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HomeMy WebLinkAboutBuilding Permit #428-11 - Exception 11/18/2010 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: d'y— Date Received Date Issued: 4 �� IMPORT/ANT:Applicant must complete all items on this page LOCATION © l L[��IZ4ege 1�� Print PROPERTY OWNER Print MAP NO: �Q kARCEL:GO —hONING DISTRICT: Historic District yes no I� Machine Shop Village yes no I� TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition [I Two or more family ? ❑ Industrial ❑Meration No. of units: ❑ Commercial Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other I®:Septic (®Well . I®dEloodplain� (O Wetlands `® W,aterslk&lys""tract:_ ��,Water__/,Sewe'r t. I. a DESCRIPTION OF WORK TO BE PERFORMED: S x- Identification Please Type or Print Clearly) OWNER: Name:/L/0 �-e 6--efh e , aWA%r Phone: y Address: 1,1042M 44v,, CONTRACTOR Name: C (QC, Phone: s /�z�3�szz Address: ro tl (!✓td;�P- S T cam.)/,-70ep � Supervisor's Construction License: 10 3'� J Exp. Date: J Home Improvement License: S qD 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. U1 Total Project Cost: Check No.: w� Receipt No.: T Pe sons co trac ing w t unreg' a ed ontrac do not h ve ac es to g r fund Location 111a e&kWIZ No.� Date NORTH TOWN OF NORTH ANDOVER O:�r.•o ,•1h,0 P }�e Certificate of Occupancy $ s��NuSE<� Building/Frame Permit Fee $ 411 Foundation Permit Fee $ Other Permit Fee $ t TOTAL $ Check # 237 '17 Building Inspector Plans Submitted Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Swimming Pools ❑ Tanning/MassageBody Art ❑ i Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ 1 Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS CONSERVATION Reviewed on Siqnature COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature&Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT -Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date COMMENTS Dimension 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 servicedroprequires approval of Electrical Inspector Yes DANGER ZONE LITERATURE: Yes No MGL Chapter 166 section 21A—F and G min.$100-$1000 fine NOTES and DATA— For depart use I ® Notified for pickup - Date Doc:.Building Permit Revised 2008 Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses El 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. p ent prior to Issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application ❑ Certified Surveyed yed Plot Plan . o Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract o Flo or/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) ❑ 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) o Building Permit Application o Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report o Engineering Affidavits for Engineered products NOTE: All duste m p r permits require sign off from Fire Ire De artme prior Department to Issuance p p 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 appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc: Doe-Building Permit Revised 2008mi ALCANTARA CONTRACTOR, INC 61 Tainter Street#2 Medford, MA 02155 Phone: (617)283-1522 Fax: (781)391-0933 alcantaracontractor.com November, 10 2010 Propose to: Heritage Green Condominiums 60 Edgelawn Ave # 2 North Andover, Ma 01845 C\o Affinity Realty Management 63 Atlantic Ave 3 floor Boston, Ma 02110 Description: 1- Secure ceiling with a temporary wall using 2x6, also use a 4 mil plastic to contain dust, cover carpet floor. 2- Continue to open sheetrock walls around the slider, and portion of ceiling. 3- Remove and replace rotten 2x4. 4- Remove rotten 2x10 and install new ones. 5- Insulate it. This price includes labor, materials, clean up and equipments. Total $3500.00 Alcantara Contractor Affinity Realty ORThI ToVM Of No. LAKE O dower, Mass., �A COCMIC NE WICK\fit DRATED SS ` BOARD OF HEALTH Food/Kitchen .PERMIT T D Septic System j i �� ,/ BUILDING INSPECTOR THIS CERTIFIES THAT6 �,j'�-K .. has permission to erect........................................ buildings on .&v........ 'def el wrr ................ Rough to be occupied as.. ../?.��........�.574.t. i.�.. ....��!�.1 .... �.