22 RAYMOND RD - BUILDING INSPECTION r
e, The CommanWenith of Msssuchtuetls
Board b1 Bmidmg'Regulunons aad Sttitidurds i MaIe ssachusetts State 8ulidmg Cada:78()CMR 7"addtott MUNK'SE
USE 1 fl
,13uddmg Femur Applicapon To-Constrtict Repair,Ren'ovute Or Demolish u R�ascii Juuuu;t
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SECTION 1�.S1TKINFORHATION
1.1 Propertp,lddress 11 Assessors Map Ok Pereel'Nurtrbers
1y IY
i.tu.ls thin urisue ied,street t yes:' m� nom mm Nrmber Punxl Number'
13 Zoning lidormotloo: L4 Property DMmens
' Zoning Drstdct� Proposed Use'%„P .' Gil'Aren
15, BoBding:5etbacke ff
'.FromSYard ' ;r,, Side Yaztls ° Rear Yard 5 _'
-+; Rcrcryl�, '. Provided I Required Provided.;': ;RequiIra
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14 Water Supply (M O L c 40,$44)° 17 F9sod Zane Information , ; 18 Sewage Drisposal Sgstem
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SECTION2i `PROPERTY'OW'NEYtSHIPt . :>
' Nn Print Address fore ,
Savlaturc! ". -. .TelephanF
;' J "„ St3C'!4'lON3;DESCRIPTION=OF,PA01'OSED WORK'(c1!eek;nB�that itpR�Y)",_
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Br(ef Deuript(on of Proposed QVorkt :` +
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-,t ;` ,SECTIUN4 FSTIMA,TED CQNST$[1C'PION COSTS, , '„ ;:
Rein , Esdmated�Cosurw '. r , „:O Use Odq 's '
(Lntior'nndMatertalsf`.
WOW, t Buildin` Permit Fer $ry Irtdicute htiw fec is determined
1 Buildinis
g $ 8
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O ►oul Protect tbst3(Itom t7 x multrptter x
3 1'lurpbing, $ r UtherFee
Mu
s $
4, hanicai (HYAC) t $ List
r
S.Mechantl ,{Fire -`
Su ression) $ Tutu(All Fees $ _
6 Total Project Cost S` > e� Chx�Nq, Cheik Amuunt C i Amount`
O Patd rn Fuq M_Optstandmg k un Due,
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Safety Insurance Company
20 Custom House Street
Boston, MA 02110
BUSINESSOWNERS
POLICY
Prepared For:
WILWALK FLOORING AND CONSTRUT
WILLIAM A CENTER IV
13 COLONIAL ROAD
BEVERLY, MA 01915
Represented By:
AHMED INS. AGENCY, INC.
PO BOX 449/ 106 NORTH ST.
SALEM, MA 01970
This policy jacket with the Businessowners Policy Form, Declarations Page and
Endorsements, if any, issued to form a part thereof, completes this policy.
Safety Insurance Company
ROME
20 Custom House Street
Boston,MA 02110 Businessowners Policy
1-800-951-2100 New Business Declaration
Direct Bill - Insured Declarations Effect ive 08/ 16/08
Pplte 14M
BP000109ff7u� og 12 : 01 AM STANDARD TIME 65435
termed Ensu..teddAddtssAgent
WILWALK FLOORING AND CONSTRUT AHMED INS . AGENCY , INC .
WILLIAM A CENTER IV PO BOX 449/ 106 NORTH ST .
13 COLONIAL ROAD SALEM, MA 01970
BEVERLY , MA 01915
Phone : ( 978) 745-8800
Form of Business: Corporation
Business Description: (S)Carpentry-interior
In return for the payment of the premium,and subject to all of the terms of this policy,including form
and endorsements made a part hereof,we agree with you to provide the insurance as stated in this policy.
COVERED "LOCATION(S)
LOC: 001,BLDG 001: 13 COLONIAL ROAD,BEVERLY,NIA 01915
PROPERTY
This 0611ey contains A $250 deductible Unless otherwise specified (seeadditonal coverages section).
LOC BLDG COVERAGES LIMITS VALUATION AUTOMATIC
No No I INSURANCE
NSU NCE CLAUSE
INCREASE
001 001 Personal Property $5,000 Replacement Cost 04 %
LIABILITY, AND MEDICAL EXPENSES
Except for Fire LegalLiability,eachpaid.claim for the coverages listed reduces. the amount of insurance we provide:
Burin g the applicable annuatperiod. Please refer to Paragraph DA:of the BusinessoAmers Liability Coverage Form;.., ,
DESCRIBED COVERAGES LIMITS OF INSURANCE
LIABILITY $1,000,000 PER OCCURRENCE
MEDICALEXPFNSES $10,000 PER PERSON
FIRE LEGAL LIABILITY $100,000 ANY ONE FIRE/EXPLOSION
ADDITIONAL :COVERAGES OPTIONAL COVERAGES PROPERTY,,
The foj owing additional]optional coverages are afforded under this poli
covers es Someco are.siibiecttodeductibles§pecifi6dihthe.potic forms.
LOC NO BLDG NO DESCRIBED COVERAGES LIMITS OF INSURANCE
ADDITIONAL-COVERAGES. OPTIONAL COVERAGES ., LIABILITY
The followin additional optional coverages are afforded under this policy.,
DESCRIBED COVERAGES LIMITS OF INSURANCE
.. PREMIUM
Annual Premium $1,167
Insured Copy AUTHORIZED REPRESENTATIVE
PAGE 1 09/13108 (Print Date)
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Board of of BuildingRegulations and Standards
HOMEJMPROVEMENT CONTRACTOR t
Registration 151767
ExpiW161I 6/29/2010.,.' Tr8 267138
DBA'
r WILWALK FLOORING
WILLIAM CENTER IV
13 COLONIAL ROAD.
BEVERLY MA 01915 Adm_in� isitra`t r i
License or registration valid for individul use only-
before the expiration date. If found return to:
Board_of Building Regulations and Standards '
One Ashburton Place Rut 1301
�J Boston,Ma.02108
I
Not) d without signature '.�
JOB 9a— N,rroAA RA . Ya kP"A
SHEET NO. OF
WILWALK FLOORING & CONSTRUCTION CALCDLATEDBV DATE
(978) 360.5288
CHECKED BY DATE
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Board of Building Regulations and Standards
Construction Supervisor License
-# License: CS 85701
Birthdate: 7/19/1966
Expiration: 7/1912009 Tr# 18 t
Restriction: 00
JEFFREY L LEGERE
15 CANNON HILL RD EXT
"�-
GROVELAND,MA 01834 Commissioner