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43 SCHOOL ST - BUILDING INSPECTION (2) The Commonwealth of Massachusetts wn of Board of Building Regulations and Standards TOtr Massachusetts State Building Code, 780 Ch1R. T"edition lowsoBudding Dept Building Permit Application To Construct. Repair. Renovate Or Demolish a One- or Tuv-Fuinili-Duelling This Section For Official Use Only Building Permit Nu r: ,, Date Appl ed: Signature: _ Budding Commissiunerl pect°r of Buildings i Date. SECTION I., ITE INFORMATION 1.1 Prope Address: 1.2 Assessors Map d Parcel'Numbers 3 ,g!# si 1.1 a Is this an accepted street?yes no Map Number Parcel Number 1.3 taing Information: I 1.6 Property Dimensions: /0 0 Zoning District Proposed Use La es(sq fl) Frontage(R) 1.5 Building Setbacks(R) Front Yard Side Yards Rear Yard Required Rovided Required Provided Required Provided /5 1 lo io 0 1.6 Water Supply:(M.G.L c. 40,154) 1.7 Flood Zone Information: Ls Sewage Disposal System: Zone: _ Outside Flood Zone? Munici al. On site disposal system ❑ Public Private O Check if ❑s P SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: L Name ni) Address for Service: Signature Telephone SECTION J: DESCRIPTION OF PROPOSED WORK'(cheek all that apply) New Construction Existing Building O Owner-Occupied ❑ 1 Repairs(s) ❑ 1 Alteration(s) O Addition O Demolition O Accessory Bldg. O Number of Units_ Other ❑ Specify: Brief De cription of Proposed Work': A C, A L r r SECTION 4: ESTIMATED CONSTRUCTION COSTS he Estimated Costs: 011lclal Use Only Labor and Materials I. Building f ? O I. Building Permit Fee: f Indicate how fee is determined: O Standard CiryiTown Application Fee 1 Elecincal f 0�20 O Total Project Cost'(Item 6) a multiplier a J Plumbing S O'Q0 1. Other Fees: S a. Mechanical (HVAC) S List: s Mechanical (Fire S Total All Fees: f Su ression Check No. _Check Amount: Cash Amount: 6 Total Project Cost: S d.3a ODD O Paid m Full ❑Outstanding Balance Due Z�J � SECTIONS: CONSTRUCTION SERVICES 5.1 Licensed Construction Supers isor(CSL) e5 v 7 T z 6-1- 1 '/�1� 11 A,el ` Wed cl Licenw—Nu�mber E,puauon Dale Li,r CSL Type ivee below) AJdrrsf T Descn non U Unresrncted u ro)5,000 Cu. Ft. R Reslncted IA2 Famd DwelLn GSryrutmt/ C' N Alason Onl RC Restdenual Roofin Covenn Telephone w'S Rrsttknual Window and Stdm SF Restdenual Sohd Fuel Btrmm A liance Insullauon D Restderrttal Demolition S.2 Regl tj ed Ho a myrpvertical Contractor 11 eH`ICoell 9 ,� �9 j HI ompag a or HIC Registrant Name ( Regtsrrattoon Number Add 41' / y 44 �) 7 ���� / —/C7 �78-I;S8so/6 Expiration Date Sig"Kaf Telephone SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.e. 152.1 2SC(6)) Worker Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the Issuance of the building permit. Signed Affidavit Attached? Yes .......... - No........... O SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1, `C t c , as Owner of the subject property hereby authorize ,a a� to act on my behalf,in all matters relative to work authoriAd by this building permit application. Si nature of Owner Date / ' SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION M 1, /"/) L h,, d V W P /Lfn , as Owner or Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and bena,�lar I / t / Print Name 1 Signaturr oofl � er or Authorized Agent Date St red under the pains and penalties of perjury) ' NOTES: 1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC)Program), will W have access to the arbitration program or guaranty fund under M.G.L. c. I42A. Other important information on the HIC Program and Construction Supervisor Licensing(CSL)can be found in 780 CMR Regulations I IO.R6 and 110 R3, respectively. 