1&3 AURORA, 2&4 WHALERS LANE - BPA-11-313 ROOFING The Commonwealth of Massachusetts
Department of Public Safety
\fa..a•uhuwtt>State Budding Olde 1,780 CMR)Seventh Edition
City of Salem
�
Building Permit Application for an Building other than a I-or 2-Family Dwellin
(This Section For Officiai Use Only)
Budding Permit Number: Date Applied: Budding Inspector:
SECTION 1: LOCATION(Please indicate Block s and Lot N for locations for which a street address is not available)
No.and Street City /Town Lip Cude Name of Building(if applicable)
SECTION 2:PROPOSED WORK
f New Construction check here❑or check all that apply in the two rows below
Existing Building rRepair Alteration O Addition E3Demolition 13 (Pleasefill outand submit Appendix 1)
Cfinngr of Use ❑ hange of Occupancy ❑ Other ❑ Specify:
Are building plans and/or construction documents being supplied as part of this permit application? Yyes ❑ No ❑
Is an Independent Structural Engineerin view required? a afes ❑ N ❑S,
Brief Description of Proposed Work:
DO
y 0 (
SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDMON,OR
CHANGE IN USE OR OCCUPANCY
Check here if an Existing Building Evaluation is enclosed(See 780 CMR 3402.0) ❑
Existing Use Group(s): Proposed Use Group(s): f
Existing Hazard Index 780 CMR 34: Proposed Hazard Index 780 CMR 34:
SECTION 4:BUILDING HEIGHT AND AREA
Existing Proposed
No.of Flours/Stories(include basement levels)&Area Per Floor(sq.h.)
Total Area(sq.ft)and Total Height(ft.)
SECTION 5:USE GROUP(Check as applicable)
A: Assembly A-1 ❑ A-2r O A-2ne❑ A-3 ❑ A-4❑ A-5❑ 1 B: Business ❑ E: Educational ❑
F: Facto F-1 ❑ F2❑ I H: High Hazard H-1 ❑ H-2❑ H-3 ❑ H4❑ H-5❑
1: Institutional 1-1 ❑ 1-2 ❑ 1-3❑ 14❑ M: Mercantile❑ R: Residential R-1❑ R-2❑ R-3❑ R-4❑
S: Storage SI ❑ S-2 ❑ U: Utility❑ Special Use❑and pifease describe below:
Special Use:
SECTION 6:CONSTRUCTION TYPE(Check asapplicable)
IA ❑ too❑ HA ❑ HB ❑ It1A ❑ (IIB O IV ❑ VA ❑ VB ❑
SECTION 7:SITE INFORMATION(refer to 780 CMR 111.0 for details on each item)
Water Supply: Flood Zone Information: Sewage Disposal: Trench Permit: DebdRemava,1,
Pubbc❑ Check Off Mdr Pluod Lune❑ Indicate muniay�al❑ �\ trench wdl nut be Ltrenw
./ required ❑or trench ur'peaf
Pen ate❑ ur indenufc Zunr:_ ..r un.rte.r�trm❑ permit .,endo ed ❑ _
Railroad right-of-way: Hazards to Air Navigation: �Ia (Inh.n. c ..nnn.......1I4O 1.Sl nii nne..ohm aup..rt approach arca' I.their re.rete cm-r C,.n.rnt to Build enda,ed ❑ l v.❑ .'r Xu❑ l'e,❑ \u
SECTION 8:CONTENT OF CERTIFICA TE OF OICCLPANCY
I i 11,'n I L', dv _.--_ lie L sn+upiy: r%PC of Ctw.trucoon: ttcatPanl Load per l-luor
I h+oma the bud.b ng ea nit.un.ut Sprinkler tit.tem': S)4cial Sbptd,thun.
