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67-69 WINTHROP ST - BUILDING INSPECTION
The Commonwealth of Massachusetts �1 Board of Building Regulations and Standards CITY Massachusetts State Building Code,780 CMR,7"edition OF SALEM Revised January Building Permit Application To Construct,Repair,Renovate Or Demolish a 1,2008 One-or Two-Family Dwelling This Section For Official Use On] Building Permit No er, Date Applied: .Z Signature: �r l Bu ding om ssi er oroBuildiitgs Date r ` f' SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers JrrQLoP t __ L la Is this an accepted street?yes A no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Ares(sq R) Frontage(R) 1.5 Building Setbacks(R) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: ste Public❑ Private❑ Zone: _ Outside Flood Zone? Check if es❑ Municipal❑ On site disposal system ❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: dr P= sl 7 Nc` N n Address for Service: 5'atI 145 $o3fr I But Telephone SECT N 3:DESCRIPTION OF PROPOSED WORK (check all that apply) New Construction❑ Existing Building❑ Owner-Occupied ❑ 1 Repairs(s) Id( I Altemthm(s) ❑ Addition ❑ Demolition ❑ Accessory Bldg.❑ 1 Number of Units_ I Other ❑ Specify: Brief Description of Proposed work,: 12iP4tt W A!S Nn AL F Y' LWC SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Labor and Materials Official Use Only 1.Building 1. Building Permit Fee:$ Indicate how fee is determined: 8 $ btYbl .�) g 2.Electrical $ e ❑Standard City/Town Application Fee ( ) ❑Total Project Cost'(Item 6)x multiplier � 3.Pittmbing $ 2. Other Fees: $ 4.Mechanical HVAC $ lb List:_ _ 5.Mechanical (Fire _ Suppression) $ D Total All Fees:$ Check No._Check Amount: Cash Amount:_ 6.Total Protect Cost: $ Z2y b1 .3'), ❑Paid in Full 11 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES r5.1 Licensed Construction Supervlsor(CSL l ) _I�1"'1 .rjQprf( C"'gMcNge tt, License Number Expitatlon le Name of CSL-Holder t� 590 WgSHm"ItiTJa St. PaNe,AA1W List CSL Type(sce below) __ _ _ 'Addriss—•_ _ _ _ T - - - .Descri tion U Unrestricted to 35 uuu Ca.FL R Restricted l&2 Family Dwelling '}fll fS2fo z l Z M Masonry Only RC Residential Reuling Covedng Telephone WS Residential Window and Si SF Residential Solid Fuel Bumi A linnce Installation D Residential Demolition 51 Registered Home Improvement Contractor(HIC) Arm e�lt:�a 61i.a e,tC RCSzytc ►31 FYI HIC Company Name or HiC Re 'want Name Registration Number Sqp WA. N 'toN cMAAA VE Address tr E xp ell I •y L4 t t Z iration Date Si m Telephone 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 Issuance of the building permit. Signed Affidavit Attached? yes.......... No...........❑ SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT as Owner of the subject property hereby autho ' -tJ 'N .4.3 J.,A J Le'S LJ Rd to act on my behalf,in all matters relativ wo o •a d by s building permit application. 3123110 re of Dare SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION f, �2wrd7 �.oSf�t �i:2.t as Owner or utho ' t hereby declare that the statements and information on the foregoing application are true and accurate,to a my knowledge and behalf. Print Name Sigoalure o r Au th A Date 31 /0 Si rider the sins an rmlties of NOTES: 1. An Owner who obtains a building permit to do his/her own work,or an owner who hives an unregistered contractor (not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration program or guaranty fund under M.G.L.c. 142A.Other important information on the HIC Program and Construction Supervisor Licensing(CSL)can be found in 780 Ch4R Regulations 11016 and 110.R3,respectively. 