2. When substantial work is planned, provide the information below Total floors area(Sq. Ft) ;LE fO )including garage, finished basement/attics.decks or porch) Gross living area(Sq. Ft.) Oats Habitable room count /D Number of fireplaces C Vumber of bedrooms Number of bathrooms Number of halfbaths A Type of heaung iystem �44 A �-& AS Number of decks/ porches �y Tv of cooling system Enclo,ed . Open „? I 'Total Project Square Footage'may he .uh,muted for 'Total Project Coo" CITY OF SALEM ROUTING SLIT' New Construction ✓ '��, 0'O � S� Certificate of Oc 7'"�cuupancy LOCATION Sc-AOd I DATE ' �6 ASSESSORS DATE 93 Washington St. CITY CLERK DATE 93 Washington St. PUBLIC SEP-VICESA-DATE v4(` 120 Washington St. WATER 7 DATE 120 Washington St. CROSS CONNECTIONDATEL� 5 Je Ave PLANNING .<e P �) a/ ATE 120 Washington St. s CONSERVATION ATE 99 l-D 120 Washington St. la ELECTRICAL 941, DATE 22 48 Lafayette St FIRE PREVENTIOd2ie, DATE �2 29 Fort Avenue' HEALTH / / DATE S �� 120 Washi ton St. BUILDING INSPECTOR DATE 120 Washington at. L.A. AMCIATEI, INC. 5 Middlesex Ave., Suite 20A Wilmington, MA 01887 (978) 658-7675 fax (978) 658-5367 MEMO TO: David Knowlton, P.E. City Engineer, City of Salem FROM: Kristen Costa RE: 43 School Street DATE: May 6, 2010 I am writing in response to your memorandum to Christopher Mello, Eastern Land Survey, regarding the request for a building permit at 43 School St. 1. Drywell for infiltrators: a. The structure is to have gutters and downspouts piped to a drywell. b. We plan to use a 500 gallon drywell (see attached spec sheet). c. We are proposing to manage the rooftop runoff. 2. Grading at southwest lot corner: a. We are no longer proposing to alter this grade. b. Abutters were concerned about drainage, which is why we are infiltrating rooftop runoff. c. By maintaining the existing grades and managing the rooftop runoff, there will not be any increased impact on abutting properties than there was with the former dwelling, which has been demolished. 3. Waterlines: There are two proposed as the structure is to be a two family dwelling, separately metered. a,560. 4 J 91 6:59.w '1 g'-0" I r I 20" DIA I INSPECTION COVER y r I � I L i \ I Ir II I I I II I II 5'-0" II \ I II I 1 � 1 F 1 1 I I r 'I I � I L PLAN VIEW f-1" TAPER 4" TOP (6" H-20) e I •" \ (4) 6" DIA INLET r___i r__ r___i r___i IQI IQI IQI IQI IQI IQI �_. 2'-$" IQI IQI IQI IQI IQI IQI IQI 'L---' ---' �--' �---' �---' �---' Oi Lei iOi iOi Lei Lei r___i r___� r___\ r___i r___� S H EA Lei LE Lei Lei iO� 3"-1 k DRAINAGE HOLES 6"X4" TO 5"X2" TAPER SECTION VIEW WEIGHT ITEM NO. DW—SDW 5,142# DW—SDWH 6,065# NOTES: 1. CONCRETE: 4,000 PSI MINIMUM AFTER 28 DAYS. 2. AVAILABLE IN H—zo LOADING. NEW ENGLA1vD CONCRETE PRODUCTS INC. 500 GALLON DRY WELL SHALLOW WILMINGTON, MA (978) 658-2645 -- AMESBURY, MA (978) 388-1509 PAGE F2 NOTTINGHAM, NH (603) 942-5668 �COIdDIT92 CITY OF SALEM SALEM, MASSACHUSETTS ENGINEERING DEPARTMENT �. 