date Driveway Permit �-D]PW Tow,z Engineer: Signature: LOcaiea OM US ooa Street FIRE D'IEPARTIU ENT - Temp Dumpster on site yes no Located7at 124,Mair, Street: Fire 'Departmei if,signatu-r_e/date`-' COMMENTS e Vc Dimensian Number of Stories: Total square feet of floor area, based on Exterior dimensions. ;Total land area, sq. ft.: -ELECTRICAL: Movement of Meter location, mast or service drop requires approval of '.Electrical Inspector Yes No DANGER ZONE LITERATURE:. Yes No MGL -.Chapter -166. Section 21A -F and G min.$10041000.fin.e NU I tts and UA I A — wor cie ® Notified for pickup - Date Doc.Building Permit Revised 2010 ent use FA Building Department The fol owing is -'a Itst of the required forms to be filled out'for the. appropriate:permit to .be obtained. Roofing, Siding, Interior Rehabilitation Permits u., B,ailding Permit Application a Workers Comp Affidavit o Photo Copy Of H.I.C. And%Or C.S.L. Licenses a Copy of Contract o Floor Plan Or Proposed Interior Work o Engineering Affidavits for Engineered products NOTE: All dumpster. permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks o Building Permit Application o Certified Surveyed Plot Plan o Workers Comp Affidavit o Photo Copy of H.I.C. And C.S.L. Licenses o Copy Of Contract Ea Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) Li Mass check Energy Compliance Report (If Applicable) Li Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) u Building Permit Application L3 Certified Proposed Plot Plan a Photo of H.I.C. And C.S.L. Licenses o Workers Comp Affidavit o Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) o Copy of Contract o Mass check Energy Compliance Report o Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the apo•?al period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be subm.tted with the building application Doc: Doc.Building Permit Revised 2012 a Location �)3 �-7 /, 44- Et Date No. 16 Check # 41Q TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ ti C uilding Inspector Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost $ 38,400.00 m $ - $ 460.80 Plumbing Fee $ 57.60 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 57.60 Total fees collected $ 676.00 2357 Turnpike Street 675-15 on 3/2/15 Inground Pool H N N W Ga a ps e En M Cl�gdV I to M It $ ,2 � a Al f / _—obi t,�°y�p � "+�-e� b�+ • \ / ,{ �,/�/ j � Q� CCS '�Veja f \ — � G r ei/cVa axa�ooasres\wod�scce\snnto\a�a\:� m CD 0 Z CD O Cr SU CL �a to -a O O v CD CL CD O CD 00133 O CQ CD y n O EM -1 .a O .a 0 CD CD CDa CO) v Z CD 0 N � VI `* z O C " m z T 7 D-' .Z7 O aca Z T 7 °—' N fD ;oT O o�u m•p m D Z cn A 0 7 °—' 70 O Dia C W Z '� 0 m n 3 3 rD It m C O W C v Z -0 0 N 'O '* LA < rD 3 OT O CD - o m O D O T m x Cl) O M Z.cn T� c U) c� n _..� z cn 0 Z /w Z� cn Z c� m n O v O z Oh S CD N O CO O W C. CD to C rt O O N O om CD rr OO O O = = C N y CA m m Q o � -0C. O cny O_ O r+ Q O W C—) - cD cn O —1 C CD �.: CD D CL 0) � > O o CQ CL O N O O C7 C') CD O OCD cn ooNNR z (n N N Q �— =O ! L O Q1 CL N CD C CDI<D a� CL U) r�o cn to .� O ..r o • tl =r C CD CD i� .r. ma CD -3 C1 y rt — aCD CD'0 � o CL O 4 1 J V1 0 o VI `* z O W C " m z T 7 D-' .Z7 O aca n z m A 70 T 7 °—' N fD ;oT O o�u m•p m D Z cn A 0 7 °—' 70 O Dia C W Z '� 0 T 7 °—' n 3 3 rD %J O oco m C O W C v Z -0 0 N 'O '* LA < rD 3 OT O CD - o m O D O T m x c CONSERVATION DEPARTMENT Community Development Division MODIFICATION TO ORDER OF CONDITIONS The Meadows/Maplewood Reserve, North Andover At the June 25, 2014 public meeting the North Andover Conservation Commission (NACC) voted to issue a minor modification to DEP File #242- 1447. The modification is for relocation of the pool and club house locations as shown on the herein referenced plans. A "Outdoor Pool Maintenance Agreement" is also included. The modification shall conform to the plans and documents referenced below. Applicant: Mesid Development Corporation 100 Andover Bypass, Suite 