2. When substantial work is planned,provide the information below: Total floors area(Sq.Ft.) (including garage,finished basement/attics,decks or porch) Gross living area(Sq.Ft.) Habitable mom count Number of fireplaces Number of bedrooms Number of bathrooms Number of half/baths Type of heating system Number of decks/porches Type of cooling system Enclosed Open 3. "Total Project Square Footage"maybe substituted for"Toad Project Cost" The Commonwealth of Massachusetts Board of Building Regulations and Standards CITY Massachusetts State Building Code, 780 CMR, 7th edition OF SALEM Revised January Building Permit Application To Construct,Repair,Renovate Or Demolish a 1, 2008 One-or Two-Family Dwelling This Section For Official Use Only Building Permit Number: Date Applied: Signature: Building Commissioner/Inspector of Buildings Date SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers 62.64 W ,-(Ke-oP Sr. Lla Is this an accepted street?yes h no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq tt) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required 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? Check if yes❑ Municipal❑ On site disposal system ❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: lta,SG-PPc UiIA2'7A2JNc Name(Print) Address for Service: 91fd �45 tso3�t ignature Telephone SECTION 3:DESCRIPTION OF PROPOSED WORK'(check all that apply) New Construction❑ Existing Building❑ Owner-Occupied ❑ 1 Repairs(s) Qf Alteration(s) ❑ 1 Addition ❑ Demolition ❑ Accessory Bldg. ❑ Number of Units_ I Other ❑ Specify: Brief Description of Proposed Work': 7' R-n7a Ar4M (=t,JGc SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only Labor and Materials 1.Building S 21y 6t 1 1. Building Permit Fee:$ Indicate how fee is determined: 2.Electrical $ ❑ Standard City/Town Application Fee ❑Total Project Cost'(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ 6 List: 5.Mechanical (Fire Suppression) S 0 Total All Fees:$ Check No. Check Amount: Cash Amount: 6. Total Project Cost: $ Z ty bt .} } ❑Paid in Full 13 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Licensed Construction Supervisor(CSL) S 40( ; 3 Z ?,q I "L �jeAo QqzylcNg.2.t, License Number Expiration Date Name of CSL-Holder List CSL Type(see below) V 590 w�SHr�ItiTJ� St. �cM6'wIC,� Address Type Description U Unrestricted(u to 35,000 Cu.Ft.) a e R Restricted 1&2 Family Dwelling 2$t`924e, ''421-Z M Masomy Only tSF esidential Roofin CoverinTelephone Residential Window and SidinResidential Solid Fuel Burning Appliance Installation D Residential Demolition 5.2 tiRegistered.Home Iovent Contr2 or(HIC) �w etraa�� 6Jmpr r.nem e„o �Sza2- 13 k►� HIC Company Name or HIC Registrant Name Registration Number $r10 WA 1It-+ '1oiJ PcM It_c` Mq Address t/ '1I L,6 t/ Z I r ?Z I Z Expiration Date Si tnr Telephone 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 Issuance of the building permit. Signed Affidavit Attached? Yes .......... No...........❑ SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT h r4�IS%PFav Q-9 27 Ago NC as Owner of the subject property hereby authorize slew N t,� r� 6J,,p ; ( �'�LJ R.: to act on my behalf,in all matters relative to work authorized by this building permit application. Si ature of Owner Date SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION I, �QAS7 -stSnt .Z 1 as Owner or uthori [hereby declare that the statements and information on the foregoing application are true and accurate,to a es o my knowledge and behalf. Print Name Signature o r Auth ed A Date Si der the pains an enalties of e 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 not have access to the arbitration program or guaranty fund under M.G.L.c. 142A.Other important information on the HIC Program and Construction Supervisor Licensing(CSL)can be found in 780 CMR Regulations I I0.R6 and 110.R5,respectively. 