120 WASHINGTON STREET, 4TH FLOOR �cINE4a SALEM, MA 01970 _ Phone: (978) 745-9595 x5673 Kimberley Driscoll Fax: (978) 745-0349 Mayor DAVID H. KNOWLTON, P.E. CITY ENGINEER MEMORANDUM April 26, 2010 To: Christopher Mello, Eastern Land Surve ssociates, Inc. From: David H. Knowlton, P.E.; City Engine' . Re: 43 School Street Kristen Costa New Construction Building Permit Li. This memo has been prepared to provide comments on the above referenced building permit, as follows: 1. Please provide additional detailed information on the following: a. Dry well for infiltrators i. Serves what? ii. How sized? iii. What is proposed? b. Grading at south west corner of lot i. Why? ii. How much(limits of grading)? iii. Any impact on abutting properties? c. Waterlines i. Why are 2 proposed? . \\Salemdc0l\WaterAdmin\dknowlton\My Documents\miscellaneous\misc\43 school st building permit app comments 4-26-1 O.doc F/0 39/ Professional Land Surveyors Et Civil Engineers / ESSEX SURVEY SERVICE 1958 - 1986 OSBORN PALMER 1911 - 1970 BRADFORD & WEED 1885 - 1972 PLOT PLAN OF LAND LOCATED IN MASS. `� PJ/r/G�i/ST��Z ).�2T/tiS -49.z/j ---- _- R� wtl � h7X& i4� RiU 6�9Z I S/fEG 'V I l 11� Al 1 /� 9 3 ekl EF74zW a� a m testy-oods L! u to 4 ci,,GG ZONE: LOT AREA:/6&Z5F- LOT FRONTAGE: d k /yR. FRONT YARD:! lG P/ REAR YARD:3G/� 31317 L , I✓r/� SIDE YARD: ME r.o j n V �J Q SCALE: �r 2L(i � � Ens•'` DATE: 26& c�ti e�rrvii5� REFERENCE: BK PG _ Christopher R. Mello PLS 31317 104 LOWELL STREET PEABODY, MASS. 01960 (978).531-8121 FAX:(978) 531-5920 ■ Attic Beam @ Front Bumpout by Weyerhaeuser 3 PCs of 1 3/4" x 9 1/2" 1.9E Microllam® LVL Ti-Beam®a 35 serial Number: User.1 3122I20103:31:05PM THIS PRODUCT MEETS OR EXCEEDS THE SET DESIGN Pagel Engine Version:6.35.0 CONTROLS FOR THE APPLICATION AND LOADS LISTED I I 1❑,M 2❑ 9'11 12" Product Diagram is Conceptual. LOADS: Analysis is for a Header(Flush Beam)Member. Tributary Load Width:6 6" Primary Load Group-Residential-Living Areas(psf):20.0 Live at 100%duration, 12.0 Dead Vertical Loads: Type Class Live Dead Location Application Comment Uniform(plf) Snow(1.15) 650.0 195.0 0 To 9' 11 1/2" Adds To SUPPORTS: Input Bearing Vertical Reactions(Ibs) Detail Other Width Length Live/Dead/UplifUTotal 1 Stud wall 3.50" 2.38" 3884/1428/0/5312 Al: Blocking 1 Ply 1 3/4"x 9 1/2" 1.9E Microllam®LVL 2 Stud wall 3.50" 2.38" 3884/1428/0/5312 Al: Blocking 1 Ply 1 3/4"x 9 1/2"1.9E Microllam®LVL -See iLevel®Specifier's/Builder's Guide for detail(s):Al: Blocking DESIGN CONTROLS: Maximum Design Control Result Location Shear(Ibs) 5134 -4156 10898 Passed (38%) Rt. end Span 1 under Snow loading Moment(Ft-Lbs) 12353 12353 20312 Passed(61%) MID Span 1 under Snow loading Ili Live Load Defl(in) 0233 0.241 Passed(U495) MID Span 1 under Snow loading Total Load Defl(in) 0.319 0.481 Passed(U362) MID Span 1 under Snow loading -Deflection Criteria: STAN DARD(LL:U480,TL:U240). -Bracing(Lu):All compression edges(top and bottom)must be braced at 10'o/c unless detailed otherwise. Proper attachment and positioning of lateral bracing is required to achieve member stability. ADDITIONAL NOTES: -IMPORTANT! The analysis presented is output from software developed by iLevel®. iLevel®warrants the sizing of its products by this software will be accomplished in accordance with iLevel®product design criteria and code accepted design values. The specific product application, input design loads,and stated dimensions have been provided by the software user. This output has not been reviewed by an iLevel@ Associate. -Not all products are readily available. Check