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37 WINTER ISLAND RD - BUILDING INSPECTION (3) //-7, � 7 The Commonwealth of Ylassachusetts Board of Building Regulations and Standards CITY Massachusetts State Building Code, 780 C�IR Sd NfarM Revised Mnr 2011 Building Permit Application To Construct, Repair, Renovate Or De is One- or Tivo-Family avelling Chis Sectiori:For Official Use-0nly Building Permit Numbed. PPI d''J 71 Buildin Off-icial Pnnt, ame) Date g ( s Stgna SECTION L S[TE7NF0 TI0 l pertly 1.2 Assessors i ap 3c Parcel Numbers t Z IL416AID b 1.la is this an accepted street?yes s-' no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks (ft) Front Yard Side Yards Rear Yard quired Provided Required Provided Required Re Provided 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public❑ Private❑ Zone: _ Outside Flood Zone? Municipal❑ On site disposal system ❑ Check ifyes_"_ SECTION 2:, PROPERTY OwNERSHIF-. ' 2.1 Ownertoft Record: JJr ,,�{/�r� ^ I Na� t n '�I(Print�7�777tt'(/ J7�ll '!/(�'��UIN No.and Streets Telephone Email Address SECTION 3: DESCRIPTION OF PROPOSED WORK'(check all that apply), New Construction ❑ Existing Building ❑ Owner-Occupied ❑ Repairs(s) ❑ 1 Alteration(s) ❑ Addition ❑ Demolition ❑ Accessory Bldg. ❑ Number of Units_ Other ❑ Specify: Brief Des iption of Proposed Work 2: ��! 4 Ce v te) 1 o e J D SECTION 4: ESTIMATED CONSTRUCTION COSTS- Estimated Costs: Official Use Onl '.. Labor and Materials y` 1. Building S Z 1. Building Permit Fee:S Cndi6te how fee is determined: ❑ Standard City/Town,Application Fee 2. Electrical S 3 O O ❑Total Piolect Costa(Item 6)x multiplier x 3. Plumbing S qO o0 2. Other Fees: S f� 4. Ndechanical (HV:\C) S List: 5. Mechanical (Firs Suppression) 'total:\II Fees:S_ / `' Check No, Check Amount: Cash AITIOtltlt: G. "1'nhtl Pr jest Cost: 5 �tp 17i� ( ❑ Paid in Full ❑ Out.standin,_----_.------------b B_duncc Dui: SECTION 5: CONSTRUCTION SERVICES L5.1ConstructionSupervisorLicense(CSL) g f -)— —/7y � 600 License NNLNurnnb&r EspirstiouDate e ot'C' I Ideer /u/n// �f�,.p� List CSL Typz(sea below) No. andI S r � SGL"�_(°� 'ry e Description D Iect 7 U Unrestricted Buildin s up to 35,000 cu. R. _ Restricted 1&2 Fairly Dwelling I ydyn {ty [ M Rooting i RC Ruotn Covering !q WS Window and Siding �//mil, SF Solid Fuel Bunting Appliances W� I Insulation 'relz hone Email address D Demolition 5.2 Re tstered Home Improvement Contractor(EIIC) 1 X R)6B/ t ��Yn©2P` �O! ( HIC Registrat n Number Expiration Date 111 'bl?�Pa�y Nu nz or(1IC Regis a t Name o�y� Wf YI'nS �� � ,(_p /k.���11� 1r©. /�Ct�lo.yL thf' Cold NIO1 D gif t L ,/1,/J ,/��� L 1..�g Q d t )(�a�q�/ —� Email address City/Town./Town,State, ZIP /—{�( Telephone J L/ SECTION 6: WORKERS' COMPENSATION INSURANCE AFFIDAVIT(M.G.L. c. 152.