2. When substantial work is planned,provide the information below: Total floors area(Sq.Ft.) (including garage,finished basement/attics,decks or porch) Gross living area(Sq.Ft.) Habitable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of halfibaths Type of heating system Number of decks/porches Type of cooling system Enclosed Open 3. "Total Project Square Footage"may be substituted for"Total Project Cost" New England Build & Restore Inc. 590 Washington St.Pembroke,MA. 02359 Professional building damage evaluation&rebuilding experts (781)826-7212 Fax(781)826-0240 RI(401)272-7212 Fax(401)272-NEBR Client: QUARTARONE,GUISEPPE&QUARTARONE, Home: (978)745-8038 AGATA Property: 67 AND 69 WINTHROP ST salem,MA 01970 Home: 67 AND 69 WINTHROP ST salem,MA 01970 Operator Info: Operator: DKELLY Estimator: Stephen Coote Business: (781) 826-7212 x 22 Type of Estimate: Wind Date Entered: 3/3/2010 Date Assigned: Price List: MABOSB MAR10 Restoration/Service/Remodel Estimate: 59481 This estimate is based solely on the findings at the time of our inspection.NEBR Inc.reserves the right to amend this estimate should hidden or unforeseen damages and/or building code violations or unsuitable job site access be discovered during or prior to construction. NEBR Inc.has estimated this project based on completing the entire scope of work as written,performing all phases in a continuous workman like manner. All work to be performed within normal working hours. NEBR Inc.to have complete control ofjob site at all times which includes the following but not limited to: Job supervision and scheduling, Subcontractor selection and scheduling,job site access,and construction methods and materials. Job site access may be limited by NEBR Inc.for safety reasons at any time during construction.No work to be allowed by owner or any other parties without written approval from NEBR Inc. After the pre-construction meeting is completed,any and all requests for changes to the scope of work or changes to the project under construction,shall be addressed in writing to the contractor NEBR Inc. on the form provided to the owner by the contractor,called'change order request". Once the form has been submitted to NEBR Inc.,we will calculate the cost of the requested changes,if any,and submit them in writing to the owner for approval. Upon approval of both parties will sign the change order and the changes shall be completed. Payment for approved change orders are due at the signing of said change orders.Change orders can affect the construction schedule and projected completion date. New England Build & Restore Inc. 590 Washington St. Pembroke,MA. 02359 Professional building damage evaluation&rebuilding experts (781)826-7212 Fax(781)826-0240 RI(401)272-7212 Fax(401)272-NEBR 5948_1 Demolition DESCRIPTION QNTY 1. Dumpster load-Approx.40 yards, 7-8 tons of debris 1.00 EA Note: Extra large dumpster due to three layers of roofing Main Level Main Roof DESCRIPTION QNTY 2. Roof vent-turtle type-Detach&reset 1.00 EA 3. Roof window-Detach&reset 1.00 EA 4. Remove Tear off composition shingles(no haul off) 19.22 SQ 5. Remove Additional layer of comp.shingles,remove(no haul off) 38.44 SQ Note: There are three layers of roofing on this property 6. R&R Flashing, 14"wide 40.00 LF 7. R&R Drip edge/gutter apron 290.42 LF 8. Ice&water shield 871.27 SF 9. Roofing felt- 15 lb. 19.22 SQ 10. R&R Chimney flashing-average(32"x 36") 1.00 EA 11. R&R Roof window step flashing kit 1.00 EA 12. R&R Flashing-pipe jack 2.00 EA 13. Asphalt starter-peel and stick 290.42 LF 14. 