with your supplier or iLevel®technical representative for product availability. -THIS ANALYSIS FOR Level®PRODUCTS ONLY! PRODUCT SUBSTITUTION VOIDS THIS ANALYSIS. -Allowable Stress Design methodology was used for Building Code IBC analyzing the iLevel®Distribution product listed above. -Note:See iLevel®Specifier's/Builder's Guide for multiple ply connection. PROJECT INFORMATION: OPERATOR INFORMATION: Quality Additions 8 Remodeling Greg Monteforte Duplex Wilmington Builders Supply Salem, Me 334 Main Street Wilmington, MA 01887-0671 Phone: 978-658-4620 Fax : 978-657-5844 gmonteforte@wilmbuild.com Copyright © 2009 by iLevel®, Federal way, WA. MirrollamM is a registered trademark of iLevei®. �r ,e-'b CITY OF S.UX.%I, N L-kSSACHUSETTS BUI DLNG DEPARTMENT I'_O W.i sHLNGTON STREET, 3se FZOOR TEL (97f1) 745-9595 FAx(971) 7449846 K1,BEAIEY DRISCOLI MAYOR TiOSLU ST.PfEM DIRECTOR OF PL BLIC PROPERTY/StAIDLNG CO-%L%DSSIONER Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers lltnlicant Information Please Print Leaiblr Name (Bufirw•sa.Oryntratiovinahvodual): e, /I / �l�ll—/O NS G ��/Y1 C��fi/ 1J/1L Address: PJ S- 19 City/Stateizip: ( ;'v�-, I r)c,- b,-\,. 1IA o 1gS7 pbone a: Are you to employer'Cheek Jho appropriate box: Type of project(require+)- 1.8 1 am a employer with 4. 0 I am a general contractor and 1 mnployces(full and/or part-time).• have hired the subcaasract 7.ors 6. 0 Remodeling construction 2.01 am a sole proprietor or partner- listed an the attached shcoL : emakling ship and have no employees These subcontractors have V. ❑ Demolition workingfor me in an capacity. worker'comp.insurance. Y P ry• 9. C] Building addition [No workers'comp. insurance 5. 0 We are a corporation and its required.] ollicers have exercised their I0.❑Electrical repairs or additions 3.0 1 am a homeowner doing all work right of exemption per MOL 11.0 Plumbing repairs or additions myself iN'o workers'comp. c. 152.f 1(41 and we have no 12.0 Roof repairs insurance required.l t employees. LNo workers' 13.❑Other comp.insurance required.] 'Any applicana thin chocks Dos e1 muo alp no out On arsinees below showing their vrorkm'twttpwuatFm policy ittfutmatlotr 'I I.rtwuanter who submit this aeblovir iodicaling they am doing all work and this him cuoide coarrsckae most sobmk a new ainbvil mciiantino mace. !C.mtracton that chrek this lei mud anschod an sldiiismal sIra showing the manse of the ru►con, and their worlsm'comp.policy inromstiow /urw an employer that bproved/n>j twrRrrs'ronrpauadoa lrrtmrenetjor a y anpGkyaex Blow/x rM pe//ay 08 font side inforrnation6 Insurance Company Name: Policy N or Self-ins. Lic. #:_6 z (J ) 7 AJA GZ[) Expiration Date: Job Site Address: //_3 S G�b(D ( S/ , / City/Slate/Zip: h-ilk , /vl� 17/9 70 .mach a copy of the workers'compensation policy deeiarstloa PdP(showing the policy number and expirsdon data). Failure to secure coverage as required under Section 25A of MGL e. 152 can lead to the imposition of criminal penalties of a fine up to S 1.500.00 and/or one-year imprisonmank as well as civil penalties is the form of a STOP WORK ORDER and a Roe of up to S230.00 a day against the violator. Ile advimad that a copy of this statement may be furwurded to the Office of Invcaaigmiunr ufdte MA for insurance covcrago vuiticatiun /do hereby cerrify under tha pains nd penoldart of perjury that the information provided ubove is Irmo and