203 North Andover, MA 01845 Record Plans: Site Plan in North Andover, Massachusetts Showing Proposed Swimming Pool and Clubhouse Prepared by: Merrimack Engineering Services 66 Park Street Andover, MA 01810 Date: June 3, 2014 Other Record Documents: Outdoor Pool Maintenance Agreement Oakridge Village/Maplewood Reserve North Andover, MA 01845 Date: 6/15/2014 Approved Modifications: ♦ Pool and clubhouse proposed in revised location outside of the 100' Buffer Zone. ♦ Outdoor Pool Maintenance Agreement to be add to the Operation & Maintenance Plan for the development (See condition #80). ♦ Modifications shall be reflected on the as -built plans. ♦ Erosion Controls will be installed at the limit of proposed work and inspected by the Conservation Department prior to the start of work. 1600 Osgood Street, Building 20, Suite 2035, North Andover, Massachusetts 01845 Phone 978.688.9530 Fax 978.688.9542 Web: http://Nvww.townofnorthandover.com/Pages/NAndoverNiA_Conservation/index North Andover Health Department Community Development Division February 20, 2015 Maplewood Reserve/ Oakridge Village VRD Acquisition, LLC Anthony Mesiti, Manager 2357 Turnpike Street North Andover, MA 01845 Re: Plan approval for new semi-public swimming pool at Building 21; Sandalwood Lane The Health Department has reviewed your plan revisions, revision date February 8, 2015, regarding the pool building at the address above. This plan has been approved. As the pool building and the pool construction plans are separate and there are to be multiple contractors, please be sure that all important parties receive this approval letter with its conditions as written below. This plan is approved, with the understanding that the applicant is responsible for compliance to the MA Pool Regulations, state sanitary code 105 CMR 435, Minimum Standards for Swimming Pools, for construction as well as ensuring the impending operator is notified of their requirements to comply to the pool as well. The following items were shown on the plans 1) OK A kill switch for the pool pump must be in compliance with the electrical regulations. Please note on plan to provide to electrical inspector, for the location of the kill switch. 2) OK Plan shows common depth of five feet, but the stairs don't appear to go 5 feet deep. If there is a change in depth, please see section 435.12 details the required striping of the pool at changes on depth etc. Please note striping requirement must be followed where any transition exists and be of contrasting color. 3) OK Bathroom walls behind fixtures cannot be sheetrock and mold resistant paint. The plumbing code requires a washable durable solid surface such as FRP for example. Per plumbing code 248 CMR 10.10 4) OK Plumbing code requires a "drinking fountain" according to Jim Hurley, plumbing inspector. Page 1 of 2 North Andover Health Department, 1600 Osgood Street, Suite 2035, North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476 5) For Pool Installer Suction outlets appear 2.5 feet. The code is 3 feet minimum. The drains should be 3 ft apart or more (ANSUAPSP-7) 6) For Pool Installer Steps shall be striped; 435.12 4 inch stripe of contrasting color of the pool 7) For Pool Installer Water depth markings on pool deck and vertical on walls per 435.12 8) For Pool Installer Decking must be 4 feet around the pool minimum. Note that one end is at minimum width. This item was written ambiguously. The applicant must have emergency communication equipment per 435.25. 