3 tab-25 yr. -comp, shingle roofing-w/out felt 23.33 SQ 15. Ridge cap-composition shingles 82.57 LF Exterior DESCRIPTION QNTY 16. R&R Storm door assembly 2.00 EA Note: $279.00 material allowance 17. R&R Wood fence 5'-6'high-cedar 120.00 LF Code DESCRIPTION QNTY 18. Re-nailing of roof sheathing-complete re-nail 1,922.22 SF 19. Ice&water shield 871.27 SF Note: Ice and water up 6'of perimeter 20. Hurricane nail 1,922.22 SF 5948_1 3/22/2010 Page: 2 New England Build & Restore Inc. 590 Washington St. Pembroke,MA.02359 Professional building damage evaluation&rebuilding experts (781)826-7212 Fax(781)826-0240 RI(401)272-7212 Fax(401)272-NEBR CONTINUED-Code DESCRIPTION QNTY 21. Roofer-per hour 2.00 HR Note: Labor to cut in ridge vent 22. Continuous ridge vent-shingle-over style 82.57 LF Grand Total 22,461.77 Stephen Conte Grand Total Areas: 0.00 SF Walls 0.00 SF Ceiling 0.00 SF Walls and Ceiling 0.00 SF Floor 0.00 SY Flooring 0.00 LF Floor Perimeter 0.00 SF Long Wall 0.00 SF Short Wall 0.00 LF Ceil.Perimeter 0.00 Floor Area 0.00 Total Area 0.00 Interior Wall Area 144.07 Exterior Wall Area 0.00 Exterior Perimeter of Walls 1,922.22 Surface Area 19.22 Number of Squares 290.42 Total Perimeter Length 11.34 Total Ridge Length 144.27 Total Hip Length 5948_1 3/22/2010 Page: 3 New England Build & Restore Inc. 590 Washington St.Pembroke,MA. 02359 Professional building damage evaluation&rebuilding experts (781) 826-7212 Fax(781) 826-0240 Rl(401)272-7212 Fax(401)272-NEBR 1 Winthrop Street 3/3/2010 Taken By: Stephen Coote Winthrop Street 5948_1 3/22/2010 Page:4 New England Build & Restore Inc. 590 Washington St. Pembroke,MA. 02359 Professional building damage evaluation&rebuilding experts (781)826-7212 Fax(781) 826-0240 RI(401)272-7212 Fax(401)272-NEBR ZI ........... i 2 Winthrop Street 3/3/2010 Taken By: Stephen Coote Winthrop Street 5948_1 3/22/2010 Page: 5 New England Build & Restore Inc. 590 Washington St.Pembroke,MA. 02359 Professional building damage evaluation&rebuilding experts (781)826-7212 Fax(781)826-0240 RI(401)272-7212 Fax(401)272-NEBR h L � n yY1, a . E. • 3 Roof 3/3/2010 Taken By: Stephen Coote Roof 5948_1 3/22/2010 Page: 6 New England Build & Restore Inc. 590 Washington St. Pembroke,MA. 02359 Professional building damage evaluation&rebuilding experts (781) 826-7212 Fax(781) 826-0240 RI(401)272-7212 Fax(401)272-NEBR 1y St�` } x ♦ y..�i X RV � VVV4S.r1ly tlyM.M1 a .`r 4 Roof 3/3/2010 Taken By: Stephen Coote Roof 5948_1 3/22/2010 Page: 7 New England Build & Restore Inc. 590 Washington St.Pembroke,MA. 02359 Professional building damage evaluation&rebuilding experts (781) 826-7212 Fax(781) 826-0240 RI(401)272-7212 Fax(401)272-NEBR IKII .q :a 1Na'• .�'I d - i .ii 5 Roof 3/3/2010 Taken By: Stephen Coote Roof 5948_1 3/22/2010 Page: 8 New England Build & Restore Inc. 590 Washington St.Pembroke,MA. 02359 Professional building damage evaluation&rebuilding experts (781) 826-7212 Fax(781) 826-0240 RI(401)272-7212 Fax(401)272-NEBR r r. r 6 Storm doors 3/12/2010 Taken By: Stephen Conte Storm doors 5948_1 3/22/2010 Page: 9 New England Build & Restore Inc. 590 Washington St.Pembroke,MA. 02359 Professional building damage evaluation&rebuilding experts (781)826-7212 Fax(781)826-0240 RI(401)272-7212 Fax(401)272-NEBR 61! t,. "' \ � t o 7 Fence 3/3/2010 Taken By: Stephen Coote Fence 5948_1 3/22/2010 Page: 10 Main Level ID 6. F10(A) f, 6'— 35, s 3 tl Fi j y.t 1 yr AIR) F3IAJ F6(8) 9 N F2 __________________________ 1 F5 F6 FACE SQ FT 0 SQS F3 382.81 3.83 hq F2 382.81 3.83 F3 418.47 4.18 Il F4 448.44 4AS FS 34.99 035 F6 42.96 0.43 F7 36.57 0.37 F8 24.67 0.25 F9 24.67 0.25 F10 29.05 029 F11 13.61 0.14 F12 36.58 0.37 a F13 18.42 0.18 4 F14 18.42 0.18 F15 9.75 0.f0 Main Level 5948_1 3/22/2010 Page: ll CITY OF S.UY—a 1, 1�I�kSSACHLYSETTS ' BUUMLNG DEPART!