c'arrtea ,Z[nnalure: � Dater 01rerra/use aa/y. Do not write in this area, to lot completed by Lily or town gfJa•imj City or fuwn: Asuing Atilhorily (circle unc): I. Ituard of Ilrullh 2. Ruilding Department 3.Cilytfown Clerk J. Electrical Inspector S. Plumbing Inspector 6. Other lmmlacl Person: _ ,_. __ Phone p' REScheck Software Version 4.2.1 Compliance Certificate Energy Code: 2006 IECC Location: Burlington,Massachusetts Construction Type: Single Family Conditioned Floor Area: 2896 ft2 Glazing Area Percentage: 19% Heating Degree Days: 6573 Climate Zone: 5 Construction Site: Owner/Agent: Designer/Contractor: Compliance:2.40/6 Better Than Code Maximum UA:255 Your UA:249 Ceiling 1: Flat Ceiling or Scissor Truss 1448 38.0 0.0 43 Wall 1:Wood Frame, 16"o.c. 432 1&0 6.1 21 Window 1:Vinyl Frame:Double Pane with Low-E 50 0.320 16 SHGC:0.55 Door 1: Solid 40 0.450 18 Wall 2:Wood Frame, 16"o.c. 216 13.0 6.1 11 Window 2:Vinyl Frame:Double Pane with Low-E 38 0.320 12 SHGC:0.55 Wall 3:Wood Frame, 16"o.c. 432 13.0 6.1 20 Window 3:Vinyl Frame:Double Pane with Low-E 81 0.320 26 SHGC:0.55 Door 2: Glass 20 0,330 7 SHGC:0.55 Wall 4:Wood Frame, 16"o.c. 216 13.0 6.1 10 Window 4:Vinyl Frame:Double Pane with Low-E 32 0.320 10 SHGC: 0.55 Door 3:Glass 20 0.330 7 SHGC:0.55 Floor 1:All-Wood Joist/Truss:Over Unconditioned Space 1448 30.0 0.0 48 Compliance Statement: The proposed building design described here is consistent with the building plans,specifications,and other calculations submitted with the permit application.The proposed building has been designed to meet the 2006 IECC requirements in REScheck Version /4.2.1 and to comply with the mandatory requirements listed in the REScheck Inspection Checklist. Name b-1Title f �Ss�t�ca� �GSi9s�� S i g n a-)'uf re Date /O Project Title: Report date: 03/07/10 Data filename: Unlitled.mk Page 1 of 3 1 REScheck Software Version 4.2.1 Inspection Checklist Ceilings: ❑ Ceiling 1: Flat Ceiling or Scissor Truss,R-38.0 cavity insulation Comments: Above-Grade Walls: ❑ Wall 1:Wood Frame,16"o.c.,R-13.0 cavity+R-6.1 continuous insulation Comments: ❑ Wall 2:Wood Frame, 16"o.c., R-13.0 cavity+R-6.1 continuous insulation Comments: ❑ Wall 3:Wood Frame, 16"o.c., R-13.0 cavity+R-6.1 continuous insulation Comments: ❑ Wall 4:Wood Frame, 16"o.c., R-13.0 cavity+R-6.1 continuous insulation Comments: Windows: ❑ Window 1:Vinyl Framc:Doublc Pano with Low-E, U-factor:0.320 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes_No Comments: ❑ Window 2:Vinyl Frame:Double Pane with Low-E,U-factor:0.320 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: ❑ Window 3:Vinyl Frame:Double Pane with Low-E,U-factor:0.320 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes—No Comments: ❑ Window 4:Vinyl Frame:Double Pane with Low-E,U-factor:0.320 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes—No Comments: Note:Up to 15 sq.ft.of glazed fenestration per dwelling is exempt from U-factor and SHGC requirements. Doors: ❑ Door 1:Solid,U-factor:0.450 Comments: This door is exempt from the U-factor requirement. ❑ Door 2:Glass, U-factor:0.330 Comments: ❑ Door 3:Glass,U-factor:0.330 Comments: Floors: ❑ Floor 1:All-Wood Joist/Truss:Over Unconditioned Space,R-30.0 cavity insulation Comments: Project Title: Report date: 03/07/10 Data filename: Untitled.rck Page 2 of 3 v Floor insulation is installed in permanent contact with the underside of the