§ 25C(6)) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the Issuan of the building permit. Signed Affidavit Attached? Yes .......... No........... ❑ SECTION 7a: OWNER AUTHORIZATION TO DE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, as Owner of the subject property, hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application. Print Owner's Name(Electronic Signature) Date SECTION 7b: OWNEW OR AUTHORIZED AGENT DECLARATION By entering my name below, I hereby attest under the pains and penalties of perjury that all of the information contained in this application is true and accurate to the best of my knowledge and understandings Print Owne s or r\uthorited:\;znt's N:unz(Electronic Signature) D,uz NOTES: I. :\n Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Houle Improvement Contractor(HIC) Program),will nor have access to the arbitration program or guaranty fund under M.G.L. c. 142A. Other important information on the HIC Program can be found at tLAW.nlas3.00vioca Information on the Construction Supervisor License can be found at tvtvw.mas,.�'oiA L 2. When substantial work is planned,provide the information below: Total floor area(sq. ft.) _(including garage, finished basement/attics,decks or porch) Gros, living area(sq. ft.) _ Habitable room count Number oftircplaccs__-- Number otbedrooms _---------_-- Number utbathro,tltts Number of hallibaths -- - -- — -- fvpe oChating systcut .._---_-_- ----_-- Number of docks/ porches 1)pcol'coolingsy;tclll Enclosed Open _ 1 ..[oral ProjCct ..sgwlrc I ootj"e- Illlly be illbirtlllted rol "l'ot'll Project Cost" CITY OF Siu.Em tiL1SS�\CHL'SETIS r BulfDiNt;DEPARTMENT � ) `#� tr y'• 120 WASHLNGTON STREET, 3te FLOOR TEL (978) 745-9595. Rix(973) 7-i0-9846 M.N(BERLEY DRISCOLL THOM\5ST.MgR8 MAYO& DIRECTOR OF Pt:BLIC PROPERTY/Ot:IIDING CONalISSIO,'iElt.'a Workers' Cumpensation insurance Affidavit: Builders/Contracturx/Electricians/Plumbers Applicant informatlnn /�' Please Print Legibly Muni.:V1 (17miucss,UryniratiJlvin ividual):nt'.�Er.l�1 5�� "6�/Ul©� !"'� c Address: 1 t'✓ _g City/state/zip: l/ i LAI, PhoneM: Arc y an employer?Cheek t e appropriate bast Type of project(required): 1. 1 am a employcr with 4. 0 I am a general contractor and 1 6. ❑Now construction etployees(f all and/or part-ume).• have hired the sub-contractors 2.0 I am a sole proprietor or purtner. listed on the attachad shee6 It 1' 0 Remodeling Chip and have no employees These sub-contractors have g. ❑Demolition working for me In any capacity. workers'camp ra. lnsunce. 9, 0 Building addition (No workers'camp.insurance 5. 0 We are a corporation and its required.) of t0.❑Electrical repairs or additions officers have exercised their 3.0 1 am a homcuwnor doing all work fight of exemption per MGL I I.[]Plumbing repairs or additions myself.(No workers'cump. c. 152,$1(4),and we have no 12.0 Roof repairs insurance required.)r Jmployees.(No workers' 13.0 Other comp.insurance required.) -,hey appllcam out dluksase b I I must also till out Iliau'Lliva below thawing their vtmkas'mmpsnuttun pulley inrummtlon, 'I bvnvuwrwrt who submit this affidavit indiealne Ihry an doing all work and thin hln outside eontlncton must mhmlt a naw,affidavit indicating such. :Con miurs That cbwk this box most anachod an a"ifonul shwa showing the soma of the mbcamraatan and Ihwit wutkwn'comp.pul icy Infommdaa. l sun on employer that Is providing ivark(ns'camponsadan lnraranee for my employee% Below is rite polley,and Jab site Insurance Company Vmne: /��`o)L vy61-�t�-- /� Policy II ur Scif-its. Lie N: // nnll /`�� �J P-xpimtion Date p _ Z - 17 Job Site Address: 1 (/I sl!. At ��.6s-A 17/) City/State/zip. \ttach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date)i. Failure to sccuro coverage as required under Section 23A of MGL c. 132 can lead to the imposition of criminal penalties of a fine up to S1,500.00 and/or one-year imprisonment,as well as civil penalties in this farm of a STOP WORK ORDER and is line of up to S'-50.00 a day against ilia violator. Ile advised that a copy of this stawmcnt may be forwarded to the Mice of Investiguliuls of ilia DIA roriosuranee coverage vcriticalion. I do hdrrby verrlf t r dr this11 h: od pendldes wf perfary that Me fieforatatlro provided above provide above is true and carrrca i', 't Data• ^ I' 11 i1' -7 V i O//icial use wily. Do pat write in thlr urea,to be contpleted by city or town o/))foal I I City or'I'own: _.. _ Verm)tfilcenicI I.-suing,%ulhurily(circle one): 1, hoard of llealth Z.Iluildlnq llepa rtan Litt .1.Citylrown Clork 1. baeetrleal fnepectur 5. Plumbing lnepector 6.0tlter Contact I'ersnn:. Phone; I CITY OF 5:1L.E�tiI, jtiL1SS.ICHUSETTS Bt-:LL0LYG DEPAIM svT (, ` . \� "0 Cf/.13HL4GT0N STREET 3'°FLOOR TEL (978) 745-9595 I<IJ[OF_RL.EY DRISC0I1. F.L%(978) 7-W-9345 .�,UYo13 THO-Ntm ST.PIEAAB DIRECTOR OF PLOLIC PROPERTY/j3E:=LN(;CObO(IJSION EA q Construction Debris Disposal AfRdavit (required for all demolition and renuvatiort work) In accordance with the sixth edition of the State Building Code, 730 CAJR section l 11.5 Debris, and the provisions of mfGL c 40, S 54; Building Permit # is issued with the condition that the debris resulting from this work shall be disposed of in a properly licensed waste disposal facility as defined by tNfGL c l 11, S 150A. The debris will be trvlsportcd by: i (nanrc of hauler) The debris will be disposed of in : (name oi facility) (aJJres.c of futility) ' S mit applicnt117aofper a J„e i i From:M&M Assurance/Mason&Mason Ins 603 356 9290 05/09/2013 09'.08 #687 P.0021003 ACORD„ CERTIFICATE OF LIABILITY INSURANCE DATE(MMmDP(YY11 05/09/2013 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 policyles)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 CONTNAME pC Gwen Vosburgh Mason & Mason Insurance Agency, Inc. uc°NO E, , 781.447.5531 ac Np: 781.447.7230 458 South Ave. EMAIL ADDRESS: Whitman, MA 02382 CUSTOMER ID s: Gwen Vosburgh INSURERS)AFFORDING COVERAGE NAICN INSURED INSURERA: Main Street America Assurance 29939 Morrison Remodeling & Repairs, LLC INSURERS: NGM Insurance Company 14788 13 Windsor Road INSURERS: Continental Indemnity 028258 Beverly, MA 01915-2635 INSURERD INSURERE: INSURERF'. COVERAGES CERTIFICATE NUMBER: 12/13 GV built REVISION NUMBER: THIS IS TO CERTIFY THATTHE 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 MAYBE 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 C P CY LIMITS LTR INSR WVD POLICY NUMBER MMDO MMOD GENERAL LIABILITY MPT99520 09101/2012 09/0112013 EACH OCCURRENCE $ 2,o00,000 X COMMERCIAL GENERAL LIABILITY PREMISES SEG Ea nocuvence $ 500,000 CLAIMS-MADE ,X]OCCUR MED EOH(Any one person) $ 10,000 A