-mNT 120 W A4HNGTON STREET, r FLOOR TEL (978) 745-9595 FAX(978) 740-9M Kimmiti.EY DRISCOLL MAYOR T HomAs ST.Pmm DIRECTOR OE PUBLIC PROPERTY/BUUMING CONDIISSIONER Construction Debris Disposal Affidavit (required for all demolition and renovation work) In accordance with the sixth edition of the State Building Code, 780 CMR section 111.5 Debris, and the provisions of MGL 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 MGL c 111, S 150A. The debris will be transported by: T2z:s s a,, W ASz (name of hauler) The debris will be disposed of in : (name of facility) titi' (address of facility) 74signaeomit appli date dcbrisatr.dm CITY OF &UHN4 UNSSACHUSEM BUILDING DEPARTSMNT • d 120 WASHINGTON STREET,r FLOOR T EL (978)745.9595 FAX(978)740-9846 KI\tBERI.EY DRLSCOI.L MAYOR T HoNtAs ST.Posm DIRECTOR OF PUBLIC PROPERTY/BUILDING COMMISSIONER Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumber Annlicant Information Please Print Legibly dame(Business/Organizationiindividual): Aj�v .J e�^%LA.a� laJ1JS Address: S`kO w 45vU, titti a c r. City/State/Zip: Q 3na1tx lV� Phone Ni gib--4 Z Are you as employer?Check the appropriate box: Type of project(required): lei am a=player with ZA 4. ❑ 1 am a general contractor and I employees(full and/or part-time).* have hired the subcontractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet t 7. ❑Remodeling ship and have no employees These subcontractors have S. ❑Demolition working for me in any capacity, workers'comp.insurance, q, ❑Building addition (No workers'comp. insurance S. ❑ We are a corporation and its required.] officers have exercised their 10.0 Electrical repairs or additions 3.❑ 1 am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself,(No workers'comp, c. 152,§44),and we have no 12.Q Roof repairs insurance required.]t employees.[No workers' 13.0 Other comp.insurance required.] 'Any aPPlkaat area efiecks box rl must also fill Out the section below showing their workers'compensation policy inr meelmn t ilomove mar who submit this affidavit indicating they am doing all wort and thm him Omide cants oam opal submit a am afll hvit indicating such. :COnuosyon that chmk this bea meat augdnd an addifiotsd stunt showing Me tmtoe of IN sub. oatmaaa and the4 workers'comp,policy inftxmatim, l am an employer that is providhtg workers,compensadon Insurance for my employees. Below Is the pollcy end fob silo information. Insurance Company Name:. ��M.'D (�•$, Policy N or Self-ins.Lie.}I:_ +J +^1 o O Ir o K 5 Expiration Date-. Job Site Address: b�' 69 W k--1 MkAJP Sr City/State/Zip:__Cr1,.Z N%4, 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 S1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of STOP WORK ORDER and a fine of up to S250.00 a day against the violator. De advised that a copy of this statement may be forwarded to the Office of investigations of the DIA for insurance coverage verification. do hereby certify to er th Ins and penalties of perfmy'tat the hrformallon provided above is true and correct i n 1 err Date. � Z Z/ / Phone Official use only. Do not write in this are%to be completed by efty