SECTION 9- PROPERTY OWNER AUTHORIZATION
N ne am.Address of Pru rtv 9w•ner a
/�Slr/d ill*4fo�mr
,Name(Print) No—and Street City/Town Lip
I'mperh-l)av nrr(-ontect Intormation:
Vf--- . 00 ;2 a7-2Z,—*Z J�z-ftlf
Title Telephone No.ibusmess) Telephone No. (cell) e-mail address
If applicable the prV erty owner hereby authu zes
tc„zh X4"-5* y3 A' t.52716(-'7— ill
Name Street Addres-s City/Town State Zip
to act on the jlrojertv owner's behalf, mail matters relative to work Wthonzr.i by this building aermu a a plication.
SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 2)
(if buildin•is kv'than 35,OtX)cu.ft.of endovd s lace and/or not wafer Construction Comml then check hem O and skip SMiun 10.1)
10.1 Registered Professional Responsible for Construction Control
/3ysfs
N. r tstr Tr r a nr N e-mail a Registration Number
Street Address City/Town State Zip Discipline Expiration Datr
10.2 Gen-erralll Contractor
�D7�tI'
' S ( %1Lf•O/O[%(f/�r�//✓
Cuarry�Name(/ lGl/fii9irvs ��
Name of Peron Responsible for Construction License((7II��110^y. nd Type ifAp/�7Qh ble
I
lPlumbing
ess !Via'& 13% 93//city/Tows /,fl”, ��'i?1t;.//J'/ xle l! lJ /o.(business) ThNo.(cell) e-mail address
SECTION 11:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152. 25C(6))
ers'Compensation Insurance Affidavit from the MA Department of Industrial Accidents must be completed and
with thisapplication. Failure to provide this affidavit will result in the denial of thei uance of the building permit.
Is a si ned Affidavit submitted with this a lication? Yes 9No O
SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE
ItemEstimated Costs:(Laborand Materials) Total Construction Cost(from Item 6)s G p' Building Permit Fee=Total Construction Cost x (Insert here
S appropriate municipal factor)S
4. Mechanical (HVAC) S Note:Minimum fee=s (mntact municipality)
5.Mechanical (Other) S Enclose check payable to
6.Total Cost s p g?p;00 (contact municipality)and write check number here
SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT
By entering my name below,I herebv attest under the pans and penalties of perjury that all of the information contained in this
application is true and accurate to the best of my knowledge and understanding. "
I''}.i •pn �+nd�;n,n-u � title D�7.4� Telephone N.,.. Date
''C � Y rLnlO/P'LiJ-F- ✓� �/I��/,-r�A .
�Uvet Address City/ own Sta e Zip
f
Municipal Inspector to fill out this section upon application approval: e
Name a tr
Suggested Affidavit for Home Improvement Ooutractor Permit Application
Far office Use out], / NAME OF Cri'Y!r'OWN
Petmll He. ;q
Dde
AFFIDAVIT
+ home Improvement Contractor Law
Supplement to Permit Application
MGLQ 142At Ulm that thcleoonstructioa alteraton eenomtion.tenair nwde izstion.eOaYersion i nrovement rcmo�al demdi
or trottstntctan of an addition to env ncc-adstme owncrvooc cd building oontatame et lost one but as mac than fourdwdlme units
to sttuautcs whitb nee adiaoent to such tssidenoc or buikfinf be done by reg
rstaod o Uaaas. nh ccn a mocpaons ata g with c
- roquiecmcnts. � ev
t ;lp p Est- Cost o�`,070
Type of Work
Address of Work
C
Owner Name:.