9) No Emergency communication equipment was shown on plan. Must have per 435.25 Looking forward after approval and building permit issuance, but before opening these code items should be addressed; 1) Health signs per 435.22 2) Life guards for open hours with appropriate clothing; red or orange 435.23 4 3) Whistles, bull horn etc. by operator 4) Log book 5) Dpd Test kit; reagents must be replaced annually 6) First Aid 435.25 as listed 7) Emergency communication equipment 435.25 must be open and available to public at all times 8) Safety equipment 435.24 9) Annual bacteria test per BOH Cc: Robert Vorbeck file Page 2 of 2 North Andover Health Department, 1600 Osgood Street, Building 20, Suite 2035, North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.8476 ,any". OFFICE OF BUILDING INSPECTOR TOWN OF NORTH ANDOVER '—- CONSTRUCTION CONTROL RECEIVLO"-' 0 2014 PROJECT NUMBER: - 1'H ANDOVER PROJECT TITLE: i��; ta���;.: e c-� HEALTH DEPARTMENT PROJECT LOCATION: �7 j T�..�� :1c� S-� Sieel- 4—,% A,A©:�`-�i-� h''�A_ NAME OF BUILDING: 1 t� •-,.-� NATURE OF PROJECT: IN ACCORDANCE WITH `AFjTIC E 116 OF THE MASSACHUSETTS STATE BUILDING CODE, c�.—� REGISTRATION NO. 9'0 64F. -s BEING A REGISTERED PROFESSIONAL ENGINEER%ARCHITECH HEREBY CERTIFY THAT I HAVE PREPARED OR DIRECTLY SUPERVISED THE PREPARATION OF ALL DESIGN PLANS, COMPUTATIONS AND SPECIFICATIONS CONCERNING: ENTIRE PROJECT 0 ARCHITECTURAL I STRUCTURAL 0 MECHANICAL 0 FIRE PROTECTION 0 ELECTRICAL '0 OTHER (SPECIFY) FOR -THE ABOVE NAMED PROJECT AND THAT, TO THE BEST OF MY KNOWLEGE, SUCH PLANS, COMPUTATIONS AND SPECIFICATIONS MEET THE APPLICABLE PROVISION OF THE MASSACHUSETTS STATE BUILDING CODE, ALL ACCEPTABLE ENGINEERING PRATICES. AND APPLICABLE LAWS AND ORDINANCES FOR THE. PROPOSED USE AND OCCUPANCY. I FURTHER CERTIFY THAT I SHALL PERFORM THE NECESSARY PROFESSIONAL SERVICES AND B EPRESENT ON THE CONSTRUCTION SITE ON A REGULAR AND PERIODIC BASIS TO DETERMINE THAT THE WORK IS PROCEEEDING IN ACCORDANCE WITH THE DOCUMENTS APPROVED FOR THE BUILDING PERMIT AND SHALL BE RESPONSIBLE FOR THE FOLLOWING AS SPECIFIED IN SECTION 116.0 1. Review, for conformance to the design concept, shop drawings, samples and other submittals which are submitted by the contractor in accordance with the requirements of the construction documents. 2. Review and approval of the quality control procedures for all code -required controlled materials. 3. Be present at intervals appropriate to the stage of construction to become, generally familiar with6the progress and quality of the work and to determine, in general, if the work is being performed in a manner consistent with the construction documents. PURSUANT TO SECTION 116.2.2 1 SHALL SUBMIT WEEKLY, A PROGRESS TOGETHER WITH PERTINENT COMMENTS TO .THE NORTH ANDOVER BUILM UPON COMPLETION OF THE WORK, I SHALL SUBMIT A FINAL REPORT, SATISFACTORY COMPLETION AND READINESS OF THE PROJECT FOR BED AND SWORN TO BEFORE ME MY .LINDA QRF- �. iN$P.ECTOR. E NCY.�Q ©osrn t MIT1'A N90 Of � km March 20 .20 VORBACH ARCHITECTURE 58 MANCHESTER ST. NASHUA, NH 03064 (603) 886-1738 BUILDING 21- POOL HOUSE - MAPLEWOOD RESERVE - NORTH ANDOVER, MASSACHUSETTS INTERIOR FINISHES: FLOOR: TEXTURED COLORED CONCRETE BASE: 6" X 6" X'/2" BULLNOSE TILE BASE WALLS: '/Z" "MOLD TOUGH" REGULAR "SHEETROCK" GYPSUM BOARD PANELS BY USG OR EQUAL CEILINGS: ''/z" "MOLD TOUGH" REGULAR "SHEETROCK" GYPSUM BOARD PANELS BY USG OR EQUAL. PAINT: MOLD RESISTANT PAINT - COLOR SELECTED BY OWNER PLUMBING FIXTURES: See Sheet A-5 TOILETS: K4199-0 WHITE, WW, CH 1.28 12" ELONGATED BOWL - K4467 - 0 WHITE, WW 1.28 TANK - K4731 -C-0 WHITE STRONGHOLD SEAT BY KOHLER LAVATORIES: K2030-0 WHITE 20" X 18" 8CC LAV - B -0890 -CR PC LAV FAUCET WB T&S - 155 WC WHEELCHAIR LAV STRAINER BY KOHLER SHOWER: 14132 -R -000 -002 -LN - OPS -6036 -RS -R ADA/MA LNALVE - MASS COMPLIANT ADA ROLL IN W/SEAT, GRAB BAR, SHOWER ROD, LNALVE, '/z" THRESHOLD, SEAT AT RIGHT, REAR GRAB BAR - AKER BY MAXX ELECTRICAL and LIGHTING: See Sheet E-1 LIGHT FIXTURES: FIXTURE 1: 8 5/8" X 4'-0" SB - SQUARE BASKET WRAPAROUND, NARROW BODY SURFACE MOUNTED FLUORESCENT FIXTURE BY LITHONIA FIXTURE 2: 8 5/8" X 8'-0" SB - SQUARE BASKET WRAPAROUND, NARROW BODY SURFACE MOUNTED FLUORESCENT FIXTURE BY LITHONIA FIXTURE 3:4 5/8" X 2'-0" WC - COMMERCIAL WALL BRACKET, ALL PURPOSE FLUORESCENT FIXTURE BY LITHONIA FIXTURE 4: FV -11 VQL6 VENTILATION FANLIGHT FIXTURE BY PANASONIC FIXTURE 5: MATCH EXISTING GARAGE EXTERIOR LIGHT FIXTURE MSPCA-Angell Page 2 of 2 https:Hsecure2.convio.net/mspca/site/EcommerceCheckout/608085649?CONFIRMATIO... 