subfloor decking. Air Leakage: ❑ Joints,penetrations,and all other such openings in the building envelope that are sources of air leakage are sealed. ❑ Recessed lights are either 1)Type IC rated with enclosures sealed/gasketed against leaks to the ceiling,or 2)Type IC rated and ASTM E283 labeled,or 3)installed inside an air-tight assembly with a 0.5"clearance from combustible materials and a 3"clearance from insulation. Sunrooms: ❑ Sunrooms that are thermally isolated from the building envelope have a maximum fenestration U-factor of 0.50 and the maximum skylight U-factor of 0.75.New windows and doors separating the sunroom from conditioned space meet the building thermal envelope requirements. Vapor Retarder: Vapor retarder is installed on the warm-in-winter side of all non-vented framed ceilings,walls,and floors;or it has been determined that moisture or its freezing will not damage the materials;or other approved means to avoid condensation are provided. Comments: Materials Identification: ❑ Materials and equipment are identified so that compliance can be determined. ❑ Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment have been provided. Insulation R-values and glazing U-factors are clearly marked on the building plans or specifications. Insulation is installed according to manufacturer's instructions,in substantial contact with the surface being insulated,and in a manner that achieves the rated R-value without compressing the insulation. Duct Insulation: Ducts in unconditioned spaces or outside the building are insulated to at least R-8. ❑ Ducts in floor trusses above unconditioned spaces or above the outdoors are insulated to at least R-6. Duct Construction: Air handlers,filter boxes,and duct connections to flanges of air distribution system equipment or sheet metal fittings are sealed and mechanically fastened. Lj All joints,seams,and connections are made substantially airtight with tapes,gasketing,mastics(adhesives)or other approved closure systems.Tapes and mastics are rated UL 181A or UL 181 B. Building framing cavities are not used as supply ducts. Automatic or gravity dampers are installed on all outdoor air intakes and exhausts. ❑ Additional requirements for tape sealing and metal duct crimping are included by an inspection for compliance with the International Mechanical Code. Temperature Controls: ❑ Thermostats exist for each separate HVAC system.A manual or automatic means to partially restrict or shut off the heating and/or cooling input to each zone or floor is provided. Certificate: Q A permanent certificate is provided on or in the electrical distribution panel listing the predominant insulation R-values;window U-factors;type and efficiency of space-conditioning and water heating equipment. NOTES TO FIELD: (Building Department Use Only) Project Title: Report date: 03/07/10 Data filename: Untitled.rck Page 3 of 3 2006 IECC Energy Efficiency Certificate Ceiling I Roof 38.00 Wall 19.10 Floor I Foundation 30.00 Ductwork(unconditioned spaces): 1 . Window 0.32 0.55 Door 0.45 0.55 Water Heater: Name: Date: Comments: CERTIFICATE OF LIABILITY INSURANCE OP ID TL DATE(MM/DOYYYY)' QUALI-1 12 04/09 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Wilmington lnsuiance Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Five Middlesex Avenue Unit 14 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR P. O. Box 