�dr�/Z_ Chimney provided that the person lccepting this permit shall i;. ery respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations'-Voids this Permit. Rough _ Final ��- - PERMIT EXPIRES TN 6 MONTHS UNLESS CONSTRUC STARTS ELECTRICAL INSPECTOR Rough ....... ............................:...... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR 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 Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE J1 Smoke Det. • p The Commonwealth of Massachuse ts, Department of Industrial Accidents Office of Investigations ' 04 600 Washington Street Boston, M.4 02111 www.mass. ov is Workers' Compensation Insurance Affidavit:`Builders/Contractors/Electricians/Plumbers A Iicant Information Please Print Le 'bl Name (Business/Organizatiowbdividual): 4/-/--,4 1.,� J--r2 A Address: (,/ T /&-1 t N t2 s r City/State/Zip: ktm pct rc-tTel.: 22 AreNDLI •tan empioysr? Chsak t e appropriate-bos: Type of project(required); ' 1, erre a tanployer with •4.. � ]am a gzrrrral coatracmr and I .. craploycs(lull and/or part-time). 6. New cansavction � have hired the sub-contractors D 2.:1 I HILI a sole proprietor or perforce- listed on the at=hed sheet. 7. D.Aamodtling' sh' �tid have nc. } s These sub-ctmtm ators have g rp =r.p oyes D Demolition WoTicing Y for me in zm ,haF3 =mployrs and have wori=n 9. ❑Building additiarr • [No workers'Camp. =M== comp.incttran=4: r-q riv ed] 5. We are a corporation and,its 10.L]Elacu•ical repairs or additions 3.❑ .I am-a homeowner doing all work officers have cxcroised their L Plumb repairs or additions rrrystrlf.j4lo.worlccrs' comp, right of ersmption por•MGL errs c, 152,insurance roquirsdl�t �1•(4),and.vee have no � �,/p•�2employees,•[No workers' TPI, ' comp.insurance rcquircd.] "bnY$pPlicz at tizd im box 91 must also fill out the station bdlow showing their warkars'aompensatian policy information.• • t Homeowners wha.mbralf this rmmda t indicating tboyart doing all work and.thm hire autsidc.contrattars must submit a new sf'ttdavuind ding such• 3Contraaters'ti=the*thii bar,moist sueahtd an additional sheat showing the name of the sub-aonnaamrs and seal,whether er•notocn aaitia have ,•r� CnplayG=S If rile 9nb-CAAlZBeLQlS 11aVt GmptayeES,they meat provide Ebnir,warlars'aenap.•poliay nambet.. ..... __..,.._. .. I am an employer that is providing workers' compensation insurance for my employees.Below is the policy and job site information. - Insurance Company Name: Policy#or Self-ins.Lic.#: Cv.L.. 67M Expiration Date: ***JOB SITE ADDRESS Gw /IC City/State/Zip w Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date) Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of 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$250.00 a day against the violator.Be Advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verificatioV. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature: Date: Tel. Off 1=i=Z use only. Do raaf write in this area,to he compLacd b7'city or town ogle[ .City r..'�'owa:�QS7't�3N PzrmitlLit:euse.•# _ . Issuittm Aufhorify(circ}:onz I.$card ofHrath 2. uildingDtpartn: 3.City/Town Merit 4.Electrdaal Inspector S.Ylumbing.Inspzctor, Conta c:t Ptrso= J-im =NN'IDY Phone : 517-961-3357 .a z i tr Nl _mpiqe .'n„^-�Corral Laur mar 1 :- s all ; , fttTc +e+,��LLil 'alt. 8I1 LT7m _P S^ a �v F D2 i:�LS' LVjII;-�$�Ml for imp nr vrrarn, mo=d 3"...r„ pssnr.m tn=.�v`= of metn.r ter_,sisy=na�tm bac = igrrr is d:iincd as"an indivuiuel,nartz:rr aip assnciatinn Mf thr: am jri�t,and mnludin the lz =oxparaam, nr ntli=r Scgal am=ity,nr atiygraor marc € g in e. oint cn g gal rpr- v=s of a d-..crated 1 r Ives or zt afar iadividrtat;pa�m assothatian m athsr lz ' °y°�Dr au�si=r ai•a dwcl}iitg iuiusshavaig nisi marc than ih�sp.t.' and who nplByiug..r aapiay,s. ? crrfiit dv�11iag hm=-of anadmr who=plrvs r-=oas-to do main._ `fz pr nr ori tint grounds m building sap tthr-tp s -_m=`z 61*n nr rpau•,`�vork.nnsL b rig ho= o ,.T-„�, hall not. ?> inlvirnt.bt..d==-d m:bc a:1 152,g25C(L)also srp'T-s tt>="ay. ran-wal•afa iitxsise•m itto'a --�te.a 'cr 1a�1 �� ai:all rritbhnld'fa> issnmiror. g usm:ss or to c6=tra�i?uil � � it flee flee cnms►anv�$t�inPiint who basnatpradu d m�-gfztble zvid==of ySr mAddimy Auld, cov=- geren . .