Date of Permit Application
I hereby certify that:
Registration is not required for the following reasou(s):
Work eXcluded by law
Job under SLOW
Building not owner-Otatbied
Owner pulling own permit
—other(spedfy)
Notice is hereby given that:
OWNERS PULLING THEIR OWN PERN11T OR DEALING WITH UNREGISTERED
OONTRACPORS pORAPPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE
AOCESS TO THEARBMtATION PROGRAM OR GUARANTY FUND UNDER MGL
Q 142AA
Signed under penalties of perjury:
I hereby apply for a. i as the agent f th er.
galWiz— - //Z
Date ntractor Name Registration No-
OR-
Notwithstanding
o_ORNotwithstanding the above notice. I hereby apply for a permit as the owner of the above property:
Date Owner Name
The Voiniiiartweam of Massachusetts
am N Department of Industrial Accidents — - - -
Office of Investigations
600 Washington Street
Boston,MA 02111
www.ntassgov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information ! Please Print Legibly
W6Name(Business/Organization4ndividual):�I �% I lw_r
Address: ✓ifl�City/state/Zip: W_ Phone.#:
Arreyo an employer?Check the appropriate box: Type of project(required):
1.[97E]am a employer with 4. 0 I am a general contractor and I 6. ❑New construction
employees(full and/or part-time).' have hired the sub contractors
2.0 I am a sole proprietor or partner- listed on the attached sheet. 7. 0 Remodeling
ship and have no employees These sub-contractors have g. 0 Demolition
working for me in any capacity. employees and have workers' 9. 0 Building addition
[No workers' comp.insurance comp.insurance t
required.] 5. 0 We are a corporation and its 10.0 Electrical repairs or additions
3.0 I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions
myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs
insurance required.]t c. 152, §1(4),and we have no
employees.[No workers' 13.0 Other
comp.insurance required]
*Any applicant that checks box#1 must also fill out the section below showing their workers'compatsation policyinformation.
t Homeowners who subrmt this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating suite.
tContractors that cheek this box must attached an additional sheet slowing the name of the sub-contractors and state whether or not those entities have
employees. if the subcontractors have employees,they must provide their workers'comp.policy numbm
ram an employer that isproviding workers'compensation insuraneefor my employees. Below is thepolicy andJob site
information.
Insurance Company Name:
Policy#or Self-ins.Lic.M 20194/l�q�X/ laao /�' - Expiration Date:��/p
Job Site Address: Ir /ai0��/7 c�tC/ y S U/Yr/G�City/S.-nip:
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 tip 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 verification
Ido hereby ce fy« der the aitrs an penalties ojperjury that the Infor atian provided above Is true and correct
i
�s
S' a e: t Phone :
FOther
on Do not write in this area,to a comp by city or town official
n- Permit/License#
hority(circle one):
Health 2.Building Department 3.Cityfrown Clerk 4.Electrical Inspector 5.Plumbing Inspector
son: Phone M
CITY OF SMENI, NLxss�A c7E usE-"Ts
BU;ILDL\G DEP%RT.%m i 1'
130 W:AsHLVGToN STREET, 3° FLooR
TEL (978) 745-9595
FAx(978) 750-9846
KIMBERLEY DRISCOLL
MAYOR THOM AS ST.PIlEBRB
DIRECTOR OF PUBLIC PROPERTY/BUILDNG COMMSSIONER
Construction Debris Disposal Affidavit
(required for all demolition and renovation work)
In accordance with the sixth edition of the State Building Code, 790 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 i 50A.
The debris will be transported by:
QNB'
?D7
D.5)-790
(name of hauler)
The debris will be dios of in
///�w.� hon lCl Com!/dy
o s ee
0�8bf�3Y.5-
O
(na&c of facility)
(address of f chit 7
Y3
C
signatureoFpermit applicant
MYl o
Jan:
AGREEMENT
This Agreement, made this_day of September, 2010 by and between; Williams Brothers
Home Improvement hereinafter, called the "Contractor" and The Sanctuary Condominium Trust,
hereinafter called the "Trust'.
Accordingly,
Whereas the Contractor has entered into an Agreement with the Trust; and whereas the
Contractor is in the business to perform such work consisting of roof replacement.
Now therefore, in consideration of mutual covenants, promises, and provisions,hereinafter
contained,the Contractor and Trust agree as follows:
Representation: Contractor warrants and represents that it has carefully examined the premises
and has made a complete study of the site which the work will be performed, is knowledgeable
with respect to all applicable requirements of the City of Salem, Commonwealth of
Massachusetts, safety standards required by its insurers, guidelines for proper application of
materials required herein as is customary in the trade.