PERSONAL&ADV INJURY $ 2,DOO,000 GENERAL AGGREGATE $ 4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMPIOP AGO $ 4,000,00 POLICY JEC LOC $ AUTOMOBILE LIABILITY M1T9952B 12/16/2012 12/1612013 COMBINED SINGLE LIMIT $ ce(Ea edenli 1,000,000 ANY AUTO BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ B JX SCHEDULED AUTOS PROPERTY DAMAGEHIREDAUTOS (Per accident)NON-OWNED AUTOS $ $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS MADEAGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION 46844418010110/2812012 10/28/2013 We srATu UTH- AND EMPLOYERS'LIABILITY YIN TORY LIMITS ER ANY PROPRIETORIPARTNERYEXECUTIVE ❑ EL EACH ACCIDENT $ 500,000 G OFFICER/MEMBER EXCLUDED? NIA (Maandi in NH) MEMBERS ARE EXCLUDE EL.DISEASE-EA EMPLOYEE $ 500,00 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES Attach ACORD 101,Addifional Remarks Schedule,it more space is required) obsite: Plummer Home for Boys 7 Winter Island Road CERTIFICATE HOLDER CANCELLATION FAX: 978.740.9846 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Salem Attention: Building Inspector AUTHORIZED REPRESENTATIVE 120 Washington Street Salem, MA 01970 Philip Mason ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009109) The ACORD name and logo are registered marks of ACORD From:M&M Assurance/Mason&Mason Ins 603 356 9290 05/09/2013 09:09 #687 P.003/003 ACORD. AGENCY CUSTOMER ID: LOC#: ADDITIONAL REMARKS SCHEDULE Page of AGENCY NAMED INSURED Mason & Mason Insurance Agency, Inc. Morrison Remodeling & Repairs, LLC POLICYNUMBER Beverly, MA 01915-2635 CARRIER NAIL CODE EFFECTIVE GATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORMTITLE: ACORD Certificate of Liability Insurance Garage Liability INSR ADD'L POLICYEFFECTIVE POLICYEXPIRATION LTR INSRD POLICY NUMBER DATE IMMIDDrM DATE IMMIDDPM LIMITS AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER T� EAACC $ AUTO ONLY'. AGG $ Automobile Liability INSR ADUL POLICY EFFECTIVE POLICY EXPIRATION LTR INSRD POLICYNUMBER DATE(MMIDOIYYI DATE(MMIDDNY) B Excess/Umbrella Liability INSR ADOT POLICYEFFECTNE POLICYEXPIRATION LTR INSRD POLICY NUMBER DATE(MMIDDHII DATE IMMIODNYI LIMITS $ Other Liability INSR POUCYEFFECTIVE POLICYEXPIRATION LTR POLICYNUMBER DATE(MMIDDIYY) DATE(MMIDDNY) LIMITS ACORD 101(2008/01) OO 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD From:M&M AssurancelMason&Mason Ins 603 356 9290 05/09/2013 08:50 #685 P.002/003 r V ACORDe CERTIFICATE OF LIABILITY INSURANCE D O5/09/09/2013013IO1 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 ceniftcate 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). PRODUCER NAME. Gwen Vosburgh Mason & Mason Insurance Agency, Inc. uc°No Ext. 781.447.5531 FAX A.781.447.7230 458 South Ave. EMAIL ADDRESS. Whitman, MA 02382 PRODUCED CUSTOMER ID tl'. Gwen Vosburgh INSURER(S)AFFORDING COVERAGE NAICI INSURED INSURERA: Main Street America Assurance 29939 Morrison Remodeling & Repairs, LLC INSURER B: NGM Insurance Company 14788 13 Windsor Road INSURER C: Continental Indemnity 028258 Beverly, MA 01915-2635 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 12/13 GV built REVISION NUMBER: THIS IS TO CERTIFYTHATTHE 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 MAYBE 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. LTR TYPE OF INSURANCE INSR WVD POLICYNUMBER MWDD MMIDD LIMITS GENERAL LIABILITY MPT9952 09/0112012 09101/2013 EACH OCCURRENCE $ 2,000,000 X COMMERCIM GENERAL LIABILITY DAMAGE ET EaENTED nce $ SDD,DD CLAIMS-MADE 1 OCCUR MED EXP(Any one Person) $ 10,00 A PERSONAL&ADV INJURY '$ 2,000,060 GENERAL AGGREGATE .