11/29/2014 OUTDOOR POOL MAINTENANCE AGREEMENT Oakridge Village/ Maplewood Reserve North Andover, MA 01854 6/15/2014 Storage of Chemicals: 1. Pool will be equipped with Salt Chlorine Generation, eliminating the need for any form of chlorine or oxidizer to be stored on-site. Balancing chemicals such as Calcium Chloride, Sodium Bicarbonate, Soda Ash, and Sodium Bisulfate will be stored inside of a locked equipment shed or supply shed to ensure containment of any spill. Furthermore, all of the above named chemicals are in solid form in order to accommodate easy clean-up. Waste Water: 1. Pool filters will be of Modular Media design. These filters require no backwashing or waste water disposal. 2. There will be an extra set of filters on-site so should a filter require cleaning, the internal elements can be replaced so that the cleaning can be performed at a pool company with a proper filter cleaning station. Pool Drain Down: 1. The proposed pool will not require any water to be drained at the end of the season for winterizing. 2. Should the pool need to be drained for any reason, the water will not be discharged on-site. The owner will hire a water hauling company to pump out and truck away the water for disposal in accordance with all federal and state regulations. - The Commonwealth of tY insachusetts - De•par€mentof1m[q.sitrtq1Accxt UtS Office ofInvesggations 640 Washington,S'treet Boston, MA 42111 www.massgov/dla Wgrkerss Compensation xnsurance-Affidavitc But.dears/Coxitra.ctoro/FIectricians/Pli tubers AppIieant hi orz>oation. Please Prilat Lely, ` p 'Name (Businsss10mw*zat1on&d1M&a0: Ti! tUfl �S Address: '70 Su 7 YJD a--( LA�' kYl City/State/Zip: LA -w r,.c,.Q&--L , A&r, ®t �. Phone #' Are you an exnployer7 Check the appropriate bog : J.' am. a employar with 30 4. Q I wn a general contractor and I employees (flail and/or part-time).* have hired the sub -contractors 2. ❑ I am a solo proprietor orparbaw. listed on the attached sheet, t ship and'have no. employees. These sub -contractors have worldng for me in auy capacity. workers' comp. :hm rance. Lipa worker' comp. J'nsurance S. Q We are a emporagon and its required.] officers have exercised their 9. q I am a homeowner doing all work tight of exemption per MGL Myself [No workers° ooxap. G. 152, §1(4), and we have no insmamerequixecQ f employees. [No workers' Type of project(reVred): 6. 0New conptructton f 7. ❑ Remodeling 8. j] Deo.olwon 9. ❑ Building addition 1.0.[f Electrical repairs or additions 11. El Plutmbipgrepairs or additions 12.Q Roofxepairs UpkOlher JW0MJt ft, !Any appllcantthat checks boxgl must also fit out the section below showing their workers' eompometton policy iufnrmalon. I t-Homeownem who mbmitthts affidavit iadloatingthe j sia dping all work and then bhra outside 00atmotors must submit a new affidavit indicating such. tContmotus that check this boar must attached au iddMonal sbeet slowing the namo of the suG-contmotu.9 and then wodors' comp. potcry khan fion. 1 wn an ernp%yer that is proviribtg workers' compensation h1surance formy employees Beta v 150epolicy andjob site fnfomatioaz Iumrauce Company Npmo: � , Policy # ox' Ser- los. Lio. &I dl��- Q] +D l -5C Expiration. Dttte. T' Job site Address: City/Siate/Lipt . j Jai f� of Attach a copy of the workers' compeaMlonlpolley 1eclaration page (showing the policy member and expiration date). Failure to secure oovemp.as reciuiredunder Section 25.A: ofMGL o. 152 can lead to the imposition, ofcriminal penalties of a fore up to $ Z, So 0.00 =Nor ones -year imprisonment, ae well as civil penalties iu the form of a STOP -WORK ORDBR and a fine of -up to $250.00 it day against the