Trust and Contractor hereby agree to:
SUMMARY:
The Contractor shall provide roofing services to the Trust. The Contractor agrees to complete the
services as outlined below and on the proposal attached tot his contract as "Exhibit A." The
Contractor is responsible for any damages to the property as a result of such services described in
this contract. Work to be performed at the following three buildings:
• 9&11 Flying Cloud Lane and 2&4 Grand Turk Way (estimated cost($18,785)
• 10 & 12 Grand Turk Way and 25 & 27 Flying Cloud Lane (estimated cost $20,935)
• 1 & 3 Aurora& 2 &4 Whalers Lane(estimated cost$20,070)
The Contractor will provide advance notice to the property manager at least one week prior to
work on the buildings to ensure proper notice to owners is given. All work shall be performed in
a first class workmanlike manner. The Contractor shall schedule and coordinate the work to
minimize any inconvenience to the building occupants and any disruption of the normal use of
the building(s).
SCOPE OF WORK:
As defined in the attached proposals dated August 16, 2010, marked as Exhibit"A." This
project shall include all work necessary for the completion of asphalt shingle replacement at the
above referenced addresses.
Shingle Roof Replacement shall consist of the following:
• Install tarps to protect property.
• Remove & Dispose of existing shingles and associated flashings down to decking.
• Re-nail existing roof decking with 8D nails. Also replace up to 3 sheets of plywood per
building. (any less will be credited back to the Trust).
• Contractor assumes existing roof deck is wood and suitable for installation of roofing.
Any required replacements to be completed at $45 per sheet.
• Cut deteriorated rake ends (wood trim)minimum 4 feet at 8 rakes 32 feet.
• Replace any deteriorated rake boards (trim).
• Replace 11 bubble skylights with Velux #306 w/flashing kits.
• Install GAF ice and water shield 6' at gutters, 3' at valleys, 18" at rake edges, cheek walls
and around base of pipes, vents, chimneys and skylights.
• Install GAF 15 lb. felt paper to remaining deck surface.
• Install 8"white metal drip edge to rake and gutter lines.
• Install new vent pipe collars to all pipes penetrating roof.
• Install GAF ridge vent system and Timbertex" heavy duty cap shingles to all hips and
ridges.
• Install GAF 30 year Timberline laminated roofing shingles with 6 nails per shingle.
Includes GAF"System plus"extended factory warranty system.
• Supply and install new 30 year architectural shingles color(Shakewood—GAF Shingle—
timberline/prestique)
• Supply all necessary clapboards,trim boards, fascia boards, rake trim, fascia apron, etc.,
14 The Contractor agrees to complete the services as outlined on specifications list below not later
than 2010. Contractor is responsible for any damages to the property as
a result of such services described in this contract.
PRODUCT DELIVERY AND HANDLING
• All materials shall be new and of the best quality.
• Material shall be delivered to the site in sufficient quantities to allow continuity of work.
• All material shall be handled and stored in strict accordance with the manufacturers
requirements
• Owner will provide the location of storage facilities and staging shall be coordinated with
the Owner.
PROTECTION
• The Contractor shall be responsible for the replacement or refurbishment of any items
damaged as a result of the work. The Owner will make corrective measures,including
replacement of damaged items and deduct the cost from the contract price.
• The Contractor shall provide barriers or other protective measures to segregate the work
from surrounding areas.
• The Contractor shall take all reasonable measures to prevent problems with other
contractors that may be on site at the same time (i.e. landscapers, roofers, etc.)
• The Contractor shall take all reasonable measures to prevent blockage or disruption of
exits from buildings or other traffic areas adjacent to the work.
GUARANTEE
The Contractor shall provide the Owner a guarantee, guaranteeing the work to be free from
material or workmanship defects in accordance with the following conditions:
• The guarantee shall require the Contractor to repaint, repair, and/or replace any area
found to be deficient at no additional cost to the Owner.