} _3 C('7) s"1ithLr the c t rut:-r'izzto$rr,,crnrJzaLt irir El>z arrr 7zzyj,.of ifs poliiir subdiim shall of`publir•work iaiiil PiurinrE 7'4uis colts of 41iis ahapmr have br.�' =ntnd'to �' bl"Li>id.-n ^p} smn lmars with ' . . . P?= the cntinaztuig���,.^: :�;. .. . _. �,•. . 1�ppli=anis• Fi��^t n'71 nut thc worlsrs' cQoapnn EffaiB.vit c ^ nmPl�"'�, mgthr.bm:=4hk#ply fa.yoi=s>tinhcm.and;•d • n_cc=sary,yuPP}y sub-cnn'urrrar(s)riamc(s),'adcb-„,ss(:s) g� ' i� snd.p . n>�a;(s)along with tbair z-rc5 d mz=r== Lialiird Liabiiity Cop y arr a 'T:i> y. s 7LLP)with no lcn7=r n==� s a.paia�;of noi?bqui;-�m terry viorl^-zs'z �P far fhz =mplove-s a pofiiy is rr-quircti pc adt_�d 1�at. nmP=a�IIr '.ji.�LLC at I..LP dn•=ia t' ' This$ idayit may be suami�d m tiic Lcpsnmrat,of Ian] f�cCid�IS far LaafIImaflnn of inx„�+r�CQ�.. pL.='tzun:d totht city 'moo he sare.*n sib,and zlafs'the z itlevit. Tha s�dm should ' ar'taKm that tlxi sgpliratior,for.tcc'p=nnit ar.li is firing��iscsr:ti,no the Ur �t�. Indsx-?=ial =iii=..5hould you have$ay�usrtiaits rr °oaip==Etion of 4aass reI]$ie gardingt 'laa or•if yon am rtquirz*d.to obtiin awmiM= saif✓ixxsuran� ana a numbcr an thm aumbsr lu xd bJotiu. fial msurcd oompsairs s}iou61 cot=ril?iir Cit} or T mm C?ficiah be sur tnatfbt amdwth is caatplm:e and grix� 1., •b . Tia L� of idzc a t==han pruvid:d a spm sift 6 =am aiadavit'fai you to sill atrY am the is ttba.C}�ucc ofIm nas has-to evrrtiiat• tm you r�tding P'l c smrWnil io the p�mttlli�a,�azo} y;b wnl'bc t i sed as a � nurnba.'m ad>izi�ffi tlzal must suttauJiiplc gcimitlli zpPl> gs in=y;s?m'..y r,t=d rmf submit a=Effldzvh' policy m{t�inn(i rr_c�y)and uae�r”jab Sit,Adds-_sC"t)Zc gctm� tox,n =PD==should write`all lnaaiim=in (cityy ar 1 A copy of fht dn—dm that has)=m, o$inia t,==ptd.mr m=a=d*the bi•ty 07-tonin may be Proceed.to' ILPPlicaat m proof that a valid em- s on file iur fi=L=r.p� be i�lcdnzstascb cu'ii .s Iffidavii.must tim yL$r. �Nhrit a hams ownar or citi.-n is nh�iaing.a lizxzmt or ptraz atri r�amd to.any busuiss.ar niraiJ vm (i.=. a dog list or Perri b=I=v--s etc.)said persaii is , Sir ' t7 fzguu-d'io compistt this mmiavit hiL Cr:n�.oflnvatigafions would li1A.c to thaa.li you in advance far Pido nal h= yDur zovp-,.ratlpn�d.,}could you hariffiry gl�� =�"t iratt tc a vt us D call. �� Dcai ;sado-�,rricphane anduin _ •. . Imo;n b;r:'. ,... •�.. '�0•FEEITIDIIV�'�j;D�1111.��3C�'lt+ate .� ...: ;�.; .... �"}sartrr�l of�nd>�• Ti>�drnia '. - •• .. .. Obi ce�i'.�V iii Qn� . _ . .. • . :. B astom,IVLA 02111 Tel.4 617-727-4.900 .4;J�i.:ig�1-8 77-1v1A5.SAFS _ R--iised 4-24-07 Fa3' 6.1 727-T_A' . ... www-in gov/dia '4 o° CERTIFICATE OF LIABILITY INSURANCE DAT 11116D/YYYY) 11/16/10 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). CN PRODUCER 781-751-9080 NAME CT KW Insurance Agency, LLC. 781-751-9081 PHONE FAx 414 Washington Street E AIL Ext): A1C No Dedham, MA 02026 ADDRESS: PRODUCER ALCANT1 CUSTOMER ID#: INSURERS AFFORDING COVERAGE NAIC# INSURED Alcantara Contractor Inc. INSURER A:Arbella Protection Insurance 41360 Carlos Alcantara INSURER B: 61 A.TainterSt. INSURERC: Medford,MA 02155 INSURER D: 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. INSR TYPE OF INSURANCE ADDL UB POLICY EFF POLICY EXP LTR POLICY NUMBER MM/DDIYYYY MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY 8500037504 06/15/10 06/15/11 PREMISES Ea occurrence $ 100,00 CLAIMS-MADE a OCCUR MED EXP(Any one person) $ 5,00 PERSONAL&ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ 2,000,00 POLICY JECTPRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY CPer accident) $ SCHEDULED AUTOS PROPERTY DAMAGE HIRED AUTOS (Per accident) $ NON-OWNED AUTOS $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATIONWC STATU- OTH- AND EMPLOYERS'LIABILITY T R MIT R A ANY PROPRIETOR/PARTNER/EXECUTIVE YIN 9105410607. 