violator. Be advised that a copy ofthis statement may be forwarded to the Office of investigations of the DIA for inmrance coverage verification. X do hereby c"0 under fiiUnA s imd penalties of perjury Aat t`ha Mj' inwdon provided above is true and correct+ Off ekd use only. Do not write in this area, to be completed by e4p or town offieW, City or Town: Permif Ucenge # IssuingA.uthority (circle one): 1. Board of Health 2. Building Department 3. CitylTown Clark 4. Electrical Inspector S. Plumbing Inspector 6. Other - - Contact Person: Phone M Client#: 53642 FAMILYPOOLI ACORM CERTIFICATE OF LIABILITY INSURANCE YYY) =7/24/2014 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(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 HUB International New England 299 Ballardvale St Wilmington, MA 01887 978 657-5100INSURERS) N E: PHONNo, Ex:978 657-5100 A/AIC, No866-475.7959 E-MAIL ADDREss: nee.certificates@hubinternational.com AFFORDING COVERAGE NAIC # INSURERA: Nautilus Ins Co INSURED B: Technology Insurance Co Family Pools Patios Inc. North LLC Family Pools N 70 S. Broadway Lawrence, MA 01843 w -INSURER sURERC: Peerless Indemnity Insurance Co 18333 INSURER 0: Safety Insurance Co 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 LTR TYPE OF INSURANCE ADDL INSR SUB WVD POLICY NUMBER POLICY EFF MM/DD POLICY EXP MM/DD LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITYp�,1p CLAIMS -MADE 51OCCUR X BI/PD Ded:2,500 NN381281 9/19/2013 09/19/2014 EACH OCCURRENCE $1,000,000 SES ERENTED REMI .occurrence $100,000 MED EXP (Any one person) $5,000 PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY 7 PRO LOC JECT PRODUCTS - COMP/OP AGG $2,000,000 $ D AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED X SCHEDULED AUTOS AUTOS HIRED AUTOS X NON -OWNED AUTOS 3947232 12/31/2013 12/31/201 COMBINED SINGLE LIMIT Ea accident $1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ Per acdd . UMBRELLA LIAR EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ D; I RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILrrY ANY PROPRIETOR/PARTNER/EXECUTIVE V / N OFFICER/MEMBER EXCLUDED? a (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N I A WWC3074055 12/31/2013 12/311201 WC STATU- OTH• ORYLIMITS ER E.L. EACH ACCIDENT $5OO O00 E.L. DISEASE - EA EMPLOYEE $500,000 E.L. DISEASE - POLICY LIMIT 1 $500,000 C Property Spec Form BFS55731947 Repl Cost 9/19/2013 0911912014 Ded $1000 vrs limits DESCRIPTION OF OPERATIONS / LOCATIONS f VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) Workers Compensation has Blanket Waiver of Subrogation, as required by executed contract. Work in NY is excluded; new construction of 10+ units is excluded. 1600 Osgood Street referencing VRD Acquisition, LLC Maplewood Reserve Town of North Andover 120 Main St North Andover, MA 01845 ACORD 25 (2010/05) 1 of 1 #S1183060/M1064399 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 Signature not on file. ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD DKO04 w> Construction Super-, i-�or _ CS -010330 WILLIAM C Pou.wS . 70 S BROADWAY LAWRENCE MA 01843 07119/2015 WR .Nw- Nvi— - TOffice of Consumer Affairs nd Business Regulation 1.0 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 118204 Type: Supplement Card FAMILY POOLS & PATIOS INC Expiration: 2/13/2015 GLEN WIGGIN 70 S. BROADWAY _.. _---------- --- ------ -- LAWRENCE, MA 01843_ -- SCA I •.. e0rn-0e1 Office of Consumer Affairs & 'Business Regulation ME IMPROVEMENT CONTRACTOR Registration: 118204 Type Expiration: 2113/2015 Supplement ;'ard FAMILY POOLS & PATIOS INC GLEN WIGGIN 70 S. BROADWAY LAWRENCE, MA 01843 Undersecretary Update Address and return card. Mark reason for chancre. —Address i j Renewal j _! Employment Lost Card License or registration valid for individul use only before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, MA 02116 Not valid without signaSut� , Ck. � � � /\ ^/� �»! . CL 41 IOU