• The guarantee shall be for a minimum of two (2) years from the date of acceptance of job
completion.
FINAL CLEAN-UP
• All buildings and surrounding areas shall be cleaned of all trash, dirt and debris
associated with the work to the satisfaction of the Owner at the end of each day's work.
• Any items stained or otherwise damaged as a result of the work shall be cleaned, restored
or replaced at the satisfaction of the Owner.
• Any vehicular damage to the landscaped or other areas around the building shall be
repaired or restored to the satisfaction of the owner.
• The Owner shall require a final inspection of the work, including final clean up.
WORK SCHEDULE:
The buildings will be occupied during the project. The Contractor shall take all reasonable
measures to minimize disruption of the normal use of the buildings and inconveniences of the
occupants. Work may be performed between the hours of 8:00 AM and 5:00 PM, Monday
through Friday. No Saturday, Sunday, or Holiday work shall be permitted without prior consent
by the Board or Managing Agent.
CONTRACTOR TO SUPPLY: All labor,materials, taxes, fringes and insurance, all necessary
equipment and materials.
COMPLETION AND ACCEPTANCE: Contractor agrees to commence the work according
to the time periods outlined in the "scope of work" section of this agreement.
All work will be completed when all conditions described in this Agreement have been
performed the by Contractor to the satisfaction of the Trust.
PAYMENT: The Trust agrees to pay the Contractor agrees to accept for the full, dutiful and
prompt performance by it of the work described herein, the following sum: $59,790
• 33.3%Deposit ($19,930)
• 33.3%progress payment at '/2 way point($19,930)
• 33.3% balance ($19,930) upon completion of the job and all punch list items
resolved to the satisfaction of the Trust and receipt of manufacturers warranties.
INSPECTION& DEFECTIVE WORK: All workmanship and materials entering the
Complex shall be subject at all times to the inspection and approval of the Trust or their Agent.
Contractors will cooperate with the Trust or their Agent to facilitate these inspections.
DISCRIMINATION: The Contractor will not discriminate against any employee because of
race, sex, creed, color or national origin. The Contractor agrees to comply with all Equal
Employment Opportunity Laws, regulations, and directives, as required by any governmental
body or authority.
PERFORMANCE OF THE COVENANTS: The parties hereto for themselves, their heirs,
executors administrators representatives,le al successors, do hereby execute the full and
g
complete performance of the covenants as required.
NOTICE: Any and all notices served pursuant to or with respect to this Agreement shall be
delivered by hand or by certified return receipt, with respect to the Trust;
Sanctuary Condominium Trust
c/o Crowninshield Management Corp.
18 Crowninshield Street
Peabody, MA 01960
With respect to the Contractor; Williams Brothers Home Improvement
Any notice regarding default under this Agreement shall be confirmed in writing, but in order to
expedite corrective action a telephone call shall be deemed notice of default and after receipt by
the defaulting party, said defaulting party shall correct the default or otherwise respond within
four(4)hours.
Witness: Whereof the parties have duly executed this Agreement the day and year above
written.
Contractor: Mark Williams, for Williams Brothers Home Improvement
By:
Title:
Trust: Sanctuary Condominium Trust
By:
As Trustee and not individually
By:
As Trustee and not individually
Ref.Roof Replacement Ageement 2010
A. All contributions,taxes, or premiums which may be payable under the Unemployment
Insurance Law of any State or the Federal Social Security Act,measured from the payroll
of employees, by whomsoever employed, engaged in the performance of the work
included in the Agreement.
B. All Sales or Use Taxes, arising out of the furnishings or installing by the Contractor of
any kind of personal property under this Agreement.
C. All or any excise,property,transportation, income or other similar or dissimilar tax
imposed by any present or future law of the Federal Government, any state or any
4 subdivision thereof on any materials, articles, receipts, services or income earned by or
furnished by Contractor including but not limited to assessments or charges for
hospitalization,pension and welfare funds which may be payable under union agreements
as now or hereafter in effect.