or town ofcial City or Town: Permit/License q Issuing Authority(circle one): 1.Board of Ilealth 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other_ Contact Person: Phone M ® CERTIFICATE OF LIABILITY INSURANCE OP ID RR DATE(MM(DDIYYYI') PRODUCER NEMU-2 03/22 10 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE McSweeney & Ricci Ins Ag Inc HOLDER THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 2021 Ocean Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Marshfield MA 02050 .Phone:781-837-7788 Pax:781-837-3399 INSURERS AFFORDING COVERAGE NAIC III INSURED INSURER A: Guard Insurance GIOn New England Build & Restore, INSURER e: araad[aee m•°„ com Inc. INSURERC: Peerless.Insurance Company24198 590 rokeWashin4t022359reet INSURER D: Pembroke MMAA ' INSURER E: .COVERAGES THE POUCIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TOTHE INSURED NAMED ABOVE FORTHE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT.TERM OR CONDITION OFANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN.THE INSURANCEAFFORDED SYTHE POUCIES DESCRIBED HEREN IS SUBJECTTOALL THETERMS.EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE UMRS SHOWN MAY HAVE BEEN RECUCED BYPAIDCLAIMS. LTR NS TYPE OF INSURANCE POLICY NUMBER POUCPATE YEFF PATE MM O O LIMITS GENERAL LIABILITY EACHOCCURRENCE $1,000,000 B X X COMMERCIAL GENERAL LIABILITY GPL596562702 03/08/10 03/08/ll PREMISES ocarence) $100,000 X CLAIMS MADE ❑OCCUR MEDEXP(Anywep.—n) $5,000 PERSONAL&ADV INJURY $1,000,000, X Pollution GENERAL AGGREGATE $2,000,000 GENL AGGREGATE LIMIT APPLIES PER POLICY PRO- PROOUCTS•COMPIOPAGG $2,000,000 JECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 5 1,00 0,0 00 C % ANYAUTO SA8566858 12/19/09 12/19/10 (Eaapddent) ALL OWNED AUTOS BODILY INJURY X SCHEDULED AUTOS (Pu person) $ X HIRED AUTOS ) BODILY INJURY $ R NON-OWNm Al/TOS (Peraaiden0 PROPERTY DAMAGE $ (Puawiden0 GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANYAUTO FA ACC $ OTHER THAN AllTOONLY: AGG $ EXCESS I UMBRELLA LIABILITY EACHOCCURRENCE $l,000,000 B X I OCCUR F�CLAIMSMAOE SS0596563302 03/08/10 03/08/11 AGGREGATE $1,000,0000 $ DEDUCTIBLE $ X RETENTION $10000 1 $ WORKERS COMPENSATION X TORY UMRS X ER AND EMPLOYERS I IARIllT7 A ANY PROPRIETORPARTNEPo.l UTIV YIN M QC008085 11/01/09 11/01/10 EL.EACH ACCIDENT $500,000 OFFICERIMEMBERIXCLUOEO9 EN (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE 3500,000 Il Yes.descibewde, SPECIAL PROVISIONS below EL DISEASE-POLICY UMIr s500,000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS VEHICLESI EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISION$ + NEW Rentals is named as additional insured CERTIFICATE HOLDER CANCELLATION SHOULDANY OFTHE ABOVE DESCRIBED POLICIES BECANCELLED BEFORETHE ECPIRATIO DATETHEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL le DAYS WRITTEN NOTICE TO THE CERnRCATE HOLDER NAMEDTO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY MIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. - AVPMWM REPRESENTATIVE 1 ACORD 25(2009101) 01988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ' fI Massachusetts- Department of Puhlic WON 90'ardU Building Regulations and Standards Construction Supervisor License LLced CS 89597 r 00 UTHENBERG ' REET MA 01516 f1JExpiration: 3/2M2012 ioncr Tr#: 20293 ' 1 ij �/ie�onunxanusea.�lL o�./�amac{xueCk It �\ Board.of Building Regulations and Standards 1. HOME(MOVEMENT CONTRACTOR RegistjaLon 1371317 Expir�atton 1T9/2011 I Type -Supplement Card MEM I NEW ENGLAND BUI��&R�©R EMT GUTHENBERG e' er 590 WASHINGTON`ST 1 � 4 PEMBROKE,MA 02359 4 Administrator �I 1