06/15/10 06/15/11 E.L.EACH ACCIDENT $ 500,00 OFFICERIMEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,00 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,00 A Property Section DESCRIPTION OF OPERATIONS/LOCATIONS/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 Affinity Realty ACCORDANCE WITH THE POLICY PROVISIONS. Property Management LLC 7HORtZZED REPRESENTATIVE Heritage Green Condo Trust 39R Farrwood Ave North Andover MA 01845 ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD HIC RegistrationLookup Page 1 of 1 The Official Website of the Office of Consumer Affairs&Business Regulation(OCABR) Mass.Gov Consumer Affairs and Business Regulation Home>Consumer> Home Improvement Contracting> .........................................._................................... .......... Home Improvement Contractor Registration Lookup The list is current as of Tuesday,November 16, 2010. You can search/filter the registration list by any of the criteria below. I RELATED LINKS Search by Registration Number 1165490 Home Improvement Contractor Search Registration Number Registration Home Page . ............................................................................................................ Search by Registrant Name Search by City I __ Zip Code Search Registrants I Click on the registration number to view complaint history.You can also view arbitration and Guaranty Fund history. Search Results _ __.._......................__ _.._._....,._.............................._._...... _..__.........................._...................................._...._....___.._............... REGISTRANT NAME RESPONSIBLE REGISTRATION ADDRESS EXPIRATION STATUS INDIVIDUAL NUMBER DATE ALCANTARA 61 A TAINTER ST#2 CONTRACTOR INCA N'CARLOS,ALCANTARA j 165490 MEDFORD,MA 02155!2/22/2012 Current w ©2010 Commonwealth of Massachusetts http://db.state.ma.us/homeimprovement/licenseelist.asp 11/16/2010 i i� j e 1 I ��� •fit _ f \ `cam. I � i "4 i G C I \J I 411 ------------ �y/ 1 ` Cl) ! I ------ OP ID:TA '4 EY CERTIFICATE OF LIABILITY INSURANCE DAT11/16DIYYYY) 11/16110 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). CONTACT PRODUCER 781-751-9080 NAME: KW Insurance Agency, LLC. 781-751-9081 PHONE FAx 414 Washington Street E-MAIL Ext): AIC No Dedham,MA 02026 PRODUCER CUSTOMER ID#:ALCANT1 INSURERS AFFORDING COVERAGE NAIC# INSURED Alcantara Contractor Inc. INSURER A:Arbella Protection Insurance 41360 Carlos Alcantara INSURER B: 61 A.Tainter St. INSURERC: Medford, MA 02155 INSURER D 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. ILTR TYPE OF INSURANCE POLICY NUMBER MM DD EFF POLICY EXP LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY 8500037504 06/15/10 06/15/11 pRGE TO RENTED EMISEs Ea occurrence $ 100,00 CLAIMS-MADE FKOCCUR MED EXP(Any one person) $ 5,00 PERSONAL&ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ 2,000,00 POLICY PRO-JECT LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO — BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE $ HIRED AUTOS (Per accident) NON-OWNED AUTOS $ $ UMBRELLA LIAB HOCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY T A ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N 9105410607 06/15/10 06/15/11 E.L.EACH ACCIDENT $ 500,00 OFFICERIMEMBER EXCLUDED? F—] N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,00 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,00 A Property Section DESCRIPTION OF OPERATIONS/LOCATIONS/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 Affinity Realty ACCORDANCE WITH THE POLICY PROVISIONS. Property Management LLC Heritage Green Condo Trust ( HOR¢ED REPRESENTATIVE 39R Farrwood Ave �. North Andover MA 01845 ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD Mar 15 10 02:24p p,3 Board of Buildiag Retnistlons and Stand-rds Incense or registration valid for Individul use onlyCONTRACTOR before the expiration date. If found return to: t" ;:' HOME IMPROVEMENT P :.::•.tee..�,., Board of Building Regulations and Standards Registration: 163106 One Ashbsrtou Place Rm 1301 'j` '' Expiration: 5/112011 Tr0 284043 Boston,Ma.02108 Type: LLC �. AMERICAN BUtLDiNG TECHNOLOGIES JOSE ALVES-SANTOS --- ..; . —. =. 2 NEPTUNE RD.SUITE 438 blot._ vs1�41 witMdut signsture BOSTON,N1A 02128 Administrator Restricted to: 00 00- Unrestricted :e n s e s 101378 -- - _ IG-1 2 Family Homes - JOSE SANTOS Failure to possess a current edition of the 37 W MILTON ST APT 1 Massachusetts State Building Code HYDE PARK MA 02136 s cause for revocation of this license. 11121!2011 itefer to: WWW.Mass.Gov1DPS 101378