FAIR LABOR ACTS: The Contractor is familiar with the Fair Labor Standards Act and/or any
State or Local Acts, if any, in relation to wages and hours, and where such Acts apply to the
work or materials furnished under this Agreement the Contractor agrees to comply with the
terms and provisions thereof, and agrees to hold the Trust harmless from any violations of the
same.
INSURANCE—PROVIDED BY THE CONTRACTOR: Contractor agrees to take out and
maintain the following insurance in a company or companies satisfactory to the Trust:
The contractor must furnish a certificate of insurance, naming the Trust as an additional insured,
evidencing workers compensation(at least$500,000), general liability(at least $1 Million) and
auto coverage(at least$1 million)before any work begins.
Statutory Workers' Comp. Insurance and Employer's Liability Insurance to be carried by the
Trust. Contractor prior to commencement of any work hereunder, shall furnish to the Trust
Certificates or copies of policies showing that such insurance is in force and the premiums due
there under have been paid. Certificates or policies shall specify that the Trust shall receive 30
days prior notice of cancellation or material change.
In the event of the failure of Contractor to furnish and maintain such insurance, the Trust shall
have the right at its option to terminate this Agreement or to take out and maintain the said
insurance for any in the name of the Contractor and Contractor agrees to pay the cost thereof
through the deduction of funds due him, and to furnish all necessary information to permit the
Trust to take out and maintain such insurance for the account of the Contractor.
The contractor assumes complete responsibility to ensure all employees working on Trust
clients/properties have gone through security checks for drug/criminal and have successfully
completed prior to working on our property has the right to audit any employee file at any time
for the duration of the job. Contractor shall submit a letter before work begins to assure that the
above proper securitychecks have been performed.
STORAGE OF EOUIPMENT: Contractor, at his own risk, may store materials on site in such
locations as the Contractor may propose and the Trust may accept.
j TERMINATION OF AGREEMENT DUE TO CONTRACTOR DEFAULT: Should
Contractor fail in any respect to prosecute the work with promptness and diligence or fail in the
performance of any of the agreements herein contained except for causes beyond its control,
which include: strikes,natural disasters, etc.,the Trust shall be at liberty to provide any such
labor or materials and to deduct the cost thereof from any money then due or thereafter to
become due to Contractor. Said Contractor, for itself and for its subcontractors, and for all
parties working through or under them, covenants and agrees that no mechanics' claim shall be
filed or maintained by it, or any of them against the above described real estate. No notice of
this Agreement shall be filed or recorded in any Registry of Deeds of the Commonwealth. All
subcontractors and material will include the above provisions with respect to liens and fees or
Contract as contained herein.
REGULATIONS PERMITS AND COMPLIANCE WITH APPLICABLE LAWS: All
services and materials furnished hereunder and all work performed by Contractor under or
pursuant to this Agreement shall comply with all applicable laws, codes, ordinances,
requirements orders, directions, rules and regulations of the Federal, State, County and City
I governments, and all other governmental authorities having or claiming jurisdiction over the
work to be performed hereunder,and all other respective departments, bureaus and offices of
insurance, underwriting board or insurance inspection bureaus having or claiming jurisdiction, or
any other body exercising similar functions and all insurance companies writing policies
covering the work to be performed hereunder on the site or any part thereof.
DAMAGE TO WORK, PREMISES AND POSSESSIONS OF TRUST: The Contractor
shall effectively secure and protect its work, the premises and the possessions of the Trust, his
tenants or invitees and shall bear and be liable for all loss or damage of any kind of which may
happen as a result of Contractor's own,his employees', suppliers' or subcontractors' actions or
omissions to Contractor's work,the premises and the possessions of the Trust of the premises,his
tenants or invitees at any time prior to final completion and acceptance of the work. The
Contractor agrees that before final payment is made all areas shall be inspected for damage and
the cost of said damage will be held until the areas were damage occurred are corrected. If the
Contractor cannot complete repairs in a reasonable period of time the Trust shall contract for the
work on its own and withhold an amount equal to the repair work from the final payment.