1010 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Wilmington MA 01887-0580 Phone: 97B-658-3805 Fax;978-657-5724 INSURERS AFFORDING COVERAGE NAIC# INSURED _ INSURER A: Zurich/American - MSURERB: United specialty Insnanca co Q uality Additions 5 Aemodelinq LLC INSURER C: 314 Main Street INSURER O: Wilmington MA 01887 ' INSURERS COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY ERIOD INDICATED.NOTWITHSTANjN ANY REQUIREMENT.TERM OR CONDITION OF My CONTRACT OR OTHER DOCUMENT WITH RESPECT T( Wr11CH 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 SU POLICIES.AGGREGATE LIMBS SHOWN MAY HAVE EEN REDUCED BY PAID CLAIMS RD LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MMIDWYYYY DATE MMIOD kMM M'YY 7T5GENERAL LIABILITY EACH OCCURRENSX COMMERCIAL GENERAL LABILITY OS101836 09/08/09 09/08/10 PREMISES Eeec sCLAIMS MADE I X OCCVR MED EXP(Any One SPERSONAL SAOV S GENERAL AGGREGATE S GENT AGGREGATE LIMIT APPLIESPRODUCTS-COMP/OF AGO S POLICY JECT PRO- LOC AUTOMOBILE LIABILITY NED ANY AUTO E�wlde')SINGLE LIMIT S ALL OWNED AUTOS SCHEDULEDAUTOS BODILY IMM! $ HIREDAUTOS SODILYINJURY $ NON OWNEO AUTOS (Per accident) PROPERTY DAMAGE $ 1 lFw acddertl GARAGE LIABILITY AVTO ONLY-EA ACCIDENT S ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG E EXC ESS I UMBRELLA LIABILITY f EACH OCCURRENCE S OCCUR F-1 CLAIMS MADE - I AGGREGATE $ S DEDUCTIBLE S RETENTION $ S AND EMPL COMPENSATION AND EMPLOYERS'LIABILITY V/H X TORY LIIA RS ER A OFFICEOPRIET RIPARTUDED7ECU � 6ZZUB0742N10209 05/16/09 05/16/10 E.L.EACH ACCIDENT 3 500000 (MandaWry In NH) E.L.DISEASE-EAEMPLOYEE a500000 ❑yyas,describe lender SPECIAL PROVISIONS balaw E.L.DISEASE-POLICY LIMIT s500000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS The insured has elected, to cover employees only for worker's comp CERTIFICATE HOLDER - CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION C7AMBE•RR DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAR 10 DAYSWRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR Ruth Camber REPRESENTATIVES, 410 Chestnut Street AUTHORIZED �REPRESENTATIVE Wilmin ton MA 01887 N;Z %CORD 25(2009101) ©1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD - L'd bZL9L998L6 N30b' 30NV8nSN1 NOlONIA-11M dV£:b0 60 b0 AON I IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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 nof�confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER This Certificate of Insurance does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORN 25(2009/01) Z'd bZLSL999L6 N30V 3ONV2:jnSNI NO-LONIMIM db£:h0 60 VO AON Massachusetts- Department of Public Safeti Board of Building Regulations and Standards LL33ll Construction Supervisor License License: Cs 58707 Restricted to: 00 - MICHAEL J.WELCR PO BOX 819 WILMINGTON MA 01887 Expiration: 6/1/2010 Commissioner Tr#: 25976 ✓die Pioannramu�e¢�i •"y�✓�oar./euxlk �,-.�.*•_.._.,..,.....�._...�........_.w._......�._.. — . Board of Building Regulations and Standards - HOME IM�P,^�tOVEMENT CONTRACTOR License or registration valid forWividul use only RegistraETon i 121249 before the expiration date If found return to: Board of Building Regulations and Standards 19/2010 Tr# 265407 One Ashburton Place Rat 1301 e D i A� Boston,Ma.02108 QUALITY ADDIT�OtR�EM—OD ING MICHAEL WELC "] 1�� 42 COTTAGE ST / f WILMINGTON, MA0188T` Administrator ^�•••••••�••_•�• Not valid wi ut signature