$ 4,000,000 GENT.AGGREGATE LIMIT APPLIES PER PRODUCTS-COMPIOP AGG $ 4,000,00 POLICY F7 PROJECT 7LOG $ AUTOMOBILE LIABILITY M1T9952B 12116/2012 12116/2013 COMBINED SINGLE LIMIT (Ea accident) 1,000,00 MY AUTO BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ B X SCHEDULED AUTOS PROPERTY DAMAGE X HIRED AUTOS (Per accident) '$ X NON-OWNED AUTOS $ UMBRELLAUAB OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE b RETENTION 'M1 $ WORKERS COMPENSATION 468444180101 10/28/2012 10128/2013 WC STATu OTH- AND EMPLOYERS'UASILITY YIN TORY LIMITS ER ANY PROPRETORRARTNERIE:(EC-MVE E.L.EACHACCIDENT $ 500,000 G OFFICERIMEMBER EXCLUDED9 NIA (Mandator•in Ni MEMBERS ARE EXCLUDE E.L.DISEASE-EA EMPLOYE $ 500,000 IIr'.describe under DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT 1$ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES!Attach ACORD 101,Additional Remarks Schedule,if more space is required) obsite: Plummer Home for Boys L7 Winter Island Road CERTIFICATE HOLDER CANCELLATION FAX: 978.740.9846 - SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Salem Attention: Building Inspector AUTHORIZED REPRESENTATIVE 120 Washington Street Salem, MA 01970 Philip Mason OO 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD /�F rrom:M&M Assurance/Mason&Mason Ins 603 356 9290 05/09/2013 08:51 #685 P.0031003 Fi` 'GORA AGENCY CUSTOMER ID: LOC#: ADDITIONAL REMARKS SCHEDULE Page of AGENCY NAMED INSURED Mason & Mason Insurance Agency, Inc. Morrison Remodeling & Repairs, LLC POucYNUMBER Beverly, MA 01915-2635 CARRIER NAIL CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORMTITLE: ACORD Certificate of Liability Insurance Garage Liability INSR ADD'L POUCYEFFECTIVE POLICYEXPIRATION LTR INSIPID POLICYNUMBER DATE(MMADIYY) DATE(MMDDNY) LIMITS AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EAACC fl AUTO ONLY AGG $ Automobile Liability INSR ADD POLICYEFFECTIVE POLICYEXPIRATION LTRINSRD POLICYNUMSER DATE IMMIDDNYI DATE(MMIDDrM B Excess/Umbrella Liability INSR ADDT POUCYEFFECTNE POLCYEXPIRATION LTR INSRD POLICY NUMBER DATE(MMNONY) DATE(MMIDDIYV) LIMITS 1 Other Liability INSR POLICY EFFECTIVE POLICY EXPIRATION LTR POLICY NUMBER DATE(MMIDDM) DATE IMMIDDNYI LIMITS ACORD 101 (2008101) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD From:MIA Assurance/Mason&Mason Ins 603 356 9290 05/09/2013 08:49 #685 P.001/003 2013-05-09 aaaao�aa�aaoo®eaea��a�a®aa�o��ea�oc�a��e��w�ca®a®�eo�oaa�eoe�.aeooeaooa��oaaaaaoaaao�e��ooe�o��� Fax To : All From : Mason & Mason Insurance Shelley Vincent Phone : 800-298-0802 FAX Number : 603-356-9290 E-mail : mvincent@mmins.com Total Number of Pages (including cover) : 3 Re : certificate of insurance Please see attached certificate. Thanks, Shelley