SUBLETTING CONTRACT WORK: The Contractor agrees to provide a list of all
subcontractors, if any,to be used to perform work on the site.
ADVERTISING: The Contractor will not be permitted to display any sign,poster, etc., on or
around the structures or premises.
SOCIAL SECURITY,UNEMPLOYMENT, SALES TAX: The Contractor, for the Contract
Price herein provided for under the section entitled "Payment",hereby accepts and assumes
exclusive liability for and agrees to pay Last saved by APT. APTwhen due and shall hold the
Trust harmless against payment of
oard o g eanan
One Ashburton Place - Room 1301
Boston. Massachusetts"02108
Home Improvementiractor Registration
Registration: 1134M
Type: PattrmmOiip
E�6atlon: 811H/m11 Tr# 285935
Williams Brothers,Home Improvement
MARK WILLIAMS
9 CLIFFORD ST 4
TAUNTON, MA 02780
UpdateAddraw and ratio ord.INartr raaam fr change.
❑ Address O Raannal o Reepleyment ❑ Led Cord
„ a 2008
Masacburetts.-Department or Public Sa leo
Board of Building Regulations and Standards
Construction Supervisor License
License: cs 709175 -
Restricted to: 00 - -
"N B WILLIAM r, .;
43BE4EFITE
TAUNTON,.MAS!f M1
Expiration: 11r2QM1 .
TW. 12809 . 1
4
i
`1- Irto/L.1I / 1190L#ffRM1VVG 1 7/12/2010
THIS CERTIFICATE M 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
'UE'LOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING IMSURER(S). AUTHORIZED
REPRESENTATIVE OR PRODUCER AND THE CERTIFICATE HOLDER
IMPORTANT: H the csr(i8oa6Y holder Is an ADDITIONAL INSURED,to polley(les)must be endorsed N SUBROGATION IS WAIVED,su Jett to
the to... and conditions of the policy,certain policies may require an endomernout A satenrerd on this certificate does net confer rights to the
coMficate holder in Hou of such endorseavengs).
PRS p1tYEACT WXOOle SM=
FLAGSHIP INSURANCE AGENCY INC (508)994-9688 PAX (soe)ss1-s4s1
651 ORCHARD ST, SUITE 301 .neouza@flagehipins.Oom
PO 1308 40399 °MiSTOMERRODU� D,00002692
NEW HEDFfORD MA'02744 AP'WR COVERAGE NAcs
IRSURED _ INSURERAAtlant.1C CaaaaltV _
msURER B:. _
Williams 13roterms Home Improvement, DBA: Mark DSURERC: _
9 Clifford $treat B6UR8LD:
OISURER E'
Teuaton MA 02780 MMURER F:
COVERAGES CER7IFICATENUMBEFt10/11 REVISIONNUMBEP-
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-
IS TYPEOFINSURANCE mNaR POLICY NUMBER MMMDYNYYYI ERF PMOl1CY EXP UNITS
afENEtALUABRITY EACH OCCURRENCE s - 500,000
X COMMERCIAL GENERAL LIA91tm• aoDa.eAw $ - - 100,000
A' CLAMSf1ADE ®OCCUR L143001227 /27/2010 /27/2011 MEDEXP w ps f 5,000
PERSONAL&AIN INJURY f 500,000
GENERAL AGGREGATE $ 1,000,000
GENL AGGREGATE LIMITAPPl1ES PEft PRODUCTS AGO S 500,000
R POLICY PRC- LOC S
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT - f
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CERTIFICATE HOLDER CANCELLATION
(508)822-5133 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE.
THE EXPIRATION DATE THEREOF. NOTICE WILL BE DEL MERED IN
*FOR RECORD ]?OPPOSES ONLY* ACCORDANCE WITH THE POLICY PROVISIONS.
WILLIAMS BROTHERS NONE IMPROVEMENT
9 CLIFFORD STREET - AUTHORZEDRF3NRESErTAINE
TAUNTON, t(IL 02780
Bruce Kestenbaum/NLS L.' ca
ACORD 26(2009109) ®1988-2009 ACORD CORPORATION. AN rights reserved.
INS026¢auras) The ACORD name and logo are registered maAa of ACORD
CERTIFICATE OF LIABILITY INSURANCE DATE 0525//20D010
TRIM CERT CATS IS ISSUED AS A HATTER OF INFORMATION ONLY AND COMM NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE
DOES NOT AFPIRHATIVSLY OR NEGATIVELY AMEND, EKTRED OR ALTER THE COVERAGE AFFORDSO RY TIM POLICIES BELOW. THIS CERTIFICATE OF
INSURANCE DOES HOT 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) moat be endorsed. If SURROGATION 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).
v�0m mtracr
Flagship Insurance Agency Inc m`
P O Bog 40399 'A/O• °°• """ 'ua. `°"
New Bedford, MA 02744 A°O¢AS•
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dba Williams Brothers Home Improvement :oP¢.a C.
9 Clifford Street
Taunton, MA 02780 �BOvn"
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
=8 Ie TO nHRSIFT TRar THE POGrCrAs OP I10F0911Nc8 LZHTED BELOW SAVE BENE 1898® TO THE IBUA® -- ABOVE FOR Tet POLICY PERIOD XUDICATED.
BCMIS88'D.IU)TNG ANT REO�, TEAM OR CONDITION OF ABT CONTRACT OR USHER DOCm®T WITH RHBPRCZ A "RICH THIS cEwrt"CATE Mr 8E I8s8BD OR NAY -
PERTAIN, TSS IYRORANCS AFPOBDBD BY THE POLICISS D88CRIDND eSBEIM IB 80alECT TO ALL 'rss Tom, MMUSIONS AND CONDITIONS OF SVCS POLICZEB. LIMITS SHOWS
MY SATE .. MEDS® BY PAID CfiINE.
POLZCT RRRRan PCLICT EYP POLICY EIP LIMITS
TYPE OF IN88RANCB IOMIn+O Ialmin,n
OSNERAL LIABILITY - m1®OCNAANCA i
0CmPm1:C2AL em✓AAL LIAOILITY pyIAO qp
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incl excl W.L. PIeNm - u toWiml P❑ 6002960012010 04/03/2010 04/03/2011 500,000
t.A, vxaeaes - a tuloltW 8 100,000
oa¢mtrt Gnonerrov w oeta¢Tzon w ranTTo®,
MARK J WILLIAMS IS COVERED BY THE WORKERS' COMPENSATION POLICY
CERTIFICATE HOLDER CANCELLATION
SSOOLD ANT OF THE ABOVN DBSCRIBND POLIC=E SE CABCeLL®88F0eE TEE
EXPIRATION RAT'S THEREOF, ROTTCH R BE RBLITERSD IN ACCONDANCE WITS THE
NORTON COUNTRY CLUB FOLKS PROVISIONS.
50 FAIRWAY VIEW LANE
PJORTON, MA 02766
Page 1 of 1
Thomas McGrath
From: Jill Fama Ufama@crowninshield.com]
Sent: Monday, October 04, 2010 1:00 PM
To: Thomas McGrath
Subject: Sanctuary Condos
Dear Mr. McGrath,
Please be advised that I am the property manager for the Sanctuary Condominiums in Salem and the
Board of Trustees recently approved a proposal for the replacements of roofs through William Brothers
Home Improvements. Please let me know if you require additional information in order for Mark Williams
to pull the necessary permits.
Jill Fama
Regional Property Manager
Crowninshield Management Corp.
18 Crowninshield St.
Peabody, MA 01960
Tel: 978-532-4800
Fax: 978-532-6023
Email: ifama@crowninshield.com
ii
10/5/2010